The Human Body in Health and Illness Chapter 16 & 17
Which of the following refers to a positive inotropic effect?
an increased myocardial contractile force
The purpose of this structure is to momentarily delay the spread of the signal from the atrium to the ventricles
AV node
What do the venae cave, pulmonary artery, the aorta have in common?
All are called great vessels
Under what condition is blood most likely to flow "backward" (e.g. from the left ventricle back into the left atrium)?
an insufficient mitral valve
Decreased blood flow through the coronary arteries is most likely to cause
angina pectoris
Complete the sequence: blood flows from the pulmonary capillaries to the pulmonary veins to the left atrium to the left ventricle to the
aorta
Chordae tendineae are not associated with this valve
aortic
Stenosis of this valve causes left ventricular hypertorphy
aortic
Which of the following semilunar valves "sees" oxygenated blood
aortic
Purkinje Fibers
are distributed throughtout the ventricular myocardium
The semilunar valves
are outflow valves
The pulmonic and aortic valves
are semilunar valves
both the pulmonic and aortic valves
are semilunar valves
The mitral and bicuspid valves
are the same valve
Precordium
area of the anterior chest wall overlying the heart and great vessels.
afterload
arteriolar dilation decreases this
These conducting fibers rapidly spread the electrical signal throughout the ventricles
Purkinje fibers
Referring to the ECG, the P wave represents
atrial depolarization
Chordae tendineae
attach the cusps of the AV Valves to the ventricular walls
A cell that spontaneously depolarizes from resting membrane potential to threshold potential
called a pacemaker cell
What is the term for the sequence of events that occur during one heartbeat?
cardiac cycle
Mililiters per minute describes
cardiac ouptut
Heart rate and stroke volume determine
cardiac output
Milliliters/beat x beats/minute defines
cardiac output
Which term refers to the amount of blood pumped by the heart in one minute?
cardiac output
which of the following statements is correct about the cardiac output
cardiac output is determined by heart rate and stroke volume
Sympathetic nerve stimulation of the myocardium
causes a (+) inotropic effect
An accumulation of excess fluid in the pericardial space
causes external compression of the heart
Startling's law of the heart
change in myocardial contraction that is due to stretching of the heart muscle
inotropic effect
change in myocardial contraction that is not due to stretching of the heart muscle
starling's law of the heart
change in preload causes a change in myocardial contractile force.
An ejection fraction of 30% is
characteristic of a failing heart
Furosemide (Lasix), a potent diuretic, is administered in acute ventricular failure in order to
excrete excess water and relieve the edema
Identify this: a quivering ventricular muscle that is unable to pump blood
fibrillation
Cardiac output
is determined by heart rate and stroke volume
Which of th following is least true of the myocardium
is found in the ventricles but not the atria
The heart
is located within the mediastinum
(-) inotropic effect
least characteristic of sympathetic nerve stimulation
The aorta receives blood from the
left ventricle
This is the hardest working cardiac chamber, and therefore has the thickest myocardium
left ventricle
Which of the following is most likely to cause an elevation of pulmonary capillary hydrostatic pressure?
left ventricluar failure
bradycardia
less than 60 beats/min, vagal discharge, & (-) chronotropic effect
Which of the following is descriptive of stroke volume?
ml/beat
description of stroke volume
ml/beat
Systole and diastole describe the function of the
myocardium
This layer of the heart allows it to act as a pump
myocardium
Which layer of the heart has actin, myosin and intercalated discs
myocardium
Which of the following is descriptive of the vagus nerve?
parasympathetic
Which of the following most accurately describes the vagus nerve?
