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Anatomy and Physiology 5th Edition Marieb Hoehn Test Bank

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Anatomy and Physiology 5th Edition Marieb Hoehn Test Bank

ISBN-13: 978-0321861580

ISBN-10: 0321861582

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Anatomy and Physiology 5th Edition Marieb Hoehn Test Bank

ISBN-13: 978-0321861580

ISBN-10: 0321861582

 

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Anatomy and Physiology, 5e (Marieb/Mitchell/Smith)

Chapter 18   The Cardiovascular System: Blood Vessels

 

18.1   Matching Questions

 

 

 

Figure 18.1

 

Using Figure 18.1, match the following:

 

1) Sinusoid capillary.

Answer:  C

Diff: 1    Page Ref: 609-10 Fig. 18.3

 

2) Capillary found in endocrine organs that allows hormones to gain rapid entry into the blood.

Answer:  B

Diff: 2    Page Ref: 609-10 Fig. 18.3

 

 

3) Capillary with intercellular clefts found in the skin and muscles.

Answer:  A

Diff: 2    Page Ref: 609-10 Fig. 18.3

4) Capillary that may contain Kupffer cells in the lining.

Answer:  C

Diff: 2    Page Ref: 609-10 Fig. 18.3

 

5) Capillary found where active capillary absorption of filtrate occurs.

Answer:  B

Diff: 2    Page Ref: 609-10 Fig. 18.3

 

 

 

Figure 18.2

 

Using Figure 18.2, match the following:

 

6) Splenic vein.

Answer:  B

Diff: 1    Page Ref: 652; Fig. 18.29

 

7) Superior mesenteric vein.

Answer:  E

Diff: 1    Page Ref: 652; Fig. 18.29

 

8) Inferior mesenteric vein.

Answer:  D

Diff: 1    Page Ref: 652; Fig. 18.29

 

9) Hepatic portal vein.

Answer:  A

Diff: 1    Page Ref: 652; Fig. 18.29

10) Right gastroepiploic vein.

Answer:  C

Diff: 1    Page Ref: 652; Fig. 18.29

 

Match the following:

 

  1. A) Internal iliac artery
  2. B) Aorta
  3. C) Renal artery
  4. D) Inferior mesenteric artery
  5. E) Common hepatic artery

 

11) Largest artery of the body.

Diff: 1    Page Ref: 634

 

12) Supplies the kidney.

Diff: 1    Page Ref: 640; Tbl. 18.7

 

13) Supplies the duodenum and stomach.

Diff: 2    Page Ref: 640; Tbl. 18.7

 

14) Supplies the distal areas of the large intestine.

Diff: 2    Page Ref: 643; Tbl. 18.7

 

15) Supplies pelvic structures.

Diff: 2    Page Ref: 643; Tbl. 18.8

 

16) Artery that does not anastomose.

Diff: 3    Page Ref: 612

 

Answers: 11) B 12) C 13) E 14) D 15) A 16) C

 

Match the following:

 

  1. A) External iliac artery
  2. B) Brachiocephalic trunk
  3. C) Internal carotid artery
  4. D) Celiac trunk
  5. E) Radial artery

 

17) Gives rise to the right common carotid and right subclavian artery.

Diff: 1    Page Ref: 634; Tbl. 18.4

 

18) Supplies a lower limb.

Diff: 2    Page Ref: 634; Tbl. 18.4

 

19) Common site to take the pulse.

Diff: 2    Page Ref: 620

 

20) Major supply to the cerebral hemispheres.

Diff: 2    Page Ref: 636

 

21) Large unpaired branch of the abdominal aorta that supplies the liver, stomach, and spleen.

Diff: 2    Page Ref: 640

 

Answers: 17) B 18) A 19) E 20) C 21) D

 

 

Match the following:

 

  1. A) Axillary artery
  2. B) External jugular vein
  3. C) Pulmonary trunk
  4. D) Superior vena cava
  5. E) Subclavian vein

 

22) Receives blood from all areas superior to the diaphragm, except the heart wall.

Diff: 2    Page Ref: 645; Tbl. 18.9

 

23) Carries oxygen-poor blood to the lungs.

Diff: 2    Page Ref: 632

 

24) Drains the scalp.

Diff: 2    Page Ref: 647; Tbl. 18.10

 

25) Runs through the armpit area, giving off branches to the axillae, chest wall, and shoulder girdle.

