Serce (j.ang)

Bogdan Koczanowski Ph.D.

1. Blood returning to the heart from the systemic circuit first enters the

a) left atrium.
b) right atrium.
c) right ventricle.
d) conus arteriosus.
e) left ventricle.

2. Blood returning to the heart from the pulmonary circuit first enters the

a) right atrium.
b) right ventricle.
c) left ventricle.
d) conus arteriosus.
e) left atrium.

3. The heart lies in the

a) abdominal cavity.
b) pleural cavity.
c) abdominopelvic cavity.
d) peritoneal cavity.
e) mediastinum.

4. The expandable extension of the atrium is the

a) coronary sulcus.
b) ventricle.
c) auricle.
d) interatrial septum.
e) coronary sinus.

5. The coronary sulcus is a groove that

a) separates the coronary arteries from the coronary veins.
b) separates the atrioventricular valves from the atria.
c) marks the boundary line between the right and left ventricles.
d) marks the boundary line between the right and left atria.
e) marks the border between the atria and ventricles.

6. The pectinate muscles are

a) muscles that close the semilunar valves.
b) prominent muscular ridges in the walls of the ventricles.
c) prominent muscular ridges that run along the surface of the auricles.
d) muscles that support the atrioventricular valves.
e) muscles that anchor the chordae tendinae.

7. The cusps of atrioventricular valves are attached to papillary muscles by the

a) coronary sulci.
b) trabeculae carneae.
c) pectinate muscles.
d) interatrial septa.
e) chordae tendineae.

8. Contractions of the papillary muscles

a) close the semilunar valves.
b) eject blood from the atria into the ventricles.
c) eject blood from the ventricles.
d) prevent the atrioventricular valves from reversing into the atria.
e) close the atrioventricular valves.

9. The visceral pericardium is the same as the

a) mediastinum.
b) parietal pericardium.
c) endocardium.
d) epicardium.
e) myocardium.

10. A function of the pericardium includes

a) removing excess fluid from the heart chambers.
b) preventing expansion of the heart.
c) anchoring the heart to surrounding structures.
d) pumping blood into circulation.
e) both A and D

11. The right ventricle pumps blood to the

a) lungs.
b) right atrium.
c) left atrium.
d) systemic circuit.
e) left ventricle.

12. The left ventricle pumps blood to the

a) lungs.
b) pulmonary circuit.
c) right ventricle.
d) right atrium.
e) systemic circuit.

13. The right atrium receives blood from the

a) aorta.
b) conus arteriosus.
c) inferior vena cava.
d) pulmonary trunk.
e) pulmonary veins.

14. The atrioventricular valve on the side of the heart that receives the superior vena cava is the ________ valve.

a) pulmonary semilunar
b) bicuspid
c) mitral
d) aortic semilunar
e) tricuspid

15. Blood leaving the right ventricle enters the

a) pulmonary trunk.
b) inferior vena cava.
c) aorta.
d) pulmonary veins.
e) superior vena cava.

16. The pulmonary semilunar valve guards the entrance to the

a) pulmonary veins.
b) right ventricle.
c) pulmonary trunk.
d) left ventricle.
e) aorta.

17. The bicuspid or mitral valve is located

a) between the right atrium and right ventricle.
b) in the opening of the aorta.
c) where the vena cavae join the right atrium.
d) between the left atrium and left ventricle.
e) in the opening of the pulmonary trunk.

18. The entrance to the ascending aorta is guarded by the ________ valve.

a) tricuspid
b) bicuspid
c) semilunar
d) atrioventricular
e) mitral

19. The function of an atrium is to

a) pump blood to the lungs.
b) pump blood to the heart muscle.
c) collect blood.
d) pump blood into the systemic circuit.
e) both A and D

20. Compared to the right ventricle, the left ventricle has all the following characteristics, except:

a) produces 6 to 7 times more force when it contracts.
b) a thicker wall.
c) is round in cross section.
d) develops higher pressures when it contracts.
e) relaxes more slowly.

