Chapter 9 - Cardiac Physiology 4. The left ventricle is a stronger pump than the right ventricle because more blood is needed to supply to the body tissue than to supply the lungs. (True/False) 5. The heart lies in the left half of the thoracic cavity. !(True/False) 6. The only point of electrical contact between the atria and ventricles is the fibrous skeletal rings. (True/False) 7. Entrance of Ca²⁺ through funny channels is responsible for the unique plateau phase of the action potential in cardiac contractile cells. (True/False) 8.The atria and ventricles each act as a functional syncytium. (True/False) 9. Which of the following is the proper sequence of cardiac excitation? a. S A n o d e→AV n o d e→a t r i a l m y o c a r d i u m→b u n d l e o f H i s→P u r k i n j e fibers→ventricular myocardium. b. SA node→atrial myocardium→AV node→bundle of His→ventricular myocardium→Purkinje fibers. c. SA node→atrial myocardium→ventricular myocardium→AV node→bundle of His→Purkinje fibers. d. S A n o d e→a t r i a l m y o c a r d i u m→AV n o d e→b u n d l e o f H i s→P u r k i n j e fibers→ventricular myocardium. 10. What percentage of ventricular filling is normally accomplished before atrial contraction begins? a. 0% b. 20% c. 50% d. 80% e. 100% 11. Sympathetic stimulation of the heart a. increases the heart rate b. increases the contractility of the heart muscle c. shifts the Frank-Starling curve to the left d. both (a) and (b) e. all of the above 12. Match the following: 1. Receives O₂-poor blood from the venae cavae
(a) AV valves
2. Prevent backflow of blood from the ventricles to the atria
(b) semilunar valves
3. Pumps O₂-rich blood into the aorta
(c) left atrium
4. Prevent backflow of blood from the arteries into the ventricles
(d) left ventricle
5. Pumps O₂-poor blood into the pulmonary artery
(e) right atrium
6. Receives O₂-rich blood from the pulmonary veins
(f) right ventricle
13. Circle the correct choice in each instance to complete the statement: The first heart sound is associated with closing of the (AV/semilunar) valves and signals the onset of (systole/diastole), whereas the second heart sound is associated with closing of the (AV/semilunar) valves and signals he onset of (systole/diastole). 14. Circle the correct choice in each instance to complete the statements: During ventricular filling, ventricular pressure must be (greater than/less than) atrial pressure, whereas during ventricular ejection ventricular pressure must be (greater than/less than) aortic pressure. Atrial pressure is always (greater than/less than) aortic pressure. During isovolumetric ventricular contraction and relaxation, ventricular pressure is (greater than/less than) atrial pressure and (greater than/less than) aortic pressure. 15. Use the following answer code to compare the relative magnitudes of the pair of items in question: (a) = Item A is greater than item B (b) = Item B is greater than item A (c) = Item A and item B are approximately equal A. Resistance and pressure in pulmonary circulation 1 B. Resistance and pressure in systemic circulation
b A. Volume of blood pumped out by left side of heart
2 B. Volume of blood pumped out by right side of heart
c A. Spontaneous rate of depolarization to threshold in SA node
3 B. Spontaneous rate of depolarization to threshold in ventricular Purkinje fibers
a A. Velocity of impulse conduction through the AV node
4 B. Velocity of impulse conduction through the bundle of His and Purkinje fibers
b A. Rate of ventricular filling in early diastole
5 B. Rate of ventricular filling in late diastole
a A. Stroke volume when EDV equals 130 ml
6 B. Stroke volume when EDV equals 160 ml
b A. Normal stroke volume
7 B. Stroke volume on sympathetic stimulation
b A. Normal stroke volume
8 B. Stroke volume on parasympathetic stimulation
c A. Volume of blood in ventricles at the onset of isovolumetric ventricular contraction
9 B. Volume of blood in ventricles at the end of isovolumetric ventricular contraction
c
A. Volume of blood in left ventricle at the time aortic valve opens 10 B. Volume of blood in left ventricle at the time aortic valve closes
a A. Volume of blood in left ventricle at the time left AV valve opens
