Cook, Shepherd and Boore, Essentials of Anatomy and Physiology for Nursing Practice, 2e
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Test bank
Correct answers are indicated by *
Using This Testbank
This testbank has been designed to be used in conjunction with Essentials of Anatomy and
Physiology for Nursing Practice, 2nd edition by Neal Cook, Andrea Shepherd and Jennifer
Boore. Correct answers for multiple choice questions are indicated with asterisks.
Chapter 1: Homeostasis
1. Match the terms from the following groups:
1. Substances entering the cell
2. Waste products leaving the cell
3. Conditions which allow life to continue
a. Steady temperature; pH between 7.35 and 7.45; electrolyte balance
b. Oxygen; substances for building complex molecules; substances acting as energy sources
c. Ammonia; carbon dioxide
Ans: 1[b], 2[c], 3[a].
2. Which term is used to describe the maintenance of a constant internal environment in the
cell or body?
*a. homeostasis
b. equilibrium
c. pH balance
d. oxidative phosphorylation
3. Which of the following lists the correct sequence of levels forming the structural hierarchy
of the body?
a. organ, organ system, cellular, tissue, organism
b. chemical, cellular, tissue, organism, organ, organ system
*c. chemical, cellular, tissue, organ, organ system, organism
d. organism, organ system, organ, tissue, cellular, chemical
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4. Consider a feedback loop where the stimulus is an increase in blood sugar. If the feedback
loop is a negative feedback loop, what would be the result of such a stimulus?
a. increase in blood sugar levels
*b. decrease in blood sugar levels
c. initial increase in blood sugar levels, followed by a decrease
d. initial decrease in blood sugar levels, followed by an increase
5. What is the result of the initial stimulus in a positive feedback loop?
a. The stimulus is suppressed.
b. The stimulus is switched off.
c. There is no effect on the stimulus.
*d. The stimulus is amplified or exaggerated.
6. In systems controlled by negative feedback, the effector response returns the level of the
stimulus towards its original level.
*a. True
b. False
7. Which of the following lists the correct sequence of messaging between the components of
a control system?
a. control centre, receptors, effectors
*b. receptors, control centre, effectors
c. receptors, effectors, control system
d. effectors, control system, receptors
8. Which of the following apply to the control centre?
a. It sets the limits for a specific variable.
b. It integrates the information received with other information.
c. It sends instructions to change the action of the effector.
d. a. and c. above only
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*e. a., b. and c. above
9. Insert the missing term. Receptors and ______ communicate with the control centre to
form a feedback system that regulates various internal conditions
Ans: effectors
10. Match the following descriptions with the correct body system.
1. the system that processes sensory information
2. the system that delivers nutrients to body tissues
3. the system that breaks down and absorbs food
4. the system that includes the fingernails
5. the system that includes the bladder
a. Urinary/renal
b. Integumentary
c. Digestive
d. Cardiovascular
e. Nervous
Ans: 1 (e)
2 (d)
3 (c)
4 (b)
5 (a)
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Chapter 2: The Human Cell
1. Which of the following molecules is the primary energy store in living cells?
a. DNA
b. RNA
c. Cyclic AMP
*d. ATP
2. What would be the result if a cell lacked ribosomes?
a. It would be unable to move.
*b. It would be unable to synthesise proteins.
c. It would be unable to synthesise DNA.
d. It would be unable to metabolise sugars.
e. It would be unable to divide.
3. Which compounds (1) form the inherited genetic material inside each cell and (2) relay
instructions from the genes to guide protein synthesis?
*a. DNA and RNA
b. DNA and ATP
c. RNA and ATP
d. ADP and ATP
4. Which cell organelle is the main location for the production of useable energy in the form
of ATP?
a. ribosome
b. rough endoplasmic reticulum
c. smooth endoplasmic reticulum
d. golgi apparatus
*e. mitochondrion
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5. Which cell organelle contains enzymes that destroy invading microbes or other harmful
substances?
a. mitochondrion
b. ribosome
c. centriole
*d. lysosome
6. Proteins are packaged by the Golgi Body into secretory granules for export by exocytosis.
*a. True
b. False
7. Match the names of each of the structures to the correct number on the diagram of the cell.
Smooth endoplasmic reticulum, Golgi apparatus, Mitochondria, Nucleus, Rough endoplasmic
reticulum, Plasma membrane, Ribosomes Secretory granules,
Ans:
1. Smooth endoplasmic reticulum
2. Nucleus
3. Rough endoplasmic reticulum
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4. Golgi apparatus
5. Secretory granules
6. Plasma membrane
7. Mitochondria
8. Ribosomes
8. What is the term used to describe fluids located outside the cell membrane?
*a. extracellular
b. extranuclear
c. intracellular
d. cytoplasmic
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Chapter 3: Genetic and Epigenetic Control of Biological Systems
1. What is the correct term for external modifications to DNA that turn genes on or off and,
thus, alter particular characteristics?
a. non-coding DNA
*b. epigenetics
c. multifactorial inheritance
d. Punnett Square
2. Identify the core concepts of the three Laws of Inheritance from the list below.
a. Genetic alterations
*b. Dominance
c. Genomics
*d. Independent assortment
*e. Segregation
f. Punnett Square
g. Acquired characteristics
3. In inheritance when each parent carries one recessive gene for a specific gene, what is the
probability in each pregnancy of having a child with the condition?
a. every child
b. one in ten
*c. one in four
d. fifty per cent
4. In mitochondrial inheritance, who passes the genes concerned on to the offspring?
a. father
b. both parents
*c. mother
d. either parent
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5. Multifactorial inheritance of disease involves genetic transmission influenced by
environmental factors. Which of the following apply in this situation?
*a. Some ethnic groups develop particular disorders more commonly.
*b. A Mendelian pattern of inheritance is not shown.
*c. Concordance does not match expected Mendelian pattern in mono or dizygotic twins.
d. The disorder is sex-linked.
* e. a, b and c
f. all of these
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Chapter 4: The Human Microbiome and Health
1. Microbes can have a range of types of relationship within the human body. Link the
following types with the appropriate description.
