The Cardiovascular System- Heart
1. Which of the following membranes are found in the body cavities and have parietal layers that line the cavities and
... [Show More] visceral layers that cover the organs?
• Osseous membranes
• Serous membranes
• Cutaneous membranes
• Synovial membranes
• Mucous membranes
2. Which of the following is true of cardiac muscle tissue?
• nonstriated, Z-discs, involuntary
• striated, multinucleated, voluntary
• nonstriated, intercalated discs, multinucleated
• nonstriated, multinucleated, involuntary
• striated, uninucleated, intercalated discs
3. Determine which characteristics are true of each of the layers of the heart.
Epicardium Myocardium Endocardium
Produces pericardial fluid
Outermost layer
Composed of elastic fibers and adipose tissue Middle layer
Generates force to pump blood
Composed primarily of cardiac muscle Innermost layer
Regulates contractility
4. Which chamber of the heart has the thickest myocardium?
Left ventricle
Right ventricle
Right atrium
Septum
Left atrium
5. Match the valve to its corresponding characteristic.
Separates the right atrium from the right ventricle - Tricuspid
Separates the left atrium from the left ventricle - Bicuspid
Separates the heart from the vessel that delivers blood to the lungs to receive oxygen - Pulmonary
Separates the heart from the vessel that delivers blood to the entire body - Aortic
6. Which type of cell junction allows cardiac muscle tissue to transmit signals rapidly?
Neural synapses
Adherens junction
Tight junctions
Gap junctions
Hemidesmosomes
7. Match the heart valve with its location.
Between the right atrium and right ventricle. - Tricuspid Valve
Between the right ventricle and pulmonary trunk. - Pulmonary Semilunar Valve
Between the left atrium and left ventricle - Mitral Valve
Between the left ventricle and ascending aorta. - Aortic Semilunar Valve
8. Correctly label the following external anatomy of the anterior heart.
9. Which of the following is the region of the thoracic cavity where the heart is located?
Pleural cavity
Hypochondriac
Mediastinum
Hypogastric
10. Label the structures of the heart that are indicated.
11. Label the structures of the pericardium in the figure.
12. Which chamber of the heart has the thickest myocardium?
Left ventricle
13. Correctly label the following external anatomy of the anterior heart.
14. Select all that apply. Which of the following are functions of the pericardium?
Prevent the heart from bouncing in the thoracic cavity.
Prevent the heart from overfilling with blood.
Allow for the movement of blood through the myocardium.
Create a near-frictionless environment through the production of serous fluid.
Aid the heart in the strength of contractions.
15. What term is given to the event whereby another action potential cannot be propagated shortly after an action potential?
Reflective period
Spasmodic period
Tetanic period
Refractory period
Plateau period
16. What term is given to the event whereby the voltage of an action potential begins to return to its resting potential from the height of its peak?
Repolarization
17. Which of the following elements is required to sustain a muscular contraction?
Sodium
Calcium
Potassium
ATP
All of the above
18. Complete the sentence with the proper description of the action potential.
Cardiac contractile action potentials will have a rapid depolarization that is maintained via the presence of calcium.
Cardiac autorhythmic action potentials will have both a rapid depolarization and repolarization with not refractory period.
19. During the depolarization phase of cardiac muscle voltage-gated sodium channels open
20. Which of the following aspects of the conduction system would directly result in contraction of the myocardium in the ventricular walls?
SA node
AV bundle
Left and right bundle branches
Purkinje fibers
AV node
21. A distinct, extended plateau occurs in the action potential in cardiac muscle cells, producing a refractory period of ______ milliseconds.
20-50
1-2
100
10
250
22. What are the individual ion contributions to the resting membrane potential of the cardiac pacemaker cells? Select all that apply.
Greater concentration of sodium outside the cell
No sodium/potassium pump
Greater concentration of potassium inside the cell
Calcium gradient with more calcium outside the cell
Greater concentration of anionic proteins outside the cell.
23. Without a plateau, extending the refractory period, cardiac muscle cells might be stimulated so quickly that they would not relax, leading to a sustained contraction known as what?
Tetany
24. The ____________ phase of the action potential in cardiac muscle delays repolarization to the resting membrane potential in order to lengthen refractory period.
Hyperpolarization
Plateau
Depolarization
Repolarization
Hypopolarization
25. Which of the following phrases is true of arteries?
Arteries are thin vessels that allow for the exchange of nutrients.
Arteries always carry oxygenated blood.
Arteries always carry deoxygenated blood.
Anatomy always take blood towards the heart.
Arteries always take blood away from the heart.
26. Assuming a patient is perfectly healthy, all blood in the right atrium will move into which area?
Left atrium
Coronary sinus
Left ventricle
Right ventricle
Pericardium
27. Drag and drop each structure to indicate whether it is a part of the systemic or pulmonary circuit.
Pulmonary circuit Systemic circuit
Pulmonary veins Left ventricle
Pulmonary trunk Aorta
Lungs Venae cavae
Right ventricle Left atrium
28. Select all of the statements that are true.
Pulmonary veins pass blood into the right atrium whereas the pulmonary arteries carry blood away from the left ventricle.
