NEET-PG 2013 - Physiology Practice Questions

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: 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: What is the critical closing pressure in the context of capillary physiology?

Pressure below which capillaries close. ***Pressure below which capillaries close*** - The **critical closing pressure** is the lowest pressure at which blood can flow through a capillary. - When the luminal pressure falls below this threshold, the capillary collapses due to **extrinsic tissue pressure** and intrinsic vascular tone. *Arterial pressure minus venous pressure* - This calculation represents the **arteriovenous pressure gradient**, which drives blood flow through a vascular bed. - It does not directly define the point at which capillaries collapse. *Capillary pressure minus venous pressure* - This difference primarily influences filtration and reabsorption of fluids across the capillary wall. - It is not directly related to the **critical closing pressure** of the capillaries. *None of the options* - This is incorrect as one of the provided options accurately defines the **critical closing pressure**.

Q: All are true about baroreceptors, except?

Stimulated when BP decreases. ***Stimulated when BP decreases*** - Baroreceptors are **stretch receptors** located in the walls of the carotid sinus and aortic arch. - They are stimulated by an **increase in blood pressure (BP)**, which causes stretching of the arterial walls, not by a decrease. *Afferents are through sino-aortic nerves* - This statement is **true**. Afferent impulses from the carotid sinus baroreceptors travel via the **glossopharyngeal nerve (IX)**, and those from the aortic arch baroreceptors travel via the **vagus nerve (X)**. - These nerves collectively form the **sino-aortic nerves** that relay information to the brainstem. *Stimulation causes increased vagal discharge* - This statement is **true**. When baroreceptors are stimulated by **increased BP**, they send signals to the cardiovascular center in the medulla. - This leads to increased **parasympathetic (vagal) outflow** to the heart, causing a decrease in heart rate and contractility, and inhibition of sympathetic outflow. *Stimulate nucleus ambiguus* - This statement is **true**. The **nucleus ambiguus** is a brainstem nucleus that contains the cell bodies of preganglionic parasympathetic neurons that contribute to the vagus nerve. - Baroreceptor stimulation leads to activation of the nucleus ambiguus, thereby increasing **vagal output** to the heart.

Q: What is the normal mean velocity of blood flow in the aorta?

40-50 cm/sec. ***40-50 cm/sec*** - This range represents the **normal mean velocity** of blood flow in the **aorta**, reflecting efficient cardiac output and systemic circulation. - Blood flow velocity can vary slightly based on factors like age, cardiac health, and physical activity, but this range is a common physiological benchmark. *100-150 cm/sec* - This velocity is significantly **higher** than normal for mean aortic flow and would typically indicate a state of **hyperdynamic circulation** or specific pathological conditions. - Such elevated velocities might be seen in conditions like severe **aortic stenosis**, where the heart works harder to push blood through a narrowed valve. *200-250 cm/sec* - This range is **pathologically high** for mean aortic blood flow and is not compatible with normal physiological function. - Velocities in this range would strongly suggest a severe **cardiovascular abnormality**, such as critical **aortic stenosis** or a significant **arteriovenous shunt**. *250-300 cm/sec* - This velocity is **extremely high** and far exceeds any normal or even most pathological mean aortic flow rates found in humans. - Such high velocities would likely be associated with a highly turbulent and severely compromised cardiovascular system, potentially leading to **acute circulatory failure**.

Q: Duration of maximum contraction depends upon?

Absolute refractory period. ***Absolute refractory period*** - The duration of **maximum (sustained) contraction** in skeletal muscle depends primarily on the **absolute refractory period** - The absolute refractory period (1-2 ms in skeletal muscle) is much **shorter than the contraction duration** (20-200 ms), allowing for **temporal summation** - When stimuli arrive after the refractory period but before complete relaxation, contractions **summate** to produce **tetanus** (sustained maximum contraction) - A shorter refractory period allows **higher frequency stimulation** → more complete summation → stronger and longer sustained contraction - This is why skeletal muscle can achieve **complete tetanus** at stimulation frequencies of 50-100 Hz *Relative refractory period* - While the relative refractory period affects excitability, it is the **absolute refractory period** that sets the fundamental limit on maximum stimulation frequency - The relative refractory period is less critical for determining the duration of maximum contraction *None of the two* - This is incorrect because the refractory period directly determines the **maximum frequency** at which muscle can be stimulated - Higher stimulation frequency (limited by refractory period) → better temporal summation → sustained maximum contraction (tetanus) - The refractory period is the key factor enabling or limiting the duration of maximum contraction *Both* - While both refractory periods influence excitability, the **absolute refractory period** is the primary determinant - It sets the absolute limit on stimulation frequency and thus the ability to achieve and maintain tetanic contraction

Q: What type of reflex is the righting reflex?

Vestibular reflex. ***Vestibular reflex*** - The **righting reflex** is primarily mediated by the **vestibular system** (labyrinthine apparatus), which detects changes in head position and movement in space. - This reflex helps maintain proper **head and body orientation** relative to gravity, ensuring balance and stability. - Note: Righting reflexes are actually a group of **postural reflexes** that also involve visual, neck proprioceptive, and body proprioceptive inputs, but the **vestibular (labyrinthine) component is the most important** and is often emphasized in medical education. *Cochlear reflex* - The **cochlea** is primarily involved in **hearing**, translating sound vibrations into electrical signals. - The cochlear reflex, such as the **stapedial reflex**, is an auditory protective reflex that dampens loud sounds, not involved in postural control or spatial orientation. *Spinal reflex* - A **spinal reflex** is mediated solely by the **spinal cord** without supraspinal integration (e.g., knee jerk, withdrawal reflex). - The righting reflex requires integration at the **brainstem and higher centers**, involving the vestibular nuclei, and cannot function through spinal cord alone. *None of the options* - This option is incorrect for exam purposes, as the righting reflex is conventionally taught as primarily a **vestibular-mediated postural reflex**. - The vestibular system is the key sensory component for detecting head position changes that trigger righting responses.

Question 1

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 2

Slowest blood flow is seen in?

Accepted Answer

Capillaries

Answer

Arteriole

Answer

Veins

Answer

Venules

Question 3

P wave is due to:

Accepted Answer

Atrial depolarization

Answer

Atrial repolarization

Answer

Ventricular depolarization

Answer

Ventricular repolarization

Question 4

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 5

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 6

What is the critical closing pressure in the context of capillary physiology?

Accepted Answer

Pressure below which capillaries close

Answer

Arterial pressure minus venous pressure

Answer

Capillary pressure minus venous pressure

Answer

None of the options

Question 7

All are true about baroreceptors, except?

Accepted Answer

Stimulated when BP decreases

Answer

Stimulation causes increased vagal discharge

Answer

Stimulate nucleus ambiguus

Answer

Afferents are through sino-aortic nerves

Question 8

What is the normal mean velocity of blood flow in the aorta?

Accepted Answer

40-50 cm/sec

Answer

100-150 cm/sec

Answer

200-250 cm/sec

Answer

250-300 cm/sec

Question 9

Duration of maximum contraction depends upon?

Accepted Answer

Absolute refractory period

Answer

Both

Answer

None of the two

Answer

Relative refractory period

Question 10

What type of reflex is the righting reflex?

Accepted Answer

Vestibular reflex

Answer

Cochlear reflex

Answer

Spinal reflex

Answer

None of the options

NEET-PG 2013 — Physiology