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Human Anatomy & Physiology, 10e, (Marieb)Chapter 19 The Cardiovascular System: Blood Vessels

19.1 Matching Questions

Figure 19.1

Using Figure 19.1, match the following:A) AB) BC) C

1) Sinusoid capillary.Section: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

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2) Capillary found in endocrine organs that allows hormones to gain rapid entry into the blood.Section: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

3) Capillary with intercellular clefts found in the skin and muscles.Section: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

4) Capillary that have a discontinuous, incomplete basement membrane.Section: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

5) Capillary found where active capillary absorption of filtrate occurs.Section: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 1) C 2) B 3) A 4) C 5) B


Figure 19.2

Using Figure 19.2, match the following:A) EB) BC) DD) CE) A

6) Splenic vein.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

7) Superior mesenteric vein.Section: 19.3Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge


8) Inferior mesenteric vein.Section: 19.3Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

9) Hepatic portal vein.Section: 19.3Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

10) Right gastroepiploic vein.Section: 19.3Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 6) B 7) A 8) C 9) E 10) D


Match the following:A) Inferior mesenteric arteryB) Internal iliac arteryC) Common hepatic arteryD) Renal arteryE) Aorta

11) Largest artery of the body.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

12) Supplies the kidney.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

13) Supplies the duodenum and stomach.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

14) Supplies the distal areas of the large intestine.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

15) Supplies pelvic structures.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge


16) Artery that does not anastomose.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 11) E 12) D 13) C 14) A 15) B 16) D


Match the following:A) External iliac arteryB) Internal carotid arteryC) Brachiocephalic trunkD) Celiac trunkE) Radial artery

17) Gives rise to the right common carotid and right subclavian artery.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

18) Supplies a lower limb.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

19) Common site to take the pulse.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

20) Major supply to the cerebral hemispheres.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

21) Large unpaired branch of the abdominal aorta that supplies the liver, stomach, and spleen.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 17) C 18) A 19) E 20) B 21) D


Match the following:A) External jugular veinB) Pulmonary trunkC) Superior vena cavaD) Subclavian veinE) Axillary artery

22) Receives blood from all areas superior to the diaphragm, except the heart wall.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

23) Carries oxygen-poor blood to the lungs.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

24) Drains the scalp.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

25) Runs through the armpit area, giving off branches to the axillae, chest wall, and shoulder girdle.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

26) Drains an upper extremity, a deep vein.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 22) C 23) B 24) A 25) E 26) D


Match the following:A) Superior mesenteric arteryB) Brachial arteryC) Pulmonary veinD) Femoral arteryE) Great saphenous vein

27) Artery usually ausculated to take the blood pressure.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

28) Major artery of the thigh.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

29) Supplies the small intestine.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

30) Carries oxygen-rich blood from the lungs.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

31) Vessel commonly used as a coronary bypass vessel.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 27) B 28) D 29) A 30) C 31) E


Match the following:A) Large arteriesB) Large veinsC) CapillariesD) Large arteries E) Arterioles

32) Site where resistance to blood flow is greatest.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

33) Site where exchanges of food and gases are made.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

34) Site where blood pressure is lowest.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

35) Site where the velocity of blood flow is fastest.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

36) Site where the velocity of blood flow is slowest.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge


37) Site where the blood volume is greatest.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

38) Site where the blood pressure is greatest.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

39) Site that is the major determinant of peripheral resistance.Section: 19.2-19.4Learning Outcome: 19.3-19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 32) E 33) C 34) B 35) D 36) C 37) B 38) A 39) E


Match the following:A) Circulatory shockB) Cardiogenic shockC) Hypovolemic shockD) Vascular shock

40) Results from heart inability to sustain adequate circulation due to myocardial damage.Section: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

41) Due to inadequate blood flow to meet tissue needs.Section: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

42) Normal blood volume but poor circulation due to extreme vasodilation.Section: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

43) Due to large-scale blood loss.Section: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

Answers: 40) B 41) A 42) D 43) C


19.2 True/False Questions

1) The adjustment of blood flow to each tissue in proportion to its requirements at any point in time is termed autoregulation.Answer: TRUESection: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