Pulmonary veins pass blood into the left atrium whereas the pulmonary arteries carry blood away from the right ventricle.
Oxygenated blood enters the left atrium.
The right ventricle pumps deoxygenated blood to the lungs.
The left ventricle pumps deoxygenated blood to the lungs.
Oxygenated blood enters the right atrium.
29. Oxygenated blood flows from the ___________ to the _____________ before being pumped into the system circulation.
Left atrium; right ventricle
Left ventricle; left atrium
Right atrium; left atrium
Right atrium; right ventricle
Left atrium; left ventricle
30. Unidirectional flow in the heart is ensured because the heart contains valves that prevent backflow.
31. Match the vessels with their associated chambers.
Inferior and superior venae cavae - Right atrium
Pulmonary trunk - Right ventricle
Pulmonary veins - Left atrium
Aorta - Left ventricle
32. Order the statements below in the proper order of blood flow through the heart. Begin with "Blood enters the right atrium from the superior and inferior venae cavae" and end with "Blood returns to the heart via the venae cavae"
• Blood enters the right atrium from the superior and inferior venae cavae
• Blood in the right atrium flows through the right AV valve into the right ventricle.
• Contraction of the right ventricle forces the pulmonary valve open
• Blood flows through the pulmonary valve into the pulmonary trunk
• Blood is distributed by the left and right pulmonary arteries to the lungs
• Blood returns from the lungs via the pulmonary veins to the left atrium
• Blood in the left atrium flows through the left AV valve into the left ventricle
• Contraction of the left ventricle (simultaneous with the third step) forces the aortic valve open
• Blood flows thorugh the aortic valve into the ascending aorta
• Blood in the aorta is distributed to every organ in the body
• Blood returns to the heart via the venae cavae
33. The right side of the heart pumps blood through the vessels to the lungs and back to the left side of the heart through the pulmonary circulatory pathway?
Pulmonary
34. Which of the following ions is required to leave the cell in order to result in hyperpolarization? Potassium
35. Which of the following events of an action potential occurs with an influx of sodium ions? Depolarization
36. What tool can we use to determine the electrical events within the heart? Electrocardiogram
37. Place the events of the conduction system in the proper order beginning with the firing of the SA node.
SA node fires
AV node fires
Signal travels to AV bundle (Bundle of His)
Signal travels through bundle branches
Purkinje fibers fire
Contraction of ventricles occurs
38. The ___________ is the natural pacemaker of the heart. Select all that apply.
Sinoatrial node
AV node
Atrioventricular node, Purkinje fibers
39. Place a single word into each sentence to make it correct. Not all terms will be used.
• Electric currents in the heart can be detected by means of electrodes applied to the skin.
• An instrument called the electrocardiograph amplifies these signals and produces a record on a moving paper chart.
• The chart includes three principle deflections above and below the baseline: the P wave, QRS complex, and the T wave.
• The P wave is produced when a signal from the SA node spreads through the atria and depolarizes them.
• The QRS complex is produced when the signal from the AV node spreads through the ventricular myocardium and depolarizes the muscle.
• The T wave is generated by ventricular repolarization immediately before diastole
40. Match the events in the cardiac cycle with the corresponding component of an EKG.
Ventricles depolarize - QRS Complex
Atria depolarize - P wave
Ventricles repolarize - T wave
41. Which of the following aspects of the conduction system would directly result in the contraction of the myocardium in the ventricular walls? Purkinje fibers, AV node, AV bundle, Left and right bundle branches, SA node
42. The rate of ventricular conduction is best determined by ______________ on an EKG
The number of PQRS intervals present within a specific unit of time
The number of T-waves within a specific unit of time
The number of P-waves present within a specific unit of time
The number of PT intervals present within a specific unit of time
The number of QRS-complexes present within a specific unit of time
43. Identify each component of the electrical conduction system of the heart.
44. Place the locations of the heart’s conduction system in order, beginning with the location where the heartbeat is initiated.
• Sinoatrial node
• Atrioventricular node
• Atrioventricular bundle
• Left and right bundle branches
• Purkinje fibers
45. Diastole occurs when the heart is at its most relaxed.
46. Which of the following valves is an example of a semilunar valve?
Pyloric
Mitral
Pulmonary
Tricuspid
Bicuspid
47. Which chamber of the heart has the thickest wall?
Left ventricle
48. Identify whether the AV and/or SL valves are open or closed in each event.
• Ventricular filling AV valves open, and SL valves closed
• Isovolumic ventricular contraction AV valves closed, and SL valves closed
• Ventricular ejection AV valves closed, and SL valves open
• Isovolumic ventricular relaxation AV valves closed, and SL valves closed
Electrical and Mechanical Events
49. Place the events of the electrical and mechanical events in the correct order, beginning with start of the cardiac cycle.
• SA node fires
• Atrial systole
• Atrial diastole
• Signal reaches Purkinje fibers
• Ventricular systole
• Ventricular Repolarization
• Ventricular diastole
50.
