A&P 102 MSJC-Vessels & Cardiac Study Guide

In order to supply nourishment to liver tissue, which vessel must deliver blood to the organ? a) hepatic artery b) hepatic vein c) hepatic portal vein d) superior mesenteric artery e) splenic artery

a) hepatic artery

The period of atrial systole lasts about [dropdown 1] while the period of ventricular systole lasts approximately [dropdown 2].

0.1 second, 0.3 second

In the fetal heart, several structures allow blood from the left and right sides to mix. When the newborn takes its first breath, these structures must close to ensure that oxygenated blood from the left side does not mix with deoxygenated blood from the right side. Which of the following closed structures prevent this mixing between the systemic and pulmonary circulation after the umbilical cord is cut? a) fossa ovalis b) ligamentum arteriosum c) ligamentum venosum d) ligamentum teres

a) fossa ovalis b) ligamentum arteriosum

Which week of fetal development might be considered the stage of development of the heart with the chambers as they will be oriented for the rest of the individual's life? a) fourth b) fifth c) sixth d) seventh e) eighth

a) fourth

Nutrients from digested food enter the liver via the a) hepatic portal circulation b) hepatic vein c) abdominal aorta d) inferior vena cava e) renal veins

a) hepatic portal circulation

TRUE OR FALSE Direct pressure from the outside of the neck onto the carotid sinuses should stimulate the carotid sinus reflex and slow the heart rate and lower blood pressure.

TRUE

TRUE OR FALSE Massaging the neck over the carotid sinus might lead to a reduction in blood pressure due to nerve impulses traveling through the glossopharyngeal (IX) nerves arriving at the medulla oblongata.

TRUE

Cardiac output is dependent on both a) heart rate and stroke volume. b) stroke volume and systemic vascular resistance. c) heart rate and systemic vascular resistance. d) blood type and stroke volume. e) blood pressure and heart rate

a) heart rate and stroke volume.

Capillaries are also referred to as a) exchange vessels. b) vasoconstrictors. c) vasodilators. d) pressure reservoirs. e) distributing vessels.

a) exchange vessels.

Contraction of the ventricles of the heart leads to blood moving directly a) into arteries. b) into capillaries. c) into veins. d) through an atrioventricular valve. e) through the apex.

a) into arteries.

Which of the following correctly describes ventricular ejection? Select all that apply. a) occurs when semilunar valves are open b) occurs when semilunar valves are closed c) lasts for about 0.25 second d) lasts for about 0.1 second e) occurs when atrioventricular valves are open f) occurs when atrioventricular valves are closed

a) occurs when semilunar valves are open c) lasts for about 0.25 second f) occurs when atrioventricular valves are closed

The membrane that surrounds and protects the heart is called the a) pericardium. b) pleura. c) myocardium. d) mediastinum. e) endocardium.

a) pericardium.

What would the mean arterial pressure be for an individual with a blood pressure of 120/80? a) 40 b) 93.3 c) 13.3 d) 120 e) 200

b) 93.3

Which of the following categories of hypertension drugs lower blood pressure by blocking formation of angiotensin II, which results in vasodilation and decreased aldosterone secretion? a) Diuretics b) ACE inhibitors c) Beta blockers d) Calcium channel blockers e) Anabolic steroids

b) ACE inhibitors

Identify the groove found on the surface of the heart that marks the boundary between the right and left ventricles. a) Coronary sulcus b) Anterior interventricular sulcus c) Posterior interventricular sulcus d) Coronary sinus e) Anterior intraventricular sulcus

b) Anterior interventricular sulcus

Which wave in an electrocardiogram represents repolarization of the ventricles? a) R wave b) T wave c) S wave d) P wave e) Q wave

b) T wave

In comparison to a sedentary individual, a well-trained athlete will usually have all the following characteristics EXCEPT a) a higher cardiac reserve. b) a higher resting cardiac output. c) a higher stroke volume. d) hypertrophy of the heart. e) resting bradycardia.

b) a higher resting cardiac output.

The branches from the ascending aorta that supply blood to the cardiac muscle are the a) circumflex arteries b) coronary arteries c) anterior descending arteries d) interventricular arteries e) pulmonary arteries

b) coronary arteries

The chemical histamine causes capillary walls to become more permeable. Excess histamine secretion, as might be seen in allergic responses, might lead to a) decreased blood flow b) edema c) increased pain sensation d) blood clotting e) hypertension

b) edema

The pressure-driven movement of fluids and solutes from blood into interstitial fluid is called a) reabsorption. b) filtration. c) bulk flow. d) osmosis. e) transcytosis.

b) filtration.

