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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 โ REPEAT PAPER
External Examiner(s) Professor A. Payne
Professor S. Wray
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 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 has a point of auscultation on the 5 th^ intercostals space b. It has its point of auscultation on the right side of the sternum c. It is the one whose projection on the anterior chest surface is the most caudal of the heart valves d. It prevents regurgitation of blood into the pulmonary vein 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 flanked by the middle cardiac vein c. is the anterior interventricular artery d. is the coronary sinus e. is the left coronary artery
5- Which of the following veins opens directly into the superior vena cava? a. Accessory haemiazygos vein b. Anterior intercostals veins c. Azygos vein d. Haemiazygos vein e. Posterior intercostals veins
A
C
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B D
8- Which one of the following statements on capillaries is INCORRECT? a. They are lined internally by a monolayer of flattened cells b. They can be fenestrated, non-fenestrated, or discontinuous c. They contain abundant elastic tissue which diminishes progressively, the smaller they become d. They can have a different degree of permeability depending on the type e. They can be smaller than the size of red blood cells
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 can 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- Which of the structures listed below crosses the diaphragm through the aortic hiatus? a. Azygos vein b. Inferior vena cava c. Haemiazygos vein d. Thoracic duct e. None of the above (a.-d.)
11- The pericardial space is lined by: a. Cardiomyocytes b. Ciliated pseudostratified epithelium c. Columnar epithelial cells with brush border d. Endothelial cells e. Mesothelial cells
12- 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 lining of the anterior surface of the pericardial space d. close to the apex of the heart e. dorsal to aorta and pulmonary artery and ventral to the superior vena cava
13- The plane that divides the superior from the inferior mediastinum is at the level of: a. T b. T c. T d. T e. the tendineous centre of 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. Private vessels for the lung e. None of the above (a.-d.)
15- Which of the following locations is within the cardiac dull area? a. 2 nd^ intercostal space at 5 cm from the left sternal margin b. 4th^ intercostal space at 5 cm from the right sternal margin c. 4th^ intercostal space at 8 cm from the right sternal margin d. 5th^ intercostal space on the hemiclavicular line on the right e. None of the above (a.-d.)
16- In a cross section of the heart: a. Both ventricles have the same shape b. The left ventricle has a crescent shape c. The thickness of the interventricular septum is similar to that of the wall of the left ventricle 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 left coronary artery is correct? a. It arises from the posterior aortic sinus b. It gives off the posterior interventricular artery c. One of its branches is the main supplier of the atrioventricular node d. One of its branches is the main supplier of the interventricular septum e. One of its branches is the main supplier of the sino-atrial node
18- The intercalated discs are a. Another name for the aortic and pulmonary valves b. Cells of the heart intercalated to cardiomyocytes in the myocardium c. Junctional complexes rich in gap junctions d. Spiral blood vessels that flow between cardiomyocytes e. None of above (a.-d.)
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 foramen ovale and formation of the fossa ovale b. Closure of the interventricular foramen c. Formation of the foramen primum 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. Interventricular foramen d. Outflow tract e. Terminal ridge
22- Which one of the following veins (or portion thereof) originates from the right posterior cardinal vein? a. Vena cava inferior b. Vena cava superior c. Coronary sinus d. Pulmonary veins e. Azygos
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
31- Mark the INCORRECT statement about cardiac muscle contraction a. it requires hydrolysis of ATP b. is an all-or-none phenomenon c. increases active tension d. is weakened by reduced Ca 2+^ entry from extracellular fluid e. involves the binding of Ca 2+^ to troponin I
32- At point D on the pressure volume loop for the left ventricule which event occurs? a. first hear sound (SI) b. systole begins c. diastole ends d. left ventricular pressure rises above aortic pressure e. second heart sound (S2)
33- Which of the following segments of the circulatory system has the highest velocity of blood flow? a. aorta b. arteries c. capillaries d. venules e. veins
34- If a patient has a oxygen consumption of 240 ml/min, a pulmonary vein oxygen concentration of 180 ml/L of blood and a pulmonary artery oxygen concentration of 160 ml/L of blood, what is the cardiac output? a. 8L/min b. 10L/min c. 12 L/min d. 16L/min e. 20L/min
35- Which of the following is associated with the third heart sound? a. Inrushing of blood into the ventricles due to atrial contraction b. Closing of the A-V valves c. Closing of the pulmonary valve d. Opening of the A-V valves e. Inrushing of blood into the ventricles in the early-to-middle part of diastole
36- When travelling at 0 degrees in the frontal plane, a ventricular depolarisation wave causes a large positive deflection in which of the following leads? a. aVR b. aVL c. Lead I d. Lead III e. AVF
37 - These sets of data show pressure in the aorta and left and right atria and ventricles at various stages in the cardiac cycle. Which data set between a, b, and c best suits someone who has an aortic stenosis?
A B C
Aorta: systolic pressure (mmHg) 140 120 100 Aorta: diastolic pressure (mmHg) 60 80 80 Mean left atrial pressure (mmHg) 10 5 10 Mean right atrial pressure (mmHg) 0 0 0 Systolic pressure: left ventricle (mmHg) 140 120 150 Systolic pressure: right venticle (mmHg) 25 25 25 Left ventricular end-diastolic pressure (mmHg) 10 5 10
38- Cardiac sympathetic nerve impulses to the sinoatrial (SA) node: a. reduce the slope of the pacemaker potential b. are tonically active in a person at rest c. increase the conductance of the cell membrane to calcium ions d. decrease the conductance of the cell membrane to sodium ions e. cause the โfunnyโ current (i (^) f) to flow during phase 0 of the action potential
39- In relation to autoregulation of blood flow in systemic circulation: a. The autoregulatory range in the cerebral circulation is 35-135mmHg b. Vascular smooth muscle cells in renal arterioles contract 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 P (^) CO2 in the cerebral circulation
40- Ultrafiltration in systemic capillaries: a. never occurs in the cerebral circulation b. is increased when venous pressure is reduced c. is increased when the interstitial protein concentration increases d. is fully balanced by reabsorption in skeletal muscle capillaries e. is decreased when the plasma protein concentration is low
47- The cells of the sino-atrial (SA) node: a. are nerve cells b. have a resting membrane potential of -90mV c. when sympathetically stimulated, exhibit increased Na +^ entry d. are the secondary pacemaker in the heart e. require activation of acetylcholine-sensitive potassium channels for heart rate to be increased
48- The ventricular muscle resting membrane potential is: a. close to the equilibrium for Na
b. is unstable c. is always negative d. is dependent on Na permeability e. A and D above are correct
49- In relation to the absolute refractory period in cardiac muscle a. Potassium channels are closed b. Contraction may be induced by a sufficiently powerful stimulus c. The membrane potential is close to -90mV d. Fast sodium channels are closed e. L-type calcium channels are closed
50- What part of the conductive system of the heart directly delivers the action potential to the atrioventricular (AV) node a. Purkinje fibers b. Bundles of His c. Gap junctions d. Pacemaker cells e. Atrial cells
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