Human Anatomy and Physiology 11th Edition Elaine N. Marieb Katja Hoehn TEST BANK by ACADEMIAMILL

TEST BANK

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 1.1 Using Figure 1.1, match the following cavities: 1) Thoracic cavity.

2) Cranial cavity.

3) Abdominal cavity.

4) Vertebral cavity.

Figure 1.2 Using Figure 1.2, match the following descriptions to the most appropriate letter on the diagram: 5) Information about body temperature is sent through afferent pathways to the brain.

6) Free nerve endings in the skin detect changes in skin temperature (getting warmer).

7) Appropriate response information is sent through efferent pathways.

8) A change in the temperature of the external environment (getting warmer).

9) Sweat glands are stimulated as well as blood being distributed to the skin to allow cooling of the body to return the body's temperature to a physiological level.

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following systems to their functions: 10) Provides the force to move bones about their joints.

A) Nervous

10)

B) Integumentary 11) Responds to environmental changes by transmitting appropriate electrical impulses. 12) Provides a ridged framework to support the body and stores minerals.

11) C) Muscular D) Skeletal 12)

13) Prevents water loss, entry of germs into the body and synthesizes vitamin D.

13)

Match the following systems to their functions: 14) Controls the body with chemical molecules called hormones.

A) Endocrine

14)

B) Lymphatic 15) Delivers oxygen and nutrients to the tissues. 16) A functional organ system which provides a means of protecting us from foreign invaders.

15) C) Cardiovascular D) Immune

17) Picks up and cleans excess fluid from tissues.

16)

17)

Match the following examples of feedback mechanisms: 18) Used for changes in blood glucose levels.

A) Negative feedback

18)

B) Positive feedback 19) Used for changes in blood pressure.

19)

20) Used for blood clotting.

20)

21) Used for childbirth.

21)

Match the following systems and organs: 22) Arteries, veins, heart.

A) Cardiovascular

23) Trachea, bronchi, alveoli.

B) Endocrine

24) Adrenal glands, pancreas, pituitary.

C) Urinary

25) Esophagus, large intestine, rectum.

D) Digestive

26) Kidneys, bladder, ureters.

E) Respiratory

22) 23) 24) 25) 26)

Match the following cavities and organs: 27) Stomach.

A) Abdominal

28) Heart.

B) Thoracic

27) 28)

29) Uterus.

A) Thoracic

30) Brain.

B) Cranial

31) Lungs.

C) Pelvic

29) 30) 31)

Match the following regional terms and common terms: 32) Arm.

A) Thoracic

33) Buttock.

B) Gluteal

34) Head.

C) Brachial

35) Knee (anterior aspect).

D) Patellar

36) Chest.

E) Cephalic

32) 33) 34) 35) 36)

Match the regional/directional terms and examples: 37) The bridge of the nose is ________ to the left eye.

A) Medial

37)

B) Distal 38) The upper arm is ________ to the forearm.

C) Anterior

39) The lungs are ________ to the heart.

D) Lateral

39)

40) The fingers are ________ to the wrist.

E) Proximal

40)

38)

41) The stomach is ________ to the spine.

41)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 42) Positive feedback mechanisms tend to enhance the original stimulus so that the response is accelerated.

42)

43) Digital Subtraction Angiography (DSA) imaging is most useful in discovering obstructed blood supplies in organs and tissues.

43)

44) The elbow is proximal to the shoulder.

44)

45) The part of the serous membrane that lines the peritoneal cavity wall is called visceral peritoneum.

45)

46) A major function of serous membranes is to decrease friction.

46)

47) The right hypochondriac region contains the majority of the stomach.

47)

48) Lungs carry out an excretory function.

48)

49) Embryology concerns the structural changes that occur in an individual from conception through old age.

49)

50) A tissue consists of groups of similar cells that have a common function.

50)

51) It is important for any organism to maintain its boundaries, so that its internal environment remains distinct from the external environment surrounding it.

51)

52) Without some sort of negative feedback mechanism, it would be impossible to keep our body chemistry in balance.

52)

53) Responsiveness or irritability is the ability to sense changes in the environment and then respond to them.

53)

54) The epigastric region is superior to the umbilical region.

54)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 55) Histology would be best defined as a study of ________. A) cell chemistry B) the gross structures of the body C) tissues D) cells

55)

56) The study of large body structures, visible to the naked eye, such as the heart is called ________ anatomy. A) microscopic B) systemic C) developmental D) gross

56)

57) Expiration (breathing out) is how the body removes excessive carbon dioxide from the blood. This is an example of ________. A) maintaining boundaries B) responsiveness C) excretion of metabolic waste D) metabolism

57)

58) Generally, what is the result of the negative feedback process? A) to control body movement B) to regulate excretion via the kidneys C) to maintain homeostasis D) to keep the body's blood sugar level high

58)

59) The coxal joint is most likely found in the ________ region of the body. A) foot B) groin C) hip

59) D) hand

60) A structure that is composed of two or more tissue types that work together to perform specific functions for the body is a(n) ________. A) complex cell B) complex tissue C) organ system D) organ

60)

61) The anatomical position is characterized by all of the following EXCEPT ________. A) palms turned posteriorly B) thumbs pointed laterally C) arms at sides D) body erect

61)

62) A good example of a positive feedback mechanism would be ________. B) enhancement of labor contractions A) body temperature regulation C) blood calcium level regulation D) regulating glucose levels in the blood

62)

63) Which of the following describes a parasagittal plane? A) two cuts dividing the body into left and right halves B) any cut dividing the body into anterior and posterior portions C) a transverse cut just above the knees D) any sagittal plane except in the midline

63)

64) Which of the following organs or structures would be found in the left iliac region? A) intestines B) appendix C) stomach D) liver

64)

65) The parietal pleura would represent a serous membrane ________. A) covering the heart B) covering individual lungs C) lining the abdominal cavity D) lining the thoracic cavity

65)

66) Which one of the following systems responds fastest to environmental stimuli? A) immune B) lymphatic C) muscular D) nervous

66)

67) Choose the anatomical topic and definition that is NOT correctly matched. A) Microscopic anatomy: study of structures too small to be seen by the naked eye. B) Embryology: study of the changes in an individual from conception to birth. C) Gross anatomy: study of structures visible to the eye. D) Cytology: study of the structures in a particular region.

67)

68) Homeostasis is the condition in which the body maintains ________. A) a dynamic state within an unlimited range, depending on circumstances B) a static state with no deviation from preset points C) a relatively stable internal environment, within limits D) the lowest possible energy usage

68)

69) In which body cavities are the lungs located? A) pleural, ventral, and thoracic C) pleural, dorsal, and abdominal

69) B) pericardial, ventral, and thoracic D) mediastinal, thoracic, and ventral

70) Choose the following statement that is NOT completely correct regarding serous membranes. A) Serous membranes secrete a watery lubricating fluid. B) Serosa are very thin, double-layered structures. C) Visceral pericardium covers the outer surface of the heart, and parietal pericardium lines the internal walls of the heart. D) Serous membranes are divided into parietal and visceral membranes with a virtual space between the two.

70)

71) Place the following in correct sequence from simplest to most complex: 1. molecules 2. atoms 3. tissues 4. cells 5. organs A) 1-2-4-3-5

B) 2-1-4-3-5

C) 2-1-3-4-5

71)

D) 1-2-3-4-5

72) Which of the following imaging devices would best localize a tumor in a person's brain? A) MRI B) PET C) X-ray D) DSA

72)

73) Which of these is NOT part of the dorsal cavity? A) cranial cavity B) spinal cord

73) C) vertebral cavity

D) thoracic cavity

74) In which quadrant of the abdominopelvic cavity is the stomach located? A) right upper quadrant B) left upper quadrant C) left lower quadrant D) right lower quadrant

74)

75) Which of the following statements is the most correct regarding homeostatic imbalance? A) Positive feedback mechanisms are overwhelmed. B) Negative feedback mechanisms are functioning normally. C) It is considered the cause of most diseases. D) The internal environment is becoming more stable.

75)

76) The term pollex refers to the ________. A) thumb B) calf

76) C) fingers

77) The dorsal body cavity is the site of which of the following? B) liver C) intestines A) brain

D) great toe 77) D) lungs

78) Select the most correct statement. A) The endocrine system is not a true structural organ system. B) Organ systems can be composed of cells or tissues, but not both. C) Organ systems operate independently of each other to maintain life. D) The immune system is closely associated with the lymphatic system.

78)

79) One of the functional characteristics of life is excitability or responsiveness. This refers to ________. A) sensing changes in the environment and then reacting or responding to them B) indigestible food residues stimulating the excretory system C) the necessity for all organisms to reproduce D) the nervous system causing all living things to sometimes experience anger

79)

80) Which of the following are survival needs of the body? A) water, atmospheric pressure, growth, and movement B) nutrients, water, atmospheric pressure, and oxygen C) nutrients, water, growth, and reproduction D) nutrients, water, movement, and reproduction

80)

81) What is a vertical section through the body, dividing it into left and right, called? A) transverse B) frontal C) sagittal D) regional

81)

82) What is a vertical section through the body, dividing it into anterior and posterior regions called? A) median B) frontal C) transverse D) sagittal

82)

83) The body cavities that protect the nervous system are located in the ________ cavity. A) vertebral B) ventral C) cranial D) dorsal E) thoracic

83)

84) Which of the following describes the operation of the heart and blood vessels? A) cardiovascular anatomy B) systemic anatomy C) cardiovascular physiology D) systemic physiology

84)

85) It is wise to study anatomy alongside with physiology because ________. A) anatomy and physiology are practically the same thing B) to understand anatomy requires complete understanding of physiology C) physiology is only explainable in terms of the underlying anatomy D) it makes for more efficient use of students' and teachers' time

85)

86) The study of anatomy and physiology assumes and describes a healthy body. Select the description below that does NOT explain why this approach is useful. A) A healthy body provides a common standard to compare to. B) A healthy body establishes what "normal" is. C) Study of a healthy body is less intimidating and more familiar to new students. D) Study of a healthy body provides a foundation for a more complete understanding of all human bodies.

86)

87) One of the descriptions below is from the perspective of anatomical study, the rest are from a physiological perspective. Select the description below that comes from an anatomical perspective. A) The extremely thin tissue (simple squamous epithelium) of the lungs allows for the quick diffusion of respiratory gases into and out of the body. B) The cell-to-cell connections between heart (cardiac) muscle cells are strong. They hold the tissue together for a life time of forceful contractions. C) The direction of blood flow through the heart is directed by one way valves. D) The innermost lining of the lungs is composed primarily of a thin tissue called simple squamous epithelium.

87)

88) One of the descriptions below is from the perspective of physiological study, the rest are from an anatomical perspective. Select the description below that comes from physiological perspective. A) The skull is formed by 22 facial and cranial bones. B) The pancreas lies deep to the stomach within the abdominal cavity. C) The chambers of the heart and blood vessels leading to and from the heart are separated by valves composed of fibrous connective tissue. D) The contraction of smooth muscle in blood vessels (vasoconstriction) can reduce the flow of blood through the vessel.

88)

89) Which of the following is the best explanation for why cells are considered the smallest units of living things. A) Cells have the ability to reproduce identical copies of themselves in a process called mitosis. B) Cells cannot be seen with the naked eye and are considered microscopic. C) Cells are highly ordered and complex. D) Cells are the simplest structure to fit all of the characteristics necessary to be considered alive.

89)

90) Prevention of water loss is a necessary function for life that would best fit in the category of ________. A) maintaining boundaries B) excretion C) responsiveness D) metabolism

90)

91) Anabolic reactions are chemical reactions of the body that build things, make them bigger or more complex. Catabolic reactions break things down making them smaller or less complex. If the rate of anabolic reaction in the body is much faster than the rate of catabolic reactions, which of the following necessary life function will be accomplished? A) digestion B) movement C) growth D) responsiveness

91)

92) Anatomical position is important because ________. A) it provides the greatest circulation to the extremities B) it allows diagrams within textbooks to display a greater surface area of the body with one simple diagram C) it is the position most comfortable to hospital patients D) it allows a common point of reference for body position to help communicate anatomical relationships

92)

93) Positive feedback differs from negative feedback because ________. A) positive feedback is generally beneficial while negative feedback is typically harmful B) positive feedback is critical to health while negative feedback serves only to alert us to potential health threats C) positive feedback tends to enhance the triggering stimulus while negative feedback tends to return the body to a homeostatic balance or "ideal" level D) positive feedback provides moment-to-moment wellbeing while negative feedback causes a cascade effect

93)

94) When a baby suckles at its mother's breast the stimulus at the breast is sent to the mother's brain (a region called the hypothalamus). The brain responds by releasing hormones to stimulate the production and the ejection of milk from the breast. This helps the newborn to receive nourishment and encourages more suckling. This example is best described as a ________. A) negative feedback B) positive feedback C) loss of homeostasis D) necessary life function

94)

95) Some of the nerve endings in the skin are sensitive to changes in temperature. They are part of a negative feedback mechanism regulating body temperature. These nerve endings represent a(n) ________ in the negative feedback mechanism. A) homeostatic balance or "ideal" value B) effector C) receptor D) control center

95)

96) You are asked to take a person's heart rate at the popliteal pulse point. You will look for this pulse ________. A) on the palmar side of the hand B) in the distal end of the lower leg C) on the posterior side of the knee D) at the posterior side of the wrist

96)

97) You are told to take an axillary temperature on a small child. You will place the thermometer ________. A) in the rectum B) on the forehead C) under the tongue D) in the armpit

97)

98) You are asked to draw blood from the median cubital vein. You will search for this vein in the ________. A) anterior side of the elbow B) hand C) proximal arm D) lateral side of the foot

98)

99) The thoracic cavity contains the ________. It is found ________ to the vertebral cavity. A) kidneys and spleen; deep B) digestive viscera; inferior C) stomach and liver; superficial D) heart and lungs; anterior

99)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 100) Similar cells that have a common function are called ________.

100)

101) What does the "principle of complementarity of structures and function" mean?

101)

102) The term that describes the back of the elbow is ________.

102)

103) The term that describes the neck region is ________.

103)

104) The heart is ________ to the lungs.

104)

105) ________ is explained by chemical and physical principles and is concerned with the function of specific organs or organic systems.

105)

106) What is a dynamic equilibrium of your internal environment termed?

106)

107) Which cavity contains the bladder, some reproductive organs, and the rectum?

107)

108) What is the serous membrane that covers the intestines called?

108)

109) What broad term covers all chemical reactions that occur within the body cells?

109)

110) What is the function of the serous membranes?

110)

111) Can lungs carry out excretory functions? Explain your answer.

111)

112) Why is anatomical terminology necessary?

112) 10

113) The ability to sense changes in the environment and respond to them is called ________.

113)

114) What is the single most abundant chemical substance in the body?

114)

115) Why must a normal body temperature be maintained in order for chemical reactions to be continued at life-sustaining rates?

115)

116) What is the pathway between the receptor and the control center in the reflex pathway called?

116)

117) What type of homeostatic feedback reflex is the withdrawal reflex?

117)

118) Why are the abdominopelvic cavity organs the most vulnerable to blunt deceleration in an automobile accident with seat belts?

118)

119) What is the action of all of the negative feedback mechanisms of the body?

119)

120) Which feedback mechanism causes the variable to deviate further and further from its original value or range?

120)

121) What can happen when the usual negative feedback mechanisms are overwhelmed and destructive positive feedback mechanisms take over?

121)

122) Which body system would be most affected by a lower than normal atmospheric pressure?

122)

123) Describe the overlap in function between the cardiovascular system and respiratory system. In other words, describe how they work together.

123)

124) Describe the overlap in function between the muscular system and skeletal system. In other words, describe how they work together.

124)

125) The integumentary system helps to maintain a boundary between the internal and external environment. Give an example of something that is prevented entry to the body and an example of something prevented from escaping the body by the integumentary system.

125)

126) Describe the opposing ways that the muscular system and integumentary system act as effectors in the regulation of body temperature.

126)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 127) A small family was traveling in its van and had a minor accident. The children in the back seats were wearing lap belts, but still sustained numerous bruises about the abdomen, and had some internal organ injuries. Why is this area more vulnerable to damage than others? 128) Steve was injured in a football accident. X-ray examination showed a fracture underlying his left brachial deformity. What part of his body was injured?

129) Judy is 16 years old and collapses on the gym floor with severe pain in her chest wall every time she takes a deep breath. She is rushed by ambulance to the emergency room. Judy is diagnosed with pleurisy and is given an anti-inflammatory drug through the intravenous route. Explain why an anti -inflammatory drug would be prescribed for someone with pleurisy. 130) Sara is giving birth to her first child. She is concerned that her labor is taking longer than she thought it would. Why does giving birth usually take time for the contractions to proceed to the point when the child is born? 131) The nurse charted: "Patient has an open wound located on lateral aspect of leg." Describe where the wound is located.

Answer Key Testname: UNTITLED1

1) C 2) A 3) D 4) B 5) C 6) B 7) D 8) A 9) E 10) C 11) A 12) D 13) B 14) A 15) C 16) D 17) B 18) A 19) A 20) B 21) B 22) A 23) E 24) B 25) D 26) C 27) A 28) B 29) C 30) B 31) A 32) C 33) B 34) E 35) D 36) A 37) A 38) E 39) D 40) B 41) C 42) TRUE 43) TRUE 44) FALSE 45) FALSE 46) TRUE 47) FALSE 48) TRUE 49) FALSE 50) TRUE 13

Answer Key Testname: UNTITLED1

51) TRUE 52) TRUE 53) TRUE 54) TRUE 55) C 56) D 57) C 58) C 59) C 60) D 61) A 62) B 63) D 64) A 65) D 66) D 67) D 68) C 69) A 70) C 71) B 72) A 73) D 74) B 75) C 76) A 77) A 78) D 79) A 80) B 81) C 82) B 83) D 84) C 85) C 86) C 87) D 88) D 89) D 90) A 91) C 92) D 93) C 94) B 95) C 96) C 97) D 98) A 99) D 100) tissues 14

Answer Key Testname: UNTITLED1

101) Structure is specific to meet the needs of it's function. 102) olecranal 103) cervical 104) medial 105) Physiology 106) homeostasis 107) pelvic 108) visceral peritoneum 109) metabolism 110) They act to reduce friction and allow the organs to slide across cavity walls. 111) Yes, carbon dioxide is a metabolic waste the lungs excrete. 112) Anatomical terms are precise words that have limited usage, which prevents confusion when describing the location of body parts. 113) responsiveness or excitability 114) water 115) If body temperature is too low, chemical reactions slow and eventually stop. If body temperature is too high, chemical reactions speed up and body proteins lose their normal shape, resulting in loss of function. 116) afferent pathway 117) negative 118) The walls of the abdominal cavity are formed only by trunk muscles and are not reinforced by bone. The pelvic organs receive a somewhat greater degree of protection from the bony pelvis. 119) They provide a mechanism to maintain levels of substances within physiological limits. 120) positive feedback 121) Homeostatic imbalances increase our risk for disease processes and produce the changes we associate with aging. 122) respiratory system 123) The blood is provided a consistent supply of oxygen from the lungs while the circulatory system delivers carbon dioxide which will be removed from the body by the respiratory system. 124) The skeleton provides the ridged frame work (levers) for muscles to attach to. Muscles provide the force to move the bones about the joints. 125) The integument prevents entry of pathogens (germs, viruses, bacteria) OR harmful chemicals. The integumentary system prevents water (body fluid) loss. 126) The integument cools the body through sweat while the muscular system warms the body by shivering. 127) The abdominal organs are the least protected in the body because they are not surrounded by a bony covering such as the ribs, pelvis, or cranium. 128) His left upper arm 129) The pleural space contains a small amount of fluid that acts as a lubricant, allowing the pleurae to slide smoothly over each other as the lungs expand and contract. Pleurisy is an inflammation of the pleura around the lungs. When inflammation occurs in the pleural space, the pleurae do not slide smoothly and this causes severe pain that is more directly transmitted by the parietal than the visceral pleura. 130) Childbirth is based on the increasing levels of oxytocin that cause the uterine contractions. Under positive feedback, oxytocin levels increase which results in increasing strong contractions by the upper uterus that will ultimately result in the birth of the child. But this positive feedback needs numerous contraction cycles to overcome the muscular resistance to stretching in the lower uterus in order for the head to pass. 131) The wound is located on the outer side of the leg, the peroneal or fibular area.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 2.1 Using Figure 2.1, match the following: 1) Lipid.

2) Functional protein.

3) Nucleotide.

4) Polysaccharide.

5) Monosaccharide.

6) Polymer.

7) Tertiary (protein) structure.

Figure 2.2 Using Figure 2.2, match the following: 8) Deoxyribose sugar.

9) Thymine.

10) Guanine.

10)

11) Phosphate.

11)

12) Hydrogen bonds.

12)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following chemical bonds to the correct description: 13) A bond in which electrons are shared unequally.

A) Polar covalent bond

13)

B) Hydrogen bond 14) A bond in which electrons are completely lost or gained by the atoms involved. 15) A bond in which electrons are shared equally.

14) C) Nonpolar covalent bond D) Ionic bond 15)

16) A type of bond important in tying different parts of the same molecule together into a three-dimensional structure.

16)

Match the following particles to the correct description: 17) Negatively charged subatomic particle.

A) Electron

17)

B) Neutron 18) Neutral subatomic particle.

18) C) Proton

19) Smallest particle of an element that retains its properties.

19) D) Atom

20) Positively charged subatomic particle.

20)

21) Subatomic particle having an AMU (Atomic Mass Unit) of zero.

21)

Match the following: 22) Water.

A) Compound

23) Saline.

B) Suspension

24) Dry ice (frozen carbon dioxide).

C) Solution

25) Blood.

22) 23) 24) 25)

Match the following: 26) Can be measured only by its effects on matter.

A) Matter

26)

B) Mass 27) Anything that occupies space and has mass. 28) Although a man who weighs 175 pounds on Earth would be lighter on the moon and heavier on Jupiter, his ________ would not be different.

27) C) Energy D) Weight

29) Is a function of, and varies with, gravity.

28)

29)

Match the following: 30) Legs moving the pedals of a bicycle.

A) Radiant energy

31) When the bonds of ATP are broken, energy is released to do cellular work.

B) Electrical energy

30) 31)

C) Mechanical energy 32) Energy that travels in waves. Part of the electromagnetic spectrum.

32) D) Chemical energy

33) Represented by the flow of charged particles along a conductor, or the flow of ions across a membrane.

33)

Match the following: 34) Protein structure achieved when alpha-helical or beta-pleated regions of the polypeptide chain fold upon one another to produce a compact ball-like, or globular, molecule. 35) The sequence of amino acids that form the polypeptide chain.

A) Tertiary

34)

B) Quaternary C) Primary D) Secondary

35)

36) Protein structure represented by alpha-helices and beta-sheets.

36)

37) Two or more polypeptide chains, each with its own tertiary structure.

37)

Match the following: 38) Usually, the first one or two letters of an element's name.

A) Atomic symbol

38)

B) Atomic number 39) Number of protons in an atom.

39) C) Mass number of an element

40) Combined number of protons and neutrons in an atom.

40)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 41) The atomic number of any atom is equal to the number of electrons in its nucleus and is written as a subscript to the left of its atomic symbol.

41)

42) It is the difference in the R group that makes each amino acid chemically unique.

42)

43) Chemical properties are determined primarily by neutrons.

43)

44) A charged particle is generally called an ion or electrolyte.

44)

45) Isotopes differ from each other only in the number of electrons the atom contains.

45)

46) About 60% to 80% of the volume of most living cells consists of organic compounds.

46)

47) Triglycerides are a poor source of stored energy.

47)

48) Omega-3 fatty acids appear to decrease the risk of heart disease.

48)

49) Glucose is an example of a monosaccharide.

49)

50) Glycogen, the storage form of glucose, is primarily stored in skeletal muscle and liver cells.

50)

51) The lower the pH, the higher the hydrogen ion concentration.

51)

52) The sharing of electrons in covalent bonds makes them stronger than ionic and hydrogen bonds.

52)

53) Hydrogen bonds are too weak to bind atoms together to form molecules, but they do hold different parts of a single large molecule in a specific three-dimensional shape.

53)

54) The fact that no chemical bonding occurs between the components of a mixture is the chief difference between mixtures and compounds.

54)

55) The acidity of a solution reflects the concentration of free hydrogen ions in the solution.

55)

56) A chemical bond is an energy relationship between outer electrons and neighboring atoms.

56)

57) All organic compounds contain carbon except CO2 and CO.

57)

58) A dipeptide can be broken into two amino acids by dehydration synthesis.

58)

59) The pH of body fluids must remain fairly constant for the body to maintain homeostasis.

59)

60) Mixtures are combinations of elements or compounds that are physically blended together but are not bound by chemical bonds.

60)

61) Buffers resist abrupt and large changes in the pH of body fluids by releasing or binding ions.

61)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 62) Which of the following elements is necessary for proper conduction of nerve impulses? A) P B) I C) Fe D) Na

62)

63) The basic structural material of the body consists of ________. A) proteins B) lipids C) carbohydrates

63) D) nucleic acids

64) In general, the lipids that we refer to as oils at room temperature have ________. A) saturated fatty acids B) long fatty acid chains C) a high water content D) unsaturated fatty acids

64)

65) The genetic information is coded in DNA by the ________. A) arrangement of the histones B) three-dimensional structure of the double helix C) regular alteration of sugar and phosphate molecules D) sequence of the nucleotides

65)

66) Which of the following does NOT characterize proteins? A) They appear to be the molecular carriers of coded hereditary information. B) They may be denatured or coagulated by heat or acidity. C) They have both functional and structural roles in the body. D) Their function depends on their three-dimensional shape.

66)

67) The single most abundant protein in the body is ________. A) glucose B) DNA C) hemoglobin

67) D) collagen

68) Carbohydrates are stored in the liver and skeletal muscles in the form of ________. A) cholesterol B) glycogen C) glucose D) triglycerides

68)

69) Which of the following does NOT describe enzymes? A) Each enzyme is chemically specific. B) Some enzymes are purely protein. C) Some enzymes are protein plus a cofactor. D) Enzymes work by raising the energy of activation.

69)

70) Which of the following is a general function for a fibrous protein? A) catalysis B) body defense C) structural framework D) protein management E) transport

70)

71) A chemical reaction in which bonds are created is usually associated with ________. A) the release of energy B) degradation C) the consumption of energy D) forming a smaller molecule

71)

72) Salts are always ________. A) ionic compounds C) single covalent compounds

72) B) double covalent compounds D) hydrogen bonded

73) The numbers listed represent the number of electrons in the first, second, and third energy levels, respectively. On this basis, which of the following is an unstable or reactive atom? A) 2, 8, 1 B) 2 C) 2, 8, 8 D) 2, 8

73)

74) Which of the following statements is FALSE? A) The pH of blood is slightly basic. B) The more hydrogen ions in a solution, the more acidic the solution. C) When acids and bases are mixed, they react with each other to form water and a salt. D) When the hydrogen ion concentration decreases, the hydroxyl ion concentration also decreases.

74)

75) Which of the following is the major positive ion outside cells? A) potassium B) sodium C) magnesium

75) D) hydrogen

76) Which of the following would be regarded as an organic molecule? A) H2 O B) CO 2 C) CH4

D) NaOH

77) What is a chain of more than 50 amino acids called? A) protein B) nucleic acid

D) triglyceride

76)

77) C) polysaccharide

78) What structural level is represented by the sequence of amino acids in a polypeptide chain? A) primary structure B) secondary structure C) tertiary structure D) quaternary structure

78)

79) Carbohydrates and proteins are built up from their basic building blocks by the ________. A) removal of a water molecule between each two units B) addition of a carbon atom between each two units C) removal of a carbon atom between each two units D) addition of a water molecule between each two units

79)

80) Which statement about enzymes is FALSE? A) Enzymes may be damaged by high temperature. B) Enzymes require contact with substrate in order to assume their active form. C) Enzymes may use coenzymes derived from vitamins or cofactors from metallic elements. D) Most enzymes can catalyze millions of reactions per minute.

80)

81) Which of the following statements is FALSE? A) Chemical reactions progress at a faster rate when the reacting particles are present in higher numbers. B) Chemical reactions proceed more quickly at higher temperatures. C) Catalysts increase the rate of chemical reactions, sometimes while undergoing reversible changes in shape. D) Larger particles move faster than smaller ones and thus collide more frequently and more forcefully.

81)

82) Choose the answer that best describes HCO 3 - .

82)

A) a weak acid C) common in the liver

B) a bicarbonate ion D) a proton donor

83) Select which reactions will usually be irreversible regarding chemical equilibrium in human bodies. A) H2 O + CO2 to make H 2 CO 3

83)

B) ADP + Pi to make ATP C) glucose molecules joined to make glycogen D) glucose to CO2 and H2 O 84) What happens in redox reactions? A) both decomposition and electron exchange occur B) the organic substance that loses hydrogen is usually reduced C) the reaction is uniformly reversible D) the electron acceptor is oxidized

84)

85) Which type of proteins can function as chemical messengers or as receptors in the plasma membrane? A) communication B) transport C) defensive D) enzyme

85)

86) Which of the following does NOT describe uses for the ATP molecule? A) pigment structure B) chemical work C) transport down their concentration gradient D) mechanical work

86)

87) Select the most correct statement regarding nucleic acids. A) tDNA is considered a "molecular slave" of DNA during protein synthesis. B) RNA is a long, single-stranded molecule made up of the bases A, T, G, and C. C) Three forms exist: DNA, RNA, and tDNA. D) DNA is a long, double-stranded molecule made up of A, T, G, and C bases.

87)

88) Which of the following is an example of a suspension? B) rubbing alcohol C) cytosol A) blood

88) D) salt water

89) If the atomic mass of an element is 14 and the atomic number is 6, which of the following would describe this element? A) atom B) neutral C) isotope D) ion

89)

90) The four elements that make up about 96% of body weight are ________. A) carbon, oxygen, phosphorus, calcium B) sodium, potassium, hydrogen, oxygen C) nitrogen, hydrogen, calcium, sodium D) carbon, oxygen, hydrogen, nitrogen

90)

91) ________ is fat soluble, produced in the skin on exposure to UV radiation, and necessary for normal bone growth and function. A) Vitamin A B) Vitamin K C) Cortisol D) Vitamin D

91)

92) You notice that you cannot read your book through a test tube of patient fluid held against the print, making it so blurred as to be unreadable. There is no precipitant in the bottom of the beaker, though it has been sitting for several days in a rack. What type of liquid is this? A) mixture B) colloid C) suspension D) solution

92)

93) Atom X has 17 protons. How many electrons are in its valence shell (outermost energy level)? A) 5 B) 3 C) 10 D) 7

93)

94) A high fever causes an enzyme to lose its three-dimensional structure and function. Which bonds are broken when a protein denatures? A) hydrogen bonds B) ionic bonds C) non-polar covalent bonds D) polar covalent bonds

94)

95) If atom X has an atomic number of 74 it would have which of the following? A) 37 protons and 37 neutrons B) 37 electrons C) 37 protons and 37 electrons D) 74 protons

95)

96) What does the formula C 6 H12O6 mean?

96)

A) There are 6 calcium, 12 hydrogen, and 6 oxygen atoms. B) The molecular weight is 24. C) There are 6 carbon, 12 hydrogen, and 6 oxygen atoms. D) The substance is a colloid. 97) An atom with 3 electrons in its outermost (valence) shell may have a total of ________ electrons altogether. A) 17 B) 8 C) 13 D) 3

97)

98) Which of the following is a neutralization reaction? A) NH3 + H+ → NH4 +2

98) B) NaOH → Na + + OH-

C) HCl → H+ + Cl-

D) HCl + NaOH → NaCl + H2 O

99) The chemical symbol O=O means ________. A) both atoms are bonded and have zero electrons in the outer orbit B) the atoms are double bonded C) zero equals zero D) this is an ionic bond with two shared electrons

99)

100) What is a cation? A) an atom that shares its valence electrons B) an atom that loses one or more electrons and acquires a net positive charge C) an atom that gains one or more electrons and acquires a net negative charge D) a molecule that has both positive and negative charges

100)

101) What does CH4 mean?

101)

A) There is one carbon and four hydrogen atoms. B) There are four carbon and four hydrogen atoms. C) This was involved in a redox reaction. D) This is an inorganic molecule. 102) Amino acids joining together to make a peptide is a good example of a(n) ________ reaction. A) exchange B) synthesis C) reversible D) decomposition

102)

103) Which of the following is NOT considered a factor in influencing a reaction rate? A) time B) temperature C) particle size D) concentration of reactants

103)

104) Which property of water is demonstrated when we sweat? A) cushioning B) polar solvent properties C) high heat capacity D) reactivity E) high heat of vaporization

104)

105) Starch is a ________. A) polysaccharide C) disaccharide

105) B) monosaccharide D) triglyceride

106) What is the ratio of fatty acids to glycerol in triglycerides (neutral fats)? A) 1:1 B) 4:1 C) 2:1 107) In a DNA molecule, the phosphate serves ________. A) as nucleotides C) as a code

106) D) 3:1 107)

B) to bind the sugars to their bases D) to hold the molecular backbone together

108) When frying an egg, the protein albumin denatures and maintains only its ________ structure. A) secondary B) tertiary C) primary D) quaternary

108)

109) Which of the following is chemically inert (unreactive)? A) carbon (atomic number 6) B) oxygen (atomic number 8) C) sodium (atomic number 11) D) neon (atomic number 10)

109)

110) An atom with an atomic number of 10 and a mass number of 24 would have ________. A) 14 neutrons B) 10 neutrons C) 24 protons D) 14 electrons

110)

111) When DNA is replicated, it is necessary for the two strands to "unzip" temporarily. Choose which bonding type is most appropriate for holding the strands together in this way. A) polar covalent bonding B) hydrogen bonding C) non-polar covalent bonding D) ionic bonding

111)

112) Lithium has an atomic number of 3. How many electrons are there in the outermost (valence) shell? A) one B) two C) three D) zero

112)

113) ATP → ADP + Pi is an example of a(n) ________ reaction. A) reversible B) decomposition C) exchange

113) D) synthesis

114) An acid with a pH of 6 has ________ hydrogen ions than pure water. A) 100-fold fewer B) 10-fold more C) 10-fold fewer

D) 100-fold more

114)

115) A patient is hyperventilating. The "blowing off" of excessive carbon dioxide causes a decrease in blood H+ concentration. How can the carbonic acid-bicarbonate buffer system function to correct

115)

this imbalance? CO 2 + H2 O ↔ H2 CO 3 ↔ H+ + HCO 3 A) HCO3 - binds with H+ to form H2 CO 3 and raise pH B) H2 CO 3 dissociates to form more H + and lower pH C) HCO3 - binds with H+ to form H2 CO 3 and lower pH D) H2 CO 3 dissociates to form more H + and raise pH 116) Forming glycogen as energy storage in the liver is an example of ________. A) catabolism B) exergonic C) anabolism

116) D) oxidation

117) Salivary amylase is an enzyme produced by the salivary glands that breaks down carbohydrates. What will happen to this enzyme as it follows the food into the stomach where the pH drops to 2.5? A) The enzyme will denature but retain its function. B) The enzyme will assume an alternate form and catalyze additional reactions. C) The enzyme will continue to function as it remains unchanged in chemical reactions. D) The enzyme will denature and become inactive.

117)

118) With a family history of cardiovascular disease, which toast spread would be considered the most "heart healthy"? B) olive oil A) butter containing butterfat C) margarine containing trans fats D) lard (pig fat)

118)

119) Which of the following is incorrectly matched? A) eicosanoid; triglyceride C) monosaccharide; carbohydrate

119) B) amino acid; protein D) nucleotide; nucleic acid

120) Starch is the stored carbohydrate in plants, while ________ is the stored carbohydrate in animals. A) glycogen B) triglyceride C) glucose D) cellulose

120)

121) How many phosphates would ADP have attached to it? A) none B) two C) three

121) D) one

122) Tendons are strong, rope-like structures that connect skeletal muscle to bone. Which of the following proteins would provide strength to a tendon? A) albumin B) molecular chaperone C) actin D) collagen

122)

123) Phospholipids make up most of the lipid part of the cell membrane. Since water exists on both the outside and inside of a cell, which of the following phospholipid arrangements makes the most sense? A) a single layer of phospholipids with the polar heads facing outside the cell B) two back-to-back phospholipid layers with the non-polar tails facing out on both sides C) two back-to-back phospholipid layers with the polar heads facing out on both sides D) a single layer of phospholipids with the polar heads facing inside the cell

123)

124) What type of chemical bond can form between an atom with 11 protons and an atom with 17 protons? A) polar covalent B) ionic C) non-polar covalent D) hydrogen

124)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 125) What happens when globular proteins are denatured?

125)

126) Explain the difference between potential and kinetic energy.

126)

127) How can phospholipids form a film when mixed in water?

127)

128) What properties does water have that make it a very versatile fluid?

128)

129) What advantages does ATP have in being the energy currency molecule?

129)

130) Explain why water is considered to have partial charges even though it is sharing electrons in a polar covalent bond.

130)

131) When a set of electrodes connected to a light bulb is placed in a solution of dextrose and a current is applied, the light bulb does not light up. When the same unit is placed in HCl, it does. Why?

131)

132) Describe the factors that affect chemical reaction rates.

132)

133) Protons and electrons exist in every atom nucleus except hydrogen. Is this statement true or false and why?

133)

134) A chemical bond never occurs between components of a mixture. Discuss this.

134)

135) All chemical reactions are theoretically reversible. Comment on this statement.

135)

136) What is the major difference between polar and nonpolar covalent bonds?

136)

137) An amino acid may act as a proton acceptor or donor. Explain.

137)

138) Name at least four things you know about enzymes.

138)

139) In the compound H 2 CO 3 , what do the numbers 2 and 3 represent?

139)

140) Are all chemical reactions reversible? If not, why aren't they all reversible?

140)

141) If all protons, electrons, and neutrons are alike, regardless of the atom considered, what determines the unique properties of each element?

141)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 142) Mrs. Mulligan goes to her dentist and, after having a couple of cavities filled, her dentist strongly suggests that she reduce her intake of sodas and increase her intake of calcium phosphates in the foods she eats. Why? 143) Although his cholesterol levels were not high, Mr. Martinez read that cholesterol was bad for his health, so he eliminated all foods and food products containing this molecule. He later found that his cholesterol level dropped only 20%. Why did it not drop more? 144) How can DNA be used to "fingerprint" a suspect in a crime? 145) Why is it possible for us to drink a solution that contains a mixture of equal concentration of a strong acid and a strong base, either of which, separately, would be very caustic? 146) A 65-year-old patient came to the emergency room with complaints of severe heartburn unrelieved by taking a "large handful" of antacids. Would you expect the pH to be high or low? Explain why. 147) A 22-year-old female college student is stressed out due to final exams and begins to hyperventilate. This means she is exhaling too much carbon dioxide. As a result, the pH of the blood will become too basic creating a homeostatic imbalance. Her friend hands her a paper bag and instructs her to inhale and exhale into the bag. Breathing in the bag helps to replace the lost carbon dioxide lowering the pH back to normal levels. Which buffer system in the body will be involved in this reaction? 148) Brenda is a 26-year-old female who is being discharged from the hospital after a vaginal delivery of an 8-pound healthy infant. Brenda is instructed by the nurse to eat a diet high in fiber and to drink 8 glasses of water per day to prevent constipation. Explain the role of fiber and water to promote defecation.

Answer Key Testname: UNTITLED2

1) D 2) B 3) E 4) C 5) A 6) C 7) B 8) B 9) D 10) E 11) C 12) A 13) A 14) D 15) C 16) B 17) A 18) B 19) D 20) C 21) A 22) A 23) C 24) A 25) B 26) C 27) A 28) B 29) D 30) C 31) D 32) A 33) B 34) A 35) C 36) D 37) B 38) A 39) B 40) C 41) FALSE 42) TRUE 43) FALSE 44) TRUE 45) FALSE 46) FALSE 47) FALSE 48) TRUE 49) TRUE 50) TRUE 14

Answer Key Testname: UNTITLED2

51) TRUE 52) TRUE 53) TRUE 54) TRUE 55) TRUE 56) TRUE 57) TRUE 58) FALSE 59) TRUE 60) TRUE 61) TRUE 62) D 63) A 64) D 65) D 66) A 67) D 68) B 69) D 70) C 71) C 72) A 73) A 74) D 75) B 76) C 77) A 78) A 79) A 80) B 81) D 82) B 83) D 84) A 85) A 86) A 87) D 88) A 89) C 90) D 91) D 92) B 93) D 94) A 95) D 96) C 97) C 98) D 99) B 100) B 15

Answer Key Testname: UNTITLED2

101) A 102) B 103) A 104) E 105) A 106) D 107) D 108) C 109) D 110) A 111) B 112) A 113) B 114) B 115) B 116) C 117) D 118) B 119) A 120) A 121) B 122) D 123) C 124) B 125) The active sites are destroyed. 126) Potential energy is inactive stored energy that has potential to do work. Kinetic energy is energy in action. 127) Phospholipids have both polar and nonpolar ends. The polar end interacts with water, leaving the nonpolar end oriented in the opposite direction. 128) High heat capacity, high heat of vaporization, polar solvent properties, reactivity, and cushioning. 129) Its energy is easy to capture and store; it releases just the right amount of energy for the cell's needs so it is protected from excessive energy release. A universal energy currency is efficient because a single system can be used by all the cells in the body. 130) Due to the electronegativity of oxygen, it pulls the shared electron more strongly than the hydrogen. As a result, the oxygen acquires a partial negative charge, and the hydrogens acquire a partial positive charge. 131) HCl ionizes to form current-conducting electrolytes. Dextrose does not ionize, and therefore does not conduct current. 132) Temperature increases kinetic energy and therefore the force of molecular collisions. Particle size: smaller particles move faster at the same temperature and therefore collide more frequently; also, smaller particles have more surface area given the same concentration of reactants. Concentration: the higher the concentration, the greater the chance of particles colliding. Catalysts increase the rate of the reaction at a given temperature. Enzymes are biological catalysts. 133) False. Hydrogen has one proton and one electron. It is the neutron, not the electron that can coexist in the nucleus and that hydrogen does not have. 134) Mixtures come in three forms–solutions, colloids, and suspensions. Components of these mixtures always retain their original makeup and can be separated into their individual components; therefore, no chemical bonding has taken place. 135) It is possible to reverse any reaction if the products are still present. Those that are only slightly exergonic are easily reversible. Some would require an enormous amount of energy to reverse. In the simple reaction Na + Cl → NaCl the amount of energy it takes to reverse table salt to chlorine gas and sodium metal is enormous. When glucose is oxidized the energy goes into bonds of ATP molecules which are then spent and thus the energy is not available to reform glucose. 16

Answer Key Testname: UNTITLED2

136) Polar bonds have an unequal sharing of electrons resulting in a slight negative charge at one end of the molecule and a slight positive charge at the other end. Nonpolar bonds have an equal sharing of electrons, resulting in a balanced charge among the atoms. 137) Amino acids have two components–a base group (proton acceptor) and an organic acid part (a proton donor). Some have additional base or acid groups on the ends of their R groups as well. 138) 1. Most are proteins. 2. They have specific binding sites for specific substrates. 3. They lower the activation barrier for a specific reaction. 4. The names often end in "Suffix: -ase." 5. They can be denatured. 6. They can be used again and again. 139) The 2 indicates that there are two hydrogen atoms in the compound and the 3 indicates that there are three oxygen atoms in the compound. 140) All chemical reactions are theoretically reversible, but only if the products are not consumed and enough energy is available for the reaction. 141) Atoms of different elements are composed of different numbers of protons, electrons, and neutrons. 142) Sodas are strong acids that can reduce bone and tooth salts. Calcium phosphate makes teeth hard and therefore more resistant to tooth decay. 143) Cholesterol is produced by the liver, in addition to being ingested in foods. 144) The DNA of a person is unique to that individual. By obtaining the DNA from nucleated cells from the crime scene (e.g., blood, semen, other body tissues), enzymes may be used to break up the DNA into fragments. Because nearly everyone's DNA is different, it also breaks up into fragments differently. When the fragments are separated, they form patterns even more unique than fingerprint patterns. A match of suspect and crime scene DNA is strong evidence. 145) When an acid and base of equal strength are mixed, they undergo a displacement (neutralization) reaction to form water and a salt. 146) You would expect a high pH. Taking antacids will neutralize the acidic stomach. Taking a "handful" of antacids can cause an alkaloid state. Certain drugs, such as corticosteroids and antacids that contain baking soda, will lead to metabolic alkalosis. 147) The bicarbonate buffer system is going to be involved in this situation. In this buffer system, the weak acid is carbonic acid, which is formed from the reaction between carbon dioxide and water. The body responds to an increase in blood pH by shifting the equation to the left, causing carbonic acid to dissociate into bicarbonate and protons. These protons will bring the rising pH back to a normal level. 148) Cellulose is a polysaccharide found in all plant products that adds bulk to the diet to promote feces through the colon. Water acts as a lubricating liquid within the colon, which eases feces through the bowel.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 3.1 Using Figure 3.1, match the following: 1) Produces ATP aerobically.

2) Site of enzymatic breakdown of phagocytized material.

3) Packages proteins for insertion in the cell membrane or for exocytosis.

4) Site of synthesis of lipid and steroid molecules.

5) Forms the mitotic spindle.

6) Replicate for cell division.

7) When ruptured it releases the enzymes responsible for autolysis.

Figure 3.2 Using Figure 3.2, match the following: 8) Nonpolar region of phospholipid.

9) Glycocalyx.

10) Polar region of phospholipid.

10)

11) Peripheral protein.

11)

12) Integral protein.

12)

13) Unique glycoproteins and glycolipids involved in cell recognition.

13)

14) Hydrophilic portion of phospholipid.

14)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 15) Forms part of the subunits for the protein synthesizing organelle.

A) ATP

15)

B) Ribosomal RNA 16) A molecule that binds to a specific codon and specific amino acid simultaneously. 17) Attaches the correct amino acid to its transfer RNA.

16) C) Transfer RNA D) Messenger RNA 17) E) Synthetase enzymes

18) Provides the energy needed for synthesis reactions.

18)

19) Produced in the nucleus, this molecule specifies the exact sequence of amino acids of the protein to be made.

19)

20) May be attached to the ER or scattered in the cytoplasm.

20)

Match the following: 21) Chromosomes uncoil to form chromatin.

A) Telophase

21)

B) Early prophase 22) Chromosomal centromeres split and chromosomes migrate to opposite ends of the cell. 23) Nuclear membrane and nucleolus disintegrate.

22) C) Metaphase D) Anaphase 23) E) Late prophase

24) Chromosomes align on the spindle equator.

24)

25) Centrioles move to opposite ends of the cell.

25)

Match the following: 26) This organelle modifies, concentrates, and packages the proteins and lipids made at the RER for domestic use or export. 27) The organelle that facilitates peptic bond formation between amino acids. 28) This organelle contains oxidases and catalases.

A) Cytoskeleton

26)

B) Nucleus C) Ribosomes 27) D) Peroxisomes E) Golgi apparatus

29) This is an elaborate network of rods and accessory proteins found in the cytosol that support cellular structures and provide the machinery to generate various cell movements, as well as provide the "roads" for vesicular trafficking.

28)

29)

30) The vast majority of the cell's genetic material is housed here.

30)

Match the following: 31) Help prevent molecules from passing through the extracellular space between adjacent cells.

A) Tight junctions

32) Type of anchoring junction.

C) Gap junctions

31)

B) Desmosomes

33) Allows ions and small molecules to pass through from one cell to another.

32) 33)

34) Present in electrically excitable tissues.

34)

35) Abundant in tissues subjected to great mechanical stress.

35)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 36) Each daughter cell resulting from mitotic cell division has exactly the same genetic composition.

36)

37) Apoptosis is programmed cell death; cancer cells do not undergo this process.

37)

38) Introns represent a genome scrap yard that provides DNA segments for genome evolution and a variety of small RNA molecules.

38)

39) Enzymes and proteins needed for cell division are synthesizes and put into place during G 2 phase.

39)

40) Phagocytosis is used by the cells to secrete intracellular substances to the outside of the cell.

40)

41) Osmosis is the passive movement of water, but it follows almost completely opposite laws of physics when compared to the diffusion of ions or other small particles.

41)

42) DNA replication requires an enzyme called RNA polymerase and results in a semi-conserved new molecule of DNA.

42)

43) Dividing cells must pass through the phases of mitosis in the following order: Prophase, Metaphase, Anaphase, and Telophase.

43)

44) DNA transcription is another word for DNA replication.

44)

45) The glycocalyx is composed of glycolipids, glycoproteins, and cholesterol molecules that are displayed on the outside surface of the plasma membrane.

45)

46) Microfilaments are thin strands of the contractile protein composed of myosin.

46)

47) Interstitial fluid represents one type of extracellular material.

47)

48) Aquaporins are believed to be present in red blood cells and kidney tubules, but not in any other cells in the body.

48)

49) Microtubules are hollow tubes made of subunits of the protein tubulin.

49)

50) Telomeres are the regions of chromosomes that code for the protein ubiquitin.

50)

51) The speed of individual particle diffusion is influenced by temperature and particle size, not by concentration.

51)

52) Concentration differences cause ionic imbalances that polarize the cell membrane, and active transport processes.

52)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 53) Which of the following is FALSE regarding the membrane potential? A) The resting membrane potential occurs due to active transport of ions across the membrane due to the sodium-potassium pump. B) The resting membrane potential is maintained solely by passive transport processes. C) The resting membrane potential is determined mainly by the concentration gradients and differential permeability of the plasma membrane to K + and Na+ ions. D) In their resting state, all body cells exhibit a resting membrane potential.

53)

54) Which vesicular transport process occurs primarily in some white blood cells and macrophages? A) pinocytosis B) intracellular vesicular trafficking C) phagocytosis D) exocytosis

54)

55) In certain kinds of muscle cells, calcium ions are stored in ________. A) the rough ER B) both smooth and rough ER C) the smooth ER D) the cytoplasm

55)

56) The RNA responsible for bringing the amino acids to the ribosome for protein formation is ________. A) rRNA B) ssRNA C) tRNA D) mRNA

56)

57) A red blood cell placed in pure water would ________. A) swell initially, then shrink as equilibrium is reached B) neither shrink nor swell C) shrink D) swell and burst

57)

58) Which of the following describes the plasma membrane? A) a membrane composed of tiny shelves or cristae B) a single-layered membrane that surrounds the nucleus of the cell C) a double layer of protein enclosing the plasma D) a phospholipid bilayer surrounding the cell

58)

59) Which of the following structures would aid a cell in allowing more nutrients to be absorbed by the cell? A) microvilli B) flagella C) stereocilia D) primary cilia

59)

60) Which of the following statements is correct regarding net diffusion? A) The greater the concentration gradient, the faster the rate. B) Molecular weight of a substance does not affect the rate. C) The rate is independent of temperature. D) The lower the temperature, the faster the rate.

60)

61) In a tissue type that undergoes a relatively great deal of mechanical stress, like the tissue that lines the intestine, you would expect to see an abundance of ________ between the individual cells of the tissue. A) tight junctions B) gap junctions C) connexons D) desmosomes

61)

62) If cells are placed in a hypotonic solution containing a solute to which the membrane is impermeable, what could happen? A) The cells will show no change due to diffusion of both solute and solvent. B) The cells will lose water and shrink. C) The cells will swell and ultimately burst. D) The cells will shrink at first, but will later reach equilibrium with the surrounding solution and return to their original condition.

62)

63) Riboswitches are folded RNAs that act as switches to turn protein synthesis on or off in response to ________. A) the presence or absence of ubiquitins B) specific codes from the DNA C) specific tRNAs D) changes in the environment

63)

64) Which of the following is a function of a plasma membrane protein? A) oxygen transport B) circulating antibody C) molecular transport through the membrane D) forms a lipid bilayer

64)

65) Which of the following statements is correct regarding RNA? A) Messenger RNA, transfer RNA, and ribosomal RNA play a role in protein synthesis. B) There is exactly one specific type of mRNA for each amino acid. C) If the base sequence of DNA is ATTGCA, the messenger RNA template will be UCCAGU. D) rRNA is always attached to the rough ER.

65)

66) Which of the following would NOT be a constituent of a plasma membrane? A) glycolipids B) phospholipids C) glycoproteins D) messenger RNA

66)

67) Mitosis ________. A) is always a part of the cell cycle B) is the formation of sex cells C) is division of the genetic material within the nucleus D) creates diversity in genetic potential

67)

68) The electron microscope has revealed that one of the components within the cell consists of pinwheel array of 9 triplets of microtubules arranged to form a hollow tube. This structure is a ________. A) centrosome B) centriole C) ribosome D) chromosome

68)

69) Which of these is an inclusion, not an organelle? A) melanin B) microtubule

69) C) lysosome

D) cilia

70) Which of the following is NOT a factor that binds cells together? A) glycolipids in the glycocalyx B) glycoproteins in the glycocalyx C) wavy contours of the membranes of adjacent cells D) special membrane junctions

70)

71) If the nucleotide or base sequence of the DNA strand used as a template for messenger RNA synthesis is ACGTT, then what would be the sequence of bases in the corresponding mRNA? A) GUACC B) TGCAA C) ACGTT D) UGCAA

71)

72) Which transport process is the main mechanism for the movement of most macromolecules by body cells? A) receptor-mediated endocytosis B) secondary active transport C) pinocytosis D) phagocytosis

72)

73) Passive membrane transport processes include ________. A) movement of a substance down its concentration gradient B) consumption of ATP C) movement of water from an area of high solute concentration to an area of low concentration D) the use of transport proteins when moving substances from areas of low to high concentration

73)

74) Which of the following is NOT a function of the smooth endoplasmic reticulum? A) steroid-based hormone synthesis B) protein synthesis in conjunction with ribosomes C) breakdown of stored glycogen to form free glucose D) lipid metabolism and cholesterol synthesis

74)

75) Mitochondria ________. A) contain some of the DNA and RNA code necessary for their own function B) contain digestive enzymes called acid hydrolyses C) are single-membrane structures involved in the breakdown of ATP D) synthesize proteins for use outside the cell

75)

76) Peroxisomes ________. A) sometimes function as secretory vesicles B) function to digest particles ingested by endocytosis C) are able to detoxify substances by enzymatic action D) are functionally the same as lysosomes

76)

77) Which of the following is NOT a function of lysosomes? A) breaking down bone to release calcium ions into the blood B) digesting particles taken in by endocytosis C) degrading worn-out or nonfunctional organelles D) help in the formation of cell membranes

77)

78) In which stage of mitosis do the identical sets of chromosomes line up along the midline or equator of the cell? A) metaphase B) telophase C) prophase D) anaphase

78)

79) Which of the following is a principle of the fluid mosaic model of cell membrane structure? A) Phospholipids form a bilayer that is largely impermeable to water -soluble molecules. B) The lipid bilayer is a solid at body temperature, thus protecting the cell. C) Phospholipids consist of a polar head and a nonpolar tail made of three fatty acid chains. D) All proteins associated with the cell membrane are contained in a fluid layer on the outside of the cell.

79)

80) Which of the following statements is most correct regarding the intracellular chemical signals known as "second messengers"? A) Second messengers usually inactivate protein kinase enzymes. B) Second messengers act through receptors called K-proteins. C) Second messengers usually act to remove nitric oxide (NO) from the cell. D) Cyclic AMP and calcium may be second messengers.

80)

81) Which organelle is responsible for processing and packaging proteins destined for export from the cell? A) endoplasmic reticulum B) lysosomes C) Golgi apparatus D) peroxisomes

81)

82) The functions of centrioles include ________. A) producing ATP B) serving as the site for ribosomal RNA synthesis C) organizing the mitotic spindle in cell division D) providing a whiplike beating motion to move substances along cell surfaces

82)

83) A gene can best be defined as ________. A) a segment of DNA that carries the instructions for one polypeptide chain B) an RNA messenger that codes for a particular polypeptide C) noncoding segments of DNA up to 100,000 nucleotides long D) a three-base triplet that specifies a particular amino acid

83)

84) Crenation (shrinking) is likely to occur in blood cells immersed in ________. A) a hypertonic solution B) blood plasma C) a hypotonic solution D) an isotonic solution

84)

85) Some hormones enter cells via ________. A) pinocytosis C) receptor-mediated endocytosis

85) B) exocytosis D) primary active transport

86) If a tRNA had an AGC anticodon, it could attach to a(n) ________ mRNA codon. A) UGA B) AUG C) TCG D) UCG

86)

87) Which of the following is NOT one of the concepts collectively known as the cell theory? A) Cells only arise from other cells. B) All organisms are made of one or more cells. C) All cells must be motile and divide. D) The cell is the smallest unit of life.

87)

88) If a human cell were to increase the amount of cholesterol embedded within its plasma membrane, which of the following would most likely happen? A) The plasma membrane would become more permeable to ions and less permeable to lipids. B) The plasma membrane would become more stable, less fluid, and less permeable. C) The cell would form a plaque that could potentially block a blood vessel. D) The plasma membrane would become more fluid and the phospholipids less stable.

88)

89) Cancerous cells can divide so rapidly that they will often produce a glycocalyx that is different than the other cells in the body. This may result in ________. A) the cancer cells conserving energy for more growth B) a decrease in the permeability of the tumor cell's plasma membrane preventing the uptake of chemotherapy drugs C) cells of the immune system recognizing the tumorous cells as foreign and destroying them D) allowing the cancer cells to bind to their healthy, neighboring cells

89)

90) The myocardium (cardiac muscle tissue) undergoes a significant amount of physical stress due to its contractions. You would expect to see relatively large numbers of which of the following embedded within their plasma membrane? A) glycolipids B) tight junctions C) desmosomes D) transport proteins

90)

91) Which of the following will NOT speed up the net rate of diffusion for glucose into a cell? A) Decreasing the number of phospholipids in the plasma membrane. B) Increasing the number of glucose transport proteins within the plasma membrane. C) Increasing the concentration of glucose outside of the cell. D) Decreasing the concentration of glucose within the cell.

91)

92) The lungs deliver a regular supply of oxygen to the blood, which is in turn circulated to most all the cells of the body. At the same time oxygen is consumed during aerobic cellular respiration within these cells. This implies that ________. A) the rate of oxygen diffusion is independent of concentration B) the concentration gradient for oxygen is steepness inside of the cell C) oxygen will passively diffuse into the cells D) oxygen requires active transport to enter most cells

92)

93) The movement of water across the plasma membrane can be described by all of the following EXCEPT ________. A) facilitated diffusion through aquaporins B) passive membrane transport C) simple diffusion D) carrier-mediated facilitated diffusion

93)

94) If active transport establishes a concentration gradient with the use of ATP, then the concentration gradient can be looked at as ________. A) unwanted pressure that will be alleviated by channel mediated facilitated diffusion B) potential energy that can be harnessed when molecules passively diffuse down the concentration gradient C) a byproduct of active transport that will be alleviated by pinocytosis D) an unusable byproduct of active transport that will simply diffuse away

94)

95) Which of the following would NOT be restricted (limited) by low levels of ATP? A) osmosis B) pinocytosis C) exocytosis D) phagocytosis

95)

96) A cell engulfing a relatively large particle will likely utilize ________. A) phagocytosis B) pinocytosis C) exocytosis D) receptor-mediated endocytosis

96)

97) If a cell is non-selectively engulfing samples of extracellular fluid, for example to absorb nutrients, it will likely utilize ________. A) receptor-mediated endocytosis B) pinocytosis C) exocytosis D) phagocytosis

97)

98) If a cell is selectively reducing the concentration of a particular enzyme in the extracellular fluid it will likely utilize ________. A) phagocytosis B) receptor-mediated endocytosis C) pinocytosis D) exocytosis

98)

99) A type of transport protein found in the plasma membrane of cells lining the inside of the intestine allows sodium ions to diffuse down their concentration gradient. The ions move through the transport protein, and into the cell. These transport proteins will use the kinetic energy of the diffusing sodium ions to bring glucose into the cells as well. This transport protein would best be described as ________. A) a symporter B) a carrier protein C) a pump D) a channel

99)

100) A type of transport protein found in the plasma membrane of cells lining the inside of the intestine allows sodium ions to diffuse down their concentration gradient. The ions move through the transport protein, and into the cell. These transport proteins will use the kinetic energy of the diffusing sodium ions to bring glucose into the cells as well. Which of the following would stop transport of glucose through this transport protein? A) Stopping the activity of the sodium potassium pump. B) Increasing the number of digestive enzymes in the digestive tract. C) Lowering the energy of activation. D) Increasing the concentration of glucose outside of the cell.

100)

101) Which of the following would NOT assist in establishing a resting membrane potential? A) Selective diffusion allowing more positively charged ions to diffuse out of the cell. B) Selective diffusion allowing fewer positively charged ions to diffuse into the cell. C) Selective diffusion allowing more uncharged particles into the cell. D) Having greater concentration of glycolipids on the outside surface of the membrane.

101)

102) When tissues are injured or infected, chemical signals can be releases that affect the plasma membrane of cells that line the nearby blood vessels. These blood vessels' cells (endothelial cells) respond to the chemical signals by displaying a type of glycoproteins on their surface. These proteins will attach to circulating white blood cells bringing them to the site of injury or infection. These glycoproteins would best be described as ________. A) transport proteins B) desmosomes C) G-proteins D) Cell Adhesion Molecules (CAMs)

102)

103) Myocardium (cardiac muscle tissue) must rhythmically contract for a lifetime. This requires a considerable amount of energy production by the cells. You would expect to see a relatively high amount of which organelle in these cells? A) smooth endoplasmic reticulum B) lysosomes C) cytoskeleton D) mitochondria

103)

104) Beta cells in the pancreas produce and secrete the protein hormone insulin. You would expect to see a relatively large amount of which organelles in these cells? A) Golgi apparatus, rough endoplasmic reticulum B) cytoskeleton, and peroxisomes C) mitochondria, and cilia D) smooth endoplasmic reticulum, and lysosomes

104)

105) Colchicine is a drug that can prevent the formation of microtubules. Which is the most likely effect colchicine would have on cell division? A) It would have little or no effect on mitosis. B) It will enhance mitosis by moving chromosome toward the spindle equator. C) It would delay mitosis by preventing S phase. D) It will arrest mitosis by preventing the formation of spindle microtubules.

105)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 106) The RNA that has an anticodon and attaches to a specific amino acid is ________ RNA.

106)

107) Water may move through membrane pores constructed by transmembrane proteins called ________.

107)

108) ________ is the division of the cytoplasmic mass into two parts.

108)

109) The phase of a cell life cycle in which the DNA is replicated is called ________.

109)

110) Aerobic cellular respiration occurs in the ________.

110)

111) The most common intracellular cation is ________.

111)

112) The process of discharging particles from inside a cell to the outside is called ________.

112)

113) A red blood cell would swell if its surrounding solution were ________.

113)

114) Describe two important functions of the Golgi apparatus.

114)

115) Why can we say that a cell without a nucleus will ultimately die?

115)

116) Are random moments of particles, diffusion, and osmosis seen only in living tissue?

116)

117) What processes maintain a steady state "resting" membrane potential?

117)

118) Briefly describe the glycocalyx and its functions.

118)

119) If a sequence of nucleotides on one strand of DNA is CCGATT, what would the complementary sequence look like on the other strand?

119)

120) In all living cells hydrostatic and osmotic pressures exist. Define these pressures and explain how they are used in the concept of tonicity of the cell.

120)

121) Other than the nucleus, which organelle has its own DNA?

121)

122) How are the products of free ribosomes different from membrane-bound ribosomes?

122)

123) How are peroxisomes different from lysosomes?

123)

124) Briefly name the subphases of interphase and tell what they do.

124)

125) What are nucleolar organizer regions?

125)

126) How is the resting potential formed? How is it maintained?

126)

127) List possible causes of aging.

127)

128) What factors contribute to the fragility of the lysosome and subsequent cell autolysis?

128)

129) Why can we say that cells are protein factories?

129)

130) What are cell exons and introns?

130)

131) What are lipid rafts? What are their functions?

131)

132) Follow the pathway that a typical protein, destined for exocytosis will make as it passes from the ribosome, into the rough endoplasmic reticulum. In your answer, be sure to describe role that ribosomes play, and the events that take place in the Rough Endoplasmic reticulum.

132)

133) Describe the events that take place within the Golgi apparatus to a protein that is destined for secretion by the cell into the extracellular fluid.

133)

134) Compare a gap junction to a channel protein, how are they alike and how are the different?

134)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 135) A patient was admitted to the hospital for severe dehydration. Explain what changes occur in extracellular and intracellular fluid compartments during dehydration. 136) Your patient is sitting in your office for a pre-operative appointment and asks you why he will be given a saline IV rather than one containing pure sterile water. What is your response? 137) At the age of 6 months, Caleb was diagnosed with Tay -Sachs disease. As his primary care physician, what would you tell his parents about this disease? 138) Your patient has a respiratory disease that has literally paralyzed the cilia. Explain why this patient would be at an increased risk for a respiratory infection. 139) Describe the difference in cell division between normal cells and cancer cells. 140) Research shows that neurofibrillary tangles associated with the disintegration of microtubules are the primary cause of Alzheimer's disease. If microtubules disintegrate, what then might happen to brain cells?

Answer Key Testname: UNTITLED3

1) B 2) C 3) E 4) A 5) D 6) D 7) C 8) C 9) A 10) B 11) E 12) D 13) A 14) B 15) B 16) C 17) E 18) A 19) D 20) B 21) A 22) D 23) E 24) C 25) B 26) E 27) C 28) D 29) A 30) B 31) A 32) B 33) C 34) C 35) B 36) TRUE 37) TRUE 38) TRUE 39) TRUE 40) FALSE 41) FALSE 42) FALSE 43) TRUE 44) FALSE 45) FALSE 46) FALSE 47) TRUE 48) FALSE 49) TRUE 50) FALSE 14

Answer Key Testname: UNTITLED3

51) TRUE 52) TRUE 53) B 54) C 55) C 56) C 57) D 58) D 59) A 60) A 61) D 62) C 63) D 64) C 65) A 66) D 67) C 68) B 69) A 70) A 71) D 72) A 73) D 74) B 75) A 76) C 77) D 78) A 79) A 80) D 81) C 82) C 83) A 84) A 85) C 86) C 87) C 88) B 89) C 90) C 91) A 92) C 93) D 94) B 95) A 96) A 97) B 98) B 99) A 100) A 15

Answer Key Testname: UNTITLED3

101) C 102) D 103) D 104) A 105) D 106) transfer 107) aquaporins 108) Cytokinesis 109) S phase of interphase 110) mitochondria 111) potassium 112) exocytosis 113) hypotonic 114) To modify, sort, and package proteins. 115) Without a nucleus, a cell cannot make proteins, nor can it replace any enzymes or other cell structures (which are continuously recycled). Additionally, such a cell could not replicate. 116) No. Because they are passive processes that do not require energy, they can occur in the absence of any cellular processes. 117) Both diffusion and active transport mechanisms operate within the cell membrane to maintain a resting membrane potential. 118) The glycocalyx is the sticky, carbohydrate-rich area on the cell surface. It helps bind cells together and provides a highly specific biological marker by which cells can recognize each other. 119) The complementary strand would be GGCTAA since C bonds with G and A bonds with T. 120) Hydrostatic pressure is the pressure of water exerted on the cell membrane. Osmotic pressure is created by different concentrations of molecules in a solution separated by the cell membrane. Because these pressures are exerted on the membrane they can be used by the cell to change the shape of the cell, regulate substances entering and exiting the cell, and change the osmolarity of the cell. 121) Mitochondria 122) Free ribosomes make soluble proteins that function in the cytosol. Membrane-bound ribosomes produce proteins that are to be used on the cell membrane or exported from the cell. 123) Peroxisomes contain oxidases that use oxygen to detoxify harmful substances. They are very good at neutralizing free radicals. Peroxisomes directly bud from the ER. Lysosomes contain powerful hydrolytic enzymes that will pretty much destroy anything they come in contact with. They are manufactured by the Golgi apparatus. 124) G0 - resting phase. The cells do not undergo mitosis in this phase. G1 - growth phase. The cell is metabolically active and the centriole begins to divide at the end of this phase. S - DNA replicates itself. New histones are made and assembled into chromatin. G2 - Enzymes and proteins are synthesized and centriole replication is completed. This is the final phase of interphase. 125) nuclear regions containing the DNA that issues genetic instructions for synthesizing ribosomal RNA 126) It is formed by diffusion-limited concentration differences of ions resulting in ionic imbalances that polarize the membrane. It is maintained by active transport processes. 127) 1. chemical insults and free radical formation (wear and tear theory) 2. diminished energy production by free radical-damaged mitochondria 3. progressive disorders in the immune system 4. genetic programming 128) cell injury, cell oxygen deprivation, presence of excessive amounts of vitamin A in the cell 129) Most of the metabolic machinery of the cell is involved in protein synthesis since structural proteins constitute most of the dry cell material and functional proteins direct all cellular activities. 130) Exons are amino acid-specifying informational sequences in genes. Introns are noncoding gene segments that provide a reservoir of ready-to-use DNA segments for genome evolution and a source of a large variety of RNA molecules. 16

Answer Key Testname: UNTITLED3

131) They are assemblies of saturated phospholipids associated with sphingolipids and cholesterol. They are concentrating platforms for molecules needed for cell signaling. 132) A new polypeptide is translated at the ribosome and is threaded into the rough endoplasmic reticulum (RER). Within the RER the protein is aided in folding by chaperone proteins and modifications, like the addition of carbohydrates can be made to the protein here. The protein will be placed into a vesicle that will migrate from the RER to the cis-face of the Golgi apparatus. 133) Within the Golgi apparatus, further modifications of the protein can take place, like the addition of phosphate groups. The folded and processes protein will then be "tagged" and sent by vesicle from the trans-face of the Golgi apparatus to the plasma membrane for exocytosis. 134) Both allow ions and small molecules to pass through by diffusion. However, gap junctions are embedded within in the plasma membranes of two neighboring cells. The alignment and connection of the gap junctions between the neighboring cells allows the passage of ions and small molecules directly from one cell into another. 135) Fluid volume deficit occurs when the body loses both water and electrolytes from the extracellular fluid compartment. Fluid is initially lost from the intravascular compartment (blood). Then fluid is drawn from the interstitial compartment into the intravascular compartment, depleting the interstitial compartment. To compensate for the decreased volume, the body then draws intracellular fluid out of the cells. This could lead to collapse and death. 136) Saline contains solutes that make it isotonic or equivalent to the blood in his body. If he were given pure water instead, the lack of solutes would push water into the cells causing them to burst. Saline is a better choice because it mimics blood components. 137) It is an inherited condition where various chemicals are broken down in the brain by a cell organelle called the lysosome. Unfortunately, because of the buildup of undigested nerve cell lipids, the symptoms of listlessness and motor weakness will progress to mental retardation, seizures, blindness, and ultimately death. 138) Ciliated cells that live in the respiratory tract propel mucus, laden with dust particles and bacteria, upward and away from the lungs. If the cilia are paralyzed, bacteria remain in the lungs and may cause infection. 139) Normal cells divide in two distinct events–mitosis and cytokinesis which are well-controlled. Cancer cells divide wildly, with uncontrollable mechanisms and defective mitosis, sometimes ending in unequal chromosome sets, which makes them dangerous to their host. Additionally, the cancer cells are non -functioning (useless) cells. 140) Microtubules determine cell shape and intracellular movement. They are dynamic organelles constantly growing from the centrosome, dissembling, and then reassembling. Without microtubules, the elongated brain cell might either lose shape or lose its ability to move materials from end to end and keep its distant parts well -supplied and alive. Loss of signal followed by cell death result.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 4.1 Using Figure 4.1, match the following: 1) Supports and protects; stores calcium.

2) Forms tendons and ligaments.

3) Supports and protects; insulates against heat loss; reserve source of fuel.

4) Provides tensile strength with the ability to absorb compressive shock.

5) Composed of cells in a fluid matrix.

Figure 4.2 Using Figure 4.2, match the following: 6) Simple cuboidal epithelium.

7) Cardiac muscle.

8) Simple squamous epithelium.

9) Stratified squamous epithelium.

10) Skeletal muscle.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) The epithelial membrane that lines the closed ventral cavities of the body.

A) Serous membrane

11)

B) Endothelium membrane 12) The epithelial membrane that lines body cavities open to the exterior membrane. 13) Consists of keratinized stratified squamous epithelium.

12) C) Cutaneous D) Mucous 13)

14) Found lining the digestive and respiratory tracts.

14)

15) Makes up the pleura and pericardium.

15)

16) Lines blood vessels and the heart.

16)

Match the following: 17) Attaches to extracellular matrix.

A) Skeletal muscle

18) Found in areas subjected to wear and tear.

B) Smooth muscle

17) 18)

C) Cell adhesion molecule 19) Pull on bones or skin causing body movements.

19) D) Stratified squamous

20) Moves food through the GI tract.

20)

Match the regeneration capacity of the following tissues: 21) Smooth muscle.

A) Moderate regenerative ability

22) Skeletal muscle.

B) Regenerates extremely well

23) Cardiac muscle.

C) Virtually no functional regenerative ability

24) Areolar connective tissue.

D) Weak regenerative ability

25) Tendons and ligaments.

21) 22) 23) 24) 25)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 26) The shock-absorbing pads between the vertebrae are formed of fibrocartilage.

26)

27) The role of brown fat is to warm the body; whereas, the role of white fat is to store nutrients.

27)

28) Tendons and ligaments are composed mainly of dense irregular connective tissue.

28)

29) Macrophages are found in areolar and lymphatic tissues.

29)

30) Goblet cells are found within pseudostratified ciliated columnar epithelium.

30)

31) Epithelial tissues always exhibit polarity; that is, they have a free surface and a basal surface.

31)

32) Simple cuboidal epithelia are usually found in areas where secretion and absorption occur.

32)

33) Epithelial cells contain both blood vessels and nerve fibers.

33)

34) Elastic cartilage tissue is found in the walls of the large arteries that leave the heart.

34)

35) Adipose tissue is made up of pseudostratified columnar epithelial cells.

35)

36) Merocrine glands produce their secretions by accumulating their secretions internally until the cell ruptures.

36)

37) Salivary glands exhibit compound tubuloalveolar glandular arrangement.

37)

38) Connective tissues that possess a large quantity of collagen fibers often provide the framework for organs such as the spleen and lymph nodes.

38)

39) The basic difference between dense irregular and dense regular connective tissues is in the amount of elastic fibers and adipose cells present.

39)

40) A major characteristic of fibrocartilage is its unique amount of flexibility and elasticity.

40)

41) Cartilage tissue tends to heal less rapidly than bone tissue.

41)

42) Intercalated discs and striations are both characteristics of skeletal muscle.

42)

43) A smooth muscle cell has a central nucleus but lacks striations.

43)

44) Cartilage has good regenerative capacity, while most epithelial tissues do not.

44)

45) Squamous cells are flattened and scale-like when mature.

45)

46) Functions of connective tissues include binding, support, insulation, and protection.

46)

47) Healing of a surgical incision through the body wall will tend to increase the amount of areolar tissue.

47)

48) Endocrine glands are often called ducted glands.

48)

49) Blood is considered a type of connective tissue.

49)

50) Nervous tissue consists mainly of neurons and collagen fibers.

50)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 51) Which of the following is NOT found in cartilage but is found in bone? A) living cells B) organic fibers C) blood vessels

51) D) lacunae

52) The reason that intervertebral discs exhibit a large amount of tensile strength, which allows them to absorb shock, is because they possess ________. A) elastic fibers B) collagen fibers C) hydroxyapatite crystals D) reticular fibers

52)

53) What tissue has lacunae, calcium salts, and blood vessels? A) cartilage tissue B) areolar tissue D) fibrocartilaginous tissue C) bone (osseous tissue)

53)

54) How is hyaline cartilage different from elastic cartilage or fibrocartilage? A) It is more vascularized. B) It allows great flexibility. C) Fibers are not normally visible. D) It contains more nuclei.

54)

55) The primary blast cell for bone is the ________. A) chondroblast B) osteoblast

55) C) hemocytoblast

D) fibroblast

56) Which of the following would be of most importance to goblet cells and other glandular epithelia? A) lysosomes B) microvilli C) Golgi apparatus D) multiple nuclei

56)

57) Which of the following is a modification of the simple columnar epithelium that allows for efficient absorption along portions of the digestive tract? A) thin and permeable B) fibroblasts C) cilia D) dense microvilli

57)

58) A ciliated version of pseudostratified columnar epithelium containing mucus-secreting goblet cells ________. A) is found in some of the larger glands B) lines most of the respiratory tract C) is more durable than all other epithelia D) aids in digestion

58)

59) Which of the following epithelia forms the walls of the air sacs across which gas exchange occurs in the lungs? A) simple squamous B) pseudostratified columnar C) simple columnar D) simple cuboidal

59)

60) Which type of connective tissue serves as the universal packing material between other tissues? A) reticular connective tissue B) hyaline cartilage C) adipose D) areolar connective tissue

60)

61) Connective tissue extracellular matrix is composed of ________. A) ground substance and cells B) cells and fibers C) fibers and ground substance D) all organic compounds

61)

62) Which of the following is found in hyaline cartilage? A) mast cell B) fibroblast C) chondrocyte

62) D) macrophage

63) A substance received or given off by your body will likely pass through which tissue type? A) muscle tissue B) connective tissue C) nervous tissue D) epithelial tissue

63)

64) The fiber type that gives connective tissue great tensile strength is ________. A) muscle B) collagen C) reticular

64) D) elastic

65) When utilizing a transmission electron microscope, why is it necessary to stain the specimen with heavy metal salts? A) The salts provide the three-dimensional image of the specimen. B) The salts provide greater detailing of tissue as electrons bounce off of the tissue. C) The salts are acidic and attract to the specimen. D) The salts provide color to the specimen so that it can be seen.

65)

66) The shape of the external ear is maintained by ________. A) fibrocartilage B) hyaline cartilage C) adipose tissue D) elastic cartilage

66)

67) Inability to absorb digested nutrients and secrete mucus might indicate a disorder in which epithelial tissue? A) simple squamous B) stratified squamous C) transitional D) simple columnar

67)

68) Glands, such as the thyroid, that secrete their products directly into the blood rather than through ducts are classified as ________. A) endocrine B) ceruminous C) exocrine D) sebaceous

68)

69) Which of the following is true about epithelia? A) Pseudostratified epithelia are commonly keratinized. B) Simple epithelia are commonly found in areas of high abrasion. C) Stratified epithelia are associated with filtration. D) Endothelium provides a slick surface lining all hollow cardiovascular organs.

69)

70) Chondroblasts ________. A) remain in compact bone even after the epiphyseal plate closes B) are mature cartilage cells located in spaces called lacunae C) within the cartilage divide and secrete new matrix D) never lose their ability to divide

70)

71) ________ epithelium appears to have two or three layers of cells, but all the cells are in contact with the basement membrane. A) Stratified columnar B) Transitional C) Stratified cuboidal D) Pseudostratified columnar

71)

72) A many-layered epithelium with cuboidal basal cells and flat cells at its surface would be classified as ________. A) stratified squamous B) simple cuboidal C) simple squamous D) transitional

72)

73) Edema (swelling) occurs when ________. A) reticular connective tissue invades the area B) areolar tissue soaks up excess fluid in an inflamed area C) adipose cells enlarge by pinocytosis D) collagen fibers enlarge as they change from dehydrated to hydrated shape

73)

74) Which of the following is true about the mode of secretion of exocrine glands? A) Holocrine cells are slightly damaged by the secretory process, but repair themselves. B) Apocrine cells are destroyed, then replaced, after secretion. C) These glands are ductless. D) Merocrine glands are not altered by the secretory process.

74)

75) Heart muscle cells would tend to separate without ________. A) intercalated discs B) stroma C) myofilaments D) flana

75)

76) Blood vessels keep clots from sticking as long as their ________ is intact and healthy. A) transitional epithelium B) mesothelium C) simple cuboidal epithelium D) endothelium

76)

77) Which is true concerning muscle tissue? A) is a single-celled tissue B) cuboidal shape enhances function C) highly cellular and well vascularized D) contains contractile units made of collagen

77)

78) The first step in tissue repair involves ________. A) proliferation of fibrous connective tissue B) inflammation C) formation of scar tissue D) replacement of destroyed tissue by the same kind of cells

78)

79) What are the three main components of connective tissue? A) alveoli, fibrous capsule, and secretory cells B) collagen, elastin, and reticular fibers C) fibroblasts, chondroblasts, and osteoblasts D) ground substance, fibers, and cells

79)

80) Which of the following statements is true of connective tissue? A) Elastin fibers are sometimes called white fibers. B) When connective tissue is stretched, collagen gives it the ability to snap back. C) Reticular fibers form thick, ropelike structures. D) Collagen fibers provides high tensile strength.

80)

81) Select the correct statement regarding the stem cells of connective tissue. A) Connective tissue does not contain cells. B) "Blast" cells are undifferentiated, actively dividing cells. C) Connective tissue cells are nondividing. D) Chondroblasts are the main cell type of connective tissue proper.

81)

82) Select the correct statement regarding tissue repair. A) The clot is formed from dried blood and transposed collagen fibers. B) Inflammation causes capillaries to dilate and become permeable. C) Granulation tissue is highly susceptible to infection. D) Granulation tissue is another name for a blood clot.

82)

83) Select the correct statement regarding epithelia. A) Stratified epithelia are present where protection from abrasion is important. B) Pseudostratified epithelia consist of at least two layers of cells stacked on top of one another. C) Stratified epithelia are tall, narrow cells. D) Simple epithelia form impermeable barriers.

83)

84) Select the correct statement regarding adipose tissue. A) Its primary function is nutrient storage. B) Most of the cell volume is occupied by the nucleus. C) It is composed mostly of extracellular matrix. D) Mature adipose cells are highly mitotic.

84)

85) Which cells are commonly found wedged between simple columnar epithelial cells? A) fibroblasts B) macrophages C) mast cells D) goblet cells

85)

86) Which of the following is NOT a step in tissue repair? A) regeneration and fibrosis B) restoration of blood supply C) inflammation D) formation of new stem cells

86)

87) Mesenchymal cells are most commonly found in ________ connective tissue. A) reticular B) dense regular C) embryonic

87)

88) Which tissue type would likely function to hold the kidneys in place? A) dense regular B) adipose C) reticular

D) areolar 88) D) smooth muscle

89) Which tissue type is formed by many cells joining together, which are multinucleated? A) smooth muscle B) cardiac muscle C) dense regular D) skeletal muscle

89)

90) Choose which tissue type likely functions to add support to an organ. A) transitional B) cardiac muscle C) stratified squamous epithelium D) hyaline cartilage

90)

91) Your instructor gives you an unknown organ for you to examine and identify through microscopy. What should you do first with the sample? A) examine it for artifacts B) stain it to enhance contrast C) cut it into sections D) fix it with preservative

91)

92) Choose which tissue would line the uterine (fallopian) tubes and function as a "conveyer belt" to help move a fertilized egg towards the uterus. A) ciliated simple columnar epithelium B) simple cuboidal epithelium C) stratified squamous epithelium D) smooth muscle

92)

93) Skin, lung, and blood vessel walls have which tissue characteristic in common? A) elastic fibers B) simple squamous epithelium C) simple columnar epithelium D) reticular fibers

93)

94) Generally speaking, connective tissues are largely non-living extracellular matrix. Which of the following is an EXCEPTION? B) areolar C) adipose D) bone A) blood

94)

95) The salivary glands are a good example of a ________ exocrine gland. A) simple branched alveolar B) compound tubular C) compound alveolar D) compound tubuloalveolar

95)

96) Which tissue in the wall of the uterus is required for labor contractions? A) skeletal muscle B) smooth muscle C) stratified squamous D) elastic cartilage

96)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 97) What is the difference between exocrine and endocrine glands?

97)

98) Macrophage-like cells are found in many different tissues, and may have specific names that reflect their location or specializations. What is the one functional characteristic common to all macrophage-like cells?

98)

99) All of the following statements refer to events of tissue repair. Put the events in proper numbered order according to the sequence of occurrence. The initial event, the injury, is already indicated as number one.

99)

1. The skin receives a cut that penetrates into the dermis and bleeding begins. 2. Epithelial regeneration is nearly complete. 3. Granulation tissue is formed. 4. Blood clotting occurs and stops the blood flow. 5. The wound retracts. 6. Macrophages engulf and clean away cellular debris. 7. Fibroblasts elaborate connective tissue fibers to span the break. 100) Since mature adipocytes rarely divide, how can adults gain weight?

100)

101) Tendon tears or breaks are difficult to repair both physiologically and surgically. Why?

101)

102) How is epithelial tissue the opposite of connective tissue?

102)

103) How can one tell the difference between stratified squamous epithelium and transitional epithelium?

103)

104) How is blood unique among connective tissues?

104)

105) In terms of structure and function, compare the type of epithelium lining the trachea, air sacs of the lungs, and the epidermis of the skin.

105)

106) Explain what is meant by epithelial tissue being avascular but innervated.

106)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 107) A 45-year-old woman is admitted to the hospital for surgical removal of a tumor on her thyroid gland. The surgeon informs her that she will have only a very thin scar. How could this be possible? 108) John, a 72-year-old grandfather, had been smoking heavily for 24 years and had a persistent cough. A biopsy of his lung tissue revealed considerable amounts of carbon particles. How could this happen considering the natural cleaning mechanism of the respiratory system? 109) Aunt Jessie woke up one morning with excruciating pain in her chest. She had trouble breathing for several weeks. Following a visit to the doctor, she was told she had pleurisy. What is this condition and what did it affect? 110) In adult humans, most cancers are carcinomas or adenocarcinomas. These include cancers of the skin, lung, colon, breast, and prostate. Which of the four basic tissue types is involved? Why do you think this is so? 111) Explain why an open wound would need a bed of granulation tissue for wound healing to occur. 112) Without macrophages, wound healing is delayed. Why? 113) A 62-year-old woman was in a car accident and suffered severe brain damage. Will the brain be able to repair the damaged tissue to a functional level? Explain your answer. 114) Explain why an infection may occur in a tissue injury.

Answer Key Testname: UNTITLED4

1) D 2) B 3) A 4) C 5) E 6) B 7) C 8) A 9) D 10) E 11) A 12) D 13) C 14) D 15) A 16) B 17) C 18) D 19) A 20) B 21) A 22) D 23) C 24) B 25) A 26) TRUE 27) TRUE 28) FALSE 29) TRUE 30) TRUE 31) TRUE 32) TRUE 33) FALSE 34) TRUE 35) FALSE 36) FALSE 37) TRUE 38) FALSE 39) FALSE 40) FALSE 41) TRUE 42) FALSE 43) TRUE 44) FALSE 45) TRUE 46) TRUE 47) FALSE 48) FALSE 49) TRUE 50) FALSE 11

Answer Key Testname: UNTITLED4

51) C 52) B 53) C 54) C 55) B 56) C 57) D 58) B 59) A 60) D 61) C 62) C 63) D 64) B 65) B 66) D 67) D 68) A 69) D 70) C 71) D 72) A 73) B 74) D 75) A 76) D 77) C 78) B 79) D 80) D 81) B 82) B 83) A 84) A 85) D 86) D 87) C 88) B 89) D 90) D 91) D 92) A 93) A 94) C 95) D 96) B

Answer Key Testname: UNTITLED4

97) Exocrine glands have ducts and secrete their products onto body surfaces such as the skin or into body cavities. Examples include the liver, the pancreas, mucouse, sweat, oil, and salivary glands. Endocrine glands do not have ducts, produce hormones, and secrete them directly into the extracellular space. The hormones then enter the blood or lymphatic fluid and travel to specific target organs. Examples include the pineal gland, the pituitary gland, the testes, the ovaries, and the adrenal glands. 98) phagocytosis 99) 1, 4, 3, 7, 6, 5, 2 100) Adipocytes contain a fat-filled vacuole that can fill or empty, causing the cell to gain or lose volume. Mature adipocytes are among the largest cells in the body. 101) Tendons are composed of dense regular connective tissue, which consists of densely packed, parallel connective tissue fibers. This type of tissue has relatively few cells and vascular supply is poor; consequently, repair is slow. Because of the structure of the tissue, surgical repair can be compared to attempting to suture two bristle brushes together. The broken ends of existing collage fibers will not reunite and can still slip past each other. Furthermore, any scar that forms has an irregular pattern with less one-way strength than parallel fibers. 102) Epithelial versus connective distinctions include: tight cell packing versus wide cell spacing, avascular versus vascular (except cartilage), polar versus nonpolar orientation, no matrix versus matrix (with important fibers), limited versus numerous cell types, and surface versus subsurface purposes. 103) The most reliable distinctions are two. Compared to stratified squamous epithelium, transitional epithelium has fewer layers (6 or less) and has more rounded surface cells when it is bunched up with more apparent layers and more likely to be mistaken for stratified squamous. 104) Blood does not give mechanical support, its matrix is fluid, the cells are loose, the fibers are soluble, it carries nutrients, waste products, and other substances, and it attaches to several gases. 105) The trachea is lined with ciliated pseudostratified columnar epithelium with goblet cells. The mucus produced by the goblet cells traps dust, bacteria, and other debris and the cilia move it upwards away from the lungs. The air sacs of the lungs are lined with simple squamous epithelium that serves as a thin, efficient membrane for gas exchange between air and blood. The epidermis of the skin consists of stratified squamous epithelium which functions as physical protection against abrasion, bacteria, and drying out. 106) Epithelial tissue contains no blood vessels but is supplied by nerve fibers. 107) By making a sharp incision which minimizes the number of injured cells and wound defects once reapproximated, the amount of granulation (scar-forming) tissue will be minimal. As the scar tissue beneath matures and contracts, very little new epithelium needs to bridge the gap. The final result may be only a fine white line. 108) The sweeping action of the ciliated epithelium is essential in order to propel inhaled dust and other debris out of the respiratory tract. Anything that inhibits this mechanism would allow foreign substances to remain in the tract, which may cause damage. Chemicals such as nicotine may inhibit the action of the cilia, allowing carbon particles found in smoke to reach the lungs. 109) Pleurisy is an inflammation of the pleura, the serosal membranes covering the lungs and lining the thoracic wall. Pain is caused by the irritation and friction as the lungs rub against the walls of the cavity. 110) Epithelium gives rise to most cancers. This is probably because epithelial cells divide more, leading to more opportunity for damage to growth control mechanisms, and because epithelia are more often in contact with environmental insults such as ultraviolet radiation and carcinogens. 111) Epithelium cannot grow across a defect without a blood supply from underlying connective tissue. Granulation tissue contains capillaries that grow in from nearby areas and first lay down the needed capillary bed. 112) Macrophages are large, irregularly shaped cells that act as key defenders that avidly phagocytize a broad variety of foreign materials, ranging from foreign molecules to entire bacteria to dust particles. This "big eater" also disposes of dead tissue cells, which helps to clean out the wound, allowing for granulation tissue to form. 113) Cardiac muscle and tissues in the brain and spinal cord have virtually no functional regenerative capacity. In most cases, this tissue would be replaced by scar tissue and would remain nonfunctional. While new research is showing that unexpected cell division can sometimes occur in tissues, the chances of this occurring in the brain are very small. 114) The skin is the largest organ in the body and protects underlying tissues from injury by preventing the passage of microorganisms. The skin and the mucous membranes are considered the body's first line of defense. 13

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 5.1 Using Figure 5.1, match the following: 1) Site of the dermal ridges that produce epidermal ridges on the epidermal surfaces of the fingers.

