Which expression defines vascular distensibility?

A. ΔV / (ΔP × original volume)
B. ΔP / (ΔV × original volume)
C. ΔV / (ΔP + original volume)
D. (ΔV × ΔP) / original volume

A. ΔV / (ΔP × original volume)

Distensibility = increase in volume / (increase in pressure × original volume)

Pulse pressure is best defined as:

A. Mean arterial minus venous
B. Diastolic plus systolic
C. Stroke volume minus compliance
D. Systolic minus diastolic

D. Systolic minus diastolic

Pulse pressure is most closely approximated by:

A. Compliance divided by stroke volume
B. Stroke volume times resistance
C. Stroke volume divided by compliance
D. Systolic divided by diastolic

C. Stroke volume divided by compliance

During rapid saline loading, venous volume rises much more than arterial volume for the same pressure rise mainly because:

A. Veins have higher resting tone
B. Arterioles lack elastic tissue
C. Venous valves trap the bolus
D. Arterial walls are stronger

D. Arterial walls are stronger

After a rapid transfusion, venous pressure spikes but then falls toward baseline despite continued extra blood volume. This venous behavior is called:

A. Delayed compliance
B. Pressure-wave reflection
C. Myogenic constriction
D. Critical closing pressure

A. Delayed compliance

Delayed compliance lets venous pressure normalize quickly after an initial rise.

An elderly patient has stiff large arteries and a widened pulse pressure. Which compliance change best explains this?

A. Increased
B. Decreased
C. Delayed
D. Unchanged

B. Decreased

Compared with a young elastic aorta, a stiffened aorta transmits the arterial pressure pulse:

A. More erratically
B. More rapidly
C. More slowly
D. With no change

B. More rapidly

A patient with severe calcific aortic stenosis and diminished forward flow will most likely have which pulse-pressure change?

A. Decreased
B. Increased
C. Unchanged
D. Reversed

A. Decreased

Less blood gets ejected into the aorta from LV, so the systolic pressure does not rise as much.

A premature infant has a continuous machinery murmur from a patent ductus arteriosus. Pulse pressure is most likely:

A. Decreased
B. Increased
C. Fixed
D. Absent

B. Increased

so you have blood going from aorta to pulm artery. leading to lower diastolic (in diastolic, the aorta holds pressure while heart relaxes). also the LV might have more blood to pump now, increasing systolic.

A patient with severe aortic regurgitation has bounding pulses and marked runoff during diastole. Pulse pressure is expected to be:

A. Markedly increased
B. Mildly decreased
C. Unchanged
D. Narrowed

A. Markedly increased

Aortic regurgitation can cause an extremely wide pulse pressure because diastolic pressure falls dramatically.

Central venous pressure is referenced to pressure in the:

A. Left ventricle
B. Pulmonary artery
C. Right atrium
D. Superior vena cava

C. Right atrium

Mean right atrial pressure is closest to:

A. -5 mmHg
B. 5 mmHg
C. 0 mmHg
D. 10 mmHg

C. 0 mmHg

During forceful calf-muscle contraction, venous hydrostatic pressure within compressed leg veins must:

A. Increase
B. Decrease
C. Reach zero
D. Reverse direction

A. Increase

Which organ is chiefly responsible for cleansing blood?

A. Liver
B. Spleen
C. Kidney
D. Bone marrow

B. Spleen

During rapid volume loading, which vessels are the major blood reservoir and can store about 0.5–1.0 L of extra blood?

A. Arteries
B. Capillaries
C. Veins
D. Arterioles

C. Veins

For the same increase in pressure, veins are approximately how much more distensible than arteries?

A. Twofold
B. Eightfold
C. Twelvefold
D. Twenty-fourfold

B. Eightfold

For a given rise in pressure, veins increase blood volume by about how much more than arteries?

A. Threefold
B. Sixfold
C. Eightfold
D. Twenty-fourfold

C. Eightfold

Pulmonary arteries are about how much more distensible than systemic arteries?

A. Threefold
B. Fourfold
C. Sixfold
D. Eightfold

C. Sixfold

Which best defines vascular compliance (capacitance)?

A. Resistance per pressure change
B. Flow per radius increase
C. Pressure stored per volume
D. Volume stored per pressure rise

D. Volume stored per pressure rise

Which equation correctly defines vascular compliance?

A. ΔP / ΔV
B. ΔV × ΔP
C. ΔP / original volume
D. ΔV / ΔP

D. ΔV / ΔP

Compared with an artery, venous compliance is approximately:

A. 6-fold greater
B. 8-fold greater
C. 12-fold greater
D. 24-fold greater

D. 24-fold greater

Which relationship is correct?

