Pathophysiology Chapter 32 Structure and Function of the Cardiovascular and Lymphatic Systems

Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems

MULTIPLE CHOICE

1.            Which statement made by a student indicates the healthcare professional needs to describe the pericardium again?

a.            The pericardium is a double-walled membranous sac that encloses the heart.

b.            It is made up of connective tissue and a surface layer of squamous cells.

c.             The pericardium protects the heart against infection and inflammation from the lungs and pleural space.

d.            It contains pain and mechanoreceptors that can elicit reflex changes in blood pressure and heart rate.

2.            Which cardiac chambers have the thinnest wall and why?

a.            The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.

b.            The right and left atria; they are not directly involved in the preload, contractility, or afterload of the heart.

c.             The left ventricle; the mean pressure of blood coming into this ventricle is from the lung, which has a low pressure.

d.            The right ventricle; it pumps blood into the pulmonary capillaries, which have a lower pressure compared with the systemic circulation.

3.            Which chamber of the heart endures the highest pressures?

a.            Right atrium

b.            Left atrium

c.             Left ventricle

d.            Right ventricle

4.            What is the process that ensures mitral and tricuspid valve closure after the ventricles are filled with blood?

a.            Chordae tendineae relax, which allows the valves to close.

b.            Increased pressure in the ventricles pushes the valves to close.

c.             Trabeculae carneae contract, which pulls the valves closed.

d.            Reduced pressure in the atria creates a negative pressure that pulls the valves closed.

5.            A student asks the healthcare professional to explain the function of the papillary muscles. What response by the professional is best?

a.            The papillary muscles close the semilunar valves.

b.            These muscles prevent backward expulsion of the atrioventricular valves.

c.             They open the atrioventricular valves.

d.            The papillary muscles open the semilunar valves.

6.            During the cardiac cycle, why do the aortic and pulmonic valves close after the ventricles relax?

a.            Papillary muscles relax, which allows the valves to close.

b.            Chordae tendineae contract, which pulls the valves closed.

c.             Reduced pressure in the ventricles creates a negative pressure, which pulls the valves closed.

d.            Blood fills the cusps of the valves and causes the edges to merge, closing the valves.

 7.           Oxygenated blood flows through which vessel?

a.            Superior vena cava

b.            Pulmonary veins

c.             Pulmonary artery

d.            Coronary veins

8.            A healthcare professional tells a student that a patient has lost atrial kick. What would the student expect to see when examining this patient?

a.            Improvement in atrial dysrhythmias

b.            Increased blood pressure

c.             Signs of decreased cardiac output

d.            Elevations in serum troponin levels

9.            Occlusion of the left anterior descending artery during a myocardial infarction would interrupt blood supply to which structures?

a.            Left and right ventricles and much of the interventricular septum

b.            Left atrium and the lateral wall of the left ventricle

c.             Upper right ventricle, right marginal branch, and right ventricle to the apex

d.            Posterior interventricular sulcus and the smaller branches of both ventricles

10.          Where are the coronary ostia located?

a.            Left ventricle

b.            Aortic valve

c.             Coronary sinus

d.            Aorta

11.          The coronary sinus empties into which cardiac structure?

a.            Right atrium

b.            Left atrium

c.             Superior vena cava

d.            Aorta

12.          During the cardiac cycle, which structure directly delivers action potential to the ventricular myocardium?

a.            Sinoatrial (SA) node

b.            Atrioventricular (AV) node

c.             Purkinje fibers

d.            Bundle branches

13.          A patient has a problem with Phase 0 of the cardiac cycle. What electrolyte imbalance would the healthcare professional associate most directly with this problem?

a.            Hyperkalemia

 b.           Hyponatremia

c.             Hypercalcemia

d.            Hypomagnesemia

14.          A healthcare professional is caring for a patient who has a delay in electrical activity reaching the ventricle as seen on ECG. What ECG finding would the healthcare professional associate with this problem?

a.            A prolonged ST interval

b.            Variability in measurement with heart rate

c.             PR interval measuring 0.28 sec

d.            A QRS complex measuring 0.08 sec

15.          The cardiac electrical impulse normally begins spontaneously in the sinoatrial (SA) node because of what reason?

a.            It has a superior location in the right atrium.

b.            It is the only area of the heart capable of spontaneous depolarization.

c.             It has rich sympathetic innervation via the vagus nerve.

d.            It depolarizes more rapidly than other automatic cells of the heart.

