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Z. CV FINAL > CV Quiz Questions đź«€ > Flashcards

CV Quiz Questions đź«€ Flashcards

1
Q

The left anterior descending artery supplies blood to which areas of the heart?

a.
Inferior.

b.
Right ventricle.

c.
Posterior and lateral area.

d.
Anterior and septal area.

A

d.
Anterior and septal area.

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2
Q

Which statement is false regarding the circulatory system?

a.
The heart is essentially 2 pumps

b.
Valves cause unidirectional flow in the heart

c.
The greatest resistance to blood flow occurs at the level of the arterioles

d.
Normally there is pulsatile blood flow at the capillary level

A

d.
Normally there is pulsatile blood flow at the capillary level

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3
Q

Which of the following structures does NOT drain into the right atrium?

a.
Pulmonary veins

b.
Coronary sinus

c.
Superior vena cava

d.
Inferior vena cava

A

a.
Pulmonary veins

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4
Q

Which statement about cardiac valves is incorrect?

a.
The tricuspid valve is located between the left atrium and left ventricle.

b.
The pulmonary valve normally is 3 leaflets.

c.
Allow unidirectional flow of blood through the heart.

d.
Papillary muscles prevent prolapsing of the atrioventricular valves.

A

a.
The tricuspid valve is located between the left atrium and left ventricle.

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5
Q

A patient is found to have reduced left ventricular output caused by impaired contraction of the heart muscle. This condition will most likely lead to which of the following?

a.
Increased arterial blood pressure

b.
Increased blood flow through the lungs

c.
Reduced right ventricular output

d.
Increased blood flow in the systemic circulation

A

c.
Reduced right ventricular output

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6
Q

The sinoatrial (SA) node demonstrates a gradual upsloping of phase 4 of their action potentials. These cells become gradually less negative due to a slow influx of ___________ ions and “funny” currents.

a.
Potassium

b.
Calcium

c.
Chloride

d.
Sodium

A

d.
Sodium

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7
Q

Which of the following contributes to the Resting Membrane Potential (RMP) of the cardiac muscle cell?

a.
Potassium diffusion

b.
Sodium diffusion (small, but finite leakage of this ion)

c.
Activity of the Na+-K+ ATP-ase pump

d.
All the above contribute to the RMP of the cardiac muscle cell.

A

d.
All the above contribute to the RMP of the cardiac muscle cell.

Resting Membrane Potential
* Combination of the following results in the Resting Membrane Potential:
– Potassium diffusion
– Sodium diffusion
– Na+, K+ - ATPase

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8
Q

Which of the following statements is TRUE regarding the Na+, K+-ATPase pump?

a.
Pumps in 3:2 ratio (3 potassium for every 2 sodium).

b.
This pump is partially inhibited by digitalis.

c.
The pump is disabled by cytosolic hypercalcemia.

d.
Metabolic pump which removes potassium from the cell and pumps sodium into the cell.

A

b.
This pump is partially inhibited by digitalis.

Na+, K+ - ATPase Pump
* Steady inward leak of Na+ would depolarize cell
* Metabolic pump which extrudes Na+ from the cell and pumps in K+
* Pumps in 3:2 ratio (Na+:K+)
* Electrogenic pump
* Partially inhibited by digitalis

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9
Q

Activation of which of the following is the major contributor to phase 0 of the fast action potential in cardiac muscle?

a.
Activation of sodium channels allowing rapid movement of sodium into the cell.

b.
Activation of L-type calcium channels allowing slow, inward movement of calcium into the cell.

c.
Activation of Na+-K+ ATP-ase pumps.

d.
Activation of potassium channels allowing outward movement of potassium from the cell.

A

a.
Activation of sodium channels allowing rapid movement of sodium into the cell.

