NEET-PG 2013

1544 Questions — Page 13 of 155

Anatomy

3 questions

Q121

The roof of the olfactory region is formed by?

Q122

Which thalamic nucleus has the most extensive reciprocal connections with the association areas of the neocortex?

Q123

All of the following muscles have dual nerve supply except which one?

NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs

Question 121: The roof of the olfactory region is formed by?

A. Nasal bone
B. Sphenoid
C. Temporal bone
D. Cribriform plate of ethmoid (Correct Answer)

Explanation: ***Cribriform plate of ethmoid*** - The **cribriform plate** of the ethmoid bone forms the superior boundary, or roof, of the nasal cavity specifically in the olfactory region [1]. - It is perforated by numerous **olfactory foramina** through which the olfactory nerves pass from the nasal cavity to the olfactory bulb of the brain [2]. *Nasal bone* - The **nasal bones** form part of the bridge of the nose and contribute to the anterior part of the bony framework of the external nose. - They do not form the roof of the olfactory region within the nasal cavity. *Sphenoid* - The **sphenoid bone** is a complex bone at the base of the skull, contributing to the posterior wall of the nasal cavity and parts of the cranial floor. - It does not directly form the roof of the olfactory region. *Temporal bone* - The **temporal bones** are located on the sides and base of the skull, housing structures related to hearing and balance. - They are not involved in forming the roof of the nasal cavity or the olfactory region.

Question 122: Which thalamic nucleus has the most extensive reciprocal connections with the association areas of the neocortex?

A. Intralaminar
B. Anterior
C. Pulvinar (Correct Answer)
D. None of the options

Explanation: ***Pulvinar*** - The **pulvinar nucleus** is the largest thalamic nucleus and has the most extensive **妥reciprocal connections** with the **association cortices** of the parietal, temporal, and occipital lobes. - It plays a crucial role in **visual attention**, integration of visual and other sensory information, and facilitating cortico-cortical communication. - The pulvinar is unique in its dense, bidirectional connectivity with higher-order association areas, distinguishing it from other thalamic nuclei. *Intralaminar* - **Intralaminar nuclei** (centromedian, parafascicular) project **diffusely and non-specifically** to widespread cortical areas and the striatum [1]. - They are involved in arousal, attention, and consciousness but lack the **specific, reciprocal connections** with association cortices that characterize the pulvinar. - Their projections are more related to generalized cortical activation rather than specific sensory or cognitive processing [1]. *Anterior* - The **anterior nuclear group** (anteromedial, anterodorsal, anteroventral) projects primarily to the **cingulate gyrus** as part of the limbic system [1]. - While the cingulate is cortical tissue, it is **limbic cortex** with specific emotional and memory functions, not association neocortex involved in higher-order sensory integration. - Receives input from mammillary bodies and is part of the Papez circuit for memory and emotion. *None of the options* - This is incorrect because the **pulvinar nucleus** has well-established, extensive reciprocal connections with association areas of the neocortex. - The pulvinar is considered a "higher-order" thalamic nucleus specifically connecting cortical areas to each other via the thalamus.

Question 123: All of the following muscles have dual nerve supply except which one?

A. Pectoralis major
B. Flexor digitorum profundus
C. Biceps brachii (Correct Answer)
D. Subscapularis

Explanation: ***Biceps brachii*** - The **biceps brachii** muscle is solely innervated by the **musculocutaneous nerve (C5, C6, C7)**. - This muscle is a prime mover for forearm supination and elbow flexion and does not receive nerve supply from any other nerve. *Subscapularis* - The **subscapularis** muscle has a dual nerve supply from both the **upper and lower subscapular nerves (C5, C6)**. - This dual innervation ensures motor control of the subscapularis, which is an important medial rotator of the humerus. *Pectoralis major* - The **pectoralis major** muscle receives a dual nerve supply from both the **medial and lateral pectoral nerves** [1]. - The **lateral pectoral nerve** primarily supplies the clavicular head, while the **medial pectoral nerve** supplies both the sternocostal head and a portion of the clavicular head [1]. *Flexor digitorum profundus* - The **flexor digitorum profundus** muscle has a dual nerve supply from the **median nerve** (innervating the lateral half for digits 2 and 3) and the **ulnar nerve** (innervating the medial half for digits 4 and 5). - This dual innervation allows for independent or coordinated flexion of the distal phalanges of the fingers.

Internal Medicine

1 questions

Q121

Which of the following statements about obesity is FALSE?

Physiology

6 questions

Q121

Which of the following best describes hypoxic pulmonary vasoconstriction?

Q122

Which of the following stimuli is primarily responsible for triggering the Bezold-Jarisch reflex?

Q123

What physiological mechanism leads to an increase in cardiac output?

