2014 Midterm

Answer: B Ventricular ejection needs left ventricular pressure to be higher than

pressure in aorta b/c fluid moves from areas of high pressure to low pressure
Not A: Atrial systole contributes 10% of blood movement into ventricles (other
90% is passive)
Not C: Ventricular diastole occurs is the relaxing of the ventricles; semilunar
valves are closed and ventricular pressure does not influence aortic pressure
Not D: PR interval spans depolarization of atria, action potential propagation
down atrium and beginning portion of ventricular depolarization

Answer: D Catecholamines increase heart rate by stimulating Ca2+ entry

through RyR, SERCA, DHPR calcium channels; increased Ca2+ entry leads to
reaching of threshold (-60 mV to -40 mV threshold) for autorhythmic cells
Not A: Beta1 adrenergic receptors are not inhibited b/c catecholamines stimulate
these receptors from increased SNS activity
Not B: cAMP production is increased from increased stimulation of B1 adrenergic
GPCR (leads to activation of adenylyl cyclase to cyclize cAMP; increased cAMP
activate HCN hyperpolarization-activated cyclic nucleotide gated channels,
which corresponds with the funny current in pacemaker cells)
Not C: Muscarinic M2 Gi GPCR corresponds with Acetylcholine release from
parasympathetic nervous system

Answer: B Muscarinic M2 Gi GPCR corresponds with parasympathetic nervous

system (feed or breed; lowers heart hate)
Not A: Adrenergic stimulation acts on Beta1 adrenergic receptors from
sympathetic nervous system innervation
Not C: Walking to class = exercise, which would stimulate adrenergic stimulation
Not D: Circulatory shock is a state where body tissues are not receiving enough
blood (e.g. hemorrhage or something); heart starts pumping faster to
compensate for lack of blood by pumping remaining blood faster

Answer: B Muscarinic receptors correspond with PNS, which innervate SA and AV

node to slow down heart rate
Not A: Not discussed in class
Not C: Alpha adrenergic receptors found in smooth muscle; predominant
adrenergic receptors found in heart are beta adrenergic
Not D: What are beta receptors?

Answer: D 80 mmHg
Blood pressure is presented as systole (contraction) over diastole (relaxation)
MAP = 1/3 systole + 2/3 diastole b/c diastolic period is twice as long as systolic
period
MAP = 120/3 + 2*60/3
MAP = 40 + 40 = 80 mmHg

Answer: C More P waves b/c QRS complex represents the depolarization of the
ventricles; AV bundle (or the Bundle of His) is located at septum prior to reaching
Purkinje fibres at apex of ventricles
Not A: P-R interval represents depolarization of atria (SA to AV node; occurs
before blockage)
Not B: QRS complex corresponds with depolarization of ventricles; blockage
occurs before QRS interval
Not D: More QRS complexes indicates blockage betw/ SA and AV node (since AV
node and Purkinje fibres can act take over as main pacemakers for the heart);
but blockage is not betw/ these nodes

Answer: D Removal of sympathetic stimulation will allow smooth muscle to dilate

Not A: Ach on nicotinic receptors signal for muscular contraction
Not B: Ach on alpha receptors causes vasoconstriction
Not C: Norepinephrine binding beta1 receptors causes vasoconstriction

Answer: C Action potential of myocardial contractile cell is relatively long to avoid

tetanus (i.e. action potential summation) in the heart muscle (which would be
bad)
Not A: 1 -5 ms indicative of neuronal action potential
Not B: 50 100 ms indicative of autorhythmic cells
Not D: Textbook listed values for contractile muscles span 200 400 ms; not 500
ms

Answer: B Atrioventricular valves and semilunar valves because isoVOLUMIC

phase involves volume of ventricles to stay the same during ventricular systole
(i.e. contraction) while pressure increases, which allows ventricular pressure to
exceed aortic pressure (and to open up semilunar valves)
Not A: Atria contract only to give remaining 10% of blood into the ventricles
Not C: Blood is not ejected into the aorta until after isovolumic contraction
Not D: Ventricular systole indicates active contraction; ventricles fill with blood
passively (90% of blood enters ventricles passively)

Answer: B Yeah
Not A: RBCs dont even have nuclei; how are they going to have any power in
directing the flow of blood

Not C: SNS stimulation can help with vasoconstriction of certain vessels,

increasing contractile force and heart rate, but cannot direct flow
Not D: Pressure gradients arent always found throughout the body (e.g. arteries
are pressure focused but veins act as volume reservoirs)

