Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Choose the following statement that is NOT completely correct regarding serous membranes.
A) Serous membranes secrete a watery lubricating fluid.
B) Serous membranes are divided into parietal and visceral membranes with a virtual space
between the two.
C) Serosa are very thin, double-layered structures.
D) Visceral pericardium covers the outer surface of the heart, and parietal pericardium lines the
internal walls of the heart.
1)
2) The dorsal body cavity is the site of which of the following?
A) brain
B) lungs
C) intestines
2)
D) liver
3) Select the most correct statement.
A) Organ systems operate independently of each other to maintain life.
B) The immune system is closely associated with the lymphatic system.
C) Organ systems can be composed of cells or tissues, but not both.
D) The endocrine system is not a true structural organ system.
3)
4) Which of the following organs or structures would be found in the left iliac region?
A) liver
B) intestines
C) stomach
D) appendix
4)
5) Prevention of water loss is a necessary function for life that would best fit in the category of
________.
A) metabolism
B) responsiveness
C) excretion
D) maintaining boundaries
5)
6) 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) organ
B) complex tissue
C) complex cell
D) organ system
6)
7) Which of the following imaging devices would best localize a tumor in a person's brain?
A) DSA
B) MRI
C) PET
D) X-ray
7)
8) The coxal joint is most likely found in the ________ region of the body.
A) groin
B) hip
C) hand
8)
D) foot
9) Which one of the following systems responds fastest to environmental stimuli?
A) nervous
B) immune
C) lymphatic
D) muscular
1
9)
10) Positive feedback differs from negative feedback because ________.
A) positive feedback provides moment-to-moment wellbeing while negative feedback causes a
cascade effect
B) positive feedback tends to enhance the triggering stimulus while negative feedback tends to
return the body to a homeostatic balance or "ideal" level
C) positive feedback is generally beneficial while negative feedback is typically harmful
D) positive feedback is critical to health while negative feedback serves only to alert us to
potential health threats
10)
11) Which of these is NOT part of the dorsal cavity?
A) vertebral cavity
B) thoracic cavity
11)
C) spinal cord
D) cranial cavity
12) Homeostasis is the condition in which the body maintains ________.
A) a static state with no deviation from preset points
B) the lowest possible energy usage
C) a relatively stable internal environment, within limits
D) a dynamic state within an unlimited range, depending on circumstances
12)
13) Expiration (breathing out) is how the body removes excessive carbon dioxide from the blood. This
is an example of ________.
A) responsiveness
B) maintaining boundaries
C) metabolism
D) excretion of metabolic waste
13)
14) One of the functional characteristics of life is excitability or responsiveness. This refers to ________.
A) the necessity for all organisms to reproduce
B) the nervous system causing all living things to sometimes experience anger
C) indigestible food residues stimulating the excretory system
D) sensing changes in the environment and then reacting or responding to them
14)
15) The term pollex refers to the ________.
A) great toe
B) fingers
15)
C) thumb
D) calf
16) 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) control center
C) receptor
D) effector
16)
17) The thoracic cavity contains the ________. It is found ________ to the vertebral cavity.
A) heart and lungs; anterior
B) kidneys and spleen; deep
C) digestive viscera; inferior
D) stomach and liver; superficial
17)
18) Which of the following are survival needs of the body?
A) water, atmospheric pressure, growth, and movement
B) nutrients, water, movement, and reproduction
C) nutrients, water, atmospheric pressure, and oxygen
D) nutrients, water, growth, and reproduction
18)
2
19) 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) positive feedback
B) loss of homeostasis
C) negative feedback
D) necessary life function
19)
20) Which of the following statements is the most correct regarding homeostatic imbalance?
A) The internal environment is becoming more stable.
B) Negative feedback mechanisms are functioning normally.
C) Positive feedback mechanisms are overwhelmed.
D) It is considered the cause of most diseases.
20)
21) 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 pancreas lies deep to the stomach within the abdominal cavity.
B) The skull is formed by 22 facial and cranial bones.
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.
21)
22) In which body cavities are the lungs located?
A) pleural, ventral, and thoracic
C) pericardial, ventral, and thoracic
22)
B) mediastinal, thoracic, and ventral
D) pleural, dorsal, and abdominal
23) What is a vertical section through the body, dividing it into left and right, called?
A) transverse
B) frontal
C) sagittal
D) regional
23)
24) 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
24)
25) You are asked to draw blood from the median cubital vein. You will search for this vein in the
________.
A) lateral side of the foot
B) hand
C) proximal arm
D) anterior side of the elbow
25)
26) The body cavities that protect the nervous system are located in the ________ cavity.
A) cranial
B) vertebral
C) dorsal
D) ventral
E) thoracic
26)
27) The anatomical position is characterized by all of the following EXCEPT ________.
A) thumbs pointed laterally
B) body erect
C) palms turned posteriorly
D) arms at sides
27)
3
28) 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) 2-1-3-4-5
C) 1-2-3-4-5
28)
D) 2-1-4-3-5
29) 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) movement
B) digestion
C) responsiveness
D) growth
29)
30) You are asked to take a person's heart rate at the popliteal pulse point. You will look for this pulse
________.
A) in the distal end of the lower leg
B) at the posterior side of the wrist
C) on the posterior side of the knee
D) on the palmar side of the hand
30)
31) Which of the following describes the operation of the heart and blood vessels?
A) cardiovascular anatomy
B) cardiovascular physiology
C) systemic physiology
D) systemic anatomy
31)
32) Generally, what is the result of the negative feedback process?
A) to maintain homeostasis
B) to regulate excretion via the kidneys
C) to control body movement
D) to keep the body's blood sugar level high
32)
33) 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) Study of a healthy body provides a foundation for a more complete understanding of all
human bodies.
C) Study of a healthy body is less intimidating and more familiar to new students.
D) A healthy body establishes what "normal" is.
33)
34) Anatomical position is important because ________.
A) it allows diagrams within textbooks to display a greater surface area of the body with one
simple diagram
B) it allows a common point of reference for body position to help communicate anatomical
relationships
C) it is the position most comfortable to hospital patients
D) it provides the greatest circulation to the extremities
34)
35) Which of the following describes a parasagittal plane?
A) any sagittal plane except in the midline
B) any cut dividing the body into anterior and posterior portions
C) two cuts dividing the body into left and right halves
D) a transverse cut just above the knees
35)
4
36) The study of large body structures, visible to the naked eye, such as the heart is called ________
anatomy.
A) gross
B) systemic
C) developmental
D) microscopic
36)
37) The parietal pleura would represent a serous membrane ________.
A) covering the heart
B) lining the abdominal cavity
C) lining the thoracic cavity
D) covering individual lungs
37)
38) What is a vertical section through the body, dividing it into anterior and posterior regions called?
A) median
B) frontal
C) sagittal
D) transverse
38)
39) In which quadrant of the abdominopelvic cavity is the stomach located?
A) left upper quadrant
B) left lower quadrant
C) right upper quadrant
D) right lower quadrant
39)
40) It is wise to study anatomy alongside with physiology because ________.
A) anatomy and physiology are practically the same thing
B) physiology is only explainable in terms of the underlying anatomy
C) it makes for more efficient use of students' and teachers' time
D) to understand anatomy requires complete understanding of physiology
40)
41) Histology would be best defined as a study of ________.
A) tissues
B) cells
C) cell chemistry
D) the gross structures of the body
41)
42) 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 innermost lining of the lungs is composed primarily of a thin tissue called simple
squamous epithelium.
C) The direction of blood flow through the heart is directed by one way valves.
D) The cell-to-cell connections between heart (cardiac) muscle cells are strong. They hold the
tissue together for a life time of forceful contractions.
42)
43) Which of the following is the best explanation for why cells are considered the smallest units of
living things.
A) Cells are highly ordered and complex.
B) Cells cannot be seen with the naked eye and are considered microscopic.
C) Cells have the ability to reproduce identical copies of themselves in a process called mitosis.
D) Cells are the simplest structure to fit all of the characteristics necessary to be considered alive.
43)
44) Choose the anatomical topic and definition that is NOT correctly matched.
A) Embryology: study of the changes in an individual from conception to birth.
B) Gross anatomy: study of structures visible to the eye.
C) Microscopic anatomy: study of structures too small to be seen by the naked eye.
D) Cytology: study of the structures in a particular region.
44)
5
45) A good example of a positive feedback mechanism would be ________.
A) regulating glucose levels in the blood
B) enhancement of labor contractions
C) blood calcium level regulation
D) body temperature regulation
45)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
46) Describe the overlap in function between the muscular system and skeletal system. In
other words, describe how they work together.
46)
Figure 1.2
Using Figure 1.2, match the following descriptions to the most appropriate letter on the diagram:
47) Information about body temperature is sent through afferent pathways to the brain.
47)
48) The term that describes the back of the elbow is ________.
48)
49) Which feedback mechanism causes the variable to deviate further and further from its
original value or range?
49)
6
Figure 1.1
Using Figure 1.1, match the following cavities:
50) Vertebral cavity.
50)
51) Why is anatomical terminology necessary?
51)
52) Describe the opposing ways that the muscular system and integumentary system act as
effectors in the regulation of body temperature.
52)
53) What can happen when the usual negative feedback mechanisms are overwhelmed and
destructive positive feedback mechanisms take over?
53)
54) The heart is ________ to the lungs.
54)
55) The term that describes the neck region is ________.
55)
56) Which cavity contains the bladder, some reproductive organs, and the rectum?
56)
57) Can lungs carry out excretory functions? Explain your answer.
57)
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58) What does the "principle of complementarity of structures and function" mean?
58)
59) Similar cells that have a common function are called ________.
59)
60) What is the pathway between the receptor and the control center in the reflex pathway
called?
60)
61) Describe the overlap in function between the cardiovascular system and respiratory
system. In other words, describe how they work together.
61)
62) Why must a normal body temperature be maintained in order for chemical reactions to be
continued at life-sustaining rates?
62)
63) ________ is explained by chemical and physical principles and is concerned with the
function of specific organs or organic systems.
63)
64) What broad term covers all chemical reactions that occur within the body cells?
64)
8
Figure 1.1
Using Figure 1.1, match the following cavities:
65) Cranial cavity.
65)
66) What is the action of all of the negative feedback mechanisms of the body?
66)
67) Why are the abdominopelvic cavity organs the most vulnerable to blunt deceleration in an
automobile accident with seat belts?
67)
68) 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.
68)
9
Figure 1.1
Using Figure 1.1, match the following cavities:
69) Thoracic cavity.
69)
10
Figure 1.2
Using Figure 1.2, match the following descriptions to the most appropriate letter on the diagram:
70) Appropriate response information is sent through efferent pathways.
70)
71) What is the single most abundant chemical substance in the body?
71)
Figure 1.2
Using Figure 1.2, match the following descriptions to the most appropriate letter on the diagram:
72) Free nerve endings in the skin detect changes in skin temperature (getting warmer).
72)
73) What is the function of the serous membranes?
73)
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74) What is a dynamic equilibrium of your internal environment termed?
74)
75) Which body system would be most affected by a lower than normal atmospheric pressure?
75)
Figure 1.1
Using Figure 1.1, match the following cavities:
76) Abdominal cavity.
76)
77) The ability to sense changes in the environment and respond to them is called ________.
77)
78) What type of homeostatic feedback reflex is the withdrawal reflex?
78)
79) What is the serous membrane that covers the intestines called?
79)
12
Figure 1.2
Using Figure 1.2, match the following descriptions to the most appropriate letter on the diagram:
80) 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.
80)
81) A change in the temperature of the external environment (getting warmer).
81)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
82) Lungs carry out an excretory function.
82)
83) The elbow is proximal to the shoulder.
83)
84) Digital Subtraction Angiography (DSA) imaging is most useful in discovering obstructed blood
supplies in organs and tissues.
84)
85) Positive feedback mechanisms tend to enhance the original stimulus so that the response is
accelerated.
85)
86) The epigastric region is superior to the umbilical region.
86)
87) The right hypochondriac region contains the majority of the stomach.
87)
88) Responsiveness or irritability is the ability to sense changes in the environment and then respond to
them.
88)
89) It is important for any organism to maintain its boundaries, so that its internal environment
remains distinct from the external environment surrounding it.
89)
90) The part of the serous membrane that lines the peritoneal cavity wall is called visceral peritoneum.
90)
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91) Without some sort of negative feedback mechanism, it would be impossible to keep our body
chemistry in balance.
91)
92) Embryology concerns the structural changes that occur in an individual from conception through
old age.
92)
93) A major function of serous membranes is to decrease friction.
93)
94) A tissue consists of groups of similar cells that have a common function.
94)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following cavities and organs:
95) Stomach.
A) Abdominal
95)
Match the following systems to their functions:
96) A functional organ system which
provides a means of protecting us
from foreign invaders.
A) Immune
96)
Match the following examples of feedback mechanisms:
97) Used for blood clotting.
A) Positive feedback
97)
Match the following regional terms and common terms:
98) Knee (anterior aspect).
A) Patellar
98)
Match the following systems and organs:
99) Arteries, veins, heart.
100) Esophagus, large intestine, rectum.
A) Cardiovascular
B) Digestive
99)
100)
Match the following regional terms and common terms:
101) Arm.
A) Brachial
101)
Match the regional/directional terms and examples:
102) The lungs are ________ to the heart.
A) Lateral
102)
Match the following regional terms and common terms:
103) Chest.
A) Thoracic
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103)
Match the following systems and organs:
104) Kidneys, bladder, ureters.
A) Urinary
104)
Match the regional/directional terms and examples:
105) The upper arm is ________ to the
forearm.
A) Proximal
105)
Match the following cavities and organs:
106) Uterus.
A) Pelvic
106)
Match the following systems to their functions:
107) Delivers oxygen and nutrients to the
tissues.
A) Cardiovascular
107)
Match the following systems to their functions:
108) Provides the force to move bones
about their joints.
A) Muscular
108)
Match the following cavities and organs:
109) Heart.
A) Thoracic
109)
Match the following regional terms and common terms:
110) Buttock.
A) Gluteal
110)
Match the following systems and organs:
111) Adrenal glands, pancreas, pituitary.
A) Endocrine
111)
Match the regional/directional terms and examples:
112) The stomach is ________ to the spine.
A) Anterior
113) The fingers are ________ to the wrist.
B) Distal
112)
113)
Match the following systems to their functions:
114) Prevents water loss, entry of germs
into the body and synthesizes vitamin
D.
A) Integumentary
114)
Match the following cavities and organs:
115) Lungs.
A) Thoracic
15
115)
Match the following regional terms and common terms:
116) Head.
A) Cephalic
116)
Match the following systems to their functions:
117) Controls the body with chemical
molecules called hormones.
A) Endocrine
117)
Match the following systems and organs:
118) Trachea, bronchi, alveoli.
A) Respiratory
118)
Match the following examples of feedback mechanisms:
119) Used for childbirth.
A) Negative feedback
120) Used for changes in blood glucose
levels.
B) Positive feedback
119)
120)
Match the following systems to their functions:
121) Provides a ridged framework to
support the body and stores minerals.
122) Responds to environmental changes
by transmitting appropriate electrical
impulses.
A) Nervous
121)
B) Skeletal
122)
Match the regional/directional terms and examples:
123) The bridge of the nose is ________ to
the left eye.
A) Medial
123)
Match the following systems to their functions:
124) Picks up and cleans excess fluid from
tissues.
A) Lymphatic
124)
Match the following examples of feedback mechanisms:
125) Used for changes in blood pressure.
A) Negative feedback
125)
Match the following cavities and organs:
126) Brain.
A) Cranial
16
126)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
127) 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?
128) The nurse charted: "Patient has an open wound located on lateral aspect of leg." Describe where the wound is
located.
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) 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?
131) 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?
17
Answer Key
Testname: 1
1) D
2) A
3) B
4) B
5) D
6) A
7) B
8) B
9) A
10) B
11) B
12) C
13) D
14) D
15) C
16) C
17) A
18) C
19) A
20) D
21) D
22) A
23) C
24) D
25) D
26) C
27) C
28) D
29) D
30) C
31) B
32) A
33) C
34) B
35) A
36) A
37) C
38) B
39) A
40) B
41) A
42) B
43) D
44) D
45) B
46) The skeleton provides the ridged frame work (levers) for muscles to attach to. Muscles provide the force to move the
bones about the joints.
47) C
48) olecranal
49) positive feedback
18
Answer Key
Testname: 1
50) B
51) Anatomical terms are precise words that have limited usage, which prevents confusion when describing the location of
body parts.
52) The integument cools the body through sweat while the muscular system warms the body by shivering.
53) Homeostatic imbalances increase our risk for disease processes and produce the changes we associate with aging.
54) medial
55) cervical
56) pelvic
57) Yes, carbon dioxide is a metabolic waste the lungs excrete.
58) Structure is specific to meet the needs of it's function.
59) tissues
60) afferent pathway
61) 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.
62) 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.
63) Physiology
64) metabolism
65) A
66) They provide a mechanism to maintain levels of substances within physiological limits.
67) 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.
68) The integument prevents entry of pathogens (germs, viruses, bacteria) OR harmful chemicals. The integumentary
system prevents water (body fluid) loss.
69) C
70) D
71) water
72) B
73) They act to reduce friction and allow the organs to slide across cavity walls.
74) homeostasis
75) respiratory system
76) D
77) responsiveness or excitability
78) negative
79) visceral peritoneum
80) E
81) A
82) TRUE
83) FALSE
84) TRUE
85) TRUE
86) TRUE
87) FALSE
88) TRUE
89) TRUE
90) FALSE
91) TRUE
92) FALSE
93) TRUE
94) TRUE
19
Answer Key
Testname: 1
95) A
96) A
97) A
98) A
99) A
100) B
101) A
102) A
103) A
104) A
105) A
106) A
107) A
108) A
109) A
110) A
111) A
112) A
113) B
114) A
115) A
116) A
117) A
118) A
119) B
120) A
121) B
122) A
123) A
124) A
125) A
126) A
127) 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.
128) The wound is located on the outer side of the leg, the peroneal or fibular area.
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) 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.
131) His left upper arm
20
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following elements is necessary for proper conduction of nerve impulses?
A) Na
B) Fe
C) P
D) I
1)
2) Which of the following is an example of a suspension?
A) salt water
B) blood
C) cytosol
2)
D) rubbing alcohol
3) Which type of proteins can function as chemical messengers or as receptors in the plasma
membrane?
A) communication
B) defensive
C) transport
D) enzyme
3)
4) 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
4)
5) What is a chain of more than 50 amino acids called?
A) polysaccharide
B) nucleic acid
5)
C) protein
D) triglyceride
6) Which of the following is NOT considered a factor in influencing a reaction rate?
A) concentration of reactants
B) time
C) temperature
D) particle size
6)
7) 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.
7)
8) Amino acids joining together to make a peptide is a good example of a(n) ________ reaction.
A) synthesis
B) reversible
C) exchange
D) decomposition
8)
9) What does the formula C6 H12O6 mean?
9)
A) There are 6 calcium, 12 hydrogen, and 6 oxygen atoms.
B) The molecular weight is 24.
C) The substance is a colloid.
D) There are 6 carbon, 12 hydrogen, and 6 oxygen atoms.
10) Salts are always ________.
A) double covalent compounds
C) hydrogen bonded
B) ionic compounds
D) single covalent compounds
1
10)
11) In a DNA molecule, the phosphate serves ________.
A) as a code
C) to hold the molecular backbone together
B) as nucleotides
D) to bind the sugars to their bases
11)
12) 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 and become inactive.
B) The enzyme will denature but retain its function.
C) The enzyme will assume an alternate form and catalyze additional reactions.
D) The enzyme will continue to function as it remains unchanged in chemical reactions.
12)
13) The single most abundant protein in the body is ________.
A) collagen
B) glucose
C) DNA
13)
D) hemoglobin
14) 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
14)
15) Which of the following does NOT describe enzymes?
A) Some enzymes are protein plus a cofactor.
B) Enzymes work by raising the energy of activation.
C) Some enzymes are purely protein.
D) Each enzyme is chemically specific.
15)
16) Which of the following is chemically inert (unreactive)?
A) oxygen (atomic number 8)
B) sodium (atomic number 11)
C) neon (atomic number 10)
D) carbon (atomic number 6)
16)
17) If atom X has an atomic number of 74 it would have which of the following?
A) 37 protons and 37 neutrons
B) 74 protons
C) 37 protons and 37 electrons
D) 37 electrons
17)
18) 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) non-polar covalent bonding
C) hydrogen bonding
D) ionic bonding
18)
19) 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) two back-to-back phospholipid layers with the non-polar tails facing out on both sides
B) a single layer of phospholipids with the polar heads facing inside the cell
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 outside the cell
19)
20) 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
20)
21) Carbohydrates are stored in the liver and skeletal muscles in the form of ________.
A) cholesterol
B) triglycerides
C) glycogen
D) glucose
21)
2
22) 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, 8, 8
C) 2
D) 2, 8
22)
23) What is the ratio of fatty acids to glycerol in triglycerides (neutral fats)?
A) 4:1
B) 3:1
C) 2:1
23)
D) 1:1
24) The four elements that make up about 96% of body weight are ________.
A) carbon, oxygen, hydrogen, nitrogen
B) sodium, potassium, hydrogen, oxygen
C) carbon, oxygen, phosphorus, calcium
D) nitrogen, hydrogen, calcium, sodium
24)
25) Choose the answer that best describes HCO3 - .
25)
A) a weak acid
C) a proton donor
B) common in the liver
D) a bicarbonate ion
26) 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) suspension
B) colloid
C) solution
D) mixture
26)
27) What is a cation?
A) a molecule that has both positive and negative charges
B) an atom that shares its valence electrons
C) an atom that loses one or more electrons and acquires a net positive charge
D) an atom that gains one or more electrons and acquires a net negative charge
27)
28) Which of the following would be regarded as an organic molecule?
A) CO2
B) NaOH
C) CH4
28)
D) H2 O
29) What happens in redox reactions?
A) the organic substance that loses hydrogen is usually reduced
B) the reaction is uniformly reversible
C) both decomposition and electron exchange occur
D) the electron acceptor is oxidized
29)
30) Which of the following does NOT describe uses for the ATP molecule?
A) pigment structure
B) transport down their concentration gradient
C) chemical work
D) mechanical work
30)
31) ________ is fat soluble, produced in the skin on exposure to UV radiation, and necessary for normal
bone growth and function.
A) Vitamin K
B) Vitamin A
C) Vitamin D
D) Cortisol
31)
32) Which of the following is incorrectly matched?
A) nucleotide; nucleic acid
C) amino acid; protein
32)
B) eicosanoid; triglyceride
D) monosaccharide; carbohydrate
3
33) ATP ADP + Pi is an example of a(n) ________ reaction.
A) decomposition
B) synthesis
C) reversible
D) exchange
33)
34) In general, the lipids that we refer to as oils at room temperature have ________.
A) unsaturated fatty acids
B) saturated fatty acids
C) long fatty acid chains
D) a high water content
34)
35) 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
35)
36) Which property of water is demonstrated when we sweat?
A) reactivity
B) high heat capacity
C) polar solvent properties
D) high heat of vaporization
E) cushioning
36)
37) Atom X has 17 protons. How many electrons are in its valence shell (outermost energy level)?
A) 7
B) 3
C) 5
D) 10
37)
38) Which of the following statements is FALSE?
A) When acids and bases are mixed, they react with each other to form water and a salt.
B) The more hydrogen ions in a solution, the more acidic the solution.
C) The pH of blood is slightly basic.
D) When the hydrogen ion concentration decreases, the hydroxyl ion concentration also
decreases.
38)
39) Which of the following is a neutralization reaction?
A) NaOH Na+ + OH-
39)
C) NH3 + H+
B) HCl
NH4 +2
H+ + Cl-
D) HCl + NaOH
NaCl + H2 O
40) An atom with an atomic number of 10 and a mass number of 24 would have ________.
A) 14 neutrons
B) 24 protons
C) 14 electrons
D) 10 neutrons
40)
41) Which of the following does NOT characterize proteins?
A) Their function depends on their three-dimensional shape.
B) They may be denatured or coagulated by heat or acidity.
C) They appear to be the molecular carriers of coded hereditary information.
D) They have both functional and structural roles in the body.
41)
42) Which statement about enzymes is FALSE?
A) Enzymes may use coenzymes derived from vitamins or cofactors from metallic elements.
B) Most enzymes can catalyze millions of reactions per minute.
C) Enzymes may be damaged by high temperature.
D) Enzymes require contact with substrate in order to assume their active form.
42)
4
43) What does CH4 mean?
43)
A) There is one carbon and four hydrogen atoms.
B) This was involved in a redox reaction.
C) This is an inorganic molecule.
D) There are four carbon and four hydrogen atoms.
44) An acid with a pH of 6 has ________ hydrogen ions than pure water.
A) 10-fold fewer
B) 100-fold fewer
C) 10-fold more
D) 100-fold more
44)
45) 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
45)
46) The chemical symbol O=O means ________.
A) the atoms are double bonded
B) both atoms are bonded and have zero electrons in the outer orbit
C) zero equals zero
D) this is an ionic bond with two shared electrons
46)
47) Starch is a ________.
A) triglyceride
C) polysaccharide
47)
B) disaccharide
D) monosaccharide
48) 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
48)
this imbalance?
CO2 + H2 O
H2 CO3
H+ + HCO3 -
A) HCO3 - binds with H+ to form H2 CO3 and lower pH
B) HCO3 - binds with H+ to form H2 CO3 and raise pH
C) H2 CO3 dissociates to form more H+ and raise pH
D) H2 CO3 dissociates to form more H+ and lower pH
49) How many phosphates would ADP have attached to it?
A) none
B) two
C) three
D) one
50) The basic structural material of the body consists of ________.
A) lipids
B) proteins
C) nucleic acids
D) carbohydrates
49)
50)
51) When frying an egg, the protein albumin denatures and maintains only its ________ structure.
A) secondary
B) quaternary
C) tertiary
D) primary
51)
52) 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) non-polar covalent bonds
C) ionic bonds
D) polar covalent bonds
52)
5
53) The genetic information is coded in DNA by the ________.
A) arrangement of the histones
B) three-dimensional structure of the double helix
C) sequence of the nucleotides
D) regular alteration of sugar and phosphate molecules
53)
54) What type of chemical bond can form between an atom with 11 protons and an atom with 17
protons?
A) hydrogen
B) ionic
C) non-polar covalent
D) polar covalent
54)
55) Starch is the stored carbohydrate in plants, while ________ is the stored carbohydrate in animals.
A) cellulose
B) glucose
C) triglyceride
D) glycogen
55)
56) With a family history of cardiovascular disease, which toast spread would be considered the most
"heart healthy"?
A) lard (pig fat)
B) olive oil
C) butter containing butterfat
D) margarine containing trans fats
56)
57) Which of the following is a general function for a fibrous protein?
A) catalysis
B) protein management
C) structural framework
D) transport
E) body defense
57)
58) Select the most correct statement regarding nucleic acids.
A) RNA is a long, single-stranded molecule made up of the bases A, T, G, and C.
B) DNA is a long, double-stranded molecule made up of A, T, G, and C bases.
C) Three forms exist: DNA, RNA, and tDNA.
D) tDNA is considered a "molecular slave" of DNA during protein synthesis.
58)
59) 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) collagen
C) molecular chaperone
D) actin
59)
60) Forming glycogen as energy storage in the liver is an example of ________.
A) oxidation
B) exergonic
C) anabolism
D) catabolism
60)
61) Which of the following is the major positive ion outside cells?
A) potassium
B) hydrogen
C) magnesium
D) sodium
62) Select which reactions will usually be irreversible regarding chemical equilibrium in human
bodies.
A) glucose molecules joined to make glycogen
B) glucose to CO2 and H2 O
C) H2 O + CO2 to make H2 CO3
D) ADP + Pi to make ATP
6
61)
62)
63) An atom with 3 electrons in its outermost (valence) shell may have a total of ________ electrons
altogether.
A) 3
B) 8
C) 17
D) 13
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
Figure 2.2
Using Figure 2.2, match the following:
64) Thymine.
64)
65) Name at least four things you know about enzymes.
65)
66) What advantages does ATP have in being the energy currency molecule?
66)
67) In the compound H2CO3 , what do the numbers 2 and 3 represent?
67)
68) All chemical reactions are theoretically reversible. Comment on this statement.
68)
7
63)
69) A chemical bond never occurs between components of a mixture. Discuss this.
69)
70) What properties does water have that make it a very versatile fluid?
70)
71) Protons and electrons exist in every atom nucleus except hydrogen. Is this statement true
or false and why?
71)
Figure 2.2
Using Figure 2.2, match the following:
72) Deoxyribose sugar.
72)
73) What is the major difference between polar and nonpolar covalent bonds?
73)
8
Figure 2.1
Using Figure 2.1, match the following:
74) Nucleotide.
74)
75) Monosaccharide.
75)
76) 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?
76)
9
Figure 2.1
Using Figure 2.1, match the following:
77) Polymer.
77)
78) Tertiary (protein) structure.
78)
79) How can phospholipids form a film when mixed in water?
79)
10
Figure 2.1
Using Figure 2.1, match the following:
80) Lipid.
80)
11
Figure 2.2
Using Figure 2.2, match the following:
81) Phosphate.
81)
82) Explain why water is considered to have partial charges even though it is sharing electrons
in a polar covalent bond.
82)
83) If all protons, electrons, and neutrons are alike, regardless of the atom considered, what
determines the unique properties of each element?
83)
12
Figure 2.2
Using Figure 2.2, match the following:
84) Hydrogen bonds.
84)
85) Describe the factors that affect chemical reaction rates.
85)
86) What happens when globular proteins are denatured?
86)
87) Explain the difference between potential and kinetic energy.
87)
13
Figure 2.1
Using Figure 2.1, match the following:
88) Functional protein.
88)
89) An amino acid may act as a proton acceptor or donor. Explain.
89)
14
Figure 2.1
Using Figure 2.1, match the following:
90) Polysaccharide.
90)
15
Figure 2.2
Using Figure 2.2, match the following:
91) Guanine.
91)
92) Are all chemical reactions reversible? If not, why aren't they all reversible?
92)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
93) Triglycerides are a poor source of stored energy.
93)
94) A chemical bond is an energy relationship between outer electrons and neighboring atoms.
94)
95) 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.
95)
96) The pH of body fluids must remain fairly constant for the body to maintain homeostasis.
96)
16
97) A charged particle is generally called an ion or electrolyte.
97)
98) 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.
98)
99) Buffers resist abrupt and large changes in the pH of body fluids by releasing or binding ions.
99)
100) Glucose is an example of a monosaccharide.
100)
101) The sharing of electrons in covalent bonds makes them stronger than ionic and hydrogen bonds.
101)
102) About 60% to 80% of the volume of most living cells consists of organic compounds.
102)
103) A dipeptide can be broken into two amino acids by dehydration synthesis.
103)
104) The lower the pH, the higher the hydrogen ion concentration.
104)
105) Glycogen, the storage form of glucose, is primarily stored in skeletal muscle and liver cells.
105)
106) The acidity of a solution reflects the concentration of free hydrogen ions in the solution.
106)
107) Omega-3 fatty acids appear to decrease the risk of heart disease.
107)
108) It is the difference in the R group that makes each amino acid chemically unique.
108)
109) Chemical properties are determined primarily by neutrons.
109)
110) Isotopes differ from each other only in the number of electrons the atom contains.
110)
111) All organic compounds contain carbon except CO2 and CO.
111)
112) Mixtures are combinations of elements or compounds that are physically blended together but are
not bound by chemical bonds.
112)
113) The fact that no chemical bonding occurs between the components of a mixture is the chief
difference between mixtures and compounds.
113)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following chemical bonds to the correct description:
114) A type of bond important in tying
different parts of the same molecule
together into a three-dimensional
structure.
A) Hydrogen bond
17
114)
Match the following:
115) Is a function of, and varies with,
gravity.
A) Weight
115)
Match the following:
116) Dry ice (frozen carbon dioxide).
A) Compound
116)
Match the following:
117) Two or more polypeptide chains, each
with its own tertiary structure.
A) Quaternary
117)
Match the following particles to the correct description:
118) Smallest particle of an element that
retains its properties.
A) Atom
118)
Match the following:
119) Legs moving the pedals of a bicycle.
A) Mechanical energy
119)
Match the following:
120) Protein structure represented by
alpha-helices and beta-sheets.
A) Secondary
120)
Match the following:
121) Energy that travels in waves. Part of
the electromagnetic spectrum.
A) Radiant energy
121)
Match the following:
122) Combined number of protons and
neutrons in an atom.
A) Mass number of an element
122)
Match the following chemical bonds to the correct description:
123) A bond in which electrons are shared
equally.
A) Nonpolar covalent bond
123)
Match the following:
124) Saline.
A) Solution
18
124)
Match the following:
125) Represented by the flow of charged
particles along a conductor, or the
flow of ions across a membrane.
A) Electrical energy
125)
Match the following:
126) Although a man who weighs 175
pounds on Earth would be lighter on
the moon and heavier on Jupiter, his
________ would not be different.
A) Mass
126)
Match the following particles to the correct description:
127) Negatively charged subatomic
particle.
128) Positively charged subatomic particle.
A) Electron
127)
B) Proton
128)
Match the following:
129) 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.
A) Tertiary
129)
Match the following:
130) Usually, the first one or two letters of
an element's name.
A) Atomic symbol
130)
Match the following chemical bonds to the correct description:
131) A bond in which electrons are
completely lost or gained by the atoms
involved.
A) Polar covalent bond
131)
B) Ionic bond
132) A bond in which electrons are shared
unequally.
132)
Match the following:
133) Number of protons in an atom.
A) Atomic number
133)
Match the following:
134) Blood.
A) Suspension
19
134)
Match the following:
135) Anything that occupies space and has
mass.
A) Matter
135)
Match the following:
136) Water.
A) Compound
136)
Match the following:
137) When the bonds of ATP are broken,
energy is released to do cellular work.
A) Chemical energy
137)
Match the following particles to the correct description:
138) Subatomic particle having an AMU
(Atomic Mass Unit) of zero.
A) Electron
138)
Match the following:
139) Can be measured only by its effects on
matter.
A) Energy
139)
Match the following particles to the correct description:
140) Neutral subatomic particle.
A) Neutron
140)
Match the following:
141) The sequence of amino acids that form
the polypeptide chain.
A) Primary
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) 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.
144) How can DNA be used to "fingerprint" a suspect in a crime?
145) 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.
146) 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?
20
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) 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?
21
Answer Key
Testname: 2
1) A
2) B
3) A
4) C
5) C
6) B
7) D
8) A
9) D
10) B
11) C
12) A
13) A
14) C
15) B
16) C
17) B
18) C
19) C
20) A
21) C
22) A
23) B
24) A
25) D
26) B
27) C
28) C
29) C
30) A
31) C
32) B
33) A
34) A
35) A
36) D
37) A
38) D
39) D
40) A
41) C
42) D
43) A
44) C
45) A
46) A
47) C
48) D
49) B
50) B
22
Answer Key
Testname: 2
51) D
52) A
53) C
54) B
55) D
56) B
57) C
58) B
59) B
60) C
61) D
62) B
63) D
64) D
65) 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.
66) 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.
67) 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.
68) 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.
69) 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.
70) High heat capacity, high heat of vaporization, polar solvent properties, reactivity, and cushioning.
71) 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.
72) B
73) 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.
74) E
75) A
76) HCl ionizes to form current-conducting electrolytes. Dextrose does not ionize, and therefore does not conduct current.
77) C
78) B
79) Phospholipids have both polar and nonpolar ends. The polar end interacts with water, leaving the nonpolar end
oriented in the opposite direction.
80) D
81) C
23
Answer Key
Testname: 2
82) 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.
83) Atoms of different elements are composed of different numbers of protons, electrons, and neutrons.
84) A
85) 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.
86) The active sites are destroyed.
87) Potential energy is inactive stored energy that has potential to do work. Kinetic energy is energy in action.
88) B
89) 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.
90) C
91) E
92) All chemical reactions are theoretically reversible, but only if the products are not consumed and enough energy is
available for the reaction.
93) FALSE
94) TRUE
95) FALSE
96) TRUE
97) TRUE
98) TRUE
99) TRUE
100) TRUE
101) TRUE
102) FALSE
103) FALSE
104) TRUE
105) TRUE
106) TRUE
107) TRUE
108) TRUE
109) FALSE
110) FALSE
111) TRUE
112) TRUE
113) TRUE
114) A
115) A
116) A
117) A
118) A
119) A
120) A
121) A
122) A
123) A
124) A
125) A
24
Answer Key
Testname: 2
126) A
127) A
128) B
129) A
130) A
131) B
132) A
133) A
134) A
135) A
136) A
137) A
138) A
139) A
140) A
141) A
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) 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.
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) 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.
146) Cholesterol is produced by the liver, in addition to being ingested in foods.
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) When an acid and base of equal strength are mixed, they undergo a displacement (neutralization) reaction to form
water and a salt.
25
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) 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 delay mitosis by preventing S phase.
B) It would have little or no effect on mitosis.
C) It will arrest mitosis by preventing the formation of spindle microtubules.
D) It will enhance mitosis by moving chromosome toward the spindle equator.
1)
2) Which of the following is a function of a plasma membrane protein?
A) forms a lipid bilayer
B) circulating antibody
C) molecular transport through the membrane
D) oxygen transport
2)
3) Crenation (shrinking) is likely to occur in blood cells immersed in ________.
A) an isotonic solution
B) a hypotonic solution
C) blood plasma
D) a hypertonic solution
3)
4) Which of the following would NOT assist in establishing a resting membrane potential?
A) Selective diffusion allowing fewer positively charged ions to diffuse into the cell.
B) Selective diffusion allowing more uncharged particles into the cell.
C) Selective diffusion allowing more positively charged ions to diffuse out of the cell.
D) Having greater concentration of glycolipids on the outside surface of the membrane.
4)
5) 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) mitochondria, and cilia
B) cytoskeleton, and peroxisomes
C) smooth endoplasmic reticulum, and lysosomes
D) Golgi apparatus, rough endoplasmic reticulum
5)
6) The movement of water across the plasma membrane can be described by all of the following
EXCEPT ________.
A) simple diffusion
B) carrier-mediated facilitated diffusion
C) passive membrane transport
D) facilitated diffusion through aquaporins
6)
7) 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) cells of the immune system recognizing the tumorous cells as foreign and destroying them
C) a decrease in the permeability of the tumor cell's plasma membrane preventing the uptake of
chemotherapy drugs
D) allowing the cancer cells to bind to their healthy, neighboring cells
7)
1
8) 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 concentration gradient for oxygen is steepness inside of the cell
B) oxygen will passively diffuse into the cells
C) the rate of oxygen diffusion is independent of concentration
D) oxygen requires active transport to enter most cells
8)
9) A cell engulfing a relatively large particle will likely utilize ________.
A) exocytosis
B) receptor-mediated endocytosis
C) phagocytosis
D) pinocytosis
9)
10) 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) Increasing the number of digestive enzymes in the digestive tract.
B) Increasing the concentration of glucose outside of the cell.
C) Lowering the energy of activation.
D) Stopping the activity of the sodium potassium pump.
10)
11) 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) ribosome
B) chromosome
C) centrosome
D) centriole
11)
12) Which of the following would NOT be restricted (limited) by low levels of ATP?
A) pinocytosis
B) phagocytosis
C) osmosis
D) exocytosis
12)
13) If active transport establishes a concentration gradient with the use of ATP, then the concentration
gradient can be looked at as ________.
A) potential energy that can be harnessed when molecules passively diffuse down the
concentration gradient
B) unwanted pressure that will be alleviated by channel mediated facilitated diffusion
C) a byproduct of active transport that will be alleviated by pinocytosis
D) an unusable byproduct of active transport that will simply diffuse away
13)
14) Which of the following is NOT one of the concepts collectively known as the cell theory?
A) All cells must be motile and divide.
B) Cells only arise from other cells.
C) The cell is the smallest unit of life.
D) All organisms are made of one or more cells.
14)
15) Which of the following is NOT a function of the smooth endoplasmic reticulum?
A) steroid-based hormone synthesis
B) breakdown of stored glycogen to form free glucose
C) protein synthesis in conjunction with ribosomes
D) lipid metabolism and cholesterol synthesis
15)
2
16) Which of the following would NOT be a constituent of a plasma membrane?
A) messenger RNA
B) phospholipids
C) glycoproteins
D) glycolipids
16)
17) 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) transport proteins
B) desmosomes
C) glycolipids
D) tight junctions
17)
18) Which of the following statements is correct regarding net diffusion?
A) The lower the temperature, the faster the rate.
B) The rate is independent of temperature.
C) Molecular weight of a substance does not affect the rate.
D) The greater the concentration gradient, the faster the rate.
18)
19) In which stage of mitosis do the identical sets of chromosomes line up along the midline or equator
of the cell?
A) anaphase
B) telophase
C) metaphase
D) prophase
19)
20) If a tRNA had an AGC anticodon, it could attach to a(n) ________ mRNA codon.
A) UCG
B) AUG
C) TCG
D) UGA
20)
21) Which of the following is NOT a factor that binds cells together?
A) glycolipids in the glycocalyx
B) wavy contours of the membranes of adjacent cells
C) special membrane junctions
D) glycoproteins in the glycocalyx
21)
22) If a cell is selectively reducing the concentration of a particular enzyme in the extracellular fluid it
will likely utilize ________.
A) exocytosis
B) pinocytosis
C) receptor-mediated endocytosis
D) phagocytosis
22)
23) Some hormones enter cells via ________.
A) receptor-mediated endocytosis
C) pinocytosis
23)
B) primary active transport
D) exocytosis
24) Which of the following structures would aid a cell in allowing more nutrients to be absorbed by the
cell?
A) primary cilia
B) flagella
C) stereocilia
D) microvilli
24)
25) 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) cytoskeleton
B) smooth endoplasmic reticulum
C) mitochondria
D) lysosomes
25)
3
26) Which of the following statements is most correct regarding the intracellular chemical signals
known as "second messengers"?
A) Second messengers usually act to remove nitric oxide (NO) from the cell.
B) Cyclic AMP and calcium may be second messengers.
C) Second messengers usually inactivate protein kinase enzymes.
D) Second messengers act through receptors called K-proteins.
26)
27) Which transport process is the main mechanism for the movement of most macromolecules by
body cells?
A) pinocytosis
B) receptor-mediated endocytosis
C) phagocytosis
D) secondary active transport
27)
28) In certain kinds of muscle cells, calcium ions are stored in ________.
A) the cytoplasm
B) both smooth and rough ER
C) the rough ER
D) the smooth ER
28)
29) Which vesicular transport process occurs primarily in some white blood cells and macrophages?
A) phagocytosis
B) pinocytosis
C) intracellular vesicular trafficking
D) exocytosis
29)
30) If a cell is non-selectively engulfing samples of extracellular fluid, for example to absorb nutrients,
it will likely utilize ________.
A) exocytosis
B) pinocytosis
C) phagocytosis
D) receptor-mediated endocytosis
30)
31) 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 pump
B) a carrier protein
C) a channel
D) a symporter
31)
32) Which of the following statements is correct regarding RNA?
A) Messenger RNA, transfer RNA, and ribosomal RNA play a role in protein synthesis.
B) If the base sequence of DNA is ATTGCA, the messenger RNA template will be UCCAGU.
C) rRNA is always attached to the rough ER.
D) There is exactly one specific type of mRNA for each amino acid.
32)
33) 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) ACGTT
B) TGCAA
C) UGCAA
D) GUACC
33)
34) 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 stable, less fluid, and less permeable.
B) The plasma membrane would become more permeable to ions and less permeable to lipids.
C) The plasma membrane would become more fluid and the phospholipids less stable.
D) The cell would form a plaque that could potentially block a blood vessel.
34)
4
35) 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) desmosomes
B) gap junctions
C) connexons
D) tight junctions
35)
36) A red blood cell placed in pure water would ________.
A) neither shrink nor swell
B) shrink
C) swell and burst
D) swell initially, then shrink as equilibrium is reached
36)
37) Which of these is an inclusion, not an organelle?
A) cilia
B) melanin
37)
C) lysosome
D) microtubule
38) The RNA responsible for bringing the amino acids to the ribosome for protein formation is
________.
A) ssRNA
B) mRNA
C) rRNA
D) tRNA
38)
39) 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) desmosomes
B) transport proteins
C) Cell Adhesion Molecules (CAMs)
D) G-proteins
39)
40) Which of the following is NOT a function of lysosomes?
A) breaking down bone to release calcium ions into the blood
B) degrading worn-out or nonfunctional organelles
C) digesting particles taken in by endocytosis
D) help in the formation of cell membranes
40)
41) 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
41)
42) Passive membrane transport processes include ________.
A) the use of transport proteins when moving substances from areas of low to high concentration
B) movement of a substance down its concentration gradient
C) movement of water from an area of high solute concentration to an area of low concentration
D) consumption of ATP
42)
43) Mitochondria ________.
A) contain some of the DNA and RNA code necessary for their own function
B) contain digestive enzymes called acid hydrolyses
C) synthesize proteins for use outside the cell
D) are single-membrane structures involved in the breakdown of ATP
43)
5
44) Which of the following will NOT speed up the net rate of diffusion for glucose into a cell?
A) Decreasing the concentration of glucose within the cell.
B) Increasing the concentration of glucose outside of the cell.
C) Increasing the number of glucose transport proteins within the plasma membrane.
D) Decreasing the number of phospholipids in the plasma membrane.
44)
45) Which of the following is a principle of the fluid mosaic model of cell membrane structure?
A) All proteins associated with the cell membrane are contained in a fluid layer on the outside of
the cell.
B) Phospholipids consist of a polar head and a nonpolar tail made of three fatty acid chains.
C) The lipid bilayer is a solid at body temperature, thus protecting the cell.
D) Phospholipids form a bilayer that is largely impermeable to water-soluble molecules.
45)
46) Which of the following describes the plasma membrane?
A) a membrane composed of tiny shelves or cristae
B) a phospholipid bilayer surrounding the cell
C) a single-layered membrane that surrounds the nucleus of the cell
D) a double layer of protein enclosing the plasma
46)
47) Peroxisomes ________.
A) are able to detoxify substances by enzymatic action
B) sometimes function as secretory vesicles
C) are functionally the same as lysosomes
D) function to digest particles ingested by endocytosis
47)
48) Riboswitches are folded RNAs that act as switches to turn protein synthesis on or off in response to
________.
A) specific codes from the DNA
B) the presence or absence of ubiquitins
C) specific tRNAs
D) changes in the environment
48)
49) Which of the following is FALSE regarding the membrane potential?
A) The resting membrane potential is determined mainly by the concentration gradients and
differential permeability of the plasma membrane to K+ and Na+ ions.
B) In their resting state, all body cells exhibit a resting membrane potential.
C) The resting membrane potential is maintained solely by passive transport processes.
D) The resting membrane potential occurs due to active transport of ions across the membrane
due to the sodium-potassium pump.
49)
50) A gene can best be defined as ________.
A) a three-base triplet that specifies a particular amino acid
B) an RNA messenger that codes for a particular polypeptide
C) a segment of DNA that carries the instructions for one polypeptide chain
D) noncoding segments of DNA up to 100,000 nucleotides long
50)
51) The functions of centrioles include ________.
A) providing a whiplike beating motion to move substances along cell surfaces
B) producing ATP
C) organizing the mitotic spindle in cell division
D) serving as the site for ribosomal RNA synthesis
51)
6
52) 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 shrink at first, but will later reach equilibrium with the surrounding solution
and return to their original condition.
C) The cells will lose water and shrink.
D) The cells will swell and ultimately burst.
52)
53) Mitosis ________.
A) is always a part of the cell cycle
B) is division of the genetic material within the nucleus
C) is the formation of sex cells
D) creates diversity in genetic potential
53)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
54) 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.
54)
55) How are the products of free ribosomes different from membrane-bound ribosomes?
55)
Figure 3.2
Using Figure 3.2, match the following:
56) Glycocalyx.
56)
7
Figure 3.1
Using Figure 3.1, match the following:
57) Site of synthesis of lipid and steroid molecules.
57)
8
Figure 3.2
Using Figure 3.2, match the following:
58) Polar region of phospholipid.
58)
59) ________ is the division of the cytoplasmic mass into two parts.
59)
60) List possible causes of aging.
60)
61) The process of discharging particles from inside a cell to the outside is called ________.
61)
62) Describe two important functions of the Golgi apparatus.
62)
9
Figure 3.2
Using Figure 3.2, match the following:
63) Nonpolar region of phospholipid.
63)
64) Are random moments of particles, diffusion, and osmosis seen only in living tissue?
64)
10
Figure 3.1
Using Figure 3.1, match the following:
65) When ruptured it releases the enzymes responsible for autolysis.
65)
66) How is the resting potential formed? How is it maintained?
66)
67) What factors contribute to the fragility of the lysosome and subsequent cell autolysis?
67)
11
Figure 3.1
Using Figure 3.1, match the following:
68) Produces ATP aerobically.
68)
69) Replicate for cell division.
69)
70) Briefly describe the glycocalyx and its functions.
70)
71) Compare a gap junction to a channel protein, how are they alike and how are the different?
71)
72) The phase of a cell life cycle in which the DNA is replicated is called ________.
72)
73) Aerobic cellular respiration occurs in the ________.
73)
74) Why can we say that a cell without a nucleus will ultimately die?
74)
75) Why can we say that cells are protein factories?
75)
76) The RNA that has an anticodon and attaches to a specific amino acid is ________ RNA.
76)
77) What processes maintain a steady state "resting" membrane potential?
77)
12
Figure 3.1
Using Figure 3.1, match the following:
78) Site of enzymatic breakdown of phagocytized material.
78)
79) 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.
79)
80) The most common intracellular cation is ________.
80)
81) 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.
81)
82) Other than the nucleus, which organelle has its own DNA?
82)
13
Figure 3.2
Using Figure 3.2, match the following:
83) Hydrophilic portion of phospholipid.
83)
84) Briefly name the subphases of interphase and tell what they do.
84)
85) What are lipid rafts? What are their functions?
85)
86) How are peroxisomes different from lysosomes?
86)
14
Figure 3.1
Using Figure 3.1, match the following:
87) Packages proteins for insertion in the cell membrane or for exocytosis.
15
87)
Figure 3.2
Using Figure 3.2, match the following:
88) Unique glycoproteins and glycolipids involved in cell recognition.
88)
89) What are nucleolar organizer regions?
89)
16
Figure 3.1
Using Figure 3.1, match the following:
90) Forms the mitotic spindle.
90)
17
Figure 3.2
Using Figure 3.2, match the following:
91) Integral protein.
91)
92) Water may move through membrane pores constructed by transmembrane proteins called
________.
92)
93) A red blood cell would swell if its surrounding solution were ________.
93)
94) What are cell exons and introns?
94)
18
Figure 3.2
Using Figure 3.2, match the following:
95) Peripheral protein.
95)
96) If a sequence of nucleotides on one strand of DNA is CCGATT, what would the
complementary sequence look like on the other strand?
96)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
97) Aquaporins are believed to be present in red blood cells and kidney tubules, but not in any other
cells in the body.
97)
98) Microfilaments are thin strands of the contractile protein composed of myosin.
98)
99) Introns represent a genome scrap yard that provides DNA segments for genome evolution and a
variety of small RNA molecules.
99)
100) The speed of individual particle diffusion is influenced by temperature and particle size, not by
concentration.
100)
101) Concentration differences cause ionic imbalances that polarize the cell membrane, and active
transport processes.
101)
102) The glycocalyx is composed of glycolipids, glycoproteins, and cholesterol molecules that are
displayed on the outside surface of the plasma membrane.
102)
19
103) Each daughter cell resulting from mitotic cell division has exactly the same genetic composition.
103)
104) Dividing cells must pass through the phases of mitosis in the following order: Prophase,
Metaphase, Anaphase, and Telophase.
104)
105) DNA transcription is another word for DNA replication.
105)
106) Apoptosis is programmed cell death; cancer cells do not undergo this process.
106)
107) Interstitial fluid represents one type of extracellular material.
107)
108) 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.
108)
109) Microtubules are hollow tubes made of subunits of the protein tubulin.
109)
110) Enzymes and proteins needed for cell division are synthesizes and put into place during G2 phase.
110)
111) Telomeres are the regions of chromosomes that code for the protein ubiquitin.
111)
112) DNA replication requires an enzyme called RNA polymerase and results in a semi-conserved new
molecule of DNA.
112)
113) Phagocytosis is used by the cells to secrete intracellular substances to the outside of the cell.
113)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
114) This organelle modifies, concentrates,
and packages the proteins and lipids
made at the RER for domestic use or
export.
A) Golgi apparatus
114)
Match the following:
115) Help prevent molecules from passing
through the extracellular space
between adjacent cells.
A) Tight junctions
115)
Match the following:
116) Attaches the correct amino acid to its
transfer RNA.
A) Synthetase enzymes
116)
Match the following:
117) The organelle that facilitates peptic
bond formation between amino acids.
A) Ribosomes
20
117)
118) 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.
A) Cytoskeleton
118)
Match the following:
119) Present in electrically excitable tissues.
A) Gap junctions
120) Type of anchoring junction.
B) Desmosomes
119)
120)
Match the following:
121) Forms part of the subunits for the
protein synthesizing organelle.
A) Ribosomal RNA
121)
Match the following:
122) Chromosomes align on the spindle
equator.
123) Centrioles move to opposite ends of
the cell.
A) Early prophase
122)
B) Metaphase
123)
Match the following:
124) A molecule that binds to a specific
codon and specific amino acid
simultaneously.
A) Transfer RNA
124)
Match the following:
125) This organelle contains oxidases and
catalases.
A) Peroxisomes
125)
Match the following:
126) Provides the energy needed for
synthesis reactions.
A) ATP
126)
Match the following:
127) The vast majority of the cell's genetic
material is housed here.
A) Nucleus
21
127)
Match the following:
128) Chromosomal centromeres split and
chromosomes migrate to opposite
ends of the cell.
A) Anaphase
128)
Match the following:
129) Allows ions and small molecules to
pass through from one cell to another.
A) Gap junctions
129)
Match the following:
130) Produced in the nucleus, this molecule
specifies the exact sequence of amino
acids of the protein to be made.
A) Messenger RNA
130)
Match the following:
131) Nuclear membrane and nucleolus
disintegrate.
132) Chromosomes uncoil to form
chromatin.
A) Telophase
131)
B) Late prophase
132)
Match the following:
133) Abundant in tissues subjected to great
mechanical stress.
A) Desmosomes
133)
Match the following:
134) May be attached to the ER or scattered
in the cytoplasm.
A) Ribosomal RNA
134)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
135) Describe the difference in cell division between normal cells and cancer cells.
136) 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.
137) 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?
138) 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?
139) 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?
22
140) A patient was admitted to the hospital for severe dehydration. Explain what changes occur in extracellular and
intracellular fluid compartments during dehydration.
23
Answer Key
Testname: 3
1) C
2) C
3) D
4) B
5) D
6) B
7) B
8) B
9) C
10) D
11) D
12) C
13) A
14) A
15) C
16) A
17) B
18) D
19) C
20) C
21) A
22) C
23) A
24) D
25) C
26) B
27) B
28) D
29) A
30) B
31) D
32) A
33) C
34) A
35) A
36) C
37) B
38) D
39) C
40) D
41) C
42) A
43) A
44) D
45) D
46) B
47) A
48) D
49) C
50) C
24
Answer Key
Testname: 3
51) C
52) D
53) B
54) 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.
55) 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.
56) A
57) A
58) B
59) Cytokinesis
60) 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
61) exocytosis
62) To modify, sort, and package proteins.
63) C
64) No. Because they are passive processes that do not require energy, they can occur in the absence of any cellular
processes.
65) C
66) 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.
67) cell injury, cell oxygen deprivation, presence of excessive amounts of vitamin A in the cell
68) B
69) D
70) 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.
71) 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.
72) S phase of interphase
73) mitochondria
74) 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.
75) 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.
76) transfer
77) Both diffusion and active transport mechanisms operate within the cell membrane to maintain a resting membrane
potential.
78) C
79) 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.
80) potassium
25
Answer Key
Testname: 3
81) 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.
82) Mitochondria
83) B
84) 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.
85) They are assemblies of saturated phospholipids associated with sphingolipids and cholesterol. They are concentrating
platforms for molecules needed for cell signaling.
86) 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.
87) E
88) A
89) nuclear regions containing the DNA that issues genetic instructions for synthesizing ribosomal RNA
90) D
91) D
92) aquaporins
93) hypotonic
94) 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.
95) E
96) The complementary strand would be GGCTAA since C bonds with G and A bonds with T.
97) FALSE
98) FALSE
99) TRUE
100) TRUE
101) TRUE
102) FALSE
103) TRUE
104) TRUE
105) FALSE
106) TRUE
107) TRUE
108) FALSE
109) TRUE
110) TRUE
111) FALSE
112) FALSE
113) FALSE
114) A
115) A
116) A
117) A
118) A
119) A
120) B
26
Answer Key
Testname: 3
121) A
122) B
123) A
124) A
125) A
126) A
127) A
128) A
129) A
130) A
131) B
132) A
133) A
134) A
135) 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.
136) 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.
137) 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.
138) 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.
139) 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.
140) 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.
27
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Inability to absorb digested nutrients and secrete mucus might indicate a disorder in which
epithelial tissue?
A) simple columnar
B) stratified squamous
C) transitional
D) simple squamous
1)
2) 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) sebaceous
D) exocrine
2)
3) Chondroblasts ________.
A) within the cartilage divide and secrete new matrix
B) are mature cartilage cells located in spaces called lacunae
C) remain in compact bone even after the epiphyseal plate closes
D) never lose their ability to divide
3)
4) Which of the following is NOT a step in tissue repair?
A) inflammation
B) formation of new stem cells
C) restoration of blood supply
D) regeneration and fibrosis
4)
5) Which tissue type is formed by many cells joining together, which are multinucleated?
A) smooth muscle
B) dense regular
C) cardiac muscle
D) skeletal muscle
5)
6) Select the correct statement regarding the stem cells of connective tissue.
A) Connective tissue does not contain cells.
B) Chondroblasts are the main cell type of connective tissue proper.
C) Connective tissue cells are nondividing.
D) "Blast" cells are undifferentiated, actively dividing cells.
6)
7) 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) hydroxyapatite crystals
C) collagen fibers
D) reticular fibers
7)
8) Which of the following is true about the mode of secretion of exocrine glands?
A) Merocrine glands are not altered by the secretory process.
