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Quizzes > Health & Medicine > Human Anatomy & Medicine

Thoracic Wall, Pleura & Pericardium Quiz - Test Your Anatomy Skills

Think you know what makes up the pleura and pericardium? Start the quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper cut art showing pleura pericardium layers lungs heart and ribs on golden yellow background for anatomy quiz

This quiz helps you review what makes up the pleura and pericardium - layers, spaces, and attachments - through quick questions. Use it to spot weak points before an exam or lab. For extra practice, see the thorax anatomy quiz and the serous pericardium matching.

Which part of the parietal pleura lines the inner surface of the ribs?
Costal pleura
Diaphragmatic pleura
Mediastinal pleura
Visceral pleura
The parietal pleura is divided into costal, mediastinal, diaphragmatic, and cervical parts. The costal pleura specifically adheres to the inner surface of the ribs and intercostal spaces. It provides a smooth, frictionless lining against the thoracic wall. .
Which pleural layer directly covers the surface of the lungs?
Costal pleura
Mediastinal pleura
Diaphragmatic pleura
Visceral pleura
The visceral pleura is the serous membrane that invests the lung surface and dips into the fissures. It is continuous with the parietal pleura at the lung root. This layer follows all contours of the lung and is part of the pleural sac. .
What is the primary function of the fluid within the pleural cavity?
Temperature regulation
Gas exchange
Immune defense
Lubrication of pleural surfaces
Pleural fluid is a thin film that reduces friction between the visceral and parietal pleura during respiration. It allows the lungs to glide smoothly against the thoracic wall. The fluid volume is minimal under normal conditions. .
Which structure separates the two pleural cavities within the thorax?
Sternum
Diaphragm
Intercostal muscles
Mediastinum
The mediastinum is the central compartment of the thoracic cavity between the two pleural sacs. It contains the heart, great vessels, trachea, esophagus, and thymus. The pleural cavities are completely separate and are divided by this compartment. .
Which layer of the pericardium is composed of tough, dense connective tissue?
Visceral serous pericardium
Parietal serous pericardium
Endocardium
Fibrous pericardium
The fibrous pericardium is the outermost layer of the pericardial sac composed of dense connective tissue. It anchors the heart to the diaphragm, sternum, and mediastinal structures. It prevents acute overdistension of the heart. .
Which ligament connects the fibrous pericardium to the central tendon of the diaphragm?
Phrenicocolic ligament
Coronary ligament
Sternopericardial ligament
Pericardiacophrenic ligament
The pericardiacophrenic ligament is a fibrous band that extends between the fibrous pericardium and the central tendon of the diaphragm. It is carried by the pericardiacophrenic vessels and phrenic nerve. This ligament helps stabilize the heart's position. .
Which layer of serous pericardium lies directly on the heart surface?
Fibrous layer
Endocardial layer
Parietal layer
Visceral layer
The serous pericardium has two layers: parietal and visceral. The visceral layer (also called epicardium) is adherent to the heart surface. The parietal layer lines the inner surface of the fibrous pericardium. The visceral layer produces pericardial fluid with its counterpart. .
The superior thoracic aperture is bounded posteriorly by which vertebra?
T1
C7
T12
T2
The superior thoracic aperture (thoracic inlet) is bounded posteriorly by the body of T1, laterally by the first ribs and costal cartilages, and anteriorly by the superior border of the manubrium. It allows passage of vessels, nerves, and the trachea into the thorax. .
What is the costodiaphragmatic recess?
Potential space between costal and diaphragmatic pleura
Area where visceral and parietal pleura fuse
Reflection of pleura at the lung root
Cavity within the pericardium
The costodiaphragmatic recess is a potential space at the junction of the costal and diaphragmatic pleurae. It becomes filled by lung tissue during deep inspiration. Clinically, pleural fluid accumulates here when a patient is upright. .
Which arteries primarily supply the parietal pleura over the thoracic wall?
Left gastric artery
Superior phrenic arteries
Bronchial arteries
Posterior intercostal arteries
The parietal pleura covering the thoracic wall receives its blood supply from the posterior intercostal arteries. The diaphragmatic pleura is supplied by the superior phrenic and pericardiacophrenic arteries. Bronchial arteries supply the visceral pleura. .
Which nerve provides sensory innervation to the mediastinal pleura?
Intercostal nerves
Phrenic nerve
Sympathetic trunk
Vagus nerve
The mediastinal pleura and central diaphragmatic pleura are innervated by the phrenic nerve (C3 - C5). Pain from these regions is referred to the shoulder. The costal pleura is supplied by intercostal nerves. .
The oblique pericardial sinus lies posterior to which chamber of the heart?
Left atrium
Right ventricle
Right atrium
Left ventricle
The oblique pericardial sinus is a cul-de-sac between the reflections of the serous pericardium around the pulmonary veins and inferior vena cava. It lies directly posterior to the left atrium. It can be accessed surgically via this space. .
What anatomical landmark marks the transition between the parietal and visceral layers of serous pericardium?
Aortic valve level
Oblique sinus
Reflection at the root of the great vessels
Coronary sulcus
The serous pericardium reflects onto the heart at the roots of the great vessels (aorta, pulmonary trunk, venae cavae, pulmonary veins). This reflection demarcates the parietal and visceral layers. It forms pericardial sinuses around these structures. .
Which nerve travels in the pericardiacophrenic bundle alongside the pericardiacophrenic vessels?
Recurrent laryngeal nerve
Sympathetic trunk