2) Responsible for shock absorption and located in the hypodermis.

3) Pulls the hair follicle into an upright position.

4) Sudoriferous gland.

5) Dense irregularly arranged, fibrous connective tissue.

6) Region that thickens markedly when one gains weight.

7) Where capillary loops are found.

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 8) The most abundant cells of the epidermis.

A) Melanocyte

B) Keratin 9) Spider-shaped epithelial cells that synthesize the pigment melanin. 10) Cells plus a disc-like sensory nerve ending that functions as a sensory receptor for touch.

9) C) Dendritic cells D) Merkel cells

10)

E) Keratinocytes

11) Skin macrophages that help activate the immune system.

11)

12) The fibrous protein that helps give the epidermis its protective properties.

12)

Match the following: 13) The layer of the epidermis where the cells are considered protective but nonviable.

A) Stratum basale

14) The layer of the epidermis that is several layers thick and contains pre-keratin.

C) Stratum corneum

13)

B) Stratum spinosum 14)

D) Stratum granulosum

15) The layer that contains the mitotic viable cells of the epidermis.

15)

16) The layer of the epidermis that contains one to five layers of flattened cells and deteriorating organelles.

16)

Match the following: 17) May indicate embarrassment, fever, hypertension, inflammation, anger, or allergy.

A) Pallor

18) May indicate fear, anemia, or low blood pressure.

C) Jaundice

19) Usually indicates a liver disorder. 20) Appearance of a permanent tan; bronzing.

17)

B) Cyanosis 18)

D) Erythema 19) E) Addison's disease 20)

21) A bluish color in light-skinned individuals.

21)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 5.2 Using Figure 5.2, match the following: 22) Hypodermis.

22)

23) Epidermis.

23) 3

24) Reticular layer of the dermis.

24)

25) Papillary layer of the dermis.

25)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 26) The eccrine sweat glands are not the primary gland involved in thermoregulation.

26)

27) The dense fibrous connective tissue portion of the skin is located in the reticular region of the dermis.

27)

28) The protein found in large amounts in the superficial layer of epidermal cells is keratin.

28)

29) Joe just burned himself on a hot pot, and the burn is quite painful. Joe's burn would best be described as a third-degree burn.

29)

30) The reason that the nail bed appears pink is the presence of a large number of melanocytes in the underlying dermis.

30)

31) During the regressive phase of hair growth, the matrix is inactive and the follicle atrophies.

31)

32) The skin cancer most likely to metastasize is cancer of the melanocytes.

32)

33) The skin is not able to receive stimuli because the cells of the epidermis are not living and therefore there are no sensory receptors in the skin.

33)

34) The dermis contains blood vessels and nerve fibers while the epidermis does not.

34)

35) For a doctor, simply looking at a patient's skin can help towards making a diagnosis.

35)

36) When an individual is exposed to extremely cold air the dermal blood vessels will dilate so that more blood will be brought closer to the outside surface of the skin.

36)

37) Regardless of race, all human beings have about the same number of melanocytes.

37)

38) Cells in the stratum corneum undergo mitosis to keep the layer thick and protective.

38)

39) The pinkish hue of individuals with fair skin is the result of the crimson color of oxygenated hemoglobin (contained in red blood cells) circulating in the dermal capillaries and reflecting through the epidermis.

39)

40) When a patient is said to have "third-degree burns," this indicates that the patient has burns that cover approximately one-third or more of the body.

40)

41) Thick skin has a more extensive dermal layer than thin skin.

41)

42) The action of the arrector pili muscle is very similar in humans as it is in other mammals but its beneficial functions differ.

42)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 43) Select the most correct statement concerning skin cancer. A) Melanomas are rare but must be removed quickly to prevent them from metastasizing. B) Basal cell carcinomas are the least common but most malignant. C) Most tumors that arise on the skin are malignant. D) Squamous cell carcinomas arise from the stratum corneum.

43)

44) A needle would pierce the epidermal layers of the forearm in which order? A) corneum, granulosum, spinosum, basale B) granulosum, basale, spinosum, corneum C) basale, spinosum, granulosum, lucidum, corneum D) basale, spinosum, granulosum, corneum

44)

45) The major regions of a hair shaft include all of the following EXCEPT ________. A) cortex B) cuticle C) medulla D) external root sheath

45)

46) The single most important risk for skin cancer is ________. A) genetics B) overexposure to UV radiation C) race D) use of farm chemicals

46)

47) A splinter penetrated into the skin of the sole of the foot, almost to the papillary region of the dermis. Which layer of the epidermis would be the final layer injured? B) granulosum C) spinosum D) lucidum A) basale

47)

48) Which of the following is a skin sensory receptor for touch? A) Ruffini body B) tactile cells C) free nerve ending D) Pacinian corpuscle

48)

49) Which statement correctly explains why hair appears the way it does? A) Perfectly round hair shafts result in wavy hair. B) Air bubbles in the hair shaft cause straight hair. C) Gray hair is the result of hormonal action altering the chemical composition of melanin. D) Kinky hair has flat, ribbonlike hair shafts.

49)

50) The function of the root hair plexus is to ________. A) bind the hair root to the dermis B) cause apocrine gland secretion into the hair follicle C) serve as a source for new epidermal cells for hair growth after the resting stage has passed D) allow the hair to assist in touch sensation

50)

51) Which of the following glands secrete sebum, an oily like substance? A) sebaceous glands B) merocrine glands C) apocrine glands D) eccrine glands

51)

52) The reason the hypodermis acts as a shock absorber is that ________. A) the major part of its makeup is adipose, which serves as an effective shock absorber B) it is located just below the epidermis and protects the dermis from shock C) it has no delicate nerve endings and can therefore absorb more shock D) the cells that make up the hypodermis secrete a protective mucus

52)

53) Which type of skin cancer is the most dangerous because it is highly metastatic and resistant to chemotherapy? B) squamous cell carcinoma A) basal cell carcinoma C) adenoma D) melanoma

53)

54) Which of the following cells and their function are correctly matched? A) melanocytes – protects cells in the stratum corneum from damaging effects of sun's rays B) dendritic cells – activate the immune system C) keratinocytes – provide sense of touch and pressure D) tactile cells – protection

54)

55) Melanocytes and keratinocytes work together in protecting the skin from UV damage when keratinocytes ________. A) maintain the appropriate pH in order for the melanocyte to synthesize melanin granules B) maintain the appropriate temperature so the product of the melanocyte will not denature C) accumulate the melanin granules on their superficial portion, forming a UV-blocking pigment layer D) provide the melanocyte with nutrients necessary for melanin synthesis

55)

56) The epidermis consists of five layers of cells, each layer with a distinct role to play in the health, well-being, and functioning of the skin. Which of the following layers is responsible for cell division and replacement? A) stratum basale B) stratum lucidum C) stratum granulosum D) stratum corneum

56)

57) Water loss through the epidermis could cause a serious threat to health and well -being. Which of the following protects us against excessive water loss through the skin? A) Fat associated with skin prevents water loss. B) Glycolipids that are secreted by keratinocytes into extracellular spaces. C) The size and shape of the cells that make up the stratum spinosum, as well as the thick bundles of intermediate filaments. D) The dermis is the thickest portion of the skin and water cannot pass through it.

57)

58) The dermis is a strong, flexible connective tissue layer. Which of the following cell types are likely to be found in the dermis? A) goblet cells, parietal cells, and chondrocytes B) monocytes, reticulocytes, and osteocytes C) osteoblasts, osteoclasts, and epithelial cells D) fibroblasts, macrophages, and mast cells

58)

59) The dermis has two major layers. Which layer constitutes 80% of the dermis and is responsible for the tension lines in the skin? A) the hypodermal layer B) the reticular layer C) the papillary layer D) the subcutaneous layer

59)

60) Despite its apparent durability, the dermis is subject to tearing. How might a person know that the dermis has been previously stretched and/or torn? A) There is an episode of acute pain due to the large number of tactile corpuscles. B) The stretching causes the tension lines to disappear. C) The blood vessels in the dermis rupture and the blood passes through the tissue, causing permanent "black-and-blue marks." D) The appearance of visible, silvery-white scars is an indication of stretching of the dermis.

60)

61) The papillary layer of the dermis is composed of loosely packed connective tissue with numerous peg-like projections that provide a great deal of surface area connecting the dermis to the epidermis. Which of the statements below do NOT represent benefits provided by the papillary layer's anatomy? A) The looseness allows for phagocytes to roam through the tissue and search for infection. B) The high surface area allows for a stronger connection of dermis to epidermis. C) The spaces in the connective tissue allow many small blood vessels to deliver nutrients and pick up waste diffusing from the superficial epidermal layers. D) The looseness allows for easy separation of the dead cell layer of epidermis to be shed.

61)

62) The friction ridges seen in finger, palm and foot prints are different among various people but very similar between identical twins. This evidence suggests which of the following? A) That friction ridges change over time. B) That friction ridges allow for better tactile sensation. C) That friction ridges aid in griping. D) That friction ridges are genetically determined.

62)

63) Which of the following statements indicates the way in which the body's natural defenses protect the skin from the effects of UV damage? A) The skin is protected by the synthesis of three pigments that contribute to the skin's color. B) The skin is protected by increasing the number of epidermal dendritic cells, which help to activate the immune system. C) Prolonged exposure to the sun induces melanin dispersion, which in turn acts as a natural sunscreen. D) Carotene, which accumulates in the stratum corneum and hypodermal adipose tissue, is synthesized in large amounts in the presence of sunlight.

63)

64) Changes in the color of skin are often an indication of a homeostatic imbalance. Which of the following would indicate a liver disease such as hepatitis resulting in elevated bilirubin? A) Black-and-blue marks become evident for no apparent cause. B) The skin takes on a bronze or metallic appearance. C) The skin and sclera of the eyes appears to have an abnormal, yellowish tint. D) It is impossible to suggest Addison's disease from an inspection of a person's skin.

64)

65) A dendritic or Langerhans cell is a specialized ________. A) squamous epithelial cell B) phagocytic cell C) melanocyte D) nerve cell

65)

66) What are the most important factors influencing hair growth? A) sex and hormones B) the size and number of hair follicles C) nutrition and hormones D) age and glandular products

66)

67) Sudoriferous (sweat) glands are categorized as two distinct types. Which of the following are the two types of sweat glands? A) sebaceous and merocrine B) eccrine and apocrine C) mammary and ceruminous D) holocrine and mammary

67)

68) The composition of the secretions of the eccrine glands is ________. A) fatty substances, proteins, antibodies, and trace amounts of minerals and vitamins B) 99% water, sodium chloride, trace amounts of wastes, and vitamin C C) metabolic wastes D) primarily uric acid

68)

69) Apocrine glands, which begin to function at puberty under hormonal influence, seem to play little role in thermoregulation. Where would we find these glands in the human body? A) in the axillary and anogenital area B) in the palms of the hands and soles of the feet C) beneath the flexure lines in the body D) in all body regions and buried deep in the dermis

69)

70) The sebaceous glands are simple alveolar glands that secrete a substance known as sebum. The secretion of sebum is stimulated ________. A) by high temperatures B) when the air temperature drops C) as a protective coating when one is swimming D) by hormones, especially androgens

70)

71) In addition to protection (physical and chemical barrier), the skin serves other functions. Which of the following is another vital function of the skin? A) It absorbs vitamin C so that the skin will not be subject to diseases. B) It aids in the transport of materials throughout the body. C) It converts modified epidermal cholesterol to a vitamin D precursor important to calcium metabolism. D) The cells of the epidermis store glucose as glycogen for energy.

71)

72) Burns are devastating and debilitating because of loss of fluids and electrolytes from the body. How do physicians estimate the extent of burn damage associated with such dangerous fluid loss? A) by using the "rule of nines" B) by observing the tissues that are usually moist C) through blood analysis D) by measuring urinary output and fluid intake

72)

73) Which layer of tissue is damaged in a first-degree burn? A) hypodermis B) epidermis C) dermis D) both the epidermis and dermis

73)

74) Eyebrow hairs are always shorter than hairs on your head because ________. A) the vascular supply of the eyebrow follicle is one-tenth that of the head hair follicle B) eyebrow follicles are only active for a few months C) hormones in the eyebrow follicle switch the growth off after it has reached a predetermined length D) they grow much slower

74)

75) Cells of the stratum spinosum have many interlocking desmosomes that will remain between the cells as they migrate to the stratum corneum. These cell junctions serve the body by ________. A) preventing ultraviolet light from penetrating the deeper layers of the epidermis B) allowing secretions like sweat or sebum to pass through C) stopping water loss and preventing dehydration D) preventing mechanical stress or trauma from damaging the epidermis

75)

76) Which of the following examples listed below illustrates homeostasis maintained by a negative feedback? A) Changes in the response of the hair follicle to dihydrotestosterone (DHT). B) Formation of cerumen wax to deter insects from entering the ear. C) Production of vitamin D initiated by the suns UV light striking the skin. D) Thickening of epidermis to form a callus in places where the skin is exposed to friction.

76)

77) Which of the following examples listed below illustrates homeostasis maintained by a negative feedback? A) The secretion of antibacterial compounds in sebum. B) The near waterproof secretions of glycolipids that is released by cells in the stratum granulosum. C) Release of chemical signals by keratinocytes that have been damaged by UV light that will increase the production of melanin. D) Removal of nitrogenous compounds like urea within the sweat.

77)

78) Which of the following examples listed below illustrates homeostasis maintained by a negative feedback? A) Lack of pain in third-degree burns due to damage to sensory nerves in the dermis. B) An increase in sebum production in response to androgens (male sex hormones). C) Release of sweat by eccrine glands in response to heat. D) Excretion of salts within the sweat.

78)

79) Which layer of skin is LEAST protected by melanin? A) stratum granulosum B) stratum spinosum C) stratum basale D) stratum corneum

79)

80) Which layer of the epidermis will be supplied with the highest levels of oxygen from the blood? A) stratum granulosum B) stratum basale C) stratum spinosum D) stratum corneum

80)

81) A patient has skin that is slightly blue in color. A likely treatment for this person might be ________. A) exposing the patient to more sunlight B) encouraging the patient to eat more orange colored vegetables (rich in beta carotene) C) increasing fluids through IV therapy D) giving the patient supplemental oxygen by mask

81)

82) The arrector pili muscle's predominate, useful function in humans is to ________. A) provide warmth by making the hair stand on end B) prevent germs from entering the hair shaft C) stimulate faster hair growth D) assist in the release sebum from nearby sebaceous glands

82)

83) Which of the following is NOT one of the functions of the skin? A) Gives the body its overall shape, loss of this function can be seen with the drooping of skin with age. B) Holds a portion of the bloods total volume to be shunted (diverted) to other organs when needed. C) Conducts endergonic metabolic chemical reactions using the suns energy to initiate vitamin D synthesis. D) Delivers important information about our environmental conditions to our brains.

83)

84) All of the following will help the skin to fight infection but one. Which of the following will have little effect on the skin's ability to fight infection? A) More tight junctions between keratinocytes of the stratum corneum. B) Increased secretions of defensins from skin cells. C) Greater production of melanin. D) Greater production of keratinocytes resulting in more layers of the stratum corneum.

84)

85) A light skinned person who is very cold may have a pale appearance. Which of the following is the best explanation for why this might be so? A) The person is in fear of hypothermia (sever cold exposure). B) The person's blood vessels in the epidermis have undergone vasodilation (widening). C) The person's blood vessels in the dermis have undergone vasoconstriction (narrowing). D) The cold has slowed the movement of blood.

85)

86) A surgeon opens her patient by cutting the integument parallel to the cleavage lines of the dermis (tension lines). This will result in ________. A) greater chance of infection B) faster healing of the skin and less scaring C) less chance for infection D) slowed healing and greater scaring

86)

87) A light-skinned person may appear pink when they become over heated. The best explanation for this is ________. A) the melanocytes are responding to the heat of the sun and change the appearance of the skin with increased production B) the blood vessels of the dermis have undergone vasodilation, bringing a greater volume of blood to the skin C) blood flow has increased to the sweat glands in order to increase their metabolic activity D) the heart is pumping faster because the person was probably exercising

87)

88) William has a cut that is superficial, painful but not bleeding. Based on this information, you would predict that the cut has penetrated to ________. A) the papillary layer but not the reticular layer B) the stratum corneum but not the stratum granulosum C) the stratum basale but not the dermal layers D) the subcutaneous layer, but no deeper

88)

89) The surge of sex hormones that accompanies puberty has a wide range of effects on the body. One of those effects is to enhance the activity of the sebaceous glands, increasing the production of sebum. Which of the following is the most likely to result from the increased sebaceous activity? A) Increased hair growth. B) Increased cooling of the skin. C) Decreased vitamin D synthesis. D) Increased oily appearance and more acne.

89)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 90) Cradle cap in infants is called ________.

90)

91) The white crescent portion of the nail is called the ________.

91)

92) The dermal folds that occur at or near joints where the dermis is tightly secured to deeper structures are called ________.

92)

93) The ________ are the small muscles located in the dermis that cause goose bumps.

93)

94) Tanning or darkening of the skin occurs as a defensive response to ________.

94)

95) The coarse hair of the eyebrows and scalp is called ________ hair.

95)

96) Burns that result in injury to the epidermis and the upper regions of the dermis is called a ________ burn.

96)

97) Pigment-producing cells in the epidermis are ________.

97)

98) The only place you will find stratum ________ is in the skin that covers the palms, fingertips, and soles of the feet.

98)

99) List the layers of the dermis and describe the functions of the tissue that makes up each layer.

99)

100) There are several reasons other than genetics for hair loss. Identify some of these other factors.

100)

101) In addition to the synthesis of vitamin D, keratinocytes are able to carry out some other biologically important functions. Name at least two of these other functions.

101)

102) How are burns commonly classified? Give an example.

102)

103) What is vellus hair?

103)

104) Balding men have tried all kinds of remedies, including hair transplants, to restore their lost locks. Explain the cause of male pattern baldness.

104)

105) The skin protects, but how does it protect us and from what? Describe how the epidermal dendritic cells and melanocytes protect us. Describe what these cells protect us from.

105)

106) Billions of consumer dollars are spent for deodorants and antiperspirants each year. Explain the production of body odors frequently associated with axillary skin.

106)

107) What complications might be anticipated from the loss of large areas of skin surfaces?

107)

108) Why are the apocrine sweat glands fairly unimportant in thermal regulation?

108)

109) Why is profuse sweating on a hot day good, and yet a potential problem?

109)

110) What is the function of skin dermal folds and deep skin creases?

110)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 111) We are told that every surface we touch is teeming with bacteria, and bacteria are found in the pools we swim in, the water we wash with, and on the hands of friends. Why are we not inundated with bacterial infections on our skin? 112) The temperature yesterday was an uncomfortable 98°F. You unwisely chose to play tennis at noon, counting on your body's internal defenses to protect you against heat exhaustion. How did your body respond to this distress? 113) Mary noticed a large, brown spot on her skin. She has been playing tennis in the sun for several years without sun protection. She reported the discovery to a friend, who told her to apply the ABCD rule to determine whether or not she had malignant melanoma. Her friend told her that if her answer was "no" to the questions that were asked by the ABCD rule, she had nothing to worry about. What is the ABCD rule and should she ignore the spot if her answers are negative? 114) The Waldorf family was caught in a fire but escaped. Unfortunately, the father and daughter suffered burns. The father had second-degree burns on his entire chest, abdomen, and both arms, and third -degree burns on his entire left lower extremity. The daughter suffered first-degree burns on her whole head and neck and second-degree burns throughout both lower extremities. a. What percentage of the father's body was covered by burns? b. What percentage of the daughter's body received first-degree burns? c. What part of the daughter's body has both the dermis and epidermis involved? d. The father experiences a good deal of pain in the area of the chest and abdomen, but little pain in the leg. Why? 115) John, a younger teenager, notices that he is experiencing a lot of pimples and blackheads, which frequently become infected. What is causing this problem? 116) Janet, a 28-year-old lawyer, bought a brand new pair of shoes for her first court appearance. After wearing them for the first time, she noticed pain on her heel and a fluid -filled lesion. Explain what has happened. 117) Melanoma is a form of skin cancer that arises from melanocytes. Melanoma is most common in Caucasians between 40 and 70 years of age. Explain why Caucasians would have a greater incidence of melanoma. 118) The 68-year-old patient was admitted to the hospital medical floor with a diagnosis of chronic bronchitis. His wife asks the nurse why his skin looks blue. How would you explain cyanosis to the patient and his wife? 119) Explain why soap that has an alkaline base may not be healthy for some patients to use daily. 120) Robert, a surfer, has a mole that has changed its shape and size. His doctor, applying the ABCDE rule, diagnosed a melanoma. What do the letters ABCDE represent?

Answer Key Testname: UNTITLED5

1) E 2) B 3) A 4) C 5) D 6) B 7) E 8) E 9) A 10) D 11) C 12) B 13) C 14) B 15) A 16) D 17) D 18) A 19) C 20) E 21) B 22) D 23) A 24) C 25) B 26) FALSE 27) TRUE 28) TRUE 29) FALSE 30) FALSE 31) TRUE 32) TRUE 33) FALSE 34) FALSE 35) TRUE 36) FALSE 37) TRUE 38) FALSE 39) TRUE 40) FALSE 41) FALSE 42) TRUE 43) A 44) A 45) D 46) B 47) A 48) B 49) D 50) D 13

Answer Key Testname: UNTITLED5

51) A 52) A 53) D 54) B 55) C 56) A 57) B 58) D 59) B 60) D 61) D 62) D 63) C 64) C 65) B 66) C 67) B 68) B 69) A 70) D 71) C 72) A 73) B 74) B 75) D 76) D 77) C 78) C 79) D 80) B 81) D 82) D 83) A 84) C 85) C 86) B 87) B 88) C 89) D 90) seborrhea 91) lunula 92) flexure lines 93) arrector pili 94) UV radiation 95) terminal 96) second-degree 97) melanocytes 98) lucidum

Answer Key Testname: UNTITLED5

99) The papillary layer is composed of areolar connective tissue that allows phagocytes and other defensive cells to serve as a second line of defense against microbial invasion. The reticular layer is composed of dense irregular connective tissue that gives the skin strength and resiliency, maintains hydration, and provides elasticity to the skin. 100) Stressors such as acutely high fever, surgery, severe emotional trauma; drugs such as antidepressants and chemotherapy drugs; burns and radiation; lack of adequate nutrition due to poor skin circulation; and a protein-deficient diet can cause hair loss or thinning in our 4th decade of life and beyond. 101) Keratinocyte enzymes can neutralize carcinogens that penetrate the epidermis. Keratinocytes are also able to convert topical cortisone to a more active anti-inflammatory form. 102) Burns are classified according to their severity or depth. For example, in first-degree burns, only the epidermis is damaged; in second-degree burns, the epidermis and upper dermis are damaged; in third-degree burns, there is widespread damage of epidermis and dermis. 103) Vellus hair is pale, fine body hair associated with newborn children, women, and "peach fuzz" on all people. 104) It appears to be genetically determined and sex-linked, and is possibly caused by a delayed-action gene that responds to DHT and alters normal metabolism. 105) The epidermal dendritic cells act as antigen-presenting cells (APC): They present part of the pathogens (fragments of pathogens called epitopes) to other immune system cells to trigger an immune response to an infection. The melanocytes produce melanin in response to exposure to cell damaging, ultraviolet light. UV light is converted to heat when it strikes melanin pigment. Unlike UV light, heat will not damage the cells, particularly the DNA within the nucleus of the skin's cells. 106) Sweat is mostly an odorless watery secretion produced by eccrine and apocrine glands. The odor usually arises when bacteria break down lipids and proteins in the surface secretions. 107) Large losses of skin, as with severe burn injuries, allow excessive fluid loss and infection. Skin grafting or "synthetic skin" applications are usually necessary. 108) They are largely confined to the axillary and anogenital regions rather than distributed on the body where heat can be more readily dissipated. 109) Good because the sweat and evaporating of the sweat causes cooling of the body. Bad because excessive water and salt loss may occur. Fluid and electrolyte imbalances may follow. 110) Skin dermal folds and deep skin creases accommodate for joint movement. 111) The low pH of the skin secretions, otherwise known as the acid mantle, retards the multiplication of bacteria on the skin. Also, in areas where sufficient sebum is produced regularly, many species of bacteria cannot exist. Beside the barrier qualities of the skin, it is also true that not all bacteria are harmful or thrive on skin. Skin is dry imparing bacteria to grow; Sweat contains high salt (NaCl) along with antimicrobial agents such as defensins and antibody: IgA. 112) The thermoreceptors sense the temperature change, and neural stimulation responds by stimulating sweat glands. Their watery products evaporated at the skin surface and cooled the body. Blood vessels in the dermis also responded by dilating and releasing heat closer to the surface of the skin to allow greater heat dissipation. 113) The ABCD rule refers to the following: asymmetry–where the two sides of the spot do not match; border irregularity –the borders are not round and smooth; color–the pigmented spot contains shades of black, brown, tan, and sometimes blues and reds; and diameter–the spot is larger than 6 mm in diameter. It is imperative that Mary have a physician examine the spot immediately. Any unusual lesion on the skin of a sun worshipper should be examined and the ABCD rule does not account for all possible factors, such as rapid growth, even if less than 6 mm. The fact that she has been exposed to the sun without protection itself would be a strong recommendation for her to see a dermatologist regardless of passing the ABCD rule. 114) a. 45% (18% anterior torso + 9% both arms but not forearms + 18% lower extremity) b. 9% c. 36% d. Normally, third-degree burns sear nerve endings off. When the tissue regenerates, pain will return. Second-degree burns are usually very painful because of the irritated but live nerve endings. 115) Because of hormonal changes, teenagers frequently have overactive sebaceous (oil) glands, which can clog and become infected or inflamed. Scratching, squeezing, or irritating the tissue can lead to infection. 15

Answer Key Testname: UNTITLED5

116) A blister, a fluid-filled pocket that separates the epidermal and dermal layers, has formed due to her new shoes rubbing her heel. The repeated friction of the shoe rubbing her skin created the blister. 117) Melanoma has its beginnings in melanocytes, the skin pigment cells. These cells produce the dark protective pigment called melanin to protect against sun damage to DNA. Since the melanocytes in Caucasian people do not make as much melanin per cell as darker-skinned individuals, their melanocytes are more easily sun-damaged, resulting in damaged DNA cells that are more apt to lose genetic control of their own cell division. 118) Cyanosis is a dusky bluish or grayish discoloration of the skin and mucous membranes that occurs with reduced oxygen levels. Without enough oxygen getting to the tissues the skin in Caucasians appears blue due to the color combination of dark maroon blood seen through the yellowish tint of skin. At close inspection of the conjunctiva and palms and soles may also show evidence of cyanosis. 119) The skin's acid mantle retards growth of bacteria. Soap may destroy the acid mantle of the skin, causing it to lose its protective mechanism. Some soaps contain antibacterial agents, which can change the natural flora of the skin. 120) A = asymmetry B = border irregularity C = color D = diameter E = elevation

Exam Name___________________________________

MATCHING. Choose the item in column 2 that best matches each item in column 1.

Figure 6.1 Using Figure 6.1, match the following bone types with the numbered structure: 1) Bone 1.

A) Long

2) Bone 2.

B) Flat

3) Bone 3.

C) Irregular

4) Bone 4.

1) 2) 3) 4)

5) Bone 5.

A) Sesamoid

6) Bone 6.

B) Long

7) Bone 7.

C) Short

5) 6) 7)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 6.2 Using Figure 6.2, match the following: 8) Compact bone.

9) Location of the epiphyseal line.

10) Area where yellow marrow is found.

10)

11) Epiphysis of the bone.

11)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 12) Bones are porous and thin but bone composition is normal.

A) Osteomalacia

12)

B) Osteoporosis 13) Bone formed is poorly mineralized and soft. Deforms on weight bearing.

13) C) Paget's disease

14) Excessive and haphazard bone deposit and resorption.

14)

Match the following: 15) An incomplete fracture or cracking of the bone without actual separation of the parts. Common in children.

A) Comminuted

16) Bone fragments into many pieces.

C) Greenstick

15)

B) Spiral

17) Common sports fracture resulting from a twisting force.

16) 17)

Match the following: 18) Cartilage producing cells.

A) Elastic cartilage

19) Jelly-like ground substance and fibers found.

B) Hyaline cartilage

18) 19)

C) Chondrocytes 20) The most abundant skeletal cartilage.

20) D) Fibrocartilage

21) Contain stretchy elastic fibers and can withstand repeated bending.

21) E) Extracellular matrix

22) Has parallel rows of chondrocytes alternating with thick collagen fibers.

22)

Match the following: 23) The cells responsible for the early stages of endochondral ossification.

A) Chondrocytes

23)

B) Appositional growth 24) The growth pattern of bone in which matrix is laid down on the surface.

24)

25) Bone develops from a fibrous membrane.

A) Intramembranous ossification

25)

B) Epiphyseal plate 26) The appearance of this structure signals the end of bone growth.

26) C) Epiphyseal line

27) Area where bone longitudinal growth takes place.

27)

Match the following: 28) Sharp, slender, often pointed projection.

A) Foramen

28)

B) Facet 29) Round or oval opening through a bone.

C) Ramus

30) Smooth, nearly flat articular surface.

D) Trochanter

30)

31) Armlike bar of bone.

E) Spine

31)

29)

32) Very large, blunt, irregularly shaped process.

32)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 33) Hematopoiesis refers to the formation of blood cells within the red marrow cavities of certain bones.

33)

34) Short, irregular, and flat bones all consist of thin plates of spongy bone covered by compact bone.

34)

35) Bones are classified by whether they are weight bearing or protective in function.

35)

36) The periosteum is a tissue that serves only to protect the bone because it is not supplied with nerves or blood vessels.

36)

37) Short, irregular, and flat bones have medullary cavities in order to keep the weight of the bones light.

37)

38) In newborn infants, the medullary cavity and all areas of spongy bone contain red bone marrow.

38)

39) The structural unit of compact bone (osteon) resembles the growth rings of a tree trunk.

39)

40) The term osteoid refers to the organic part of the matrix of compact bones without mineralization.

40)

41) Sixty-five percent of the mass of bone is a compound called hydroxyapatite.

41)

42) All bones stop growing by the end of adolescence.

42)

43) An osteon contains osteocytes, lamellae, and a central canal, and is found in compact bone only.

43)

44) The trabeculae of spongy bone are oriented toward lines of stress.

44)

45) The hormone that is primarily involved in the control of bone remodeling is calcitonin.

45)

46) Each consecutive bone lamella has collagen fibers that wrap in alternating directions.

46)

47) Cartilage has a flexible matrix that can accommodate mitosis of chondrocytes.

47)

48) Closure of the epiphyseal plate stops all bone growth.

48)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 49) The structure of bone tissue suits the function. Which of the following bone tissues is adapted to support weight and withstand torsion stresses? A) compact bone B) trabecular bone C) irregular bone D) spongy bone

49)

50) Yellow bone marrow contains a large percentage of ________. A) perforating fibers B) blood-forming cells C) elastic tissue D) fat

50)

51) The cell responsible for secreting the matrix of bone is the ________. A) osteoclast B) osteocyte C) chondrocyte

51) D) osteoblast

52) What kind of tissue is the forerunner of long bones in the embryo? A) hyaline cartilage B) fibrocartilage C) dense fibrous connective tissue D) elastic connective tissue

52)

53) What can a deficiency of growth hormone during bone formation cause? A) decreased osteoclast activity B) increased osteoclast activity C) inadequate calcification of bone D) decreased epiphyseal plate activity

53)

54) A fracture in the shaft of a bone would be a break in the ________. A) articular cartilage B) diaphysis C) metaphysis D) epiphysis

54)

55) The term diploë refers to the ________. A) two types of marrow found within most bones B) fact that most bones are formed of two types of bone tissue C) internal layer of spongy bone in flat bones D) double-layered nature of the connective tissue covering the bone

55)

56) Which of the following is a bone marking described as a round or oval opening through a bone? A) ramus B) epicondyle C) fossa D) meatus E) foramen

56)

57) Which of the following is implicated in osteoporosis in older women? A) heritage such as African or Mediterranean B) estrogen deficiency due to menopause C) abnormal PTH receptors D) poor posture

57)

58) Ossification of the ends of long bones ________. A) takes twice as long as diaphysis ossification B) is a characteristic of intramembranous bone formation C) involves medullary cavity formation D) is produced by secondary ossification centers

58)

59) Which structure allows the diaphysis of the bone to increase in length until early childhood? A) osteon B) epiphyseal plate C) epiphyseal line D) lacuna

59)

60) Which of the following is the single most important stimulus for epiphyseal plate activity during infancy and childhood? A) parathyroid hormone B) calcium C) thyroid hormone D) growth hormone

60)

61) Which of the following is NOT a function of the skeletal system? A) communication B) storage of minerals C) production of blood cells (hematopoiesis) D) support

61)

62) Which of the following bones are NOT a part of the appendicular skeleton? A) shoulder B) skull C) hip

62) D) upper limb

63) Bones are covered and lined by a protective tissue called periosteum. The inner (osteogenic) layer consists primarily of ________. A) dense irregular connective tissue B) osteogenic cells C) chondrocytes and osteocytes D) cartilage and compact bone

63)

64) The periosteum is secured to the underlying bone by ________. A) the struts of bone known as spicules B) a bony matrix with hyaline cartilage C) Volkmann's canals D) perforating (Sharpey's) fibers

64)

65) The central (Haversian) canal that runs through the core of each osteon is the site of ________. A) yellow marrow and spicules B) adipose tissue and nerve fibers D) cartilage and interstitial lamellae C) blood vessels and nerve fibers

65)

66) The resilience of bone is thought to come from which of the following? A) amount of mineral salt and protein in the bone B) amount of mineral salts in the bone C) presence of osteoblasts in the bone D) sacrificial bonds in or between collagen molecules

66)

67) For intramembranous ossification to take place, which of the following is necessary? A) Ossification centers form in the fibrous connective tissue membrane. B) The cartilage matrix begins to deteriorate. C) A medullary cavity forms. D) A bone collar forms around the cartilage model.

67)

68) The process of bones increasing in thickness is known as ________. A) closing of the epiphyseal plate B) appositional growth C) epiphyseal plate closure D) concentric growth

68)

69) Bones are constantly undergoing resorption (breaking bone down) for various reasons. Which of the following cells accomplishes this process? A) osteoblast B) stem cell C) osteocyte D) osteoclast

69)

70) Which hormone increases osteoclast activity to release more calcium ions into the bloodstream? A) calcitonin B) parathyroid hormone C) thyroxine D) estrogen

70)

71) Which bone would likely take the longest to heal? A) thigh bone of an elderly individual C) finger bone of a young individual

71) B) thigh bone of a young individual D) finger bone of an elderly individual

72) Wolff's law is concerned with ________. A) the thickness and shape of a bone being dependent on stresses placed upon it B) the function of bone being dependent on shape C) vertical growth of bones being dependent on age D) the diameter of the bone being dependent on the ratio of osteoblasts to osteoclasts

72)

73) Cranial bones develop ________. A) from a tendon C) from cartilage models

73) B) within fibrous membranes D) within osseous membranes

74) In humans, the effect of the hormone calcitonin is to ________. A) decrease mitosis of chondrocytes at the epiphyseal plate B) increase blood calcium levels by inhibiting osteoblasts C) increase blood calcium levels by stimulating osteoclasts D) temporarily decrease blood calcium levels when administered in large doses

74)

75) At what age do bones reach their peak density? A) early childhood C) at birth

75) B) late adulthood D) early adulthood

76) Cartilage grows in two ways, appositional and interstitial. What is appositional growth? A) along the edges only of existing osteons, making each osteon larger B) the lengthening of hyaline cartilage C) growth at the epiphyseal plate D) the secretion of new matrix against the external face of existing cartilage

76)

77) Which of the following statements best describes interstitial growth of cartilage? A) Fibroblasts give rise to chondrocytes that differentiate and form cartilage. B) Growth occurs in the lining of the long bones. C) Unspecialized cells from mesenchyme develop into chondrocytes, which divide and form cartilage. D) Chondrocytes in the lacunae divide and secrete matrix, allowing the cartilage to grow from within.

77)

78) In the epiphyseal plate, cartilage grows ________. A) by pulling the diaphysis toward the epiphysis B) by pushing the epiphysis away from the diaphysis C) in a circular fashion D) from the edges inward

78)

79) Spongy bone contains ________. A) osseous lamellae C) osteons

79) B) trabeculae D) lamellar bone

80) Ossification (Osteogenesis) is the process of ________. A) bone formation B) bone destruction to liberate calcium C) making collagen fibers for calcified cartilage D) making a cartilage model of the fetal bone

80)

81) Lengthwise, long bone growth during infancy and youth is exclusively through ________. A) calcification of the matrix of the zone underlying articular cartilage B) interstitial growth of the epiphyseal plates C) differentiation of osteoclasts into osteocytes D) the secretion of bone matrix into the medullary cavity

81)

82) Growth of bones is controlled by a symphony of hormones. Which hormone is of greatest importance for bone growth during infancy and childhood? A) parathyroid hormone B) thyroid hormones C) calcitonin D) growth hormone

82)

83) In some cases, the epiphyseal plate of the long bones of children closes too early. What might be the cause? A) osteoblast activity exceeds osteoclast activity B) too much vitamin D in the diet C) overproduction of thyroid hormone D) elevated levels of sex hormones

83)

84) Prevention of osteoporosis includes adequate intake of ________. A) calcium and vitamin E B) vitamin D and chloride C) calcium and vitamin D D) potassium and vitamin D

84)

85) What tissue forms the model for endochondral ossification? A) fascia B) fibrous membrane D) cartilage C) bone

85)

86) The pubic symphysis connects the two hip bones anteriorly and provides a little movement during childbirth. Choose the most appropriate tissue for this structure that is subjected to both pressure and stretch. B) fibrocartilage A) bone C) elastic cartilage D) hyaline cartilage

86)

87) At an archeological site you discover a bone that is cylindrical in shape, about one inch long and a quarter of an inch wide. Choose the correct classification. A) long B) irregular C) short D) sesamoid

87)

88) Choose the structures that most directly provide nutrients and remove wastes from osteocytes in compact bone. A) canaliculi B) perforating (Volkmann's) canals C) nutrient foramens D) central canals

88)

89) Skeletal remains are discovered at an archeological site. X -rays of the femur show evidence of a thin epiphyseal plate. This bone likely belonged to which of the following? A) 18-year-old male B) 25-year-old female C) 8-year-old female D) 60-year-old male

89)

90) When an osteoblast becomes completely surrounded by its own matrix secretions it is referred to as a(n) ________. A) osteogenic cell B) chondrocyte C) osteocyte D) osteoclast

90)

91) Choose the best location for obtaining a red bone marrow sample from a patient. A) head of humerus B) frontal bone C) medullary cavity of femur D) hip bone

91)

92) Which of the following is a bone disorder characterized by excessive and haphazard bone deposit and resorption? A) rickets B) osteoporosis C) osteomalacia D) Paget's disease

92)

93) Choose which bone marking type would likely increase in size when a weight lifter repeatedly exercises muscles that attach to it. A) fossa B) foramen C) trochanter D) meatus

93)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 94) List in order the four major healing stages of a simple fracture.

94)

95) What is found in a central (Haversian) canal?

95)

96) Proper blood calcium levels are required for muscle contraction, nerve function, and other critical activities in the body. How does the body maintain homeostasis in response to decreased blood calcium levels? Discuss the main gland, hormone, and target of the hormone.

96)

97) Why are the bones of young children much more flexible than those of the elderly?

97)

98) Create an analogy for the chemical composition of bone using highway construction.

98)

99) Bones appear to be lifeless structures. Does bone material renew itself?

99)

100) Compare the function of the organic materials in the bone matrix with the function of the inorganic materials in the matrix.

100)

101) What are the differences between the diaphysis and the epiphyses of long bones?

101)

102) Compare how nutrients reach individual osteocytes in compact bone and in spongy bone.

102)

103) Compare the starts of intramembranous ossification and endochondral ossification.

103)

104) What are the three characteristics used to classify bone fractures?

104)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 105) While on spring break from college, June fell on the pavement and broke her wrist. At the emergency room, a resident placed a cast on her wrist after manipulating the bones. It seemed to heal within a few months. Now, decades later she has noticed lumps in the area where the break happened and she has been complaining of pain. What could be causing the lumps and the pain? 106) Alice and James adopted a 3-year-old child from a developing country. They noticed that her legs were bowed and there were some deformities in her cranial and pelvic bones. They brought her to a physician for a diagnosis. What was the likely diagnosis, and what was the treatment for the disorder? 107) Emily, a 64-year-old formerly obese woman who successfully lost over 100 pounds, was brought to the hospital suffering pain in her legs, and an X-ray revealed that she had a simple fracture in her right femur and a crack in her left tibia. Other tests revealed that her bones were brittle and porous. What might have happened to Emily, and what advice would she have been given by the physician? 108) A 75-year-old woman and her 9-year-old granddaughter were victims of a train crash. In both cases, trauma to the chest was sustained. X-rays of the grandmother revealed several fractured ribs, but her granddaughter had none. Explain these different findings. 109) Johnny fractured the lower third of his right tibia in a skiing accident. The soft tissues in the area were severely damaged and their surgical removal was necessary. After prolonged immobilization, it was found that Johnny was healing very poorly. The explanation offered by the orthopedic surgeon was that vascularization of the fracture site was still inadequate and good healing was absolutely dependent upon an adequate blood supply. Describe how a long bone receives its blood supply and trace the path of nutrient delivery to the osteocytes. 110) People who live in northern latitudes may require supplemental calcium with vitamin D. Explain why. 111) When does prevention of osteoporosis start? 112) If your elderly patient's blood calcium level is normal, does that mean the patient does not have osteoporosis? Explain.

113) Mrs. Brown was outside on her patio cleaning windows when she fell off her step ladder and fractured her right hip. She had emergency surgery with an open reduction and internal fixation of the right hip. Three days postoperatively, she asks you if she will have trouble going through airport security. What has prompted her concern? 114) How can a tooth be moved in a bony socket during orthodontic treatment? 115) Mimi, a 70-year-old seamstress, is having difficulty walking and pain in her left knee. After consulting with her physician, she is notified that she is suffering from a loss of cartilage in her knee. Which type of cartilage is usually found in the knee and why is its loss painful?

Answer Key Testname: UNTITLED6

1) B 2) A 3) B 4) C 5) B 6) A 7) C 8) C 9) B 10) D 11) A 12) B 13) A 14) C 15) C 16) A 17) B 18) C 19) E 20) B 21) A 22) D 23) A 24) B 25) A 26) C 27) B 28) E 29) A 30) B 31) C 32) D 33) TRUE 34) FALSE 35) FALSE 36) FALSE 37) FALSE 38) TRUE 39) TRUE 40) TRUE 41) TRUE 42) FALSE 43) TRUE 44) TRUE 45) FALSE 46) TRUE 47) TRUE 48) FALSE 49) A 50) D 12

Answer Key Testname: UNTITLED6

51) D 52) A 53) D 54) B 55) C 56) E 57) B 58) D 59) B 60) D 61) A 62) B 63) B 64) D 65) C 66) D 67) A 68) B 69) D 70) B 71) A 72) A 73) B 74) D 75) D 76) D 77) D 78) B 79) B 80) A 81) B 82) D 83) D 84) C 85) D 86) B 87) A 88) A 89) A 90) C 91) D 92) D 93) C 94) Hematoma formation, fibrocartilaginous callus formation, bony callus formation, and bone remodeling. 95) Small blood vessels and nerve fibers that serve the osteon's cells. 96) In response to decreased blood calcium levels, the parathyroid glands release parathyroid hormone (PTH) which stimulates osteoclasts to liberate calcium from bone and into blood. PTH also encourages the digestive system to absorb more calcium and the kidneys to retain more calcium in blood. 97) Bones of children are not completely calcified, with a higher ratio of more flexible organic fibers. Bones in the elderly are more completely calcified, which gives the characteristic of rigidity. 13

Answer Key Testname: UNTITLED6

98) In highway construction metal rebar is used with concrete to form a road that is hard, yet resistant to cracking. Likewise, with bone tissue, the organic collagen fibers are akin to the metal rebar, providing flexibility, while the inorganic minerals provide the hardness like concrete in a roadway. 99) Bone only appears lifeless in gross anatomy. Microscopically, bone is full of cells and blood vessels that maintain and renew bone tissue. Approximately 5% to 7% of our bone mass is recycled each week. Up to 0.5 g of calcium may enter or leave the bones each day, depending on the negative feedback hormonal mechanism and gravitational forces. 100) The organic matrix contributes to the bone structure and its tensile strength, while the inorganic matrix contributes to hardness and resistance to compression. 101) Diaphyseal bone is composed almost entirely of compact bone (except in irregular and short bones), while the epiphyses are composed almost entirely of spongy bone. The epiphyses are on the ends of the bone; the diaphysis is the "shaft" of the bone. The diaphysis in long bones has a large medullary cavity, whereas the epiphyses do not. 102) In spongy bone, nutrients reach osteocytes by diffusing through the canaliculi from capillaries in the endosteum surrounding the trabeculae. In compact bone, nutrients travel from the blood supply of the medullary cavity through perforating (Volkmann's) canals that meet up with a central canal for each osteon. From a central canal, canaliculi connect with osteocytes. 103) Intramembranous ossification starts in connective tissue from mesenchymal cells that become osteoblasts. These osteoblasts cluster together into an ossification center. Endochondral ossification starts with a hyaline cartilage "template." Mesenchymal cells become osteoblasts and begin forming bone around the cartilage as well as within. 104) Position of the bone ends after the fracture occurs. Completeness of the break. Whether the bone penetrates the skin. 105) June probably has "bone spurs," which are abnormal projections from a bone due to bone overgrowth. 106) The child most likely has rickets, a condition caused by poor diet, especially one deficient in vitamin D. The parents were told to increase her intake of calcium and vitamin D and to make sure that she gets some sunshine every day. 107) Emily has osteoporosis, a debilitating bone disease that strikes more women than men after age 45 -50. The bones become weak and brittle due to osteoclast out pacing of osteoblast in the bone. Emily has been told that she needs to take supplements of Ca, Vitamin D, and do weight -bearing exercise. 108) The child had more organic material in her bones, which allows bones to be more flexible, while her grandmother's bones are extensively calcified, with little organic material, and are probably thin due to osteoporosis. 109) Long bones are nourished by nutrient arteries that frequently enter the shaft. Removal of the soft tissues probably reduced the flow of blood to the affected area. The pathway requires transport of nutrients from blood vessels in the medullary cavity to perforating (Volkmann's) canals to central (Haversian) canals to canaliculi to lacunae that contain osteocytes. 110) Vitamin D is manufactured by the skin using sunlight and is needed for absorption of dietary calcium. People who live in the north where the winter months are severe may need supplemental vitamin D because of the decreased amount of sunlight exposure. 111) The prevention of osteoporosis should begin with children. Parents need to provide children with the opportunity to develop as much bone as they have inherited the ability to develop. If people increase their peak bone mass as young adults, they will have additional protection from osteoporotic fractures in the future. 112) No. The level of calcium in the blood is expected to be normal, even in advanced cases of osteoporosis. The calcium in the bones will be low, but that occurs in order to maintain a normal blood calcium level. The priority is to maintain blood calcium levels regardless of the state of the bones. 113) Open (internal) reduction is the correction of the bone alignment through a surgical incision. It may include internal fixation of the fracture with the use of rods, wire, screws, pins, or nails, metal items that may trigger security alarms. 114) Because bone deposition and reabsorption can occur, and because bone responds to mechanical stress (Wolff's law), a tooth can be moved. By applying slight pressure to a tooth, the bone on the forward side will reabsorb, while the bone on the reverse side will be reformed, that is, bone remodeling according to the stress imposed on it. 115) Fibrocartilage forms the menisci of the knee to help absorb pressure and aids stretching when the knee moves. The hyaline cartilage covers the articulating surfaces of the distal end of the femur (condyles) as well as the condyles of the tibia. The pain is caused by the knee bones rubbing together due to the lack of fibrocartilage, or wear and tear of hyaline cartilage which might have worn off to expose the underlying bone tissue. 14

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 7.1 Using Figure 7.1, match the following: 1) Articulates with hip bones of the pelvis.

2) Attach to ribs.

3) Bears most of the weight.

4) Transvers foramina allow the passage of vertebral arteries.

5) No canals or foramen present.

5) 1

6) Includes the atlas and the axis.

7) Contains a pivot joint that allows you to rotate your head "no."

Figure 7.2 Using Figure 7.2, match the following: 8) Anchor the pterygoid muscles.

9) Passageway for optic nerve.

10) Pituitary gland is suspended here.

10)

11) Forms parts of the middle cranial fossa, dorsal walls of the orbits, and external walls of the skull.

11)

12) Allow cranial nerves that control eye movements to enter the orbit.

12)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 13) These very small bones are at the medial wall of each orbit and provides a groove for the tear ducts.

A) Sphenoid

14) Failure of these anterior bones to fuse causes a condition known as cleft palate.

C) Temporal bones

13)

B) Maxillae 14)

D) Lacrimal bones

15) This bone houses the apparatus of the internal and middle ear.

15)

16) This bone is wing-shaped and extends behind the eyes and forms part of the floor of the cranial vault.

16)

17) The bones that contain teeth.

17)

18) This bone has a passageway into the nasal cavity.

18)

19) The sella turcica is a portion of this bone.

19)

Match the following: 20) The fingers have three of these bones and the thumb has only two.

A) Radius

20)

B) Phalanges 21) This bone articulates with the glenoid fossa.

21) C) Humerus

22) Forearm bone that articulates with most of the carpals.

22)

Match the following: 23) This bone shapes the posterior wall of the pelvis.

A) Intervertebral disc

23)

B) Sacrum 24) The fused rudimentary tailbone.

24) C) Cervical vertebrae

25) The bone that articulates with the occipital condyles. 26) These bones are the smallest and lightest vertebrae.

25) D) Atlas E) Coccyx

27) Allows the head to nod "yes."

26)

27)

28) A cushionlike shock absorber of two parts: a nucleus pulposus and annulus fibrosus.

28)

Match the following: 29) Lambdoid suture.

A) Connects occipital and temporal bones

30) Sagittal suture.

B) Connects right and left parietal bones.

31) Squamosal suture.

C) Connects parietal and frontal bones

32) Coronal suture.

D) Connects temporal and parietal bones

33) Occipitomastoid suture.

E) Connects occipital and parietal bones.

29) 30) 31) 32) 33)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 34) The femur is the largest and strongest bone in the body.

34)

35) All of the bones of the skull, except the mandible, are united by sutures and are therefore immovable.

35)

36) The frontal bone articulates with the parietal bone by means of the sagittal suture.

36)

37) The mastoid sinuses are located at a position in the skull where they are usually free from infections.

37)

38) The vertebral column is held in place primarily by the anterior and posterior longitudinal ligaments.

38)

39) Most of the body's weight is carried by the talus and calcaneus.

39)

40) The most common site of fracture in the humerus is the surgical neck which is distal to the anatomical neck.

40)

41) The shallow socket of the shoulder joint restricts dislocation of the humerus and is the main contributor to the stability of the joint.

41)

42) Costal cartilages join most ribs to the sternum.

42)

43) The tubercle of a rib articulates with the transverse process of a vertebra.

43)

44) In women of childbearing age, the dimensions of the true pelvis are of utmost importance.

44)

45) The term vertebrochondral ribs refers to the "false ribs," that attach to each other before they attach to the sternum.

45)

46) In the anatomical position, the lateral forearm bone is the radius.

46)

47) The vomer along with the perpendicular plate of the ethmoid bone forms the bony part of the nasal septum.

47)

48) The temporal bone connects to the zygomatic bone via the temporal process of the temporal bone.

48)

49) The lacrimal bone contains a groove that forms part of lacrimal fossa. Along with the soft tissue of the lacrimal sac, these structures drain tears from the eye into the nasal passage.

49)

50) The largest and strongest bone of the face is the maxilla.

50)

51) There are seven cervical, twelve thoracic, and five lumbar vertebrae.

51)

52) Lordosis affects the thoracic vertebrae.

52)

53) All vertebrae possess a body, a spine, and transverse foramina.

53)

54) The dens articulates with the occipital bone.

54)

55) The pituitary gland is housed in a saddle-like depression in the temporal bone called the sella turcica.

55)

56) The ischium articulates with both the ilium and the pubis forming the acetabulum.

56)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 57) The bones in the skull have many different names but what are the boundaries of each bone? Where do they start and stop? A) The boundaries are indistinct and are simply vague generalized regions. B) Boundaries for skull bones are seen only in the infant skull. C) Bones of the skull are separated by immobile joints called sutures. D) Bones of the skull are continuous but named for their specific markings.

57)

58) Which of the following can be considered a function of the paranasal sinuses? A) Sinuses take away a minimal amount of strength from bones while reducing the weight of bones. B) Sinuses are often referred to as vestigial, anatomical features with no know function. C) Sinuses have rough patches that aid in muscle attachment. D) The paranasal sinuses are passageways for nerves to pass through.

58)

59) Which of the bones of the skull would you also refer to as a cheekbone? A) the parietal bone B) the temporal bone C) the occipital bone D) the zygomatic bone

59)

60) Which of the following would be most associated with housing the special sense organs? A) the temporal bones B) hyoid bone C) the bones of the inner ear D) the cranial bones

60)

61) Which of the following would be most associated with process of warming, humidifying, and filtering the air we inhale? A) the cranial bones B) the bones comprising the orbits C) the nasal cavity D) hyoid bone

61)

62) Which is the best description for the function of the cranial bones? A) allow introduction of food into the digestive system B) house the special sense organs C) provide passageways for respiratory gases to move into and out of the body D) protect the brain

62)

63) The sphenoid bone is sometimes referred to as a "key stone" of the skull. This is due to the fact that ________. A) the sphenoid is in the center of the skull and it articulates (joins) with all of the other bones of the skull (excluding the mandible) B) the sphenoid bone is solid like a stone and provides the strength necessary to support the skull C) the intricate shape of the sphenoid makes it critical to the distinct characteristics of the individual human face D) the sphenoid is wedged in the superior most portion of the skull and supports all of the other bones below (excluding the mandible)

63)

64) The sella turcica is part of the ________ bone and houses the ________ gland. A) ethmoid; thymus B) ethmoid; pituitary C) sphenoid; pituitary D) sphenoid; thymus

64)

65) The hypothalamus is a region of the brain controlling many aspects of the endocrine system. It works closely with the pituitary gland. The hypothalamus is directly superior to the pituitary and is, therefore, ________. A) the only region of the brain that is outside of the skull B) inferior to the cribriform plate C) superior to the crista galli D) superior to the sella turcica

65)

66) During concussion (a type of traumatic brain injury) the brain will move within the cranial cavity. Damage is caused to the brain as it crashes into parts of the bony cavity walls. Ironically one of the bone markings that can cause serious damage to the brain is the ________. This is ironic because one of the functions of this bone marking is to ________. A) styloid process; attach to and support the hyoid bone B) perpendicular plate; separate the left and right halves of the nasal cavity C) crista galli; attach to the dura matter holding the brain in place D) pterygoid processes; anchor important chewing muscles

66)

67) Curvatures of the spine serve the body by ________. A) giving additional springiness and flexibility to the spine which absorbs shock B) providing space for soft organs in the various body cavities C) applying greater pressure to the intervertebral disks preventing them from slipping D) limiting the flexibility of the spine and preventing hyperextension

67)

68) When looking at the range of motion of the various sections of the vertebral column the ________ has the most flexibility. A) lumbar spine B) sacral spine C) cervical spine D) thoracic spine

68)

69) The range of motion as well as the direction of motion for the various regions of the spine differs. For example, the lumbar spine is capable of flexion and extension but little rotational movement, while the thoracic spine rotates with little flexion or extension. This is due to variation in ________. A) the arrangement of muscular attachment to the spinous processes B) the thickness of the intervertebral disc C) the orientation of the superior and inferior articular facets D) the composition of the intervertebral disks

69)

70) The anatomy of the thoracic cage provides ridged support and protection but at the same time is also flexible and mobile. Of the list below, which feature does NOT aid in the flexibility and movement of the thoracic cage? A) the sternal angle B) the costal cartilages C) the costal spaces occupied by costal muscle D) the jugular notch

70)

71) The glenohumeral joint that articulates the humerus to the pectoral girdle is a highly mobile joint. This mobility comes at a cost because ________. A) the blood vessels that lead to the arm and hand can easily be cut off by the free range of motion B) these type of joints are harder to control and coordinate C) muscles that span this mobile joint will only provide a reduced amount of power D) the joint is relatively unstable and can easily dislocate

71)

72) From the list below, select the least likely explanation for the relatively high mobility of the arms. A) The subscapular notch is a passageway for nerves. B) The clavicle articulates to the axial skeleton at only the sternal end. C) The scapula does not articulate to the axial skeleton directly. D) The relatively open glenoid cavity of the glenohumeral joint.

72)

73) The proximal end of the ulna illustrates the relationship of form and function. The rounded trochlear notch articulates with the hourglass shape of the trochlea. This forms a joint that allows for ________. A) the hyper extension of the forearm B) the curling of the fingers C) the rotational motion of the forearm D) the hinge like motion of the forearm

73)

74) The proximal end of the radius illustrates the relationship of form and function. The cup -like surface of the radial head articulates with the rounded shape of the capitulum. This forms a joint that allows for ________. A) the hyper extension of the forearm B) the curling of the fingers C) the rotational motion of the forearm D) the hinge like motion of the forearm

74)

75) The axial skeleton includes ________. A) arms, legs, hands, and feet B) the skull, the scapula, and the vertebral column C) the skull, vertebral column, and rib cage D) the skull, vertebral column, and pelvis

75)

76) Which vertebra does NOT have a body? A) last cervical B) last lumbar

76) C) atlas

D) axis

77) The suture that is found where a parietal and temporal bone meet on the lateral aspect of the skull is ________. A) sagittal B) lambdoid C) squamous D) coronal

77)

78) The hyoid bone is unique because it ________. A) is composed of three bones joined together B) is the only bone formed by the fusion of right and left halves C) is the only irregular bone found in the neck D) is the only bone of the body that does not articulate with any other bone

78)

79) Along with support, the anterior longitudinal ligament of the vertebral column also acts to ________. A) protect the spinal cord B) hold the discs in place C) hold the spine erect D) prevent hyperextension of the spine

79)

80) What are the major functions of the intervertebral discs? A) to prevent hyperextension and allow rotation of the spine B) to remove curvatures of the spine and provide springiness to the spinal column C) to absorb shock and provide flexibility to the spine D) to hold together the vertebra and support the body

80)

81) Paranasal sinuses are found in which of these facial bones? A) maxillae B) nasal conchae C) vomer D) zygomatic bones

81)

82) Which of the following is an abnormal lateral curvature of the vertebral column often seen in the thoracic region? A) kyphosis B) scoliosis C) swayback D) lordosis

82)

83) Which part of the vertebral column receives the most stress by bearing most of the weight of the body? A) the sacrum B) the cervical region C) the sacral promontory D) the lumbar region

83)

84) How many bones make up the adult skull? A) 5 B) 7

84) C) 22

D) 12

85) Thoracic vertebrae differ from the other vertebrae in that they have ________. A) costal facets B) transverse foramina C) no transverse processes D) no intervertebral discs

85)

86) What is the major function of the axial skeleton? A) provide a space for the major digestive organs B) provide an attachment point for muscles that allow movement C) provide central support for the body and protect internal organs D) give the body resilience

86)

87) The antebrachium is composed of which of the following two bones? A) the scapula and the clavicle B) the humerus and the radius C) the radius and the ulna D) the humerus and the clavicle

87)

88) The "true wrist" or carpus consists of ________. A) the metacarpals B) a group of eight short bones united by ligaments C) the styloid processes of the radius and ulna D) the phalanges

88)

89) Which bone is in direct contact with the first metatarsal? A) calcaneus B) cuboid C) medial cuneiform D) lateral cuneiform

89)

90) Which bone forms the anterior cranium? A) temporal bone B) frontal bone

90) C) sphenoid bone

D) palatine bone

91) The superior orbital fissure is formed in the sphenoid bone, whereas the inferior orbital fissure is formed between the sphenoid and ________. A) ethmoid B) maxilla C) lacrimal D) palatine

91)

92) Which of the following is the abnormal curve often seen in pregnant women as they attempt to preserve their center of gravity toward the end of the pregnancy? A) hunchback B) kyphosis C) scoliosis D) lordosis

92)

93) How are thoracic vertebrae 11 and 12 different from the other vertebrae? A) The transverse processes do not have facets that articulate with the tubercles of the ribs. B) The spinous processes are directed parallel with the centrum. C) The orientation of the articular processes is different from all the other thoracic vertebrae. D) There are two foramina on vertebrae 11 and 12.

93)

94) The superior nasal concha is a part of which bone? A) sphenoid B) maxilla

C) ethmoid

D) vomer

94)

95) The pelvic girdle does NOT include the ________. A) pubis B) ischium

C) ilium

D) femur

95)

96) Which of the following bones is NOT weight bearing? A) tibia B) talus C) femur

96) D) fibula

97) Which portion of the fibula articulates with the talus? A) lateral malleolus B) medial malleolus C) calcaneus D) head

97)

98) Which part of the ethmoid bone forms the superior part of the nasal septum? A) cribriform plate B) perpendicular plate C) crista galli D) orbital plate

98)

99) Which of the following is NOT a movement that can occur between vertebrae? A) flexion and extension B) supination C) lateral flexion D) rotation

99)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 100) The kneecap is called the ________.

100)

101) The lateral condyle of the femur articulates with the lateral condyle of the ________.

101)

102) The medial condyle of the femur articulates with the medial condyle of the ________.

102)

103) The largest foramen in the body is the ________ foramen.

103)

104) The smallest short bone in the hand is the ________.

104)

105) The styloid process of the ________ points to the thumb.

105)

106) Only the ________ vertebrae have transverse foramina.

106)

107) The ________ is the bone confined to the septum of the nose.

107)

108) Your "cheekbone" is mostly formed from the ________ bone.

108)

109) What structure is the "missing" body of the second cervical vertebrae?

109)

110) What is the function of the lumbar curvature?

110)

111) Which vertebral curvature abnormality is the most serious? Why?

111)

112) What is the purpose of the vertebral curvatures?

112)

113) Why is the area just distal to the tubercles of the humerus called the surgical neck?

113)

114) What are the fontanelles and what advantages do they confer on the fetus? The mother?

114)

115) What are the subdivisions of the axial skeleton and how do they function?

115)

116) Describe the differences between the bones of the lower and upper limb and briefly state why these differences exist.

116)

117) How are the pectoral and pelvic girdles structurally different? How is this difference reflected in their functions?

117)

118) How do the first two cervical vertebrae differ from other cervical vertebrae? What are their functions?

118)

119) Identify the arches of the foot and describe how they are maintained.

119)

120) Identify the four major cranial sutures in any order and the bones they connect.

120)

121) How might low back pain be related to poor abdominal muscle tone?

121)

122) If the hyoid bone is not attached to another bone why is it so important?

122)

123) What is the purpose of the articular processes of the vertebrae?

123)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 124) After having a severe cold accompanied by nasal congestion, Jamila complained that she had a headache just above her eyes and that the right side of her face ached. What specific bony structures probably became infected by the bacteria or viruses causing the cold? 125) A skeleton was found in a wooded area. It was brought to a forensic medicine laboratory for identification. The first thing the coroner did was determine the age, sex, and possible size of the person. What was examined in order to get this information? 126) Jason is a 14-year-old who recently had his nose pierced through the nasal septum. He tells his mother that the area is very tender and warm to the touch. The area is also red. The mother calls the pediatrician's office and the nurse recommends that the mother bring Jason in for evaluation. The nurse explains to the mother that a local infection can spread and cause serious harm. Where do you think the infection could spread and why? 127) Sharon is a 32-year-old horse trainer. While training a young horse, she was thrown off of the horse and suffered a mild head injury. The nurse inquires about the use of a helmet. Sharon replies, "This is the first time I have ever had a head injury from a horse. I don't think I need a helmet." Based on your understanding of the skull, how should the nurse respond to the patient?

128) You are a school nurse in a middle school. You are responsible for screening the children for scoliosis. What is involved in this screening? 129) When administering chest compression to someone whose heart has stopped beating, the heel of the hand should be placed on the sternum on a line drawn between the nipples. Why would it be a problem if the hand was placed at a lower part of the sternum? 130) Jim and his son Matthew are driving home from shopping the day after Thanksgiving and are involved in a car accident. Jim hit his head on the dashboard resulting in a fractured C2 vertebra. What exactly does this mean and why is it a concern to Jim's doctor?

Answer Key Testname: UNTITLED7

1) D 2) B 3) C 4) A 5) E 6) A 7) A 8) E 9) A 10) C 11) B 12) D 13) D 14) D 15) C 16) A 17) B 18) D 19) A 20) B 21) C 22) A 23) B 24) E 25) D 26) C 27) D 28) A 29) E 30) B 31) D 32) C 33) A 34) TRUE 35) TRUE 36) FALSE 37) FALSE 38) TRUE 39) TRUE 40) TRUE 41) FALSE 42) TRUE 43) TRUE 44) TRUE 45) TRUE 46) TRUE 47) TRUE 48) FALSE 49) TRUE 50) FALSE 13

Answer Key Testname: UNTITLED7

51) TRUE 52) FALSE 53) FALSE 54) FALSE 55) FALSE 56) TRUE 57) C 58) A 59) D 60) A 61) C 62) D 63) A 64) C 65) D 66) C 67) A 68) C 69) C 70) D 71) D 72) A 73) D 74) C 75) C 76) C 77) C 78) D 79) D 80) C 81) A 82) B 83) D 84) C 85) A 86) C 87) C 88) B 89) C 90) B 91) B 92) D 93) A 94) C 95) D 96) D 97) A 98) B 99) B 100) patella 14

Answer Key Testname: UNTITLED7

101) tibia 102) tibia 103) obturator 104) pisiform 105) radius 106) cervical 107) vomer 108) zygomatic 109) dens 110) It positions the weight of the trunk over the body's center of gravity, thus providing optimal balance when standing. 111) Scoliosis is the most serious abnormality, due to the pressure that can be placed on the lungs and resulting breathing difficulties. 112) Their purpose is to increase the resilience and flexibility of the spine, allowing it to function like a spring rather than a rigid rod. 113) This area is called the surgical neck because it is the most frequently fractured part of the humerus. 114) The fontanelles are regions of unossified, fibrous membrane in the skull allowing the cranium to grow and yet allow bony overriding during head compression in delivery. 115) The skull, vertebral column, and the thoracic cage function to provide support and protection. 116) The lower limbs carry the weight of the body and are subjected to exceptional forces. These bones are thicker and stronger. The upper limb bones are adapted for flexibility and mobility and are therefore smaller and lighter. 117) The pectoral girdle moves freely across the thorax and allows the upper limb a high degree of mobility, while the pelvic girdle is secured to the axial skeleton to provide strength and support. This is why the glenoid cavity of the scapula is relatively shallow and the acetabulum of the pelvis is a deep socket. 118) The atlas or C 1 vertebra has no body. It articulates with the skull with large curved articular surfaces to allow the skull to rock in a "yes" motion. The axis or C 2 vertebra has a projection called the dens that allows the axis to pivot, giving the head the "no" motion. The vertebral foramen of the atlas is enlarged so that when the head is pivoted in the "no" motion, the spinal cord can move. 119) There are three arches: the medial and lateral longitudinal arches, and the transverse arch. Together they form a half-cone that distributes the weight of the body. They are maintained by the shape of the foot bones, strong ligaments, and by the pull of some tendons. 120) 1. Coronal - parietal and frontal 2. Sagittal - between the parietal bones 3. Squamous - parietal and temporal 4. Lambdoidal - parietal and occipital 121) If the abdominal muscles are weak and can't maintain contraction, the belly sags forward, increasing the amount of lordosis. With greater curvature, the ligaments and muscles of the back undergo greater strain in order to maintain alignment of the vertebrae and counterbalance the shift in the center of gravity. 122) The hyoid acts as an attachment point for muscles in the neck region to connect the muscles in the lower jaw region. It allows for the muscles to make a right angle at the junction of the lower jaw and throat. The hyoid serves as a movable base for the tongue and its horns are attachment points for neck muscles that raise and lower the larynx during speech and swallowing. 123) These processes (superior and inferior) allow the vertebral column to flex forward some, but lock the vertebrae if the column is flexed back and limit rotation to avoid injury to the spinal cord and its nerve roots. In a four -legged animal, such as a horse, these processes allow the back to remain in place while you ride it. 124) The paranasal sinuses, specifically the frontal sinus located in the frontal bone and the right maxillary sinus located in the right maxilla.

Answer Key Testname: UNTITLED7

125) By examining the shape of the pelvic inlet, the depth of the iliac fossa, the characteristics of the ilium, and the angle inferior to the pubic symphysis, one could determine the sex. Also significant for determining the sex of the skeleton are the position of the acetabulum, the shape of the obturator foramen, and the general design of the ischium. To determine the age of the individual, bone density, the status of growth plates, and markings are important. The markings where muscles were attached will reveal information about the mass and the general shape of the person. 126) Infection of nasal piercings can spread to the brain and cause serious complications. Infections in the brain may occur because of the direct extension from ear, tooth, mastoid, or sinus infections. 127) The skull protects the brain from blows. A helmet would add extra protection in sports where there is an increased risk for head injury. 128) Scoliosis literally means "twisted disease" and is an abnormal rotational curvature causing lateral deviation that occurs most often in the thoracic region. It is quite common during late childhood. The nurse would need to observe the child standing erect, disrobed from the waist up. An older girl may leave her bra on. The child is observed from behind and the nurse would note any asymmetry of the shoulders and hips. With the child bending forward so that the back is parallel to the floor, the nurse may observe from behind, noting tilting of the rib cage. 129) The compressions could break the xiphoid process of the sternum and drive it into the heart, diaphragm, or liver resulting in possibly deadly complications. 130) The C2 vertebra is the second cervical vertebra, or the axis. It causes the physician to be concerned because this vertebra has limited movement already, and also protects the spinal cord. An injury to this vertebra could also injure the spinal cord resulting in paralysis and sometimes death.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 8.1 Using Figure 8.1, match the following: 1) Periosteum.

2) Articular cartilage.

3) Joint (articular) cavity.

4) Synovial membrane.

5) Fibrous layer.

MATCHING. Choose the item in column 2 that best matches each item in column 1.

Figure 8.2 Using Figure 8.2, what type of axial movement does each joint have? 6) Joint 1.

A) Multiaxial

7) Joint 2.

B) Uniaxial

8) Joint 3.

C) Nonaxial

9) Joint 4.

D) Biaxial

10) Joint 5.

6) 7) 8) 9) 10)

11) Joint 6.

11)

Figure 8.3 Using Figure 8.3, identify each type of synovial joint by name. 12) Joint 1.

A) Hinge

13) Joint 2.

B) Plane

14) Joint 3.

C) Ball and socket

15) Joint 4.

D) Pivot

16) Joint 5.

E) Condyloid

17) Joint 6.

F) Saddle

12) 13) 14) 15) 16) 17)

Match the following: 18) Moving a limb so it describes a cone in a space.

A) Abduction

18)

B) Circumduction 19) Movement of a limb away from the midline of the body. 20) Movement of a limb toward the midline of the body.

19) C) Adduction D) Flexion

21) A bending movement that decreases the angle of the joint.

20)

21)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 22) The amount of movement permitted by a particular joint is the basis for the functional classification of that joint.

22)

23) All joints permit some degree of movement, even if very slight.

23)

24) Hinge joints permit movement in only one plane.

24)

25) Synovial fluid is a viscous material that is derived by filtration from blood.

25)

26) The articular surfaces of synovial joints play a minimal role in joint stability.

26)

27) The major role of ligaments at synovial joints is to unite bones and prevent undesirable movement.

27)

28) Gliding movements occur when one flat, or nearly flat, bone surface glides or slips over another.

28)

29) Movement at the hip joint does not have as wide a range of motion as at the shoulder joint.

29)

30) A person who has been diagnosed with a sprained ankle has an injury to the ligaments that attach to that joint.

30)

31) Supination is the movement of the forearm in which the palm of the hand is turned anteriorly or superiorly.

31)

32) The wrist joint can exhibit adduction and eversion movements.

32)

33) Moving a limb so that it describes a cone in space is called circumduction.

33)

34) Movement of the ankle so that the superior aspect of the foot approaches the shin is called dorsiflexion.

34)

35) The gripping of the trochlea by the trochlear notch constitutes the "hinge" for the elbow joint.

35)

36) Pronation is a much stronger movement than supination.

36)

37) The structural classification of joints is based on the composition of the binding material and the presence or absence of a joint cavity.

37)

38) Synovial fluid contains phagocytic cells that protect the cavity from invasion by microbes or other debris.

38)

39) A person who has been diagnosed with rheumatoid arthritis would be suffering loss of the synovial fluids.

39)

40) A ball-and-socket joint is a multiaxial joint.

40)

41) Bending of the tip of the finger exhibits flexion.

41)

42) Dislocations in the TMJ almost always dislocate posteriorly with the mandibular condyles ending up in the infratemporal fossa.

42)

43) Symphyses are synarthrotic joints designed for strength with flexibility.

43)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 44) A situation where the bones are connected exclusively by ligaments, cords, or bands of fibrous tissue is a ________. A) synchondrosis B) suture C) syndesmosis D) gomphosis

44)

45) The cruciate ligaments of the knee ________. A) tend to run parallel to one another C) prevent hyperextension of the knee

45) B) attach to each other in their midportions D) are also called collateral ligaments

46) Articular cartilage found at the ends of the long bones serves to ________. A) produce red blood cells (hemopoiesis) B) attach tendons C) provide a smooth surface at the ends of synovial joints D) form the synovial membrane

46)

47) Synchondroses and symphyses are examples of ________ joints. A) synovial B) periodontal C) fibrous

D) cartilaginous

47)

48) On the basis of structural classification, which is a fibrous joint? A) pivot B) symphysis C) synchondrosis

D) syndesmosis

48)

49) Connective tissue sacs lined with synovial membrane that act as cushions in places where friction develops are called ________. D) ligaments A) menisci B) tendons C) bursae

49)

50) Articulations permitting only slight degrees of movement are ________. A) amphiarthroses B) synarthroses C) synovial joints

50)

D) diarthroses

51) Which of the following are cartilaginous joints? A) syndesmoses B) sutures

51) C) gomphoses

D) synchondroses

52) Bowing to your opponent before a jiu jitsu match would be considered a ________ movement. A) flexion B) extension C) hyperextension D) circumduction

52)

53) The ligaments that protect the alignment of the femoral and tibial condyles and limit the movement of the femur anteriorly and posteriorly are called ________. A) anterior ligaments B) patellar ligaments C) tibial collateral ligaments D) cruciate ligaments

53)

54) Bending your head back until it hurts is an example of ________. A) circumduction B) extension C) flexion

54) D) hyperextension

55) In the classification of joints, which of the following is true? A) All synovial joints are freely movable. B) Synarthrotic joints are slightly movable. C) In cartilaginous joints, a joint cavity is present. D) Immovable joints are called amphiarthroses.

55)

56) Synarthrotic joints ________. A) have large joint cavities C) are immovable joints

56) B) are found only in adults D) characterize all cartilaginous joints

57) Fibrous joints are classified as ________. A) symphysis, sacroiliac, and articular C) hinge, saddle, and ellipsoidal

B) pivot, hinge, and ball and socket D) sutures, syndesmoses, and gomphoses

57)

58) In symphysis joints the articular surfaces of the bones are covered with ________. A) tendon sheaths B) synovial membranes C) hyaline cartilage D) fibrocartilage

58)

59) Synovial fluid is present in joint cavities of freely movable joints. Which of the following statements is true about this fluid? A) It contains enzymes only. B) It contains hydrochloric acid. C) It contains hyaluronic acid. D) It contains lactic acid.

59)

60) Which of the following statements defines synchondroses? A) amphiarthrotic joints designed for strength and flexibility B) interphalangeal joints C) cartilaginous joints where hyaline cartilage unites the ends of bones D) joints that permit angular movements

60)

61) What are menisci (articular discs)? A) small sacs containing synovial fluid B) tendon sheaths C) cavities lined with cartilage D) wedges of fibrocartilage that partially or completely divide the synovial cavity

61)

62) Which of the following is a true statement regarding gliding movements? A) Gliding movements are multiaxial. B) Gliding movements allow flexibility of the upper limbs. C) Gliding movements occur at the intercarpal and intertarsal joints. D) An example of a gliding movement is nodding one's head.

62)

63) What is moving a limb away from the midline of the body along the frontal plane called? A) flexion B) abduction C) extension D) adduction

63)

64) The terms inversion and eversion pertain only to the ________. A) feet B) hands and the feet C) arms D) hands

64)

65) The hip joint is a good example of a(n) ________ synovial joint. A) biaxial B) uniaxial C) nonaxial

65) D) multiaxial

66) Which of the following movements does NOT increase or decrease the angle between bones? A) extension B) abduction C) circumduction D) rotation

66)

67) Compared to the shoulder, displacements of the hip joints are ________. A) common in all people who are overweight B) rare because the rotator cuff stabilizes the hip joint C) rare because of the ligament reinforcement D) common due to the weight bearing the hip endures

67)

68) Which ligament of the knee initiates the knee-jerk reflex when tapped? A) the lateral patellar retinacula B) the patellar ligament C) the extracapsular ligament D) the medial patellar retinacula

68)

69) Football players often sustain lateral blows to the extended knee. Which of the following is (are) damaged as a result? A) oblique popliteal and extracapsular ligaments B) suprapatellar ligament C) tibial collateral ligament, medial meniscus, and anterior cruciate ligament D) arcuate popliteal and the posterior cruciate ligaments

69)

70) Pointing the toes is an example of ________. A) pronation B) plantar flexion

70) C) protraction

D) circumduction

71) Which of the following is a true statement? A) The greater tubercle of the humerus articulates at the coracoid process of the scapula. B) The annular ligament surrounds the head of the radius. C) The head of the humerus articulates with the acromion process. D) The rotator cuff is responsible for the flexible extensions at the elbow joint.

71)

72) Presence of a synovial cavity, articular cartilage, synovial membrane, and ligaments are characteristics of what type of joint? A) symphysis B) hinge joint C) synchondrosis D) suture

72)

73) Extracapsular ligaments stabilizing the knee include ________. A) fibular and tibial collateral ligaments, which prevent lateral or medial rotation B) the patellar ligament extending from femur to patella C) cruciate ligaments, which help secure the articulating bones together D) the oblique popliteal crossing the knee anteriorly

73)

74) Baseball pitchers often require "Tommy John" surgery to repair damage to their elbow. Which ligament would this surgery target? A) lateral ligament B) acetabular labrum C) ulnar collateral ligament D) anular ligament

74)

75) An example of an interosseous fibrous joint is ________. A) the radius and ulna along its length B) between the vertebrae C) between the humerus and the glenoid cavity D) the clavicle and the scapula at the distal ends

75)

76) Which of the following statements best describes angular movements? A) They turn a bone along its own long axis. B) They change (increase or decrease) the angle between two bones. C) They occur only between bones with flat articular processes. D) They allow movement only in one plane.

76)

77) Saddle joints have concave and convex surfaces. Identify a saddle joint of the skeleton. A) interphalangeal joint of the finger B) carpometacarpal joint of the thumb C) carpometacarpal joint of the phalanges D) metacarpophalangeal joint of the finger

77)

78) Tendon sheaths ________. A) act as friction-reducing structures B) are extensions of periosteum C) help anchor the tendon to the muscle D) are lined with dense irregular connective tissue

78)

79) Which of the following is NOT strictly a part of a synovial joint? A) tendon sheath B) articular cartilage D) articular (joint) capsule C) joint (articular) cavity

79)

80) All of the following are factors that influence synovial joint stability EXCEPT ________. A) arrangement and tension of the muscles B) structure and shape of the articulating bone C) strength and tension of joint ligaments D) number of bones in the joint

80)

81) Performing "jumping jacks" requires ________. A) flexion and extension C) abduction and adduction

81) B) inversion and eversion D) pronation and supination

82) Moving your jaw forward, causing an underbite, is called ________. A) protraction B) adduction C) pronation

82) D) retraction

83) Which of the following conditions is joint inflammation or degeneration accompanied by stiffness, pain, and swelling? A) rheumatoid arthritis B) osteoarthritis C) Lyme disease D) arthritis

83)

84) Lifting up a glass to take a drink involves the elbow joint. Which of the following correctly characterizes that joint? C) pivot D) cartilaginous A) diarthrotic B) biaxial

84)

85) An individual with a "double-jointed" thumb can pull it back towards the wrist much farther than normal. What does it mean to be "double-jointed?" A) Greater than normal production of serous fluid lubricates the joint and extends it. B) The joint capsules and ligaments are more stretchy and loose than normal. C) The additional joint present doubles the range of motion. D) Articular cartilage at bone ends is replaced with hyaline cartilage.

85)

86) The type of joint between the carpal (trapezium) and the first metacarpal is a ________ joint. A) hinge B) plane C) saddle D) condylar

86)

87) Which joint does NOT belong with the others? A) wrist C) ankle

87) B) interphalangeal (toes) D) elbow

88) Which joints are correctly matched? A) wrist; saddle C) elbow; pivot

B) interphalangeal; plane D) ankle; hinge

88)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 89) Why are epiphyseal plates considered temporary joints?

89)

90) A friend finally completes a basement floor tiling project that required extensive time on his knees. Afterwards, knee pain took him to a doctor who diagnosed bursitis. Help explain to your friend what bursitis is and what can be done to relieve it.

90)

91) After months of very little exercise, you decide to go for a long run. After a mile, you start to feel pain in your kneecap area. What could explain this?

91)

92) Synovial joints have six distinguishing features. What are they?

92)

93) How can gout be treated?

93)

94) For each of the following movements, indicate the specific kind of joint involved (e.g., hinge, etc.) and the movement performed (e.g., extension, etc.).

94)

a. Bending the elbow: ________, ________. b. Turning head side to side: ________, ________. c. Lowering your arm to your side in the frontal plane: ________, ________. d. Turning the sole of foot medially: ________, ________.

95) While the fingers can exhibit flexion and extension and other angular motions, the thumb has much greater freedom. Why?

95)

96) Briefly describe the structure of a typical synovial joint.

96)

97) Although uric acid is a normal waste product of nucleic acid metabolism, excessive levels lead to gouty arthritis. How does this waste product build up and cause so much pain when things go wrong and why is it more common in men?

97)

98) After reading a medical report, you learn that a 45-year-old female has the following symptoms: inflammation of synovial membranes, accumulation of synovial fluid, pain and tenderness about the joints, pannus formation, and some immobility at certain joints. On the basis of these symptoms, what would the patient probably have?

98)

99) Greg is somewhat of a "weekend athlete" who has overextended himself by pitching multiple baseball games for a local team during the week and by playing golf on the weekends for several hours. He presented himself to the emergency room last week with severe shoulder pain (at the glenohumeral joint). The physician told him that the X-ray was not conclusive, but he may have damage to his rotator cuff. What is the rotator cuff, and how might he have caused this damage? What remedies will the physician recommend?

99)

100) Many inflammations of joint areas can be treated by injections of cortisone into the area. Why don't we continually get injections rather than operations?

100)

101) Why is muscle tone the most important stabilizing factor for most joints?

101)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 102) Steven, a football player, complained of severe pain and the inability to use his right arm and shoulder after having been tackled during a game. What would you guess might be his problem? 103) Mary has been suffering from a "bad knee" for several months. She is a tennis player who often slides in to attack a ball; she is an aerobic devotee and a jogger. She visited an orthopedic surgeon last week who told her that he would "like to have a look at her knee joint." He also told her that her symptoms indicated damage to the meniscus, and it might have to be removed. What will the doctor do to see the joint, and if the meniscus is removed will Mary be able to play tennis again? 104) Farhad begins typing his term paper on his new computer early one morning. After 8 hours of typing, he notices that his wrists are stiff and very sore. The next morning, Farhad begins to finish his paper, but soon finds his wrists hurt worse than last night. What is wrong? 105) Alexis grinds her teeth at night when she sleeps, especially when she is stressed. One morning she woke up with extreme pain in her jaw muscles, a popping sound when she chewed, and joint stiffness. How do you explain her condition and how is it treated? 106) A nurse is instructing the patient care assistants (PCAs) on transfer techniques. For patients needing to be slid toward the head of the bed, the nurse tells the PCAs to use a draw sheet under the patient's torso. She tells them to avoid pulling on their hands or arms. Based on your knowledge of the shoulder joint, explain why pulling on the extremities should be avoided. 10

107) Maggie is a 28-year-old Caucasian woman who has newly diagnosed rheumatoid arthritis. She complains of painful, stiff hands and feet, feeling tired all the time, and reports an intermittent low -grade fever. She asks the doctor if she is going to be "crippled." How might the doctor explain the pathophysiology of rheumatoid arthritis? 108) Susan was bitten by a deer tick and now complains of joint pain, flu-like symptoms, and difficulty thinking. What might be her diagnosis and the treatment required to alleviate her symptoms?

