This quiz takes into account a number of laws applicable to flow throughout the systemic circulation – and indeed respiratory system too – to test your knowledge of the application of the physiology to the underpinnings of pathology. Good luck!

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Pressure and Flows in the Systemic Circulation

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Question 1
Mean arterial pressure is defined as
A
Pressure against arterial wall in ventricular systole
B
Combined pressures present throughout a cardiac cycle
C
Average arterial pressure during a cardiac cycle
D
Mean arterial pressure during a cardiac action potential
Question 2
A patient requires the mean arterial pressure to be estimated to assess damage from severe sepsis to the end-organ perfusion. Their stats are given as follows:
HR 70 ; RR 22 ; Sats 99% ; BP 130/90 ; Temp 38.0ºC ;
Calculate the MAP of this patient
A
103
B
106
C
112
D
110
Question 2 Explanation: 
MAP can be calculated with the following equation: MAP = 0.33(SBP-DBP)+DBP
Question 3
The carotid sinus sends sensory information through which nerve?
A
The nerve that innervates the diaphragm
B
The nerve which also innervates stylopharyngeus
C
The nerve supplying parasympathetic innervation to the myenteric plexus
D
The nerve responsible for motoric innervation of the tongue
Question 3 Explanation: 
The answer is CNIX, the glossopharyngeal nerve which solely innervates the stylopharyngess muscle in the pharynx.
Question 4
A patient presents in hypovolaemic shock.  What is the consequence of this state to the mechanoreceptors of the atrium?
A
They will increase their firing rate
B
They will neither increase or decrease their firing rate
C
They will decrease their firing rate
D
There are no mechanoreceptors in the atrium
Question 4 Explanation: 
There are, of course, mechanoreceptors in the atrium. When there is a decrease of volume - ergo stretch - then they will decrease their medullary efferent fibres. This necessitates an up regulation of the cardiac accelerator nerves from the brainstem to increase heart rate to compensate - in an attempt to stave off hypoperfusion of organs.
Question 5
Carotid body receptors are not stimulated by ...
A
Hypoxia
B
Hypercapnia
C
Hypocarbia
D
Temperature
Question 6
The arterial pressure curve features a "notch" as ventricular ejection ceases. What is the rationale of this trace?
A
The closure of the semilunar valves
B
The closure of the atrioventricular vales
C
The closure of the mitral valve
D
The closure of the aortic valve
Question 6 Explanation: 
Revise the arterial pressure curve if you are unfamiliar with the dicrotic notch.
Question 7
"Minor changes to radius of a vessel have a dramatic physiologic consequence" Which law supports this observation?
A
Laplace
B
Poiseuille
C
Boyle
D
Henry
E
Ideal Gas
Question 7 Explanation: 
Poiseuille's law is related to resistance. Thus we can say that there is an indirect correlation between flow through a tube and the narrowing of its aperture. You require a dilated tube to better flow.
Question 8
Which is the best example of a capacitance vessel?
A
The structure that carries blood from the left ventricle to the systemic circulation
B
The structure that arches over the right main bronchus to empty into the SVC
C
The structure that is a small diameter vessel and key for vascular resistance
D
A small blood vessel formed of a single layer of endothelium
Question 8 Explanation: 
Capacitance vessels are either veins or venules. In this instance, the correct answer is describing the course of the azygous vein.
Question 9
In terms of local perfusion regulation, sort the following organs by order of flow rate (from highest, to lowest)
A
liver, kidney, bone, skin
B
liver, kidney, skin, bone
C
kidney, liver, skin, bone
D
kidney, skin, bone, liver
Question 10
Endothelial cells suffering shear-stress result in cGMP-mediated upregulation of protein kinases. This causes exocytosis of ...
A
Endothelin
B
tPA
C
NO
D
ADP
Question 11
Which of the following statements adequately encapsulate the innervation of blood vessels?
A
Adrenergic endings vasodilate the periphery classically
B
Adrenergic endings do not possess constant tone
C
Cholinergic endings possess constant tone
D
Cholinergic fibres cause vasodilation of the periphery
Question 12
A physician is treating a patient for bradycardia of 55bpm. Which of the following is the best treatment class?
A
Anti-nicotinic
B
Anti-muscarinic
C
Beta-agonist
D
Alpha-agonist
Question 13
A patient, during an anxiety attack, is in full fight-or-flight sympathetic overdrive.  Which of the following vessels in the body are vasodilated by the upsurge in sympathetic neurotransmitters?
A
Femoral artery
B
Dorsalis pedis
C
Internal carotid artery
D
Marginal branch of the right coronary artery
Question 14
Which of the following is true of ADH?
A
It is released from the anterior pituitary gland
B
It is synthesised in the posterior pituitary gland
C
It is a potent vasodilator causing marked peripheral oedema
D
It increase polydipsia by acting on the lateral hypothalamic nucleus
Question 15
Which of the following would be activated by shear-stress induced maceration of the endothelium?
A
ANP
B
Calcium
C
Aldosterone
D
Kallikrein
Question 15 Explanation: 
This is a kinin class, a small peptide, that is a potent vasodilator and increases vascular permeability to allow WBC to reach the site of infection.
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