Diff: 2    Page Ref: 638; Tbl. 18.6

 

26) Drains an upper extremity, a deep vein.

Diff: 2    Page Ref: 645; Tbl. 18.9

 

Answers: 22) D 23) C 24) B 25) A 26) E

 

Match the following:

 

  1. A) Pulmonary vein
  2. B) Great saphenous vein
  3. C) Brachial artery
  4. D) Superior mesenteric artery
  5. E) Femoral artery

 

27) Artery usually ausculated to take the blood pressure.

Diff: 1    Page Ref: 638

 

28) Major artery of the thigh.

Diff: 1    Page Ref: 643

 

29) Supplies the small intestine.

Diff: 1    Page Ref: 640

 

30) Carries oxygen-rich blood from the lungs.

Diff: 1    Page Ref: 632

 

31) Vessel commonly used as a coronary bypass vessel.

Diff: 2    Page Ref: 653

 

Answers: 27) C 28) E 29) D 30) A 31) B

 

Match the following:

 

  1. A) Capillaries
  2. B) Large veins
  3. C) Arterioles
  4. D) Large arteries

 

 

32) Site where resistance to blood flow is greatest.

Diff: 1    Page Ref: 608-609

 

33) Site where exchanges of food and gases are made.

Diff: 1    Page Ref: 609

 

34) Site where blood pressure is lowest.

Diff: 1    Page Ref: 613-614

 

35) Site where the velocity of blood flow is fastest.

Diff: 2    Page Ref: 622-23 Fig18.14

 

36) Site where the velocity of blood flow is slowest.

Diff: 2    Page Ref: 622-23; Fig18.14

 

37) Site where the blood volume is greatest.

Diff: 2    Page Ref: 611; Tbl. 18.5

 

38) Site where the blood pressure is greatest.

Diff: 2    Page Ref: 613-614

 

39) Site that is the major determinant of peripheral resistance.

Diff: 2    Page Ref: 608-609

 

Answers: 32) C 33) A 34) B 35) D 36) A 37) B 38) D 39) C

 

Match the following:

 

  1. A) Circulatory shock
  2. B) Cardiogenic shock
  3. C) Hypovolemic shock
  4. D) Vascular shock

 

40) Results from heart inability to sustain adequate circulation due to myocardial damage

Diff: 2    Page Ref: 631

 

41) Due to inadequate blood flow to meet tissue needs

Diff: 2    Page Ref: 630-631

 

42) Normal blood volume but poor circulation due to extreme vasodilation

Diff: 2    Page Ref: 630

 

43) Due to large-scale blood loss

Diff: 2    Page Ref: 627, 630

 

Answers: 40) B 41) A 42) D 43) C

 

18.2   True/False Questions

 

1) The adjustment of blood flow to each tissue in proportion to its requirements at any point in time is termed autoregulation.

Answer:  TRUE

Diff: 1    Page Ref: 623

 

2) Arterial pressure in the pulmonary circulation is much higher than in the systemic circulation because of its proximity to the heart.

Answer:  FALSE

Diff: 1    Page Ref: 632-633

 

3) Osmotic pressure is created by the presence in a fluid of small diffusible molecules that easily move through the capillary membrane.

Answer:  FALSE

Diff: 1    Page Ref: 627

 

4) The cerebral arterial circle (circle of Willis) is an arterial anastomosis.

Answer:  TRUE

Diff: 1    Page Ref: 637

 

5) The outermost layer of a blood vessel is the tunica intima.

Answer:  FALSE

Diff: 1    Page Ref: 606

 

 

6) The thick-walled arteries close to the heart are called muscular arteries.

Answer:  FALSE

Diff: 1    Page Ref: 608

7) Hypotension is generally considered systolic blood pressure that is below 100 mm Hg.

Answer:  TRUE

Diff: 1    Page Ref: 622

 

8) A precapillary sphincter is a cuff of smooth muscle that regulates the flow of blood into the capillaries.

Answer:  TRUE

Diff: 1    Page Ref: 610

 

9) The carotid sinus reflex protects the blood supply to the brain, whereas the aortic reflex is more concerned with maintaining adequate blood pressure in the systemic circuit as a whole.

Answer:  TRUE

Diff: 2    Page Ref: 616

 

10) Vasodilation is a widening of the lumen due to smooth muscle contraction.

Answer:  FALSE

Diff: 1    Page Ref: 607

 

11) The pulmonary circulation does not directly serve the metabolic needs of body tissues.

