Deck 20: Cardiovascular System: the Heart

Question 1

All cardiac veins empty into the ________, which then empties into the ________.

A) coronary sinus; left atrium
B) coronary sinus; right atrium
C) great cardiac vein; right atrium
D) great cardiac vein; superior vena cava
E) inferior vena cava; left atrium

Answer 1

B

Question 2

Which of the following statements about coronary vessels is true?

A) The left coronary artery is a branch of the left pulmonary vein.
B) The coronary sinus returns blood to the left atrium.
C) The coronary arteries arise from the pulmonary trunk.
D) The great cardiac vein collects blood from the left anterior surface of the heart.
E) The pulmonary arteries carry blood to the left atrium.

Answer 2

D

Question 3

Another name for the visceral pericardium is the ________.

A) endocardium
B) epicardium
C) isocardium
D) myocardium
E) visocardium

Answer 3

B

Question 4

The function of the pericardial fluid is to

A) reduce friction between the pericardial membranes.
B) lubricate the heart valves.
C) replace any blood that is lost.
D) provide oxygen and nutrients to the endocardium.
E) stimulate the heart.

Question 5

The delivery of oxygen and nutrients to the tissues of the body is accomplished through the ________ circulation.

A) hepatic
B) pulmonary
C) peripheral
D) systemic

Question 6

The heart

A) is a four-chambered muscular pump.
B) is posterior to the trachea.
C) is lined with an epithelial layer called the epicardium.
D) lies mostly to the right of the midline of the sternum.
E) has a superior apex and an inferior base.

Question 7

Blood in the pulmonary veins returns to the

A) right atrium.
B) left atrium.
C) right ventricle.
D) left ventricle.
E) coronary sinus.

Question 8

The epicardium

A) covers the surface of the heart.
B) lines the walls of the ventricles.
C) is known as the fibrous pericardium.
D) attaches inferiorly to the diaphragm.
E) is also called endocardium.

Question 9

The great cardiac vein and middle cardiac vein empty into a venous cavity called the

A) pulmonary vein.
B) inferior vena cava.
C) superior vena cava.
D) coronary sinus.
E) coronary artery.

Question 10

A serious condition in which a large amount of fluid accumulates in the pericardial cavity and puts pressure on the heart is ________.

A) endocarditis
B) pericarditis
C) a myocardial infarction
D) cardiac tamponade

Question 11

The right side of the heart receives blood from the body and pumps through the ________ circulation to the lungs.

A) hepatic
B) pulmonary
C) peripheral
D) systemic

Question 12

The pericardial sac is lined with

A) fibrous pericardium.
B) parietal pericardium.
C) visceral pericardium.
D) myocardium.
E) epicardium.

Question 13

Which of the following is NOT true about the heart?

A) The heart is about the size of a closed fist.
B) The heart is located in the mediastinum.
C) The apex of the heart is directed superiorly and to the left.
D) Knowing the heart's position is important for effective CPR.

Question 14

Which of the following is NOT a function of the heart?

A) Providing a location for gas exchange between oxygen and carbon dioxide
B) Regulating blood supply to tissues depending on need
C) Generating blood pressure through contraction
D) Routing blood to either the pulmonary circulation or the systemic circulation

Question 15

A stab wound into the heart can result in cardiac tamponade. This means that

A) blood enters the pleural cavity.
B) the heart is compressed by blood in the pericardial sac.
C) the electrical conduction system of the heart is damaged.
D) the left coronary artery has been damaged or cut.
E) the heart has lost all of its blood.

Question 16

Which of the following layers forms the bulk of the heart wall?

A) Epicardium
B) Pericardium
C) Endocardium
D) Myocardium
E) Visceral pericardium

Question 17

Ezra is admitted to the cardiac unit with a diagnosis of endocarditis. When Ezra asks the nurse where the infection is located, the nurse replies that the infection is in

A) the outer layer of the heart wall.
B) the inner lining of the heart.
C) a membranous sac that encloses the heart.
D) the muscular layer of the heart.
E) the lining of the mediastinum.

