BIOD 152 – Module 4 Examination | Portage Learning | 2026-2027 Edition A+ Graded • Verified Answers
BIOD 152 Essential Human Anatomy & Physiology II with Lab
Module 4 Examination
Portage Learning • Comprehensive 120-Question Practice Exam
2026–2027 Edition • A+ Graded • Verified Answers with Detailed Rationales
Instructions: This examination consists of 120 multiple-choice questions distributed across seven sections covering
cardiovascular anatomy and physiology, blood composition, lymphatic/immune systems, and endocrine regulation.
Each question has exactly one best answer (A–D). Cognitive distribution: 25% recall, 50% application, 25% analysis.
Approximately 70% of items are scenario-based to mirror the Portage Learning BIOD 152 Module 4 format. After
each question, the correct answer is identified and followed by a BIOD 152-specific A&P rationale covering
anatomical relationships, physiological mechanisms, and clinical correlations.
Section Topic Questions
1 CV System – Heart Anatomy & Blood Flow Q1 – Q30 (30)
2 CV System – Cardiac Physiology Q31 – Q45 (15)
3 CV System – Blood Vessels & Hemodynamics Q46 – Q65 (20)
4 Blood Composition & Function Q66 – Q80 (15)
5 Lymphatic System & Immunity Q81 – Q95 (15)
6 Endocrine System – Hormones & Regulation Q96 – Q110 (15)
7 Comprehensive Integration & Case Studies Q111 – Q120 (10)
Section 1: Cardiovascular System – Heart Anatomy and Blood Flow
Heart Chambers, Valves, Great Vessels, Pulmonary/Systemic Circuits, & Fetal Circulation (Q1–Q30)
Q1: A patient presents with a superior vena cava obstruction. Blood returning from the upper body would be unable
to enter which heart chamber first?
A. Left atrium
B. Right atrium [CORRECT]
C. Right ventricle
D. Left ventricle
Correct Answer: B — B. Right atrium [CORRECT]
Rationale: Deoxygenated blood from the upper body drains via the superior vena cava directly into the right atrium, the
first chamber of the heart receiving systemic venous return. The left atrium receives oxygenated blood from the
pulmonary veins, while the ventricles receive blood from their respective atria through the AV valves. An SVC
obstruction impairs systemic venous return to the right atrium, causing upper-body congestion.
Page 1
,BIOD 152 – Module 4 Examination | Portage Learning | 2026-2027 Edition A+ Graded • Verified Answers
Q2: During a cardiac catheterization, a catheter is advanced from the right femoral vein. After passing through the
IVC, what is the correct sequence of structures the catheter traverses to reach the pulmonary trunk?
A. Right atrium → mitral valve → left ventricle → aorta
B. Right atrium → tricuspid valve → right ventricle → pulmonary valve [CORRECT]
C. Right atrium → pulmonary valve → right ventricle → tricuspid valve
D. Right ventricle → tricuspid valve → right atrium → pulmonary trunk
Correct Answer: B — B. Right atrium → tricuspid valve → right ventricle → pulmonary valve
[CORRECT]
Rationale: Venous blood enters the right atrium from the IVC, then flows through the tricuspid (right AV) valve into the
right ventricle. During ventricular systole, the pulmonary valve opens, ejecting blood into the pulmonary trunk. The
mitral valve and aorta belong to the left side of the heart; reversing the valve order (option C) contradicts the
unidirectional flow maintained by the heart's valves.
Q3: Which valve prevents backflow of blood from the aorta into the left ventricle during ventricular diastole?
A. Mitral (bicuspid) valve
B. Tricuspid valve
C. Aortic semilunar valve [CORRECT]
D. Pulmonary semilunar valve
Correct Answer: C — C. Aortic semilunar valve [CORRECT]
Rationale: The aortic semilunar valve, located between the left ventricle and the aorta, closes during ventricular
diastole when aortic pressure exceeds ventricular pressure, preventing regurgitation into the left ventricle. The mitral
valve prevents backflow from the left ventricle to the left atrium; the pulmonary valve guards the right
ventricle-pulmonary trunk junction; the tricuspid valve is on the right AV side.
Q4: A newborn is diagnosed with a patent ductus arteriosus (PDA). In fetal circulation, this vessel shunts blood from
the pulmonary trunk to the aorta. Which structure functions as a shunt between the right and left atria in the fetus?
