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National Boards Part I > Physiology > Flashcards

Physiology Flashcards

1
Q 
Where is the arch of the azygous system located?
A. Posterior mediastinum 
B. Middle mediastinum 
C. Anterior mediastinum 
D. Superior mediastinum
A

B. Middle mediastinum

* this is the exception. Everything except the arch of the azygous system is located in the posterior mediastinum

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2
Q 
What is normal end diastolic volume at rest?
A. 120 ml
B. 100 ml
C. 60 ml
D. 50 ml
A

A. 120 ml

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3
Q 
What is normal average stroke volume?
A. 50 ml
B. 70 ml
C. 100 ml
D. 120 ml
A

B. 70 ml

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4
Q

During left ventricular contraction, about 70 mL of blood is pumped out into the systemic circulation. Roughly 50 mL of blood will remain in the left ventricle after the contraction. The 50 mL of blood remaining is referred to the…

A

End systolic volume a.k.a. afterload

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5
Q 
Where is the highest concentration of oxygen in the cardiac system?
A. Pulmonary vein
B. Inferior vena cava
C. Superior vena cava
D. Pulmonary artery
A

A. Pulmonary vein
* there are only two arteries in the body that carry deoxygenated blood and those are the pulmonary arteries in the umbilical artery

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6
Q 
The right side of the Bundle of His is known as...
A. Interventricular septum
B. Cordae tympani
C. Moderator band
D. Papillary muscle
A

C. Moderator band

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7
Q 
What is the physiological factor resulting in the absolute refractory period in the heart?
A. Leaky sodium channels
B. Slow potassium channels
C. Slow calcium channels
D. Slow sodium channels
A

C. Slow calcium channels
* it is absolutely impossible for and other action potential to fire during the absolute refractory period (AKA plateau). Leaky sodium channels are responsible for “auto rhythmicity” (AKA automatic conductivity)

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8
Q 
Where does atrial repolarization occur on the EKG?
A. Under the T wave
B. Under the QRS complex
C. Over the QRS complex
D. The J point
A

B. Under the QRS complex
* p-wave = atrial depolarization, QRS complex = ventricle depolarization, T-wave = ventricular repolarization, U-wave = repolarization of papillary muscle, and the J point indicates a myocardial infarction

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9
Q 
In what condition would you hear the third and/or fourth heart sound?
A. MI
B. CHF
C. Left sided heart failure
D. Right sided heart failure
A

B. CHF

*Congestive Heart Failure

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10
Q 
What is the most common cause of left sided heart failure?
A. Pulmonary disease
B. Aortic stenosis 
C. Mitral stenosis 
D. Hypertension
A

D. Hypertension
* aortic stenosis is the SECOND most common cause of left-sided heart failure. Due to the chronic hypertension, heart has to pump harder due to the increased blood volume causing left ventricular hypertrophy.

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11
Q

In left sided heart failure, there is an increase in hydrostatic pressure in the pulmonary viens which leads to fluid in the lungs. Where does the fluid first collect?

A

A. Diaphragmatic recess

* aka costophrenic angle

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12
Q 
At what vertebral level does the hemiazygous vein cross to join the azygous?
A. L1
B. T12
C. T8
D. T1
A

C. T8
* The azygous system starts at L1-L2. Hemiazygous vein is on the left and the azygous is on the right side of the body. The azygous system dumps its blood into the superior vena cava. The purpose of the azygous system is to take over and drain the lower extremities in the event the inferior vena cava gets obstructed.
(lower extremities = IVC, upper extremities = SVC)

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13
Q 
What is the first clinical presentation to occur due to left sided heart failure?
A. Increased cardiac output 
B. Pitting edema
C. Cyanosis 
D. Difficulty breathing
A

D. Difficulty breathing

* fluid in the lungs will cause difficulty breathing.

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14
Q 
Emphysema is a deficiency of...
A. Alpha I troponin
B. Beta I troponin 
C. Alpha I antitripsin 
D. Alpha II antitripsin
A

C. Alpha I antitripsin

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15
Q

Pitting edema is seen in…
A. Left sided heart failure
B. Right sided heart failure

A

B. Right sided heart failure
* the right atrium gets backed up due to the difference in pressure. If the right atrium gets backed up that will also back up the superior and inferior vena cavas. The backing up of the IVC will cause fluid to flow into the interstitium of the lower extremities.

