Physiology - Ch 15 Blood Flow

Human Physiology: An Integrated Approach, 6e (Silverthorn)
Chapter 15 Blood Flow and the Control of Blood Pressure

1) Fainting is also known as
A) eclampsia.
B) vasovagal syncope.
C) infarction.
D) reactive hyperemia.
E) orthostatic hypotension.

: B Section Title: Introduction Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

2) Perfusion is
A) blood flow through an organ.
B) the driving force behind blood flow.
C) delivery of oxygen to cells.
D) the connection between capillaries and other vessels.
E) movement of blood through a shunt.

: A Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

3) ________ are also known as the pressure reservoir of the cardiovascular system.
A) Veins
B) Venules
C) Capillaries
D) Arterioles
E) Arteries

: E Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
4) The inner lining of blood vessels is called
A) endocardium.
B) endoangium.
C) endothelium.
D) basal lamina.
E) endostatin.

: C Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

5) Smooth muscle is present in the walls of
A) veins only.
B) arteries only.
C) muscular arteries only.
D) all vessel types except capillaries.
E) all vessel types.

: D Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

6) The highly branched contractile cells that regulate capillary permeability are called
A) podocytes.
B) vascular smooth muscle.
C) endothelial cells.
D) pericytes.
E) epitheliocytes.

: D Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

7) Differences between arterioles and metarterioles include the fact that arterioles
A) have a continuous smooth muscle layer in their walls.
B) allow blood to bypass capillary beds.
C) have an endothelial lining.
D) have a continuous smooth muscle layer in their walls and allow blood to bypass capillary beds.
E) All of the answers are correct.

: A Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)
8) The only blood vessels whose walls permit exchange between the blood and the surrounding interstitial fluids are the
A) arterioles.
B) venules.
C) capillaries.
D) arterioles and capillaries.
E) venules and capillaries.

: E Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

9) Angiogenesis is
A) an examination of the arteries and veins.
B) having blood drawn into a tube for tests.
C) the growth of new blood vessels.
D) surgical restructuring of the coronary arteries.
E) being able to detect a pulse in arteries.

: C Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

10) Angiostatin and endostatin may be useful in the treatment of
A) myocardial infarction.
B) hypertension.
C) hypotension.
D) cancer.
E) vasovagal syncope.

: D Section Title: The Blood Vessels Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

11) The values obtained when measuring blood pressure, such as 120/80,
A) exactly match the pressures inside the ventricle during systole and diastole.
B) reflect the pressure in the major arteries during ventricular systole and diastole.
C) are the same on both the pulmonary and systemic circuits.
D) exactly match the pressures inside the ventricle during systole and diastole and reflect the pressure in the major arteries during ventricular systole and diastole.
E) All of the answers are correct.

: B Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
12) Which of the following is occurring during systole?
A) blood pressure increases
B) pulse pressure decreases
C) more stress is placed on arterial walls
D) blood pressure increases and pulse pressure decreases
E) blood pressure increases and more stress is placed on arterial walls

: E Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

13) The mean arterial pressure (MAP) is important because
A) it represents the driving pressure for blood flow.
B) it reflects the difference in time that systole lasts compared to diastole.
C) it forces the practitioner to do math, thus they must pay attention to the values obtained.
D) it represents the driving pressure for blood flow and it reflects the difference in time that systole lasts compared to diastole.
E) All of the answers are correct.

: A Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

14) Blood flow to a tissue will increase if the
A) level of oxygen at the tissue increases.
B) level of carbon dioxide at the tissue increases.
C) pH rises.
D) vessels constrict.
E) All of the answers are correct.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

15) Blood pressure is determined by
A) measuring the size of the pulse pressure.
B) measuring the pressure in the left ventricle.
C) measuring the force exerted by blood in a vessel.
D) measuring the degree of turbulence in a closed vessel.
E) All of the answers are correct.

: C Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
16) The difference between the systolic and diastolic pressures is called the
A) systemic pressure.
B) mean arterial pressure.
C) pulse pressure.
D) blood pressure.
E) circulatory pressure.

: C Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

17) All of the following would cause an increase in blood pressure EXCEPT
A) an increase in arterial resistance.
B) a decrease in arterial diameter.
C) a decrease in cardiac output.
D) sympathetic stimulation.

: C Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

18) The vessels that are the main site of variable resistance in the circulatory system, and that contribute more than 60% of the total resistance, are the
A) muscular arteries.
B) elastic arteries.
C) arterioles.
D) venules.
E) veins.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

19) If cardiac output increases and resistance in arterioles does NOT change, what happens to arterial blood pressure?
A) increases
B) decreases
C) is unchanged

: A Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Application)
20) Increased blood volume ________ blood pressure.
A) increases
B) decreases
C) has no effect on

: A Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

21) Which organ is NOT part of the cardiovascular system and plays an important role in regulating blood pressure?
A) liver
B) spleen
C) lung
D) kidney
E) skin

: D Section Title: Blood Pressure Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

22) The matching of blood flow to the changing metabolic needs of a tissue is due to
A) neural control.
B) hormonal control.
C) local control.

: C Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

23) Myogenic autoregulation means that
A) increased blood pressure in a vessel triggers relaxation in that vessel.
B) stretched smooth muscle in a blood vessel constricts reflexively.
C) blood vessel diameter is adjusted by centers in the brain through monitoring blood pressure in areas throughout the body.
D) increased blood pressure in a vessel triggers relaxation in that vessel and blood vessel diameter is adjusted by centers in the brain through monitoring blood pressure in areas throughout the body.
E) stretched smooth muscle in a blood vessel constricts reflexively and blood vessel diameter is adjusted by centers in the brain through monitoring blood pressure in areas throughout the body.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)
24) Each of the following paracrines may cause vasodilation EXCEPT
A) nitric oxide.
B) H+ ions from metabolic acids.
C) Ca2+.
D) K+.
E) CO2.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

25) Reactive hyperemia is
A) lack of blood flow due to an allergic reaction.
B) increased blood flow following a period of reduced blood flow.
C) increased blood pressure after stress.
D) reflex contraction of smooth muscle in response to stress.
E) None of the answers are correct.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

26) Reactive hyperemia is triggered by
A) local accumulation of paracrines due to reduced blood flow.
B) reflex contraction of smooth muscle following a period of dilation.
C) stress and the hormones released during stress.
D) toxins or allergens, such as bee venom or pollen.
E) None of the answers are correct.

: A Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

27) The elevated blood pressure that sometimes accompanies pregnancy is known as
A) preeclampsia.
B) vasovagal syncope.
C) infarction.
D) reactive hyperemia.
E) orthostatic hypotension.

: A Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
28) In order to cause vasodilation of most vascular smooth muscle,
A) acetylcholine combines with nicotinic receptors.
B) acetylcholine combines with muscarinic receptors.
C) norepinephrine combines with alpha receptors.
D) norepinephrine combines with β1 receptors.
E) sympathetic stimulation is removed.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

29) Several blood-borne chemicals affect the lumen size of arterioles. Which are NOT paired correctly?
A) kinins — vasodilation
B) histamine — vasodilation
C) serotonin — vasodilation
D) sumatriptan — vasoconstriction
E) epinephrine — vasoconstriction with alpha receptors

: C Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

30) ________ capillaries are very porous and allow high volumes of fluids to pass through them, whereas ________ capillaries consist of more tightly joined cells that allow a high degree of selective materials to pass.
A) Fenestrated, transcytotic
B) Continuous, fenestrated
C) Transcytotic, continuous
D) Fenestrated, continuous
E) Transcytotic, fenestrated

: D Section Title: Resistance in Arterioles Learning Outcome: 15.7

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

31) Sinusoids are modified vessels that replace ________ in some tissues.
A) arteries
B) veins
C) capillaries

: C Section Title: Resistance in Arterioles Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
32) Compared to arteries, the velocity of flow of the blood through the capillaries is
A) at least 10 times faster.
B) at least twice as fast.
C) about the same.
D) much slower.
E) impossible to predict without more information.

: D Section Title: Exchange at the Capillaries Learning Outcome: 15.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

33) Due to the differences in opposing forces, there is net ________ occurring at the arteriolar end of most capillaries, coupled with net ________ at the venous end.
A) absorption, filtration
B) filtration, absorption

: B Section Title: Exchange at the Capillaries Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

34) Restoring lost fluid from the capillaries back to the circulatory system is one of the major functions of the ________ system.
A) urinary
B) thirst-quenching
C) lymphatic
D) immune
E) digestive

: C Section Title: The Lymphatic System Learning Outcome: 15.8

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

35) Osmotic pressure resulting from presence of plasma proteins in blood is called ________ pressure.
A) oncotic
B) colloid osmotic
C) hydrostatic
D) oncotic and colloid osmotic
E) colloid osmotic and hydrostatic

: D Section Title: Exchange at the Capillaries Learning Outcome: 15.7

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
36) A parasitic condition resulting in extreme enlargement of one or both legs is called
A) elephantiasis.
B) elephantitis.
C) elephantosis.
D) ascites.

: A Section Title: The Lymphatic System Learning Outcome: 15.8

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

37) The integrating center for neural control of blood pressure resides in the
A) cerebrum.
B) cerebellum.
C) medulla oblongata.
D) pons variolli.
E) hypothalamus.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

38) Stretch-sensitive mechanoreceptors known as ________ are located in some artery walls.
A) nociceptors
B) chemoreceptors
C) baroreceptors
D) elasticeptors

: C Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

39) Blood pressure and flow to the brain are monitored by receptors located in the wall of the
A) carotid artery.
B) aorta.
C) venae cavae.
D) cerebral arteries.
E) cephalic arteries.

: A Section Title: Cardiovascular Disease Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
40) When blood pressure is normal, the receptors in arterial walls fire action potentials
A) very seldom.
B) continuously.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

41) When blood pressure receptors sense a loss of blood pressure, they ________ their firing rate.
A) increase
B) decrease

: B Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

42) Blood pressure and cardiac output can be altered according to
A) body temperature.
B) emotional responses.
C) blood oxygen levels.
D) body temperature and emotional responses.
E) body temperature, emotional responses, and blood oxygen levels.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

43) When the baroreceptor reflex is triggered by a decline in blood pressure,
A) sympathetic activity increases.
B) cardiac output increases.
C) peripheral resistance decreases.
D) sympathetic activity increases and cardiac output increases.
E) sympathetic activity increases, cardiac output increases, and peripheral resistance decreases.

