Cardiac Muscle Properties — MCQs
What is the role of gap junctions in cardiac muscle function?
If the contractility of the heart is decreased, which of the following is seen ?
Which of the following structures in the heart are known for their rapid conduction of electrical impulses?
How many phases are there in the action potential of cardiac muscles?
Hyperpolarization is caused by which ions?
Which one of the following substances increases the release of Ca2+ from the endoplasmic reticulum?
Which of the following statements about cardiac muscle is incorrect?
The fiber marked as X is:
In the context of muscle physiology, which structure is described as a threadlike component that extends along the length of a muscle fiber?
Sarcomere is the area between which two Z lines?
Cardiac Muscle Properties Indian Medical PG Practice Questions and MCQs
Question 1: What is the role of gap junctions in cardiac muscle function?
- A. Are not found in cardiac muscles
- B. Are not found in smooth muscles
- C. Have no significant role in cardiac muscle function
- D. Facilitate impulse transmission between cardiac myocytes (Correct Answer)
Explanation: ***Facilitate impulse transmission between cardiac myocytes*** - **Gap junctions** are specialized channels between adjacent cells that allow for direct communication and rapid movement of **ions** and small molecules. - In cardiac muscle, they form an essential part of **intercalated discs**, enabling the heart to function as a **syncytium** by allowing electrical impulses to spread quickly from one myocyte to another. *Are not found in cardiac muscles* - This statement is incorrect; **gap junctions** are a defining feature of **cardiac muscle** and are crucial for its coordinated contraction. - They are located within the **intercalated discs** that connect individual cardiac muscle cells. *Are not found in smooth muscles* - This statement is incorrect; **gap junctions** are indeed found in **smooth muscle**, particularly in single-unit smooth muscle, where they contribute to synchronized contractions, such as in the **gastrointestinal tract**. - They allow for the rapid propagation of electrical signals, leading to coordinated muscle activity. *Have no significant role in cardiac muscle function* - This statement is incorrect; **gap junctions** play a critically significant role in cardiac muscle function by ensuring the **rapid and synchronized spread of electrical impulses**. - Without functional gap junctions, the heart would not be able to contract efficiently or effectively as a pump.
Question 2: If the contractility of the heart is decreased, which of the following is seen ?
- A. Increased ejection fraction
- B. Increased stroke work
- C. Decreased stroke volume (Correct Answer)
- D. Increased cardiac output
Explanation: ***Decreased stroke volume*** - A decrease in the **contractility** of the heart directly reduces the force of myocardial contraction. - This weaker contraction results in less blood being ejected from the ventricle per beat, leading to a **decreased stroke volume**. *Increased ejection fraction* - **Ejection fraction** is the percentage of blood ejected from the ventricle with each beat, calculated as (stroke volume / end-diastolic volume) x 100. - When contractility decreases, **stroke volume** decreases, which would typically lead to a *decreased* ejection fraction, not an increased one. *Increased stroke work* - **Stroke work** is a measure of the work done by the ventricle to eject blood, and it depends on both stroke volume and aortic pressure. - With decreased contractility, **stroke volume** falls, which would *decrease* the stroke work, assuming afterload remains constant. *Increased cardiac output* - **Cardiac output** is the product of stroke volume and heart rate (CO = SV x HR). - Since decreased contractility leads to a **decreased stroke volume**, without a compensatory increase in heart rate, cardiac output would *decrease*, not increase.
Question 3: Which of the following structures in the heart are known for their rapid conduction of electrical impulses?
- A. Sinoatrial (SA) node
- B. Atrioventricular (AV) node
- C. His bundle
- D. Purkinje fibers (Correct Answer)
Explanation: ***Correct: Purkinje fibers*** - **Purkinje fibers** have the **fastest conduction velocity** among all cardiac tissues, approximately **4 m/s** - These specialized myocardial fibers ensure **rapid and synchronized depolarization of the ventricles**, allowing for efficient and coordinated ventricular contraction - Their rapid conduction is essential for simultaneous contraction of ventricular myocardium from apex to base *Incorrect: Sinoatrial (SA) node* - The SA node is the natural **pacemaker** of the heart, initiating electrical impulses at a rate that determines heart rate - However, its conduction velocity is **very slow** (~0.05 m/s), much slower than Purkinje fibers - Its role is impulse generation, not rapid conduction *Incorrect: Atrioventricular (AV) node* - The AV node has the **slowest conduction velocity** in the heart (~0.05 m/s) - It **delays electrical impulses** from the atria to the ventricles (AV delay ~0.1 seconds) - This delay allows for **complete ventricular filling** before ventricular contraction begins *Incorrect: His bundle* - The bundle of His transmits impulses from the AV node to the bundle branches - While faster than the AV node (~1-1.5 m/s), it is still **significantly slower than Purkinje fibers** - Its conduction velocity is intermediate between the AV node and Purkinje fibers
Question 4: How many phases are there in the action potential of cardiac muscles?
