Preguntas Final Fisio 2 PDF

UNIT 2: COMPOSITION OF BLOOD (Ana Bosch and Rafa Salvador) 1. Importance of Albumin in blood: It is synthesized by the liver and it is regulated by the colloid osmotic pressure of the blood. It is responsible of the transport of fatty acids, cholesterol, lipoproteins phosphoglyceride, bilirubi...

UNIT 2: COMPOSITION OF BLOOD (Ana Bosch and Rafa Salvador) 1. Importance of Albumin in blood: It is synthesized by the liver and it is regulated by the colloid osmotic pressure of the blood. It is responsible of the transport of fatty acids, cholesterol, lipoproteins phosphoglyceride, bilirubin, calcium, steroids hormones, amino acids and drugs. 2. Which affirmation is correct about the blood?: a) The red colour is given by the platelets b) Its medium pH is around 7.4 c) The density of the blood is 2 times more the density of the water d) With a severe anemia the haematocrit is higher than the normal values e) The haematocrit is the number of RBC that we have in blood 3. Which affirmation is false about the blood?: a) There is a constant diffusion between plasma and interstitial fluid but also between interstitial fluid and intracellular fluid, which is the major portion of the body fluids b) Men have higher amount of RBC than women c) Proteins are in their anionic form in the plasma d) The oncotic pressure helps to maintain the water outside the vessels and it is exerted by the plasma proteins. e) About 60% of the blood is plasma and 40% is RBC, but these percentages can vary considerably in different people, depending on gender, weight and other factors. 4. Which ion is the regulator of acid-base balance and CO2 transport? a) Carbonate b) Sodium c) Calcium d) Chlorine e) Phosphate UNIT 3: RED BLOOD CELLS. ANEMIA. POLYCYTEMIA (Cristina Soler y Alejandro Casanovas) How are red blood cells differentiated? 1. The first cell that can be identified as belonging to the red blood cell series is the proerythroblast. 2. Under appropriate stimulation, large numbers of these cells are formed from the CFU-E stem cells. 3. Once the proerythroblast has been formed, it divides multiple times. 4. The first generation cells are called basophil erythroblasts because they stain with basic dyes; the cell at this time has accumulated very Little HGB. 5. In the succeeding generations,the cells become filled with HGB to a concentration of about 34%, the nucleus condenses to a small size, and its final remnant is absorbed or extruded from the cell. 6. At the same time, the endoplasmic reticulum is also reabsorbed. 7. The cell at this stage is called a reticulocyte because it still contains a small amount of basophilic material, consisting of remnants of the Golgi apparatus, mitochondria, and a few other cytoplasmic organelles. 8. During this reticulocyte stage, the cells pass from the bone marrow into the blood capillaries by diapedesis (squeezing through the pores of the capillary membrane). 9. The remaining basophilic material in the reticulocyte normally disappears within 1 to 2 days, and the cell is then a mature erythrocyte. 10. Because of the short life of the reticulocytes, their concentration among all the red cells of the blood is normally slightly less than 1 percent. 90% of Erythropoietin is created in the… a) Liver b) Bone marrow c) Kindey d) Spleen e) All of the above are false In pernicious anemia the basic abnormality is: a) There is a fail to produce gastric secretions as IF, having a lack in vit.B12 b) There is a lack in folic acid c) We obtain too much vit.B12 d) Elongated crystals are created inside the RBC e) All of the above are true About the red blood cells. Which is false? a) They can function as an acid-base buffer b) A major function is to transport hemoglobin, which in turn carries oxygen from the lungs to the tissues c) Hemoglobin can act effectively outside the RB d) They can change their shape remarkably as the cells squeeze through capillaries e) They are cells with no nucleus UNIT 4: RESISTANCE OF THE BODY TO INFECTION. LEUKOCYTE, GRANULOCYTE MONOCYTE- MACROPHAGE SYSTEM. (Damián García y Helena Borrel) 1-Which is true about leukocytes? a) They are a type of RBC. b) They are the mobile units of the body’s protection system. c) They are a type of monocytes. d) They are tissue macrophages. e) They can be called “polys”. 2-Which of the following statements is true? a) Neutrophils have granular appearance and produce antibodies. b) Lymphocytes have a granular appearance and can be called “polys”. c) Lymphocytes perform important phagocytic functions at the tissue level. d) Monocytes have granular appearance and can be called “polys”. e) Monocytes are converted into tissue macrophages. 3- Which of the following sentences is true? a) The chemotactic signal barely arrives to almost all the tissues. b) Chemotaxis depends on the concentration gradient of the chemotactic substance. c)When a tissue becomes inflamed, only one single product can cause chemotaxis toward the inflamed area, the reaction products of the complement complex. d) Only monocytes once they have become macrophages can move trhough the tissues by ameboid motion. e) After neutrophils enter the tissues and become macrophages, may become attached to the tissues for months ir even years. 4- Explain the Monocyte-Macrophage Cell System in the Lungs. Tissue macrophages are components of the alveolar wall and they can phagocyte the particles that become entrapped in the alveoli. When these particles are digestible, the macrophages digest them and release the products to the lymph. When they are not digestible, macrophages will form a "giant cell"campsule that, if it is possible, will be slo UNIT 5: INFLAMMATION (Julia Baixauli e Irene Martínez) 1. Name and explain the steps of the response of neutrophils and macrophages during inflammation. 1st line of defense against infection (Tissue macrophage), which is very quickly, the macrophages present in tissues begins their phagocytic actions. 2nd line of defense (Neutrophil invasion), neutrophils begins to invade the inflamed area. And they produce 3 reactions: margination (neutrophils stick to capillary and venule walls in inflamed area), intracellular attachments (allowing entrance of neutrophils by diapedesis from blood into tissue spaces) and chemotaxis of neutrophils into injured tissues. It’s produced an acute increase in the number of neutrophils in the blood, which is called neutrophilia, caused by product of inflammation. 