Deck 17: Functional Anatomy of the Cardiovascular System

Question 1

Where can the normal PMI be felt and sometimes seen?

A) At the intersection of the third intercostal space and the midclavicular line
B) At the intersection of the fourth intercostal space and the midclavicular line
C) At the intersection of the fifth intercostal space and the midclavicular line
D) At the intersection of the sixth intercostal space and the midclavicular line

Answer 1

At the intersection of the fifth intercostal space and the midclavicular line

Question 2

Which of the following are features of the pain produced by coronary artery occlusion?
I.It is often felt beneath the sternum.
II.It is often felt in the left arm.
III.It is often felt in the neck.
IV.It is known as angina pectoris.

A) I, IV
B) III, IV
C) I, II, III, IV
D) II, IV

Answer 2

I, II, III, IV

Question 3

How soon do levels of troponins rise after a myocardial infarction?

A) 1 to 6 hours
B) 3 to 12 hours
C) 16 to 24 hours
D) 12 to 48 hours

Answer 3

3 to 12 hours

Question 4

During which part of the cardiac cycle does most coronary perfusion occur?

A) Systole
B) Diastole
C) It is unaffected by the phase of the cardiac cycle.
D) Only during the first third of the systolic phase

Question 5

Which of the following is the preferred biomarker for diagnosing acute myocardial infarction?

A) Troponin
B) Bradykinin
C) Lipase
D) CPK

Question 6

While at rest, the whole body extracts approximately 25% of the oxygen from its arterial blood flow, and the myocardium extracts approximately what percentage?

A) 40%
B) 50%
C) 60%
D) 70%

Question 7

Why would a heart rate in excess of 170 to 220 bpm result in decreased cardiac output?

A) The diastolic time becomes too short to allow adequate ventricular filling.
B) The sinoatrial conduction slows down at high heart rates.
C) The blood volume in the ventricles is normal but the ejection fraction decreases.
D) The systolic time becomes too short to allow adequate ventricular emptying.

Question 8

Which of the following vascular compartments contains about 64% of the total blood volume?

A) Large arteries
B) Systemic veins
C) Arterioles
D) Pulmonary vessels

Question 9

Which of the following terms describes coronary artery occlusion that causes hypoxemia to the myocardium?

A) Infarction
B) Apoptosis
C) Hypoxia
D) Ischemia

Question 10

Which of the following conditions can cause a shift in the PMI?

A) Pneumothorax
B) Pneumonia
C) Pulmonary fibrosis
D) Segmental atelectasis

Question 11

Which of the following are signs of cardiac tamponade?
I.Distended neck veins
II.Bradycardia
III.Muffled, distant heart sounds
IV.Low systolic blood pressure

A) I, IV
B) I, III, IV
C) I, II, III, IV
D) II, IV

Question 12

Which of the following statements are true of the sinoatrial node?
I.It is embedded in the right atrial muscle.
II.It is near the superior vena cava.
III.It initiates the electrical impulses that produce sequential atrial and ventricular contraction.
IV.It is near the right ventricle.

A) I, II, III
B) II, III
C) I, II, III, IV
D) II, III, IV

Question 13

Which of the following statements is true of ventricular diastole or filling?

A) Approximately 50% of ventricular filling is passive; the remaining 50% is caused by the atrial kick.
B) Approximately 60% of ventricular filling is passive; the remaining 40% is caused by the atrial kick.
C) Approximately 70% of ventricular filling is passive; the remaining 30% is caused by the atrial kick.
D) Approximately 80% of ventricular filling is passive; the remaining 20% is caused by the atrial kick.

Question 14

Which of the following statements is true of the Frank-Starling mechanism?

A) The greater the preload, the greater the force of contraction.
B) The greater the afterload, the greater the force of contraction.
C) The greater the venous return, the lower the force of contraction.
D) The greater the afterload, the greater the venous return.

Question 15

Which of the following is the most common congenital heart defect?

A) VSD
B) ASD
C) Coarctation of the aorta
D) TGV

Question 16

Which of the following is the main type of adrenergic receptor in the heart?

A) α
B) β₁
C) β₂
D) Nicotinic

Question 17

Which of the following are the basic mechanisms that explain venous return?
I.Muscular "milking" of leg veins containing one-way valves
II.Sympathetic venous constriction
III.Cardiac pumping action, creating a "cardiac suction"
IV.Subatmospheric intrathoracic pressures during breathing

A) III, IV
B) I, II, III
C) I, II, IV
D) I, II, III, IV

Question 18

Upon auscultation of a patient's heart sounds a diastolic murmur is heard.Which of the following valvular defects will be associated this type of murmur?
I.Leaky semilunar valves
II.Stenotic semilunar valves
III.Leaky atrioventricular valves
IV.Stenotic atrioventricular valves

A) I, II
B) III, IV
C) I, III
D) I, IV

Question 19

Which of the following is the most important factor governing coronary blood flow?

