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A&P Spring Practice Questions > Cardiovascular, Lange > Flashcards

Cardiovascular, Lange Flashcards

1
Q

Whenever skeletal muscle blood flow increases, blood flow to other organs must decrease.

True

False

A

False

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2
Q

When a heart valve does not close properly, a sound called a “murmur” can often be detected as the valve leaks.

Would you expect a leaky aortic valve to cause a systolic or diastolic murmur?

A

Diastolic Murmur

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3
Q

The pressure in the aorta is normally about 100 mm Hg, whereas that in the pulmonary artery is normally about 15 mm Hg.

A few of your fellow students offer the following alterative hypotheses about why this might be so:

A) The right heart pumps less blood than the left heart.
B) The right heart rate is slower than the left heart rate.
C) The right ventricle is less muscular than the left ventricle.
D) The pulmonary vascular bed has less resistance than the systemic
bed.
E) The stroke volume of the right heart is less than that of the left
heart.
F) It must be genetics.

A

D) The pulmonary vascular bed has less resistance than the systemic
bed.

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4
Q

Usually, an individual who has lost a significant amount of blood is weak and does not reason very clearly.

Why would blood loss have these effects?

A
  • decreased CO
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5
Q

What direct cardiovascular consequences would you expect from an intravenous injection of norepinephrine?

A
  • increased HR
  • increased contractility
  • increased arteriolar constriction
  • increased venous constriction
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6
Q

The Fick principle implies that doubling the flow through an organ will necessarily double the organ’s rate of metabolism (or production) of a substance.

True

False

A

False

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6
Q

Which organ in the body always receives the most blood flow?

A

Lungs

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7
Q

Which of the following interventions will increase cardiac stroke volume?

A) increased ventricular filling pressure
B) decreased arterial pressure
C) increased activity of cardiac sympathetic nerves
D) increased circulating catecholamine levels

A

All (a,b,c,d)

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8
Q

Increases in sympathetic neural activity to the heart will result in an increase in stroke volume by causing a decrease in end-systolic volume for any given end-diastolic volume.

True

False

A

True

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9
Q

Three of these conditions exist during the same phase of the cardiac cycle and one does not. Which one is the odd one?

A) The mitral valve is open.
B) The ST segment of the ECG is occurring.
C) Ventricular volume is increasing.
D) Aortic pressure is falling.

A

B) The ST segment of the ECG is occurring.

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10
Q

With all other factors equal, myocardial oxygen demands will be increased to the greatest extent by which of the following?

A) increases in the heart rate
B) increases in coronary flow
C) increases in end-diastolic volume
D) decreases in arterial pressure
E) decreases in cardiac contractility

A

A) increases in the heart rate

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11
Q

Sympathetic neural activation of the heart will decrease which of the following?

A) heart rate
B) PR interval on the ECG
C) metabolic demands
D) coronary flow rate
E) cardiac contractility

A

B) PR interval on the ECG

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12
Q

The metabolic requirement of the heart muscle in any situation is always equal to how much external work the heart is doing in that situation.

True

False

A

False

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13
Q

Given the following information, calculate cardiac output and indicate if this is normal for a resting 70-kg man:

Systemic arterial blood oxygen concentration, [O 2]SA = 200 mL/L

Pulmonary arterial blood oxygen concentration, [O 2]PA = 140 mL/L

Total body oxygen consumption, VO 2 = 600 mL/min

A

Q = VO2 / [O2 sa - O2 pa]
Q = 600 / (200-140)
Q = 10 L/min

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14
Q

You hear a systolic murmur that seems to be coming from the right side of the heart.

A) Which valve condition(s) might be the cause of this abnormal sound?

B) Would you expect your patient to have pulmonary congestion?

A

A) Pulmonic valve stenosis or tricuspid valve regurgitation will both cause systolic murmurs.

B) No.

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15
Q

Which of the following arrhythmias might result in a reduced stroke volume?

A) paroxysmal atrial tachycardia
B) ventricular tachycardia
C) atrial fibrillation
D) ventricular fibrillation
E) third-degree heart block

A

All except E.

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16
Q

Describe the primary pressure abnormalities across the cardiac valve that are associated with:

A) aortic stenosis

B) mitral stenosis

A

A) Aortic stenosis produces a significant pressure difference between the left ventricle and the aorta during systolic ejection

B) Mitral stenosis produces a significant pressure difference

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17
Q

You notice an abnormally large pulsation of your patient’s jugular vein, which occurs at about the same time as heart sound, S 1.

What is your diagnosis?

A

Tricuspid Insufficiency/Regurgitation

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18
Q

Given the following data, name the abnormal valve, predict the type of murmur that might be detected.

Calculate the resistance to flow across this valve.

Aortic pressures (systolic/diastolic) = 150/100 mm Hg
Left ventricular pressures (systolic/diastolic) = 150/2 mm Hg
Left atrial pressures (systolic/diastolic) = 50/32 mm Hg
Heart rate = 60 beats/min
Stroke volume = 50 mL/beat

A
  • Mitral Valve Stenosis

R = ∆P/CO
R = 30/mm Hg/3 L/min
R = 10 mm Hg per L/min

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19
Q

Your 75-year-old male patient is alert with complaints of general fatigue. His heart rate = 90 beats/min and arterial pressure = 180/50 mm Hg.