During embryonic development, blood cells are formed from a) endodermal cells. b) pluripotent stem cells. c) angioblasts. d) fibroblasts. e) osteoblasts.

b) pluripotent stem cells.

Blood flow passing through the posterior aspect of the knee is achieved through the a) tibial arteries b) popliteal arteries c) common iliac arteries d) internal iliac arteries e) external iliac arteries

b) popliteal arteries

Which of the following structures is used to control the flow of blood through a capillary bed? a) thoroughfare channels b) precapillary sphincters c) postcapillary sphincters d) venules e) valves in veins

b) precapillary sphincters

The pulmonary circulatory route carries blood from the a) right atrium to the right ventricle. b) right ventricle to the left atrium. c) left atrium to the left ventricle. d) left ventricle to the right atrium. e) left ventricle to the coronary sinus.

b) right ventricle to the left atrium.

Which term refers to the period of time during a cardiac cycle when contraction of a chamber occurs and pressure within the chamber rises? a) filling b) systole c) repolarization d) diastole e) fibrillation

b) systole

Emphysema is a chronic obstructive pulmonary disease (COPD) that causes progressive destruction of alveoli (air sacs) in the lungs leading to a decreased ability to exhale. How does this disease affect carbon dioxide levels in the blood? a) they are unaffected b) they increase c) they decrease d) the result varies with each individual e) first, they increase, then they decrease

b) they increase

The apex of the heart is normally pointed a) at the midline. b) to the left of the midline. c) to the right of the midline. d) is different for males and females e) posteriorly.

b) to the left of the midline.

Which layer of the arterial wall is responsible for vasoconstriction? a) tunica interna b) tunica media c) tunica externa d) tunica albuginea e) tunica fascia

b) tunica media

Positive inotropic agents often promote inflow of which cation to increase contractility of the heart? a) sodium b) potassium c) magnesium d) phosphorus e) calcium

e) calcium

Which of the following is a corrective cardiac procedure in which a large piece of a patient's own latissimus dorsi muscle is wrapped around the heart and stimulated by an implanted pacemaker to assist the pumping action of a damaged heart? a) cardioversion b) cardiogenic transplant c) cardiomyopathy d) cardiomegaly e) cardiomyoplasty

e) cardiomyoplasty

The most common disorder affecting the heart and blood vessels is a) hypotension b) aneurysm c) infarction d) arrhythmia e) hypertension

e) hypertension

All the veins of the systemic circulation eventually drain into the a) superior vena cava. b) inferior vena cava. c) coronary sinus. d) superior and inferior vena cava. e) superior and inferior vena cava and coronary sinus.

e) superior and inferior vena cava and coronary sinus.

The bronchial arteries arise from the a) left subclavian artery b) brachiocephalic trunk c) right subclavian artery d) left common carotid artery e) thoracic aorta

e) thoracic aorta

Isovolumetric contraction is the phase of the cardiac cycle in which a) the semilunar valves are open. b) ventricular repolarization occurs. c) atrial depolarization occurs. d) oxygenated blood leaves the heart into the systemic circulation. e) ventricular pressure increases and ventricular volume remains the same.

e) ventricular pressure increases and ventricular volume remains the same.

Cardiac output is the volume of blood ejected from the [dropdown 1] ventricle into the [dropdown 2] each minute.

left or right, aorta or pulmonary trunk

In comparison to skeletal muscle fibers, the contractile fibers of the heart are depolarized for [___] period of time

longer

Normal blood pressure for a young adult male is less than a) 120/80. b) 130/90. c) 80/120. d) 100/80. e) 150/85.

a) 120/80.

What is the function of the foramen ovale during fetal life? a) Allowing blood to flow directly from the right atrium into the left atrium. b) Allowing blood to flow directly from the right ventricle into the left ventricle. c) Serves as a valve in the vena cava to regulate venous blood flow. d) Prevents back flow of blood from aorta into the left ventricle. e) Prevents back flow of blood from pulmonary trunk into the right ventricle.

a) Allowing blood to flow directly from the right atrium into the left atrium.