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10
Q

During excitation–contraction coupling in cardiac myocytes, which 2 statements below apply?

a.
Calcium binds to troponin C

b.
Myosin heads bind to actin

c.
SERCA pumps calcium out of the sarcoplasmic reticulum

d.
Calcium binds to myosin causing ATP hydrolysis

A

a.
Calcium binds to troponin C

b.
Myosin heads bind to actin

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11
Q

Which of the following is associated with aortic valve closure?

a.
Dicrotic notch on the aortic pressure tracing

b.
C-wave on the central venous pressure tracing

c.
Second heart sound

d.
Both a and c

A
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12
Q

During isovolumic contraction of the left ventricle, which of the following valves are open?

a.
Both the AV valves are open.

b.
Mitral valve.

c.
Aortic valve.

d.
Both the AV valves are closed.

A

d.
Both the AV valves are closed.

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13
Q

An increase of which of the following will result in a decrease in cardiac output?

a.
Preload

b.
Increased stroke volume

c.
Afterload

d.
Contractility

A

c.
Afterload

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14
Q

Which statement regarding the Frank-Starling Mechanism is TRUE?

a.
Allows the heart to readily adapt to changes in venous return.

b.
The Frank-Starling Mechanism plays an important role in balancing the output of the 2 ventricles.

c.
Increasing venous return and ventricular preload leads to an increase in stroke volume.

d.
All of the above statements are true.

A

d.
All of the above statements are true.

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15
Q

Most of the ventricular filling occurs passively. Atrial contraction to increase ventricular filling is important

a.
During isovolumetric contraction

b.
During rest

c.
With bradycardia

d.
At high heart rates when diastolic filling time is shorter

A

d.
At high heart rates when diastolic filling time is shorter

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16
Q

The 3 primary factors which regulate stroke volume (SV) are

a.
Preload, afterload, and contractility.

b.
Heart rate, cardiac output, and SVR.

c.
CVP, SVR, and wall stress.

d.
None of the above.

A

a.
Preload, afterload, and contractility.

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17
Q

Which of the following will increase blood flow to the greatest extent in a single isolated blood vessel that is perfused with blood in vitro at a constant perfusion pressure?

a.
Decreasing the blood temperature by 10°C

b.
Increasing the vessel diameter by 25%

c.
Doubling the vessel radius

d.
Increasing blood viscosity by 100%

A

c.
Doubling the vessel radius

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18
Q

Which of the following may create an error or artifact that may provide inaccurate information when trying to obtain hemodynamic information?

a.
Use of a blood pressure cuff that is too small for a given patient.

b.
Transducer not level to appropriate position for pressure being monitored.

c.
Having a large amount of air in the tubing between the transducer and a Swan-Ganz catheter.

d.
All of the above.

A

d.
All of the above.

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19
Q

You are asked to inflate a Swan-Ganz catheter balloon after it has been inserted through the central venous introducer. Which of the following statements is TRUE?

a.
You should watch the pulmonary artery tracing on the monitor as you inflate the balloon.

b.
You should inflate the balloon slowly.

c.
You should stop inflation of the balloon if resistance to inflation is detected.

d.
All of the above are true.

A
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20
Q

Venous return to the right atrium is:

a.
Decreased as cardiac output increases.

b.
Increased during inspiration.

c.
Increased during a forced expiration against a closed glottis.

d.
Decreased by sympathetic activation of veins.

A

b.
Increased during inspiration.

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21
Q

Which parameter would you NOT be able to measure directly with a Swan-Ganz catheter?

a.
Pulmonary capillary wedge pressure

b.
Blood temperature

c.
Pulmonary artery systolic pressure

d.
Systemic vascular resistance

A

d.
Systemic vascular resistance

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22
Q

Which of the following is used to predict laminar versus turbulent flow in a conduit?

a.
Sutton’s Law

b.
Poiseuille’s Law

c.
Ohm’s Law

d.
Reynold’s Number

A

d.
Reynold’s Number

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23
Q

In the diagram below, the change depicted by moving from the pressure-volume loop on the right to the new pressure-volume loop on the left is:

A.
Decreased contractility

B.
Increased afterload

C.
Decreased preload

D.
Decreased afterload

A
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24
Q

From the diagram below, estimate the strove volume and cardia output. Pt heart rate is 60.

a.
70 ml - 4.2L

b.
50ml – 3.0L

c.
80ml – 4.8L

d.
Not enough data to calculate.

