Federal state budgetary educational institution of higher education

YAROSLAVL STATE MEDICAL UNIVERSITY

of the Ministry of Health of Russia

Department of Normal Physiology with Biophysics

Test assignment book for

NORMAL PHYSIOLOGY
Textbook on the discipline of Normal physiology for students specializing
in GENERAL MEDICINE
 The authors
M.V. Malakhov – associated professor at the Department of Normal physiology of
YSMU, Ph.D.
I.V. Filippov – professor at the Department of Normal physiology of YSMU, Ph.D.,
D.Sc.
P.M. Maslyukov – head of the Department of Normal physiology of YSMU, professor,
Ph.D., D.Sc.

Reviewer:
…

Test assignment book for NORMAL PHYSIOLOGY / M.V. Malakhov, I.V. Filippov,
P.M. Maslyukov, … 302p. 2024

Summary. The textbook is a collection of test questions on the subject of Normal phys-
iology. The main aim of the book is to help students to master the course and to evaluate their
knowledge of the subject. The textbook can be used both for studying the material and for self-
preparation of the students, as well as for assessment and control of the students’ knowledge
during classes.
The textbook is designed for students specializing in GENERAL MEDICINE and is
composed according to the requirements of the FSES on the specialization 31.05.01 GEN-
ERAL MEDICINE.

2
 CONTENTS
CONTENTS........................................................................................................................ 3
INTRODUCTION.............................................................................................................. 6
Structure and specification of test questions ................................................................... 6
Instructions for students.................................................................................................... 7
TEST QUESTIONS AND CORRECT ANSWER KEYS .............................................. 9
Section I. PHYSIOLOGY OF THE EXCITABLE TISSUES ....................................... 9
1.1 Physiology of cell membranes. Electrical phenomena in the neuromuscular system
.................................................................................................................................................... 9
1.2 Physiology of nerves and neuromuscular junction ................................................. 17
1.3 Muscle physiology. Mechanism of muscle contraction ........................................... 26
CORRECT ANSWER KEYS FOR SECTION I .......................................................... 37
1.1 Physiology of cell membranes. Electrical phenomena in the neuromuscular system
.................................................................................................................................................. 37
1.2 Physiology of nerves and neuromuscular junction ................................................. 37
1.3 Muscle physiology. Mechanism of muscle contraction ........................................... 38
Section II. PHYSIOLOGY OF THE CENTRAL NERVOUS SYSTEM ................... 39
2.1 General physiology of the central nervous system .................................................. 39
2.2 Physiology of the spinal cord. Physiology of the medulla and midbrain .............. 49
2.3 Physiology of the reticular formation. Cerebellum, basal nuclei. The extrapyram-
idal system............................................................................................................................... 58
2.4 Physiology of the autonomic nervous system .......................................................... 68
CORRECT ANSWER KEYS FOR SECTION II......................................................... 78
2.1 General physiology of the central nervous system .................................................. 78
2.2 Physiology of the spinal cord. Physiology of the medulla and midbrain .............. 78
2.3 Physiology of the reticular formation. Cerebellum, basal nuclei. The extrapyram-
idal system............................................................................................................................... 79
2.4 Physiology of the autonomic nervous system .......................................................... 80
Section III. PHYSIOLOGY OF THE ENDOCRINE SYSTEM ................................. 81
3.1 General physiology of the endocrine glands ............................................................ 81
3.2 Special physiology of the endocrine glands ............................................................. 89
CORRECT ANSWER KEYS FOR SECTION III ....................................................... 97
3.1 General physiology of the endocrine glands ............................................................ 97
3.2 Special physiology of the endocrine glands ............................................................. 97

3
 Section IV. PHYSIOLOGY OF THE BLOOD ............................................................. 99
4.1 Physiology of blood cells ............................................................................................ 99
4.2 Erythrocyte sedimentation rate. Respiratory function of the blood ................... 107
4.3 Hemostasis and blood clotting. Species and individual features of the blood .... 115
CORRECT ANSWER KEYS FOR SECTION IV ..................................................... 124
4.1 Physiology of blood cells .......................................................................................... 124
4.2 Erythrocyte sedimentation rate. Respiratory function of the blood ................... 124
4.3 Hemostasis and blood clotting. Species and individual features of the blood .... 125
Section V. RESPIRATORY PHYSIOLOGY .............................................................. 126
5.1 Mechanism of ventilation. Gas exchange in the lungs .......................................... 126
5.2 Transport of gases in the blood. Control of respiration ....................................... 134
CORRECT ANSWER KEYS FOR SECTION V ....................................................... 144
5.1 Mechanism of ventilation. Gas exchange in the lungs .......................................... 144
5.2 Transport of gases in the blood. Control of respiration ....................................... 144
Section VI. CARDIOVASCULAR PHYSIOLOGY ................................................... 146
6.1 The cardiac cycle and its phases. Automaticity of the heart ................................ 146
6.2 Physiological characteristics of the cardiac muscle .............................................. 154
6.3 Physical manifestations of activity of the heart. Physiological basis of electrocar-
diography .............................................................................................................................. 164
6.4 Blood flow through the vessels. Blood pressure .................................................... 173
6.5 Neurohumoral regulation of the heart and vasculature ....................................... 183
6.6 Reflex regulation of the cardiovascular system..................................................... 191
CORRECT ANSWER KEYS FOR SECTION VI ..................................................... 200
6.1 The cardiac cycle and its phases. Automaticity of the heart ................................ 200
6.2 Physiological characteristics of the cardiac muscle .............................................. 200
6.3 Physical manifestations of activity of the heart. Physiological basis of electrocar-
diography .............................................................................................................................. 201
6.4 Blood flow through the vessels. Blood pressure .................................................... 202
6.5 Neurohumoral regulation of the heart and vasculature ....................................... 202
6.6 Reflex regulation of the cardiovascular system..................................................... 203
Section VII. EXCRETORY PHYSIOLOGY .............................................................. 204
7.1 Physiology of the kidney .......................................................................................... 204
CORRECT ANSWER KEYS FOR SECTION VII .................................................... 214
7.1 Physiology of the kidney .......................................................................................... 214

4
 Section VIII. PHYSIOLOGY OF DIGESTION. METABOLIC BASIS OF PHYSIO-
LOGICAL FUNCTIONS .................................................................................................... 215
8.1 Secretory function of the digestive glands ............................................................. 215
8.2 Digestion in small and large intestine. Absorption. Gastrointestinal motility ... 225
8.3 Metabolism. Principles of assessment of energy balance. Physiological basis of the
rational nutrition.................................................................................................................. 233
CORRECT ANSWER KEYS FOR SECTION VIII .................................................. 241
8.1 Secretory function of the digestive glands ............................................................. 241
8.2 Digestion in small and large intestine. Absorption. Gastrointestinal motility ... 241
8.3 Metabolism. Principles of assessment of energy balance. Physiological basis of the
rational nutrition.................................................................................................................. 242
Section IX. PHYSIOLOGY OF THE SENSORY SYSTEMS ................................... 243
9.1 General phycology of the sensory system. Auditory sensory system .................. 243
9.2 Visual sensory system .............................................................................................. 252
9.3 Somatosensory system (cutaneous and pain receptors). Neurophysiology of pain.
Olfactory and gustatory sensory systems .......................................................................... 260
CORRECT ANSWER KEYS FOR SECTION IX ..................................................... 271
9.1 General phycology of the sensory system. Auditory sensory system .................. 271
9.2 Visual sensory system .............................................................................................. 271
9.3 Somatosensory system (cutaneous and pain receptors). Neurophysiology of pain.
Olfactory and gustatory sensory systems .......................................................................... 272
Section X. PHYSIOLOGY OF HIGHER NERVOUS ACTIVITY........................... 273
10.1 Physiology of the hemispheres .............................................................................. 273
10.2 The basics of the physiology of learning and behavior ....................................... 281
10.3 Higher nervous activity in humans. Physiological basis of speech, memory, sleep
and emotions. The concept of the functional system ........................................................ 289
CORRECT ANSWER KEYS FOR SECTION X ....................................................... 298
10.1 Physiology of the hemispheres .............................................................................. 298
10.2 The basics of the physiology of learning and behavior ....................................... 298
10.3 Higher nervous activity in humans. Physiological basis of speech, memory, sleep
and emotions. The concept of the functional system ........................................................ 299
APPENDIX 1 .................................................................................................................. 300
LITERATURE ............................................................................................................... 302

5
 INTRODUCTION
Normal physiology is a complex subject that is undoubtedly very difficult to master. To
study normal physiology efficiently, a student must have a deep knowledge not only of the
morphological subjects such as anatomy and histology, but also of the basic natural sciences –
biology, physics, chemistry. In turn, a deep understanding of normal physiology is essential for
mastering the clinical subjects – pharmacology, pathophysiology, etc.
There are numerous pedagogical methods aimed at efficient studying; one of them is
test control. Tests can be used not only for the actual control, but also for self-preparation of
the students and for exams, as well as for distance learning.

Structure and specification of test questions

This textbook has been prepared in accordance with the requirements of the Federal
State Educational Standard for the specialization 31.05.01 GENERAL MEDICINE. The
amount and order of the material presentation is based on the program of the Normal Physiol-
ogy course for students of medical universities. There are different types of questions, which
are arranged according to the principle “from easy to hard”: first there are multiple-choice
questions, followed by matching questions, then there are questions on correct order (they are
missing in some topics), and finally there are open-end questions where filling the gaps is re-
quired.

The total number of test questions is 1855 and they are distributed as follows (see Ta-
ble 1)

Table 1. The number of questions in each topic

Number
Topics of the course of
questions
Section I. PHYSIOLOGY OF THE EXCITABLE TISSUES 190
1.1 Physiology of cell membranes. Electrical phenomena in the neuromus-
57
cular system
1.2 Physiology of nerves and neuromuscular junction 65
1.3 Muscle physiology. Mechanism of muscle contraction 68
Section II. PHYSIOLOGY OF THE CENTRAL NERVOUS SYSTEM 258
2.1 General physiology of the central nervous system 68
2.2 Physiology of the spinal cord. Physiology of the medulla and midbrain 61
2.3 Physiology of the reticular formation. Cerebellum, basal nuclei. The ex-
65
trapyramidal system
2.4 Physiology of the autonomic nervous system 64
Section III. PHYSIOLOGY OF THE ENDOCRINE SYSTEM 115
3.1 General physiology of the endocrine glands 62

6
 3.2 Special physiology of the endocrine glands 53
Section IV. PHYSIOLOGY OF THE BLOOD 177
4.1 Physiology of blood cells 60
4.2 Erythrocyte sedimentation rate. Respiratory function of the blood 59
4.3 Hemostasis and blood clotting. Species and individual features of the
58
blood
Section V. RESPIRATORY PHYSIOLOGY 127
5.1 Mechanism of ventilation. Gas exchange in the lungs 65
5.2 Transport of gases in the blood. Control of respiration 62
Section VI. CARDIOVASCULAR PHYSIOLOGY 376
6.1 The cardiac cycle and its phases. Automaticity of the heart 65
6.2 Physiological characteristics of the cardiac muscle 63
6.3 Physical manifestations of activity of the heart. Physiological basis of
67
electrocardiography
6.4 Blood flow through the vessels. Blood pressure 68
6.5 Neurohumoral regulation of the heart and vasculature 53
6.6 Reflex regulation of the cardiovascular system 60
Section VII. EXCRETORY PHYSIOLOGY 68
7.1 Physiology of the kidney 68
Section VIII. PHYSIOLOGY OF DIGESTION. METABOLIC BASIS
183
OF PHYSIOLOGICAL FUNCTIONS
8.1 Secretory function of the digestive glands 72
8.2 Digestion in small and large intestine. Absorption. Gastrointestinal mo-
57
tility
8.3 Metabolism. Principles of assessment of energy balance. Physiological
54
basis of the rational nutrition
Section IX. PHYSIOLOGY OF THE SENSORY SYSTEMS 195
9.1 General phycology of the sensory system. Auditory sensory system 63
9.2 Visual sensory system 65
9.3 Somatosensory system (cutaneous and pain receptors). Neurophysiology
67
of pain. Olfactory and gustatory sensory systems
Section X. PHYSIOLOGY OF HIGHER NERVOUS ACTIVITY 166
10.1 Physiology of the hemispheres 58
10.2 The basics of the physiology of learning and behavior 53
10.3 Higher nervous activity in humans. Physiological basis of speech,
55
memory, sleep and emotions. The concept of the functional system

The correct answer keys are given at the end of each section.

Instructions for students

This test assignment book is intended for the students specializing in GENERAL MED-
ICINE. The test questions can be used for self-preparation for each of the classes of the entire

7
Normal Physiology course. To make the most of it, students should try to answer all the ques-
tions on their own and then evaluate their knowledge by checking the answer keys. This way,
a student can identify the questions that were most difficult to understand and review the ma-
terial again.
When creating quizzes from the Test Bank, the “from easy to hard” principle is used:
the easiest questions are placed at the beginning of a quiz, and the most difficult ones are placed
at the end. The quiz structure begins with multiple-choice questions, followed by matching
questions, questions on the correct order, and finally there are open-ended questions that re-
quire filling the gaps. Each quiz blank contains ten questions.
There are four variants of the quiz blanks for each topic. Each variant composed in such
a way that participants can’t answer one question using information from another. The quiz
blanks are regularly updated (at least once a year). It’s possible due to the large number of
questions in the test assignment book. An example of a quiz variant with the correct answer
keys is provided in Appendix 1.
While taking the quiz, using any informational material (lectures, textbooks, etc.) as
well as any electronic device (tablet, cell phone, etc.) is prohibited. There must not be any
extraneous items on the table except for a piece of paper and a pen. It is also prohibited to leave
the classroom and to talk to each other.
The quiz forms and answer sheets are given by the teacher. During the quiz, the teacher
remains in the classroom to maintain discipline. Participants must return the answer sheet at-
tached to the quiz form at the end.
Each test question is graded on a binary principle: 0 if the answer is incorrect (partially
or completely) and 1 if the answer is correct. The total score for the quiz can be converted from
the absolute to the relative (five-point) score according to Table 2.

Table 2. Absolute and relative (five-point) scores

Absolute score Five-point score

9 – 10 Excellent
7–8 Good
5–6 Satisfactory
4 and less Unsatisfactory

8
 TEST QUESTIONS AND CORRECT AN-
SWER KEYS

Section I. PHYSIOLOGY OF THE EXCITABLE TIS-

SUES

1.1 Physiology of cell membranes. Electrical phenomena in the neu-

romuscular system

Choose one correct answer

1. How are the hydrophobic parts of the phospholipid molecules in the outer and inner
layers of the membrane bilayer oriented?
a. towards each other
b. away from each other

2. How are the hydrophilic parts of the phospholipid molecules in the outer and inner
layers of the membrane bilayer oriented?
a. towards each other
b. away from each other

3. Ion channels are made up of which of the following proteins?

a. peripheral
b. integral

4. In an excitable tissue, which type of stimulus requires more energy to elicit excitation?
a. adequate stimulus
b. inadequate stimulus

5. The amplitude of the action potential when exposed to a suprathreshold stimulus

a. depends on the strength of the stimulus
b. doesn’t depend on the strength of the stimulus

6. Which tissue is more excitable?

a. nerve
b. muscle

7. When the membrane is hyperpolarized, its potential becomes more

a. positive
b. negative

9
8. When the membrane is depolarized, its potential becomes
a. less negative
b. more negative
9. What does the activity Na+/K+-ATPase cause?
a. depolarization
b. hyperpolarization

10. At rest, potassium channels are in which of the following states?

a. closed
b. open
c. inactivated

11. At rest, sodium channels are in which of the following states?

a. closed
b. opened
c. inactivated

12. The amplitude of the local response compared to the amplitude of the action potential
is
a. the same
b. higher
c. lower

13. On which surface of the cell membrane is the glycocalyx located?

a. inner
b. outer
c. both

14. What are the proteins located on the surface of the membrane called?
a. integral
b. surface
c. peripheral
d. contact

15. Which of the following is the main component of the cell membrane?
a. triacylglycerol
b. carbohydrates
c. phospholipid
d. cholesterol

16. What is the ability of all living beings to respond to a stimulus by a changing their
metabolism called?

10
 a. excitability
b. rheobase
c. chronaxie
d. irritability

17. What is the ability of the certain tissues to respond to a stimulus by generating an
action potential called?
a. excitability
b. irritability
c. chronaxie
d. rheobase

18. Which of the following ratios for the exchange of sodium and potassium ions
(Na+:K+) by the Na+/K+-ATPase is correct?
a. 1:2
b. 3:2
c. 1:1
d. 2:2

19. Which of the following is a characteristic of the absolute refractory phase?

a. increased excitability
b. reduced excitability
c. increased metabolism
d. absence of excitability

20. The transmembrane potential is mainly determined by the concentration gradient for
which of the following ions
a. sodium
b. magnesium
c. potassium
d. calcium

21. At rest, the permeability of the cell membrane is highest for which of the following
ions?
a. K+
b. Na+
c. Mg2+
d. Cl-

22. Which of the following types do membrane phospholipids belong to, according to
their physicochemical properties?
a. amphiphilic
b. hydrophilic
c. hydrophobic

11
 d. amphoteric

23. What is the minimum stimulus intensity to evoke an action potential called?
a. subthreshold
b. suprathreshold
c. local
d. threshold

24. What is the decrease in the transmembrane potential called (it becomes less nega-
tive)?
a. depolarization
b. repolarization
c. hyperpolarization
d. overshoot

25. What is the increase in the transmembrane potential called (it becomes more nega-
tive)?
a. depolarization
b. repolarization
c. hyperpolarization
d. overshoot

26. What is the change of the transmembrane potential to the opposite called?
a. depolarization
b. repolarization
c. hyperpolarization
d. overshoot

27. What is the recovery of the transmembrane potential (it returns to the resting state)
called?
a. depolarization
b. repolarization
c. hyperpolarization
d. overshoot

28. According to Nernst’s law, the amplitude of the transmembrane potential depends on
which of the following?
a. the product of the ion concentrations on both sides of the membrane
b. the ratio of the ion concentrations on both sides of the membrane
c. the sum of the ion concentrations on both sides of the membrane
d. the difference of the ion concentrations on both sides of the membrane

29. Repolarization is caused by the efflux (exit) of which of the following ions?
a. Na+

12
 b. Cl-
c. Ca2+
d. K+

30. The minimum duration of a stimulus at twice the rheobase intensity that elicits an
action potential is called the
a. latent period
b. irritability
c. chronaxie
d. lability

Match the items in the left and right columns

31. Strength-duration curve Parameters

a. chronaxie
b. rheobase
c. lability
d. latency
e. refractoriness

32. Graph Changes in excitability

a. supernormal excitability
b. afterdepolarization
c. absolute refractoriness
d. afterhyperpolarization
e. relative refractoriness

33. Phases of action potential Excitability

1. Depolarization a. subnormal excitability
2. Repolarization b. absolute refractoriness
3. Afterhyperpolarization c. supernormal excitability
d. relative refractoriness

34. Receptor Characteristic

13
 1. Ionotropic a. when a ligand acts on the receptor, the formation of a second
messenger is triggered
2. Metabotropic b. the receptor activates spontaneously without interacting with a
ligand
3. Cytoplasmic c. when a ligand acts on the receptor, the permeability of the cell
membrane to ions changes
d. ligand-receptor complex enters cell nucleus and affects protein
synthesis

35. Graph Phases of action potential

a. absolute refractoriness
b. local response
c. afterdepolarization
d. repolarization
e. depolarization

Choose two or more correct answers

36. Which of the following is true about the action potential?

a. obeys the “all-or-none” law
b. can be summed
c. propagates without decrement
d. its amplitude depends on the strength of a stimulus
e. propagates with decrement

37. Which of the following is true about the local response?

a. obeys the “all-or-none” law
b. can be summed
c. propagates without decrement
d. its amplitude depends on the strength of a stimulus
e. can’t be summed

38. Identify the phases of the action potential

a. depolarization
b. trace potentials
c. absolute refractoriness
d. rheobase
e. repolarization

14
39. Which of the following terms describe changes in excitability during the excitation?
a. rheobase
b. chronaxie
c. depolarization
d. absolute refractoriness
e. relative refractoriness

40. Which of the following are functions of membrane proteins?

a. information storage
b. transmembrane transport
c. acting as receptors
d. providing adhesion
e. catalyzing metabolic reactions
f. regulation of intracellular temperature

41. Which of the following are primary active transport systems?

a. Na+/K+-ATPase
b. Na+/Ca2+-exchanger
c. sodium-glucose cotransporter
d. Ca2+-ATPase
e. glucose transporter

42. Which of the following are secondary active transport systems?

a. Na+/K+-ATPase
b. Na+/Ca2+-exchanger
c. sodium-glucose cotransporter
d. Ca2+-ATPase
e. glucose transporter

43. Which of the following fluxes of ions across the cell membrane cause depolarization?
a. influx of Na+
b. efflux of K+
c. efflux of Cl-
d. influx of Cl-
e. influx of Ca2+

44. Which of the following fluxes of ions across the cell membrane cause hyperpolariza-
tion?
a. influx of Na+
b. efflux of K+
c. efflux of Cl-
d. influx of Cl-
e. influx of Ca2+

15
 Arrange the correct sequence

45. Arrange the phases of the action potential in the correct order
a. afterhyperpolarization
b. depolarization
c. repolarization

46. Arrange the following ions in ascending order of concentration in the extracellular
fluid
a. potassium
b. sodium
c. calcium

47. Arrange the following ions in ascending order of concentration in the intracellular
fluid
a. calcium
b. potassium
c. sodium

48. Arrange the changes in excitability during the action potential in the correct order
a. supernormal excitability
b. subnormal excitability
c. absolute refractoriness
d. relative refractoriness

49. Arrange the phases of action potential in the correct order

a. local response
b. repolarization
c. depolarization
d. afterhyperpolarization

Fill in the gaps

50. The universal ability of all living beings to respond to a stimulus by altering their
metabolism is called ______.

51. The minimum time required for a stimulus of two rheobase strengths to evoke an ac-
tion potential is called _______.

52. The minimum time required for a stimulus of one rheobase strength to evoke an action
potential is called _______.

16
53. The ability of the certain tissues to respond to a threshold or suprathreshold stimulus
by generating an action potential is called ________.

54. The transport of substances across the cell membrane down the gradient without a
carrier is called ________.

55. The transport of substances across the cell membrane against the gradient with the
expenditure of energy is called _________.

56. Ion channels that change their permeability in response to a change in the membrane
potential are known as __________.

57. The state of an excitable tissue, in which it is impossible to evoke an action potential
regardless of the stimulus strength, is referred to as ___________.

1.2 Physiology of nerves and neuromuscular junction

Choose one correct answer

1. Which type of axonal transport can be both retrograde and anterograde?

a. fast
b. slow

2. The axonal transport from the soma to the axonal terminal is called
a. anterograde
b. retrograde

3. In nerve fibers of A and B types, the conduction of excitation is

a. saltatory
b. continuous

4. The axonal transport from the axonal terminal to the soma is called
a. anterograde
b. retrograde

5. If a stimulus acts in the middle of the nerve fiber, how does it propagate an action
potential?
a. unidirectionally
b. bidirectionally

6. At rest, the inner surface of the nerve fiber membrane is charged

17
 a. positively
b. negatively

7. Conduction in nerve fibers is

a. isolated
b. non-isolated
c. mixed

8. During the depolarization phase, how does the transmembrane potential in the nerve
fiber change?
a. becomes less negative
b. becomes more negative
c. doesn’t change

9. Which of the following structures underlies the nerve fiber?

a. dendrite
b. axon
c. neuron chain
d. astrocyte projection

10. Which of the following is a function of myelin?

a. integrating
b. trophic
c. regenerative
d. insulating

11. Which of the following is true about the nerve fibers?

a. are susceptible to fatigue
b. conduct excitation bidirectionally
c. generate action potentials without an external stimulus
d. have a lower excitability than muscle fibers

12. What is the major constituent of myelin?

a. protein
b. carbohydrate
c. lipid
d. glycosaminoglycan

13. What is the region of the myelinated nerve fibers lacking myelin called?
a. node of Ranvier
b. axon hole
c. node of Selye
d. axon tract
14. Which of the following is true about the unmyelinated fiber?

18
 a. it conducts excitation saltatory
b. it conducts excitation slower than myelinated fiber
c. it has nodes of Ranvier
d. it is usually larger in diameter than myelinated fiber

15. Which of the following organelles is involved in axon transport?

a. ribosome
b. Golgi apparatus
c. microtubule
d. lysosome

16. Which of the following proteins is responsible for fast retrograde axonal transport?
a. kinesin
b. dynein
c. prestin
d. calmodulin

17. Which of the following proteins is responsible for fast anterograde axonal transport?
a. kinesin
b. dynein
c. prestin
d. calmodulin

18. Which of the following types of nerve fibers is unmyelinated?

a. Аα
b. Аβ
c. B
d. C

19. Which of the following types of nerve fibers has a conduction velocity of 40 – 70 m/s?
a. Аα
b. Аβ
c. B
d. C

20. During an action potential in a nerve fiber, depolarization is caused by the influx (en-
try) of which of the following ions?
a. Na+
b. K+
c. Ca2+
d. Cl-

21. Which of the following ions is involved in the repolarization of nerve fibers?

19
 a. sodium
b. potassium
c. calcium
d. chloride

22. The transmembrane potential in the nerve cells is approximately equal to (mV)
a. +10
b. +70
c. -10
d. -70

23. The nerve fibers of the A and B types are

a. myelinated
b. unmyelinated
c. A type is myelinated, B type is unmyelinated
d. A type is unmyelinated, B type is myelinated

24. To which system do nerve fibers of the B and C types belong?

a. somatic
b. B – somatic, C – autonomic
c. B – autonomic, C – somatic
d. autonomic

25. What is special about the node of Ranvier?

a. it has specialized “node” proteins
b. the cell membrane in the node of Ranvier is thicker compared to the rest of the
membrane
c. it has a high concentration of the voltage-gated sodium channels
d. it has a high concentration of the voltage-gated calcium channels

26. An action potential doesn’t propagate backwards, because the nerve fiber is in which
of the following states?
a. local response
b. refractoriness
c. supernormal excitability
d. intolerance

27. The refractoriness of a nerve fiber during excitation is caused by the inactivation of
which of the following ion channels?
a. chloride
b. sodium
c. potassium
d. calcium
28. Which of the following is a neurotransmitter in the neuro-muscular junction?

20
 a. norepinephrine
b. serotonin
c. epinephrine
d. acetylcholine

29. Which of the following components is found in the presynaptic membrane of the neu-
romuscular junction?
a. ligand-gated sodium channel
b. synaptic vesicle
c. voltage-gated calcium channel
d. cholinesterase

30. In which of the following structure is acetylcholine produced?

a. in the soma of neuron
b. in the synaptic ending
c. in the postsynaptic membrane
d. in the axon hillock

31. In the end plate, there are channels that permeable to which ions?
a. Na+ and K+
b. only Na+
c. Na+ and Ca2+
d. only Ca2+

32. The amount of acetylcholine released from … vesicle(s) is called a “quantum”

a. 1
b. 5
c. 10
d. 100

33. Which of the following structures is located in the end plate of the neuromuscular
junction?
a. voltage gated sodium channels
b. voltage gated calcium channels
c. N cholinergic receptors
d. synaptic vesicles

34. Which of the following is true about the end plate potential (EPP)?
a. is an all-or-none response
b. propagates without decay
c. can be summed
d. the amplitude doesn’t depend on the intensity of a stimulus

35. Which of the following potentials is generated at the end plate at rest?

21
 a. generator potential
b. miniature end plate potential
c. excitatory postsynaptic potential
d. receptor potential

36. Which of the following types of cholinergic receptors are located in the end plate?
a. M
b. α
c. β
d. N

37. At the neuromuscular junction, how many action potentials must arrive at the pre-
synaptic membrane in order to generate an endplate potential?
a. one action potential
b. 5 action potentials
c. 10 action potentials
d. 100 action potentials

Match the items in the left and right columns

38. Types of nerve fibers Conduction velocity (m/s)

1. Aα a. 0.01 – 0.05
2. B b. 0.5 – 2
3. C c. 3 – 18
d. 40 – 50
e. 70 – 120

39. Types of nerve fi- Functions

bers
1. Aα a. sensory afferent from pain and cold receptors
2. Aδ b. supply skeletal muscles; sensory afferents from propriocep-
tors
3. B c. sensory afferents from tactile receptors (mechanoreceptors of
skin)
4. C d. postganglionic fibers of the sympathetic nervous system; sen-
sory afferents from pain and warm receptors
e. preganglionic fibers of the autonomic nervous system

40. Part of neuromuscular junction Characteristic

22
 1. Presynaptic membrane a. contains vesicles filled with neurotrans-
mitter, mitochondria
2. Postsynaptic membrane b. has ligand gated Na+-K+ channels
3. Synaptic terminal c. contains extracellular fluid
d. has voltage gated Ca2+ channels

41. Potential Amplitude (mV)

1. Miniature end plate potential a. 0.4
2. Action potential b. 40
3. End plate potential c. 110
d. 200

42. Type of axonal transport Speed (mm/day)

1. Fast anterograde a. ~0.2 – 8
2. Fast retrograde b. ~10 – 25
3. Slow anterograde c. ~200 – 300
d. ~400

Choose two or more correct answers

43. Which of the following are characteristics of a nerve fiber?

a. contractility
b. excitability
c. conductivity
d. elasticity
e. plasticity

44. What are the functions of nerve fibers?

a. conduction of action potential
b. axonal transport
c. contractile
d. protective
e. energy storage

45. Which of the following is true about the axonal transport?

a. is necessary to replenish neurotransmitter in the synaptic ending
b. provides impulse conduction along nerve fibers
c. maintains ionic asymmetry
d. involved in the regeneration of nerve fibers
e. is involved in synaptic transmission

46. Which of the following subunits does the N-cholinergic receptor consists of?

23
 a. 2α
b. 1β
c. 1γ
d. 2σ
e. 1δ
f. 2μ
g. 1ε

47. What are the advantages of saltatory conduction of excitation?

a. unidirectional conduction
b. more accurate transmission of information
c. decremental propagation
d. high conduction velocity
e. low energy consumption

48. Identify the structures in which the exocytosis proteins are located
a. the presynaptic membrane
b. the postsynaptic membrane
c. the synaptic cleft
d. the membrane of the synaptic vesicles
e. mitochondria in the synaptic ending

49. Identify the characteristics of the neuromuscular junction

a. absence of synaptic delay
b. functional asymmetry of the presynaptic and postsynaptic membranes
c. synaptic delay
d. bidirectional conduction
e. unidirectional conduction

50. According to their function, nerve fibers are divided into which of the following types?
a. myelinated
b. unmyelinated
c. afferent
d. somatic
e. autonomous
f. efferent

51. Which of the following components are parts of the neuromuscular junction?
a. presynaptic membrane
b. postsynaptic membrane
c. prosynaptic membrane
d. postsynaptic cleft
e. axon hillock

24
52. Synaptic transmission at the neuromuscular junction is affected by substances acting
of which of the following?
a. reuptake of acetylcholine
b. acetylcholine esterase
c. chloride channels
d. mono amino oxidase
e. receptors in the end plate

53. Identify the properties of the end plate potential

a. is not an “all-or-none” response
b. doesn’t cause refractoriness
c. has a high amplitude
d. its duration is 0.1 – 0.2
e. is an “all-or-none” response
f. depends on the amount of the acetylcholine
g. is decremental
h. prevents the generation of action potentials

Arrange the correct sequence

54. Arrange the following types of nerve fibers in ascending order of conduction speed
(from slowest to fastest)
a. Аβ
b. Aδ
c. В
d. С

55. Arrange the following types of nerve fibers in descending order of conduction speed
(from fastest to slowest)
a. thin myelinated
b. thick myelinated
c. unmyelinated

56. Arrange the following types of nerve fibers in ascending order of diameter (from thin-
nest to thickest)
a. Aβ
b. Aγ
c. Aα
d. Aδ

57. Arrange the following phases of synaptic transmission at the neuromuscular junction
in the correct order

25
 a. an action potential arrives at the presynaptic membrane
b. an action potential is generated at the sarcolemma
c. mediator is released by exocytosis
d. Ca2+ enters the synaptic terminal
e. an end plate potential is generated

58. Arrange in the correct order the following processes that take place during conduction
along a myelinated nerve fiber
a. an action potential is generated at the node of Ranvier
b. a stimulus acts on the membrane of a node of Ranvier
c. the potential difference between the excited and resting nodes of Ranvier appears
d. action potential is generated at the next node of Ranvier
e. membrane of the next (resting) node of Ranvier depolarizes

Fill in the gaps

59. The maximum number of impulses per time that an excitable tissue can generate is
called _______.

60. The mechanism of conduction when an action potential “jumps” from one node of
Ranvier to another is referred to as ________.

61. The enzyme that breaks down acetylcholine is called _______.

62. The neurotransmitter at the neuromuscular junction is called ________.

63. The membrane that envelops the synaptic terminal is known as the ________ mem-
brane.

64. The motor protein that is involved in the fast anterograde axonal transport is called
________.

65. The motor protein that is involved in the fast retrograde axonal transport is called
_________.

1.3 Muscle physiology. Mechanism of muscle contraction

26
 Choose one correct answer

1. Which of the following muscles has automaticity?

a. skeletal
b. smooth

2. Myosin ATPase activity is higher in which muscle?

a. skeletal
b. smooth

3. Excitation can be transmitted directly from one cell to another in which muscles?
a. skeletal
b. smooth

4. How do the myosin bridges interact with the actin?

a. asynchronously
b. synchronously

5. The force of muscle contraction is greater in which tetanus?

a. fused
b. unfused

6. In the sarcomere, the light part of the A-bands (H-zone) is made up of which of the
following protofibrils?
a. only actin
b. only myosin
c. both actin and myosin

7. Which of the following types of muscle fibers is called “white”?

a. fast oxidative type
b. fast glycolytic type
c. slow oxidative type

8. How is excitation conducted along the muscle fiber?

a. continuously
b. saltatory
c. depending on the type of fiber

9. During muscle contraction, the potassium levels in the sarcoplasm…

a. rises
b. decreases
c. doesn’t change

27
10. In a muscle twitch, the duration of the contraction phase compared to the relaxation
phase is usually
a. longer
b. shorter
c. the same

11. When the strength of the muscle contraction is at its maximum?

a. during a muscle twitch
b. during unfused tetanus
c. during fused tetanus

12. Which of the following types of muscle contraction occurs during walking?
a. auxotonic
b. isotonic
c. isometric

13. Which of the following is the myofibril made up of?

a. muscle fibers
b. sarcomeres
c. myomeres
d. protomeres

14. Which of the following is the structural functional unit of the skeletal muscle?
a. sarcomere
b. metamere
c. muscle fiber
d. Z-line

15. In the myofibril, the sarcomeres are separated from each other by which of the fol-
lowing?
a. Z-line
b. T-tubule
c. S-membrane
d. I-band

16. The light part of the sarcomere between the two A-bands is called the
a. I-band
b. Z-line
c. H-zone
d. M-line

17. What filaments does the I-band consist of

a. myosin

28
 b. actin
c. collagen
d. elastin

18. Identify the number of actin filaments surrounding one myosin filament
a. 3
b. 4
c. 5
d. 6

19. Which of the following filaments is a thin protofibril?

a. actin
b. myosin
c. collagen
d. fibrinogen

20. Which of the following proteins consists of three subunits (T, C, and I)?
a. actin
b. myosin
c. troponin
d. tropomyosin

21. In the sarcomere, which of the following filaments is attached to the Z-line?
a. actin
b. myosin
c. fibrin
d. collagen

22. What does the T-tubule in the muscle fiber do?

a. conducts action potentials
b. releases acetylcholine
c. connects actin to myosin
d. detaches actin from myosin

23. The triad is a junction of which of the following structures?

a. two T-tubules and one L-cistern
b. two L-cisterns and one T-tubule
c. one T-tubule and one L-cistern
d. two L-cisterns and two T-tubules

24. What is the invagination of sarcoplasm called?

a. L-tubule
b. T-tubule
c. myotubule

29
 d. Ca2+-channel

25. Which of the following ion does the sarcoplasmic reticulum contain?
a. Na+
b. K+
c. Ca2+
d. Cl-

26. When an action potential propagates along the T-tubule in a muscle fiber, which of
the following receptors is activated?
a. dihydropyridine
b. β adrenergic
c. M cholinergic
d. N cholinergic

27. Where does Ca2+ go during muscle contraction?

a. from the sarcoplasm to the sarcoplasmic reticulum down the concentration gradi-
ent
b. from the sarcoplasm to the sarcoplasmic reticulum against the concentration gra-
dient
c. from the sarcoplasmic reticulum to the sarcoplasm against the concentration gra-
dient
d. from the sarcoplasmic reticulum to the sarcoplasm down the concentration gradi-
ent

28. How does the sarcoplasmic reticulum Ca2+-ATPase (SERCA) move Ca2+ ions?
a. from the sarcoplasm to the sarcoplasmic reticulum against the concentration gra-
dient
b. from the sarcoplasm to the sarcoplasmic reticulum down the concentration gradi-
ent
c. from the sarcoplasmic reticulum to the sarcoplasm down the concentration gradi-
ent
d. from the sarcoplasmic reticulum to the sarcoplasm against the concentration gra-
dient

29. Which of the following systems of ATP resynthesis in skeletal muscles acts almost in-
stantaneously?
a. anaerobic
b. aerobic
c. phosphogenic
d. all systems start working simultaneously

30. The sliding of the actin along myosin is due to the movement of which of the following
structures?

30
 a. myosin bridges
b. G-actin
c. F-actin
d. L-cisterns

31. What is the time between stimulation of a muscle and the start of its contraction
called?
a. latent period
b. waiting period
c. exaltation period
d. initiation period

32. The motor unit is formed by a group of muscle fibers innervated by

a. a single γ-motoneuron
b. all α-motoneurons of a spinal cord segment
c. all γ-motoneurons of a spinal cord segment
d. a single α-motoneuron

33. Which of the following parameters changes during an isometric contraction of a mus-
cle?
a. muscle length
b. muscle tension
c. muscle diameter
d. muscle composition

34. Which of the listed muscles contains the smallest number of muscle fibers per motor
unit?
a. opponens pollicis
b. gluteus
c. latissimus dorsi
d. quadriceps

35. What is the mechanism of excitation conduction in unmyelinated nerve fibers and in
skeletal muscle fiber?
a. in muscle fibers – saltatory, in unmyelinated nerve fibers – continuous
b. in nerve unmyelinated fibers – saltatory, in muscle fibers – continuous
c. both in muscle and unmyelinated nerve fibers continuous
d. both in muscle and unmyelinated nerve fibers saltatory

36. In smooth muscle cells, membrane depolarization is mainly caused by the entry of
which of the following ions?
a. Na+
b. Ca2+
c. K+

31
 d. Cl-

37. Which of the following is a regulatory protein in the smooth muscle?

a. troponin
b. tropomyosin
c. titin
d. calmodulin

38. Plasticity is a characteristic of which of the following types of muscle?

a. smooth
b. skeletal
c. cardiac
d. all muscles

Match the items in the left and the right columns

39. Picture Components of protofibrils

a. actin
b. myosin
c. troponin
d. tropomyosin
e. cross bridge

40. Picture Parts of sarcomere

a. A-band
b. I-band
c. H-zone
d. M-line
e. Z-line

41. Troponin subunits Function

1. I a. breaks down ATP
2. C b. pumps Ca2+ into sarcoplasmic reticulum
3. T c. binds troponin to tropomyosin
d. prevents actin and myosin from interacting
e. binds Ca2+

42. Types of muscle con- Characteristics

traction

32
 1. Isometric a. muscle length decreases, its tension increases
2. Isotonic b. muscle length increases, its tension decreases
3. Auxotonic c. muscle tension increases, its length doesn’t change
d. muscle length decreases, its tension doesn’t change

43. Type of muscle fiber Characteristic

1. Fast glycolytic a. moderate myoglobin content and capillary density,
(type IIb) moderate speed and force of contraction, intermedi-
ate resistance to fatigue
2. Fast oxidative b. large diameter, low myoglobin content and capillary
(type IIa) density, high speed and force of contraction, large
motor units, low resistance to fatigue, highly devel-
oped sarcoplasmic reticulum
3. Slow oxidative c. small diameter, high myoglobin content and capil-
(type I) lary density, low speed and force of contraction,
high resistance to fatigue, poorly developed sarco-
plasmic reticulum, small motor units
d. small diameter, large motor units, abundant myoglo-
bin and mitochondria, high speed and force of con-
traction, highly developed sarcoplasmic reticulum,
high resistance to fatigue

Choose two or more correct answers

44. Which of the following proteins are attached to the actin filament at rest (when a mus-
cle is relaxed)?
a. troponin
b. tropomyosin
c. myoglobin
d. myosin
e. fibronectin

45. What do the centers on the head of the myosin molecule do?
a. have ATPase activity
b. bind to the troponin
c. bind to the tropomyosin
d. bind to the actin
e. bind O2

46. Which of the following organs have smooth muscle?

a. bone
b. stomach
c. blood vessel

33
 d. pleura
e. brain

47. Which of the following are physiological characteristics of the skeletal muscle?
a. excitability
b. automaticity
c. plasticity
d. conductivity
e. contractility

48. Which of the following is true of the white muscle fibers?

a. the concentration of aerobic glycolysis enzymes is high
b. they have more myofibrils
c. the capillary network is extensive
d. they have less amount of myoglobin
e. they have small diameter

49. Which of the following is true of red muscle fiber?

a. thin capillary network
b. large number of mitochondria
c. high myoglobin level
d. high speed of contraction
e. they have large diameter

50. What happens in the sarcomere during muscle contraction?

a. A-band contracts
b. M-line stretches
c. H-zone decreases
d. I-band contracts
e. H-zone increases

51. Identify the correct types of tetanic contraction

a. fused
b. unfused
c. multiple
d. mixed
e. expanded

52. Which of the following is correct regarding smooth muscle?

a. low myosin ATPase activity
b. low contraction velocity
c. high speed of contraction
d. presence of troponin in sarcoplasm
e. low fatigability

34
 f. high relaxation velocity
g. presence of calmodulin in sarcoplasm
h. the only source of Ca2+ is sarcoplasmic reticulum

53. What are the electrical properties of the smooth muscle?

a. spontaneous electrical activity
b. resting membrane potential is equal to -85 – -90 mv
c. resting membrane potential is equal to -50 – -60 mv+
d. slow waves of transmembrane potential
e. action potential never has a plateau phase
f. action potential duration is greater than 10 ms
g. action potential duration is less than 10 ms
h. depolarization is caused only by the entry of sodium ions

Arrange the correct sequence

54. Arrange the tissues in ascending order of duration of an action potential?

a. skeletal muscle
b. nerve
c. smooth muscle

55. Arrange amplitude of muscle contraction types of in ascending order (from lowest to
highest)
a. fused tetanus
b. twitch
c. unfused tetanus

56. Arrange the phases of muscle twitch in the correct order

a. contraction
b. relaxation
c. latency

57. Arrange the processes that take place during excitation-contraction coupling in the
correct order
a. an action potential propagates along T-tubule
b. Ca2+ binds to troponin
c. Ca2+ is released from the sarcoplasmic reticulum
d. tropomyosin moves away from the myosin-binding site of actin

58. Arrange the processes that take place during muscle contraction in the correct order
a. ATP is hydrolyzed and the myosin head shifts to the cocked state
b. ATP molecule binds to a myosin head and the myosin head detaches from the
actin filament

35
 c. the myosin head changes conformation and produces the power stroke
d. phosphate is released and the myosin head binds to the next myosin-binding center
of actin

59. Arrange the mechanisms of ATP resynthesis in ascending order of the duration of
energy supply to the working muscle (from the shortest to the longest)
a. aerobic
b. phosphogenic
c. anaerobic

60. Arrange the phases of heat production in the correct order

a. heat of activation
b. heat of relaxation
c. heat of contraction

Fill in the gaps

61. The stimulation frequency that causes a tetanic contraction of maximum amplitude is
called ______.

62. The part of a myofibril between two Z-lines is called a _____.

63. The part of the sarcomere made up of myosin filaments is called the _______.

64. A motor neuron with all of the muscle fibers it supplies is called a _______.

65. A T-tubule with two adjacent L-cisternae is called a ________.

66. A regulatory protein consisting of three subunits, one of which binds Ca2+ and another
blocks the myosin-binding center of actin, is called ______.

67. The type of contraction, in which the length of the muscle doesn’t change and the
tension increases is called _______.