A. Foramen ovale [CORRECT]
B. Ductus venosus
C. Ductus arteriosus
D. Umbilical vein
Correct Answer: A — A. Foramen ovale [CORRECT]
Rationale: The foramen ovale is the interatrial shunt allowing fetal blood to bypass the nonfunctional lungs by moving
from the right atrium to the left atrium. After birth, rising pulmonary vascular resistance falls and left atrial pressure
rises, functionally closing the foramen ovale (later anatomically sealed as the fossa ovalis). The ductus venosus shunts
portal/umbilical blood, the ductus arteriosus connects pulmonary trunk to aorta, and the umbilical vein carries
oxygenated placental blood.
Page 2
,BIOD 152 – Module 4 Examination | Portage Learning | 2026-2027 Edition A+ Graded • Verified Answers
Q5: The fossa ovalis is a remnant of the fetal foramen ovale. After birth, failure of this structure to close properly
results in which condition?
A. Atrial septal defect (ASD) [CORRECT]
B. Ventricular septal defect (VSD)
C. Patent ductus arteriosus (PDA)
D. Coarctation of the aorta
Correct Answer: A — A. Atrial septal defect (ASD) [CORRECT]
Rationale: Incomplete closure of the foramen ovale after birth leaves an atrial septal defect (ASD), allowing persistent
left-to-right (or right-to-left) shunting between atria. A VSD involves the interventricular septum, PDA is a patent ductus
arteriosus, and coarctation is a narrowing of the aorta. ASDs may be asymptomatic or cause right-heart volume
overload and pulmonary hypertension over time.
Q6: Which great vessel carries oxygenated blood into the heart?
A. Superior vena cava
B. Inferior vena cava
C. Pulmonary veins [CORRECT]
D. Pulmonary trunk
Correct Answer: C — C. Pulmonary veins [CORRECT]
Rationale: The pulmonary veins are the only veins in the body that carry oxygenated blood, transporting it from the
lungs to the left atrium. Both venae cavae carry deoxygenated systemic blood into the right atrium; the pulmonary trunk
carries deoxygenated blood from the right ventricle to the lungs. This arrangement is essential to the dual circulatory
loop.
Q7: A cardiologist identifies the right coronary artery during angiography. Which structures does this vessel
primarily supply?
A. Left atrium and left ventricle
B. Right atrium, right ventricle, and the conduction system (SA and AV nodes) [CORRECT]
C. Anterior wall of the left ventricle only
D. Posterior interventricular septum and lateral left ventricle
Correct Answer: B — B. Right atrium, right ventricle, and the conduction system (SA and AV nodes)
[CORRECT]
Rationale: The right coronary artery (RCA) supplies the right atrium, most of the right ventricle, and typically the SA
node (~55%) and AV node (~90%). The left coronary artery supplies the left side; its anterior interventricular (LAD)
branch supplies the anterior left ventricle, while the circumflex branch supplies the lateral and posterior left ventricle.
Conduction system dominance is a key reason RCA occlusion can cause life-threatening arrhythmias.
Q8: Occlusion of the left anterior descending (LAD) artery is colloquially called the 'widow-maker.' This vessel is a
branch of which artery?
A. Right coronary artery
B. Left coronary artery [CORRECT]
C. Circumflex artery
D. Right marginal artery
Correct Answer: B — B. Left coronary artery [CORRECT]
Rationale: The LAD (anterior intererventricular artery) branches from the left coronary artery and supplies the anterior
wall of the left ventricle and most of the interventricular septum. The circumflex is the other major branch of the left
coronary artery. The right coronary artery gives rise to the right marginal and posterior interventricular branches.
Proximal LAD occlusion causes massive anterior wall ischemia.
Page 3
, BIOD 152 – Module 4 Examination | Portage Learning | 2026-2027 Edition A+ Graded • Verified Answers
Q9: Which structure forms the posterior surface of the heart and is also known as the anatomical base?
A. Apex of the left ventricle
B. Left atrium [CORRECT]
C. Right ventricle
D. Anterior interventricular sulcus
Correct Answer: B — B. Left atrium [CORRECT]
Rationale: The left atrium forms most of the heart's posterior surface (anatomical base), lying anterior to the
esophagus; this relationship is exploited in transesophageal echocardiography. The apex is formed by the tip of the left
ventricle and points inferiorly, anteriorly, and to the left. The interventricular sulci mark the boundary between ventricles
on the heart's surface.
