Multiple Choice Questions: A. B. C. D

Chapter 12 - Cardiovascular Physiology
Chapter 12
Cardiovascular Physiology

Multiple Choice Questions

1. Which of the following is not primarily a function of blood plasma?

A. Transport of hormones
B. Maintaining the size of red blood cells
C. Providing protein osmotic pressure favoring fluid absorption in the capillaries
D. Providing clotting factors that are ready to be activated
E. Transport of oxygen
Bloom's Level: 1. Remember

Section 12A.01
Topic: Cardiovascular System

2. Which of the following does not describe erythrocytes? They

A. Contain myoglobin
B. Have a high surface-to-volume ratio
C. Carry oxygen and carbon dioxide in blood
D. Are red
E. Have no nucleus

Section 12A.01

3. The process of erythrocyte production is called

A. Hemaglutination
B. Erythrocytosis
C. Erythropoiesis
D. Erythroblastosis
E. Hemostasis
Bloom's Level: 2. Understand

Section 12F.02

12-1
4. Anemia
A. Can be caused by too little iron in the diet
B. Can be caused by kidney failure
C. Can be caused by abnormal hemoglobin
D. Refers to reduced oxygen-carrying capacity of the blood
E. Is described by all of these choices

Section 12F.02

5. A female patient has a blood test. One ml of her blood is drawn, spun in a centrifuge, and
the plasma volume is measured and found to be 0.6 ml. Two months later the same patient
returns to the doctor and, after doing another blood test, the doctor tells the patient that she
has become anemic compared to her previous visit. Which of the following is most likely to
be the woman's hematocrit on the second visit?
A. 35%
B. 50%
C. 70%
D. 100%
E. 0.6 ml
Bloom's Level: 4. Analyze

Section 12A.01

6. A male patient complains of physical weakness and fatigue. A blood test shows his
hematocrit to be 35%. Which of the following diagnoses is the least likely to explain his
symptoms?
A. Internal bleeding
B. Dietary iron deficiency
C. Dietary vitamin B12 deficiency
D. Lung disease
E. Kidney disease
Bloom's Level: 3. Apply

Section 12F.02

12-2
7. Most of the iron in a person's body is

A. Stored in the bone marrow
B. Stored in the liver
C. Found in the cytochromes
D. Found in erythrocytes
E. Excreted daily

Section 12F.02

8. Dietary requirements for optimal erythrocyte production and function include

A. Iron
B. Vitamin B12
C. Erythropoietin
D. Iron and vitamin B12
E. All of these things

Section 12F.02

9. Consider the equation F = DP/R.

It describes the flow (F) of fluid in a tube in which there is a pressure difference (DP) between
the two ends and a resistance (R) to flow. The equation indicates that
A. The flow of fluid in a tube depends upon the absolute pressure at the beginning of the tube
B. The flow of fluid from point A to point B in a tube depends upon the difference in pressure
between A and B
C. The greater the resistance to flow in a tube, the greater the flow for any given pressure
difference
D. Both the flow of fluid in a tube depends upon the absolute pressure at the beginning of the
tube and the greater the resistance to flow in a tube, the greater the flow for any given
pressure difference are correct
E. Both the flow of fluid from point A to point B in a tube depends upon the difference in
pressure between A and B and the greater the resistance to flow in a tube, the greater the flow
for any given pressure difference are correct

Section 12A.02

12-3
12-4
10. Which of the following changes would most increase the resistance to blood flow in a
blood vessel?
A. Halving the diameter of the vessel
B. Doubling the diameter of the vessel
C. Halving the length of the vessel
D. Doubling the length of the vessel
E. Decreasing the hematocrit from 50% to 40%

Section 12A.02

11. Cardiac and smooth muscle share some characteristics, including

A. Desmosomes
B. Gap junctions
C. Pacemaker capability in some cells
D. Gap junctions and pacemaker capability in some cells
E. All of these things

Section 12B.02

12. The pacemaker of the heart is normally the

A. Sinoatrial node
B. Atrioventricular node
C. Mitral valve
D. Bundle of His
E. Left ventricle

Section 12B.02

12-5
13. Which of the following criteria must be met for the heart to function efficiently?
A. Excitation and the consequent contraction of the cardiac muscle fibers of each heart
chamber should be coordinated to assure efficient pumping
B. The atria should be excited and contract before the onset of ventricular contraction to
assure that ventricular filling is complete
C. The right side of the heart should contract first to assure that oxygenated blood is delivered
to the heart before the left side contracts
D. Both excitation and the consequent contraction of the cardiac muscle fibers of each heart
chamber should be coordinated to assure efficient pumping and the atria should be excited
and contract before the onset of ventricular contraction to assure that ventricular filling is
complete are correct
E. All of the choices are correct

Section 12B.03

14. Which of the following statements concerning the differences between action potentials in
skeletal-muscle cells and in ventricular cardiac muscle cells is true?
A. Like skeletal-muscle cells, ventricular cardiac-muscle cells have a resting membrane
potential closer to the sodium equilibrium potential than to the potassium equilibrium
potential
B. Unlike skeletal-muscle cells, the initial depolarization of ventricular cells is mainly due to
calcium influx, not sodium influx
C. After sodium influx through fast channels occurs in ventricular cells, an influx of calcium
occurs. No such calcium influx occurs after sodium influx in the skeletal-muscle cells
D. Action potentials in skeletal-muscle cells are longer in duration than action potentials in
cardiac cells
E. All of the choices are true

