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(J) Physiology Test 2 > Example Questions From Lecture > Flashcards

Example Questions From Lecture Flashcards

1
Q

During the conduction of a signal from the SA node to the ventricular fibers, there is a .16 second delay from the initial origin of the signal until onset of ventricular contraction. More than half of this delay occurs in which of the following areas of the transmission?

A. SA node

B. AV node

C. SA node

D. penetrating bundles

A

B. AV node

Delay in the AV node is .09 seconds.

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2
Q

In a typical ECG, which of the following waves occurs at the beginning of the contraction of the atria?

A. T

B. R

C. S

D. P

E. Q

A

D. P

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3
Q

Which of the following events is generally not seen on a typical ECG?

A. atrial depolarization

B. atrial repolarization

C. ventricular depolarization

D. ventricular depolarization

A

B. atrial repolarization

Atrial repolariztaion is hidden by the QRS complex.

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4
Q

Which of the following is the direction of bipolar lead III?

A. 0 degrees

B. 60 degrees

C. 90 degrees

D. 120 degrees

A

D. 120 degrees

The connections of bipolar lead III are the left arm and the left leg.

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5
Q

Of the three bipolar leads, which one is connected to both the left and right arm?

A. Lead I

B. Lead II

C. Lead III

D. All leads are connected to only one arm each

A

A. Lead I

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6
Q

Of the three bipolar leads, which one would have the highest amplitude for the normal QRS wave, and which of the following reasons would explain this high amplitude?

A. Lead I, because it is most perpendicular to the vector for the depolarization wave

B. Lead I, because it is most parallel to the vector for the depolarization wave

C. Lead II, because it is most perpendicular to the vector for the depolarization wave

D. Lead II, because it is most parallel to the vector for the depolarization wave

A

D. Lead II, because it is most parallel to the vector for the depolarization wave

The direction of lead II is 60˚ and the mean axis of the heart is 59˚. The mean axis of the heart is a sum of all the mean electrical vectors that occur during ventricular depolarization.

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7
Q

Which of the following represents the mean electrical axis of the normal ventricle?

A. 59 degrees

B. 67 degrees

C. 120 degrees

D. 157 degrees

E. 270 degrees

A

A. 59 degrees

The mean axis of the heart is a sum of all the mean electrical vectors that occur during ventricular depolarization. The more muslce present in a region will result in a larger deviation of the axis towards that muscle. The left ventricle is more muscular than the right ventricle resulting in the mean axis pointing more to the left.

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8
Q

Which of the following conditions may result in tachycardia?

A. Toxic conditions of the heart

B. Increased body temperature

C. Sympathetic nerve stimulation

D. All of the above

E. B and C only

A

D. All of the above (toxic conditions of the heart, increased body temperature, and sympathetic nerve stimulation)

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9
Q

In the ECG shown, which of the following heart activities is represented?

A. Sinus tachycardia

B. Sinus bradycardia

C. Complete AV block

D. Incomplete second degree block

A

B. Sinus bradycardia

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10
Q

The electrocardiogram shown indicates which of the following conditions?

A. Tachycardia

B. Bradycardia

C. SA node block

D. AV block

A

D. AV block

There are several P waves present without a QRS segment. This means that the electrical activity generated from the SA node is not reaching the ventricle. This is characteristic of an AV block

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11
Q

Circus movements are the basis of heart fibrillation. Which of the following statements is NOT true?

A. Fibrillation may occur when the refractory period of the muscle is greatly shortened.

B. Fibrillation may occur when the pathway around the circle is too short.

C. Fibrillation may occur when the conduction velocity slows down.

D. Fibrillation may occur when the heart become dilated.

A

B. Fibrillation may occur when the pathway around the circle is too short.

Circus movements occur when the point where a wave of depolarization in cardiac tissue originates from has repolarized by the time the wave of depolarization has returned to that spot. This causes the tissue to depolarize again but this time out of sync with the hearts pacemaker.

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12
Q

84% of the blood volume is in the systemic circulation. Of this, 64% is in which of the following?

A. Capillaries

B. Systemic arterioles

C. Veins

D. Arterioles

A

C. Veins

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13
Q

Blood flow resistance is inversely (indirectly) proportional to which of the following?

