A&p 2 The Heart

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  • 1. 
    Damage to the__________ is referred to as heart block
    • A. 

      SA node

    • B. 

      AV valves

    • C. 

      AV bundles

    • D. 

      AV node


  • 2. 
    Normal heart sounds are caused by which of the following events?
    • A. 

      Excitation of the SA node

    • B. 

      Closure of the heart valves

    • C. 

      Friction of blood against the chamber walls

    • D. 

      Opening and closing of the heart valves


  • 3. 
    The p wave of a normal electrocardiogram indicates_____________
    • A. 

      Ventricular repolarization

    • B. 

      Ventricular depolarization

    • C. 

      Atrial repolarization

    • D. 

      Atrial depolarization


  • 4. 
    Which of the following is not an age-related change affecting the heart?
    • A. 

      Atherosclerosis

    • B. 

      Decline in cardiac reserve

    • C. 

      Fibrosis of cardiac muscle

    • D. 

      Thinning of the valve flaps


  • 5. 
    Which of the following is not part of the conduction system of the heart?
    • A. 

      AV node

    • B. 

      Bundle of His

    • C. 

      AV valve

    • D. 

      SA node


  • 6. 
    Blood within the pulmonary veins returns to the
    • A. 

      Right atrium

    • B. 

      Left atrium

    • C. 

      Right ventricle

    • D. 

      Left ventricle


  • 7. 
    The left ventricular wall of the heart is thicker than the right wall in order to
    • A. 

      Acoommodate a greater volume of blood

    • B. 

      Expand the thracic cage during diastole

    • C. 

      Pump blood with greater pressure

    • D. 

      Pump blood through a smaller valve


  • 8. 
    Small muscle masses attached to the chordae tendineae are the
    • A. 

      Trabeculae carneae

    • B. 

      Pectinate muscles

    • C. 

      Papillary muscles

    • D. 

      Venae cavae


  • 9. 
    Which of the events below does not occur when the semilunar valves are open?
    • A. 

      Ventricles are in diastole

    • B. 

      Blood enters pulmonary artieries and the aorta

    • C. 

      Av valves are closed

    • D. 

      Ventricles are in systole


  • 10. 
    The term for pain associated with deficient blood delivery to the heart that may be caused by the transient spasm of coronary arteries is
    • A. 

      Ischemia

    • B. 

      Pericarditis

    • C. 

      Myocardial infarct

    • D. 

      Angina pectoris


  • 11. 
    To auscultate the aortic semilunar valve, you would place your stethoscope in the
    • A. 

      Second intercostal space to the right of the sternum

    • B. 

      Second intercostal space to the left of the sternum

    • C. 

      Fifth intercostal space inferior to the left nipple

    • D. 

      Fifth right intercostal space


  • 12. 
    The source of blood carried to capillaries in the myocardium would be the
    • A. 

      Coronary sinus

    • B. 

      Fossa ovalis

    • C. 

      Coronary arteries

    • D. 

      Coronary veins


  • 13. 
    The fact that the left ventricle of the heart is thicker than the right ventricle reveals that it
    • A. 

      Pumps a greater volume of blood

    • B. 

      Pumps blood against a greater resistance

    • C. 

      Expands the thoracic cage

    • D. 

      Sends blood through a smaller valve


  • 14. 
    Hemrrhage with a large loss of blood causes
    • A. 

      A lowering of blood pressure due to change in cardiac output

    • B. 

      A rise in blood pressure due to change in cardiac output

    • C. 

      No change in blood pressure but a slower heart rate

    • D. 

      No change in blood pressure but a change in respiration


  • 15. 
    If cardiac muscle is deprived of its normal blood supply, damage would primarily result from
    • A. 

      Decreased delivery of oxygen

    • B. 

      A decrease in the number of available mitochondria for energy production

    • C. 

      A lack of nutrients to feed into metabolic pathways

    • D. 

      An inadequate supply of lactic acid


  • 16. 
    If the length of the absolute refractory period in cardiac muscle cells was the same as it is for skeletal muscle cells
    • A. 

      It would be much longer before cardiac cells could respond to a second stimulation

    • B. 

