CH:16/17

Which group is incorrect?

A. Parts of the conduction system: SA node, AV node, bundle of His, Purkinje fibers, medulla oblongata

Which of the following is lease likely to be used in the treatement of left ventricular failure and pulmonary edema?

A. Peripheral vasoconstrictor such as norepinephrine (levophed)

In which structure is the oxygen saturation highest?

A. Pulmonary veins

Which of the following is not part of coronary circulation?

A. Pulmonary veins

Where does the cardiac action potential (cardiac impulse) normally originate?

A. SA node

An increase in venous return causes an increase in cardiac output. This is accomplished by

A. Starling's law of the heart

Cardiac output is determined by heart rate and

A. Stroke volume

Describe the valvular response to the relaxation of the right ventricle

A. The tricuspid valve opens

What is the name of the valve that prevents backflow of blood into the right atrium when the right ventricle contracts?

A. Tricuspid

Which of the following elicits the same effect as vagmimetic activity?

A. Use of a muscarinic agonist

Which of the following is least likely to increase cardiac output

A. Vagal discharge

The mitral and the bicuspid valves

A. are the same valves

Refering to the ECG, the P wave represents

A. atrial depolariation

An ejection fraction of 30% is

A. characteristic of a failing heart

Which of the following spaces does not contain the heart?

A. dorsal cavity

Cor pulmonale refers to

A. elevation in pulmonary artery pressure and right ventricular hypertrophy

The heart

A. lies within teh mediastinal, thoracic, and ventral cavities

What is the significance of elevated plasma levels of AST, CPK, AND LDH?

A. myocardial damage as in myocardial infarction

The right ventricle pumps blood to the

A. pulmonary artery

Most of the symptoms of acute left-sided heart failure are

A. respiratory in nate (emg., dyspnea, orthopnea).

The pacemaker of the heart is located in the upper wall of the

A. right atrium

Which cavity first receives unoxygenated blood from teh vena cava?

A. right atrium

Which of the structure is not perfused by blood that flows from the pulmonary capillaries to the aorta?

A. right atrium

During a atrial systole, the

A. ventricles are relaxed

Which of the following defines a nodal thythm?

B. the electrical signal arises within the AV node.

Which of the following is responsible for the Starling effect?

C. End-diastolic volume (EDV) or preload

Sympathetic stimulation to the heart

C. Increases heart rate

Which of the following is least true of S2?

C. Indicative of a gallop rhythm

Which of the following is true of the aorta?

C. It arises within the left ventricle

Which of the following best describes the function of the pulmonary artery?

C. It carries unoxygenated blood to the pulmonary capillaries, where gas exchange occures

What is the term that refers to an increase in stroke gvolume in response to the stretching of the heart?

D. Starling's law of the heart

What term refers to the amount of blood pumped by the ventricle in one beat?

D. Stroke volume

Which of the following best indicates why the left ventricular myocardium is thicker than the right ventricular myocardium?

D. The left ventricleworks harder than the right ventricle

What is the valvular response to the contraction of the ventricles?

D. The pulmonic and aortic valves open

What is the cause of ventricular hypertrophy?

D. The ventricle is working too hard

Which of the following must precede ventricular contraction?

D. Ventricular depolarization

Under what condition will the AV node become the pacemaker?

D. When its rate of spontaneous depolarization exeeds that of the SA node

Decreased blood flow through the coronary arteries is most likely to cause

D. angina pectoris

The correct sequence is: blood flows from teh pulmonary capillaries to the pulmonary eins to the left atrium to the left ventricle to the

D. aorta

In normal sinus ryhthm (NSR), the

D. cardiac impulse originates in the sinoatrial node

Mililiters/beat x beats/min defines

D. cardiac output

Venodilation

D. decreases preload

Vagal stimulation to teh heart causes

D. heart rate to slo

Increased return of blood to the heart stretches the heart muscle, thereby

D. increasing stroke volume

The semilunar valves

D. receive blood from the contracting ventricles

When is coronary blood flow greatest?

C. During ventricular diastole

All of the following are electrical terms execpt

D. Sarcomere

Into what structure does blood reflux as a consequence of an incompetent aortic semilunar valve?

A. Left ventricle

What is the hardest working cardiac chamber and therefore has the thickest myocardium?

A. Left ventricle

Which layer of the heart allows it to act as a pump?