A

a.
70 ml - 4.2L

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25
Q

From the diagram below, estimate the strove volume and cardia output. Pt heart rate is 60.

a.
70 ml - 4.2L

b.
50ml – 3.0L

c.
80ml – 4.8L

d.
Not enough data to calculate.

A

a.
70 ml - 4.2L

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26
Q

In the image above, what point would best indicate the patients systolic blood pressure?

Answers:
a.
b.
c.
d.
f.

A

E or F

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27
Q

Mean circulatory filling pressure is a measure of:

A.
Contractility

B.
Total blood volume

C.
Venous compliance

D.
Both b and c

A

D.
Both b and c

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28
Q

A long distance runner undergoes a cardiac catheterization to assess their LV function after a performance drop during their last marathon. What is the best parameter to use as the index of their cardiac preload?

a.
Mean arterial pressure.

b.
Blood volume.

c.
Central venous pressure.

d.
Pulmonary wedge pressure.

e.
Left ventricular end diastolic volume.

A

e.
Left ventricular end diastolic volume.

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29
Q

Which of the following contribute to optimal conditions for nutrient and waste exchange at the capillary level?

a.
Continuous blood flow

b.
Large surface area

c.
Low blood flow velocity

d.
All of the above

A

d.
All of the above

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30
Q

Conversion of pulsatile blood flow to continuous blood flow by the aorta and large arteries has which of the following benefits for the cardiovascular system?

a.
Steady blood flow at the capillaries which helps them carry out their function.

b.
Increases blood pressure.

c.
Decreases the workload on the heart.

d.
Both a and c are correct.

A

d.
Both a and c are correct.

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31
Q

Vessels that have no smooth muscle but are composed of endotheilal cells and a basement membrane are termed __________ and represent the smallest vessels wihin the microcirculation.

a.
Capillaries

b.
Capacitance

c.
Conductance

d.
Venules

A

a.
Capillaries

32
Q

As we get older which of the following changes occurs in our arteries?

a.
The arteries become more distensible.

b.
Pumping blood through rigid vessels creates much more work for the heart.

c.
The arterial compliance increases.

d.
There is increased elastic tissue in the arteries.

A

b.
Pumping blood through rigid vessels creates much more work for the heart.

33
Q

Some of the factors that can increase this venous return and thereby increase the right atrial pressure are

a.
increased blood volume,

b.
increased large vessel tone throughout the body with resultant increased peripheral venous pressures.

c.
dilation of the aterioles, which decreases the peripheral resistance and allows rapid flow of blood from the arteries into the veins.

d.
None of the above.

e.
All of the above.

A

e.
All of the above.

34
Q

Ernest Starling pointed out more than a century ago that under normal conditions, a state of near equilibrium exists in most capillaries. That is, the amount of fluid filtering outward from the arterial ends of capillaries equals almost exactly the fluid returned to the circulation by absorption. Excessive interstitial fluid is handled by the body by?

a.
Lymphatics

b.
Osmosis

c.
Edema formation

d.
Evaporation

A

a.
Lymphatics

35
Q

Which of the following can increase the rate of oxygen diffusion from blood to tissue?

a.
Increased tissue PO2

b.
Decreased number of flowing veins

c.
Decreased arteriolar PO2

d.
Arteriolar vasodilation

A

d.
Arteriolar vasodilation

36
Q

Which of the following vasoactive substances is NOT released from the endothelium?

a.
Prostacyclin

b.
Nitric oxide

c.
Aldosterone

d.
Endothelin

A

c.
Aldosterone

37
Q

Of the various hydrostatic and osmotic forces that cause fluid movement across the capillary, which one is the only one under normal conditions to create an inward force (from the interstitium into the capillary) for water movement?