2) Arterial pressure in the pulmonary circulation is much higher than in the systemic circulation because of its proximity to the heart.Answer: FALSESection: Part 3Learning Outcome: 19.14Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

3) Osmotic pressure is created by the presence in a fluid of small diffusible molecules that easily move through the capillary membrane.Answer: FALSESection: 19.6Learning Outcome: 19.7Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

4) The cerebral arterial circle (circle of Willis) is an arterial anastomosis.Answer: TRUESection: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

5) The carotid sinus reflex protects the blood supply to the brain, whereas the aortic reflex is more concerned with maintaining adequate blood pressure in the systemic circuit as a whole.Answer: TRUESection: 19.7Learning Outcome: 19.8Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge


6) The pulmonary circulation does not directly serve the metabolic needs of body tissues.Answer: TRUESection: Part 3Learning Outcome: 19.14Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

7) An obstruction in the superior vena cava would decrease the flow of blood from the head and neck to the heart.Answer: TRUESection: Part 3Learning Outcome: 19.15Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

8) Arteries supplying the same territory are often merged with one another, forming arterial anastomoses.Answer: TRUESection: 19.5Learning Outcome: 19.6Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

9) An increase in blood viscosity will cause an increase in peripheral resistance.Answer: TRUESection: 19.2Learning Outcome: 19.3Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

10) Whereas diffusion is more important for solute exchange between plasma and interstitial fluid, bulk flow is more important for regulation of the relative volumes of blood and interstitial fluid.Answer: TRUESection: 19.10Learning Outcome: 19.13Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application


1.3 Multiple Choice Questions

1) Reduction in the concentration of albumin in blood plasma would alter capillary exchange by ________.A) increasing hydrostatic pressure and blood volume, blood pressure increasesB) decreasing colloid osmotic pressure and edema will occurC) increasing hydrostatic pressure and edema will occurD) decreasing colloid osmotic pressure and blood volume, blood pressure increasesAnswer: BSection: 19.10Learning Outcome: 19.13Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

2) If a person were to have substantial blood loss you would expect to see all of the following physiological events to except one. Select the least likely response to substantial blood loss. A) increasing vasomotor toneB) decreased heart rateC) increases peripheral resistanceD) a weak, thread pulseAnswer: BSection: 19.8Learning Outcome: 19.9Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

3) During a marathon which of the following hormones is least likely to be released by the runner? A) epinephrineB) antidiuretic hormone (ADH)C) angiotensin IID) atrial natriuretic peptide (ANP)Answer: DSection: 19.8Learning Outcome: 19.9Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

4) If a person stands up suddenly from the prone (lying) position they may feel a sudden dizzy or lightheadedness. Which of the following is the least likely physiological response to this situation?A) increased sympathetic output to the heartB) faster heart rate and greater heart contractilityC) increased parasympathetic nerve impulses to the heart


D) increasing peripheral resistance due to vasoconstrictionAnswer: CSection: 19.8Learning Outcome: 19.9Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

5) A drug that restricts the activity of angiotensin converting enzyme (ACE) would like result in all of the following physiologic changes but one. Which of the following is the least likely to result from a drug blocking ACE activity?A) decreased peripheral resistance due to decreases vasomotor toneB) lower levels of circulating aldosterone and lowered sodium reabsorptionC) increased thirst and higher blood volumeD) increased urine output due to reduction in circulating antidiuretic hormone (ADH)Answer: CSection: 19.8Learning Outcome: 19.9Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

6) Which of the following would not be expected from taking a diuretic drug?A) decreased blood pressureB) greater stress on the heart to provide adequate perfusionC) increased urine outputD) lower plasma volumeAnswer: BSection: 19.8Learning Outcome: 19.9Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

7) A person suddenly gaining significant amounts of adipose tissue can expect all of the following physiological changes except one. Which of the following is least likely to occur with a sudden and significant gain in adipose tissue?A) increased angiogenesis and higher peripheral resistanceB) higher peripheral resistance and higher blood pressureC) increased risk of developing atherosclerosisD) lower heart rate and reduced blood flowAnswer: DSection: 19.8Learning Outcome: 19.9Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application