Which of the following hormones would NOT stimulate changes that lead to an increase in arterial blood pressure? a) Atrial natriuretic peptide (ANP) b) Antidiuretic hormone (ADH) c) Aldosterone d) Angiotensin II e) Norepinephrine

a) Atrial natriuretic peptide (ANP)

Which of the following blood vessels is used to distribute oxygenated blood to the myocardium? a) Coronary artery b) Coronary vein c) Coronary sinus d) Vena cava e) Myocardial vein

a) Coronary artery

What type of tissue comprises the valves of the heart? a) Dense connective tissue b) Areolar connective tissue c) Hyaline cartilage d) Cardiac muscle tissue e) Adipose tissue

a) Dense connective tissue

Which of the following vessels carries the venous blood from the lower body into the right atrium? a) Inferior vena cava b) Superior vena cava c) Tibial vein d) Coronary vein e) Iliac vein

a) Inferior vena cava

Identify the muscular ridges that are found on the anterior wall of the right atrium and extend into the auricles. a) Pectinate muscles b) Trabeculae carneae c) Coronary sulci d) Papillary muscles e) Chordae tendinae

a) Pectinate muscles

Which of the following blood vessels carries blood away from the heart to other organs? a) arteries b) capillaries c) venules d) arterioles e) veins

a) arteries

Which of the following types of blood vessels have high, pulsing blood pressure? a) arterioles b) capillaries c) venules d) veins e) vena cavae

a) arterioles

The volume of blood ejected from the left ventricle into the aorta each minute is called the a) cardiac output. b) cardiac input. c) stroke volume. d) heart rate. e) pulse pressure.

a) cardiac output.

Which of the following is the most important method of capillary exchange? a) diffusion b) facilitated diffusion c) bulk flow d) primary active transport e) secondary active transport

a) diffusion

The visceral layer of the serous pericardium is also considered to be the a) epicardium b) myocardium c) endocardium d) fibrous pericardium e) None of the answer selections is correct

a) epicardium

Vascular resistance depends on which of these factors? Select all that apply. a) size of the blood vessel lumen b) blood viscosity c) total blood vessel length d) glucose content of the blood

a) size of the blood vessel lumen b) blood viscosity c) total blood vessel length

The tunica interna of [dropdown 1] is thin with a fenestrated internal elastic lamina that disappears distally, while the tunica interna of [dropdown 2] is made of endothelium and a basement membrane with no internal elastic lamina.

arterioles, veins

Which of the following veins drains the muscles, bones and skin of the hand of the forearm? Select all that apply. a) axillary veins b) ulnar veins c) radial veins d) brachial veins

b) ulnar veins c) radial veins

Which of the following is NOT a contribution of the cardiovascular system to other body systems? a) Blood delivers clotting factors and WBCs that aid in hemostasis when skin is damaged. b) Blood delivers calcium and phosphate ions that are needed for building bone extracellular matrix. c) Blood carries carbon dioxide to body tissues and removes oxygen for use by other organs. d) Blood carries newly absorbed nutrients and water to the liver. e) Blood circulates cells and chemicals that carry out immune functions.

c) Blood carries carbon dioxide to body tissues and removes oxygen for use by other organs.

Which of the following types of muscle contains the largest number of mitochondria per cell? a) Smooth muscle b) Skeletal muscle c) Cardiac muscle d) All the muscle types contain approximately the same number. e) Mitochondria are not found in muscle cells.

c) Cardiac muscle

Which of the following would NOT result in an increase in systemic vascular resistance? a) Decreased diameter of systemic arterioles b) Increased blood viscosity c) Decreased length of the systemic circulatory route d) Increased vasoconstriction of systemic arterioles e) Increased red blood cell count

c) Decreased length of the systemic circulatory route

Which of the following would lead to a decreased heart rate? a) Increased norepinephrine release b) Increased thyroid hormone release c) Increased potassium levels in plasma d) Increased calcium levels in plasma e) Increased sympathetic stimulation

c) Increased potassium levels in plasma

An increase in the carbon dioxide levels in the blood leads to a change in the chemical composition of the blood. This input would be received by which part of the brain that regulates heart rate? a) Midbrain b) Cerebrum c) Medulla oblongata d) Cerebellum e) Thalamus

