Multiple Choice

Directions: Circle the letter that BEST completes each statement.

1.      The heart weighs between …

a.       7 and 15 ounces (200 to 425 grams) and is a little larger than the size of your fist.

b.      3 and 5 ounces (100 to 200 grams) and is a little larger than the size of your fist.

c.       9 and 18 ounces (250 to 475 grams) and is a little smaller than the size of your fist.

d.      5 and 12 ounces (150 to 350 grams) and is a little smaller than the size of your fist.

2.      By the end of a long life, a person's heart may have beat more than ___ billion times.

a.       4.5

b.      3.5

c.       1.5

d.      2.5

3.      Each day, the average heart beats ____________  times.

a.       1,000

b.      10,000

c.       100,000

d.      1,000,000

4.      The average heart pumps about ___________ gallons ( ________ liters) of blood each day.

a.       20,000 (75,571)

b.      200,000 (700,571)

c.       2,000 (7,571)

d.      2,000,000 (7,500,571)

e.       200 (757)

5.      Your heart has ___ chambers.

a.       2

b.      3

c.       4

d.      5

e.       6

6.      Your heart has ___ valves.

a.       2

b.      3

c.       4

d.      5

e.       6

7.      The double-layered membrane surrounding the heart is called the_________________.

a.       pericardium

b.      plural sac

c.       mediastinal

d.      pnemothorax

e.       pons centre

8.      The purpose of the circulatory system is to …

a.       Allow us to breathe.

b.      Support the administration of medication or fluids.

c.       Transport oxygen and nutrients to the body and to remove wastes and other by-products from the body.

d.      Send chemical signals to all parts of the body through chemo-receptors.

e.        All of the above

f.        None of the above

9.      Blood acts as the transportation medium for these materials and is pumped through the body by the ____________.

a.       pancreas

b.      bundle of His

c.       heart

d.      red blood cells

e.       All of the above

f.        None of the above

10.  Blood is comprised of …

a.       spinal fluid, quartz, and other minerals absorbed into the blood by digestion.

b.      red and blue blood cells, HIV, HBV, and HCV.

c.       red blood cells, white blood cells, plasma, and platelets

d.      intra-cellular material, xylum, phloem, and cellulose,

e.       red blood cells, white blood cells, chlorophyll, water, nutrients and waste.

f.        All of the above

g.       None of the above

11.  White blood cells are part of the body's defense against ________________.

a.       anaphylaxis

b.      hypothermia and other heat-related issues

c.       the mitochondria and golgi apparatus

d.      infection

e.       All of the above

f.        None of the above

12.  Platelets are cells that...

a.       Allow the transport of oxygen to all tissues in the body

b.      Protect the body from disease

c.       fight any infection

d.      help the blood clot

e.       All of the above

f.        None of the above

13.  plasma…

a.       transports oxygen to all body tissues.

b.      is the fluid that carries the blood cells and nutrients.

c.       surrounds and fights any pathogen that enters the body.

d.      Is the fluid that helps the blood to clot

e.       All of the above

f.        None of the above

14.  The ____________   ___________ receives blood from the veins of the body and the heart and pumps oxygen-poor blood to the right ventricle.

a.       right atrium

b.      right ventricle

c.       left atrium

d.      left ventricle

15.  The ____________   ___________ pumps blood to the lungs.

a.       right atrium

b.      right ventricle

c.       left atrium

d.      left ventricle

16.  The ____________   ___________ receives blood from the pulmonary veins (lungs) and pumps oxygen-rich blood to left ventricle.

a.       right atrium

b.      right ventricle

c.       left atrium

d.      left ventricle

17.  The ____________   ___________ pumps blood to the body.

a.       right atrium

b.      right ventricle

c.       left atrium

d.      left ventricle

18.   __________   _________ — regulates blood flow between the right atrium and right ventricle.

a.       Tricuspid Valve

b.      Pulmonary Valve

c.       Mitral Valve

d.      Aortic Valve

19.  __________   _________ — controls blood flow from the right ventricle into the pulmonary arteries, which carry blood to your lungs to pick up oxygen.

