A & P Test 2 -

1. 1Number the following in order of cellular organization (1 is the largest, 4 is the smallest):
   [blank_start]3[blank_end]. Sarcoplasmic reticulum
   [blank_start]2[blank_end]. Myofibrils
   [blank_start]1[blank_end]. Muscle fibers
   [blank_start]4[blank_end]. Sarcomeres

   1. A3
   2. B2
   3. C1
   4. D4
2. 2Drag and drop the descriptors for muscle fibers and myofibrils:
   
   Muscle fibers are: [blank_start]single cells[blank_end], [blank_start]multinucleated[blank_end], and surrounded by the [blank_start]sarcolemma[blank_end].
   
   Myofibrils are: [blank_start]contractile elements[blank_end] and surrounded by the [blank_start]sarcoplasm[blank_end].

   1. Asingle cells
   2. Bmultinucleated
   3. Csarcolemma
   4. Dcontractile elements
   5. Esarcoplasm
3. 3Label the following anatomy of skeletal muscle.

   

   1. Amuscle
   2. BMuscle fascicles
   3. CMuscle fibers
4. 4Label the components of a myosin molecule (A) and a myosin filament (B).

   

   1. ATail
   2. BLight chains
   3. CTwo heavy chains
   4. DActin filaments
   5. EBody
   6. FMyosin filament
   7. GHinges
   8. HCross-bridges
5. 5What acts as the cell membrane of muscle fibers?

   1. AT-tubules
   2. BSarcolemma
   3. CMyosin
   4. DSarcoplasmic reticulum
6. 6[blank_start]Sarcoplasm[blank_end] is the intracellular fluid of a muscle fiber. It requires large quantities of [blank_start]mitochondria[blank_end] to supply ATP for contracting myofibrils.

   1. Amitochondria
   2. BSarcoplasm
7. 7[blank_start]T-tubules[blank_end] are narrow tubes continuous with sarcolemma and extend into sarcoplasm at right angles to the cell surface.

   1. AT-tubules
8. 8Sarcoplasmic reticulum has [blank_start]high[blank_end] concentrations of calcium, which initiates muscle contractions.

   1. Ahigh
   2. Blow
9. 9What is the endoplasmic reticulum of skeletal muscle?

   1. ASarcolemma
   2. BMitochondria
   3. CMyofibrils
   4. DSarcoplasmic reticulum
10. 10Two [blank_start]sarcoplasmic reticulum cisterna[blank_end] and one [blank_start]transverse tubule[blank_end] make up the triad in the skeletal muscle.

    1. Asarcoplasmic reticulum cisterna
    2. Btransverse tubule
    3. Cmyofbril
    4. DA-band
    5. ECavaolae
    6. FZ-disk

11. 11The sarcoplasmic reticulum membrane contains a [blank_start]ryanodine[blank_end] receptor. This receptor contains a [blank_start]calcium[blank_end] release channel.

    1. Aryanodine
    2. Bcalcium
12. 12The t-tubule membrane contains voltage-sensitive [blank_start]dihydropyridine (DHP)[blank_end] receptors.

    1. Adihydropyridine (DHP)
13. 13Assign a 1 to 4 for the steps of calcium entering the cell. 1 is the first step and 4 is the last step.
    
    [blank_start]3[blank_end]. Calcium exits the SR via the CA-release channel and activates troponin C, leading to muscle contraction.
    
    [blank_start]1[blank_end]. Membrane depolarization opens the L-type Ca channel.
    
    [blank_start]4[blank_end]. Ca entering the cell via L-type CA channels also can activate the Ca-release channels. However, this pathway is not essential in skeletal muscle.
    
    [blank_start]2[blank_end]. Mechanical coupling between the L-type Ca channel and the Ca-release channel causes the Ca-release channel to open.

    1. A3
    2. B1
    3. C4
    4. D2
14. 14[blank_start]Myofibrils[blank_end] are the contractile elements of the muscle. They are divided into functional units called [blank_start]sarcomeres[blank_end].

    1. AMyofibrils
    2. Bsarcomeres
15. 15[blank_start]Myosin[blank_end] is the thick filament of the sarcomere.
    
    [blank_start]Actin[blank_end] is the thin filament of the sarcomere.
    
    [blank_start]Titin[blank_end] is the filamentous structural protein of the sarcomere.

    1. AMyosin
    2. BActin
    3. CTitin
16. 16Projections from myosin filaments are called [blank_start]cross-bridges[blank_end].

    1. Across-bridges
17. 17Myosin heads function as an [blank_start]ATPase enzyme[blank_end].

    1. AATPase enzyme
18. 18Check the three boxes of the proteins of a filament.

    1. AActin
    2. BTropomyosin
    3. CTroponin
    4. DT-tubules
    5. EADP
19. 19[blank_start]Actin[blank_end] - The active sites on this filament are ADP molecules. This is where myosin [blank_start]cross-bridges[blank_end] bind.
    
    [blank_start]Tropomyosin[blank_end] - Prevents binding of myosin to actin filament. Contractions can't occur when these are present.
    
    [blank_start]Troponin[blank_end] - Attaches alongside of tropomyosin.

    1. AActin
    2. Bcross-bridges
    3. CTropomyosin
    4. DTroponin
20. 20[blank_start]T-I[blank_end] : Has a strong affinity for actin.
    
    [blank_start]T-C[blank_end]: Has a strong affinity for calcium.
    
    [blank_start]T-T[blank_end]: Has an affinity for tropomyosin.

    1. AT-I
    2. BT-C
    3. CT-T
21. 21The theory of Mechanism of Muscle Contraction is:
    
    The binding of Ca to [blank_start]troponin[blank_end] results in a conformational change in [blank_start]tropomyosin[blank_end] that "uncovers" the active sites on the actin molecule, allowing for myosin to bind.

    1. Atroponin
    2. Btropomyosin
22. 22Place the (basic) steps of a muscle contraction in order from one to step five.
    
    Step [blank_start]2[blank_end]: Exposure of active sites. The influx of calcium binds to troponin. The binding weakens the bonds between troponin-tropomyosin complex. The troponin changes position, pulls tropomyosin molecule away from active sites. This allows cross-bridges to form.
    
