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Human Physiology From Cells to Systems 8th Edition Sherwood Test Bank

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Human Physiology From Cells to Systems 8th Edition Sherwood Test Bank

ISBN-13: 978-1133104551

ISBN-10: 113310455X

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Human Physiology From Cells to Systems 8th Edition Sherwood Test Bank

ISBN-13: 978-1133104551

ISBN-10: 113310455X

 

 

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Free Nursing Test Questions:

 

Chapter 9—Cardiac Physiology

 

MULTIPLE CHOICE

 

  1. The systemic circulation
a. receives more blood than the pulmonary circulation does
b. receives blood from the left ventricle
c. is a low pressure system compared to the pulmonary circulation
d. has characteristics a and b
e. has characteristics b and c

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. Which valve(s) prevent(s) regurgitation of blood from a ventricle to an atrium?
a. Tricuspid
b. Mitral
c. Pulmonary
d. Both a and b
e. Both b and c

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. Semilunar valves prevent backflow of blood from
a. the ventricles to the atria
b. the atria to the ventricles
c. the ventricles to the arterial trunks
d. the arterial trunks to the ventricles
e. none of the above

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. The wall of the left ventricle is thicker than the wall of the right ventricle, which allows the
a. left ventricle to pump much more blood than the right ventricle
b. right ventricle to hold more blood than the left ventricle
c. left ventricle to pump blood into a higher-resistance, higher-pressure system
d. right ventricle to create higher tension within its walls
e. left ventricle to pump oxygenated blood,

 

 

ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. Adjacent cardiac muscle cells are joined together end-to-end in the ventricles by
a. intercalated discs
b. sarcomeres
c. Purkinje fibers
d. sinoatrial nodes
e. atrioventricular nodes

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

 

 

 

 

  1. The primary function of the pericardial sac is to
a. prevent excessive expansion of the heart as it fills with blood
b. secrete a fluid that reduces friction as the heart beats
c. serve as a reservoir for blood to be used during strenuous exercise
d. provide oxygen and nutrients to the heart muscle
e. catch and kill any bacteria in the blood flowing through the heart chambers

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. The chordae tendineae
a. keep the AV valves from averting during ventricular systole
b. hold the AV valves open during diastole
c. hold the right and left ventricles together
d. transmit the electrical impulse from the atria to the ventricles
e. contract when the ventricles contract

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. The heart chamber that has the greatest work load is
a. the right ventricle
b. the left ventricle
c. the left atrium
d. the right atrium
e. both atria

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. A lumen that contains blood with a comparatively higher concentration of oxygen is in the
a. right ventricle
b. inferior vena cava
c. pulmonary artery
d. pulmonary vein
e. coronary veins

 

 

ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. The aortic valve
a. prevents the backflow of blood into the aorta during ventricular diastole
b. prevents the backflow of blood into the left ventricle during ventricular diastole
c. prevents the backflow of blood into the right ventricle during ventricular diastole
d. closes when the first heart sound is heard
e. does not do any of the above

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. The right half of the heart pumps blood through the ____ circuit and the left half pumps blood through the ____ circuit.
a. systolic; diastolic
b. coronary; pulmonary
c. systemic; pulmonary
d. pulmonary; systemic
e. systemic; coronary

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. Blood returning from the lungs
a. enters the right atrium
b. enters the left atrium
c. is poorly oxygenated
d. passes through the pulmonary valve before entering the heart
e. pass through the aortic valve before entering the heart

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. Choose a correct sequence of blood flow during one pass through the heart and lungs (some steps may have been omitted):
a. Right atrium®bicuspid valve®pulmonary vein
b. Aortic valve®right ventricle®lung
c. Lung®pulmonary artery®left atrium
d. Right ventricle®bicuspid valve®aortic valve
e. None of the above sequences are correct

 

 

ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. The pathway that permits electrical activity to pass from cell-to-cell in myocardial tissue is the
a. desmosome
b. septum
c. gap junction
d. T-tubule
e. sarcoplasmic reticulum

 

 

ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. What component of the cardiac conduction system distributes electrical signals directly through the papillary muscles?
a. AV nodes
b. AV bundle
c. bundle of His
d. Purkinje fibers
e. SA node

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. The plateau of the cardiac action potential results from the opening of voltage-gated slow ____ channels in the plasma membrane of the ____ cell.
a. sodium; contractile
b. potassium; autorhythmic
c. calcium; contractile
d. chloride; pacemaker
e. potassium; contractile

 

 

ANS:  C                    PTS:   1                    DIF:    Comprehension

 

 

 

 

 

 

 

  1. The _____ phase of the action potential in _____ cells is due to a _____.
a. rising, autorhythmic cells,  rapid Ca2+ influx
b. rising, contractile cells, rapid Na+ influx
c. plateau, contractile cells, slow Ca2+ influx
d. All of the above correctly complete the sentence.
e. Only b and c correctly complete the sentence.

 

 

ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. On a normal ECG, a wave for repolarization of the atria is not recorded. Why?
a. The leads are not placed in a position to pick it up.
b. No repolarization of the atria occurs normally.
c. It occurs simultaneously with ventricular depolarization and is masked by the QRS complex.
d. It does not travel through body fluids.
e. It is too small to be picked up by external recording electrodes.

 

 

ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. Which of the following criteria must be met for the heart to function efficiently?
a. Excitation and contraction of each heart chamber should be coordinated to ensure efficient pumping.
b. The atria should be excited and contract before the onset of ventricular contraction to ensure that ventricular filling is complete.
c. The right side of the heart should contract first to ensure that oxygenated blood is delivered to the heart before the left side contracts.
d. Both a and b
e. Both b and c

 

 

ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. The AV nodal delay ensures that:
a. The atria contract and empty their contents into the ventricles prior to ventricular systole.
b. The ventricles contract prior to atrial systole.
c. Tetanic contractions of cardiac muscle are impossible.
d. Ventricular diastole occurs before systole.
e. Atrial diastole occurs before atrial systole.

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. The normal pacemaker of the heart is the
a. SA node
b. AV node
c. bundle of His
d. Purkinje system
e. ventricular myocardium

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

 

 

 

 

 

  1. The function of the atrioventricular node is to
a. excite the left and right atrium
b. control the heart rate
c. prevent the atria and ventricles from contracting simultaneously
d. repolarize the heart after systole
e. stimulate ventricular contractile cells directly

 

 

ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. The direction of impulses through the conduction system of the heart is normally
a. AV node¾SA node¾bundle of His¾Purkinje fibers
b. AV node¾bundle of His¾SA node-¾Purkinje fibers
c. bundle of His¾AV node¾Purkinje fibers¾SA node
d. SA node¾AV node¾bundle of His¾Purkinje fibers
e. SA node¾bundle of His¾Purkinje fibers¾AV node

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. Which of the following is not occurring at the same time when the QRS complex appears on an ECG?
a. depolarization of Purkinje fibers
b. depolarization of the ventricles
c. repolarization of the atria
d. depolarization of internodal pathways
e. All of the above are occurring at the same time

 

 

ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. The fastest rate of autorhythmicity is normally carried out by the
a. AV bundle
b. AV node
c. bundle of His
d. Purkinje fibers
e. SA node

 

 

ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. Depolarization occurs at the AV node
a. during the P wave
b. between the P wave and QRS complex
c. during the QRS complex
d. between the QRS complex and T wave
e. during the T wave

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. Which of the following ECG waves represents ventricular repolarization?
a. P wave
b. QRS complex
c. T wave
d. PR segment
e. Ventricular repolarization occurs simultaneously with atrial depolarization and consequently cannot be recorded.