68. The type of contraction, in which the length the muscle decreases and the tension
doesn’t change is called _______.

36
 CORRECT ANSWER KEYS FOR SECTION I

1.1 Physiology of cell membranes. Electrical phenomena in the neu-

romuscular system

1. a 21. a 41. a, d
2. b 22. a 42. b, c
3. b 23. d 43. a, c, e
4. b 24. a 44. b, d
5. b 25. c 45. 1b, 2c, 3a
6. a 26. d 46. 1c, 2a, 3b
7. b 27. b 47. 1a, 2c, 3b
8. a 28. b 48. 1c, 2d, 3a, 4b
9. b 29. d 49. 1a, 2c, 3b, 4d
10. b 30. c 50. irritability
11. a 31. 1b, 2a, 3d 51. chronaxie
12. c 32. 1c, 2e, 3a 52. latency
13. b 33. 1b, 2d, 3a 53. excitability
14. c 34. 1c, 2a, 3d 54. simple diffusion
15. c 35. 1e, 2d, 3c 55. active transport
16. d 36. a, c 56. voltage-gated
17. a 37. b, d 57. absolute refractoriness
18. b 38. a, b, e
19. d 39. d, e
20. c 40. b, c, d, e

1.2 Physiology of nerves and neuromuscular junction

1. a 23. a 45. a, d
2. a 24. d 46. a, b, c, e
3. a 25. c 47. d, e
4. b 26. b 48. a, d
5. b 27. b 49. b, c, e
6. b 28. d 50. c, f
7. a 29. c 51. a, b
8. a 30. b 52. b, e
9. b 31. a 53. a, b, f, g
10. d 32. a 54. 1d, 2c, 3b, 4a
11. b 33. c 55. 1b, 2a, 3c
12. c 34. c 56. 1d, 2b, 3a, 4c
13. a 35. b 57. 1a, 2d, 3c, 4e, 5b
14. b 36. d 58. 1b, 2a, 3c, 4e, 5d

37
 15. c 37. a 59. lability
16. b 38. 1e, 2c, 3b 60. saltatory
17. a 39. 1b, 2a, 3e, 4d 61. cholinesterase
18. d 40. 1d, 2b, 3a 62. acetylcholine
19. b 41. 1a, 2c, 3b 63. presynaptic
20. a 42. 1d, 2c, 3a 64. kinesin
21. b 43. b, c 65. dynein
22. d 44. a, b

1.3 Muscle physiology. Mechanism of muscle contraction

1. b 24. b 47. a, d, e
2. a 25. c 48. b, d
3. b 26. a 49. b, c
4. a 27. d 50. c, d
5. a 28. a 51. a, b
6. b 29. c 52. a, b, e, g
7. b 30. a 53. a, c, d, f
8. a 31. a 54. 1b, 2a, 3c
9. c 32. d 55. 1b, 2c, 3a
10. b 33. b 56. 1c, 2a, 3b
11. c 34. a 57. 1a, 2c, 3b, 4d
12. a 35. c 58. 1b, 2a, 3d, 4c
13. b 36. b 59. 1b, 2c, 3a
14. c 37. d 60. 1a, 2c, 3b
15. a 38. a 61. optimum
16. a 39. 1a, 2d, 3c 62. sarcomere
17. b 40. 1b, 2a, 3d 63. A-band
18. d 41. 1d, 2e, 3c 64. motor unit
19. a 42. 1c, 2d, 3a 65. triad
20. c 43. 1b, 2a, 3c 66. troponin
21. a 44. a, b 67. isometric
22. a 45. a, d 68. isotonic
23. b 46. b, c

38
 Section II. PHYSIOLOGY OF THE CENTRAL NERV-
OUS SYSTEM

2.1 General physiology of the central nervous system

Choose one correct answer

1. Which of the following glial cells are of mesenchymal origin?

a. astrocytes
b. ependymal cells
c. oligodendroglia
d. microglia

2. Which of the following types of nervous system do mammals have?

a. diffuse
b. ganglionic
c. tubular
d. planar

3. Which of the following glial cells have an immune function?

a. astrocytes
b. ependymal cells
c. oligodendrocytes
d. microglia

4. Which of the following glial cells form the lining of cerebral ventricles?
a. astrocytes
b. ependymal cells
c. oligodendrocytes
d. microglia

5. Which of the following cells are mainly involved in the formation of the blood-brain
barrier?
a. astrocytes
b. ependymal cells
c. oligodendrocytes
d. neurilemmocytes

6. Which of the following cell types forms the myelin sheath in the CNS?
a. oligodendrocytes
b. Schwan cells
c. ependymal cell

39
 d. astrocytes

7. A neuron can have several

a. somata (bodies)
b. dendrites
c. axons
d. nuclei

8. Which of the following types of neurons carries sensory information to the CNS?
a. afferent
b. efferent
c. interneurons
d. unipolar neurons

9. Which of the following types of neurons conveys information from the CNS to the
effector organs?
a. afferent
b. efferent
c. interneurons
d. unipolar neurons

10. Which of the following types of neurons has a T-branched axon?

a. unipolar
b. bipolar
c. multipolar
d. pseudounipolar

11. Which of the following types of neurons has one dendrite and one axon?
a. unipolar
b. pseudounipolar
c. bipolar
d. multipolar

12. In which of the following parts of the neuron is the action potential usually generated?
a. dendrite
b. soma
c. axon hillock
d. axon terminal

13. Which of the following types of neurons are usually located in the ganglia rather than
the CNS?
a. unipolar
b. pseudounipolar

40
 c. bipolar
d. multipolar

14. The central time of a reflex is the time at which a nerve impulse is transmitted:
a. from the afferent neuron to the efferent
b. from the afferent neuron to the interneuron
c. from the interneuron to the effector
d. from the receptor to the effector

15. The simplest reflex arc consists of which of the following neurons?
a. efferent and interneuron
b. afferent and interneuron
c. two interneurons
d. afferent and efferent

16. Which of the following neurons may be missing from the reflex arc?
a. afferent neuron
b. interneuron
c. efferent neuron
d. effector

17. A set of receptors, stimulation of which triggers a reflex, is called the

a. receptive field
b. receptive network
c. reflex field
d. receptive zone

18. Reflex is a reaction of an organism with the obligatory participation of the:

a. central nervous system
b. brain
c. nervous system
d. endocrine system

19. Which of the following parts of the neuron is called the “initial zone”?
a. presynaptic membrane
b. dendrites
c. soma
d. axon hillock

20. Which of the following is required for a neuron to generate an action potential?
a. the membrane potential must reach the threshold level of depolarization
b. inhibitory influences must be absent
c. two or more excitatory synapses must be acting on the neuron

41
 d. the membrane potential must reach the threshold level of hyperpolarization

21. Which of the following parts of the synapse has the most receptors for a neurotrans-
mitter?
a. presynaptic membrane
b. postsynaptic membrane
c. synaptic cleft
d. synaptic terminal

22. Which of the following parts of the synapse has voltage-gated calcium channels?
a. presynaptic membrane
b. postsynaptic membrane
c. synaptic cleft
d. synaptic terminal

23. Which of the following parts of the synapse contains synaptic vesicles?
a. presynaptic membrane
b. postsynaptic membrane
c. synaptic cleft
d. synaptic terminal

24. The synaptic cleft is mainly filled with which of the following?
a. extracellular fluid
b. axoplasm
c. sarcoplasm
d. cerebrospinal fluid

25. The entry of which of the following ions into the synaptic terminal causes the release
of mediator into the synaptic cleft
a. Na+
b. K+
c. Ca2+
d. Mg2+

26. Which of the following is true about the excitatory postsynaptic potential (EPSP)?
a. is an all-or-none response
b. propagates without decrement
c. causes refractoriness
d. can be summed

27. Which of the following neurotransmitters is almost always inhibitory?

a. glutamate
b. acetylcholine
c. histamine

42
 d. GABA

28. Which of the following neurotransmitters increases the permeability of the postsyn-
aptic membrane to chloride ions?
a. glutamate
b. acetylcholine
c. histamine
d. GABA

29. Primary inhibition is divided into which of the following types

a. presynaptic and postsynaptic
b. presynaptic and pessimal
c. pessimal and recurrent
d. postsynaptic and recurrent

30. Presynaptic inhibition occurs in which of the following types of synapses?

a. axodendritic
b. axosomatic
c. axoaxonic
d. axospinous

31. Which of the following underlies pessimal inhibition?

a. sustained depolarization of the postsynaptic membrane
b. sustained hyperpolarization of the postsynaptic membrane
c. inactivation of Ca2+ channels in the presynaptic membrane
d. sustained depolarization of the presynaptic membrane

32. Which of the following processes is inhibited by presynaptic inhibition?

a. fusion of synaptic vesicles with the presynaptic membrane
b. Ca2+ entry into the synaptic ending
c. activation of neurotransmitter receptors
d. reuptake of the neurotransmitter by the synaptic ending

33. Inhibition of a nervous center by a center-antagonist is called

a. reciprocal
b. recurrent
c. presynaptic
d. pessimal

34. The increased response of the synaptic terminal after high-frequency stimulation is
called
a. posttetanic depression
b. posttetanic potentiation
c. long-term potentiation

43
 d. central facilitation

35. Posttetanic potentiation is caused by the accumulation of which of the following ions
in the synaptic terminal?
a. chloride
b. sodium
c. calcium
d. magnesium

36. The transmission of sensory information from the effector to the control center un-
derlies which of the following mechanisms?
a. dominance
b. feedback
c. central facilitation
d. concentration

37. What is the spread of excitation beyond the boundaries of a nerve center called?
a. irradiation
b. summation
c. distribution
d. contamination

38. Which of the following causes tonic activity of the nervous center?
a. increased amplitude of the EPSP
b. spontaneous activity of neurons
c. depletion neurotransmitters
d. sustained depolarization of neurons

39. The phenomenon in which the combined effect of two stimuli acting simultaneously is
less than the sum of their individual effects is called
a. transformation
b. central facilitation
c. occlusion
d. potentiation

40. Which of the following phenomena underlies spatial summation?

a. divergence
b. convergence
c. potentiation
d. dominant

Match the items in the left and the right columns

44
41. Potential Characteristic
1. Action potential a. local, can’t be summed, obeys the all-or-none
law, doesn’t cause refractoriness
2. Excitatory postsynaptic po- b. propagates with decrement, its amplitude de-
tential pends on the amount of the neurotransmitter,
depolarizing, doesn’t cause refractoriness
3. Inhibitory postsynaptic po- c. obeys the “all-or-none” law, propagates with-
tential out decrement, can’t be summed
d. local, its amplitude depends on the amount of
neurotransmitter, can be summed, hyperpo-
larizing

42. Classifying characteristic Types of synapses

1. Mechanism of transmission a. excitatory, inhibitory, modulating
2. Effect on the postsynaptic neuron b. electrical, chemical
3. Neurotransmitter released c. axoaxonic, axodendritic, axosomatic
d. glutamatergic, cholinergic, GABAergic…

43. Classifying characteristic Types of reflexes

1. Localization of reflex center a. simple, complex, chain
2. Receptors b. secretory, vasomotor, motor
3. Reflex reactions c. exteroceptive, interoceptive, proprio-
ceptive
d. spinal, bulbar, mesencephalic…

44. Types of inhibition Characteristic

1. Postsynaptic a. occurs in axosomatic and axodendritic inhibitory syn-
apses
2. Presynaptic b. occurs in axosomatic and axodendritic excitatory syn-
apses
3. Pessimal c. occurs in axoaxonic inhibitory synapses
d. occurs in axoaxonic excitatory synapses

45
 45. Characteristics of Definition
neural center
1. Occlusion a. the frequency and rhythm of the impulses at the input and
output of the neural center are different
2. Aftereffect b. the neural center transmits impulses only in one direction
3. Transformation c. the combined effect of two stimuli acting simultaneously
is less than the sum of their individual effects
d. the neural center continues to generate impulses even after
stimulation has ceased

46. Glial cell Characteristics

1. Astrocyte a. forms the myelin sheath in the CNS
2. Oligodendrocyte b. has trophic function, participates in formation of blood-
brain barrier
3. Ependymal cell c. forms the lining of the cerebral ventricles
d. has immune and protective functions

Choose two or more correct answers

47. Which of the following cells form myelin sheath?

a. Schwann cells
b. ependymal cell
c. oligodendrocytes
d. astrocytes
e. fibrocytes

48. How are reflexes classified according to the location of their center?
a. exteroceptive
b. vascular
c. defensive
d. spinal
e. bulbar

49. How are synapses classified according to their transmission mechanism?

a. electrical
b. ionotropic
c. metabotropic
d. axosomatic
e. chemical

50. Which of the following is true about the chemical synapse as opposed to the electrical
synapse?
a. has higher lability

46
 b. transmits excitation unidirectionally
c. is able to change their strength depending on previous activity
d. is not able to amplify a signal
e. has greater synaptic delay

51. Which of the following is true about inhibition?

a. is an active process
b. occurs only in axosomatic and axodendritic synapses
c. occurs in the absence of excitation
d. involved in the coordination of functions (reflexes)
e. occurs only in the brain

52. Which of the following processes are involved in inhibition?

a. hyperpolarization
b. sustained depolarization
c. repolarization
d. local response
e. axonal transport

53. Which of the following types of inhibition are primary?

a. pessimal
b. inhibition after excitation
c. presynaptic
d. postsynaptic

54. IPSP is caused by the increased membrane permeability to which of the following
ions?
a. sodium
b. chloride
c. calcium
d. magnesium
e. potassium

Arrange the correct sequence

55. Arrange the processes that take place during transmission in the excitatory synapse
in the correct order
a. voltage-gated Ca2+ channels open and Ca2+ enters the synaptic terminal
b. an action potential arrives at the presynaptic membrane
c. EPSP is generated
d. neurotransmitter acts on receptors in the postsynaptic membrane
e. neurotransmitter is released into the synaptic cleft
f. sodium channels in the postsynaptic membrane open

47
56. Arrange the processes that take place during postsynaptic inhibition in the correct
order
a. neurotransmitter acts on receptors in the postsynaptic membrane
b. an action potential arrives at the presynaptic membrane
c. IPSP is generated
d. chloride channels in the postsynaptic membrane open
e. voltage-gated Ca2+ channels open and Ca2+ enters the synaptic terminal
f. neurotransmitter is released into the synaptic cleft

57. Arrange the processes that take place during presynaptic inhibition in the correct or-
der
a. chloride channels in the presynaptic membrane of the excitatory neuron open
b. voltage-gated Ca2+ channels open and Ca2+ enters the synaptic terminal of the in-
hibitory neuron
c. an action potential arrives at the presynaptic membrane of the inhibitory neuron
d. neurotransmitter acts on receptors in the presynaptic membrane of the excitatory
neuron
e. neurotransmitter is released from the synaptic ending of the inhibitory neuron into
the synaptic cleft
f. Ca2+ channels in the presynaptic membrane of the excitatory neuron become in-
activated

58. Arrange elements of the reflex arc in the correct order

a. efferent neuron
b. interneuron
c. effector
d. receptor
e. afferent neuron

Fill in the gaps

59. The part of a neuron where the action potential is generated is called the axon ____.

60. The glial cell that participates in the formation of the blood-brain barrier is called
_____.

61. The glial cell that forms the myelin sheath in the CNS is known as ______.

62. The type of inhibition in which an inhibitory neuron blocks the neurotransmitter re-
lease from the terminal of an excitatory synapse is called _________ inhibition.

63. The glial cells that form lining of the cerebral ventricles are called ________ cells.

48
64. The type of inhibition that occurs in excitatory synapses after a prolonged intense
stimulation is known as _______ inhibition.

65. The increase in EPSP amplitude after high-frequency (tetanic) stimulation is called
________.

66. There are two types of summation: temporal and _______.

67. The spread of excitation beyond the boundaries of a nerve center is called _______.

68. The phenomenon in which the combined effect of two stimuli acting simultaneously is
less than the sum of their individual effects is called _________.

2.2 Physiology of the spinal cord. Physiology of the medulla and

midbrain

Choose one correct answer

1. Which of the following is true about the roots of the spinal cord?
a. ventral roots are efferent, dorsal roots are afferent
b. dorsal roots are efferent, ventral roots are afferent
c. ventral roots are both afferent and efferent, dorsal roots are efferent
d. dorsal roots are both afferent and efferent, ventral roots are efferent

2. All the motor neurons that supply one skeletal muscle are called the
a. motor unit
b. end plate unit
c. motor pool
d. muscle metamere

3. What neurons are mainly found in the dorsal horn of the spinal cord?
a. afferent
b. interneurons
c. efferent (motor)
d. autonomic

4. What neurons are mainly found in the lateral horn of the spinal cord?
a. afferent
b. interneurons
c. efferent (motor)
d. autonomic

49
5. Which of the following is true about the Renshaw cells?
a. they are inhibitory neurons
b. they are found mainly in the dorsal horn
c. they are afferent neurons
d. they have one dendrite

6. Skeletal muscle tendons have receptors that detect the muscle tension. What are these
receptors called?
a. neuromuscular spindles
b. Golgi tendon organs
c. Meissner’s corpuscles
d. free nerve endings

7. Skeletal muscles have receptors that detect the muscle length. What are these recep-
tors called?
a. Golgi tendon organs
b. Meissner’s corpuscles
c. neuromuscular spindles
d. free nerve endings

8. What neurons are mainly found in the ventral horn of the spinal cord?
a. afferent
b. interneurons
c. efferent (motor)
d. autonomic

9. From which of the following receptors does the elbow reflex originate?
a. Golgi tendon organ
b. neuromuscular spindles
c. tactile
d. pain

10. Identify the segments of the spinal cord in which the center of the knee-jerk (patellar)
reflex is located
a. LI – LII
b. LII – LIV
c. LV – SI
d. SI – SII

11. Which of the following neurons provide motor input to the extrafusal fibers?
a. α-motoneurons
b. Renshaw cells
c. interneurons
d. γ-motoneurons

50
12. Which of the following spinal pathways carries information from the pain and tem-
perature receptors?
a. gracile fasciculus
b. rubrospinal tract
c. tectospinal tract
d. spinothalamic tract

13. Which of the following spinal pathways carries information from the proprioceptors?
a. gracile fascicle
b. spinothalamic tract
c. rubrospinal tract
d. tectospinal tract

14. Which of the following spinal pathways originates from the quadrigeminal plate?
a. gracile fascicle
b. spinothalamic tract
c. rubrospinal tract
d. tectospinal tract

15. Which of the following neurotransmitters is released by neurons in the compact part
of the substantia nigra?
a. glutamate
b. GABA
c. dopamine
d. acetylcholine

16. Which of the following does the Golgi tendon organ respond to?
a. absolute muscle length
b. rate of change of muscle length
c. muscle tension
d. electrical activity of the muscle

17. In a decerebrated animal, when the head is bent to the left, the right limbs extend and
the left limbs flex. The reflex described belongs to which of the following types?
a. neck reflex
b. labyrinthine
c. righting
d. statokinetic

18. Which of the following structures in the medulla oblongata is a segmental nerve cen-
ter?
a. Deiters nucleus
b. dorsal nucleus of the vagal nerve
c. inferior olivary nucleus

51
 d. respiratory center

19. Which of the following cranial nerve nuclei is located in the midbrain?
a. glossopharyngeal
b. oculomotorius
c. trigeminal
d. hypoglossal

20. Which of the following cranial nerve nuclei is located in the medulla oblongata?
a. trochlear
b. oculomotorius
c. trigeminal
d. hypoglossal

21. Identify the structure which is innervated by the III cranial nerve
a. sublingual salivary gland
b. muscles of the tongue
c. pupillary sphincter
d. parotid salivary gland

22. How does the red nucleus affect muscular tone?

a. increases flexor tone, decreases extensor tone
b. increases extensor tone, decreases flexor tone
c. increases tone of both flexors and extensors
d. decreases tone of both flexors and extensors

23. Which of the following lesions causes decerebrate rigidity?

a. destruction of the vestibular nuclei
b. damage to the α-motor neurons of the spinal cord
c. destruction of the red nuclei
d. lesion of the substantia nigra

24. Which of the following represents a manifestation of decerebrate rigidity?

a. flexor muscle tone increases, extensor muscle tone decreases
b. extensor muscle tone increases, flexor muscle tone decreases
c. muscle tone increases on the left side of the body and decreases on the right side
d. muscle tone decreases on the left side of the body and increases on the right side

25. The superior colliculi of the quadrigeminal plate are the subcortical center of which
of the following sensory systems?
a. auditory
b. visual
c. somatosensory
d. olfactory

52
26. The inferior colliculi of the quadrigeminal plate are the subcortical center of which of
the following sensory systems?
a. auditory
b. visual
c. somatosensory
d. olfactory

27. The superior colliculi of the quadrigeminal plate send projections to which of the fol-
lowing nuclei?
a. medial geniculate body
b. lateral geniculate body
c. substantia nigra pars compacta
d. substantia nigra pars reticulata

28. The inferior colliculi of the quadrigeminal plate send projections to which of the fol-
lowing nuclei?
a. lateral geniculate body
b. substantia nigra pars compacta
c. substantia nigra pars reticulata
d. medial geniculate body

29. Which of the following is the association thalamic nucleus?

a. medial geniculate body
b. ventral lateral
c. pulvinar
d. centromedian

30. Which of the following is the relay thalamic nucleus?

a. lateral geniculate body
b. mediodorsal
c. pulvinar
d. reticular

31. In which part of the central nervous system is the center of the lacrimatory reflex
located
a. midbrain
b. pons
c. diencephalon
d. medulla oblongata

32. In which part of the central nervous system is the center of the pupillary reflex located
a. midbrain

53
 b. pons
c. diencephalon
d. medulla oblongata

33. Which of the following is a static reflex?

a. rotational
b. rectilinear
c. righting
d. knee-jerk (patellar)

34. Which of the following reflexes aims to restore impaired balance?

a. statokinetic
b. righting
c. neck
d. labyrinthine

35. Where do the neurons of the relay nuclei of the thalamus send their axons?
a. to the basal nuclei
b. to the associative areas of the cerebral cortex
c. to the neurons of all layers of the cerebral cortex to form diffuse projections
d. to the projection areas of the cerebral cortex

36. What is the main function of the non-specific thalamic nuclei?

a. analysis of stimuli of different modalities and transmission of the integrated signal
to the cortical association areas
b. transmitting information from the receptors to the cerebral cortex
c. modulating the level of excitability of the cerebral cortex
d. providing feedback from the cerebral cortex to the sensory systems

Match the items in the left and the right columns

37. Cranial nerve number Cranial nerve name

1. VII a. glossopharyngeal
2. IX b. hypoglossal
3. XII c. facial
d. oculomotor

38. Cranial nerve Function

54
 1. Hypoglossal a. supplies sensory innervation of the middle ear, nasal cavity,
soft palate, anterior two-thirds of the tongue (gustatory), ex-
ternal auditory meatus; supplies lacrimal and nasal glands,
sublingual, submandibular and palatine salivary glands;
supplies the muscle of facial expression
2. Oculomotor b. supplies the extraocular superior oblique muscle
3. Facial c. supplies tongue muscles
d. supplies all extraocular muscles except for lateral rectus and
superior oblique; supplies ciliary muscle and sphincter pu-
pillae

39. Type of thalamic nuclei Examples

1. Relay a. pulvinar, anterior, dorsomedial, lateral posterior
2. Association b. central medial, central lateral, paracentral, centrome-
dian
3. Nonspecific c. red, vestibular, inferior olive
d. lateral and medial geniculate bodies, ventral lateral,
ventral posterolateral, ventral posteromedial

40. Type of thalamic nuclei Functions

1. Relay a. send diffuse projections to all of the cortical areas to
modulate the activity of the cerebral cortex; involved
in the regulation of the sleep-wake cycle
2. Association b. transmit information of a particular modality from the
subcortical sensory nuclei to the projection cortical
areas
3. Non-specific c. regulate visceral functions, control the activity of the
autonomic nervous system, provide the sensation of
hunger and satiety
d. have polysensory neurons that integrate information
of different modalities from the subcortical sensory
nuclei and projection cortical areas to send projec-
tions to the association cortical areas

41. Tendon reflex Location of reflex center (segments of the spinal cord)
1. Biceps a. SI – SII
2. Patellar (knee-jerk) b. LII – LIV
3. Achilles (ankle-jerk) c. CV – CVI
d. CVIII – ThII

42. Spinal pathway Function

55
 1. Rubrospinal a. carries sensory information from pain and temperature re-
ceptors to the thalamus
2. Spinothalamic b. carries proprioceptive information to the thalamus
3. Tectospinal c. carries information from the quadrigeminal plate to the
cervical part of the spinal cord; involved in the startle re-
flex
d. increases flexor muscle tone, involved in the regulation of
voluntary movement

Choose two or more correct answers

43. Which parts of the spinal cord have enlargements?

a. cervical
b. thoracic and lumbar
c. lumbar
d. sacral
e. cervical and thoracic

44. Centers of which of the following reflexes are located in the spinal cord?
a. sucking
b. withdrawal
c. rhythmic (stepping, scratch)
d. labyrinthine
e. corneal

45. Which of the following neurons innervates the neuromuscular spindles?

a. afferent
b. α-motor neuron
c. excitatory interneuron
d. inhibitory interneuron
e. γ-motor neuron

46. Which of the following is true of the nuclear chain intrafusal fibers?
a. are parallel to the extrafusal fibers
b. respond to the tension of a muscle
c. are innervated by type II fibers
d. provide a dynamic response
e. are in series with the extrafusal fibers

47. Which of the following is true of the myotatic reflex?

a. its center is located in the thalamus
b. is monosynaptic
c. the efferent limb contains γ-motoneurons

56
 d. starts from the neuromuscular spindles
e. starts from the Golgi tendon organs

48. Centers of which of the following reflexes are located in the medulla oblongata?
a. orienting
b. pupillary light reflex
c. respiratory
d. labyrinthine
e. righting

49. Which of the following are the defense reflexes of the medulla oblongata and pons?
a. vomiting
b. cough
c. sucking
d. labyrinthine
e. salivating
f. blinking

50. Which of the following nerve centers (nuclei) are located in the medulla oblongata and
pons?
a. cardiovascular center
b. inferior colliculi of the quadrigemina
c. red nuclei
d. vestibular nuclei
e. substantia nigra

Arrange the correct sequence

51. Arrange the cranial nerves in ascending order of number

a. trigeminal
b. oculomotor
c. hypoglossal
d. vagal
e. facial

52. Arrange the elements of the γ-loop in the correct order

a. α-motor neurons
b. intrafusal fibers
c. extrafusal fibers
d. γ-motor neurons
e. afferent neurons

Fill in the gaps

57
53. γ-motor neurons supply _____ muscle fibers.

54. The tonic reflexes are divided into two types: static and ________.

55. Autonomic neurons are located in the _______ horn of the spinal cord.

56. Renshaw cells are mainly located in the ________ horn of the spinal cord

57. The ______ colliculus of the quadrigeminal plate is a center of the auditory sensory
system.

58. The _____ colliculus of the quadrigeminal plate is a center of the visual sensory sys-
tem.

59. The exaggerated extensor tone due to damage to the red nuclei and/or rubrospinal
tract is called ________.

60. Thalamic nuclei can be classified as relay, association and _______.

61. The receptor that responds to an increase in muscle tension are called __________.

2.3 Physiology of the reticular formation. Cerebellum, basal nuclei.

The extrapyramidal system

Choose one correct answer

1. Which of the following parts of the cerebellum is involved in the regulation of eye
movements?
a. vestibulocerebellum
b. spinocerebellum
c. cerebrocerebellum

2. Which of the following parts of the cerebellum is involved in the movement timing?
a. vestibulocerebellum
b. spinocerebellum
c. cerebrocerebellum

3. How many columns are there in the reticular formation?

a. 2
b. 3

58
 c. 4
d. 5

4. Which of the following nuclei is located in the median column of the reticular for-
mation?
a. raphe
b. gigantocellular
c. parvocellular
d. locus coeruleus

5. Which of the following is a neurotransmitter in the raphe nucleus?

a. enkephalin
b. serotonin
c. dopamine
d. acetylcholine

6. Which of the following is a neurotransmitter in the locus coeruleus?

a. norepinephrine
b. serotonin
c. dopamine
d. acetylcholine

7. Identify the structure that relays information passing from the cerebral cortex to the
cerebellar cortex
a. vestibular nuclei
b. ventrolateral thalamic nuclei
c. ventral anterior thalamic nuclei
d. pontine nuclei

8. From which part of the CNS does the cerebellum receive afferent information via the
upper peduncles?
a. inferior olivary nuclei
b. vestibular nuclei
c. spinal cord
d. cerebral cortex

9. Which of the following brainstem nuclei receives afferent input directly from the cer-
ebellar cortex?
a. gigantocellular
b. vestibular
c. red
d. thalamic ventral lateral

10. Which of the following neurons in the cerebellar cortex are excitatory?

59
 a. stellate cells
b. basket cells
c. granule cells
d. ganglion (Purkinje) cells

11. Which of the following structure is the origin of the climbing fibers?
a. pontine nuclei
b. superior quadrigeminal collicules
c. inferior olivary nuclei
d. red nuclei

12. The climbing fibers synapse with which of the following nerve cells?
a. granule cells
b. Golgi cells
c. basket cells
d. Purkinje cells

13. The axons of which of the following neurons form parallel fibers in the cerebellar cor-
tex?
a. Golgi cells
b. Purkinje cells
c. granule cells
d. stellate cells

14. Which of the following cerebellar nuclei is a part of the neocerebellum?

a. dentate
b. emboliform
c. globose
d. fastigial

15. If the cerebellum is damaged, the ability to perform rapid alternating movements (for
example, pronating and supinating) is lost. This condition is called
a. ataxia
b. dysdiadochokinesis
c. hemiballismus
d. disequilibria

16. The typical cerebellar speech disorder characterized by slowed articulatory move-
ments, monotonous and “scanning” speech is called
a. dysarthria
b. dysgraphia
c. ataxia
d. astasia
17. Which of the following is a neurotransmitter in the substantia nigra (pars compacta)?

60
 a. norepinephrine
b. acetylcholine
c. epinephrine
d. dopamine

18. Identify the structure in which most of the fibers from the globus pallidus terminate
a. thalamus
b. cerebral cortex
c. striatum
d. red nucleus

19. What does the spinocerebellum do?

a. controls eye movement
b. compares the plan of a movement with its execution
c. initiates movement
d. maintains balance

20. The outer (superficial) layer of the cerebellar cortex is called

a. granular
b. molecular
c. pyramidal
d. ganglion

21. The inner (deep) layer of the cerebellar cortex is called

a. granular
b. molecular
c. pyramidal
d. ganglion

22. Which of the following cells form efferent fibers from the cerebellar cortex?
a. granule
b. basket
c. stellate
d. ganglion (Purkinje)

23. Purkinje cells axons project mainly to which of the following nuclei?
a. deep cerebellar and vestibular
b. deep cerebellar and red
c. red and pontine
d. pontine and vestibular

24. What are the effects of mossy and climbing fibers on the cerebellar cortex?
a. mossy fibers are excitatory, climbing fibers are inhibitory

61
 b. mossy fibers are inhibitory, climbing fibers are excitatory
c. both mossy and climbing fibers are excitatory
d. both mossy and climbing fibers are inhibitory

25. Projections from the cerebral cortex to the corpus striatum are mainly
a. glutamatergic
b. glycinergic
c. GABAergic
d. cholinergic

26. Projections from the corpus striatum to the globus pallidus are mainly
a. glutamatergic
b. glycinergic
c. GABAergic
d. cholinergic

27. Which of the following brain divisions forms the upper boundary of the reticular for-
mation?
a. medulla oblongata
b. pons
c. diencephalon
d. midbrain

28. Rapid movements that can’t be controlled while performing are called
a. ballistic
b. kinetic
c. tetanic
d. missile

29. The corpus striatum is made up of which of the following structures?

a. caudate nucleus and putamen
b. substantia nigra and globus pallidus
c. globus pallidus and subthalamic nucleus
d. globus pallidus and caudate nucleus

30. Which of the following structures receives afferent information from the cerebral cor-
tex?
a. subthalamic nucleus
b. corpus striatum
c. globus pallidus
d. substantia nigra

31. If the corpus striatum is damaged, which of the following conditions occurs?
a. hemiballismus

62
 b. chorea
c. Parkinson’s disease
d. athetosis

32. Which of the following tracts is a part of the pyramidal system?

a. rubrospinal
b. reticulospinal
c. tectospinal
d. corticonuclear

33. Which of the following conditions is hypokinesia?

a. Parkinson’s disease
b. athetosis
c. chorea
d. hemiballismus

Match the items in the left and tight columns

34. Functional subdivision Anatomical subdivision

1. Vestibulocerebellum a. vermis and intermediate zone
2. Spinocerebellum b. flocculonodular lobe
3. Cerebrocerebellum c. inferior medullary vellum
d. lateral hemispheres

35. Subdivision Corresponding main connections

1. Archicerebellum a. input: cerebral cortex (via pons); output: cerebral cor-
tex (via thalamus)
2. Paleocerebellum b. input: nucleus tractus solitarius; output: dorsal nucleus
of the vagal nerve
3. Neocerebellum c. input: vestibular nucleus, semicircular channels; out-
put: reticular formation, vestibular nucleus
d. input: spinal cord (proprioceptors), cerebral cortex (via
pons); output: red nucleus, cerebral cortex (via thala-
mus)

36. Subdivision Function

63
 1. Vestibulocerebellum a. involved in programming of voluntary movements
and movement timing
2. Spinocerebellum b. controls balance, regulates eye movement
3. Cerebrocerebellum c. involved in regulating body temperature and blood
glucose levels
d. compares the plan of a movement with its execution

37. Sign Characteristic

1. Dysmetria a. involuntary rapid oscillating movements of the eyes
2. Nystagmus b. poor muscle control and coordination in arms and legs
3. Ataxia c. inability to assess the distance to an object accurately (un-
dershoot or overshoot of intended position with the hand)
d. inability to perform rapid alternating movements

38. Types of the fibers Sources

1. Climbing a. α- and γ-motor neurons of the spinal cord
2. Mossy b. pontine nuclei
3. Non-specific c. locus coeruleus and raphe nucleus
d. inferior olive nucleus

39. Nuclei Neurotransmitters

1. Locus coeruleus a. norepinephrine
2. Raphe nucleus b. dopamine
3. Ventral tegmental area c. serotonin
d. acetylcholine

40. Columns Nuclei

1. Median a. parvacellular
2. Medial b. raphe nucleus
3. Lateral c. gigantocellular
d. inferior olivary nucleus

41. Nuclei Neurotransmitters

1. Substantia nigra a. serotonin
2. Subthalamic b. GABA
3. Globus pallidus c. glutamate
d. dopamine

42. Nucleus Condition when it is damaged

64
 1. Substantia nigra a. Parkinson’s disease (muscle rigidity, tremor at rest, hin-
drance of voluntary movements, bradykinesia)
2. Putamen b. flaccid paralysis (areflexia, muscular atonia and atro-
phy)
3. Subthalamic nu- c. ballism (flinging movements of the proximal extremi-
cleus ties)
d. chorea (involuntary dance-like movements, twisting
and jerking movements of arms, legs, face)

Choose two or more correct answers

43. Which of the following nuclei are part of the reticular formation?
a. raphe nuclei
b. fastigial
c. gigantocellularis
d. inferior olive
e. red

44. Which of the following is true about neurons of the reticular formation?
a. are located in the basal nuclei and cerebellum
b. are organized into nuclei with distinct borders
c. they are polysensory
d. have axons that don’t usually branch
e. have tonic activity
f. have a marked divergence

45. What does the reticular formation do?

a. regulates voluntary movements of the limbs
b. activates the cerebral cortex
c. carries information to the sensory areas of the cerebral cortex
d. controls muscle tone
e. controls autonomic functions

46. From which of the following receptors does the cerebellum receive afferent infor-
mation?
a. olfactory
b. proprioceptors
c. vestibular
d. gustatory
e. auditory

47. Which of the following are the functions of the neocerebellum?

65
 a. balance maintenance
b. movement timing (timing of a sequence of movements)
c. selecting of an appropriate motor command
d. planning of movements
e. control of eye movements

48. Identify the structures that belong to the basal nuclei

a. red nucleus
b. substantia nigra
c. nucleus caudate
d. globus pallidus
e. subthalamic nucleus

49. Which of the following nuclei are NOT part of the direct pathway?
a. outer segment of the globus pallidus
b. inner segment of the globus pallidus
c. ventral lateral thalamic nucleus
d. subthalamic nucleus
e. substantia nigra

50. Which of the following structures are a part of the extrapyramidal system?
a. globus pallidus
b. red nucleus
c. nucleus of the solitary tract
d. paravertebral ganglia
e. nucleus ambiguous

51. Which of the following sign are seen in the central paralysis?
a. hyperreflexia
b. areflexia
c. muscle contracture
d. decreased muscle tone
e. increased muscle tone

Arrange the correct sequence

52. Arrange the structures that constitute the main neural circuit in the cerebellar cortex
in the order through which impulses are transmitted
a. mossy fibers
b. deep cerebellar nuclei
c. Purkinje cells
d. granule cells

66
53. Arrange the structures that constitute the direct pathway of the basal nuclei in their
correct sequence for impulse transmission.
a. corpus striatum
b. cortex (almost all regions)
c. ventral anterior thalamic nucleus
d. globus pallidus (internal segment)

54. Arrange the structures in the correct sequence for the transmission of impulses from
the neurons of the cerebral cortex to the Purkinje cells
a. mossy fibers
b. granule cells
c. cerebral cortex
d. pons nuclei
e. Purkinje cells

55. Arrange the structures in the correct sequence for the transmission of excitation from
the intermediate cerebellar cortex to the motor neurons in the ventral horn of the
spinal cord
a. motor neurons in the spinal cord
b. motor cortex
c. thalamus (ventral lateral nucleus)
d. interposed nucleus
e. Purkinje cells

56. Arrange the structures in the correct sequence for the transmission of excitation from
the lateral cerebellar cortex to the motor cortex
a. Purkinje cells
b. nucleus dentate
c. motor cortex
d. thalamus (ventral lateral nucleus)

Fill in the gaps

57. The nerve fibers that travel from the inferior olivary nucleus to the cerebellar cortex
are called ________ fibers.

58. The nuclei in the median column of the reticular formation that release primarily ser-
otonin are called _______ nuclei.

59. The only excitatory cells in the cerebellar cortex are the _______ cells.

60. The climbing fibers synapse primarily with the ________ cells in the cerebellar cortex.

67
61. The inability to perform rapid alternating movements (for example, pronating and
supinating) due to a cerebellar disorder is termed ________.

62. The corpus striatum is made up of the caudate nucleus and the _______.

63. The pyramidal system consists of the ventral and lateral corticospinal tracts and
_________ tract.

64. ________ paralysis is associated with areflexia, muscular atonia and atrophy.

65. The neurological disorder involving the subthalamic nucleus, characterized by fling-
ing movements of the proximal extremities, is known as ________.

2.4 Physiology of the autonomic nervous system

Choose one correct answer

1. Which system predominates at rest?

a. sympathetic
b. parasympathetic

2. Compared to the type B fiber, the type C fiber conducts action potentials
a. faster
b. slower

3. Which division of the nervous system stimulates the motility of the gastrointestinal
tract?
a. sympathetic
b. parasympathetic
c. somatic

4. Which of the following is true about the autonomic nervous system?

a. has two efferent neurons arranged in series
b. its centers are only found in the brain
c. all efferent ending release acetylcholine
d. is not controlled by the cerebral cortex

5. Which of the following structures is supplied by the III cranial nerve?

a. musculus dilator pupillae
b. musculus sphincter pupillae
c. submandibular salivary gland
d. parotid salivary gland

68
6. Which of the following structures is supplied by the VII cranial nerve?
a. trachea
b. musculus sphincter pupillae
c. submandibular salivary gland
d. parotid salivary gland

7. Which of the following structures is supplied by the IX cranial nerve?

a. trachea
b. musculus sphincter pupillae
c. submandibular salivary gland
d. parotid salivary gland

8. Which of the following structures is supplied by the X cranial nerve?

a. trachea
b. musculus sphincter pupillae
c. submandibular salivary gland
d. parotid salivary gland

9. Which of the following organs is innervated by sympathetic preganglionic fibers?

a. salivary gland
b. adrenal medulla
c. sweat gland
d. skeletal muscle

10. Which of the following organs is innervated by the parasympathetic neurons in the
sacral segments of the spinal cord?
a. gallbladder
b. kidney
c. pancreas
d. urinary bladder

11. Which of the following cranial nerve nuclei contains parasympathetic neurons?
a. II
b. III
c. IV
d. V

12. Identify the structures in which the sympathetic centers are located
a. lateral horn of the spinal cord, sacral region
b. ventral horn of the spinal cord, thoracolumbar region
c. lateral horn of the spinal cord, thoracolumbar region
d. medulla oblongata

69
13. Which of the following organs is NOT innervated by the vagal nerve?
a. larynx
b. stomach
c. pancreas
d. urinary bladder

14. Which of the following is NOT true about the paravertebral ganglia?
a. switching from the preganglionic to the ganglionic neuron takes place in the gan-
glia
b. afferent fibers pass through the ganglia
c. they contain afferent neurons
d. autonomic reflex centers are located in the ganglia

15. In which of the following ganglia are postganglionic neurons NOT found?
a. spinal
b. paravertebral
c. prevertebral
d. intramural

16. Which of the following neurons is located in the paravertebral ganglia?

a. preganglionic sympathetic
b. postganglionic sympathetic
c. preganglionic parasympathetic
d. postganglionic parasympathetic

17. Which of the following neurons is located in the intramural ganglia?

a. preganglionic sympathetic
b. postganglionic sympathetic
c. preganglionic parasympathetic
d. postganglionic parasympathetic

18. Which of the following neurons is found in the lateral horn of the thoracic segment VI
of the spinal cord?
a. preganglionic sympathetic
b. postganglionic sympathetic
c. preganglionic parasympathetic
d. postganglionic parasympathetic

19. Which of the following neurons is found in the lateral horn of the sacral segment III
of the spinal cord?
a. preganglionic sympathetic
b. postganglionic sympathetic
c. preganglionic parasympathetic
d. postganglionic parasympathetic

70
20. The presence of the reflex arcs in the walls of hollow organs is typical of which of the
following systems?
a. parasympathetic
b. sympathetic
c. enteric (metasympathetic)
d. somatic

21. Which of the following adrenergic receptors is primarily found in the bronchial wall?
a. α1
b. α2
c. β1
d. β2

22. Which of the following is true about the gray rami communicantes?
a. are made up of preganglionic fibers
b. run from the paravertebral ganglion to the spinal nerve
c. are a part of the parasympathetic system
d. connect adjacent paravertebral ganglia

23. Identify the correct types of preganglionic and postganglionic fibers

a. preganglionic – type B, postganglionic – type C
b. preganglionic – type C, postganglionic – type B
c. preganglionic – type Аδ, postganglionic – type B
d. preganglionic – type Аβ, postganglionic – type Аδ

24. Which of the following relationships between the preganglionic and postganglionic
fibers is typical of the sympathetic system?
a. long preganglionic and short postganglionic fibers
b. short preganglionic and long postganglionic fibers
c. both pre- and postganglionic fibers are short
d. both pre- and postganglionic fibers are long

25. Which of the following relationships between the preganglionic and postganglionic
fibers is typical of the parasympathetic system?
a. long preganglionic and short postganglionic fibers
b. short preganglionic and long postganglionic fibers
c. both pre- and postganglionic fibers are short
d. both pre- and postganglionic fibers are long

26. Which of the following organs is supplied only by the sympathetic nervous system?
a. heart
b. salivary gland
c. sweat gland
d. bronchi

71
27. The neurotransmitter released from the preganglionic fiber acts on which of the fol-
lowing types of receptors?
a. β adrenergic
b. β adrenergic
c. M cholinergic
d. N cholinergic

28. The parasympathetic neurotransmitter acts on which of the following types of recep-
tors?
a. β adrenergic
b. N cholinergic
c. α adrenergic
d. M cholinergic

29. Sympathetic neurotransmitter acts on … receptor in the bronchi and causes their …
a. β2 adrenergic receptors, dilation
b. N cholinergic receptors, dilation
c. β2 adrenergic receptors, constriction
d. M cholinergic receptors, dilation
e. M cholinergic receptors, constriction
f. β1 adrenergic receptors, dilation

30. Stimulation of α2 adrenergic receptors located on the presynaptic membrane causes

which of the following effects?
a. stimulation of the main neurotransmitter release
b. inhibition of the main neurotransmitter release
c. stimulation of co-transmitters release
d. inhibition of neurotransmitter reuptake

31. Which of the following substances is a co-transmitter (is released along with the main
neurotransmitter) if the parasympathetic terminals?
a. vasoactive intestinal peptide
b. neuropeptide Y
c. histamine
d. glycine

32. Which of the following neurotransmitters is mainly released from sympathetic pre-
ganglionic fibers?
a. norepinephrine
b. acetylcholine
c. glutamate
d. GABA

72
33. Which of the following neurotransmitters is mainly released from parasympathetic
postganglionic fibers?
a. norepinephrine
b. acetylcholine
c. glutamate
d. GABA

34. Which of the following neurotransmitters is mainly released from sympathetic post-
ganglionic fibers?
a. norepinephrine
b. acetylcholine
c. glutamate
d. GABA

35. Where are the enteric (metasympathetic) neurons located?

a. in the spinal cord
b. in the medulla oblongata
c. in the walls of viscera
d. in the hypothalamus

36. Which of the following autonomic neurotransmitters is secreted only by neurons in

the enteric division of the autonomic system?
a. acetylcholine
b. neuropeptide Y
c. vasoactive intestinal peptide
d. GABA

37. In various pathological conditions associated with irritation of the peritoneum (in-
flammation, bleeding), the abdominal muscles are tensed. This sign is a manifestation
of which of the following reflexes?
a. viscero-somatic
b. somato-visceral
c. viscero-visceral
d. viscero-sensory

38. Which of the following hypothalamic nuclei regulates circadian rhythms?

a. arcuate
b. suprachiasmatic
c. paraventricular
d. supraoptic

73
 Match the left and the right columns

39. Autonomic neuron Location

1. Preganglionic parasympathetic a. thoracic segment of the spinal cord
2. Preganglionic sympathetic b. intramural ganglion
3. Enteric c. dorsal vagal nucleus
d. paravertebral ganglion

40. Autonomic neuron Location

1. Preganglionic parasympathetic a. paravertebral ganglion
2. Ganglionic sympathetic b. accessory nucleus of the oculomotor nerve
3. Ganglionic parasympathetic c. hypothalamus
d. pterygopalatine ganglion

41. Location of the Function

autonomic center
1. Reticular formation a. adapts autonomic functions to environmental
conditions and emotional states
2. Hypothalamus b. coordinates activities of the autonomic and so-
matic nervous systems
3. Cerebral cortex and subcor- c. regulates the simplest autonomic reflexes
tical nuclei
d. ensures interaction and correct sequence of
autonomic reflexes

42. Autonomic center Function

1. Dorsal vagal nucleus a. increases pancreatic secre-
tion
2. Lateral horn of the thoracic segment of the b. constricts the pupils
spinal cord
3. Lateral horn of the sacral segment of the spi- c. initiates urination
nal cord
d. increases heart rate

Choose two or more correct answers

43. Which of the following substances are co-transmitters (released with the primary neu-
rotransmitters) in the sympathetic endings?
a. neuropeptide Y
b. dopamine
c. epinephrine
d. ATP
e. GABA

74
44. Which of the following types of nerve fibers are part of the autonomic nervous system?
a. Aα
b. Aβ
c. Aγ
d. B
e. C

45. Which of the following structures contain preganglionic autonomic neurons?

a. paravertebral ganglion
b. dorsal vagal nucleus
c. intramural ganglion
d. dorsal root ganglion
e. lateral horn of spinal cord

46. What does the sympathetic nervous system do?

a. stimulates glycogenolysis
b. inhibits proteolysis
c. stimulates gluconeogenesis
d. stimulates lipogenesis
e. decreases body temperature

47. What does the sympathetic system do?

a. constricts the bronchi
b. dilates the pupils
c. inhibits gastric motility
d. decreases heart rate
e. stimulates pancreatic secretion

48. What does the parasympathetic system do?

a. dilates the pupil
b. decreases the heart rate
c. dilates the bronchi
d. stimulates pancreatic secretion
e. increases heart rate

49. Which of the following structures does the enteric (metasympathetic) system regulate?
a. secretory epithelium
b. visceral smooth muscles
c. skeletal muscles
d. hair cells of the inner ear
e. ciliary muscle

75
50. Which of the following physiological responses occurs when the β-adrenergic receptor
is activated?
a. vasoconstriction
b. vasodilation
c. increase in heart rate
d. decrease in cardiac contractility
e. decrease in gastric secretion

51. Which of the following structures contain ganglionic autonomic neurons?

a. dorsal vagal nucleus
b. paravertebral ganglion
c. lateral horn of spinal cord
d. dorsal root ganglion
e. intramural ganglion

52. Which of the following neurons are mainly cholinergic?

a. preganglionic sympathetic
b. preganglionic parasympathetic
c. ganglionic sympathetic
d. ganglionic parasympathetic
e. somatic motor neurons

53. Which of the following structures contain parasympathetic neurons?

a. mesencephalon
b. thoracic segment of the spinal cord
c. medulla
d. hypothalamus
e. sacral segment of the spinal cord

Arrange the correct sequence

54. Arrange the centers of the autonomic nervous system in ascending order (from lowest
to highest)
a. bulbar
b. thoracolumbar
c. sacral
d. mesencephalic

55. Arrange the elements of an autonomic reflex arc in the correct order
a. receptor
b. interneuron
c. afferent neuron
d. effector

76
 e. preganglionic neuron
f. ganglionic neuron

56. Arrange the centers of the autonomic nervous system in ascending order (from lowest
to highest)
a. hypothalamus
b. autonomic ganglion
c. reticular formation
d. spinal cord

Fill in the gaps

57. The ganglia that form two trunks on either side of the vertebral column are referred
to as the ________ ganglia.

58. The ________ division of the autonomic nervous system is activated during stress.

59. Sympathetic preganglionic neurons are located in the _____ horn of the spinal cord.

60. Parasympathetic neurons that innervate the colon, urinary bladder, and genitals are
located in the ______ segment of the spinal cord.

