Which statement is true regarding myocardial functioning in the normal heart, based upon the Frank Starling law?

An increase in afterload results in decreased systolic pressure, which creates a decreased cardiac output.

A decrease in afterload causes the cardiac muscles to hypertrophy, resulting in increased diastolic volume.

An increase in preload results in greater shortening of myocardial fibers, thereby increasing contractility.

A decrease in preload results in increasing diastolic muscle fiber length, which impedes contractility.

Answer and Explanation

The Correct Answer is C

A) An increase in afterload results in decreased systolic pressure, which creates a decreased cardiac output:

This statement is not consistent with the Frank-Starling law. Afterload refers to the resistance against which the heart must pump blood during systole. An increase in afterload typically results in increased systolic pressure, not decreased, as the heart works harder to overcome the increased resistance. However, increased afterload can lead to decreased cardiac output due to the increased work of the heart.

B) A decrease in afterload causes the cardiac muscles to hypertrophy, resulting in increased diastolic volume:

This statement is not consistent with the Frank-Starling law. Afterload refers to the pressure or resistance against which the heart must pump blood during systole. A decrease in afterload typically reduces the workload on the heart, which may lead to reverse remodeling and a reduction in cardiac hypertrophy. Increased diastolic volume may occur due to reduced afterload, but it's not the direct result of hypertrophy.

C) An increase in preload results in greater shortening of myocardial fibers, thereby increasing contractility:

Correct. According to the Frank-Starling law, an increase in preload (end-diastolic volume or stretch of myocardial fibers) leads to greater overlap of actin and myosin filaments within myocardial fibers during systole. This increased overlap results in stronger myocardial contraction (increased contractility), leading to an increased stroke volume and cardiac output.

D) A decrease in preload results in increasing diastolic muscle fiber length, which impedes contractility:

This statement is not consistent with the Frank-Starling law. Preload refers to the degree of stretch of the myocardial fibers at the end of diastole. A decrease in preload would lead to decreased stretch of the myocardial fibers, not increasing diastolic muscle fiber length. Decreased preload typically results in decreased contractility rather than impediment to contractility due to reduced myocardial stretch.

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Correct Answer is D

Explanation

A) Bronchioles:

Bronchioles are small airways in the lungs that lack cartilage and are primarily responsible for conducting air to the alveoli. While changes in bronchioles, such as bronchoconstriction or bronchiolitis, can contribute to airflow limitation in conditions like asthma or chronic bronchitis, they are not primarily associated with the pathophysiological processes of emphysema.

B) Trachea:

The trachea, or windpipe, is the large airway that connects the larynx to the bronchi. It serves as a conduit for air movement into and out of the lungs but is not directly involved in gas exchange. Changes in the trachea are not typically associated with the pathophysiological processes of emphysema.

C) Bronchi:

Bronchi are larger airways in the lungs that branch off from the trachea and further divide into bronchioles. While chronic bronchitis, a common comorbidity of emphysema in chronic obstructive pulmonary disease (COPD), primarily affects the bronchi, it is not the primary structure associated with the pathophysiological processes of emphysema.

D) Alveoli:

Correct. Emphysema is a type of COPD characterized by the destruction of alveolar walls, leading to enlarged airspaces and loss of lung elasticity. This structural damage results in decreased surface area for gas exchange and impaired diffusion of oxygen and carbon dioxide across the alveolar-capillary membrane. Alveolar destruction in emphysema leads to poor gas exchange and contributes to the characteristic symptoms of dyspnea, hypoxemia, and hypercapnia in affected individuals. Therefore, the alveoli are directly associated with the pathophysiological processes of emphysema

A. Shivering. B. Purulent drainage. C. Temperature of 102° F (37.8° C). D. Redness and localized heat.

Correct Answer is D

Explanation

A) Shivering:

Shivering is not a normal inflammatory response to wound healing. It may indicate systemic symptoms such as fever or chills, which could be indicative of infection or other complications.

B) Purulent drainage:

Purulent drainage (pus) is often a sign of infection rather than a normal inflammatory response to wound healing. While some serous or serosanguinous drainage may be expected initially, purulent drainage suggests an abnormal response.

C) Temperature of 102° F (37.8° C):

A temperature of 102° F (37.8° C) is indicative of fever, which can occur in response to infection or inflammation. While fever is part of the inflammatory response, it is not necessarily considered a normal finding in the context of wound healing and may indicate an abnormal response such as infection.

D) Redness and localized heat:

Correct. Redness (erythema) and localized heat are typical signs of the inflammatory phase of wound healing. Inflammation is a normal response to tissue injury and is characterized by increased blood flow to the area, resulting in redness and warmth. These signs indicate that the body's immune response is active and working to repair the injured tissue.

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Which statement is true regarding myocardial functioning in the normal heart, based upon the Frank Starling law?

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