Chapter 18 Cardiopulmonary Homework

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Which of the following actions causes the AV valves to close?

Increased intraventricular pressure

When stroke volume decreases, which of the following could maintain cardiac output?

Increased heart rate

Each of the following compares the output of blood from the left and right ventricles witheach contraction of a normal heart? Which is correct?

Left ventricular output equals the right ventricular output

Which of the following describes the pericardial cavity correctly?

It is a potential space containing a very small amount of serous fluid

Which of the following factors greatly improves venous return to the heart during strenuous exercise?

Contraction and relaxation of skeletal muscle

What is the function of the baroreceptors? To:

signal the cardiovascular control center of changes in systemic blood pressure

The normal delay in conduction through the atriovenricular node is essential for:

completing ventricular filling

Which of the following results from increased secretion of epinephrine?

Increased heart rate and force of contraction

Which of the following causes increased heart rate?

Stimulation of the sympathetic nervous system

Which event causes the QRS wave on an ECG tracing?

Ventricular depolarization

What is the cardiac reserve?

The ability of the heart to increase cardiac output when needed

What does the term preload refer to?

Volume of venous return

Which are the first arteries to branch off the aorta?

Coronary arteries

Vasodilation in the skin and viscera results directly from

relaxation of smooth muscle in the arterioles

Which of the following drugs decrease sodium and fluid retention in the body?

Hydrochlorothiazide Hydro DIURIL

Which of the following are predisposing factors to thrombus formation in the circulation?

2 3 4; damaged blood vessel walls, immobility, prosthetic valves

Which drug is taken in small doses on a continuing basis to reduce platelet adhesion?

Acetylsalicylic acid A S A

What will a partial obstruction in a coronary artery likely cause?

Angina attacks

Cigarette smoking is a risk factor in coronary artery disease because smoking:

promotes platelet adhesion

What does the term arteriosclerosis specifically refer to?

Degeneration with loss of elasticity and obstruction in small arteries

Modifiable factor that increase the risk for atherosclerosis include:

sedentary lifestyle

An atheroma develops from

accumulated lipids, cells, and fibrin where endothelial injury has occurred

Low-density lipoproteins or L D L:

promote atheroma development

Factors that may precipitate an angina attack include all of the following except:

walking down stairs

When comparing angina with myocardial infarction, which statement is true?

Angina pain is relieved by rest and intake of nitroglycerine; the pain of M I is not. True!

Which of the following best describes the basic pathophysiology of myocardial infarction?

Total obstruction of a coronary artery causes myocardial necrosis

Which of the following are typical early signs or symptoms of myocardial infarction?

Persistent chest pain radiating the the left arm, pallor, and rapid, weak pulse.

Which statement describes a coronary artery bypass procedure?

Attaching a section of vein to the coronary artery proximal and distal to the obstruction

Calcium-channel blocking drugs are effective in

reducing cardiac and smooth muscle contractions

Which of the following confirms the presence of a myocardial infarction?

characteristic patterns for serum isoenzymes and the ECG

The size of the nectoric area resulting from myocardial infarction maybe minimized by all of the following except

removing the predisposing factors to atheroma development

What is the most common cause of death immediately following a myocardial infarction?

Cardiac arrhythmias

Why does ventricular fibrillation result in cardiac arrest?

Insufficient blood is supplies to the myocardium

What does the term Cardiac Arrest mean?

cessation of all cardiac function

Which change results from total heart block?

spontaneous slow ventricular contractions, not coordinated with atrial contraction

What does the term PVC mean?

Additional contractions arise from ectopic foci in the ventricular muscle

Which of the following is most likely to cause left-sided congestive heart failure?

uncontrolled essential hypertension

which is the best definition of congestive heart failure?

inability of the heart to pump enough blood to meet the metabolic needs of the body

which of the following are significant signs of right-sided congestive heart failure?

edematous feet and legs with hepatomegaly

Paroxysmal nocturnal dyspnea is marked by

hemoptsis and rales

Which of the following occur as compensation mechanisms for decreased cardiac output in cases of congestive heart failure?

Increased renin and aldosterone secretions

In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure?

Pulmonary capillaries

Which of the following drugs improves cardiac efficient by slowing the heart rate and increasing the force of cardiac contractions?

Digoxin

In an infant, which of the following is frequently the initial indication of congestive heart failure?

Feeding problems

Which of the following effects may be expected from a beta-adrenergic blocking drug?

Decreased sympathetic stimulation of the heart

Which of the following is a sign of aortic stenosis?

A heart murmur

What would an incompetent mitral valve cause?

Decreased output from the left ventricle

Which of the following describes blood flow occurring with a ventricular septal defect?

From the left ventricle to the right ventricle

In children with a tetralogy of Fallot, why does unoxygenated blood enter the systemic circulation?

Pulmonary stenosis changes the ventricular pressures

Why does cyanosis occur in children with tetralogy of Fallot?

A large amount of hemoglobin in the general circulation is unoxygenated

Which of the following represents the pathophysiologic changes in the heart in cases of rheumatic fever?

An abnormal immune response, causing acute inflammation in all layers of the heart.

Common signs of rheumatic fever include all of the following except

arthritis causing deformity of the small joints in the hands and feet. Not true!