61. The sympathetic system causes ______ of the pupils.

62. Under the influence of the _______ division of the autonomic nervous system, gastric
motility increases.

63. The reflex arcs of the ______ nervous system are located within the walls of the vis-
cera.

64. The main neurotransmitter in the sympathetic nervous system is ________.

77
 CORRECT ANSWER KEYS FOR SECTION II

2.1 General physiology of the central nervous system

1. d 24. a 47. a, c
2. c 25. c 48. d, e
3. d 26. d 49. a, e
4. b 27. d 50. b, c, e
5. a 28. d 51. a, d
6. a 29. a 52. a, b
7. b 30. c 53. c, d
8. a 31. a 54. b, e
9. b 32. b 55. 1b, 2a, 3e, 4d, 5f, 6c
10. d 33. a 56. 1b, 2e, 3f, 4a, 5d, 6c
11. c 34. b 57. 1c, 2b, 3e, 4d, 5a, 6f
12. c 35. c 58. 1d, 2e, 3b, 4a, 5c
13. b 36. b 59. hillock
14. a 37. a 60. astrocyte
15. d 38. b 61. oligodendrocyte
16. b 39. c 62. presynaptic
17. a 40. b 63. ependymal
18. c 41. 1c, 2b, 3d 64. pessimal
19. d 42. 1b, 2a, 3d 65. post-tetanic potentiation
20. a 43. 1d, 2c, 3b 66. spatial
21. b 44. 1a, 2c, 3b 67. irradiation
22. a 45. 1c, 2d, 3a 68. occlusion
23. d 46. 1b, 2a, 3c

2.2 Physiology of the spinal cord. Physiology of the medulla and

midbrain

1. a 22. a 43. a, c
2. c 23. c 44. b, c
3. b 24. b 45. a, e
4. d 25. b 46. a, c
5. a 26. a 47. b, d
6. b 27. b 48. c, d
7. c 28. d 49. a, b, f
8. c 29. c 50. a, d
9. b 30. a 51. 1b, 2a, 3e, 4d, 5c
10. b 31. b 52. 1d, 2b, 3e, 4a, 5c
11. a 32. a 53. intrafusal

78
 12. d 33. c 54. statokinetic
13. a 34. b 55. lateral
14. d 35. d 56. ventral
15. c 36. c 57. inferior
16. c 37. 1c, 2a, 3b 58. superior
17. a 38. 1c, 2d, 3a 59. decerebrate rigidity
18. b 39. 1d, 2a, 3b 60. non-specific
19. b 40. 1b, 2d, 3a 61. Golgi tendon organ
20. d 41. 1c, 2b, 3a
21. c 42. 1d, 2a, 3c

2.3 Physiology of the reticular formation. Cerebellum, basal nuclei.

The extrapyramidal system

1. a 24. c 47. b, d
2. c 25. a 48. c, d
3. d 26. c 49. a, d, e
4. a 27. d 50. a, b
5. b 28. a 51. a, c, e
6. a 29. a 52. 1a, 2d, 3c, 4b
7. d 30. b 53. 1b, 2a, 3d, 4c
8. c 31. b 54. 1c, 2d, 3a, 4b, 5e
9. b 32. d 55. 1e, 2d, 3c, 4b, 5a
10. c 33. a 56. 1a, 2b, 3d, 4c
11. c 34. 1b, 2a, 3d 57. climbing
12. d 35. 1c, 2d, 3a 58. raphe
13. c 36. 1b, 2d, 3a 59. granule
14. a 37. 1c, 2a, 3b 60. Purkinje (ganglion)
15. b 38. 1d, 2b, 3c 61. dyskiadochokinesys (dysdiado-
16. a 39. 1a, 2c, 3b chokinesia)
17. d 40. 1b, 2c, 3a 62. putamen
18. a 41. 1d, 2c, 3b 63. corticobulbar (corticonuclear)
19. b 42. 1a, 2d, 3c 64. peripheral (flaccid)
20. b 43. a, c 65. ballism
21. a 44. c, e, f
22. d 45. b, d, e
23. a 46. b, c, e

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2.4 Physiology of the autonomic nervous system

1. b 23. a 45. b, e
2. b 24. b 46. a, c
3. b 25. a 47. b, c
4. a 26. c 48. b, d
5. b 27. d 49. a, b
6. c 28. d 50. b, c
7. d 29. a 51. b, e
8. a 30. b 52. a, b, d, e
9. b 31. a 53. a, c, e
10. d 32. b 54. 1c, 2b, 3a, 4d
11. b 33. b 55. 1a, 2c, 3b, 4e, 5f, 6d
12. c 34. a 56. 1b, 2d, 3c, 4a
13. d 35. c 57. paravertebral
14. c 36. d 58. sympathetic
15. a 37. a 59. lateral
16. b 38. b 60. sacral
17. d 39. 1c, 2a, 3b 61. dilation
18. a 40. 1b, 2a, 3d 62. parasympathetic
19. c 41. 1d, 2b, 3a 63. enteric (metasympathetic)
20. c 42. 1a, 2d, 3c 64. norepinephrine
21. d 43. a, d
22. b 44. d, e

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Section III. PHYSIOLOGY OF THE ENDOCRINE SYS-
TEM

3.1 General physiology of the endocrine glands

Choose one correct answer

1. Which hormones are physiologically active?

a. protein-bound
b. free

2. Which of the following is usually used to assess endocrine gland function?

a. pharmacological block
b. recording of electrical activity

3. Which of the following is an endocrine gland?

a. parotid gland
b. adrenal gland

4. Do peptide hormones cross the cell membrane?

a. yes
b. no

5. Where is vasopressin stored in the pituitary gland?

a. in neurohypophysis
b. in adenohypophysis

6. What does inositol-3-phosphate do?

a. decreases the permeability of the cell membrane to sodium ions
b. increases the permeability of the sarcoplasmic reticulum to the calcium ions

7. Releasing factors and hypophysiotropic hormones are

a. the same substances
b. different substances

8. The statement “endocrine and nervous systems usually act independently” is

a. true
b. false

9. The statement “hydrophilic hormones always act more rapidly than hydrophobic hor-
mones” is
a. true

81
 b. false

10. Which of the following conditions occurs when the neurohypophysis is damaged?
a. diabetes insipidus
b. diabetes mellitus

11. What does antidiuretic hormone do?

a. increases reabsorption in the collecting ducts
b. decreases vascular tone

12. How do hypothalamic hormones get to the adenohypophysis?

a. by axonal transport
b. via hypophyseal portal system

13. How do hypothalamic hormones get to the neurohypophysis?

a. by axonal transport
b. via hypophyseal portal system

14. The pancreas is a … gland…

a. exocrine
b. endocrine
c. of mixed secretion

15. Which of the following structures in CNS is a neuroendocrine interface?

a. hypothalamus
b. thalamus
c. amygdala
d. hippocampus

16. Where are hormones released?

a. in the environment
b. in the cerebrospinal fluid
c. in the intestinal lumen
d. in the blood

17. Which of the following endocrine gland is considered as the “master” gland?
a. thyroid
b. pituitary
c. adrenal
d. parathyroid

18. If there is a growth hormone deficiency in childhood, which of the following conditions
develops?
a. dwarfism

82
 b. gigantism
c. acromegaly
d. diabetes insipidus

19. Which of the following effects do hormones have?

a. transforming
b. sensibilizing
c. kinetic
d. correcting

20. Which of the following is a physiological property of hormones?

a. low specificity of action
b. distant action
c. accumulation in target tissues
d. high species specificity

21. Which of the following is true about peptide hormones?

a. cross the cell membrane
b. are used as a structural component of the cell
c. never act on the genetic machinery
d. act through a second messenger system

22. Which of the following second messengers stimulates Ca2+ release from the store?
a. inositol triphosphate
b. diacylglycerol
c. cAMP
d. cGMP

23. Which of the following enzymes is activated by cAMP?

a. adenylyl cyclase
b. protein kinase A
c. protein kinase C
d. phospholipase C

24. Which of the following second messengers is formed without a G-protein-coupled re-
ceptor?
a. cAMP
b. diacylglycerol
c. cGMP
d. inositol triphosphate

25. Which enzyme breaks down cAMP?

a. phospholipase C
b. adenylyl cyclase

83
 c. phosphoprotein phosphatase
d. phosphodiesterase

26. Which of the following hormones is missing from the axis “… – ACTH – cortisol”?
a. corticotropin-releasing hormone
b. corticotropin-inhibiting hormone
c. TSH
d. oxytocin

27. On which of the following zones of the adrenal glands does ACTH primarily act?
a. zona glomerulosa
b. zona fasciculata
c. zona reticularis
d. adrenal medulla

28. The secretion of which of the following pituitary hormones is inhibited by a release-
inhibiting hormone?
a. growth hormone
b. follicle stimulating hormone
c. adrenocorticotropic hormone
d. luteinizing hormone

29. A deficiency of which of the following hormones causes diabetes insipidus?

a. oxytocin
b. somatoliberin
c. vasopressin
d. insulin

30. How are releasing hormones delivered to the adenohypophysis?

a. by axonal transport
b. by the lymphatic capillaries
c. via the system of canaliculi connecting the hypothalamus to the pituitary gland
d. through the capillaries of the portal system

31. Which of the following is true of antidiuretic hormone?

a. is produced by the hypothalamus
b. doesn’t affect the vascular tone
c. stimulates Na+ reabsorption
d. it is a steroid hormone

32. Which of the following is an action of ACTH?

a. stimulation of glucagon production
b. skin pigmentation

84
 c. increase in muscle mass
d. stimulation of thyroxine production

33. Which of the following is prolactostatin?

a. epinephrine
b. oxytocin
c. dopamine
d. gonadotropin-releasing hormone

34. Which of the following hormones triggers ovulation?

a. luteinizing
b. follicle stimulating
c. oxytocin
d. gonadotropin-releasing

35. Which of the following conditions develops when there is an excess of growth hormone
in childhood?
a. dwarfism
b. gigantism
c. acromegaly
d. diabetes mellites

36. Which of the following hormones stimulates water reabsorption in the collecting duct?
a. thyroxine
b. natriuretic peptide
c. aldosterone
d. vasopressin

37. What happens under the influence of antidiuretic hormone?

a. integration of AQP subunits into the apical membrane of the collecting duct epi-
thelium
b. activation of the Na+/K+-ATPase in the basolateral membrane of the distal tubule
epithelium
c. integration of sodium channel subunits into the apical membrane of the collecting
duct epithelium
d. inhibition of the Na+/H+-exchanger

38. Which of the following hormones binds to a cytoplasmic receptor?

a. vasopressin
b. corticotropin-releasing hormone
c. cortisol
d. epinephrine

39. Which of the following is true of steroid hormones?

85
 a. affect synthesis of hormones in peripheral endocrine glands
b. stimulate the synthesis of diacylglycerol
c. can cross the cell membrane
d. activate adenylyl cyclase

Match the left and right columns

40. Hormones Physiological effects

1. Liberins a. control peripheral gland functions
2. Statins b. increase heart conductivity
3. Tropic hormones c. stimulate secretion of the adenohypophysis hormones
d. inhibit secretion of the adenohypophysis hormones

41. Tropic hormone Target gland

1. Thyrotropic a. adrenal cortex
2. Adrenocorticotropic b. thyroid gland
3. Luteinizing c. adrenal medulla
d. testis

42. Hormone effect Characteristic

1. Kinetic a. initiates activity of effector organs
2. Morphogenetic b. influences sensitivity of receptors to their ligands
3. Reactogenic c. influences metabolism
d. influences differentiation, specialization and growth of
tissues and organs

43. Second messenger Effect

1. cAMP a. activates protein kinase C
2. Diacylglycerol b. activates protein kinase A
3. Inositol triphosphate c. initiates release of calcium ions from stores
d. activates alkaline phosphatase

44. Hormone Chemical structure

1. Epinephrine a. amino acid derivative
2. Cortisol b. peptide
3. Insulin c. cholesterol derivative
d. fatty acid derivative

Choose two or more correct answers

86
45. Identify the glands of mixed secretion (both exocrine and endocrine).
a. pancreas
b. pituitary gland
c. gonads
d. adrenal gland
e. thyroid gland

46. Which of the following hormones can cross the cell membrane?
a. insulin
b. aldosterone
c. epinephrin
d. thyroxin
e. oxytocin
f. cortisol

47. According to responsiveness to hormones, target cells can be classified as

a. hormone-positive
b. hormone-sensitive
c. hormone-negative
d. hormone-dependent
e. hormone-adaptive

48. Which of the following pituitary hormones are effector hormones?

a. growth hormone
b. luteinizing hormone
c. thyroid stimulating hormone
d. adrenocorticotropic hormone
e. prolactin

49. Which of the following is true about oxytocin?

a. is a steroid hormone
b. is produced in the hypothalamus and stored in the neurohypophysis
c. increases vascular tone
d. stimulates uterine contractions during labor
e. increases blood calcium levels

Arrange the correct sequence

50. Arrange the following events related to hormonal action in the correct chronological
order
a. binding to receptor in target cell
b. transport of hormone in blood

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 c. secretion of hormone
d. metabolic inactivation

51. Arrange the following events related to the interaction of a hormone with a G-protein-
coupled receptor in the correct order
a. activation of adenylyl cyclase
b. activation of the G-protein
c. activation of protein kinase A
d. generation of cAMP

52. Arrange the following events related to the interaction of a hormone with a G-protein-
coupled receptor in the correct order
a. activation of G-protein
b. generation of diacylglycerol
c. activation of phospholipase C
d. activation of protein kinase С

53. Arrange the following events related to the interaction of a hormone with a G-protein-
coupled receptor in the correct order
a. activation of phospholipase C
b. release of calcium from stores
c. activation of G-protein
d. generation of inositol 3 phosphate

54. Arrange the following events related to the interaction of a hormone with a cytoplas-
mic receptor in the correct order
a. hormone-receptor complex enters the nucleus
b. hormone-receptor complex binds to DNA
c. hormone interacts with the receptor
d. hormone crosses the cell membrane

Fill in the gaps

55. The enzyme catalyzing generation of cAMP from ATP is called __________.

56. Target cells that do not develop without the hormone, are referred to as _________.

57. Based on their chemical structure, hormones are classified as peptides, amino acids
derivatives, and ________.

58. The pituitary hormone that stimulates breast development and milk production is
called __________.

88
59. The hormone that stimulates uterine contraction during labor and milk ejection dur-
ing breastfeeding is called _______.

60. The second messenger that initiates the release of calcium from the stores is called
_________.

61. According to their chemical structure, all pituitary hormones are ________.

62. The hypothalamic hormone that inhibits secretion of growth hormone is referred to
as ____________.

3.2 Special physiology of the endocrine glands

Choose one correct answer

1. The effects of epinephrine are similar to the effects of which of the following systems
a. sympathetic
b. parasympathetic

2. Aldosterone stimulates the reabsorption of which of the following ions in the kidney?
a. sodium
b. potassium

3. Estrogens are mainly produced

a. in male gonads
b. in female gonads

4. Vasodilation occurs when epinephrine acts on which of the following receptors?

a. α adrenergic
b. β adrenergic

5. How does cortisol affect carbohydrate metabolism compared to insulin?

a. in the same way
b. in the opposite way

6. Which of the following is the target tissue for insulin?

a. adipose
b. bone

7. The adrenal medulla produces more of which of the following hormones?

a. epinephrine
b. norepinephrine

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8. Which of the following does thyroid hormone do?
a. stimulates oxidative processes in tissues
b. lowers body temperature

9. How does parathyrin affect blood calcium levels?

a. increases
b. decreases

10. Progesterone levels are higher during which phase of the menstrual cycle
a. follicle
b. lutein

11. How does testosterone affect protein metabolism?

a. stimulates catabolism
b. stimulates anabolism

12. Thyroid hormones act on which type of receptors?

a. membrane
b. cytoplasmic
c. nuclear

13. Which of the following endocrine glands is innervated by preganglionic sympathetic

fibers?
a. thyroid gland
b. adrenal cortex
c. adrenal medulla
d. pituitary gland

14. Which of the following hormones stimulates protein synthesis?

a. glucagon
b. epinephrine
c. calcitonin
d. growth hormone

15. Compared to the thyroxin, triiodothyronine…

a. has higher activity, its blood levels are lower
b. has lower activity, its blood levels are higher
c. has higher activity, its blood levels are higher
d. has lower activity, its blood levels are lower

16. Secretion of which of the following hormones is stimulated by the angiotensin II?
a. oxytocin
b. aldosterone

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 c. atrial natriuretic peptide
d. thyroxin

17. Which of the following hormones lowers blood glucose levels?

a. epinephrine
b. insulin
c. glucagon
d. cortisol

18. Which of the following hormones stimulates lipogenesis?

a. insulin
b. glucagon
c. epinephrine
d. vasopressin

19. Which of the following is true of progesterone?

a. is secreted under the influence of follicular stimulating hormone
b. decreases libido
c. is produced in the corpus luteum
d. increases the thickness of the endometrium

20. Which of the following hormones are produced in the glomerular zone of the adrenal
cortex?
a. glucocorticoids
b. androgens
c. catecholamines
d. mineralocorticoids

21. Which of the following is true about epinephrine?

a. decreases heart rate
b. stimulates intestinal motility
c. is a peptide
d. dilates the bronchi

22. Which of the following is the target organ for aldosterone?

a. liver
b. pancreas
c. kidney
d. testes

23. The protein that is a part of the colloid of the thyroid follicles is called
a. thyrostatin
b. thyroalbumin
c. thyroprotein

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 d. thyroglobulin

24. Which of the following stimulates the production of parathormone?

a. decrease in Ca2+ levels
b. increase in vitamin D levels
c. increase in phosphate levels
d. decrease in phosphate levels

25. What causes metabolic acidosis in diabetes mellitus?

a. increased glucose levels
b. accumulation of ketone bodies
c. increased free fatty acids levels
d. increased diuresis

26. Identify the type of pancreatic cell in which glucagon is produced

a. A (α)
b. B (β)
c. D (δ)
d. PP (γ)

27. Identify the type of pancreatic cell in which insulin is produced

a. A (α)
b. B (β)
c. D (δ)
d. PP (γ)

28. Which of the following is true about glucagon?

a. its secretion is inhibited by insulin
b. stimulates glycogenolysis in muscle tissue
c. increases muscle mass
d. decreases the amount of extracellular fluid

29. Which of the following is true for estradiol?

a. weakens the effects of progesterone
b. increases the deposition of belly fat
c. stimulates the closure of epiphyseal cartilage
d. supports pregnancy in the early stages

30. A deficiency of which of the following hormones can cause glucosuria (the presence of
glucose in the urine)?
a. glucagon
b. thyroxin
c. epinephrine
d. insulin

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31. Which of the following is true of insulin?
a. its secretion is stimulated by fatty acids and amino acids
b. activates GLUT-2
c. acts on the G-protein coupled receptor
d. stimulates lipolysis in muscle

32. How do estrogens affect gonadotropin-releasing hormone synthesis?

a. inhibit
b. stimulate
c. inhibit at low levels, stimulate when significantly elevated
d. stimulates at low levels, inhibit when significantly elevated

33. Which of the following stimulates secretion of insulin?

a. increase in blood glucose levels
b. obesity
c. increase in blood sodium levels
d. decrease in body temperature

Match the left and the right column

34. Hormone Action

1. Insulin a. increases calcium reabsorption in the kidney
2. Norepinephrine b. increases sodium reabsorption in the kidney
3. Parathyrin c. decreases blood glucose
d. increases vascular tone

35. Hormone Action

1. Aldosterone a. decreases blood glucose levels
2. Cortisol b. increases oxygen consumption in tissues
3. Thyroxin c. inhibits inflammatory response
d. increases sodium reabsorption in the kidney

36. Adrenal cortex zone Hormones

1. Glomerular a. mineralocorticoids
2. Fascicular b. catecholamines
3. Reticularis c. androgens
d. glucocorticoids

37. Endocrine glans Hormone

1. Adrenal cortex a. insulin
2. Endocrine pancreas b. aldosterone
3. Adrenal medulla c. estradiol
d. epinephrine

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 Choose two or more correct answers

38. What does the sympathoadrenal system do?

a. stimulates defecation
b. accelerates blood clotting
c. reduces skeletal muscle fatiguability
d. stimulates gastric secretion
e. inhibits glycogenolysis

39. Which of the following does epinephrin do?

a. increases the heart rate
b. dilates the bronchi
c. stimulates lipogenesis
d. dilates the pupil
e. stimulates gastric secretion

40. Which of the following does thyroid hormones do?

a. increases the heart rate and contractility
b. inhibits gluconeogenesis
c. increases O2 consumption
d. promotes closure of epiphyseal cartilage
e. increases body temperature
f. stimulates glycogen synthesis

41. Which of the following are signs of hyperthyroidism?

a. obesity
b. low tolerance for exercise
c. dry skin
d. apathy
e. high body temperature
f. tremor in the fingertips

42. What are the physiological effects of cortisol?

a. anti-inflammatory
b. inhibition of glucose absorption
c. permissive effect in catecholamines action on the cardiovascular system
d. inhibition of glycogenolysis
e. stimulation of erythropoiesis

43. Which of the following are signs of glucocorticoid excess?

a. increase in muscle mass
b. anemia
c. fat deposits in the abdomen, neck, face, and upper back

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 d. hyperglycemia
e. increased blood pressure

44. Which of the following is true about vitamin D?

a. is a derivative of phenylalanine
b. its formation is stimulated by parathyrin
c. stimulates Ca2+ absorption in the small intestine
d. inhibits bone mineralization at physiological levels
e. inhibits parathyrin secretion

45. What does parathormone do?

a. increases bone resorption
b. stimulates Ca2+ absorption in the small intestine
c. inhibits Ca2+ reabsorption in the kidney
d. inhibits the reabsorption of HPO42- in the kidney
e. inhibits Na+ reabsorption in the kidney

46. What does aldosterone do?

a. stimulates Na+ reabsorption
b. stimulates H+ secretion
c. stimulates K+ reabsorption
d. inhibits Ca2+ reabsorption
e. increases extracellular fluid volume

47. Which of the following is true of testosterone?

a. inhibits erythropoiesis
b. increases the level of very low-density lipoproteins
c. is converted into the estrogens in some organs
d. has mainly catabolic effects
e. increases muscle mass

Fill in the gaps

48. Hormones of the adrenal medulla that are derivates of the amino acid tyrosine are
referred to as ___________.

49. The hormone that is produced by the parathyroid gland and increases blood calcium
levels is called __________.

50. The condition that develops in early childhood as a result of thyroid hormone defi-
ciency and is associated with severe mental and physical retardation is called
________.

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51. Aldosterone is produced be the ______ zone of the adrenal cortex.

52. The condition that results from a lack of insulin or insulin receptors is referred to as
_________.

53. The thyroid gland produces two thyroid hormones: thyroxine and __________.

54. The adrenal medulla is innervated by the ________ sympathetic fibers.

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 CORRECT ANSWER KEYS FOR SECTION III

3.1 General physiology of the endocrine glands

1. b 22. a 43. 1b, 2a, 3c

2. a 23. b 44. 1a, 2c, 3b
3. b 24. c 45. a, c
4. b 25. d 46. b, d, f
5. a 26. a 47. b, d
6. b 27. b 48. a, e
7. a 28. a 49. b, d
8. b 29. c 50. 1c, 2b, 3a, 4d
9. b 30. d 51. 1b, 2a, 3d, 4c
10. a 31. a 52. 1a, 2c, 3b, 4d
11. a 32. b 53. 1c, 2a, 3d, 4b
12. b 33. c 54. 1d, 2c, 3a, 4b
13. a 34. a 55. adenylyl cyclase
14. c 35. b 56. hormone-dependent
15. a 36. d 57. steroids
16. d 37. a 58. prolactin (lactotrophic)
17. b 38. c 59. oxytocin
18. a 39. c 60. inositol-3-phosphate
19. c 40. 1c, 2d, 3a 61. peptides
20. b 41. 1b, 2a, 3d 62. somatostatin
21. d 42. 1a, 2d, 3b

3.2 Special physiology of the endocrine glands

1. a 20. d 39. a, b, d
2. a 21. d 40. a, c, e
3. b 22. c 41. b, e, f
4. b 23. d 42. a, с, e
5. b 24. a 43. c, d, e
6. a 25. b 44. b, c, e
7. a 26. a 45. a, d
8. a 27. b 46. a, b, e
9. a 28. a 47. b, c, e
10. b 29. c 48. catecholamines (epineph-
11. b 30. d rine, norepinephrine)
12. c 31. a 49. parathyrin (parathormone,
13. c 32. c parathyroid hormone)

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14. d 33. a 50. cretinism
15. a 34. 1c, 2d, 3a 51. glomerular
16. b 35. 1d, 2c, 3b 52. diabetes mellitus
17. b 36. 1a, 2d, 3c 53. preganglionic
18. a 37. 1b, 2a, 3d
19. c 38. b, c

98
 Section IV. PHYSIOLOGY OF THE BLOOD

4.1 Physiology of blood cells

Choose one correct answer

1. Plasma oncotic pressure is generated by

a. proteins
b. ions

2. Plasma osmotic pressure is mainly generated by

a. proteins
b. ions

3. How does the hematocrit change when the body loses water?
a. increases
b. decreases
c. doesn’t change

4. Which of the following solutions has the same osmolality as the plasma?
a. hypotonic
b. isotonic
c. hypertonic

5. How long does a red blood cell live in a healthy adult (days)?
a. 20
b. 120
c. 230

6. Which of the following causes the hematocrit to rise?

a. erythrocytosis
b. erythropenia
c. leukocytosis
d. leukopenia

7. What is the ratio of the plasma to the total blood volume (%)?
a. 15 – 20
b. 20 – 30
c. 55 – 60
d. 85 – 90

99
8. The density of blood is equal to (g/ml)
a. 0.350 – 0.380
b. 1.050 – 1.060
c. 2.050 – 2.060
d. 3.050 – 3.060

9. Which of the following parameters is maintained at a constant level by blood buffering

systems?
a. osmolarity
b. viscosity
c. gas composition
d. pH

10. Identify the correct amount of blood (% of body mass) in a healthy adult
a. 1 – 2
b. 3 – 4
c. 6 – 8
d. 10 – 12

11. The viscosity of whole blood (in relation to water) is

a. 1.5 – 2.5
b. 4.5 – 5.5
c. 6.5 – 7.5
d. 8.5 – 10.5

12. Which of the following is the correct value of blood pH?

a. 6.9 – 7.12
b. 7.11 – 7.21
c. 7.37 – 7.41
d. 7.81 – 7.92

13. Which of the following is the most powerful buffering system in the blood?
a. hemoglobin
b. carbonate
c. protein
d. phosphate

14. Which of the following makes up the phosphate buffering system of the blood?
a. НРО42-/Н2РО4-
b. Н2РО4-/Н3РО4
c. ATP/ADP
d. НРО42-/РО43-

100
15. Which of the globulin fractions are immunoglobulins?
a. α1
b. α2
c. β
d. γ

16. Identify normal blood glucose levels (mmol/L)

a. 1.1– 2.1
b. 2.5 – 3.5
c. 3.3 – 6.1
d. 7.8 – 8.5

17. Which of the following substances makes up the oncotic pressure in plasma?
a. albumin
b. glucose
c. sodium
d. urea

18. What is the erythrocyte precursor, which retains some organelles, called?
a. blastocyte
b. reticulocyte
c. poikilocyte
d. myelocyte

19. Which of the following is true about the erythrocytes?

a. they are anucleated cells with a spherical form
b. they are nucleated cells with a biconcave disc form
c. they are anucleated cells with a biconvex disc form
d. they are anucleated cells with a biconcave disc form

20. What is the condition in which abnormally shaped erythrocytes are found?
a. anisocytosis
b. poikilocytosis
c. microcytosis
d. reticulocytosis

21. Identify the correct number of erythrocytes in 1 L of blood in an adult male (×1012)
a. 1.5 – 2.8
b. 4.5 – 6.1
c. 11.3 – 14.2
d. 21.2 – 24.6

22. Which of the following is the function of erythrocytes?

a. respiratory

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 b. trophic
c. bactericidal
d. thermoregulatory

23. Osmotic hemolysis of erythrocytes occurs in which of the following solutions?

a. high pH
b. low pH
c. high temperature
d. hypotonic

24. Identify the concentration of NaCl solution (%) at which hemolysis of red blood cells
begins
a. 0.3
b. 0.5
c. 0.7
d. 0.9

25. Identify the concentration of NaCl solution (%) at which total hemolysis of red blood
cells occurs
a. 0.3
b. 0.5
c. 0.7
d. 0.9

26. What is the condition when there are many red blood cells of different sizes called?
a. microcytosis
b. macrocytosis
c. anisocytosis
d. poikilocytosis

27. Which of the following is the main organ where red blood cells complete their life
cycle?
a. spleen
b. liver
c. kidney
d. red bone marrow

28. Which of the following organs produces red blood cells?

a. spleen
b. liver
c. kidney
d. red bone marrow

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29. Identify the correct number of leukocytes in 1 L of blood (×109)
a. 1 – 2
b. 4 – 9
c. 8 – 12
d. 15 – 20

30. Which of the following is the correct percentage of neutrophils in the blood of a
healthy adult?
a. 1 – 5
b. 6 – 11
c. 20 – 40
d. 48 – 72

31. Which of the following blood cells are differentiated in the thymus?
a. B-lymphocytes
b. T-lymphocytes
c. monocytes
d. basophils

32. Which of the following blood cells are responsible for specific cellular immunity?
a. B-lymphocytes
b. eosinophils
c. T-lymphocytes
d. neutrophils

33. Which of the following cells fight multicellular parasites (helminths)?

a. eosinophils
b. basophils
c. neutrophils
d. monocytes

34. Which of the following cells contain granules of histamine and heparin?
a. eosinophils
b. basophils
c. macrophages
d. neutrophils

35. Identify the correct number of large squares in Goryaev’s grid for counting erythro-
cytes
a. 5
b. 10
c. 15
d. 25

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36. Identify the correct number of large squares in Goryaev’s grid for counting white
blood cells
a. 5
b. 10
c. 15
d. 25

Match the left and the right columns

37. Plasma protein Content range (g/L)

1. Albumin a. 2 – 4
2. Globulin b. 20 – 40
3. Fibrinogen c. 35 – 45
d. 90 – 110

38. Type of hemolysis Causing factors

1. Osmotic a. exposure to hypotonic solution
2. Chemical b. freezing and thawing of the blood
3. Thermal c. transfusion of the wrong blood group
d. exposure to acids, alkalis, gasoline etc.

39. Granulocyte type Main functions

1. Neutrophil a. inactivation of histamine
2. Eosinophil b. phagocytosis
3. Basophil c. production of heparin and histamine
d. specific cellular immunity

40. Agranulocyte type Main functions

1. T-lymphocyte a. macrophage precursor
2. B-lymphocyte b. produces heparin and histamine
3. Monocytes c. mediates specific cellular immunity
d. mediates specific humoral immunity

41. Plasma protein Specific function

1. Albumin a. generates oncotic pressure
2. γ-Globulin b. involved in blood clotting
3. Fibrinogen c. participates in the specific immune response
d. serves as a carrier for transporting oxygen

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 Choose two or more correct answers

42. Which of the following is true of erythropoietin?

a. is mainly produced in the kidneys
b. is mainly produced in the liver
c. hypoxemia is the main stimulus for its secretion
d. glucocorticoids inhibit its secretion
e. it is a tyrosine derivate

43. Identify hormones that stimulate erythropoiesis

a. oxytocin
b. cortisol
c. testosterone
d. estradiol
e. parathyrin

44. Which of the following is true about leukocytes?

a. they are nucleated cells
b. they are anucleated cells
c. they are red blood cells
d. they are white blood cells
e. they have biconcave shape

45. Identify the blood cells that belong to the agranulocytes

a. neutrophils
b. basophils
c. monocytes
d. lymphocytes
e. eosinophils

46. Identify the blood cells that belong to the granulocytes

a. neutrophils
b. basophils
c. monocytes
d. lymphocytes
e. eosinophils

47. Which of the following solutions may cause hemolysis?

a. pure water
b. 5% glucose
c. 0.85% sodium chloride
d. 70% ethylic alcohol
e. 5% hydrochloric acid

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48. Which of the following vitamins are needed for red blood cells to develop normally?
a. B12
b. folic acid
c. D
d. A
e. K

Arrange the correct sequence

49. Arrange the granulocytes in descending order of their percentage in the blood (%)
a. lymphocytes
b. neutrophils
c. basophils
d. monocytes
e. eosinophils

50. Arrange the red blood cell precursors in the correct order of development
a. erythrocyte
b. proerythroblast
c. reticulocyte
d. erythroblast

51. Arrange the following plasma proteins in ascending order of content in the blood
a. fibrinogen
b. albumins
c. globulins

52. Arrange the following plasma proteins in descending order of electrophoretic mobility
a. γ globulins
b. α globulins
c. fibrinogen
d. albumins

Fill in the gaps

53. An absolute or relative decrease in the number of white blood cells in the blood is
called _________.

54. An increase in the number of erythrocytes in the blood is referred to as ________.

55. The peptide hormone produced in the kidney that stimulates red blood cells formation
is called _________.

106
56. There are four buffering systems in the blood: bicarbonate, protein, phosphate, and
__________.

57. The percentage of different types of white blood cells is referred to as the ________.

58. The type of hemolysis that occurs in hypotonic solutions is termed ______ hemolysis.

59. Plasma albumins are primarily responsible for generating ______ pressure.

60. The percentage of the volume of formed elements in the blood is called the________.

4.2 Erythrocyte sedimentation rate. Respiratory function of the

blood

Choose one correct answer

1. How do inflammatory conditions affect ESR?

a. increase
b. decrease

2. The affinity of myoglobin for oxygen compared to hemoglobin is

a. higher
b. lower

3. What is hemoglobin's affinity for carbon monoxide (CO) compared to oxygen (O2)?
a. lower
b. higher
c. the same

4. Which of the following is used to assess ESR?

a. Goryaev chamber
b. Sahli hemoglobinometer
c. Panchenkov’s device
d. oxyhemometer

5. Which of the following solutions is used to prevent blood clotting during the Panchen-
kov ESR test?
a. 5% acetic acid
b. 5% sodium citrate
c. 3% sodium chloride

107
 d. 0.5% sodium chloride

6. An increase in ESR is associated with which of the following changes?

a. increase in plasma albumin levels
b. decrease in glucose levels
c. increase in sodium levels
d. increase in plasma globulin and fibrinogen levels

7. What is the correct way to draw a blood sample and sodium citrate solution into the
Panchenkov capillary when assessing the ESR?
a. solution should be drawn once to the P-mark, blood should be drawn twice to the
K-mark
b. solution should be drawn twice to the P-mark, blood should be drawn once to the
K-mark
c. solution should be drawn twice to the P-mark, blood should also be drawn twice
to the K-mark
d. solution should be drawn once to the P-mark, blood should be drawn three times
to the K-mark

8. The Z-potential is the potential difference between the

a. inner and outer surfaces of the erythrocyte membrane
b. positively charged compact layer and negatively charged diffuse layer
c. negatively charged compact layer and positively charged diffuse layer
d. two closest erythrocytes

9. An increase in plasma globulin levels causes an increase in ESR, because globulins…

a. adsorb to the surface of erythrocytes and increase their weight
b. increase plasma viscosity
c. increase plasma density
d. decrease the Z-potential

10. Which of the following causes an increase in ESR?

a. aggregation of erythrocytes
b. increase in the hemoglobin content of the erythrocytes
c. increase in blood viscosity
d. macrocytosis

11. The ESR value for an adult male is equal to (mm/hour)

a. 1 – 2
b. 4 – 6
c. 6 – 12
d. 12 – 15

12. Which of the following respiratory pigments contains copper?

108
 a. hemerythrin
b. hemocyanin
c. chlorocruorin
d. myoglobin

13. Which of the following metals does hemocyanin contain?

a. copper
b. iron
c. chromium
d. cobalt

14. In the hemoglobin molecule, oxygen binds to which of the following atoms?
a. nitrogen
b. carbon
c. hydrogen
d. iron

15. In which of the following organs does oxygenation of hemoglobin occurs?

a. lungs
b. skeletal muscles
c. liver
d. brain

16. What is the mass fraction of the non-protein part of hemoglobin (%)?
a. 1
b. 4
c. 7
d. 12

17. What oxidation state does iron have in the hemoglobin molecule?
a. 0
b. +1
c. +2
d. +3

18. How many iron atoms are there in a molecule of hemoglobin?

a. 1
b. 2
c. 3
d. 4

19. How many oxygen molecules can one molecule of hemoglobin bind?
a. 1

109
 b. 2
c. 4
d. 6

20. How much O2 (ml) can 1 gram of hemoglobin bind?

a. 0.56
b. 1.34
c. 2.54
d. 3.26

21. How many subunits is a molecule of myoglobin made up of?

a. 1
b. 2
c. 3
d. 4

22. In order to calculate the mean corpuscular hemoglobin, one needs to divide
a. the number of erythrocytes by the hemoglobin content
b. the hemoglobin content by the number of erythrocytes
c. the mean corpuscular volume by the hemoglobin content
d. the hemoglobin content by the mean corpuscular volume

23. Which of the following types of hemoglobin is predominant in adults?

a. HbA
b. HbF
c. HbP
d. HbF

24. Mean corpuscular hemoglobin in a healthy adult is equal to (pg)

a. 6 – 16
b. 26 – 36
c. 56 – 76
d. 116 – 156

25. According to a complete blood count, the mean cell hemoglobin (MCH) is equal to 22
pg. The result means that the patient has
a. anemia
b. polycythemia
c. hyperchromic erythrocytes
d. microcytosis
e. hypochromic erythrocytes
f. macrocytosis
26. Which of the following types of hemoglobin is abnormal?
a. HbA

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 b. HbF
c. HbP
d. HbS

27. What is the hemoglobin content (g/L) in the blood of a healthy adult woman?
a. 100 – 110
b. 120 – 140
c. 130 – 160
d. 150 – 180

28. What is the color (farb) index in a healthy adult?

a. 0.1 – 0.3
b. 0.5 – 0.7
c. 0.7 – 1.1
d. 1.9 – 2.5

29. Which of the following hemoglobin compounds has a broad band in the yellow-green
region of the spectrum?
a. deoxygenated
b. oxyhemoglobin
c. carboxyhemoglobin
d. methemoglobin

30. Which of the following processes causes the formation of methemoglobin?

a. reduction of iron in heme (oxidation state changes from +2 to 0)
b. replacing of glutamate by valine at position 6 of the β chain
c. replacing of the β chain by the δ chain
d. oxidation of iron in heme (oxidation state changes from +2 to +3)

31. What is the process by which O2 is bound to hemoglobin called?

a. oxidation
b. oxygenation
c. saturation
d. oxidization

32. Which of the following is a method for assessing hemoglobin using the Sahli hemoglo-
binometer?
a. colorimetry
b. calorimetry
c. gasometry
d. metallometry

33. The test tubes of the Sahli’s hemoglobinometer contain a solution of a substance
formed by the interaction of hemoglobin with…

111
 a. acetic acid
b. 3% NaCl
c. hydrochloride acid
d. sodium citrate

34. Which of the following is a compound of hemoglobin with carbon dioxide?

a. carbaminohemoglobin
b. carboxyhemoglobin
c. oxyhemoglobin
d. myoglobin

35. Which of the following is a compound of hemoglobin with carbon monoxide?

a. carbaminohemoglobin
b. carboxyhemoglobin
c. oxyhemoglobin
d. myoglobin

Match the left and the right columns

36. Gender/age ESR value (mm/hour)

1. Male a. 1 – 2
2. Female b. 6 – 12
3. Newborns c. 8 – 15
d. 50 – 80

37. Red blood cell type Characteristic

1. Normochromic a. low hemoglobin content
2. Hypochromic b. normal hemoglobin content
3. Hyperchromic c. excessive saturation of hemoglobin with O2
d. excessive hemoglobin content

38. Hemoglobin compound Substance bound to hemoglobin

1. Oxyhemoglobin a. carbon monoxide
2. Carbamino hemoglobin b. carbon dioxide
3. Carboxyhemoglobin c. oxygen
d. hydrogen

39. Hemoglobin type Characteristics

1. HbA a. adult hemoglobin

112
 2. HbF b. hemoglobin in patients with sickle cell disease
3. HbP c. embryonic hemoglobin
d. fetal hemoglobin

40. Hemoglobin com- Absorption spectrum

pound
1. Deoxygenated a. two bands in the yellow and green regions of the spec-
trum
2. Oxyhemoglobin b. broad-band in the yellow-green region of spectrum
3. Methemoglobin c. one band in the blue region and one band in the green
region of the spectrum
d. one band in the red region, one band in the yellow region,
and one band in the green region of the spectrum

Choose two or more correct answers

41. Which of the following components are found in the hemoglobin molecule?
a. 6 polypeptide chains
b. 4 pyrrole rings linked by methine bridges
c. Fe2+
d. Fe3+
e. 4 polypeptide chains

42. Which of the following conditions are associated with the elevated ESR?
a. pregnancy
b. erythrocytosis
c. inflammatory disease
d. hyperglycemia
e. cancer

43. Which of the following is true of hemoglobin F?

a. contains 2α and 2γ chains
b. binds more O2 molecules than HbA
c. has Fe3+ as part of it
d. has a greater affinity for O2 than HbA
e. contains 2α and 2β chains

44. Which of the following hemoglobin compounds are abnormal?

a. oxyhemoglobin
b. carboxyhemoglobin
c. methemoglobin
d. deoxyhemoglobin
e. carbamino hemoglobin

113
45. Which of the following is true about the binding of CO to hemoglobin?
a. it binds to the iron in heme
b. CO binding causes hemoglobin to switch to the R-conformation, dramatically in-
creasing its affinity for oxygen
c. CO binding causes the formation of methemoglobin
d. CO bound to hemoglobin blocks anion exchangers in the erythrocyte
e. it binds to the amino groups of globin

46. Which of the following is true about bilirubin?

a. indirect bilirubin is converted to direct bilirubin by a conjugation reaction with
glucuronic acid
b. indirect bilirubin is excreted in bile into the small intestine
c. direct bilirubin is transported to the liver by albumin
d. indirect bilirubin is formed from biliverdin
e. it is a product of heme metabolism

47. Which of the following is true about the indirect bilirubin?

a. is formed from the direct bilirubin by the conjugation reaction
b. is transported by albumin
c. is excreted in the bile
d. is fat soluble
e. is water soluble

Arrange the correct sequence

48. Arrange the following groups of people in ascending order of ESR value
a. women
b. neonates
c. men

49. Arrange the following groups of people in descending order of hemoglobin value
a. men
b. neonates
c. women

50. Arrange the following forms of hemoglobin in order of appearance

a. HbP
b. HbA
c. HbF

51. Arrange the following heme metabolites in the correct order of their production
a. indirect bilirubin

114
 b. biliverdin
c. urobilin
d. direct bilirubin
e. urobilinogen

Fill in the gaps

52. If the hemoglobin content in a blood sample is 150 g/L and the number red blood cells
is 5.0×1012/L, the mean corpuscular hemoglobin is ___ pg.