: D Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)
44) If a person is bedridden for several days, the baroreceptor reflex may fail upon standing. Why?
A) Blood pools in the feet and legs.
B) There is reduced blood flow to the brain.
C) The kidneys have reduced the blood volume.
D) Blood pools in the feet and legs and there is reduced blood flow to the brain.
E) All of the statements are correct.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

45) Which of these does NOT increase the risk for cardiovascular disease?
A) being a male over 30 but under 55
B) being a female over 30 but under 55
C) having a sister with coronary artery disease
D) menopause without estrogen replacement therapy
E) having diabetes mellitus

: B Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

46) For a diagnosis of hypertension, a patient must have
A) a systolic pressure above 120 mm Hg.
B) a systolic pressure above 140 mm Hg.
C) a diastolic pressure above 90 mm Hg.
D) a diastolic pressure below 80 mm Hg.
E) a systolic pressure above 140 mm Hg or a diastolic pressure above 90 mm Hg.

: E Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

47) The endothelium of the blood vessels and its adjacent connective tissue make up the ________, which is surrounded by layers of smooth muscle and connective tissue called ________.

: tunica intima or intima, tunica media Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)
48) Capillaries lack smooth muscle and elastic or fibrous tissue reinforcement. Instead, their walls consist of ________, supported on a cellular matrix called ________.

: a flat layer of endothelium, the basal lamina. Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

49) Cerebral capillaries are surrounded by ________ and glial cells and have tight junctions that create the ________.

: pericytes, blood-brain barrier Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

50) Venules are similar to capillaries: they have ________ epithelium and little ________. They are distinguished from capillaries by ________.

: a thin exchange, connective tissue (Fig. 15.2); their convergent pattern of flow Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

51) Blood pressure is highest in the ________ and decreases continuously as blood flows through the circulatory system, due to ________.

: arteries, the energy lost as a result of the resistance to flow offered by the vessels. Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

52) The rapid pressure increase that occurs when the left ventricle pushes blood into the aorta can be felt as ________.

: pulse Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

53) Venous return to the heart is aided by ________ and the ________.

: the skeletal muscle pump, respiratory pump Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)
54) A rupture of a blood vessel in the brain is called ________ and may cause the loss of neurological function commonly called ________.

: a cerebral hemorrhage, a stroke Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

55) Mean arterial pressure is (indirectly/directly) proportional to ________ and (indirectly/directly) proportional to ________.

: directly, cardiac output, directly, resistance of arterioles Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

56) ________ is an increase in blood flow that accompanies an increase in metabolic activity.

: Active hyperemia Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

57) Norepinephrine binding to alpha receptors on vascular smooth muscle causes ________ and epinephrine binding to alpha receptors on vascular smooth muscle causes ________.

: vasoconstriction, vasoconstriction Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension)

58) The osmotic pressure created by the presence of proteins is known as ________, which is (higher/lower) in the plasma than in the interstitial fluid.

: colloid osmotic or oncotic pressure, higher Section Title: Exchange at the Capillaries Learning Outcome: 15.7

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

59) The decrease in blood pressure upon standing is known as ________.

: orthostatic hypotension Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension)

60) The term for chronically elevated blood pressure is ________.

: hypertension Section Title: Resistance in Arterioles Learning Outcome: 15.10

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
61) Loss of pericytes around retinal capillaries is a hallmark of the disease ________.

: diabetic retinopathy Section Title: Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

62) Capillary exchange involving movement between the endothelial cells is called the ________ pathway.

: paracellular Section Title: Exchange at the Capillaries Learning Outcome: 15.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

63) Capillary exchange involving movement through the cells is called ________ transport.

: transendothelial Section Title: Exchange at the Capillaries Learning Outcome: 15.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

64) The turbulent flow of blood causes a noise called a ________ that can be heard through the stethoscope when taking blood pressure.

: Korotkoff sound Section Title: Blood Pressure Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

65) The structures that regulate blood flow into single capillaries within a tissue are ________.

: precapillary sphincters Section Title: Blood Pressure Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

66) The accumulation of fluid in the interstitial space is called ________.

: edema Section Title: The Lymphatic System Learning Outcome: 15.8

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)

67) Receptors that monitor blood pressure are called ________.

: baroreceptors Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge)
68) Compensation for decreased blood volume includes increases in
A) sympathetic stimulation to blood vessels.
B) sympathetic stimulation of the heart.
C) water conservation by the kidneys.
D) sympathetic stimulation to blood vessels and water conservation by the kidneys.
E) sympathetic stimulation to blood vessels, sympathetic stimulation of the heart, and water conservation by the kidneys.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

69) Fenestrated capillaries are present in
A) skeletal muscles.
B) cardiac muscle.
C) the liver.
D) the spleen.
E) skin.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.1

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension)

70) Regarding the cardiovascular system, the main role(s) of the kidneys is/are to
A) restore lost fluid to the blood and therefore raise blood pressure.
B) minimize fluid loss from the blood and therefore maintain blood pressure.
C) reduce blood volume and therefore reduce blood pressure.
D) restore lost fluid to the blood and therefore raise blood pressure and minimize fluid loss from the blood and therefore maintain blood pressure.
E) minimize fluid loss from the blood and therefore maintain blood pressure and reduce blood volume and therefore reduce blood pressure.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

71) Which of the following conditions would have the greatest effect on peripheral resistance?
A) doubling the length of a vessel
B) doubling the diameter of a vessel
C) doubling the viscosity of the blood
D) doubling the turbulence of the blood
E) doubling the number of white cells in the blood

: B Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

72) Each of the following factors would increase peripheral resistance except one. Identify the exception.
A) increased sympathetic stimulation
B) elevated levels of epinephrine
C) vasodilation
D) irregularities in the vessel walls caused by plaques
E) factors that cause increased hematocrit

: C Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

73) If a person has a blood pressure of 120/80, her mean arterial pressure would be
A) 200 mm Hg.
B) 100 mm Hg.
C) 93 mm Hg.
D) 80 mm Hg.
E) 40 mm Hg.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

74) The lymphatic system
A) has heart-like pumps called lymph nodes.
B) stores blood when circulatory demand is low.
C) empties the lymph vessels into the veins near the clavicles.
D) can be removed without health consequences.
E) All of the answers are correct.

: C Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension)

75) The cardiovascular control center in the brain can directly cause
A) arterioles to dilate or constrict.
B) the heart rate to increase or decrease.
C) the contractility of the heart to increase or decrease.
D) arterioles to dilate or constrict and the heart rate to increase or decrease.
E) All of the answers are correct.

: D Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

76) Malnutrition can cause edema because
A) there are not enough nutrients for plasma protein synthesis.
B) interstitial protein levels are lower than plasma protein levels.
C) the resulting anemia increases blood pressure.
D) there are not enough nutrients for plasma protein synthesis and interstitial protein levels are lower than plasma protein levels.
E) All of the answers are correct.

: A Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

77) The continual movement of fluid through the interstitial space functions to
A) accelerate the distribution of nutrients and hormones.
B) assist the transport of insoluble substances that cannot enter the capillaries.
C) help carry toxins and bacteria to cells of the immune system.
D) flush hormones and wastes from the interstitial space.
E) All of the answers are correct.

: E Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

78) Edema is likely to occur when
A) the concentration of protein in the blood increases.
B) hemorrhage occurs.
C) the heart becomes an insufficient pump.
D) blood hydraulic pressure at the capillary decreases.
E) the blood hydraulic pressure in a capillary is equal to the blood osmotic pressure.

: C Section Title: Cardiovascular Disease Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

79) Which of the following is greater?
A) blood pressure when sympathetic stimulation to the heart increases
B) blood pressure when parasympathetic stimulation to the heart increases

: A Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

80) Which of the following is greater?
A) heart rate normally
B) heart rate during circulatory shock

: B Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

81) Which of the following is/are (a) possible treatment(s) for hypertension?
A) calcium channel blockers
B) ACE inhibitors
C) ANP blockers
D) chloride leak channel blockers
E) calcium channel blockers and ACE inhibitors

: E Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

82) Which of the following is greater?
A) blood pressure when the peripheral vessels dilate
B) blood pressure when the peripheral vessels constrict

: B Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

83) Increased levels of carbon dioxide in the blood will result in
A) decreased heart rate.
B) decreased cardiac output.
C) decreased blood flow to the lungs.
D) decreased parasympathetic stimulation of the heart.
E) All of the answers are correct.

: D Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

84) Tom suffers from hypertension (high blood pressure). Which of the following might help deal with his problem? A drug that
A) stimulates α1 receptors in cardiac muscle tissue.
B) blocks α2 receptors in cardiac muscle tissue.
C) stimulates cAMP formation in cardiac muscle tissue.
D) blocks beta receptors in cardiac muscle tissue.
E) blocks muscarinic receptors in cardiac muscle tissue.

: D Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

85) Because the suffix "itis" means ________, swelling of the lower extremities due to blockage of lymph flow is NOT called ________-itis; rather it is called ________.

: "inflammation of", elephant, elephantiasis Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension)

86) Three tissues-________, ________, and ________-do NOT have traditional capillaries. Instead, they have modified vessels called ________ that are (wider/narrower) than a capillary.

: the bone marrow, the liver, the spleen; sinusoids, wider Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension)

87) ________ refers to the mass movement of fluid between the blood and the interstitial fluid as the result of ________ or ________ pressure gradients. If the direction of bulk flow is into the capillary, the fluid movement is called ________. If the direction of flow is out of the capillary, the fluid movement is known as ________.

: Bulk flow, hydrostatic, osmotic; absorption; filtration Section Title: Exchange at the Capillaries Learning Outcome: 15.7

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

88) During the fight-or-flight reaction, ________ is released from the adrenal medulla and binds to ________ receptors, found on the vascular smooth muscle of heart, liver, and skeletal muscle arterioles and results in (increased/decreased) blood flow to these organs; the same hormone binds to ________ receptors on other tissues, causing (increased/decreased) blood flow to these organs.