Question 18

Blood vessels enter and exit from the ________ of the heart.

A) apex
B) base
C) auricles
D) trigone
E) inferior aspect

Question 19

Occlusion of which of the following would primarily damage the posterior wall of the heart?

A) Circumflex artery
B) Pulmonary artery
C) Right marginal artery
D) Coronary sinus artery
E) Right coronary artery

Question 20

Which of the following terms is mismatched with its description?

A) Endocardium - covers the inner surfaces of the heart
B) Myocardium - cardiac muscle
C) Trabeculae carneae - found on the interior walls of ventricles
D) Pectinate muscles - muscles that close valves
E) Chordae tendineae - connective tissue strings that connect to cusps of valves

Question 21

An incompetent pulmonary semilunar valve could result in less blood reaching the

A) lungs.
B) heart muscle.
C) right ventricle.
D) aorta.
E) right atrium.

Question 22

Which of the following is NOT a major opening into the right atrium?

A) Pulmonary vein
B) Inferior vena cava
C) Superior vena cava
D) Coronary sinus

Question 23

Angina pectoris is chest pain caused by reduced

A) stimulation of the myocardium.
B) blood supply to cardiac muscle.
C) fluid in the pericardial sac.
D) contractility of the heart.
E) action potentials from SA node.

Question 24

Contraction of the papillary muscles would

A) eject blood from the ventricles.
B) prevent the AV valves from protruding into the atria.
C) close the semilunar valves.
D) cause the atria to eject their contents into the ventricles.
E) open the semilunar valves.

Question 25

Which of the following is NOT an enzyme given to someone experiencing a myocardial infarction to break up blood clots?

A) Streptokinase
B) Tissue plasminogen activator (t-Pa)
C) Nitroglycerin
D) Urokinase

Question 26

What is the foramen ovale?

A) An opening between the right and left atria in the embryo and fetus
B) An opening between the right and left ventricles in the embryo and fetus
C) An oval hole in the pericardium in the embryo and fetus
D) An opening between the pulmonary trunk and aorta in the embryo and fetus

Question 27

The AV valve that is located on the same side of the heart as the origin of the aorta is the

A) bicuspid or mitral valve.
B) tricuspid valve.
C) aortic semilunar valve.
D) pulmonary semilunar valve.
E) coronary sinus valve.

Question 28

The valve located between the right ventricle and the pulmonary trunk is the

A) aortic semilunar valve.
B) pulmonary semilunar valve.
C) tricuspid valve.
D) mitral valve.
E) bicuspid valve.

Question 29

Which vessels transport blood to the right and left lungs?

A) Aorta
B) Right atrium
C) Pulmonary trunk
D) Pulmonary arteries
E) Pulmonary veins

Question 30

Blood flow through the coronary blood vessels decreases during myocardial contraction and increases during myocardial relaxation.

Question 31

A direct connection between arteries is called a/an ________.

A) auricle
B) sulcus
C) sinus
D) anastamosis

Question 32

The procedure whereby a small balloon is placed into a partially occluded coronary artery and then inflated to increase blood flow through the artery is called a/an ________.

A) angioplasty
B) coronary bypass
C) urokinase injection
D) tissue plasminogen activation
E) angiogram

Question 33

From the right ventricle, blood flows directly into the ________.

A) aorta
B) right atrium
C) pulmonary trunk
D) pulmonary arteries
E) pulmonary veins

Question 34

The chordae tendineae

A) connect the atria to the ventricles.
B) are found in the interventricular septum.
C) are part of the conducting system of the heart.
D) connect the cusps of the AV valves to the papillary muscles.
E) are a part of the myocardium.

Question 35

Which blood vessel carries blood away from the left ventricle?