53. The respiratory pigment that is found in the striated muscles and consists of one sub-
unit is called _______.

54. The compound of hemoglobin with carbon monoxide is referred to as ________.

55. The reaction of reversible binding of oxygen to hemoglobin is called _________.

56. The Z (dzeta) potential is the difference in charge between the compact and _____
layers surrounding a red blood cell.

57. The predominant hemoglobin type in newborns is _______.

58. The hemoglobin compound formed when exposed to a strong oxidizing agent (such as
potassium permanganate or potassium chlorate) is called __________.

59. The absorption spectrum of the ________ is a broad band in the yellow-green region
of the spectrum.

4.3 Hemostasis and blood clotting. Species and individual features

of the blood

Choose one correct answer

1. Which of the following is called “serum”?

a. plasma without fibrinogen
b. plasma without albumins

2. Which of the following is the rhesus factor (Rh)?

a. antibody
b. antigen

115
3. The statement “vitamin K is required for the production of clotting factors II, VII, IX,
and X” is
a. true
b. false

4. Which of the following pathways of prothrombinase formation is initiated by the tis-

sue factor?
a. intrinsic
b. extrinsic

5. Which of the following is found in plasma?

a. agglutinin
b. agglutinogen

6. Which of the following components is found in the erythrocyte membrane?

a. agglutinin
b. agglutinogen

7. How does epinephrin affects blood clotting?

a. accelerates
b. inhibits
c. doesn’t affect

8. How does the bleeding time change in thrombocytopenia?

a. increases
b. decreases
c. doesn’t change

9. Which of the following substance is responsible for the thrombus retraction?

a. prothrombin
b. serotonin
c. ADP
d. fibrinase

10. Which of the following clotting factors is contact?

a. fibrinogen (I)
b. antihemophilic globulin A (VIII)
c. Hageman factor (XII)
d. Stuart-Prower factor (X)

11. Which of the following cells are precursors of blood platelets?

a. megakaryocytes
b. myelocytes
c. macronucleocytes

116
 d. macronucleoblasts

12. Which of the following substances is found in the α-granules of platelets?

a. Ca2+
b. serotonin
c. fibrinogen
d. ADP

13. Identify the correct number of platelets in 1 liter of blood (×109/L)

a. 10 – 20
b. 50 – 60
c. 180 – 320
d. 450 – 500

14. Platelets adhere to the damaged vessel wall by

a. adhesin
b. von Willebrand factor
c. thrombospondin
d. thrombomodulin

15. Which of the following substances enhances the formation of the Hageman factor?
a. fibrinase
b. kallikrein
c. von Willebrand factor
d. high molecular weight kininogen

16. Which of the following coagulation factors is a serine protease?

a. III
b. V
c. VII
d. VIII

17. Which of the following coagulation factors is responsible for the transition from solu-
ble to insoluble fibrin?
a. XI
b. XII
c. IX
d. XIII

18. Which of the following substances activates coagulation factors V and VIII?
a. thrombin
b. von Willebrand Factor
c. fibrin
d. kallikrein

117
19. From which of the following coagulation factors does the extrinsic pathway starts?
a. I
b. III
c. VII
d. XII

20. Which of the following substances is/are produced along with fibrin monomer as a
result of the action of thrombin on fibrinogen?
a. fibrinopeptides A and B
b. products of fibrin degradation
c. D-dimer
d. fibrinolysin

21. Which of the following coagulation factors is called proconvertin?

a. II
b. V
c. VII
d. IX

22. Which of the following substances activates the protein C?

a. thrombomodulin
b. thromboglobulin
c. prothrombin
d. proaccelerin

23. Which of the following coagulation factors is inactivated by sodium citrate and sodium
oxalate?
a. II
b. IV
c. VII
d. X

24. Which of the following anticoagulants has heparin as a cofactor?

a. α2-macroglobulin
b. protein C
c. tissue factor pathway inhibitor
d. antithrombin III

25. Which of the following is true of indirect anticoagulants?

a. inhibit the synthesis of vitamin K-dependent coagulation factors
b. inhibit vitamin K dependent coagulation factors
c. inhibit the synthesis of vitamin K
d. are produced by the liver

118
26. Which of the following substances breaks up a fibrinous clot?
a. kallikrein
b. plasmin
c. fibrinase
d. urokinase

27. Antagonists of which of the following vitamins do have anticoagulant activity?

a. vitamin D
b. vitamin A
c. vitamin E
d. vitamin K

28. Which of the following is true of agglutinins?

a. they are antibodies
b. they are antigens
c. are found in the erythrocyte membrane
d. belong to the β-globulins

29. Which of the following combinations of agglutinins and agglutinogens is found in

blood group III?
a. agglutinogen A, agglutinin α
b. agglutinogen A, agglutinin β
c. agglutinogen B, agglutinin α
d. agglutinogens A and B, no agglutinins

30. If agglutination is seen in serum of groups I and III, the blood group determined is
a. I
b. II
c. III
d. IV

31. In which of the following condition is there a risk of Rh conflict?

a. the mother is Rh+, the father is Rh-
b. the father is Rh+, the mother is Rh-
c. both parents are Rh+
d. both parents are Rh-

32. What is the approximate percentage of Rh-positive people in the worldwide popula-
tion?
a. 15
b. 50
c. 85
d. 92

119
 Match the left and right columns

33. Type of hemophilia Coagulation factor deficiency

1. Hemophilia A a. factor VIII
2. Hemophilia B b. factor IX
3. Hemophilia C c. factor X
d. factor XI

34. Arachidonic acid de- Effects

rivatives
1. Thromboxane a. inhibits platelet aggregation, causes vasodilation
2. Prostacyclin b. stimulates platelet aggregation, causes vasocon-
striction
3. Leukotriene c. promotes inflammatory process
d. stimulates endothelial proliferation

35. Platelet factors Effects

1. Serotonin a. vasodilatation
2. Thrombostenin b. platelet aggregation
3. ADP c. platelet thrombus retraction
d. vasoconstriction

36. Blood groups Agglutinins and agglutinogens

1. I a. no agglutinogens, agglutinins α and β
2. II b. agglutinogen B, agglutinin α
3. III c. agglutinogen A, agglutinin β
d. agglutinogens A and B, no agglutinins

37. Coagulation factor numbers Coagulation factor names

1. Factor II a. Hageman factor
2. Factor VII b. tissue factor
3. Factor XII c. prothrombin
d. proconvertin

Choose two or more correct answers

38. Which of the following are platelet factors?

a. Christmas factor
b. thrombosthenin
c. ADP
d. Hageman factor
e. serotonin

120
39. What are the functions of platelets?
a. respiratory
b. angiotrophic
c. maintenance of pH
d. hemostatic
e. osmoregulatory

40. Which of the following is true of thromboxane A2?

a. is formed from arachidonic acid
b. enhances platelet aggregation and increases vascular tone
c. is found in the α-granules
d. activates coagulation factors V and VIII
e. prostacyclin is its antagonist

41. Which of the following substances are components of prothrombinase?

a. clotting factor II
b. clotting factor X
c. proteins C and S
d. clotting factor V
e. clotting factor VIII
f. phospholipids of the platelet membrane

42. Which of the following are the primary anticoagulants?

a. α2-macroglobulin
b. fibrin
c. active factor XI
d. antithrombin III
e. heparin

43. Which of the following coagulation factors are inactivated by proteins C and S?
a. II
b. V
c. VIII
d. IX
e. X

44. Which of the following substances are plasminogen activators?

a. urokinase
b. ADP
c. streptokinase
d. prostacyclin
e. nitrogen oxide

45. Vitamin K is needed for the synthesis of which of the following clotting factors

121
 a. I
b. II
c. VII
d. V
e. X

46. Which of the following types of blood can be transfused into type II blood?
a. I
b. II
c. III
d. IV

Arrange the correct sequence

47. Arrange the stages of platelet hemostasis in the correct order

a. reversible platelet aggregation
b. vasoconstriction of the injured vessel
c. platelet thrombus retraction
d. platelet adhesion
e. irreversible platelet aggregation

48. Arrange the stages of coagulation hemostasis in the correct order

a. conversion of soluble fibrin into insoluble fibrine
b. formation of prothrombinase
c. activation of factor VII
d. conversion of fibrinogen into soluble fibrin
e. conversion of prothrombin into thrombin

49. Arrange the stages of fibrinolysis in the correct order

a. conversion of plasminogen into plasmin
b. fibrin degradation
c. formation of plasminogen activator

50. Arrange the following coagulation factors in the ascending order of their number
a. prothrombin
b. fibrinogen
c. calcium ions
d. tissue factor
e. proconvertin

Fill in the gaps

122
51. The substance that breaks up fibrin is called _________.

52. The antithrombin III cofactor produced by mast cells is referred to as _______.

53. The I group blood contains α and β agglutinins and lacks ________.

54. The condition that develops in individuals with factor VIII deficiency is called _____.

55. The substance found in the dense granules of platelets that causes vasoconstriction is
called _______.

56. The extrinsic pathway of coagulation starts with the activation of ______ factor.

57. Soluble fibrin is converted to insoluble fibrin by _________.

58. The arachidonic acid derivative produced by platelets during hemostasis that stimu-
lates platelet aggregation and causes vasoconstriction is called ___________.

123
 CORRECT ANSWER KEYS FOR SECTION IV

4.1 Physiology of blood cells

1. a 22. a 43. b, c
2. b 23. d 44. a, d
3. a 24. b 45. c, d
4. b 25. a 46. a, b, e
5. b 26. c 47. a, d, e
6. a 27. a 48. a, b
7. c 28. d 49. 1b, 2a, 3d, 4e, 5c
8. b 29. b 50. 1b, 2d, 3c, 4a
9. d 30. d 51. 1a, 2c, 3b
10. c 31. b 52. 1d, 2b, 3c, 4a
11. b 32. c 53. leukopenia
12. c 33. a 54. erythrocytosis
13. b 34. b 55. erythropoietin
14. a 35. a 56. hemoglobin
15. d 36. d 57. leucocyte formula (leukocyte
16. c 37. 1c, 2b, 3a differential count)
17. a 38. 1a, 2d, 3b 58. osmotic
18. b 39. 1b, 2a, 3c 59. oncotic
19. d 40. 1c, 2d, 3a 60. hematocrit
20. b 41. 1a, 2c, 3b
21. b 42. a, c

4.2 Erythrocyte sedimentation rate. Respiratory function of the

blood

1. a 21. a 41. b, c, e
2. a 22. b 42. a, c, e
3. b 23. a 43. a, d
4. c 24. b 44. b, c
5. b 25. e 45. a, b
6. d 26. d 46. a, d, e
7. a 27. b 47. b, d
8. c 28. c 48. 1b, 2c, 3a
9. d 29. a 49. 1b, 2a, 3c
10. a 30. d 50. 1a, 2c, 3b
11. c 31. b 51. 1b, 2a, 3d, 4e, 5c

124
 12. b 32. a 52. 30
13. a 33. c 53. myoglobin
14. d 34. a 54. carboxyhemoglobin
15. a 35. b 55. oxygenation
16. b 36. 1b, 2c, 3a 56. diffuse
17. c 37. 1b, 2a, 3d 57. HbF (fetal)
18. d 38. 1c, 2b, 3a 58. methemoglobin
19. c 39. 1a, 2d, 3c 59. deoxyhemoglobin
20. b 40. 1b, 2a, 3d

4.3 Hemostasis and blood clotting. Species and individual features

of the blood

1. a 21. c 41. b, d, f
2. b 22. a 42. a, d, e
3. a 23. b 43. b, c
4. b 24. d 44. a, c
5. a 25. a 45. b, c, e
6. b 26. b 46. a, b
7. a 27. d 47. 1b, 2d, 3a, 4e, 5c
8. a 28. a 48. 1c, 2b, 3e, 4d, 5a
9. d 29. c 49. 1c, 2a, 3b
10. c 30. b 50. 1b, 2a, 3d, 4c, 5e
11. a 31. b 51. fibrinolysin (plasmin)
12. c 32. c 52. heparin
13. c 33. 1a, 2b, 3d 53. agglutinogens
14. b 34. 1b, 2a, 3c 54. hemophilia A
15. b 35. 1d, 2c, 3b 55. serotonin
16. c 36. 1a, 2c, 3b 56. tissue
17. d 37. 1c, 2d, 3a 57. fibrinase (factor XIII)
18. a 38. b, c, e 58. thromboxane A2
19. b 39. b, d
20. a 40. a, b, e

125
 Section V. RESPIRATORY PHYSIOLOGY

5.1 Mechanism of ventilation. Gas exchange in the lungs

Choose one correct answer

1. How does chest volume change during inspiration?

a. increases
b. decreases

2. Which phase of respiration usually has a longer duration?

a. inspiration
b. expiration

3. At rest, exhalation is an/a

a. active process
b. passive process

4. Which of the following groups do external intercostals belong to?

a. main inspiratory muscles
b. accessory inspiratory muscles

5. Abdominal muscles are

a. expiratory
b. inspiratory

6. Which of the following types of breathing is performed primarily by the diaphragm?

a. thoracic
b. abdominal

7. Dead space includes which of the following zone

a. conductive
b. transitory

8. Compared to atmospheric pressure, intrapleural pressure at rest is

a. negative
b. positive

9. At the end of forced exhalation, the intrapleural pressure compared to atmospheric

pressure is
a. negative
b. positive

126
10. In an individual with a unilateral pneumothorax, breathing is
a. possible
b. impossible

11. How does surfactant change the surface tension in the alveolar walls?
a. increases
b. decreases

12. Which of the following methods is used to assess lung volumes?

a. spirometry
b. calorimetry

13. How is the increase in respiratory rate called?

a. tachypnoea
b. bradypnea

14. Which of the following areas of the lung is better ventilated?

a. the apex
b. the base

15. During inhalation, the intra-alveolar pressure is

a. lower than atmospheric
b. higher than atmospheric
c. equal to atmospheric

16. During the inspiratory breath holding, the intra-alveolar pressure compared to the
atmospheric pressure is
a. more than atmospheric
b. less than atmospheric
c. equal to atmospheric

17. What is the percentage of carbon dioxide in the alveolar gas mixture?
a. 0.3
b. 5.3
c. 20.8
d. 46.1

18. In a healthy individual, which of the following is the ventilation-perfusion ratio equal
to?
a. 0.5
b. 1.0
c. 1.5
d. 5.0

127
19. At rest, which of the following is the tidal volume equal to (ml)?
a. 200
b. 500
c. 700
d. 1000

20. Volume of the anatomical dead space in an adult male is equal to (ml)
a. 50
b. 75
c. 150
d. 250

21. In which generation of branching of the bronchial tree does the conductive zone end?
a. 5
b. 10
c. 16
d. 20

22. The contraction of the respiratory muscles directly affects which of the following pa-
rameters?
a. the strength of the elastic recoil the lungs
b. lung volume
c. tidal volume
d. the strength of the elastic recoil of the chest wall

23. Which of the following factors contributes most to the elastic recoil of the lungs?
a. presence of the elastic fibers
b. the tone of the bronchial smooth muscle
c. alveolar surface tension
d. elastic recoil of the chest wall

24. Why does the volume of the thoracic cavity increase when the diaphragm muscle con-
tracts?
a. because the dome of the diaphragm flattens
b. because the diaphragm pulls the lower ribs up and to the sides
c. because the intra-abdominal pressure increases
d. because the pressure in the chest decreases

25. At rest, exhalation occurs mainly due to the

a. contraction of internal intercostal muscles
b. elastic recoil of the lungs
c. contraction of the abdominal muscles
d. decrease of the intrapleural pressure
26. How does surfactant prevent collapse of the alveoli?

128
 a. surfactant film prevents evaporation of water, so alveolar wall doesn’t shrink
b. surfactant molecules repel each other, preventing the alveolar surface from shrink-
ing
c. the surfactant film forms a frame, stabilizing the structure of the alveoli
d. phospholipid heads embed into the water surface, preventing interaction of water
molecules and reducing surface tension

27. Which of the following is the direct cause of lung collapse in pneumothorax?
a. the elastic recoil of the lung
b. the elastic recoil of the chest wall
c. appearance of a leak in the pleural cavity
d. depletion of surfactant

28. Which of the following volumes remains in the lungs after a quiet exhalation?
a. residual volume
b. expiratory reserve volume
c. functional residual capacity
d. inspiratory capacity

29. Which of the following lung volumes is a part of both VC and FRC?
a. expiratory reserve volume
b. residual volume
c. inspiratory reserve volume
d. tidal volume

30. Emphysema is associated with the destruction of the elastic fibers. Which of the fol-
lowing lung volumes is increased in emphysema?
a. inspiratory reserve volume
b. expiratory reserve volume
c. tidal
d. residual

31. Which of the following indices can’t be assessed by spirometry?

a. exspiratory reserved volume
b. tidal volume
c. vital capacity
d. functional residual capacity

32. Normal FEV1/FVC ratio is not less than

a. 35%
b. 55%
c. 75%
d. 95%
33. What is the correct way to calculate alveolar ventilation?

129
 a. multiply the respiratory rate by the difference between the tidal volume and the
volume of anatomical dead space
b. multiply the minute respiratory volume by the difference between the vital capac-
ity and the inspiratory reserve volume
c. multiply the minute ventilation of the dead space by the difference between the
minute respiratory volume and the vital capacity
d. divide the respiratory rate by the difference between the minute ventilation of the
dead space and the functional residual capacity

34. What is the substance that lines the inner surface of the alveoli called?
a. deoxidant
b. carboxin
c. trimethylxilan
d. surfactant

35. Which of the following is the correct percentage of O2 in the alveolar gas mixture?
a. 5
b. 14
c. 16
d. 21

36. Why is the O2 content of exhaled air higher than that of the alveolar gas mixture?
a. because the alveolar gas is mixed with the air in the anatomical dead space during
exhalation
b. because oxygen is constantly being absorbed from the alveoli
c. because there is more water vapor in the alveolar gas mixture
d. because CO2 is constantly entering the alveolar gas mixture

37. Gas exchange in the lungs occurs by which of the following mechanisms?
a. convection
b. diffusion
c. filtration
d. secondary active transport

38. The partial tension of oxygen in the arterial blood is equal to (mm Hg)
a. 40
b. 46 – 48
c. 100
d. 159

39. What is the driving force for gas exchange in the lungs?
a. blood pressure in the pulmonary capillaries
b. pressure of the gas mixture on the alveolar wall
c. partial pressure gradient of the gases

130
 d. heat energy of the gases

40. Why does CO2 cross the aero hematic barrier better than O2?
a. because CO2 is more soluble in water than O2
b. because CO2 has a higher molecular weight than O2
c. because the cells of the aero hematic barrier have special channels for CO2
d. because CO2 diffuses by the paracellular rout, whereas O2 diffuses only by the
transcellular route

Match the left and right columns

41. Lung volume Definition

1. Tidal volume a. volume of air that can be inhaled and exhaled during
quiet breathing
2. Inspiratory reserve b. air volume that can be additionally inhaled after
volume quiet expiration
3. Residual volume c. volume of air remaining in the lungs after maximal
expiratory effort
d. volume of air that can be additionally inhaled after
quiet inspiration

42. Type of respiratory muscle Muscle

1. Main inspiratory a. internal intercostals
2. Accessory inspiratory b. sternocleidomastoid
3. Expiratory c. iliopsoas
d. external intercostal

43. Phase of respiration Intrapleural pressure (mm Hg)

1. End of quiet inhalation a. -20
2. Forced exhalation b. -3
3. Deep inhalation c. +2
d. +20

44. Gas content Value, %

1. O2 in the exhaled air a. 5.5
2. O2 in the alveolar gas mixture b. 14
3. CO2 in the alveolar gas mixture c. 16
d. 30

45. Zone Bronchi generation

131
 1. Conductive a. 4
2. Transitory b. 22
3. Respiratory c. 18
d. 30

Choose two or more correct answers

46. Which of the following stages of respiration are carried out by the mechanism of con-
vection?
a. ventilation
b. gas exchange in the lungs
c. transport of gases in the blood
d. internal respiration
e. gas exchange in the tissues

47. In which of the following zones of the bronchial system does gas exchange take place?
a. conductive
b. transitional
c. intermediate
d. respiratory
e. capacitive

48. Which of the following are inspiratory muscles?

a. diaphragm
b. internal intercostals
c. abdominal
d. quadriceps femoris
e. external intercostals

49. Which of the following are accessory muscles of inspiration?

a. sternocleidomastoid
b. rectus abdominis
c. iliopsoas
d. serratus posterior superior
e. quadriceps femoris

50. Functional dead space includes which of the following?

a. pleural cavity
b. non-ventilated alveoli
c. airways
d. non-perfused alveoli
e. pulmonary vessels

132
51. Which of the following is responsible for the elastic recoil of the lungs?
a. tone of the intercostal muscles
b. alveolar surface tension
c. elastic fibers
d. tension of the pleura
e. hydrostatic pressure in the pulmonary capillaries

52. Which of the following lung volumes make up vital capacity?

a. tidal
b. inspiratory reserve volume
c. residual
d. expiratory reserve volume
e. functional residual capacity

53. Which of the following are parts of the blood-air barrier?

a. visceral pleura
b. type I pneumocytes
c. basal membrane
d. parietal pleura
e. capillary endothelium

Arrange the correct sequence

54. Arrange the following volumes in ascending order

a. residual
b. anatomic dead space
c. inspiratory reserve volume
d. tidal

55. Arrange the following stages of respiration in the correct order

a. gas exchange in the lung
b. ventilation
c. gas exchanges in the tissues
d. transport of gases in the blood

56. Arrange the following gas partial pressures/tensions in ascending order

a. CO2 partial tension in venous blood
b. O2 pressure in inhaled air
c. O2 tension in arterial blood
d. CO2 partial pressure in the alveolar gas mixture

57. Arrange the following gas contents in ascending order

a. CO2 content in the alveolar gas mixture

133
 b. O2 content in the alveolar gas mixture
c. CO2 content in exhaled air
d. O2 content in exhaled air

58. Arrange the following lung capacities in descending order

a. total lung capacity
b. functional residual capacity
c. inspiratory capacity
d. vital capacity

Fill in the gaps

59. If the respiratory rate is 12 per minute and the tidal volume is 0.5 L, the minute ven-
tilation is equal to ____ liters.

60. The difference between minute ventilation and minute dead space ventilation is called
______ ventilation.

61. The volume of airways up to the 16th generation is referred to as the anatomic _____.

62. The method of lung volumes recording is called ________.

63. The pathological condition in which air is found in the pleural cavity is called _____.

64. The sum of the residual and expiratory reserve volumes makes up the _____ capacity.

65. The driving force for the diffusion of gases in the lungs is their _________ gradient.

5.2 Transport of gases in the blood. Control of respiration

Choose one correct answer

1. Where does the oxyhemoglobin dissociation curve shift as the CO2 tension in the blood
increases?
a. to the left
b. to the right

2. Which of the following receptors detects changes in the blood gases?

a. baroreceptors
b. chemoreceptors

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3. If the brainstem is cut between the medulla and the spinal cord, spontaneous breath-
ing is
a. impossible
b. possible

4. Afferent impulses from the aortic chemoreceptors travel to the brainstem via which
of the following nerves?
a. vagal
b. glossopharyngeal

5. Which of the following gases is better dissolved in plasma?

a. oxygen
b. carbon dioxide

6. What shape does oxyhemoglobin dissociation curve have from 60 to 80 mm Hg?

a. flat
b. steep

7. How does breathing change when the level of CO2 in the blood increases?
a. increases
b. decreases
c. doesn’t change

8. How does breathing change when the level of O2 in the blood increases?
a. increases
b. decreases
c. doesn’t change

9. In adults, which of the following changes in blood gas levels is the respiratory center
more sensitive to?
a. hypoxemia
b. hypercapnia
c. equally to both

10. The oxyhemoglobin dissociation curve has which of the following shapes?
a. linear
b. hyperbole
c. U-shape
d. S-shape

11. Identify the O2 content in the venous blood (vol%)

a. 0.3
b. 14

135
 c. 20
d. 58

12. Identify the CO2 content in plasma (vol%)

a. 0.3
b. 2.5
c. 52
d. 58

13. Which of the following relationships is represented by the oxyhemoglobin dissociation

curve?
a. the saturation of hemoglobin and the partial tension of oxygen in the blood
b. the amount of hemoglobin and the partial tension of oxygen in the blood
c. percentage of O2 in blood and its partial pressure in the alveolar gas mixture
d. percentage of O2 in blood and its partial tension in plasma

14. The oxygen saturation of hemoglobin is calculated as the ratio of

a. amount of oxyhemoglobin to amount of deoxyhemoglobin
b. amount of oxygen to amount of hemoglobin
c. amount of oxyhemoglobin to the total amount of hemoglobin
d. amount of hemoglobin to partial tension of oxygen in blood

15. Hemoglobin saturation in venous blood is equal to (%)

a. 35
b. 50
c. 75
d. 90

16. Why is the initial part of the oxyhemoglobin dissociation curve flat?
a. there is too little hemoglobin in the blood
b. oxygen is poorly soluble in plasma
c. CO2 is bound to hemoglobin
d. all hemoglobin is in the T conformation and therefore binds O2 poorly

17. If the hemoglobin content in the blood is 100 g/l, what is its oxygen capacity (ml)?
a. 8.6
b. 13.4
c. 14.4
d. 20.1

18. The shift of the oxyhemoglobin dissociation curve to the right indicates which of the
following?
a. decreased affinity of hemoglobin for O2
b. increased affinity of hemoglobin for O2

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 c. increased carboxyhemoglobin content
d. transition of hemoglobin to the R-conformation

19. The cooperativity effect (heme-heme interaction) is caused by which of the following?
a. binding of O2 molecules causes hemoglobin to change from the T- to the R- con-
formation
b. binding of O2 molecules causes the formation of hydrogen bonds between hemes
c. when O2 binds, Fe2+ changes to Fe3+
d. binding of O2 molecules to hemoglobin leads to the enlargement of red blood cells

20. Carbonic anhydrase catalyzes the formation of which of the following?

a. carboxyhemoglobin
b. chloride-bicarbonate exchanger
c. carbonic acid
d. acetic acid

21. What is the partial pressure of oxygen in arterial blood (mm Hg)?
a. 10
b. 50
c. 100
d. 150

22. Where are the motor neurons that innervate the diaphragm located?
a. medulla
b. spinal cord, segment CIV
c. spinal cord, segment CI
d. spinal cord, segment ThI

23. Identify the form in which most CO2 is transported

a. carbaminohemoglobin
b. dissolved in plasma
c. H2CO3
d. HCO3-

24. In which of the following structures is the respiratory center located?

a. reticular formation of the medulla oblongata
b. quadrigeminal plate
c. subthalamic region
d. periaqueductal grey

25. What is the enzyme catalyzing the formation of bicarbonate ion from CO2 and OH-
called?
a. carboxypeptidase
b. carboxylase

137
 c. carbonic anhydrase
d. carbohydrase

26. What happens to the H+ ion that is formed during the dissociation of H2CO3?
a. it binds to globin
b. it binds to the iron in the heme
c. it is moved out of the erythrocyte into the plasma in exchange for Na+
d. it is moved out of the erythrocyte into the plasma in exchange for K+

27. The HCO3- ions are moved out of the erythrocytes in exchange for which of the fol-
lowing ions?
a. lactate
b. Cl-
c. Na+
d. K+

28. The spinal division of the respiratory center is made up of which of the following neu-
rons
a. γ-motor neurons
b. sympathetic neurons
c. Renshaw cells
d. α-motor neurons

29. Which of the following structures is a part of the dorsal respiratory group?
a. nucleus of the solitary tract
b. Bötzinger complex
c. nucleus paraambigualis
d. pre-Bötzinger zone

30. Which of the following types of neurons are found in the ventral respiratory group?
a. inspiratory only
b. expiratory only
c. both inspiratory and expiratory
d. sensory

31. Which of the following nuclei is a part of the pneumotaxic center?

a. parabrachial
b. gigantocellular
c. raphe
d. superior olivary nucleus

32. Where are central chemoreceptors located?

a. in the carotid sinus
b. on the ventrolateral surface of the medulla oblongata

138
 c. in the aqueduct of Sylvius
d. on the floor of the third ventricle

33. To which of the following do central chemoreceptors respond directly?

a. CO2 partial tension in the blood
b. pH of the blood
c. O2 level in the cerebrospinal fluid
d. pH of the cerebrospinal fluid

34. Which of the following nuclei is a collector of afferent information from the mechano-
receptors of the lungs and airways?
a. nucleus of the solitary tract
b. parabrachial
c. raphe
d. dorsal nucleus of the vagal nerve

35. What is the Herring-Brayer reflex?

a. cessation of breathing, then rapid shallow breathing
b. bronchospasm
c. transition from inhalation to exhalation
d. progressive increase in depth and rate of breathing

36. From which of the following receptors does the Herring-Brayer reflex originate?
a. chemoreceptors in the airways
b. slow adapting stretch receptors in the airways
c. proprioceptors in the diaphragm and external intercostal muscles
d. thermoreceptors in the airways

37. Juxta alveolar receptors are sensitive to which of the following stimuli?
a. accumulation of fluid in the interstitial space
b. exposure to dust
c. overstretching of the alveolar walls
d. hypoxemia in the pulmonary circulation

Match the left and the right columns

38. Receptor Adequate stimulus

1. Stretching a. stretching of the airways
2. Irritant b. lung interstitial edema
3. J-receptors c. caustic agents

139
 d. stretching of pleura

39. Neuron type Location

1. Inspiratory neurons a. thoracic spinal cord, ventral horn
2. Motor neurons of diaphragm b. cervical spinal cord, ventral horn
3. Motor neurons of external intercostals c. thoracic spinal cord, lateral horn
d. medulla oblongata

40. Receptors Location

1. Peripheral chemoreceptor a. airways
2. Central chemoreceptor b. surface of the medulla oblongata
3. Irritant receptor c. carotid sinus
d. surface of the spinal cord

41. Receptors Afferent nerves

1. Carotid sinus chemoreceptors a. vagal
2. Aortic chemoreceptors b. glossopharyngeal
3. Intercostal muscles proprioceptors c. trigeminal
d. spinal

42. Gases in the blood Total content (vol%)

1. O2 in venous blood a. 0.3
2. O2 in arterial blood b. 14
3. CO2 in venous blood c. 20
d. 55 – 58

Choose two or more correct answers

43. Which of the following influences the affinity of hemoglobin for oxygen?
a. CO2 tension
b. blood flow velocity
c. viscosity of the blood
d. temperature
e. blood sodium levels

44. Which of the following is true about 2.3-DPG?

a. is formed in erythrocytes in response to hypoxemia
b. is formed in the kidneys in response to hypoxemia
c. is one of the by-products of gluconeogenesis
d. decreases the affinity of hemoglobin for oxygen
e. binds to the iron atom in heme
f. does not affect HbF

140
45. Which of the following is true about the binding of CO2 to hemoglobin?
a. it binds to the iron to replace oxygen
b. it binds to the amino groups of globin
c. the binding of CO2 promotes the transition of hemoglobin from the R-confor-
mation to the T-conformation
d. it binds to the methine bridges of heme
e. the binding of CO2 increases the affinity of hemoglobin to O2

46. Which of the following parts are found in the respiratory center?
a. pressor
b. depressor
c. expiratory
d. pneumotaxic
e. cardiotonic

47. Where are peripheral chemoreceptors located?

a. in the aortic arch
b. in the carotid sinus
c. in the medulla oblongata
d. in the pulmonary vessels
e. in the spinal cord

48. Peripheral chemoreceptors respond to changes in which of the following parameters?

a. oxyhemoglobin levels
b. HCO3- levels
c. partial tension of O2 in the blood
d. partial tension of CO2 in the blood
e. pH
f. epinephrine levels

49. Which of the following are the receptors of the lungs and airways?
a. alveolar thermoreceptors
b. irritant
c. J-receptors
d. pharyngeal receptors
e. slow adapting stretch receptors

Arrange the correct sequence

50. Arrange the following contents of gases in blood (vol.%) in ascending order
a. oxygen in arterial blood
b. carbon dioxide in arterial blood

141
 c. carbon dioxide in plasma
d. oxygen in venous blood
e. carbon dioxide in venous blood

51. Arrange the following forms of carbon dioxide transport in the blood in ascending
order
a. carbaminohemoglobin
b. dissolved
c. bicarbonate

52. Arrange the following events related to the transport of carbon dioxide in the correct
order
a. exchange of bicarbonate for chloride
b. formation of carbonic acid
c. dissociation of H2CO3 into H+ and HCO3-
d. CO2 entry of in the red blood cell

53. Arrange the following events related to central chemoreceptor functions in the correct
order
a. CO2 enters cerebrospinal fluid
b. central chemoreceptors are activated
c. H2CO3 is formed by carbonic anhydrase
d. pH of cerebrospinal extracellular fluid decreases
e. blood CO2 tension increases

54. Arrange the following events related to peripheral chemoreceptor function in the cor-
rect order
a. blood O2 tension decreases
b. glomus cell membrane depolarizes
c. neurotransmitter (dopamine) is released
d. calcium channels open
e. O2 sensitive potassium channels in the glomus cell close

Fill in the gaps

55. The increase in respiratory rate is called _______.

56. The afferent impulses causing the Hering Breuer reflex are conveyed via the fibers of
the ________ nerve.

57. The enzyme that catalyzes the formation of the carbonic acid from the water (hydrox-
ide ion) and carbon dioxide is termed ________.

142
58. The pontine neural center that controls the rate and depth of breathing and prevents
lung overdistension is called __________ center.

59. The ______ respiratory group in the medulla oblongata contains only inspiratory neu-
rons.

60. The increase in CO2 levels in the blood is called _______.

61. The curve reflecting the dependance of hemoglobin saturation on the oxygen partial
tension in the blood is called the ____________.

62. The _______ chemoreceptors are located on the ventral surface of the medulla.

143
 CORRECT ANSWER KEYS FOR SECTION V

5.1 Mechanism of ventilation. Gas exchange in the lungs

1. a 23. c 45. 1a, 2c, 3b

2. b 24. a 46. a, c
3. b 25. b 47. b, d
4. a 26. d 48. a, e
5. a 27. a 49. a, d
6. b 28. c 50. c, d
7. a 29. a 51. b, c
8. a 30. d 52. a, b, d
9. b 31. d 53. b, c, e
10. a 32. c 54. 1b, 2d, 3a, 4c
11. b 33. a 55. 1b, 2a, 3d, 4c
12. a 34. d 56. 1d, 2a, 3c, 4b
13. a 35. b 57. 1c, 2a, 3b, 4d
14. b 36. a 58. 1a, 2d, 3c, 4b
15. a 37. b 59. 6
16. c 38. c 60. alveolar
17. b 39. c 61. dead space
18. b 40. a 62. spirometry
19. b 41. 1a, 2d, 3c 63. pneumothorax
20. c 42. 1d, 2b, 3a 64. functional residual
21. c 43. 1b, 2c, 3a 65. partial pressure
22. d 44. 1c, 2b, 3a

5.2 Transport of gases in the blood. Control of respiration

1. b 23. d 45. b, c
2. b 24. a 46. c, d
3. a 25. c 47. a, b
4. a 26. a 48. c, d, e
5. b 27. b 49. b, c, e
6. a 28. d 50. 1c, 2d, 3a, 4b, 5e
7. a 29. a 51. 1b, 2a, 3c
8. c 30. c 52. 1d, 2b, 3c, 4a
9. b 31. a 53. 1e, 2a, 3c, 4d, 5b
10. d 32. b 54. 1a, 2e, 3b, 4d, 5c
11. b 33. d 55. tachypnea
12. b 34. a 56. vagal (X)
13. a 35. c 57. carbonic anhydrase

144
14. c 36. b 58. pneumotaxic
15. c 37. a 59. dorsal
16. d 38. 1a, 2c, 3b 60. hypercapnia
17. b 39. 1d, 2b, 3a 61. oxyhemoglobin dissociation
18. a 40. 1c, 2b, 3a curve
19. a 41. 1b, 2a, 3d 62. central
20. c 42. 1b, 2c, 3d
21. c 43. a, d
22. b 44. a, d, f

145
 Section VI. CARDIOVASCULAR PHYSIOLOGY

6.1 The cardiac cycle and its phases. Automaticity of the heart

Choose one correct answer

1. Blood from the left ventricle enters into which of the following circuits
a. systemic
b. pulmonary

2. Blood from the right ventricle enters into which of the following circuits
a. systemic
b. pulmonary

3. Which of the following nodes is the main (I order) heart pacemaker?

a. sinoatrial
b. atrioventricular

4. In the fetus, which of the following chambers of the heart communicate through the
foramen ovale?
a. atria
b. ventricles

5. In the fetus, the left and the right halves of the heart are hemodynamically connected
in which of the following ways?
a. in series
b. in parallel

6. Which of the following is the state of the atrioventricular valves during the isovolu-
metric contraction phase?
a. opened
b. closed

7. The contractile cardiomyocytes

a. have automaticity
b. don’t have automaticity

8. The cardiac conduction system is made up of which of the following tissues?

a. nerve
b. muscular

9. How many leaflets does the left atrioventricular (mitral) valve have?

146
 a. two
b. three

10. How many leaflets does the right atrioventricular valve have?
a. two
b. three

11. What is the increase in heart rate called?

a. tachycardia
b. bradycardia

12. What is the decrease in heart rate called?

a. tachycardia
b. bradycardia

13. In adults, the wall thickness of the left ventricle compared to that of the right ventricle
is
a. greater
b. lower
c. the same

14. Blood drains into the right atrium from which of the following vessels?
a. aorta
b. pulmonary artery
c. pulmonary veins
d. inferior vena cava

15. How mjkkany layers are there in the myocardium?

a. two
b. three
c. two in the atrial myocardium, three in the ventricular myocardium
d. two in the atrial myocardium, four in the ventricular myocardium

16. Which of the following structures are the fibers of the atrial myocardium attached to?
a. fibrous rings
b. chordae tendineae
c. leaflets of the atrioventricular valves
d. leaflets of the semilunar valves

17. What do semilunar valves do?

a. prevent blood from flowing from the great vessels to the ventricles during diastole
b. prevent blood from flowing from the great vessels to the ventricles during systole
c. restrict blood flow from the ventricles to the great vessels during systole
d. prevent the aorta and pulmonary artery orifices from overstretching during systole

147
18. During which phase (period) of the cardiac cycle does intraventricular pressure in-
crease while the blood volume remains constant?
a. isovolumetric relaxation phase
b. isovolumetric contraction phase
c. protodiastolic period
d. slow filling

19. Why don’t the atrioventricular valve leaflets protrude into the atrial lumen during
systole?
a. because they are attached to the papillary muscles by the chordae tendineae
b. because they adhere to each other
c. because they are held in place by connective tissue flaps
d. because there are blood vortices in the atria that prevent the leaflets from protrud-
ing

20. When do the semilunar valves open?

a. when the pressure in the ventricles becomes higher than the systolic pressure in
the aorta and pulmonary artery
b. when the pressure in the ventricles becomes higher than in the atria
c. when the pressure in the ventricles becomes higher than the diastolic pressure in
the aorta and pulmonary artery
d. when the atrioventricular valves close

21. The duration of the protodiastolic period is equal to (s)

a. 0.02
b. 0.04
c. 0.1
d. 0.4

22. If the heart rate is 100 beats per minute, how long is one cardiac cycle (s)?
a. 0.5
b. 0.6
c. 0.8
d. 1.0

23. What is the duration of the rapid ejection phase (s)?

a. 0.08
b. 0.12
c. 0.13
d. 0.25

24. If the duration of a cardiac cycle is equal to 0.8 s, what is the duration of atrial diastole
(s)?

148
 a. 0.3
b. 0.4
c. 0.6
d. 0.7

25. Which of the following events occurs during the asynchronous contraction phase?
a. closure of the semilunar valves
b. closure of the atrioventricular valves
c. opening of the semilunar valves
d. opening of the atrioventricular valves

26. Atrial systole occurs between which of the following phases of the cardiac cycle?
a. slow filling phase and asynchronous contraction phase
b. rapid filling phase and asynchronous contraction phase
c. slow filling phase and isovolumetric contraction phase
d. slow ejection phase and protodiastolic period

27. Which of the following parts of the myocardium is the first to be involved in contrac-
tion?
a. interventricular septum
b. apex of the heart
c. ventricular walls
d. base of the heart

28. At the beginning of the rapid ejection phase, the pressure in the left ventricle is equal
to (mm Hg)
a. 25
b. 80
c. 120
d. 150

29. During atrial systole, the pressure in the left atrium is equal to (mm Hg)
a. 8
b. 15
c. 20
d. 25

30. During the rapid ejection phase, the pressure in the right ventricle is equal to (mm
Hg)
a. 5
b. 25
c. 80
d. 120

149
31. Which of the following structures is the normal pacemaker of the heart?
a. atrioventricular node
b. His bundle
c. contractile myocardium
d. sinoatrial node

32. Which of the following structures is the heart pacemaker of the third degree?
a. sinoatrial node
b. atrioventricular node
c. His bundle
d. Purkinje fibers

