Chapter 13 The Cardiovascular System: Cardiac Function

Multiple Choice Questions

1) Keeping blood in the different chambers of the heart from mixing is a function what
structure?
A) Valves
B) arteries
C) septum
D) apex
E) chordae tendinae

2) The primary site of exchange between blood and interstitial fluid occurs across what
type of blood vessel?
A) arteries
B) veins
C) arterioles
D) venules
E) capillaries

3) When blood leaves the heart, it first enters what type of blood vessel?
A) arteries
B) veins
C) arterioles
D) venules
E) capillaries

4) Which of the following functions in forming blood clots?

A) erythrocytes only
B) leukocytes only
C) platelets only
D) both erythrocytes and leukocytes E) both leukocytes
and platelets

5) Which of the following is NOT a component of the pulmonary circuit?

A) right ventricle
B) pulmonary arteries
C) pulmonary veins
D) pulmonary capillaries

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 2

E) venae cava

6) Blood supply to the heart comes from ________.

A) coronary arteries
B) cerebral arteries
C) aorta
D) blood within the ventricles
E) blood within the atria

7) What structure separates the thoracic cavity from the abdominal cavity?
A) heart
B) diaphragm
C) intestines
D) liver
E) lungs

8) Which chamber of the heart has the thickest musculature?

A) right atrium
B) right ventricle
C) left atrium
D) left ventricle
E) both ventricles have equal thickness and are thicker than the atria

9) Chordae tendinae are strands of connective tissue extending from ________ to ________.
A) atria : ventricle
B) inferior vena cava : right atrium
C) aortic valves : ventricular myocardium
D) semilunar valves : atrial myocardium
E) AV valves : papillary muscle

10) The opening and closure of the atrioventricular and semilunar valves is driven by ________.
A) contraction of the valve
B) contraction of muscles attached to the valves
C) contraction of the ventricle and atria that pull the valves into place
D) differences in pressure across the valve
E) contraction and relaxation of the valve

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 3

11) Closure of the atrioventricular valve occurs when ________.

A) the valve contracts
B) pressure inside the ventricle is less than pressure inside the atrium
C) pressure inside the ventricle is greater than pressure inside the atrium
D) the papillary muscle contracts
E) the atrium contracts

12) Whereas the contractile activity of skeletal muscle is called ________, that of cardiac muscle is
________ because the contraction originates within the musculature itself.
A) somatic : autonomic
B) voluntary : involuntary
C) neurogenic : myogenic
D) somatic : autorhythmic
E) extrinsic : intrinsic

13) What is mitral valve prolapse?

A) inversion of the left AV valve
B) inversion of the right AV valve
C) inversion of the pulmonary valve
D) inversion of the aortic valve
E) None of the above

14) What are the two major regions of the heart containing pacemaker cells?
A) sinoatrial node and atrioventricular node
B) sinoatrial node and Purkinje fibers
C) sinoatrial node and bundle of His
D) bundle of His and atrioventricular node
E) bundle of His and Purkinje fibers

15) What blood vessel carries deoxygenated blood to the lungs?

A) inferior vena cava
B) aorta
C) pulmonary vein
D) pulmonary artery
E) superior vena cava

16) The relative color (depth of redness) of blood is a direct indication of the amount of ________
bound to hemoglobin.

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 4

A) sodium ions
B) oxygen
C) glucose
D) hydrogen ions
E) carbon dioxide

17) The term autorhythmicity refers to the heart s ability to ________.

A) conduct action potentials along the conduction pathway
B) generate its own contractile cycle
C) originate its contraction neurogenically
D) act as a functional syncytium
E) intrinsically modify its contractility

18) What structure provides the pathway for the movement of electrical current between the cells of
the conduction pathway and the ventricular myocytes?
A) Desmosomes
B) Sodium channels
C) Gap junctions
D) Potassium channels
E) Funny channels

19) Which of the following is the correct conduction pathway through the heart?
A) Purkinje fibers; bundle of His; bundle branches; SA node; AV node
B) SA node; AV node; bundle of His; bundle branches; Purkinje fibers
C) AV node; SA node; bundle branches; bundle of His; Purkinje fibers
D) Bundle of His; bundle branches; Purkinje fibers; SA node; AV node
E) SA node; Purkinje fibers; AV node; bundle of His; bundle branches

20) Conduction through which of the following is slow to allow atria to contract before the
ventricles?
A) atria
B) SA node
C) AV node
D) bundle of His
E) E) Purkinje fibers

21) Why do AV nodal cells NOT determine the heart rate?