B) Holocrine cells are slightly damaged by the secretory process, but repair themselves.
C) These glands are ductless.
D) Apocrine cells are destroyed, then replaced, after secretion.
8)
9) Which type of connective tissue serves as the universal packing material between other tissues?
A) areolar connective tissue
B) reticular connective tissue
C) adipose
D) hyaline cartilage
9)
1
10) A substance received or given off by your body will likely pass through which tissue type?
A) muscle tissue
B) epithelial tissue
C) connective tissue
D) nervous tissue
10)
11) Which of the following is true about epithelia?
A) Endothelium provides a slick surface lining all hollow cardiovascular organs.
B) Stratified epithelia are associated with filtration.
C) Pseudostratified epithelia are commonly keratinized.
D) Simple epithelia are commonly found in areas of high abrasion.
11)
12) The salivary glands are a good example of a ________ exocrine gland.
A) compound alveolar
B) compound tubular
C) compound tubuloalveolar
D) simple branched alveolar
12)
13) Which of the following is a modification of the simple columnar epithelium that allows for efficient
absorption along portions of the digestive tract?
A) cilia
B) thin and permeable
C) dense microvilli
D) fibroblasts
13)
14) Which tissue type would likely function to hold the kidneys in place?
A) reticular
B) smooth muscle
C) adipose
14)
D) dense regular
15) ________ epithelium appears to have two or three layers of cells, but all the cells are in contact with
the basement membrane.
A) Transitional
B) Stratified cuboidal
C) Pseudostratified columnar
D) Stratified columnar
15)
16) How is hyaline cartilage different from elastic cartilage or fibrocartilage?
A) It contains more nuclei.
B) Fibers are not normally visible.
C) It allows great flexibility.
D) It is more vascularized.
16)
17) Select the correct statement regarding tissue repair.
A) Granulation tissue is highly susceptible to infection.
B) Inflammation causes capillaries to dilate and become permeable.
C) The clot is formed from dried blood and transposed collagen fibers.
D) Granulation tissue is another name for a blood clot.
17)
18) Choose which tissue type likely functions to add support to an organ.
A) transitional
B) stratified squamous epithelium
C) hyaline cartilage
D) cardiac muscle
18)
19) What are the three main components of connective tissue?
A) collagen, elastin, and reticular fibers
B) fibroblasts, chondroblasts, and osteoblasts
C) ground substance, fibers, and cells
D) alveoli, fibrous capsule, and secretory cells
19)
20) Blood vessels keep clots from sticking as long as their ________ is intact and healthy.
A) endothelium
B) transitional epithelium
C) simple cuboidal epithelium
D) mesothelium
20)
2
21) Connective tissue extracellular matrix is composed of ________.
A) fibers and ground substance
B) ground substance and cells
C) cells and fibers
D) all organic compounds
21)
22) Skin, lung, and blood vessel walls have which tissue characteristic in common?
A) simple squamous epithelium
B) elastic fibers
C) simple columnar epithelium
D) reticular fibers
22)
23) Which cells are commonly found wedged between simple columnar epithelial cells?
A) mast cells
B) macrophages
C) fibroblasts
D) goblet cells
23)
24) Select the correct statement regarding adipose tissue.
A) Mature adipose cells are highly mitotic.
B) Its primary function is nutrient storage.
C) Most of the cell volume is occupied by the nucleus.
D) It is composed mostly of extracellular matrix.
24)
25) Which of the following would be of most importance to goblet cells and other glandular epithelia?
A) microvilli
B) lysosomes
C) multiple nuclei
D) Golgi apparatus
25)
26) 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.
26)
27) The primary blast cell for bone is the ________.
A) fibroblast
B) hemocytoblast
27)
C) osteoblast
28) Mesenchymal cells are most commonly found in ________ connective tissue.
A) areolar
B) reticular
C) dense regular
D) chondroblast
D) embryonic
28)
29) 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
29)
30) The fiber type that gives connective tissue great tensile strength is ________.
A) elastic
B) collagen
C) muscle
30)
D) reticular
31) The shape of the external ear is maintained by ________.
A) hyaline cartilage
B) elastic cartilage
C) adipose tissue
D) fibrocartilage
31)
32) Heart muscle cells would tend to separate without ________.
A) myofilaments
B) stroma
C) intercalated discs
D) flana
32)
3
33) Which of the following is NOT found in cartilage but is found in bone?
A) lacunae
B) blood vessels
C) living cells
D) organic fibers
33)
34) A many-layered epithelium with cuboidal basal cells and flat cells at its surface would be classified
as ________.
A) simple cuboidal
B) transitional
C) stratified squamous
D) simple squamous
34)
35) Generally speaking, connective tissues are largely non-living extracellular matrix. Which of the
following is an EXCEPTION?
A) areolar
B) adipose
C) blood
D) bone
35)
36) Which is true concerning muscle tissue?
A) highly cellular and well vascularized
B) contains contractile units made of collagen
C) cuboidal shape enhances function
D) is a single-celled tissue
36)
37) Which of the following statements is true of connective tissue?
A) Elastin fibers are sometimes called white fibers.
B) Reticular fibers form thick, ropelike structures.
C) Collagen fibers provides high tensile strength.
D) When connective tissue is stretched, collagen gives it the ability to snap back.
37)
38) A ciliated version of pseudostratified columnar epithelium containing mucus-secreting goblet cells
________.
A) aids in digestion
B) is found in some of the larger glands
C) is more durable than all other epithelia
D) lines most of the respiratory tract
38)
39) The first step in tissue repair involves ________.
A) proliferation of fibrous connective tissue
B) formation of scar tissue
C) inflammation
D) replacement of destroyed tissue by the same kind of cells
39)
40) Which tissue in the wall of the uterus is required for labor contractions?
A) elastic cartilage
B) skeletal muscle
C) smooth muscle
D) stratified squamous
40)
41) Which of the following is found in hyaline cartilage?
A) fibroblast
B) chondrocyte
C) macrophage
D) mast cell
42) Select the correct statement regarding epithelia.
A) Simple epithelia form impermeable barriers.
B) Pseudostratified epithelia consist of at least two layers of cells stacked on top of one another.
C) Stratified epithelia are present where protection from abrasion is important.
D) Stratified epithelia are tall, narrow cells.
4
41)
42)
43) 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) smooth muscle
B) simple cuboidal epithelium
C) ciliated simple columnar epithelium
D) stratified squamous epithelium
43)
44) Your instructor gives you an unknown organ for you to examine and identify through microscopy.
What should you do first with the sample?
A) stain it to enhance contrast
B) examine it for artifacts
C) fix it with preservative
D) cut it into sections
44)
45) Which of the following epithelia forms the walls of the air sacs across which gas exchange occurs in
the lungs?
A) pseudostratified columnar
B) simple squamous
C) simple columnar
D) simple cuboidal
45)
46) What tissue has lacunae, calcium salts, and blood vessels?
A) bone (osseous tissue)
B) cartilage tissue
C) areolar tissue
D) fibrocartilaginous tissue
46)
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:
47) Composed of cells in a fluid matrix.
47)
48) How is epithelial tissue the opposite of connective tissue?
48)
5
Figure 4.2
Using Figure 4.2, match the following:
49) Simple cuboidal epithelium.
49)
50) 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.
50)
51) Explain what is meant by epithelial tissue being avascular but innervated.
51)
52) How is blood unique among connective tissues?
52)
6
Figure 4.2
Using Figure 4.2, match the following:
53) Cardiac muscle.
53)
7
Figure 4.1
Using Figure 4.1, match the following:
54) Forms tendons and ligaments.
54)
55) Tendon tears or breaks are difficult to repair both physiologically and surgically. Why?
55)
56) How can one tell the difference between stratified squamous epithelium and transitional
epithelium?
56)
57) 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?
57)
8
Figure 4.2
Using Figure 4.2, match the following:
58) Skeletal muscle.
58)
9
Figure 4.1
Using Figure 4.1, match the following:
59) Supports and protects; insulates against heat loss; reserve source of fuel.
59)
60) 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.
60)
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.
61) What is the difference between exocrine and endocrine glands?
10
61)
Figure 4.2
Using Figure 4.2, match the following:
62) Stratified squamous epithelium.
62)
11
Figure 4.1
Using Figure 4.1, match the following:
63) Provides tensile strength with the ability to absorb compressive shock.
63)
64) Supports and protects; stores calcium.
64)
65) Since mature adipocytes rarely divide, how can adults gain weight?
65)
12
Figure 4.2
Using Figure 4.2, match the following:
66) Simple squamous epithelium.
66)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
67) The shock-absorbing pads between the vertebrae are formed of fibrocartilage.
67)
68) Adipose tissue is made up of pseudostratified columnar epithelial cells.
68)
69) Squamous cells are flattened and scale-like when mature.
69)
70) Endocrine glands are often called ducted glands.
70)
71) Intercalated discs and striations are both characteristics of skeletal muscle.
71)
72) A major characteristic of fibrocartilage is its unique amount of flexibility and elasticity.
72)
73) Connective tissues that possess a large quantity of collagen fibers often provide the framework for
organs such as the spleen and lymph nodes.
73)
74) The basic difference between dense irregular and dense regular connective tissues is in the amount
of elastic fibers and adipose cells present.
74)
13
75) Tendons and ligaments are composed mainly of dense irregular connective tissue.
75)
76) Goblet cells are found within pseudostratified ciliated columnar epithelium.
76)
77) Merocrine glands produce their secretions by accumulating their secretions internally until the cell
ruptures.
77)
78) The role of brown fat is to warm the body; whereas, the role of white fat is to store nutrients.
78)
79) Elastic cartilage tissue is found in the walls of the large arteries that leave the heart.
79)
80) Functions of connective tissues include binding, support, insulation, and protection.
80)
81) Epithelial cells contain both blood vessels and nerve fibers.
81)
82) Healing of a surgical incision through the body wall will tend to increase the amount of areolar
tissue.
82)
83) Cartilage tissue tends to heal less rapidly than bone tissue.
83)
84) Macrophages are found in areolar and lymphatic tissues.
84)
85) Cartilage has good regenerative capacity, while most epithelial tissues do not.
85)
86) Nervous tissue consists mainly of neurons and collagen fibers.
86)
87) Blood is considered a type of connective tissue.
87)
88) Epithelial tissues always exhibit polarity; that is, they have a free surface and a basal surface.
88)
89) Simple cuboidal epithelia are usually found in areas where secretion and absorption occur.
89)
90) Salivary glands exhibit compound tubuloalveolar glandular arrangement.
90)
91) A smooth muscle cell has a central nucleus but lacks striations.
91)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
92) Pull on bones or skin causing body
movements.
93) Attaches to extracellular matrix.
A) Cell adhesion molecule
92)
B) Skeletal muscle
93)
14
Match the following:
94) Consists of keratinized stratified
squamous epithelium.
A) Cutaneous
94)
Match the regeneration capacity of the following tissues:
95) Skeletal muscle.
A) Weak regenerative ability
95)
Match the following:
96) Found lining the digestive and
respiratory tracts.
A) Mucous
96)
Match the following:
97) Found in areas subjected to wear and
tear.
A) Stratified squamous
97)
Match the following:
98) The epithelial membrane that lines the
closed ventral cavities of the body.
A) Serous membrane
98)
Match the regeneration capacity of the following tissues:
99) Areolar connective tissue.
A) Moderate regenerative ability
100) Cardiac muscle.
B) Regenerates extremely well
101) Tendons and ligaments.
C) Virtually no functional regenerative ability
99)
100)
101)
Match the following:
102) Moves food through the GI tract.
A) Smooth muscle
102)
Match the regeneration capacity of the following tissues:
103) Smooth muscle.
A) Moderate regenerative ability
103)
Match the following:
104) Makes up the pleura and pericardium.
A) Mucous
105) Lines blood vessels and the heart.
B) Endothelium membrane
106) The epithelial membrane that lines
body cavities open to the exterior
membrane.
C) Serous membrane
15
104)
105)
106)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
107) 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?
108) 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?
109) 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?
110) Explain why an infection may occur in a tissue injury.
111) Explain why an open wound would need a bed of granulation tissue for wound healing to occur.
112) 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?
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) Without macrophages, wound healing is delayed. Why?
16
Answer Key
Testname: 4
1) A
2) A
3) A
4) B
5) D
6) D
7) C
8) A
9) A
10) B
11) A
12) C
13) C
14) C
15) C
16) B
17) B
18) C
19) C
20) A
21) A
22) B
23) D
24) B
25) D
26) B
27) C
28) D
29) B
30) B
31) B
32) C
33) B
34) C
35) B
36) A
37) C
38) D
39) C
40) C
41) B
42) C
43) C
44) C
45) B
46) A
47) E
48) 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.
17
Answer Key
Testname: 4
49) B
50) 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.
51) Epithelial tissue contains no blood vessels but is supplied by nerve fibers.
52) 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.
53) C
54) B
55) 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.
56) 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.
57) phagocytosis
58) E
59) A
60) 1, 4, 3, 7, 6, 5, 2
61) 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.
62) D
63) C
64) D
65) 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.
66) A
67) TRUE
68) FALSE
69) TRUE
70) FALSE
71) FALSE
72) FALSE
73) FALSE
74) FALSE
75) FALSE
76) TRUE
77) FALSE
78) TRUE
79) TRUE
80) TRUE
81) FALSE
82) FALSE
18
Answer Key
Testname: 4
83) TRUE
84) TRUE
85) FALSE
86) FALSE
87) TRUE
88) TRUE
89) TRUE
90) TRUE
91) TRUE
92) B
93) A
94) A
95) A
96) A
97) A
98) A
99) B
100) C
101) A
102) A
103) A
104) C
105) B
106) A
107) 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.
108) 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.
109) 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.
110) 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.
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) 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.
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) 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.
19
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following is a skin sensory receptor for touch?
A) Pacinian corpuscle
B) free nerve ending
C) tactile cells
D) Ruffini body
1)
2) The function of the root hair plexus is to ________.
A) cause apocrine gland secretion into the hair follicle
B) allow the hair to assist in touch sensation
C) serve as a source for new epidermal cells for hair growth after the resting stage has passed
D) bind the hair root to the dermis
2)
3) Melanocytes and keratinocytes work together in protecting the skin from UV damage when
keratinocytes ________.
A) accumulate the melanin granules on their superficial portion, forming a UV-blocking
pigment layer
B) provide the melanocyte with nutrients necessary for melanin synthesis
C) maintain the appropriate temperature so the product of the melanocyte will not denature
D) maintain the appropriate pH in order for the melanocyte to synthesize melanin granules
3)
4) 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?
A) granulosum
B) spinosum
C) basale
D) lucidum
4)
5) Which type of skin cancer is the most dangerous because it is highly metastatic and resistant to
chemotherapy?
A) adenoma
B) basal cell carcinoma
C) melanoma
D) squamous cell carcinoma
5)
6) 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) as a protective coating when one is swimming
C) by hormones, especially androgens
D) when the air temperature drops
6)
7) 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) The dermis is the thickest portion of the skin and water cannot pass through it.
B) Glycolipids that are secreted by keratinocytes into extracellular spaces.
C) Fat associated with skin prevents water loss.
D) The size and shape of the cells that make up the stratum spinosum, as well as the thick
bundles of intermediate filaments.
7)
1
8) Sudoriferous (sweat) glands are categorized as two distinct types. Which of the following are the
two types of sweat glands?
A) holocrine and mammary
B) eccrine and apocrine
C) sebaceous and merocrine
D) mammary and ceruminous
8)
9) 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) The skin and sclera of the eyes appears to have an abnormal, yellowish tint.
B) The skin takes on a bronze or metallic appearance.
C) Black-and-blue marks become evident for no apparent cause.
D) It is impossible to suggest Addison's disease from an inspection of a person's skin.
9)
10) Which layer of tissue is damaged in a first-degree burn?
A) dermis
B) epidermis
C) hypodermis
D) both the epidermis and dermis
10)
11) 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) the cells that make up the hypodermis secrete a protective mucus
C) it has no delicate nerve endings and can therefore absorb more shock
D) it is located just below the epidermis and protects the dermis from shock
11)
12) Which of the following examples listed below illustrates homeostasis maintained by a negative
feedback?
A) Removal of nitrogenous compounds like urea within the sweat.
B) The secretion of antibacterial compounds in sebum.
C) Release of chemical signals by keratinocytes that have been damaged by UV light that will
increase the production of melanin.
D) The near waterproof secretions of glycolipids that is released by cells in the stratum
granulosum.
12)
13) 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
13)
14) 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 blood vessels in the dermis rupture and the blood passes through the tissue, causing
permanent "black-and-blue marks."
C) The appearance of visible, silvery-white scars is an indication of stretching of the dermis.
D) The stretching causes the tension lines to disappear.
14)
15) 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 reticular layer
B) the papillary layer
C) the subcutaneous layer
D) the hypodermal layer
15)
2
16) 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 aid in griping.
B) That friction ridges allow for better tactile sensation.
C) That friction ridges are genetically determined.
D) That friction ridges change over time.
16)
17) 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) Greater production of melanin.
B) More tight junctions between keratinocytes of the stratum corneum.
C) Increased secretions of defensins from skin cells.
D) Greater production of keratinocytes resulting in more layers of the stratum corneum.
17)
18) 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 granulosum
C) stratum lucidum
D) stratum corneum
18)
19) The single most important risk for skin cancer is ________.
A) genetics
B) race
C) use of farm chemicals
D) overexposure to UV radiation
19)
20) 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) tactile cells – protection
C) keratinocytes – provide sense of touch and pressure
D) dendritic cells – activate the immune system
20)
21) The major regions of a hair shaft include all of the following EXCEPT ________.
A) cuticle
B) cortex
C) external root sheath
D) medulla
21)
22) Which of the following examples listed below illustrates homeostasis maintained by a negative
feedback?
A) Production of vitamin D initiated by the suns UV light striking the skin.
B) Changes in the response of the hair follicle to dihydrotestosterone (DHT).
C) Formation of cerumen wax to deter insects from entering the ear.
D) Thickening of epidermis to form a callus in places where the skin is exposed to friction.
22)
23) Which layer of skin is LEAST protected by melanin?
A) stratum corneum
C) stratum spinosum
23)
3
B) stratum basale
D) stratum granulosum
24) Which of the following examples listed below illustrates homeostasis maintained by a negative
feedback?
A) Excretion of salts within the sweat.
B) Release of sweat by eccrine glands in response to heat.
C) Lack of pain in third-degree burns due to damage to sensory nerves in the dermis.
D) An increase in sebum production in response to androgens (male sex hormones).
24)
25) A needle would pierce the epidermal layers of the forearm in which order?
A) corneum, granulosum, spinosum, basale
B) basale, spinosum, granulosum, lucidum, corneum
C) basale, spinosum, granulosum, corneum
D) granulosum, basale, spinosum, corneum
25)
26) 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's blood vessels in the dermis have undergone vasoconstriction (narrowing).
B) The cold has slowed the movement of blood.
C) The person is in fear of hypothermia (sever cold exposure).
D) The person's blood vessels in the epidermis have undergone vasodilation (widening).
26)
27) The composition of the secretions of the eccrine glands is ________.
A) metabolic wastes
B) primarily uric acid
C) 99% water, sodium chloride, trace amounts of wastes, and vitamin C
D) fatty substances, proteins, antibodies, and trace amounts of minerals and vitamins
27)
28) 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) stopping water loss and preventing dehydration
B) allowing secretions like sweat or sebum to pass through
C) preventing ultraviolet light from penetrating the deeper layers of the epidermis
D) preventing mechanical stress or trauma from damaging the epidermis
28)
29) A dendritic or Langerhans cell is a specialized ________.
A) phagocytic cell
B) squamous epithelial cell
C) melanocyte
D) nerve cell
29)
30) A patient has skin that is slightly blue in color. A likely treatment for this person might be
________.
A) giving the patient supplemental oxygen by mask
B) encouraging the patient to eat more orange colored vegetables (rich in beta carotene)
C) increasing fluids through IV therapy
D) exposing the patient to more sunlight
30)
31) 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 stratum basale but not the dermal layers
B) the papillary layer but not the reticular layer
C) the subcutaneous layer, but no deeper
D) the stratum corneum but not the stratum granulosum
31)
4
32) 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) Squamous cell carcinomas arise from the stratum corneum.
D) Most tumors that arise on the skin are malignant.
32)
33) The arrector pili muscle's predominate, useful function in humans is to ________.
A) assist in the release sebum from nearby sebaceous glands
B) provide warmth by making the hair stand on end
C) stimulate faster hair growth
D) prevent germs from entering the hair shaft
33)
34) 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) through blood analysis
C) by observing the tissues that are usually moist
D) by measuring urinary output and fluid intake
34)
35) 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) slowed healing and greater scaring
C) faster healing of the skin and less scaring
D) less chance for infection
35)
36) 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 easy separation of the dead cell layer of epidermis to be shed.
B) The looseness allows for phagocytes to roam through the tissue and search for infection.
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 high surface area allows for a stronger connection of dermis to epidermis.
36)
37) 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) Decreased vitamin D synthesis.
B) Increased oily appearance and more acne.
C) Increased hair growth.
D) Increased cooling of the skin.
37)
38) 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 increasing the number of epidermal dendritic cells, which help to
activate the immune system.
B) Carotene, which accumulates in the stratum corneum and hypodermal adipose tissue, is
synthesized in large amounts in the presence of sunlight.
C) Prolonged exposure to the sun induces melanin dispersion, which in turn acts as a natural
sunscreen.
D) The skin is protected by the synthesis of three pigments that contribute to the skin's color.
38)
5
39) The dermis is a strong, flexible connective tissue layer. Which of the following cell types are likely
to be found in the dermis?
A) osteoblasts, osteoclasts, and epithelial cells
B) goblet cells, parietal cells, and chondrocytes
C) monocytes, reticulocytes, and osteocytes
D) fibroblasts, macrophages, and mast cells
39)
40) 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) The cells of the epidermis store glucose as glycogen for energy.
B) It converts modified epidermal cholesterol to a vitamin D precursor important to calcium
metabolism.
C) It aids in the transport of materials throughout the body.
D) It absorbs vitamin C so that the skin will not be subject to diseases.
40)
41) 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) beneath the flexure lines in the body
B) in the axillary and anogenital area
C) in the palms of the hands and soles of the feet
D) in all body regions and buried deep in the dermis
41)
42) Which of the following is NOT one of the functions of the skin?
A) Conducts endergonic metabolic chemical reactions using the suns energy to initiate vitamin D
synthesis.
B) Holds a portion of the bloods total volume to be shunted (diverted) to other organs when
needed.
C) Delivers important information about our environmental conditions to our brains.
D) Gives the body its overall shape, loss of this function can be seen with the drooping of skin
with age.
42)
43) What are the most important factors influencing hair growth?
A) age and glandular products
B) nutrition and hormones
C) sex and hormones
D) the size and number of hair follicles
43)
44) Which of the following glands secrete sebum, an oily like substance?
A) apocrine glands
B) sebaceous glands
C) merocrine glands
D) eccrine glands
44)
45) 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 heart is pumping faster because the person was probably exercising
C) the blood vessels of the dermis have undergone vasodilation, bringing a greater volume of
blood to the skin
D) blood flow has increased to the sweat glands in order to increase their metabolic activity
45)
6
46) Which statement correctly explains why hair appears the way it does?
A) Air bubbles in the hair shaft cause straight hair.
B) Kinky hair has flat, ribbonlike hair shafts.
C) Perfectly round hair shafts result in wavy hair.
D) Gray hair is the result of hormonal action altering the chemical composition of melanin.
46)
47) 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) hormones in the eyebrow follicle switch the growth off after it has reached a predetermined
length
C) they grow much slower
D) eyebrow follicles are only active for a few months
47)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
48) The coarse hair of the eyebrows and scalp is called ________ hair.
48)
49) Tanning or darkening of the skin occurs as a defensive response to ________.
49)
50) What is vellus hair?
50)
7
Figure 5.1
Using Figure 5.1, match the following:
51) Where capillary loops are found.
51)
52) 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.
52)
53) What is the function of skin dermal folds and deep skin creases?
53)
54) How are burns commonly classified? Give an example.
54)
8
Figure 5.1
Using Figure 5.1, match the following:
55) Site of the dermal ridges that produce epidermal ridges on the epidermal surfaces of the
fingers.
55)
56) Dense irregularly arranged, fibrous connective tissue.
56)
57) List the layers of the dermis and describe the functions of the tissue that makes up each
layer.
57)
9
Figure 5.2
Using Figure 5.2, match the following:
58) Epidermis.
58)
10
Figure 5.1
Using Figure 5.1, match the following:
59) Responsible for shock absorption and located in the hypodermis.
59)
60) Pulls the hair follicle into an upright position.
60)
61) The only place you will find stratum ________ is in the skin that covers the palms,
fingertips, and soles of the feet.
61)
62) Billions of consumer dollars are spent for deodorants and antiperspirants each year.
Explain the production of body odors frequently associated with axillary skin.
62)
63) The ________ are the small muscles located in the dermis that cause goose bumps.
63)
64) Why is profuse sweating on a hot day good, and yet a potential problem?
64)
11
65) 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.
65)
Figure 5.1
Using Figure 5.1, match the following:
66) Sudoriferous gland.
66)
67) There are several reasons other than genetics for hair loss. Identify some of these other
factors.
67)
68) Balding men have tried all kinds of remedies, including hair transplants, to restore their
lost locks. Explain the cause of male pattern baldness.
68)
69) The white crescent portion of the nail is called the ________.
69)
12
Figure 5.2
Using Figure 5.2, match the following:
70) Hypodermis.
70)
71) Pigment-producing cells in the epidermis are ________.
71)
13
Figure 5.2
Using Figure 5.2, match the following:
72) Papillary layer of the dermis.
72)
73) Cradle cap in infants is called ________.
73)
14
Figure 5.1
Using Figure 5.1, match the following:
74) Region that thickens markedly when one gains weight.
74)
75) Burns that result in injury to the epidermis and the upper regions of the dermis is called a
________ burn.
75)
76) The dermal folds that occur at or near joints where the dermis is tightly secured to deeper
structures are called ________.
76)
77) Why are the apocrine sweat glands fairly unimportant in thermal regulation?
77)
15
Figure 5.2
Using Figure 5.2, match the following:
78) Reticular layer of the dermis.
78)
79) What complications might be anticipated from the loss of large areas of skin surfaces?
79)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
80) 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.
80)
81) Regardless of race, all human beings have about the same number of melanocytes.
81)
82) 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.
82)
83) The dense fibrous connective tissue portion of the skin is located in the reticular region of the
dermis.
83)
84) For a doctor, simply looking at a patient's skin can help towards making a diagnosis.
84)
85) During the regressive phase of hair growth, the matrix is inactive and the follicle atrophies.
85)
16
86) The protein found in large amounts in the superficial layer of epidermal cells is keratin.
86)
87) Cells in the stratum corneum undergo mitosis to keep the layer thick and protective.
87)
88) The dermis contains blood vessels and nerve fibers while the epidermis does not.
88)
89) The skin cancer most likely to metastasize is cancer of the melanocytes.
89)
90) 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.
90)
91) 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.
91)
92) Thick skin has a more extensive dermal layer than thin skin.
92)
93) The reason that the nail bed appears pink is the presence of a large number of melanocytes in the
underlying dermis.
93)
94) The eccrine sweat glands are not the primary gland involved in thermoregulation.
94)
95) The action of the arrector pili muscle is very similar in humans as it is in other mammals but its
beneficial functions differ.
95)
96) 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.
96)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
97) The fibrous protein that helps give the
epidermis its protective properties.
98) Spider-shaped epithelial cells that
synthesize the pigment melanin.
A) Keratin
97)
B) Melanocyte
98)
Match the following:
99) The layer of the epidermis that is
several layers thick and contains
pre-keratin.
A) Stratum spinosum
17
99)
Match the following:
100) Appearance of a permanent tan;
bronzing.
101) May indicate fear, anemia, or low
blood pressure.
A) Erythema
100)
B) Pallor
C) Addison's disease
102) May indicate embarrassment, fever,
hypertension, inflammation, anger, or
allergy.
101)
102)
Match the following:
103) The most abundant cells of the
epidermis.
104) Cells plus a disc-like sensory nerve
ending that functions as a sensory
receptor for touch.
A) Keratinocytes
103)
B) Dendritic cells
C) Merkel cells
105) Skin macrophages that help activate
the immune system.
104)
105)
Match the following:
106) Usually indicates a liver disorder.
A) Cyanosis
107) A bluish color in light-skinned
individuals.
B) Jaundice
106)
107)
Match the following:
108) The layer of the epidermis where the
cells are considered protective but
nonviable.
A) Stratum basale
109) The layer of the epidermis that
contains one to five layers of flattened
cells and deteriorating organelles.
C) Stratum corneum
108)
B) Stratum granulosum
110) The layer that contains the mitotic
viable cells of the epidermis.
109)
110)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
111) 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.
18
112) 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?
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 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?
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) 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?
117) Explain why soap that has an alkaline base may not be healthy for some patients to use daily.
118) 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?
119) 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?
120) 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.
19
Answer Key
Testname: 5
1) C
2) B
3) A
4) C
5) C
6) C
7) B
8) B
9) A
10) B
11) A
12) C
13) B
14) C
15) A
16) C
17) A
18) A
19) D
20) D
21) C
22) D
23) A
24) B
25) A
26) A
27) C
28) D
29) A
30) A
31) A
32) A
33) A
34) A
35) C
36) A
37) B
38) C
39) D
40) B
41) B
42) D
43) B
44) B
45) C
46) B
47) D
48) terminal
49) UV radiation
50) Vellus hair is pale, fine body hair associated with newborn children, women, and "peach fuzz" on all people.
20
Answer Key
Testname: 5
51) E
52) 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.
53) Skin dermal folds and deep skin creases accommodate for joint movement.
54) 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.
55) E
56) D
57) 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.
58) A
59) B
60) A
61) lucidum
62) 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.
63) arrector pili
64) 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.
65) Keratinocyte enzymes can neutralize carcinogens that penetrate the epidermis. Keratinocytes are also able to convert
topical cortisone to a more active anti-inflammatory form.
66) C
67) 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.
68) 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.
69) lunula
70) D
71) melanocytes
72) B
73) seborrhea
74) B
75) second-degree
76) flexure lines
77) They are largely confined to the axillary and anogenital regions rather than distributed on the body where heat can be
more readily dissipated.
78) C
79) Large losses of skin, as with severe burn injuries, allow excessive fluid loss and infection. Skin grafting or "synthetic
skin" applications are usually necessary.
80) FALSE
81) TRUE
82) FALSE
83) TRUE
84) TRUE
21
Answer Key
Testname: 5
85) TRUE
86) TRUE
87) FALSE
88) FALSE
89) TRUE
90) TRUE
91) FALSE
92) FALSE
93) FALSE
94) FALSE
95) TRUE
96) FALSE
97) A
98) B
99) A
100) C
101) B
102) A
103) A
104) C
105) B
106) B
107) A
108) C
109) B
110) A
111) 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.
112) A = asymmetry
B = border irregularity
C = color
D = diameter
E = elevation
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) 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.
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.
116) 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.
22
Answer Key
Testname: 5
117) 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.
118) 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.
119) 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.
120) 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.
23
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Bones are constantly undergoing resorption (breaking bone down) for various reasons. Which of
the following cells accomplishes this process?
A) osteocyte
B) osteoclast
C) stem cell
D) osteoblast
1)
2) Which of the following is the single most important stimulus for epiphyseal plate activity during
infancy and childhood?
A) growth hormone
B) thyroid hormone
C) parathyroid hormone
D) calcium
2)
3) 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) growth at the epiphyseal plate
C) the lengthening of hyaline cartilage
D) the secretion of new matrix against the external face of existing cartilage
3)
4) 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) short
B) sesamoid
C) long
D) irregular
4)
5) Which of the following is implicated in osteoporosis in older women?
A) abnormal PTH receptors
B) poor posture
C) estrogen deficiency due to menopause
D) heritage such as African or Mediterranean
5)
6) Which of the following bones are NOT a part of the appendicular skeleton?
A) upper limb
B) skull
C) hip
D) shoulder
6)
7) In humans, the effect of the hormone calcitonin is to ________.
A) increase blood calcium levels by inhibiting osteoblasts
B) temporarily decrease blood calcium levels when administered in large doses
C) increase blood calcium levels by stimulating osteoclasts
D) decrease mitosis of chondrocytes at the epiphyseal plate
7)
8) Bones are covered and lined by a protective tissue called periosteum. The inner (osteogenic) layer
consists primarily of ________.
A) chondrocytes and osteocytes
B) dense irregular connective tissue
C) cartilage and compact bone
D) osteogenic cells
8)
9) Which bone would likely take the longest to heal?
A) finger bone of an elderly individual
C) thigh bone of an elderly individual
9)
B) finger bone of a young individual
D) thigh bone of a young individual
1
10) What kind of tissue is the forerunner of long bones in the embryo?
A) hyaline cartilage
B) dense fibrous connective tissue
C) fibrocartilage
D) elastic connective tissue
10)
11) 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) 25-year-old female
B) 60-year-old male
C) 18-year-old male
D) 8-year-old female
11)
12) Choose the structures that most directly provide nutrients and remove wastes from osteocytes in
compact bone.
A) nutrient foramens
B) central canals
C) canaliculi
D) perforating (Volkmann's) canals
12)
13) The central (Haversian) canal that runs through the core of each osteon is the site of ________.
A) cartilage and interstitial lamellae
B) yellow marrow and spicules
C) adipose tissue and nerve fibers
D) blood vessels and nerve fibers
13)
14) What tissue forms the model for endochondral ossification?
A) fibrous membrane
B) cartilage
C) fascia
D) bone
14)
15) At what age do bones reach their peak density?
A) early adulthood
C) early childhood
15)
B) late adulthood
D) at birth
16) Which of the following is NOT a function of the skeletal system?
A) support
B) communication
C) storage of minerals
D) production of blood cells (hematopoiesis)
16)
17) Ossification of the ends of long bones ________.
A) takes twice as long as diaphysis ossification
B) involves medullary cavity formation
C) is produced by secondary ossification centers
D) is a characteristic of intramembranous bone formation
17)
18) In the epiphyseal plate, cartilage grows ________.
A) by pulling the diaphysis toward the epiphysis
B) from the edges inward
C) in a circular fashion
D) by pushing the epiphysis away from the diaphysis
18)
19) Lengthwise, long bone growth during infancy and youth is exclusively through ________.
A) interstitial growth of the epiphyseal plates
B) calcification of the matrix of the zone underlying articular cartilage
C) differentiation of osteoclasts into osteocytes
D) the secretion of bone matrix into the medullary cavity
19)
20) The cell responsible for secreting the matrix of bone is the ________.
A) osteoclast
B) chondrocyte
C) osteocyte
20)
2
D) osteoblast
21) A fracture in the shaft of a bone would be a break in the ________.
A) diaphysis
B) epiphysis
C) metaphysis
D) articular cartilage
21)
22) Cranial bones develop ________.
A) within osseous membranes
C) within fibrous membranes
22)
B) from cartilage models
D) from a tendon
23) The term diploë refers to the ________.
A) fact that most bones are formed of two types of bone tissue
B) internal layer of spongy bone in flat bones
C) double-layered nature of the connective tissue covering the bone
D) two types of marrow found within most bones
23)
24) What can a deficiency of growth hormone during bone formation cause?
A) increased osteoclast activity
B) decreased osteoclast activity
C) decreased epiphyseal plate activity
D) inadequate calcification of bone
24)
25) Which structure allows the diaphysis of the bone to increase in length until early childhood?
A) osteon
B) epiphyseal line
C) epiphyseal plate
D) lacuna
25)
26) Growth of bones is controlled by a symphony of hormones. Which hormone is of greatest
importance for bone growth during infancy and childhood?
A) calcitonin
B) growth hormone
C) thyroid hormones
D) parathyroid hormone
26)
27) Which of the following is a bone disorder characterized by excessive and haphazard bone deposit
and resorption?
A) rickets
B) Paget's disease
C) osteoporosis
D) osteomalacia
27)
28) Spongy bone contains ________.
A) osteons
C) lamellar bone
28)
B) osseous lamellae
D) trabeculae
29) 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.
29)
30) Prevention of osteoporosis includes adequate intake of ________.
A) vitamin D and chloride
B) calcium and vitamin D
C) calcium and vitamin E
D) potassium and vitamin D
30)
31) Yellow bone marrow contains a large percentage of ________.
A) fat
B) blood-forming cells
C) perforating fibers
D) elastic tissue
31)
3
32) The periosteum is secured to the underlying bone by ________.
A) Volkmann's canals
B) the struts of bone known as spicules
C) perforating (Sharpey's) fibers
D) a bony matrix with hyaline cartilage
32)
33) The structure of bone tissue suits the function. Which of the following bone tissues is adapted to
support weight and withstand torsion stresses?
A) spongy bone
B) trabecular bone
C) irregular bone
D) compact bone
33)
34) The resilience of bone is thought to come from which of the following?
A) amount of mineral salt and protein in the bone
B) presence of osteoblasts in the bone
C) amount of mineral salts in the bone
D) sacrificial bonds in or between collagen molecules
34)
35) Wolff's law is concerned with ________.
A) vertical growth of bones being dependent on age
B) the diameter of the bone being dependent on the ratio of osteoblasts to osteoclasts
C) the thickness and shape of a bone being dependent on stresses placed upon it
D) the function of bone being dependent on shape
35)
36) For intramembranous ossification to take place, which of the following is necessary?
A) A bone collar forms around the cartilage model.
B) A medullary cavity forms.
C) Ossification centers form in the fibrous connective tissue membrane.
D) The cartilage matrix begins to deteriorate.
36)
37) Ossification (Osteogenesis) is the process of ________.
A) making collagen fibers for calcified cartilage
B) bone destruction to liberate calcium
C) bone formation
D) making a cartilage model of the fetal bone
37)
38) When an osteoblast becomes completely surrounded by its own matrix secretions it is referred to as
a(n) ________.
A) osteoclast
B) chondrocyte
C) osteogenic cell
D) osteocyte
38)
39) Choose which bone marking type would likely increase in size when a weight lifter repeatedly
exercises muscles that attach to it.
A) meatus
B) trochanter
C) fossa
D) foramen
39)
40) In some cases, the epiphyseal plate of the long bones of children closes too early. What might be the
cause?
A) overproduction of thyroid hormone
B) too much vitamin D in the diet
C) osteoblast activity exceeds osteoclast activity
D) elevated levels of sex hormones
40)
41) The process of bones increasing in thickness is known as ________.
A) concentric growth
B) epiphyseal plate closure
C) closing of the epiphyseal plate
D) appositional growth
41)
4
42) Which hormone increases osteoclast activity to release more calcium ions into the bloodstream?
A) thyroxine
B) estrogen
C) calcitonin
D) parathyroid hormone
42)
43) Which of the following is a bone marking described as a round or oval opening through a bone?
A) meatus
B) epicondyle
C) foramen
D) ramus
E) fossa
43)
44) Choose the best location for obtaining a red bone marrow sample from a patient.
A) head of humerus
B) medullary cavity of femur
C) hip bone
D) frontal bone
44)
45) 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.
A) bone
B) fibrocartilage
C) hyaline cartilage
D) elastic cartilage
45)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
46) Compare how nutrients reach individual osteocytes in compact bone and in spongy bone.
46)
47) Bones appear to be lifeless structures. Does bone material renew itself?
47)
5
Figure 6.2
Using Figure 6.2, match the following:
48) Epiphysis of the bone.
48)
49) Compact bone.
49)
50) Why are the bones of young children much more flexible than those of the elderly?
50)
51) 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.
51)
52) Create an analogy for the chemical composition of bone using highway construction.
52)
6
Figure 6.2
Using Figure 6.2, match the following:
53) Location of the epiphyseal line.
53)
54) Compare the starts of intramembranous ossification and endochondral ossification.
54)
7
Figure 6.2
Using Figure 6.2, match the following:
55) Area where yellow marrow is found.
55)
56) List in order the four major healing stages of a simple fracture.
56)
57) What are the differences between the diaphysis and the epiphyses of long bones?
57)
58) What are the three characteristics used to classify bone fractures?
58)
59) What is found in a central (Haversian) canal?
59)
60) Compare the function of the organic materials in the bone matrix with the function of the
inorganic materials in the matrix.
60)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
61) Each consecutive bone lamella has collagen fibers that wrap in alternating directions.
61)
62) Short, irregular, and flat bones all consist of thin plates of spongy bone covered by compact bone.
62)
8
63) The structural unit of compact bone (osteon) resembles the growth rings of a tree trunk.
63)
64) The hormone that is primarily involved in the control of bone remodeling is calcitonin.
64)
65) Closure of the epiphyseal plate stops all bone growth.
65)
66) The periosteum is a tissue that serves only to protect the bone because it is not supplied with nerves
or blood vessels.
66)
67) Short, irregular, and flat bones have medullary cavities in order to keep the weight of the bones
light.
67)
68) The trabeculae of spongy bone are oriented toward lines of stress.
68)
69) Hematopoiesis refers to the formation of blood cells within the red marrow cavities of certain
bones.
69)
70) All bones stop growing by the end of adolescence.
70)
71) Sixty-five percent of the mass of bone is a compound called hydroxyapatite.
71)
72) In newborn infants, the medullary cavity and all areas of spongy bone contain red bone marrow.
72)
73) Bones are classified by whether they are weight bearing or protective in function.
73)
74) An osteon contains osteocytes, lamellae, and a central canal, and is found in compact bone only.
74)
75) The term osteoid refers to the organic part of the matrix of compact bones without mineralization.
75)
76) Cartilage has a flexible matrix that can accommodate mitosis of chondrocytes.
76)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
77) The most abundant skeletal cartilage.
A) Hyaline cartilage
77)
Match the following:
78) Excessive and haphazard bone deposit
and resorption.
A) Paget's disease
9
78)
Figure 6.1
Using Figure 6.1, match the following bone types with the numbered structure:
79) Bone 4.
A) Irregular
79)
Match the following:
80) The growth pattern of bone in which
matrix is laid down on the surface.
A) Appositional growth
80)
Match the following:
81) Contain stretchy elastic fibers and can
withstand repeated bending.
A) Elastic cartilage
81)
Match the following:
82) Bone formed is poorly mineralized
and soft. Deforms on weight bearing.
A) Osteomalacia
10
82)
Figure 6.1
Using Figure 6.1, match the following bone types with the numbered structure:
83) Bone 1.
A) Flat
84) Bone 2.
B) Long
83)
84)
Match the following:
85) The cells responsible for the early
stages of endochondral ossification.
A) Chondrocytes
85)
Match the following:
86) Has parallel rows of chondrocytes
alternating with thick collagen fibers.
A) Fibrocartilage
11
86)
Match the following:
87) An incomplete fracture or cracking of
the bone without actual separation of
the parts. Common in children.
A) Greenstick
87)
Figure 6.1
Using Figure 6.1, match the following bone types with the numbered structure:
88) Bone 5.
A) Long
88)
Match the following:
89) Jelly-like ground substance and fibers
found.
A) Extracellular matrix
89)
Match the following:
90) Armlike bar of bone.
A) Facet
91) Smooth, nearly flat articular surface.
B) Ramus
12
90)
91)
Figure 6.1
Using Figure 6.1, match the following bone types with the numbered structure:
92) Bone 6.
A) Sesamoid
92)
Match the following:
93) Bones are porous and thin but bone
composition is normal.
A) Osteoporosis
93)
Match the following:
94) Area where bone longitudinal growth
takes place.
A) Epiphyseal plate
13
94)
Figure 6.1
Using Figure 6.1, match the following bone types with the numbered structure:
95) Bone 7.
A) Short
95)
Match the following:
96) Bone fragments into many pieces.
A) Comminuted
96)
Match the following:
97) The appearance of this structure
signals the end of bone growth.
A) Epiphyseal line
97)
Match the following:
98) Round or oval opening through a
bone.
A) Foramen
14
98)
Figure 6.1
Using Figure 6.1, match the following bone types with the numbered structure:
99) Bone 3.
A) Flat
99)
Match the following:
100) Common sports fracture resulting
from a twisting force.
A) Spiral
100)
Match the following:
101) Bone develops from a fibrous
membrane.
A) Intramembranous ossification
101)
Match the following:
102) Sharp, slender, often pointed
projection.
A) Spine
15
102)
103) Very large, blunt, irregularly shaped
process.
A) Trochanter
103)
Match the following:
104) Cartilage producing cells.
A) Chondrocytes
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) 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?
107) 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.
108) If your elderly patient's blood calcium level is normal, does that mean the patient does not have osteoporosis?
Explain.
109) How can a tooth be moved in a bony socket during orthodontic treatment?
110) 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?
111) 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?
112) 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?
113) When does prevention of osteoporosis start?
114) 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.
115) People who live in northern latitudes may require supplemental calcium with vitamin D. Explain why.
16
Answer Key
Testname: 6
1) B
2) A
3) D
4) C
5) C
6) B
7) B
8) D
9) C
10) A
11) C
12) C
13) D
14) B
15) A
16) B
17) C
18) D
19) A
20) D
21) A
22) C
23) B
24) C
25) C
26) B
27) B
28) D
29) D
30) B
31) A
32) C
33) D
34) D
35) C
36) C
37) C
38) D
39) B
40) D
41) D
42) D
43) C
44) C
45) B
46) 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.
17
Answer Key
Testname: 6
47) 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.
48) A
49) C
50) 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.
51) 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.
52) 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.
53) B
54) 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.
55) D
56) Hematoma formation, fibrocartilaginous callus formation, bony callus formation, and bone remodeling.
57) 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.
58) Position of the bone ends after the fracture occurs. Completeness of the break. Whether the bone penetrates the skin.
59) Small blood vessels and nerve fibers that serve the osteon's cells.
60) The organic matrix contributes to the bone structure and its tensile strength, while the inorganic matrix contributes to
hardness and resistance to compression.
61) TRUE
62) FALSE
63) TRUE
64) FALSE
65) FALSE
66) FALSE
67) FALSE
68) TRUE
69) TRUE
70) FALSE
71) TRUE
72) TRUE
73) FALSE
74) TRUE
75) TRUE
76) TRUE
77) A
78) A
79) A
80) A
81) A
82) A
83) A
84) B
18
Answer Key
Testname: 6
85) A
86) A
87) A
88) A
89) A
90) B
91) A
92) A
93) A
94) A
95) A
96) A
97) A
98) A
99) A
100) A
101) A
102) A
103) A
104) A
105) June probably has "bone spurs," which are abnormal projections from a bone due to bone overgrowth.
106) 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.
107) 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.
108) 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.
109) 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.
110) 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.
111) 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.
112) 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.
113) 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.
114) 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.
115) 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.
19
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following bones is NOT weight bearing?
A) tibia
B) talus
C) femur
D) fibula
1)
2) Which portion of the fibula articulates with the talus?
A) head
B) medial malleolus
C) lateral malleolus
D) calcaneus
2)
3) Which is the best description for the function of the cranial bones?
A) provide passageways for respiratory gases to move into and out of the body
B) house the special sense organs
C) protect the brain
D) allow introduction of food into the digestive system
3)
4) The pelvic girdle does NOT include the ________.
A) ischium
B) pubis
4)
C) ilium
5) Which vertebra does NOT have a body?
A) axis
B) atlas
C) last cervical
D) femur
D) last lumbar
5)
6) Which of the following is an abnormal lateral curvature of the vertebral column often seen in the
thoracic region?
A) lordosis
B) scoliosis
C) swayback
D) kyphosis
6)
7) Which of the following would be most associated with process of warming, humidifying, and
filtering the air we inhale?
A) the nasal cavity
B) the cranial bones
C) the bones comprising the orbits
D) hyoid bone
7)
8) What is the major function of the axial skeleton?
A) provide an attachment point for muscles that allow movement
B) provide central support for the body and protect internal organs
C) provide a space for the major digestive organs
D) give the body resilience
8)
9) The sella turcica is part of the ________ bone and houses the ________ gland.
A) sphenoid; thymus
B) sphenoid; pituitary
C) ethmoid; pituitary
D) ethmoid; thymus
9)
10) 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 have rough patches that aid in muscle attachment.
C) The paranasal sinuses are passageways for nerves to pass through.
D) Sinuses are often referred to as vestigial, anatomical features with no know function.
1
10)
11) 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) Bones of the skull are separated by immobile joints called sutures.
C) Boundaries for skull bones are seen only in the infant skull.
D) Bones of the skull are continuous but named for their specific markings.
11)
12) The axial skeleton includes ________.
A) the skull, vertebral column, and pelvis
B) arms, legs, hands, and feet
C) the skull, the scapula, and the vertebral column
D) the skull, vertebral column, and rib cage
12)
13) From the list below, select the least likely explanation for the relatively high mobility of the arms.
A) The clavicle articulates to the axial skeleton at only the sternal end.
B) The subscapular notch is a passageway for nerves.
C) The scapula does not articulate to the axial skeleton directly.
D) The relatively open glenoid cavity of the glenohumeral joint.
13)
14) 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 wedged in the superior most portion of the skull and supports all of the other
bones below (excluding the mandible)
B) 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)
C) the sphenoid bone is solid like a stone and provides the strength necessary to support the
skull
D) the intricate shape of the sphenoid makes it critical to the distinct characteristics of the
individual human face
14)
15) 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 costal spaces occupied by costal muscle
B) the costal cartilages
C) the sternal angle
D) the jugular notch
15)
16) Paranasal sinuses are found in which of these facial bones?
A) nasal conchae
B) vomer
C) maxillae
D) zygomatic bones
16)
17) The "true wrist" or carpus consists of ________.
A) the phalanges
B) the styloid processes of the radius and ulna
C) a group of eight short bones united by ligaments
D) the metacarpals
17)
2
18) 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) superior to the crista galli
B) inferior to the cribriform plate
C) the only region of the brain that is outside of the skull
D) superior to the sella turcica
18)
19) How many bones make up the adult skull?
A) 22
B) 5
19)
C) 7
20) Which bone forms the anterior cranium?
A) temporal bone
B) palatine bone
C) sphenoid bone
D) 12
D) frontal bone
20)
21) What are the major functions of the intervertebral discs?
A) to hold together the vertebra and support the body
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 prevent hyperextension and allow rotation of the spine
21)
22) Which part of the vertebral column receives the most stress by bearing most of the weight of the
body?
A) the sacral promontory
B) the lumbar region
C) the sacrum
D) the cervical region
22)
23) The superior orbital fissure is formed in the sphenoid bone, whereas the inferior orbital fissure is
formed between the sphenoid and ________.
A) maxilla
B) ethmoid
C) palatine
D) lacrimal
23)
24) 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 curling of the fingers
B) the hyper extension of the forearm
C) the rotational motion of the forearm
D) the hinge like motion of the forearm
24)
25) Which of the following would be most associated with housing the special sense organs?
A) the cranial bones
B) the bones of the inner ear
C) hyoid bone
D) the temporal bones
25)
26) When looking at the range of motion of the various sections of the vertebral column the ________
has the most flexibility.
A) cervical spine
B) lumbar spine
C) sacral spine
D) thoracic spine
26)
27) Which of the following is NOT a movement that can occur between vertebrae?
A) supination
B) rotation
C) lateral flexion
D) flexion and extension
27)
3
28) 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
28)
29) Along with support, the anterior longitudinal ligament of the vertebral column also acts to
________.
A) hold the discs in place
B) protect the spinal cord
C) prevent hyperextension of the spine
D) hold the spine erect
29)
30) 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 curling of the fingers
B) the hyper extension of the forearm
C) the hinge like motion of the forearm
D) the rotational motion of the forearm
30)
31) Which bone is in direct contact with the first metatarsal?
A) calcaneus
B) cuboid
C) medial cuneiform
D) lateral cuneiform
31)
32) The superior nasal concha is a part of which bone?
A) maxilla
B) sphenoid
C) vomer
D) ethmoid
32)
33) Curvatures of the spine serve the body by ________.
A) limiting the flexibility of the spine and preventing hyperextension
B) providing space for soft organs in the various body cavities
C) applying greater pressure to the intervertebral disks preventing them from slipping
D) giving additional springiness and flexibility to the spine which absorbs shock
33)
34) Which part of the ethmoid bone forms the superior part of the nasal septum?
A) crista galli
B) cribriform plate
C) perpendicular plate
D) orbital plate
34)
35) Which of the bones of the skull would you also refer to as a cheekbone?
A) the zygomatic bone
B) the parietal bone
C) the occipital bone
D) the temporal bone
35)
36) How are thoracic vertebrae 11 and 12 different from the other vertebrae?
A) The orientation of the articular processes is different from all the other thoracic vertebrae.
B) The spinous processes are directed parallel with the centrum.
C) The transverse processes do not have facets that articulate with the tubercles of the ribs.
D) There are two foramina on vertebrae 11 and 12.
36)
4
37) 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) crista galli; attach to the dura matter holding the brain in place
B) perpendicular plate; separate the left and right halves of the nasal cavity
C) styloid process; attach to and support the hyoid bone
D) pterygoid processes; anchor important chewing muscles
37)
38) 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 joint is relatively unstable and can easily dislocate
B) these type of joints are harder to control and coordinate
C) the blood vessels that lead to the arm and hand can easily be cut off by the free range of
motion
D) muscles that span this mobile joint will only provide a reduced amount of power
38)
39) 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 composition of the intervertebral disks
B) the thickness of the intervertebral disc
C) the orientation of the superior and inferior articular facets
D) the arrangement of muscular attachment to the spinous processes
39)
40) The antebrachium is composed of which of the following two bones?
A) the humerus and the clavicle
B) the scapula and the clavicle
C) the humerus and the radius
D) the radius and the ulna
40)
41) Thoracic vertebrae differ from the other vertebrae in that they have ________.
A) transverse foramina
B) no transverse processes
C) costal facets
D) no intervertebral discs
41)
42) The suture that is found where a parietal and temporal bone meet on the lateral aspect of the skull
is ________.
A) coronal
B) squamous
C) sagittal
D) lambdoid
42)
43) 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) lordosis
B) scoliosis
C) hunchback
D) kyphosis
43)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
44) If the hyoid bone is not attached to another bone why is it so important?
5
44)
Figure 7.2
Using Figure 7.2, match the following:
45) Allow cranial nerves that control eye movements to enter the orbit.
45)
46) The ________ is the bone confined to the septum of the nose.
46)
47) Which vertebral curvature abnormality is the most serious? Why?
47)
6
Figure 7.1
Using Figure 7.1, match the following:
48) Bears most of the weight.
48)
49) What are the subdivisions of the axial skeleton and how do they function?
49)
7
Figure 7.1
Using Figure 7.1, match the following:
50) Attach to ribs.
50)
51) Transvers foramina allow the passage of vertebral arteries.
51)
52) No canals or foramen present.
52)
53) The smallest short bone in the hand is the ________.
53)
8
Figure 7.2
Using Figure 7.2, match the following:
54) Anchor the pterygoid muscles.
54)
55) The styloid process of the ________ points to the thumb.
55)
56) What structure is the "missing" body of the second cervical vertebrae?
56)
57) How are the pectoral and pelvic girdles structurally different? How is this difference
reflected in their functions?
57)
58) Identify the four major cranial sutures in any order and the bones they connect.
58)
59) Only the ________ vertebrae have transverse foramina.
59)
60) What is the function of the lumbar curvature?
60)
61) What is the purpose of the articular processes of the vertebrae?
61)
9
Figure 7.1
Using Figure 7.1, match the following:
62) Articulates with hip bones of the pelvis.
62)
10
Figure 7.2
Using Figure 7.2, match the following:
63) Forms parts of the middle cranial fossa, dorsal walls of the orbits, and external walls of the
skull.
63)
64) Pituitary gland is suspended here.
64)
65) Passageway for optic nerve.
65)
66) How do the first two cervical vertebrae differ from other cervical vertebrae? What are their
functions?
66)
11
Figure 7.1
Using Figure 7.1, match the following:
67) Contains a pivot joint that allows you to rotate your head "no."
67)
68) The largest foramen in the body is the ________ foramen.
68)
69) How might low back pain be related to poor abdominal muscle tone?
69)
70) The medial condyle of the femur articulates with the medial condyle of the ________.
70)
71) Identify the arches of the foot and describe how they are maintained.
71)
72) The kneecap is called the ________.
72)
73) What is the purpose of the vertebral curvatures?
73)
12
74) Why is the area just distal to the tubercles of the humerus called the surgical neck?
74)
Figure 7.1
Using Figure 7.1, match the following:
75) Includes the atlas and the axis.
75)
76) Describe the differences between the bones of the lower and upper limb and briefly state
why these differences exist.
76)
77) What are the fontanelles and what advantages do they confer on the fetus? The mother?
77)
78) The lateral condyle of the femur articulates with the lateral condyle of the ________.
78)
79) Your "cheekbone" is mostly formed from the ________ bone.
79)
13
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
80) The largest and strongest bone of the face is the maxilla.
80)
81) The shallow socket of the shoulder joint restricts dislocation of the humerus and is the main
contributor to the stability of the joint.
81)
82) The vomer along with the perpendicular plate of the ethmoid bone forms the bony part of the nasal
septum.
82)
83) The temporal bone connects to the zygomatic bone via the temporal process of the temporal bone.
83)
84) The vertebral column is held in place primarily by the anterior and posterior longitudinal
ligaments.
84)
85) In the anatomical position, the lateral forearm bone is the radius.
85)
86) The pituitary gland is housed in a saddle-like depression in the temporal bone called the sella
turcica.
86)
87) All vertebrae possess a body, a spine, and transverse foramina.
87)
88) The mastoid sinuses are located at a position in the skull where they are usually free from
infections.
88)
89) The tubercle of a rib articulates with the transverse process of a vertebra.
89)
90) 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.
90)
91) Lordosis affects the thoracic vertebrae.
91)
92) The ischium articulates with both the ilium and the pubis forming the acetabulum.
92)
93) The frontal bone articulates with the parietal bone by means of the sagittal suture.
93)
94) The femur is the largest and strongest bone in the body.
94)
95) Costal cartilages join most ribs to the sternum.
95)
96) The most common site of fracture in the humerus is the surgical neck which is distal to the
anatomical neck.
96)
97) There are seven cervical, twelve thoracic, and five lumbar vertebrae.
97)
98) All of the bones of the skull, except the mandible, are united by sutures and are therefore
immovable.
98)
14
99) Most of the body's weight is carried by the talus and calcaneus.
99)
100) The dens articulates with the occipital bone.
100)
101) In women of childbearing age, the dimensions of the true pelvis are of utmost importance.
101)
102) The term vertebrochondral ribs refers to the "false ribs," that attach to each other before they attach to
the sternum.