Answer Key Testname: UNTITLED8

1) A 2) C 3) B 4) E 5) D 6) A 7) B 8) B 9) C 10) D 11) D 12) C 13) D 14) A 15) B 16) F 17) E 18) B 19) A 20) C 21) D 22) TRUE 23) FALSE 24) TRUE 25) TRUE 26) TRUE 27) TRUE 28) TRUE 29) TRUE 30) TRUE 31) TRUE 32) FALSE 33) TRUE 34) TRUE 35) TRUE 36) FALSE 37) TRUE 38) TRUE 39) FALSE 40) TRUE 41) TRUE 42) FALSE 43) FALSE 44) C 45) C 46) C 47) D 48) D 49) C 50) A 12

Answer Key Testname: UNTITLED8

51) D 52) A 53) D 54) D 55) A 56) C 57) D 58) C 59) C 60) C 61) D 62) C 63) B 64) A 65) D 66) D 67) C 68) B 69) C 70) B 71) B 72) B 73) A 74) C 75) A 76) B 77) B 78) A 79) A 80) D 81) C 82) A 83) D 84) A 85) B 86) C 87) A 88) D 89) Once long bone growth in length is complete, the cartilage of the epiphyseal plates completely ossifies to become a permanent connection between the bones. 90) Bursitis is inflammation of the bursa. Repeated pressure and friction on the knee while completing the project caused damage to the prepatellar bursa. This can be treated by avoiding pressure to the area and injection of anti-inflammatory drugs into the bursa. If significant fluid accumulates, aspiration may be required to relieve pressure. 91) Muscle tone is very important for stabilizing the knee joint. The long time off allowed the muscles whose tendons span the knee joint to weaken and lose that stabilizing force. Running should stop until the muscles can be reconditioned. Then the distance should be short at first and increased incrementally. 92) Articular cartilage, a joint (articular) cavity, an articular (joint) capsule, synovial fluid, reinforcing ligaments, nerves, and blood vessels. 13

Answer Key Testname: UNTITLED8

93) Several drugs (colchicine, nonsteroidal anti-inflammatory drugs, glucocorticoids, and others) that terminate or prevent gout attacks are available. Patients are advised to drink plenty of water and to avoid excessive alcohol consumption (which promotes uric acid overproduction) and foods high in purine -containing nucleic acids, such as liver, kidneys, and sardines. 94) a. hinge; flexion b. pivot; rotation c. ball and socket; adduction d. plane; inversion 95) The thumb's carpometacarpal joint is a biaxial saddle joint whereas the other carpometacarpal joints are plane joints with no angular freedom. 96) The ends of each bone are covered with hyaline cartilage that is continuous with the synovial membrane enclosing the joint. Synovial fluid fills the space between the articular cartilage. Outside the synovial membrane there is a very tough, fibrous capsule that prevents the synovial membrane from bulging out as pressure is applied to the ends of the bones. 97) Blood levels of uric acid increase due to excessive production or slow excretion. Males have higher blood levels of uric acid than females because estrogens are thought to increase the rate of uric acid excretion. When blood levels of uric acid rise excessively, it is deposited as needle-shaped urate crystals in the soft tissues of joints. This causes an inflammatory response and pain, typically at one joint at the base of the great big toe. 98) Rheumatoid arthritis 99) Greg has either stretched or torn his rotator cuff. He will be told to rest for a few months, and if the pain does not subside, surgery will be necessary. The rotator cuff is made up of four tendons that belong to the subscapularis, supraspinatus, infraspinatus, and teres minor muscles and encircle the shoulder joint. They are vulnerable to damage when the arm is circumducted vigorously. Greg is obviously overdoing his activities by pitching multiple baseball games per week and playing golf on weekends. 100) A joint inflammation is always a symptom of an underlying problem such as cartilage or ligament damage, arthritis, etc. Continued injection might cause the patient to reinjure the area, or it might mask a more severe injury that may appear later. 101) The shapes of the articular surfaces may hinder rather than help joint stability. Ligaments can stretch and reduce stability. Muscle tendons are kept taut at all times by the tone of their muscle. 102) He might have suffered a shoulder dislocation since the shoulder joint has sacrificed stability for flexibility. 103) The doctor will perform arthroscopic surgery on Mary in order to view the interior of the joint. If she has severely damaged the meniscus, it can be removed with little impairment to the knee except some loss in stability. However, over the long term, the lack of weight distribution by the missing meniscus increases the likelihood of osteoarthritis in her knee. Mary might consider taking up swimming instead. 104) Farhad is suffering from tendonitis. If he continues to use the keyboard incorrectly, the tendonitis could develop into the more serious condition called carpal tunnel syndrome. 105) Alexis is suffering from dislocation of her temporomandibular joint (TMJ), which was probably exacerbated by her grinding her teeth. Treatment includes relaxation of the jaw muscles using massage, muscle -relaxant drugs, heat or cold, or stress reduction techniques. Use of a mouth guard at night may also help. 106) In the shoulder joint, stability has been sacrificed to provide the most freely moving joint of the body. The shoulder joint is a ball-and-socket joint. Shoulder dislocations are fairly common; therefore, forces that are not under the patient's control should be avoided. 107) Rheumatoid arthritis (RA) is a chronic, systemic, and inflammatory disorder. RA is an autoimmune disease in which the body's immune system attacks its own tissue. RA begins with inflammation of the synovial membrane of the affected joints. Fluid accumulates, causing joint swelling. The doctor should explain that RA is a chronic crippling disease with joint stiffening (ankylosis) resulting in restriction of joint movement and extreme pain. 108) Susan should consider Lyme disease and test for it. Treatment is taking antibiotics for 3 to 6 months.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 9.1 Using Figure 9.1, match the following: 1) Connective tissue sheath surrounding individual muscle fibers.

2) Bundle of muscle cells surrounded by a perimysium.

3) Connective tissue covering the exterior of a muscle organ.

4) Connective tissue surrounding muscle fiber bundles.

5) Individual muscle fiber.

Figure 9.2 Using Figure 9.2, match the following: 6) I band.

7) H zone.

8) A band.

9) Z disc.

10) M line.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) Depend on oxygen delivery and aerobic mechanisms.

A) Fast (glycolytic), fatigable fibers

11)

B) Fast (oxidative), fatigue-resistant fibers 12) Have very fast-acting myosin ATPases and depend upon aerobic metabolism during contraction.

12) C) Slow (oxidative), fatigue-resistant fibers

13) Red fibers, the smallest of the fiber types.

13)

14) Contain abundant amounts of glycogen.

14)

15) Abundant in muscles used to maintain posture.

15)

16) A relatively high percentage are found in successful marathon runners.

16)

Match the following: 17) When muscle tension develops but the load is not moved.

A) Multiple motor unit summation

17)

B) Muscle tone 18) Determined by alternating motor units of a muscle organ even when the muscle is at rest. 19) Continued sustained smooth contraction due to rapid stimulation.

18) C) Isometric contraction D) Isotonic contraction 19) E) Tetanus

20) When the muscle tension developed overcomes the load and muscle shortening occurs.

20)

21) How a smooth increase in muscle force is produced.

21)

Match the following: 22) A sarcomere is the distance between two ________.

A) A band

22)

B) Myosin 23) The ________ contains only the actin filaments. 24) The thicker filaments are the ________ filaments.

23) C) Z discs D) I band

24)

25) Both actin and myosin are found in the ________.

25)

26) The myosin filaments are located in the ________.

26)

Match the following: 27) The final chemical messenger and "trigger" for muscle contraction. It binds to troponin.

A) Sodium ions

28) A neurotransmitter released at motor end plates by the axon terminals.

C) Calcium ions

29) It diffuses across the cell membrane resulting in depolarization.

27)

B) Acetylcholine 28)

D) Neuromuscular junction 29) E) Acetylcholinesterase

30) Activates synaptic vesicles in axon terminals to fuse with plasma membrane of axon terminal.

30)

31) Where the axon of a motor neuron connects with the muscle fibers.

31)

32) Breaks down ACh into its building blocks, rendering it inactive.

32)

Match the sport to the energy system primarily used to perform the activity: 33) Marathons.

A) Direct phosphorylation

34) 25-meter swim.

B) Aerobic pathway

35) Weight lifting.

C) Anaerobic pathway

33) 34) 35)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 36) Once a motor neuron has fired, all the muscle fibers in a muscle contract.

36)

37) The thin filaments (actin) contain a polypeptide subunit G actin that bears active sites for myosin attachment.

37)

38) The force of muscle contraction is controlled by multiple motor unit summation or recruitment.

38)

39) A skeletal muscle contracts with varying force and length of time in response to the body's needs at the time.

39)

40) A motor neuron and all the muscle cells that it stimulates are referred to as a motor end plate.

40)

41) Peristalsis is characteristic of smooth muscle.

41)

42) A contraction in which the muscle does not shorten but its tension increases is called isometric contraction.

42)

43) Muscle cells store more creatine phosphate than ATP resulting in the muscle having a reserve source of energy.

43)

44) During isometric contraction, the energy used appears as movement.

44)

45) One of the functions of skeletal muscle contraction is production of heat.

45)

46) An increase in the calcium ion level in the sarcoplasm starts the sliding of the thin filaments. When the level of calcium ions declines, sliding stops.

46)

47) Muscle contraction will always promote movement of body parts regardless of how they are attached.

47)

48) Although there are no sarcomeres, smooth muscle still possesses thick and thin filaments.

48)

49) Muscle tone is the small amount of tautness or tension in the muscle due to weak, involuntary contractions of its motor units.

49)

50) Cells of unitary smooth muscle are found in the longitudinal and circular muscle layers of the intestine.

50)

51) Excitability is the ability of a cell to receive and respond to stimulus by changing its membrane potential.

51)

52) The effect of a neurotransmitter on the muscle cell membrane is to modify its ion permeability properties temporarily.

52)

53) When a muscle fiber contracts, the I bands diminish in size, the H zones disappear, and the A bands do not diminish in length.

53)

54) Cardiac muscle has a limited regenerative capacity.

54)

55) Smooth muscles relax when intracellular Ca 2+ levels drop but may not cease contractions.

55)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 56) What is the role of tropomyosin in skeletal muscles? A) Tropomyosin serves as a contraction inhibitor by blocking the myosin binding sites on the actin molecules. B) Tropomyosin is the chemical that activates the myosin heads. C) Tropomyosin is the receptor for the motor neuron neurotransmitter. D) Tropomyosin serves as a contraction inhibitor by blocking the actin binding sites on the myosin molecules.

56)

57) Which muscle cells have the greatest ability to regenerate? A) smooth B) cardiac C) skeletal D) no muscle can regenerate

57)

58) Most skeletal muscles contain ________. A) a predominance of slow oxidative fibers C) muscle fibers of the same type

58) B) a mixture of fiber types D) a predominance of fast oxidative fibers

59) The strongest muscle contractions are normally achieved by ________. A) increasing stimulus above the treppe stimulus B) increasing stimulus above the threshold C) recruiting small and medium muscle fibers D) increasing the stimulation up to the maximal stimulus

59)

60) Which of the following would be recruited later in muscle stimulation when contractile strength increases? A) motor units with larger, less excitable neurons B) many small motor units with the ability to stimulate other motor units C) large motor units with small, highly excitable neurons D) motor units with the longest muscle fibers

60)

61) Which of the following is a factor that affects the velocity and duration of muscle contraction? A) muscle length B) number of muscle fibers stimulated C) size of the muscle fibers stimulated D) load on the fiber

61)

62) Myoglobin ________. A) stores oxygen in muscle cells B) breaks down glycogen C) produces the end plate potential D) is a protein involved in the direct phosphorylation of ADP

62)

63) What structure in skeletal muscle cells functions in calcium storage? A) sarcoplasmic reticulum B) myofibrillar network C) intermediate filament network D) mitochondria

63)

64) What does excess postexercise oxygen consumption represent? A) the difference between the amount of oxygen needed for totally aerobic muscle activity and the amount actually used B) the amount of oxygen taken into the body immediately after the exertion C) the amount of oxygen equal to the oxygen already used D) amount of oxygen needed for aerobic activity to accomplish the same amount of work

64)

65) Immediately following the arrival of the stimulus at a skeletal muscle cell there is a short period called the ________ period during which the neurotransmitter is released by exocytosis, diffuses across the synaptic cleft, and binds to its receptors. A) refractory B) latent C) contraction D) relaxation

65)

66) Creatine phosphate functions in the muscle cell by ________. A) storing energy that will be transferred to ADP to resynthesize ATP B) forming a chemical compound with actin C) inducing a conformational change in the myofilaments D) forming a temporary chemical compound with myosin

66)

67) What is the primary function of wave summation? A) prevent muscle fatigue B) prevent muscle relaxation C) increase muscle tension D) produce smooth, continuous muscle contraction

67)

68) During muscle contraction, myosin cross bridges attach to which active sites? A) Z discs B) thick filaments C) actin filaments D) myosin filaments

68)

69) Which of the following surrounds an individual muscle cell? A) fascicle B) endomysium C) epimysium

69) D) perimysium

70) Rigor mortis occurs because ________. A) sodium ions leak into the muscle causing continued contractions B) no ATP is available to release attached actin and myosin molecules C) the cells are dead D) proteins are beginning to break down, thus preventing a flow of calcium ions

70)

71) The oxygen-binding protein found in muscle cells is ________. A) immunoglobin B) myoglobin C) ATP

71) D) hemoglobin

72) The contractile units of skeletal muscles are ________. A) T tubules B) microtubules C) mitochondria

D) myofibrils

73) Sarcomeres are functional units of ________ muscle. A) smooth B) skeletal

D) B and C only

72)

73) C) cardiac

74) What is the functional role of the T tubules? A) enhance cellular communication during muscle contraction B) hold cross bridges in place in a resting muscle C) synthesize ATP to provide energy for muscle contraction D) stabilize the G and F actin

74)

75) During vigorous exercise, there may be insufficient oxygen available to completely break down pyruvic acid for energy. As a result, the pyruvic acid is converted to ________. A) stearic acid B) a strong base C) lactic acid D) hydrochloric acid

75)

76) When a muscle is unable to respond to stimuli temporarily, it is in which of the following periods? A) refractory period B) latent period C) fatigue period D) relaxation period

76)

77) In an isotonic contraction, the muscle ________. A) changes in length and moves the "load" B) does not change in length but increases tension C) rapidly resynthesizes creatine phosphate and ATP D) never converts pyruvate to lactate

77)

78) Which of the following is the correct sequence of events for muscle contractions? A) motor neuron action potential, neurotransmitter release, muscle cell action potential, release of calcium ions from SR, ATP-driven power stroke, sliding of myofilaments B) muscle cell action potential, neurotransmitter release, ATP-driven power stroke, calcium ion release from SR, sliding of myofilaments C) neurotransmitter release, muscle cell action potential, motor neuron action potential, release of calcium ions from SR, sliding of myofilaments, ATP-driven power stroke D) neurotransmitter release, motor neuron action potential, muscle cell action potential, release of calcium ions from SR, ATP-driven power stroke

78)

79) The mechanism of contraction in smooth muscle is different from skeletal muscle in that ________. A) the site of calcium binding site differs B) the trigger for contraction is a rise in intracellular calcium C) actin and myosin interact by the sliding filament mechanism D) ATP energizes the sliding process

79)

80) Which of the following describes the cells of unitary smooth muscle? A) They are used for vision and hair raising. B) They depend upon recruitment using the autonomic nervous system. C) They consist of muscle fibers that are structurally independent of each other. D) They exhibit spontaneous action potentials.

80)

81) Which of the following is true about smooth muscle? A) Smooth muscle has well-developed T tubules at the site of invagination. B) Smooth muscle, in contrast to skeletal muscle, cannot synthesize or secrete any connective tissue elements. C) Smooth muscle cannot stretch as much as skeletal muscle. D) Certain smooth muscle cells can actually divide to increase their numbers.

81)

82) Smooth muscle is characterized by all of the following EXCEPT ________. A) it appears to lack troponin B) there are more thick filaments than thin filaments C) there are noncontractile intermediate filaments that attach to dense bodies within the cell D) there are no sarcomeres

82)

83) The ability of muscle to shorten forcibly when adequately stimulated is known as ________, and sets muscle apart from other tissue types. A) elasticity B) extensibility C) contractility D) excitability

83)

84) Which of the following statements is true? A) Cardiac muscle cells have many nuclei. B) Cardiac muscle cells are found in the heart and large blood vessels. C) Smooth muscle cells have T tubules. D) Striated muscle cells are long and cylindrical with many nuclei.

84)

85) An anaerobic metabolic pathway that results in the production of two net ATPs per glucose plus two pyruvic acid molecules is ________. A) hydrolysis B) the electron transport chain C) the citric acid cycle D) glycolysis

85)

86) Muscle tone is ________. A) the condition of athletes after intensive training B) a state of sustained partial contraction C) the feeling of well-being following exercise D) the ability of a muscle to efficiently cause skeletal movements

86)

87) The sliding filament model of contraction involves ________. A) actin and myosin sliding past each other and partially overlapping B) actin and myosin lengthening in order to slide past each other C) the shortening of thick filaments so that thin filaments slide past D) the Z discs sliding over the myofilaments

87)

88) After nervous stimulation stops, what prevents ACh in the synaptic cleft from continuing to stimulate contraction? A) the action potential stops going down the overloaded T tubules B) acetylcholinesterase breaks apart the ACh C) calcium ions returning to the terminal cisternae D) the tropomyosin blocking the myosin once full contraction is achieved

88)

89) Which of the following is the correct order for the phases of a muscle twitch? A) latent, contraction, relaxation B) latent, relaxation, contraction C) relaxation, contraction, latent D) contraction, relaxation, latent

89)

90) What is the most distinguishing characteristic of muscle tissue? A) It is composed of multiple cells working together. B) the ability to respond to nervous stimulation C) the ability to transform chemical energy into mechanical energy to move the body D) its cells' inability to reproduce by mitosis

90)

91) Of the following muscle types, which has the longest muscle cells and has obvious stripes called striations? A) multiunit smooth muscle B) visceral smooth muscle C) cardiac muscle D) skeletal muscle

91)

92) Hypothetically, if a muscle were stretched to the point where thick and thin filaments no longer overlapped, ________. A) ATP consumption would increase because the sarcomere is "trying" to contract B) cross bridge attachment would be optimum because of all the free binding sites on actin C) no muscle tension could be generated D) maximum force production would result because the muscle has a maximum range of travel

92)

93) What part of the sarcolemma contains acetylcholine receptors? A) part adjacent to another muscle cell B) end of the muscle fiber C) motor end plate D) any part of the sarcolemma

93)

94) Although all the anatomical parts of muscle work together to give it its characteristics, which of the following proteins listed below would be most associated with the characteristics of extensibility? A) potassium (K+ ) leak channels B) elastic (titin) filaments C) thick (myosin) filaments D) acetylcholine receptors in the motor end plate

94)

95) Although all the anatomical parts of muscle work together to give it it's characteristics, which of the following proteins listed below would be most associated with the characteristics of excitability? A) actin of thin filaments B) elastic (titin) filaments C) the Na+ -K+ pump D) acetylcholine receptors in the motor end plate

95)

96) Although all the anatomical parts of muscle work together to give it it's characteristics, which of the following proteins listed below would be most associated with the characteristics of contractility? A) voltage gated sodium channels B) elastic (titin) filaments + C) potassium (K ) leak channels D) thick (myosin) filaments

96)

97) Oxygen starved tissues can release chemical signals into the blood that can change the diameter of nearby blood vessels delivering oxygen and nutrients to the tissues. In doing so, the blood vessels will respond through vasodilation (widening of the vessel). Which muscle type is responsible for this vasodilation? A) cardiac muscle B) skeletal muscle C) striated muscle D) smooth muscle

97)

98) Of the following items listed below, which is the best description for why skeletal muscle stores glycogen? A) Glycogen provides a smooth surface for filaments to slide on. B) Glycogen is part of muscles rigid supporting framework. C) The glycogen is an insulating layer that helps regulate body temperature. D) Skeletal muscle is a heavy consumer of energy.

98)

99) During development embryonic cells will fuse to form muscle fibers. This will result in ________. A) interlocking of cells that can prevent the filaments from sliding B) the striations that appear in skeletal and cardiac muscle tissues C) the coordination of nerve signals to muscle fibers D) multinucleated muscle fibers that can extend as long as 30 centimeters

99)

100) Approximately 80% of a muscle fiber's volume are the myofibrils. This characteristic reflects muscles ability to ________. A) produce movement through contractile force B) produce relatively high amounts of ATP C) generate and propagate action potential D) store oxygen molecules that can be used in aerobic respiration

100)

101) Troponin, a major protein in thin filaments, is a globular protein with three polypeptide subunits. Which of the following is NOT a function of the troponin? A) One subunit binds to calcium ions. B) One subunit binds to potassium ions. C) One subunit attaches troponin to actin. D) One subunit binds tropomyosin and helps position it on actin.

101)

102) Curare is a poisonous plant extract. Curare molecules have a chemical structure like the neurotransmitter ACh. Curare can bind to the ACh receptor site on the chemically gated ion channels in the motor end plate. Even though curare will bind to the receptor site it will not open the ion channel and no ions will pass through. What do you think the symptoms of curare poisoning would look like? A) Curare will only affect muscles with ACh receptors, paralyzing them. B) Curare will only affect cardiac muscle, causing fibrillations of the heart. C) Smooth muscles will become stimulated causing quick movement of nutrients through the digestive system. D) Muscles will respond too quickly and cause a severe tremor.

102)

103) Myasthenia gravis is a disease that is believed to be caused by autoimmune disorder, resulting in the loss of ACh receptors at the motor end plate of muscle fibers. Which of the following is likely to be a symptom of myasthenia gravis? A) coma and loss of voluntary muscle movement B) seizures and uncontrollable muscle movement C) dehydration with headache D) weakness of muscle

103)

104) Which of the following statements best illustrates the fact that skeletal muscle is voluntary muscle? A) Skeletal muscle fibers are innervated by somatic motor neurons. B) Skeletal muscle is wrapped in several layers of connective tissue. The deepest layer being the endomysium. C) The shivering reflex aids in maintaining body temperature. D) Skeletal muscle appears striated due to the structure of the sarcomeres.

104)

105) If a muscle fiber were to suddenly and permanently stop producing ATP the fiber would no longer be able to actively transport calcium out of the cytoplasm (sarcoplasm) and the intracellular calcium concentration would rise. Which of the following would you expect to happen? A) The fiber would twitch uncontrollably due to excessive calcium bound to troponin. B) Calcium would be transported to the sarcoplasmic reticulum therefore contractions would cease. C) Myosin would be able to bind to the exposed binding sites on thin filaments but it would not be able to detach. D) No change would occur in a muscle that was relaxed to begin with.

105)

106) When a sarcomere contracts and thin filaments move over thick filaments you would expect to see ________. A) the I bands to appear smaller B) the H zone to appear wider C) the A band to appear darker D) the I bands to appear wider

106)

107) Addition of more myoglobin to a muscle fiber would have the largest effect on ________. A) fast oxidative and slow oxidative fibers B) fast oxidative fibers only C) fast glycolytic fibers only D) fast glycolytic and fast oxidative fibers

107)

108) Exhaustion of glycogen storage within a muscle fiber would have the biggest effect on ________. A) slow oxidative fibers B) fast glycolytic fibers C) fast oxidative fibers D) both slow and fast oxidative fibers

108)

109) Reduction in blood flow to a muscle fiber would have the greatest effect on ________. A) fast oxidative fibers B) both slow and fast oxidative C) slow oxidative fibers D) fast glycolytic

109)

110) A potential benefit of recruiting slow oxidative fibers for contraction before recruiting fast oxidative and fast glycolytic fibers might be ________. A) because they are slower to respond, slow oxidative fibers must be stimulated first in order to contract simultaneously with the faster fibers B) recruiting slow oxidative fibers early helps to tire them out first so that they won't interfere with the more powerful contractions of fast glycolytic fibers C) to allow for fine control with delicate contractile force with a small stimulus D) There is little to no benefit from recruiting slow oxidative fibers first, and therefore it is in fact fast glycolytic fibers that will be recruited first.

110)

111) Addition of more mitochondria to a muscle fiber will have the greatest effect on ________. A) slow oxidative fibers B) fast glycolytic fibers C) fast oxidative fibers D) both slow and fast oxidative fibers

111)

112) If given the exact same amount of ATP, which of the three fiber types would be able to contract for the longest amount of time? A) fast oxidative fibers B) fast glycolytic fibers C) both fast glycolytic and fast oxidative fibers D) slow oxidative fibers

112)

113) The 100-meter dash is a quick and short run requiring explosive speed. On completion of the dash, the runners will continue to breathe hard for several seconds to minutes even though they are no longer running. Which of the following is the best explanation for why this is so? A) The runners' fast oxidative muscles are so slow to utilize oxygen, they only begin aerobic respiration by the time the run has finished. B) Slow oxidative fibers are recruited last and have only started to work at completion of the run. C) The runners' use of stored oxygen, glucose, and creatine phosphate is being replenished and this requires a prolonged increase of oxygen intake. D) Since the exercise was mostly aerobic exercise, the runners' bodies have not yet realized the run is over. SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 114) Only ________ muscle cells are multinucleated.

114)

115) The end of the muscle that is attached to the part of the body in motion when a muscle contracts is called the ________.

115)

116) The enzyme ________ is present in the synaptic cleft at the neuromuscular junction. Its activity stops the neurotransmitters stimulation.

116)

117) Which cells help repair injured skeletal muscle fibers and allows regeneration of dead skeletal muscle?

117)

118) Only ________ muscle cells have intercalated discs at their gap junctions.

118)

119) A smooth, sustained contraction from rapid stimulation of skeletal muscle fibers is called ________.

119)

120) Define muscle fatigue.

120)

121) Describe two ways in which the lack of ATP production results in rigor mortis.

121)

122) What ultimately stops muscle stimulation when the motor neuron ceases firing?

122)

123) Describe the anatomical parts of the muscle triad and how the function of these organelles work together to initiate contraction.

123)

124) Briefly explain the sources of energy for a one-minute sustained muscle contraction.

124)

125) Caveolae are an anatomical feature of smooth muscle. Describe this anatomical feature and specifically how it improves smooth muscles' response to nervous stimulation

125)

126) How is it that norepinephrine (NE) can inhibit smooth muscle action in airways, yet stimulate contractions in smooth muscles everywhere else in the body?

126)

113)

127) Describe how the unique contractile mechanism of smooth muscle allows it to contract and remain in a contracted state for long periods of time with relatively little energy expenditure.

127)

128) Describe the difference between muscle tension, muscle contraction and a muscle twitch.

128)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 129) Gary was injured in an automobile accident that severed the motor neurons innervating his quadriceps. Even though he has had extensive physical therapy, he is still suffering from muscle atrophy. Why is the therapy not working? 130) Aaron arrived at the hospital with the following symptoms: drooping eyelids; fatigue and weakness of his muscles; and difficulty talking, breathing, and swallowing. What was his diagnosis? 131) Lynn has been waking up each night with intense pain in her calves. She does not feel that it is serious enough to seek medical attention but would like to know what is causing the pain. What would you tell her concerning this problem? She has been playing tennis all summer for several hours each day. Could this have anything to do with the night pain? 132) After much delayed removal of an elbow cast, Lauren noticed her arm was immovable. What happened to her arm? 133) When a geriatric patient is admitted to the postsurgical unit, an important nursing measure is to prevent the loss of muscle mass. What is the term used for loss of muscle mass and how can the patient prevent it? 134) A patient has no peristalsis in the gastrointestinal tract. Explain a possible complication of this condition. 135) The nurse encourages the patient to do his own activities of daily living such as bathing, eating, dressing, and toileting activities. How do these activities promote physical conditioning? 136) A 5-year-old male is diagnosed with Duchenne muscular dystrophy (DMD). Discuss what this means in terms of the boy's muscles and what should his parents expect to observe.

Answer Key Testname: UNTITLED9

1) B 2) D 3) A 4) E 5) C 6) C 7) B 8) D 9) A 10) E 11) C 12) B 13) C 14) A 15) C 16) C 17) C 18) B 19) E 20) D 21) A 22) C 23) D 24) B 25) A 26) A 27) C 28) B 29) A 30) C 31) D 32) E 33) B 34) C 35) A 36) FALSE 37) TRUE 38) TRUE 39) TRUE 40) FALSE 41) TRUE 42) TRUE 43) TRUE 44) FALSE 45) TRUE 46) TRUE 47) FALSE 48) TRUE 49) TRUE 50) TRUE 15

Answer Key Testname: UNTITLED9

51) TRUE 52) TRUE 53) TRUE 54) TRUE 55) TRUE 56) A 57) A 58) B 59) D 60) A 61) D 62) A 63) A 64) A 65) B 66) A 67) D 68) C 69) B 70) B 71) B 72) D 73) D 74) A 75) C 76) A 77) A 78) A 79) A 80) D 81) D 82) B 83) C 84) D 85) D 86) B 87) A 88) B 89) C 90) C 91) D 92) C 93) C 94) B 95) D 96) D 97) D 98) D 99) D 100) A 16

Answer Key Testname: UNTITLED9

101) B 102) A 103) D 104) A 105) C 106) A 107) A 108) B 109) C 110) C 111) A 112) D 113) C 114) skeletal 115) insertion 116) acetylcholinesterase 117) satellite cells 118) cardiac 119) tetanus 120) It is an inability of the muscle to contract despite continued stimulation. 121) Following the death of an individual, ATP is rapidly consumed and cannot be replaced. Because cross bridge detachment and calcium active transport are ATP-driven, calcium leakage from the sarcoplasmic reticulum causes attachment of cross bridges, and lack of ATP prevents detachments. 122) The ultimate switch is the enzyme acetylcholinesterase. When the neuron stops releasing ACh, the muscle would not stop contracting if the acetylcholinesterase did not split the ACh into its two components, acetic acid and choline, making them release their binding sites. 123) The parts of the muscle triad are two adjacent SR terminal cisterns plus one intervening T tubule. The sarcoplasmic reticulum is a reservoir for calcium ions in the cell's normal resting state. The T tubule is a fold in the cell membrane between the sarcoplasmic reticuli. When an impulse is activated by a motor neuron, the voltage -regulated change causes SR foot proteins to open Ca 2+ channels. The calcium ions are flushed out where they interact with the troponin complex to initiate a contraction. Once the axon stops firing, the membrane polarity is quickly restored and the calcium ions are pulled off the troponin and attracted back into the sarcoplasmic reticulum. 124) 1. The first 4-6 seconds of energy come from stored ATP in the muscle cell. 2. 6-15 seconds of energy come from the transfer of creatine phosphate and ADP (which come from the first few seconds of burn) to form additional ATP. 3. 15-60 seconds of energy come from glycolysis, which by now has begun full production of ATP from glucose. 125) Caveolae are pouch like inholdings on the sarcolemma that contain many voltage gated calcium ion channels. These inholdings greatly increase the surface area that will respond to nervous stimulation. 126) Norepinephrine's effects depend upon the action of the receptor to which it binds. There is a different type of NE receptor on bronchiolar muscle than the NE receptor in other places. 127) Smooth muscle possesses a latch state in which it can maintain its new length while relaxed and therefore hold a contracted state using little energy. 128) A muscle twitch is the response of a motor unit to a single action potential from a motor neuron. A twitch consists of three phases, latent period, contraction and relaxation. Contraction is simply the activation of the myosin cross bridge cycle and tension is the force that is excreted by this contraction. 129) In denervation atrophy, fibrous connective tissue replaces the muscle tissue that was lost. When atrophy is complete, fibrous tissue cannot be reversed to muscle tissue. 130) Aaron probably has myasthenia gravis (an autoimmune disease), which involves a shortage of ACh receptors at the neuromuscular junction. 17

Answer Key Testname: UNTITLED9

131) This is due to sustained spasm, or tetanic contraction, of the gastrocnemius muscle. The causes could be low blood sugar, electrolyte depletion (particularly sodium and calcium), dehydration, or irritability of the spinal cord neurons. The fact that Lynn has been playing tennis for several hours each day may have caused an electrolyte depletion. She should increase her intake of sodium and calcium. 132) Two things have occurred to Lauren while she was convalescing from her injury. First, the immobilization of the arm caused some muscle mass to atrophy. Second, the loss of muscle was replaced with tough connective tissue that locked her arm in place. With therapy the tissue can be stretched or torn enough to return the full range of motion. 133) Disuse atrophy is degeneration and loss of muscle mass. The size, shape, tone, and strength of muscles (including the heart) are maintained with mild exercise and increased with strenuous exercise. Promoting exercise to maintain a patient's muscle tone, joint mobility, and cardiovascular function is an important nursing function. 134) Peristalsis is wavelike movement produced by the circular and longitudinal muscle fibers of the intestinal walls that propels the intestinal contents forward. Without peristalsis, the patient would be unable to expel his or her stool, leading to abdominal discomfort, then vomiting, and finally obstruction. 135) These activities are isotonic exercises in which muscle tension is constant and then shortens to produce muscle contraction and movement. Because the muscles contract, the shape, size, and strength of the muscles are maintained as well as joint mobility. 136) Duchenne muscular dystrophy is a muscle disorder inherited as a sex -linked recessive disease and is expressed almost exclusively in males. Active, normal appearing boys become clumsy and fall frequently as their skeletal muscles weaken due to atrophy and degeneration. It starts at the extremities and moves upward toward the head and chest muscles, and cardiac muscle.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 10.1 Using Figure 10.1, match the following: 1) Second-class lever.

2) Humerus-ulna joint.

3) Tibia-calcaneus joint.

4) Atlanto-occipital joint.

5) First-class lever.

6) The action of lifting a shovel of snow.

Figure 10.2 Using Figure 10.2, match the following: 7) Deltoid.

8) Serratus anterior.

9) Sternocleidomastoid.

10) Pectoralis minor.

10)

11) Coracobrachialis.

11)

Figure 10.3 Using Figure 10.3, match the following: 12) Trapezius muscle.

12)

13) Teres major muscle.

13)

14) The latissimus dorsi.

14)

15) Rotates scapula.

15)

16) Rhomboid minor and Rhomboid major.

16)

17) Elevates and adducts scapula.

17)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following muscle actions: 18) Powerful flexor and adductor of hand.

A) Flexor carpi ulnaris

19) Flexes distal interphalangeal joints.

B) Flexor digitorum profundus

18) 19)

20) Stabilizes the wrist during finger extension.

A) Palmaris longus

20)

B) Extensor carpi radialis brevis 21) Extends and abducts the hand.

21) C) Flexor carpi ulnaris

22) Tenses skin and fascia of palm during hand movements.

22)

Match the following: 23) Muscle that opposes and reverses the action of another muscle.

A) Antagonist

23)

B) Synergist 24) Muscle that stabilizes the origin of another muscle. 25) Muscle that is primarily responsible for bringing about a particular movement.

24) C) Agonist (prime mover) D) Fixator

26) Muscle that aids another by promoting the same movement.

25)

26)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 27) A wheelbarrow is a good example of a second -class lever.

27)

28) Both first- and second-class levers operate at a mechanical disadvantage.

28)

29) Although all skeletal muscles have different shapes, the fascicle arrangement of each muscle is exactly the same.

29)

30) Muscles are only able to pull, they never push.

30)

31) Regardless of type, all levers follow the same basic principle: effort farther than load from fulcrum = mechanical advantage; effort nearer than load to fulcrum = mechanical disadvantage.

31)

32) The buccinator muscle compresses the cheek and is well developed in nursing infants.

32)

33) Muscles that help maintain upright posture are fixators.

33)

34) Deep muscles of the thorax promote movements for breathing.

34)

35) The deltoid is a prime mover of the arm that acts in adduction.

35)

36) The soleus is an antagonist of the gastrocnemius during plantar flexion.

36)

37) Muscles that help to maintain posture are best described as synergists.

37)

38) In order to propel food down to the esophagus, the pharyngeal constrictor muscles are used.

38)

39) The major head flexors are the sternocleidomastoid muscles, with the help of the muscles attached to the hyoid bone.

39)

40) The arrangement of a muscle's fascicles determines its range of motion and power.

40)

41) Muscle power depends mostly on the total number of muscle fibers (cells) in the muscle.

41)

42) The calcaneal tendon (Achilles tendon) is the largest tendon in the body.

42)

43) The diaphragm flattens and moves inferiorly during inspiration.

43)

44) The broadest muscle of the back is the latissimus dorsi.

44)

45) Muscle spasms of the back often are due to the erector spinae contraction.

45)

46) Muscles connecting to the hyoid bone are important for swallowing and speech.

46)

47) The muscles of facial expression insert into skin or other muscles, not bones.

47)

48) Most superficial thorax muscles are extrinsic shoulder muscles.

48)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 49) Which type of lever is exemplified by the flexing of the forearm by the biceps brachii muscle? A) a first-class lever B) a second-class lever C) a third-class lever D) a fourth-class lever

49)

50) What muscle is primarily responsible for preventing foot drop? A) extensor digitorum longus B) fibularis tertius C) extensor hallucis longus D) tibialis anterior

50)

51) What is the major factor controlling how levers work? A) the difference in the positioning of the effort, load, and fulcrum B) the weight of the load C) the structural characteristics of the muscles of the person using the lever D) the direction the load is being moved

51)

52) Which of the following is NOT a muscle primarily involved in the breathing process? A) latissimus dorsi B) external intercostal C) internal intercostal D) diaphragm

52)

53) What is the main factor that determines the power of a muscle? A) the number of neurons innervating it B) the length C) the total number of muscle fibers (cells) available for contraction D) the shape

53)

54) What is a muscle that provides the major force for producing a specific movement called? A) an antagonist B) an agonist (prime mover) C) a fixator D) a synergist

54)

55) When the term biceps, triceps, or quadriceps forms part of a muscle's name, what does it tell you about the muscle? A) The muscle has two, three, or four origins, respectively. B) The muscle has two, three, or four insertions, respectively. C) The muscle is able to change direction twice, three times, or four times faster than other muscles, respectively. D) The muscle has two, three, or four functions, respectively.

55)

56) The most powerful muscle in the body is the ________. A) gluteus maximus B) quadriceps femoris C) gastrocnemius D) rectus abdominis

56)

57) Which of the following describes a bipennate pattern of fascicles? A) An arrangement in which the fascicles insert into only one side of a tendon. B) An arrangement of five fascicles on each side of the tendon. C) An arrangement that looks like many feathers side by side. D) An arrangement in which the fascicles insert into the tendon from opposite sides.

57)

58) Which of the following describes the suprahyoid muscles? A) They are often called strap muscles. B) They are a group of muscles that lie superior to the hyoid bone and help form the floor of the oral cavity. C) They depress the larynx and hyoid bone if the mandible is fixed. D) They move the pharynx superiorly during swallowing.

58)

59) The supraspinatus is named for its location on the posterior aspect of the scapula above the spine. What is its action? A) to extend and medially rotate the humerus and to act as a synergist of the latissimus dorsi B) to flex and adduct the humerus and to act as a synergist of the pectoralis major C) to help hold the head of the humerus in the glenoid cavity and rotate the humerus laterally D) to initiate abduction of the arm, to stabilize the shoulder joint and to help prevent downward dislocation of the humerus

59)

60) Which of the following muscles is NOT a rotator cuff muscle? A) supraspinatus B) levator scapulae C) subscapularis D) teres minor

60)

61) Which of the following muscles is involved in producing horizontal wrinkles in the forehead? A) the temporalis B) the frontal belly of the epicranius C) the medial pterygoid D) the zygomaticus major

61)

62) At the grocery store a cute, little curly-haired child is standing behind you in line. You turn around for a moment and she sticks her tongue out at you. Which tongue muscle did she use? A) genioglossus B) hyoglossus C) stylohyoid D) orbicularis oris

62)

63) Which of these is the function of the external oblique muscles? A) extend vertebral column and head and rotates them to opposite sides B) flex vertebral column and compress abdominal wall C) elevate and adduct scapula in synergy with superior fibers of trapezius D) pull ribs toward one another to elevate the rib cage

63)

64) Which of the following muscles is involved in crossing one leg over the other to produce the cross-legged position? A) the gastrocnemius B) the quadriceps femoris C) the sartorius D) all of the hamstrings

64)

65) Which of the following muscles inserts to the posterior calcaneus via the calcaneal tendon? A) the tibialis anterior B) the semitendinosus C) the sartorius D) the gastrocnemius

65)

66) If a lever operates at a mechanical advantage, it means that the ________. A) load is far from the fulcrum and the effort is applied near the fulcrum B) load is near the fulcrum and the effort is applied far from the fulcrum C) effort is farther than the load from the fulcrum D) lever system is useless

66)

67) Which of the following muscles fixes and stabilizes the pelvis during walking? A) transversus abdominis B) rectus abdominis C) internal oblique D) external oblique

67)

68) A muscle that opposes, or reverses, a particular movement is a(n) ________. A) synergist B) antagonist C) agonist (prime mover) D) fixator

68)

69) What type of muscle assists an agonist by causing a like movement or by stabilizing a joint over which an agonist acts? A) an agonist B) a prime mover C) an antagonist D) a synergist

69)

70) Which of the following is NOT a member of the hamstrings? A) gracilis B) biceps femoris C) semitendinosus D) semimembranosus

70)

71) A nursing infant develops a powerful sucking muscle that inserts to the muscle which adults also use for whistling (orbicularis oris). What is this muscle called? D) platysma A) masseter B) zygomaticus C) buccinator

71)

72) The sternocleidomastoid muscle inserts on the ________. A) sternum B) mastoid process of the temporal bone C) platysma D) clavicle

72)

73) In general, a muscle that crosses on the anterior side of a joint produces ________. A) flexion B) extension C) adduction D) abduction

73)

74) Which of these is NOT a way of classifying muscles? A) the type of muscle fibers B) muscle shape C) the type of action they cause D) muscle location

74)

75) Which of the following muscles is used to form a smile? A) corrugator supercilli B) zygomaticus major C) mentalis D) orbicularis oris

75)

76) Which of the following best describes the orbicularis oris? A) It closes the eye. B) It draws the eyebrows together. C) It closes, purses, and protrudes the lips. D) It pulls the lower lip down and back.

76)

77) Which muscle group is involved when a "pulled groin" occurs? A) quadriceps B) lateral rotators C) hamstrings D) thigh adductors

77)

78) What are the levers that operate at a mechanical advantage called? A) dysfunctional levers B) power levers C) speed levers D) functional levers

78)

79) Tennis players often complain about pain in the arm (forearm) that swings the racquet. What muscle is usually strained under these conditions? A) the brachioradialis B) the triceps brachii C) the flexor digitorum profundus D) the anconeus

79)

80) Which muscle(s) is (are) contracted to exhale forcibly? A) rectus abdominis and diaphragm B) diaphragm alone C) internal intercostals and rectus abdominus D) external intercostals and diaphragm

80)

81) Paralysis of which of the following would make an individual unable to flex the thigh? A) biceps femoris B) iliopsoas and rectus femoris C) soleus D) vastus medialis

81)

82) First-class levers ________. A) have load at one end of the lever, fulcrum at the other, and effort applied somewhere in the middle B) in the body can operate at a mechanical advantage or mechanical disadvantage, depending on specific location C) are typified by tweezers or forceps D) are used when standing on tip-toe

82)

83) What do the genioglossus, hyoglossus, and styloglossus muscles have in common? A) Each acts synergistically to elevate the jaw. B) All names indicate the relative size of the muscle. C) All names reflect direction of muscle fibers. D) All act on the tongue.

83)

84) If L = load, F = fulcrum, and E = effort, what type of lever system is described as LEF? A) first-class lever B) second-class lever C) third-class lever D) fourth-class lever

84)

85) Which of the following muscles is a flexor of the thigh at the hip? A) gluteus maximus B) adductor magnus C) vastus lateralis D) tibialis posterior

85)

86) Which of the following muscles is involved in inversion at the ankle joint? A) fibularis (peroneus) tertius B) fibularis (peroneus) longus C) extensor digitorum longus D) tibialis anterior

86)

87) Which of the following muscles serves as a common intramuscular injection site, particularly in infants as the buttocks and arm muscles are poorly developed? A) the vastus medialis B) the vastus intermedius C) rectus femoris D) the vastus lateralis

87)

88) Paralysis of which of the following muscles would make an individual unable to flex the knee? A) brachioradialis B) soleus C) gluteal muscles D) hamstring muscles

88)

89) Which of the following muscles does NOT act in plantar flexion? A) flexor digitorum longus B) gastrocnemius and soleus C) tibialis posterior D) popliteus

89)

90) ________ is a powerful forearm extensor at the elbow joint. A) Brachioradialis B) Brachialis C) Triceps brachii

90) D) Biceps brachii 91)

91) The ________ is known as the "boxer's muscle." A) biceps brachii C) serratus anterior

B) rectus abdominis D) flexor digitorum longus

92) The ________ runs deep to the internal oblique. A) external oblique C) latissimus dorsi

B) transversus abdominis D) rectus abdominis

92)

93) The ________ helps keep food between the grinding surfaces of the teeth during chewing. D) mentalis A) orbicularis oris B) risorius C) buccinator

93)

94) The ________ tightens the neck and draws the corners of the mouth downward as in expressing horror. A) platysma B) sternocleidomastoid C) sternohyoid D) mentalis

94)

95) The ________ is the main chewing muscle. A) buccinator C) lateral pterygoid

95) B) hyoglossus D) masseter

96) The abnormal protrusion of the small intestine through a weak point in the muscle of the abdominal wall is called a ________. A) hernia B) hyperextension C) sprain D) pulled muscle

96)

97) The quadriceps femoris is composed of three "vastus" muscles and the ________. A) rectus femoris B) biceps femoris C) semimembranosus D) semitendinosus

97)

98) The ________ is a synergist of the latissimus dorsi; it extends, medially rotates, and adducts the humerus. A) teres minor B) teres major C) infraspinatus D) supraspinatus

98)

99) The ________ extends the great toe. A) fibularis (peroneous)tertius C) tibialis anterior

99) B) extensor hallucis longus D) gastrocneumius

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 100) From superficial to deep, order the transversus abdominis, external oblique and internal oblique muscles. Describe the orientation of the muscle fibers for each of these as well as for the rectus abdominis muscles.

100)

101) What are the components of a lever system? Describe the role of each component.

101)

102) Bodybuilders are known for their "great quads." Describe the quadriceps muscles.

102)

103) A woman mentions to her friend that another person on the beach has "great abs." What is she talking about?

103)

104) Muscles that act as synergists seem to have valuable functions, especially in stabilizing joints. Briefly explain their functions.

104)

105) How does an antagonist differ from a prime mover (agonist)? How is it the same?

105)

106) An elderly woman, with extensive osteoarthritis of her left hip joint, entered the hospital to have a total hip joint replacement (prosthesis implantation). After surgery, her left hip had to be maintained in abduction to prevent dislocation of the prosthesis while healing was occurring. An abduction pillow was used to keep the legs apart, especially when lying on her side. Name the abductor muscles and describe the action of each that need to be strengthened in order to help maintain abduction.

106)

107) A wide receiver for a college football team pulled a hamstring muscle. What muscles could be affected and what would the effect be?

107)

108) How can a lever system work at a mechanical disadvantage but still be of use to us?

108)

109) List and describe the muscles involved in biting and chewing an apple?

109)

110) A college student told her friend that she was going to the gym to work on tightening her gluteus maximus. Which muscle is she referring to and what is its function?

110)

111) Damage to the ischiocavernosus muscle would have what effect?

111)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 112) David is playing football when he suffers from a ruptured calcaneal tendon. The rupture is accompanied by abrupt pain and the calf muscle bulges due to the release of two muscles from their insertion. Name these two muscles. 113) Brian decided to enter a 5-mile race designed to raise money for a class trip. He did not do any preconditioning, nor has he ever jogged before. The morning after the race, Brian had so much pain in both his shins, he was unable to go to school. What caused this pain? 114) A young pregnant woman went to a childbirth class and the instructor informed them about strengthening the muscles of the pelvic floor. What are these muscles? 115) A nurse can facilitate respiratory functioning by encouraging deep breathing exercises such as diaphragmatic breathing. Explain diaphragmatic breathing. 116) In emphysema, the lungs become overdistended with trapped air, which increases the effort required for breathing. Describe the muscles involved when breathing becomes a forced process, such as a patient who has emphysema. 117) The nurse is explaining Kegel exercises to strengthen the pelvic floor muscles. What factors may contribute to a weakening of the pelvic floor muscles? 118) Tom has been told that he has an inguinal hernia. What is an inguinal hernia and what is its possible cause? 119) A patient has a stroke and has weakness on his right side. How will the weakness affect his ability to swallow?

Answer Key Testname: UNTITLED10

1) A 2) B 3) A 4) C 5) C 6) B 7) B 8) E 9) A 10) C 11) D 12) B 13) D 14) E 15) B 16) C 17) A 18) A 19) B 20) C 21) B 22) A 23) A 24) D 25) C 26) B 27) TRUE 28) FALSE 29) FALSE 30) TRUE 31) TRUE 32) TRUE 33) TRUE 34) TRUE 35) FALSE 36) FALSE 37) FALSE 38) TRUE 39) TRUE 40) TRUE 41) TRUE 42) TRUE 43) TRUE 44) TRUE 45) TRUE 46) TRUE 47) FALSE 48) TRUE 49) C 50) D 12

Answer Key Testname: UNTITLED10

51) A 52) A 53) C 54) B 55) A 56) B 57) D 58) B 59) D 60) B 61) B 62) A 63) B 64) C 65) D 66) B 67) B 68) B 69) D 70) A 71) C 72) B 73) A 74) A 75) B 76) C 77) D 78) B 79) A 80) C 81) B 82) B 83) D 84) C 85) B 86) D 87) D 88) D 89) D 90) C 91) C 92) B 93) C 94) A 95) D 96) A 97) A 98) B 99) B 13

Answer Key Testname: UNTITLED10

100) Fibers of the external oblique muscle run downward and medially (like outstretched fingers in pants pockets) and at right angles to those of the internal oblique that runs just deep to it. Under these is the transversus abdominis whose fibers run horizontally across the abdomen at an angle to both oblique muscles. The rectus abdominis muscles run medially from the pubis to the rib cage. 101) The lever system components are lever, fulcrum, effort, and load. The lever is a rigid bar that moves on a fixed point (the fulcrum) when a force is applied to it. The applied force, or effort, is used to move a resistance, or load. 102) These are the muscles of the front and sides of the thigh, and include the rectus femoris and the lateral, medial, and intermediate vastus muscles. 103) The woman is referring to well-developed rectus abdominis muscles. This is a term coined by bodybuilders and refers to the bulging muscles between the tendinous intersections. 104) Synergists aid prime movers (agonists) by promoting the same movement or by reducing undesirable or unnecessary movements that might occur as the prime mover contracts. These latter muscles are called fixators. 105) A prime mover is the muscle that causes the desired movement to occur. An antagonist is a muscle that opposes the action of the prime mover in a given movement. If, however, the direction of movement reverses, the former antagonist is now the prime mover and the former prime mover is now the antagonist. 106) Gluteus maximus, gluteus medius, and gluteus minimus. These muscles originate on the pelvis; they act as major extensors of the thigh and abduct and rotate the thigh as well. The tensor fascia lata also abducts the thigh. 107) The muscles include the biceps femoris, semitendinosus, and semimembranosus. They are important flexors of the leg and extensors of the thigh. Injuries here could make it impossible to run properly or to extend the thigh. 108) A lever that operates with the load far from the fulcrum and the effort applied near the fulcrum is operating at a disadvantage in terms of power, but the advantage is that the load can move over large distances at a rapid rate. Wielding a shovel is an example. 109) Open and close lips – levator labii superioris and orbicularis oris Open the mouth – digastric and mylohyoid Closing the mouth and chewing – masseter, temporalis, and pterygoids Tongue – genioglossus, hypoglossus, and styloglossus Extra – buccinator holds food in teeth grinding area 110) The college student was referring to the largest and most superficial gluteus muscle that forms the bulk of the buttock mass. It functions as the major extensor of the thigh and is most effective when the thigh is flexed and force is necessary. 111) In the male, it would be impossible to achieve an erection of the penis. In the female, the clitoris would not become erect. 112) Gastrocnemius medialis and lateralis and soleus. 113) Brian was not conditioned for this type of run, and he now has shin splints. This is a condition in which the anterior tibialis muscle is irritated, and as the inflamed muscle swells, its circulation is impaired by the tight fascial wrappings, causing pain and tenderness. 114) The levator ani and coccygeus muscles form the bulk of the pelvic diaphragm (pelvic floor). Strengthening these muscles helps in the delivery of the child by resisting downward forces when "pushing." 115) Diaphragmatic breathing is the alternating contraction and relaxation of the diaphragm causing pressure in the abdominopelvic cavity below that facilitates blood to the heart. Diaphragmatic breathing promotes maximum inhalation and lung expansion. 116) During forced inspiration, the scalenes and sternocleidomastoid muscles help lift the ribs and the erector spinae muscle help in deep inspirastion. Forced expiration is aided by internal intercostal muscles that pull the ribs inferiorly and by abdominal wall muscles that push the diaphragm superiorly by compressing the abdominal contents. 117) Aging and multiple births. 118) An inguinal hernia is an abnormal protrusion of abdominal contents, usually the small intestine, through a weak spot in muscles of the abdominal wall. It is usually a result of increased intraabdominal pressure during lifting or straining. 119) The patient may have difficulty swallowing related to weakness or paralysis of the suprahyoid muscles. The suprahyoid muscles help elevate the larynx and close the epiglottis to prevent choking during the swallowing process. 14

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 11.1 Using Figure 11.1, match the following: 1) Which neuron would activate to a muscle?

2) Which neuron would be found in the retina of the eye?

3) Which neuron is a sensory neuron found in a reflex arc?

4) Which neuron is never myelinated?

5) Which neuron is typically involved in the special senses of sight and smell?

6) In a reflex arc, which neuron has its cell body inside the spinal cord?

7) Which neuron is common only in dorsal root ganglia of the spinal cord and sensory ganglia of cranial nerves?

8) Which is by far the most common neuron type?

Figure 11.2 Using Figure 11.2, match the following: 9) Ion channel.

10) Synaptic vesicles.

10)

11) Calcium ions.

11)

12) Postsynaptic membrane.

12)

13) Synaptic cleft.

13)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 14) The neuron cannot respond to a second stimulus, no matter how strong.

A) Absolute refractory period

15) The interior of the cell becomes less negative due to an influx of sodium ions.

C) Depolarization

16) The specific period during which potassium ions diffuse out of the neuron due to a change in membrane permeability.

14)

B) Repolarization 15)

D) Relative refractory period E) Action potential

16)

17) Also called a nerve impulse transmitted by axons.

17)

18) An exceptionally strong stimulus can trigger a response.

18)

Match the following: 19) Voltage-gated Na+ channels open.

A) Threshold stimulus

20) Na+ channels are inactivating, and voltage-gated K+ channels open.

B) Hyperpolarization

19) 20)

C) Repolarization 21) Some K+ channels remain open, and Na+ channels rest.

21) D) Depolarization

22) Any stimulus at or above this level will result in action potential.

22)

Match the following: 23) Area where nerve impulse is generated.

A) Conducting region

23)

B) Trigger zone 24) Receives stimuli.

24) C) Receptive region

25) Plasma membrane exhibits voltage-gated Na+ and K+ channels.

25)

26) Plasma membrane exhibits voltage-gated Ca2+ channels.

A) Receptive region

26)

B) Secretory zone 27) Axon terminals release neurotransmitters.

C) Secretory region

28) Plasma membrane exhibits chemically gated ion channels.

27)

28)

Match the following: 29) One incoming axon triggers responses in ever-increasing numbers farther and farther along the circuit.

A) Reverberating circuit

30) May be involved in complex, exacting types of mental processing.

C) Converging circuit

31) Involved in control of rhythmic activities such as breathing.

29)

B) Diverging circuit 30)

D) Parallel after-discharge circuit 31)

32) Involved in activating fibers of a skeletal muscle such as the biceps muscle.

32)

33) Different types of sensory input can have the same ultimate effect.

33)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 34) The all-or-none phenomenon as applied to nerve conduction states that the whole nerve cell must be stimulated for conduction to take place.

34)

35) Reflexes are rapid, automatic responses to stimuli that will produce the same effect every time.

35)

36) Cell bodies of sensory neurons may be located in ganglia lying outside the central nervous system.

36)

37) During depolarization, the inside of the neuron's membrane becomes less negative.

37)

38) The peripheral nervous system is divided into afferent and efferent divisions.

38)

39) Strong stimuli cause the amplitude of action potentials generated to increase.

39)

40) Enkephalins and endorphins are peptides that act like morphine.

40)

41) In myelinated axons the voltage-regulated sodium channels are concentrated at the nodes of Ranvier.

41)

42) A postsynaptic potential is a graded potential that is the result of a neurotransmitter released into the synapse between two neurons.

42)

43) Unipolar neurons have axons structurally divided into peripheral and central processes.

43)

44) A stimulus traveling toward a synapse appears to open calcium ion channels at the presynaptic end, which in turn promotes fusion of synaptic vesicles to the axonal membrane.

44)

45) Axon diameter and degree of myelination determine nerve impulse conduction velocity.

45)

46) The action potential is caused by permeability changes in the plasma membrane.

46)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 47) Nerve impulses are sent to slow the heart's rate of contraction. The nerve fibers sending these signals will most likely belong to which division of the nervous system? A) sensory (afferent) division B) somatic nervous system C) sympathetic division D) parasympathetic division

47)

48) Nerve impulses leading to the brain carry information about cool temperatures on the skin. The nerve fibers sending these signals will most likely belong to which division of the nervous system? A) sensory (afferent) division B) somatic nervous system C) sympathetic division D) parasympathetic division

48)

49) Nerve impulses leading to the skeletal muscle carry information to direct movement. The nerve fibers sending these signals will most likely belong to which division of the nervous system? A) sensory (afferent) division B) somatic nervous system C) sympathetic division D) parasympathetic division

49)

50) Cranial nerve II, the optic nerve sends nerve impulses to the brain carrying information about the things we see. These nerve fibers most likely belong to which division of the nervous system? A) sensory (afferent) division B) somatic nervous system C) sympathetic division D) parasympathetic division

50)

51) The concentration of ions in the chemical environment surrounding the neurons must be tightly regulated for neurons to function properly. Which of the following cells is most responsible for this? A) oligodendrocytes B) satellite cells C) Schwann cells D) astrocytes

51)

52) Some nerve fibers of the peripheral nervous system have the ability to regenerate after damage has occurred. Which of the following cells is most responsible for aiding in this regulation? A) satellite cells B) oligodendrocytes C) Schwann cells D) astrocytes

52)

53) It is important for newly developed neurons to form synapses with other neurons. Which cells are most responsible for guiding the formation of these particular junctions? A) Schwann cells B) satellite cells C) microglial cells D) astrocytes

53)

54) Meningitis can be caused by infection of the central nervous system by bacteria. Which cells would be most responsible for removing the infection? A) satellite cells B) microglia C) oligodendrocytes D) Schwann cells

54)

55) Like all cells, the neurons' internal organization dictates its function. Neurons have relatively many mitochondria, an extensive network of rough endoplasmic reticulum and many clusters of ribosomes. These cellular features indicate all of the following EXCEPT ________. A) neurons produce many proteins B) neurons must meet a high demand for ATP C) neurons have a relatively high consumption of oxygen D) neurons have stable, relatively unchanging internal environments

55)

56) An action potential is regarded as an example of a positive feedback. Which of the following examples below best illustrates the positive feedback aspect of an action potential? A) Voltage gated potassium ion channels open slowly and remain open long enough to cause hyperpolarization. B) The sodium potassium pump consistently moves ions as long as ATP is available, and regardless of membrane potential changes. C) Potassium permeability is about 25 times greater than sodium ions. D) A threshold stimulus will cause the opening of voltage gated sodium ion channels that will cause further depolarizing stimulus. This stimulus will open still more voltage gated sodium ion channels.

56)

57) The depolarization phase of an action potential is punctuated by the closing of inactivation gates in the voltage gated sodium ion channels. All of the following are consequences of this inactivation except one. Choose the statement below that is not a consequence of the closing of inactivating gates. A) This allows for the one way transmission of action potential down the axon. B) This allows for the efflux (diffusion out) of potassium ions, resulting in the repolarization of the cell. C) This stops the depolarization of the axon membrane. D) This limits the frequency of action potentials down the axon.

57)

58) During the relative refractory period of an action potential, a larger than normal stimulus is needed to cause another action potential. This is due to the fact that ________. A) the membrane is now impermeable to all ions B) the sodium potassium pump will stop working during relative refractory C) the inactivation gates on voltage gated sodium ion channels are closed D) the voltage gated potassium ion channels remain open long enough to hyperpolarize the axon membrane

58)

59) If a postsynaptic neuron is stimulated to threshold by spatial summation this implies that ________. A) the postsynaptic cell has many voltage gated ion channels B) the postsynaptic cell is slow to repolarize C) the postsynaptic cell has many synapses with many presynaptic neurons D) the postsynaptic cell has a lower than normal threshold

59)

60) If a postsynaptic cell is stimulated to threshold by temporal summation this implies that ________. A) the postsynaptic cell is sending frequent action potential B) the presynaptic neuron is sending frequent IPSP C) the postsynaptic cell can be influenced by only one presynaptic cell D) a presynaptic neuron is sending frequent EPSP

60)

61) When a neurotransmitter like acetylcholine is acting in an excitatory manner which of the following is likely a result of the acetylcholine acting on the postsynaptic cell? A) Chemically gated chloride channels will open. B) Chemically gated potassium channels will open. C) Chemically gated sodium channels will be closed. D) Chemically gated sodium channels will open.

61)

62) When a neurotransmitter like GABA is acting in an inhibitory manner which of the following is likely a result of the GABA acting on the postsynaptic cell? A) hyperpolarization of the postsynaptic cell membrane B) opening of chemically gated sodium channels C) influx of positively charged ions into the postsynaptic cell D) depolarization of the postsynaptic cell membrane

62)

63) The effect of acetylcholine can be stimulating or inhibiting. Which of the following gives the best explanation for why this is so? A) Acetylcholine has many different forms. B) Acetylcholine has a "dose effect." Larger doses are stimulating while small doses inhibit. C) Postsynaptic cells have a dynamic and changing metabolism and respond differently at different times. D) Different postsynaptic cells will have different receptors.

63)

64) Which of the following is NOT a function of dendrites? A) provide enormous surface area for receiving signals from other neurons B) produce short-distance signals called graded potentials C) generate nerve impulses and transmit them away from the cell body D) convey incoming messages toward the cell body

64)

65) Which of the choices below describes the ANS? A) sensory and motor neurons that supply the digestive tract B) motor fibers that conduct nerve impulses from the CNS to smooth muscle, cardiac muscle, and glands C) motor fibers that conduct nerve impulses from the CNS to skeletal muscles D) sensory neurons that convey information from somatic receptors in the head, body wall, and limbs and from receptors from the special senses of vision, hearing, taste, and smell to the CNS

65)

66) These cells in the CNS have cilia that move in order to circulate cerebrospinal fluid. A) oligodendrocytes B) astrocytes C) Schwann cells D) ependymal cells

66)

67) What does the central nervous system use to determine the strength of a stimulus? A) size of action potentials B) type of stimulus receptor C) origin of the stimulus D) frequency of action potentials

67)

68) Bipolar neurons are commonly ________. A) found in ganglia C) motor neurons

68) B) found in the retina of the eye D) called neuroglial cells

69) Which of the following is an excitatory neurotransmitter secreted by motor neurons innervating skeletal muscle? A) acetylcholine B) norepinephrine C) cholinesterase D) gamma aminobutyric acid

69)

70) Which of the following describes the nervous system integrative function? A) analyzes sensory information, stores information, makes decisions B) senses changes in the environment C) responds to stimuli by gland secretion or muscle contraction

70)

71) The period after an initial stimulus when a neuron is not sensitive to another stimulus is the ________. A) absolute refractory period B) resting period C) depolarization D) repolarization

71)

72) Which of the following is NOT a characteristic of neurons? A) They have extreme longevity. B) They are mitotic. C) They conduct impulses. D) They have an exceptionally high metabolic rate.

72)

73) Which ion channel opens in response to a change in membrane potential and participates in the generation and conduction of action potentials? A) voltage-gated channel B) leakage channel C) ligand-gated channel D) mechanically-gated channel

73)

74) Loss of function in the enzyme acetylcholine esterase would result in which of the following? A) amplify or enhance the effect of ACh B) inability to destroy and remove acetylcholine from the synaptic cleft C) stimulation of the production of acetylcholine D) inability to release acetylcholine

74)

75) Which of the following is NOT a function of the autonomic nervous system? A) innervation of smooth muscle of the digestive tract B) innervation of glands C) innervation of cardiac muscle D) innervation of skeletal muscle

75)

76) Collections of nerve cell bodies outside the central nervous system are called ________. A) nerves B) ganglia C) nuclei D) tracts

76)

77) The term central nervous system refers to the ________. A) spinal nerves B) somatic nerves D) sensory (afferent) nerves C) brain and spinal cord

77)

78) A neuron that has as its primary function the job of connecting other neurons is called a(n) ________. A) afferent neuron B) glial cell C) interneuron D) efferent neuron

78)

79) Saltatory conduction is made possible by ________. A) erratic transmission of nerve impulses C) diphasic impulses

79) B) the myelin sheath D) large nerve fibers

80) Which of the following is NOT a chemical class of neurotransmitters? B) nucleic acid A) biogenic amine C) ATP and other purines D) amino acid

80)

81) Which of the following is false or incorrect? A) An excitatory postsynaptic potential occurs if the excitatory effect is greater than the inhibitory effect but less than threshold. B) An inhibitory postsynaptic potential occurs if the inhibitory effect is greater than the excitatory, causing hyperpolarization of the membrane. C) A nerve impulse occurs if the excitatory and inhibitory effects are equal.

81)

82) Select the correct statement regarding chemical synapses. A) Neurotransmitter receptors are located on the axons terminals of cells. B) Cells with gap junctions use chemical synapses. C) The synaptic cleft uses the action potential to transmit a chemical signal to the postsynaptic cell. D) The release of neurotransmitter molecules gives cells the property of being electrically coupled.

82)

83) Which of the following correctly describes a graded potential? A) It can have amplitudes of various sizes. B) It has a depolarization, repolarization, and hyperpolarization phase. C) It travels long distances. D) It is initiated by voltage changes in the membrane.

83)

84) Schwann cells are functionally similar to ________. A) oligodendrocytes C) ependymal cells

84) B) astrocytes D) microglia

85) Immediately after an action potential has peaked, which of the following channels will open? A) chemically-gated chloride channels B) voltage-gated potassium channels C) voltage-gated sodium channels D) voltage-gated calcium channels

85)

86) An inhibitory postsynaptic potential (IPSP) is associated with ________. A) opening of voltage-regulated channels B) lowering the threshold for an action potential to occur C) a change in sodium ion permeability D) hyperpolarization

86)

87) Which of the following will occur when an excitatory postsynaptic potential (EPSP) is being generated on the dendritic membrane? A) Specific sodium gates will open. B) Specific potassium gates will open. C) A single type of channel will open, permitting simultaneous flow of sodium and potassium. D) Sodium gates will open first, then close as potassium gates open.

87)

88) When a sensory neuron is excited by some form of energy, the resulting graded potential is called a(n) ________. A) excitatory potential B) postsynaptic potential C) action potential D) generator potential

88)

89) Which of the following is NOT true of graded potentials? A) They are short-lived. B) They can be called postsynaptic potentials. C) They increase amplitude as they move away from the stimulus point. D) They can form on receptor endings.

89)

90) Which of the following is true about the movement of ions across excitable living membranes? A) Ions always move passively across membranes. B) Sodium gates in the membrane can open in response to electrical potential changes. C) Ions always move from an area of higher concentration to an area of lower concentration. D) Ions always move actively across membranes through leakage channels.

90)

91) A second nerve impulse cannot be generated until ________. A) the Na ions have been pumped back into the cell B) proteins have been resynthesized C) the membrane potential has been reestablished D) all sodium gates are closed

91)

92) The interior surface of a neuron's plasma membrane at resting membrane potential will have a ________. A) negative charge and contains more sodium than outside of the cell B) positive charge and contains more sodium than outside of the cell C) positive charge and contains less sodium than outside of the cell D) negative charge and contains less sodium than outside of the cell

92)

93) If a motor neuron in the body were stimulated by an electrode placed about midpoint along the length of the axon, ________. A) muscle contraction would occur B) the impulse would move to the axon terminal only, and the muscle contraction would occur C) the impulse would spread bidirectionally D) the impulse would move to the axon terminal only

93)

94) Which of the following neurotransmitters is the principal inhibitory neurotransmitter of the spinal cord? A) serotonin B) endorphin C) glycine D) acetylcholine

94)

95) Which of the following describes the excitatory postsynaptic potential? A) short distance depolarization B) opens K+ or Cl- channels C) moves membrane potential away from threshold D) short distance hyperpolarization

95)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 96) The part of the nervous system that conducts impulses from the CNS to the skeletal muscles is the ________ nervous system.

96)

97) Neuroglia found in the CNS that change the permeability of capillaries in the brain by binding to and surrounding these blood vessels are called ________.

97)

98) Which group of neurotransmitters play a role in emotional behavior and help regulate the biological clock?

98)

99) What mechanism is responsible for axonal transport?

99)

100) The synapse more common in embryonic nervous tissue than in adults is the ________.

100)

101) When information is delivered within the CNS simultaneously by different parts of the neural pathway, the process is called ________ processing.

101)

102) When one or more presynaptic neurons fire in rapid order it produces a much greater depolarization of the postsynaptic membrane than would result from a single EPSP; this event is called ________ summation.

102)

103) What is the role of microglial cells and why are they so important in the CNS?

103)

104) Define synaptic delay.

104)

105) What is the difference between a direct acting neurotransmitter and an indirect acting neurotransmitter?

105)

106) What function is served by the increased axon diameter at the nodes of Ranvier?

106)

107) Imagine a neuron that has several hundred axonal knobs impinging on it. The majority of these axonal knobs are shown to be "firing." However, the neuron in question does not transmit an impulse. Give a valid explanation of why this could occur.

107)

108) At the biochemical level, what is the explanation of the hyperpolarization phase at the conclusion of the action potential?

108)

109) What are the basic divisions of the peripheral nervous system?

109)

110) Because all action potentials are alike, how does the brain separate situations that require immediate attention from ordinary "positional" reports?

110)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 111) Multiple sclerosis (MS) is a disease in which the myelin sheaths are destroyed. What process does this interfere with and what would be the consequence? 112) A patient is admitted to the hospital with exacerbation of multiple sclerosis (MS). She asks the nurse, "Why did this have to happen to me again? I was doing so well." Explain why some forms of MS are characterized by periods of remission and exacerbation. 113) A heroin addict was brought into the emergency room. The addict's friend asks the emergency room physician why heroin and morphine are such addictive drugs. How does the physician respond? 114) What symptoms would a nurse focus on in his or her care of a patient with multiple sclerosis? 115) Sally, a 5-year-old child, was bitten on the hand by a bat that was later diagnosed with rabies. She was immediately treated after the bite but had to go through a series of more involved treatments after the rabies diagnosis in the bat that bit her. How does the rabies virus get to the brain from a simple hand wound?

Answer Key Testname: UNTITLED11

1) A 2) B 3) C 4) B 5) B 6) A 7) C 8) A 9) E 10) C 11) A 12) B 13) D 14) A 15) C 16) B 17) E 18) D 19) D 20) C 21) B 22) A 23) B 24) C 25) A 26) C 27) B 28) A 29) B 30) D 31) A 32) B 33) C 34) FALSE 35) TRUE 36) TRUE 37) TRUE 38) TRUE 39) FALSE 40) TRUE 41) TRUE 42) TRUE 43) TRUE 44) TRUE 45) TRUE 46) TRUE 47) D 48) A 49) B 50) A 13

Answer Key Testname: UNTITLED11

51) D 52) C 53) D 54) B 55) D 56) D 57) B 58) D 59) C 60) D 61) D 62) A 63) D 64) C 65) B 66) D 67) D 68) B 69) A 70) A 71) A 72) B 73) A 74) B 75) D 76) B 77) C 78) C 79) B 80) B 81) C 82) C 83) A 84) A 85) B 86) D 87) C 88) D 89) C 90) B 91) C 92) D 93) C 94) C 95) A 96) somatic 97) astrocytes 98) biogenic amine neurotransmitters 99) ATP-dependent "motor" proteins such as kinesin and dynein myosin are responsible. They propel cellular components along microtubules. 14

Answer Key Testname: UNTITLED11

100) electrical synapse 101) parallel 102) temporal 103) In the presence of invading microbes, microglial cells become macrophages to phagocytize the microbes and neuronal debris. This protective role is important because cells of the immune system are denied access to the CNS. 104) Synaptic delay reflects the time required for neurotransmitter release, diffusion across the synaptic cleft, and binding to receptors. 105) Direct acting neurotransmitters bind to and open ion channels. Indirect acting neurotransmitters act through intracellular second-messenger molecules. 106) Increased diameter results in less resistance to lengthwise intra-axonal flow. This results in increased speed of impulse propagation. 107) Both excitatory and inhibitory potentials impinge on neurons. In this case, inhibitory postsynaptic potentials (IPSPs) outnumber EPSPs, and due to the IPSP neurotransmitter released and its action, the postsynaptic neuron is inhibited from "firing" (hyperpolarized). 108) The voltage gated K+ channels are slow to open as well as to close. These channels will remain open long enough to hyperpolarize the cell. The K+ ions decrease the positive ion concentration momentarily below the normal -70mV and thus hyperpolarize the cell. This assists in preventing the AP from reversing direction. 109) Sensory and motor divisions. Sensory has two divisions: the somatic and visceral. Motor has two divisions: the somatic and autonomic. The autonomic has two divisions: the sympathetic and parasympathetic. 110) The importance of a stimulus is derived from the number of stimuli received from the same source. The frequency of impulse transmission indicates the stimulus intensity and the brain responds appropriately. 111) Demyelination interferes with saltatory conduction, which would result in a slowing down and even permanent cessation of nerve impulse propagation. 112) Even though someone is diagnosed with MS, the axons are not damaged. Growing numbers of sodium channels appear spontaneously in the demyelinated fibers so that conduction resumes, even if slower. This may account for the cycles of relapse and remission in different patients. 113) The physician would respond that heroin, morphine, and other opiates cause the body to have the same responses as when endorphins are released. Endorphins are neurotransmitters that inhibit pain. 114) Visual disturbances, paralysis, and weakness 115) The rabies virus uses retrograde axonal transport to reach the neuron cell bodies as it makes its way to the brain cells.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 12.1 Using Figure 12.1, Match the following: 1) White fiber tracts.

2) Thalamus.

3) Pons.

4) Hypothalamus.

5) Medulla Oblongata.

Figure 12.2 Using Figure 12.2, match the following: 6) Pons.

7) Corpus callosum.

8) Caudate nucleus.

9) Globus pallidus.

10) Thalamus.

10)

Figure 12.3 Using Figure 12.3, match the following: 11) Site of somatic motor neuron cell bodies.

11)

12) Consists entirely of interneuron cell bodies.

12)

13) Site of sensory neuron cell bodies.

13)

14) Gray commissure.

14)

15) Site of autonomic motor neuron cell bodies.

15)

16) Area that encloses the central canal.

16)

17) Unipolar neurons are found here.

17)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 18) Auditory area.

A) Parietal lobe

19) Primary somatosensory cortex.

B) Temporal lobe

20) Primary (somatic) motor cortex.

C) Occipital lobe

21) Motor speech (Broca's) area.

D) Insula

22) Premotor cortex.

E) Frontal lobe

23) Visual area.

18) 19) 20) 21) 22) 23)

24) Gustatory (taste) area.

24)

25) Seat of intelligence, abstract reasoning.

25)

Match the following: 26) The brain area just anterior to the precentral gyrus that selects and sequences basic motor movements into more complex tasks. 27) This brain area lies on the medial aspect of the temporal lobe and allows for conscious awareness of different odors.

A) Primary auditory cortex

26)

B) Primary olfactory cortex C) Primary visual cortex 27) D) Premotor cortex

28) The area of the brain located in the superior margin of the temporal lobe that interprets impulses as pitch, loudness, and location.

28)

29) This area is on the extreme posterior of the occipital lobe and receives visual information that originates on the retina of the eye.

29)

Match the following stages of sleep with their descriptions: 30) The stage when vital signs (blood pressure, heart rate, and body temperature) reach their lowest normal levels. 31) Indicated by movement of the eyes under the lids; dreaming occurs. 32) Theta and delta waves begin to appear.

A) NREM stage 2

30)

B) REM C) NREM stage 3 31) D) NREM stage 4 E) NREM stage 1

33) Very easy to awaken; EEG shows alpha waves; may even deny being asleep.

32)

33)

34) Typified by sleep spindles.

34)

35) The sleep cycle where bed-wetting, night terrors, and sleepwalking may occur.

35)

36) May allow the brain to work through emotional problems in dream imagery.

36)

Match the following: 37) Gateway to the cerebrum.

A) Cerebrum

38) Ensures coordination and balance.

B) Brain stem

39) Produces automatic behaviors necessary for survival.

C) Thalamus

37) 38) 39)

D) Cerebellum 40) Executive suite.

40) E) Hypothalamus

41) Visceral command center.

41)

Match the following: 42) Where nerves serving the upper limbs arise.

A) Cervical enlargement

42)

43) Anchors the spinal cord to the coccyx.

A) Conus medullaris

44) Collection of nerve roots at the inferior end of the vertebral canal.

B) Filum terminale

43) 44)

C) Cauda equina 45) Inferior point of termination of the spinal cord in an adult.

45)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 46) Passing through the NREM stages (1 through 4), the frequency of the EEG waves declines, but their amplitude increases.

46)

47) Nuclei relating to the startle reflex are located in the corpora quadrigemina of the midbrain.

47)

48) Specific motor and sensory functions are localized in specific areas called domains, whereas memory and language have overlapping domains.

48)

49) REM sleep begins about 90 minutes after sleep begins.

49)

50) The three basic regions of the cerebrum are the cerebral cortical gray matter, internal white matter, and the superior and inferior colliculi.

50)

51) Cell bodies of somatic motor neurons are located in the ventral (anterior) horn of the spinal cord.

51)

52) The blood brain barrier is the protective mechanism that helps maintain the brain's stable environment.

52)

53) The adult spinal cord ends between the level L 1 and L2 of the vertebral column.

53)

54) Cerebrospinal fluid circulates within the ventricles of the brain and in the subarachnoid space.

54)

55) The terms fainting and syncope describe the same thing.

55)

56) The reticular activating system (RAS) is comprised of specific pathways primarily in the limbic system.

56)

57) Nondeclarative memories preserve the circumstances in which they are learned.

57)

58) The brain and spinal cord begin as an embryonic structure called the neural plate.

58)

59) In most people, the left cerebral hemisphere has greater control over language abilities, math, and logic.

59)

60) The limbic system acts as our emotional, or affective (feelings), brain.

60)

61) The canal connecting the third and fourth ventricles and running through the midbrain is the interventricular foramen.

61)

62) Commissural fibers connect the cerebrum to the diencephalon.

62)

63) A disturbance of posture, muscle tremors at rest, and uncontrolled muscle contraction are all symptoms of damage to the basal nuclei.

63)

64) Projection fibers in the brain mainly connect the right and left hemispheres.

64)

65) Most of the ascending and descending pathways to and from the brain cross over (decussate) from one side of the body to the other.

65)

66) The primary visual cortex contains a map of visual space.

66)

67) One functional center found within the medulla oblongata is a respiratory center involved in the control of the rate and depth of breathing.

67)

68) Sorting of sensory information and relaying it to the appropriate cerebral sensory area occurs in the hypothalamus.

68)

69) Embryonic damage to the mesencephalon could result in improper formation of the midbrain.

69)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 70) Which brain structure functions to control the autonomic nervous system and to regulate body temperature? A) mammillary body B) pons C) medulla oblongata D) hypothalamus

70)

71) Nuclei of cranial nerves V (trigeminal), VI (abducens), and VII (facial) are found in the ________. A) pons B) medulla C) midbrain D) cerebrum

71)

72) The arbor vitae refers to ________. A) flocculonodular nodes B) the pleatlike convolutions of the cerebellum C) cerebellar white matter D) cerebellar gray matter

72)

73) The brain stem consists of the ________. A) midbrain, medulla, and pons C) cerebrum, pons, midbrain, and medulla

73) B) pons, medulla, cerebellum, and midbrain D) midbrain only

74) The primary somatosensory cortex is located in the ________. A) temporal lobe B) parietal lobe C) frontal lobe 75) Spinocerebellar tracts ________. A) give rise to conscious experience of perception B) are found in the dorsal columns of the spinal cord C) terminate in the spinal cord D) carry information about muscle or tendon stretch to the cerebellum

74) D) prefrontal lobe 75)

76) What type of cells line the ventricles of the brain? A) astrocytes C) epithelial cells

76) B) neurons D) ependymal cells

77) The subarachnoid space lies between what two layers of meninges? A) dura and epidura B) arachnoid and epidura C) arachnoid and dura D) arachnoid and pia

77)

78) Vital centers for the control of heart rate, respiration, and blood pressure are located in the ________. A) medulla oblongata B) pons C) cerebrum D) midbrain

78)

79) Cell bodies of sensory neurons are located in ________. A) the ventral root ganglia of the spinal cord B) sympathetic ganglia C) the thalamus D) the dorsal root ganglia of the spinal cord

79)

80) What groove separates the frontal lobe from the parietal lobe? A) longitudinal fissure B) central sulcus C) parieto-occipital sulcus D) lateral fissure

80)

81) Which of the following best describes the cerebrum? A) decussation center B) visceral command center C) executive suite D) motor command center

81)

82) An elevated ridge of the cortex is called a ________. A) fissure B) sulcus

82) C) gyrus

D) furrow

83) Which of the following generalizations does NOT describe the cerebral cortex? A) No functional area of the cortex works alone. B) Each hemisphere is chiefly concerned with sensory and motor functions of the contralateral side of the body. C) The cerebral cortex contains three kinds of functional areas. D) The hemispheres are exactly equal in function.

83)

84) If the caudal portion of the neural tube failed to develop properly the ________. A) spinal cord may be affected B) cranial nerves would not form C) telencephalon would cease development D) hindbrain would not be present

84)

85) The lateral sulcus separates which lobes? A) frontal from parietal C) parietal from occipital

85) B) frontal from temporal D) temporal from parietal

86) Neural tracts that convey information to the brain concerning temperature and pain would be ________. A) ventral (anterior) spinothalamic B) posterior spinothalamic C) lateral spinothalamic D) reticulospinal

86)

87) Which of these would you NOT find in the cerebral cortex? A) dendrites B) interneurons C) fiber tracts

87)

D) cell bodies

88) The white matter of the spinal cord contains ________. A) unmyelinated nerve fibers only B) myelinated nerve fibers only C) myelinated and unmyelinated nerve fibers D) cell bodies

88)

89) Which of the following is NOT a role of the basal nuclei? A) inhibiting unnecessary or antagonistic movements B) initiating protective reflex actions C) controlling starting and stopping movements D) playing a role in cognition and emotion

89)

90) An individual accidentally transected (cut across) the spinal cord between T 1 and L 1 . This would

90)

result in ________. A) quadriplegia C) hemiplegia

B) spinal shock only D) paraplegia

91) Spastic paralysis suggests involvement of the ________. A) neuromuscular junction B) spinal nerve roots C) lower motor neurons D) upper motor neurons

91)

92) Ridges of tissue on the surface of the cerebral hemispheres are called ________. A) ganglia B) fissures C) sulci D) gyri

92)

93) The frontal lobe is separated from the temporal lobe by the ________. A) lateral sulcus B) cranial fossa C) central sulcus D) longitudinal fissure

93)

94) Which of the following statements is FALSE? A) Damage to the primary auditory cortex results in the inability to interpret pitch, loudness, and location. B) Damage to the premotor cortex results in loss of motor skills programmed in that area but movement is still possible. C) Damage to the primary (somatic) motor cortex results in the loss of both voluntary muscle control and all reflexive contractions. D) Damage to the visual association area can result in blindness.

94)

95) Two terms for the massive motor tracts serving voluntary movement are ________. A) pyramidal and corticospinal B) extrapyramidal and rubrospinal C) supplementary and cerebellar-pontine D) segmental and nigrostriatal

95)

96) An individual who could trace a picture of a bicycle with his or her finger but could not recognize it as a bicycle is most likely to have sustained damage to the ________. A) visual association area B) primary visual cortex C) calcarine cortex D) lateral geniculate body

96)

97) Broca's area ________. A) is usually found only in the right hemisphere B) is considered a motor speech area C) controls voluntary movements of the eyes D) serves the recognition of complex objects

97)

98) Which part of the cerebral cortex is involved in intellect, cognition, recall, and personality? A) combined primary somatosensory cortex and somatosensory association cortex B) prefrontal cortex (anterior association area) C) posterior association area D) limbic association area

98)

99) The blood-brain barrier is effective against ________. A) nutrients such as glucose B) anesthetics C) metabolic waste such as urea D) alcohol

99)

100) All of the following are structures of the limbic system EXCEPT the ________. A) hippocampus B) amygdaloid body C) caudate nucleus D) cingulate gyrus

100)

101) The process of linking new facts with old facts already stored in the memory bank is called ________. A) association B) rehearsal C) long-term memory D) automatic memory

101)

102) Which category of memory is involved when playing the piano? A) procedural B) emotional C) motor

102) D) declarative

103) The brain area that regulates activities that control the state of wakefulness or alertness of the cerebral cortex is the ________. A) limbic system B) thalamus C) pyramids D) reticular formation

103)

104) Which of the following would you NOT find in normal cerebrospinal fluid? A) red blood cells B) protein C) glucose

104) D) potassium

105) REM sleep is associated with ________. A) decreased activity of the brain, especially the cerebral cortex B) temporary skeletal muscle inhibition except for ocular muscles and diaphragm C) decreased oxygen use, especially in the cerebral cortex D) decreased vital signs, such as heart rate and blood pressure

105)

106) Which of the following is NOT a function of the CSF? A) reduction of brain weight B) nourishment of the brain C) initiation of some nerve impulses D) protection from blows

106)

107) Injury to the hypothalamus may result in all of the following EXCEPT ________. A) loss of fine motor control B) sleep disturbances C) loss of body temperature control D) dehydration

107)

108) Important nuclei of the indirect (multineuronal) system that receive impulses from the equilibrium apparatus of the inner ear and help to maintain balance by varying muscle tone of postural muscles are the ________. A) reticular nuclei B) superior colliculi C) vestibular nuclei D) red nuclei

108)

109) Which of the following structures is probably NOT directly involved in memory? A) thalamus B) medulla oblongata C) hippocampus D) prefrontal cortex

109)

110) The area of the cortex that is responsible for sensing a full bladder and the feeling that your lungs will burst when you hold your breath too long is the ________. A) visceral sensory area B) olfactory cortex C) vestibular cortex D) gustatory cortex

110)

111) Which statement about coma is true? A) Coma is neurologically identical to syncope. B) During coma, brain oxygen consumption resembles that of a waking state. C) Coma may be caused by widespread cerebral or brain stem trauma. D) Coma is a form of deep sleep.

111)

112) A patient suffering from memory loss, shortened attention span, disorientation, and eventual language loss is most likely suffering from ________. A) Alzheimer's disease B) cerebellar disease C) Parkinson's disease D) Huntington's disease

112)

113) Which of the following is the mildest consequence of traumatic brain injury? A) swelling B) concussion C) contusion

113) D) hemorrhage

114) Emotional memory ________. A) involves your pounding heart when you hear a rattlesnake B) involves remembering a skill such as playing a musical instrument C) involves remembering names, faces, words, and dates D) involves remembering motor skills such as riding a bike

114)

115) Which of the following is (are) involved with motor activity (either initiation or coordination)? A) Wernicke's area B) postcentral gyrus C) gustatory cortex D) red nuclei

115)

116) Which statement about epilepsy is most accurate? A) Absence seizures typically begin in adolescence and are often severely disabling. B) Epilepsy is often genetically induced but also frequently caused by head trauma, stroke, infection, and tumor. C) The aura in tonic-clonic seizures typically occurs as the patient regains consciousness. D) During seizures, sensory messages are processed normally but responses are blocked.

116)

117) White matter is found in all of the following locations EXCEPT the ________. A) corticospinal tracts B) corpus callosum C) outer portion of the spinal cord D) cerebral cortex

117)

118) Second-order neurons of ascending pathways that contribute to sensory perception terminate in the ________. A) spinal cord B) thalamus C) medulla D) somatosensory cortex

118)

119) Loss of ability to perform skilled motor activities such as piano playing, with no paralysis or weakness in specific muscles, might suggest damage to the ________. A) primary motor cortex B) rubrospinal tracts C) spinal cord D) premotor cortex

119)

120) Which brain waves are uncommon for awake adults, but are common for children? C) delta D) alpha A) theta B) beta

120)

121) While sleep requirements vary, most adults need ________ hours of sleep for optimal health and function. A) 11-12 B) 3-4 C) 7-8 D) 9-10

121)

122) The large commissure that connects the right and left sides of the brain is called the ________. A) corona radiata B) internal capsule C) longitudinal fissure D) corpus callosum

122)

123) Degeneration of the dopamine-releasing neurons of the ________ is the ultimate cause of Parkinson's disease. A) internal capsule B) reticular formation C) red nucleus D) substantia nigra

123)

124) What connects the hypothalamus to the pituitary gland? A) infundibulum B) arbor vitae C) mammillary bodies D) optic chiasma

124)

125) Arachnoid granulations are knoblike projections that protrude superiorly through the ________ mater to absorb cerebrospinal fluid into venous blood. A) arachnoid B) dura C) subarachnoid D) pia

125)

126) Interneurons receiving input from sensory neurons are located in the ________. A) dorsal (posterior) horn B) dorsal root ganglion C) ventral (anterior) horn D) lateral horn

126)

127) Which type of memory is exemplified by a racing heartbeat upon hearing a rattlesnake nearby? A) motor B) procedural (skills) C) emotional D) declarative (fact)

127)

128) The ________ includes the thalamus, hypothalamus, and epithalamus. C) brain stem A) diencephalon B) basal nuclei

128) D) midbrain

129) The two longitudinal ridges on the medulla oblongata where many descending fibers cross over are called the ________. A) pyramids B) olives C) lateral horns D) nuclei

129)

130) The corpora quadrigemina are found in the ________. A) pons B) diencephalon C) cerebellum

D) midbrain

130)

131) Which type of wave predominates during stage 1 NREM sleep? A) alpha B) beta C) delta

D) theta

131)

132) The ________ is the main switch station for memory; if the right and left areas are destroyed, the result is widespread amnesia. A) hypothalamus B) hippocampus C) thalamus D) Wernicke's area

132)

133) Sleepwalking may occur during ________. A) REM B) NREM stage 2

133) C) NREM stage 4

D) NREM stage 1

134) Which of the following is a dural septum, described as a large sickle -shaped fold that dips into the longitudinal fissure between the cerebral hemispheres? A) tentorium cerebelli B) falx cerebri C) corpus callosum D) falx cerebelli

134)

135) The light of dawn and the buzz of an alarm clock lead to wakefulness through the ________. A) limbic system B) basal nuclei C) cerebellar peduncles D) reticular activating system

135)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 136) Describe the cause of hydrocephalus and explain why this condition is much more serious in adults than in newborns.

