Chapter 18- The Heart

The heart is actually (one, two, or three) pumps?

two pumps

Which chamber receives blood from the superior and inferior vena cavae?

right atrium

Which heart chamber receives blood from the pulmonary veins?

left atrium

Which heart chamber pumps unoxygenated blood out the pulmonary trunk?

right ventricle

Which chamber pumps oxygenated blood out the aorta to the systemic circuit?

left ventricle

The layers of the heart wall from superficial to deep are:

epicardium, myocardium, and endocardium.

The heart has _____ chambers and _____ valves.

4; 4

Which of the following does not deliver blood to the right atrium?
Inferior vena cava
Superior vena cava
Coronary sinus
Pulmonary veins

Pulmonary veins

The role of the coronary arteries is to:

supply blood to the heart tissue

Which of the following is not a difference between the left and right ventricles?
The walls of the left ventricle are thicker than the walls of the right ventricle.
The left ventricle pumps blood to the systemic circuit, while the right ventricle pumps blood to the pulmonary circuit.
The left ventricle receives a smaller percentage of coronary blood supply than the right ventricle.
The left ventricle is a more powerful pump than the right ventricle.

The left ventricle receives a smaller percentage of coronary blood supply than the right ventricle.

The ________ valve is located between the right atrium and the right ventricle.

tricuspid

Which of the following is not a difference between cardiac and skeletal muscle?
The plasma membranes of cardiac muscle cells interlock, but skeletal muscle fibers are independent.
Cardiac muscle does not use the sliding filament mechanism for contraction; skeletal muscle does.
Cardiac muscle cells quickly die in the absence of oxygen; skeletal muscle cells are better able to adapt to oxygen deficiency.
Cardiac muscle cells contain more mitochondria than do skeletal muscle cells.

Cardiac muscle does not use the sliding filament mechanism for contraction; skeletal muscle does

Which heart chamber sends deoxygenated blood to the lungs?

right ventricle

Which valve is located between the right atrium and ventricle?

tricuspid valve

What structures connect the individual heart muscle cells?

intercalated discs

Which of the following terms refers to a lack of oxygen supply to heart muscle cells?
ischemia
infarction
functional syncytium
embolism

ischemia

Which of the events below does not occur when the semilunar valves are open?
AV valves are closed.
Ventricles are in systole.
Blood enters pulmonary arteries and the aorta.
Ventricles are in diastole.

Ventricles are in diastole.

The left ventricular wall of the heart is thicker than the right wall in order to ________.

pump blood with greater pressure

Blood within the pulmonary veins returns to the ________.

left atrium

Small muscle masses attached to the chordae tendineae are the ________.

papillary muscles

The term for pain associated with deficient blood delivery to the heart that may be caused by the transient spasm of coronary arteries is ________.

angina pectoris

The source of blood carried to capillaries in the myocardium would be the ________.

coronary arteries

The fact that the left ventricle of the heart is thicker than the right ventricle reveals that it ________.

pumps blood against a greater resistance

When viewing a dissected heart, it is easy to visually discern the right and left ventricles by ________.

noticing the thickness of the ventricle walls

Select the correct statement about the heart valves.
The mitral valve separates the right atrium from the right ventricle.
Aortic and pulmonary valves control the flow of blood into the heart.
The tricuspid valve divides the left atrium from the left ventricle.
The AV valves are supported by chordae tendineae so that regurgitation of blood into the atria during ventricular contraction does not occur.

The AV valves are supported by chordae tendineae so that regurgitation of blood into the atria during ventricular contraction does not occur

Select the correct statement about the structure of the heart wall.
Connective tissue in the heart wall aids in the conduction of the action potential.
The heart chambers are lined by the endomysium.
The myocardium is the layer of the heart that actually contracts.
The fibrous skeleton forms the bulk of the heart.

The myocardium is the layer of the heart that actually contracts.

The enlarged coronary vessel outside the heart that empties blood into the right atrium is the ________.

coronary sinus

The ________ valve of the heart has three flaps with chordae tendineae.

tricuspid

The ________ and ________ valves of the heart have no chordae tendineae attached.

aortic,pulmonary

The myocardium receives its blood supply from the coronary arteries.