: epinephrine, β2, increased, α, decreased Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

89) Map the following terms: blood distribution, blood volume, cardiac output, diameter of the arterioles, diameter of the veins, fluid intake, fluid loss, heart rate, mean arterial pressure, passive, regulated at kidneys, resistance to blood flow, and stroke volume.

: See Figure 15.8 in the chapter. Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

90) List the factors that influence arteriolar resistance, and give an example of each.

: 1. Sympathetic reflexes. Example: temperature regulation. 2. Local control of arteriolar resistance matches tissue blood flow to the metabolic needs of the tissue-Example: paracrines that respond to low oxygen, high carbon dioxide. 3. Hormones such as those that regulate salt and water excretion by the kidney. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

91) Define and describe the mechanism of myogenic autoregulation.

: Myogenic autoregulation is the self-regulation by the vascular smooth muscle in response to an increase in blood pressure. The mechanism responsible for the intrinsic response of vascular smooth muscle is stretch that opens mechanically gated Ca2+ channels in the muscle membrane. Calcium entering the smooth muscle cell combines with calmodulin and activates myosin light chain kinase, which in turn increases myosin ATPase activity and crossbridge activity. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

92) Compare and contrast the structure and location of arteries, arterioles, capillaries, and veins. How do these differences contribute to the differences in function of each?

: See Figure 15.2 in the chapter for a summary of structural differences in vessel walls. Arteries contain relatively more smooth muscle, for active regulation of vessel diameter. Large, elastic arteries have more elastic fibers, so that the vessel can stretch and recoil with ventricular contraction and relaxation, thereby minimizing fluctuation in blood pressure. Capillaries are thin and porous, reflecting their role in exchange of substances with the interstitial fluid. Veins contain valves to prevent backflow of blood, which is especially important in leg veins. Section Title: The Blood Vessels Learning Outcome: 15.1

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)
93) Draw a map of the baroreceptor reflex, starting with decrease in blood pressure. Indicate on the map the following: stimulus, receptor, afferent pathway, integrating center, efferent pathway, effector, tissue response, systemic response.

: See Figure 15.14 in the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.9

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

94) What effect does a calcium channel blocker have on the heart, the blood pressure, and cardiac output? Why?

: Calcium channel blockers inhibit the opening of calcium channels and ensuing calcium current. Vascular smooth muscle dilates, and heart rate decreases. Vasodilation will result in a decrease in systemic blood pressure, and the decrease in heart rate will decrease cardiac output. Section Title: Cardiovascular Disease Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

95) Diagram the components and interactions of the baroreceptor reflex.

: See Figure 15.14 in the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.9

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

96) Why is there a loss of blood volume when a patient is confined to bed for two or three days? What symptoms commonly follow this confinement?

: Inactivity causes edema, because of the lack of skeletal muscle pump. The accumulated fluid of edema represents loss from the blood capillaries. This decreased blood volume causes decreased blood pressure, which may give the patient a sense of light-headedness upon standing. Section Title: Resistance in Arterioles Learning Outcome: 15.7

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)
97) Children who suffer from protein starvation have bloated bellies of ascites (an accumulation of fluid in the tissue spaces of the abdomen). How would a shortage of protein in the diet cause this condition?

: Protein is needed by the body for proper growth, maintenance, and reproduction. If there is a shortage of protein in the diet, the body must turn to itself for a source of amino acids. One of the first proteins to be dismantled for amino acids is plasma albumin. As the level of albumin in the plasma decreases, so does the osmotic pressure. Fluid that has leaked from the capillaries to the interstitial spaces does not return to the blood because of the decreased plasma osmotic pressure; because of the large vascular network in the abdominal viscera, the majority pools in this region. Section Title: The Lymphatic System Learning Outcome: 15.7

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

98) Define, compare, and contrast each of the pathologies listed below. Are the risk factors for each the same? Explain your answer.
A. coronary artery disease
B. atherosclerosis
C. myocardial infarction
D. hypertension
E. congestive heart failure

: A. Coronary blood vessels become blocked by cholesterol or blood clots, causing reduced blood flow. B. Atherosclerosis is hardening of the arteries, which results from accumulation of cholesterol and other lipids, proliferation of vascular smooth muscle, and hardening due to calcification and fibrosis. The bulge that forms protrudes into the vessel lumen, reducing blood flow. C. Myocardial infarction is the death of heart cells as a result of blocked blood flow. D. Hypertension is high systemic blood pressure that develops as a result of increased peripheral resistance. E. Congestive heart failure occurs after prolonged hypertension, when the cardiac muscle can no longer generate the necessary cardiac output against the high peripheral resistance. As left cardiac output decreases, fluid backs up into the lungs. Oxygenation of the blood decreases, the heart becomes even weaker, leading to more fluid accumulation, and eventually death. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application)

99) What are some dangers of having coronary artery disease? What are some dangers of having hypertension?

: This is discussed in the "Cardiovascular Disease" section of the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)
100) Outline the relationship between hypertension and the development of congestive heart failure.

: This is discussed in the "Cardiovascular Disease" section of the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

101) List the steps and briefly explain what happens in orthostatic hypotension. What reflex counteracts it?

: Orthostatic hypotension is the decrease in blood pressure upon moving rapidly from a stable reclining position to standing. While reclining flat, gravity is distributed equally and so is blood. When moving to a standing position, blood initially pools in the lower extremities and cardiac output drops from about 5 L/min to about 3 L/min. Arterial blood pressure then decreases. The baroreceptor reflex should counteract orthostatic hypotension. Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

102) By binding to the Ca2+ channel proteins, drugs known as calcium channel blockers have two main effects. Name them. Why are some cells unaffected by these drugs?

: Binding to calcium channels makes them less likely to open, effectively blocking the normal inward calcium current that would result from neural or endocrine stimulation. This causes vasodilation and a decrease in heart rate. Insensitive tissues have a different subtype of calcium channel. Section Title: Cardiovascular Disease Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Analysis)

103) While you study blood vessel structure in your dorm room, your roommate prepares to bike to his favorite fishing hole. You absent-mindedly watch as he puts on his bike shorts, which look absurdly small in his hands but stretch easily then snap back to fit tightly. His fishing shirt is a nonstretchy cotton weave that fits loosely, with open mesh panels across the back and armpits for ventilation. Considering only the basic structural differences in arteries, veins, and capillaries, which of the types of fabrics resemble which vessels, and why?

: The bike shorts stretch and recoil like elastic arteries, the cotton weave is floppy and nonstretchy like veins, and the mesh is porous like capillaries. Section Title: The Blood Vessels Learning Outcome: 15.1

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)
104) Baroreceptors have stretch-sensitive ion channels in their cell membrane. Increased pressure on the membrane opens the channels and allows ion flow that initiates action potentials. What kind of ion probably flows through these channels and in which direction?

: Action potentials are created when a cell depolarizes to threshold. Depolarization results from net influx of positive ions or efflux of negative ions. The most likely ion is Na+, moving into the receptor cell. Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)

105) Nicotine stimulates cholinergic receptors of the autonomic nervous system. Based on this information, how would cigarette smoking affect the cardiovascular system?

: Since cholinergic receptors are found in all of the ganglia of the autonomic nervous system, you would expect nicotine to stimulate both sympathetic and parasympathetic responses in the cardiovascular target tissues. In response to increased sympathetic stimulation the heart would beat faster and more forcefully. At the same time, however, increased parasympathetic stimulation would decrease the blood flow to the heart muscle. The increased heart rate and force of contraction would contribute to increased blood pressure as would vasoconstriction of peripheral blood vessels as a result of sympathetic stimulation. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)

106) The condition known as shock is characterized by a decreased return of venous blood to the heart. How could an upsetting situation such as the sight of a tragic accident or very bad news produce shock?

: The upsetting stimuli would be processed by the higher centers of the central nervous system and relayed to the hypothalamus. The hypothalamus could suppress the vasomotor center of the medulla, resulting in fewer sympathetic impulses to peripheral blood vessels. This would cause a decrease in sympathetic tone in the smooth muscle of the blood vessels, resulting in vasodilation. The vasodilation would cause blood to pool in the extremities, decreasing the amount of blood returning to the heart and producing shock. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)
107) One of the most common signs of polycystic kidney disease is hypertension in an otherwise seemingly healthy individual. Why would cysts on the kidney lead to higher blood pressure?

: Cysts developing on the kidney will put pressure on the kidneys and decrease the ability of the blood vessels in the kidney to filter out urine, causing an increase in plasma in the blood and higher blood pressure. Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)

108) Nitroglycerine is a medication taken by people who experience chest pain known as angina. One of the major side effects of the medication is that the patient will notice a severe headache. What causes this side effect?

: Nitroglycerine is a vasodilator that is non-specific (the nitric oxide content causes all blood vessels it contacts to dilate). When it is ingested it will cause dilation of the coronary arteries, reliving the chest pain and preventing myocardial infarction, but it will also cause dilation of cerebral blood vessels, causing a headache. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.5

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)

109) The sympathetic nervous system will cause vasodilation in the arteries of many blood vessels, but vasoconstriction in the brain. Why does this occur?

: Because the brain needs a relatively constant flow of blood, whether the body is at rest or under stress, it will try to maintain a constant level of perfusion to the brain. Since the sympathetic nervous system increases heart rate, blood will flow to the brain faster than it does while at rest, so by constricting the arteries, it will decrease the amount of blood each beat that reaches the brain and thereby keeping a fairly constant amount of blood flowing to the brain. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.5

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)

110) Many drugs used to treat migraine headaches contain caffeine. What mechanism does caffeine have that can help with migraine headaches?

: Migraine headaches are caused by dilation of blood vessels in the brain. Caffeine is a drug that mimics the sympathetic nervous system. Since the sympathetic nervous system causes vasoconstriction in the brain, it will counteract the effects of migraine headaches. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.5

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)
111) Josie is in her last weeks of pregnancy. During a routine check-up, she asks why she is suddenly experiencing swollen feet when she wears knee-high stockings (with a tight elastic band just below the knee). She is confused because an elderly relative wears support stockings to prevent swollen feet, an apparent contradiction. Speculate on a logical explanation for her swelling feet and the difference between support hose and knee-high stockings.