      Contractions would last as long as the refractory period

    • C. 

      Tetanic contractions might occur, which would stop the hearts pumping action

    • D. 

      It would be less than 1 2 ms


  • 17. 
    Norepinephrine acts on the heart by
    • A. 

      Decreasing heart contractility

    • B. 

      Causing a decrease in stroke volume

    • C. 

      Blocking the action of calcium

    • D. 

      Causing threshold to be reached more quickly


  • 18. 
    If the vagal nerves to the heart were cut, the result would be that
    • A. 

      The heart would stop, since the vagal nerves trigger the heart to contract

    • B. 

      The heart rate would increase by about 25 beats per minute

    • C. 

      The av node would become the pacemaker of the heart

    • D. 

      Parasympathetic stimulation would increase, causing a decrease in heart rate


  • 19. 
    Foramen ovale
    • A. 

      Connects the two atria in the fetal heart

    • B. 

      Is a condition in which the heart valves do not completley close

    • C. 

      Is a shallow depression in the intreventricular septum

    • D. 

      Is a connection between the pulmonary trunk and the aorta in the fetus


  • 20. 
    Which vessel of the heart recieves blood during right ventricular systole?
    • A. 

      Venae cavae

    • B. 

      Pulmonary trunk

    • C. 

      Aorta

    • D. 

      Pulmonary veins


  • 21. 
    Which of these vessels receives blood during ventricular systole?
    • A. 

      Aorta only

    • B. 

      Pulmonary arteries only

    • C. 

      Pulmonary veins only

    • D. 

      Both aorta and pulmonary trunk


  • 22. 
    The tricuspid valve is closed
    • A. 

      While the ventricle is in diastole

    • B. 

      When the ventricle is in systole

    • C. 

      While the atrium is contracting

    • D. 

      By the movement of blood from the atrium to ventricle


  • 23. 
    Which of the following factors does not influence heart rate
    • A. 

      Skin color

    • B. 

      Age

    • C. 

      Gender

    • D. 

      Body temperature


  • 24. 
    When viewing a dissected heart, it is easy to visually discern the right and left ventricles by
    • A. 

      Tracing out where the auricles connect

    • B. 

      Noticing the thickness of the venricle walls

    • C. 

      Locating the apex

    • D. 

      Finding the papillary muscles


  • 25. 
    Select the correct statement about the heart valves
    • A. 

      The mitral valve seperates the right atrium from the right ventricle

    • B. 

      The tricuspid valve divides the left atrium from the left ventricle

    • C. 

      Aortic and pulmonary valves control the flow of blood into the heart

    • D. 

      The AV valves are supported by chordae tendineae so that regurgitation of blood into the atria during ventricle contaction does not occur


  • 26. 
    Select the correct statement about the structure of the heart wall
    • A. 

      The fibrous skeleton forms the bulk of the heart

    • B. 

      Connective tissue in the heart wall aids in the conduction of the action potential

    • C. 

      The heart chambers are lined by the endomysium

    • D. 

      They myocardium is the layer of the heart that actually contracts


  • 27. 
    The second heart sound is heard during which phase of the cardiac cylce?
    • A. 

      Isovolumetric relaxation

    • B. 

      Isovolumetric contraction

    • C. 

      Ventricular ejection

    • D. 

      Ventricular filling


  • 28. 
    Select the correct statement about cardiac output
    • A. 

      A slow heart rate increases end diastolic volume, stroke volume, and force of contraction

    • B. 

      Decreased venous return will result in increased end diastolic volume

    • C. 

      If a semilunar valve were partially obstructed, the end systolic volume in the affected ventricle would be decreased

    • D. 

      Stroke volume increasees if end diastolic volume decreases


  • 29. 
    Isovolumetric contraction
    • A. 

      Refers to the short period during ventricular systole when the ventricles are completely

    • B. 

      Occurs while the AV valves are open

    • C. 

      Occurs immediately after the aortic and pulmonary valves close

    • D. 

      Occurs only in people with heart valve defects


  • 30. 
    Compared to skeletal muscle, cardiac muscle
    • A. 

