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Perfusion > A & P > Flashcards

A & P Flashcards

1
Q

True or False: The right side of the heart is the most posterior portion of the heart.

A

False

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2
Q

The layer that makes up 95% of the heart wall:
a. Myocardium
b. Pericardium
c. Endocardium
d. Epicardium

A

a. Myocardium

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3
Q

What are the 2 serous pericardial layers?
a. Visceral & parietal
b. Somatic & visceral
c. Parietal & occipital
d. Fibrous & myocardial

A

a. Visceral & parietal

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4
Q

The pulmonary & aortic valves are also referred to as:
a. Cardiac tricuspid valves
b. Atrioventricular valves
c. Semilunar valves
d. Coronary ostia

A

c. Semilunar valves

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5
Q
  1. All are true regarding heart valves & circulation, except:
    a. The mitral valve has two cusps (anterior and posterior)
    b. Prevent back flow in the heart
    c. Open and close due to pressure differences in the cardiac chambers
    d. Atrioventricular valves separate the ventricles from pulmonary and systemic circulations
A

d. Atrioventricular valves separate the ventricles from pulmonary and systemic circulations

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6
Q

True or False: 85% of patients have left coronary dominance, due to the left coronary artery supplying the posterior descending branch.

A

False

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7
Q

All of the following regarding the myocyte are true, except:
a. The Sarcoplasmic Reticulum of cardiac muscle cells are histologically the exact same as skeletal muscle fibers
b. Are connected to neighboring fibers by intercalated discs
c. Depolarization of one myocyte is transmitted to adjacent cells
d. Cardiac muscle cells are self excitable

A

a. The Sarcoplasmic Reticulum of cardiac muscle cells are histologically the exact same as skeletal muscle fibers

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8
Q

Which wave on the ECG represents atrial depolarization?
a. T-wave
b. QRS complex
c. R-T interval
d. P-wave

A

d. P-wave

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9
Q

The SA node has an isolated depolarization firing rate of:
a. 70-80 bpm
b. 100-110 bpm
c. 40-60 bpm
d. 50-60 bpm

A

a. 70-80 bpm

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10
Q

The average resting membrane potential of a cardiac myocyte is?
a. +100 to +100 mv
b. +60 to +90 mv
c. -60 to -90 mv
d. -100 to -110 mv

A

c. -60 to -90 mv

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11
Q

The correct order of a Cardiac Cycle is as follows:
a. Electrical events, volume changes, pressure changes, mechanical events, heart sounds
b. Electrical events, heart sounds, mechanical events, pressure changes, volume changes
c. Electrical events, pressure changes, heart sounds, volume changes, mechanical evens
d. Electrical events, volume changes, heart sounds, pressure changes, mechanical events

A

c. Electrical events, pressure changes, heart sounds, volume changes, mechanical events

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12
Q

Atrial systole contributes what percentage of end diastolic ventricular volume?
a. 45%
b. 20%
c. 50%
d. 80%

A

b. 20%

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13
Q

True or False: The coronary arteries are perfused during systole.

A

False

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14
Q

True or False: Regarding Starlings Law of the heart, low preload volume in the ventricles will shorten the cardiac fibers, which up to an optimum, will produce a stronger contraction.

A

False

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15
Q

Typically, arteries transport oxygenated blood. The only exception is the:
a. Pulmonary vein
b. Subclavian artery
c. Pulmonary artery
d. Aortic artery

A

c. Pulmonary artery

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16
Q
  1. The normal pacemaker of the heart is the:
    a. SA node
    b. AV node
    c. Right & left bundle branches
    d. Purkinje network
A

a. SA node

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17
Q

Which coronary artery provides the primary blood supply to the sinoatrial & atrioventricular nodes of the heart’s conduction system?
a. Intermediate branch
b. Circumflex
c. Left coronary
d. Right coronary

A

d. Right coronary

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18
Q

This structure becomes hypertrophies in its attempt to eject blood through a stenotic aortic valve
a. Left atrium
b. Right atrium
c. Right ventricle
d. Left ventricle

