Bio 431 Exam 2 - Cardiovascular System
What is the normal blood potassium level?
3.5-5 mEQ/L
A person who has hypersecretion of ADH will have a(n) _____________ MAP. A. increased B. decreased
A
A person who is hyposecreting erythropoietin with an increased hematocrit: A. may have primary polycythemia B. may have secondary polycythemia C. may have anemia D. A & C E. B & C
A
Blood flow in the capillaries is steady (not pulsating) because: A. elastic connective tissue in arteries absorbs most of the pulsation B. mean arterial pressure averages blood pulsation out C. peripheral resistance is greatest at a capillary bed.
A
If colloid osmotic pressure (OPif) increases in a tissue: A. water tends to enter the tissue from the capillary B. water tends to remain in the capillary and not enter the tissue
A
In which order do cardiovascular system components form during fetal life? A. blood, blood vessels, heart B. blood vessels, blood, heart C. blood vessels, heart, blood
A
The ________ side of the heart directs blood to the lungs (pulmonary). A. right B. left
A
The ________ side of the heart receives blood low in oxygen from the body (system). A. right B. left
A
The ___________ receive blood from the body via veins. A. atria B. ventricles
A
The base of the heart is _____________ to the apex of the heart. A. superior B. inferior
A
The first vessels to branch from the aorta are the: A. coronary arteries B. carotid arteries C. brachiocephalic artery D. coronary sinus
A
Vascular smooth muscle in peripheral vessels has _____ adrenergic receptors. A. alpha 1 B. alpha 2
A
What opens the atrioventricular valves? A. increased pressure in the atria B. increased pressure in the ventricles
A
When vascular smooth muscle contracts, what happens to the blood vessel? A. vasoconstriction B. vasodilation
A
Which cell has an action potential that is complete before contraction begins? A. skeletal muscle cell B. cardiac muscle cell
A
Which circulation is normally under lower pressure? A. pulmonary circulation B. systemic circulation
A
Which heart valves are connected to papillary muscles via chordae tendineae? A. atrioventricular valves B. semilunar valves
A
Which lists the correct sequence of the heart's intrinsic conduction system? A. SA node, AV node, AV bundle, bundle branches, Purkinje fibers B. SA node, AV bundle, AV node, Purkinje fibers, bundle branches C. AV node, SA node, AV bundle, bundle branches, Purkinje fibers
A
Which organ contains fenestrated capillaries? A. kidney B. liver C. bone marrow D. Both A & C are correct
A
Which valves close during the ventricular ejection phase of the cardiac cycle? A. atrioventricular valves B. semilunar valves C. Both A & B are correct
A
universal recipient blood type
AB positive
Primary polycythemia
Absolute increase in RBC mass. primary is decreased EPO or N --> red bone marrow tumor --> polycythemia vera
Plasma proteins and their functions
Albumins (60%) - osmotic pressure, transport lipids, steroid hormones Globulins ( 35%) - Transport ions, hormones, lipids; immune function Fibrinogen (4%) - Essential for clotting system, converted to insoluble fibrin Regulatory proteins (<1%)
What adrenergic receptors are located on smooth muscle of peripheral blood vessels?