Types: 1. Commensals
2. Pathogens
3. Opportunists
4. Transients
Descriptions:
a. Briefly within the microbiota but do not colonise body
b. Normally harmless but can cause disease when immune system defences depressed
c. In symbiosis with host, harmless and gain nutrients from host
d. Cause disease, severity due to virulence of host and organism
Ans: 1(c), 2(d) 3(b) 4(a)
2. Match the following names and descriptions of types of bacteria.
Names: 1. Coccus
2. Vibrios
3. Spirochaetes
4. Bacillus
Descriptions: a. Spiral: as individuals
b. Rod: as individuals and chains
c. Curved: as individuals
d. Round: as individuals, pairs, chains and clusters
Ans: 1 (d); 2 (c); 3 (a); 4 (b)
3. Viruses are intracellular parasites and the virome is the viruses within the microbiome.
Identify the correct statements in those given below.
*a. viruses multiply within their host cell
b. following multiplication, viruses congregate in groups in the ECF
*c. viruses consist of nucleic acid (RNA or DNA) surrounded by a protein capsule
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d. individuals on similar diets can develop very different viromes
*e. bacteriophages infect bacteria
*f. the virome in an individual remains fairly stable
4. The human microbiome is distributed in various parts of the body. Which of the following
groups of parts of the body all contain components of the microbiome?
*a. stomach, skin, large intestine, rectum
b. upper respiratory system, mouth, inner ear, duodenum
c. skin, upper respiratory system, liver, vagina
d. vagina, liver, large intestine, inner ear
5. From the following list, which actions accurately identify functions of the human
microbiota?
*a. Energy production by carbohydrate metabolism and formation of long chain fatty acids
b. Formation of Vitamin K in the skin
*c. Some drugs are metabolised by microbes in the gut
d. There is no influence on pathogenic infections
*e. Maturation of the gut and its immune system is promoted
f. a, c, e
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Chapter 5: The Nervous System: Control of Body Function
1. Which two body systems function to regulate and control body activities?
a. cardiovascular and urinary
b. lymphatic and respiratory
c. reproductive and gastrointestinal
*d. nervous and endocrine
2. Which of the following statements about the parasympathetic nervous system is not true?
*a. It is active when the person is prepared for fight or flight.
b. It enhances the motility of the gastrointestinal tract.
c. It reduces the respiratory rate.
d. It includes the vagus nerve.
3. Which of the following Neurotransmitters perform the functions identified?
Neurotransmitters:
a. Acetylcholine
b. Monoamines
c. Amino acids (AAs)
d. Neuropeptides
Functions:
1. Longer effect, at lower level, than other neurotransmitters; acts in relation to analgesia,
metabolism, reproduction, social behaviours, learning and memory
2. Normally excitatory function as sympathetic NS, but some parasympathetic action.
3. Synthesised from amino acids. Include adrenaline and noradrenaline, mediate emotion,
arousal and cognition
4. Inhibitory or excitatory AAs: glycine ˗ inhibitory in SC, brainstem, retina; glutamate ˗
excitatory in relation to learning and memory
Ans: a (2); b (3); c (4); d (1)
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4. Specify the functions associated with the four key areas in the brain central to maintaining
mental health.
Areas Regulating Mental Health:
1. Amygdala
2. Anterior Cingulate Cortex
3. Hippocampus
4. Prefrontal Cortex
Functions of these areas:
a. creates memories, lays down long term memories, promotes quality of life and learning
new skills. Key in regulating mood
b. coordinates cognitive functioning, problem-solving, judgement-making - linking with other
parts of brain above
c. fright, flight and fight response (fear). Phobic experience ˗ links fear with previous
unpleasant experiences, relearning response is part of management
d regulates emotional responses, including motivation, focus and realisation. Inefficiency, can
cause depression, lack of motivation or drive. Dysfunction can cause behaviour disorders or
schizophrenia.
Ans: 1 (c); 2 (d); 3 (a); 4 (b)
5. The diencephalon is part of the forebrain consisting of three main sections and specific
functions. Link the functions with the particular section.
Sections of Diencephalon:
1. thalamus
2. hypothalamus
3. epithalamus
Functions:
a. several nuclei and tracts of nerves. Three main functions:
- control of autonomic nervous system
- control of neuro-endocrine system (pituitary gland links nervous and endocrine systems)
- control of limbic system.
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b. Pineal gland: regulates sleep-wake cycle by serotonin (day) and melatonin (night)
Habenula (relay from limbic system) deals with sleep, pain & reinforcement
c. Relay centre for impulses to and from cerebrum. All sensory impulses pass through.
Processes pain, temperature and attention collaborating with reticular activating system.
Ans: 1 (c); 2 (a); 3 (b)
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Chapter 6: Special and General Senses: Responding to the Environment
1. Link the following stimuli with the relevant sensory organs?
Ans:
Stimuli:
1. Taste (gustation)
2. Vision
3. Pain
4. Balance/equilibrium
5. Sound
6. Temperature
7. Light touch
8. Smell
Sense Organs:
a. cochlea
b. vestibule
c. free nerve endings
d. eyes
e. taste buds in mouth
f. tactile discs and Merkel cells
g. chemical sense neurons in olfactory mucosa
Ans: 1(e); 2(d); 3/6(c); 4(b); 5(a); 7(f) 8(g)
2. Match the names of each of the structures to the correct number on the diagram of the eye.
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Cornea; Posterior cavity (vitreous chamber); Pupil; Retina; Iris; Sclera; Choroid; Optic disc
(blind spot); Anterior cavity (contains aqueous humour)
Ans:
1. Posterior cavity (Vitreous chamber)
2. Sclera
3. Retina
4. Choroid
5. Anterior cavity (contains aqueous humour)
6. Lens
7. Pupil
8. Iris
9. Cornea
10. Optic disc (Blind spot)
3. Identify the names of the three different processes involved in the stages of image
formation.
