Chapter 15 Flashcards
The apical heartbeat in a adult is best heard at the level of the A. Diaphragm B. first rib C. Fifth intercostal space D. Seventh intercostal space
C. Fifth intercostal space
The apex or conical point of the heart beats against the wall of the thorax between the fifth and sixth ribs in an average adult
The membrane closest to the heart muscle is the A. Fibrous pericardium B. visceral pericardium C. Parietal pericardium D. Peritoneum
B. visceral pericardium
The visceral pericardium is the serous membrane on the heart that fuses in the embryo with the outer layer of the heart called the epicardium, causing the two terms in the adult to be interchangeable
What is a prominent symptom of pericarditis
Severe chest pain
Inflammation of the pericardial sac causes an increase in friction between the heart and membranes resulting in severe chest pain
Which part of the heart is usually damaged by scarlet fever or syphilis?
Endocardium
The atria will empty during
Atrial systole
During the contraction phase of the atria, or atrial systole, the pressure is sufficient to propel the remaining blood out of the atrial chambers, the chambers fill during relaxation or diastole
The first heart sound results when the
A-V valves close
The force of the atrioventricular valves slapping shut produces the first heart sound or Lubb, the second sound is from the closure of the semilunar valves
A stethoscope placed at the tip of the sternum will best be able to detect which sound
Tricuspid valve
The tricuspid valve can be heard at the tip of the sternum while the bicuspid valve is heard from the fifth intercostal space
Which fiber system is the first to depolarize in a cardiac cycle?
Sinoatrial node
In the cardiac cycle, the sinoatrial node is the first area of specialized cells to conduct an impulse and is therefore called the pacemaker
Which chamber of the heart contains the pacemaker (sinoatrial node)
Right atrium
The sinoatrial node or pacemaker is an area of specialized cells in the right atrial wall that initiates the cardiac cycle
The amount of blood ejected by the left ventricle each minute is calculated from which from which formula
Heart rate X stroke volume
The cardiac output is the amount of blood ejected by the heart each minute and is about 70X70 or 4,900 ml per minute (male)
The three factors that contribute yo arterial blood pressure are cardiac output, blood volume and
Resistance
The resistance to the flow of blood, which is related to its viscosity is a major determinant of pressure
The central venous pressure is the pressure in the
Right atrium
A CVP results in the right atrium from the return of all the veins and Amy be assessed by measuring jugular vein movements or pressure
Which are the first vessels to branch off from the aorta A. Right subclavian B. left subclavian C. Brachiocephalic D. Coronary arteries
D. Coronary arteries
The two coronary arteries are the first branches off the base of the aorta
The three arteries that arise from the aortic arch are the left subclavian, left common carotid and A. Right subclavian B. right common carotid C. Brachiocephalic D. Celiac
C. Brachiocephalic
The brachiocephalic artery is a short merger of the right common carotid and right subclavian arteries.
The left gastric, splenic and common hepatic arteries come from the A. Superior mesenteric B. celiac C. Splanchnic D. Inferior mesenteric
B. celiac
The first abdominal unpaired artery is the short celiac artery which branches into three main divisions
Freshly oxygenated blood enters the heart through the ? And is pumped out the ?
Left atrium. Aorta
The pulmonary circulation ends in the left atrium and the system circulation begins with the aorta
Someone suffering a heart attack in his anterior lower right ventricle probably had a blockage in which coronary artery? A. Anterior interventricular artery B. circumflex artery C. Posterior interventricular artery D. Marginal artery
A. Anterior interventricular artery
The anterior portion of the ventricles is served by the anterior interventricular artery or LAD
When do the AV valves close during the cardiac cycle
When ventricular pressure exceeds that of the atria
Pressure differences between the atria and ventricles open and close AV valves
How does the impulse to contract slow down slightly before it is transferred into the ventricles?
