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Semester 2 Examinations 2011 / 2012
Exam Code(s) MD 121
Exam(s)^1
st medical
Module Code(s) MD 121
Module(s) Cardiovascular system
Paper No. 1
External Examiner(s) Prof. A. Payne
Prof. S. Wray
Dr. B. Mรผller
Internal Examiner(s) Dr. F. Quondamatteo
Prof. A. Wheatley
Dr. S. Healy
Instructions: Answer all 50 questions in the computer readable form provided
Students must select ONLY ONE OPTION in each question
ONLY ANSWERS ENTERED IN THE COMPUTER
READABLE FORM ACCORDING TO BLACKBOARD
INSTRUCTIONS WILL BE EVALUATED
Duration 2 Hours (TWO HOURS)
No. of Pages 10 (TEN) including this front page
Department(s) Anatomy, Physiology, Biochemistry
Requirements Computer readable forms (a,b,c,d,e)
NOT TO RELEASE
Image to questions 1-
1-Select the correct option. In the above image, the structure marked by A: a. does not have any contractile function b. its contraction opens the valve in order to facilitate ventricle filling c. is attached to a valve whose auscultation point is at the 2 nd^ intercostal space right of the sternum d. is located in a cavity whose separation from the contralateral cavity normally occurs within the end of the second month of intrauterine life e. is predominantly composed of smooth musculature
2- Which of the following statements on the structure marked by B in the above image is correct? a. It closes to prevent excessive blood perfusion of the lungs during systole b. It has a sinus which gives rise to the left coronary artery c. It has its point of auscultation on the left side of the sternum d. It is the one whose projection on the anterior chest surface is the most caudal of the heart valves e. none of the above (a.-d.)
3- Select the correct option. In the above image, the vessels marked by C, in the proximo-distal order, are: a. brachiocephalic artery โ left common carotid artery โ left subclavian artery b. brachiocephalic artery โ left internal carotid artery โ left external carotid artery c. brachiocephalic artery โ left subclavian artery - left common carotid artery d. right brachiocephalic artery โ left brachiocephalic artery โ left subclavian artery e. right external carotid artery โ right internal carotid artery โ brachiocephalic artery
4- Select the correct option. In the above diagram, the artery marked by D: a. is a branch of the right coronary artery b. is the coronary sinus c. is the left coronary artery d. is the main supplier of the interventricular septum e. is the posterior interventricular artery
5- Which one of the following statements on veins is correct? a. Veins are lined by a two-layered endothelium b. Veins have a wall in which the muscle cells are abundant, particularly packed, and tight with each other c. Veins have a wall in which the layers are much less distinct in comparison to arteries d. Veins have generally higher elasticity than arteries e. Veins, in particular the large ones, have a very regular lumen (rounded/oval)
A
C
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B D
8- Which one of the following statements on arteries is correct? a. Arteries are lined internally by a monolayer of flattened cells b. Arteries can be fenestrated, non-fenestrated, or discontinuous c. Arteries contain elastic tissue which becomes progressively more abundant the smaller the arteries become d. Arteries have the highest amount of muscular cells in their tunica adventitia e. Large arteries are rich in vasa vasorum in their tunica intima
9- From the following statements, select the correct one on Lymph drainage a. Lymph drainage from the entire thorax occurs by the thoracic duct b. Lymph drainage of the mammary region does not occur via mediastinal lymphatics c. Lymph drainage opens in the venous circulation only on the left side, whereas on the right side it opens in the arterial circulation d. Lymph drainage opens in the venous circulation, only at the angle between the left internal jugular and left subclavian vein e. None of the above statements (a.-d.) is correct
10- Select the correct option. The organ which is located just dorsal to the heart (and pericardial sac) is: a. azygos vein b. oesophagus c. thoracic aorta d. thoracic duct e. trachea
11- Select the correct option. The transverse sinus of the pericardium is located: a. anterior to the inferior vena cava, diaphragm and right atrium b. between the pulmonary veins just dorsal to the left atrium c. between the sterno costal surface of the heart and the mesothelial lining of the anterior surface of the pericardial sac d. close to the apex of the heart e. dorsal to aorta and pulmonary artery and ventral to the superior vena cava