A. Viscosity

B. Vessel diameter

C. Density

D. Both A and C

A

B. Vessel diameter

An equation for blood flow resistance is: (8 x vessel length x viscosity) / (π x R^4).

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14
Q

If rate of blood flow through the entire circulatory system (= cardiac output) = 100 mL/sec AND the pressure difference from the systemic arteries to the systemic veins = 100 mmHg; the total peripheral resistance is equal to…?

A. 10 PRU

B. 1 PRU

C. .01 PRU

D. 100,000 PRU

A

B. 1 PRU

An equation for blood flow resistance is: (change in pressure) / (blood flow).

The unit for blood flow resistance is the PRU which is equivalent to (1 mmHg) / (1 mL/sec).

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15
Q

Reynolds number is a measure of which of the following parameters?

A. Tendency for turbulence

B. Blood pressure

C. Conductance

D. Resistance

A

A. Tendency for turbulence

A higher Reynolds number indicates a higher tendency for turbulence.

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16
Q

Which of the following represents the viscosity of blood with a hematocrit of 38-42?

A. 1.5

B. 3.0

C. 38

D. 42

A

B. 3.0

The viscosity of blood plasma (blood minus the formed elements, essentially a hematocrit of 0%) is 1.5 due to plasma proteins.

The viscosity of blood with a hematocrit of 60-70% is ≈10.

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17
Q

Consider the following statements:

  1. Veins are about 8 times more distensible than arteries.
  2. Vascular compliance is directly proportional to volume increase and indirectly proportional to pressure.

A. Only statement 1 is true.

B. Only statement 2 is true.

C. Both statements are true.

D. Both false statements are false.

A

C. Both statements are true.

The equation for vascular compliance is: (increase in volume) / (increase in pressure).

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18
Q

Which of the following relationships is correct?

A. The greater the amount of elastic tissue in a blood vessel, the higher the compliance and the lower the elastance.

B. The greater the amount of elastic tissue in a blood vessel, the higher the compliance and the elastance.

C. The greater the amount of elastic tissue in a blood vessel, the lower the compliance and the elastance.

D. The greater the amount of elastic tissue in a blood vessel, the lower the compliance and the greater the elastance.

A

D. The greater the amount of elastic tissue in a blood vessel, the lower the compliance and the greater the elastance.

Elastic tissue is responsible for the elasticity of a blood vessel.

Elastance is the reciprocal of compliance.

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19
Q

High resistance in which of the following groups of vessels results in a disappearance in the phasic pressure pattern such as is seen in the aorta?

A. Pulmonary arteries

B. Systemic arterioles

C. Systemic veins

D. Pulmonary capillaries

A

B. Systemic arterioles

Resistance is the inverse of conductance/compliance and the less compliant a vessel is the less its volume changes with changes in pressure, such as those seen in the aorta.

The equation for pulse pressure is: (stroke volume) / (arterial compliance).

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20
Q

The least amount of damping of pressure pulses would occur in which of the following components of the circulatory system?

A. Femoral artery

B. Arterioles

C. Capillaries

D. Venules

A

A. Femoral artery

Pulse pressures are more prominent in arteries and therefore harder to dampen.

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21
Q

Precapillary sphincters are associated with which of the following types of vessels?

A. Small arteries

B. Arterioles

C. Metarterioles

D. Capillaries

A

C. Metarterioles

Metarterioles lack a smooth muslce coating that is found on most other vessels excluding capillaries.

Capillaries are found beyond the precapillary sphincters.

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22
Q

The forces that determine whether fluid will move out of the blood into the interstitial fluid or in the opposite direction are referred to as Starling forces. Which of the following forces tends to move fluid inward at the arterial end of the capillary?

A. Capillary hydrostatic pressure

B. Negative interstitial free fluid pressure

C. Plasma colloid osmotic pressure

D. Interstitial fluid colloid osmotic pressure

A

C. Plasma colloid osmotic pressure

Plasma colloid osmotic pressure is the force generated by proteins in the plasma which draws water into the vessel.

Capillary hydrostatic pressure pushes water out of the vessel.

Interstitial fluid colloid osmotic pressue draws water out of the vessel.

A positive interstitial free fluid pressure would push fluid into the vessel, however, it is negative so it pulls fluid out.

