Ryerson Physiology 20.2-20.4
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 7) The atrioventricular valves permit blood flow A) in one direction only. B) in both directions. C) in many directions. D) in opposite directions on the right and left. E) from a ventricle to an atrium.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 8) Blood returning to the heart from the systemic circuit first enters the A) right atrium. B) right ventricle. C) left atrium. D) left ventricle. E) conus arteriosus.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 53) The ________ covers the outer surface of the heart. A) epicardium B) myocardium C) endocardium D) parietal pericardium E) mediastinum
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 17) The right ventricle pumps blood to the A) right and left lungs. B) left ventricle. C) left atrium. D) aorta. E) right atrium.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 36) The pulmonary veins carry blood to the A) heart. B) lungs. C) brain. D) intestines. E) liver.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 40) The marginal branch and posterior interventricular branch are branches of the A) right coronary artery. B) left coronary artery. C) circumflex artery. D) coronary sinus. E) aorta.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 56) Oxygen is added to blood as it flows through the ________ circuit. A) pulmonary B) systemic C) oxygen D) portal E) primary
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 11) The coronary sulcus is a groove that A) marks the border between the atria and ventricles. B) marks the boundary line between the right and left ventricles. C) marks the boundary line between the right and left atria. D) separates the atrioventricular valves from the atria. E) separates the coronary arteries from the coronary veins.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 16) Most of the middle layer in the heart wall is composed of A) cardiac muscle cells. B) chondrocytes. C) epithelial cells. D) fibrocytes. E) smooth muscle cells.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 2) The heart pumps approximately ________ liters of blood each day. A) 8,000 B) 15,000 C) 20,000 D) 50,000 E) 100,000
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 4) The term used to describe fluid collecting in the pericardial cavity that restricts the movement of the heart is known as A) cardiac tamponade. B) mitral valve prolapse. C) pleural effusion. D) cardiomyopathy. E) pericarditis.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 45) The inferior point of the heart is called the A) apex. B) hilum. C) base. D) septum. E) mediastinum.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 49) The ________ circuit carries blood to and from the lungs. A) pulmonary B) systemic C) oxygen D) portal E) primary
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 69) Prominent muscular ridges in the anterior atrial wall and auricles are called A) pectinate muscles. B) conus arteriosus. C) papillary muscles. D) trabeculae carneae. E) fossa ovalis.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 59) In a procedure known as ________, an inflatable balloon at the end of a catheter is used to press plaque back against the vessel wall. A) balloon angioplasty B) coronary arterial bypass graft C) intravenous catheterization D) ablation E) atherectomy
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 78) One possible consequence of untreated strep throat is a disease causing inflammation of heart called A) rheumatic fever. B) rheumatoid arthritis. C) coronary thrombosis. D) coronary ischemia. E) angina pectoris.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 5) The structure that permits blood flow from the right atrium to the left atrium in the fetal circulation is the A) foramen ovale. B) interatrial septum. C) coronary sinus. D) fossa ovalis. E) ligamentum arteriosus.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 58) ________ is the symptom generally brought on by coronary ischemia. A) Angina pectoris B) Memory loss C) A rash D) Hematuria E) Fluid in the lungs
Answer: A
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 114) The AV node delay is beneficial because A) it allows time for the atria to contract. B) it allows time for the ventricles to contract. C) it allows time to send feedback to the brain about heartrate. D) it decreases neural stimulation of the heart. E) it hyperpolarizes the ventricular cell membranes.
Answer: A
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 5) Which division of the autonomic nervous system would increase heart rate? (Figure 20-21) A) sympathetic nervous system B) parasympathetic nervous system
Answer: A
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 109) A faster-than-normal heart rate is called A) tachycardia. B) bradycardia. C) hypercardia. D) hypocardia. E) procardia.
Answer: A
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 104) Depolarization of the atria corresponds to the EKG's A) P wave. B) QRS complex. C) QT interval. D) T wave. E) S-T segment.
Answer: A
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 4) Which ion's entry causes rapid depolarization? Which ion's entry causes the plateau? Which ion's exit causes repolarization? (Figure 20-15) A) sodium; calcium; potassium B) potassium; calcium; sodium C) calcium; sodium; potassium D) sodium; potassium; calcium E) sodium; iron; potassium
Answer: A
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 88) In cardiac muscle, the fast depolarization phase of the action potential is the result of A) increased membrane permeability to sodium ions. B) increased membrane permeability to potassium ions. C) decreased membrane permeability to calcium ions. D) decreased membrane permeability to sodium ions. E) increased membrane permeability to chloride ions.