Q124

Slowest blood flow is seen in?

Q125

In a healthy person, arterial baroreceptor activity is seen at what stage of the cardiac cycle?

Q126

By what percentage can cardiac output increase in a healthy adult during intense physical activity compared to resting levels?

NEET-PG 2013 - Physiology NEET-PG Practice Questions and MCQs

Question 121: Which of the following best describes hypoxic pulmonary vasoconstriction?

A. Reversible pulmonary vasoconstriction due to hypoxia (Correct Answer)
B. Irreversible pulmonary vasoconstriction due to hypoxia
C. Redirects blood to well-ventilated areas
D. Occurs immediately in response to hypoxia

Explanation: ***Reversible pulmonary vasoconstriction due to hypoxia*** - Hypoxic pulmonary vasoconstriction (HPV) is a physiological response in which **pulmonary arterioles constrict** in areas of the lung with low oxygen levels. - This mechanism is **reversible**, meaning that when oxygen levels improve, the constricted vessels will dilate again. - The underlying mechanism involves hypoxia-induced inhibition of voltage-gated K⁺ channels in pulmonary arterial smooth muscle, leading to membrane depolarization, Ca²⁺ influx, and smooth muscle contraction. *Irreversible pulmonary vasoconstriction due to hypoxia* - This statement is incorrect because HPV is fundamentally a **reversible process**, designed to adapt to transient changes in alveolar oxygen. - Irreversible vasoconstriction typically occurs in chronic hypoxia, leading to **pulmonary hypertension** and structural remodeling (vascular remodeling with medial hypertrophy), which is a pathological state rather than the acute physiological response of HPV. *Redirects blood to well-ventilated areas* - While this is the **physiological purpose** and overall effect of hypoxic pulmonary vasoconstriction, it describes the functional outcome rather than what HPV fundamentally is. - The redirection of blood flow is the **consequence** of vasoconstriction in hypoxic areas, which optimizes ventilation-perfusion matching. *Occurs immediately in response to hypoxia* - While HPV does begin rapidly in response to hypoxia (within seconds to minutes), this describes the **timing characteristic** rather than what HPV is. - This statement is also somewhat imprecise, as the response involves intracellular signaling pathways that take time to manifest fully, though the onset is relatively quick compared to other vascular responses.

Question 122: Which of the following stimuli is primarily responsible for triggering the Bezold-Jarisch reflex?

A. Parasympathetic withdrawal
B. Decreased venous return
C. Increased sympathetic stimulation
D. Activation of cardiac C-fiber afferents (Correct Answer)

Explanation: ***Activation of cardiac C-fiber afferents*** - The **Bezold-Jarisch reflex** is primarily triggered by stimulation of **cardiac mechanoreceptors and chemoreceptors** located in the ventricles, particularly the inferoposterior wall of the left ventricle. - These receptors have **unmyelinated vagal C-fiber afferents** that transmit signals to the medullary cardiovascular centers. - Activation of these afferents leads to the characteristic triad: **bradycardia, hypotension, and vasodilation** via increased parasympathetic activity and withdrawal of sympathetic tone. - Common triggers include vigorous ventricular contraction with decreased filling, certain drugs (veratridine), myocardial ischemia (especially inferior wall MI), and reperfusion. *Decreased venous return* - While **decreased venous return** creates the hemodynamic context (ventricular underfilling) that can lead to vigorous contraction of a relatively empty ventricle, it is not itself the *trigger* of the reflex. - The actual trigger is the activation of the ventricular receptors sensing this abnormal contraction pattern, which then signal via C-fiber afferents. - Decreased venous return alone, without receptor activation, would not produce the reflex. *Parasympathetic withdrawal* - **Parasympathetic withdrawal** would cause tachycardia and is opposite to the Bezold-Jarisch reflex, which involves **increased parasympathetic activity**. - This is a compensatory response seen in other reflexes like the baroreceptor reflex during hypotension. *Increased sympathetic stimulation* - **Increased sympathetic stimulation** produces tachycardia, increased contractility, and vasoconstriction—effects opposite to the Bezold-Jarisch reflex. - The reflex actually causes **sympathetic withdrawal** along with parasympathetic activation.

Question 123: What physiological mechanism leads to an increase in cardiac output?