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23
Q

If mean capillary pressure is 17.3 mmHg; and negative interstitial free fluid pressure is 3.0 mmHg; and interstitial fluid colloid osmotic pressure is 8.0 mmHg; and plasma colloid osmotic pressure is 28.0 mmHg; what is the total inward force?

A. 17.3 mmHg

B. 20.3 mmHg

C. 28.0 mmHg

D. 28.3 mmHg

A

C. 28.0 mmHg

Plasma colloid osmotic pressure is the only inward force listed.

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24
Q

In any tissue in the body, a rapid increase in arterial pressure causes an immediate rise in blood flow. But within less than a minute, the blood flow in most tissues returns almost to the normal level even though the arterial pressure is kept elevated. This return of flow to normal is due to which of the following events?

A. Autoregulation of blood flow

B. Tubuloglomerular feedback

C. Sympathetic response

D. Mean sympathetic pressure feedback

A

A. Autoregulation of blood flow

25
Q

Which of the following factors is most responsible for controlling the rate of blood flow to each tissue of the body so that it is precisely controlled in relation to tissue need?

A. Sympathetic system

B. Renin-aldosterone-angiotensinogen system

C. Oxygen and accumulation of tissue waste products

D. Constriction of large venous resevoirs

A

C. Oxygen and accumulation of tissue waste products

26
Q

Which of the following substances would NOT result in vasoconstriction?

A. Epinephrine/norepineprhine

B. Angiotensin II

C. Nitric oxide

D. Endothelin

A

C. Nitric oxide

27
Q

Signals from peripheral baroreceptors have which of the following effect(s) on the cardiac centers in the brain stem?

A. Inhibit vasoconstrictor and excite vasodilator centers

B. Inhibit both vasoconstrictor and vasodilator centers

C. Inhibit vasodilator and excite vasoconstrictor centers

D. Excite both vasoconstrictor and vasodilator centers

A

A. Inhibit vasoconstrictor and excite vasodilator centers

Peripheral baroreceptors increase stimulation of the vagus nerve and Herring’s nerves with increased blood pressure. Increased stimulation of these nerves lead to stimulation of the vasodilator center which then inhibits the vasoconstrictor center resulting in vasodilation. A decrease in blood pressure has the opposite effect as long as blood pressure remains above 60 mmHg in the carotid artery.

28
Q

Which of the following factors results in decreased peripheral resistance (vessel dilation) leading to decreased blood pressure?

A. Increased production of angiotension II

B. Increased release of thromboxane

C. Increased release of catecholamines

D. Increase in atrionatriuretic peptide (ANP)

A

D. Increase in atrionatriuretic peptide (ANP)

ANP is released due to atrial stretch (increase atrial pressure) and increases renal naturesis which results in decreased

29
Q

Which of the following factors is related to primary (essential) hypertension?

A. Sedentary life style

B. Preeclampsia

C. Renal artery constriction

D. Coarctation of the aorta

A

A. Sedentary life style

Primary hypertension is hypertension that does not occur secondary to other medical conditions. It is characterized by increased cardiac output, increased sympathetic nerve activity, increased angiotension II and aldosterone levels, impairment of renal pressure naturesis, and inadequate secretion of water and salt.

30
Q

Characteristics of primary hypertension would NOT include which of the following?

A. Sympathetic nerve activity

B. Increased cardiac output

C. Activation of renal-pressure naturesis mechanism

D. Increased levels of angiotension II and aldosterone in obese patients

A

C. Activation of renal-pressure naturesis mechanism

Activation of renal-pressure naturesis mechanism would correct for hypertension by increasing release of water and sodium which decreases blood volume.

31
Q

Angiotensionogen is converted to angiotensin I by renin. Angiotensin I is then converted to angiotension II, which then results in an increase in extracellular fluid volume. Angiotensinogen is derived from which of the following sources?

A. Kidney

B. Liver

C. Adrenal cortex

D. Adrenal medulla

A

B. Liver

Most (not all) proteins that are always present in the blood stream are secreted by the liver.

32
Q

Blocking of the renin-angiotensin mechanism would have which of the following effects on arterial pressure?

