chapter 20 The Circulatory System: Blood Vessels and Circulation

Blood flow through a capillary bed is regulated by precapillary sphincters.

TRUE

Large veins, medium veins, and venules have valves to prevent the backflow of blood.

FALSE

Blood flow is pulsatile in arteries and veins, but it is steady in capillaries.

FALSE

Vasomotion can raise or lower blood pressure throughout the body.

TRUE

Increased capillary filtration, reduced reabsorption, or obstruction of lymphatic drainage can lead to edema.

TRUE

Most tissue fluid is reabsorbed by the lymphatic system.

FALSE

Decompensated shock is normally corrected by the body's homeostatic mechanisms.

FALSE

The pulmonary circuit is the only route in which arteries carry less oxygen than veins.

TRUE

Lung tissue receives nourishment and waste removal from the pulmonary circuit.

FALSE

The greatest outflow from the dural venous sinuses is via the internal jugular vein.

TRUE

The three primary branches of the celiac trunk are the common hepatic, left gastric, and splenic veins.

FALSE

Blood filtered through the hepatic sinusoids exits the liver via the hepatic veins.

TRUE

Arterial flow to the lower limb comes from the external iliac artery.

TRUE

The brachial vein is the most common site of blood pressure measurement with the sphygmomanometer.

FALSE

The radial artery is lateral to the ulnar artery.

TRUE

Arteries are sometimes called the __________ vessels of the cardiovascular system because they have strong-resilient tissue structure.

A. resistance
B. capacitance
C. hydrodynamic
D. compliance
E. fenestrated

A. resistance

Which vessels have the thickest tunica media?

A. Small arteries
B. Small veins
C. Large arteries
D. Large veins
E. Capillaries

C. Large arteries

The outermost wall of an artery or vein is called the __________ and in large arteries and veins contains the __________.

A. tunica media; smooth muscle
B. tunica externa; vasa vasorum
C. tunica externa; valves
D. tunica intima; endothelium
E. tunica intima; basement membrane

B. tunica externa; vasa vasorum

Where is the greatest volume of blood found in the body?

A. Pulmonary circuit
B. Heart
C. Arteries
D. Veins
E. Capillaries

D. Veins

Alternative routes of blood supply are called __________.

A. metarterioles
B. capillary beds
C. preferred channels
D. thoroughfare channels
E. anastomoses

E. anastomoses

Which of the following is not a possible circulatory route from the heart?

A. Heart → arteries → capillary bed → veins → heart
B. Heart → arteries → capillary bed → vein → capillary bed → veins → heart
C. Heart → arteries → capillary bed → vein → capillary bed → arteries → heart
D. Heart → arteries → arterial anastomosis → capillary bed → veins → heart
E. Heart → arteries → arterial anastomosis → capillary bed → venous anastomosis → veins → heart

C. Heart → arteries → capillary bed → vein → capillary bed → arteries → heart

Which of the following is associated with vasomotion?
A. Collagen and elastic tissue in the tunica media
B. Elastic tissue in the tunica externa
C. Endothelium in the tunica interna
D. Smooth muscle in the tunica media
E. Fenestrations in the tunica externa

D. Smooth muscle in the tunica media

In people who stand for long periods, blood tends to pool in the lower limbs and this may result in varicose veins. What causes the varicose veins?

A. An aneurysm or weak point in an artery
B. An aneurysm or weak point in a vein
C. Failure of the venous valves
D. Failure of the lymphatic valves
E. A ruptured aneurysm in a vein

C. Failure of the venous valves

What is the mean arterial pressure for a person with 110 and 65 mm Hg as systolic and diastolic pressure, respectively?

A. 45 mm Hg
B. 80 mm Hg
C. 87.5 mm Hg
D. 90 mm Hg
E. 175 mm Hg

B. 80 mm Hg

Which of the following would decrease the velocity of blood flow?

A. Increased viscosity
B. Increased blood pressure
C. Increased vessel radius
D. Increased afterload
E. Decreased vasomotion

A. Increased viscosity

What does the medullary ischemic reflex result in?