8) In the brain the fluid that filters out of capillaries is highly regulated. You would expect to see ________ feeding the brain.A) continuous capillaries, with no intercellular clefts B) sinusoid capillaries, with incomplete basement membraneC) fenestrated capillaries, with thin diaphragms made of extracellular glycoproteinsD) metarterioles leading directly to thoroughfare cannelsAnswer: ASection: 19.3Learning Outcome: 19.4Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

9) In red bone marrow newly formed blood cells enter the circulation. You would expect to see many ________ type of capillaries in red bone marrow. A) metarteriolesB) continuous capillaries C) sinusoid capillariesD) fenestrated capillariesAnswer: CSection: 19.3Learning Outcome: 19.4Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

10) The aorta receives the full force of blood exiting the heart during ventricular systole. Which of the following statements best describes the adaptive anatomy of the aorta?A) Smooth muscle is relatively thin in the aorta to increase lumen size and systemic blood flow.B) Elastic fibers are extensive in the tunica media of the aorta and dampen the pulse pressure generated by the heart.C) The aorta's tunica media is thick with dense regular connective tissue to withstand the blood's pressure.D) The tunica external of the aorta is nearly absent compared to other vessels.Answer: BSection: 19.1Learning Outcome: 19.1Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

11) Which of the following statements is not true of the precapillary sphincters?A) They decrease the osmotic pressure in the thoroughfare channel. B) They increase or decrease rates of perfusion to the tissues served by the true capillaries.C) They allow blood to bypass the true capillaries that are fed by the metarteriole.D) They regulate the flow of blood to tissues served by the true capillaries.


Answer: ASection: 19.3Learning Outcome: 19.4Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

12) Which of the following would not promote filtration from the arteriole end of the capillary bed?A) increasing blood pressureB) reducing hydrostatic pressure within the interstitial fluidC) increasing plasma protein concentrationD) relaxing precapillary sphinctersAnswer: CSection: 19.10Learning Outcome: 19.13Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

13) Which of the following would not promote reabsorption from the venous end of the capillary bed?A) increasing solute concentration in the nearby interstitial fluidB) decreasing hydrostatic pressure of the blood.C) reducing solute concentration in the nearby interstitial fluidD) increasing solute concentration in the plasma of the circulating bloodAnswer: ASection: 19.10Learning Outcome: 19.13Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

14) In general it is expected that ________.A) osmotic pressure will be lower in the arteriole end of the capillary bed compared to the venous endB) hydrostatic pressure will rise as blood moves away from the arteriole end of the capillary bedC) hydrostatic pressure will drop as blood moves away from the arteriole end of the capillary bedD) hydrostatic pressure will remain constant throughout the capillary bedAnswer: CSection: 19.10Learning Outcome: 19.13Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

15) In general it is expected that ________.


A) hydrostatic pressure will remain constant throughout the capillary bedB) osmotic pressure will be higher in the arteriole end of the capillary bed compared to the venous endC) osmotic pressure will be lower in the arteriole end of the capillary bed compared to the venous endD) osmotic pressure will remain relatively consistent throughout the capillary bedAnswer: DSection: 19.10Learning Outcome: 19.13Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

16) Which of the following is most likely to occur in the arteriovenous shuts present in the blood vessels of the finger tips and toes?A) Exercise will result in vasoconstriction in the arteriovenous shuts.B) Warmer temperatures will result in vasoconstriction in the arteriovenous shuts.C) Colder temperatures will result in vasodilation in the arteriovenous shuts. D) Colder temperatures will result in vasoconstriction in the arteriovenous shuts.Answer: DSection: 19.9Learning Outcome: 19.12Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

17) Which of the following best describes the benefit of the vasomotion process?A) It provides a balance between adequate perfusion to all of the tissues while maintaining blood's pressure.B) It allows for rapid increase in blood flow to vital organs during fight or flight response.C) It decreases hydrostatic pressure while also increasing osmotic pressure to enhance reabsorption.D) It lowers blood's pressure by reducing the distribution of blood flow to all of the tissues in the capillary bed.Answer: ASection: 19.10Learning Outcome: 19.13Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