Processes involved:
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a. bending of light by lens and cornea
b. changing shape of lens
c. narrowing of the pupil
Ans:
a. refraction
b. accommodation
c. constriction
4. Match the names of each of the structures to the correct number on the diagram of the ear.
Malleus, Stapes, Auditory canal, Semicircular canals, Cochlea, Tympanic membrane, Oval
window, Incus, Cochlear nerve, Eustachian tube, Vestibular nerve, Vestibule
Ans:
1. Auditory canal
Middle ear
2. Tympanic membrane
3. Malleus
4. Incus
5. Stapes
Inner Ear
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6. Semicircular canals
7. Oval window
8. Vestibule
9. Vestibular nerve
10. Cochlea
11. Cochlear nerve
12. Eustachian tube
5. Static and dynamic equilibrium are controlled by:
: the vestibule consisting of (a) and (b)
: the semicircular canals known as : (c), (d) and (e)
Ans: a. saccule
b. utricle
c. anterior
d. posterior
e. lateral
6. Nociception is the process of transmitting noxious stimuli through five phases to cause
pain.
Name these phases:
Ans: Transduction → Conduction → Transmission → Modulation → Perception
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Chapter 7: The Endocrine System: Control of Internal Functions
1. Identify the different modes of action of hormones named below:
Modes of action of hormones:
1. Classical endocrine function
2. Paracrine
3. Juxtacrine
4. Autocrine
5. Intracrine
Different types of functions:
a. Hormones act on cells which make them.
b. Hormones (chemical mediators) secreted into body fluids, carried around body and effects
functioning of cells in other parts of body.
c. Hormone is activated within the cell where formed and modifies function of that cell.
d. Hormones act on other cells in the neighbourhood.
e. Hormones from one cell act on immediate neighbours.
Ans: 1(b); 2(d); 3(e), 4(a); 5(c)
2. What are the three types of hormones and how are hormones released?
Name the three types of hormones.
Ans:
*1. Steroid hormones
*2. Protein/polypeptide hormones
*3. Modified amino-acid hormones
Specify how the release of hormones are stimulated:
Ans:
*1. hypothalamus and pituitary gland
*2. influence of factors in blood stream
*3. nervous stimulation
3. Identify the main hormone functions from the list below.
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*a. Nutrient supply
*b. Reproduction and Sex Differentiation
*c. Stress response
d. Control of body movement
*e. Development and growth
f. Elimination of contents of large intestine
*g. Regulation of metabolism
*h. Maintenance of internal environment
i. Protection by the skin
j. b, c, g
*kj. a, b, c, e, g, h
4. Name the two components which comprise the adrenal glands situated on top of the two
kidneys.
*a. Adrenal Cortex
*b. Adrenal Medulla
5. Match the missing labels to the numbers on the correct organs and structures of the adrenal
gland.
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Zona reticularis, Site where androgens are produced, Zona glomerulosa, Adrenal Medulla,
Zona fasciculata, Site where catecholamines are produced (e.g. adrenaline/noradrenaline),
Site where androgens are produced, Site of cortisol production
Ans:
1. Zona glomerulosa
2. Zona fasciculata
3. Zona reticularis
4. Adrenal Medulla
5. Site of aldosterone production
6. Site of cortisol production
7. Site where androgens are produced
8. Site where catecholamines are produced (e.g. adrenaline/noradrenaline)
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Chapter 8: The Digestive System: Nutrient Supply and Waste Elimination
1. Which of the following terms is used to describe the breakdown of complex molecules into
simpler ones?
a. anabolism
b. synthesis
c. homeostasis
*d. catabolism
2. Which of the following organelles of a cell increase the surface area to facilitate absorption
of extracellular materials?
a. endoplasmic reticulum
b. cilia
*c. microvilli
d. lysosomes
3. Identify from the following those statements that apply to the pancreas:
*a. Secretions are alkaline.
*b. Secretions contain enzymes that digest fat.
c. Secretions are acidic.
*d. Secretions contain precursors of protein-digesting enzymes.
e. Secretions enter the intestine through the pyloric sphincter.
*f. Release of secretions is stimulated by the acid content of chyme
4. Food entering the stomach can initiate the gastro-colic reflex, where ______.
a. the contents of the colon are rapidly moved towards the rectum
b. the person feels the need to defecate
c. it is strongest after breakfast
d. a. and c. above
*e. all of these
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5. Which of the following statements about gastric action are correct?
a. The sight, smell or thought of food triggers the gastric phase of gastric secretion.
*b. The entry of food into the stomach triggers the gastric phase of gastric secretion.
*c. A fatty meal remains longest in the stomach.
d. Chyme entering the small intestine stimulates the gastric phase of gastric secretion.
*e. The pyloric sphincter controls the movement of chyme into the duodenum.
*f. b, c, e
6. Glycerol and fatty acids (recombined as triglycerides) take which of the following
pathways into the blood?
a. lacteals in villi, hepatic portal vein, liver
*b. lacteals in villi, lymphatics, subclavian vein
c. capillaries, lymphatics, hepatic portal vein
d. lymphatics, lacteals in villi, subclavian vein
7. Digestion converts large molecules in the diet to small ones and enables their passage into
the body.
Match the nutrients with the products of digestion:
1. Proteins
2. Carbohydrates
3. Fats
a. Monosaccharides
b. Amino acids
c. Glycerol and fatty acids
Ans: 1. (b)
2. (a)
3. (c)
8. The stomach begins digestion and absorption of glucose, absorbs water and alcohol, and
kills micro-organisms which enter the stomach
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Body, Rugae, Pyloric sphincter, Pyloric antrum, Fundus, Oesophagus
Ans:
1. Pyloric antrum
2. Body
3. Rugae
4. Fundus
5. Oesophagus
6. Pyloric sphincter
9. The large intestine moves contents into the rectum by mass movements, absorbs water and
electrolytes, and synthesises vitamin K
Match the missing labels to the numbers on the diagram
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Transverse colon, Descending colon, Vermiform appendix, Rectum, Ascending colon,
Hepatic flexure of colon, Caecum
Ans:
1. Vermiform appendix
2. Transverse colon
3. Ascending colon
4. Descending colon
5. Hepatic flexure of colon
6. Rectum
7. Caecum
10. The small intestine carries out which of the following?
a. Movement of intestinal contents towards the large intestine, protection against infection by
lymphoid tissue, eliminates waste products
*b. Absorption of nutrients, movement of intestinal contents towards the large intestine,
protection against infection by lymphoid tissue
c. Absorption of nutrients, completion of digestion of nutrients, absorbs water from chyme
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d. Protection against infection by lymphoid tissue, completion of digestion of nutrients,