A. Compliance = resistance × volume
B. Compliance = distensibility × volume
C. Compliance = pressure × flow
D. Compliance = stroke volume × radius

B. Compliance = distensibility × volume

On a classic volume-pressure graph, which vessel has the curve showing far greater volume at a given pressure?

A. Artery
B. Venule
C. Capillary
D. Vein

D. Vein

A patient receives an α-adrenergic agonist that increases sympathetic tone to vessels. On the volume-pressure curve, the vessel curve shifts:

A. Rightward
B. Downward
C. Leftward
D. Upward

C — Sympathetic stimulation shifts the curve left because less volume is stored at a given pressure.

After sympathetic inhibition, the vascular volume-pressure curve shifts:

A. Leftward
B. Rightward
C. Downward
D. Upward

B — Sympathetic inhibition shifts the curve right because more volume is stored at a given pressure

Immediately after sudden vessel filling, the prompt distention is due mainly to:

A. Stress-relaxation
B. Delayed compliance
C. Smooth-muscle remodeling
D. Elastic distention

D. Elastic distention

What mechanism causes the slower phase called delayed compliance?

A. Endothelial nitric oxide release
B. Smooth-muscle stress-relaxation
C. Instant elastic recoil
D. Arteriolar vasoconstriction

B. Smooth-muscle stress-relaxation

Which best describes delayed compliance?

A. Immediate fall in resistance
B. Slow pressure change after loading
C. Fixed pressure despite volume loss
D. Reflex tachycardia after hemorrhage

B. Slow pressure change after loading

The delayed relaxation of vascular smooth muscle after stretch is called:

A. Elastic recoil
B. Stress-relaxation
C. Hysteresis
D. Pulse-wave damping

B. Stress-relaxation

If stroke volume stays constant but arterial compliance increases, pulse pressure will most likely:

A. Increase
B. Remain fixed
C. Become negative
D. Decrease

D. Decrease

During exercise, stroke volume rises while arterial compliance is unchanged. Pulse pressure will most likely:

A. Decrease
B. Remain fixed
C. Rise
D. Equal mean pressure

C. Rise

Which two variables most directly determine pulse pressure?

A. Heart rate and resistance
B. Venous tone and volume
C. Stroke volume and compliance
D. Preload and afterload

C. Stroke volume and compliance

Why does atherosclerosis typically widen pulse pressure?

A. It lowers arterial compliance
B. It raises venous capacitance
C. It slows ventricular ejection
D. It increases capillary filtration

A. It lowers arterial compliance

Which best describes transmission of the arterial pressure pulse?

A. Blood cells moving fastest
B. Retrograde venous pressure spread
C. Turbulent systolic jet formation
D. Distention wave spreading forward

D. Distention wave spreading forward

In the proximal aorta, pulse transmission usually travels at approximately:

A. 15–35 m/sec
B. 3–5 m/sec
C. 20–25 m/sec
D. 7–10 m/sec

B. 3–5 m/sec

In large arterial branches, pulse transmission speed is usually:

A. 3–5 m/sec
B. 7–10 m/sec
C. 15–35 m/sec
D. 1–2 m/sec

B. 7–10 m/sec

In small arteries, pulse transmission speed is usually:

A. 5–7 m/sec
B. 7–10 m/sec
C. 15–35 m/sec
D. 3–5 m/sec

C. 15–35 m/sec

Compared with the aorta, pressure-pulse transmission in small arteries is:

A. Slower because flow is slower
B. Equal in all vessels
C. Absent beyond arterioles
D. Faster because walls are stiffer

D. Faster because walls are stiffer

Smaller arteries are less compliant, so pulse waves travel faster.

Normal aortic pulsations largely disappear by the capillaries because of:

A. Reflection
B. Dampening
C. Backflow
D. Shunting

B. Dampening

Which equation best describes arterial dampening?

A. Resistance / compliance
B. Resistance + compliance
C. Resistance × compliance
D. Compliance / resistance

C. Resistance × compliance

A patient has unusually low arterial resistance and low arterial compliance. What happens to dampening?

A. It becomes very low
B. It becomes very high
C. It is unchanged
D. It becomes immeasurable

A. It becomes very low

Korotkoff sounds are heard when cuff pressure is:

A. Always below diastolic
B. Equal to venous pressure
C. Lower than systolic only
D. Sufficient to intermittently occlude artery

D. Sufficient to intermittently occlude artery

Korotkoff sounds occur when the artery is compressed enough to close during parts of the pressure cycle.