18) The velocity and pressure of blood is slowest and lowest in the capillary beds. Which of the following is not an accurate description of the benefits of slow, low pressure blood in the capillary beds?A) Lower pressure on the venus end of the capillary bed allows for greater reabsorption of fluid back to the plasma.B) Slower blood flow through capillaries allows more time for diffusion to take place in the


capillary bed.C) Lower pressure in the capillary bed helps to increase pressure in the venus circulation.D) Lower pressure reduces the chance of injury to delicate capillary vessels.Answer: CSection: 19.10Learning Outcome: 19.13Global LO: G2, G3HAPS LO: HAPS1, HAPS2Bloom's Level: 3 Application

19) Which of the following would have the least influence on blood pressure?A) peripheral resistanceB) cardiac outputC) white blood cell countD) blood volumeAnswer: CSection: 19.6Learning Outcome: 19.7Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

20) Which of the following chemicals effects blood pressure for both the short and long term?A) atrial natriuretic peptideB) angiotensin IIC) nitric acidD) aldosteroneAnswer: BSection: 19.6Learning Outcome: 19.7Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

21) Which statement best describes arteries?A) Only large arteries are lined with endothelium.B) All contain valves to prevent the backflow of blood.C) All carry blood away from the heart.D) All carry oxygenated blood to the heart.Answer: CSection: 19.2Learning Outcome: 19.3Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

22) Permitting the exchange of nutrients and gases between the blood and tissue cells is the


primary function of ________.A) capillariesB) arteriolesC) veinsD) arteriesAnswer: ASection: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

23) Which of the following statements regarding the hepatic portal system is false?A) Its major vessels are the superior mesenteric, inferior mesenteric, and splenic veins.B) It consists of a vein connecting two capillary beds together.C) It carries nutrients, toxins, and microorganisms to the liver for processing.D) It branches off of the inferior vena cava.Answer: DSection: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

24) The arteries that are also called distributing arteries are the ________.A) elastic arteriesB) arteriolesC) muscular arteriesD) capillariesAnswer: CSection: 19.2Learning Outcome: 19.3Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

25) Each of the following describes the action of aldosterone except one. Which of the following does not describe the activity of aldosterone hormone?A) It will result in higher sodium levels in the urine.B) It promotes an increase in blood pressure.C) It promotes an increase in sodium reabsorption from the kidney to the blood.D) It will reduce urine output.Answer: ASection: 19.8Learning Outcome: 19.9Global LO: G2, G7HAPS LO: HAPS1


Bloom's Level: 3 Application

26) The pulse pressure is ________.A) systolic pressure divided by diastolic pressureB) systolic pressure plus diastolic pressureC) diastolic pressure plus 1/3 (systolic pressure plus diastolic pressure)D) systolic pressure minus diastolic pressureAnswer: DSection: 19.7Learning Outcome: 19.8Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

27) Which of the following signs of hypovolemic shock is a relatively late sign?A) increased heart rateB) cold, clammy skinC) rapidly falling blood pressureD) rapid, thready pulseAnswer: CSection: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

28) Which of the following is likely during vigorous exercise?A) Blood flow to the kidneys increases.B) Blood will be diverted to the digestive organs.C) The skin will be cold and clammy.D) Capillaries of the active muscles will be engorged with blood.Answer: DSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

29) Which of the choices below explains why the arterioles are known as resistance vessels?A) The contraction and relaxation of the smooth muscle in their walls can change their diameter.B) They contain a large quantity of elastic tissue.C) They distribute blood to various parts of the body.D) Their prime function is the exchange of nutrients and wastes between the blood and tissue cells.Answer: ASection: 19.2Learning Outcome: 19.3


Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

30) Which of the following processes provides a long-term response to changes in blood pressure?A) chemoreceptor-initiated reflexesB) neural controlsC) renal regulationD) baroreceptor-initiated reflexesAnswer: CSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

31) Brain blood flow autoregulation ________.A) is less sensitive to pH than to a decreased oxygen levelB) is controlled by cardiac centers in the ponsC) is abolished when abnormally high CO2 levels persistD) causes constriction of cerebral blood vessels in response to a drop in systemic blood pressureAnswer: CSection: 19.9Learning Outcome: 19.12Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