21. The following is a list of vessels and structures that are associated with the heart. 1. right atrium 2. left atrium 3. right ventricle 4. left ventricle 5. vena cavae 6. Aorta 7. pulmonary trunk 8. pulmonary veins What is the correct order for the flow of blood entering from the systemic circulation?

a) 5, 3, 1, 7, 8, 4, 2, 6
b) 1, 7, 3, 8, 2, 4, 6, 5
c) 5, 1, 3, 8, 7, 2, 4, 6
d) 1, 2, 7, 8, 3, 4, 6, 5
e) 5, 1, 3, 7, 8, 2, 4, 6

22. The left and right pulmonary arteries carry blood to the

a) lungs.
b) liver.
c) brain.
d) intestines.
e) heart.

23. The left and right pulmonary veins carry blood to the

a) lungs.
b) brain.
c) heart.
d) liver.
e) intestines.

24. The heart wall is composed of ________ layers of tissue.

a) 3
b) 6
c) 4
d) 2
e) 5

25. The myocardium is primarily composed of ________ tissue.

a) elastic
b) fibrous connective
c) smooth muscle
d) cardiac muscle
e) epithelial

26. The fibrous skeleton of the heart functions in all of the following, except to

a) help distribute the forces of cardiac contraction.
b) allow more rapid contraction of the ventricles.
c) maintain the normal shape of the heart.
d) strengthen and help prevent overexpansion of the heart.
e) physically isolate the muscle fibers of the atria from those of the ventricles.

27. The first blood vessels to branch from the aorta are the ________ arteries.

a) subclavian
b) coronary
c) pulmonary
d) circumflex
e) carotid

28. The marginal branch and posterior interventricular branch are branches of the

a) left coronary artery.
b) right coronary artery.
c) circumflex artery.
d) aorta.
e) coronary sinus.

29. The circumflex branch and the anterior descending artery are branches of the

a) left coronary artery.
b) right coronary artery.
c) interventricular artery .
d) aorta.
e) coronary sinus.

30. The great and middle cardiac veins drain blood into the

a) coronary sinus.
b) superior vena cava.
c) aorta.
d) inferior vena cava.
e) coronary sulcus.

31. The heart is innervated by ________ nerves.

a) parasympathetic
b) sympathetic
c) both parasympathetic and sympathetic
d) neither parasympathetic nor sympathetic

32. In cardiac muscle, the depolarization phase of the action potential is the result of

a) decreased membrane permeability to calcium ions.
b) increased membrane permeability to chloride ions.
c) increased membrane permeability to sodium ions.
d) decreased membrane permeability to sodium ions.
e) increased membrane permeability to potassium ions.

33. The plateau phase of the cardiac muscle action potential is due to

a) the increased membrane permeability to potassium ion.
b) a decrease in the amount of calcium diffusing across the membrane.
c) the calcium channels remaining open longer than the sodium channels.
d) the movement of fewer sodium ions across the cell membrane.
e) an increased membrane permeability to sodium ions.

34. The pacemaker cells of the heart are located in the

a) AV node.
b) both the left and right ventricles.
c) wall of the left ventricle.
d) SA node.
e) Purkinje fibers.

35. The following are various components of the conducting system of the heart. 1. Purkinje fibers 2. AV bundle 3. AV node 4. SA node 5. bundle branches.The sequence in which an action potential would move through this system is

a) 3, 2, 4, 5, 1.
b) 3, 5, 4, 2, 1.
c) 4, 2, 3, 5, 1.
d) 4, 3, 2, 5, 1.
e) 1, 4, 3, 2, 5.

36. The pace established by the SA node depends on all of the following, except the

a) frequency of sympathetic and parasympathetic action potentials.
b) extracellular concentration of potassium ion.
c) temperature of the body.
d) type and amount of neurotransmitter present.
e) extracellular concentration of calcium ion.

