7. Cardiovascular System

1. The primary pacemaker of the heart at physiological conditions is:

a) sino-atrial node;

b) atrio-ventricular node;

c) bundle of His;

d) mitral valve;

e) left ventricle.

a

2. Currents caused by opening of which of the following channels contribute to the repolarisation phase of the ventricular cardiomyocytes action potential:

a) Na+ channels;

b) CI- channels;

c) Ca2+ channel;

d) K+ channels;

e) HCO2- channels.

d

3. In second degree atrio ventricular block:

a) the ventricular rate is lower than the atrial rate;

b) the ventricular ECG complexes are distorted;

c) there is a high incidence of ventricular tachycardia;

d) stroke volume is decreased;

e) cardiac output is increased.

a

4. On the electrocardiogram (ECG), the QRS complex reflects:

a) depolarization of the atria;

b) repolarization of the atria;

c) depolarization of the ventricles;

d) repolarization of the ventricles;

e) delay at the AV node.

c

5. An ECG would be useful for determining a patient's:

a) heart murmur,

b) stroke volume;

c) cardiac output;

d) blockage of electrical impulses conduction from atria to ventricles;

e) end diastolic volume.

d

6. According to the Frank-Starling mechanism:

a) with each systole the left ventricle ejects a larger volume of blood than the right ventricle;

b) the intrinsic rate of the heart's pacemaker is 100 beats per minute;

c) cardiac output increases with increased heart rate;

d) stroke volume increases in directly proportional manner to the increase of the venous return;

e) both ventricles contract simultaneously.

d

7. Within protodiastole of the ventricles:

a) A-V valves are opened, S-L valves closed;

b) A-V and S-L valves are closed;

c) A-V and S-L valves are opened;

d) AV valves are closed, S-L valves are closing;

e) none of the upper menshioned is correct.

d

8. The heart:

a) has no genetic mechanisms for self excitation;

b) is an organ characterized by automaticity;

c) has no intrinsic mechanisms for adaptation to the changing demands of the organism;

d) has stroke volume directly proportional to the afterload;

e) has stroke volume inversely proportional to the preload.

b

9. During isovolumetric contraction:

a) A-V valves are opened, S-L valves are opened;

b) A-V valves are closed, S-L valves are opened;

c) A-V valves are opened, S-L valves are closed;

d) A-V valves are closed, S-L valves are closed;

e) sometimes A-V valves are opened, sometimes closed, depending on the end-diastolic volume (EDV).

d

10. The aortic valve:

a) prevents the backflow of blood into the aorta during ventricular diastole;

b) prevents the backflow of blood to the left ventricle during the ventricular diastole;

c) prevents the backflow of blood into the left ventricle during ventricular ejection;

d) prevents the backflow of blood into the aorta during ejection;

e) closes when the first heart sound is heard.

b

11. The cardiac index:

a) is 5,25L per 1m2 body surface area;

b) doesn't depend on the body surface area;

c) is 3,5L per 1m2 body surface area;

d) doesn't depend on the height of the individual;

e) doesn't depend on the body mass of the individual.

c

12. The heart sounds:

a) express the arterial wall fluctuations synchronous with the cardiac performance;

b) register the cardyomyocytes 'bioelectrical activity during the cardiac cycle;

c) reflect the volume of blood, which the heart ejects in the large and small circle per minute;

d) are registered and analized via auscultation and phonocardiography;

e) are registered via phlebography.

d

13. Which of the following organs has the greatest blood flow per 100g of tissue?

a) brain;

b) heart muscle;

c) skin;

d) liver;

e) kidney.

e

14. If the heart rate is 70 bt min-1, the cardiac output is closer to:

a) 3.45 L min-1

b) 4.55 L min-1

c) 5.25 L min-1

d) 8.0 L min-1

e) 9.85 L min-1

c

15. Which of ECG elements reflects the so called conduction time?

a) PO interval;

b) ORS complex;

c) QT interval;

d) ST segment;

e) T wave.

a

16. What percentage is the Cardiac Output (C.O.) of the right heart of that of the left?

a) 25%;

b) 50 %;

c) 75 %;

d) 100 %;

e) 125 %.

d

17. During the ventricular filling:

a) A-V valves are opened, S-L valves are opened;

b) A-V valves are closed, S-L valves are opened;

c) A-V valves are opened, S-L valves are closed;

d) A-V valves are closed, S-L valves are closed;

e) there is no correct answer.