absorbs water from chyme
11. Which of the following are water-soluble vitamins?
Ans:
*a. C
b. E
c. K
*d. Folic acid
e. D
f. A
*g. Niacin
*h. B12
12. Which of the following criteria are met by essential amino acids?
Ans:
*a. There are eight (nine in infants) (one of them essential only in infants)
*b. They can contribute as an energy source for the body by the loss of nitrogen
c. They can be formed in the body from glucose derivatives with the addition of N in the
body
*d. a. and b. above
e. b. and c. above
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Chapter 9: Metabolism and Liver Function
1. Which of the following are functions of the liver?
*a Drug metabolism ˗ first pass metabolism
b. Defaecation
*c. Nutrient metabolism ˗ different nutrients
*d. Heat production
e. Pancreatic secretion
f. Appetite management
*g. Bilirubin metabolism and bile production
*h. Hormone synthesis and deactivation
*i. Immunological functions
*j. a, c, d, g, h, i.
2. Which compound acts as an energy source for active transport across the cell membrane?
Ans: (any of the following ˗ different presentations of the same compound)
a. ATP
b. Adenosine tri-phosphate
c. Adenosine triphosphate
3. Bile is produced in the ______ and stored in the ______.
Ans: (in correct order):
a. liver
b. gall bladder
4. Bile pigments arise from the breakdown of ______.
a. platelets
*b. haemoglobin
c. proteins
d. liver cells
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5. Insert the missing word: Bile salts ______ fats and therefore promote digestion and
absorption of fats.
Ans: emulsify
6. Complete the following statement: The endocrine secretions of the pancreas regulate the
metabolism of ______.
Ans: glucose
7. Nutrients other than fats are carried to the liver in the ______.
Ans:
a. intestinal vein
b. hepatic artery
c. gastric artery
*d. hepatic portal vein
8. When glucose levels are low, new glucose is made from (a) ______ through a process
called (b)______.
Ans:
(a) protein
(b) gluconeogenesis
9. Which of the following organs is usually dependent on glucose as an energy source?
a. heart
b. stomach
*c. brain
d. liver
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Chapter 10: The Respiratory System: Gaseous Exchange
1. Match the missing labels to the numbers on the correct organs and structures of the
respiratory system.
Match the missing labels to the numbers on the diagram.
Left lung, Heart, Trachea, Ribs, Diaphragm, Right lung, Larynx
Ans:
1. Heart
2. Left lung
3. Right lung
4. Ribs
5. Larynx
6. Trachea
7. Diaphragm
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2. Which of the following are functions of the respiratory system?
a. Regulation of Blood Nitrogen levels
*b. Regulation of blood pH
*c Blood pressure regulation through chemical mediators
d. Roof of mouth separates nasopharynx and oropharynx
*e. Production of sound (e.g. speech)
f. The number of alveoli reach functional maturity by 3 to 5 years.
*g. Enabling smell
*h. Protection against microorganisms
*i. b; c; e; g; h.
3. Identify which of the following statements are correct about the lower respiratory tract.
*a. It consists of the trachea, the lungs, the bronchial tree and the alveoli.
b. Carbon dioxide moves from the alveoli into the pulmonary capillaries.
*c. The alveoli permit external respiration when gases move between the alveoli and the
pulmonary capillaries.
d. Air enters the lungs when the pressure inside is higher than in the atmosphere.
*e. The phrenic nerves stimulate the diaphragm to enable the change from inhalation and
exhalation.
*f. a; c; e.
4. Which of the following terms is used to describe the movement of oxygen from an area of
high concentration to an area of low concentration?
a. osmosis
b. active transport
*c. diffusion
d. passive transport
e. filtration
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5. Oxygen is transported in the blood stream in combination with haemoglobin with the
amount specified by oxygen saturation. What is the usual level and range of oxygen
saturation?
Ans:
The usual level of oxygen saturation is 98.5%.
The normal range is 94–100%.
6. Carbon dioxide is transported in three forms which are:
a. dissolved in plasma
b. combined with protein part of haemoglobin
c. as bicarbonate ions.
What proportion is carried in each format?
Ans:
a. 7%
b. 23%
c. 70%
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Chapter 11: The Renal System: Fluid, Electrolyte and Acid–Base Balance
1. Which of the following pH ranges best matches the pH range found in the majority of body
fluids?
a. 7.8–8.0
b. 7.15–7.65
c. 7.2–7.5
*d. 7.35–7.45
2. Which of the following functions are carried out by the renal system in order to maintain a
state of homeostasis within the body?
*a. maintenance of fluid and electrolyte balance
*b. maintenance of pH
c. supply of nutrients to the body
*d. excretion of nitrogenous waste products
e. fighting infection
3. Match the missing labels to the numbers on the correct organs and structures of the kidney.
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Medulla, Renal pyramid, Major calyx, Cortex, Minor calyx, Ureter, Renal capsule, Renal
pelvis
Ans:
1. Cortex
2. Medulla
3. Renal pyramid
4. Minor calyx
5. Major calyx
6. Renal capsule
7. Renal pelvis
8. Ureter
3. What is the most abundant inorganic substance in the human body?
a. glucose
b. fat
*c. water
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d. ATP
e. iron
4. Which of the following would best describe what is meant by ‘diffusion’?
*a. the movement of a substance down a concentration gradient until equilibrium is reached
b. the movement of a substance across the cell membrane against a concentration gradient
c. the movement of a substance across the cell membrane by a carrier protein
d. the packaging of proteins for export out of the cell
5. The term ‘osmosis’ refers to the movement of water across a semi-permeable membrane
which solute molecules cannot cross.