37. Depolarization of the ventricles is represented on an electrocardiogram by the

a) PR complex.
b) s wave.
c) QRS complex.
d) t wave.
e) p wave.

38. The T wave on an ECG tracing represents

a) atrial depolarization.
b) ventricular repolarization.
c) atrial repolarization.
d) ventricular contraction.
e) ventricular depolarization.

39. Analysis of the electrocardiogram can reveal all of the following, except the

a) size of the ventricles.
b) position of the heart in the thoracic cavity.
c) condition of the pulmonary trunk.
d) condition of the conducting system.
e) effects of altered ion concentrations.

40. The first heart sound is heard when the

a) atria contract.
b) semilunar valves close.
c) AV valves close.
d) blood enters the aorta.
e) AV valves open.

41. During the isovolumetric phase of ventricular systole, the

a) blood is ejected into the great vessels.
b) atrioventricular valves and semilunar valves are closed.
c) atria are contracting and the ventricles are relaxing.
d) all of the above
e) B and C only

42. In cardiac muscle

a) calcium ions play an important role in repolarizing the membrane after the depolarization phase.
b) calcium ions do not bind to troponin molecules.
c) at least half of the calcium ion required for contraction comes from outside of the cell.
d) calcium ions are not released from the sarcoplasmic reticulum.
e) calcium ions play no role in the process of contraction.

43. During the cardiac cycle, the

a) QRS complex of the ECG precedes the increase in ventricular pressure.
b) third heart sound occurs during atrial systole.
c) second heart sound coincides with the QRS complex of the ECG.
d) p wave of the ECG occurs between the first and second heart sounds.
e) both A and C

44. The volume of blood ejected from each ventricle during a contraction is called the

a) stroke volume.
b) cardiac output.
c) end-diastolic volume.
d) cardiac reserve.
e) end-systolic volume.

45. The cardiac output is equal to the

a) product of heart rate and blood pressure.
b) difference between the stroke volume at rest and the stroke volume during exercise.
c) product of heart rate and stroke volume.
d) stroke volume less the end-systolic volume.
e) difference between the end-diastolic volume and the end-systolic volume.

46. Each of the following factors will increase cardiac output, except

a) increased venous return.
b) increased sympathetic stimulation.
c) increased heart rate.
d) increased parasympathetic stimulation.
e) both B and D

47. According to Starling's 'law of the heart', the cardiac output is directly related to the

a) size of the ventricle.
b) heart rate.
c) venous return.
d) end-systolic volume.
e) thickness of the myocardium.

48. Each of the following conditions would increase heart rate, except

a) increased parasympathetic stimulation of nodal fibers.
b) increased levels of epinephrine in the interstitial fluid surrounding the myocardium.
c) increased permeability of the myocardial membrane to sodium ion.
d) activation of cAMP in heart muscle.
e) increased sympathetic stimulation of nodal fibers.

49. Increased venous blood flow to the right atrium

a) will result in increased heart rate.
b) triggers the atrial (Bainbridgreflex.
c) causes cells of the SA node to depolarize faster.
d) all of the above
e) B and C only

50. Drugs known as beta-blockers will

a) decrease the end-systolic volume.
b) decrease heart rate.
c) increase cardiac output.
d) increase stroke volume.
e) increase heart rate.

51. At an intercalated disc

a) the myofibrils are loosely attached to the membrane of the disc.
b) the cell membranes of two cardiac muscle fibers are completely separated by a synapse.
c) t-tubules unite the membranes of the adjoining cells.
d) two cardiac muscle cells are connected by a gap junction.
e) both B and C

52. Cardiac muscle is similar to skeletal muscle in the

a) arrangement of the sarcoplasmic reticulum.
b) presence of striations.
c) arrangement of the t-tubules.
d) presence of intercalated discs.
e) both A and D

53. During ventricular systole, the

a) pressure in the ventricles declines.
b) atria are contracting.
c) ventricles are relaxed.
d) blood is entering the ventricles.
e) AV valves are closed.