c

18. In complete atrioventricular block:

a) fainting may occur because the atria are unable to pump blood into the ventricles;

b) ventricular fibrillation is common;

c) the atrial rate is lower than the ventricular rate;

d) the atrial rate is the same as the ventricular rate;

e) fainting may occur because of the low ventricular rate (20-40 bt.min-1).

e

19. The left ventricular performance is substantially greater then that performed by the right ventricle because:

a) the contraction is slower;

b) the afterload is greater;

c) the stroke volume (SV) is greater;

d) the preload is greater;

e) the wall is thicker.

b

20. The ejection fraction (EF):

a) reflects stroke volume of the right ventricle end diastolic volume ratio and is expressed in percents;

b) reflects stroke volume end diastolic volume ratio of the left ventricle and is expressed in percents;

c) is about 40%;

d) is about 70ml;

e) is about 200ml.

b

21. Which effects is/are caused by sympathetic stimulation?

a) decreased cardiac conductibility;

b) decreased cardiac metabolism;

c) increased strength of cardiac contraction;

d) decreased excitability;

e) the heart is resistant to sympathetic stimulation.

c

22. Which are the peculiarities of the cardiomiocytes' action potential?

a) slow waves;

b) type plateau and short duration (0.01 s);

c) type spyke and short absolute refractory period;

d) type plateau and prolonged duration (0.3 s);

e) lack of after potentials.

d

23. The integral of arterial pressure values during one cardiac cycle is defined as:

a) pulse pressure;

b) mean arterial blood pressure;

c) diastolic blood pressure;

d) systolic arterial pressure;

e) closer in value to the systolic blood pressure.

b

24. The duration of the cardiac cycle depends on:

a) the stroke volume;

b) the time needed one systole to occur;

c) the time needed one diastole to occur;

d) the heart rate;

e) the cardiac pause.

d

25. Hypokalaemia causes:

a) short PO interval;

b) ventricular extrasystoles;

c) elevated ST segment;

d) prolonged QRS interval;

e) prolonged QT interval.

b

26. Hyperkalaemia:

a) causes a prolonged QT interval;

b) prolongs the QRS complex;

c) causes ST segment elevation;

d) potentiates digoxin toxicity;

e) causes lack of P wave.

b

27. The End-Systolic volume (ESV) is:

a) the volume of blood in the ventricles at the end of their diastoli;

b) the volume of blood in the ventricles at the end of their systoli;

c) about 130 ml at physiologic rest;

d) about 70 ml at physiologic rest;

e) the volume of blood each of the ventricles eject during their systoli.

b

28. The automatic heart rate of 20-40 imp. min'1 is typical for the:

a) bundle of His;

b) A-V node;

c) sino-atrial node;

d) Purkinje cells;

e) left and right ventricular branches.

d

29. The End-Diastolic volume (EDV):

a) depends on the stroke volume;

b) is directly proportional to the venous return to the heart;

c) doesn't depend on length and strength, developed by the ventricular myocardium;

d) increases when the blood pressure in the aorta increases;

e) doesn't depend on atrial systole and diastole.

b

30. In the cardiac muscle, the number of excited muscle fibres generating action potentials:

a) varies;

b) is always maximal;

c) depends on subthreshold stimuli;

d) doesn't depend on membrane ion permeability;

e) doesn't depend on the activity of the Na+/K+ pump.

b

31. The slowest conduction velocity is characteristic for:

a) atria;

b) Purkinje fibres;

c) bundle of His;

d) AV node;

e) ventricular muscle.

d

32. Effect on a- and B-adrenergic receptors has:

a) noradrenaline (norepinephrine);

b) adrenaline (epinephrine);

c) atropine;

d) angiotensin II;

e) serotonin.

b

33. The absolute refractory period of cardiomyocytes:

a) is the time the cells are refractory to stimuli, never mind their strength or characteristics;

b) is the time the cells are tetanised;

c) is the time a stimulus of superthreshold manner can trigger a new action potential;

d) has a continuity of 30 to 50 ms;

e) corresponds to their depolarisation.

a

34. Nitric oxide:

a) is a vasoconstrictor;

b) increases arterial pressure;

c) decreases capillary wall permeability;

d) increases heart rate;

e) is a local vasodilator.