11 B. Volume of blood in left ventricle at the time left AV valve closes
b A. Duration of refractory period in cardiac muscle
12 B. Duration of contraction in cardiac muscle
c
Chapter 10 - The Blood Vessels and Blood Pressure 1. In general, the parallel arrangement of the vascular system enables each organ to receive its own separate arterial blood supply. (True/False) 2. More blood flows through the capillaries during cardiac systole than during diastole. (True/False) 3. The capillaries contain only 5% of the total blood volume at any point in time. (True/ False) 4. The same volume of blood passes through the capillaries in a minute as passes through the aorta, even though blood flow is much slower in the capillaries. (True/False) 5. Because capillary walls have no carrier transport systems, all capillaries are equally permeable. (True/False) 6. Because of gravitational effects, venous pressure in the lower extremities is greater when a person is standing up than when the person is lying down. (True/False) 7. Which of the following functions is (are) attributable to arterioles? a. produce a significant decline in mean pressure, which helps establish the driving pressure gradient between the heart and organs b. serve as site of exchange of materials between blood and surrounding tissue cells c. act as main determinant of total peripheral resistance d. determine the pattern of distribution of cardiac output e. help regulate mean arterial blood pressure f. convert the pulsatile nature of arterial blood pressure into a smooth, nonfluctuating pressure in the vessels farther downstream g. act as a pressure reservoir 8. Using the following answer code to indicate whether the following factors increase or decrease venous return: (a) increases venous return (b) decreases venous return (c) has no effect on venous return 1 sympathetically induced venous vasoconstriction
a
2 skeletal muscle activity
a
3 gravitational effects on the venous system
b
4 respiratory activity
a
5 increased atrial pressure associated with a leaky AV lake
b
6 ventricular pressure change associated with diastolic recoil
a
9. Using the following answer code to indicate what kind of compensatory changes occur in the factors in question to restore blood pressure to normal in response to hypovolemic hypotension resulting from severe hemorrhage: (a) increased (b) decreased (c) no effect 1 rate of afferent firing generated by the carotid sinus and aortic arch baroreceptors
b
2 sympathetic output by the cardiovascular center
a
3 parasympathetic output by the cardiovascular center
b
4 heart rate
a
5 stroke volume
a
6 cardiac output
a
7 arteriolar radius
b
8 total peripheral resistance
a
9 venous radius
b
10 venous return
a
11 urinary output
b
12 fluid retention within the body
a
13 fluid movement from interstitial fluid into plasma across the capillaries
a
Chapter 11 - The Blood 1. Blood can absorb metabolic heat while undergoing only small changes in temperature. (True/False) 2. Hemoglobin can carry only O₂. (True/False) 3. Erythrocytes, leukocytes, and platelets all originate from the same undifferentiated stem cells. (True/False) 4. Erythrocytes are unable to use the O₂ they contain for their own ATP formation. (True/ False) 5. White blood cells spend the majority of their time in the blood. (True/False) 8. Which of the following is not a function of plasma proteins? a. facilitating retention of fluid in the blood vessels b. playing an important role in blood clotting c. transporting water-insoluble substances in the blood d. transporting O₂ in the blood e. serving as antibodies f. contributing to the buffering capacity of the blood 9. Which of the following is not directly triggered by exposed collagen in an injured vessel? a. initial vascular spam b. platelet aggregation c. activation of the clotting cascade d. activation of plasminogen 10. Match the following (an answer may be used more than once): 1
causes platelets to aggregate in positive-feedback fashion
c
(a) prostacyclin
2
activates prothrombin
f
(b) plasmin
3
fibrinolytic enzyme
b
(c) ADP
4
inhibits platelet aggregation
a
(d) fibrin
5
first factor activated in intrinsic clotting pathway