parasympathetic
(?) dromotropic effect and heart block (sympathetic activity or parasympathetic activity)
parasympathetic activity
activiation of the muscarinic receptors by ACh (sympathetic activity or parasympathetic activity)
parasympathetic activity
inhibition of the SA node activity and bradycardia (sympathetic activity or parasympathetic activity)
parasympathetic activity
vagal effects (sympathetic activity or parasympathetic activity)
parasympathetic activity
vagus nerve
parasympathetic, slows heart rate, autonomic
P wave
part of the ECG that indicates the atrial depolarization
P-R interval
part of the ECG that indicates the time it takes for the electrical signal to travel from the atrium to the ventricle
T wave
part of the ECG that represents ventricular repolarization
Which is wrong
parts of the conduction system: SA node, AV node, bundle of His, Purkinje fibers, medulla oblongata
ejection fraction
percentage of EDV pumped by the ventricle
This sling-like structure supports the heart
pericardium
Which of the following is least likely to be used in the treatment of left ventricular failure and pulmonary edema
peripheral vasoconstrictor such as norepinephrine (levophed)
Systole
phase of the cardiac cycle that refers to myocardial contraction
Diastole
phase of the cardiac cycle that refers to myocardial relaxiation
depolarization
phase of the cardiac impulse (action potential) that is due to the inflow (influx) of Na+
repolarization
phase of the cardiac impulse (action potential) that is due to the outflow (efflux) of K+
Which of the following spaces does not contain the heart?
pleural cavity
Starling's law relates force of myocardial contraction with
preload
Which of the following is the same as end dialostic volume?
preload
starling's law relates force of myocardial contraction with
preload
During ventricular contraction, the AV valves close in order to
prevent the backflow of blood from the ventricles to the atria
The right ventricle pumps blood from the pulmonary capillaries to the left atrium
pulmonary artery
Which of the following structures "sees" unoxyenated blood
pulmonary artery
Complete the sequence: blood flows from the right atrium to the right ventricle to the pulmonary artery to the
pulmonary capillaries
In which structure does blood change from blue to red?
pulmonary capillary
Which of the following is a consequense of backward failure assoicated with left sided heart failure?
pulmonary edema
Which of the following is the most likely consequence of acute left ventricular failure?
pulmonary edema
Vessel (s) that carry (ies) blood from the pulmonary capillaries to the left atrium
pulmonary veins
Which of the following "sees" oxygenated blood
pulmonary veins
Which structure "sees" oxygenated blood
pulmonary veins
Cardiac output is determined by heart rate and
stroke volume
What terms refers to the amount of blood pumped by the ventricle in one boat?
stroke volume
Which group is incorrect
structures that carry unoxygenated blood: right ventricle, venae cavae, pulmonary veins
(+) inotropic effect, (+) chronotropic effect, and increased cardiac output (sympathetic activity or parasympathetic activity)
sympathetic activity
activation of the beta1 adrenergic receptors by norepinephrine (sympathetic activity or parasympathetic activity)
sympathetic activity
increased heat rate and force of myocardial contraction (sympathetic activity or parasympathetic activity)
sympathetic activity
release of stress hormones, such as adrenalin by the adrenal medulla (sympathetic activity or parasympathetic activity)
sympathetic activity
stimulation of the SA node (sympathetic activity or parasympathetic activity)
sympathetic activity
tachycardia and palpitations (sympathetic activity or parasympathetic activity)
sympathetic activity
least descriptive of bradycardia
sympathetic nerve stimulation
Which of the following is descriptive of a drug that causes a (+) inotropic effect, a (+) dromotropic effect, and a (+) chronotropic effect?
sympathomimetic
Which of the following is most likely to elicit a (+) inotropic effect, a (+) drinitriouc effect abd a (+) chronotropic effect?
sympathomimetic activity
An enlarged myocardium (ventricular hypertorphy) indicates
that the heart must work harder than normal
Preload
the amount of blood in the ventrcle at the end of its resting phase
Pulmonary Artery
the blood vessel that carries blood from the right ventrticle to the lungs
Aorta
the left ventricle ejects blood into this blood vessel
which of the following is not true about the left ventricle? pumps blood into the aorta. receives blood from the left atrium. contains oxygenated blood. the oxygen from blood with in the left ventricle diffuses across the endocardium in to the left ventricular myocardium.
the oxygen from blood with in the left ventricle diffuses across the endocardium into the left ventricular myocardium.
SA node
the pacemaker of the heart
QRS complex
the part of the ECG that represents ventricular depolarization.
Which of the following is not true of the heart
the pericardium is compared of actin and myosin
Left Atrium
the pulmonary veins empty blood into this cardiac chamber
Right ventricle
the pulmonic and tricuspid valves are associated with this structure.
Purkinje Fibers
the rapidly conducting fibers that supply the ventricles.