c) Medulla oblongata

Which of the following vessels supplies blood to the intestines? a) Radial artery b) Subclavian artery c) Mesenteric artery d) Coronary artery e) Popliteal artery

c) Mesenteric artery

Which layer of the heart wall consists of cardiac muscle tissue? a) Epicardium b) Pericardium c) Myocardium d) Endocardium e) Hypocardium

c) Myocardium

Which valve below prevents blood from flowing back into the right ventricle? a) Tricuspid valve b) Bicuspid valve c) Pulmonary semilunar valve d) Aortic semilunar valve e) Mitral valve

c) Pulmonary semilunar valve

Which of the following chambers of the heart contains deoxygenated blood? a) Left atrium and left ventricle b) Left atrium only c) Right atrium and right ventricle d) Right ventricle only e) Left atrium and right ventricle

c) Right atrium and right ventricle

Which of the following vessels drains blood from the lower leg? a) Jugular vein b) Superior vena cava c) Tibial vein d) Coronary vein e) Inferior mesenteric vein

c) Tibial vein

Through which structure does blood pass from the right atrium to the right ventricle? a) Bicuspid valve b) Interventricular septum c) Tricuspid valve d) Mitral valve e) Ascending aorta

c) Tricuspid valve

A patient presents with a fever, heart murmur, irregular heartbeat, fatigue, loss of appetite and night sweats. As a physician, your diagnosis would be that of endocarditis typically caused by a) a virus b) an autoimmune condition c) a bacterial infection d) exposure to radiation e) cancer

c) a bacterial infection

During embryonic development, blood vessels are formed by a) endodermal cells. b) pluripotent stem cells. c) angioblasts. d) fibroblasts. e) osteoblasts.

c) angioblasts.

The largest driving force for pulling fluid from the interstitial spaces back into the capillaries is a) interstitial fluid hydrostatic pressure. b) interstitial fluid osmotic pressure. c) blood colloid osmotic pressure. d) blood hydrostatic pressure. e) glomerular hydrostatic pressure.

c) blood colloid osmotic pressure.

The right common carotid artery branches directly off the a) left common carotid artery b) left subclavian artery c) brachiocephalic trunk d) right subclavian artery e) right coronary artery

c) brachiocephalic trunk

The volume of blood that circulates through the systemic (or pulmonary) blood vessels per minute is called a) stroke volume. b) tidal volume. c) cardiac output. d) cardiac reserve. e) total peripheral resistance.

c) cardiac output.

Trauma to the pericardium associated with bleeding into the pericardial cavity, might cause a) myocarditis b) endocarditis c) cardiac tamponade d) rapid heart rate e) none of these

c) cardiac tamponade

When the umbilical cord is tied after birth, the umbilical arteries close by filling in with a) placental fluid. b) platelet plugs. c) connective tissue. d) smooth muscle. e) epithelial tissue.

c) connective tissue.

A blockage in the external iliac artery will reduce blood flow to the a) external iliac artery b) common iliac artery c) femoral artery d) abdominal aorta e) ileal artery

c) femoral artery

Cardiac muscle fibers are electrically connected to neighboring fibers by a) desmosomes. b) tight junctions. c) gap junctions. d) interneurons. e) chordae tendinae.

c) gap junctions.

The formula for calculating cardiac output (CO) is a) heart rate multiplied by cardiac reserve b) heart rate multiplied by end diastolic volume c) heart rate multiplied by stroke volume d) end diastolic volume multiplied by cardiac reserve e) venous return multiplied by stroke volume

c) heart rate multiplied by stroke volume

Which of the following selections lists conditions that would lead to increased stroke volume? a) increased preload, increased afterload, increased contractility b) decreased preload, decreased afterload, decreased contractility c) increased preload, decreased afterload, increased contractility d) decreased preload, increased afterload, increased contractility e) increased preload, increased afterload, decreased contractility

c) increased preload, decreased afterload, increased contractility

Abnormal conditions such as atherosclerosis and patent (open) ductus arteriosus cause a large increase in the a) blood colloid osmotic pressure. b) net filtration pressure c) pulse pressure. d) blood hydrostatic pressure. e) interstitial fluid hydrostatic pressure.

c) pulse pressure.

