Physiology: The circulation (10 questions)

1. In major arterial blood vessels:

(A) The aorta and other large elastic arteries contain a well developed internal elastic
lamina in their intimal layer

(B) The media is well vascularised

(C) The vasa vasorum are dispersed in the medial layer

(D ) The nutritional supply to the medial layer is principally by diffusion from the luminal
blood

(E) They become more distensible with ageing

2. Endothelial cell properties include all of the following except:

(A) Elaboration of prostacyclin

(B) Elaboration of Von Willebrand factor

(C) Elaboration of nitric oxide synthetase inhibitor

(D) Elaboration of plasminogen activator

(E) Elaboration of thrdmbomodulin

3. Dissecting aortic aneurysms maybe associated with all of the following except:

(A) Homers Syndrome

(B) Hoarse voice

(C) Myocardial infarction

(D) Aortic incompetence

(E) Aortic stenosis

4. In dissecting aneurysm of the aorta:

(A) The haematoma dissects between the media and intimal layers

(B) The intimal tear is most commonly in the descending aorta

(C) The haematoma most commonly ruptures into the pericardial sac

(D) Is increased in incidence in scleroderma

(E) Is a complication of syphilitic aortitis

 5. The coronary arteries:

CA) Run subendocardially

CB) Have a functional collateral network in the normal heart

CC) The right coronary supplies the posterior two thirds of the interventricular septum

CD) The left coronary's most common site of stenosing plaque is in the distal 113

CE ) Occlusion of the right coronary may cause left ventricular damage

6. Following acute coronary artery occlusion:

CA) Irreversible cell injury occurs within an hour in acutely ischaemic cells

CB) Gross morphologic changes are only visible in the infarcted territory after 48 hours

CC) The process of collagenous scarring is complete in three weeks

CD) Median time to rupture of the left ventricle is two days

CE ) Pericarditis is a complication of subendocardial infarction

7. In acute rheumatic fever:

CA) The pericardium is not involved

CB) Vauulitis most commonly affects the aortic valve

CC) Carditis occurs in >95% of cases

CD) Reactivation does not occur

CE ) Mitral incompetence may resolve with resolution of the acute attack

8. Predisposition to infective endocarditis includes all the following except:

CA) Mitral valve prolapse

CB) Papillary muscle dysfunction
CC) Swan-Ganz catheters
CD ) Mitral valve replacements
CE ) Small VSD's

9.Regarding Volumes of Blood in different parts of the circulation:

Ca ) The Systemic circulation has 84% of the entire blood volume of the body.
C b) Veins have 30% of the entire blood volume of the body.

C c) The Pulmonary circulation has 20% of the entire blood volume of the body

Cd ) The heart contains 30% of the entire blood volume of the body.

Ce) The capillaries have 19% of the entire blood volume of the body.
lOIn which of the following lists of blood vessels is the sequence of vessels arranged
from highest to lowest total cross-sectional area in the body?

(a) Arteries, capillaries, arterioles, veins.

(b) Arterioles, capillaries, arteries, veins.

(c) C apillaries, arterioles, small arteries, vena cava.

(d) Veins, capillaries, arterioles, arteries.

(e) Arteries, veins, arterioles, capillaries.

II Velocity of Blood Flow:

(a) Is directly proportional to the cross-sectional area.

(b ) Is inversely proportional to the cross-sectional area.

(c) Under resting conditions averages 33 ems/sec in the capillaries.

(d) Under resting conditions averages 0.3 mm1sec in the arteries.

(e) Is inversely proportional to blood flow.

12 Regarding pressures in the various portions of the circulation:

(a) The mean pressure in the pulmonary circulation is 28 mmHg.

(b) The pressure in the pulmonary arterioles is 18 mmHg.

(c) The pressure in the venae cavae is -20 mmHg.

(d) The mean pressure in the aorta is 100 mmHg.

(e) The pressure in the pulmonary veins is -20 mmHg.

13 The flow through a blood vessel is determined by:

(a) Graham's Law of Pressure Gradients.

(b) Pressure difference between two ends of the vessel (Pressure Gradient)
and the Vasular Resistance.

( c) Ohm's Law of Diffusion.

(d) Volume difference between two ends of the vessel and the Vascular Resistance.

(e) Law of Laplase.

14 Blood Flow:

( a) Simply means the quantity of blood that passes two given points in the circulation in a
given period.

(b ) Simply means the quantity of blood that passes three given points in the circulation in a
given period.

(c ) Measured by Venous Occlusion Plethysmography.

(d) Measured by Electromagnetic Resistometer.

(e) Measured by Gas Chamber Technique.

15 Regarding Laminar and Turbulent Flow:

When Laminar Flow occurs, the velocity of flow near the vessel wall is far greater than
towards the centre of the vessel.

Laminar Flow creates sounds; turbulent flow is silent.