e

35. Oxygen consumption at rest is the highest in the:

a) brain;

b) heart;

c) liver;

d) kidneys;

e) skeletal muscles.

b

36. The coronary blood flow is:

a) dominant in the left coronary artery in 60% of people;

b) not decreased during systole in the left ventricle; better delivered to subendocardium during systole;

c) not suspended during systole in the right coronary artery;

d) better delivered to the left ventricle during systole;

e) suspended during systole in the right coronary artery.

c

37. The second heart sound is:

a) prolonged of low frequency and strong in intensity;

b) strong, of low frequency and weak;

c) short, of high frequency and weak;

d) prolonged of high frequency and strong;

e) short, of high frequency and strong in intensity.

c

38. If on an ECG the P wave is missing, but the QRS complex and I wave are normal, the actual pacemaker of the heart is:

a) SA node;

b) bundle of His;

c) AV node;

d) Purkinje fibres;

e) ventricular muscles.

c

39. The isovolumetric contraction is:

a) a part of the ejection phase of ventricular contraction;

b) a part of the ventricular contraction phase;

c) a part of ventricular diastole;

d) the rapid filling phase of ventricular diastole;

e) the slow filling phase of ventricular diastole.

b

40. The baroreceptors in arcus aortae and carotid artery detect changes in:

a) the systolic blood pressure;

b) the diastolic blood pressure;

c) the mean arterial blood pressure (MAP);

d) pCO2 in blood;

e) pO2 in blood.

c

41. The asynchronous contraction is:

a) a phase of the ventricular systole;

b) a phase of the ventricular diastole;

c) starts with S-L valves closure;

d) ends with S-L valves opening;

e) starts with A-V valves opening.

a

42. The standard ECG bipolar leads are:

a) aVR, aVL and aVF;

b) I, II and III;

c) Vi to V6;

d) II and V2;

e) all ECG leads are bipolar.

b

43. The gradient of Gasskall:

a) states that going away from the sino-atrial node, the rate of spontaneously generated impulses increases;

b) determines the sino-atrial node as the potential pacemaker of the heart;

c) states that the number of excited muscle fibres generating action potentials is maximal;

d) states that going away from the sino-atrial node, the rate of spontaneously generated impulses decreases;

e) is the basis of the intrinsic mechanisms of the heart via which it adapts to the demands of the organism.

d

44. The peripheral chemoreceptors trigger:

a) pressor and depressor reflexes;

b) only pressor reflexes;

c) long term regulation of arterial blood pressure;

d) only depressor reflexes;

e) oculocardiac reflex.

b

45. The following would directly increase the heart rate:

a) sympathetic stimulation;

b) parasympathetic stimulation;

c) decreased blood pressure;

d) Hi-receptors stimulation;

e) increased atrial natriuretic peptide (ANP) concentration.

a

46. The long-term regulation of arterial pressure is:

a) nerve-reflex;

b) carried out by pressor and depressor baroreceptive reflexes;

c) humoral and restores the volume of blood;

d) carried out by depressor chemoreceptive reflexes;

e) carried out by ventral medial hypothalamus.

c

47. The sympathetic postganglionic neurons innervate:

a) only atria;

b) only ventricles;

c) both atria and ventricles;

d) only right atrium;

e) only left ventricle.

c

48. The T wave in ECG indicates:

a) resting potential;

b) atrial depolarization;

c) SA node excitation;

d) ventricular repolarization;

e) Purkinie fibers excitation.

d

49. The End-Diastolic volume (EDV) is about:

a) 130 ml;

b) 50 ml;

c) 70 ml;

d) 100 ml;

e) 200 ml.

a

50. Increased vagal tone causes:

a) hypertension;

b) tachycardia;

c) bradycardia;

d) increase in cardiac output;

e) increase in stroke volume.

c

51. The dicrotic notch on the common carotid artery sphygmographyc curve is caused by the:

a) closure of mitral valve;

b) closure of tricuspid valve;

c) closure of aortic valve;

d) closure of pulmonary valve;

e) opening the atrioventricular valve.

c

52. For the peripheral vascular resistance of a definite region of highest significance is the:

a) the viscosity of blood;

b) the length of the vessel;

c) the laminar blood flow;

d) the radius of the vessel;

e) the venous valves.