A diastolic murmur is present. There are no ECG abnormalities identified and mean electrical axis = 10 degrees.

Cardiac catheterization indicates that LV pressure = 180/20 mm Hg and left atrial pressure = 10/3 mm Hg (as peak systolic/end- diastolic).

What abnormality is most consistent with these findings?

A

Aortic insufficiency.

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20
Q

Determine the direction of transcapillary fluid movement ( ) within a tissue, given the following data:
Capillary hydrostatic pressure, Pc = 28 mmHg
plasma oncotic pressure, πc = 24 mm Hg
tissue hydrostatic pressure, P i = −4 mm Hg tissue oncotic pressure, πi = 0 mm Hg

A

F = K [(Pc - Pi) - (π c- π i)]
F= K [ 28 -(-4) - 24 +0]
F = K x 8

Result is positive, indicating net movement of fluid out of the capillaries.

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21
Q

Which of the following conditions favor edema formation?

A) lymphatic blockage
B) thrombophlebitis (venous clot)
C) decreased plasma protein concentration
D) greatly increased capillary pore size

A

All (a,b,c,d)

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22
Q

Whenever cardiac output is increased, mean arterial pressure must also be increased.

True

False

A

False

23
Q

Acute rapid increases in arterial pulse pressure usually result from increases in stroke volume.

True

False

A

True

24
Q

Estimate the mean arterial pressure when the measured arterial pressure is 110/70 mm Hg.

A

MAP = DPB + 1/3 (SBP-DBP)
MAP = 83.32

25
Q

Which of the following is consistent with a normal mean arterial pressure but an abnormally high arterial pulse pressure?

A) low stroke volume
B) high heart rate
C) decreased total peripheral resistance
D) increased arterial stiffness
E) aortic valve stenosis

A

D) increased arterial stiffness

26
Q

Which of the following would increase blood flow through a skeletal muscle?

A) an increase in tissue P CO2
B) an increase in tissue adenosine
C) the presence of α-receptor-blocking drugs
D) sympathetic activation

A

A) an increase in tissue P CO2
B) an increase in tissue adenosine
C) the presence of α-receptor-blocking drugs

27
Q

Autoregulation of blood flow implies that arterial pressure is adjusted by local mechanisms to ensure constant flow through an organ.

True

False

A

False

28
Q

Coronary blood flow will normally increase when:

A) arterial pressure increases .
B) the heart rate increases .
C) sympathetic activity increases .

A

All

29
Q

How would a stenotic aortic valve influence coronary blood flow?

(question to ask Schmidt)

A
  • Higher Left Ventricle Pressure are needed to eject blood through the stenotic valve
  • increased Myocardial oxygen consumption, increasing coronary flow.
30
Q

Arteriolar constriction tends to do which of the following?

A) decrease total peripheral resistance
B) decrease mean arterial pressure
C) decrease capillary hydrostatic pressure
D) increase transcapillary fluid filtration
E) increase blood flow through the capillary bed

A

C) decrease capillary hydrostatic pressure

31
Q

When an organ responds to an increase in metabolic activity with a decrease in its arteriolar resistance, this is known as

A) active hyperemia
B) reactive hyperemia
C) autoregulation of blood flow
D) flow-dependent vasodilation
E) metabolic vasoconstriction

A

A) active hyperemia

32
Q

In which of the following organs does decreased P O 2 cause arteriolar vasoconstriction?

A) lungs
B) skin
C) skeletal muscle d. brain
E) none of the above

A

A) lungs

33
Q

Coronary blood flow occurs largely during diastole.

True

False

A

True

34
Q

Which of the following will decrease the mean circulatory filling pressure?

A) increased circulating blood volume
B) decreased arteriolar tone
C) increased venous tone

A

None of the choices

35
Q

What determines central venous pressure?

A

Central venous pressure always settles at the value that makes cardiac output and venous return equal

Anything that shifts the cardiac function curve or the venous return curve affects central venous pressure

36
Q

According to the Starling law, cardiac output always decreases when central venous pressure decreases.

True

False

A

False

37
Q

In a steady state, venous return will be greater than cardiac output when

A) peripheral venous pressure is higher than normal
B) blood volume is higher than normal
C) cardiac sympathetic nerve activity is lower than normal

A

None.

Venous return must always equal cardiac output in the steady-state situation.

38
Q

What approaches might a physician logically pursue in an attempt to lower a patient’s cardiac preload?

A
  • Diuretic drugs,
  • Vasodilator drugs
39
Q

In a severely dehydrated patient, you might expect to find:

A) a depressed cardiac function curve
B) an increased mean circulatory filling pressure
C) an increased central venous pressure
D) distended jugular veins
E) decreased cardiac output

A

E) decreased cardiac output

40
Q

If you gave a blood transfusion to a patient who had recently experienced a severe hemorrhage, you would expect.

