Integrated Control Of CVS
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Which of the following would occur in a healthy person during the act of changing body position from supine to standing when the baroreceptor reflex is activated? Baroreceptor Firing Activation of NTS Heart Rate
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Increase increase increase
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Increase decrease increase
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Decrease increase increase
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Decrease decrease increase
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Decrease decrease decrease
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This quiz titled 'Integrated control of CVS' assesses understanding of cardiovascular physiology, focusing on responses to changes in body positions, hemorrhage effects, and coronary artery conditions. It evaluates critical thinking in clinical scenarios, relevant for medical students and professionals.
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- 2.
A patient experiences a hemorrhage that lasts for 30 minutes. At the end of that time, the mean arterial pressure has dropped from 90 to 75 mmHg. The heart rate has increased from 70 to 150 beats per minute, but the stroke volume has decreased from 80 to 40 ml per beat. What is the patients cardiac output after the hemorrhage?
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4.0 L/min
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5.0 L/min
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6.0 L/min
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7.0 L/min
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8.0 L/min
Correct Answer
A. 6.0 L/minExplanation
The cardiac output is calculated by multiplying the heart rate by the stroke volume. In this case, the heart rate has increased from 70 to 150 beats per minute, while the stroke volume has decreased from 80 to 40 ml per beat. Therefore, the cardiac output would be 150 beats per minute multiplied by 40 ml per beat, which equals 6.0 L/min.Rate this question:
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- 3.
How has the patient’s total peripheral resistance (TPR) changed after the hemorrhage?
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Increased
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Decreased
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No change
Correct Answer
A. DecreasedExplanation
After a hemorrhage, the patient's total peripheral resistance (TPR) is likely to decrease. This is because hemorrhage leads to a decrease in blood volume, which results in a decrease in the amount of blood circulating in the blood vessels. With less blood volume, the blood vessels do not need to constrict as much to maintain adequate blood pressure, leading to a decrease in TPR.Rate this question:
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- 4.
A 65-year-old man presents to a cardiologist for evaluation of recurrent episodes of light headedness, syncope, chest pain, and shortness of breath. Several tests are ordered to evaluate the patient. Blood pressure is 150/90 and heart rate is 90 beats per minute. Echocardiography reveals a heavily calcified coronary artery with a calculated diameter of half the normal size. The pressure-volume loop below was generated for this patient. After the hemorrhage, it could be concluded that:
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Capillary fluid pressure is decreased.
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Interstitial fluid volume is increased.
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Capillary colloid osmotic pressure is increased
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Interstitial fluid pressure is increased
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Interstitial colloid osmotic pressure is decreased.
Correct Answer
A. Capillary fluid pressure is decreased.Explanation
The pressure-volume loop shows a decrease in the end-diastolic volume (EDV) and end-systolic volume (ESV), indicating a decrease in the amount of blood filling the ventricles during diastole and being ejected during systole. This decrease in volume suggests a decrease in preload and stroke volume, which could be caused by a decrease in capillary fluid pressure. A decrease in capillary fluid pressure would result in reduced filling of the ventricles, leading to decreased EDV and ESV. Therefore, the correct answer is that capillary fluid pressure is decreased.Rate this question:
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- 5.
A 65-year-old man presents to a cardiologist for evaluation of recurrent episodes of light headedness, syncope, chest pain, and shortness of breath. Several tests are ordered to evaluate the patient. Blood pressure is 150/90 and heart rate is 90 beats per minute. Echocardiography reveals a heavily calcified coronary artery with a calculated diameter of half the normal size. The pressure-volume loop below was generated for this patient. The patients mean arterial pressure is closest to
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80 mmHg
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90 mmHg
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100 mmHg
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110 mmHg
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120 mmHg
Correct Answer
A. 110 mmHgExplanation
Based on the information provided, the patient's blood pressure is 150/90 mmHg. To calculate the mean arterial pressure (MAP), we use the formula MAP = diastolic pressure + 1/3 (systolic pressure - diastolic pressure). In this case, the diastolic pressure is 90 mmHg and the systolic pressure is 150 mmHg. Plugging these values into the formula, we get MAP = 90 + 1/3 (150 - 90) = 90 + 1/3 (60) = 90 + 20 = 110 mmHg. Therefore, the patient's mean arterial pressure is closest to 110 mmHg.Rate this question:
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- 6.
