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98 Cards in this Set
- Front
- Back
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The duration of action of the cardiac action potential is longer/shorter than that of the skeletal muscle?
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Longer
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The three types of cardiac muscle are:
a. smooth, striated and conducting b. atrial, ventricular and specialized pacemaker and conducting c. atrial, ventricular, and striated d. smooth, striated and atrial and ventricular |
b. atrial, ventricular and specialized pacemaker and conducting cells
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Th purpose of intercalated disks is to allow the spread of electrical activity between myocardial cells by:
a. Low- resistance b. High- resistance c. pacemaker cells d. gated release |
a. Low- resistance
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In 40% of people the fossa ovalis remains open after birth. This is called:
a. Foramen Ovale b. VSD c. Patent Foramen Ovale d. Right to left shunt |
c. Patent Foramen Ovale
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The course of blood flow in a normal, healthy heart:
a. RA, TV, RV, PV, LA, MV, LV, Aorta b. RA, MV, RV, PV, LA, TV, LV, Aorta c. RA, TV, LV, PV, LA, TV, LV, Aorta d. RA, LA, TV, PV, RV, LV, MV, Aorta |
a. RA, TV, RV, PV, LA, MV, LV, Aorta
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Thebesian valve guards what?
a. fossa ovalis b. Coronary arteries c. PFO d. coronary sinus |
d. coronary sinus
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What is the function of the thebesian valve?
a. Seals the fossa ovalis after birth b. Prevents backflow of blood into the coronary arteries during systole c. Found in the right atrium in an adult with a PFO d. Prevent regurgitation of blood into the coronary sinuses during atrial contraction |
d. Prevent regurgitation of blood into the coronary sinuses during atrial contraction
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How many leaflets are found on the TV, MV, PV and AV respectively?
a. They all have 2 leaflets b. 2,2,3,3 c. 3,2,3,3 d. 3,2,2,2 |
c. 3,2,3,3
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These types of valves can be described as curtains: Thin, filmy, large, and low resistance flow.
a. Semi lunar valves b. Atrial Ventricular valves |
b. Atrial Ventricular valves
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SVO2 measured at the RA would be?
a. 60-80 b. 40-60 c. 30-40 d. 80-100 |
a. 60-80 because of non oxygenated blood that has been returned to the heart to be oxygenated
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Low pressure volume resevoir, more purkinje fibers, greater electric innovation, wraps around 1/3 o the LV, continuous muscle fibers all describe:
a. RA b. Internodal patheways c. RV d. LA |
c. RV
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Smaller valves, handle much higher velocity and can be described as a door slamming shut d/t distal to a pumping chamber all describe what type of valve?
a. Semi lunar valve b. Atrial Ventricular valve |
a. Semi lunar
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Flow of blood from the RV to the LA:
a. 4 pulmonary veins, 2 lungs, 2 pulmonary arteries b. 2 pulmonary veins, 2 lungs, 4 pulmonary arteries c. 4 pulmonary arteries, 2 lungs, 2 pulmonary veins d. 2 pulmonary arteries, 2 lungs, 4 pulmonary veins |
d. 2 pulmonary arteries, 2 lungs, 4 pulmonary veins
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This valve is unique in that it has 2 leaflets that are connected to papillary muscle, 4 cusps and 100's of chordae tendinae.
a. TV b. PV c. MV d. AV |
c. MV
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Of the 3 cusps of the aortic valve, which is the non coronary cusp?
a. posterior b. anterior c. right d. left |
a. posterior
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The nodule of Arantius is located at the center of each cusp in the aortic valve, what is its purpose?
a. I have no clue b. prevent regurgitation c. form the sinuses of valsalva d. form part of the trabeculae |
b. prevent regurgitation by adhering together when closed
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The aorta dilates just distal to aortic valve to form:
a. Nodule of Arantius b. cusps c. thebesian valve d. Sinuses of Valsalva |
d. Sinuses of Valsalva in which the right and left coronary ostia are located
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Action potential Phase 0, 1, 2, 3 and 4 in order:
a. early rapid repolarization b. activation of fast sodium channels c. final repolarization, inactivation of Ca channels d. Resting potential e. Plateau, activation of slow Ca channels |
0 = b.activation of fast sodium channels
1 = a.early rapid repolarization 2 = e.plateau, activation of slow Ca channels 3 = c.final repolarization, inactivation of Ca channels 4 = d.resting potential |
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The LAD supplies_____.
a. Intraventricular groove, RBB, LBB b. Atrioventricular groove c. SA node, AV node, Bundle of His d. Intraventricular groove and Bundle of His |
a. Intraventricular groove, RBB, and LBB
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The Circumflex supplies____.
