Which phrase best describes the normal mechanical role of the atria?
A. Strong afterload generators
B. Weak primer pumps
C.
Passive resistance chambers
D. Major ejection reservoirs
B. Weak primer pumps
A congenital lesion selectively impairs right ventricular outflow. Which circulation is most directly underfilled?
A. Coronary circulation
B. Systemic circulation
C.
Pulmonary circulation
D. Cerebral circulation
C. Pulmonary circulation
A patient in sinus rhythm has repeated, orderly heart contractions occurring without interruption. This ongoing sequence is best termed:
A. Cardiac rhythmicity
B. Mechanical lusitropy
C.
Ventricular compliance
D. Myocardial refractoriness
A. Cardiac rhythmicity
A physiology lab asks which grouping correctly lists the three major types of heart muscle. Which is correct?
A. Atrial, Purkinje, papillary
B. Ventricular, nodal,
septal
C. Atrial, ventricular, conductive
D. Smooth,
skeletal, conductive
C. Atrial, ventricular, conductive
Compared with skeletal muscle, cardiac muscle contraction is most similar except for which feature being longer?
A. Sarcomere width
B. Duration
C. Threshold
voltage
D. Resting resistance
B. Duration
On microscopy, a student identifies the usual contractile myofibrillar elements of cardiac muscle. These are:
A. Troponin and tropomyosin
B. Dynein and kinesin
C.
Actin and myosin filaments
D. Desmin and titin
C. Actin and myosin filaments
Intercalated discs are best described as:
A. Extracellular collagen partitions
B. Cell membranes between
myocytes
C. Sarcoplasmic reticulum expansions
D.
Intracellular glycogen bands
B. Cell membranes between myocytes
At the intercalated disc, adjacent cardiac cell membranes join to form structures that permit ionic current spread. These are:
A. Tight occluding junctions
B. Impermeable desmosomal
plates
C. Permeable communicating junctions
D. Sodium leak
channel clusters
C. Permeable communicating junctions
A toxic exposure disrupts gap junction function throughout the myocardium. Which immediate effect is most expected?
A. Slower action potential spread
B. Stronger skeletal-like
contraction
C. Lower myosin production
D. Faster valve opening
A. Slower action potential spread
In a normal heart, the myocardium is functionally arranged into two major syncytia. These are:
A. Endocardial and epicardial
B. Right and left
C. Basal
and apical
D. Atrial and ventricular
D. Atrial and ventricular
During dissection, a fibrous plane is identified encircling the atrioventricular valvular openings. This tissue normally separates the:
A. Great arteries from atria
B. Ventricles from
pericardium
C. Atria from ventricles
D. Conduction fibers
from valves
C. Atria from ventricles
In the normal heart, impulses do not freely pass directly from one syncytium to the other because the atria and ventricles are separated by:
A. Fatty connective septa
B. Fibrous tissue
C. Skeletal
muscle cuffs
D. Elastic lamellar sheets
B. Fibrous tissue
The normal separation of atrial and ventricular syncytia provides which mechanical advantage?
A. Simultaneous chamber ejection
B. Ventricles fill after
atria contract
C. Atria relax after systole
D. Semilunar
valves open earlier
B. Ventricles fill after atria contract
When a standard fast-response cardiac action potential is recorded for teaching purposes, it is classically taken from a:
A. Ventricular muscle fiber
B. SA nodal cell
C. Atrial
septal fibroblast
D. AV nodal cell
A. Ventricular muscle fiber
A ventricular myocyte action potential is measured from resting potential to peak positivity. Its average amplitude is closest to:
A. 55 mV
B. 75 mV
C. 90 mV
D. 105 mV
D. 105 mV
During a ventricular action potential, the intracellular potential typically rises from resting level to approximately which peak?