Answer: A
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 136) What occurs at "A" on the graph? A) Semilunar valve opens. B) Semilunar valve closes. C) AV valve opens. D) AV valve closes. E) end systolic volume
Answer: A
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 138) What occurs at the circle labeled "5" on the graph? A) peak systolic pressure B) isovolumetric systole C) isovolumetric contraction D) ventricular refilling E) increased heart rate
Answer: A
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 141) What occurs at the circle labeled "7" on the graph? A) isovolumetric ventricular relaxation B) sympathetic stimulation C) isovolumetric ventricular contraction D) ventricular ejection E) ventricular filling
Answer: A
Learning Outcome: 20-4 Bloom's Taxonomy: Applying 153) Cardiac output is increased by A) sympathetic stimulation. B) increased end systolic volume. C) decreased end diastolic volume. D) decreased venous return. E) inhibiting the atrial reflex.
Answer: A
Learning Outcome: 20-4 Bloom's Taxonomy: Applying 169) A tumor on the adrenal gland increasing catecholamine release will cause all of the following cardiovascular responses except A) decreased heart rate. B) increased contractility. C) increased venous return. D) increased preload. E) decreased ESV.
Answer: A
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 158) A patient has an end-diastolic volume of 125 ml. A heart attack has weakened her left ventricle so it can pump a stroke volume of only 40 ml. Calculate her end-systolic volume. A) 85 ml B) 3.1 ml C) 5000 ml D) 165 ml E) There is not enough data given to calculate the end-systolic volume.
Answer: A
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 161) ________ is when the heart can't maintain adequate cardiac output. A) Heart failure B) Fibrillation C) Flutter D) Murmur E) Coronary heart disease
Answer: A
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 150) Cardiac output can be increased by all of the following except A) decreasing ejection fraction. B) decreasing end systolic volume. C) increasing stroke volume. D) increasing ejection fraction. E) increasing heart rate.
Answer: A
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 3) The adult heart is roughly the size of A) the liver. B) a man's clenched fist. C) the gallbladder. D) the hand of a 10-year-old. E) the brain.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 3) What happens to the electrical impulse when it reaches the AV node? (Figure 20-11) A) It fizzles out. B) It gets delayed. C) It gets stronger. D) It spreads across the purkinje fibers. E) It causes ventricular contraction to occur.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 35) The pulmonary arteries carry blood to the A) heart. B) lungs. C) brain. D) intestines. E) liver.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 39) The first blood vessels to branch from the aorta are the ________ arteries. A) pulmonary B) coronary C) circumflex D) carotid E) subclavian
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 41) The circumflex branch and the anterior interventricular artery are branches of the A) right coronary artery. B) left coronary artery. C) interventricular artery. D) coronary sinus. E) aorta.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 50) The ________ circuit carries blood from the aorta to the right ventricle. A) pulmonary B) systemic C) oxygen D) portal E) primary
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 51) The ________ carry blood away from the heart. A) arterioles B) arteries C) veins D) venules E) capillaries
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 54) The muscle layer of the heart is the A) epicardium. B) myocardium. C) endocardium. D) parietal pericardium. E) mediastinum.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 6) Blood leaves the right ventricle by passing through the A) aortic valve. B) pulmonary valve. C) mitral valve. D) tricuspid valve. E) bicuspid valve.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 62) The coronary sinus drains the ________ into the ________. A) coronary arteries; left ventricle B) cardiac veins; right atrium C) interventricular artery; left ventricle D) right atrium; right ventricle E) cardiac vein; right ventricle
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 66) The endocardium consists of this type of tissue. A) cardiac muscle B) simple squamous epithelium C) dense irregular connective tissue D) reticular connective tissue E) stratified squamous epithelium
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 73) Which valve(s) cusps open up toward the base of the heart? A) right and left AV valves B) aortic and pulmonary valves C) left AV and aortic valves D) right AV and pulmonary valves E) right AV, left AV, aortic and pulmonary valves
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 25) Rupture of the papillary muscles in the left ventricle may result in A) pulmonary valve regurgitation. B) mitral valve prolapse. C) tricuspid regurgitation. D) tricuspid prolapse. E) aortic valve prolapse.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 48) Muscular ridges on the inner surface of the ventricles are called A) coronary sinuses. B) trabeculae carneae. C) intercalated discs. D) papillary muscles. E) chordae tendineae.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 72) Which valve(s) contains 2 cusps? A) right AV valve B) left AV valve C) right and left AV valves D) left AV and aortic valves E) right AV and pulmonary valves
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 60) A procedure in which a length of the patient's vein or artery is used to create a detour around an obstruction in a coronary artery is called A) balloon angioplasty. B) coronary artery bypass graft. C) intravenous catheterization. D) ablation. E) atherectomy.