Answer:  TRUE

Diff: 1    Page Ref: 632-633

 

12) Every minute, about 1.5 ml of fluid leaks out of the capillaries.

Answer:  TRUE

Diff: 1    Page Ref: 627

 

13) The pancreas is an example of an organ with arteries that do not anastomose.

Answer:  FALSE

Diff: 1    Page Ref: 612

 

14) An obstruction in the superior vena cava would decrease the flow of blood from the head and neck to the heart.

Answer:  TRUE

Diff: 2    Page Ref: 645; Tbl. 18.9

 

15) Arteries supplying the same territory are often merged with one another, forming arterial anastomoses.

Answer:  TRUE

Diff: 2    Page Ref: 612

 

16) An increase in blood viscosity will cause an increase in peripheral resistance.

Answer:  TRUE

Diff: 2    Page Ref: 612

 

17) The azygos vein originates in the abdomen.

Answer:  TRUE

Diff: 3    Page Ref: 649

18) Whereas diffusion is more important for solute exchange between plasma and interstitial fluid, bulk flow is more important for regulation of the relative volumes of blood and interstitial fluid.

Answer:  TRUE

Diff: 2    Page Ref: 626-627

 

18.3   Multiple-Choice Questions

 

1) Which of the following is not one of the three main factors influencing blood pressure?

  1. A) cardiac output
  2. B) peripheral resistance
  3. C) emotional state
  4. D) blood volume

Answer:  C

Diff: 2    Page Ref: 615

 

2) Which of the following chemicals does not help regulate blood pressure?

  1. A) ADH
  2. B) atrial natriuretic peptide
  3. C) angiotensin II
  4. D) nitric acid

Answer:  D

Diff: 1    Page Ref: 618

 

3) Which statement best describes arteries?

  1. A) All carry oxygenated blood to the heart.
  2. B) All carry blood away from the heart.
  3. C) All contain valves to prevent the backflow of blood.
  4. D) Only large arteries are lined with endothelium.

Answer:  B

Diff: 1    Page Ref: 605

 

4) The most common type of blood capillary is the ________.

  1. A) sinusoidal capillary
  2. B) continuous capillary
  3. C) fenestrated capillary
  4. D) distributing capillary

Answer:  B

Diff: 1    Page Ref: 609

 

 

5) Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary function of ________.

  1. A) arterioles
  2. B) arteries
  3. C) veins
  4. D) capillaries

Answer:  D

Diff: 1    Page Ref: 609

6) Which of the following statements regarding the hepatic portal system is false?

  1. A) It carries nutrients, toxins, and microorganisms to the liver for processing.
  2. B) Its major vessels are the superior mesenteric, inferior mesenteric, and splenic veins.
  3. C) It consists of a vein connecting two capillary beds together.
  4. D) It branches off of the inferior vena cava.

Answer:  D

Diff: 2    Page Ref: 651

 

7) The arteries that are also called distributing arteries are the ________.

  1. A) elastic arteries
  2. B) muscular arteries
  3. C) arterioles
  4. D) capillaries

Answer:  B

Diff: 1    Page Ref: 608

 

8) Aldosterone will ________.

  1. A) promote an increase in blood pressure
  2. B) promote a decrease in blood volume
  3. C) result in a larger output of urine
  4. D) decrease sodium reabsorption

Answer:  A

Diff: 1    Page Ref: 618-619

 

9) The pulse pressure is ________.

  1. A) systolic pressure plus diastolic pressure
  2. B) systolic pressure minus diastolic pressure
  3. C) systolic pressure divided by diastolic pressure
  4. D) diastolic pressure plus 1/3 (systolic pressure plus diastolic pressure)

Answer:  B

Diff: 2    Page Ref: 614

 

 

10) Which of the following signs of hypovolemic shock is a relatively late sign?

  1. A) cold, clammy skin
  2. B) increased heart rate
  3. C) rapid, thready pulse
  4. D) rapidly falling blood pressure

Answer:  D

Diff: 2    Page Ref: 627,630Fig 18.18

 

11) Which of the following is likely during vigorous exercise?

  1. A) Blood will be diverted to the digestive organs.
  2. B) The skin will be cold and clammy.
  3. C) Capillaries of the active muscles will be engorged with blood.
  4. D) Blood flow to the kidneys increases.