Section 12B.02

12-6
15. Which of the following statements is true concerning the depolarization of a cell in the
SA node?
A. The cell will not depolarize until it receives sympathetic stimulation
B. The pacemaker potential is caused by calcium entering the cell via slow channels
C. The pacemaker potential is slower in achieving threshold when acetylcholine is applied to
the SA cells
D. Both the pacemaker potential is caused by calcium entering the cell via slow channels and
the pacemaker potential is slower in achieving threshold when acetylcholine is applied to the
SA cells are correct
E. None of the choices are true

Section 12B.04

16. If action potential propagation through the bundle of His were blocked, which of the
following events would you expect to occur?
A. There would be a slowing of the rate of contraction of the ventricles
B. The atria would contract more frequently than the ventricles
C. The SA node would no longer set the pace for atrial contraction
D. Both there would be a slowing of the rate of contraction of the ventricles and the atria
would contract more frequently than the ventricles would occur
E. All of these things would occur
Bloom's Level: 4. Analyze

Section 12B.02

17. The plateau of the action potential in cardiac ventricular cells results from the opening of
voltage-gated slow ___________ channels in the plasma membrane of the cell.
A. Sodium
B. Potassium
C. Calcium
D. Chloride
E. Glucose

Section 12B.02

12-7
12-8
18. Which of the following statements about membrane potentials in different types of cardiac
muscle cells is correct?
A. Myocardial cells have a resting membrane potential of about -90 mV; pacemaker cells do
not have a true resting membrane potential
B. Once threshold depolarization is reached in both myocardial and pacemaker cells, the rapid
upswing of the action potential is caused by the opening of voltage-gated sodium channels
C. Voltage-gated calcium channels are opened at some time during the action potential in both
myocardial and pacemaker cells
D. Both myocardial cells have a resting membrane potential of about -90 mV; pacemaker cells
do not have a true resting membrane potential and once threshold depolarization is reached in
both myocardial and pacemaker cells, the rapid upswing of the action potential is caused by
the opening of voltage-gated sodium channels are correct
E. Both myocardial cells have a resting membrane potential of about -90 mV; pacemaker cells
do not have a true resting membrane potential and voltage-gated calcium channels are opened
at some time during the action potential in both myocardial and pacemaker cells are correct

Section 12B.02

19. In an electrocardiogram, the QRS complex represents the

A. Depolarization of the atria
B. Repolarization of the atria
C. Depolarization of the ventricles
D. Repolarization of the ventricles
E. The delay at the AV node

Section 12B.02

12-9
20. An ECG would be useful for determining a patient's

A. Heart murmur
B. Stroke volume
C. Cardiac output
D. Blockage of conduction of electrical signals between the atria and the ventricles
E. None of the choices are correct

Section 12B.02

12-10
21. Comparing excitation-contraction coupling in cardiac muscle with that in skeletal muscle:

A. Extracellular calcium plays a major role in cardiac but not skeletal muscle
B. The stimulus for calcium release from the sarcoplasmic reticulum is the same in both
muscles
C. Troponin sites are always saturated immediately after calcium release in both muscles
D. There is no net change in total intracellular calcium concentration in either muscle
E. Both extracellular calcium plays a major role in cardiac but not skeletal muscle and the
stimulus for calcium release from the sarcoplasmic reticulum is the same in both muscles are
correct

Section 12B.02

22. Which of the following statements about the absolute refractory period of cardiac muscle
cells is true?
A. It lasts almost as long as the resultant period of contraction of the cells
B. It is much longer than the refractory period of skeletal muscle cells
C. It allows for tetanic contractions of the heart to occur to assure smooth, coordinated
ejection of blood from the ventricles
D. Both it lasts almost as long as the resultant period of contraction of the cells and it is much
longer than the refractory period of skeletal muscle cells are true

Section 12B.02

12-11
23. Which of the following statements about the refractory period of nerve or muscle
membranes is correct?
A. In nerve cells, the absolute refractory period coincides with the period of increased K+
permeability
B. In skeletal-muscle cells, the absolute refractory period lasts almost as long as the twitch
C. In ventricular cells, the absolute refractory period coincides with the period of increased
Na+ and Ca2+ permeability
D. Both in nerve cells, the absolute refractory period coincides with the period of increased
K+ permeability and in skeletal-muscle cells, the absolute refractory period lasts almost as
long as the twitch are correct
E. Both in skeletal-muscle cells, the absolute refractory period lasts almost as long as the
twitch and in ventricular cells, the absolute refractory period coincides with the period of
increased Na+and Ca2+ permeability are correct

Section 12B.02

24. Which of the following statements about the cardiac cycle is true?
A. The duration of systole is greater than that of diastole
B. During isovolumetric ventricular relaxation, blood flows from the atria into the ventricles
C. Closure of the atrioventricular valves occurs at the onset of systole
D. Both the duration of systole is greater than that of diastole and during isovolumetric
ventricular relaxation, blood flows from the atria into the ventricles are true
E. Both during isovolumetric ventricular relaxation, blood flows from the atria into the
ventricles and closure of the atrioventricular valves occurs at the onset of systole are true