A. Increased circulation to the brain
B. Reduced circulation to the brain
C. Ischemia of the medulla oblongata
D. Increased circulation to the adrenal medulla
E. Hormone secretion by the adrenal medulla when perfusion drops

A. Increased circulation to the brain

Which of the following has the most important effect on blood velocity?

A. Blood viscosity
B. Vessel radius
C. Blood osmolarity
D. Hematocrit
E. Vessel length

B. Vessel radius

What causes reactive hyperemia to increase tissue perfusion?

A. Urinary controls
B. Neural controls
C. Hormonal controls
D. Local controls
E. Respiratory controls

D. Local controls

Which of the following decreases blood pressure?

A. Norepinephrine
B. Antidiuretic hormone
C. Angiotensin II
D. Aldosterone
E. Natriuretic peptides

E. Natriuretic peptides

Where is the vasomotor center located?

A. Hypothalamus
B. Medulla oblongata
C. Spinal cord
D. Cerebellum
E. Cerebral cortex

B. Medulla oblongata

Hypertension is commonly considered to be a chronic resting blood pressure higher than __________.

A. 180/90
B. 130/60
C. 120/75
D. 140/90
E. 200/90

D. 140/90

Which of the following are powerful vasoconstrictors?

A. Norepinephrine and antidiuretic hormone (ADH)
B. Norepinephrine and natriuretic peptides
C. Norepinephrine and angiotensin II
D. Epinephrine and aldosterone
E. Epinephrine and antidiuretic hormone (ADH)

C. Norepinephrine and angiotensin II

Which of the following does not move substances across capillary walls?

A. Reabsorption
B. Filtration
C. Group transport
D. Transcytosis
E. Diffusion

C. Group transport

What is the most important force driving filtration at the arterial end of a capillary?

A. Oncotic pressure
B. Tissue fluid colloid osmotic pressure
C. Blood colloid osmotic pressure
D. Interstitial hydrostatic pressure
E. Blood hydrostatic pressure

E. Blood hydrostatic pressure

What is taken up by the capillaries at their venous end?

A. Waste products
B. Oxygen
C. Glucose
D. Amino acids
E. Organic nutrients

A. Waste products

What is the most important force driving reabsorption at the venous end of a capillary?

A. Oncotic pressure
B. Tissue fluid colloid osmotic pressure
C. Blood colloid osmotic pressure
D. Interstitial hydrostatic pressure
E. Blood hydrostatic pressur

C. Blood colloid osmotic pressure

Which of the following does not lead to edema?

A. Obstruction of lymphatic vessels
B. Liver disease
C. Famine
D. Hyperproteinemia
E. Hypertension

D. Hyperproteinemia

Which of the following would decrease capillary filtration?

A. Increased permeability of lymphatic capillaries
B. Dehydration
C. Increased capillary permeability
D. Dietary protein deficiency
E. Obstructed venous return

B. Dehydration

A mean arterial pressure below 60 mmHg can cause which of the following?

A. Neurogenic shock
B. Cardiogenic shock
C. Compensated shock
D. Cerebral edema
E. Syncope

E. Syncope

Which of the following does not contribute to venous return?

A. The difference of pressure between venules and the venae cavae
B. The expansion and contraction of the thoracic cavity during ventilation
C. The suction created by the atria slightly expanding during ventricular systole
D. Widespread vasodilation
E. Contraction of skeletal muscles of the limbs

D. Widespread vasodilation

What type of shock can be produced by hemorrhage, severe burns, or dehydration?

A. Anaphylactic
B. Cardiogenic
C. Hypovolemic
D. Venous pooling
E. Neurogenic

C. Hypovolemic

What type of shock occurs when bacterial toxins trigger vasodilation and increase capillary permeability?

A. Compensated
B. Anaphylactic
C. Neurogenic
D. Cardiogenic
E. Septic

E. Septic

A bee sting can trigger a massive release of histamine, which causes __________ and a(n) __________.

A. vasodilation; decrease
B. vasodilation; increase
C. vasoconstriction; decrease
D. vasoconstriction; increase
E. vasoconstriction; oscillation

A. vasodilation; decrease

Myocardial infarction can lead to what type of shock?