d

53. The working myocardium:

a) is a functional syncitium;

b) is comprised of cells whose cytoplasm communicates;

c) plays the role of pacemaker of the heart;

d) is comprised of cells connected by structures that impede ion flow;

e) reacts to threshold stimuli with different numbers of excited fibres.

a

54. The heart rate at physiologic rest is:

a) 100-140 bt min'1;

b) 40-60 bt-min'1

c) approximately 50 bt min'1;

d) 60-90 bt-min'1;

e) 20-40 bt-min'1

d

55. The full compensatory pause is typical of:

a) the atrial extrasystoles only;

b) both the atrial and the ventricular extrasystoles;

c) the ventricular extrasystoles only;

d) extrasystoles during atrial fibrillation;

e) extrasystoles during atrial flutter.

c

56. The effect of sympathetic stimulation via B2-adrenergic receptors is:

a) vasodilation in splanchnicus;

b) vasodilation of renal arterioles;

c) decrease in vascular resistance and increase in blood flow in skin blood vessels;

d) vasodilation in working striated muscles and coronary blood flow;

e) decrease in vascular resistance and increase in blood flow through the systemic veins.

d

57. The valvular aparatus during the ventricular rapid ejection of the cardiac cycle is:

a) A-V valves - open, S-L valves - open;

b) A-V valves - open, S-L valves - closed;

c) A-V valves - closed, S-L vaves - closed;

d) A-V valves - closed, S-L valves - open;

e) there is no correct answer.

d

58. The increased heart rate is called:

a) tachypnoea;

b) bradycardia;

c) atrial fibrillation;

d) atrial flutter;

e) tachycardia.

e

59. When the actual pacemaker of the heart is AV node, the heart rate is:

a) 60-90 bt min'1:

b) 20-40 bt-min'1;

c) approximately 75 bt min'1;

d) 40-60 bt min'1;

e) 8-120 bt-min'1.

d

60. Automaticity is characteristic for:

a) the cardiac muscle only;

b) the striated muscles;

c) conduction system cells, some neurons and smooth muscle cells;

d) all excitable tissues;

e) the smooth muscle cells only.

c

61. The cardyomyocytes action potential is characterized by:

a) slow depolarization and quick repolarization;

b) rapid depolarization and slow repolarization;

c) rapid de- and repolarizations;

d) slow de- and repolarizations;

e) period of current electrical activity, expressed as slow waves and spike potentials.

b

62. The P wave on the ECG reflects:

a) repolarisation of the atria;

b) depolarisation of the ventricles;

c) depolarisation of the atria;

d) hyperpolarisation of the atria;

e) the time necessary for the impulse originating in the S.A. node to reach the Purkinje fibres.

c

63. The parasympathetic postganglionic neurons innervate:

a) only atria;

b) only ventricles;

c) both atria and ventricles;

d) right atrium only;

e) right ventricle only.

a

64. Determining factor for the gradient of arterial pressure is:

a) the linear velocity of blood;

b) the volume velocity of blood;

c) the total vascular peripheral resistance;

d) the venous pulse;

e) the viscosity of blood.

c

65. The stroke volume of the heart at physiologic rest is:

a) 60-90 bt min';

b) approximately 70 ml;

c) 5.2 L;

d) 0.500 L;

e) 100-140 mmHg.

b

66. The electrical axis of the heart is determined by:

a) the vectorial sum of QRS complexes in the standard leads;

b) the vectorial sum of QRS complexes in the precordial leads;

c) the vector's direction of the electrical forces of the ventricular muscle tissue;

d) the supine or straight position of the body;

e) the vector's direction of the electrical forces of the atrial muscle tissue.

a

67. The augmented unipolar leads are:

a) I, II and III;

b) aVR, aVL and aVF;

c) V1, V2 and V3;

d) V4, V5 and V6;

e) I, aVR and V1.

b

68. The auscultation of the mitral valve is performed at:

a) I sternal intercostal space, right of the sternum;

b) Vth left intercostal space, 2 cm medial to the midclavicular line;

c) IVth sternal intercostal space, right of the sternum;

d) Ind sternal intercostal space, left of the sternum;

e) Illrd sternal intercostal space, left of the sternum.