102)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
103) Allows the head to nod "yes."
A) Atlas
103)
Match the following:
104) Lambdoid suture.
A) Connects temporal and parietal bones
105) Squamosal suture.
B) Connects occipital and temporal bones
106) Occipitomastoid suture.
C) Connects occipital and parietal bones.
107) Coronal suture.
D) Connects parietal and frontal bones
104)
105)
106)
107)
Match the following:
108) These very small bones are at the
medial wall of each orbit and provides
a groove for the tear ducts.
A) Lacrimal bones
108)
Match the following:
109) The fused rudimentary tailbone.
A) Coccyx
109)
Match the following:
110) Failure of these anterior bones to fuse
causes a condition known as cleft
palate.
A) Temporal bones
110)
B) Lacrimal bones
111) This bone houses the apparatus of the
internal and middle ear.
111)
Match the following:
112) The fingers have three of these bones
and the thumb has only two.
A) Phalanges
15
112)
Match the following:
113) The bone that articulates with the
occipital condyles.
A) Atlas
113)
Match the following:
114) This bone articulates with the glenoid
fossa.
A) Humerus
114)
Match the following:
115) This bone is wing-shaped and extends
behind the eyes and forms part of the
floor of the cranial vault.
A) Sphenoid
115)
Match the following:
116) Sagittal suture.
A) Connects right and left parietal bones.
116)
Match the following:
117) The sella turcica is a portion of this
bone.
A) Sphenoid
117)
Match the following:
118) A cushionlike shock absorber of two
parts: a nucleus pulposus and annulus
fibrosus.
A) Cervical vertebrae
118)
B) Intervertebral disc
119) These bones are the smallest and
lightest vertebrae.
119)
Match the following:
120) Forearm bone that articulates with
most of the carpals.
A) Radius
120)
Match the following:
121) This bone has a passageway into the
nasal cavity.
A) Lacrimal bones
121)
Match the following:
122) This bone shapes the posterior wall of
the pelvis.
A) Sacrum
16
122)
Match the following:
123) The bones that contain teeth.
A) Maxillae
123)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
124) 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?
125) 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?
126) You are a school nurse in a middle school. You are responsible for screening the children for scoliosis. What is
involved in this screening?
127) 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?
128) 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?
129) 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?
130) 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?
17
Answer Key
Testname: 7
1) D
2) C
3) C
4) D
5) B
6) B
7) A
8) B
9) B
10) A
11) B
12) D
13) B
14) B
15) D
16) C
17) C
18) D
19) A
20) D
21) C
22) B
23) A
24) D
25) D
26) A
27) A
28) D
29) C
30) D
31) C
32) D
33) D
34) C
35) A
36) C
37) A
38) A
39) C
40) D
41) C
42) B
43) A
44) 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.
45) D
46) vomer
18
Answer Key
Testname: 7
47) Scoliosis is the most serious abnormality, due to the pressure that can be placed on the lungs and resulting breathing
difficulties.
48) C
49) The skull, vertebral column, and the thoracic cage function to provide support and protection.
50) B
51) A
52) E
53) pisiform
54) E
55) radius
56) dens
57) 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.
58) 1. Coronal - parietal and frontal
2. Sagittal - between the parietal bones
3. Squamous - parietal and temporal
4. Lambdoidal - parietal and occipital
59) cervical
60) It positions the weight of the trunk over the body's center of gravity, thus providing optimal balance when standing.
61) 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.
62) D
63) B
64) C
65) A
66) The atlas or C1 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 C2 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.
67) A
68) obturator
69) 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.
70) tibia
71) 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.
72) patella
73) Their purpose is to increase the resilience and flexibility of the spine, allowing it to function like a spring rather than a
rigid rod.
74) This area is called the surgical neck because it is the most frequently fractured part of the humerus.
75) A
76) 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.
77) 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.
78) tibia
19
Answer Key
Testname: 7
79) zygomatic
80) FALSE
81) FALSE
82) TRUE
83) FALSE
84) TRUE
85) TRUE
86) FALSE
87) FALSE
88) FALSE
89) TRUE
90) TRUE
91) FALSE
92) TRUE
93) FALSE
94) TRUE
95) TRUE
96) TRUE
97) TRUE
98) TRUE
99) TRUE
100) FALSE
101) TRUE
102) TRUE
103) A
104) C
105) A
106) B
107) D
108) A
109) A
110) B
111) A
112) A
113) A
114) A
115) A
116) A
117) A
118) B
119) A
120) A
121) A
122) A
123) A
124) 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.
125) 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.
20
Answer Key
Testname: 7
126) 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.
127) The compressions could break the xiphoid process of the sternum and drive it into the heart, diaphragm, or liver
resulting in possibly deadly complications.
128) The paranasal sinuses, specifically the frontal sinus located in the frontal bone and the right maxillary sinus located in
the right maxilla.
129) 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.
130) The skull protects the brain from blows. A helmet would add extra protection in sports where there is an increased risk
for head injury.
21
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following is NOT strictly a part of a synovial joint?
A) articular cartilage
B) tendon sheath
C) articular (joint) capsule
D) joint (articular) cavity
1)
2) Which of the following is a true statement regarding gliding movements?
A) Gliding movements allow flexibility of the upper limbs.
B) Gliding movements occur at the intercarpal and intertarsal joints.
C) Gliding movements are multiaxial.
D) An example of a gliding movement is nodding one's head.
2)
3) Football players often sustain lateral blows to the extended knee. Which of the following is (are)
damaged as a result?
A) tibial collateral ligament, medial meniscus, and anterior cruciate ligament
B) arcuate popliteal and the posterior cruciate ligaments
C) suprapatellar ligament
D) oblique popliteal and extracapsular ligaments
3)
4) Extracapsular ligaments stabilizing the knee include ________.
A) the oblique popliteal crossing the knee anteriorly
B) cruciate ligaments, which help secure the articulating bones together
C) the patellar ligament extending from femur to patella
D) fibular and tibial collateral ligaments, which prevent lateral or medial rotation
4)
5) On the basis of structural classification, which is a fibrous joint?
A) syndesmosis
B) pivot
C) synchondrosis
5)
6) Which joints are correctly matched?
A) wrist; saddle
C) interphalangeal; plane
D) symphysis
B) ankle; hinge
D) elbow; pivot
6)
7) The type of joint between the carpal (trapezium) and the first metacarpal is a ________ joint.
A) hinge
B) saddle
C) condylar
D) plane
7)
8) Bowing to your opponent before a jiu jitsu match would be considered a ________ movement.
A) extension
B) circumduction
C) hyperextension
D) flexion
8)
9) The cruciate ligaments of the knee ________.
A) tend to run parallel to one another
C) attach to each other in their midportions
9)
B) prevent hyperextension of the knee
D) are also called collateral ligaments
10) Which of the following statements defines synchondroses?
A) joints that permit angular movements
B) amphiarthrotic joints designed for strength and flexibility
C) interphalangeal joints
D) cartilaginous joints where hyaline cartilage unites the ends of bones
1
10)
11) All of the following are factors that influence synovial joint stability EXCEPT ________.
A) number of bones in the joint
B) strength and tension of joint ligaments
C) structure and shape of the articulating bone
D) arrangement and tension of the muscles
11)
12) Which of the following statements best describes angular movements?
A) They occur only between bones with flat articular processes.
B) They change (increase or decrease) the angle between two bones.
C) They turn a bone along its own long axis.
D) They allow movement only in one plane.
12)
13) What is moving a limb away from the midline of the body along the frontal plane called?
A) adduction
B) flexion
C) abduction
D) extension
13)
14) Saddle joints have concave and convex surfaces. Identify a saddle joint of the skeleton.
A) carpometacarpal joint of the phalanges
B) interphalangeal joint of the finger
C) carpometacarpal joint of the thumb
D) metacarpophalangeal joint of the finger
14)
15) Synchondroses and symphyses are examples of ________ joints.
A) periodontal
B) cartilaginous
C) synovial
15)
D) fibrous
16) Which of the following movements does NOT increase or decrease the angle between bones?
A) abduction
B) circumduction
C) rotation
D) extension
16)
17) Fibrous joints are classified as ________.
A) symphysis, sacroiliac, and articular
C) sutures, syndesmoses, and gomphoses
B) pivot, hinge, and ball and socket
D) hinge, saddle, and ellipsoidal
17)
18) Synarthrotic joints ________.
A) are found only in adults
C) have large joint cavities
B) are immovable joints
D) characterize all cartilaginous joints
18)
19) In symphysis joints the articular surfaces of the bones are covered with ________.
A) tendon sheaths
B) synovial membranes
C) hyaline cartilage
D) fibrocartilage
19)
20) Tendon sheaths ________.
A) act as friction-reducing structures
B) help anchor the tendon to the muscle
C) are extensions of periosteum
D) are lined with dense irregular connective tissue
20)
21) Which joint does NOT belong with the others?
A) elbow
C) wrist
B) ankle
D) interphalangeal (toes)
2
21)
22) 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) The additional joint present doubles the range of motion.
B) The joint capsules and ligaments are more stretchy and loose than normal.
C) Greater than normal production of serous fluid lubricates the joint and extends it.
D) Articular cartilage at bone ends is replaced with hyaline cartilage.
22)
23) Connective tissue sacs lined with synovial membrane that act as cushions in places where friction
develops are called ________.
A) bursae
B) menisci
C) ligaments
D) tendons
23)
24) A situation where the bones are connected exclusively by ligaments, cords, or bands of fibrous
tissue is a ________.
A) synchondrosis
B) gomphosis
C) syndesmosis
D) suture
24)
25) In the classification of joints, which of the following is true?
A) Immovable joints are called amphiarthroses.
B) Synarthrotic joints are slightly movable.
C) All synovial joints are freely movable.
D) In cartilaginous joints, a joint cavity is present.
25)
26) Articular cartilage found at the ends of the long bones serves to ________.
A) produce red blood cells (hemopoiesis)
B) form the synovial membrane
C) provide a smooth surface at the ends of synovial joints
D) attach tendons
26)
27) An example of an interosseous fibrous joint is ________.
A) the radius and ulna along its length
B) between the humerus and the glenoid cavity
C) between the vertebrae
D) the clavicle and the scapula at the distal ends
27)
28) Which of the following is a true statement?
A) The annular ligament surrounds the head of the radius.
B) The rotator cuff is responsible for the flexible extensions at the elbow joint.
C) The greater tubercle of the humerus articulates at the coracoid process of the scapula.
D) The head of the humerus articulates with the acromion process.
28)
29) Lifting up a glass to take a drink involves the elbow joint. Which of the following correctly
characterizes that joint?
A) diarthrotic
B) pivot
C) cartilaginous
D) biaxial
29)
30) Compared to the shoulder, displacements of the hip joints are ________.
A) common due to the weight bearing the hip endures
B) rare because the rotator cuff stabilizes the hip joint
C) common in all people who are overweight
D) rare because of the ligament reinforcement
30)
3
31) Presence of a synovial cavity, articular cartilage, synovial membrane, and ligaments are
characteristics of what type of joint?
A) symphysis
B) synchondrosis
C) hinge joint
D) suture
31)
32) Performing "jumping jacks" requires ________.
A) abduction and adduction
C) flexion and extension
32)
B) inversion and eversion
D) pronation and supination
33) Articulations permitting only slight degrees of movement are ________.
A) diarthroses
B) synovial joints
C) amphiarthroses
D) synarthroses
34) Bending your head back until it hurts is an example of ________.
A) extension
B) hyperextension
C) flexion
D) circumduction
33)
34)
35) What are menisci (articular discs)?
A) small sacs containing synovial fluid
B) tendon sheaths
C) wedges of fibrocartilage that partially or completely divide the synovial cavity
D) cavities lined with cartilage
35)
36) Moving your jaw forward, causing an underbite, is called ________.
A) retraction
B) pronation
C) adduction
D) protraction
36)
37) The hip joint is a good example of a(n) ________ synovial joint.
A) multiaxial
B) uniaxial
C) nonaxial
D) biaxial
38) Pointing the toes is an example of ________.
A) circumduction
B) plantar flexion
D) pronation
C) protraction
37)
38)
39) The terms inversion and eversion pertain only to the ________.
A) feet
B) hands
C) hands and the feet
D) arms
39)
40) Which of the following conditions is joint inflammation or degeneration accompanied by stiffness,
pain, and swelling?
A) Lyme disease
B) rheumatoid arthritis
C) osteoarthritis
D) arthritis
40)
41) Baseball pitchers often require "Tommy John" surgery to repair damage to their elbow. Which
ligament would this surgery target?
A) anular ligament
B) acetabular labrum
C) ulnar collateral ligament
D) lateral ligament
41)
42) Which ligament of the knee initiates the knee-jerk reflex when tapped?
A) the patellar ligament
B) the extracapsular ligament
C) the medial patellar retinacula
D) the lateral patellar retinacula
42)
4
43) Synovial fluid is present in joint cavities of freely movable joints. Which of the following statements
is true about this fluid?
A) It contains hyaluronic acid.
B) It contains enzymes only.
C) It contains hydrochloric acid.
D) It contains lactic acid.
43)
44) 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) tibial collateral ligaments
B) cruciate ligaments
C) anterior ligaments
D) patellar ligaments
44)
45) Which of the following are cartilaginous joints?
A) gomphoses
B) synchondroses
45)
C) syndesmoses
D) sutures
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:
46) Articular cartilage.
46)
5
47) Synovial membrane.
47)
48) 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.).
48)
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: ________, ________.
49) 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?
49)
50) Why are epiphyseal plates considered temporary joints?
50)
51) 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?
51)
52) 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?
52)
6
Figure 8.1
Using Figure 8.1, match the following:
53) Fibrous layer.
53)
54) Why is muscle tone the most important stabilizing factor for most joints?
54)
55) How can gout be treated?
55)
56) While the fingers can exhibit flexion and extension and other angular motions, the thumb
has much greater freedom. Why?
56)
57) 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?
57)
58) Briefly describe the structure of a typical synovial joint.
58)
59) Synovial joints have six distinguishing features. What are they?
59)
7
60) 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?
60)
61) 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.
61)
Figure 8.1
Using Figure 8.1, match the following:
62) Joint (articular) cavity.
62)
63) Periosteum.
63)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
64) Synovial fluid is a viscous material that is derived by filtration from blood.
8
64)
65) Gliding movements occur when one flat, or nearly flat, bone surface glides or slips over another.
65)
66) Hinge joints permit movement in only one plane.
66)
67) A ball-and-socket joint is a multiaxial joint.
67)
68) Movement at the hip joint does not have as wide a range of motion as at the shoulder joint.
68)
69) Synovial fluid contains phagocytic cells that protect the cavity from invasion by microbes or other
debris.
69)
70) Pronation is a much stronger movement than supination.
70)
71) All joints permit some degree of movement, even if very slight.
71)
72) A person who has been diagnosed with rheumatoid arthritis would be suffering loss of the synovial
fluids.
72)
73) Dislocations in the TMJ almost always dislocate posteriorly with the mandibular condyles ending
up in the infratemporal fossa.
73)
74) Supination is the movement of the forearm in which the palm of the hand is turned anteriorly or
superiorly.
74)
75) The gripping of the trochlea by the trochlear notch constitutes the "hinge" for the elbow joint.
75)
76) The articular surfaces of synovial joints play a minimal role in joint stability.
76)
77) A person who has been diagnosed with a sprained ankle has an injury to the ligaments that attach
to that joint.
77)
78) The wrist joint can exhibit adduction and eversion movements.
78)
79) The major role of ligaments at synovial joints is to unite bones and prevent undesirable movement.
79)
80) The structural classification of joints is based on the composition of the binding material and the
presence or absence of a joint cavity.
80)
81) Movement of the ankle so that the superior aspect of the foot approaches the shin is called
dorsiflexion.
81)
82) Symphyses are synarthrotic joints designed for strength with flexibility.
82)
83) The amount of movement permitted by a particular joint is the basis for the functional classification
of that joint.
83)
84) Moving a limb so that it describes a cone in space is called circumduction.
84)
9
85) Bending of the tip of the finger exhibits flexion.
85)
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?
86) Joint 2.
A) Nonaxial
87) Joint 4.
B) Uniaxial
88) Joint 3.
86)
87)
88)
10
Figure 8.3
Using Figure 8.3, identify each type of synovial joint by name.
89) Joint 1.
A) Hinge
90) Joint 5.
B) Ball and socket
91) Joint 3.
C) Saddle
89)
90)
91)
Match the following:
92) Movement of a limb toward the
midline of the body.
A) Adduction
11
92)
Figure 8.3
Using Figure 8.3, identify each type of synovial joint by name.
93) Joint 6.
A) Condyloid
12
93)
Figure 8.2
Using Figure 8.2, what type of axial movement does each joint have?
94) Joint 5.
A) Biaxial
94)
Match the following:
95) A bending movement that decreases
the angle of the joint.
A) Flexion
13
95)
Figure 8.2
Using Figure 8.2, what type of axial movement does each joint have?
96) Joint 6.
A) Biaxial
96)
Match the following:
97) Moving a limb so it describes a cone in
a space.
A) Circumduction
14
97)
Figure 8.2
Using Figure 8.2, what type of axial movement does each joint have?
98) Joint 1.
A) Multiaxial
15
98)
Figure 8.3
Using Figure 8.3, identify each type of synovial joint by name.
99) Joint 4.
A) Plane
100) Joint 2.
B) Pivot
99)
100)
Match the following:
101) Movement of a limb away from the
midline of the body.
A) Abduction
16
101)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
102) 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?
103) 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?
104) 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?
105) 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.
106) 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?
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) 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?
17
Answer Key
Testname: 8
1) B
2) B
3) A
4) D
5) A
6) B
7) B
8) D
9) B
10) D
11) A
12) B
13) C
14) C
15) B
16) C
17) C
18) B
19) C
20) A
21) C
22) B
23) A
24) C
25) C
26) C
27) A
28) A
29) A
30) D
31) C
32) A
33) C
34) B
35) C
36) D
37) A
38) B
39) A
40) D
41) C
42) A
43) A
44) B
45) B
46) C
47) E
18
Answer Key
Testname: 8
48) a. hinge; flexion
b. pivot; rotation
c. ball and socket; adduction
d. plane; inversion
49) 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.
50) Once long bone growth in length is complete, the cartilage of the epiphyseal plates completely ossifies to become a
permanent connection between the bones.
51) 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.
52) Rheumatoid arthritis
53) D
54) 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.
55) 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.
56) The thumb's carpometacarpal joint is a biaxial saddle joint whereas the other carpometacarpal joints are plane joints
with no angular freedom.
57) 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.
58) 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.
59) Articular cartilage, a joint (articular) cavity, an articular (joint) capsule, synovial fluid, reinforcing ligaments, nerves,
and blood vessels.
60) 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.
61) 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.
62) B
63) A
64) TRUE
65) TRUE
66) TRUE
67) TRUE
68) TRUE
69) TRUE
70) FALSE
19
Answer Key
Testname: 8
71) FALSE
72) FALSE
73) FALSE
74) TRUE
75) TRUE
76) TRUE
77) TRUE
78) FALSE
79) TRUE
80) TRUE
81) TRUE
82) FALSE
83) TRUE
84) TRUE
85) TRUE
86) B
87) A
88) B
89) B
90) C
91) A
92) A
93) A
94) A
95) A
96) A
97) A
98) A
99) A
100) B
101) A
102) 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.
103) He might have suffered a shoulder dislocation since the shoulder joint has sacrificed
stability for flexibility.
104) 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.
105) 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.
106) Susan should consider Lyme disease and test for it. Treatment is taking antibiotics for 3 to 6 months.
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) 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.
20
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following statements is true?
A) Cardiac muscle cells are found in the heart and large blood vessels.
B) Cardiac muscle cells have many nuclei.
C) Striated muscle cells are long and cylindrical with many nuclei.
D) Smooth muscle cells have T tubules.
1)
2) During muscle contraction, myosin cross bridges attach to which active sites?
A) myosin filaments
B) Z discs
C) actin filaments
D) thick filaments
2)
3) What part of the sarcolemma contains acetylcholine receptors?
A) end of the muscle fiber
B) motor end plate
C) part adjacent to another muscle cell
D) any part of the sarcolemma
3)
4) Sarcomeres are functional units of ________ muscle.
A) smooth
B) skeletal
4)
C) cardiac
D) B and C only
5) Which of the following describes the cells of unitary smooth muscle?
A) They consist of muscle fibers that are structurally independent of each other.
B) They exhibit spontaneous action potentials.
C) They are used for vision and hair raising.
D) They depend upon recruitment using the autonomic nervous system.
5)
6) Which of the following is the correct order for the phases of a muscle twitch?
A) latent, contraction, relaxation
B) relaxation, contraction, latent
C) contraction, relaxation, latent
D) latent, relaxation, contraction
6)
7) 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) dehydration with headache
B) coma and loss of voluntary muscle movement
C) weakness of muscle
D) seizures and uncontrollable muscle movement
7)
8) 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) hydrochloric acid
B) lactic acid
C) a strong base
D) stearic acid
8)
9) Smooth muscle is characterized by all of the following EXCEPT ________.
A) there are more thick filaments than thin filaments
B) there are no sarcomeres
C) there are noncontractile intermediate filaments that attach to dense bodies within the cell
D) it appears to lack troponin
9)
1
10) What does excess postexercise oxygen consumption represent?
A) the amount of oxygen taken into the body immediately after the exertion
B) amount of oxygen needed for aerobic activity to accomplish the same amount of work
C) the difference between the amount of oxygen needed for totally aerobic muscle activity and
the amount actually used
D) the amount of oxygen equal to the oxygen already used
10)
11) The strongest muscle contractions are normally achieved by ________.
A) increasing stimulus above the treppe stimulus
B) increasing the stimulation up to the maximal stimulus
C) recruiting small and medium muscle fibers
D) increasing stimulus above the threshold
11)
12) Which of the following surrounds an individual muscle cell?
A) perimysium
B) endomysium
C) fascicle
D) epimysium
12)
13) A potential benefit of recruiting slow oxidative fibers for contraction before recruiting fast oxidative
and fast glycolytic fibers might be ________.
A) 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
B) because they are slower to respond, slow oxidative fibers must be stimulated first in order to
contract simultaneously with the faster 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.
13)
14) 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) skeletal muscle
B) smooth muscle
C) striated muscle
D) cardiac muscle
14)
15) Addition of more myoglobin to a muscle fiber would have the largest effect on ________.
A) fast oxidative and slow oxidative fibers
B) fast glycolytic fibers only
C) fast glycolytic and fast oxidative fibers
D) fast oxidative fibers only
15)
16) Creatine phosphate functions in the muscle cell by ________.
A) inducing a conformational change in the myofilaments
B) forming a chemical compound with actin
C) storing energy that will be transferred to ADP to resynthesize ATP
D) forming a temporary chemical compound with myosin
16)
17) 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
17)
2
18) When a sarcomere contracts and thin filaments move over thick filaments you would expect to see
________.
A) the A band to appear darker
B) the H zone to appear wider
C) the I bands to appear wider
D) the I bands to appear smaller
18)
19) Reduction in blood flow to a muscle fiber would have the greatest effect on ________.
A) fast glycolytic
B) slow oxidative fibers
C) fast oxidative fibers
D) both slow and fast oxidative
19)
20) 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.
20)
21) The contractile units of skeletal muscles are ________.
A) mitochondria
B) myofibrils
C) T tubules
21)
D) microtubules
22) Of the following items listed below, which is the best description for why skeletal muscle stores
glycogen?
A) Skeletal muscle is a heavy consumer of energy.
B) The glycogen is an insulating layer that helps regulate body temperature.
C) Glycogen provides a smooth surface for filaments to slide on.
D) Glycogen is part of muscles rigid supporting framework.
22)
23) 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) contraction
B) refractory
C) relaxation
D) latent
23)
24) 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
24)
25) 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 potassium ions.
B) One subunit binds tropomyosin and helps position it on actin.
C) One subunit attaches troponin to actin.
D) One subunit binds to calcium ions.
25)
26) Which muscle cells have the greatest ability to regenerate?
A) cardiac
B) skeletal
C) smooth
D) no muscle can regenerate
26)
3
27) Which of the following is a factor that affects the velocity and duration of muscle contraction?
A) number of muscle fibers stimulated
B) muscle length
C) load on the fiber
D) size of the muscle fibers stimulated
27)
28) 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) Since the exercise was mostly aerobic exercise, the runners' bodies have not yet realized the
run is over.
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) The runners' fast oxidative muscles are so slow to utilize oxygen, they only begin aerobic
respiration by the time the run has finished.
28)
29) Which of the following is the correct sequence of events for muscle contractions?
A) neurotransmitter release, motor neuron action potential, muscle cell action potential, release
of calcium ions from SR, ATP-driven power stroke
B) neurotransmitter release, muscle cell action potential, motor neuron action potential, release
of calcium ions from SR, sliding of myofilaments, ATP-driven power stroke
C) muscle cell action potential, neurotransmitter release, ATP-driven power stroke, calcium ion
release from SR, sliding of myofilaments
D) motor neuron action potential, neurotransmitter release, muscle cell action potential, release
of calcium ions from SR, ATP-driven power stroke, sliding of myofilaments
29)
30) What is the primary function of wave summation?
A) produce smooth, continuous muscle contraction
B) prevent muscle relaxation
C) prevent muscle fatigue
D) increase muscle tension
30)
31) 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) the Na+ -K+ pump
C) elastic (titin) filaments
D) acetylcholine receptors in the motor end plate
31)
32) Hypothetically, if a muscle were stretched to the point where thick and thin filaments no longer
overlapped, ________.
A) no muscle tension could be generated
B) maximum force production would result because the muscle has a maximum range of travel
C) ATP consumption would increase because the sarcomere is "trying" to contract
D) cross bridge attachment would be optimum because of all the free binding sites on actin
32)
4
33) 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 cardiac muscle, causing fibrillations of the heart.
B) Curare will only affect muscles with ACh receptors, paralyzing them.
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.
33)
34) Myoglobin ________.
A) is a protein involved in the direct phosphorylation of ADP
B) produces the end plate potential
C) stores oxygen in muscle cells
D) breaks down glycogen
34)
35) Which of the following would be recruited later in muscle stimulation when contractile strength
increases?
A) motor units with the longest muscle fibers
B) motor units with larger, less excitable neurons
C) large motor units with small, highly excitable neurons
D) many small motor units with the ability to stimulate other motor units
35)
36) Approximately 80% of a muscle fiber's volume are the myofibrils. This characteristic reflects
muscles ability to ________.
A) generate and propagate action potential
B) produce movement through contractile force
C) store oxygen molecules that can be used in aerobic respiration
D) produce relatively high amounts of ATP
36)
37) 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
37)
38) What is the most distinguishing characteristic of muscle tissue?
A) It is composed of multiple cells working together.
B) the ability to transform chemical energy into mechanical energy to move the body
C) the ability to respond to nervous stimulation
D) its cells' inability to reproduce by mitosis
38)
39) 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 receptor for the motor neuron neurotransmitter.
C) Tropomyosin serves as a contraction inhibitor by blocking the actin binding sites on the
myosin molecules.
D) Tropomyosin is the chemical that activates the myosin heads.
39)
5
40) 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
40)
41) Exhaustion of glycogen storage within a muscle fiber would have the biggest effect on ________.
A) fast glycolytic fibers
B) slow oxidative fibers
C) fast oxidative fibers
D) both slow and fast oxidative fibers
41)
42) 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) both fast glycolytic and fast oxidative fibers
B) fast glycolytic fibers
C) slow oxidative fibers
D) fast oxidative fibers
42)
43) When a muscle is unable to respond to stimuli temporarily, it is in which of the following periods?
A) fatigue period
B) relaxation period
C) refractory period
D) latent period
43)
44) The oxygen-binding protein found in muscle cells is ________.
A) ATP
B) hemoglobin
C) immunoglobin
44)
D) myoglobin
45) Rigor mortis occurs because ________.
A) proteins are beginning to break down, thus preventing a flow of calcium ions
B) no ATP is available to release attached actin and myosin molecules
C) sodium ions leak into the muscle causing continued contractions
D) the cells are dead
45)
46) 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) thick (myosin) filaments
B) acetylcholine receptors in the motor end plate
C) elastic (titin) filaments
D) potassium (K+ ) leak channels
46)
47) 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) thick (myosin) filaments
B) elastic (titin) filaments
C) potassium (K+ ) leak channels
D) voltage gated sodium channels
47)
48) Of the following muscle types, which has the longest muscle cells and has obvious stripes called
striations?
A) visceral smooth muscle
B) cardiac muscle
C) multiunit smooth muscle
D) skeletal muscle
48)
6
49) Which of the following is true about smooth muscle?
A) Certain smooth muscle cells can actually divide to increase their numbers.
B) Smooth muscle has well-developed T tubules at the site of invagination.
C) Smooth muscle cannot stretch as much as skeletal muscle.
D) Smooth muscle, in contrast to skeletal muscle, cannot synthesize or secrete any connective
tissue elements.
49)
50) What structure in skeletal muscle cells functions in calcium storage?
A) mitochondria
B) sarcoplasmic reticulum
C) intermediate filament network
D) myofibrillar network
50)
51) After nervous stimulation stops, what prevents ACh in the synaptic cleft from continuing to
stimulate contraction?
A) calcium ions returning to the terminal cisternae
B) acetylcholinesterase breaks apart the ACh
C) the tropomyosin blocking the myosin once full contraction is achieved
D) the action potential stops going down the overloaded T tubules
51)
52) Which of the following statements best illustrates the fact that skeletal muscle is voluntary muscle?
A) Skeletal muscle appears striated due to the structure of the sarcomeres.
B) The shivering reflex aids in maintaining body temperature.
C) Skeletal muscle fibers are innervated by somatic motor neurons.
D) Skeletal muscle is wrapped in several layers of connective tissue. The deepest layer being the
endomysium.
52)
53) What is the functional role of the T tubules?
A) stabilize the G and F actin
B) synthesize ATP to provide energy for muscle contraction
C) enhance cellular communication during muscle contraction
D) hold cross bridges in place in a resting muscle
53)
54) An anaerobic metabolic pathway that results in the production of two net ATPs per glucose plus
two pyruvic acid molecules is ________.
A) the citric acid cycle
B) glycolysis
C) the electron transport chain
D) hydrolysis
54)
55) The mechanism of contraction in smooth muscle is different from skeletal muscle in that ________.
A) the site of calcium binding site differs
B) ATP energizes the sliding process
C) actin and myosin interact by the sliding filament mechanism
D) the trigger for contraction is a rise in intracellular calcium
55)
56) Most skeletal muscles contain ________.
A) a mixture of fiber types
C) a predominance of slow oxidative fibers
56)
B) muscle fibers of the same type
D) a predominance of fast oxidative fibers
7
57) Muscle tone is ________.
A) the condition of athletes after intensive training
B) the ability of a muscle to efficiently cause skeletal movements
C) the feeling of well-being following exercise
D) a state of sustained partial contraction
57)
58) The ability of muscle to shorten forcibly when adequately stimulated is known as ________, and
sets muscle apart from other tissue types.
A) extensibility
B) excitability
C) contractility
D) elasticity
58)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
Figure 9.2
Using Figure 9.2, match the following:
59) Z disc.
59)
60) Describe the anatomical parts of the muscle triad and how the function of these organelles
work together to initiate contraction.
60)
61) 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.
61)
8
Figure 9.2
Using Figure 9.2, match the following:
62) H zone.
62)
63) A band.
63)
64) What ultimately stops muscle stimulation when the motor neuron ceases firing?
64)
9
Figure 9.2
Using Figure 9.2, match the following:
65) M line.
65)
66) Which cells help repair injured skeletal muscle fibers and allows regeneration of dead
skeletal muscle?
66)
67) Describe two ways in which the lack of ATP production results in rigor mortis.
67)
68) The enzyme ________ is present in the synaptic cleft at the neuromuscular junction. Its
activity stops the neurotransmitters stimulation.
68)
10
Figure 9.2
Using Figure 9.2, match the following:
69) I band.
69)
70) Only ________ muscle cells are multinucleated.
70)
71) How is it that norepinephrine (NE) can inhibit smooth muscle action in airways, yet
stimulate contractions in smooth muscles everywhere else in the body?
71)
72) Describe the difference between muscle tension, muscle contraction and a muscle twitch.
72)
73) The end of the muscle that is attached to the part of the body in motion when a muscle
contracts is called the ________.
73)
11
Figure 9.1
Using Figure 9.1, match the following:
74) Bundle of muscle cells surrounded by a perimysium.
74)
75) Individual muscle fiber.
75)
76) Only ________ muscle cells have intercalated discs at their gap junctions.
76)
77) Caveolae are an anatomical feature of smooth muscle. Describe this anatomical feature and
specifically how it improves smooth muscles' response to nervous stimulation
77)
78) A smooth, sustained contraction from rapid stimulation of skeletal muscle fibers is called
________.
78)
79) Briefly explain the sources of energy for a one-minute sustained muscle contraction.
79)
12
Figure 9.1
Using Figure 9.1, match the following:
80) Connective tissue sheath surrounding individual muscle fibers.
80)
81) Connective tissue surrounding muscle fiber bundles.
81)
82) Define muscle fatigue.
82)
13
Figure 9.1
Using Figure 9.1, match the following:
83) Connective tissue covering the exterior of a muscle organ.
83)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
84) Muscle tone is the small amount of tautness or tension in the muscle due to weak, involuntary
contractions of its motor units.
84)
85) The thin filaments (actin) contain a polypeptide subunit G actin that bears active sites for myosin
attachment.
85)
86) One of the functions of skeletal muscle contraction is production of heat.
86)
87) Peristalsis is characteristic of smooth muscle.
87)
88) Muscle contraction will always promote movement of body parts regardless of how they are
attached.
88)
89) Excitability is the ability of a cell to receive and respond to stimulus by changing its membrane
potential.
89)
90) A motor neuron and all the muscle cells that it stimulates are referred to as a motor end plate.
90)
91) Although there are no sarcomeres, smooth muscle still possesses thick and thin filaments.
91)
14
92) The effect of a neurotransmitter on the muscle cell membrane is to modify its ion permeability
properties temporarily.
92)
93) A skeletal muscle contracts with varying force and length of time in response to the body's needs at
the time.
93)
94) 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.
94)
95) A contraction in which the muscle does not shorten but its tension increases is called isometric
contraction.
95)
96) Once a motor neuron has fired, all the muscle fibers in a muscle contract.
96)
97) During isometric contraction, the energy used appears as movement.
97)
98) Smooth muscles relax when intracellular Ca2+ levels drop but may not cease contractions.
98)
99) Cells of unitary smooth muscle are found in the longitudinal and circular muscle layers of the
intestine.
99)
100) The force of muscle contraction is controlled by multiple motor unit summation or recruitment.
100)
101) Cardiac muscle has a limited regenerative capacity.
101)
102) When a muscle fiber contracts, the I bands diminish in size, the H zones disappear, and the A
bands do not diminish in length.
102)
103) Muscle cells store more creatine phosphate than ATP resulting in the muscle having a reserve
source of energy.
103)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
104) The ________ contains only the actin
filaments.
105) Both actin and myosin are found in the
________.
A) I band
104)
B) A band
105)
Match the following:
106) A neurotransmitter released at motor
end plates by the axon terminals.
107) Activates synaptic vesicles in axon
terminals to fuse with plasma
membrane of axon terminal.
A) Acetylcholine
106)
B) Calcium ions
107)
15
Match the following:
108) Red fibers, the smallest of the fiber
types.
A) Slow (oxidative), fatigue-resistant fibers
109) Abundant in muscles used to maintain
posture.
108)
109)
Match the following:
110) The thicker filaments are the ________
filaments.
111) The myosin filaments are located in
the ________.
A) A band
110)
B) Myosin
111)
Match the following:
112) When the muscle tension developed
overcomes the load and muscle
shortening occurs.
A) Isotonic contraction
112)
Match the following:
113) Depend on oxygen delivery and
aerobic mechanisms.
A) Slow (oxidative), fatigue-resistant fibers
113)
Match the following:
114) A sarcomere is the distance between
two ________.
A) Z discs
114)
Match the following:
115) Where the axon of a motor neuron
connects with the muscle fibers.
A) Neuromuscular junction
115)
Match the sport to the energy system primarily used to perform the activity:
116) 25-meter swim.
A) Anaerobic pathway
116)
Match the following:
117) Have very fast-acting myosin
ATPases and depend upon aerobic
metabolism during contraction.
A) Fast (oxidative), fatigue-resistant fibers
16
117)
Match the following:
118) The final chemical messenger and
"trigger" for muscle contraction. It
binds to troponin.
A) Calcium ions
118)
Match the sport to the energy system primarily used to perform the activity:
119) Marathons.
A) Aerobic pathway
119)
Match the following:
120) Determined by alternating motor units
of a muscle organ even when the
muscle is at rest.
A) Tetanus
120)
B) Muscle tone
121) Continued sustained smooth
contraction due to rapid stimulation.
121)
Match the following:
122) It diffuses across the cell membrane
resulting in depolarization.
123) Breaks down ACh into its building
blocks, rendering it inactive.
A) Acetylcholinesterase
122)
B) Sodium ions
123)
Match the following:
124) When muscle tension develops but the
load is not moved.
A) Isometric contraction
124)
Match the following:
125) Contain abundant amounts of
glycogen.
126) A relatively high percentage are found
in successful marathon runners.
A) Fast (glycolytic), fatigable fibers
125)
B) Slow (oxidative), fatigue-resistant fibers
126)
Match the following:
127) How a smooth increase in muscle
force is produced.
A) Multiple motor unit summation
127)
Match the sport to the energy system primarily used to perform the activity:
128) Weight lifting.
A) Direct phosphorylation
17
128)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
129) 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?
130) After much delayed removal of an elbow cast, Lauren noticed her arm was immovable. What happened to her
arm?
131) A patient has no peristalsis in the gastrointestinal tract. Explain a possible complication of this condition.
132) 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?
133) 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?
134) 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.
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) 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?
18
Answer Key
Testname: 9
1) C
2) C
3) B
4) D
5) B
6) B
7) C
8) B
9) A
10) C
11) B
12) B
13) C
14) B
15) A
16) C
17) A
18) D
19) B
20) C
21) B
22) A
23) D
24) A
25) A
26) C
27) C
28) C
29) D
30) A
31) D
32) A
33) B
34) C
35) B
36) B
37) A
38) B
39) A
40) D
41) A
42) C
43) C
44) D
45) B
46) C
47) A
48) D
49) A
50) B
19
Answer Key
Testname: 9
51) B
52) C
53) C
54) B
55) A
56) A
57) D
58) C
59) A
60) 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 Ca2+ 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.
61) 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.
62) B
63) D
64) 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.
65) E
66) satellite cells
67) 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.
68) acetylcholinesterase
69) C
70) skeletal
71) 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.
72) 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.
73) insertion
74) D
75) C
76) cardiac
77) 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.
78) tetanus
79) 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.
80) B
81) E
82) It is an inability of the muscle to contract despite continued stimulation.
83) A
20
Answer Key
Testname: 9
84) TRUE
85) TRUE
86) TRUE
87) TRUE
88) FALSE
89) TRUE
90) FALSE
91) TRUE
92) TRUE
93) TRUE
94) TRUE
95) TRUE
96) FALSE
97) FALSE
98) TRUE
99) TRUE
100) TRUE
101) TRUE
102) TRUE
103) TRUE
104) A
105) B
106) A
107) B
108) A
109) A
110) B
111) A
112) A
113) A
114) A
115) A
116) A
117) A
118) A
119) A
120) B
121) A
122) B
123) A
124) A
125) A
126) B
127) A
128) A
129) 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.
21
Answer Key
Testname: 9
130) 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.
131) 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.
132) Aaron probably has myasthenia gravis (an autoimmune disease), which involves a shortage of ACh receptors at the
neuromuscular junction.
133) 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.
134) 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.
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) 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.
22
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following is NOT a member of the hamstrings?
A) semitendinosus
B) semimembranosus
C) biceps femoris
D) gracilis
1)
2) 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) orbicularis oris
B) genioglossus
C) hyoglossus
D) stylohyoid
2)
3) The ________ helps keep food between the grinding surfaces of the teeth during chewing.
A) mentalis
B) orbicularis oris
C) buccinator
D) risorius
3)
4) The most powerful muscle in the body is the ________.
A) gastrocnemius
B) gluteus maximus
C) rectus abdominis
D) quadriceps femoris
4)
5) The ________ is known as the "boxer's muscle."
A) serratus anterior
C) rectus abdominis
5)
B) biceps brachii
D) flexor digitorum longus
6) The ________ is a synergist of the latissimus dorsi; it extends, medially rotates, and adducts the
humerus.
A) teres minor
B) infraspinatus
C) supraspinatus
D) teres major
6)
7) The ________ extends the great toe.
A) tibialis anterior
C) gastrocneumius
7)
B) extensor hallucis longus
D) fibularis (peroneous)tertius
8) ________ is a powerful forearm extensor at the elbow joint.
A) Biceps brachii
B) Triceps brachii
C) Brachialis
D) Brachioradialis
9) Which of the following muscles inserts to the posterior calcaneus via the calcaneal tendon?
A) the tibialis anterior
B) the sartorius
C) the semitendinosus
D) the gastrocnemius
8)
9)
10) Paralysis of which of the following would make an individual unable to flex the thigh?
A) soleus
B) biceps femoris
C) iliopsoas and rectus femoris
D) vastus medialis
10)
11) 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
11)
1
12) What are the levers that operate at a mechanical advantage called?
A) power levers
B) functional levers
C) dysfunctional levers
D) speed levers
12)
13) First-class levers ________.
A) are typified by tweezers or forceps
B) are used when standing on tip-toe
C) in the body can operate at a mechanical advantage or mechanical disadvantage, depending
on specific location
D) have load at one end of the lever, fulcrum at the other, and effort applied somewhere in the
middle
13)
14) Which of the following best describes the orbicularis oris?
A) It pulls the lower lip down and back.
B) It closes the eye.
C) It draws the eyebrows together.
D) It closes, purses, and protrudes the lips.
14)
15) Which of the following muscles is used to form a smile?
A) zygomaticus major
B) mentalis
C) orbicularis oris
D) corrugator supercilli
15)
16) Tennis players often complain about pain in the arm (forearm) that swings the racquet. What
muscle is usually strained under these conditions?
A) the triceps brachii
B) the flexor digitorum profundus
C) the anconeus
D) the brachioradialis
16)
17) Which of these is the function of the external oblique muscles?
A) flex vertebral column and compress abdominal wall
B) extend vertebral column and head and rotates them to opposite sides
C) elevate and adduct scapula in synergy with superior fibers of trapezius
D) pull ribs toward one another to elevate the rib cage
17)
18) Which of the following muscles is involved in inversion at the ankle joint?
A) fibularis (peroneus) tertius
B) extensor digitorum longus
C) fibularis (peroneus) longus
D) tibialis anterior
18)
19) What is the main factor that determines the power of a muscle?
A) the number of neurons innervating it
B) the total number of muscle fibers (cells) available for contraction
C) the shape
D) the length
19)
20) Which muscle(s) is (are) contracted to exhale forcibly?
A) diaphragm alone
B) external intercostals and diaphragm
C) internal intercostals and rectus abdominus
D) rectus abdominis and diaphragm
20)
2
21) The supraspinatus is named for its location on the posterior aspect of the scapula above the spine.
What is its action?
A) to initiate abduction of the arm, to stabilize the shoulder joint and to help prevent downward
dislocation of the humerus
B) to help hold the head of the humerus in the glenoid cavity and rotate the humerus laterally
C) to extend and medially rotate the humerus and to act as a synergist of the latissimus dorsi
D) to flex and adduct the humerus and to act as a synergist of the pectoralis major
21)
22) 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.
22)
23) Which of the following muscles is involved in producing horizontal wrinkles in the forehead?
A) the zygomaticus major
B) the frontal belly of the epicranius
C) the temporalis
D) the medial pterygoid
23)
24) A muscle that opposes, or reverses, a particular movement is a(n) ________.
A) agonist (prime mover)
B) synergist
C) fixator
D) antagonist
24)
25) What is a muscle that provides the major force for producing a specific movement called?
A) a fixator
B) an antagonist
C) an agonist (prime mover)
D) a synergist
25)
26) Which of the following muscles is a flexor of the thigh at the hip?
A) vastus lateralis
B) tibialis posterior
C) adductor magnus
D) gluteus maximus
26)
27) What muscle is primarily responsible for preventing foot drop?
A) extensor hallucis longus
B) tibialis anterior
C) fibularis tertius
D) extensor digitorum longus
27)
28) In general, a muscle that crosses on the anterior side of a joint produces ________.
A) adduction
B) flexion
C) extension
D) abduction
28)
29) The ________ tightens the neck and draws the corners of the mouth downward as in expressing
horror.
A) sternohyoid
B) mentalis
C) sternocleidomastoid
D) platysma
29)
30) 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
30)
3
31) 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) an antagonist
C) a prime mover
D) a synergist
31)
32) Which of the following muscles is NOT a rotator cuff muscle?
A) supraspinatus
B) teres minor
C) subscapularis
D) levator scapulae
32)
33) The quadriceps femoris is composed of three "vastus" muscles and the ________.
A) biceps femoris
B) semitendinosus
C) semimembranosus
D) rectus femoris
33)
34) The abnormal protrusion of the small intestine through a weak point in the muscle of the
abdominal wall is called a ________.
A) hernia
B) pulled muscle
C) sprain
D) hyperextension
34)
35) 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 that looks like many feathers side by side.
C) An arrangement of five fascicles on each side of the tendon.
D) An arrangement in which the fascicles insert into the tendon from opposite sides.
35)
36) 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 intermedius
B) the vastus lateralis
C) rectus femoris
D) the vastus medialis
36)
37) The ________ is the main chewing muscle.
A) lateral pterygoid
C) hyoglossus
37)
B) masseter
D) buccinator
38) 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 insertions, respectively.
B) The muscle has two, three, or four functions, respectively.
C) The muscle has two, three, or four origins, respectively.
D) The muscle is able to change direction twice, three times, or four times faster than other
muscles, respectively.
38)
39) Which of the following muscles fixes and stabilizes the pelvis during walking?
A) rectus abdominis
B) external oblique
C) internal oblique
D) transversus abdominis
39)
40) Which of the following muscles is involved in crossing one leg over the other to produce the
cross-legged position?
A) the sartorius
B) all of the hamstrings
C) the quadriceps femoris
D) the gastrocnemius
40)
4
41) Which of these is NOT a way of classifying muscles?
A) muscle location
B) muscle shape
C) the type of muscle fibers
D) the type of action they cause
41)
42) Paralysis of which of the following muscles would make an individual unable to flex the knee?
A) gluteal muscles
B) brachioradialis
C) hamstring muscles
D) soleus
42)
43) Which of the following muscles does NOT act in plantar flexion?
A) popliteus
B) flexor digitorum longus
C) tibialis posterior
D) gastrocnemius and soleus
43)
44) Which of the following describes the suprahyoid muscles?
A) They are often called strap muscles.
B) They depress the larynx and hyoid bone if the mandible is fixed.
C) They are a group of muscles that lie superior to the hyoid bone and help form the floor of the
oral cavity.
D) They move the pharynx superiorly during swallowing.
44)
45) 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
45)
46) Which of the following is NOT a muscle primarily involved in the breathing process?
A) latissimus dorsi
B) internal intercostal
C) diaphragm
D) external intercostal
46)
47) The ________ runs deep to the internal oblique.
A) rectus abdominis
C) transversus abdominis
47)
B) external oblique
D) latissimus dorsi
48) Which muscle group is involved when a "pulled groin" occurs?
A) hamstrings
B) lateral rotators
C) thigh adductors
D) quadriceps
48)
49) The sternocleidomastoid muscle inserts on the ________.
A) sternum
B) platysma
C) clavicle
D) mastoid process of the temporal bone
49)
50) What is the major factor controlling how levers work?
A) the difference in the positioning of the effort, load, and fulcrum
B) the direction the load is being moved
C) the structural characteristics of the muscles of the person using the lever
D) the weight of the load
50)
51) 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?
A) platysma
B) zygomaticus
C) masseter
D) buccinator
51)
5
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:
52) The action of lifting a shovel of snow.
52)
53) How can a lever system work at a mechanical disadvantage but still be of use to us?
53)
6
Figure 10.2
Using Figure 10.2, match the following:
54) Sternocleidomastoid.
54)
7
Figure 10.3
Using Figure 10.3, match the following:
55) Teres major muscle.
55)
56) Rhomboid minor and Rhomboid major.
56)
57) Trapezius muscle.
57)
58) Rotates scapula.
58)
8
Figure 10.1
Using Figure 10.1, match the following:
59) Atlanto-occipital joint.
59)
60) List and describe the muscles involved in biting and chewing an apple?
60)
61) 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.
61)
62) How does an antagonist differ from a prime mover (agonist)? How is it the same?
62)
9
Figure 10.1
Using Figure 10.1, match the following:
63) Humerus-ulna joint.
63)
64) Tibia-calcaneus joint.
64)
65) Bodybuilders are known for their "great quads." Describe the quadriceps muscles.
65)
10
Figure 10.2
Using Figure 10.2, match the following:
66) Deltoid.
66)
67) A woman mentions to her friend that another person on the beach has "great abs." What is
she talking about?
67)
11
Figure 10.1
Using Figure 10.1, match the following:
68) Second-class lever.
68)
69) 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.
69)
70) Muscles that act as synergists seem to have valuable functions, especially in stabilizing
joints. Briefly explain their functions.
70)
12
Figure 10.2
Using Figure 10.2, match the following:
71) Serratus anterior.
71)
72) Pectoralis minor.
72)
73) Coracobrachialis.
73)
13
Figure 10.1
Using Figure 10.1, match the following:
74) First-class lever.
74)
75) 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?
75)
76) Damage to the ischiocavernosus muscle would have what effect?
76)
14
Figure 10.3
Using Figure 10.3, match the following:
77) The latissimus dorsi.
77)
78) A wide receiver for a college football team pulled a hamstring muscle. What muscles could
be affected and what would the effect be?
78)
79) What are the components of a lever system? Describe the role of each component.
79)
15
Figure 10.3
Using Figure 10.3, match the following:
80) Elevates and adducts scapula.
80)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
81) Although all skeletal muscles have different shapes, the fascicle arrangement of each muscle is
exactly the same.
81)
82) Muscle power depends mostly on the total number of muscle fibers (cells) in the muscle.
82)
83) The broadest muscle of the back is the latissimus dorsi.
83)
84) The arrangement of a muscle's fascicles determines its range of motion and power.
84)
85) Muscle spasms of the back often are due to the erector spinae contraction.
85)
86) The buccinator muscle compresses the cheek and is well developed in nursing infants.
86)
87) Muscles connecting to the hyoid bone are important for swallowing and speech.
87)
88) 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.
88)
16
89) The soleus is an antagonist of the gastrocnemius during plantar flexion.
89)
90) The major head flexors are the sternocleidomastoid muscles, with the help of the muscles attached
to the hyoid bone.
90)
91) The diaphragm flattens and moves inferiorly during inspiration.
91)
92) The calcaneal tendon (Achilles tendon) is the largest tendon in the body.
92)
93) Muscles are only able to pull, they never push.
93)
94) The muscles of facial expression insert into skin or other muscles, not bones.
94)
95) Both first- and second-class levers operate at a mechanical disadvantage.
95)
96) In order to propel food down to the esophagus, the pharyngeal constrictor muscles are used.
96)
97) The deltoid is a prime mover of the arm that acts in adduction.
97)
98) Muscles that help maintain upright posture are fixators.
98)
99) Deep muscles of the thorax promote movements for breathing.
99)
100) Muscles that help to maintain posture are best described as synergists.
100)
101) Most superficial thorax muscles are extrinsic shoulder muscles.
101)
102) A wheelbarrow is a good example of a second-class lever.
102)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following muscle actions:
103) Flexes distal interphalangeal joints.
A) Flexor digitorum profundus
103)
Match the following:
104) Muscle that is primarily responsible
for bringing about a particular
movement.
A) Synergist
104)
B) Agonist (prime mover)
105) Muscle that aids another by promoting
the same movement.
105)
17
Match the following muscle actions:
106) Powerful flexor and adductor of hand.
A) Palmaris longus
107) Tenses skin and fascia of palm during
hand movements.
B) Flexor carpi ulnaris
108) Stabilizes the wrist during finger
extension.
106)
107)
108)
Match the following:
109) Muscle that stabilizes the origin of
another muscle.
110) Muscle that opposes and reverses the
action of another muscle.
A) Fixator
109)
B) Antagonist
110)
Match the following muscle actions:
111) Extends and abducts the hand.
A) Extensor carpi radialis brevis
111)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
112) 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?
113) A nurse can facilitate respiratory functioning by encouraging deep breathing exercises such as diaphragmatic
breathing. Explain diaphragmatic breathing.
114) A patient has a stroke and has weakness on his right side. How will the weakness affect his ability to swallow?
115) 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?
116) Tom has been told that he has an inguinal hernia. What is an inguinal hernia and what is its possible cause?
117) 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.
118) 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.
119) The nurse is explaining Kegel exercises to strengthen the pelvic floor muscles. What factors may contribute to a
weakening of the pelvic floor muscles?
18
Answer Key
Testname: 10
1) D
2) B
3) C
4) D
5) A
6) D
7) B
8) B
9) D
10) C
11) C
12) A
13) C
14) D
15) A
16) D
17) A
18) D
19) B
20) C
21) A
22) D
23) B
24) D
25) C
26) C
27) B
28) B
29) D
30) B
31) D
32) D
33) D
34) A
35) D
36) B
37) B
38) C
39) A
40) A
41) C
42) C
43) A
44) C
45) C
46) A
47) C
48) C
49) D
50) A
19
Answer Key
Testname: 10
51) D
52) B
53) 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.
54) A
55) D
56) C
57) B
58) B
59) C
60) 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
61) 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.
62) 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.
63) B
64) A
65) 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.
66) B
67) 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.
68) A
69) 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.
70) 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.
71) E
72) C
73) D
74) C
75) 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.
76) In the male, it would be impossible to achieve an erection of the penis. In the female, the clitoris would not become
erect.
77) E
78) 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.
79) 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.
80) A
20
Answer Key
Testname: 10
81) FALSE
82) TRUE
83) TRUE
84) TRUE
85) TRUE
86) TRUE
87) TRUE
88) TRUE
89) FALSE
90) TRUE
91) TRUE
92) TRUE
93) TRUE
94) FALSE
95) FALSE
96) TRUE
97) FALSE
98) TRUE
99) TRUE
100) FALSE
101) TRUE
102) TRUE
103) A
104) B
105) A
106) B
107) A
108) B
109) A
110) B
111) A
112) 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.
113) 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.
114) 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.
115) 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."
116) 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.
117) 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.
118) Gastrocnemius medialis and lateralis and soleus.
119) Aging and multiple births.
21
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) The period after an initial stimulus when a neuron is not sensitive to another stimulus is the
________.
A) absolute refractory period
B) repolarization
C) resting period
D) depolarization
1)
2) The effect of acetylcholine can be stimulating or inhibiting. Which of the following gives the best
explanation for why this is so?
A) Postsynaptic cells have a dynamic and changing metabolism and respond differently at
different times.
B) Acetylcholine has a "dose effect." Larger doses are stimulating while small doses inhibit.
C) Acetylcholine has many different forms.
D) Different postsynaptic cells will have different receptors.
2)
3) Which of the following will occur when an excitatory postsynaptic potential (EPSP) is being
generated on the dendritic membrane?
A) Specific potassium gates will open.
B) Specific sodium 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.
3)
4) Saltatory conduction is made possible by ________.
A) erratic transmission of nerve impulses
C) large nerve fibers
4)
B) diphasic impulses
D) the myelin sheath
5) An inhibitory postsynaptic potential (IPSP) is associated with ________.
A) a change in sodium ion permeability
B) lowering the threshold for an action potential to occur
C) hyperpolarization
D) opening of voltage-regulated channels
5)
6) Which of the following correctly describes a graded potential?
A) It has a depolarization, repolarization, and hyperpolarization phase.
B) It can have amplitudes of various sizes.
C) It travels long distances.
D) It is initiated by voltage changes in the membrane.
6)
7) Which of the following is NOT a function of the autonomic nervous system?
A) innervation of glands
B) innervation of smooth muscle of the digestive tract
C) innervation of skeletal muscle
D) innervation of cardiac muscle
7)
1
8) 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
8)
9) Which of the following is NOT a chemical class of neurotransmitters?
A) ATP and other purines
B) amino acid
C) nucleic acid
D) biogenic amine
9)
10) Which of the following is true about the movement of ions across excitable living membranes?
A) Sodium gates in the membrane can open in response to electrical potential changes.
B) Ions always move from an area of higher concentration to an area of lower concentration.
C) Ions always move passively across membranes.
D) Ions always move actively across membranes through leakage channels.
10)
11) Which of the following is NOT a characteristic of neurons?
A) They are mitotic.
B) They conduct impulses.
C) They have an exceptionally high metabolic rate.
D) They have extreme longevity.
11)
12) If a postsynaptic neuron is stimulated to threshold by spatial summation this implies that ________.
A) the postsynaptic cell is slow to repolarize
B) the postsynaptic cell has a lower than normal threshold
C) the postsynaptic cell has many voltage gated ion channels
D) the postsynaptic cell has many synapses with many presynaptic neurons
12)
13) If a postsynaptic cell is stimulated to threshold by temporal summation this implies that ________.
A) the postsynaptic cell can be influenced by only one presynaptic cell
B) the postsynaptic cell is sending frequent action potential
C) a presynaptic neuron is sending frequent EPSP
D) the presynaptic neuron is sending frequent IPSP
13)
14) Which ion channel opens in response to a change in membrane potential and participates in the
generation and conduction of action potentials?
A) mechanically-gated channel
B) leakage channel
C) voltage-gated channel
D) ligand-gated channel
14)
15) Which of the following describes the excitatory postsynaptic potential?
A) short distance depolarization
B) opens K+ or Cl- channels
C) short distance hyperpolarization
D) moves membrane potential away from threshold
15)
2
16) Which of the choices below describes the ANS?
A) motor fibers that conduct nerve impulses from the CNS to smooth muscle, cardiac muscle,
and glands
B) 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
C) motor fibers that conduct nerve impulses from the CNS to skeletal muscles
D) sensory and motor neurons that supply the digestive tract
16)
17) Schwann cells are functionally similar to ________.
