WorksheetsCardiac Physiology & Histology Worksheet (Grade 13)
Total questions: 130
Worksheet time: 1hrs 5mins
A 22-year-old student observes that cardiac muscle continues contracting rhythmically even when isolated in a lab experiment. This property is due to:
Excitability
Conductivity
Contractility
Automaticity
Elasticity
A patient develops arrhythmia due to defective cell-to-cell electrical transmission in the myocardium. Which histological structure is most likely damaged?
Desmosomes
Tight junctions
Gap junctions
Z-lines
Sarcoplasmic reticulum
A drug prolongs the plateau phase of the ventricular action potential. Which ion movement is most affected?
Na+ influx
K+ influx
Ca2+ influx
Cl− efflux
Na+ efflux
A transplanted heart continues to beat despite loss of nerve supply because cardiac muscle has:
High contractility
Functional syncytium
Automaticity
Prolonged systole
Long diastole
A histology slide shows branched, striated muscle fibers with centrally placed nuclei. The tissue is most likely:
Skeletal muscle
Smooth muscle
Cardiac muscle
Elastic tissue
Dense connective tissue
A delay in impulse transmission is essential for ventricular filling. This delay occurs at the level of:
SA node
Atrial muscle
AV node
Purkinje fibers
Ventricular myocardium
Tetany cannot occur in cardiac muscle because of:
Lack of Ca2+
Short action potential
Long refractory period
Slow conduction
Reduced ATP
Failure of fibrous insulation between atria and ventricles would cause:
Bradycardia
Reduced stroke volume
Simultaneous atrial and ventricular contraction
Cardiac arrest
Ventricular fibrillation
Which cell type lacks a stable resting membrane potential?
Ventricular myocyte
Skeletal muscle fiber
Purkinje fiber
SA node cell
Smooth muscle cell
Phase 4 depolarization in pacemaker cells is mainly due to:
Fast Na+ channels
K+ efflux
Funny Na+ current
Cl− influx
Ca2+ influx
A patient with atrial fibrillation loses atrial contraction. Which phase of the cardiac cycle is most affected?
Ventricular ejection
Isovolumetric contraction
Ventricular filling
Isovolumetric relaxation
Rapid ejection
The first heart sound (S1) occurs due to closure of:
Semilunar valves
Aortic valve
Pulmonary valve
AV valves
Venous valves
A pressure–volume loop shows rising pressure without volume change. This represents:
Ventricular filling
Ventricular ejection
Isovolumetric contraction
Isovolumetric relaxation
Atrial systole
Coronary blood flow is maximal during:
Ventricular systole
Atrial systole
Ventricular diastole
Isovolumetric contraction
Rapid ejection
A rapid ventricular filling sound (S3) is most likely heard in:
Healthy young adults only
Mitral stenosis
Ventricular stiffness
Heart failure
Aortic stenosis
A patient with hemorrhage shows reduced cardiac output primarily due to reduced:
Afterload
Contractility
Preload
Heart rate
Peripheral resistance
Frank–Starling law explains increased force of contraction with increased:
Afterload
End-systolic volume
End-diastolic volume
Heart rate
Blood pressure
Hypertension reduces stroke volume mainly by increasing:
Preload
Contractility
Afterload
Heart rate
Venous return
Sympathetic stimulation increases cardiac output mainly by:
Decreasing preload
Increasing heart rate and contractility
Decreasing afterload
Increasing diastolic time
Increasing venous pooling
Calcium ions directly influence which cardiac parameter?
Heart rate
Preload
Afterload
Contractility
Blood volume
A histology slide shows a vessel with thick tunica media and multiple elastic laminae. This vessel is:
Vein
Venule
Elastic artery
Muscular artery
Arteriole
The primary resistance vessels responsible for BP regulation are:
Veins
Capillaries
Elastic arteries
Arterioles
Venules
A vessel acting as a capacitance vessel is characterized by:
Thick media and narrow lumen
Thin wall and wide lumen
Absence of smooth muscle
Elastic lamina dominance
High pressure flow
Presence of valves is a characteristic feature of:
Arteries
Arterioles
Capillaries
Veins
Elastic arteries
Which vessel lacks tunica media and adventitia?