      Has gap junctions that allow it to act as a functional syncytium

    • B. 

      Lacks striations

    • C. 

      Has more nuclei per cell

    • D. 

      Cells are larger than skeletal muscle cells


  • 31. 
    During the period of ventricular filling
    • A. 

      Pressure in the heart is at its peak

    • B. 

      Blood flows passively through the atria and the open AV valves into the ventricles

    • C. 

      The atria remain in diastole

    • D. 

      It is represented by the P wave on the ECG


  • 32. 
    The time of day most hazardous for heart attacks is
    • A. 

      Morning

    • B. 

      Noon time

    • C. 

      Evening

    • D. 

      During sleep


  • 33. 
    Select the correct statement about the function of myocardial cells
    • A. 

      The entire heart contracts as a unit or it does not contract at all

    • B. 

      Each cardiac muscle cell is nnervated by a sympathetic nerve ending so that the nervous system can increase heart rate

    • C. 

      The refactory period in skeletal muscle is much longer than that in cardiac muscle

    • D. 

      The influx of potassium ions from extracellular sources is the initiating event in cardiac muscle contraction.


  • 34. 
    During contraction of hear muscle cells
    • A. 

      The action potential is initiated by voltage-gated slow calcium channels

    • B. 

      Some calcium enters the cell from the extracellular space and triggers the release of larger amounts of calcium from intracellular stores

    • C. 

      The action potential is prevented from spreading from cell to cell by gap junctions

    • D. 

      Calcium is prevented from entering cardiac fibers that have been stimulated


  • 35. 
    Commotio cordis is heart failure due to a
    • A. 

      Mild electrical shock to the heart itself

    • B. 

      Severe electrical shock to the body

    • C. 

      Relatively mild blow to the chest that occurs during a vulnerable interval (2 ms) when the heart is repolarizing

    • D. 

      Loss of blood from an artery


  • 36. 
    Which statement best describes arteries
    • A. 

      All carry oxygenated blood to the heart

    • B. 

      All carry blood away from the heart

    • C. 

      All contain valves to prevent the backflow of blood

    • D. 

      Only large arteries are lined with endothelium


  • 37. 
    If we were able to artificially alter the membrane permeability of pacemaker cells so that sodium influx is more rapid
    • A. 

      Threshold is reached more quickly and heart rate would increase

    • B. 

      Potassium channels compensate and no change in heart rate would occur

    • C. 

      Heart rate would decrease, but blood pressure would rise due to the excess sodium present

    • D. 

      Tetanic contraction would occur due to the short absolute refractory period of cardiac muscle


  • 38. 
    Which tunic of an artery is most responsible for maintaining blood pressure and continous blood circulation?
    • A. 

      Tunica intima

    • B. 

      Tunica media

    • C. 

      Tunica externa

    • D. 

      Basement membrane


  • 39. 
    Which of hte following chemicals does not help regulate blood pressure?
    • A. 

      ADH

    • B. 

      Atrial natriuretic peptide

    • C. 

      Angiotensin II

    • D. 

      Nitric acid


  • 40. 
    Which tunic of an artery contains endothelium?
    • A. 

      Tunica intima

    • B. 

      Tunica media

    • C. 

      Tunica externa

    • D. 

      Basement membrane


  • 41. 
    Aldosterone will
    • A. 

      Promote an increase in blood pressure

    • B. 

      Promote a decrease in blood volume

    • C. 

      Result in a larger ouput of urine

    • D. 

      Decrease sodium reabsorption


  • 42. 
    Brain blood flow autoregulaton
    • A. 

      Is less sensitive to pH than to a decreased oxygen level

    • B. 

      Causes constriction of cerebral blood vessels in response to a drop in systemic blood pressure

    • C. 

      Is abolished when abnormally high CO2 levels persist

    • D. 

      Is controlled by caridac centers in the pons


  • 43. 
    Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary function of
    • A. 

      Arterioles

    • B. 

      Arteries

    • C. 

      Veins

    • D. 

      Capillaries


  • 44. 
    The circulatory route that runs from the digestive tract to the liver is called
    • A. 

      Hepatic portal circulation

    • B. 