a. Intraventricular groove, RBB, LBB b. Atrioventricular groove c. SA node, AV node, Bundle of His d. Intraventricular groove and Bundle of His |
b. Atrioventricular groove
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The RCA supplies______.
a. Intraventricular groove, RBB, LBB b. Atrioventricular groove c. SA node, AV node, Bundle of His d. Intraventricular groove and Bundle of His |
c. SA node, AV node and the Bundle of His
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Obtuse marginal, Diagonals, & Posterior Descending Artery belong to what Coronary artery respectively?
a. LAD, Circumflex, RCA b. RCA, LAD, Circumflex c. LAD, RCA, Circumflex d. Circumflex, LAD, RCA |
d. Circumflex, LAD, RCA
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Monitoring of LAD, Circumflex and RCA is done by what leads, respectively?
a. II, III, aVF/ I, aVL/ V3-V5 b. V3-V5/ I, aVL/ II, III, aVF c. I, aVL/ V3-V5/ II, III, aVF d. I, II, III/ aVL, aVF/ V3-V5 |
b. V3-V5/ I, aVL/ II, III, aVF
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The left or right coronary artery that crosses the junction between atria and ventricles to supply the PDA determines what?
a. Coronary dominance b. CAD c. Cardiac conduction d. Coronary artery blood flow |
a. Coronary dominance
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______ have the fastest conduction velocities.
a. SA node b. AV node c. His Purkinje fibers d. internodal pathways |
c. His Purkinje fibers
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What effect do anesthetic gases have on SA node and AV node?
a. depress/prolong conduction b. excite/ increase refractoriness d. depress/ shorten refractoriness d. no effect |
a. depress/prolong conduction
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Intrinsic HR of the SA/AV node?
a. 40-60/ 60-90 b. 90/40-60 c. 30-40/60-80 d. 100/80 |
b. 90/40-60
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What is the resting membrane potential of the SA node?
a. -30mV, threshold of -20mV b. -70mV, threshold of -40mV c. -40mV, threshold of -30mV d. -50mV, threshold of -40mV |
d. -50 to -60mV, threshold of -40mV
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What channels open during phase II of the action potential?
a. Na b. Ca c. K |
b. Ca
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Extracellular Ca enters t-tubules during depolarization via what type of voltage gated receptors?
a. dihydorpyridine b. ryanodine |
a. dihydorpyridine are voltage gated receptors
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Calcium that is released from the sarcoplasmic tubules must cross _____ non-voltage channels.
a. dihydorpyridine b. ryanodine |
b. ryanodine are non-voltage gated receptors in sarcoplasmic reticulum
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_____ of contraction is directly dependent on the magnitude of initial influx of Ca.
a. Rate b. Force c. Repitition d. Size |
b. Force
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ATP is required for contraction, ___ is required for relaxation.
a. ADP b. gAMP c. cAMP d. ATP |
d. ATP
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Volatile anesthetics:
a. Increase Ca b. Decrease Ca |
b. decrease Ca = depress contractility
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PNS/SNS inhibits the heart and PNS/SNS stimulates the heart.
a. PSN, SNS b. SNS, PNS |
a. PNS, SNS
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PNS/SNS:
Primarily innervates the atria, conducting tissue and can decrease the CO to nearly 0. |
PNS
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PNS/SNS:
more widely distributed throughout the heart, has fibers that originate in the thoracic spinal cord T1-T4 and travel to the heart via cervical ganglia. |
SNS
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PNS/SNS:
Ach acts on cardiac muscarinic receptors to produce negative chronotropy, dromotropy and inotropy. |
PNS
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PNS/SNS:
Norepinephrine release activates B1 receptors causing positive chronotropy, dromotropy and inotropy. |
SNS
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PNS/SNS:
effects have more gradual onset and dissipation. |
SNS
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PNS/SNS:
effects have rapid onset and resolution. |
PNS
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This wave follows p-wave on ECG and is d/t atrial systole; provides 20-30% of ventricular filling.
a. a wave b. c wave c. v wave d. x descent e. y descent |
a. a wave
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Coincides with ventricular contraction against a closed AV valve.
a. a wave b. c wave c. v wave d. x descent e. y descent |
b. c wave
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Results from pressure build up from venous return before AV valve opens again
a. a wave b. c wave c. v wave d. x descent e. y descent |
c. v wave
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Decline in pressure between the c and v waves.
a. a wave b. c wave c. v wave d. x descent e. y descent |
d. x descent
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Follows v wave and represents decline in pressure as AV valve opens.