    Step [blank_start]5[blank_end]: Reactivation of myosin - occurs when free myosin head splits the ATP into ADP and phosphate group. Energy released in this process used to recock myosin head. The entire cycle can now be repeated.
    
    Step [blank_start]1[blank_end]: The terminal cisternae releases calcium. The depolarization of the T-tubule causes ryanodine calcium release channels to open, releasing calcium.
    
    Step [blank_start]4[blank_end]: Detachment of cross-bridges. When ATP binds to myosin head, the link between active site on actin molecule and myosin head broken. The active site not exposed and able to interact with another cross bridge.
    
    Step [blank_start]3[blank_end]: Pivoting - in resting sarcomeres, each cross bridge points away from the M-line. Cocking myosin requires energy, and energy obtained by hydrolysis of ATP to ADP and a phosphate group. After cross-bridge attachment has occurred, stored energy released as myosin head pivots toward M line. This is a power stroke.

    1. A2
    2. B5
    3. C1
    4. D4
    5. E3
23. 23Label the components of a

    

    1. ASubneural cleft
    2. BRelease sites
    3. CNeural membrane
    4. DVesicles
    5. EDense bar
    6. FCalcium channels
    7. GAcetylcholine receptors
    8. HVoltage-activated Na channels
24. 24Identify the portions of the transverse t-tubule.

    

    1. AMyofibrils
    2. BZ disk
    3. CTriad of the reticulum
    4. DA band
    5. EM line
    6. FH zone
    7. GI band
    8. HSarcolemma
    9. ITerminal cisternae
    10. JTransverse tubule
    11. KMitochondrion
    12. LSarcoplasmic reticulum
25. 25Identify the portions of the motor end plate.

    

    1. AMyofibrils
    2. BTeloglial cell
    3. CTerminal nerve branches
    4. DAxon
    5. EMuscle nuclei
    6. FSynaptic vesicles
    7. GSubneural clefts
    8. HAxon terminal in synaptic trough
26. 26Drag and drop to the appropriate location:
    
    [blank_start]Afferent system[blank_end]: Conveys information from receptors to the central nervous system.
    
    [blank_start]Efferent system[blank_end]: Conveys information from the central nervous system to muscles and glands.
    
    [blank_start]Somatic nervous system (SNS)[blank_end]: Conveys information from the central nervous system to skeletal muscles.
    
    Autonomic Nervous System: Conveys information from the central nervous system to smooth muscle, cardiac muscle, and glands.
    
    

    1. AAfferent system
    2. BEfferent system
    3. CSomatic nervous system (SNS)
27. 27The sympathetic and parasympathetic nervous system are part of the [blank_start]autonomic[blank_end] nervous system.

    1. Aautonomic
28. 28Motor and sensory nerves are [blank_start]somatic[blank_end] nerves.

    1. Asomatic
29. 29[blank_start]Motor[blank_end] nerves exit the ventral or anterior cord. These are known as [blank_start]efferent[blank_end] nerves.
    
    [blank_start]Sensory[blank_end] nerves enter the dorsal or posterior cord. These are known as [blank_start]afferent[blank_end] nerves.

    1. AMotor
    2. Befferent
    3. CSensory
    4. Dafferent
30. 30The [blank_start]neuromuscular junction[blank_end] is a specialized [blank_start]synapse[blank_end] between a motor neuron and a [blank_start]muscle fiber[blank_end]. It occurs at a structure on the muscle fiber called the [blank_start]motor end plate[blank_end]. There is usually only one per fiber.

    1. Aneuromuscular junction
    2. Bsynapse
    3. Cmuscle fiber
    4. Dmotor end plate
31. 31The [blank_start]synaptic trough[blank_end] is the invagination in the motor endplate membrane.
    
    The [blank_start]synaptic cleft[blank_end] contains large quantities of acetylcholinesterase (AChE).
    
    The [blank_start]sub neural clefts[blank_end] increase the surface area of the post-synaptic membrane. On the top of the portion are [blank_start]Ach-gated channels[blank_end] and at the bottom are voltage-gated [blank_start]Na channels[blank_end].
    in bottom half

    1. Asynaptic trough
    2. Bsynaptic cleft
    3. Csub neural clefts
    4. DAch-gated channels
    5. ENa channels
32. 32Synaptic vesicles are formed from [blank_start]budding Golgi[blank_end].

    1. Abudding Golgi
33. 33What is formed in the cytoplasm and transported into the vesicles?

    1. AAcetylcholine
    2. BNicotinic receptors
    3. CAcetylcholinesterase
    4. DTitin
34. 34Ach filled vesicles occasionally fuse with the post-synaptic membrane and release their contents. This causes [blank_start]miniature end-plate potentials[blank_end] in the post-synaptic membrane.

    1. Aminiature end-plate potentials
35. 35Action potentials for ACH release in the motor neuron begin in the [blank_start]ventral[blank_end] horn of the spinal cord.

    1. Aventral
    2. Bdorsal
36. 36Linear structures on the pre-synaptic membrane are called [blank_start]dense bars[blank_end].

    1. Adense bars
37. 37Place the following steps to neuromuscular transmission in order. 1 is step 1, the last step is step 6.
    
    Step [blank_start]4[blank_end]: The amount of calcium is increased.
    
    Step [blank_start]1[blank_end]: AP enters and depolarizes the nerve terminal.
    
    Step [blank_start]3[blank_end]: cAMP causes Ca channels to open.
    
    Step [blank_start]6[blank_end]: ACh is released into synaptic cleft.
    
    Step [blank_start]2[blank_end]: Adenylate cyclase activated ~~ cAMP
    
    Step [blank_start]5[blank_end]: Calcium causes the vesicles to fuse with nerve cell membranes.

    1. A1
    2. B2
    3. C3
    4. D4
    5. E5
    6. F6
38. 38At the [blank_start]postsynaptic membrane[blank_end], ACh combines with the 2 alpha subunits on the [blank_start]nicotinic[blank_end] receptor. This causes the channels to [blank_start]open[blank_end].