      Pulmonary circulation

    • C. 

      Coronary circulation

    • D. 

      Cerebral circulation


  • 45. 
    The arteries that are also called distributing arteries are the
    • A. 

      Elastic arteries

    • B. 

      Muscular arteries

    • C. 

      Arterioles

    • D. 

      Capillaries


  • 46. 
    Which of the following signs of hypovolemic shock is a relatively late sign?
    • A. 

      Cold, clammy skin

    • B. 

      Increased heart rate

    • C. 

      Rapid, thready pulse

    • D. 

      Rapildy falling blood pressure


  • 47. 
    Which of the following is likely during vigorous exercise?
    • A. 

      Blood will be deverted to the digestive organs

    • B. 

      The skin will be cold and clammy

    • C. 

      Capillaries of the active muscles will be engorged with blood

    • D. 

      Blood flow to the kidneys increases


  • 48. 
    Which of the following is not one of the three main factors influencing blood pressure?
    • A. 

      Cardiac output

    • B. 

      Peripheral resistance

    • C. 

      Emotional state

    • D. 

      Blood volume


  • 49. 
    Which of the choices below explains why the artreioles are known as resistance vessels?
    • A. 

      Their prime function is the exchange of nutrients and wastes between the blood and tissue cells

    • B. 

      The contraction and realxation of the smooth muscle in their walls can change their diameter

    • C. 

      They distribute blood to various parts of the body

    • D. 

      They contain a large quantity of elastic tissue


  • 50. 
    Which of the following processes provides a long-term response to changes in blood pressure?
    • A. 

      Neural controls

    • B. 

      Baroreceptor-initiated reflexes

    • C. 

      Chemoreceptor-initiated reflexes

    • D. 

      Renal regulation


  • 51. 
    The form of circulatory shock known as hypovolemic shock is
    • A. 

      The form of shock caused by anaphylaxis

    • B. 

      Any condition in which blood vessels are inadequately filled and blood cannot circulate normally

    • C. 

      Shock that results form large-scale loss of blood volume, or after severe vomitting or diarrhea

    • D. 

      Always fatal


  • 52. 
    Peripheral resistance
    • A. 

      Decreases with increasing length of the blood vessel

    • B. 

      Increases as blood vessel diameter increases

    • C. 

      Increases as blood viscostiy increases

    • D. 

      Is not a major factor in blood pressure in healthy individuals


  • 53. 
    Blood flow to the skin
    • A. 

      Is controlled mainly by decreasing pH

    • B. 

      Increases when environmental temperature rises

    • C. 

      Increases when body temperature drops so that the skin does not freeze

    • D. 

      Is not an important source of nutrients and oxygen for skin cells


  • 54. 
    The pulse pressure is
    • A. 

      Systolic pressure plus diastolic pressure

    • B. 

      Systolic pressure minus diastolic pressure

    • C. 

      Systolic pressure divided by diastolic pressure

    • D. 

      Diastolic pressure plus 1/3 (systolic pressure plus diastolic pressure)


  • 55. 
    Which of the following do not influence arterial pulse rate?
    • A. 

      Acitvity

    • B. 

      Postural changes

    • C. 

      Emotions

    • D. 

      The vessel selected to palpate


  • 56. 
    Which of the following is true about veins?
    • A. 

      Venous valves are formed from the tunica media

    • B. 

      Up to 35% of total body blood is in venous circulation at any given time

    • C. 

      Veins have a small lumen in relation to the thickness of the vessel wall

    • D. 

      Veins are called capacitance vessels or blood reservoirs


  • 57. 
    Which of the choices belwo reflects the balance (or imbalance) between the direction and amount of luid that flows across the capillary walls?
    • A. 

      Hydrostatic and osmotic pressure

    • B. 

      Hydrostatic pressure only

    • C. 

      Blood volume and viscosity

    • D. 

      Plasma and formed element concentration


  • 58. 
    The influence of blood vessel diameter on peripheral resistance is
    • A. 

      The only factor that incfluences resistance

    • B. 

      Significant because resistance is inversely proportional to the fourth power of the vessel radius

    • C. 