33. Where is the sinoatrial node located?

a. in the right atrium at the opening of the superior vena cava
b. in the left atrium at the opening of the left upper pulmonary vein
c. in the upper part of the interventricular septum
d. in the lower posterior part of the interatrial septum

34. Where is the atrioventricular node located?

a. in the lower posterior part of the interatrial septum
b. in the lower anterior part of the interatrial septum
c. in the upper posterior part of the interventricular septum
d. in the auricle of the right atrium

35. Which of the following is true for the heart valves during the isovolumetric contrac-
tion phase?
a. the atrioventricular valves are opened, the semilunar valves are closed
b. the atrioventricular valves are closed, the semilunar valves are opened
c. both atrioventricular and semilunar valves are closed
d. both atrioventricular and semilunar valves are opened

36. Which of the following structures transmits excitation to the contractile myocardium?
a. sinoatrial node
b. atrioventricular node
c. His bundle
d. Purkinje fibers
37. What is the ability of the heart to contract without any external stimulus called?
a. automaticity
b. excitability
c. autonomy
d. contractility

38. What is the automaticity gradient of the heart?

150
 a. decrease in automaticity when recovering from exercise or stress
b. decrease in excitability from the base to the apex of the heart
c. decrease in automaticity from the base to the apex of the heart
d. decrease in automaticity with age

39. How does the frog heart contract after applying the second ligature in the Stannius
experiment?
a. the sinus venous contracts to the rhythm of the sinoatrial node, the atria don’t
contract, the ventricle contracts to the rhythm of the atrioventricular node
b. the sinus venosus contracts to the rhythm of the sinoatrial node, the atria and ven-
tricle contract to the rhythm of the atrioventricular node
c. the sinus venosus and atria don’t contract, ventricle contracts to the rhythm of the
atrioventricular node
d. the sinus venous contracts to the rhythm of the sinoatrial node, the atria contract
at the rhythm of the atrioventricular node, the ventricle doesn’t contract

Match the left and right columns

40. Structure of the cardiac Function

conduction system
1. Sinoatrial node a. decreasing excitability of the myocardium
2. Atrioventricular node b. conduction along the ventricular myocardium
3. His bundle legs c. delay in conduction from the atria to the ventri-
cles
d. main pacemaker of the heart

41. Cardiac pacemaker Localization

1. I order a. sinoatrial node
2. II order b. His bundle
3. III order c. atrioventricular node
d. intramural ganglia

42. Phase of the cardiac cycle (chamber of the Pressure (mm Hg)
heart)
1. Atrial systole (left atrium) a. 1
2. End of the isovolumetric phase (left ventricle) b. 8
3. End of the rapid ejection phase (left ventricle) c. 80
d. 120

151
 43. Chamber of the Vessel that drains into the chamber or originates from the
heart chamber
1. Left ventricle a. pulmonary artery
2. Right ventricle b. aorta
3. Right atrium c. pulmonary vein
d. inferior vena cava

Choose two or more correct answers

44. Which of the following cardiac valves have three leaflets (cusps)?
a. aortic
b. pulmonary
c. left atrioventricular
d. right atrioventricular

45. Which of the following are semilunar valves?

a. left atrioventricular
b. aortic
c. pulmonary
d. right atrioventricular

46. Which of the following are structures of the cardiac conduction system?
a. sinoatrial node
b. node of Ranvier
c. His bundle
d. stellate ganglion
e. nodose ganglion

47. Blood leaves the heart through which of the following vessels?
a. aorta
b. inferior vena cava
c. superior vena cava
d. pulmonary trunk
e. pulmonary veins

48. The intraventricular pressure rises during which of the following phases (periods) of
the cardiac cycle?
a. rapid filling
b. protodiastolic
c. isovolumetric contraction
d. isovolumetric relaxation
e. rapid ejection

152
49. Which of the following phases of the cardiac cycle are a part of ventricular systole?
a. protodiastolic
b. rapid ejection
c. isovolumetric contraction
d. presystolic
e. rapid filling

50. The intraventricular pressure decreases during which of the following phases (peri-
ods) of the cardiac cycle?
a. isovolumetric contraction
b. rapid filling
c. rapid ejection
d. presystolic
e. isovolumetric relaxation

51. What was W. Harvey’s contribution to the theory of the cardiovascular system?
a. he discovered that the vascular system is closed
b. he described the cardiac cycle
c. he discovered microcirculation
d. he developed methods of measuring blood pressure
e. he described the function of the heart valves

52. What does the pericardium do?

a. prevents overstretching of myocardium when the ventricles are overfilled with
blood
b. involved in cardiac contractility
c. reduces friction force during heart activity
d. produces substances that regulate the activity of the myocardium
e. increases cardiac contractility

Arrange the correct sequence

53. Arrange the phases of the cardiac cycle in ascending order of their duration
a. atrial diastole
b. atrial systole
c. ventricular diastole
d. ventricular systole

54. Arrange the following structures of the cardiac conduction system in descending order
of automaticity (rate of impulse generation)
a. sinoatrial node
b. Purkinje fibers
c. atrioventricular node

153
 d. His bundle

55. Arrange the phases (periods) of the cardiac cycle after atrial systole in the correct
order
a. rapid ejection phase
b. asynchronous contraction phase
c. protodiastolic period
d. slow ejection phase

56. Arrange the blood vessels and chambers of the heart in the correct order for blood to
flow from the left ventricle
a. right atrium
b. venules, veins
c. aorta, arteries
d. right ventricle

57. Arrange the layers of the cardiac wall in the correct order from the inside to outside
a. endocardium
b. myocardium
c. pericardium
d. epicardium

Fill in the gaps

58. If the heart rate is equal to 60, the duration of the cardiac cycle is ___ second(s).

59. The atrioventricular node generates impulses at a rate of _______ per minute.

60. There are two muscular layers in the atria and ____ in the ventricles.

61. During the ________ phase of the ventricular systole, all cardiac valves are closed.

62. The _______ node is the main (first order) pacemaker of the heart.

63. The isometric relaxation phase is followed by the ________ phase.

64. The _________ node is the second order pacemaker of the heart.

65. During the ________ phase, the intraventricular pressure is maximal.

6.2 Physiological characteristics of the cardiac muscle

154
 Choose one correct answer

1. Tetanic contractions in the cardiac muscle are

a. possible
b. impossible

2. Which of the following refractory periods makes up most of the action potential?
a. effective (absolute)
b. relative

3. How is the conduction impairment through the cardiac conducting system called?
a. cardiac block
b. extrasystole

4. The sarcoplasmic reticulum in the cardiomyocytes, compared to the skeletal muscle

fibers is
a. more developed
b. less developed

5. The absolute refractory period is longer in which of the following muscles

a. cardiac
b. skeletal

6. The slow diastolic depolarization tracing has a steeper slope in the cells of which of
the following nodes
a. sinoatrial
b. atrioventricular

7. Which of the following is true about myocardial contractility?

a. obeys the “all-or-none” law
b. depends on the stimulus intensity

8. Which of the following is the “ladder” phenomenon?

a. increase in cardiac contractility as heart rate increases
b. increase in cardiac contractility as heart rate decreases
c. decrease in cardiac contractility as heart rate increases

9. What do the P-cells do?

a. delay conduction
b. conduct the excitation to the ventricular cardiomyocytes
c. spontaneously generate action potential
d. prevent premature heart beats

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10. In which of the following cells action potential has the greatest duration?
a. P-cells
b. contractile cardiomyocyte
c. nerve fiber
d. skeletal muscle fiber

11. Which of the following tissues does the conducting system of the heart consist of?
a. nervous
b. connective
c. epithelial
d. muscle

12. What is a contact between two adjacent cardiomyocytes called?

a. desmosome
b. gap junction
c. intercalated disc
d. podosome

13. At rest, the cardiomyocyte membrane is more permeable to which of the following
ions
a. potassium
b. sodium
c. calcium
d. chloride

14. In the contractile cardiomyocyte, depolarization is associated with increased permea-

bility to which of the following ions
a. potassium
b. calcium
c. sodium
d. chloride

15. The resting membrane potential in the contractile cardiomyocyte is equal to (mV)
a. -40
b. -60
c. -90
d. -120

16. How does the permeability of the cardiomyocyte membrane change during the slow
repolarization phase (plateau)?
a. increases permeability to Ca2+
b. increases permeability to Cl-
c. decreases permeability to Ca2+
d. increases permeability to Na+

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17. Which of the following changes in ion permeability takes place during the fast repolar-
ization phase in the contractile cardiomyocyte?
a. decreased permeability to Ca2+
b. increased permeability to K+
c. increased permeability to Na+
d. decreased permeability to Cl-

18. Which of the following ion channels are absent from contractile cardiomyocytes?
a. voltage-gated Na+ channels
b. Ca2+ channels
c. K+ channels
d. funny channels

19. The automaticity of the heart is associated which of the following phases of the action
potential?
a. slow repolarization (plateau)
b. slow diastolic depolarization
c. rapid depolarization
d. rapid repolarization

20. Which of the following is the maximal diastolic potential of the pacemaker cell (mv)?
a. -30
b. -55
c. -80
d. -115

21. In the contractile cardiomyocyte, adjacent T-tubule and L-cisterna form a…

a. dyad
b. triad
c. tetrad
d. pentad

22. What distinguishes electromechanical coupling in cardiac muscle from that in skeletal
muscle?
a. in cardiac muscle, Ca2+ binds to calmodulin instead of troponin
b. the cardiac muscle uses for contraction only extracellular Ca2+
c. the release of Ca2+ from the sarcoplasmic reticulum is induced by extracellular
Ca2+
d. cardiac sarcoplasmic reticulum doesn’t have Ca2+ ATPase

23. What is the physiological role of the atrioventricular delay?

a. to ensure consistent contraction of the atria and ventricles
b. to prevent regurgitation of blood from the ventricles into the atria

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 c. to ensure synchronous contraction of both ventricles
d. to increase the rate and force of atrial contraction

24. Which of the following structures provides propagation of excitation from one cardi-
omyocyte to another?
a. desmosomes
b. gap junctions
c. chemical synapses
d. nodes of Ranvier

25. What is the conduction velocity at the atrioventricular junction (m/s)?

a. 0.02 – 0.05
b. 0.1 – 0.3
c. 0.8 – 1
d. 2 – 4

26. What is the conduction velocity trough the atrial myocardium (m/s)?
a. 0.02 – 0.05
b. 0.1 – 0.3
c. 0.8 – 1
d. 12 – 4

27. What is the conduction velocity trough the ventricular conduction system (m/s)?
a. 0.02 – 0.05
b. 0.1 – 0.3
c. 0.8 – 1
d. 2 – 4

28. What is the premature beat called?

a. block
b. supersystole
c. extrasystole
d. ectopic focus

29. Which of the following is a common cause of premature heart beats?

a. re-entry of excitation due to the unidirectional block in the conduction system
b. accumulation of excess Ca2+ due to inhibition of Ca2+-ATPase
c. hyperpolarization of the cardiomyocyte membrane due to excessive activity of the
Na+-K+-ATPase
d. second-degree pacemaker inhibition

30. Unlike supraventricular extrasystoles, ventricular extrasystoles have a complete com-

pensatory pause because

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 a. excitation spreads from the ventricular ectopic focus and discharges the sinoatrial
node
b. excitation from the ventricular ectopic focus blocks the atrioventricular node
c. excitation from the ventricular ectopic focus blocks the bundle of His
d. the next impulse from the sinoatrial node arrives when the ventricular myocardium
is in the refractory period

31. What is the time between an extrasystole and the next contraction called?
a. compensatory pause
b. coupling interval
c. compensatory interval
d. interval of compensation

32. Which of the following is a sign of first-degree atrioventricular block?

a. duration of atrioventricular delay greater than 0.2 s
b. dropped beats periodically occur
c. asynchronous ventricular contraction
d. occasional absence of ventricular contractions

33. Which of the following is a sign of second-degree atrioventricular block?

a. duration of atrioventricular delay greater than 0.7 s
b. complete dissociation of atrial and ventricular contractions
c. dropped beats periodically occur
d. occasional absence of contraction of one of the ventricles

34. Which of the following is a sign of His bundle block?

a. duration of atrioventricular delay greater than 0.5 s
b. dropped beats periodically occur
c. asynchronous ventricular contraction
d. complete dissociation of atrial and ventricular contractions

35. Which of the following is true about the myocardium?

a. number of contracting cardiomyocytes depends on the vascular resistance
b. obeys the “all-or-none” law
c. unfused, but not fused tetanus can occur in the myocardium
d. summation contractions of can occur in the myocardium

36. According to Frank-Starling’s law, the force of ventricular contraction is…

a. directly proportional to the vascular resistance
b. inversely proportional to the heart rate
c. inversely proportional to the blood volume
d. directly proportional to the stretch of the ventricular myocardium in diastole

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 Match the left and right columns

37. Contractile cardiomyocyte action poten- Phases

tial
a. slow repolarization (plateau)
b. repolarization
c. depolarization
d. slow diastolic depolarization

38. Pacemaker cell action potential Phases

a. depolarization
b. slow repolarization (plateau)
c. repolarization
d. slow diastolic depolarization

39. Phase of the contractile cardio- Ion channels active during this phase
myocyte action potential
1. Rapid depolarization a. funny (nonselective sodium-potassium)
channels
2. Slow repolarization (plateau) b. delayed potassium channels
3. Rapid repolarization (final) c. slow calcium channels
d. fast sodium channels

40. Type of heart block Characteristic

1. First-degree atrioventricular a. dropped beats periodically occur
block
2. Second-degree atrioventric- b. duration of atrioventricular delay is greater
ular block than 0.2 s

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 3. His bundle block c. complete dissociation of atrial and ventricular
contractions
d. asynchronous ventricular contraction

41. Cells of the Characteristic

conduction system
1. P-cells a. small spindle-shaped cells found primarily in the si-
noatrial node; they spontaneously generate impulses
and are responsible for automaticity
2. Transition cells b. large cylindrical cells found in the ventricular conduc-
tion system; they provide fast conduction
3. Purkinje fibers c. slender elongated cells found primarily in the atrio-
ventricular node; they delay conduction
d. pyramidal cells with many processes; they form an ex-
tensive network in the subendothelial space

Choose two or more correct answers

42. What are the morphological characteristics of P-cells?

a. small size (7 – 10 μm)
b. well-defined T-system
c. poorly defined L-system
d. myofibrils are oriented parallelly
e. cylindrical shape

43. Which of the following are the physiological properties of the cardiac muscle?
a. automaticity
b. rigidity
c. plasticity
d. excitability
e. conductivity

44. Which of the following ionic currents occur during the slow repolarization phase
(plateau)?
a. inward potassium
b. inward chloride
c. outward potassium
d. inward calcium
e. outward chloride
45. What is the physiological significance of the plateau phase?
a. during the plateau phase, the myocardium is in a refractory state, so summation of
contraction in the heart is impossible
b. Cl- entering the cardiomyocytes during the plateau phase prevents the accumula-
tion of positive charges in the intracellular space

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 c. during the plateau phase, Ca2+ required for contraction enters the cardiomyocytes
d. the presence of the plateau phase stimulates cardiomyocyte secretion of sub-
stances that increase myocardial contractility
e. it prevents premature diastole

46. Which of the following phases does the action potential have in pacemaker cells?
a. slow diastolic depolarization
b. plateau phase
c. repolarization
d. depolarization
e. effective refractoriness

47. Which of the following is true about the action potential of contractile cardiomyo-
cytes?
a. its amplitude depends on the intensity of the stimulus
b. it propagates with decay
c. obeys the “all-or-none” law
d. has a large amplitude (100 – 130 mV)
e. it is elicited by hyperpolarization

48. During slow diastolic depolarization, the permeability of the cell membrane to which
of the following ions increases?
a. Cl-
b. Ca2+
c. K+
d. Na+
e. Mg2+

49. Which of the following is true of the action potential of P-cells?

a. presence of the plateau phase
b. slow diastolic depolarization
c. low maximal diastolic potential
d. high amplitude
e. low amplitude

50. Which of the following types of premature beats are there?

a. supraventricular
b. ventricular
c. subepicardial
d. subendocardial
e. autonomic

Arrange the correct sequence

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51. Arrange the phases of the action potential of the contractile cardiomyocyte in the cor-
rect order
a. initial fast repolarization
b. final fast repolarization
c. depolarization
d. slow repolarization (plateau)

52. Arrange the phases of the action potential of the P-cells in the correct order
a. depolarization
b. slow diastolic depolarization
c. repolarization

53. Arrange the changes in excitability of the contractile cardiomyocyte during excitation
in the correct order
a. absolute refractoriness
b. supernormal excitability
c. relative refractoriness

54. Arrange the following cardiac structures in ascending order of conduction velocity
a. His-Purkinje system
b. contractile myocardium
c. atrioventricular junction

55. Arrange the following structures in ascending order of action potential duration
a. skeletal muscle
b. cardiac muscle
c. nerve

Fill in the gaps

56. The rapid depolarization phase of the contractile cardiomyocyte action potential is
associated with the inward current of _______ ions.

57. Increased (greater than 0.2 seconds) atrioventricular delay is a sign of _______ atrio-
ventricular block.

58. The ________ cells in the atrioventricular node are mainly responsible for the atrio-
ventricular delay.

59. An abnormal pacemaker site in the myocardium from which premature beats origi-
nate is called _________.

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60. The conduction velocity in the His-Purkinje system is equal to _____ m/s.

61. The longer compensatory pause is typical of _______ extrasystoles.

62. The _____ depolarization in P-cells begins with the opening of the funny channels.

63. In the contractile cardiomyocyte, the T-tubule and adjacent L-cisterna form a _____.

6.3 Physical manifestations of activity of the heart. Physiological

basis of electrocardiography

Choose one correct answer

1. The heart sound I is

a. systolic
b. diastolic

2. The heart sound II is

a. systolic
b. diastolic

3. Which of the following heart sounds has a longer duration?

a. heart sound I
b. heart sound II

4. The ECG records which of the following processes?

a. excitation
b. contraction

5. What is an ECG sign of the sinus rhythm?

a. the T wave is after the QRS complex
b. the ST segment is on the isoelectric line
c. the P wave is before the QRS complex
d. the QRS complex is wide

6. Where is the left border of the heart located?

a. 1.5 cm lateral to the left midclavicular line
b. 1.5 cm medial to the left anterior axillary line
c. at the left midclavicular line
d. 1.5 cm medial to the left midclavicular line

7. Where is the lower border of the heart located?

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 a. at the upper edge of the fourth rib
b. in the IV intercostal space
c. in the V intercostal space
d. at the lower edge of the third rib

8. Where is the apex beat palpated in adults?

a. in the IV intercostal space, 1.5 cm laterally from the left sternal border
b. in the V intercostal space, 1.5 cm medial to the left midclavicular line
c. in the V intercostal space, 1.5 cm lateral to the left midclavicular line
d. in the IV intercostal space, 1.5 cm medial to the left anterior axillary line

9. What is the main mechanism of the apex beat origin?

a. the heart rotates during systole and therefore hits the chest wall
b. the heart changes shape from spherical to the conical during systole
c. the elastic recoil of the great vessels causes the heart to hit the chest wall
d. the recoil force is created when blood is ejected from the left ventricle into the
aorta

10. Identify the main mechanism of the heart sounds origin

a. collision of the atrioventricular valves leaflets as they close
b. abrupt deceleration of the moving blood column when it encounters an obstacle
c. abrupt tension of stretching of the myocardium
d. vibration of the walls of great vessels

11. Which of the periods (phases) of the cardiac cycle does the second heart sound corre-
spond to?
a. protodiastolic
b. transition from the rapid filling phase to the slow filling phase
c. transition of the phase of rapid ejection to the phase of slow ejection
d. atrial systole

12. Which of the periods (phases) of the cardiac cycle does the third heart sound corre-
spond to?
a. protodiastolic
b. transition from the rapid filling phase to the slow filling phase
c. transition of the phase of rapid ejection to the phase of slow ejection
d. atrial systole

13. Which of the following heart sounds corresponds to the atrial systole?
a. I
b. II
c. III
d. IV

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14. Which of the following phases (periods) of the cardiac cycle does the fourth heart
sound correspond to?
a. atrial systole
b. isovolumetric contraction
c. rapid filling phase
d. period of ejection

15. Which of the following areas of the chest wall is the best place to auscultate the pul-
monary artery valve?
a. V intercostal space; 1.5 cm medial to the left midclavicular line
b. the base of the xiphoid process
c. II intercostal space at the left parasternal line
d. II intercostal space at the right parasternal line

16. Which of the following areas of the chest wall is the best place to auscultate the left
atrioventricular (mitral) valve?
a. V intercostal space; 1.5 cm medial to the left midclavicular line
b. II intercostal space at the left parasternal line
c. the base of the xiphoid process
d. II intercostal space at the right parasternal line

17. The electrical dipole in the heart is the vector that is oriented from the negative to the
positive charge and connects the
a. excited and resting areas of the myocardium
b. the subendocardial and subepicardial layers of the myocardium
c. two resting areas of the myocardium
d. inner and outer surfaces of the cardiomyocyte membrane

18. Which of the following best defines an electrocardiographic lead?

a. a conventional axis connecting two parts of the body between which there is a
potential difference
b. an electrical scheme inside the electrocardiograph that records electrical processes
in the myocardium
c. an electrode placed on the surface of the body
d. two electrodes placed on the body surface and connected to a recorder by wires

19. When recording an ECG, where is the ground electrode usually placed?
a. right arm
b. left arm
c. right leg
d. left leg

20. Where are the positive and the negative electrodes of the I limb lead placed?
a. the positive electrode on the left arm, the negative electrode on the right arm

166
 b. the negative electrode on the left arm, the positive electrode on the right arm
c. the negative electrode on the left arm, the positive electrode on the left leg
d. the negative electrode on the right arm, the positive electrode on the left leg

21. In the aVR lead, the active electrode is placed on the right arm. Which of the following
is true about the reference electrode?
a. it is placed on the left arm
b. it is placed on the anterior axillary line in the intercostal V
c. it is the average of the left arm and right leg electrodes
d. it is the average of the left arm and left leg electrodes

22. The aVR lead is an augmented lead from which of the following limb?
a. right leg
b. left leg
c. right arm
d. left arm

23. The aVL lead is an augmented lead from which of the following limb?
a. right leg
b. left leg
c. right arm
d. left arm

24. Which of the following processes can be seen on an ECG?

a. depolarization of the atria
b. repolarization of the atria
c. increase in the coronary blood flow
d. relaxation of the ventricular myocardium

25. In lead V1, the active electrode is placed at the IV intercostal to the right of the ster-
num. Which of the following is true of the reference electrode?
a. it is placed at the IV intercostal to the left of the sternum
b. it is the average of the three limb electrodes
c. it is placed on the left arm
d. it is the average of the remaining five precordial electrodes

26. What is the portion of an ECG that is made up of a wave and an isoelectric line called?
a. interval
b. segment
c. complex
d. pattern

27. What is the portion of an ECG from the end of one wave to the beginning of another
wave called?

167
 a. interval
b. segment
c. track
d. axis

28. Excitation of which of the following parts of the heart is represented by the P wave of
ECG?
a. interventricular septum
b. atria
c. apex of the heart
d. base of the heart

29. When is an ECG wave positive?

a. when the direction of the moment vector coincides with the electrical axis of the
heart
b. when the excitation spreads towards the apex of the heart
c. when the direction of the moment vector coincides with the axis of the lead
d. when the repolarization vector coincides with the depolarization vector

30. Which of the following is true of the T wave of the ECG?

a. its direction coincides with the direction of the R wave in the same lead
b. is typically smaller than the P wave in the same lead
c. represents the diastole of the ventricles
d. is always positive

31. Which of the following ECG waves represents depolarization of the interventricular
septum?
a. P
b. Q
c. R
d. S

32. In a healthy individual, the amplitude of the Q wave is

a. greater than ¼ of the R wave in the same lead
b. less than ¼ of the R wave in the same lead
c. equal to the T wave in the same lead
d. not less than the P wave in the same lead

33. Which of the following ECG waves represents depolarization of the base of the heart?
a. P
b. Q
c. R
d. S

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34. Why is the ST segment of the ECG on the isoelectric line?
a. because all the ventricular myocardium is excited
b. because all the ventricular myocardium is at rest
c. because there is ventricular diastole
d. because repolarization of the cardiomyocytes is taking place

35. Which of the following is represented by the T wave of the ECG?

a. atrial repolarization
b. ventricular repolarization
c. repolarization of the bundle of His
d. depolarization of the interventricular septum

36. When the position of the electrical axis of the heart is oblique, which of the following
relationships of the ECG R waves is correct?
a. RI>RII>RIII
b. RII>RI>RIII
c. RII>RIII>RI
d. RI>RIII>RII

37. Which of the following relationships of the R-wave heights in the limb leads is impos-
sible?
a. RI>RII>RIII
b. RII>RI>RIII
c. RII>RIII>RI
d. RI>RIII>RII

38. Which of the following angles corresponds to the vertical direction of the cardiac axis?
a. 0 – 30°
b. 31 – 60°
c. 61 – 90°
d. 91 – 120°

39. Which of the following angles corresponds to the horizontal direction of the cardiac
axis?
a. 0 – 30°
b. 31 – 60°
c. 61 – 90°
d. 91 – 120°

40. During the ECG analysis, the α angle appeared to be equal to -10°. This means that
the patient has
a. the vertical position of the electrical axis of the heart
b. the horizontal position of the electrical axis of the heart
c. a deviation of the electrical axis of the heart to the left

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 d. a deviation of the electrical axis of the heart to the right

Match the left and right columns

41. Manifestation of activity of the heart Method of assessment

1. Apex beat a. electrocardiography
2. Heart sounds b. auscultation
3. Electrical phenomena c. palpation
d. percussion

42. ECG interval Maximum duration (seconds)

1. QRS a. 0.1
2. QT b. 0.2
3. PQ c. 0.45
d. 0.85

43. ECG wave/interval Recorded event

1. P a. atrial repolarization
2. T b. ventricular depolarization
3. QRS c. ventricular repolarization
d. atrial depolarization

44. Cardiac valve Auscultation site

1. Mitral a. V intercostal space; 1.5 cm medial to the left midclavicular line
2. Aortic b. IV intercostal space at the right anterior axillary line
3. Pulmonary c. II intercostal space at the left parasternal line
d. II intercostal space at the right parasternal line

45. ECG lead Placement of electrodes

1. V1 a. V intercostal space at the left medium axillary line
2. V4 b. V intercostal space at the left anterior axillary line
3. V5 c. IV intercostal space at the right parasternal line
d. V intercostal space at the left midclavicular line

46. Direction of the electric axis of the Angle of the electric axis of the heart
heart
1. Oblique a. 0 – 30°
2. Vertical b. 60 – 90°
3. Right deviation c. >90°
d. 30 – 60°

170
 Choose two or more correct answers

47. Which of the following methods are used to assess heart sounds?
a. echocardiography
b. auscultation
c. palpation
d. phonocardiography
e. vectorcardiography

48. Which of the following are bipolar leads?

a. I
b. aVR
c. aVL
d. V2
e. II

49. Which of the following are unipolar leads?

a. I
b. aVR
c. aVL
d. V2
e. II

50. In a healthy individual, which of the following angles can the electrical axis of the
heart have?
a. 0 – 30°
b. 30 – 60°
c. 60 – 90°
d. 90 – 120°
e. 120 – 150°

51. Which of the following heart sounds can be auscultated in a healthy adult?
a. I
b. II
c. III
d. IV

52. Which of the following heart sounds are not auscultated in a healthy adult?
a. I
b. II
c. III
d. IV

171
53. Which of the following ECG waves represent ventricular depolarization?
a. P
b. Q
c. R
d. S
e. T

54. Which of the following parameters of cardiac activity can be assessed using the apex
beat?
a. heart rate
b. cardiac rhythm
c. conductivity of the heart
d. blood flow velocity through the orifices of the great vessels
e. localization of the cardiac apex

Arrange the correct sequence

55. Arrange the ECG waves in the correct order

a. Q
b. P
c. T
d. R
e. S

56. Arrange the following lead II ECG waves in ascending order of amplitude
a. P
b. R
c. T

57. Arrange the following limb leads in the correct order (I – III)
a. right arm-left leg
b. right arm-left arm
c. left arm-left leg

58. Arrange the following heart sounds in the descending order of duration
a. III
b. I
c. II

59. Arrange the following precordial limbs in ascending order (V1 – V2 – V4 – V5)
a. IV intercostal space at the right parasternal line
b. V intercostal space at the anterior auxiliary line

172
 c. V intercostal space at the left midclavicular line
d. IV intercostal space at the left parasternal line

Fill in the gaps

60. A system of two electrodes connected by wires to an ECG recorder is called a _____.

61. The heart sound II is associated with the closure of the _________ valves.

62. The potential difference between the right arm and the combined electrode from the
left arm and left leg is recorded in the _____ lead.

63. Ventricular repolarization is represented by the ECG wave ____.

64. The sum of all depolarization vectors is called the _______ of the heart.

65. The palpable cardiac impulse associated with the ventricular systole is called the
________.

66. The best area for auscultation of the _______ valve is the V intercostal space 1.5 cm
medial to the left midclavicular line.

67. The depolarization of the interventricular septum is represented by the ECG wave
____.

6.4 Blood flow through the vessels. Blood pressure

Choose one correct answer

1. Which of the following types of blood flow is associated with noise?

a. laminar
b. turbulent

2. Which of the following is true of blood flow in the aorta?

a. it is pulsatile
b. it is continuous (not pulsatile)

3. Which of the following vascular systems has greater resistance?

a. pulmonary circulation
b. systemic circulation

173
4. As the chest expands, how does the blood pressure change in the heart and thoracic
vessels?
a. increases
b. decreases
c. doesn’t change

5. As an individual moves from a supine to a standing position, how does the vascular
tone in the lower extremities change?
a. increases
b. decreases
c. doesn’t change

6. As vascular resistance increases at the same pressure, how does the volume flow rate
change?
a. increases
b. decreases
c. doesn’t change

7. In arteries, the velocity of the pulse wave compared to the velocity of the blood is
a. lower
b. greater
c. the same

8. In small vessels, how does the viscosity of the blood change as the velocity of the blood
flow decreases?
a. decreases
b. increases
c. doesn’t change

9. How does the blood pressure change when resistance vessels dilate?
a. increase
b. decrease
c. doesn’t change

10. How does the volume of the right ventricle change during inspiration?
a. increases
b. decreases
c. doesn’t change

11. How does an increase in the cardiac output affect the blood pressure?
a. increases
b. decreases
c. doesn’t affect

174
12. Which of the following is true about the work of the left and the right ventricles?
a. the right ventricle performs a greater work than the left ventricle
b. both ventricles perform equal work
c. the left ventricle performs a greater work than the right ventricle

13. Which of the following is mechanical work of the heart mainly spent on?
a. accelerating the blood
b. overcoming vascular resistance
c. dilation of the ventricles during diastole

14. Into which chamber of the heart do the pulmonary veins drain?
a. right atrium
b. right ventricle
c. left ventricle
d. left atrium

15. In a healthy adult, the stroke volume is equal to which of the following (ml)?
a. 10
b. 60
c. 150
d. 300

16. What is the velocity of the pulse wave in the muscular arteries (m/s)?
a. 0.1 – 0.5
b. 1 – 2
c. 8 – 12
d. 40 – 60

17. What is the ratio between the volumes of the left and right ventricles?
a. left more than right
b. right more than left
c. they are equal
d. depends on physical activity and ambient temperature

18. Which of the following is the correct way to calculate the ejection fraction?
a. as the ratio of the stroke volume to the end-diastolic volume
b. as the ratio of the stroke volume to the end-systolic volume
c. as the difference between the end-diastolic volume and end-systolic volume
d. as the ratio of the end-diastolic volume to the end-systolic volume

19. What is the correct way to calculate the cardiac output according to Fick’s principle?
a. to divide the O2 content of the arterial blood by the volume of O2 consumed in one
minute

175
 b. to divide the arteriovenous O2 difference by the volume of O2 consumed in one
minute
c. to subtract the product of the in the arterial and venous O2 content from the volume
of O2 consumed in one minute
d. to divide the volume of O2 consumed in one minute by the arteriovenous O2 dif-
ference

20. Which of the following are capacitance vessels?

a. large arteries
b. capillaries
c. arteriolovenular anastomoses
d. veins

21. How do the aorta and pulmonary artery smooth out the pulsation of blood flow?
a. they resist blood flow, reducing oscillations in blood flow velocity
b. they are distended during systole and return to their original shape during diastole,
pushing the blood forward
c. they reduce friction, allowing blood to move through inertia during diastole
d. they transit turbulent blood flow to laminar flow, reducing oscillations in blood
flow velocity

22. What is the correct way to calculate the minute volume of blood?
a. multiply the stroke volume by the heart rate
b. divide the heart rate by the mean arterial pressure
c. multiply the end-diastolic volume by the blood volume
d. multiply the heart rate by the end-diastolic volume

23. Small arteries and arterioles are called resistance blood vessels because
a. blood flow velocity is greatest in these vessels
b. they make the greatest contribution to the vascular resistance
c. they convert pulsatile blood flow into continuous flow
d. they have well-defined muscular layer

24. What does an arteriovenous anastomosis do?

a. feeds the walls of the large veins
b. is a blood reservoir
c. along with capillaries participates in the exchange between blood and interstitial
fluid
d. transfers blood from arteries to veins, bypassing capillaries

25. Which of the following vessels contain the least amount of blood?
a. arterioles
b. veins

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 c. capillaries
d. large arteries

26. Which of the following is the main factor in blood flow through the vessels?
a. vascular resistance
b. the difference in pressure at the beginning and the of the vascular system
c. the elasticity of the blood vessels
d. the force gravity

27. Why is linear velocity of blood greatest in the aorta?

a. because the aorta is the largest blood vessel in the body
b. because the aorta has the smallest cross-sectional area
c. because the aorta originates from the left ventricle
d. because the aorta is an elastic vessel

28. What is the correct way to calculate the total resistance of the parallel blood vessels?
a. to sum the resistances of each vessel
b. to sum the values inversely proportional to the resistances of each vessel
c. to divide 1 by the sum of the resistances of each vessel
d. to divide 1 by the sum of the values inversely proportional to the resistances of
each vessel

29. What is the correct way to calculate the linear velocity of blood?
a. divide the volume flowrate by the cross-sectional area
b. divide the volume flowrate by the vascular resistance
c. multiply the difference between the pressure at the beginning and the end of the
blood vessel by the blood volume
d. divide the volume flowrate by the length of the vessel

30. Which of the following vessels have the slowest blood flow?
a. aorta
b. capillaries
c. veins
d. equal in all vessels

31. In which of the following blood vessels is the volume flowrate highest
a. aorta
b. capillaries
c. veins
d. equal in all vessels

32. The total blood circulation time is equal to (s)

a. 10 – 15

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 b. 23 – 25
c. 40 – 50
d. 60 – 70

33. In which of the following types of blood flow do the layers of blood mix irregularly?
a. torsional
b. kinetic
c. turbulent
d. laminar

34. The mean arterial pressure represents which of the following?

a. blood pressure averaged over the cardiac cycle
b. blood pressure averaged over the whole vascular system
c. the average of the systolic and diastolic blood pressure
d. the average of terminal and lateral blood pressures

35. Second-order waves in the blood pressure tracing are associated with which of the
following?
a. breathing
b. heart activity
c. oscillations in vascular tone
d. oscillations in blood volume

36. Blood pressure, which is the difference between systolic and diastolic pressure, is
called
a. lateral
b. terminal
c. pulse
d. systemic

37. Identify the correct ratio of hydrostatic pressure and oncotic pressure of plasma in
the arterial and venous ends of a capillary
a. the hydrostatic pressure is greater than the oncotic pressure in the arterial end, the
oncotic pressure is greater than the hydrostatic pressure in the venous end
b. the hydrostatic pressure is less than the oncotic pressure in the arterial end, the
oncotic pressure is less than the hydrostatic pressure in the venous end
c. the hydrostatic pressure is equal to the oncotic pressure in the arterial end, the
oncotic pressure is less than the hydrostatic pressure in the venous end
d. the oncotic pressure is greater than the hydrostatic pressure in the arterial end, the
oncotic pressure is equal to the hydrostatic pressure in the venous end

38. Which of the following waves in the phlebogram represents atrial systole?
a. a
b. c

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 c. v
d. x

39. Which of the following is a method for recording the arterial pulse?
a. tonography
b. pulsography
c. sphygmography
d. arteriography

Match the left and the right column

40. Vessel Functional type

1. Veins a. exchange
2. Capillary b. capacitance
3. Muscular arteries, arterioles c. resistance
d. bypass

41. Waves in arterial pressure Associated with

1. I order a. fluctuations of the vasomotor center tone
2. II order b. respiration
3. III order c. pulse wave
d. excretory processes

42. Type of vessels Blood flow velocity

1. Aorta a. 0.5 mm/s
2. Small arteries b. 0.1 m/s
3. Capillaries c. 0.5 m/s
d. 10 m/s

43. Phlebogram Associated with

wave
1. a a. atrial diastole
2. c b. increase in the atrial pressure at the end of the ventricular sys-
tole
3. v c. bulging of the leaflets of the atrioventricular valves into the
atria
d. atrial systole

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 44. Type of vessel Relative blood volume (%)
1. Systemic arteries and arterioles a. 5
2. Capillaries b. 15
3. Veins c. 65
d. 80

45. Type of vessel Relative resistance (%)

1. Small arteries and arterioles a. 7
2. Veins b. 27
3. Capillaries c. 47
d. 95

Choose two or more correct answers

46. Which of the following is true about the vascular resistance?

a. inversely proportional to the square of the radius of a blood vessel
b. directly proportional to the velocity of blood flow
c. directly proportional to blood viscosity
d. directly proportional to the square of the blood density
e. inversely proportional to the fourth power of the radius of a blood vessel
f. directly proportional to the length of a blood vessel

47. The end-systolic volume is made up of which of the following volumes?

a. minute blood volume
b. reserve volume
c. stroke volume
d. residual volume
e. end-diastolic volume

48. Identify the factors that promote blood flow through the veins
a. contraction of smooth muscles in the venous wall
b. contraction of skeletal muscles
c. sucking action of the heart
d. blood viscosity
e. blood density

49. Which of the following is true for turbulent blood flow?

a. requires a large amount of energy to maintain
b. more likely when blood viscosity is low
c. more likely when blood density is low
d. occurs in large blood vessels during psycho-emotional stress
e. more likely when blood flow velocity is high

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50. Which of the following is true of the lateral pressure?
a. is oriented perpendicular to the wall of a blood vessel
b. reflects only pressure-volume work
c. reflects only kinetic energy
d. reflects the sum of pressure-volume work and kinetic energy
e. is greater than the terminal pressure

51. Identify the factors affecting blood pressure

a. linear blood velocity
b. blood volume
c. blood viscosity
d. intrapleural pressure
e. vascular tone

52. Filtration and reabsorption in capillaries depend on which of the following pressures
a. atmospheric
b. hydrostatic in the capillaries
c. hydrostatic of interstitial fluid
d. oncotic of plasma
e. intrapleural

53. Volume flow rate is inversely proportional to which of the following?

a. vessel radius
b. heart rate
c. vessel length
d. blood viscosity
e. stroke volume

54. Which of the following are waves of the sphygmogram?

a. a
b. c
c. n
d. d
e. q

Arrange the correct sequence

55. Arrange the following vessels in ascending order of blood flow velocity
a. capillaries
b. inferior vena cava
c. arterioles
d. aorta

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56. Arrange the following volumes in ascending order
a. stroke
b. end-systolic
c. end-diastolic
d. cardiac output

57. Arrange the following vessels in descending order of blood pressure

a. veins
b. capillaries
c. large arteries
d. aorta

58. Arrange the following vessels in ascending order of resistance to blood flow
a. capillaries
b. large arteries
c. veins
d. arterioles

59. Arrange the waves of the phlebogram in the correct order

a. y
b. x
c. v
d. c
e. a

60. Arrange the following vessels in ascending order of the volume of blood they contain
a. capillaries
b. pulmonary vessels
c. veins
d. systemic arteries

Fill in the gaps

61. The difference between systolic and diastolic pressure is referred to as __________
pressure.

62. The method of recording the arterial pulse is called ________.

63. If the arteriovenous O2 difference is equal to 8% and the volume of O 2 consumed in

one minute is equal to 400 ml, then the cardiac output is equal to _________.

64. According to their functions, veins are considered ________ vessels.

182
65. Vascular resistance is directly proportional to blood viscosity and vessel length, and
inversely proportional to the fourth power of the vessel ________.

66. Capillary filtration is facilitated by the hydrostatic pressure of blood and opposed by
the _________ of plasma.

67. The method of recording the venous pulse is called _________.

68. In the venous system of the lower extremities, blood doesn’t move downward due to
the presence of _______ in the veins.