Section 12B.03

12-12
25. Which of the following statements regarding the cardiac cycle is correct?
A. The AV valves are open during mid-to-late diastole
B. The aortic valve is open during isovolumetric ventricular contraction
C. The first heart sound is the closing of the semilunar valves
D. Both the AV valves are open during mid-to-late diastole and the aortic valve is open
during isovolumetric ventricular contraction are correct
E. Both the AV valves are open during mid-to-late diastole and the first heart sound is the
closing of the semilunar valves are correct

Section 12B.03

26. During the cardiac cycle,

A. The volume of blood leaving the left side of the heart is greater than that leaving the right
side
B. The pressure of blood leaving the right side of the heart is greater than that leaving the left
side
C. The duration of systole is greater than that of diastole
D. The duration of diastole is greater than that of systole
E. Both the volume of blood leaving the left side of the heart is greater than that leaving the
right side and the duration of diastole is greater than that of systole occur

Section 12B.03

27. The aortic valve

A. Prevents the backflow of blood into the aorta during ventricular diastole
B. Prevents the backflow of blood into the left ventricle during ventricular diastole
C. Prevents the backflow of blood into the left ventricle during ventricular ejection
D. Prevents the backflow of blood into the aorta during ventricular ejection
E. Closes when the first heart sound is heard

Section 12B.03

12-13
28. During isovolumetric ventricular contraction,

A. Rapid filling of the ventricles occurs
B. No blood enters or leaves the ventricles
C. The maximum volume of blood is ejected
D. Ventricular pressure is at a maximum
E. None of these things would occur

Section 12B.03

29. The heart valves open and close due to

A. Stimulation by the sympathetic and parasympathetic nerves
B. A pressure difference on the two sides of the valve
C. Na+ and K+ fluxes during ventricular depolarization
D. Turbulent flow in the atria and ventricles

Section 12B.03

30. A heart murmur that is detected between the first and second heart sounds is indicative of
A. Insufficiency of a semilunar valve or stenosis of an AV valve

B. Insufficiency of an AV valve or stenosis of a semilunar valve
C. Heart failure
D. Heart block
E. A myocardial infarction

Section 12B.03

12-14
31. Cardiac output is the

A. Volume of blood pumped per minute by both ventricles
B. Volume of blood flowing through the systemic circulation each minute
C. Product of the number of heartbeats per minute and the volume pumped per beat
D. Both volume of blood pumped per minute by both ventricles and product of the number of
heartbeats per minute and the volume pumped per beat are correct
E. Both volume of blood flowing through the systemic circulation each minute and product
of the number of heartbeats per minute and the volume pumped per beat are correct

Section 12B.04

32. Sinoatrial node cells

A. Are normally the pacemakers of the heart
B. Exhibit spontaneous depolarization that is speeded by activation of their cholinergic
receptors
C. Exhibit spontaneous depolarization that is speeded by activation of their beta-adrenergic
receptors
D. Both are normally the pacemakers of the heart and exhibit spontaneous depolarization that
is speeded by activation of their cholinergic receptors are correct
E. Both are normally the pacemakers of the heart and exhibit spontaneous depolarization that
is speeded by activation of their beta-adrenergic receptors are correct

Section 12B.04

33. With regard to the regulation of heart rate,

A. Stimulation of parasympathetic nerves to the heart causes a slowing of heart rate
B. Stimulation of sympathetic nerves to the heart causes an increase in heart rate
C. A person whose heart lacks autonomic innervation has a faster heart rate at rest than a
person with a normally innervated heart
D. Both stimulation of parasympathetic nerves to the heart causes a slowing of heart rate and
stimulation of sympathetic nerves to the heart causes an increase in heart rate are true

Section 12B.04

12-15
12-16
34. The discharge rate of the SA node is

A. Increased by parasympathetic stimulation
B. Decreased by sympathetic stimulation
C. Increased by acetylcholine
D. Increased by epinephrine

Section 12B.04

35. The Frank-Starling mechanism of the heart describes

A. The relationship between end-diastolic volume and heart rate
B. The relationship between end-diastolic volume and stroke volume
C. The relationship between length and tension in cardiac muscle
D. The relationship between end-diastolic volume and heart rate and the relationship between
length and tension in cardiac muscle
E. The relationship between end-diastolic volume and stroke volume and the relationship
between length and tension in cardiac muscle

Section 12B.04

36. According to the Frank-Starling mechanism of the heart,

A. The left ventricle ejects a larger volume of blood with each systole than the right ventricle
B. The intrinsic rate of the heart's pacemaker is 100 beats/min
C. Cardiac output increases with increased heart rate
D. Stroke volume increases with increased venous return
E. Both ventricles contract simultaneously

Section 12B.04

12-17
37. Which of the following is not an effect of sympathetic stimulation of the heart?

A. It increases heart rate
B. It decreases the duration of systole
C. It decreases the slope of the pacemaker potential
D. It increases the amount of calcium ion entering cardiac cells
E. It increases the rate of cross-bridge cycling in ventricular cells

Section 12B.04

38. Which of the following statements about blood vessel structure and function is false?
A. Veins are more compliant than arteries
B. The aorta and other large arteries serve as a pressure reservoir for the circulatory system
C. Arterioles are small vessels whose resistance to blood flow can be varied
D. Arterioles, capillaries, and veins all have valves that allow only one-way flow of blood
E. If your blood pressure is 100/70 your mean arterial blood pressure is ~80 mm Hg

Section 12C.04

12-18
39. Which of the following statements concerning regulation of blood flow is true?

