Biochem/Physiology Flashcards
Sugars that contain aldehyde groups that are \_\_\_ to carboxylic acids are classified as \_\_\_\_ sugars. • oxidized, non-reducing • oxidized, reducing • reduced, non-reducing • reducing, oxidizing copyright Cl 20 13-2014 Dental Decks BIOCHEMISTRY /PHYSIOLOGY
aldehydes oxidized to acids;
reducing
lactose, maltose, glucose, fructose
contain free anomeric carbon (C1, carbonyl group, available for redox, can be oxidized)
it’s the one on the rightmost of the ring, usually involved in bond formation
if that oxygen is not attached to anything else, it is a reducing sugar
carbonyl - reducing properties
sucrose is NOT reducing - reducing groups of glucose and fructose involved in glycosidic bond (no free anomeric carbon)
reducing sugars:
lactose, glucose, maltose (2x glu), fructose, galactose
reducing carbon
anomeric C1 carbonyl
aldehyde group that can be oxidized to carboxyl
Which of the following glycosaminoglycans can be found functioning in synovial fluid? • heparin • keratan sulfate • hyaluronate • dermatan sulfate • chondroitin sulfate • heparan sulfate
hyaluronate
glycoproteins - no repeat units, covalent bond bw sugars and protein
proteoglycans - w/ carbohydrate chains (GAGs) linked covalently to protein core
disaccharide repeat units: hexosamine + uronic acid
only hyaluronate is NOT sulfated and not covalently attached to protein
GAGs - lubricants, support elements in CT
hyaluronate - synovial fluid, eye humor, loose CT ECM - large polymer, shock absorbing
CS - ctlg, bone, heart valves - most abundant GAG
Heparan sulfate - BM, cell surfaces - more acetylated than heparin
heparin - granules of maast cells - anticoagulant, more sulfated than heparan sulfate
dermatan sulfate - skin, blood vessels, heart valves
keratan sulfate - cornea, bone, ctlg; aggregated w CS
GAG in basement membrane
heparan sulfate
less sulfated than heparin
more acetylated than heparin
mast cells GAG
heparin
more sulfated than heparan, less acetylated than heparan
most abundant GAG
CS
synovial fluid GAG
hyaluronate
not covalently bound to protein, not sulfated
large polymer, absorbs shock
non-sulfated GAG and where
hyaluronate, humor of eye, synovial
large, absorbs shock
Which intestinal enzyme breaks down the O-glycosidic bond between glucose and fructose? • maltase • lactase • sucrase • none of the above copyright Cl 20 13-2014 Dental Decks BIOCHEMISTRY /PHYSIOLOGY
SAADDES
sucrase
maltose = 2 glucoses lactose = glu + gala sucrose = glu + fru
Glucose, fructose, and galactose are classified as: • monosaccharides • disaccharides • oligosaccharides • polysaccharides copyright Cl 20 13-2014 Dental Decks
SAADDES
monosaccharides
Which of the following polysaccharides is hydrolyzed by glucan transferase? • starch • glycogen • cellulose • glycosaminoglycans copyright Cl 20 13-2014 Dental Decks BIOCHEMISTRY /PHYSIOLOGY SAADDES
glycogen
starch and glycogen - storage
structural - cellulose
GAGs are heteropolysacch
starch modes: alpha 1-6 amylose - unbranched amylopectin - v branched both hydrolyzed by amylase (parotid and pancreas)
glycogen - branched
alpha 1-4
especialy abundant in liver
cleaved by glucan transferase
modes, link and cleavage of starch
amylose (unbranched) and amylopectin (branched)
alpha 1-6
amylase from parotid and pancreas
link and cleavage of glycogen
branched, alpha 1-4
glucan transferase
The ground substance ofthe extracellular matrix is made up of: • type II collagen • type Ill collagen • proteoglycan molecules • fibri lli n
PGs = core protein with GAG side chains
major fx - lubricants, ecm, sieve
glycoproteins: NO serial repeat, covalent bond between carbs (NOT GAGs) protein; shorter and branched
enzymes, hormones, ABs, components of cll membrane
glycolipids - cell membrane receptors, all derived from ceramide
The most abundant glycosaminoglycan in the body is: • keratan sulfate • dermatan sulfate • chondroit in sulfate • heparan sulfate
CS
For each letter, choose the most appropriate answer to fill in the blank.