- A. 2 phases
- B. 3 phases
- C. 4 phases
- D. 5 phases (Correct Answer)
Explanation: ***5 phases*** - The cardiac myocyte action potential is classically described in **five phases** (phases 0, 1, 2, 3, and 4), which encompass depolarization, repolarization, and the resting state. - Each phase is characterized by specific ion channel activities leading to distinct electrical changes essential for proper cardiac function. *2 phases* - Action potentials in nerve cells typically follow a simpler two-phase model: **depolarization** and **repolarization**. - This model does not account for the additional plateau and resting phases characteristic of cardiac muscle cells. *3 phases* - Some simplified models might describe three phases (depolarization, repolarization, and a resting phase), but this still **omits specific nuances** of cardiac repolarization and the sustained plateau phase. - This simplification leaves out the early repolarization and the critical plateau phase (phase 2), which is vital for the prolonged contraction of the heart. *4 phases* - While some sources might refer to four phases, they typically combine certain repolarization steps or omit the distinct early repolarization phase. - This description would likely miss the **early, rapid repolarization phase (phase 1)**, understating the complex ion movements.
Question 5: Hyperpolarization is caused by which ions?
- A. K+ (Correct Answer)
- B. Na+
- C. HCO3-
- D. Ca2+
Explanation: ***K+*** - **Efflux of K+ ions** out of the cell makes the inside of the cell more negative, leading to **hyperpolarization**. - This efflux is typically mediated by **voltage-gated potassium channels** opening, or by activation of **GABA-A** or **glycine receptors** that increase K+ conductance. *Na+* - **Influx of Na+ ions** into the cell makes the inside of the cell more positive, causing **depolarization**, not hyperpolarization. - This influx is responsible for the **rising phase of an action potential**. *Ca2+* - **Influx of Ca2+ ions** into the cell also contributes to **depolarization** and can trigger various intracellular processes. - Ca2+ influx is crucial for **neurotransmitter release** and muscle contraction, but not for hyperpolarization. *HCO3-* - Bicarbonate ions (**HCO3-**) play a significant role in **maintaining pH balance** in the body and are involved in various physiological processes. - While ion channels can conduct HCO3-, their movement is not typically the primary cause of cell membrane hyperpolarization.
Question 6: Which one of the following substances increases the release of Ca2+ from the endoplasmic reticulum?
- A. Inositol triphosphate (Correct Answer)
- B. 1,25 - dihydroxy cholecalciferol
- C. Diacylglycerol
- D. Parathyroid hormone
Explanation: ***Inositol triphosphate*** - **Inositol triphosphate (IP3)** is a secondary messenger that binds to specific receptors on the **endoplasmic reticulum (ER)**, triggering the release of stored **Ca2+** into the cytoplasm. - This calcium release plays a crucial role in various cellular processes, including **muscle contraction**, **neurotransmission**, and **hormone secretion**. *1,25 - dihydroxycholecalciferol* - This is the active form of **vitamin D**, primarily involved in **calcium absorption** from the gut and **calcium reabsorption** in the kidneys. - It does not directly increase Ca2+ release from the endoplasmic reticulum. *Diacylglycerol* - **Diacylglycerol (DAG)** is another secondary messenger, also produced from the cleavage of **PIP2** along with IP3. - DAG primarily activates **protein kinase C (PKC)**, which is involved in signal transduction pathways, but it does not directly trigger Ca2+ release from the ER. *Parathyroid hormone* - **Parathyroid hormone (PTH)** is a hormone that primarily regulates **extracellular calcium levels** by promoting bone resorption, increasing renal calcium reabsorption, and stimulating the synthesis of 1,25-dihydroxycholecalciferol. - While it ultimately increases blood calcium, it does not directly cause Ca2+ release from the endoplasmic reticulum.
Question 7: Which of the following statements about cardiac muscle is incorrect?
- A. Cardiac muscle has a short refractory period. (Correct Answer)
- B. Cardiac muscle obeys the all or none law.