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16
Q 
What is the most common lung condition causing right sided heart failure?
A. Bronchitis 
B. Pneumonia 
C. Emphysema 
D. Pleuritis
A

C. Emphysema
* Be careful! This is the most common LUNG condition that causes R sided heart failure. The most common OVERALL condition that will cause R sided heart failure is L sided heart failure.

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17
Q 
What is the mc cause of liver destruction in the western world?
A. Alcoholism 
B. Hepatitis C
C. Hepatitis B
D. Mono
A

A. Alcoholism

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18
Q 
In whom will you see Mallory Weiss bodies in the liver?
A. Diabetic
B. Anorexic
C. Bulimic
D. Alcoholic
A

D. Alcoholic

* Mallory Weiss Syndrome is caused from excessive vomiting in alcoholism.

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19
Q 
Edema from a decrease in blood proteins is seen in which condition?
A. Marasmus 
B. Hypothyroidism 
C. Diabetes Mellitus 
D. Kwashiorkor
A

D. Kwashiorkor

* they are getting enough calories but are not consuming proteins.

20
Q 
Hypoparathyroidism in infants is termed...
A. Marfan's 
B. Cretinism 
C. Hashimoto's 
D. Grave's Disease
A

B. Cretinism

* this will cause mental retardation in children

21
Q 
Which of these heart blocks will cause two P waves on an EKG?
A. Primary block 
B. Secondary block 
C. Tertiary block
D. Complete block
A

B. Secondary block
* This is known as “Winkebocks phenomena.” Primary blocks will cause elongation of the P-R interval. Complete blocks will cause a “random EKG.” And there’s no such thing as a tertiary block (at least in Irene Gold)

22
Q 
What will be present during a systolic murmur?
A. Aortic regurgitation 
B. Mitral stenosis 
C. Pulmonary regurgitation 
D. Aortic stenosis
A

D. Aortic stenosis
*ARMS PRTS = (A = aortic, R = regurgitation, M = mitral, S = stenosis. P = pulmonic, R = regurgitation, T = tricuspid, S = stenosis) ARMS PRTS is an acronym for diastolic murmurs. If they ask about systolic murmurs, switch the R’s and the S’s.

23
Q

Which is the precursor to ALL blood cells?

A

Hemocystoblast

24
Q 
Which is not part of tetrology of fallot?
A. Malposition of the aorta
B. Left ventricular hypertrophy
C. Interventricular septal defect 
D. Pulmonary stenosis
A

B. Left ventricular hypertrophy

* This should be right ventricular hypertrophy. Malposition = Dextraposition as in the acronym “DRIP”.

25
Q 
Marfan's Syndrome will cause which of the following?
A. Right ventricular hypertrophy 
B. Left ventricular hypertrophy 
C. Right atrial hypertrophy 
D. Left atrial hypertrophy
A

B. Left ventricular hypertrophy

26
Q 
Which of the conditions will cause mitral stenosis?
A. Systolic murmur 
B. Rheumatic fever
C. SBE
D. TB
A

B. Rheumatic fever
* The culprit in rheumatic fever is strep pyogens. The bacteria will create Aschoff bodies (vegetations (growths) of the heart valve)

27
Q 
Which causes aortic valve stenosis?
A. Strep pyogens
B. Staph aueros 
C. Treponema pallidum
D. Borrelia burgdorferi
A

C. Treponema pallidum

* this is the syphilis bacteria!! Strep pyogens = rheumatic fever. Borrelia burgdoferi = Lyme’s disease.

28
Q

Aka for Bohr Effect?

A

Hemoglobin dissociation curve

29
Q

Explain the Bohr Effect.

A

Basically the Bohr Effect is the necessity for hemoglobin to bind to O2 as tightly as possible, and to be able to release it as easily as possible. When hemoglobin is in the lungs, it needs to bind to O2 as tightly as possible (Left curve). But, when it travels out of the lungs and into the tissues, it needs to be able to easily release the O2 it’s carrying. Hemoglobin reaches the tissues and it “trades” the its O2 for CO2. If the tissues don’t have enough O2, hemoglobin will settle for H+. Increase in temperature and diphosphoglycerate (DPG) will also allow hemoglobin to release its O2 easily. Soooo, a right Bohr Curve will be achieved in 4 ways:
1. Increase in CO2
2. Increase in H+
3. Increase in temp
4. Increase in DPG
(A right Bohr Curve will be a decrease in all of those)

30
Q

Normal breathing (tidal volume) is controlled by…

A

The Pneumotaxic Center

31
Q

What is the Herring-Breuer Reflex?