a.       Tricuspid Valve

b.      Pulmonary Valve

c.       Mitral Valve

d.      Aortic Valve

20.  __________   _________ — lets oxygen-rich blood from your lungs pass from the left atrium into the left ventricle.

a.       Tricuspid Valve

b.      Pulmonary Valve

c.       Mitral Valve

d.      Aortic Valve

21.  __________   _________ — opens the way for oxygen-rich blood to pass from the left ventricle into the aorta (body's largest artery), where it is delivered to the rest of your body.

a.       Tricuspid Valve

b.      Pulmonary Valve

c.       Mitral Valve

d.      Aortic Valve

22.  Any irregularity in your heart's natural rhythm is called an ___________________.

a.       arrhythmia

b.      angioplasti

c.       arterial-passive rhythm

d.      aortic valve block

e.       irregular heart block

f.        All of the above

g.       None of the above

23.  ____________ ____________happen in the heart's two lower chambers, called the ventricles

a.       Ventricular arrhythmias

b.      Supraventricular arrhythmias

c.       Arterial arrhythmias

d.      AV block arrhythmias

e.       SA block arrhythmias

f.        All of the above

g.       None of the above

24.  ____________ ____________happen in the structures above the ventricles, mainly the atria, which are the heart's two upper chambers.

a.       Ventricular arrhythmias

b.      Supraventricular arrhythmias

c.       Arterial arrhythmias

d.      AV block arrhythmias

e.       SA block arrhythmias

f.        All of the above

g.       None of the above

25.  Arrhythmias are further defined by the speed of the heartbeats. A very slow heart rate, called _____________, means the heart rate is less than 60 beats per minute. ______________ is a very fast heart rate, meaning the heart beats faster than 100 beats per minute. _______________, the most serious form of arrhythmia, is fast, uncoordinated beats, which are contractions of individual heart-muscle fibers.

a.       Tachycardia, Fibrillation, Bradycardia

b.      Tachycardia, Bradycardia, Fibrillation

c.       Fibrillation, Bradycardia, Tachycardia

d.      Bradycardia, Tachycardia, Fibrillation

e.       Bradycardia, Fibrillation, Tachycardia

f.        All of the above

g.       None of the above

Fill in the Blanks

Directions: fill in each blank. (1 mark for each blank)

1.      A heartbeat is a ________-part pumping action that takes about a ___________. As blood collects in the upper chambers (the right and left ___________), the heart's natural pacemaker (the _____ node) sends out an electrical signal that causes the ___________ to contract. This contraction pushes blood through the ____________ and _________ valves into the resting lower chambers (the right and left ________________). This part of the two-part pumping phase (the longer of the two) is called ____________.

2.      The second part of the pumping phase begins when the ______________ are full of blood. The electrical signals from the ____ node travel along a pathway of cells to the _______________, causing them to _____________. This is called _________. As the ______________ and ____________ valves shut tight to prevent a back flow of blood, the ___________________ and ___________ valves are pushed open. While blood is pushed from the __________ ventricle into the lungs to pick up oxygen, oxygen-rich blood flows from the ____________ ventricle to the heart and other parts of the body.

3.      After blood moves into the pulmonary artery and the aorta, the _____________ relax, and the pulmonary and aortic valves ___________. The ______________ pressure in the ventricles causes the _________________ and ____________ valves to open, and the cycle begins again. This series of contractions is repeated over and over again, increasing during times of exertion and decreasing while you are at rest. The heart normally beats about ____ to 80 times a minute when you are at rest, but this can vary. As you get older, your ___________ heart rate rises. Also, it is usually _________________ in people who are physically fit.

4.      Your heart does not work alone, though. Your ______________ tracks the conditions around you—climate, stress, and level of physical activity—and adjusts your _________________________ system to meet those needs.

5.      The human heart is a __________________ designed to remain strong and reliable for a hundred years or longer. By reducing your _______________ factors for cardiovascular disease, you may help your heart stay healthy longer.

6.      Your heart has a natural "___________________-" called the _______________ (SA) node. The SA node is a specialized group of cells at the top of your heart's upper-__________ chamber (the ___________ atrium). Anywhere between ____ and 100 times a minute, the SA node sends an ____________ impulse throughout your heart to cause it to beat (contract).