Q10: The pericardial cavity normally contains 15-50 mL of fluid. What is the primary function of this fluid?
A. To supply nutrients to the myocardium
B. To provide lubrication that reduces friction during heart movement [CORRECT]
C. To generate the electrical impulses of the heart
D. To oxygenate the epicardium
Correct Answer: B — B. To provide lubrication that reduces friction during heart movement [CORRECT]
Rationale: Pericardial fluid, secreted by the serous pericardium's parietal and visceral layers, lubricates the heart's
continuous movement within the pericardial sac, reducing friction. Coronary vessels supply myocardial nutrients and
oxygen; the SA node generates electrical impulses; gas exchange for the epicardium occurs via diffusion from
coronary capillaries, not pericardial fluid.
Q11: A patient in the ICU has a pulmonary artery catheter (Swan-Ganz). Pressure readings from the wedge position
reflect which chamber's pressure?
A. Right atrium
B. Right ventricle
C. Left atrium [CORRECT]
D. Pulmonary trunk
Correct Answer: C — C. Left atrium [CORRECT]
Rationale: When the pulmonary artery catheter balloon is wedged in a branch of the pulmonary artery, it occludes
flow, creating a continuous static column from the catheter tip through the pulmonary capillary bed, pulmonary veins, to
the left atrium. Therefore the pulmonary capillary wedge pressure (PCWP) approximates left atrial pressure, an
indicator of left ventricular preload.
Q12: During fetal circulation, the ductus venosus allows blood to bypass which organ?
A. Lungs
B. Liver [CORRECT]
C. Kidneys
D. Spleen
Correct Answer: B — B. Liver [CORRECT]
Rationale: The ductus venosus shunts oxygenated placental blood from the umbilical vein directly into the inferior
vena cava, bypassing the liver's hepatic circulation so the most oxygen-rich blood reaches the fetal heart and brain.
The foramen ovale and ductus arteriosus bypass the lungs; the kidneys and spleen are not bypassed by a dedicated
fetal shunt.
Page 4
BIOD 152 Essential Human Anatomy & Physiology II with Lab
Module 4 Examination
Portage Learning • Comprehensive 120-Question Practice Exam
2026–2027 Edition • A+ Graded • Verified Answers with Detailed Rationales
Instructions: This examination consists of 120 multiple-choice questions distributed across seven sections covering
cardiovascular anatomy and physiology, blood composition, lymphatic/immune systems, and endocrine regulation.
Each question has exactly one best answer (A–D). Cognitive distribution: 25% recall, 50% application, 25% analysis.
Approximately 70% of items are scenario-based to mirror the Portage Learning BIOD 152 Module 4 format. After
each question, the correct answer is identified and followed by a BIOD 152-specific A&P rationale covering
anatomical relationships, physiological mechanisms, and clinical correlations.
Section Topic Questions
1 CV System – Heart Anatomy & Blood Flow Q1 – Q30 (30)
2 CV System – Cardiac Physiology Q31 – Q45 (15)
3 CV System – Blood Vessels & Hemodynamics Q46 – Q65 (20)
4 Blood Composition & Function Q66 – Q80 (15)
5 Lymphatic System & Immunity Q81 – Q95 (15)
6 Endocrine System – Hormones & Regulation Q96 – Q110 (15)
7 Comprehensive Integration & Case Studies Q111 – Q120 (10)
Section 1: Cardiovascular System – Heart Anatomy and Blood Flow
Heart Chambers, Valves, Great Vessels, Pulmonary/Systemic Circuits, & Fetal Circulation (Q1–Q30)
Q1: A patient presents with a superior vena cava obstruction. Blood returning from the upper body would be unable
to enter which heart chamber first?
A. Left atrium
B. Right atrium [CORRECT]
C. Right ventricle
D. Left ventricle
Correct Answer: B — B. Right atrium [CORRECT]
Rationale: Deoxygenated blood from the upper body drains via the superior vena cava directly into the right atrium, the
first chamber of the heart receiving systemic venous return. The left atrium receives oxygenated blood from the
pulmonary veins, while the ventricles receive blood from their respective atria through the AV valves. An SVC
obstruction impairs systemic venous return to the right atrium, causing upper-body congestion.