136)

137) Which brain areas lack a blood-brain barrier, and what purpose does this absence serve?

137)

138) What is the importance of the fact that the outer portion of the cerebral hemispheres is convoluted?

138)

139) What is the cauda equina and why is it given this name?

139)

140) Describe the role of the reticular activating system in cortical arousal and stimulation.

140)

141) Which spinal cord tract transmits impulses concerned with temperature and pain? Describe the pathway and include the location and destination of the first, second, and third-order neurons.

141)

142) List the three current suppositions about consciousness.

142)

143) Differentiate clearly between short-term and long-term memory.

143)

144) Thomas is wearing a T-shirt with the saying "Only Left-Handed People Are In Their Right Minds." What does this mean in terms of lateralization of cortical function?

144)

145) List seven homeostatic roles of the hypothalamus.

145)

146) What is the role of the pineal gland in the sleep-wake cycle?

146)

147) What is the somatosensory homunculus? Which body region would be larger in the homunculus, the face or the hips? Why?

147)

148) What is the basis for classifying the fibers and tracts of cerebral white matter? List and define each of the three types.

148)

149) Describe how the function of a particular brain area is known.

149)

150) Would damage to the frontal lobe or the medulla oblongata be more likely to lead to death? Describe the overall functions of these brain regions.

150)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 151) Mrs. Sagalov has recently been diagnosed with Alzheimer's disease. What clinical symptoms is she likely to show, and what would probably be seen if her brain were examined? 152) A patient is admitted to the rehabilitation unit five days after having a stroke. The nurse assesses his muscle strength and determines that he has right-sided weakness. Based on this assessment data, what part of the brain was injured? 153) A patient was admitted to the medical/surgical unit with a stroke that affected the motor neurons in the direct (pyramidal) pathway. This affected the loss of voluntary movement to his left side. What other problems might the patient experience? 154) Death from amyotrophic lateral sclerosis usually results from respiratory infection secondary to compromised respiratory function. Explain why. 155) A small child is admitted to the hospital with a possible diagnosis of meningitis. What body fluid should they sample to confirm the diagnosis? Explain. 156) Robert was helping his son work on the son's car when he temporarily lost the ability to speak in a normal manner and had difficulty handing his son the requested tools. This episode lasted for several minutes and then he was himself again. Robert's son insisted that his dad see his doctor after this episode. What might be the doctor's diagnosis of Robert's episode and what could be the cause? 157) An 86-year-old patient with Alzheimer's disease was admitted to the hospital with dehydration. Her daughter states that her mother has been very confused and combative lately. Explain why the patient likely developed dehydration. 158) The location and arrangement of the arteries supplying the hippocampus make it particularly vulnerable to injury. How would memory be affected if the hippocampus suffered deterioration? 159) Susan and Robert are the parents of three children. One night while the family was sleeping, a fire broke out next door. Susan and Robert heard the fire trucks and rushed out to see what was happening. None of the children woke up, even with the sound of sirens close to the house. Why did the parents wake up, but the children didn't wake up?

Answer Key Testname: UNTITLED12

1) A 2) B 3) D 4) C 5) E 6) E 7) A 8) B 9) C 10) D 11) C 12) B 13) E 14) A 15) D 16) A 17) E 18) B 19) A 20) E 21) E 22) E 23) C 24) D 25) E 26) D 27) B 28) A 29) C 30) D 31) B 32) C 33) E 34) A 35) D 36) B 37) C 38) D 39) B 40) A 41) E 42) A 43) B 44) C 45) A 46) TRUE 47) TRUE 48) TRUE 49) TRUE 50) FALSE 15

Answer Key Testname: UNTITLED12

51) TRUE 52) TRUE 53) TRUE 54) TRUE 55) TRUE 56) FALSE 57) FALSE 58) TRUE 59) TRUE 60) TRUE 61) FALSE 62) FALSE 63) TRUE 64) FALSE 65) TRUE 66) TRUE 67) TRUE 68) FALSE 69) TRUE 70) D 71) A 72) C 73) A 74) B 75) D 76) D 77) D 78) A 79) D 80) B 81) C 82) C 83) D 84) A 85) D 86) C 87) C 88) C 89) B 90) D 91) D 92) D 93) A 94) C 95) A 96) A 97) B 98) B 99) C 100) C 16

Answer Key Testname: UNTITLED12

101) A 102) A 103) D 104) A 105) B 106) C 107) A 108) C 109) B 110) A 111) C 112) A 113) B 114) A 115) D 116) B 117) D 118) B 119) D 120) A 121) C 122) D 123) D 124) A 125) B 126) A 127) C 128) A 129) A 130) D 131) A 132) B 133) C 134) B 135) D 136) Hydrocephalus refers to a blockage of the normal circulation and drainage of cerebrospinal fluid (CSF) throughout the meninges and ventricles. If CSF is allowed to accumulate, excessive pressure could be exerted on the brain. In newborns, the fontanels allow the skull to enlarge, while in adults, the cranial bones are fused and no expansion is possible thus causing earlier destruction of cortex instead. This disorder is treated by insertion of a shunt into the ventricles to drain excess fluid into the abdominal cavity. 137) The blood-brain barrier is absent around the vomiting center of the brain stem, so that it can monitor the blood for poisonous substances. It is also absent around the hypothalamus, so that it can monitor the chemical composition of the blood and adjust water balance and other factors. 138) The cerebral cortex is only 2-4 mm thick; however, the convolutions effectively triple the cortical surface area. As a result, the cortex accounts for 40% of the total brain mass and functions in all conscious activity, including movement, sensory perception, thinking, and memory. 139) The cauda equina is a collection of nerve roots at the inferior end of the vertebral canal and is given this name because of its resemblance to a horse's tail. This arrangement reflects the different rates of growth between the vertebral column and spinal cord. Because the column grows more rapidly than the cord, the lower nerves must "chase" their exit points inferiorly, thus forming the cauda equina. 17

Answer Key Testname: UNTITLED12

140) The reticular activating system (RAS) appears to mediate the alertness state of the cerebral cortex. The thalamus, hypothalamus, and other areas such as the brain stem appear to be interconnected with the RAS. The hypothalamus seems to be the structure responsible for the actual timing of the sleep-wake cycle. The primary neurotransmitter involved is serotonin. 141) The lateral spinothalamic tract conveys impulses concerned with temperature and pain to the opposite side of the brain for interpretation by the somatosensory cortex. First-order sensory neurons enter the spinal cord and synapse with second-order interneurons in the dorsal horn. These second-order neurons crossover to the other side of the cord and then ascend to the thalamus where they synapse with third -order neurons. Thalamic neurons then ascend to the somatosensory cortex. 142) (1) Consciousness involves simultaneous activity of large areas of the cerebral cortex; (2) consciousness is superimposed on other types of neural activity; and (3) consciousness is holistic and totally interconnected. 143) Short-term memory (STM) is a fleeting memory of events that one is continuously exposed to, and seems to be limited to 7 or 8 chunks of information at a time. Long -term memory (LTM) is semipermanent storage of information that involves the transfer of data from STM banks to LTM banks based on several factors such as rehearsal, emotional state, and association. 144) Left handedness typically occurs when right cerebral dominance occurs. As a result, left handed people are using their right cerebrum for motor activity. 145) 1. Control of the autonomic nervous system (ANS) 2. Initiate physical responses to emotions 3. Body temperature regulation 4. Regulation of food intake 5. Regulation of water balance and thirst 6. Regulation of the sleep-wake cycles 7. Control endocrine system function 146) The pineal gland secretes the hormone melatonin (a sleep-inducing signal and antioxidant) and helps regulate the sleep-wake cycle. 147) The somatosensory homunculus is a body map depicting the relative amount and location of cortical tissue devoted to sensory reception for each body structure. The amount of sensory cortex devoted to a particular body region is related to that region's sensitivity (that is, how many receptors it has), not its size. The face (especially the lips) and fingertips are the most sensitive body areas, so these regions are the largest part of the homunculus. 148) The fibers and tracts are classified according to the direction in which they run. Association fibers connect different parts of the same hemisphere. Commissural fibers connect corresponding gray areas of the two hemispheres. Projection fibers either enter the cerebral cortex from the lower brain or cord or descend from the cortex to lower areas. 149) When a particular area of the brain is damaged, for example by a stroke, the neurons cannot be replaced and the area of damage loses its function. Thus, by examining functional loss in a patient, it can be inferred what the role of the damaged area is. In addition, functional imaging, for example by fMRI, can demonstrate how various areas of the brain are active during particular activities such as thinking, talking, seeing, or hearing. 150) Damage to the medulla oblongata would be more likely to lead to death. The medulla oblongata has a crucial role as an autonomic reflex center involved in maintaining homeostasis. For example, the cardiovascular center adjusts the force and rate of heart contraction and maintains blood pressure through adjustments in blood vessel diameter. Respiratory centers generate the respiratory rhythm and help control the rate and depth of breathing. The frontal lobe contains motor areas that control voluntary movement as well as association areas involved in working memory, task management, consciousness, and problem solving. 151) Mrs. Sagalov is likely to show increasing cognitive deficits, including difficulties with memory and attention, and personality changes such as irritability, moodiness, and confusion. Her brain, particularly in the cerebral cortex and hippocampus, is likely to show senile plaques (clumps of cells and fibers around a protein core) and neurofibrillary tangles (twisted fibers within neuron cell bodies). 152) Damage to localized areas of the primary motor cortex paralyzes the body muscles controlled by these areas. If the stroke is in the left hemisphere, the right side of the body will be weak or paralyzed. 18

Answer Key Testname: UNTITLED12 153) Eventually, spasticity of the affected left side is likely to develop. If the stroke involves more of the non -dominant right hemisphere than the precentral gyrus, the patient might show sensory neglect to objects on his left side. 154) Amyotrophic lateral sclerosis, or Lou Gehrig's disease, is a rare neuromuscular disease that involves progressive destruction of the ventral horn motor neurons and fibers of the pyramidal tract. As the disease progresses, the sufferer loses the ability to speak, swallow, and breathe. Because the lungs have difficulty fully expanding, secretions may accumulate, causing respiratory infection. 155) The body fluid that should be sampled is the cerebrospinal fluid due to its proximity to the brain, which is covered in membranes called meninges. Meningitis is the inflammation of these membranes caused by a pathogen, usually a bacterium or a virus. Sampling the cerebrospinal fluid can confirm the presence of the pathogen and also indicates to the physician how to treat the patient. 156) Robert experienced a TIA (transient ischemic attack) where brain cells are temporarily deprived of oxygen. The attack commonly lasts for only a short time but is a possible precursor of a more serious cerebrovascular accident (CVA), also called a stroke. 157) One of the simplest mechanisms for maintaining fluid balance is the thirst mechanism. Normally, when a person is thirsty, he or she drinks because the thirst center in the hypothalamus is stimulated. In this patient's confused and combative state, she is probably refusing or forgetting to eat or drink, thereby developing dehydration. 158) The hippocampus oversees the circuitry for learning and remembering spatial relationships. In other words, it acts as a switchboard, receiving and sorting information, helping to turn that information into a memory, and forwarding it to other parts of the brain. Without the help of the hippocampus we might learn, but we wouldn't remember. 159) The reticular formation activation system, which filters stimuli, awakened the parents, who were responsible for the safety of their children. It allowed the children to ignore the stimuli so that they could get their rest, because the parents were in charge of the situation. It is also possible that the children were in a deeper stage of NREM sleep at the time the sirens sounded, depending upon when they were put to bed.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 13.1 Using Figure 13.1, match the following: 1) Innervates the superior oblique muscle.

2) Longest cranial nerve.

3) Damage to this nerve would cause dizziness, nausea, and loss of balance.

4) Involved in movement of the digestive tract.

5) Damage to this nerve would cause difficulty in speech and swallowing, but no effect on visceral organs.

6) Damage to this nerve would keep the eye from rotating inferolaterally.

Figure 13.2 Using Figure 13.2, identify the following components of the reflex arc: 7) Integration center.

8) Sensory neuron.

9) Effector.

10) Motor neuron.

10)

11) Receptor.

11)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 12) Mixed nerves; primarily motor; main general sensory nerves of the face.

A) Optic

12)

B) Trigeminal 13) Purely sensory; transmit visual impulses from the retina to the thalamus. 14) Mixed nerves; transmit sensory impulses from the taste buds of the posterior tongue.

13) C) Trochlear D) Facial 14) E) Glossopharyngeal

15) Primarily motor; carry motor and propioceptor impusles to and from the eyeballs.

15)

16) Mixed nerves; carry sensory impulses from the taste buds of anterior two-thirds of the tongue.

16)

Match the following reflexes to their function: 17) Tests both upper and lower motor pathways. The sole of the foot is stimulated with a dull instrument.

A) Stretch

18) Consists of an ipsilateral withdrawal reflex and a contralateral extensor reflex; important in maintaining balance.

C) Crossed-extensor

19) Produces a rapid withdrawal of the body part from a painful stimulus; ipsilateral.

17)

B) Plantar 18)

D) Flexor E) Tendon 19)

20) Prevents muscle overstretching and maintains muscle tone.

20)

21) Produces muscle relaxation and lengthening in response to tension; the contracting muscle relaxes as its antagonist is activated.

21)

Match the following: 22) The obturator and femoral nerves branch from this plexus.

A) Brachial plexus

22)

B) Cervical plexus 23) Striking the "funny bone" (ulnar nerve) may cause injury to a nerve of this plexus. 24) Trauma to a nerve of this plexus may cause wrist drop.

23) C) Lumbar plexus D) Sacral plexus 24)

25) A fall or improper administration of an injection to the buttocks may injure a nerve of this plexus.

25)

26) The phrenic nerve branches from this plexus.

26)

Match the following: 27) Controls the outputs of the cortex and regulates motor activity.

A) Segmental level

27)

B) Projection level 28) Central pattern generators.

28) C) Precommand level

29) Intermediate relay for incoming and outgoing neurons.

29)

30) The cerebellum and basal nuclei.

30)

31) Includes cortical and brain stem motor areas.

31)

32) The neural machinery of the spinal cord, including spinal cord circuits.

32)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 13.3 Using Figure 13.3, match the following: 33) Contain autonomic nerve fibers.

33)

34) Supplies the posterior body trunk.

34)

35) Supplies all of the body except the posterior.

35)

36) All but T 2 -T12 branch and form nerve plexuses.

36)

37) Supplies each muscle with fibers from more than one nerve.

37)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 38) Lamellar corpuscle.

A) Ruffini endings

39) Bulbous corpuscle.

B) Meissner corpuscle

40) Tactile corpuscle.

C) Pacinian corpuscle

38) 39) 40)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 41) The meningeal branch of a spinal nerve actually reenters the vertebral canal to innervate the meninges and blood vessels.

41)

42) Lamellar corpuscles can only be exteroceptors or proprioceptors.

42)

43) The musculocutaneous nerve is a major nerve of the brachial plexus.

43)

44) The second cranial nerve forms a chiasma at the base of the brain for partial crossover of neural fibers.

44)

45) Dorsal and ventral rami are similar in that they both contain sensory and motor fibers.

45)

46) Irritation of the phrenic nerve may cause diaphragm spasms called hiccups.

46)

47) Reciprocal inhibition means that while one sensory nerve is stimulated, another sensory neuron for synergistic muscles in the same area is inhibited and cannot respond.

47)

48) Drooping of the upper eyelid, and double vision are potential symptoms of damage to the olfactory nerve.

48)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 49) If someone spills very hot coffee (200°F) on their skin, they will likely perceive much pain. Which of the following receptor types is causing this sensation? A) chemoreceptors B) nociceptors C) thermoreceptors D) mechanoreceptors

49)

50) Receptors that respond to changes in room temperature are found in the skin. Which of the following pairs of classifications below best fit the receptor type that is being described above? A) thermoreceptors that are also exteroceptors B) thermoreceptors that are also interoceptors C) mechanoreceptors that are also interoceptors D) mechanoreceptors that are also exteroceptors

50)

51) We can touch our finger to our nose while our eyes are closed in part because we can sense the position and movement of our joints as well as the length of stretch in our muscles. These sensations create awareness of our body's positioning. The following receptors are most likely responsible for this ability. A) exteroceptors B) proprioceptors C) nociceptors D) interoceptors

51)

52) Tactile sensation is a combination of touch, pressure, stretch, and vibration. Which of the following is most likely the receptor type that senses tactile stimulation? A) mechanoreceptors B) nociceptors C) thermoreceptors D) proprioceptors

52)

53) A person has gone for an appointment to receive a deep -tissue therapeutic massage. Which of the following receptors would be stimulated by the massage? A) tendon organ B) free nerve ending D) lamellae corpuscle C) bulbous corpuscle

53)

54) Which of the following is the best explanation of how a stimulus's strength is transmitted to the central nervous system from sensory nerves? A) More than one type of receptor will respond to larger stimulus. B) An action potential will increase in strength as stimulus strength increases. C) Action potential frequency is increased as stimulus strength increases. D) Action potentials as well as graded potentials are sent to the central nervous system when stimulus strength increases.

54)

55) A patient is suffering from the inability to distinguish various types of odors. This patient may have damage to which of the following? A) hypoglossal nerve (XII) B) facial nerve (VIII) C) vagus nerve (X) D) olfactory nerve (I)

55)

56) A patient has lost the ability to taste food. Which nerve may have been damaged? A) the facial nerves B) the abducens nerves C) trigeminal nerves D) the optic nerves

56)

57) An emergency medical technician is examining a trauma victim by shining a pen light into her patient's eye. She records the reactivity of the patient's pupils as they constrict when stimulated by the light. This test supports which of the following? A) The patient has function of the oculomotor nerve (III). B) The patient has function of the trochlear nerve (IV). C) The patient has suffered brain damage. D) The patient has lost function of the optic nerve (II).

57)

58) A bit of dust blows into and touches the cornea of the eye. Which of the following is likely to happen? A) Nothing, because there is no sensory information sent from the cornea. B) Stimulation of the ophthalmic division of the trigeminal nerve (V) will cause blinking. C) Stimulation of the facial nerve (VII) will be perceived as pain. D) Stimulation of the optic nerve (II) will cause tears to flow from the lacrimal gland.

58)

59) A doctor asks her patient to follow the motion of her finger as she moves it up and down, left and right. Which of the following cranial nerves is NOT being tested? A) the abducens (VI) B) the trochlear nerve (IV) C) the oculomotor nerve (III) D) the vestibulocochlear nerve (VIII)

59)

60) As a cook chops red onions he begins to tear up due to activation of the lacrimal gland. Which of the following nerves provided the stimulus? A) the facial nerve (VII) B) the vagus nerve (X) C) the optic nerve (II) D) the olfactory nerve (I)

60)

61) Dermatome maps are useful to clinicians because ________. A) they can help pinpoint the location of spinal injury B) they show the routes of motor nerves C) they outline the location of the numerous nerve plexus D) they show doctors how to avoid striking spinal nerves during surgery

61)

62) A patient has an injury of the spine and is now suffering from a loss of motor function in his right arm. However, he still has normal sensory function in the arm. Based on this information it is likely that the patient has nervous tissue damage located at ________. A) the dorsal rootlets located at one of the thoracic vertebra B) the ventral root located at one or more of the cervical vertebra C) spinal nerves of the cervical vertebra D) the dorsal root located at one or more of the cervical vertebra

62)

63) Injury to cervical vertebrae C 3 -C4 is particularly problematic because ________.

63)

A) the phrenic nerve that serves the diaphragm receives its fibers from here B) several ganglia are near this region that serve the heart C) part of the brain stem is located here D) the greater auricular nerve that serve the parotid gland receive there fibers from here 64) Complicated interlacing of the ventral rami form networks called nerve plexus. The crisscrossing of the nerve fibers from the various spinal nerves is advantageous because ________. A) viruses that infect us by moving through PNS nerves are prevented entry to the CNS B) having several nerve fibers unite enhances sensory function C) injury to any single spinal nerve will be less damaging as there is less chance of total loss of innervation to any particular organ D) having several nerve fibers unite enhances motor function

64)

65) Bill is a mechanic that works with vibrating tools. He also exerts force on his wrists when twisting wrenches and screws. Bill has a tingling sensation in the lateral portion of his hand. The doctor suspects carpal tunnel syndrome. Which of the following tests might the doctor try on her patient? A) Check for reflex on the medial condyle of the humerus with a rubber mallet. B) Check for hyperextension at the knuckles of the little and ring finger. C) Have Bill flex and extend his arm against resistance. D) Have Bill grip an object with his thumb and index finger and try to pull the object away.

65)

66) Which of the following nerves does NOT arise from the brachial plexus? A) phrenic B) median C) radial

66)

D) ulnar

67) The posterior side of the thigh, leg, and foot is served by the ________ nerve. A) obturator B) common fibular C) femoral D) tibial

67)

68) Starting at the spinal cord, the subdivisions of the brachial plexus are (in order) ________. A) trunks, divisions, cords, and roots B) roots, divisions, cords, and trunks C) roots, trunks, divisions, and cords D) divisions, roots, trunks, and cords

68)

69) The cranial nerve that emerges from the pons and serves the motor and proprioceptive functions of the eyeball is the ________. A) glossopharyngeal B) hypoglossal C) vagus D) abducens

69)

70) Which of the following is an incorrect statement regarding the occurrence of a sensation? A) The stimulus energy must match the specificity of the receptor. B) A generator potential in the associated sensory neuron must reach threshold. C) The stimulus energy must be converted into the energy of a graded potential called a transduction potential. D) The stimulus energy must occur within the receptor's receptive field.

70)

71) A major nerve of the lumbar plexus is the ________. A) femoral B) sciatic

71) C) iliohypogastric

D) ilioinguinal

72) Spinal nerves exiting the cord from the level of L 4 to S4 form the ________. A) thoracic plexus

B) femoral plexus

C) lumbar plexus

72) D) sacral plexus

73) Inborn or intrinsic reflexes are ________. A) autonomic only B) always mediated by the brain C) rapid, predictable, and can be learned responses D) involuntary, yet may be modified by learned behavior 74) Striking the "funny bone" is actually stimulation of (or injury to) the ________. A) ulnar nerve B) sciatic nerve C) median nerve

73)

74) D) radial nerve

75) A reflex that causes muscle relaxation and lengthening in response to muscle tension is called a ________. A) tendon reflex B) crossed-extensor reflex C) plantar reflex D) flexor reflex

75)

76) Which receptors respond to stimuli within the body? A) exteroceptors B) photoreceptors C) interoceptors

76) D) proprioceptors

77) Nerves that carry impulses toward the CNS only are ________. A) afferent nerves B) motor nerves C) mixed nerves

D) efferent nerves

78) After axonal injury, regeneration in peripheral nerves is guided by ________. A) dendrites B) Wallerian cells C) Schwann cells

D) Golgi organs

77)

78)

79) Regeneration within the CNS ________. A) is promoted by growth inhibitors and glial scars B) typically allows axonal sprouting of 20 mm C) is prevented due to growth-inhibiting proteins of oligodendrocytes D) is more successful than with the PNS

79)

80) In a crossed-extensor reflex, if the right arm was grabbed it would flex and the left arm would ________. A) extend B) adduct C) abduct D) also flex

80)

81) Select the correct definition. A) Spatial discrimination allows us to recognize textures. B) Magnitude estimation is the simplest level of sensation. C) Perceptual detection is the ability to detect how much stimulus is applied to the body. D) Pattern recognition allows us to see a familiar face.

81)

82) All processing at the circuit level going up to the perceptual level must synapse in the ________. A) thalamus B) reticular formation C) pons D) medulla

82)

83) The sciatic nerve is a combination of which two nerves? A) pudendal and common fibular B) common fibular and tibial C) posterior femoral cutaneous and tibial D) pudendal and posterior femoral cutaneous

83)

84) Which nerve is compressed in carpal tunnel syndrome? A) ulnar B) median C) radial

84) D) axillary

85) Bell's palsy is ________. A) often caused by inflammation of the trigeminal nerve B) characterized by loss of vision C) characterized by paralysis of facial muscles D) characterized by partial paralysis of diaphragm muscles

85)

86) Which of the following is the correct simple spinal reflex arc? A) effector, efferent neuron, integration center, afferent neuron, receptor B) receptor, efferent neuron, integration center, afferent neuron, effector C) receptor, afferent neuron, integration center, efferent neuron, effector D) effector, afferent neuron, integration center, efferent neuron, receptor

86)

87) Mixed cranial nerves containing both motor and sensory fibers include all EXCEPT which of the following? A) trigeminal B) facial C) olfactory D) oculomotor

87)

88) Transduction refers to conversion of ________. A) presynaptic nerve impulses to postsynaptic nerve impulses B) afferent impulses to efferent impulses C) receptor energy to stimulus energy D) stimulus energy into energy of a graded potential

88)

89) The flexor muscles in the anterior arm (biceps brachii and brachialis) are innervated by what nerve? A) ulnar B) musculocutaneous C) median D) radial

89)

90) Problems in balance may follow trauma to which nerve? A) accessory B) vestibulocochlear C) trigeminal D) abducens

90)

91) A fracture of the ethmoid bone could result in damage to which cranial nerve? A) olfactory B) vagus C) accessory D) glossopharyngeal

91)

92) Select the statement that is most correct. A) The dorsal root ganglion is a motor-only structure. B) The cell bodies of afferent ganglia are located in the spinal cord. C) Ganglia associated with afferent nerve fibers contain cell bodies of sensory neurons. D) Ganglia are collections of neuron cell bodies in the spinal cord that are associated with efferent fibers.

92)

93) A fall or an improperly delivered gluteal injection could result in ________. A) sciatica B) phantom limb pain C) postpoliomyelitis muscular atrophy D) neurofibromatosis

93)

94) Feeling a gentle caress on your arm would likely involve all of the following EXCEPT ________. A) hair follicle receptors B) Meissner's corpuscles C) tactile discs D) Lamellar corpuscles

94)

95) A patient who received a blow to the side of the skull exhibits the following signs and symptoms on that side of the face: he is unable to close his eye and the corner of his mouth droops. Which cranial nerve has been damaged? A) accessory B) hypoglossal C) glossopharyngeal D) facial

95)

96) If the ventral root of a spinal nerve were cut, what would be the result in the tissue or region that nerve supplies? A) a complete loss of sensation B) a complete loss of voluntary movement C) loss of neither sensation nor movement but only of autonomic control D) a complete loss of sensation and movement

96)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 97) One of the adaptive advantages of human body hair is believed to be its ability to help us detect potentially harmful insects crawling or landing on our skin. Which receptor type is most associated with this type of perception?

97)

98) Which of the body receptors have restricted locations and constantly advise the brain of our body movements?

98)

99) Receptors that are stimulated by temperature changes are called ________.

99)

100) The perineurium defines the boundary of a ________.

100)

101) We are aware of our facial expression because of which functional feature of which cranial nerve?

101)

102) Describe the cause and symptoms of paresthesia.

102)

103) Describe the symptoms that may occur from lesions of the olfactory nerve, cranial nerve I.

103)

104) An incorrectly placed intramuscular injection can cause injury to which nerve of the sacral plexus?

104)

105) Information regarding skeletal muscle tension is provided by ________ and muscle length by ________.

105)

106) Mr. Smith staggered home after a long night at the local pub. While attempting to navigate the stairs, he passed out cold and lay all night with his right armpit straddling the staircase banister. When he awoke the next morning, he had a severe headache, but what bothered him more was that he had no sensation in his right arm and hand. Explain what caused this symptom in his arm.

106)

107) Describe how the muscle spindles and the tendon organs vary in their role during the stretch reflex and opposing tendon reflex.

107)

108) Distinguish between monosynaptic and polysynaptic reflexes and between ipsilateral and contralateral reflex responses.

108)

109) An adult patient shows Babinski's sign during a test of plantar reflex. How is Babinski's sign different than the normal response and what does the altered response indicate?

109)

110) List and describe the functions of the three cranial nerves that serve the muscles of the eye.

110)

111) Name and describe five examples of exteroceptors that are NOT cutaneous receptors of the skin.

111)

112) The phrenic nerve arises from the left and right sides of cervical vertebra 3, 4 and 5. Describe the potential benefit of having the nerve exit from such a superior position and from multiple places on the spinal column.

112)

113) How is a receptor potential similar to an excitatory postsynaptic potential (EPSP) generated at a synapse?

113)

114) Name three unencapsulated sensory receptors and tell what they are used for.

114)

115) Describe the steps of the regeneration process of a damaged peripheral nerve fiber.

115)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 116) Ralph sustained a leg injury in a bowling accident and had to use crutches. Unfortunately, he never took the time to learn how to use them properly. After two weeks of use, he noticed his fingers were becoming numb. Then he noticed his arms were getting weaker and tingling. What could be his problem? 117) A patient suffers nerve damage to the median nerve, requiring surgery to suture the nerve back together. After surgery, the patient reports that sensation from the lateral and medial sides of the index finger seem to be reversed. How could this happen? 118) David, an aspiring baseball player, was struck on the left side of his face with a fastball pitch. He was not wearing a safety helmet. His zygomatic arch was crushed, as well as parts of the temporal bone. Following the accident and reconstructive surgery, he noted that his left lower eyelid was still drooping and the corner of his mouth sagged. What nerve damage did he sustain? 119) A nurse is asked what is tabes dorsalis and what causes it. What should the response be? 120) Good friends Sami and Sara were picking roses when both encountered rose thorns. Sami just laughed and continued to pick more roses. Sara, however, had tears in her eyes and complained of how much the thorn prick hurt. What accounts for the difference in their response to the same pain stimulus?

Answer Key Testname: UNTITLED13

1) B 2) D 3) C 4) D 5) E 6) B 7) E 8) C 9) B 10) D 11) A 12) B 13) A 14) E 15) C 16) D 17) B 18) C 19) D 20) A 21) E 22) C 23) A 24) A 25) D 26) B 27) C 28) A 29) B 30) C 31) B 32) A 33) C 34) A 35) B 36) B 37) B 38) C 39) A 40) B 41) TRUE 42) FALSE 43) TRUE 44) TRUE 45) TRUE 46) TRUE 47) FALSE 48) FALSE 49) B 50) A 13

Answer Key Testname: UNTITLED13

51) B 52) A 53) D 54) C 55) D 56) A 57) A 58) B 59) D 60) A 61) A 62) B 63) A 64) C 65) D 66) A 67) D 68) C 69) D 70) C 71) A 72) D 73) D 74) A 75) A 76) C 77) A 78) C 79) C 80) A 81) D 82) A 83) B 84) B 85) C 86) C 87) C 88) D 89) B 90) B 91) A 92) C 93) A 94) D 95) D 96) B 97) Hair follicle receptors 98) Proprioceptors 99) thermoreceptors 100) fascicle 14

Answer Key Testname: UNTITLED13

101) The proprioception of facial muscles by the facial nerve, cranial nerve VII 102) Paresthesia is the tingling sensation that is felt when blood flow is reduced to a sensory nerve. 103) anosmia 104) sciatic nerve 105) tendon organs; muscle spindles 106) Continuous pressure interrupts blood flow along with oxygen and nutrients to the neuron processes. As a result, impulse transmission is inhibited temporarily. 107) Tendon organs work with muscle spindles to act as proprioceptors in skeletal muscles and their associated tendons. When muscles are stretched due to contraction of antagonist muscles, the spindle neurons send impulses to the spinal cord, where they synapse with motor neurons of the stretched muscle. Impulses are then sent to the stretched muscle, which then resists further stretching. At more severe degrees of stretch, the tendon organs inhibit rather than increase resistance to stretching in order to prevent muscle tissue damage. 108) Monosynaptic refers to a single synapse in the reflex arc (one sensory and one motor neuron). Polysynaptic refers to more than one synapse in the arc involving sensory neurons, interneurons, and motor neurons. Ipsilateral refers to a reflex arc limited to one side of the spinal cord, while contralateral reflexes cross to the opposite side. 109) The plantar reflex tests the integrity of the spinal cord from L 4 to S2 and also determines if corticospinal tracts are functioning and properly myelinated. The normal plantar response is downward flexion of the toes. If there is damage, the great toe dorsiflexes and smaller toes fan laterally (Babinski's sign). Infants, who normally lack complete myelination, exhibit this sign. 110) The three cranial nerves are: oculomotor, trochlear, and abducens. The oculomotor is mostly motor, with branches to the inferior oblique and superior, inferior, and medial rectus muscles, as well as to the muscles of the iris and lens. The trochlear supplies mostly motor fibers to the superior oblique muscles of the eye. The abducens supplies mostly motor fibers to the lateral rectus muscles of the eye. Like most motor nerves, they also carry some sensory information for proprioception. 111) Exteroceptors that are not cutaneous receptors include the chemoreceptors of the tongue and nasal mucosa, the photoreceptors of the eyes, and the mechanoreceptors of the inner ear. These all monitor changes in the external environment, so they are classified as exteroceptors. 112) The fact that the phrenic nerve originates from multiple vertebra and from such a superior position, it reduces the likelihood of a spinal injury that would stop the diaphragm from working. 113) A receptor potential acts essentially the same as an EPSP in that stimulus causes changes in permeability of the receptor membrane, which results in a depolarizing graded potential. It will increase or decrease depending on the intensity of the stimulus. 114) 1. Free nerve endings are found throughout the body. They are used by most body tissues to determine stretching, joint positioning, etc. In the epidermis they become pain receptors, heat and cold receptors, and possibly very light pressure receptors. 2. Modified free nerve endings called tactile disks are used as light touch receptors. 3. Hair follicle receptors are mechanical receptors that become very fine touch receptors. 115) The portion of the axon distal to the injury is degraded and cleaned up by Schwann cells and macrophages. Growth of new axon filaments is stimulated by growth factors released by Schwann cells. Schwann cells will form a regeneration tube that will guide and support the growth of a new axon and ultimately produce a new myelin sheath. Also, the neurilemma needs to be intact for regeneration. 116) Compression of the radial nerve (in the region of the armpit) may cause temporary cessation of nervous transmission, often called "Saturday night paralysis." Continued pressure could cause permanent damage. 117) In suturing the nerve back together, there is no guide to ensure that each nerve fiber continues across the transection into the same neurilemma in which it started. Nerve fibers can grow into pathways different from their original ones and establish new synapses. The brain cannot keep track of which nerve fibers have grown into different pathways, and projects sensations back to the point of origin. 118) He suffered facial nerve damage on his left side. Due to the bone damage, branches to the eye and jaw were probably damaged. It is possible that the damage could be reversible if the nerves were not cut or crushed completely. 15

Answer Key Testname: UNTITLED13

119) Tabes dorsalis is a slowly progressive condition caused by deteriorating dorsal tracts and associated dorsal roots. This is a late sign of the neurological damage caused by the syphilis bacterium. Affected individuals have poor muscle coordination and an unstable gait. 120) Even though both individuals have the same pain threshold since they both perceived pain at the same stimulus intensity, each one's tolerance to pain is different. Sarah has a lower pain threshold compared to Sami's.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 14.1 Using Figure 14.1, match the following: 1) Myelin sheath.

2) Cell body of an ANS preganglionic neuron.

3) Cell body of an ANS postganglionic neuron.

4) Cell body of a somatic motor neuron.

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 5) Short preganglionic, long postganglionic fibers.

A) Sympathetic

B) Parasympathetic 6) Collateral ganglia.

7) Known to be active during "rest and digest" responses.

8) Decreases heart rate.

9) Maintenance functions.

10) Stimulates ciliary muscles of the eye, which makes the lens bulge for close vision.

10)

11) Active during "fight or flight" responses.

11)

Match the following: 12) Secreted by preganglionic sympathetic fibers.

A) Norepinephrine (NE)

12)

B) Acetylcholine (ACh) 13) Secreted by preganglionic parasympathetic fibers.

13)

14) Secreted by postganglionic sympathetic fibers to sweat glands.

14)

15) Secreted by postganglionic parasympathetic fibers.

15)

16) Secreted by most postganglionic sympathetic fibers.

16)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 17) Somatic and visceral reflex arcs are similar, but visceral reflex arcs lack afferent fibers (visceral sensory neurons).

17)

18) The rami communicantes are associated only with the sympathetic division of the ANS.

18)

19) The gray rami communicantes consist of myelinated postganglionic fibers.

19)

20) The parasympathetic division innervates more organs than the sympathetic division.

20)

21) The autonomic nervous system may cause activation or inhibition, depending on the division that is active and the target that is affected.

21)

22) The celiac ganglion is primarily associated with the sympathetic division.

22)

23) All visceral organs receive dual innervation from both the sympathetic and parasympathetic divisions of the ANS.

23)

24) Thermoregulatory responses to increased heat are mediated by the parasympathetic nervous division.

24)

25) Most disorders of the autonomic nervous system reflect abnormalities of smooth muscle control.

25)

26) The effect of beta-blocker drugs (block beta-receptors) is to increase blood pressure.

26)

27) The adrenal medulla is considered by some to be a "misplaced" sympathetic ganglion since embryologically, they arise from the same tissue.

27)

28) Acetylcholine is released by all somatic motor neurons, all preganglionic neurons of the ANS and by the postganglionic parasympathetic nerve fibers.

28)

29) The sympathetic and parasympathetic divisions of the ANS have the same effect on most body organ systems.

29)

30) Some sympathetic preganglionic fibers stimulate the adrenal medulla to release norepinephrine and epinephrine into the blood, producing a "surge of adrenaline."

30)

31) The facial (VII), glossopharyngeal (IX), and vagus (X) nerves contain postganglionic fibers of the parasympathetic nervous system.

31)

32) The ANS stimulates smooth muscles, skeletal muscles and glands, whereas the somatic nervous system innervates skeletal muscles only.

32)

33) Norepinephrine-releasing fibers are called cholinergic fibers.

33)

34) Autonomic ganglia are motor ganglia, containing the cell bodies of motor neurons.

34)

35) The craniosacral division is another name for the parasympathetic division.

35)

36) Autonomic ganglia are sights of synapse and information transmission from preganglionic to postganglionic neurons.

36)

37) Most blood vessels are innervated by the sympathetic division alone.

37)

38) The blood vessels of the skin are one of the few areas of the body where the vessels are innervated by both the sympathetic and parasympathetic divisions.

38)

39) The effect of the parasympathetic division on the penis is vasodilation causing erection, while ejaculation is due to sympathetic stimulation.

39)

40) All splanchnic nerves are sympathetic.

40)

41) Most splanchnic nerves pass through the abdominal aortic plexus.

41)

42) The vasomotor tone of blood vessels is mostly under sympathetic control.

42)

43) Because many of the same cardiac cells are innervated by both parasympathetic and sympathetic fibers, the influence of the two divisions on the heart is synergistic, meaning contraction is strongest when both divisions act together.

43)

44) β-adrenergic receptors are the only receptors found on the heart.

44)

45) Visceral reflexes include the reflexes that empty the bladder and the rectum.

45)

46) Cranial nerves III (oculomotor), VII (facial), and IX (glossopharyngeal) supply the entire parasympathetic innervation of the head; however, only the preganglionic fibers lie within these three pairs of cranial nerves.

46)

47) The sacral part of the parasympathetic division serves the pelvic organs and the distal half of the large intestine.

47)

48) Rami communicantes are designated white or gray to indicate whether or not the fibers passing through them are myelinated.

48)

49) The autonomic and somatic nervous systems are two separate systems that work totally independent of each other and lack any functional overlap.

49)

50) Albuterol (Ventolin) binds to β2 receptors and is used by asthma patients to constrict the bronchioles of the lungs and ease breathing.

50)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 51) The secretions of the adrenal medulla act to supplement the effects of ________. A) somatic stimulation B) sympathetic stimulation C) vagus (X) nerve activity D) parasympathetic innervation

51)

52) Which of the following does NOT describe the ANS? A) a system of motor neurons that innervates smooth and cardiac muscle and glands B) a system of motor neurons that innervates all muscle cells C) general visceral motor system D) involuntary nervous system

52)

53) Preparing the body for the "fight-or-flight" response is the role of the ________. A) somatic nervous system B) cerebrum C) parasympathetic division D) sympathetic division

53)

54) The somatic and autonomic nervous systems differ in all of the following EXCEPT ________. A) target organ responses to their neurotransmitters B) their effectors C) their efferent pathways and ganglia D) regulation of activity by higher brain centers

54)

55) Where would you NOT find a cholinergeric nicotinic receptor? A) sarcolemma of skeletal muscle cells at neuromuscular junctions B) all postganglionic neurons (cell bodies and dendrites) C) all parasympathetic target organs D) adrenal medulla hormone producing cells

55)

56) The parasympathetic ganglion that serves the lacrimal gland and nasal mucosa is the ________. A) ciliary ganglion B) otic ganglion C) pterygopalatine ganglion D) submandibular ganglion

56)

57) Which of the following is a function of the parasympathetic division? A) increases heart rate and force of contraction B) dilates bronchioles C) produces "goosebumps" D) contracts smooth muscle of the bladder wall and relaxes urethral sphincter

57)

58) Over 90% of all parasympathetic fibers are derived from cranial nerve ________. A) XII (hypoglossal) B) X (vagus) C) VII (facial) D) V (trigeminal)

58)

59) The "fight or flight" division of the autonomic nervous system is the ________. A) sympathetic division B) peripheral division C) somatic division D) parasympathetic division

59)

60) Control of temperature, endocrine activity, and thirst are functions associated with the ________. A) medulla B) hypothalamus C) cerebellum D) thalamus

60)

61) Which of these effectors is NOT directly controlled by the autonomic nervous system? A) most glands B) cardiac muscle C) smooth muscle D) skeletal muscle

61)

62) Which of the following is NOT a result of parasympathetic stimulation? A) salivation B) increased peristalsis of the digestive viscera C) elimination of urine D) dilation of the pupils

62)

63) Which of the following statements is FALSE? A) Sympathetic ganglia are within a few centimeters of the CNS; parasympathetic ganglia are close to the visceral organs served. B) Sympathetic has extensive branching of preganglionic fibers; parasympathetic has minimal branching of preganglionic fibers. C) Sympathetic origin is craniosacral; parasympathetic is thoracolumbar. D) Sympathetic division has short preganglionic and long postganglionic fibers; parasympathetic has long preganglionic and short postganglionic fibers.

63)

64) Sympathetic responses generally are widespread because ________. A) preganglionic fibers are short B) inactivation of ACh is fairly slow C) NE and epinephrine are secreted into the blood as part of the sympathetic response D) preganglionic fibers are long

64)

65) Sympathetic nerves may leave the spinal cord at which vertebra? A) first thoracic B) first coccyx C) second cervical

65) D) third lumbar

66) Autonomic ganglia contain ________. A) an outer connective tissue capsule around the cell bodies of preganglionic motor neurons B) the cell bodies of motor neurons C) synapses between postganglionic fibers and their effectors D) both somatic afferent and efferent neurons

66)

67) The parasympathetic fibers of the ________ nerve stimulate many large glands in the head such as the nasal and lacrimal glands. A) optic (II) B) trochlear (IV) C) oculomotor (III) D) facial (VII)

67)

68) Fibers that enter and leave the sympathetic trunks without synapsing form structures called ________. A) splanchnic nerves B) white rami communicantes C) gray rami communicantes D) spinal nerves

68)

69) Which of the following is NOT a plexus of the vagus (X) nerve? A) esophageal B) inferior hypogastric C) cardiac D) pulmonary

69)

70) Visceral reflex arcs differ from somatic in that ________. A) somatic arcs contain one additional component that visceral arcs do not possess B) visceral arcs involve two motor neurons C) visceral arcs contain two sensory neurons D) visceral arcs do not use integration centers

70)

71) The parasympathetic tone ________. A) prevents unnecessary heart deceleration B) causes blood pressure to rise C) determines normal activity of the urinary tract D) accelerates activity of the digestive tract

71)

72) Once a sympathetic preganglionic axon reaches a trunk ganglion, it can do all of the following EXCEPT ________. A) pass through the trunk ganglion without synapsing with another neuron B) synapse with a parasympathetic neuron in the same trunk ganglion C) ascend or descend the trunk to synapse in another trunk ganglion D) synapse with a ganglionic neuron in the same trunk ganglion

72)

73) Which of the following appears to exert the most direct influence over autonomic functions? A) midbrain B) medulla oblongata C) reticular formation D) hypothalamus

73)

74) Drugs called beta-blockers ________. A) have widespread sympathetic effects C) increase a dangerously low heart rate

74) B) decrease heart rate and blood pressure D) are potent antidepressants

75) Erection (vasodilation) of the penis or clitoris ________. A) is primarily under sympathetic control B) depends very little on autonomic activation C) is the result of coordinated activation by both sympathetic and parasympathetic input D) is primarily under parasympathetic control

75)

76) Which is an exclusively sympathetic function? A) regulation of cardiac rate C) regulation of body temperature

76) B) regulation of respiratory rate D) regulation of pupil size

77) Raynaud's disease ________. A) is induced by heat stress B) is frequently life threatening C) is characterized by exaggerated vasoconstriction in the extremities D) occurs primarily in association with injury to the spinal cord

77)

78) Which of the following is NOT true about hypertension? A) It is a disorder of the parasympathetic division of the ANS. B) It is serious because it forces the heart to work harder and increases wear and tear on artery walls. C) It may result from an overactive sympathetic vasoconstrictor response. D) It is also known as high blood pressure.

78)

79) Which sympathetic fibers form a splanchnic nerve? A) those that pass through the trunk ganglion to synapse in collateral or prevertebral ganglia B) those that synapse in the same trunk ganglion they entered C) those that synapse with parasympathetic fibers D) those that synapse with somatic fibers

79)

80) Which of the following adrenergic neurotransmitter receptors plays the major role in heart activity? B) beta 2 C) beta 3 D) alpha 1 A) beta 1

80)

81) Where would you NOT find autonomic ganglia? A) within spinal cord B) within wall of organ served or close to organ C) paired, beside spinal cord D) unpaired, anterior to spinal cord

81)

82) Sympathetic division stimulation causes ________. A) increased blood glucose, decreased GI peristalsis, and increased heart rate and blood pressure B) decreased blood glucose, increased GI peristalsis, and decreased heart rate and blood pressure C) decreased blood glucose, increased GI peristalsis, and increased heart rate and blood pressure D) increased blood glucose, increased GI peristalsis, and decreased heart rate and blood pressure

82)

83) The smooth muscle of the digestive viscera is served largely by the ________. A) lumbar splanchnic nerves B) vagus (X) nerves C) cephalic plexus D) pelvic nerves

83)

84) The route of major parasympathetic outflow from the head is via the ________. A) sympathetic trunk B) vagus (X) nerves C) phrenic nerve D) sacral nerves

84)

85) Parasympathetic functions include ________. A) allowing the body to cope with an external threat B) raising blood glucose levels C) lens accommodation for close vision D) a stimulation of heart rate and force of contraction

85)

86) Emotions influence autonomic reactions primarily through integration in the ________. A) hypothalamus B) inferior colliculus C) lateral geniculate of the thalamus D) lateral horn of the spinal cord

86)

87) The mushroom poison muscarine can bind to receptors on ________. A) all effector cells stimulated by postganglionic cholinergic fibers B) cell bodies and dendrites of sympathetic postganglionic neurons C) the hormone producing cells of the adrenal medulla D) cell bodies and dendrites of parasympathetic postganglionic neurons

87)

88) Which of the following drug classes would be useful for smoking cessation products? A) parasympathomimetic agents (muscarinic agents) B) acetylcholinesterase inhibitors C) sympathomimetic agents D) nicotinic agents

88)

89) A mugger steals your wallet causing all of the following to happen EXCEPT ________. A) increased rate and force of heartbeat B) increased glucose uptake to the liver from blood C) inability to read close-up print D) increased metabolic rate

89)

90) Which of the following is mismatched? A) bronchiole dilation in lungs; sympathetic B) penis ejaculation; sympathetic C) gallbladder contracts to expel bile; parasympathetic D) promotes urination; sympathetic

90)

91) Which type of drug would be useful in dilating the pupils for an examination of the retina? A) muscarinic receptor inhibitor B) beta-1 receptor mimic C) beta-3 receptor mimic D) alpha-1 receptor inhibitor

91)

92) Which target organ receives dual innervation? A) sweat glands C) kidney

92) B) small intestine D) coronary blood vessels

93) Which of the following is mismatched? A) parasympathetic preganglionic fibers; release ACh B) sympathetic postganglionic fibers; release NE C) sympathetic preganglionic fibers; release ACh D) parasympathetic postganglionic fibers; release NE

93)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 94) Explain the concept of dual innervation in the autonomic nervous system. Provide two examples.

94)

95) What studies have suggested that the ANS can also be subject to voluntary controls?

95)

96) How is Raynaud's disease related to the ANS?

96)

97) Carla was startled by an extremely loud bang that sounded like a gunshot. Her heartbeat accelerated rapidly. When she found that the noise was only a car backfiring, she felt greatly relieved but her heart kept beating heavily for over half an hour. Why did this happen?

97)

98) Mark eats a very big meal in the evening. After the meal his wife would like him to help clean up, but Mark explains that he is "too tired" and promptly goes to sleep. What seems to be his problem?

98)

99) Richard has been under great stress and has complained of migraine headaches for weeks. He tried all kinds of drugs, with little effect. When he was at the end of his rope, a friend suggested yoga and meditation. Having nothing to lose, he tried them and after several months, felt like a new person. How could these practices help him?

99)

100) Describe three potential outcomes that result when a preganglionic axon reaches a sympathetic trunk ganglion.

100)

101) Discuss a way in which the sympathetic and parasympathetic divisions cooperate with each other.

101)

102) List three key anatomical differences between the sympathetic and parasympathetic divisions.

102)

103) In what ways are the autonomic and the somatic nervous systems different?

103)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 104) Mrs. Oberhaus needs surgery to correct a severe case of Raynaud's disease, affecting one of her hands. What surgical procedure will be performed? After the surgery, will she be more likely to suffer from anhidrosis (lack of sweating) or hyperhidrosis (profuse sweating) in the affected hand? 105) An elderly patient in a nursing home has recurrent episodes of fainting when he stands. An alert nurse notes that this occurs only when his room is fairly warm; on cold mornings, he has no difficulty. What is the cause of the fainting, and how does it relate to the autonomic nervous system and to room temperature? 106) Describe outcome criteria that can be used to evaluate whether a patient is effectively coping with a stressful problem. 107) Baroreceptors in the carotid sinus monitor blood pressure. When the carotid sinus is stretched by blood pressure or manipulation, a feedback response through the vagus (X) nerve can be blocked by atropine. How would external stimulation of the carotid artery, such as carotid massage, affect the heart rate? 108) A patient with diabetes comes into the doctor's office complaining of sexual dysfunction, dizziness upon standing, and sluggish eye pupil reactions. What is causing the patient's issues and how should it be treated?

Answer Key Testname: UNTITLED14

1) E 2) A 3) C 4) D 5) A 6) A 7) B 8) B 9) B 10) B 11) A 12) B 13) B 14) B 15) B 16) A 17) FALSE 18) TRUE 19) FALSE 20) FALSE 21) TRUE 22) TRUE 23) FALSE 24) FALSE 25) TRUE 26) FALSE 27) TRUE 28) TRUE 29) FALSE 30) TRUE 31) FALSE 32) FALSE 33) FALSE 34) TRUE 35) TRUE 36) TRUE 37) TRUE 38) FALSE 39) TRUE 40) FALSE 41) TRUE 42) TRUE 43) FALSE 44) FALSE 45) TRUE 46) TRUE 47) TRUE 48) TRUE 49) FALSE 50) FALSE 11

Answer Key Testname: UNTITLED14

51) B 52) B 53) D 54) D 55) C 56) C 57) D 58) B 59) A 60) B 61) D 62) D 63) C 64) C 65) A 66) B 67) D 68) A 69) B 70) B 71) C 72) B 73) D 74) B 75) D 76) C 77) C 78) A 79) A 80) A 81) A 82) A 83) B 84) B 85) C 86) A 87) A 88) D 89) B 90) D 91) A 92) B 93) D 94) Dual innervation refers to the innervation of a target organ by both divisions of the ANS. Usually, the effects of the sympathetic and parasympathetic divisions on that target organ are antagonistic; they oppose each other. For example, sympathetic stimulation on the heart causes an increase in heart rate and force of contraction, while parasympathetic stimulation decreases heart rate. See table 14.5 for additional examples of dual innervation.

Answer Key Testname: UNTITLED14

95) Remembering a frightening event can make your heart race. Thinking about a favorite food can increase saliva production. Further, experimentation involving meditation and biofeedback indicates that cortical controls of the ANS are possible. Meditating yogis have changed their physiological states, while biofeedback techniques have been successful in helping patients overcome migraine headaches and improve stress management to reduce the risk of heart attack. 96) Raynaud's disease is characterized by intermittent periods that cause the skin of the fingers and toes to become pale, then cyanotic and painful. It is an exaggerated vasoconstriction response to exposure to cold temperatures or emotional stress. It can potentially cause tissue ischemia and death. 97) The effects of sympathetic activators are long lasting, because norepinephrine is inactivated slowly. Also, the adrenal medulla releases this neurotransmitter into the bloodstream, which adds to the long -lasting effects of adrenergic stimulation. 98) After a meal, parasympathetic influences dominate, which increase digestive functions while decreasing cardiac and respiratory activity. This causes the individual to feel sleepy. 99) The practitioner of meditation and biofeedback techniques seems to enter a physiological state of concentration that can reduce sympathetic-induced hypertension. By concentrating on relaxing thoughts, the practitioner can slow heart and respiratory rates. The effects are more widespread than can be explained by parasympathetic influences; the control could be consciously induced. 100) The preganglionic and postganglionic neurons can (1) synapse at the same level, in the same trunk ganglion, (2) synapse at a higher or lower level; the preganglionic axon ascends or descends the sympathetic trunk to another trunk ganglion, (3) synapse in a distant collateral ganglion; the preganglionic axon passes through the trunk ganglion and emerges from the trunk without synapsing. These fibers synapse in collateral ganglia, located anterior to the vertebral column. 101) Prior to and during intercourse the parasympathetic system causes erection in the male penis and female clitoris. During the climax the sympathetic system causes ejaculation of semen by the penis and reflex contractions of the vagina. 102) 1. They have unique origin sites within the CNS. 2. They have different lengths of pre- and post-ganglionic axons. 3. Their ganglia are located in different areas. 103) 1. The autonomic is a two-neuron system; the somatic uses one outside the CNS. 2. The autonomic uses smaller neuron fibers (type B or C) to innervate smooth muscle, cardiac muscle and glands; the somatic generally uses type A fibers for rapid transmission to skeletal muscle. 3. The autonomic is mostly involuntary and automatic; the somatic is voluntary. 4. The autonomic uses several neurotransmitters and many receptor types; the somatic uses only one. 5. The autonomic is a slow system; the somatic is a fast system. 6. The autonomic has opposing forces to regulate the body; the somatic does not. 104) Mrs. Oberhaus' doctor will perform a sympathectomy. Cutting the sympathetic fibers will result in dilation of the affected blood vessels. Because sweating is stimulated by sympathetic nerves, after they are cut the affected hand will suffer from anhidrosis. 105) The fainting episodes are a result of orthostatic hypotension, due to slowed responding of aging sympathetic vasoconstrictor centers. The condition is exaggerated when blood supply to the skin is increased (as when the room is warm) because the shunting of blood to the skin reduces blood flow to other body parts. 106) Signs of mobilization of the sympathetic nervous system are: pounding heart, rapid deep breathing, cold and sweaty skin, and dilated pupils. Therefore, outcome criteria to evaluate a patient's ability to cope would be: regular heartbeat, even and unlabored breathing, warm and dry skin, and constricted or normal pupils. 107) External stimulation of the carotid artery would slow the heart down because of the parasympathetic effect of the vagus (X) nerve. 108) The patient is suffering from autonomic neuropathy or damage to autonomic nerves caused by diabetes mellitus. Treatment for this issue is to maintain tight control of blood glucose levels by watching glucose intake and managing insulin. 13

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 15.1 Using Figure 15.1, match the following: 1) Ganglion cells.

2) Bipolar cells.

3) Horizontal cell.

4) Amacrine cell.

5) Rod.

Figure 15.2 Using Figure 15.2, match the following: 6) Protects and shapes the eyeball; provides a sturdy anchoring site for extrinsic eye muscles.

7) Blood vessels that supply nutrition to most of the eyes' structures (excluding the lens and cornea).

8) Contains only cones; provides detailed color vision.

9) Lacks photoreceptors; where optic nerve exits the eye.

10) Consists of a pigmented layer and a neural layer.

10)

Figure 15.3 Using Figure 15.3, match the following: 11) Acts as a reflexively activated diaphragm to vary pupil size.

11)

12) The only tissue in the body that can be transplanted from one person to another with little or no rejection.

12)

13) Controls lens shape.

13)

14) Viscous liquid that holds the retina firmly against the pigmented layer.

14)

15) Increased pressure here causes glaucoma.

15)

Figure 15.4 Using Figure 15.4, match the following: 16) Auricle.

16)

17) Tympanic membrane.

17)

18) Stapes.

18)

19) Semicircular canals.

19)

20) Cochlea.

20)

21) Balance organ.

21)

22) Houses organ of Corti.

22)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 23) The sensory layer of the eye.

A) Retina

23)

24) The structure most responsible for focusing light rays that enter the eye.

A) Aqueous humor

24)

B) Lens 25) Helps maintain the intraocular pressure; located in the anterior part of the eye.

25) C) Fovea centralis

26) Area of greatest visual acuity.

26)

Match the following: 27) Ear stones.

A) Pharyngotympanic tube

28) Connects the middle ear with the nasopharynx.

B) Vestibule

27) 28)

C) Otoliths 29) Separates external acoustic meatus from the middle ear.

29) D) Tympanic membrane

30) Contains utricle and saccule.

30)

31) Detects linear acceleration.

31)

Match the following: 32) A condition that can result from a deficiency of vitamin A.

A) Glaucoma

32)

B) Otitis media 33) A condition of deafness that may result from otosclerosis. 34) An inflammation of the lining of the middle ear.

33) C) Conduction deafness D) Night blindness

35) A condition often leading to blindness due to chronic persistent intraocular pressure.

34)

35)

Match the following: 36) Hair cells receptive to changes in dynamic equilibrium are found in this structure.

A) Taste buds

37) Chemically sensitive microvilli found in this structure.

C) Cochlear duct

38) Hair cells receptive to changes in static equilibrium are found in this structure. 39) Chemically sensitive cilia are found in this structure. 40) Houses the spiral organ (of Corti).

36)

B) Crista ampullaris 37)

D) Vestibule 38) E) Macula F) Tympanic membrane 39) G) Olfactory epithelium H) Spiral organ (of Corti)

41) The receptor organ for hearing.

40) 41)

42) The central part of the bony labyrinth.

42)

43) A membrane that transmits sound vibrations to the auditory ossicles.

43)

Match the following: 44) Loss of hearing resulting from prolonged exposure to high-intensity sounds.

A) Tinnitus

45) Can result from the fusion of the auditory ossicles.

C) Conduction deafness

44)

B) Sensorineural deafness 45)

46) A possible side effect of medications such as aspirin.

46)

47) One of the most common results of otitis media.

47)

48) Can result from impacted cerumen.

48)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 49) The mucous membrane that lines the eyelids and is reflected over the anterior surface of the eyeball is the conjunctiva.

49)

50) Vitamin A needed by the photoreceptor cells is stored by the cells of the retina pigmented layer.

50)

51) Static equilibrium involves the sensation of linear acceleration as well as changes in head rotation.

51)

52) The optic disc forms a blind spot where the optic nerve leaves the eyeball.

52)

53) Sour taste receptors are stimulated by hydrogen ions of acidic food substances.

53)

54) The fluid contained within the membranous labyrinth is called perilymph.

54)

55) Precision of eye movement is due to the fact that extrinsic eye muscle motor units typically innervate 8 to 12 muscle cells and in some cases as few as 2 or 3 muscle cells.

55)

56) Ciliary muscles are considered voluntary, skeletal muscle.

56)

57) The structure that allows equalization of the pressure in the middle ear with the atmospheric pressure is the external auditory meatus.

57)

58) The bending of light rays is called reflection.

58)

59) The anterior chamber of the eye is filled with vitreous humor.

59)

60) The neural layer of the retina prevents excessive scattering of light within the eye.

60)

61) In order for sound to reach the spiral organ (of Corti), the auditory ossicles must vibrate the oval window and set the endolymph in motion.

61)

62) Sound is generally perceived in the occipital lobe of the cerebral cortex.

62)

63) Light passes through the entire thickness of the neural layer of the retina to excite the photoreceptors.

63)

64) Without a functioning crista ampullaris, the semicircular canals would not function.

64)

65) Contraction of the ciliary muscle causes the lens to bend the light less.

65)

66) Theoretically, an individual born without a middle ear would be able to hear by bone conduction with a hearing aid.

66)

67) When we move from darkness to bright light, retinal sensitivity is lost, but visual acuity is gained.

67)

68) The function of the lens of the eye is to allow precise focusing of light on the retina.

68)

69) Odorants must be volatile to be smelled.

69)

70) Hair cells in the spiral organ of the ear are never replaced.

70)

71) The quality of a sound is based on the atmospheric pressure at the time the sound is generated.

71)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 72) Nutrients are delivered and waste products are carried away from the cells of the posterior segment of the eye by blood vessels. However, the cells in the cornea and lens (in the anterior segment) are avascular. Which is the best explanation for how these cells are maintained? A) The nutrients and waste products of the anterior segment diffuse into and through the vitreous humor of the posterior segment. B) The metabolic activity of these cells is very low. They produce little waste and need few nutrients. C) The aqueous humor is continuously replenished and flows from the ciliary process to drain in the scleral venous sinus. D) These cells, like the cells of the corneal layer of the integument are not living cells.

72)

73) In a person who is color-blind, which of the following would you most expect to see? A) an inability to regenerate 11-cis-retinal after bleaching B) a loss of their peripheral vision C) absence of green or red cones in their foveae D) a loss of functions in the rods of their retina

73)

74) Which of the following is the best explanation of why it is difficult to discriminate the color of an object at night? A) At night, dilation of pupils stimulates the retina, where more rods are located rather than cones. B) As many as 100 cones may converge on one ganglion cell. C) The foveae are densely packed with cones. D) Cones come in three types, each sensitive to different wavelengths of light.

74)

75) Which of the following best describes the function of the iris? A) refracts light through the pupil B) adjusts the shape of the lens C) gives the eye its color D) controls amount of light entering eye

75)

76) Which of the following is the best explanation for our perception of color? A) The foveae are densely packed with cones. B) Rods contain a single kind of visual pigment. C) As many as 100 cones may converge on one ganglion cell. D) Cones come in three types, each sensitive to different wavelengths of light.

76)

77) The elasticity of the lens decreases with age. This leads to which of the following? A) lowered accommodation of the pupillary reflex and blurry vision B) a clouding of the lenses known as a cataract C) less light getting to the retina and diminished visual acuity D) less accommodation of the lenses and difficulty focusing on nearby objects

77)

78) Paralysis of which eye muscle would prevent the right eye from looking to the left? A) Inferior rectus B) Medial rectus C) Lateral rectus D) Superior rectus

78)

79) Overlap in the visual fields of our eyes ________. A) gives us higher visual acuity for small detail by doubling the number of photoreceptors that are being stimulated B) leaves a blind spot anterior to the nose and in the lateral fields of vision C) is essentially a waste of brain processing for what is essentially the same image D) allows us to subconsciously estimate the distance of objects based on the different angles the image strikes our two retinas

79)

80) If you shine a light into one eye both pupils will constrict. The best explanation for this is ________. A) a small portion of light always enters the other eye B) sensory input from the retinas of both eyes converges at the optic chiasm and information from each eye is delivered to both the left and right sides of the brain C) information from one eye is directly and immediately transferred to the other eye to maintain alignment of the eyes D) This, in fact, does not occur; information from both eyes is always separated.

80)

81) Select the statement below that is NOT true with regards to the process of light adaptation. A) Visual acuity is diminished. B) The activity of rods is reduced by rapid bleaching of rhodopsin. C) Rhodopsin is uncoupled from light transduction. D) Retinal sensitivity decreases.

81)

82) Humans can see several thousand shades of color but have cone photoreceptors that are sensitive to only three (perhaps four) wavelengths of light. What is the best explanation for why we see so many colors? A) Color perception is achieved by activation of various combinations between the three cone types. B) Color perception is dependent on the millions of rods as well as cone photoreceptors. C) Shades of color are purely psychological and learned by association with age, infants only seeing in black and white. D) Colors are added and enhanced in the primary visual cortex of the brain.

82)

83) Color vision has much greater resolution than night vision (vision that is mostly in shades of gray). Which of the following is the best explanation for why this is so? A) There are many more cone photoreceptors in the eye than rod photoreceptors. B) A larger proportion of the brain's visual cortex is active during the day when our cone photoreceptors are most active. C) There are several types of cone photoreceptors, each of which enrich the clarity and resolution of vision. D) A single cone photoreceptor often connects to a single bipolar cell and a single ganglion cell while as many as 100 rods will converge to a single ganglion cell.

83)

84) Humans can smell as many as 10,000 different odors but have significantly fewer types of olfactory receptors. Which of the following is the best explanation for why humans can distinguish so many smells? A) The olfactory pathway travels to location in the brain in which memories are formed and we simply mix this new sensory information with old memories. B) Taste receptors that are active at the same time influence the subtlety of what we smell. C) The sensation of a single, distinct smell is a combination of a variety of chemicals that stimulate different combinations of olfactory receptor cells all at once. D) The belief that we can smell so many different distinct odors is a psychological process referred to as an uncinate fit or olfactory hallucination.

84)

85) As light travels through the eye, it passes through several structures or chambers before reaching the retina. Which list below gives those structures in the correct order? A) cornea, pupil, lens, anterior chamber, posterior segment B) cornea, anterior chamber, pupil, lens, posterior segment C) cornea, lens, pupil, anterior chamber, posterior segment D) cornea, pupil, anterior chamber, lens, posterior segment

85)

86) Labyrinthitis is a medical condition often caused by a viral infection, resulting in swelling and inflammation of the membranous labyrinth. Which of the following symptoms would you most associate with the condition of labyrinthitis? A) loss of balance and dizziness B) ringing in the ears (tinnitus) C) loss of hearing D) auditory hallucination

86)

87) The sensation of loudness or the volume of a sound is detected by ________. A) vibration along a greater length of the basilar membrane, stimulating a greater number of hair cells B) sounds that can travel all the way to the apex of the scala vestibule with enough energy remaining to deflect hair cells C) greater movement of the basilar membrane resulting in greater deflection of the hair cells D) faster vibration of the basilar membrane resulting in a higher frequency of hair cell stimulation

87)

88) A patient has a loss of hearing in only one ear. Which of the following is likely to be a result? A) The patient will have a loss of balance with dizziness and vertigo. B) The patient will not be able to localize the origin of sounds. C) The patient will have increased sensitivity to sound in the unaffected ear. D) The patient will not be able to track objects with the eye on the same side as the hearing loss.

88)

89) Dancers will use a technique called "spotting" when they perform spins of the body. By holding their head and eyes on a fixed point in front of them as their body spins they reduce the amount of head spinning and this prevents dizziness. Which of the following is the most likely explanation for why this works? A) This helps keep the motions detected by the eyes congruent (aligned) with the motions sensed by the vestibular apparatus. B) This will help to reduce the lateral flection of the head and will prevent hyper polarization or depolarization of the hair cells in the macula. C) When the eyes send a static vision of stability to the brain, it is tricked into believing the body is still and therefore dizziness will not occur. D) Reducing the inertia of head spin will reduce the flow of endolymph that deflects the hair cells of the crista ampullaris.

89)

90) Tom is a 45-year-old male that has lost his ability to hear high frequency sounds. The most likely explanation for this would be ________. A) a middle ear infection B) an overgrowth of bony tissue, fusing the ossicles together C) a perforated tympanic membrane D) damage to the hair cells near the oval window in the cochlear duct

90)

91) What is the main function of the rods in the eye? A) vision in dim light C) color vision

91) B) depth perception D) accommodation for near vision

92) What structure regulates the amount of light passing to the visual receptors of the eye? A) cornea B) iris C) aqueous humor D) lens

92)

93) Receptors for hearing are located in the ________. A) tympanic membrane C) cochlea

93) B) semicircular canals D) vestibule

94) Which of the following types of neurons are replaced throughout adult life? A) retinal ganglion cells B) retinal bipolar cells C) auditory outer and inner hair cells D) olfactory receptor cells 95) Bitter taste is elicited by ________. A) alkaloids B) metal ions

C) hydrogen ions

96) The receptor for static equilibrium is the ________. A) utricle C) cochlear duct

B) macula D) semicircular canals

94)

95) D) acids 96)

97) The ability to clearly see objects at a distance but not close up is properly called ________. A) myopia B) hyperopia C) presbyopia D) hypopia

97)

98) Seventy percent of all sensory receptors are located in the ________. A) ears B) eye C) nose

98) D) skin

99) Which of the following structures is NOT part of the external ear? A) pharyngotympanic tube B) pinna C) external acoustic meatus D) tympanic membrane

99)

100) Nerve fibers from the medial aspect of each eye ________. A) pass posteriorly without crossing over at the chiasma B) divide at the chiasma, with some crossing and some not crossing C) go to the superior colliculus only D) cross over to the opposite side at the chiasma

100)

101) Ordinarily, it is NOT possible to transplant tissues from one person to another, yet corneas can be transplanted without tissue rejection. This is because the cornea ________. A) has no blood supply B) is not a living tissue C) has no nerve supply D) does not contain connective tissue

101)

102) The oval window is connected directly to which passageway? A) scala vestibuli B) scala tympani C) external acoustic meatus D) pharyngotympanic tube

102)

103) There are three layers of neurons in the retina. The axons of which of these neuron layers form the optic nerves? C) cone cells D) ganglion cells A) rod cells B) bipolar cells

103)

104) The first "way station" in the visual pathway from the eye, after there has been partial crossover of the fibers in the optic chiasma, is the ________. A) superior colliculi B) lateral geniculate body of the thalamus C) temporal lobe D) visual cortex

104)

105) As sound levels increase in the spiral organ (of Corti), ________. A) outer hair cells stiffen the basilar membrane B) inner hair cells bend the cilia away from the kinocilium C) outer hair cells bend the cilia away from the kinocilium D) inner hair cells stiffen the basilar membrane

105)

106) Which of the following is true about gustatory receptors? A) The receptors generate an action potential in response to chemical stimuli. B) Complete adaptation occurs in about one to five minutes. C) In order for a chemical to be sensed, it must be hydrophobic. D) All gustatory receptors have the same threshold for activation.

106)

107) Taste buds are NOT found ________. A) lining the buccal cavity C) in circumvallate papillae

107) B) in fungiform papillae D) in filiform papillae

108) Select the correct statement about olfaction. A) Some of the sensation of olfaction is actually one of pain. B) Olfactory receptors have a high degree of specificity toward a single type of chemical. C) Substances must be volatile and hydrophobic in order to activate olfactory receptors. D) Olfactory adaptation is only due to fading of receptor cell response.

108)

109) Which of the following describes a response of the eye to sympathetic stimulation? A) ciliary muscle contraction B) pupil constriction C) pupil dilation D) ciliary muscle relaxation

109)

110) Which of the following taste sensations is incorrectly matched to the chemicals that produce it? A) sweet-organic substances such as sugar and some lead salts B) umami-triglycerides and fatty acids C) salty-metal ions D) sour-acids E) bitter-alkaloids

110)

111) Which best describes the function of olfactory cilia? A) help move air through nasal passages B) trap inhaled particulates before air reaches lungs C) help transport mucus toward nasopharynx D) increase surface area of neurons receptive to airborne chemicals

111)

112) What is a modiolus? A) bone in the center of a semicircular canal B) a bony area around the junction of the facial, vestibular, and cochlear nerves C) bone around the cochlea D) a bone pillar in the center of the cochlea

112)

113) Which statement about malnutrition-induced night blindness is most accurate? A) Visual pigment content is reduced in cones more than rods. B) Vitamin supplements can reverse degenerative changes. C) The impaired vision is caused by reduced cone function. D) The most common cause is vitamin D deficiency.

113)

114) Dark adaptation ________. A) involves accumulation of rhodopsin B) results in inhibition of rod function C) primarily involves improvement of acuity and color vision D) is much faster than light adaptation

114)

115) Conscious perception of vision probably reflects activity in the ________. A) chiasma B) occipital lobe of the cortex C) superior colliculus D) thalamus

115)

116) In the visual pathways to the brain, the optic radiations project to the ________. A) optic chiasma B) medial retina C) primary visual cortex D) lateral geniculate body

116)

117) Visual inputs to the ________ serve to synchronize biorhythms with natural light and dark. A) suprachiasmatic nucleus B) lateral geniculate body C) pretectal nuclei D) superior colliculi

117)

118) Which of the following types of receptors are located in the mouth? A) chemoreceptors, thermoreceptors, and nociceptors only B) chemoreceptors only C) chemoreceptors, mechanoreceptors, thermoreceptors, and nociceptors D) thermoreceptors, mechanoreceptors, and nociceptors only

118)

119) Motion sickness seems to ________. A) result from mismatch between visual and vestibular inputs B) respond best to medication that "boosts" vestibular inputs C) respond best to medication taken after salivation and pallor begins D) result from activation of nausea centers in the brain stem

119)

120) The only special sense NOT fully functional at birth is the sense of ________. A) smell B) taste C) hearing D) vision E) equilibrium

120)

121) Most newborns ________. A) often use only one eye at a time B) produce more tears when they cry than a toddler C) see in tones of red and green only D) are myopic

121)

122) The blind spot of the eye is caused by ________. A) more rods than cones within the retina B) an absence of cones in the foveae C) the macula lutea interrupts the nerve pathway D) an absence of photoreceptors where the optic nerve leaves the eye

122)

123) The first vestiges of eyes in the embryo are called ________. A) optic discs B) mesenchyme C) optic vesicles

123) D) optic cups

124) Which pairing of terms is incorrectly related? A) quality of a sound: frequency of the sound B) frequency of sound waves: number of wavelengths C) frequency of sound waves: loudness of the sound D) amplitude of a sound: intensity of the sound

124)

125) A patient who has experienced previous jaw and face trauma now reports difficulty tasting with the tip of her tongue. Which cranial nerve was likely damaged in that injury? A) Trigeminal (V) B) Glossopharyngeal (IX) C) Hypoglossal (XII) D) Facial (VII)

125)

126) Which of the following could NOT be seen as one looks into the eye with an ophthalmoscope? A) fovea centralis B) optic disc C) macula lutea D) optic chiasma

126)

127) The cells of the retina in which action potentials are generated are the ________. A) rods and cones B) amacrine cells C) ganglion cells D) bipolar cells

127)

128) During dark adaptation, ________. A) the rate of rhodopsin breakdown is accelerated B) the sensitivity of the retina decreases C) the cones are activated D) rhodopsin accumulates in the rods

128)

129) Tinnitus, vertigo, and gradual hearing loss typify the disorder called ________. A) Ménière's syndrome B) strabismus C) motion sickness D) conjunctivitis

129)

130) Which of the following is NOT a characteristic of olfactory receptor cells? A) They have a short life span of about 60 days. B) They are chemoreceptors. C) They are unipolar neurons. D) They are ciliated.

130)

131) An essential part of the maculae involved in static equilibrium is (are) the ________. A) spiral organ (of Corti) B) otoliths C) scala media D) cupula

131)

132) What is the primary function of cerumen? A) prevents water from entering middle ear B) lubricates ossicles C) cleans and lubricates the external auditory canal D) softens tympanic membrane

132)

133) Which of the following is true about photoreceptors? A) If all cones are stimulated equally, all colors are absorbed by the cones and the color perceived is black. B) Three types of color-sensitive photoreceptors exist: red, green, and yellow. C) In dim light, images are focused directly on the rods in the fovea centralis. D) Rods absorb light throughout the visual spectrum but confer only gray tone vision.

133)

134) Select the correct statement about equilibrium. A) Cristae respond to angular acceleration and deceleration. B) Due to dynamic equilibrium, movement can be perceived if rotation of the body continues at a constant rate. C) Hair cells involved in both static and dynamic equilibrium hyperpolarize only, resulting in an increased rate of impulse transmission. D) The weight of the endolymph contained within the semicircular canals against the maculae is responsible for static equilibrium.

134)

135) The eye muscle that rotates the eye upward and turns the eye laterally is the ________. A) superior oblique B) inferior oblique C) medial rectus D) lateral rectus

135)

136) The receptor membranes of gustatory cells are ________. A) fungiform papillae B) taste buds D) gustatory hairs C) basal cells

136)

137) A perceived increase in the volume of sound is best explained by ________. A) an increase in the height of the sound wave B) a combination of multiple sound waves C) an increase in the width of the sound wave D) a decrease in the width of the sound wave

137)

138) Damage to the medial rectus muscles would probably affect ________. A) pupil constriction B) convergence C) accommodation D) refraction

138)

139) Which movement of ions produces EPSPs in cochlea hair cells? A) Influx of Na+ B) Efflux of Ca++ C) Efflux of K+ D) Influx of K+ and Ca++

139)

140) Fusing of the ossicles (otosclerosis) results in ________. A) Ménière's Syndrome B) sensorineural deafness C) conduction deafness D) tinnitus

140)

141) Visual processing in the thalamus does NOT contribute significantly to ________. A) depth perception B) night vision C) high-acuity vision D) movement perception

141)

142) The visible light portion of the electromagnetic spectrum fits between ________. A) UV and infrared waves B) infrared and microwaves C) microwaves and radio waves D) X-rays and UV waves

142)

143) Ceruminous glands are ________. A) modified apocrine sweat glands B) modified taste buds C) glands found in the lateral corners of your eye D) saliva glands found at the base of the tongue

143)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 144) High frequency sounds are detected when the basilar membrane is displaced near the ________.

144)

145) The synapse of the olfactory nerves with the mitral cells is called a(n) ________.

145)

146) The middle ossicle in the ear is the ________.

146)

147) The ________ nuclei are in the visual pathway and mediate the pupillary light reflexes.

147)

148) Taste is solely a response to chemicals dissolved in ________.

148)

149) Hot chili peppers contain a chemical compound called capsaicin that stimulate which type of receptor?

149)

150) The apex of the cochlea hears sounds in the range of ________ Hz.

150)

151) Describe the process of light and dark adaptation and include the role of the rods and cones.

151)

152) What is the chemical composition of the rod pigment, rhodopsin, and how does it appear to act in the reception of light?

152)

153) After head trauma from an automobile accident, a man has anosmia. Define anosmia. Why is this condition fairly common after such injuries and in cases of severe nasal cavity inflammation?

153)

154) Explain why your nose runs during and immediately after a good cry.

154)

155) Trace the pathway of sound as it enters the external ear until it is perceived in the brain.

155)

156) Explain the role of the endolymph of the semicircular canals in activating the receptors during angular motion.

156)

157) What two things does the ciliary body do?

157)

158) When you go to the fair and ride the roller coaster, where do those wild sensations come from?

158)

159) What is the pharyngotympanic tube and what is its purpose?

159)

160) Explain why prolonged periods of reading tire the eye muscles and result in eye strain.

160)

161) Distinguish between the maculae and cristae ampullaris in terms of their sensory reception.

161)

162) Explain why a bad cold can result in food not tasting the same as it normally does.

162)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 163) Roger went for his yearly eye examination and was informed that his intraocular pressure was slightly elevated (at 22 mm Hg). The physician expressed concern over this condition and noted that if the condition got worse, eye drops would be merited. What is wrong with Roger's eyes, and what are the possible consequences of this condition? Explain the function of eye drops used for therapy. 164) Baby Susie's pediatrician notices that one of her eyes rotates outward and that she does not appear to be using it for vision. What is her condition and what does the pediatrician recommend? 165) A 60-year-old woman is experiencing vertigo. She ignores the symptoms initially, but now her attacks are accompanied by severe nausea and vomiting. Following an attack, she hears a roaring in her ears that causes temporary deafness for some time after. What do you think her problem is, and what is its suspected cause? 166) Ling, a 75-year-old grandmother, complained that her vision was becoming obscured. Upon examination by an ophthalmologist she was told she had cataracts. What are they, how do they occur, and how are they treated? 167) A nurse is administering Pilocarpine eye drops. The nurse instructs the patient to press on the nasolacrimal duct for 30 seconds because the medication can have some systemic side effects, such as affecting the heart rate. Explain the rationale for pressing on the nasolacrimal duct.

Answer Key Testname: UNTITLED15

1) E 2) C 3) A 4) D 5) B 6) A 7) B 8) D 9) E 10) C 11) C 12) B 13) A 14) E 15) D 16) A 17) E 18) C 19) B 20) D 21) B 22) D 23) A 24) B 25) A 26) C 27) C 28) A 29) D 30) B 31) B 32) D 33) C 34) B 35) A 36) B 37) A 38) E 39) G 40) C 41) H 42) D 43) F 44) B 45) C 46) A 47) C 48) C 49) TRUE 50) FALSE 18

Answer Key Testname: UNTITLED15

51) FALSE 52) TRUE 53) TRUE 54) FALSE 55) TRUE 56) FALSE 57) FALSE 58) FALSE 59) FALSE 60) FALSE 61) TRUE 62) FALSE 63) TRUE 64) TRUE 65) FALSE 66) TRUE 67) TRUE 68) TRUE 69) TRUE 70) FALSE 71) FALSE 72) C 73) C 74) A 75) D 76) D 77) D 78) B 79) D 80) B 81) A 82) A 83) D 84) C 85) B 86) A 87) C 88) B 89) D 90) D 91) A 92) B 93) C 94) D 95) A 96) B 97) B 98) B 99) A 100) D 19

Answer Key Testname: UNTITLED15

101) A 102) A 103) D 104) B 105) A 106) B 107) D 108) A 109) C 110) B 111) D 112) D 113) B 114) A 115) B 116) C 117) A 118) C 119) A 120) D 121) D 122) D 123) C 124) C 125) D 126) D 127) C 128) D 129) A 130) C 131) B 132) C 133) D 134) A 135) B 136) D 137) A 138) B 139) D 140) C 141) B 142) A 143) A 144) base 145) glomerulus 146) incus 147) pretectal 148) saliva 149) Nociceptors 150) 20 20

Answer Key Testname: UNTITLED15

151) Rods respond to low-intensity light that provides night and peripheral vision, while cones are bright-light, high-discrimination receptors that provide color vision. During light adaptation, rods are inactivated and as cones respond to the high-intensity light, high visual acuity results. In dark adaptation, cones do not function (visual acuity decreases) and rod function resumes when sufficient rhodopsin accumulates. 152) Rhodopsin is a combination of retinal and opsin. Retinal is chemically related to vitamin A and is synthesized from it. Retinal can form a variety of three-dimensional forms called isomers. The opsin protein combines with the 11-cis retinal to form rhodopsin. The light-triggered changes in retinal cause hyperpolarization of the rods. This happens because the light turns off sodium entry, which then inhibits the release of neurotransmitter, thus turning off electrical signals. 153) Anosmia means the loss of chemical sense of smell due to some olfactory disorder. Most anosmia results from head injuries or nasal cavity inflammations, allergies, smoking, and aging. The olfactory pathways are very sensitive to irritations or to damage, especially if the ethmoid bones have been damaged due to trauma. 154) The tears flow into the lacrimal canaliculi and then into the nasolacrimal sac. As the sac fills, the tears begin to run down the nasolacrimal duct and out your nose. 155) A sound wave passing through the external acoustic meatus causes the eardrum to vibrate at the same frequency as the wave. The auditory ossicles amplify and deliver vibrations to the oval window. Pressure waves in the cochlear fluids cause basilar membrane resonance that stimulates the hair cells of the spiral organ (of Corti). Impulses are then generated along the cochlear nerve that travel to the cochlear nuclei of the medulla and, from there, through several brain stem nuclei to the auditory cortex of the brain. 156) The crista ampullaris responds to changes in the velocity of head movement (angular acceleration). The crista consists of a tuft of hair cells whose microvilli are embedded in the gelatinous cupula. Rotational movement causes the endolymph to flow in the opposite direction, thus bending the cupula and exciting the hair cells. 157) 1. Constriction of the ciliary muscle that is attached to the lens via the ciliary zonule causes the lens to change shape. 2. The epithelium of the ciliary body secretes aqueous humor. 158) The wild sensations occur when the receptor for dynamic equilibrium, the crista ampularis, is excited by endolymph moving in the semicircular canals. This movement is the result of rotational acceleration or deceleration. Many times these wild rides spin us around enough that our eyes tell us we are going one way but the vestibule and semicircular canal tell us something different. Conflicts like that can often cause us to get quite dizzy or even sick. 159) The pharyngotympanic tube links the middle ear cavity with the nasopharynx. Normally it is flattened and closed, but swallowing or yawning opens it briefly to equalize pressure in the middle ear cavity with external air pressure. It also replenishes air in the middle ear. 160) Reading or other close work requires almost continuous accommodation, pupillary constriction, and convergence, which lead to tiredness of the eye muscles. 161) Maculae are sensory receptors for static equilibrium. They monitor the position of the head in space by responding to linear acceleration forces. Cristae ampullaris respond to rotary (angular) movements. 162) Taste is 80% smell. When the ability to smell is blocked due to nasal congestion, taste is primarily via the taste receptors which account for only about 20% of the taste sensation. This results in a distinct difference in the "taste" of food. Additionally, you become a mouth breather and the oral mucosa becomes dry and reduces the ability to taste 163) If the drainage of the aqueous humor is blocked, pressure within the eye can increase, causing compression of the retina and optic nerve, resulting in a condition called glaucoma. The resulting destruction of the neural structures causes blindness unless the condition is detected early. Early glaucoma can be treated with eye drops that increase the rate of aqueous humor drainage or decrease its production. 164) Susie has strabismus, caused by congenital weakness of the external eye muscles in her affected eye. To prevent this eye from becoming functionally blind, the doctor will recommend either eye exercises or putting a patch on the unaffected eye to force her to use the affected eye. If her case is deemed severe, surgery on the eye muscles will be recommended.

Answer Key Testname: UNTITLED15

165) She most likely has a condition known as Ménière's syndrome. It affects both the semicircular canals and the cochlea. The cause of the syndrome is uncertain, but it may result from distortion of the membranous labyrinth by excessive endolymph accumulation. Less severe cases can usually be managed by antimotion drugs. For more debilitating attacks, salt restriction and diuretics are used to decrease overall extracellular fluid volumes. Also, wearing a visor (baseball hat) reduces the visual field and allows the person to enhance their depth perception and reduce the dizziness. 166) A cataract is a clouding of the lens that causes the world to appear distorted, as if looking through frosted glass. Some cataracts are congenital, but most are due to age-related hardening and thickening of the lens, or are a possible consequence of diabetes mellitus. The direct cause is probably inadequate delivery of nutrients to the deeper lens fibers. The metabolic changes that result are thought to promote unfolding of the lens proteins. Unprotected exposure to the UV rays of sunlight over time is also associated with cataract formation. The lens can be removed and replaced with an artificial lens. 167) Applying gentle pressure to the nasolacrimal duct prevents the delivery of the drug to the nasal mucosa and general circulation, where it may affect heart rate.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 16.1 Using Figure 16.1, match the following: 1) Produces the hormones that promote the development of the female secondary sexual characteristics at puberty.

2) Storehouse for the hormones produced by the hypothalamus of the brain.

3) Produces the hormones that direct the production of the secondary male sex characteristics.

4) Produce hormones involved in electrolyte balance and the stress response.

5) Produces hormones and is considered a neuroendocrine organ.

Figure 16.2 Using Figure 16.2, match the following anterior pituitary hormones with their targets: 6) Growth hormone.

7) Follicle stimulating hormone.

8) Prolactin.

9) Adrenocorticotropic hormone.

10) Thyroid stimulating hormone.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) An autoimmune problem involving the thyroid gland.

A) Pituitary dwarfism

11)

B) Acromegaly 12) Hyposecretion of growth hormone.