b

69. The 'plateau'-phase of the cardiomyocytes' action potential is due to:

a) outflux of K* from the cells;

b) influx of Na* into the cells;

c) influx of K* into the cells;

d) slow influx of Ca2+ into the cells;

e) influx of Nat into the cells and outflux of K* from the cells.

d

70. The electrical axis of the heart is of indifferent type when a-angle is:

a) from +60 to +90 degrees;

b) from +30 to +60 degrees;

c) from -90 degrees upward;

d) from +30 to -30 degrees;

e) from -30 degrees downward.

b

71. The secreted by postganglionic sympathetic neurones, noradrenaline and adrenaline, activate in myocardium:

a) B2 adrenergic receptors;

b) M2 cholinergic receptors;

c) A2 adrenergic receptors;

d) B1 adrenergic receptors;

e) H1 receptors.

d

72. At physiologic rest the diastolic arterial pressure is:

a) 90 - 95 mmHg;

b) 140 - 160 mmHg;

c) 60 - 90 mmHg;

d) 100 - 140 mmHg;

e) 75 mmHg.

c

73. The blood flow through microcirculation is controlled by:

a) hyperoxemia and hypocapnia;

b) hypoxia and hypercapnia;

c) increased pH;

d) lowered tissue metabolism;

e) hyperoxemia and hypercholesterolemia.

b

74. Throughout the isovolumetric relaxation of the ventricles:

a) A-V valves are opened, S-L valves are opened;

b) A-V valves are closed, S-L valves are opened;

c) A-V valves are opened, S-L valves are closed;

d) A-V valves are closed, S-L valves are closed;

e) none of the above.

d

75. The first heart sound is:

a) systolic, result of the ventricular contractions and AV valves closing;

b) systolic, result of the A-V valves opening;

c) systolic, result of the S-L valves closing;

d) diastolic, result of the A-V valves closing;

e) diastolic, result of S-L valves closing.

a

76. Cardiac output (C.O.) depends on:

a) Vital Capacity (VC);

b) Stroke Volume (SV), Heart Rate (HR) and pre- and afterload;

c) Heart Rate (HR) only;

d) the preload and afterload only;

e) Stroke Volume (SV) only.

b

77. The intracardial regulation of the heart is carried out by:

a) integrated reflexes;

b) neural regulatory mechanisms;

c) humoral factors;

d) adaptation to changes in venous return or in peripheral resistance;

e) the automaticity.

d

78. The heart would stop in diastole because of:

a) increased level of Ca2+ in the extracellular fluid;

b) increased levels of catecholamines;

c) increased levels of glucocorticoids;

d) increased concentration of K+ in the extracellular fluid (above 8 mmol L-1);

e) increased secretion of T3 and T4.

d

79. When the heart rate is 60 bt-min'1, the duration of the cardiac cycle is:

a) 0.5 s;

b) 0.8 s;

c) 1 S;

d) 0.2 s;

e) 60 s.

c

80. The pulse pressure (PP) is:

a) closer in value to the systolic than to the diastolic pressure;

b) the arithmetic mean of systolic and diastolic pressures;

c) closer in value to the diastolic than to the systolic pressure;

d) the difference between the systolic and diastolic pressures;

e) one third of the mean arterial pressure.

d

81. The cardiovascular center is situated in:

a) hypothalamus;

b) mesencephalon;

c) the cortex;

d) medulla oblongata;

e) C8-Th1-2 spinal cord segments.

d

82. Via the reflex of Pavlov-Bainbridge:

a) the greater volume of blood in the pulmonary circulation leads to decreased heart rate and slight decrease in arterial pressure;

b) the bigger venous return to the heart triggers tachycardia;

c) the ventricular diastolic filling is limited;

d) the distention of ventricles is followed by compensatory bradycardia and decrease in arterial pressure;

e) the viscosity of blood decreases.

b

83. The atrial Na+-uretic peptide:

a) is synthesized by right atrial cardiomyocytes and stimulates Na+-uresis via kidneys;

b) decreases Nat-uresis via kidneys;

c) is a vasoconstrictor;

d) worsens the renal blood flow;

e) stimulates reabsorption of water in kidnevs.

a

84. The short-term regulation of arterial pressure is:

a) humoral;

b) neural;

c) performed via depressor hemoreceptive reflexes;

d) performed via renin-angiotensinII system;

e) performed via body fluids control.