Phrenic nerve
Vagus nerve
The phrenic nerve (C3 - C5) runs within the fibrous pericardium alongside the pericardiacophrenic artery and vein. It supplies sensory innervation to the fibrous and parietal serous pericardium and motor supply to the diaphragm. .
Which intercostal muscle layer is most superficial on the anterolateral thoracic wall?
Internal intercostal
Transversus thoracis
Innermost intercostal
External intercostal
The external intercostal muscles are the most superficial of the intercostal layers. They run obliquely downward and medially between adjacent ribs. They elevate ribs during inspiration. .
At which dermatome level is the nipple located, corresponding to thoracic wall innervation?
T6
T10
T2
T4
The nipple is typically supplied by the T4 dermatome. Dermatome mapping helps in diagnosing nerve root or spinal cord lesions. The T2 level supplies the apex of the axilla and upper chest. .
Which pleural recess is narrow and lies adjacent to the mediastinum, often accommodating lung expansion during deep inspiration?
Costodiaphragmatic recess
Cervical recess
Oblique sinus
Costomediastinal recess
The costomediastinal recess is a slit-like potential space between the costal and mediastinal parietal pleura. It is more prominent on the left side near the heart border. During deep inspiration, the anterior margin of the lung moves into this recess. .
What embryonic tissue gives rise to the serous layers of both pleura and pericardium?
Lateral plate mesoderm
Paraxial mesoderm
Neural crest
Endoderm
The serous membranes of pleura, pericardium, and peritoneum derive from the lateral plate mesoderm. This mesoderm splits into somatic and splanchnic layers, forming body cavities lined by serosa. The visceral layer covers organs while the parietal layer lines the body wall. .
Which statement best describes the reflection of the pleura at the lung root?
Parietal pleura becomes visceral pleura
Mediastinal pleura becomes diaphragmatic pleura
Visceral pleura fuses with endothoracic fascia
Cervical pleura extends into the root
At the lung root, the parietal pleura reflects onto the lung surface and becomes the visceral pleura. This continuous reflection forms the sleeve of pleura known as the pulmonary ligament. No fusion with fascia occurs at this point. .
Which vessels provide the main arterial supply to the fibrous pericardium?
Pericardiacophrenic arteries
Musculophrenic arteries
Bronchial arteries
Coronary arteries
The pericardiacophrenic arteries, branches of the internal thoracic arteries, supply the fibrous and parietal serous pericardium. They run with the phrenic nerves. Musculophrenic and superior phrenic arteries make minor contributions. .
Where does the costodiaphragmatic recess extend to at the midaxillary line in an adult?
At the level of the 2nd rib
Between the 12th and 14th ribs
Between the 8th and 10th ribs
Between the 4th and 6th ribs
At the midaxillary line, the costodiaphragmatic recess descends to the level of the 8th rib anteriorly, 10th rib laterally, and 12th rib posteriorly. It is the deepest part of the pleural cavity when upright. Pleural effusions accumulate here first. .
Which lymph nodes receive drainage from the costal parietal pleura?
Bronchopulmonary lymph nodes
Intercostal lymph nodes
Thoracic duct lymph nodes
Parasternal lymph nodes
The costal parietal pleura drains lymph to the intercostal lymph nodes located along the posterior intercostal vessels. Mediastinal pleura drains to parasternal nodes, and diaphragmatic pleura drains to phrenic and posterior mediastinal nodes. .
Which area of the parietal pleura is innervated by intercostal nerves rather than the phrenic nerve?
Costal pleura
Mediastinal pleura
Cervical pleura
Central diaphragmatic pleura
The costal and peripheral diaphragmatic parietal pleura are innervated by intercostal nerves, which carry pain from these regions. The mediastinal and central diaphragmatic pleura are innervated by the phrenic nerve. Cervical pleura also receives intercostal innervation. .
During embryonic development, which structure separates the pericardial cavity from the pleural cavities?
Pleuropericardial folds
Pleuroperitoneal membranes
Septum transversum
Truncus arteriosus
Pleuropericardial folds grow medially from the lateral body wall and eventually fuse to form the pleuropericardial membranes, separating the pericardial cavity from the pleural cavities. This process is crucial for partitioning the thoracic cavities. The septum transversum contributes to the diaphragm, not this separation. .
The pulmonary ligament of the lung is formed by which layers of pleura reflecting at the lung root?
Diaphragmatic pleura and costal pleura
Cervical pleura and mediastinal pleura
Costal parietal pleura and visceral pleura
Visceral pleura and mediastinal parietal pleura
The pulmonary ligament is created where the visceral pleura reflects onto the mediastinal parietal pleura inferior to the root of the lung. It extends downward toward the diaphragm. It stabilizes the inferior lung hilum structures. .
Referred pain from inflammation of the fibrous pericardium is often felt in the shoulder region via which spinal level?
C7 dermatome
C4 dermatome
T1 dermatome
T4 dermatome
The phrenic nerve (C3 - C5, primarily C4) supplies sensory fibers to the fibrous and parietal serous pericardium. Inflammation can cause referred pain to the shoulder (C4 dermatome). This is known as Kehr's sign when diaphragmatic peritoneum is involved. .
Which hemodynamic sign is most characteristic of cardiac tamponade affecting the pericardial sac?
Bounding pulse
Wide pulse pressure
Pulsus paradoxus
Fixed split S2
Pulsus paradoxus is an exaggerated decrease in systolic blood pressure during inspiration and is a hallmark of cardiac tamponade. It results from impaired ventricular filling due to pericardial fluid accumulation. Bounding pulses and fixed split S2 are not associated with tamponade. .
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Study Outcomes