6.5 Neurohumoral regulation of the heart and vasculature

Choose one correct answer

1. When blood CO2 levels increase and blood pH decreases in the systemic vessels, which
of the following occurs
a. vasodilation
b. vasoconstriction

2. In an adult, which of the following nerves has a greater influence on the heart?
a. vagal
b. sympathetic

3. Activation of the axon reflex causes which of the following?

a. vasodilation
b. vasoconstriction

4. When blood pressure drops, how does the secretion of vasopressin change?
a. decreases
b. doesn’t change
c. increases

5. How many neurons are there in the reflex arc of the axon reflex?
a. one
b. two
c. three

6. How does the heart rate change when the sympathetic nerve is stimulated?
a. increases

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 b. decreases
c. doesn’t change

7. Where are the preganglionic neurons that innervate the heart located?
a. dorsal nucleus of the vagal nerve
b. solitary tract nucleus
c. superior salivatory nucleus
d. nucleus ambiguous

8. In which of the following structure are the preganglionic parasympathetic neurons

that supply the heart located
a. lateral horns of the spinal cord (ThI – ThV)
b. medulla oblongata
c. intramural ganglia
d. stellate and cervical ganglia

9. Which of the following effects of the autonomic system on the heart is aimed at con-
ductivity?
a. inotropic
b. bathmotropic
c. dromotropic
d. chronotropic

10. The escape phenomenon is caused by stimulation of which of the following nerves?
a. right vagal nerve
b. lower right cardiac nerve
c. left vagal nerve
d. lower left cardiac nerve

11. After prolonged stimulation of the right vagal nerve, the heart stops beating and then
starts beating again at half the normal rate (vagal escape phenomenon). What causes
the heart to restart?
a. depletion of mediators in the vagal nerve endings
b. the atrioventricular node takes over pacemaker activity
c. desensitization of cholinergic receptors
d. more active degradation of the transmitter when it acts for a long time

12. Who was the first to carry out the experiment that revealed the chemical mechanism
of transmission in autonomic synapses?
a. Pavlov
b. Cion
c. Frederic
d. Levi

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13. Most sympathetic preganglionic neurons supplying the heart release which of the fol-
lowing neurotransmitters?
a. serotonin
b. norepinephrine
c. acetylcholine
d. GABA

14. Stimulation of which of the following nerves causes a slowing of conduction through
the cardiac conduction system?
a. right vagal
b. lower right cardiac nerve
c. left vagal
d. lower left cardiac nerve

15. How does the heart activity change after the vagal nerves are cut?
a. heart rate doubles
b. heart rate increases by 10 – 15%
c. heart rate decreases by half
d. heart contractions stop

16. How is it possible to detect the tonic influence of the vagal nerves on the heart?
a. by intravenous infusion of the neurotransmitter
b. by lesioning the hypothalamus
c. by cutting them
d. by lesioning nuclei of the reticular formation

17. Pavlovian reinforcing nerve fibers increase cardiac contractility and don’t affect heart
rate because they
a. cause vasodilation in the coronary vessels, improving blood supply
b. stimulate only contractile cardiomyocytes
c. bind to metabotropic receptors that stimulate protein synthesis
d. release cortisol as a mediator

18. Which of the following types of adrenergic receptors is predominant in the cardiomy-
ocytes?
a. α1
b. α2
c. β1
d. β2

19. How does an increased level of extracellular Ca2+ affect cardiac activity?
a. a moderate elevation increases contractility; a marked elevation causes the heart
to stop during systole

185
 b. a moderate elevation increases heart rate, a marked elevation increases contractil-
ity
c. a moderate elevation inhibits cardiac activity, a marked elevation increases con-
tractility
d. a moderate elevation increases contractility, a marked elevation increases heart
rate

20. In severe hyperkaliemia, the heart stops in diastole because

a. the membrane becomes hyperpolarized and cardiomyocyte excitability decreases
b. Ca2+ release from the sarcoplasmic reticulum is blocked
c. Na+/K+-ATPase is blocked and ionic asymmetry disappears
d. sodium channels are inactivated, so the cardiomyocytes lose excitability

21. In the Bernard experiment, when the cervical sympathetic nerve in a rabbit is cut, its
ear becomes enlarged, red and warm. Which of the following phenomena is illustrated
by this experiment?
a. constant basal vascular tone
b. constant vasoconstrictor effect of the sympathetic nerves
c. the main role of humoral factors in the regulation of vascular tone
d. constant vasodilatory effect of the sympathetic nerves

22. Norepinephrine, released from the sympathetic nerve endings acts mainly on the …
and causes mainly …
a. α1-adrenergic receptors; vasoconstriction
b. α1-adrenergic receptors; vasodilation
c. β2-adrenefgic receptors; vasoconstriction
d. β2-adrenefgic receptors; vasodilation
e. α2-adrenergic receptors; vasoconstriction

23. In which of the following organs are blood vessels innervated by the sympathetic cho-
linergic fibers?
a. in the external genitalia
b. in the kidneys
c. in the skeletal muscles
d. in the adrenal glands

24. How does epinephrine affect vascular tone?

a. low levels decrease vascular tone, high levels increase vascular tone
b. low levels increase vascular tone, high levels decrease vascular tone
c. epinephrine itself is a vasodilator, but its metabolite formed in the vascular wall is
a vasoconstrictor
d. when epinephrine acts on the vessel wall for a short time, it dilates vessels, and
when it acts for a long time, it increases vascular tone

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25. Which of the following substances do endotheliocytes produce?
a. bradykinin
b. histamine
c. acetylcholine
d. NO

26. Which of the following substances produced in the hypothalamus causes vasocon-
striction and stimulates water reabsorption in the kidney?
a. oxytocin
b. vasopressin
c. corticotropin-releasing hormone
d. somatostatin

Match the left and right columns

27. Type of nerve fiber Effect

1. Sympathetic cholinergic a. increase in heart rate
2. Sympathetic adrenergic (when act- b. vasodilation in the skeletal muscles
ing on β1-adrenergic receptors)
3. Vagal nerve c. vasoconstriction of pulmonary ves-
sels
d. decrease in heart rate

28. Type of adrenergic receptors Effect

1. α1 a. vasodilation
2. β1 b. decrease in heart rate and contractility
3. β2 c. vasoconstriction
d. increase in heart rate and contractility

29. Nerve Effect

1. Right vagal a. positive chronotropic
2. Left vagal b. positive inotropic
3. Pavlovian reinforcing nerve c. negative dromotropic
d. negative chronotropic

30. Effect on vascular tone Substance

1. Vasoconstriction a. angiotensin II
2. Vasodilation b. NO
3. Vasoconstriction or vasodilation depending on c. calcitriol
concentration
d. epinephrine

187
 31. Changes in the extracel- Effects on the heart
lular ion levels
1. Hypercalcemia a. increased contractility, heart may stop during sys-
tole
2. Hypokalemia b. decreased excitability; heart may stop during dias-
tole
3. Acute severe hyper- c. increases excitability; cardiac arrhythmias are pos-
kalemia sible
d. impaired conduction; asynchronous contractions
of the left and right ventricles are possible

Choose two or more correct answers

32. Which of the following structures does the right vagal nerve innervate?
a. atrioventricular node
b. ventricular myocardium
c. sinoatrial node
d. bundle of His
e. right atrium

33. What does acetylcholine do to P cells?

a. stimulates Ca2+ release from the sarcoplasmic reticulum
b. stimulates opening of the If channels
c. increases membrane permeability to K+
d. decreases the rate of slow diastolic depolarization
e. activates voltage-gated ion channels

34. What does norepinephrine do to contractile cardiomyocytes?

a. increases the rate of slow diastolic depolarization
b. increases membrane permeability to Ca2+
c. inhibits Ca2+ entry into the sarcoplasmic reticulum
d. stimulates Ca2+ release from the sarcoplasmic reticulum
e. stimulates synthesis of contractile proteins

35. Which of the following effects does the sympathetic nervous system have on the heart?
a. negative dromotropic
b. positive inotropic
c. positive chronotropic
d. positive bathmotropic
e. negative chronotropic

188
36. Which of the following substances have a positive inotropic effect?
a. epinephrine
b. histamine
c. acetylcholine
d. cortisol
e. aldosterone

37. Which of the following components make up basal vascular tone?

a. structural
b. myogenic
c. neurogenic
d. secretory
e. endocrine

38. Which of the following are local neurogenic vasodilatory mechanisms?

a. sympathetic cholinergic fibers action
b. effect of histamine
c. axon reflex
d. effect of sympathetic fibers on α adrenergic receptors
e. parasympathetic fibers action

39. Identify the organs in which blood vessels receive parasympathetic innervation
a. lungs
b. external genitalia
c. pancreas
d. salivary glands
e. skeletal muscle

40. Which of the following substances are vasoconstrictors?

a. antidiuretic hormone
b. aldosterone
c. angiotensin II
d. oxytocin
e. NO

41. Which of the following causes an increase in local blood flow?

a. increase in pH
b. increase in O2 tension
c. decrease in temperature
d. increase in CO2 tension
e. decrease in pH

42. Activation of β adrenergic receptors causes which of the following?

189
 a. vasoconstriction
b. vasodilation
c. increase in heart rate
d. decrease in heart rate
e. increase in heart conductivity

43. Epinephrine may cause which of the following?

a. vasoconstriction
b. vasodilation
c. increase in heart rate
d. decrease in heart rate
e. decrease in heart conductivity

44. Stimulation of the right vagal nerve causes which of the following?
a. vasoconstriction
b. vasodilation in skeletal muscles
c. decrease in heart rate
d. increase in heart rate
e. decrease in heart excitability

Fill in the gaps

45. The influence of the autonomic nervous system on the cardiac contractility is called
the ________ effect.

46. The influence of the autonomic nervous system on the heart rate (automaticity) is
called the ________ effect.

47. The influence of the autonomic nervous system on cardiac conduction is called the
_________ effect.

48. The influence of the autonomic nervous system on cardiac excitability is called the
________ effect.

49. The right vagal nerve primarily affects the _______ node.

50. The left vagal nerve primarily affects the ________ node.

51. The endothelium produces _______ – a gaseous compound that causes vasodilation.

52. Excess extracellular potassium can cause the heart to stop during ________.

53. Excess extracellular calcium can cause the heart to stop during _________.

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6.6 Reflex regulation of the cardiovascular system

Choose one correct answer

1. The Aschner reflex is triggered from which of the following receptors?

a. mechanoreceptors of the eyeball
b. peritoneal mechanoreceptors

2. The Goltz reflex is triggered from which of the following receptors?

a. mechanoreceptors of the eyeball
b. peritoneal mechanoreceptors

3. When hit in the area of the carotid sinus, how does the heart rate change?
a. increase
b. decrease
c. doesn’t change

4. How does cerebral blood flow change during exercise?

a. increases
b. decreases
c. doesn’t change

5. Which of the following organs has constant blood flow (at rest and during exercise)?
a. brain
b. skin
c. skeletal muscle
d. intestine

6. Stimulation of the aortic arch baroreceptors causes which of the following?

a. inhibition of sympathetic and parasympathetic centers
b. activation of sympathetic and parasympathetic centers
c. activation of sympathetic and inhibition of parasympathetic centers
d. activation of parasympathetic and inhibition of sympathetic centers

7. Which of the following hormones is produced by the walls of the atria?

a. antidiuretic
b. aldosterone
c. oxytocin
d. natriuretic

191
8. Which of the following parameters is controlled by long-term regulatory mecha-
nisms?
a. blood volume
b. vascular tone
c. heart rate
d. blood viscosity

9. In which reflexogenic zone are the baroceptors located

a. vena cava
b. carotid sinus
c. aortic bulb
d. femoral arteries

10. In which reflexogenic zone are the volume receptors located

a. aortic arch
b. right ventricle
c. vena cava
d. carotid sinus

11. What stimuli do the A and B atrial receptors respond to?

a. A receptor – to the atrial contraction, B receptor – to the atrial stretch
b. A receptor – to atrial stretch, B receptor – to atrial contraction
c. A receptor – to increase of atrial volume, B receptor – to change of gas content in
blood
d. A receptor – to change in plasma osmolarity, B receptor – to change in blood gas
content

12. Which of the following cranial nerves innervates the aortic arch?
a. XII
b. IX
c. X
d. XI

13. Which of the following cranial nerves innervates the carotid sinus?
a. VII
b. IX
c. X
d. XI

14. From which of the following reflexogenic zones does the baroreflex originate?
a. aortic arch
b. atria
c. pulmonary circulation
d. vena cava

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15. Identify the part of the CNS where the baroreflex center is located
a. spinal cord
b. medulla oblongata
c. pons
d. hypothalamus

16. In which of the following structures of the medulla oblongata is the pressor zone of
the cardiovascular center located
a. caudal ventrolateral medulla
b. nucleus of the solitary tract
c. dorsal nucleus of vagal nerve
d. rostral ventrolateral medulla

17. Which of the following schemes accurately describes the relationships between parts
of the cardiovascular center?
a. nucleus of the solitary tract stimulates the vasodilatory area; the vasodilatory area
inhibits the vasoconstrictor area
b. nucleus of the solitary tract stimulates the vasodilatory area, the vasodilatory area
stimulates the vasoconstrictor area
c. vasoconstrictor area inhibits the vasodilatory area, the vasodilatory area stimulates
nucleus of the solitary tract
d. vasodilatory area stimulates the vasoconstrictor area, the vasoconstrictor area in-
hibits nucleus of the solitary tract

18. Which of the following nuclei is a part of the cardioinhibitory center?

a. ambiguous
b. nucleus of the solitary tract
c. raphe
d. gigantocellular

19. Which of the following structures does the pressor zone act on directly?
a. para- and prevertebral ganglia
b. myocardium
c. vascular wall
d. lateral horns of the spinal cord

20. In which of the following structures is the segmental level of the cardiovascular center
located
a. pre- and paravertebral ganglia
b. lateral horns of the spinal cord
c. ventral horns of the spinal cord
d. lateral parvocellular nucleus

193
21. What is the humoral component of the chemoreflex?
a. activation of the adrenal cortex
b. increase in the sensitivity of chemoreceptors
c. activation of the adrenal medulla
d. increase in the influence of the non-specific metabolites (CO2, adenosine) on the
vessels

22. What is the physiological significance of the pulmonary unloading reflex?

a. prevention of pulmonary hypertension
b. improvement of blood supply to lung tissue
c. stimulation of gas exchange in lungs
d. increase of blood pressure in the pulmonary circulation when blood volume is re-
duced

23. What is the physiological significance of the Bainbridge reflex?

a. improvement in atrial contractility
b. increase in pulmonary blood pressure
c. reduction of blood volume
d. redistribution of blood from the systemic to the pulmonary circulation

24. The Bainbridge reflex causes which of the following?

a. decrease in heart rate
b. increase in heart rate
c. vasoconstriction
d. decreased diuresis

25. The Aschner reflex causes which of the following?

a. increase in heart rate
b. decrease in heart rate
c. vasoconstriction
d. decreased diuresis

26. Which of the following reflexes has only one component?

a. baroreflex
b. chemoreflex
c. Bainbridge’s reflex
d. unloading reflex
27. What is the physiological significance of the chemoreflex?
a. increases arterial pressure when it is decreased
b. decreases blood volume
c. decreases arterial pressure when it is increased
d. ensures adequate blood flow in hypoxemia

28. Which of the following reflexes is triggered by a fall in arterial pressure?

194
 a. baroreflex
b. chemoreflex
c. Bainbridge
d. Goltz

29. From which of the following receptors does the Goltz reflex originate
a. mechanoreceptors of the pericardium
b. chemoreceptors of the pericardium
c. mechanoreceptors of the peritoneum
d. mechanoreceptors of the renal capsule

30. Which of the following reflexes is triggered by a moderate pressure on the eyeball?
a. Bainbridge reflex
b. baroreflex
c. chemoreflex
d. Aschner reflex

31. Which of the following cortical areas is involved in the regulation of the cardiovascu-
lar system?
a. insula
b. postcentral gyrus
c. occipital lobe
d. hippocampus

32. Hyperventilation (deep and fast breathing) is often associated with dizziness. Which
of the following is the cause of this phenomenon?
a. excess O2 significantly stimulates aerobic metabolism in neurons
b. vasoconstriction of cerebral vessels due to hypocapnia
c. hypocapnia inhibits cardiovascular center
d. excessive O2 increases intracranial pressure

33. How does coronary blood flow depend on the phases of the cardiac cycle?
a. in the left coronary artery blood flow occurs mainly during diastole, in the right –
during systole
b. in the left coronary artery blood flow occurs mainly during systole, in the right –
during diastole
c. in both coronary arteries, blood flow occurs mainly during systole
d. in both coronary arteries, blood flow occurs mainly during diastole

34. Which of the following metabolic factors is the most important in regulating the cor-
onary circulation?
a. pH
b. K+
c. CO2

195
 d. adenosine

Match the left and right columns

35. Reflex Receptors

1. Bainbridge a. peritoneal mechanoreceptors
2. Goltz b. volume receptors
3. Aschner c. mechanoreceptors of the eyeball
d. chemoreceptors

36. Receptors Reflexogenic zones where they predominate

1. Volume receptors a. carotid sinus
2. Baroreceptors b. orifice of the vena cava, atria
3. Chemoreceptors c. aortic arch
d. splanchnic arteries

37. Chemoreflex components Characteristics

1. Cardiac (first component) a. tachypnea
2. Vascular b. vasoconstriction
3. Humoral c. secretion of catecholamines
d. tachycardia

38. Type of mechanism Mechanism of regulation of the cardiovascular system

1. Short-term a. secretion of atrial natriuretic peptide
2. Intermediate-term b. renin angiotensin system
3. Long-term c. Bainbridge reflex
d. secretion of parathyrin

Choose two or more correct answers

39. Which of the following are short-term mechanisms regulating the cardiovascular sys-
tem?
a. changes in transcapillary exchange
b. Bainbridge reflex
c. aldosterone secretion
d. activation of the sympathoadrenal system
e. secretion of atrial natriuretic peptide

40. Which of the following blood vessels have reflexogenic zones?

a. arch of the aorta
b. skin vessels
c. brain vessels
d. splanchnic vessels

196
 e. vena cava

41. Which of the following are components of the baroreflex?

a. respiratory
b. renal
c. cardiac
d. vascular
e. humoral

42. Which of the following stimuli induce chemoreflex?

a. hypoxemia
b. acidosis
c. increase in plasma osmolarity
d. decrease in epinephrine levels
e. increase in blood sodium levels

43. Increased arterial pressure in the pulmonary circulation causes which of the following
reflex responses?
a. increased systemic blood pressure
b. enlargement of the spleen
c. bradycardia
d. increased Na+ reabsorption in the kidney
e. tachycardia

44. Which of the following mechanisms are involved in the autoregulation of cerebral
blood flow?
a. neurogenic
b. hormonal
c. myogenic
d. metabolic
e. autocrine

45. The baroreflex causes which of the following?

a. vasodilation
b. secretion of catecholamines
c. increased ventilation
d. bradycardia
e. increased natriuresis

46. Which of the following receptors are found in the carotid sinus?
a. chemoreceptors
b. osmoreceptors
c. baroreceptors
d. thermoreceptors

197
 e. photoreceptors

47. Which of the following are the major baroreceptor zones?

a. intercostal muscles
b. pulmonary veins
c. atria
d. aortic arch
e. carotid sinus

48. Which of the following reflexes cause bradycardia?

a. Aschner
b. Goltz
c. Bainbridge
d. unloading
e. Gauer-Henry

Arrange the correct sequence

49. Arrange the following elements of the chemoreceptor reflex pathway in the correct
order
a. glossopharyngeal nerve fibers
b. vasomotor area
c. carotid sinus
d. blood vessels
e. ganglionic neurons in the spinal cord

50. Arrange the following elements of the baroreceptor reflex pathway in the correct or-
der
a. vagal nerve fibers
b. aortic arch
c. blood vessel
d. vasomotor area
e. ganglionic neurons in the spinal cord

51. Arrange the following elements of the Bainbridge reflex pathway in the correct order
a. afferent fibers of the vagal nerve
b. nucleus ambiguous
c. solitary tract nucleus
d. sinoatrial node
e. atrial volume receptor

52. Arrange the following elements of the Aschner reflex pathway in the correct order

198
 a. sinoatrial node
b. ophthalmic branch of the trigeminal nerve
c. sensory nucleus of the trigeminal nerve
d. vagal nerve
e. nucleus ambiguous
f. mechanoreceptors of the eyeball

Fill in the gaps

53. Afferent impulses from the aortic arch are transmitted by fibers of the ______ nerve.

54. The Bainbridge reflex is elicited by stimulation of volume receptors located in the
_____.

55. Reflexes that affect the cardiovascular system but are elicited by the receptors outside
of it are called _______ reflexes.

56. The hormone produced by the right atrium when it is stretched is called __________.

57. Decrease in heart rate when the peritoneal mechanoreceptors are stimulated is caused
by the ______ reflex.

58. The renin-angiotensin system is an _______-term regulatory mechanism.

59. The Baroreflex belongs to the _________-term regulatory mechanism.

60. The ______ area of the vasomotor center is located in the rostral ventrolateral me-
dulla.

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 CORRECT ANSWER KEYS FOR SECTION VI

6.1 The cardiac cycle and its phases. Automaticity of the heart

1. a 23. b 45. b, c
2. b 24. d 46. a, c
3. a 25. b 47. a, d
4. a 26. a 48. c, e
5. a 27. a 49. b, c
6. b 28. b 50. b, e
7. b 29. a 51. a, b, e
8. b 30. b 52. a, c
9. a 31. d 53. 1b, 2d, 3c, 4a
10. b 32. c 54. 1a, 2c, 3d, 4b
11. a 33. a 55. 1b, 2a, 3d, 4c
12. b 34. a 56. 1c, 2b, 3a, 4d
13. a 35. c 57. 1a, 2b, 3d, 4c
14. d 36. d 58. 1
15. c 37. a 59. 40 – 50
16. a 38. c 60. three
17. a 39. a 61. isovolumetric
18. b 40. 1d, 2c, 3b 62. sinoatrial
19. a 41. 1a, 2c, 3b 63. rapid filling
20. c 42. 1b, 2c, 3d 64. atrioventricular
21. b 43. 1b, 2a, 3d 65. rapid ejection
22. b 44. a, b, d

6.2 Physiological characteristics of the cardiac muscle

1. b 23. a 45. a, c
2. a 24. b 46. a, c, d
3. a 25. a 47. c, d
4. b 26. c 48. b, d
5. a 27. d 49. b, c, e
6. a 28. c 50. a, b
7. a 29. a 51. 1c, 2a, 3d, 4b
8. a 30. d 52. 1b, 2a, 3c
9. c 31. a 53. 1a, 2c, 3b
10. b 32. a 54. 1c, 2b, 3a
11. d 33. c 55. 1c, 2a, 3b
12. c 34. c 56. sodium (Na+)

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 13. a 35. b 57. first degree
14. c 36. d 58. transitional (T-cells)
15. c 37. 1c, 2a, 3b 59. ectopic focus
16. a 38. 1d, 2a, 3c 60. 2 – 4
17. b 39. 1d, 2c, 3b 61. ventricular
18. d 40. 1b, 2a, 3d 62. slow diastolic
19. b 41. 1a, 2c, 3b 63. dyad
20. b 42. a, c
21. a 43. a, d, e
22. c 44. c, d

6.3 Physical manifestations of activity of the heart. Physiological

basis of electrocardiography

1. a 24. a 47. b, d
2. b 25. b 48. a, e
3. a 26. a 49. b, c, d
4. a 27. b 50. a, b, c
5. c 28. b 51. a, b
6. d 29. c 52. c, d
7. c 30. a 53. b, c, d
8. b 31. b 54. a, b, e
9. d 32. b 55. 1b, 2a, 3d, 4e, 5c
10. b 33. d 56. 1a, 2c, 3b
11. a 34. a 57. 1b, 2a, 3c
12. b 35. b 58. 1b, 2c, 3a
13. d 36. b 59. 1a, 2d, 3c, 4b
14. a 37. d 60. lead
15. c 38. c 61. semilunar
16. a 39. a 62. aVR
17. a 40. c 63. T
18. d 41. 1c, 2b, 3a 64. electrical axis
19. c 42. 1a, 2c, 3b 65. apex beat
20. a 43. 1d, 2c, 3b 66. mitral (left atrioventricular)
21. d 44. 1a, 2d, 3c 67. Q
22. c 45. 1c, 2d, 3b
23. d 46. 1d, 2b, 3c

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6.4 Blood flow through the vessels. Blood pressure

1. b 24. d 47. b, d
2. a 25. c 48. b, c
3. b 26. b 49. a, b, e
4. b 27. b 50. a, d
5. a 28. d 51. b, c, e
6. b 29. a 52. b, c, d
7. b 30. b 53. c, d
8. b 31. d 54. a, b, d
9. b 32. b 55. 1a, 2c, 3b, 4d
10. a 33. c 56. 1b, 2a, 3c, 4d
11. a 34. a 57. 1d, 2c, 3b, 4a
12. c 35. a 58. 1c, 2b, 3a, 4d
13. b 36. c 59. 1e, 2d, 3b, 4c, 3a
14. d 37. a 60. 1a, 2b, 3d, 4c
15. b 38. a 61. pulse
16. c 39. c 62. sphygmography
17. c 40. 1b, 2a, 3c 63. 5000 ml/min (5 L/min)
18. a 41. 1c, 2b, 3a 64. capacitance
19. d 42. 1c, 2b, 3a 65. radius
20. d 43. 1d, 2c, 3b 66. oncotic pressure
21. b 44. 1b, 2a, 3c 67. phlebography
22. a 45. 1c, 2a, 3b 68. valves
23. b 46. c, e, f

6.5 Neurohumoral regulation of the heart and vasculature

1. a 19. a 37. a, b
2. a 20. d 38. a, c, e
3. a 21. b 39. b, d
4. c 22. a 40. a, c
5. a 23. c 41. d, e
6. a 24. a 42. b, c, e
7. d 25. d 43. a, b, c
8. b 26. b 44. c, e
9. c 27. 1b, 2a, 3d 45. inotropic
10. a 28. 1c, 2d, 3a 46. chronotropic
11. b 29. 1d, 2c, 3b 47. dromotropic
12. d 30. 1a, 2b, 3d 48. bathmotropic
13. c 31. 1a, 2c, 3b 49. sinoatrial
14. c 32. c, e 50. atrioventricular
15. a 33. c, d 51. NO (nitric oxide II)

202
 16. c 34. b, d 52. diastole
17. b 35. b, c, d 53. systole
18. c 36. a, d

6.6 Reflex regulation of the cardiovascular system

1. a 21. c 41. c, d
2. b 22. a 42. a, b
3. b 23. d 43. b, c
4. c 24. b 44. c, d
5. a 25. b 45. a, d
6. c 26. c 46. a, c
7. d 27. d 47. d, e
8. a 28. a 48. a, b, d
9. b 29. c 49. 1c, 2a, 3b, 4e, 5d
10. c 30. d 50. 1b, 2a, 3d, 4e, 5c
11. a 31. a 51. 1e, 2a, 3c, 4b, 5d
12. c 32. b 52. 1f, 2b, 3c, 4e, 5d, 6a
13. b 33. a 53. vagal (X)
14. a 34. d 54. atria
15. b 35. 1b, 2a, 3c 55. conjugated
16. d 36. 1b, 2c, 3a 56. atrial natriuretic peptide
17. a 37. 1d, 2b, 3c 57. Goltz
18. a 38. 1c, 2b, 3a 58. intermediate
19. d 39. b, d 59. short
20. b 40. a, e 60. pressor

203
 Section VII. EXCRETORY PHYSIOLOGY

7.1 Physiology of the kidney

Choose one correct answer

1. Blood flow is greater in which of the following regions of the kidney?

a. cortex
b. medulla

2. How does aldosterone affect extracellular fluid volume?

a. decreases
b. increases

3. Which particles of the same size pass more easily through the glomerular filtration
barrier in the kidney?
a. positively charged
b. negatively charged
c. uncharged

4. The osmolarity of primary urine compared to the osmolarity of plasma is

a. higher
b. lower
c. the same

5. How many millions of nephrons are there in each kidney?

a. 0.5
b. 1
c. 2
d. 5

6. Deficiency of which of the following hormones results in a significant (> 6 L) increase

in diurnal diuresis?
a. insulin
b. vasopressin
c. glucagon
d. cortisol

7. The glomerular filtration rate in a young (20 – 30 years old) healthy adult is equal to
(ml/min)
a. 10 – 20

204
 b. 50 – 65
c. 100 – 125
d. 250 – 300

8. Which of the following ions is NOT reabsorbed in the proximal tubule?

a. Na+
b. K+
c. H+
d. HPO42-

9. The macula densa is a part of which of the following structures?

a. proximal tubule
b. distal tubule
c. Bowman’s capsule
d. afferent arteriole

10. What is the functional unit of the kidney called?

a. acinus
b. sarcomere
c. nephroton
d. nephron

11. Identify the part of the nephron where filtration takes place
a. loop of Henle
b. renal corpuscle
c. proximal tubule
d. distal tubule

12. Identify the part of the nephron where most of sodium ions are reabsorbed
a. proximal tubule
b. loop of Henle
c. distal tubule
d. collecting duct

13. Identify the correct relationship between the diameters of the afferent and efferent
arterioles in nephrons
a. the diameter of the afferent arteriole is greater than that of the efferent arteriole
b. the diameter of the efferent arteriole is greater than that of the afferent arteriole
c. diameters of the afferent and efferent arterioles are equal
d. in cortical nephrons, diameter of the afferent arteriole is greater than that the ef-
ferent arteriole, whereas in juxtamedullary nephrons, they are equal

14. Which of the following cells is a part of the glomerular filter?

a. astrocyte

205
 b. fibrocyte
c. podocyte
d. myocyte

15. Which of the following substances is used to assess glomerular filtration rate?
a. glucose
b. inulin
c. para-amino hippuric acid
d. acetazolamide

16. Identify the correct amount of primary urine produced per day in a healthy adult (L)
a. 5 – 10
b. 30 – 40
c. 150 – 180
d. 270 – 290

17. Which of the following is true about the primary urine?

a. it is formed in the renal corpuscle as a result of filtration
b. passes from the ureters into the urinary bladder
c. it is formed in the collecting duct
d. its osmolarity is much higher than that of plasma

18. In the proximal renal tubules, reabsorption of amino acids is coupled to which of the
following ions?
a. chloride
b. potassium
c. magnesium
d. sodium

19. Which of the following is a threshold substance for reabsorption in the kidney?
a. angiotensin
b. glucose
c. glycerol
d. sodium chloride

20. Which of the following substances is NOT reabsorbed in the renal tubules?
a. glucose
b. amino acids
c. sodium ions
d. creatinine

21. Which of the following ions is completely reabsorbed with a normal diet?
a. Na+
b. K+

206
 c. Cl-
d. HCO3-

22. Which of the following is the mechanism of water reabsorption?

a. facilitated diffusion
b. osmosis
c. filtration
d. secondary active transport

23. In which of the following segments of the nephron reabsorption is obligatory

a. proximal tubule
b. distal tubule
c. collecting duct
d. renal corpuscle

24. In which of the following structures is renin produced

a. proximal tubule
b. distal tubule
c. collecting duct
d. juxtaglomerular apparatus

25. Which of the following does NOT stimulate renin secretion?

a. decreased Na+ concentration in the lumen of the distal tubule
b. decreased blood flow in the afferent arteriole
c. increased Na+ concentration in the lumen of the proximal tubule
d. increased renal sympathetic nerve activity

26. In which of the following parts of the kidney is the osmolarity of the interstitial fluid
greatest?
a. outer cortex
b. inner cortex
c. outer medulla
d. inner medulla

27. Which of the following is true of the vasa recta?

a. arise from the afferent arteriole
b. they are arteries
c. they are veins
d. run parallel to the loop of Henle

28. Which of the following is true about reabsorption in the loop of Henle?
a. water is reabsorbed in the descending part; ions are reabsorbed in the ascending
part

207
 b. water is reabsorbed in the ascending part; ions are reabsorbed in the descending
part
c. both water and ions are reabsorbed in the descending part; only ions are reab-
sorbed in the ascending part
d. both water and ions are reabsorbed in the ascending part; only water is reabsorbed
in the descending part

29. Which of the following mechanisms is used to concentrate urine in the kidney?
a. countercurrent multiplier
b. reciprocating
c. potential-kinetic
d. osmotic-tonic

30. Receptors in the macula densa respond to which of the following stimuli?
a. increase in urine osmolarity
b. change in urine sodium concentration
c. change in plasma sodium concentration
d. decrease in urine pH

31. Which of the following substances is reabsorbed in the collecting duct?

a. urea
b. uric acid
c. glucose
d. creatinine

32. In adults, what is the volume of the urinary bladder (ml)?

a. 50 – 70
b. 300 – 400
c. 700 – 800
d. 1000 – 1200

33. The first urge to urinate appears when the volume of urine in the bladder reaches
approximately (ml)
a. 100 – 200
b. 300 – 400
c. 600 – 700
d. 900 – 1000

34. Which of the following substances is absent in the final urine?

a. urobilin
b. dihydrophosphate
c. acetoacetate
d. urate

208
35. Which of the following structures controls the external urethral sphincter?
a. parasympathetic centers in the sacral segments of the spinal cord
b. sympathetic centers in the upper lumbar segments of the spinal cord
c. α-motor neurons in the ventral horns in of the spinal cord
d. pontine reticular nuclei

Match the left and right columns

36. Structure Function

1. Renal corpuscle a. reabsorbs water
2. Loop of Henle b. regulates urine osmolarity
3. Collecting duct c. produces aldosterone
d. filtrates plasma

37. Pressure Value, mm Hg

1. Hydrostatic pressure in the glomerular capillary a. 20
2. Plasma oncotic pressure b. 30
3. Capsular hydrostatic pressure c. 70
d. 120

38. Hormone Effect on the nephron

1. Parathyrin a. increases water reabsorption
2. Vasopressin b. increases Ca2+ reabsorption
3. Aldosterone c. increases Na+ reabsorption and K+ secretion
d. increases glucose reabsorption

39. Segment of the nephron Relative water reabsorption, %

1. Proximal tubule a. 1 – 2
2. Loop of Henle b. 8 – 10
3. Distal tubule c. 15 – 20
d. 65

40. Excretory organ Water excreted (ml/day)

1. Kidney a. 20
2. Gastrointestinal tract b. 100
3. Lungs, airways c. 400
d. 1 500

41. Segment of the nephron Osmolarity (mOsm/L)

1. Proximal tubule a. <200
2. Loop of Henle hairpin bend b. ~300
3. Distal tubule c. 1200
d. 2500

209
 Choose two or more correct answers

42. Which of the following is true of renin?

a. is a protease
b. increases vascular tone
c. is secreted mainly in response to hypoxemia
d. is formed in the juxtaglomerular apparatus
e. it is a derivate of arachidonic acid

43. The juxtaglomerular apparatus contains which of the following structures?

a. mesangiocytes
b. podocytes
c. glomerular cells
d. macula densa
e. endothelial cells

44. Which of the following are excretory organs?

a. spleen
b. adrenal gland
c. kidney
d. lung
e. skin

45. Which of the following are mechanisms of urine formation?

a. incretion
b. filtration
c. secretion
d. convection
e. reabsorption

46. Which of the following is true about the juxtaglomerular apparatus?

a. produces angiotensinogen
b. produces renin
c. includes the macula densa as part of it
d. includes the endothelium of the efferent arteriole as part of it
e. it converts angiotensinogen in angiotensin I

47. Hydrogen ions are primarily excreted as a part of which of the following compounds?
a. dihydrophosphate (H2PO4-)
b. oxalate
c. acetate (CH3COOH-)
d. ammonium (NH4+)
e. hydrosulfate (HSO4-)

210
48. The acid-base balance is maintained by which of the following systems?
a. nervous system (brain)
b. blood buffering systems
c. respiratory system (lungs)
d. excretory system (kidneys)
e. skeletal system (bones)

49. Which of the following substances pass through the glomerular filter?
a. glucose
b. Na+
c. fibrinogen
d. IgM
e. glutamate

50. Which of the following is true about the proximal tubule?

a. reabsorbs most (~2/3) of the filtrate
b. doesn’t secrete substances
c. reabsorbs glucose completely
d. the osmolarity of the urine changes as it passes through
e. reabsorbs amino acids completely

Arrange the correct sequence

51. Arrange the following pressure values in ascending order

a. plasma oncotic
b. capsular hydrostatic
c. glomerular capillary hydrostatic

52. Arrange the following processes in the correct order

a. increase in blood volume
b. increase in diuresis
c. distension of the atria
d. secretion of the atrial natriuretic peptide
e. stimulation of the atrial volume receptors

53. Arrange the following processes in the correct order

a. secretion of renin
b. conversion of angiotensin I to angiotensin II
c. conversion of angiotensinogen to angiotensin
d. secretion of aldosterone

54. Arrange the following structures in the correct order

211
 a. loop of Henle
b. distal tubule
c. proximal tubule
d. collecting duct

55. Arrange the segments of the nephron in ascending order of volume of fluid reabsorbed
a. distal tubule
b. proximal tubule
c. loop of Henle

56. Arrange the following fluid compartments in ascending order

a. intracellular fluid
b. extracellular (interstitial) fluid
c. blood (plasma)

Fill in the gaps

57. The nephrons that have their renal corpuscles at the border of the cortex and the
medulla, and whose loop of Henle penetrates deeply into the medulla, are called
______ nephrons.

58. The decrease in blood pH is called _______.

59. The increase in blood pH is called ________.

60. The net filtration pressure is calculated as the difference between the capillary hydro-
static pressure and the sum of the capsular hydrostatic pressure and the plasma
_______ pressure.

61. Increased urine formation is called ______.

62. The absence of urine in the bladder is called ______.

63. Excretion of a large volume of urine as a result of excess osmotically active particles
is called _____ diuresis.

64. Decreased urine excretion (less than 400 ml/day) is called _______.

65. The atrial hormone that stimulates glomerular filtration and decreases sodium reab-
sorption is called __________.

66. The hypothalamic hormone that stimulates water reabsorption is called _________.

212
67. Urine formation involves three mechanisms: filtration, reabsorption, and ________.

68. The glomerular filter is composed of endothelium, basal membrane, and _________.

213
 CORRECT ANSWER KEYS FOR SECTION VII

7.1 Physiology of the kidney

1. a 25. c 49. a, b, e
2. b 26. d 50. a, c, e
3. a 27. d 51. 1b, 2a, 3c
4. c 28. a 52. 1a, 2c, 3e, 4d, 5b
5. b 29. a 53. 1a, 2c, 3b, 4d
6. b 30. b 54. 1c, 2a, 3b, 4d
7. c 31. a 55. 1a, 2c, 3b
8. c 32. b 56. 1c, 2b, 3a
9. b 33. a 57. juxtamedullary
10. d 34. c 58. acidosis
11. b 35. c 59. alkalosis
12. a 36. 1d, 2b, 3a 60. oncotic
13. d 37. 1c, 2b, 3a 61. polyuria
14. c 38. 1b, 2a, 3c 62. anuria
15. b 39. 1d, 2c, 3b 63. osmotic
16. c 40. 1d, 2b, 3c 64. oliguria
17. a 41. 1b, 2c, 3a 65. atrial natriuretic peptide
18. d 42. a, d (factor)
19. b 43. a, c, d 66. antidiuretic hormone (vaso-
20. d 44. c, d, e pressin)
21. d 45. b, c, e 67. secretion
22. b 46. b, c 68. podocytes
23. a 47. a, d
24. d 48. b, c, d

214
 Section VIII. PHYSIOLOGY OF DIGESTION.
METABOLIC BASIS OF PHYSIOLOGICAL FUNC-
TIONS

8.1 Secretory function of the digestive glands

Choose one correct answer

1. How does gastrin affect the gastric secretion?

a. increases
b. decreases

2. Which of the following cells produces the intrinsic factor of Castle?

a. chief
b. parietal

3. A large secretion of liquid saliva is caused by stimulation of which of the following

nerves?
a. parasympathetic
b. sympathetic

4. How does histamine affect the gastric secretion?

a. inhibits
b. stimulates

5. Which of the following is the primary mechanisms controlling salivation?

a. neural
b. humoral

6. Gastric secretion is stimulated by which of the following nerves?

a. sympathetic
b. parasympathetic
c. somatic

7. How do the peptide digestion products affect gastric secretion?

a. stimulate
b. inhibit
c. don’t affect

8. The osmolarity of saliva compared to osmolarity of plasma is

a. higher

215
 b. lower
c. same

9. In which of the following parts of the stomach are G-cells located?

a. cardia
b. fundus
c. corpus
d. antrum

10. How does the composition of saliva change as its secretion increases?
a. pH increases, osmolarity decreases
b. pH decreases, osmolarity increases
c. both pH and osmolarity increase
d. both pH and osmolarity decrease

11. Which of the following cranial nerves supplies the parotid gland?
a. III
b. VII
c. IX
d. X

12. Which of the following sympathetic ganglia contains neurons that regulate salivation?
a. coeliac
b. stellate
c. upper mesenteric
d. upper cervical

13. Which digestive juice contains enzymes that are the first to break down polysaccha-
rides?
a. saliva
b. gastric juice
c. intestinal juice
d. pancreatic juice

14. Which of the following types of cells of the gastric mucosa produces somatostatin?
a. G-cells
b. D-cells
c. ECL -cells
d. chief cells

15. Which of the following cells in the stomach mucosa secret hydrochloric acid?
a. parietal
b. chief

216
 c. G-cells
d. mucous

16. Which of the following transport systems moves H+ into the interstitial space of the
pancreas during the process of HCO3- secretion?
a. Na+/K+-ATPase
b. Ca2+-ATPase
c. H+/K+-ATPase
d. Na+/H+-exchanger

17. The bicarbonate ion moves from the pancreatic cells into the duct lumen in exchange
for which of the following ions
a. Cl-
b. H+
c. Na+
d. PO43-

18. Which of the following transport systems moves H+ into the gastric lumen during the
process of HCl secretion?
a. Na+/K+-ATPase
b. Ca2+-ATPase
c. H+/K+-ATPase
d. Na+/H+-exchanger

19. Stimulation of which of the following receptors initiates the condition-reflex compo-
nent of the cephalic phase of gastric secretion?
a. oral and pharyngeal mechanoreceptors and gustatory receptors
b. visual, olfactory, and auditory receptors
c. gastric mucosal mechano- and chemoreceptors
d. intestinal mucosal mechano- and chemoreceptors

20. Which of the following compounds is responsible for the yellowish (brown) color of
bile?
a. cholesterol
b. lecithin
c. bilirubin
d. bile acid

21. Which of the following hormones stimulates gallbladder contractions?

a. cholecystokinin
b. secretin
c. somatostatin
d. insulin

217
22. Which of the following diagnostic methods is used to assess the secretory function of
the gastrointestinal tract?
a. Roentgenography (X-ray)
b. pH measurement
c. magnetic resonance imaging
d. electrogastrography

23. Which of the following enzymes is found in gastric juice?

a. pepsin
b. phospholipase
c. amylase
d. trypsin

24. Which of the following substances does pepsin break down?

a. fat
b. carbohydrate
c. protein
d. nucleic acid

25. At the peak of digestion, the pH value of gastric juice is equal to

a. 1.5 – 2.0
b. 5.2 – 6.5
c. 7.1 – 7.3
d. 8.1 – 8.7

26. During which phase of gastric acid secretion is the production of gastric juice great-
est?
a. cephalic
b. intestinal
c. basal
d. gastric

27. Which of the following hormones has NO effect during the gastric phase of the gastric
secretion?
a. secretin
b. gastrin
c. histamine
d. somatostatin

28. Which of the following ions makes pancreatic juice alkaline?

a. Ca2+
b. Cl-
c. OH-
d. HCO3-

218
29. Which of the following pancreatic enzymes is an exopeptidase?
a. trypsin
b. chymotrypsin
c. elastase
d. carboxypeptidase

30. Identify the enzyme that is secreted in active form (not as a zymogen)
a. pepsin
b. lipase
c. carboxypeptidase
d. chymotrypsin

31. Which of the following pancreatic proenzymes is activated by enterokinase (entero-

peptidase)?
a. trypsinogen
b. chymotrypsinogen
c. proelastase
d. procarboxypeptidase

32. When carbohydrates dominate in the diet for a long time, the activity of which of the
following pancreatic enzymes increases?
a. amylase
b. lipase
c. trypsin
d. chymotrypsin

33. Which of the following nutrients are digested by the pancreatic juice?
a. only proteins
b. only fats
c. only carbohydrates
d. all types of nutrients

34. Which of the following stimulates the secretion of water and bicarbonate in the pan-
creas?
a. cholecystokinin
b. secretin
c. substance P
d. somatostatin

35. Which of the following pancreatic enzymes is most effective in the presence of bile
acids?
a. lipase
b. amylase

219
 c. ribonuclease
d. trypsin

36. Which of the following pancreatic enzymes is most active in the presence of a coen-
zyme?
a. amylase
b. trypsin
c. lipase
d. carboxypeptidase

37. Which of the following substances converts primary bile acids into secondary bile ac-
ids?
a. gastrin
b. microflora enzymes
c. trypsin
d. phospholipase

38. Which of the following components of bile is needed for fat digestion?
a. bile salts
b. bile pigments
c. cholesterol
d. lecithin

39. Which of the following hormones stimulates the contraction of the gallbladder and the
secretion of bile into the lumen of the duodenum?
a. secretin
b. cholecystokinin
c. gastrin
d. motilin

40. Which of the following hormones is produced in the duodenum?

a. somatostatin
b. thyroxin
c. secretin
d. epinephrine

41. Which of the following hormones is produced in the stomach?

a. somatostatin
b. secretin
c. thyroxin
d. epinephrine

42. Which of the following compounds is responsible for the protective (bactericidal)
function of saliva?

220
 a. hydrochloric acid
b. IgG
c. lysozyme
d. amylase

Match the left and right columns

43. Salivary gland Predominating secret

1. Parotid a. serous
2. Submandibular b. mucous
3. Sublingual c. mixed
d. acidic

44. Gland Innervation (cranial nerve)

1. Parotid gland a. VII (facial)
2. Submandibular gland b. IX (glossopharyngeal)
3. Gastric glands c. X (vagal)
d. XII (hypoglossal)

45. Pancreatic enzyme Function

1. Trypsin a. digests disaccharides
2. Amylase b. digests triacylglycerols
3. Lipase c. digests polysaccharides (starch)
d. digests peptides

46. Gastric cell Secreted substance

1. G-cell a. HCl, intrinsic factor of Castle
2. Chief cell b. pepsinogen
3. Parietal cell c. gastrin
d. mucus

47. Digestive juice pH

1. Saliva a. 1.5 – 2.0
2. Pancreatic juice b. 6.0 – 7.4
3. Gastric juice (at the peak of secretion) c. 8.0 – 8.6
d. 11.2 – 12.5

Choose two or more correct answers

48. Which of the following components are found in the saliva?

a. amylase
b. pepsin
c. saccharase

221
 d. mucoproteins
e. bicarbonates
f. lactase

49. Which of the following processes take place as primary saliva passes through the ex-
cretory duct?
a. K+ secretion
b. Na+ reabsorption
c. Cl- secretion
d. HCO3- secretion
e. Ca2+ reabsorption

50. Which of the following cranial nerves control salivation?

a. III
b. V
c. VII
d. IX
e. X

51. Which of the following are functions of the saliva?

a. motor function
b. moistening food and dissolving substances
c. digestion of carbohydrates
d. digestion of peptides
e. protective

52. What does hydrochloric acid in gastric juice do?

a. inhibits gastrin secretion
b. stimulates histamine secretion
c. has a bactericidal effect
d. splits peptide chains
e. activates pepsinogen

53. Which of the following are components of the gastric juice?

a. hydrochloric acid
b. pepsinogen
c. bile acids
d. trypsinogen
e. amylase

54. Which of the following is true of the gastric mucosa?

a. presence of complex alveolar tubular glands
b. presence of simple epithelium that secretes mucus
c. presence of pits and folds

222
 d. presence of stratified epithelium
e. presence of transitional epithelium

55. Which of the following substances stimulate gastric secretion?

a. secretin
b. somatostatin
c. gastrin
d. vasoactive intestinal peptide
e. histamine

56. Which of the following substances inhibit gastric secretion?

a. gastrin
b. secretin
c. histamine
d. somatostatin
e. amylase

57. Which of the following enzymes are secreted in an inactive state?

a. pepsin
b. lipase
c. amylase
d. trypsin
e. enteropeptidase

58. Which of the following are functions of the digestive system?

a. motor
b. secretory
c. protective
d. respiratory
e. thermoregulatory

Arrange the correct sequence

59. Arrange the phases of gastric secretion in the correct order

a. gastric
b. cephalic
c. intestinal

60. Arrange the layers of the gastrointestinal tract in the correct order (from innermost
to outermost)
a. muscular
b. mucosa
c. submucosa

223
 d. serous

61. Arrange the structures of the salivary reflex pathway in the correct order
a. mechano- and thermoreceptors of the oral cavity, gustatory receptors
b. superior and inferior salivatory nuclei
c. afferent fibers of the trigeminal, facial, glossopharyngeal, and vagal nerves
d. salivary glands
e. efferent fibers of the facial and glossopharyngeal nerves

62. Arrange the following events involved in the secretion of hydrochloric acid in the gas-
tric mucosa in the correct order
a. H+ is removed to the gastric lumen by the H+/K+ ATPase
b. CO2 enters the parietal cell
c. carbonic acid dissociates into H+ and HCO3-
d. CO2 combines with H2O to form carbonic acid

63. Arrange the following events involved in the secretion of bicarbonate ion in the pan-
creas in the correct order
a. the bicarbonate ion is removed to the duct lumen by the Cl-/HCO3- exchanger
b. CO2 combines with H2O to form carbonic acid
c. Carbonic acid dissociates into H+ and HCO3-
d. CO2 enters the pancreatic cell

64. Arrange the following events involved in the regulation of gastric secretion in the cor-
rect order
a. gastrin stimulates gastric secretion
b. proteins are digested by the gastric juice
c. peptides (product of protein breakdown) stimulate G-cells
d. G-cells produce gastrin
e. protein-rich food enters the stomach

Fill in the gaps

65. The tube that connects the lumen of the gastrointestinal tract or a duct of the digestive
gland to the environment is called a _______.