Dextrans are (A) __ of (B) __ produced extracellularly by bacteria and
yeast. The enzyme used to produce dextrans is (C) __, and the substrate
is (D) __ . A side product of dextran production is (E) __ , which is
formed into (F) __ and stored intracellularly as reserve nutrients.
• (A) monosacchari des I polysaccharides I oligosacchari des
• (B) glucose I fructose I galactose
• (C) dextran synthase I glucosyl transferase I fructosyl t ransferase
• (D) maltose I sucrose I lactose
• (E) glucose I fructose I galactose
• (F) starch I glycogen I !evans
Dextrans are polysaccharides of glucose produced extracellularly by bacteria and
yeast. The enzyme used to produce dextrans is glucosyl transferase (dextran sucrase), and the substrate
is sucrose . A side product of dextran production is fructose , which is
formed into fructans (levans) and stored intracellularly as reserve nutrients.
strep mutans produces dextran from sucrose
dextran - sticky polymer of glucose
enzyme splits sucrose into glucse and fructose and links glucoses into dextran
dextran deposited as thick glycocalyx
All of the following statements are true EXCEPT one. Which one is the EXCEPTION?
• rods contain rhodopsin -a photopigment
• cones are responsible for color vision
• rods are used for dark adaptation
• rods and cones are located in the retina
• cones are more abundant than rods
• cones are more abundant than rods
retina - innermost nervous tissue of eye
photopigments: opsin + retinal
rods - rhodopsin; no color; light intensity, night vision, vit A; periphery; MORE abundant, higher sensitivity, lower acuity
cones - color, central retina(fovea); red green blue
rods vs cones: sensitivity, acuity, type
rods higher sensitivity, more at periphery and more in general, lower acuity, night vision, vit A
cones central (fovea)
photopigment
opsin + retinal
which one’s night vision
rods
Which of the following structures of the eye functions like a shutter in the
camera analogy, allowing more or less light into the eye?
·lens
• retina
• cornea
• iris
iris
A sound wave will strike the first. • membrane of the oval window • membrane of the round window • tectorial membrane • tympanic membrane special sense organs 11 copyright Cl 20 13-2014 Dental Decks BIOCHEMISTRY /PHYSIOLOGY
tympanic membrane
tympanic –> membrane of oval –> move perilymph in bony labirynth of cohclea and endolymph in membranous labirynth
endolymph –> basiar membranes vibrate –> stimulate hairs of Corti –> transmit
inner ear = membranous and bony labyrinth
vestibule (utricle and saccule) - balance
semicircular canals - equilibrium
cochlea - vestibular and basilar meambranes
balance in inner ear
utricle and saccule, vestibule
endolymph vs perilymph
membranous vs bony labyrinth
also endolymph transmits further: vibrates basilar membrane –> hairs of Corti
Your patient just returned from an ophthalmology appointment where
she received tropicamide to induce mydriasis. What significance does
this have on her dental appointment?
• the patient can’t distinguish colors when choosing denture teeth
• the patient will be extra sensitive to the overhead dental light
• the patient will have trouble seeing without bright light
• the patient will experience blurry vision
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BIOCHEMISTRY /PHYSIOLOGY
• the patient will be extra sensitive to the overhead dental light
miosis - constriction
mydriasis - dilation
myopia - eye too long, far objects focus in front of retina
hyperopia - focus is behind retina
astigmatism - curvature not uniform
presbyopia - loss of elasticity of lens
The normal range for hemoglobin is different between the sexes and is
approximately ___ for men and ___ for women.