      Significant because resistance is directly proportional to the blood vessel diameter

    • D. 

      Insignificant because vessel diameter does not vary


  • 59. 
    Histologically, the _________  is squamous epithelum supported by a sparse connective tissue layer
    • A. 

      Tunica intima

    • B. 

      Tunica media

    • C. 

      Tunica externa

    • D. 

      Tunica adventitia


  • 60. 
    In the dynamics of blood flow through capillaries, hydrostatic pressure
    • A. 

      And ostmotic pressure are the same

    • B. 

      Is the same as capillary blood pressure

    • C. 

      Generally forces fluid from the interstitial space into the capillaries

    • D. 

      Is completley canceled out by osmotic pressure


  • 61. 
    Mechanisms that do not help regulate blood prssure include
    • A. 

      Nervous control that operates via reflex arcs involving baroreceptors, chemoreceptors and higher brain centers

    • B. 

      The dural sinus reflex

    • C. 

      Renal regulation via the renin-angiotensin system of vasoconstriction

    • D. 

      Chemical controls such as atrial natriuretic peptide


  • 62. 
    The term ductus venosus refers to
    • A. 

      A fetal shunt that bypasses the lungs

    • B. 

      Damage to the valves in the veins, leading to varicose veins

    • C. 

      A conditon of the aged in which the arteries lose elasticity

    • D. 

      A special fetal vessel that allow umbilical blood to bypass the liver


  • 63. 
    Which of the following is a type of circulatory shock?
    • A. 

      Hypovolemic, caused by increased blood volume

    • B. 

      Cardiogenic, which results from any defect in blood vessels

    • C. 

      Vascular, due to extreme vasodilation as a result of loss of vasomotor tone

    • D. 

      Circulatory, where blood volume is normal and constant


  • 64. 
    Which of the choices below does not involve tissue perfusion?
    • A. 

      Delivery of oxygen and nutrients to, and removal of wastes from, tissue cells

    • B. 

      Gas exchange in the lungs

    • C. 

      Absorption of nutrients form the digestive tract

    • D. 

      Blood clotting


  • 65. 
    A patient with essential hypertension might have pressures of 200/120 mm Hg. This hyperstensive state could result in all of the following changes except
    • A. 

      Increased work of the left ventricle

    • B. 

      Increased incidence of coronary artery disease

    • C. 

      Increased damage to blood vessel endothelium

    • D. 

      Decreased size of the heart muscle


  • 66. 
    Arteriole blood pressure increases in response to all but which of the following?
    • A. 

      Increasing stroke volume

    • B. 

      Increasing heart rate

    • C. 

      Rising blood volume

    • D. 

      Falling blood volume

    • E. 

      All of these


  • 67. 
    Which of the following are involved directly in pulmonary circulation?
    • A. 

      Superior vena cava, right atrium, and left ventricle

    • B. 

      Right ventricle, pulmonary artery, and left atrium

    • C. 

      Left ventricle, aorta, and inferior vena cava

    • D. 

      Right atrium, aorta, and left ventrilce


  • 68. 
    Fenestrated capillaries
    • A. 

      Are not more permeable than continous capillaries

    • B. 

      Are not common in endocrine oragns and in areas ewhere capillary absorption is an imprtant function

    • C. 

      Do not occur in the glomerular capillaries of the kidneys

    • D. 

      Are not found in the brain


  • 69. 
    The hepatic portal vein
    • A. 

      Is actually an artery

    • B. 

      Carries nutrient-rich blood to the liver

    • C. 

      Carries oxygen-rich blood from the liver to the viscera

    • D. 

      Carries blood from the liver to the inferior vena cava


  • 70. 
    Factors that aid venous return include all except
    • A. 

      Activity of skeletal muscles

    • B. 

      Pressure changes in the thorax

    • C. 

      Venous valves

    • D. 

      Urinary output


  • 71. 
    Select the correct statement about blood flow
    • A. 

      It is relatively constant through all body organs

    • B. 

      It is measured in mm Hg

    • C. 

      It is greatest where resistance is highest

    • D. 

      Blood flow through the entire vascular system is equivalent to cardiac output


  • 72. 
    What do the ductus  arteriousus and the foramen ovale become at birth?
    • A. 