g
(e) thrombin
6
form meshwork of the clot
d
(f) factor X
7
stabilizes the clot
h
(g) factor XII
8
activates fibrinogen
e
(h) factor XIII
9
activated by tissue thromboplastin
f
11. Match the following blood abnormalities with their causes: 1
deficiency of intrinsic factor
e
(a) hemolytic anemia
2
insufficient amount of iron to synthesize adequate hemoglobin
c
3
destruction of bone marrow
b
(c) nutritional anemia
4
abnormal loss of blood
d
(d) hemorrhagic anemia
5
tumorlike condition of bone marrow
g
(e) pernicious anemia
6
inadequate erythropoietin secretion
f
(f) renal anemia
7
excessive rupture of circulating erythrocytes
a
(g) primary polycythemia
8
associated with living at high altitudes
h
(h) secondary polycythemia
(b) aplastic anemia
Chapter 14 - The Urinary System 1. Part of the kidneysʼ energy supply is used to accomplish glomerular filtration. (True/ False) 2. Sodium reabsorption is under hormonal control throughout the length of the tubule. (True/False) 3. Glucose and amino acids are reabsorbed by secondary active transport. (True/False) 4. Solute excretion is always accompanied by comparable H₂O excretion. (True/False) 5. Water excretion can occur without comparable solute excretion. (True/False) 9. Indicate whether each of the following factors would (a) increase or (b) decrease the GFR, if everything else remained constant. 1
a rise in Bowmanʼs capsule pressure resulting from ureteral obstruction by a b kidney stone
2
a fall in plasma protein concentration resulting from loss of these proteins from a a large burned surface of skin
3
a dramatic fall in arterial blood pressure following severe hemorrhage (<80 mm b Hg)
4
afferent arteriolar vasoconstriction
5
tubuloglomerular feedback response to decreased salt delivery to the distal a tubule
6
myogenic response to decreased stretched as a result of an increased driving b blood pressure
7
↑ sympathetic activity to the afferent arterioles
b
8
contraction of mesangial cells
b
9
contraction of podocytes
b
b
10. Which of the following filtered substances is normally not present in the urine at all? a. Na⁺ b. PO₄³⁻ c. urea d. H⁺ e. glucose 11. Reabsorption of which of the following substances is not linked in some way to active Na⁺ reabsorption? a. glucose b. PO₄³⁻ c. H₂O d. urea e. Cl⁻
In questions 12-14, indicate, by writing the identifying letters in the proper order in the blanks, the proper sequence through which fluid flows as it traverses the structures in question. 12. a. ureter b. kidney c. urethra d. bladder e. renal pelvis Answer: b, e, a, d, c 13. a. efferent arteriole b. peritubular capillaries c. renal artery d. glomerulus e. afferent arteriole f. renal vein Answer: c, e, d, a, b, f 14. a. loop of Henle b. collecting duct c. Bowman始s capsule d. proximal tubule e. renal pelvis f. distal tubule g. glomerulus Answer: g, c, d, a, f, b, e 15. Using the following answer code to indicate what the osmolarity of the tubular fluid is at each of the designated points in a nephron: (a) isotonic (300 mOsm) (b) hypotonic (100 mOsm) (c) hypertonic (1200 mOsm) (d) ranging from hypotonic to hypertonic (100 mOsm to 1200 mOsm) 1
Bowman始s capsule
a
2
end of proximal tubule
a
3
tip of Henle始s loop of juxtamedullary nephron (at the bottom of the U-turn)
c
4
end of Henle始s loop of juxtamedullary nephron (before entry into distal tubule)
b
5
end of collecting duct
d
Chapter 15 - Fluid and Acid-Base Balance 1. The only avenue by which materials can be exchanged between the cells and the external environment is the ECF. (True/False) 2. Water is driven into the cells when the ECF volume is expanded by an isotonic fluid gain. (True/False) 3. Salt balance in humans is poorly regulated because of our hedonistic salt appetite. (True/False) 4. An unintentional increase in CO₂ is a cause of respiratory acidosis, but a deliberate increase in CO₂ compensates for metabolic alkalosis. (True/False) 5. Secreted H⁺ that is coupled with HCO₃⁻ reabsorption is not excreted, whereas secreted H⁺ that is excreted is linked with the addition of new HCO₃⁻ to plasma. (True/False) 8. Which of the following individuals would have the lowest percentage of body H₂O? a. a chubby baby b. a well-proportioned