: The elastic band in one of Josie's stocking is so tight that it constantly compresses her veins just in the area under the elastic. This reduces venous return, increasing pressure below that area and causing fluid to exit her blood. Support stockings are medical devices that apply uniform pressure along their entire length, and so produce no constriction. They increase pressure slightly, continuously aiding venous return much like a muscle pump does intermittently. Section Title: Blood Pressure Learning Outcome: 15.8

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)

112) Tom loves to soak in hot tubs and whirlpools. One day he decides to raise the temperature in his hot tub as high as it will go. After a few minutes in the very warm water, he feels faint, passes out, and nearly drowns. Luckily he is saved by an observant bystander. Explain what happened.

: In response to the high temperature of the water, Tom's body shunted more blood to the superficial veins to decrease body temperature. The dilation of the superficial veins caused a shift in blood to the arms and legs and resulted in a decreased venous return. Because of the decreased venous return, the cardiac output decreased and less blood (and less oxygen) was delivered to the brain. This caused Tom to feel light-headed and faint, nearly causing his demise. Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis)

113) Millie's grandfather suffers from congestive heart failure. Whenever she visits him, she notices that his ankles and feet appear to be quite swollen. She knows that you are an avid student of anatomy and physiology, and she asks you why this occurs. What would you tell her?

: In heart failure, the heart is not able to produce enough force to circulate the blood properly. The blood tends to pool in the extremities and as more and more fluid accumulates in the capillaries, the blood hydraulic pressure increases. This results in a fluid shift from the blood to the interstitial space. The fluid accumulation exceeds the ability of the lymphatics to drain it and as a result, edema occurs and produces the obvious swelling. Section Title: The Lymphatic System Learning Outcome: 15.8

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis)

114) Brian, 53, finally visited his doctor, after 6 months of being winded after climbing the two flights of stairs to his apartment. He kept blaming himself for being "out of shape," and thought he would be OK after his spring yard work started, but he wasn't. The doctor wasn't surprised when Brian's blood pressure was 160/110 mm Hg. The doctor prescribed some beta blockers and more tests, including an ECG and blood tests. Why did the doctor want this additional information? What are some items he would check in the blood tests, and why?

: Abnormalities on the ECG would reveal evidence of scarring or damage to the heart and the myocardium; blood tests would be checked for electrolyte levels, especially calcium, sodium, and potassium, as well as for changes associated with volume fluctuation. Heart enzymes would not be elevated unless damage was very recent. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis)

115) Siegfried experiences a hemorrhage in an artery, and now blood is leaking out of the resulting hole. His blood pressure decreases. Draw a flow chart illustrating the cardiovascular reflex responses that follow to compensate for the drop in blood pressure.

: As blood exits the vasculature, there is a loss in blood volume, which in turn causes the systemic blood pressure to decrease. Baroreceptors (stretch receptors) in the carotid and artery walls are less stretched, and therefore their action potential firing frequency decreases. The baroreceptors project to the cardiovascular control center in the medulla oblongata. In response to decreased baroreceptor input, the cardiovascular control center stimulates sympathetic output and inhibits parasympathetic output. Sympathetic activity causes vasoconstriction and consequent increases in peripheral resistance and blood pressure. Decreased parasympathetic activity causes the SA node firing rate to increase and therefore heart rate increases. Combined with the sympathetic stimulation of the ventricles and consequent increase in contraction force, cardiac output increases as a result, also helping to increase blood pressure. Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis)
116) Compare and contrast the types of pressure and flow in systemic, pulmonary, glomerular, and peritubular capillaries using simple diagrams or tables. Be as complete and specific as possible. You do not need to provide values for the pressures, but you should indicate the relative strength of the different pressures.

: Systemic and pulmonary blood flow is equal to the cardiac output, which is about 720 L/day, or 0.5 L/min. The glomerular and peritubular capillaries receive about 180 L/day, or 0.13 L/min, which represents about 25% of the cardiac output. Blood pressure (in mm Hg) is highest in the systemic circulation (120/80). Blood pressure in the pulmonary circulation is 25/8, in glomerular circulation is 55, and in peritubular capillaries is 10. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.3

: Level III: Problem Solving (Bloom's Taxonomy: Evaluation)

117) Describe what a nurse hears through the stethoscope while using a blood pressure cuff, and explain the significance of the sounds.

: During a normal reading, the first thing the nurse hears is the absence of sound, because there is no blood flowing through the brachial artery; she has successfully compressed the artery with the inflated cuff. As soon as she has released enough pressure to allow blood to flow again, she hears the rumbling sounds of turbulent blood flow through a partially compressed artery. As she continues to release pressure, eventually the blood flows smoothly again as the artery is no longer compressed. The cuff pressure at the initial sound is the systolic blood pressure, and the cuff pressure when the sounds then disappear is the diastolic blood pressure. Section Title: Blood Pressure Learning Outcome: 15.3

: Level III: Problem Solving (Bloom's Taxonomy: Analysis)

118) Given what you know about blood pressure at various locations in the circulatory system, what pressure is actually determined during a standard blood pressure measurement? Why is the arm the chosen location for determining blood pressure? Is there a more accurate way to determine blood pressure?

: The pressure in the brachial artery is what is determined, but it is assumed to be very close to the pressure in the aorta, which is the desired information. The arm is chosen for proximity to the heart and convenience; farther from the heart in linear distance, the systolic pressure will be lower and the difference between systolic and diastolic will be less. A more accurate way to determine blood pressure in the aorta would be to place pressure sensors inside the vessel, though this is an invasive and unnecessary procedure given the reliability of the brachial pressure. Section Title: Blood Pressure Learning Outcome: 15.3

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis)
119) While a nurse takes a blood pressure measurement on a patient, what determines how much the pressure cuff should be inflated? How would the nurse determine if he inflated the cuff too much? Too little?

: How much to inflate the cuff is determined from what systolic pressure is expected. Therefore, factors such as age and weight, BP history, and suspected cardiovascular pathology are relevant. The higher the cuff pressure, the greater the chance of causing a patient pain. The nurse would not know for certain he had inflated the cuff too much until he opened the valve to reduce pressure, and determined the systolic blood pressure, at which point he could conclude that he inflated the cuff more than necessary. If he had inflated the cuff insufficiently, he would hear sounds associated with flowing blood as soon as he begins to listen through the stethoscope. Section Title: Blood Pressure Learning Outcome: 15.3

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis)

120) Calculate the pulse pressure for each example listed.
A. a person with a blood pressure of 120/80 mm Hg
B. a person with a blood pressure of 130/95 mm Hg

: Pulse pressure is systolic P minus diastolic P. A. 40 mm Hg B. 35 mm Hg Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom's Taxonomy: Synthesis)

121) Calculate the mean arterial pressure (MAP) for each example listed.
A. a person with a blood pressure of 120/80 mm Hg
B. a person with a blood pressure of 130/95 mm Hg

: MAP = diastolic P + 1/3 (systolic P - diastolic P) A. MAP = 80 + 1/3 (40) = 93 mm Hg B. MAP = 95 + 1/3 (35) = 107 mm Hg Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom's Taxonomy: Synthesis)

122) Arthur's peripheral resistance has increased by 10%. To prevent his mean arterial pressure from changing, what factor must change to compensate, and by how much?

: MAP CO × R Arthur's cardiac output will have to decline by 10%. Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom's Taxonomy: Synthesis)
123) Using the appropriate formula, what effect does changing the following vessel diameters have on blood flow?
A. diameter = 8 mm, decreasing to 6 mm
B. diameter = 8 mm, increasing to 12 mm
C. diameter = 10 mm, decreasing to 5 mm
D. diameter = 10 mm, increasing to 20 mm

: Flow ΔP/R and R 1/r4. A. Radius changes from 4 to 3, 44 = 256, 34 = 81, 256/81 = 3.16, so flow decreases by a factor of 3.16. B. Flow increases by a factor of 5.06. C. Flow decreases by a factor of 16. D. Flow increases by a factor of 16. Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom's Taxonomy: Synthesis)

124) Place these organs in order of descending percentage of blood flow received at rest: bones and other connective, brain, digestive organs and liver, heart, kidneys, lungs, skeletal muscle, skin.

: Lungs (100%) > liver and digestive (27%) > skeletal muscle (21%) > kidneys (20%) > brain (14%) > bone and other (9%) > skin (5%) > heart (4%). Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.11

: Level IV: Quantitative Problems (Bloom's Taxonomy: Synthesis)

125) Colloid osmotic pressure in plasma is fairly constant in a healthy person. How would protein starvation affect this pressure? How may a very high-protein diet affect this pressure? Suppose a person is suffering from an imbalance that causes an increase in colloid osmotic pressure from the typical
25 mm Hg to 30 mm Hg. Calculate the effect on net fluid flow across the capillary. What negative health consequences could result?

: Protein starvation would reduce this pressure whereas excess protein would increase this pressure. Absorption would be affected in this way: πin = πIF - πcap. Assuming πIF = 0 mm Hg, πin = -30 mm Hg, favoring absorption. This is a 20% increase in absorption pressure. This would raise blood volume and blood pressure over normal. Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom's Taxonomy: Synthesis)

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Human Physiology: An Integrated Approach, 6e (Silverthorn)
Chapter 15 Blood Flow and the Control of Blood Pressure

1) Fainting is also known as
A) eclampsia.
B) vasovagal syncope.
C) infarction.
D) reactive hyperemia.
E) orthostatic hypotension.

: B Section Title: Introduction Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

2) Perfusion is
A) blood flow through an organ.
B) the driving force behind blood flow.
C) delivery of oxygen to cells.
D) the connection between capillaries and other vessels.
E) movement of blood through a shunt.

: A Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

3) ________ are also known as the pressure reservoir of the cardiovascular system.
A) Veins
B) Venules
C) Capillaries
D) Arterioles
E) Arteries

: E Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
4) The inner lining of blood vessels is called
A) endocardium.
B) endoangium.
C) endothelium.
D) basal lamina.
E) endostatin.

