CV Quiz Review Flashcards

1
Q

Which of the following statements is true?

A

a. The pericardium is made up of a fibrous and serous layer
b. The phrenic nerves coarse over the pericardium on both sides of the heart
c. The visceral layer of the serous pericardium is also known as the epicardium
d. All of the above*****

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2
Q

Which of the following statements regarding thee autonomic nervous system is TRUE.

A

a. The parasympathetic nervous system has a craniosacral origin
b. The “cardiac accelerators” of the sympathetic nervous system originate from T1-T4
c. The Vagus nerve (CN X) is part of the parasympathetic nervous system
d. All of the above***

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3
Q

The basic part of the circulatory system include:

A

a. A pump with an electrical system for regular running
b. Distributing and collecting tubes
c. Extensive system of thin vessels that permit rapid exchange between the tissues and the vascular channels
d. All of the above*******

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4
Q

T/F the majority of the blood volume is contained within the arterial portion of the circulation.

A

False- venous holds 70% of blood volume

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5
Q

Which of the following structures does NOT drain into the right atrium?

A

a. Coronary sinus
b. Inferior vena cava
c. Superior vena cava
d. Pulmonary veins****

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6
Q

Which of the following statements is FALSE regarding the NA, K, ATPase pump?

A

a. Metabolic pump which removes potassium from the cell and pumps sodium into the cell **
b. Pumps in 3:2 ratio (3 sodiums for every 2 potassiums)
c. The pump is electrogenic
d. This pump is partially inhibited by digitalis

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7
Q

Which of the following contributes to the resting membrane potential (RMP) of the cardiac muscle cell?

A

a. Potassium diffusion
b. Sodium diffusion (small, but finite leakage of this ion)
c. Activity of Na+-K+ ATP-are pump
d. All of the above contribute to RMP of the cardiac muscle *****

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8
Q

Which of the following is the major contributor to the phase of the action potential depicted by the arrow
(Phase 0 of membrane potential diagram)?

A

C. Activation of the sodium channels allowing rapid, inward movement of sodium into the cell

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9
Q

Pacemaking cells found in the sinoatrial (SA) node demonstrate a gradual upsloping of phase 4 of their action potentials. These cells become gradually less negative due to a slow influx of sodium ions. The potential in the cell will slowly increase until an action potential is triggered in the cell. This process is called:

A

Diastolic depolarization

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10
Q

The majority of ventricular filling occurs:

A

During the rapid filling phase (phase 6)

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11
Q

Which of the following is associated with aortic valve closure?

A

Dicrotic notch on the aortic pressure tracing and second heart sound

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12
Q

Which statement regarding the Frank-Starling mechanism is TRUE?

A

a. Allows the heart to readily adapt to changes in venous return
b. The Frank-Starling Mechanism plays an important role in balancing the output of the 2 ventricles
c. Increasing the venous return and ventricular preload leads to an increase in stroke volume
d. All of the above statements are true *****

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13
Q

An increase of which of the following will result in a decrease of CO?

A

Afterload

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14
Q

During isovolumetric contraction which of the following occurs?

A

Aortic valve is closed, mitral valve is closed

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15
Q

T/F The circulatory filling pressure is the pressure in the CV system when CO is equal to 0.

A

True

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16
Q

T/F. Except for brief transient disparities, CO equals venous return

A

True

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17
Q

Which parameter would you not be able to measure directly with a Swan-Ganz catheter?

A

Systemic vascular resistance

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18
Q

You are asked to inflate a Swan-Ganz catheter balloon after is has even inserted through the central venous introducer. Which of the following statements is true?

A

a. You should watch the pulmonary artery tracing on the monitor as you inflate the balloon
b. You should inflate the balloon slowly
c. You should stop inflation of the balloon if resistance to inflation is detected
d. All of the above are true**

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19
Q

Which of the following is used to predict laminar vs turbulent flow in a conduit?

A

Reynold’s number

20
Q

Which of the following changes will result in the greatest increase in flow through a conduit?

A

Doubling the radius of the conduit

21
Q

Which of the following may create an error or artifact that may provide inaccurate information when trying to obtain hemodynamic information?

A

a. Use of a blood pressure cuff that is too small for a given patient
b. “Ringing” in an arterial line setup
c. Having a large amount of air in the tubing between the transducer and a Swan-Ganze catheter
d. All of the above **

22
Q

Which of the following factors help to optimize the exchange functions of the capillaries?

A

a. Large surface area
b. Large cross-sectional area with low blood flow velocity
c. Non-pulsation blood flow due to pulse dampening effects of the aorta and large arteries
d. All of the above **

23
Q

In healthy individual lying supine, you simultaneously measure blood pressures in the aorta and the dorsalis pedis (dorsal foot) artery using arterial catheters. Compared to the aortic systolic pressure you would expect the systolic pressure in the dorsalis pedis artery to be:

A

Higher

24
Q

Which of the following statements regarding the venous system is true?