Junctional fibers leading into the AV node have very small diameters
The impulse travels slowly from the SA node to the AV node
what does the electrocardiogram (ECG) QRS wave indicate is happening in the heart
The ventricles are depolarizing while the atria repolarize
The atrioventricular sulcus separates the
Atria and ventricle areas
The atrioventricular sulcus is a groove that encircles the outer part of the heart, the inter ventricular sulcus separates the right from left ventricle
Blood from the cardiac muscle itself drains into
The coronary sinus
The coronary sinus is a vein which represents a merger of all of the veins that drain the heart tissue and directs the blood into the right atrium
Mitral valve prolapse is a condition which causes blood to back flow into the
Left atrium
The normal function do the mitral or bicuspid valve is to prevent back flow of blood into the left atrium from the left ventricle
Which one contains blood with relatively high oxygen content A. Left ventricle B. right ventricle C. Right atrium D. Superior vena cava
A. Left ventricle
The left ventricle receives the blood which has been oxygenated in the lungs via the left atrium
Which one contains blood with relatively low oxygen content A. Left ventricle B. aorta C. Pulmonary vein D. Pulmonary artery
D. Pulmonary artery
Which one does not belong with the others A. Right coronary artery B. left coronary artery C. Circumflex artery D. Anterior interventricular artery
A. Right coronary artery
The left coronary artery branches into the circumflex and the anterior interventricular arteries.
What term indicates that tissue in the heart has died
Infarction
A myocardial infraction (MI) or heart attack occurs from lack of oxygen because of a restricted blood flow or ischemia.
What term refers to the severe chest pain evident during an attack of the myocardial ischemia ?
Angina
When does blood flow into the coronary arteries?
During ventricular relaxation
Because of the structure and pressure differences among the vessels leaving the heart, blood actually flows best to the myocardium when the ventricles are relaxing (diastole)
About ?% of the atrial blood flows into the ventricle before the atria contract
70%
About 70% of the blood from the atria has already entered the ventricles before the atria contract to propel the 30% remaining
The ? Allows the atria to communicate with the ventricles
A-V bundle
Which part of the heart is the last to become excited during a cardiac cycle A. Apex B. atria C. Ventricular septum D. Superior ventricular region
D. Superior ventricular region
The purkinje fibers spread their impulses down the ventricles and up the sides of the walls to terminate near the base of the heart (superior ventricle region )
Which area allows the atria to completely empty as the ventricles fill with blood A. A-V node B. A-V bundle C. S-A node D. Purkinje fibers
A. A-V node
The atrioventricular node has junctional fibers which will slightly delay the passage of the impulse, allowing the ventricles sufficient filling time
The cardiac reflex control centers are located within the
Medulla oblongata
The baroreceptors located in the ? Respond to stretching by slowing the rate of the heart
Aortic arch
The purpose of the medullary cardiac centers is to
Maintain blood pressure
The purpose of the cardiac centers is to maintain blood pressure homeostatically, heart rates rise and fall in response to metabolic demand.
The increase in heart rate caused by seeing a wild dog run after you is probably the result of the ?
Hypothalamus
The hypothalamus is involved with what could be considered emotional responses such as a sudden increase in heart rate or irregular beat in situations of fear or anxiety
In a ECG where does the repolarization of the atria occur?
The QRS complex
In the ECG, the time taken for an implies to travel from SA node to the AV node is evidenced in the
P-Q interval.
The P wave is the initiation of the cycle and is followed by the QRS complex which implies that the impulse has spread from the atria to the A-V node near the ventricles.