A. Neurogenic
B. Cardiogenic
C. Obstructed venous return
D. Venous pooling (vascular)
E. Hypovolemic

B. Cardiogenic

What is the most important force in venous flow?

A. Cardiac suction
B. The pressure generated by the heart
C. The skeletal muscle pump
D. The thoracic (respiratory) pump
E. The one way flow due to val

B. The pressure generated by the heart

Blood flow to the __________ remains quite stable even when mean arterial pressure (MAP) fluctuates from 60 to 140 mm Hg.

A. hypothalamus
B. adrenal gland
C. stomach
D. skeletal muscles
E. kidneys

A. hypothalamus

Pulmonary arteries have __________ blood pressure compared to systemic arteries.

A. similar
B. a little lower
C. considerably lower
D. considerably higher
E. a little higher

C. considerably lower

How many pulmonary arteries empty into the right atrium of the heart?

A. 0
B. 1
C. 2
D. 4
E. 8

A. 0

The lungs receive a systemic blood supply by way of which vessel(s)?

A. Right pulmonary artery
B. Left pulmonary artery
C. Pulmonary veins
D. Bronchial arteries
E. Lobar arteries

D. Bronchial arteries

Which of the following is absent in humans?

A. Right and left common carotid arteries
B. Right and left brachiocephalic arteries
C. Right and left brachiocephalic veins
D. Right and left subclavian veins
E. Right and left subclavian arteries

B. Right and left brachiocephalic arteries

Which vessel supplies 80% of the cerebrum?

A. Superficial temporal artery
B. Occipital artery
C. Internal carotid artery
D. Anterior cerebral artery
E. Middle cerebral artery

C. Internal carotid artery

Which of the following best describes the cerebral arterial circle (circle of Willis)?

A. An anastomosis surrounding the pituitary gland
B. A portal system connecting the hypothalamus with the anterior pituitary
C. A short anastomosis found in the cerebellum
D. Formed by the superior and inferior sagittal sinuses
E. An anastomosis circling the entire cortex

A. An anastomosis surrounding the pituitary gland

What are the major branches of the abdominal aorta from superior to inferior?

A. Celiac trunk, superior mesenteric artery, renal arteries, gonadal arteries, inferior mesenteric artery, and common iliac arteries
B. Celiac trunk, superior mesenteric artery, gonadal arteries, renal arteries, inferior mesenteric artery,
and common iliac arteries
C. Superior mesenteric artery, celiac trunk, renal arteries, gonadal arteries, inferior mesenteric artery,
and common iliac arteries
D. Superior mesenteric artery, celiac trunk, gonadal arteries, renal arteries, inferior mesenteric artery,
and common iliac arteries
E. Superior mesenteric artery, inferior mesenteric artery, celiac trunk, gonadal arteries, renal arteries,
and common iliac arteries

A. Celiac trunk, superior mesenteric artery, renal arteries, gonadal arteries, inferior mesenteric artery, and common iliac arteries

Which of the following constitutes the principal venous drainage of the thoracic organs?

A. The branches of the celiac trunk
B. The azygos system
C. The mesenteric circulation
D. The hepatic portal system
E. The coronary and pulmonary veins

B. The azygos system

Which of the following are not tributaries of the inferior vena cava?

A. The hepatic veins
B. The internal and external iliac veins
C. The inferior phrenic veins
D. The vertebral veins
E. The lumbar veins

D. The vertebral veins

Which of the following is not a vein of the upper limb?

A. Cephalic vein
B. Great saphenous vein
C. Basilic vein
D. Median antebrachial vein
E. Ulnar vein

B. Great saphenous vein

Which of the following is not a vein of the lower limb?

A. Popliteal vein
B. Posterior tibial artery
C. Medial plantar artery
D. Fibular vein
E. Anterior interosseous artery

E. Anterior interosseous artery

What is the longest vein commonly used in grafts in coronary bypass surgery?

A. Inferior vena cava
B. Femoral vein
C. Deep femoral vein
D. Great saphenous vein
E. Common iliac vein

D. Great saphenous vein

What are the afferent vessels that carry blood back to the heart?