12- Select the correct option. The oblique sinus of the pericardium is located: a. anterior to the inferior vena cava, diaphragm and right atrium b. between the pulmonary veins just dorsal to the left atrium c. between the sterno costal surface of the heart and the mesothelial lining of the anterior surface of the pericardial sac d. close to the apex of the heart e. dorsal to aorta and pulmonary artery and ventral to the superior vena cava
13- Select the correct option. The plane that divides the superior from the inferior mediastinum: a. also passes at the level of the origin of the brachiocephalic artery (brachiocephalic trunk) b. is a plane tilted anteriorly and caudally which passes at the upper margin of the first rib, jugular notch and first thoracic vertebra c. is the horizontal plane that passes at the level of the sternal angle and the 4th^ thoracic vertebra d. is the horizontal plane which passes at the level of the passage of the inferior vena cava through the diaphragm e. is the same as the diaphragm
14- Which of the following vessels (or vessel groups) branch out of the thoracic aorta? a. Anterior intercostal arteries b. Coronary sinus c. Right coronary artery d. Thoracic duct e. none of the above
15- Which of the following locations is within the cardiac dull area? a. 2nd^ intercostal space at 5 cm from the left sternal margin b. 4th^ intercostal space at 1 cm from the left sternal margin c. 4th^ intercostal space at 8 cm from the right sternal margin d. 5th^ intercostal space on the mid-clavicular line on the right e. None of the above
16- Select the correct option. In a cross section of the heart: a. Both ventricles have the same shape b. The interventricular septum has a concavity towards the left c. The right ventricle has a circular shape d. The wall has the same thickness in both ventricles e. The wall of the left ventricle is about ten times thicker than the wall of the right ventricle
17- Which one of the following statements on the right coronary artery is correct? a. It arises from the posterior aortic sinus b. It gives off the circumflex artery c. It is the main supplier of the atrioventricular node d. It is the main supplier of the interventricular septum e. It supplies the sinoatrial node only in a very small percentage of cases
18- Which one of the following statements on the human heart is correct? a. It contains cardiomyocytes connected with each other by abundant gap junctions b. It contains Purkinje cells c. It is lined internally by a mesothelium d. It is provided with a bony skeleton e. It is rich in sarcomeres that are connected with each other by disci intercalares
19- With regard to the innervation of the heart, which of the following statements is correct? a. Connection to the central nervous system is necessary to the heart in order to generate heart beat b. Sympathetic supply arises entirely from the stellate ganglion c. The cardiac plexus is a network composed only of parasympathetic ganglia d. The vagus nerve provides sympathetic supply e. None of the above is correct
20- Which one of the following developmental events occurs chronologically as the last one? a. Closure of the interventricular foramen b. Formation of septum secundum c. Obliteration of the ductus arteriosus d. Septation of bulbus and truncus arteriosus e. Start of the heart beat
21- Which one of the following structures is NOT normally present in an adult heart? a. Sinus of the venae cavae b. Fossa ovale c. Foramen primum d. Outflow tract e. Terminal ridge
22- Which one of the following veins (or portion thereof) originates from the right anterior cardinal vein? a. Vena cava inferior b. Vena cava superior c. Coronary sinus d. Pulmonary veins e. None of the above
23 โ To what extent is the phrenic nerve involved in the supply of organs/structures of the cardiovascular system? a. It does not have any involvement b. It provides sensory supply to the heart tissue c. It provides sensory supply to the pericardial sac d. It provides stimulatory signals to the sino atrial node, which are necessary to the generation of the heart beat e. It provides sympathetic innervation to the conducting system of the heart
30- In relation to the cardiac cycle, select the correct statement from the following: a. At rest, diastole and systole are of equal length b. Atrial contraction marks the beginning of systole c. Atrial filling occurs during systole d. Isovolumetric contraction occurs in early diastole e. The length of the cardiac cycle with a heart rate of 30 beats/min is 1 sec
31- In relation to right atrial and jugular venous pressure, select the correct statement from the following: a. The a wave occurs following ventricular contraction b. The c wave occurs during systole c. The v wave occurs at the same time in the right atrium and jugular veins d. The x descent is due to a fall in atrial pressure after the AV valve opens e. The x descent occurs between the a and c waves