A. -65 mV to +10 mV
B. -85 mV to +20 mV
C. -90 mV to +35
mV
D. -70 mV to 0 mV
B. -85 mV to +20 mV
After rapid upstroke, the ventricular cardiac muscle membrane remains depolarized for approximately:
A. 0.02 seconds
B. 2 seconds
C. 0.2 seconds
D.
0.002 seconds
C. 0.2 seconds
A student asks why ventricular contraction persists much longer in cardiac than skeletal muscle. The best explanation is the cardiac action potential:
A. Has no repolarization phase
B. Lacks sodium channel
activation
C. Includes a plateau phase
D. Begins from a
positive baseline
C. Includes a plateau phase
The action potential of skeletal muscle is caused almost entirely by sudden opening of many:
A. L-type calcium channels
B. Fast sodium channels
C.
Potassium rectifier channels
D. Chloride conductance channels
B. Fast sodium channels
Fast sodium channels are termed “fast” primarily because they:
A. Carry calcium inward rapidly
B. Open only during
diastole
C. Inactivate after several seconds
D. Open
briefly and then close abruptly
D. Open briefly and then close abruptly
Cardiac muscle action potentials depend on opening which two channel types?
A. Fast sodium and L-type calcium
B. T-type calcium and
chloride
C. Potassium and funny channels
D.
Sodium-potassium cotransporters only
A. Fast sodium and L-type calcium
Which property best distinguishes the L-type calcium channel?
A. Opens faster and closes faster
B. Opens slower and remains
open longer
C. Inactivates at lower voltages
D. Conducts
only sodium inward
B. Opens slower and remains open longer
A drug selectively reduces current through calcium-sodium channels in ventricular muscle. Which immediate action-potential change is most expected?
A. Faster phase 0 upstroke
B. Shorter skeletal twitch
only
C. Loss of prolonged plateau
D. Earlier atrial depolarization
C. Loss of prolonged plateau
Compared with skeletal muscle, which membrane property of cardiac muscle most helps explain the prolonged action potential plateau?
A. Increased chloride permeability
B. Reduced sodium channel
density
C. Greater resting calcium leak
D. Fivefold
potassium permeability decrease
D. Fivefold potassium permeability decrease
During intracardiac mapping, conduction through ordinary atrial and ventricular muscle fibers is closest to:
A. 0.3 to 0.5 m/sec
B. 1 to 2 m/sec
C. 2 to 3
m/sec
D. 4 to 5 m/sec
A. 0.3 to 0.5 m/sec
Which conduction velocity best matches Purkinje fibers?
A. 0.05 m/sec
B. 0.5 m/sec
C. 4 m/sec
D. 8 m/sec
C. 4 m/sec
Which refractory timing pair is normal for cardiac muscle?
A. Absolute 0.05; relative 0.3
B. Absolute 0.25-0.3; relative
0.05
C. Absolute 0.1; relative 0.2
D. Absolute 0.4;
relative 0.1
B. Absolute 0.25-0.3; relative 0.05
Compared with ventricles, the refractory period of atrial muscle is:
A. Much shorter
B. Slightly longer
C. Nearly
identical
D. More calcium-dependent
A. Much shorter
A physiology professor defines excitation-contraction coupling. Which statement is correct?
A. Electrical isolation of atria
B. Refractory recovery after
systole
C. Purkinje conduction to papillary muscle
D. AP
triggering myofibril contraction
D. AP triggering myofibril contraction
In cardiac muscle, an action potential traveling down a T-tubule directly acts on the:
A. Fibrous annulus
B. Sarcoplasmic tubules
C.
Intercalated discs
D. Purkinje membrane
B. Sarcoplasmic tubules
The immediate result of T-tubule activation of the sarcoplasmic tubules is:
A. Sodium release into sarcoplasm
B. Potassium uptake into
SR
C. Calcium release into sarcoplasm
D. Troponin movement
into T-tubules
C. Calcium release into sarcoplasm
A key distinction from skeletal muscle is that cardiac myocyte calcium for contraction comes:
A. From T-tubules and mitochondria
B. Primarily from SR
stores
C. From T-tubules and SR
D. From extracellular
sodium exchange
C. From T-tubules and SR
Calcium entering the cardiac cell through membrane channels next activates which SR structure?