A) astrocytes
C) microglia
17)
B) oligodendrocytes
D) ependymal cells
18) 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) The sodium potassium pump consistently moves ions as long as ATP is available, and
regardless of membrane potential changes.
B) Potassium permeability is about 25 times greater than sodium ions.
C) 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.
D) Voltage gated potassium ion channels open slowly and remain open long enough to cause
hyperpolarization.
18)
19) Which of the following is NOT a function of dendrites?
A) generate nerve impulses and transmit them away from the cell body
B) convey incoming messages toward the cell body
C) produce short-distance signals called graded potentials
D) provide enormous surface area for receiving signals from other neurons
19)
20) Loss of function in the enzyme acetylcholine esterase would result in which of the following?
A) inability to destroy and remove acetylcholine from the synaptic cleft
B) amplify or enhance the effect of ACh
C) inability to release acetylcholine
D) stimulation of the production of acetylcholine
20)
21) 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 sodium channels will open.
B) Chemically gated chloride channels will open.
C) Chemically gated sodium channels will be closed.
D) Chemically gated potassium channels will open.
21)
22) Immediately after an action potential has peaked, which of the following channels will open?
A) voltage-gated calcium channels
B) voltage-gated sodium channels
C) chemically-gated chloride channels
D) voltage-gated potassium channels
22)
23) The term central nervous system refers to the ________.
A) sensory (afferent) nerves
B) somatic nerves
C) brain and spinal cord
D) spinal nerves
23)
3
24) These cells in the CNS have cilia that move in order to circulate cerebrospinal fluid.
A) ependymal cells
B) oligodendrocytes
C) astrocytes
D) Schwann cells
24)
25) Which of the following is an excitatory neurotransmitter secreted by motor neurons innervating
skeletal muscle?
A) norepinephrine
B) cholinesterase
C) acetylcholine
D) gamma aminobutyric acid
25)
26) 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) astrocytes
D) microglial cells
26)
27) Bipolar neurons are commonly ________.
A) found in the retina of the eye
C) found in ganglia
27)
B) called neuroglial cells
D) motor neurons
28) Select the correct statement regarding chemical synapses.
A) The release of neurotransmitter molecules gives cells the property of being electrically
coupled.
B) Neurotransmitter receptors are located on the axons terminals of cells.
C) The synaptic cleft uses the action potential to transmit a chemical signal to the postsynaptic
cell.
D) Cells with gap junctions use chemical synapses.
28)
29) Which of the following is false or incorrect?
A) An inhibitory postsynaptic potential occurs if the inhibitory effect is greater than the
excitatory, causing hyperpolarization of the membrane.
B) An excitatory postsynaptic potential occurs if the excitatory effect is greater than the
inhibitory effect but less than threshold.
C) A nerve impulse occurs if the excitatory and inhibitory effects are equal.
29)
30) 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 limits the frequency of action potentials down the axon.
B) This allows for the efflux (diffusion out) of potassium ions, resulting in the repolarization of
the cell.
C) This allows for the one way transmission of action potential down the axon.
D) This stops the depolarization of the axon membrane.
30)
31) 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) opening of chemically gated sodium channels
B) depolarization of the postsynaptic cell membrane
C) influx of positively charged ions into the postsynaptic cell
D) hyperpolarization of the postsynaptic cell membrane
31)
4
32) 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) Schwann cells
C) satellite cells
D) astrocytes
32)
33) A neuron that has as its primary function the job of connecting other neurons is called a(n)
________.
A) afferent neuron
B) efferent neuron
C) glial cell
D) interneuron
33)
34) When a sensory neuron is excited by some form of energy, the resulting graded potential is called
a(n) ________.
A) postsynaptic potential
B) excitatory potential
C) generator potential
D) action potential
34)
35) Which of the following is NOT true of graded potentials?
A) They can be called postsynaptic potentials.
B) They are short-lived.
C) They can form on receptor endings.
D) They increase amplitude as they move away from the stimulus point.
35)
36) If a motor neuron in the body were stimulated by an electrode placed about midpoint along the
length of the axon, ________.
A) the impulse would spread bidirectionally
B) muscle contraction would occur
C) the impulse would move to the axon terminal only
D) the impulse would move to the axon terminal only, and the muscle contraction would occur
36)
37) A second nerve impulse cannot be generated until ________.
A) all sodium gates are closed
B) proteins have been resynthesized
C) the membrane potential has been reestablished
D) the Na ions have been pumped back into the cell
37)
38) Collections of nerve cell bodies outside the central nervous system are called ________.
A) ganglia
B) nerves
C) nuclei
D) tracts
38)
39) Meningitis can be caused by infection of the central nervous system by bacteria. Which cells would
be most responsible for removing the infection?
A) oligodendrocytes
B) satellite cells
C) Schwann cells
D) microglia
39)
40) 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
40)
5
41) 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
41)
42) 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) astrocytes
B) oligodendrocytes
C) satellite cells
D) Schwann cells
42)
43) Which of the following describes the nervous system integrative function?
A) senses changes in the environment
B) responds to stimuli by gland secretion or muscle contraction
C) analyzes sensory information, stores information, makes decisions
43)
44) Which of the following neurotransmitters is the principal inhibitory neurotransmitter of the spinal
cord?
A) serotonin
B) glycine
C) acetylcholine
D) endorphin
44)
45) 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 have stable, relatively unchanging internal environments
B) neurons have a relatively high consumption of oxygen
C) neurons must meet a high demand for ATP
D) neurons produce many proteins
45)
46) The interior surface of a neuron's plasma membrane at resting membrane potential will have a
________.
A) positive charge and contains more sodium than outside of the cell
B) positive charge and contains less sodium than outside of the cell
C) negative charge and contains less sodium than outside of the cell
D) negative charge and contains more sodium than outside of the cell
46)
47) 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 sodium potassium pump will stop working during relative refractory
B) the voltage gated potassium ion channels remain open long enough to hyperpolarize the axon
membrane
C) the membrane is now impermeable to all ions
D) the inactivation gates on voltage gated sodium ion channels are closed
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) What does the central nervous system use to determine the strength of a stimulus?
A) frequency of action potentials
B) type of stimulus receptor
C) origin of the stimulus
D) size of action potentials
49)
6
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:
50) Which is by far the most common neuron type?
50)
51) What are the basic divisions of the peripheral nervous system?
51)
7
Figure 11.1
Using Figure 11.1, match the following:
52) Which neuron would activate to a muscle?
52)
53) Which neuron is typically involved in the special senses of sight and smell?
53)
54) What is the difference between a direct acting neurotransmitter and an indirect acting
neurotransmitter?
54)
55) The part of the nervous system that conducts impulses from the CNS to the skeletal
muscles is the ________ nervous system.
55)
8
Figure 11.1
Using Figure 11.1, match the following:
56) Which neuron is a sensory neuron found in a reflex arc?
56)
57) Neuroglia found in the CNS that change the permeability of capillaries in the brain by
binding to and surrounding these blood vessels are called ________.
57)
58) The synapse more common in embryonic nervous tissue than in adults is the ________.
58)
9
Figure 11.2
Using Figure 11.2, match the following:
59) Ion channel.
59)
60) What mechanism is responsible for axonal transport?
60)
10
Figure 11.1
Using Figure 11.1, match the following:
61) In a reflex arc, which neuron has its cell body inside the spinal cord?
61)
62) 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.
62)
11
Figure 11.2
Using Figure 11.2, match the following:
63) Synaptic vesicles.
63)
64) Define synaptic delay.
64)
12
Figure 11.1
Using Figure 11.1, match the following:
65) Which neuron would be found in the retina of the eye?
65)
66) What is the role of microglial cells and why are they so important in the CNS?
66)
13
Figure 11.2
Using Figure 11.2, match the following:
67) Synaptic cleft.
67)
68) Postsynaptic membrane.
68)
69) Because all action potentials are alike, how does the brain separate situations that require
immediate attention from ordinary "positional" reports?
69)
70) 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.
70)
71) When information is delivered within the CNS simultaneously by different parts of the
neural pathway, the process is called ________ processing.
71)
72) At the biochemical level, what is the explanation of the hyperpolarization phase at the
conclusion of the action potential?
72)
14
Figure 11.1
Using Figure 11.1, match the following:
73) Which neuron is common only in dorsal root ganglia of the spinal cord and sensory
ganglia of cranial nerves?
73)
74) What function is served by the increased axon diameter at the nodes of Ranvier?
74)
15
Figure 11.1
Using Figure 11.1, match the following:
75) Which neuron is never myelinated?
75)
76) Which group of neurotransmitters play a role in emotional behavior and help regulate the
biological clock?
76)
16
Figure 11.2
Using Figure 11.2, match the following:
77) Calcium ions.
77)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
78) The all-or-none phenomenon as applied to nerve conduction states that the whole nerve cell must
be stimulated for conduction to take place.
78)
79) Strong stimuli cause the amplitude of action potentials generated to increase.
79)
80) The peripheral nervous system is divided into afferent and efferent divisions.
80)
81) Cell bodies of sensory neurons may be located in ganglia lying outside the central nervous system.
81)
82) Axon diameter and degree of myelination determine nerve impulse conduction velocity.
82)
83) Reflexes are rapid, automatic responses to stimuli that will produce the same effect every time.
83)
84) During depolarization, the inside of the neuron's membrane becomes less negative.
84)
85) The action potential is caused by permeability changes in the plasma membrane.
85)
86) Unipolar neurons have axons structurally divided into peripheral and central processes.
86)
17
87) A postsynaptic potential is a graded potential that is the result of a neurotransmitter released into
the synapse between two neurons.
87)
88) In myelinated axons the voltage-regulated sodium channels are concentrated at the nodes of
Ranvier.
88)
89) Enkephalins and endorphins are peptides that act like morphine.
89)
90) 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.
90)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
91) The specific period during which
potassium ions diffuse out of the
neuron due to a change in membrane
permeability.
A) Repolarization
91)
Match the following:
92) Plasma membrane exhibits
voltage-gated Na+ and K+ channels.
A) Conducting region
92)
Match the following:
93) An exceptionally strong stimulus can
trigger a response.
A) Relative refractory period
93)
Match the following:
94) Plasma membrane exhibits chemically
gated ion channels.
A) Receptive region
94)
Match the following:
95) Voltage-gated Na+ channels open.
A) Depolarization
95)
Match the following:
96) Involved in activating fibers of a
skeletal muscle such as the biceps
muscle.
A) Diverging circuit
96)
Match the following:
97) Na+ channels are inactivating, and
voltage-gated K+ channels open.
A) Repolarization
18
97)
Match the following:
98) Area where nerve impulse is
generated.
A) Trigger zone
98)
Match the following:
99) Involved in control of rhythmic
activities such as breathing.
100) May be involved in complex, exacting
types of mental processing.
101) Different types of sensory input can
have the same ultimate effect.
A) Diverging circuit
99)
B) Converging circuit
C) Parallel after-discharge circuit
D) Reverberating circuit
102) One incoming axon triggers responses
in ever-increasing numbers farther
and farther along the circuit.
100)
101)
102)
Match the following:
103) The neuron cannot respond to a
second stimulus, no matter how
strong.
A) Absolute refractory period
103)
Match the following:
104) Axon terminals release
neurotransmitters.
105) Plasma membrane exhibits
voltage-gated Ca2+ channels.
A) Secretory zone
104)
B) Secretory region
105)
Match the following:
106) Some K+ channels remain open, and
Na+ channels rest.
A) Hyperpolarization
106)
Match the following:
107) The interior of the cell becomes less
negative due to an influx of sodium
ions.
A) Depolarization
107)
Match the following:
108) Receives stimuli.
A) Receptive region
19
108)
Match the following:
109) Any stimulus at or above this level
will result in action potential.
A) Threshold stimulus
109)
Match the following:
110) Also called a nerve impulse
transmitted by axons.
A) Action potential
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 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?
113) 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.
114) 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?
115) What symptoms would a nurse focus on in his or her care of a patient with multiple sclerosis?
20
Answer Key
Testname: 11
1) A
2) D
3) C
4) D
5) C
6) B
7) C
8) D
9) C
10) A
11) A
12) D
13) C
14) C
15) A
16) A
17) B
18) C
19) A
20) A
21) A
22) D
23) C
24) A
25) C
26) C
27) A
28) C
29) C
30) B
31) D
32) D
33) D
34) C
35) D
36) A
37) C
38) A
39) D
40) B
41) A
42) D
43) C
44) B
45) A
46) C
47) B
48) A
49) A
50) A
21
Answer Key
Testname: 11
51) 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.
52) A
53) B
54) Direct acting neurotransmitters bind to and open ion channels. Indirect acting neurotransmitters act through
intracellular second-messenger molecules.
55) somatic
56) C
57) astrocytes
58) electrical synapse
59) E
60) ATP-dependent "motor" proteins such as kinesin and dynein myosin are responsible. They propel cellular components
along microtubules.
61) A
62) 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).
63) C
64) Synaptic delay reflects the time required for neurotransmitter release, diffusion across the synaptic cleft, and binding to
receptors.
65) B
66) 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.
67) D
68) B
69) 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.
70) temporal
71) parallel
72) 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.
73) C
74) Increased diameter results in less resistance to lengthwise intra-axonal flow. This results in increased speed of impulse
propagation.
75) B
76) biogenic amine neurotransmitters
77) A
78) FALSE
79) FALSE
80) TRUE
81) TRUE
82) TRUE
83) TRUE
84) TRUE
85) TRUE
86) TRUE
87) TRUE
88) TRUE
89) TRUE
22
Answer Key
Testname: 11
90) TRUE
91) A
92) A
93) A
94) A
95) A
96) A
97) A
98) A
99) D
100) C
101) B
102) A
103) A
104) A
105) B
106) A
107) A
108) A
109) A
110) A
111) Demyelination interferes with saltatory conduction, which would result in a slowing down and even permanent
cessation of nerve impulse propagation.
112) 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.
113) 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.
114) The rabies virus uses retrograde axonal transport to reach the neuron cell bodies as it makes its way to the brain cells.
115) Visual disturbances, paralysis, and weakness
23
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following statements is FALSE?
A) Damage to the primary (somatic) motor cortex results in the loss of both voluntary muscle
control and all reflexive contractions.
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 auditory cortex results in the inability to interpret pitch, loudness, and
location.
D) Damage to the visual association area can result in blindness.
1)
2) Which of the following is (are) involved with motor activity (either initiation or coordination)?
A) Wernicke's area
B) red nuclei
C) gustatory cortex
D) postcentral gyrus
2)
3) What groove separates the frontal lobe from the parietal lobe?
A) lateral fissure
B) parieto-occipital sulcus
C) longitudinal fissure
D) central sulcus
3)
4) The light of dawn and the buzz of an alarm clock lead to wakefulness through the ________.
A) limbic system
B) basal nuclei
C) reticular activating system
D) cerebellar peduncles
4)
5) Interneurons receiving input from sensory neurons are located in the ________.
A) ventral (anterior) horn
B) dorsal (posterior) horn
C) dorsal root ganglion
D) lateral horn
5)
6) Which of the following is NOT a role of the basal nuclei?
A) playing a role in cognition and emotion
B) initiating protective reflex actions
C) inhibiting unnecessary or antagonistic movements
D) controlling starting and stopping movements
6)
7) Which category of memory is involved when playing the piano?
A) procedural
B) emotional
C) motor
D) declarative
7)
8) Two terms for the massive motor tracts serving voluntary movement are ________.
A) supplementary and cerebellar-pontine
B) extrapyramidal and rubrospinal
C) pyramidal and corticospinal
D) segmental and nigrostriatal
8)
9) 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) premotor cortex
B) spinal cord
C) rubrospinal tracts
D) primary motor cortex
9)
1
10) Which statement about epilepsy is most accurate?
A) Absence seizures typically begin in adolescence and are often severely disabling.
B) During seizures, sensory messages are processed normally but responses are blocked.
C) Epilepsy is often genetically induced but also frequently caused by head trauma, stroke,
infection, and tumor.
D) The aura in tonic-clonic seizures typically occurs as the patient regains consciousness.
10)
11) Which of the following would you NOT find in normal cerebrospinal fluid?
A) glucose
B) protein
C) potassium
D) red blood cells
11)
12) The corpora quadrigemina are found in the ________.
A) diencephalon
B) midbrain
C) pons
D) cerebellum
12)
13) Arachnoid granulations are knoblike projections that protrude superiorly through the ________
mater to absorb cerebrospinal fluid into venous blood.
A) pia
B) dura
C) subarachnoid
D) arachnoid
13)
14) 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) olfactory cortex
B) vestibular cortex
C) gustatory cortex
D) visceral sensory area
14)
15) 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
15)
16) The brain stem consists of the ________.
A) midbrain, medulla, and pons
C) pons, medulla, cerebellum, and midbrain
16)
B) cerebrum, pons, midbrain, and medulla
D) midbrain only
17) An individual accidentally transected (cut across) the spinal cord between T1 and L1 . This would
result in ________.
A) paraplegia
C) hemiplegia
17)
B) spinal shock only
D) quadriplegia
18) The frontal lobe is separated from the temporal lobe by the ________.
A) cranial fossa
B) central sulcus
C) lateral sulcus
D) longitudinal fissure
19) Which of the following is the mildest consequence of traumatic brain injury?
A) hemorrhage
B) concussion
C) swelling
20) The subarachnoid space lies between what two layers of meninges?
A) arachnoid and dura
B) arachnoid and pia
C) arachnoid and epidura
D) dura and epidura
2
18)
D) contusion
19)
20)
21) Emotional memory ________.
A) involves remembering names, faces, words, and dates
B) involves remembering motor skills such as riding a bike
C) involves remembering a skill such as playing a musical instrument
D) involves your pounding heart when you hear a rattlesnake
22) The ________ includes the thalamus, hypothalamus, and epithalamus.
A) brain stem
B) basal nuclei
C) diencephalon
21)
D) midbrain
22)
23) Which part of the cerebral cortex is involved in intellect, cognition, recall, and personality?
A) prefrontal cortex (anterior association area)
B) combined primary somatosensory cortex and somatosensory association cortex
C) posterior association area
D) limbic association area
23)
24) Second-order neurons of ascending pathways that contribute to sensory perception terminate in
the ________.
A) thalamus
B) somatosensory cortex
C) medulla
D) spinal cord
24)
25) The primary somatosensory cortex is located in the ________.
A) parietal lobe
B) prefrontal lobe
C) frontal lobe
25)
D) temporal lobe
26) Which brain structure functions to control the autonomic nervous system and to regulate body
temperature?
A) medulla oblongata
B) mammillary body
C) hypothalamus
D) pons
26)
27) Nuclei of cranial nerves V (trigeminal), VI (abducens), and VII (facial) are found in the ________.
A) pons
B) midbrain
C) medulla
D) cerebrum
27)
28) Cell bodies of sensory neurons are located in ________.
A) sympathetic ganglia
B) the dorsal root ganglia of the spinal cord
C) the thalamus
D) the ventral root ganglia of the spinal cord
28)
29) The lateral sulcus separates which lobes?
A) parietal from occipital
C) frontal from temporal
29)
B) temporal from parietal
D) frontal from parietal
30) If the caudal portion of the neural tube failed to develop properly the ________.
A) cranial nerves would not form
B) spinal cord may be affected
C) telencephalon would cease development
D) hindbrain would not be present
30)
31) Which type of memory is exemplified by a racing heartbeat upon hearing a rattlesnake nearby?
A) declarative (fact)
B) motor
C) emotional
D) procedural (skills)
31)
3
32) Broca's area ________.
A) is considered a motor speech area
B) is usually found only in the right hemisphere
C) controls voluntary movements of the eyes
D) serves the recognition of complex objects
32)
33) Spastic paralysis suggests involvement of the ________.
A) lower motor neurons
B) neuromuscular junction
C) spinal nerve roots
D) upper motor neurons
33)
34) 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) corpus callosum
B) falx cerebri
C) tentorium cerebelli
D) falx cerebelli
34)
35) Vital centers for the control of heart rate, respiration, and blood pressure are located in the
________.
A) pons
B) midbrain
C) medulla oblongata
D) cerebrum
35)
36) Which type of wave predominates during stage 1 NREM sleep?
A) beta
B) delta
C) theta
36)
D) alpha
37) Which statement about coma is true?
A) Coma is a form of deep sleep.
B) Coma may be caused by widespread cerebral or brain stem trauma.
C) During coma, brain oxygen consumption resembles that of a waking state.
D) Coma is neurologically identical to syncope.
37)
38) The arbor vitae refers to ________.
A) cerebellar gray matter
B) flocculonodular nodes
C) cerebellar white matter
D) the pleatlike convolutions of the cerebellum
38)
39) The large commissure that connects the right and left sides of the brain is called the ________.
A) internal capsule
B) corpus callosum
C) longitudinal fissure
D) corona radiata
39)
40) Injury to the hypothalamus may result in all of the following EXCEPT ________.
A) dehydration
B) loss of body temperature control
C) loss of fine motor control
D) sleep disturbances
40)
41) An elevated ridge of the cortex is called a ________.
A) furrow
B) sulcus
41)
C) fissure
D) gyrus
42) Neural tracts that convey information to the brain concerning temperature and pain would be
________.
A) lateral spinothalamic
B) ventral (anterior) spinothalamic
C) reticulospinal
D) posterior spinothalamic
4
42)
43) The two longitudinal ridges on the medulla oblongata where many descending fibers cross over
are called the ________.
A) pyramids
B) nuclei
C) lateral horns
D) olives
43)
44) REM sleep is associated with ________.
A) decreased vital signs, such as heart rate and blood pressure
B) decreased oxygen use, especially in the cerebral cortex
C) temporary skeletal muscle inhibition except for ocular muscles and diaphragm
D) decreased activity of the brain, especially the cerebral cortex
44)
45) What type of cells line the ventricles of the brain?
A) neurons
C) ependymal cells
45)
B) astrocytes
D) epithelial cells
46) The process of linking new facts with old facts already stored in the memory bank is called
________.
A) automatic memory
B) long-term memory
C) association
D) rehearsal
46)
47) Which of the following is NOT a function of the CSF?
A) reduction of brain weight
B) protection from blows
C) initiation of some nerve impulses
D) nourishment of the brain
47)
48) Which of the following structures is probably NOT directly involved in memory?
A) prefrontal cortex
B) hippocampus
C) thalamus
D) medulla oblongata
48)
49) Degeneration of the dopamine-releasing neurons of the ________ is the ultimate cause of
Parkinson's disease.
A) internal capsule
B) substantia nigra
C) reticular formation
D) red nucleus
49)
50) Sleepwalking may occur during ________.
A) NREM stage 2
B) NREM stage 4
50)
C) REM
D) NREM stage 1
51) What connects the hypothalamus to the pituitary gland?
A) mammillary bodies
B) arbor vitae
C) infundibulum
D) optic chiasma
51)
52) The brain area that regulates activities that control the state of wakefulness or alertness of the
cerebral cortex is the ________.
A) pyramids
B) thalamus
C) reticular formation
D) limbic system
52)
53) Spinocerebellar tracts ________.
A) give rise to conscious experience of perception
B) carry information about muscle or tendon stretch to the cerebellum
C) are found in the dorsal columns of the spinal cord
D) terminate in the spinal cord
53)
5
54) 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) calcarine cortex
C) lateral geniculate body
D) primary visual cortex
54)
55) Which of these would you NOT find in the cerebral cortex?
A) dendrites
B) fiber tracts
C) interneurons
55)
D) cell bodies
56) The white matter of the spinal cord contains ________.
A) unmyelinated nerve fibers only
B) myelinated nerve fibers only
C) cell bodies
D) myelinated and unmyelinated nerve fibers
56)
57) White matter is found in all of the following locations EXCEPT the ________.
A) corticospinal tracts
B) outer portion of the spinal cord
C) corpus callosum
D) cerebral cortex
57)
58) The blood-brain barrier is effective against ________.
A) nutrients such as glucose
B) anesthetics
C) metabolic waste such as urea
D) alcohol
58)
59) Which of the following best describes the cerebrum?
A) executive suite
B) motor command center
C) visceral command center
D) decussation center
59)
60) Which brain waves are uncommon for awake adults, but are common for children?
A) theta
B) beta
C) alpha
D) delta
60)
61) A patient suffering from memory loss, shortened attention span, disorientation, and eventual
language loss is most likely suffering from ________.
A) cerebellar disease
B) Parkinson's disease
C) Huntington's disease
D) Alzheimer's disease
61)
62) Which of the following generalizations does NOT describe the cerebral cortex?
A) The hemispheres are exactly equal in function.
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) No functional area of the cortex works alone.
62)
63) All of the following are structures of the limbic system EXCEPT the ________.
A) cingulate gyrus
B) caudate nucleus
C) amygdaloid body
D) hippocampus
63)
64) The ________ is the main switch station for memory; if the right and left areas are destroyed, the
result is widespread amnesia.
A) hypothalamus
B) thalamus
C) Wernicke's area
D) hippocampus
64)
6
65) Ridges of tissue on the surface of the cerebral hemispheres are called ________.
A) sulci
B) gyri
C) ganglia
D) fissures
65)
66) 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) vestibular nuclei
B) reticular nuclei
C) superior colliculi
D) red nuclei
66)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
Figure 12.3
Using Figure 12.3, match the following:
67) Site of autonomic motor neuron cell bodies.
67)
7
Figure 12.2
Using Figure 12.2, match the following:
68) Corpus callosum.
68)
8
Figure 12.1
Using Figure 12.1, Match the following:
69) Pons.
69)
70) What is the role of the pineal gland in the sleep-wake cycle?
70)
71) Describe how the function of a particular brain area is known.
71)
9
Figure 12.1
Using Figure 12.1, Match the following:
72) Medulla Oblongata.
72)
10
Figure 12.3
Using Figure 12.3, match the following:
73) Site of sensory neuron cell bodies.
73)
11
Figure 12.2
Using Figure 12.2, match the following:
74) Globus pallidus.
74)
75) List the three current suppositions about consciousness.
75)
76) What is the cauda equina and why is it given this name?
76)
12
Figure 12.1
Using Figure 12.1, Match the following:
77) White fiber tracts.
77)
78) List seven homeostatic roles of the hypothalamus.
78)
79) Which brain areas lack a blood-brain barrier, and what purpose does this absence serve?
79)
80) What is the basis for classifying the fibers and tracts of cerebral white matter? List and
define each of the three types.
80)
13
Figure 12.2
Using Figure 12.2, match the following:
81) Thalamus.
81)
82) Describe the cause of hydrocephalus and explain why this condition is much more serious
in adults than in newborns.
82)
14
Figure 12.3
Using Figure 12.3, match the following:
83) Gray commissure.
83)
84) What is the importance of the fact that the outer portion of the cerebral hemispheres is
convoluted?
84)
85) What is the somatosensory homunculus? Which body region would be larger in the
homunculus, the face or the hips? Why?
85)
15
Figure 12.3
Using Figure 12.3, match the following:
86) Site of somatic motor neuron cell bodies.
86)
16
Figure 12.1
Using Figure 12.1, Match the following:
87) Thalamus.
87)
88) 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.
88)
89) Differentiate clearly between short-term and long-term memory.
89)
90) Describe the role of the reticular activating system in cortical arousal and stimulation.
90)
17
Figure 12.3
Using Figure 12.3, match the following:
91) Consists entirely of interneuron cell bodies.
91)
18
Figure 12.1
Using Figure 12.1, Match the following:
92) Hypothalamus.
92)
19
Figure 12.3
Using Figure 12.3, match the following:
93) Unipolar neurons are found here.
93)
94) 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.
94)
20
Figure 12.2
Using Figure 12.2, match the following:
95) Caudate nucleus.
95)
96) Pons.
96)
97) 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?
97)
21
Figure 12.3
Using Figure 12.3, match the following:
98) Area that encloses the central canal.
98)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
99) One functional center found within the medulla oblongata is a respiratory center involved in the
control of the rate and depth of breathing.
99)
100) Cell bodies of somatic motor neurons are located in the ventral (anterior) horn of the spinal cord.
100)
101) In most people, the left cerebral hemisphere has greater control over language abilities, math, and
logic.
101)
102) The canal connecting the third and fourth ventricles and running through the midbrain is the
interventricular foramen.
102)
103) Nondeclarative memories preserve the circumstances in which they are learned.
103)
104) Sorting of sensory information and relaying it to the appropriate cerebral sensory area occurs in the
hypothalamus.
104)
105) A disturbance of posture, muscle tremors at rest, and uncontrolled muscle contraction are all
symptoms of damage to the basal nuclei.
105)
22
106) Commissural fibers connect the cerebrum to the diencephalon.
106)
107) Nuclei relating to the startle reflex are located in the corpora quadrigemina of the midbrain.
107)
108) The terms fainting and syncope describe the same thing.
108)
109) The adult spinal cord ends between the level L1 and L2 of the vertebral column.
109)
110) Specific motor and sensory functions are localized in specific areas called domains, whereas
memory and language have overlapping domains.
110)
111) The brain and spinal cord begin as an embryonic structure called the neural plate.
111)
112) The three basic regions of the cerebrum are the cerebral cortical gray matter, internal white matter,
and the superior and inferior colliculi.
112)
113) Projection fibers in the brain mainly connect the right and left hemispheres.
113)
114) Embryonic damage to the mesencephalon could result in improper formation of the midbrain.
114)
115) REM sleep begins about 90 minutes after sleep begins.
115)
116) The reticular activating system (RAS) is comprised of specific pathways primarily in the limbic
system.
116)
117) Passing through the NREM stages (1 through 4), the frequency of the EEG waves declines, but their
amplitude increases.
117)
118) The primary visual cortex contains a map of visual space.
118)
119) The blood brain barrier is the protective mechanism that helps maintain the brain's stable
environment.
119)
120) The limbic system acts as our emotional, or affective (feelings), brain.
120)
121) Cerebrospinal fluid circulates within the ventricles of the brain and in the subarachnoid space.
121)
122) Most of the ascending and descending pathways to and from the brain cross over (decussate) from
one side of the body to the other.
122)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
123) Ensures coordination and balance.
A) Cerebellum
23
123)
Match the following stages of sleep with their descriptions:
124) Indicated by movement of the eyes
under the lids; dreaming occurs.
A) REM
124)
Match the following:
125) Motor speech (Broca's) area.
A) Frontal lobe
126) Premotor cortex.
125)
126)
Match the following:
127) This area is on the extreme posterior of
the occipital lobe and receives visual
information that originates on the
retina of the eye.
A) Primary visual cortex
127)
Match the following:
128) Visual area.
A) Occipital lobe
128)
Match the following stages of sleep with their descriptions:
129) May allow the brain to work through
emotional problems in dream
imagery.
A) REM
129)
B) NREM stage 3
130) Theta and delta waves begin to
appear.
130)
Match the following:
131) Produces automatic behaviors
necessary for survival.
A) Brain stem
131)
Match the following:
132) The brain area just anterior to the
precentral gyrus that selects and
sequences basic motor movements
into more complex tasks.
A) Premotor cortex
132)
Match the following:
133) Gateway to the cerebrum.
A) Thalamus
133)
Match the following:
134) Gustatory (taste) area.
A) Insula
24
134)
Match the following stages of sleep with their descriptions:
135) Typified by sleep spindles.
A) NREM stage 2
135)
Match the following:
136) Collection of nerve roots at the inferior
end of the vertebral canal.
A) Cauda equina
136)
Match the following stages of sleep with their descriptions:
137) The sleep cycle where bed-wetting,
night terrors, and sleepwalking may
occur.
A) NREM stage 4
137)
B) NREM stage 1
138) Very easy to awaken; EEG shows
alpha waves; may even deny being
asleep.
138)
Match the following:
139) Where nerves serving the upper limbs
arise.
A) Cervical enlargement
139)
Match the following stages of sleep with their descriptions:
140) The stage when vital signs (blood
pressure, heart rate, and body
temperature) reach their lowest
normal levels.
A) NREM stage 4
140)
Match the following:
141) The area of the brain located in the
superior margin of the temporal lobe
that interprets impulses as pitch,
loudness, and location.
A) Primary auditory cortex
141)
Match the following:
142) Visceral command center.
A) Cerebrum
143) Executive suite.
B) Hypothalamus
142)
143)
Match the following:
144) Seat of intelligence, abstract reasoning.
A) Frontal lobe
145) Primary (somatic) motor cortex.
144)
145)
25
Match the following:
146) Inferior point of termination of the
spinal cord in an adult.
A) Conus medullaris
146)
Match the following:
147) Auditory area.
A) Temporal lobe
147)
Match the following:
148) Anchors the spinal cord to the coccyx.
A) Filum terminale
148)
Match the following:
149) This brain area lies on the medial
aspect of the temporal lobe and allows
for conscious awareness of different
odors.
A) Primary olfactory cortex
149)
Match the following:
150) Primary somatosensory cortex.
A) Parietal lobe
150)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
151) 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.
152) 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?
153) 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?
154) 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?
155) 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.
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?
26
157) Death from amyotrophic lateral sclerosis usually results from respiratory infection secondary to compromised
respiratory function. Explain why.
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?
27
Answer Key
Testname: 12
1) A
2) B
3) D
4) C
5) B
6) B
7) A
8) C
9) A
10) C
11) D
12) B
13) B
14) D
15) C
16) A
17) A
18) C
19) B
20) B
21) D
22) C
23) A
24) A
25) A
26) C
27) A
28) B
29) B
30) B
31) C
32) A
33) D
34) B
35) C
36) D
37) B
38) C
39) B
40) C
41) D
42) A
43) A
44) C
45) C
46) C
47) C
48) D
49) B
50) B
28
Answer Key
Testname: 12
51) C
52) C
53) B
54) A
55) B
56) D
57) D
58) C
59) A
60) A
61) D
62) A
63) B
64) D
65) B
66) A
67) D
68) A
69) D
70) The pineal gland secretes the hormone melatonin (a sleep-inducing signal and antioxidant) and helps regulate the
sleep-wake cycle.
71) 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.
72) E
73) E
74) C
75) (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.
76) 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.
77) A
78) 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
79) 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.
80) 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.
81) D
29
Answer Key
Testname: 12
82) 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.
83) A
84) 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.
85) 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.
86) C
87) B
88) 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.
89) 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.
90) 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.
91) B
92) C
93) E
94) 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.
95) B
96) E
97) Left handedness typically occurs when right cerebral dominance occurs. As a result, left handed people are using their
right cerebrum for motor activity.
98) A
99) TRUE
100) TRUE
101) TRUE
102) FALSE
103) FALSE
104) FALSE
105) TRUE
106) FALSE
30
Answer Key
Testname: 12
107) TRUE
108) TRUE
109) TRUE
110) TRUE
111) TRUE
112) FALSE
113) FALSE
114) TRUE
115) TRUE
116) FALSE
117) TRUE
118) TRUE
119) TRUE
120) TRUE
121) TRUE
122) TRUE
123) A
124) A
125) A
126) A
127) A
128) A
129) A
130) B
131) A
132) A
133) A
134) A
135) A
136) A
137) A
138) B
139) A
140) A
141) A
142) B
143) A
144) A
145) A
146) A
147) A
148) A
149) A
150) A
151) 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.
152) 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.
31
Answer Key
Testname: 12
153) 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.
154) 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).
155) 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.
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) 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.
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.
32
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) 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 trochlear nerve (IV)
B) the abducens (VI)
C) the vestibulocochlear nerve (VIII)
D) the oculomotor nerve (III)
1)
2) 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) spinal nerves of the cervical vertebra
B) the dorsal root located at one or more of the cervical vertebra
C) the dorsal rootlets located at one of the thoracic vertebra
D) the ventral root located at one or more of the cervical vertebra
2)
3) A fall or an improperly delivered gluteal injection could result in ________.
A) sciatica
B) phantom limb pain
C) neurofibromatosis
D) postpoliomyelitis muscular atrophy
3)
4) A patient has lost the ability to taste food. Which nerve may have been damaged?
A) the abducens nerves
B) trigeminal nerves
C) the facial nerves
D) the optic nerves
4)
5) Transduction refers to conversion of ________.
A) presynaptic nerve impulses to postsynaptic nerve impulses
B) stimulus energy into energy of a graded potential
C) afferent impulses to efferent impulses
D) receptor energy to stimulus energy
5)
6) Which of the following nerves does NOT arise from the brachial plexus?
A) phrenic
B) ulnar
C) median
6)
D) radial
7) Injury to cervical vertebrae C3 -C4 is particularly problematic because ________.
7)
8) The flexor muscles in the anterior arm (biceps brachii and brachialis) are innervated by what
nerve?
A) ulnar
B) median
C) musculocutaneous
D) radial
8)
9) Striking the "funny bone" is actually stimulation of (or injury to) the ________.
A) ulnar nerve
B) median nerve
C) radial nerve
9)
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) the greater auricular nerve that serve the parotid gland receive there fibers from here
D) part of the brain stem is located here
1
D) sciatic nerve
10) Select the statement that is most correct.
A) Ganglia associated with afferent nerve fibers contain cell bodies of sensory neurons.
B) The cell bodies of afferent ganglia are located in the spinal cord.
C) The dorsal root ganglion is a motor-only structure.
D) Ganglia are collections of neuron cell bodies in the spinal cord that are associated with
efferent fibers.
10)
11) Inborn or intrinsic reflexes are ________.
A) rapid, predictable, and can be learned responses
B) always mediated by the brain
C) involuntary, yet may be modified by learned behavior
D) autonomic only
11)
12) A reflex that causes muscle relaxation and lengthening in response to muscle tension is called a
________.
A) plantar reflex
B) crossed-extensor reflex
C) flexor reflex
D) tendon reflex
12)
13) Select the correct definition.
A) Magnitude estimation is the simplest level of sensation.
B) Perceptual detection is the ability to detect how much stimulus is applied to the body.
C) Spatial discrimination allows us to recognize textures.
D) Pattern recognition allows us to see a familiar face.
13)
14) 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) Have Bill flex and extend his arm against resistance.
B) Have Bill grip an object with his thumb and index finger and try to pull the object away.
C) Check for reflex on the medial condyle of the humerus with a rubber mallet.
D) Check for hyperextension at the knuckles of the little and ring finger.
14)
15) Problems in balance may follow trauma to which nerve?
A) trigeminal
B) vestibulocochlear
C) accessory
D) abducens
15)
16) 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
16)
17) Spinal nerves exiting the cord from the level of L4 to S4 form the ________.
17)
A) lumbar plexus
B) sacral plexus
C) thoracic plexus
18) Which receptors respond to stimuli within the body?
A) photoreceptors
B) proprioceptors
C) interoceptors
2
D) femoral plexus
D) exteroceptors
18)
19) A bit of dust blows into and touches the cornea of the eye. Which of the following is likely to
happen?
A) Stimulation of the optic nerve (II) will cause tears to flow from the lacrimal gland.
B) Stimulation of the ophthalmic division of the trigeminal nerve (V) will cause blinking.
C) Nothing, because there is no sensory information sent from the cornea.
D) Stimulation of the facial nerve (VII) will be perceived as pain.
19)
20) In a crossed-extensor reflex, if the right arm was grabbed it would flex and the left arm would
________.
A) abduct
B) adduct
C) extend
D) also flex
20)
21) 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) hypoglossal
B) accessory
C) facial
D) glossopharyngeal
21)
22) 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 show doctors how to avoid striking spinal nerves during surgery
D) they outline the location of the numerous nerve plexus
22)
23) Mixed cranial nerves containing both motor and sensory fibers include all EXCEPT which of the
following?
A) facial
B) olfactory
C) trigeminal
D) oculomotor
23)
24) 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 vagus nerve (X)
B) the olfactory nerve (I)
C) the optic nerve (II)
D) the facial nerve (VII)
24)
25) Feeling a gentle caress on your arm would likely involve all of the following EXCEPT ________.
A) Lamellar corpuscles
B) hair follicle receptors
C) Meissner's corpuscles
D) tactile discs
25)
26) Bell's palsy is ________.
A) characterized by paralysis of facial muscles
B) often caused by inflammation of the trigeminal nerve
C) characterized by loss of vision
D) characterized by partial paralysis of diaphragm muscles
26)
27) 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) lamellae corpuscle
B) bulbous corpuscle
C) tendon organ
D) free nerve ending
27)
28) After axonal injury, regeneration in peripheral nerves is guided by ________.
A) Golgi organs
B) Schwann cells
C) dendrites
28)
3
D) Wallerian cells
29) 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.
29)
30) 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) nociceptors
B) thermoreceptors
C) mechanoreceptors
D) chemoreceptors
30)
31) 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) olfactory nerve (I)
C) vagus nerve (X)
D) facial nerve (VIII)
31)
32) Which nerve is compressed in carpal tunnel syndrome?
A) median
B) ulnar
C) axillary
32)
D) radial
33) A fracture of the ethmoid bone could result in damage to which cranial nerve?
A) glossopharyngeal
B) olfactory
C) accessory
D) vagus
33)
34) 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) interoceptors
B) proprioceptors
C) nociceptors
D) exteroceptors
34)
35) Regeneration within the CNS ________.
A) is more successful than with the PNS
B) typically allows axonal sprouting of 20 mm
C) is promoted by growth inhibitors and glial scars
D) is prevented due to growth-inhibiting proteins of oligodendrocytes
35)
36) 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 lost function of the optic nerve (II).
B) The patient has function of the trochlear nerve (IV).
C) The patient has suffered brain damage.
D) The patient has function of the oculomotor nerve (III).
36)
37) The posterior side of the thigh, leg, and foot is served by the ________ nerve.
A) tibial
B) obturator
C) common fibular
D) femoral
37)
38) Nerves that carry impulses toward the CNS only are ________.
A) afferent nerves
B) motor nerves
C) mixed nerves
4
D) efferent nerves
38)
39) Starting at the spinal cord, the subdivisions of the brachial plexus are (in order) ________.
A) roots, trunks, divisions, and cords
B) trunks, divisions, cords, and roots
C) roots, divisions, cords, and trunks
D) divisions, roots, trunks, and cords
39)
40) All processing at the circuit level going up to the perceptual level must synapse in the ________.
A) pons
B) reticular formation
C) thalamus
D) medulla
40)
41) 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 interoceptors
B) mechanoreceptors that are also interoceptors
C) mechanoreceptors that are also exteroceptors
D) thermoreceptors that are also exteroceptors
41)
42) 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 voluntary movement
B) a complete loss of sensation
C) loss of neither sensation nor movement but only of autonomic control
D) a complete loss of sensation and movement
42)
43) 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) nociceptors
B) thermoreceptors
C) mechanoreceptors
D) proprioceptors
43)
44) 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) Action potentials as well as graded potentials are sent to the central nervous system when
stimulus strength increases.
B) More than one type of receptor will respond to larger stimulus.
C) Action potential frequency is increased as stimulus strength increases.
D) An action potential will increase in strength as stimulus strength increases.
44)
45) 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) having several nerve fibers unite enhances motor function
B) viruses that infect us by moving through PNS nerves are prevented entry to the CNS
C) having several nerve fibers unite enhances sensory function
D) injury to any single spinal nerve will be less damaging as there is less chance of total loss of
innervation to any particular organ
45)
46) A major nerve of the lumbar plexus is the ________.
A) sciatic
B) femoral
46)
5
C) ilioinguinal
D) iliohypogastric
47) The sciatic nerve is a combination of which two nerves?
A) posterior femoral cutaneous and tibial
B) pudendal and common fibular
C) pudendal and posterior femoral cutaneous
D) common fibular and tibial
47)
48) Which of the following is the correct simple spinal reflex arc?
A) receptor, afferent neuron, integration center, efferent neuron, effector
B) effector, efferent neuron, integration center, afferent neuron, receptor
C) receptor, efferent neuron, integration center, afferent neuron, effector
D) effector, afferent neuron, integration center, efferent neuron, receptor
48)
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:
49) Longest cranial nerve.
49)
50) Damage to this nerve would cause dizziness, nausea, and loss of balance.
50)
6
51) Name and describe five examples of exteroceptors that are NOT cutaneous receptors of the
skin.
51)
52) How is a receptor potential similar to an excitatory postsynaptic potential (EPSP)
generated at a synapse?
52)
53) Receptors that are stimulated by temperature changes are called ________.
53)
54) Describe the steps of the regeneration process of a damaged peripheral nerve fiber.
54)
55) The perineurium defines the boundary of a ________.
55)
Figure 13.3
Using Figure 13.3, match the following:
56) All but T2 -T12 branch and form nerve plexuses.
56)
7
Figure 13.1
Using Figure 13.1, match the following:
57) Innervates the superior oblique muscle.
57)
8
Figure 13.3
Using Figure 13.3, match the following:
58) Contain autonomic nerve fibers.
58)
59) Describe the symptoms that may occur from lesions of the olfactory nerve, cranial nerve I.
59)
Figure 13.2
Using Figure 13.2, identify the following components of the reflex arc:
60) Integration center.
60)
61) 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.
61)
9
Figure 13.3
Using Figure 13.3, match the following:
62) Supplies the posterior body trunk.
62)
63) We are aware of our facial expression because of which functional feature of which cranial
nerve?
63)
64) Information regarding skeletal muscle tension is provided by ________ and muscle length
by ________.
64)
65) 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?
65)
10
Figure 13.3
Using Figure 13.3, match the following:
66) Supplies all of the body except the posterior.
66)
67) 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?
67)
11
Figure 13.1
Using Figure 13.1, match the following:
68) Damage to this nerve would cause difficulty in speech and swallowing, but no effect on
visceral organs.
68)
69) Damage to this nerve would keep the eye from rotating inferolaterally.
69)
70) List and describe the functions of the three cranial nerves that serve the muscles of the eye.
70)
12
Figure 13.3
Using Figure 13.3, match the following:
71) Supplies each muscle with fibers from more than one nerve.
71)
72) Distinguish between monosynaptic and polysynaptic reflexes and between ipsilateral and
contralateral reflex responses.
72)
73) Describe how the muscle spindles and the tendon organs vary in their role during the
stretch reflex and opposing tendon reflex.
73)
74) Which of the body receptors have restricted locations and constantly advise the brain of
our body movements?
74)
Figure 13.2
Using Figure 13.2, identify the following components of the reflex arc:
75) Effector.
75)
76) Describe the cause and symptoms of paresthesia.
76)
13
Figure 13.2
Using Figure 13.2, identify the following components of the reflex arc:
77) Receptor.
77)
78) An incorrectly placed intramuscular injection can cause injury to which nerve of the sacral
plexus?
78)
Figure 13.1
Using Figure 13.1, match the following:
79) Involved in movement of the digestive tract.
79)
80) Name three unencapsulated sensory receptors and tell what they are used for.
80)
14
81) 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.
81)
Figure 13.2
Using Figure 13.2, identify the following components of the reflex arc:
82) Motor neuron.
82)
83) Sensory neuron.
83)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
84) 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.
84)
85) Dorsal and ventral rami are similar in that they both contain sensory and motor fibers.
85)
86) Lamellar corpuscles can only be exteroceptors or proprioceptors.
86)
87) The second cranial nerve forms a chiasma at the base of the brain for partial crossover of neural
fibers.
87)
88) Drooping of the upper eyelid, and double vision are potential symptoms of damage to the olfactory
nerve.
88)
89) Irritation of the phrenic nerve may cause diaphragm spasms called hiccups.
89)
90) The meningeal branch of a spinal nerve actually reenters the vertebral canal to innervate the
meninges and blood vessels.
90)
91) The musculocutaneous nerve is a major nerve of the brachial plexus.
91)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
92) Striking the "funny bone" (ulnar
nerve) may cause injury to a nerve of
this plexus.
A) Brachial plexus
15
92)
Match the following reflexes to their function:
93) Prevents muscle overstretching and
maintains muscle tone.
A) Stretch
93)
Match the following:
94) Controls the outputs of the cortex and
regulates motor activity.
95) Intermediate relay for incoming and
outgoing neurons.
A) Projection level
94)
B) Precommand level
95)
Match the following:
96) Lamellar corpuscle.
A) Pacinian corpuscle
96)
Match the following:
97) Primarily motor; carry motor and
propioceptor impusles to and from the
eyeballs.
A) Trochlear
97)
B) Optic
98) Purely sensory; transmit visual
impulses from the retina to the
thalamus.
98)
Match the following reflexes to their function:
99) Consists of an ipsilateral withdrawal
reflex and a contralateral extensor
reflex; important in maintaining
balance.
A) Crossed-extensor
99)
Match the following:
100) Mixed nerves; primarily motor; main
general sensory nerves of the face.
A) Trigeminal
100)
Match the following:
101) The obturator and femoral nerves
branch from this plexus.
A) Lumbar plexus
101)
Match the following:
102) The neural machinery of the spinal
cord, including spinal cord circuits.
A) Segmental level
16
102)
103) Includes cortical and brain stem motor
areas.
A) Projection level
103)
Match the following reflexes to their function:
104) Tests both upper and lower motor
pathways. The sole of the foot is
stimulated with a dull instrument.
A) Plantar
104)
Match the following:
105) Mixed nerves; carry sensory impulses
from the taste buds of anterior
two-thirds of the tongue.
A) Facial
105)
Match the following:
106) Tactile corpuscle.
A) Meissner corpuscle
106)
Match the following:
107) Trauma to a nerve of this plexus may
cause wrist drop.
108) A fall or improper administration of
an injection to the buttocks may injure
a nerve of this plexus.
A) Sacral plexus
107)
B) Brachial plexus
108)
Match the following reflexes to their function:
109) Produces muscle relaxation and
lengthening in response to tension; the
contracting muscle relaxes as its
antagonist is activated.
A) Tendon
109)
Match the following:
110) Bulbous corpuscle.
A) Ruffini endings
110)
Match the following:
111) The cerebellum and basal nuclei.
A) Precommand level
111)
Match the following reflexes to their function:
112) Produces a rapid withdrawal of the
body part from a painful stimulus;
ipsilateral.
A) Flexor
17
112)
Match the following:
113) Central pattern generators.
A) Segmental level
113)
Match the following:
114) Mixed nerves; transmit sensory
impulses from the taste buds of the
posterior tongue.
A) Glossopharyngeal
114)
Match the following:
115) The phrenic nerve branches from this
plexus.
A) Cervical plexus
115)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
116) 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?
117) 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?
118) A nurse is asked what is tabes dorsalis and what causes it. What should the response be?
119) 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?
120) 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?
18
Answer Key
Testname: 13
1) C
2) D
3) A
4) C
5) B
6) A
7) A
8) C
9) A
10) A
11) C
12) D
13) D
14) B
15) B
16) D
17) B
18) C
19) B
20) C
21) C
22) A
23) B
24) D
25) A
26) A
27) A
28) B
29) C
30) A
31) B
32) A
33) B
34) B
35) D
36) D
37) A
38) A
39) A
40) C
41) D
42) A
43) C
44) C
45) D
46) B
47) D
48) A
49) D
50) C
19
Answer Key
Testname: 13
51) 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.
52) 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.
53) thermoreceptors
54) 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.
55) fascicle
56) B
57) B
58) C
59) anosmia
60) E
61) 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.
62) A
63) The proprioception of facial muscles by the facial nerve, cranial nerve VII
64) tendon organs; muscle spindles
65) Hair follicle receptors
66) B
67) The plantar reflex tests the integrity of the spinal cord from L4 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.
68) E
69) B
70) 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.
71) B
72) 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.
73) 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.
74) Proprioceptors
75) B
76) Paresthesia is the tingling sensation that is felt when blood flow is reduced to a sensory nerve.
77) A
78) sciatic nerve
79) D
20
Answer Key
Testname: 13
80) 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.
81) Continuous pressure interrupts blood flow along with oxygen and nutrients to the neuron processes. As a result,
impulse transmission is inhibited temporarily.
82) D
83) C
84) FALSE
85) TRUE
86) FALSE
87) TRUE
88) FALSE
89) TRUE
90) TRUE
91) TRUE
92) A
93) A
94) B
95) A
96) A
97) A
98) B
99) A
100) A
101) A
102) A
103) A
104) A
105) A
106) A
107) B
108) A
109) A
110) A
111) A
112) A
113) A
114) A
115) A
116) 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.
117) 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.
118) 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.
21
Answer Key
Testname: 13
119) 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.
120) 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.
22
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) The secretions of the adrenal medulla act to supplement the effects of ________.
A) vagus (X) nerve activity
B) parasympathetic innervation
C) somatic stimulation
D) sympathetic stimulation
1)
2) Which of the following adrenergic neurotransmitter receptors plays the major role in heart activity?
A) beta 1
B) beta 2
C) beta 3
D) alpha 1
2)
3) 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) synapse with a ganglionic neuron in the same trunk ganglion
D) ascend or descend the trunk to synapse in another trunk ganglion
3)
4) The parasympathetic ganglion that serves the lacrimal gland and nasal mucosa is the ________.
A) submandibular ganglion
B) otic ganglion
C) pterygopalatine ganglion
D) ciliary ganglion
4)
5) 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
5)
6) Which of the following is a function of the parasympathetic division?
A) increases heart rate and force of contraction
B) produces "goosebumps"
C) contracts smooth muscle of the bladder wall and relaxes urethral sphincter
D) dilates bronchioles
6)
7) Which sympathetic fibers form a splanchnic nerve?
A) those that synapse in the same trunk ganglion they entered
B) those that pass through the trunk ganglion to synapse in collateral or prevertebral ganglia
C) those that synapse with somatic fibers
D) those that synapse with parasympathetic fibers
7)
8) The somatic and autonomic nervous systems differ in all of the following EXCEPT ________.
A) their effectors
B) their efferent pathways and ganglia
C) regulation of activity by higher brain centers
D) target organ responses to their neurotransmitters
8)
1
9) Raynaud's disease ________.
A) is characterized by exaggerated vasoconstriction in the extremities
B) occurs primarily in association with injury to the spinal cord
C) is induced by heat stress
D) is frequently life threatening
9)
10) Which type of drug would be useful in dilating the pupils for an examination of the retina?
A) alpha-1 receptor inhibitor
B) beta-3 receptor mimic
C) beta-1 receptor mimic
D) muscarinic receptor inhibitor
10)
11) Which of the following is mismatched?
A) sympathetic preganglionic fibers; release ACh
B) parasympathetic preganglionic fibers; release ACh
C) parasympathetic postganglionic fibers; release NE
D) sympathetic postganglionic fibers; release NE
11)
12) Emotions influence autonomic reactions primarily through integration in the ________.
A) inferior colliculus
B) hypothalamus
C) lateral horn of the spinal cord
D) lateral geniculate of the thalamus
12)
13) The route of major parasympathetic outflow from the head is via the ________.
A) sacral nerves
B) vagus (X) nerves
C) phrenic nerve
D) sympathetic trunk
13)
14) Where would you NOT find autonomic ganglia?
A) paired, beside spinal cord
B) within wall of organ served or close to organ
C) unpaired, anterior to spinal cord
D) within spinal cord
14)
15) Which of the following is NOT a result of parasympathetic stimulation?
A) dilation of the pupils
B) increased peristalsis of the digestive viscera
C) salivation
D) elimination of urine
15)
16) 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) adrenal medulla hormone producing cells
D) all parasympathetic target organs
16)
17) 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
17)
2
18) The smooth muscle of the digestive viscera is served largely by the ________.
A) pelvic nerves
B) lumbar splanchnic nerves
C) cephalic plexus
D) vagus (X) nerves
18)
19) Which of the following statements is FALSE?
A) Sympathetic division has short preganglionic and long postganglionic fibers;
parasympathetic has long preganglionic and short postganglionic fibers.
B) Sympathetic ganglia are within a few centimeters of the CNS; parasympathetic ganglia are
close to the visceral organs served.
C) Sympathetic origin is craniosacral; parasympathetic is thoracolumbar.
D) Sympathetic has extensive branching of preganglionic fibers; parasympathetic has minimal
branching of preganglionic fibers.
19)
20) Control of temperature, endocrine activity, and thirst are functions associated with the ________.
A) hypothalamus
B) thalamus
C) cerebellum
D) medulla
20)
21) Sympathetic division stimulation causes ________.
A) decreased blood glucose, increased GI peristalsis, and increased heart rate and blood pressure
B) increased blood glucose, decreased GI peristalsis, and increased heart rate and blood pressure
C) increased blood glucose, increased GI peristalsis, and decreased heart rate and blood pressure
D) decreased blood glucose, increased GI peristalsis, and decreased heart rate and blood
pressure
21)
22) Parasympathetic functions include ________.
A) allowing the body to cope with an external threat
B) lens accommodation for close vision
C) a stimulation of heart rate and force of contraction
D) raising blood glucose levels
22)
23) Autonomic ganglia contain ________.
A) the cell bodies of motor neurons
B) an outer connective tissue capsule around the cell bodies of preganglionic motor neurons
C) synapses between postganglionic fibers and their effectors
D) both somatic afferent and efferent neurons
23)
24) Preparing the body for the "fight-or-flight" response is the role of the ________.
A) cerebrum
B) somatic nervous system
C) parasympathetic division
D) sympathetic division
24)
25) Fibers that enter and leave the sympathetic trunks without synapsing form structures called
________.
A) spinal nerves
B) splanchnic nerves
C) gray rami communicantes
D) white rami communicantes
25)
26) Over 90% of all parasympathetic fibers are derived from cranial nerve ________.
A) XII (hypoglossal)
B) VII (facial)
C) X (vagus)
D) V (trigeminal)
26)
3
27) Erection (vasodilation) of the penis or clitoris ________.
A) is the result of coordinated activation by both sympathetic and parasympathetic input
B) is primarily under parasympathetic control
C) is primarily under sympathetic control
D) depends very little on autonomic activation
27)
28) 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) cell bodies and dendrites of parasympathetic postganglionic neurons
D) the hormone producing cells of the adrenal medulla
28)
29) The "fight or flight" division of the autonomic nervous system is the ________.
A) peripheral division
B) parasympathetic division
C) somatic division
D) sympathetic division
29)
30) Which target organ receives dual innervation?
A) kidney
C) coronary blood vessels
30)
B) small intestine
D) sweat glands
31) Which of the following appears to exert the most direct influence over autonomic functions?
A) reticular formation
B) hypothalamus
C) midbrain
D) medulla oblongata
31)
32) The parasympathetic fibers of the ________ nerve stimulate many large glands in the head such as
the nasal and lacrimal glands.
A) trochlear (IV)
B) optic (II)
C) oculomotor (III)
D) facial (VII)
32)
33) Which of the following is NOT true about hypertension?
A) It is serious because it forces the heart to work harder and increases wear and tear on artery
walls.
B) It may result from an overactive sympathetic vasoconstrictor response.
C) It is also known as high blood pressure.
D) It is a disorder of the parasympathetic division of the ANS.