3rd line of defense (Second macrophage invasion), with the invasion of neutrophils also monocytes enter the inflamed tissue and become macrophages. 4th line of defense (Increased production of granulocytes and monocytes by the bone marrow), results from the stimulation of the progenitor cells of the marrow 5th: Formation of pus. When neutrophils and macrophages engulf bacterias and necrotic tissue they eventually die. A cavity in the inflamed tissue contains portions of necrotic tissue, dead neutrophils and macrophages and tissue fluid, this mixture is know as pus. 2. Which of these features is NOT a typical from inflammation: A) Vasoconstriction of local blood vessels B) Swelling of the tissue cells C) Increased permeability of capillaries D) Warm E) All of them are true 3. Which of these definitions is FALSE: a) Opsonization is the selection and phagocytosis process b) There are 2 types of responses in front of inflammation (general and localize) c) Tissue macrophage is the second line of response against infection d) Leukopenia is caused by a decrease on white blood cells production by the bone marrow e) Leukemia is caused by an uncontrolled production of white blood cells 4. About the formation of Pus, which is the CORRECT one: a) Is a cavity excavated in the healthy endothelial tissue b) After infection, the dead cells and necrotic tissue gradually autolyze c) It is formed by necrotic tissue, dead cells, and tissue fluids d) A and c are false e) B and c are true UNIT 6: STRUCTURE OF THE IMMUNE SYSTEM. (Marian Botella, Marina Aspas and Marta Sole) 1. Which of the following is not a characteristic of the thymus? a. Bilobed organ b. Acts as a T cell classroom for differentiation and maturation c. As individual ages it becomes “invisible” on a chest film d. Site where the lymphocytes undergo differentiation and clonal expansion in an antigen-dependent fashion e. Is in the anterior mediastinum 2. Which of the following is true? a. Epithelial barriers are considered part of the innate immune system b. The innate immune system has immune memory  c. The spleen is divided into medulla, paracortex and cortex d. In the cortex of the thymus the b cells undergo positive selection e. The spleen is a primary lymphoid organ 3. Which of the following statements is correct about the lymph nodes? a. The flow through a lymph node is: afferent lymphatic vessel→ subscapular sinus→ medullary sinus→ trabecular sinus→ efferent lymphatic vessel b. Lymph nodes are encapsulated and trabeculated secondary lymphoid organs with one afferent vessel and many efferents c. The medulla of the node consists primarily of cords and sinuses d. B cells are concentrated within the paracortex e. The cortex is where T cells migrate 4. State the characteristics of the innate immune system The innate immune system is characterized by its fast and nonspecific response as well as its lack of immune memory. UNIT 7: Acquired immunity Choose the INCORRECT one: a) In the cellular inmunity, the secondary response is much more potent and will form antibodies for months. b) In humoral immunity, memory cells are created but not in the cellular immunity. c) T lymphocytes respond to antigens only when they are bound to specific molecules called MHC proteins on teh surface of antigen-presenting cells. d)There are five genaral classes of antibodies: IgM, IgG, IgA, IgD and IgE. e) Macrophags can act both in humoral and cellular immunity presenting the antigen. Select the CORRECT one: a) Lymphokines are formed by cytotoxic T cells b) Supressor T cells are the responsible of supress the functions of the cytotoxic cells exclusively. c) Perforins are a hole-forming proteins secreted by T-helper cells d) Cytotoxic-cells are the most numerous and the major regulator of virtually all the immune functions. e) Immune tolerance is the absence or limitation of the immune response, i.e., ability of the system to attack it's own body tissues. Short Question: -Write the two types of acquired immunity that occur in our body and explain them briefly. 1.Humoral immunity /B-cells immunity (because B lymphocytes produce the antibodies): The body develops circulating antibodies,which are globulin molecules in the blood plasma that are capable of attacking the invading agent. 2.Cell-mediated immunity /T-cell immunity (because the activated lymphocytes are T- lymphocytes): This immunity is achieved through the formation of large numbers of activated T lymphocytes that are specifically crafted in the lymph nodes to destroy the foreign agent. Choose the CORRECT affirmation: a). The three major types of antigen-presenting cells are macrophages, B lymphocytes, and dendritic cells. b).The molecular groups which depens the process of antigenicity are the editopes. c).The B lymphocytes, is responsible for forming antibodies that provide “cell-mediated” immunity. d). T lymphocytes, is responsible for forming the activated lymphocytes that provide “humoral” immunity e).All of them are true UNIT 8. Immune response. Complement. MHC. Younes Elbachouti Khalil 1. MHC class I is encoded by human leukocyte antigen genes HLA-DP,HLA-DR and... -HLA-A -HLA-B -HLA-C -HLA-DQ -HLA-DT 2.Which of these statements is correct about the immune response? - Humoral response is developed by the B lymphocytes and coordinated by TH1 lymphocytes. - Cellular response is developed by cytotoxic T limphocytes and coordinated by TH2 lymphocytes. -Humoral response is developed by the B lymphocytes and coordinated by TH2 lymphocytes. -Cellular response is developed by B lymphocytes and coordinates by TH1 lymphocytes. -Cellular response is developed by citotoxic T lymphocytes and is not coordinated. 3.Choose the correct answer: -MHC class I is present only on antigen-presenting cells. -TAP is the molecule involved in transport of peptides and loading of MHC in class I. -The site of peptide loading of MHC in class I is the specialized vesicular compartment. -The MHC I is recognized by helper T cells (CD4+ T cells) -MHC class II is present on macrophages that are not antigen-presenting cells. 