A. Arteries
B. Arterioles
C. Veins
D. Capillaries

C. Veins

Which of the following routes of blood flow is correct?

A. Heart → venule → medium vein → large vein → capillary → conducting artery → distributing
artery → arteriole → heart
B. Heart → large vein → medium vein → venule→ capillary → arteriole → distributing artery →
conducting artery → heart
C. Heart → distributing artery → conducting artery → arteriole → capillary → venule → large vein →
medium vein → heart
D. Heart → conducting artery → distributing artery → arteriole → capillary → venule → medium vein
→ large vein → heart

D. Heart → conducting artery → distributing artery → arteriole → capillary → venule → medium vein→ large vein → heart

Which of the following is a portal system?

A. Heart → artery → vein → heart
B. Heart → artery → arteriole → capillary bed → arteriole → capillary bed → venule → vein → heart
C. Heart → artery → artery → arteriole → capillary bed → venule → vein → heart
D. Heart → artery → arteriole → capillary bed → venule → vein → vein → heart

B. Heart → artery → arteriole → capillary bed → arteriole → capillary bed → venule → vein → heart

Why does our blood pressure generally go up as we age?

A. Our veins get 'hard' and absorb less systolic force
B. Our veins get 'hard' and absorb less diastolic force
C. Our arteries get 'hard' and absorb less systolic force
D. Our arteries get 'hard' and absorb less diastolic force

C. Our arteries get 'hard' and absorb less systolic force

A nurse takes your blood pressure and tells you the numbers are 110/70. What are your blood pressures?

A.Systolic = 110 mmHg, Diastolic = 70 mmHg, Pulse Pressure = 40 mmHg, MAP = 83 mmMg
B. Systolic = 110 mmHg, Diastolic = 70 mmHg, Pulse Pressure = 40 mmHg, MAP = 90 mmMg
C. Diastolic = 110 mmHg, Systolic = 70 mmHg, Pulse Pressure = 40 mmHg, MAP = 107 mmMg
D. Diastolic = 110 mmHg, Systolic = 70 mmHg, Pulse Pressure = 40 mmHg, MAP = 90 mmMg

A.Systolic = 110 mmHg, Diastolic = 70 mmHg, Pulse Pressure = 40 mmHg, MAP = 83 mmMg

What might account for a soldier experiencing syncope after standing at attention for a long period of time?

A. Increased respiratory rate
B. Vasoconstriction
C. Increased heart rate
D. Venous pooling

D. Venous pooling

How is venous return to your heart affected when you go for an easy jog?

A. It is increased due to increased skeletal muscular pump activity
B. It is decreased due to decreased skeletal muscular pump activity
C. It is decreased due to increased skeletal muscular pump activity
D. It is increased due to decreased skeletal muscular pump activity

A. It is increased due to increased skeletal muscular pump activity

While out hiking, a friend of yours falls and suffers a trauma. You notice they start to go into shock. What do you do to help?

A. Lie them down and elevate their head
B. Hold them upright in a standing position
C. Encourage them to sit up
D. Lie them down and elevate their legs

D. Lie them down and elevate their legs

Which of the following statements about TIAs and CVAs is true?

A. TIAs are often early warning signs of an impending stroke.
B. TIAs are the result of brain tissue death caused by ischemia.
C. A CVA usually results from spasms of diseased cerebral arteries.
D. TIAs often result in blindness and paralysis

A. TIAs are often early warning signs of an impending stroke.

Your grandmother is experiencing temporary dizziness, blurred vision, paralysis on her left side, and mild aphasia. What do you think might be happening?

A. She has arteriosclerosis.
B. She is having a myocardial infarction.
C. She has an aortic aneurism.
D. She is having a TIA.

D. She is having a TIA.

Which of the following activities would fatigue your hand muscles the fastest?

A. Squeezing a ball as hard as you can without stopping
B. Alternately squeezing a ball then relaxing
C. Bouncing a ball on the floor as many times as you can
D. Throwing a ball in the air and catching it as many times as you can

A. Squeezing a ball as hard as you can without stopping

During exercise, arterioles to the skeletal muscles __________.

