Module 3 A&P Practice Mult. Choice Questions.
Which chamber of the heart contains the pacemaker? A. right ventricle B. right atrium C. left ventricle D. left atrium
B. right atrium
Which fiber system is the first to depolarize in a cardiac cycle? A. atrioventricular node B. sinoatrial node C. bundle of His D. Purkinje fibers
B. sinoatrial node
Epinephrine is primarily a A. vasodilator B. vasoconstrictor
B. vasoconstrictor
Serotonin is a ? A. vasodilator B. vasoconstrictor
B. vasoconstrictor
Histamine is a? A. vasoconstrictor B. Vasodilator
B. vasodilator
The membrane closest to the heart muscle is the _____. A. fibrous pericardium B. visceral pericardium C. parietal pericardium D. Pericardial cavity
B. visceral pericardium
True/false: heart failure and congestive heart failure are the same
False
True or False: Hypovolemic shock should typically present with a reduced cardiac output.
True
True or False: Septic shock should present with a normal or high cardiac output
True
True/False Patients with left-sided duastolic dysfunction heart failure usually have a normal ejection fraction.
True
True/False the amount of blood that the heart must pump with each beat is determined by venous return and stretch of cardiac muscle fibers.
True
True/False: non-pathologic S3 heart sounds can be heard during inspiration.
True
What of the 5 type(s) of Shock have vasodilation? Select all that apply. A. cardiogenic b. septic c. anaphylactic d. hypovolemic e. neurogenic
b, c, e
In general, atherosclerosis is caused by: a. high serum cholesterol levels b. endothelial injury and inflammation c. an increase in antithrombotic substances
b. endothelial injury and inflammation
What causes a client to develop a deep vein thrombosis (venous thrombus event)? a. slow venous blood flow b. incompetent venous valves c. migration of smooth muscle into the intima d. foamy macrophages engulfing lipids
b. incompetent venous valves
Cardiac muscle cells communicate through an intricate system of proteins and attachments called a. t-tubules b. intercalated discs c. desmonic apertures d. branched striation
b. intercalated discs
The largest layer of the heart consisting predominantly of cardiac myocytes is called the a. endocardium b. endothelium c. myocardium d. epicardium
c. myocardium
Which area allows the atria to completely empty as the ventricles fill with blood? A. AV node B. AV bundle C. SA node D. Purkinje fibers
A. AV node
Which of the following ions has the greatest affect on the autorhythmic capabilities of the myocardium?- A.Ca2+ B. K+ C. Na+ D. Cl-
A. Ca2+
Which type of shock is associated with low blood levels? A. Hypovolemic shock B. Septic shock C. Anaphylactic shock D. Cardiogenic shock
A. Hypovolemic shock
Where does the depolarization of the atria occur? A. P wave B. QRS complex at the R C. QRS complex at the S D. T wave E. U wave
A. P wave
A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of the follwoing are expected findings with this condition? A. an echocardiogram showing an ejection fraction of 38%. B. heart catheterization shows an ejection fraction of 65%. C. Patient has frequent episodes of nocturnal paroxysmal dyspnea. D. options A and C are both expected with left-side systolic dysfunction.