A

As the lungs expand during NORMAL breathing, sensory stretch receptors fire when the lungs are “full.” This limits further inspiration. This is known as the Herring-Breur Reflex. The signal travels up the the vagus nerve up to the pneumotaxic center (asked on every test). The Apneustic center in the pons shuts off the pneumotaxic center and therefore the Herring-Breur Reflex to allow for deep breathing.

32
Q 
Which of these have the highest volume of air in the lungs?
A. Inspiratory reserve volume
B. Tidal volume
C. Vital capacity 
D. Residual volume
A

A. Inspiratory reserve volume

* roughly 3500 ml. You have to shut of the pneumotaxic center to get IRV

33
Q

What is the “dead space” in the lungs?

A

Air in the pulmonary tree not involved with gas exchange

34
Q 
The throat muscles used during respiration are controlled by...
A. Dorsal motor nucleus of vagus 
B. Nucleus ambiguous 
C. Pneumotaxic center
D. Apneustic center
A

B. Nucleus ambiguous
* Respiration itself is controlled by by the Dorsal motor nucleus of vagus but the throat muscles are from the nucleus ambigous (CN 9, 10, and 11).

35
Q 
Which cells produce surfactant?
A. Alveolar sacs 
B. Macrophages 
C. Type I pnuemocytes 
D. Type II pneumocytes
A

D. Type II pneumocytes

* Type I is responsible for gas exchange

36
Q

What happens to the transpulmonary pressure in emphysema?
A. It goes up
B. It goes down
C. It stays the same

A

B. It goes down
* transpulmonary pressure (aka recoil pressure aka end of inspiration pressure) - This is the difference between alveolar pressure and pleural pressure. It’s a good measure of elastic forces in the lungs which is greatest at the end of inspiration.

37
Q 
Neonatal Hyaline Membrane Disease is a deficiency of hat at birth?
A. Surfactant 
B. Hyaline cartilage 
C. Mucous membranes
D. Sweat glands
A

A. Surfactant

* neonatal hyaline membrane disease aka acute respiratory distress syndrome

38
Q 
What ligament separates the left lobe from the quadrate lobe of the liver?
A. Coronary ligament 
B. Ligamentum venosum 
C. Falciform ligament 
D. Ligamentum teres
A

D. Ligamentum teres aka Round ligament of the liver
* The coronary ligament attaches the liver to the underside of the diaphragm. The falciform ligament separates the right and left lobes. The gall bladder separates the quadrate lobe from the right lobe.

39
Q

The umbilical vein in an infant becomes the __________ in an adult.

A

Round ligament of the liver

40
Q 
What is the normal partial pressure of O2 in the capillary beds?
A. 104 mm/Hg
B. 40 mm/Hg
C. 43 mm/Hg
D. 110 mm/Hg
A

B. 40 mm/Hg

* 104 mm/HG = O2 in the lungs. There is also 40 mm/Hg of CO2 in the lungs. 43 mm/Hg = CO2 in capillary beds.

41
Q 
Where in the kidneys are most things reabsorbed?
A. Proximal convoluted tubules 
B. Distal convoluted tubules
C. Collecting ducts
D. Loop of Henle
A

A. Proximal convoluted tubules

* by podocytes

42
Q 
How does fluid leave the collecting ducts of the kidney?
A. Ureter 
B. Hilus 
C. Papilla
D. Pyramids
A

C. Papilla

43
Q 
The ureters run \_\_\_\_\_\_\_\_\_ to the psoas major.
A. Superior
B. Inferior 
C. Anterior 
D. Posterior
A

C. Anterior

44
Q 
The ureters attach to the \_\_\_\_\_\_\_\_\_ bladder and leaves the bladder by way of the urethra.
A. Superior
B. Inferior 
C. Anterior 
D. Posterior
A

D. Posterior

45
Q

Explain the course of the urethra as it leaves the bladder in the male and name the different sections.

A

As the urethra leaves the bladder it’s called the “preprostatic urethra.” As it passes through to prostate gland, it’s called the “prostatic urethra.” As it courses through the urogenital diaphragm it’s called the “membranous urethra.” And lastly, as it passes through the corpus spongiosum of the penis, it’s called the “spongy urethra” aka “penile urethra.”

National Boards Part I (5 decks)

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