Answer:  C

Diff: 1    Page Ref: 624-625

12) Which of the choices below explains why the arterioles are known as resistance vessels?

  1. A) Their prime function is the exchange of nutrients and wastes between the blood and tissue cells.
  2. B) The contraction and relaxation of the smooth muscle in their walls can change their diameter.
  3. C) They distribute blood to various parts of the body.
  4. D) They contain a large quantity of elastic tissue.

Answer:  B

Diff: 2    Page Ref: 608-609

 

13) Which of the following is true about veins?

  1. A) Venous valves are formed from the tunica media.
  2. B) Up to 35% of total body blood is in venous circulation at any given time.
  3. C) Veins have a small lumen in relation to the thickness of the vessel wall.
  4. D) Veins are called capacitance vessels or blood reservoirs.

Answer:  D

Diff: 2    Page Ref: 611

 

14) Which of the following processes provides a long-term response to changes in blood pressure?

  1. A) neural controls
  2. B) baroreceptor-initiated reflexes
  3. C) chemoreceptor-initiated reflexes
  4. D) renal regulation

Answer:  D

Diff: 1    Page Ref: 618

 

 

15) Peripheral resistance ________.

  1. A) decreases with increasing length of the blood vessel
  2. B) increases as blood vessel diameter increases
  3. C) increases as blood viscosity increases
  4. D) is not a major factor in blood pressure in healthy individuals

Answer:  C

Diff: 2    Page Ref: 612

 

16) Brain blood flow autoregulation ________.

  1. A) is less sensitive to pH than to a decreased oxygen level
  2. B) causes constriction of cerebral blood vessels in response to a drop in systemic blood pressure
  3. C) is abolished when abnormally high CO2levels persist
  4. D) is controlled by cardiac centers in the pons

Answer:  C

Diff: 2    Page Ref: 625

 

17) Blood flow to the skin ________.

  1. A) is controlled mainly by decreasing pH
  2. B) increases when environmental temperature rises
  3. C) increases when body temperature drops so that the skin does not freeze
  4. D) is not an important source of nutrients and oxygen for skin cells

Answer:  B

Diff: 1    Page Ref: 625

18) Which of the choices below reflects the balance (or imbalance) between the direction and amount of fluid that flows across the capillary walls?

  1. A) hydrostatic and osmotic pressure
  2. B) hydrostatic pressure only
  3. C) blood volume and viscosity
  4. D) plasma and formed element concentration

Answer:  A

Diff: 2    Page Ref: 626-627

 

19) Which of the following is a type of circulatory shock?

  1. A) hypovolemic, caused by increased blood volume
  2. B) cardiogenic, which results from any defect in blood vessels
  3. C) vascular, due to extreme vasodilation as a result of loss of vasomotor tone
  4. D) circulatory, where blood volume is normal and constant

Answer:  C

Diff: 2    Page Ref: 627, 630-631

 

 

20) Which tunic of an artery is most responsible for maintaining blood pressure and continuous blood circulation?

  1. A) tunica intima
  2. B) tunica media
  3. C) tunica externa
  4. D) tunica adventitia

Answer:  B

Diff: 2    Page Ref: 607

 

21) The influence of blood vessel diameter on peripheral resistance is ________.

  1. A) the only factor that influences resistance
  2. B) significant because resistance is inversely proportional to the fourth power of the vessel radius
  3. C) significant because resistance is directly proportional to the blood vessel diameter
  4. D) insignificant because vessel diameter does not vary

Answer:  B

Diff: 2    Page Ref: 613

 

22) The form of circulatory shock known as hypovolemic shock is ________.

  1. A) the form of shock caused by anaphylaxis
  2. B) any condition in which blood vessels are inadequately filled and blood cannot circulate normally
  3. C) shock that results from large-scale loss of blood volume, or after severe vomiting or diarrhea
  4. D) always fatal

Answer:  C

Diff: 1    Page Ref: 627

23) In the dynamics of blood flow through capillaries, hydrostatic pressure ________.

  1. A) and osmotic pressure are the same
  2. B) is the same as capillary blood pressure
  3. C) generally forces fluid from the interstitial space into the capillaries
  4. D) is completely canceled out by osmotic pressure

Answer:  B

Diff: 1    Page Ref: 626

 

24) Which of the following is the most significant source of blood flow resistance?

  1. A) blood viscosity
  2. B) total blood vessel length
  3. C) blood vessel diameter
  4. D) blood vessels type

Answer:  C

Diff: 3    Page Ref: 612-613

 

 

25) Which of the choices below does not explain why low capillary pressures are desirable?

