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Difficult Multiple Choice
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Which of the following is not true of a normal adult heart?
A)both atria receive only venous blood
B)both ventricles discharge blood only into arteries
C)the two left chambers conduct only oxygenated blood
D)the left ventricle pumps at a faster rate than the right
The serous pericardium does not
A)facilitate almost frictionless movement as the heart beats
B)form a mucous membrane lining the pericardial cavity
C)consist of an outer parietal layer and an inner visceral layer
D)secrete a lubricating fluid into the pericardial cavity
Oxygenated blood flows through ____________ in the systemic circuit but through ____________ and the opposite heart chambers in the pulmonary circuit.
A)arteries and the left atrium and ventricle; veins
B)arteries and the right atrium and ventricle; veins
C)veins and the left atrium and ventricle; arteries
D)veins and the right atrium and ventricle; arteries
Blood from the systemic circuit returns to the right atrium through
A)the superior vena cava
B)the inferior vena cava
C)the coronary sinus
D)all of the above
In terms of oxygen content of the blood they transmit, left atrioventricular is to aortic semilunar as ____________ is to pulmonary semilunar.
D)none of the above
A type of heart murmur called mitral valve prolapse would most likely involve a defect in
A)the size or shape of the right atrioventricular opening
B)the left chordae tendineae or papillary muscles
C)one of the three cusps of the tricuspid valve
D)the structure of either semilunar valve
The left and right coronary arteries
A)are functional end arteries despite sharing tiny anastomoses
B)are the only branches from the ascending aorta
C)have highly variable distribution in the posterior ventricular walls
D)all of the above
In the coronary circulation, all venous blood returns to the heart through the
A)great cardiac vein
B)middle cardiac vein
C)coronary sinus
D)all of the above
Although the valve itself is located elsewhere, the best auscultation site for the left AV valve is
A)in the second intercostal space to the right of the sternum
B)in the second intercostal space to the left of the sternum
C)by the right side of the inferior end of the sternum
D)near the apex of the heart in the fifth intercostal space
Just before leaving the heart to go to the lungs, blood must pass through a smooth-walled region called the
A)bulbus cordis
B)sinus venosus
C)conus arteriosus
D)pulmonary trunk
What would happen if the papillary muscles could not contract?
A)the ventricular myocardium would also fail to contract
B)the atrioventricular valves would not seal tightly
C)blood would not enter the ventricles during diastole
D)the semilunar valves would stay open throughout the cardiac cycle
Which set correctly lists the sequence in which events in the cardiac cycle begin?
A)atrial systole, atrial diastole, ventricular systole, ventricular diastole
B)atrial systole, ventricular systole, atrial diastole, ventricular diastole
C)ventricular systole, atrial systole, ventricular diastole, atrial diastole
D)ventricular systole, ventricular diastole, atrial diastole, atrial systole
Rank the following in order from the longest lasting to the shortest-lived condition in a normal cardiac cycle: (1) atria relaxed (2) ventricles contracting (3) AV valves open (4) semilunar valves closed
A)3, 2, 4, 1
B)2, 4, 1, 3
C)1, 4, 3, 2
D)4, 1, 2, 3
What happens during ventricular diastole?
A)both ventricles fill with blood
B)both semilunar valves remain open
C)both AV valves remain closed
D)both ventricles contract
Under normal conditions, only two heart chambers are ever concurrently in ____________, but all four are ____________ together for the last half of the cardiac cycle.
A)diastole; relaxing
B)systole; contracting
C)systole; relaxing
D)diastole; contracting
In which of the following pairs do the events start almost simultaneously?
A)ventricular systole, first heart sound ("lubb")
B)atrial diastole, ventricular systole
C)ventricular diastole, closing of semilunar valves
D)all of the above
Tachycardia predisposes a person to inadequate coronary blood flow because
A)it lowers blood pressure, reducing the "push" of blood through the myocardium
B)it reduces the time that the myocardium is relaxed enough to permit blood flow
C)it raises blood pressure, forcing blood too quickly past the coronary arteries
D)it shortens systole, when blood would normally be squeezed through the myocardium
Arrange these components of the heart's conduction system in their sequence of activity, beginning with the pacemaker: (1) Purkinje fibers (2) AV node (3) SA node (4) AV bundle
A)3, 2, 4, 1
B)2, 3, 1, 4
C)4, 2, 1, 3
D)1, 3, 2, 4
In an ECG tracing, what might an unusually strong QRS complex indicate?
A)damage to the sinoatrial node
B)acute coronary ischemia
C)hypertrophy of the ventricular myocardium
D)damage to the AV bundle or Purkinje fibers
When a person's heart "skips a beat," what has most likely occurred?
A)ventricular fibrillation
B)premature ventricular contraction
C)atrial flutter or fibrillation
D)angina pectoris
All of the following accurately characterize heart development except
A)two heart tubes fuse to form a single primitive heart tube by day 21
B)four expansions that give rise to postnatal heart structures develop by day 22
C)the heart tube becomes partitioned into four chambers during weeks 5-8
D)the heart starts beating as soon as development is complete, by week 8
If the fetal septum primum and septum secundum fail to fuse properly at birth, the newborn has a congenital heart malformation called
A)pulmonary stenosis
B)tetralogy of Fallot
C)an atrial septal defect
D)a ventricular septal defect
Which potentially fatal heart problem is most like a stroke, or cerebrovascular accident?
A)myocardial infarction
B)ventricular fibrillation
C)cardiac arrest
D)cardiac tamponade
What heart problem may be caused, ironically, by the body's attempt to protect itself from a streptococcal throat infection?
B)rheumatic heart disease
C)coronary atherosclerosis
D)infectious endocarditis
What causes a heart murmur?
A)valvular leakage
B)decreased valve flexibility
C)a misshapen valve
D)any of the above

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