    1. Anicotinic
    2. Bpostsynaptic membrane
    3. Copen
39. 39For neuromuscular transmission, the release of ACh depends on entry of what into nerve terminal?

    1. ASodium
    2. BPotassium
    3. CCalcium
    4. DMagnesium
40. 40At the termination of neurotransmitter action,
    
    
    AChE breaks down ACh to [blank_start]choline[blank_end] and [blank_start]acetate[blank_end]. The metabolism of ACh causes [blank_start]depolarization[blank_end] to occur. [blank_start]Choline[blank_end] is then transported back into the [blank_start]nerve terminal[blank_end], which is then used to re-synthesize [blank_start]ACh[blank_end].

    1. Acholine
    2. Bacetate
    3. Cdepolarization
    4. DCholine
    5. Enerve terminal
    6. FACh
41. 41Drag and drop (not all options will be used):
    
    Nicotinic cholinergic receptors are stimulated by [blank_start]nicotine[blank_end] and [blank_start]ACh[blank_end]. They are inhibited by [blank_start]curare[blank_end].

    1. Anicotine
    2. BACh
    3. Ccurare
    4. Dmuscarinic
    5. Ecalcium
    6. Fpotassium
    7. Gacetylcholinesterase
42. 42The nicotinic cholinergic receptors (in alpha order) include:
    2 [blank_start]alpha[blank_end]
    1 [blank_start]beta[blank_end]
    1 [blank_start]delta[blank_end]
    1 [blank_start]gamma[blank_end]

    1. Aalpha
    2. Bbeta
    3. Cdelta
    4. Dgamma
43. 43For nicotinic cholinergic receptors, ACh binds to the [blank_start]2 alpha subunits[blank_end] opening the channel.

    1. A2 alpha subunits
44. 44It takes [blank_start]two[blank_end] molecules of ACh to open the acetylcholine-gated channel of the skeletal muscle [blank_start]motor end plate[blank_end].

    1. Atwo
    2. Bmotor end plate
45. 45Nicotinic cholinergic receptors are located at the motor end plate ([blank_start]postsynaptic[blank_end]) and on [blank_start]presynaptic[blank_end] nerve endings.

    1. Apostsynaptic
    2. Bpresynaptic
46. 46There are [blank_start]2[blank_end] types of postsynaptic receptors: [blank_start]junctional[blank_end] and [blank_start]exntrajunctional[blank_end].
    
    How many presynaptic receptors are there? [blank_start]One[blank_end]

    1. A2
    2. Bextrajunctional
    3. Cjunctional
    4. DOne
47. 47(Select all that apply)
    Exntrajunctional postsynaptic receptors are especially responsive to what:

    1. AACh
    2. BSux
    3. CEtomidate
    4. DNorepinephrine
    5. EEpinephrine
48. 48Exntrajunctional postsynaptic receptors tend to be located in:

    1. ADiseased or damaged skeletal muscle after an injury.
    2. BHealthy skeletal muscle.
    3. CHealthy nerve tissue.
49. 49[blank_start]Presynaptic[blank_end] ACh receptors influence the release of neurotransmitters from nerve ending.

    1. APresynaptic
50. 50Which of the following doesn't diffuse across open ACh channels?

    1. ANa
    2. BK
    3. CCl
    4. DCa
51. 51[blank_start]End plate potential[blank_end] is when a large number of sodium ions pour into a cell, creating a positive potential charge inside the muscle fiber. This increases it in a positive direction.

    1. AEnd plate potential
52. 52An increase of > 20 to 30 mV is sufficient to initiate more and more Na channels to open. This initiates a full action potential at the muscle fiber.

    1. A10 to 20
    2. B20 to 30
    3. C30 to 40
    4. D40 to 50
53. 53[blank_start]Acetylcholinesterase[blank_end] terminates the process by which nACh receptor channels produce an end plate potential.

    1. AAcetylcholinesterase
54. 54The presynaptic nicotinic receptors on the motor nerve terminal are an example of a [blank_start]positive[blank_end] feedback system because they prevent the depletion of ACh at the neuromuscular junction.

    1. Apositive
55. 55Hypocalcemia causes a [blank_start]decrease[blank_end] in the amount of neurotransmitter released.
    
    Hyperkalemia causes an [blank_start]increase[blank_end] in the amount of neurotransmitter released.

    1. Adecrease
    2. Bincrease
56. 56[blank_start]Hypomagnesia[blank_end] increases the amount of neurotransmitter increased.
    
    [blank_start]Hypermagnesia[blank_end] decreases the amount of neurotransmitter released.

    1. AHypomagnesia
    2. BHypermagnesia
57. 57[blank_start]Curariform[blank_end] drugs are end plate potential inhibitors. They block [blank_start]nicotinic[blank_end] ACH channels by competing for ACh binding sites. They [blank_start]reduce[blank_end] amplitude of end plate potential, therefore, no ATP.

    1. ACurariform
    2. Bnicotinic
    3. Cmuscarinic
    4. Dreduce
    5. Eincrease
58. 58[blank_start]Botulinum toxin[blank_end] decreases the release of ACh from nerve terminals. As a result, it's [blank_start]not enough[blank_end] of a stimulus to initiate an action potential.

    1. ABotulinum toxin
    2. BCurariform drugs
    3. CACh-Like drugs
    4. DAnti-AChE
    5. Enot enough
    6. Ftoo much
59. 59Drugs that inhibit end plate potential are: [blank_start]curariform drugs[blank_end] and [blank_start]Botulinum toxin[blank_end].
    
    Drugs that stimulate end plate potential are [blank_start]ACh-like drugs[blank_end] and [blank_start]Anti-AChE[blank_end].

    1. Acurariform drugs
    2. BBotulinum toxin
    3. CACh-like drugs
    4. DAnti-AChE
60. 60Click on the boxes of drugs that are ACh-like drugs:

    1. Amethacholine
    2. Bcarbachol
    3. Cphysostigmine
    4. Dneostigmine
    5. Enicotine
    6. Fcurariform drugs
61. 61Check on all the drugs that are Anti-AChE drugs that block the degradation of ACh, prolonging its effect.