*a. True
b. False
6. Which of the following are features of active transport?
a. Energy in the form of ATP is required.
b. Carrier proteins are used to move molecules across the cell membrane.
c. Transport of molecules may occur against a concentration gradient.
*d. All of these
e. None of these
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Chapter 12: The Cardiovascular and Lymphatic Systems: Internal
Transport
1. Clarify the role of the cardiovascular system in the maintenance of homeostasis and
identify the different functions.
Ans:
Provision of nutrients for provision of energy and oxygen for cellular respiration
Waste disposal including carbon dioxide, ammonia and heat
Protection from pathogens and injury by circulating blood cells and clotting factors to the
necessary sites haemostasis and healing
2. Outline the structure and function of blood.
Ans:
Plasma: straw coloured fluid: 90–92% water with dissolved substances:
plasma proteins – albumins creating osmotic pressure
fibrinogen and prothrombin for blood clotting
globulins for immunity
enzymes, hormones, gases, electrolytes, waste products
Blood cells:
erythrocytes (red blood cells) – oxygen transport to cells
leucocytes (white blood cells) – part of immune system
thrombocytes (platelets) – blood clotting
3. Describe how Erythrocyte formation is maintained.
Ans:
Erythrocytes are formed in response to changes in oxygen supply substances required are
iron, vitamin B12 and folic acid low oxygen in blood stimulates release of erythropoietin
(EPO) from kidneys which stimulates bone marrow to produce erythrocytes.
4. Outline the main blood groups.
Ans:
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ABO system:
blood comes in antigen groups and develop antibodies
Group A (42% population):
A antigens
anti-B antibodies
Group B (10% population):
B antigens
anti-A antibodies
Groups AB (4% population): A and B
Group O (44% population):
antigens
No antibodies
No antigens anti A/anti B antibodies
Rhesus system:
D is main antigen in this group: Rh positive (Rh+ ) carry RhD antigen
Rh negative (Rh˗) do not
(Rh˗) exposed to (Rh+ ) blood - produce anti-D (anti-Rhesus) antibodies
5. What are the main white cells (Leuckocytes) in the blood?
Ans:
Granulocytes:
Neutrophils – engulf bacteria, chemicals destroy foreign bodies increased in acute infections,
some malignancies, etc.
Eosinophils – allergic responses, chemicals weaken/kill parasites
Basophils – inflammatory response by histamine release, heparin secretion increases blood
flow
Agranulocytes:
Lymphocytes – key defences against cancer, viral infections, foreign cells B-cells, T-cells,
Natural killer cells
Monocytes – differentiate into macrophages (large phagocytes) destroy pathogens, clear
debris, activate other immune cells
6. Match the missing labels to the numbers on the correct organs and structures of the heart:
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Tricuspid valve, Left ventricle, Left atrium, Superior vena cava, Aorta, Left pulmonary vein,
Right ventricle, Pulmonary artery, Right atrium, Mitral valve
Ans:
1. Superior vena cava
2. Aorta
3. Pulmonary artery
4. Left pulmonary vein
5. Right atrium
6. Tricuspid valve
7. Right ventricle
8. Left atrium
9. Mitral valve
10. Left ventricle
7. Outline the basic structure of the circulation through the body.
Ans:
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Types of blood vessel:
arteries carry blood away from heart
veins carry blood back to heart
capillaries – water, nutrients, waste products between blood and tissues
Pulmonary circulation – blood supply between heart and lungs
Systemic circulation – blood supply to rest of the body
Coronary circulation – blood supply to heart
Lymphatic circulation: fluid goes from tissues through lymphatic vessels and glands
important in tissue drainage
8. Outline the conduction system which regulates how the heart functions.
Ans:
1. Sinoatrial (SA) node: pacemaker
2. Atrioventricular (AV) node
3. Atrioventricular bundle (AV bundle) / bundle of His
4. Right and left bundle branches
5. Purkinje fibres
Impulse initiated at SA node, spreads over atria to AV node, passes down
Bundle of His to ventricle walls and through the network of Purkinje fibres. Impulse leads to
cardiac systole (contraction) followed by diastole (relaxation).
9. How are cardiac output and blood pressure determined?
Ans:
Cardiac output = volume of blood passing out of heart per minute
Cardiac output = stroke volume × heart rate
(stroke volume ˗ volume from ventricle per stroke) (heart rate per minute)
Blood pressure = cardiac output × peripheral resistance
(peripheral resistance = resistance to flow of blood from arterial walls)
Control of blood pressure:
Neural control: short term/fast-acting, baroreceptors within CVS respond to changes in
pressure, chemoreceptors to chemical changes
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Endocrine control: long-term/slow action
Renin angiotensin aldosterone system (RAAS): involves kidney, liver, lungs
Atrial natriuretic peptide: released from heart
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Chapter 13: The Immune System: Internal Protection
1. The immune system protects the body against infection and abnormalities of cells. Identify
the three sequences of immunity which occur:
Ans:
Innate
Recognition by
immunity → Infection →
non-specific
(0-4 hours)
Innate
Removal of
→ infectious agent
molecules in body fluids
Innate
PAMPs recognized
Removal of
immunity → Infection → immune cells → immune cells cause
→ infectious
agent
(4–96 hours)
Adaptive
activated
inflammation
Antigen
Naive B
Immune cells
Removal of
immunity → Infection → transported to → and T cells → multiply and →
infectious agent
(> 96 hours)
lymphoid organs
recognise
antigens
antigen
activated
2. What is innate (natural) immunity and what are the three key characteristics?
Ans:
a. first line of defence against pathogens
b. reacts rapidly to pathogens
c. responds same way each time it meets pathogens
d. starts again each time it meets a pathogen
3. What are the barriers to infection?
Ans:
Physical – keratinised external layer of skin prevents pathogen entry
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Membranes lining organ systems which link to external environment
Biochemical substances protect against pathogens
Commensal microbes in microbiome prevent pathogens inhabiting sites already in use.