 

 

ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. Which is the normal sequence of the spread of cardiac excitation?

 

1. AV node
2. SA node
3. atria
4. Purkinje fibers
5. bundle of His
6. ventricular myocardium

 

a. 2¾3¾1¾5¾4¾6
b. 3¾2¾1¾4¾5¾6
c. 2¾3¾1¾4¾5¾6
d. 1¾2¾3¾4¾5¾6
e. none of these

 

 

ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. Extrasystole of the heart means that it
a. beats too slowly
b. fills with too much blood
c. has a complete block
d. loses blood
e. produces a premature beat

 

 

ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. The SA node is the heart’s normal pacemaker because
a. it has the fastest rate of autorhythmicity
b. it has both sympathetic and parasympathetic innervation
c. it lies in the right atrium
d. activation of K+ channels occurs more rapidly in this region than elsewhere in the heart
e. it can directly stimulate atrial and ventricular cardiac myocardial contractile cells

 

 

ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. Fibrillation is the
a. backflow of blood throughout the heart
b. coordinated function of nodal cells
c. failure of the heart valves to function
d. flow of blood through the heart’s fibrous skeleton
e. uncoordinated excitation and contraction of cardiac cells

 

 

ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. The AV node
a. is the normal pacemaker of the heart
b. is the only electrical connection between the atria and the ventricles
c. rapidly conducts impulses from the atria to the ventricles so that they contract simultaneously
d. is not innervated by the vagus nerve
e. has the slowest rate of depolarization in the heart

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. The electrocardiogram is most useful in determining which component of cardiac output?
a. stroke volume
b. heart rate
c. ejection fraction
d. end-diastolic volume
e. murmurs

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. An ectopic focus is the place where
a. an abnormally excitable area of the heart initiates a premature action potential
b. all of the electrical impulses of the heart terminate normally
c. an ECG lead is attached on the outside of the chest
d. a heart valve is attached
e. the chordae tendineae attach to a valve

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. The function of the ventricular conduction system of the heart is to
a. spread the action potential throughout the ventricle to ensure a single, coordinated contraction of the both ventricles
b. spread the action potential in the absence of sympathetic stimulation
c. spread the action potential throughout the atria and ventricles
d. slow down the original action potential so it has time to spread through the ventricles evenly
e. perform both a and d

 

 

ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. The refractory period of cardiac muscle
a. lasts almost as long as the contraction period
b. is much longer than the refractory period in skeletal muscle
c. prevents tetanic contraction of the heart to occur to ensure smooth, coordinated ejection of blood from the ventricles
d. is important for all of the above reasons
e. is important for only reasons a and b

 

 

ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. The membrane potential of cardiac contractile cells at rest is about ____ mV.
a. -110
b. -90
c. -70
d. -50
e. -30

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

 

 

 

 

 

  1. Why can’t tetanus occur in the heart?
a. There are no distinct motor units in the heart.
b. There is inadequate oxygen supply via the coronary circulation to metabolically support a sustained contraction.
c. The refractory period in cardiac muscle lasts almost as long as the contraction.
d. The heart contracts with maximal force every beat so it is impossible to increase the strength of its contraction.
e. Vagal stimulation slows down the heart rate to prevent summation of contractions.

 

 

ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. During isovolumetric phases of the cardiac cycle,
a. the atria are contracting
b. all heart valves are closed
c. blood is being ejected into the aorta
d. the ventricles can only be relaxing
e. both a and b are true

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. 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

 

 

ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. The cardiac output is equal to
a. (EDV – ESV) x HR
b. heart rate x EDV
c. the difference between the stroke volume at rest and the stroke volume during exercise
d. the stroke volume minus the ESV
e. heart rate x blood pressure

 

 

ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. Which factor(s) would decrease cardiac output?
a. increased venous return
b. decreased vagal stimulation of the heart
c. increased preload
d. decreased preload
e. Both a and c

 

 

ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. If the connection between the SA node and AV node becomes blocked,
a. the QRS complex will be absent on an ECG
b. the ventricles will beat more slowly
c. the atria will beat slower
d. tachycardia will occur
e. both a and d will occur

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. Which is true when your sympathetic nervous system is more active?
a. The SA node depolarizes more rapidly.
b. The myocardium repolarizes more frequently during one minute.
c. More Ca2+ becomes available and causes more forceful heart contractions.
d. Norepinephrine is stimulating the heart.
e. All of the above are true.

 

 

ANS:  E                    PTS:   1                    DIF:    Comprehension

 

  1. Which of the following leads to a decrease in ESV?
a. acetylcholine
b. preload
c. afterload
d. parasympathetic activity
e. vagal activity

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. What percentage of ventricular filling is normally accomplished before atrial contraction begins?
a. 0%
b. 20%
c. 80%
d. 50%
e. 100%

 

 

ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. Vagal influences on the heart result in
a. enhanced calcium permeability at the SA node
b. enhanced potassium permeability at the SA node
c. less frequent depolarization of the SA node
d. both a and b
e. both b and c

 

 

ANS:  E                    PTS:   1                    DIF:    Comprehension

 

  1. A condition in which the heart is contracting in an uncontrolled, rapid, and irregular manner
a. is heart block
b. is fibrillation
c. can be treated with administration of an electrical current
d. is none of the above
e. is both b and c

 

 

ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. The heart is
a. sympathetically innervated via cardiac nerve fibers
b. parasympathetically innervated by vagus nerve fibers
c. only partly innervated by the somatic nervous system
d. innervated by only the sympathetic division of the autonomic nervous system
e. both a and b

 

 

ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. When the heart is sympathetically stimulated,
a. ESV will likely decrease
b. it is responding to acetylcholine
c. the fibrous skeleton of the heart is depolarizing
d. its stroke volume will decrease
e. all except c will occur

 

 

ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. The second heart sound is produced by the
a. opening of the AV valves
b. closing of the AV valves
c. opening of the semilunar valves
d. closing of the semilunar valves
e. blood rushing through the AV valves during diastole, creating a turbulent flow

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. The first heart sound
a. occurs when the AV valves open
b. occurs when the semilunar valves close
c. signals the onset of ventricular diastole
d. occurs when the AV valves close, and signals the onset of ventricular systole
e. occurs when the semilunar valves close, and signals the onset of ventricular diastole

