Guyton hall problems

which of the following often occurs during progressive shock? A. decreased capillary permeability b. vasomotor center failure c. increased mitochondrial activity d. increased urine output e. increased pH in the tissues throughout the body

B several events occur in progressive shock, including increased capillary permeability, which allows fluid to leak out of the vasculature, thus decreasing the blood volume. other deteriorating factors include vasomotor center failure, peripheral circulatory failure, decreased cellular mitochondrial activity, and acidosis throughout the body. usually urine output decreases strikingly

a 40 year old women is diagnosed with a heart murmur. during auscultation, a blowing murmur of relatively high pitch is heard maximally over the left ventricle. the chest radiograph shows an enlarged heart. arterial pressure in the aorta is 140/ 40 mm hg. which of the following is the most likely diagnosis a. aortic valve stenosis b. aortic valve regurgitation c. pulmonary valve stenosis d. mitral valve stensosis e. tricuspid valve regurgitation

B blowing murmurs of relatively high pitch are usually associated with valvular insufficiency. the key pieces of data to identify this murmur are the systolic and diastolic pressures. aortic valve regurgitation typically has a high pulse pressure (systolic pressure minus diastolic pressure), which is 100 mm agin this patient. note also that the diastolic pressure decreases to a very low value of 40 mm hg as the blood leaks back into the left ventricle

which of the following heart murmurs is heard only during diastole? a. patent ductus arteriosus b. mitral regurgitation c. tricuspid valve stenosis d. inter ventricular septal defect e. aortic stenosis

C mitral regurgitation and aortic stenosis are murmurs heard during the systolic period. a ventricular septal defect murmur is normally heard only during the stolid phase. tricuspid valve stenosis and patent ductus arterioles murmurs are heard during diastole, but patent ductus arteriousus is also heard during systole

which of the following is associated with the third heart sound a. inrushing of blood into the ventricles due to atrial contraction b. closing of the atrioventricular (A-V) valves c. closing of the pulmonary valve d. opening of the A-V valves e. inrushing of blood into the ventricles in the early to middle part of diastole

E the third heart sound is associated with inrushing of blood into the ventricles in the early to middle [art f diastole. the next heart sound, the fourth heart sound. is caused by inrushing of blood in the ventricles caused b atrial contraction. the first heart sound is caused by closing of the atrioventricular valves, and the second heart sound is caused by closing of the pulmonary and aortic valves

which of the following conditions is most likely to decrease the risk of coronary artery disease? a. physical inactivity b. diabetes mellitus c. hypertension d. aging e. moderately decreased body weight

E there are several factors that increase of coronary artery disease, including physical inactivity, diabetes mellitus, hypertension, and agin. increases in body weight also increase the risk of coronary artery disease. decreases in body weight reduce the risk of coronary disease

in which of the following conditions is administration of a sympathomimetic drug the therapy of choice to prevent shock a. spinal cord injury b. shock due to excessive vomiting c. hemorrhagic shock d sock caused by excess diuretics

a. spinal cord injury sympathomimetic drugs are given to counteract hypotension under several circumstances, including spinal cord injury in which the sympathetic output is interrupted. sympathomimetic drugs are also given during very deep anesthesia, which decreases the sympathetic output, and in anaphylactic shock that results from histamine release and the accompanying vasodilatation. sympathomimetic drugs such as norepinephrine increase blood pressure by causing vasoconstriction. shock caused by excess vomiting, hemorrhage, or excess administration of diuretics results in fluid volumee depletion that results in decreased blood volume and decreased mens systemic filling pressure. giving a balanced electrolyte solution best counteracts this condition

which of the following vasoactive agents is usually the most important controller of coronary blood flow a. adenosine b bradykinin c. prostaglandins d. carbon dioxide e. potassium ions

adenosine

the diameter of precapillary arteriole is increased in a muscle vascular bed. which of the following changes in the microcirculation would be expected a. decreased capillary filtration rate b. decreased interstitial volume c. increased lymph flow d. decreased capillary hydrostatic pressure e. increased arteriolar resistance

c

a 30 year old patient who took an overdoes of furosemide is in shock . which of the following is the appropriate therapy a. infusion of blood b. infusion of plasma c. infusion of a balanced electrolyte solution d. infusion of a sympathomimetic drug e. adminatation of a glucocorticoid

c an overdoes of furosemide causes a tremendous increase in urinary volume

an increase in shear stress in a blood vessel results in which of the following changes? a. decreased enothelin production b. decreased cyclic guanosine monophosphate production c. increased nitric oxide release d. increased renin production e. decreased prostacyclin production