A. Myocardium

Which of the following is the most likely consequence of a very rapid heart rate?

A. Decreased ventricular filling (with blood)

Which of the following is descriptive of the vagus nerve?

A. Parasympathetic

Digoxin exerts a (-) chronnotropic effect and (+) inotropic effect. Which of the following describes these effects?

A. Decreases heart rate and strengthen myocardial contraction

Referring to the ECG, the QRS complex represents ventricular

A. Depolarization

Which of the following is an electrical event?

A. Depolarization

With which of the following is inotropism most associated?

A. Force of myocardial contraction

Heart rate and stroke volume determine

B. Cardiac output

A stenotic aortic valve

A. Increases afterload, thereby increasing the work of the left ventricle

A drug (e.g., atropine) that blocks the effects of the vagus nerve

A. Increases heart rate

What structure is not perfused as blood flows from the venae cavae to the pulmonary veins?

A. Left anterior descending artery

A signal is generated by the SA node and is regularly discharged to the rest of the conduction system. Which of the following best describes this activity?

A. Automaticity and rhythmicity

What is the term for the sequence of events that occur during one heartbeat?

A. Cardiac cycle

Sympathetic nerve stimulation of the myocardium

A. Causes a (+) inotropic effect

What causes S1, and S2?

A. Closure of heart valves

What is the cause of the heart sounds "lubb-dupp"?

B. Closing of the heart valves

What event causes the pulmonic valve to open?

A An increase in the pressure within the right ventricle

Which of the following best describes a pacemaker cell?

A Spontaneous depolarization

Which of teh following located between the visceral and parietal pericardium?

A. A space that contains serous fluid

During the ventricular contraction, the

A. AV valves close in response to intraventricular pressure

Which groups is incorrect?

A. Abnormal heart rates: tachycardia, bradycardia, normal sinus rhythm

Which of the following refers to a positive inotropic effect?

A. An increased myocardial contractile force

Under what condition is blood most likely to flow "backward" (e.g., from the left ventricle back into the Left atrium)?

A. An insufficient mitral valve

Which of the following semilunar valves "sees" oxygenated blood?

A. Aortic

Which of the following supplies oxygenated blood to the heart muscle?

A. Coronary arteries

With which of the following are these words most related: electrical signal, action potentail, cardiac impulse, adn nerve impulse?

B. Depolarization and repolarization

Why may a "racin heart" (170 bpm) cause chest pain?

B. A racing heart decreases diastole, the period when coronary blood flow is maximal

Which of the following is true of the myocardium?

B. All of the above (contains thick and thin filaments, contains actin adn myosin, and is thicker in the left ventricle than in the right ventricle

Chordae tendineae are not associated with this valve

B. Aortic

Which of the following drugs is sympathomimetic?

B. Beta1-adrenergic agonist

Which of the following is most likely to relieve an anxiety-induced tachycardia?

B. Beta1-adrenergic blocker

Which of the following is a correct valvular position when the atria are contracting?

B. Both AV valves are open

Furosemide (lasix), a potent diuretic, is administered in acute ventricular failure to

B. Ecrete excess water and relieve the edema

Which of the following is most descriptive o the tricuspid valve?

B. Entrance valve: right ventricle

Which of the following is least related to a bradycardia?

B. Greater than 60 beats/min

Which of the following defines cardiac output?

B. Heart rate X Stroke volume

Which of the following is true of the structures of the electrical conduction system?

B. In normal sinus rhythm, the electrical signal arises with in the SA node

Atropine, a muscarinic blocker,

B. Increases heart rate

Which of the following is not considered a "great" vessel?

B. Left anterior descending artery

Systole and diastole describe the function of the

B. Myocardium

Which layer of the heart has actin, myosin, and intercalated discs?

B. Myocardium

The epicardium is a layer of the

B. Pericardium

Which of the following is the same as end-diastolic volume?

B. Preload

Which of the followingi s a function of a valve?

B. Regulates the direction of the flow of blood through the heart

Vagal stimulation on the heart

B. Slows the heart rate

Which of the following is not true of the heart?

B. The pericardium is composed of actin and myosin

Which of the following is least descriptive of the myocardium?

B. Thicker in the left atrium than the right ventricle

Which of the following is most apt to cause a (+) inotropic effect?

B. Use of a beta1-adrenergic agonist

Which of the following is least related to tachydysrhythmias?