a. a wave b. c wave c. v wave d. x descent e. y descent |
e. y descent
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Sharp, narrow spikes which are atrial contraction against a closed AV valve, also called cannon waves.
a. a wave b. c wave c. v wave d. x descent e. y descent |
a. a waves
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Pronounced waves seen when atrial filling increases.
a. a wave b. c wave c. v wave d. x descent e. y descent |
c. v waves
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Aortic valve closing; caused by brief period of backward flow into LV immediately before valve closure, followed by sudden cessation of flow.
a. systole b. ejection c. incisura d. diastasis |
c. incisura = dicrotic notch
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Time period between closure of mitral valve to after closure of aortic valve and starts with action potential at SA node.
a. diastole b. systole |
b. systole
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Requires energy to reaccumulate cytoplasmic calcium in sarcoplasmic reticulum.
a. diastole b. systole |
a. diastole
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LAP<LVP<AoP, closes the MV, LVP continues to rise, without a change in ventricular volume.
a. atrial systole b. diastasis c. ejection d. isovolumic contraction |
d. isovolumic contraction
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When LVP exceeds Ao, rapid ejection (2/3 of SV), followed by slow ejection (1/3 of SV).
a. atrial systole b. diastasis c. ejection d. isovolumic contraction |
c. ejection
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Time after aortic valve closes but before MV opens, LAP>LVP:
a. atrial systole b. diastasis c. ejection d. isovolumic relaxation |
d. isovolumic relaxation
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Passive filling, as LVP approaches LAP:
a. atrial systole b. diastasis c. ejection d. isovolumic relaxation |
b. diastasis
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"Atrial Kick" 20-30% of ventricular filling; in stiff ventricles may provide 40% of EDV
a. atrial systole b. diastasis c. ejection d. rapid filling phase |
a. atrial systole
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"Suction" of blood thru open MV
a. atrial systole b. diastasis c. ejection d. rapid filling phase |
d. rapid filling phase
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MVO2 saturation is the best determinant of CO in the absence of what 2 things?
a. anemia b. hypokalemia c. hypoxia d. SVR |
a. anemia
c. hypoxia |
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The volume before ejection @ 110-120ml is:
a. EDV b. SV c. ESV d. EF |
a. EDV
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The ejected volume @ 70ml
a. EDV b. SV c. ESV d. EF |
b. SV
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Volume remaining after ejection @ 40-50ml.
a. EDV b. SV c. ESV d. EF |
c. ESV
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The fraction of EDV that is ejected. Normal is @ 68%.
a. EDV b. SV c. ESV d. EF |
d. EF
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A principle of physics that the tension on the wall of a sphere is the product of the pressure x the radius of the chamber and the tension is inversely related to the thickness of the wall.
a. Starling's Law b. LaPlace's Law c. Ohm's Law |
b. LaPlace's Law
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Flow= pressure/resistance describes what law?
a. Starling's Law b. LaPlace's Law c. Ohm's Law |
c. Ohm's Law
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The greater the end-diastolic volume, the greater the stroke volume describes what law?
a. Starling's Law b. LaPlace's Law c. Ohm's Law |
a. Starling's Law
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Afterload is:
a. muscle length prior to contraction b. the tension against which the muscle must contract c. intrinsic property of the muscle that influences force of contraction d. none of the above |
b. the tension against which the muscle must contract
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Preload is:
a. muscle length prior to contraction b. the tension against which the muscle must contract c. intrinsic property of the muscle that influences force of contraction d. none of the above |
a. muscle length prior to contraction
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Contractility is:
a. muscle length prior to contraction b. the tension against which the muscle must contract c. intrinsic property of the muscle that influences force of contraction d. none of the above |
c. intrinsic property of the muscle that influences force of contraction
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T/F As we age, our intrinsic heart rate decreases.
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True
HR = 118bpm-(0.57xage) |
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PNS/SNS has the most important effect on contractility.
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SNS, it is also altered by neural, humoral, and pharmacologic factors
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With ventricular filling elastance (decreases/increases) passively and compliance (decreases/increases).
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elastance increases passively
compliance decreases |
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With contraction elastance (decreases/increases).
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Increases rapidly & actively
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With isovolumic relaxation elastance (decreases/increases) and compliance (decreases/increases).
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elastance decreases
compliance increases |
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What is the most important detrminant of preload?
a. HR b. Muscle length prior to contraction c. RV EDP d. venous return |
d. venous return
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The echo reads: a)Anterioseptal akinesis, b)RV dyskinesis, and c)LV hypokinesis. What is the most serious finding of this reading.