4. Main functions of the complement system: (Opsonization, neutrophil chemotaxis, viral neutralization, lysis, anaphylactic reaction) UNIT 9- Hemostasis Anna Sala Segura 1. Which term means prevention of blood loss? a) Hemostasis b) Chemotaxis c) Coagulation d) Fagocitosis e) Opsonization 2. The platelets are eliminated from the circulation mainly by the tissue macrophage system. In which of this organs are removed more than one half of the platelets? a) Spleen b) Thymus c)Bone Marrow d) Thyroid e) Liver 3. They are formed in the bone marrow from... a) Reticulocytes b) Megakaryocytes c) Monocytes d) Lymphocytes e) Prothrombin 4. Whenever a vessel is severed or ruptured, hemostasis is achieved by several mechanisms, which ones? (1) vascular constriction, (2) formation of a platelet plug,  (3) formation of a blood clot as a result of blood coagulation, and (4) eventual growth of fibrous tissue into the blood clot to close the hole in the vessel permanently. UNIT 10. Coagulation Alba Rodríguez Sánchez 1) Which is false? a) The reticulum of the clot is stabilized by the fibrin-stabilizing factor. b) There are four low-molecular-weight peptides removed from the fibrinogen by the thrombin. c) At the beginning of the polymerization the molecules are held together by covalent hydrogen bonding but then they form multiple cross-linkages between adjacent fibrin fibers. d) Each molecule of fibrin monomer polymerizes with other molecules forming long fibrin fibers and they are going to form the network of the clot. e) The fibrin stabilizing factor is released from platelets but we can also find it in normal plasma 2) Which of the following sentences is false? a) Clotting occurs by both pathways simultaneously whereas contact of factor XII (from the extrinsic pathway) and platelets with collagen in the vascular wall initiates the intrinsic pathway. b) The factor VII in the presence of Ca++ acts over the factor X in order to form Xa (active). c) The intrinsic pathway is much slower to proceed. d) In the absence of calcium ions these two pathways use a lot of alternative pathways to form the blood clot. e) The extrinsic pathway begins with trauma to the vascular wall and surrounding tissues while the intrinsic pathway begins in the blood itself. 3) Which of the following sentences is true? a) The thrombin acts as an enzyme and converts the fibrin fibers into fibrinogen by polymerization b) The prothrombin activator is formed as a result of rupture of a blood vessel but it only acts over the prothrombin if there is an enough amount of calcium. c) When the prothrombin activator is activated it always makes able the conversion of prothrombin to thrombin d) The most important factor in causing blood coagulation is the complex cascade of chemical reactions after the formation of the thrombin e) In the blood stream the procoagulants normally predominate.  SHORT QUESTIONS: 1) Explain the mechanism of blood clot retraction: After a clot is formed, it begins to contract and usually expresses most of the liquid part from the clot. The platelets contribute directly to clot contraction by activating platelet thrombosthenin, actin, and myosin molecules and cause strong contraction of the platelet spicules attached to the fibrin. This also helps compress the fibrin meshwork into a smaller mass. The contraction is activated and accelerated by thrombin, as well as by calcium ions released from calcium stores. As the clot retracts, the edges of the broken blood vessel are pulled together, thus contributing still further to hemostasis. UNIT 11: PULMONARY VENTILATION PAULA MARTINEZ GANDIA 1. Which are the 4 major functions of respiration? Pulmonary ventilation= inflow + outflow of air between atmosphere and lung alveoli. Diffusion of O2 and CO2 between alveoli and blood Transport of O2 and CO2 in blood and body fluids to and from body’s tissue cells. Regulation of ventilation and other facets of respiration. 2. Muscles working in respiration: o INSPIRATION (raising rib cage) § External intercostals § Esternocleidomastoid muscles § Anterior serrate § Scaleni § Diaphragm o EXPIRATION (pulling it down) § Abdominal recti § Internal intercostals § Diaphragm 3. Explain the elastic forces of the lungs: Elastic force of lung tissue: tend to collapse the air-filled lung.  Elastic forces caused by surface tension of fluid lining inner walls of alveoli and other lung spaces: when water forms a surface with air, water molecules on the surface have strong attraction for one another, so the water surface is always attempting to contract. On the inner surfaces of the alveoli the water surface is also attempting to contract. This results in an attempt to force the air out of the alveoli through the bronchi and, in doing so, causes the alveoli to try to collapse. The net effect is to cause an elastic contractile force of the entire lungs, which is called the surface tension elastic force. 4. Which is not a major function of respiration? a. Pulmonary ventilation, which is the inflow and outflow of air between atmosphere and lung alveoli. b. Diffusion of O2 and CO2 between alveoli and blood c. Transport of O2 and CO2 in blood and body fluids to and from body’s tissue cells. d. Elevation and depression of the rib cage by muscles of inspiration and expiration (IS NOT) e. Regulation of ventilation and other facets of respiration. 5. Which is FALSE? a. Pleural pressure is the pressure of fluid in the space between lung pleura and chest wall pleura (true) b. Normal pleural pressure at the beginning of inspiration is positive (FALSE, negative). c. Expansion of the chest cage pulls outward on the lungs, creating a negative pleural pressure (true, during inspiration) d. To cause inward flow of air into the alveoli during inspiration, the pressure in the alveoli must fall to a value slightly below atmospheric pressure (below 0). e. To cause outward flow of air into the alveoli during expiration, alveolar pressure raises. 