The most serious and life threatening arrhythmia of the heart is
Fibrillation
The ? Layer of an artery contains the greatest amount of smooth muscle A. Endothelium B. tunica intima C. Tunica media D. Tunica adventitia
C. Tunica media
Which one does not have the ability to contract A. Veins B. arteries C. Venules D. Capillaries
D. Capillaries
Capillaries are thin walled vessels that do not have smooth muscle but are specialized for nutrient exchanges
Which capillary beds have the greatest permeability ? A. Liver B. smooth muscle C. Pancreas D. Heart
A. Liver
The liver, spleen and bone marrow capillaries have the largest pores and even allow proteins to cross
Which area contains the tightest capillary endothelial junctions? A. Spleen B. skeletal muscle C. Brain D. Thyroid gland
C. Brain
The tight junctions in the cranial capillaries creat a blood-brain barrier that only allow certain substances to pass
Which one totally lacks capillaries? A. Spinal cord B. cartilage C. Dermis D. Gall badder
Cartilage
Which factor assists venous return to the heart? A. Valves B. inspiration C. Skeletal muscle D. All of these
D. All of these
Since pressure within the veins approaches zero, factors such as the presence of valves and the force of the skeletal muscle pump become significant methods of directing blood flow to the heart
The highest pressure exerted by the heart is called
Systolic pressure
The systolic pressure occurs while the ventricles contract while the diastolic or lowest pressure is during relaxation, the pulse pressure is the difference between them
? Is characterized by some defect or weakness in a vessel wall
Aneurysm
The obstructive accumulation of cholesterol in a vessel is the result of
Atherosclerosis
Atherosclerosis is hardening of the arteries
The following vessels will direct blood to the brain except which one A. Common carotid B. internal carotid C. Vertebral D. Jugular
D. Jugular
The jugular veins drain the brain and head, the common carotid bifurcated into the internal and external carotid s for the brain and face
The brachial artery divides into the radial and ?
Ulnar.
The ulnar and radial arteries join at various locations near the wrist to form the anastomotic palmar arches
The ? Will send blood into the femoral artery A. External iliac B. internal iliac C. Pudendal D. Popliteal
A. External iliac
The external iliac branch of the common iliac artery becomes the femoral artery as it enters the lower limb
The ? Vein represents a functional connection between the superior and inferior banana cavae. A. Thoracic B. azygos C. Intercostal D. Cephalic
B. azygos
Although the 2 Vena cavae are not directly connected by a large vein, the azygos vein complex system of vessels will drain the inner thoracic wall and can deliver blood between the cavae
The superior mesenteric vein joins the splenic vein to form the ? Vein A. Hepatic B. hepatic portal C. Gastric D. Inferior mesenteric
B. hepatic portal
The hepatic portal vein is a merger of the gastrointestinal and splenic veins that bring nutrient rich blood to the liver
The longest vein in the body is A. Femoral B. gluteal C. Brachial D. Saphenous
D. Saphenous
The great saphenous vein runs along the anterior surface of the leg and is used as a graft for coronary bypass procedures
In an ECG, where does the depolarization of the atria occur
P wave
The deflection called the P wave corresponds to the depolarization of the atrial chambers, the T wave correlates with ventricular repolarization.
What layer serves the dual purpose of forming the inner layer of the pericardium and forming the outermost wall of the heart
Visceral pericardium
Visceral pericardium and epicardium are the same
The bicuspid valve is located
On the left side of the heart and is the same as the left AV valve
Which artery supplies blood to the ilium and muscles of the lower back? A. Aorta B. common iliac artery C. Internal iliac artery D. Iliolumber artery
D. Iliolumbar artery
The iliolumber artery runs just superior to the iliac crest
A deep wound to the upper thigh might damage the ? Artery
Femoral
The femoral artery is located in the anterior thigh
Blood is drained from the face, scalp, and superficial regions of the neck by the A. Carotid arteries B. external jugular veins C. Internal jugular veins D. Brachiocephalic veins
B. external jugular veins
The external jugulars receive blood from the facial vein, temporal veins and superficial neck veins
A unique venous system called ? Carries blood directly from the intestines to the liver for processing rather than directly into the inferior vena cava A. Hepatic portal system B. superior mesenteric vein C. Saphenous vein D. Gonadal vein
A. Hepatic portal system
This system is similar to the hypophyseal portal system in the endocrine system
The inability of the left ventricle to pump blood adequately to the body’s cells is indicative of
Congestive heart failure
When blood backs up due to weak contractions it is called CHF
A condition in which there is a congenital predisposition for a ruptured aorta is
Marfan syndrome
Aortic aneurysm is common in Marfan syndrome
What membrane is closest to the heart
Visceral pericardium
The visceral pericardium or epicardium is in contact with the myocardium
How many openings are there in the right atrium
4
The superior and inferior vena cava, the coronary sinus and the AV orifice. That is 4
The ? Valve lies between the right atrium and right ventricle
Tricuspid
The tricuspid is the same as the right AV valve
The pulmonary semilunar valve prevents a back flow of blood into the
Right ventricle
The right ventricle pumps blood to the pulmonary circuit
The aortic semilunar valve prevents blood from returning to the
Left ventricle
The left ventricle pumps blood to the systemic circuit
Which structure contains the lowest amount of oxygen A. Pulmonary vein B. aorta C. Vena cava D. Left ventricle
C. Vena cava
The vena cava carry Deoxyhemoglobin, while all the other choices carry oxyhemoglobin
Cardiac output can be determined by what formula
HR X SV
Cardiac output is equal to the amount of blood pumped through each ventricle in one minute. sV is the amount of blood in one beat, and HR is the number of beats per minute
The central cardiac control region is in the ?