16.          What period follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated?

a.            Refractory

 b.           Hyperpolarization

c.             Threshold

d.            Sinoatrial (SA)

17.          A patient has a disorder affecting ventricular depolarization. What ECG finding would the healthcare professional associate with this condition?

a.            Shortened PR interval

b.            Prolonged QRS interval

c.             QT interval variability

d.            Absence of P waves

18.          What can shorten the conduction time of action potential through the atrioventricular (AV) node?

a.            Parasympathetic nervous system

b.            Catecholamines

c.             Vagal stimulation

d.            Sinoatrial node (SA)

19.          A patient had a myocardial infarction that damaged the SA node, which is no longer functioning as the pacemaker of the heart. What heart rate would the healthcare provider expect the patient to have?

a.            60 to 70 beats/min

b.            40 to 60 beats/min

c.             30 to 40 beats/min

d.            10 to 20 beats/min

 20.         What is the effect of epinephrine on ?3 receptors on the heart?

a.            Decreases coronary blood flow

b.            Supplements the effects of both ?1 and ?2 receptors

c.             Increases the strength of myocardial contraction

d.            Prevents overstimulation of the heart by the sympathetic nervous system

21.          Where in the heart are the receptors for neurotransmitters located?

a.            Semilunar and atrioventricular (AV) valves

b.            Endocardium and sinoatrial (SA) node

c.             Myocardium and coronary vessels

d.            Epicardium and AV node

22.          What enables electrical impulses to travel in a continuous cell-to-cell fashion in myocardial cells?

a.            Sarcolemma sclerotic plaques

b.            Intercalated disks

c.             Trabeculae carneae

d.            Bachmann bundles

 23.         Within a physiologic range, what does an increase in left ventricular end-diastolic volume (preload) result in?

a.            Increase in force of contraction

b.            Decrease in refractory time

c.             Increase in afterload

d.            Decrease in repolarization

24.          The healthcare professional explains to a student that the amount of volume of blood in the heart is directly related to the _                of contraction.

a.            Pressure

b.            Strength

c.             Viscosity

d.            Speed

25.          Pressure in the left ventricle must exceed pressure in which structure before the left ventricle can eject blood?

a.            Superior vena cava

b.            Aorta

c.             Inferior vena cava

d.            Pulmonary veins

26.          A healthcare professional is caring for a patient who has continuous increases in left ventricular filing pressures. What disorder would the professional assess the patient for?

a.            Mitral regurgitation

b.            Mitral stenosis

c.             Pulmonary edema

d.            Jugular vein distention

27.          The resting heart rate in a healthy person is primarily under the control of which nervous system?

a.            Sympathetic

b.            Parasympathetic

c.             Somatic

d.            Spinal

28.          The Bainbridge reflex is thought to be initiated by sensory neurons in which cardiac location?

a.            Atria

b.            Aorta

c.             Sinoatrial (SA) node

d.            Ventricles

29.          A healthcare professional cares for older adults in a skilled nursing facility. What should the professional assess for in these individuals related to cardiovascular functioning?

a.            Increased rate of falling and dizzy spells

b.            Improved exercise tolerance

c.             A gradual slowing of the heart rate

d.            Progressive ECG changes

30.          Reflex control of total cardiac output and total peripheral resistance is controlled by what mechanism?

a.            Parasympathetic stimulation of the heart, arterioles, and veins

b.            Sympathetic stimulation of the heart, arterioles, and veins

c.             Autonomic control of the heart only

d.            Somatic control of the heart, arterioles, and veins

31.          What is the most important negative inotropic agent?

a.            Norepinephrine

b.            Epinephrine

c.             Acetylcholine

d.            Dopamine

32.          The right lymphatic duct drains into which structure?

a.            Right subclavian artery

b.            Right atrium

c.             Right subclavian vein

d.            Superior vena cava

33.          A patient had a motor vehicle crash and suffered critical injuries to the brainstem. What physiological responses would the healthcare professional expect to see?

a.            Prolonged QRS segment

b.            Shortened PR interval

c.             Pulse and blood pressure changes

d.            Fluid overload

34.          What is an expected change in the cardiovascular system that occurs with aging?

a.            Arterial stiffening

b.            Decreased left ventricular wall tension

c.             Decreased aortic wall thickness

d.            Arteriosclerosis

35.          What is the major determinant of the resistance that blood encounters as it flows through the systemic circulation?

a.            Volume of blood in the systemic circulation

b.            Muscle layer of the metarterioles

c.             Muscle layer of the arterioles

d.            Force of ventricular contraction

36.          What physical sign does the healthcare professional relate to the result of turbulent blood flow through a vessel?

a.            Increased blood pressure during periods of stress

b.            Bounding pulse felt on palpation

c.             Cyanosis observed on exertion

d.            Murmur heard on auscultation

37.          What is the major effect of a calcium channel blocker such as verapamil on cardiac contractions?

a.            Increases the rate of cardiac contractions

b.            Decreases the strength of cardiac contractions

c.             Stabilizes the rhythm of cardiac contractions

d.            Stabilizes the vasodilation during cardiac contractions

38.          An early diastole peak caused by filling of the atrium from peripheral veins is identified by which intracardiac pressure?

a.            A wave

b.            V wave

c.             C wave

d.            X descent

MULTIPLE RESPONSE

 

1. Which statements are true concerning the method in which substances pass between capillaries and the interstitial fluid? (Select all that apply.)

a.            Substances pass through junctions between endothelial cells.

b.            Substances pass through pores or oval windows (fenestrations).

c.             Substances pass between vesicles by active transport across the endothelial cell membrane.

d.            Substances pass across the endothelial cell membrane by osmosis.

e.            Substances pass through endothelial cell membranes by diffusion.