355.The heart has nociceptive nerves called c-fibers that sense extracellu-
lar ATP that leaks from cells that die due to lack of oxygen. In angina pec-
toris, the pain that is often referred down the left arm, is mediated by
increased activity in the c-fibers in which of the following nerves?
a. Carotid branch of the glossopharyngeal nerves
b. Greater splanchnic nerves
c. Phrenic nerves
d. Cardiac plexus
e. Vagus nerve and recurrent laryngeal nerves
356.You deliver a 6 lb, 6 oz fullterm baby girl. Her breathing rate is
slightly elevated, and when she cries her lips turn blue. Her toes are also
bluish. You immediately send for a pediatric cardiologist who orders an
echocardiogram. The sonographer, who immediately performs the echo
study, is convinced that the baby girl has transposition of her great vessels.
Which of the following is the most likely additional heart defect that is
present in the newborn girl?
a. Overriding aorta
b. Ventricular septal defect
c. Ligamentum arteriosum
d. Coarctation of the aorta
e. Aortic aneurysm
357.To improve the blood flow to the interventricular septum, a coronary
bypass procedure is elected. During surgery the anterior interventricular
artery is located and prepared to receive a graft. The vessel lying adjacent
to the anterior interventricular artery is which of the following?
a. Anterior cardiac vein
b. Coronary sinus
c. Great cardiac vein
d. Middle cardiac vein
e. Small cardiac vein
Thorax 471