A 65-year-old man presents to a cardiologist for evaluation of recurrent episodes of light headedness, syncope, chest pain, and shortness of breath. Several tests are ordered to evaluate the patient. Blood pressure is 150/90 and heart rate is 90 beats per minute. Echocardiography reveals a heavily calcified coronary artery with a calculated diameter of half the normal size. The pressure-volume loop below was generated for this patient. (ESV 60ml, EDV =110) The patients cardiac output is closest to
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4.0 L/min
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4.5 L/min
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5.0 L/min
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5.5 L/min
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6.0 L/min
Correct Answer
A. 4.5 L/minExplanation
Based on the given information, the patient has a heavily calcified coronary artery with a calculated diameter of half the normal size. This suggests that the patient may have coronary artery disease (CAD), which can lead to decreased blood flow to the heart. This can result in symptoms such as chest pain, shortness of breath, and lightheadedness. The pressure-volume loop generated for this patient shows that the end-systolic volume (ESV) is 60ml and the end-diastolic volume (EDV) is 110ml. Cardiac output is calculated by subtracting the ESV from the EDV and multiplying by the heart rate. Therefore, the cardiac output in this case would be (110-60) * 90 = 4.5 L/min.Rate this question:
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- 7.
A 65-year-old man presents to a cardiologist for evaluation of recurrent episodes of light headedness, syncope, chest pain, and shortness of breath. Several tests are ordered to evaluate the patient. Blood pressure is 150/90 and heart rate is 90 beats per minute. Echocardiography reveals a heavily calcified coronary artery with a calculated diameter of half the normal size. The pressure-volume loop below was generated for this patient. Flow through the calcified coronary artery is
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Reduced by 50%.
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Reduced by 1/16
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Reduced 16-fold
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Reduced by 25%.
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Reduced by 16%.
Correct Answer
A. Reduced 16-foldExplanation
The pressure-volume loop generated for the patient indicates that the flow through the heavily calcified coronary artery is reduced 16-fold. This means that the flow is significantly decreased compared to normal. The calcification in the artery has caused a significant obstruction, leading to reduced blood flow and the patient's symptoms of light headedness, syncope, chest pain, and shortness of breath.Rate this question:
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- 8.
A 24 year old medical student presents with chest pain sweating and palpitations. An EKG reveals a heart rate of 120 per minute. The patient has been experiencing these episodes several times a day since he found out that his father was diagnosed with severe hypertension. Where would you report the effect of his father’s illness?
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In the HPI
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In his mental status examination
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In his psychiatric review of systems
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In his family history
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All of the above
Correct Answer
A. All of the aboveExplanation
The effect of the patient's father's illness would be reported in all of the mentioned sections - HPI, mental status examination, psychiatric review of systems, and family history. The patient's symptoms of chest pain, sweating, and palpitations are likely related to anxiety or stress caused by his father's diagnosis of severe hypertension. These symptoms and their association with the father's illness would be discussed in the HPI. The patient's mental status examination would assess his emotional state and any signs of anxiety or distress. The psychiatric review of systems would further explore any psychological or emotional symptoms related to the father's illness. Lastly, the family history section would document the father's diagnosis and its potential impact on the patient's health.Rate this question:
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- 9.
This patient expresses anxiety about his father’s illness. The patient complaint about feeling anxious would be considered which of the following?
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A sign of a panic attack
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A sign of acute anxiety
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An associated symptom
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A baseline health statement
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Unrelated to his presenting complaints
Correct Answer
A. An associated symptomExplanation
The patient's expression of anxiety about his father's illness is considered an associated symptom because it is related to the patient's presenting complaints. It is not a sign of a panic attack or acute anxiety, as those would typically involve more intense and immediate symptoms. It is also not a baseline health statement or unrelated to the presenting complaints, as it directly relates to the patient's concern about his father's illness.Rate this question:
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- 10.
Alberto Contador, who just won the Tour de France, has dramatic changes in his cardiac output and distribution of blood flow to exercising skeletal muscle while cycling. If blood flow to exercising skeletal muscle increases 15-fold and cardiac output increases 5-fold, what are the expected changes in renal vascular resistance (RVR), resistance to blood flow to exercising skeletal muscle (SkVR), and total peripheral resistance (TPR) while he is cycling? Assume his mean arterial pressure remains the same during exercise as it was while he was at rest. RVR SkVR TPR
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Increase Decrease Increase
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Increase Decrease Decrease
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Decrease Increase Increase
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Decrease Increase Decrease
Correct Answer
A. Increase Decrease DecreaseExplanation
During exercise, when blood flow to exercising skeletal muscles increases, there is a decrease in renal vascular resistance (RVR) to allow for more blood flow to the muscles. This is because the body prioritizes delivering oxygen and nutrients to the working muscles. On the other hand, resistance to blood flow to exercising skeletal muscles (SkVR) decreases because of the increased blood flow. The total peripheral resistance (TPR) decreases as well because of the decreased resistance in the exercising muscles. Overall, the changes in RVR, SkVR, and TPR are expected to be an increase in RVR and a decrease in both SkVR and TPR.Rate this question:
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- 11.