True

The left side of the heart pumps the same volume of blood as the right.

True

Anastomoses among coronary arterial branches provide collateral routes for blood delivery to the heart muscle.

True

Arterial blood supply to heart muscle is continuous whether the heart is in systole or diastole.

False

Trabeculae carneae are found in the ventricles and never the atria.

True

The papillary muscles contract after the other ventricular muscles so that they can take up the slack on the chordae tendineae before the full force of ventricular contractions sends blood against the AV valve flaps.

False

Isovolumetric relaxation and ventricular filling (two phases of the cardiac cycle) take place during __________.

ventricular diastole

Which of the following is correct about the filling of the ventricles?
The majority of ventricular filling is caused by contraction of the atria.
Most blood flows passively into the ventricles through open AV valves.

Most blood flows passively into the ventricles through open AV valves.

Describe the pressures in the atria and ventricles that would cause the opening of the AV valves.

Pressure in the atria would be greater than the pressure in the ventricles.

What causes the aortic semilunar valve to close?

greater pressure in the aorta than in the left ventricle

Put the phases of the cardiac cycle in the correct order, starting after ventricular filling.
isovolumetric contraction, ventricular ejection, isovolumetric relaxation
ventricular ejection, ventricular relaxation, isovolumetric contraction
ventricular ejection, isovolumetric contraction, isovolumetric relaxation
isovolumetric relaxation, ventricular ejection, isovolumetric contraction

isovolumetric contraction, ventricular ejection, isovolumetric relaxation

Increased pressure in the ventricles would close what valve(s)?

AV valves only

Which part of the conduction system initiates the depolarizing impulse, which spreads throughout the heart?

SA node

What does the ECG wave tracing represent?

electrical activity in the heart

What does the QRS complex represent in the ECG wave tracing?

ventricular depolarization

Contraction of the atria results from which wave of depolarization on the ECG tracing?

P wave

Which part of the intrinsic conduction system delays the impulse briefly before it moves on to the ventricles?

AV node

Which of the following would increase cardiac output to the greatest extent?
decreased heart rate and increased stroke volume
decreased heart rate and decreased stroke volume
increased heart rate and decreased stroke volume
increased heart rate and increased stroke volume

increased heart rate and increased stroke volume

Which of the following would increase heart rate?
epinephrine and norepinephrine
acetylcholine
decreased activity of the sympathetic nervous system
increased activity of the parasympathetic nervous system

epinephrine and norepinephrine

How would an increase in the sympathetic nervous system increase stroke volume?

increased contractility

By what mechanism would an increase in venous return increase stroke volume?

increased end diastolic volume

How would a decrease in blood volume affect both stroke volume and cardiac output?

decreased stroke volume and no change in cardiac output

What is the main function of heart valves?

to prevent backward flow of blood

When the atria contract, which of the following is true?
The AV valves are closed.
The ventricles are in diastole.
The atria are in diastole.
The semilunar valves are open.

The ventricles are in diastole.

Which of the following is equivalent to the ventricular volume during isovolumetric contraction?
the minimum ventricular volume (MVV)
the stroke volume (SV)
The end diastolic volume (EDV)
the end systolic volume (ESV)

The end diastolic volume (EDV)

Which of the following is true during ventricular systole?
The atria are in systole.
The ventricles are empty.
The AV valves are closed.
The ventricles are relaxed.

The AV valves are closed.

During the ventricular ejection phase of the cardiac cycle, which of the following is true?

The semilunar valves are open.

Most of the decrease in ventricular volume takes place during which phase of the cardiac cycle?

ventricular ejection

Which of the following is equivalent to the ventricular volume during isovolumetric relaxation?
end diastolic volume (EDV)
maximum ventricular volume (MVV)
stroke volume (SV)
end systolic volume (ESV)

end systolic volume (ESV)

Most of the increase in left ventricular volume takes place during what phase of the cardiac cycle?

ventricular filling

In what direction does blood flow through the heart?

from a region of high pressure to a region of low pressure

Atrial pressure is greater than ventricular pressure during which phase of the cardiac cycle?

atrial contraction

At what point during the cardiac cycle does the AV valve close?

when ventricular pressure becomes greater than atrial pressure

At what point in the cardiac cycle does the semilunar valve open?

when ventricular pressure becomes greater than aortic pressure

Ventricular pressure is greater than aortic pressure during which phase of the cardiac cycle?

ventricular ejection

At what point in the cardiac cycle does the semilunar valve close?

when pressure in the ventricle becomes less than aortic pressure

Isovolumetric relaxation is characterized by which of the following?