6. About the transpulmonary pressure, which option is true: a. It is the difference between alveolar pressure and pleural pressure (TRUE). b. It is a measure of the elastic forces in the lungs that tend to collapse the lungs at each instant of respiration (FALSE, it is the definition of recoil pressure). c. It is the pressure difference between that in alveoli and that on the inner surfaces of the lungs (FALSE, outer). d. It is the pressure of air inside the lung alveoli (FALSE, it is the definition of the alveolar pressure) e. Options a) and c) are correct (FALSE). 7. Select the wrong sentence: a. Recoil pressure is a measure of the elastic forces in the lungs that tend to collapse the lungs at each instant of respiration.  b. Lung compliance is the extent to which the lungs will expand for each unit increase in alveolar pressure (FALSE, for each unit increase of transpulmonary pressure). c. Alveolar pressure is the pressure of air inside the lung alveoli. d. Transpulmonary pressure is the difference between the pressure in the alveoli and the pressure on the outer surfaces of the lung. e. Pleural pressure is the pressure of fluid in the space between lung pleura and chest wall pleura. 8. All are correct but: a. There are no attachments between the lung and the walls of the chest cage, except where it is suspended at its hilum from the mediastinum. b. During heavy breathing, elastic forces are not powerful enough, so extra force is achieved mainly by contraction of the abdominal muscles. c. The lung is an elastic structure that collapses like a balloon and expels all its air through the trachea whenever is not force to keep it inflated. d. The compliance of the lungs is determined by elastic forces of the lungs. e. Elastic forces of the lung tissue that tend to collapse the air-filled lung represent the total lung elasticity/ total elastic forces of the lungs (FALSE, total elastic forces of the lungs are: elastic forces of lung tissue+ elastic forces caused by surface tension). 9. About surfactant, is not true that: a. Surfactant is a surface active agent in water, which means that it greatly reduces the surface tension of water. b. Surfactant is a surface agent in water and it is secreted by special surfactant secreting epithelial cells called type V pulmonary epithelial cells (FALSE, type II alveolar epithelial cells) c. Surfactant is a complex mixture of several phospholipids, proteins and ions. d. The most important components of surfactant are the phospholipid dipalmitoylphosphatidylcholine, surfactant apoproteins, and calcium ions. e. Dipalmitoylphosphatidylcholine is a major component of surfactant responsible for reducing the surface tension by not dissolving uniformly in the fluid lining the alveolar surface. UNIT 12: PULMONARY CIRCULATION: Silvia Hernández García: - When the concentration of oxygen in the air of the alveoli decreases below normal, which is TRUE: a) Blood vessel constrict and the vascular resistance decreases. b) Low oxygen levels do not affect to the alveoli. c) Blood vessels dilate and the vascular resitance increases. d) Blood vessels constrict and the vascular resitance increases. e) Blood vessels dilate and the vascular resistance decreases.  - Explain briefly the three possible zones (patterns) of pulmonary blood flow. Marta Jiménez Muro: 1. Which of the following statements about the pulmonary arterial tree is TRUE: a) Pulmonary arterial branches are long b) Pulmonary arteries and arterioles have a larger diameter =distensibility than their counterpart systemic arteries c) Pulmonary artery wall is as thick as the wall of the aorta d) Pulmonary arterial branches are thick and not-distensible e) The large compliance of the pulmonary arteries don’t allow them to accommodate the stroke volume output of the right ventricle 2. The alveolar ventilation is the rate at which new air reaches some areas of the lungs. Which of the following areas don’t take part in this alveolar ventilation: a) Respiratory bronchioles b) Alveolar sacs c) Alveoli d) Trachea e) Alveolar ducts UNIT 14: Physical principles of gas exchange; diffusion of O2 and CO2 through the respiratory membrane Blanca Carreras Gamón 1. Which of the following statements is false? a) Net diffusion of gases occur from the highest concentration areas to the lowest concentration areas b) At any temperature all molecules of all matter are continually undergoing motion c) The solubility of the gas in fluid is one of the factors that affects the rate of gas diffusion in a fluid d) Gas exchange occurs through the membranes of all the terminal portions of the lungs, not merely in the alveoli themselves e) For a given pressure difference the rate of diffusion of CO2 is about 20 times faster than that for O2 2. Which of the following statements about respiration is true? a) Atmospheric air is the same as alveolar air, so their composition is the same b) At the end of six breaths the excess gas has been completely removed from the alveoli c) Atmospheric air is composed almost entirely of N2, CO2 and O2 (ordered from the highest concentration to the lowest) d) Slow replacement of alveolar air prevents sudden changes in gas concentrations in the blood e) At the end of a normal expiration there is no volume of air remaining in the lungs 3. Which factors determine the rate of the gas passing through the respiratory membrane? a) The thickness of the membrane and the diffusion coefficient of the gas in the substance of the membrane b) The surface area of the membrane and the partial pressure difference of the gas between the two sides of the membrane c) Hydrostatic pressure and colloid osmotic pressure d) a and b are correct e) a, b and c are correct 4. Name the different layers of the respiratory membrane 1) A layer of fluid lining the alveolus and containing surfactant 2) The alveolar epithelium 3) An epithelial basement membrane 4) A thin interstitial space 5) A capillary basement membrane 6) The capillary endothelial membrane UNIT 15.Transport of oxygen and carbon dioxide in blood and tissue fluids. 