A

a. Veins have valves which help create unidirectional flow of blood in the venous system
b. The venous system contains approximately 70% of the blood volume in a normovolemic individual.
c. Contraction of venous smooth muscles help increase venous return back to the heart
d. All of the above statements are true ****

25
Q

Which of the following statements regarding arterioles is false?

A

a. Normally contribute to most of the resistance to blood flow across the circulation
b. Met Arterioles regulate flow to capillary beds
c. Considered the “Stopcock” of the circulation
d. Do not contain smooth muscle ***

26
Q

Match the following:

A
  • intima = innnermost tissue layer of a blood vessel
  • media = middle tissue layer of a blood vessel
  • Adventitia = outermost tissue layer of a blood vessel
27
Q

Plasma colloid osmotic pressure (oncotic pressure) is the result of plasma proteins which are largely confined to the intravascular space. The plasma protein which makes the greatest contribution to plasma colloid osmotic pressure is?

A

Albumin

28
Q

Of the various hydrostatic and osmotic forces that cause fluid movement across the capillary, which one is the only one under normal conditions to create inward force (from the interstitium into the capillary) for water movement?

A

Oncotic/osmotic pressure of plasma proteins in the vascular space

29
Q

Autoregulation is the intrinsic ability of an organ to maintain a constant perfusion pressure over a wide range of blood flows.

A

True

30
Q

Any intervention that results in an inadequate oxygen (nutrient) supply for the metabolic requirements of the tissues results in the formation fo ______________ ________________ , which increase blood flow to the tissues.

A

Vasodilator substances

31
Q

Which of the following anatomical structures is involved in the baroreceptor reflex?

A

Carotid SINUS

32
Q

While waiting for the surgeon to arrive in the OR to start a laparoscopic cholecystectomy you rapidly infuse 1.5 Liters of LR into the pt. At the start of the infusion the patient’s vital signs are: BP= 126/78 and HR = 56. When the infusion finishes, the vital signs are: BP = 130/80 and HR= 88. What is the cause of this hemodynamic response?

A

Bainbridge reflex

33
Q

During a carotid endartectomy the pt’s HR abruptly decreases to 20 BPM while the surgeon is working in the vicinity of the carotid bifurcation. What caused this hemodynamic response?

A

Baroreceptor reflex

34
Q

A patient with a large brain tumor is bought to the OR for emergency craniotomy for debulking of the tumor. The pt is drowsy and disoriented. The pt is complaining of a severe frontal HA The pt’s BP is 206/120. Their HR is 40bpm. What is the best explanation for this pt’s VS?

A

Cushing Reflex

35
Q

The intracelllar effects of Ăź-1-receptor activation by epinephrine are due to:

A

Stimulation of adenylyl Cyclase, which results in increased amounts of intracellular cAMP

36
Q

Because of the squeezing effects of the contracting myocardium on the blood vessels that course through it, the majority of left ventricular coronary blood flow occurs during:

A

Diastole

37
Q

T/F. Volatile anesthetic agents appear to have effects on the heart similar to ischemic pre-conditioning which allows the heart to tolerate longer periods of ischemia before myocardial damage ensues.

A

True

38
Q

T/f Myocardial ischemia ultimately leads to severe intracellular calcium overload and subsequent impaired myocardial contraction and death.

A

True

39
Q

Which portion of the myocardium is at greatest risk for becoming ischemic?

A

Subendocardium

40
Q

A patient with CAD is found to have an LVEF of 40%. The patient undergoes an uneventful CABG. 2 months after surgery the pt is found to have a LVEF of 55%. What is the name of this phenomenon?

A

Myocardial hibernation

41
Q

A pt is going to undergo a mitral valve replacement for severe mitral regurgitation. A preoperative echocardiogram shows an LVEF of 40%. Pot-procedure you would expect the LVEF to:

A

Decrease

42
Q

A young female pt presents with CHF and A fib with RVR. You order an echo and observe the following: large left atrium, small LV, normal aortic valve and a heavily calcified mitral valve. You not a soft diastolic murmur on auscultation. Which of the following management strategies would you follow?

A

Decrease HR to allow more time/flow through the stenotic lesion

43
Q

Appearance of which of the following symptoms is considered significant in the patient with severe aortic stenosis?

A

a. Congestive heart failure
b. Angina
c. Syncope
d. All of the above*****—> classic triad of severe AS

44
Q

A pt with severe aortic stenosis undergoes induction of GA. immediately after induction the pt has the following hemodynamic measurements: HR= 72 bpm, BP= 78/50, CVP = 12 mmHg. At this point your priority in hemodynamic measurement would be:

A

Increase BP with 100µg (mcg) of IV phenylephrine

45
Q

A pt with severe mitral stenosis undergoes induction of GA. Immediately after induction the pt has the following hemodynamic measurements: HR= 130, BP= 84/54, CVP= 17. At this point your priority in hemodynamic management would be:

A

Decrease HR with 30mg of IV esmolol