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. The aortic valve opens
a. when ventricular pressure exceeds aortic pressure
b. just before ventricular systole begins
c. just after the isovolumetric relaxation phase
d. in response to the repolarization of contractile cells in the left ventricle
e. just before atrial diastole begins

 

 

ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. During isovolumetric contraction,
a. rapid filling of the ventricles occurs
b. no blood enters or leaves the ventricles
c. the maximum volume of blood is ejected
d. the maximum rate of ejection occurs
e. Both a and b occur

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. The period lasting from closure of the AV valve to opening of the aortic valve is known as
a. isovolumetric ventricular contraction
b. isovolumetric ventricular relaxation
c. the rapid ejection phase
d. the rapid filling phase
e. ventricular diastole

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

 

  1. A heart valve opens and closes due to
a. being pulled by the heart muscle
b. pressure differences on the valve’s two sides
c. Na+ and K+ fluxes during ventricular depolarization
d. turbulent flow in the atria and ventricles
e. none of the above

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. Cardiac output
a. is the volume of blood pumped by each ventricle during each contraction or beat
b. is the volume of blood pumped by each ventricle per minute
c. equals heart rate divided by stroke volume
d. is both a and c
e. is both b and c

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. The dicrotic notch on the aortic pressure curve is due to
a. a disturbance set up by the aortic valve closing
b. a disturbance set up when the AV valves close
c. elastic recoil of the aorta during ventricular diastole
d. turbulent flow through a stenotic valve
e. atherosclerosis in the aorta

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. An insufficient AV valve
a. fails to open completely
b. is not connected to chordae tendineae
c. produces a gurgling diastolic murmur
d. allows blood to backflow into a ventricle during diastole
e. allows blood to leak into the pulmonary artery during right ventricular diastole

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. Atrial flutter is characterized by a ____ rhythm, as impulses pass from the AV node to the ventricles.
a. 1:1
b. 2:1
c. 3:4
d. 5:2
e. 7:1

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. A whistling murmur heard between the second and first heart sound would be indicative of
a. a stenotic AV valve
b. an insufficient AV valve
c. a myocardial infarction
d. an insufficient semilunar valve
e. an everted AV valve during atrial diastole

 

 

ANS:  A                    PTS:   1                    DIF:    Knowledge

 

 

  1. At rapid heart rates
a. systole and diastole shorten equally
b. systole stays almost constant, but diastole shortens
c. systole lengthens and diastole shortens
d. diastole lengthens and systole shortens
e. none of the above occur

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. Twelve complete ECG patterns are recorded over 10 seconds, which means the heart rate is ____ beats per minute.
a. 60
b. 72
c. 90
d. 108
e. 120

 

 

ANS:  B                    PTS:   1                    DIF:    Analysis

 

  1. If stroke volume is 80 ml and the heart rate is 70 beats per minute, the cardiac output is
a. 150 ml/min
b. 560 ml/min
c. 5,600 ml/min
d. 8,700 ml/min
e. none of the above

 

 

ANS:  C                    PTS:   1                    DIF:    Analysis

 

  1. If the cardiac output is 4,800 ml/min and the heart rate is 60 beats per minute, the stroke volume averages ____ ml.
a. 60
b. 70
c. 80
d. 120
e. 140

 

 

ANS:  C                    PTS:   1                    DIF:    Analysis

 

  1. According to the Frank-Starling law of the heart,
a. shortening cardiac muscle fibers prior to contraction causes more forceful contractions
b. increasing venous return increases EDV, which leads to an increased stroke volume
c. as cardiac output decreases, blood pools in the vasculature and increases arterial blood pressure
d. the left ventricle must pump more blood than the right ventricle since the left ventricle must pump blood to more regions of the body
e. the greater the stroke volume, the smaller the subsequent ESV, because as more blood is squeezed out, the heart cannot fill as completely.

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

 

 

 

 

  1. During heart failure,
a. the Frank-Starling curve shifts to the left
b. the heart pumps out a smaller stroke volume than normal for a given EDV
c. a compensatory increase in sympathetic activity increases the contractility of the heart to normal in the early stages of the disease
d. both a and c occur
e. both b and c occur

 

 

ANS:  E                    PTS:   1                    DIF:    Comprehension

 

  1. The term systole means
a. closure
b. conduction
c. contraction
d. opening
e. relaxation

 

 

ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. Parasympathetic innervation to the heart
a. involves the vagus nerve
b. decreases the rate at which the pacemaker potential reaches threshold
c. decreases the strength of ventricular contraction
d. is characterized by all of the above
e. is characterized by only a and b

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. Sympathetic stimulation of the heart
a. increases the heart rate
b. increases the heart’s contractility
c. shifts the Frank-Starling curve to the left
d. involves the release of norepinephrine
e. causes all of the above

 

 

ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. Select the incorrect statement about rheumatic fever.
a. It causes a heart murmur.
b. It is an autoimmune disease.
c. It is triggered by a streptococcus bacterium.
d. The heart conduction system is disrupted.
e. The heart valves become inflamed and scarred.

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. Increased ____ permeability of nodal cells hyperpolarizes the SA node.
a. chloride
b. iodide
c. potassium
d. sodium
e. zinc

 

 

ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. The parasympathetic nervous system has little effect on ____ activity.
a. atrial
b. AV node
c. heart rate
d. SA node
e. ventricular

 

 

ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. If the EDV were held constant, increased cardiac output could be accomplished by
a. decreased sympathetic stimulation of the heart
b. decreased parasympathetic stimulation of the heart
c. decreased contractility
d. increased length of isovolumetric contraction
e. increased arterial blood pressure

 

 

ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. Which of the following is not associated with an increase in stroke volume?
a. increased end-diastolic volume
b. increased contractility of the heart
c. increased end-systolic volume
d. increased preload
e. increased venous return

 

 

ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. Vasodilation of coronary arteries is induced by
a. adenosine
b. nitroglycerin
c. nitric oxide
d. all of the above
e. only a and b

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. The cardiac muscle
a. extracts oxygen and nutrients from the blood within its chambers
b. receives its blood supply primarily during ventricular systole when blood is forced into coronary arteries
c. receives its blood supply directly from the pulmonary circulation as all of this blood passes through the coronary circulation
d. receives most of its blood supply during ventricular diastole by means of coronary arteries
e. does not receive blood in any of the ways mentioned above

 

 

ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. A metabolic predictor of heart disease that is independent of one’s cholesterol/lipid profile is
a. HDL
b. VLDL
c. homocysteine
d. methionine
e. creatine

 

 

ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. A swishy murmur heard between the second and first heart sounds is indicative of a(n) ____________ valve.
a. insufficient semilunar
b. insufficient AV
c. stenotic semilunar
d. stenotic AV
e. Either a or d correctly completes the sentence.