Alpha 1
Arterio vs. atherosclerosis
Arteriosclerosis: hardening of arteries, making them less elastic Atherosclerosis: fatty plaque buildup Both cause increased PR
At rest, most of the blood volume is in the ________________ of the cardiovascular system. A. arteries B. veins C. capillary beds
B
Erythropoietin: A. targets osteoblasts B. increases erythropoiesis C. decreases erythropoiesis D. A & B E. A & C
B
In the adult, most EPO (erythropoietin) is secreted from cells in the: A. liver B. kidneys C. red bone marrow
B
Regulation of blood flow is greatest in: A. arteries B. arterioles C. veins D. venules
B
Renin: A. targets cells in the kidneys B. converts angiotensinogen produced by the liver to angiotensin I within the capillaries C. Both A & B are correct
B
Sympathetic stimulation of the heart: A. occurs when norepinephrine stimulates muscarinic receptors B. occurs when norepinephrine stimulates beta-1 adrenergic receptors C. occurs when norepinephrine stimulates beta-2 adrenergic receptors D. Both B & C are correct E. A, B & C are all correct
B
The epicardium is also known at the: A. parietal pericardium B. visceral pericardium C. pericardial sac
B
The heart is found within the _______________ cavity A. pleural B. mediastinum C. peritoneal D. abdominopelvic
B
The myocardium of the ____________ ventricle is normally thickest. A. right B. left
B
The ventricles are in ______________ during ventricular filling. A. systole B. diastole
B
When a blood clot breaks off and travels within the blood it called a(n) _________. If it then gets lodged in a smaller blood vessel blocking blood flow it is called a(n) ___________. A. thrombus/embolism B. embolus/embolism C. thrombocytopenia/embolism
B
Which cardiac cell type is contractile? A. autorhythmic cell B. contractile cell C. Both A & B are correct
B
Which cell has a longer contraction phase? A. skeletal muscle cell B. cardiac muscle cell
B
Which correctly lists the layers of the heart wall from superficial to deep? A. endocardium, myocardium, epicardium B. epicardium, myocardium, endocardium C. myocardium, endocardium, epicardium
B
14. Which valves are closed during the isovolumetric phases of the cardiac cycle? A. atrioventricular valves B. semilunar valves C. Both A & B are correct
C
Blood flow is the slowest in the ___________________. A. arteries B. veins C. capillary beds
C
Blood pressure: A. is highest where peripheral resistance is highest B. is measured in millimeters of mercury C. Both A & B are correct
C
The _________ collects blood from the heart muscle itself. A. superior vena cava B. inferior vena cava C. coronary sinus
C
The cardiac autorhythmic cell pacemaker potential: A. depolarizes (i.e., it is not "flat" or does not rest) between action potentials B. is produced by sodium channels opening while potassium channels are closing C. Both A & B are correct
C
The intrinsic conduction system of the heart: A. works without nervous stimulation B. is composed of non-contractile cells C. Both A & B are correct
C
Vitamin ____ is a cofactor in hemostasis A. A B. B12 C. K
C
What enzyme makes insoluble fibrin form the soluble protein fibrinogen? A. fibrinase B. prothrombinase C. thrombin
C
What produces the plateau phase in the cardiac contractile cell action potential? A. sodium influx and potassium efflux during the same time period B. sodium influx and calcium influx during the same time period C. calcium influx and potassium efflux during the same time period
C
Which fetal structure shunts blood from the right atrium to the left atrium? A. ductus venosus B. ductus arteriosis C. foramen ovale
C
Which is not a granulocyte? A. eosinophil B. basophil C. monocyte D. neutrophil
C
Which is not common to both cardiac contractile cells and skeletal muscle cells? A. Sodium influx via voltage-gated sodium channels initiates depolarization. B. Transmission of the action potential moves from sarcolemma down T-tubules. C. Cell membrane calcium channels allow extracellular calcium into the cytoplasm.
C
__________ may result from lack of vitamin B12 or low stomach enzyme activity A. hemolytic anemia B. thalassemia C. pernicious anemia
C
CO cardiac output equation
CO = HR x SV (L/min = Beats/min X mL/beat)
Albumin: A. helps to maintain body water within blood vessels B. is a formed element of the blood C. is produced by the liver D. A & C E. A, B, & C
D
An ectopic focus: A. is an area of additional or alternative electrical activation of the heart B. is any area that depolarizes more quickly than the SA node C. may cause atrial fibrillation D. A, B & C are all correct
D
Blood: A. is classified as a special connective tissue B. contains soluble fibers in its plasma C. cells make up the highest percentage of total blood volume D. A & B E. A, B, & C are correct
D
Hemoglobin: A. molecules can each bind 4 oxygen molecules B. has a higher affinity for carbon dioxide than for oxygen C. binds either oxygen or carbon monoxide on its heme group D. A & C E. A, B, & C
D
Mean Arterial Pressure (MAP) is: A. equal to systolic pressure - diastolic pressure B. the time average of systolic and diastolic pressure C. diastolic pressure + 1/3 pulse pressure D. Both B & C are correct E. A, B & C are all correct
D
The cardioacceleratory center: A. is the control center for the heart's sympathetic stimulation B. has output to the heart via the vagus nerve (CN X) C. directly causes an increase in both heart rate and contractile force D. Both A & C are correct E. A, B & C are all correct
D
The cardioinhibitory center: A. is the control center for the heart's parasympathetic stimulation B. has output to the heart via the vagus nerve (CN X) C. directly causes decrease in both heart rate and contractile force D. Both A & B are correct E. A, B & C are all correct
D
What is recycled during erythrocyte turnover? A. iron B. amino acids C. bilirubin D. A & B E. A, B, and C
D
Which is not a function of blood? A. Temp regulation B. Regulation of body pH C. Hemostasis D. Hematopoiesis
D
Which would dilate a systemic pre-capillary sphincter? A. decrease in tissue oxygen B. increase in tissue carbon dioxide C. decrease in tissue carbon dioxide D. Both A & B are correct
D
Stimulus for reactive hyperemia
Decreased blood flow. Results from blockage of blood flow (ischemia)
What happens if afterload increases?