a.
Capillary hydrostatic pressure

b.
Interstitial fluid osmotic pressure

c.
Interstitial fluid hydrostatic pressure

d.
Plasma colloid osmotic pressure

A

d.
Plasma colloid osmotic pressure

38
Q

If Net Driving Forces are positive, does it favor capillary filtration or reabsorption?

a.
Filtration

b.
Reabsorption

c.
Neither

d.
Both

A

a.
Filtration

39
Q

Which statement is FALSE regarding blood flow through the left ventricle?

a.
During early systole there is an initial flow reversal.

b.
Flow is greatly reduced during the majority of systole.

c.
There is an abrupt rise in left ventricular coronary blood flow during diastole.

d.
Most of the blood flow through the left ventricle occurs during systole.

A

d.
Most of the blood flow through the left ventricle occurs during systole.

40
Q

Which of the following statements regarding Extravascular Compressive Forces on coronary blood flow is FALSE?

a.
The heart influences its own blood supply by the squeezing effect of the contracting myocardium on the blood vessels coursing through the heart.

b.
Right ventricular coronary blood flow is reduced in systole to about the same extent as is left ventricular coronary blood flow.

c.
There is an abrupt increase in left ventricular coronary blood flow during diastole.

d.
Reversal of blood flow occurs during early systole in the left ventricle.

A

b.
Right ventricular coronary blood flow is reduced in systole to about the same extent as is left ventricular coronary blood flow.

41
Q

cWhich of the following would increase wall stress in the heart?

a.
Decreased left ventricular cavity size.

b.
Decreased left ventricular pressures.

c.
Decreased left ventricular wall thickness.

d.
None of the above.

A

c.
Decreased left ventricular wall thickness.

42
Q

The primary determinants of myocardial O2 consumption, from most to least important, are

a.
Heart rate > afterload > preload

b.
Heart rate > preload > afterload

c.
Preload > afterload > heart rate

d.
Afterload > preload > heart rate

A

a.
Heart rate > afterload > preload

43
Q

If a coronary artery is occluded for 1 minute and then the occlusion is released

a.
Interstitial adenosine concentrations will increase and constrict coronary arterioles.

b.
A period of active hyperemia follows.

c.
Endothelial release of nitric oxide will contribute to the reactive hyperemia.

d.
Coronary flow increases because of vasoconstriction occurring during the ischemia.

A

c.
Endothelial release of nitric oxide will contribute to the reactive hyperemia.

44
Q

Which of the following is a consequence of myocardial ischemia?

a.
Diastolic dysfunction

b.
Myocardial stunning

c.
Myocardial hibernation

d.
All the above

A

d.
All the above

45
Q

Which of the following statements regarding cardiovascular changes during exercise is true?

a.
The increase in cardiac output observed with exercise is correlated principally with an increase in heart rate.

b.
Release of adenosine, lactic acid and potassium enhance vasodilation.

c.
Blood is diverted away from the GI tract, inactive muscle, and the kidneys during exercise.

d.
Arterial blood pressure rises during exercise.

e.
All of the above.

A
46
Q

Which of the following enables us to provide skeletal muscle with adequate amounts of oxygen and nutrients during strenuous exercise?

a.
Shortening the distance for diffusion by capillary recruitment.

b.
Rightward shift of hemoglobin-oxygen dissociation curve.

c.
Increased cardiac output.

d.
All of the above.

A
47
Q

During hemorrhagic shock activation of the Baroreceptor Reflex causes vasoconstriction in certain vascular beds (i.e., GI tract, skin, muscle) while other vascular beds such as the brain and heart have minimal changes in blood flow. This favors redistribution of blood flow to the brain and heart during shock.

T/F

A

T

48
Q

Treatment of hypotension includes all except:

a.
Administration of sympathomimetic drugs

b.
Oxygen therapy

c.
Reverse Trendelendburg positioning

d.
Blood and plasma transfusions

e.
Treatment with glucocorticoids

A

c.
Reverse Trendelendburg positioning

49
Q

Physiological factors that decrease venous return causing shock include which of the following factors?

a.
Diminished blood volume.

b.
Decreased vascular tone, especially in the venous blood reservoirs.

c.
Both a and b

d.
None of the above.