 

 

ANS:  B                    PTS:   1                    DIF:    Knowledge

 

TRUE/FALSE

 

  1. The pulmonary circulation carries oxygenated blood from the lungs through the coronary circulation and then into the aorta.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. The right ventricle pumps deoxygenated blood through the tricuspid valve and into the pulmonary arteries.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. The aortic valve prevents backflow of blood from entering the left ventricle during ventricular diastole.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The mitral valve prevents regurgitation of blood back into the left atrium from the left ventricle.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The function of the chordae tendineae and papillary muscles is to hold the AV valves open during diastole to ensure complete ventricular filling.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. The AV valve controls the amount of blood entering the atrium from the venous system.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. The SA node is the only part of the heart that can function as the heart’s pacemaker.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. The only point of electrical contact between the atria and the ventricles is the AV valve.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. An action potential spreads through the atria by gap junctions, but there are no gap junctions present in the ventriclesRemember, the impulse must be propagated throughout the ventricular myocardium by the bundle of His and Purkinje system.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. An action potential impulse passes through the internodal pathways between the P wave and Q waves on an ECG.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. Ventricular systole is displayed as the QRS on the ECG, and ventricular diastole is displayed as the T wave.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. With 2:1 rhythm, the atrial rate is very rapid and the ventricular rate is normal or above normal, whereas with 2:1 block, the atrial rate is normal but the ventricular rate is below normal.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The plateau phase of the action potential in a contractile cardiac muscle cell occurs as a result of activation of slow Ca2+ channels.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. Oxygenated blood flows through semilunar valves, whereas deoxygenated blood flows through AV valves.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Diastole refers to the period of cardiac repolarization.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Atrial systole is responsible for the first heart sound, whereas the ventricular systole is responsible for the second heart sound.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Ventricular filling occurs more rapidly early in diastole than it does later in diastole.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. Atrial systole contributes most of a ventricle’s EDV.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. Ventricular ejection occurs once the afterload has been overcome.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. The refractory period in cardiac muscle is much shorter than the refractory period in skeletal muscle to ensure that the heart can quickly be re-stimulated to produce alternate periods of contraction and relaxation.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. The long refractory period of cardiac muscle prevents tetanic contractions of the heart.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. High blood pressure decreases the afterload and increases the preload.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Under normal conditions, all of the EDV is ejected before ventricular diastole begins.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. Contraction of the spirally arranged cardiac muscle fibers produces a wringing effect for efficient pumping.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The AV and semilunar valves are never open at the same time.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. A pacemaker potential depends on the increased inward current of calcium ions.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The first heart sound signals the onset of ventricular depolarization.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Complete heart block results from a damaged AV node.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The second heart sound is due to closure of the AV valves.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. The stroke volume is the total volume of blood ejected by both ventricles each minute.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. Pacemaker activity by the Purkinje fibers is an example of an ectopic focus.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. Normally, the stroke volume of the right side of the heart is the same as the stroke volume of the left side of the heart.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

 

  1. One important function of the intrinsic control of the heart (Frank-Starling law of the heart) is to equalize the left and right cardiac outputs.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. The extent of ventricular filling is the preload of the heart, whereas the magnitude of the arterial blood pressure is the afterload of the heart.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. Parasympathetic stimulation slows the rate of depolarization of the SA node and thus decreases the heart rate.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. An increased heart rate can result due to a decrease in parasympathetic stimulation or an increase in sympathetic stimulation of the heart.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. The addition of ACh to the SA node would decrease the number of T waves observed per minute on an ECG.

 

ANS:  T                    PTS:   1                    DIF:    Application

 

  1. Cardiac output is equal to the EDV-ESV.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Norepinephrine increases calcium permeability in cardiac muscle cells and thus increases the heart’s contractility.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The average resting heart rate is normally established by the rhythm of autorhythmic cells located near the base of the right atrium.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. The amount of blood pumped out of the heart during each beat is known as the cardiac output.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. Increased EDV results in decreased stroke volume, and increased stroke volume results in increased ESV.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Parasympathetic stimulation of the heart increases cardiac reserve by allowing more time for the heart to relax between contractions.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. According to the Frank-Starling law of the heart, the shorter the initial length of the cardiac muscle fibers prior to contraction, the more forceful will be the subsequent contraction because the fibers are already partially contracted.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. Left-sided congestive heart failure can lead to pulmonary edema.

 

ANS:  T                    PTS:   1                    DIF:    Application

 

  1. Most blood flow through the coronary vessels occurs during ventricular systole when the heart is driving blood forward.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. The heart utilizes glucose almost exclusively for energy production.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. Not all forms of cholesterol are equally harmful to the heart.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. Cardiac output is equal to (EDV-ESV) times the number of heart beats per minute

 

ANS:  T                    PTS:   1                    DIF:    Application

 

  1. Isovolumetric contraction appears on the ECG as part of the QRS complex.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. An increase in venous return would increase preload and decrease ESV.

 

ANS:  T                    PTS:   1                    DIF:    Application

 

  1. The Frank-Starling law of the heart relates to how stretching of the ventricles during ventricular filling will affect stroke volume.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. Stroke volume is inversely correlated to preload; i.e., a lower preload increases stroke volume.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. An increase in afterload will cause the heart to remain longer in the period of isovolumetric relaxation.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. An increase in afterload will cause the heart to remain longer in the period of isovolumetric contraction.

 

ANS:  T                    PTS:   1                    DIF:    Comprehension

 

  1. During congestive heart failure, the heart is pumping out deoxygenated at a faster rate than it is pumping out oxygenated blood.

 

ANS:  T                    PTS:   1                    DIF:    Analysis

 

  1. An stationary embolus in a pulmonary artery could break loose and travel as a thrombus where it could stop up a smaller blood vessel in the lung.

 

ANS:  F                    PTS:   1                    DIF:    Knowledge

 

  1. L-type calcium channels allow the refractory periods in the heart’s contractile cells to be about as long as the cells’ relaxation periods.

 

ANS:  T                    PTS:   1                    DIF:    Knowledge

 

  1. The ECG allows one to detect the electrical activity of a single contractile cell in the heart, but it does not show any mechanical events such as contraction and relaxation.

 

ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. Oxygenated blood would pass through the mitral valve and pulmonary valves, but would not pass through the tricuspid valve.

 

ANS:  F                    PTS:   1                    DIF:    Analysis

 

COMPLETION

 

Complete each of the following statements.

 

  1. The ____________________ is the normal pacemaker of the heart.

 

ANS:  SA node

 

PTS:   1                    DIF:    Knowledge

 

  1. The ____________________ delay ensures that atrial systole is complete before ventricular systole begins.

 

ANS:  AV nodal

 

PTS:   1                    DIF:    Knowledge

 

  1. The refractory period in skeletal muscle is ____________________ than the refractory period in cardiac muscle.

 

ANS:  shorter

 

PTS:   1                    DIF:    Knowledge

 

 

 

  1. A swishy murmur heard between the second and first heart sounds is indicative of a(n) ____________________ (stenotic or insufficient) ____________________ (AV or semilunar) valve.