    1. Aneostigmine
    2. Bmethacholine
    3. Cphysostigmine
    4. Ddiisopropyl fluorophosphate (nerve gas)
    5. Enicotine
62. 62What drug type works by binding and activating nicotinic ACh receptors and aren't destroyed by AChE, this prolonging the effect of acetylcholine?

    1. AAnti-AChE
    2. BCurariform drugs
    3. CBotulinum toxin
    4. DACh-like drugs
63. 63What condition is an autoimmune disease that causes the body to make antibodies against the nicotinic ACh receptor?

    1. ALambert-Eaton myasthenic syndrome
    2. BMyasthenia gravis
    3. CMultiple sclerosis
    4. DGrave's disease
64. 64What drug is the treatment of choice for myasthenia gravis?

    1. APhysostigmine
    2. BNeostigmine
    3. CBotulinum toxin
    4. DMethacholine
65. 65What medical condition causes an autoimmune attack against voltage-gated calcium channels on the presynaptic motor nerve terminal?

    1. AMyasthenia graves
    2. BLambert-Eaton Myasthenic Syndrome
    3. CBotulism
    4. DCerebral palsy
66. 66Lambert-Eaton Myasthenic Syndrome is treated with [blank_start]neostigmine[blank_end].

    1. Aneostigmine
67. 67Identify the following characteristics of skeletal muscle versus cardiac muscle:
    
    Vertebrate skeletal muscle has: [blank_start]two[blank_end] T-tubule networks per sarcomere. They are located near the [blank_start]ends of the myosin filaments[blank_end].
    
    Cardiac muscle has [blank_start]a single[blank_end] T-tubule network per sarcomere. They are located at the [blank_start]level of the Z-disc[blank_end].

    1. Atwo
    2. Ba single
    3. Cends of the myosin filaments
    4. Dlevel of the Z-disc
68. 68What condition causes a constant leak of Calcium through ryanodine receptors?

    1. AMalignant hyperthermia
    2. BMyasthenia gravis
    3. CLambert Eaton Myasthenic Syndrome
69. 69Match the following characteristic of skeletal muscle versus cardiac muscle:
    Skeletal Muscle
    Trigger for SR release is [blank_start]voltage.[blank_end]
    The T-tubule membrane has a [blank_start]voltage sensor[blank_end].
    The ryanodine receptor is the [blank_start]SR Ca-release channel.[blank_end]
    Ca release is proportional to [blank_start]membrane voltage[blank_end].
    
    Cardiac Muscle
    Trigger for SR release is [blank_start]calcium[blank_end].
    The T-tubule membrane has a [blank_start]calcium channel[blank_end].
    The ryanodine receptor is the SR Ca-release channel.
    The ryanodine receptor is Ca gated and calcium release is [blank_start]proportional to Ca entry[blank_end].

    1. Avoltage.
    2. Bvoltage sensor
    3. CSR Ca-release channel.
    4. Dmembrane voltage
    5. Ecalcium
    6. Fcalcium channel
    7. Gproportional to Ca entry
70. 70Smooth muscle has/does not have striations.

    1. Ahas
    2. Bdoes not have
71. 71Smooth muscle has [blank_start]dense bodies[blank_end] in the cytoplasm instead of [blank_start]Z-lines[blank_end].

    1. Adense bodies
    2. BZ-lines
72. 72Smooth muscle lack [blank_start]troponin[blank_end]. They also have few [blank_start]mitochondria[blank_end] because they rely on [blank_start]glycolysis[blank_end] for metabolism.

    1. Atroponin
    2. Btropomyosin
    3. Cmitochondria
    4. Dsarcoplasmic reticulum
    5. Eglycolysis
    6. Fpyruvate metabolism
73. 73Select the areas where smooth muscle is located in the body:

    1. AGI tract
    2. BHeart
    3. CBladder
    4. DKidneys
    5. EUterus
    6. FBronchioles
    7. GEye muscles
74. 74A function of __________ muscle is to produce motility and to maintain tension.

    1. Askeletal muscle
    2. Bsmooth muscle
    3. Ccardiac muscle
75. 75Identify some key characteristics of unitary smooth muscle:
    [blank_start]Gap junctions between cells[blank_end]
    [blank_start]Functions in a syncytial fashion[blank_end]
    [blank_start]Has spontaneous pacemaker activity[blank_end]

    1. AGap junctions between cells
    2. BW/O interconnecting gap junction bridges
    3. CFunctions in a syncytial fashion
    4. DEach fiber contracts independently
    5. EHas spontaneous pacemaker activity
    6. FInnervated by postganglionic fibers
76. 76This image is an example of what type of muscle?

    

    1. AMulti-unit smooth muscle
    2. BSingle-unit smooth muscle
77. 77This is an example of what type of muscle?

    

    1. ASingle-unit smooth muscle
    2. BMulti-unit smooth muscle
78. 78[blank_start]Multi-unit smooth muscle[blank_end] is tissue made of discrete bundles of cells which are densely innervated and contract only in response to its innervation. Examples include the iris of the eye and vas deferens.

    1. AMulti-unit smooth muscle
79. 79A major difference between multiunit smooth muscle and unitary smooth muscle is the presence and/or lack of [blank_start]gap junction bridges[blank_end].

    1. Agap junction bridges
80. 80In the smooth muscle excitation-contraction coupling, the interaction of actin and myosin is controlled by Ca binding to [blank_start]calmodulin[blank_end].

    1. Acalmodulin
81. 81Two additional sources of intracellular calcium are: [blank_start]ligand-dated Calcium[blank_end] channels in the sarcolemma membrane and [blank_start]IP-gated Ca channels[blank_end] in sarcoplasmic reticulum membrane.

    1. Aligand-dated Calcium
    2. BIP-gated Ca channels
82. 82Enter the steps for opening a voltage-gated Ca channel in the smooth muscle:
    
    [blank_start]3[blank_end]. Ca flows into cell down electrochemical gradient.
    
    [blank_start]1[blank_end]. Ca channels in the sarcolemmal membrane.
    