The first Korotkoff sound appears because:

A. Laminar flow resumes completely
B. Blood jets through compressed artery
C. Veins begin collapsing first
D. Diastolic pressure exceeds cuff pressure

B. Blood jets through compressed artery

Korotkoff sounds that persist even when the cuff is fully deflated most strongly suggest:

A. Arterial malformation or dysfunction
B. Severe venous insufficiency
C. Complete arterial occlusion
D. Marked bradycardia alone

A. Arterial malformation or dysfunction

Persistent Korotkoff sounds after full cuff deflation can be seen with:

A. Mitral stenosis or venous insufficiency
B. Pulmonary fibrosis or venous insufficiency
C. Atrioventricular fistula or aortic insufficiency
D. Tricuspid regurgitation or aortic insufficiency

C. Atrioventricular fistula or aortic insufficiency

Compared with direct catheter measurement, the auscultatory method is:

A. Exact in all patients
B. Unreliable clinically
C. Wrong by fifty percent
D. Usually within ten percent

D. Usually within ten percent

Mean arterial pressure is weighted more toward diastolic pressure because:

A. Diastole occupies more cardiac time
B. Systole generates less flow
C. Venous return exceeds ejection
D. Diastole has higher pressure

A. Diastole occupies more cardiac time

On a normal arterial pressure tracing, mean arterial pressure most closely follows:

A. Systolic pressure
B. Pulse pressure
C. Diastolic pressure
D. Central venous pressure

C. Diastolic pressure

At very high heart rates, mean arterial pressure shifts to lie:

A. Near diastolic only
B. Near venous pressure
C. Near systolic only
D. More equally between both

D. More equally between both

At high heart rates, MAP moves toward the midpoint between systolic and diastolic pressures.

Central venous pressure is also called right atrial pressure because:

A. It equals pulmonary wedge pressure
B. Systemic veins empty into right atrium
C. It reflects left atrial filling
D. It measures coronary sinus flow

B. Systemic veins empty into right atrium

Right atrial pressure is primarily determined by which two processes?

A. Systemic resistance and heart rate
B. Right-heart pumping and venous return
C. Left ventricular output and preload
D. Arterial compliance and afterload

B. Right-heart pumping and venous return

Normal right atrial pressure is closest to:

A. +5 mmHg
B. -5 mmHg
C. 0 mmHg
D. +10 mmHg

C. 0 mmHg

A patient in cardiogenic shock develops marked systemic venous congestion. Right atrial pressure may become what numbers?

A. -3 to -5 mmHg
B. 0 to +5 mmHg
C. +8 to +12 mmHg
D. +20 to +30 mmHg

D. +20 to +30 mmHg

Which situation would most likely lower right atrial pressure below zero?

A. Massive transfusion
B. Right-sided heart failure
C. Hemorrhage
D. Pulmonary edema

C. Hemorrhage

Hemorrhage lowers venous return and can reduce right atrial pressure below zero.

Exceptionally vigorous cardiac pumping with otherwise normal circulation would most likely produce a right atrial pressure of:

A. +20 to +30 mmHg
B. 0 mmHg
C. -3 to -5 mmHg
D. +4 to +6 mmHg

C. -3 to -5 mmHg

Strong heart pump = right atrium gets emptied more = RAP falls below 0.

Small peripheral veins are usually about 4–6 mmHg higher than right atrial pressure mainly because:

A. Arterioles transmit systolic pressure
B. Large veins are externally compressed
C. Capillaries actively constrict downstream
D. Lymphatic flow raises venous tone

B. Large veins are externally compressed

Early right-sided heart failure may be clinically subtle in peripheral veins because:

A. Arterioles buffer the pressure rise
B. Capillary filtration immediately falls
C. Veins dilate before pressure rises
D. Venous valves prevent backflow

C. Veins dilate before pressure rises

Peripheral veins can dilate as atrial pressure rises, so peripheral venous pressure may not initially change much.

A patient has an intra-abdominal pressure of 23 mmHg. To continue venous return, femoral venous pressure must be at least:

A. 10 mmHg
B. 23 mmHg
C. 0 mmHg
D. 35 mmHg

B. 23 mmHg

Femoral venous pressure must at least equal the surrounding abdominal pressure to keep flow going.