 

ANS:  insufficient, AV

 

PTS:   1                    DIF:    Knowledge

 

  1. The ____________________ is equal to the cardiac output divided by the heart rate.

 

ANS:  stroke volume

 

PTS:   1                    DIF:    Application

 

  1. The ____________________ is the volume of blood pumped by each ventricle/minute.

 

ANS:  cardiac output

 

PTS:   1                    DIF:    Knowledge

 

  1. The ____________________ volume is the blood in the ventricle when ejection is complete, whereas the ____________________ volume is the blood in the ventricle just before ejection begins.

 

ANS:  end-systolic, end-diastolic

 

PTS:   1                    DIF:    Knowledge

 

  1. Myocardial ____________________ is the insufficient circulation of oxygenated blood to cardiac muscle in order to maintain its aerobic metabolism.

 

ANS:  ischemia

 

PTS:   1                    DIF:    Knowledge

 

  1. During the period of ____________________ and the period of ____________________ in the cardiac cycle, all heart valves are closed.

 

ANS:  isovolumetric contraction, isovolumetric relaxation

 

PTS:   1                    DIF:    Knowledge

 

  1. ____________________ carries cholesterol to cells, whereas ____________________ transports it away from cells.

 

ANS:  LDL, HDL

 

PTS:   1                    DIF:    Knowledge

 

  1. The ____________________ extracts cholesterol from the blood and converts it into ____________________, which are secreted into the bile.

 

ANS:  liver, bile salts

 

PTS:   1                    DIF:    Knowledge

 

  1. Vitamins ____________________ and ____________________ have been shown to slow plaque deposition in coronary arteries.

 

ANS:  E, C

 

PTS:   1                    DIF:    Knowledge

 

  1. A(n) ____________________ is a clot attached to the wall of a vessel.

 

ANS:  thrombus

 

PTS:   1                    DIF:    Knowledge

 

  1. PAF is released from the ____________________ lining of vessels.

 

ANS:  endothelium

 

PTS:   1                    DIF:    Knowledge

 

  1. The ____________________ are the kinds of blood vessels that experience congestion for congestive heart failure.

 

ANS:  veins

 

PTS:   1                    DIF:    Knowledge

 

Complete each of the following statements with increases, decreases, or has no effect on.

 

  1. Increasing stroke volume ____________________ cardiac output.

 

ANS:  increases

 

PTS:   1                    DIF:    Comprehension

 

  1. An increase in stroke volume ____________________ ESV.

 

ANS:  decreases

 

PTS:   1                    DIF:    Comprehension

 

  1. Increasing the afterload ____________________ the length of time the heart is in isovolumetric contraction.

 

ANS:  increases

 

PTS:   1                    DIF:    Comprehension

 

 

 

 

 

  1. Decreasing preload ____________________ contractility, which then ____________________ stroke volume.

 

ANS:  decreases, decreases

 

PTS:   1                    DIF:    Comprehension

 

  1. Norepinephrine ____________________ the SA node’s permeability to Ca2+, which then ____________________ the length of time between subsequent heart beats.

 

ANS:  increases, decreases

 

PTS:   1                    DIF:    Comprehension

 

  1. Decreasing venous return ____________________ preload and ____________________ EDV.

 

ANS:  decreases, decreases

 

PTS:   1                    DIF:    Comprehension

 

  1. Acetylcholine ____________________ the SA node’s permeability to potassium ions; as a result, the length of time between successive T waves ____________________.

 

ANS:  increases, increases

 

PTS:   1                    DIF:    Comprehension

 

  1. Becoming more physically fit ____________________ a person’s cardiac reserve.

 

ANS:  increases

 

PTS:   1                    DIF:    Knowledge

 

  1. An increase in venous return ____________________ the end-diastolic volume.

 

ANS:  increases

 

PTS:   1                    DIF:    Comprehension

 

  1. An increase in afterload ____________________ the length of time available for ventricular ejection.

 

ANS:  decreases

 

PTS:   1                    DIF:    Comprehension

 

  1. An increase in the length of the cardiac muscle fibers prior to contraction ____________________ the number of heart sounds heard.

 

ANS:  has no effect on

 

PTS:   1                    DIF:    Comprehension

 

  1. Increasing the time when all heart valves are closed ____________________ the length of time that a lub heart sound lasts.

 

ANS:  has no effect on

 

PTS:   1                    DIF:    Comprehension

 

  1. An increase in parasympathetic activity ____________________ the stroke volume.

 

ANS:  has no effect on

 

PTS:   1                    DIF:    Knowledge

 

  1. An increase in the parasympathetic activity ____________________ the AV-nodal delay.

 

ANS:  increases

 

PTS:   1                    DIF:    Comprehension

 

  1. An increase in cardiac sympathetic activity ____________________ the stroke volume.

 

ANS:  increases

 

PTS:   1                    DIF:    Knowledge

 

  1. An increase in parasympathetic activity ____________________ the atrial contractility.

 

ANS:  decreases

 

PTS:   1                    DIF:    Knowledge

 

  1. An increase in cardiac sympathetic activity ____________________ the velocity of impulse conduction through the heart.

 

ANS:  increases

 

PTS:   1                    DIF:    Knowledge

 

  1. Unique voltage-gated Na+ channels in pacemaker cells that open when the membrane becomes more negative (hyperpolarizes) and bring about the initial depolarization in the pacemaker potential are called  ________ channels.

 

ANS:  funny or If

 

PTS:   1                    DIF:    Knowledge

 

  1. The second half of the pacemaker potential is brought about through the opening of ____-type ____ channels.

 

ANS:  T, Ca2+

 

PTS:   1                    DIF:    Knowledge

 

  1. Once threshold is reached, the rising phase of the action potential in pacemaker cells is brought about by the opening of ____-type ____ channels.

 

ANS:  L, Ca2+

 

PTS:   1                    DIF:    Knowledge

 

  1. Although not seen on an ECG, the period of isovolumetric relaxation would occur nearest which deflection on the ECG?

 

ANS:  T wave

 

PTS:   1                    DIF:    Comprehension

 

  1. Although not seen on an ECG, the period of isovolumetric contraction would occur nearest which deflection of an ECG?

 

ANS:  QRS complex

 

PTS:   1                    DIF:    Comprehension

 

  1. The heart muscle is completely repolarized and at rest during the _______ segment on the ECG.

 

ANS:  T-P

 

PTS:   1                    DIF:    Comprehension

 

  1. The _______ diagram correlates various events that occur concurrently during the cardiac cycle.

 

ANS:  Wigger’s

 

PTS:   1                    DIF:    Knowledge

 

  1. The dicrotic notch on the aortic pressure wave is due to a disturbance caused by the closure of the ______ valve.

 

ANS:  aortic or aortic semilunar

 

PTS:   1                    DIF:    Knowledge

 

  1. The only veins in an adult that contain highly oxygenated blood are the ______ veins.

 

ANS:  pulmonary

 

PTS:   1                    DIF:    Comprehension

 

  1. The only arteries in an adult that contain deoxygenated blood are the ________ arteries.

 

ANS:  pulmonary

 

PTS:   1                    DIF:    Comprehension

 

  1. The entire cardiovascular system is lined internally with a special type of epithelial tissue called _______.

 

ANS:  endothelium

 

PTS:   1                    DIF:    Knowledge

 

  1. The presence of _______ within intercalated discs allow the heart’s contractile cells to work together as a functional syncytium.