A) They depolarize faster than all other conducting fibers.

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 5

B) They depolarize slower than all other conducting fibers.

C) They slow conduction of the wave of excitation.
D) As depolarization initiated in the SA node reaches the AV node, it leaves the AV node
in a refractory state.
E) The AV node is connected to the SA node, but not to other conducting fibers in the
heart.

22) What is an ectopic focus?

A) a site where an abnormal depolarization in cardiac muscle initiates an extrasystole
B) a site in the conduction fibers that functions as a pacemaker
C) the site where coronary arteries branch off of the aorta
D) an abnormal hole in the interventricular septum allowing blood to flow between
ventricles
E) an extra T wave in the ECG

23) Opening of which of the following channels contributes to the spontaneous depolarization of
pacemaker cells?
A) calcium channels only
B) potassium channels only
C) funny channels only
D) both calcium and potassium channels
E) both calcium channels and funny channels

24) The rapid depolarization phase of a pacemaker cell action potential is caused by which of the
following types of ion movement?
A) movement of sodium through funny channels
B) movement of calcium through L-type channels
C) movement of potassium through funny channels
D) movement of calcium through T-type channels
E) movement of sodium and calcium through funny channels

25) The transition from slow depolarization to an action potential in pacemaker cells is driven by
the ________ of the ________ channel.
A) opening : T-type calcium
B) opening : sodium
C) closure : L-type calcium
D) closure : T-type calcium
E) opening : L-type calcium

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 6

26) Which of the following is responsible for the rapid depolarization phase of an action potential
within the pacemaker cells?
A) decrease in PNa
B) An increase in PNa
C) A decrease in PK
D) An increase in PK

E) An increase in PCa

27) Which of the following ion channels must open for a cardiac pacemaker cell to depolarize to
threshold for an action potential?
A) funny channels only
B) L-type calcium channels only
C) T-type calcium channels only
D) both funny channels and L-type calcium channels
E) both funny channels and T-type calcium channels

28) Which of the following is responsible for the repolarization of pacemaker cells?
A) An increase in PCa
B) An increase in PNa
C) A decrease in PK
D) An increase in PK

E) A decrease in PNa

29) The rapid depolarization phase of a contractile cell is also known as phase ________.
A) 0
B) 1
C) 2
D) 3
E) 4

30) What causes the rapid depolarization phase of a contractile cell action potential?
A) sodium movement into the cell
B) sodium movement out of the cell
C) calcium movement into the cell
D) calcium movement out of the cell
E) potassium movement into the cell

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 7

31) Which of the following statements about the plateau phase of a contractile cell action potential is
FALSE?
A) Calcium permeability is high relative to the resting state.
B) Sodium channels are inactivated.
C) Potassium permeability is low relative to the resting state.
D) The cardiac muscle is in the absolute refractory period.
E) The membrane potential remains the same as the peak of the action potential for about
200 milliseconds.

32) During phase 3 of a contractile cell action potential, ________.

A) only sodium permeability is increased
B) only calcium permeability is increased
C) only potassium permeability is increased
D) sodium and calcium permeability are both increased
E) sodium and potassium permeability are both increased

33) Which of the following ion channels does NOT participate in the contractile cell action
potential?
A) type T calcium channels
B) type L calcium channels
C) delayed rectifying potassium channels
D) inward rectifying potassium channels
E) voltage-gated sodium channels

34) Which of the following is NOT a part of the excitation-contraction coupling in cardiac muscle?
A) An action potential travels along transverse tubules.
B) Calcium channels in the plasma membrane open, allowing calcium ions to enter the cell.
C) Calcium channels in the sarcoplasmic reticulum open, allowing calcium ions to enter the
cytosol.
D) Calcium binds to calmodulin in the cytosol.
E) Calcium opens calcium channels in the sarcoplasmic reticulum.

35) What is the function of the sodium-calcium exchanger in cardiac muscle?