Arteriole
Venule
Capillary
Vein
Elastic artery
A patient develops edema due to low plasma proteins. Which Starling force is reduced?
Capillary hydrostatic pressure
Interstitial hydrostatic pressure
Plasma oncotic pressure
Interstitial oncotic pressure
Lymphatic pressure
Capillary type allowing passage of large proteins is:
Continuous
Fenestrated
Sinusoidal
Muscular
Elastic
Precapillary sphincters regulate blood flow primarily based on:
Systemic blood pressure
Heart rate
Local metabolic demand
Plasma proteins
Venous return
Removal of lymph nodes leads to edema because:
Filtration increases
Reabsorption decreases
Interstitial fluid cannot return to circulation
Hydrostatic pressure decreases
Plasma oncotic pressure increases
The most important function of microcirculation is:
Blood storage
Pressure regulation
Exchange of gases and nutrients
Pulse generation
Cardiac output regulation
The property that allows cardiac muscle to act as a single unit despite being made of individual cells is primarily due to:
Desmosomes
Tight junctions
Gap junctions
T-tubules
Sarcomeres
Failure of fibrous insulation between atria and ventricles would most directly result in:
Bradycardia
Ventricular tachycardia
Simultaneous atrial and ventricular contraction
AV nodal delay
Reduced contractility
Cardiac muscle fatigue resistance is most directly related to:
Myosin isoforms
Large fiber diameter
High mitochondrial density
Slow Ca2+ channels
Glycogen stores
The feature that prevents tetany in cardiac muscle is:
Short refractory period
Plateau phase of action potential
Gap junctions
High potassium permeability
SA node dominance
The mechanical strength of intercalated discs is primarily due to:
Gap junctions
Ion channels
Desmosomes
Sarcoplasmic reticulum
Actin filaments
Which ion movement dominates Phase 0 of ventricular action potential?
Ca2+ influx (slow)
Na+ influx (fast)
K+ efflux
Cl- influx
Ca2+ efflux
The plateau phase (Phase 2) of the ventricular action potential is sustained mainly by balance between:
Na+ influx and K+ efflux
Ca2+ influx and K+ efflux
Ca2+ influx and Na+ efflux
Cl- influx and K+ influx
Na+ influx and Cl- efflux
Pacemaker cells lack a stable resting membrane potential because of:
Continuous Na+ channel opening
Slow Ca2+ leak channels
Funny Na+ current (If)
Absence of K+ channels
Excess Cl- conductance
SA node action potential upstroke is mainly due to:
Fast Na+ channels
Slow Ca2+ channels
K+ channel closure
Cl- channels
Na+-K+ pump
A drug that selectively blocks Ca2+ channels will most significantly affect:
Phase 0 of ventricular action potential
Phase 1 of ventricular action potential
Phase 2 of ventricular action potential
Phase 4 of ventricular action potential
Phase 0 of skeletal muscle action potential
The AV nodal delay is physiologically important because it:
Increases heart rate
Allows ventricular filling
Prevents atrial contraction
Synchronizes ventricles
Increases contractility
Purkinje fibers are specialized for:
Pacemaker activity
Slow conduction
Rapid impulse transmission
Electrical insulation
Atrial depolarization
Which structure has the fastest conduction velocity?
SA node
AV node
Atrial muscle
Purkinje fibers
Ventricular muscle
Loss of gap junction function would most likely cause:
Weak Contraction
Asynchronous contraction
Reduced preload
Bradycardia
Valve dysfunction
Cardiac muscle automaticity is BEST defined as ability to:
Contract strongly
Respond to nerve impulses
Generate impulses spontaneously
Conduct impulses rapidly
Resist fatigue
Atrial systole contributes approximately what percentage to ventricular filling?