Decreased ejection fraction
Hyperkalemia and the heart
Decreases HR, arrythmias, wider QRS because of persistent depolarization
What types of CT make the pericardial sac?
Dense irregular and adipose
When does atrial repolarization occur?
During the QRS complex. Same time as ventricular depolarization
If blood pressure drops: A. aortic baroreceptors send afferent information via CN X B. carotid artery baroreceptors send afferent information via CN IX C. sympathetic nerves stimulate cardiac muscle and peripheral blood vessels D. Both A & C are correct E. A, B & C are all correct
E
The formed elements of the blood: A. are produced in hematopoietic tissue B. include specific and non-specific immune cells C. volume can be measured via hematocrit D. A & B are correct E. A, B, & C are correct
E
Finding SV stroke volume
EDV - ESV = SV
Finding EF ejection fraction
EF = SV/EDV
Hemostasis Factor X pathway
Factor X --> Prothrombinase --> Prothrombin --> Thrombin --> Fibrinogen --> Fibrin
Heart layers in order from superficial to deep
Fibrous pericardium Parietal pericardium (mesothelium) Epicardium/Visceral pericardium (mesothelium) Myocardium Endocardium (endothelium)
How to find BPM on an EKG
Find # of large boxes (5x5 little ones), count how many go from R wave to R wave (peak). 300 / (^that number) = ____ bpm
Besides thrombocytes, what other blood cells are derived from myeloid stem cells?
Granulocytes, monocytes, proerythroblasts
Anemia disorders Decreased formation or increased destruction of RBCs:
Hemorrhagic anemia Hemolytic anemia Aplastic anemia Congenital dyserythropoietic anemia
What does Renin do?
In response to decreased MAP, low BP: Renin is released by the kidneys, acts on a protein called angiotensinogen (released from liver) which creates Angiotensin I. ACE (angiotensen converting enzyme) from the lungs (endothelium) acts to create Angiotensin II, which acts on peripheral blood vessels --> causes vasoconstriction...increases MAP!
Secondary polycythemia
Increased EPO Hypoxia driven: really high altitude, cardiopulmonary disease, defective O2 transport Hypoxia-independent: renal cysts or tumors, extrarenal tumors
What happens if preload and contractility increase?
Increased ejection fraction
Hypokalemia and the heart
Increases HR, arrythmias, ST segment depression and T wave inversion because of difficult repolarization
Anemia disorders Lack of raw materials or enzymes
Iron deficiency anemia Pernicious anemia (lack of vitamin B12)
Finding MAP mean arterial pressure
MAP = 2/3(DBP) + 1/3(SBP)
NFP net filtration pressure equation
NFP = (HPc + OPif) - (OPc + HPif) [out - in]
Cardiac muscle: neuromuscular junctions yes or no?
NO
The order in which ions are used in both authorhythmic and contractile cells are:
Na+, Ca2+, K+
WBCs Never Let Monkeys Eat Bananas
Neutrophils, Lymphocytes, Monocytes (macrophages in tissues), Eosinophils, Basophils (mast cells in tissues). This is in order from highest to lowest amount present in formed elements
Does vascular smooth muscle have parasympathetic receptors?
No
universal donor blood type
O negative
Formed elements percentage
Plasma (55%), Leukocytes and platelets (<1%), Erythrocytes (45%)
Does EPO target proerythroblasts or myeloid stem cells?
Proerythroblasts
Where do all blood cells form?