    [blank_start]2[blank_end]. Open with depolarization during action potential.

    1. A3
    2. B2
    3. C1
    4. D1
    5. E2
    6. F3
    7. G2
    8. H1
    9. I3
83. 83Select some of the ways besides nervous system and action potentials that smooth muscle vasodilates:

    1. ALack of oxygen in tissues
    2. BExcess bicarb
    3. CExcess CO2
    4. DExcess Hydrogen ions
    5. EIncreased amounts of potassium
    6. FIncreased amounts of Ca ions
84. 84If the muscle cell membrane has [blank_start]excitatory[blank_end] hormone-gated receptors, smooth muscle contraction occurs.
    
    If the muscle cell membrane has [blank_start]inhibitory[blank_end] hormone-gated receptors, relaxation occurs.

    1. Aexcitatory
    2. Binhibitory
85. 85Hormones can cause contraction or inhibition without directly changing membrane potential.

    1. ATrue
    2. BFalse
86. 86True or false: The SR in smooth muscle are not well-developed.

    1. ATrue
    2. BFalse
87. 87[blank_start]Caveolae[blank_end] are small invaginations in the smooth muscle cell membrane that are near the SR.

    1. ACaveolae
88. 88Force of smooth muscle contraction is highly dependent upon [blank_start]ECF[blank_end] calcium ion concentration.

    1. AECF
    2. BICF
89. 89In order for smooth muscle cell to relax, Calcium ions must be removed from [blank_start]ICF[blank_end]. This process in much [blank_start]slower[blank_end] than in skeletal muscle because the Ca moves via a pump.

    1. AICF
    2. BECF
    3. Cslower
    4. Dfaster
90. 90What is the initial precursor to norepinephrine?

    1. ATyramine
    2. BMAO
    3. CTyrosine
    4. DAmine
91. 91Norepinephrine and serotonin are normally destroyed by the enzyme [blank_start]monoamine oxidase (MAO)[blank_end].

    1. Amonoamine oxidase (MAO)
92. 92The Central Nervous System (CNS) is further divide into:
    
    1. [blank_start]Afferent (Sensory) System[blank_end] AND 2. E[blank_start]fferent (Motor) System[blank_end]
    
    The next divisions are:
    
    3. [blank_start]Somatic Nervous System[blank_end] AND 4. [blank_start]Autonomic Nervous System[blank_end]
    
    Which is further divided into
    
    5. [blank_start]Sympathetic Nervous System[blank_end] AND 6. [blank_start]Parasympathetic Nervous System[blank_end]

    1. AAfferent (Sensory) System
    2. Bfferent (Motor) System
    3. CSomatic Nervous System
    4. DAutonomic Nervous System
    5. ESympathetic Nervous System
    6. FParasympathetic Nervous System
93. 93Anesthesia practice is largely spent taking advantage of or avoiding the [blank_start]autonomic nervous system (ANS)[blank_end] side effects of anesthetic drugs.

    1. Aautonomic nervous system (ANS)
94. 94Drag and drop the descriptors to the appropriate category of Somatic or Autonomic Nervous System.
    
    Somatic Efferent
    
    Effectors: [blank_start]Skeletal muscles[blank_end]
    Types of Control: [blank_start]Voluntary[blank_end]
    Neural pathway: [blank_start]One efferent neuron extends from the CNS[blank_end]
    Action on effector: [blank_start]Always excitatory[blank_end]
    Neurotransmitters: [blank_start]Acetylcholine (ACh)[blank_end]
    
    Autonomic
    
    Effectors: [blank_start]Cardiac & smooth muscle,[blank_end] glandular epithelium
    Types of Control: [blank_start]Involuntary[blank_end]
    Neural pathway: One efferent neuron extends for the CNS and synapses with another efferent neuron
    Action on effector: [blank_start]May be excitatory or inhibitory[blank_end]
    Neurotransmitters: [blank_start]Acetylcholine or norepinephrine[blank_end]

    1. ASkeletal muscles
    2. BVoluntary
    3. COne efferent neuron extends from the CNS
    4. DAlways excitatory
    5. EAcetylcholine (ACh)
    6. FCardiac & smooth muscle,
    7. GInvoluntary
    8. HMay be excitatory or inhibitory
    9. IAcetylcholine or norepinephrine
95. 95The ANS controls the visceral functions of the body, including partial control over (check all that apply):

    1. ASystemic blood pressure
    2. BGI motility and secretion
    3. CUrinary bladder emptying
    4. DReflex movement
    5. ESweating
    6. FThermal homeostasis
96. 96The [blank_start]ANS[blank_end] is the portion of the nervous system that regulates the activities of smooth muscle, cardiac muscle, and glands.

    1. AANS
97. 97The regulatory centers of the ANS are in the:

    1. Acerebral cortex
    2. Bhypothalamus
    3. Cbrain stem
    4. Dmedulla oblongata
    5. ESpinal cord
98. 98The divisions of the autonomic nervous system are:
    1. [blank_start]Sympathetic nervous system[blank_end]
    2. [blank_start]Parasympathetic nervous system[blank_end]
    3. [blank_start]Enteric nervous system[blank_end]

    1. ASympathetic nervous system
    2. BParasympathetic nervous system
    3. CEnteric nervous system
99. 99While the SNS and PNS typically function as physiologic antagonists, they both influence the [blank_start]GI[blank_end] system.

    1. AGI
100. 100The [blank_start]cerebral cortex[blank_end] is the highest level of ANS integration.
     
     [blank_start]Hypothalamic nuclei[blank_end] are the peripheral sites for ANS organization.
     
     The [blank_start]medulla[blank_end] and [blank_start]pons[blank_end] are the vital centers for hemodynamic and ventilatory control, integrating and maintaining the automaticity of ventilation.

     1. Acerebral cortex
     2. BHypothalamic nuclei
     3. Cpons
     4. Dmedulla
101. 101Preganglionic fibers of the [blank_start]SNS[blank_end] arise from cells in the thoracolumbar portions of the spinal cord.

     1. ASNS
102. 102Cell bodies of the preganglionic fibers of the [blank_start]PNS[blank_end] originate in the craniosacral region.