c. an increase in shear stress in blood vessels is one of the major stimuli for the release of nitric oxide by endothelial cells. nitric oxide increases blood flow by increasing cyclic guanosine monophosphate

the diameter of a precapillary arteriole is increased in a muscle vascular bed. a decrease in which of the following would be expected a. capillary filtration rate b. vascular conductance c. capillary blood flow d. capillary hydrostatic pressure e. arteriolar resistance

e an increase in the diameter of a precapillary arteriole would decrease arteriolar resistance. the decrease in arteriolar resistance would lead to an increase in vascular conductance and capillary blood flow, hydrostatic pressure, and filtration rate

left ventricle hypertrophy occurs in which of the following disorders> a. pulmonary valve regurgitation b. tricuspid regurgitation c. mitral stenosis d. tricuspid stenosis e. aortic stenosis

e. left ventricle hypertrophy occurs either when the left ventricle has to produce high pressure or when It pumps extra volume with each stroke. in pulmonary valve regurgitation, extra blood leaks back into the ventricle during the diastolic period. this extra volume must be expelled during the next heartbeat but this causes right ventricular hypertrophy. in aortic aortic stenosis, the left ventricle must contract very strongly, producing high wall tension in order to increase the aortic pressure to values that are high enough to expel blood into the aorta. ion mitral stenosis and tricuspid stenosis, the ventricles are normal, because the atrium produces extra pressure to move blood through the stenotic valves

if a person has been exercising for 1 hour, which of the following organs experiences the smallest decrease in blood flow? . BRAIN B. INTESTINES C. Kidneys d. nonexcercising skeletal muscle e. pancreas

A. during increases in sympathetic output, the brain and the heart are the two main organs that maintain their blood flow. During 1 hour of exercise, the intestinal flow and the renal and pancreatic blood flow decrease significantly. the skeletal muscle blood flow to nonexcercising muscles also decreases at this time. the cerebral blood flow remains close to its control valve

a healthy 25 year old male medical student has an exercise stress test at a local health club. which of the following sets of physiological changes is most likely to occur in this man's skeletal muscles during exercise? arteriolar diameter, adenosine concentration, vascular conductance (Q of blood flow)

A. the increase in local metabolism during exercise causes cells to release vasodilator substances such as adenosine. the increase in tissue adenosine concentration increases arteriolar diameter, vascular conductance, and blood flow to skeletal muscles

a 65 year old an enter the emergency department a few minutes after receiving an influenza inoculation. he has allow, tachycardia, and an arterial pressure of 80/50 mm hg. he has trouble walking. which of the following therapies would be recommended to prevent shock a. infusion of blood b. administration of an antihistamine c. infusion of a balanced electrolyte solution d. infusion of a sympathomimetic drug e. administration of a tissue plasminogen activator

d the patient received an influenza inoculation and quickly went into shock. this may be anaphylactic shock, which is a state of extreme vasodilation because of histamine release. antihistamines would be somewhat helpful, but they are very slow acting drugs, and the patient could die in the meantime. therefore, a very rapid acting agent must be used, such as a sympathomimetic drug

a 65 year old man with a 5 year history of congestive heart failure is being treated with an angiotensin converting enzyme (ACE) inhibitor. which of the following sets of changes would be expected to occur in response to the ACE inhibitor drug theragpy arterial pressure, angiotensin 2, total peripheral resistance

decrease arterial pressure, increase angiotensin 2, increase in total peripheral resistance angiotensin 2 is a powerful vasoconstrictor. angiotensin 1 is formed by an enzyme (renin) acting on a substrate called angiotensinogen. angiotensin 1 is converted to angiotensin 2 by a converting enzyme. angiotensin 2 is a powerful vasoconstrictor and sodium retaining hormone that increases arterial pressure. administration of an ACE inhibitor would be expected to decrease angiotensin 2 formation, total peripheral resistance, and arterial pressure

histamine is infused into the brachial artery. which of the following sets of microcirculatory changes would be expected in the infused arm? arteriolar resistance, capillary hydrostatic pressure, capillary filtration rate

decrease arteriolar resistance, increased capillary hydrostatic pressure, increased capillary filtration rate histamine is a vasodilator that is typically released by mast cells and basophils. infusion of histamine into a brachial artery would decrease arteriolar resistance and increase blood flow. the decrease in arteriolar resistance would also increase capillary hydrostatic pressure and capillary filtration rate