The baroreceptor reflex includes several effector pathways. Predict the changes in the variables of the table below when arterial pressure decreases by 25 mm Hg. Abbreviations: skeletal muscle vascular resistance (SkVR); plasma vasopressin [AVP]Pl; plasma angiotensin II [Ang II]Pl; plasma norepinephrine [NE]Pl; cardiac parasympathetic nerve activity (cardiac PANS) SkVR [AVP]Pl [Ang II]Pl [NE]Pl Cardiac PANS
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Increase Increase Increase Increase Increase
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Decrease Decrease Decrease Increase Increase
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Increase Increase Decrease Increase Decrease
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Increase Increase Increase Increase Decrease
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Decrease Increase Decrease Increase Decrease
Correct Answer
A. Increase Increase Increase Increase DecreaseExplanation
The correct answer suggests that when arterial pressure decreases by 25 mm Hg, there will be an increase in skeletal muscle vascular resistance (SkVR), an increase in plasma vasopressin [AVP]Pl, an increase in plasma angiotensin II [Ang II]Pl, an increase in plasma norepinephrine [NE]Pl, and a decrease in cardiac parasympathetic nerve activity (cardiac PANS). This is likely because the baroreceptor reflex is activated in response to the decrease in arterial pressure, leading to vasoconstriction and increased release of vasoconstrictive hormones to increase blood pressure. The decrease in cardiac parasympathetic nerve activity may be due to the compensatory increase in sympathetic activity.Rate this question:
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- 12.
During Phase IV of the Valsalva maneuver:
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Venous return and cardiac output are decreased
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Venous return and cardiac output are increased.
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Parasympathetic stimulation of the heart increases cardiac output.
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Sympathetic stimulation of the heart decreases cardiac output.
Correct Answer
A. Venous return and cardiac output are increased.Explanation
During Phase IV of the Valsalva maneuver, venous return and cardiac output are increased. The Valsalva maneuver is a breathing technique that involves forceful exhalation against a closed airway. In Phase IV, which occurs after the release of the Valsalva maneuver, there is a sudden decrease in intrathoracic pressure. This causes a rapid increase in venous return, leading to an increase in preload and subsequently an increase in cardiac output. This is due to the release of intrathoracic pressure, allowing blood to flow more easily back to the heart.Rate this question:
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- 13.
A healthy 22 year old undergoes a graded exercise test on a treadmill at his local gym. What hemodynamic responses would you expect to see as the work load increases? Stroke Volume Systolic Pressure Diastolic Pressure Heart Rate
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Increase increase no change increase
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Increase increase increase increase
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Decrease decrease decrease decrease
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Decrease no change increase increase
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Increase no change no change increase
Correct Answer
A. Increase increase no change increaseExplanation
As the workload increases during the graded exercise test, it is expected that the stroke volume and systolic pressure will increase. This is because the heart needs to pump more blood to meet the increased demand for oxygen and nutrients by the muscles. However, the diastolic pressure is expected to remain unchanged as the blood vessels dilate to accommodate the increased blood flow. Additionally, the heart rate is expected to increase in order to pump more blood. Therefore, the correct answer is "increase increase no change increase".Rate this question:
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- 14.
Ms. Stanton, a 57 year old woman from Orlando, presents complaining of light-headedness upon standing. Her blood pressure is 90/65 while standing versus 130/80 while in a supine position, thus documenting a significant case of orthostatic hypotension. Based on your knowledge of the baroreceptor response, which of the following would occur in a healthy individual during the act of changing body position from supine to standing (the initial effect of standing up)? Baroreceptor Firing Activation of NTS Heart Rate
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Increase increase decrease
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Increase increase increase
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Decrease increase increase
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Decrease decrease increase
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Decrease decrease decrease
Correct Answer
A. Decrease decrease increaseExplanation
When a healthy individual changes from a supine to a standing position, the baroreceptors in the body detect the decrease in blood pressure caused by gravity pulling blood downwards. This leads to a decrease in baroreceptor firing, which in turn reduces the activation of the NTS (nucleus tractus solitarius) in the brainstem. As a result, there is a decrease in parasympathetic activity and an increase in sympathetic activity, leading to an increase in heart rate.Rate this question:
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Current Version
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Mar 20, 2023Quiz Edited by
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Nov 07, 2011Quiz Created by
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