54. When the left ventricle contracts, the distance from the apex to the base

a) decreases.
b) increases.
c) remains unchanged.

55. When the left ventricle contracts, the diameter of the ventricular chamber

a) increases.
b) remains the same.
c) decreases.

56. Which of the following is longer?

a) the refractory period of cardiac muscle
b) the refractory period of skeletal muscle

57. As a result of the long refractory period, cardiac muscle cannot exhibit

a) recruitment.
b) treppe.
c) tonus.
d) tetany.
e) fatigue.

58. Which of the following is greater?

a) the concentration of calcium ions in the sarcoplasmic reticulum of skeletal muscle
b) the concentration of calcium ions in the sarcoplasmic reticulum of cardiac muscle

59. Drugs known as calcium channel blockers can be used to

a) increase stroke volume.
b) decrease the force of cardiac contraction.
c) constrict the coronary arteries.
d) increase sympathetic stimulation of the myocardium.
e) increase blood pressure.

60. Enzymes that are found in blood following a myocardial infarction include all of the following, except

a) LDH.
b) ST-P.
c) MB-CK.
d) SGOT.
e) CPK.

61. When a clot forms on the plaque in a coronary vessel and obstructs blood flow to the muscle, the condition is referred to as a(n)

a) angina pectoris.
b) myocardial infarction.
c) angioplasty.
d) pulmonary embolism.
e) coronary thrombosis.

62. Which of the following is greater?

a) the number of action potentials per minute spontaneously generated by the SA node
b) the number of action potentials per minute spontaneously generated by the AV node
c) Neither is greater.

63. Which of the following is greater?

a) the conduction velocity along a normal myocardial fiber
b) the conduction velocity along a Purkinje fibe+r
c) Neither is greater.

64. Which of the following is greater during left ventricular systole?

a) the pressure in the ventricle
b) the pressure in the aorta
c) Neither is greater.

65. If the connections between the vagus nerve and the heart are severed, the

a) stroke volume will decrease.
b) nodal fibers will depolarize more slowly.
c) heart will beat slower.
d) cardiac output will decrease.
e) none of the above

66. Which of the following would be greater?

a) the amount of intracellular calcium ions in cardiac muscle after muscarinic receptors are stimulated
b) the amount of intracellular calcium ions in cardiac muscle after beta receptors are stimulated

67. Cardiac output would be greatest when

a) sympathetic stimulation of the heart increases.
b) parasympathetic stimulation of the heart increases.

68. Which of the following would be greater?

a) the end-diastolic volume when the heart rate is 150 beats/minute
b) the end-diastolic volume when the heart rate is 90 beats/minute

69. Which of the following would be greater?

a) stroke volume when extracellular calcium ion concentrations are high
b) stroke volume when extracellular calcium ion concentrations are low

70. Which of the following is greater?

a) heart rate when norepinephrine is released at the SA node
b) heart rate when acetylcholine is released at the SA node

71. If the papillary muscles fail to contract

a) the ventricles will not pump blood.
b) the AV valves will not close properly.
c) the semilunar valves will not open.
d) the atria will not pump blood.
e) none of the above

72. Abnormally slow conduction through the ventricles would change the shape of the ________ in an ECG tracing.

a) R-T interval
b) t wave
c) P-R interval
d) QRS complex
e) p wave

73. The ECG of a person suffering from third degree heart block would show

a) no visible T wave.
b) an inverted P wave.
c) more P waves than QRS complexes per minute.
d) an increased P-R interval+.
e) a smaller QRS complex.