A

d. Left ventricle

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19
Q
  1. This may be caused by a ruptured papillary muscle:
    a. Endocarditis
    b. Mitral valve regurgitation
    c. Ostium primum ASD
    d. Patent ductus arteriosus
A

b. Mitral valve regurgitation

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20
Q
  1. All of the following would be expected to occur in the setting of aortic valve regurgitation, except:
    a. Increased workload of let ventricle
    b. Turbulent blood flow in the heart
    c. Decrease in left ventricular diastolic volume
    d. Impaired coronary blood flow
A

c. Decrease in left ventricular diastolic volume

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21
Q

Which feature of a vein is structurally much smaller as opposed to the same feature of an artery
a. Tunica media
b. Valves
c. Tunica adventitia
d. Tunica intima

A

a. Tunica media

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22
Q

Which vessel doesn’t usually drain blood back to the “right side” of the heart?
a. Pulmonary veins
b. Azygous vein
c. Coronary sinus
d. IVC

A

a. Pulmonary veins

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23
Q

The 3 basic types of arteries are:
a. Fibrous, serous, endothelial
b. Elastic, myocardial, pericardial
c. Elastic, muscular, arteriole
d. Elastic, muscular, capillary

A

c. Elastic, muscular, arteriole

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24
Q

Which vessel plays a key role in regulating blood flow from arteries to capillaries?
a. Sinusoid
b. Venules
c. Thorough fare channel
d. Arterioles

A

d. Arterioles

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25
Q

The 3 basic types of capillaries are:
a. Continuous, fenestrated, sinusoid
b. Fenestrated, meta-arteriole, sinusoid
c. Continuous, sinusoid, discontinuous
d. Continuous, arteriole, venule

A

a. Continuous, fenestrated, sinusoid

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26
Q

All of the following regarding veins are true, except:
a. Many contain valves to prevent back flow
b. Distensibility allows for accommodation of high pressures
c. Have thin medial layers
d. Distensible to accommodate large variations in volume

A

b. Distensibility allows for accommodation of high pressures

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27
Q

The __ are microscopic vessels that bring blood supply to the layers of blood vessels.
a. Capillaries
b. Vasa-vasorum
c. Meta-arteriole
d. Venule

A

b. Vasa-vasorum

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28
Q

What are the 3 basic mechanisms by which substances enter & leave capillaries?
a. Diffusion, phagocytosis, exocytosis
b. Permeability, active transport, filtration
c. Diffusion, active transport, exocytosis
d. Diffusion, transcytosis, bulk flow

A

d. Diffusion, transcytosis, bulk flow

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29
Q

The pressure driven movement of fluid from the capillaries to the interstitium is known as:
a. Active transport
b. Hydrostatic pressure
c. Reabsorption
d. Filtration

A

d. Filtration

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30
Q
  1. The pressure driven movement of fluid from the interstitium to the blood capillaries is known as:
    a. Hydrostatic pressure
    b. Filtration
    c. Oncotic pressure
    d. Reabsorption
A

d. Reabsorption

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31
Q

The presence of large molecules (proteins, esp albumin) in the blood exerts a force that counteracts filtration, this force is known as __.
a. Reabsorption
b. Filtration
c. Oncotic pressure
d. Hydrostatic pressure

A

c. Oncotic pressure

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32
Q

All of the following statements are true regarding lymphatic vessels, except:
a. Have less valves than veins
b. Have thinner walls than veins
c. Begin as lymphatic capillaries between cells
d. Unite to form larger lymphatic vessels

A

a. Have less valves than veins

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33
Q

In what regions do the lymphatic ducts drain lymph back into the vasculature?
a. Junction between the internal jugular veins & subclavian veins
b. Coronary sinus & azygous veins
c. Junction between the internal & external jugular veins
d. Junction of the IVC & the right atrium

A

a. Junction between the internal jugular veins & subclavian veins

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34
Q

All of the following statements are true regarding lymphatic capillaries, except:
a. Lymphatic capillaries are a one-way structure, close ended
b. Pressure gradients are involved with lymphatic capillary filling
c. Have less permeability than blood capillaries
d. Are slightly larger than blood capillaries

A

c. Have less permeability than blood capillaries

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35
Q

The correct fluid flow lymph sequence are as follows:
a. Blood Capillaries – Interstitial spaces – Lymphatic capillaries – Lymphatic ducts – Lymphatic vessels – Junction of IVC & right atrium
b. Blood Capillaries – Interstitial spaces – Lymphatic vessels – Lymphatic ducts – Junction of IJ & subclavian (blood)
c. Blood Capillaries – Interstitial spaces – Lymphatic capillaries – Lymphatic vessels – Lymphatic ducts – Junction of IJ & external jugular (blood)
d. Interstitium – Blood capillaries – Lymphatic capillaries – Lymphatic vessels – Lymphatic ducts – Junction of IJ & subclavian (blood)