A. an echocardiogram showing an ejection fraction of 38%.
Most frequent systolic murmur usually due to calcification of the valves. Loud harsh crescendo heard between S2 and S1. A. aortic stenosis B. mitral stensosis C. aortic regurgitaion D. pulmonic regurgitation
A. aortic stenosis
Patent ductus arteriosus is: A. congenital defect where there is an opening between the aortic and pulmonic trunk B. congenital defect where there is an opening between the right and left ventricles C. congenital defect where there is an opening between the right and left atria D. a congenital murmur
A. congenital defect where there is an opening between the aortic and pulmonic trunk
The increase in heart rate caused by seeing a wild dog run after you is probably the result of the _____. A. hypothalmus B. increase in SNS C. decrease in SNS D. Increase in PNS E. decrease in PNS
A. hypothalmus
Stimulation of a cardiac cell A. is initiated by Na diffusion into the cell B. is stimulated by ACh binding to Na and K channels C. triggers the expulsion of Ca out of the cells D. is accomplished by coordinated Na leakage across all tissue cells E. is unnecessary, as the cell fires spontaneously, without preceding changes in membrane potential
A. is initiated by Na diffusion into the cell
Dyspnea is associated with? A. left sided heart failure B. right sided heart failure C. low output heart failure D. high output heart failure
A. left sided heart failure
Common systolic murmur that is high in frequency with a blowing sound. A. mitral regurgitation B. tricuspid regurgitation C. mitral stenosis D. pulmonic regurgitation E. aortic stenosis
A. mitral regurgitation
Which of the following is FALSE concerning the role of Ca in the cell? A. prolongs the absolute refractory period by counteracting the effects of Na movement during an action potential B. enters the cell through slow electrically gated channels on the cell membrane C. has both voltage and ligand gated channels in the cell that regulate its movement D. responsible for both a faster membrane depolarization and a longer absolute refractory period
A. prolongs the absolute refractory period by counteracting the effects of Na movement during an action potential
The highest pressure exerted by the heart is called the _____. A. systolic pressure B. diastolic pressure C. pulse pressure D. mean arterial pressure E. afterload F. preload
A. systolic pressure
During the spike of an action potential in a cardiac muscle cell A. there is a rapid influx of Na+ into the cell. B. Ca2+ moves out of the cell into the extracellular fluid. C. K+ channels open to let K+ move into the cell. D. both Na+ and Ca2+ move into the cell at the same time. E. Na+ moves out of the cell into the extracellular flui
A. there is a rapid influx of Na+ into the cell
Norepinephrine is primarily a A. vasoconstrictor B. vasodilator
A. vasoconstrictor
Bradykinin is a? A. vasodilator B. vasoconstrictor
A. vasodilator
Prostoglandins are? A. vasodilator B. vasoconstrictor
A. vasodilator
About _____% of the atrial blood flows into the ventricles before the atria conact. A. 30 B. 50 C. 70 D. 100 E. 90
B. 70
Which of the following is not part of Virchow's Triad? A. Venous stasis B. Cardiac dysrhythmias C. Endothelial damage D. Hypercoagulability
B. Cardiac dysrhythmias Virchow's triad: 1. Venous stasis (due to immobility, age, heart failure) 2. Endothelial damage (trauma, IV infusion) 3. Hypercoagulability (inherited disorders, and more)
Secreted by endothelial cells of the heart when they sense too much stretch and causes vasodilation A. Epinephrine B. Nitrous oxide C. Angiotensin II D. Norepinephrine
B. Nitrous oxide
In an ECG, where does the repolarization of the atria occur? A. P wave B. QRS complex at S C. QRS complex at R D. T wave E. U wave
B. QRS complex at S
Identify the FALSE statement: A. Hypovolemic shock is associated with low cardiac output B. Septic shock is associated with cold clammy skin C. Cardiogenic shock is associated with arrhythmia, MI, and myocarditis D. Extracardiac obstructive shock is associated with cardiac tamponade, pneumothorax, and pulmonary emboli
B. Septic shock is associated with cold clammy skin
Which of the following factors gives the myocardium its high resistance to fatigue? A.intercalated discs B. a very large number of mitochondrion C. gap junctions D. coronary circulation E. low pressure system
B. a very large number of mitochondrian
An enlarged R wave on an ECG would indicate A. a myocardial infarction. B. an enlarged ventricle. C. cardiac ischemia. D. repolarization abnormalities.
B. an enlarged ventricle
The condition called _____ is characterized by some defect or weakness in a vessel wall. A. phlebitis B. aneurysm C. arteriosclerosis D. atherosclerosis E. thrombosis
B. aneurysm
Diastolic murmur that is high-pitched with a blowing sound. Best heard of Erb's point. A. Mitral insufficiency (regurgitation) B. Aortic regurgitation (insufficiency) C. Tricuspid stenosis D. pulmonic insufficiency E. Mitral stenosis.
B. aortic regurgitation
Baroreceptors located in the _____ respond to stretching and slowing of the rate of the heart. A. medulla B. aortic sinus C.jugular vein D. heart
B. aortic sinus
The P wave of an electrocardiogram represents: A. ventricular depolarization. B. atrial depolarization. C. atrial repolarization. D. ventricular repolarization.