Answer: B Beta-blockers block the beta1adrenergic receptors, which are

responsible for increasing heart rate
Not A: See above
Not C: Stroke volume corresponds with contractile force which can increase by
SNS; we want to decrease heart rate, which is antagonistic to SNS
Not D: See above

Answer: C Ventricular contraction occurs after isovolumic contraction and spans Q

wave and includes the T wave
Not A: Ventricular diastole (relaxation) occurs just after T wave
Not B: P wave corresponds with atrial depolarization; not even at the ventricles
yet
Not D: Ventricular contraction includes T wave
2013 Midterm

Answer: A Thats the point; you want the refractory period to be minute so that no
tetanus (i.e. summation) will occur
Not B: Irrelevant
Not C: Irrelevant
Not D: Irrelevant

Answer: B
Not A: Blood flow rate can regulated via increased resistance (via reduced
radius; recall Poiseilles Law)
Not C: Blood pressure regulated primarily by left ventricular pressure and
resistance to be overcome
Not D: This is just handy

Answer: B 99 mmHg
MAP = 1/3 systole + 2/3 diastole
MAP = 107/3 + 2*95/3
MAP = 35.67 + 63.33
MAP = 99 mmHg

Answer: A Increase radius by 1 unit

Poiseuilles Law is proportional to: (Pressure*Viscosity*r4)/L
Increasing radius by 1 unit = (x +1)4, which increases it by a lot
Decreasing length and decreasing viscosity have the same effect

Answer: A Na+ only causes the rapid depolarization phase

Not B: Ca2+ and K+ play a role in maintaining plateau that prevents tetanus; not
in initial depolarization phase
Not C: K+ is involved with repolarization (equilibrium potential wants K+ to go
outside, which polarizes the cell)
Not D: Na+ and K+ play roles in HCN activation in funny currents, which are
found in autorhythmic cells

Answer: B L-type calcium channels are the first to be opened in response to action
potential (located in T-tubules)
Not A: Na+/K+ ATPase is activated in response to NCX transporters
Not C: HCN channels found in autorhythmic/pacemaker cells; not contractile cells
Not D: NCX transporters are activated to restore Ca2+ concentration outside of
cell (pumps 1 Ca2+ out, 3 Na+ in)

Answer: D This is the law

Starlings Law of the Heart: As additional blood enters the heart, heart contracts
more forcefully and ejects more blood; within physiological limits, heart will
pump all blood that returns to it
Not A: End-systolic volume plays role in stroke volume (SV = EDV ESV), but it is
not directly related to CO based on Starlings Law
Not B: Size of ventricle consistent among humans
Not C: Heart rate does not necessarily correspond with contractile force
(dependent more on preload)

Answer: A This is how they do

Not B: Pacemaker in a normal heart is the SA node (located near base)
Not C: AV node propagates electrical impulses down the Bundle of His down to
the ventricles; not immediate intermediary betw/ ventricles and atria
Not D: AV valves (valves separated atria and ventricles) are not electrically
opened or closed

Answer: A Pressure is the driving force for blood flow; this is established by your
left ventricle
Not B: People who choose this answer probably arent getting enough blood to
their brain because GRAVITY
Not C: Osmotic pressure important for filtration and other things
Not D: Volume wtf

Answer: B This is it; reactive hyperemia is the local widening of the arterioles in
response to a blockage
Not A: This wasnt mentioned
Not C: No
Not D: No

Answer: D Reduced flow

Resistance is proportional to L over r 4
Not A: Viscosity is related to flow and is not affected by resistance
Not B: Increased blood vessel diameter decreases resistance
Not C: Decreasing length decreases resistance

Answer: C ACE inhibitors; angiotensin is responsible for systemic arteriolar

vasoconstriction, which increases blood pressure (causing hypertension)
Not A: ANP decreases blood pressure in response to high blood pressure;
blocking this would keep blood pressure elevated
Not B: Calcium channels are more associated with heart contractile muscle; this
doesnt affect systemic circulation

Not D: Not a mentioned parameter

Answer C: No plasma protein synthesis causes decreased colloid oncotic pressure

(which draws in fluid from ISF); edema results from leakage of fluid into
interstitium from increased blood pressure, increased ISF plasma protein
(increasing the ISF oncotic pressure) and decreased plasma protein
Not A and B because they are basically reiterations of each other
Not D: Anemia has to do with RBCs (unless its pernicious anemia, which has to
do with nutrition, but only elements affected are folic acid, vitamin B12, etc.)