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 22) As blood leaves the right ventricle, it passes through the ________ and then into the pulmonary trunk. A) pulmonary veins B) conus arteriosus C) aorta D) inferior vena cava E) superior vena cava
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 24) There are ________ pulmonary veins. A) 2 B) 4 C) 6 D) 8 E) 12
Answer: B
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 61) A fine tubular wire mesh called a ________ may be inserted into a coronary vessel, holding it open. A) angioplast B) stent C) angiogram D) keyhole E) catheter
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Applying 116) The first heart sound ("lubb") is associated with A) atrial systole. B) closing of the atrioventricular valves. C) opening of the atrioventricular valves. D) closing of the semilunar valves. E) opening of the semilunar valves.
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Applying 95) If the connection between the SA node and AV node becomes blocked, A) the ventricles will beat faster. B) the ventricles will beat more slowly. C) the ventricular beat will remain unchanged. D) cardiac output will increase. E) the atria will contract more forcefully.
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 101) Analysis of the electrocardiogram can reveal all of the following except A) heart rate. B) stroke volume. C) the condition of the conducting system. D) the effects of drugs and poisons. E) the duration of the ventricular action potential.
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 107) The structures responsible for distributing excitation to the contractile cells are A) contractile cells. B) conducting cells. C) intercalated cells. D) pacemaker cells. E) intermodal cells.
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 108) A slower-than-normal heart rate is called A) tachycardia. B) bradycardia. C) hypercardia. D) hypocardia. E) procardia.
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 89) The long plateau phase of the cardiac muscle action potential is due to A) movement of fewer sodium ions across the cell membrane. B) calcium channels remaining open. C) increased membrane permeability to potassium ion. D) decrease in the amount of calcium diffusing across the membrane. E) increased membrane permeability to sodium ions.
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 91) The normal pacemaker of the heart is located in A) the Purkinje fibers. B) the sinoatrial node. C) the atrioventricular node. D) the wall of the left ventricle. E) both the left and right ventricles.
Answer: B
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 112) Gradual drifting of membrane potential toward threshold in autorhythmic cells is termed a A) receptor potential. B) pacemaker potential. C) gated potential. D) ligand-gated potential. E) action potential.
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 123) Abnormal heart sounds caused by turbulent flow through faulty valves are called A) ectopic foci. B) murmurs. C) asystole. D) fibrillations. E) flutters.
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 129) The heart spends most of the cardiac cycle in which phase? A) atrial systole B) atrial diastole C) ventricular systole D) ventricular diastole E) isovolumetric contraction
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 127) The ________ is the volume of blood in a ventricle at the beginning of systole. A) ejection fraction B) end-diastole volume C) asystolic volume D) end-systolic volume E) stroke volume
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 133) Which of the following is occurring during ventricular diastole? A) The ventricles are passively filling. B) The ventricles are passively filling and atria are contracting. C) The AV valves are closed. D) The SL valves are open. E) Ventricular ejection.
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 130) During the beginning of ventricular systole when the muscle is contracting but not enough pressure has built up to open the semilunar valves the heart is said to be in A) atrial kick. B) isovolumetric contraction. C) isovolumetric relaxation. D) atrial systole. E) passive ventricular filling.
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 143) What occurs at the area labeled "C" on the graph? A) AV valve opens. B) AV valve closes. C) Ventricular filling begins. D) Semilunar valve closes. E) Semilunar valve opens.
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 121) The contraction phase of the cardiac cycle is called A) depolarization. B) systole. C) diastole. D) hyperpolarization. E) asystole.
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 137) What volume is labeled "E" on the graph? A) cardiac output B) stroke volume C) end-diastolic volume D) end-systolic volume E) total cardiac volume
Answer: B
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 144) What is occurring in the left atrium at the circle labeled "2" on the graph? A) Left atrium is pressurizing the left ventricle. B) Left atrium is in systole. C) Left atrial pressure is decreasing. D) Left atrium is in diastole. E) Left atrium is receiving pressure from the left ventricle.
Answer: B
Learning Outcome: 20-4 Bloom's Taxonomy: Remembering 147) Each of the following factors will increase cardiac output except increased A) venous return. B) parasympathetic stimulation. C) sympathetic stimulation. D) heart rate. E) force of contraction.
Answer: B
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 167) Hypertension increases ________ causing stroke volume to ________. A) afterload; increase B) afterload; decrease C) preload; increase D) preload; decrease E) contractility; increase
Answer: B
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 154) Activation of which kind of receptor causes heart rate to increase? A) alpha-one B) beta-one C) muscarinic D) beta-two E) preganglionic
Answer: B
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 155) Drugs that block the beta-one adrenergic receptors will A) increase heart rate. B) decrease heart rate. C) increase contractility. D) increase cardiac output. E) decrease the end-systolic volume.