12) C) Graves' disease

13) Hyposecretion of the pancreas.

13) D) Diabetes mellitus

14) Hyposecretion of the adrenal cortex.

14) E) Addison's disease

15) Hypersecretion of growth hormone that occurs during adulthood.

15)

Match the following: 16) Hyposecretion of the thyroid in adults.

A) Myxedema

16)

B) Gigantism 17) Hypersecretion of the adrenal cortex.

17) C) Cretinism

18) Hypersecretion of growth hormone during childhood.

18) D) Cushing's disease

19) Hyposecretion of the thyroid in infants.

19)

Match the following: 20) The size and shape of a pea; produces hormones that stimulate other endocrine glands.

A) Thyroid gland

21) Is part of the sympathetic nervous system.

C) Pancreas

22) Produces hormones that regulate glucose levels in the body.

20)

B) Parathyroid glands 21)

D) Adrenal medulla 22) E) Pituitary gland (hypophysis)

23) Primary regulators of blood calcium levels.

23)

24) Produces the body's major metabolic hormones.

24)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 16.3 Using Figure 16.3, match the following: 25) Mainly produces glucocorticoids.

25)

26) Produces epinephrine.

26)

27) Produces aldosterone.

27)

28) Excess hormone levels from this region result in Cushing's syndrome.

28)

29) Hormones mimic sympathetic nervous system neurotransmitters.

29)

30) Mainly produces small amounts of gonadocorticoids.

30)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 31) Testosterone production.

A) Hormonal stimulus

31)

32) Epinephrine production.

A) Hormonal stimulus

33) Aldosterone production.

B) Neural stimulus

34) Parathyroid hormone production.

C) Humoral stimulus

32) 33) 34)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 35) The pineal gland is used as a brain orientation reference landmark for brain X-rays.

35)

36) Calcitonin is the main regulator of blood calcium levels.

36)

37) The hormone that raises blood sugar levels is insulin.

37)

38) The number of receptors for a particular hormone can change due to consistently high or low levels of that hormone, which is referred to as up- and down-regulation.

38)

39) Both "turn on" factors (hormonal, humoral, and neural stimuli) and "turn off" factors (feedback inhibition and others) may be modulated by the activity of the nervous system.

39)

40) ACTH stimulates the adrenal cortex to release corticosteroid hormones.

40)

41) LH is also referred to as a gonadotropin.

41)

42) Insufficient dietary iodine can cause Graves' disease.

42)

43) Oxytocin is a strong stimulant of uterine contractions.

43)

44) Enteroendocrine cells of the GI tract produce some hormones that are chemically identical to neurotransmitters.

44)

45) Type 2 diabetes mellitus may reflect declining receptor sensitivity to insulin rather than decreased insulin production.

45)

46) The prime metabolic effect of cortisol is gluconeogenesis.

46)

47) The beta cells in the pancreatic islets produce insulin.

47)

48) Most type 2 diabetics do NOT produce insulin.

48)

49) Cyclic AMP (cAMP), diacylglycerol (DAG), inositol triphosphate (IP 3 ), and calcium ions can serve

49)

as second messengers. 50) Atrial natriuretic peptide is a hormone that controls blood pressure in part by increasing the urinary excretion of sodium.

50)

51) Hypersecretion of catecholamines (epinephrine and norepinephrine) can result in hypertension.

51)

52) Thyroid hormone production requires the presence of both iodine and calcium.

52)

53) Many hormones synthesized in the gastrointestinal tract are chemically identical to brain neurotransmitters.

53)

54) Oxytocin and ADH are produced in the posterior pituitary.

54)

55) Iodine is an essential element required for the synthesis of thyroxine.

55)

56) The endocrine gland that is probably malfunctioning if a person has a high metabolic rate is the parathyroid.

56)

57) Growth hormone solely exerts its influence by targeting other endocrine glands to produce hormones.

57)

58) Glucocorticoids are steroid hormones that usually enhance the immune responses when an individual is suffering from severe stress.

58)

59) Direct gene activation involves a second-messenger system.

59)

60) All amino acid-based hormones are lipid soluble and can cross the plasma membrane.

60)

61) All anterior pituitary hormones EXCEPT growth hormone affect their target cells via a cyclic AMP second-messenger system.

61)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 62) Gluconeogenesis, the formation of glucose from fats and proteins, is due to the action of ________. A) aldosterone B) secretin C) insulin D) cortisol

62)

63) Normal development of the immune response is due in part to hormones produced by the ________. A) pancreas B) thymus gland C) thyroid gland D) adrenal medulla

63)

64) Virtually all amino acid-based hormones exert their signaling effects through intracellular ________. A) deactivating ions B) calcium C) second messengers D) nucleotides

64)

65) Which of the following is NOT a category of endocrine gland stimulus? A) neural B) hormonal C) humoral

65) D) enzymatic

66) Chemical substances secreted by cells into the extracellular fluids that travel through the blood and regulate the metabolic function of other cells in the body are called ________. A) hormones B) antibodies C) enzymes D) proteins

66)

67) The hypothalamic-hypophyseal tract ________. A) runs through the infundibulum B) connects the hypophysis to the pituitary gland C) is the site of prolactin synthesis D) conducts aldosterone to the hypophysis

67)

68) Which of the following is NOT a cardinal sign of diabetes mellitus? A) polyuria B) polyphagia C) polydipsia

68) D) polycythemia

69) Which of the following can act on receptors inside the target cell that directly activate specific genes? A) testosterone B) calcitonin C) growth hormone D) melatonin

69)

70) Oxytocin ________. A) exerts its most important effects during menstruation B) controls milk production C) release is an example of a positive feedback control mechanism D) is an anterior pituitary secretion

70)

71) Antidiuretic hormone (ADH) ________. A) secretion is inhibited by alcohol C) increases urine production

71) B) promotes dehydration D) is produced by the anterior pituitary

72) Enterochromaffin-like cells of the gastric mucosa can be triggered to release histamine. Histamine, in this case, causes nearby parietal cells of the stomach lining to produce hydrochloric acid. The effect of histamine on parietal cells would best be described as a(n) ________. A) second messenger B) paracrine C) exocrine D) autocrine

72)

73) Which of the following is NOT a change typically produced by a hormonal stimulus? A) activates or deactivates enzymes B) alters plasma membrane permeability C) induces secretory activity D) stimulates production of an action potential

73)

74) Which of the following hormones suppresses appetite and increases energy expenditure? A) secretin B) leptin C) aldosterone D) gastrin

74)

75) Which of the following is NOT a change that may be caused by hormonal stimulus? A) stimulation of mitosis B) an increase in enzyme synthesis C) direct control of the nervous system D) a change in membrane potential

75)

76) The ability of a specific tissue or organ to respond to the presence of a hormone is dependent on ________. A) the membrane potential of the cells of the target organ B) the location of the tissue or organ with respect to the circulatory path C) the presence of the appropriate receptors on the cells of the target tissue or organ D) nothingall hormones of the human body are able to stimulate any and all cell types because hormones are powerful and nonspecific

76)

77) Several hormones are synthesized in the hypothalamus and transported to the anterior pituitary gland. The mechanism of transportation from hypothalamus to anterior pituitary gland is through the ________. A) hypophyseal portal system B) feedback loop C) general circulatory system D) hepatic portal system

77)

78) The posterior lobe of the pituitary gland is NOT a true endocrine gland because ________. A) it is strictly a part of the neural system and has little or nothing to do with hormonal release B) it is only a hormone storage area that receives hormones from the hypothalamus for release C) it is unable to function as an endocrine tissue because it is actually part of the neural system due to its location D) embryonically it was an endocrine tissue, but in the adult human it is no longer functional

78)

79) Steroid hormones exert their action by ________. A) binding cell receptors and initiating cAMP activity B) activating the hypothalamic release of regulating hormones C) entering the cell and activating mitochondrial DNA D) entering the nucleus of a cell and initiating or altering the expression of a gene

79)

80) The second-messenger mechanism of hormone action operates by ________. A) altering gene expression in the nuclear DNA B) increasing the basal metabolic rate in the target organ C) synthesizing more than one hormone at a time D) binding to specific receptors and employing the services of G proteins and cAMP

80)

81) Hormones often cause a cell to elicit multiple responses; this is because ________. A) the protein kinases are rapidly metabolized into functional amino acids B) the receptors bind to several hormones at the same time C) there are thousands of receptors on the cell membrane D) during protein kinase activation, enzymes phosphorylate many other enzymes

81)

82) Which of the following statements is true of amino acid-based hormones? A) They require a receptor in the plasma membrane. B) They cross the plasma membrane. C) They are lipid soluble. D) They are synthesized from cholesterol.

82)

83) Thyroid hormone (a small iodinated amine) enters target cells in a manner similar to ________. A) glucagon, because the structure of glucagon is similar to that of thyroid hormone B) insulin, because insulin is a small peptide C) growth hormone, because the thyroid works synergistically with thyroid hormone D) steroid hormones, because both diffuse easily into target cells

83)

84) Which anterior pituitary hormone does NOT target another endocrine gland? A) luteinizing hormone(LH) B) adrenocorticotropic hormone (ACTH) C) follicle-stimulating hormone (FSH) D) growth hormone (GH)

84)

85) One of the least complicated of the endocrine control systems directly responds to changing blood levels of ions and nutrients. Which of the following describes this mechanism? A) neural stimulation B) humoral stimulation C) protein synthesis D) catabolic inhibition

85)

86) The major targets of growth hormone are ________. A) the blood vessels C) the thyroid and adrenal glands

86) B) liver, bones, and skeletal muscles D) the liver and gall bladder

87) Which of the following is NOT a parathyroid gland mechanism to maintain adequate levels of blood calcium? A) increased intestinal absorption of calcium ions B) activation of osteoclasts C) inhibition of calcitonin synthesis D) increased calcium ion reabsorption by the kidneys

87)

88) Which organ is responsible for synthesizing the hormone atrial natriuretic peptide (ANP)? A) the skin B) the heart C) the spleen D) the kidney

88)

89) Mineralocorticoid is to aldosterone as glucocorticoid is to ________. A) epinephrine B) estrogen C) testosterone

89) D) cortisol

90) Leptin is secreted by ________. A) adipose cells B) lymphocytes

D) goblet cells

90) C) fibroblasts

91) Which of the following is NOT a component of the cyclic AMP signaling mechanism? A) steroid B) G protein C) hormone receptor D) effector enzyme

91)

92) Which of the following is NOT a steroid-based hormone? A) estrogen B) epinephrine C) cortisol

92) D) aldosterone

93) The single most important regulator of calcium levels in the blood is ________. A) thyroid hormone B) calcitonin C) parathyroid hormone D) gonadotropic hormones

93)

94) Hormones that bind to plasma proteins ________. A) are usually synthesized from cholesterol B) are usually made of amino acids C) are usually water soluble D) must also bind to plasma membrane receptors

94)

95) Regulating hormones from the hypothalamus ________. A) first enter into the hypophyseal portal system B) enter venous circulation and travel to the heart, which pumps the hormone-containing blood to the pituitary C) enter the hepatic portal system, which feeds the pituitary D) travel by arteries to the pituitary

95)

96) The effect of a hormone on a target cell may be decreased by the presence of ________. A) permissive hormones B) synergistic hormones C) antagonistic hormones D) plasma membrane receptors

96)

97) Aldosterone ________. A) is secreted by the posterior pituitary B) functions to increase sodium reabsorption C) production is greatly influenced by ACTH D) presence increases potassium concentration in the blood

97)

98) Which of the following is NOT a step in thyroxine (T4) production? A) the binding of iodine to tyrosines in the colloid B) the diffusion of iodide from blood plasma into the follicular cell C) the linking of two diiodotyrosine (DIT) molecules in the colloid D) the production of thyroglobulin by follicular cells

98)

99) In circumstances where the body requires prolonged or increased levels of a hormone, the DNA of target cells will specify the synthesis of more receptors on the surface of the cells of the target organ. This is known as ________. A) sensitivity increase B) cellular affinity C) a stressor reaction D) up-regulation

99)

100) A release of parathyroid hormone (PTH) will trigger ________. A) a reduction of calcium reabsorption in the kidney tubules B) increased activation of vitamin D by the kidney C) increased osteoblast activity D) a drop in blood calcium levels

100)

101) A man has been told that he is NOT synthesizing enough follicle -stimulating hormone (FSH), and for this reason he may be unable to father a child. Choose the correct statement to explain this problem. A) A hormone made in the anterior pituitary cannot influence fertility. B) FSH stimulates estrogen secretion by ovarian cells; therefore, it is not synthesized by males. C) The man must be producing progesterone, which inhibits the synthesis of FSH. D) FSH stimulates sperm production in the testes.

101)

102) Thyroxine is a peptide hormone, but its mechanism is different from other peptide hormones. Which of the following statements is true concerning this difference? A) It is a stimulant of cellular metabolism and targets all cells. B) It is very specific in the cell type it targets. C) It does not require a second messenger to cause a response. D) It causes positive feedback.

102)

103) How do glucocorticoids enable the body to deal appropriately with stress? A) by stimulating the pancreas to release insulin B) by increasing blood glucose, fatty acid, and amino acid levels and enhancing blood pressure C) by decreasing the heart rate, thus decreasing blood pressure D) by releasing the neurotransmitters that prepare the body for the stress response

103)

104) What ion is sometimes used as a second messenger of amino acid -based hormones? A) calcium B) iron C) sodium D) chlorine

104)

105) John tells you that cholesterol is bad and should be eliminated from your diet. You explain to him that cholesterol is important. Which of the following hormones is synthesized from cholesterol? A) growth hormone B) thyroxine C) oxytocin D) testosterone

105)

106) Which hormone has only one known effect: to stimulate milk production by the breasts? A) prolactin B) oxytocin C) progesterone D) estrogen

106)

107) Which of the following is correctly matched? A) adrenal medulla — glucocorticoids B) zona fasciculata — mineralocorticoids C) zona glomerulosa — epinephrine and norepinephrine D) zona reticularis — gonadocorticoids

107)

108) The parathyroid glands respond to which type of stimulus? A) positive B) hormonal C) humoral

108) D) neural

109) Dave has discovered a new lipid-soluble hormone. Which of the following is true regarding this hormone? A) will be bound to a transport protein in the blood B) can be stored in secretory vesicles C) will likely act through a second-messenger system D) receptor will be located on the plasma membrane

109)

110) During an afternoon class, Lisa starts to feel hungry and worries that her blood sugar level may be dropping. Which hormone is helping to prevent a drop in blood sugar level? A) insulin B) aldosterone C) thyroxine D) glucagon

110)

111) Upon landing at the airport in Lagos, Nigeria, Eric feels wide awake even though the local time is 11pm. Which synthetic hormone supplement could he administer to help adjust to the new time zone? A) glucagon B) insulin C) growth hormone D) melatonin

111)

112) At age 85, Lyle's immune system does not respond to vaccines as well as it did when he was younger. The atrophy of which endocrine gland is likely responsible for this? A) thymus B) thyroid C) anterior pituitary D) adrenal

112)

113) Johanna, a 7-year-old girl, is significantly shorter than normal for her age. Her doctor recommends treatment with a hormone before her growth plates ossify in her long bones. Which hormone is recommended? A) growth hormone B) cortisol C) parathyroid hormone D) thyroid stimulating hormone

113)

114) As a result of stress, the anterior pituitary releases ________, which stimulates release of hormones from the adrenal cortex that retain sodium and water, increase blood sugar, and begin breaking down fats. A) ACTH B) ADH C) thyroid stimulating hormone D) growth hormone

114)

115) Melatonin ________. A) is responsible for regulating the sleep cycle B) triggers sexual maturation and puberty C) is at its highest levels at around noon D) is produced by the parathyroid glands

115)

116) Glucagon ________. A) stimulates the absorption of glucose from the blood B) is considered a hypoglycemic hormone C) triggers the conversion of glucose into glycogen D) triggers gluconeogenesis

116)

117) Which of the following is NOT a typical result of a long -term stress response? A) impaired immune function B) decreased production of glucocorticoids C) elevated blood pressure D) loss of muscle mass

117)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 118) Compare the structure and function of endocrine and exocrine glands.

118)

119) Why should the hypothalamus instead of the anterior pituitary be called the "master endocrine gland"?

119)

120) Why would one NOT expect to continue increasing in height with age?

120)

121) A woman with excessive body hair, a deep voice, and an enlarged clitoris shows the outward symptoms of which hormonal dysfunction?

121)

122) A person who drinks a lot of alcoholic beverages must urinate frequently. Why?

122)

123) What is the role of hormone producing cells found within the heart?

123)

124) List three factors that target cell activation depends on, after the hormone binds to the receptor.

124)

125) Glucagon and insulin both target the cells of the liver and are both made in the pancreas, yet they have very different effects on the cells they target. What accounts for this fact?

125)

126) Explain how parathyroid hormone (PTH) acts to increase blood calcium ion levels.

126)

127) List the four mechanisms involved in the regulation of aldosterone secretion.

127)

128) What is the difference between autocrines and paracrines?

128)

129) Define synergism in hormone interaction at target cells and give an example.

129)

130) While visiting another country, you notice many individuals with iodine -deficiency goiters. Describe the feedback loop responsible for these goiters.

130)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 131) Mrs. James appeared at the clinic complaining of extreme nervousness and sweating, saying that she could feel and hear her heart thumping when she tried to sleep at night. She was found to have a severely elevated and fluctuating blood pressure. Although laboratory testing revealed hyperglycemia and increased basal metabolic rate, tests of thyroid function were normal. What is your diagnosis? What treatment should be used? 132) Mr. Sanchez makes an appointment to see his doctor for pain in his abdominal area. Tests and X -rays reveal kidney stones as well as bones with a moth-eaten appearance. Physical exam reveals hyporeflexia and hypotonia (weakness). What is the problem and what treatment would be recommended? 133) It was often rumored that one of our deceased presidents was suffering from Addison's disease (inadequate synthesis of mineralocorticoids and glucocorticoids). What symptoms may have led to the diagnosis of this condition? 134) Following workup for symptoms of decreased libido and erectile dysfunction, a patient is told that his pituitary is hypersecreting prolactin. Is there need for concern about this young man? 135) The parents of a 17-year-old boy are concerned about his height because he is only 5 feet tall and they are both close to 6 feet tall. After tests by their doctor, a certain hormone is prescribed for the boy. What is the probable diagnosis, and what hormone was prescribed? Why might the child still expect to reach his growth potential? 136) John is a 26-year-old man who begins to notice a progressive enlargement of feet, hands, cranium, nose, and lower jaw bone. His doctor recommends a pituitary gland operation. What is the most likely diagnosis? Why? 137) Explain how antidiuretic hormone can help regulate an abnormal increase in solute concentration in the extracellular fluid. 138) What is the most important nursing intervention when caring for a patient with Cushing's syndrome? 139) A 25-year-old male was admitted to the medical/surgical unit with a blood glucose of 600 mg/dl. On assessment, the nurse observed his breathing was deep and rapid, and his breath smelled of acetone. His face was flushed and his skin was dry. His pH was low. Describe the physiological response that is occurring. 140) Thomas is a diabetic. While at work, he began to tremble, was somewhat disoriented, and showed signs similar to that of a drunk. One of his colleagues gave him some hard candy, which seemed to help him return to normal functions. Why? Was this a proper action, considering that Thomas is diabetic?

Answer Key Testname: UNTITLED16

1) D 2) B 3) E 4) C 5) A 6) A 7) C 8) B 9) E 10) D 11) C 12) A 13) D 14) E 15) B 16) A 17) D 18) B 19) C 20) E 21) D 22) C 23) B 24) A 25) B 26) D 27) A 28) B 29) D 30) C 31) A 32) B 33) A 34) C 35) TRUE 36) FALSE 37) FALSE 38) TRUE 39) TRUE 40) TRUE 41) TRUE 42) FALSE 43) TRUE 44) TRUE 45) TRUE 46) TRUE 47) TRUE 48) FALSE 49) TRUE 50) TRUE 14

Answer Key Testname: UNTITLED16

51) TRUE 52) FALSE 53) TRUE 54) FALSE 55) TRUE 56) FALSE 57) FALSE 58) FALSE 59) FALSE 60) FALSE 61) TRUE 62) D 63) B 64) C 65) D 66) A 67) A 68) D 69) A 70) C 71) A 72) B 73) D 74) B 75) C 76) C 77) A 78) B 79) D 80) D 81) D 82) A 83) D 84) D 85) B 86) B 87) C 88) B 89) D 90) A 91) A 92) B 93) C 94) A 95) A 96) C 97) B 98) B 99) D 100) B 15

Answer Key Testname: UNTITLED16

101) D 102) C 103) B 104) A 105) D 106) A 107) D 108) C 109) A 110) D 111) D 112) A 113) A 114) A 115) A 116) D 117) B 118) Endocrine glands are ductless glands that release hormones into the surrounding tissue fluid; the hormones diffuse into the blood to be transported to target cells throughout the body. Exocrine glands have ducts through which products (such as sweat or saliva) are released to a membrane surface. 119) Although the anterior pituitary produces hormones that regulate other endocrine glands, the hypothalamus controls anterior pituitary activity through releasing and inhibiting hormones. 120) The amount of growth hormone secreted declines with age and the closure of the epiphyseal plates prohibits further growth in length of the long bones. 121) The hormonal dysfunction is hypersecretion of androgens. 122) The function of ADH is to increase water reabsorption in the kidneys, producing concentrated urine. Alcohol inhibits ADH secretion, causing copious urine output. 123) In response to high blood pressure, a few cardiac cells secrete atrial natriuretic peptide (ANP), which helps regulate salt output by the kidney. In the kidney, ANP inhibits sodium ion reabsorption and renin release. In the adrenal cortex, ANP inhibits secretion of aldosterone. These effects reduce blood volume and blood pressure. 124) Interaction depends on (1) blood levels of the hormone, (2) relative numbers of receptors for that hormone on or in the target cells, and (3) the affinity (strength) of the binding between the hormone and the receptor. 125) Glucagon and insulin use different cell surface receptors. 126) Parathyroid hormone stimulates osteoclasts (bone resorbing cells) to liberate calcium from bone into the blood. PTH also increases calcium reabsorption by the kidneys as well as calcium absorption by the small intestine through promotion of vitamin D activation. 127) The four mechanisms are: (1) the renin-angiotensin mechanism, (2) plasma concentration of sodium and potassium ions, (3) control exerted by ACTH, and (4) plasma concentration of atrial natriuretic peptide. 128) Autocrines are self-regulating chemical messengers because their target is the cell from which they are manufactured. Paracrines are chemical messengers that act locally. They tend to affect only the cells immediately around them. 129) Synergism occurs when more than one hormone produces the same effects at the target cell and their combined effects are amplified. For example, the liver will release glucose in the presence of glucagon or epinephrine. If both hormones are present, the amount of glucose released is increased 150%. 130) Upon detecting low levels of thyroid hormone in the blood, the hypothalamus uses a releasing hormone to signal to the anterior pituitary to produce thyroid stimulating hormone (TSH). The effect of TSH is to ramp up production of thyroid hormone in the thyroid gland. Iodine is required for functional thyroid hormone. Lack of iodine causes the continued effort by the thyroid to increase production (goiter) as the hypothalamus continues to stimulate TSH production. 131) The diagnosis is hypersecretion of catecholamines (epinephrine and norepinephrine), sometimes arising from a rare chromaffin cell tumor called a pheochromocytoma. Treatment is surgical removal of the tumor. 16

Answer Key Testname: UNTITLED16

132) The problem is hyperparathyroidism resulting from a parathyroid gland tumor. The treatment is removal of the tumor. 133) Low body weight, low plasma glucose and sodium levels, high potassium levels, hypotension, severe dehydration, and hypotension might all have been observed in the patient. 134) Yes; there should be great concern, because hypersecretion of prolactin will lead to impotence. 135) The diagnosis is insufficient growth hormone. The prescription is synthetic growth hormone. The reason the child might reach his growth potential is that the epiphyseal plates of the long bones have not yet closed, allowing additional growth of the long bones. 136) The diagnosis is acromegaly. The condition results from excess secretion of growth hormone from the pituitary gland postpuberty and after the epiphyseal plates of the long bones have fused. 137) The release of antidiuretic hormone can regulate an increase in solute concentration by causing reabsorption of water by the kidney. With reabsorption, blood water volume increases, decreasing solute concentration. 138) Because of enhanced anti-inflammatory effects, infections may become overwhelmingly severe. Therefore, the nurse should warn the patient to avoid shaving nicks and other sources of infection. 139) In severe cases of diabetes mellitus, blood levels of fatty acids and their metabolites rise dramatically. The fatty acid metabolites, collectively called ketones, are strong organic acids. When they accumulate faster than they are used or excreted, the blood pH drops, resulting in ketoacidosis, and ketones begin to spill into the urine. The nervous system responds by initiating rapid deep breathing to blow off carbon dioxide from the blood and increase pH. 140) Thomas was suffering from hypoglycemia. The low blood sugar level affected his brain resulting in his appearance of being drunk. The candy raised his blood sugar back up to a normal level. This was a proper action because he was hypoglycemic; the brain needs constant glucose levels for normal function.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 17.1 Using Figure 17.1, match the following: 1) Monocyte.

2) Lymphocyte.

3) Eosinophil.

4) Neutrophil.

5) A granulocyte, phagocyte and the most common white blood cell found in whole blood.

6) Mounts a humoral immune response by producing antibodies.

7) Releases granules that kill parasitic worms.

8) When activated, becomes a macrophage that fights infection.

9) Main bacteria killer during acute infections.

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 10) Nucleus has two lobes; contains granules of lysosomal enzymes; functions in attacking parasitic worms and plays complex roles in inflammatory diseases like allergies and asthma. 11) Nucleus is multilobed; functions as a phagocyte; contains fine indistinct granules.

A) Basophil

10)

B) Monocyte C) Erythrocyte D) Neutrophil 11) E) Eosinophil

12) Transports CO2 and oxygen.

12)

13) Contains a U- or an S-shaped nucleus; granules stain very dark; releases histamine and heparin.

13)

14) Largest of the WBCs become macrophages associated with chronic infections.

14)

Match the following: 15) The major contributor to plasma osmotic pressure.

A) Organic nutrients

15)

B) Fibrinogen 16) Thrombin catalyzes the activation of these molecules present in plasma. 17) Precursor to the structural framework of a blood clot.

16) C) Electrolytes D) Albumin

18) Makes up most of plasma protein.

17)

18)

19) Material absorbed from the digestive tract, including simple sugars, amino acids, and fatty acids.

19)

20) Ions in the plasmalike sodium, potassium, and chloride ions.

20)

Match the following: 21) Main contributor to osmotic pressure.

A) Alpha and beta globulins

22) Antibodies released by plasma cells during immune response.

B) Gamma globulins

21) 22)

C) Albumin 23) Necessary for coagulation.

23) D) Fibrinogen

24) Transport proteins like transferrin (that carries iron ions) or others that bind to lipids or fat-soluble vitamins.

24)

Match the following: 25) Polymorphonuclear leukocyte.

A) Hemoglobin

26) White blood cell without cytoplasmic granules.

B) Monocyte

25) 26)

C) Factor VIII 27) Protein capable of changing shape and color in the presence of O2 . 28) Adverse reaction of donor blood cells with recipient plasma.

27) D) Neutrophil E) Agglutination

29) Lacking in hemophilia type A.

28)

29)

Match the following: 30) Produced by platelets.

A) Spectrin

31) A fibrous protein that gives shape to an RBC plasma membrane.

B) Prostaglandin derivates such as Thromboxane A2

31)

32) Hormone that stimulates production of RBCs.

C) Heparin

32)

30)

D) Interleukins and CSFs 33) Stimulates WBC production.

33) E) Erythropoietin

34) Natural anticoagulant found in basophils.

34)

Figure 17.2 Using Figure 17.2, match the following: 35) Type O.

A) B

36) Type A.

B) A

37) Type AB.

C) D

38) Type B.

D) C

39) Universal donor.

E) D (O negative)

40) Universal recipient.

F) A (AB positive)

35) 36) 37) 38) 39) 40)

Match the following: 41) Cancerous condition involving white blood cells.

A) Thrombocytopenia

41)

B) Embolism 42) Condition in which blood has abnormally low oxygen-carrying capacity. 43) Abnormal excess of erythrocytes resulting in an increase in blood viscosity.

42) C) Leukemia D) Anemia 43) E) Polycythemia

44) Free-floating thrombus in the bloodstream.

44)

45) Platelet deficiency resulting in spontaneous bleeding from small blood vessels seen as petechiae on the skin.

45)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 46) The primary source of RBCs in the adult human being is the bone marrow in the shafts of the long bones.

46)

47) Leukemia refers to cancerous conditions involving white blood cells.

47)

48) The immediate response to blood vessel injury is clotting.

48)

49) The process of fibrinolysis disposes of bacteria when healing has occurred.

49)

50) The normal RBC "graveyard" is the liver.

50)

51) Hemorrhagic anemias result from blood loss.

51)

52) White blood cells are produced through the action of colony-stimulating factors.

52)

53) When erythrocytes are destroyed, some of the heme is converted into bilirubin and then secreted as bile.

53)

54) Hemoglobin is made up of the protein heme and the red pigment globin.

54)

55) Myeloid stem cells give rise to all leukocytes.

55)

56) Each hemoglobin molecule can transport two molecules of oxygen.

56)

57) Diapedesis is the process by which red blood cells move into tissue spaces from the interior of blood capillaries.

57)

58) Positive chemotaxis is a feedback system that signals leukocyte migration into damaged areas.

58)

59) Clotting factor activation turns clotting factors into enzymes.

59)

60) Basophils increase in number when parasitic invasion occurs.

60)

61) Leukopenia is an abnormally low number of leukocytes.

61)

62) A person with type B blood could receive blood from a person with either type B or type O blood.

62)

63) Leukocytes move through the interstitial spaces by amoeboid motion.

63)

64) Granulocytes called neutrophils are phagocytic and are the most numerous of all white blood cell types.

64)

65) In clotting, prothrombin activator catalyzes prothrombin into thrombin, which in turn converts fibrinogen into fibrin.

65)

66) Myelocytic leukemia involves a cancerous condition of lymphocytes.

66)

67) Fetal hemoglobin has a higher affinity for oxygen than does adult hemoglobin.

67)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 68) A person with an extremely high count of neutrophils is likely suffering ________. A) anemia B) a viral infection C) polycythemia D) a bacterial infection

68)

69) A person exhibiting suppression of immunity and clotting disorder as well as low oxygen-carrying capacity is likely suffering from which of the following? A) iron deficiency anemia B) hemorrhagic anemia C) aplastic anemia D) pernicious anemia

69)

70) Which body activity would be most affected if a patient lacked an adequate number of erythrocytes (anemia)? A) clotting B) oxygen transport C) hormone transport D) immune response

70)

71) Which blood component primarily contributes to plasma osmotic pressure? A) electrolytes B) gamma globulin C) albumin D) blood borne nutrients

71)

72) Loss of fibrinogen within the plasma would most likely cause which of the following? A) edema (swelling) B) fever with pain C) loss of blood clotting D) pallor (pale skin)

72)

73) A patient's hematocrit shows an unusually large buffy coat. What is a likely cause for this? A) anemia B) lipidemia C) severe infection D) thrombocytopenia

73)

74) With a patient that is administered an injection of erythropoietin (EPO) you would expect to see ________. A) decreased hematocrit B) increased white blood cell count C) increased hematocrit D) decreased white blood cell count

74)

75) With a patient who is administered an injection of colony stimulating factor (CSF), you would expect to see ________. A) decreased white blood cell count B) decreased red blood cell count C) increased white blood cell count D) increased red blood cell count

75)

76) Higher viscosity of blood will increase the amount of stress placed on the heart while it is pumping. Viscosity of blood is highest when ________. A) hematocrit is highest B) HbA1C levels are lowest C) plasma levels are highest D) hemoglobin levels are lowest

76)

77) Which of the following would you expect to have the least effect on hematocrit percentage? A) living at higher altitude B) prolonged or excessive fever C) dehydration D) injection with erythropoietin (EPO)

77)

78) People that have a single allele (gene copy) for sickle cell anemia are typically not sick from the disease and are said to be carriers of sickle cell trait. These people will more often live in the malaria belt of sub-Saharan Africa. The most likely explanation for this is ________. A) people with sickle cell trait have a better chance of surviving malaria B) sickle cell trait is passed on to the biting mosquitoes as malaria C) the tropical climate attracts people with sickle cell trait D) malaria is a cause of sickle cell trait

78)

79) Lipids (either nutrients or hormones) are insoluble in water but are found traveling in the plasma of the blood. Which of the following is the most likely explanation for this? A) lipids are carried only in the lymph which is primarily composed of unsaturated fats B) lipids are carried in plasma bound to soluble plasma transport proteins C) lipids are carried inside blood cells D) enzymes in the plasma convert lipids to soluble forms

79)

80) A mismatch of blood types during a transfusion is dangerous because ________. A) clotting factors in the donor's blood will cause unwanted clots known as thrombus B) preformed antibodies in the recipient's blood will bind and clump (agglutinate) the donated cells C) antibodies in the donor's plasma will attack and kill the recipient's healthy blood cells D) white blood cells from the donor's blood cause inflammation

80)

81) If you centrifuge (spin) whole blood, you will find the red blood cells (erythrocytes) at the bottom of the tube and white blood cells atop them. This implies that ________. A) white blood cells are fewer in number than red blood cells B) red blood cells have a greater density than white blood cells C) white blood cells are smaller than red blood cells D) red blood cells are larger than white blood cells

81)

82) If you centrifuge (spin) whole blood you will find the band of white blood cells and platelets (the buffy coat) is much thinner than the packed red blood cells below it. This difference reflects the fact that ________. A) white blood cells are smaller than red blood cells B) platelets are larger than red blood cells C) platelets are larger than white blood cells D) white blood cells are fewer in number than red blood cells

82)

83) Which two factors below make rapid and substantial blood loss life threatening? A) loss of blood pressure and loss of oxygen carrying capacity B) loss of clotting ability and loss of osmotic pressure C) loss of immunity and loss of carbon dioxide carrying capacity D) loss of immunity and loss of blood pressure

83)

84) If a person is severely dehydrated you would expect to see all of the following EXCEPT ________. A) lower plasma levels B) higher hematocrit C) lower immunity D) higher blood viscosity

84)

85) Which of the following is NOT a functional characteristic of WBCs? A) ameboid motion B) granulosis C) diapedesis D) positive chemotaxis

85)

86) What is the average normal pH range of blood? A) 4.65-4.75 B) 7.75-7.85

86) C) 8.35-8.45

87) The special type of hemoglobin present in fetal red blood cells is ________. A) hemoglobin B B) hemoglobin S C) hemoglobin F

D) 7.35-7.45 87) D) hemoglobin A

88) Which of the choices below is the parent cell for all formed elements of blood? A) megakaryocyte B) hemocytoblast C) normoblast D) polymorphonuclear cell

88)

89) Which blood type is generally called the universal donor? A) O negative B) A positive C) AB positive

89) D) B negative

90) If a patient with type B blood received a transfusion of AB blood, which of the following would occur? A) The patient's B antigens (antiglutinogens) will agglutinate with the anti-B antibodies (agglutinins) in the donor blood. B) The patient's anti-B antibodies (agglutinins) will agglutinate with the B antigens (agglutinins) in the donor blood. C) The patient's A antigens (antiglutinogens) will agglutinate with the anti-A antibodies (agglutinins) in the donor blood. D) The patient's anti-A antibodies (agglutinins) will agglutinate with the A antigens (antiglutinogens) in the donor blood.

90)

91) Which of the following might trigger erythropoiesis? A) an increased number of RBCs B) moving to a lower altitude C) hypoxia of EPO-producing cells D) decreased tissue demand for oxygen

91)

92) Blood reticulocyte counts provide information regarding ________. A) WBC ability to defend the body against disease B) rate of platelet formation C) clotting ability of the blood D) rate of erythrocyte formation

92)

93) A patient with type A positive blood can, in theory, safely donate blood to someone with ________ blood. A) A positive or O positive B) A positive or AB positive C) A positive, A negative, AB positive, or AB negative D) A positive, A negative, O positive, or O negative

93)

94) When neither anti-A serum nor anti-B serum clot on a blood plate with donor blood, the blood is type ________. A) B B) AB C) O D) A

94)

95) All of the following can be expected with polycythemia EXCEPT ________. A) low blood viscosity B) high hematocrit C) high blood pressure D) increased blood volume

95)

96) Which is NOT true of leukocytes? A) They account for less than 1% of total blood volume. B) They move by amoeboid motion. C) They are the only formed elements that are true cells. D) They all contain easily recognizable membrane-bound cytoplasmic granules.

96)

97) Replacing lost blood volume with an isotonic saline solution ________. A) lowers the patient's blood volume B) restores the patient's blood glucose levels C) restores the oxygen-carrying capacity of the circulation D) lowers the patient's hematocrit

97)

98) Blood doping refers to the practice of ________ before an athletic event. A) removing, storing, and re-injecting a person's red blood cells B) injecting high amounts of oxygen into the blood stream C) training at high altitude to increase red blood cell production D) injecting performance-enhancing steroids into the blood

98)

99) A lack of intrinsic factor, leading to a deficiency of vitamin B 12 and causing an appearance of large pale cells called macrocytes, is characteristic of ________. A) pernicious anemia B) aplastic anemia C) sickle-cell anemia D) polycythemia

99)

100) Which is NOT true of thrombocytopenia? A) It can be caused by conditions that destroy bone marrow. B) It is caused by having a low number of circulating platelets. C) It increases the risk of embolus formation. D) It may produce petechiae.

100)

101) Leukocytes displaying red cytoplasmic granules when treated with Wright's stain are most likely ________. D) erythrocytes A) monocytes B) eosinophils C) basophils

101)

102) Fred's blood was determined to be AB positive. What does this mean? A) Antibodies to A and B are present in the red cells. B) He can only receive blood from a donor who is AB positive. C) There are no antibodies to A, to B, or to Rh antigens in the plasma. D) His blood lacks Rh factor.

102)

103) Which of the following would NOT be a possible cause of sickling of red blood cells in someone with sickle-cell anemia? A) vigorous exercise B) prolonged exposure to cold C) travel at high altitude D) malaria

103)

104) The cells responsible for producing platelets are called ________. A) lymphoid stem cells B) megakaryocytes C) monoblasts D) myeloblasts

104)

105) Hemolytic disease of the newborn will NOT be possible in which of the following situations listed below? A) if the child is Rh + B) if the father is Rh+ C) if the child is type O positive D) if the father is Rh-

105)

106) What organ in the body regulates erythrocyte production? B) pancreas C) kidney A) brain

106) D) liver

107) Why is blood considered a connective tissue? A) Plasma contains dissolved fibrous proteins. B) It allows for chemical signals from one area of the body to reach another. C) It is found in all areas of the body. D) It acts as an adhesive layer between tissue types. 108) Which of the following is NOT a typical plasma protein? A) albumin B) globulins C) erythropoietin

107)

108) D) fibrinogen

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 109) If a person has AB type blood, which of the ABO blood types can they receive as a transfusion?

109)

110) When monocytes migrate into the interstitial spaces to fight infection, they change to a different type of cell called ________.

110)

111) The group of blood disorders in which blood oxygen levels are inadequate to support normal metabolism is called ________.

111)

112) How many polypeptide chains make up hemoglobin?

112)

113) List the two general factors that limit normal clot growth to the sight of injury.

113)

114) List the most common causes of bleeding disorders.

114)

115) List the granulocytes and describe the appearance of their granules in a typical blood smear.

115)

116) Why is iron not stored or transported in its free form? In what form(s) is it stored or transported in blood?

116)

117) Explain why blood is classified as a connective tissue.

117)

118) What determines whether blood is bright red or a dull, dark red?

118)

119) Why is hemoglobin enclosed in erythrocytes rather than existing free in plasma?

119)

120) What is the buffy coat found in centrifuged whole blood?

120)

121) When diagnosing an iron deficiency one of the first tests is a red blood cell count. Why is this so?

121)

122) Why are the two pathways of blood clotting referred to as the extrinsic and intrinsic pathways?

122)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 123) Why would there be cause for concern if a young pregnant mother is Rh - , her husband is Rh+ , and this is their second child? 124) A total WBC count and a differential WBC count have been ordered for Mrs. Johnson. What information is obtained from the differential count that the total count does not provide? 125) List three blood tests that might be ordered if anemia is suspected. 126) A patient complains of no energy, a chronic sore throat, a low-grade fever, and is tired and achy. His doctor notes an enlarged spleen upon examination. What diagnosis would you expect and what definitive test would you request? 127) A man of Mediterranean ancestry goes to his doctor with the following symptoms. He is very tired all of the time. He has difficulty catching his breath after even mild exercise. His doctor orders the following tests: CBC, hematocrit, differential WBC count, and hemoglobin electrophoresis. The tests show immature erythrocytes, fragile erythrocytes, and less than 2 million RBCs per cubic millimeter. What would be a tentative diagnosis and suggested treatment?

128) A 68-year-old male is admitted to the hospital for emphysema. He is hypoxic and his lab tests reveal low oxygen levels. His hematocrit is 65%. The physician has told him that he has a type of polycythemia in which he has an increased number of erythrocytes circulating in his bloodstream. The patient tells the nurse that he does not understand what that means. How would the nurse explain this in terms the patient could understand? 129) An elderly patient tells the nurse that she has been very tired lately and has difficulty walking to her mailbox without getting very short of breath. The nurse notes the mucous membranes are pale. The patient states that since her husband died three months ago, she has not been eating well. The physician confirms that she has iron-deficiency anemia. How are the patient's clinical manifestations and iron-deficiency anemia related? 130) A 17-year-old black male is admitted to the hospital in sickle-cell crisis. Pain management is a top priority for patients in sickle-cell crisis. Explain why. 131) A 52-year-old woman was diagnosed with leukemia and has been receiving chemotherapy as an outpatient. She tells the RN that she hasn't been feeling well. The patient's skin is warm to the touch and she has a low-grade fever of 100.2°F. The neutrophil blood count is less than 1000/μl. The nurse is concerned about the possibility of infection because of the neutropenia and low-grade fever. Explain why.

Answer Key Testname: UNTITLED17

1) B 2) D 3) C 4) A 5) A 6) D 7) C 8) B 9) A 10) E 11) D 12) C 13) A 14) B 15) D 16) B 17) B 18) D 19) A 20) C 21) C 22) B 23) D 24) A 25) D 26) B 27) A 28) E 29) C 30) B 31) A 32) E 33) D 34) C 35) C 36) A 37) B 38) D 39) E 40) F 41) C 42) D 43) E 44) B 45) A 46) FALSE 47) TRUE 48) FALSE 49) FALSE 50) FALSE 13

Answer Key Testname: UNTITLED17

51) TRUE 52) TRUE 53) TRUE 54) FALSE 55) FALSE 56) FALSE 57) FALSE 58) TRUE 59) TRUE 60) FALSE 61) TRUE 62) TRUE 63) TRUE 64) TRUE 65) TRUE 66) FALSE 67) TRUE 68) D 69) C 70) B 71) C 72) C 73) C 74) C 75) C 76) A 77) B 78) A 79) B 80) B 81) B 82) D 83) A 84) C 85) B 86) D 87) C 88) B 89) A 90) D 91) C 92) D 93) B 94) C 95) A 96) D 97) D 98) A 99) A 100) C 14

Answer Key Testname: UNTITLED17

101) B 102) C 103) B 104) B 105) D 106) C 107) A 108) C 109) All (A, B, AB, and O) 110) macrophage(s) 111) anemia 112) Four 113) Rapid removal of coagulation factors and inhibition of activated clotting factors. 114) Platelet deficiency (thrombocytopenia); deficiency of procoagulants due to liver disorders; or certain genetic conditions (hemophilias). 115) Neutrophils: pale, indistinct; eosinophils: red; basophils: dark purple 116) Because free iron is toxic to body cells, iron is stored within cells as protein-iron complexes such as ferritin and hemosiderin. It is transported loosely bound to a protein called transferrin. 117) Blood develops from mesenchyme which is the same embryonic tissue that develops into all the other types of connective tissue: Therefore, it has both solid (cells) and liquid (extracellular) components. The formed elements (cells) are suspended in a nonliving fluid matrix (plasma). 118) In bright red blood, oxygen is bound to hemoglobin (oxygenated blood). In dull, dark -red blood, oxygen has been released from the hemoglobin (deoxygenated blood). 119) Hgb needs to be packaged for efficient transport which in turn transports oxygen in an organized way. Additionally, erythrocytes generate energy anaerobically meaning it does not use the oxygen that it is transporting for the tissues. 120) The buffy coat is a layer of centrifuged whole blood that contains leukocytes and platelets. 121) Iron is mostly stored in hemoglobin of RBCs. Additional free ions are bound to protein -iron molecules like ferritin, hemosiderin, and transferrin. Ferritin and hemosiderin molecules are stored in the liver, spleen, and bone marrow. Transferrin transports iron in the blood. 122) The factors required to initiate clotting are present within the blood in the intrinsic pathway and outside the blood in the extrinsic pathway. 123) If the mother was given RhoGAM before and shortly after the birth of their first child who is Rh +, there is little concern, because the RhoGAM prevented the mother from sensitizing herself against her child. If the second child is RH + and she did not take RhoGAM, there is a chance the second child will develop erythroblastosis fetalis and die before birth. 124) The differential count determines the relative proportion of individual leukocyte types in percentage and absolute value of each type of WBC (a valuable diagnostic tool). The total WBC count indicates an increase or decrease in number of WBCs. 125) The three tests for anemia include hemoglobin, hematocrit and RBC count. 126) The test would be a differential white blood cell count to look for elevated numbers of monocytes and atypical lymphocytes. The diagnosis would be possible infectious mononucleosis, pending test results. Order a Mono spot test! 127) The diagnosis is thalassemia. The treatment is blood transfusion and chelation therapy to remove excessive iron accumulate from transfusions. 128) "Because you have decreased oxygen levels in your blood, your body has responded by producing more red blood cells, which we call polycythemia, the term for excessive RBC production. The low oxygen level causes your kidneys to make a hormone (erythropoietin) to stimulate the production of more red blood cells." 129) Without iron as a source material, the red bone marrow cannot manufacture sufficient hemoglobin to meet demand. The clinical manifestations are directly attributed to the reduction in the amount of oxygen available to tissues. Anemic individuals are fatigued, often pale, short of breath, and chilly. 15

Answer Key Testname: UNTITLED17

130) Sickle-cell anemia results from a defective hemoglobin S-producing gene that causes red blood cells to roughen and become sickle shaped. Such sickling can produce hemolysis. The altered cells tend to pile up in capillaries and smaller blood vessels, making the blood more viscous. Normal circulation is impaired, and the oxygen -deprived tissues are forced to switch to anaerobic metabolism, producing lactic acid which causes severe pain and swelling. 131) A low-grade fever in someone who has neutropenia is a major concern for survival. Neutropenia is a concern because of the neutrophil's role in phagocytosis. This patient has a decreased ability to fight off infection and cannot respond by quickly developing more white blood cells the way a normal patient would. Patient is susceptible to opportunistic infections and should be treated as well as placed in protective isolation.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 18.1 Using Figure 18.1, match the following: 1) Subendocardial conducting network (Purkinje fibers).

2) Sinoatrial (SA) node.

3) Atrioventricular (AV) bundle.

4) Atrioventricular (AV) node.

5) Bundle branches.

Figure 18.2 Using Figure 18.2, match the following: 6) Atrial depolarization.

7) Point after which pressure begins to rise in the aorta.

8) Ventricular repolarization.

9) Point that represents the "dup" sound made by the heart.

Figure 18.3 Using Figure 18.3, match the following: 10) Ventricular fibrillation.

10)

11) Second-degree heart block.

11)

12) Junctional rhythm.

12)

13) Normal sinus rhythm.

13)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 14) The inner lining of the heart.

A) Endocardium

15) Heart muscle.

B) Epicardium

16) Serous layer covering the heart muscle.

C) Parietal layer

14) 15) 16)

D) Myocardium 17) The outermost layer of the serous pericardium.

17)

Match the following: 18) Heart rate at rest under both autonomic divisions signaling.

A) Tachycardia

18)

B) Bradycardia 19) An abnormally fast heart rate.

19) C) Vagal tone

20) An abnormally slow heart rate.

20) D) Cardiac reserve

21) Difference between resting and maximal cardiac output.

21)

Match the following: 22) Prevents backflow into the left ventricle.

A) Tricuspid valve

22)

B) Pulmonary semilunar valve 23) Prevents backflow into the right atrium.

C) Aortic semilunar valve

24) Prevents backflow into the left atrium.

D) Mitral (bicuspid) valve

23)

24)

25) Prevents backflow into the right ventricle.

25)

26) Atrioventricular (AV) valve with two flaps.

26)

27) Atrioventricular (AV) valve with three flaps.

27)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 18.4 Using Figure 18.4, match the following: 28) Tricuspid valve.

28)

29) Mitral (bicuspid) valve.

29)

30) Right atrium.

30)

31) Left ventricle.

31)

32) Pulmonary veins.

32)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 33) Heart muscle is deprived of oxygen.

A) Ectopic focus

34) Death of heart muscle cells.

B) Quiescent period

35) A condition of rapid and irregular or out-of-phase contraction of ventricular heart muscle cells.

C) Ischemia

36) An abnormal pacemaker.

E) Infarction

33) 34) 35)

D) Fibrillation

37) Total heart relaxation.

36) 37)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 38) The myocardium receives its blood supply from the coronary arteries.

38)

39) Cardiac muscle has more mitochondria and depends less on a continual supply of oxygen than does skeletal muscle.

39)

40) Anastomoses among coronary arterial branches provide collateral routes for blood delivery to the heart muscle.

40)

41) If blood volume decreased dramatically due to massive bleeding, the autonomic nervous system will attempt to maintain cardiac output by increasing the heart rate.

41)

42) Tissues damaged by myocardial infarction are replaced by fibrous connective tissue.

42)

43) The left side of the heart pumps the same volume of blood as the right.

43)

44) When released in large quantities, thyroxine, a thyroid gland hormone, causes a sustained increase in heart rate.

44)

45) Arterial blood supply to heart muscle is continuous whether the heart is in systole or diastole.

45)

46) Auricles slightly increase blood volume in the ventricles.

46)

47) The "lub" sounds of the heart are valuable in diagnosis because they provide information about the function of the heart's pulmonary and aortic semilunar valves.

47)

48) Autonomic regulation of heart rate is via two reflex centers found in the pons.

48)

49) The papillary muscles contract after the other ventricular muscles so that they can take up the slack on the chordae tendineae before the full force of ventricular contractions sends blood against the atrioventricular (AV) valve flaps.

49)

50) An electrocardiogram (ECG) provides direct information about valve function.

50)

51) As pressure in the aorta rises due to atherosclerosis, more ventricular pressure is required to open the aortic valve.

51)

52) If the aorta and pulmonary trunk were switched, oxygen rich blood would be pumped from the left ventricle to the lungs.

52)

53) Heart tissue is supplied with nutrients primarily by diffusion from the heart chambers through the myocardium.

53)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 54) Normal heart sounds are caused by which of the following events? A) closure of the heart valves B) opening of the heart valves C) friction of blood against the chamber walls D) excitation of the sinoatrial (SA) node

54)

55) During the isovolumetric relaxation phase of the cardiac cycle, _______. A) atrioventricular valves are open; aortic and pulmonary valves are closed B) atrioventricular valves are closed; aortic and pulmonary valves are open C) atrioventricular, aortic, and pulmonary valves are closed D) atrioventricular, aortic, and pulmonary valves are open

55)

56) Hemorrhage with a large loss of blood causes ________. A) a lowering of blood pressure due to change in cardiac output B) no change in blood pressure but a change in respiration C) no change in blood pressure but a slower heart rate D) a rise in blood pressure due to change in cardiac output

56)

57) The left ventricular wall of the heart is thicker than the right wall in order to ________. A) accommodate a greater volume of blood B) pump blood with greater pressure C) expand the thoracic cage during diastole D) pump blood through a smaller valve

57)

58) Which chambers of the heart contain oxygenated blood? A) right and left ventricles B) left atrium and ventricle C) right and left atria D) right atrium and ventricle

58)

59) If the SA node is not functioning, an ECG will show ________. A) higher P waves B) no QRS waves C) no P waves with a HR between 40-60 bpm D) more P waves than QRS waves

59)

60) The receiving chambers of the heart include the ________. A) right and left atria B) right atrium and ventricle C) left atrium and ventricle D) right and left ventricles

60)

61) The condition where fluid compresses the heart and limits its ability to contract is called ________. A) cardiac tamponade B) myocardial infarction C) pericarditis D) angina pectoris

61)

62) The term for pain associated with deficient blood delivery to the heart that may be caused by the transient spasm of coronary arteries is ________. A) ischemia B) angina pectoris C) pericarditis D) myocardial infarct

62)

63) To auscultate the aortic semilunar valve, you would place your stethoscope in the ________. A) fifth right intercostal space B) fifth intercostal space inferior to the left nipple C) second intercostal space to the left of the sternum D) second intercostal space to the right of the sternum

63)

64) The source of blood carried to capillaries in the myocardium would be the ________. A) coronary veins B) coronary arteries C) coronary sinus D) fossa ovalis

64)

65) The fact that the left ventricle of the heart is thicker than the right ventricle reveals that it ________. A) pumps blood against a greater resistance B) sends blood through a smaller valve C) pumps a greater volume of blood D) expands the thoracic cage

65)

66) The parietal pericardium ________. A) is also called the epicardium B) lines the internal surface of the fibrous pericardium C) is separated from the fibrous pericardium by serous fluid D) is found within the pericardial cavity

66)

67) Which of the following is NOT an age-related change affecting the heart? A) atherosclerosis B) thinning of the valve flaps C) decline in cardiac reserve D) fibrosis of cardiac muscle

67)

68) If cardiac muscle is deprived of its normal blood supply, damage would primarily result from ________. A) an inadequate supply of lactic acid B) decreased delivery of oxygen C) a decrease in the number of available mitochondria for energy production D) a lack of nutrients to feed into metabolic pathways

68)

69) If the length of the absolute refractory period in cardiac muscle cells was the same as it is for skeletal muscle cells, ________. A) contractions would last as long as the refractory period B) pacemaker cells would cease to spontaneously depolarize C) tetanic contractions might occur, which would stop the heart's pumping action D) it would be much longer before cardiac cells could respond to a second stimulation

69)

70) Norepinephrine acts on the heart by ________. A) causing a decrease in stroke volume B) causing threshold to be reached more quickly C) decreasing heart contractility D) blocking the action of calcium

70)

71) If the vagal nerves to the heart were cut, the result would be that ________. A) parasympathetic stimulation would increase, causing a decrease in heart rate B) the heart rate would increase by about 25 beats per minute C) the atrioventricular (AV) node would become the pacemaker of the heart D) the heart would stop, since the vagal nerves trigger the heart to contract

71)

72) The foramen ovale ________. A) is a shallow depression in the interventricular septum B) is a condition in which the heart valves do not completely close C) is a connection between the pulmonary trunk and the aorta in the fetus D) connected the two atria in the fetal heart

72)

73) Which vessel(s) of the heart receive(s) blood from the right ventricle? A) aorta B) pulmonary veins C) venae cavae D) pulmonary trunk

73)

74) Which of the following receive(s) blood during ventricular systole? A) aorta only B) pulmonary veins only C) pulmonary arteries only D) both the aorta and pulmonary trunk

74)

75) Which of the following is NOT part of the intrinsic conduction system of the heart? A) sinoatrial (SA) node B) bundle branches C) atrioventricular (AV) valve D) atrioventricular (AV) node

75)

76) The atrioventricular (AV) valves are closed ________. A) while the atria are contracting B) by the movement of blood from atria to ventricles C) when the ventricles are in diastole D) when the ventricles are in systole

76)

77) Pectinate muscles are found in the ________. A) atria only C) ventricles only

77) B) right atrium and right ventricle only D) atria and ventricles

78) Select the correct statement about the heart valves. A) The tricuspid valve divides the left atrium from the left ventricle. B) Aortic and pulmonary semilunar valves control the flow of blood into the heart. C) The atrioventricular (AV) valves prevent backflow of blood added into the atria during ventricular contraction. D) The mitral (bicuspid) valve separates the right atrium from the right ventricle.

78)

79) Select the correct statement about the function of myocardial cells. A) The influx of potassium ions from extracellular sources is the initiating event in cardiac muscle contraction. B) Cardiac muscle cells are innervated by sympathetic, parasympathetic, and somatic nerve fibers so that the nervous system can increase heart rate. C) The refractory period in skeletal muscle is much longer than that in cardiac muscle. D) The entire heart contracts as a unit or it does not contract at all.

79)

80) Select the correct statement about the structure of the heart wall. A) The heart chambers are lined by the endomysium. B) The myocardium is the layer of the heart that actually contracts. C) Connective tissue in the heart wall aids in the conduction of the action potential. D) The fibrous cardiac skeleton forms the bulk of the heart.

80)

81) Compared to skeletal muscle, cardiac muscle ________. A) has gap junctions that allow it to act as a functional syncytium B) cells are larger than skeletal muscle cells C) has more nuclei per cell D) lacks striations

81)

82) During the period of ventricular filling, ________. A) the aortic and pulmonary semilunar valves are open B) pressure in the heart is at its peak C) blood flows mostly passively from the atria through the atrioventricular (AV) valves into the ventricles D) the atria remain in diastole

82)

83) The second heart sound is heard during which phase of the cardiac cycle? A) ventricular filling B) isovolumetric contraction C) ventricular ejection D) isovolumetric relaxation

83)

84) Which is most responsible for the synchronized contraction of cardiac muscle tissue? A) gap junctions B) desmosomes C) small motor units D) branching cells

84)

85) Select the correct statement about cardiac output. A) If a semilunar valve were partially obstructed, the end systolic volume in the affected ventricle would be decreased. B) A slow heart rate increases end diastolic volume, stroke volume, and force of contraction. C) Stroke volume increases if end diastolic volume decreases. D) Decreased venous return will result in increased end diastolic volume.

85)

86) Which is NOT a vessel that brings blood directly into the right atrium? A) pulmonary vein B) coronary sinus C) inferior vena cava D) superior vena cava

86)

87) Isovolumetric contraction ________. A) occurs only in people with heart valve defects B) occurs immediately after the aortic and pulmonary semilunar valves close C) occurs while the atrioventricular (AV) valves are open D) refers to the short period during ventricular systole when the ventricles are completely closed chambers

87)

88) Given an end diastolic volume (EDV) of 120 ml / beat and an end systolic volume (ESV) of 50 ml / beat, the stroke volume (SV) would be ________. A) 70 ml / beat B) 170 ml / beat C) 120 ml / beat D) 50 ml / beat

88)

89) If the mitral valve is unable to close properly, ________. A) blood could flow back into the right ventricle B) blood could flow back into the left ventricle C) blood could flow back into the left atrium D) blood could flow back into the right atrium

89)

90) During exercise, which of the following would occur on an electrocardiogram (ECG) compared to an individual at rest? A) the time from one R to the R of the next heartbeat would decrease B) the S-T segment would decrease C) the T wave would decrease D) the P-R interval would decrease

90)

91) Which coronary artery is most responsible for supplying blood to the myocardial tissue of the left atrium? A) circumflex artery B) posterior interventricular artery C) right marginal artery D) anterior interventricular artery

91)

92) What is the expected heart rate when a heart is removed from a living body? A) the heart would immediately stop beating B) 100 beats / minute C) 50 beats / minute D) 75 beats / minute

92)

93) While auscultating heart sounds during a checkup, Andy's doctor hears a high -pitched sound during ventricular contraction. Which type of valve could cause this? A) incompetent tricuspid valve B) deficient pulmonary semilunar valve C) stenotic aortic semilunar valve D) insufficient mitral (bicuspid) valve

93)

94) Exercise results in skeletal muscles compressing veins which encourages blood to return to the heart. In this scenario, which of the following is correct? A) stroke volume decreases B) preload increases C) end diastolic volume (EDV) decreases D) venous return decreases

94)

95) The "pacemaker potential" of pacemaker cells is produced by the opening of ________ at the end of an action potential. A) slow Na+ channels B) slow Ca2+ channels C) fast Ca2+ channels D) K+ channels

95)

96) The plateau phase of an action potential in cardiac muscle cells is due to the ________. A) efflux of K+ through K+ channels B) influx of Ca2+ through slow Ca2+ channels C) efflux of Ca2+ through fast Ca2+ channels D) influx of Na+ through fast Na+ channels

96)

97) The Frank-Starling Law states that, if other factors are constant, a ________. A) higher stroke volume will produce a higher end diastolic volume B) higher end diastolic volume will produce a higher stroke volume C) higher stroke volume will produce a lower end diastolic volume D) higher end diastolic volume will produce a lower stroke volume

97)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 98) Define systole and diastole. Which heart chambers are usually referenced when these terms are used?

98)

99) Define the terms end diastolic volume (EDV) and end systolic volume (ESV) and relate them to the calculation of stroke volume.

99)

100) What is the difference between the auricles and the atria?

100)

101) The heart is called a "double pump" because there are two functionally separate circulations. Trace the pathway of each of these circulations and include the following information: heart chambers involved, major blood vessels involved, and general areas through which the blood flows. Begin with the right atrium.

101)

102) What two important functions does the intrinsic cardiac conduction system perform?

102)

103) Explain the role of pacemaker cells in cardiac tissue.

103)

104) Why is oxygen so much more critical to the heart muscle than to skeletal muscles?

104)

105) What is the functional importance of the intercalated discs of cardiac muscle? What is the functional importance of the fibrous cardiac skeleton of the heart?

105)

106) List the three vessels that bring oxygen-poor blood to the right atrium. Which regions of the body do they serve?

106)

107) List and define the three most important factors that affect stroke volume.

107)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 108) A 14-year-old girl undergoing a physical examination prior to being admitted to summer camp was found to have a loud diastolic murmur at the second intercostal space to the left side of the sternum. Explain the reason for the loud heart murmur associated with this girl's condition.

109) A man enters the hospital complaining of chest pain. His history includes smoking, a stressful job, a diet heavy in saturated fats, lack of exercise, and high blood pressure. Although he is not suffering from a heart attack, his doctor explains to him that a heart attack is quite possible. What did the chest pain indicate? Why is this man a prime candidate for a heart attack? 110) An older woman complains of shortness of breath and intermittent fainting spells. Her doctor runs various tests and finds that the atrioventricular (AV) node is not functioning properly. What is the suggested treatment? 111) A Doppler ultrasound was performed on an infant who had symptoms of breathlessness and it was found that he had a patent ductus arteriosus. Discuss the location and function of the ductus arteriosus in the fetus and relate it to the reason for the infant's breathlessness. 112) A patient takes a nitroglycerin tablet sublingually for chest pain. Nitroglycerin acts directly on smooth muscle, producing relaxation and vessel dilation. How would this relieve chest pain? 113) A patient was admitted to the hospital with chest pains. On admission, his pulse was 110 and blood pressure was 96/64. According to his history, his normal pulse rate is usually between 80 and 88 and his blood pressure runs from 120/70 to 130/80. Explain why these changes in BP and HR occur. 114) A 55-year-old male was admitted to the hospital with heart failure. He complains of increasing shortness of breath on exertion and needing to sleep on three pillows at night. On physical assessment, the nurse determines that his ankles and feet are very swollen. Which of these symptoms reflect left -sided heart failure and which reflect right-sided heart failure? 115) Asystole is the total absence of ventricular electrical activity. Explain why defibrillation would not be effective in this situation. 116) A patient is prescribed a calcium channel blocker to prevent angina (chest pain), by decreasing the demand for oxygen. Explain why.

Answer Key Testname: UNTITLED18

1) E 2) A 3) C 4) B 5) D 6) A 7) D 8) E 9) E 10) D 11) C 12) B 13) A 14) A 15) D 16) B 17) C 18) C 19) A 20) B 21) D 22) C 23) A 24) D 25) B 26) D 27) A 28) B 29) D 30) A 31) E 32) C 33) C 34) E 35) D 36) A 37) B 38) TRUE 39) FALSE 40) TRUE 41) TRUE 42) TRUE 43) TRUE 44) TRUE 45) FALSE 46) FALSE 47) FALSE 48) FALSE 49) FALSE 50) FALSE 14

Answer Key Testname: UNTITLED18

51) TRUE 52) TRUE 53) FALSE 54) A 55) C 56) A 57) B 58) B 59) C 60) A 61) A 62) B 63) D 64) B 65) A 66) B 67) B 68) B 69) C 70) B 71) B 72) D 73) D 74) D 75) C 76) D 77) A 78) C 79) D 80) B 81) A 82) C 83) D 84) A 85) B 86) A 87) D 88) A 89) C 90) A 91) A 92) B 93) C 94) B 95) A 96) B 97) B 98) Systole is contraction of the muscle. Diastole is relaxation of the muscle. The contraction and relaxation of the ventricles are normally described with the terms systole and diastole. 15

Answer Key Testname: UNTITLED18

99) EDV is the amount of blood that collects in a ventricle during diastole (filling of ventricles). ESV is the volume of blood remaining in a ventricle after it has contracted. Stroke volume (ml / beat) equals EDV - ESV. 100) Auricles are the flaplike appendages attached to the atria that provides a reserve capacity to increase the atrial volume. The atria are receiving chambers for blood returning to the heart from the pulmonary and systemic circulation. 101) Right atrium to right ventricle to pulmonary trunk to pulmonary arteries to lungs to pulmonary veins (pulmonary circuit pump); left atrium to left ventricle to aorta to body tissues to venae cavae (systemic circuit pump). 102) The important functions of the intrinsic cardiac conduction system are to initiate impulses (pacemaker) and to distribute impulses throughout the heart so that it depolarizes and contracts in an orderly, sequential manner. 103) Pacemaker cells do not maintain a stable resting membrane potential. Instead, they have an unstable resting potential that continuously depolarizes, drifting toward threshold for firing. These spontaneously changing membrane potentials, called pacemaker potentials, initiate the action potentials that trigger the heart's rhythmic contractions. 104) Cardiac muscle cells are highly dependent on oxygen and rely almost exclusively on aerobic respiration. Thus, they cannot tolerate lack of oxygen due to an inadequate blood supply. When there is a forced switch to anaerobic respiration, lactic acid and rising H + levels impair heart function. 105) Intercalated discs contain anchoring desmosomes that prevent cell separation, and gap junctions that allow ions to travel from cell to cell enabling greater communication by increasing the surface area, transmitting current across the entire heart. The fibrous cardiac skeleton acts as a tendon, an insertion and insulator, giving the cardiac cells something to pull or exert their force on and isolating atrial from ventricular contractions. 106) The superior vena cava returns oxygen-poor blood from body regions superior to the diaphragm. The inferior vena cava returns oxygen-poor blood from body areas inferior to the diaphragm. The coronary sinus collects blood draining from the myocardium. 107) 1. Preload – the degree to which heart muscle cells are stretched before they contract 2. Contractility – contractile strength achieved at a given muscle length 3. Afterload – pressure that must be overcome for the ventricles to eject blood 108) The heart murmur is due to incomplete closure of the pulmonary valve and regurgitation of pulmonary trunk blood during diastole. 109) His symptoms indicate angina pectoris, possibly due to either atherosclerosis or stress-induced spasms of the coronary arteries. If the arteries are occluded (atherosclerosis), the heart muscle could be deprived of blood, and therefore oxygen. A heart attack could occur if the coronary vessels experience further (or progressive) occlusion. 110) The suggested treatment is surgery to implant an artificial pacemaker. 111) The ductus arteriosus is a shunt between the pulmonary trunk and the aorta in the fetus, which normally closes at birth and becomes a ligament (ligamentum arteriosum). Breathlessness is due to the mixing of oxygenated and deoxygenated blood because the connection between the aorta and the pulmonary trunk remains slightly open. 112) Angina pectoris is thoracic pain caused by a fleeting deficiency in blood delivery to the myocardium, with resulting decreased oxygen being delivered to the cells. Because nitroglycerin acts as a vasodilator (similar to nitric oxide), blood flow is increased, promoting the delivery of oxygen to the cells. 113) Increased heart rate (measured by taking his pulse) without maintaining his normal blood pressure is suggestive of reduced stroke volume. Both a drop in blood volume and a weakened heart could cause this, but the chest pains suggest heart damage. Failure of compensating mechanisms to maintain blood pressure suggests a serious decline in cardiac output. 114) Because the heart is a double pump, each side can initially fail independently of the other. If the left side fails, pulmonary congestion occurs. The right side of the heart continues to propel blood to the lungs, but the left side does not adequately eject the returning blood into the systemic circulation. Thus, blood vessels in the lungs become engorged with blood, pressure within them increases, and fluid leaks from the circulation into the lung tissue, causing pulmonary edema. Shortness of breath and difficulty breathing in a prone position may occur. If the right side of the heart fails, peripheral congestion occurs. Blood stagnates within body organs, and pooled fluids in the tissue spaces impair the ability of body cells to obtain adequate nutrients and oxygen and to rid themselves of wastes. Edema is most noticeable in the extremities (feet, ankles, and fingers). 16

Answer Key Testname: UNTITLED18

115) Defibrillation is accomplished by electrically shocking the heart, which interrupts its chaotic twitching by depolarizing the entire myocardium. In this case, the ventricles are at a total standstill and defibrillation would not be effective. 116) By preventing the influx of calcium ions into myocardial and vascular smooth muscle cells, calcium channel blockers inhibit the intracellular release of additional stores of calcium ions. A drug that inhibits the release of intracellular calcium ions decreases the force of myocardial contractility, thereby decreasing the oxygen demand. Calcium channel blockers reduce the amount of calcium to bind to the troponin thereby reducing the work load on the heart.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 19.1 Using Figure 19.1, match the following: 1) Sinusoid capillary.

2) Capillary found in endocrine organs that allows hormones to gain rapid entry into the blood.

3) Capillary with intercellular clefts found in the skin and muscles.

4) Capillary that has a discontinuous, incomplete basement membrane.

5) Capillary found where active capillary absorption of filtrate occurs.

Figure 19.2 Using Figure 19.2, match the following: 6) Splenic vein.

7) Superior mesenteric vein.

8) Inferior mesenteric vein.

9) Hepatic portal vein.

10) Right gastroepiploic vein.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) Largest artery of the body.

A) Internal iliac artery

12) Supplies the kidney.

B) Common hepatic artery

13) Supplies the duodenum and stomach.

C) Aorta

14) Supplies the distal areas of the large intestine.

D) Renal artery

11) 12) 13) 14)

E) Inferior mesenteric artery 15) Supplies pelvic structures.

15)

16) Artery that does not anastomose.

16)

Match the following: 17) Gives rise to the right common carotid and right subclavian artery.

A) Celiac trunk

17)

B) Brachiocephalic trunk 18) Supplies a lower limb.

18) C) External iliac artery

19) Common site to take the pulse.

19) D) Internal carotid artery

20) Major supply to the cerebral hemispheres.

20) E) Radial artery

21) Large unpaired branch of the abdominal aorta that supplies the liver, stomach, and spleen.

21)

Match the following: 22) Receives blood from all areas superior to the diaphragm, except the heart wall.

A) Superior vena cava

22)

B) Pulmonary trunk

23) Carries oxygen-poor blood to the lungs.

23)

24) Drains the scalp.

A) Subclavian vein

25) Runs through the armpit area, giving off branches to the axillae, chest wall, and shoulder girdle.

B) Axillary artery

24) 25)

C) External jugular vein

26) Drains an upper extremity, a deep vein.

26)

Match the following: 27) Artery usually ausculated to take the blood pressure.

A) Brachial artery

27)

B) Femoral artery 28) Major artery of the thigh.

28) C) Great saphenous vein

29) Supplies the small intestine.

29) D) Pulmonary vein

30) Carries oxygen-rich blood from the lungs.

30) E) Superior mesenteric artery

31) Vessel commonly used as a coronary bypass vessel.

31)

Match the following: 32) Site where resistance to blood flow is greatest.

A) Arterioles

32)

B) Large arteries 33) Site where exchanges of food and gases are made.

C) Large veins

34) Site where blood pressure is lowest.

D) Capillaries

33)

34)

35) Site where the velocity of blood flow is fastest.

35)

36) Site where the velocity of blood flow is slowest.

36)

37) Site where the blood volume is greatest.

37)

38) Site where the blood pressure is greatest.

38)

39) Site that is the major determinant of peripheral resistance.

39)

Match the following: 40) Results from heart inability to sustain adequate circulation due to myocardial damage.

A) Cardiogenic shock

41) Due to inadequate blood flow to meet tissue needs.

C) Hypovolemic shock

42) Normal blood volume but poor circulation due to extreme vasodilation.

40)

B) Vascular shock 41)

D) Circulatory shock 42)

43) Due to large-scale blood loss.

43)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 44) The adjustment of blood flow to each tissue in proportion to its requirements at any point in time is termed autoregulation.

44)

45) Arterial pressure in the pulmonary circulation is much higher than in the systemic circulation because of its proximity to the heart.

45)

46) Osmotic pressure is created by the presence in a fluid of small diffusible molecules that easily move through the capillary membrane.

46)

47) The cerebral arterial circle (circle of Willis) is an arterial anastomosis.

47)

48) The carotid sinus reflex protects the blood supply to the brain, whereas the aortic reflex is more concerned with maintaining adequate blood pressure in the systemic circuit as a whole.

48)

49) The pulmonary circulation does not directly serve the metabolic needs of body tissues.

49)

50) An obstruction in the superior vena cava would decrease the flow of blood from the head and neck to the heart.

50)

51) Arteries supplying the same territory are often merged with one another, forming arterial anastomoses.

51)

52) An increase in blood viscosity will cause an increase in peripheral resistance.

52)

53) Whereas diffusion is more important for solute exchange between plasma and interstitial fluid, bulk flow is more important for regulation of the relative volumes of blood and interstitial fluid.

53)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 54) Reduction in the concentration of albumin in blood plasma would alter capillary exchange by ________. A) increasing hydrostatic pressure and edema will occur B) increasing hydrostatic pressure and blood volume, blood pressure increases C) decreasing colloid osmotic pressure and edema will occur D) decreasing colloid osmotic pressure and blood volume, blood pressure increases

54)

55) If a person were to have substantial blood loss, you would expect to see all of the following physiological events to happen EXCEPT one. Select the least likely response to substantial blood loss. A) increases peripheral resistance B) a weak, thread pulse C) increasing vasomotor tone D) decreased heart rate

55)

56) During a marathon which of the following hormones is least likely to be released by the runner? A) epinephrine B) antidiuretic hormone (ADH) C) atrial natriuretic peptide (ANP) D) angiotensin II

56)

57) Which structural layer of blood vessels is most responsible for maintaining blood pressure? A) subendothelial B) tunica media C) tunica intima D) tunica externa

57)

58) Vessels that carry blood away from the heart and are named by the organs they supply (renal) are _________. A) muscular arteries B) elastic arteries C) arterioles D) capillaries

58)

59) Which of the following would NOT be expected from taking a diuretic drug? A) decreased blood pressure B) greater stress on the heart to provide adequate perfusion C) lower plasma volume D) increased urine output

59)

60) A person suddenly gaining significant amounts of adipose tissue can expect all of the following physiological changes except one. Which of the following is least likely to occur with a sudden and significant gain in adipose tissue? A) increased risk of developing atherosclerosis B) increased angiogenesis and higher peripheral resistance C) lower heart rate and reduced blood flow D) higher peripheral resistance and higher blood pressure

60)

61) Which blood vessels lack elastic tissue? A) capillaries and venules C) muscular arteries and arterioles

61) B) arterioles and capillaries D) venules and veins

62) In red bone marrow newly formed blood cells enter the circulation. You would expect to see many ________ type of capillaries in red bone marrow. A) sinusoid B) fenestrated C) continuous D) metarterioles

62)

63) The aorta receives the full force of blood exiting the heart during ventricular systole. Which of the following statements best describes the adaptive anatomy of the aorta? A) The tunica external of the aorta is nearly absent compared to other vessels. B) The aorta's tunica media is thick with dense regular connective tissue to withstand the blood's pressure. C) Elastic fibers are extensive in the tunica media of the aorta and dampen the pulse pressure generated by the heart. D) Smooth muscle is relatively thin in the aorta to increase lumen size and systemic blood flow.

63)

64) Which of the following statements is NOT true of the precapillary sphincters? A) They increase or decrease rates of perfusion to the tissues served by the true capillaries. B) They decrease the osmotic pressure in the thoroughfare channel. C) They regulate the flow of blood to tissues served by the true capillaries. D) They allow blood to bypass the true capillaries that are fed by the metarteriole.

64)

65) Blood flow is ________ proportional to the difference in blood pressure. Blood flow is ________ proportional to the total peripheral resistance. A) inversely; directly B) inversely; inversely C) directly; directly D) directly; inversely

65)

66) Atherosclerosis causes elastic arteries to become less stretchy. How does this affect pulse pressure? A) Pulse pressure is chronically increased. B) Pulse pressure is temporarily decreased. C) Pulse pressure is chronically decreased. D) Pulse pressure is unaffected by atherosclerosis. E) Pulse pressure is temporarily increased.

66)

67) In general, it is expected that ________. A) osmotic pressure will be lower in the arteriole end of the capillary bed compared to the venous end B) hydrostatic pressure will remain constant throughout the capillary bed C) hydrostatic pressure will drop as blood moves away from the arteriole end of the capillary bed D) hydrostatic pressure will rise as blood moves away from the arteriole end of the capillary bed

67)

68) In general, it is expected that ________. A) hydrostatic pressure will remain constant throughout the capillary bed B) osmotic pressure will be higher in the arteriole end of the capillary bed compared to the venous end C) osmotic pressure will remain relatively consistent throughout the capillary bed D) osmotic pressure will be lower in the arteriole end of the capillary bed compared to the venous end

68)

69) Which of the following is most likely to occur in the arteriovenous shuts present in the blood vessels of the finger tips and toes? A) Colder temperatures will result in vasoconstriction in the arteriovenous shuts. B) Warmer temperatures will result in vasoconstriction in the arteriovenous shuts. C) Colder temperatures will result in vasodilation in the arteriovenous shuts. D) Exercise will result in vasoconstriction in the arteriovenous shuts.

69)

70) Which of the following does NOT contribute to venous blood pressure? A) skeletal muscle activity B) constriction of smooth muscle around veins by the sympathetic nervous system C) increased abdominal pressure during breathing D) venous anastomoses

70)

71) The velocity of blood is slowest in the capillaries and pressure of blood is lowest in the veins. Which of the following is NOT an accurate description of the benefits of slow, low pressure blood in the capillary beds? A) Lower pressure on the venous end of the capillary bed allows for greater reabsorption of fluid back to the plasma. B) Slower blood flow through capillaries allows more time for diffusion to take place in the capillary bed. C) Lower pressure in the capillary bed helps to increase pressure in the venous circulation. D) Lower pressure reduces the chance of injury to delicate capillary vessels.

71)

72) The release of which hormone is most likely to cause a reduction in blood volume and pressure? A) aldosterone B) norepinephrine C) antidiuretic hormone D) atrial natriuretic peptide

72)

73) Which will NOT occur if blood pressure drops below homeostatic levels? A) Baroreceptors in the carotid sinuses and aortic arch will be stimulated. B) Cardiac output will increase. C) The cardioacceleratory center of the medulla will be activated. D) Vasomotor center of the medulla will trigger vasoconstriction.

73)

74) Which statement best describes arteries? A) All contain valves to prevent the backflow of blood. B) All carry oxygenated blood to the heart. C) All carry blood away from the heart. D) Only large arteries are lined with endothelium.

74)

75) Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary function of ________. A) capillaries B) arterioles C) veins D) arteries

75)

76) Which of the following statements regarding the hepatic portal system is FALSE? A) It carries nutrients, toxins, and microorganisms to the liver for processing. B) It consists of a vein connecting two capillary beds together. C) It branches off of the inferior vena cava. D) Its major vessels are the superior mesenteric, inferior mesenteric, and splenic veins.

76)

77) Which of the following contain oxygenated blood? A) pulmonary arteries C) lobar arteries

77) B) pulmonary veins D) pulmonary trunk

78) Each of the following describes the action of aldosterone except one. Which of the following does NOT describe the activity of aldosterone hormone? A) It promotes an increase in sodium reabsorption from the kidney to the blood. B) It will reduce urine output. C) It will result in higher sodium levels in the urine. D) It promotes an increase in blood pressure.

78)

79) The pulse pressure is ________. A) systolic pressure minus diastolic pressure B) diastolic pressure plus 1/3 (systolic pressure plus diastolic pressure) C) systolic pressure divided by diastolic pressure D) systolic pressure plus diastolic pressure

79)

80) Which of the following signs of hypovolemic shock is a relatively late sign? A) rapidly falling blood pressure B) rapid, thready pulse C) increased heart rate D) cold, clammy skin

80)

81) Which of the following is likely during vigorous exercise? A) Blood will be diverted to the digestive organs. B) The skin will be cold and clammy. C) Blood flow to the kidneys increases. D) Capillaries of the active muscles will be engorged with blood.

81)

82) Which of the choices below explains why the arterioles are known as resistance vessels? A) The contraction and relaxation of the smooth muscle in their walls can change their diameter. B) Their prime function is the exchange of nutrients and wastes between the blood and tissue cells. C) They contain a large quantity of elastic tissue. D) They distribute blood to various parts of the body.

82)

83) Which of the following processes provides a long-term response to changes in blood pressure? A) renal regulation B) neural controls C) chemoreceptor-initiated reflexes D) baroreceptor-initiated reflexes

83)

84) Peripheral resistance ________. A) increases as blood viscosity increases B) is not a major factor in blood pressure in healthy individuals C) increases as blood vessel diameter increases D) decreases with increasing length of the blood vessel

84)

85) Brain blood flow autoregulation ________. A) is less sensitive to pH than to a decreased oxygen level B) is controlled by cardiac centers in the pons C) is abolished when abnormally high CO 2 levels persist D) causes constriction of cerebral blood vessels in response to a drop in systemic blood pressure

85)

86) Blood flow to the skin ________. A) increases when environmental temperature rises B) increases when body temperature drops so that the skin does not freeze C) is not an important source of nutrients and oxygen for skin cells D) is controlled mainly by decreasing pH

86)

87) Which of the choices below reflects the balance (or imbalance) between the direction and amount of fluid that flows across the capillary walls? A) hydrostatic pressure only B) hydrostatic and osmotic pressure C) blood volume and viscosity D) plasma and formed element concentration

87)

88) Which of the following is a type of circulatory shock? A) cardiogenic, which results from any defect in blood vessels B) circulatory, where blood volume is normal and constant C) vascular, due to extreme vasodilation as a result of loss of vasomotor tone D) hypovolemic, caused by increased blood volume

88)

89) The abdominal aorta splits into which vessels? A) right and left common carotid arteries C) right and left femoral arteries

89) B) right and left common iliac arteries D) right and left subclavian arteries

90) The influence of blood vessel diameter on peripheral resistance is ________. A) significant because resistance is inversely proportional to the fourth power of the vessel radius B) the only factor that influences resistance C) insignificant because vessel diameter does not vary D) significant because resistance is directly proportional to the blood vessel diameter

90)

91) The form of circulatory shock known as hypovolemic shock is ________. A) any condition in which blood vessels are inadequately filled and blood cannot circulate normally B) the form of shock caused by anaphylaxis C) shock that results from large-scale loss of blood volume, or after severe vomiting or diarrhea D) always fatal

91)

92) Which of the following is the most significant source of blood flow resistance? A) total blood vessel length B) blood vessels type D) blood viscosity C) blood vessel diameter

92)

93) The term ductus venosus refers to ________. A) a fetal shunt that bypasses the lungs B) a special fetal vessel that allows umbilical blood to bypass the liver C) a condition of the aged in which the arteries lose elasticity D) damage to the valves in the veins, leading to varicose veins

93)

94) The beginning of a true capillary is surrounded by a precapillary sphincter. The opening and closing of precapillary sphincters is controlled by ________. A) sympathetic nervous system B) local chemical conditions D) parasympathetic nervous system C) blood pressure in the metarteriole

94)

95) The pulse rate depends on all of the following except one. Select the one answer the does NOT affect a pulse rate reading. A) activity B) postural changes C) the vessel selected to palpate D) emotions

95)

96) Which of the following is least involved in pulmonary circulation? A) right ventricle B) superior vena cava C) left atrium D) pulmonary arteries and veins

96)

97) Histologically, the ________ is squamous epithelium supported by a sparse connective tissue layer. A) tunica externa B) tunica intima C) tunica adventitia D) tunica media

97)

98) Due to the branching of arteries the type of arteries that would be most numerous would be ________. A) elastic arteries B) arterioles C) pulmonary arteries D) muscular arteries

98)

99) Which of the following is NOT true regarding fenestrated capillaries? A) Fenestrated capillaries in the small intestine receive nutrients from digested food. B) Fenestrated capillaries are essential for filtration of blood plasma in the kidney. C) Fenestrated capillaries form the blood-brain barrier. D) Fenestrated capillaries in endocrine organs allow hormones rapid entry into the blood.

99)

100) These capillaries may be lined with phagocytes that can extend their process into the plasma to catch "prey." A) thoroughfare channels B) anastomoses C) sinusoids D) fenestrations

100)

101) Factors that aid venous return include all EXCEPT ________. A) venous valves B) pressure changes in the thorax C) urinary output D) activity of skeletal muscles

101)

102) Which of the following blood pressure readings would be indicative of hypertension? A) 120/80 B) 170/96 C) 140/90 D) 110/60

102)

103) Select the correct statement about factors that influence blood pressure. A) Systemic vasodilation would increase blood pressure, due to diversion of blood to essential areas. B) Excess albumen transport protein production would decrease blood pressure. C) An increase in cardiac output corresponds to a decrease in blood pressure, due to the increased delivery. D) Excess red cell production would cause a blood pressure increase.

103)

104) Mechanisms that do NOT help regulate blood pressure include ________. A) chemical controls such as atrial natriuretic peptide B) nervous control that operates via reflex arcs involving baroreceptors, chemoreceptors, and higher brain centers C) renal regulation via the renin-angiotensin system of vasoconstriction D) the dural sinus reflex

104)

105) The velocity of blood flow is ________. A) slowest in the capillaries because the total cross-sectional area is the greatest B) slower in the arteries than in capillaries because arteries possess a relatively large diameter C) in direct proportion to the total cross-sectional area of the blood vessels D) slower in the veins than in the capillaries because veins have a large diameter

105)

106) Select the correct statement about blood flow. A) It is greatest where resistance is highest. B) It is relatively constant through all body organs. C) It is measured in mm Hg. D) Blood flow through the entire vascular system is proportional to cardiac output.

106)

107) A thrombus (blood clot) in the first branch of the arch of the aorta would affect the flow of blood to the ________. A) left side of the head and neck B) left upper arm C) myocardium of the heart D) right side of the head and neck and right upper arm

107)

108) Cerebral blood flow is regulated by ________. A) skin temperature C) ADH

108) B) intrinsic autoregulatory mechanisms D) the hypothalamic "thermostat"

109) A patient with essential hypertension might have pressures of 200/120 mm Hg. This hypertensive state could result in all of the following changes EXCEPT ________. A) increased damage to blood vessel endothelium B) decreased size of the heart muscle C) increased incidence of coronary artery disease D) increased work of the left ventricle

109)

110) The short-term controls of blood pressure, mediated by the nervous system and bloodborne chemicals, primarily operate via all but which of the following? A) reflex arcs associated with vasomotor fibers B) chemoreceptors C) altering blood volume D) reflex arcs involving baroreceptors

110)

111) Secondary hypertension can be caused by ________. A) smoking B) kidney disease

111) C) obesity

D) stress

112) Where in the body would you find low oxygen levels causing vasoconstriction and high levels causing vasodilation? A) liver B) lungs C) heart D) kidney

112)

113) Normal average blood pressure for a newborn baby is ________. A) 90/55 B) 130/80 C) 150/90

113) D) 120/80

114) If a person has lost a significant amount of blood but still maintains a normal blood pressure it does not necessarily mean that the person is maintaining adequate perfusion. Which of the following best explains why this is so? A) The heart has increased its rate to increase cardiac output. B) The heart has increased its contractile force increasing cardiac output. C) The sympathetic nervous system has increased its nervous impulses. D) Blood vessels are constricting causing greater peripheral resistance.

114)

115) What do the ductus arteriosus and the foramen ovale become at birth? A) fossa ovalis; ligamentum arteriosum B) ligamentum arteriosum; ligamentum teres C) ligamentum teres; fossa ovalis D) ligamentum arteriosum; fossa ovalis

115)

116) Which of the following would NOT result in the dilation of the feeder arterioles and opening of the precapillary sphincters in systemic capillary beds? A) a local increase in histamine B) a local increase in pH C) an increase in local tissue carbon dioxide D) a decrease in local tissue oxygen content

116)

117) Arteriolar blood pressure increases in response to all but which of the following? A) increasing stroke volume B) falling blood volume C) rising blood volume D) increasing heart rate E) all of these

117)

118) The baroreceptors in the carotid sinus and aortic arch are sensitive to which of the following? A) a decrease in carbon dioxide B) a decrease in oxygen levels C) changes in arterial pressure D) an increase in oxygen levels

118)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 119) A family of peptides called ________ are released by the endothelium and are among the most potent vasoconstrictors known.