B. atrial depolarization
Which of the following is the cause of the "plateau" in cardiac muscle action potentials? A. Sodium ion influx B. Calcium ion influx C. Calcium ion outflux D. Sodium and potassium ion outflux E. Potassium ion influx
B. calcium ion influx
Which of these areas totally lack capillaries? A. spinal cord B. cartilage C. dermis D. gall bladder
B. cartilage
When does blood flow into the coronary arteries? A. early systole B. early diastole C. late systole D. late diastole
B. early diastole
The cells of the myocardium behave as a single coordinated unit called a A. pacemaker B. functional syncytium C. contractile unit D. sarcomere E. cardiac cycle
B. functional syncytium
The amount of blood ejected by the left ventricle each minute is calculated from which formula? A. mean pulse pressure x stroke volume B. heart rate X stroke volume C. Cardiac output divided by heart rate D. stroke volume divided by heart rate
B. heart rate x stroke volume
Where is the heart specifically located?A. thoracic cavity B. mediastinum C.pleural cavity D.ventral cavity
B. mediastinum
The cardiac reflex control centers are located within the _____. A. hypothalamus B. medulla oblongata C. aorta D. heart E. pons
B. medulla oblongata
The end diastolic volume is the A. volume of blood in the atria at the end of atrial relaxation. B. volume of blood in the ventricle at the end of ventricular relaxation. C. volume of blood in the ventricle at the end of ventricular contraction. D. volume of blood in the atria at the end of atrial contraction.
B. volume of blood in the ventricle at the end of ventricular relaxation.
The _____ allows the atria to communicate with the ventricles. A. SA node B. bundle of His C. AV node D. Purkinje fibers
C. AV node
The time taken for an impulse to travel from the S-A to the A-V node is represented in the _____ in an ECG. A.QRS complex B. ST interval C. PR interval D. Plateua phase after the S wave. E. U wave
C. PR interval
Which stage of shock is associated with the worsening of tissue hypoperfusion and onset of worsening circulatory and metabolic imbalances, including acidosis? A. Initial nonprogressive phase B. Developing phase C. Progressive stage D. Irreversible stage
C. Progressive stage
Which is true in regard to systemic anaphylaxis? A. Anaphylaxis occurs due to the IgE reacting with the foreign object ultimately leading to release of vasoconstictors. The vasoconstrictors lead to severe hypertension and bronchospasms B Systemic anaphylaxis is associated with Vomiting, abdominal cramps, diarrhea, and hypertension C. Systemic anaphylaxis occurs due to mast cell degranulation and release of mediators that causes acute vasodilation. Which can ultimately lead to increased vascular permeability, bronchospasms, and hypotension
C. Systemic anaphylaxis occurs due to mast cell degranulation and release of mediators that causes acute vasodilation. Which can ultimately lead to increased vascular permeability, bronchospasms, and hypotension
What characteristics distinguish septic shock from hypovolemic and cardiogenic shock? A. Septic shock patients will present with cool skin due to vasoconstriction B. Patients with septic shock will have a bluish color to their skin C. Vasodilation will lead to warm flushed skin in septic shock patients D. Septic shock patients present with pulsus paradoxus
C. Vasodilation will lead to warm flushed skin in septic shock patients
Cardiac cells A. unlike skeletal muscle, do not exhibit striations B. are all self-excitable (universal automaticity) C. are electrically coupled to each other through gap junctions D. release large volumes of Ca ions into the intercellular fluid upon excitation E. require direct nervous stimulation for contraction
C. are electrically coupled to each other through gap junctions
Which part of the heart is most susceptible to infection? A. pericardium B. Myocardium C. Endocardium D. Epicardium
C. endocardium
Heart rate is affected by A. positive and negative ionotropic factors B. cardiac centers within the pons C. extrinsic innervation by sympathetic and parasympathetic nerves D. hypertension E. norepinephrine from the vagus nerve
C. extrinsic innervation by sympathetic and parasympathetic nerves
Ventricular filling A. is accomplished exclusively by negative pressure created by the expanding ventricle B. is preceded by the QRS wave C. has both passive and active elements D. is characterized by a constant volume, which is very difficult to alter E. occurs during the QRS wave
C. has both passive and active elements
Diastolic murmur with an opening "snap" heard early in diastole. A. Aortic stenosis B. pulmonic stenosis C. mitral stenosis D. tricuspid stenosis E. aortic regurgitation
C. mitral stenosis
Congenital murmur. Loud, harsh, midsystolic ejection. A. pulmonic insufficiency B. aortic stensois C. pulmonic stenosis D. mitral insufficiency E. aortic insufficiency
C. pulmonic stenosis
Repolarization in cardiac muscle A. occurs at a faster rate than in skeletal muscle B. is determined by Na levels in the cell C. results from the gradual inactivation of Ca channels D. is slower than in skeletal due to slower opening of K channels E. is preceded by a short (relative to skeletal) contractile phase
C. results from the gradual inactivation of Ca channels
The absolute refractory period refers to the time during which A. the muscle cell is ready to respond to a threshold stimulus. B. the muscle cell is ready to respond to any stimulus. C. the muscle cell is NOT in a position to respond to a stimulus of any strength
C. the muscle cell is NOT in a position to respond to a stimulus of any strength
The myocardium functions as a functional syncytium due to A. the presence of striations in the myocardium. B. branching of myocardial cells. C. the presence of gap junctions. D. the presence of desmosomes.