A. Ryanodine receptor channels
B. Calcium-ATPase pumps
C. Fast sodium channels
D. Potassium leak channels
A. Ryanodine receptor channels
Once present in the sarcoplasm, calcium most directly binds:
A. Titin
B. Desmin
C. Tropomyosin
D. Troponin
D. Troponin
Calcium binding to troponin initiates:
A. Sodium extrusion from cell and contraction
B. Cross-bridge
formation and contraction
C. Gap junction opening and
contraction
D. SR calcium reuptake and contraction
B. Cross-bridge formation, contraction
Histology shows mucopolysaccharide-rich regions important in calcium handling. These are found in:
A. Z lines
B. AV node
C. T-tubules
D. Intercalated discs
C. T-tubules
The major functional role of these mucopolysaccharides is to:
A. Buffer intracellular sodium
B. Store abundant calcium
ions
C. Accelerate potassium efflux
D. Stabilize actin filaments
B. Store abundant calcium ions
In cardiac muscle, the strength of contraction depends strongly on:
A. ECF calcium concentration
B. Intracellular chloride
levels
C. Resting membrane sodium
D. Myosin ATPase subtype
A. ECF calcium concentration
A perfused heart is placed into a calcium-free solution. It will eventually stop:
A. Relaxing
B. Conducting
C. Filling
D. Beating
D. Beating
The amount of calcium available in the T-tubule system depends mainly on:
A. Plasma glucose concentration
B. ECF calcium
concentration
C. SR potassium content
D. Intracellular ATP stores
B. ECF calcium concentration
Moderate changes in extracellular calcium concentration have little effect on the force of:
A. Skeletal muscle contraction
B. Purkinje fiber
conduction
C. Cardiac atrial contraction
D. AV nodal depolarization
A. Skeletal muscle contraction
Return of calcium from sarcoplasm back into SR is mediated chiefly by the:
A. Sodium-potassium ATPase
B. Ryanodine receptor
C.
Calcium-ATPase pump
D. Fast sodium channel
C. Calcium-ATPase pump
Calcium is removed from the cardiac cell across the membrane primarily by the:
A. L-type calcium channel
B. Sodium-calcium exchanger
C.
Ryanodine receptor
D. Funny current channel
B. Sodium-calcium exchanger
All mechanical and electrical events occurring from one heartbeat to the next make up the:
A. Cardiac rhythm
B. Ventricular filling phase
C.
Absolute refractory period
D. Cardiac cycle
D. Cardiac cycle
Each normal cardiac cycle is initiated by the:
A. AV node
B. Sinus node
C. Purkinje fibers
D.
Ventricular septum
B. Sinus node
The sinus node is located in the:
A. Inferior medial left atrium
B. Superior lateral right
atrium
C. Posterior interventricular septum
D. Coronary
sinus floor
B. Superior lateral right atrium
The normal conduction delay between atria and ventricles is approximately:
A. 1 second
B. 0.2 second
C. 0.1 second
D. 0.01 second
C. 0.1 second
This atrioventricular delay allows the:
A. Atria to contract before ventricles
B. Ventricles to
contract before atria
C. Semilunar valves to open early
D.
Purkinje fibers to repolarize first
A. Atria to contract before ventricles
Why is atrial contraction before ventricular contraction functionally important?