• 5-8 grams per deciliter, 2-3 grams per deciliter
• 9-11 grams per decili ter, 7-9 grams per deciliter
• 13-18 grams per decili ter, 12-16 grams per deciliter
• 20-22 grams per decili ter, 18-21 grams per deciliter
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13-18, 12-16
each Hb - 4 Fe
leaving lung - 98% saturated
returning is 75% saturated
only 30% of CO2 binds to Hb, rest is dissolved
CO2 binds to protein portion
oxygen - to Fe (coordination bonds, loose)
congestive heart failure and COPD - high Hb
anemia, cirrhosis and HYPERthyroidism - low Hb
Bohr effect in Hb bnding
acid in tissues assists unloading
high Hb
polycythemia, COPD, congestive HF
low Hb
anemia, hyperthyroidism, cirrhosis
Although albumin accounts for only 60% of the total plasma protein, it provides
80% of the colloid osmotic pressure of the plasma.
The colloid osmotic pressure is necessary to prevent edema.
• both statements are true
• both statements are fa lse
• the first statement is true, the second is fa lse
• the first statement is fa lse, the second is true
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both true
80% of colloid pressure in plasma is albumin
loss of albumin –> hyper Bb emia and jaundice
The principal hormone for serum calcium regulation is: • calcitonin • parathyroid hormone • thyroid hormone • vasopressin/antidiuretic hormone
PTH via kidneys and bones
calcitonin is complementary
increased Ca - hyperD, hyperPTH
decreased Ca - diarrhea, hypo
PTH increases serum Ca and decreases P
vit D increases both P and Ca
Which of the following blood equations is correct? • serum = plasma- fibrinogen • plasma = serum -fibrinogen • serum = hematocrit + plasma • hematocrit = fibrinogen - plasma blood
• serum = plasma - fibrinogen
serum - no fibrin and other coagulation products
plasma = blood - formed elements; 55% of blood
45% of blood - formed elements
The general term for reactions that prevent or minimize loss of blood
from the vessels if they are injured or ruptured is:
• erythropoiesis
• syneresis
• homeostasis
• hemostasis
hemostasis
guarding against blood loss: cnstriction, plt aggregation, coagulation
prothrombin activator = X+V
thrombin coverts fibrinogen to fibrin
liver synthesizes factors II, VII, IX and X
clotting factors from liver
2, 7, 9, 10
prothrombin activator
5+10
draw out clotting pathways
NOW
tissue factor and 7a contact in injury
Iron, the most important mineral in the formation of hemoglobin, is absorbed
mainly in the ___ and is only absorbed as ___ .
• ascending colon, Fe3•
• sigmoid colon, Fe2•
• duodenum, Fe2+
• jejunum, Fe2+
duodenum, Fe2+
ferritin and hemosiderin for intracellular iron storage
75% in hemoglobin ad myoglobin
in duodenum –> binds to apotransferrin –> transferrin in plasma for transport
excess - in liver
vit C promotes Fe uptake (antioxidant)
Bb - product of heme degradation
transferrin vs ferritin
trans is transport
ferritin and hemosiderin - storage
effects of vit D on Ca and P
both increase
which vitamin promotes Fe absorption
C! reduces to Fe2+
absorbed in duodenum
0 blood type is referred to as: • universal donor • universal recipient • neither of t he above blood
universal donor
don’t produce AB antigens
AB - no AB antibodies, universal recipients
O blood type - no antibodies or no antigens?
no antigens
AB type is vv
The most important feature of the hemoglobin molecule is its ability to
combine loosely and reversibly with oxygen.
Oxygen does not combine with the two positive bonds of the iron in the
hemoglobin molecule. Instead it binds loosely with one of the so-called
coordination bonds of the iron atom.