A. Increased levels of metabolic waste products and decreased oxygen concentration in
tissues promote hyperemia through the tissues
B. If blood flow to a tissue is blocked for a period of time and then the block is removed, the
result is a reactive hyperemia in which blood flow through the affected tissue remains low
C. According to flow autoregulation, if blood pressure to an arteriole is decreased, blood flow
will not return toward its original level until the original blood pressure is restored
D. Both increased levels of metabolic waste products and decreased oxygen concentration in
tissues promote hyperemia through the tissues and if blood flow to a tissue is blocked for a
period of time and then the block is removed, the result is a reactive hyperemia in which
blood flow through the affected tissue remains low are true
E. Both increased levels of metabolic waste products and decreased oxygen concentration in
tissues promote hyperemia through the tissues and according to flow autoregulation, if blood
pressure to an arteriole is decreased, blood flow will not return toward its original level until
the original blood pressure is restored are true

Section 12C.02

12-19
40. Active hyperemia refers to

A. Increased metabolic activity that results in vasoconstriction
B. Increased metabolic activity that results in vasodilation
C. Decreased blood flow to tissues that results in vasoconstriction
D. Decreased blood flow to tissues that results in vasodilation

Section 12C.02

41. Which of the following statements concerning control of blood flow through arterioles is
true?
A. Beta-adrenergic receptors are more abundant on most arteriolar smooth muscle than are
alpha-adrenergic receptors
B. Binding of epinephrine to alpha-adrenergic receptors causes vasodilation
C. Increased stimulation of vascular smooth muscle by the parasympathetic nervous system
causes increased vasoconstriction
D. If the arterial blood pressure to an organ suddenly decreases, arterioles in the organ will
dilate in response

Section 12C.02

42. Blood flow through most organs is regulated primarily by increasing or decreasing the
________ activity to arteriolar smooth muscles in the organ. Another form of regulation,
called ________, depends upon the metabolic activity of the organ. Increased activity leads to
increased interstitial-fluid metabolites, which cause ________ of the arterioles. The former is
a type of ________ regulation of blood flow; the latter is an example of ________ regulation.
A. Sympathetic; active hyperemia; dilation; extrinsic; intrinsic
B. Sympathetic; reactive hyperemia; dilation; intrinsic; extrinsic
C. Parasympathetic; active hyperemia; constriction; extrinsic; intrinsic
D. Sympathetic; flow autoregulation; constriction; intrinsic; extrinsic
E. Parasympathetic; reactive hyperemia; dilation; extrinsic; intrinsic

Section 12C.02

12-20
12-21
43. If the arterial blood pressure in the brain is suddenly decreased, the flow through arterioles
in the brain will immediately fall and then return to near their original levels due to flow
autoregulation.
A. This statement is false. The arterioles of the brain do not exhibit flow autoregulation to any
significant extent
B. This statement is false. The flow of blood will only rise
C. This statement is false. The flow of blood will only fall
D. This statement is false. The flow of blood will not change
E. This statement is true

Section 12C.02

44. Normally, the hydrostatic pressure difference between capillary fluid and interstitial fluid
favors movement of fluid (into/out of) the capillary. The osmotic pressure difference between
capillary fluid and interstitial fluid favors movement of fluid (into/out of) the capillary.
A. Into; into
B. Into; out of
C. Out of; out of
D. Out of; into

Section 12C.03

45. Which of the following statements concerning the capillaries is false?

A. Increasing capillary hydrostatic pressure decreases the likelihood that filtration will occur
B. Velocity of blood flow is slower in the capillaries than in the arteries
C. It is possible for a capillary to filter at its arterial end and absorb at its venous end
D. Discontinuous endothelium is more likely to be found in liver capillaries than in brain
capillaries
E. Large proteins that enter the interstitial fluid are returned to the circulation via the
lymphatic system

Section 12C.03

12-22
46. Capillary exchange is somewhat different in the pulmonary capillaries and produces

interstitial fluids which have a higher accumulation of proteins than in other areas of the body
because
A. Pulmonary circulation is low resistance
B. The pulmonary circuit is a low pressure circuit
C. The pulmonary capillary hydrostatic pressures in this area is lower than at other locations
D. The Starling forces present in the lungs, favor filtration

Section 12C.03

47. Distinguishing characteristics of veins include which of the following?

A. All veins carry deoxygenated blood
B. All veins carry blood toward the heart
C. All veins have thick, elastic walls
D. Both all veins carry deoxygenated blood and all veins carry blood toward the heart are
correct
E. Both all veins carry blood toward the heart and all veins have thick, elastic walls are
correct

Section 12C.04

48. Movement of blood in veins is determined by

A. The blood pressure difference between veins and atria
B. The skeletal pump
C. The decrease of thoracic pressure and increase of abdominal pressure due to diaphragm
movement
D. Valves in the veins

Section 12C.04

12-23
49. Which of the following is a result of increased sympathetic stimulation of vascular smooth

muscle?
A. Filtration in capillaries increases
B. Total arteriolar diameter increases
C. The percentage of blood volume in the veins increases
D. Blood flow to the brain decreases
E. Venous return of blood to the heart increases