A. Coronary flow rises before systole
B. AV valves open during
ejection
C. Aortic pressure falls before filling
D. Blood
enters ventricles before systole
D. Blood enters ventricles before systole
The period of cardiac relaxation is called:
A. Diastole
B. Systole
C. Afterload
D. Ejection
A. Diastole
The period of cardiac contraction is called:
A. Diastole
B. Lusitropy
C. Systole
D. Refractoriness
C. Systole
A student is asked how to determine total cardiac cycle duration from heart rate alone. It is best described as the:
A. Reciprocal of heart rate
B. Product of stroke volume
C. Sum of systole only
D. Fraction of end-systole
A. Reciprocal of heart rate
In a patient with a heart rate of 75/min, total cardiac cycle duration is closest to:
A. 1.2 seconds
B. 0.8 second
C. 0.5 second
D. 0.2 second
B. 0.8 second
cardiac cycle duration = 60 seconds/HR
In normal electromechanical coupling, the QRS complex begins just before the onset of:
A. Ventricular systole
B. Atrial systole
C. Ventricular
repolarization
D. Semilunar closure
A. Ventricular systole
A normal upright T wave on ECG most directly represents:
A. Atrial contraction
B. Ventricular repolarization
C.
Ventricular depolarization
D. AV nodal delay
B. Ventricular repolarization
In a resting healthy heart, approximately what fraction of ventricular filling occurs before atrial contraction?
A. 20%
B. 40%
C. 60%
D. 80%
D. 80%
On the right atrial pressure tracing, the a wave is produced by:
A. Atrial contraction
B. Venous filling only
C. AV valve
opening
D. Ventricular ejection
A. Atrial contraction
The c wave of the atrial pressure curve occurs when the ventricles:
A. Finish relaxing
B. Begin to contract
C. Finish
ejecting
D. Begin repolarizing
B. Begin to contract
The v wave of the atrial pressure curve occurs toward the end of:
A. Atrial contraction
B. Isovolumic relaxation
C.
Ventricular contraction
D. Rapid ventricular filling
C. Ventricular contraction
During ventricular systole, substantial blood accumulates within the:
A. Ventricles
B. Great arteries
C. Coronary
sinuses
D. Right and left atria
D. Right and left atria
The period of rapid ventricular filling normally occupies about the:
A. First third of diastole
B. Last third of systole
C.
Middle half of systole
D. Final tenth of diastole
A. First third of diastole
Which statement best defines isovolumic contraction?
A. Ventricles fill without tension rise
B. Fibers shorten
without pressure rise
C. Tension rises with little
shortening
D. Ejection occurs with valve opening
C. Tension rises with little shortening
Ventricular ejection is classically divided into:
A. Filling and relaxation phases
B. Rapid and slow
ejection
C. Atrial and ventricular phases
D. Pressure and
volume waves
B. Rapid and slow ejection
During ventricular ejection, the rapid ejection phase accounts for approximately what proportion of the ejected blood?
A. 30%
B. 50%
C. 70%
D. 90%
C. 70%
A ventricle ejects 60 mL from an end-diastolic volume of 100 mL. The ejection fraction is:
A. 0.3
B. 0.4
C. 0.6
D. 0.8
C. 0.6
ef= sv/edv
The fraction of end-diastolic volume ejected by the ventricle is called the:
A. Cardiac index
B. Stroke work
C. Ejection
fraction
D. End-systolic reserve
C. Ejection fraction
During systole, backflow from ventricles into atria is prevented by the:
A. Semilunar valves
B. AV valves
C. Coronary ostia
D. Eustachian valves
B. AV valves
During diastole, backflow from the aorta and pulmonary arteries into the ventricles is prevented by the:
A. AV valves
B. Papillary muscles
C. Chordae
tendineae
D. Semilunar valves
D. Semilunar valves
Papillary muscles contract when the:
A. Atria depolarize
B. Ventricular walls contract
C.
Semilunar valves open
D. AV node fires
B. Ventricular walls contract
The primary role of papillary muscles is to:
A. Open AV valves wider
B. Pull AV leaflets inward
C.