4. What are the two main phases in the inflammatory process?
Ans:
Vascular phase when dilation of blood vessel increases blood flow, plasma proteins move
from blood stream into tissues drawing fluid in.
Leucocytes are chemically attracted to site of injury when cytokines released attract
phagocytic cells.
5. Link the names of the specialised cell types with the descriptions provided.
Cell type names:
1. Phagocytes (neutrophils and macrophages)
2. Mast cells
3. Natural killer cells
4. Eosinophils
Cell descriptors:
a. Develop from monocytes in bone marrow and phagocytose large microbes
b. Present in smallest amounts but defend against parasites, allergic responses and tissue
inflammation
c. Mobile leucocytes which engulf and destroy pathogens
d. Formed from lymphoid cell line and kill virally infected cells by apoptosis
Ans:
1 (c); 2 (a); 3 (d); 4 (b)
6. In which organs of the body are the cells of the adaptive immune system formed?
*thymus gland
*bone marrow
7. Name the cells and their main functions of the Adaptive Immune System.
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Ans:
B-lymphocytes
a. Plasma cells: form antibodies into blood stream to react with antigens
b. Memory cells: express antibody and contact with antigen initiates rapid antibody
production
c. T-lymphocytes
d. T-helper cells: affect behaviour of other cells (B-lymphocytes and macrophages) to
enhance efficiency
e. T-cytotoxic cells: cell-mediated immunity kill virus-infected cells
f. T-regulatory cells: control immune responses by suppressing other cells
g. T-memory cells: meeting antigen again leads to rapid immune response
8. Specify the four stages of the primary antibody response and relate the changes to each
stage.
Stages:
1. Plateau
2. Log
3. Decline
4. Lag
Characteristics of stages:
a. Antibody levels multiply exponentially as cells become antibody-secreting plasma cells
b. Cell division beginning, period between exposure and onset of symptoms
c. Antibody decay faster than formation
d. Antibody levels are constant – synthesis and decay are balanced
Ans:
1 (d); 2 (a); 3 (c); 4 (b)
9. Differentiate between the meaning of the terms immunisation and vaccination. Identify the
importance of programmes to promote immunity.
Ans:
Immunisation: inducing immunity to an infectious agent in an individual through vaccination
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Vaccination: administration of vaccine – biological preparation to improve immunity
Importance of Vaccination programmes: significant proportion of population immunised →
break in chain of infection → herd immunity
10. Link the names and characteristics of disorders of immunity.
Disorders:
1. Hypersensitivity
2. Autoimmunity
3.1 Immunodeficiency (Primary)
3.2 Immunodeficiency (Secondary)
Characteristics:
a. Primary (genetic cause(congenital) → severe infections early in life
b. Secondary (acquired): acquired during life, e.g. cytotoxic therapy
c. Antibodies act against self-antigens and → tissue damage
d. Presentation can vary from minor to severe, i.e. hypersensitive
Ans: 1 (d); 2 (c); 3.1(a); 3.2 (b)
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Chapter 14: Skin and Temperature Regulation
1. Which organ is the largest in the body and identify the three layers of this organ.
Ans:
a. The skin
Layers:
b. Epidermis
c. Dermis
d. Hypodermis
2. Is the following statement true or false: the epidermis has no blood supply.
*True
False
3. Which of the following conditions are protected against by the skin and how?
1. the skin is waterproof and tough
2. ultraviolet radiation
3. pathogens
a. Melanin
b. Macrophages and lysozyme
c. Keratin
Ans:
1 (c); 2 (a); 3 (b)
4. Which of these characteristics does the connective tissue have?
a. connects the skin to nerve cells
b. is tough and rigid to protect the body
c. is elastic, containing blood and lymph vessels and nerves*
*d. is rich in collagen and elastin
e. is rich in keratin and melanin
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5. Which cells of the dermis produce collagen (a) and what kind of tissue primarily makes up
the hypodermis(b) ?
*(a). fibroblasts
*(b). adipose
6. What are the three main groups of sensory receptors in the dermis?
Ans:
mechanoceptors/mechanoreceptors
nociceptors
thermoceptors/thermoreceptors
7. Eccrine/merocrine glands ______.
a. are rarely located within the skin
*b. are widely distributed and most numerous, being found on the palms of the hand, soles of
the feet and dermis of the forehead
*c. produce a clear, watery sweat
d. produce an odorous, translucent, oily sweat
e. are widely distributed throughout the skin but not found on the palms of the hands or soles
of the feet
*f. b and c
8. What hormone is created under the influence of ultraviolet light onto the skin?
Ans: vitamin D
9. What are the two methods by which skin can heal?
Ans:
a. regeneration
b. fibrosis
10. Which of these are stages of wound healing?
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a. apoptosis
*b. haemostasis
c. infiltration
*d. inflammation
*e. proliferation
f. modulation
g. segmentation
*h. maturation
*i. b; d; e; h.
11. Which of these processes are involved in cooling the body?
a. thermogenesis
b. cutaneous vasoconstriction
c. piloerection
*d. cutaneous vasodilation
*e. increased respiration
*f. anorexia
g. apoptosis
*h. d; e; f.
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Chapter 15: The Musculoskeletal System: Support and Movement
1. Identify the main functions of the musculoskeletal system.
Ans:
It provides body shape and enables movement.
The blood cells are formed within the bone marrow.
It is an important storage area for minerals.
It provides protection for a number of bodily organs, e.g. cranium protects brain, thorax
protects heart and lungs
2. Specify the different tissues of the musculoskeletal system.
Ans:
Bone: consists of collagen (90–95% of organic part of bone), inorganic crystals (largely
calcium). Provides rigidity but has some flexibility.