A

b. Blood Capillaries – Interstitial spaces – Lymphatic vessels – Lymphatic ducts – Junction of IJ & subclavian (blood)

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36
Q

Which duct drains lymph from the right side of the head, right upper extremity, & right chest?
a. Right lymphatic duct
b. Thoracic duct
c. Right thoracic duct
d. Left lymphatic duct

A

a. Right lymphatic duct

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37
Q

The __ drains the overwhelming majority of lymph fluid back into the systemic blood circulation.
a. Thoracic duct
b. Left thoracic duct
c. Right lymphatic duct
d. Right thoracic duct

A

a. Thoracic duct

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38
Q

The __ is a dilatation that marks the most inferior portion of the thoracic duct.
a. Anchoring filament
b. Peyer’s patch
c. Cisterna chyli
d. Mediastinal sinus

A

c. Cisterna chyli

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39
Q

Under normal physiology, the human adult body has a filtered __ to the interstitium.
a. Net loss of 3 liters/day
b. Net gain of 3 liters/day
c. Plasma concentration of 1 liter/day
d. Zero balance

A

a. Net loss of 3 liters/day

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40
Q

True or False: During inhalation, lymph flows through lymphatic vessels due to a higher pressure in the abdominal region & a lower pressure in the thoracic region.

A

True

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41
Q

Which of the following is called the resting state?
a. Phase 1
b. Phase 3
c. Phase 4
d. Phase 2

A

c. Phase 4

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42
Q

Which of the following means the ability to transmit electrical current from one cell to another?
a. Automaticity
b. Contractility
c. Conductivity
d. Excitability

A

c. Conductivity

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43
Q

An electrical difference across the fibers of the heart is called the
a. Depolarization
b. Action potential
c. Absolute refractory period
d. Resting membrane potential

A

d. Resting membrane potential

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44
Q

Which of the following is the rapid upstroke in the action potential?
a. Phase 1
b. Phase 3
c. Phase 0
d. Phase 2

A

c. Phase 0

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45
Q

When does the inward flow of Ca++ into the heart stop?
a. Phase 4
b. Phase 3
c. Phase 2
d. Phase 1

A

b. Phase 3

46
Q

The entire sequence of electrical changes during depolarization and repolarization is called
a. Conductivity
b. Nonrefractory period
c. Action potential
d. Contractility

A

c. Action potential

47
Q

Which of the following are Agranulocytes?
a. Neutrophils
b. Basophils
c. Monocytes
d. Eosinophils

A

c. Monocytes

48
Q

True or False: A normal cardio-thoracic ratio is less than 50%

A

True

49
Q

True or False: The endocardium is also the visceral layer of the serous pericardium

A

False

50
Q

In capillary exchange, __ is a pressure that promotes filtration.
a. Interstitial fluid oncotic pressure
b. Net filtration pressure
c. Blood hydrostatic pressure
d. Blood colloid osmotic pressure

A

c. Blood hydrostatic pressure

51
Q

During which refractory period represent the time which cells cannot respond to a stimulus?
a. Nonrefractory period
b. Second half of phase 3
c. Relative refractory period
d. Absolute refractory period

A

d. Absolute refractory period

52
Q

Which of the following slows the heart rate & AV conduction?
a. Pacemaker
b. Parasympathetic nervous system
c. Sympathetic nervous system
d. Resting membrane potential

A

b. Parasympathetic nervous system

53
Q

During what “Mechanical Event” of the cardiac cycle represents the start of systole with both sets of atrio-ventricular & semilunar valves being simultaneously closed?
a. Ventricular ejection
b. Atrial contraction
c. Isovolumetric relaxation
d. Isovolumetric contraction

A

d. Isovolumetric contraction

54
Q

A “Formed Elements” typically make up what percentage of blood volume?
a. 55%
b. 50%
c. 40%
d. 45%