How does the rheumatic heart disease usually manifest in later years?

Cardiac arrhythmias and heart murmurs

Why are septic emboli a common complication of infective endocarditis?

Vegetations are loosely attached and fragile.

Which of the following apply to subacute infective endocarditis?

A microbe of low virulence attacks abnormal or damaged heart valves

Why does pericarditis cause a reduction in cardiac output?

Excess fluid in the pericardial cavity decreases ventricular filling.

Which of the following may cause pericarditis?

Infection, abnormal immune responses, injury, malignant neoplasm. 1, 2, 3, 4

Which of the following could be the source of an embolus causing an obstruction in the brain?

Carotid artery

What is considered to be the basic pathophysiologic change in essential hypertension?

Increased systemic vasoconstriction

Where is uncontrolled hypertension most likely to cause ischemia and loss of function?

Kidney, brains, and retinas of the eye

When is a diagnosis of essential hypertension most likely to be considered in young or middle-aged individuals?

Blood pressure remains consistently above 140/90

What is atherosclerosis in the iliac or femoral arteries likely to cause?

Gangrenous ulcers in the leg, intermittent claudication. 1, 3

What does the term intermittent claudication refer to?

Ischemic muscle pain in the legs, particularly with exercise

What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease?

Prevents spread of infection and reduces pain

An echocardiogram is used to demonstrate any abnormal

movement of the heart valves

A friction rub is associated with

pericarditis

How does a dissecting aortic aneurysm develop?

A tear in the intimal lining allows blood flow between layers of the aortic wall

What is the outcome for many aortic aneurysms?

Rupture and hemorrhage

Which factor predisposes to varicose veins during pregnancy?

Compressed pelvic veins

Phlebothrombosis is more likely to cause pulmonary emboli than is thrombophlebitis because

thrombus form in a vein and is asymptomatic

How is shock defined?

Decreased circulating blood and tissue perfusion

When does shock follow myocardial infarction?

A large portion of the myocardium is damaged

What are early signs of circulatory shock?

Pale, moist skin, anxiety and restlessness. 1, 3

What indicates compensation for shock?

Increased heart rate and oliguria

Why does anaphylactic shock cause severe hypoxia very quickly?

Bronchoconstriction and bronchial edema reduce airflow

Why does neurogenic, also known as vasogenic shock, result from systemic vasodilation?

Increased capacity of the vascular system and reduced venous return

What is a prolonged period of shock likely to cause?

Damage and increased permeability of pulmonary capillaries

What would indicate decompensated acidosis related to shock?

Serum p h below normal range

With shock, anaerobic cell metabolism and decreased renal blood flow cause

metabolic acidosis

Why does shock develop in patients with severe burns?

Pain and loss of plasma

The classic early manifestations of left-sided congestive heart failure are what, whereas the early indicators of right-sided failure are what?

Shortness of breath on exertion or lying down, swelling of the ankles

Which is a common adverse effect of many antihypertensive medications?

Orthostatic hypotension

The cause of essential hypertension is considered to be

idiopathic

For which of the following would a cardiac pacemaker likely be inserted?

Heart block

Which of the following is considered to be the most dangerous arrhythmia?

Ventricular fibrillation

Which of the following is not true of the drug nitroglycerine?

It strengthens the myocardial contraction. Not true!

Which of the following would confirm a diagnosis of a myocardial infarction?

Specific changes in the ECG, elevation of cardiac isoenzymes in serum. 1, 3

Which of the following statements regarding aneurysms is true?

Manifestations of aneurysms result from compression of adjacent structures. True!

What is the most common factor predisposing to the development of varicose veins?

Increased venous pressure

In the period immediately following a myocardial infarction, the manifestations of pallor and diaphoresis, rapid pulse, and anxiety result from

onset of circulatory shock

Septic shock differs from hypovolemic shock in that it is frequently manifested by

fever and flushed face

Heart block, in which a conduction delay at the A V node results in intermittent missed ventricular contractions, is called

second-degree block

More extensive permanent damage is likely when a myocardial infarction is cause by

an embolus

A very rapid heart rate reduces cardiac output because

ventricular filling is reduced

The right side of the heart would fail first in the case of

large infarction in the right ventricle, advanced COPD. 3, 4.

Which of the following compensationsthat develop in patients with congestive heart failure eventually increase the workload of the heart?

Faster heart rate and cardiomegaly, peripheral vasoconstriction, increased secretion of renin. A, b, and c.

Which statement applies to paroxysmal nocturnal dyspnea?

It is caused by increased blood in the lungs when lying in a supine position

In patients with congestive heart failure, ACE inhibitor drugs are useful because they

reduce rennin and aldosterone secretion

In a child with ventricular septal defect, altered blood flow:

is called a left-to-right shunt

In a child with acute rheumatic fever, arrhythmias may develop due to the presence of

myocarditis

Prophylactic antibacterial drugs such as amoxicillin are given to those with certain congenital heart defects or damaged heart valves immediately before invasive procedures to prevent

infections endocarditis

Varicose ulcers may develop and be slow to heal because

edema reduces arterial blood supply to the area

Excessive fluid in the pericardial space causes

reduced venous return

Aortic stenosis means the aortic valve

cannot fully open during systole

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