5–10%
10–15%
20–30%
40–50%
>50%
The first heart sound (S1) coincides with:
Opening of semilunar valves
Closure of semilunar valves
Closure of AV valves
Opening of AV valves
Atrial systole
Isovolumetric contraction is characterized by:
Rising volume and pressure
Rising pressure, constant volume
Falling pressure, constant volume
Falling pressure and volume
Constant pressure and volume
The second heart sound (S2) occurs at the beginning of:
Ventricular systole
Isovolumetric contraction
Ventricular diastole
Rapid filling
Atrial systole
Coronary blood flow occurs predominantly during:
Atrial systole
Ventricular systole
Isovolumetric contraction
Ventricular diastole
Rapid ejection
Tachycardia reduces cardiac output mainly by:
Increasing preload
Increasing afterload
Shortening diastole
Increasing contractility
Increasing venous return
S3 heart sound is associated with:
Valve closure
Ventricular stiffness
Rapid ventricular filling
Atrial contraction
Isovolumetric relaxation
S4 heart sound is MOST closely related to:
Dilated ventricle
Reduced contractility
Ventricular stiffness
Valve incompetence
Rapid ejection
During ventricular ejection, ventricular volume:
Increases
Decreases
Remains constant
Oscillates
Doubles
Loss of atrial contraction will MOST significantly reduce CO in:
Young healthy adults
Athletes
Patients with ventricular stiffness
Children
Pregnant females
Cardiac output is mathematically expressed as:
HR + SV
HR × SV
SV − EDV
EDV − ESV
MAP × TPR
Frank–Starling law explains relationship between:
HR and BP
Afterload and SV
Preload and force of contraction
Contractility and calcium
CO and resistance
Preload is BEST represented by:
End-systolic volume
End-diastolic volume
Stroke volume
Mean arterial pressure
Central venous pressure only
Increased afterload will MOST likely:
Increase stroke volume
Decrease stroke volume
Increase preload
Increase contractility
Increase HR
Contractility differs from preload because it is:
Volume-dependent
Pressure-dependent
Independent of fiber length
Determined by venous return
Reduced by calcium
Sympathetic stimulation increases CO primarily by:
Reducing preload
Reducing afterload
Increasing HR and contractility
Increasing diastolic time
Decreasing venous return
Parasympathetic stimulation primarily affects:
Ventricular contractility
Stroke volume
Heart rate
Afterload
Preload
High-output heart failure is MOST likely in:
MI
Hypertension
Anemia
Cardiomyopathy
Aortic stenosis
Reduction in venous return will FIRST reduce:
Afterload
Contractility
Preload
HR
TPR
Increased calcium availability directly increases:
HR
Preload
Contractility
Afterload
Diastolic time
Mean arterial pressure is MOST important because it reflects:
Systolic pressure
Diastolic pressure
Tissue perfusion
Cardiac contractility
Pulse pressure
Primary resistance vessels are:
Arteries
Veins
Capillaries
Arterioles
Venules
Baroreceptors respond to changes in:
Blood oxygen
Blood pH
Vessel stretch
Blood volume
Blood viscosity
Sudden standing causes reflex tachycardia due to:
Chemoreceptor activation
Reduced baroreceptor firing
Increased vagal tone
Increased preload
Increased MAP
Long-term BP regulation is MOST dependent on:
Baroreceptors
Chemoreceptors
RAAS
Vagus nerve
Sympathetic reflex
Primary site of exchange of gases and nutrients is:
Arteries
Arterioles
Capillaries
Venules
Veins
Precapillary sphincters regulate:
BP
Venous return
Capillary blood flow
Lymph flow
Cardiac output
Fenestrated capillaries are commonly found in:
Brain
Muscle
Kidney
Skin
Heart
Sinusoidal capillaries are characterized by:
Tight junctions
High resistance
Large pores
Continuous basement membrane
Low permeability
Filtration is favored when:
Plasma oncotic pressure increases
Capillary hydrostatic pressure increases
Interstitial oncotic pressure decreases
Lymph flow increases
Venous pressure decreases
Reabsorption predominates at the:
Arterial end of capillary
Venous end of capillary
Precapillary sphincter
Arteriole
Venule
Edema due to low plasma proteins occurs because of reduced:
Hydrostatic pressure
Plasma oncotic pressure
Interstitial pressure
Capillary permeability
Lymph flow
Lymphatic obstruction causes edema because:
Filtration increases
Reabsorption increases
Interstitial fluid cannot return
Capillary pressure falls
Oncotic pressure rises
Shock affects microcirculation primarily by:
Increasing capillary permeability
Reducing capillary perfusion
Increasing lymph flow
Increasing filtration
Increasing reabsorption
Diabetes damages microcirculation mainly by affecting:
Large arteries
Venous valves
Capillary walls
Cardiac output
Baroreceptors
The primary reason ventricular muscle cannot be tetanized is due to:
Reduced Ca 2+ availability
Long absolute refractory period
Slow conduction velocity
AV nodal delay
Reduced Na + permeability
Electrical insulation between atria and ventricles is mainly provided by:
Gap junctions
Intercalated discs
Fibrous skeleton of heart
Purkinje fibers
AV node
A decrease in gap junction conductivity would MOST directly affect:
Heart rate
Stroke volume
Synchrony of contraction
Ventricular filling
Valve closure
The slow conduction velocity of the AV node is physiologically important because it:
Prevents atrial contraction
Allows ventricular filling
Increases cardiac output
Enhances contractility
Prevents arrhythmias only
Which structure normally sets the intrinsic rhythm of the heart?