The flow may become turbulent rather than streamline when the blood passes an obstruction
in a vessel.

The tendency for turbulent flow increases in inverse proportion to the velocity of blood flow.

When eddy currents are present, blood flows with much lesser resistance than when the flow
is streamline.

16 Blood Pressure:

(a) Can be measured by placement of a needle or catheter directly into the

veIn.

(b) Is the force exerted by the blood against three unit areas of the vessel wall.

(c) Can be measured directly with a sphygmomanometer.

( d) Korothoff sounds are useless in measuring blood pressure directly with a

sphygmomanometer.

(e) The pressure of 50 mmHg means that the force exerted is sufficient to push a column
of mercury up to a level of 50 mm high.

17 Regarding resistance to blood flow, all are true except:

(a) Resistance is the impediment to the blood flow in a vessel.

(b) It cannot be measured by any direct means.

(c) The resistance of the entire systemic circulation is I PRU.

(d) Great majority of vascular circuits are in series.

(e) The resistances in the kidneys and liver are in series.

18 Regarding conductance, all are true except:

(a) It is a measure of blood flow through a vessel for a given pressure difference.

(b) Conductance of the vessel decreases in proportion to the fourth power of the diameter.

(c) Conductance is the reciprocal of resistance.

(d) A 4-fold increase in the vessel diameter theoretically could increase the flow as much
as 256-fold.

(e) Units of measurement are mlslsec/mrnHg or Llsec/mrnHg.

19 According to Poiseuille's Law, flow through a cylindrical tube or any segment is:

(a) Directly proportional to pressure difference between the ends of the vessel.

(b) Directly proportional to the length of the segment (vessel).

(c) Directly proportional to viscosity of the blood.

(d) Inversely proportional to the radius of the vessel.

(e) Inversely proportional to the pressure difference between the ends of the vessel.

20 Regarding blood hematocrit and viscosity:

(a) The greater the viscosity the greater the flow in a vessel.

(b) The viscosity of normal blood is about 10 times as great as the viscosity of water.

( c) The viscosity of blood increases as the hematocrit increases.

(d) Anaemia increases the viscosity of blood.

(e) Leukaemia and Polycythaemia decrease the viscosity of blood.

21 Regarding vascular distensibility:

(a) The most distensible by far of all vessels are the veins.

( b) The veins are called the resistance vessels.

( c) The arteries provide a reservoir function for storing large quantities of blood.

(d) Veins are about 30 times as distensible as the arteries.

(e) When extra blood is administered by transfusion 40% of the blood is administered by
transfusion 40% of the blood is distributed to the systemic veins.

21 Regarding venous return to the heart, all are true except:

(a) Depends on skeletal muscle pump of the lower extremity.

(b) Depends on venomotor tone.

(c) Depends on the venous valves.

 (d ) Depends on valves in the Lymphatics.

(e) Depends on the respiratory pump (thoracic pump).

23 Lymph flow from the foot is:

(a) Increased when an individual rises from the supine to the standing position.

(b) Increased by massaging the foot.

(c) Increased when capillary permeability is decreased.

(d) Decreased when the valves of the leg veins are incompetent.

(e) Decreased by exercise.

24 The mean pressure in the artery supplying a given organ is 100 mmHg, the mean pressure in
the vein draining it is 10 mmHg and the blood flow through the organ is 600 mllmin. What is
the vascular resistance across the organ?

( a) 0.1 R Unit.

( b) 0.9 R Unit.

(c) I R Unit.

(d) 9 R Units.

(e) I I R Units.

25 Regarding veins:

(a) Numerous valves are present in the abdominal vena cava and the splanchnic vessels.

(b) While superficial veins of the extremities respond strongly to sympathetic sthnulation,
deep veins of the calf and forearm respond very little and veins of the skeletal muscle
not at all to neural sthnuli.

(c ) Valves are more numerous in superficial veins than deep veins.

(d) The skeletal muscle pump has been regarded by Rowell as the third heart.

(e) A 20-20 minute suspension in an upright position causes the blood pressure to rise,
immediately.

26 Regarding venous pressure all are true except:

(a) Pressure in the right atrium when a person is standing is 0 mmHg.

(b) Pressure in the veins of the feet when a person is standing is +90 mmHg.

(c) Pressure in the sagittal sinus when a person is standing is -20 mmHg.

(d) Pressure in the neck veins when person is standing is 0 mmHg.

(e) Pressure in the peritoneal cavity normally in a person standing is 6 mmHg.

27 Regarding the capillary bed:

Ca) The arterioles are highly muscular and their diameter can change many fold.

Cb) The metarterioles have a continuous muscular coat.

Cc ) The pre-capillary sphincter is present at the junction of the arteriole and the true
capillaries.

Cd) Plasmalemmal vesicle transport is of great importance quantitatively.

Ce) The capillary wall comprises a multicellular layer of endothelial cells.

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