A

d. 45%

55
Q

In the resting state, the inside of the cardiac cell is negatively charged due to a preponderance of which cation?
a. Calcium
b. Magnesium
c. Potassium
d. Sodium

A

c. Potassium

56
Q

The left ventricle is typically __ the size of the right ventricle.
a. 3 times larger than
b. 2 times larger than
c. 2 times smaller than
d. Equal

A

a. 3 times larger than

57
Q

The first heart sound S1 designates what?
a. Closure of atrioventricular valves
b. Closure of semilunar valves
c. Opening of semilunar valves
d. Opening of atrioventricular valves

A

a. Closure of atrioventricular valves

58
Q

Which of the following statements is correct concerning Autonomic Motor Efferent Neurons:
a. Are neurons that transmit impulses from the CNS to effector smooth muscles, cardiac muscles, & glands.
b. Sensory neurons that convey info from autonomic receptors back to the CNS
c. Neurons that transmit impulses from voluntary muscle effectors to the CNS
d. Neurons that transmit impulses from the CNS to voluntary muscle effector organs

A

a. Are neurons that transmit impulses from the CNS to effector smooth muscles, cardiac muscles, & glands.

59
Q

Which of the following statements are correct concerning Visceral Afferent Sensory Neurons:
a. Neurons that transmit impulses from the CNS to effector smooth muscles, cardiac muscles, & glands
b. Neuron fibers that convey impulses from visceral organs & blood vessels to the CNS for interpretation
c. Neurons that transmit impulses from voluntary muscle effectors to the CNS
d. Neurons that transmit impulses from the CNS to voluntary muscle effector organs

A

b. Neuron fibers that convey impulses from visceral organs & blood vessels to the CNS for interpretation

60
Q

True or False: Cerebral autoregulation will constrict cerebral blood vessels due to high concentrations of carbon dioxide in the blood.

A

False

61
Q

What are the 2 types of adrenergic receptors?
a. Nicotinic & Muscarinic
b. Alpha & Beta
c. Norepinephrine & Epinephrine
d. Acetylcholine & Norepinephrine

A

b. Alpha & Beta

62
Q

This nerve is responsible for carrying parasympathetic information to the heart:
a. Mesenteric
b. Vagus
c. Glossopharyngeal
d. Hypoglossal

A

b. Vagus

63
Q

The thermodilution component of the Pulmonary Artery Catheter is used for:
a. Central Venous Pressure
b. Venous Saturation measurement
c. Temperature
d. Cardiac Output measurement

A

d. Cardiac Output measurement

64
Q

All statements are true regarding the vagus nerve except:
a. Vagal stimulation increases heart rate
b. Is a mixed cranial nerve
c. Innervates the sino atrial node
d. “Bearing down” or carotid massage can stimulate a vagal response

A

a. Vagal stimulation increases heart rate

65
Q

True or False: Autonomic motor neurons always conduct impulses along 2 neurons in series (pre-synaptic & post-synaptic).

A

True

66
Q

All of the following statements regarding ANS neurons are true, except:
a. Functions independently without conscious control
b. The main input to the ANS comes from visceral sensory neurons
c. Regulates skeletal muscle movements
d. Most ANS organs have dual innervation

A

c. Regulates skeletal muscle movements

67
Q

True or False: Both Acetylcholine (ACh) & Norepinephrine (NE) are the neurotransmitters that are involved in the pre-ganglionic synapses of the ANS.

A

False

68
Q

What are the 2 types of cholinergic receptors that bind ACh?
a. Norepinephrine & Epinephrine
b. Alpha & Beta receptors
c. Visceral nerve & Somatic receptors
d. Nicotinic & Muscarinic

A

d. Nicotinic & Muscarinic

69
Q

What binds to Adrenergic Neuron receptors?
a. Nicotinic & Muscarinic
b. Acetylcholine (ACh) & Nicotinic
c. Norepinephrine (NE) & Epinephrine (Epi)
d. Acetylcholine (ACh) & Muscarinic

A

c. Norepinephrine (NE) & Epinephrine (Epi)

70
Q

Alpha agonist stimulation causes
a. Vasoconstriction
b. Vasodilation
c. Decreased heart contractility
d. Fat break down

A

a. Vasoconstriction

71
Q

True or False: An antagonist is a substance that binds & blocks a receptor.