AV node
Bundle of His
Purkinje fibers
SA node
Ventricular myocardium
In pacemaker cells, spontaneous depolarization during phase 4 is mainly due to:
Fast Na + channels
Increased K + efflux
Funny Na + current and Ca 2+ influx
Cl − influx
Na + –K + pump failure
A drug that slows the slope of pacemaker potential will:
Increase stroke volume
Increase contractility
Decrease heart rate
Increase preload
Increase afterload
Which ion channel is MOST responsible for repolarization in ventricular muscle?
Na + channels
L-type Ca 2+ channels
Fast Ca {2+} Channels
k + channels
Cl- Channels
Failure of Purkinje fibers would MOST severely affect:
Atrial contraction
Ventricular contraction timing
AV nodal delay
Pacemaker activity
Valve function
Cardiac muscle cells are described as a functional syncytium because they:
Share cytoplasm
Are multinucleated
Are electrically coupled
Are structurally fused
Contract independently
Compared to skeletal muscle, cardiac muscle action potentials are longer due to:
Increased Na+ influx
Decreased K+ permeability
Plateau phase
Increased Cl− conductance
Reduced Ca2+ entry
Which property allows the heart to continue beating after denervation?
Excitability
Conductivity
Automaticity
Contractility
Elasticity
A decrease in extracellular potassium would MOST likely:
Suppress pacemaker activity
Increase excitability
Stop cardiac contraction
Reduce action potential duration
Prevent depolarization
Electrical impulses normally pass from atria to ventricles through the:
Gap junctions
Purkinje network
Fibrous skeleton only
AV node
Ventricular myocardium
The primary pacemaker fails. Which structure MOST likely takes over?
Ventricular muscle
Purkinje fibers
AV node
Bundle branches
Papillary muscles
Ventricular filling occurs predominantly during:
Atrial systole
Isovolumetric relaxation
Early diastole
Isovolumetric contraction
Ventricular systole
Which event marks the transition from ventricular systole to diastole?
Opening of AV valves
Opening of semilunar valves
Closure of semilunar valves
Closure of AV valves
Rapid filling
During isovolumetric relaxation:
Ventricular volume increases
Ventricular volume decreases
Ventricular pressure falls with no volume change
Blood enters ventricles
Semilunar valves open
Loss of atrial systole is MOST detrimental in:
Athletes
Young adults
Patients with ventricular hypertrophy
Children
Healthy adults at rest
Systolic blood pressure MOST closely reflects which phase?
Isovolumetric relaxation
Atrial systole
Ventricular ejection
Rapid filling
Diastasis
The longest phase of the cardiac cycle at rest is:
Atrial systole
Ventricular systole
Ventricular diastole
Isovolumetric contraction
Ejection
Tachycardia reduces coronary perfusion primarily by:
Increasing systole
Increasing afterload
Shortening diastole
Increasing stroke volume
Increasing preload
Mitral stenosis primarily impairs which phase?
Ventricular ejection
Isovolumetric contraction
Ventricular filling
Atrial systole only
Ventricular relaxation
Which heart sound is associated with ventricular stiffness?
