nbme 11 old lady ct scan carcinoma of breast

[abelabbot]

old lady has carcinoma of breast....tumor next to right side of heart....which structur is involved?


i got it wrong

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[targ489]

Phrenic nerve

 

[ChessMaster3000]

Hey @targ489 , I get that the phrenic nerve innervates the pericardium (fibrous part) and runs along it, but how is coronary sinus not an equally good answer??

 

[targ489]

Coronary sinus is more the left posterior heart. I think there was also a CT image with this question. That made it seem like it was right next to the right side of the ventricle. I took this a while ago now though

@ChessMaster3000

 

[alicealicealice]

Was the diaphragm elevated/did she have SOB? That would've pushed towards phrenic.

 

[ChessMaster3000]

Was the diaphragm elevated/did she have SOB? That would've pushed towards phrenic.

Nah, it was an axial ct just thru the heart and they did not describe any symptoms (for fear of making it 'easier'?). It wasnt clear to me if it was at the level of the RA/RV. Regardless, I didnt realize at the time the phrenic was in the region so that didnt cross my mind as an option. Even if it had, I probably would have still picked coronary sinus--it seems a little bit of a stretch to expect students to distinguish between the precise locations of the coronary sinus and phrenic nerve on a single ct scan...