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Guyton & Hall: Textbook of Medical Physiology, 11th Edition

UNIT II: Membrane Physiology, Nerve, and Muscle

MULTIPLE CHOICE

1. The diffusion rate of a substance will decrease if there is an increase in which one of
the following?
a. Concentration gradient
b. Length of the diffusion pathway
c. Surface area available for diffusion
d. Temperature

ANS: B
The diffusion rate of a substance is directly proportional to the concentration gradient, the
temperature, and the surface area available for diffusion, and it is inversely proportional
to the length of the diffusion pathway.

2. Which of the following would demonstrate a maximum rate of diffusion at very high
substrate concentrations?
a. Simple diffusion only
b. Facilitated diffusion only
c. Both simple and facilitated diffusion
d. Neither simple nor facilitated diffusion

ANS: B
Because facilitated diffusion involves a membrane carrier protein, the maximum rate of
facilitated diffusion of a substance through a cell membrane is determined by the rate at
which the carrier protein can move the substrate through the membrane. Simple diffusion
involves no specific carrier proteins, and the rate of simple diffusion increases in
proportion to the concentration gradient, without limit.

3. Which one of the following involves solute transport across a cell membrane using
energy derived directly from the hydrolysis of ATP?
a. Simple diffusion
b. Facilitated diffusion
c. Secondary active transport
d. Primary active transport

ANS: D

Copyright 2006 by Elsevier, Inc.


Additional Test Bank 2

Primary active transport is capable of moving substances across a cell membrane, even
against an electrochemical gradient, because of the direct use of the energy released by
the breakdown of ATP or other high-energy compounds. Secondary active transport uses
the energy stored in ion gradients, which were originally created by the action of primary
active transporters. Simple diffusion and facilitated diffusion use the energy stored in
substrate concentrations, and when the substrate concentrations are equal across the
membrane, the net rate of simple or facilitated diffusion is zero.

4. For each complete cycle of activity, the membrane sodium-potassium ATPase moves
____ sodium ions out of the cell and ____ potassium ions into the cell.
a. Three three
b. Three two
c. Two three
d. Two two

ANS: B
Sodium-potassium ATPase moves three sodium ions out of the cell and two potassium
ions into the cell with each cycle, allowing this membrane transporter to contribute to the
regulation of cell volume and to the resting membrane potential.

5. The resting membrane potential of a typical central nervous system neuron is close to
the Nernst potential for potassium primarily because of which one of the following?
a. The action of the sodium-potassium ATPase
b. Relatively high resting membrane potassium permeability
c. A membrane concentration gradient that favors potassium entry into the cell
d. Unrestricted diffusion of chloride ions

ANS: B
Because the nerve cell membrane is only slightly permeable to sodium ions and is quite
permeable to potassium ions, the outward diffusion of potassium ions, making the interior
of the cell more negative, contributes more to the resting membrane potential than the
inward diffusion of sodium ions.

6. According to the Goldman equation, a decrease in the extracellular concentration of


potassium ions causes the nerve cell membrane to ____, moving the membrane
potential ____ the threshold for initiation of an action potential.
a. Depolarize closer to
b. Depolarize away from
c. Hyperpolarize closer to
d. Hyperpolarize away from

ANS: D
A decrease in the extracellular potassium concentration makes the membrane potential
more negative and hyperpolarizes the cell membrane, moving the membrane potential
away from the threshold potential for activation and making the cell less excitable.

Copyright 2006 by Elsevier, Inc.


Additional Test Bank 3

7. In a typical nerve cell, the repolarization phase of the action potential is most likely
caused by which one of the following?
a. Efflux of potassium ions from the cell
b. Opening of voltage-gated sodium channels
c. Decreased membrane potassium conductance
d. Opening of the sodium inactivation gates

ANS: A
The repolarization phase of the nerve cell action potential is dominated by a high
potassium conductance due to opening of voltage-gated potassium channels and closure
of the voltage-gated sodium channels. Opening of the voltage-gated sodium channels
causes the initial depolarization. Opening of the inactivation gates occurs when
repolarization is nearly completed, but it does not cause repolarization to occur.

8. The absolute refractory period in a nerve cell action potential primarily is caused by
which one of the following?
a. Hyperpolarization of the cell membrane
b. Closure of voltage-gated potassium channels
c. Inactivation of the voltage-gated sodium channels
d. Inhibition of the sodium-potassium ATPase

ANS: C
Inactivation of the voltage-gated sodium channels, which occurs with depolarization, is
not reversed until the membrane potential has been returned to or is near the original
resting membrane potential. During this time, the nerve cell membrane is absolutely
refractory, and no new action potentials can be generated.

9. Skeletal muscles are considered striated because they


a. Are contained within a sarcolemma
b. Are made up of myofibrils, actin, and myosin
c. Contain light and dark bands that polarize light differently
d. Contract by action of the cross-bridges

ANS: C
A is incorrect because every muscle cellskeletal, smooth, or cardiacis contained
within a sarcolemma. B is incorrect because, although actin and myosin make up the
fibers, the arrangement of the myofibrils is the important concept, not just that they are
contained in the cells. D is incorrect because, although skeletal muscles do contract by
action of the cross-bridges, the function is not the determining cause of their striated
appearance.

Copyright 2006 by Elsevier, Inc.