S1
S2
S3
S4
Murmur
Rapid ventricular filling may produce which sound in heart failure?
S1
S2
S3
S4
Click
Mean arterial pressure is approximately equal to:
Diastolic + pulse pressure
Systolic − diastolic
Diastolic + 1/3 pulse pressure
Systolic − pulse pressure
Average of systolic and diastolic
An increase in total peripheral resistance will initially:
Increase stroke volume
Decrease afterload
Increase blood pressure
Increase venous return
Increase preload
Which vessel type primarily acts as a capacitance vessel?
Arteries
Arterioles
Capillaries
Veins
Venules
Baroreceptor reflex acts mainly through:
Hormonal regulation
Renal mechanisms
Autonomic nervous system
Local metabolites
Lymphatic system
Chemoreceptors are stimulated by:
High blood pressure
Low oxygen levels
High blood volume
High plasma proteins
Increased Preload
The MOST important long-term regulator of blood pressure is:
Baroreceptors
Chemoreceptors
RAAS
Vagus nerve
Sympathetic tone
Arteriolar constriction primarily increases blood pressure by increasing:
Stroke volume
Heart rate
Total peripheral resistance
Blood volume
Venous return
Microcirculation includes vessels with diameters:
>1 mm
500–1000 μm
<100 μm
>5 mm
Only capillaries
Continuous capillaries are LEAST permeable because they have:
Fenestrations
Wide pores
Tight junctions
No basement membrane
Large intercellular gaps
Sinusoidal capillaries are MOST suited for:
Gas exchange
Rapid nutrient absorption
Passage of large proteins
High-pressure flow
Neural tissue supply
Net filtration at the arterial end of a capillary occurs mainly due to:
High oncotic pressure
High hydrostatic pressure
Low permeability
Lymphatic drainage
Venous pressure
Reabsorption at the venous end occurs because:
Hydrostatic pressure increases
Oncotic pressure predominates
Capillary wall thickens
Lymph flow increases
Arterioles constrict
Edema in heart failure is mainly due to:
Increased oncotic pressure
Decreased capillary permeability
Increased venous pressure
Reduced hydrostatic pressure
Increased lymph flow
Lymphatic obstruction causes edema because:
Filtration decreases
Reabsorption increases
Interstitial fluid accumulates
Capillary pressure falls
Blood volume decreases
Diabetes mellitus damages microcirculation mainly by:
Increasing cardiac output
Thickening capillary basement membrane
Increasing venous tone
Reducing blood volume
Enhancing baroreceptor sensitivity
Shock reduces tissue oxygenation primarily by:
Increasing blood pressure
Increasing capillary perfusion
Reducing microcirculatory flow
Increasing venous return
Increasing lymph drainage
Capillary exchange of gases occurs mainly by:
Active transport
Vesicular transport
Diffusion
Filtration
Reabsorption
Increased capillary permeability during inflammation causes edema by:
Increasing oncotic pressure
Allowing protein leakage
Reducing hydrostatic pressure
Increasing lymph flow
Reducing filtration
Removal of lymph nodes MOST likely leads to:
Reduced filtration
Increased reabsorption
Lymphedema
Reduced blood pressure
Increased oncotic pressure
Which factor opposes filtration?
Capillary hydrostatic pressure
Interstitial hydrostatic pressure
Plasma oncotic pressure
Arterial pressure
Venous pressure
Capillary beds are bypassed via:
Venules
Arterioles
Arteriovenous anastomoses
Precapillary sphincters
Sinusoids
Opening of precapillary sphincters is regulated primarily by:
Systemic blood pressure
Local metabolic demand
Hormones only
Heart rate
Plasma proteins
Which condition MOST favors generalized edema?
High plasma proteins
Low venous pressure
Low plasma oncotic pressure
Reduced capillary permeability
Increased lymph flow
Venous pooling reduces blood pressure mainly by decreasing:
Afterload
Contractility
Preload
Total peripheral resistance
Heart rate
The MOST important function of microcirculation is:
Blood storage
Pressure regulation
Exchange of substances
Pulse generation
Valve function