Cartilage: more elastic than bone. semi-rigid, protective at some joint surfaces three types:
hyaline, fibrous, elastic
Ligaments: tough fibrous bands of collagen and fibrocytes, attach bone to bone at joints
Tendons: similar to ligaments but attach muscle to bone
3. Match the missing labels to the numbers on the long bone illustrated.
Spongy bone, Epiphyseal line, Periosteum, Epiphysis (x2), Articular cartilage, Diaphysis,
Medullary cavity, Endosteum, Nutrient foramen
Ans:
1. Epiphysis (×2)
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2. Diaphysis
3. Articular cartilage
4. Epiphyseal line
5. Spongy bone
6. Medullary cavity
7. Nutrient foramen
8. Endosteum
9. Periosteum
4. Identify the four types and functions of bone cells.
Types of cells:
a. osteocytes
b. osteogenic cells
c. osteoclasts
d. osteoblasts
Functions:
1. in periosteum, endosteum and canals containing blood vessels. develop into osteoblasts
2. large, in endosteum, remove old bone (usually linked with osteoblast activity)
3. develop from osteoblasts, are the main type of bone cell, ensure exchange of nutrients and
waste products with blood
4. bone building cells, make collagen and cause calcification
Ans:
1 (b); 2 (c); 3 (a); 4 (d)
5. Bone formation (ossification) is when bone is formed from mesenchymal tissue or
cartilage.
Name the six stages of endochondrial ossification.
Ans:
1. Development of cartilage model – general shape of future bone
2. Growth of cartilage model – chondroblasts become chondrocytes
3. Development of primary ossification centre – from external surface of bone in
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4. Development of medullary cavity – some spongy bone breaks down to cavity
5. Development of secondary ossification centre – outwards from epiphyses to outside
6. Formation of articular cartilage and epiphyseal plate – hyaline cartilage becomes articular
cartilage; epiphyseal plate enables growth and later becomes bone
6. Outline the stages of bone repair.
Ans:
Formation of fracture haematoma: blood clot forms, damaged bone cells removed, blood
supply to bone re-established
Formation of fibrocartilagenous callus: collagen and cartilage close gap at break
Formation of bony callus: osteogenic cells become osteoblasts and form bony joins
Bone remodelling: dead and spongy bone tissue reabsorbed, compact bone formed
7. Identify the six types of bones.
Ans:
Long bones: longer than width, slight curvature gives strength and withstand pressure
e.g. thigh bone, upper and lower leg, arms, phalanges
Short bones: cuboidal, spongy bone with compact bone outside. Little movement
e.g. wrists, ankles
Flat bones: flat, thin may be curved. 2 layers of compact either side of spongy bone.
e.g. cranium, sternum, ribs, scapulae, some pelvic bones
Irregular bones: complex shapes, spongy layer with compact.
e.g. vertebrae, facial bones, pelvic bones
Sesamoid bones: in tendons where friction, tension and physical stress
e.g. Patellae (kneecapsbones bones )
Sutural bones: additional bones within suture lines of skull.
8. Outline the skeletal structure of body.
Ans:
Axial skeleton includes:
skull – cranial and facial bones
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spinal column – cervical, thoracic, lumbar vertebrae, sacrum, coccyx
thoracic bones – ribs, sternum
Appendicular skeleton includes:
pectoral girdle – clavicles, scapulae
upper limbs – humerus, radius, ulna, bones of carpal, metacarpal, phalanges
pelvic girdle
lower limbs – femur, tibia, fibula, (patella), tarsal, metatarsal, phalanges
9. Bones meet at joints. Identify the types of joints.
Ans:
fibrous, cartilagenous, synovial joints.
synovial joints – commonest synovial cavity with articular – allows free movement.
include: hinge, pivot, ball and socket, saddle, condyloid, gliding types of movement:
Synarthroses (fixed or unmovable) Amphiarthoses (slightly moveable (Diarthroses
(freely moveable)
10. Identify the major modes of action and the key functions of skeletal muscle.
Ans:
Modes of Action:
Contractility (shortens)
Excitability (responds to stimulus and causes action potentials)
Extensibility (stretches beyond resting length without damage)
Elasticity (returns to resting length after stretching)
Key functions:
Production of body movements
Maintenance of body position and posture
Storage (of water and ions) and movement (lymph and blood flow)
Generation of heat through use of ATP
11. How do muscle fibres create movement?
Ans:
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The sliding filament mechanism enables the thick and thin filaments to have shorter or longer
length of the muscle fibre.
Calcium is essential in muscle contraction. It is stored in the sarcoplasmic reticulum and
released as needed for contraction.
Contraction is initiated by the action of motor neurones at the neuromuscular junction which
creates the muscle action potential in four steps:
Release of acetylcholine (ACh)
Activation of ACh receptors
Production of muscle action potential
Termination of ACh activity
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Chapter 16: The Reproductive Systems
1. Identify the correct order of the stages of gender determination below:
Stages in gender determination:
a. Zygote is formed by fertilization of ovum by sperm.
Zygote with XX will become female foetus.
Zygote with XY will become male foetus.
b. Fertilized zygote embeds in endometrium and develops into foetus determined by sex
chromosomes.
c. Gametes contain 23 pairs of chromosomes: 22 autosomes and one sex pair
Sex pair in ovum from female contains XX chromosomes.
Sperm from male contains XX or XY pair of chromosomes.
d. Gametes formed: ovum in ovary of female/sperm in testicle of male
e. Fertilization of ovum by sperm takes place in the Fallopian tube.
Ans:
(1) d; (2) c; (3) e; (4) a; (5) b
2. State the functions of the female reproductive system in the correct order.
Ans:
Produce the female gametes.
Transport the ovum along the Fallopian tube where it is fertilized.
Protect and the developing embryo and foetus.
Deliver the baby.
3. Match the numbers on the diagram of the female pelvic region to the correct organs and
structures
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Uterus, Uretha, Rectum, Anal canal, Fallopian tube, Cervix, Ovary, Vagina
Ans:
1. Fallopian tube
2. Ovary
3. Uterus
4. Urethra
5. Cervix
6. Rectum
7. Vagina
8. Anal canal
4. State in order the functions of the male reproductive system.
Ans:
a. Form the male gametes (sperm) and hormones (testosterone).
b. Carry the sperm through the tubules (spermatic ducts and accessory glands) for activation.
c. To penetrate the and deposit sperm within the female reproductive system.
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5. Match the numbers on the diagram of the male pelvic region to the correct organs and
structures.