A) depolarize the cell
B) trigger the release of calcium from the sarcoplasmic reticulum
C) remove calcium from the cytosol by transporting it to the extracellular fluid
D) remove calcium from the cytosol by transporting it into the sarcoplasmic reticulum

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 8

E) interact with troponin to initiate cross-bridge cycling

36) What is the role of ryanodine receptors in cardiac muscle?

A) They release calcium from the sarcoplasmic reticulum.
B) They transport calcium from cytosol to extracellular fluid.
C) They transport calcium from cytosol into the sarcoplasmic reticulum.
D) They bind hormones that affect the strength of contraction.
E) They bind to troponin to initiate cross-bridge cycling.

37) Which of the following components of an ECG represents ventricular depolarization?

A) P wave
B) QRS complex
C) T wave
D) PQ interval
E) TQ segment

38) Which of the following components of an ECG represents ventricular repolarization?

A) P wave
B) QRS complex
C) T wave
D) PQ interval
E) TQ segment

39) If damage to the AV node slowed down conduction through this tissue, what would be
observed on an ECG?
A) a larger P wave
B) a longer P wave
C) a longer PR interval
D) a wider QRS complex
E) an inverted T wave

40) In an ECG recording, the RR interval is 0.5 seconds. What is the heart rate?
A) 50 beats/min
B) 100 beats/min
C) 30 beats/min
D) 60 beats/min
E) 120 beats/min

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 9

41) Which of the following describes second degree heart block?

A) there is a longer delay between atrial contraction and ventricular contraction
B) not every atrial contraction is followed by a ventricular contraction
C) not every ventricular contraction is preceded by an atrial
contraction
D) the ventricles no longer contract
E) the atria no longer contract

42) During isovolumetric relaxation, ________.

A) the AV and semilunar valves are closed and ventricular pressure is increasing
B) the AV and semilunar valves are closed and ventricular pressure is decreasing
C) the AV and semilunar valves are open and ventricular pressure is increasing
D) the AV and semilunar valves are open and ventricular pressure is decreasing
E) the AV valves are open, the semilunar valves are closed, and ventricular pressure is
decreasing

43) What is occurring during ventricular ejection?

A) the AV and semilunar valves are closed as ventricular pressure is increasing
B) the AV valves are open and the semilunar valves are closed as ventricular pressure is
increasing
C) the AV and semilunar valves are open as blood is leaving the ventricles
D) the AV valves are closed and the semilunar valves are open as blood is leaving the
ventricles
E) the AV valves are open and the semilunar valves are closed as blood is leaving the
ventricles

44) Which of the following is TRUE of the ventricular filling phase of the cardiac cycle?
A) Ventricular filling occurs during systole.
B) All valves in the heart are open.
C) Ventricular pressure is less than aortic pressure.
D) Ventricular pressure is greater than atrial pressure.
E) Ventricular pressure is decreasing.

45) What phase of the cardiac cycle is the heart in when all four valves of the heart are closed and
ventricular pressure is less than atrial pressure?
A) ventricular filling
B) isovolumetric contraction
C) ventricular ejection
D) isovolumetric relaxation
E) none

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 10

46) What phase of the cardiac cycle is the heart in when all four valves of the heart are open and
ventricular pressure is less than atrial pressure?
A) ventricular filling
B) isovolumetric contraction
C) ventricular ejection
D) isovolumetric relaxation
E) none

47) During which phase of the cardiac cycle are all four heart valves open?
A) ventricular filling
B) isovolumetric contraction
C) ventricular ejection
D) isovolumetric relaxation
E) none

48) Ejection of blood from the right ventricle will continue until ________.
A) the pulmonary semilunar valve contracts, inducing closure
B) pressure in the pulmonary artery is less than pressure in the right ventricle
C) pressure in the aorta is greater than pressure in the right ventricle
D) pressure in the pulmonary artery is greater than pressure in the right ventricle
E) pressure in the aorta is less than pressure in the right ventricle

49) The increase in ventricular volume early in diastole reflects ________.

A) the increased stiffness of the heart
B) the contraction of the atria moving blood into the ventricle
C) the passive movement of blood through the atrium and into the ventricle
D) the relaxation of the ventricle
E) the back-flow of blood from the aorta

50) The small increase in ventricular pressure observed late in diastole is caused by ________.
A) ventricular contraction
B) ventricular relaxation
C) atrial contraction
D) atrial relaxation
E) blood moving into the atria from vena cava

51) Blood is ejected from the left ventricle once pressure within ________.