7.      When the SA node sends an electrical impulse, that impulse first travels through the heart's upper chambers (the ___________). It then passes through a small group of cells called the _______________________ (AV) node. The AV node checks the impulse and sends it along a track called the bundle of ______. The bundle of _____ divides into a right and left bundle branch, which lead to your heart's _________ chambers (the ________________).

8.      Sometimes the electrical impulse cannot travel throughout the heart because part of the heart's conduction system is "blocked." If an impulse is blocked as it travels through the bundle branches, you are said to have _______________ ________________ ___________.

9.      If there is a block in one of these branches, the electrical impulse must travel to the _____________ by a different route. When this happens, the __________ and ____________ of your heartbeat are not affected, but the impulse is ________________. Your ventricle will still contract, but it will take longer because of the slowed impulse. This slowed impulse causes one ventricle to contract a fraction of a second _________________ than the other.

10.  The block can be caused by _______________ artery disease, cardiomyopathy, or valve disease. Right bundle branch block may also occur in a ___________________ heart.

11.  We worry about bundle branch block because it can be a warning sign of other, more serious heart conditions. For example, it might mean that a small part of your heart is not getting enough _______________-rich ____________. Also, researchers have found that people who have left bundle branch block may be at greater risk for ____________ disease than are people who do not have the condition.

12.  Doctors can use an ___________________________ (EKG or ECG) machine to record the electrical impulses of your heart. Bundle branch block shows up on the EKG tracing. The __________________ patterns recorded by the EKG machine can even show your doctor whether the block is located in the right or left bundle branch.

13.  In most cases, bundle branch block does not need _________________. But patients who have bundle branch block along with another heart condition may need treatment. For example, if bundle branch block develops during a heart attack, you may need a ________________. After a heart attack, your heart is fragile, and bundle branch block may cause a very slow heart rhythm (__________________). A __________________ will help regulate the heart's _________________ after a heart attack.

14.  For patients with both bundle branch block and dilated cardiomyopathy, a new type of pacing called _____________ _________________________ ___________________ (CRT) may be used. Normally, pacemakers pace only one of the lower heart chambers (the _______________) at a time. But CRT re-coordinates the beating of the two _____________ by pacing them at the same time. Recent studies have shown that CRT works for certain patients with both bundle branch block and dilated cardiomyopathy.

15.  Some people are born with arrhythmias, meaning the condition is ________________. Some medical conditions, including many types of heart disease and high blood _______________, may be factors. Also, ____________, ______________, ______________, _____________, and some over-the-counter ______________ and _____________ medicines can affect the pattern of your heartbeat.

16.  Anti-_____________________ medicines, including digitalis, __________-blockers, and ______________ channel blockers, are often the first approach taken for treating arrhythmia.

17.  Ventricular ______________ and ventricular __________________ can be treated by an implantable _____________________ defibrillator (ICD). This is a device that applies electric impulses or, if needed, a ______________ to restore a normal heartbeat. The device's power source is implanted in a pouch beneath the skin of your ___________ or the area above your _________________ and connected to patches placed on your heart.

18.  An electronic ____________________ is used in some cases of slow heart rate. ______________ than a matchbox, the pacemaker is surgically implanted near the bone below your __________ (the ________________). The _________________'s batteries supply the electrical energy that acts like your heart's natural ___________________.

19.  Radiofrequency ________________ is a procedure that uses a catheter and a device for mapping the electrical pathways of the heart. After you are given medicine to relax you, a catheter is inserted into a __________ and guided to your heart, where doctors use high-frequency ___________ ____________ to destroy (__________) the pathways causing the arrhythmia.

20.  _______________ _______________ - The vessels that supply the heart with blood.

21.  __________ - the major artery originating from the heart and lying in front of the spine in the thoracic and abdominal cavities…divides at the level of the navel into the iliac arteries.

22.  ________________ ________________ - originates at the right ventricle and carries oxygen-poor blood to the lungs.

23.  ____________  _________________ - is the major artery of the neck that supplies the head with blood. Pulsations can be palpated on either side of the neck.

24.  ________________ ___________ - is the major artery of the thigh that supplies the groin and the lower extremities with blood. Pulsations can be palpated in the groin area.