A

True

72
Q

All are true regarding the ANS, except:
a. Each division has 2 motor neurons
b. All preganglionic neurons utilize ACh as its neurotransmitter
c. Epinephrine is released by chromatin cells in the renal medulla by sympathetic stimulation
d. All postganglionic sympathetic neurons are adrenergic

A

d. All postganglionic sympathetic neurons are adrenergic

73
Q

All are true regarding the effects of parasympathetic stimulation, except:
a. Restores nutrients & conserves energy during times of recovery
b. Utilizes cholinergic neurons
c. Contracts the bladder
d. Dilates bronchioles

A

d. Dilates bronchioles

74
Q

True or False: Betta 1 stimulation increases heart rate & contractility of the heart.

A

True

75
Q

True or False: Parasympathetic postganglionic neurons exhibit extensive branching so that multiple organs can be mobilized at once for a fast stimulation.

A

False

76
Q

The __ of the brain, is the major control & integration center of the ANS.
a. Cerebrum
b. Brain stem
c. Medulla Oblongata
d. Hypothalamus

A

d. Hypothalamus

77
Q

What neurotransmitter is responsible for accelerating the heart rate and dilating the coronary arteries?
a. Norepinephrine
b. Acetylcholine
c. Cholinergic
d. Nicotinic

A

a. Norepinephrine

78
Q

True or False: Parasympathetic pre-ganglionic neurons are known as the thoracolumbar division.

A

False

79
Q

Which vessel plays a key role in regulating blood flow from arteries to capillaries?
a. Venules
b. Thorough fare channel
c. Arterioles
d. Portal capillaries

A

c. Arterioles

80
Q

Calculate SVR based on the following data: __ dynes/sec/cm5
MAP = 65 mmHg
CVP = 3 mmHg
CO = 4.5 LPM
a. 1054
b. 1102
c. 1239
d. 1540

A

b. 1102

81
Q

Which determinant below has the greatest overall impact on vascular resistance?
a. Total blood vessel length
b. Blood viscosity
c. Size of the lumen of the blood vessel
d. Oncotic pressure

A

c. Size of the lumen of the blood vessel

82
Q

Which blood vessel has the greatest total cross-sectional area therefore the slowest velocity of flow?
a. Arteries
b. Aorta
c. Capillaries
d. Vena Cavae

A

c. Capillaries

83
Q

For which of the following activities is the sympathetic nervous system generally responsible?
a. Fight or flight responses
b. Pain & temperature
c. Taste & smell
d. Resting & digesting

A

a. Fight or flight responses

84
Q

True or False: As the vagus nerve passes into the thorax, it sends branches to the cardiac plexuses to increase heart rate.

A

False

85
Q

__ & __ are the major neurotransmitters released by autonomic nervous system neurons.
a. Serotonin & dopamine
b. Acetylcholine & norepinephrine
c. Nicotine & muscarine
d. Acetylcholine & epinephrine

A

b. Acetylcholine & norepinephrine

86
Q

True or False: Norepinephrine & epinephrine post-ganglionic receptrs can have either excitatory or inhibitory effects on target organs.

A

True

87
Q

Which of the following statements about parasympathetic neurons is true?
a. They exhibit much postganglionic branching
b. They synapse in the terminal ganglia, close to target organs
c. They originate in the thoracolumbar area
d. Postganglionic fibers are usually longer than those of sympathetic neurons.

A

b. They synapse in the terminal ganglia, close to target organs

88
Q

Which of the following is an a1-adrenergic response?
a. Inhibition (relaxation) of the digestive tract muscular motility, such as peristalsis
b. Opening (dilation) of the airways or bronchioles in the lung
c. Increasing the force & rate of contraction of the heart & vasoconstriction of blood vessels
d. Dilating the smooth muscle of blood vessels in the skin & intestinal area

A

c. Increasing the force & rate of contraction of the heart & vasoconstriction of blood vessels

89
Q

The most common site for central venous catheterization is:
a. Right External Jugular Vein
b. Right internal Jugular Vein
c. Left Internal Jugular Vein
d. Femoral Vein

A

b. Right internal Jugular Vein

90
Q

The brain area that contains the cardiovascular center that helps regulate blood pressure, is the:
a. Medulla oblongata
b. Pituitary gland
c. Cerebellum
d. Hypothalamus