C. the presence of gap junctions
All but which of the following statements about autorhythmic myocardial cells are correct? A. They do not maintain a stable resting membrane potential. B. They have special ion channels in their sarcolemma. C. They are the first myocardial cells to contract. D. They make up the intrinsic cardiac conduction system. E. all of the above are true
C. they are the first myocardial cells to contract
The _____ layer of an artery contains the greatest amount of smooth muscle. A. endothelium B. tunica intima C. tunica media D. tunica adventitia
C. tunica media
What are characteristics of the irreversible stage of shock? A. The worsening of tissue hypoperfusion and the onset of worsening circulatory and metabolic imbalances, including acidosis B. The body tries to initiate compensatory mechanisms C. Nothing can correct the hemodynamic defect D. Tissue and cell damage is too great tissue and necrosis of the tissue will occur even if the underlying hemodynamic defect is corrected
D. Tissue and cell damage is too great tissue and necrosis of the tissue will occur even if the underlying hemodynamic defect is corrected
Which of the following is a difference between cardiac muscle and skeletal muscle? A. Unlike skeletal muscle cells, cardiac muscle cells do not rely on an influx of calcium ions for depolarization. B. Unlike skeletal muscle, cardiac muscle does not use a sliding filament mechanism for contraction. C. Unlike skeletal muscle, cardiac muscle is not striated. D. Unlike skeletal muscle cells, cardiac muscle cells can be autorhythmic.
D. Unlike skeletal muscle cells, cardiac muscle cells can be autorhythmic.
Which of the following does not have the ability to contract? A. veins B. arteries C. venules D. capillaries
D. capillaries- due to lack of smooth muscle.
Blood from the cardiac muscle itself drains into the _____. A. superior vena cava B. left ventricles C. right ventricle D. coronary sinus
D. coronary sinus
Which of the following is not a cause of varicose veins A. heredity B. prolonged standing C.pregnancy D. decrease in intra-abdominal pressure E. aging
D. decrease in intra-abdominal pressure
The ejection fraction A. is a function of cardiac output, divided by the end diastolic volume B. is decreased by exercise and althlete's heart C. will approach 90% in a diseased heart, due to leakage of blood back into atria D. depends on both the pre-contractile filling of the ventricles and strength of ventricular contractility E. increases with increasing end systolic volume
D. depends on both the pre-contractile filling of the ventricles and strength of ventricular contractility
Which of the following is not associated with the long-term regulation of blood flow. A. angiogenesis B. Angiotensin II C. Collateral circulation mechanism D. endothelial control of vascular tone
D. endothelial control of vascular tone (this is short term).
Which factor does not assist venous return to the heart? A. valves B. inspiration C. skeletal muscle D. expiration
D. expiration
The most serious and life threatening arrhythmia of the heart is _____. A. tachycardia B. bradycardia C. flutter D. fibrillation
D. fibrillation
Positive inotropic agents A. decrease the contractility of the heart. B. cause hemolysis of blood clots. C. prevent blood clotting. D. increase the contractility of the heart
D. increase the contractility of the heart.
Which type of heart failure does nthis statement describe? The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up inot the lungs causing the patient to experience shortness of breath. A. left ventricular systolic dysfunction B. Left ventricular right-sided dysfunction C. Right ventricular diastolic dysfunction D. Left ventricular diastolic dysfunction.
D. left ventricular diastolic dysfunction
The purpose of the medullary cardiac centers is to _____. A. increase heart rate B. decrease heart rate C. maintain heart rate D. maintain blood pressure
D. maintain blood pressure
Which of the following would lead to a decrease in heart rate? A. Exercise B. Norepinephrine C. Sharply decreased blood volume D. Parasympathetic stimulation
D. parasympathetic stimulation
The inner lining of the fibrous pericardium is formed by the- pericardial cavity. A. myocardium. B. visceral layer of serous pericardium diaphragm. C. endocardium. D. parietal layer of serous pericardium. E. epicardium
D. parietal layer of serous pericardium
Which is the correct path of blood through the heart? A. vena cava, left atrium, tricuspid valve, left ventricle, pulmonary valve, right atrium, mitral valve, right ventricle, aortic valve B.right atrium, bicuspid valve, right ventricle, pulmonary valve, left atrium, mitral valve, left ventricle,aortic valve C. vena cava, right atrium, tricuspid valve, right ventricle, aortic valve, left atrium, mitral valve, left ventricle, pulmonary semilunar valve D. right atrium, tricuspid valve, right ventricle, pulmonary valve, left atrium, mitral valve, left ventricle, aortic valve E.vena cava, left atrium, tricuspid valve, right ventricle, pulmonary valve, left atrium, mitral valve, right ventricle, aortic valve
D. right atrium, tricuspid valve, right ventricle, pulmonary valve, left atrium, mitral valve, left ventricle, aortic valve
Which part of the heart is the last to become excited during a cardiac cycle. A. apex B. atria C. ventricular septum D.superior ventricular region
D. superior ventricular region
Which statement about the extrinsic innervation of the heart is NOT true? A. Sympathetic nerve stimulation of the heart increases the rate and force of the heart. B. The cardiac centers are located in the medulla oblongata of the brain stem. C. Parasympathetic nerve stimulation reduces the heartbeat. D. Sympathetic impulses travel through the vagus nerve. E. The vagus nerve is the tenth cranial nerve.