Answer: B
Fundamentals of Anatomy and Physiology, 11e (Martini) Chapter 20 The Heart Multiple Choice Questions 1) The heart beats approximately ________ times each day. A) 1,000 B) 10,000 C) 100,000 D) 1,000,000 E) 10,000,000
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Applying 68) Thick projections of muscle in the ventricles that anchor chordae tendineae are called A) pectinate muscles. B) conus arteriosus. C) papillary muscles. D) trabeculae carneae. E) auricles.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 13) The cusps (leaflets) of atrioventricular valves attach directly to A) papillary muscles. B) trabeculae carneae. C) chordae tendineae. D) interatrial septa. E) coronary sulci.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 29) The ________ valve prevents backward flow into the left atrium. A) semicaval B) semilunar C) bicuspid D) tricuspid E) pulmonic
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 44) The superior portion of the heart where major blood vessels enter and exit is the A) apex. B) hilum. C) base. D) septum. E) mediastinum.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 52) The ________ carry blood toward the heart. A) arterioles B) arteries C) veins D) lacteals E) capillaries
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 9) Blood returning to the heart from the pulmonary circuit first enters the A) right atrium. B) right ventricle. C) left atrium. D) left ventricle. E) conus arteriosus.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 12) In the middle of the thoracic cavity is a region occupied by the heart, great vessels, thymus, esophagus, and trachea called the A) pleural space. B) pericardial space. C) mediastinum. D) cardiac notch. E) ventral cavity.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 23) Coronary veins empty into the A) left atrium. B) left ventricle. C) right atrium. D) right ventricle. E) conus arteriosus.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 31) Compared to the right ventricle, the left ventricle has all the following characteristics except A) has a thicker wall. B) is round in cross section. C) pumps a greater volume. D) works harder. E) produces about four to six times more pressure when it contracts.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 32) Which of the following are involved in the pulmonary circuit? A) superior vena cava, right atrium, left ventricle B) right ventricle, pulmonary veins, aorta C) right ventricle, pulmonary trunk, left atrium D) inferior vena cava, right atrium, aorta E) left ventricle, pulmonary veins, right atrium
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 42) The great and middle cardiac veins drain blood into the A) superior vena cava. B) inferior vena cava. C) coronary sinus. D) coronary sulcus. E) aorta.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 46) Pericardial fluid A) provides oxygen to the heart muscle. B) is located between the myocardium and the endocardium. C) is a lubricant between the heart and the pericardial sac. D) consists of plasma that has leaked out of whole blood. E) flows through the four chambers of the heart.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 55) The ________ lines the chambers of the heart, covers the heart valves, and is continuous with the endothelium. A) epicardium B) myocardium C) endocardium D) visceral pericardium E) mediastinum
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 57) The term ________ refers to blockage in the coronary circulation. A) congestive heart failure B) atherosclerosis C) coronary artery disease D) embolism E) phlebitis
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 15) The visceral pericardium is the same as the A) mediastinum. B) parietal pericardium. C) epicardium. D) myocardium. E) endocardium.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 20) When a blood clot forms on a ruptured plaque in a coronary artery, the condition is referred to as a(n) A) coronary spasm. B) myocardial infarction. C) coronary thrombosis. D) angina pectoris. E) pulmonary embolism.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 76) Which chamber has the thickest wall? A) left atrium B) right atrium C) left ventricle D) right ventricle E) left auricle
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 86) Tetanic muscle contractions don't occur in a normal cardiac muscle because A) cardiac muscle tissue contracts on its own. B) neural stimulation is lacking. C) the refractory period lasts until the muscle relaxes. D) the refractory period ends before the muscle reaches peak tension. E) potassium channels outnumber sodium channels.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 26) Blood is supplied to the muscular wall of the left atrium by the A) brachiocephalic artery. B) right coronary artery. C) left coronary artery. D) phrenic arteries. E) pulmonary arteries.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 79) Rheumatic fever causes generalized inflammation of the heart called A) rheumatoid arthritis. B) coronary thrombosis. C) carditis. D) coronary ischemia. E) myocardial infarction.
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 34) The following is a list of vessels and structures that are associated with the heart. What is the correct order for the flow of blood entering from the systemic circulation? 1. right atrium 2. left atrium 3. right ventricle 4. left ventricle 5. venae cavae 6. aorta 7. pulmonary trunk 8. pulmonary veins A) 1, 2, 7, 8, 3, 4, 6, 5 B) 1, 7, 3, 8, 2, 4, 6, 5 C) 5, 1, 3, 7, 8, 2, 4, 6 D) 5, 3, 1, 7, 8, 4, 2, 6 E) 5, 1, 3, 8, 7, 2, 4, 6
Answer: C
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 38) Blood is supplied to the myocardium by A) the coronary sinus. B) contact with blood in the pumping chambers. C) the coronary arteries. D) arteries that branch from the pulmonary arteries. E) arteries that branch off the subclavian arteries.