 

ANS:  gap junctions

 

PTS:   1                    DIF:    Knowledge

 

  1. ____-type calcium channels are present only in the pacemaker cells of the heart.

 

ANS:  T

 

PTS:   1                    DIF:    Knowledge

 

  1. Random, uncoordinated excitation and contraction of the cardiac cells is known as _________.

 

ANS:  fibrillation

 

PTS:   1                    DIF:    Knowledge

 

  1. About 90% of the calcium needed for contraction of heart muscle cells comes from the _________.

 

ANS:  sarcoplasmic reticulum

 

PTS:   1                    DIF:    Knowledge

 

  1. The arrangement of a particular pair of electrodes used to record electrical activity of the heart a called a(n) _________.

 

ANS:  lead

 

PTS:   1                    DIF:    Knowledge

 

  1. A heart rate of more than 100 beats per minute is called ________, while a heart rate less than 60 beats per minute is called ___________.

 

ANS:  tachycardia, bradycardia

 

PTS:   1                    DIF:    Knowledge

 

  1. The pulse deficit is the difference between the _________ and the _________.

 

ANS:  heart rate, pulse rate

 

PTS:   1                    DIF:    Knowledge

 

SHORT ANSWER

 

Sequencing

 

  1. Indicate the proper order of events during the cardiac cycle by placing numbers in the blanks preceding the events in sequence. (Some steps may have been omitted.) The first event is labeled as your starting point.

 

1 AV valve open; aortic valve closed; ventricular filling occurring
  Blood ejected from the ventricles
  Isovolumetric ventricular relaxation
  Atrial contraction
  AV valve opens; ventricular filling occurs again; one cardiac cycle is complete
  Aortic valve opens
  SA node discharges
  Ventricular filling complete
  Ventricular relaxation begins
  Aortic valve closes
  Isovolumetric ventricular contraction
  Ventricular contraction begins; AV valve closes

 

 

ANS:

1, 8, 11, 3, 12, 7, 2, 4, 9, 10, 6, 5

 

PTS:   1                    DIF:    Evaluation

 

MATCHING

 

Match EKG feature with the correct characteristic.

a. P wave
b. QRS complex
c. T wave
d. PR interval
e. TP interval
f. ST segment

 

 

  1. Ventricular depolarization

 

  1. Time during which ventricles are contracting and emptying

 

  1. Atrial depolarization

 

  1. Time during which atria are repolarizing

 

  1. Time during which impulse is traveling through the AV node

 

  1. Time during which ventricles are filling

 

  1. Time when threshold voltage is reached in pacemaker cells

 

  1. Ventricular repolarization

 

  1. Time when L-type Ca2+ channels in atrial contractile cells are closing

 

  1. EKG deflection seen immediately before the semilunar valves close

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  D                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  E                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  C                    PTS:   1                    DIF:    Analysis

 

Match the characteristic with the appropriate term(s).

a. tricuspid valve
b. bicuspid valve
c. mitral valve
d. pulmonary valve
e. aortic valve
f. all heart valves
g. aortic valve; pulmonary valve
h. bicuspid valve; mitral valve
i. tricuspid valve; bicuspid valve
j. tricuspid valve; pulmonary valve
k. mitral valve; aortic valve
l. fibrous skeleton
m. chordae tendineae
n. oxygenated blood
o. deoxygenated blood

 

 

  1. Prevents backflow of blood into the left ventricle

 

  1. Type of blood in a pulmonary vein

 

  1. Prevents valves from opening into the atria

 

  1. Type of blood flowing through the right AV valve

 

  1. Surrounds and supports the heart valves

 

  1. Closes as a result of the right ventricle experiencing systole

 

  1. Prevents blood from leaving the left ventricle during isovolumetric contraction

 

  1. Prevents blood from entering the right ventricle during isovolumetric relaxation

 

  1. Prevents blood from entering a ventricle from an artery

 

  1. Allow blood to move in only one direction

 

  1. Name is based on the resemblance to a hat

 

  1. Blood passes out of the right ventricle through this valve

 

  1. Blood passes out of ventricles through these valves

 

  1. Oxygenated blood passes through these valves

 

  1. ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  N                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  M                   PTS:   1                    DIF:    Knowledge

 

  1. ANS:  O                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  L                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  K                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  J                     PTS:   1                    DIF:    Comprehension

 

  1. ANS:  G                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  F                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  G                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  K                    PTS:   1                    DIF:    Comprehension

 

Match cardiovascular feature with correct characteristic.

a. angina pectoris
b. embolus
c. atherosclerosis
d. thrombus

 

 

  1. Consists of abnormal smooth muscle cells, cholesterol deposits, scar tissue, and possible calcium deposits plaque

 

  1. Referred cardiac pain

 

  1. Freely floating clot

 

  1. Abnormal clot attached to a vessel wall

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  D                    PTS:   1                    DIF:    Knowledge

 

Indicate the effects of sympathetic and parasympathetic stimulation on the heart using the following answer code:

a. caused by sympathetic stimulation
b. caused by parasympathetic stimulation
c. not brought about by sympathetic or parasympathetic stimulation

 

 

  1. Increases the heart rate

 

  1. Decreases the contractility of the atrial muscle

 

  1. Increases the AV nodal delay

 

  1. Decreases the rate of depolarization to threshold of the SA node

 

  1. Increases the contractility of the atrial and ventricular muscle

 

  1. Decreases the contractility of the ventricular muscle

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  C                    PTS:   1

 

Use the following answer code to indicate which factor involved in the initiation and spread of cardiac excitation is being identified.

a. SA node
b. AV node
c. bundle of His and Purkinje system
d. gap junctions

 

 

  1. Has the fastest rate of pacemaker activity

 

  1. Allows the impulse to spread from cell to cell

 

  1. Delays conduction of the impulse

 

  1. Only point of electrical contact between the atria and ventricles

 

  1. Normal pacemaker of the heart

 

  1. Rapidly conducts the impulse down the ventricular septum and throughout much of the ventricular musculature

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

Indicate which ion is involved in each event being described by using the following answer code.

a. K+
b. Na+
c. Ca2+

 

 

  1. Inactivation of _____ channels brings about the slow drift of membrane potential to threshold in the cardiac autorhythmic cells.

 

  1. Explosive increase in membrane permeability to _____ brings about the rapidly rising phase of the action potential in contractile cardiac cells.