Close semilunar cusps
D. Shorten ventricular systole
B. Pull AV leaflets inward
Dysfunction of papillary muscles or chordae tendineae can cause:
A. Valve leakage
B. Sinus bradycardia
C. Aortic
stenosis
D. Atrial standstill
A. Valve leakage
Compared with semilunar valves, AV valve closure is generally:
A. Snapping and louder
B. Softer
C. Delayed by T
wave
D. Linked to incisura
B. Softer
Compared with AV valves, semilunar valves close with a more:
A. Soft closure
B. Fused motion
C. Snapping
closure
D. Silent recoil
C. Snapping closure
Semilunar valves have smaller openings than AV valves, so blood ejection velocity through them is:
A. Lower
B. Variable
C. Unchanged
D. Greater
D. Greater
The valve type exposed to greater mechanical abrasion is the:
A. AV valves
B. Semilunar valves
C. Mitral valve
D. Tricuspid valve
B. Semilunar valves
Immediately after aortic valve closure, a brief notch appears on the aortic pressure curve. This is the:
A. c wave
B. Dicrotic plateau
C. Incisura
D. v descent
C. Incisura
The incisura occurs because of a brief:
A. Forward atrial jet
B. Backward blood flow
C.
Papillary contraction
D. Ventricular filling surge
B. Backward blood flow
A clinician hears acute papillary muscle rupture after myocardial infarction. Which complication best matches the normal function lost?
A. AV valve prolapse backward
B. Semilunar valve
calcification
C. Delayed SA node firing
D. Reduced atrial depolarization
A. AV valve prolapse backward
During early ventricular systole, the first heart sound is produced primarily by closure of the:
A. Semilunar valves
B. AV valves
C. Pulmonary
veins
D. Venae cavae
B. AV valves
On auscultation, closure of the AV valves typically generates a sound best described as:
A. Low-pitched, prolonged vibration
B. High-pitched, brief
snap
C. Silent, pressure-only event
D. Musical midsystolic click
A. Low-pitched, prolonged vibration
At the end of systole, semilunar valve closure is heard as a:
A. Low rumbling vibration
B. Long harsh murmur
C. Rapid
snap, briefly vibrating
D. Sustained opening click
C. Rapid snap, briefly vibrating
The amount of energy the heart converts to work during a single heartbeat is called:
A. Cardiac output
B. Stroke work output
C. Minute work
output
D. Tension-time index
B. Stroke work output
The total energy converted to work by the heart in 1 minute is the:
A. External work
B. Potential energy
C. Minute work
output
D. Kinetic pressure load
C. Minute work output
Minute work output is equal to:
A. Stroke volume × afterload
B. Stroke work × heart rate
C. Oxygen use × preload
D. Cardiac output × preload
B. Stroke work × heart rate
External work, or volume-pressure work, is performed when blood is moved from:
A. High arteries to low veins
B. Low veins to high
arteries
C. Atria to coronary sinuses
D. Pulmonary veins
to venae cavae
B. Low veins to high arteries
The kinetic energy of blood flow refers most directly to:
A. Passive ventricular filling
B. Valve leaflet recoil
C. Myocardial heat generation
D. Acceleration to ejection velocity
D. Acceleration to ejection velocity
Right ventricular external work output is normally about what fraction of left ventricular work?
A. One half
B. One sixth
C. One third
D. One tenth
B. One sixth
The main reason right ventricular external work is far lower than left ventricular work is the:
A. Lower right ventricular volume
B. Shorter right ventricular
systole
C. Sixfold systolic pressure difference
D. Smaller
tricuspid valve area
C. Sixfold systolic pressure difference
The degree of tension on a muscle when it begins to contract is called:
A. Afterload
B. Contractility
C. Preload
D. Compliance
C. Preload
The load against which a muscle exerts contractile force is the:
A. Afterload
B. Preload
C. Stroke work
D. Efficiency
A. Afterload
For cardiac muscle, preload is usually considered to be the ventricular:
A. End-systolic pressure
B. End-diastolic pressure
C.