: C Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

5) Smooth muscle is present in the walls of
A) veins only.
B) arteries only.
C) muscular arteries only.
D) all vessel types except capillaries.
E) all vessel types.

: D Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

6) The highly branched contractile cells that regulate capillary permeability are called
A) podocytes.
B) vascular smooth muscle.
C) endothelial cells.
D) pericytes.
E) epitheliocytes.

: D Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

7) Differences between arterioles and metarterioles include the fact that arterioles
A) have a continuous smooth muscle layer in their walls.
B) allow blood to bypass capillary beds.
C) have an endothelial lining.
D) have a continuous smooth muscle layer in their walls and allow blood to bypass capillary beds.
E) All of the answers are correct.

: A Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)
8) The only blood vessels whose walls permit exchange between the blood and the surrounding interstitial fluids are the
A) arterioles.
B) venules.
C) capillaries.
D) arterioles and capillaries.
E) venules and capillaries.

: E Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

9) Angiogenesis is
A) an examination of the arteries and veins.
B) having blood drawn into a tube for tests.
C) the growth of new blood vessels.
D) surgical restructuring of the coronary arteries.
E) being able to detect a pulse in arteries.

: C Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

10) Angiostatin and endostatin may be useful in the treatment of
A) myocardial infarction.
B) hypertension.
C) hypotension.
D) cancer.
E) vasovagal syncope.

: D Section Title: The Blood Vessels Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

11) The values obtained when measuring blood pressure, such as 120/80,
A) exactly match the pressures inside the ventricle during systole and diastole.
B) reflect the pressure in the major arteries during ventricular systole and diastole.
C) are the same on both the pulmonary and systemic circuits.
D) exactly match the pressures inside the ventricle during systole and diastole and reflect the pressure in the major arteries during ventricular systole and diastole.
E) All of the answers are correct.

: B Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
12) Which of the following is occurring during systole?
A) blood pressure increases
B) pulse pressure decreases
C) more stress is placed on arterial walls
D) blood pressure increases and pulse pressure decreases
E) blood pressure increases and more stress is placed on arterial walls

: E Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

13) The mean arterial pressure (MAP) is important because
A) it represents the driving pressure for blood flow.
B) it reflects the difference in time that systole lasts compared to diastole.
C) it forces the practitioner to do math, thus they must pay attention to the values obtained.
D) it represents the driving pressure for blood flow and it reflects the difference in time that systole lasts compared to diastole.
E) All of the answers are correct.

: A Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

14) Blood flow to a tissue will increase if the
A) level of oxygen at the tissue increases.
B) level of carbon dioxide at the tissue increases.
C) pH rises.
D) vessels constrict.
E) All of the answers are correct.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

15) Blood pressure is determined by
A) measuring the size of the pulse pressure.
B) measuring the pressure in the left ventricle.
C) measuring the force exerted by blood in a vessel.
D) measuring the degree of turbulence in a closed vessel.
E) All of the answers are correct.

: C Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
16) The difference between the systolic and diastolic pressures is called the
A) systemic pressure.
B) mean arterial pressure.
C) pulse pressure.
D) blood pressure.
E) circulatory pressure.

: C Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

17) All of the following would cause an increase in blood pressure EXCEPT
A) an increase in arterial resistance.
B) a decrease in arterial diameter.
C) a decrease in cardiac output.
D) sympathetic stimulation.

: C Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

18) The vessels that are the main site of variable resistance in the circulatory system, and that contribute more than 60% of the total resistance, are the
A) muscular arteries.
B) elastic arteries.
C) arterioles.
D) venules.
E) veins.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

19) If cardiac output increases and resistance in arterioles does NOT change, what happens to arterial blood pressure?
A) increases
B) decreases
C) is unchanged

: A Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Application)
20) Increased blood volume ________ blood pressure.
A) increases
B) decreases
C) has no effect on

: A Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

21) Which organ is NOT part of the cardiovascular system and plays an important role in regulating blood pressure?
A) liver
B) spleen
C) lung
D) kidney
E) skin

: D Section Title: Blood Pressure Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

22) The matching of blood flow to the changing metabolic needs of a tissue is due to
A) neural control.
B) hormonal control.
C) local control.

: C Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

23) Myogenic autoregulation means that
A) increased blood pressure in a vessel triggers relaxation in that vessel.
B) stretched smooth muscle in a blood vessel constricts reflexively.
C) blood vessel diameter is adjusted by centers in the brain through monitoring blood pressure in areas throughout the body.
D) increased blood pressure in a vessel triggers relaxation in that vessel and blood vessel diameter is adjusted by centers in the brain through monitoring blood pressure in areas throughout the body.
E) stretched smooth muscle in a blood vessel constricts reflexively and blood vessel diameter is adjusted by centers in the brain through monitoring blood pressure in areas throughout the body.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)
24) Each of the following paracrines may cause vasodilation EXCEPT
A) nitric oxide.
B) H+ ions from metabolic acids.
C) Ca2+.
D) K+.
E) CO2.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

25) Reactive hyperemia is
A) lack of blood flow due to an allergic reaction.
B) increased blood flow following a period of reduced blood flow.
C) increased blood pressure after stress.
D) reflex contraction of smooth muscle in response to stress.
E) None of the answers are correct.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

26) Reactive hyperemia is triggered by
A) local accumulation of paracrines due to reduced blood flow.
B) reflex contraction of smooth muscle following a period of dilation.
C) stress and the hormones released during stress.
D) toxins or allergens, such as bee venom or pollen.
E) None of the answers are correct.

: A Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

27) The elevated blood pressure that sometimes accompanies pregnancy is known as
A) preeclampsia.
B) vasovagal syncope.
C) infarction.
D) reactive hyperemia.
E) orthostatic hypotension.

: A Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
28) In order to cause vasodilation of most vascular smooth muscle,
A) acetylcholine combines with nicotinic receptors.
B) acetylcholine combines with muscarinic receptors.
C) norepinephrine combines with alpha receptors.
D) norepinephrine combines with β1 receptors.
E) sympathetic stimulation is removed.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

29) Several blood-borne chemicals affect the lumen size of arterioles. Which are NOT paired correctly?
A) kinins — vasodilation
B) histamine — vasodilation
C) serotonin — vasodilation
D) sumatriptan — vasoconstriction
E) epinephrine — vasoconstriction with alpha receptors

: C Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

30) ________ capillaries are very porous and allow high volumes of fluids to pass through them, whereas ________ capillaries consist of more tightly joined cells that allow a high degree of selective materials to pass.
A) Fenestrated, transcytotic
B) Continuous, fenestrated
C) Transcytotic, continuous
D) Fenestrated, continuous
E) Transcytotic, fenestrated

: D Section Title: Resistance in Arterioles Learning Outcome: 15.7

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

31) Sinusoids are modified vessels that replace ________ in some tissues.
A) arteries
B) veins
C) capillaries

: C Section Title: Resistance in Arterioles Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
32) Compared to arteries, the velocity of flow of the blood through the capillaries is
A) at least 10 times faster.
B) at least twice as fast.
C) about the same.
D) much slower.
E) impossible to predict without more information.

: D Section Title: Exchange at the Capillaries Learning Outcome: 15.4

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

33) Due to the differences in opposing forces, there is net ________ occurring at the arteriolar end of most capillaries, coupled with net ________ at the venous end.
A) absorption, filtration
B) filtration, absorption

: B Section Title: Exchange at the Capillaries Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

34) Restoring lost fluid from the capillaries back to the circulatory system is one of the major functions of the ________ system.
A) urinary
B) thirst-quenching
C) lymphatic
D) immune
E) digestive

: C Section Title: The Lymphatic System Learning Outcome: 15.8

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

35) Osmotic pressure resulting from presence of plasma proteins in blood is called ________ pressure.
A) oncotic
B) colloid osmotic
C) hydrostatic
D) oncotic and colloid osmotic
E) colloid osmotic and hydrostatic

: D Section Title: Exchange at the Capillaries Learning Outcome: 15.7

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
36) A parasitic condition resulting in extreme enlargement of one or both legs is called
A) elephantiasis.
B) elephantitis.
C) elephantosis.
D) ascites.

: A Section Title: The Lymphatic System Learning Outcome: 15.8

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

37) The integrating center for neural control of blood pressure resides in the
A) cerebrum.
B) cerebellum.
C) medulla oblongata.
D) pons variolli.
E) hypothalamus.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

38) Stretch-sensitive mechanoreceptors known as ________ are located in some artery walls.
A) nociceptors
B) chemoreceptors
C) baroreceptors
D) elasticeptors

: C Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

39) Blood pressure and flow to the brain are monitored by receptors located in the wall of the
A) carotid artery.
B) aorta.
C) venae cavae.
D) cerebral arteries.
E) cephalic arteries.

: A Section Title: Cardiovascular Disease Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
40) When blood pressure is normal, the receptors in arterial walls fire action potentials
A) very seldom.
B) continuously.

: B Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

41) When blood pressure receptors sense a loss of blood pressure, they ________ their firing rate.
A) increase
B) decrease

: B Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

42) Blood pressure and cardiac output can be altered according to
A) body temperature.
B) emotional responses.
C) blood oxygen levels.
D) body temperature and emotional responses.
E) body temperature, emotional responses, and blood oxygen levels.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

43) When the baroreceptor reflex is triggered by a decline in blood pressure,
A) sympathetic activity increases.
B) cardiac output increases.
C) peripheral resistance decreases.
D) sympathetic activity increases and cardiac output increases.
E) sympathetic activity increases, cardiac output increases, and peripheral resistance decreases.

: D Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)
44) If a person is bedridden for several days, the baroreceptor reflex may fail upon standing. Why?
A) Blood pools in the feet and legs.
B) There is reduced blood flow to the brain.
C) The kidneys have reduced the blood volume.
D) Blood pools in the feet and legs and there is reduced blood flow to the brain.
E) All of the statements are correct.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

45) Which of these does NOT increase the risk for cardiovascular disease?
A) being a male over 30 but under 55
B) being a female over 30 but under 55
C) having a sister with coronary artery disease
D) menopause without estrogen replacement therapy
E) having diabetes mellitus

: B Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

46) For a diagnosis of hypertension, a patient must have
A) a systolic pressure above 120 mm Hg.
B) a systolic pressure above 140 mm Hg.
C) a diastolic pressure above 90 mm Hg.
D) a diastolic pressure below 80 mm Hg.
E) a systolic pressure above 140 mm Hg or a diastolic pressure above 90 mm Hg.