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 102) Pacemaker cells isolated from the SA node generate action potentials at ________ beats per minute. A) 20-40 B) 40-60 C) 80-100 D) 100-140 E) 140-180
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 103) ________ is to slow heart rate as ________ is to fast heart rate. A) Tachycardia; bradycardia B) Bradycardia; cardiomyopathy C) Bradycardia; tachycardia D) Cardiac tamponade; bradycardia E) Angina; infarction
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 97) The P wave of the electrocardiogram is a signal from A) the SA node. B) depolarization of the AV node. C) depolarization of the atria. D) repolarization of the atria. E) depolarization of the ventricles.
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 110) Collectively, the conducting cells that carry the impulse from the SA node to the AV node is known as the A) conducting system. B) AV block. C) internodal pathway. D) bundle branches. E) pacemaker cells.
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 92) Abnormally slow depolarization of the ventricles would most change the shape of the ________ in an ECG tracing. A) P wave B) T wave C) QRS complex D) P-R interval E) R-T interval
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 106) The property of heart muscle to contract in the absence of neural or hormonal stimulation is called A) intrinsic. B) extrinsic. C) automaticity. D) self-replicating. E) self-starting.
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 93) As a result of the long refractory period in the cardiac action potential, cardiac muscle cannot exhibit A) tonus. B) treppe. C) tetany. D) recruitment. E) fatigue.
Answer: C
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 115) An ECG is used to diagnose all of the following conditions except A) an AV block. B) an ectopic pacemaker. C) angina pectoris. D) premature atrial contractions. E) ventricular tachycardia.
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 122) The relaxation phase of the cardiac cycle is called A) depolarization. B) systole. C) diastole. D) hyperpolarization. E) asystole.
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 125) In mitral valve prolapse, the cusps of the mitral valve are pushed into the A) left ventricle. B) right ventricle. C) left atrium. D) right atrium. E) aorta.
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding Figure 20-2 Cardiac Cycle Use Figure 20-2 to answer the following questions: 134) What occurs at the circle labeled "3" on the graph? A) atrial systole B) isovolumetric relaxation C) atrial diastole and ventricle systole D) atrial ejection E) ventricular ejection
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 119) During ventricular systole, the A) atria are contracting. B) blood is entering the ventricles. C) AV valves are closed. D) pressure in the ventricles remains constant. E) pressure in the aorta remains constant.
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 132) In an adult at rest, the end-diastolic volume is typically A) 50 mL. B) 80 mL. C) 130 mL. D) 320 mL. E) 560 mL.
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 142) What volume is labeled "F" on the graph? A) cardiac output B) end-systolic volume C) end-diastolic volume D) total cardiac volume E) stroke volume
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 135) What volume is labeled "G" on the graph? A) cardiac output B) stroke volume C) end-systolic volume D) end-diastolic volume E) ejection fraction
Answer: C
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 140) What occurs at the circle labeled "4" on the graph? A) ventricular ejection B) sympathetic stimulation C) isovolumetric ventricular contraction D) isovolumetric ventricular relaxation E) ventricular filling
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Applying In-Text Figure Based Questions 1) The ________ side of the heart supplies blood to the systemic circuit, while the ________ side of the heart supplies blood to the pulmonary circuit. (Figure 20-1) A) superior; inferior B) inferior; superior C) left; right D) right; left E) left; superior
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Remembering 162) The ________ is the difference between the resting and maximal cardiac output. A) end-systolic volume B) end-diastolic volume C) cardiac reserve D) stroke volume E) ejection fraction
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Remembering 6) What is considered a "normal" cardiac output when resting? Please provide units. (Figure 20-24) A) 1-2 L/min B) 2-5 L/min C) 5-7.5 L/min D) 10-12.5 L/min E) 20-25 L/min
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 151) Heart rate is controlled by neurons of the cardiovascular center located in the A) pons. B) thalamus. C) medulla oblongata. D) hypothalamus. E) higher centers.
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 159) Calculate cardiac output if the heart rate is 125 beats/minute, the end-diastolic volume is 130 ml, and the end-systolic volume is 40 ml. A) 21,250 ml / min B) 16,250 ml / min C) 11,250 ml / min D) 195 ml / min E) 200 ml / min
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 146) The volume of blood ejected from each ventricle during a contraction is called the A) end-diastolic volume. B) end-systolic volume. C) stroke volume. D) cardiac output. E) cardiac reserve.
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 152) Which of the following would cause stroke volume to increase? A) when venous return is decreased B) when ventricular contraction is reduced C) drugs that stimulate beta-1 receptors D) decrease in heart rate E) decreased sympathetic stimulation
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 166) Positive inotropic drugs such as glucagon and thyroid hormone cause A) decreased heart rate. B) increased heart rate. C) increased contractility. D) decreased contractility. E) asystole.
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 160) Calculate the cardiac output of a patient with a heart rate of 100 beats/minute and a stroke volume of 75 ml. A) 0.75 ml / min B) 750 ml / min C) 7500 ml / min D) 175 ml / min E) 25 ml / min
Answer: C
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding Essay Questions 1) A doctor tells her nursing students that it is important to monitor patients' blood pressure when they are receiving verapamil (a calcium channel blocker). Why?