• both statements are true
• both statements are fa lse
• the first statement is true, the second is fa lse
• the first statement is fa lse, the second is true
both true
oxyHb dissociation curve to right
to right means harder to saturate, affinity decreased, dissociation enhanced
low PO2, increased acid, increased temperature, increased BPG, increased CO2
p50 - half-saturated Hb
27 mmHg
dissociation curve to left
means higher affinity, harder to dissociate
higher PO2, higher PH, lower BPG
what is Hb curve
binding vs pressure
All of the following are common subunit hemoglobin chains EXCEPT one. Which one is the EXCEPTION? • alpha • beta • gamma • delta • epsilon
epsilon
normal Hb - 2 alpha and 2 beta, fetal is 2 alpha nad 2 gamma
Fe is Fe2+
combination with CO2 is at protein portion
CO has higher affinity
metHb has Fe3+ and can’t bind oxygen
The most common form of hemoglobin in the adult human being i s: • hemoglobin H • hemoglobin S • hemoglobin M • hemoglobin A • hemoglobin C
A; 2 alpha and 2 beta
H is 4 beta chains (defect in alpha, thalassemia)
S - val instead of glu, sickle cell; decreased solubility of deoxyHb
M - metHb (Fe3+, can’t bind)
C - lysine instead of glu, reduced RBC plasticity
HbH
alpha-thalassemia, 4 beta chains
HbM
metHb, Fe3+, can’t bind
HbS
sickle, val instead of glu, reduced solubility of deoxy
HbC
reduced plasticity, lys instead of glu
In the normal person, about 90% of all erythropoietin is formed in the
—‘·the remainder is formed mainly in the __ _
• kidneys, liver
•liver, kidneys
· bone marrow, kidneys
· kidneys, bone marrow
kidney; liver
erythrocytes contain Hb and carbonic anhydrase
in adults made in marrow of membranous bones (vertebrae, sternum, ribs, ilia)
Which ofthe following will shift the oxygen-hemoglobin dissociation curve to the right? Select all that apply. • increased carbon dioxide concentration • increased blood temperature • increase in pH • increased 2,3-biphosphoglycerate (BPG)
increased CO2, increased t, decreased pH, increased BPG
dissociation curve to right mena slower affinity, easier to unload
BPG forms in hypoxia
BPG?
forms in hypoxia, shifts curve to right
The substance intrinsic factor, essential for absorption of vitamin B12 in the ileum, is secreted by the: • chief cell s • parietal cell s • gastrin cells • mucous cells
parietal
oxyntic gland = mucous, chief and parietal
vagus - strongest stimulant of all secretion
All of the following slow gastric emptying EXCEPT one. Which one is the
EXCEPTION?
• gastri c inhibitory peptide
• activation of the sympathetic nervous system
• secretin
• activation of the enteric nervous system
• cholecystokinin
• activation of the parasympathetic nervous system
parasymps
CKK, secretin and gastric inhibitory peptide inhibit emptying
feedback from small intestine inhibits emptying
gastrin and presence of food in stomach enhance emptying
sympathetic inhibits GI motility
but parasymp and ACh stimulate digestive activities
contractions in GI: peristalsis and mixing/segmentation
Three of the following signaling molecules are important in causing
pancreatic secretion. Which of the following is NOT one of them?
• cholecystokinin
• secretin
• acetylcholine
• epinephrine
Epi
ACh - from vagus
CKK - secr by duodenum and upper jejunum
secretin - same
ACh and CKK stimulate pancreatic enzymes
secretin stimulates water and bicarbonate in pancreatic ducts
CKK and secretin secreted in
duodenum and jejunum
ACh and CKK effect on pancreas
enzymes from acinar
secretin effect on pancreas
water and bicarb from ducts
Your patient comes in and says that his physician has diagnosed him with pernicious
anemia. As you know, this is caused by the malabsorption of vitamin
812.