A
50
Q

Which of the following is a compensatory mechanism during shock?

a.
Baroreceptor reflex

b.
Reabsorption of tissue fluids at the capillary level

c.
Salt and water conservation by the kidneys

d.
All of the above are compensatory mechanisms that are active during shock.

A

d.
All of the above are compensatory mechanisms that are active during shock.

51
Q

The intracellular effects of beta-1-receptor activation by epinephrine are due to:

a. Stimulation of adenylyl cyclase which results in increased amounts of intracellular cyclic-AMP.
b. Increased production of renin.
c. Increased release of nitric oxide from endothelial cells
d. None of the above

A

a. Stimulation of adenylyl cyclase which results in increased amounts of intracellular cyclic-AMP.

52
Q

During a carotid endarterectomy the patient’s heart rate abruptly decreases to 20 bpm while the surgeon is working in the vicinity of the carotid bifurcation. What caused this hemodynamic response?

a. Cushing Response
b. Diver’s Reflex
c. Baroreceptor Reflex
d. Bainbridge Reflex

A

c. Baroreceptor Reflex

53
Q

Which of the following terms refers to ventricular relaxation?

a. Lusitropy
b. Inotropy
c. Dromotropy
d Chronotropy

A

a. Lusitropy

54
Q

Which of the following statements regarding the sympathetic nervous system is FALSE?

a. Beta-2 receptor stimulation causes bronchodilatic nano uterine relaxatior
b. The majority of adrenal gland catecholamine output is epinephrine
c. Sympathetic outflow is craniosacral, while parasympathetic outflow is thoracolumbar.
d. Alpha receptor stimulation causes vasoconstriction

A

c. Sympathetic outflow is craniosacral, while parasympathetic outflow is thoracolumbar.

55
Q

Vasopressin is released from which of the following?

a. Kidney
b. Posterior pituitary
c. Adrenal gland
d. Lung

A

b. Posterior pituitary

56
Q

Activation of which of the following adrenergic receptors causes inhibition of norepinephrine release from the sympathetic nerve terminal?

a. Beta-2
b. Alpha-1
c. Alpha-2
d. Beta-1

A

c. Alpha-2

57
Q

Functions of the Cardiovascular System (5)

A
  • Transport essential substances to the tissues
  • Remove by-products of metabolism
  • Regulation of body temperature
  • Humoral communication throughout body
  • Adjustments of oxygen and nutrient supply in different physiologic states
58
Q

Basic Parts of the Circulatory System (3)

A
  • Pump – Has an electrical system for regular running
  • Series of distributing and collecting tubes
  • Extensive system of thin vessels that permit rapid exchange between the tissues and the vascular
    channels
59
Q

Where do the different pumps of the heart send the blood?

What causes unidirectional flow in the heart?

A

RV â–ş Pulmonary Circulation
LV â–ş Systemic Circulation

Valves cause unidirectional flow in the heart

60
Q

Continuous Blood Flow (4)

A
  • Distention of the aorta and its branches during systole
  • Elastic recoil of the large arteries with forward propulsion of blood during ventricular relaxation
    during diastole
  • Frictional resistance in the arterioles
  • Blood flow is essentially non-pulsatile at the capillary level
61
Q

Blood Flow Velocity vs. Cross-sectional Area (2)

A
  • Velocity of blood flow is inversely related to the cross-sectional area of the vascular system
  • Blood flow velocity is very slow in the capillaries (large cross-sectional area) which makes
    conditions ideal for exchange of diffusible substances
62
Q

Basic Theory of Circulatory Function (3)

A
  • The blood flow to each tissue of the body is almost always precisely controlled in relation to the tissue needs
  • The cardiac output is controlled mainly by the sum of all the local tissue flows
    11%
  • In general, the arterial pressure is controlled independently of either local blood flow or cardiac output control
63
Q

What are the different parts of the Mediastinum? (2)

A
  • Superior
    – Above plane between sternal angle and inferior border of T4 vertebral body
  • Inferior
    – Anterior
    – Middle
    – Posterior
64
Q

What are the different parts of the Pericardium? (2)

A

– Fibrous
– Serous
* Parietal layer
* Visceral layer
- Phrenic Nerves

65
Q

How is the heart innervated?