Red bone marrow
Autorhythmic conduction system order:
SA node, AV node, AV bundle, bundle branches, Purkinje fibers
How is calcium removed from the sarcoplasm of contractile cells?
Secondary active transport
What type of epithelium is endothelium?
Simple squamous
Erythropoiesis in Red Bone Marrow developmental pathway
Stem cell --> committed cell from myeloid stem cell --> Phase 1: Ribosome synthesis (basophilic erythroblast, polychromatic erythroblast), Phase 2: Hemoglobin accumulation --> Phase 3: ejection of nucleus
Anemia disorders Hemoglobin mutation (genetic)
Thalassemia Sickle-cell anemia
How does portal circulation differ from microcirculation?
Two capillary beds
Cardiac muscle: gap junctions yes or no?
Yes
Does blood vessel endothelium have parasympathetic receptors?
Yes
B1 receptors are found on
all cardiac cells
Cardiac muscle refractory period length:
almost as long as the entire muscle twitch to prevent tetanus
Endothelium lines all....
blood vessels
Baroreceptors are located in the
carotid sinus and aortic arch
Which capillary type provides greatest boundary between plasma and tissues?
continuous
B2 receptors are found on
coronary artery smooth muscle
Exchange in capillaries occurs via:
diffusion, bulk flow, transcytosis
Blood flow is ______ proportional to blood pressure
directly
MAP is _____ proportional to cardiac output X resistance
directly
Which of the formed elements is specialized to carry oxygen?
erythrocyte
What are the stages of erythrocyte turnover in the correct sequence?
erythropoiesis, degradation, recycling, excretion
What produces the dicrotic notch? (sudden drop in aortic pressure after ventricular systole)
flow of blood in aorta back toward the heart
Carotid sinus baroreceptors communicate via the
glossopharyngeal nerve
Stimulus for active hyperemia
increased metabolic rate (like in exercise or when you have a fever)
Sympathetic NS increases HR by:
increased permeability Na+ and increased permeability Ca2+
Parasympathetic NS decreases HR by:
increased permeability of K+ and Ca2+, decreased permeability Na+
Does decreased BP stimulate or inhibit baroreceptors?
inhibit
Is fibrin soluble or insoluble?
insoluble
Blood flow is _____ proportional to peripheral resistance
inversely
Which organ has the most blood flow at rest?
liver and kidneys
Where do erythrocytes load and unload oxygen?
load oxygen in lungs unload oxygen at tissues
Negative NFP means
reabsorption is occurring
Which valves open to produce the ventricular ejection phase?
semilunar
Is fibrinogen soluble or insoluble?
soluble
Which branch of the ANS innervates the smooth muscle of BVs?
sympathetic only
Afterload is:
the force against which the ventricles must act in order to eject blood. Largely dependent on arterial BP and vascular tone
Aortic arch baroreceptors communicate via the
vagus nerve
PR is inversely proportional to....
vessel diameter
Which of the 3 sources of PR is most often used to change blood flow?
vessel diameter
PR is directly proportional to...
viscosity & vessel length
3 sources of peripheral resistance (opposition to blood flow)
viscosity (thickness), vessel length, vessel diameter
cardiovascular embryonic development order
1 blood 2 blood vessels 3 heart 4 circulation
Reading mV on an EKG
1 small box = 0.1 mV. Any ST segment that is greater than 0.1 mV
Regulation of erythropoiesis: Stimulus Hypoxia
1 stimulus: hypoxia 2 kidney & liver releases erythropoietin 3 EPO stimulates red bone marrow 4 enhanced erythropoiesis increases RBC count 5 O2 carrying ability of blood rises
Action Potential of a contractile cell. What happens in the steps?
1. depolarization: Rapid Na+ influx 2. plateau: Ca2+ influx, K+ efflux 3. Repolarization K+ efflux 4. RMP
Action potential of an autorhythmic cell: What happens in the steps?
1. pacemaker potential: Na+ influx, K+ efflux 2. Depolarization: rapid Ca2+ influx 3. Repolarization: Rapid K+ efflux 4. K+ channels close
Phases of Hemostasis
1. vascular spasm - vasoconstriction 2. Platelet plug formation 3. Coagulation - fibrin forms mesh that forms the clot