1. What protein is crucial in the absorption of vitamin B12?
• gastrin
• intrinsic factor
• pepsin
2. What cell is responsible for the faulty glycoprotein implicated in pernicious anemia?
• chief cell s
• parietal cell s
• mucous neck cell s
•gcells
3. What type of glands within the stomach contain these cells?
• pyloric glands
• gastric glands
• cardiac glands
• none of the above
1 - IF
2 - parietal
3 - gastric
oxyntic = gastric
pyloric - mucus + gastrin
oxyntic - parietal + peptic + mucous neck
HCl secretion increased by ACh, gastrin and histamine
what increases HCl secretion
histamine, gastrin, ACh
Distension of the intestine by chyme and parasympathetic neural activity
___ the contractile force, while sympathetic neural activity ____ it.
• decrease, increases
• increase, decreases
• have no effect on, increases
• none of the above
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increase, decrease
Which of the following pairings regarding the absorption in the small intestine is INCORRECT? • fructose -- facilitated diffusion • free fatty acids -- simple diffusion • dipeptides -- primary active transport • glucose -- secondary active transport 30
• dipeptides – primary active transport
they are actually SECONDARY active transport
free FAs diffuse simply after being emulsified by bile salts and pancreatic lipase
dipeptides and AAs: Na-dependent transporter (AA) or H-dependent contransport
sugars - secondary active transporters driven by Na gradient
absorption of free FAs
simple diffusion when emulsified by bile salts and pancreatic lipase
absorption of monosaccharides
secondary active transport, driven by Na
absorption of peptides
AA: secondary active w/ Na
dipeptides: H-driven secondary active
Place the following phases of gastric secretion in their proper order: • intestinal phase • gastric phase • cephalic phase 31
cephalic gastric intestinal
intestinal phase (CKK, secretin, gastric inhibitory peptide) inhibit stomach activity
presence of food and gastrin enhances
gastrin on stomach activity
enhances
As an action potential reaches a skeletal muscle cell, what is the order of
activation by which the signal is transmitted internally through the muscle
cell so that contraction results?
• acetylcholine, calcium, t roponin, tropomyosin, myosin heads
• calcium, acetylcholine, t roponin, tropomyosin, myosin heads
• acetylcholine, calcium, tropomyosin, t roponin, myosin heads
• calcium, acetylcholine, t ropomyosin, t roponin, myosin heads
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ACh, Ca, troponin, tropomyosin, myosin heads
dissociation of actin-myosin when ATP binds to myosin
The immediate source of energy for muscle contraction is ATP binding to
myosin. The ATP pool, however, is extremely small and has three sources
of replenishment. Which of the following is NOT a source?
• creatine phosphate
• lactic acid
• glycogen
• cellular respiration
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lactic acid
creatine phosphate + ADP creatine + ATP
glycogen - 2 ATPs
As you complete the seating of a crown, you ask your patient to tap lightly on
the articulating paper. Which of the following statements correctly describes
the physiology responsible for a patient’s light tapping on the articulating
paper?
• the “all or nothing” phenomenon occurs; all fibers in the masseter and medial
pterygoid are partially stimulated, causing a light contraction
• fractionation occurs; each muscle fiber involved is stimulated only by a fraction of
the alpha-motor neurons innervating the fiber, and so the fibers contract lightly
• fractionation occurs; only a few small alpha-motor units are recruited, and the masseter
and medial pterygoid muscles contract lightly
• the”all or nothing” phenomenon occurs; the muscles that close the mouth are stimulated
ful ly but are countered by stimulation of the muscles that open the mouth,
causing a slight closing of the mouth
fractionation; few small motor units recruited
small tension required - small units recruited
greater force needed - larger motor units recruited
neuromuscular jxn - ACh nicotinic
All of the following statements comparing fast and slow-twitch muscle fibers
are true EXCEPT one. Which one is the EXCEPTION?