bradykinin is infused into the brachial artery of a 22 year old man. which of the following sets of microcirculatory changes would be expected in the infused arm arteriolar resistance, interstitial hydrostatic pressure, lymph flow

decrease in arteriolar resistance, increase in interstitial hydrostatic pressure, increase lumps flow

administration of a drug decreases the diameter of arterioles in the muscle bed of an experimental animal. which of the following sets of physiological changes would be expected to occur in response to the decrease in diameter vascular conductance (Q), capillary filtration, blood flow (q)

decrease in vascular conductance, decrease in capillary filtration, decrease in blood flow administration of a drug that decreases diameter of arterioles in a muscle bed increases the vascular resistance. the increased vascular resistance decreases vascular conductance and blood flow. the reduction in arteriolar diameter also leads to a decrease in capillary hydrostatic pressure and capillary filtration rate

a 60 year old women has experienced dizziness for the past 6 months when getting out of bed in the morning and when standing up. her mean arterial pressure is 130/90 mm Hg lying down and 95/60 sitting. which of the following sets of physiological changes would be expected in response to moving from a supine to an upright position? vagal tone, heart rate, sympathetic activity

decrease vagal tone, increase heart rate, increase sympathetic activity Explanation: moving from a supine to a standing position causes an acute fall in arterial pressure that is sensed by arterial baroreceptors located in the carotid sinuses and aortic arch. activation of the baroreceptors results in an increase in sympathetic activity and a decrease in parasympathetic activity (vagal tone), which lead to an increase in heart rate

while participating in a cardiovascular physiology laboratory, a medical student isolates the carotid artery of an animal and partially constricts the artery with a tie mourned the vessel,. which of the following sets of changes would be expected to occur in response to contraction of the carotid artery heart rate, vagal tone, total peripheral resistance

increase heart rate, increase vagal tone, increase total peripheral resistance constriction of the carotid artery reduces blood pressure at the carotid bifurcation where the arterial pressure activate baroreceptors, which in turn leads to an increase in sympathetic activity and a decrease in parasympathetic activity. the enhanced sympathetic activity results in constriction of peripheral blood vessels and increase in total peripheral resistance. the combination of enhanced sympathetic activity and decreased vagal tone also leads to an increase in heart rate

cognitive stimuli such as reading, problem solving, ad talking all result in significant increases in cerebral blood flow. which of the following changes in cerebral tissue concentration is the most likely explanation for the increase in cerebral blood flow? carbon dioxide, pH, adenosine

increase in carbon dioxide, decrease in pH, increase in adenosine cognitive stimuli increase cerebral blood flow by decreasing cerebral vascular resistance. the diameter of cerebral vessels is decreased by various metabolic factors in response to cognitive stimuli. metabolic factors that enhance cerebral blood flow increase increases in carbon dioxide, hydrogen ion (decreased pH), and adenosine

a 60 year old man visits his family practitioner for an annual examination. he has a mean blood pressure of 130 mm hg and a heart rate of 78 beats/min. his plasma cholesterol level is in the upper 25th percentile, and he is diagnosed as having atherosclerosis. which of the following sets of changes would be expected in this patient pulse pressure, arterial compliance, systolic pressure

increase in pulse pressure, decrease arterial compliance, increase systolic pressure

a 35 year old women visits her family practitioner for an examination. she has a blood pressure of 160/75 mm hg and a heart rate of 74 beats/min . further tests by a cardiologist reveal that the patient has moderate aortic regurgitation. which of the following sets of changes would be expected in this patient? pulse pressure, systolic pressure, stroke volume

increase in pulse pressure, increase in systolic pressure, increase in stroke volume the difference between systolic pressure and diastolic pressure is the pulse pressure. the two major factors that affect pulse pressure are the stroke volume output of the heart and the compliance of the arterial tree. in patients with moderate aortic regurgitation (due to incomplete closure of the aortic valve), the blood that is pumped into the aorta immediately flows back into the left ventricle. the back flow of blood into the left ventricle increases stroke volume and systolic pressure. the rapid back flow of blood also results in a decrease in diastolic pressure. thus, patients with moderate aortic regurgitation have high systolic pressure, low diastolic pressure, and high pulse pressure

a 24 year old woman delivers a 6 pound, 8 ounce female baby. the newborn is diagnosed as having patent ductus arterioles. which of the following sets of changes would be expected in this baby? pulse pressure, stroke volume, systolic pressure

increase in pulse pressure, increase stroke volume. increase in systolic pressure