NEET-PG 2013 - Physiology Practice Questions

Q: Which of the following best describes hypoxic pulmonary vasoconstriction?

Reversible pulmonary vasoconstriction due to hypoxia. ***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.

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

Activation of cardiac C-fiber afferents. ***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.

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

300 - 400 %. ***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.

Q: When blood pressure falls below 40 mm Hg, which mechanism of regulation is working?

CNS ischemic reflex. ***CNS ischemic reflex*** - The **CNS ischemic reflex** is activated when blood pressure falls below 60 mmHg, with maximal activation below 40 mmHg, indicating severe ischemia in the brain's vasomotor center. - This reflex elicits an intense **sympathetic vasoconstriction** and cardiac stimulation to prioritize blood flow to the brain even at the expense of other organs. *Chemoreceptor response* - The chemoreceptor reflex is primarily activated by a decrease in **arterial pO2**, an increase in **pCO2**, or a decrease in **pH**. - While it can increase blood pressure, it is not the primary or most profound regulatory mechanism specifically triggered by extremely low blood pressure (below 40 mmHg) to prevent brain ischemia. *Baroreceptor response* - **Baroreceptors** are most sensitive to changes in blood pressure within the normal to moderately hypotensive range (e.g., 60-180 mmHg). - At very low pressures (below 40-50 mmHg), baroreceptors become **less sensitive** or "saturated," and their effectiveness in raising blood pressure significantly diminishes. *None of the options* - This option is incorrect because the **CNS ischemic reflex** specifically functions as a powerful, last-ditch mechanism to maintain cerebral blood flow during severe hypotension which is a life saving reflex during conditions like hemorrhage.

Q: Deoxygenated blood is not seen in which of the following?

Pulmonary vein. ***Pulmonary vein*** - The pulmonary veins carry **oxygenated blood** from the lungs back to the left atrium of the heart. - Their primary function is to transport blood that has undergone **gas exchange** in the lungs, making it rich in oxygen. *Pulmonary artery* - The pulmonary artery carries **deoxygenated blood** from the right ventricle of the heart to the lungs. - This is an exception to the general rule that arteries carry oxygenated blood, as its purpose is to deliver blood for **oxygenation**. *Right atrium* - The right atrium receives **deoxygenated blood** from the systemic circulation via the superior and inferior vena cava. - It acts as a collecting chamber for blood that has supplied oxygen to the body's tissues before it is pumped to the lungs. *Umbilical artery* - The umbilical arteries carry **deoxygenated blood** and waste products from the fetus to the placenta. - In fetal circulation, these arteries are responsible for removing metabolic wastes and carbon dioxide from the fetal circulation.

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

Increased myocardial contractility. ***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.

Q: Slowest blood flow is seen in?

Capillaries. ***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**.

Q: P wave is due to:

Atrial depolarization. **Atrial depolarization** - The **P wave** on an electrocardiogram (ECG) represents the electrical activity associated with the **depolarization of the atria**. - This depolarization leads to **atrial contraction**, pushing blood into the ventricles. *Atrial repolarization* - **Atrial repolarization** also occurs but is usually hidden within the **QRS complex** and thus not separately visible as a distinct wave on a standard ECG. - While it's an electrical event, it does not produce the P wave. *Ventricular depolarization* - **Ventricular depolarization** is represented by the **QRS complex** on an ECG. - This electrical activity leads to **ventricular contraction**, pumping blood out of the heart. *Ventricular repolarization* - **Ventricular repolarization** is represented by the **T wave** on an ECG. - This process allows the ventricles to relax and refill with blood.

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

Both. ***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**.

Q: Which type of nerve fibers are responsible for carrying joint position and vibration sense?

A-beta fibers. ***A-beta fibers*** - **A-beta fibers** are **large-diameter, myelinated** sensory fibers that conduct impulses rapidly. - They are primarily responsible for transmitting **light touch, pressure, joint position (proprioception), and vibration sense**. - **This is the correct answer** because A-beta fibers carry **BOTH joint position AND vibration sense together**. *A-alpha fibers* - **A-alpha fibers** are the **largest and fastest** conducting nerve fibers. - They include **motor nerves to skeletal muscles** and **sensory fibers from muscle spindles (Ia) and Golgi tendon organs (Ib)**. - While Ia fibers (A-alpha) do carry **proprioception from muscle spindles**, they do **NOT carry vibration sense**. - The question asks for fibers carrying **BOTH** joint position **AND** vibration sense, making A-beta the correct answer. *C fibers* - **C fibers** are **small-diameter, unmyelinated** nerve fibers with **slow conduction velocities**. - They are responsible for transmitting **dull, aching pain, temperature, and crude touch**. *A-delta fibers* - **A-delta fibers** are **small-diameter, thinly myelinated** nerve fibers with an intermediate conduction velocity. - They primarily transmit **sharp, fast pain** and **cold temperature sensations**.

Question 1

Which of the following best describes hypoxic pulmonary vasoconstriction?

Accepted Answer

Reversible pulmonary vasoconstriction due to hypoxia

Answer

Irreversible pulmonary vasoconstriction due to hypoxia

Answer

Redirects blood to well-ventilated areas

Answer

Occurs immediately in response to hypoxia

Question 2

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

Accepted Answer

Activation of cardiac C-fiber afferents

Answer

Parasympathetic withdrawal

Answer

Decreased venous return

Answer

Increased sympathetic stimulation

Question 3

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

Accepted Answer

300 - 400 %

Answer

0 - 50 %

Answer

50 - 100 %

Answer

100 - 200 %

Question 4

When blood pressure falls below 40 mm Hg, which mechanism of regulation is working?

Accepted Answer

CNS ischemic reflex

Answer

Chemoreceptor response

Answer

Baroreceptor response

Answer

None of the options

Question 5

Deoxygenated blood is not seen in which of the following?

Accepted Answer

Pulmonary vein

Answer

Pulmonary artery

Answer

Umbilical artery

Answer

Right atrium

Question 6

What physiological mechanism leads to an increase in cardiac output?

Accepted Answer

Increased myocardial contractility

Answer

Inhalation

Answer

Increased parasympathetic activity

Answer

Transitioning from a supine to a standing position

Question 7

Slowest blood flow is seen in?

Accepted Answer

Capillaries

Answer

Arteriole

Answer

Veins

Answer

Venules

Question 8

P wave is due to:

Accepted Answer

Atrial depolarization

Answer

Atrial repolarization

Answer

Ventricular depolarization

Answer

Ventricular repolarization

Question 9

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

Accepted Answer

Both

Answer

None of the options

Answer

Diastole

Answer

Systole

Question 10

Which type of nerve fibers are responsible for carrying joint position and vibration sense?

Accepted Answer

A-beta fibers

Answer

A-alpha fibers

Answer

C fibers

Answer

A-delta fibers

NEET-PG 2013 — Physiology