32) Blood flow to the skin ________.A) is not an important source of nutrients and oxygen for skin cellsB) is controlled mainly by decreasing pHC) increases when environmental temperature risesD) increases when body temperature drops so that the skin does not freezeAnswer: CSection: 19.9Learning Outcome: 19.12Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

33) Which of the choices below reflects the balance (or imbalance) between the direction and amount of fluid that flows across the capillary walls?A) hydrostatic pressure onlyB) hydrostatic and osmotic pressureC) plasma and formed element concentrationD) blood volume and viscosity


Answer: BSection: 19.10Learning Outcome: 19.13Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

34) Which of the following is a type of circulatory shock?A) vascular, due to extreme vasodilation as a result of loss of vasomotor toneB) cardiogenic, which results from any defect in blood vesselsC) circulatory, where blood volume is normal and constantD) hypovolemic, caused by increased blood volumeAnswer: ASection: 19.8Learning Outcome: 19.10aGlobal LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

35) Which tunic of an artery is most responsible for maintaining blood pressure and continuous blood circulation?A) tunica externaB) tunica adventitiaC) tunica mediaD) tunica intimaAnswer: CSection: 19.1Learning Outcome: 19.2Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

36) The influence of blood vessel diameter on peripheral resistance is ________.A) significant because resistance is inversely proportional to the fourth power of the vessel radiusB) significant because resistance is directly proportional to the blood vessel diameterC) insignificant because vessel diameter does not varyD) the only factor that influences resistanceAnswer: ASection: 19.6Learning Outcome: 19.7Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

37) The form of circulatory shock known as hypovolemic shock is ________.A) shock that results from large-scale loss of blood volume, or after severe vomiting or diarrhea


B) always fatalC) the form of shock caused by anaphylaxisD) any condition in which blood vessels are inadequately filled and blood cannot circulate normallyAnswer: ASection: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

38) Which of the following is the most significant source of blood flow resistance?A) blood viscosityB) blood vessel diameterC) total blood vessel lengthD) blood vessels typeAnswer: BSection: 19.6Learning Outcome: 19.7Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

39) The term ductus venosus refers to ________.A) damage to the valves in the veins, leading to varicose veinsB) a condition of the aged in which the arteries lose elasticityC) a fetal shunt that bypasses the lungsD) a special fetal vessel that allows umbilical blood to bypass the liverAnswer: DSection: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

40) Which of the choices below does not explain why low capillary pressures are desirable?A) Low blood pressure is associated with longer life span than high blood pressure.B) Low capillary pressure reduces the load of drainage the lymphatic drainage must handle.C) Capillaries are fragile and high pressures would rupture them.D) Most capillaries are extremely permeable and thus even low pressures force solute-containing fluid out of the bloodstream.Answer: ASection: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension


41) The pulse rate depends on all of the following except one. Select the one answer the does not affect a pulse rate reading.A) activityB) the vessel selected to palpateC) emotionsD) postural changesAnswer: BSection: 19.7Learning Outcome: 19.8Global LO: G7HAPS LO: HAPS1Bloom's Level: 4 Analysis

42) Which of the following is least involved in pulmonary circulation?A) right ventricleB) superior vena cavaC) pulmonary arteries and veinsD) left atriumAnswer: BSection: Part 3Learning Outcome: 19.14Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

43) Histologically, the ________ is squamous epithelium supported by a sparse connective tissue layer.A) tunica externaB) tunica adventitiaC) tunica intimaD) tunica mediaAnswer: CSection: 19.1Learning Outcome: 19.1Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

44) Due to the branching of arteries the type of arteries that would be most numerous would be ________.A) arteriolesB) pulmonary arteriesC) muscular arteriesD) elastic arteriesAnswer: ASection: 19.2


Learning Outcome: 19.3Global LO: G7HAPS LO: HAPS1Bloom's Level: 4 Analysis

45) Which of the following is not true regarding fenestrated capillaries?A) Fenestrated capillaries in endocrine organs allow hormones rapid entry into the blood.B) Fenestrated capillaries are essential for filtration of blood plasma in the kidney.C) Fenestrated capillaries form the blood-brain barrier.D) Fenestrated capillaries in the small intestine receive nutrients from digested food.Answer: CSection: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