: E Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

47) The endothelium of the blood vessels and its adjacent connective tissue make up the ________, which is surrounded by layers of smooth muscle and connective tissue called ________.

: tunica intima or intima, tunica media Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)
48) Capillaries lack smooth muscle and elastic or fibrous tissue reinforcement. Instead, their walls consist of ________, supported on a cellular matrix called ________.

: a flat layer of endothelium, the basal lamina. Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

49) Cerebral capillaries are surrounded by ________ and glial cells and have tight junctions that create the ________.

: pericytes, blood-brain barrier Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

50) Venules are similar to capillaries: they have ________ epithelium and little ________. They are distinguished from capillaries by ________.

: a thin exchange, connective tissue (Fig. 15.2); their convergent pattern of flow Section Title: The Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

51) Blood pressure is highest in the ________ and decreases continuously as blood flows through the circulatory system, due to ________.

: arteries, the energy lost as a result of the resistance to flow offered by the vessels. Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

52) The rapid pressure increase that occurs when the left ventricle pushes blood into the aorta can be felt as ________.

: pulse Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

53) Venous return to the heart is aided by ________ and the ________.

: the skeletal muscle pump, respiratory pump Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)
54) A rupture of a blood vessel in the brain is called ________ and may cause the loss of neurological function commonly called ________.

: a cerebral hemorrhage, a stroke Section Title: Blood Pressure Learning Outcome: 15.3

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

55) Mean arterial pressure is (indirectly/directly) proportional to ________ and (indirectly/directly) proportional to ________.

: directly, cardiac output, directly, resistance of arterioles Section Title: Blood Pressure Learning Outcome: 15.2

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

56) ________ is an increase in blood flow that accompanies an increase in metabolic activity.

: Active hyperemia Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

57) Norepinephrine binding to alpha receptors on vascular smooth muscle causes ________ and epinephrine binding to alpha receptors on vascular smooth muscle causes ________.

: vasoconstriction, vasoconstriction Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Comprehension)

58) The osmotic pressure created by the presence of proteins is known as ________, which is (higher/lower) in the plasma than in the interstitial fluid.

: colloid osmotic or oncotic pressure, higher Section Title: Exchange at the Capillaries Learning Outcome: 15.7

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

59) The decrease in blood pressure upon standing is known as ________.

: orthostatic hypotension Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Comprehension)

60) The term for chronically elevated blood pressure is ________.

: hypertension Section Title: Resistance in Arterioles Learning Outcome: 15.10

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
61) Loss of pericytes around retinal capillaries is a hallmark of the disease ________.

: diabetic retinopathy Section Title: Blood Vessels Learning Outcome: 15.1

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

62) Capillary exchange involving movement between the endothelial cells is called the ________ pathway.

: paracellular Section Title: Exchange at the Capillaries Learning Outcome: 15.6

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

63) Capillary exchange involving movement through the cells is called ________ transport.

: transendothelial Section Title: Exchange at the Capillaries Learning Outcome: 15.6

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

64) The turbulent flow of blood causes a noise called a ________ that can be heard through the stethoscope when taking blood pressure.

: Korotkoff sound Section Title: Blood Pressure Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

65) The structures that regulate blood flow into single capillaries within a tissue are ________.

: precapillary sphincters Section Title: Blood Pressure Learning Outcome: 15.11

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

66) The accumulation of fluid in the interstitial space is called ________.

: edema Section Title: The Lymphatic System Learning Outcome: 15.8

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)

67) Receptors that monitor blood pressure are called ________.

: baroreceptors Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level I: Reviewing Facts and Terms (Bloom’s Taxonomy: Knowledge)
68) Compensation for decreased blood volume includes increases in
A) sympathetic stimulation to blood vessels.
B) sympathetic stimulation of the heart.
C) water conservation by the kidneys.
D) sympathetic stimulation to blood vessels and water conservation by the kidneys.
E) sympathetic stimulation to blood vessels, sympathetic stimulation of the heart, and water conservation by the kidneys.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

69) Fenestrated capillaries are present in
A) skeletal muscles.
B) cardiac muscle.
C) the liver.
D) the spleen.
E) skin.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.1

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Comprehension)

70) Regarding the cardiovascular system, the main role(s) of the kidneys is/are to
A) restore lost fluid to the blood and therefore raise blood pressure.
B) minimize fluid loss from the blood and therefore maintain blood pressure.
C) reduce blood volume and therefore reduce blood pressure.
D) restore lost fluid to the blood and therefore raise blood pressure and minimize fluid loss from the blood and therefore maintain blood pressure.
E) minimize fluid loss from the blood and therefore maintain blood pressure and reduce blood volume and therefore reduce blood pressure.

: E Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

71) Which of the following conditions would have the greatest effect on peripheral resistance?
A) doubling the length of a vessel
B) doubling the diameter of a vessel
C) doubling the viscosity of the blood
D) doubling the turbulence of the blood
E) doubling the number of white cells in the blood

: B Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

72) Each of the following factors would increase peripheral resistance except one. Identify the exception.
A) increased sympathetic stimulation
B) elevated levels of epinephrine
C) vasodilation
D) irregularities in the vessel walls caused by plaques
E) factors that cause increased hematocrit

: C Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

73) If a person has a blood pressure of 120/80, her mean arterial pressure would be
A) 200 mm Hg.
B) 100 mm Hg.
C) 93 mm Hg.
D) 80 mm Hg.
E) 40 mm Hg.

: C Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

74) The lymphatic system
A) has heart-like pumps called lymph nodes.
B) stores blood when circulatory demand is low.
C) empties the lymph vessels into the veins near the clavicles.
D) can be removed without health consequences.
E) All of the answers are correct.

: C Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Comprehension)

75) The cardiovascular control center in the brain can directly cause
A) arterioles to dilate or constrict.
B) the heart rate to increase or decrease.
C) the contractility of the heart to increase or decrease.
D) arterioles to dilate or constrict and the heart rate to increase or decrease.
E) All of the answers are correct.

: D Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

76) Malnutrition can cause edema because
A) there are not enough nutrients for plasma protein synthesis.
B) interstitial protein levels are lower than plasma protein levels.
C) the resulting anemia increases blood pressure.
D) there are not enough nutrients for plasma protein synthesis and interstitial protein levels are lower than plasma protein levels.
E) All of the answers are correct.

: A Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

77) The continual movement of fluid through the interstitial space functions to
A) accelerate the distribution of nutrients and hormones.
B) assist the transport of insoluble substances that cannot enter the capillaries.
C) help carry toxins and bacteria to cells of the immune system.
D) flush hormones and wastes from the interstitial space.
E) All of the answers are correct.

: E Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

78) Edema is likely to occur when
A) the concentration of protein in the blood increases.
B) hemorrhage occurs.
C) the heart becomes an insufficient pump.
D) blood hydraulic pressure at the capillary decreases.
E) the blood hydraulic pressure in a capillary is equal to the blood osmotic pressure.

: C Section Title: Cardiovascular Disease Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

79) Which of the following is greater?
A) blood pressure when sympathetic stimulation to the heart increases
B) blood pressure when parasympathetic stimulation to the heart increases

: A Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

80) Which of the following is greater?
A) heart rate normally
B) heart rate during circulatory shock

: B Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

81) Which of the following is/are (a) possible treatment(s) for hypertension?
A) calcium channel blockers
B) ACE inhibitors
C) ANP blockers
D) chloride leak channel blockers
E) calcium channel blockers and ACE inhibitors

: E Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

82) Which of the following is greater?
A) blood pressure when the peripheral vessels dilate
B) blood pressure when the peripheral vessels constrict

: B Section Title: Resistance in Arterioles Learning Outcome: 15.3

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

83) Increased levels of carbon dioxide in the blood will result in
A) decreased heart rate.
B) decreased cardiac output.
C) decreased blood flow to the lungs.
D) decreased parasympathetic stimulation of the heart.
E) All of the answers are correct.

: D Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

84) Tom suffers from hypertension (high blood pressure). Which of the following might help deal with his problem? A drug that
A) stimulates α1 receptors in cardiac muscle tissue.
B) blocks α2 receptors in cardiac muscle tissue.
C) stimulates cAMP formation in cardiac muscle tissue.
D) blocks beta receptors in cardiac muscle tissue.
E) blocks muscarinic receptors in cardiac muscle tissue.

: D Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

85) Because the suffix "itis" means ________, swelling of the lower extremities due to blockage of lymph flow is NOT called ________-itis; rather it is called ________.

: "inflammation of", elephant, elephantiasis Section Title: The Lymphatic System Learning Outcome: 15.8

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Comprehension)

86) Three tissues-________, ________, and ________-do NOT have traditional capillaries. Instead, they have modified vessels called ________ that are (wider/narrower) than a capillary.

: the bone marrow, the liver, the spleen; sinusoids, wider Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Comprehension)

87) ________ refers to the mass movement of fluid between the blood and the interstitial fluid as the result of ________ or ________ pressure gradients. If the direction of bulk flow is into the capillary, the fluid movement is called ________. If the direction of flow is out of the capillary, the fluid movement is known as ________.

: Bulk flow, hydrostatic, osmotic; absorption; filtration Section Title: Exchange at the Capillaries Learning Outcome: 15.7

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

88) During the fight-or-flight reaction, ________ is released from the adrenal medulla and binds to ________ receptors, found on the vascular smooth muscle of heart, liver, and skeletal muscle arterioles and results in (increased/decreased) blood flow to these organs; the same hormone binds to ________ receptors on other tissues, causing (increased/decreased) blood flow to these organs.

: epinephrine, β2, increased, α, decreased Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

89) Map the following terms: blood distribution, blood volume, cardiac output, diameter of the arterioles, diameter of the veins, fluid intake, fluid loss, heart rate, mean arterial pressure, passive, regulated at kidneys, resistance to blood flow, and stroke volume.

