Pathophysiology & Pharmacology, – 4th-Year Medical Student
Level – Clinical 85 Q&A Set
Anatomy
1. Q: What are the layers of the heart wall?
A: The heart wall consists of three layers: the epicardium (outer layer), myocardium
(muscular middle layer responsible for contraction), and endocardium (inner lining).
2. Q: Describe the flow of blood through the heart chambers.
A: Blood flows from the body into the right atrium, then to the right ventricle, from
where it is pumped to the lungs via the pulmonary artery. Oxygenated blood returns to
the left atrium, flows into the left ventricle, and is then pumped to the body through the
aorta.
3. Q: Which valves prevent backflow of blood from the ventricles to the atria?
A: The atrioventricular (AV) valves - the tricuspid valve on the right and the mitral
(bicuspid) valve on the left side.
4. Q: What is the significance of the sinoatrial (SA) node?
A: The SA node is the heart's natural pacemaker, initiating electrical impulses that cause
atrial contraction.
5. Q: Name the main arteries supplying blood to the heart muscle.
A: The coronary arteries: left coronary artery (dividing into LAD and circumflex) and right
coronary artery.
6. Q: What anatomical feature separates the left and right sides of the heart?
A: The interventricular septum separates the ventricles; the interatrial septum separates
the atria.
7. Q: Where is the baroreceptor located in the carotid sinus?
A: Baroreceptors are stretch-sensitive mechanoreceptors located in the carotid sinus (at
the bifurcation of the common carotid artery), sensing blood pressure changes.
8. Q: Which nerve transmits baroreceptor signals from the carotid sinus to the brainstem?
A: The glossopharyngeal nerve (cranial nerve IX).
9. Q: What is the role of the juxtaglomerular apparatus in the kidney?
A: It regulates blood pressure by sensing sodium levels and releasing renin to activate
the RAAS system when necessary.
, 10. Q: Name the three tunics of blood vessels.
A: Tunica intima (inner), tunica media (middle muscular layer), tunica adventitia (outer
connective tissue).
Hypertension Pathophysiology
11. Q: Define hypertension.
A: Hypertension is persistently elevated arterial blood pressure, typically defined as a
systolic pressure ≥ 140 mmHg or diastolic pressure ≥ 90 mmHg.
12. Q: What are the main classifications of hypertension?
A: Primary (essential) hypertension, with no identifiable cause, and secondary
hypertension, which results from an underlying condition.
13. Q: What role does the renin-angiotensin-aldosterone system (RAAS) play in
hypertension?
A: RAAS increases blood pressure by promoting vasoconstriction (angiotensin II) and
increasing sodium and water retention (aldosterone), raising blood volume.
14. Q: How does sympathetic nervous system activation contribute to hypertension?
A: It raises heart rate and contractility, causes vasoconstriction, and stimulates renin
release, increasing blood pressure.
15. Q: What vascular changes occur in chronic hypertension?
A: Hypertrophy of smooth muscle in arterioles, increased vascular resistance,
endothelial dysfunction, and increased arterial stiffness.
16. Q: How does endothelial dysfunction contribute to hypertension?
A: Reduced nitric oxide production leads to impaired vasodilation and promotes
vasoconstriction.
17. Q: What are the effects of angiotensin II on blood vessels?
A: It causes potent vasoconstriction and stimulates aldosterone secretion, both
increasing blood pressure.
18. Q: Why is salt intake linked to hypertension?
A: High salt intake increases plasma volume by retaining water, elevating blood pressure
in salt-sensitive individuals.
19. Q: What is the role of natriuretic peptides in blood pressure regulation?
A: They promote vasodilation and sodium excretion, lowering blood pressure.