1. Which of the following sentences is true: a. Hemoglobin protein is a powerful acid-base buffer b. Most of the carbon dioxide in blood is transported in the dissolved state c. Most of the oxygen in blood is transported in the dissolved state d. Transport of oxygen and carbon dioxide only depends on the flow of blood e. The enzyme involved in the reaction of carbon dioxide with water to form carbonic acid is acid anhydrase 2. Which of the following sentences is false: a. The presence of hemoglobin in the red blood cells allows oxygen to be transported 30 to 100 times more as could be transported in the dissolved form b. Transport of oxygen and carbon dioxide by the blood depends on both diffusion and flow of blood c. Carbon dioxide diffuses in the direction exactly opposite to that of oxygen d. Oxygen can diffuse 20 times as rapidly as carbon dioxide e. The oxygen molecules combines reversibly with the heme portion of hemoglobin 3. Which of these factors do not affect the oxygen-hemoglobin dissociation curve: a. Ph b. Carbon dioxide concentration c. Partial pressure difference d. Blood temperature e. 2,3 - biphosphoglycerate(BPG) 4. Explain the meaning of the oxygen-hemoglobin dissociation curve: The oxygen-hemoglobin dissociation curve demonstrates a progressive increase in the percentage of hemoglobin bound with oxygen as blood PO2 increases, which is called the percent saturation of hemoglobin. UNIT 16. Regulation of respiration. 1. The inspiratory “ramp” signal in normal respiration… a) It’s an instantaneous burst of action potentials. b) Begins strongly and decreases abruptly. c) Begins strongly and decreases steadily in a ramp manner. d) Begins weakly and decreases steadily in a ramp manner. e) Causes a decrease in the volume of the lungs. 2. Which is the function of the pneumotaxic center? a) Inspiration. b) Expiration. c) Control of rate and depth of breathing / limit inspiration. d) Basic rhythm of respiration. e) Control of the “switch-on” point of the respiratory ramp. 3. The peripheral chemoreceptor system… a) It’s located in some areas of the brain. b) Controls the changes in CO2. c) It’s located in the carotid and aortic bodies in an equal proportion. d) It’s exposed at all time to arterial blood, not venous blood. e) It’s involved only in the expiratory activity. 4. Why when the CO2 concentration increases in the blood, the concentration of H+ of the respiratory chemosensitive area increases too? Because CO2 combines with the water of the tissues forming H2CO3 (reaction regulated by the carbonic anhydrase) that breaks forming H+ and bicarbonate. UNIT 17. Respiratory insufficiency. 1. DEFINITION OF RESPIRATORY INSUFFICIENCY. It is the failure to provide the peripheral tissues with 02 and to remove the CO2 from those peripheral tissues. 2. AMONG THE MOST FUNDAMENTAL OF ALL TESTS OF PULMONARY PERFORMANCE ARE: a) Determination of the blood volume. b) Determination of the blood P02. c) Determinatiojn of the blood pH. d) Determination of blood PC02. e) All but a) are correct. 3. WHICH ARE THE COMMON CAUSES OF ATELACTASIS? a) Total obstruction of the airway. b) Contractile hypersensitivity of the bronchioles in response to foreign substances in the air. c) Lack of surfactant in the fluids lining the alveoli. d) a) and c) are correct. e) b) and c) are correct. 4. THE MAXIMUM EXPIRATORY FLOW IS MUCH GREATER WHEN: a) The lungs are almost empty. b) The lungs are filled with a large volume of air. c) The lungs are collapsed. d) a) and c) are correct e) All of them are incorrect UNIT 18.1. Cardiac muscle; the heart as a pump and fuction of the heart valves. 1. Interval of time during which a cardiac impulse cannot reexcite an already excited area of cardiac muscle. a) Cardiac cycle b) Plateau c) Refractory period  d) Period of slow ejection e) Inhibitory period 2. Which ion return the membrane potential to its resting level? a) Sodium b) Magnesium c) Calcium d) Potassium e) Nitrogen 3. During cardiac cycle, period of rapid ejection and period of slow ejection occur in: a) Systole b) Diastole c) Ventricular relaxation d) Period of isovolumic contraction e) Period of isometric contraction 4. Why ventricular contraction is longer than skeletal muscle contraction? Because the presence of a plateau that prolongs the period of depolarization 0.2 to 0.3 second in the contraction of heart muscle. This plateau is caused by the prolonged opening of slow calcium-sodium channels after the usual opening of sodium fast channels. UNIT18.2. Cardiac muscle; the heart as a pump and fuction of the heart valves 1. Which is the correct option? a) The atrioventricular valves prevent the backflow of blood from the ventricles to the atria during systole b) The atrioventricular valves prevent backflow from the aorta and pulmonary arteries into the ventricles during systole. c) The semilunar valves prevent the backflow of blood from the ventricles to the atria during systole. d) Semilunar valves require almost no backflow to cause clousure. e) Atrioventricular valves are much heavier and require rather rapid backflow for a few miliseconds. 2. A short period of backward of blood immediately before clousure of a valve causes a incisura in the pressure curve given by this valve. Which valve is it? a) Pulmonary valve b) Aortic valve c) Mitral valve d) Tricuspid valve e) Any heart valve produce a incisura. 3. Which is the false option? a) Preload is the degree of tension on the muscle when it begins to contract. b) Afterload is the load against wich the muscle exerts its contractile force. c) The parasympathetic vagal fibers are distributed mainly to the atria and not much to the ventricles. d) Excess of potassium in the extracellular fluids causes the heart to increase the heart rate, increasing the resting membrane potencial of the heart progressively, causing abnormal heart rhythm. e) Excess of calcium ions causes the heart to go toward spastic contraction causing cardiac flaccidity. 