A) Aorta
B) Right atrium
C) Pulmonary trunk
D) Pulmonary arteries
E) Pulmonary veins

Question 36

The right atrium receives blood from

A) the lungs and the heart.
B) the heart.
C) the body and the heart.
D) the lungs and the body.

Question 37

Which vessels empty blood into the left atrium?

A) Aorta
B) Right atrium
C) Pulmonary trunk
D) Pulmonary arteries
E) Pulmonary veins

Question 38

Blood in the superior vena cava will enter the ________.

A) aorta
B) right atrium
C) pulmonary trunk
D) pulmonary arteries
E) pulmonary veins

Question 39

Coronary artery disease can diminish myocardial blood flow resulting in the death of myocardial cells. This condition is known as a myocardial ________.

A) attack
B) angina
C) necrosis
D) cirrhosis
E) infarction

Question 40

What vessel exits the left ventricle?

A) Pulmonary trunk
B) Pulmonary vein
C) Aorta
D) Pulmonary artery

Question 41

When a pacemaker potential in the SA node reaches threshold,

A) the permeability to K⁺ increases.
B) many voltage-gated Ca²⁺ channels open.
C) voltage-gated Ca²⁺ channels close.
D) resting membrane potential has been restored.
E) permeability of the cell does not change.

Question 42

Which of the following phrases would apply to cardiac muscle cells?

A) Organized in parallel columns or bundles
B) Contain actin but no myosin
C) Develop a significant oxygen deficit during systole
D) Multinucleated like skeletal muscle fibers
E) Possess special cell-to-cell contacts called intercalated discs

Question 43

What is the importance of the delay in the action potential in the AV node?

A) It allows the action potential to reach both ventricles at the same time.
B) It allows an action potential to reach the left atrium so both atria contract together.
C) It allows an action potential to reach the left atrium so both atria contract together, before the ventricles contract.
D) It allows time for the atria to fill with blood.

Question 44

The plateau phase seen during the action potential of a cardiac muscle cell is due to the

A) sodium-potassium pump.
B) opening of Na⁺ channels.
C) continuing to have open Ca²⁺ channels.
D) closure of Cl⁻ channels.
E) closing of Ca²⁺ channels.

Question 45

Which of the following heart chambers is correctly associated with the blood vessel that enters or leaves it?

A) Right atrium - pulmonary veins
B) Left atrium - aorta
C) Right ventricle - pulmonary trunk
D) Left ventricle - superior vena cava and inferior vena cava
E) Right atrium - aorta

Question 46

Action potentials pass from one cardiac muscle cell to another through areas of low electrical resistance called

A) gap junctions.
B) fibrous heart rings.
C) electromagnetic discs.
D) sarcolemma sclerotic plaques.
E) tight junctions.

Question 47

Ventricular contraction begins at the

A) AV bundle.
B) apex of the heart.
C) base of the heart.
D) superior portion of the interventricular septum.
E) top of the ventricles.

Question 48

The "pacemaker" of the heart is the

A) right bundle branch.
B) left bundle branch.
C) AV node.
D) SA node.
E) PM node.

Question 49

Calcium channel blockers are frequently used to

A) increase the heart rate.
B) treat tachycardia or other arrhythmias.
C) speed up conduction of impulses through the AV node.
D) slow the closing of K⁺ channels.
E) treat bradycardia and low blood pressure.

Question 50

The cardiac electrical impulse normally begins spontaneously in the SA node because

A) of the superior location of the SA node in the right atrium.
B) the SA node is the only area of the heart capable of spontaneous depolarization.
C) of the rich sympathetic innervation of the SA node.
D) this area produces action potentials more rapidly than any other portion of the conduction system.
E) of action potentials from the cardioregulatory center.

Question 51

If the SA node is nonfunctional, which of the following is most likely to occur?

A) The heart will go into asystole (stop).
B) Tachycardia will develop.
C) Another portion of the heart will become the pacemaker.
D) The heart will go into defibrillation.
E) The heart will be desensitized.