Gravitational pressure in the venous system is also called:

A. Oncotic pressure
B. Transmural pressure
C. Hydrostatic pressure
D. Pulse pressure

C. Hydrostatic pressure

In a motionless standing adult, venous pressure in the feet is approximately:

A. +20 mmHg
B. +35 mmHg
C. +60 mmHg
D. +90 mmHg

D. +90 mmHg

In a motionless standing adult, venous pressure in the hands is approximately:

A. +10 mmHg
B. +35 mmHg
C. +90 mmHg
D. 0 mmHg

B. +35 mmHg

While standing upright, jugular venous pressure is usually approximately:

A. +10 mmHg
B. 0 mmHg
C. -10 mmHg
D. +35 mmHg

B. 0 mmHg

In the upright position, dural sinus pressure is normally about:

A. +10 mmHg
B. 0 mmHg
C. +35 mmHg
D. -10 mmHg

D. -10 mmHg

During cranial surgery in a seated patient, negative dural sinus pressure is dangerous because it can cause:

A. Cerebral vasospasm
B. Air embolism
C. Venous thrombosis
D. CSF overproduction

B. Air embolism

In a walking person, venous pressure in the feet is usually closest to:

A. +90 mmHg
B. +60 mmHg
C. +20 mmHg
D. 0 mmHg

C. +20 mmHg

After a person stops walking and stands still, foot venous pressure usually returns toward resting standing levels in about:

A. 5 seconds
B. 30 seconds
C. 2 minutes
D. 10 minutes

B. 30 seconds

After 15–30 minutes of quiet standing, leg swelling develops mainly because:

A. Arterial flow abruptly ceases
B. Plasma filters into tissues
C. Lymphatics rupture from pressure
D. Venous valves fully close

B. Plasma filters into tissues

Prolonged standing increases capillary filtration into interstitial tissue, causing swelling.

Venous valve incompetence most directly causes:

A. Varicose veins
B. Deep arterial aneurysm
C. Lymphedema only
D. Raynaud phenomenon

A. Varicose veins

A patient with long-standing varicose veins is at risk for which complication set?

A. Cyanosis, bradycardia, syncope
B. Edema, weak muscles, ulcers
C. Jaundice, ascites, melena
D. Hemoptysis, wheeze, clubbing

B. Edema, weak muscles, ulcers

The lower neck veins begin to protrude when right atrial pressure reaches about:

A. 0 mmHg
B. +4 mmHg
C. +10 mmHg
D. +20 mmHg

C. +10 mmHg

The most direct way to determine right atrial pressure is with a:

A. Swan-Ganz balloon wedge
B. Central venous catheter
C. Radial arterial line
D. Sphygmomanometer cuff

B. Central venous catheter

The body reference level at which vascular pressure changes little with position is located near the:

A. Aortic arch
B. Mitral annulus
C. Tricuspid valve
D. Femoral vein

C. Tricuspid valve

In a supine person, the zero-pressure reference level lies at the tricuspid valve, approximately:

A. 20% chest thickness anterior
B. 40% chest thickness anterior
C. 60% chest thickness anterior
D. 80% chest thickness anterior

C. 60% chest thickness anterior

In a supine person, the zero reference level is about 60% of chest thickness anterior to the back.

Which is considered a specific blood reservoir?

A. Kidney cortex
B. Spleen
C. Brain parenchyma
D. Skeletal muscle artery

B. Spleen

Which structure can release several hundred milliliters of blood and is a specific reservoir?

A. Liver
B. Pulmonary artery
C. Coronary sinus
D. Cerebral veins

A. Liver

Which specific reservoir contributes about 300 mL of blood?

A. Great saphenous veins
B. Dural venous sinuses
C. Large abdominal veins
D. Renal venous plexus

C. Large abdominal veins

Which specific blood reservoir can contribute several hundred milliliters through cutaneous venoconstriction?

A. Skin venous plexus
B. Pulmonary capillaries
C. Carotid sinus
D. Bone marrow sinusoids

A. Skin venous plexus

Which pair can contribute blood but are not classically listed as specific blood reservoirs?

A. Brain and kidneys
B. Heart and lungs
C. Liver and spleen
D. Skin and muscle

B. Heart and lungs

The spleen can decrease in size and rapidly release approximately how much blood?

A. 25 mL
B. 100 mL
C. 300 mL
D. 700 mL

B. 100 mL

Which splenic compartment can release concentrated red blood cells and raise hematocrit by 1–2%?

A. White pulp
B. Capsule
C. Red pulp
D. Trabeculae

C. Red pulp