Medulla oblongata of the brain
The cardioacceleratory and cardioinhibitory centers are in the medulla oblongata at the base of the vagus nerve
The T wave of an electrocardiograph represents which event
Ventricular repolarization
The T wave is usually the last wave and indicates ventricular repolarization
A heart beat of less than 60 beats per minute is called
Bradycardia
Brady- means slow
The blood in the pulmonary arteries has a relatively high carbon dioxide concentration
T or F
True
Blood in the pulmonary arteries is systemic in nature because it contains oxygen poor blood and high carbon dioxide that it received as it passed through the tissues
Patients complain of diaphoresis, which is difficulty breathing, during a myocardial infarction
T or F
False
Diaphoresis is the excessive sweating and dyspnea is the difficulty breathing evident during a heart attack in progress
The coronary circulation has a rich array of anastomoses between arteries and veins
T or F
False
Anastomoses are shunts or connections made between coronary vessels and only appear on some of the smaller arteries, this relative lack of anastomoses is the factor that prompted the use of the coronary bypass procedures
Pressure within the atria is greatest when the ventricles are relaxing and the atria are contracting
T or F
True
The pressure with in the atria rises sharply when the atria contract
As the ventricles contract, the pressure in them exceeds the pressure in the atria
T or F
True
As the ventricles contract they exert a back pressure which closes the atrioventricular valves because the pressure behind them in the atria is lower
A murmur is a heart sound heard when the valves do not close sufficiently
T or F
True
Insufficient closing of a heart valve can be evidenced by sounds of blood surging past them (murmur) during a stethoscope examination
A functional syncytium occurs when one cardiac muscle cell causes the ones around to inhibit their beat
T or F
False
A functional syncytium occurs when one heart cell causes the cells around it to contract synchronously with it
An injection of acetylcholine into the heart could decrease the rate of the heart
T or F
True
Acetylcholine is the neurotransmitter released by the vagus nerve branches that usually cause the A-V and S-A nodes to lower their rates
The sympathetic nervous system usually has the effect of increasing heart rate
T or F
True
The accelerator nerves are branches of the sympathetic system that secrete norepinephrine which increases the rates of the S-A and A-V nodes
The electrocardiogram tracing is a measurement of the contraction sequences of the heart
T or F
False
The ECG measures the electrical changes that occur in a cardiac cycle, it is assumed that the cardiac muscle contraction is related, but not necessarily directly, to the appearance of the waves
Either hyperkalemia or hypokalemia could cause an irregular heart rhythm
T or F
True
Hyperkalemia or excess of potassium will correlate with a slowing of the rate and possible cardiac arrest, low potassium blood levels are related to various arrhythmias
An increase in blood calcium or hypercalcemia can cause the heart to increase its pressure and have a prolonged QRS interval
T or F
True
Since calcium is required for contraction, changes in blood levels may adversely affect the heart, the prolonged length of the QRS interval is related to a possible spasm of the cardiac musculature
A slow heart rate that is diagnosed as a bradycardia condition always is abnormal and should be treated
T or F
False
Bradycardia or tachycardia occurs in normal people without necessarily being serious, athletes have bradycardia because their metabolic demands are being controlled more efficiently
The technique called defibrillation is the application of an electric current to the chest wall with the desired effect of directly stabilizing the abnormal heart rhythm.