Answer: Calcium channel blockers inhibit the movement of calcium ions from the interstitial fluid into cardiac and smooth muscle cells. This would cause a decrease in heart rate, stroke volume, and cardiac output. These in turn would lower blood pressure. In addition, the calcium channel blockers would also inhibit contraction of the smooth muscle in the wall of blood vessels, causing them to get wider and thus also lower blood pressure. Because both heart and smooth muscle cells are inhibited by verapamil, its effects on blood pressure are particularly potent.
3) If a patient's resting cardiac output is 5.6 l/min and on a stress test she elevated her heart rate to a maximum of 176 beats/min with a stroke volume of 115 ml/beat, what is her cardiac reserve? Show your work.
Answer: Cardiac reserve equals maximum cardiac output - resting cardiac output. Maximum CO = HR × SV = 176 beats/minute × 0.115 liters/beat = 20.2 liters/minute. Cardiac reserve equals 14.6 liters/minute.
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 80) The connective tissues of the heart are important for all of the following reasons except A) they help distribute the forces of contraction. B) they prevent overexpansion of the heart. C) they provide support for blood vessels and nerves. D) they produce the pericardial fluid. E) they provide elasticity to help the heart return to its original shape after contraction.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 14) Contractions of the papillary muscles A) close the atrioventricular valves. B) close the semilunar valves. C) eject blood from the ventricles. D) prevent the atrioventricular valves from reversing into the atria. E) eject blood from the atria into the ventricles.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 18) The left ventricle pumps blood to the A) lungs. B) right ventricle. C) right atrium. D) aorta. E) pulmonary circuit.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 27) The pulmonary valve prevents backward flow into the A) aorta. B) pulmonary trunk. C) pulmonary veins. D) right ventricle. E) left atrium.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 47) The ________ is shared by the two ventricles. A) vena cava B) bicuspid valve C) chordae tendineae D) interventricular septum E) trabeculae carneae
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 70) Which of the following is not true regarding the right atrioventricular valve? A) It has 3 cusps. B) It is also called the tricuspid valve. C) It prevents backflow of blood from the right ventricle into the right atrium. D) The valve closes when the right atrium contracts. E) The cusps provide one-way flow of blood.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 75) Which statement correctly describes the term left atrioventricular valve? A) Its cusps open into the left atrium. B) Its cusps open into the superior vena cava. C) Its cusps open into the aorta. D) Its cusps open into the left ventricle. E) Its cusps open into the pulmonary trunk.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 10) The earlike extension of the atrium is the A) ventricle. B) coronary sinus. C) coronary sulcus. D) auricle. E) interatrial septum.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 77) An MI that affects the ________ side of the heart is more severe because it has to pump blood with ________ force. A) right; less B) right; more C) left; less D) left; more E) right; equal
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 65) Cardiac muscle layers form this distinct pattern. A) inner longitudinal layer B) outer longitudinal layer C) outer circular layer D) figure eight E) weave
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 71) The ________ is an important ridge of muscle extending horizontally around the right ventricle from the interventricular septum to the base of the anterior papillary muscle containing part of the conducting system. A) auricle B) pectinate muscle C) trabeculae carneae D) moderator band E) conus arteriosus
Answer: D
Learning Outcome: 20-2 Bloom's Taxonomy: Applying 99) Depolarization of the ventricles is represented on an electrocardiogram by the A) P wave. B) T wave. C) S wave. D) QRS complex. E) PR complex.
Answer: D
Learning Outcome: 20-2 Bloom's Taxonomy: Applying 96) The following are structural components of the conducting system of the heart. 1. Purkinje fibers 2. AV bundle 3. AV node 4. SA node 5. bundle branches The sequence in which excitation would move through this system is A) 1, 4, 3, 2, 5. B) 3, 2, 4, 5, 1. C) 3, 5, 4, 2, 1. D) 4, 3, 2, 5, 1. E) 4, 2, 3, 5, 1.
Answer: D
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 90) In cardiac muscle, A) calcium ions are not released from the sarcoplasmic reticulum. B) calcium ions do not bind to troponin molecules. C) calcium ions play no role in the process of contraction. D) about 20 percent of the calcium ion required for contraction comes from outside the cell. E) calcium ions play an important role in repolarizing the membrane after the depolarization phase.
Answer: D
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 111) Which of the following describes what is directly measured by an ECG? A) the force of contractions B) blood vessel resistance C) end-systolic volume D) electrical conduction E) neural stimulation of cardiac myocytes
Answer: D
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 113) The basic heartrate established by the SA node is called the A) pacemaker potential. B) action potential. C) vagal tone. D) sinus rhythm. E) SA potential.