b

85. Vasopressin:

a) is secreted when arterial pressure is raised;

b) is a potent vasoconstrictor;

c) stimulates sodium uresis;

d) stimulates diuresis;

e) is vasodilator.

b

86. Exchange of nutrients and gases between the blood and tissue cells is the main function of the:

a) arterioles;

b) arteries;

c) veins;

d) capillaries;

e) venules.

d

87. In the heart, (within physiological limits) the strength of contraction is directly proportional to the:

a) pacemaker activity;

b) A-V nodal delay;

c) initial length of the cardiomyocytes;

d) respiratory rate;

e) ST-segment.

c

88. Endothelins:

a) are vasodilators;

b) are vasoconstrictors;

c) depress migration of leucocytes;

d) are stimulated by hyperoxemia and hypocholesterolemia;

e) decrease intracellular concentration of Ca2+

b

89. The coronary blood vessels:

a) have rich parasympathetic innervation;

b) that belong to the epicardial plexus have mainly a1 adrenergic receptors and react via vasoconstriction;

c) that belong to the epicardial plexus have mainly B1 adrenergic receptors and react via vasodilation;

d) that belong to the epicardial plexus have mainly M1 adrenergic receptors and react via vasodilation;

e) that belong to the epicardial plexus have mainly M2 adrenergic receptors and react via vasoconstriction.

b

90. The brain blood flow:

a) is not a constant parameter:

b) has unlimited pulse and volume changes:

c) is constant when the mean arterial pressure is in the interval 80-180 mmHg;

d) decreases when pCO2 is increased;

e) increases when pO2 is increased.

c

91. The pulse wave velocity:

a) is lowest in the small arteries at physiologic conditions;

b) is one and the same in the different vascular regions;

c) is highest in the small arteries at physiologic conditions;

d) is highest in aorta;

e) is lower in the small arteries compared to that in mid-size arteries at physiologic conditions.

c

92. The rate of self excitation of the conduction system cells is:

a) highest of Purkinje fibers;

6) lowest of sino-atrial node;

c) lowest of Purkinje fibers;

d) highest of atrio-ventricular node;

e) higher of Purkinje fibers compared to these of atrio-ventricular node.

c

93. The myocardium functions as a functional syncytium due to:

a) striated muscle fibers;

b) branching of myocardial cells;

c) gap junctions (intercalated disks);

d) the presence of desmosomes;

e) higher concentration of Ca2+ ;

c

94. Positive bathmotropic effect on the heart is produced by:

a) stimulation of vagus nerve;

b) stimulation of sympathetic nerves;

c) atropin;

d) cutting vagus;

e) K+ application.

b

95. At physiologic conditions, the pulmonary vascular resistance:

a) is equal to the systemic vascular resistance;

b) decreases when the partial pressure of oxygen in alveli is lowered;

c) is low, as the pulmonary blood vessels are short, wide and have high percentage of elastic fibers in their vascular wall;

d) is higher compared to that in the systemic vascular resistance;

e) decreases when the partial pressure of carbon dioxyde in alveoli is increased.

c

96. The pulmonary valve is auscultated at:

a) II^nd left intercostal space, at the sternal edge;

b) II^nd right intercostal space, to the sternum;

c) III^rd left intercostal space, at the sternal edge;

d) IV^th right intercostal space, at the sternal edge;

e) V^th left intercostal space, 2 cm inwards of the clavicular line.

a

97. Which of the pointed factors plays key role for the effective filtration pressure at the microcirculatory unit:

a) hemodynamic pressure;

b) intrapleural pressure;

c) plasma protein colloid osmotic pressure;

d) tissue pressure;

e) interstitial colloid osmotic pressure.

a

98. The second heart sound differs from the first heart sound in that it is:

a) related to turbulence set up by valve closure;

b) longer lasting than the first sound;

c) higher in frequency;

d) occasionally split;

e) heard when the ventricles are contracting.

c

99. Pulmonary vascular resistance is:

a) is equal to that offered by the systemic circuit;

b) decreased when alveolar oxygen pressure falls;

c) expressed in units of volume flow per unit time per unit pressure gradient;

d) decreased during exercise;

e) regulated reflexely by sympathetic vasoconstrictor nerves.

d

100. Which of the vessels mentioned below are not under sympathetic control:

a) cerebral;

b) splanchnic;

c) cardiac;

d) cutaneous;

e) in the striated muscles.

a