Thorax: left heart border in mitral stenosis: 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 heart border in mitral stenosis

Sample item

In long-standing mitral stenosis, a postero-anterior chest film shows straightening of the left heart border between the pulmonary trunk and the left ventricle. Which structure enlarges to fill the normal concavity?

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

The answer and the reasoning

B. Left atrial appendage

The left heart border on a PA film is formed from above downward by the aortic knuckle, pulmonary trunk, left atrial appendage (auricle) and left ventricle. In mitral stenosis, high left atrial pressure dilates the left atrium and appendage, which fills the concavity below the pulmonary trunk.

Option by option

  • A. Apex of the left ventricle

    The left ventricle forms the lowest arc but is not the segment filling the concavity.

  • B. Left atrial appendage (correct)

    Correct. The left atrial appendage forms the third arc and enlarges in mitral stenosis.

  • C. Arch of the aorta

    The aortic arch forms the uppermost knuckle of the border.

  • D. Right atrial appendage

    The right atrial appendage lies on the right side of the cardiac silhouette.

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.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Left atrial appendage. The left heart border on a PA film is formed from above downward by the aortic knuckle, pulmonary trunk, left atrial appendage (auricle) and left ventricle.

Why is "Apex of the left ventricle" not the answer?

The left ventricle forms the lowest arc but is not the segment filling the concavity.

Why is "Arch of the aorta" not the answer?

The aortic arch forms the uppermost knuckle of the border.

Why is "Right atrial appendage" not the answer?

The right atrial appendage lies on the right side of the cardiac silhouette.

What concept does this question test?

It tests Thorax: left heart border in mitral stenosis in Anatomy. In mitral stenosis, high left atrial pressure dilates the left atrium and appendage, which fills the concavity below the pulmonary trunk.

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 heart border in mitral stenosis?

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.