33)
34) Which of the following drug classes would be useful for smoking cessation products?
A) parasympathomimetic agents (muscarinic agents)
B) sympathomimetic agents
C) acetylcholinesterase inhibitors
D) nicotinic agents
34)
35) Which is an exclusively sympathetic function?
A) regulation of respiratory rate
C) regulation of body temperature
35)
B) regulation of pupil size
D) regulation of cardiac rate
36) Drugs called beta-blockers ________.
A) increase a dangerously low heart rate
C) are potent antidepressants
B) decrease heart rate and blood pressure
D) have widespread sympathetic effects
4
36)
37) Sympathetic nerves may leave the spinal cord at which vertebra?
A) first thoracic
B) third lumbar
C) first coccyx
D) second cervical
37)
38) Which of these effectors is NOT directly controlled by the autonomic nervous system?
A) skeletal muscle
B) smooth muscle
C) most glands
D) cardiac muscle
38)
39) Visceral reflex arcs differ from somatic in that ________.
A) visceral arcs involve two motor neurons
B) visceral arcs contain two sensory neurons
C) somatic arcs contain one additional component that visceral arcs do not possess
D) visceral arcs do not use integration centers
39)
40) The parasympathetic tone ________.
A) accelerates activity of the digestive tract
B) determines normal activity of the urinary tract
C) causes blood pressure to rise
D) prevents unnecessary heart deceleration
40)
41) Sympathetic responses generally are widespread because ________.
A) preganglionic fibers are long
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 short
41)
42) Which of the following is NOT a plexus of the vagus (X) nerve?
A) pulmonary
B) cardiac
C) esophageal
D) inferior hypogastric
42)
43) 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
43)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
44) In what ways are the autonomic and the somatic nervous systems different?
44)
45) Describe three potential outcomes that result when a preganglionic axon reaches a
sympathetic trunk ganglion.
45)
5
Figure 14.1
Using Figure 14.1, match the following:
46) Myelin sheath.
46)
47) Cell body of a somatic motor neuron.
47)
48) List three key anatomical differences between the sympathetic and parasympathetic
divisions.
48)
49) 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?
49)
50) How is Raynaud's disease related to the ANS?
50)
51) What studies have suggested that the ANS can also be subject to voluntary controls?
51)
6
Figure 14.1
Using Figure 14.1, match the following:
52) Cell body of an ANS postganglionic neuron.
52)
53) 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?
53)
54) 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?
54)
7
Figure 14.1
Using Figure 14.1, match the following:
55) Cell body of an ANS preganglionic neuron.
55)
56) Explain the concept of dual innervation in the autonomic nervous system. Provide two
examples.
56)
57) Discuss a way in which the sympathetic and parasympathetic divisions cooperate with
each other.
57)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
58) Somatic and visceral reflex arcs are similar, but visceral reflex arcs lack afferent fibers (visceral
sensory neurons).
58)
59) Most disorders of the autonomic nervous system reflect abnormalities of smooth muscle control.
59)
60) Visceral reflexes include the reflexes that empty the bladder and the rectum.
60)
61) 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.
61)
62) The effect of beta-blocker drugs (block beta-receptors) is to increase blood pressure.
62)
63) All splanchnic nerves are sympathetic.
63)
8
64) 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.
64)
65) All visceral organs receive dual innervation from both the sympathetic and parasympathetic
divisions of the ANS.
65)
66) The craniosacral division is another name for the parasympathetic division.
66)
67) 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.
67)
68) The rami communicantes are associated only with the sympathetic division of the ANS.
68)
69) Norepinephrine-releasing fibers are called cholinergic fibers.
69)
70) The autonomic and somatic nervous systems are two separate systems that work totally
independent of each other and lack any functional overlap.
70)
71) Acetylcholine is released by all somatic motor neurons, all preganglionic neurons of the ANS and
by the postganglionic parasympathetic nerve fibers.
71)
72) Most splanchnic nerves pass through the abdominal aortic plexus.
72)
73) The sacral part of the parasympathetic division serves the pelvic organs and the distal half of the
large intestine.
73)
74) The parasympathetic division innervates more organs than the sympathetic division.
74)
75) The autonomic nervous system may cause activation or inhibition, depending on the division that
is active and the target that is affected.
75)
76) The ANS stimulates smooth muscles, skeletal muscles and glands, whereas the somatic nervous
system innervates skeletal muscles only.
76)
77) The vasomotor tone of blood vessels is mostly under sympathetic control.
77)
78) Autonomic ganglia are motor ganglia, containing the cell bodies of motor neurons.
78)
79) Thermoregulatory responses to increased heat are mediated by the parasympathetic nervous
division.
79)
80) The adrenal medulla is considered by some to be a "misplaced" sympathetic ganglion since
embryologically, they arise from the same tissue.
80)
81) The sympathetic and parasympathetic divisions of the ANS have the same effect on most body
organ systems.
81)
9
82) The facial (VII), glossopharyngeal (IX), and vagus (X) nerves contain postganglionic fibers of the
parasympathetic nervous system.
82)
83) The effect of the parasympathetic division on the penis is vasodilation causing erection, while
ejaculation is due to sympathetic stimulation.
83)
84) Rami communicantes are designated white or gray to indicate whether or not the fibers passing
through them are myelinated.
84)
85) The gray rami communicantes consist of myelinated postganglionic fibers.
85)
86) -adrenergic receptors are the only receptors found on the heart.
86)
87) Some sympathetic preganglionic fibers stimulate the adrenal medulla to release norepinephrine
and epinephrine into the blood, producing a "surge of adrenaline."
87)
88) Albuterol (Ventolin) binds to 2 receptors and is used by asthma patients to constrict the
bronchioles of the lungs and ease breathing.
88)
89) Autonomic ganglia are sights of synapse and information transmission from preganglionic to
postganglionic neurons.
89)
90) Most blood vessels are innervated by the sympathetic division alone.
90)
91) The celiac ganglion is primarily associated with the sympathetic division.
91)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
92) Secreted by most postganglionic
sympathetic fibers.
A) Norepinephrine (NE)
92)
Match the following:
93) Short preganglionic, long
postganglionic fibers.
94) Collateral ganglia.
A) Parasympathetic
93)
B) Sympathetic
94)
95) Known to be active during "rest and
digest" responses.
95)
96) Maintenance functions.
96)
97) Decreases heart rate.
97)
10
Match the following:
98) Secreted by preganglionic
parasympathetic fibers.
A) Acetylcholine (ACh)
98)
Match the following:
99) Stimulates ciliary muscles of the eye,
which makes the lens bulge for close
vision.
A) Parasympathetic
99)
B) Sympathetic
100) Active during "fight or flight"
responses.
100)
Match the following:
101) Secreted by postganglionic
parasympathetic fibers.
A) Acetylcholine (ACh)
101)
102) Secreted by preganglionic sympathetic
fibers.
102)
103) Secreted by postganglionic
sympathetic fibers to sweat glands.
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) Describe outcome criteria that can be used to evaluate whether a patient is effectively coping with a stressful
problem.
106) 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?
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?
11
Answer Key
Testname: 14
1) D
2) A
3) B
4) C
5) D
6) C
7) B
8) C
9) A
10) D
11) C
12) B
13) B
14) D
15) A
16) D
17) B
18) D
19) C
20) A
21) B
22) B
23) A
24) D
25) B
26) C
27) B
28) A
29) D
30) B
31) B
32) D
33) D
34) D
35) C
36) B
37) A
38) A
39) A
40) B
41) C
42) D
43) B
44) 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.
12
Answer Key
Testname: 14
45) 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.
46) E
47) D
48) 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.
49) 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.
50) 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.
51) 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.
52) C
53) After a meal, parasympathetic influences dominate, which increase digestive functions while decreasing cardiac and
respiratory activity. This causes the individual to feel sleepy.
54) 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.
55) A
56) 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.
57) 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.
58) FALSE
59) TRUE
60) TRUE
61) FALSE
62) FALSE
63) FALSE
64) FALSE
65) FALSE
66) TRUE
67) TRUE
68) TRUE
69) FALSE
70) FALSE
71) TRUE
13
Answer Key
Testname: 14
72) TRUE
73) TRUE
74) FALSE
75) TRUE
76) FALSE
77) TRUE
78) TRUE
79) FALSE
80) TRUE
81) FALSE
82) FALSE
83) TRUE
84) TRUE
85) FALSE
86) FALSE
87) TRUE
88) FALSE
89) TRUE
90) TRUE
91) TRUE
92) A
93) B
94) B
95) A
96) A
97) A
98) A
99) A
100) B
101) A
102) A
103) A
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) 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.
106) 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.
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.
14
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) The receptor membranes of gustatory cells are ________.
A) fungiform papillae
B) gustatory hairs
C) basal cells
D) taste buds
1)
2) What is the primary function of cerumen?
A) lubricates ossicles
B) softens tympanic membrane
C) cleans and lubricates the external auditory canal
D) prevents water from entering middle ear
2)
3) 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) visual cortex
C) lateral geniculate body of the thalamus
D) temporal lobe
3)
4) Select the correct statement about olfaction.
A) Some of the sensation of olfaction is actually one of pain.
B) Olfactory adaptation is only due to fading of receptor cell response.
C) Olfactory receptors have a high degree of specificity toward a single type of chemical.
D) Substances must be volatile and hydrophobic in order to activate olfactory receptors.
4)
5) 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) The foveae are densely packed with cones.
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.
5)
6) Most newborns ________.
A) are myopic
B) see in tones of red and green only
C) produce more tears when they cry than a toddler
D) often use only one eye at a time
6)
7) Which of the following types of neurons are replaced throughout adult life?
A) retinal bipolar cells
B) auditory outer and inner hair cells
C) retinal ganglion cells
D) olfactory receptor cells
7)
8) Damage to the medial rectus muscles would probably affect ________.
A) pupil constriction
B) refraction
C) convergence
D) accommodation
8)
9) The first vestiges of eyes in the embryo are called ________.
A) optic cups
B) optic discs
C) optic vesicles
1
D) mesenchyme
9)
10) Which of the following best describes the function of the iris?
A) gives the eye its color
B) adjusts the shape of the lens
C) refracts light through the pupil
D) controls amount of light entering eye
10)
11) The sensation of loudness or the volume of a sound is detected by ________.
A) sounds that can travel all the way to the apex of the scala vestibule with enough energy
remaining to deflect hair cells
B) vibration along a greater length of the basilar membrane, stimulating a greater number of 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
11)
12) An essential part of the maculae involved in static equilibrium is (are) the ________.
A) spiral organ (of Corti)
B) otoliths
C) cupula
D) scala media
12)
13) The cells of the retina in which action potentials are generated are the ________.
A) rods and cones
B) amacrine cells
C) bipolar cells
D) ganglion cells
13)
14) 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 not be able to track objects with the eye on the same side as the hearing loss.
D) The patient will have increased sensitivity to sound in the unaffected ear.
14)
15) In a person who is color-blind, which of the following would you most expect to see?
A) a loss of their peripheral vision
B) an inability to regenerate 11-cis-retinal after bleaching
C) a loss of functions in the rods of their retina
D) absence of green or red cones in their foveae
15)
16) 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) less light getting to the retina and diminished visual acuity
C) less accommodation of the lenses and difficulty focusing on nearby objects
D) a clouding of the lenses known as a cataract
16)
17) What structure regulates the amount of light passing to the visual receptors of the eye?
A) iris
B) cornea
C) aqueous humor
D) lens
17)
18) What is the main function of the rods in the eye?
A) color vision
C) depth perception
18)
B) accommodation for near vision
D) vision in dim light
19) During dark adaptation, ________.
A) the cones are activated
B) the sensitivity of the retina decreases
C) the rate of rhodopsin breakdown is accelerated
D) rhodopsin accumulates in the rods
2
19)
20) 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, lens, pupil, anterior chamber, posterior segment
C) cornea, pupil, anterior chamber, lens, posterior segment
D) cornea, anterior chamber, pupil, lens, posterior segment
20)
21) In the visual pathways to the brain, the optic radiations project to the ________.
A) medial retina
B) optic chiasma
C) lateral geniculate body
D) primary visual cortex
21)
22) Fusing of the ossicles (otosclerosis) results in ________.
A) Ménière's Syndrome
B) sensorineural deafness
C) tinnitus
D) conduction deafness
22)
23) The ability to clearly see objects at a distance but not close up is properly called ________.
A) hypopia
B) hyperopia
C) presbyopia
D) myopia
23)
24) The receptor for static equilibrium is the ________.
A) semicircular canals
C) cochlear duct
24)
B) macula
D) utricle
25) 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 ciliated.
D) They are unipolar neurons.
25)
26) Which pairing of terms is incorrectly related?
A) frequency of sound waves: number of wavelengths
B) amplitude of a sound: intensity of the sound
C) frequency of sound waves: loudness of the sound
D) quality of a sound: frequency of the sound
26)
27) Ceruminous glands are ________.
A) glands found in the lateral corners of your eye
B) saliva glands found at the base of the tongue
C) modified apocrine sweat glands
D) modified taste buds
27)
28) What is a modiolus?
A) bone around the cochlea
B) bone in the center of a semicircular canal
C) a bone pillar in the center of the cochlea
D) a bony area around the junction of the facial, vestibular, and cochlear nerves
28)
3
29) Select the statement below that is NOT true with regards to the process of light adaptation.
A) Rhodopsin is uncoupled from light transduction.
B) Retinal sensitivity decreases.
C) The activity of rods is reduced by rapid bleaching of rhodopsin.
D) Visual acuity is diminished.
29)
30) Which of the following types of receptors are located in the mouth?
A) thermoreceptors, mechanoreceptors, and nociceptors only
B) chemoreceptors, mechanoreceptors, thermoreceptors, and nociceptors
C) chemoreceptors, thermoreceptors, and nociceptors only
D) chemoreceptors only
30)
31) Select the correct statement about equilibrium.
A) Due to dynamic equilibrium, movement can be perceived if rotation of the body continues at
a constant rate.
B) Cristae respond to angular acceleration and deceleration.
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.
31)
32) Dark adaptation ________.
A) involves accumulation of rhodopsin
B) primarily involves improvement of acuity and color vision
C) results in inhibition of rod function
D) is much faster than light adaptation
32)
33) There are three layers of neurons in the retina. The axons of which of these neuron layers form the
optic nerves?
A) bipolar cells
B) cone cells
C) ganglion cells
D) rod cells
33)
34) As sound levels increase in the spiral organ (of Corti), ________.
A) inner hair cells stiffen the basilar membrane
B) inner hair cells bend the cilia away from the kinocilium
C) outer hair cells stiffen the basilar membrane
D) outer hair cells bend the cilia away from the kinocilium
34)
35) 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) has no nerve supply
C) is not a living tissue
D) does not contain connective tissue
35)
36) 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) Glossopharyngeal (IX)
B) Hypoglossal (XII)
C) Trigeminal (V)
D) Facial (VII)
36)
4
37) The only special sense NOT fully functional at birth is the sense of ________.
A) hearing
B) smell
C) taste
D) vision
E) equilibrium
38) Bitter taste is elicited by ________.
A) metal ions
B) alkaloids
C) acids
37)
D) hydrogen ions
38)
39) Which of the following is the best explanation for our perception of color?
A) Rods contain a single kind of visual pigment.
B) As many as 100 cones may converge on one ganglion cell.
C) Cones come in three types, each sensitive to different wavelengths of light.
D) The foveae are densely packed with cones.
39)
40) Which of the following could NOT be seen as one looks into the eye with an ophthalmoscope?
A) optic disc
B) fovea centralis
C) optic chiasma
D) macula lutea
40)
41) Conscious perception of vision probably reflects activity in the ________.
A) superior colliculus
B) thalamus
C) occipital lobe of the cortex
D) chiasma
41)
42) 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) a perforated tympanic membrane
C) an overgrowth of bony tissue, fusing the ossicles together
D) damage to the hair cells near the oval window in the cochlear duct
42)
43) Visual inputs to the ________ serve to synchronize biorhythms with natural light and dark.
A) lateral geniculate body
B) superior colliculi
C) suprachiasmatic nucleus
D) pretectal nuclei
43)
44) 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 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.
B) Taste receptors that are active at the same time influence the subtlety of what we smell.
C) The belief that we can smell so many different distinct odors is a psychological process
referred to as an uncinate fit or olfactory hallucination.
D) 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.
44)
5
45) 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) Rods absorb light throughout the visual spectrum but confer only gray tone vision.
C) In dim light, images are focused directly on the rods in the fovea centralis.
D) Three types of color-sensitive photoreceptors exist: red, green, and yellow.
45)
46) Paralysis of which eye muscle would prevent the right eye from looking to the left?
A) Superior rectus
B) Lateral rectus
C) Medial rectus
D) Inferior rectus
46)
47) Taste buds are NOT found ________.
A) lining the buccal cavity
C) in circumvallate papillae
47)
B) in filiform papillae
D) in fungiform papillae
48) Which of the following structures is NOT part of the external ear?
A) pinna
B) tympanic membrane
C) pharyngotympanic tube
D) external acoustic meatus
48)
49) 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) Colors are added and enhanced in the primary visual cortex of the brain.
B) Color perception is dependent on the millions of rods as well as cone photoreceptors.
C) Color perception is achieved by activation of various combinations between the three cone
types.
D) Shades of color are purely psychological and learned by association with age, infants only
seeing in black and white.
49)
50) Which movement of ions produces EPSPs in cochlea hair cells?
A) Influx of Na+
B) Influx of K+ and Ca++
C) Efflux of Ca++
D) Efflux of K+
50)
51) A perceived increase in the volume of sound is best explained by ________.
A) a decrease in the width of the sound wave
B) an increase in the height of the sound wave
C) an increase in the width of the sound wave
D) a combination of multiple sound waves
51)
52) Which best describes the function of olfactory cilia?
A) increase surface area of neurons receptive to airborne chemicals
B) trap inhaled particulates before air reaches lungs
C) help transport mucus toward nasopharynx
D) help move air through nasal passages
52)
53) Visual processing in the thalamus does NOT contribute significantly to ________.
A) night vision
B) high-acuity vision
C) depth perception
D) movement perception
53)
6
54) 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
54)
55) Nerve fibers from the medial aspect of each eye ________.
A) pass posteriorly without crossing over at the chiasma
B) cross over to the opposite side at the chiasma
C) go to the superior colliculus only
D) divide at the chiasma, with some crossing and some not crossing
55)
56) 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) 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.
B) This helps keep the motions detected by the eyes congruent (aligned) with the motions sensed
by the vestibular apparatus.
C) Reducing the inertia of head spin will reduce the flow of endolymph that deflects the hair
cells of the crista ampullaris.
D) 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.
56)
57) Which of the following is true about gustatory receptors?
A) In order for a chemical to be sensed, it must be hydrophobic.
B) Complete adaptation occurs in about one to five minutes.
C) The receptors generate an action potential in response to chemical stimuli.
D) All gustatory receptors have the same threshold for activation.
57)
58) The blind spot of the eye is caused by ________.
A) an absence of photoreceptors where the optic nerve leaves the eye
B) an absence of cones in the foveae
C) the macula lutea interrupts the nerve pathway
D) more rods than cones within the retina
58)
59) 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) sour-acids
C) umami-triglycerides and fatty acids
D) bitter-alkaloids
E) salty-metal ions
59)
60) Overlap in the visual fields of our eyes ________.
A) leaves a blind spot anterior to the nose and in the lateral fields of vision
B) gives us higher visual acuity for small detail by doubling the number of photoreceptors that
are being stimulated
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
60)
7
61) 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 several types of cone photoreceptors, each of which enrich the clarity and resolution
of vision.
B) There are many more cone photoreceptors in the eye than rod photoreceptors.
C) A larger proportion of the brain's visual cortex is active during the day when our cone
photoreceptors are most active.
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.
61)
62) 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.
62)
63) The oval window is connected directly to which passageway?
A) external acoustic meatus
B) pharyngotympanic tube
C) scala vestibuli
D) scala tympani
63)
64) Receptors for hearing are located in the ________.
A) cochlea
C) semicircular canals
64)
B) vestibule
D) tympanic membrane
65) 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) These cells, like the cells of the corneal layer of the integument are not living cells.
D) The aqueous humor is continuously replenished and flows from the ciliary process to drain in
the scleral venous sinus.
65)
66) 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 hearing
B) auditory hallucination
C) loss of balance and dizziness
D) ringing in the ears (tinnitus)
66)
67) Which statement about malnutrition-induced night blindness is most accurate?
A) Visual pigment content is reduced in cones more than rods.
B) The most common cause is vitamin D deficiency.
C) Vitamin supplements can reverse degenerative changes.
D) The impaired vision is caused by reduced cone function.
67)
8
68) The eye muscle that rotates the eye upward and turns the eye laterally is the ________.
A) lateral rectus
B) superior oblique
C) medial rectus
D) inferior oblique
68)
69) Motion sickness seems to ________.
A) respond best to medication that "boosts" vestibular inputs
B) result from activation of nausea centers in the brain stem
C) respond best to medication taken after salivation and pallor begins
D) result from mismatch between visual and vestibular inputs
69)
70) Tinnitus, vertigo, and gradual hearing loss typify the disorder called ________.
A) conjunctivitis
B) motion sickness
C) strabismus
D) Ménière's syndrome
70)
71) The visible light portion of the electromagnetic spectrum fits between ________.
A) X-rays and UV waves
B) infrared and microwaves
C) UV and infrared waves
D) microwaves and radio waves
71)
72) Seventy percent of all sensory receptors are located in the ________.
A) skin
B) eye
C) nose
72)
D) ears
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
73) What is the pharyngotympanic tube and what is its purpose?
73)
74) The ________ nuclei are in the visual pathway and mediate the pupillary light reflexes.
74)
9
Figure 15.3
Using Figure 15.3, match the following:
75) Viscous liquid that holds the retina firmly against the pigmented layer.
10
75)
Figure 15.2
Using Figure 15.2, match the following:
76) Contains only cones; provides detailed color vision.
11
76)
Figure 15.3
Using Figure 15.3, match the following:
77) Acts as a reflexively activated diaphragm to vary pupil size.
77)
78) Explain the role of the endolymph of the semicircular canals in activating the receptors
during angular motion.
78)
79) High frequency sounds are detected when the basilar membrane is displaced near the
________.
79)
80) Explain why prolonged periods of reading tire the eye muscles and result in eye strain.
80)
12
Figure 15.4
Using Figure 15.4, match the following:
81) Semicircular canals.
81)
82) The middle ossicle in the ear is the ________.
82)
13
Figure 15.1
Using Figure 15.1, match the following:
83) Ganglion cells.
83)
14
Figure 15.2
Using Figure 15.2, match the following:
84) Protects and shapes the eyeball; provides a sturdy anchoring site for extrinsic eye muscles.
84)
85) What is the chemical composition of the rod pigment, rhodopsin, and how does it appear
to act in the reception of light?
85)
86) 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?
86)
15
Figure 15.4
Using Figure 15.4, match the following:
87) Cochlea.
87)
16
Figure 15.3
Using Figure 15.3, match the following:
88) The only tissue in the body that can be transplanted from one person to another with little
or no rejection.
17
88)
Figure 15.1
Using Figure 15.1, match the following:
89) Rod.
89)
90) Horizontal cell.
90)
91) When you go to the fair and ride the roller coaster, where do those wild sensations come
from?
91)
18
Figure 15.2
Using Figure 15.2, match the following:
92) Blood vessels that supply nutrition to most of the eyes' structures (excluding the lens and
cornea).
92)
93) Explain why a bad cold can result in food not tasting the same as it normally does.
93)
94) Explain why your nose runs during and immediately after a good cry.
94)
95) Distinguish between the maculae and cristae ampullaris in terms of their sensory
reception.
95)
19
Figure 15.2
Using Figure 15.2, match the following:
96) Lacks photoreceptors; where optic nerve exits the eye.
96)
97) Consists of a pigmented layer and a neural layer.
97)
98) Describe the process of light and dark adaptation and include the role of the rods and
cones.
98)
20
Figure 15.3
Using Figure 15.3, match the following:
99) Increased pressure here causes glaucoma.
99)
100) Controls lens shape.
100)
101) The synapse of the olfactory nerves with the mitral cells is called a(n) ________.
101)
102) The apex of the cochlea hears sounds in the range of ________ Hz.
102)
103) Taste is solely a response to chemicals dissolved in ________.
103)
21
Figure 15.1
Using Figure 15.1, match the following:
104) Bipolar cells.
104)
22
Figure 15.4
Using Figure 15.4, match the following:
105) Houses organ of Corti.
105)
106) Trace the pathway of sound as it enters the external ear until it is perceived in the brain.
106)
23
Figure 15.4
Using Figure 15.4, match the following:
107) Stapes.
107)
108) Auricle.
108)
109) Balance organ.
109)
24
Figure 15.1
Using Figure 15.1, match the following:
110) Amacrine cell.
110)
111) What two things does the ciliary body do?
111)
112) Hot chili peppers contain a chemical compound called capsaicin that stimulate which type
of receptor?
112)
25
Figure 15.4
Using Figure 15.4, match the following:
113) Tympanic membrane.
113)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
114) The anterior chamber of the eye is filled with vitreous humor.
114)
115) Odorants must be volatile to be smelled.
115)
116) Sour taste receptors are stimulated by hydrogen ions of acidic food substances.
116)
117) The quality of a sound is based on the atmospheric pressure at the time the sound is generated.
117)
118) Vitamin A needed by the photoreceptor cells is stored by the cells of the retina pigmented layer.
118)
119) Theoretically, an individual born without a middle ear would be able to hear by bone conduction
with a hearing aid.
119)
120) The optic disc forms a blind spot where the optic nerve leaves the eyeball.
120)
121) When we move from darkness to bright light, retinal sensitivity is lost, but visual acuity is gained.
121)
122) Sound is generally perceived in the occipital lobe of the cerebral cortex.
122)
26
123) Without a functioning crista ampullaris, the semicircular canals would not function.
123)
124) 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.
124)
125) The function of the lens of the eye is to allow precise focusing of light on the retina.
125)
126) Light passes through the entire thickness of the neural layer of the retina to excite the
photoreceptors.
126)
127) The mucous membrane that lines the eyelids and is reflected over the anterior surface of the eyeball
is the conjunctiva.
127)
128) The bending of light rays is called reflection.
128)
129) Hair cells in the spiral organ of the ear are never replaced.
129)
130) Contraction of the ciliary muscle causes the lens to bend the light less.
130)
131) 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.
131)
132) Static equilibrium involves the sensation of linear acceleration as well as changes in head rotation.
132)
133) The structure that allows equalization of the pressure in the middle ear with the atmospheric
pressure is the external auditory meatus.
133)
134) The neural layer of the retina prevents excessive scattering of light within the eye.
134)
135) Ciliary muscles are considered voluntary, skeletal muscle.
135)
136) The fluid contained within the membranous labyrinth is called perilymph.
136)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
137) The central part of the bony labyrinth.
A) Vestibule
137)
Match the following:
138) Connects the middle ear with the
nasopharynx.
A) Pharyngotympanic tube
138)
Match the following:
139) A condition of deafness that may
result from otosclerosis.
A) Conduction deafness
27
139)
Match the following:
140) Hair cells receptive to changes in
dynamic equilibrium are found in this
structure.
A) Crista ampullaris
140)
Match the following:
141) An inflammation of the lining of the
middle ear.
A) Otitis media
141)
Match the following:
142) Detects linear acceleration.
A) Vestibule
142)
Match the following:
143) The sensory layer of the eye.
A) Retina
143)
Match the following:
144) Houses the spiral organ (of Corti).
A) Cochlear duct
144)
Match the following:
145) A condition that can result from a
deficiency of vitamin A.
A) Night blindness
145)
Match the following:
146) The structure most responsible for
focusing light rays that enter the eye.
A) Lens
146)
Match the following:
147) The receptor organ for hearing.
A) Spiral organ (of Corti)
147)
Match the following:
148) Can result from the fusion of the
auditory ossicles.
A) Conduction deafness
148)
Match the following:
149) Chemically sensitive cilia are found in
this structure.
A) Olfactory epithelium
149)
Match the following:
150) Contains utricle and saccule.
A) Vestibule
28
150)
Match the following:
151) Hair cells receptive to changes in static
equilibrium are found in this
structure.
A) Tympanic membrane
151)
B) Macula
152) A membrane that transmits sound
vibrations to the auditory ossicles.
152)
Match the following:
153) Ear stones.
A) Otoliths
153)
Match the following:
154) A possible side effect of medications
such as aspirin.
155) Can result from impacted cerumen.
A) Conduction deafness
154)
B) Tinnitus
155)
Match the following:
156) Chemically sensitive microvilli found
in this structure.
A) Taste buds
156)
Match the following:
157) One of the most common results of
otitis media.
A) Conduction deafness
157)
Match the following:
158) Separates external acoustic meatus
from the middle ear.
A) Tympanic membrane
158)
Match the following:
159) Loss of hearing resulting from
prolonged exposure to high-intensity
sounds.
A) Sensorineural deafness
159)
Match the following:
160) Area of greatest visual acuity.
A) Aqueous humor
161) Helps maintain the intraocular
pressure; located in the anterior part of
the eye.
B) Fovea centralis
29
160)
161)
Match the following:
162) A condition often leading to blindness
due to chronic persistent intraocular
pressure.
A) Glaucoma
162)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
163) 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?
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) 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?
166) 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.
167) 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.
30
Answer Key
Testname: 15
1) B
2) C
3) C
4) A
5) A
6) A
7) D
8) C
9) C
10) D
11) C
12) B
13) D
14) B
15) D
16) C
17) A
18) D
19) D
20) D
21) D
22) D
23) B
24) B
25) D
26) C
27) C
28) C
29) D
30) B
31) B
32) A
33) C
34) C
35) A
36) D
37) D
38) B
39) C
40) C
41) C
42) D
43) C
44) A
45) B
46) C
47) B
48) C
49) C
50) B
31
Answer Key
Testname: 15
51) B
52) A
53) A
54) C
55) B
56) C
57) B
58) A
59) C
60) D
61) D
62) B
63) C
64) A
65) D
66) C
67) C
68) D
69) D
70) D
71) C
72) B
73) 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.
74) pretectal
75) E
76) D
77) C
78) 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.
79) base
80) Reading or other close work requires almost continuous accommodation, pupillary constriction, and convergence,
which lead to tiredness of the eye muscles.
81) B
82) incus
83) E
84) A
85) 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.
86) 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.
87) D
88) B
89) B
32
Answer Key
Testname: 15
90) A
91) 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.
92) B
93) 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
94) 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.
95) 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.
96) E
97) C
98) 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.
99) D
100) A
101) glomerulus
102) 20
103) saliva
104) C
105) D
106) 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.
107) C
108) A
109) B
110) D
111) 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.
112) Nociceptors
113) E
114) FALSE
115) TRUE
116) TRUE
117) FALSE
118) FALSE
119) TRUE
120) TRUE
121) TRUE
122) FALSE
123) TRUE
124) TRUE
33
Answer Key
Testname: 15
125) TRUE
126) TRUE
127) TRUE
128) FALSE
129) FALSE
130) FALSE
131) TRUE
132) FALSE
133) FALSE
134) FALSE
135) FALSE
136) FALSE
137) A
138) A
139) A
140) A
141) A
142) A
143) A
144) A
145) A
146) A
147) A
148) A
149) A
150) A
151) B
152) A
153) A
154) B
155) A
156) A
157) A
158) A
159) A
160) B
161) A
162) A
163) 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.
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.
34
Answer Key
Testname: 15
165) 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.
166) 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.
167) 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.
35
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) 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) adrenal
D) anterior pituitary
1)
2) The effect of a hormone on a target cell may be decreased by the presence of ________.
A) antagonistic hormones
B) synergistic hormones
C) plasma membrane receptors
D) permissive hormones
2)
3) Dave has discovered a new lipid-soluble hormone. Which of the following is true regarding this
hormone?
A) can be stored in secretory vesicles
B) will likely act through a second-messenger system
C) will be bound to a transport protein in the blood
D) receptor will be located on the plasma membrane
3)
4) Oxytocin ________.
A) exerts its most important effects during menstruation
B) release is an example of a positive feedback control mechanism
C) controls milk production
D) is an anterior pituitary secretion
4)
5) Regulating hormones from the hypothalamus ________.
A) first enter into the hypophyseal portal system
B) travel by arteries to the pituitary
C) enter venous circulation and travel to the heart, which pumps the hormone-containing blood
to the pituitary
D) enter the hepatic portal system, which feeds the pituitary
5)
6) 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
6)
7) The parathyroid glands respond to which type of stimulus?
A) humoral
B) neural
C) positive
7)
8) Glucagon ________.
A) is considered a hypoglycemic hormone
B) triggers gluconeogenesis
C) stimulates the absorption of glucose from the blood
D) triggers the conversion of glucose into glycogen
1
D) hormonal
8)
9) Thyroid hormone (a small iodinated amine) enters target cells in a manner similar to ________.
A) growth hormone, because the thyroid works synergistically with thyroid hormone
B) insulin, because insulin is a small peptide
C) glucagon, because the structure of glucagon is similar to that of thyroid hormone
D) steroid hormones, because both diffuse easily into target cells
9)
10) 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) cortisol
B) parathyroid hormone
C) thyroid stimulating hormone
D) growth hormone
10)
11) 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) growth hormone
C) ADH
D) thyroid stimulating hormone
11)
12) Which of the following is NOT a change that may be caused by hormonal stimulus?
A) an increase in enzyme synthesis
B) a change in membrane potential
C) stimulation of mitosis
D) direct control of the nervous system
12)
13) Which organ is responsible for synthesizing the hormone atrial natriuretic peptide (ANP)?
A) the skin
B) the heart
C) the kidney
D) the spleen
13)
14) How do glucocorticoids enable the body to deal appropriately with stress?
A) by increasing blood glucose, fatty acid, and amino acid levels and enhancing blood pressure
B) by stimulating the pancreas to release insulin
C) by releasing the neurotransmitters that prepare the body for the stress response
D) by decreasing the heart rate, thus decreasing blood pressure
14)
15) Which of the following is NOT a typical result of a long-term stress response?
A) loss of muscle mass
B) impaired immune function
C) elevated blood pressure
D) decreased production of glucocorticoids
15)
16) Aldosterone ________.
A) production is greatly influenced by ACTH
B) functions to increase sodium reabsorption
C) is secreted by the posterior pituitary
D) presence increases potassium concentration in the blood
16)
17) Which anterior pituitary hormone does NOT target another endocrine gland?
A) luteinizing hormone(LH)
B) adrenocorticotropic hormone (ACTH)
C) growth hormone (GH)
D) follicle-stimulating hormone (FSH)
17)
18) Which hormone has only one known effect: to stimulate milk production by the breasts?
A) prolactin
B) estrogen
C) progesterone
D) oxytocin
18)
19) Mineralocorticoid is to aldosterone as glucocorticoid is to ________.
A) estrogen
B) epinephrine
C) testosterone
19)
2
D) cortisol
20) 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) catabolic inhibition
D) protein synthesis
20)
21) The posterior lobe of the pituitary gland is NOT a true endocrine gland because ________.
A) embryonically it was an endocrine tissue, but in the adult human it is no longer functional
B) it is unable to function as an endocrine tissue because it is actually part of the neural system
due to its location
C) it is strictly a part of the neural system and has little or nothing to do with hormonal release
D) it is only a hormone storage area that receives hormones from the hypothalamus for release
21)
22) Steroid hormones exert their action by ________.
A) activating the hypothalamic release of regulating hormones
B) entering the nucleus of a cell and initiating or altering the expression of a gene
C) binding cell receptors and initiating cAMP activity
D) entering the cell and activating mitochondrial DNA
22)
23) Which of the following hormones suppresses appetite and increases energy expenditure?
A) gastrin
B) secretin
C) aldosterone
D) leptin
23)
24) 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) enzymes
B) proteins
C) hormones
D) antibodies
24)
25) Which of the following is NOT a parathyroid gland mechanism to maintain adequate levels of
blood calcium?
A) increased calcium ion reabsorption by the kidneys
B) activation of osteoclasts
C) increased intestinal absorption of calcium ions
D) inhibition of calcitonin synthesis
25)
26) 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 presence of the appropriate receptors on the cells of the target tissue or organ
C) the location of the tissue or organ with respect to the circulatory path
D) nothing all hormones of the human body are able to stimulate any and all cell types because
hormones are powerful and nonspecific
26)
27) Which of the following is NOT a component of the cyclic AMP signaling mechanism?
A) steroid
B) hormone receptor
C) G protein
D) effector enzyme
27)
28) 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.
28)
3
29) Leptin is secreted by ________.
A) adipose cells
B) goblet cells
C) lymphocytes
30) Which of the following is NOT a steroid-based hormone?
A) cortisol
B) aldosterone
C) epinephrine
D) fibroblasts
D) estrogen
29)
30)
31) 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) binding to specific receptors and employing the services of G proteins and cAMP
D) synthesizing more than one hormone at a time
31)
32) Which of the following statements is true of amino acid-based hormones?
A) They are synthesized from cholesterol.
B) They cross the plasma membrane.
C) They are lipid soluble.
D) They require a receptor in the plasma membrane.
32)
33) Hormones that bind to plasma proteins ________.
A) are usually water soluble
B) are usually made of amino acids
C) must also bind to plasma membrane receptors
D) are usually synthesized from cholesterol
33)
34) A release of parathyroid hormone (PTH) will trigger ________.
A) a drop in blood calcium levels
B) increased activation of vitamin D by the kidney
C) increased osteoblast activity
D) a reduction of calcium reabsorption in the kidney tubules
34)
35) What ion is sometimes used as a second messenger of amino acid-based hormones?
A) chlorine
B) sodium
C) iron
D) calcium
35)
36) The major targets of growth hormone are ________.
A) the thyroid and adrenal glands
C) the blood vessels
36)
B) the liver and gall bladder
D) liver, bones, and skeletal muscles
37) Normal development of the immune response is due in part to hormones produced by the
________.
A) thymus gland
B) thyroid gland
C) pancreas
D) adrenal medulla
37)
38) The hypothalamic-hypophyseal tract ________.
A) is the site of prolactin synthesis
B) connects the hypophysis to the pituitary gland
C) runs through the infundibulum
D) conducts aldosterone to the hypophysis
38)
4
39) 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) general circulatory system
C) feedback loop
D) hepatic portal system
39)
40) Gluconeogenesis, the formation of glucose from fats and proteins, is due to the action of ________.
A) insulin
B) aldosterone
C) cortisol
D) secretin
40)
41) 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) testosterone
B) oxytocin
C) thyroxine
D) growth hormone
41)
42) Virtually all amino acid-based hormones exert their signaling effects through intracellular
________.
A) second messengers
B) calcium
C) nucleotides
D) deactivating ions
42)
43) 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) glucagon
B) aldosterone
C) insulin
D) thyroxine
43)
44) 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 sperm production in the testes.
C) FSH stimulates estrogen secretion by ovarian cells; therefore, it is not synthesized by males.
D) The man must be producing progesterone, which inhibits the synthesis of FSH.
44)
45) 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) growth hormone
B) melatonin
C) glucagon
D) insulin
45)
46) Which of the following is correctly matched?
A) zona fasciculata — mineralocorticoids
B) zona glomerulosa — epinephrine and norepinephrine
C) adrenal medulla — glucocorticoids
D) zona reticularis — gonadocorticoids
46)
47) Which of the following can act on receptors inside the target cell that directly activate specific
genes?
A) calcitonin
B) testosterone
C) growth hormone
D) melatonin
47)
5
48) 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) exocrine
B) autocrine
C) paracrine
D) second messenger
48)
49) Which of the following is NOT a change typically produced by a hormonal stimulus?
A) induces secretory activity
B) stimulates production of an action potential
C) activates or deactivates enzymes
D) alters plasma membrane permeability
49)
50) Which of the following is NOT a category of endocrine gland stimulus?
A) humoral
B) enzymatic
C) hormonal
50)
D) neural
51) Melatonin ________.
A) is responsible for regulating the sleep cycle
B) is produced by the parathyroid glands
C) is at its highest levels at around noon
D) triggers sexual maturation and puberty
51)
52) Antidiuretic hormone (ADH) ________.
A) is produced by the anterior pituitary
C) secretion is inhibited by alcohol
52)
B) increases urine production
D) promotes dehydration
53) The single most important regulator of calcium levels in the blood is ________.
A) thyroid hormone
B) parathyroid hormone
C) calcitonin
D) gonadotropic hormones
53)
54) Which of the following is NOT a step in thyroxine (T4) production?
A) the diffusion of iodide from blood plasma into the follicular cell
B) the binding of iodine to tyrosines in the colloid
C) the production of thyroglobulin by follicular cells
D) the linking of two diiodotyrosine (DIT) molecules in the colloid
54)
55) Which of the following is NOT a cardinal sign of diabetes mellitus?
A) polydipsia
B) polycythemia
C) polyphagia
55)
D) polyuria
56) 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) cellular affinity
B) a stressor reaction
C) up-regulation
D) sensitivity increase
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
57) Explain how parathyroid hormone (PTH) acts to increase blood calcium ion levels.
57)
58) List three factors that target cell activation depends on, after the hormone binds to the
receptor.
58)
6
56)
Figure 16.1
Using Figure 16.1, match the following:
59) Produces the hormones that promote the development of the female secondary sexual
characteristics at puberty.
59)
60) While visiting another country, you notice many individuals with iodine-deficiency
goiters. Describe the feedback loop responsible for these goiters.
60)
61) Why would one NOT expect to continue increasing in height with age?
61)
7
Figure 16.3
Using Figure 16.3, match the following:
62) Mainly produces small amounts of gonadocorticoids.
62)
63) Excess hormone levels from this region result in Cushing's syndrome.
63)
8
Figure 16.2
Using Figure 16.2, match the following anterior pituitary hormones with their targets:
64) Thyroid stimulating hormone.
64)
9
Figure 16.3
Using Figure 16.3, match the following:
65) Produces epinephrine.
65)
66) What is the difference between autocrines and paracrines?
66)
10
Figure 16.2
Using Figure 16.2, match the following anterior pituitary hormones with their targets:
67) Follicle stimulating hormone.
67)
68) Growth hormone.
68)
69) Prolactin.
69)
70) A woman with excessive body hair, a deep voice, and an enlarged clitoris shows the
outward symptoms of which hormonal dysfunction?
70)
71) A person who drinks a lot of alcoholic beverages must urinate frequently. Why?
71)
72) What is the role of hormone producing cells found within the heart?
72)
73) Define synergism in hormone interaction at target cells and give an example.
73)
74) Why should the hypothalamus instead of the anterior pituitary be called the "master
endocrine gland"?
74)
11
Figure 16.1
Using Figure 16.1, match the following:
75) Produces hormones and is considered a neuroendocrine organ.
12
75)
Figure 16.3
Using Figure 16.3, match the following:
76) Produces aldosterone.
76)
77) 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?
77)
13
Figure 16.2
Using Figure 16.2, match the following anterior pituitary hormones with their targets:
78) Adrenocorticotropic hormone.
78)
14
Figure 16.3
Using Figure 16.3, match the following:
79) Mainly produces glucocorticoids.
79)
80) Hormones mimic sympathetic nervous system neurotransmitters.
80)
81) Compare the structure and function of endocrine and exocrine glands.
81)
82) List the four mechanisms involved in the regulation of aldosterone secretion.
82)
15
Figure 16.1
Using Figure 16.1, match the following:
83) Produces the hormones that direct the production of the secondary male sex characteristics.
83)
84) Produce hormones involved in electrolyte balance and the stress response.
84)
85) Storehouse for the hormones produced by the hypothalamus of the brain.
85)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
86) Enteroendocrine cells of the GI tract produce some hormones that are chemically identical to
neurotransmitters.
86)
87) Growth hormone solely exerts its influence by targeting other endocrine glands to produce
hormones.
87)
88) The hormone that raises blood sugar levels is insulin.
88)
16
89) Calcitonin is the main regulator of blood calcium levels.
89)
90) Insufficient dietary iodine can cause Graves' disease.
90)
91) Cyclic AMP (cAMP), diacylglycerol (DAG), inositol triphosphate (IP3 ), and calcium ions can serve
91)
92) Iodine is an essential element required for the synthesis of thyroxine.
92)
93) The endocrine gland that is probably malfunctioning if a person has a high metabolic rate is the
parathyroid.
93)
94) LH is also referred to as a gonadotropin.
94)
95) The beta cells in the pancreatic islets produce insulin.
95)
96) Many hormones synthesized in the gastrointestinal tract are chemically identical to brain
neurotransmitters.
96)
97) Hypersecretion of catecholamines (epinephrine and norepinephrine) can result in hypertension.
97)
98) Atrial natriuretic peptide is a hormone that controls blood pressure in part by increasing the
urinary excretion of sodium.
98)
99) Type 2 diabetes mellitus may reflect declining receptor sensitivity to insulin rather than decreased
insulin production.
99)
as second messengers.
100) Oxytocin is a strong stimulant of uterine contractions.
100)
101) Direct gene activation involves a second-messenger system.
101)
102) All amino acid-based hormones are lipid soluble and can cross the plasma membrane.
102)
103) All anterior pituitary hormones EXCEPT growth hormone affect their target cells via a cyclic AMP
second-messenger system.
103)
104) Glucocorticoids are steroid hormones that usually enhance the immune responses when an
individual is suffering from severe stress.
104)
105) 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.
105)
106) 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.
106)
107) Most type 2 diabetics do NOT produce insulin.
107)
108) Oxytocin and ADH are produced in the posterior pituitary.
108)
17
109) ACTH stimulates the adrenal cortex to release corticosteroid hormones.
109)
110) The pineal gland is used as a brain orientation reference landmark for brain X-rays.
110)
111) Thyroid hormone production requires the presence of both iodine and calcium.
111)
112) The prime metabolic effect of cortisol is gluconeogenesis.
112)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
113) Hypersecretion of the adrenal cortex.
A) Cushing's disease
113)
Match the following:
114) Produces hormones that regulate
glucose levels in the body.
A) Pancreas
114)
Match the following:
115) Epinephrine production.
A) Neural stimulus
115)
Match the following:
116) Produces the body's major metabolic
hormones.
A) Thyroid gland
116)
Match the following:
117) Aldosterone production.
A) Hormonal stimulus
117)
Match the following:
118) Hyposecretion of the thyroid in adults.
A) Myxedema
118)
Match the following:
119) Is part of the sympathetic nervous
system.
120) The size and shape of a pea; produces
hormones that stimulate other
endocrine glands.
A) Adrenal medulla
119)
B) Parathyroid glands
C) Pituitary gland (hypophysis)
121) Primary regulators of blood calcium
levels.
120)
121)
18
Match the following:
122) Hyposecretion of the pancreas.
A) Diabetes mellitus
122)
Match the following:
123) Hypersecretion of growth hormone
during childhood.
A) Gigantism
123)
Match the following:
124) Hyposecretion of growth hormone.
A) Pituitary dwarfism
124)
Match the following:
125) Hyposecretion of the thyroid in
infants.
A) Cretinism
125)
Match the following:
126) Testosterone production.
A) Hormonal stimulus
126)
Match the following:
127) Hyposecretion of the adrenal cortex.
A) Addison's disease
127)
Match the following:
128) Parathyroid hormone production.
A) Humoral stimulus
128)
Match the following:
129) An autoimmune problem involving
the thyroid gland.
130) Hypersecretion of growth hormone
that occurs during adulthood.
A) Graves' disease
129)
B) Acromegaly
130)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
131) 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?
132) 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?
19
133) 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?
134) Explain how antidiuretic hormone can help regulate an abnormal increase in solute concentration in the
extracellular fluid.
135) 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?
136) What is the most important nursing intervention when caring for a patient with Cushing's syndrome?
137) 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?
138) 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?
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) 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?
20
Answer Key
Testname: 16
1) A
2) A
3) C
4) B
5) A
6) D
7) A
8) B
9) D
10) D
11) A
12) D
13) B
14) A
15) D
16) B
17) C
18) A
19) D
20) B
21) D
22) B
23) D
24) C
25) D
26) B
27) A
28) C
29) A
30) C
31) C
32) D
33) D
34) B
35) D
36) D
37) A
38) C
39) A
40) C
41) A
42) A
43) A
44) B
45) B
46) D
47) B
48) C
49) B
50) B
21
Answer Key
Testname: 16
51) A
52) C
53) B
54) A
55) B
56) C
57) 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.
58) 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.
59) D
60) 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.
61) 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.
62) C
63) B
64) D
65) D
66) 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.
67) C
68) A
69) B
70) The hormonal dysfunction is hypersecretion of androgens.
71) The function of ADH is to increase water reabsorption in the kidneys, producing concentrated urine. Alcohol inhibits
ADH secretion, causing copious urine output.
72) 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.
73) 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%.
74) Although the anterior pituitary produces hormones that regulate other endocrine glands, the hypothalamus controls
anterior pituitary activity through releasing and inhibiting hormones.
75) A
76) A
77) Glucagon and insulin use different cell surface receptors.
78) E
79) B
80) D
81) 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.
82) 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.
22
Answer Key
Testname: 16
83) E
84) C
85) B
86) TRUE
87) FALSE
88) FALSE
89) FALSE
90) FALSE
91) TRUE
92) TRUE
93) FALSE
94) TRUE
95) TRUE
96) TRUE
97) TRUE
98) TRUE
99) TRUE
100) TRUE
101) FALSE
102) FALSE
103) TRUE
104) FALSE
105) TRUE
106) TRUE
107) FALSE
108) FALSE
109) TRUE
110) TRUE
111) FALSE
112) TRUE
113) A
114) A
115) A
116) A
117) A
118) A
119) A
120) C
121) B
122) A
123) A
124) A
125) A
126) A
127) A
128) A
129) A
130) B
131) Yes; there should be great concern, because hypersecretion of prolactin will lead to impotence.
23
Answer Key
Testname: 16
132) 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.
133) 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.
134) 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.
135) The problem is hyperparathyroidism resulting from a parathyroid gland tumor. The treatment is removal of the
tumor.
136) 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.
137) 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.
138) 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.
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) 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.
24
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) The cells responsible for producing platelets are called ________.
A) lymphoid stem cells
B) monoblasts
C) megakaryocytes
D) myeloblasts
1)
2) All of the following can be expected with polycythemia EXCEPT ________.
A) low blood viscosity
B) increased blood volume
C) high hematocrit
D) high blood pressure
2)
3) Fred's blood was determined to be AB positive. What does this mean?
A) There are no antibodies to A, to B, or to Rh antigens in the plasma.
B) His blood lacks Rh factor.
C) He can only receive blood from a donor who is AB positive.
D) Antibodies to A and B are present in the red cells.
3)
4) Which of the following is NOT a functional characteristic of WBCs?
A) positive chemotaxis
B) diapedesis
C) ameboid motion
D) granulosis
4)
5) Which of the following would you expect to have the least effect on hematocrit percentage?
A) injection with erythropoietin (EPO)
B) prolonged or excessive fever
C) dehydration
D) living at higher altitude
5)
6) Replacing lost blood volume with an isotonic saline solution ________.
A) restores the patient's blood glucose levels
B) restores the oxygen-carrying capacity of the circulation
C) lowers the patient's blood volume
D) lowers the patient's hematocrit
6)
7) Which of the choices below is the parent cell for all formed elements of blood?
A) hemocytoblast
B) megakaryocyte
C) normoblast
D) polymorphonuclear cell
7)
8) A person with an extremely high count of neutrophils is likely suffering ________.
A) polycythemia
B) a bacterial infection
C) anemia
D) a viral infection
8)
9) When neither anti-A serum nor anti-B serum clot on a blood plate with donor blood, the blood is
type ________.
A) AB
B) A
C) B
D) O
9)
10) Which body activity would be most affected if a patient lacked an adequate number of erythrocytes
(anemia)?
A) oxygen transport
B) hormone transport
C) clotting
D) immune response
10)
1
11) What is the average normal pH range of blood?
A) 8.35-8.45
B) 4.65-4.75
C) 7.75-7.85
D) 7.35-7.45
11)
12) With a patient that is administered an injection of erythropoietin (EPO) you would expect to see
________.
A) increased hematocrit
B) decreased white blood cell count
C) decreased hematocrit
D) increased white blood cell count
12)
13) A mismatch of blood types during a transfusion is dangerous because ________.
A) preformed antibodies in the recipient's blood will bind and clump (agglutinate) the donated
cells
B) clotting factors in the donor's blood will cause unwanted clots known as thrombus
C) white blood cells from the donor's blood cause inflammation
D) antibodies in the donor's plasma will attack and kill the recipient's healthy blood cells
13)
14) What organ in the body regulates erythrocyte production?
A) liver
B) pancreas
C) kidney
14)
D) brain
15) 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) red blood cells have a greater density than white blood cells
B) white blood cells are smaller than red blood cells
C) red blood cells are larger than white blood cells
D) white blood cells are fewer in number than red blood cells
15)
16) 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) plasma levels are highest
C) HbA1C levels are lowest
D) hemoglobin levels are lowest
16)
17) Which of the following would NOT be a possible cause of sickling of red blood cells in someone
with sickle-cell anemia?
A) malaria
B) prolonged exposure to cold
C) travel at high altitude
D) vigorous exercise
17)
18) 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 RhC) if the child is type O positive
D) if the father is Rh+
18)
19) 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) hemorrhagic anemia
B) aplastic anemia
C) iron deficiency anemia
D) pernicious anemia
19)
20) Which two factors below make rapid and substantial blood loss life threatening?
A) loss of clotting ability and loss of osmotic pressure
B) loss of immunity and loss of carbon dioxide carrying capacity
C) loss of blood pressure and loss of oxygen carrying capacity
D) loss of immunity and loss of blood pressure
20)
2
21) With a patient who is administered an injection of colony stimulating factor (CSF), you would
expect to see ________.
A) increased white blood cell count
B) decreased red blood cell count
C) increased red blood cell count
D) decreased white blood cell count
21)
22) If a person is severely dehydrated you would expect to see all of the following EXCEPT ________.
A) lower immunity
B) higher blood viscosity
C) lower plasma levels
D) higher hematocrit
22)
23) Leukocytes displaying red cytoplasmic granules when treated with Wright's stain are most likely
________.
A) basophils
B) eosinophils
C) erythrocytes
D) monocytes
23)
24) Blood reticulocyte counts provide information regarding ________.
A) rate of platelet formation
B) clotting ability of the blood
C) rate of erythrocyte formation
D) WBC ability to defend the body against disease
24)
25) 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.
25)
26) If a patient with type B blood received a transfusion of AB blood, which of the following would
occur?
A) The patient's A antigens (antiglutinogens) will agglutinate with the anti-A antibodies
(agglutinins) in the donor blood.
B) The patient's anti-A antibodies (agglutinins) will agglutinate with the A antigens
(antiglutinogens) in the donor blood.
C) The patient's anti-B antibodies (agglutinins) will agglutinate with the B antigens (agglutinins)
in the donor blood.
D) The patient's B antigens (antiglutinogens) will agglutinate with the anti-B antibodies
(agglutinins) in the donor blood.
26)
27) A patient with type A positive blood can, in theory, safely donate blood to someone with ________
blood.
A) A positive, A negative, AB positive, or AB negative
B) A positive or AB positive
C) A positive, A negative, O positive, or O negative
D) A positive or O positive
27)
28) Which blood component primarily contributes to plasma osmotic pressure?
A) electrolytes
B) albumin
C) blood borne nutrients
D) gamma globulin
28)
3
29) Blood doping refers to the practice of ________ before an athletic event.
A) injecting high amounts of oxygen into the blood stream
B) removing, storing, and re-injecting a person's red blood cells
C) injecting performance-enhancing steroids into the blood
D) training at high altitude to increase red blood cell production
29)
30) Which of the following might trigger erythropoiesis?
A) moving to a lower altitude
B) hypoxia of EPO-producing cells
C) an increased number of RBCs
D) decreased tissue demand for oxygen
30)
31) Which is NOT true of thrombocytopenia?
A) It increases the risk of embolus formation.
B) It is caused by having a low number of circulating platelets.
C) It can be caused by conditions that destroy bone marrow.
D) It may produce petechiae.
31)
32) The special type of hemoglobin present in fetal red blood cells is ________.
A) hemoglobin F
B) hemoglobin B
C) hemoglobin S
D) hemoglobin A
32)
33) 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 in plasma bound to soluble plasma transport proteins
B) lipids are carried inside blood cells
C) enzymes in the plasma convert lipids to soluble forms
D) lipids are carried only in the lymph which is primarily composed of unsaturated fats
33)
34) 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 white blood cells
C) platelets are larger than red blood cells
D) white blood cells are fewer in number than red blood cells
34)
35) A lack of intrinsic factor, leading to a deficiency of vitamin B12 and causing an appearance of large
pale cells called macrocytes, is characteristic of ________.
A) polycythemia
B) sickle-cell anemia
C) aplastic anemia
D) pernicious anemia
35)
36) Which is NOT true of leukocytes?
A) They are the only formed elements that are true cells.
B) They move by amoeboid motion.
C) They account for less than 1% of total blood volume.
D) They all contain easily recognizable membrane-bound cytoplasmic granules.
36)
37) A patient's hematocrit shows an unusually large buffy coat. What is a likely cause for this?
A) severe infection
B) thrombocytopenia
C) anemia
D) lipidemia
37)
4
38) Loss of fibrinogen within the plasma would most likely cause which of the following?
A) pallor (pale skin)
B) loss of blood clotting
C) fever with pain
D) edema (swelling)
38)
39) 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) sickle cell trait is passed on to the biting mosquitoes as malaria
B) people with sickle cell trait have a better chance of surviving malaria
C) malaria is a cause of sickle cell trait
D) the tropical climate attracts people with sickle cell trait
39)
40) Which blood type is generally called the universal donor?
A) B negative
B) O negative
C) AB positive
D) A positive
40)
41) Which of the following is NOT a typical plasma protein?
A) globulins
B) erythropoietin
C) albumin
D) fibrinogen
41)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
42) What determines whether blood is bright red or a dull, dark red?
42)
43) Explain why blood is classified as a connective tissue.
43)
44) What is the buffy coat found in centrifuged whole blood?
44)
45) Why is iron not stored or transported in its free form? In what form(s) is it stored or
transported in blood?
45)
46) The group of blood disorders in which blood oxygen levels are inadequate to support
normal metabolism is called ________.
46)
5
Figure 17.1
Using Figure 17.1, match the following:
47) Mounts a humoral immune response by producing antibodies.
47)
48) Monocyte.
48)
49) When diagnosing an iron deficiency one of the first tests is a red blood cell count. Why is
this so?