A) Myocardial oxygen need
B) Valvular function
C) Systolic blood pressure
D) Sinoatrial rhythm

Question 20

Which of the following statements are true of the stroke volume?
I.It is about 110 to 120 mL.
II.Contraction ejects about 70 mL.
III.The end-systolic volume is about 50 mL.
IV.A low ejection fraction is considered one that is less than 50%.

A) I, II, III
B) II, III
C) I, II, III, IV
D) II, III, IV

Question 21

A high SVR in a patient is an indicator of which of the following?

A) Increased left ventricular afterload
B) Increased right ventricular afterload
C) Increased left ventricular preload
D) Increased right ventricular preload

Question 22

Which of the following abnormalities identified in the laboratory report is associated with an increase in SVR?

A) Increased calcium
B) Increased hematocrit
C) Increased WBC
D) Increased potassium

Question 23

Which of the following are consistent with the definition of hypertension?
I.Diastolic pressure of approximately 90 mm Hg
II.Diastolic pressure of 80 mm Hg and systolic pressure of 130 mm Hg
III.Mean arterial pressure greater than 110 mm Hg at rest
IV.Systolic pressure of approximately 135 to 140 mm Hg

A) III, IV
B) I, III, IV
C) I, II, IV
D) I, II, III, IV

Question 24

Which of the following statements are consistent with the response of baroreceptors to high blood pressure?
I.The cardioregulatory center slows the heart rate.
II.The carotid and aortic baroreceptors transmit impulses through the glossopharyngeal and vagus nerves.
III.Impulses are sent to the brain's vasomotor and cardioregulatory centers.
IV.The vasomotor center causes vasodilation.

A) I, II, III
B) I, II, III, IV
C) I, III
D) I, IV

Question 25

What is the overall effect of the renin-angiotensin-aldosterone mechanism?

A) It decreases reabsorption of sodium.
B) It decreases reabsorption of water.
C) It increases circulating blood volume and pressure.
D) It decreases circulating blood volume and pressure.

Question 26

What is the explanation for using two times the diastolic pressure to calculate the MAP?

A) The diastolic pressure is half the systolic pressure.
B) The diastolic pressure is twice the mean systolic pressure.
C) The heart spends two-thirds of the cardiac cycle in diastole.
D) The diastolic pressure is less than half the systolic pressure

Question 27

Which of the following terms describes the difference between systolic and diastolic blood pressures?

A) Mid-systolic pressure
B) Mid-diastolic pressure
C) Pulse pressure
D) Mean arterial pressure

Question 28

Which of the following best describes afterload?

A) The resistance to blood ejection immediately after aortic and pulmonary semilunar valves open
B) The resistance to blood ejection immediately after tricuspid and mitral semilunar valves open
C) The resistance to blood ejection immediately after aortic and pulmonary semilunar valves close
D) The resistance to blood ejection immediately after tricuspid and mitral semilunar valves close

Question 29

In a patient with moderate to severe COPD, which specific condition may adversely affect vascular resistance?

A) FEV₁
B) Lung volumes
C) Blood viscosity
D) Atherosclerosis

Question 30

What is the overall effect of ADH?

A) It decreases reabsorption of sodium.
B) It increases reabsorption of water.
C) It decreases circulating blood volume and pressure.
D) It increases reabsorption of sodium.

Question 31

Which of the following clinical conditions are associated with an increase in pulse pressure?
I.Increased stroke volume
II.Decreased arterial compliance
III.Hypotension
IV.Dehydration

A) I, II, III, IV
B) II, IV
C) III, IV
D) I, II

Question 32

Other than the heart's ability to pump blood out of the right atrium, pressure in the right atrium is determined by which of the following?

A) The diastolic pressure
B) The systolic pressure
C) The rate at which blood flows in from the vena cavae
D) The rate at which blood flows in from the pulmonary veins

Question 33

Which of the following physical signs are consistent with right ventricular failure?
I.Hepatomegaly
II.Jugular venous distension
III.Ascites
IV.Pedal edema

A) I, II, III
B) I, II, III, IV
C) I, III
D) I, IV

Question 34

Which of the following phenomena triggers release of the B-type natriuretic peptide?

A) High blood pressure
B) Dehydration
C) Hypotension
D) Excessive diuresis