119)

120) Arterial ________ provide alternate pathways for blood to get to an organ.

120)

121) The ________ in the carotid sinuses and aortic arch detect increases in blood pressure.

121)

122) The internal carotid arteries supply the ________ with blood.

122)

123) List the major factors that are linked to essential hypertension and note which ones are controllable by the patient.

123)

124) What are the sounds of Korotkoff?

124)

125) Which type of blood vessels contain valves and what is their function?

125)

126) Describe the forces that determine fluid movements across capillary walls.

126)

127) Define vasoconstriction and vasodilation. What is the mechanism of regulation?

127)

128) Consider the diameter of one 4-mm blood vessel and two 2-mm blood vessels. Would the two 2-mm vessels carry more, less, or the same amount of fluid, given that pressure is a constant? Why?

128)

129) The abdominal aorta divides into three arteries at its terminus; what are they?

129)

130) The mesenteric arteries branch off the abdominal aorta, but the mesenteric veins do not connect directly to the vena cava. Why?

130)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 131) Describe the effect of hypovolemic shock on the blood vessels and the heart. 132) Atherosclerosis is a progressive disease of blood vessels that is responsible for millions of deaths each year. Describe the disease process, noting the involvement of specific cell/tissue types and molecules. 133) A woman in her early 50s appeared at a walk -in clinic, complaining of aching pain in her right leg following a fall. Visual examination revealed that the medial aspect of that leg was red and swollen. A diagnosis of phlebitis was made. What is phlebitis, and what more serious condition may result if proper healing does not occur? 134) For each of the following situations, describe the anticipated effect on blood pressure and the physiological basis of the response: (1) a high-salt diet, (2) a blow on the head that damages (disables) the vasomotor center, (3) an attack by a mugger, and (4) a hypothalamic tumor resulting in excess ADH production. 135) Mrs. Gray, a 50-year-old mother of seven children, is complaining of dull, aching pains in her legs. She reports that they have been getting progressively worse since the birth of her last child. During her physical examination, numerous varicosities are seen in both legs. How are varicosities recognized? What veins are most likely involved? What pathologic changes have occurred in these veins, and what is the most likely cause in this patient's case? 136) Mr. Wilson is a 45-year-old stockbroker with essential hypertension. He is African American, obese, and he smokes 2-3 packs of cigarettes daily. What risk factors for hypertension are typified by Mr. Wilson? What steps should be taken to treat Mr. Wilson, and what lifestyle changes should he make? What complications are likely if corrective steps are not taken? 137) A pregnant patient comes into a clinic and asks about a small painless dark compressible bulge that is becoming more apparent on her leg. What is it and what caused it? 138) At the battle of Shiloh in the American Civil War, Confederate General A. S. Johnston was killed when he was shot in the thigh. Witnesses reported that he bled to death almost before he realized that he was wounded. Which blood vessel was most likely to have been injured? Why is a tourniquet usually ineffective in stopping the bleeding from this wound? 14

139) A patient lost a lot of blood during surgery and his blood pressure dropped from 120/80 to 90/50. Describe how the kidneys respond to this change in blood pressure. 140) A patient has an 80% blockage of his left anterior descending coronary artery. Describe what occurs in terms of myocardial oxygen supply and demand if his sympathetic nervous system is stimulated.

Answer Key Testname: UNTITLED19

1) C 2) B 3) A 4) C 5) B 6) B 7) E 8) D 9) A 10) C 11) C 12) D 13) B 14) E 15) A 16) D 17) B 18) C 19) E 20) D 21) A 22) A 23) B 24) C 25) B 26) A 27) A 28) B 29) E 30) D 31) C 32) A 33) D 34) C 35) B 36) D 37) C 38) B 39) A 40) A 41) D 42) B 43) C 44) TRUE 45) FALSE 46) FALSE 47) TRUE 48) TRUE 49) TRUE 50) TRUE 16

Answer Key Testname: UNTITLED19

51) TRUE 52) TRUE 53) TRUE 54) C 55) D 56) C 57) B 58) A 59) B 60) C 61) A 62) A 63) C 64) B 65) D 66) A 67) C 68) C 69) A 70) D 71) C 72) D 73) A 74) C 75) A 76) C 77) B 78) C 79) A 80) A 81) D 82) A 83) A 84) A 85) C 86) A 87) B 88) C 89) B 90) A 91) C 92) C 93) B 94) B 95) C 96) B 97) B 98) B 99) C 100) C 17

Answer Key Testname: UNTITLED19

101) C 102) B 103) D 104) D 105) A 106) D 107) D 108) B 109) B 110) C 111) B 112) B 113) A 114) D 115) D 116) B 117) B 118) C 119) endothelins 120) anastomoses 121) baroreceptors 122) brain 123) The factors are heredity, diet, obesity, age, diabetes mellitus, stress, and smoking. All of these factors are controllable by the patient except for heredity and age. 124) They are thumping sounds heard as an inflated blood pressure cuff is deflated on the arm. They represent blood spurting through the constricted artery and continue until the vessel is no longer constricted. 125) Veins contain valves to prevent blood from flowing backward. This is necessary because the venous vessels are a low-pressure system and the blood must sometimes flow against gravity, particularly in the limbs. 126) (1) Capillary hydrostatic pressure (equal to capillary blood pressure) tends to force fluid out of capillaries into the interstitial spaces. (2) Osmotic pressure, created by large nondiffusible particles in the blood, tends to draw water into the capillaries. At the arterial end of the capillary bed, hydrostatic forces dominate and fluid moves out, while at the venous end, osmotic forces dominate and the net fluid movement is into the capillaries. The net filtration pressure is positive resulting in an overall loss of plasma fluid into the interstitial space. Hence, the function of the lymphatics to eventually return the lost fluid. 127) Vasoconstriction is a reduction in the lumen diameter of a blood vessel due to smooth muscle contraction. Vasodilation is a widening of the lumen due to smooth muscle relaxation. Both are regulated by vasomotor nerve fibers of the sympathetic division of the autonomic nervous system and by local metabolic substances. 128) The two 2-mm vessels would deliver considerably less (8 times less) fluid for two reasons: (1) the resistance in the smaller vessels is much greater and (2) the volume of the 4-mm vessel is greater than that of two 2-mm vessels. Draw a 4-inch circle; then put two 2-inch circles in it and notice the volume difference. Alternatively, consider the effect of the fourth power of the radius, if the radius halves, the flow decreases 16 times, and even 2 smaller vessels would only reduce the difference to an 8-fold decrease. 129) Left and right common iliac arteries and the median sacral artery. 130) The mesenteric veins merge into the hepatic portal vein before entering the liver. The liver dumps into the vena cava. 131) Hypovolemic shock causes blood vessels to constrict to increase venous return and maintain pressure. Heart rate increases to compensate for loss of blood pressure and to maintain cardiac output. If volume loss continues, pressure eventually drops sharply and the shock becomes irreversible, leading to death.

Answer Key Testname: UNTITLED19

132) The disease process involves several stages and usually affects the aorta and coronary arteries. The initial event involves damage to the tunica intima caused by bloodborne chemicals or physical factors such as a mechanical stress from hypertension or infection. Injured endothelial cells release chemicals that increase the uptake by the endothelium of fats, LDLs, and cholesterol. This eventually attracts macrophages that ingest the oxidized fats and, along with smooth muscle cells from the tunica media, transform into foam cells. Foam cells become fatty streaks, which, along with collagen and elastin fibers secreted by smooth muscle cells, form atherosclerotic plaques. These protrude into the lumen and narrow the blood vessels. 133) Phlebitis is an inflammation of a vein accompanied by painful throbbing and redness of the skin over the inflamed vessel. Thrombophlebitis (inflammation of a vein caused by clot formation) can result if proper healing does not occur. The danger in thrombophlebitis is the possibility that a clot could detach and form an embolus. 134) (1) A high-salt diet causes increased sodium in the blood, which increases total extracellular fluid volume. This leads to increased blood volume and blood pressure. (2) Damage to the vasomotor center will cause a loss of vasomotor tone and a drop in blood pressure because the vasomotor center is the integrating center for blood pressure control. (3) During the mugger attack, blood pressure would increase due to sympathetic nervous system stimulation (the fight-or-flight response) triggered by the hypothalamus. (4) Excess ADH production would cause an increase in blood pressure through increased water retention and therefore increased blood volume. ADH also stimulates vasoconstriction. 135) Varicosities are recognized by the enlargement of the veins. Superficial veins are most likely involved because they have little support from surrounding tissues. The veins have become tortuous and dilated because of incompetent valves that allow the blood to pool, stretching the vein walls. The likely cause in this patient's case is her pregnancies, because the enlarged uterus exerts downward pressure on groin vessels, restricting return blood flow to the heart. 136) The risk factors are obesity, race, a high-stress job, and smoking. Mr. Wilson should lose weight, reduce salt intake, quit smoking, and try to reduce his stress level, perhaps by relaxation training. Medical intervention could include treatment with diuretics, beta blockers, calcium channel blockers, and angiotensin converting enzyme inhibitors. Complications could include atherosclerosis, heart failure, renal failure, and stroke. 137) The patient is getting a varicose vein. Due to the growing fetus putting downward pressure on the vessels of the groin and restricting the return of blood to the heart, the valves in the peripheral veins begin to fail. This causes blood pooling, which enlarges these veins and puts additional strain on other peripheral vein valves down the line. 138) The wound severed his femoral artery, the largest artery serving the lower limb. A tourniquet may be ineffective because it is a high-pressure, deep artery with a large diameter. It is therefore difficult to exert enough pressure through the thigh muscles to stop the bleeding. 139) When arterial blood pressure declines, special cells in the kidneys release the enzyme renin into the blood. Renin triggers a series of enzymatic reactions that produce angiotensin II, which is a potent vasoconstrictor. Angiotensin causes an increase in systemic blood pressure, and increases the rate of blood delivery to the kidneys and renal perfusion. It also stimulates the adrenal cortex to secrete aldosterone, a hormone that enhances renal reabsorption of sodium with water following causing water retention and stimulates the posterior pituitary to release ADH, which promotes more water reabsorption. As sodium moves into the bloodstream, water follows; thus, both blood volume and blood pressure rise. Stimulates the thirst center to consume more fluids. 140) When the sympathetic nervous system is stimulated there is increased myocardial contractility, which increases cardiac output and blood flow to active muscles. This increases the demand for oxygen to the cells. The coronary artery is a major blood vessel of the heart. When the demand for myocardial oxygen exceeds the ability of the coronary arteries to supply it, death of myocardial tissue can occur.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 20.1 Using Figure 20.1, match the following: 1) Axillary node(s).

2) Cisterna chyli.

3) Entrance of thoracic duct into subclavian vein.

4) Thoracic duct.

5) Collecting lymphatic vessels.

Figure 20.2 Using Figure 20.2, match the following: 6) Efferent vessels.

7) Cortex.

8) Medullary cord.

9) Trabecula.

10) Medulla.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) Protein-containing fluid within lymphatic vessels.

A) Lymph

11)

B) Thoracic duct 12) Stores blood platelets.

12) C) Spleen

13) Receives lymph from most of the body.

13)

14) Small organs intimately associated with lymphatic vessels.

A) Peyer's patches

14)

B) Lymph nodes 15) Largest lymphatic organ.

15) C) Spleen

16) Isolated clusters of lymph follicles found in the wall of the small intestine.

16)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 17) Peyer's patches are clusters of lymphoid tissue found primarily in the large intestine.

17)

18) The lymphatic capillaries function to absorb the excess protein-containing interstitial fluid and return it to the bloodstream.

18)

19) Lymph capillary permeability is due to minivalves and protein filaments.

19)

20) Lymphatic capillaries are permeable to proteins.

20)

21) Digested fats are absorbed from the intestine by the lymph capillaries.

21)

22) Chyle is delivered to the blood via the lymphatic system.

22)

23) There are more efferent lymphatic vessels leaving a lymph node than there are afferent vessels entering a lymph node.

23)

24) About 3 liters of fluid are lost to the tissue spaces every 24 hours and are returned to the bloodstream as lymph.

24)

25) Because lymph vessels are very low-pressure conduits, movements of adjacent tissues are important in propelling lymph through the lymphatics.

25)

26) Lymphoid tissue is mainly reticular connective tissue.

26)

27) Lymphocytes reside temporarily in lymphoid tissue, then move to other parts of the body.

27)

28) The thymus is the only lymphoid organ that does not DIRECTLY fight antigens.

28)

29) Like blood, lymph flows both to and from the heart.

29)

30) When tissues are inflamed, lymphatic capillaries permit uptake of large particles such as cell debris, pathogens, and cancer cells.

30)

31) The cisterna chyli collects lymph from the lumbar trunks draining the upper limbs and from the intestinal trunk draining the digestive organs.

31)

32) If even a small part of the spleen is left in a ten -year-old child, it will most likely regenerate itself.

32)

33) In the spleen, red pulp is involved in the immune functions and white pulp is involved in disposing of worn-out RBCs.

33)

34) The most important role of the spleen is to provide a site for lymphocyte proliferation and immune surveillance and response.

34)

35) The most important of the secondary lymphoid organs in the body are the lymph nodes.

35)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 36) Small secondary lymphoid organs, which cluster along lymphatic vessels, are termed ________. A) lymphatics B) lymph follicles C) lymph nodes D) lacteals

36)

37) Which of the following would NOT be classified as a lymphoid organ? A) spleen B) tonsils C) pancreas D) Peyer's patches of the intestine

37)

38) Which of the following statements regarding the thymus is FALSE? A) Its stroma consists of epithelial tissue. B) It functions strictly in T lymphocyte maturation. C) It has follicles similar to those in the spleen. D) It does not directly fight antigens.

38)

39) Which of the following correctly describes the pathway of lymph? A) lymphatic ducts to lymphatic capillaries to lymphatic vessels to lymphatic trunks B) lymphatic capillaries to lymphatic vessels to lymphatic trunks to lymphatic ducts C) lymphatic ducts to lymphatic trunks to lymphatic vessels to lymphatic capillaries D) lymphatic vessels to lymphatic trunks to lymphatic ducts to lymphatic capillaries

39)

40) The thymus is most active during ________. A) childhood C) fetal development

40) B) middle age D) old age

41) Lymph traveling from the left arm would enter the venous circulation via the _______. A) thoracic duct B) axillary nodes C) right lymphatic duct D) cisterna chili

41)

42) Which of the following is NOT a part of the lymphatic system? A) lymphatic vessels B) lymph C) erythrocytes D) lymph nodes

42)

43) The lymphatic capillaries are ________. A) less permeable than blood capillaries C) completely impermeable

43) B) as permeable as blood capillaries D) more permeable than blood capillaries

44) Antibodies that act against a particular foreign substance are released by ________. A) T lymphocytes B) plasma cells C) medullary cords D) lymph nodes

44)

45) Lymph leaves a lymph node via ________. A) efferent lymphatic vessels C) the cortical sinus

45) B) the subcapsular sinus D) afferent lymphatic vessels

46) Lymph vessels do NOT transport ________. A) leaked plasma proteins B) lymphocytes C) dietary fats D) excess tissue fluid E) erythrocytes

46)

47) Functions of the spleen include all of those below EXCEPT ________. A) forming crypts that trap bacteria B) removal of old or defective blood cells from the blood C) storage of iron D) storage of blood platelets

47)

48) When the lymphatic structures of a limb are blocked due to tumors, the result is ________. A) abnormally high lymph drainage from the distal region B) severe localized edema distal to the blockage of that limb C) increased pressure in the lymphatics proximal in the limb to the blockage D) shrinkage of tissues distal in the limb to the blockage due to inadequate delivery of lymph

48)

49) Select the correct statement about lymph transport. A) Lymph transport depends on the movement of adjacent tissues, such as skeletal muscles. B) Under normal conditions, lymph vessels are very high-pressure conduits. C) Lymph transport is faster than that occurring in veins. D) Lymph transport is only necessary when illness causes tissue swelling.

49)

50) Select the correct statement about lymphocytes. A) The two main types are T cells and macrophages. B) B cells produce plasma cells, which secrete antibodies into the blood. C) T cells are the only form of lymphocyte found in lymphoid tissue. D) T cells are the precursors of B cells.

50)

51) Select the correct statement about lymphoid tissue. A) Lymphoid tissue is predominantly reticular connective tissue. B) Once a lymphocyte enters the lymphoid tissue, it resides there permanently. C) Lymphoid macrophages secrete antibodies into the blood. D) T lymphocytes act by ingesting foreign substances.

51)

52) Lymphoid tissue that appears as a swelling of the mucosa in the oral cavity is called a(n) ________. A) tonsil B) Peyer's patch C) thymus D) appendix

52)

53) Which of the following structures is NOT considered mucosa-associated lymphoid tissue (MALT)? A) Peyer's patches B) appendix C) thymus D) tonsils

53)

54) Peyer's patches are found in the distal portion of the ________. A) small intestine B) esophagus C) large intestine

54)

D) stomach

55)

55) Lymphatic capillaries are present in ________. A) CNS C) bones and teeth

B) bone marrow D) digestive organs

56) What is a bubo? A) a wall in a lymph node C) a lobe of the spleen

B) an infected lymph node D) an infected Peyer's patch

56)

57) The thymus is the only lymphoid organ that does NOT ________. A) directly fight antigens B) have lymphocytes C) have a cortex and medulla D) produce hormones 58) Large clusters of lymph nodes are NOT found in the ________ region. A) inguinal B) axillary C) cervical

57)

58) D) popliteal

59) Mucosa-associated lymphoid tissues include all of the following EXCEPT ________. A) palatine tonsils B) Peyer's patches C) islets of Langerhans D) lingual tonsils

59)

60) Which of the following is NOT a method that maintains lymph flow? A) capillary smooth muscle contraction B) valves in lymph vessel walls C) skeletal muscle contraction D) breathing

60)

61) The tonsils located at the base of the tongue are the ________. A) palatine tonsils B) pharyngeal tonsils C) Peyer's tonsils D) lingual tonsils

61)

62) Which lymphoid organs and tissues are characterized by a cortex and medulla? A) spleen and thymus only B) lymph nodes, spleen, and mucosa-associated lymphoid tissues (MALT) only C) lymph nodes, thymus and spleen only D) lymph nodes and thymus only

62)

63) Which lymphoid organ atrophies as we age? A) thymus B) appendix

63) C) tonsils

64) Which of the following is considered a primary lymphoid organ? A) tonsils B) thymus C) spleen

D) spleen 64) D) appendix

65) Which of the following is NOT a function of the lymphatic system? A) transporting respiratory gases B) carrying out immune responses C) transporting dietary fats D) draining excess interstitial fluid

65)

66) Which of the following is NOT a function of the spleen? A) produce new erythrocytes in adults B) store iron from hemoglobin C) house B and T lymphocytes D) remove and recycle old erythrocytes and platelets

66)

67) The blood testis barrier is to newly formed sperm cells as the blood thymus barrier is to ________. A) plasma cells B) mast cells C) T lymphocyte precursors D) white pulp

67)

68) Which of the following statements is FALSE? A) Antibodies mark antigens for destruction. B) T lymphocytes originate from the red bone marrow. C) Only lymph nodes filter lymph. D) The thymus consists mainly of lymphoid tissue.

68)

69) Which of the following statements is FALSE regarding the spleen? A) The splenic artery and vein enter and exit the spleen at the hilum. B) Red pulp is where immune functions take place. C) Clusters of white pulp look like islands in a sea of red pulp. D) The spleen is the largest lymphoid organ.

69)

70) Flow of lymph through a lymph node is slowed due to ________. A) the presence of lymphocytes and macrophages B) the viscous nature of lymph C) fewer efferent vessels draining it compared to many afferent vessels feeding it D) mini-valves

70)

71) Tonsils have blind-ended structures called ________ that trap bacteria and particulate matter. A) tonsillar corpuscles B) germinal centers C) lymphoid follicles D) tonsillar crypts

71)

72) From the right leg, lymph moves in which order? A) right lumbar trunk, thoracic duct, left subclavian vein B) right lumbar trunk, right lymphatic duct, left subclavian vein C) right lumbar trunk, right lymphatic duct, right subclavian vein D) right lumbar trunk, thoracic duct, right subclavian vein

72)

73) Although B and T lymphocytes originate in the bone marrow, T cells mature in the ________. A) appendix B) spleen C) tonsils D) thymus

73)

74) Lymphatic ________ are formed from the union of the largest collecting lymphatic vessels. A) capillaries B) trunks C) ducts D) nodes

74)

75) Fats absorbed from the small intestine are transported to the bloodstream via ________. A) lymph nodes B) Peyer's patches C) lacteals D) tonsils

75)

76) Which lymphoid organ or tissue lacks a reticular fiber stroma? A) spleen B) thymus C) mucosa-associated lymphoid tissue (MALT) D) lymph nodes

76)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 77) Describe the structural and functional relationship between a capillary bed of the blood vascular system and lymphatic capillaries.

77)

78) Describe the mechanisms by which lymphatic fluid is moved through the lymphatics.

78)

79) What is the consequence of obstruction of the lymphatics?

79)

80) Where are the lymph node aggregations most dense?

80)

81) What is the special role of the thymus gland?

81)

82) Name the tonsils and state their body locations.

82)

83) List the functions of the spleen.

83)

84) Characterize lymph transport in terms of rate, volume, and ability to change.

84)

85) How do the lymphatic capillaries differ from blood capillaries?

85)

86) How does the lymphatic system both help and hinder the spread of cancer through the body?

86)

87) How does the structure of a lymph node allow lymphocytes and macrophages to perform their protective function?

87)

88) Define the term MALT. What is its function?

88)

89) How are lymphatic capillaries affected by tissue inflammation?

89)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 90) A mother takes her son to the doctor and describes the following symptoms that she has observed. The child is running a fever, has flu-like symptoms, and his lymph glands are very swollen and sore to the touch. Of what significance are the swollen and sore lymph glands? 91) A woman had a mastectomy that included the removal of axillary lymph nodes on her left side. What does she risk regarding her left arm and why? 92) A man involved in a traffic accident is rushed to the emergency room of a hospital with severe internal bleeding. Examination reveals a ruptured spleen. What is the treatment of choice and what is the likely long-term outcome (prognosis)? 93) While passing through a village on safari you notice a man with one enormous leg and one normal -sized leg. What could have caused the increased size of the swollen leg?

94) Lymphedema may occur as a complication after a radical mastectomy, in which lymph nodes have been removed. Explain why it might occur. 95) A nurse palpated enlarged lymph nodes. Describe signs and symptoms that help to distinguish cancerous lymph nodes from infected lymph nodes. 96) Describe why the prognosis of cancer is best when there is no detectable spread from the region of the primary tumor to the lymph nodes. 97) As the human immunodeficiency virus (HIV) progresses, some individuals develop persistent generalized lymphadenopathy (any disease of the lymph nodes). Explain why this may occur.

Answer Key Testname: UNTITLED20

1) B 2) D 3) A 4) C 5) E 6) E 7) C 8) D 9) A 10) D 11) A 12) C 13) B 14) B 15) C 16) A 17) FALSE 18) TRUE 19) TRUE 20) TRUE 21) TRUE 22) TRUE 23) FALSE 24) TRUE 25) TRUE 26) TRUE 27) TRUE 28) TRUE 29) FALSE 30) TRUE 31) FALSE 32) TRUE 33) FALSE 34) FALSE 35) TRUE 36) C 37) C 38) C 39) B 40) A 41) A 42) C 43) D 44) B 45) A 46) E 47) A 48) B 49) A 50) B 10

Answer Key Testname: UNTITLED20

51) A 52) A 53) C 54) A 55) D 56) B 57) A 58) D 59) C 60) A 61) D 62) D 63) A 64) B 65) A 66) A 67) C 68) D 69) B 70) C 71) D 72) A 73) D 74) B 75) C 76) B 77) Blind-ended lymphatic capillaries weave between the tissue cells and blood capillaries in the loose connective tissues of the body. Although similar to blood capillaries, lymphatic capillaries are even more permeable due to minivalves that act as one-way swinging doors. Leaked fluid from blood capillaries is taken up by the lymphatic capillaries as well as proteins in the interstitial space that are unable to enter blood capillaries. 78) Lymphatic fluid is moved through the lymphatics by the milking action of active skeletal muscles, pressure changes within the thorax during breathing, valves to prevent backflow, and pulsation of adjacent arteries. 79) Obstruction of the lymphatics results in edema distal in the body to the obstruction. 80) Lymph node aggregations are most dense near the body surface in the inguinal, axillary, and cervical regions of the body. 81) By secreting hormones, the thymus gland causes T lymphocytes to become immunocompetent (able to defend against specific pathogens in the immune response). 82) Palatine tonsils are located on either side at the posterior end of the oral cavity. The lingual tonsil lies at the base of the tongue. The pharyngeal tonsil is in the posterior wall of the nasopharynx. The tiny tubal tonsils surround the openings of the auditory tubes into the pharynx. 83) The spleen's main functions are to remove aged or defective blood cells and platelets from the blood and to store or release some of the breakdown products of RBCs to the blood for processing by the liver. Other functions include acting as a blood filter and reservoir, serving as a site for erythrocyte production in developing embryos, storing blood platelets, and providing a site for lymphocyte proliferation and immune surveillance and response. 84) Lymph transport is sporadic and much slower than that occurring in veins. About 3 liters of lymph enters the bloodstream in a 24-hour period. An increase in physical activity will cause lymph flow to increase, balancing the greater rate of fluid outflow from the vascular system.

Answer Key Testname: UNTITLED20

85) Although similar to blood capillaries, lymphatic capillaries differ structurally in the following ways: (1) The endothelial cells forming the walls of lymphatic capillaries are not tightly joined. Their edges loosely overlap one another, forming flaplike minivalves. (2) Bundles of fine filaments anchor the endothelial cells to surrounding structures so that any increase in interstitial fluid volume separates the cell flaps, exposing gaps in the wall rather than causing the lymphatic capillary to collapse. 86) Lymph nodes help rid the body of cancer cells by immune mechanisms. Lymph vessels may also be used to spread cancer cells throughout the body if immunity is not effective against the cancer cells because a cancer cell that escapes lymphatic filtration will reach the bloodstream and be carried anywhere in the body. 87) Macrophages and lymphocytes are located in lymph nodes. Macrophages ingest microorganisms and cellular debris. Lymphocytes monitor the lymphatic stream for the presence of antigens and mount an immune response. Because there are fewer efferent vessels draining the node than afferent vessels that feed it, the flow of lymph through the node stagnates somewhat, allowing time for the lymphocytes and macrophages to work. 88) MALT is an acronym for mucosa-associated lymphoid tissues. It includes Peyer's patches, the appendix, and the tonsils in the digestive tract, lymphoid follicles in the walls of the bronchi, and genitourinary tract. Collectively, MALT protects passages open to the exterior from foreign matter invading the walls. 89) When tissues become inflamed, lymphatic capillaries develop openings that permit uptake of larger particles such as cell debris, pathogens (disease-causing microorganisms such as bacteria and viruses), and cancer cells. In the lymph nodes, cells of the immune system "examine" the lymph and cleanse it of debris. 90) When tissues are inflamed, such as due to a bacterial infection, lymphatic capillaries develop openings that permit the uptake of the pathogens. The inflammation and pain indicate lymph nodes infected by microorganisms. 91) Total removal of the axillary lymph nodes results in severe localized edema because the lymphatic vessels are also lost. This results in chronic edema along the arm, although some lymphatic drainage is eventually reestablished by regrowth of the vessels. 92) Supportive care or splenic repair is the treatment of choice, depending on severity. Splenectomy is not as necessary as once believed, and is now performed less frequently. If the spleen does need to be removed, the prognosis is very good, as the functions of the spleen are largely taken over by the liver and bone marrow. 93) The man has Filariasis commonly known as elephantiasis, which is caused by parasitic worms that get in the lymph system and reproduce to proportions that block the vessels. The swelling is due to edema. 94) Anything that prevents the normal return of lymph to the blood, such as blockage of the lymphatics by tumors or removal of lymphatics during surgery, results in severe localized edema (lymphedema). 95) Tender nodes are usually due to inflammation, whereas hard, fixed, nontender nodes are suggestive of malignancy. 96) Cancer cells that break free from the primary tumor can metastasize via the lymph system. Even if a lymph node is 99% effective in trapping malignant cells, given the ability of a tumor to continuously shed cells into lymphatic capillaries, that still means that 100 out of every 10,000 cells get through. So the presence of any trapped cells in a lymph node is a warning that a few others may have escaped entrapment. 97) This may occur because lymph nodes are overwhelmed by a large number of virus particles trapped in the nodes, which stimulate an ineffective immune reaction but cannot be quickly eliminated due to the weakened immune state. The weak immune reaction persists, causing swelling of the nodes.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 21.1 Using Figure 21.1, match the following: 1) Heavy chain.

2) Light chain.

3) Variable region.

4) Constant region.

5) Antigen-binding site.

Figure 21.2 Using Figure 21.2, match the following: 6) Area where B cells become immunocompetent.

7) Area where T cells become immunocompetent.

8) Area where activated immunocompetent B and T cells recirculate.

9) Area seeded by immunocompetent B and T cells.

10) Area where antigen challenge and clonal selection are most likely to occur.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) First line of defense.

A) Inflammatory response and skin and mucous membranes

12) Second line of defense. B) Inflammatory response 13) Third line of defense. C) Immune response 14) Innate defense system. D) Intact skin and mucous membranes 15) Adaptive defense system.

11) 12) 13) 14) 15)

Match the following: 16) Enables quick and efficient response to secondary exposure to antigen.

A) T helper cell

16)

B) Cytotoxic T cell 17) Absence results in no immune response.

C) Regulatory T cell

18) Forms antibody-producing cells.

D) Memory cell

18)

19) Kills cancer cells and virus infected body cells.

E) B cell

19)

17)

20) Slows or stops the immune response.

20)

Match the following: 21) Main antibody of both primary and secondary immune response.

A) IgM

21)

B) IgE 22) Protects mucosal barriers.

22) C) IgG

23) Involved in allergies.

23) D) IgA

24) Along with IgM, this is a B cell receptor.

24) E) IgD

25) First to peak during a primary immune response.

25)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 26) Virus infected cells secrete interferons to "warn" other cells of the presence of virus and deny entry to them.

26)

27) Perforins form complexes that penetrate the cell membrane and allow the passage of the apoptosis inducing protein granzyme to enter the targeted cell.

27)

28) Natural killer cells destroy target cells or pathogens by ingestion and destruction of particulate matter in a process called phagocytosis.

28)

29) The respiratory burst produced by activated macrophages releases free radicals which are effective at killing pathogens.

29)

30) The directional movement of cells in response to chemicals is called chemotaxis.

30)

31) Soluble proteins secreted by plasma cells are called antibodies.

31)

32) Viral infection will provoke cell mediated immunity but will not activate a humoral response.

32)

33) Fever is often a beneficial immune response because it can speed the activities of leucocytes.

33)

34) Monoclonal antibodies are used in clinical laboratory diagnosis because they bind to many antigenic determinates.

34)

35) B cells must accomplish double recognition: they must simultaneously recognize self and nonself to be activated.

35)

36) Some immunocompetent cells will never encounter an antigen to which they can bind and therefore will never be called to service in our lifetime.

36)

37) Anaphylactic shock is a rare but severe allergic response that may occur if the allergen enters the blood stream.

37)

38) In a case of immediate hypersensitivity, the immune system responds with an allergic response on the first exposure to the allergen.

38)

39) Subacute hypersensitivities are categorically less harmful than acute (immediate) hypersensitivities.

39)

40) The nucleotide sequence within the genes that produce B cell receptor and antibodies are reshuffled by a process called somatic recombination. This produces the huge variability in antibody types.

40)

41) Antibodies typically act extracellularly in body fluids and are therefore considered part of the humoral branch of adaptive immunity.

41)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 42) An advantage to adaptive immunity is ________. A) its memory cells that provide quicker, larger and more efficient immune response upon second and subsequent exposure to an antigen B) its need for several cells to be activated over several days on first exposure C) the use of antibodies that cause cell lysis and kill invading cells D) the ability of its individual cells to respond to many different pathogens

42)

43) A cellular component of the innate defenses includes ________. A) natural killer cells B) B cells C) plasma cells D) T cells

43)

44) B lymphocytes are categorized as part of the adaptive branch of the immune system for all of the following reason but one. Which of the following is NOT one of the reasons B lymphocytes are considered part of the adaptive immunity? A) They require costimulation from an activated T helper cell. B) Their receptors will bind to only one antigen. C) They produce memory cells when activated. D) They are a first line of defense that can begin killing pathogens immediately.

44)

45) T cells are differentiated into two groups based on their glycoproteins: CD4 or CD8. Which of the following is true of CD4 T cells? A) They become plasma cells. B) They become T helper cells. C) They become antigen presenting cells (APC) cells. D) They become cytotoxic T cells.

45)

46) Which of the following examples below describes an autoimmune disease? A) Antibody binding to acetylcholine receptors of the motor end plate resulting in muscle weakness. B) Release of bacterial endotoxins that block acetylcholine release result in muscle paralysis. C) Infection and death of T helper cells by a virus, resulting in a loss of adaptive immunity. D) Uncontrolled cell division resulting in cell surface abnormalities recognized by NK cells.

46)

47) Which of the following does NOT describe actions of interferon (IFN)? A) Virally infected cells can release interferon which attracts NK cells to attack and kill the IFN secreting cell. B) IFN will attract macrophages to the secreting cell to be removed by phagocytosis. C) IFN binds to normal, uninfected cells stimulating the activation of genes that produce anti-viral proteins. D) IFN can penetrate the viral capsid and destroy the virus.

47)

48) A vaccine is effective because ________. A) B-lymphocytes are unable to mount an immune response the first time they are exposed to a new pathogen B) the vaccine contains the lymphocytes necessary to fight infection C) the vaccine contains the antibodies necessary to fight infection D) the secondary response of the adaptive immunity is faster and more efficient than the primary response

48)

49) A flu vaccine is needed seasonally to be effective but a polio vaccine is only needed once. The best explanation of this is ________. A) the polio virus is substantially weaker than the flu virus B) exposure to flu vaccine produces no memory cells from proliferating B -lymphocytes C) the flu vaccine is substantially weaker than the polio vaccine D) the flu has several strains that change seasonally

49)

50) All of the following are true of the classical pathway of complement activation except one. Select the one answer that does NOT describe the classical pathway of complement activation. A) Classical activation will result in enhanced inflammation, opsonization as well as formation of MAC proteins. B) It activates T helper cells by presenting antigen to them. C) It is an example of overlap between innate and adaptive immune function. D) It requires that circulating antibodies are bound to antigens.

50)

51) Vaccines work by ________. A) boosting innate immunity with cytokines B) priming the adaptive immunity with a relatively harmless primary exposure C) suppressing inflation to help speed healing D) providing the necessary antibodies to fight infections

51)

52) Inflammation ________. A) brings more leukocytes to the sight of infection B) is caused by bacterial activity to enhance the spread of disease C) slows the healing process with swelling that can impair bodily function D) is caused by viral activity to enhance the spread of the disease

52)

53) Membrane attack complex (MAC) kills by ________. A) providing a passage for antibodies to enter into the bacterial cytosol B) penetrating the capsule of the bacteria giving antibiotic drugs access to bacterial cells C) allowing the organelles to spill free from the bacteria D) disrupting the selectively permeability of a bacteria's plasma membrane

53)

54) All but one of the following occurs during the inflammatory response. Select the example below that does NOT describe the process of inflammation. A) Vasoconstriction prevents excessive blood loss due to injury. B) Chemotaxis draws leucocytes to the site of injury. C) Release of prostaglandins results in pain. D) Inflammation increases capillary permeability.

54)

55) During inflammation, fluids will passively diffuse out of blood vessels into the nearby infected tissues. This implies all of the following EXCEPT ________. A) nearby capillaries have become more permeable B) the surrounding tissue will swell with excessive fluids C) the osmolarity of the fluids surrounding infected tissue is higher than the plasma D) B-lymphocytes will differentiate to become plasma cells

55)

56) Which of the following is true of antigens? A) Antigens are limited to one antigenic determinant per antigen molecule. B) Antigens are typically composed of nucleotides. C) Antigens are substances that activate the adaptive immune response. D) Antigens are produced by the body in response to a foreign invader.

56)

57) Which of the following is true of incomplete antigens (haptens)? A) Incomplete antigens are nonreactive. B) Incomplete antigens are typically large macromolecules such as proteins. C) Incomplete antigens are only immunogenic when attached to protein carriers. D) Incomplete antigens include pollen grains, microorganisms, and viruses.

57)

58) Allergens differ from antigens because ________. A) allergens are primarily plant derived while antigens are bacterial or viral in nature B) allergens produce an abnormally large immune response to what is an otherwise harmless particle C) allergens do not involve the leucocytes, they simply stimulate the inflammatory response D) allergens are only active seasonally and are generally harmless to the body

58)

59) Without the positive selection process in lymphocyte maturation ________. A) autoimmune diseases would be likely to result B) monocytes would not be able to migrate into infected tissue and differentiate into macrophages C) T cells would not be able to properly bind to APC's and therefore not be activated by them D) NK cells would be non-functional

59)

60) Lymphocyte "education" refers to ensuring that T cells _______. A) that demonstrate immunological self-tolerance undergo apoptosis B) that do not recognize self-MHC proteins undergo apoptosis C) that contain MHC receptors undergo apoptosis D) that do not recognize self-antigens displayed on self-MHC proteins undergo apoptosis

60)

61) Plasma cells ________. A) are small so that they slip between endothelial cells of capillaries to fight infection in the surrounding tissues B) have a great deal of rough endoplasmic reticulum to dispose of ingested pathogens C) are large so that they can envelope their prey by phagocytosis D) have a great deal of rough endoplasmic reticulum reflecting the fact that they secrete a tremendous amount of protein (antibody)

61)

62) Which of the following is associated with passive immunity? A) passage of IgG antibodies from a pregnant mother to her fetus B) infusion of weakened viruses C) booster shot of vaccine D) exposure to an antigen

62)

63) Which of the following is NOT a type of T cell? A) helper B) regulatory

63) C) cytotoxic

D) antigenic

64) B lymphocytes develop immunocompetence in the ________. C) thymus A) lymph nodes B) bone marrow

64) D) spleen

65) Which of the following is NOT a function of the inflammatory response? A) sets the stage for repair processes B) prevents the spread of the injurious agent to nearby tissue C) replaces injured tissues with connective tissue D) disposes of cellular debris and pathogens

65)

66) The redness and heat of an inflamed area are due to a local hyperemia caused by ________. A) vasoconstriction B) complement production C) phagocyte mobilization D) vasodilation

66)

67) In clonal selection of B cells, which substance is responsible for determining which cells will eventually become cloned? A) complement B) interferon C) antigen D) antibody

67)

68) Which of the following statements regarding NK cells is a false or incorrect statement? A) NK cells attack cancer cells and virus-infected body cells. B) NK cells are a type of neutrophil. C) NK cells are present in the blood, spleen, lymph nodes, and red bone marrow. D) NK cells attack cells that display abnormal or lack MHC antigens.

68)

69) Small molecules that bind with self-proteins to produce antigenic substances are called ________. A) antibodies B) reagins C) ions D) haptens

69)

70) Which of the following is NOT a role of activated complement? A) enhancement of inflammation B) insertion of MAC and cell lysis C) opsonization D) prevention of immediate hypersensitivity reactions

70)

71) Interferons ________. A) are virus-specific, so that an interferon produced against one virus could not protect cells against another virus B) are routinely used in nasal sprays for the common cold C) act by increasing the rate of cell division D) interfere with viral replication within cells

71)

72) Regulatory T cells ________. A) may function in preventing autoimmune reactions B) aid B cells in antibody production C) release cytokines that increase the activity of cytotoxic T cells and activated B cells D) decrease their activity as antigenic stimulus decreases

72)

73) Which of the statements below does NOT describe antigens? A) Antigens exhibit immunogenicity and reactivity. B) Antigens can include proteins, nucleic acids, lipoproteins, glycoproteins, and certain large polysaccharides. C) The parts of antigen molecules that initiate immune responses are called epitopes or antigenic determinants. D) Antigens only come from microbes.

73)

74) Activated T cells and macrophages release ________ to mobilize immune cells and attract other leukocytes into the area. A) perforins B) interleukin 1 proteins C) cytokines D) interleukin 2 proteins

74)

75) Which of the following would be a component of the body's first line of defense? A) inflammation B) phagocytes C) mucous membranes D) natural killer cells

75)

76) Which of the following is characteristic of complete antigens? A) inhibit production of antibodies B) contain many repeating chemical units C) small molecules D) reactivity with an antibody

76)

77) B cells respond to the initial antigen challenge by ________. A) producing progeny cells that include plasma cells and memory cells B) forming a large number of cytotoxic cells C) immediately producing antigen-specific antibodies D) reducing its size

77)

78) T-cell activation requires ________. A) antibody production and co-stimulation B) antigen binding and co-stimulation C) antigen binding, antibody production, and co -stimulation D) antigen binding and antibody production

78)

79) Cancer cells and virus-infected body cells can be killed before activation of adaptive immunity by ________. A) T-lymphocytes B) natural killer cells C) B-lymphocytes D) pinocytosis

79)

80) Complement proteins and antibodies coat a microorganism and provide binding sites, enabling macrophages and neutrophils to phagocytize the organism. This phenomenon is termed ________. A) chemotaxis B) diapedesis C) agglutination D) opsonization

80)

81) Monoclonal antibodies are used for the diagnosis of all of the following EXCEPT ________. A) hepatitis B) pregnancy C) rabies D) elevated blood glucose

81)

82) Innate immune system defenses include ________. A) phagocytosis B) T cells

82) C) plasma cells

D) B cells

83) Which of the following statements is incorrect or false? A) Class II MHC molecules appear only on the surface of antigen-presenting cells, thymic cells, and T cells that have been activated by exposure to antigens. B) Haptens lack immunogenicity unless attached to protein carriers. C) MHC proteins are the cell's identity markers. D) Class I MHC molecules are built into the plasma membranes of all body cells.

83)

84) Phagocyte mobilization involves ________. A) mainly neutrophil and macrophage migration into inflamed areas B) diapedesis, during which cells line up against the capillary wall C) margination, which is the process of white cell movement through the walls of capillaries into injured tissues D) monocytes as the most active phagocyte

84)

85) Fever ________. A) production is regulated by chemicals that reset the body's thermostat to a higher setting B) is a higher-than-normal body temperature that is always dangerous C) causes the liver to release large amounts of iron, which seems to inhibit bacterial replication D) decreases the metabolic rate of the body to conserve energy

85)

86) Immunocompetence ________. A) is the ability of individual cells to recognize a specific antigen by binding to it B) prevents intercellular communication so that only specific cell types respond to the invader C) occurs in one specific organ of the adaptive immune system D) requires exposure to an antigen

86)

87) Select the correct statement about active and passive immunity. A) The antibodies utilized in active immunity are acquired from another organism. B) Immunological memory is established by passive immunization. C) Active and passive humoral immunity are both mechanisms of adaptive immunity that use antibodies. D) A vaccination is an example of the introduction of passive immunity into the body.

87)

88) Cytotoxic T cells ________. A) function mainly to stimulate the proliferation of other T cell populations B) self-destruct once the antigen has been neutralized C) can directly attack and kill other cells of the body D) require the double recognition signal of class I MHC plus class II MHC on the target cell in order to function

88)

89) T helper cells ________. A) release B7 proteins B) often function to decrease the immune response C) bind tightly to target cells and release a lymphotoxin called perforin D) function in the adaptive immune system activation

89)

90) Immediate and subacute hypersensitivities are caused by ________ that trigger the release of _________. A) memory T cells; perforins B) memory B cells; antibodies C) viruses; interferon D) antibodies; histamine

90)

91) Natural killer (NK) cells ________. A) are also called cytotoxic T cells B) can kill cancer cells before the immune system is activated C) are a type of phagocyte D) are cells of the adaptive immune system

91)

92) Select the correct statement about antigens. A) The largest type of antigen is called a hapten. B) One antigen may have many different antigenic determinants and may therefore cause the formation of more than one antibody. C) Only small antigens exhibit reactivity. D) "Self-antigens" is another name for incomplete antigens.

92)

93) Clonal selection of B cells ________. A) only occurs in the secondary immune response B) occurs during fetal development C) cannot occur in the presence of antigens D) results in the formation of plasma cells

93)

94) The primary immune response ________. A) is another name for immunological memory B) has a lag period while B cells proliferate and differentiate into plasma cells C) occurs when memory cells are stimulated D) occurs more rapidly and is stronger than the secondary response

94)

95) Tissue rejection after an organ transplant is least likely due to the action of _________. A) natural killer cells B) macrophages C) regulatory T cells D) cytotoxic T cells

95)

96) Which of the following is NOT a mechanism for the development of autoimmune disorders? A) exposure of previously "hidden" self-antigens to the adaptive immune system during trauma B) a second exposure to an allergen C) cross-reaction of antibodies formed against foreign antigens (haptens) bound with self-antigens D) mutation followed by the appearance of membrane proteins not previously present

96)

97) Which of the following is activated by the binding of proteins to sugars on the surface of microorganisms? A) lectin pathway B) classical pathway C) alternative pathway D) lactate pathway

97)

98) Antibody functions include all of the following EXCEPT ________. A) cross-linking cell-bound antigens on red blood cells when blood types are properly matched B) binding and inactivating chemical toxins released by bacteria or other microorganisms C) targeting foreign cells so that complement proteins can cause cellular lysis D) linking soluble antigens together so that they fall out of solution

98)

99) Which statement is true about T cells? A) Their proliferation is enhanced by interleukins 1 and 2. B) They usually directly recognize antigens, which then activates a subpopulation of killer cells. C) Once activated, they cannot secrete cytokines. D) They will develop into cytotoxic T cells if antigen is complexed with class II MHC proteins.

99)

100) What is the role of interferon in defense against disease? A) protects cells that have not yet been infected by bacteria B) protects cells that have not yet been infected by viruses C) activates the inflammatory process D) activates the complement mechanism

100)

101) Which of the following statements is a false or incorrect statement? A) T cells and B cells become activated when they bind with recognized antigens. B) The lymphoid organs where lymphocytes become immunocompetent are called primary lymph organs. All other lymphoid organs are referred to as secondary lymphoid organs. C) It is our genes, not antigens, that determine what specific foreign substances our immune system will be able to recognize and resist. D) After becoming immunocompetent, the naive T cells and B cells are exported to the bone marrow where the encounters with antigens occur.

101)

102) Which immunoglobulin class is the most abundant antibody in plasma? A) IgD B) IgM C) IgG D) IgE

102) E) IgA

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 103) Suppressor factors are ________ that suppress the immune system.

103)

104) Pure antibody preparations specific for a single antigenic determinant are called ________ antibodies.

104)

105) The most common type of immediate hypersensitivity is ________.

105)

106) Natural killer cells can lyse and kill cancer cells and virus-infected body cells ________ the immune system is activated.

106)

107) Septic shock is a dangerous condition where the ________ are released unchecked, making the capillaries very leaky and thus depleting blood fluids.

107)

108) Harmful or disease-causing microorganisms are called ________.

108)

109) A group of at least 20 plasma proteins that normally circulate in an inactive state and are a major mechanism for destroying foreign substances in the body are referred to as ________.

109)

110) The antibody that becomes bound to mast cells and basophils and causes the cells to release histamine and other chemicals is ________.

110)

111) Failure of developing T cells to recognize self MHC during positive selection results in ________.

111)

112) An autoimmune disease that severely impairs renal function is ________.

112)

113) List and briefly discuss innate body defenses to disease.

113)

114) What are monoclonal antibodies? How are they produced, and what are some of their clinical uses?

114)

115) What is the antigen challenge, and where does it usually take place?

115)

116) Why are regulatory T cells important to the immune process?

116)

117) What is the most likely type of hypersensitivity associated with an agonizingly itchy case of poison ivy, appearance of hives after eating shellfish, or a positive TB test?

117)

118) Children born without a thymus must be kept in a germ -free environment if they are to survive. Explain why this is necessary.

118)

119) What are the signs of inflammation, and how does inflammation serve as a protective function?

119)

120) Name four autoimmune diseases.

120)

121) What are two general mechanisms by which autoimmune diseases could arise?

121)

122) Elderly people tend to develop cancer more frequently than younger people. Give an explanation for this observation that relates to immune function.

122)

123) Why do schools require inoculations for childhood diseases such as mumps, measles, and whooping cough? Why are the inoculations of value?

123)

124) Tom gets a cut on his hand. After several days he notes swelling, pain, heat, and redness. Upon opening the wound to relieve the pressure, the presence of pus is noted. What has happened to the wound?

124)

125) What are some of the drawbacks of passive humoral immunity?

125)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 126) A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-brown skin lesions (a symptom of Kaposi's sarcoma) and a persistent cough. A physical examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte count. Information taken during the personal history reveals that he has multiple sex partners with whom he frequently engages in unprotected sex. What is likely to be the man's problem and what is his outlook?

127) A young girl requires a liver transplant due to failure of her liver to function. What is required for her to have a good prognosis and why? 128) A woman comes into the hospital emergency room complaining that she is having problems swallowing and her neck is swelling. She has a history of radiation treatment to her neck as a child for acne. What could be the problem? 129) Max is bitten by a rattlesnake while on a camping trip. His friends immediately apply ice packs to the bitten area to slow the spread of the protein-based toxin; they then rush him to an emergency facility. What treatment would be given and why? 130) A physician orders Tylenol for a temperature greater than 101°F. The patient's temperature is 100.4°F. Explain the rationale for not medicating a fever of 100.4°F. 131) Nursing care of a patient with acquired immune deficiency syndrome (AIDS) includes monitoring of T lymphocyte counts. Explain why. 132) After receiving penicillin intravenously, a 32-year-old male patient has an anaphylactic reaction. The nurse understands that therapeutic management includes what critical items? 133) When the white blood cell count is depressed, the classic signs of infection such as redness, heat, and swelling are not manifested. In this case, the nurse should avoid administering aspirin. Explain why.

Answer Key Testname: UNTITLED21

1) B 2) D 3) C 4) E 5) A 6) C 7) B 8) E 9) D 10) D 11) D 12) B 13) C 14) A 15) C 16) D 17) A 18) E 19) B 20) C 21) C 22) D 23) B 24) E 25) A 26) TRUE 27) TRUE 28) FALSE 29) TRUE 30) TRUE 31) TRUE 32) FALSE 33) TRUE 34) FALSE 35) FALSE 36) TRUE 37) TRUE 38) FALSE 39) FALSE 40) TRUE 41) TRUE 42) A 43) A 44) D 45) B 46) A 47) D 48) D 49) D 50) B 15

Answer Key Testname: UNTITLED21

51) B 52) A 53) D 54) A 55) D 56) C 57) C 58) B 59) C 60) B 61) D 62) A 63) D 64) B 65) C 66) D 67) C 68) B 69) D 70) D 71) D 72) A 73) D 74) C 75) C 76) D 77) A 78) B 79) B 80) D 81) D 82) A 83) A 84) A 85) A 86) A 87) C 88) C 89) D 90) D 91) B 92) B 93) D 94) B 95) C 96) B 97) A 98) A 99) A 100) B 16

Answer Key Testname: UNTITLED21

101) D 102) C 103) cytokines 104) monoclonal 105) allergy 106) before 107) cytokines 108) pathogens 109) complement 110) IgE 111) apoptosis 112) glomerulonephritis 113) Innate body defenses to disease include surface membrane barriers, such as the skin and mucous membranes, as the first line of defense. Not only do the skin and mucous membranes act as a physical barrier to microorganisms, but they also secrete chemicals such as saliva, sebum, mucus, and HCl that kill microorganisms. Innate cellular defenses include the use of phagocytes and natural killer cells. Inflammation occurs in response to injury. The inflammatory response includes vasodilation, increased vascular permeability, and phagocyte mobilization. Antimicrobial substances such as interferon and complement are also produced as innate defenses by the body. 114) Monoclonal antibodies are pure antibody preparations that exhibit specificity for a single antigenic determinant. They are produced from the progeny of a single B cell hybridoma "clone," prepared by injecting a specific antigen into a lab animal and then harvesting sensitized B cells from its spleen. The cells are mixed with myeloma cells and incubated, and the resulting hybridoma cells (B cells fused with myeloma cells) produce the monoclonal antibody. They are used for the diagnosis of pregnancy, certain sexually transmitted diseases, hepatitis, rabies, and for other purposes. 115) The antigen challenge is the first encounter between an immunocompetent lymphocyte and an invading antigen. It usually takes place in the spleen or a lymph node, but may happen in any lymphoid tissue. 116) They are vital in the final stopping of an immune response after the antigen is inactivated. They may also help prevent autoimmune reactions. 117) The hypersensitivity associated with poison ivy is an example of delayed hypersensitivity called allergic contact dermatitis. The hypersensitivity associated with hives is an immediate hypersensitivity in the form of a local anaphylactic reaction. The hypersensitivity associated with a positive TB test is a type of delayed hypersensitivity. 118) If the thymus fails to develop, the T cells will not mature and become immunocompetent. If T cell function is disrupted, there is no resistance to disease. 119) The four signs of inflammation are swelling, redness, heat, and pain. The signs are caused by local vasodilation and increased capillary permeability. This is of benefit because the process helps to dilute harmful substances that may be present; brings in large quantities of oxygen, nutrients, and cells necessary for the repair process; and allows the entry of clotting proteins. Pain helps immobilize the injury. An additional sign would be the loss of function. 120) Multiple sclerosis, myasthenia gravis, Graves' disease, juvenile (type I) diabetes, systemic lupus erythematosus, glomerulonephritis, rheumatoid arthritis. 121) 1. Appearance of new self-proteins in the circulation that have not previously been exposed to the immune system. 2. An immune response to foreign antigens resembling self-antigens. 122) As one ages, the efficiency of the immune system begins to decline. Over time one becomes exposed to harmful agents accumulatively, thus increasing the incidence of developing cancer cells. This may allow cancer to become established more easily. 123) The inoculations are required to try to prevent epidemics of these microbiological infections. The inoculations are of great benefit in preventing the diseases because the vaccines cause immunity to the pathogens by stimulating both the formation of protective antibodies and the establishment of immunological memory against future infection. 124) The wound has become infected, probably with bacteria. The initial symptoms indicate acute inflammation. Pus indicates the presence of dead or dying neutrophils, broken-down tissue cells, and living and dead pathogens. 125) The effects are short lived; it does not trigger memory cell production; and your body degrades the antibodies. 17

Answer Key Testname: UNTITLED21

126) He is probably suffering from AIDS. His outlook is poor once the disease has progressed to this advanced stage. There is no cure, and drug therapy has had limited short -term success. 127) The ABO and other blood group antigens of the donor and recipient must be determined. Next, donor and recipient tissues (MHC groups) are matched as closely as possible. Following surgery, she must receive immunosuppressive therapy to keep her body from rejecting the new liver as foreign tissue. 128) The woman is suffering from Hashimoto's thyroiditis. The radiation injured the thyroid gland and released thyroidglobulin into the bloodstream. The immune system has recently become sensitized and mounted an attack on the thyroid gland. 129) Max could be given an immune serum to the rattlesnake venom, thereby conferring passive immunity. The reason for passive immunization is that the venom could kill the person before active immunity could be established. The passive immunity would last until the "borrowed" antibodies naturally degraded in the body. No immunological memory would be established because B cells are not activated. 130) A mild or moderate fever is an adaptive response that seems to benefit the body. Bacteria need large amounts of zinc and iron to multiply. During fever, the liver and spleen sequester these nutrients, making them less available, which helps to reduce the bacterial population. 131) The primary defect in patients with AIDS is depletion of T helper cells, and therefore the cell-mediated response. This immunodeficiency makes the patient more susceptible to infection and unusual cancers. Thus, the lower the count, the more protective precautions need to be taken. 132) Therapeutic management includes speed in recognition of signs and symptoms of an anaphylactic reaction because death can occur within minutes. Maintaining an open airway is critical, because the bronchioles constrict, making it difficult to breathe. An agent to counteract the extreme vasodilation, such as epinephrine, is often the key to survival. 133) Aspirin would disguise a fever that would indicate infection.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 22.1 Using Figure 22.1, match the following: 1) Main (primary) bronchus.

2) Pharynx.

3) Larynx.

4) Carina of trachea.

5) Trachea.

Figure 22.2 Using Figure 22.2, match the following: 6) Tidal volume.

7) Inspiratory reserve volume.

8) Residual volume.

9) Expiratory reserve volume.

10) Air that does not participate in the exchange of gases.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) NO exchange of gases occurs here.

A) Segmental (tertiary) bronchi

12) Secrete a fluid containing surfactant.

B) Type I alveolar cells

13) Where the respiratory zone of the lungs begins.

C) Type II alveolar cells

11) 12) 13)

D) Respiratory bronchioles 14) Composed of simple squamous epithelium.

14)

15) Terminates in alveoli.

A) Alveolar duct

16) Composed of cuboidal cells.

B) Type I alveolar cells

17) The respiratory membrane is composed of fused basement membrane of the capillary walls and ________.

C) Type II alveolar cells

15) 16) 17)

Match the following: 18) TV + IRV + ERV + RV.

A) Total lung capacity

19) ERV + RV.

B) Inspiratory capacity

20) TV + IRV + ERV.

C) Functional residual capacity

21) TV + IRV.

D) Vital capacity

18) 19) 20) 21)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 22) Ventilation perfusion coupling means that more blood flows past functional alveoli than past nonfunctional alveoli.

22)

23) The lingual tonsil is found on the posterior surface of the root of the tongue.

23)

24) The functions of the nasal conchae are to enhance the air turbulence in the cavity and to increase the mucosal surface area exposed to air for greater efficiency.

24)

25) The lungs are perfused by two circulations: the pulmonary and the bronchial. The pulmonary circulation is for oxygenation of blood. The bronchial circulation supplies blood to the lung structures (tissue).

25)

26) A drop in blood pH is likely to cause a slower breathing rate.

26)

27) Intrapleural pressure is normally about 4 mm Hg less than the pressure in the alveoli.

27)

28) During normal quiet breathing, males breathe 25% more than females.

28)

29) The alveolar ventilation rate is the best index of effective ventilation.

29)

30) In chronic bronchitis, mucus production is decreased and this leads to the inflammation and fibrosis of the mucosal lining of the bronchial tree.

30)

31) Labored breathing is termed hypercapnia.

31)

32) The largest amount of carbon dioxide is transported in the bloodstream in the form of carbonic anhydrase.

32)

33) Increased temperature results in decreased O 2 unloading from hemoglobin.

33)

34) The paired lungs occupy the mediastinum of the thoracic cavity.

34)

35) The Heimlich maneuver is a procedure in which air in the lungs is used to expel a piece of food lodged in the esophagus.

35)

36) Smoking diminishes ciliary action and eventually destroys the cilia.

36)

37) Tracheal obstruction is life threatening.

37)

38) The parietal pleura lines the thoracic wall.

38)

39) The average individual has 500 ml of residual volume in his lungs.

39)

40) Atelectasis (lung collapse) renders the lung useless for ventilation.

40)

41) The inflation (Hering-Breuer) reflex is a potentially dangerous response that may cause overinflation of the lung.

41)

42) Strong emotions and pain, acting through the limbic system and hypothalamus, send signals to the respiratory centers that modulate respiratory rate and depth.

42)

43) As carbon dioxide enters systemic blood, it causes more oxygen to dissociate from hemoglobin (the Haldane effect), which in turn allows more CO 2 to combine with hemoglobin and more

43)

bicarbonate ions to be generated (the Bohr effect). 44) Dalton's law of partial pressures states that the total pressure exerted by a mixture of gases is the sum of the pressures exerted independently by each gas in the mixture.

44)

45) Oxygenated hemoglobin releases oxygen more readily when the pH is more basic.

45)

46) Nasal conchae heat and moisten inhaled air, and reclaim heat and moisture during exhalation.

46)

47) Under certain conditions, the vocal folds act as a sphincter that prevents air passage.

47)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 48) Which bone does NOT contain paranasal sinuses? A) frontal B) temporal

48) C) maxillary

49) The loudness of a person's voice depends on the ________. A) length of the vocal folds B) strength of the intrinsic laryngeal muscles C) force with which air rushes across the vocal folds D) thickness of vestibular folds

D) ethmoid 49)

50) The walls of the alveoli are composed of two types of cells, type I and type II alveolar cells. The function of type II alveolar cells is to ________. A) protect the lungs from bacterial invasion B) replace mucus in the alveoli C) trap dust and other debris D) secrete surfactant

50)

51) Air moves out of the lungs when the pressure inside the lungs is ________. A) less than the pressure in the atmosphere B) greater than the intra-alveolar pressure C) greater than the pressure in the atmosphere D) equal to the pressure in the atmosphere

51)

52) Which of the following is true regarding normal quiet expiration of air? A) It is driven by increased blood CO 2 levels.

52)

B) It requires contraction of abdominal wall muscles. C) It depends on the complete lack of surface tension on the alveolar wall. D) It is a passive process that depends on the recoil of elastic fibers that were stretched during inspiration. 53) Which of the following maintains the patency (openness) of the trachea? A) surface tension of water B) pseudostratified ciliated epithelium C) surfactant production D) C-shaped cartilage rings

53)

54) Intrapulmonary pressure is the ________. A) negative pressure in the intrapleural space B) pressure within the pleural cavity C) pressure within the alveoli of the lungs D) difference between atmospheric pressure and respiratory pressure

54)

55) The relationship between gas pressure and gas volume is described by ________. A) Henry's law B) Charles' law C) Boyle's law D) Dalton's law

55)

56) The statement, "in a mixture of gases, the total pressure is the sum of the individual partial pressures of gases in the mixture" paraphrases ________. A) Dalton's law B) Henry's law C) Boyle's law D) Charles' law

56)

57) Surfactant helps to prevent the alveoli from collapsing by ________. A) interfering with the cohesiveness of water molecules, thereby reducing the surface tension of alveolar fluid B) warming the air before it enters C) humidifying the air before it enters D) protecting the surface of alveoli from dehydration and other environmental variations

57)

58) As the tension of vocal folds in the larynx increase, the voice becomes ________. A) lower in pitch B) louder C) more distinct D) higher in pitch

58)

59) The Bohr effect describes the tendency for hemoglobin to more readily unload oxygen under which conditions? A) increased pH and decreased PCO2 B) increased pH and PCO2 C) decreased pH and PCO2 D) decreased pH and increased PCO2

59)

60) The most powerful respiratory stimulus for breathing in a healthy person is ________. A) alkalosis B) acidosis C) loss of oxygen in tissues D) increase of carbon dioxide

60)

61) The local matching of blood flow with ventilation is ________. A) ventilation-perfusion coupling B) the Bohr effect C) the Haldane effect D) chloride shifting

61)

62) In the plasma, the quantity of oxygen in solution is ________. A) not present except where it is combined with carrier molecules B) only about 1.5% of the oxygen carried in blood C) about equal to the oxygen combined with hemoglobin D) greater than the oxygen combined with hemoglobin

62)

63) Which of the following is the leading cause of cancer death for both men and women in North America? A) esophageal B) colorectal C) lung D) skin

63)

64) Which of the choices below describes the forces that act to pull the lungs away from the thorax wall and thus collapse the lungs? A) compliance and the surface tension of the alveolar fluid B) the natural tendency for the lungs to recoil and the surface tension of the alveolar fluid C) the natural tendency for the lungs to recoil and transpulmonary pressures D) compliance and transpulmonary pressures

64)

65) Which of the following counteracts the movement of bicarbonate ions from the RBC? A) release of hydrogen ion B) the Haldane effect C) chloride shifting D) the Bohr effect

65)

66) Hemoglobin has a much greater affinity for carbon monoxide than oxygen. Which principle explains why a hyperbaric chamber (containing high levels of oxygen) can treat carbon monoxide poisoning? A) Boyle's law B) Dalton's law C) Charles' law D) Henry's law

66)

67) Which of the following refers to the movement of air into and out of the lungs? A) gas exchange B) pulmonary ventilation C) internal respiration D) external respiration

67)

68) The major nonelastic source of resistance to air flow in the respiratory passageways is ________. A) air pressure B) friction C) surfactant D) surface tension

68)

69) Which of the following determines lung compliance? A) muscles of inspiration B) flexibility of the thoracic cage C) alveolar surface tension D) airway opening

69)

70) Tidal volume is air ________. A) exchanged during normal breathing B) forcibly expelled after normal expiration C) inhaled after normal inspiration D) remaining in the lungs after forced expiration

70)

71) Which of the choices below determines the direction of respiratory gas movement? A) solubility in water B) the temperature C) molecular weight and size of the gas molecule D) partial pressure gradient

71)

72) Possible causes of hypoxia include ________. A) too little oxygen in the atmosphere C) getting very cold

72) B) obstruction of the esophagus D) taking several rapid deep breaths

73) The lung volume that represents the total volume of exchangeable air is the ________. A) tidal volume B) inspiratory capacity C) expiratory reserve volume D) vital capacity

73)

74) Which of the following is correct regarding acclimatization? A) Decreases in arterial P O2 cause the peripheral chemoreceptors to become less responsive to

74)

increases in PCO2. B) High-altitude conditions always result in lower-than-normal hemoglobin saturation levels because less O2 is available to be loaded. C) When blood O2 levels decline, the kidneys produce more erythropoietin, which stimulates breakdown of red blood cells in the spleen. D) At high altitudes, hemoglobin's affinity for O 2 is increased because BPG concentrations increase. 75) Which of the following is NOT a stimulus for breathing? A) arterial PO2 below 60 mm Hg B) rising carbon dioxide levels C) rising blood pressure

75)

D) acidosis resulting from CO 2 retention

76) Respiratory control centers are located in the ________. A) midbrain and medulla B) upper spinal cord and medulla C) pons and midbrain D) medulla and pons

76)

77) The amount of air that can be inspired above the tidal volume is called ________. A) vital capacity B) inspiratory reserve volume C) reserve air D) expiratory capacity

77)

78) Which statement about CO2 is FALSE?

78)

A) More CO 2 dissolves in the blood plasma than is carried in the RBCs. B) Its accumulation in the blood is associated with a decrease in pH. C) Its concentration in the blood is decreased by hyperventilation. D) CO 2 concentrations are greater in venous blood than arterial blood. 79) Inspiration occurs when the ________ is less than the ________. A) intrapleural pressure; transpulmonary pressure B) thoracic cavity volume; lung volume C) intrapulmonary pressure; atmospheric pressure D) tidal volume; vital capacity

79)

80) The left lung differs from the right in that the left lung has ________. A) an oblique fissure B) a wider and more vertical primary bronchus C) a cardiac notch D) three lobes

80)

81) The larynx contains ________. A) a cricoid cartilage also called the Adam's apple B) lateral cartilage ridges called false vocal folds C) the thyroid cartilage D) an upper pair of avascular mucosal folds called true vocal folds

81)

82) Which respiratory-associated muscles would contract or relax during forced expiration, for example blowing up a balloon? A) diaphragm would contract, internal intercostals would relax B) diaphragm would contract, external intercostals would relax C) internal intercostals and abdominal muscles would contract D) external intercostals would contract and diaphragm would relax

82)

83) How is the bulk of carbon dioxide transported in blood? A) as carbonic acid in the plasma B) chemically combined with the amino acids of hemoglobin as carbaminohemoglobin in the red blood cells C) as bicarbonate ions in plasma after first entering the red blood cells D) chemically combined with the heme portion of hemoglobin

83)

84) Which of the choices below is NOT a role of the pleurae? A) assist in blood flow to and from the heart because the heart sits between the lungs B) help limit the spread of local infections C) help divide the thoracic cavity into three chambers D) allow the lungs to glide easily over the thorax wall during breathing movements

84)

85) Which of the following incorrectly describes mechanisms of CO 2 transport?

85)

A) 7-10% of CO 2 is dissolved directly into the plasma B) as bicarbonate ions in plasma C) attached to the heme part of hemoglobin D) just over 20% of CO 2 is carried in the form of carbaminohemoglobin 86) Factors that influence the rate and depth of breathing include ________. A) stretch receptors in the alveoli B) voluntary cortical control C) temperature of alveolar air D) thalamic control

86)

87) Which of the following provide the greatest surface area for gas exchange? A) alveoli B) alveolar sacs C) respiratory bronchioles D) alveolar ducts

87)

88) Which of the following is NOT part of the respiratory membrane of the lungs? A) alveolar epithelium B) single layer of smooth muscle cells D) capillary endothelium C) basement membrane

88)

89) The symptoms of hyperventilation may be averted by breathing into a paper bag because it ________. A) helps retain carbon dioxide in the blood B) lowers blood pH levels C) reduces brain perfusion by constricting cerebral blood vessels D) helps retain oxygen in the blood

89)

90) Inspiratory capacity is ________. A) the total amount of exchangeable air B) functional residual capacity C) the total amount of air that can be inspired after a tidal expiration D) air inspired after a tidal inhalation

90)

91) Which center is located in the pons? A) pontine respirator group (PRG) C) pacemaker neuron center

91) B) inspiratory center D) expiratory center

92) The nose serves all of the following functions EXCEPT ________. A) cleansing the air B) warming and humidifying the air C) as a passageway for air movement D) as the direct initiator of the cough reflex

92)

93) According to the oxygen-hemoglobin dissociation curve, PO2 in the lungs of 100 mm Hg results in

93)

Hb being 98% saturated. At high altitude, there is less O 2 . At a PO2 in the lungs of 80 mm Hg, Hb would be ________ saturated. A) 100% B) 95%

C) 98%

D) less than 50%

94) Which of the following is an appropriate response to carbon monoxide (CO) poisoning? A) immediate application of bicarbonate ions to facilitate removal of CO from Hb B) hyperbaric oxygen chamber to increase P O2 and clear CO from the body

94)

C) hyperventilation to exhale CO from the body D) slow breathing into a paper bag 95) Which pressure actually keeps the lungs from collapsing? A) transpulmonary pressure B) intrapulmonary pressure C) atmospheric pressure D) intrapleural pressure

95)

96) Which of the choices below is NOT a factor that promotes oxygen binding to and dissociation from hemoglobin? A) temperature B) number of red blood cells C) partial pressure of oxygen D) partial pressure of carbon dioxide

96)

97) Which of the following is responsible for holding the lungs to the thorax wall? A) the visceral pleurae and the changing volume of the lungs B) the diaphragm and the intercostal muscles alone C) surface tension from pleural fluid and negative pressure in the pleural cavity D) the smooth muscles of the lung

97)

98) The erythrocyte (red blood cell) count increases after a while when an individual goes from a low to a high altitude because the ________. A) basal metabolic rate is higher at high altitudes B) concentration of oxygen and/or total atmospheric pressure is higher at higher altitudes C) concentration of oxygen and/or total atmospheric pressure is lower at high altitudes D) temperature is lower at higher altitudes

98)

99) Most inspired particles such as dust fail to reach the lungs because of the ________. A) porous structure of turbinate bones B) ciliated mucous lining in the nose C) abundant blood supply to nasal mucosa D) action of the epiglottis

99)

100) Which of the following is INCORRECT? A) Pressure gradient equals gas flow over resistance. B) Gas flow equals pressure gradient over resistance. C) Resistance equals pressure gradient over gas flow. D) The amount of gas flowing in and out of the alveoli is directly proportional to the difference in pressure or pressure gradient between the external atmosphere and the alveoli.

100)

101) Select the correct statement about the physical factors influencing pulmonary ventilation. A) As alveolar surface tension increases, additional muscle action will be required. B) Surfactant helps increase alveolar surface tension. C) A decrease in compliance causes an increase in ventilation. D) A lung that is less elastic will require less muscle action to perform adequate ventilation.

101)

102) Select the correct statement about oxygen transport in blood. A) During conditions of acidosis, hemoglobin is able to carry oxygen more efficiently. B) A 50% oxygen saturation level of blood returning to the lungs might indicate an activity level higher than normal. C) Increased BPG levels in the red blood cells enhance oxygen-carrying capacity. D) During normal activity, a molecule of hemoglobin returning to the lungs carries one molecule of O2 .

102)

103) Which of the disorders below is characterized by destruction of the walls of the alveoli producing abnormally large air spaces that remain filled with air during exhalation? A) pneumonia B) emphysema C) coryza D) tuberculosis

103)

104) Which of the following does NOT influence hemoglobin saturation? A) nitric oxide B) temperature C) BPG D) partial pressure of carbon dioxide

104)

105) For inspiration of air, which of the following happens first? A) thoracic cavity volume decreases B) intrapulmonary pressure drops C) diaphragm descends, thoracic volume begins to increase, and rib cage rises D) air (gases) flows into lungs

105)

106) Spirometry results reveal a vital capacity of two liters which is well below the predicted value of five liters. This suggests which disorder? A) asthma B) obstructive pulmonary disease C) restrictive disease D) emphysema

106)

107) Which law describes the relationship between the pressure and volume of a gas? A) Henry's law B) Charles' law C) Boyle's law D) Dalton's law

107)

108) The Bohr effect refers to the unloading of ________ in a RBC due to declining blood pH. A) oxygen B) chloride ions C) carbon dioxide D) BPG

108)

109) Which structure is lined with simple squamous epithelium? A) oropharynx B) nasopharynx C) trachea

109) D) alveolus

110) Using spirometry, a patient discovers their forced expiratory volume (FEV) after the first second is 40%. What does this suggest? A) healthy lungs B) exposure to asbestos C) restrictive disease D) obstructive pulmonary disease

110)

111) Which of the following anchor(s) the vocal folds? A) corniculate cartilages C) cricoid cartilage

111) B) arytenoid cartilages D) cuneiform cartilages

112) Which of the following is a conducting zone structure? A) alveolar sac B) terminal bronchiole C) respiratory bronchiole D) alveolar duct

112)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 113) How is alveolar gas exchange affected by emphysema and pneumonia?

113)

114) Briefly differentiate between atmospheric pressure, intrapulmonary pressure, and intrapleural pressure. Which of these is always negative in a healthy individual during normal breathing? What happens if intrapleural pressure becomes equal to atmospheric pressure?

114)

115) The contraction of the diaphragm and the external intercostal muscles begins inspiration. Explain exactly what happens, in terms of volume and pressure changes in the lungs, when these muscles contract.

115)

116) What is the chloride shift and why does it occur?

116)

117) Infant respiratory distress syndrome (IRDS) is a condition peculiar to premature babies. In IRDS insufficient surfactant is produced. What does this cause and how is it treated?

117)

118) How is it possible to change the pitch of our voice from high to low?

118)

119) The partial pressure gradient for oxygen (in the body) is much steeper than that for carbon dioxide. Explain how equal amounts of these two gases can be exchanged (in a given time interval) in the lungs and at the tissues.

119)

120) Define anatomical dead space. What is the relationship between anatomical and alveolar dead space? Which value is likely to increase during lung pathology?

120)

121) Distinguish among anemic, ischemic (stagnant), histotoxic, and hypoxemic hypoxia.

121)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 122) Timothy has been having difficulty breathing since he had pneumonia last month. Recently he had severe pain in his chest and back, and his breathing was extremely irregular. The doctor at the emergency room told him that one of the lobes of his lung had collapsed. How could this happen? 123) While having a physical examination, a young male informed his doctor that at age 8 he had lobar pneumonia and pleurisy in his left lung. The physician decided to measure his VC. Describe the apparatus and method used for taking this measurement. Define the following terms used in the description of lung volumes: TV, IRV, ERV, RV, and VC. 124) Jane had been suffering through a severe cold and was complaining of a frontal headache and a dull, aching pain at the side of her face. What regions are likely to become sites of secondary infection following nasal infection? 125) A smoker sees his doctor because he had a persistent cough for months and is short of breath after very little exertion. What diagnosis will the doctor make and what can the person expect if he does not quit smoking? 126) After a long scuba diving session on a Caribbean reef, Carl boards a plane to Dallas. He begins to feel pain in his elbow on the flight back to Dallas. What is happening to him? 127) A patient was admitted to the hospital with chronic obstructive pulmonary disease. His P O2 was 55 and PCO2 was 65. A new resident orders 54% oxygen via the venturi mask. One hour later, after the oxygen was placed, the nurse finds the patient with no respiration or pulse. She calls for a Code Blue and begins cardiopulmonary resuscitation (CPR). Explain why the patient stopped breathing. 128) While dining out in a restaurant a man suddenly chokes on a piece of meat. The waitress is also a student nurse and comes to the man's aid. She asks him if he can talk. The man responds by shaking his head no and grabbing at his neck. What is the significance of the man's inability to talk? 129) How will the lungs compensate for an acute rise in the partial pressure of CO 2 in arterial blood? 130) A patient with tuberculosis is often noncompliant with treatment. Explain why this may happen. 131) John has undergone surgery and has developed pneumonia. He also has a history of emphysema. Which symptoms and signs would the nurse expect to find?

Answer Key Testname: UNTITLED22

1) D 2) A 3) B 4) E 5) C 6) B 7) A 8) D 9) C 10) D 11) A 12) C 13) D 14) B 15) A 16) C 17) B 18) A 19) C 20) D 21) B 22) TRUE 23) TRUE 24) TRUE 25) TRUE 26) FALSE 27) TRUE 28) FALSE 29) TRUE 30) FALSE 31) FALSE 32) FALSE 33) FALSE 34) FALSE 35) FALSE 36) TRUE 37) TRUE 38) TRUE 39) FALSE 40) TRUE 41) FALSE 42) TRUE 43) FALSE 44) TRUE 45) FALSE 46) TRUE 47) TRUE 48) B 49) C 50) D 13

Answer Key Testname: UNTITLED22

51) C 52) D 53) D 54) C 55) C 56) A 57) A 58) D 59) D 60) D 61) A 62) B 63) C 64) B 65) C 66) D 67) B 68) B 69) C 70) A 71) D 72) A 73) D 74) B 75) C 76) D 77) B 78) A 79) C 80) C 81) C 82) C 83) C 84) A 85) C 86) B 87) A 88) B 89) A 90) C 91) A 92) D 93) B 94) B 95) A 96) B 97) C 98) C 99) B 100) A 14

Answer Key Testname: UNTITLED22

101) A 102) B 103) B 104) A 105) C 106) C 107) C 108) A 109) D 110) C 111) B 112) B 113) In pneumonia, gas exchange is impaired due to the thickening of the walls of the alveoli, shared basement membrane and capillary wall. It may even reduce the vital capacity. In emphysema, the progressive destruction of alveoli leads to a reduction in the cross-sectional area of gas exchange, resulting in having to supplement with oxygen the air that these patients breathe. Additionally, due to a reduction in elastic connective tissue and normal tissue parenchyma, the compliance will also be reduced. 114) Atmospheric pressure is the pressure exerted by gases of the atmosphere. Intrapulmonary pressure is the pressure within the alveoli of the lungs. Intrapleural pressure is the pressure within the intrapleural space. Intrapleural pressure is negative relative to the other two during normal inspiration/expiration. Equalization of the intrapleural pressure with atmospheric pressure or intrapulmonary pressure immediately causes lung collapse. 115) With contraction of the diaphragm, the height of the thoracic cavity increases. Contraction of the external intercostal muscles expands the diameter of the thorax. With an increase in volume of the thorax, the intrapulmonary volume increases, causing a drop in pressure relative to atmospheric pressure. Air rushes into the lungs along this pressure gradient until intrapulmonary and atmospheric pressures are equal. 116) The chloride shift is an ionic exchange process whereby chloride ions move from the plasma into the erythrocytes to counterbalance the net positive charge left within the erythrocytes by the rapid outrush of negative bicarbonate ions whenever blood CO 2 rises. 117) Too little surfactant results in increased surface tension that can collapse the alveoli. Great effort is required to completely reinflate the alveoli during each inspiration. IRDS is treated by spraying natural or synthetic surfactant into the newborn's respiratory passageways. Also, devices that maintain positive airway pressure throughout the respiratory cycle can keep the alveoli open between breaths. Severe cases require mechanical ventilators. 118) Usually, the tenser the vocal folds, the faster they vibrate and the higher the pitch. To produce deep tones, the glottis widens, and to produce high-pitched tones, the glottis becomes a slit. Intrinsic laryngeal muscles control the true vocal folds and the size of the glottis. 119) Equal amounts of O2 and CO2 can be exchanged in the lungs and at the tissues because CO 2 solubility in plasma and alveolar fluid is 20 times greater than that of O 2 . 120) Anatomical dead space is the space in the conducting respiratory passageways. Alveolar dead space is the space in nonfunctional alveoli. Anatomical dead space and alveolar dead space together make up the total dead space. Alveolar dead space will increase during lung pathology. 121) Anemic hypoxia reflects poor oxygen delivery resulting from too few RBCs or RBCs that contain abnormal or too little Hb. Ischemic (stagnant) hypoxia results when blood circulation is impaired or blocked. Histotoxic hypoxia occurs when body cells are unable to use O 2 even though adequate amounts are delivered. Hypoxemia hypoxia is indicated by reduced arterial P O2. 122) Timothy suffered a pneumothorax, or lung collapse, most likely caused by a rupture of the visceral pleura as a result of coughing during his bout with pneumonia. The pneumothorax was large enough to cause atelectasis, or collapse, of one of his lobes, but not the remainder of his lung.

Answer Key Testname: UNTITLED22

123) His vital capacity (VC) was measured using a spirometer. As he breathed into a handheld device, the speed and volume of air flow was calculated from the output of a pressure transducer. Tidal volume (TV) is the amount of air that moves into and out of the lungs with normal breathing. Inspiratory reserve volume (IRV) is the amount of air that can be forcibly inhaled beyond a tidal inspiration. The expiratory reserve volume (ERV) is the amount of air that can be evacuated from the lungs over and above a tidal expiration. Residual volume (RV) is the amount of air that remains in the lungs even after the most strenuous expiration. Vital capacity (VC) is the total amount of exchangeable air. 124) Following nasal infection, the frontal and maxillary sinuses become infected. 125) The person is suffering from chronic bronchitis, which causes the dyspnea and coughing. If he does not stop smoking, he can expect frequent pulmonary infections, more coughing, and progressively worse dyspnea (all symptoms of chronic obstructive pulmonary disease). Ultimately, he can expect to develop hypoxemia, CO 2 retention, and respiratory acidosis. He may develop emphysema or lung cancer. 126) Carl is experiencing decompression sickness, "the bends," due to several problems: (1) Applying Boyle's law, a lot of gas was forced into Carl's bloodstream during the dive and there was not sufficient time to decompress the excess before he boarded the plane. (2) The plane is not pressurized to sea level, which further reduced atmospheric pressure holding the gases in suspension (Henry's law). Carl should be transported to a hyperbaric chamber to be repressurized. This will reduce the volume of the gas bubbles in his arm so that normal circulation can resume. 127) In people who retain carbon dioxide because of pulmonary disease, arterial P CO2 is chronically elevated and chemoreceptors become unresponsive to this chemical stimulus. In such cases, declining P O2 levels act on the oxygen-sensitive peripheral chemoreceptors and provide the principle respiratory stimulus, or the so-called hypoxic drive. Pure oxygen will stop a person's breathing, because his respiratory stimulus (low P O2 levels) would be removed. 128) Speech involves the intermittent release of expired air and opening and closing of the glottis. Because the man is unable to speak, this indicates that he is choking on a piece of food that suddenly closed off air at or below the glottis. 129) Respiratory rate will increase. 130) Noncompliance may occur because of the length of treatment. Treatment entails a 12 -month course of antibiotics. Once the patient begins to feel better and the clinical symptoms dissipate, the patient may stop taking the medication. 131) 1. The patient may have dyspnea. 2. The patient may have hypoxemia because of increased secretions in the lungs. 3. The patient may use his accessory muscles to assist breathing. 4. The patient may have a productive cough. 5. The patient's breath sounds may have rales (crackles).

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 23.1 Using Figure 23.1, match the following: 1) Mucosa.

2) Duodenal glands found here.

3) Smooth muscle layer.

4) MALT found here.

5) Serosa.

6) Area of the lamina propria.

7) Continuation of the mesentery.

Figure 23.2 Using Figure 23.2, match the following: 8) Absorptive cells that line the intestinal tract.

9) Cell type specialized to secrete mucus into the lumen of the intestinal tract.

10) Structures that increase the absorptive area of the small intestine.

10)

11) Wide lymph capillary located in the villus.

11)

12) Paneth cells are found here.

12)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 13) Wavelike smooth muscle contractions that move foodstuffs through the alimentary tube.

A) Hydrolysis

14) Chemical or mechanical process of breaking down foodstuffs into simpler units.

C) Digestion

13)

B) Absorption 14)

D) Peristalsis

15) Enzymatic breakdown of any type of food molecule.

15)

16) Process by which simpler chemical units pass through the lumen of the gastrointestinal tract into the blood or lymph.

16)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 23.3 Using Figure 23.3, match the following: 17) Produces enzymes that break down all categories of foodstuffs.

17)

18) Increases surface area for absorption via villi and microvilli.

18)

19) Bacteria process undigested chyme from the small intestine.

19)

20) Only digestive structure with three muscle layers.

20)

21) Receives blood via the hepatic portal system.

21)

22) Contains the brush border enzymes that complete digestion of carbohydrates and proteins.

22)

23) Main function is to filter and process the nutrient-rich blood delivered to it.

23)

24) Produces intrinsic factor.

24)

25) Produces a mucoid barrier to prevent self-digestion.

25)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 26) Increases output of enzymatic-rich pancreatic juice.

A) Secretin

26)

B) Gastric inhibitory peptide 27) Increases output of pancreatic juice rich in bicarbonate ions. 28) Increases HCl secretion and stimulates contraction of intestinal muscle.

27) C) Cholecystokinin D) Gastrin

29) Stimulates insulin release and mildly inhibits HCl production.

28)

29)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 30) The relatively unchanging pressure in a filling stomach is due to the contraction of the stomach oblique muscle layer.

30)

31) The circular folds of the small intestine enhance absorption by causing the chyme to spiral, rather than to move in a straight line, as it passes through the small intestine.

31)

32) Gastric accommodation is an example of smooth muscle plasticity.

32)

33) Food often contains bacteria, but the HCl of the stomach is effective in killing most ingested microbes.

33)

34) Stellate macrophages are found in the liver and are responsible for removing bacteria and worn-out cells.

34)

35) The pharyngeal-esophageal phase of swallowing is involuntary and is controlled by the swallowing center in the thalamus and lower pons.

35)

36) All the chemical and mechanical phases of digestion from the mouth through the small intestine are directed toward changing food into forms that can pass through the epithelial cells lining the mucosa into the underlying blood and lymphatic vessels.

36)

37) Pepsinogen is the precursor to the gastric enzyme for protein digestion and is secreted by the parietal cells.

37)

38) The only essential function of the stomach is to begin the digestion of proteins.

38)

39) The major role of absorption in the ileum is to reclaim bile salts to be recycled back to the liver.

39)

40) The peritoneum is the most extensive serous membrane in the body.

40)

41) Peyer's patches are primarily found in the submucosa of the duodenum.

41)

42) The submucosal nerve plexus provides the major nerve supply to the GI tract wall and controls GI motility.

42)

43) The major means of propulsion through the alimentary canal is peristalsis.

43)

44) Dentin anchors the tooth in place.

44)

45) The digestive function of the liver is to produce digestive enzymes.

45)

46) The pancreas has both an endocrine and an exocrine function.

46)

47) Another term for swallowing is deglutition.

47)

48) The splanchnic circulation refers to the arteries that serve the digestive organs and the veins that carry blood from the digestive organs to the liver.

48)

49) The stomach's contractile rhythm is set by pacemaker cells found in the spinal cord.

49)

50) The major stimulus for production of intestinal fluid is distention or irritation of the intestinal mucosa by hypertonic or acidic chyme.

50)

51) Most nutrients are absorbed through the mucosa of the intestinal villi by active transport.

51)

52) Severe diarrhea can diminish potassium ion absorption.

52)

53) Mumps is an inflammation of the parotid glands caused by myxovirus.

53)

54) Fats significantly delay the emptying of the stomach through hormonal and neuronal signals.

54)

55) The soft palate reflexively opens the nasopharynx to allow the passage of food, which is now called a bolus.

55)

56) When swallowing, the glottis covers the epiglottis.

56)

57) Most gastric ulcers are due to excessive production of hydrochloric acid.

57)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 58) The enterohepatic circulation reabsorbs bile salts in the distal portion of the small intestine (ileum). All of the following statements about the enterohepatic circulation are true except one. Select the statement below that is NOT true of the enterohepatic circulation? A) Reabsorption of bile salts reduces the need to synthesize new bile salts. B) The reabsorption of bile salts allows them to be reused within new bile. C) All of the components of bile are recycled by this circulation. D) Reabsorbing bile salts in the ileum gives more time to emulsify lipid and aid in their absorption within a greater length of the small intestine.