The semilunar and AV valves are closed.

At what point in the cardiac cycle does the AV valve open?

when atrial pressure becomes greater than ventricular pressure

The order of impulse conduction in the heart, from beginning to end, is:

SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.

A premature ventricular contraction is classified as a(n):

extrasystole.

The QRS complex on an electrocardiogram represents:

ventricular depolarization.

The first heart sound (the ‘lub’ of ‘lub-dup’) is caused by:

closure of the atrioventricular valves.

Which is correctly matched?
Stroke volume: amount of blood pumped out by each ventricle in one minute
Diastole: contraction period
Quiescent period: total heart relaxation between heartbeats
Systole: relaxed period

Quiescent period: total heart relaxation between heartbeats

In a healthy individual which of the following would be low?

Afterload

Which of the following would increase heart rate?
Epinephrine
Low metabolic rate
Parasympathetic stimulation
Cold temperature

Epinephrine

The left side of the heart is considered the systemic circuit pump.

True

Which of the following structures sets the pace of heart contraction?
atrioventricular bundle
AV node
bundle branches
SA node

SA node

What does the T wave of the electrocardiogram represent?

ventricular repolarization

What is afterload?

back pressure exerted by arterial blood

What causes heart sounds?

heart valve closure

Which of the following is NOT a factor that regulates stroke volume?
afterload
preload
contractility
heart rate
all the factors above regulate stroke volume

all the factors above regulate stroke volume

Normal heart sounds are caused by which of the following events?

closure of the heart valves

Hemorrhage with a large loss of blood causes ________.

a lowering of blood pressure due to change in cardiac output

a lowering of blood pressure due to change in cardiac output

AV node

The P wave of a normal electrocardiogram indicates ________.

atrial depolarization

The tricuspid valve is closed ________.

when the ventricle is in systole

During the period of ventricular filling ________.

blood flows passively through the atria and the open AV valves into the ventricles

The time of day most hazardous for heart attacks is ________.

morning

Tissues damaged by myocardial infarction are replaced by connective tissue.

True

Congestive heart failure means that the pumping efficiency of the heart is depressed so that there is inadequate delivery of blood to body tissues.

True

Chronic release of excess thyroxine can cause a sustained increase in heart rate and a weakened heart.

True

The "lub" sounds of the heart are valuable in diagnosis because they provide information about the function of the heart’s pulmonary and aortic valves.

False

The heart’s pacemaker is the:

sinoatrial node

What is the source of ATP for cardiac muscle contraction?

cellular respiration

If cardiac muscle is deprived of its normal blood supply, damage would primarily result from ________.

decreased delivery of oxygen

If the length of the absolute refractory period in cardiac muscle cells was the same as it is for skeletal muscle cells ________.

tetanic contractions might occur, which would stop the heart’s pumping action

Select the correct statement about the function of myocardial cells in a healthy, normally functioning heart.
The refractory period in skeletal muscle is much longer than that in cardiac muscle.
The atria, followed by the ventricles, contract as a unit or they do not contract at all.
The influx of potassium ions from extracellular sources is the initiating event in cardiac muscle contraction.
Each cardiac muscle cell is innervated by a sympathetic nerve ending so that the nervous system can increase heart rate.

The atria, followed by the ventricles, contract as a unit or they do not contract at all.

Compared to skeletal muscle, cardiac muscle ________.

has gap junctions that allow it to act as a functional syncytium

During contraction of heart muscle cells ________.

some calcium enters the cell from the extracellular space and triggers the release of larger amounts of calcium from intracellular stores

Cardiac muscle has more mitochondria and depends less on a continual supply of oxygen than does skeletal muscle.

False