 

  1. Slow inward diffusion of _____ is largely responsible for the plateau portion of the cardiac action potential.

 

  1. The rapid falling phase of the cardiac action potential is brought about primarily by the outward diffusion of _____.

 

  1. Changes in cytosolic _____ concentration bring about changes in the strength of cardiac contraction.

 

  1. Parasympathetic stimulation increases the permeability of the SA node to _____, whereas sympathetic stimulation decreases the permeability to this same ion.

 

  1. ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  A                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  A                    PTS:   1                    DIF:    Comprehension

 

Indicate which valve abnormality is being described using the answer code below.

a. valvular stenosis
b. valvular insufficiency

 

 

  1. Produces a “gurgling” murmur

 

  1. Produces a “whistling” murmur

 

  1. Valve does not close completely

 

  1. Valve does not open completely

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

Using the following answer code, indicate which pressure relationship exists during the time in question.

a. aortic pressure > ventricular pressure > atrial pressure
b. aortic pressure > ventricular pressure < atrial pressure
c. aortic pressure < ventricular pressure > atrial pressure
d. aortic pressure < ventricular pressure < atrial pressure

 

 

  1. During ventricular filling

 

  1. Moment when the atrioventricular valve closes

 

  1. During isovolumetric ventricular contraction

 

  1. When the aortic valve opens

 

  1. When ventricular ejection is occurring

 

  1. When the aortic valve closes

 

  1. During isovolumetric ventricular relaxation

 

  1. When the atrioventricular valve opens

 

  1. Pressure differences that do not occur in a normal heart

 

  1. ANS:  B                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  A                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  A                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  C                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  C                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  A                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  A                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  B                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  D                    PTS:   1                    DIF:    Analysis

 

Use the answer code below to complete the following statements.

a. stroke volume
b. end-diastolic volume
c. cardiac output
d. heart rate
e. end-systolic volume
f. sympathetic activity
g. stroke volume and heart rate
h. end-diastolic volume and end-systolic volume
i. end-diastolic volume and sympathetic activity

 

 

  1. The volume of blood ejected by each ventricle each minute is known as the _____.

 

  1. The two main determinants of cardiac output are _____ and _____.

 

  1. The volume of blood ejected by each ventricle each beat is known as the _____.

 

  1. The stroke volume may be calculated by _____ minus _____.

 

  1. The maximum volume of blood that the ventricle contains after filling is complete is the _____.

 

  1. The minimum volume of blood that the ventricle contains after emptying is complete is the _____.

 

  1. Stroke volume can be increased by increasing _____ and _____.

 

  1. The number of times the heart contracts each minute is the _____.

 

  1. Heart rate can be increased by increasing _____.

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  G                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  H                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  E                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  I                     PTS:   1                    DIF:    Knowledge

 

  1. ANS:  D                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  F                    PTS:   1

 

Use the following answer code to compare the magnitude of the items in question.

a. A is greater than B.
b. B is greater than A.
c. A and B are equal or nearly equal.

 

 

  1. A. Resistance and pressure in the pulmonary circulation
  2. Resistance and pressure in the systemic circulation

 

  1. A. Volume of blood pumped out by the left side of the heart
  2. Volume of blood pumped out by the right side of the heart

 

  1. A. Spontaneous rate of depolarization in the SA node
  2. Spontaneous rate of depolarization in the ventricles

 

  1. A. Velocity of impulse through the bundle of His and Purkinje system
  2. Velocity of impulse conduction through the AV node

 

  1. A. Rate of depolarization of the SA node during parasympathetic stimulation
  2. Rate of depolarization of the SA node during sympathetic stimulation

 

  1. A. Duration of systole at resting heart rate
  2. Duration of systole at rapid heart rate during exercise

 

  1. A. Duration of diastole at resting heart rate
  2. Duration of diastole at rapid heart rate during exercise

 

  1. A. Rate of ventricular filling in early diastole
  2. Rate of ventricular filling in late diastole

 

  1. A. Stroke volume when end-diastolic volume equals 130 ml
  2. Stroke volume when end-diastolic volume equals 160 ml

 

  1. A. Normal stroke volume
  2. Stroke volume on sympathetic stimulation

 

  1. A. Volume of blood in the ventricles at the onset of isovolumetric ventricular contraction
  2. Volume of blood in the ventricles at the end of isovolumetric ventricular contraction

 

  1. A. Volume of blood in the left ventricle when the aortic valve opens
  2. Volume of blood in the left ventricle when the aortic valve closes

 

  1. A. Volume of blood in the left ventricle when the left AV valve opens
  2. Volume of blood in the left ventricle when the left AV valve closes

 

  1. A. Duration of the refractory period in cardiac muscle
  2. Duration of contraction in cardiac muscle

 

  1. A. Duration of the refractory period in cardiac muscle
  2. Duration of the refractory period in skeletal muscle

 

  1. A. Coronary blood flow during systole
  2. Coronary blood flow during diastole

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  C                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  A                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  B                    PTS:   1                    DIF:    Analysis

 

  1. ANS:  C                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Analysis

 

Match heart characteristic with correct anatomical structure.

a. tricuspid valve
b. myocardium
c. aortic semilunar valve
d. AV node
e. sinoatrial node

 

 

  1. Contains Purkinje fibers

 

  1. Its cells have slow Ca2+ channels

 

  1. Is much thicker on the left side

 

  1. In a normal heart, its fast Ca2+ channels initiate action potentials that determine heart rate

 

  1. It is prevented from opening into the right atrium by papillary muscle action

 

  1. This overcomes the afterload of the circuits

 

  1. Its closing partially creates the heart sound “lub”

 

  1. Contraction of this generates blood pressure

 

  1. This electrically connects the atria to the ventricles

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  E                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  A                    PTS:   1                    DIF:    Knowledge

 

  1. ANS:  B                    PTS:   1                    DIF:    Comprehension

 

  1. ANS:  D                    PTS:   1                    DIF:    Knowledge

 

 

 

 

 

 

 

 

 

 

ART-BASED QUESTIONS

 

 

Use this figure to answer the corresponding questions.

 

  1. The structure labeled 1
a. allows blood to pass into the ventricle
b. has deoxygenated blood flowing past it
c. is connected to chordae tendineae
d. all of these
e. none of these

 

 

ANS:

d

 

PTS:   1                    DIF:    Knowledge

 

  1. Which structures have oxygenated blood flowing through them?
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 2 and 4
e. 3, 4, and 5

 

 

ANS:

e

 

PTS:   1                    DIF:    Analysis

 

 

 

 

 

  1. Which structures are closed during ventricular ejection?
a. 1 and 2
b. 1 and 3
c. 2 and 4
d. 1, 2, 3, and 4
e. only 3 and 4

 

 

ANS:

b

 

PTS:   1                    DIF:    Comprehension

 

  1. Which structures are open during isovolumetric relaxation?
a. 1 and 2
b. 1 and 3
c. 2 and 4
d. 1, 2, 3, and 4
e. none of these

 

 

ANS:

e

 

PTS:   1                    DIF:    Comprehension

 

 

Use this figure to answer the corresponding questions.