Mean arterial pressure
D. Pulse pressure
B. End-diastolic pressure
Myocardial oxygen consumption is a good measure of the:
A. Stroke volume reserve
B. Valvular pressure gradient
C. Chemical energy liberated
D. Ventricular filling fraction
C. Chemical energy liberated
Additional work that could be done if the ventricle emptied all blood with each beat is called:
A. Kinetic reserve
B. Volume-pressure work
C. Potential
energy
D. Residual afterload
C. Potential energy
Cardiac oxygen consumption is most proportional to the:
A. Heart rate alone
B. Pressure-volume area
C. Tension
× time duration
D. Stroke volume × pulse pressure
C. Tension × time duration
The tension-time index measures:
A. Pressure plus heart rate
B. Tension × contraction
duration
C. Volume × ejection velocity
D. Preload minus afterload
B. Tension × contraction duration
During cardiac contraction, most expended chemical energy is converted into:
A. Electrical current
B. External work
C. Kinetic
energy
D. Heat
D. Heat
The ratio of work output to total chemical energy expenditure is the:
A. Cardiac reserve
B. Ejection fraction
C. Contractile
efficiency
D. Tension-time index
C. Contractile efficiency
The volume pumped by the heart is regulated by:
A. Valve area and venous tone
B. Intrinsic control and
ANS
C. Coronary flow alone
D. Papillary muscle tension
B. Intrinsic control and ANS
The intrinsic ability of the heart to adapt to increasing venous inflow is the:
A. Bainbridge mechanism
B. Hering-Breuer reflex
C.
Frank-Starling mechanism
D. Baroreceptor reflex
C. Frank-Starling mechanism
As ventricular filling increases, myocardial stretch increases, producing:
A. Less force, less output
B. More force, more output
C.
Less force, more output
D. More force, less output
B. More force, more output
Parasympathetic vagal fibers are distributed mainly in the:
A. Ventricles
B. Purkinje system
C. Interventricular
septum
D. Atria
D. Atria
Excess extracellular potassium classically makes the heart:
A. Spastic and tachycardic
B. Dilated, flaccid,
bradycardic
C. Hypercontractile and narrowed
D. Small,
rigid, tachycardic
B. Dilated, flaccid, bradycardic
Excess extracellular calcium most characteristically causes the heart to undergo:
A. Flaccid dilation
B. Spastic contraction
C. Electrical
standstill
D. Marked valve insufficiency
B. Spastic contraction
Which measure more directly tracks chemical energy use?
A. Tension-time index
B. Ejection fraction
C. Valve
closing pressure
D. End-systolic volume
A. Tension-time index
Which change most directly increases left ventricular work?
A. Lower preload
B. Lower vagal tone
C. Higher
afterload
D. Shorter systole
C. Higher afterload
A patient with isolated right ventricular failure would most directly impair blood flow through the:
A. systemic circulation
B. coronary circulation
C.
lungs
D. cerebral circulation
C. lungs
A patient with severe left ventricular systolic dysfunction will most directly reduce blood flow through the:
A. pulmonary circulation
B. systemic circulation
C.
coronary sinus
D. right atrium
B. systemic circulation
The phrase “cardiac rhythmicity” most directly refers to:
A. valve closure sequence
B. coronary artery filling
C.
AP transmission causing beats
D. papillary muscle shortening
C. AP transmission causing beats
Specialized cardiac tissue is best divided into:
A. atrial and ventricular
B. excitatory and conductive
C. nodal and papillary
D. automatic and contractile
B. excitatory and conductive
Specialized excitatory and conductive fibers contract feebly because they contain:
A. excess intercalated discs
B. few contractile fibrils
C. low resting potassium
D. reduced membrane calcium
B. few contractile fibrils
Dark transverse bands crossing cardiac muscle fibers are called:
A. Z lines
B. T tubules
C. sarcoplasmic discs
D.