Question 52

The action potentials are slowed at the AV node to allow the

A) ventricles to repolarize.
B) ventricles to completely empty of blood.
C) pacemaker to reset for the next beat.
D) atria to complete their contraction.
E) atria to begin their contraction.

Question 53

Which of the following events occurs first?

A) Threshold
B) Depolarization
C) Early repolarization
D) Final repolarization
E) Pacemaker potential

Question 54

Cardiac muscle cells

A) have smooth ER but no T tubules.
B) form the heart valves.
C) are maintained by an extensive capillary network.
D) develop a significant oxygen deficit during systole.
E) do not contain actin and myosin like skeletal muscle fibers.

Question 55

Which of the following sequences for the conducting system is correct?

A) AV node, AV bundle, SA node, Purkinje fibers, bundle branches
B) Purkinje fibers, bundle branches, AV node, AV bundle, SA node
C) SA node, AV node, AV bundle, bundle branches, Purkinje fibers
D) SA node, AV bundle, AV node, bundle branches, Purkinje fibers
E) AV node, SA node, bundle branches, AV bundle, Purkinje fibers

Question 56

Which of the following is a function of the heart skeleton?

A) Provides electrical insulation between the atria and ventricles
B) Supplies support and reinforcement for the valves
C) Provides a rigid site for cardiac muscle attachment
D) All of the choices are functions of the heart skeleton.

Question 57

Depolarization of a cardiac muscle cell occurs as the result of

A) a decrease in the permeability of the plasma membrane to Na⁺.
B) the opening of voltage-gated Na⁺ channels and voltage-gated Ca²⁺ channels.
C) the closure of voltage-gated Ca²⁺ channels.
D) the opening of voltage-gated K⁺ channels.
E) the closure of the voltage-gated Na⁺ channels.

Question 58

Energy for contraction of cardiac muscle cells comes primarily from

A) aerobic respiration in the mitochondria.
B) anaerobic respiration in the cytosol.
C) glycolysis in the cytosol.
D) ATP that is stored while the heart is not contracting.
E) creatine phosphate.

Question 59

The spontaneous opening of Na⁺ channels marks the beginning of ________ of a cardiac muscle cell.

A) depolarization
B) repolarization
C) hyperpolarization
D) isopolarization
E) afterpolarization

Question 60

Which of the following will depolarize immediately after the AV node depolarizes?

A) The AV bundle
B) Purkinje fibers
C) Atrial myocardium
D) Bundle branches in the ventricular septum
E) The SA node

Question 61

When left atrial pressure exceeds left ventricular pressure,

A) left ventricular ejection begins.
B) aortic blood pressure begins to rise.
C) the bicuspid (mitral) valve opens.
D) ventricular volume decreases.
E) the tricuspid valve opens.

Question 62

Which of the following areas of the conduction system would produce spontaneous action potentials most frequently if the SA node were not functioning?

A) AV bundle
B) Purkinje fibers
C) AV node
D) Bundle branch
E) The pacemaker

Question 63

What action is most responsible for the resting membrane potential in cardiac muscle cells?

A) Movement of K⁺ through voltage-gated K⁺ channels
B) Movement of Na⁺ through open Na⁺ channels
C) Movement of Ca²⁺ through voltage-gated Ca²⁺ channels.
D) Closing of Na⁺ and K⁺ voltage-gated channels

Question 64

Which of the following would result from a reduced function of the Na⁺ channels in the SA node?

A) Depolarization would be delayed.
B) The heart rate would decrease.
C) Repolarization would not occur.
D) The plateau phase would be shorter.
E) Depolarization would be delayed, and the heart rate would decrease.

Question 65

Which statement accurately describes a condition of the heart chambers during the cardiac cycle?