46) These capillaries may be lined with phagocytes that can extend their process into the plasma to catch "prey."A) fenestrationsB) anastomosesC) thoroughfare channelsD) sinusoidsAnswer: DSection: 19.3Learning Outcome: 19.4Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

47) Factors that aid venous return include all except ________.A) venous valvesB) activity of skeletal musclesC) pressure changes in the thoraxD) urinary outputAnswer: DSection: 19.4Learning Outcome: 19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

48) Which of the following blood pressure readings would be indicative of hypertension?A) 140/90 B) 110/60 C) 120/80 D) 170/96


Answer: DSection: 19.8Learning Outcome: 19.10aGlobal LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

49) Select the correct statement about factors that influence blood pressure.A) Excess albumen transport protein production would decrease blood pressure.B) Excess red cell production would cause a blood pressure increase.C) An increase in cardiac output corresponds to a decrease in blood pressure, due to the increased delivery.D) Systemic vasodilation would increase blood pressure, due to diversion of blood to essential areas.Answer: BSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

50) Mechanisms that do not help regulate blood pressure include ________.A) nervous control that operates via reflex arcs involving baroreceptors, chemoreceptors, and higher brain centersB) chemical controls such as atrial natriuretic peptideC) the dural sinus reflexD) renal regulation via the renin-angiotensin system of vasoconstrictionAnswer: CSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

51) The velocity of blood flow is ________.A) slower in the veins than in the capillaries because veins have a large diameterB) slowest in the capillaries because the total cross-sectional area is the greatestC) in direct proportion to the total cross-sectional area of the blood vesselsD) slower in the arteries than in capillaries because arteries possess a relatively large diameterAnswer: BSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

52) Select the correct statement about blood flow.


A) It is relatively constant through all body organs.B) Blood flow through the entire vascular system is proportional to cardiac output.C) It is measured in mm Hg.D) It is greatest where resistance is highest.Answer: BSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

53) A thrombus (blood clot) in the first branch of the arch of the aorta would affect the flow of blood to the ________.A) left upper armB) myocardium of the heartC) left side of the head and neckD) right side of the head and neck and right upper armAnswer: DSection: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

54) Cerebral blood flow is regulated by ________.A) skin temperatureB) ADHC) the hypothalamic "thermostat"D) intrinsic autoregulatory mechanismsAnswer: DSection: 19.9Learning Outcome: 19.12Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

55) A patient with essential hypertension might have pressures of 200/120 mm Hg. This hypertensive state could result in all of the following changes except ________.A) decreased size of the heart muscleB) increased incidence of coronary artery diseaseC) increased work of the left ventricleD) increased damage to blood vessel endotheliumAnswer: ASection: 19.8Learning Outcome: 19.10aGlobal LO: G7HAPS LO: HAPS1


Bloom's Level: 1 Knowledge

56) The short-term controls of blood pressure, mediated by the nervous system and bloodborne chemicals, primarily operate via all but which of the following?A) chemoreceptorsB) altering blood volumeC) reflex arcs involving baroreceptorsD) reflex arcs associated with vasomotor fibersAnswer: BSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

57) Secondary hypertension can be caused by ________.A) kidney diseaseB) stressC) smokingD) obesityAnswer: ASection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

58) Where in the body would you find low oxygen levels causing vasoconstriction and high levels causing vasodilation?A) heartB) kidneyC) lungsD) liverAnswer: CSection: 19.9Learning Outcome: 19.12Global LO: G7HAPS LO: HAPS1Bloom's Level: 4 Analysis

59) Normal average blood pressure for a newborn baby is ________.A) 150/90B) 120/80C) 90/55D) 130/80Answer: CSection: Developmental aspects of blood vessels


Learning Outcome: 19.10aGlobal LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

60) If a person has lost a significant amount of blood but still maintains a normal blood pressure it does not necessarily mean that the person is maintaining adequate perfusion. Which of the following best explains why this is so?A) The heart has increased its rate to increase cardiac output.B) Blood vessels are constricting causing greater peripheral resistance.C) The heart has increased its contractile force increasing cardiac output.D) The sympathetic nervous system has increased its nervous impulses.Answer: BSection: 19.8Learning Outcome: 19.9Global LO: G2, G7HAPS LO: HAPS1Bloom's Level: 4 Analysis