• fast-twitch fibers are about twice as large in diameter than slow-twitch muscle fibers
• slow-twitch fibers have a greater resistance to fatigue than fast-twitch muscle fibers
• the enzymes of oxidative phosphorylation are considerably more active in slowtwitch
fibers than in fast-twitch fibers
• fast-twitch fibers contain more mitochondria and myoglobin than slow-twitch
muscle fibers
• fast-twitch fibers can deliver extreme amounts of power for a few seconds to a
minute versus slow-twitch fibers
fast-twitch fibers contain more mitochondria and myoglobin than slow-twitch
muscle fibers
this is false
fast mm - rapid powerful actions low oxidative capacity, low resistance to fatigue very anaerobic, not a lot of m/ch extensive SR low myoglobin, high glycogen
slow mm - prolonged
all vv
oxidative capacity related to number of capillaries, myoglobin content and number of m/ch
which mm type is a lot of myoglobin
slow
also very oxidative
fast is anaerobic and glycogen instead
which mm type is glycogen
fast
also very anaerobic and not many m/ch
in which mm more SR
fast
All of the following statements concerning muscle spindles are true
EXCEPT one. Which one is the EXCEPTION?
• they are found within the belly of muscles
• they consist of small, encapsulated intrafusal f ibers and run in parallel with the
main muscle f ibers (extrafusal f ibers)
• the finer the movement required, the smaller the number of muscle spindles in a
muscle
• they detect both static and dynamic changes in muscle length
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• the finer the movement required, the smaller the number
of muscle spindles in a muscle
***This is false; the finer the movement required, the greater the number of muscle
spindles in a muscle.
sensory organs (proprioception) in mm - 1 - muscle spindles (measure length): specialized intrafusal fibers, sensory terminals, motor terminals (gamma); when stretched, activate alpha motor neurons
alpha for skel mm, gamma for spindle
runs parallel with main fibers
2 - Golgi tendon organs - measure mm tension (=contraction); inhibit alpha motor
opposite of spindle
mm spindle senses what
measures length, recruits more alphas by its gamma motor
intrafusal, parallel to main
finer movement - more spindles
When a muscle is ___, the ___ reflex reacts. This reflex is considered
__ , and the result is __ _
• contracted/golgi tendon/monosynaptic/contraction
• stretched/golgi tendon/ disynaptic/ relaxation
• stretched/ stretch/monosynaptic/contraction
• contracted/ stretch/disynaptic/relaxation
• stretched/ stretch/monosynaptic/ relaxation
when mm stretched, stretch reflex
monosynaptic, results in contracion
detected by spindles
like knee jerk
golgi tendon reflex is reverse; disynaptic, results in relaxation
flexor withdrawal reflex (like touching hot stove) - polysynaptic
spindle reflex =
when stretched –> contraction (like knee jerk)
monosynaptic
activates alpha units
tendon reflex =
Golgi tendon organs
when contracted –> relaxation
disynaptic
inhibits alpha units
flexor reflex =
like hot stove
polysynaptic in response to pain
Most reflex arcs have: • three basic elements • four basic elements • f ive basic elements • six basic elements muscles
six
receptor, sensory (afferent), integration center, interneuron, motor (efferent) and effector
spinal reflexes - stretch and tendon reflex
In a single muscle, there are both intrafusal and extrafusal fibers. All of the
following statements are true in the description of intrafusal fibers EXCEPT
one. Which one is the EXCEPTION?
• contain nucl ear bag f ibers that detect fast, dynamic changes
• innervated by gamma-motor neurons
• contain nuclear linking f ibers that transmit afferent signals
• encapsulated in sheaths to form muscle spindles
• contain nuclear chain fibers that detect static changes
• contain nuclear linking fibers that transmit afferent signals
extrafusal fibers - bulk of mm, innerv by efferent alpha neurons
intrafusal - encapsulated, form spindles, innerv by efferent gamma
types: nuclear bag (fast, dynamic changes; fast ia afferents) and nuclear chain (static changes, slow II afferents and Ia too)
no such thing as nuclear linking?
efferents and afferents of intrafusal
intrafusals form spindles, encapsulated
gamma efferents
bag: fast dynamic, Ia afferents
chain: slow, II and Ia afferents
Within the spinal cord, the H-shaped mass of gray matter is divided into
horns, which consist mainly of neuron cell bodies. Cell bodies in the
posterior (dorsal) horn relay:
• voluntary motor impulses
• reflex motor impulses
• sensory impulses
• all of the above
sensory
anterior is motor
Which of the following structures plays a role by associating with the
corticospinal system to control complex patterns of motor activity?