4. Explain what is the Frank-Starling mechanisim and its most important features. The Frank-Starling mechanism is the intrinsic ability of the heart to adapt to increasing volumes of inflowing blood. It means that the greater the heart muscle is stretched during filling, the greater if the force of contraction and the greater the quantity of blood pumped into the aorta. UNIT 19. Rhythmical excitation of the heart 1) Why is produced an ischemia? a. Bizarrre heart rythm b. Abnormal sequence of contraction of the heart chambers c. Failure in umping efectiveness d. Poor coronary blood flow d. Left ventricle defect 2) Which of these sentences, about the sinus node, is true? a. Is located medial to the inferior vena cava b. Is placed lateral to the superior vena cava c. Is lateral to the inferior vena cava d. Is located at the left atrium e. It has a lot of contractile muscle filaments 3. The atrial muscle is separated from the ventricular muscle by a continuous fibrous barrier except at: a. The AV node b. The punkinje fibers c. The SA node d. The AV bundle e. The AV valves 4. Which is the pacemaker of the heart, in normal conditions, that controls its excitability and conductivity? Why does it control those aspects of the heart? UNIT 20. The normal electrocardiogram 1. Which of the following is false? a) QRS complex can be sometimes be separate waves Q,R,S, waves respectively but not always. b) In calibration paper, 10 small lines represent 1mV measured positively upward direction and negativity in downward direction. c) Typical EKG runs at a speed of 20mm/s d) Type aVR augmented unipolar limb leads is inverted e) T wave is a repolarization wave 2. Choose the correct statement a) QRS complex happens together with ventricular repolarization b) There is no atrial T wave c) During depolarization, normal negative potential inside the fibers becomes negative inside and positive outside d) During depolarization, normal negative potential inside the fibers becomes positive inside and negative outside e) Atrial repolarization happens 0.25-0.35s after the P wave. UNIT 21. Principles of vectorial analysis of electrocardiograms 1) In the vectorial analysis of potentials in different leads, which is TRUE? a) When the vector in the heart is in a direction almost perpendicular to the axis of one determined lead, the voltage recorded of this lead is very high. b) When the heart vector has almost exactly the same axis as one determined lead axis, the entire voltage of the vector will be recorded at that lead. c) When the vector in the heart is in a direction almost perpendicular to the axis of one determined lead, the voltage recorded of that lead is double than in the heart. d) When the heart vector has almost exactly the same axis as one determined lead axis, the recording is positive at that lead. e) When the vector in the heart is in a direction almost perpendicular to the axis of one determined lead, there is not recording of voltage at that lead. 2) In the vectorial analysis of the heart current flows, which property of the current flow is represented by the length of the vector? a) The axis of the vector b) The direction of the current flow c) The lead of the EKG d) The localization of the vector e) The voltage of the potential 3) Which of the follows is the axis of lead II? a) +60 degrees b) 0 degrees c) +220 degrees d) +90 degrees e) -40 degrees 4) Write the direction of the depolarization through the ventricles: Atrioventricular bundle → left endocardial surface of the septum → both endocardial surfaces of the septum → both ventricular endocardial surfaces → ventricular muscle to the outside. UNIT 22. Physical characteristics of the circulation 1. Which of the following options is true about the circulation? a) The function of the arteries is to transport blood under high pressures to the tissues, for that these ones have strong vascular walls, and blood flows at a non-high velocity in the arteries b) Arterioles act as control conduits through which blood is released into the arteries. c) Arterioles have the capability of vastly altering blood flow in each tissue in response to its needs. d) Venules collect blood from the veins and gradually coalesce into progressively larger capillaries. e) We have more pressure in our veins in comparison to the arteries, that is the reason of being these veins a good reservoir of blood. 2. In which one of the following vessels we have the highest pressure? a) Left Subclavian artery. b) Superior mesenteric artery. c) Superior vena cava. d) Celiac artery. e) Azygos vein. 3. All of these answers about the nervous signals are true except one, find it: a) Increase the force of heart pumping. b) Cause generalized constriction of most of the arterioles. c) Cause contraction of the large venous reservoirs. d) If at any time the pressure falls significantly below the normal level, a barrage of nervous reflexes elicits circulatory changes to raise it to its normal range. e) To provide more blood to the heart these nervous signals will cause dilation of most of the large venous reservoirs. 4. Four major functions of the circulation: To service the needs of the body tissues transporting nutrients to the body tissues. To transport waste products away, To transport hormones from one part of the body to another. To maintain an appropriate environment in all the tissue fluids of the body for optimal survival and function of the cells. UNIT 22. physical characteristics of the circulation. SERGIO MARTÍNEZ ROCA. 1. What is the main function of circulation? -Control respiration and immune processes. -Manage the energy consumption of the body. -Maintain an appropriate environment in all the tissue fluids of the body for optimal survival and function of the cells. -Control the excretory function of the kidney. -Maintain the correct cardiac output and arterial pressure. 2. What is the mean pressure of the aorta? -120 mmHg. -80 mmHg. -130 mmHg. -35/55 mmHg. -100 mmHg. 3. The nervous signals specially… -Increase the force of heart pumping. -Cause contraction of the large venous reservoirs. -Cause generalized constriction of most of the arterioles. -All of the above. -None of the above. 4. How is arterial pressure regulated? - It is generally independent of either local blood flow control or cardiac output control. UNIT 22 Alejandro López Lluch 1.Explain the basic principles of circulation A. The rate of blood flow to each tissue of the body is almost always precisely controlled in relation to the tissue need. B. The cardiac output is controlled mainly by the sum of all the local tissue flows. C. Arterial pressure regulation is generally independent of either local blood flow control or cardiac outputcontrol. 