58)

59) Which of the following is the best illustration of the difference between metabolism and digestion? A) Digestions must happen first for metabolism to follow it. B) Digestion has a wide variety of chemical reactions while metabolism is restricted to only a few reaction types. C) Metabolism comprises all of the chemical reactions preformed within the body while digestion is only the breakdown of food within the GI tract. D) Digestion requires enzymes for it to take place while metabolism does not necessarily need or use them.

59)

60) Which of the following is least involved in the mechanical breakdown of food, digestion, or absorption? A) the oral cavity B) the small ingestion C) the esophagus D) large intestine

60)

61) Which of the following would likely be absorbed in the stomach? A) a serving of alcohol B) a piece of candy C) a serving of lean chicken breast D) a serving of pasta

61)

62) Which of the following is the best explanation of the benefit in the digestive system having the largest collection of lymphoid tissue (MALT) at the distal end of the small intestine? A) The alkaline secretions of the small intestine aid in the growth of bacteria and these bacteria must be controlled. B) The huge numbers of bacteria living in the large intestine must be prevented from entering the lumen of the small intestine and being absorbed with food's nutrients into the blood stream. C) The body will actively excrete pathogens out of the body, into the digestive system, to be removed from the body in feces. D) The digestive systems first and foremost job is to digest and absorb nutrients so it puts off immunity for last.

62)

63) Bile salts break up the fat globule into smaller fat droplets. This role of bile salts is best described as ________. A) lipid digestion B) lipid emulsification C) lipid ingestion D) lipid absorption

63)

64) A doctor consulting a patient that recently has had their gall bladder removed would likely advise ________. A) eating a low to no carb diet B) eating foods that are low in fat C) eating fewer, but larger meals D) increasing unsaturated fats while eliminating trans fats in their diets

64)

65) A ruptured appendix is life threatening because ________. A) it is likely to cause severe internal bleeding B) the large intestine will no longer be able to receive digested material from the small intestine C) it is likely to cause massive infection of the abdominopelvic cavity D) loss of the appendix's function will cause an immune deficiency in the digestive system

65)

66) All but one of the following is a function of the low pH found in the stomach. Select the description below that does NOT reflect a role of stomach acid. A) The stomach's acid catabolically breaks down food stuffs in preparation for absorption. B) Many potentially harmful bacteria will be prevented entry to the small intestine by stomach acid. C) Low pH converts pepsinogen to its active form of pepsin, preventing the protease enzyme from digesting the cells that produce it. D) Stomach acid denatures proteins making the poly peptide chain more accessible to pepsin digestive enzymes.

66)

67) Fat absorption through the plasma membrane of epithelial cells ________. A) requires vesicular, active transport of the relatively large fatty acids and monoglyceride B) requires enzymes attached to the brush border to further breakdown the fats C) occurs by simple diffusion because lipids are able to penetrate the hydrophobic fatty acid tails within the plasma membrane D) is accomplished by cotransporters that use the concentration gradient of Na + outside of the

67)

cells 68) Select the best explanation for why protease enzymes are secreted in inactive forms. A) The immunoglobulins protecting the digestive tract would be digested without proper regulation of protein digesting enzymes. B) The enzymes would digest each other if they were not properly regulated. C) The cells producing inactive enzymes are themselves protected from the enzymes until they are safely within the lumen of the GI tract. D) Inactive enzymes will simply be expelled with the feces if no protein is present in the digesting food; this will help to conserve energy.

68)

69) Select the description below that illustrates a difference between a sphincter and circular muscle. A) Sphincters are found throughout the GI tract while circular muscle is found only in the proximal portion of the GI tract. B) A sphincter is composed of smooth muscle while circular muscle is composed of skeletal muscle tissue. C) Sphincters are found in the proximal portion of the GI tract while circular muscle is found in the distal portions. D) A sphincter is a thickening of circular muscle that can prevent the movement of digesting materials while circular muscle is involved in propulsion digesting material.

69)

70) In the enteric nervous system, a long reflexive pathway has an advantage over a short reflexive pathway in the fact that ________. A) long reflexive pathways are quicker to respond than short reflexive pathways B) long reflexive pathways can be stimulated by things outside of the GI tract C) long reflexive pathways can respond throughout the entire length of the GI tract while short reflexive pathways can only respond in the proximal end D) long reflexive pathways last much longer than short reflexive pathways

70)

71) The sight of food can trigger a series of events that results in the release of gastric juice. All but one of the following is true in regards to the previous statement. Select the one answer that is NOT true. A) This is an example of a long reflexive pathway. B) The motor nerves of this pathway are part of the sympathetic division of the autonomic nervous system. C) The cerebral cortex, hypothalamus and medulla oblongata are all involved in processing the stimulatory information. D) This prepares the stomach for food before its arrival in the stomach.

71)

72) All of the following are true of swallowing (deglutition) except one. Select the statement that is NOT true of swallowing. A) The epiglottis assists in propelling food into the trachea. B) The involuntary portion of swallowing takes place in the pharynx. C) The voluntary phase of swallowing takes place within the mouth. D) The mouth, pharynx and esophagus all take part in swallowing.

72)

73) Some antacid drugs block histamine receptors, resulting in reduction of the production and excretion of stomach acid. These drugs have the biggest effect on which of the following? A) mucous neck cells B) chief cells C) parietal cells D) surface epithelial cells

73)

74) Which of the following is NOT a function of cholecystokinin (CCK)? A) stimulate gall bladder to release bile B) open hepatopancreatic sphincter C) increase production of stomach acid D) increase production of pancreatic juice

74)

75) Generally, the hormones secretin and cholecystokinin which are released by duodenal enteroendocrine cells will ________. A) increase the force of stomach contractions B) increase stomach emptying C) increase the release of digestive enzymes and bile D) decrease the activities of the accessory digestive organs

75)

76) Select the one response below that would NOT result from a drug that blocks histamine receptors in the cells lining the stomach. A) It would cause the release of secretin and cholecystokinin. B) It would reduce the symptoms of heartburn. C) It would raise the pH of the stomach. D) It would lower the activity of parietal cells.

76)

77) Specific enteroendocrine cells of the stomach, called G cells, are stimulated by partially digested proteins, caffeine, and rising pH. When stimulated, G cells secrete ________. A) hydrochloric acid B) ghrelin C) pepsin D) gastrin

77)

78) The mechanical and chemical receptors that control digestive activity are located ________. A) in the glandular tissue that surround the organ lumen B) in the pons and medulla C) in the walls of the tract organs D) in the oral cavity

78)

79) The function of the hepatic portal circulation is to ________. A) collect absorbed nutrients for metabolic processing in the liver B) return glucose to the general circulation when blood sugar is low C) distribute hormones throughout the body D) carry toxins to the kidney for disposal through the urinary tract

79)

80) The chemical and mechanical processes of food breakdown are called ________. A) digestion B) absorption C) secretion D) ingestion

80)

81) When we ingest large molecules such as lipids, carbohydrates, and proteins, they must undergo catabolic reactions whereby enzymes split these molecules. This series of reactions is called ________. A) mechanical breakdown B) secretion C) chemical digestion D) absorption

81)

82) The sheets of peritoneal membrane that hold the digestive tract in place are called ________. A) mesenteries B) serosal lining C) lamina propria D) mucosal lining

82)

83) From the esophagus to the anal canal, the walls of every organ of the alimentary canal are made up of the same four basic layers. Arrange them in order from the lumen. A) submucosa, serosa, muscularis externa, and mucosa B) muscularis externa, serosa, mucosa, and submucosa C) mucosa, submucosa, muscularis externa, and serosa D) serosa, mucosa, submucosa, and muscularis externa

83)

84) Which of the following is NOT a factor that helps create the stomach mucosal barrier? A) secretion of pepsinogen B) replacing of damaged epithelial mucosa cells C) tight junctions of epithelial mucosa cells D) thick coating of bicarbonate-rich mucus

84)

85) What part of the tooth bears the force and resists the friction of chewing? A) crown B) pulp C) enamel

85) D) cementum

86) The capillaries that nourish the epithelium and absorb digested nutrients lie in the ________. A) adventitia B) submucosa C) serosa D) lamina propria

86)

87) Choose the incorrect statement regarding bile. A) Bile functions to carry bilirubin formed from breakdown of worn-out RBCs. B) Bile functions to emulsify fats. C) Bile is both an excretory product and a digestive secretion. D) Bile contains enzymes for digestion.

87)

88) The absorptive effectiveness of the small intestine is enhanced by increasing the surface area of the mucosal lining. Which of the following accomplish this task? A) the rugae and haustra B) the vast array of digestive enzymes C) villi, and microvilli D) Brunner's glands and Peyer patches

88)

89) Select the statement that is true concerning primary teeth. A) There are 20 primary teeth, and by 24 months of age, most children have all 20. B) There are 32 primary teeth, and by 36 months of age, most children have all 32. C) There are 24 primary teeth, and no new primary teeth appear after 13 months. D) There are 27 primary teeth, and the molars are permanent.

89)

90) Which of the following is true concerning the number and type of permanent teeth? A) There are 32 permanent teeth, and the wisdom teeth are the last to emerge. B) The number of upper permanent teeth is not equal to the number of lower permanent teeth. C) The number of permanent teeth is always equal to the number of primary teeth. D) There are 27 permanent teeth, and the first molars are usually the last to emerge.

90)

91) Which of the following is NOT true of saliva? A) contains enzymes that begin the breakdown of carbohydrates B) contains acids which aid in chemical digestion C) moistens food and aids in compacting of the bolus D) cleanses the mouth

91)

92) Which of the following is NOT found in saliva? A) protease C) lysozyme

92) B) electrolytes D) urea and uric acid

93) The bolus is liquefied in the ________ and it is now called chyme. A) esophagus B) stomach C) mouth

93) D) small intestine

94) Peristaltic waves are ________. A) segmental regions of the gastrointestinal tract B) churning movements of the gastrointestinal tract that aid in mechanical breakdown of chyme C) waves of muscular contractions that propel contents from one point to another D) pendular movements of the gastrointestinal tract

94)

95) Pepsinogen, an inactive digestive enzyme, is secreted by the ________. A) Brunner's glands in the duodenum B) parietal cells of the stomach C) chief cells of the stomach D) goblet cells of the small intestine

95)

96) You have just eaten a meal high in complex carbohydrates. Which of the following enzymes will help to digest the meal? A) trypsin B) cholecystokinin C) gastrin D) amylase

96)

97) The ducts that deliver bile and pancreatic juice from the liver and pancreas, respectively, unite to form the ________. A) hepatopancreatic ampulla B) pancreatic acini D) portal vein C) bile canaliculus

97)

98) Short-chain triglycerides found in foods such as butterfat molecules in milk are split by a specific enzyme in preparation for absorption. Which of the following enzymes is responsible? A) lipase B) pepsin C) chymotrypsin D) amylase

98)

99) Hepatocytes do NOT ________. A) store fat-soluble vitamins C) process nutrients

99) B) produce digestive enzymes D) detoxify toxic chemicals

100) Which vitamin requires intrinsic factor in order to be absorbed? A) C B) K C) A

100) D) B12

101) Gastric pits, as opposed to gastric glands, are completely lined with ________. A) parietal cells B) mucous cells C) chief cells D) enteroendocrine cells

101)

102) Chemical digestion reduces large complex molecules to simpler compounds by the process of ________. A) excretion B) anabolism C) catabolism D) mastication

102)

103) The ________ contains lobules with sinusoids (lined with macrophages) that lead to a central venous structure. A) stomach B) liver C) spleen D) pancreas

103)

104) Digestion and absorption of which of the following would be affected the most if the liver were severely damaged? A) carbohydrates B) proteins C) lipids D) starches

104)

105) The dental formula for an adult is 2-1-2-3. What does the 1 stand for? A) premolar tooth B) canine tooth C) molar tooth

105)

106) The lamina propria is composed of ________. A) dense regular connective tissue C) reticular connective tissue

D) incisor tooth 106)

B) dense irregular connective tissue D) loose connective tissue

107) Which of the following is (are) NOT important as a stimulus in the gastric phase of gastric secretion? A) carbohydrates B) low acidity C) distention D) peptides

107)

108) The function of goblet cells is to ________. A) produce mucus that protects parts of the digestive organs from the effects of powerful enzymes needed for food digestion B) secrete buffers in order to keep the pH of the digestive tract close to neutral C) provide protection against invading bacteria and other disease -causing organisms that enter the digestive tract in food D) absorb nutrients from digested food and store them for future use

108)

109) Which of the following is an essential role played by large intestine bacteria? A) absorb bilirubin B) synthesize vitamins C and D C) synthesis of vitamin K D) produce gas

109)

110) Nervous control of gastric secretion is provided by ________. A) somatic neurons in the spinal cord B) the rubrospinal tracts C) the reticulospinal and vestibulospinal tracts D) the vagus nerve and enteric plexus

110)

111) Which of the following are types of papillae on the tongue that contain taste buds? A) palatine and circumvallate B) circumvallate and filiform C) fungiform, circumvallate, and filiform D) fungiform and circumvallate

111)

112) Which of the following produce intrinsic factor? A) enteroendocrine cells C) parietal cells

112) B) zymogenic cells D) mucous neck cells

113) Which of the following enzymes would be most active in the presence of high concentrations of protein fragments? A) trypsin B) amylase C) dextrinase D) lipase

113)

114) A child with restricted tongue movement may have a surgery that involves the cutting of the ________. A) lingual frenulum B) palatine tonsils C) terminal sulcus D) uvula

114)

115) Which of the following is NOT characteristic of the large intestine? A) It exhibits external muscular bands called teniae coli. B) It has pocket-like sacs called haustra. C) It does not contain villi. D) It is longer than the small intestine.

115)

116) What stomach secretion is necessary for normal hemoglobin production in RBCs? A) gastric lipase B) HCl C) pepsinogen D) intrinsic factor

116)

117) Select the correct statement about the regulation of gastric secretion. A) The presence of food in the stomach prevents hormonal control of gastric secretion. B) Gastric secretion can be stimulated before food has entered the mouth. C) Vagus stimulation of the stomach results in decreased secretion of gastric juice. D) Gastric secretion is enhanced by very low pH (below a pH of 2).

117)

118) Paneth cells ________. A) secrete bicarbonate ions C) secrete hormones

118) B) secrete enzymes that kill bacteria D) secrete digestive enzymes

119) Select the correct statement about absorption. A) Carbohydrates diffuse across the mucosal endothelium and are then actively transported into blood capillaries. B) In the rare case that intact, whole proteins are transported across the mucosal endothelium, an immune response may be generated. C) Amino acid transport is linked to chloride transport. D) Eighty percent of ingested materials have been absorbed by the end of the large intestine.

119)

120) Which is NOT true of lipid absorption? A) Fatty acids and monoglycerides are packaged with proteins to form chylomicrons. B) Fatty acids and monoglycerides are absorbed passively by diffusion. C) Products of lipid digestion are transported to the blood by the lymphatic system. D) Enterocytes require the presence of lipoprotein lipase to effectively absorb micelles.

120)

121) The ingestion of a meal high in fat content would cause which of the following to occur? A) Increased production of trypsinogen. B) Bile would be released from the gallbladder to emulsify the fat in the duodenum. C) This type of food would cause secretion of gastrin to cease, resulting in faster gastric emptying. D) The acid secretions from the stomach would be sufficient to digest this food but may cause heartburn.

121)

122) Hormones or paracrines that inhibit gastric secretion include ________. A) secretin B) histamine C) gastrin

122) D) ACh

123) Which of these is NOT part of the splanchnic circulation? A) inferior vena cava B) hepatic portal vein C) superior mesenteric artery D) celiac artery

123)

124) Which of these is NOT a component of saliva? A) defensins C) lysozyme

124) B) metabolic waste D) a cyanide derivative

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 125) The longest portion of the small intestine is the ________.

125)

126) The principal enzyme for breaking down carbohydrates is ________.

126)

127) Cells of the stomach that secrete HCl are ________ cells.

127)

128) The chief bile pigment is ________.

128)

129) Cells are found in the sinusoids of the liver that remove debris from the blood as it flows past are called ________ macrophages.

129)

130) The part of the peritoneum that covers the external surfaces of most digestive organs is the ________ peritoneum.

130)

131) The ________ ligament anchors a tooth in the alveolus of the jaw.

131)

132) The ________ phase of gastric secretions occurs when food enters the stomach.

132)

133) The protective outermost layer of the esophagus is the ________.

133)

134) Compare and contrast the structure and function of a premolar and a molar.

134)

135) What are chylomicrons?

135)

136) What is heartburn and what causes it?

136)

137) Name two regions of the digestive tract where mechanical food breakdown processes are very important. Name two organs that are primarily food conduits. Name the organ where protein digestion is begun. Name the organ where fat digestion begins.

137)

138) Define constipation and diarrhea. Note possible causes of each.

138)

139) Assume you have been chewing a piece of bread for 5 or 6 minutes. How would you expect its molecular chemistry to change during this time? Why?

139)

140) Your friend suffers from heartburn and was told that he should "stop drinking caffeinated coffee because it is acidic." Explain to your friend why this is good advice but explain the mistaken facts to him.

140)

141) Why is it necessary for the stomach contents to be so acidic? How does the stomach protect itself from digestion?

141)

142) Identify three ways the small intestine is modified to increase the surface area for digestion and absorption.

142)

143) How is digestive activity provoked after eating? What activates the secretion of digestive juices into the lumen or hormones into the blood?

143)

144) How is salivation regulated?

144)

145) What is bile and where is it produced? What is its digestive function? Where is it stored and concentrated?

145)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 146) Mrs. Wong goes to the emergency room with the following symptoms: severe pain in the umbilical region, loss of appetite, nausea, and vomiting. While she was waiting to see a doctor, the pain moved to the lower right abdominal quadrant. What is the likely diagnosis and treatment?

147) Jose is brought to the emergency room complaining of a burning sensation in his chest, increased salivation, and difficulty in swallowing. He is having difficulty breathing and feels the presence of a "lump in his throat." The diagnosis is gastroesophageal reflux disease. Explain. 148) Sami has been hospitalized with acute gastritis. Her symptoms were epigastric pressure (just above the stomach), headache, nausea, and vomiting with traces of old dark blood. She revealed that she had been suffering back pain and drank four shots of gin and took three aspirin to "kill the pain." What led the physician to make this diagnosis, and what may have caused the sudden attack? 149) A woman is brought to an emergency room complaining of severe pain in her left iliac region. She claims previous episodes and says that the condition is worse when she is constipated, and is relieved by defecation. A large, tender mass is palpated in the left iliac fossa and a barium study reveals a large number of diverticula in her descending and sigmoid colon. What are diverticula, and what is believed to promote their formation? Does this woman have diverticulitis or diverticulosis? Explain. 150) A patient is 67 years old and has had a hiatal hernia for three years. In the last year, she has complained of worsening heartburn, especially at night. What are the characteristic symptoms of a hiatal hernia and which of these symptoms did the patient have? 151) A patient was admitted to the hospital because of severe epigastric pain. He has noted that his stools were darker than the usual brown color. He appears pale and very anxious. The history reports that he drinks 2 -3 beers per day and smokes 2 packs of cigarettes a day. Based on the assessment data, what condition might the nurse determine this patient has? Explain why. 152) A patient has esophageal cancer and must have a feeding tube inserted. The doctor tells the patient that the tube will be inserted surgically into the duodenum. The patient's wife asks why the tube will not be inserted into the stomach. What would the doctor say? 153) A 45-year-old patient was admitted to the hospital with a diagnosis of cirrhosis of the liver. He is thin and malnourished. His abdomen is very large due to an accumulation of fluid in the abdominal cavity. His lower extremities are very swollen. Explain why these changes have occurred. 154) A 45-year-old patient was admitted to the hospital with a diagnosis of cirrhosis of the liver. The nurse is observing him closely for the possibility of gastrointestinal bleeding. Why is this considered a possible complication?

Answer Key Testname: UNTITLED23

1) A 2) B 3) C 4) B 5) D 6) A 7) D 8) B 9) D 10) A 11) C 12) E 13) D 14) C 15) A 16) B 17) D 18) B 19) E 20) C 21) A 22) B 23) A 24) C 25) C 26) C 27) A 28) D 29) B 30) FALSE 31) TRUE 32) TRUE 33) TRUE 34) TRUE 35) FALSE 36) TRUE 37) FALSE 38) FALSE 39) TRUE 40) TRUE 41) FALSE 42) FALSE 43) TRUE 44) FALSE 45) FALSE 46) TRUE 47) TRUE 48) TRUE 49) FALSE 50) TRUE 17

Answer Key Testname: UNTITLED23

51) TRUE 52) TRUE 53) TRUE 54) TRUE 55) FALSE 56) FALSE 57) FALSE 58) C 59) C 60) C 61) A 62) B 63) B 64) B 65) C 66) A 67) C 68) C 69) D 70) B 71) B 72) A 73) C 74) C 75) C 76) A 77) D 78) C 79) A 80) A 81) C 82) A 83) C 84) A 85) C 86) D 87) D 88) C 89) A 90) A 91) B 92) A 93) B 94) C 95) C 96) D 97) A 98) A 99) B 100) D 18

Answer Key Testname: UNTITLED23

101) B 102) C 103) B 104) C 105) B 106) D 107) A 108) A 109) C 110) D 111) D 112) C 113) A 114) A 115) D 116) D 117) B 118) B 119) B 120) D 121) B 122) A 123) A 124) D 125) ileum 126) amylase 127) parietal 128) bilirubin 129) stellate 130) visceral 131) periodontal 132) gastric 133) adventitia 134) Premolars have a broad crown with rounded cusps but have only one root except the first upper molars that often have two. Molars also have broad crowns with rounded cusps but are larger than premolars. Molars have at least two roots. 135) Chylomicrons are tiny fatty droplets composed of triglycerides, small amounts of phospholipids, cholesterol, free fatty acids, and some protein that circulate in the blood but have not yet been reprocessed by the liver. These are picked up by lacteals of the lymphatics which are then transported through the lymph vessels and eventually into the systemic circulation via the lymphatic duct. 136) Heartburn is the discomfort felt in the chest area when the acidic gastric juices get regurgitated into the esophagus. This may happen when someone has eaten or drunk too much, or it can be caused by extreme obesity or the discomfort of pregnancy. It is related to weakness of the gastroesophageal sphincter, frequently associated with hiatal hernia. 137) Mechanical food processes are very important in the mouth (mastication) and stomach (contractions causing mixing of food into chyme). The esophagus and pharynx are primarily food conduits. Protein digestion begins in the stomach. Fat digestion begins in the small intestine.

Answer Key Testname: UNTITLED23

138) Watery stools are called diarrhea. Constipation is a condition in which too much water has been absorbed and the stool becomes hard and difficult to pass. Any condition (such as irritation of the colon by bacteria) that rushes food residue through the large intestine before that organ has had sufficient time to absorb the remaining water results in diarrhea. Constipation may ensue from the lack of fiber in the diet, improper bowel habits, laxative abuse, or anything that decreases motility. 139) The bread will begin to change as some of the starch is broken down into the sugar maltose due to the chemical digestion of carbohydrates by salivary amylase. 140) Coffee's pH does not cause heartburn. However, caffeine can promote the release of gastrin hormone from G cells in the stomach. Release of gastrin will result in the greater production of stomach acid that could worsen the pain of heartburn. 141) HCl is necessary for the activation and optimal activity of pepsin, and it kills many of the bacteria ingested with food. Mucous cells in the lining of the stomach secrete an alkaline mucus that clings to the stomach wall and helps to shield it from the acid. The epithelial cells of the mucosa are joined together by tight junctions that prevent gastric juice from leaking into underlying tissue layers. Damaged epithelial cells are shed and quickly replaced by cell division. 142) The plicae circulares, villi, and microvilli are modifications of the small intestine for digestion and absorption. The plicae circulares are circular folds of the mucosa and submucosa. They force chyme to move spirally through the lumen. The villi are fingerlike projections of the mucosa. They increase the absorptive surface area. Microvilli are projections of the plasma membrane of the absorptive cells of the mucosa that bear intestinal digestive enzymes. They also increase surface area and enhance absorption. 143) Mechanoreceptors located in the walls of the gastrointestinal tract respond to stretching by the introduction of food into the lumen. Likewise, chemoreceptors in the walls are able to respond to changes in solute concentration and pH as well as the presence of substrates and end products of digestion. 144) When we ingest food, chemoreceptors and pressoreceptors in the mouth send signals to the salivatory nuclei in the brain stem. The parasympathetic nervous system activity increases and motor fibers trigger the increase in serous, enzyme-rich saliva. 145) Bile is an alkaline solution containing bile salts, bile pigments, cholesterol, neutral fats, phospholipids, and a variety of electrolytes. It is produced in the liver. Its digestive function is to emulsify fats. It is stored and concentrated in the gallbladder. 146) The most likely diagnosis is appendicitis. The accepted treatment is immediate surgical removal of the appendix. You should rule out pregnancy if she is of child bearing age. Can be an OBGYN condition. 147) Gastroesophageal reflux disease is a disorder in which the rate of reflux is greater than in normal individuals and causes clinical symptoms and/or histological changes. Reflux and regurgitation may result in aspiration of gastric contents into the air passages, causing respiratory distress such as hoarseness, asthma, and pneumonia. The sensation of a lump in his throat may be due to esophageal muscle spasm from irritation or even worse, that he has developed a stricture (narrowing) or cancer from prolonged neglect. 148) Gastritis is an inflammation of the mucosal lining of the stomach and is suspected because of the pain location, accompanying symptoms, and ingesting of likely causative agents. He would likely confirm the diagnosis by doing an upper GI endoscopy. The probable reason for the abrupt onset of symptoms is due to rapid and heavy ingestion of alcohol and aspirin. Acute gastritis is often due to chemical irritants that destroy the alkaline mucus barrier, particularly alcohol or salicylate. 149) Diverticula are small herniations of the mucosa through the colon walls, a condition called diverticulosis. They are believed to form when the diet lacks bulk (low-fiber diet) and the volume of residue in the colon is small. The colon narrows contractions of its circular muscles and they become more powerful, increasing the pressure on its walls. Diverticulitis is a condition in which the diverticula become inflamed. This woman has diverticulitis due to the inflammation of her diverticula, as evidenced by the pain and mass. 150) Heartburn and regurgitation from gastroesophageal reflux are the most common clinical manifestations of hiatal hernia. This patient complained of heartburn. When the patient lies down, the hernia slides upward into the thoracic cavity, which increases the discomfort.

Answer Key Testname: UNTITLED23

151) The patient most likely has a gastric ulcer. The most distressing symptom of a gastric ulcer is gnawing epigastric pain that seems to bore through to the back. The danger posed by ulcers is perforation of the stomach wall followed by peritonitis and massive hemorrhage. Because the patient's stools are darker than usual, and he is pale and anxious, the doctor suspects a bleeding ulcer. Factors such as smoking and alcohol increase hypersecretion of hydrochloric acid and low secretion of mucus. 152) The duodenum is part of the small intestine, which is the body's major digestive organ. Digestion is completed and absorption is best in the small intestine. There is also less risk for vomiting, which may cause complications. 153) Cirrhosis is a diffuse and progressive chronic scarring of the liver that typically results from chronic alcoholism or severe chronic hepatitis. Cirrhosis is characterized by extensive degeneration and destruction of the liver parenchymal cells. Edema and ascites (accumulation of fluid in the peritoneal cavity) occur because the portal blood cannot flow as easily through narrowed, scarred canaliculi, leading to a backup of pressure (portal hypertension) that causes increased filtration loss of fluid through intestinal capillary walls. 154) As scar tissue eventually shrinks, it obstructs blood flow throughout the hepatic portal system, causing portal hypertension. Some veins of the portal system anastomose with veins that drain into the venae cavae. However, these connecting veins called esophageal varices are small, include submucosal veins in the lower esophagus and gastric cardia, and tend to burst when forced to carry large volumes of blood. Signs of their failure include vomiting blood.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 24.1 Using Figure 24.1, match the following: 1) Ten-step enzymatically driven process that converts glucose into pyruvic acid.

2) Occurs via substrate-level phosphorylation.

3) Produces the CO 2 involved during glucose oxidation.

4) Where the hydrogen atoms removed during the oxidation of food fuels are combined with O2 .

5) Contains ATP synthase rotor rings.

6) ATP formed by oxidative phosphorylation.

7) Involves sugar activation, sugar cleavage, oxidation, and ATP formation.

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 8) Glucose serves as the initial reactant.

A) Electron transport chain

9) Involves the removal of hydrogen electrons and CO 2 from the substrate

B) Glycolysis

molecule.

8) 9)

C) Citric acid (Krebs) cycle

10) Occurs in the cytosol of a cell.

10)

11) Produces the most ATP.

11)

12) Involves the use of oxygen to pick up excess hydrogen and electrons.

12)

Match the following: 13) Breakdown of glycogen to release glucose.

A) Glycogenesis

13)

B) Gluconeogenesis 14) Formation of glucose from proteins or fats. 15) Storage of glucose in the form of glycogen.

14) C) Glycogenolysis D) Glycolysis

16) Breakdown of glucose to pyruvic acid.

15)

16)

Match the following: 17) Synthesis of lipids from glucose or amino acids.

A) Beta oxidation

17)

B) Lipolysis 18) Splitting of triglycerides into glycerol and fatty acids. 19) Conversion of fatty acids into acetyl groups.

18) C) Ketogenesis D) Lipogenesis

20) Formation of ketone bodies.

19)

20)

Match the following: 21) Heat transfer into the chair you are sitting on.

A) Conduction

21)

B) Convection 22) Heat exchange when you are under a ceiling fan. 23) Heat loss in the form of infrared waves.

22) C) Evaporation D) Radiation

24) Heat loss during sweating.

23)

24)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 25) Beta oxidation is the initial phase of fatty acid oxidation, and it occurs in the cytoplasm.

25)

26) The increased use of noncarbohydrate molecules for energy to conserve glucose is called glucose sparing.

26)

27) Except for lactose and some glycogen, the carbohydrates we ingest are mainly from animals.

27)

28) The term essential nutrient refers to the chemicals that can be interconverted in the liver so that the body can maintain life and good health.

28)

29) The most abundant dietary lipids in the diets of most Americans are triglycerides.

29)

30) There are no nutritionally complete proteins. All animal products should be eaten with plant material to make a nutritionally complete protein.

30)

31) The body is considered to be in nitrogen balance when the amount of nitrogen ingested in lipids equals the amount excreted in urine.

31)

32) The amount of protein needed by each person is determined by their age, size, metabolic rate, and the need to build new proteins.

32)

33) Vitamins are inorganic compounds that are essential for growth and good health.

33)

34) Cellular respiration is an anabolic process.

34)

35) The preferred energy fuel for the brain is fat.

35)

36) Glycogenesis begins when ATP levels are high, and glucose entering cells is phosphorylated to glucose-6-phosphate and converted to its isomer, glucose-1-phosphate.

36)

37) Glycogen accounts for 80-85% of stored energy in the body.

37)

38) In order for amino acids to be oxidized for energy, the amine group (NH 2 ) must be removed.

38)

39) Glucose sparing refers to the use of noncarbohydrate fuel molecules in the post absorptive state.

39)

40) Processes that break down complex molecules into simpler ones are described as anabolic.

40)

41) For use as fuel, all food carbohydrates are eventually transformed to glucose.

41)

42) Triglycerides and cholesterol do NOT circulate freely in the bloodstream.

42)

43) The major role of high-density lipoproteins (HDLs) is to store energy in the form of fat.

43)

44) It would not be healthy to eliminate all fats from your diet because they serve a useful purpose in maintaining the body.

44)

45) Carbohydrate and fat pools are oxidized directly to produce cellular energy, but amino acid pools must first be converted to a carbohydrate intermediate before being sent through cellular respiration pathways.

45)

46) High levels of HDLs are considered good.

46)

47) Diets high in cholesterol and saturated fats tend to produce high HDL concentrations.

47)

48) Ghrelin, produced by the stomach, is a powerful appetite stimulant.

48)

49) Peptides called NPY (neuropeptide Y) and AgRP (agouti-related peptides) are powerful appetite enhancers.

49)

50) The primary function of dietary protein is energy production within cells.

50)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 51) Which type of food molecule provides components for cellular structures like plasma membranes, myelin sheaths, and steroid hormones? A) complex carbohydrates B) lipids C) glucose D) protein

51)

52) Which of the choices below is NOT a fate of carbohydrate taken into the body? A) glycogenesis B) direct conversion to a nucleic acid C) amino acid synthesis D) ATP production E) lipogenesis

52)

53) Which of the following is the major role of leptin in the body? A) promote weight loss with activity B) increase appetite and food intake C) shrink fat stores D) protect against weight loss during nutritional deprivation

53)

54) Cholesterol, though it is NOT an energy molecule, has importance in the body because it ________. A) helps mobilize fats during periods of starvation B) enters the glycolytic pathway without being altered C) helps provide essential nutrients to the brain and lungs D) is a stabilizing component of the plasma membranes and is the parent molecule of steroid hormones

54)

55) Which of the following statements best describes complete protein? A) derived only from legumes and other plant material B) must contain all the body's amino acid requirements for tissue maintenance and growth C) derived from meat and fish only D) meets all the minimum daily requirements for a healthy diet

55)

56) The term metabolism is best defined as ________. A) a measure of carbohydrate utilization, typically involving measurement of calories B) the length of time it takes to digest and absorb fats C) the sum of all biochemical reactions in the body D) the number of calories it takes to keep from shivering on a cold day

56)

57) Which of the following is NOT true of the basal metabolic rate (BMR)? A) It is best calculated when the subject is in the absorptive state. B) It is measured when the subject is reclining and at rest. C) It represents the amount of energy the body needs to perform only essential functions. D) It should account for body surface area.

57)

58) When proteins undergo deamination, the waste substance found in the urine is mostly ________. A) acetyl CoA B) ketone bodies C) ammonia D) urea

58)

59) It is important to ensure that your diet is adequately rich in vitamins because ________. A) very few foods contain vitamins B) most vitamins are coenzymes needed to help the body utilize essential nutrients C) all vitamins are water soluble and pass out of the body too quickly to ensure utilization D) vitamins provide protection against the common cold

59)

60) Minerals required by the body in moderate amounts include all of the following EXCEPT ________. A) sodium and chlorine B) iron and selenium C) sulfur and potassium D) calcium and phosphorus

60)

61) Which of the choices below describes the pathway of cellular respiration (the complete oxidation of glucose)? A) gluconeogenesis, citric acid (Krebs) cycle, lipolysis B) lipolysis, glycogenolysis, beta oxidation C) glycolysis, citric acid (Krebs) cycle, electron transport chain, oxidative phosphorylation D) glycogenesis, lipogenesis, electron transport chain

61)

62) Catabolism of food molecules involves ________. A) synthesis reactions C) dehydration reactions

62) B) glycogenesis D) hydrolysis reactions

63) Catabolism would be best described as a process that ________. A) elevates glucagon levels B) causes a decline in circulating ketone bodies C) breaks down complex structures to simpler ones D) builds up triglycerides during the postabsorptive state

63)

64) The goal of cellular respiration is to _______. A) convert ADP molecules into ATP molecules B) generate body heat C) convert polymers into monomers D) provide the body with essential vitamins and minerals

64)

65) The process of breaking triglycerides down into glycerol and fatty acids is known as ________. A) gluconeogenesis B) lipolysis C) glycogenesis D) lipogenesis

65)

66) Which of the following mechanisms produces the most ATP during cellular respiration? A) substrate-level phosphorylation B) oxidation reactions C) lactic acid production D) oxidative phosphorylation

66)

67) Lipogenesis occurs when ________. A) excess proteins are transported through the cell membrane B) glucose levels drop slightly C) cellular ATP and glucose levels are high D) there is a shortage of fatty acids

67)

68) Oxidative deamination takes place in the ________. B) blood A) brain

68) C) muscles

D) liver

69) Transamination is the process whereby the amine group of an amino acid is ________. A) converted to urea B) transferred to a keto acid C) transferred to acetyl CoA D) converted to ammonia

69)

70) Glycogen is formed in the liver during the ________. A) starvation period B) absorptive state C) postabsorptive state D) period when the metabolic rate is lowest

70)

71) Which of the following is a normal consequence of the activation of the heat -promoting center? A) release of epinephrine B) sympathetic sweat gland activation C) vasodilation of cutaneous blood vessels D) increase in ADH production

71)

72) Gluconeogenesis is the process in which ________. A) glycogen is broken down to release glucose B) glycogen is formed C) glucose is formed from noncarbohydrate molecules D) glucose is converted into carbon dioxide and water

72)

73) Glycolysis is best defined as a catabolic reaction based upon the ________. A) formation of sugar B) conversion of glucose into carbon dioxide and water C) conversion of pyruvic acid into carbon dioxide and water D) conversion of glucose into two molecules of pyruvic acid

73)

74) What is the outcome of ketosis? A) metabolic alkalosis B) glycogen buildup C) water retention and edema D) glucogenesis E) metabolic acidosis

74)

75) Which of the choices below happens during the absorptive state? A) Catabolic processes exceed anabolic ones. B) Only glucose metabolism occurs. C) No metabolism occurs. D) Anabolic processes exceed catabolic ones.

75)

76) In the case of a person who consumes a normal, balanced diet, proteins are essential to the body for all of the following EXCEPT ________. A) formation of functional molecules like hemoglobin and cytochromes B) production of energy C) production of some hormones D) production of enzymes, clotting factors, and antibodies

76)

77) The most abundant dietary lipids are ________. A) phospholipids B) triglycerides

77) C) cholesterol

D) fatty acids

78) The ingestion of which nutrient type results in the greatest food-induced thermogenesis? A) carbohydrates B) lipids C) proteins D) vitamins

78)

79) Which hormone directs essentially all the events of the absorptive state? A) insulin B) epinephrine C) thyroid hormone D) growth hormone

79)

80) Why is external respiration (breathing) necessary for cellular respiration? A) Inhaled oxygen is necessary for receiving electrons and hydrogen ions from the electron transport chain. B) Inhaled oxygen is necessary for the breakdown of glucose in glycolysis. C) Inhaled oxygen is needed to bind to carbon atoms to form carbon dioxide during the citric acid cycle. D) Inhaled oxygen provides the energy that drives cellular respiration.

80)

81) Which of the following is NOT an important function of the liver? A) protein metabolism B) synthesis of vitamin K C) carbohydrate and lipid metabolism D) synthesis of bile salts

81)

82) As the body progresses from the absorptive to the postabsorptive state, the ________ continues to burn glucose while virtually every other organ in the body switches to fatty acids as its major energy source. D) spleen A) pancreas B) liver C) brain

82)

83) In gluconeogenesis, during the postabsorptive state, amino acids and ________ are converted to glucose. A) glycogen B) glucagon C) glycerol D) acetyl Co A

83)

84) In the liver, the amine group of glutamic acid is removed as ________ in the oxidative state. A) ammonia B) pyruvic acid C) oxaloacetic acid D) glyceraldehyde

84)

85) Which of the choices below is NOT a mechanism of heat production? A) enhanced thyroxine release B) sweating C) shivering D) vasoconstriction of cutaneous blood vessels

85)

86) Heat-loss enhancing mechanisms do NOT include ________. A) reducing activity B) behavior measures such as wearing light, loose clothing C) the evaporation of sweat D) vasoconstriction of peripheral blood vessels

86)

87) The amount of ________ produced is probably the most important hormonal factor in determining basal metabolic rate (BMR). A) prolactin B) thyroxine C) norepinephrine D) ADH

87)

88) When ketone bodies are present in the blood and urine in large amounts, it usually indicates increased metabolism of ________. A) glycogen B) amino acids C) fatty acids D) lactic acid

88)

89) The "thermostat" or temperature regulator of the body is the ________. A) pituitary B) thyroid C) thalamus

89) D) hypothalamus

90) When sitting on a cold park bench, body heat is transferred to the bench by ________. A) radiation B) excretion C) conduction D) convection

90)

91) During exercise, increased metabolic activity increases body heat, which then triggers sweating. Which of the following best describes the function of sweating? A) direct conduction B) infrared radiation C) sensible evaporation D) forced convection

91)

92) Which of the following statements is FALSE? A) Fats and carbohydrates are oxidized directly to produce cellular energy. B) Amino acids can be used to supply energy only after being converted to a citric acid cycle intermediate. C) Excess carbohydrate and fat can be stored as such, whereas excess amino acids are oxidized for energy or converted to fat or glycogen for storage. D) The amino acid pool is the body's total supply of amino acids in the body's proteins.

92)

93) Which of the following provides a good source of complex carbohydrates? A) vegetable oil B) chicken breast C) grain

93)

D) fruit

94) Which of the following nutrients yield the highest amount of energy per gram when metabolized? A) proteins B) fats C) foods and beverages high in caffeine D) vitamins and minerals

94)

95) Which of the following does NOT occur in the mitochondria? A) citric acid (Krebs) cycle B) formation of malic acid from fumaric acid C) electron transport D) glycolysis

95)

96) Which of the following is NOT true of beta oxidation? A) It occurs in the mitochondria. B) The carbon in the beta (third) position is oxidized during the process. C) Fatty acids are broken into acetic acid fragments. D) It involves the anabolism of fats.

96)

97) Select the correct statement about proteins. A) Catabolic steroids (hormones) accelerate the rate of protein synthesis. B) Proteins will be used by most cells for ATP synthesis if insufficient carbohydrates are ingested. C) All proteins can be synthesized in the body if most of the amino acids are present. D) Strict vegetarians need not worry about adequate protein intake, as most vegetables are almost perfect sources of amino acids.

97)

98) In an oxidation-reduction reaction, the "reduced" reactant ________. A) gains negatively charged ions B) gains electrons C) loses energy D) loses hydrogen ions

98)

99) What process primes a molecule to change in a way that increases its activity, produces motion, or does work? A) cellular respiration B) phosphorylation C) glycolysis D) beta oxidation

99)

100) Which of the choices below is NOT a source of blood glucose during the postabsorptive state? A) catabolism of cellular protein B) absorption of glucose from the GI tract C) lipolysis in adipose tissues and the liver D) glycogenolysis in the liver

100)

101) Which of the following is correct? A) Most ATP from cellular respiration are produced directly in the citric acid (Krebs) cycle. B) Most of the ATP are produced by substrate-level phosphorylation. C) Each FADH 2 yields about 1.5 ATP via oxidative phosphorylation.

101)

D) Glycolysis relies on substrate-level oxidation for the four ATP produced in this pathway. 102) Which of the following food groups are considered good sources of complete proteins? A) egg yolk, fish roe (eggs), and grains B) lima beans, kidney beans, nuts, and cereals C) corn, cottonseed oil, soy oil, and wheat germ D) eggs, milk, yogurt, meat, and fish

102)

103) Conditions that promote the oxidative deamination and energy use of amino acids include ________. A) adequate essential amino acids B) ammonia combining with oxygen to form urea C) adequate fat calories to provide adequate ATP formation D) excessive amounts of protein in the diet

103)

104) When blood is cooler than the hypothalamic set point, the person may ________. A) shiver B) exhibit vasodilation of skin vessels C) perspire heavily D) pant

104)

105) Glucose can be obtained from ________. A) glycogenolysis C) triglyceride anabolism

105) B) protein anabolism D) lipogenesis

106) Which of the following is NOT a function of low-density-lipoproteins (LDLs)? A) assist in the storage of cholesterol when supply exceeds demand B) make cholesterol available to tissue cells for hormone synthesis C) make cholesterol available to tissue cells for membrane formation D) transport cholesterol from the peripheral tissues to the liver

106)

107) Which of the following best defines negative nitrogen balance? A) It is a condition usually caused by having a diet low in fish and meat. B) Protein breakdown exceeds protein synthesis. C) It occurs when amino acids are broken down by liver enzymes and carried to the bloodstream. D) A negative nitrogen balance is normal and is a way of maintaining homeostasis.

107)

108) Red blood cells lack mitochondria. As a result, ATP production is solely through ________. A) electron transport chain B) glycolysis C) citric acid (Krebs) cycle D) aerobic respiration

108)

109) In India, rice is a large part of the diet. Lack of which vitamin in rice would lead to higher levels of blindness in this population? A) vitamin A B) vitamin E C) vitamin D D) vitamin C

109)

110) Which term describes the action of an endurance runner the night before the race as she "carbo-loads" when eating a large pasta dinner? A) glycogenolysis B) glycolysis C) gluconeogenesis D) glycogenesis

110)

111) Several hours after your last meal, declining blood glucose levels stimulate release of the hormone ________, which stimulates glycogenolysis, lipolysis and fat mobilization, and gluconeogenesis. A) glucagon B) cortisol C) thyroxine D) insulin

111)

112) At the conclusion of glycolysis, most of glucose's chemical energy is found in the ________. A) acetyl CoA B) NADH C) pyruvic acid molecules D) ATP

112)

113) While traveling abroad in Africa you observe a large number of people with goiter (enlarged thyroid). Which mineral deficiency could be responsible for this? A) fluorine B) chromium C) iron D) iodine

113)

114) A recent health screening revealed a low-density-lipoprotein (LDL) level over 130. Which of the following should be prescribed? A) iron B) glucagon C) insulin D) statins

114)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 115) A friend expresses concern that their family hardly ever consumes fruits and vegetables and is not eating healthy. Use the USDA's MyPlate food guide to help your friend understand how to improve this family's diet.

115)

116) Your car breaks down along the highway on a cold winter afternoon. As you wait for help to arrive, the temperature drops significantly inside the car. Describe two involuntary adjustments an adult body will make in order to maintain core body temperature.

116)

117) What are the four mechanisms of heat exchange and how are they defined?

117)

118) Define amino acid pool and explain how the pool is maintained even though we excrete amino acids daily.

118)

119) Megadoses of vitamin supplements may have serious consequences. Extreme excess of which vitamin group, water or fat soluble, is most likely to cause serious health problems, and why?

119)

120) What is obesity, and what health problems accompany or follow its onset?

120)

121) How is the postabsorptive state controlled and initiated?

121)

122) What is the significance of the fact that monosaccharides are phosphorylated immediately upon entry into cells?

122)

123) Explain what happens to pyruvic acid if oxygen is not present in sufficient quantities to support the electron transport system.

123)

124) Define nitrogen balance. List three factors that might lead to negative nitrogen balance and three that might result in positive nitrogen balance.

124)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 125) After chopping wood for about 2 hours on a hot but breezy afternoon, John stumbled into the house and immediately fainted. His T-shirt was wringing wet with perspiration, and his pulse was faint and rapid. What is your tentative diagnosis? Explain your reasoning and note what you should do to help John's recovery. 126) Harry is hospitalized with bacterial pneumonia. When you visit him, his teeth are chattering, his skin is cool and clammy to the touch, and he complains of feeling cold, even though the room is quite warm. Explain his symptoms.

127) Hank, a 17-year-old high school student, suffered a heart attack during a recreational swim. An autopsy revealed that he had had atherosclerosis and that his death had been caused by coronary artery disease. What might have been the cause of this disease that usually strikes a person much older than Hank? 128) The patient is a 28-year-old female with type-1 diabetes mellitus. She developed viral gastroenteritis with nausea and vomiting. She did not take her insulin and she became increasingly nonresponsive. Her husband called 911 and she was taken to the emergency room. Her pulse rate was 128 and her respiratory rate was 28, deep, and smelled fruity (Kussmaul breathing). Her urinary glucose and ketone levels were both 4 +. Her pH was dangerously low. Explain how the body attempted to compensate for the low serum pH. 129) The patient is 45 years old and is obese. He states he has been on the Atkins diet (low carbohydrate and high protein and fat) and has lost 20 pounds. What are the dangers inherent in following fad diets for quick weight loss? 130) What are four possible complications of obesity from a medical standpoint? 131) The patient is 52 years old and has a history of hypertension. His cholesterol level is 245. He states his job is very stressful and he is recently going through a divorce. He admits to being overweight and has an inactive lifestyle. His father died of a stroke at age 60. He is worried about having a heart attack and/or stroke and wishes to change his lifestyle. Among other advice, the nurse encourages the patient to eat more cold -water fish such as salmon. Explain why eating more fish would be of benefit for this patient.

Answer Key Testname: UNTITLED24

1) A 2) D 3) B 4) C 5) C 6) E 7) A 8) B 9) C 10) B 11) A 12) A 13) B 14) C 15) A 16) D 17) D 18) B 19) A 20) C 21) A 22) B 23) D 24) C 25) FALSE 26) TRUE 27) FALSE 28) FALSE 29) TRUE 30) FALSE 31) FALSE 32) TRUE 33) FALSE 34) FALSE 35) FALSE 36) TRUE 37) FALSE 38) TRUE 39) TRUE 40) FALSE 41) TRUE 42) TRUE 43) FALSE 44) TRUE 45) TRUE 46) TRUE 47) FALSE 48) TRUE 49) TRUE 50) FALSE 13

Answer Key Testname: UNTITLED24

51) B 52) B 53) B 54) D 55) B 56) C 57) A 58) D 59) B 60) B 61) C 62) D 63) C 64) A 65) B 66) D 67) C 68) D 69) B 70) B 71) A 72) C 73) D 74) E 75) D 76) B 77) B 78) C 79) A 80) A 81) B 82) C 83) C 84) A 85) B 86) D 87) B 88) C 89) D 90) C 91) C 92) D 93) C 94) B 95) D 96) D 97) B 98) B 99) B 100) B 14

Answer Key Testname: UNTITLED24

101) C 102) D 103) D 104) A 105) A 106) D 107) B 108) B 109) A 110) D 111) A 112) C 113) D 114) D 115) The USDA's guidelines are represented by a dinner plate that suggests how to plan meals relative to amounts and varieties of foods from each group. The plate depicts approximately 30% grains, 30% vegetables, 20% fruits, and 20% protein. A cup nearby represents dairy. The plate illustrates that half of your foods should be fruits and vegetables. Many people consume less than this recommended amount. 116) 1. Constriction of cutaneous blood vessels: Sympathetic fibers cause vasoconstriction of the blood vessels in skin in order to reduce heat otherwise lost through radiation from the skin. 2. Shivering: Brain centers controlling muscle tone are activated which eventually cause heat generation from the involuntary contraction of skeletal muscles. 117) (1) Radiation is the loss of heat as thermal energy. (2) Conduction is the transfer of heat between objects that are in direct contact with each other. (3) Convection is the process of replacing the warm air around the body with cooler air and thus removing body heat. (4) Evaporation cools by removing large amounts of heat as water changes state from liquid to gas. 118) The amino acid pool consists of the body's total supply of free amino acids needed to resynthesize body proteins. Even though a small amount of amino acids and proteins is lost daily in urine, these are replaced through diet. If they are not replaced, the amino acids resulting from tissue breakdown become a part of the pool. 119) Fat-soluble vitamins are most likely to cause serious health problems such as damage to the brain, kidneys, liver, bone, and cardiovascular system, because they are stored in the body and excesses are not removed. 120) Obesity is a BMI (body mass index) greater than 30. Health problems accompanying or following obesity include a higher incidence of arteriosclerosis, hypertension, coronary artery disease, and diabetes mellitus. 121) The postabsorptive state is controlled by the interaction of the sympathetic nervous system and several hormones, especially glucagon. The trigger for initiating postabsorptive events is damping of insulin release, which occurs as blood glucose levels begin to drop. Insulin levels decline, and the insulin -induced cellular responses are inhibited. 122) Monosaccharides are phosphorylated immediately upon entry into cells so that entry into metabolic pathways is possible. Additionally, phosphorylation, to change the structure of glucose, allows the maintenance of a diffusion gradient for simple glucose. Phosphorylation also prevents glucose from leaving the cell. 123) When oxygen is not present in sufficient amounts, the NADH + H+ produced during glycolysis begins to unload its hydrogen "baggage" back onto pyruvic acid, reducing it. This addition of hydrogen atoms to pyruvic acid results in the production of lactic acid. 124) Nitrogen balance is a state when the amount of nitrogen ingested in proteins equals the amount of nitrogen excreted in urine and feces. Factors leading to negative nitrogen balance (when protein breakdown exceeds the use of protein for building structural or functional molecules) include: physical and emotional stress, poor -quality dietary protein, and starvation. Factors leading to positive nitrogen balance (when the rate of protein synthesis is higher than the rate of its breakdown and loss) include: the normal condition in growing children and pregnant women, periods of rebuilding or repair following illness, and site-specific regeneration following injury.

Answer Key Testname: UNTITLED24 125) John was suffering from heat exhaustion due to excessive loss of body fluids (indicated by his wet T -shirt); his low blood pressure; and cool, clammy skin. To help his recovery, he should be given fluid and electrolyte replacement therapy and should be cooled down. 126) Harry's symptoms indicate a fever caused by his bacterial pneumonia. The white cells battling the pneumonia release pyrogens that act directly on the hypothalamus, causing its neurons to release prostaglandins. The prostaglandins reset the hypothalamic thermostat to a higher temperature, causing the body to initiate heat -promoting mechanisms including shivering and vasoconstriction that causes a decline of heat loss from the body surface, cooling of the skin, and shivering. 127) Hank suffered from a genetic disorder known as "familial hypercholesterolemia," a condition in which the LDL receptors are absent or abnormal, the uptake of cholesterol by tissue cells is blocked, and the total concentration of cholesterol and LDLs in the blood is enormously elevated. Victims of the disease usually die in adolescence of coronary artery disease. 128) Ketosis leads to metabolic acidosis. The deep, rapid respirations were the body's attempt to compensate for the extremely low pH by blowing off CO 2 , resulting in less carbonic acid that in turn caused pH to rise. 129) Many fad diets are nutritionally unhealthy, particularly if they limit certain groups of nutrients. Some of the liquid high-protein diets contain poor-quality protein and are actually dangerous. 130) Obesity contributes to insulin resistance and type 2 diabetes mellitus; the obese also have a higher incidence of atherosclerosis, hypertension, heart disease, and osteoarthritis. 131) The omega-3 fatty acids in cold-water fish lower the proportions of both saturated fats and cholesterol, make blood platelets less sticky, thus helping to prevent spontaneous clotting that can block blood vessels and they also appear to lower blood pressure.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 25.1 Using Figure 25.1, match the following: 1) Glomerulus.

2) Afferent arteriole.

3) Collecting duct.

4) Nephron loop.

5) Peritubular capillaries.

6) Structure most closely associated with granular cells.

7) Which label marks a structure at the medulla of the kidney?

Figure 25.2 Using Figure 25.2, match the following: 8) Podocyte.

9) Is composed of simple squamous epithelium.

10) Collecting duct cells.

10)

11) Proximal convoluted tubule cells.

11)

12) Filtrate at the site of these cells is about the same osmolarity as blood plasma.

12)

13) Cells that are the most active in reabsorbing the filtrate.

13)

14) Cells that reabsorb virtually all the nutrients.

14)

15) Cells that are most affected by ADH.

15)

16) Almost no water is absorbed in these cells.

16)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 17) Proximal convoluted tubule.

A) Site of filtrate formation

18) Glomerulus.

B) Site at which most of the tubular reabsorption occurs

19) Peritubular capillaries. 20) Collecting duct.

C) Blood supply that directly receives substances from the tubular cells

17) 18) 19) 20)

D) Site that drains the distal convoluted tubule Match the following: 21) Low pressure, porous vessels that reabsorb solutes and water from the tubule cells.

A) Glomerular capillaries

22) High pressure vessel that forces fluid and solutes into the glomerular capsule.

C) Afferent arterioles

23) May form meandering vessels or bundles of long straight vessels.

21)

B) Efferent arterioles 22)

D) Vasa recta E) Peritubular capillaries

24) Play a role in urine concentration.

23)

24)

25) Fenestrated vessels that allow passage of all plasma elements but not blood cells.

25)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 26) If the GFR is too low, needed substances may pass so quickly through the renal tubules that they are not absorbed and instead are lost in the urine.

26)

27) In the kidneys, the countercurrent mechanism involves the interaction between the flow of filtrate through the nephron loop of the juxtamedullary nephrons (the countercurrent multiplier) and the flow of blood through the limbs of adjacent blood vessels (the countercurrent exchanger). This relationship establishes and maintains an osmotic gradient extending from the cortex through the depths of the medulla that allows the kidneys to vary urine concentration dramatically.

27)

28) The path urine takes after it is formed until it leaves the body is the urethra, urinary bladder, and finally the ureter.

28)

29) Water reabsorption through the proximal convoluted tubule is termed obligatory water reabsorption, whereas water reabsorption through the distal convoluted tubule is termed facultative water reabsorption.

29)

30) The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the term retroperitoneal.

30)

31) The entire responsibility for urine formation lies with the nephron.

31)

32) Both the male and female urethras serve both the urinary and the reproductive systems.

32)

33) The act of emptying the bladder is called voiding.

33)

34) Glomerular filtration is an ATP-driven process.

34)

35) In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to water.

35)

36) The collecting duct is impermeable to water in the presence of ADH.

36)

37) The urethra contains an internal sphincter of smooth muscle.

37)

38) High blood pressure triggers granular cells of the juxtaglomerular complex to release renin.

38)

39) Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate.

39)

40) Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve body water.

40)

41) The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct.

41)

42) Salt is actively transported out of the filtrate in the nephron loop.

42)

43) Incontinence is the inability to control voluntary micturition.

43)

44) The myogenic mechanism reflects the tendency of vascular smooth muscle to stretch.

44)

45) An excessive urine output is called anuria.

45)

46) Tubular secretion is effective in controlling blood pH.

46)

47) The trigone is so named because of the shape of the urinary bladder.

47)

48) Atrial natriuretic peptide inhibits sodium reabsorption.

48)

49) The macula densa cells are chemoreceptors that respond to changes in the urea content of the filtrate.

49)

50) Blood in the urine may be a symptom of bladder cancer.

50)

51) Obligatory water reabsorption involves the movement of water along an osmotic gradient.

51)

52) Having a kinked ureter is called renal ptosis.

52)

53) Cortical nephrons are responsible for producing concentrated urine.

53)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 54) Which of the following is the best explanation for why the cells of the proximal convoluted tubule (PCT) contain so many mitochondria? A) A great deal of active transport takes place in the PCT. B) Contraction of the PCT moves filtrate through the tubule. C) This provides the energy needed to fight kidney infection. D) Cells of the PCT go through a great deal of mitosis.

54)

55) What is the best explanation for the microvilli on the apical surface of the proximal convoluted tubule (PCT)? A) They hold on to enzymes that cleanse the filtrate before reabsorption. B) Their movements propel the filtrate through the tubules. C) They increase the amount of surface area that comes in contact with the blood's plasma to help actively excrete toxins. D) They increase the surface area and allow for a greater volume of filtrate components to be reabsorbed.

55)

56) The thin segment of the nephron loop's descending limb ________. A) helps to pack a greater number of nephron loops into a smaller space B) aids in the passive movement of water out of the tubule C) is easily broken and replaced often D) aids in the passive excretion of nitrogenous waste

56)

57) The relatively long half-life of lipid-soluble hormones (steroid hormones) compared to water-soluble hormones is due in part to the way that these hormones are passed into the filtrate from the glomerular capillaries. From the list below select the best explanation for why lipid-soluble (steroid) hormones have a relatively long half -life. A) Steroid hormones travel in the plasma on large transport proteins that cannot pass through the filtration membrane. B) Steroid hormones are absorbed by target cells before they can reach the kidneys. C) The large size of the steroid hormones prevents them from passing through the filtration membrane. D) The relatively small size of steroid hormones allows them to easily pass back into the peritubular capillaries if released into the filtrate.

57)

58) The presence of protein in the urine indicates which of the following? A) damage to the renal tubules B) high levels of transcription and translation by the bodies tissues C) too much protein in the diet D) damage to the filtration membrane

58)

59) Hydrostatic pressure is the primary driving force of plasma through the filtration membrane into the capsular space. All but one of the following statements reflects why hydrostatic pressure is so high in the glomerular capillaries. Select the one statement that does NOT explain the high pressure within the glomerular capillaries. A) The volume of plasma in the efferent arteriole is higher when compared to the afferent arteriole. B) The efferent arteriole has higher resistance to blood flow than the afferent arteriole. C) The diameter of the efferent arteriole is smaller than the afferent arteriole. D) The flow of blood is reduced as blood reaches the efferent arteriole.

59)

60) Cells and transport proteins are physically prevented from passing through the filtration membrane. This has the following effect on filtration. A) increasing osmotic pressure in the glomerular capillaries that reduces the amount of filtration B) increased osmotic pressure in the filtrate that draws plasma through the membrane C) neutral change in osmotic pressure with no effect on filtration D) decreased osmotic pressure in the filtrate that increases the amount of filtration

60)

61) If the diameter of the afferent arterioles leading to the glomerulus increases (vasodilation), which of the following is NOT likely to occur? A) Glomerular filtration rate will increase. B) Urine output will increase. C) Systemic blood pressure will go up. D) Net filtration pressure will increase.

61)

62) If the diameter of the efferent arterioles leading away from the glomerulus increases (vasodilation), which of the following is NOT likely to occur? A) Glomerular filtration rate will decrease. B) Urine output will decrease. C) Net filtration pressure will decrease. D) Systemic blood pressure will decrease.

62)

63) If the diameter of the afferent arterioles leading to the glomerulus decreases (vasoconstriction), which of the following is NOT likely to occur? A) Glomerular filtration rate will decrease. B) Systemic blood pressure will decrease. C) Urine output will decrease. D) Net filtration pressure will decrease.

63)

64) If the diameter of the efferent arterioles leading away from the glomerulus decreases (vasoconstriction), which of the following is NOT likely to occur? A) Systemic blood pressure will go up. B) Net filtration pressure will increase. C) Glomerular filtration rate will increase. D) Urine output will increase.

64)

65) If the glomerular mesangial cells contract, reducing the overall surface area of the glomerulus, which of the following is NOT likely to occur? A) Systemic blood pressure will be lowered. B) Glomerular filtration rate will decrease. C) Net filtration rate will decrease. D) Urine output will decrease.

65)

66) If blood pressure drops very low (MAP is below 80mmHg) renin enzyme will be secreted by granular cells. Which of the following is NOT likely to occur? A) Blood plasma and extracellular fluids volume will increase. B) Net filtration pressure (NFP) will decrease. C) Kidney perfusion will increase. D) Glomerular filtration rate (GFR) will decrease.

66)

67) Which of the following statements best describes the difference between the intrinsic and extrinsic controls of the kidney? A) Extrinsic controls will reduce blood plasma volume while intrinsic controls will increase blood plasma volumes. B) Extrinsic and intrinsic controls work in nearly opposite ways. C) Intrinsic controls raise blood pressure while extrinsic controls lower blood pressure. D) Extrinsic controls have the greatest effect on systemic blood pressure while intrinsic controls have a greater effect on GFR.

67)

68) Reabsorption of nutrients like glucose and amino acids takes place in the proximal convoluted tubule (PCT) via cotransporters that utilize secondary active transport. Which of the following would stop the reabsorption of glucose at the apical surface of the cells in the PCT? A) increasing Na+ concentration in the filtrate

68)

B) increasing Na+ in the interstitial fluid C) loss of K+ leak channels at the apical surface D) loss of Na+ -K+ ATPase in the basolateral surface of PCT cells 69) Bulk flow of nutrients, ions and water into the peritubular capillaries is the result of all of the following except one. Select the answer below that does NOT describe a cause of bulk flow of fluids into the peritubular capillaries. A) leaky tight junctions of peritubular capillary's endothelium B) higher osmotic pressure in the peritubular capillary C) increased resistance to blood flow at the efferent arteriole D) lower hydrostatic pressure in the peritubular capillary

69)

70) The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________. A) nephron loop B) glomerular filtration membrane C) distal convoluted tubule D) collecting duct

70)

71) Which of the following is NOT associated with the renal corpuscle? A) a fenestrated capillary B) a vasa recta C) an efferent arteriole D) a podocyte

71)

72) An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________. A) decrease in the production of ADH B) increase in the production of aldosterone C) increase in the production of ADH D) decrease in the concentration of the blood plasma

72)

73) The urinary bladder is composed of ________ epithelium. A) transitional B) stratified squamous C) simple squamous D) pseudostratified columnar

73)

74) The kidneys are stimulated to produce renin ________. A) when the peritubular capillaries are dilated B) by a decrease in the blood pressure C) when the specific gravity of urine rises above 1.10 D) when the pH of the urine decreases

74)

75) Which of the choices below is NOT a function of the urinary system? A) regulates blood glucose levels and produces hormones B) maintains blood osmolarity C) helps maintain homeostasis by controlling the composition, volume, and pressure of blood D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat

75)

76) The ________ artery lies on the boundary between the cortex and medulla of the kidney. A) arcuate B) interlobar C) cortical radiate D) lobar

76)

77) The glomerulus differs from other capillaries in the body in that it ________. A) has a blood pressure much lower than other organ systems B) is drained by an efferent arteriole C) has a basement membrane D) is impermeable to most substances

77)

78) The descending limb of the nephron loop ________. A) is freely permeable to sodium and urea B) pulls water by osmosis into the lumen of the tubule C) contains fluid that becomes more concentrated as it moves down into the medulla D) is not permeable to water

78)

79) Select the correct statement about the ureters. A) The epithelium is stratified squamous like the skin, which allows a great deal of stretch. B) The ureters are capable of peristalsis like that of the gastrointestinal tract. C) The ureter is innervated by parasympathetic nerve endings only. D) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine.

79)

80) The fatty tissue surrounding the kidneys is important because it ________. A) stabilizes the position of the kidneys by holding them in their normal position B) ensures adequate energy for the adrenal glands to operate efficiently C) is necessary as a barrier between the adrenal glands and kidneys D) produces vitamin D and other chemicals needed by the kidney

80)

81) The renal corpuscle is made up of ________. A) Bowman's capsule and glomerulus C) the renal papilla

81) B) the renal pyramid D) the descending nephron loop

82) The functional and structural unit of the kidneys is the ________. A) glomerular capsule B) nephron loop C) capsular space D) nephron

82)

83) Which of the following does NOT describe the juxtaglomerular complex? A) Its granular cells produce rennin. B) It helps control systemic blood pressure. C) Its macula densa cells produce aldosterone. D) It regulates the rate of filtrate formation.

83)

84) The chief force pushing water and solutes out of the blood across the filtration membrane is ________. A) glomerular hydrostatic pressure (glomerular blood pressure) B) protein-regulated diffusion C) the size of the pores in the basement membrane of the capillaries D) the ionic electrochemical gradient

84)

85) Which of the following acts as the trigger for the initiation of micturition (voiding)? A) motor neurons B) the pressure of the fluid in the bladder C) the stretching of the bladder wall D) the sympathetic efferents

85)

86) The filtration membrane includes all EXCEPT ________. A) basement membrane B) renal fascia C) glomerular endothelium D) podocytes

86)

87) The mechanism of water reabsorption by the renal tubules is ________. A) filtration B) cotransport with sodium ions C) osmosis D) active transport

87)

88) The glomerular capsular space contains ________. A) plasma B) urine

88) C) blood

D) filtrate

89) The macula densa cells respond to ________.

89)

A) aldosterone

B) changes in pressure in the tubule D) changes in Na + content of the filtrate

C) antidiuretic hormone

90) Which of the following is NOT reabsorbed by the proximal convoluted tubule? A) Na+ B) glucose C) creatinine D) K+

90)

91) The fluid in glomerular capsule is similar to plasma except that it does NOT contain a significant amount of ________. A) plasma protein B) hormones C) electrolytes D) glucose

91)

92) Alcohol acts as a diuretic because it ________. A) inhibits the release of ADH C) increases secretion of ADH

92) B) increases the rate of glomerular filtration D) is not reabsorbed by the tubule cells

93) The function of angiotensin II is to ________. A) decrease water absorption B) decrease the production of aldosterone C) constrict arterioles and increase blood pressure D) decrease arterial blood pressure

93)

94) An important physical characteristic of urine is its specific gravity or density, which is ________. A) less than water B) much higher than water C) the same as water D) slightly higher than water

94)

95) Place the following in correct sequence from the formation of a drop of urine to its elimination from the body.

95)

1. major calyx 2. minor calyx 3. nephron 4. urethra 5. ureter 6. collecting duct A) 2, 1, 3, 6, 5, 4

B) 6, 3, 2, 1, 5, 4

C) 3, 1, 2, 6, 5, 4

D) 3, 6, 2, 1, 5, 4

96) Select the correct statement about the nephrons. A) Filtration slits are the pores that give fenestrated capillaries their name. B) The glomerulus is correctly described as the proximal end of the proximal convoluted tubule. C) The parietal layer of the glomerular capsule is simple squamous epithelium. D) Podocytes are the branching epithelial cells that line the tubules of the nephron.

96)

97) What would happen if the capsular hydrostatic pressure were increased above normal? A) Net filtration would decrease. B) Net filtration would increase above normal. C) Filtration would increase in proportion to the increase in capsular pressure. D) Capsular osmotic pressure would compensate so that filtration would not change.

97)

98) Which of the following is NOT a part of the juxtaglomerular complex? A) macula densa B) podocyte cells C) granular cells

98) D) mesangial cells

99) Which of the following is incorrect? A) Urine concentration and volume are determined by countercurrent mechanisms B) The kidneys produce a small volume of concentrated urine when dehydrated. C) The concentration of urine is lower when urine volume is reduced. D) The kidneys produce a large volume of dilute urine when overhydrated.

99)

100) Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________. A) facilitated diffusion B) countertransport C) secondary active transport D) passive transport

100)

101) Which of the choices below is a function of the nephron loop? A) absorb water and electrolytes into the tubular network B) form a large volume of very dilute urine or a small volume of very concentrated urine C) absorb electrolytes actively and water by osmosis in the same segments D) form a large volume of very concentrated urine or a small volume of very dilute urine

101)

102) What is the effect of antidiuretic hormone on the cells of the collecting duct? A) causes aquaporins to be inserted into the apical membranes B) inhibits sodium reabsorption through the apical membranes C) triggers synthesis of more potassium channels in the apical membranes D) triggers synthesis of more sodium channels in the apical membranes

102)

103) Which of the following hormones acting on the collecting duct is most responsible for retaining sodium ions in the blood? A) atrial natriuretic peptide B) parathyroid hormone C) antidiuretic hormone D) aldosterone

103)

104) The factor that promotes filtrate formation at the glomerulus is the ________. A) capsular hydrostatic pressure B) colloid osmotic pressure of the blood C) glomerular hydrostatic pressure D) myogenic mechanism

104)

105) Glomerular filtration rate can be controlled by manipulating one major variable, which is ________. A) activation of sympathetic nerve fibers B) systemic blood pressure C) glomerular hydrostatic pressure D) the renin-angiotensin-aldosterone mechanism

105)

106) If one says that the clearance value of glucose is zero, what does this mean? A) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules. B) The clearance value of glucose is relatively high in a healthy adult. C) 100% of glucose is reabsorbed. D) The glucose molecule is too large to be filtered out of the blood.

106)

107) Excretion of dilute urine requires ________. A) the presence of ADH B) transport of sodium and chloride ions out of the descending nephron loop C) relative permeability of the distal tubule to water D) impermeability of the collecting tubule to water

107)

108) Which of the choices below is NOT a method by which the cells of the renal tubules can raise blood pH? A) by reabsorbing filtered bicarbonate ions B) by producing new bicarbonate ions C) by secreting sodium ions D) by secreting hydrogen ions into the filtrate

108)

109) In the ascending limb of the nephron loop the ________. A) thick segment moves ions out into interstitial spaces for reabsorption B) thick segment is permeable to water C) thin segment is not permeable to sodium and chloride D) thin segment is freely permeable to water

109)

110) Except for potassium ions, tubular secretion of most unwanted substances occurs in the ________. A) collecting duct B) nephron loop C) proximal convoluted tubule D) distal convoluted tubule

110)

111) What is the most direct function of the juxtaglomerular apparatus? A) help regulate urea absorption by the kidneys B) help regulate blood pressure and the rate of blood filtration by the kidneys C) help regulate blood pressure and the rate of excretion by the kidneys D) help regulate water and electrolyte excretion by the kidneys

111)

112) Which of the choices below is the salt level-monitoring part of the nephron? A) macula densa B) vasa recta C) principal cell

112) D) nephron loop

113) Which of the hormones below is responsible for facultative water reabsorption? A) atrial natriuretic peptide B) thyroxine C) ADH D) aldosterone

113)

114) Which of the choices below is NOT a glomerular filtration rate control method? A) neural regulation B) electrolyte levels C) renal autoregulation D) hormonal regulation

114)

115) Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion? A) angiotensin II and aldosterone B) angiotensin I and atrial natriuretic peptide C) angiotensin I and epinephrine D) angiotensin II and ADH

115)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 116) ADH activated water channels called ________ are essential for water reabsorption in the collecting duct.

116)

117) The need to get up in the middle of the night to urinate is called ________.

117)

118) The area between the ureters and urethra that is often the location of infection is called the ________ in a bladder.

118)

119) The ________ mechanism is the general tendency of vascular smooth muscle to contract when stretched.

119)

120) The presence of pus in the urine is a condition called ________.

120)

121) Sodium-linked water flow across a membrane not under hormonal control is called ________ water reabsorption.

121)

122) Explain how filtration works in the glomerular capillaries.

122)

123) List three substances that are abnormal urinary constituents and provide the proper clinical term for such abnormalities.

123)

124) Explain the role of aldosterone in sodium and water balance.

124)

125) Explain what is meant by the terms cotransport process and transport maximum.

125)

126) Humans can survive for a period of time without water thanks to the ability of the kidneys to produce concentrated urine. Briefly explain the factors that allow this to happen.

126)

127) List and describe three pressures operating at the filtration membrane, and explain how each influences net filtration pressure.

127)

128) What are aquaporins?

128)

129) Freshly voided urine has very little smell, but shortly after voiding it can give off a very strong smell. Why?

129)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 130) An older man sees his doctor for severe pain in his lower abdominal or flank area, elevated temperature, and nausea. Exhaustive tests rule out abdominal obstructions and infections. Plain X -rays indicate a radiopaque (whitish) spot in the area of his right ureter. Diagnose his problem. Give suggested treatment and prognosis. 131) What clinical effects would low blood pressure have on the kidneys of a burn patient? 132) Eleven-year-old Harry is complaining of a severe sore throat and gets to stay home from school. His pediatrician prescribes a course of broad-spectrum antibiotics, and Harry feels much better within a few days. However, some two weeks later, Harry has a dull, bilateral pain in his lower back and his urine is a smoky brown color. On the basis of Harry's signs and symptoms, diagnose his condition and indicate the relationship (if any) between his present condition and his earlier sore throat. 133) Ellen, a 47-year-old woman who has suffered kidney disease for several years, has been diagnosed with proteinuria. Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What is proteinuria, and could this condition be playing a role in her swollen limbs? 134) Rachael has been complaining of frequent and burning urination. She also reported seeing some blood in her urine. Her physician suspects cystitis. What is cystitis, and how can it cause these symptoms? 135) An 18-year-old patient has a complaint of painful urination, fever, chills, and back pain. This is her second urinary tract infection (UTI) within 5 months. How can the doctor instruct the patient on prevention of another UTI? 136) A 58-year-old woman complains of loss of urine when coughing and sneezing, and during exercise. She has had three children. Describe the possible causes of urinary incontinence in this patient. 137) Explain how an angiotensin converting enzyme inhibitor (ACE inhibitor) such as captopril would be effective as an antihypertensive.

Answer Key Testname: UNTITLED25

1) C 2) A 3) B 4) E 5) D 6) A 7) E 8) B 9) A 10) C 11) E 12) E 13) E 14) E 15) C 16) D 17) B 18) A 19) C 20) D 21) E 22) C 23) B 24) D 25) A 26) FALSE 27) TRUE 28) FALSE 29) TRUE 30) TRUE 31) TRUE 32) FALSE 33) TRUE 34) FALSE 35) TRUE 36) FALSE 37) TRUE 38) FALSE 39) TRUE 40) FALSE 41) FALSE 42) TRUE 43) TRUE 44) FALSE 45) FALSE 46) TRUE 47) FALSE 48) TRUE 49) FALSE 50) TRUE 14

Answer Key Testname: UNTITLED25

51) TRUE 52) FALSE 53) FALSE 54) A 55) D 56) B 57) A 58) D 59) A 60) A 61) C 62) D 63) B 64) A 65) A 66) C 67) D 68) D 69) A 70) A 71) B 72) C 73) A 74) B 75) D 76) A 77) B 78) C 79) B 80) A 81) A 82) D 83) C 84) A 85) C 86) B 87) C 88) D 89) D 90) C 91) A 92) A 93) C 94) D 95) D 96) C 97) A 98) B 99) C 100) C 15

Answer Key Testname: UNTITLED25

101) B 102) A 103) D 104) C 105) C 106) C 107) D 108) C 109) A 110) C 111) B 112) A 113) C 114) B 115) A 116) aquaporins 117) nocturia 118) trigone 119) myogenic 120) pyuria 121) obligatory 122) The glomerular capillaries are fenestrated, allowing fairly large molecules to pass through. The substances must pass through the basement membrane, where they are further selected for size by the filtration slits of the podocytes. 123) Abnormal urinary constituents include the following (the clinical term for each is listed in parentheses): glucose (glycosuria), proteins (proteinuria or albuminuria), ketone bodies (ketonuria), hemoglobin (hemoglobinuria), bile pigments (bilirubinuria), erythrocytes (hematuria), and leukocytes (pyuria). 124) Aldosterone targets the distal tubule and collecting duct and enhances sodium ion reabsorption so that very little leaves the body in urine. Aldosterone also causes increased water reabsorption because, as sodium is reabsorbed, water follows it back into the blood. 125) Cotransport process refers to the active transport of one solute "uphill" (against a concentration gradient) coupled to the "downhill" (with a concentration gradient) movement of another during tubular reabsorption. Transport maximum reflects the number of carriers in the renal tubules available to "ferry" a particular substance. 126) Facultative water reabsorption depends on the presence of antidiuretic hormone. In the presence of ADH, the pores of the collecting tubule increase in number and the filtrate loses water by osmosis as it passes through the medullary regions of increasing osmolarity. Consequently, water is conserved and urine becomes concentrated. The water that passes through these regions is reabsorbed by the body in order to prevent dehydration. 127) Glomerular hydrostatic pressure is the chief force pushing water and solutes across the filtration membrane. The higher the glomerular hydrostatic pressure, the more filtrate is pushed across the membrane. Colloid osmotic pressure of plasma proteins in the glomerular blood, and capsular hydrostatic pressure exerted by fluids in the glomerular capsule, drive fluids back into the glomerular capillaries. The net filtration pressure equals glomerular hydrostatic pressure minus the sum of colloid osmotic pressure of glomerular blood and capsular hydrostatic pressure. 128) Aquaporins are transmembrane proteins that form water -filled pores in water-permeable portions of the convoluted tubules such as the PCT and collecting duct. 129) Freshly voided urine is relatively sterile but if it is allowed to stand, bacteria begin to metabolize the urea solutes to release ammonia and other smells depending on the person's diet. A fruity smell generally means there is a diabetes problem. 130) The symptoms indicate a kidney stone that has been passed into the ureter. Recommended treatments include IV therapy to flush the stone out, surgery, or ultrasound waves to shatter the calculi. The usual prognosis is for complete recovery. There is a possibility of kidney stones forming again. 16

Answer Key Testname: UNTITLED25

131) This patient would have a much lower glomerular hydrostatic pressure due to water losses through burned skin and would have a low GFR. This is highly dangerous, leading to failure of the nephron loop to maintain countercurrent flow, flowed by anuria. It is made worse if any muscle is burned and myoglobin in the blood exceeds its transport maximum, resulting in plugging of the tubules and death of the nephron. Often massive fluid transfusions are required to maintain blood volume, high GFR, and dilution of myoglobinuria to avoid catastrophe. 132) Harry is showing the symptoms of kidney inflammation. Kidney inflammations usually result from infections either of the lower urinary tract or, in Harry's case, from his earlier infection of a sore throat. Streptococcal infection of the throat can induce anti-streptococcal antibodies that bind to them, depositing immune complexes in the glomerular membranes. The kidney inflammation that primarily involves glomeruli is called glomerulonephritis, and if severe enough can cause permanent renal failure. In post-streptococcal glomerulonephritis, the smoky brown color of urine most commonly represents the leakage of blood cells through the damaged glomerular membrane. 133) Proteinuria is a condition in which the permeability of the glomerular capillaries is increased to such an extent that large amounts of plasma proteins (mostly albumin) pass into the glomerular filtrate and are excreted in the urine. If the condition is severe, the loss of plasma proteins may decrease osmotic pressure substantially. When this happens there is a tendency for fluid to leave the systemic blood vessels and enter the tissue space. This is the reason for Ellen's swollen limbs. 134) It is possible that Rachael has cystitis, a condition in which the mucous membrane lining the bladder becomes swollen and bleeding occurs. This condition is caused by bacterial invasion of the bladder or by chemical or mechanical irritation. Burning on urination alone implies urethritis – inflammation of the urethra alone, but urinary frequency suggests the bladder itself is also involved, with the inflammation causing smooth muscle irritability lowering the stretch trigger point for micturition. 135) Escherichia coli are normal residents of the digestive tract and generally cause no problems there, but these bacteria account for 80% of all urinary tract infections. The doctor can instruct the patient on proper hygiene measures, including wiping from front to back following urination to avoid introduction of anal bacteria, reduction in sexual activity if sexually active, and increased fluid intake to increase flushing of the urethra. The doctor should also explain that sexually transmitted infections can also inflame the urinary tract, clogging some of its ducts. 136) Stress incontinence is found most commonly in women with relaxed pelvic musculature deprived of estrogen. Stress incontinence may occur with a sudden increase in intra-abdominal pressure such as coughing or sneezing, which forces urine through the external sphincter. Aging, multiple pregnancies, and obesity are risk factors in increasing the relaxation and/or pressure from above. 137) Angiotensin II is a potent vasoconstrictor activating smooth muscle of arterioles throughout the body, causing mean arterial blood pressure to rise. ACE inhibitors reduce blood pressure by interrupting the renin-angiotensin-aldosterone system.

Exam Name___________________________________

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 1) Dissociate into ions in water.

A) Intracellular

2) Do not dissociate in solution.

B) Nonelectrolytes

3) The main fluid compartment outside the cells.

C) Extracellular

1) 2) 3)

D) Electrolytes 4) The main fluid compartment located within the cell.

4) E) Interstitial

5) Fluid in the spaces between cells.

Match the following: 6) Magnesium excess.

A) Hyponatremia

7) Calcium depletion.

B) Hypocalcemia

8) Sodium excess.

C) Hyperkalemia

9) Potassium excess.

D) Hypernatremia

10) Sodium depletion.

E) Hypermagnesemia

6) 7) 8) 9) 10)

Match the following: 11) An atypical accumulation of fluid in the interstitial space.

A) Edema

11)

B) Dehydration 12) Fluid loss, either the loss of water or the loss of water and solutes together.

12)

13) A disorder entailing deficient aldosterone production by the adrenal cortex.

A) Addison's disease

14) Regulates sodium ion concentrations in the extracellular fluid.

C) Aldosterone

13)

B) Hyponatremia

15) A condition due to excessive water intake that results in net osmosis into tissue cells. This leads to severe metabolic disturbances.

14)

15)

Match the electrolyte composition for the following: 16) The concentration of sodium ions is highest in ________.

A) Intracellular fluid

16)

B) Interstitial fluid 17) The concentration of potassium ions is highest in ________.

17) C) Blood plasma

18) The concentration of phosphate ions is highest in ________.

18)

19) The concentration of bicarbonate ions is highest in ________.

19)

20) The concentration of protein anions is highest in ________.

20)

Match the following: 21) Possibly caused by severe diarrhea or untreated diabetes mellitus.

A) Metabolic alkalosis

21)

B) Respiratory acidosis 22) Possibly occurring with emphysema, extreme obesity, or narcotic overdose. 23) Possibly caused by asthma, pneumonia, or a severe panic attack.

22) C) Metabolic acidosis D) Respiratory alkalosis

24) Possibly caused by vomiting, use of diuretics, or use of antacids.

23)

24)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 25) Adipose tissue is one of the most hydrated of all tissues in the human body.

25)

26) The most abundant cation in intracellular fluid is sodium.

26)

27) Electrolytes determine most of the chemical and physical reactions of body fluids.

27)

28) Solutes, regardless of size, are able to move freely between compartments because water carries them along the osmotic gradients.

28)

29) The thirst center in the brain is located in the hypothalamus.

29)

30) Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus.

30)

31) It is impossible to overhydrate because people need as much water as they can drink to carry out ordinary body functions.

31)

32) Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed dehydration.

32)

33) Salts are lost from the body in perspiration and urine only.

33)

34) Excessive loss of water from the extracellular fluid (ECF) leads to a rise in osmotic pressure in the ECF which causes cells to shrink as water leaves by osmosis.

34)

35) Although the sodium content of the body may be altered, its concentration in the ECF remains relatively stable because of immediate adjustments in water volume.

35)

36) Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems.

36)

37) When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the distal convoluted tubule.

37)

38) Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion.

38)

39) Some potassium ions are reabsorbed from the kidney filtrate via type A intercalated cells, a unique population of collecting duct cells.

39)

40) Aldosterone is secreted in response to low extracellular potassium.

40)

41) To remain properly hydrated, water intake must equal water output.

41)

42) The main way the kidney regulates potassium ions is to excrete them.

42)

43) Obligatory water loss occurs because humans always take in more fluids through eating and drinking than they need to maintain water balance.

43)

44) Premenstrual edema may be due to enhanced reabsorption of sodium chloride.

44)

45) Heavy consumption of salt substitutes high in potassium can present a serious clinical problem when aldosterone release is not normal.

45)

46) Insensible water loss includes water lost in feces.

46)

47) The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin.

47)

48) Calcitonin targets the bones and causes the release of calcium from storage when serum calcium levels are low.

48)

49) The normal pH of blood is 7.35-7.45.

49)

50) Most acidic substances (hydrogen ions) originate as by-products of cellular metabolism.

50)

51) Weak acids are able to act as chemical buffering systems for the body because they only partially dissociate.

51)

52) The phosphate buffer system is relatively unimportant for buffering blood plasma.

52)

53) The single most important blood buffer system is the bicarbonate buffer system.

53)

54) One of the most powerful and plentiful sources of buffers is the protein buffer system.

54)

55) As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion concentration of the blood decreases.

55)

56) Carotid artery and aortic baroreceptors are involved in long term adjustment to total body sodium ion content.

56)

57) Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient.

57)

58) Prolonged hyperventilation can cause alkalosis.

58)

59) Thirst is normally triggered by hypothalamic osmoreceptors sensitive to a 1 -2% increase in plasma osmolality.

59)

60) Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of the CNS.

60)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 61) The body's water volume is closely tied to the level of which of the following ions? A) hydrogen ions B) sodium ions C) potassium ions D) calcium ions

61)

62) The term hypotonic hydration refers to ________. A) the feeling one might have after profuse sweating with exertion B) a condition that may result from renal insufficiency or drinking excessive amounts of water C) a condition that is caused by high levels of sodium in the extracellular fluid compartment D) the unpleasant feeling people have after drinking too much liquor

62)

63) When antidiuretic hormone (ADH) levels are low, ________. A) nearly all of the filtered water is reabsorbed B) a small volume of concentrated urine is excreted C) most of the water reaching the collecting ducts is not reabsorbed D) aquaporins are inserted into the collecting duct principal cell apical membranes

63)

64) Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid? A) erythropoietin B) renin C) antidiuretic hormone D) aldosterone

64)

65) Atrial natriuretic peptide (ANP) is a hormone that is made in the atria of the heart. The influence of this hormone is to ________. A) prevent pH changes caused by organic acids B) enhance atrial contractions C) reduce blood pressure and blood volume by inhibiting sodium and water retention D) activate the renin-angiotensin mechanism

65)

66) Respiratory acidosis can occur when ________. A) a person consumes excessive amounts of antacids B) a person's breathing is shallow due to obstruction C) the kidneys secrete hydrogen ions D) a runner has completed a very long marathon

66)

67) Total body water is NOT a function of which of the following? A) amount of water ingested B) body mass C) amount of body fat D) age

67)

68) Which of the choices below is NOT an essential role of salts in the body? A) membrane permeability B) secretory activity C) neuromuscular activity D) anabolism of lipids

68)

69) Which of the choices below exerts primary control over sodium levels in the body? A) glucocorticoids B) water levels C) aldosterone D) ADH

69)

70) The fluid link between the external and internal environment is ________. A) plasma B) cerebrospinal fluid C) intracellular fluid D) interstitial fluid

70)

71) In a car accident, Jane suffered a chest injury that resulted in impaired breathing and respiratory acidosis. How will her body compensate for this imbalance? A) Kidneys eliminate bicarbonate ions. B) Kidneys eliminate carbon dioxide. C) Kidneys retain bicarbonate ions. D) Kidneys retain hydrogen ions.