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 11

A) the ventricle is greater than pressure within the aorta

B) the ventricle is less than pressure within the aorta
C) the ventricle is greater than pressure within the pulmonary artery
D) the ventricle is less than pressure within the pulmonary artery
E) the muscles of the pulmonary semilunar valve relax

52) The increased aortic pressure that occurs during systole reflects a(n) ________.
A) decreased resistance of the vasculature
B) decreased volume of blood within the aorta
C) increased resistance of the vasculature
D) increased volume of blood in the aorta
E) decreased stiffness of the aorta

53) With a systolic pressure of 135 mm Hg and a diastolic pressure of 75 mm Hg, mean arterial
pressure would be ________.
A) 60 mm Hg
B) 95 mm Hg
C) 30 mm Hg
D) 75 mm Hg
E) 135 mm Hg

54) The end-diastolic volume minus the end-systolic volume is the ________.
A) ejection fraction
B) stroke volume
C) cardiac output
D) total ventricular volume
E) total atrial volume

55) The volume of blood ejected from the ventricle with each contraction can be described by the
equation ________.
A) (end-diastolic volume) - (end-systolic volume)
B) (ejection fraction) × (end-diastolic volume)
C) (stroke volume) - (end-diastolic volume)
D) (end-systolic volume) - (stroke volume)
E) (pulse pressure) - (end-diastolic volume)

56) What causes the sounds that one hears as the heart beats?
A) the snapping of the valves into a closed position

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 12

B) the turbulence created as the valves close

C) the snapping of the valves into the open position
D) the turbulence created as the valves open
E) the bulk movement of blood into and out of the ventricle

57) Which of the following structures is POORLY innervated by the parasympathetic nervous
system, therefore, an increase in parasympathetic activity has little effect on this structure?
A) sinoatrial node
B) atrioventricular node
C) ventricles
D) conduction pathway
E) Purkinje fibers

58) The SA node is innervated by ________.

A) the sympathetic nervous system only
B) the parasympathetic nervous system only
C) the somatic nervous system only
D) the sympathetic and parasympathetic nervous systems
E) the sympathetic, parasympathetic, and somatic nervous systems

59) Which of the following is an effect of parasympathetic activity to the heart?

A) Postganglionic neurons release acetylcholine, which binds to nicotinic cholinergic
receptors in the SA node.
B) SA nodal cells are depolarized.
C) Heart rate is increased.
D) The rate of spontaneous depolarization in SA nodal cells decreases.
E) cAMP is activated.

60) Which of the following is FALSE of sympathetic activity to the SA node?

A) Norepinephrine binds to beta1 adrenergic receptors.
B) cAMP levels in the pacemaker cells increases.
C) Funny channel opening is enhanced.
D) The rate of spontaneous depolarization is increased.
E) Potassium channel closing is enhanced.

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 13

of the following
61) Which would NOT result from an increase in ventricular contractility?
A) increased stroke volume
B) increased ejection fraction
C) decreased end-systolic volume
D) increased proportion of end-diastolic volume that is ejected
E) increased end-diastolic volume

62) Under resting conditions, heart rate is primarily under the control of what control
system?
A) the parasympathetic nervous system
B) the sympathetic nervous system
C) epinephrine
D) the somatic nervous system
E) intrinsic mechanisms

63) An increase in heart rate can be mediated through which of the following?
A) a decrease in parasympathetic nervous activity only
B) a decrease in sympathetic activity only
C) an increase in sympathetic activity only
D) an increase in parasympathetic activity and a decrease in sympathetic activity
E) a decrease in parasympathetic activity and an increase in sympathetic activity

64) Which of the following variables is NOT involved in the regulation of stroke volume?
A) ventricular contractility
B) preload
C) parasympathetic nervous activity
D) sympathetic nervous activity
E) afterload

65) Which of the following hormones does NOT increase cardiac contractility?
A) epinephrine
B) thyroid hormones
C) glucagon
D) insulin
E) angiotensin II

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 14

of the following
66) Which best describes the effect of sympathetic activity on ventricular contractile cells?
A) the rates of contraction and relaxation both increase, whereas the force of
contraction decreases
B) the rate of contraction and the force of contraction both increase, whereas the
rate of relaxation decreases
C) the rates of contraction and relaxation and the force of contraction all increase
D) the rates of contraction and relaxation both decrease, whereas the force of
contraction increases
E) the force of contraction increases, whereas the rates of contraction and
relaxation are not affected

67) Which of the following statements is FALSE of sympathetic activity on ventricular

contractile cells?
A) Norepinephrine binds to beta1 adrenergic receptors.
B) Phospholipase C is activated.
C) Calcium channel opening is augmented.
D) The rate of the Ca-ATPase activity is augmented.
E) The rate of the myosin ATPase activity is enhanced.