  1. A) Capillaries are fragile and high pressures would rupture them.
  2. B) Most capillaries are extremely permeable and thus even low pressures force solute-containing fluid out of the bloodstream.
  3. C) Low blood pressure is associated with longer life span than high blood pressure.
  4. D) Low capillary pressure reduces the load of drainage the lymphatic drainage must handle

Answer:  C

Diff: 2    Page Ref: 621

 

26) Which of the choices below does not involve tissue perfusion?

  1. A) delivery of oxygen and nutrients to, and removal of wastes from, tissue cells
  2. B) gas exchange in the lungs
  3. C) absorption of nutrients from the digestive tract
  4. D) blood clotting

Answer:  D

Diff: 1    Page Ref: 622

 

27) Which of the following do not influence arterial pulse rate?

  1. A) activity
  2. B) postural changes
  3. C) emotions
  4. D) the vessel selected to palpate

Answer:  D

Diff: 2    Page Ref: 621

 

28) Which of the following are involved directly in pulmonary circulation?

  1. A) superior vena cava, right atrium, and left ventricle
  2. B) right ventricle, pulmonary artery, and left atrium
  3. C) left ventricle, aorta, and inferior vena cava
  4. D) right atrium, aorta, and left ventricle

Answer:  B

Diff: 2    Page Ref: 632-633

29) Histologically, the ________ is squamous epithelium supported by a sparse connective tissue layer.

  1. A) tunica intima
  2. B) tunica media
  3. C) tunica externa
  4. D) tunica adventitia

Answer:  A

Diff: 2    Page Ref: 606

 

 

30) The arteries that directly feed into the capillary beds are called ________.

  1. A) muscular arteries
  2. B) elastic arteries
  3. C) arterioles
  4. D) venules

Answer:  C

Diff: 2    Page Ref: 608

 

31) Which of the following is not true regarding fenestrated capillaries?

  1. A) Fenestrated capillaries in the small intestine receive nutrients from digested food.
  2. B) Fenestrated capillaries in endocrine organs allow hormones rapid entry into the blood.
  3. C) Fenestrated capillaries are essential for filtration of blood plasma in the kidney.
  4. D) Fenestrated capillaries form the blood-brain barrier.

Answer:  D

Diff: 3    Page Ref: 610

 

32) Modified capillaries that are lined with phagocytes are called ________.

  1. A) fenestrations
  2. B) sinusoids
  3. C) thoroughfare channels
  4. D) anastomoses

Answer:  B

Diff: 2    Page Ref: 610

 

33) Factors that aid venous return include all except ________.

  1. A) activity of skeletal muscles
  2. B) pressure changes in the thorax
  3. C) venous valves
  4. D) urinary output

Answer:  D

Diff: 2    Page Ref: 614

 

34) Which of the following blood pressure readings would be indicative of hypertension?

  1. A) 120/80 in a 30-year-old man
  2. B) 140/90 in a 70-year-old woman
  3. C) 170/96 in a 50-year-old man
  4. D) 110/60 in a 20-year-old woman

Answer:  C

Diff: 2    Page Ref: 621

 

35) Select the correct statement about factors that influence blood pressure.

  1. A) An increase in cardiac output corresponds to a decrease in blood pressure, due to the increased delivery.
  2. B) Systemic vasodilation would increase blood pressure, due to diversion of blood to essential areas.
  3. C) Excess protein production would decrease blood pressure.
  4. D) Excess red cell production would cause a blood pressure increase.

Answer:  D

Diff: 2    Page Ref: 612-613

 

36) Mechanisms that do not help regulate blood pressure include ________.

  1. A) nervous control that operates via reflex arcs involving baroreceptors, chemoreceptors, and higher brain centers
  2. B) the dural sinus reflex
  3. C) renal regulation via the renin-angiotensin system of vasoconstriction
  4. D) chemical controls such as atrial natriuretic peptide

Answer:  B

Diff: 2    Page Ref: 615-619

 

37) The velocity of blood flow is ________.

  1. A) in direct proportion to the total cross-sectional area of the blood vessels
  2. B) slower in the arteries than in capillaries because arteries possess a relatively large diameter
  3. C) slower in the veins than in the capillaries because veins have a large diameter
  4. D) slowest in the capillaries because the total cross-sectional area is the greatest

Answer:  D

Diff: 2    Page Ref: 622-623

 

38) Select the correct statement about blood flow.