     1. APNS
103. 103First-order neurons of the [blank_start]SNS[blank_end] and [blank_start]PNS[blank_end] originate within the central nervous system (CNS), and preganglionic fibers relay impulses to second-order neurons known as [blank_start]autonomic ganglia[blank_end]

     1. ASNS
     2. BPNS
     3. Cautonomic ganglia
104. 104The autonomic ganglion contains the cell bodies of the postganglionic fibers responsible for relaying the information to the [blank_start]effector organ[blank_end].

     1. Aeffector organ
105. 105Preganglionic fibers of the SNS and PNS [blank_start]are[blank_end] myelinated. Postganglionic fibers [blank_start]are not[blank_end].
     
     Myelinated fibers are rapidly conducting.

     1. Aare
     2. Bare not
106. 106The postganglionic fibers of the SNS are distributed [blank_start]more widely[blank_end] in the body for mass reflex response. The distribution of the PNS is [blank_start]more limited[blank_end].

     1. Amore widely
     2. Bmore limited
107. 107The [blank_start]PNS[blank_end] has its terminal ganglia near the organ innervated and is more discrete in its discharge of impulses.

     1. APNS
     2. BANS
108. 108Thepreganglionic fibers of the SNS originate in the intermediolateral column of the thoracic ([blank_start]T1-T12[blank_end]) and the first three lumbar segments ([blank_start]L1-L3[blank_end]) of the spinal cord

     1. AT1-T12
     2. BL1-L3
109. 109 The myelinated motor nerves leave the spinal cord as white communicating fibers and synapse at one of three different types of ganglia: one of the [blank_start]paired[blank_end] chains of 22 sympathetic ganglia, an unpaired prevertebral ganglia, or a terminal ganglia

     1. Apaired
110. 110An exception to the usual synapse rules of the SNS are the adrenal glands. They are innervated by the [blank_start]preganglionic[blank_end] fibers that bypass the paravertebral ganglia.

     1. Apreganglionic
111. 111[blank_start]SNS[blank_end] stimulation of the adrenal medulla is triggered by [blank_start]acetylcholine[blank_end], which then triggers the release of epinephrine (80 percent) and norepinephrine.

     1. ASNS
     2. Bacetylcholine
112. 112Epinephrine and NE released by the adrenal medulla function as [blank_start]hormones[blank_end], not as [blank_start]neurotransmitters[blank_end].

     1. Ahormones
     2. Bneurotransmitters
113. 113[blank_start]Preganglionic neurons[blank_end] stimulate nicotinic receptors on postganglionic sympathetic neurons by releasing acetylcholine.
     
     [blank_start]Postganglionic neurons[blank_end] synapse at targeted end-organs by releasing norepinephrine.

     1. APreganglionic neurons
     2. BPostganglionic neurons
114. 114The effector organs of the SNS have [blank_start]adrenergic[blank_end] receptors. They are characterized as [blank_start]alpha[blank_end], [blank_start]beta[blank_end], and [blank_start]dopamine[blank_end] receptors.

     1. Aadrenergic
     2. Balpha
     3. Cbeta
     4. Ddopamine
115. 115The preganglionic fibers of the SNS and PNS release [blank_start]acetylcholine[blank_end] as the neurotransmitter at the preganglionic neuronal site.

     1. Aacetylcholine
116. 116The post-ganglionic fibers of the SNS release [blank_start]norepinephrine[blank_end] or [blank_start]dopamine[blank_end] as the neurotransmitter.

     1. Anorepinephrine
     2. Bdopamine
117. 117Norepinephrine stimulates [blank_start]a[blank_end] and [blank_start]B-adrenergic[blank_end] receptors, whereas dopamine stimulates dopamine receptors present on the effector site.

     1. Aa
     2. Bdopamine
     3. CB-adrenergic
118. 118Which receptors are most located on the postsynaptic membranes of the vascular and intestinal smooth muscle and endocrine glands and a few are present in the heart?

     1. Aa1
     2. Ba2
     3. Cb1
     4. Db2
     5. Edopamine
119. 119Which receptors are usually pre-synaptic (except in the CNS) and function in a negative-feedback loop such that their activation inhibits subsequent release of the neurotransmitter epinephrine.

     1. Aa1
     2. Ba2
     3. Cb1
     4. Db2
     5. Edopamine
120. 120Check all that apply as the responses to beta-1 receptors in the SNS to synthetic drugs.

     1. AIncreased heart rate
     2. BIncreased contractility
     3. CDilation
     4. DIncreased conduction velocity
     5. EInsulin secretion
121. 121What are three examples of drugs with beta-1 agonist activities?

     1. AClonidine
     2. BDobutamine
     3. CDopamine
     4. DIsuprel
     5. EPhenylephrine
122. 122Beta-2 receptors have effects on which four organs?

     1. ABlood vessels (especially skeletal and coronary arteries)
     2. BBronchioles
     3. CHeart
     4. DIntestine
     5. ELiver
     6. FUterus
123. 123The response to beta-2 stimulation includes what?

     1. ADilation
     2. BIncreased heart rate
     3. CIncreased contractility
     4. DRelaxation
     5. EGlycogenolysis
     6. FGlucogenesis
124. 124Check the drugs that are beta-2 agonists.

     1. AAlbuterol
     2. BDopamine
     3. CRitodrine
     4. DTimolol
125. 125Name the effector organs of the alpha-1 receptors.

     1. ABlood vessels
     2. BIntestine and bladder
     3. CPlatelets
     4. DHeart
     5. EPancreas
126. 126Name the response to stimulation of alpha-1 receptors.

     1. AConstriction
     2. BInhibition of insulin secretion
     3. CIncrease in potassium conductance
     4. DRelaxation
     5. EConstriction of sphincters
127. 127[blank_start]Phenylephrine[blank_end] and [blank_start]high-dose dopamine[blank_end] are alpha-1 agonists.

     1. APhenylephrine
     2. BClonidine
     3. CPrecedex
     4. Dhigh-dose dopamine
     5. Edopamine
     6. Fdobutamine
     7. Galbuterol
128. 128What are the effector organs of alpha-2 receptors?