2) Arterioles: a) Have the capability of vastly altering blood flow in each tissue in response to its needs. b) Arethe medial branches of the arterial system; they act as control conduits through which blood is releasedinto the capillaries. c) They are unable to respond to some stimuli due to their thick walls, and this is what alters blood flow.It is a specialcharacteristic that only arterioles have. d) A is correct e) A and C are correct 3) Refered to systemic circulation: a) Thepressure in the aorta is low at first,oscillating between100-120 mmHg and then increases progessively during when it flows by the systemic circulationand atthe point it reaches the right atrium. b) Thepressure in the aorta is high at first,oscillating between100-120 mmHg and then decreases progessively during when it flows by the systemic circulationand atthe point it reaches the right atrium. c) The total blood flow through the lungs each minute is different as through the systemic circulation, in accord withthe needs ofthe lungs because all that is requiredis to expose the blood in the pulmonary capillaries tooxygen and other gases in the pulmonaryalveoli. d) A is correct e) A and C are correct UNIT 23. interrelationships of pressure, flow and resistance Laura Laguarda Marín and Angela Domenech Cubi 1. TRUE ABOUT BLOOD FLOW: A) The quantity of blood that passes a given point in the circultion in a indefinite period. B) Blood flow is expressed in liters per frequency C) Blood flow is expressed in liters per concentration of the oxygenated blood D) Blood flow is expressed in milliliters per minute or liters per minute E) Laminar flow and turbulent flow have the same characteristics but just in different parts of the body. 2. FALSE CONDITION TO OCCUR TURBULENCE IN THE PROXIMAL AORTA AND PULMONARY ARTERY: A) Pulsatile nature of the blood flow B) Slow velocity of blood flow  C) Sudden change in vessel diameter D) High velocity of blood flow E) Sudden change in large vessel diameter 3. NAME AND EXPLAIN BRIEFLY THE 2 FACTORS THAT DETERMIINE THE BLOOD FLOW THROUGH A BLOOD VESSEL: 1) PRESSURE DIFFERENCE of the blood between the two ends of the vessel, also sometimes called ‘’pressure gradient’’ along the vessel, which is the force that pushes the blood through the vessel. 2) VASCULAR RESISTANCE: The impediment to blood flow through the vessel. 4. Conductance of blood in a vessel is said to be: a. The result of friction between the flowing blood and the intravascular endothelium along the vessel. b. A measure of blood flow and pressure difference between two points in the vessel. c. The absolute pressure in the vessel. d. A measure of the blood flow through a vessel for a given pressure difference. e. Is the pressure at the origin of the vessel. 5. Which of the following sentences is true? In a large vessel all the rapidly flowing central stream of blood flow does not exist. The diameter of the blood vessel does not play a role in determining the rate of blood flow. Parallel arrangemet of a blood vessel regulate its own blood flow depending of flow to other tissues. Increasing the resistance of any of the blood vessels decreases the total vascular resistance. The total resistance of blood flow is the sum of flow through each blood vessel as the sum of the conductance of each parallel pathway makes the total conductance for blood flow. 6. Poiseuille’s Law. It demonstrates that the rate of blood flow is directly proportional to the diameter of a blood vessel and that the diameter plays the greatest role in determining the rate of blood flow. This law demostrates that using a formula that integrates the velocities of all the concentric rings of flowing blood and multiplying them by the áreas of the rings. Knowing that the blood that is near the wall of the vessel flows slowly because of its adherence to the vascular endothelium , whereas in the next rings of blood, the vessels slip past the ring and therefore blood flow will be faster. UNIT 24: vascular distensibility & functions of the arterial and venous systems Jorge illarramendi 1) Which of these statements about blood vessels distensibility is true? a) Only veins and arterioles are distensible. b) Capillaries provides a reservoir function for storing large quantities of extra blood that can be called into use whenever required in any capillary for exchange with interstitial fluid. c) Distensibility of pulmonary veins is similar to the systemic circulation. d) Pulmonary arteries normally operate under pressures lesser than the systemic circulation so pulmonary arteries are less distensible. e) Veins are less distensible than arteries because they have weaker walls 2) Which of this statements is true? a) A vessel exposed to increased volume at first exhibits a large increase in pressure but fast stretching of smooth muscle in the vessel wall allows the pressure to return back toward normal in few seconds, this mechanism is known as delayed compliance. b) The greater the compliance of each vascular segment greater is the pressure in the vessel so higher is the velocity.  c) Pressure at the top of each pulse is diastolic pressure and at the lowest point is systolic pressure, difference between them gives as pulse pressure. d) The greater the stroke volume output, the greater the amount of blood that must be accommodated in the arterial tree with each heartbeat, this causes greater pulse pressure. e) Normally if the right heart is pumping strongly the pressure in the right heart atria will increase proportional to the cardiac output. Which are the factors that affect pulse pressure: 1) The stroke volume output of the heart. 2)The compliance of the arterial tree. 3) character of ejection from the heart during systole. UNIT 25: the microcirculation and lymphatic system: capillary fluid exchange, interstitial fluid, and lymph flow Iris Ariño 1. which sentence is true about the osmotic pressure: a) it forces fluid and dissolve substances through the capillary pores into the interstitial spaces. b) It tends to cause fluid movement by osmosis from the interstitial spaces into the blood. c) It is caused by the plasma proteins d) It prevents significant loss of fluid volumen from the blood into the interstitial spaces e) All are true except a 2. which sentence is true about the “Starling forces”: a) the capillary pressure forcé fluid inward through the capillary membrane. b) The capillary plasma colloid osmotic pressure cause osmosis of fluid outward through the capillary membrane c) The interstitial fluid pressure force fluid inward through the capillary membrane when is positive but outward when is negative d) The sum of these forces is called the net filtration pressure and it’s normally negative e) If the sum of the Starling forces is positive, there will be a net fluid absorption from the interstitial spaces into the capillaries. 