66. The gastric mucoprotein that prevents vitamin B12 from being broken down is called
the ________.

67. The enzyme that catalyzes the conversion of trypsinogen to trypsin is called _______.

68. The transport system responsible for the release of H+ from the parietal cell into the
gastric lumen is called _________.

224
69. The components of bile produced from cholesterol and involved in the emulsification
of fat are called __________.

70. Saliva contains the enzyme ________, which breaks down polysaccharides.

71. The hormone _________ is produced in the small intestine and stimulates enzyme se-
cretion in the pancreatic acinar cells.

72. Gastric chief cells produce the proenzyme __________.

8.2 Digestion in small and large intestine. Absorption. Gastrointes-

tinal motility

Choose one correct answer

1. Which of the following divisions of the autonomic nervous system stimulates gastro-
intestinal motility?
a. sympathetic
b. parasympathetic

2. When there is no swallowing, the lower esophageal sphincter is

a. opened
b. closed

3. Water is mainly absorbed through the

a. enterocytes
b. intercellular spaces
c. goblet cells

4. How does intestinal motility usually change under the influence of a chemical or me-
chanical stimulus?
a. increases
b. decreases
c. doesn’t change

5. Which of the following phases of swallowing is voluntary?

a. oral
b. pharyngeal
c. esophageal

6. Food rich in which of the following nutrients stays in the stomach the longest?

225
 a. proteins
b. fats
c. carbohydrates
d. vitamins

7. Which of the following digestive enzymes is NOT secreted by the mucosa of the small
intestine?
a. maltase
b. lactase
c. saccharase-isomaltase
d. amylase

8. What is special about the secretion of enzymes in the small intestine?

a. it is not controlled by the CNS
b. enzymes are released from shed enterocytes
c. it is stimulated by enterokinase
d. it is suppressed by the microflora

9. Which of the following substances is produced in the small intestine?

a. epinephrine
b. histamine
c. secretin
d. insulin

10. What is the pH of the juice of the small intestine?

a. 1.5 – 2.0
b. 2.5 – 3.5
c. 5.4 – 6.0
d. 7.2 – 7.5

11. Which of the following is the main part of the gastrointestinal tract where water and
various substances are absorbed?
a. oral cavity
b. stomach
c. small intestine
d. colon

12. In which part of the gastrointestinal tract are bile salts absorbed
a. duodenum
b. jejunum
c. ileum
d. large intestine
13. In the small intestine, amino acids are absorbed together with which of the following
ions

226
 a. Na+
b. K+
c. Ca2+
d. Cl-

14. Which of the following is a mechanism for the absorption of amino acids and glucose
in the small intestine?
a. simple diffusion
b. osmosis
c. primary active transport
d. secondary active transport

15. In the small intestine, which of the following monosaccharides is absorbed passively?
a. glucose
b. fructose
c. galactose
d. ribose

16. In the small intestine, glucose is absorbed together with which of the following ions
a. Na+
b. K+
c. Ca2+
d. Cl-

17. Fats are absorbed mainly as

a. monoacylglycerol and fatty acids
b. diacylglycerol and fatty acids
c. glycerol and fatty acids
d. micelles

18. The absorption of fat-soluble vitamins is coupled with the absorption of

a. proteins
b. carbohydrates
c. lipids
d. mineral substances

19. Where are the chylomicrons formed?

a. in the lumen of the small intestine
b. on the surface of enterocytes
c. inside the enterocytes
d. in the hepatocytes

20. Which of the following is the main component of a chylomicron?

a. phospholipid

227
 b. triacylglycerol
c. protein
d. cholesterol

21. When does the pharyngeal phase of swallowing begin?

a. when food enters the oral cavity
b. when the bolus of food enters the stomach
c. when the bolus of food touches the root of the tongue
d. when the food bolus enters the esophagus

22. What contractions occur in the esophagus

a. rhythmic segmentation
b. peristaltic
c. antiperistaltic
d. pendular

23. How does gastric motility change during a meal?

a. tone of the proximal part of the stomach decreases
b. tone of the proximal part of the stomach increases
c. tone of the distal part of the stomach decreases
d. regular peristaltic contractions begin immediately after food enters the stomach

24. Which if the following parts of the stomach has the strongest peristaltic contractions?
a. cardia
b. pyloric
c. corpus
d. fundus

25. Which of the following substances stimulates gastric motility?

a. vasoactive intestinal peptide
b. gastrin
c. epinephrine
d. secretin

26. How does duodenal pH affect the pyloric sphincter?

a. decreased pH stimulates sphincter closure
b. increased pH stimulates sphincter closure
c. has no effect
d. decreased pH stimulates opening of the sphincter

27. In which of the following parts of the stomach does retropulsion occur?
a. cardia
b. fundal

228
 c. body
d. pylorus

28. In the stomach, the prepyloric sphincter is formed during digestion of which of the
following nutrients?
a. carbohydrates
b. proteins
c. fats
d. vitamins

29. The peristalsis of the small intestine is mainly regulated by which of the following?
a. hypothalamus
b. medulla oblongata
c. spinal cord
d. intramural ganglia

30. What is the main factor that causes the ileocecal sphincter to open and the contents of
the ileum to pass into the caecum?
a. alkaline reaction of the chyme
b. acid reaction of the chyme
c. increase in pressure in the ileum
d. increase in pressure in the caecum

Match the left and right columns

31. Substance Mechanism of absorption in the small intestine

1. Water a. facilitated diffusion
2. Fructose b. osmosis
3. Glutamate c. secondary active transport (cotransport)
d. primary active transport

32. Part of the gastrointestinal tract Slow wave frequency (per minute)
1. Stomach a. 3
2. Duodenum b. 8
3. Ileum c. 12
d. 32

33. Type of gastric mo- Characteristic, function

tility
1. Tonic a. returns contents to the esophagus

229
 2. Peristaltic b. wave-like contraction, mixes contents with gastric juice
3. Antral systole c. strong contraction, pushes contents into the duodenum
d. slowly shifts contents from the fundal part and corpus to
the antrum

34. Type of intestinal motility Characteristic, function

1. Tonic a. mixes contents with intestinal juices
2. Peristaltic b. wave-like contraction, moves contents caudally
3. Rhythmic segmentation c. increases intraintestinal pressure, stimulates ab-
(churning) sorption
d. wave-like contraction, moves contents in the oral
direction

35. Part of the gastrointestinal Function

tract
1. Small intestine a. mixes contents with digestive juices; digests and
absorbs of all types of nutrients
2. Colon b. processes food mechanically
3. Rectum c. collects feces and propels them into the environ-
ment
d. stores contents, mixes with mucus; absorbs water
and ions; forms feces

36. Part of the gastrointestinal tract Transit time

1. Small intestine a. ~1 min
2. Colon b. 0.5 – 1 hour
3. Mouth c. 4 – 6 hours
d. 10 – 72 hours

Choose two or more correct answers

37. Which of the following is true about the mucosa of the large intestine as opposed to
the mucosa of the small intestine?
a. it doesn’t have crypts
b. it doesn’t have villi
c. it doesn’t produce digestive enzymes
d. it doesn’t produce mucus
e. it is lined with the transitional epithelium

38. Which of the following is true of the intestinal microflora?

a. is present in the intestine from birth
b. hydrolyzes cellulose into short-chain fatty acids

230
 c. is mainly represented by Escherichia coli
d. converts bilirubin into urobilinogen
e. does not elicit an immune response from the intestine
f. synthetizes vitamin K

39. Identify normal types of motilities in the small intestine

a. churning (rhythmic segmentation)
b. peristalsis
c. antiperistalsis
d. systolic
e. pendular

40. Which of the following is correct about the large intestine as opposed to the small
intestine?
a. motility is faster in the large intestine compared to the small intestine
b. it has antiperistaltic motility
c. the function of colonic peristalsis is to mix contents rather than propel them
d. systolic contractions are typical of the large intestine
e. motility is slower in the large intestine compared to the small intestine
f. it doesn’t have pendular motility

41. Which of the following substances are absorbed in the small intestine?
a. dipeptides
b. galactose
c. lactose
d. triacylglycerol
e. Fe3+

42. Which of the following happens during the pharyngeal phase of swallowing?
a. pyloric sphincter opens
b. salivation ceases
c. soft palate rises
d. epiglottis goes down
e. mouth opens

43. Which of the following factors affect the passage of food from the stomach to the du-
odenum?
a. consistency of the stomach content
b. vitamin content of the food
c. osmolarity of the gastric contents
d. presence of mucus in the stomach lumen
e. volume of the stomach content

44. Which of the following is true about migrating myoelectric complex?

231
 a. starts in the cardia of the stomach
b. occurs once every 90 minutes
c. aims to mix nutrients with digestive juices
d. is triggered by gastrin
e. removes large particles from the stomach and small intestine
f. inhibits the development of bacteria in the small intestine

Arrange the correct sequence

45. Arrange the swallowing phases in the correct order

a. pharyngeal
b. oral
c. esophageal

46. Arrange the nutrients in descending order of the speed at which they leave the stom-
ach
a. carbohydrate
b. fat
c. protein

47. Arrange the mastication (chewing) phases in the correct order

a. main chewing phase
b. formation of the bolus
c. orientation phase
d. placing food in the mouth

48. Arrange the structures of the defecation reflex pathway in the correct order
a. rectal stretch receptors
b. spinal segments SII – SIV
c. rectal afferent nerves
d. rectal muscles, internal and external anal sphincters
e. efferent fibers of the pelvic and pudendal nerves

49. Arrange the processes involved in iron absorption in the small intestine in the correct
order
a. Fe2+ enters the enterocyte together with H+ through the DMT transporter
b. Fe2+ binds to mobilferrin and this complex moves to the basal membrane of the
enterocyte
c. Fe3+ is reduced to Fe2+ by reductase at the apical membrane of the enterocyte
d. Fe2+ leaves the enterocyte via ferroportin
e. Fe3+ enters the capillary and binds to plasma transferrin
f. Fe2+ is oxidized by hephestin to Fe3+

232
 Fill in the gaps

50. The inhibition of gastric motility during and after a meal is called __________.

51. The movement of water and solutes from the intestinal lumen into the blood and
lymph is called ________.

52. In the small intestine, glucose and amino acids are absorbed along with the _____ ions.

53. The polysaccharide network that lines the small intestinal mucosa is called the
________.

54. The strong contraction of the antral part of the stomach that serves to mechanically
process contents and to move them to the duodenum is called ________.

55. The hormone _______ inhibits gastric motility as the acid contents enter the duode-
num.

56. Glucose and galactose are absorbed by secondary active transport, while fructose is
absorbed by _________.

57. During swallowing, the _________ phase follows the oral phase.

8.3 Metabolism. Principles of assessment of energy balance. Physi-

ological basis of the rational nutrition

Choose one correct answer

1. Basal metabolic rate is higher (per 1 kg of body weight) in

a. children
b. adults

2. Excess of thyroid hormones stimulates which of the following directions of protein

metabolism?
a. catabolism (breakdown of protein)
b. anabolism (protein synthesis)

3. Which of the following is the type of the nitrogen balance in which protein breakdown
predominates over protein synthesis?
a. positive
b. negative
c. nitrogen equilibrium

233
4. The protein consumption of a child compared to an adult is
a. higher
b. lower
c. the same

5. The oxidation of which of the following nutrients consumes the most oxygen?
a. proteins
b. fats
c. carbohydrates

6. The respiratory quotient is maximal when oxidizing which of the following nutrients?
a. protein
b. fats
c. carbohydrates

7. Which of the following types of food is best assimilated?

a. animal
b. vegetable
c. mixed

8. How many grams of protein contain 1 g of nitrogen?

a. 2.25
b. 4.5
c. 6.25
d. 8.5

9. What is the daily requirement (g/kg of body weight) for proteins in a healthy adult?
a. 0.3
b. 1.5
c. 2.5
d. 4.5
10. Which of the following organs is most vulnerable to hypoglycemia?
a. skeletal muscle
b. liver
c. kidney
d. brain

11. What is the main function of proteins?

a. structural
b. heat exchanging
c. energetic
d. informational

234
12. What is the energy value of protein (kcal/g)?
a. 3.2
b. 4.1
c. 7.5
d. 9.3

13. Which of the following nutrients is the main source of energy in the body?
a. protein
b. fats
c. carbohydrates
d. minerals

14. Which of the following hormones is produced by adipose tissue and causes satiety?
a. leptin
b. ghrelin
c. cholecystokinin
d. glucagon

15. Stimulation of which of the following hypothalamic nuclei causes satiety?

a. ventromedial
b. dorsomedial
c. supraoptic
d. paraventricular

16. Which of the following hormones is produced by the gastric mucosa and causes hun-
ger?
a. leptin
b. cholecystokinin
c. somatostatin
d. ghrelin

17. Identify the correct definition of the caloric equivalent of oxygen

a. the amount of energy released when 1 liter of oxygen is consumed
b. the amount of oxygen required to produce 1 kcal
c. the amount of glucose oxidized by1 liter of oxygen
d. the amount of energy released when 1 liter of oxygen is oxidized

18. The greatest amount of heat is released when oxidizing which of the following nutri-
ents?
a. carbohydrates
b. fatty acids
c. phospholipids
d. brown fat

235
19. How much energy (kcal/g) is released when fat is oxidized?
a. 4.1
b. 5.7
c. 9.3
d. 12.2

20. The direct calorimetry method implies assessing of which of the following?
a. heat consumed by the body
b. heat produced by the body
c. gas exchange
d. water-salt balance

21. When fat is oxidized, what is the respiratory quotient?

a. 0.1
b. 0.5
c. 0.7
d. 1.0

22. The respiratory quotient is calculated as follows

a. ratio of CO2 produced to O2 consumed
b. ratio of O2 consumed to CO2 produced
c. ratio of O2 in exhaled air to O2 in inhaled air
d. ratio of CO2 in exhaled air to CO2 in inhaled air

23. What is the basal metabolic rate value in a healthy adult (kcal/kg/hour)?
a. 1
b. 3
c. 5
d. 7

24. Which of the following conditions is associated with an increase in the basal metabolic
rate?
a. thyroid hypofunction
b. thyroid hyperfunction
c. hyperfunction of the gonad
d. hypofunction of the parathyroid gland

25. Rubner’s law determines the release of energy

a. per unit of body mass
b. per unit of body surface area
c. according to age
d. according to sex

236
26. Identify the correct proportions of proteins, fats and carbohydrates in a balanced diet
a. 1:3:2
b. 1:1:4
c. 2:3:4
d. 2:5:7

27. Which of the following hormones stimulates lipogenesis?

a. glucagon
b. cortisol
c. insulin
d. growth hormone

28. Which of the following is the correct way to assess nitrogen balance (A – dietary ni-
trogen, B – fecal nitrogen, C – urinary nitrogen)
a. A – C vs. B
b. A vs. B + C
c. A vs. C – B
d. A – B vs. C

29. Which of the following hormones stimulates protein synthesis?

a. epinephrine
b. cortisol
c. growth hormone
d. calcitonin

30. The greatest diet-induced thermogenesis is caused by food rich with which of the fol-
lowing
a. proteins
b. fats
c. carbohydrates
d. vitamins

31. Which of the following is a chemical characteristic of essential fatty acids?

a. they have more than 10 carbon atoms
b. they have less than 12 carbon atoms
c. their carbon skeletons branch
d. they have double bond(s) in the carbon skeleton

Match the left and right columns

32. Nutrient Energetic value (kcal/g)

1. Carbohydrates (glucose) a. 3.75
2. Fats b. 4.1

237
 3. Proteins c. 9.3
d. 12.3

33. Hormone Site of secretion (source); function

1. Leptin a. small intestine mucosa; causes satiety
2. Ghrelin b. stomach mucosa; causes hunger
3. Cholecystokinin c. hypothalamus; causes hunger
d. adipose tissue; causes satiety

34. Nutrient Respiratory quotient

1. Protein a. 0.1
2. Fat b. 0.7
3. Carbohydrate c. 0.8
d. 1.0

35. Nutrient Daily requirement (g/kg of body weight)

1. Protein (optimum) a. 0.1
2. Fat b. 1.0
3. Carbohydrate c. 1.5
d. 6

36. Nitrogen balance Condition

1. Positive a. healthy adult
2. Neutral b. pregnancy
3. Negative c. starvation

Choose two or more correct answers

37. Which of the following conditions are associated with a positive nitrogen balance?
a. fasting
b. obesity
c. pregnancy
d. childhood
e. systemic inflammatory disease

38. Which of the following are essential amino acids?

a. histidine
b. glutamine
c. valine
d. tyrosine
e. asparagine

238
39. Which of the following are essential fatty acids?
a. linolenic
b. arachidonic
c. palmitic
d. oleic
e. stearic

40. Which of the following factors affect the basal metabolic rate?
a. ambient temperature
b. age
c. food intake
d. exercise
e. gender

41. Which of the following hormones increase blood glucose levels?

a. insulin
b. growth hormone
c. epinephrine
d. parathyrin
e. aldosterone

42. Which of the following are fats used for in the body?
a. for energy
b. as compounds of the cell membrane
c. to insulate heat
d. for the synthesis of biogenic amines
e. for the synthesis of eicosanoids
f. for the synthesis of nucleic acids

43. Which of the following are amino acids used for in the body?
a. to insulate heat
b. for the protein synthesis
c. for the synthesis of eicosanoids
d. for the synthesis of biogenic amines
e. for the synthesis of nucleic acids

44. Total energy expenditure includes which of the following?

a. basal metabolic rate
b. diet induced thermogenesis
c. expenditure on physical activity
d. protein catabolism
e. sleep

239
45. In which of the following conditions nitrogen balance is negative?
a. pregnancy
b. childhood
c. starvation
d. muscle mass gain
e. advanced age
f. severe trauma

46. Which of the following hormones cause satiety?

a. ghrelin
b. cholecystokinin
c. glucagon
d. leptin
e. insulin
f. epinephrin

Fill in the gaps

47. Insert the formula for calculating the respiratory quotient: RQ=_______

48. The amount of energy released when 1 liter of O2 is consumed is called the ________.

49. The minimum amount of energy required to maintain vital functions is called the
________.

50. In a pregnant woman and in a child, the nitrogen balance is ________.

51. Each _____ g of protein contains 1 g of nitrogen.

52. The daily requirement of protein for a healthy adult is ________ of body weight.

53. The energy expenditure on the digestion of food is termed ___________.

54. The method of assessing energy expenditure by measuring the amount of heat released
by a living organism is called _____________.

240
 CORRECT ANSWER KEYS FOR SECTION VIII

8.1 Secretory function of the digestive glands

1. a 26. d 51. b, c, e
2. b 27. a 52. a, c, e
3. a 28. d 53. a, b
4. b 29. d 54. b, c
5. a 30. b 55. c, e
6. b 31. a 56. b, d
7. a 32. a 57. a, d
8. b 33. d 58. a, b, c
9. d 34. b 59. 1b, 2a, 3c
10. c 35. a 60. 1b, 2c, 3a, 4d
11. c 36. c 61. 1a, 2c, 3b, 4e, 5d
12. d 37. b 62. 1b, 2d, 3c, 4a
13. a 38. a 63. 1d, 2b, 3c, 4a
14. b 39. b 64. 1e, 2b, 3c, 4d, 5a
15. a 40. c 65. fistula
16. d 41. a 66. intrinsic factor of Castle
17. a 42. c 67. enterokinase (enteropepti-
18. c 43. 1a, 2c, 3b dase)
19. b 44. 1b, 2a, 3c 68. H+/K+-ATPase (proton
20. c 45. 1d, 2c, 3b pump)
21. a 46. 1c, b, 3a 69. bile acids
22. b 47. 1b, 2c, 3a 70. amylase
23. a 48. a, d, e 71. cholecystokinin
24. c 49. a, b, d 72. pepsinogen
25. a 50. c, d

8.2 Digestion in small and large intestine. Absorption. Gastrointes-

tinal motility

1. b 20. b 39. a, b, e
2. b 21. c 40. b, c, e
3. b 22. b 41. a, b
4. a 23. a 42. c, d
5. a 24. b 43. a, c, e
6. b 25. b 44. b, e, f
7. d 26. a 45. 1b, 2a, 3c
8. b 27. d 46. 1a, 2c, 3b
9. c 28. c 47. 1d, 2c, 3a, 4b

241
 10. d 29. d 48. 1a, 2c, 3b, 4e, 5d
11. c 30. c 49. 1c, 2a, 3b, 4d, 5f, 6e
12. c 31. 1b, 2a, 3c 50. receptive relaxation
13. a 32. 1a, 2c, 3b 51. absorption
14. d 33. 1d, 2b, 3c 52. sodium (Na+)
15. b 34. 1c, 2b, 3a 53. glycocalyx
16. a 35. 1a, 2d, 3c 54. antral systole
17. a 36. 1c, 2d, 3a 55. cholecystokinin
18. c 37. b, c 56. facilitated diffusion
19. c 38. b, d, f 57. pharyngeal

8.3 Metabolism. Principles of assessment of energy balance. Physi-

ological basis of the rational nutrition

1. a 20. b 39. a, b, d
2. a 21. c 40. b, e
3. b 22. a 41. b, c
4. a 23. a 42. a, b, c, e
5. b 24. b 43. b, d, e
6. c 25. b 44. a, b, c
7. a 26. b 45. c, f
8. c 27. c 46. b, d, e
9. b 28. d 47. V(CO2)/V(O2)
10. d 29. c 48. caloric oxygen equivalent
11. a 30. a 49. basal metabolic rate
12. b 31. d 50. positive
13. c 32. 1a, 2c, 3b 51. 6.25
14. a 33. 1d, 2b, 3a 52. 1 – 1.5 g/kg
15. a 34. 1c, 2b, 3d 53. diet induced thermogenesis
16. d 35. 1c, 2b, 3d (thermic effect of food).
17. a 36. 1b, 2a, 3c 54. direct calorimetry
18. d 37. c, d
19. c 38. a, c

242
 Section IX. PHYSIOLOGY OF THE SENSORY
SYSTEMS

9.1 General phycology of the sensory system. Auditory sensory sys-

tem

Choose one correct answer

1. How are receptors usually distributed over the receptive surface?

a. evenly
b. unevenly

2. Does the loudness of a sound depend on its frequency?

a. yes
b. no

3. When stereocilia bend toward the longest one, what is change in the membrane po-
tential?
a. depolarization
b. hyperpolarization

4. Which of the following types of coding is used to convey information about the
strength of a stimulus?
a. spatial
b. frequency (rate)
c. both

5. Which of the following types of coding is used to convey information about the locali-
zation of a stimulus?
a. spatial
b. frequency (rate)
c. both

6. Where is the part of the basilar membrane that receives 200 Hz sounds located?
a. closer to the apex of the cochlea
b. in the middle part
c. closer to the base of cochlea

7. Which of the following is an objective sensory physiology term?

a. differential threshold
b. intensity of sensation
c. sensation threshold

243
 d. receptor potential

8. The minimum stimulus intensity that causes a sensation is called the

a. critical
b. threshold
c. basic
d. sufficient

9. Who developed the theory of specific energy?

a. Müller
b. Helmholtz
c. Golgi
d. Fechner

10. The minimal difference in the properties of the acting stimuli that cause a new sensa-
tion is called the … threshold.
a. sensation
b. differential
c. perception
d. adaptation

11. Which of the following is a subjective sensory physiology term?

a. differential threshold
b. generator potential
c. frequency coding
d. receptor potential

12. Stimulus to which a sensory system has adapted over the course of evolution is called
a. adequate
b. stimulating
c. appropriate
d. positive

13. Differentiation is the ability of a sensory system to

a. discriminate stimuli of different modalities
b. detect differences in the properties of stimuli acting simultaneously or sequentially
c. discriminate one object from another
d. detect stimuli in different environmental conditions

14. What is a decrease in the absolute sensitivity of a sensory system to a continuous stim-
ulus called?
a. sensibilization
b. sensitization

244
 c. adaptation
d. habituation

15. Which of the following is the best definition of the term “sensory funnel”?
a. presence of different types of neurons in adjacent layers
b. presence of different types of neurons within a layer
c. different numbers of neurons in adjacent layers
d. varying numbers of active sensory neurons under the influence of different stimuli

16. Which of the following values is a constant according to Weber’s law?

a. the ratio of the differential threshold to the intensity of the applied stimulus
b. the ratio of the sensory threshold to the intensity of the applied stimulus
c. the ratio of the differential threshold to the sensory threshold
d. the difference between the differential threshold and the sensory threshold

17. What is the relationship between the stimulus and the sensation intensity according to
Fechner’s law?
a. direct
b. inverse
c. exponential
d. logarithmic

18. Which of the following types of receptors does the auditory receptor belong to?
a. photoreceptors
b. mechanoreceptors
c. chemoreceptors
d. thermoreceptors

19. Unlike the primary receptor, the secondary receptor

a. has a specialized receptor cell
b. adapts faster
c. has greater lability
d. has a connective tissue capsule

20. Which of the following is true about the slow-adapting receptors?

a. late response to a stimulus
b. generate impulses throughout the action of a stimulus
c. they generate bursts of impulses at the beginning and end of a stimulus action
d. low sensitivity to acting stimuli
21. When a stimulus acts on a secondary receptor, where is the action potential gener-
ated?
a. at the membrane of the receptor cell
b. on the axon hillock of the afferent neuron
c. at the postsynaptic membrane of the afferent fiber

245
 d. in the first node of Ranvier

22. Which of the following is true for the generator but not for the receptor potential?
a. is not an all-or-none response
b. propagates with decrement
c. can be summed
d. the amplitude depends on the amount of neurotransmitter released

23. Identify the range of frequencies (Hz) that a human can hear
a. 1 – 100
b. 16 – 20 000
c. 1 000 – 4 000
d. 200 000 – 300 000

24. Which of the following sound parameters is perceived as pitch?

a. amplitude of sound vibrations
b. sound pressure level
c. frequency of sound vibrations
d. regularity of sound vibrations

25. Through the Eustachian tube, the middle ear communicates with which of the follow-
ing structures?
a. oropharynx
b. nasopharynx
c. laryngopharynx
d. inner ear

26. Which of the following structures is responsible for the difference in ion concentration
between perilymph and endolymph?
a. basilar membrane
b. vestibular membrane
c. stria vascularis
d. striola

27. What is the correct number of the outer hair cells in the organ of Corti?
a. 1 500
b. 3 500
c. 7 000
d. 12 000
28. Mechanosensitive channels at the tip of stereocilia are permeable to which of the fol-
lowing ions?
a. potassium
b. sodium
c. calcium

246
 d. chloride

29. Which of the following causes depolarization of the hair cells in the organ of Corti?
a. increase in permeability to Na+
b. increase in permeability to K+
c. decrease in permeability to Na+
d. decrease in permeability to K+

30. The middle ear cavity is filled with which of the following?
a. air
b. perilymph
c. endolymph
d. cerebrospinal fluid

31. What is the charge of the endolymph in relation to the perilymph (mV)?
a. -80
b. -40
c. +40
d. +80

32. Which of the following is a function of the auditory ossicles?

a. preventing loss of sound during transmission from air to liquids
b. transformation of sound frequency
c. filtering sounds of a certain frequency range (5000 – 6000 Hz)
d. converting sound vibrations into action potentials

33. How do the auditory ossicles transform sound vibrations?

a. increase amplitude and decrease intensity
b. decrease amplitude and increase intensity
c. increase frequency and decrease amplitude
d. increase frequency and decrease intensity

34. Which of the following is a function of the outer hear cells in the organ of Corti?
a. amplifying a sound signal
b. detecting the low frequency sounds
c. detecting the high frequency sounds
d. trophic

35. Which of the following sound frequencies (Hz) is detected at the base of the basilar
membrane?
a. 200
b. 4 000
c. 10 000
d. 50 000

247
36. Which of the following structures locates the source of sound in the horizontal plane?
a. auricle
b. cochlear nucleus
c. superior olivary nucleus
d. medial geniculate body

Match the left and right column

37. Function of sensory Definition

system
1. Differentiation a. ability to detect differences in properties of stimuli acting
simultaneously or sequentially
2. Registration b. detection of stimuli from the environment
3. Coding c. selective analysis of certain characteristic of the acting
stimulus
d. transformation of information into a form suitable for trans-
mission

38. Ratio of neurons in adjacent layers Functional characteristic of sensory system

1. Divergence a. high sensitivity
2. Convergence (strong) b. fast impulse conduction
3. 1:1 ratio (or weak convergence) c. high spatial resolution
d. complex detailed signal processing

39. Sensory system Receptor type

1. Visual a. mechanoreceptor
2. Auditory b. photoreceptor
3. Gustatory c. chemoreceptor
d. thermoreceptor

40. Stimulus parameters Type of coding

1. Intensity a. both spatial and frequency (rate)
2. Duration b. spatial
3. Localization c. frequency (rate)
d. remitting

41. Part of the cochlea Frequency of perceived sound (Hz)

1. Near the base a. 200
2. Near the apex b. 4 000

248
 3. Middle part c. 10 000
d. 50 000

Choose two or more correct answers

42. Which of the following are distance receptors?

a. visual
b. auditory
c. tactile
d. gustatory
e. olfactory

43. Which of the following are contact receptor?

a. visual
b. auditory
c. gustatory
d. olfactory
e. tactile

44. Which of the following are secondary receptors?

a. olfactory
b. tactile
c. auditory
d. gustatory
e. aortic arch baroreceptor

45. Which of the following are chemoreceptors?

a. tactile
b. visual
c. auditory
d. olfactory
e. gustatory

46. Which of the following are mechanoreceptors?

a. tactile
b. visual
c. auditory
d. olfactory
e. gustatory

47. Which of the following are primary receptors?

a. auditory
b. gustatory

249
 c. olfactory
d. tactile
e. nociceptor

48. How is the intensity of a stimulus encoded in the sensory systems?

a. by the frequency of the impulses
b. by the amplitude of the impulses
c. by the shape of the impulses
d. by the number of activated receptors
e. by the form of the receptor cells

49. Which of the following channels are filled with perilymph?

a. cochlear duct
b. scala vestibula
c. semicircular canals
d. middle ear
e. scala tympani

50. Which of the following does the external ear do?

a. amplifies sound vibrations within a specific frequency range
b. is responsible for localizing the source of sound in the horizontal plane
c. provides the primary coding of a sound signal
d. is responsible for localizing the source of sound in the vertical plane
e. detects changes in head position in the gravitational field

Arrange the correct sequence

51. Arrange the processes of primary encoding of a stimulus in the correct order
a. release of neurotransmitter
b. acting of a stimulus
c. generation of the generator potential
d. generation of the receptor potential
e. action potential generation

52. Arrange the auditory ossicles in the correct order (from the outside to the inside)
a. malleus
b. stapes
c. incus

53. Arrange the processes involved in sound perception in the inner ear in the correct
order
a. displacement of the basilar membrane
b. movement of the perilymph and endolymph in the inner ear

250
 c. oscillations of the ear drum
d. bending of the stereocilia
e. oscillation of the membrane of the oval window

54. Arrange the processes involved in sound perception in the hair cell in the correct order
a. bending of the stereocilia toward the longest one
b. neurotransmitter release
c. opening of the potassium channels, depolarization of the membrane
d. influx of calcium into the cell
e. displacement of the basilar membrane upward

55. Arrange the following structures responsible for the processing of the auditory infor-
mation in the correct order
a. medial geniculate nucleus
b. primary auditory cortex
c. superior olivary nucleus
d. cochlear nucleus
e. inferior colliculi of the quadrigeminal plate

Fill in the gaps

56. The ability of a sensory system to detect differences in the properties of stimuli acting
simultaneously or sequentially is called _________.

57. A decrease in the absolute sensitivity of a sensory system to a prolonged stimulus is

called ________.

58. The process of transforming information into a form suitable for transmission is
called _________.

59. There are two forms of coding in sensory systems: frequency (rate) coding and
_______ coding.

60. The potential generated in the afferent fiber, when exposed to the neurotransmitter
released from the receptor cell, is called the ________ potential.

61. The smallest difference in the properties of simultaneous or sequential stimuli at

which a new sensation appears is called the __________.

62. The hole at the top of the cochlea connecting the scala tympani and the scala vestibuli
is termed the __________.

63. The fluid that fills the cochlear duct is called __________.

251
9.2 Visual sensory system

Choose one correct answer

1. When one looks at a nearby object, the crystalline lens becomes

a. more convex
b. flattened

2. Visual acuity is higher in which of the following areas of the retina?

a. central
b. peripheral

3. When exposed to light, the membrane potential of the receptor cell changes in which
of the following ways?
a. depolarizes
b. hyperpolarizes

4. The pupils respond to low luminance in which of the following ways?

a. dilate
b. constrict

5. Which cells predominate in the human retina?

a. rods
b. cones

6. When one eye is exposed to light, how do the pupils respond?

a. only the exposed pupil constricts
b. both pupils constrict

7. In which receptor cells does visual pigment recover faster?

a. rods
b. cones

8. Which of the following optical media of the eye has the greatest refractive power?
a. cornea
b. crystalline lens
c. corpus vitreum
d. aqueous humor of the anterior and posterior chambers of the eye

9. Where is the anterior eye chamber located?

a. between the cornea and the lens

252
 b. between the cornea and the vitreous body
c. between the cornea and the iris
d. between the lens and the vitreous body

10. The anterior eye chamber communicates with the posterior eye chamber through
which of the following?
a. Schlemm channel
b. pupil
c. venous sinus
d. openings between the ligaments of Zinn

11. The refractive power of the cornea is equal to (D)

a. 13
b. 23
c. 43
d. 73

12. What is the simplified model of the eye considering it as a single lens called?
a. primitive eye
b. relative eye
c. short eye
d. reduced eye

13. Which optical media of the eye can change its refractive power?
a. cornea
b. crystalline lens
c. vitreous body
d. aqueous humor in the anterior and posterior chambers of the eye

14. The refractive power of the lens (without accommodation) is equal to (D)
a. 5
b. 19
c. 30
d. 70

15. A refractive error in which light rays are focused behind the retina (due to a decrease
in the length of the eyeball) is called:
a. myopia
b. hypermetropia
c. presbyopia
d. astigmatism

16. What is the reason why the nearest point of clear vision moves away with age?
a. the transparency of the optical media decreases

253
 b. strength of ciliary muscle contraction decreases
c. length of the eyeball increases
d. elasticity of the lens decreases

17. What lenses are used to correct astigmatism?

a. convex
b. concave
c. conical
d. cylindrical

18. What lenses are used to correct myopia?

a. convex
b. concave
c. conical
d. cylindrical

19. What is the number of ganglion cells in the retina (M)?

a. 0.8 – 1.2
b. 5 – 6
c. 50 – 70
d. 100 – 200

20. What is the number of cones in the retina (M)?

a. 0.8 – 1.2
b. 5 – 6
c. 50 – 70
d. 100 – 200

21. What is the number of rods in the retina (M)?

a. 0.8 – 1.2
b. 5 – 6
c. 50 – 70
d. 100 – 200

22. The visual pigment of the cones is called

a. transducin
b. retinal
c. rhodopsin
d. chromopsin
23. In which of the following parts of the CNS is the center of the pupillary light reflex
located?
a. medulla
b. pons
c. midbrain

254
 d. diencephalon

24. Which of the following parameters of light is perceived as color?

a. wavelength
b. velocity
c. intensity
d. pressure

25. Which of the following enzymes is activated by transducin when the receptor cell is
exposed to light?
a. adenylyl cyclase
b. phospholipase A2
c. phosphodiesterase
d. phospholipase C

26. When exposed to light, the membrane of the photoreceptor cell hyperpolarizes due to
which of the following changes in ion channel state?
a. closure of Na+-Ca2+ channels
b. opening of Cl- channels
c. opening of K+ channel
d. closure of Na+-K+-channels

27. Which of the following processes causes the closure of Na+-Ca2+-channels in the mem-
brane of the photoreceptor cell when it is exposed to light?
a. degradation of cGMP
b. formation of cGMP
c. formation of cAMP
d. phosphorylation of the channel protein

28. Which of the following retinal structures is hit first by light rays?
a. pigment epithelium
b. rod and cone outer segments
c. amacrine cells
d. ganglion cells axons

29. Identify the type of retinal neurons that generate action potentials
a. rods and cones
b. ganglion
c. horizontal
d. bipolar

30. How long does it take for dark adaptation to reach maximum (min)?
a. 5
b. 15

255
 c. 30
d. 60

31. The optic tract contains nerve fibers that convey impulses from the…
a. lateral half of the ipsilateral retina and the medial half of the contralateral retina
b. medial half of the ipsilateral retina and the lateral half of the contralateral retina
c. lateral halves of both retinas
d. medial halves of both retinas

32. Which of the following thalamic nuclei processes visual information?

a. lateral geniculate body
b. medial geniculate body
c. anterior
d. pulvinar

33. Which of the following colors has the shortest wavelength?

a. red
b. yellow
c. green
d. violet

34. Which of the following color ranges is maximally absorbed by the S-cones?
a. red
b. yellow-green
c. blue-violet
d. ultraviolet

35. The absence of L-type cones causes which of the following conditions?
a. protanopia
b. deuteranopia
c. tritanopia
d. achromasia

36. The lateral geniculate body receives afferent information via the fibers that are part
of which of the following pathways?
a. optic nerve
b. optic tract
c. optic radiation
d. lateral lemniscus
37. Which of the following is a method for assessing the visual field?
a. telemetry
b. perimetry
c. colorimetry
d. parametry

256
 Match the left and right columns

38. Optical media Refractive power (D)

1. Cornea a. 19
2. Crystalline lens (without accommodation) b. 30
3. Crystalline lens (with maximum accommodation) c. 43
d. 70

39. Anomaly of refraction Reason

1. Myopia a. decrease in the crystalline lens transparency
2. Hypermetropia b. decrease in the elasticity of the crystalline lens
3. Presbyopia c. shortening of the eyeball
d. lengthening of the eyeball

40. Cell type Amount (M)

1. Ganglion a. 0.8 – 1.5
2. Rods b. 5 – 6
3. Cones c. 20 – 40
d. 100 – 120

41. Cell type Function

1. Ganglion a. perceive light, have high sensitivity
2. Rods b. generate the action potential, transmit information to the CNS
3. Cones c. allow to estimate the distance to object
d. perceive light, have different sensitivity to different wavelengths
of light

42. Cone type Perceived color range

1. L-type a. red-orange
2. M-type b. ultraviolet
3. S-type c. blue-violet
d. yellow-green

43. Color vision abnormality Genetic deficiency

1. Protanopia a. lack of M-type cones
2. Deuteranopia b. lack of L-type cones
3. Tritanopia c. lack of S-type cones
d. lack of M- and L-type cones

257
 Choose two or more correct answers

44. Which of the following is true of the retinal fovea centralis?

a. is located in the center of the macula lutea
b. it has rods and cones
c. convergence is a characteristic of its receptor cells
d. it has only rods
e. has a 1:1 ratio of receptor cells to ganglion cells

45. Visual acuity in the periphery of the retina is low because

a. there are fewer cones
b. receptive fields of the ganglion cells are large
c. there are more rods
d. the rods have a high sensitivity to light
e. the density of the photoreceptor cells is low

46. Which of the following happens when an individual looks at a nearby object?
a. the pupil dilates
b. the pupil constricts
c. ciliary muscle relaxes
d. lens curvature increases
e. cornea changes its shape

47. Which of the following is true about hypermetropia?

a. the cornea is abnormally shaped
b. accommodation is needed to see distant objects clearly
c. the nearest point of clear vision moves away
d. it is corrected by the cylindrical lens
e. the eyeball is elongated

48. Which of the following is true about myopia?

a. the crystalline lens is abnormally shaped
b. the elasticity of the crystalline lens is reduced
c. is corrected by the concave lens
d. the nearest point of clear vision becomes closer
e. the eyeball is elongated

49. Which of the following retinal cells are receptors?

a. rods
b. cones
c. amacrine
d. bipolar

258
 e. horizontal

50. What of the following happens when the luminance decreases?

a. lens curvature increases
b. optical pigment degradation accelerates
c. the pupil dilates
d. the pupil constricts
e. cones stop working

51. What are the pairs of opposing colors according to Herring’s theory?
a. red-blue
b. yellow-blue
c. red-green
d. yellow-green
e. yellow-violet

Arrange the correct sequence

52. Arrange the optical media of the eye in the correct order (front to back)
a. crystalline lens
b. anterior eye chamber
c. posterior eye chamber
d. cornea
e. corpus vitreum

53. Arrange the optical media of the eye in ascending order of refractive power
a. crystalline lens (with maximum accommodation)
b. crystalline lens (without accommodation)
c. cornea

54. Arrange the retinal cells in the correct order (from the outside to the inside)
a. bipolar cells
b. pigment epithelium
c. ganglion cells
d. rods and cones

55. Arrange the retinal cells in ascending order of their number

a. ganglion
b. rods
c. cones

56. Arrange the processes involved in the phototransduction in the correct order
a. formation of metarhodopsin II

259
 b. degradation of cGMP
c. activation of transducin
d. activation of phosphodiesterase
e. isomerization of 11-cis-retinal

57. Arrange the colors in ascending order of wavelength

a. violet
b. yellow
c. green
d. orange
e. red

Fill in the gaps

58. The anterior and posterior eye chambers communicate with each other through the
_______.

59. The mechanism that allows clear vision of objects at different distances is called
________.

60. The refractive error in which rays of light are focused in front of the retina is called
_______.

61. The refractive error in which rays of light are focused behind the retina is called
_____________.

62. Impaired accommodation in elderly individuals due to reduced elasticity of the crys-
talline lens is referred to as _________.

63. The refractive error in which the refractive power of the optical media is not the same
in different meridians is called __________.