A) The right atrium and the right ventricle contract simultaneously.
B) The left atrium contracts before the right atrium.
C) All four chambers of the heart contract at the same time.
D) All four chambers of the heart are in diastole at the same time.

Question 66

The P wave of an electrocardiogram indicates

A) atrial depolarization.
B) atrial repolarization.
C) ventricular depolarization.
D) ventricular repolarization.
E) threshold.

Question 67

The period of time in which cardiac muscle cells are insensitive to further stimulation is called the

A) absolute refractory period.
B) hyperpolarization period.
C) AV period.
D) SA period.
E) ectopic focus.

Question 68

Contraction of the ventricles is referred to as ventricular ________.

A) systole
B) diastole
C) fibrillation
D) ischemia
E) depolarization

Question 69

In a normal electrocardiogram, the

A) P wave results from repolarization of the atria.
B) QRS complex results from ventricular depolarization.
C) P wave occurs after the QRS complex but before the T wave.
D) T wave represents depolarization of the atria.
E) repolarization of the atria is clearly visible.

Question 70

Which of the following pairs concerning action potentials in cardiac muscle is mismatched?

A) Opening of Na⁺ channels - depolarization
B) Closing of Ca²⁺ channels - plateau phase
C) Opening of K⁺ channels - rapid repolarization
D) Closure of Na⁺ channels - early repolarization
E) Opening of Ca²⁺ channels - plateau phase

Question 71

During the cardiac cycle,

A) the right atrium and the right ventricle contract simultaneously.
B) the two atria relax while the two ventricles contract.
C) the left atrium contracts before the right atrium.
D) all four chambers of the heart contract at the same time.
E) all four chambers of the heart are in systole at the same time.

Question 72

When comparing cardiac muscle cells and skeletal muscle cells,

A) the rate of action potential propagation is faster in cardiac muscle.
B) both possess intercalated discs.
C) only skeletal muscle has a plateau phase in its contraction cycle.
D) action potentials are conducted from cell to cell only in cardiac muscle.
E) both are voluntary.

Question 73

What abnormal heart rhythm could be caused by an elevated body temperature, excessive sympathetic stimulation, or toxic conditions?

A) Bradycardia
B) Atrial fibrillation
C) Second-degree AV node block
D) Tachycardia

Question 74

If cardiac muscle cells are unable to repolarize, this would cause

A) cardiac output to increase.
B) no harm. These cells can spontaneously depolarize anyway.
C) the heart rate to decrease. It might cause cardiac arrest.
D) an increased demand on mitochondria to produce more ATP.
E) tachycardia.

Question 75

The period of isovolumetric contraction is immediately followed by

A) the period of ejection.
B) AV node depolarization.
C) passive ventricular filling.
D) atrial contraction.
E) isovolumetric relaxation.

Question 76

What event(s) occur during the QRS complex of an electrocardiogram?

A) Depolarization of the atria
B) Repolarization of the ventricles
C) Depolarization of the atria and repolarization of the ventricles
D) Depolarization of the ventricles and repolarization of the atria

Question 77

The long refractory period observed in cardiac muscle

A) prolongs depolarization of the cardiac muscle.
B) prevents tetanic contractions of the cardiac muscle.
C) ensures that the heart has adequate time to contract.
D) prevents the heart rate from slowing down.
E) prevents an increase in heart rate.

Question 78

Of the types of damage resulting from a myocardial infarction, which is most likely to cause the greatest increase in the Q-T interval?

A) Infarction in the AV node
B) Left bundle branch block
C) Infarction affecting the SA node
D) Tachycardia
E) Ectopic focus

Question 79

Variations in respiratory rate is a symptom of

A) sinus arrhythmia.
B) ventricular tachycardia.
C) SA node block.
D) paroxysmal atrial tachycardia

Question 80

Which cardiac arrhythmia will have no QRS complex as a symptom?

A) Atrial fibrillation
B) Ventricular fibrillation
C) Bradycardia
D) Premature ventricular contractions