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b. RV dyskinesis
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Which of the following external pressures effect CO? (more than 1)
a. cyclic changes of breathing b. breathing against - pressure c. + pressure ventilation d. opening thoracic cage e. cardiac tamponade |
a, b, c, d, e
all of these effect CO |
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ANS and non pathological hypertrophy ( think marathoners) can cause a heart to be:
a. hypereffectie b. hypoeffective c. normal |
a. hypereffective
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Nervous inhibition, abnormal rate, rhythm, hypertension, ischemia or valvular disease can cause a heart to be:
a. hypereffective b. hypoeffective c. normal |
b. hypoeffective
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What is the most stressful event for the circulatory system?
a. birth and the transition from fetal circulation b. strenuous exercise c. myocardial ischemia d. advanced age |
b. strenuous exercise
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(Hgb)(1.34ml)(%saturation) + (0.003)(PO2) is the equation for what?
a. Myocardial oxygen demand b. O2 content of arterial blood c. Mixed venous saturation d. Coronary blood flow |
b. O2 content of arterial blood
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Ensuring max O2 content involves high Hgb, highly saturated blood and high PO2. What other factors favor tissue release of O2?
a. Normal temperature b. Normal PH c. high levels of 2,3 DPG d. all of the above |
d. all of the above
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O2 content of arterialblood, O2 to myocardium, CBF, CVR and _____ are all determinants of myocardial oxygen supply.
a. Hydraulic factors b. Contractility c. HR d. autoregulation |
d. autoregulation (maintains a constant blood flow from 50-150mmHg)
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These metabolic factors decrease CVR:
a. Increased O2, CO2, H b. Increased O2, H, decreased CO2 c. Decreased O2, increased CO2, H d. none of these have any effect |
c. Decreased O2, increased CO2, H
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The autonomic nervous system contricts and dilates the coronary vasculature. Which constricts and which dilates respectively?
a. alpha 1/ beta b. beta/ alpha 1 |
a. alpha 1 constricts/ beta dilates
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____ = AoDBP - LVEDP
a. DBP b. HR c. CPP d. CBF |
c. CPP
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Goals to optimize CPP are normal to high DBP and:
a. low LVEDP, low HR b. high LVEDP, high HR c. low LVEDP, high HR d. high LVEDP, low HR |
a. low LVEDP, low HR
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What are the types of stenosis?
a. dynamic, fixed, local b. focal, fixed, diffuse c. segmental, dynamic, diffuse d. focal, dynamic, fixed |
d. focal, dynamic, fixed
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The cath report reads 50% lesion in the LM. 1) What % decrease in flow and 2) what symptoms would you expect?
a. 50%, no symptoms b. 75%, angina on exertion c. 98%,angina at rest |
b. 75%, angina on exertion
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What are the determinants of Myocardial Oxygen Demand?
a. SBP, HR, contractility b. MVO2 by direct measurement c. HR, contractility, wall stress d. There is no way to determine |
c. HR, contractility, wall stress
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T/F: MVO2 more than doubles with a doubling of the HR is a linear relationship.
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F: MVO2 more than doubles with a doubling of the HR, but it is not a linear relationship
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T/F: Contractility is not influenced by preload and afterload.
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T
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While looking at your A line, what infers good contractility?
a. brisk rise b. visible dicrotic notch c. brisk fall in slope d. frequency of wave forms |
a. brisk rise
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Increased wall thickness = (less/more) stress and (increase/decrease) in MVO2.
a. less/decrease b. less/increase c. more/decrease d. more/increase |
b. less wall stress (disperses the workload)
increase MVO2 |
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LV: Increase pressure has what effect on O2 demand, Increase volume has what effect on O2 demand.
a. modest increase, doubles b. no effect, doubles c. doubles, doubles d. doubles, modest increase |
d. doubles, modest increase
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ST changes on an ECG occur when in relation to ischemia?
a. simultaneously b. within 30 seconds c. 60-120 seconds after d. 30-60 seconds before |
c. 60-120 seconds after
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Monitoring in an inferior lead (II, III, aVF) and V5 detects what % of ischemic events?
a. 90% b. 75% c. 50% d. <50% |
a. 90%
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T/F: A new V wave on PCWP wave form is associated with functional MR d/t new ischemic papillary muscle dysfunction.
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True
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Cause of death after Acute Coronary Occlusion is d/t:
a. Decreased CO b. Damming of blood in venous system c. fibrillation d. rupture of infarcted area e. all of the above |
e. all of the above
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