If a patient is confined to bed and is unable to walk at all, which of the following will be seriously affected? a) blood flow to the lungs b) blood flow to the kidneys c) the circulation returning from the lower body d) circulation in the jugular veins d) blood flow to the intestines

c) the circulation returning from the lower body

Athletes tend to have higher cardiac reserves because a) they produce less epinephrine. b) they eat more protein and vitamins. c) their hearts operate more efficiently due to training d) they take in less oxygen than average individuals e) they put out more carbon dioxide than average individuals

c) their hearts operate more efficiently due to training

Blood leaving the left ventricle passes through which of the following structures? a) Right atrium b) Interventricular septum c) Bicuspid valve d) Aortic semilunar valve e) Pulmonary semilunar valve

d) Aortic semilunar valve

Which network of specialized cardiac muscle fibers provides a path for each cycle of cardiac excitation to progress through the heart? a) Systemic circuit b) Intercalated discs c) Cardiovascular center d) Cardiac conduction system e) Pulmonary circuit

d) Cardiac conduction system

Which of the following effectors would NOT be activated as described below in response to hypovolemic shock? a) Adrenal cortex releases aldosterone. b) Kidneys conserve salt and water. c) Heart rate increases. d) Decreased blood flow to the kidneys. e) Heart contractility increases.

d) Decreased blood flow to the kidneys.

Which of the following terms identifies the anatomical region found between the lungs that extends from the sternum to the vertebral column and from the first rib to the diaphragm? a) Epicardium b) Abdominal cavity c) Pericardium d) Mediastinum e) Thoracic cavity

d) Mediastinum

Which of the following electrocardiogram (ECG) waves represents atrial depolarization? a) R wave b) T wave c) S wave d) P wave e) Q wave

d) P wave

Which of the following is used to reduce friction between the layers of membranes surrounding the heart? a) Synovial fluid b) Endocardium c) Pleural fluid d) Pericardial fluid e) Capillary endothelium

d) Pericardial fluid

Which of the following would NOT occur in response to hypovolemic shock? a) Activation of the renin-angiotensin-aldosterone (RAA) system. b) Secretion of antidiuretic hormone (ADH) c) Activation of the sympathetic division of the ANS. d) Release of atrial natriuretic peptide (ANP). e) Release of local vasodilators.

d) Release of atrial natriuretic peptide (ANP).

Which of the following correctly lists the sequence of structures that a cardiac action potential follows in order to excite normal contraction of the heart? a) Bundle of His, Purkinje fibers, Atrioventricular (AV) node b) Sinoatrial (SA) node, Purkinje fibers, AV node, Bundle of His c) Purkinje fibers, AV node, SA node, Bundle of His d) SA node, AV node, Bundle of His, Purkinje fibers e) Bundle of His, SA node, AV node, Purkinje fibers

d) SA node, AV node, Bundle of His, Purkinje fibers

The second heart sound (dupp) closely follows which of the events listed below? a) Valvular stenosis b) Semilunar valves opening c) Atrioventricular valves closing d) Semilunar valves closing e) Atrioventricular valves opening

d) Semilunar valves closing

Which structure in the heart initiates action potentials that stimulate contraction of the heart at a constant rate of about 100 beats per minute? a) Cardiac accelerator nerves b) Atrioventricular node c) Cardiovascular center d) Sinoatrial node e) Bundle of His

d) Sinoatrial node

Into which of the following categories would an individual with a blood pressure of 145/95 be placed? a) Normal b) High normal c) Prehypertension d) Stage 1 hypertension e) Stage 2 hypertension

d) Stage 1 hypertension

Stimulation of which nerve reduces heart rate? a) Cardiac accelerator nerve b) Hypoglossal nerve c) Spinal accessory d) Vagus nerve e) Phrenic nerve

d) Vagus nerve

In resting individuals, which vessels serve as a large blood reservoir from which blood can be quickly diverted to other vessels as needed? a) Arteries and arterioles b) Arterioles and capillaries c) Venules and capillaries d) Veins and venules e) Aorta and veins

d) Veins and venules

The difference between a person's maximum cardiac output and resting cardiac output is called the a) stroke volume. b) peripheral resistance. c) afterload. d) cardiac reserve. e) venous return.

d) cardiac reserve.

The alternate route of blood flow to a body part through an anastomosis is called a) a thoroughfare channel. b) a blood reservoir. c) a detour route. d) collateral circulation. e) microcirculation.

d) collateral circulation.