74. Identify the structure labeled "14".

a) bicuspid valve
b) tricuspid valve
c) aortic semilunar valve
d) ligamentum arteriosum
e) pulmonary semilunar valve

75. Identify the structure labeled "22".

a) moderator band
b) papillary muscles
c) chordae tendineae
d) trabeculae carneae
e) pectinate muscles

76. Identify the structure labeled "6".

a) aortic semilunar valve
b) tricuspid valve
c) ligamentum arteriosum
d) pulmonary semilunar valve
e) bicuspid valve

77. Which chamber receives oxygenated blood from the pulmonary circuit?

a) 5
b) 20
c) 8
d) 17
e) both 5 and 17

78. Identify the structure labeled "12".

a) bicuspid valve
b) pulmonary semilunar valve
c) aortic semilunar valve
d) tricuspid valve
e) ligamentum arteriosum

79. What occurs at the area labeled "B" on the graph?

a) Semilunar valve opens
b) Ventricular ejection occurs
c) AV valve closes
d) AV valve opens
e) Semilunar valve closes

80. What volume is labeled "G" on the graph?

a) stroke volume
b) end-diastolic volume
c) cardiac reserve
d) end-systolic volume
e) cardiac output

81. What occurs at the area labeled "A" on the graph?

a) semilunar valve opens
b) semilunar valve closes
c) ventricular ejection occurs
d) AV valve opens
e) AV valve closes

82. What volume is labeled "E" on the graph?

a) cardiac output
b) end-diastolic volume
c) end-systolic volume
d) stroke volume
e) cardiac reserve

83. What occurs at the circled label "4" on the graph?

a) ventricular ejection
b) ventricular diastole
c) isovolumetric contraction
d) isovolumetric relaxation
e) sympathetic stimulation

84. If the membrane of the cardiac muscle cells in the SA node become more permeable to potassium ions, the

a) heart rate will increase.
b) membrane will depolarize.
c) stroke volume will increase.
d) heart rate will decrease.
e) intracellular concentration of calcium ion will increase.

85. If the connection between the SA node and AV node becomes blocked,

a) the ventricles will beat faster.
b) the stroke volume will increase.
c) the ventricles will beat more slowly.
d) the ventricular rate of contraction will not be affected.
e) none of the above

86. If a myocardial infarction results in the formation of scar tissue along the pathway of the left bundle branch,

a) blood flow to the lungs will decrease.
b) conduction through the left ventricle would remain normal.
c) the right ventricle will fail to contract.
d) cardiac arrhythmias may occur.
e) the ventricle will contract more forcefully.

87. What effect would compressing the inferior vena cava just below the diaphragm have on cardiac function?

a) Stroke volume would increase.
b) Sympathetic stimulation of the heart would increase.
c) Cardiac output would increase.
d) all of the above
e) both A and B

88. In which of the following situations would the end systolic volume (ESV) be the greatest?

a) when the intracellular stores of calcium are increased
b) when stroke volume is increased
c) when parasympathetic stimulation of the heart is increased
d) when the force of myocardial contraction is increased
e) when sympathetic stimulation of the heart is increased

89. In which situation would the stroke volume be the greatest?

a) when the force of contraction is decreased
b) when the difference between the end diastolic volume and the end systolic volume is small
c) when venous return is increased
d) when venous return is decreased
e) when calcium channel blockers are present

90. Manganese ion blocks the calcium channels in the cardiac muscle membrane. How would the presence of manganese in the extracellular fluid affect the contraction of the heart muscle?

a) The refractory period would be shorter.
b) The heart rate would increase.
c) The contraction phase would be prolonged.
d) The heart would beat less forcefully.
e) The plateau phase of contraction would be shorter.

91. David suffers from a regurgitating mitral valve. This condition would cause

a) decreased force of cardiac contraction.
b) increased cardiac output from the right ventricle.
c) increased cardiac output from the left ventricle.
d) decreased heart rate.
e) fluid congestion in the lungs.

92. If there is a blockage between the AV node and the AV bundle, how will this affect the appearance of the electrocardiogram?

a) The QRS interval will be longer.
b) The T wave will disappear.
c) The P-R interval will be smaller.
d) There will be more QRS complexes than p waves.
e) There will be more p waves than QRS complexes.

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