 

 

 

 

 

 

 

 

 

 

  1. Identify the location(s) where fast calcium channels are open.
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 3 and 4
e. 4 only

 

 

ANS:

c

 

PTS:   1                    DIF:    Comprehension

 

  1. This graph shows the electrical activity for one of the heart’s
a. Purkinje fibers
b. pacemaker cells
c. contractile cells
d. ventricular cells
e. pacemaker and ventricular cells

 

 

ANS:

b

 

PTS:   1                    DIF:    Knowledge

 

  1. Identify the location(s) where the cell’s permeability to Na+ is the greatest.
a. between 1 and 2
b. between 2 and 3
c. between 2 and 4
d. between 3 and 4
e. 4 only

 

 

ANS:

a

 

PTS:   1                    DIF:    Comprehension

 

  1. Identify the location(s) where fast calcium channels are open.
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 3 and 4
e. 4 only

 

 

ANS:

c

 

PTS:   1                    DIF:    Comprehension

 

 

Use this figure to answer the corresponding questions.

 

  1. Identify the location(s) that indicates when fast calcium channels open within the cell.
a. 1
b. 2 and 3
c. 2, 3, and 4
d. 1 and 4
e. There are no fast calcium channels in these cells.

 

 

ANS:

e

 

PTS:   1                    DIF:    Analysis

 

  1. This graph shows the electrical activity for one of the heart’s
a. contractile cells
b. pacemaker cells
c. autorhythmic cells
d. contractile and autorhythmic cells
e. pacemaker and autorhythmic cells

 

 

ANS:

a

 

PTS:   1                    DIF:    Comprehension

 

 

  1. Identify the location(s) where slow calcium channels are open.
a. 1 only
b. 1 and 2
c. 3 only
d. 3 and 4
e. These cells do not have slow calcium channels.

 

 

ANS:

c

 

PTS:   1                    DIF:    Analysis

 

  1. Identify the location(s) where “ordinary” voltage-gated potassium channels are open.
a. 1 only
b. only between 2 and 3
c. only between 3 and 4
d. 2, 3, 4
e. 5 only

 

 

ANS:

d

 

PTS:   1                    DIF:    Analysis

 

ESSAY

 

  1. Describe how contractile cells are able to contract rapidly but are not likely to experience tetanus. Include the following terms in your answer: refractory period, calcium channels, contraction period, relaxation period, depolarization, and repolarization.

 

ANS:

When a contractile cell is brought to threshold, its voltage-gated Na+ channels open, causing the membrane potential to reverse. At the peak of the depolarization, the Na+ channels close and then voltage-gated K+ channels open and the membrane begins to repolarize. However, slow calcium channels then open and prolong the depolarized condition as Ca2+ ions rush into the cell, thereby counteracting the repolarization occurring as K+ ions are flowing out of the cell. In a short while, the Ca2+ channels close but the K+ remains open. Repolarization then proceeds and brings the membrane potential back to the repolarized condition. This relatively long refractory period (when the membrane is depolarized and not capable of responding to another stimulus) is about as long as the contraction period for the muscle cell. Therefore, the cell is able to relax before it can respond to another stimulus and begin a subsequent contraction.

 

PTS:   1                    DIF:    Comprehension

 

 

 

 

 

 

 

  1. List the following in the correct order of their occurrence within the ST segment on the ECG: ventricular ejection begins, lub sound, opening of semilunar valves, period of isovolumetric contraction, closing of AV valves, ventricular systole begins.

 

ANS:

1. ventricular systole begins
2. closing of AV valves
3. lub sound
4. best time to measure EDV
5. opening of semilunar valves
6. ventricular ejection begins

 

 

PTS:   1                    DIF:    Analysis

 

  1. Describe the mechanisms involved by which the parasympathetic and sympathetic nervous systems affect cardiac output. Include ACh, NE, regulated K+ channels, If channels and T-type Ca2+ channels, vagus nerve, cardiac nerves, contractility, stroke volume, and heart rate in your answer.

 

ANS:

The parasympathetic nervous system stimulates the heart with ACh released from the vagus nerve. The ACh binds to receptors that ultimately cause the opening of ACh-regulated K+ channels. As K+ ions diffuse out of the cell, it takes longer for the pacemaker cells to reach threshold; therefore, the heart rate slows. The ACh also lessens the contractility of the heart by depressing the inward movement of Ca2+ through If and T-type Ca2+ channels; thus, the stroke volume and cardiac output decreases. The sympathetic nervous system stimulates the heart with NE, which causes the If and T-type Ca2+ channels to open more readily and allow more Ca2+ to enter the cell. This causes the pacemaker cells to reach threshold more quickly (faster heart rate) and it causes the contractile cells to increase their contractility (greater stroke volume). The result is a greater cardiac output.

 

PTS:   1                    DIF:    Comprehension

 

  1. Describe the way in which high blood pressure and a defective semilunar valve can make it more difficult for the heart to pump blood into the systemic circulation and how these factors can decrease cardiac output. Include the following in your answer: afterload, period of isovolumetric contraction, stenosis, and blood flow resistance.

 

ANS:

High blood pressure means that the afterload on the heart is higher than normal, which means the ventricles must pump more forcefully to open the semilunar valves. When the ventricle begins systole, the higher afterload will cause the semilunar valves to stay closed longer, which means the period of isovolumetric contraction will last longer. This leaves less time for ventricular ejection to occur when the semilunar valve finally opens; consequently, the cardiac output can decrease. Stenosis means that a valve does not open completely, which means that during ventricular ejection the total amount of blood ejected will be less than what would occur if the valve openly freely and all the way.

 

PTS:   1                    DIF:    Evaluation

 

 

 

 

  1. Describe the generation of pacemaker action potentials and then track the resulting impulse through the cardiac conduction system. Include the names of specific types of channels in the first part of your answer.

 

ANS:

The pacemaker cells in the SA node steadily depolarize spontaneously to near threshold as Na+ leaks into the cells through the If (funny channels). As the voltage nears threshold voltage, the If channels close and T-type Ca2+ channels open. Calcium ions diffusing into the cell through these channels brings the voltage to threshold, at which time the T-type channels close and L-type Ca2+ channels open. Enough Ca2+ ions pass into the cell through these channels to begin the impulse. Impulses spread out from the SA node and reach the contractile cells of the atria, which contract simultaneously. In addition, the impulse reaches the AV node and then passes into the AV bundle. From the AV bundle, the impulses passes along the bundle branches located in the septum between the two ventricles. From there, the impulse passes through the Purkinje fibers and spreads superiorly through the outer walls of the ventricles.

 

PTS:   1                    DIF:    Comprehension

 

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