  1. Identify Pleural and Pericardial Components -

    After completing the pleura anatomy test, the learner can list and characterize the structures that make up pleura and pericardium, including serous membranes and connective tissues.

  2. Differentiate Pleural and Pericardial Layers -

    Distinguish between the visceral and parietal layers of both pleura and pericardium, highlighting their unique structural features and functional roles.

  3. Locate Key Thoracic Wall Structures -

    Identify the position and attachments of costal cartilages, intercostal spaces, and related membranes in a thoracic wall anatomy quiz context.

  4. Describe Innervation Patterns -

    Explain the sensory and motor nerve supply to the pleura and pericardium, and how innervation influences thoracic wall sensation and pain referral.

  5. Apply Knowledge in Quiz Scenarios -

    Use insights from the pericardium structure quiz to answer targeted questions and reinforce mastery of thoracic anatomy through self-assessment.

Cheat Sheet

  1. Dual Pleural Layers -

    The pleura consist of visceral and parietal layers; the visceral pleura envelops the lungs while the parietal pleura lines the thoracic cavity (Gray's Anatomy). A handy mnemonic "VIP" (Visceral = Inner, Parietal = Peripheral) helps cement their relationship. This basic architecture is crucial when you take a pleura anatomy test or thoracic wall anatomy quiz.

  2. Pericardial Sac Components -

    The pericardium comprises a tough fibrous layer and a serous component, which splits into parietal and visceral layers (the epicardium) that encase the heart (Guyton & Hall). Think "FSP" (Fibrous - Separates - Protects) to recall that the fibrous pericardium anchors the heart and prevents overfilling. Grasping what makes up the pleura and pericardium together highlights parallels in serous membrane organization.

  3. Innervation of Serous Membranes -

    The phrenic nerve innervates the mediastinal and diaphragmatic parietal pleura and parietal pericardium, while intercostal nerves supply the costal parietal pleura (Standring). Visceral pleura and epicardium receive autonomic fibers and are relatively pain insensitive. Mastering this neural supply is a staple question in pleura anatomy tests and pericardium structure quizzes.

  4. Pleural Recesses & Clinical Landmarks -

    Costodiaphragmatic and costomediastinal recesses are potential spaces formed during respiration; fluid often collects here (Netter's Atlas). Use the "CD-CM" mnemonic to recall position: Costodiaphragmatic is posterolateral, costomediastinal is anteromedial. Identifying these recesses is vital for interpreting chest drains in a thoracic wall anatomy quiz.

  5. Costal Cartilages & Thoracic Boundary -

    Costal cartilages connect ribs to the sternum, outlining the anterior boundary that the parietal pleura adheres to (Moore). A visual trick: trace ribs 1 - 7 sliding along their cartilages to outline the costal pleura borders. Solid knowledge of costal cartilage structure anchors your understanding of what makes up pleura and pericardium within the thoracic wall anatomy context.

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