: See Figure 15.8 in the chapter. Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

90) List the factors that influence arteriolar resistance, and give an example of each.

: 1. Sympathetic reflexes. Example: temperature regulation. 2. Local control of arteriolar resistance matches tissue blood flow to the metabolic needs of the tissue-Example: paracrines that respond to low oxygen, high carbon dioxide. 3. Hormones such as those that regulate salt and water excretion by the kidney. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

91) Define and describe the mechanism of myogenic autoregulation.

: Myogenic autoregulation is the self-regulation by the vascular smooth muscle in response to an increase in blood pressure. The mechanism responsible for the intrinsic response of vascular smooth muscle is stretch that opens mechanically gated Ca2+ channels in the muscle membrane. Calcium entering the smooth muscle cell combines with calmodulin and activates myosin light chain kinase, which in turn increases myosin ATPase activity and crossbridge activity. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

92) Compare and contrast the structure and location of arteries, arterioles, capillaries, and veins. How do these differences contribute to the differences in function of each?

: See Figure 15.2 in the chapter for a summary of structural differences in vessel walls. Arteries contain relatively more smooth muscle, for active regulation of vessel diameter. Large, elastic arteries have more elastic fibers, so that the vessel can stretch and recoil with ventricular contraction and relaxation, thereby minimizing fluctuation in blood pressure. Capillaries are thin and porous, reflecting their role in exchange of substances with the interstitial fluid. Veins contain valves to prevent backflow of blood, which is especially important in leg veins. Section Title: The Blood Vessels Learning Outcome: 15.1

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)
93) Draw a map of the baroreceptor reflex, starting with decrease in blood pressure. Indicate on the map the following: stimulus, receptor, afferent pathway, integrating center, efferent pathway, effector, tissue response, systemic response.

: See Figure 15.14 in the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.9

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

94) What effect does a calcium channel blocker have on the heart, the blood pressure, and cardiac output? Why?

: Calcium channel blockers inhibit the opening of calcium channels and ensuing calcium current. Vascular smooth muscle dilates, and heart rate decreases. Vasodilation will result in a decrease in systemic blood pressure, and the decrease in heart rate will decrease cardiac output. Section Title: Cardiovascular Disease Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

95) Diagram the components and interactions of the baroreceptor reflex.

: See Figure 15.14 in the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.9

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

96) Why is there a loss of blood volume when a patient is confined to bed for two or three days? What symptoms commonly follow this confinement?

: Inactivity causes edema, because of the lack of skeletal muscle pump. The accumulated fluid of edema represents loss from the blood capillaries. This decreased blood volume causes decreased blood pressure, which may give the patient a sense of light-headedness upon standing. Section Title: Resistance in Arterioles Learning Outcome: 15.7

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)
97) Children who suffer from protein starvation have bloated bellies of ascites (an accumulation of fluid in the tissue spaces of the abdomen). How would a shortage of protein in the diet cause this condition?

: Protein is needed by the body for proper growth, maintenance, and reproduction. If there is a shortage of protein in the diet, the body must turn to itself for a source of amino acids. One of the first proteins to be dismantled for amino acids is plasma albumin. As the level of albumin in the plasma decreases, so does the osmotic pressure. Fluid that has leaked from the capillaries to the interstitial spaces does not return to the blood because of the decreased plasma osmotic pressure; because of the large vascular network in the abdominal viscera, the majority pools in this region. Section Title: The Lymphatic System Learning Outcome: 15.7

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

98) Define, compare, and contrast each of the pathologies listed below. Are the risk factors for each the same? Explain your answer.
A. coronary artery disease
B. atherosclerosis
C. myocardial infarction
D. hypertension
E. congestive heart failure

: A. Coronary blood vessels become blocked by cholesterol or blood clots, causing reduced blood flow. B. Atherosclerosis is hardening of the arteries, which results from accumulation of cholesterol and other lipids, proliferation of vascular smooth muscle, and hardening due to calcification and fibrosis. The bulge that forms protrudes into the vessel lumen, reducing blood flow. C. Myocardial infarction is the death of heart cells as a result of blocked blood flow. D. Hypertension is high systemic blood pressure that develops as a result of increased peripheral resistance. E. Congestive heart failure occurs after prolonged hypertension, when the cardiac muscle can no longer generate the necessary cardiac output against the high peripheral resistance. As left cardiac output decreases, fluid backs up into the lungs. Oxygenation of the blood decreases, the heart becomes even weaker, leading to more fluid accumulation, and eventually death. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Application)

99) What are some dangers of having coronary artery disease? What are some dangers of having hypertension?

: This is discussed in the "Cardiovascular Disease" section of the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)
100) Outline the relationship between hypertension and the development of congestive heart failure.

: This is discussed in the "Cardiovascular Disease" section of the chapter. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

101) List the steps and briefly explain what happens in orthostatic hypotension. What reflex counteracts it?

: Orthostatic hypotension is the decrease in blood pressure upon moving rapidly from a stable reclining position to standing. While reclining flat, gravity is distributed equally and so is blood. When moving to a standing position, blood initially pools in the lower extremities and cardiac output drops from about 5 L/min to about 3 L/min. Arterial blood pressure then decreases. The baroreceptor reflex should counteract orthostatic hypotension. Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

102) By binding to the Ca2+ channel proteins, drugs known as calcium channel blockers have two main effects. Name them. Why are some cells unaffected by these drugs?

: Binding to calcium channels makes them less likely to open, effectively blocking the normal inward calcium current that would result from neural or endocrine stimulation. This causes vasodilation and a decrease in heart rate. Insensitive tissues have a different subtype of calcium channel. Section Title: Cardiovascular Disease Learning Outcome: 15.5

: Level II: Reviewing Concepts (Bloom’s Taxonomy: Analysis)

103) While you study blood vessel structure in your dorm room, your roommate prepares to bike to his favorite fishing hole. You absent-mindedly watch as he puts on his bike shorts, which look absurdly small in his hands but stretch easily then snap back to fit tightly. His fishing shirt is a nonstretchy cotton weave that fits loosely, with open mesh panels across the back and armpits for ventilation. Considering only the basic structural differences in arteries, veins, and capillaries, which of the types of fabrics resemble which vessels, and why?

: The bike shorts stretch and recoil like elastic arteries, the cotton weave is floppy and nonstretchy like veins, and the mesh is porous like capillaries. Section Title: The Blood Vessels Learning Outcome: 15.1

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)
104) Baroreceptors have stretch-sensitive ion channels in their cell membrane. Increased pressure on the membrane opens the channels and allows ion flow that initiates action potentials. What kind of ion probably flows through these channels and in which direction?

: Action potentials are created when a cell depolarizes to threshold. Depolarization results from net influx of positive ions or efflux of negative ions. The most likely ion is Na+, moving into the receptor cell. Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)

105) Nicotine stimulates cholinergic receptors of the autonomic nervous system. Based on this information, how would cigarette smoking affect the cardiovascular system?

: Since cholinergic receptors are found in all of the ganglia of the autonomic nervous system, you would expect nicotine to stimulate both sympathetic and parasympathetic responses in the cardiovascular target tissues. In response to increased sympathetic stimulation the heart would beat faster and more forcefully. At the same time, however, increased parasympathetic stimulation would decrease the blood flow to the heart muscle. The increased heart rate and force of contraction would contribute to increased blood pressure as would vasoconstriction of peripheral blood vessels as a result of sympathetic stimulation. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)

106) The condition known as shock is characterized by a decreased return of venous blood to the heart. How could an upsetting situation such as the sight of a tragic accident or very bad news produce shock?

: The upsetting stimuli would be processed by the higher centers of the central nervous system and relayed to the hypothalamus. The hypothalamus could suppress the vasomotor center of the medulla, resulting in fewer sympathetic impulses to peripheral blood vessels. This would cause a decrease in sympathetic tone in the smooth muscle of the blood vessels, resulting in vasodilation. The vasodilation would cause blood to pool in the extremities, decreasing the amount of blood returning to the heart and producing shock. Section Title: Resistance in Arterioles Learning Outcome: 15.5

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)
107) One of the most common signs of polycystic kidney disease is hypertension in an otherwise seemingly healthy individual. Why would cysts on the kidney lead to higher blood pressure?

: Cysts developing on the kidney will put pressure on the kidneys and decrease the ability of the blood vessels in the kidney to filter out urine, causing an increase in plasma in the blood and higher blood pressure. Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)

108) Nitroglycerine is a medication taken by people who experience chest pain known as angina. One of the major side effects of the medication is that the patient will notice a severe headache. What causes this side effect?

: Nitroglycerine is a vasodilator that is non-specific (the nitric oxide content causes all blood vessels it contacts to dilate). When it is ingested it will cause dilation of the coronary arteries, reliving the chest pain and preventing myocardial infarction, but it will also cause dilation of cerebral blood vessels, causing a headache. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.5

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)

109) The sympathetic nervous system will cause vasodilation in the arteries of many blood vessels, but vasoconstriction in the brain. Why does this occur?

: Because the brain needs a relatively constant flow of blood, whether the body is at rest or under stress, it will try to maintain a constant level of perfusion to the brain. Since the sympathetic nervous system increases heart rate, blood will flow to the brain faster than it does while at rest, so by constricting the arteries, it will decrease the amount of blood each beat that reaches the brain and thereby keeping a fairly constant amount of blood flowing to the brain. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.5

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)

110) Many drugs used to treat migraine headaches contain caffeine. What mechanism does caffeine have that can help with migraine headaches?

: Migraine headaches are caused by dilation of blood vessels in the brain. Caffeine is a drug that mimics the sympathetic nervous system. Since the sympathetic nervous system causes vasoconstriction in the brain, it will counteract the effects of migraine headaches. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.5

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)
111) Josie is in her last weeks of pregnancy. During a routine check-up, she asks why she is suddenly experiencing swollen feet when she wears knee-high stockings (with a tight elastic band just below the knee). She is confused because an elderly relative wears support stockings to prevent swollen feet, an apparent contradiction. Speculate on a logical explanation for her swelling feet and the difference between support hose and knee-high stockings.

