Which of the following is an example of a physiologic shunt?
a. A ventricular septal defect
b. Blood returning from the inferior vena cava to the right atrium
c. A septal infarct
d. Thebesian vessels returning deoxygenated blood to the left ventricle
D
The thebesian vessels return blood to the left ventricle. The mixing of unoxygenated blood with freshly oxygenated blood is called a physiologic shunt. A ventricular septal defect (VSD) allows mixing of blood from both ventricles. The clinical impact depends on the size of the intracardiac shunt. A VSD is a congenital opening between the ventricles; a ventricular septal rupture can occur as a complication of a large anterior wall myocardial infarction.
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