49)
Figure 17.1
Using Figure 17.1, match the following:
50) Lymphocyte.
50)
51) If a person has AB type blood, which of the ABO blood types can they receive as a
transfusion?
51)
52) List the two general factors that limit normal clot growth to the sight of injury.
52)
6
Figure 17.1
Using Figure 17.1, match the following:
53) A granulocyte, phagocyte and the most common white blood cell found in whole blood.
53)
54) How many polypeptide chains make up hemoglobin?
54)
55) List the granulocytes and describe the appearance of their granules in a typical blood
smear.
55)
56) Why are the two pathways of blood clotting referred to as the extrinsic and intrinsic
pathways?
56)
57) Why is hemoglobin enclosed in erythrocytes rather than existing free in plasma?
57)
Figure 17.1
Using Figure 17.1, match the following:
58) When activated, becomes a macrophage that fights infection.
58)
59) List the most common causes of bleeding disorders.
59)
7
Figure 17.1
Using Figure 17.1, match the following:
60) Main bacteria killer during acute infections.
60)
61) Releases granules that kill parasitic worms.
61)
62) When monocytes migrate into the interstitial spaces to fight infection, they change to a
different type of cell called ________.
62)
Figure 17.1
Using Figure 17.1, match the following:
63) Eosinophil.
63)
64) Neutrophil.
64)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
65) Positive chemotaxis is a feedback system that signals leukocyte migration into damaged areas.
65)
66) Leukocytes move through the interstitial spaces by amoeboid motion.
66)
8
67) The normal RBC "graveyard" is the liver.
67)
68) Leukemia refers to cancerous conditions involving white blood cells.
68)
69) Each hemoglobin molecule can transport two molecules of oxygen.
69)
70) Granulocytes called neutrophils are phagocytic and are the most numerous of all white blood cell
types.
70)
71) In clotting, prothrombin activator catalyzes prothrombin into thrombin, which in turn converts
fibrinogen into fibrin.
71)
72) White blood cells are produced through the action of colony-stimulating factors.
72)
73) Basophils increase in number when parasitic invasion occurs.
73)
74) Myeloid stem cells give rise to all leukocytes.
74)
75) A person with type B blood could receive blood from a person with either type B or type O blood.
75)
76) The process of fibrinolysis disposes of bacteria when healing has occurred.
76)
77) Myelocytic leukemia involves a cancerous condition of lymphocytes.
77)
78) Fetal hemoglobin has a higher affinity for oxygen than does adult hemoglobin.
78)
79) Hemoglobin is made up of the protein heme and the red pigment globin.
79)
80) Clotting factor activation turns clotting factors into enzymes.
80)
81) Hemorrhagic anemias result from blood loss.
81)
82) The primary source of RBCs in the adult human being is the bone marrow in the shafts of the long
bones.
82)
83) Leukopenia is an abnormally low number of leukocytes.
83)
84) The immediate response to blood vessel injury is clotting.
84)
85) When erythrocytes are destroyed, some of the heme is converted into bilirubin and then secreted as
bile.
85)
86) Diapedesis is the process by which red blood cells move into tissue spaces from the interior of
blood capillaries.
86)
9
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
87) Antibodies released by plasma cells
during immune response.
88) Necessary for coagulation.
89) Transport proteins like transferrin
(that carries iron ions) or others that
bind to lipids or fat-soluble vitamins.
A) Alpha and beta globulins
87)
B) Gamma globulins
C) Fibrinogen
88)
89)
Match the following:
90) Contains a U- or an S-shaped nucleus;
granules stain very dark; releases
histamine and heparin.
A) Basophil
90)
Match the following:
91) Natural anticoagulant found in
basophils.
A) Heparin
91)
Match the following:
92) Free-floating thrombus in the
bloodstream.
A) Embolism
92)
Match the following:
93) Transports CO2 and oxygen.
A) Erythrocyte
93)
Match the following:
94) Main contributor to osmotic pressure.
A) Albumin
94)
Match the following:
95) Hormone that stimulates production
of RBCs.
A) Erythropoietin
10
95)
Figure 17.2
Using Figure 17.2, match the following:
96) Universal donor.
A) D (O negative)
96)
Match the following:
97) Nucleus is multilobed; functions as a
phagocyte; contains fine indistinct
granules.
A) Neutrophil
97)
Match the following:
98) Thrombin catalyzes the activation of
these molecules present in plasma.
A) Fibrinogen
11
98)
Figure 17.2
Using Figure 17.2, match the following:
99) Type A.
A) B
99)
Match the following:
100) Precursor to the structural framework
of a blood clot.
A) Fibrinogen
12
100)
Figure 17.2
Using Figure 17.2, match the following:
101) Type B.
A) C
101)
Match the following:
102) Ions in the plasma like sodium,
potassium, and chloride ions.
A) Electrolytes
102)
Match the following:
103) Abnormal excess of erythrocytes
resulting in an increase in blood
viscosity.
A) Polycythemia
13
103)
Figure 17.2
Using Figure 17.2, match the following:
104) Type AB.
A) A
104)
Match the following:
105) Produced by platelets.
A) Prostaglandin derivates such as
Thromboxane A2
105)
Match the following:
106) Material absorbed from the digestive
tract, including simple sugars, amino
acids, and fatty acids.
A) Organic nutrients
106)
Match the following:
107) Condition in which blood has
abnormally low oxygen-carrying
capacity.
A) Anemia
14
107)
108) Cancerous condition involving white
blood cells.
A) Leukemia
108)
Match the following:
109) Stimulates WBC production.
A) Interleukins and CSFs
109)
Match the following:
110) Platelet deficiency resulting in
spontaneous bleeding from small
blood vessels seen as petechiae on the
skin.
A) Thrombocytopenia
110)
Figure 17.2
Using Figure 17.2, match the following:
111) Universal recipient.
A) A (AB positive)
15
111)
Match the following:
112) Protein capable of changing shape and
color in the presence of O2 .
A) Hemoglobin
112)
Match the following:
113) The major contributor to plasma
osmotic pressure.
A) Albumin
113)
Match the following:
114) Largest of the WBCs become
macrophages associated with chronic
infections.
A) Monocyte
114)
Match the following:
115) A fibrous protein that gives shape to
an RBC plasma membrane.
A) Spectrin
16
115)
Figure 17.2
Using Figure 17.2, match the following:
116) Type O.
A) D
116)
Match the following:
117) Lacking in hemophilia type A.
A) Factor VIII
117)
Match the following:
118) 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.
A) Eosinophil
17
118)
Match the following:
119) Polymorphonuclear leukocyte.
A) Monocyte
120) Adverse reaction of donor blood cells
with recipient plasma.
B) Neutrophil
121) White blood cell without cytoplasmic
granules.
119)
120)
C) Agglutination
121)
Match the following:
122) Makes up most of plasma protein.
A) Albumin
122)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
123) List three blood tests that might be ordered if anemia is suspected.
124) 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?
125) Why would there be cause for concern if a young pregnant mother is Rh- , her husband is Rh+ , and this is their
second child?
126) 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.
127) 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?
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) 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?
130) 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?
18
131) 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.
19
Answer Key
Testname: 17
1) C
2) A
3) A
4) D
5) B
6) D
7) A
8) B
9) D
10) A
11) D
12) A
13) A
14) C
15) A
16) A
17) B
18) B
19) B
20) C
21) A
22) A
23) B
24) C
25) A
26) B
27) B
28) B
29) B
30) B
31) A
32) A
33) A
34) D
35) D
36) D
37) A
38) B
39) B
40) B
41) B
42) 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).
43) 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).
44) The buffy coat is a layer of centrifuged whole blood that contains leukocytes and platelets.
45) 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.
46) anemia
20
Answer Key
Testname: 17
47) D
48) B
49) 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.
50) D
51) All (A, B, AB, and O)
52) Rapid removal of coagulation factors and inhibition of activated clotting factors.
53) A
54) Four
55) Neutrophils: pale, indistinct; eosinophils: red; basophils: dark purple
56) The factors required to initiate clotting are present within the blood in the intrinsic pathway and outside the blood in
the extrinsic pathway.
57) 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.
58) B
59) Platelet deficiency (thrombocytopenia); deficiency of procoagulants due to liver disorders; or certain genetic conditions
(hemophilias).
60) A
61) C
62) macrophage(s)
63) C
64) A
65) TRUE
66) TRUE
67) FALSE
68) TRUE
69) FALSE
70) TRUE
71) TRUE
72) TRUE
73) FALSE
74) FALSE
75) TRUE
76) FALSE
77) FALSE
78) TRUE
79) FALSE
80) TRUE
81) TRUE
82) FALSE
83) TRUE
84) FALSE
85) TRUE
86) FALSE
87) B
88) C
89) A
90) A
91) A
21
Answer Key
Testname: 17
92) A
93) A
94) A
95) A
96) A
97) A
98) A
99) A
100) A
101) A
102) A
103) A
104) A
105) A
106) A
107) A
108) A
109) A
110) A
111) A
112) A
113) A
114) A
115) A
116) A
117) A
118) A
119) B
120) C
121) A
122) A
123) The three tests for anemia include hemoglobin, hematocrit and RBC count.
124) The diagnosis is thalassemia. The treatment is blood transfusion and chelation therapy to remove excessive iron
accumulate from transfusions.
125) 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.
126) 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.
127) 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.
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."
22
Answer Key
Testname: 17
129) 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.
130) 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!
131) 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.
23
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) The source of blood carried to capillaries in the myocardium would be the ________.
A) coronary arteries
B) coronary veins
C) fossa ovalis
D) coronary sinus
1)
2) 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) end diastolic volume (EDV) decreases
B) venous return decreases
C) preload increases
D) stroke volume decreases
2)
3) If the SA node is not functioning, an ECG will show ________.
A) more P waves than QRS waves
B) higher P waves
C) no QRS waves
D) no P waves with a HR between 40-60 bpm
3)
4) The "pacemaker potential" of pacemaker cells is produced by the opening of ________ at the end of
an action potential.
A) K+ channels
B) slow Ca2+ channels
C) fast Ca2+ channels
D) slow Na+ channels
4)
5) If the vagal nerves to the heart were cut, the result would be that ________.
A) the atrioventricular (AV) node would become the pacemaker of the heart
B) parasympathetic stimulation would increase, causing a decrease in heart rate
C) the heart rate would increase by about 25 beats per minute
D) the heart would stop, since the vagal nerves trigger the heart to contract
5)
6) 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
6)
7) If the mitral valve is unable to close properly, ________.
A) blood could flow back into the left ventricle
B) blood could flow back into the right ventricle
C) blood could flow back into the left atrium
D) blood could flow back into the right atrium
7)
8) If cardiac muscle is deprived of its normal blood supply, damage would primarily result from
________.
A) a decrease in the number of available mitochondria for energy production
B) an inadequate supply of lactic acid
C) decreased delivery of oxygen
D) a lack of nutrients to feed into metabolic pathways
8)
1
9) Which vessel(s) of the heart receive(s) blood from the right ventricle?
A) aorta
B) venae cavae
C) pulmonary veins
D) pulmonary trunk
9)
10) 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
10)
11) 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) angina pectoris
B) pericarditis
C) myocardial infarct
D) ischemia
11)
12) 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 T wave would decrease
C) the P-R interval would decrease
D) the S-T segment would decrease
12)
13) Which chambers of the heart contain oxygenated blood?
A) right atrium and ventricle
B) right and left ventricles
C) left atrium and ventricle
D) right and left atria
13)
14) Select the correct statement about the structure of the heart wall.
A) The fibrous cardiac skeleton forms the bulk of the heart.
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 heart chambers are lined by the endomysium.
14)
15) The receiving chambers of the heart include the ________.
A) right and left ventricles
B) right atrium and ventricle
C) left atrium and ventricle
D) right and left atria
15)
16) Hemorrhage with a large loss of blood causes ________.
A) no change in blood pressure but a change in respiration
B) a lowering of blood pressure due to change in cardiac output
C) a rise in blood pressure due to change in cardiac output
D) no change in blood pressure but a slower heart rate
16)
17) 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
17)
18) Pectinate muscles are found in the ________.
A) right atrium and right ventricle only
C) atria and ventricles
18)
B) ventricles only
D) atria only
2
19) 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) 75 beats / minute
D) 50 beats / minute
19)
20) Which is NOT a vessel that brings blood directly into the right atrium?
A) pulmonary vein
B) inferior vena cava
C) coronary sinus
D) superior vena cava
20)
21) The Frank-Starling Law states that, if other factors are constant, a ________.
A) higher end diastolic volume will produce a higher stroke volume
B) higher stroke volume will produce a higher end diastolic volume
C) higher stroke volume will produce a lower end diastolic volume
D) higher end diastolic volume will produce a lower stroke volume
21)
22) To auscultate the aortic semilunar valve, you would place your stethoscope in the ________.
A) fifth right intercostal space
B) second intercostal space to the right of the sternum
C) fifth intercostal space inferior to the left nipple
D) second intercostal space to the left of the sternum
22)
23) The atrioventricular (AV) valves are closed ________.
A) when the ventricles are in systole
B) while the atria are contracting
C) when the ventricles are in diastole
D) by the movement of blood from atria to ventricles
23)
24) The plateau phase of an action potential in cardiac muscle cells is due to the ________.
A) influx of Na+ through fast Na+ channels
B) influx of Ca2+ through slow Ca2+ channels
C) efflux of K+ through K+ channels
D) efflux of Ca2+ through fast Ca2+ channels
24)
25) 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
25)
26) During the period of ventricular filling, ________.
A) blood flows mostly passively from the atria through the atrioventricular (AV) valves into the
ventricles
B) the aortic and pulmonary semilunar valves are open
C) pressure in the heart is at its peak
D) the atria remain in diastole
26)
27) The left ventricular wall of the heart is thicker than the right wall in order to ________.
A) pump blood through a smaller valve
B) pump blood with greater pressure
C) expand the thoracic cage during diastole
D) accommodate a greater volume of blood
27)
3
28) If the length of the absolute refractory period in cardiac muscle cells was the same as it is for
skeletal muscle cells, ________.
A) tetanic contractions might occur, which would stop the heart's pumping action
B) it would be much longer before cardiac cells could respond to a second stimulation
C) contractions would last as long as the refractory period
D) pacemaker cells would cease to spontaneously depolarize
28)
29) Which is most responsible for the synchronized contraction of cardiac muscle tissue?
A) desmosomes
B) branching cells
C) small motor units
D) gap junctions
29)
30) 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) 170 ml / beat
B) 70 ml / beat
C) 50 ml / beat
D) 120 ml / beat
30)
31) Which of the following is NOT an age-related change affecting the heart?
A) thinning of the valve flaps
B) decline in cardiac reserve
C) atherosclerosis
D) fibrosis of cardiac muscle
31)
32) During the isovolumetric relaxation phase of the cardiac cycle, _______.
A) atrioventricular, aortic, and pulmonary valves are open
B) atrioventricular, aortic, and pulmonary valves are closed
C) atrioventricular valves are closed; aortic and pulmonary valves are open
D) atrioventricular valves are open; aortic and pulmonary valves are closed
32)
33) The parietal pericardium ________.
A) is separated from the fibrous pericardium by serous fluid
B) is found within the pericardial cavity
C) is also called the epicardium
D) lines the internal surface of the fibrous pericardium
33)
34) Isovolumetric contraction ________.
A) occurs while the atrioventricular (AV) valves are open
B) occurs immediately after the aortic and pulmonary semilunar valves close
C) occurs only in people with heart valve defects
D) refers to the short period during ventricular systole when the ventricles are completely closed
chambers
34)
35) The foramen ovale ________.
A) is a shallow depression in the interventricular septum
B) connected the two atria in the fetal heart
C) is a condition in which the heart valves do not completely close
D) is a connection between the pulmonary trunk and the aorta in the fetus
35)
36) 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) Stroke volume increases if end diastolic volume decreases.
C) A slow heart rate increases end diastolic volume, stroke volume, and force of contraction.
D) Decreased venous return will result in increased end diastolic volume.
36)
4
37) 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) deficient pulmonary semilunar valve
B) incompetent tricuspid valve
C) insufficient mitral (bicuspid) valve
D) stenotic aortic semilunar valve
37)
38) 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) lacks striations
D) has more nuclei per cell
38)
39) Select the correct statement about the heart valves.
A) The tricuspid valve divides the left atrium from the left ventricle.
B) The mitral (bicuspid) valve separates the right atrium from the right ventricle.
C) The atrioventricular (AV) valves prevent backflow of blood added into the atria during
ventricular contraction.
D) Aortic and pulmonary semilunar valves control the flow of blood into the heart.
39)
40) Which of the following is NOT part of the intrinsic conduction system of the heart?
A) sinoatrial (SA) node
B) atrioventricular (AV) valve
C) atrioventricular (AV) node
D) bundle branches
40)
41) The fact that the left ventricle of the heart is thicker than the right ventricle reveals that it ________.
A) expands the thoracic cage
B) pumps blood against a greater resistance
C) pumps a greater volume of blood
D) sends blood through a smaller valve
41)
42) 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) The entire heart contracts as a unit or it does not contract at all.
C) Cardiac muscle cells are innervated by sympathetic, parasympathetic, and somatic nerve
fibers so that the nervous system can increase heart rate.
D) The refractory period in skeletal muscle is much longer than that in cardiac muscle.
42)
43) Norepinephrine acts on the heart by ________.
A) causing threshold to be reached more quickly
B) causing a decrease in stroke volume
C) decreasing heart contractility
D) blocking the action of calcium
43)
44) 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
44)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
45) Define the terms end diastolic volume (EDV) and end systolic volume (ESV) and relate them to
the calculation of stroke volume.
5
45)
Figure 18.2
Using Figure 18.2, match the following:
46) Atrial depolarization.
46)
6
Figure 18.4
Using Figure 18.4, match the following:
47) Mitral (bicuspid) valve.
47)
48) 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.
48)
7
Figure 18.2
Using Figure 18.2, match the following:
49) Point after which pressure begins to rise in the aorta.
8
49)
Figure 18.4
Using Figure 18.4, match the following:
50) Left ventricle.
50)
9
Figure 18.3
Using Figure 18.3, match the following:
51) Junctional rhythm.
51)
52) What is the difference between the auricles and the atria?
52)
53) Explain the role of pacemaker cells in cardiac tissue.
53)
10
Figure 18.3
Using Figure 18.3, match the following:
54) Normal sinus rhythm.
54)
11
Figure 18.4
Using Figure 18.4, match the following:
55) Right atrium.
55)
12
Figure 18.1
Using Figure 18.1, match the following:
56) Bundle branches.
56)
13
Figure 18.4
Using Figure 18.4, match the following:
57) Pulmonary veins.
57)
58) Define systole and diastole. Which heart chambers are usually referenced when these terms
are used?
58)
14
Figure 18.1
Using Figure 18.1, match the following:
59) Subendocardial conducting network (Purkinje fibers).
15
59)
Figure 18.3
Using Figure 18.3, match the following:
60) Second-degree heart block.
60)
16
Figure 18.2
Using Figure 18.2, match the following:
61) Point that represents the "dup" sound made by the heart.
17
61)
Figure 18.3
Using Figure 18.3, match the following:
62) Ventricular fibrillation.
62)
18
Figure 18.1
Using Figure 18.1, match the following:
63) Atrioventricular (AV) bundle.
63)
64) What two important functions does the intrinsic cardiac conduction system perform?
64)
19
Figure 18.2
Using Figure 18.2, match the following:
65) Ventricular repolarization.
65)
20
Figure 18.1
Using Figure 18.1, match the following:
66) Atrioventricular (AV) node.
66)
67) List the three vessels that bring oxygen-poor blood to the right atrium. Which regions of
the body do they serve?
67)
68) List and define the three most important factors that affect stroke volume.
68)
21
Figure 18.4
Using Figure 18.4, match the following:
69) Tricuspid valve.
69)
70) Why is oxygen so much more critical to the heart muscle than to skeletal muscles?
70)
71) 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?
71)
22
Figure 18.1
Using Figure 18.1, match the following:
72) Sinoatrial (SA) node.
72)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
73) Arterial blood supply to heart muscle is continuous whether the heart is in systole or diastole.
73)
74) Heart tissue is supplied with nutrients primarily by diffusion from the heart chambers through the
myocardium.
74)
75) If blood volume decreased dramatically due to massive bleeding, the autonomic nervous system
will attempt to maintain cardiac output by increasing the heart rate.
75)
76) As pressure in the aorta rises due to atherosclerosis, more ventricular pressure is required to open
the aortic valve.
76)
77) Autonomic regulation of heart rate is via two reflex centers found in the pons.
77)
78) Tissues damaged by myocardial infarction are replaced by fibrous connective tissue.
78)
23
79) Anastomoses among coronary arterial branches provide collateral routes for blood delivery to the
heart muscle.
79)
80) 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.
80)
81) Cardiac muscle has more mitochondria and depends less on a continual supply of oxygen than
does skeletal muscle.
81)
82) The left side of the heart pumps the same volume of blood as the right.
82)
83) If the aorta and pulmonary trunk were switched, oxygen rich blood would be pumped from the left
ventricle to the lungs.
83)
84) Auricles slightly increase blood volume in the ventricles.
84)
85) When released in large quantities, thyroxine, a thyroid gland hormone, causes a sustained increase
in heart rate.
85)
86) An electrocardiogram (ECG) provides direct information about valve function.
86)
87) 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.
87)
88) The myocardium receives its blood supply from the coronary arteries.
88)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
89) An abnormally slow heart rate.
A) Bradycardia
89)
Match the following:
90) Prevents backflow into the right
atrium.
A) Tricuspid valve
90)
Match the following:
91) An abnormally fast heart rate.
A) Tachycardia
91)
Match the following:
92) A condition of rapid and irregular or
out-of-phase contraction of
ventricular heart muscle cells.
A) Quiescent period
92)
B) Fibrillation
93) Total heart relaxation.
93)
24
Match the following:
94) Heart muscle.
A) Parietal layer
95) Serous layer covering the heart
muscle.
B) Myocardium
96) The outermost layer of the serous
pericardium.
94)
95)
C) Epicardium
96)
Match the following:
97) Death of heart muscle cells.
A) Infarction
97)
Match the following:
98) Prevents backflow into the right
ventricle.
99) Prevents backflow into the left atrium.
A) Mitral (bicuspid) valve
98)
B) Pulmonary semilunar valve
99)
Match the following:
100) Heart muscle is deprived of oxygen.
A) Ischemia
101) An abnormal pacemaker.
B) Ectopic focus
100)
101)
Match the following:
102) Prevents backflow into the left
ventricle.
103) Atrioventricular (AV) valve with three
flaps.
A) Tricuspid valve
102)
B) Aortic semilunar valve
103)
Match the following:
104) The inner lining of the heart.
A) Endocardium
104)
Match the following:
105) Difference between resting and
maximal cardiac output.
A) Cardiac reserve
105)
Match the following:
106) Atrioventricular (AV) valve with two
flaps.
A) Mitral (bicuspid) valve
25
106)
meg.e.sulli@gmail.comMatch the following:
107) Heart rate at rest under both
autonomic divisions signaling.
A) Vagal tone
107)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
108) 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?
109) 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?
110) 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.
111) Asystole is the total absence of ventricular electrical activity. Explain why defibrillation would not be effective
in this situation.
112) A patient is prescribed a calcium channel blocker to prevent angina (chest pain), by decreasing the demand for
oxygen. Explain why.
113) 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.
114) 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?
115) 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.
116) 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?
26
Answer Key
Testname: 18
1) A
2) C
3) D
4) D
5) C
6) D
7) C
8) C
9) D
10) A
11) A
12) A
13) C
14) B
15) D
16) B
17) A
18) D
19) B
20) A
21) A
22) B
23) A
24) B
25) A
26) A
27) B
28) A
29) D
30) B
31) A
32) B
33) D
34) D
35) B
36) C
37) D
38) A
39) C
40) B
41) B
42) B
43) A
44) D
45) 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.
46) A
47) D
48) 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).
27
Answer Key
Testname: 18
49) D
50) E
51) B
52) 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.
53) 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.
54) A
55) A
56) D
57) C
58) 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.
59) E
60) C
61) E
62) D
63) C
64) 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.
65) E
66) B
67) 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.
68) 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
69) B
70) 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.
71) 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.
72) A
73) FALSE
74) FALSE
75) TRUE
76) TRUE
77) FALSE
78) TRUE
79) TRUE
80) FALSE
81) FALSE
82) TRUE
83) TRUE
84) FALSE
28
Answer Key
Testname: 18
85) TRUE
86) FALSE
87) FALSE
88) TRUE
89) A
90) A
91) A
92) B
93) A
94) B
95) C
96) A
97) A
98) B
99) A
100) A
101) B
102) B
103) A
104) A
105) A
106) A
107) A
108) 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.
109) 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).
110) 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.
111) 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.
112) 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.
113) The heart murmur is due to incomplete closure of the pulmonary valve and regurgitation of pulmonary trunk blood
during diastole.
114) 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.
29
Answer Key
Testname: 18
115) 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.
116) The suggested treatment is surgery to implant an artificial pacemaker.
30
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following is the most significant source of blood flow resistance?
A) blood viscosity
B) blood vessel diameter
C) blood vessels type
D) total blood vessel length
1)
2) Secondary hypertension can be caused by ________.
A) obesity
B) kidney disease
2)
C) smoking
D) stress
3) 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
3)
4) 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) Slower blood flow through capillaries allows more time for diffusion to take place in the
capillary bed.
B) Lower pressure in the capillary bed helps to increase pressure in the venous circulation.
C) Lower pressure reduces the chance of injury to delicate capillary vessels.
D) Lower pressure on the venous end of the capillary bed allows for greater reabsorption of fluid
back to the plasma.
4)
5) Which of the following is a type of circulatory shock?
A) vascular, due to extreme vasodilation as a result of loss of vasomotor tone
B) hypovolemic, caused by increased blood volume
C) cardiogenic, which results from any defect in blood vessels
D) circulatory, where blood volume is normal and constant
5)
6) The form of circulatory shock known as hypovolemic shock is ________.
A) the form of shock caused by anaphylaxis
B) shock that results from large-scale loss of blood volume, or after severe vomiting or diarrhea
C) any condition in which blood vessels are inadequately filled and blood cannot circulate
normally
D) always fatal
6)
7) 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
7)
8) Which of the following does NOT contribute to venous blood pressure?
A) constriction of smooth muscle around veins by the sympathetic nervous system
B) venous anastomoses
C) increased abdominal pressure during breathing
D) skeletal muscle activity
8)
1
9) Which of the following is least involved in pulmonary circulation?
A) left atrium
B) right ventricle
C) superior vena cava
D) pulmonary arteries and veins
9)
10) The pulse pressure is ________.
A) diastolic pressure plus 1/3 (systolic pressure plus diastolic pressure)
B) systolic pressure plus diastolic pressure
C) systolic pressure minus diastolic pressure
D) systolic pressure divided by diastolic pressure
10)
11) The abdominal aorta splits into which vessels?
A) right and left subclavian arteries
C) right and left femoral arteries
11)
B) right and left common carotid arteries
D) right and left common iliac arteries
12) Blood flow is ________ proportional to the difference in blood pressure. Blood flow is ________
proportional to the total peripheral resistance.
A) directly; directly
B) inversely; directly
C) inversely; inversely
D) directly; inversely
12)
13) Due to the branching of arteries the type of arteries that would be most numerous would be
________.
A) pulmonary arteries
B) elastic arteries
C) arterioles
D) muscular arteries
13)
14) A thrombus (blood clot) in the first branch of the arch of the aorta would affect the flow of blood to
the ________.
A) right side of the head and neck and right upper arm
B) left upper arm
C) myocardium of the heart
D) left side of the head and neck
14)
15) 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 rise as blood moves away from the arteriole end of the capillary bed
C) hydrostatic pressure will remain constant throughout the capillary bed
D) hydrostatic pressure will drop as blood moves away from the arteriole end of the capillary
bed
15)
16) Vessels that carry blood away from the heart and are named by the organs they supply (renal) are
_________.
A) capillaries
B) muscular arteries
C) arterioles
D) elastic arteries
16)
17) Which of the following is likely during vigorous exercise?
A) The skin will be cold and clammy.
B) Capillaries of the active muscles will be engorged with blood.
C) Blood will be diverted to the digestive organs.
D) Blood flow to the kidneys increases.
17)
2
18) Select the correct statement about factors that influence blood pressure.
A) Excess albumen transport protein production would decrease blood pressure.
B) Systemic vasodilation would increase blood pressure, due to diversion of blood to essential
areas.
C) Excess red cell production would cause a blood pressure increase.
D) An increase in cardiac output corresponds to a decrease in blood pressure, due to the
increased delivery.
18)
19) The pulse rate depends on all of the following except one. Select the one answer the does NOT affect
a pulse rate reading.
A) emotions
B) activity
C) postural changes
D) the vessel selected to palpate
19)
20) 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 work of the left ventricle
B) increased incidence of coronary artery disease
C) decreased size of the heart muscle
D) increased damage to blood vessel endothelium
20)
21) In general, it is expected that ________.
A) hydrostatic pressure will remain constant throughout the capillary bed
B) osmotic pressure will be lower in the arteriole end of the capillary bed compared to the
venous end
C) osmotic pressure will be higher in the arteriole end of the capillary bed compared to the
venous end
D) osmotic pressure will remain relatively consistent throughout the capillary bed
21)
22) Which of the following would NOT be expected from taking a diuretic drug?
A) decreased blood pressure
B) increased urine output
C) greater stress on the heart to provide adequate perfusion
D) lower plasma volume
22)
23) Atherosclerosis causes elastic arteries to become less stretchy. How does this affect pulse pressure?
A) Pulse pressure is temporarily increased.
B) Pulse pressure is chronically decreased.
C) Pulse pressure is unaffected by atherosclerosis.
D) Pulse pressure is chronically increased.
E) Pulse pressure is temporarily decreased.
23)
24) The baroreceptors in the carotid sinus and aortic arch are sensitive to which of the following?
A) a decrease in carbon dioxide
B) an increase in oxygen levels
C) changes in arterial pressure
D) a decrease in oxygen levels
24)
25) Which of the following statements regarding the hepatic portal system is FALSE?
A) It consists of a vein connecting two capillary beds together.
B) Its major vessels are the superior mesenteric, inferior mesenteric, and splenic veins.
C) It branches off of the inferior vena cava.
D) It carries nutrients, toxins, and microorganisms to the liver for processing.
25)
3
26) Where in the body would you find low oxygen levels causing vasoconstriction and high levels
causing vasodilation?
A) kidney
B) lungs
C) heart
D) liver
26)
27) 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 will result in higher sodium levels in the urine.
B) It promotes an increase in sodium reabsorption from the kidney to the blood.
C) It will reduce urine output.
D) It promotes an increase in blood pressure.
27)
28) The velocity of blood flow is ________.
A) in direct proportion to the total cross-sectional area of the blood vessels
B) slower in the arteries than in capillaries because arteries possess a relatively large diameter
C) slowest in the capillaries because the total cross-sectional area is the greatest
D) slower in the veins than in the capillaries because veins have a large diameter
28)
29) 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) Blood vessels are constricting causing greater peripheral resistance.
B) The sympathetic nervous system has increased its nervous impulses.
C) The heart has increased its rate to increase cardiac output.
D) The heart has increased its contractile force increasing cardiac output.
29)
30) Which statement best describes arteries?
A) All carry blood away from the heart.
B) All contain valves to prevent the backflow of blood.
C) All carry oxygenated blood to the heart.
D) Only large arteries are lined with endothelium.
30)
31) Brain blood flow autoregulation ________.
A) is controlled by cardiac centers in the pons
B) is less sensitive to pH than to a decreased oxygen level
C) is abolished when abnormally high CO2 levels persist
D) causes constriction of cerebral blood vessels in response to a drop in systemic blood pressure
31)
32) Cerebral blood flow is regulated by ________.
A) intrinsic autoregulatory mechanisms
C) the hypothalamic "thermostat"
32)
B) ADH
D) skin temperature
33) Which of the following processes provides a long-term response to changes in blood pressure?
A) neural controls
B) renal regulation
C) chemoreceptor-initiated reflexes
D) baroreceptor-initiated reflexes
33)
34) Which blood vessels lack elastic tissue?
A) muscular arteries and arterioles
C) venules and veins
34)
B) arterioles and capillaries
D) capillaries and venules
4
35) Arteriolar blood pressure increases in response to all but which of the following?
A) increasing heart rate
B) increasing stroke volume
C) falling blood volume
D) rising blood volume
E) all of these
35)
36) 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) plasma and formed element concentration
D) blood volume and viscosity
36)
37) Histologically, the ________ is squamous epithelium supported by a sparse connective tissue layer.
A) tunica intima
B) tunica adventitia
C) tunica media
D) tunica externa
37)
38) Normal average blood pressure for a newborn baby is ________.
A) 90/55
B) 130/80
C) 150/90
38)
D) 120/80
39) 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) decreased heart rate
B) increasing vasomotor tone
C) a weak, thread pulse
D) increases peripheral resistance
39)
40) These capillaries may be lined with phagocytes that can extend their process into the plasma to
catch "prey."
A) anastomoses
B) sinusoids
C) thoroughfare channels
D) fenestrations
40)
41) The term ductus venosus refers to ________.
A) a condition of the aged in which the arteries lose elasticity
B) damage to the valves in the veins, leading to varicose veins
C) a fetal shunt that bypasses the lungs
D) a special fetal vessel that allows umbilical blood to bypass the liver
41)
42) The release of which hormone is most likely to cause a reduction in blood volume and pressure?
A) atrial natriuretic peptide
B) antidiuretic hormone
C) aldosterone
D) norepinephrine
42)
43) Select the correct statement about blood flow.
A) It is greatest where resistance is highest.
B) It is measured in mm Hg.
C) It is relatively constant through all body organs.
D) Blood flow through the entire vascular system is proportional to cardiac output.
43)
5
44) Which of the following signs of hypovolemic shock is a relatively late sign?
A) rapidly falling blood pressure
B) cold, clammy skin
C) rapid, thready pulse
D) increased heart rate
44)
45) 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) significant because resistance is directly proportional to the blood vessel diameter
D) insignificant because vessel diameter does not vary
45)
46) Mechanisms that do NOT help regulate blood pressure include ________.
A) renal regulation via the renin-angiotensin system of vasoconstriction
B) nervous control that operates via reflex arcs involving baroreceptors, chemoreceptors, and
higher brain centers
C) the dural sinus reflex
D) chemical controls such as atrial natriuretic peptide
46)
47) Factors that aid venous return include all EXCEPT ________.
A) urinary output
B) pressure changes in the thorax
C) activity of skeletal muscles
D) venous valves
47)
48) 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) higher peripheral resistance and higher blood pressure
B) increased risk of developing atherosclerosis
C) lower heart rate and reduced blood flow
D) increased angiogenesis and higher peripheral resistance
48)
49) Which structural layer of blood vessels is most responsible for maintaining blood pressure?
A) tunica media
B) tunica intima
C) tunica externa
D) subendothelial
49)
50) 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) Smooth muscle is relatively thin in the aorta to increase lumen size and systemic blood flow.
B) Elastic fibers are extensive in the tunica media of the aorta and dampen the pulse pressure
generated by the heart.
C) The aorta's tunica media is thick with dense regular connective tissue to withstand the blood's
pressure.
D) The tunica external of the aorta is nearly absent compared to other vessels.
50)
51) The beginning of a true capillary is surrounded by a precapillary sphincter. The opening and
closing of precapillary sphincters is controlled by ________.
A) parasympathetic nervous system
B) blood pressure in the metarteriole
C) local chemical conditions
D) sympathetic nervous system
51)
6
52) 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) Exercise will result in vasoconstriction in the arteriovenous shuts.
C) Colder temperatures will result in vasodilation in the arteriovenous shuts.
D) Warmer temperatures will result in vasoconstriction in the arteriovenous shuts.
52)
53) Which will NOT occur if blood pressure drops below homeostatic levels?
A) Baroreceptors in the carotid sinuses and aortic arch will be stimulated.
B) The cardioacceleratory center of the medulla will be activated.
C) Vasomotor center of the medulla will trigger vasoconstriction.
D) Cardiac output will increase.
53)
54) 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 involving baroreceptors
B) chemoreceptors
C) altering blood volume
D) reflex arcs associated with vasomotor fibers
54)
55) Which of the following statements is NOT true of the precapillary sphincters?
A) They allow blood to bypass the true capillaries that are fed by the metarteriole.
B) They increase or decrease rates of perfusion to the tissues served by the true capillaries.
C) They decrease the osmotic pressure in the thoroughfare channel.
D) They regulate the flow of blood to tissues served by the true capillaries.
55)
56) 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) metarterioles
C) continuous
D) fenestrated
56)
57) What do the ductus arteriosus and the foramen ovale become at birth?
A) fossa ovalis; ligamentum arteriosum
B) ligamentum teres; fossa ovalis
C) ligamentum arteriosum; ligamentum teres
D) ligamentum arteriosum; fossa ovalis
57)
58) Which of the following is NOT true regarding fenestrated capillaries?
A) Fenestrated capillaries are essential for filtration of blood plasma in the kidney.
B) Fenestrated capillaries form the blood-brain barrier.
C) Fenestrated capillaries in endocrine organs allow hormones rapid entry into the blood.
D) Fenestrated capillaries in the small intestine receive nutrients from digested food.
58)
59) 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 decrease in local tissue oxygen content
B) an increase in local tissue carbon dioxide
C) a local increase in pH
D) a local increase in histamine
59)
60) Which of the following contain oxygenated blood?
A) pulmonary trunk
C) pulmonary arteries
60)
B) pulmonary veins
D) lobar arteries
7
61) 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) They distribute blood to various parts of the body.
C) Their prime function is the exchange of nutrients and wastes between the blood and tissue
cells.
D) They contain a large quantity of elastic tissue.
61)
62) Which of the following blood pressure readings would be indicative of hypertension?
A) 110/60
B) 140/90
C) 120/80
D) 170/96
62)
63) Reduction in the concentration of albumin in blood plasma would alter capillary exchange by
________.
A) increasing hydrostatic pressure and blood volume, blood pressure increases
B) decreasing colloid osmotic pressure and edema will occur
C) decreasing colloid osmotic pressure and blood volume, blood pressure increases
D) increasing hydrostatic pressure and edema will occur
63)
64) Peripheral resistance ________.
A) increases as blood vessel diameter increases
B) increases as blood viscosity increases
C) is not a major factor in blood pressure in healthy individuals
D) decreases with increasing length of the blood vessel
64)
65) During a marathon which of the following hormones is least likely to be released by the runner?
A) antidiuretic hormone (ADH)
B) angiotensin II
C) atrial natriuretic peptide (ANP)
D) epinephrine
65)
8
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:
66) Capillary with intercellular clefts found in the skin and muscles.
66)
67) Capillary found where active capillary absorption of filtrate occurs.
67)
9
Figure 19.2
Using Figure 19.2, match the following:
68) Superior mesenteric vein.
68)
10
Figure 19.1
Using Figure 19.1, match the following:
69) Capillary found in endocrine organs that allows hormones to gain rapid entry into the
blood.
69)
70) What are the sounds of Korotkoff?
70)
71) 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?
71)
72) Arterial ________ provide alternate pathways for blood to get to an organ.
72)
11
Figure 19.2
Using Figure 19.2, match the following:
73) Splenic vein.
73)
74) The mesenteric arteries branch off the abdominal aorta, but the mesenteric veins do not
connect directly to the vena cava. Why?
74)
75) A family of peptides called ________ are released by the endothelium and are among the
most potent vasoconstrictors known.
75)
12
Figure 19.1
Using Figure 19.1, match the following:
76) Capillary that has a discontinuous, incomplete basement membrane.
76)
77) The abdominal aorta divides into three arteries at its terminus; what are they?
77)
13
Figure 19.2
Using Figure 19.2, match the following:
78) Inferior mesenteric vein.
78)
79) Describe the forces that determine fluid movements across capillary walls.
79)
80) Which type of blood vessels contain valves and what is their function?
80)
81) The ________ in the carotid sinuses and aortic arch detect increases in blood pressure.
81)
14
Figure 19.2
Using Figure 19.2, match the following:
82) Right gastroepiploic vein.
82)
83) List the major factors that are linked to essential hypertension and note which ones are
controllable by the patient.
83)
15
Figure 19.2
Using Figure 19.2, match the following:
84) Hepatic portal vein.
84)
16
Figure 19.1
Using Figure 19.1, match the following:
85) Sinusoid capillary.
85)
86) Define vasoconstriction and vasodilation. What is the mechanism of regulation?
86)
87) The internal carotid arteries supply the ________ with blood.
87)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
88) The pulmonary circulation does not directly serve the metabolic needs of body tissues.
88)
89) 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.
89)
17
90) The adjustment of blood flow to each tissue in proportion to its requirements at any point in time is
termed autoregulation.
90)
91) Osmotic pressure is created by the presence in a fluid of small diffusible molecules that easily move
through the capillary membrane.
91)
92) 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.
92)
93) The cerebral arterial circle (circle of Willis) is an arterial anastomosis.
93)
94) An increase in blood viscosity will cause an increase in peripheral resistance.
94)
95) Arterial pressure in the pulmonary circulation is much higher than in the systemic circulation
because of its proximity to the heart.
95)
96) Arteries supplying the same territory are often merged with one another, forming arterial
anastomoses.
96)
97) An obstruction in the superior vena cava would decrease the flow of blood from the head and neck
to the heart.
97)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
98) Site where blood pressure is lowest.
A) Large veins
98)
Match the following:
99) Gives rise to the right common carotid
and right subclavian artery.
A) Brachiocephalic trunk
99)
Match the following:
100) Site where the blood pressure is
greatest.
A) Large arteries
101) Site where the velocity of blood flow is
fastest.
100)
101)
Match the following:
102) Largest artery of the body.
A) Renal artery
103) Supplies the kidney.
B) Aorta
18
102)
103)
Match the following:
104) Due to inadequate blood flow to meet
tissue needs.
A) Circulatory shock
104)
Match the following:
105) Artery that does not anastomose.
A) Renal artery
105)
Match the following:
106) Due to large-scale blood loss.
A) Hypovolemic shock
106)
Match the following:
107) Site where resistance to blood flow is
greatest.
A) Arterioles
107)
Match the following:
108) Runs through the armpit area, giving
off branches to the axillae, chest wall,
and shoulder girdle.
A) Axillary artery
108)
Match the following:
109) Supplies a lower limb.
A) External iliac artery
109)
Match the following:
110) Vessel commonly used as a coronary
bypass vessel.
A) Great saphenous vein
110)
Match the following:
111) Site that is the major determinant of
peripheral resistance.
A) Arterioles
111)
Match the following:
112) Receives blood from all areas superior
to the diaphragm, except the heart
wall.
A) External jugular vein
112)
B) Superior vena cava
113) Drains the scalp.
113)
19
Match the following:
114) Large unpaired branch of the
abdominal aorta that supplies the
liver, stomach, and spleen.
A) Celiac trunk
114)
Match the following:
115) Supplies the small intestine.
A) Superior mesenteric artery
115)
Match the following:
116) Site where the velocity of blood flow is
slowest.
A) Capillaries
117) Site where exchanges of food and
gases are made.
116)
117)
Match the following:
118) Common site to take the pulse.
A) Radial artery
118)
Match the following:
119) Major artery of the thigh.
A) Femoral artery
119)
Match the following:
120) Site where the blood volume is
greatest.
A) Large veins
120)
Match the following:
121) Supplies the duodenum and stomach.
A) Common hepatic artery
121)
Match the following:
122) Major supply to the cerebral
hemispheres.
A) Internal carotid artery
122)
Match the following:
123) Normal blood volume but poor
circulation due to extreme
vasodilation.
A) Vascular shock
123)
Match the following:
124) Supplies the distal areas of the large
intestine.
A) Inferior mesenteric artery
20
124)
Match the following:
125) Artery usually ausculated to take the
blood pressure.
A) Brachial artery
125)
Match the following:
126) Supplies pelvic structures.
A) Internal iliac artery
126)
Match the following:
127) Carries oxygen-poor blood to the
lungs.
128) Drains an upper extremity, a deep
vein.
A) Pulmonary trunk
127)
B) Subclavian vein
128)
Match the following:
129) Carries oxygen-rich blood from the
lungs.
A) Pulmonary vein
129)
Match the following:
130) Results from heart inability to sustain
adequate circulation due to
myocardial damage.
A) Cardiogenic shock
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) 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?
133) 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.
134) 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.
135) 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.
136) 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?
21
137) 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?
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?
139) 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.
140) 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?
22
Answer Key
Testname: 19
1) B
2) B
3) A
4) B
5) A
6) B
7) A
8) B
9) C
10) C
11) D
12) D
13) C
14) A
15) D
16) B
17) B
18) C
19) D
20) C
21) D
22) C
23) D
24) C
25) C
26) B
27) A
28) C
29) A
30) A
31) C
32) A
33) B
34) D
35) C
36) B
37) A
38) A
39) A
40) B
41) D
42) A
43) D
44) A
45) A
46) C
47) A
48) C
49) A
50) B
23
Answer Key
Testname: 19
51) C
52) A
53) A
54) C
55) C
56) A
57) D
58) B
59) C
60) B
61) A
62) D
63) B
64) B
65) C
66) A
67) B
68) E
69) B
70) 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.
71) 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.
72) anastomoses
73) B
74) The mesenteric veins merge into the hepatic portal vein before entering the liver. The liver dumps into the vena cava.
75) endothelins
76) C
77) Left and right common iliac arteries and the median sacral artery.
78) D
79) (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.
80) 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.
81) baroreceptors
82) C
83) 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.
84) A
85) C
86) 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.
24
Answer Key
Testname: 19
87) brain
88) TRUE
89) TRUE
90) TRUE
91) FALSE
92) TRUE
93) TRUE
94) TRUE
95) FALSE
96) TRUE
97) TRUE
98) A
99) A
100) A
101) A
102) B
103) A
104) A
105) A
106) A
107) A
108) A
109) A
110) A
111) A
112) B
113) A
114) A
115) A
116) A
117) A
118) A
119) A
120) A
121) A
122) A
123) A
124) A
125) A
126) A
127) A
128) B
129) A
130) A
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.
25
Answer Key
Testname: 19
132) 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.
133) 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.
134) 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.
135) 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.
136) 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.
137) 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.
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) (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.
140) 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.
26
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which lymphoid organs and tissues are characterized by a cortex and medulla?
A) lymph nodes and thymus only
B) lymph nodes, spleen, and mucosa-associated lymphoid tissues (MALT) only
C) lymph nodes, thymus and spleen only
D) spleen and thymus only
1)
2) Which of the following is NOT a function of the spleen?
A) house B and T lymphocytes
B) remove and recycle old erythrocytes and platelets
C) produce new erythrocytes in adults
D) store iron from hemoglobin
2)
3) The tonsils located at the base of the tongue are the ________.
A) palatine tonsils
B) pharyngeal tonsils
C) lingual tonsils
D) Peyer's tonsils
3)
4) Lymph vessels do NOT transport ________.
A) leaked plasma proteins
B) lymphocytes
C) dietary fats
D) excess tissue fluid
E) erythrocytes
4)
5) Which of the following is NOT a part of the lymphatic system?
A) lymph nodes
B) erythrocytes
C) lymphatic vessels
D) lymph
5)
6) Which of the following is NOT a method that maintains lymph flow?
A) valves in lymph vessel walls
B) breathing
C) skeletal muscle contraction
D) capillary smooth muscle contraction
6)
7) The lymphatic capillaries are ________.
A) completely impermeable
C) more permeable than blood capillaries
7)
B) less permeable than blood capillaries
D) as permeable as blood capillaries
8) Which lymphoid organ atrophies as we age?
A) appendix
B) spleen
C) tonsils
D) thymus
9) Lymphoid tissue that appears as a swelling of the mucosa in the oral cavity is called a(n) ________.
A) appendix
B) tonsil
C) thymus
D) Peyer's patch
10) Peyer's patches are found in the distal portion of the ________.
A) small intestine
B) stomach
C) esophagus
1
D) large intestine
8)
9)
10)
11) Lymphatic capillaries are present in ________.
A) bone marrow
C) digestive organs
11)
B) CNS
D) bones and teeth
12) Select the correct statement about lymphocytes.
A) T cells are the only form of lymphocyte found in lymphoid tissue.
B) T cells are the precursors of B cells.
C) B cells produce plasma cells, which secrete antibodies into the blood.
D) The two main types are T cells and macrophages.
12)
13) Fats absorbed from the small intestine are transported to the bloodstream via ________.
A) lacteals
B) tonsils
C) lymph nodes
D) Peyer's patches
13)
14) What is a bubo?
A) a lobe of the spleen
C) an infected lymph node
14)
B) a wall in a lymph node
D) an infected Peyer's patch
15) Lymphatic ________ are formed from the union of the largest collecting lymphatic vessels.
A) nodes
B) ducts
C) capillaries
D) trunks
15)
16) Although B and T lymphocytes originate in the bone marrow, T cells mature in the ________.
A) spleen
B) thymus
C) appendix
D) tonsils
16)
17) The thymus is the only lymphoid organ that does NOT ________.
A) have a cortex and medulla
B) directly fight antigens
C) produce hormones
D) have lymphocytes
17)
18) Small secondary lymphoid organs, which cluster along lymphatic vessels, are termed ________.
A) lymph nodes
B) lacteals
C) lymphatics
D) lymph follicles
18)
19) Large clusters of lymph nodes are NOT found in the ________ region.
A) axillary
B) popliteal
C) inguinal
19)
D) cervical
20) Which of the following statements is FALSE regarding the spleen?
A) Clusters of white pulp look like islands in a sea of red pulp.
B) Red pulp is where immune functions take place.
C) The spleen is the largest lymphoid organ.
D) The splenic artery and vein enter and exit the spleen at the hilum.
20)
21) Which of the following is NOT a function of the lymphatic system?
A) transporting dietary fats
B) draining excess interstitial fluid
C) carrying out immune responses
D) transporting respiratory gases
21)
22) Which of the following correctly describes the pathway of lymph?
A) lymphatic vessels to lymphatic trunks to lymphatic ducts to lymphatic capillaries
B) lymphatic ducts to lymphatic capillaries to lymphatic vessels to lymphatic trunks
C) lymphatic capillaries to lymphatic vessels to lymphatic trunks to lymphatic ducts
D) lymphatic ducts to lymphatic trunks to lymphatic vessels to lymphatic capillaries
22)
2
23) Mucosa-associated lymphoid tissues include all of the following EXCEPT ________.
A) islets of Langerhans
B) Peyer's patches
C) palatine tonsils
D) lingual tonsils
23)
24) The blood testis barrier is to newly formed sperm cells as the blood thymus barrier is to ________.
A) plasma cells
B) white pulp
C) T lymphocyte precursors
D) mast cells
24)
25) Select the correct statement about lymph transport.
A) Lymph transport is only necessary when illness causes tissue swelling.
B) Lymph transport depends on the movement of adjacent tissues, such as skeletal muscles.
C) Under normal conditions, lymph vessels are very high-pressure conduits.
D) Lymph transport is faster than that occurring in veins.
25)
26) Which of the following statements is FALSE?
A) Only lymph nodes filter lymph.
B) T lymphocytes originate from the red bone marrow.
C) The thymus consists mainly of lymphoid tissue.
D) Antibodies mark antigens for destruction.
26)
27) 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) increased pressure in the lymphatics proximal in the limb to the blockage
C) shrinkage of tissues distal in the limb to the blockage due to inadequate delivery of lymph
D) severe localized edema distal to the blockage of that limb
27)
28) Which lymphoid organ or tissue lacks a reticular fiber stroma?
A) lymph nodes
B) thymus
C) mucosa-associated lymphoid tissue (MALT)
D) spleen
28)
29) The thymus is most active during ________.
A) childhood
C) old age
29)
B) middle age
D) fetal development
30) Which of the following is considered a primary lymphoid organ?
A) tonsils
B) thymus
C) spleen
D) appendix
30)
31) Lymph traveling from the left arm would enter the venous circulation via the _______.
A) cisterna chili
B) right lymphatic duct
C) axillary nodes
D) thoracic duct
31)
32) Which of the following statements regarding the thymus is FALSE?
A) It does not directly fight antigens.
B) Its stroma consists of epithelial tissue.
C) It functions strictly in T lymphocyte maturation.
D) It has follicles similar to those in the spleen.
32)
3
33) Flow of lymph through a lymph node is slowed due to ________.
A) the viscous nature of lymph
B) fewer efferent vessels draining it compared to many afferent vessels feeding it
C) mini-valves
D) the presence of lymphocytes and macrophages
33)
34) From the right leg, lymph moves in which order?
A) right lumbar trunk, thoracic duct, right subclavian vein
B) right lumbar trunk, right lymphatic duct, right subclavian vein
C) right lumbar trunk, right lymphatic duct, left subclavian vein
D) right lumbar trunk, thoracic duct, left subclavian vein
34)
35) Functions of the spleen include all of those below EXCEPT ________.
A) forming crypts that trap bacteria
B) storage of blood platelets
C) storage of iron
D) removal of old or defective blood cells from the blood
35)
36) Which of the following structures is NOT considered mucosa-associated lymphoid tissue (MALT)?
A) thymus
B) appendix
C) Peyer's patches
D) tonsils
36)
37) Which of the following would NOT be classified as a lymphoid organ?
A) tonsils
B) pancreas
C) spleen
D) Peyer's patches of the intestine
37)
38) Tonsils have blind-ended structures called ________ that trap bacteria and particulate matter.
A) lymphoid follicles
B) tonsillar corpuscles
C) germinal centers
D) tonsillar crypts
38)
39) Lymph leaves a lymph node via ________.
A) the cortical sinus
C) afferent lymphatic vessels
39)
B) efferent lymphatic vessels
D) the subcapsular sinus
40) Antibodies that act against a particular foreign substance are released by ________.
A) medullary cords
B) lymph nodes
C) T lymphocytes
D) plasma cells
40)
41) Select the correct statement about lymphoid tissue.
A) Lymphoid macrophages secrete antibodies into the blood.
B) T lymphocytes act by ingesting foreign substances.
C) Once a lymphocyte enters the lymphoid tissue, it resides there permanently.
D) Lymphoid tissue is predominantly reticular connective tissue.
41)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
42) Describe the structural and functional relationship between a capillary bed of the blood
vascular system and lymphatic capillaries.
4
42)
Figure 20.2
Using Figure 20.2, match the following:
43) Cortex.
43)
44) Define the term MALT. What is its function?
44)
5
Figure 20.2
Using Figure 20.2, match the following:
45) Trabecula.
45)
6
Figure 20.1
Using Figure 20.1, match the following:
46) Collecting lymphatic vessels.
46)
47) Axillary node(s).
47)
48) Cisterna chyli.
48)
49) Entrance of thoracic duct into subclavian vein.
49)
50) Name the tonsils and state their body locations.
50)
51) What is the consequence of obstruction of the lymphatics?
51)
7
Figure 20.1
Using Figure 20.1, match the following:
52) Thoracic duct.
52)
53) List the functions of the spleen.
53)
8
Figure 20.2
Using Figure 20.2, match the following:
54) Efferent vessels.
54)
55) Describe the mechanisms by which lymphatic fluid is moved through the lymphatics.
55)
56) How does the structure of a lymph node allow lymphocytes and macrophages to perform
their protective function?
56)
57) How does the lymphatic system both help and hinder the spread of cancer through the
body?
57)
58) Where are the lymph node aggregations most dense?
58)
9
Figure 20.2
Using Figure 20.2, match the following:
59) Medulla.
59)
60) Medullary cord.
60)
61) How are lymphatic capillaries affected by tissue inflammation?
61)
62) What is the special role of the thymus gland?
62)
63) Characterize lymph transport in terms of rate, volume, and ability to change.
63)
64) How do the lymphatic capillaries differ from blood capillaries?
64)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
65) Peyer's patches are clusters of lymphoid tissue found primarily in the large intestine.
65)
66) The thymus is the only lymphoid organ that does not DIRECTLY fight antigens.
66)
67) Chyle is delivered to the blood via the lymphatic system.
67)
68) Digested fats are absorbed from the intestine by the lymph capillaries.
68)
69) Lymph capillary permeability is due to minivalves and protein filaments.
69)
10
70) About 3 liters of fluid are lost to the tissue spaces every 24 hours and are returned to the
bloodstream as lymph.
70)
71) Lymphatic capillaries are permeable to proteins.
71)
72) Lymphocytes reside temporarily in lymphoid tissue, then move to other parts of the body.
72)
73) Because lymph vessels are very low-pressure conduits, movements of adjacent tissues are
important in propelling lymph through the lymphatics.
73)
74) The lymphatic capillaries function to absorb the excess protein-containing interstitial fluid and
return it to the bloodstream.
74)
75) The most important of the secondary lymphoid organs in the body are the lymph nodes.
75)
76) Like blood, lymph flows both to and from the heart.
76)
77) In the spleen, red pulp is involved in the immune functions and white pulp is involved in
disposing of worn-out RBCs.
77)
78) Lymphoid tissue is mainly reticular connective tissue.
78)
79) When tissues are inflamed, lymphatic capillaries permit uptake of large particles such as cell
debris, pathogens, and cancer cells.
79)
80) The most important role of the spleen is to provide a site for lymphocyte proliferation and immune
surveillance and response.
80)
81) There are more efferent lymphatic vessels leaving a lymph node than there are afferent vessels
entering a lymph node.
81)
82) The cisterna chyli collects lymph from the lumbar trunks draining the upper limbs and from the
intestinal trunk draining the digestive organs.
82)
83) If even a small part of the spleen is left in a ten-year-old child, it will most likely regenerate itself.
83)
11
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
84) Stores blood platelets.
A) Lymph nodes
85) Receives lymph from most of the
body.
B) Spleen
86) Isolated clusters of lymph follicles
found in the wall of the small
intestine.
87) Largest lymphatic organ.
84)
85)
C) Peyer's patches
D) Lymph
86)
E) Thoracic duct
87)
88) Protein-containing fluid within
lymphatic vessels.
88)
89) Small organs intimately associated
with lymphatic vessels.
89)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
90) Lymphedema may occur as a complication after a radical mastectomy, in which lymph nodes have been
removed. Explain why it might occur.
91) 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?
92) 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?
93) A nurse palpated enlarged lymph nodes. Describe signs and symptoms that help to distinguish cancerous
lymph nodes from infected lymph nodes.
94) 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?
95) As the human immunodeficiency virus (HIV) progresses, some individuals develop persistent generalized
lymphadenopathy (any disease of the lymph nodes). Explain why this may occur.