B. Vagal discharge

Which of the following is not the result of the firing of the sympathetic nerves on the heart?

B. Vagally induced bradycardia

During ventricular filling, the

B. Ventricles are relaxed

Cells that spontaneously depolarize from resting membrane potential to threshold potential

B. are called pacemaker cells

Which of the following does not happen during ventricular diastole

B. blood is being pumped into the great vessels

A hole in the interventricular septum causes

B. blood to shunt from the left ventricle to the right ventricle

Increased return of the blood to the heart stretches the muscle, thereby

B. increasing stroke volume

Cardiac output

B. is determined by heart rate and stroke volume

The aorta receives blood from the

B. left ventricle

Which of the following is most true os S1?

B. occurs during the beginning of ventricular systole with the closure o the tricuspid and mitral valves

The correct sequence is: Blood flows from the right atrium to the right ventricle to the pulmonary arter to teh

B. pulmonary capillaries

Which of the following electrical events is caused by the outflow (efflux) of K+?

B. repolarization

Jugular vein distention is most associated with

B. right-sided heart failure

The bicuspid and mitral valves

C. "see" only oxygenated blood

Which of the following describes Starling's Law of the heart?

C. All of the Above (an increase in preload increases cardiac output, an increase in venous return to the ventricles causes an increase in cardiac output, and a decrease in preload decreases cardiac output

The pulmonic aortic valves

C. Are semilunar valves

What is located at the second rib and the fifth intercostal space?

C. Base and apex of the heart

A very anxious person appears in the ER. He has a heart rate of 160 b/min and indicates that he has a history of pani attacks. He is prescribed an antianxiety agent and a drug to slow his heart rate. Identify the drug (to slow heart rate)

C. Beta1-adrenergic blocker

Which of the following is least true of the aortic valve?

C. Blood flows from the ventricle through this valave into the pulmonary artery

Which term refers to the amount of blood pumped by the heart in 1 minute?

C. Cardiac output

Which of the following statements is correct about cardiac output?

C. Cardiac output is determined by heart rate x stroke volume

With which of the following is "lubb-dupp" associated?

C. Closing of heart valves

The atrioventricular node (AV node)

C. Delays the electrical signal coming from the atria into teh ventricles

Which of the following is happening during atrial systole

C. More than one of the above are true

Which slinglike structure supports the heart?

C. Pericardium

Which of the following is the most likely consequence of acute left ventricular failure?

C. Pulmonary edema

Which of the following "sees" oxygenated blood?

C. Pulmonary veins

What are the conducting fibers that rapidly spread the electrical signal throughout the ventricles?

C. Purkinje fibers

What are ventricles "doing" during atrial contraction

C. Relaxing

With which term is afterload most associated?

C. Resistance

Which of the following best describes the heart as a double pump?

C. Right and left

In which structure is oxygen saturation lowest?

C. Right atrium

Stenosis of which valve causes right ventricular hypertrophy

C. Right semilunar

An elevation in pulmonary artery pressure is most likely to cause

C. Right ventricular hypertrophy

Which of the following is least related to the mitral valve?

C. Semilunar

A drug causes a (+) inotropic effect, a (-) dromotropic effect, and a (-) chronotropic effect. What drug response would you expect to observe?

C. Slow heart rate

A change in preload causes a change in myocardial contractile force. This response is known as (a)

C. Starling's law of the heart

Which group is incorrect?

C. Structures that carry unoxygenated blood: right ventricle venae cavae, pulmonary veins

Which of the following is descriptive of a drug that causes a (+) inotropic effect, a (+) dromotropic effect, adn a (+) chronotropic effect?

C. Sympathomimetic

Which of the following is true regarding the mediastinum?

C. The mediastinum is a space between the lungs

Initially a child witha ventricular septal defect (VSD) and pulmonic valve stenosis is acyanotic. Over time, however, the pulmonic valve stenosis worsens and the child becomes cyanotic. What is the most probable explanation?

C. The pulmonic stenosis elevates right ventricular pressure, thereby shunting unoxygenated blood from the right ventricle into the left ventricle; unoxygenated blood is then pumped to the systemic circulation

S2 is

C. The second heart rate

What happens during ventricular diastole?