     1. ACentral nervous system (postsynaptic)
     2. BBlood vessels
     3. CPancreas
     4. DPlatelets
     5. EPostganglionic (presynaptic sympathetic nerve ending)
129. 129Name the effects of alpha-2 agonists in response to stimulation.

     1. AInhibition of NE release
     2. BConstriction
     3. CIncrease in potassium conductance
     4. DAggregation
     5. ERelaxation
130. 130What is the receptor organ for dopamine-1 receptors?

     1. ABlood vessels
     2. BKidneys
     3. CHeart
     4. DPancreas
131. 131What medication is an agonist to dopamine-1?

     1. ADopamine
     2. BFenoldopam
     3. CPrecedex
     4. DPhenylephrine
132. 132What medication works on dopamine-2 receptors?

     1. AFenoldopam
     2. BPhenylephrine
     3. CNE
     4. DDopamine
133. 133Tyrosine is converted into dopamine during [blank_start]norepinephrine[blank_end] synthesis.

     1. Anorepinephrine
134. 134Put the synthesis of norepinephrine in order, 1 being the first and 3 being the last.
     
     [blank_start]2[blank_end]. In the cytoplasm tyrosine is converted into dopamine via a two-step process.
     
     [blank_start]1[blank_end]. The active transport of tyrosine into the adrenergic presynaptic nerve terminal cytoplasm.
     
     [blank_start]3[blank_end]. Dopamine is transported into storage vesicles where it is B-hydroxylated to NE.

     1. A2
     2. B1
     3. C3
135. 135NE is removed from the synaptic junction by two (three) mechanisms:
     – Reuptake(primary mechanism and most important) into the presynaptic terminal → availability for reuse
     – Enzymatic metabolism by monoamine oxidase (MAO) and COMT → metabolites (3-methoxy-4-hydroxy- mandelic acid ([blank_start]VMA[blank_end]), metanephrine, and normetanephrine)
     – Diffusion

     1. AVMA
136. 136In the adrenal medulla, most of the formed [blank_start]norepinephrine[blank_end] is converted to the hormone epinephrine by the action of PNM. The activity of PNM is enhanced by [blank_start]cortisol[blank_end].

     1. Anorepinephrine
     2. Bcortisol
137. 137Addison's disease is the result of [blank_start]adrenocortical[blank_end] insufficiency.

     1. Aadrenocortical
138. 138The [blank_start]PNS[blank_end] has its cell bodies in the brainstem and the sacral segment of the spinal cord.

     1. APNS
     2. BANS
     3. CCNS
139. 139About 75 percent of all PNS fibers are in the [blank_start]vagus[blank_end] nerve.

     1. Avagus
140. 140Cranial nerve [blank_start]III[blank_end] passes to the eye.
     
     Cranial nerve [blank_start]VII[blank_end] passes to the lacrimal, nasal, and submaxillary glands.
     
     Cranial nerve [blank_start]IX[blank_end] innervates the parotid gland.
     
     Cranial nerve [blank_start]X[blank_end] innervates the thoracic and abdominal regions of the body.

     1. AIII
     2. BII
     3. CVII
     4. DV
     5. EIX
     6. FVIII
     7. GX
     8. HXI
141. 141[blank_start]Sacral[blank_end] nerves distribute fibers to the distal colon, rectum, bladder, and lower portions of the uterus.

     1. ASacral
142. 142The preganglionic fiber of the [blank_start]PNS[blank_end] pass near uninterrupted to ganglia near or in the innervated organ.

     1. APNS
     2. BSNS
     3. CANS
143. 143[blank_start]Acetylcholine[blank_end] is the principle neurotransmitter released at the postganglionic fibers of the PNS.

     1. AAcetylcholine
144. 144Postganglionic fibers of the PNS that release acetylcholine as the neurotransmitter are described as [blank_start]cholinergic[blank_end]. Postsynaptic receptor sites are described as [blank_start]nicotinic[blank_end] (Somatic site) and [blank_start]muscarinic[blank_end].

     1. Acholinergic
     2. Bnicotinic
     3. Cmuscarinic
145. 145Drugs that are PNS receptor-agonists include [blank_start]Methacholine[blank_end] and [blank_start]Carbacohol[blank_end].
     
     Drugs that are PNS receptor-antagonists are [blank_start]Atropine[blank_end], [blank_start]Scopolamine[blank_end], and [blank_start]Glycopyrrolate[blank_end].

     1. AMethacholine
     2. BCarbacohol
     3. CAtropine
     4. DScopolamine
     5. EGlycopyrrolate
146. 146Muscarinic receptors affect what organ predominantly?

     1. AKidney
     2. BPancreas
     3. CBronchioles
     4. DAutonomic ganglia
147. 147The effector organ of nicotinic receptors are [blank_start]autonomic ganglia.[blank_end]

     1. Aautonomic ganglia.
148. 148The response to nicotinic receptor stimulation is [blank_start]SNS stimulation[blank_end].

     1. ASNS stimulation
149. 149Synthesis of acetylcholine occurs in the [blank_start]cytoplasm[blank_end] of the preganglionic and postganglionic parasympathetic nerve endings. [blank_start]Choline acetyltransferase (CAT)[blank_end] catalyzes the combination of choline and acetyl coenzyme A into acetylcholine.

     1. ACholine acetyltransferase (CAT)
     2. Bcytoplasm
150. 150Each binds and activates [blank_start]nicotinic[blank_end] receptors in autonomic ganglia and at neuromuscular junctions and [blank_start]muscarinic[blank_end] receptors at numerous sites.

     1. Amuscarinic
     2. Bnicotinic
151. 151Acetylcholine has a brief effect at receptors before undergoing rapid hydrolysis by [blank_start]acetylcholinesterase[blank_end] to choline and acetate.

     1. Aacetylcholinesterase
152. 152[blank_start]Tricyclic antidepressants[blank_end], [blank_start]cocaine[blank_end] and [blank_start]ketamine[blank_end] all work to inhibit the uptake of neurotransmitter on the ANS.