T or F
False
Defibrillation momentarily causes all muscle fibers to depolarize and stop functioning. It is hoped that a normal sinus rhythm will re-establish itself
Vasoconstriction of a blood vessel causes an increase in blood pressure
T or F
False
It is not always true that vasoconstriction will raise the blood pressure, constriction might redirect the flow of blood or be so extensive that the flow and pressure leaving the vessel drops
The control of blood flow to a specific area is related to the amount of oxygen present
T or F
True
There are several factors that regulate the flow of blood such as direct local chemical oxygen sensitivity and control of the precapillary sphincters.
Normally the hydrostatic pressure of the blood exceeds its osmotic pressure which causes a loss of fluids into the tissue spaces
T or F
True
Fluids are constantly lost from the capillary circulation but this excess fluid is brought back to the circulation by the lymphatic vessels
Ankle edema or ascites is caused by an abnormal increase in blood osmotic pressure
T or F
False
Blood osmotic forces usually tend to prevent loss of excessive fluids and edema is caused by many factors including heart failure, ascites is fluid in the abdominal cavity resulting whenever the protein in the blood is low or the pressure within the vein is excessive
A decrease in stroke volume will cause a drop in blood pressure and a drop in heart rate will also result in a pressure decrease
T or F
False
If the stroke volume were to fall, the pressure will not necessarily fall if the heart rate rises to compensate or vice versa
Starling’s law of the heart states that the force of a heart chamber decreases when the chamber is full
T or F
False
As the fibers stretch from the amount of blood present the cardiac muscle in the walls will exert a greater force of contraction
A dilation in a vein is called varicosity
T or F
True
Varicose veins pose no serious problem when they occur on the leg but are more serious as hemorrhoids or the varicosities seen in the esophagus
Atrial natriuretic peptide is a hormone released from the heart in response to low blood pressure
T or F
False
Atrial natriuretic peptide (factor) is released under conditions of high blood pressure which causes stretching of the atria, the effect is to inhibit the renin mechanism and lower blood pressure
The vasomotor center in the medulla regulated blood pressure by altering the diameters of blood vessels throughout the body
T or F
True
One of the control influences on blood pressure and perfusion flow are the vasoconstriction or vasodilation of blood vessels by neurological reflexes
Hypertension is related to an increased risk for developing a heart attack, stroke or obesity.
T or F
False
Obesity could cause but not be the result of hypertension, high blood pressure always increases the chance of myocardial infarction or cerebral vascular accident (CVA)
Pulmonary edema may be caused by damage to the heart that has weakened the left ventricle
T or F
True
Since blood is part of a continuous circulatory pathway, failure to eject sufficient blood from the left ventricle will cause an increase in pressure in the pulmonary veins which forces fluid out of lung capillaries
The circle of Willis represents an anastomosis of blood vessels supplying the cranial cavity and brain
T or F
True
The circle of Willis at the base of the brain is a merger of internal carotid and vertebral pathways and surrounds the pituitary
Most of the average adult heart lies to the left of the midline
T orF
True
The heart is twisted and tilted to the left
Pericardial fluid is serous and allows the heart to beat without friction in the pericardial sac
T or F
True
The inner lining of the pericardial sac is the parietal pericardium and the outer layer of the heart is the visceral pericardium. Together they make a serous membrane.
The right and left sides of the Heart separated by the interventricular septum
T or F
False
The interventricular septum only separates the ventricles
Blood is all veins is relatively low in oxygen
T or F
False
The pulmonary veins, and in the fetus the umbilical veins, carry blood high is oxygen
When an atrium is in systole the ventricle is in diastole
T or F
True
In a normally functioning heart, the atria and ventricles are in opposite phases