Section 12C.04

50. Which of the following factors would not tend to increase blood pressure directly?
A. Increased sympathetic stimulation of the blood vessels
B. Increased blood volume
C. Increased venous return
D. Increased parasympathetic stimulation of the heart
E. Increased activity of the skeletal muscle pump

Section 12D.01

51. Hypotension
A. Refers to blood loss
B. Can be caused by sweating, vomiting, or emotional responses
C. Stimulates increased firing of the arterial baroreceptors
D. Both refers to blood loss and stimulates increased firing of the arterial baroreceptors are
correct
E. Both can be caused by sweating, vomiting, or emotional responses and stimulates increased
firing of the arterial baroreceptors are correct

Section 12E.01

12-24
52. Jane donates a pint of blood to a blood bank. A few minutes later, which of the following
would be increased compared to its/their pre-donation values?
A. Her stroke volume and total peripheral resistance
B. Her heart rate and total peripheral resistance
C. Her heart rate and mean arterial pressure
D. The percentage of her cardiac output flowing to her kidneys
E. Blood flow to her brain

Section 12D.01

53. Jane donates a pint of blood to a blood bank. A few minutes later, which of the following
would be decreased compared to its/their pre-donation values?
A. Her stroke volume and total peripheral resistance
B. Her heart rate and total peripheral resistance
C. Her heart rate and mean arterial pressure
D. The percentage of her cardiac output flowing to her kidneys
E. Blood flow to her brain

Section 12D.01

54. The body responds to hemorrhage by

A. Decreasing the heart rate below normal
B. Decreasing total peripheral resistance to below normal levels
C. Raising mean arterial pressure to above normal
D. Increasing cardiac output to above normal levels
E. Keeping mean arterial pressure to levels approaching but below normal

Section 12E.01

12-25
55. Following hemorrhage, reflexes are triggered that attempt to compensate for the blood
loss. As a result of the blood loss and the reflex mechanisms, which of the following will be
true, compared to prehemorrhage values?
A. Both cardiac output and total peripheral resistance will be increased
B. Both cardiac output and total peripheral resistance will be decreased
C. Cardiac output will be increased and total peripheral resistance will be decreased
D. Cardiac output will be decreased and total peripheral resistance will be increased
E. Hematocrit will be increased

Section 12E.01

56. How would a hemorrhage immediately affect the activity of the baroreceptors?

A. The baroreceptors would decrease their rate of firing. This would cause vasodilation and a
decrease in cardiac output, which together would decrease blood pressure
B. The baroreceptors would increase their rate of firing. This would cause vasoconstriction
and an increase in cardiac output, which together would increase blood pressure
C. The baroreceptors would decrease their rate of firing. This would cause vasoconstriction
and an increase in cardiac output, which together would increase blood pressure
D. The baroreceptors would increase their rate of firing. This would cause vasodilation and a
decrease in cardiac output, which together would decrease blood pressure
E. The baroreceptors would decrease their rate of firing. This would cause vasodilation and an
increase in cardiac output, which together would decrease blood pressure

Section 12E.01

57. Which of the following would a soldier standing very still, at attention, likely experience?
A. Decreased pressure in the capillaries of the feet
B. Increased absorption of interstitial fluid by the capillaries of the feet
C. Increased storage of blood in the veins of the feet and legs
D. Increased venous return

Section 12E.02

12-26
12-27
58. During exercise, there is an increased flow of blood to

A. The brain
B. The kidneys
C. The skin
D. The kidneys and the skin

Section 12E.03

59. Which of the following does not contribute to increased stroke volume during exercise?
A. Increased contractility of cardiac muscle
B. Increased venous return
C. Increased length of filling time during diastole
D. Increased sympathetic stimulation of ventricular muscle
E. Increased end-diastolic volume

Section 12E.03

60. Physical endurance training enhances a person's

A. Maximal cardiac output
B. Maximal stroke volume
C. Maximal heart rate
D. Both maximal cardiac output and maximal stroke volume are correct

Section 12E.03

12-28
61. A trained athlete differs from a "couch potato" in that the athlete has
A. A lower heart rate at rest
B. A higher heart rate at rest
C. Greater stroke volume at maximal effort
D. A lower heart rate at rest and greater stroke volume at maximal effort
E. A higher heart rate at rest and greater stroke volume at maximal effort

Section 12E.03

62. Which of the following does not describe hypertension? Hypertension

A. Refers to a chronic state of elevated blood pressure
B. Is usually defined as a systolic pressure greater than 140 mm Hg and a diastolic pressure
greater than 90 mm Hg
C. Is usually a result of chronically elevated cardiac output
D. May be caused by kidney disease
E. Can sometimes be treated with drugs that increase excretion of water in the urine

Section 12E.04

63. Traditionally, a "normal" blood pressure is considered to be 120 systolic/80 diastolic, but

presently new guidelines suggest that medical interventions should be initiated for treating
hypertension at systolic pressures of ____ and diastolic pressures of _____.
A. 130-139, 85-89
B. 140-154, 90-95
C. 155-160, 96-101
D. 110-119, 70-79
E. Actually this is determined by individual physicians without regard to accepted norms

Section 12E.04

12-29
64. Which of the following drugs might be prescribed to alleviate hypertension?