Page 1
,BIOD 152 – Module 4 Examination | Portage Learning | 2026-2027 Edition A+ Graded • Verified Answers
Q2: During a cardiac catheterization, a catheter is advanced from the right femoral vein. After passing through the
IVC, what is the correct sequence of structures the catheter traverses to reach the pulmonary trunk?
A. Right atrium → mitral valve → left ventricle → aorta
B. Right atrium → tricuspid valve → right ventricle → pulmonary valve [CORRECT]
C. Right atrium → pulmonary valve → right ventricle → tricuspid valve
D. Right ventricle → tricuspid valve → right atrium → pulmonary trunk
Correct Answer: B — B. Right atrium → tricuspid valve → right ventricle → pulmonary valve
[CORRECT]
Rationale: Venous blood enters the right atrium from the IVC, then flows through the tricuspid (right AV) valve into the
right ventricle. During ventricular systole, the pulmonary valve opens, ejecting blood into the pulmonary trunk. The
mitral valve and aorta belong to the left side of the heart; reversing the valve order (option C) contradicts the
unidirectional flow maintained by the heart's valves.
Q3: Which valve prevents backflow of blood from the aorta into the left ventricle during ventricular diastole?
A. Mitral (bicuspid) valve
B. Tricuspid valve
C. Aortic semilunar valve [CORRECT]
D. Pulmonary semilunar valve
Correct Answer: C — C. Aortic semilunar valve [CORRECT]
Rationale: The aortic semilunar valve, located between the left ventricle and the aorta, closes during ventricular
diastole when aortic pressure exceeds ventricular pressure, preventing regurgitation into the left ventricle. The mitral
valve prevents backflow from the left ventricle to the left atrium; the pulmonary valve guards the right
ventricle-pulmonary trunk junction; the tricuspid valve is on the right AV side.
Q4: A newborn is diagnosed with a patent ductus arteriosus (PDA). In fetal circulation, this vessel shunts blood from
the pulmonary trunk to the aorta. Which structure functions as a shunt between the right and left atria in the fetus?
A. Foramen ovale [CORRECT]
B. Ductus venosus
C. Ductus arteriosus
D. Umbilical vein
Correct Answer: A — A. Foramen ovale [CORRECT]
Rationale: The foramen ovale is the interatrial shunt allowing fetal blood to bypass the nonfunctional lungs by moving
from the right atrium to the left atrium. After birth, rising pulmonary vascular resistance falls and left atrial pressure
rises, functionally closing the foramen ovale (later anatomically sealed as the fossa ovalis). The ductus venosus shunts
portal/umbilical blood, the ductus arteriosus connects pulmonary trunk to aorta, and the umbilical vein carries
oxygenated placental blood.
Page 2
,BIOD 152 – Module 4 Examination | Portage Learning | 2026-2027 Edition A+ Graded • Verified Answers
Q5: The fossa ovalis is a remnant of the fetal foramen ovale. After birth, failure of this structure to close properly
results in which condition?
A. Atrial septal defect (ASD) [CORRECT]
B. Ventricular septal defect (VSD)
C. Patent ductus arteriosus (PDA)
D. Coarctation of the aorta
Correct Answer: A — A. Atrial septal defect (ASD) [CORRECT]
Rationale: Incomplete closure of the foramen ovale after birth leaves an atrial septal defect (ASD), allowing persistent
left-to-right (or right-to-left) shunting between atria. A VSD involves the interventricular septum, PDA is a patent ductus
arteriosus, and coarctation is a narrowing of the aorta. ASDs may be asymptomatic or cause right-heart volume
overload and pulmonary hypertension over time.
Q6: Which great vessel carries oxygenated blood into the heart?
A. Superior vena cava
B. Inferior vena cava
C. Pulmonary veins [CORRECT]
D. Pulmonary trunk
Correct Answer: C — C. Pulmonary veins [CORRECT]
Rationale: The pulmonary veins are the only veins in the body that carry oxygenated blood, transporting it from the
lungs to the left atrium. Both venae cavae carry deoxygenated systemic blood into the right atrium; the pulmonary trunk
carries deoxygenated blood from the right ventricle to the lungs. This arrangement is essential to the dual circulatory
loop.