Answer: D
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 100) The T wave on an ECG tracing represents A) atrial depolarization. B) atrial repolarization. C) ventricular depolarization. D) ventricular repolarization. E) ventricular contraction.
Answer: D
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 105) Which of the following statements is true regarding cardiac muscle? A) Its main source of ATP production is glycogen. B) The actin and myosin myofilaments are not arranged in sarcomeres. C) Cardiac muscle preferentially metabolizes anaerobically. D) There are specialized gap junctions in cardiac muscle not found in skeletal or smooth muscles. E) Cardiac muscle goes into sustained contractions faster than skeletal muscle.
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 126) The ________ is the amount of blood in a ventricle after it has contracted and before it begins to refill. A) ejection fraction B) end-diastole volume C) start-diastolic volume D) end-systolic volume E) stroke volume
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 117) Considering the left ventricle, why does isovolumetric ventricular contraction occur during ventricular systole? A) The ventricle needs to pressurize the blood to close the aortic valve. B) Ventricular pressure is greater than atrial pressure so the ventricle cannot eject blood. C) The bicuspid valve needs time to shut before the ventricle can eject blood. D) Aortic pressure is higher than ventricular pressure and the ventricle must pressurize the blood to open the aortic valve. E) The ventricle is still filling with blood and therefore cannot eject blood during this time.
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 124) The backward flow of blood from a ventricle to its atrium or from a outflow vessel to its ventricle is called A) emesis. B) flutter. C) fibrillation. D) regurgitation. E) stenosis.
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 128) The amount of blood remaining in the ventricle when the semilunar valve closes is the A) ejection fraction. B) end-diastole volume. C) start-diastolic volume. D) end-systolic volume. E) stroke volume.
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Remembering 131) When heart rate increases, the time spent in A) systole increases. B) diastole increases. C) all phases decreases but most of the decrease is during systole. D) all phases decreases but most of the decrease is during diastole. E) isovolumetric contraction increases.
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 118) The phase in the cardiac cycle when the mitral valve is closed and the aortic valve is open is the A) atrial systole. B) early diastolic filling phase. C) late diastolic filling phase. D) systolic ejection phase. E) dicrotic phase.
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 139) What occurs at the area labeled "B" on the graph? A) Ventricular ejection occurs. B) AV valve closes. C) Semilunar valve opens. D) Semilunar valve closes. E) AV valve opens.
Answer: D
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 145) An increase in the rate of action potentials from baroreceptors will trigger a reflex to A) increase heart rate. B) decrease heart rate. C) decrease blood pressure. D) both decrease heart rate and decrease pressure. E) both increase heart rate and increase pressure.
Answer: D
Learning Outcome: 20-4 Bloom's Taxonomy: Applying 168) John encounters a bear while hiking. His heart will respond in all of the following ways except A) increasing preload. B) increasing heart rate. C) increasing contractility. D) decreasing heart rate and contractility. E) increasing venous return.
Answer: D
Learning Outcome: 20-4 Bloom's Taxonomy: Remembering 163) The principle that increasing the end-diastolic volume results in a corresponding increase in the stroke volume is known as A) afterload. B) cardiac capacity. C) cardiac reserve. D) Frank-Starling principle. E) expandibility.
Answer: D
Learning Outcome: 20-4 Bloom's Taxonomy: Remembering 156) If the force of ventricular contraction increases, what will happen to the end-systolic volume? A) increase B) fluctuate rapidly C) remain the same D) decrease E) reduced to zero
Answer: D
Learning Outcome: 20-4 Bloom's Taxonomy: Remembering 165) Which factor directly influences preload? A) contractility B) heart rate C) stroke volume D) venous return E) parasympathetic tone
Answer: D
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 157) End-systolic volume is defined as the A) amount of blood a ventricle ejects per cycle. B) amount of blood which backflows into a ventricle. C) amount of blood remaining in an atrium after atrial systole. D) amount of blood remaining in a ventricle after contraction. E) stroke volume multiplied by the heart rate.
Answer: D
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 33) The right pulmonary veins carry ________ blood to the ________. A) deoxygenated; left atrium B) oxygenated; right lung C) deoxygenated; superior vena cava D) deoxygenated; right atrium E) oxygenated; left atrium
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 19) The right atrium receives blood from all of the following structures except the A) coronary sinus. B) superior vena cava. C) inferior vena cava. D) systemic circuit. E) pulmonary veins.
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 2) Beginning with the right atrium, what is the order of the valves through which blood will pass? (Figure 20-5) A) mitral valve, aortic valve, tricuspid valve, pulmonary valve B) aortic valve, tricuspid valve, mitral valve, pulmonary valve C) tricuspid valve, mitral valve, pulmonary valve, aortic valve D) pulmonary valve, tricuspid valve, aortic valve, mitral valve E) tricuspid valve, pulmonary valve, mitral valve, aortic valve
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 28) The bicuspid or mitral valve is located A) in the opening of the aorta. B) in the opening of the pulmonary trunk. C) where the venae cavae join the right atrium. D) between the right atrium and right ventricle. E) between the left atrium and left ventricle.