A) to expand arterial volume
B) to expand venous volume
C) to decrease central venous pressure
D) to decrease the mean circulatory filling pressure
E) to reduce cardiac output

A

B) to expand venous volume

41
Q

Which of the following would directly (by themselves in the absence of any compensatory responses) tend to decrease central venous (cardiac filling) pressure?

A) increased sympathetic nerve activity to only the heart
B) increased parasympathetic nerve activity to only the heart
C) increased blood volume
D) decreased total peripheral resistance
E) immersion in water up to the waist

A

A) increased sympathetic nerve activity to only the heart

42
Q

Consider the various components of the arterial baroreceptor reflex and predict whether the following variables will increase or decrease in response to a rise in arterial pressure.

A) arterial baroreceptor firing rate
B) parasympathetic activity to the heart
C) sympathetic activity to the heart
D) arteriolar tone
E) venous tone
F) peripheral venous pressure
G) total peripheral resistance
H) cardiac output

A

A & B will increase

D –> H will decrease

42
Q

Massage of the neck over the carotid sinus area in a person experiencing a bout of paroxysmal atrial tachycardia is often effective in terminating the episode.

Why?

A
  • Causes arterial baroreceptors to fire, which in turn increases parasympathetic activity from the medullary cardiovascular centers.
  • This can either slow the pacemaker activity or interrupt a reentry tachycardia and allow a more normal rhythm to be established.
43
Q

Your patient has lower-than-normal mean arterial pressure and higher-than-normal pulse rate. Which of the following are possible diagnoses?

A) low blood volume
B) anxiety
C) a cardiac valve problem
D) elevated intracranial pressure

A

A) low blood volume
C) a cardiac valve problem

43
Q

In the normal operation of the arterial baroreceptor reflex, a cardiovascular disturbance that lowers mean arterial pressure will evoke a decrease in

A) baroreceptor firing rate
B) sympathetic nerve activity
C) heart rate
D) total peripheral resistance
E) myocardial contractility

A

A) baroreceptor firing rate

44
Q

If your patient’s mean systemic arterial pressure changes, it must be because of changes in:

A) the heart rate and/or myocardial contractility
B) cardiac output and/or total peripheral resistance
C) blood volume and/or venous tone
D) sympathetic and/or parasympathetic nerve activity
E) arterial compliance and/or stroke volume

A

B) cardiac output and/or total peripheral resistance

45
Q

For several days after an extended period of bed rest, patients often become dizzy when they stand upright quickly because of an exaggerated transient fall in arterial pressure (orthostatic hypotension).

Why might this be so?

A
  • During extended bed rest, patients tend to lose rather than retain fluid and end up with lower-than-normal blood volumes.
  • Because of low blood volume, central venous pressure and cardiac filling are significantly reduced when the patient assumes an upright posture.
  • short-term compensatory actions (increased sympathetic drive, skeletal muscle pump, and respiratory pump) may be inadequate and blood pressure may fall.
  • This may lead to a decrease in brain blood flow and dizziness ensues.
46
Q

The “iron lung,” used to help polio victims breathe in the mid- 20th century, applied an external intermittent negative pressure to the patient’s thoracic cavity. How might this be better than positive-pressure artificial ventilation of the patient’s lungs?

A
  • The external negative pressure served to expand the thorax and “pull” air into the lungs through the patient’s airways in much the same way that the thoracic muscle and diaphragm expand the thorax in normal breathing.
  • This method of ventilating the lungs did not have the adverse cardiovascular consequences that positive-pressure artificial ventilation has.
47
Q

All of the following tend to occur when a person lies down.

Which one is the primary disturbance that causes all the others to happen?
A) The heart rate will decrease.
B) Cardiac contractility will increase.
C) Sympathetic activity will decrease.
D) Parasympathetic activity will increase.
E) Central venous pressure will increase.

A

E) Central venous pressure will increase.

48
Q

Which of the following represents a normal compensatory response to chronic endurance exercise training?

A) an increase in circulating blood volume
B) an increase in the resting heart rate
C) an increase in resting mean arterial pressure
D) a decrease in resting stroke volume
E) a decrease in resting blood flow to the kidneys

A

A) an increase in circulating blood volume

49
Q

Aortic stiffness may increase substantially with old age. What is/are the expected consequences of this change?

A) an increase in total peripheral resistance
B) an increase in stroke volume
C) an increase in pulse pressure
D) an increase in mean arterial pressure

A

C) an increase in pulse pressure

50
Q

Left ventricular chamber enlargement with congestive heart failure increases the wall tension required to generate a given systolic pressure.

True

False

A

True

51
Q

Compression stockings are often used by people with congestive heart failure.

Why?

A
  • Stockings counteracts the tendency for high peripheral venous pressures to cause edema in the lower extremities.
  • Aid in keeping fluid within the vascular circulation.
52
Q

Would compression stockings be helpful for someone with a large clot in a major vein (deep vein thrombosis).

A

Yes.

  • A clot in a large vein can increase upstream venous pressure and lead to significant edema, swelling, pressure, and pain.
  • A compression stocking can be used to minimize these symptoms but will not correct the primary problem.

A&P Spring Practice Questions (8 decks)

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