32- In relation to pulmonary circulation a. Arterial pressure is the same as in the systemic circulation b. CO2 moves from the pulmonary capillaries into the alveoli by active transport c. Pulmonary vascular resistance is higher than TPR d. The circuit is in parallel with the systemic circuit e. Venous blood is oxygenated
33- The average velocity of blood flow in the aorta is: a. 0.2 cm/sec b. 2 cm/sec c. 2 m/sec d. 20 cm/sec e. 20 m/sec
34- In relation to tension development by cardiac muscle, select the correct statement from the following: a. active tension = total tension + passive tension b. For active tension to be developed, calcium must enter the muscle cells c. Increased passive tension always increases total tension when the muscle is stimulated d. Passive tension exceeds developed active tension when the muscle fibres are at resting length e. Reducing the end-diastolic volume of the ventricle leads to increased passive tension
35- Which of the following vessels has the greatest total cross-sectional area in the circulatory system? a. Aorta b. Capillaries c. Small arteries d. Vena cava e. Venules
36- Which of the following events is associated with the first heart sound? a. Beginning of diastole b. Closing of the A-V valves c. Closure of the aortic valve d. Inrushing of blood into the ventricles during diastole e. Opening of the A-V valves
37- In relation to the absolute refractory period in cardiac muscle, select the correct statement from the following: a. Contraction can be induced by a sufficiently powerful stimulus b. Fast sodium channels are closed c. L-type calcium channels are closed d. Potassium channels are closed e. The membrane potential is close to -90mV
38- In relation to the contraction of ventricular muscle, which of the following is INCORRECT? a. It involves the function of the L-type calcium channel b. It is associated with ATP hydrolysis c. It is facilitated by calcium-induced calcium release from the SR d. It requires activation of the ryanodine receptor e. Parasympathetic stimulation is a prerequisite
39- In relation to arterial blood pressure, select the correct statement from the following: a. During measurement, diastolic pressure is detected when the Korotkoff sounds are first heard b. It reaches a maximum during the ejection phase of systole c. MAP = CO รท TPR d. MAP = diastolic pressure โ 1/3(systolic pressure โ diastolic pressure) e. Systolic pressure tends to fall with age
40- Following haemorrhage (blood loss): a. Baroreceptor firing rate to the cardiovascular centre is increased b. Capillary hydrostatic pressure is reduced c. Haematocrit is reduced d. The actions of adenosine will increase total peripheral resistance (TPR) e. Venous return to the right side of the heart is increased
41- Which of the following pressures is normally sub-atmospheric (negative) in a muscle capillary bed in the lower extremities? a. Capillary hydrostatic pressure b. Interstitial colloid osmotic pressure c. Interstitial hydrostatic pressure d. Plasma colloid osmotic pressure e. Venous hydrostatic pressure
42- An increase in which of the following would be expected to reduce blood flow in a blood vessel? a. Plasma colloid osmotic pressure b. Plasma sodium concentration c. Pressure gradient across the vessel d. Radius of the vessel e. Viscosity of the blood
43- Cognitive stimuli such as watching TV results in significant increases in cerebral blood flow. Which of the following changes in cerebral tissue concentrations is the most likely explanation for the increase in cerebral blood flow? CO2 pH Adenosine a โ โ โ b โ โ โ c โ โ โ d โ โ โ e โ โ โ
44- When travelling at โ150 degrees in the frontal plane, a ventricular depolarisation wave causes a large positive deflection in which of the followwing leads? a. AVF b. aVL c. aVR d. Lead I e. Lead II
49- Which change in the cells of the SA node would occur during the pacemaker potential? a. Decreased conductance to sodium b. Decreased SERCA activity c. Increased activity of the sodium-calcium exchanger d. Increased activity of the sodium-potassium ATPase pump e. Increased conductance to sodium
50- Select the correct statement in relation to autoregulation of blood flow in systemic circulation: a. The autoregulatory range in the cerebral circulation is 50-150mmHg b. Vascular smooth muscle cells in renal arterioles relax when renal artery pressure increases c. Autoregulation maintains blood flow to the small intestines during haemorrhage d. Autoregulation occurs in the skin circulation when core body temperature increases e. Autoregulation is caused by elevation in arterial PCO2 in the cerebral circulation
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