A. An alpha-adrenergic receptor agonist
B. A beta-adrenergic receptor antagonist
C. A cholinergic antagonist
D. Both an alpha-adrenergic receptor agonist and a cholinergic antagonist are correct
E. Both a beta-adrenergic receptor antagonist and a cholinergic antagonist are correct

Section 12E.04

65. Which of the drug treatments listed below is mismatched to its mode of action in treating
hypertension?
A. Alpha-adrenergic receptor blockers - reduce TPR by decreased stimulation
B. of arteriolar smooth muscle
C. Antagonists of parasympathetic receptors - reduce TPR by decreased
D. stimulation of arteriolar smooth muscle
E. Diuretics - increase excretion of sodium and water in urine
F. Calcium channel blockers - reduce speed and force of contraction in vascular smooth
muscle
G. ACE inhibitors - lowers peripheral resistance by promoting vasodilation

Section 12E.04

66. Which of the following is not likely to result in edema?

A. Blockage of lymph vessels
B. Prolonged standing
C. Liver disease
D. Heart failure
E. Elevated plasma protein concentrations

Section 12E.05

12-30
67. Atherosclerosis is
A. The major cause of heart attacks
B. A thinning in the walls of arteries
C. Associated with low blood levels of cholesterol and heavy exercise
D. The major cause of heart attacks and is associated with low blood levels of cholesterol and
heavy exercise

Section 12E.07

68. Hemostasis
A. Is the maintenance of relatively stable conditions in the internal environment
B. Refers to the prevention or stoppage of blood loss
C. Is dependent upon platelet aggregation
D. Both is the maintenance of relatively stable conditions in the internal environment and
refers to the prevention or stoppage of blood loss are correct
E. Both refers to the prevention or stoppage of blood loss and is dependent upon platelet
aggregation are correct

Section 12F.03

69. Which of the following occurs first in hemostasis?

A. Activation of the fibrinolytic system
B. Platelet aggregation
C. A clotting cascade that leads to the conversion of fibrinogen to stable fibrin
D. Conversion of prothrombin to thrombin
E. Conversion of plasminogen to plasmin

Section 12F.03

12-31
70. Platelets participate in hemostasis by

A. Aggregating to form a plug
B. Releasing chemicals that promote vasoconstriction
C. Secreting prostacyclin, which prevents platelet aggregation on blood vessel endothelium
D. Aggregating to form a plug and releasing chemicals that promote vasoconstriction

Section 12F.03

71. Platelet aggregation is

A. The first step in the formation of a platelet plug
B. Stimulated by ATP
C. Stimulated by von Willebrand factor
D. Stimulated by the conversion of arachidonic acid in platelet plasma membranes to
prostacyclin
E. Described by none of these choices

Section 12F.03

72. Which of the following statements regarding blood clotting is true?

A. Blood clotting requires activation of thrombin
B. Blood clotting is the result of a cascade of enzyme activation
C. A blood clot is a network of interlacing strands of fibrinogen
D. Both blood clotting requires activation of thrombin and blood clotting is the result of a
cascade of enzyme activation are true

Section 12F.03

12-32
73. Which of the following statements about blood clotting is not true? Blood clotting
A. Is the formation of a thrombus
B. Occurs after formation of a platelet plug in a damaged vessel
C. Requires the presence of erythrocytes
D. Is a result of a cascade of enzyme activation
E. Is an example of positive feedback

Section 12F.03

74. Which of the following statements regarding the dissolving of blood clots is true?
A. Activation of the reactions that lead to blood clotting ultimately lead to blood clot
dissolution
B. Blood clot dissolution requires activation of thrombin
C. Blood clots are digested by plasmin
D. Both activation of the reactions that lead to blood clotting ultimately lead to blood clot
dissolution and blood clot dissolution requires activation of thrombin are true

Section 12F.03

75. Which of the following is not an anticoagulant or stimulator of blood clot dissolution?

A. Vitamin K
B. Aspirin
C. Thrombin
D. Heparin
E. Tissue plasminogen activator

Section 12F.03

12-33
76. Protein C
A. Is present in active form at all times in the blood plasma
B. Inhibits clot formation
C. Inactivates factors Va and VIIIa
D. Inactivates thrombin
E. Both inhibits clot formation and inactivates factors Va and VIIIa are correct

Section 12F.03

True / False Questions

77. An anemic person is likely to have higher than normal plasma levels of erythropoietin.
TRUE

Section 12F.02

78. The primary stimulus for erythropoietin secretion is decreased iron concentrations in the
liver.
FALSE

Section 12F.02

79. Blood vessels that carry well-oxygenated blood are called arteries.

FALSE

Section 12C.01

12-34
80. At rest, more blood flows per minute to the kidneys and abdominal organs than to the
muscles and skin.
TRUE

Section 12B.04

81. At rest, more blood flows per minute to the skin and abdominal organs than to the lungs.
FALSE

Section 12B.04

82. The myocardial cells receive their blood supply from the cardiac arteries that branch off
from the aorta.
FALSE

Section 12B.01

83. A major difference between the contractile cardiac cells and the cells in the cardiac
conducting system is that the contractile cells do not undergo spontaneous depolarization.
TRUE