C. The ventricles are filling with blood

The purpose of the right heart is to pump blood

C. To the lungs for oxygenation

Blood flows from the right atrium through which atrioventricular valve to the right ventricles?

C. Tricuspid

Heart rate is slowest if the pacemaker activity signal originates in the

C. Ventricular conduction cells

Ventricular systole refers to

C. contraction of the ventricular myocardium

Increased afterload (e.g., hypertension)

C. increase the work of the heart

Atropine is anticholinergic and antimuscarinic and therefore

C. is used to treat bradydysrhythmias such as heart block and a prolonged P-R interval

Bothe the semilunar valves

C. prevent the backflow of blood from the aorta and pulmonary artery into thh ventricular

Atropine is a muscarinic antagonist and is therefore used to

C. relieve bradycardia

Activation of the muscarinic receptors by acetylcholine

C. slows heart rate

A vessel(s) that carry(ies) blood from the pulmonary capillaries to the left atrium is (are) the

D. Pulmonary veins

Digoxin, a drug used in the treatment of heart failure, increases contractile force and is therefore called a

D. (+) inotropic agent

Which of the following is most likely to increase stroke volume?

D. A (+) inotropic drug

The purpose of this structure is to delay the spread of the signal from the atrium to the ventricles.

D. AV node

A patient in heart failure is given a drug that is classified as a beta1-adrenergic agonist. The drug

D. Activates the beta1-adrenergic receptors and causes a (+) inotropic effect

Which of the following is most likely to increase ejection fraction?

D. Activation of beta1-adrenergic receptors

Which of the following is most apt to induce an autonomically induced bradycardia?

D. Activation of teh muscarninic receptors

Which of the following is most related to "lubb" (of the lubb-dupp duo)?

D. All of the above (occurs in response to ventricular contraction, caused by the closure of the AV valves, and is called S1)

The amount of blood in the ventricle at the end of its resting phase is the

D. All of the above (preload, amount of blood in the ventricle at the end of its resting phase, and end-diastolic volume (EDV)

Which of the following is true regarding cardiac blood flow?

D. All of the above are true (ina diseased heart coronary blood flow may be maximal at rest, in the normal heart coronary blood flow increases with exercise, and in a diseased heart exertion may cause ischemia and angina)

Which of the following is approximately 70 mL?

D. An average stroke volume

Which structure is not perfused by the blood that is pumped from the right ventricle to the left ventricle?

D. Aorta

Which of the following is a result of ventricular contraction?

D. Blood is pumped into the pulmonary artery and the aorta

With regard to a ventricular septal defect,

D. Blood shunts from the left to the right ventricle

Excess vagal stimulation to teh SA node is most likely to cause

D. Bradycardia

Which term refers to a heart rate less than 60 beats/min?

D. Bradycardia

Mililiters per minute describes

D. Cardiac output

An acumulation of excess fluid in the pericardial space

D. Causes external compression of the heart

The intent is to measure pulmonary wedge pressure, a procedure that requires the advancement of a catheter up to the pulmonary capillaries. The catheter is inserted into the left subclavian vein. Identify the structure that the catheter does not pass through on its way tot eh pulmonary capillaries.

D. Pulmonary veins

Which structure "sees" oxygenated blood?

D. Pulmonary veins

Which structure connects the cusps of the AV valves to teh ventricles?

D. Chordae tendieae

The purkinje fibers

D. Conduct electrical signals throughout the ventricles

Which of the following is the best description of systole and diastole?

D. Contraction and relaxation

Which of the following is true about the left ventricular myocardium?

D. Contraction is caused by the sliding of actin and myosin

What are the two phases of the ventricular action potential (cardiac impulse)?

D. Depolarization and repolarization

Which of the following does not happen to a ventricle?

D. Discharge of the vagal nerve

With which term is preload synonymous?

D. End-diastolic volume

Under what condition is end-diastolic volume (EDV) most likely to increase hile ejection fraction decreases?

D. Heart failure

An increased preload

D. Increases stroke volume

Which of the following is part of the blood flow through the heart?

D. Left atrium

Which of the following most accurately describes the vagus nerve?

D. Parasympathetic

Starling's Law of the heart relates force of myocardial contraction with

D. Preload

Which of the following is responsible for the opening and closing of the heart valves?

D. Pressure exerted on teh valves as the heart contracts and relaxes

Which of the following structures "sees" unoxygenated blood?

D. Pulmonary artery