      Ligamentum teres; fossa ovalis

    • B. 

      Fossa ovalis; ligamentum arteriosum

    • C. 

      Ligamentum arteriosum; ligamentum teres

    • D. 

      Ligamentum arteriosum; fossa ovails


  • 73. 
    Which of the following blood pressue readings would be indicative of hypertension?
    • A. 

      120/80 in a 30 year old man

    • B. 

      140/90 in a 70 year old woman

    • C. 

      170/96 in a 50 year old man

    • D. 

      110/60 in a 20 year old woman


  • 74. 
    The velocity of blood flow is
    • A. 

      In direct proportion to the toal cross-secitonal area of the blood vessels

    • B. 

      Slower in the arteries than in capillaries because arteries possess a realtively large diameter

    • C. 

      Slower in the veins than in the capillaries because veins have a large diameter

    • D. 

      Slowest in the capillaries because the total cross-secitonal area is the greatest


  • 75. 
    A throumbus (blood clot) in the first branch of the arch of the aorta would affect the flow of blood to the
    • A. 

      Left side of the head and neck

    • B. 

      Myocardium of the heart

    • C. 

      Left upper arm

    • D. 

      Right side of the head and neck and right upper arem


  • 76. 
    Cerebral blood flow is regulated by
    • A. 

      Skin temperature

    • B. 

      ADH

    • C. 

      Intrinsic autoregulatory mechanisms

    • D. 

      The hypthalamic "thermostat"


  • 77. 
    Normal average blood pressure for a newborn baby is
    • A. 

      120/80

    • B. 

      90/55

    • C. 

      150/90

    • D. 

      130/80


  • 78. 
    Modified capillareis that are lined with phagocytes are called
    • A. 

      Sinuses

    • B. 

      Sinusoids

    • C. 

      Thoroughfare channels

    • D. 

      Anastomoses


  • 79. 
    Select the correct statement about factors that influence blood pressure
    • A. 

      An incrase in cardiac ouput corresponds to a decrease in blood pressure, due to the increased delivery

    • B. 

      Systemic vasodilation would increase blood pressure, due to diversion of blood to essential areas

    • C. 

      Excess protein production would decrease blood pressure

    • D. 

      Excess red cell production would cause a blood pressure increase


  • 80. 
    The baroreceptors in the carotid sinus and aortic arch aresitive to which of the following?
    • A. 

      A decrease in carbon dioxide

    • B. 

      Changes in arterial pressure

    • C. 

      A decrease in oxygen levels

    • D. 

      An increase in oxygen levels


  • 81. 
    The arterise that direcetly feed into the capillary beds are called
    • A. 

      Muscular arteries

    • B. 

      Elastic arteries

    • C. 

      Areterioles

    • D. 

      Venules


  • 82. 
    The short term controls of blood pressure, mediated by the nervous sytem and bloodborne chemicals, primarily operate via all but which of the following?
    • A. 

      Reflex arcs involving baroreceptors

    • B. 

      Altering blood volume

    • C. 

      Reflex arcs associated with vasomotor fibers

    • D. 

      Chemoreceptors


  • 83. 
    Where in the body would you find low oxygen levels causing vasoconstrition and high levels causing vasodilation?
    • A. 

      Kidney

    • B. 

      Lungs

    • C. 

      Liver

    • D. 

      Heart


  • 84. 
    If blood pressure is almost normal in a person who has lost blood, doos that mean the tisssues are receiving adequate blood flow?
    • A. 

      Yes

    • B. 

      No

    • C. 

      Not necessarily


  • 85. 
    Which of the following would not result in the dilation of the feeder arterioles and opening of the precapillary sphincters in systemic capillary beds?
    • A. 

      A decrease in lical tissue oxygen content

    • B. 

      An increase in local tissue carbon dioxide

    • C. 

      A local increase in histamine

    • D. 

      A local increase in pH


  • 86. 
    Secondary hypertension can be caused by
    • A. 

      Obesity

    • B. 

      Stess

    • C. 

      Arteriosclerosis

    • D. 

      Smoking


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