female college student c. a well-muscled male college student d. an obese elderly woman e. a lean elderly man 9. Which of the following factors does not increase vasopressin secretion? a. ECF hypertonicity b. alcohol c. stressful situations d. an ECF volume deficit e. angiotensin II 10. Indicate all correct answers: pH a. equals log 1/[H⁺] b. equals pK + log [CO₂]/[HCO₃⁻] c. is high in acidosis d. falls lower as [H⁺] increases e. is normal when the [HCO₃⁻]/[CO₂] ratio is 20/1 11. Indicate all correct answers: Acidosis a. causes overexcitability of the nervous system b. exists when the plasma pH falls below 7.35 c. occurs when the [HCO₃⁻]/[CO₂] ratio exceeds 20/1 d. occurs when CO₂ is blown off more rapidly than it is being produced by metabolic activities e. occurs when excessive HCO₃⁻ is lost from the body, as in diarrhea 12. Indicate all correct answers: The kidney tubular cells secrete NH₃ a. when the urinary pH becomes too high b. when the body is in a state of alkalosis c. to enable further renal secretion of H⁺ to occur d. to buffer excess filtered HCO₃⁻ e. when there is excess NH₃ in the body fluids
Chapter 16 - The Digestive System 1. The extent of nutrient uptake from the digestive tract depends on the body始s needs. (True/False) 2. The stomach is relaxed during vomiting. (True/False) 3. Acid cannot normally penetrate into or between the cells lining the stomach, which enables the stomach to contain acid without inuring itself. (True/False) 4. Protein is continually lost from the body through digestive secretions and sloughed epithelial, which pass out in the feces. (True/False) 5. Foodstuffs not absorbed by the small intestine are absorbed by the large intestine. (True/False) 6. The endocrine pancreas secretes secretin and CCK. (True/False) 12. Which of the following is not a function of saliva? a. begins digestion of carbohydrate b. facilitates absorption of glucose across the oral mucosa c. facilitates speech d. exerts and antibacterial effect e. plays an important role in oral hygiene 13. Match the following 1
prevents reentry of food into the mouth during swallowing
c
(a) closure of the pharyngoesophageal sphincter
2
triggers the swallowing reflex
e
(b) elevation of the uvula
3
seals off the nasal passages during swallowing
b
(c) position of the tongue against the hard palate
4
prevents air from entering the esophagus during breathing
a
(d) closure of the gastroesophageal sphincter
5
closes off the respiratory airways during swallowing
f
(e) bolus pushed to the rear of the mouth by the tongue
6
prevents gastric contents from backing up into the esophagus
d
(f) tight apposition of the vocal folds
14. Use the following answer code to identify the characteristics of the listed substances: (a) pepsin (b) mucus (c) HCl (d) intrinsic factor (e) histamine 1
activates pepsinogen
c
2
inhibits amylase
c
3
is essential for vitamin Bâ&#x201A; â&#x201A;&#x201A; absorption
d
4
can act autocatalytically
a
5
is a potent stimulant for acid secretion
e
6
breaks down connective tissue and muscle fibers
c
7
begins protein digestion
a
8
serves as a lubricant
b
9
kills ingested bacteria
c
10
is alkaline
b
11
is deficient in pernicious anemia
d
12
coats the gastric mucosa
b
Chapter 18 - Principles of Endocrinology; The Central Endocrine Glands 1. One endocrine gland may secrete more than one hormone. (True/False) 2. One hormone ma influence more than one type of target cell. (True/False) 3. All endocrine glands are exclusively endocrine in function. (True/False) 4. A single target cell may be influenced by more than one hormone. (True/False) 5. Hyposecretion or hypersecretion of a specific hormone can occur even though its endocrine gland is perfectly normal. (True/False) 6. Growth hormone levels in the blood are no higher during the early childhood growing years than during adulthood. (True/False) 11. Indicate the relationships among the hormones in the hypothalamic/anterior pituitary/ adrenal cortex system by using the following answer code to identify which hormone belongs in each blank: (a) cortisol (b) ACTH (c) CRH (1)________ from the hypothalamus stimulates the secretion of (2)________ from the anterior pituitary. (3)________, in turn, stimulates the secretion of (4)________ from the adrenal cortex. In negative-feedback fashion, (5)________ inhibits secretion of the releasing hormone (6)________ and further more inhibits secretion of the tropic hormone (7)________. 1.c, 2.b, 3.b, 4.a, 5.a, 6.c, 7.b