A. dilate in response to increased muscle metabolites
B. constrict in response to increased muscle metabolites
C. dilate in response to increased O2 and decreased CO2
D. constrict in response to increased O2 and decreased CO2

A. dilate in response to increased muscle metabolites

What is the path of blood flow from the heart to the lung tissues and back to the heart?

A. Left ventricle → aorta → brachiocephalic artery → lung tissues → bronchial veins → brachiocephalic vein
→ superior vena cava → right atrium
B. Right ventricle → pulmonary trunk → pulmonary arteries → lung tissues → pulmonary veins → left atrium
C. Right ventricle → brachiocephalic arteries → lung tissues → brachiocephalic veins → inferior vena cava →
left atrium
D. Left ventricle → aorta → bronchial arteries → lung tissues → bronchial veins → azygos vein → superior
vena cava → right atrium

B. Right ventricle → pulmonary trunk → pulmonary arteries → lung tissues → pulmonary veins → left atrium

What is the path of blood from the heart, to the left zygomaticus muscles, and back to the heart?
A. Aorta → left brachiocephalic artery → left common carotid artery → left internal carotid artery →left occipital artery → zygomatic tissues → left maxillary vein → left internal jugular vein → left subclavian vein → left brachiocephalic vein → superior vena cava
B. Aorta → left common carotid artery → left internal carotid artery → left maxillary artery →
zygomatic tissues → left facial vein → left external jugular vein → left subclavian vein → left
brachiocephalic vein → superior vena cava
C. Aorta → left common carotid artery → left external carotid artery → left facial artery → zygomatic tissues → left facial vein → left internal jugular vein → Left subclavian vein → Left
brachiocephalic vein → Superior vena cava

C. Aorta → left common carotid artery → left external carotid artery → left facial artery → zygomatic tissues → left facial vein → left internal jugular vein → Left subclavian vein → Left
brachiocephalic vein → Superior vena cava

What is the path of blood from the heart to the right little finger (pinky) and back to the heart?

A. Aorta → brachiocephalic trunk → right subclavian artery → right axillary artery → right brachial
artery → right ulnar artery → palmar arches → venous palmar arches → right ulnar vein → right
brachial vein → right axillary vein → right subclavian vein → right brachiocephalic vein →
superior vena cava
B. Aorta → right subclavian artery → right axillary artery → right brachial artery → right radial artery
→ palmar arches → venous palmar arches → right radial vein → right brachial vein → right
axillary vein → right subclavian vein → superior vena cava
C. Aorta → brachiocephalic trunk → right subclavian artery → right axillary artery → right brachial
artery → right ulnar artery → palmar arches → venous palmar arches → right basilic vein → right
cephalic vein → right axillary vein → right brachiocephalic vein → superior ve

A. Aorta → brachiocephalic trunk → right subclavian artery → right axillary artery → right brachial
artery → right ulnar artery → palmar arches → venous palmar arches → right ulnar vein → right
brachial vein → right axillary vein → right subclavian vein → right brachiocephalic vein →
superior vena cava

What is one possible path of blood from the heart to the left hallux and back to the heart?

A. Aorta → left common iliac artery → left internal iliac artery → left femoral artery → left popliteal
artery → left posterior tibial artery → dorsal pedal artery → arcuate arteries → dorsal venous arch
→ left fibular vein → left popliteal vein → left internal iliac vein → left common iliac vein →
inferior vena cava
B. Aorta → left common iliac artery → left external iliac artery → left femoral artery → left popliteal
artery → left anterior tibial artery → dorsal pedal artery → arcuate arteries → dorsal venous arch →
left great saphenous vein → left femoral vein → left external iliac vein → left common iliac vein →
inferior vena cava
C. Aorta → left common iliac artery → lleft external iliac artery → left great saphenous artery → left
anterior tibial artery → dorsal pedal artery → arcuate arteries → dorsal venous arch → left

B. Aorta → left common iliac artery → left external iliac artery → left femoral artery → left popliteal artery → left anterior tibial artery → dorsal pedal artery → arcuate arteries → dorsal venous arch →left great saphenous vein → left femoral vein → left external iliac vein → left common iliac vein →inferior vena cava