Additional Test Bank 4

10. You are seeing Jessica Borland because she has Duchenne's muscular dystrophy and
is unable to lift her arm above her head due to weakness. Normally, the cross-bridge
action required for her to perform this activity results from the binding of calcium
ions to ______ to allow binding and/or activation of the ______.
a. Troponin I tropomyosin
b. Troponin C H+ ions
c. Troponin T ATPase enzyme
d. Troponin-tropomyosin complex myosin

ANS: D
A is incorrect because troponin I is responsible for binding the troponin complex to actin,
and it does not require calcium ions to perform this function. Tropomyosin does not
require activation. B is incorrect because troponin C has a high affinity for calcium ions,
but it does not bind to or activate H+ ions. C is incorrect because troponin T has a strong
affinity to bind to tropomyosin, but it is not involved in the binding and/or activation of
ATPase, which is located in the myosin head.

11. During muscle contraction, myofibrils slide


a. Into each other like a telescope
b. Over each other because of movement triggered by H+ ions
c. Over each other by action of the actin head's cocking action
d. Over each other by action of the myosin head's cocking action

ANS: D
A is incorrect because the myofilaments do not touch each other except at cross-bridges.
B is incorrect because the action is triggered by Ca2+ ions, not H+. C is incorrect because
actin is a thin, double-helical molecule with troponin/tropomyosin complexes attached;
they do not have a "head" to cock.

12. Tiffany Smith asks you why she is unable to pick up a book from her bedside table
using just her biceps with her elbow flexed to 90 degrees, although she is able to lift
the book if her elbow is straight. What is your explanation?
a. With her elbow bent, the overlap of her actin and myosin filaments in her biceps
muscle is suboptimal, and she is unable to develop adequate tension in her muscle
to overcome the weight of the book, resulting in an eccentric contraction of her
muscle.
b. A straight elbow positions the biceps muscle to perform at its optimal length,
allowing the greatest tension development.
c. With her elbow bent more than 150 degrees, she must first perform an isometric
biceps contraction before the filaments in her muscle will be able to bind and move
her arm.
d. A bent elbow generates more tension than normal with forceful contraction
because the I bands are longer.

ANS: B

Copyright 2006 by Elsevier, Inc.


Additional Test Bank 5

A is incorrect because the contraction that would occur in this instance is an isotonic or
isometric contraction, not an eccentric contraction, unless she were lowering the book to
the bedside table. The answer is inconsistent within the distractor. C is incorrect because
tension development does not require an isometric contraction before a concentric
contraction. D is incorrect because a muscle in a position that is shorter than the optimal
position generates less tension due to overlap of the filaments.

13. Jessica asks you why she is able to pick up a small book quickly, but a heavier book
requires more time and effort. Which of the following is the correct answer?
a. The muscle contracts quickly, but no movement occurs until the tension developed
in the muscle is greater than the weight of the load.
b. Muscular contraction is a result of complex molecular interactions resulting in
quickly shortening muscle.
c. Small books weigh less, and the muscle therefore must generate less tension to lift
it than to lift the heavier book, requiring more ATP expenditure.
d. Lifting the larger book requires greater balance on her part and requires more net
ATP than lifting the smaller book.

ANS: A
B is incorrect because it does not answer the question. C is incorrect because it is
internally inconsistent. D is incorrect for this question because this distractor discusses
balance, which is completely out of context of the question because the patient is fully
supported.

14. A muscle twitch results from which of the following?


a. A series of myosin head movements that result in sustained contraction
b. A very fast, single, sudden contraction
c. An increased number of cross-bridge cycles
d. Increased frequency of cross-bridge cycles

ANS: B
A is incorrect because this is the definition of tetany. C is incorrect because this is a
contributor to tetany, not a twitch. D is incorrect because this is a contributor to tetany,
not a twitch.

15. Postural muscles, although having a mixture of fiber types, are predominantly made
up of which of the following?
a. Fast-twitch fibers
b. Slow-twitch fibers
c. Intermediate-twitch fibers
d. Very-fast-twitch fibers

ANS: B
A is incorrect because fast-twitch fibers contract quickly and fatigue quickly. C and D are
incorrect because these types of fibers do not exist.

Copyright 2006 by Elsevier, Inc.


Additional Test Bank 6

16. The primary physiological basis for the length-tension curve of skeletal and cardiac
muscle is which one of the following?
a. Number of motor units activated
b. Cross-sectional area of the muscle fibers
c. Degree of overlap of actin and myosin filaments
d. Frequency of motor unit stimulation

ANS: C
In a striated muscle that contains sarcomeres, the maximum contractile force is achieved
when there is a maximum degree of overlap between the actin and myosin filaments,
allowing a maximum number of cross-bridges to be formed. Cross-sectional area
determines the force of a muscle contraction, but it is not related to muscle fiber length.
The frequency of stimulation affects intracellular calcium concentration and therefore the
force of contraction, but it is not responsible for the length-tension curve.

17. Which one of the following best describes a motor unit?


a. A single muscle fiber and all the motoneurons innervating it
b. All of the sarcomeres in a muscle fiber
c. A single motoneuron and all the muscle fibers it innervates
d. A sarcomere

ANS: C
A motor unit consists of a single somatic motoneuron and all of the skeletal muscle fibers
it innervates. Each skeletal muscle fiber is innervated by one motoneuron, but one
motoneuron can innervate multiple muscle fibers.

Copyright 2006 by Elsevier, Inc.