  1. A) It is relatively constant through all body organs.
  2. B) It is measured in mm Hg.
  3. C) It is greatest where resistance is highest.
  4. D) Blood flow through the entire vascular system is equivalent to cardiac output.

Answer:  D

Diff: 2    Page Ref: 612

 

39) A thrombus (blood clot) in the first branch of the arch of the aorta would affect the flow of blood to the ________.

  1. A) left side of the head and neck
  2. B) myocardium of the heart
  3. C) left upper arm
  4. D) right side of the head and neck and right upper arm

Answer:  D

Diff: 3    Page Ref: 634; Tbl. 18.4

 

40) Cerebral blood flow is regulated by ________.

  1. A) skin temperature
  2. B) ADH
  3. C) intrinsic autoregulatory mechanisms
  4. D) the hypothalamic “thermostat”

Answer:  C

Diff: 3    Page Ref: 625

 

41) A patient with essential hypertension might have pressures of 200/120 mm Hg. This hypertensive state could result in all of the following changes except ________.

  1. A) increased work of the left ventricle
  2. B) increased incidence of coronary artery disease
  3. C) increased damage to blood vessel endothelium
  4. D) decreased size of the heart muscle

Answer:  D

Diff: 3    Page Ref: 621

 

42) The short-term controls of blood pressure, mediated by the nervous system and bloodborne chemicals, primarily operate via all but which of the following?

  1. A) reflex arcs involving baroreceptors
  2. B) altering blood volume
  3. C) reflex arcs associated with vasomotor fibers
  4. D) chemoreceptors

Answer:  B

Diff: 1    Page Ref: 615-618

 

43) Secondary hypertension can be caused by ________.

  1. A) obesity
  2. B) stress
  3. C) arteriosclerosis
  4. D) smoking

Answer:  C

Diff: 1    Page Ref: 622

 

44) Where in the body would you find low oxygen levels causing vasoconstriction and high levels causing vasodilation?

  1. A) kidney
  2. B) lungs
  3. C) liver
  4. D) heart

Answer:  B

Diff: 2    Page Ref: 625-626

 

 

45) If blood pressure is almost normal in a person who has lost blood, does that mean the tissues are receiving adequate blood flow?

  1. A) yes
  2. B) no
  3. C) not necessarily

Answer:  C

Diff: 3    Page Ref: 627

46) Which of the following would not result in the dilation of the feeder arterioles and opening of the precapillary sphincters in systemic capillary beds?

  1. A) a decrease in local tissue oxygen content
  2. B) an increase in local tissue carbon dioxide
  3. C) a local increase in histamine
  4. D) a local increase in pH

Answer:  D

Diff: 2    Page Ref: 615-619

 

47) Arteriolar blood pressure increases in response to all but which of the following?

  1. A) increasing stroke volume
  2. B) increasing heart rate
  3. C) rising blood volume
  4. D) falling blood volume
  5. E) all of these

Answer:  D

Diff: 2    Page Ref: 613-614

 

48) The baroreceptors in the carotid sinus and aortic arch are sensitive to which of the following?

  1. A) a decrease in carbon dioxide
  2. B) changes in arterial pressure
  3. C) a decrease in oxygen levels
  4. D) an increase in oxygen levels

Answer:  B

Diff: 1    Page Ref: 616

 

 

18.4   Fill-in-the-Blank/Short Answer Questions

 

1) Branches of the celiac trunk include the common hepatic, left gastric, and ________ arteries.

Answer:  splenic

Diff: 2    Page Ref: 640; Tbl, 18.7

 

2) The most common form of shock is ________.

Answer:  hypovolemic

Diff: 1    Page Ref: 627

 

3) A family of peptides called ________ are released by the endothelium and are among the most potent vasoconstrictors known.

Answer:  endothelins

Diff: 2    Page Ref: 623

 

4) Arterial ________ provide alternate pathways for blood to get to an organ.

Answer:  anastomoses

Diff: 1    Page Ref: 612

 

5) The ________ in the carotid sinuses and aortic arch detect increases in blood pressure.

Answer:  baroreceptors

Diff: 1    Page Ref: 616

6) The type of circulatory shock due to abnormal expansion of blood vessels and a rapid drop in blood pressure is ________.

