The Human Body in Health and Illness Chapter 16 & 17

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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


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