Thorax: left atrium relations: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Thorax: left atrium relations

Sample item

A 40-year-old woman with long-standing rheumatic mitral stenosis has a hoarse voice and mild dysphagia. A barium swallow shows indentation of the oesophagus. Which anatomical change best explains both symptoms?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. An enlarged left atrium pressing on the oesophagus and left recurrent laryngeal nerve

The left atrium forms most of the base of the heart and lies directly in front of the oesophagus. The left recurrent laryngeal nerve hooks under the aortic arch beside the ligamentum arteriosum, close to the left pulmonary artery and left atrium. Gross left atrial enlargement can indent the oesophagus (dysphagia) and stretch the nerve, causing hoarseness (cardiovocal or Ortner syndrome).

Option by option

  • A. An enlarged left atrium pressing on the oesophagus and left recurrent laryngeal nerve (correct)

    Correct. The left atrium lies in front of the oesophagus, and its enlargement can stretch the left recurrent laryngeal nerve.

  • B. An enlarged right atrium pressing on the right vagus nerve

    The right atrium lies to the right and anteriorly, away from the oesophagus.

  • C. An enlarged right ventricle pressing on the left phrenic nerve

    The right ventricle lies anteriorly and does not contact the oesophagus or recurrent laryngeal nerve.

  • D. A dilated ascending aorta pressing on the trachea

    A dilated ascending aorta lies anteriorly and does not explain oesophageal indentation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is A, An enlarged left atrium pressing on the oesophagus and left recurrent laryngeal nerve. The left atrium forms most of the base of the heart and lies directly in front of the oesophagus.

Why is "An enlarged right atrium pressing on the right vagus nerve" not the answer?

The right atrium lies to the right and anteriorly, away from the oesophagus.

Why is "An enlarged right ventricle pressing on the left phrenic nerve" not the answer?

The right ventricle lies anteriorly and does not contact the oesophagus or recurrent laryngeal nerve.

Why is "A dilated ascending aorta pressing on the trachea" not the answer?

A dilated ascending aorta lies anteriorly and does not explain oesophageal indentation.

What concept does this question test?

It tests Thorax: left atrium relations in Anatomy. The left recurrent laryngeal nerve hooks under the aortic arch beside the ligamentum arteriosum, close to the left pulmonary artery and left atrium. Gross left atrial enlargement can indent the oesophagus (dysphagia) and stretch the nerve, causing hoarseness (cardiovocal or Ortner syndrome).

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thorax: left atrium relations?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.