: The elastic band in one of Josie’s stocking is so tight that it constantly compresses her veins just in the area under the elastic. This reduces venous return, increasing pressure below that area and causing fluid to exit her blood. Support stockings are medical devices that apply uniform pressure along their entire length, and so produce no constriction. They increase pressure slightly, continuously aiding venous return much like a muscle pump does intermittently. Section Title: Blood Pressure Learning Outcome: 15.8

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)

112) Tom loves to soak in hot tubs and whirlpools. One day he decides to raise the temperature in his hot tub as high as it will go. After a few minutes in the very warm water, he feels faint, passes out, and nearly drowns. Luckily he is saved by an observant bystander. Explain what happened.

: In response to the high temperature of the water, Tom’s body shunted more blood to the superficial veins to decrease body temperature. The dilation of the superficial veins caused a shift in blood to the arms and legs and resulted in a decreased venous return. Because of the decreased venous return, the cardiac output decreased and less blood (and less oxygen) was delivered to the brain. This caused Tom to feel light-headed and faint, nearly causing his demise. Section Title: Resistance in Arterioles Learning Outcome: 15.11

: Level III: Problem Solving (Bloom’s Taxonomy: Synthesis)

113) Millie’s grandfather suffers from congestive heart failure. Whenever she visits him, she notices that his ankles and feet appear to be quite swollen. She knows that you are an avid student of anatomy and physiology, and she asks you why this occurs. What would you tell her?

: In heart failure, the heart is not able to produce enough force to circulate the blood properly. The blood tends to pool in the extremities and as more and more fluid accumulates in the capillaries, the blood hydraulic pressure increases. This results in a fluid shift from the blood to the interstitial space. The fluid accumulation exceeds the ability of the lymphatics to drain it and as a result, edema occurs and produces the obvious swelling. Section Title: The Lymphatic System Learning Outcome: 15.8

: Level III: Problem Solving (Bloom’s Taxonomy: Synthesis)

114) Brian, 53, finally visited his doctor, after 6 months of being winded after climbing the two flights of stairs to his apartment. He kept blaming himself for being "out of shape," and thought he would be OK after his spring yard work started, but he wasn’t. The doctor wasn’t surprised when Brian’s blood pressure was 160/110 mm Hg. The doctor prescribed some beta blockers and more tests, including an ECG and blood tests. Why did the doctor want this additional information? What are some items he would check in the blood tests, and why?

: Abnormalities on the ECG would reveal evidence of scarring or damage to the heart and the myocardium; blood tests would be checked for electrolyte levels, especially calcium, sodium, and potassium, as well as for changes associated with volume fluctuation. Heart enzymes would not be elevated unless damage was very recent. Section Title: Cardiovascular Disease Learning Outcome: 15.10

: Level III: Problem Solving (Bloom’s Taxonomy: Synthesis)

115) Siegfried experiences a hemorrhage in an artery, and now blood is leaking out of the resulting hole. His blood pressure decreases. Draw a flow chart illustrating the cardiovascular reflex responses that follow to compensate for the drop in blood pressure.

: As blood exits the vasculature, there is a loss in blood volume, which in turn causes the systemic blood pressure to decrease. Baroreceptors (stretch receptors) in the carotid and artery walls are less stretched, and therefore their action potential firing frequency decreases. The baroreceptors project to the cardiovascular control center in the medulla oblongata. In response to decreased baroreceptor input, the cardiovascular control center stimulates sympathetic output and inhibits parasympathetic output. Sympathetic activity causes vasoconstriction and consequent increases in peripheral resistance and blood pressure. Decreased parasympathetic activity causes the SA node firing rate to increase and therefore heart rate increases. Combined with the sympathetic stimulation of the ventricles and consequent increase in contraction force, cardiac output increases as a result, also helping to increase blood pressure. Section Title: Resistance in Arterioles Learning Outcome: 15.9

: Level III: Problem Solving (Bloom’s Taxonomy: Synthesis)
116) Compare and contrast the types of pressure and flow in systemic, pulmonary, glomerular, and peritubular capillaries using simple diagrams or tables. Be as complete and specific as possible. You do not need to provide values for the pressures, but you should indicate the relative strength of the different pressures.

: Systemic and pulmonary blood flow is equal to the cardiac output, which is about 720 L/day, or 0.5 L/min. The glomerular and peritubular capillaries receive about 180 L/day, or 0.13 L/min, which represents about 25% of the cardiac output. Blood pressure (in mm Hg) is highest in the systemic circulation (120/80). Blood pressure in the pulmonary circulation is 25/8, in glomerular circulation is 55, and in peritubular capillaries is 10. Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.3

: Level III: Problem Solving (Bloom’s Taxonomy: Evaluation)

117) Describe what a nurse hears through the stethoscope while using a blood pressure cuff, and explain the significance of the sounds.

: During a normal reading, the first thing the nurse hears is the absence of sound, because there is no blood flowing through the brachial artery; she has successfully compressed the artery with the inflated cuff. As soon as she has released enough pressure to allow blood to flow again, she hears the rumbling sounds of turbulent blood flow through a partially compressed artery. As she continues to release pressure, eventually the blood flows smoothly again as the artery is no longer compressed. The cuff pressure at the initial sound is the systolic blood pressure, and the cuff pressure when the sounds then disappear is the diastolic blood pressure. Section Title: Blood Pressure Learning Outcome: 15.3

: Level III: Problem Solving (Bloom’s Taxonomy: Analysis)

118) Given what you know about blood pressure at various locations in the circulatory system, what pressure is actually determined during a standard blood pressure measurement? Why is the arm the chosen location for determining blood pressure? Is there a more accurate way to determine blood pressure?

: The pressure in the brachial artery is what is determined, but it is assumed to be very close to the pressure in the aorta, which is the desired information. The arm is chosen for proximity to the heart and convenience; farther from the heart in linear distance, the systolic pressure will be lower and the difference between systolic and diastolic will be less. A more accurate way to determine blood pressure in the aorta would be to place pressure sensors inside the vessel, though this is an invasive and unnecessary procedure given the reliability of the brachial pressure. Section Title: Blood Pressure Learning Outcome: 15.3

: Level III: Problem Solving (Bloom’s Taxonomy: Synthesis)
119) While a nurse takes a blood pressure measurement on a patient, what determines how much the pressure cuff should be inflated? How would the nurse determine if he inflated the cuff too much? Too little?

: How much to inflate the cuff is determined from what systolic pressure is expected. Therefore, factors such as age and weight, BP history, and suspected cardiovascular pathology are relevant. The higher the cuff pressure, the greater the chance of causing a patient pain. The nurse would not know for certain he had inflated the cuff too much until he opened the valve to reduce pressure, and determined the systolic blood pressure, at which point he could conclude that he inflated the cuff more than necessary. If he had inflated the cuff insufficiently, he would hear sounds associated with flowing blood as soon as he begins to listen through the stethoscope. Section Title: Blood Pressure Learning Outcome: 15.3

: Level III: Problem Solving (Bloom’s Taxonomy: Synthesis)

120) Calculate the pulse pressure for each example listed.
A. a person with a blood pressure of 120/80 mm Hg
B. a person with a blood pressure of 130/95 mm Hg

: Pulse pressure is systolic P minus diastolic P. A. 40 mm Hg B. 35 mm Hg Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom’s Taxonomy: Synthesis)

121) Calculate the mean arterial pressure (MAP) for each example listed.
A. a person with a blood pressure of 120/80 mm Hg
B. a person with a blood pressure of 130/95 mm Hg

: MAP = diastolic P + 1/3 (systolic P – diastolic P) A. MAP = 80 + 1/3 (40) = 93 mm Hg B. MAP = 95 + 1/3 (35) = 107 mm Hg Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom’s Taxonomy: Synthesis)

122) Arthur’s peripheral resistance has increased by 10%. To prevent his mean arterial pressure from changing, what factor must change to compensate, and by how much?

: MAP CO × R Arthur’s cardiac output will have to decline by 10%. Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom’s Taxonomy: Synthesis)
123) Using the appropriate formula, what effect does changing the following vessel diameters have on blood flow?
A. diameter = 8 mm, decreasing to 6 mm
B. diameter = 8 mm, increasing to 12 mm
C. diameter = 10 mm, decreasing to 5 mm
D. diameter = 10 mm, increasing to 20 mm

: Flow ΔP/R and R 1/r4. A. Radius changes from 4 to 3, 44 = 256, 34 = 81, 256/81 = 3.16, so flow decreases by a factor of 3.16. B. Flow increases by a factor of 5.06. C. Flow decreases by a factor of 16. D. Flow increases by a factor of 16. Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom’s Taxonomy: Synthesis)

124) Place these organs in order of descending percentage of blood flow received at rest: bones and other connective, brain, digestive organs and liver, heart, kidneys, lungs, skeletal muscle, skin.

: Lungs (100%) > liver and digestive (27%) > skeletal muscle (21%) > kidneys (20%) > brain (14%) > bone and other (9%) > skin (5%) > heart (4%). Section Title: Distribution of the Blood to the Tissues Learning Outcome: 15.11

: Level IV: Quantitative Problems (Bloom’s Taxonomy: Synthesis)

125) Colloid osmotic pressure in plasma is fairly constant in a healthy person. How would protein starvation affect this pressure? How may a very high-protein diet affect this pressure? Suppose a person is suffering from an imbalance that causes an increase in colloid osmotic pressure from the typical
25 mm Hg to 30 mm Hg. Calculate the effect on net fluid flow across the capillary. What negative health consequences could result?

: Protein starvation would reduce this pressure whereas excess protein would increase this pressure. Absorption would be affected in this way: πin = πIF – πcap. Assuming πIF = 0 mm Hg, πin = -30 mm Hg, favoring absorption. This is a 20% increase in absorption pressure. This would raise blood volume and blood pressure over normal. Section Title: Blood Pressure Learning Outcome: 15.2

: Level IV: Quantitative Problems (Bloom’s Taxonomy: Synthesis)

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