• hypothalamus
• hippocampus
• basal ganglia
• thalamus
basal ganglia
= striatum (caudate + putamen) globus pallidus, substantia nigra and subthalamic nucleus
lateral and around thalamus
dmg - Parkinsons and Huntington’s
thalamus relays sensory
hypothalamus - 4Fs
hippocampis - memory and learning
sensory relay
thalamus
memory and learning
hippocampus
homeostasis and 4Fs
hypothalamus
corticospinal and motor contrrol
basal ganglia
The main structures of the hindbrain include which of the following? Select all that apply. • medulla oblongata • pons • cerebral hemispheres • cerebellum
medulla, pons and cerebellum
medulla - reflexes
pons - respiratory/urinary centers; facial sensation/motor, control of eye mvmt
cerebellum - equiibrium
limbic is in temporal lobe
where is limbic
temporal lobe
pons
respiratory/urinary
eye mvmt
sensory and motor of face
diencephalon =
thalamus and hypothalamus
temporal fxx
hearing, language comprehension, memory storage and recall
memory storage and recall lobe
temporal
frontal fxx
motor, judgment, reasoning, language expression, social behavior
language expression lobe
frontal
social behavior lobe
frontal
judgment lobe
frontal
awareness of body shape lobe
parietal
sensation lobe
parietal
parietal fxx
somatosensory + body image and awareness
For the following questions, use the same answer choices.
1. Which of the following has the thickest layer of muscle?
2. Which of the following is the major regulator of blood flow?
3. Which of the following contain valves?
4. Which of the following are large vessels that contain deoxygenated
blood? Is there an EXCEPTION to this rule?
5. Which has higher compliance, veins or arteries?
• veins
• arteries
• capillaries
• arterioles
• venules
arteries - thickest mm
arterioles - regulator of blood flow
veins - valves, large compliance, carry deoxygenated (except pulmonary)
Which structures are the site of highest resistance in the cardiovascular system? • veins • arteries • arterioles • venules When these structures are acted on by nitric oxide or adenosine, they will: • constrict • dil ate • stay the same This will affect total peripheral resistance in what way? • increase • decrease • stay the same
arterioles
dilate
decrease
a1 adrenergic receptors - arterioles
b2 adrenergic - skel arterioles
b1 - heart mm and kidney
b blockers - antuHTN
b1 adrenergic receptors
heart and kidney
beta bockers are antiHTN
For the following questions, use the same answer choices.
1. Which circuit supplies the alveoli of the lungs?
2. Which circuit supplies the connective tissue of the lungs?
3. Which has a lower blood pressure?
4. Which has a greater volume of blood flow per minute?
5. Which circuit involves the thick-walled left ventricle?
• pulmonary circuit
• systemic circuit
• both
• neither
alveoli supplied by pulmonary connective of lungs by systemic lower pressure in pulmonary circuit greater volume of blood flow per minute in neither LV is from systemic
pulmonary circuit supplies ONLY alveoli
Your patient tells you that he just had a heart bypass operation. He says that
they used a vein from his leg and re-routed blood that previously flowed
through his left anterior descending coronary artery (often referred to as the
widow maker). Which of the following explanations is correct in answering
how a vein can adequately replace an artery?