A

a. Medulla oblongata

91
Q

Invasive hemodynamic monitoring consists of:
a. Blood pressure cuff
b. Arterial or venous catheter
c. ECG leads
d. Mechanical ventilation

A

b. Arterial or venous catheter

92
Q

All are true regarding the arterial pressure waveform, except:
a. The upstroke is known as the Anacrotic limb
b. The opening of the aortic valve marks the beginning of systole
c. The dicrotic limb signifies the down slope of the waveform
d. The end of the systolic cycle occurs after peak systole, just before the down slope

A

d. The end of the systolic cycle occurs after peak systole, just before the down slope

93
Q

Calculate the MAP for a blood pressure of 138/87
a. 114 mmHg
b. 112 mmHg
c. 96 mmHg
d. 104 mmHg

A

d. 104 mmHg

94
Q

As arteries bifurcate & become smaller, there is a backflow of blood which leads to phenomenon known as __ which adds to the amplitude “height” of the systolic pressure.
a. Waveform descent
b. Wave reflection
c. Compliance
d. Systemic vascular resistance

A

b. Wave reflection

95
Q

All of the following increase the amplitude height of an arterial waveform, except:
a. Compliant healthy aorta
b. Higher velocity of blood flow
c. Larger stroke volume
d. Stiff aorta

A

a. Compliant healthy aorta

96
Q

True or False: The femoral artery is the most frequently accessed artery for insertion of an arterial line catheter.

A

False

97
Q

__ is the greatest determinant of arterial pressure.
a. Cardiac output
b. Vascular resistance
c. Blood volume
d. Viscosity

A

b. Vascular resistance

98
Q

True or False: According to Poiseuille’s Law, pressure will increase in response to an increase in tube radius.

A

False

99
Q

True or False: According to Poiseuille’s Law, pressure will increase in response to an increase in tube length.

A

True

100
Q

True or False: According to Poiseuille’s Law, pressure will decrease in response to an increase in fluid viscosity.

A

False

101
Q

A 50% reduction in the diameter of a cylinder vessel, will increase the pressure in that cylinder __ times.
a. 4
b. 2
c. 16
d. .50

A

c. 16

102
Q

All are true regarding central venous pressure, except:
a. Increases with an increase in venous volume
b. Decreases with a decrease in venous compliance (veno-constriction)
c. Is the pressure of the venous system in the cava near the right atrium
d. Is considered nearly equal to right atrial pressure

A

b. Decreases with a decrease in venous compliance (veno-constriction)

103
Q

Which of the following statements is true regarding activity of the heart?
a. Cardiac action potentials spread slowly from cell to cell
b. Cardiac muscle requires innervation to be activated
c. The autonomic nervous system initiates heart function
d. The heart can generate action potentials in the absence of stimuli

A

d. The heart can generate action potentials in the absence of stimuli

104
Q

Purkinje fibers and ventricular myocytes generate which type of action potential?
a. Fast response action potentials
b. Slow response action potentials

A

a. Fast response action potentials

105
Q

These three ions contribute to the formation of both fast and slow response action potentials.
a. Calcium, chloride, sodium
b. Magnesium, calcium, sodium
c. Potassium, sodium, chloride
d. Sodium, calcium, potassium

A

d. Sodium, calcium, potassium

106
Q

True or False: Pacemaker cells have a true resting membrane potential.

A

False

107
Q

Outward flow of which ion helps maintain ventricular myocytes at resting membrane potential?
a. Calcium
b. Magnesium
c. Potassium
d. Sodium

A

c. Potassium

108
Q

Which phase of the fast response action potential is caused by an increase in the inward sodium conductance?
a. Phase 0
b. Phase 2
c. Phase 3
d. Phase 4

A

a. Phase 0

109
Q

Phase 2 of the fast response action potential is caused by the flow of which ions?
a. Inward calcium, inward sodium
b. Inward calcium, outward potassium
c. Inward sodium, inward potassium
d. Inward sodium, outward potassium

A

b. Inward calcium, outward potassium

110
Q

True or False: New action potentials can be generated during the absolute refractory period.

A

False

111
Q

Slow response action potentials are found primarily in __.
a. Atrial myocytes
b. Purkinje fibers
c. SA node
d. Ventricular myocytes

A

c. SA node

Perfusion (11 decks)

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