3. which sentence is false about the lymphatic system: a) The lymphatic system represents an accessory route through which fluid can flow from the interstitial spaces into tje blood. b) Lymphatics can carry proteins and large particulate matter away from the tissue spaces c) The return of proteins to the blood from the interstitial spaces is an essential function without which we would die within about 24 hours. d) The total quantity of all this lymph is normally 2 to 3 liters each day e) Endothelial cells of the lymphatic capillary are attached by anchoring filaments to the surrounding epithelial tissue 2n part UNIT 25 Alexandra Osca Oliver 1. Which of this statements about the pores is true? a) The intercellular cleft is a big passageway that connect the interior of the arteries with the exterior.  b) Caveolae are hormons that play a role in endocytosis and transcytosis of macromolecules across endothelial cells. c) In the brain, the junctions between the capillary endothelial cells are mainly “tight” junctions that allow only extremely small molecules. d) In the liver, the clefts between the capillary endothelial cells are wide open so that almost all dissolved substances of the plasma, but not the plasma proteins. 2. The most important factor found thus far to affect the degree of opening and closing of the metarterioles and precapillary sphincters is... a) concentration of carbon dioxide b) concentration of oxygen in the tissues c) fluids d) water molecules d) particles and ions 3)The interstitium contains two major types of solid structures: collagen fiber bundles: extend long distances in the interstitium and they are extremely strong. proteoglycan filaments are thin and they form a mat of very fine reticular filaments. UNIT 26: local and humoral control of tissue blood flow CARLOS FERRER 1) The cyclical opening and closing of precapillary sphincters is called a) Vasodinamism b) Cyclic movement c) Vasokinetics d) Vasomotion e) Sphincter motion 2) Which is a powerful vasoconstrictor hormone? a) Bradykinin b) Norepinephrine c) Epinephrine d) Histamine e) Dopamine 3) An increase in carbon dioxide concentration causes a highly marked vasodilatation in: a) The liver b) The spleen c) The skin  d) The brain e) The kidneys Ángela María García de la Chica Unit 26. Local and Humoral control of Tissue blood flow. 1) Which are the functions of the circulatory system? - Deliver of oxygen and nutrients to the tissues. - Removal of carbon dioxide and hydrogen ions from the tissues. - Maintenance of proper concentrations of other ions in tissues. - Transport of various hormones and other substances to the different tissues. - Supply the special requirements of blood flow to certain organs. 2) True or False - In resting state, the metabolic activity is higher due to the metabolic need of the muscles (False) - Local blood flow can be divided into two phases: acute control (rapid changes in vessels) and long-term control (slow controlled changes). (True) - In the long-term control there are three theories that support it: vasodilation theory, oxygen lack theory and the increase in carbon dioxide levels theory. (False) - According to the oxygen lack theory, precapillary sphincters and metarterioles open and close cyclically (True) 3) According to humoral control of circulation: - Norepinephrine is a powerful vasodilator hormone. - Angiotensin II is a mild vasodilator hormone. - Vasopressin has a major function in water excretion. - Kinins are powerful vasodilators when they are formed in lymph nodes. - Calcium ions concentration stimulates smooth muscle contraction. UNIT 27. nervous regulation of circulation, and rapid control of arterial pressure Marta Chillarón Martí y Cristina Sanjuán 1. Which of these about nervous regulation of circulation is true?  a. Sympathetic nerves carry tremendous numbers of vasodilator fibers and a few of vasoconstrictor fibers. b. Sympathetic vasoconstrictor effect is very powerful in skeletal muscle and brain and less powerful in kidneys, intestines, spleen and skin. *c. Vasomotor center in the brain is located bilaterally mainly in the reticular substance of the medulla and the lower third of the pons d. Vasomotor center transmits sympathetic impulses through the vagus nerve to heart. e. Vasomotor center transmits sympathetic impulses through the spinal cord and peripheral sympathetic nerves to all arteries and arterioles but not to veins 2.Which of these locations is true? a. Vasoconstrictor area is located bilaterally in the posterolateral portions of lower medulla b. Vasoconstrictor area is located bilaterally in the anterolateral portions of lower medulla *c. Vasodilator area is located bilaterally in the anterolateral portions of lower half of the medulla d. Vasodilator area is located bilaterally in the posterolateral portions of lower half of the medulla e. Sensory area is located bilaterally in the tractus solitaries of the pons exclusively 3. Which of these sentences is false about the arterial pressure? a) Arterioles and veins are constricted, which helps to increase arterial pressure b) The heart itself is directly stimulated by the autonomic nervous system, enhancing cardiac pumping c) Sympathetic have a direct effect decreasing contractile force of heart muscle. d) Nervous control of arterial pressure is a rapid process 4. What is false about baroreceptors? a) Baroreceptors respond rapidly to changes in arterial pressure. b) The baroreceptor reflex is initiated by strech receptors, called baroreceptor or pressoreceptors. c) Baroreceptors are in few quantities in the wall of aortic arch d) There are a lot of baroreceptors in an area called carotid sinus