A. Inhalation
B. Increased myocardial contractility (Correct Answer)
C. Increased parasympathetic activity
D. Transitioning from a supine to a standing position

Explanation: ***Increased myocardial contractility*** - **Increased myocardial contractility** directly leads to a greater **stroke volume** (the amount of blood pumped with each beat), thus increasing cardiac output (Cardiac Output = Stroke Volume × Heart Rate). - This can be stimulated by factors such as **sympathetic nervous system activation** or positive inotropic agents. *Inhalation* - While inhalation can temporarily affect venous return and intrathoracic pressure, it does not directly or consistently lead to a sustained increase in **cardiac output**. - Its primary effect is on **respiration**, not cardiac performance. *Increased parasympathetic activity* - Increased parasympathetic activity, primarily via the **vagus nerve**, acts to **decrease heart rate** and myocardial contractility. - This effect would typically **reduce cardiac output**, not increase it. *Transitioning from a supine to a standing position* - Transitioning to a standing position usually causes a **temporary decrease in venous return** and a brief drop in cardiac output as blood pools in the lower extremities. - The body then compensates by increasing heart rate and peripheral vascular resistance to maintain blood pressure, but the initial effect on cardiac output is generally a transient decrease.

Question 124: Slowest blood flow is seen in?

A. Arteriole
B. Veins
C. Capillaries (Correct Answer)
D. Venules

Explanation: ***Capillaries*** - Blood flow is slowest in capillaries due to their **large total cross-sectional area**, allowing sufficient time for efficient **exchange of nutrients, gases, and waste products** between blood and tissues. - Despite their individual small diameter, the combined area of millions of capillaries significantly reduces the overall velocity of blood flow. *Arteriole* - **Arterioles** are designed to **regulate blood flow** into capillary beds by constricting and dilating, but blood velocity is still relatively high compared to capillaries. - While smaller than arteries, the **cross-sectional area** of individual arterioles does not collectively exceed that of the major arteries enough to cause the slowest flow rate in the circulatory system. *Veins* - Blood flow in **veins** is generally faster than in capillaries, and is aided by muscle pumps and valves, as they collect blood from the capillary beds. - Although veins have a larger total capacity than arteries, the **velocity of blood flow increases** as blood returns to the heart through progressively larger vessels. *Venules* - **Venules** collect blood from capillaries and begin the return journey to the heart, with blood flow velocity starting to increase as they merge into larger veins. - While slightly faster than in capillaries, the flow in venules is still relatively slow compared to larger veins and arteries, but not the slowest in the system due to their **collecting function and relatively small combined cross-sectional area compared to the entire capillary network**.

Question 125: In a healthy person, arterial baroreceptor activity is seen at what stage of the cardiac cycle?

A. None of the options
B. Diastole
C. Systole
D. Both (Correct Answer)

Explanation: ***Both*** - Baroreceptors respond to changes in **arterial pressure**, which fluctuates throughout both systole and diastole. - The baroreflex mechanism is continuously active, monitoring and adjusting blood pressure through changes in **heart rate**, **contractility**, and **vascular resistance** during both phases of the cardiac cycle. *Systole* - While baroreceptors are active during systole due to the **rise in arterial pressure**, they are not exclusively active during this phase. - Their primary role is to detect and respond to the **peak pressure** changes that occur during **ejection**, but their activity extends beyond this. *Diastole* - Baroreceptors continue to fire during diastole, albeit at a lower rate, as blood pressure falls; however, their activity is not limited to this phase alone. - They monitor the **decline in pressure** to help regulate the overall mean arterial pressure, not just the trough. *None of the options* - This option is incorrect because arterial baroreceptors are indeed active and crucial for blood pressure regulation throughout the entire cardiac cycle, encompassing both systole and diastole. - Their continuous monitoring is essential for maintaining **hemodynamic stability**.

Question 126: By what percentage can cardiac output increase in a healthy adult during intense physical activity compared to resting levels?

A. 300 - 400 % (Correct Answer)
B. 0 - 50 %
C. 50 - 100 %
D. 100 - 200 %

Explanation: ***300 - 400 %*** - In a healthy adult, **cardiac output** can increase remarkably during intense physical activity. - The heart can increase its output by **3 to 4 times** (or 300-400%) above resting levels during peak exertion. - At rest, cardiac output is approximately **5 L/min**, but during maximal exercise, it can reach **20-25 L/min** in well-conditioned individuals. - This represents the heart's **reserve capacity** to meet increased metabolic demands during exercise. *0 - 50 %* - This range represents a very **limited increase** in cardiac output and would be indicative of significant underlying cardiac impairment or **heart failure**. - A healthy individual would experience a much greater increase in cardiac output during intense activity than this small percentage. *50 - 100 %* - This range also suggests a **suboptimal cardiac response** for a healthy adult undergoing intense physical activity. - While some increase is present, it does not reflect the full capacity of a healthy cardiovascular system to adapt to extreme demands. *100 - 200 %* - While a 100-200% increase is substantial, it still **underestimates the maximal capacity** achievable in a healthy, well-conditioned individual during intense physical exertion. - The heart has a greater capacity for increasing its output to meet metabolic demands during peak exercise.