intercalated discs
D. intercalated discs
At each intercalated disc, cell membranes form permeable:
A. occluding junctions
B. insulating septa
C.
communicating junctions
D. desmin bridges
C. communicating junctions
These communicating junctions are important because they allow rapid diffusion of:
A. proteins
B. ions
C. glycogen
D. ATP
B. ions
Cardiac muscle is called a syncytium because excitation in one cell rapidly:
A. stops at fibrous rings
B. spreads to neighboring
cells
C. enters coronary vessels
D. depolarizes connective tissue
B. spreads to neighboring cells
The two major syncytia of the heart are the:
A. right and left
B. atrial and ventricular
C. basal and
apical
D. septal and free-wall
B. atrial and ventricular
Potentials are normally not directly conducted from atrial to ventricular syncytium through the intervening:
A. fatty tissue
B. fibrous tissue
C. Purkinje
tissue
D. nodal tissue
B. fibrous tissue
The classic fast-response action potential averaging about 105 mV is recorded in:
A. SA nodal tissue
B. atrial pacemaker cells
C.
ventricular muscle
D. papillary fibroblasts
C. ventricular muscle
A student asks why cardiac muscle, but not skeletal muscle, has a plateau phase. The best answer is that cardiac muscle uses:
A. chloride and potassium channels
B. sodium and funny
channels
C. sodium channels only
D. sodium and L-type calcium
D. sodium and L-type calcium
Skeletal muscle action potentials depend primarily on:
A. slow calcium influx
B. fast sodium channels
C.
potassium channel closure
D. sodium-calcium exchange
B. fast sodium channels
Immediately after cardiac action potential onset, membrane permeability to potassium:
A. rises fivefold
B. disappears completely
C. decreases
about fivefold
D. remains unchanged
C. decreases about fivefold
During phase 0 of the cardiac muscle action potential, the main event is opening of:
A. slow potassium channels
B. L-type calcium channels
C.
fast sodium channels
D. chloride channels
C. fast sodium channels
During phase 1, the fast sodium channels:
A. remain open
B. close
C. reactivate fully
D.
become calcium selective
B. close
During phase 1, which ion also leaves the cell?
A. calcium
B. chloride
C. sodium
D. potassium
D. potassium
During phase 2, the plateau phase is produced when:
A. calcium opens, fast potassium closes
B. sodium opens,
chloride closes
C. slow potassium opens, calcium closes
D.
sodium closes, calcium closes
A. calcium opens, fast potassium closes
During phase 3 rapid repolarization, calcium channels close and which channels open?
A. fast sodium
B. funny sodium
C. slow potassium
D. chloride leak
C. slow potassium
The resting membrane potential in phase 4 is closest to:
A. -60 mV
B. -75 mV
C. -90 mV
D. +20 mV
C. -90 mV
The conduction velocity in Purkinje fibers may reach:
A. 0.3 m/sec
B. 1 m/sec
C. 2 m/sec
D. 4 m/sec
D. 4 m/sec
The main physiologic importance of rapid Purkinje conduction is:
A. slower atrial filling
B. rapid ventricular activation
C. delayed valve closure
D. reduced coronary flow
B. rapid ventricular activation
A histology stain highlights negatively charged material within cardiac T tubules that binds calcium. This material is:
A. phospholipids
B. mucopolysaccharides
C.
troponins
D. desmosomes
B. mucopolysaccharides
The major functional importance of mucopolysaccharides in cardiac T tubules is that they:
A. store abundant calcium ions
B. accelerate sodium
influx
C. inhibit potassium efflux
D. open ryanodine channels
A. store abundant calcium ions
More than 0.1 second normally elapses during conduction from atria to ventricles. This interval reflects the:
A. SA nodal recovery time
B. atrioventricular conduction
delay
C. ventricular refractory period
D. semilunar valve
opening time
B. atrioventricular conduction delay
The minor elevations of the atrial pressure curve are termed the:
A. x, y, z waves
B. p, q, r waves
C. a, c, v waves
D. s, t, u waves
C. a, c, v waves
During ventricular systole, blood accumulates in both atria primarily because the:
A. semilunar valves are open
B. AV valves are closed
C.