25.  ___________ ____________ - is the major artery of the lower hand. Pulsations can be palpated at the wrist thumbside.

26.  ____________ ___________ - is an artery of the upper arm. Pulsations can be palpated on the inside of the arm between the elbow and the shoulder. This artery is used when determining a blood pressure (BP) using a BP cuff (sphygmomanometer) and a stethoscope.

27.  ________________ ____________ ______________ - runs through the leg. Pulsations can be palpated on the posterior surface of the medial malleolus.

28.  ______________ ____________ - is an artery in the foot. Pulsations can be palpated on the anterior surface of the foot.

29.  As the arteries branch throughout the body, they become smaller and smaller. The smallest branches of an artery are called ___________________, which lead to the ______________, which are found in all parts of the body and allow for the exchange of nutrients and waste at the cellular level. Blood is returned to the heart through the ___________. The smallest branches of the veins are called _____________, which lead to the ______________.

30.  ________________ _______________ - carries oxygen-rich blood from the lungs to the left atrium.

31.  ________________ _______________ ___________ - carries oxygen-poor blood from the upper body back to the right atrium.

32.  ________________ _______________ ___________ - carries oxygen-poor blood from the lower body back to the right atrium.

33.  _____________________ is the circulation of blood through an organ structure. _______________ delivers oxygen and other nutrients to the cells of all organ systems and removes waste products. ___________________ is the inadequate circulation of blood through an organ.

34.  Blood pressure (also called the “____________ _______________”) is the pressure of circulating blood against the ___________ of the arteries. __________________ blood pressure is the pressure exerted against the walls of the artery when the left ventricle contracts. This is the ___________ number in a blood pressure reading. The pressure __________ when the left ventricle relaxes.

35.  _______________ blood pressure is the pressure exerted against the __________ of the artery when the left ventricle is at rest. This is the _____________ number in a blood pressure reading.

36.  High blood pressure can affect your health in four main ways:
_______________ of the _________________ — Pressure inside your arteries can cause the muscles that line the walls of the arteries to thicken. Thickening causes the arteries to narrow. A heart attack or stroke can occur if a blood clot blocks blood flow to your heart or brain.

37.  _________________ _______________ — High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger. The bigger your heart is, the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Your heart has begun to fail.  Without treatment, your heart failure will only get worse.

38.  ____________ ______________ — Prolonged high blood pressure can damage your kidneys if the arteries supplying your kidneys with blood are affected.

39.  _________ ________________ — If you have diabetes, high blood pressure can cause the tiny capillaries in the retina of your eye to bleed. This condition, called retinopathy, can lead to blindness.

40.  Fill in the following chart:

Category	Systolic (mm Hg)	Diastolic (mm Hg)
Normal	Lower than ______	Lower than ____
Prehypertension	_______ - _______	_______ - _______
Hypertension:
- Stage 1	_______ - _______	_______ - _______
- Stage 2	_____ or higher	_____ or higher

 

41.  The first course of action usually involves ______________ changes, especially for people with ___________________.
Start eating a low-fat and low-salt diet, Lose weight, if you need to, Begin a regular exercise program, Learn to manage stress, If you smoke, quit, Drink alcohol in moderation, if at all, Remember that moderate intake is an average of one or two drinks per day for men and one drink per day for women.

42.  Medicines are available if these changes do not help control your blood pressure within 3 to 6 months. _____________ help rid your body of water and sodium. ______ inhibitors block the enzyme that raises your blood pressure.

43.  Other types of medicines — _________ blockers, _______________ channel blockers, and other _____________ — work in different ways, but their overall effect is to help relax and widen your blood vessels and _______________ the pressure inside the vessel.