Penis, Anal canal, Deferent duct, Prostate gland, Scrotum, Urethra, Rectum, Seminal vesicles
Ans:
1. Deferent duct
2. Prostate gland
3. Urethra
4. Penis
5. Scrotum
6. Seminal vesicles
7. Rectum
8. Anal canal
6. Pregnancy usually lasts 38 weeks from fertilization, and (normally) 40 weeks from the first
day of the last menstrual period. Identify the functions of the mother's body which are
prominent during pregnancy.
Ans:
The endocrine system to maintain the pregnancy and adjust structure and function
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Maternal immune tolerance develops to foetal genetic makeup
Physical changes adapting to increase in weight due to changes in shape, weight and posture
Adaptation of cardiovascular system to maintain foetal growth
7. The baby is delivered through the three stages of labour. Specify these stages.
Ans:
Stage 1: from beginning of contractions to full dilatation of the cervix
Stage 2: from full dilation of cervix to delivery of the baby
Stage 3: from delivery of baby to delivery of placenta and membranes
8. The stages of the post-partum period include two main issues which are ______.
Ans:
Puerperium in 6 weeks after pregnancy. Specify the changes in vaginal discharge
lochhia rubra (3-5 days)
lochia serosa (up to 10 days)
lochia alba (2nd - through 3rd to 6th weeks)
feeding and nurturing the baby
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Chapter 17: Development through the Life Span
1. What is apoptosis and how is it important through the lifespan?
Ans:
a. Apoptosis is programmed cell death.
b. It is important in development as it removes cells and tissues no longer required and
permits remodelling.
c. It can also occur due to external stresses, e.g. hypoxia, nutrient lack, viral infection, cell
damage
2. Outline the rapid growth and development into the foetus that occurs during the first eight
weeks of embryogenesis.
Ans:
a. Placenta established by the 4th week permitting substances to exchange between maternal
and embryonic tissues
b. Gastrulation occurs with the development of three germ layers, which form embryo and
support tissues
c. Basic structure of body laid down and heart starts beating at fourth week.
d. Waste products eliminated through placenta
e. Blastocyst with fluid-filled space – enters uterus and embeds in uterine wall by 7 days
1 (e); 2 (b); 3 (a); 4 (d); 5 (c).
3. Specify the functions of the placenta.
Ans:
a. Exchange of substances, but not cells, between foetus and mother
b. Nutrients and oxygen supplied to foetus
c. Waste products from foetus are eliminated into maternal circulation
d. Waste products excreted from maternal circulation
e. Endocrine function – secretes human chorionic gonadotrophin during early pregnancy
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4. During foetal life the mother provides all requirements but adaptations must occur to
enable the infant to adapt to independent life. Outline the major changes at and after birth.
Ans:
Heart and circulation:
immediate changes to enable lungs to inspire air and provide oxygen to body
circulation alters so that blood no longer goes from the right to left atrium
Infant develops adult-type circulation
Gastrointestinal tract, sense organs and immune system adapt over hours and days.
Circadian rhythm development is essential for normal development.
5. Outline some of the key characteristics of growth leading to adulthood.
Ans:
Infancy lasts from birth to about 24 months – rapid growth
Reaches approximately 50% of adult height
During same time – brain reaches approximately 80% of adult size
Different tissues grow at different rates
During infancy to adolescence – height, body systems, weight grow along with increasing
motor skills and coordination.
Brain reaches adult weight before early teens, but is still developing synapses and
remodelling until about 25 years
6. During puberty and adolescence individuals reach functional reproductive ability and
social adulthood. Outline some of the key events which occur.
Ans:
Hormonal changes from hypothalamus and pituitary gland influence gonads. gonadal changes
result in physical changes
Major events: menarche (beginning of menstruation) about 12–13 (girls) first ejaculation
about 13 in boys.
Puberty begins earlier in girls (about 10–11 completing 15–17), than boys (12–13 completing
16–17)
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Adolescence lasts from the beginning of puberty to the achievement of adulthood (may be in
early 20s)
7. Brain development is an essential part of adolescence. Outline key events:
Ans:
Limbic system (reward system) develops more quickly than control mechanisms (prefrontal
cortex) – leads to increased risk-taking in adolescents
Circadian rhythm phase shift – increased evening activity, can cause reduced sleep with
disturbed behaviour, psychological problems, and poor academic performance.
Continuing changes in brain in frontal and parietal cortices lead to refinement of brain
structure and executive function.
8. Specify stages of adulthood:
Ans:
Early adulthood 24–40:
optimum functioning
Middle adulthood 40–65:
decline beginning need to be fit to work, care for children and
family life.
Late adulthood 65–death:
decline continues
9. Women achieve menopause, the end of reproductive life at about 45–55 years, with an
average of 51 in the United Kingdom. Changes occur in pattern of menstruation; 1 year
without menstruation defines menopause. Identify the signs and symptoms.
Ans:
Reduced sex drive
Vaginal dryness and itching, pain/discomfort in sex
Hot flushes
Problems with sleeping – sometimes night sweats
Urinary tract infections
Changes in mood and tiredness, possibly depression and/or anxiety
Headaches
Palpitations
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10. Outline how abilities in late adulthood decline at a variable rate with increasing frailty
and debility at different stages.
Ans:
young–old: working till recently – often still involved with local activities
middle–old: less active but some are still involved with physical exercise.
Social activities maintain interactions oldest-old: many becoming frailer, physically and
mentally, may need some support.
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Appendices
Appendix 1
1. Which of the following best describes an enzyme?
a. a substance that increases the rate of a chemical reaction
b. a protein that remains in position to function again
c. a macromolecule that is formed from amino acids
*d. all of these
e. a. and c. above
Appendix 3
2. What terms refer to the structure and function of the human body?
Ans:
a. anatomy
b. physiology
3. What does the term proximal mean when applied to an organ?
a. The organ is nearer the front of the body.
*b. The organ is nearer to the point of attachment of a limb, or origin of a body part.
c. The organ is further from the point of attachment of a limb or origin of a body part.
d. The organ is nearer to the mid-line.
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