atria stop receiving venous return
D. ventricles become highly compliant
B. AV valves are closed
The tricuspid and mitral valves are classified as:
A. semilunar valves
B. AV valves
C. outflow valves
D. arterial valves
B. AV valves
The aortic and pulmonary valves are examples of:
A. semilunar valves
B. AV valves
C. venous valves
D. inflow valves
A. semilunar valves
Papillary muscles attach to the leaflets of the AV valves by the:
A. trabeculae carneae
B. annulus fibrosus
C. chordae
tendineae
D. moderator bands
C. chordae tendineae
Which valve type is supported by chordae tendineae?
A. aortic valves
B. semilunar valves
C. AV valves
D. pulmonary valves
C. AV valves
The second heart sound is produced when the:
A. AV valves close slowly
B. ventricles begin filling
C.
semilunar valves close rapidly
D. papillary muscles relax suddenly
C. semilunar valves close rapidly
Why is the second heart sound relatively short in duration?
A. atrial contraction is brief
B. valves close before
systole
C. ventricular filling is passive
D. surrounding
tissues vibrate briefly
D. surrounding tissues vibrate briefly
Movement of blood from low-pressure veins to high-pressure arteries is termed:
A. kinetic reserve work
B. external volume-pressure work
C. potential pressure loading
D. contractile efficiency work
B. external volume-pressure work
A hemodynamics lecturer uses “external work” and “volume-pressure work” interchangeably. This work refers to:
A. valve closure energy
B. blood acceleration alone
C.
venous-to-arterial blood movement
D. papillary muscle shortening
C. venous-to-arterial blood movement
In a healthy adult, the normal left ventricle can generate a maximum systolic pressure closest to:
A. 250-300 mm Hg
B. 100-120 mm Hg
C. 60-80 mm Hg
D. 150-180 mm Hg
A. 250-300 mm Hg
During invasive hemodynamic testing, the normal right ventricle can generate a maximum systolic pressure closest to:
A. 20-30 mm Hg
B. 100-120 mm Hg
C. 250-300 mm Hg
D. 60-80 mm Hg
D. 60-80 mm Hg
Which sequence correctly lists the major phases of the cardiac cycle?
A. filling, ejection, relaxation, contraction
B. filling,
isovolumic contraction, ejection, relaxation
C. filling, atrial
systole, ejection, dilation
D. contraction, filling, ejection, recovery
B. filling, isovolumic contraction, ejection, relaxation
For the ventricle, preload is usually considered to be the end-diastolic pressure when the chamber has become:
A. emptied
B. stretched maximally
C. afterloaded
D. filled
D. filled
For the left ventricle, afterload is best approximated by the pressure in the:
A. pulmonary artery
B. aorta
C. left atrium
D.
vena cava
B. aorta
Maximum efficiency of the normal heart is usually:
A. 5-10 percent
B. 20-25 percent
C. 35-40 percent
D. 50-60 percent
B. 20-25 percent
In severe heart failure, cardiac efficiency may fall to:
A. 15-20 percent
B. 20-25 percent
C. 30-35 percent
D. 5-10 percent
D. 5-10 percent
A patient receives a large saline bolus. If intrinsic cardiac regulation is intact, the immediate rise in ventricular filling should produce:
A. weaker contraction, less output
B. no change in force
C. stronger contraction, more output
D. slower rate, less output
C. stronger contraction, more output
A ventricle must generate enough force to overcome pressure in the vessel leaving it. For the left ventricle, that vessel is the:
A. pulmonary artery
B. left atrium
C. aorta
D.
superior vena cava
C. aorta