61) What do the ductus arteriosus and the foramen ovale become at birth?A) ligamentum arteriosum; fossa ovalisB) ligamentum teres; fossa ovalisC) fossa ovalis; ligamentum arteriosumD) ligamentum arteriosum; ligamentum teresAnswer: ASection: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

62) Which of the following would not result in the dilation of the feeder arterioles and opening of the precapillary sphincters in systemic capillary beds?A) a local increase in pHB) an increase in local tissue carbon dioxideC) a decrease in local tissue oxygen contentD) a local increase in histamineAnswer: ASection: 19.9Learning Outcome: 19.12Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application


1.4 Short Answer Questions

1) A family of peptides called ________ are released by the endothelium and are among the most potent vasoconstrictors known.Answer: endothelinsSection: 19.9Learning Outcome: 19.12Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

2) Arterial ________ provide alternate pathways for blood to get to an organ.Answer: anastomosesSection: 19.5Learning Outcome: 19.6Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

3) The ________ in the carotid sinuses and aortic arch detect increases in blood pressure.Answer: baroreceptorsSection: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 1 Knowledge

4) The internal carotid arteries supply the ________ with blood.Answer: brainSection: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 2 Comprehension

5) List the major factors that are linked to essential hypertension and note which ones are controllable by the patient.Answer: The factors are heredity, diet, obesity, age, diabetes mellitus, stress, and smoking. All of these factors are controllable by the patient except for heredity and age.Section: 19.8Learning Outcome: 19.10aGlobal LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

6) What are the sounds of Korotkoff?Answer: They are thumping sounds heard as an inflated blood pressure cuff is deflated on the


arm. They represent blood spurting through the constricted artery and continue until the vessel is no longer constricted.Section: 19.7Learning Outcome: 19.8Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

7) Which type of blood vessels contain valves and what is their function?Answer: Veins contain valves to prevent blood from flowing backward. This is necessary because the venous vessels are a low-pressure system and the blood must sometimes flow against gravity, particularly in the limbs.Section: 19.4Learning Outcome: 19.5Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

8) Define vasoconstriction and vasodilation. What is the mechanism of regulation?Answer: Vasoconstriction is a reduction in the lumen diameter of a blood vessel due to smooth muscle contraction. Vasodilation is a widening of the lumen due to smooth muscle relaxation. Both are regulated by vasomotor nerve fibers of the sympathetic division of the autonomic nervous system and by local metabolic substances.Section: 19.1Learning Outcome: 19.2Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

9) The abdominal aorta divides into three arteries at its terminus; what are they?Answer: Left and right common iliac arteries and the median sacral artery.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

10) The mesenteric arteries branch off the abdominal aorta, but the mesenteric veins do not connect directly to the vena cava. Why?Answer: The mesenteric veins merge into the hepatic portal vein before entering the liver. The liver dumps into the vena cava.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application


1.5 Clinical Questions

1) Describe the effect of hypovolemic shock on the blood vessels and the heart.Answer: Hypovolemic shock causes blood vessels to constrict to increase venous return and maintain pressure. Heart rate increases to compensate for loss of blood pressure and to maintain cardiac output. If volume loss continues, pressure eventually drops sharply and the shock becomes irreversible, leading to death.Section: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

2) Atherosclerosis is a progressive disease of blood vessels that is responsible for millions of deaths each year. Describe the disease process, noting the involvement of specific cell/tissue types and molecules.Answer: The disease process involves several stages and usually affects the aorta and coronary arteries. The initial event involves damage to the tunica intima caused by bloodborne chemicals or physical factors such as a mechanical stress from hypertension or infection. Injured endothelial cells release chemicals that increase the uptake by the endothelium of fats, LDLs, and cholesterol. This eventually attracts macrophages that ingest the oxidized fats and, along with smooth muscle cells from the tunica media, transform into foam cells. Foam cells become fatty streaks, which, along with collagen and elastin fibers secreted by smooth muscle cells, form atherosclerotic plaques. These protrude into the lumen and narrow the blood vessels.Section: A Closer LookLearning Outcome: 19.3Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