Section 12B.01

12-35
84. The sinoatrial node is normally the heart's pacemaker because it has the fastest
spontaneous rate of depolarization.
TRUE

Section 12B.02

12-36
85. The wave of contraction that spreads through the ventricles starts at their tips and flows
upward.
TRUE

Section 12B.02

86. An ectopic focus is an area of the myocardial conducting system, other than the
atrioventricular node, that initiates cardiac depolarization.
FALSE

Section 12B.02

87. The QRS wave of the ECG corresponds to depolarization of the atria.

FALSE

Section 12B.02

88. An electrocardiogram would be useful for diagnosing diseases involving the valves of the
heart.
FALSE

Section 12B.02

12-37
89. Cardiac muscle cannot undergo tetanus because its absolute refractory period lasts almost
as long as the muscle twitch.
TRUE

Section 12B.02

12-38
90. Sympathetic stimulation of cardiac muscle produces stronger and faster contractions

because the concentrations of calcium in the sarcoplasm are reduced by the activity of
actively transporting proteins pumping it out of the cell.
FALSE

Section 12B.04

91. In general the parasympathetic nervous system's effects on the heart are to reduce activity
through its release of acetycholine and binding with muscarinic receptors, but there is no
significant effect observed on the ventricular cardiac muscle, compared to other parts of the
heart.
TRUE

Section 12B.04

92. The determinant for whether blood ejection occurs during ventricular contraction or
whether filling occurs during ventricular relaxation is the pressure difference across the heart
valves.
TRUE

Section 12B.03

93. The left ventricle has to pump more blood than the right ventricle because the left
ventricle has to pump blood through the whole body, not just the pulmonary system.
FALSE

Section 12B.03

12-39
94. The left ventricle has a thicker wall than the right ventricle because the left ventricle has
to pump blood against a higher pressure.
TRUE

Section 12B.03

95. The only time during the cardiac cycle that the AV valves are open is systole.
FALSE

Section 12B.03

96. During most of systole, left ventricular pressure exceeds aortic pressure, allowing blood
ejection.
TRUE

Section 12B.03

97. Long-term studies show that the risk for heart attack and stroke doubles for every 20 mm
increase in diastolic pressure and 10 mm Hg in systolic pressure.
TRUE

Section 12E.04

12-40
98. Normal heart sounds are produced by the slamming shut of the AV valves at the end of
diastole and the aortic and pulmonary valves at the end of systole.
TRUE

Section 12B.03

12-41
99. The inherent pacemaker discharge rate of the sinoatrial node is 72 beats per minute.
FALSE

Section 12B.02

100. During stimulation of the parasympathetic nerves, plasma levels of epinephrine increase.

FALSE

Section 12B.04

101. Sympathetic stimulation of the heart increases conduction through the AV node.

TRUE

Section 12B.04

102. The Frank-Starling mechanism of the heart states that an increased venous return will
normally result in a higher heart rate.
FALSE

Section 12B.04

103. The stroke volume of the heart can be increased by recruiting more cardiac muscle fibers
into activity.
FALSE

Section 12B.04

12-42
12-43
104. The Frank-Starling curve is a length-tension curve.

TRUE

Section 12B.04

105. Ventricular contractility is the strength of ventricular contraction at any given end-

diastolic volume.
TRUE

Section 12B.04

106. Systolic pressure is the peak pressure in systemic arteries and occurs at the beginning of
systole.
FALSE

Section 12C.01

107. Mean arterial pressure can be estimated by determining the average of the systolic and
diastolic pressures.
FALSE

Section 12C.01

12-44
108. The flow rate of blood through an organ is determined by the relative dilation or
constriction of the walls of the organ's arterioles.
TRUE

Section 12C.02

12-45
109. The smooth muscle in arteriole walls can be stimulated either to contract or to relax, and
thus either decrease or increase the amount of blood flowing through arteriolar beds.
TRUE

Section 12C.02

110. The hydrostatic pressure difference between the plasma inside the capillary beds and the
interstitial fluid surrounding the cells favors filtration of fluid.
TRUE

Section 12C.03

111. The osmotic pressure difference between the plasma inside the capillary beds and the
interstitial fluid surrounding the cells favors filtration of fluid.
FALSE

Section 12C.03

112. The amount of nutrients and waste products moved across the capillary wall by bulk flow
is greater than the amount that diffuses across under normal conditions.
FALSE

Section 12C.03

12-46
113. Strong vasoconstriction of arterioles leading to a capillary bed will probably result in loss
of plasma by filtration in the capillary bed.
FALSE

Section 12C.03

114. Valves are important for promoting one-way flow of blood through the heart and veins.
TRUE

Section 12C.04

115. The regulated variable of the cardiovascular system is the mean systemic arterial blood
pressure.
TRUE

Section 12D.02

116. Total peripheral resistance in the circulatory system is primarily determined by the

degree of vasoconstriction in the veins.
FALSE

Section 12D.01

12-47
117. Increasing the mean arterial pressure or the pulse pressure in the carotid artery will cause
decreased firing of action potentials in the afferent fibers associated with the baroreceptors.
FALSE

Section 12D.01

12-48
118. The medullary cardiovascular center is the only part of the brain involved with the
regulation of blood pressure.
FALSE