A prolonged P-R interval means that
the signal traveling from the atria to the vetricles is abnormally slow
Pericardium
the sling-like fold of the epicardium that supports the heart
AV node
the structure that is located in the septum that seperates the right atrium and rt ventricle; it delays the entrance of the electrical signals in the ventricles
Right Atrium
the venae cavae empties blood into this cardiac chamber
What happens during ventricular diastole?
the ventricles are filling with blood
what is happening when the ventricles are filling?
the ventricles are relaxed
coronary arteries
these blood vessels arise at the base of the aorta just beyond the aortic valve.
Which of the following is least descriptive of the myocardium
thicker in the left atrium than the right ventricle
Biscupid Valve
this AV valve "sees" oxygenated blood
Pulmonic Valve
this similunar valve "sees" unoxygenated blood
The purpose of the right heart is to pump blood
to the lungs for oxygenation
Blood flows from the right atrium through this atrioventricular valve to the right ventricle
tricuspid
What is the name of the valve that prevents backflow of blood into the right atrium when the right ventricle contracts
tricuspid valve
Bradycardia is most likely to be caused by
vagal discharge
Which of the following is least likely to increase cardiac output?
vagal discharge
Which of the following is least related to tachydysrhythmia?
vagal discharge
lest likely to increase cardiac output
vagal discharge
During atrial systole, the
ventricles are relaxed
Referring to the ECG, the QRS complex represents
ventricular depolarization
Which of the following must precede ventricular contraction
ventricular depolarization
What is the cause of the heart sounds "lubb dupp"?
vibrations caused by closure of the valves
vagal discharge most likely causes
bradycardia
Digoxin, a drug used in the treatment of heart failure, increases contractile force and is therefore called a
(+) inotropic agent
least related to vagus nerve
(+) inotropic effect
which of the following is least related to the vagus nerve
(+) inotropic effect
Which of the following is least characteristic of sympathetic nerve stimulation?
(?) inotropic effect
Which of the following is least related to "lubb" (of the lubb-dupp duo)?
Caused by the firing of the SA node
Where does the cardiac action potential (cardiac impulse) normally originate
SA node
A drug causes a (+) inotropic effect, a (?) dromotropic effect. What drug response would you expect to observe
Slow heart rate
A change in preload causes a change in myocardial contractile force. This response is known as a
Starling's law of the heart
An increase in venous return causes an increase in cardiac output. This is accomplished by
Starling's law of the heart
What is the term that refers to an increase in stroke volume in response to the stretching of the heart?
Starling's law of the heart
Cardiac output
Stroke volume times heart rate
Left ventricle
The mitral valve and the aortic valve are associated with this structure.
Which of the following is most likely to increase stroke volume?
a (+) inotrpic drug
Pericardial Space
a cavity located between the epicardium and the parietal pericardium.
The AV valves close in response to
a rising ventricular pressure during ventricular contraction
What event causes the pulmonic valve to open
an increase in the pressure within the right ventricle
Which group is not right
abnormal heart rates: tachycardia, bradycardia, normal sinus rhythm
Myocardium
actin, myosin, and sarcomeres are terms that describe this contacting layer
in heart failure, patient is given drug classified as beta 1 adrenergic agonist. The drug
activates the beta 1 adrenergic receptors & causes (+) inotropic effect
A patient in heart failure is given a drug that is classified as a beta, adrenergic agonist. The drug
activates the beta1 adrenergic receptors and causes a (+) inotropic effect
Which of the following is most likely to increase ejection fraction?
activation of beta1 adrenergic receptors
tachydysrythmia
activation of sympathetic nervous system, beta 1 adrenergic receptor, & (+) dromotropic effect
Which of the following is true of the coronary blood flow?
all of the above are true--in a healthy heart, cornonary blood flow can increase. Atherosclerotic cornary blood vessels are usually maximally dilated at rest. A decrease in coronary blood flow causes pain(agina)
A collection of excess fluid in the pericardial space
all of the above are true. is called pericardial effusion, compresses the heart externally, impairs myocardial contraction.
preload
amount of blood in the ventricle @ the end of its resting phase
stroke volume
amount of blood pumped by the ventricle in one beat
Which of the following contains 70ml?
an average stroke volume
What is located at the second rib and fifth intercostal space?
bace and apex of the heart
Which of the following drugs is sympathomimetic?
beta1 adrenergic agonist
Which of the following is most likely to relieve an anxiety-induced tachycardia?