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 37) The foramen ovale in the fetal heart is located in the A) right atrium. B) left atrium. C) right ventricle. D) left ventricle. E) interatrial septum.
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 30) The function of an atrium is to A) store blood for use by the myocardial cells. B) pump blood to the lungs. C) pump blood into the systemic circuit. D) pump blood to the ventricle. E) collect blood then pump it to the ventricle.
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 43) The heart lies within the ________ cavity. A) peritoneal B) pleural C) orbital D) dorsal E) pericardial
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 63) The ________ is a remnant of an important fetal blood vessel that once linked the pulmonary and systemic circuits. A) fossa ovalis B) ductus arteriosus C) foramen ovale D) ductus venosus E) ligamentum arteriosum
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Remembering 67) A hole in the interventricular septum in an infant may cause all of the following symptoms except A) mixing of oxygen-rich and oxygen-poor blood. B) a murmur to be heard. C) the heart to work harder. D) the individual to have low peripheral oxygen saturation. E) build-up of atherosclerotic plaque.
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 21) Cardiac cells damaged by infarction will show all of the following except A) a switch to anaerobic metabolism. B) release of enzymes into the circulation. C) release of troponin T and I into the circulation. D) release of CK-MB into the circulation. E) an increase in metabolic activity.
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 64) Which of the following statements is true concerning differences between the right and left ventricles? A) The right ventricle pumps with more force compared to the left. B) The left ventricles pumps twice as much blood as the right ventricle. C) The right ventricles pumps blood to the body, whereas the left ventricle pumps blood to the lungs. D) The right ventricle is conical-shaped while the left ventricle is half-moon shaped. E) The efficiency of the right ventricle is increased by the left ventricle because the wall of the left ventricle pushes into the right ventricle.
Answer: E
Learning Outcome: 20-1 Bloom's Taxonomy: Understanding 74) These structures keep the aortic valve cusps from sticking to the wall of the aorta. A) auricles B) chordae tendineae C) papillary muscles D) pectinate muscles E) aortic sinuses
Answer: E
Learning Outcome: 20-2 Bloom's Taxonomy: Remembering 98) If there is a complete block between the SA node and the AV node, how would the ECG be affected? A) The P-R interval will be shorter. B) The QRS duration will be longer. C) There will be much bigger P waves. D) The ventricles will stop beating. E) The rate of P waves will be faster than the rate of QRS complexes.
Answer: E
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 94) If the pacemaker cells in the SA node become more permeable to potassium ions, the A) heart rate will increase. B) heart rate will decrease. C) cells will depolarize. D) cells will hyperpolarize. E) heart rate will decrease and cells will hyperpolarize.
Answer: E
Learning Outcome: 20-2 Bloom's Taxonomy: Understanding 87) Cardiac muscle cells and skeletal muscle cells differ in a few ways. Which of the following is not one of them? A) Cardiac muscle cells are smaller in size. B) Cardiac muscle cells have a single, centered nucleus. C) Cardiac muscle cells branch. D) Skeletal muscle cells lack intercalated discs. E) Cardiac muscle cells lack transverse tubules.
Answer: E
Learning Outcome: 20-3 Bloom's Taxonomy: Understanding 120) With each ventricular systole, A) blood pressure remains steady. B) the ventricles fill with blood. C) blood pressure decreases. D) cardiac output decreases. E) blood pressure increases.
Answer: E
Learning Outcome: 20-4 Bloom's Taxonomy: Applying 149) Stroke volume depends on all of the following factors except A) end diastolic volume. B) the contractility of the ventricle. C) the pressure required to pump blood into the aorta. D) venous return of blood to the heart. E) respiratory rate.
Answer: E
Learning Outcome: 20-4 Bloom's Taxonomy: Remembering 164) The amount of blood returning to the heart is the A) afterload. B) stroke volume. C) end-diastolic volume. D) cardiac reserve. E) venous return.
Answer: E
Learning Outcome: 20-4 Bloom's Taxonomy: Understanding 148) Which of the following would not increase heart rate? A) increased sympathetic stimulation of SA node B) decreased parasympathetic stimulation of nodal fibers C) increased levels of epinephrine D) faster depolarization of the pacemaker potential E) beta blocking drugs
Answer: E
2) A patient's ECG recording shows a very long P-R interval. What is the cause of this abnormal wave pattern?
Answer: The P wave marks the time of atrial depolarization and the QRS complex signals ventricular depolarization. Between those two events the AV node was excited and the action potential was spread through the conducting tissue to the ventricular myocardium. A prolonged P-R interval signifies an unusually slow conduction through the AV node and conducting system, possibly due to insufficient blood flow (ischemia).