68) Which of the following describes the effect of end-diastolic volume on stroke volume?
A) An increase in end-diastolic volume stretches ventricular muscle cells to lengths
greater than optimum, decreasing the strength of contraction and thereby decreasing
stroke volume.
B) An increase in end-diastolic volume stretches ventricular muscle cells to lengths
closer to optimum, increasing the strength of contraction and thereby increasing stroke
volume.
C) A decrease in end-diastolic volume allows ventricular muscle cells to relax
more during diastole, allowing more blood to return to the heart increasing stroke
volume.
D) A decrease in end-diastolic volume creates a vacuum drawing more blood into
the ventricle increasing stroke volume.
E) A decrease in end-diastolic volume allows cardiac muscle to relax, conserving
energy for the next contraction, thereby increasing stroke volume of that next
contraction.

69) Which of the following variables is NOT an intrinsic factor that alters cardiac function?
A) preload
B) atrial pressure

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 15

of the following
C) end-systolic volume
D) hormonal stimulation
E) afterload

70) Which events will NOT occur in response to norepinephrine binding to a beta
adrenergic receptor on the ventricular contractile cell?
A) an increase in cyclic AMP
B) an increase in calcium influx through the opening of membrane calcium
channels
C) an increase in calcium release from the sarcoplasmic reticulum
D) an increase in slow depolarization
E) an increase in calcium bound to troponin

71) The binding of a catecholamine to a beta adrenergic receptor will ________.

A) activate guanylate cyclase
B) activate adenylate cyclase
C) activate phospholipase C
D) inhibit guanylate cyclase
E) inhibit phospholipase C

72) Cardiac function curves plot ________ against ________.

A) stroke volume : end-diastolic volume
B) stroke volume : end-systolic volume
C) heart rate : end-diastolic volume
D) heart rate : end-systolic volume
E) cardiac output : end-diastolic volume

73) The preload is approximately the same as the ________.

A) end-diastolic pressure
B) end-systolic pressure
C) aortic systolic pressure
D) aortic diastolic pressure
E) atrial pressure

74) The pressure in the large systemic veins leading into the heart is called what?
A) Preload

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 16

of the following
B) afterload
C) central venous pressure
D) peripheral venous pressure
E) systemic venous pressure

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 17

of the following
75) An increase in venous return would result in a(n) ________.
A) increased end-systolic volume
B) decreased end-systolic volume
C) decreased end-diastolic volume
D) increased end-diastolic volume
E) increase mid-systolic volume
Answer: D
Diff: 5 Page Ref: 391

76) Which of the following variables is NOT involved in determining ventricular preload?
A) filling time
B) atrial pressure
C) venous return
D) end-systolic volume
E) central venous pressure
Answer: D
Diff: 4 Page Ref: 391

77) Which of the following variables is NOT capable of directly altering venous pressure?
A) blood volume
B) parasympathetic nervous activity
C) standing upright
D) posture
E) muscle activity
Answer: B
Diff: 4 Page Ref: 391

78) A decrease in afterload will lead to which of the following?

A) increased heart rate
B) decreased heart rate
C) increased stroke volume
D) decreased stroke volume
E) decreased cardiac output
Answer: C
Diff: 5 Page Ref: 391

79) Which of the following decreases stroke volume?

A) decrease in central venous pressure
B) increase in filling time
C) increase sympathetic activity
D) increase parasympathetic activity
E) increase in atrial pressure
Answer: A
Diff: 6 Page Ref: 391

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 CHAPTER 13 The Cardiovascular System: Cardiac Function 18

of the following
80) Which of the following decreases heart rate?
A) increase in venous pressure
B) increase in filling time
C) increase in sympathetic activity
D) increase in parasympathetic activity
E) increase in stroke volume
Answer: D
Diff: 4 Page Ref: 386

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