Section 12D.01

119. The condition of shock is an example of failure of homeostatic mechanisms to

compensate when one or more parts of the reflex control system are damaged.
TRUE

Section 12E.01

120. An athlete who has just run 2 kilometers would be expected to have both an increased
mean arterial blood pressure and an increased total peripheral resistance.
FALSE

Section 12E.03

121. During exercise, sympathetic stimulation of the heart and arteriolar smooth muscle is
enhanced because of reflexes triggered by elevated mean arterial pressure and elevated pulse
pressure.
FALSE

Section 12E.03

12-49
122. Hypertension is often treated with drugs that increase total peripheral resistance.
FALSE

Section 12E.04

123. A failing heart does not respond to increased end-diastolic volume by increasing stroke
volume.
FALSE

Section 12E.05

124. Left ventricular failure often results in increased net pulmonary capillary filtration into
the interstitial fluid of the lungs and a resulting decrease in the diffusional exchange of O2
and CO2 between lung and blood.
TRUE

Section 12E.05

125. Increased concentrations of plasma proteins, increased venous pressure, and lymphatic

obstruction all tend to cause tissue edema.
FALSE

Section 12E.05

12-50
126. Hemostatic mechanisms can generally stop blood loss from a small vein that is cut.
TRUE

Section 12F.03

12-51
127. The function of the platelet plug is to block the blood vessel so that blood cannot flow
through it.
FALSE

Section 12F.03

128. Chemical mediators released from platelet granules and plasma membranes stimulate
contraction of vascular smooth muscle.
TRUE

Section 12F.03

129. A blood clot is essentially an intricate network of interlacing strands of thrombin.

FALSE

Section 12F.03

130. In the clotting cascade, an enzyme activated toward the end of the cascade stimulates its
own activation.
TRUE

Section 12F.03

12-52
131. In the clotting cascade, an enzyme activated toward the end of the cascade inhibits its
own activation.
TRUE

Section 12F.03

12-53
132. The Starling forces which influence the rates of movement of fluid out of capillaries and
into the interstitial fluids are the same in all sites for capillary exchange - throughout the
body.
FALSE

Section 12C.03

133. When arterioles constrict it raises blood pressure and increases the volume of forward
flow, while constriction in veins reduces forward flow by decreasing pressure.
FALSE

Section 12D.01

134. The term AED (Automatic Electronic Defibrillator) refers to a recently developed device
used to regulate blood pressure with the surprise benefit of being useful in contraception with
some individuals within a narrowly defined age group.
FALSE

Section 12E.07

135. Thrombin is inactivated when it binds to heparin.

FALSE

Section 12F.03

12-54
136. The adaptive value of having a complex cascade system for blood clotting is that a defect
of one participant in the cascade can be corrected by another down the chain.
FALSE

Section 12F.03

12-55

Multiple Choice Questions: A. B. C. D

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Chapter 12 - Cardiovascular Physiology

Multiple Choice Questions

1. Which of the following is not primarily a function of blood plasma?

Bloom's Level: 1. Remember

2. Which of the following does not describe erythrocytes? They

Bloom's Level: 1. Remember

3. The process of erythrocyte production is called

Bloom's Level: 2. Understand

Bloom's Level: 2. Understand

Bloom's Level: 4. Analyze

Bloom's Level: 3. Apply

7. Most of the iron in a person's body is

Bloom's Level: 3. Apply

8. Dietary requirements for optimal erythrocyte production and function include

Bloom's Level: 3. Apply

9. Consider the equation F = DP/R.

Bloom's Level: 2. Understand

Bloom's Level: 3. Apply

11. Cardiac and smooth muscle share some characteristics, including

Bloom's Level: 2. Understand

12. The pacemaker of the heart is normally the

Bloom's Level: 1. Remember

Bloom's Level: 2. Understand

Bloom's Level: 2. Understand

Bloom's Level: 1. Remember

Bloom's Level: 4. Analyze

Bloom's Level: 1. Remember

Bloom's Level: 2. Understand

19. In an electrocardiogram, the QRS complex represents the

Bloom's Level: 1. Remember

20. An ECG would be useful for determining a patient's

Bloom's Level: 3. Apply

21. Comparing excitation-contraction coupling in cardiac muscle with that in skeletal muscle:

Bloom's Level: 2. Understand

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 2. Understand

Bloom's Level: 2. Understand

26. During the cardiac cycle,

Bloom's Level: 1. Remember

27. The aortic valve

Bloom's Level: 1. Remember

28. During isovolumetric ventricular contraction,

Bloom's Level: 2. Understand

29. The heart valves open and close due to

Bloom's Level: 2. Understand

A. Insufficiency of a semilunar valve or stenosis of an AV valve

Bloom's Level: 3. Apply

31. Cardiac output is the

Bloom's Level: 1. Remember

32. Sinoatrial node cells

Bloom's Level: 1. Remember

33. With regard to the regulation of heart rate,

Bloom's Level: 2. Understand

34. The discharge rate of the SA node is

Bloom's Level: 1. Remember

35. The Frank-Starling mechanism of the heart describes

Bloom's Level: 1. Remember

36. According to the Frank-Starling mechanism of the heart,

Bloom's Level: 2. Understand

37. Which of the following is not an effect of sympathetic stimulation of the heart?

Bloom's Level: 2. Understand