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) 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)?
12
Answer Key
Testname: 20
1) A
2) C
3) C
4) E
5) B
6) D
7) C
8) D
9) B
10) A
11) C
12) C
13) A
14) C
15) D
16) B
17) B
18) A
19) B
20) B
21) D
22) C
23) A
24) C
25) B
26) C
27) D
28) B
29) A
30) B
31) D
32) D
33) B
34) D
35) A
36) A
37) B
38) D
39) B
40) D
41) D
42) 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.
43) C
44) 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.
45) A
13
Answer Key
Testname: 20
46) E
47) B
48) D
49) A
50) 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.
51) Obstruction of the lymphatics results in edema distal in the body to the obstruction.
52) C
53) 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.
54) E
55) 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.
56) 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.
57) 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.
58) Lymph node aggregations are most dense near the body surface in the inguinal, axillary, and cervical regions of the
body.
59) D
60) D
61) 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.
62) By secreting hormones, the thymus gland causes T lymphocytes to become immunocompetent (able to defend against
specific pathogens in the immune response).
63) 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.
64) 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.
65) FALSE
66) TRUE
67) TRUE
68) TRUE
69) TRUE
70) TRUE
71) TRUE
72) TRUE
73) TRUE
74) TRUE
14
Answer Key
Testname: 20
75) TRUE
76) FALSE
77) FALSE
78) TRUE
79) TRUE
80) FALSE
81) FALSE
82) FALSE
83) TRUE
84) B
85) E
86) C
87) B
88) D
89) A
90) 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).
91) 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.
92) 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.
93) Tender nodes are usually due to inflammation, whereas hard, fixed, nontender nodes are suggestive of malignancy.
94) 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.
95) 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.
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) 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.
15
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) T helper cells ________.
A) often function to decrease the immune response
B) bind tightly to target cells and release a lymphotoxin called perforin
C) function in the adaptive immune system activation
D) release B7 proteins
1)
2) Which of the following is associated with passive immunity?
A) passage of IgG antibodies from a pregnant mother to her fetus
B) booster shot of vaccine
C) infusion of weakened viruses
D) exposure to an antigen
2)
3) 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
3)
4) Which of the following examples below describes an autoimmune disease?
A) Release of bacterial endotoxins that block acetylcholine release result in muscle paralysis.
B) Uncontrolled cell division resulting in cell surface abnormalities recognized by NK cells.
C) Antibody binding to acetylcholine receptors of the motor end plate resulting in muscle
weakness.
D) Infection and death of T helper cells by a virus, resulting in a loss of adaptive immunity.
4)
5) Antibody functions include all of the following EXCEPT ________.
A) binding and inactivating chemical toxins released by bacteria or other microorganisms
B) targeting foreign cells so that complement proteins can cause cellular lysis
C) linking soluble antigens together so that they fall out of solution
D) cross-linking cell-bound antigens on red blood cells when blood types are properly matched
5)
6) Activated T cells and macrophages release ________ to mobilize immune cells and attract other
leukocytes into the area.
A) interleukin 2 proteins
B) perforins
C) interleukin 1 proteins
D) cytokines
6)
7) T-cell activation requires ________.
A) antigen binding, antibody production, and co-stimulation
B) antigen binding and co-stimulation
C) antibody production and co-stimulation
D) antigen binding and antibody production
7)
8) A cellular component of the innate defenses includes ________.
A) plasma cells
B) B cells
C) T cells
D) natural killer cells
8)
1
9) Vaccines work by ________.
A) providing the necessary antibodies to fight infections
B) suppressing inflation to help speed healing
C) boosting innate immunity with cytokines
D) priming the adaptive immunity with a relatively harmless primary exposure
9)
10) Regulatory T cells ________.
A) may function in preventing autoimmune reactions
B) decrease their activity as antigenic stimulus decreases
C) aid B cells in antibody production
D) release cytokines that increase the activity of cytotoxic T cells and activated B cells
10)
11) Immediate and subacute hypersensitivities are caused by ________ that trigger the release of
_________.
A) memory T cells; perforins
B) memory B cells; antibodies
C) antibodies; histamine
D) viruses; interferon
11)
12) Innate immune system defenses include ________.
A) phagocytosis
B) B cells
C) plasma cells
D) T cells
12)
13) Which of the following is NOT a type of T cell?
A) antigenic
B) helper
C) regulatory
D) cytotoxic
13)
14) 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) They are a first line of defense that can begin killing pathogens immediately.
C) They produce memory cells when activated.
D) Their receptors will bind to only one antigen.
14)
15) Which of the following statements is incorrect or false?
A) MHC proteins are the cell's identity markers.
B) 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.
C) Haptens lack immunogenicity unless attached to protein carriers.
D) Class I MHC molecules are built into the plasma membranes of all body cells.
15)
16) Complement proteins and antibodies coat a microorganism and provide binding sites, enabling
macrophages and neutrophils to phagocytize the organism. This phenomenon is termed ________.
A) diapedesis
B) opsonization
C) chemotaxis
D) agglutination
16)
17) 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) have a great deal of rough endoplasmic reticulum reflecting the fact that they secrete a
tremendous amount of protein (antibody)
D) are large so that they can envelope their prey by phagocytosis
17)
2
18) 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 present in the blood, spleen, lymph nodes, and red bone marrow.
C) NK cells are a type of neutrophil.
D) NK cells attack cells that display abnormal or lack MHC antigens.
18)
19) 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
19)
20) Which of the following would be a component of the body's first line of defense?
A) mucous membranes
B) inflammation
C) natural killer cells
D) phagocytes
20)
21) Monoclonal antibodies are used for the diagnosis of all of the following EXCEPT ________.
A) rabies
B) elevated blood glucose
C) hepatitis
D) pregnancy
21)
22) Which of the following is characteristic of complete antigens?
A) contain many repeating chemical units
B) small molecules
C) reactivity with an antibody
D) inhibit production of antibodies
22)
23) 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 binds to normal, uninfected cells stimulating the activation of genes that produce
anti-viral proteins.
C) IFN can penetrate the viral capsid and destroy the virus.
D) IFN will attract macrophages to the secreting cell to be removed by phagocytosis.
23)
24) Interferons ________.
A) act by increasing the rate of cell division
B) are virus-specific, so that an interferon produced against one virus could not protect cells
against another virus
C) interfere with viral replication within cells
D) are routinely used in nasal sprays for the common cold
24)
25) What is the role of interferon in defense against disease?
A) protects cells that have not yet been infected by bacteria
B) activates the inflammatory process
C) protects cells that have not yet been infected by viruses
D) activates the complement mechanism
25)
3
26) Cytotoxic T cells ________.
A) self-destruct once the antigen has been neutralized
B) can directly attack and kill other cells of the body
C) function mainly to stimulate the proliferation of other T cell populations
D) require the double recognition signal of class I MHC plus class II MHC on the target cell in
order to function
26)
27) A flu vaccine is needed seasonally to be effective but a polio vaccine is only needed once. The best
explanation of this is ________.
A) exposure to flu vaccine produces no memory cells from proliferating B-lymphocytes
B) the polio virus is substantially weaker than the flu virus
C) the flu has several strains that change seasonally
D) the flu vaccine is substantially weaker than the polio vaccine
27)
28) Select the correct statement about active and passive immunity.
A) Immunological memory is established by passive immunization.
B) Active and passive humoral immunity are both mechanisms of adaptive immunity that use
antibodies.
C) The antibodies utilized in active immunity are acquired from another organism.
D) A vaccination is an example of the introduction of passive immunity into the body.
28)
29) Clonal selection of B cells ________.
A) cannot occur in the presence of antigens
B) only occurs in the secondary immune response
C) occurs during fetal development
D) results in the formation of plasma cells
29)
30) Inflammation ________.
A) slows the healing process with swelling that can impair bodily function
B) is caused by viral activity to enhance the spread of the disease
C) is caused by bacterial activity to enhance the spread of disease
D) brings more leukocytes to the sight of infection
30)
31) The primary immune response ________.
A) has a lag period while B cells proliferate and differentiate into plasma cells
B) occurs when memory cells are stimulated
C) is another name for immunological memory
D) occurs more rapidly and is stronger than the secondary response
31)
32) Phagocyte mobilization involves ________.
A) monocytes as the most active phagocyte
B) margination, which is the process of white cell movement through the walls of capillaries into
injured tissues
C) diapedesis, during which cells line up against the capillary wall
D) mainly neutrophil and macrophage migration into inflamed areas
32)
33) Membrane attack complex (MAC) kills by ________.
A) penetrating the capsule of the bacteria giving antibiotic drugs access to bacterial cells
B) disrupting the selectively permeability of a bacteria's plasma membrane
C) providing a passage for antibodies to enter into the bacterial cytosol
D) allowing the organelles to spill free from the bacteria
33)
4
34) Allergens differ from antigens because ________.
A) allergens do not involve the leucocytes, they simply stimulate the inflammatory response
B) allergens are only active seasonally and are generally harmless to the body
C) allergens are primarily plant derived while antigens are bacterial or viral in nature
D) allergens produce an abnormally large immune response to what is an otherwise harmless
particle
34)
35) Which of the statements below does NOT describe antigens?
A) The parts of antigen molecules that initiate immune responses are called epitopes or antigenic
determinants.
B) Antigens exhibit immunogenicity and reactivity.
C) Antigens only come from microbes.
D) Antigens can include proteins, nucleic acids, lipoproteins, glycoproteins, and certain large
polysaccharides.
35)
36) Fever ________.
A) decreases the metabolic rate of the body to conserve energy
B) causes the liver to release large amounts of iron, which seems to inhibit bacterial replication
C) is a higher-than-normal body temperature that is always dangerous
D) production is regulated by chemicals that reset the body's thermostat to a higher setting
36)
37) Immunocompetence ________.
A) requires exposure to an antigen
B) prevents intercellular communication so that only specific cell types respond to the invader
C) is the ability of individual cells to recognize a specific antigen by binding to it
D) occurs in one specific organ of the adaptive immune system
37)
38) 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.
38)
39) Which of the following is true of antigens?
A) Antigens are typically composed of nucleotides.
B) Antigens are produced by the body in response to a foreign invader.
C) Antigens are limited to one antigenic determinant per antigen molecule.
D) Antigens are substances that activate the adaptive immune response.
39)
40) 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) NK cells would be non-functional
D) T cells would not be able to properly bind to APC's and therefore not be activated by them
40)
5
41) Which of the following statements is a false or incorrect statement?
A) After becoming immunocompetent, the naive T cells and B cells are exported to the bone
marrow where the encounters with antigens occur.
B) It is our genes, not antigens, that determine what specific foreign substances our immune
system will be able to recognize and resist.
C) T cells and B cells become activated when they bind with recognized antigens.
D) The lymphoid organs where lymphocytes become immunocompetent are called primary
lymph organs. All other lymphoid organs are referred to as secondary lymphoid organs.
41)
42) A vaccine is effective because ________.
A) the vaccine contains the lymphocytes necessary to fight infection
B) the secondary response of the adaptive immunity is faster and more efficient than the
primary response
C) B-lymphocytes are unable to mount an immune response the first time they are exposed to a
new pathogen
D) the vaccine contains the antibodies necessary to fight infection
42)
43) 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 cytotoxic T cells.
B) They become antigen presenting cells (APC) cells.
C) They become plasma cells.
D) They become T helper cells.
43)
44) All but one of the following occurs during the inflammatory response. Select the example below
that does NOT describe the process of inflammation.
A) Inflammation increases capillary permeability.
B) Vasoconstriction prevents excessive blood loss due to injury.
C) Chemotaxis draws leucocytes to the site of injury.
D) Release of prostaglandins results in pain.
44)
45) Lymphocyte "education" refers to ensuring that T cells _______.
A) that contain MHC receptors undergo apoptosis
B) that do not recognize self-MHC proteins undergo apoptosis
C) that do not recognize self-antigens displayed on self-MHC proteins undergo apoptosis
D) that demonstrate immunological self-tolerance undergo apoptosis
45)
46) Which immunoglobulin class is the most abundant antibody in plasma?
A) IgE
B) IgA
C) IgM
D) IgD
46)
E) IgG
47) 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) They will develop into cytotoxic T cells if antigen is complexed with class II MHC proteins.
D) Once activated, they cannot secrete cytokines.
6
47)
48) An advantage to adaptive immunity is ________.
A) the use of antibodies that cause cell lysis and kill invading cells
B) the ability of its individual cells to respond to many different pathogens
C) its need for several cells to be activated over several days on first exposure
D) its memory cells that provide quicker, larger and more efficient immune response upon
second and subsequent exposure to an antigen
48)
49) Small molecules that bind with self-proteins to produce antigenic substances are called ________.
A) ions
B) haptens
C) antibodies
D) reagins
49)
50) Cancer cells and virus-infected body cells can be killed before activation of adaptive immunity by
________.
A) natural killer cells
B) T-lymphocytes
C) pinocytosis
D) B-lymphocytes
50)
51) 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
51)
52) Which of the following is NOT a mechanism for the development of autoimmune disorders?
A) mutation followed by the appearance of membrane proteins not previously present
B) exposure of previously "hidden" self-antigens to the adaptive immune system during trauma
C) a second exposure to an allergen
D) cross-reaction of antibodies formed against foreign antigens (haptens) bound with
self-antigens
52)
53) Which of the following is NOT a function of the inflammatory response?
A) prevents the spread of the injurious agent to nearby tissue
B) sets the stage for repair processes
C) disposes of cellular debris and pathogens
D) replaces injured tissues with connective tissue
53)
54) The redness and heat of an inflamed area are due to a local hyperemia caused by ________.
A) vasoconstriction
B) vasodilation
C) complement production
D) phagocyte mobilization
54)
55) Which of the following is true of incomplete antigens (haptens)?
A) Incomplete antigens are nonreactive.
B) Incomplete antigens are only immunogenic when attached to protein carriers.
C) Incomplete antigens include pollen grains, microorganisms, and viruses.
D) Incomplete antigens are typically large macromolecules such as proteins.
55)
56) In clonal selection of B cells, which substance is responsible for determining which cells will
eventually become cloned?
A) complement
B) antibody
C) antigen
D) interferon
56)
7
57) 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 osmolarity of the fluids surrounding infected tissue is higher than the plasma
C) B-lymphocytes will differentiate to become plasma cells
D) the surrounding tissue will swell with excessive fluids
57)
58) B lymphocytes develop immunocompetence in the ________.
A) lymph nodes
B) bone marrow
C) thymus
58)
D) spleen
59) Natural killer (NK) cells ________.
A) are also called cytotoxic T cells
B) can kill cancer cells before the immune system is activated
C) are cells of the adaptive immune system
D) are a type of phagocyte
59)
60) Which of the following is NOT a role of activated complement?
A) opsonization
B) enhancement of inflammation
C) insertion of MAC and cell lysis
D) prevention of immediate hypersensitivity reactions
60)
61) Select the correct statement about antigens.
A) The largest type of antigen is called a hapten.
B) "Self-antigens" is another name for incomplete antigens.
C) Only small antigens exhibit reactivity.
D) One antigen may have many different antigenic determinants and may therefore cause the
formation of more than one antibody.
61)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
62) 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?
8
62)
Figure 21.1
Using Figure 21.1, match the following:
63) Antigen-binding site.
63)
64) Natural killer cells can lyse and kill cancer cells and virus-infected body cells ________ the
immune system is activated.
64)
65) Harmful or disease-causing microorganisms are called ________.
65)
9
Figure 21.2
Using Figure 21.2, match the following:
66) Area seeded by immunocompetent B and T cells.
66)
67) Why do schools require inoculations for childhood diseases such as mumps, measles, and
whooping cough? Why are the inoculations of value?
67)
68) An autoimmune disease that severely impairs renal function is ________.
68)
69) Why are regulatory T cells important to the immune process?
69)
70) 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?
70)
71) Pure antibody preparations specific for a single antigenic determinant are called ________
antibodies.
71)
10
Figure 21.1
Using Figure 21.1, match the following:
72) Heavy chain.
72)
73) What are two general mechanisms by which autoimmune diseases could arise?
73)
11
Figure 21.1
Using Figure 21.1, match the following:
74) Light chain.
74)
75) Suppressor factors are ________ that suppress the immune system.
75)
76) Children born without a thymus must be kept in a germ-free environment if they are to
survive. Explain why this is necessary.
76)
12
Figure 21.2
Using Figure 21.2, match the following:
77) Area where antigen challenge and clonal selection are most likely to occur.
77)
78) The most common type of immediate hypersensitivity is ________.
78)
13
Figure 21.2
Using Figure 21.2, match the following:
79) Area where B cells become immunocompetent.
79)
80) What are the signs of inflammation, and how does inflammation serve as a protective
function?
80)
14
Figure 21.2
Using Figure 21.2, match the following:
81) Area where activated immunocompetent B and T cells recirculate.
81)
82) What are some of the drawbacks of passive humoral immunity?
82)
83) 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 ________.
83)
84) The antibody that becomes bound to mast cells and basophils and causes the cells to
release histamine and other chemicals is ________.
84)
85) Failure of developing T cells to recognize self MHC during positive selection results in
________.
85)
86) What is the antigen challenge, and where does it usually take place?
86)
15
87) Septic shock is a dangerous condition where the ________ are released unchecked, making
the capillaries very leaky and thus depleting blood fluids.
87)
88) Elderly people tend to develop cancer more frequently than younger people. Give an
explanation for this observation that relates to immune function.
88)
89) List and briefly discuss innate body defenses to disease.
89)
90) Name four autoimmune diseases.
90)
Figure 21.1
Using Figure 21.1, match the following:
91) Constant region.
91)
92) Variable region.
92)
16
Figure 21.2
Using Figure 21.2, match the following:
93) Area where T cells become immunocompetent.
93)
94) What are monoclonal antibodies? How are they produced, and what are some of their
clinical uses?
94)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
95) In a case of immediate hypersensitivity, the immune system responds with an allergic response on
the first exposure to the allergen.
95)
96) Some immunocompetent cells will never encounter an antigen to which they can bind and
therefore will never be called to service in our lifetime.
96)
97) The respiratory burst produced by activated macrophages releases free radicals which are effective
at killing pathogens.
97)
17
98) Natural killer cells destroy target cells or pathogens by ingestion and destruction of particulate
matter in a process called phagocytosis.
98)
99) The directional movement of cells in response to chemicals is called chemotaxis.
99)
100) Subacute hypersensitivities are categorically less harmful than acute (immediate)
hypersensitivities.
100)
101) 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.
101)
102) Fever is often a beneficial immune response because it can speed the activities of leucocytes.
102)
103) B cells must accomplish double recognition: they must simultaneously recognize self and nonself to
be activated.
103)
104) Soluble proteins secreted by plasma cells are called antibodies.
104)
105) Virus infected cells secrete interferons to "warn" other cells of the presence of virus and deny entry
to them.
105)
106) Monoclonal antibodies are used in clinical laboratory diagnosis because they bind to many
antigenic determinates.
106)
107) Perforins form complexes that penetrate the cell membrane and allow the passage of the apoptosis
inducing protein granzyme to enter the targeted cell.
107)
108) Antibodies typically act extracellularly in body fluids and are therefore considered part of the
humoral branch of adaptive immunity.
108)
109) Anaphylactic shock is a rare but severe allergic response that may occur if the allergen enters the
blood stream.
109)
110) Viral infection will provoke cell mediated immunity but will not activate a humoral response.
110)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
111) Involved in allergies.
A) IgE
111)
Match the following:
112) Absence results in no immune
response.
A) T helper cell
18
112)
Match the following:
113) Main antibody of both primary and
secondary immune response.
114) First to peak during a primary
immune response.
A) IgG
113)
B) IgM
114)
Match the following:
115) Adaptive defense system.
A) Immune response
115)
Match the following:
116) Forms antibody-producing cells.
A) B cell
116)
Match the following:
117) Third line of defense.
A) Immune response
117)
Match the following:
118) Enables quick and efficient response to
secondary exposure to antigen.
A) Memory cell
118)
Match the following:
119) First line of defense.
A) Intact skin and mucous membranes
119)
Match the following:
120) Slows or stops the immune response.
A) Regulatory T cell
121) Kills cancer cells and virus infected
body cells.
B) Cytotoxic T cell
120)
121)
Match the following:
122) Along with IgM, this is a B cell
receptor.
A) IgD
122)
Match the following:
123) Innate defense system.
A) Inflammatory response and skin and
mucous membranes
123)
Match the following:
124) Protects mucosal barriers.
A) IgA
19
124)
Match the following:
125) Second line of defense.
A) Inflammatory response
125)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
126) 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.
127) After receiving penicillin intravenously, a 32-year-old male patient has an anaphylactic reaction. The nurse
understands that therapeutic management includes what critical items?
128) Nursing care of a patient with acquired immune deficiency syndrome (AIDS) includes monitoring of
T lymphocyte counts. Explain why.
129) 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?
130) 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?
131) 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.
132) 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?
133) 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?
20
Answer Key
Testname: 21
1) C
2) A
3) C
4) C
5) D
6) D
7) B
8) D
9) D
10) A
11) C
12) A
13) A
14) B
15) B
16) B
17) C
18) C
19) A
20) A
21) B
22) C
23) C
24) C
25) C
26) B
27) C
28) B
29) D
30) D
31) A
32) D
33) B
34) D
35) C
36) D
37) C
38) B
39) D
40) D
41) A
42) B
43) D
44) B
45) B
46) E
47) A
48) D
49) B
50) A
21
Answer Key
Testname: 21
51) A
52) C
53) D
54) B
55) B
56) C
57) C
58) B
59) B
60) D
61) D
62) 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.
63) A
64) before
65) pathogens
66) D
67) 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.
68) glomerulonephritis
69) They are vital in the final stopping of an immune response after the antigen is inactivated. They may also help prevent
autoimmune reactions.
70) 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.
71) monoclonal
72) B
73) 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.
74) D
75) cytokines
76) 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.
77) D
78) allergy
79) C
80) 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.
81) E
82) The effects are short lived; it does not trigger memory cell production; and your body degrades the antibodies.
83) complement
84) IgE
85) apoptosis
86) 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.
87) cytokines
22
Answer Key
Testname: 21
88) 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.
89) 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.
90) Multiple sclerosis, myasthenia gravis, Graves' disease, juvenile (type I) diabetes, systemic lupus erythematosus,
glomerulonephritis, rheumatoid arthritis.
91) E
92) C
93) B
94) 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.
95) FALSE
96) TRUE
97) TRUE
98) FALSE
99) TRUE
100) FALSE
101) TRUE
102) TRUE
103) FALSE
104) TRUE
105) TRUE
106) FALSE
107) TRUE
108) TRUE
109) TRUE
110) FALSE
111) A
112) A
113) A
114) B
115) A
116) A
117) A
118) A
119) A
120) A
121) B
122) A
123) A
124) A
125) A
23
Answer Key
Testname: 21
126) 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.
127) 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.
128) 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.
129) 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.
130) 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.
131) Aspirin would disguise a fever that would indicate infection.
132) 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.
133) 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.
24
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following is NOT a stimulus for breathing?
A) rising blood pressure
B) arterial PO2 below 60 mm Hg
1)
2) Which pressure actually keeps the lungs from collapsing?
A) intrapleural pressure
B) atmospheric pressure
C) transpulmonary pressure
D) intrapulmonary pressure
2)
3) Select the correct statement about oxygen transport in blood.
A) During normal activity, a molecule of hemoglobin returning to the lungs carries one molecule
of O2 .
3)
4) 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) secrete surfactant
C) replace mucus in the alveoli
D) trap dust and other debris
4)
5) Which law describes the relationship between the pressure and volume of a gas?
A) Boyle's law
B) Charles' law
C) Henry's law
D) Dalton's law
5)
6) The major nonelastic source of resistance to air flow in the respiratory passageways is ________.
A) surface tension
B) surfactant
C) friction
D) air pressure
6)
7) Which of the choices below determines the direction of respiratory gas movement?
A) partial pressure gradient
B) the temperature
C) molecular weight and size of the gas molecule
D) solubility in water
7)
8) The loudness of a person's voice depends on the ________.
A) force with which air rushes across the vocal folds
B) length of the vocal folds
C) strength of the intrinsic laryngeal muscles
D) thickness of vestibular folds
8)
9) The relationship between gas pressure and gas volume is described by ________.
A) Dalton's law
B) Henry's law
C) Charles' law
D) Boyle's law
9)
C) acidosis resulting from CO2 retention
D) rising carbon dioxide levels
B) Increased BPG levels in the red blood cells enhance oxygen-carrying capacity.
C) A 50% oxygen saturation level of blood returning to the lungs might indicate an activity level
higher than normal.
D) During conditions of acidosis, hemoglobin is able to carry oxygen more efficiently.
1
10) 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) surface tension from pleural fluid and negative pressure in the pleural cavity
C) the smooth muscles of the lung
D) the diaphragm and the intercostal muscles alone
10)
11) The nose serves all of the following functions EXCEPT ________.
A) cleansing the air
B) as the direct initiator of the cough reflex
C) warming and humidifying the air
D) as a passageway for air movement
11)
12) Which of the following determines lung compliance?
A) alveolar surface tension
B) muscles of inspiration
C) flexibility of the thoracic cage
D) airway opening
12)
13) The larynx contains ________.
A) a cricoid cartilage also called the Adam's apple
B) an upper pair of avascular mucosal folds called true vocal folds
C) the thyroid cartilage
D) lateral cartilage ridges called false vocal folds
13)
14) Tidal volume is air ________.
A) forcibly expelled after normal expiration
B) inhaled after normal inspiration
C) exchanged during normal breathing
D) remaining in the lungs after forced expiration
14)
15) Which of the following is INCORRECT?
A) Pressure gradient equals gas flow over resistance.
B) Resistance equals pressure gradient over gas flow.
C) Gas flow equals pressure gradient over resistance.
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.
15)
16) Which of the following provide the greatest surface area for gas exchange?
A) alveolar ducts
B) alveoli
C) alveolar sacs
D) respiratory bronchioles
16)
17) Which of the choices below is NOT a factor that promotes oxygen binding to and dissociation from
hemoglobin?
A) partial pressure of oxygen
B) number of red blood cells
C) temperature
D) partial pressure of carbon dioxide
17)
18) Respiratory control centers are located in the ________.
A) midbrain and medulla
B) medulla and pons
C) upper spinal cord and medulla
D) pons and midbrain
18)
19) The most powerful respiratory stimulus for breathing in a healthy person is ________.
A) increase of carbon dioxide
B) loss of oxygen in tissues
C) acidosis
D) alkalosis
19)
2
20) Which of the following is the leading cause of cancer death for both men and women in North
America?
A) esophageal
B) skin
C) lung
D) colorectal
20)
21) 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) tuberculosis
B) pneumonia
C) emphysema
D) coryza
21)
22) As the tension of vocal folds in the larynx increase, the voice becomes ________.
A) louder
B) higher in pitch
C) more distinct
D) lower in pitch
22)
23) Factors that influence the rate and depth of breathing include ________.
A) temperature of alveolar air
B) thalamic control
C) voluntary cortical control
D) stretch receptors in the alveoli
23)
24) Most inspired particles such as dust fail to reach the lungs because of the ________.
A) action of the epiglottis
B) abundant blood supply to nasal mucosa
C) ciliated mucous lining in the nose
D) porous structure of turbinate bones
24)
25) Inspiration occurs when the ________ is less than the ________.
A) tidal volume; vital capacity
B) intrapleural pressure; transpulmonary pressure
C) thoracic cavity volume; lung volume
D) intrapulmonary pressure; atmospheric pressure
25)
26) In the plasma, the quantity of oxygen in solution is ________.
A) not present except where it is combined with carrier molecules
B) about equal to the oxygen combined with hemoglobin
C) only about 1.5% of the oxygen carried in blood
D) greater than the oxygen combined with hemoglobin
26)
27) Which bone does NOT contain paranasal sinuses?
A) ethmoid
B) temporal
C) frontal
D) maxillary
27)
28) Which of the following refers to the movement of air into and out of the lungs?
A) external respiration
B) pulmonary ventilation
C) gas exchange
D) internal respiration
28)
29) Select the correct statement about the physical factors influencing pulmonary ventilation.
A) As alveolar surface tension increases, additional muscle action will be required.
B) A decrease in compliance causes an increase in ventilation.
C) Surfactant helps increase alveolar surface tension.
D) A lung that is less elastic will require less muscle action to perform adequate ventilation.
29)
30) 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
30)
3
31) The symptoms of hyperventilation may be averted by breathing into a paper bag because it
________.
A) lowers blood pH levels
B) helps retain carbon dioxide in the blood
C) reduces brain perfusion by constricting cerebral blood vessels
D) helps retain oxygen in the blood
31)
32) Inspiratory capacity is ________.
A) air inspired after a tidal inhalation
B) functional residual capacity
C) the total amount of air that can be inspired after a tidal expiration
D) the total amount of exchangeable air
32)
33) Which of the following anchor(s) the vocal folds?
A) cuneiform cartilages
C) arytenoid cartilages
33)
B) cricoid cartilage
D) corniculate cartilages
34) According to the oxygen-hemoglobin dissociation curve, PO2 in the lungs of 100 mm Hg results in
34)
Hb being 98% saturated. At high altitude, there is less O2 . At a PO2 in the lungs of 80 mm Hg, Hb
would be ________ saturated.
A) 95%
B) 100%
C) 98%
D) less than 50%
35) The local matching of blood flow with ventilation is ________.
A) chloride shifting
B) the Bohr effect
C) ventilation-perfusion coupling
D) the Haldane effect
35)
36) Which of the following is correct regarding acclimatization?
A) At high altitudes, hemoglobin's affinity for O2 is increased because BPG concentrations
36)
increase.
B) Decreases in arterial PO2 cause the peripheral chemoreceptors to become less responsive to
increases in PCO2.
C) High-altitude conditions always result in lower-than-normal hemoglobin saturation levels
because less O2 is available to be loaded.
D) When blood O2 levels decline, the kidneys produce more erythropoietin, which stimulates
breakdown of red blood cells in the spleen.
37) Which of the following is a conducting zone structure?
A) terminal bronchiole
B) respiratory bronchiole
C) alveolar duct
D) alveolar sac
37)
38) The Bohr effect refers to the unloading of ________ in a RBC due to declining blood pH.
A) chloride ions
B) BPG
C) oxygen
D) carbon dioxide
38)
39) Intrapulmonary pressure is the ________.
A) difference between atmospheric pressure and respiratory pressure
B) pressure within the alveoli of the lungs
C) pressure within the pleural cavity
D) negative pressure in the intrapleural space
39)
4
40) For inspiration of air, which of the following happens first?
A) thoracic cavity volume decreases
B) diaphragm descends, thoracic volume begins to increase, and rib cage rises
C) intrapulmonary pressure drops
D) air (gases) flows into lungs
40)
41) Which of the following is true regarding normal quiet expiration of air?
A) It depends on the complete lack of surface tension on the alveolar wall.
B) It requires contraction of abdominal wall muscles.
C) It is driven by increased blood CO2 levels.
41)
42) 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) Henry's law
B) Boyle's law
C) Charles' law
D) Dalton's law
42)
43) Which of the following counteracts the movement of bicarbonate ions from the RBC?
A) the Haldane effect
B) the Bohr effect
C) release of hydrogen ion
D) chloride shifting
43)
44) Which of the choices below is NOT a role of the pleurae?
A) allow the lungs to glide easily over the thorax wall during breathing movements
B) assist in blood flow to and from the heart because the heart sits between the lungs
C) help divide the thoracic cavity into three chambers
D) help limit the spread of local infections
44)
45) Which of the following maintains the patency (openness) of the trachea?
A) C-shaped cartilage rings
B) surfactant production
C) surface tension of water
D) pseudostratified ciliated epithelium
45)
46) 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) the natural tendency for the lungs to recoil and the surface tension of the alveolar fluid
B) the natural tendency for the lungs to recoil and transpulmonary pressures
C) compliance and transpulmonary pressures
D) compliance and the surface tension of the alveolar fluid
46)
47) The amount of air that can be inspired above the tidal volume is called ________.
A) vital capacity
B) reserve air
C) expiratory capacity
D) inspiratory reserve volume
47)
48) Which of the following is NOT part of the respiratory membrane of the lungs?
A) alveolar epithelium
B) single layer of smooth muscle cells
C) basement membrane
D) capillary endothelium
48)
49) Possible causes of hypoxia include ________.
A) obstruction of the esophagus
C) too little oxygen in the atmosphere
49)
D) It is a passive process that depends on the recoil of elastic fibers that were stretched during
inspiration.
B) taking several rapid deep breaths
D) getting very cold
5
50) Using spirometry, a patient discovers their forced expiratory volume (FEV) after the first second is
40%. What does this suggest?
A) exposure to asbestos
B) healthy lungs
C) obstructive pulmonary disease
D) restrictive disease
50)
51) Which of the following incorrectly describes mechanisms of CO2 transport?
51)
A) as bicarbonate ions in plasma
B) just over 20% of CO2 is carried in the form of carbaminohemoglobin
C) attached to the heme part of hemoglobin
D) 7-10% of CO2 is dissolved directly into the plasma
52) Which of the following is an appropriate response to carbon monoxide (CO) poisoning?
A) hyperbaric oxygen chamber to increase PO2 and clear CO from the body
52)
53) Surfactant helps to prevent the alveoli from collapsing by ________.
A) protecting the surface of alveoli from dehydration and other environmental variations
B) warming the air before it enters
C) humidifying the air before it enters
D) interfering with the cohesiveness of water molecules, thereby reducing the surface tension of
alveolar fluid
53)
54) The Bohr effect describes the tendency for hemoglobin to more readily unload oxygen under which
conditions?
A) decreased pH and PCO2
B) increased pH and decreased PCO2
C) increased pH and PCO2
D) decreased pH and increased PCO2
54)
55) Which structure is lined with simple squamous epithelium?
A) alveolus
B) trachea
C) oropharynx
55)
B) slow breathing into a paper bag
C) immediate application of bicarbonate ions to facilitate removal of CO from Hb
D) hyperventilation to exhale CO from the body
D) nasopharynx
56) 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) Henry's law
B) Boyle's law
C) Charles' law
D) Dalton's law
56)
57) The lung volume that represents the total volume of exchangeable air is the ________.
A) tidal volume
B) vital capacity
C) expiratory reserve volume
D) inspiratory capacity
57)
58) Which center is located in the pons?
A) inspiratory center
C) expiratory center
58)
B) pacemaker neuron center
D) pontine respirator group (PRG)
6
59) The erythrocyte (red blood cell) count increases after a while when an individual goes from a low
to a high altitude because the ________.
A) concentration of oxygen and/or total atmospheric pressure is higher at higher altitudes
B) concentration of oxygen and/or total atmospheric pressure is lower at high altitudes
C) temperature is lower at higher altitudes
D) basal metabolic rate is higher at high altitudes
59)
60) Air moves out of the lungs when the pressure inside the lungs is ________.
A) less than the pressure in the atmosphere
B) equal to the pressure in the atmosphere
C) greater than the intra-alveolar pressure
D) greater than the pressure in the atmosphere
60)
61) How is the bulk of carbon dioxide transported in blood?
A) chemically combined with the heme portion of hemoglobin
B) as bicarbonate ions in plasma after first entering the red blood cells
C) as carbonic acid in the plasma
D) chemically combined with the amino acids of hemoglobin as carbaminohemoglobin in the red
blood cells
61)
62) 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) restrictive disease
C) emphysema
D) obstructive pulmonary disease
62)
63) Which statement about CO2 is FALSE?
63)
A) Its accumulation in the blood is associated with a decrease in pH.
B) More CO2 dissolves in the blood plasma than is carried in the RBCs.
C) CO2 concentrations are greater in venous blood than arterial blood.
D) Its concentration in the blood is decreased by hyperventilation.
64) Which of the following does NOT influence hemoglobin saturation?
A) partial pressure of carbon dioxide
B) BPG
C) nitric oxide
D) temperature
64)
65) The left lung differs from the right in that the left lung has ________.
A) a cardiac notch
B) three lobes
C) a wider and more vertical primary bronchus
D) an oblique fissure
65)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
66) Distinguish among anemic, ischemic (stagnant), histotoxic, and hypoxemic hypoxia.
7
66)
Figure 22.1
Using Figure 22.1, match the following:
67) Larynx.
67)
68) What is the chloride shift and why does it occur?
68)
8
Figure 22.2
Using Figure 22.2, match the following:
69) Tidal volume.
69)
70) How is it possible to change the pitch of our voice from high to low?
70)
71) 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?
71)
9
Figure 22.2
Using Figure 22.2, match the following:
72) Inspiratory reserve volume.
72)
73) 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?
73)
10
Figure 22.2
Using Figure 22.2, match the following:
74) Expiratory reserve volume.
74)
11
Figure 22.1
Using Figure 22.1, match the following:
75) Trachea.
75)
76) Carina of trachea.
76)
12
Figure 22.2
Using Figure 22.2, match the following:
77) Air that does not participate in the exchange of gases.
77)
78) 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.
78)
79) 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.
79)
80) Define anatomical dead space. What is the relationship between anatomical and alveolar
dead space? Which value is likely to increase during lung pathology?
80)
81) How is alveolar gas exchange affected by emphysema and pneumonia?
81)
13
Figure 22.1
Using Figure 22.1, match the following:
82) Pharynx.
82)
83) Main (primary) bronchus.
83)
14
Figure 22.2
Using Figure 22.2, match the following:
84) Residual volume.
84)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
85) The Heimlich maneuver is a procedure in which air in the lungs is used to expel a piece of food
lodged in the esophagus.
85)
86) 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.
86)
87) The paired lungs occupy the mediastinum of the thoracic cavity.
87)
88) The lingual tonsil is found on the posterior surface of the root of the tongue.
88)
89) In chronic bronchitis, mucus production is decreased and this leads to the inflammation and
fibrosis of the mucosal lining of the bronchial tree.
89)
90) Oxygenated hemoglobin releases oxygen more readily when the pH is more basic.
90)
91) Ventilation perfusion coupling means that more blood flows past functional alveoli than past
nonfunctional alveoli.
91)
92) During normal quiet breathing, males breathe 25% more than females.
92)
93) A drop in blood pH is likely to cause a slower breathing rate.
93)
15
94) The inflation (Hering-Breuer) reflex is a potentially dangerous response that may cause
overinflation of the lung.
94)
95) Increased temperature results in decreased O2 unloading from hemoglobin.
95)
96) As carbon dioxide enters systemic blood, it causes more oxygen to dissociate from hemoglobin (the
Haldane effect), which in turn allows more CO2 to combine with hemoglobin and more
96)
97) Atelectasis (lung collapse) renders the lung useless for ventilation.
97)
98) The largest amount of carbon dioxide is transported in the bloodstream in the form of carbonic
anhydrase.
98)
99) The average individual has 500 ml of residual volume in his lungs.
99)
bicarbonate ions to be generated (the Bohr effect).
100) Tracheal obstruction is life threatening.
100)
101) Labored breathing is termed hypercapnia.
101)
102) Strong emotions and pain, acting through the limbic system and hypothalamus, send signals to the
respiratory centers that modulate respiratory rate and depth.
102)
103) Intrapleural pressure is normally about 4 mm Hg less than the pressure in the alveoli.
103)
104) 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).
104)
105) Nasal conchae heat and moisten inhaled air, and reclaim heat and moisture during exhalation.
105)
106) The parietal pleura lines the thoracic wall.
106)
107) Smoking diminishes ciliary action and eventually destroys the cilia.
107)
108) 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.
108)
109) The alveolar ventilation rate is the best index of effective ventilation.
109)
110) Under certain conditions, the vocal folds act as a sphincter that prevents air passage.
110)
16
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
111) NO exchange of gases occurs here.
A) Type I alveolar cells
112) Where the respiratory zone of the
lungs begins.
B) Alveolar duct
113) Composed of simple squamous
epithelium.
111)
112)
C) Segmental (tertiary) bronchi
D) Respiratory bronchioles
114) Terminates in alveoli.
113)
114)
Match the following:
115) TV + IRV + ERV.
A) Vital capacity
116) TV + IRV + ERV + RV.
B) Total lung capacity
115)
116)
Match the following:
117) Composed of cuboidal cells.
A) Type II alveolar cells
117)
Match the following:
118) TV + IRV.
A) Inspiratory capacity
118)
Match the following:
119) The respiratory membrane is
composed of fused basement
membrane of the capillary walls and
________.
A) Type I alveolar cells
119)
Match the following:
120) ERV + RV.
A) Functional residual capacity
120)
Match the following:
121) Secrete a fluid containing surfactant.
A) Type II alveolar cells
121)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
122) 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.
17
123) A patient was admitted to the hospital with chronic obstructive pulmonary disease. His PO2 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.
124) 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?
125) 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?
126) 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?
127) A patient with tuberculosis is often noncompliant with treatment. Explain why this may happen.
128) 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?
129) How will the lungs compensate for an acute rise in the partial pressure of CO2 in arterial blood?
130) 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?
131) 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?
18
Answer Key
Testname: 22
1) A
2) C
3) C
4) B
5) A
6) C
7) A
8) A
9) D
10) B
11) B
12) A
13) C
14) C
15) A
16) B
17) B
18) B
19) A
20) C
21) C
22) B
23) C
24) C
25) D
26) C
27) B
28) B
29) A
30) C
31) B
32) C
33) C
34) A
35) C
36) C
37) A
38) C
39) B
40) B
41) D
42) D
43) D
44) B
45) A
46) A
47) D
48) B
49) C
50) D
19
Answer Key
Testname: 22
51) C
52) A
53) D
54) D
55) A
56) A
57) B
58) D
59) B
60) D
61) B
62) B
63) B
64) C
65) A
66) 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 O2 even though adequate amounts are delivered. Hypoxemia hypoxia is indicated
by reduced arterial PO2.
67) B
68) 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 CO2 rises.
69) B
70) 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.
71) 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.
72) A
73) 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.
74) C
75) C
76) E
77) D
78) 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.
79) Equal amounts of O2 and CO2 can be exchanged in the lungs and at the tissues because CO2 solubility in plasma and
alveolar fluid is 20 times greater than that of O2 .
80) 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.
20
Answer Key
Testname: 22
81) 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.
82) A
83) D
84) D
85) FALSE
86) TRUE
87) FALSE
88) TRUE
89) FALSE
90) FALSE
91) TRUE
92) FALSE
93) FALSE
94) FALSE
95) FALSE
96) FALSE
97) TRUE
98) FALSE
99) FALSE
100) TRUE
101) FALSE
102) TRUE
103) TRUE
104) TRUE
105) TRUE
106) TRUE
107) TRUE
108) TRUE
109) TRUE
110) TRUE
111) C
112) D
113) A
114) B
115) A
116) B
117) A
118) A
119) A
120) A
121) A
21
Answer Key
Testname: 22
122) 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.
123) In people who retain carbon dioxide because of pulmonary disease, arterial PCO2 is chronically elevated and
chemoreceptors become unresponsive to this chemical stimulus. In such cases, declining PO2 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 PO2 levels) would be
removed.
124) 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.
125) 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).
126) Following nasal infection, the frontal and maxillary sinuses become infected.
127) 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.
128) 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, CO2 retention, and
respiratory acidosis. He may develop emphysema or lung cancer.
129) Respiratory rate will increase.
130) 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.
131) 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.
22
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) Which of the following is NOT found in saliva?
A) protease
C) lysozyme
B) electrolytes
D) urea and uric acid
1)
2) Which of the following is (are) NOT important as a stimulus in the gastric phase of gastric
secretion?
A) low acidity
B) peptides
C) distention
D) carbohydrates
2)
3) Pepsinogen, an inactive digestive enzyme, is secreted by the ________.
A) chief cells of the stomach
B) goblet cells of the small intestine
C) parietal cells of the stomach
D) Brunner's glands in the duodenum
3)
4) The chemical and mechanical processes of food breakdown are called ________.
A) secretion
B) digestion
C) absorption
D) ingestion
4)
5) The lamina propria is composed of ________.
A) loose connective tissue
C) reticular connective tissue
5)
B) dense irregular connective tissue
D) dense regular connective tissue
6) Which of the following is NOT true of saliva?
A) moistens food and aids in compacting of the bolus
B) contains enzymes that begin the breakdown of carbohydrates
C) cleanses the mouth
D) contains acids which aid in chemical digestion
6)
7) Which of the following is least involved in the mechanical breakdown of food, digestion, or
absorption?
A) large intestine
B) the small ingestion
C) the oral cavity
D) the esophagus
7)
8) What stomach secretion is necessary for normal hemoglobin production in RBCs?
A) pepsinogen
B) intrinsic factor
C) HCl
D) gastric lipase
8)
9) Which of the following is NOT characteristic of the large intestine?
A) It does not contain villi.
B) It is longer than the small intestine.
C) It has pocket-like sacs called haustra.
D) It exhibits external muscular bands called teniae coli.
9)
10) Digestion and absorption of which of the following would be affected the most if the liver were
severely damaged?
A) starches
B) lipids
C) carbohydrates
D) proteins
1
10)
11) 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) This prepares the stomach for food before its arrival in the stomach.
D) The cerebral cortex, hypothalamus and medulla oblongata are all involved in processing the
stimulatory information.
11)
12) 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) surface epithelial cells
B) mucous neck cells
C) parietal cells
D) chief cells
12)
13) Which of the following would likely be absorbed in the stomach?
A) a serving of alcohol
B) a serving of pasta
C) a piece of candy
D) a serving of lean chicken breast
13)
14) The ducts that deliver bile and pancreatic juice from the liver and pancreas, respectively, unite to
form the ________.
A) pancreatic acini
B) hepatopancreatic ampulla
C) bile canaliculus
D) portal vein
14)
15) 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) provide protection against invading bacteria and other disease-causing organisms that enter
the digestive tract in food
C) secrete buffers in order to keep the pH of the digestive tract close to neutral
D) absorb nutrients from digested food and store them for future use
15)
16) The function of the hepatic portal circulation is to ________.
A) collect absorbed nutrients for metabolic processing in the liver
B) carry toxins to the kidney for disposal through the urinary tract
C) distribute hormones throughout the body
D) return glucose to the general circulation when blood sugar is low
16)
17) 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 digestive systems first and foremost job is to digest and absorb nutrients so it puts off
immunity for last.
B) The alkaline secretions of the small intestine aid in the growth of bacteria and these bacteria
must be controlled.
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 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.
17)
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18) Which of the following is true concerning the number and type of permanent teeth?
A) The number of permanent teeth is always equal to the number of primary teeth.
B) There are 27 permanent teeth, and the first molars are usually the last to emerge.
C) The number of upper permanent teeth is not equal to the number of lower permanent teeth.
D) There are 32 permanent teeth, and the wisdom teeth are the last to emerge.
18)
19) Fat absorption through the plasma membrane of epithelial cells ________.
A) requires vesicular, active transport of the relatively large fatty acids and monoglyceride
B) is accomplished by cotransporters that use the concentration gradient of Na+ outside of the
19)
20) Which of these is NOT part of the splanchnic circulation?
A) hepatic portal vein
B) superior mesenteric artery
C) inferior vena cava
D) celiac artery
20)
21) Which of the following is NOT a factor that helps create the stomach mucosal barrier?
A) replacing of damaged epithelial mucosa cells
B) thick coating of bicarbonate-rich mucus
C) secretion of pepsinogen
D) tight junctions of epithelial mucosa cells
21)
22) Which vitamin requires intrinsic factor in order to be absorbed?
A) A
B) K
C) B12
22)
cells
C) occurs by simple diffusion because lipids are able to penetrate the hydrophobic fatty acid tails
within the plasma membrane
D) requires enzymes attached to the brush border to further breakdown the fats
D) C
23) Which of the following is an essential role played by large intestine bacteria?
A) synthesis of vitamin K
B) synthesize vitamins C and D
C) produce gas
D) absorb bilirubin
23)
24) A doctor consulting a patient that recently has had their gall bladder removed would likely advise
________.
A) eating fewer, but larger meals
B) eating a low to no carb diet
C) eating foods that are low in fat
D) increasing unsaturated fats while eliminating trans fats in their diets
24)
25) Nervous control of gastric secretion is provided by ________.
A) somatic neurons in the spinal cord
B) the reticulospinal and vestibulospinal tracts
C) the vagus nerve and enteric plexus
D) the rubrospinal tracts
25)
26) Select the correct statement about the regulation of gastric secretion.
A) Gastric secretion is enhanced by very low pH (below a pH of 2).
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) The presence of food in the stomach prevents hormonal control of gastric secretion.
26)
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27) Chemical digestion reduces large complex molecules to simpler compounds by the process of
________.
A) mastication
B) excretion
C) anabolism
D) catabolism
27)
28) A child with restricted tongue movement may have a surgery that involves the cutting of the
________.
A) uvula
B) lingual frenulum
C) terminal sulcus
D) palatine tonsils
28)
29) 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) Low pH converts pepsinogen to its active form of pepsin, preventing the protease enzyme
from digesting the cells that produce it.
B) The stomach's acid catabolically breaks down food stuffs in preparation for absorption.
C) Stomach acid denatures proteins making the poly peptide chain more accessible to pepsin
digestive enzymes.
D) Many potentially harmful bacteria will be prevented entry to the small intestine by stomach
acid.
29)
30) 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) gastrin
C) ghrelin
D) pepsin
30)
31) Gastric pits, as opposed to gastric glands, are completely lined with ________.
A) enteroendocrine cells
B) parietal cells
C) chief cells
D) mucous cells
31)
32) What part of the tooth bears the force and resists the friction of chewing?
A) pulp
B) cementum
C) enamel
D) crown
32)
33) 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 raise the pH of the stomach.
B) It would reduce the symptoms of heartburn.
C) It would cause the release of secretin and cholecystokinin.
D) It would lower the activity of parietal cells.
33)
34) Bile salts break up the fat globule into smaller fat droplets. This role of bile salts is best described as
________.
A) lipid ingestion
B) lipid emulsification
C) lipid absorption
D) lipid digestion
34)
35) 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
35)
4
36) The bolus is liquefied in the ________ and it is now called chyme.
A) mouth
B) small intestine
C) stomach
D) esophagus
36)
37) 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 27 primary teeth, and the molars are permanent.
C) There are 24 primary teeth, and no new primary teeth appear after 13 months.
D) There are 32 primary teeth, and by 36 months of age, most children have all 32.
37)
38) Select the description below that illustrates a difference between a sphincter and circular muscle.
A) A sphincter is composed of smooth muscle while circular muscle is composed of skeletal
muscle tissue.
B) Sphincters are found in the proximal portion of the GI tract while circular muscle is found in
the distal portions.
C) 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.
D) Sphincters are found throughout the GI tract while circular muscle is found only in the
proximal portion of the GI tract.
38)
39) 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
39)
40) Which of the following is NOT a function of cholecystokinin (CCK)?
A) increase production of pancreatic juice
B) increase production of stomach acid
C) stimulate gall bladder to release bile
D) open hepatopancreatic sphincter
40)
41) Peristaltic waves are ________.
A) churning movements of the gastrointestinal tract that aid in mechanical breakdown of chyme
B) waves of muscular contractions that propel contents from one point to another
C) segmental regions of the gastrointestinal tract
D) pendular movements of the gastrointestinal tract
41)
42) The sheets of peritoneal membrane that hold the digestive tract in place are called ________.
A) mucosal lining
B) lamina propria
C) serosal lining
D) mesenteries
42)
43) Hepatocytes do NOT ________.
A) detoxify toxic chemicals
C) store fat-soluble vitamins
43)
B) process nutrients
D) produce digestive enzymes
44) Which of the following enzymes would be most active in the presence of high concentrations of
protein fragments?
A) dextrinase
B) trypsin
C) amylase
D) lipase
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44)
45) The ingestion of a meal high in fat content would cause which of the following to occur?
A) Bile would be released from the gallbladder to emulsify the fat in the duodenum.
B) This type of food would cause secretion of gastrin to cease, resulting in faster gastric
emptying.
C) The acid secretions from the stomach would be sufficient to digest this food but may cause
heartburn.
D) Increased production of trypsinogen.
45)
46) The ________ contains lobules with sinusoids (lined with macrophages) that lead to a central
venous structure.
A) stomach
B) spleen
C) liver
D) pancreas
46)
47) The capillaries that nourish the epithelium and absorb digested nutrients lie in the ________.
A) submucosa
B) adventitia
C) serosa
D) lamina propria
47)
48) You have just eaten a meal high in complex carbohydrates. Which of the following enzymes will
help to digest the meal?
A) trypsin
B) gastrin
C) amylase
D) cholecystokinin
48)
49) Which is NOT true of lipid absorption?
A) Fatty acids and monoglycerides are absorbed passively by diffusion.
B) Fatty acids and monoglycerides are packaged with proteins to form chylomicrons.
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.
49)
50) Select the correct statement about absorption.
A) Carbohydrates diffuse across the mucosal endothelium and are then actively transported into
blood capillaries.
B) Eighty percent of ingested materials have been absorbed by the end of the large intestine.
C) Amino acid transport is linked to chloride transport.
D) In the rare case that intact, whole proteins are transported across the mucosal endothelium, an
immune response may be generated.
50)
51) Paneth cells ________.
A) secrete hormones
C) secrete digestive enzymes
51)
B) secrete enzymes that kill bacteria
D) secrete bicarbonate ions
52) Which of the following produce intrinsic factor?
A) enteroendocrine cells
C) parietal cells
B) mucous neck cells
D) zymogenic cells
53) All of the following are true of swallowing (deglutition) except one. Select the statement that is NOT
true of swallowing.
A) The involuntary portion of swallowing takes place in the pharynx.
B) The epiglottis assists in propelling food into the trachea.
C) The voluntary phase of swallowing takes place within the mouth.
D) The mouth, pharynx and esophagus all take part in swallowing.
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52)
53)
54) 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) serosa, mucosa, submucosa, and muscularis externa
D) mucosa, submucosa, muscularis externa, and serosa
54)
55) Which of these is NOT a component of saliva?
A) metabolic waste
C) a cyanide derivative
55)
B) defensins
D) lysozyme
56) Choose the incorrect statement regarding bile.
A) Bile functions to carry bilirubin formed from breakdown of worn-out RBCs.
B) Bile contains enzymes for digestion.
C) Bile functions to emulsify fats.
D) Bile is both an excretory product and a digestive secretion.
56)
57) 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) chemical digestion
B) absorption
C) secretion
D) mechanical breakdown
57)
58) 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) Brunner's glands and Peyer patches
D) villi, and microvilli
58)
59) 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) All of the components of bile are recycled by this circulation.
B) The reabsorption of bile salts allows them to be reused within new bile.
C) Reabsorption of bile salts reduces the need to synthesize new bile salts.
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.
59)
60) Generally, the hormones secretin and cholecystokinin which are released by duodenal
enteroendocrine cells will ________.
A) increase the force of stomach contractions
B) decrease the activities of the accessory digestive organs
C) increase stomach emptying
D) increase the release of digestive enzymes and bile
60)
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61) Select the best explanation for why protease enzymes are secreted in inactive forms.
A) The cells producing inactive enzymes are themselves protected from the enzymes until they
are safely within the lumen of the GI tract.
B) The enzymes would digest each other if they were not properly regulated.
C) The immunoglobulins protecting the digestive tract would be digested without proper
regulation of protein digesting enzymes.
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.
61)
62) The dental formula for an adult is 2-1-2-3. What does the 1 stand for?
A) molar tooth
B) premolar tooth
C) canine tooth
62)
D) incisor tooth
63) A ruptured appendix is life threatening because ________.
A) it is likely to cause massive infection of the abdominopelvic cavity
B) loss of the appendix's function will cause an immune deficiency in the digestive system
C) it is likely to cause severe internal bleeding
D) the large intestine will no longer be able to receive digested material from the small intestine
63)
64) Which of the following are types of papillae on the tongue that contain taste buds?
A) palatine and circumvallate
B) fungiform, circumvallate, and filiform
C) fungiform and circumvallate
D) circumvallate and filiform
64)
65) Hormones or paracrines that inhibit gastric secretion include ________.
A) secretin
B) gastrin
C) ACh
65)
D) histamine
66) Which of the following is the best illustration of the difference between metabolism and digestion?
A) Metabolism comprises all of the chemical reactions preformed within the body while
digestion is only the breakdown of food within the GI tract.
B) Digestion has a wide variety of chemical reactions while metabolism is restricted to only a
few reaction types.
C) Digestions must happen first for metabolism to follow it.
D) Digestion requires enzymes for it to take place while metabolism does not necessarily need or
use them.
66)
67) 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 can be stimulated by things outside of the GI tract
B) long reflexive pathways last much longer than short reflexive pathways
C) long reflexive pathways are quicker to respond than short reflexive pathways
D) long reflexive pathways can respond throughout the entire length of the GI tract while short
reflexive pathways can only respond in the proximal end
67)
8
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:
68) Smooth muscle layer.
68)
9
Figure 23.3
Using Figure 23.3, match the following:
69) Receives blood via the hepatic portal system.
69)
70) How is digestive activity provoked after eating? What activates the secretion of digestive
juices into the lumen or hormones into the blood?
70)
71) Cells of the stomach that secrete HCl are ________ cells.
71)
10
Figure 23.1
Using Figure 23.1, match the following:
72) Continuation of the mesentery.
72)
73) Define constipation and diarrhea. Note possible causes of each.
73)
11
Figure 23.1
Using Figure 23.1, match the following:
74) MALT found here.
74)
75) Compare and contrast the structure and function of a premolar and a molar.
75)
76) Why is it necessary for the stomach contents to be so acidic? How does the stomach protect
itself from digestion?
76)
12
Figure 23.2
Using Figure 23.2, match the following:
77) Wide lymph capillary located in the villus.
77)
78) 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.
78)
13
Figure 23.2
Using Figure 23.2, match the following:
79) Structures that increase the absorptive area of the small intestine.
79)
80) Identify three ways the small intestine is modified to increase the surface area for digestion
and absorption.
80)
14
Figure 23.3
Using Figure 23.3, match the following:
81) Produces enzymes that break down all categories of foodstuffs.
15
81)
Figure 23.2
Using Figure 23.2, match the following:
82) Cell type specialized to secrete mucus into the lumen of the intestinal tract.
82)
83) What is heartburn and what causes it?
83)
16
Figure 23.1
Using Figure 23.1, match the following:
84) Serosa.
84)
85) How is salivation regulated?
85)
17
Figure 23.3
Using Figure 23.3, match the following:
86) Only digestive structure with three muscle layers.
86)
87) 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.
87)
18
Figure 23.1
Using Figure 23.1, match the following:
88) Area of the lamina propria.