beta1 adrenergic blocker
Which of the following is least true of the aortic valve
blood blows from the ventricle through this valve into the pulmonary artery
During ventricular diastole
blood fills the ventricles
during ventricular diastole
blood fills the ventricles
Which of the following is a result of ventricular contraction
blood is pumped into the pulmonary artery and the aorta
A hold in the interventricular septum causes
blood to shunt from the left ventricle to the right ventricle
Excess vagal stimulation to the SA node is most likely to cause
bradycardia
This term refers to a heart rate of fewer that 60 beats/min
bradycardia
This structure connects the cusps of the AV valves to the ventricles
chordae tendineae
With which of the following is "lubb-dubb" associated?
closing of heart valves
What is the cause of the heart sounds "lubb-dubb"
closing of the heart valves
The Purkinje fibers
conduct electrical signals throughout the ventricles
Ventricular systole refers to
contraction of the ventricular myocardium
ventricular systole
contraction of the ventricular myocardium
Which of the following supplies oxygenated blood to the heart muscle
coronary arteries
Plasma elevations of CPK, AST, LDH and troponin are indicative of
damage of myocardial cells
Which of the following is the most likely consequence of a very rapid heart rate?
decreased ventricular filling (with blood)
Venodialation
decreases preload
venodilation
decreases preload
The atrioventricular node (AV node)
delays the electrical signal coming from the atria into the ventricles
Which of the following is an electrical event
depolarization
The action potential (cardiac impulse) has two phases:
depolarization and repolarization
cardiac output
determined by heart rate & stroke volume
Which of the following is an example of forward failure?
diminished renal blood flow stimulates the kidney to decrease urinary output and to retain Na+ and water
Which of the following does not happen to a ventricle?
discharge of the vagal nerve
S2 is
due to the closure of the semilunar valves at the beginning of the ventricular relaxation
Which of the following is responsible for the Starling effect?
end diastolic volume (EDV)
The pericardium is part of the
epicardium
under what condition is end-diastolic volume (EDV) most likely to increase while ejection freaction decreases
heart failure
Vagal stimulation to the heart causes
heart rate to slow
Which of the following is true of the structures of the structures of the electrical conduction system
in normal sinus rhythm, the electrical signal arises within the SA node
heart failure
increased end-diastolic volume increases while ejection fraction decreases
(-) inotropic effect
increased heart rate,stroke volume, & cardiac output
increased stroke volume
increased return of blood to heart stretches the heart muscle
A stenotic aortic valve
increases afterload, thereby increasing the work of the left ventricle
Digoxin is a (+) inotropic agent and therefore
increases cardiac output
digoxin is a (+) inotropic agent, therefore
increases cardiac output
Atropine, a muscarinic blocker
increases heart rate
Sympathetic stimulation to the heart
increases heart rate
atropine, a muscarinic blocker
increases heart rate
An increased preload
increases stroke volume
A drug (i.e., atropine) that blocks the vagus nerve
increases the heart rate
An increased afterload (e.g., hypertension)
increases the work of the heart
Increased return of the blood to the heart stretches the muscle, thereby
increasing stroke volume
increased return of blood to the heart stretches the heart muscle, thereby
increasing stroke volume
Which of the following is a function of a valve
regulates the direction of the flow of blood through the heart
What are ventricles "doing" during trial contraction?
relaxing
Atropine is a muscarinic antagonist and is therefore used to
relieve bradycardia
Most of the symptoms of acute left-sided heart failure are
respiratory in nature (e.g., dyspnea, orthopnea)
The pacemaker of the heart is located in the upper wall of the
right atrium
Which cavity first receives unoxygenated blood from the vena cava
right atrium
An elevation in pulmonary artery pressure is most likely to cause
right ventricular hypertrophy
elevation in pulmonary artery pressure is most likely to cause
right ventricular hypertrophy
Jugular vein distention is most associated with
right-sided heart failure
the semilunar valves open in response to
rising ventricular pressure during ventricular contraction
preload
same as end-diastolic volume (EDV)
All of the following are electrical terms except
sarcomere
Which of the following is least related to the mitral valve
semilunar
drug causes (+) inotropic effect, (-) dromotropic effect, & (-) chronotropic effect. what drug response would you observe
slow heart rate
Activation of the muscarinic receptors by acetylcholine
slows heart rate
Vagal stimulation on the heart
slows the heart rate