A. It would have no effect on arterial pressure

B. It would result in sodium and water retention and increased arterial pressure.

C. It would result in sodium and water retention and decreased arterial pressure.

D. It would result in sodium and water loss and increased arterial pressure.

E. It would result in sodium and water loss and decreased arterial pressure.

A

E. It would result in sodium and water loss and decreased arterial pressure.

The renin-angiotensin mechanism is a response to low blood pressure in the kidney and results in increased blood pressure. This occurs via activation of angiotensin II which, on its own, stimulates vasoconstriction and also causes secretion of aldosterone from the adrenal gland which causes retention of water and salt in the kidney resulting in increased blood volume.

33
Q

Using the Flick principle for calculating the cardiac output, the patient’s oxygen consumption volume could be divided by which of the following?
A. The difference between the oxygen concentration in the systemic arterial blood and the systemic mixed venous blood.

B. The difference between the oxygen concentration in the systemic arterial blood and the pulmonary vein.

C. The difference between the oxygen concentration in the systemic mixed venous blood and the pulmonary vein.

D. The difference between the oxygen concentraiton in the systemic mixed venous blood and the pulmonary artery.

A

A. The difference between the oxygen concentration in the systemic arterial blood and the systemic mixed venous blood.

Flick’s principle: cardiac output = oxygen absorption per minute / the difference in arteriovenous oxygen concentration

Arterial oxygen concentraiton - venous oxygen concentration is how much oxygen the body used from the blood as it fully circulated. Oxygen absorption from the blood will fully replenish this.

34
Q

Which of the following factors would cause a hypereffective heart?

A. Hypertrophy of the heart

B. Valvular heart disease

C. Inhibition of nervous excitation of the heart

D. Coronary artery blockage

A

A. Hypertrophy of the heart

Hypertrophy of the heart is enlargement of cardiac muslce tissue. This results in a stronger force of contraction. The other answers result in a weakening of contraction or loss of effiency in pumping blood

35
Q

A certain dietary deficiency condition weakens the heart. Under these conditions, if the systemic filling pressure is 11.5, the right atrial pressure is 9 mmHg, and the cardiac output is 8 L/min, this type of heart failure would be best referred to as which of the following?

A. Low-output cardiac failure

B. Left-right cardiac shunt

C. Right-left cardiac shunt

D. High-output cardiac failure

A

D. High-output cardiac failure

The question states that it is a dietary deficiency causing heart weakening which is responsible for the changes (this eliminates the cardiac shunts). Cardiac output is higher than normal (5 L/min) indicates high-output cardiac failure.

36
Q

Which of the following factors is NOT quantitatively expressed on the venous return curve?

A. Mean systemic filling pressure

B. Right atrial pressure

C. Blood flow resistance between peripheral vessels and right atrium

D. Cardiac output

A

D. Cardiac output

Cardiac output is a sperate curve from the venous return curve.

The x-axis represents right atrial pressure, the intersection of the graph with the x-axis represents mean systemic filling pressure, and blood flow resistance can be calculated using mean systemic filling pressure, right atrial pressure, and venous return. (See slide 30 of cardiac output lecture)

37
Q

An increase in blood volume would have which of the following effects on the cardiac and vascular function curves?

A. A decrease in mean systemic pressure and a shift of the vascular function curve to the right.

B. A decrease in mean systemic pressure and a shift of the vascular function curve to the left.

C. An increase in mean systemic pressure and a shift of the vascular function curve to the right.

D. An increase in mean systemic pressure and a shift of the vascular function curve to the left.

A

C. An increase in mean systemic pressure and a shift of the vascular function curve to the right.

An increase in blood volume will increase arterial pressure (which is directly related to cardiac output; see slide 17 of cardiac output lecture).

An increase in blood volume will increase mean systemic filling pressure (see slide 44 of the cardiac output lecture) which is represented by a shift to the right on vascular function curve.

38
Q

During exercise, total peripheral resistance decreases because of the effect of which of the following?

A. The sympathetic nervous system on splanchnic nerve

B. The parasympathetic nervous system on the skeletal muscle arterioles

C. Local metabolites of the skeletal muscle arterioles

D. Local metabolites on the cerebral arteries

A

C. Local metabolites of the skeletal muscle arterioles

The most important factor regulating vasomotion (which directly effects peripheral resistance) is the local oxygen (a metabolite) concentration in the tissues.

The factors regulating blood flow control specifically in muslce tissues include oxygen, adenosine, potassium, ATP, lactic acid, and CO2.

39
Q

When both the mean systemic filling pressure and right atrial pressure are 7, what is the venous return rate?