Length of a Cardiac Cycle
51. Determine the length of a single cardiac cycle given a patient with a heart rate of 85 beats per minute.
706
52. During which event of the cardiac cycle does aortic pressure reach its maximum?
Ventricular ejection
53. Regurgitation of blood through a prolapsed mitral valve (detected as a heart murmur) may cause _________ pressure in the __________ atrium.
Increased; left
54. When blood is flowing out of the left ventricle, the bicuspid valve is ________ and the aortic semilunar valve is _________.
Closed; open
55. Select all that occur during ventricular systole.
The AV valves open to allow blood to enter the ventricles from the atria.
All valves in the heart close in order to complete relaxation.
The semilunar valves remain closed throughout systole to prevent backflow of blood into the ventricles.
The AV valves close to prevent backflow of blood into the atria.
The semilunar valves open to allow blood to flow into the large arteries.
56. Put the steps of the cardiac cycle into the correct order, beginning with the atria in diastole.
• Atria begin systole and ventricles are filling
• Atria are relaxing (diastole) and ventricles are in isovolumetric contraction
• Ventricles are in systole and ejecting blood
• Ventricles are in isovolumetric relaxation
• Atria are in diastole, atria are filling and ventricles are filling
57. Drag and drop the label to the correct location on the graph showing pressures on the left side of the heart and aorta.
58. The ___________ is a low-pitched sound caused by vibration of the atrioventricular valves and surrounding fluid as the valves close at the beginning of ventricular systole.
Second heart sound
Fifth heart sound
Third heart sound
Fourth heart sound
First heart sound
59. The AV valves close in response to the _______________.
Contraction of the ventricles and the resulting drop in ventricular pressure.
Contraction of the atria and the resulting rise in atrial pressure.
Contraction of the atria and resulting drop in atrial pressure.
Contraction of the ventricles and the resulting rise in ventricular pressure.
60. Which of the following would NOT increase heart rate?
Running 2 miles
Becoming anxious before an exam
Stimulation by the vagal nerve
Receiving an injection of epinephrine
Increasing blood calcium
61. Which of the following regions of the brain contains the cardioregulatory centers?
Limbic system
Insula lobe
Cerebellum
Medulla oblongata
Frontal lobe
Cardiac output is directly proportional to the heart rate and stroke volume of a patient. For example, take a patient with a heart rate of 60 bpm and a stroke volume of 80 mL/beat.
62. Detemine the cardiac output of a patient with a heart rate of 80 beats/min with a stroke volume of 75 mL/beat.
CO = (HR)(SV)
Answer = 6 L/min
63. Determine the cardiac output of a patient with a heart rate of 80 beats/min with an end diastolic volume of 80 mL and an end systolic volume of 120 mL.
3.2 L/min
Factors for Stroke Volume
64. Match the factor that affects stroke volume to its description.
Preload - The stretch of the atria during ventricular filling.
Afterload - The pressure required to overcome the vascular resistance.
Venous return - The amount of blood returned to the heart via the veins.
Contractility - The intrinsic strength of the contractions of the cardiac muscle.
65. Categorize the compounds below as either positive or negative ionotropic agents. Drag and drop the compounds to the correct column.
Positive Negative
Ionotropic Agent Glucagon
Angiotensin II
Catecholamine
Insulin Antiarrhythmic
Beta blockers
66. Categorize the compounds below as either positive or negative chronotropic agents. Drag and drop the compounds to the correct column.
Positive Negative
Chronotropic Agent Epinephrine
Dopamine Acetylcholine
Beta blockers
67. As blood pressure increases, the volume of blood returned to the left ventricle will increase, stretching it more than typical, leading to an increase in stroke volume. This is an example of ______________.
Cardiac reserve
Contractility
Preload
Afterload
Cardiac output
68. Schwannomas are due to tumor formation within the Schwann cells of the peripheral nervous system. When they occur in the neck, removal is difficult due to the possibility of severing a cranial nerve responsible for parasympathetic activity in the heart. What is this cranial nerve?
Glossopharyngeal
Trigeminal
Vagal
Accessory
Cardiac accelerator nerve
69. The difference between the maximum and resting cardiac output is called ____________.
Cardiac reserve
Preload
Stroke volume
Afterload
Contractility
70. A patient with a heart rate of 85 beats per minute has an end systolic volume of 70 mL and an end diastolic volume of 150 mL. Determine the cardiac output in L/min. Your answer should be rounded to the nearest 10th, and ensure you use the proper units.
L/min
6.8 L/min
71. Classify the following statements as belonging to either sympathetic or parasympathetic stimulation of the heart.
Sympathetic Stimulation Parasympathetic Stimulation
Statement Fibers pass through the cardiac plexus
Increases the contraction strength of the heart
Dilates the coronary arteries Little or no innervation to the myocardium
Slows the heart rate
72. What variable(s) determine the effects of cardiac output? Choose the best answer.
Only a conduction system change
Changes to both HR and SV
Only change in heart rate
Changes to HR, SV, and rearrangement of the conduction system
Only change in stroke volume
73. Identify whether each item would increase or decrease stroke volume.
Increase stroke volume Decrease stroke volume
Factors Increased venous return
Positive inotropic agent
Systemic vasodilation Decreased venous return
Negative inotropic agent
Decreased preload [Show Less]