Answer:  Vascular

Diff: 1    Page Ref: 630

 

7) The left subclavian artery is the ________ major branch of the aortic arch.

Answer:  third

Diff: 1    Page Ref: 634; Tbl. 18.4

 

8) The internal carotid arteries supply the ________ with blood.

Answer:  brain

Diff: 1    Page Ref: 634; Tbl. 18.4

 

9) The ________ veins drain the gall bladder.

Answer:  cystic

Diff: 2    Page Ref: 651; Tbl. 18.12

 

10) List the major factors that are linked to essential hypertension and note which ones are controllable by the patient.

Answer:  The factors are heredity, diet, obesity, age, diabetes mellitus, stress, and smoking. All of these factors are controllable by the patient except for heredity and age.

Diff: 3    Page Ref: 621

 

 

11) What are the sounds of Korotkoff?

Answer:  They are thumping sounds heard as an inflated blood pressure cuff is deflated on the arm. They represent blood spurting through the contricted artery and continue until the vessel is no longer constricted.

Diff: 3    Page Ref: 620-621

 

12) Which type of blood vessels contain valves and what is their function?

Answer:  Veins contain valves to prevent blood from flowing backward. This is necessary because the venous vessels are a low-pressure system and the blood must sometimes flow against gravity, particularly in the limbs.

Diff: 2    Page Ref: 611

 

13) Describe the forces that determine fluid movements across capillary walls.

Answer:  (1) Capillary hydrostatic pressure (equal to capillary blood pressure) tends to force fluid out of capillaries into the interstitial spaces. (2) Osmotic pressure, created by large nondiffusible particles in the blood, tends to draw water into the capillaries. At the arterial end of the capillary bed, hydrostatic forces dominate and fluid moves out, while at the venous end, osmotic forces dominate and the net fluid movement is into the capillaries.

Diff: 3    Page Ref: 626-627

 

14) Define vasoconstriction and vasodilation. What is the mechanism of regulation?

Answer:  Vasoconstriction is a reduction in the lumen diameter of a blood vessel due to smooth muscle contraction. Vasodilation is a widening of the lumen due to smooth muscle relaxation. Both are regulated by vasomotor nerve fibers of the sympathetic division of the autonomic nervous system and by local metabolic substances.

Diff: 2    Page Ref: 607, 615-616

15) Consider the diameter of one 4-mm blood vessel and two 2-mm blood vessels. Would the two 2-mm vessels carry more, less, or the same amount of fluid, given that pressure is a constant? Why?

Answer:  The two 2-mm vessels would deliver considerably less (8 times less) fluid for two reasons: (1) the resistance in the smaller vessels is much greater and (2) the volume of the 4-mm vessel is greater than that of two 2-mm vessels. Draw a 4-inch circle; then put two 2-inch circles in it and notice the volume difference. Alternatively, consider the effect of the fourth power of the radius, if the radius halves, the flow decreases 16 times, and even 2 smaller vessels would only reduce the difference to an 8-fold decrease.

Diff: 3    Page Ref: 612-613

 

16) The abdominal aorta divides into three arteries at its terminus; what are they?

Answer:  Left and right common iliac arteries and the median sacral artery.

Diff: 2    Page Ref: 640; Tbl. 18.7

 

17) The mesenteric arteries branch off the abdominal aorta, but the mesenteric veins do not connect directly to the vena cava. Why?

Answer:  The mesenteric veins merge into the hepatic portal vein before entering the liver. The liver dumps into the vena cava.

Diff: 2    Page Ref: 651

 

18.5   Clinical Questions

 

1) Describe the effect of hypovolemic shock on the blood vessels and the heart.

Answer:  Hypovolemic shock causes blood vessels to constrict to increase venous return and maintain pressure. Heart rate increases to compensate for loss of blood pressure and to maintain cardiac output. If volume loss continues, pressure eventually drops sharply and the shock becomes irreversible, leading to death.

Diff: 3    Page Ref: 627, 630

 

2) For each of the following situations, describe the anticipated effect on blood pressure and the physiological basis of the response: (1) a high-salt diet, (2) a blow on the head that damages (disables) the vasomotor center, (3) an attack by a mugger, and (4) a hypothalamic tumor resulting in excess ADH production.