3) For each of the following situations, describe the anticipated effect on blood pressure and the physiological basis of the response: (1) a high-salt diet, (2) a blow on the head that damages (disables) the vasomotor center, (3) an attack by a mugger, and (4) a hypothalamic tumor resulting in excess ADH production.Answer: (1) A high-salt diet causes increased sodium in the blood, which increases total extracellular fluid volume. This leads to increased blood volume and blood pressure. (2) Damage to the vasomotor center will cause a loss of vasomotor tone and a drop in blood pressure because the vasomotor center is the integrating center for blood pressure control. (3) During the mugger attack, blood pressure would increase due to sympathetic nervous system stimulation (the fight-or-flight response) triggered by the hypothalamus. (4) Excess ADH production would cause an increase in blood pressure through increased water retention and therefore increased blood volume. ADH also stimulates vasoconstriction.Section: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application


4) Mr. Wilson is a 45-year-old stockbroker with essential hypertension. He is African American, obese, and he smokes 2-3 packs of cigarettes daily. What risk factors for hypertension are typified by Mr. Wilson? What steps should be taken to treat Mr. Wilson, and what lifestyle changes should he make? What complications are likely if corrective steps are not taken?Answer: The risk factors are obesity, race, a high-stress job, and smoking. Mr. Wilson should lose weight, reduce salt intake, quit smoking, and try to reduce his stress level, perhaps by relaxation training. Medical intervention could include treatment with diuretics, beta blockers, calcium channel blockers, and angiotensin converting enzyme inhibitors. Complications could include atherosclerosis, heart failure, renal failure, and stroke.Section: 19.8Learning Outcome: 19.10aGlobal LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

5) A pregnant patient comes into a clinic and asks about a small painless dark compressible bulge that is becoming more apparent on her leg. What is it and what caused it?Answer: The patient is getting a varicose vein. Due to the growing fetus putting downward pressure on the vessels of the groin and restricting the return of blood to the heart, the valves in the peripheral veins begin to fail. This causes blood pooling, which enlarges these veins and puts additional strain on other peripheral vein valves down the line.Section: 19.8Learning Outcome: 19.10aGlobal LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

6) At the battle of Shiloh in the American Civil War, Confederate General A. S. Johnston was killed when he was shot in the thigh. Witnesses reported that he bled to death almost before he realized that he was wounded. Which blood vessel was most likely to have been injured? Why is a tourniquet usually ineffective in stopping the bleeding from this wound?Answer: The wound severed his femoral artery, the largest artery serving the lower limb. A tourniquet may be ineffective because it is a high-pressure, deep artery with a large diameter. It is therefore difficult to exert enough pressure through the thigh muscles to stop the bleeding.Section: 19.11Learning Outcome: 19.16Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

7) A patient lost a lot of blood during surgery and his blood pressure dropped from 120/80 to 90/50. Describe how the kidneys respond to this change in blood pressure.Answer: When arterial blood pressure declines, special cells in the kidneys release the enzyme renin into the blood. Renin triggers a series of enzymatic reactions that produce angiotensin II, which is a potent vasoconstrictor. Angiotensin causes an increase in systemic blood pressure, and increases the rate of blood delivery to the kidneys and renal perfusion. It also stimulates the


adrenal cortex to secrete aldosterone, a hormone that enhances renal reabsorption of sodium, and prods the posterior pituitary to release ADH, which promotes more water reabsorption. As sodium moves into the bloodstream, water follows; thus both blood volume and blood pressure rise.Section: 19.8Learning Outcome: 19.11Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application

8) A patient has an 80% blockage of his left anterior descending coronary artery. Describe what occurs in terms of myocardial oxygen supply and demand if his sympathetic nervous system is stimulated.Answer: When the sympathetic nervous system is stimulated there is increased myocardial contractility, which increases cardiac output and blood flow to active muscles. This increases the demand for oxygen to the cells. The coronary artery is a major blood vessel of the heart. When the demand for myocardial oxygen exceeds the ability of the coronary arteries to supply it, death of myocardial tissue can occur.Section: 19.8Learning Outcome: 19.9Global LO: G7HAPS LO: HAPS1Bloom's Level: 3 Application


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