A. 5.2 liters per minute

B. 5 liters per minute

C. 4 liters per minute

D. 0 liters per minute

A

D. 0 liters per minute

If both pressures are the same there is no force driving blood into the atrium resulting in no venous returnn.

40
Q

Which of the following would not occur as a result of a mass discharge of the sympathetic system during exercise?

A. Strong contraction of coronary arteries

B. Increase in the mean systemic filling pressure due to contraction of the muscle walls of veins

C. Increase in heart rate

D. Strong contraction of most peripheral arteries

A

A. Strong contraction of coronary arteries

The coronary arteries supply blood to the heart. Strong contraction of the coronary artieres would cause decreased blood flow to the heart and result in weakening of the heart and decreased cardiac output. This is bad for you.

41
Q

Which of the following is the primary controller of coronary artery blood flow?

A. Sympathetic innervations

B. Parasympathetic innervations

C. Local muscle metabolism

D. Systemic venous resistance

A

C. Local muscle metabolism

“Rate of blood flow to each tissue in the body is almost always precisely controlled in relation to the tissue need.”

42
Q

Which of the following mechanisms would most likely serve as the major immediate factor in compensating for an acute myocardial infarction?

A. Renin-angiotensin system

B. Aldosterone

C. Sympathetic response

D. Intravenous fluid therapy

A

C. Sympathetic response

Myocardial infarction results in localized weakening of cardiac muscle tissue and decreases cardiac output.

Sympathetic stimulation will increase the force of contraction of muscle tissue and constrict most vessels resulting in increased venous return. Both of these act to compensate for the decrease in cardiac output.

43
Q

Which of the following pairs of potentially fatal conditions may follow severe acute left heart failure?

A. Pulmonary vascular congestion and pulmonary edema

B. Systemic vascular congestion and pulmonary edema

C. Systemic vascular congestion and systemic edema

D. Pulmonary vascular congestion and systemic edema

A

A. Pulmonary vascular congestion and pulmonary edema

Acute left heart failure results in blood volume in the pulmonary vessels (pulmonary vascular congestion) due to the left heart being unable to pump blood out to receive blood from the pulmonary system. If pressure isn’t he pulmonary system is high enough, leakage of fluid from the vessels into interstitial spaces and alveoli of the lungs occurs (pulmonary edema).

44
Q

The second heart sound is due to which of the following events?

A. Closure of the atrioventricular valves at the onset of ventricular systole

B. Opening of the atrioventricular valves at the onset of atrial systole

C. Closure of semilunar valves at onset of ventricular diastole

D. Opening of semilunar valves at onset of ventricular diastole

A

C. Closure of semilunar valves at onset of ventricular diastole

Heart sounds are made by the closing of valves and are numbered by the order in which they occur in a cardiac cycle (systole followed by diastole). The first heart sound occurs at the beginning of ventricular systole when the AV valves close and the second occurs at the beginning of ventricular diastole when the semilunar valves close.

45
Q

Compared to non-progressive shock, which of the following is one of the most important features of progressive shock?

A. Sympathetic reflexes

B. Hemorrhagic in origin

C. Cardiac depression

D. Increased vascular permeability

A

B. Hemorrhagic in origin

Continued loss of blood volume counteracts the bodies attempts to compensate for cardiac output. Eventually levels of cardiac output get low enough that they are not able to provide adequate blood supply to the heart through the coronary arteries which leads to a positive feedback mechanism resulting in progressive loss of cardiac output.

46
Q

Spinal anesthesia has which of the following effects on cardiac output and venous returns?

A. It decreases venous return but increases cardiac output

B. It decreases venous return and cardiac output

C. It increases venous return but decreases cardiac output.

D. It increases venous return and cardiac output

A

B. It decreases venous return and cardiac output

Spinal anesthesia blocks sympathetic nervous stimulation which will result in dilation of blood vessels, decrease in heart rate, and decreased force of heart contraction.

47
Q

Which of the following conditions increases the systemic filling pressure by decreasing vascular compliance?

A. Lying down

B. Renin-angiotensin-aldosterone system

C. Burn trauma

D. Inhibition of the sympathetic system

A

A. Lying down

48
Q

ADH (anti-diuretic hormone) is found in the supraoptic and paraventricular nuclei. It is secreted by specialized neurons from which of the following areas?