71)

72) Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid. D) iron A) chloride B) potassium C) bicarbonate

72)

73) Which of the following describes the distribution of sodium and potassium between cells and body fluids? A) Na+ mainly in the cells, K+ in the body fluids B) K+ mainly in the cells, Na + in the body fluids C) equal amounts of each ion in the cells and body fluids D) little of either in the cells, but large amounts of each in the body fluids

73)

74) For bulk flow across capillary walls, ________. A) hydrostatic pressure of the interstitial space returns fluid to the capillary B) hydrostatic pressure of blood forces nearly protein-free plasma out of the blood into the interstitial space C) fluid runs into lymphatic capillaries that empty into the interstitial space D) osmotic pressure of plasma proteins pulls fluid from the capillary into the interstitial space

74)

75) The single most important factor influencing potassium ion secretion is ________. A) intracellular sodium levels B) the pH of the intracellular fluid C) the potassium ion content in the renal tubule cells D) potassium ion concentration in extracellular fluid

75)

76) Amphoteric molecules _______. A) can function as acids at low pH B) can function as an acid or a base depending on the pH C) trigger pH imbalances and must be neutralized by buffers D) can function as bases at high pH

76)

77) A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________. A) respiratory alkalosis B) metabolic alkalosis C) respiratory acidosis D) metabolic acidosis

77)

78) The movement of fluids between cellular compartments ________. A) requires active transport B) requires ATP for the transport to take place C) always involves filtration D) is regulated by osmotic and hydrostatic forces

78)

79) What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention? A) antidiuretic hormone (ADH) B) atrial natriuretic peptide (ANP) C) aldosterone D) thyroxine

79)

80) When a strong acid such as HCl is added to the carbonic acid buffer system, _________. A) carbonic acid is converted into bicarbonate B) hydrochloric acid is neutralized by sodium hydroxide C) more carbonic acid is formed D) the blood plasma pH is reduced

80)

81) Which of the following is NOT a chemical buffer system? B) phosphate C) protein A) bicarbonate

81)

D) nitrogen

82) Which of the following is NOT a trigger for juxtaglomerular granular cells to release renin? A) increased extracellular fluid water levels B) decreased stretch of the granular cells of the afferent arterioles C) decreased filtrate NaCl concentration D) sympathetic stimulation

82)

83) Which of the following statements is true regarding fluid shifts? A) Nonelectrolytes are the controlling factor in directing fluid shifts. B) Electrolytes are not as important as proteins in regulating fluid shifts in the body. C) There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts. D) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.

83)

84) Which of the following would describe nonelectrolytes? A) inorganic salts B) inorganic acids C) organic bases D) polar covalent compounds

84)

85) The maintenance of the proper pH of the body fluids may be the result of ________. A) control of the acids produced in the stomach B) the control of respiratory ventilation C) the operation of the various buffer systems in the stomach D) the active secretion of OH- into the filtrate by the kidney tubule cells

85)

86) Which of the following is NOT a disorder of water balance? A) excess water in interstitial spaces due to a low level of plasma proteins B) hypotonic hydration, in which sodium content is normal but water content is high C) excessive hydration due to excess atrial natriuretic peptide (ANP) secretion D) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure

86)

87) The regulation of sodium ________. A) involves aldosterone, a hormone that increases sodium excretion in the kidneys B) is linked to blood pressure C) involves hypothalamic osmoreceptor detection of ion concentration D) is due to specific sodium receptors in the hypothalamus

87)

88) Blood analysis indicates a low pH, and the patient is breathing rapidly. Given your knowledge of acid-base balance, which of the following is most likely? A) metabolic alkalosis B) respiratory alkalosis C) metabolic acidosis D) respiratory acidosis

88)

89) A patient is breathing slowly, and blood pH analysis indicates an abnormally high value. What is the likely diagnosis? A) respiratory acidosis B) respiratory alkalosis C) metabolic alkalosis D) metabolic acidosis

89)

90) Which of the following is NOT a likely source of hydrogen ions in blood plasma? A) anaerobic metabolism of glucose B) metabolism of proteins containing phosphorus C) metabolism of fats D) aerobic metabolism of glucose

90)

91) Annie has just eaten a large order of heavily salted French fries, some pickled eggs, and some cheese. How will consuming this much salt affect her physiology? A) There will be a temporary increase in blood volume. B) She will experience hypotension. C) It will cause a prolonged increase in the osmolality of the blood. D) There will be a shift in the pH of her body fluids to the higher side of the pH scale.

91)

92) The most important force causing net outward water flow across capillary walls is ________. A) osmotic pressure of plasma proteins B) intracellular hydrostatic pressure C) hydrostatic pressure of interstitial fluid D) hydrostatic pressure of capillary blood

92)

93) When the blood becomes acidic (acidosis) and bicarbonate ions have been depleted, new bicarbonate ions must be generated in the plasma. Which of the following is NOT a means for replenishing bicarbonate ions? A) Bicarbonate ions are reclaimed by tubular reabsorption. B) Glutamine is metabolized by deamination, oxidation, and acidification. C) Buffered hydrogen ions are excreted in urine. D) Ammonium ions are excreted in urine.

93)

94) The regulation of potassium balance ________. A) is not linked to sodium balance B) involves aldosterone-induced secretion of potassium C) includes renal secretion, but never absorption D) is accomplished mainly by hepatic mechanisms

94)

95) After completing a marathon on a particularly warm day, Dave consumes four liters of water. Soon after, he begins to feel nauseous and starts vomiting. What is likely happening to Dave? A) obligatory water loss B) dehydration C) hypoproteinemia; unusually low levels of plasma proteins D) hyponatremia; very low extracellular sodium ion concentration

95)

96) Mary finds that she regularly retains water at a certain point in the menstrual cycle. Which of the following is chemically similar to aldosterone, and like aldosterone, enhances NaCl reabsorption in the renal tubules? A) estrogen B) follicle-stimulating hormone C) luteinizing hormone D) progesterone

96)

97) Nancy is experiencing an acute panic attack. While hyperventilating, she remembers to open a paper bag and breathe into it. What is Nancy trying to prevent? A) respiratory acidosis B) respiratory alkalosis C) metabolic acidosis D) metabolic alkalosis

97)

98) If the thyroid and parathyroid glands are surgically removed, which of the following would go out of balance without replacement therapy? A) calcium ion levels B) potassium ion levels C) anion levels D) sodium ion levels

98)

99) Insufficient parathyroid hormone production in the body could result in ________. A) muscle weakness B) kidney stones C) muscle twitching D) cardiac arrhythmia

99)

100) In the case of edema, excess fluid is held in which fluid compartment(s)? A) blood plasma B) intracellular fluid and interstitial fluid C) interstitial fluid D) intracellular fluid

100)

101) Falling arterial blood pressure promotes ________. A) vasodilation C) vasoconstriction

101) B) enhanced sodium ion loss in urine D) enhanced water loss in urine

102) An illness causes Doug to experience severe diarrhea and an accompanying loss of bicarbonate-rich secretions. How can this metabolic acidosis be compensated? A) hypoventilation B) enhanced sodium ion loss in urine C) increased renin secretion D) increased respiratory rate and depth

102)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 103) What provides the shortest-term mechanism for preventing acid-base imbalances in the body? The longest-term mechanism?

103)

104) What is the effect of acidosis on the body? Of alkalosis?

104)

105) Describe the mechanisms by which the kidneys remove hydrogen ions from the body.

105)

106) Describe the influence of rising parathyroid hormone (PTH) levels on bone, the small intestine, and the kidneys.

106)

107) When the blood becomes hypertonic (too many solutes) due to dehydration, antidiuretic hormone (ADH) is released. What is the effect of ADH on the kidney tubules?

107)

108) Why would an infant with colic be suffering from respiratory alkalosis?

108)

109) How does the respiratory system influence the buffer systems of the body?

109)

110) Identify and describe the operation of the three major chemical buffers of the body.

110)

111) List and describe three stimuli that activate the hypothalamic thirst center.

111)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 112) A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO 3 - is 20 mEq/L. What diagnosis would you give and what prognosis? A medical history reveals that this patient is a chronic alcoholic. 113) A pregnant woman complains to her doctor that her ankles and feet stay swollen all of the time. She is very worried about this. As her doctor, what would you tell her? 114) Helen is a 62-year-old smoker. Her physician has diagnosed her as having emphysema that has caused her to hypoventilate. Surprisingly, when her blood pH is checked, it is 7.40. Why? 115) After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. The clinic's diagnosis is respiratory alkalosis. What has caused this problem? 116) A patient is 72 years old and was admitted to the hospital for severe shortness of breath and edema to her lower extremities. She was diagnosed with heart failure. A symptom of heart failure is generalized edema. Explain the finding of generalized edema in heart failure. 117) A 13-year-old girl is admitted to the psychiatric unit for anorexia. Her body weight is 89 lbs. and height is 64 inches. She admits to frequent self-induced vomiting and abuse of laxatives. She was treated on the medical unit with intravenous fluids. Now that she is on the psychiatric unit she is experiencing fluid retention as evidenced by mild puffiness and bloating. Explain these symptoms. 118) A patient's anxiety caused her to develop respiratory alkalosis. The nurse instructs the patient to take some slow deep breaths. Explain why this would be effective.

Answer Key Testname: UNTITLED26

1) D 2) B 3) C 4) A 5) E 6) E 7) B 8) D 9) C 10) A 11) A 12) B 13) A 14) C 15) B 16) C 17) A 18) A 19) B 20) A 21) C 22) B 23) D 24) A 25) FALSE 26) FALSE 27) TRUE 28) FALSE 29) TRUE 30) TRUE 31) FALSE 32) TRUE 33) FALSE 34) TRUE 35) TRUE 36) TRUE 37) TRUE 38) TRUE 39) TRUE 40) FALSE 41) TRUE 42) TRUE 43) FALSE 44) TRUE 45) TRUE 46) FALSE 47) FALSE 48) FALSE 49) TRUE 50) TRUE 11

Answer Key Testname: UNTITLED26

51) TRUE 52) TRUE 53) TRUE 54) TRUE 55) TRUE 56) TRUE 57) TRUE 58) TRUE 59) TRUE 60) TRUE 61) B 62) B 63) C 64) D 65) C 66) B 67) A 68) D 69) C 70) A 71) C 72) B 73) B 74) B 75) D 76) B 77) C 78) D 79) B 80) C 81) D 82) A 83) D 84) D 85) B 86) C 87) B 88) C 89) C 90) D 91) A 92) D 93) A 94) B 95) D 96) A 97) B 98) A 99) C 100) C 12

Answer Key Testname: UNTITLED26

101) C 102) D 103) Chemical buffers act within a fraction of a second to resist a pH change. The longest -term mechanism is the kidney system, which ordinarily requires from several hours to a day or more to effect changes in blood pH. 104) When the body is in acute acidosis, the nervous system becomes so severely depressed that the person goes into a coma and death soon follows. Alkalosis causes overexcitement of the nervous system. Characteristic signs include muscle tetany, extreme nervousness, and convulsions. Death often results from respiratory arrest. 105) Virtually all of the H+ that leaves the body in urine is secreted into the filtrate. The tubule cells, including collecting ducts, appear to respond directly to the pH of the ECF and to alter their rate of H + secretion accordingly. The secreted H+ ions are obtained from the dissociation of carbonic acid within the tubule cells. For each H + ion actively secreted into the tubule lumen, one sodium ion is reabsorbed into the tubule cell from the filtrate, thus maintaining the electrochemical balance. 106) Parathyroid hormone (PTH) activates osteoclasts that break down the bone matrix, resulting in the release of Ca 2+ and PO 4 3- to the blood. PTH enhances intestinal absorption of Ca 2+ indirectly by stimulating the kidneys to transform vitamin D to its active form, which is necessary for calcium absorption by the small intestine. PTH increases the reabsorption of calcium by the renal tubules, which simultaneously decreases phosphate ion reabsorption. 107) The release of ADH causes the kidney tubules to reabsorb excess water, resulting in the excretion of concentrated urine. 108) If the infant is uncomfortable and cries forcefully for long periods of time, this would be similar to hyperventilation. Hyperventilation would cause respiratory alkalosis because the infant is losing carbon dioxide rapidly. 109) The respiratory system maintains a constant bicarbonate level in the bloodstream by outgassing carbon dioxide. In the event of a respiratory problem the CO 2 to bicarbonate ratio might change, in turn changing buffering effects on pH. 110) The bicarbonate buffer system (carbonic acid plus sodium bicarbonate) acts to tie up the hydrogen ions released by a strong acid, thus converting it to a weaker acid, which lowers the pH only slightly. For a strong base, the carbonic acid will be forced to donate more H + to tie up the OH - released by the base, with the net result of replacement of a strong base by a weak one. The pH rise is very small. The phosphate buffer system, composed of the sodium salts of dihydrogen phosphate and monohydrogen phosphate, acts in a similar fashion to the bicarbonate system. NaH 2 PO4 acts as a weak acid; Na 2 HPO4 acts as a weak base. Hydrogen ions released by strong acids are tied up in weak acids; strong bases are converted to weak bases. Amino acids of the protein buffer system release H + when the pH begins to rise by dissociating carboxyl groups, or bind hydrogen ions with amine groups to form NH 3 + when the pH falls. 111) Hypothalamic osmoreceptors detect ECF osmolality through changes in plasma membrane stretch that result from gaining or losing water. Dry mouth resulting from increased blood osmotic pressure and reduced saliva production. A substantial decrease in blood volume or pressure, as in hemorrhage, also triggers the thirst mechanism. 112) The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. With a pH below 7.0, the patient will go into a coma and death soon follows. 113) She is showing edema, an atypical accumulation of fluid in the spaces between cells (interstitial spaces). This is caused by her pregnancy due to a high blood volume that increases capillary hydrostatic pressure and enhances capillary permeability. She should be monitored for the edema during the pregnancy and her BP for possible pre -eclampsia, and urine should be periodically checked for proteinuria, but the edema should clear up at the end of the pregnancy once both blood volume and uterine pressure on venous return disappear. 114) Helen is suffering from respiratory acidosis because she is retaining too much carbon dioxide. Her shallow breathing, due to the damage to her lungs from the disease, is the cause. In order to release the carbon dioxide, one must be able to breathe normally (deep breathing would be optimal). However, because this has been a long -term problem, her kidneys have excreted greater amounts of acids while retaining HCO 3 - , thus providing renal compensation to her chronic respiratory acidosis. 115) Respiratory alkalosis is always caused by hyperventilation. Claire is experiencing the effect of the high altitude and was overcompensating or trying to do too much the first day in Denver. 13

Answer Key Testname: UNTITLED26

116) Edema is an atypical accumulation of fluid in the interstitial space, leading to tissue swelling. Heart failure is one cause of edema. 117) It is not uncommon for anorexics who are chronically fluid depleted to develop a compensatory increased production of aldosterone, which causes the kidneys to conserve sodium and water. 118) Instructing the patient to breathe more slowly will reduce the elimination of CO 2 . Breathing into a paper bag will cause retention of CO 2 .

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 27.1 Using Figure 27.1, match the following: 1) Spermatogonium.

2) First cells with n number of chromosomes.

3) Type B daughter cell.

4) Early spermatids.

5) Primary spermatocyte.

Figure 27.2 Using Figure 27.2, match the following: 6) Location of acrosome.

7) Location of mitochondria.

8) Midpiece.

9) Location of nucleus.

10) Area of compacted DNA.

10)

11) Flagellum.

11)

Figure 27.3 Using Figure 27.3, match the following: 12) The stage called ovulation.

12)

13) Vesicular (Graafian) follicle.

13)

14) Primary follicles.

14)

15) Primordial follicle.

15)

16) Corpus luteum.

16)

17) Mature follicle.

17)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 18) Homologous chromosomes separate.

A) Metaphase I of meiosis

19) Tetrads align randomly on the spindle equator.

B) Anaphase II of meiosis

18) 19)

C) Anaphase I of meiosis 20) Chromosomes that have undergone crossing over line up individually along the spindle equator. 21) Chromosomes that have not undergone crossing over line up individually along the spindle equator.

20) D) Metaphase of mitosis E) Metaphase II of meiosis 21)

22) Centromeres separate.

22)

23) Part of a process that produces genetically identical daughter cells.

23)

Match the following: 24) Human papillomavirus.

A) Genital warts

25) Treponema pallidum.

B) Gonorrhea

26) Causes urethritis in males.

C) Genital herpes

27) Human herpes simplex virus.

D) Chlamydia

28) Pathogen responsible for 25-50% of all diagnosed cases of pelvic inflammatory disease.

E) Syphilis

24) 25) 26) 27) 28)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 29) It is necessary for the testes to be kept below body temperature for abundant, viable sperm formation.

29)

30) The prostate atrophies as a man ages, and it usually causes no health problems.

30)

31) When it is cold, the scrotum is pulled away from the body.

31)

32) When a couple is having difficulty conceiving a child, it is necessary to investigate the sperm of the male.

32)

33) The amount of testosterone and sperm produced by the testes is dependent on the influence of FSH alone.

33)

34) Ovarian follicles contain mature eggs.

34)

35) Sexually transmitted infections are the most important cause of reproductive disorders.

35)

36) The testis is divided into seminiferous tubules which contain the lobules that produce sperm and the ejaculatory duct that allows the sperm to be ejected from the body.

36)

37) The smaller cell produced by oogenesis meiosis I, called the first polar body, is essentially a packet of discarded nuclear material.

37)

38) A human egg or sperm contains 23 pairs of chromosomes.

38)

39) The Pap smear is a test to detect cancerous changes in cells of the cervix.

39)

40) The adenohypophyseal hormone that triggers ovulation is estrogen.

40)

41) Ovulation occurs near the end of the ovarian cycle.

41)

42) The corpus luteum secretes progesterone only.

42)

43) Female orgasm is required for conception.

43)

44) The first sign of puberty in females is budding breasts.

44)

45) Sustentocytes prevent sperm antigens from entering the bloodstream.

45)

46) The stage in meiosis where chromosomal exchange takes place is telophase I.

46)

47) Male erection is a response to a parasympathetic reflex, and ejaculation is a response to a sympathetic reflex.

47)

48) The soft mucosal lining of the uterus is the endometrium.

48)

49) A scrotal muscle that contracts in response to cold environmental temperature is the cremaster.

49)

50) The secretions of the bulbourethral glands neutralize traces of acidic urine in the urethra and serve as a lubricant during sexual intercourse.

50)

51) The zona pellucida is formed as the follicle becomes a secondary follicle.

51)

52) The molecule that enhances the ability of testosterone to promote spermatogenesis is inhibin.

52)

53) Sperm are ejaculated from the corpora cavernosa of the penis.

53)

54) Male testicular functions are regulated by FSH and LH.

54)

55) Extremely stressful physical activity in young females can result in excessive bone mass due to large amounts of estrogen production.

55)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 56) All of the following things occur during meiosis I. Select the statement below that does NOT occur during meiosis I. A) A single diploid (2n) nucleus has become two haploid (n) nuclei. B) Portions of maternal chromosomes crossover with equivalent portions of paternal chromosomes. C) The sister chromatids are separated from each other. D) The homologous chromosomes are separated from each other.

56)

57) Which of the following statements is true of metaphase I of meiosis I? A) Homologous pairs align randomly on the spindle equator with a mix of paternal and maternal homologs destined for each of the daughter cells. B) Joined homologous pair uniformly line up on the equatorial spindle with chromosome one at the top and chromosome 23 on the bottom. C) The sister chromatids line up randomly on the spindle equator with some maternal and paternal chromatids on both sides of the equator. D) Tetrads align randomly on the spindle equator with all the maternal homologs on one side and all the paternal homologs on the opposite side.

57)

58) Select the statement below that is FALSE. A) Meiosis occurs only after the onset of puberty while mitosis occurs throughout an entire lifetime. B) A cell undergoing meiosis results in 4 cells while a cell undergoing mitosis results in 2 cells. C) Meiosis produces genetically unique cells while mitosis produces genetically identical cells. D) Meiosis results in haploid cells while mitosis results in diploid cells.

58)

59) Select the statement which is true regarding independent assortment. A) Its effects are significant in meiosis and in mitosis. B) It is a significant source of genetic variation that occurs in meiosis I and meiosis II. C) It is a significant source of genetic variation only during meiosis I. D) It only occurs in meiosis II.

59)

60) Select the statement which is FALSE. A) Further genetic variation typically does not occur after meiosis I. B) Crossing over is a source of genetic variability seen in meiosis while independent assortment is a source of genetic variability seen in mitosis. C) Meiosis II is essentially the same process as mitosis except the starting cells are haploid (n). D) Meiosis II is essentially the same process as mitosis except the genetic material will not replicate before division takes place.

60)

61) All but one of the following statements are true regarding the differences between early and late spermatids. Select the answer below that does NOT reflect a difference between early and late spermatids. A) Early spermatids are round and have excessive cytoplasm. B) Early spermatids have not undergone meiosis and are still diploid. C) Early spermatids have not formed flagella. D) Early spermatids have not undergone spermiogenesis.

61)

62) During spermiogenesis ________. A) the acrosome migrates towards the anterior end of the spermatid because its pointy shape helps the sperm to move more efficiently B) the acrosome migrates towards the posterior end of the spermatid because of its ability to propel the flagella moving the sperm through the female reproductive system towards the egg C) the acrosome migrates towards the anterior end of the spermatid because its hydrolytic enzymes will be needed for penetration when the sperm contacts the egg during fertilization D) the acrosome migrates towards the posterior end of the spermatid because its hydrolytic enzymes will be needed for digestion of the excessive cytoplasm around the flagella of the developing sperm

62)

63) All but one of the events described below occur during spermiogenesis. Select the event that does NOT occur during spermiogenesis. A) Mitochondrial DNA is packaged into the nucleus to be delivered to the egg during fertilization. B) The centrioles migrate to the posterior end of the developing sperm to form the microtubules that make up the flagellum. C) Excessive cytoplasm will be shed to reduce unneeded mass of the maturing sperm. D) Mitochondria form around the proximal end of the flagellum. They will provide the ATP to drive the motion of the flagellum.

63)

64) All but one of the following statements is true with regard to the blood testis barrier. Select the one statement that is FALSE. A) The barrier is made up of astrocytes that surround blood vessels in the testis. B) The barrier prevents the spermatocytes from exposing their unique antigens to the immune system. C) The barrier marks the border between the basal compartment and the adluminal compartment. D) The cells that form the blood testis barrier are joined by tight junctions.

64)

65) Of the following statements, select the statement that is NOT true of uterine function. A) The myometrium contracts to expel the fetus during childbirth. B) The narrow portion of the uterus near the cervix is the most typical site of fertilization. C) The endometrium has a functional layer that the embryo will implant into. D) The rhythmic, reverse peristalsis of the uterus can propel sperm toward the egg.

65)

66) The oral contraceptive pill, informally called "the pill," contains an estrogen and progesterone, or a synthetic mimic of this hormone. The combination of these two hormones, taken in the pill and circulating in the blood, works because ________. A) the hormones prevent the proliferative or secretory phase of the menstrual cycle and the embryo will have no place to implant B) the hormones cause a thickening of the mucus plug at the cervix that prevents sperm from penetrating the womb and reaching the ovulated egg C) the hormones create an acid condition in the vagina that acts as a spermicide D) the hormones cause the woman's body to mimic the activities of a pregnancy and disrupt the ovarian cycle, preventing ovulation

66)

67) The diploid number of chromosomes in a human is 46. Therefore, the number of chromosomes in a primary spermatocyte or primary oocyte is ________. A) 46 B) 23 C) 38 D) 92

67)

68) The dartos and cremaster muscles are important to the integrity of the male reproductive system. Which of the following best describes the role they play? A) They regulate the temperature of the testes. B) They contract to push sperm along the ductus deferens. C) They contract to allow ejaculation. D) They are responsible for penile erection.

68)

69) The ability of sperm cells to move along the ductus deferens is due to ________. A) hormonal action B) gravity C) enzymatic activity D) peristaltic contractions

69)

70) The most important risk for testicular cancer in young males is ________. A) sexually transmitted infections B) a diet high in fat C) failure of the testis to make their normal descent D) smoking

70)

71) Which of the following glands are responsible for producing 70% of semen volume? A) the prostate B) the seminal vesicles C) the bulbourethral glands D) the pituitary

71)

72) Which of the following hormones controls the release of anterior pituitary gonadotropins? A) LH B) testosterone C) FSH D) GnRH

72)

73) The critical factor that determines gender during development is ________. A) inhibition of estrogen B) the SRY gene C) presence of progesterone D) lack of an X chromosome

73)

74) The structures that receive the ovulated oocyte, providing a site for fertilization, are called the ________. A) Graafian follicles B) fimbriae C) infundibula D) uterine tubes

74)

75) If gametes were diploid like somatic cells, how many chromosomes would the zygote contain? A) Half the diploid number with no change in development. B) Triple the diploid number, and with every succeeding generation, the chromosome number would continue to triple and normal development would not occur. C) Twice the diploid number, and with every succeeding generation, the chromosome number would continue to double and normal development could not occur. D) There is no relationship between gametes and somatic cells.

75)

76) Human egg and sperm are similar in that ________. A) they have the same degree of motility B) about the same number of each is produced per month C) they are about the same size D) they have the same number of chromosomes

76)

77) The constancy of the chromosome number from one cell generation to the next is maintained through ________. A) cytokinesis B) DNA synthesis C) mitosis D) meiosis

77)

78) Fertilization generally occurs in the ________. A) vagina B) uterine tubes

78) C) ovary

79) Which of the following female structures is homologous to the male scrotum? A) labia majora B) clitoris C) labia minora

D) uterus 79) D) vagina

80) In humans, separation of the cells at the two-cell state following fertilization may lead to the production of twins, which in this case would be ________. A) dizygotic B) potentially of different sexes C) genetically identical D) fraternal

80)

81) Which of the following is incurable? A) gonorrhea B) trichomoniasis

81) C) syphilis

82) Effects of estrogen include ________. A) growth of the larynx C) increased oiliness of the skin

B) growth of the breasts at puberty D) deepening of the voice

D) genital herpes 82)

83) Secretion of progesterone stimulates ________. A) preparation of the mammary glands for lactation B) contraction of uterine muscles C) development of the female secondary sex characteristics D) proliferation of the uterine myometrium

83)

84) The cells that produce testosterone in the testis are called ________. A) interstitial endocrine cells B) spermatocytes C) sustentacular cells D) spermatogonia

84)

85) If a woman has just ended her menstrual phase, when is she most likely to ovulate? A) within the next 4 days B) in about 14 days C) in about 24 days D) in about 10 days

85)

86) Erection of the penis results from ________. A) a sympathetic activation of bulbospongiosus muscles B) parasympathetic activation of the bulbourethral glands C) a parasympathetic reflex that promotes release of nitric oxide D) dilation of the veins in the penis

86)

87) Which is NOT a part of the proliferative phase of the female menstrual cycle? A) development of endometrial cells B) corpus luteum secretion C) late in this phase, cervical mucus becomes thin and crystalline D) vesicular follicle growth

87)

88) Which of the choices below is NOT a function of the vagina? A) serves as a passageway for menstrual flow B) serves as a passageway for the primary oocyte C) serves as the birth canal D) receives semen from the penis during sexual intercourse

88)

89) Which of the following is true of testosterone? A) Testosterone is produced by interstitial endocrine cells. B) Testosterone provides positive feedback on gonadotropin release. C) The release of testosterone surges during ejaculation. D) The production of testosterone is stimulated by FSH.

89)

90) Which of the choices below is NOT a function of testosterone? A) stimulates the male pattern of development B) stimulates the HPG axis C) contributes to male sexual behavior and spermatogenesis D) stimulates protein synthesis

90)

91) Which male hormone provides negative feedback for the secretion of FSH? A) inhibin B) ACTH C) ICSH

91) D) GnRH

92) During the secretory phase of the menstrual cycle, ________ reaches its highest levels. A) estrogen B) FSH C) progesterone D) LH

92)

93) Select the correct statement about the uterine cycle. A) During the secretory phase, estrogen levels are at their highest. B) During the proliferative phase, levels of progesterone rise as the follicle produces more hormone. C) If fertilization occurs, the corpus luteum is maintained by a hormone secreted by the developing embryo. D) The menstrual phase of the cycle is normally from day 1 to day 8.

93)

94) Which of the choices below is NOT a part of the hypothalamic-pituitary-gonadal axis? A) hypothalamus B) interstitial cells C) thalamus D) anterior pituitary gland

94)

95) Which of the following statements is true concerning the mammary glands of both males and females? A) The only time hormones target breast tissue is during pregnancy and lactation. B) Both sexes are equally prone to breast cancer. C) All lumps identified in breast tissue are malignant. D) The mammary glands are modified sweat glands that are part of the integumentary system.

95)

96) Normally menstruation occurs when ________. A) blood levels of FSH fall off B) blood levels of estrogen and progesterone increase C) blood levels of estrogen and progesterone decrease D) the corpus luteum secretes estrogen

96)

97) The basic difference between spermatogenesis and oogenesis is that ________. A) during spermatogenesis two more polar bodies are produced B) in oogenesis, one mature ovum is produced from the parent cell, and in spermatogenesis four mature sperm are produced from the parent cell C) spermatogenesis involves mitosis and meiosis, but oogenesis involves meiosis only D) the mature ovum is n, while the sperm is 2n

97)

98) Occasionally three polar bodies are found clinging to the mature ovum. One came from an unequal division of the ovum, but from where did the other two arise? A) One is an undeveloped primary oocyte that failed to mature. B) There were originally four polar bodies and one disappeared. C) What you really see are two polar bodies and the sperm that will fertilize the egg. D) The first polar body has also divided to produce two polar bodies.

98)

99) Which of the following will occur immediately after ovulation? A) The corpus luteum secretes estrogen only. B) The corpus luteum becomes a corpus albicans. C) The secretion of anterior pituitary gonadotropins is enhanced. D) The endometrium enters its secretory phase.

99)

100) Why doesn't semen enter the urinary bladder during ejaculation? A) Ejaculation is a parasympathetic reflex that activates urinary contraction muscles. B) There is no urge to urinate during sexual intercourse because of the suppression of LH by testosterone buildup in the blood. C) The smooth muscle sphincter at the base of the urinary bladder closes. D) There is no common duct between the reproductive system and the urinary system.

100)

101) Spermatogenesis ________. A) involves a two-part process called mitosis I and mitosis II B) is the process of releasing mature sperm cells into the lumen of the seminiferous tubule C) results in the formation of diploid cells D) involves a kind of cell division limited to the gametes

101)

102) Which hormone is the necessary trigger for ovulation to occur? A) estrogen B) FSH C) progesterone

102)

D) LH

103) The hypothalamic-pituitary-gonadal axis ________. A) involves posterior pituitary release of two regulating hormones B) involves positive feedback control of spermatogenesis C) involves the release of testosterone from the anterior pituitary D) involves FSH and LH release from the anterior pituitary

103)

104) Which of the following does NOT occur in both the male and female sexual response? A) Muscles of structures in the reproductive duct contract rhythmically. B) Blood pressure and heart rate increase. C) Blood flow to genital structures increases. D) A refractory period follows orgasm.

104)

105) Which of the following is a correct statement about uterine tubes? A) The infundibulum is the funnel-shaped region near the ovary. B) The isthmus is the normal site of fertilization. C) The ampulla is the narrow constricted region. D) The mesometrium supports the uterine tubes along their entire length.

105)

106) Select the correct statement about the hormonal events of the ovarian cycle. A) High estrogen levels result in a surge of LH release. B) Rising levels of estrogen start follicle development. C) The LH surge stimulates further development of the secondary oocyte. D) The follicle begins to secrete progesterone in response to estrogen stimulation.

106)

107) Which of these statements about sexually transmitted infections is FALSE? A) Gonorrhea is caused by a bacterium that can bring on painful discharges in males. B) Genital herpes is caused by a virus that may cause intermittent lesions. C) Chlamydia is caused by bacteria that can often be asymptomatic or bring on a wide variety of symptoms. D) Syphilis is caused by a virus that may lead to death if untreated.

107)

108) Which of the following statements about spermatogenesis is NOT true? A) Each spermatid forms two sperm. B) The primary spermatocyte forms two secondary spermatocytes. C) The spermatogonium forms the primary spermatocyte. D) The secondary spermatocytes each form two spermatids.

108)

109) A boy who has not passed through puberty sustains an injury to his anterior pituitary such that FSH is no longer released, but LH is normal. After he grows to maturity, one would expect that he would ________. A) be unable to produce viable sperm B) have impaired function of interstitial cells D) not develop secondary sex characteristics C) be impotent (unable to have an erection)

109)

110) A patient with trichomoniasis, if they have any symptoms at all, will most likely exhibit which of the following? A) sterility B) yellow-green vaginal discharge and strong odor C) pink rash all over the body D) painful lesions on the genitals

110)

111) A low secretion of luteinizing hormone (LH) in the normal male adult would cause ________. A) increased spermatogenesis B) excessive beard growth C) shrinkage of the anterior pituitary gland D) decreased testosterone secretion

111)

112) All of the following statements referring to the uterine cycle are true EXCEPT ________. A) estrogen is secreted by the developing follicle in the follicular phase of the cycle B) FSH and LH directly promote development of the uterine endometrium C) a decrease in the levels of ovarian hormones signals menstruation D) the corpus luteum is formed from the ruptured follicle after ovulation

112)

113) Which of the following phases or processes in the monthly reproductive cycle of the female occur simultaneously? A) early follicular development and the secretory phase in the uterus B) maximal LH secretion and menstruation C) maximal steroid secretion by the corpus luteum and menstruation D) regression of the corpus luteum and a decrease in ovarian progesterone secretion

113)

114) The duct system of the male reproductive system includes all but which of the following? A) corpus spongiosum B) ductus deferens C) urethra D) epididymis

114)

115) Prostate cancer is ________. A) the number one cause of death in men B) often the result of a distortion of the urethra C) sometimes a slow-growing cancer that may never represent a threat to the patient D) most common in Asians

115)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 116) The ________ plexus of testicular veins assists in cooling the testis.

116)

117) Surgical cutting of the ductus deferens as a form of birth control is called a(n) ________.

117)

118) The erectile tissue around the urethra is the corpus ________.

118)

119) The midpiece of the sperm tail contains mostly ________.

119)

120) The ________ of the testis nourish the newly formed sperm cells.

120)

121) The suspensory ligament and mesovarium are part of the ________ ligament.

121)

122) A follicle with only a small antrum in it would be classified as a(n) ________ follicle.

122)

123) The portion of the uterine endometrium that is not sloughed off every month is called the ________.

123)

124) Treponema pallidum causes the sexually transmitted disease called ________.

124)

125) What are some risk factors for developing breast cancer?

125)

126) What is the name given to the female homologue to the penis?

126)

127) Describe the composition and functional roles of semen.

127)

128) Explain the function of the myometrium and endometrium.

128)

129) What is the purpose of the male bulbourethral gland?

129)

130) What is the physiological importance of the fact that the male testes descend to reside in the scrotal sac?

130)

131) Ovulation occurs when the oocyte is released into the peritoneal cavity. By what means does it usually enter the uterine tube?

131)

132) At what point is the sex of the embryo determined, and what determines it?

132)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 133) Teresa has been complaining of severe abdominal pain, vaginal discharge, and a low -grade fever. What might be the doctor's diagnosis, and how should the condition be treated? 134) A 38-year-old male is upset about his low sperm count and visits a "practitioner" who commonly advertises his miracle cures of sterility. The practitioner is a quack who treats conditions of low sperm count with megadoses of testosterone. Although his patients experience a huge surge in libido, their sperm count is even lower after hormone treatment. Explain why. 135) Debbye has been having pelvic pain, especially during her monthly period, for many months. She has been to several doctors and they all tell her that she is just experiencing extra -heavy monthly flows. The tests all turn up negative. She has been trying to conceive but nothing works. What could the problem be? 136) Based on your knowledge of how the prostate encircles part of the urethra, what are two clinical manifestations of an enlarged prostate? 137) A woman, whose family history contains severe osteoporosis, asked her doctor to prescribe estrogen after she reached menopause to reduce her risk of osteoporosis. The doctor refused to provide long -term estrogen replacement therapy. Why? 138) Explain the action of drugs like sildenafil (Viagra) on the male reproductive system. 139) What are some possible complications a patient may have after a radical mastectomy?

Answer Key Testname: UNTITLED27

1) A 2) D 3) B 4) E 5) C 6) B 7) A 8) A 9) C 10) C 11) D 12) E 13) C 14) B 15) A 16) D 17) C 18) C 19) A 20) E 21) D 22) B 23) D 24) A 25) E 26) B 27) C 28) D 29) TRUE 30) FALSE 31) FALSE 32) TRUE 33) FALSE 34) FALSE 35) TRUE 36) FALSE 37) TRUE 38) FALSE 39) TRUE 40) FALSE 41) FALSE 42) FALSE 43) FALSE 44) TRUE 45) TRUE 46) FALSE 47) TRUE 48) TRUE 49) TRUE 50) TRUE 15

Answer Key Testname: UNTITLED27

51) TRUE 52) FALSE 53) FALSE 54) TRUE 55) FALSE 56) C 57) A 58) A 59) C 60) B 61) B 62) C 63) A 64) A 65) B 66) D 67) A 68) A 69) D 70) C 71) B 72) D 73) B 74) D 75) C 76) D 77) D 78) B 79) A 80) C 81) D 82) B 83) A 84) A 85) B 86) C 87) B 88) B 89) A 90) B 91) A 92) C 93) C 94) C 95) D 96) C 97) B 98) D 99) D 100) C 16

Answer Key Testname: UNTITLED27

101) D 102) D 103) D 104) D 105) A 106) A 107) D 108) A 109) A 110) B 111) D 112) B 113) D 114) A 115) C 116) pampiniform 117) vasectomy 118) spongiosum 119) mitochondria 120) sustenocytes 121) broad 122) secondary 123) stratum basalis 124) syphilis 125) Some of the risk factors for developing breast cancer are: (1) early onset of menses and late menopause; (2) first pregnancy late in life or no pregnancies at all; (3) familial history of breast cancer; (4) postmenopausal hormone replacement. 126) The female clitoris is homologous to the glans penis of the male. It is homologous in that it contains dorsal erectile columns and can become swollen with blood during tactile stimulation. 127) Semen is a fluid mixture of sperm and accessory gland secretions (prostate, seminal vesicles, and bulbourethral glands). The liquid provides a transport medium for nutrients and contains chemicals that protect the sperm and facilitate their movements. 128) The myometrium plays an active role during childbirth when it contracts rhythmically to force the baby out of the mother's body. The endometrium is the innermost lining of the uterus that nourishes the embryo from the time of implantation until delivery. 129) Because it releases its contents prior to ejaculation, its function is probably to neutralize the acids in the urethra and for lubrication to help the initiation of intercourse. 130) The male testes descend into the scrotal sac so that a fairly constant intrascrotal temperature is maintained. Failure of the testes to descend results in sterility, because production of viable spermatozoa requires a temperature several degrees lower than normal body temperature, and also increases the incidence of testicular cancer. 131) Fimbriae, which drape over the ovary, become very active close to the time of ovulation and their cilia create currents in the peritoneal fluid. These currents usually carry the oocyte to the uterine tube, where it begins its journey toward the uterus. 132) Genetic sex is determined at the instant the genes of a sperm combine with those of an ovum. The determining factor is the sex chromosomes each gamete contains. 133) The symptoms sound like pelvic inflammatory disease (PID), a collective term for any extensive bacterial infection of the pelvic organs, especially the uterus, uterine tubes, or ovaries. PID at one time was most commonly caused by the bacterium that causes gonorrhea, but any bacterium can trigger the infection. Early treatment should include antibiotics (doxycycline or a cephalosporin). 17

Answer Key Testname: UNTITLED27

134) Megadoses of testosterone would inhibit hypothalamic release of GnRH and may act directly on the anterior pituitary to inhibit gonadotropin (FSH ) release. Spermatogenesis is inhibited in the absence of FSH stimulation. 135) Debbye likely has endometriosis. This problem is very difficult to diagnose and every case is different. Generally it requires laparoscopic views to find the problem. Endometriosis can cause sterility by cycles of endometrial cell growth and death, leading to inflammation followed by scar formation that in turn may block the uterine tubes, which prevents the sperm from getting to the egg or the egg from getting to the uterus. 136) Awakening at night to void caused by incomplete bladder emptying from an enlarging prostate; a small urinary stream; hesitancy in starting the urinary stream; dribbling at the end of voiding. 137) The risk of breast cancer is proportional to a woman's lifetime exposure to estrogens. It would be better for her to find alternative treatments to reduce her risk of osteoporosis than to increase her risk of breast cancer from long -term estrogen supplementation. 138) Sildenafil and other similar drugs enhance the effect of nitric oxide on the reproductive tissues. Nitric oxide relaxes smooth muscle in the blood vessels of the penis, dilating the vessels and allowing erectile tissues to fill with blood. This enhanced action of engorging the corpora cavernosa and corpora spongiosum enhances and prolongs erections. 139) The entire breast is removed along with underlying muscles, fascia, and associated lymph nodes. Therefore, the patient might experience lymphedema related to edema on the operative side. The patient may also experience problems with arm function due to the removal of muscles. The patient might experience muscle shortening and decreased muscle tone of other muscles on the affected side.

Exam Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 28.1 Using Figure 28.1, match the following: 1) Liver.

2) Esophagus.

3) Trachea.

4) Stomach.

5) Pancreas.

Figure 28.2 Using Figure 28.2, match the following: 6) Protective water-filled embryonic sac surrounding the embryo.

7) Extraembryonic membrane that develops from the trophoblast and some extraembryonic mesoderm, and forms part of the placenta.

8) Site of early blood cell production, and forms part of the gut (digestive tube).

9) The part of the endometrium destined to be a part of the placenta.

10) The part of the endometrium that surrounds the uterine cavity face of the implanted embryo.

10)

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 11) Leads to the development of a morula and then a blastocyst.

A) Cleavage

11)

B) Implantation 12) Embedding of the blastocyst in the uterine wall.

12)

13) Leads to the formation of the first cell of the new individual.

A) Fertilization

13)

B) Gastrulation 14) Leads to the establishment of the three primary germ layers.

14) C) Capacitation

15) Leads to enhancement of sperm motility and increasing membrane fragility to enable enzyme release from acrosomes.

15)

Match the following: 16) Forms the mother's part of the placenta.

A) Trophoblast

16)

B) Decidua capsularis 17) Becomes the embryonic disc.

17) C) Decidua basalis

18) A solid sphere of undifferentiated cells.

D) Inner cell mass

19) Forms the chorion.

E) Morula

18)

20) Surrounds the uterine cavity face of the implanted embryo.

19) 20)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 21) True fertilization occurs when the sperm's membrane binds to the oocyte's sperm-binding receptors.

21)

22) The period from fertilization through week eight is called the embryonic period.

22)

23) Fertilization occurs while the egg is still in the ovarian follicle.

23)

24) Freshly deposited sperm are not immediately capable of penetrating an oocyte.

24)

25) By 72 hours after fertilization, the egg has divided into more than 160 cells and is called the morula.

25)

26) Implantation begins six to seven days after ovulation.

26)

27) A pregnancy test involves antibodies that detect growth hormone (GH) levels in a woman's blood or urine.

27)

28) By the end of the embryonic period, at 8 weeks, all the adult organ systems are recognizable.

28)

29) Of the three germ layers, the mesoderm forms the most body parts.

29)

30) A pregnant woman urinates more often than usual because the uterus compresses the bladder, her metabolic rate and blood volume are increased, and she must also dispose of fetal metabolic wastes.

30)

31) The "fluid-filled, hollow ball of cells" stage of development is the blastocyst.

31)

32) The embryonic period lasts until the end of the eighth week.

32)

33) The embryo is directly enclosed in and protected by the amnion.

33)

34) In fetal circulation, one way in which blood bypasses the nonfunctional lungs is by way of the foramen ovale.

34)

35) An episiotomy is an incision made to widen the vaginal orifice, aiding fetal expulsion.

35)

36) Humans do not have a yolk sac associated with embryonic development.

36)

37) Human placental lactogen initiates labor.

37)

38) Premature infants often need to be placed on a ventilator because their undeveloped lungs produce excess surfactant.

38)

39) A blastocyst is a hollow ball of cells, while the morula is a solid ball of cells.

39)

40) A zygote is usually formed within the uterus.

40)

41) Acrosomal enzymes trigger exocytosis of cortical granules in the cortical reaction.

41)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 42) What destroys the zona pellucida sperm-binding receptors? A) the process of capacitation B) human placental lactogen C) zonal inhibiting proteins D) the acrosomal reaction

42)

43) The result of polyspermy in humans is ________. A) interruption of meiosis C) multiple births

43) B) mitotic insufficiency D) a nonfunctional zygote

44) It is impossible for sperm to be functional (able to fertilize the egg) until after ________. A) they have been stored in the uterus for several days B) they undergo capacitation C) the tail disappears D) they become spermatids

44)

45) Milk ejection (the letdown reflex) is stimulated by which of the following hormones associated with pregnancy? A) inhibin B) prolactin C) oxytocin D) gonadotropin

45)

46) The corpus luteum prevents loss of the implanted embryo through menstruation by secreting ________. A) follicle-stimulating hormone B) human chorionic gonadotropin C) estrogens and progesterone D) luteinizing hormone

46)

47) The placenta, a vitally important metabolic organ, is made up of a contribution from mother and fetus. Which portion is from the fetus? A) yolk sac B) chorion C) amnion D) umbilicus

47)

48) Relaxin is a hormone produced by the placenta and ovaries. The function of this hormone is to ________. A) ensure the implantation of the blastula B) prevent morning sickness C) relax the pubic symphysis D) block the pain of childbirth

48)

49) Which embryonic structure produces human chorionic gonadotropin (hCG)? A) the cytotrophoblast B) the epiblast C) the hypoblast D) the syncytiotrophoblast

49)

50) The neonatal period refers to ________. A) the last trimester of pregnancy C) the first trimester of pregnancy

50) B) the first year after birth D) the first month after birth

51) The most common assisted reproductive technology process used by couples having difficulty conceiving is _______. A) in vitro fertilization B) cloning of parent stem cells C) artificial insemination D) hormone therapy

51)

52) Which hormone maintains the viability of the corpus luteum? A) estrogen B) human placental lactogen C) human chorionic gonadotropin D) progesterone

52)

53) Which of the following events does NOT occur during the first 8 weeks of development? A) presence of all body systems B) beginning of ossification C) formation of a functional cardiovascular system D) myelination of the spinal cord

53)

54) Which of the following is NOT a correct matching of a fetal structure with what it becomes at birth? A) ductus arteriosus–ligamentum teres B) foramen ovale–fossa ovalis C) ductus venosus–ligamentum venosum D) umbilical arteries–medial umbilical ligaments

54)

55) Which body system of a pregnant woman undergoes the most dramatic physiological changes during pregnancy? A) cardiovascular system B) urinary system C) respiratory system D) digestive system

55)

56) Thalidomide was once used to treat intense nausea and morning sickness in pregnant women. Unfortunately, if administered at certain points during gestation it resulted in limb malformation. This drug is an example of a(n) ________. A) neurotoxin B) teratogen C) carcinogen D) endocrine disruptor

56)

57) The correct sequence of preembryonic structures is ________. B) zygote, morula, blastocyst A) blastocyst, morula, zygote C) morula, zygote, blastocyst D) zygote, blastocyst, morula

57)

58) Which of the following is NOT assessed as part of the Apgar score? A) muscle tone B) heart rate C) respiration

58) D) temperature

59) Prior to the let-down reflex, the mammary glands secrete a yellowish fluid called ________ that has less lactose than milk and almost no fat. D) meconium A) prolactin B) colostrum C) bilirubin

59)

60) How long is the secondary oocyte viable and capable of being fertilized after it is ovulated? A) 12-24 hours B) 36-72 hours C) 24-36 hours D) a full week

60)

61) Select the correct statement about fertilization. A) Once inside the uterus, most sperm cells are protected and remain viable. B) If estrogen is present, the pathway through the cervical opening is blocked from sperm entry. C) Millions of sperm cells are destroyed by the vagina's acidic environment. D) Both spermatozoa and the ovulated secondary oocyte remain viable for about 72 hours in the female reproductive tract.

61)

62) Shortly after implantation, ________. A) the embryo gastrulates (within 3 days) B) maternal blood sinuses bathe the inner cell mass C) the trophoblast forms two distinct layers D) myometrial cells cover and seal off the blastocyst

62)

63) Gastrulation begins when a groove with raised edges called the ________ appears on the dorsal surface of the embryonic disc. A) primitive streak B) placenta C) spinal cord D) notochord

63)

64) Muscle tissue is formed by the ________. A) endoderm B) epiderm

64) C) mesoderm

D) ectoderm

65) Neural tissue is formed by the ________. A) epiderm B) mesoderm

C) ectoderm

D) endoderm

65)

66) The trophoblast is mostly responsible for forming the ________. A) lining of the endometrium B) placental tissue C) archenteron D) allantois

66)

67) The cardiovascular system of a newborn must be adjusted after the infant takes its first breath. Which of the following is also true? A) The ductus venosus is disconnected at the severing of the umbilical cord and all visceral blood goes into the vena cava. B) The urinary system is activated at birth. C) The foramen ovale between the atria of the fetal heart closes at the moment of birth. D) The ductus arteriosus constricts and is converted to the ligamentum arteriosum.

67)

68) Sperm move to the uterine tube through uterine contractions and the energy of their own flagella. What other factor is involved in sperm movement? A) reverse peristalsis of the uterus and uterine tubes B) the increased temperature in the vagina, which stimulates sperm motility C) the cilia on the apex of the cells lining the endometrium D) hormonal attraction to the ova

68)

69) At which stage of labor is the "afterbirth" expelled? A) placental B) dystocia

69) C) full dilation

D) expulsion

70) Which hormone is NOT produced by the placenta? A) human placental lactogen C) relaxin

70) B) oxytocin D) human chorionic gonadotropin

71) During which stage of labor is the fetus delivered? A) placental stage B) expulsion stage

C) gastrula stage

71) D) dilation stage

72) Implantation of the blastocyst is the result of all of the following EXCEPT ________. A) adherence of the trophoblast cells to the endometrium B) digestive enzymes and growth factors produced by the trophoblast cells C) phagocytosis by the trophoblast cells D) settling of the blastocyst onto the prepared uterine lining

72)

73) The presence of endoderm, ectoderm, and mesoderm is first seen in the ________ stage. A) gastrula B) morula C) blastocyst D) fetal

73)

74) Which of the following is true in reference to what may pass through the placental barriers? A) nutrients and respiratory gases only B) hormones, blood cells, and nutrients C) respiratory gases, hormones, nutrients, and blood cells D) nutrients, respiratory gases, wastes, and alcohol

74)

75) Drinking alcohol during pregnancy is ________. A) not significantly harmful, since alcohol does not cross the placenta B) associated with microencephaly and intellectual disorders of the fetus C) beneficial to the fetus, as it stimulates cardiovascular development D) only harmful to the fetus if the mother drinks hard liquor

75)

76) Derivatives of the mesoderm include ________. A) epithelium of the digestive tract B) glandular derivatives of the digestive tract C) all nervous tissue D) vertebrae and ribs

76)

77)

77) Derivatives of the endoderm include ________. A) heart and blood vessels C) kidneys and gonads

B) brain and spinal cord D) epithelial lining of the respiratory tract

78) Which of the choices below occurs if implantation is successful? A) The corpus luteum is maintained until the placenta takes over its hormone-producing functions. B) Increased levels of FSH will be produced. C) The ovarian cycle begins. D) The corpus luteum degenerates and becomes the corpus albicans.

78)

79) Select the correct statement about the special fetal blood vessels. A) The fossa ovalis becomes the foramen ovale. B) The distal parts of the umbilical arteries form the superior vesical arteries. C) The umbilical vein becomes the ligamentum teres. D) The hepatic portal vein forms from the umbilical artery.

79)

80) The decidua basalis is ________. A) not a maternal contribution to the placenta B) the tissue that surrounds the uterine cavity face of the implanted embryo C) the part of the endometrium that lies beneath the embryo D) destined to remain in the uterus after the birth of the infant

80)

81) At what point is meiosis II completed for the female gamete? A) ovulation B) puberty C) implantation

81) D) fertilization

82) A urine test reveals a positive result for human chorionic gonadotropin (hCG). This indicates ________ was successful. A) gastrulation B) fertilization C) ovulation D) implantation

82)

83) The first major event in organogenesis is ________. A) myelination B) ossification

83) C) gastrulation

D) neurulation

84) As pregnancy continues, the increasing bulkiness of the anterior abdomen changes the woman's center of gravity, possibly causing an accentuated lumbar curvature called ________. A) kyphosis B) hunchback C) lordosis D) scoliosis

84)

85) Which of the following would be the best method for delaying the onset of labor? A) giving the mother antiprostaglandin drugs B) giving the mother prostaglandins C) giving the mother anti progesterone drugs D) giving the mother oxytocin

85)

86) Which of the following refers to the transfer of sperm and harvested oocytes together into the woman's uterine tubes in the hopes that fertilization will take place there? A) in vitro fertilization (IVF) B) gamete intrafallopian transfer (GIFT) C) rhythm method D) zygote intrafallopian transfer (ZIFT)

86)

87) In the block to polyspermy, entry of the sperm's contents causes ________ levels in the oocyte's cytoplasm to rise, triggering the cortical reaction. A) sodium ion B) calcium ion C) ATP D) phosphate ion

87)

88) Which method of contraception is most reliable? A) vasectomy C) rhythm method

88) B) cervical cap D) morning-after pills

89) Cells of the ________ gather around the notochord and neural tube and produce the vertebra and rib at their associated level. A) dermatome B) intermediate mesoderm C) myotome D) sclerotome

89)

90) A friend confides that she desires to have children but is having trouble conceiving. Which of the following is true regarding implantation? A) In cases where implantation fails to occur, a nonreceptive uterus becomes receptive once again. B) An estimated 60% of implanted embryos later miscarry due to genetic defects of the embryo. C) It is estimated that a minimum of two-thirds of all zygotes formed fail to implant by the end of the first week or spontaneously abort. D) Detection of human chorionic gonadotropin (hCG) in blood or urine indicates failure of the blastocyst to implant.

90)

91) Human chorionic gonadotropin (hCG) is at its highest levels ________. A) just before birth B) about 2 months after implantation during the 8 th gestational week

91)

C) after copulation but before implantation D) at about the midpoint of pregnancy SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 92) Explain what triggers a baby's first breath.

92)

93) At what time in the pregnancy is the placenta fully prepared to fulfill the needs of the developing fetus?

93)

94) Briefly describe the events leading to the implantation of the blastocyst in the uterus, including how it is nourished.

94)

95) How are the metabolic needs of the implanted embryo provided for?

95)

96) Describe the events of the oocyte from sperm penetration to first cleavage.

96)

97) Define Braxton Hicks contractions.

97)

98) List four factors that help to precipitate parturition (birth).

98)

99) Briefly describe the physiological changes occurring in the mother during pregnancy.

99)

100) Describe the events allowing monospermy.

100)

101) When do we begin to call the developing individual a fetus rather than an embryo? Why?

101)

102) A couple interested in conceiving has been carefully charting her menstrual cycles for many months. Relative to ovulation, what window of time does coitus need to occur in order to achieve fertilization?

102)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 103) A 30-year-old woman is admitted to the emergency room. Her husband, who rode in the ambulance with her, said that she had suddenly complained of severe pain in the right iliac region of her abdomen and then had collapsed. Upon examination, she was shown to have signs of internal hemorrhage and her abdominal muscles were rigid. Her menstrual history revealed that she had missed her last menstrual period. A diagnosis of ruptured tubal, or ectopic, pregnancy was made and surgery scheduled. What is an ectopic pregnancy, and why is it problematic? 104) Mrs. Phang, eight months pregnant with her first child, makes an appointment with her obstetrician to investigate the cause of vaginal bleeding. Because it is actually more "spotting" than frank bleeding, and painless, she is becoming worried. Ultrasound visualization of her abdomen shows that the placenta is formed across the internal os of the cervix, and she is ordered to her bed for the remainder of the pregnancy. What name is given to Mrs. Phang's condition? Why is it an extremely serious condition? Why was she ordered to have complete bed rest for the remainder of her pregnancy? 105) A mother who has been nursing her infant for over seven months is beginning to have problems throughout the day with nausea. Is there a connection? 106) A 28-year-old woman has been in the first stage of labor for several hours. Her uterine contractions are weak, and her labor is not progressing normally. Because the woman insists upon a vaginal delivery, the physician orders that pitocin (a synthetic oxytocin) be infused. What will be the effect of pitocin? What is the normal mechanism by which oxytocin acts to promote birth? 107) A 19-year-old, single, sexually active college student, who has not used birth control on a regular basis, is in her first trimester of pregnancy. She is at the OB/GYN clinic for her first prenatal visit. In assessing her nutrition, the doctor discovers that the patient drinks heavily on a regular basis. She also states she does not like milk. What information will the doctor give the patient regarding nutrition? 108) The lactation nurse visits a first-time mother six hours after her delivery of a healthy 8 -pound boy. The patient is giving the baby boy a bottle of sugar water. She tells the lactation nurse that she does not seem to be producing milk. What should the nurse say to the patient? 109) The patient is in her first trimester of pregnancy. She complains of feeling nauseated and has vomited on occasion. She tells the nurse that she did not have this with her first pregnancy. She asks the nurse, "What is causing this and when will it end?" How should the nurse respond?

Answer Key Testname: UNTITLED28

1) D 2) A 3) B 4) C 5) E 6) C 7) B 8) D 9) A 10) E 11) A 12) B 13) A 14) B 15) C 16) C 17) D 18) E 19) A 20) B 21) FALSE 22) TRUE 23) FALSE 24) TRUE 25) FALSE 26) TRUE 27) FALSE 28) TRUE 29) TRUE 30) TRUE 31) TRUE 32) TRUE 33) TRUE 34) TRUE 35) TRUE 36) FALSE 37) FALSE 38) FALSE 39) TRUE 40) FALSE 41) FALSE 42) C 43) D 44) B 45) C 46) C 47) B 48) C 49) D 50) D 11

Answer Key Testname: UNTITLED28

51) A 52) C 53) D 54) A 55) A 56) B 57) B 58) D 59) B 60) A 61) C 62) C 63) A 64) C 65) C 66) B 67) D 68) A 69) A 70) B 71) B 72) C 73) A 74) D 75) B 76) D 77) D 78) A 79) C 80) C 81) D 82) D 83) D 84) C 85) A 86) B 87) B 88) A 89) D 90) C 91) B 92) A buildup of carbon dioxide in the baby's blood once the carbon dioxide is not being removed by the placenta causes central acidosis. This excites respiratory control centers in the baby's brain and triggers the first inspiration. 93) The placenta is fully formed and functional as a nutritive, respiratory, excretory, and endocrine organ by the end of the third month of pregnancy. 94) The blastocyst floats freely in the uterine cavity for two to three days, during which time it is nourished by uterine secretions. Six to seven days after ovulation, implantation begins. The trophoblast determines the readiness of the endometrium for implantation. If the mucosa is prepared for implantation, the blastocyst becomes embedded high in the uterus. 12

Answer Key Testname: UNTITLED28

95) Initially, the implanted embryo obtains nutrition by digesting the endometrial cells, but by the second month, the placenta is providing all the nourishment and oxygen the embryo requires. The placenta is also responsible for disposing of embryonic metabolic wastes. 96) After sperm penetration, the secondary oocyte completes meiosis II and releases the second polar body. The two nuclei swell into pronuclei and join each other to form a zygote. The cell then undergoes its first mitosis and cell division to form two daughter cells. 97) Braxton Hicks contractions are the weak, irregular uterine contractions resulting from the increase in estrogen production. Estrogen causes oxytocin receptors to form on the myometrial cells of the uterus and antagonizes progesterone's quieting influence on the uterine muscle. As a result, the myometrium becomes increasingly irritable, resulting in weak, irregular contractions. 98) Four factors that help to precipitate parturition include: (1) estrogens peak to their highest levels in the mother's blood, causing irregular uterine contractions due to oxytocin and negation of progesterone's influence on the uterine muscle; (2) prostaglandins are stimulated by the increase in oxytocin to act as uterine muscle stimulants; (3) increasing emotional and physical stressors activate the mother's hypothalamus, which signals oxytocin release; and (4) certain cells of the fetus begin to produce oxytocin, which in turn acts on the placenta, stimulating production and release of prostaglandins. 99) Many women suffer nausea until their systems become adjusted to elevated levels of hCG, estrogens and progesterone. Heartburn is common due to displacement of the esophagus and crowding of the stomach by the growing fetus in the uterus. Additional wastes from fetal metabolism cause the production of more urine. Due to pressure on the bladder by the uterus, urination is more frequent. Tidal volume increases during pregnancy, as does respiratory rate. Residual volume decreases and many women exhibit dyspnea (difficult breathing). Total body water rises, acting as a safeguard against blood loss during birth. Blood volume increases, blood pressure and pulse rise, and cardiac output increases. 100) A sperm entering the secondary oocyte causes ionic calcium to be released into the oocyte cytoplasm, activating the oocyte and preparing it for the second meiotic division. This also causes the cortical granules to spill their contents into the extracellular space beneath the zona pellucida. Enzymes from the cortical granules destroy sperm receptors, preventing further sperm entry. This spilled material binds with water, and as it swells, detaches all sperm still in contact with the oocyte membrane. 101) We begin to call the developing individual a fetus at the beginning of the ninth week. It is at this point that all body systems are present as a result of organogenesis, at least in a rudimentary form. 102) The oocyte is viable for 12 to 24 hours after it is cast out of the ovary. Most sperm retain their fertilizing power for 24 to 48 hours after ejaculation. Consequently, for successful fertilization to occur, coitus must occur no more than two days before ovulation and no later than 24 hours after. 103) An ectopic pregnancy occurs when the embryo implants in any site other than the uterus. In a tubal pregnancy the embryo implants in the uterine tube. When the swelling uterine tube is unable to accommodate growth, it ruptures. It is highly vascular leading to severe bleeding upon rupturing. 104) Mrs. Phang's condition is called placenta previa. It is an extremely serious condition because as the uterus and cervix stretch, tearing of the placenta may occur. The placenta is covering over the cervix preventing any possibility to deliver vaginally. Furthermore, if the placenta is located inferior to the fetus and separates, the placenta will be expelled before the fetus, who isn't yet in a location to breathe. Given the length of time needed for fetal expulsion, the fetus will suffocate and die. She was ordered to have complete bed rest to keep physical activity at a minimum so that the placenta would not tear away. Vaginal delivery is not an option and the doctor will have to perform a cesarean section before going into labor. 105) The mother was not taking birth control pills because she assumed that she could not get pregnant while nursing. Under normal conditions that would be true, but after a few months some women do begin to ovulate again. This mother is probably pregnant again. 106) Pitocin will act on the placenta, stimulating production and release of prostaglandins. The pitocin and prostaglandins are powerful uterine muscle stimulants. Oxytocin normally causes frequent and vigorous contractions of the uterine wall. In a positive feedback loop, greater distension of the cervix causes the release of more oxytocin from the mother's hypothalamus, which causes greater contractile force, and so on. 13

Answer Key Testname: UNTITLED28

107) Because many potentially harmful substances can cross placental barriers and enter the fetal blood, the doctor instructs the patient to not drink alcohol. The nurse should warn the patient that alcohol can cause serious permanent damage to the fetus. The doctor prescribes the patient to take prenatal multivitamins containing folic acid to reduce the risk of birth defects. If the patient's caloric intake is marginal, she should increase her daily calorie intake by 300 calories to sustain proper fetal growth. 108) The nurse should explain that she won't produce true milk until two to three days later. During this delay, colostrum is produced that contains protein, vitamin A, and minerals and is rich in antibodies that are necessary for the baby. The nurse should explain that continual milk production depends on mechanical stimulation of the nipples, normally provided by the sucking infant. Before attempting to nurse, the mother should massage her breasts and "roll" the nipples to start the stimulatory effects herself. Furthermore, until the baby is able to nurse sufficiently, supplementation should be given only after the baby has nursed for 5-10 minutes on a side, not before. Babies prefer the ease of sucking through bottle nipples more than breast nipples if they are allowed. 109) The nurse should explain that nausea is a common occurrence during the first trimester of pregnancy, believed to be related to elevated levels of hCG, progesterone and estrogens, and that the nausea should end once her body adjusts to the increased hormone levels. Over 50% of pregnancies are accompanied by nausea and vomiting, at least to a slight degree. But she should report any weight loss, since if she loses >5% of her body weight, the condition of hyperemesis gravidarum should be considered, which can lead to electrolyte imbalances, miscarriage, and even death.

Exam Name___________________________________

MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 1) Actual genetic makeup.

A) Recessive

2) A chromosome pair that may be very different in size.

B) Homozygous

1) 2)

C) Sex chromosomes 3) Genes not expressed unless they are present in homozygous condition.

3) D) Genotype

4) Situation in which an individual requires identical alleles for that particular trait to be expressed.

Match the following: 5) Lack of skin pigmentation.

A) Huntington's disease

6) Rare type of dwarfism resulting from an impaired ability of the fetus to lengthen long bones by endochondral ossification.

B) Tay-Sachs disease

7) An unremitting, fatal nervous system disease involving degeneration of the basal nuclei.

5) 6)

C) Albinism D) Cystic fibrosis 7) E) Achondroplasia

8) A condition of drier excessively sticky mucus production.

9) A disorder of brain lipid metabolism.

Match the following: 10) Genes for the same trait that have different expressions.

A) Allele

10)

11) The gene allele that suppresses or masks the expression of the other allele.

A) Heterozygous

12) Situation in which an individual has different alleles making up the genotype for a particular trait.

C) Autosomes

11)

B) Dominant

13) Chromosomes regulating most body characteristics.

12)

13)

Match the following: 14) The dominant gene is expressed when present; the recessive gene is expressed only in the absence of the dominant gene. 15) The heterozygote has a phenotype intermediate between those of the homozygous dominant and homozygous recessive.

A) Incomplete dominance

14)

B) Multiple-allele inheritance C) Polygenic inheritance 15) D) Sex-linked inheritance E) Dominant-recessive

16) Inheritance of the ABO blood group type is an example of this type of inheritance.

16)

17) Inheritance that results in continuous or qualitative phenotypic variations between two extremes; an example is skin color.

17)

18) Inherited traits determined by genes on the X or Y chromosomes.

18)

Match the following: 19) Distribution of chromosomes to different gametes.

A) Chromosome segregation

19)

B) Gene recombination 20) Results in chromosomes that have mixed contributions from each parent. 21) A particular gene's allele received by a gamete has no influence over selection of a different gene's allele.

20) C) Chromosome crossover D) Independent assortment

22) Means by which genes trade places, some maternal and some paternal, on each chromosome.

21)

22)

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 23) When genes are on the X or Y chromosomes, they are considered X -linked.

23)

24) Height in humans is determined by polygene inheritance.

24)

25) The expression of all physical traits is strictly due to the inheritance of specific genes.

25)

26) Y chromosomes contain far more genes than X chromosomes.

26)

27) The same allele can have a different effect depending on which parent it comes from.

27)

28) Hereditary characteristics are transmitted to offspring by genes.

28)

29) Alleles may code for alternative expressions of a genetic trait.

29)

30) Hemophilia is an X-linked condition caused by a recessive gene.

30)

31) Environmentally produced phenotypes that mimic conditions that may be caused by genetic mutation are called phenocopies.

31)

32) A diagram of human relatives with specific genetic traits is called a pedigree.

32)

33) A Punnett square is a diagram that may be used to figure out the possible combinations of genes for a trait.

33)

34) The term lethal dominant gene indicates that the gene causes death only when the individual is homozygous dominant.

34)

35) In incomplete dominance, the heterozygote has an intermediate phenotype between that of homozygous dominant and homozygous recessive individuals.

35)

36) Down syndrome is an example of nondisjunction of chromosomes.

36)

37) Genomic imprinting refers to the methylation of an allele during gamete formation that causes one parent's allele to be expressed and the other parent's allele to be ignored.

37)

38) Genetic segregation implies that the members of the allele pair determining each trait are distributed to different gametes during mitosis.

38)

39) Genetic variation results from the crossing over and exchange of chromosomal parts that occur during meiosis II.

39)

40) Small RNAs control the timing of programmed cell death during development.

40)

41) Mitochondrial genes are free of errors. As a result, all genetic problems are due exclusively to nuclear genes.

41)

42) It is possible for a baby to have type O blood if neither parent is type O.

42)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 43) How many alleles exist for a given gene? A) Only two alleles can exist per gene. B) Only one allele can exist per gene. C) Each gene can have a different number of alleles. D) Four alleles exist per gene, two from each parent.

43)

44) Select the statement that best describes the difference between a gene and an allele. A) Genes follow Mendelian patterns of inheritance while alleles follow non-Mendelian patterns of inheritance. B) Genes express a specific trait while alleles are variations of a particular gene that result in the variation we see in that trait. C) Alleles are found on chromosomes while genes are independent. D) Genes code for a single protein or a single trait while an allele can code for many traits or many proteins.

44)

45) If a person is homozygous for a particular trait this means ________. A) the person cannot pass on that trait B) the person has two dominant alleles for the gene responsible for the trait C) the person has two identical alleles for the gene responsible for the trait D) the person will not have a recessive condition

45)

46) A dominant allele is best defined as ________. A) an allele that stops or hides the expression of another allele B) the stronger of two matched alleles C) the healthy allele sometimes referred to as the wild type allele D) the allele that is most frequently expressed in a given population

46)

47) Recessive alleles are best defined as ________. A) an allele only expressed when the allele is homozygous B) the least frequently expressed allele in a given population C) a weakened or attenuated allele D) a deleterious or disease-causing allele

47)

48) Of the different sources of genetic variability, which one causes the variation in the combinations of homologs from paternal and maternal linage found within a haploid cell? A) crossing over B) random fertilization C) mutation D) independent assortment

48)

49) Of the different sources of genetic variability, which one produces the variation in the combinations of alleles on a single chromosome? A) independent assortment B) mutation C) random fertilization D) crossing over

49)

50) Of the different sources of genetic variability, which one produces the variation seen by the combination of any particular male gamete with any particular female gamete? A) independent assortment B) crossing over C) mutation D) random fertilization

50)

51) Of the different sources of genetic variability, which one could be defined as permanent, transmissible changes to the DNA coding sequence often caused by outside environmental factors? A) mutation B) crossing over C) random fertilization D) independent assortment

51)

52) The cleft chin trait follows a dominant-recessive inheritance pattern with cleft chin being the dominant trait. John is heterozygous for a cleft chin as is his wife Betty. John and Betty have two kids, both with cleft chins. According to Punnett square prediction what is the likely hood that their next child will have a cleft chin? A) 25% chance, the same probability for all of their children B) 0% because the two previous children have cleft chins already C) 100% chance because the mother and father both have cleft chins D) 75% chance, the same probability for all of their children

52)

53) Steven has the dominant tongue rolling phenotype but he does not know his genotype. His wife has the recessive non-tongue rolling trait. If their son cannot roll his tongue this means ________. A) Steven has a homozygous recessive genotype B) Steven has a heterozygous genotype C) Steven has a homozygous dominant genotype D) that it is impossible to tell Steven's genotype from this information alone

53)

54) Steven has the dominant tongue rolling phenotype but he does not know his genotype. His wife has the recessive non-tongue rolling trait. If their son can roll his tongue this means ________. A) Steven has a homozygous recessive genotype B) Steven has a heterozygous genotype C) Steven has a homozygous dominant genotype D) that it is impossible to tell Steven's genotype from this information alone

54)

55) Two alleles expressing exactly the same information for a trait are described as ________. A) monogamous B) heterozygous C) hemizygous D) homozygous

55)

56) Dominant alleles are so called because under most circumstances they ________. A) code for desired traits only B) code for the most common phenotypic and genotypic expressions of a trait C) code for genes that are never considered harmful or lethal D) can suppress the expression of other alleles

56)

57) Recessive genes are usually expressed in humans only when ________. A) they are coding for skin color B) the organism is in the embryonic stage C) they are coding for genetic diseases D) both alleles for the gene are exactly the same, or homozygous

57)

58) The expressed form of a gene is described as the organism's ________. A) karyotype B) genotype C) phenotype

58) D) genome

59) If a digital image is made of chromosomes in a cell going through mitosis, and the chromosomes are sorted and paired, the resulting display is a ________. A) genome B) karyotype C) genotype D) phenotype

59)

60) A female infant is born with several hundred oocytes, each one genetically unique. This is due to ________. A) chromosome deletion B) independent assortment and crossing over C) mutation D) random fertilization

60)

61) Which event can directly produce one chromosome containing both maternal and paternal genes? A) crossing-over only B) crossing-over and independent assortment C) independent assortment only D) one chromosome can never have genes from both parents

61)

62) The reason recessive genetic disorders are more frequent than dominant genetic disorders is that ________. A) dominant genetic disorders are never expressed in males B) people carrying dominant genetic disorders always die before birth C) recessive genetic disorders are limited to persons of the same ethnicity D) carriers are not eliminated by the disease before passing the defective alleles on to their offspring

62)

63) The gene responsible for the condition known as sickle-cell anemia demonstrates ________. A) a sex-linked genetic disorder B) a dominant genetic disorder C) a recessive genetic disorder D) incomplete dominance

63)

64) The variation seen in ABO blood groups is due to ________. A) multiple-allele inheritance B) incomplete dominance C) polygene inheritance D) sex-linked inheritance

64)

65) Which of the following best describes genotypes and phenotypes? A) A person's genotypes often change during their lifetime, but their phenotypes typically do not. B) A trait that is expressed such as eye color is the phenotype and the gene responsible for eye color is the genotype. C) A person's genotypes and phenotypes often both change during their lifetime. D) A person's genotypes and phenotypes are typically unchanging during their lifetime.

65)

66) The genotype of a normal man is ________. A) Y B) XY

66) C) XX

D) YY

67) Which is NOT one of the ways in which small, non-coding RNA-enzyme complexes influence gene expression? A) destroying the peptide generated by the translation of the target mRNA B) blocking the transcription of the gene that codes for the target mRNA C) destroying the target mRNA D) inhibiting translation of the target mRNA into a peptide

67)

68) Mitochondrial DNA (mDNA) is inherited ________. A) only from the father C) only from the mother

68)

B) from neither the father or the mother D) from both the father and the mother

69) Errors in mitochondrial DNA are likely to cause genetic disorders associated with ________. A) nondisjunction B) glycolysis C) oxidative phosphorylation D) gametogenesis

69)

70) An individual who is heterozygous for a particular trait, yet expresses both alleles of that trait, is demonstrating an example of ________. A) recessive inheritance B) sex-linked inheritance C) incomplete dominance D) dominance

70)

71) CRISPR-Cas9 refers to a(n) ________. A) technique used to change and edit sequences of DNA B) enzyme responsible for self-destructing mutated cells C) technique for creating a karyotype of one's chromosomes D) locus on a chromosome where the trait for sickle-cell anemia is carried

71)

72) The epigenetic mark that indicates that a gene is available for transcription is ________ bound to the DNA or histone proteins. A) a small RNA-enzyme complex B) a methyl group C) an acetyl group D) an amine group

72)

73) The epigenetic mark that silences the expression of a gene is ________ bound to the DNA or histone proteins. A) a methyl group B) a carboxyl group C) an acetyl group D) an amine group

73)

74) Albinism is a recessive trait. If one parent is heterozygous for albinism, and the other parent does not carry the allele, what is the probability that they will have a child with albinism? A) 0% B) 25% C) 100% D) 50%

74)

75) ________ is the most common type of fetal testing. A) CVS C) A DNA probe

75) B) Blood chemistry D) Amniocentesis

76) Jeff made a detailed pedigree of his extended family over several generations. He noted all of the family members who expressed a specific genetic trait. He noted that this trait was not observed in every generation, and that it was expressed far more frequently in the males of the family. Based on this information alone, what terms would best describe this trait? A) autosomal dominant B) sex-linked dominant C) autosomal recessive D) sex-linked recessive

76)

77) Which of the following statements is true concerning genetic screening? A) Screening can be done only in the first trimester of pregnancy. B) Screening can be done before conception by carrier recognition or during fetal testing. C) Genetic screening is rarely done because it yields very little accurate information. D) Screening is illegal in over half of the world.

77)

78) Amy's hand was exposed to X-rays. A gene in a skin cell of her hand mutated. This mutant gene will ________. A) not form an exact duplicate of itself when the cell divides B) replicate itself when the cell divides but will not be passed on to Amy's offspring C) very likely cause skin cancer D) replicate itself and be passed on to Amy's children

78)

79) The main way a recessive allele would be fully expressed even when only one copy is present would be ________. A) recessive inheritance B) co-dominance C) incomplete dominance D) sex-linked inheritance

79)

80) A couple whose blood types are AB (I AIB) and B (IBi) may have a child with which of the following blood types? A) A or B only B) AB only C) A, B, AB, or O D) A, B, or AB only

80)

81) Gene mutations in the X chromosome would tend to become visibly expressed ________. A) more frequently in males B) equally frequently in both sexes C) more frequently in females D) in neither males nor females

81)

82) For which of the following are newborn infants NOT routinely screened at birth? A) imperforate anus B) color blindness C) congenital hip dysplasia D) PKU

82)

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 83) The X and Y chromosomes are considered the ________ chromosomes.

83)

84) An allele that completely masks the expression of the other alleles is called ________.

84)

85) Observable characteristics expressed by the genes for a trait are called the ________.

85)

86) Albinism is a good example of a(n) ________ trait.

86)

87) Color blindness is a(n) ________ trait.

87)

88) Removing a sample of the fluid surrounding the fetus for the purpose of studying the chromosomes is a procedure called ________.

88)

89) The 23rd pair of human chromosomes are called ________ chromosomes.

89)

90) The ABO blood type is a good example of a(n) ________ inheritance.

90)

91) Define phenocopy.

91)

92) Define karyotype.

92)

93) How might carriers of deleterious genes be recognized?

93)

94) ________ disease is a disorder of brain lipid metabolism and is an example of a recessive trait.

94)

Figure 29.1 Use Figure 29.1 to answer the following: 95) Is the trait sex-linked?

95)

96) Is the trait dominant or recessive?

96)

97) Identify, by numbers, any known carriers.

97)

98) Identify, by numbers, any other possible carriers.

98)

99) Are there any afflicted females?

99)

100) Are there any male carriers?

100)

101) When might amniocentesis be appropriate?

101)

102) Describe briefly the three mechanisms that lead to genetic variability.

102)

103) What is (are) the phenotype(s) of the first-generation offspring?

103)

104) What is (are) the genotype(s) of the first-generation offspring?

104)

105) A cross of two second-generation, straight-shorthaired individuals would yield what phenotype?

105)

106) What would the parental gametes be from a cross of two second -generation, straight-shorthaired individuals?

106)

107) What would be the gametes of the first-generation individuals?

107)

108) The second-generation types would have what phenotypes?

108)

109) The second-generation phenotypes would follow what ratio? (Pair the number with a phenotype in each case.)

109)

110) What possible genotype(s) could the second-generation, fuzzy-longhaired individuals possess?

110)

111) What were the genotypes of the parental (P1) individuals?

111)

112) Two tall red pea plants, when crossed, produced some offspring that were white and dwarf. Assuming that tallness and redness are dominant, what are the genotypes of the parents?

112)

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 113) In humans, farsightedness is inherited by possession of a dominant gene. If a man who is homozygous for normal vision (aa) marries a woman who is heterozygous for farsightedness, what proportion of their children would be expected to be farsighted? 114) Parents are informed after an amniocentesis that the results show a baby who has an extra number 21 chromosome. Should there be concern and what might the problem be? 115) Jane and Allen have just discovered that their son is a hemophiliac. Neither of them has hemophilia, and Allen claims that no such condition was ever expressed in his family. Jane was told that her father was a hemophiliac and that problems resulting from this condition caused his death. Allen has also been told that hemophilia can only be passed on to an offspring by parents and not by grandparents; he believes that Jane was unfaithful and that the child is not his. If you were a genetic counselor, what would you tell Allen? 116) The folk singer, Woody Guthrie, died of Huntington's chorea. One of his parents also died of this disease affecting the nervous system. The disease usually affects carriers between 25 and 45 years of age and is inherited as a Mendelian autosomal dominant trait. Using Punnett squares, determine the probability that any of the three Guthrie offspring will have this devastating disease. 117) A 40-year-old pregnant woman is concerned about possible genetic defects in her unborn fetus. Her physician recommends prenatal testing and advises her of two methods. Compare and contrast amniocentesis with chorionic villus sampling relative to the time each can be performed, and the relative advantages and disadvantages of each. 118) A family has four offspring belonging respectively to ABO blood groups A, B, O, and AB. Give the genotypes and phenotypes of the parents. 10

119) Assume that the allele controlling brown eyes (B) is dominant over that controlling blue eyes (b) in human beings. (In actuality, eye color in humans is an example of polygene inheritance, which is much more complex than this.) A blue-eyed man marries a brown-eyed woman, and they have six children, all brown-eyed. What is the most likely genotype of the father? What is the most likely genotype of the mother? If a seventh child had blue eyes, what can you conclude about the parents' genotypes? 120) Colorblindness is a recessive sex-linked trait. Suppose a colorblind female marries a man with normal vision. (a) What is their probability of producing a color-blind son? (b) What is their probability of producing a color-blind daughter? (c) What is their probability of producing a daughter who is a carrier for the color-blind gene? 121) Assume that brown eyes (B) are dominant over blue (b); and right-handedness (R) is dominant over left-handedness (r). A brown-eyed, right-handed man marries a blue-eyed, right-handed woman. Their first child is brown-eyed and right-handed, and their second child is blue-eyed and left-handed. What are the genotypes of the parents? 122) This is a first pregnancy for a 22-year-old woman. She is in her 16th week of pregnancy. She is scheduled for an amniocentesis and expresses concern that the "baby will be stuck with the needle." What should the doctor say to the woman? 123) A patient is heterozygous for sickle-cell anemia. Explain why the patient would have few or no symptoms of sickle-cell anemia. 124) A nurse is providing genetic counseling to a couple who both have the sickle-cell anemia trait, but not the disease. The couple is trying to decide whether or not to have a child. What is the possibility that a child would inherit the disease? What is one reason they might consider not having a child?

Answer Key Testname: UNTITLED29

1) D 2) C 3) A 4) B 5) C 6) E 7) A 8) D 9) B 10) A 11) B 12) A 13) C 14) E 15) A 16) B 17) C 18) D 19) A 20) B 21) D 22) C 23) FALSE 24) TRUE 25) FALSE 26) FALSE 27) TRUE 28) TRUE 29) TRUE 30) TRUE 31) TRUE 32) TRUE 33) TRUE 34) FALSE 35) TRUE 36) TRUE 37) TRUE 38) FALSE 39) FALSE 40) TRUE 41) FALSE 42) TRUE 43) C 44) B 45) C 46) A 47) A 48) D 49) D 50) D 12

Answer Key Testname: UNTITLED29

51) A 52) D 53) B 54) D 55) D 56) D 57) D 58) C 59) B 60) B 61) A 62) D 63) D 64) A 65) B 66) B 67) A 68) C 69) C 70) C 71) A 72) C 73) A 74) A 75) D 76) D 77) B 78) B 79) D 80) D 81) A 82) B 83) sex 84) dominant 85) phenotype 86) recessive 87) sex-linked 88) amniocentesis 89) sex 90) multiple-allele 91) Environmentally produced phenotypes that mimic conditions that may be caused by genetic mutations. 92) Karyotype is the chromosomal content of a cell. 93) Carriers of deleterious genes may be recognized if their offspring show symptoms of the condition or disease caused by the deleterious gene. Because the genes are usually recessive, they would show phenotypically only if the offspring received the recessive genes from both parents. A pedigree analysis may be done to trace a particular trait back through several generations. Blood chemistry tests (and DNA probing) may also be done if particular genetic traits are suspected. 94) Tay-Sachs 95) Yes. 96) Recessive. 13

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97) 2, 5, 7, and 18. 98) 14, 16, 23, and 25. 99) No. 100) No. 101) Amniocentesis might be performed any time a history of any genetic disability is discovered in a family, especially if there are several occurrences in a family. This will give the parents an early warning of any possible problem with the fetus. Other "high-risk pregnancies" (such as in women over 35) may also suggest use of amniocentesis. Parents are required to be informed of the possible risks in performing an amniocentesis. 102) The three mechanisms that lead to genetic variability include independent assortment of chromosomes, crossover of homologues, and random fertilization of eggs by sperm. Each pair of homologous chromosomes synapses during meiosis I, forming a tetrad. The alignment and orientation of the tetrads on the metaphase I spindle depend on chance. The chromosomes are then randomly distributed to daughter cells. Because the way each tetrad aligns is random, and many mother cells are undergoing meiosis simultaneously, each alignment and each type of gamete occurs with the same frequency as all others. Additional variation results from the crossing -over and exchange of chromosomal parts that occur during meiosis I. During meiosis, paternal chromosomes can precisely exchange gene segments with the homologous maternal ones, giving rise to recombinant chromosomes with mixed contributions from each parent. A single human egg will be fertilized by a single sperm on a totally haphazard basis. 103) The phenotypes of the first-generation offspring are all fuzzy-longhaired. 104) The genotypes of the first-generation offspring are all FfTt. 105) A cross of two second-generation, straight-shorthaired individuals would yield a straight-shorthaired phenotype. 106) The parental gametes from the cross would all be ft. 107) The gametes of the first-generation individuals from the original cross would be FT, fT, Ft, and ft. 108) The second-generation recombination types would have the following phenotypes: fuzzy -longhaired, fuzzy-shorthaired, straight-longhaired, and straight-shorthaired. 109) The second-generation phenotypes would appear in the following ratios: 9 fuzzy-longhaired, 3 fuzzy-shorthaired, 3 straight-longhaired, and 1 straight-shorthaired. 110) The second-generation, fuzzy-longhaired individuals could be FFTT, FfTT, FFTt, or FfTt. 111) The genotypes of the parental individuals were FFTT and fftt. 112) The parents must both be heterozygous for the dominant traits; therefore, their genotypes would be TtRr, where T = dominant trait for height, t = recessive trait for height, R = dominant trait for color, and r = recessive trait for color. 113) One-half of their children would be expected to be farsighted. 114) The fetus will become a Down syndrome baby. The baby will probably be retarded, have short fingers and a large tongue, and have a tendency for a short stature. 115) The grandfather of the child was a hemophiliac and gave his X chromosome to Jane. She did not express the disease because she has two X chromosomes, and the normal dominant allele suppressed the expression of hemophilia (a male needs only one hemophiliac allele to express the disease). Jane was not unfaithful, as she is a carrier who would not be expected to express the recessive phenotype. The child probably received the allele from Jane even though she did not have the disease. 116) Woody had to have been a heterozygote Hh for the allele because the dominant homozygous condition is lethal to the fetus. Woody's wife did not have the disease so she was not carrying it. Genetically they were Hh × hh. Using a Punnett square, the probability of having a child with the disease would be 50%. 117) Amniocentesis is not normally done before the 14th week of pregnancy. The disadvantage is the risk of injury to the fetus, but ultrasound visualization has dramatically reduced the risk. Tests can be done on the fluid withdrawn to determine the presence of chemicals that serve as markers for specific diseases. The cells themselves are cultured and examined for DNA markers of genetic disease. Karyotyping is also done to check for chromosomal abnormalities. Chorionic villus sampling can be done at eight weeks. It is much faster but may be more risky for the fetus. Karyotyping can be done on the rapidly dividing cells very quickly. 118) The parents have the following genotypes and phenotypes: One parent is I Ai (heterozygous for A) with type A blood; the other parent is I Bi (heterozygous for B) with type B blood. 14

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119) The most likely genotype of the father is bb (homozygous recessive) for the trait. The most likely genotype for the mother is either Bb (heterozygous with both a dominant and a recessive gene) or BB (homozygous dominant) for the trait. If a seventh child had blue eyes, the mother's genotype would be Bb, and the father's genotype still would be bb. 120) (a) 100% of their sons will be color-blind. (b) 0% of the daughters will be color-blind. (c) All of the daughters will be carriers for the color-blind gene. 121) The man has a BbRr genotype, while the woman has a bbRr genotype. 122) The doctor should explain that this is a fairly simple procedure and that an ultrasound will be used to visualize the position of the fetus and the amniotic sac to assist accuracy. The mother will need to decide whether to consent to the procedure after being informed of a small risk of losing the pregnancy (currently 0.3-1%) as a complication of amniocentesis. 123) Individuals heterozygous for the sickling gene make both normal and sickling hemoglobin. As a rule, these individuals are quite healthy since under reasonable aerobic conditions (at rest and during moderate exercise), the mixed Hb-A and Hb-S still has sufficient O2 -carrying capacity and will not sickle, but they can suffer if there is prolonged reduction in blood oxygen levels. 124) The chances of having a child with the disease are 25%. A reason not to have a child is that if a child is afflicted with sickle-cell anemia, the child will suffer and have severe pain.

Human Anatomy and Physiology 11th Edition Elaine N. Marieb Katja Hoehn TEST BANK

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