44.  As the left ventricle contracts, it sends a wave of blood through the arteries. This wave can be felt, or ______________, anywhere an artery simultaneously passes near the skin surface and over a bone. Common places to feel for a pulse include the following:

45.  The ____________ pulse is taken at the neck.

46.  The ____________ pulse is taken in the groin area.

47.  The ____________ pulse can be felt on the thumb side of the wrist.

48.  The ____________ pulse can be felt on the inside of the upper arm.

49.  The ____________ ____________ pulse can be felt on the inside of the ankle.

50.  The ____________ ____________ pulse can be felt on the top of the foot.

Matching

Directions: Match each item in the left-hand column with the correct description from the right-hand columns. Write the letter of the correct description in the space provided or alongside the description. (1 mark each)

___ 1.    Angiotensin II receptor blockers ___ 2.    Angiotensin-Converting Enzyme (ACE) Inhibitors ___ 3.    Class I antiarrhythmic ___ 4.    Class II antiarrhythmic ___ 5.    Class III antiarrhythmic ___ 6.    Class IV antiarrhythmic ___ 7.    Antiplatelet Therapy ___ 8.    Aspirin ___ 9.     Beta-Blockers ___ 10. Blood-Thinning Medicines ___ 11. Calcium Channel Blockers ___ 12. Cholesterol-Lowering Medicines ___ 13. Statins ___ 14. Bile Acid Sequestrants or Resins ___ 15. Nicotinic Acid ___ 16. Fibric Acid Derivatives ___ 17. Cholesterol Absorption Inhibitors ___ 18. Digitalis Medicines ___ 19. Diuretics ___ 20. Nitrate

a.        Is used to lower levels of LDL ("bad") cholesterol. This medicine can also be given in combination with a statin. These medications work in the digestive tract by reducing the amount of cholesterol absorbed from foods you eat. It is important that you stay on a cholesterol-lowering diet while taking this medicine. b.        Control irregular heart rhythms (called arrhythmias) by slowing the signals that start in the sinoatrial (SA) node. This, in turn, reduces the number of signals that travel through the atrioventricular (AV node). Fewer signals mean fewer arrhythmias. c.        Slow the electrical impulses in the heart by blocking the heart's potassium channels. d.        Slow the rate at which calcium passes into the heart muscle and into the vessel walls. This relaxes the vessels. e.        A group of medicines that stop blood cells from sticking together and forming a blood clot. f.         "Block" the effects of adrenaline on your body's beta receptors. This slows the nerve impulses that travel through the heart. As a result, your heart does not have to work as hard because it needs less blood and oxygen. g.        Are beta-blockers, which work by blocking the impulses that may cause an irregular heart rhythm and by interfering with hormonal influences (such as adrenaline) on the heart's cells. By doing this, they also reduce blood pressure and heart rate. h.        Are used to lower triglyceride levels. These types of medications break down the particles that make triglycerides and use them in other ways in your body. Lower triglycerides can lead to increased levels of HDL ("good") cholesterol. i.         A type of medicine called a salicylate. j.         Part of a class of medicines called anticoagulants. k.        Sodium-channel blockers, which slow electrical conduction in the heart. l.         These medicines block the action of angiotensin II, an enzyme that is responsible for causing the blood vessels to narrow. m.      Used to treat congestive heart failure (CHF) and high blood pressure (hypertension). You may also be given this medication after you have had a heart attack, because some studies have shown that these medicines may prevent further damage to the heart muscle. This medication is also prescribed for certain kinds of kidney problems, especially if you have diabetes. These medicines block an enzyme in the body that is responsible for causing the blood vessels to narrow. n.        Work like class II medicines but act by blocking the calcium channels in the heart. o.        Are a vasodilator p.       Sometimes called "water pills." q.        Is a form of vitamin B. It appears to slow the liver's production of certain chemicals that help to make LDL ("bad") cholesterol. This medication has also been found to lower triglycerides and raise HDL ("good cholesterol") levels. r.         Statins, Bile Acid Sequestrants or Resins, Nicotinic Acid, Fibric Acid Derivatives, Cholesterol Absorption Inhibitors s.        Also called HMG-CoA reductase inhibitors. HMG-CoA reductase is an enzyme that helps your body make cholesterol. This medication helps to block this enzyme, which causes your body to make less cholesterol. t.         Your body uses cholesterol to make bile, an acid used in the digestive process. These medicines bind to bile, so it cannot be used during the digestive process. Your liver responds by making more bile. The more bile your liver makes, the more cholesterol it uses. So, less cholesterol is left to circulate through your bloodstream.

Diagram

Directions: Annotate the following diagrams. (1 mark each blank)