64. The ability of the visual system to distinguish between two points at the minimum
distance is called __________.

65. The G-protein found in the membrane of the receptor cells (rods and cones) is called
__________.

9.3 Somatosensory system (cutaneous and pain receptors). Neuro-

physiology of pain. Olfactory and gustatory sensory systems

Choose one correct answer

260
1. In humans, which of the following receptors are more numerous?
a. warm
b. cold

2. Afferent information from the proprioceptors is transmitted by which of the following

systems (pathways)?
a. dorsal column
b. anterolateral

3. Afferent information from the warm receptors is transmitted by which of the follow-
ing systems (pathways)?
a. dorsal column
b. anterolateral

4. Afferent information from the tactile receptors of the upper half of the body is pro-
cessed in which of the following nuclei in the medulla?
a. cuneate
b. gracile

5. Afferent information from the tactile receptors of the lower half of the body is pro-
cessed in which of the following nuclei in the medulla?
a. cuneate
b. gracile

6. Identify the structure with the lowest two-point discrimination threshold

a. sole
b. tip of the index finger
c. belly
d. calf

7. Identify the type of receptor that responds to low frequency (30 – 40 Hz) vibration
and the sliding of objects along the surface of the fingertips
a. Merkel’s disc
b. Meissner’s corpuscle
c. Ruffini’s corpuscle
d. Pacinian corpuscle

8. Identify the type of receptor that responds to stretching of the skin

a. Merkel’s disc
b. Meissner’s corpuscle
c. Ruffini’s corpuscle
d. Pacinian corpuscle

261
9. Identify the type of receptor that responds to high frequency (250 – 350 Hz) vibration
a. Merkel’s disc
b. Meissner’s corpuscle
c. Ruffini’s corpuscle
d. Pacinian corpuscle

10. Identify the type of receptor that is responsible for assessing the shape of objects and
the texture of surfaces
a. Merkel’s disc
b. Meissner’s corpuscle
c. Ruffini’s corpuscle
d. Pacinian corpuscle

11. Which of the following parameters determines the value of the two-point discrimina-
tion threshold of a body part?
a. dominant type of tactile receptor
b. thickness of the epithelium
c. size of the receptive fields of the afferent neurons
d. type of afferent fiber that innervate the receptors

12. At what temperature range are the warm thermoreceptors active?

a. 10 – 30
b. 25 – 50
c. 35 – 55
d. 40 – 60

13. At what temperature range are the cold thermoreceptors active?

a. 0 – 10
b. 5 – 25
c. 10 – 40
d. 20 – 45

14. Which of the following nerves carries somatosensory information from the face?
a. oculomotorius
b. trigeminal
c. facial
d. glossopharyngeal
15. Identify the type of nerve fibers that convey impulses from the tactile receptors to the
CNS
a. Аα
b. Аβ
c. Аδ
d. C

262
16. Which of the following types of nerve fibers convey information from the warm re-
ceptors to the CNS?
a. Аα
b. Аβ
c. Аδ
d. C

17. Impulses from the cold receptors are transmitted to the CNS via the fibers of the type
a. Аα
b. Аβ
c. Аδ
d. C

18. In which of the following nuclei does the spinothalamic tract terminate?
a. gracile
b. cuneatus
c. ventral posteromedial
d. ventral posterolateral

19. Which of the following thalamic nuclei processes somatosensory information from the
face?
a. lateral geniculate body
b. medial geniculate body
c. ventral posterolateral
d. ventral posteromedial

20. Which of the following thalamic nuclei processes somatosensory information from the
trunk and extremities?
a. lateral geniculate body
b. medial geniculate body
c. ventral posterolateral
d. ventral posteromedial

21. In which of the following structures is the II (second-order) neuron of the anterol-
ateral system located?
a. spinal cord
b. medulla oblongata
c. thalamus
d. cerebral cortex

22. In which of the following structures is the II (second-order) neuron of the dorsal col-
umn system located
a. spinal cord
b. medulla oblongata

263
 c. thalamus
d. cerebral cortex

23. In which of the following structures is the III (third-order) neuron of the dorsal col-
umn system located
a. spinal cord
b. medulla oblongata
c. thalamus
d. cerebral cortex

24. In which of the following cortical areas do pain and temperature afferent impulses
project?
a. precentral gyrus
b. postcentral gyrus
c. sulcus calcaneus of the occipital lobe
d. transverse temporal gyrus

25. The parts of the body that have the largest representation in the somatosensory cortex
are those that
a. have the largest number of receptors
b. perform complex movements
c. have better blood supply
d. have a higher two points discrimination threshold

26. Which of the following body parts has the largest representation in the somatosensory
cortex?
a. lips
b. back
c. shoulder
d. calf

27. Which of the following pathways conveys pain and temperature sensory information?
a. spinothalamic
b. spinocerebellar
c. cuneatus tract
d. gracile tract

28. Pain in a missing limb is called

a. projected
b. phantom
c. referred
d. peripheral

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29. Which of the following afferent fibers conveys information about the primary (epi-
critic) pain?
a. Аα
b. Аβ
c. Аδ
d. C

30. Pain that occurs in the area of peripheral nerve innervation due to intense stimulation
of that nerve (or its damage) is called
a. projected
b. phantom
c. referred
d. peripheral

31. Which of the following types of pain occurs when a bone is broken?
a. superficial somatic
b. deep somatic
c. visceral
d. causalgia

32. Which of the following types of pain can be precisely localized?

a. superficial somatic
b. deep somatic
c. visceral
d. causalgia

33. The permeability of which of the following ion channels increases when the pH is low-
ered?
a. NMDA
b. ASIC
c. AMPA
d. AQP

34. When a tissue is damaged, substance P is released from which of the following
cells/structures?
a. endothelium
b. mast cells
c. afferent endings
d. platelets

35. Which of the following nuclei processes gustatory sensory information?

a. vestibular
b. inferior olive
c. nucleus of the solitary tract

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 d. cuneatus

36. The olfactory neurons synapse with the which of the following cells?
a. basket cells
b. mitral cells
c. spikelet cells
d. villous cells

37. Substances of which of the following tastes have the lowest threshold concentration to
be detected by the gustatory system?
a. sweet
b. sour
c. salty
d. bitter

38. Which of the following cranial nerves supplies gustatory innervation to the posterior
third of the tongue?
a. trigeminal
b. facial
c. glossopharyngeal
d. vagal

Match the left and right columns

39. Receptor type Function

1. Meissner’s corpus- a. responds to low frequency (30 – 40 Hz) vibration and the
cle sliding of objects along the surface of the fingertips
2. Pacinian corpuscle b. responds to high frequency (250 – 350 Hz) vibration
3. Merkel’s disc c. responds to stretching of the skin
d. allows to assess the shape of the object and the texture of
the surface

40. Sensation Type of TRP receptor

1. Cool a. TRPM8
2. Warm b. TRPA1
3. Freezing cold c. TRPV3
d. TRPC

41. Receptor type Afferent fibers

1. Tactile a. Aδ

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 2. Warm b. Aγ
3. Cold c. Aβ
d. C

42. Damage Type of pain

1. Skin cut a. phantom
2. Bone fracture b. visceral
3. Myocardial ischemia c. deep somatic
d. superficial somatic

43. Pain type Characteristic

1. Projected a. occurs in a missing limb
2. Phantom b. occurs in the area of peripheral nerve innervation due to intense
stimulation of that nerve (or its damage)
3. Referred c. occurs when thalamic nuclei are damaged
d. occurs in a location other than the site of painful stimulus

44. Cranial nerve Function

1. Trigeminal a. gustatory innervation of the pharynx, epiglottis, and
esophagus
2. Facial b. afferent innervation of the posterior third of the tongue
3. Glossopharyngeal c. pain, temperature and tactile innervation of the anterior
two-thirds of the tongue
d. gustatory innervation of the anterior two thirds of the
tongue

Choose two or more correct answers

45. Which of the following receptors transmit information via the anterolateral system?
a. Pacinian corpuscle
b. Merkel’s disc
c. cold receptor
d. nociceptor
e. Meissner’s corpuscle

46. Which of the following receptors transmit information via the dorsal column path-
way?
a. Pacinian corpuscle
b. Merkel’s disc
c. cold receptor
d. nociceptor
e. Meissner’s corpuscle

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47. Which of the following thalamic nuclei process somatosensory information?
a. lateral geniculate body
b. ventral posterolateral nucleus
c. medial geniculate body
d. ventral posteromedial nucleus
e. ventral lateral nucleus

48. Which of the following are components of pain?

a. sensory
b. affective
c. palliative
d. vegetative
e. projective

49. Which of the following are algogenic substances?

a. bradykinin
b. corticotropin-releasing hormone
c. substance P
d. ATP
e. cholecystokinin

50. Which of the following structures are parts of the antinociceptive (pain modulation)
system?
a. vestibular nucleus
b. raphe nucleus
c. periaqueductal grey
d. locus coeruleus
e. lateral geniculate nucleus

51. What happens when an odorant binds to the olfactory receptor?

a. G protein becomes activated
b. cAMP levels increase
c. phospholipase C becomes activated
d. cGMP levels increase
e. nucleotide-gated Na+-Ca2+-channels open

52. What papillae are found on the surface of the tongue?

a. vallate
b. fungiform
c. foliate
d. dendritic
e. cuneate

53. Which of the following tastes are perceived by the ionotropic gustatory receptors?

268
 a. sour
b. sweet
c. sault
d. bitter
e. umami

54. Which of the following tastes are perceived by the metabotropic gustatory receptors?
a. sour
b. sweet
c. sault
d. bitter
e. umami

Arrange the correct sequence

55. Arrange the following body parts in ascending order of the two-point discrimination
threshold
a. palm
b. back
c. tip of the index finger
d. forehead

56. Arrange the following structures of the dorsal column pathway in the correct order
(from the lower to the upper)
a. gracile/cuneate nucleus
b. dorsal root ganglion
c. postcentral gyrus
d. ventral posterolateral thalamic nucleus

57. Arrange the following structures of the anterolateral system in the correct order (from
the lower to the upper)
a. dorsal horn of the spinal cord
b. ventral posterolateral thalamic nucleus
c. postcentral gyrus
d. nuclei of the reticular formation
e. dorsal root ganglion

58. Arrange the following structures of the antinociceptive (pain modulating) system in
the correct order (from the lower to the upper)
a. raphe nucleus
b. amygdala
c. periaqueductal grey
d. spinal interneurons

269
59. Arrange the following structures of the gustatory sensory system in the correct order
(from the lower to the upper)
a. geniculate ganglion of the facial nerve
b. insular cortex
c. nucleus of the solitary tract
d. ventral posteromedial thalamic nucleus

Fill in the gaps

60. The slowly adapting receptors that respond to stretching of the skin are called
________.

61. The smallest distance between two tactile stimuli at which they are perceived as dif-
ferent is called the _________.

62. Afferent information about a touch on the palm is processed in the ________ nucleus,
located in the medulla.

63. Afferent information about a touch on the calf is processed in the ________ nucleus,
located in the medulla.

64. Pain in a missing limb, such as an amputated leg, is called _______ pain.

65. The condition in which an injured part of the body experiences severe pain from even
a weak painful stimulus is called __________.

66. The condition in which an injured part of the body experiences pain from an innocu-
ous stimulus is called ________.

67. The fibers of the ________ nerve are responsible for the gustatory innervation of the
anterior two-thirds of the tongue.

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 CORRECT ANSWER KEYS FOR SECTION IX

9.1 General phycology of the sensory system. Auditory sensory sys-

tem

1. b 22. d 43. c, e
2. a 23. b 44. c, d
3. a 24. c 45. d, e
4. c 25. b 46. a, c
5. a 26. c 47. c, d, e
6. a 27. d 48. a, d
7. d 28. a 49. b, e
8. b 29. b 50. a, d
9. a 30. a 51. 1b, 2d, 3a, 4c, 5e
10. b 31. d 52. 1a, 2c, 3b
11. a 32. a 53. 1c, 2e, 3b, 4a, 5d
12. a 33. b 54. 1e, 2a, 3c, 4d, 5b
13. b 34. a 55. 1d, 2c, 3e, 4a, 5b
14. c 35. c 56. differentiation
15. c 36. c 57. adaptation
16. a 37. 1a, 2b, 3d 58. encoding
17. d 38. 1d, 2a, 3c 59. spatial
18. b 39. 1b, 2a, 3c 60. generator
19. a 40. 1a, 2c, 3b 61. differential threshold
20. b 41. 1c, 2a, 3b 62. helicotrema
21. d 42. a, b, e 63. endolymph

9.2 Visual sensory system

1. a 23. c 45. b, e
2. a 24. a 46. b, d
3. b 25. c 47. b, c
4. a 26. a 48. c, d, e
5. a 27. a 49. a, b
6. b 28. d 50. c, e
7. b 29. b 51. b, c
8. a 30. c 52. 1d, 2b, 3c, 4a, 5e
9. c 31. a 53. 1b, 2a, 3c
10. b 32. a 54. 1b, 2d, 3a, 4c
11. c 33. d 55. 1a, 2c, 3b
12. d 34. c 56. 1e, 2a, 3c, 4d, 5b
13. b 35. a 57. 1a, 2c, 3b, 4d, 5e

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 14. b 36. b 58. pupil
15. b 37. b 59. accommodation
16. d 38. 1c, 2a, 3b 60. myopia
17. d 39. 1d, 2c, 3b 61. hypermetropia
18. b 40. 1a, 2d, 3b 62. presbyopia
19. a 41. 1b, 2a, 3d 63. astigmatism
20. b 42. 1a, 2d, 3c 64. visual acuity
21. d 43. 1b, 2a, 3c 65. transducin
22. c 44. a, e

9.3 Somatosensory system (cutaneous and pain receptors). Neuro-

physiology of pain. Olfactory and gustatory sensory systems

1. b 24. b 47. b, d
2. a 25. a 48. a, b, d
3. b 26. a 49. a, c, d
4. a 27. a 50. b, c, d
5. b 28. b 51. a, b, e
6. b 29. c 52. a, b, c
7. b 30. a 53. a, c
8. c 31. b 54. b, d, e
9. d 32. a 55. 1c, 2a, 3d, 4b
10. a 33. b 56. 1b, 2a, 3d, 4c
11. c 34. c 57. 1e, 2a, 3d, 4b, 5c
12. b 35. c 58. 1d, 2a, 3c, 4b
13. c 36. b 59. 1a, 2c, 3d, 4b
14. b 37. d 60. Ruffini corpuscles
15. b 38. c 61. two-point discrimination
16. d 39. 1a, 2b, 3d threshold
17. c 40. 1a, 2c, 3b 62. cuneate
18. d 41. 1c, 2d, 3a 63. gracile
19. d 42. 1d, 2c, 3b 64. phantom
20. c 43. 1b, 2a, 3d 65. hyperalgesia
21. a 44. 1c, 2d, 3b 66. allodynia
22. b 45. c, d 67. facial (VII)
23. c 46. a, b, e

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 Section X. PHYSIOLOGY OF HIGHER NERVOUS
ACTIVITY

10.1 Physiology of the hemispheres

Choose one correct answer

1. Axons of which neurons terminate within the cerebral cortex?

a. pyramidal
b. stellate

2. Axons of which neurons form projection fibers?

a. pyramidal
b. stellate

3. Cytoarchitectonic defines which of the following?

a. distribution, shape, and localization of neurons
b. distribution of nerve fivers
c. distribution and shape of glial cells

4. How are the columns (modules) of cortical neurons oriented in relation to the surface
of the cerebellar cortex?
a. oblique
b. parallel
c. perpendicular

5. How many layers does the cerebral cortex (neocortex) have?

a. 3
b. 4
c. 5
d. 6

6. When the cerebral cortex is removed, which of the following animals suffers from
impaired vision and hearing, loss of all condition reflexes, but retains the ability to
locomote?
a. dog
b. fish
c. turtle
d. monkey

273
7. Afferent thalamocortical fibers from the relay nuclei of the thalamus synapse mainly
with
a. cells of the inner granular layer
b. cells of the inner pyramid layer
c. dendrites in the molecular layer
d. cells of the multiform layer

8. Which of the following layers of the cerebral cortex contains mainly spindle-like cells?
a. outer granular
b. inner pyramidal
c. inner pyramidal
d. multiform

9. In which of the following layers are the neurons that form the corticothalamic con-
nections primarily located?
a. multiform
b. inner granular
c. inner pyramidal
d. molecular

10. The nerve fibers that connect the cerebral cortex to the subcortical centers are called
a. commissural
b. associative
c. collateral
d. projection

11. Which of the following features of the cerebral cortex are determined by myeloarchi-
tectonic?
a. density, location and shape of neurons
b. location and density of blood vessels
c. location and distribution of nerve fibers
d. location, distribution and shape of glial cells

12. The nerve fibers that connect the hemispheres to each other are called
a. commissural
b. associative
c. collateral
d. projection

13. Which of the following cortex areas is located in the postcentral gyrus?
a. motor
b. projection (primary)
c. secondary
d. associative

274
14. Which of the following areas is located in the prefrontal cortex?
a. motor
b. projection (primary)
c. secondary
d. associative

15. The principle of strict topographic organization in the somatosensory cortex is called
a. somatotopy
b. tonotopy
c. retinotopy
d. methatopy

16. Which of the following muscles have the greatest representation in the precentral gy-
rus?
a. abdomen muscles
b. face muscles
c. lower limb muscles
d. back muscles

17. Identify the Brodmann areas in which the auditory projection cortex is located
a. 17, 18
b. 41, 42
c. 1, 2, 3
d. 21, 22

18. In which of the following activities are the primary (projection) cortical areas in-
volved?
a. recognition of an object
b. sensation of a certain modality
c. analysis and synthesis of the incoming information
d. behavioral reactions

19. In which of the following cortical areas is the visual projection cortex located
a. postcentral gyrus (area 3)
b. temporal lobe (area 42)
c. precentral gyrus (area 4)
d. occipital lobe (area 17)

20. In which of the following cortical areas is the primary motor cortex located?
a. postcentral gyrus (area 3)
b. temporal lobe (area 42)
c. precentral gyrus (area 4)
d. occipital lobe (area 17)

275
21. In which of the following cortical areas is the primary somatosensory cortex located?
a. postcentral gyrus (area 3)
b. temporal lobe (area 42)
c. precentral gyrus (area 4)
d. occipital lobe (area 17)

22. A decrease in muscle strength and impairment of voluntary movements on the right
side of the body occurs when there is damage to which of the following gyrus?
a. left precentral
b. right precentral
c. left superior temporal
d. right postcentral

23. In which of the following cortical areas is the projection olfactory cortex located
a. hippocampus
b. cingulate gyrus
c. pyriformis gurus
d. prefrontal cortex

24. Identify the structure in which the axons of olfactory neurons terminate
a. olfactory tuberculum
b. olfactory bulb
c. olfactory tract
d. dorsomedial thalamic nucleus

25. If the secondary visual cortex is damaged, which of the following signs will occur?
a. optical agnosia
b. optical apraxia
c. sensory aphasia
d. motor aphasia

26. Which of the following is used to record the summary electrical activity of neurons in
the cerebral cortex?
a. electroencephalography
b. magnetoencephalography
c. microelectrode
d. rheoencephalography

27. Which of the following types of electrical activity in the cerebral cortex is represented
by the EEG?
a. slow background
b. slow evoked
c. impulse evoked

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 d. impulse background

28. Select the correct beta (β) rhythm frequency range (Hz)
a. 0.5 – 3
b. 4 – 7
c. 8 – 13
d. 14 – 30

29. Which of the following EEG rhythms is recorded in a state of active wakefulness (with
open eyes)?
a. α
b. β
c. θ
d. δ

30. What is the frequency (Hz) of the θ-rhythm?

a. 0.5 – 3
b. 4 – 7
c. 8 – 13
d. 14 – 30

31. At rest, when a person is mentally and physically relaxed and his/her eyes are closed,
which of the following EEG rhythms is recorded?
a. α
b. β
c. θ
d. δ

32. Which of the following rhythms reflects EEG desynchronization?

a. α
b. β
c. θ
d. δ

33. Potential that occurs in the CNS in response to stimulation of receptors, afferent
nerves, sensory nuclei or other sensory structures, is called an
a. evoked potential
b. local response
c. electroencephalogram
d. electrocorticogram

34. When the sensory information is conveyed to the cerebral cortex via the non-specific
pathways, which of the following responses (in the context of evoke response) is
formed?

277
 a. primary
b. secondary
c. tertiary
d. mixed

Match the left and right columns

35. Cortical center Localization in the cerebral cortex

1. Primary visual cortex a. calcarine sulcus
2. Primary auditory cortex b. precentral gyrus
3. Primary motor cortex c. transverse temporal gyrus
d. postcentral gyrus

36. EEG rhythm Physical and mental state

1. α a. deep sleep
2. β b. muscular fatigue
3. δ c. rest, physical and mental relaxation (eyes are closed)
d. active waking state (eyes are open)

37. Type of cortical fiber Function

1. Associative a. connect the cerebral cortex with subcortical centers
2. Projection b. connect the cerebral cortex to effector organs
3. Commissural c. connect hemispheres to each other
d. connect cortical areas of the same hemisphere

38. EEG rhythm Frequency (Hz)

1. α a. 0.5 – 4
2. β b. 4 – 7
3. θ c. 8 – 13
d. 14 – 30

39. Associative cortical Function

area
1. Prefrontal a. orientation in space, stereognosis, body schema
2. Parietal b. planning, behavioral control, obeying laws and rules
3. Temporal c. recognition and identification of complex stimuli
d. control of the cardiovascular and respiratory systems

Choose two or more correct answers

278
40. Neurons that form corticocortical associative connections are located primarily in
which of the following cortical layers?
a. molecular
b. multiform
c. outer granular
d. outer pyramidal
e. inner pyramidal

41. The slow-wave electrical activity of the cerebral cortex can be divided into which of
the following types?
a. background
b. impulse
c. phasic
d. evoked
e. tetanic

42. Which of the following are characteristics of the α rhythm?

a. amplitude 150 – 200 µV
b. amplitude 50 – 75 µV
c. frequency 14 – 30 Hz
d. frequency 0.5 – 4 Hz
e. frequency 8 – 13 Hz

43. Which of the following are characteristics of the θ rhythm?

a. amplitude 150 – 200 µV
b. amplitude 50 – 75 µV
c. frequency 8 – 13 Hz
d. frequency 14 – 30 Hz
e. frequency 4 – 7 Hz

44. Which of the following are the functions of the prefrontal associative cortex?
a. recognition of complex stimuli
b. orientation in space
c. analysis of smell and taste
d. behavioral control
e. planning

45. Which of the following are the functions of the parietal associative cortex?
a. behavioral control
b. recognition of complex stimuli
c. orientation in space
d. stereognosis
e. planning

279
46. Which of the following areas of the cortex are projection sensory areas?
a. postcentral gyrus
b. precentral gyrus
c. prefrontal cortex
d. calcarine sulcus
e. hippocampus

47. Which of the following is true about the primary response (in the context of evoked
potentials)?
a. it has a large amplitude
b. it has a small amplitude
c. it has a long latency
d. it has a short latency
e. it occurs when the sensory information is transmitted via the specific afferent path-
ways

48. Which of the following is true about the secondary response (in the context of evoked
potentials)?
a. it has a large amplitude
b. it has a small amplitude
c. it has a long latency
d. it has a short latency
e. it occurs when the sensory information is transmitted via the specific afferent path-
ways

Fill in the gaps

49. The EEG rhythm that is recorded at rest (with eyes closed) and has a frequency of 8
– 13 Hz is called the ________.

50. The electrical response recorded from the cerebral cortex following presentation of a
specific stimulus is called the __________.

51. The fibers connecting hemispheres to each other are called ________ fibers.

52. The fibers connecting the cerebral cortex to subcortical centers are called _______
fibers.

53. The primary visual cortex is located in the _______ lobe.

54. The primary auditory cortex is located in the _______ lobe.

280
55. The EEG rhythm that is recorded during deep sleep and has a frequency of 0.5 – 4 Hz
is called the __________.

56. The primary _______ cortex is located in the precentral gyrus.

57. The primary somatosensory cortex is located in the ________ gyrus.

58. The primary response (in the context of evoked potential) occurs when the sensory
information is transmitted via the _________ afferent pathways

10.2 The basics of the physiology of learning and behavior

Choose one correct answer

1. By its nature, the protective inhibition is

a. conditioned
b. unconditioned

2. The extrinsic inhibition is

a. innate
b. acquired

3. The intrinsic inhibition is

a. innate
b. acquired

4. In the formation of a conditioned reflex, the strength of a conditioned stimulus com-

pared to the strength of an unconditioned stimulus must be
a. greater
b. smaller
c. equal

5. To form a conditioned reflex, an unconditioned stimulus compared to a conditioned

stimulus must be
a. equal
b. weaker
c. stronger

6. In the conditioned salivary reflex of a dog, the light is a

a. conditioned stimulus
b. unconditioned stimulus

281
 c. conditioned response

7. Which of the following characteristics of the major nervous processes (excitation and
inhibition) in the cerebral cortex determines resistance to strong or prolonged stimuli?
a. strength
b. balance
c. mobility

8. Which of the following characteristics of the major nervous processes (excitation and
inhibition) in the cerebral cortex determines the speed of switching from one activity
to another?
a. strength
b. balance
c. mobility

9. Which of the following characteristics of the major nervous processes in the cerebral
cortex determines the ratio of excitation and inhibition?
a. strength
b. balance
c. mobility

10. Which of the following is formed between the cortical centers of conditioned and un-
conditioned stimuli?
a. temporary connection
b. collateral
c. neural column
d. anastomosis

11. A conditioned reflex formed on the basis of an unconditioned reflex belongs to which
of the following types?
a. first order
b. second order
c. third order
d. fourth order

12. A classic salivation reflex to sound, formed in a dog, is a

a. simple
b. complex
c. chain
d. combined
13. Which of the following is true for the conditioned reflex?
a. common to all animals of a species
b. is innate
c. can be extinguished

282
 d. can be centered in the midbrain

14. Identify the correct sequence of stages in the formation of conditioned reflexes
a. generalization → concentration → specialization
b. generalization → specialization → concentration
c. generalization → concretization → specialization
d. generalization → specialization → differentiation

15. Which of the following is an unconditioned stimulus in the conditioned salivary reflex
to sound?
a. sound
b. food
c. salivation
d. action potential in the facial nerve fibers

16. Which of the following is an example of active learning?

a. a pigeon blinks when a bell rings after repeatedly coupling of the bell with a stream
of air into its eye
b. a cat withdraws its paw when a bell rings after repeatedly coupling of a bell with
an electric shock
c. a rat pushes a lever to get food
d. a dog salivates when a light is turned on after repeatedly coupling the light with a
meal

17. Which of the following types of inhibition occurs when an animal or human is exposed
to a very intense or prolonged stimulus?
a. extinguishing
b. delayed
c. differentiating
d. protective

18. When an individual is exposed to a new stimulus and initially reacts to it and then
ignores it, this is an example of which of the following types of inhibition?
a. protective
b. fading
c. extinguishing
d. differentiating

19. According to Pavlov, excitation and inhibition interact through which of the following
mechanisms?
a. convergence
b. divergence
c. induction

283
 d. occlusion

20. Extrinsic inhibition is caused by which of the following types of induction?

a. sequential
b. negative
c. positive
d. transfer

21. A reduction in the cortical area of a major nervous process (excitation or inhibition)
is called
a. concentration
b. irradiation
c. induction
d. localization

22. The spread of the major nervous process’s (excitation or inhibition) cortical area is
called
a. concentration
b. irradiation
c. induction
d. localization

23. The change of the major nervous process by the opposite (excitation by inhibition or
vice versa) is called
a. concentration
b. irradiation
c. induction
d. localization

24. Which of the following is an extrinsic (unconditioned) inhibition?

a. fading inhibitor
b. extinguishing
c. differentiating
d. conditioned inhibitor

25. An experimental animal was exposed to two sounds, one (1000 Hz) was reinforced by
food, and the other (400 Hz) was not. The food response to the 400 Hz sound faded
over time. This experiment illustrates which of the following types of cortical inhibi-
tion?
a. protective
b. delayed

284
 c. differentiating
d. extinguishing

26. A dog obeys only its owner’s commands and doesn’t respond to other people’s voices.
This is an example of which of the following types of cortical inhibition?
a. differentiating
b. extinguishing
c. conditioned inhibitor
d. protective

27. Which temperament corresponds to the “strong, unbalanced” type?

a. choleric
b. sanguine
c. phlegmatic
d. melancholic

28. Which temperament corresponds to the “strong, balanced, inert” type?

a. choleric
b. sanguine
c. phlegmatic
d. melancholic

29. Which temperament corresponds to the “weak” type?

a. choleric
b. sanguine
c. phlegmatic
d. melancholic

30. Which temperament corresponds to the “strong, balanced, mobile” type?

a. choleric
b. sanguine
c. phlegmatic
d. melancholic

31. A permanent complex of conditioned reflexes formed in response to a strict sequence

of conditioned stimuli is called
a. instinct
b. imprinting
c. temperament
d. dynamic stereotype

Match the left and right columns

285
32. Characteristic of the major Definition
nervous processes
1. Strength a. ratio of excitation and inhibition
2. Mobility b. speed of switching from one activity to another
3. Balance c. resistance to strong or prolonged stimuli
d. spread out over the entire cerebral cortex

33. Temperament Type of higher nervous activity

1. Choleric a. weak
2. Sanguine b. strong balanced mobile
3. Phlegmatic c. strong balance inert
d. strong unbalanced

34. Type of cortical inhibi- The condition in which inhibition occurs

tion
1. Protective a. a strong or/and prolonged stimulus is presented
2. Differentiating b. one stimulus is reinforced, but its combination with an-
other is not
3. Conditioned in- c. two similar stimuli are presented, with one is reinforced,
hibitor and the other – is not
d. conditioned stimulus is reinforced with a delay

35. Type of cortical inhibi- Function

tion
1. Protective a. prevents an animal (an individual) from responding to
stimuli with similar properties unless they are reinforced
2. Differentiating b. prevents the cerebral cortex from being overworked
3. Conditioned in- c. prevents an individual from breaking social taboos
hibitor
d. provides the timing of response to appropriate reinforce-
ment

36. Process Definition

1. Irradiation a. change of the major nervous process by the opposite (exci-
tation by inhibition or vice versa)
2. Induction b. spread of the cortical area of the major nervous processes
(excitation or inhibition)
3. Concentration c. formation of a connection between two cortical areas

286
 d. reduction in the cortical area of a major nervous process
(excitation or inhibition)

Choose two or more correct answers

37. Which of the following are innate activities in humans?

a. classical conditioned reflex
b. aversive learning
c. unconditioned reflexes
d. instincts
e. instrumental conditioned reflex

38. Which of the following are vital instincts?

a. food instinct
b. self-preservation
c. parental
d. sexual
e. herd instinct

39. Which of the following is true of the unconditioned reflex?

a. is innate
b. is individual
c. has a specific receptive field
d. prepares the body for an upcoming event
e. can be extinguished

40. Which of the following reflexes are unconditioned?

a. blinking
b. cough
c. obeying an owner’s command by a dog
d. sucking reflex at feeding time in newborns
e. knee jerk (patellar)

41. Which of the following types of learning are passive?

a. instrumental conditioned reflex
b. insight
c. habituation
d. classical conditioning
e. aversive

42. Identify the operant types of learning

a. sensitization
b. trial and error method

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 c. vicarious learning
d. instrumental conditioned reflex
e. aversive learning

43. Which of the following parameters of the main nervous processes underlie the classi-
fication of types of higher nervous activity?
a. polarity
b. adaptivity
c. mobility
d. strength
e. balance

44. Which of the following types of cortical inhibition are conditioned?

a. constant inhibitor
b. fading inhibitor
c. protective
d. extinguishing
e. differentiating

45. Which of the following is required for a conditioned reflex to form?

a. a conditioned stimulus must precede an unconditioned stimulus
b. the presence of a significant extraneous stimulus
c. an unconditioned stimulus must precede a conditioned stimulus
d. the unconditioned stimulus must have greater biological significance than the con-
ditional stimulus
e. a repeated combination of the conditioned and unconditioned stimuli

46. Which of the following is a higher nervous activity?

a. a badger digging a hole
b. salivation in a dog when it sees a light and anticipates food
c. increase in heart rate in an athlete before the competition
d. a deer looking for a mate
e. birds singing

Fill in the gaps

47. Repeated presentation of a condition stimulus without reinforcement results in

________ inhibition.

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48. Cortical inhibition caused by a very intense or prolonged stimulus is called ________
inhibition.

49. If an extraneous stimulus is more important than reinforcement and thus always in-
hibits a conditioned reflex, it is called a ________ inhibitor.

50. If an extraneous stimulus is less important than reinforcement, and thus ceases to in-
hibit a conditioned reflex after a few presentations, it is called a _______ inhibitor.

51. Cortical induction is divided into positive, negative, ________ and sequential.

52. A permanent complex of conditioned reflexes formed in response to a strict sequence

of conditioned stimuli is called the _________.

53. A form of learning in which a single presentation of an intense negative stimulus re-
sults in the formation of a persistent negative conditioned reflex is called ________
learning.

10.3 Higher nervous activity in humans. Physiological basis of

speech, memory, sleep and emotions. The concept of the functional
system

Choose one correct answer

1. Which signaling system(s) do animals have?

a. only first
b. only second
c. both

2. What signaling system(s) do humans have?

a. only first
b. only second
c. both

3. The word is perceived by a person as a

a. single sound
b. complex of sounds
c. signal of signals

4. When Broca’s area is damaged, which of the following conditions occurs?

a. sensory aphasia

289
 b. dysgraphia
c. optical agnosia
d. motor aphasia

5. In which of the following cortical regions is Wernicke’s area located?

a. posterior segment of the inferior frontal gyrus (area 44)
b. posterior segment of the superior temporal gyrus (area 22)
c. angular gyrus at the border of the temporal, parietal, and occipital lobes (area 39)
d. precentral gyrus (area 4)

6. Which of the following is the system-forming factor for the functional systems?
a. triggering stimulus
b. beneficial outcome
c. decision making
d. memory

7. What stage of functional system formation follows the afferent synthesis stage?
a. stable performance
b. anxiety
c. paradoxical
d. decision making

8. When Wernicke’s area is damaged, which of the following conditions occurs?

a. sensory aphasia
b. dysgraphia
c. motor aphasia
d. optical agnosia

9. What is impairment of speech perception with intact ability to pronounce words

called?
a. motor aphasia
b. sensory aphasia
c. dysarthria
d. echolalia

10. What is the perceived speech called?

a. impressive
b. expressive
c. obsessive
d. compulsive

11. The reflection of an object in general, as a whole complex of its properties, is called
a. representation
b. imagination

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 c. perception
d. analysis

12. Damage to which of the following cortical areas causes motor aphasia?
a. left inferior frontal gyrus
b. left superior temporal gyrus
c. left postcentral gyrus
d. right superior temporal gyrus

13. The ability of the living beings to imprint events that have happened is called
a. emotion
b. consciousness
c. imagination
d. memory

14. Which of the following types of memory is used to retell a text?

a. emotional
b. procedural
c. declarative
d. classical conditioning

15. Posttetanic potentiation is a mechanism of which of the following types of memory?

a. short-term
b. long-term
c. iconic
d. echoic

16. The synthesis of protein molecules underlies which of the following types of memory?
a. short-term
b. long-term
c. iconic
d. echoic

17. The reverberation of impulses in closed neural loops underlies which of the following
types of memory?
a. long-term
b. short-term
c. iconic
d. echoic

18. What is the transition from shot-term to long-term memory called?

a. concentration
b. potentiation
c. consolidation

291
 d. transformation

19. Which of the following parts of the limbic system is responsible for the memorization
and storing information related to a strong emotional experience?
a. amygdala
b. corpus mammillarias
c. hippocampus
d. nucleus accumbens

20. The type of memory that is formed with the active participation of the consciousness
and is related to the cognition of the reality is called?
a. declarative
b. procedural
c. conditional
d. emotional

21. Which of the following is a mechanism of short-term memory?

a. afterdepolarization and afterhyperpolarization
b. circulation of impulses in neuronal loops
c. formation of new protein molecules
d. irradiation of excitation

22. Which of the following structures is responsible for the transition of information from
short-term to long-term declarative memory (consolidation)?
a. hypothalamus
b. hippocampus
c. prefrontal cortex
d. globus pallidus

23. Why is REM sleep called paradoxical?

a. because it is accompanied by rapid eye movements
b. because the muscular tone is low during REM sleep
c. because it is characterized by deep inhibition of consciousness
d. because it is characterized by high frequency and low amplitude EEG activity

24. During which of the sleep stages are the K-complexes and the sleep spindles recorded?
a. I
b. II
c. III
d. IV

25. When the periods of the REM sleep are the longest?
a. immediately after falling asleep
b. in the first half of a night’s sleep

292
 c. in the middle of a night’s sleep
d. before waking up

26. At what stage of sleep do EEG δ-waves dominate

a. I
b. II
c. III
d. IV

27. Asthenic emotion occurs in which of the following stages of the emotional tension?
a. I
b. II
c. III
d. IV

28. Which of the following is an uncontrolled component of emotion?

a. facial expression
b. posture
c. sweating
d. vocal reactions

29. What is the controlled component of emotion?

a. tachycardia
b. sweating
c. facial expression
d. contraction of arrector pili muscle

30. Sthenic emotion occurs in which of the following stages of the emotional tension?
a. I
b. II
c. III
d. IV

31. In which of the following stages of functional system formation do emotions appear?
a. afferent synthesis
b. decision making
c. formation of the acceptor of action result
d. evaluation of outcome

Match the left and right columns

32. Stage of sleep Predominant EEG rhythm

1. Drowsiness a. α

293
 2. Deep sleep (stage IV) b. β
3. REM sleep c. δ
d. θ

33. Memory type CNS structure

1. Emotional a. cerebellum
2. Habits b. hippocampus
3. Motor skills c. amygdala
d. basal nuclei

34. Emotional stress stage Characteristics

1. I a. sthenic emotions appear
2. II b. mobilization of resources, activation
3. III c. CNS structural changes occur
d. asthenic emotions appear

35. Cortical area related to speech Function

1. Broca’s area (posterior segment of the inferior frontal a. center of writing
gyrus)
2. Wernicke’s area (posterior segment of the superior b. center of impressive
temporal gyrus) speech
3. Angular gyrus at the border of the temporal, parietal, c. center of reading
and occipital lobes
d. center of expressive
speech

36. Type of memory Mechanism

1. Immediate (sensory) a. trace potentials in sensory systems
2. Short-term b. synthesis of memory-related hormones in the hypo-
thalamus
3. Long-term c. structural changes in the synapses
d. circulation of impulses in closed neural loops

Choose two or more correct answers

37. What are the characteristics of the word as an element of the second signal system?
a. it is an unconditioned signal
b. it is an abstract signal
c. it is a semantic signal
d. it is an integrated signal
e. it is a sociably determined signal

38. Which of the following is true of the short-term memory?

294
 a. its lasts for a few second
b. its capacity is very large
c. it is very sensitive to chemical substances and electric current
d. provides information about the nature of acting stimuli
e. it always involves hippocampus

39. What happens during slow wave sleep?

a. rapid eye movements
b. high activity of cortical neurons
c. increased synchronization of the cortical electrical activity
d. inhibition of the visceral activity
e. increase in heart rate

40. Which of the following components of emotion are uncontrollable?

a. pantomimic
b. mimic
c. sweating
d. change in heart rate
e. change in vascular tone

41. Which of the following components of emotion are controllable?

a. pantomimic
b. mimic
c. sweating
d. change in heart rate
e. change in vascular tone

42. Which of the following structures are involved in the formation of emotions?
a. amygdala
b. medulla oblongata
c. Broca’s center
d. cingulate gyrus
e. quadrigeminal plate

43. Which of the following emotions are asthenic?

a. wrath
b. joy
c. interest
d. fear
e. sadness

44. Which of the following is seen during stage IV sleep?

a. active awareness
b. absence of awareness

295
 c. decreased muscle tone
d. decrease in heart rate
e. increase in heart rate
f. δ rhythm on EEG

45. Which of the following is seen during REM sleep?

a. active awareness
b. absence of awareness
c. decreased muscle tone
d. decrease in heart rate
e. increase in heart rate
f. β rhythm on EEG

46. Which of the following are the forms of the abstract reflection of reality?
a. concept
b. perception
c. representation
d. imagination
e. judgement

47. Which of the following are the cortical speech areas?

a. Wernicke’s
b. Heschl’s
c. Broca’s
d. Pavlov’s
e. calcarine gyrus

Fill in the gaps

48. The simplest form of reflection, which represents characteristics and properties of the
acting stimulus, is called ________.

49. Memory can be divided into __________ and implicit.

50. In stage III of emotional stress, ______ negative emotions appear.

51. In stage II of sleep, K-complexes and sleep ______ appear.

52. A form of communication using language that also serves as the basis of abstract rea-
soning is called ______.

53. The ability of living beings to acquire, store, and reproduce information is called
________.

296
54. If the Wernicke’s area is damaged, _______ aphasia develops.

55. The CNS structure that is responsible for the consolidation of the explicit memory is
called the __________.

297
 CORRECT ANSWER KEYS FOR SECTION X

10.1 Physiology of the hemispheres

1. b 21. a 41. a, d
2. a 22. a 42. b, e
3. a 23. c 43. a, e
4. c 24. b 44. d, e
5. d 25. a 45. c, d
6. a 26. a 46. a, d
7. a 27. a 47. b, d, e
8. d 28. d 48. a, c
9. a 29. b 49. α (alpha) rhythm
10. d 30. b 50. evoked potential (evoked re-
11. c 31. a sponse)
12. a 32. b 51. commissural
13. b 33. a 52. projection
14. d 34. b 53. occipital
15. a 35. 1a, 2c, 3b 54. temporal
16. b 36. 1c, 2d, 3a 55. δ (delta) rhythm
17. b 37. 1d, 2a, 3c 56. motor
18. b 38. 1c, 2d, 3b 57. postcentral
19. d 39. 1b, 2a, 3c 58. specific
20. с 40. c, d

10.2 The basics of the physiology of learning and behavior

1. b 19. c 37. c, d
2. a 20. b 38. a, b
3. b 21. a 39. a, c
4. b 22. b 40. a, b, e
5. c 23. c 41. c, d, e
6. a 24. a 42. b, d
7. a 25. c 43. c, d, e
8. c 26. a 44. d, e
9. b 27. a 45. a, d, e
10. a 28. c 46. b, c
11. a 29. d 47. extinguishing
12. a 30. b 48. protective
13. c 31. d 49. constant
14. a 32. 1c, 2b, 3a 50. fading
15. b 33. 1d, 2b, 3c 51. simultaneous

298
 16. c 34. 1a, 2c, 3b 52. dynamic stereotype
17. d 35. 1b, 2a, 3c 53. aversive
18. b 36. 1b, 2a, 3d

10.3 Higher nervous activity in humans. Physiological basis of

speech, memory, sleep and emotions. The concept of the functional
system

1. a 20. a 39. c, d
2. c 21. b 40. c, d, e
3. c 22. b 41. a, b
4. d 23. d 42. a, d
5. b 24. b 43. d, e
6. b 25. d 44. b, c, d, f
7. d 26. d 45. b, c, e, f
8. a 27. c 46. a, e
9. b 28. c 47. a, c
10. a 29. c 48. sensation
11. c 30. b 49. explicit (declarative)
12. a 31. d 50. asthenic
13. d 32. 1a, 2c, 3b 51. spindles
14. c 33. 1c, 2d, 3a 52. speech
15. a 34. 1b, 2a, 3d 53. memory
16. b 35. 1d, 2b, 3c 54. sensory
17. b 36. 1a, 2d, 3c 55. hippocampus
18. c 37. b, c, e
19. a 38. a, c

299
 APPENDIX 1
An example of a quiz variant with
the correct answer keys
on the topic
Somatosensory system (cutaneous and pain receptors). Neuro-
physiology of pain. Olfactory and gustatory sensory systems

1. (1) In humans, which of the following receptors are more numerous?

a. warm
b. cold

2. (5) Afferent information from the tactile receptors of the lower half of the body is
processed in which of the following nuclei in the medulla?
a. cuneate
b. gracile

3. (9) Identify the type of receptor that responds to high frequency (250 – 350 Hz) vibra-
tion
a. Merkel’s disc
b. Meissner’s corpuscle
c. Ruffini’s corpuscle
d. Pacinian corpuscle

4. (17) Impulses from the cold receptors are transmitted to the CNS via the fibers of the
type
a. Аα
b. Аβ
c. Аδ
d. C

5. (26) Which of the following body parts has the largest representation in the soma-
tosensory cortex?
a. lips
b. back
c. shoulder
d. calf

6. (31) Which of the following types of pain occurs when a bone is broken?
a. superficial somatic
b. deep somatic

300
 c. visceral
d. causalgia

7. (43) Pain type Characteristic

1. Projected a. occurs in a missing limb
2. Phantom b. occurs in the area of peripheral nerve innervation due to intense
stimulation of that nerve (or its damage)
3. Referred c. occurs when thalamic nuclei are damaged
d. occurs in a location other than the site of painful stimulus

8. (49) Which of the following are algogenic substances?

a. bradykinin
b. corticotropin-releasing hormone
c. substance P
d. ATP
e. cholecystokinin

9. (59) Arrange the following structures of the gustatory sensory system in the correct
order (from the lower to the upper)
a. geniculate ganglion of the facial nerve
b. insular cortex
c. nucleus of the solitary tract
d. ventral posteromedial thalamic nucleus

10. (65) The condition in which an injured part of the body experiences severe pain from
even a weak painful stimulus is called __________.

Note: the numbers in brackets indicate the corresponding questions in the test assignment
book.

Correct answer keys for the quiz

1. b
2. b
3. d
4. c
5. a
6. b
7. 1b, 2a, 3d
8. a, c, d
9. 1a, 2c, 3d, 4b
10. Hyperalgesia

301
 LITERATURE
Dorokhov, Ye.V. Normal physiology / Dorokhov Ye.V., Karpova A.V., Semi-
letova V.A. [et al.] – Москва: ГЭОТАР-Медиа, 2021. – 512 с. – ISBN 978-5-
9704-6136-5. – Текст: электронный // ЭБС «Консультант студента»:
[сайт]. – URL:
https://www.studentlibrary.ru/book/ISBN9785970461365.htm

302