The cardiovascular center is located a) in the thoracic cavity. b) in the cerebral cortex. c) in the cerebellum. d) in the medulla oblongata. e) in the hypothalamus.

d) in the medulla oblongata.

If the foramen ovale doesn't close at birth, the result will be a) overloading the lungs with blood b) excessive volume in the pulmonary trunk c) a reduction of volume in the aorta d) introducing deoxygenated blood into the systemic circulation e) no change in the content of the systemic or pulmonary circulations

d) introducing deoxygenated blood into the systemic circulation

Which of the following chambers of the heart is surrounded by the thickest layer of myocardium? a) right atrium b) left atrium c) right ventricle d) left ventricle e) right auricle

d) left ventricle

A blockage in the proximal portion of the right subclavian artery will not only affect circulation to the right arm, but also to the a) left arm b) left ventricle c) right ventricle d) left vertebral artery e) left common carotid artery

d) left vertebral artery

Prior to physical activity, the heart rate may climb. This anticipatory increase is caused by nerve impulses traveling to the cardiovascular center of the medulla oblongata that originate in the a) cerebral cortex b) hypothalamus c) baroreceptors d) limbic system e) proprioceptors

d) limbic system

Cardiac tamponade may develop following a case of a) myocarditis b) endocarditis c) palpitation d) pericarditis e) tachycardia

d) pericarditis

The pulmonary trunk divides into a) brachiocephalic trunk and left subclavian artery b) right and left subclavian arteries. c) right and left pulmonary veins. d) right and left pulmonary arteries. e) right and left common carotid arteries.

d) right and left pulmonary arteries.

Contraction of the atria of the heart leads to blood moving directly a) into auricles. b) into arteries. c) into veins d) through atrioventricular valves e) through semilunar valves.

d) through atrioventricular valves

Pericardial arteries supply blood to the a) outer heart muscle b) tissue of the aorta c) tissue of the pulmonary trunk d) tissues of the pericardial sac e) all of these

d) tissues of the pericardial sac

Which of the following blood vessels carries blood from the tissues back to the heart? a) arteries b) arterioles c) aorta d) veins e) capillaries

d) veins

During which of the following periods does the largest volume of blood enter the arteries? a) atrial diastole b) ventricular diastole c) atrial systole d) ventricular systole e) the volume is about the same during each period

d) ventricular systole

Identify the structure found in a fetus that allows blood to flow directly from the pulmonary trunk into the aorta. a) Fossa ovalis b) Foramen ovale c) Trabeculae carneae d) Descending aorta e) Ductus arteriosus

e) Ductus arteriosus

Which of the following would NOT result in an increase in arterial blood pressure? a) Increased blood volume b) Increased sympathetic stimulation c) Increased heart rate d) Increased stroke volume e) Increased arteriolar vasodilation

e) Increased arteriolar vasodilation

Which of the following vessels drains blood from the head and neck? a) Median cubital vein b) Inferior vena cava c) Axillary vein d) Femoral vein e) Jugular vein

e) Jugular vein

The circulatory system aids in the homeostasis of the skeletal system by a) delivering calcium b) delivering phosphate c) transporting hormones for bone metabolism d) transporting hormones for production of red blood cells e) all of the above

e) all of the above

Which of the following types of tissues contains continuous capillaries? a) skeletal muscle b) smooth muscle c) connective tissue d) lungs e) all of these choices

e) all of these choices

Pectinate muscles extend from the atrial internal wall into the pouch-like structures that increase the total filling capacity of the atrium. These structure are the a) ventricles b) coronary sulci c) fossa ovalis d) interatrial septa e) auricles

e) auricles

The coronary sulcus marks the external boundary between the [dropdown 1] and the [dropdown 2].

superior atria, inferior ventricles

Two hormones that increase heart rate are [dropdown 1] and [dropdown 2].

thyroid hormone, epinephrine

The layer of a blood vessel that is in direct contact with the blood is the [dropdown 1] while the layer of the vessel that is made up of smooth muscle and elastic fibers is the [dropdown 2].

tunica interna, tunica media

During heart transplants, the [___] nerves are severed resulting in a faster resting heart rate (approximately 100 beats per minute) after the transplant.

vagus

Heart murmurs are often heard in individuals with abnormalities in the [dropdown 1] of the heart.

valves