Q7: A cardiologist identifies the right coronary artery during angiography. Which structures does this vessel
primarily supply?
A. Left atrium and left ventricle
B. Right atrium, right ventricle, and the conduction system (SA and AV nodes) [CORRECT]
C. Anterior wall of the left ventricle only
D. Posterior interventricular septum and lateral left ventricle
Correct Answer: B — B. Right atrium, right ventricle, and the conduction system (SA and AV nodes)
[CORRECT]
Rationale: The right coronary artery (RCA) supplies the right atrium, most of the right ventricle, and typically the SA
node (~55%) and AV node (~90%). The left coronary artery supplies the left side; its anterior interventricular (LAD)
branch supplies the anterior left ventricle, while the circumflex branch supplies the lateral and posterior left ventricle.
Conduction system dominance is a key reason RCA occlusion can cause life-threatening arrhythmias.
Q8: Occlusion of the left anterior descending (LAD) artery is colloquially called the 'widow-maker.' This vessel is a
branch of which artery?
A. Right coronary artery
B. Left coronary artery [CORRECT]
C. Circumflex artery
D. Right marginal artery
Correct Answer: B — B. Left coronary artery [CORRECT]
Rationale: The LAD (anterior intererventricular artery) branches from the left coronary artery and supplies the anterior
wall of the left ventricle and most of the interventricular septum. The circumflex is the other major branch of the left
coronary artery. The right coronary artery gives rise to the right marginal and posterior interventricular branches.
Proximal LAD occlusion causes massive anterior wall ischemia.
Page 3
, BIOD 152 – Module 4 Examination | Portage Learning | 2026-2027 Edition A+ Graded • Verified Answers
Q9: Which structure forms the posterior surface of the heart and is also known as the anatomical base?
A. Apex of the left ventricle
B. Left atrium [CORRECT]
C. Right ventricle
D. Anterior interventricular sulcus
Correct Answer: B — B. Left atrium [CORRECT]
Rationale: The left atrium forms most of the heart's posterior surface (anatomical base), lying anterior to the
esophagus; this relationship is exploited in transesophageal echocardiography. The apex is formed by the tip of the left
ventricle and points inferiorly, anteriorly, and to the left. The interventricular sulci mark the boundary between ventricles
on the heart's surface.
Q10: The pericardial cavity normally contains 15-50 mL of fluid. What is the primary function of this fluid?
A. To supply nutrients to the myocardium
B. To provide lubrication that reduces friction during heart movement [CORRECT]
C. To generate the electrical impulses of the heart
D. To oxygenate the epicardium
Correct Answer: B — B. To provide lubrication that reduces friction during heart movement [CORRECT]
Rationale: Pericardial fluid, secreted by the serous pericardium's parietal and visceral layers, lubricates the heart's
continuous movement within the pericardial sac, reducing friction. Coronary vessels supply myocardial nutrients and
oxygen; the SA node generates electrical impulses; gas exchange for the epicardium occurs via diffusion from
coronary capillaries, not pericardial fluid.
Q11: A patient in the ICU has a pulmonary artery catheter (Swan-Ganz). Pressure readings from the wedge position
reflect which chamber's pressure?
A. Right atrium
B. Right ventricle
C. Left atrium [CORRECT]
D. Pulmonary trunk
Correct Answer: C — C. Left atrium [CORRECT]
Rationale: When the pulmonary artery catheter balloon is wedged in a branch of the pulmonary artery, it occludes
flow, creating a continuous static column from the catheter tip through the pulmonary capillary bed, pulmonary veins, to
the left atrium. Therefore the pulmonary capillary wedge pressure (PCWP) approximates left atrial pressure, an
indicator of left ventricular preload.
Q12: During fetal circulation, the ductus venosus allows blood to bypass which organ?
A. Lungs
B. Liver [CORRECT]
C. Kidneys
D. Spleen
Correct Answer: B — B. Liver [CORRECT]
Rationale: The ductus venosus shunts oxygenated placental blood from the umbilical vein directly into the inferior
vena cava, bypassing the liver's hepatic circulation so the most oxygen-rich blood reaches the fetal heart and brain.
The foramen ovale and ductus arteriosus bypass the lungs; the kidneys and spleen are not bypassed by a dedicated
fetal shunt.
Page 4