D. sympathetic impulses travel through the vagus nerve.
Which of the following valves is most often faulty in the heart? A. the aortic semilunar valve B. the tricuspid valve C. the pulmonary semilunar valve D. the mitral or bicuspid valve
D. the mitral or bicuspid valve
The apical heartbeat in an adult is best heard at the level of the _____. A. 2nd ICS LSB B. 2nd ICS RSB C. 3rd ICS LSB D. 4th ICS LSB E. 5th ICS MCL F. 5th ICS MAL
E. 5th ICS MCL
Cardiac contractions A. are spontaneous and rhythmic B. exhibit automaticity C. have a relatively short refractory period D. a, b and c are all true E. a and b are both true
E. a and b are both true
The ability of some cardiac muscle cells to initiate their own depolarization and cause depolarization of the rest of the heart is called A. absolute refractory period B. fibrillation C. a functional syncytium. D. an action potential. E. automaticity
E. automaticity
The Frank-Starling law of the heart A. is explained by the length-tension relationship of sarcomeres with the conclusion that cardiac fibers are shorterthan-optimal in length B. states that an increase in cardiac output requires an in crease in heart rate and stroke volume C. states that an increase in venous return has a positive effect on SV and CO D. all of the above are correct E. only a and c are correct
E. only a and c are correct
Commone cause of right ventricular heave. High-pitched and holosystolic. A. mitral insufficiency B. tricuspid stenosis C. aortic insufficiency D. pulmonic insufficiency E. tricuspid insufficiency
E. tricuspid insufficiency
__________ is the ability of tissues to increase blood flow in situations of increased activity. _________ is the increase blood flow to each tissue in response to a brief period of ischemia.
Functional hyperemia, reactive hyperemia
Why does a patient with septic shock have increased BP in the compensatory phase? Because... a. of systemic vasodilation b. of a loss of blood volume c. of an allergic reaction d. the heart is unable to contract normally
a. of systemic vasodilation
The vagus nerve carries ________ fibers to the SA node. a. parasympathetic -responsible for decreasing heart rate b. sympathetic- responsible for decreasing heart rate c. paraysmpathetic- responsible for increasing heart rate d. sympathetic- responsible for increasing heart rate
a. parasympathetic- responsible for decreasing heart rate
What are located behind valves to prevent blockage of coronary openings? a. sinus cusps b. chordae tendinae c. paillary muscles d. pectinate muscles
a. sinus cusps
The correct sequence of parts that function to carry cardiac impulses is a. A-V node, S-A node, Purkinje fibers, A-V bundle b. A-V node, A-V bundle, Purkinje fibers, S-A node c. S-A node, Purkinje fibers, A-V node, A-V bundle d. S-A node, A-V node, A-V bundle, Purkinje fibers
d. SA node, AV node, AV bundle, Purkinje fibers
Prominent muscular ridges that run along the inner surface of the atrial walls are the a. chordae tendineae b. foramen ovale c. papillary muscles d. trabeculae carneae e. pectinate muscles
d. trabeculae carneae
The visceral pericardium is the same as the a. mediastinum b. endocardium c. parietal pericardium d. myocardium e. epicardium
e. epicardium
An artery can be distinguished from a vein by all of the following means except a. arterial walls are thicker than those of veins b. arteries have a smaller lumen than does a similar-sized vein c. because arterial walls are thick and strong, they retain their round shape, while those of veins are thinner and tend to collapse. d. in cross section, the lumen of a vein appears to be thrown into folds, while that of an artery is smooth. e. no exceptions- all of the above are true
e. no exceptions- all of the above are true