A. Adrenal cortex

B. Adrenal medulla

C. Anterior pituitary

D. Posterior pituitary

A

D. Posterior pituitary

49
Q

Which of the following factors would decrease venous return and increase right atrial pressure?

A. Hemorrhage

B. Vasodilation

C. Decreased venous compliance

D. Increased ADH secretion

A

A. Hemorrhage

50
Q

Vascular distensibility is directly proportional to which of the following?

A. Increase in volume

B. Original volume

C. Increase in pressure

D. Original pressure

E. Both A and C

A

A. Increase in volume

The equation for distensibility is: increase in volume / (increase in pressure x original volume).

51
Q

Which of the following properties is a measure of the ease with which a hollow structure may be distended?

A. Elastance

B. Compliance

C. Resistance

D. Distensibility

A

B. Compliance

Who knows why, but this is what he said we need to remember the answer as.

52
Q

Which of the following factors affect(s) pulse pressure?

A. Vascular elastance

B. Arterial complaince

C. Stroke volume

D. All of the above

E. B and C only

A

E. B and C only (arterial compliance and stroke volume)

Pulse pressure = stroke volume / arterial compliance.

53
Q

Which of the following is the most important means for the exchange of substances between the blood and interstitial fluid?

A. Blood hydrostatic pressure

B. Capillary oncotic pressure

C. Diffusion

D. Interstitial fluid hydrostatic pressure

E. Osmotic pressure

A

C. Diffusion

Lipid souble substances diffuse through capillary cell membranes.

Non-lipid-soluble substances diffuse through intercellular pores/clefts.

54
Q

Baroreceptors are extremely abundant in carotid sinuses and the walls of the aortic arch. Which of the following transmit signals from baroreceptors to cranial nerve IX (glossopharyngeal nerve)?

A. Mueller nerves

B. Hering nerves

C. Starling nerves

D. Purkinje nerves

A

B. Hering nerves

55
Q

Approximately how much of the total cardiac output is received by the kidneys?

A. 25%

B. 50%

C. 75%

D. 100%

A

A. 25%

Kidneys receive ~22% of cardiac output.

56
Q

Which of the following describes the effects of adding hypertonic sodium chloride to extracellular fluid after osmotic equilibrium is reached?

A. Both extracellular and intracellular volume decrease and osmolarity in both compartments increases.

B. The extracellular volume decreases and the intracellular volume increases; osmolarity in both compartments increases.

C. The extracellular volume increases and the intracellular volume decreases; osmolarity in both compartments increases.

D. Both extracellular and intracellular volumes increase and osmolarity in both compartments increases.

A

C. The extracellular volume increases and the intracellular volume decreases; osmolarity in both compartments increases.

Volme in the extracellular space increases as that is where the fluid is added.

Volume in the intracellular space decreases because the higher concentration of sodium in the extracellular space generates an osmotic force.

Osmolarity in the extracellular space increases because the concentration of sodium in the fluid that is added was a high than the concentration initially present in the space.

Osmolarity in the intracellular space increases because the amount of sodium present stays the same but the volume decreases.

57
Q

The osmolar gap can be determined from the basic metabolic profile and helps to narrow the differential diagnosis. Which of the following can elevate the osmolar gap?

A. Ethanol

B. Glycerol

C. Sucrose

D. Glucose

A

A. Ethanol

He just wants you to remember that this is the answer. Glucose does this as well but ignore that fact.

58
Q

Which of the following characteristics would be true for cortical nephrons?

A. Glomeruli lie deep in the cortex near the medulla of the kidney and have short loops of Henle.

B. Glomeruli lie deep in the cortex near the medulla of the kidney and have long loops of Henle.

C. Glomeruli lie in the outer cortex and have short loops of Henle.

D. Glomeruli lie in the outer cortex and have long efferent arterioles.

A

C. Glomeruli lie in the outer cortex and have short loops of Henle.

Glomeruli that are in the cortex near the medulla with long loops of Henle which extend into the medulla are called juxtamedullary nephrons.

59
Q

The electrocardiogram below indicates which of the following conditions?

A. Tachycardia

B. Bradycardia

C. SA node block

D. AV block

A

A. Tachycardia

(J) Physiology Test 2 (10 decks)

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