CCI practice exam from ESP, Questions and answers. Rated A.

CCI practice exam from ESP, Questions and answers. Rated A. At what time during fetal growth is the heart first fully developed? - 40 Days On the 30th day, the truncus normally divides. What anomaly occurs if the truncus does not divide? - truncus arteriosus The sinus venosus forms: - coronary sinus, right atrium and inferior vena cava The truncus arteriosus forms: - carotid artery, pulmonary arteries and ductus arteriosus What are the two right-to-left shunts in the normal fetal circulation? - foramen ovale and ductus arteriosus Which of the following left-to-right shunts is the last to close in the normal post-partum period? - patent foramen ovale, close at the end of the first week In the normal fetal circulation, which of the following has the least amount of blood flow? - pulmonary veins What hemodynamic events occur post-delivery? - pulmonary artery blood flow increases, pulmonary resistance decreases, and foramen ovale flow decreases The fetal ductus arteriosus closes soon after birth. What structure does it become? - ligamentum arteriosum The ductus arteriosus connects the pulmonary artery and aorta in the fetus. At what site does the ductus attach to the aorta? - aortic isthmus The following 5 structures are activated during a single cardiac cycle. Rank them in the normal order of activation: Bundle of His, purkinje fibers, AV node, SA node and left bundle branch - SA node, AV node, bundle of His, left bundle branch, purkinje fibers Which of the following structures is the primary pacemaker of the heart? - SA node During the resting state, which ions are pumped out of the cells of the myocardium? - sodium Following electrical depolarization of the myocardial cell membrane, which ion rushes in first and which ion rushes in later? - sodium followed by calcuim Which ions help to slow heart muscle contractions? - potassium In the cardiac cell action potential, what phases are included in the absolute refractory period? - phase 1 into phase 3 When contracting against which of the following pressures will the velocity of muscle cell contraction be most rapid? a. 75 mmHG b. 100 mmHg c. 125 mmHg d. 150 mmHg - 75 mmHg What happens to the beat following a premature ventricular contraction? - The beat is stronger than a typical beat What is the Frank-Starling Law? - The more heart muscle is stretched, the more forcefully it contracts What best describes preload? - left ventricular filling All of the following tend to increase preload except? a. MR b. AI c. AS d. volume overload - AS Which best describes afterload? - aortic pressure All of the following tend to increase afterload except? a. MR b. AS c. ASH d. HTN - MR What is the predominant echo finding associated with increased afterload? - LVH What is the predominant echo finding associated with increased preload? - LV dilatation A patients blood pressure is 120/80 mmHg, stroke volume is 80 ml, R-R interval is .86 seconds, HR is 70 BPM, and age is 42 years. What is the patient's cardiac output? - 5.5 l/min In the normal circulation, what is the value of the Qp/Qs ratio? - 1 In a patient with a VSD, which site will provide a measure of pulmonic flow? - mitral valve What best describes a patient with severe MR? - RF=50% Heart muscle beats automatically, without outside simulation. The rate that the heart naturally contracts is called the inherent rate. What term has the same meaning as inherent? - intrinsic What are cardiac responses to increased sympathetic stimulation? - increased heart rate, increased contractility and increased irritability Stimulation of the vagus nerve will result in: - increased R-R interval During the cardiac cycle, which valve event most closely follows the P-wave on ECG? - tricuspid valve closure What hemodynamic event follows the P wave on the ECG? - atrial systole What hemodynamic event follows the R wave on the ECG? - isovolumic contraction During the cardiac cycle, which valve event most closely follows the R-wave on the ECG? - pulmonic valve opening During the cardiac cycle, which valve event most closely follows the T-wave on the ECG? - aortic valve closure What hemodynamic event follows the T wave? - isovolumic relaxation What 2 pressures allows for the evaluation of aortic stenosis? - LV pressure and aotric pressure What 2 pressures allows for the evaluation of mitral stenosis? - LV pressure and LA pressure What 2 pressures allows for the evaluation of pulmonic stenosis? - RV pressure and PA pressure What 2 pressures allows for the evaluation of tricuspid stenosis? - RA pressure and RV pressure The hemodynamic evaluation of mitral regurgitationis performed during ________. - systole The hemodynamic evaluation of aortic stenosis is performed during ________. - systole The hemodynamic evaluation of tricuspid stenosis is performed during ________. - diastole The hemodynamic evaluation of pulmonic regurgitation is performed during _________. - diastole What flow pattern is the longest? - pulmonic insufficiency What valve closures are associated with the first heart sound? - mitral and tricuspid valve What valve event is associated with the second heart sound? - aortic closure Which of the following grades represents a murmur that is most faint? - 2 of 6 A thrill is most likely associated with which murmur? - grade 5 of 6 A crescendo murmur is quite often associated with a __________ - stenotic valve What is a typical or normal value for hematocrit? - 40% Mean right atrial pressure is ______ than mean left atrial pressure - less What is a typical value for mean left atrial pressure? - 10 mmHg What is typical value for mean right atrial pressure? - 5 mmHg What is the normal O2 saturation of blood in the pulmonary artery? - 75% What is the nomal O2 saturation of blood in the pulmonary vein? - 100% Where is the oxygen saturation of blood the lowest? - coronary sinus The size of a color flow jet is ______ related to the volume of blood creating the jet - sometimes During systole, the aortic and left venticular pressure are quite different. What is this finding indicative of? - aortic stenosis During systole, the left atrial pressure is much lower than the left ventricular pressure. What does this indicate? a. mitral stenosis b. mitral regurgitation c. aortic insufficiency d. none of the above - none of the above During diastole, the right atrial pressure is much higher than right ventricular pressure. What does this indicate? - tricuspid stenosis Sinus bradycardia is defined as a heart rate less than 60 BPM. How do the R waves appear on the ECG? - more than 5 big boxes apart Sinus tachycardia is defined