A

Sympathetic Nervous System
- T1-T4
> “cardiac accelerators”
- Stellate ganglia (cervicothoracic ganglia) and middle cervical ganglia
- Distributed throughout the heart
Parasympathetic
– Originate in medulla oblongata
– Vagus nerves
– Much innervation to SA and AV nodes
– Little innervation to ventricles

66
Q

What are the different portions of the Conduction System?

A

Sinoatrial Node
– Interatrial conduction pathways (SA to LA)
– Internodal conduction pathways (SA to AV)
* Atrioventricular Node
– Bundle of His
* Bundle Branches
– Left Bundle Branch
* Left anterior division
* Left posterior division
– Right Bundle Branch

67
Q

Where is the AV node situated?

A

AV node is situated on the right side of interatrial septum near the ostium of the coronary sinus

68
Q

Look Up Heart Anatomy

A

Right Atrium
* Vena Cavae
– Superior
– Inferior
* Eustachian valve
* Crista terminalis (divides right atrium)
– Right atrial appendage (right auricle)
* Trabeculated
– Smooth portion of atrium around vena cavae
* Coronary Sinus (venous drainage of heart)
* Fossa Ovalis
– Remnant of foramen ovale * Tricuspid Valve
Right Ventricle vs. Left Ventricle
Aortic Valve
* Separates left ventricle and aorta
* Located between (and on the same plane as) the Mitral and Tricuspid valves
* Trileaflet (3 leaflets)
* Right and Left Main Coronary Arteries originate in sinuses behind valve leaflets
* Sino-tubular junction
Mitral Valve
* Separates Left atrium from Left Ventricle
* Two leaflets
– Anterior Leaflet
* Wide and short
– Posterior Leaflet
* Narrow and long
* Papillary muscles
* Chordae tendinae
Tricuspid Valve
* Separates Right atrium from Right ventricle
* 3 Leaflets
– Anterior leaflet
– Posterior leaflet
– Septal leaflet
Pulmonary Valve
* Separates Right Ventricle from Pulmonary artery
* 3 Cusps
– Sinuses of Valsalva
* Located behind the valve cusps
Coronary Arteries
* Right Coronary
– Dominance: In 85% of individuals the RCA supplies the posterior descending artery
(PDA) * Left Coronary
– Left anterior descending (LAD)
* Diagonal – Left circumflex
* Obtuse marginal
– Ramus intermedius (37%)

69
Q

What does the Tricuspid Valve seperate?

A

Right Atrium from Right Ventricle

3 Leaflets

70
Q

What does the Aortic Valve seperate?

A

The left ventricle and aorta

71
Q

What does the mitral valve seperate?

A

The left atrium from the left ventricle

72
Q

What does the Pulmonary Valve Seperate?

A

Right ventricle from the pulmonary artery

73
Q

What does the Pulmonary Valve Separate?

A

Right ventricle from the pulmonary artery

74
Q

What is the major determinant of the Resting Membrane Potential?

A

Potassium is the major determinant of the Resting Membrane Potential
* Potassium and sodium ion channels allow leakage of these ions across the cell membranes
* In the normal nerve fiber, the permeability of the membrane to potassium is about 100 times as
great as to sodium

75
Q

How does the cell prevent further K+ from leaving the cell?

A

As K+ leaves cell, negativity increases on the inside of the cell membrane and electrostatically attracts K+. This electrostatic force prevents K+ from leaving cell.

76
Q

What is the concentration of K+ for cardiac cells?

A

K+ is high inside and low outside.

77
Q

What three factors result in the Resting Membrane potential?

A

Potassium Diffusion, Sodium Diffusion and Na+, K+ and -ATPase Pump

Z. CV FINAL (11 decks)

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