Chapter 19 - The Peripheral Endocrine Glands 1. The response to thyroid hormone is detectable within a few minutes after its secretion. (True/False) 2. “Male” sex hormones are produced in both males and females by the adrenal cortex. (True/False) 3. Adrenal androgen hypersecretion is caused by a deficit of an enzyme crucial to cortisol synthesis. (True/False) 4. Excess glucose and amino acids as well as fatty acids can be stored as triglycerides. (True/False) 5. Insulin is the only hormone that can lower blood glucose levels. (True/False) 6. The most life-threatening consequence of hypocalcemia is reduced blood clotting. (True/ False) 7. All ingested Ca²⁺ is indiscriminately absorbed in the intestine. (True/False) 8. The Ca₃(PO₄)₂ bone crystals form a labile pool from which Ca²⁺ can rapidly be extracted under the influence of PTH. (True/False) 14. Which of the following hormones does not exert a direct metabolic effect? a. epinephrine b. growth hormone c. aldosterone d. cortisol e. thyroid hormone 15. Which of the following are characteristic of the postabsorptive state? (Indicate all that apply.) a. glycogenolysis b. glyconeogenesis c. lipolysis d. glycogenesis e. protein synthesis f. triglyceride synthesis g. protein degradation h. increased insulin secretion i. increased glucagon secretion j. glucose sparing
Chapter 20 - The Reproductive System 1. It is possible for a genetic male to have the anatomic appearance of a female. (True/ False) 2. Testosterone secretion essentially ceases from birth until puberty. (True/False) 3. Prostaglandins are derived from arachidonic acid found in the plasma membrane. (True/ False) 4. Females do not experience erection. (True/False) 5. Most of the lubrication for sexual intercourse is provided by the female. (True/False) 6. If a follicle does not reach maturity during one ovarian cycle, it can finish maturing during the next cycle. (True/False) 7. Rising, moderate levels of estrogen inhibit tonic LH secretion, whereas high levels of estrogen stimulate the LH surge. (True/False) 12. Which of the following statements concerning chromosomal distribution is incorrect? a. All human somatic cells contain 23 chromosomal pairs for a total diploid number of 46 chromosomes. b. Each gamete contains 23 chromosomes, one member of each chromosomal pair. c. During meiotic division, the members of the chromosome pairs regroup themselves into the original combinations derived from the individual始s mother and father for separation into haploid gametes. d. Sex determination depends on the combination of sex chromosomes, an XY combination being a genetic male, and XX a genetic female. e. The sex chromosome content of the fertilizing sperm determines the sex of the offspring. 13. When the corpus luteum degenerates, a. Circulating levels of estrogen and progesterone rapidly decline. b. FSH and LH secretion start to rise as the inhibitory effects of the gonadal steroid are withdrawn. c. The endometrium sloughs off. d. Both (a) and (b) e. All of the above 14. Match the following: 1
secrete(s) prostaglandins
c
(a) epididymis and ductus deferens
2
increase(s) motility and fertility of sperm
a
(b) prostate gland
3
secrete(s) an alkaline fluid
b
(c) seminal vesicles
4
provide(s) fructose
c
(d) bulbourethral glands
5
storage site for sperm
a
(e) penis
6
concentrate(s) the sperm a hundredfold
a
7
secrete(s) fibrinogen
c
8
provide(s) clotting enzymes
b
9
contain(s) erectile tissue
e
15. Using the answer code below to indicate when each event takes place during the ovarian cycle: (a) occurs during the follicular phase (b) occurs during the luteal phase (c) occurs during both the follicular and luteal phases 1
development of antral follicles
a
2
secretion of estrogen
c
3
secretion of progesterone
b
4
menstruation
a
5
repair and proliferation of the endometrium
a
6
increased vascularization and glycogen storage in the endometrium
b