     1. ATricyclic antidepressants
     2. BPhenylephrine
     3. Ccocaine
     4. DPrecedes
     5. Eketamine
     6. FClonidine
153. 153Select all the drugs that act on the ANS that mimic the action of neurotransmitter at the receptors.

     1. APhenylephrine
     2. BTricyclic antidepressants
     3. CPrecedex
     4. DCocaine
154. 154Which drugs inhibit the action of neurotransmitters on the postsynaptic receptors? This is on alpha-1, alpha-2, beta-1, and beta-2 areas.

     1. APrazosin
     2. BPrecedex
     3. CPhenylephrine
     4. DMetoprolol
     5. EEsmolol
     6. FPropranolol
155. 155[blank_start]Atropine[blank_end] works on the SNS by inhibiting the metabolism of neurotransmitter on postsynaptic receptors on the muscarinic and nicotinic receptors.

     1. AAtropine
156. 156What drugs work by inhibiting the metabolism of neurotransmitter on the ANS?

     1. AMonoamine oxidase inhibitors
     2. BNeostigmine
     3. CEdrophonium
     4. DPyridostigmine
     5. EPropanolol
     6. FPrazosin
157. 157The [blank_start]systemic[blank_end] circulation contains 84 percent of blood volume.

     1. Asystemic
     2. Bpulmonary
158. 158The [blank_start]pulmonary[blank_end] circulation contains 16 percent of the blood volume.

     1. Apulmonary
159. 159The [blank_start]arterioles[blank_end] act as control conduits for blood being released to capillaries. Their strong muscular wall can close the arteriole completely or relax, causing great amounts of dilation.

     1. Aarterioles
160. 160[blank_start]Capillaries[blank_end] exchange fluid, nutrients, electrolytes, and hormones between blood and interstitial fluid. They have very thin walls and numerous minute pores.
     
     [blank_start]Venules[blank_end] collect blood from capillaries.
     
     [blank_start]Veins[blank_end] act as conduits for transport of blood from venues back to heart. They act as a major reservoir for extra blood.

     1. ACapillaries
     2. BVenules
     3. CVeins
161. 161Total blood volume is [blank_start]2/3[blank_end] preload and [blank_start]1/3[blank_end] after load.

     1. A2/3
     2. B1/3
162. 162A majority of the blood volume is where?

     1. AVeins
     2. BArterioles
     3. CCapillaries
163. 163[blank_start]Capillaries[blank_end] have a much greater cross-sectional area than other types of arteries and veins.

     1. ACapillaries
164. 164Arteries and veins have multiple lumens while [blank_start]capillaries[blank_end] do not.

     1. Acapillaries
165. 165Velocity of Blood Flow = [blank_start]Blood Flow[blank_end] / [blank_start]Cross-sectional Area[blank_end]

     1. ABlood Flow
     2. BCross-sectional Area
166. 166Blood flow velocity and total cross sectional area are [blank_start]inversely[blank_end] related.

     1. Ainversely
167. 167The Blood Pressure Profile in the Circulatory System:
     1. [blank_start]High[blank_end] pressures in the arterial tree.
     2. [blank_start]Low[blank_end] pressure in the venous side of the circulation.
     3. [blank_start]Large[blank_end] pressure drop across the arteriolar-capillary junction.

     1. AHigh
     2. BLow
     3. CLarge
168. 168[blank_start]Blood Flow:[blank_end]
     Controlled in relation to tissue needs
     [blank_start]Cardiac Output:[blank_end]
     1. Mainlycontrolledbylocaltissueflow
     2. Respondstodemandsoftissuesautomatically
     3. Needs specialized nerve signal input to pump required amounts
     of blood flow
     [blank_start]Arterial pressure[blank_end]
     Controlled independent of: 1. Localbloodflowcontrol 2. Cardiac output control

     1. ABlood Flow:
     2. BCardiac Output:
     3. CArterial pressure
169. 169Q=Δ[blank_start]P[blank_end]/[blank_start]R[blank_end]

     1. AP
     2. BR
170. 170The [blank_start]pressure difference[blank_end] between the two ends of the vessel of the force that pushes the blood thru the vessel.

     1. Apressure difference
171. 171Flow rate determined by [blank_start]difference[blank_end] in pressure between two points in the vessel, not by absolute pressure within the vessel.

     1. Adifference
172. 172According to Ohm's law:
     1. Flow is [blank_start]directly[blank_end] proportional to the pressure difference.
     2. Flow is [blank_start]inversely[blank_end] proportional to the resistance.

     1. Adirectly
     2. Binversely
173. 173Determinants of Blood Flow:
     Flow = [blank_start]arterial[blank_end] - [blank_start]venous[blank_end] pressure / resistance (R)

     1. Aarterial
     2. Bvenous
174. 174The overall flow in the circulation of an adult is how many liters per minute?

     1. A3
     2. B4
     3. C5
     4. D6
175. 175[blank_start]Viscosity[blank_end] is the degree of slipperiness between two layers of fluid.

     1. AViscosity
176. 176[blank_start]Laminar[blank_end] flow is silent. [blank_start]Turbulent[blank_end] flow tends to cause murmurs.

     1. ALaminar
     2. BTurbulent
177. 177When Reynold's number is greater than [blank_start]2,000[blank_end], turbulent flow will occur even in small, straight vessels.

     1. A2,000
178. 178[blank_start]Blood pressure[blank_end] is the force exerted by the blood against any unit area of vessel wall.

     1. ABlood pressure
179. 179[blank_start]Conductance[blank_end] is the measure of flow through a vessel for a given pressure difference.

     1. AConductance
180. 180Poiseulle's Law states that slight changes in vessel [blank_start]diameter[blank_end] affect conductance of flow when flow is laminar.

     1. Adiameter
181. 181According to Poiseulle's Law, the flow through each vessel increases to the [blank_start]fourth[blank_end] power of its radius.

     1. Afourth
182. 182The formula for conductance is C = 1 / [blank_start]Radius[blank_end]

     1. ARadius

Description

This covers Chapters 14, 6, 7, and 8.

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Rachel Nall

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English

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