• although veins have higher compliance normally, when under high pressure, compliance
decreases and so the vein acts very similar to an artery when put in these conditions
• although veins have lower compliance normally, when under the high pressure, compliance
increases and so the vein acts very similar to an artery when put in these conditions
• although veins have higher resistance normally, when under the high pressure, resistance
decreases and so the vein act s very similar to an artery when put in these conditions
• although veins have lower resistance normally, when under high pressure, resistance increases
and so the vein acts very similar to an artery when put in these conditions
although veins have higher compliance normally, when under high
pressure, compliance decreases and so the vein acts very similar to
an artery when put in these conditions
at rest most blood is in systemic veins
compliance can decrease under high pressure, so veins can accomodate
Your patient presents with stage 1 hypertension. His blood pressure is
15O mmHg/99 mmHg, confirming his diagnosis.
l. ls his pulse pressure normal, high, or low?
2. To bring his blood pressure down to normal, he could attempt to do what to the total
peripheral resistance?
• increase it
• decrease it
3. Normally, the mean pressure in the aorta is about 100 mmHg. Eventually, the blood will
return via the vena cava at a pressure of 4 mmHg. Where did the blood pressure decrease
the most as blood traveled through the body?
• large veins
• large arteries
• arterioles
• venules
• capillaries
high
decrease
arterioles
pulse pressure = systolic - diastolic
aorta 100mmHg, arterioles 30mmHg, vena cava 4 mmHg
There are two general causes of extracellular fluid edema:
(1) abnormal leakage of fluid from the plasma to the interstitial spaces
across the capillaries, and (2) failure of the lymphatics to return fluid from
the interstitium back into the blood.
The most common clinical cause of interstitial fluid accumulation is
excessive capillary fluid filtration.
• both statements are true
• both statements are fa lse
• the first statement is true, the second is fa lse
• the first statement is fa lse, the second is true
both true
capillary filtration: increased hydrostatic pressure, decreased plasma colloid
positive net –> filtration; negative net –> absorption back into capillaries
hydrostatic favors filtration, colloid osmotic favors reabsorption
Your patient has just finished her 2-hour appointment and is eager to get
out of the office. She stands up from the chair very fast, and quickly becomes
dizzy and nearly faints. This is termed orthostatic hypotension.
1. Which of the following receptors a re most important in the short-term regul ation of her
blood pressure and returning it to normal?
• stretch receptors in the carotid sinus
• chemoreceptors in the aortic bodies
• chemoreceptors in the carotid bodies
• stretch receptors in the pulmonary circul ation
2. This drop in blood pressure will cause what to happen?
• sympathetic impulses to increase
• parasympathetic impulses to increase
• both to increase
• neither to increase
3. The effect on the heart will be:
• increased heart rate, decreased stroke volume
• increased heart rate, increased stroke volume
• decreased heart rate, decreased stroke volume
• decreased heart rate, increased stroke volume
stretch in carotid (IX)
symp increase
increased HR and SV
It’s 4 o’clock on a Friday afternoon, and you are about to do a quick preparation and
restoration. When you give the injection, the patient complains of severe discomfort. You
realize you forgot to aspirate the needle first, and you have just injected into an artery.
1. Your needle passed through the artery layers in which order?
• tunica adventitia, tunica media, tunica intima
• tunica media, tunica intima, tunica adventitia
• tunica intima, tunica media, tunica adventitia
• tunica adventitia, tunica intima, tunica media
2. Judging by their relative thicknesses, which is the toughest vessel to puncture?
• artery
• vein
• capillary
3. Which layer is thicker: tunica media or tunica adventitia?
4. Which layer is innervated by the autonomic nervous system?
• tunica intima
• tunica media
• tunica adventitia
5. By puncturing this artery, you have hit the vessel with the greatest:
• resistance
• pressure
• cross-sectional area
• blood volume
adventitia-media-intima artery media media pressure
arteries - largest pressure
arterioles - largest resistance
capillaries - largest X-section
veins - largest volume
largest pressure
arteries
largest X-section
capillaries