Answer:  (1) A high-salt diet causes increased sodium in the blood, which increases total extracellular fluid volume. This leads to increased blood volume and blood pressure. (2) Damage to the vasomotor center will cause a loss of vasomotor tone and a drop in blood pressure because the vasomotor center is the integrating center for blood pressure control. (3) During the mugger attack, blood pressure would increase due to sympathetic nervous system stimulation (the fight-or-flight response) triggered by the hypothalamus. (4) Excess ADH production would cause an increase in blood pressure through increased water retention and therefore increased blood volume. ADH also stimulates vasoconstriction.

Diff: 3    Page Ref: 615-618

3) Mrs. Gray, a 50-year-old mother of seven children, is complaining of dull, aching pains in her legs. She reports that they have been getting progressively worse since the birth of her last child. During her physical examination, numerous varicosities are seen in both legs. How are varicosities recognized? What veins are most likely involved? What pathologic changes have occurred in these veins, and what is the most likely cause in this patient’s case?

Answer:  Varicosities are recognized by the enlargement of the veins. Superficial veins are most likely involved because they have little support from surrounding tissues. The veins have become tortuous and dilated because of incompetent valves that allow the blood to pool, stretching the vein walls. The likely cause in this patient’s case is her pregnancies, because the enlarged uterus exerts downward pressure on groin vessels, restricting return blood flow to the heart.

Diff: 3    Page Ref: 611

 

4) Mr. Wilson is a 45-year-old stockbroker with essential hypertension. He is African American, obese, and he smokes 2-3 packs of cigarettes daily. What risk factors for hypertension are typified by Mr. Wilson? What steps should be taken to treat Mr. Wilson, and what lifestyle changes should he make? What complications are likely if corrective steps are not taken?

Answer:  The risk factors are obesity, race, a high-stress job, and smoking. Mr. Wilson should lose weight, reduce salt intake, quit smoking, and try to reduce his stress level, perhaps by relaxation training. Medical intervention could include treatment with diuretics, beta blockers, calcium channel blockers, and angiotensin converting enzyme inhibitors. Complications could include atherosclerosis, heart failure, renal failure, and stroke.

Diff: 3    Page Ref: 621-622

 

5) A pregnant patient comes into a clinic and asks about a small painless dark compressible bulge that is becoming more apparent on her leg. What is it and what caused it?

Answer:  The patient is getting a varicose vein. Due to the growing fetus putting downward pressure on the vessels of the groin and restricting the return of blood to the heart, the valves in the peripheral veins begin to fail. This causes blood pooling, which enlarges these veins and puts additional strain on other peripheral vein valves down the line.

Diff: 3    Page Ref: 611

 

6) At the battle of Shiloh in the American Civil War, Confederate General A. S. Johnston was killed when he was shot in the thigh. Witnesses reported that he bled to death almost before he realized that he was wounded. Which blood vessel was most likely to have been injured? Why is a tourniquet usually ineffective in stopping the bleeding from this wound?

Answer:  The wound severed his femoral artery, the largest artery serving the lower limb. A tourniquet may be ineffective because it is a high-pressure, deep artery with a large diameter. It is therefore difficult to exert enough pressure through the thigh muscles to stop the bleeding.

Diff: 3    Page Ref: 643

7) A patient lost a lot of blood during surgery and his blood pressure dropped from 120/80 to 90/50. Describe how the kidneys respond to this change in blood pressure.

Answer:  When arterial blood pressure declines, special cells in the kidneys release the enzyme renin into the blood. Renin triggers a series of enzymatic reactions that produce angiotensin II, which is a potent vasoconstrictor. Angiotensin causes an increase in systemic blood pressure, and increases the rate of blood delivery to the kidneys and renal perfusion. It also stimulates the adrenal cortex to secrete aldosterone, a hormone that enhances renal reabsorption of sodium, and prods the posterior pituitary to release ADH, which promotes more water reabsorption. As sodium moves into the bloodstream, water follows; thus both blood volume and blood pressure rise.

Diff: 3    Page Ref: 618-619

 

8) A patient has an 80% blockage of his left anterior descending coronary artery. Describe what occurs in terms of myocardial oxygen supply and demand if his sympathetic nervous system is stimulated.

Answer:  When the sympathetic nervous system is stimulated there is increased myocardial contractility, which increases cardiac output and blood flow to active muscles. This increases the demand for oxygen to the cells. The coronary artery is a major blood vessel of the heart. When the demand for myocardial oxygen exceeds the ability of the coronary arteries to supply it, death of myocardial tissue can occur.

Diff: 3    Page Ref: 634; Tbl. 18.4