- C. Cardiac muscle exhibits the Frank-Starling mechanism
- D. Cardiac muscle has automaticity and rhythmicity
Explanation: ***Cardiac muscle has a short refractory period.*** - This statement is **incorrect** because cardiac muscle has a **long refractory period** (~250 ms), which prevents summation and tetanus by ensuring that the muscle relaxes completely before another action potential can be initiated. - The long refractory period is crucial for maintaining the heart's **pumping efficiency** and preventing arrhythmias. *Cardiac muscle obeys the all or none law.* - This statement is **correct**. Individual **cardiac muscle cells** obey the **all-or-none law**; when a stimulus reaches threshold, the cell contracts fully. - The heart as a whole organ can grade its contraction force through recruitment of more fibers and the Frank-Starling mechanism, but at the cellular level, the all-or-none principle applies. *Cardiac muscle exhibits the Frank-Starling mechanism* - This statement is **correct**. The **Frank-Starling mechanism** describes the heart's ability to increase its force of contraction and stroke volume in response to an increase in **venous return** or end-diastolic volume. - This intrinsic regulatory mechanism allows the heart to match its output to the venous return, optimizing cardiac efficiency. *Cardiac muscle has automaticity and rhythmicity* - This statement is **correct**. **Automaticity** refers to the ability of specialized cardiac cells (e.g., in the sinoatrial node) to spontaneously generate action potentials without external nervous stimulation. - **Rhythmicity** is the regular, cyclical discharge of these action potentials, which drives the rhythmic beating of the heart.
Question 8: The fiber marked as X is:
- A. Nerve fiber
- B. Modified cardiac muscle (Correct Answer)
- C. Modified nerve fiber
- D. Modified connective tissue
Explanation: ***Modified cardiac muscle*** - The fiber marked as X represents **Purkinje fibers**, which are part of the cardiac conduction system consisting of **specialized cardiac muscle cells** (modified cardiomyocytes). - These cells have **lost most of their contractile elements** and have developed specialized properties for **rapid electrical impulse conduction** throughout the ventricles. - Histologically, they are **larger and paler** than regular cardiac muscle cells, with abundant glycogen and fewer myofibrils, but they retain their cardiac muscle origin and characteristics. - Found in the **subendocardial layer** of the ventricles, they are the terminal component of the cardiac conduction system. *Modified nerve fiber* - This is a **common misconception**. While Purkinje fibers conduct electrical impulses rapidly (similar to nerve fibers), they are **not nerve tissue**. - The cardiac conduction system consists entirely of **modified cardiac muscle cells**, not neurons or nerve fibers. - True nerve fibers (autonomic nervous system) modulate the heart rate but are **separate from the conduction system**. *Nerve fiber* - **Nerve fibers** are axons of neurons and are part of the nervous system. - The cardiac conduction system, including Purkinje fibers, is **not composed of nervous tissue** but rather specialized cardiac muscle. - Autonomic nerve fibers do innervate the heart but are distinct from the conduction system structures. *Modified connective tissue* - **Connective tissue** provides structural support but does not have the ability to generate or conduct electrical impulses. - Purkinje fibers are **specialized cardiac muscle cells**, not connective tissue derivatives.
Question 9: In the context of muscle physiology, which structure is described as a threadlike component that extends along the length of a muscle fiber?
- A. Sarcomere
- B. Sarcolemma
- C. Myofibril (Correct Answer)
- D. Myofilament
Explanation: ***Myofibril*** - A **myofibril** is a cylindrical organelle that runs longitudinally inside a muscle fiber and contains **contractile proteins**. - Myofibrils are composed of repeating units called **sarcomeres**, which are the fundamental units of muscle contraction. *Sarcomere* - A **sarcomere** is the basic contractile unit of a muscle fiber, extending from one Z-disc to the next. - While it is a key component for muscle contraction, it is a **segment within a myofibril**, not the threadlike component that extends the entire length of the fiber. *Sarcolemma* - The **sarcolemma** is the cell membrane of a muscle fiber, responsible for transmitting nerve impulses to the muscle cell. - It encloses the muscle fiber but is not an internal, threadlike contractile component. *Myofilament* - **Myofilaments** are the individual protein filaments (actin and myosin) that make up a sarcomere within a myofibril. - They are the **smallest contractile elements**, but they are not the threadlike structure that extends along the entire muscle fiber.
Question 10: Sarcomere is the area between which two Z lines?
- A. Two adjacent Z lines (Correct Answer)
- B. A band and I band
- C. Two H zones
- D. Two consecutive I bands
Explanation: ***Two adjacent Z lines*** - A **sarcomere** is defined as the fundamental contractile unit of muscle, extending from one **Z line** to the next. - The **Z lines** anchor the **actin (thin) filaments**, and their proximity helps delineate the functional sarcomere unit. *Two consecutive I bands* - The **I band** contains only **thin (actin) filaments** and is bisected by a Z line. It is not a boundary that defines a sarcomere. - A sarcomere encompasses parts of two I bands, plus an A band in the middle. *A band and I band* - The **A band** contains **thick (myosin) filaments** and overlapping thin filaments, while the **I band** contains only thin filaments. - These bands are components within a sarcomere, not boundaries that define its extent. *Two H zones* - The **H zone** is a region within the A band that contains only **thick (myosin) filaments** and is visible in relaxed muscle. - It is located in the center of the A band and does not serve as a boundary for the entire sarcomere.
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