88)
89) The part of the peritoneum that covers the external surfaces of most digestive organs is the
________ peritoneum.
89)
19
Figure 23.3
Using Figure 23.3, match the following:
90) Bacteria process undigested chyme from the small intestine.
90)
91) The protective outermost layer of the esophagus is the ________.
91)
20
Figure 23.3
Using Figure 23.3, match the following:
92) Increases surface area for absorption via villi and microvilli.
92)
93) The ________ phase of gastric secretions occurs when food enters the stomach.
93)
21
Figure 23.3
Using Figure 23.3, match the following:
94) Produces intrinsic factor.
94)
95) 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?
95)
22
Figure 23.3
Using Figure 23.3, match the following:
96) Produces a mucoid barrier to prevent self-digestion.
96)
97) Contains the brush border enzymes that complete digestion of carbohydrates and proteins.
97)
23
Figure 23.1
Using Figure 23.1, match the following:
98) Duodenal glands found here.
98)
99) The principal enzyme for breaking down carbohydrates is ________.
99)
100) What is bile and where is it produced? What is its digestive function? Where is it stored
and concentrated?
24
100)
Figure 23.2
Using Figure 23.2, match the following:
101) Absorptive cells that line the intestinal tract.
101)
102) Paneth cells are found here.
102)
103) What are chylomicrons?
103)
25
Figure 23.3
Using Figure 23.3, match the following:
104) Main function is to filter and process the nutrient-rich blood delivered to it.
104)
105) The chief bile pigment is ________.
105)
106) Cells are found in the sinusoids of the liver that remove debris from the blood as it flows
past are called ________ macrophages.
106)
26
Figure 23.1
Using Figure 23.1, match the following:
107) Mucosa.
107)
108) The ________ ligament anchors a tooth in the alveolus of the jaw.
108)
109) The longest portion of the small intestine is the ________.
109)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
110) 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.
110)
111) The major stimulus for production of intestinal fluid is distention or irritation of the intestinal
mucosa by hypertonic or acidic chyme.
111)
112) The relatively unchanging pressure in a filling stomach is due to the contraction of the stomach
oblique muscle layer.
112)
113) The stomach's contractile rhythm is set by pacemaker cells found in the spinal cord.
113)
114) The major role of absorption in the ileum is to reclaim bile salts to be recycled back to the liver.
114)
115) Mumps is an inflammation of the parotid glands caused by myxovirus.
115)
116) The submucosal nerve plexus provides the major nerve supply to the GI tract wall and controls GI
motility.
116)
27
117) Most nutrients are absorbed through the mucosa of the intestinal villi by active transport.
117)
118) Peyer's patches are primarily found in the submucosa of the duodenum.
118)
119) Pepsinogen is the precursor to the gastric enzyme for protein digestion and is secreted by the
parietal cells.
119)
120) The pharyngeal-esophageal phase of swallowing is involuntary and is controlled by the
swallowing center in the thalamus and lower pons.
120)
121) The only essential function of the stomach is to begin the digestion of proteins.
121)
122) 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.
122)
123) Food often contains bacteria, but the HCl of the stomach is effective in killing most ingested
microbes.
123)
124) Gastric accommodation is an example of smooth muscle plasticity.
124)
125) The soft palate reflexively opens the nasopharynx to allow the passage of food, which is now called
a bolus.
125)
126) The pancreas has both an endocrine and an exocrine function.
126)
127) The major means of propulsion through the alimentary canal is peristalsis.
127)
128) The peritoneum is the most extensive serous membrane in the body.
128)
129) Most gastric ulcers are due to excessive production of hydrochloric acid.
129)
130) Severe diarrhea can diminish potassium ion absorption.
130)
131) Fats significantly delay the emptying of the stomach through hormonal and neuronal signals.
131)
132) 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.
132)
133) Another term for swallowing is deglutition.
133)
134) Stellate macrophages are found in the liver and are responsible for removing bacteria and
worn-out cells.
134)
135) When swallowing, the glottis covers the epiglottis.
135)
136) The digestive function of the liver is to produce digestive enzymes.
136)
137) Dentin anchors the tooth in place.
137)
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MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
138) Chemical or mechanical process of
breaking down foodstuffs into simpler
units.
A) Digestion
138)
Match the following:
139) Stimulates insulin release and mildly
inhibits HCl production.
140) Increases HCl secretion and stimulates
contraction of intestinal muscle.
A) Cholecystokinin
139)
B) Gastrin
C) Gastric inhibitory peptide
141) Increases output of enzymatic-rich
pancreatic juice.
140)
141)
Match the following:
142) Wavelike smooth muscle contractions
that move foodstuffs through the
alimentary tube.
A) Absorption
142)
B) Peristalsis
143) Process by which simpler chemical
units pass through the lumen of the
gastrointestinal tract into the blood or
lymph.
143)
Match the following:
144) Increases output of pancreatic juice
rich in bicarbonate ions.
A) Secretin
144)
Match the following:
145) Enzymatic breakdown of any type of
food molecule.
A) Hydrolysis
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) 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.
29
148) 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.
149) 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?
150) 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?
151) 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?
152) 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?
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 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.
30
Answer Key
Testname: 23
1) A
2) D
3) A
4) B
5) A
6) D
7) D
8) B
9) B
10) B
11) B
12) C
13) A
14) B
15) A
16) A
17) D
18) D
19) C
20) C
21) C
22) C
23) A
24) C
25) C
26) B
27) D
28) B
29) B
30) B
31) D
32) C
33) C
34) B
35) C
36) C
37) A
38) C
39) A
40) B
41) B
42) D
43) D
44) B
45) A
46) C
47) D
48) C
49) D
50) D
31
Answer Key
Testname: 23
51) B
52) C
53) B
54) D
55) C
56) B
57) A
58) D
59) A
60) D
61) A
62) C
63) A
64) C
65) A
66) A
67) A
68) C
69) A
70) 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.
71) parietal
72) D
73) 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.
74) B
75) 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.
76) 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.
77) C
78) 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.
79) A
80) 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.
81) D
82) D
32
Answer Key
Testname: 23
83) 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.
84) D
85) 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.
86) C
87) 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.
88) A
89) visceral
90) E
91) adventitia
92) B
93) gastric
94) C
95) 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.
96) C
97) B
98) B
99) amylase
100) 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.
101) B
102) E
103) 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.
104) A
105) bilirubin
106) stellate
107) A
108) periodontal
109) ileum
110) TRUE
111) TRUE
112) FALSE
113) FALSE
114) TRUE
115) TRUE
116) FALSE
117) TRUE
118) FALSE
119) FALSE
120) FALSE
33
Answer Key
Testname: 23
121) FALSE
122) TRUE
123) TRUE
124) TRUE
125) FALSE
126) TRUE
127) TRUE
128) TRUE
129) FALSE
130) TRUE
131) TRUE
132) TRUE
133) TRUE
134) TRUE
135) FALSE
136) FALSE
137) FALSE
138) A
139) C
140) B
141) A
142) B
143) A
144) A
145) A
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) 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.
148) 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.
149) 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.
150) 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.
151) 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.
34
Answer Key
Testname: 23
152) 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.
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) 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.
35
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) It is important to ensure that your diet is adequately rich in vitamins because ________.
A) most vitamins are coenzymes needed to help the body utilize essential nutrients
B) all vitamins are water soluble and pass out of the body too quickly to ensure utilization
C) vitamins provide protection against the common cold
D) very few foods contain vitamins
1)
2) Conditions that promote the oxidative deamination and energy use of amino acids include
________.
A) adequate fat calories to provide adequate ATP formation
B) adequate essential amino acids
C) ammonia combining with oxygen to form urea
D) excessive amounts of protein in the diet
2)
3) The goal of cellular respiration is to _______.
A) convert polymers into monomers
B) convert ADP molecules into ATP molecules
C) generate body heat
D) provide the body with essential vitamins and minerals
3)
4) Glucose can be obtained from ________.
A) protein anabolism
C) lipogenesis
4)
B) glycogenolysis
D) triglyceride anabolism
5) Which of the following food groups are considered good sources of complete proteins?
A) corn, cottonseed oil, soy oil, and wheat germ
B) eggs, milk, yogurt, meat, and fish
C) egg yolk, fish roe (eggs), and grains
D) lima beans, kidney beans, nuts, and cereals
5)
6) 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) gluconeogenesis
B) glycolysis
C) glycogenolysis
D) glycogenesis
6)
7) Which of the following provides a good source of complex carbohydrates?
A) vegetable oil
B) chicken breast
C) grain
7)
8) Which hormone directs essentially all the events of the absorptive state?
A) insulin
B) thyroid hormone
C) growth hormone
D) epinephrine
1
D) fruit
8)
9) The term metabolism is best defined as ________.
A) the sum of all biochemical reactions in the body
B) a measure of carbohydrate utilization, typically involving measurement of calories
C) the length of time it takes to digest and absorb fats
D) the number of calories it takes to keep from shivering on a cold day
9)
10) When sitting on a cold park bench, body heat is transferred to the bench by ________.
A) convection
B) radiation
C) excretion
D) conduction
10)
11) The amount of ________ produced is probably the most important hormonal factor in determining
basal metabolic rate (BMR).
A) ADH
B) thyroxine
C) prolactin
D) norepinephrine
11)
12) Which of the choices below is NOT a mechanism of heat production?
A) enhanced thyroxine release
B) shivering
C) sweating
D) vasoconstriction of cutaneous blood vessels
12)
13) Which of the choices below happens during the absorptive state?
A) No metabolism occurs.
B) Anabolic processes exceed catabolic ones.
C) Catabolic processes exceed anabolic ones.
D) Only glucose metabolism occurs.
13)
14) Which of the following best defines negative nitrogen balance?
A) Protein breakdown exceeds protein synthesis.
B) A negative nitrogen balance is normal and is a way of maintaining homeostasis.
C) It is a condition usually caused by having a diet low in fish and meat.
D) It occurs when amino acids are broken down by liver enzymes and carried to the
bloodstream.
14)
15) Red blood cells lack mitochondria. As a result, ATP production is solely through ________.
A) citric acid (Krebs) cycle
B) glycolysis
C) electron transport chain
D) aerobic respiration
15)
16) When proteins undergo deamination, the waste substance found in the urine is mostly ________.
A) acetyl CoA
B) ketone bodies
C) ammonia
D) urea
16)
17) Which of the following nutrients yield the highest amount of energy per gram when metabolized?
A) fats
B) proteins
C) vitamins and minerals
D) foods and beverages high in caffeine
17)
18) Which of the following is the major role of leptin in the body?
A) increase appetite and food intake
B) protect against weight loss during nutritional deprivation
C) shrink fat stores
D) promote weight loss with activity
18)
19) Transamination is the process whereby the amine group of an amino acid is ________.
A) transferred to acetyl CoA
B) transferred to a keto acid
C) converted to ammonia
D) converted to urea
19)
2
20) Which of the following is a normal consequence of the activation of the heat-promoting center?
A) release of epinephrine
B) vasodilation of cutaneous blood vessels
C) increase in ADH production
D) sympathetic sweat gland activation
20)
21) Which of the following is correct?
A) Glycolysis relies on substrate-level oxidation for the four ATP produced in this pathway.
B) Most ATP from cellular respiration are produced directly in the citric acid (Krebs) cycle.
C) Most of the ATP are produced by substrate-level phosphorylation.
D) Each FADH2 yields about 1.5 ATP via oxidative phosphorylation.
21)
22) Why is external respiration (breathing) necessary for cellular respiration?
A) Inhaled oxygen provides the energy that drives cellular respiration.
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 is necessary for receiving electrons and hydrogen ions from the electron
transport chain.
22)
23) Which of the following does NOT occur in the mitochondria?
A) formation of malic acid from fumaric acid
B) electron transport
C) glycolysis
D) citric acid (Krebs) cycle
23)
24) 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.
A) brain
B) pancreas
C) liver
D) spleen
24)
25) In the liver, the amine group of glutamic acid is removed as ________ in the oxidative state.
A) oxaloacetic acid
B) pyruvic acid
C) ammonia
D) glyceraldehyde
25)
26) Select the correct statement about proteins.
A) All proteins can be synthesized in the body if most of the amino acids are present.
B) Catabolic steroids (hormones) accelerate the rate of protein synthesis.
C) Proteins will be used by most cells for ATP synthesis if insufficient carbohydrates are
ingested.
D) Strict vegetarians need not worry about adequate protein intake, as most vegetables are
almost perfect sources of amino acids.
26)
27) During exercise, increased metabolic activity increases body heat, which then triggers sweating.
Which of the following best describes the function of sweating?
A) sensible evaporation
B) forced convection
C) infrared radiation
D) direct conduction
27)
28) Lipogenesis occurs when ________.
A) glucose levels drop slightly
B) cellular ATP and glucose levels are high
C) there is a shortage of fatty acids
D) excess proteins are transported through the cell membrane
28)
3
29) Which of the following is NOT an important function of the liver?
A) carbohydrate and lipid metabolism
B) protein metabolism
C) synthesis of bile salts
D) synthesis of vitamin K
30) Oxidative deamination takes place in the ________.
A) muscles
B) liver
C) brain
29)
D) blood
30)
31) Which of the following is NOT true of beta oxidation?
A) Fatty acids are broken into acetic acid fragments.
B) It occurs in the mitochondria.
C) It involves the anabolism of fats.
D) The carbon in the beta (third) position is oxidized during the process.
31)
32) The process of breaking triglycerides down into glycerol and fatty acids is known as ________.
A) gluconeogenesis
B) glycogenesis
C) lipolysis
D) lipogenesis
32)
33) When blood is cooler than the hypothalamic set point, the person may ________.
A) pant
B) shiver
C) perspire heavily
D) exhibit vasodilation of skin vessels
33)
34) Catabolism of food molecules involves ________.
A) dehydration reactions
C) hydrolysis reactions
B) synthesis reactions
D) glycogenesis
34)
35) The most abundant dietary lipids are ________.
A) triglycerides
B) phospholipids
C) cholesterol
D) fatty acids
35)
36) 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) chromium
B) fluorine
C) iron
D) iodine
36)
37) Which of the choices below describes the pathway of cellular respiration (the complete oxidation of
glucose)?
A) glycolysis, citric acid (Krebs) cycle, electron transport chain, oxidative phosphorylation
B) glycogenesis, lipogenesis, electron transport chain
C) gluconeogenesis, citric acid (Krebs) cycle, lipolysis
D) lipolysis, glycogenolysis, beta oxidation
37)
38) 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 some hormones
C) production of enzymes, clotting factors, and antibodies
D) production of energy
38)
39) What process primes a molecule to change in a way that increases its activity, produces motion, or
does work?
A) phosphorylation
B) cellular respiration
C) beta oxidation
D) glycolysis
39)
4
40) Which of the choices below is NOT a fate of carbohydrate taken into the body?
A) lipogenesis
B) direct conversion to a nucleic acid
C) amino acid synthesis
D) glycogenesis
E) ATP production
40)
41) 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) insulin
B) cortisol
C) glucagon
D) thyroxine
41)
42) At the conclusion of glycolysis, most of glucose's chemical energy is found in the ________.
A) acetyl CoA
B) ATP
C) NADH
D) pyruvic acid molecules
42)
43) 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 E
B) vitamin D
C) vitamin A
D) vitamin C
43)
44) Catabolism would be best described as a process that ________.
A) causes a decline in circulating ketone bodies
B) elevates glucagon levels
C) breaks down complex structures to simpler ones
D) builds up triglycerides during the postabsorptive state
44)
45) Glycolysis is best defined as a catabolic reaction based upon the ________.
A) conversion of glucose into two molecules of pyruvic acid
B) conversion of glucose into carbon dioxide and water
C) conversion of pyruvic acid into carbon dioxide and water
D) formation of sugar
45)
46) A recent health screening revealed a low-density-lipoprotein (LDL) level over 130. Which of the
following should be prescribed?
A) glucagon
B) iron
C) statins
D) insulin
46)
47) What is the outcome of ketosis?
A) water retention and edema
B) glucogenesis
C) metabolic acidosis
D) metabolic alkalosis
E) glycogen buildup
47)
48) Which of the following is NOT true of the basal metabolic rate (BMR)?
A) It represents the amount of energy the body needs to perform only essential functions.
B) It should account for body surface area.
C) It is measured when the subject is reclining and at rest.
D) It is best calculated when the subject is in the absorptive state.
48)
5
49) Which type of food molecule provides components for cellular structures like plasma membranes,
myelin sheaths, and steroid hormones?
A) protein
B) lipids
C) complex carbohydrates
D) glucose
49)
50) 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) meets all the minimum daily requirements for a healthy diet
D) derived from meat and fish only
50)
51) Glycogen is formed in the liver during the ________.
A) absorptive state
B) starvation period
C) period when the metabolic rate is lowest
D) postabsorptive state
51)
52) Gluconeogenesis is the process in which ________.
A) glycogen is formed
B) glucose is formed from noncarbohydrate molecules
C) glucose is converted into carbon dioxide and water
D) glycogen is broken down to release glucose
52)
53) When ketone bodies are present in the blood and urine in large amounts, it usually indicates
increased metabolism of ________.
A) fatty acids
B) glycogen
C) lactic acid
D) amino acids
53)
54) Which of the following mechanisms produces the most ATP during cellular respiration?
A) substrate-level phosphorylation
B) lactic acid production
C) oxidation reactions
D) oxidative phosphorylation
54)
55) Cholesterol, though it is NOT an energy molecule, has importance in the body because it ________.
A) is a stabilizing component of the plasma membranes and is the parent molecule of steroid
hormones
B) helps mobilize fats during periods of starvation
C) helps provide essential nutrients to the brain and lungs
D) enters the glycolytic pathway without being altered
55)
56) Which of the following is NOT a function of low-density-lipoproteins (LDLs)?
A) make cholesterol available to tissue cells for membrane formation
B) make cholesterol available to tissue cells for hormone synthesis
C) transport cholesterol from the peripheral tissues to the liver
D) assist in the storage of cholesterol when supply exceeds demand
56)
57) Heat-loss enhancing mechanisms do NOT include ________.
A) the evaporation of sweat
B) behavior measures such as wearing light, loose clothing
C) reducing activity
D) vasoconstriction of peripheral blood vessels
57)
58) The "thermostat" or temperature regulator of the body is the ________.
A) thyroid
B) thalamus
C) pituitary
6
D) hypothalamus
58)
59) The ingestion of which nutrient type results in the greatest food-induced thermogenesis?
A) lipids
B) proteins
C) carbohydrates
D) vitamins
59)
60) Minerals required by the body in moderate amounts include all of the following EXCEPT ________.
A) sodium and chlorine
B) sulfur and potassium
C) calcium and phosphorus
D) iron and selenium
60)
61) In gluconeogenesis, during the postabsorptive state, amino acids and ________ are converted to
glucose.
A) glucagon
B) glycogen
C) glycerol
D) acetyl Co A
61)
62) 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.
62)
63) In an oxidation-reduction reaction, the "reduced" reactant ________.
A) loses energy
B) loses hydrogen ions
C) gains electrons
D) gains negatively charged ions
63)
64) Which of the choices below is NOT a source of blood glucose during the postabsorptive state?
A) lipolysis in adipose tissues and the liver
B) absorption of glucose from the GI tract
C) catabolism of cellular protein
D) glycogenolysis in the liver
64)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
65) 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?
65)
66) 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.
66)
67) Define amino acid pool and explain how the pool is maintained even though we excrete
amino acids daily.
67)
7
Figure 24.1
Using Figure 24.1, match the following:
68) Contains ATP synthase rotor rings.
68)
69) ATP formed by oxidative phosphorylation.
69)
70) Involves sugar activation, sugar cleavage, oxidation, and ATP formation.
70)
71) 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.
71)
8
Figure 24.1
Using Figure 24.1, match the following:
72) Where the hydrogen atoms removed during the oxidation of food fuels are combined
with O2.
72)
73) Explain what happens to pyruvic acid if oxygen is not present in sufficient quantities to
support the electron transport system.
73)
74) Define nitrogen balance. List three factors that might lead to negative nitrogen balance and
three that might result in positive nitrogen balance.
74)
9
Figure 24.1
Using Figure 24.1, match the following:
75) Produces the CO2 involved during glucose oxidation.
75)
76) What is the significance of the fact that monosaccharides are phosphorylated immediately
upon entry into cells?
76)
10
Figure 24.1
Using Figure 24.1, match the following:
77) Occurs via substrate-level phosphorylation.
77)
78) How is the postabsorptive state controlled and initiated?
78)
79) What is obesity, and what health problems accompany or follow its onset?
79)
11
Figure 24.1
Using Figure 24.1, match the following:
80) Ten-step enzymatically driven process that converts glucose into pyruvic acid.
80)
81) What are the four mechanisms of heat exchange and how are they defined?
81)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
82) Diets high in cholesterol and saturated fats tend to produce high HDL concentrations.
82)
83) The most abundant dietary lipids in the diets of most Americans are triglycerides.
83)
84) The amount of protein needed by each person is determined by their age, size, metabolic rate, and
the need to build new proteins.
84)
85) For use as fuel, all food carbohydrates are eventually transformed to glucose.
85)
86) Triglycerides and cholesterol do NOT circulate freely in the bloodstream.
86)
87) 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.
87)
12
88) Glycogen accounts for 80-85% of stored energy in the body.
88)
89) The body is considered to be in nitrogen balance when the amount of nitrogen ingested in lipids
equals the amount excreted in urine.
89)
90) There are no nutritionally complete proteins. All animal products should be eaten with plant
material to make a nutritionally complete protein.
90)
91) Processes that break down complex molecules into simpler ones are described as anabolic.
91)
92) Ghrelin, produced by the stomach, is a powerful appetite stimulant.
92)
93) Vitamins are inorganic compounds that are essential for growth and good health.
93)
94) 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.
94)
95) The preferred energy fuel for the brain is fat.
95)
96) It would not be healthy to eliminate all fats from your diet because they serve a useful purpose in
maintaining the body.
96)
97) The primary function of dietary protein is energy production within cells.
97)
98) The major role of high-density lipoproteins (HDLs) is to store energy in the form of fat.
98)
99) Glucose sparing refers to the use of noncarbohydrate fuel molecules in the post absorptive state.
99)
100) High levels of HDLs are considered good.
100)
101) In order for amino acids to be oxidized for energy, the amine group (NH2 ) must be removed.
101)
102) Except for lactose and some glycogen, the carbohydrates we ingest are mainly from animals.
102)
103) Peptides called NPY (neuropeptide Y) and AgRP (agouti-related peptides) are powerful appetite
enhancers.
103)
104) The increased use of noncarbohydrate molecules for energy to conserve glucose is called glucose
sparing.
104)
105) Cellular respiration is an anabolic process.
105)
106) 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.
106)
107) Beta oxidation is the initial phase of fatty acid oxidation, and it occurs in the cytoplasm.
107)
13
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
108) Glucose serves as the initial reactant.
A) Glycolysis
108)
Match the following:
109) Formation of ketone bodies.
A) Ketogenesis
109)
Match the following:
110) Heat loss during sweating.
A) Evaporation
111) Heat transfer into the chair you are
sitting on.
B) Conduction
110)
111)
Match the following:
112) Involves the removal of hydrogen
electrons and CO2 from the substrate
A) Citric acid (Krebs) cycle
112)
molecule.
Match the following:
113) Breakdown of glucose to pyruvic acid.
A) Glycolysis
113)
Match the following:
114) Occurs in the cytosol of a cell.
A) Glycolysis
114)
Match the following:
115) Splitting of triglycerides into glycerol
and fatty acids.
116) Synthesis of lipids from glucose or
amino acids.
A) Lipolysis
115)
B) Lipogenesis
116)
Match the following:
117) Heat loss in the form of infrared
waves.
A) Radiation
117)
Match the following:
118) Involves the use of oxygen to pick up
excess hydrogen and electrons.
A) Electron transport chain
119) Produces the most ATP.
118)
119)
14
Match the following:
120) Conversion of fatty acids into acetyl
groups.
A) Beta oxidation
120)
Match the following:
121) Heat exchange when you are under a
ceiling fan.
A) Convection
121)
Match the following:
122) Breakdown of glycogen to release
glucose.
123) Formation of glucose from proteins or
fats.
A) Glycogenolysis
122)
B) Glycogenesis
C) Gluconeogenesis
124) Storage of glucose in the form of
glycogen.
123)
124)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
125) 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.
126) 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.
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 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?
129) What are four possible complications of obesity from a medical standpoint?
130) 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.
15
131) 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.
16
Answer Key
Testname: 24
1) A
2) D
3) B
4) B
5) B
6) D
7) C
8) A
9) A
10) D
11) B
12) C
13) B
14) A
15) B
16) D
17) A
18) A
19) B
20) A
21) D
22) D
23) C
24) A
25) C
26) C
27) A
28) B
29) D
30) B
31) C
32) C
33) B
34) C
35) A
36) D
37) A
38) D
39) A
40) B
41) C
42) D
43) C
44) C
45) A
46) C
47) C
48) D
49) B
50) B
17
Answer Key
Testname: 24
51) A
52) B
53) A
54) D
55) A
56) C
57) D
58) D
59) B
60) D
61) C
62) D
63) C
64) B
65) 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.
66) 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.
67) 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.
68) C
69) E
70) A
71) 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.
72) C
73) 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.
74) 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.
75) B
76) 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.
77) D
78) 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.
79) 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.
18
Answer Key
Testname: 24
80) A
81) (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.
82) FALSE
83) TRUE
84) TRUE
85) TRUE
86) TRUE
87) FALSE
88) FALSE
89) FALSE
90) FALSE
91) FALSE
92) TRUE
93) FALSE
94) TRUE
95) FALSE
96) TRUE
97) FALSE
98) FALSE
99) TRUE
100) TRUE
101) TRUE
102) FALSE
103) TRUE
104) TRUE
105) FALSE
106) TRUE
107) FALSE
108) A
109) A
110) A
111) B
112) A
113) A
114) A
115) A
116) B
117) A
118) A
119) A
120) A
121) A
122) C
123) A
124) B
125) Ketosis leads to metabolic acidosis. The deep, rapid respirations were the body's attempt to compensate for the
extremely low pH by blowing off CO2 , resulting in less carbonic acid that in turn caused pH to rise.
19
Answer Key
Testname: 24
126) 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.
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) 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.
129) Obesity contributes to insulin resistance and type 2 diabetes mellitus; the obese also have a higher incidence of
atherosclerosis, hypertension, heart disease, and osteoarthritis.
130) 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.
131) 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.
20
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) What is the best explanation for the microvilli on the apical surface of the proximal convoluted
tubule (PCT)?
A) They increase the amount of surface area that comes in contact with the blood's plasma to
help actively excrete toxins.
B) They hold on to enzymes that cleanse the filtrate before reabsorption.
C) Their movements propel the filtrate through the tubules.
D) They increase the surface area and allow for a greater volume of filtrate components to be
reabsorbed.
1)
2) Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________.
A) passive transport
B) secondary active transport
C) countertransport
D) facilitated diffusion
2)
3) Which of the following is NOT reabsorbed by the proximal convoluted tubule?
A) K+
B) creatinine
C) Na+
D) glucose
3)
4) The ________ artery lies on the boundary between the cortex and medulla of the kidney.
A) cortical radiate
B) interlobar
C) lobar
D) arcuate
4)
5) Which of the following is the best explanation for why the cells of the proximal convoluted tubule
(PCT) contain so many mitochondria?
A) Cells of the PCT go through a great deal of mitosis.
B) Contraction of the PCT moves filtrate through the tubule.
C) A great deal of active transport takes place in the PCT.
D) This provides the energy needed to fight kidney infection.
5)
6) Select the correct statement about the nephrons.
A) Podocytes are the branching epithelial cells that line the tubules of the nephron.
B) Filtration slits are the pores that give fenestrated capillaries their name.
C) The glomerulus is correctly described as the proximal end of the proximal convoluted tubule.
D) The parietal layer of the glomerular capsule is simple squamous epithelium.
6)
7) The mechanism that establishes the medullary osmotic gradient depends most on the permeability
properties of the ________.
A) collecting duct
B) distal convoluted tubule
C) nephron loop
D) glomerular filtration membrane
7)
8) Select the correct statement about the ureters.
A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine.
B) The ureters are capable of peristalsis like that of the gastrointestinal tract.
C) The ureter is innervated by parasympathetic nerve endings only.
D) The epithelium is stratified squamous like the skin, which allows a great deal of stretch.
8)
9) Which of the following is NOT a part of the juxtaglomerular complex?
A) mesangial cells
B) podocyte cells
C) macula densa
9)
1
D) granular cells
10) An important physical characteristic of urine is its specific gravity or density, which is ________.
A) slightly higher than water
B) much higher than water
C) less than water
D) the same as water
10)
11) 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) The relatively small size of steroid hormones allows them to easily pass back into the
peritubular capillaries if released into the filtrate.
C) The large size of the steroid hormones prevents them from passing through the filtration
membrane.
D) Steroid hormones are absorbed by target cells before they can reach the kidneys.
11)
12) Which of the choices below is the salt level-monitoring part of the nephron?
A) vasa recta
B) nephron loop
C) macula densa
12)
D) principal cell
13) The presence of protein in the urine indicates which of the following?
A) damage to the renal tubules
B) damage to the filtration membrane
C) too much protein in the diet
D) high levels of transcription and translation by the bodies tissues
13)
14) Which of the following acts as the trigger for the initiation of micturition (voiding)?
A) the sympathetic efferents
B) the pressure of the fluid in the bladder
C) the stretching of the bladder wall
D) motor neurons
14)
15) Excretion of dilute urine requires ________.
A) transport of sodium and chloride ions out of the descending nephron loop
B) relative permeability of the distal tubule to water
C) the presence of ADH
D) impermeability of the collecting tubule to water
15)
16) What is the effect of antidiuretic hormone on the cells of the collecting duct?
A) triggers synthesis of more sodium channels in the apical membranes
B) triggers synthesis of more potassium channels in the apical membranes
C) causes aquaporins to be inserted into the apical membranes
D) inhibits sodium reabsorption through the apical membranes
16)
17) 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
17)
2
18) 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 diameter of the efferent arteriole is smaller than the afferent arteriole.
B) The volume of plasma in the efferent arteriole is higher when compared to the afferent
arteriole.
C) The efferent arteriole has higher resistance to blood flow than the afferent arteriole.
D) The flow of blood is reduced as blood reaches the efferent arteriole.
18)
19) 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) higher osmotic pressure in the peritubular capillary
B) leaky tight junctions of peritubular capillary's endothelium
C) lower hydrostatic pressure in the peritubular capillary
D) increased resistance to blood flow at the efferent arteriole
19)
20) The kidneys are stimulated to produce renin ________.
A) when the pH of the urine decreases
B) when the specific gravity of urine rises above 1.10
C) when the peritubular capillaries are dilated
D) by a decrease in the blood pressure
20)
21) The fluid in glomerular capsule is similar to plasma except that it does NOT contain a significant
amount of ________.
A) electrolytes
B) hormones
C) glucose
D) plasma protein
21)
22) Which of the following hormones acting on the collecting duct is most responsible for retaining
sodium ions in the blood?
A) parathyroid hormone
B) atrial natriuretic peptide
C) aldosterone
D) antidiuretic hormone
22)
23) In the ascending limb of the nephron loop the ________.
A) thin segment is not permeable to sodium and chloride
B) thin segment is freely permeable to water
C) thick segment is permeable to water
D) thick segment moves ions out into interstitial spaces for reabsorption
23)
24) Which of the choices below is NOT a function of the urinary system?
A) helps maintain homeostasis by controlling the composition, volume, and pressure of blood
B) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat
C) regulates blood glucose levels and produces hormones
D) maintains blood osmolarity
24)
3
25) 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) loss of K+ leak channels at the apical surface
25)
B) loss of Na+ -K+ ATPase in the basolateral surface of PCT cells
C) increasing Na+ in the interstitial fluid
D) increasing Na+ concentration in the filtrate
26) Which of the choices below is NOT a method by which the cells of the renal tubules can raise blood
pH?
A) by producing new bicarbonate ions
B) by reabsorbing filtered bicarbonate ions
C) by secreting sodium ions
D) by secreting hydrogen ions into the filtrate
26)
27) 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
27)
28) 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 excretion by the kidneys
C) help regulate blood pressure and the rate of blood filtration by the kidneys
D) help regulate water and electrolyte excretion by the kidneys
28)
29) The thin segment of the nephron loop's descending limb ________.
A) aids in the passive movement of water out of the tubule
B) aids in the passive excretion of nitrogenous waste
C) helps to pack a greater number of nephron loops into a smaller space
D) is easily broken and replaced often
29)
30) An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________.
A) decrease in the concentration of the blood plasma
B) increase in the production of aldosterone
C) increase in the production of ADH
D) decrease in the production of ADH
30)
31) If one says that the clearance value of glucose is zero, what does this mean?
A) The clearance value of glucose is relatively high in a healthy adult.
B) 100% of glucose is reabsorbed.
C) The glucose molecule is too large to be filtered out of the blood.
D) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted
tubules.
31)
32) The glomerular capsular space contains ________.
A) plasma
B) blood
32)
C) filtrate
4
D) urine
33) 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) Glomerular filtration rate (GFR) will decrease.
B) Net filtration pressure (NFP) will decrease.
C) Kidney perfusion will increase.
D) Blood plasma and extracellular fluids volume will increase.
33)
34) Which of the following is NOT associated with the renal corpuscle?
A) a podocyte
B) a fenestrated capillary
C) an efferent arteriole
D) a vasa recta
34)
35) Which of the following is incorrect?
A) Urine concentration and volume are determined by countercurrent mechanisms
B) The kidneys produce a large volume of dilute urine when overhydrated.
C) The kidneys produce a small volume of concentrated urine when dehydrated.
D) The concentration of urine is lower when urine volume is reduced.
35)
36) Which of the following does NOT describe the juxtaglomerular complex?
A) Its macula densa cells produce aldosterone.
B) Its granular cells produce rennin.
C) It regulates the rate of filtrate formation.
D) It helps control systemic blood pressure.
36)
37) Which of the choices below is NOT a glomerular filtration rate control method?
A) electrolyte levels
B) hormonal regulation
C) neural regulation
D) renal autoregulation
37)
38) The functional and structural unit of the kidneys is the ________.
A) nephron loop
B) glomerular capsule
C) nephron
D) capsular space
38)
39) What would happen if the capsular hydrostatic pressure were increased above normal?
A) Filtration would increase in proportion to the increase in capsular pressure.
B) Net filtration would increase above normal.
C) Capsular osmotic pressure would compensate so that filtration would not change.
D) Net filtration would decrease.
39)
40) The filtration membrane includes all EXCEPT ________.
A) basement membrane
B) glomerular endothelium
C) renal fascia
D) podocytes
40)
41) If the glomerular mesangial cells contract, reducing the overall surface area of the glomerulus,
which of the following is NOT likely to occur?
A) Glomerular filtration rate will decrease.
B) Net filtration rate will decrease.
C) Urine output will decrease.
D) Systemic blood pressure will be lowered.
41)
5
42) The chief force pushing water and solutes out of the blood across the filtration membrane is
________.
A) protein-regulated diffusion
B) the ionic electrochemical gradient
C) the size of the pores in the basement membrane of the capillaries
D) glomerular hydrostatic pressure (glomerular blood pressure)
42)
43) Which of the choices below are the most important hormone regulators of electrolyte reabsorption
and secretion?
A) angiotensin II and ADH
B) angiotensin I and epinephrine
C) angiotensin I and atrial natriuretic peptide
D) angiotensin II and aldosterone
43)
44) The macula densa cells respond to ________.
A) changes in Na+ content of the filtrate
44)
B) antidiuretic hormone
C) aldosterone
D) changes in pressure in the tubule
45) Alcohol acts as a diuretic because it ________.
A) is not reabsorbed by the tubule cells
C) increases secretion of ADH
B) inhibits the release of ADH
D) increases the rate of glomerular filtration
45)
46) Which of the following statements best describes the difference between the intrinsic and extrinsic
controls of the kidney?
A) Extrinsic controls have the greatest effect on systemic blood pressure while intrinsic controls
have a greater effect on GFR.
B) Extrinsic controls will reduce blood plasma volume while intrinsic controls will increase
blood plasma volumes.
C) Intrinsic controls raise blood pressure while extrinsic controls lower blood pressure.
D) Extrinsic and intrinsic controls work in nearly opposite ways.
46)
47) The mechanism of water reabsorption by the renal tubules is ________.
A) osmosis
B) active transport
C) filtration
D) cotransport with sodium ions
47)
48) If the diameter of the afferent arterioles leading to the glomerulus decreases (vasoconstriction),
which of the following is NOT likely to occur?
A) Net filtration pressure will decrease.
B) Glomerular filtration rate will decrease.
C) Urine output will decrease.
D) Systemic blood pressure will decrease.
48)
49) If the diameter of the efferent arterioles leading away from the glomerulus increases (vasodilation),
which of the following is NOT likely to occur?
A) Urine output will decrease.
B) Systemic blood pressure will decrease.
C) Glomerular filtration rate will decrease.
D) Net filtration pressure will decrease.
49)
6
50) Cells and transport proteins are physically prevented from passing through the filtration
membrane. This has the following effect on filtration.
A) increased osmotic pressure in the filtrate that draws plasma through the membrane
B) increasing osmotic pressure in the glomerular capillaries that reduces the amount of filtration
C) decreased osmotic pressure in the filtrate that increases the amount of filtration
D) neutral change in osmotic pressure with no effect on filtration
50)
51) The factor that promotes filtrate formation at the glomerulus is the ________.
A) glomerular hydrostatic pressure
B) myogenic mechanism
C) capsular hydrostatic pressure
D) colloid osmotic pressure of the blood
51)
52) The renal corpuscle is made up of ________.
A) the descending nephron loop
C) the renal pyramid
52)
B) the renal papilla
D) Bowman's capsule and glomerulus
53) 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) is impermeable to most substances
D) has a basement membrane
53)
54) The function of angiotensin II is to ________.
A) decrease water absorption
B) constrict arterioles and increase blood pressure
C) decrease arterial blood pressure
D) decrease the production of aldosterone
54)
55) Except for potassium ions, tubular secretion of most unwanted substances occurs in the ________.
A) proximal convoluted tubule
B) collecting duct
C) distal convoluted tubule
D) nephron loop
55)
56) The urinary bladder is composed of ________ epithelium.
A) stratified squamous
B) simple squamous
C) pseudostratified columnar
D) transitional
56)
57) If the diameter of the efferent arterioles leading away from the glomerulus decreases
(vasoconstriction), which of the following is NOT likely to occur?
A) Urine output will increase.
B) Systemic blood pressure will go up.
C) Glomerular filtration rate will increase.
D) Net filtration pressure will increase.
57)
58) If the diameter of the afferent arterioles leading to the glomerulus increases (vasodilation), which of
the following is NOT likely to occur?
A) Urine output will increase.
B) Systemic blood pressure will go up.
C) Glomerular filtration rate will increase.
D) Net filtration pressure will increase.
58)
59) 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) is not permeable to water
D) contains fluid that becomes more concentrated as it moves down into the medulla
59)
7
60) Place the following in correct sequence from the formation of a drop of urine to its elimination from
the body.
60)
1. major calyx
2. minor calyx
3. nephron
4. urethra
5. ureter
6. collecting duct
A) 6, 3, 2, 1, 5, 4
B) 3, 6, 2, 1, 5, 4
C) 2, 1, 3, 6, 5, 4
D) 3, 1, 2, 6, 5, 4
61) Glomerular filtration rate can be controlled by manipulating one major variable, which is ________.
A) activation of sympathetic nerve fibers
B) the renin-angiotensin-aldosterone mechanism
C) glomerular hydrostatic pressure
D) systemic blood pressure
61)
62) Which of the hormones below is responsible for facultative water reabsorption?
A) atrial natriuretic peptide
B) thyroxine
C) ADH
D) aldosterone
62)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
63) 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.
63)
64) Explain how filtration works in the glomerular capillaries.
64)
8
Figure 25.2
Using Figure 25.2, match the following:
65) Podocyte.
65)
66) List and describe three pressures operating at the filtration membrane, and explain how
each influences net filtration pressure.
66)
67) The area between the ureters and urethra that is often the location of infection is called the
________ in a bladder.
67)
9
Figure 25.1
Using Figure 25.1, match the following:
68) Afferent arteriole.
68)
10
Figure 25.2
Using Figure 25.2, match the following:
69) Almost no water is absorbed in these cells.
69)
70) Is composed of simple squamous epithelium.
70)
11
Figure 25.1
Using Figure 25.1, match the following:
71) Peritubular capillaries.
71)
72) The ________ mechanism is the general tendency of vascular smooth muscle to contract
when stretched.
72)
12
Figure 25.1
Using Figure 25.1, match the following:
73) Which label marks a structure at the medulla of the kidney?
73)
74) The presence of pus in the urine is a condition called ________.
74)
75) What are aquaporins?
75)
13
Figure 25.1
Using Figure 25.1, match the following:
76) Nephron loop.
76)
77) Collecting duct.
77)
78) Sodium-linked water flow across a membrane not under hormonal control is called
________ water reabsorption.
78)
14
Figure 25.2
Using Figure 25.2, match the following:
79) Cells that reabsorb virtually all the nutrients.
79)
80) The need to get up in the middle of the night to urinate is called ________.
80)
15
Figure 25.2
Using Figure 25.2, match the following:
81) Collecting duct cells.
81)
16
Figure 25.1
Using Figure 25.1, match the following:
82) Structure most closely associated with granular cells.
17
82)
Figure 25.2
Using Figure 25.2, match the following:
83) Cells that are most affected by ADH.
83)
84) Explain what is meant by the terms cotransport process and transport maximum.
84)
18
Figure 25.2
Using Figure 25.2, match the following:
85) Filtrate at the site of these cells is about the same osmolarity as blood plasma.
85)
86) Cells that are the most active in reabsorbing the filtrate.
86)
87) List three substances that are abnormal urinary constituents and provide the proper
clinical term for such abnormalities.
87)
88) Freshly voided urine has very little smell, but shortly after voiding it can give off a very
strong smell. Why?
88)
19
Figure 25.1
Using Figure 25.1, match the following:
89) Glomerulus.
89)
90) Explain the role of aldosterone in sodium and water balance.
90)
91) ADH activated water channels called ________ are essential for water reabsorption in the
collecting duct.
91)
20
Figure 25.2
Using Figure 25.2, match the following:
92) Proximal convoluted tubule cells.
92)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
93) Glomerular filtration is an ATP-driven process.
93)
94) The act of emptying the bladder is called voiding.
94)
95) 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.
95)
96) Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve
body water.
96)
97) Having a kinked ureter is called renal ptosis.
97)
98) 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.
98)
21
99) Blood in the urine may be a symptom of bladder cancer.
99)
100) 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.
100)
101) In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to
water.
101)
102) Cortical nephrons are responsible for producing concentrated urine.
102)
103) The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct.
103)
104) Tubular secretion is effective in controlling blood pH.
104)
105) An excessive urine output is called anuria.
105)
106) Atrial natriuretic peptide inhibits sodium reabsorption.
106)
107) The macula densa cells are chemoreceptors that respond to changes in the urea content of the
filtrate.
107)
108) Both the male and female urethras serve both the urinary and the reproductive systems.
108)
109) The urethra contains an internal sphincter of smooth muscle.
109)
110) The trigone is so named because of the shape of the urinary bladder.
110)
111) The entire responsibility for urine formation lies with the nephron.
111)
112) The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the
term retroperitoneal.
112)
113) The collecting duct is impermeable to water in the presence of ADH.
113)
114) Salt is actively transported out of the filtrate in the nephron loop.
114)
115) Obligatory water reabsorption involves the movement of water along an osmotic gradient.
115)
116) High blood pressure triggers granular cells of the juxtaglomerular complex to release renin.
116)
117) Incontinence is the inability to control voluntary micturition.
117)
118) Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate.
118)
119) The myogenic mechanism reflects the tendency of vascular smooth muscle to stretch.
119)
22
120) The path urine takes after it is formed until it leaves the body is the urethra, urinary bladder, and
finally the ureter.
120)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
121) Glomerulus.
A) Site of filtrate formation
121)
Match the following:
122) Play a role in urine concentration.
A) Peritubular capillaries
123) May form meandering vessels or
bundles of long straight vessels.
B) Vasa recta
124) Low pressure, porous vessels that
reabsorb solutes and water from the
tubule cells.
122)
123)
C) Efferent arterioles
124)
Match the following:
125) Proximal convoluted tubule.
A) Site at which most of the tubular
reabsorption occurs
125)
Match the following:
126) Fenestrated vessels that allow passage
of all plasma elements but not blood
cells.
A) Glomerular capillaries
126)
Match the following:
127) Peritubular capillaries.
A) Blood supply that directly receives
substances from the tubular cells
127)
Match the following:
128) High pressure vessel that forces fluid
and solutes into the glomerular
capsule.
A) Afferent arterioles
128)
Match the following:
129) Collecting duct.
A) Site that drains the distal convoluted
tubule
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
130) What clinical effects would low blood pressure have on the kidneys of a burn patient?
23
129)
131) 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.
132) 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.
133) Explain how an angiotensin converting enzyme inhibitor (ACE inhibitor) such as captopril would be effective as
an antihypertensive.
134) 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.
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) 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?
137) 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?
24
Answer Key
Testname: 25
1) D
2) B
3) B
4) D
5) C
6) D
7) C
8) B
9) B
10) A
11) A
12) C
13) B
14) C
15) D
16) C
17) B
18) B
19) B
20) D
21) D
22) C
23) D
24) B
25) B
26) C
27) A
28) C
29) A
30) C
31) B
32) C
33) C
34) D
35) D
36) A
37) A
38) C
39) D
40) C
41) D
42) D
43) D
44) A
45) B
46) A
47) A
48) D
49) B
50) B
25
Answer Key
Testname: 25
51) A
52) D
53) B
54) B
55) A
56) D
57) B
58) B
59) D
60) B
61) C
62) C
63) 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.
64) 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.
65) B
66) 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.
67) trigone
68) A
69) D
70) A
71) D
72) myogenic
73) E
74) pyuria
75) Aquaporins are transmembrane proteins that form water-filled pores in water-permeable portions of the convoluted
tubules such as the PCT and collecting duct.
76) E
77) B
78) obligatory
79) E
80) nocturia
81) C
82) A
83) C
84) 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.
85) E
86) E
87) 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).
26
Answer Key
Testname: 25
88) 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.
89) C
90) 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.
91) aquaporins
92) E
93) FALSE
94) TRUE
95) TRUE
96) FALSE
97) FALSE
98) FALSE
99) TRUE
100) TRUE
101) TRUE
102) FALSE
103) FALSE
104) TRUE
105) FALSE
106) TRUE
107) FALSE
108) FALSE
109) TRUE
110) FALSE
111) TRUE
112) TRUE
113) FALSE
114) TRUE
115) TRUE
116) FALSE
117) TRUE
118) TRUE
119) FALSE
120) FALSE
121) A
122) B
123) C
124) A
125) A
126) A
127) A
128) A
129) A
27
Answer Key
Testname: 25
130) 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.
131) 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.
132) 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.
133) 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.
134) 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.
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) 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.
137) 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.
28
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) When antidiuretic hormone (ADH) levels are low, ________.
A) most of the water reaching the collecting ducts is not reabsorbed
B) aquaporins are inserted into the collecting duct principal cell apical membranes
C) a small volume of concentrated urine is excreted
D) nearly all of the filtered water is reabsorbed
1)
2) The regulation of sodium ________.
A) is linked to blood pressure
B) is due to specific sodium receptors in the hypothalamus
C) involves hypothalamic osmoreceptor detection of ion concentration
D) involves aldosterone, a hormone that increases sodium excretion in the kidneys
2)
3) The regulation of potassium balance ________.
A) includes renal secretion, but never absorption
B) is accomplished mainly by hepatic mechanisms
C) involves aldosterone-induced secretion of potassium
D) is not linked to sodium balance
3)
4) Total body water is NOT a function of which of the following?
A) body mass
B) amount of body fat
C) age
D) amount of water ingested
4)
5) The single most important factor influencing potassium ion secretion is ________.
A) the potassium ion content in the renal tubule cells
B) potassium ion concentration in extracellular fluid
C) the pH of the intracellular fluid
D) intracellular sodium levels
5)
6) 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) aerobic metabolism of glucose
D) metabolism of fats
6)
7) 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) follicle-stimulating hormone
B) progesterone
C) luteinizing hormone
D) estrogen
7)
8) In the case of edema, excess fluid is held in which fluid compartment(s)?
A) intracellular fluid and interstitial fluid
B) intracellular fluid
C) interstitial fluid
D) blood plasma
8)
1
9) 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) hyponatremia; very low extracellular sodium ion concentration
C) hypoproteinemia; unusually low levels of plasma proteins
D) dehydration
9)
10) The movement of fluids between cellular compartments ________.
A) requires active transport
B) requires ATP for the transport to take place
C) is regulated by osmotic and hydrostatic forces
D) always involves filtration
10)
11) The maintenance of the proper pH of the body fluids may be the result of ________.
A) the operation of the various buffer systems in the stomach
B) the control of respiratory ventilation
C) the active secretion of OH- into the filtrate by the kidney tubule cells
D) control of the acids produced in the stomach
11)
12) The most important force causing net outward water flow across capillary walls is ________.
A) intracellular hydrostatic pressure
B) osmotic pressure of plasma proteins
C) hydrostatic pressure of interstitial fluid
D) hydrostatic pressure of capillary blood
12)
13) Which of the following hormones is important in the regulation of sodium ion concentrations in the
extracellular fluid?
A) renin
B) aldosterone
C) erythropoietin
D) antidiuretic hormone
13)
14) Falling arterial blood pressure promotes ________.
A) enhanced water loss in urine
C) enhanced sodium ion loss in urine
14)
B) vasodilation
D) vasoconstriction
15) Which of the choices below exerts primary control over sodium levels in the body?
A) glucocorticoids
B) water levels
C) ADH
D) aldosterone
15)
16) Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the
intracellular fluid.
A) potassium
B) bicarbonate
C) iron
D) chloride
16)
17) 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) equal amounts of each ion in the cells and body fluids
C) little of either in the cells, but large amounts of each in the body fluids
D) K+ mainly in the cells, Na+ in the body fluids
17)
2
18) Amphoteric molecules _______.
A) trigger pH imbalances and must be neutralized by buffers
B) can function as acids at low pH
C) can function as bases at high pH
D) can function as an acid or a base depending on the pH
18)
19) Which of the following is NOT a trigger for juxtaglomerular granular cells to release renin?
A) decreased filtrate NaCl concentration
B) decreased stretch of the granular cells of the afferent arterioles
C) increased extracellular fluid water levels
D) sympathetic stimulation
19)
20) 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) aldosterone
C) thyroxine
D) atrial natriuretic peptide (ANP)
20)
21) For bulk flow across capillary walls, ________.
A) fluid runs into lymphatic capillaries that empty into the interstitial space
B) hydrostatic pressure of the interstitial space returns fluid to the capillary
C) osmotic pressure of plasma proteins pulls fluid from the capillary into the interstitial space
D) hydrostatic pressure of blood forces nearly protein-free plasma out of the blood into the
interstitial space
21)
22) Which of the following statements is true regarding fluid shifts?
A) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest
ability to cause fluid shifts.
B) Nonelectrolytes are the controlling factor in directing fluid shifts.
C) There are always more positive electrolytes than negative in a solution; it is therefore
impossible to follow fluid shifts.
D) Electrolytes are not as important as proteins in regulating fluid shifts in the body.
22)
23) The term hypotonic hydration refers to ________.
A) a condition that may result from renal insufficiency or drinking excessive amounts of water
B) a condition that is caused by high levels of sodium in the extracellular fluid compartment
C) the feeling one might have after profuse sweating with exertion
D) the unpleasant feeling people have after drinking too much liquor
23)
24) A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or
emphysema indicates ________.
A) metabolic acidosis
B) respiratory alkalosis
C) metabolic alkalosis
D) respiratory acidosis
24)
25) A patient is breathing slowly, and blood pH analysis indicates an abnormally high value. What is
the likely diagnosis?
A) respiratory acidosis
B) metabolic acidosis
C) respiratory alkalosis
D) metabolic alkalosis
25)
3
26) The fluid link between the external and internal environment is ________.
A) cerebrospinal fluid
B) intracellular fluid
C) interstitial fluid
D) plasma
26)
27) Which of the following is NOT a disorder of water balance?
A) hypotonic hydration, in which sodium content is normal but water content is high
B) excessive hydration due to excess atrial natriuretic peptide (ANP) secretion
C) excess water in interstitial spaces due to a low level of plasma proteins
D) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure
27)
28) When a strong acid such as HCl is added to the carbonic acid buffer system, _________.
A) more carbonic acid is formed
B) the blood plasma pH is reduced
C) hydrochloric acid is neutralized by sodium hydroxide
D) carbonic acid is converted into bicarbonate
28)
29) 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 retain bicarbonate ions.
B) Kidneys eliminate carbon dioxide.
C) Kidneys eliminate bicarbonate ions.
D) Kidneys retain hydrogen ions.
29)
30) Which of the following would describe nonelectrolytes?
A) inorganic salts
B) inorganic acids
C) organic bases
D) polar covalent compounds
30)
31) 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) Buffered hydrogen ions are excreted in urine.
B) Bicarbonate ions are reclaimed by tubular reabsorption.
C) Ammonium ions are excreted in urine.
D) Glutamine is metabolized by deamination, oxidation, and acidification.
31)
32) 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) respiratory acidosis
B) metabolic alkalosis
C) metabolic acidosis
D) respiratory alkalosis
32)
33) The body's water volume is closely tied to the level of which of the following ions?
A) hydrogen ions
B) potassium ions
C) calcium ions
D) sodium ions
33)
34) Respiratory acidosis can occur when ________.
A) the kidneys secrete hydrogen ions
B) a person's breathing is shallow due to obstruction
C) a person consumes excessive amounts of antacids
D) a runner has completed a very long marathon
34)
35) Which of the choices below is NOT an essential role of salts in the body?
A) neuromuscular activity
B) anabolism of lipids
C) secretory activity
D) membrane permeability
35)
4
36) Insufficient parathyroid hormone production in the body could result in ________.
A) cardiac arrhythmia
B) kidney stones
C) muscle twitching
D) muscle weakness
36)
37) An illness causes Doug to experience severe diarrhea and an accompanying loss of
bicarbonate-rich secretions. How can this metabolic acidosis be compensated?
A) increased renin secretion
B) enhanced sodium ion loss in urine
C) increased respiratory rate and depth
D) hypoventilation
37)
38) If the thyroid and parathyroid glands are surgically removed, which of the following would go out
of balance without replacement therapy?
A) sodium ion levels
B) anion levels
C) calcium ion levels
D) potassium ion levels
38)
39) 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 alkalosis
B) metabolic acidosis
C) metabolic alkalosis
D) respiratory acidosis
39)
40) 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) There will be a shift in the pH of her body fluids to the higher side of the pH scale.
D) It will cause a prolonged increase in the osmolality of the blood.
40)
41) Which of the following is NOT a chemical buffer system?
A) phosphate
B) nitrogen
C) protein
41)
D) bicarbonate
42) Atrial natriuretic peptide (ANP) is a hormone that is made in the atria of the heart. The influence of
this hormone is to ________.
A) activate the renin-angiotensin mechanism
B) reduce blood pressure and blood volume by inhibiting sodium and water retention
C) prevent pH changes caused by organic acids
D) enhance atrial contractions
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
43) 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?
43)
44) How does the respiratory system influence the buffer systems of the body?
44)
45) What is the effect of acidosis on the body? Of alkalosis?
45)
46) What provides the shortest-term mechanism for preventing acid-base imbalances in the
body? The longest-term mechanism?
46)
47) Describe the influence of rising parathyroid hormone (PTH) levels on bone, the small
intestine, and the kidneys.
47)
5
42)
48) Describe the mechanisms by which the kidneys remove hydrogen ions from the body.
48)
49) List and describe three stimuli that activate the hypothalamic thirst center.
49)
50) Identify and describe the operation of the three major chemical buffers of the body.
50)
51) Why would an infant with colic be suffering from respiratory alkalosis?
51)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
52) Salts are lost from the body in perspiration and urine only.
52)
53) Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion.
53)
54) Prolonged hyperventilation can cause alkalosis.
54)
55) To remain properly hydrated, water intake must equal water output.
55)
56) The single most important blood buffer system is the bicarbonate buffer system.
56)
57) Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient.
57)
58) Solutes, regardless of size, are able to move freely between compartments because water carries
them along the osmotic gradients.
58)
59) The normal pH of blood is 7.35-7.45.
59)
60) Heavy consumption of salt substitutes high in potassium can present a serious clinical problem
when aldosterone release is not normal.
60)
61) Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of
the CNS.
61)
62) Most acidic substances (hydrogen ions) originate as by-products of cellular metabolism.
62)
63) Adipose tissue is one of the most hydrated of all tissues in the human body.
63)
64) Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed
dehydration.
64)
65) Carotid artery and aortic baroreceptors are involved in long term adjustment to total body sodium
ion content.
65)
66) Thirst is normally triggered by hypothalamic osmoreceptors sensitive to a 1-2% increase in plasma
osmolality.
66)
6
67) Obligatory water loss occurs because humans always take in more fluids through eating and
drinking than they need to maintain water balance.
67)
68) Calcitonin targets the bones and causes the release of calcium from storage when serum calcium
levels are low.
68)
69) The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin.
69)
70) 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.
70)
71) The main way the kidney regulates potassium ions is to excrete them.
71)
72) Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems.
72)
73) Aldosterone is secreted in response to low extracellular potassium.
73)
74) The phosphate buffer system is relatively unimportant for buffering blood plasma.
74)
75) Weak acids are able to act as chemical buffering systems for the body because they only partially
dissociate.
75)
76) One of the most powerful and plentiful sources of buffers is the protein buffer system.
76)
77) Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes
insipidus.
77)
78) Electrolytes determine most of the chemical and physical reactions of body fluids.
78)
79) 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.
79)
80) Insensible water loss includes water lost in feces.
80)
81) As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion
concentration of the blood decreases.
81)
82) The thirst center in the brain is located in the hypothalamus.
82)
83) The most abundant cation in intracellular fluid is sodium.
83)
84) It is impossible to overhydrate because people need as much water as they can drink to carry out
ordinary body functions.
84)
85) When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the distal
convoluted tubule.
85)
86) Premenstrual edema may be due to enhanced reabsorption of sodium chloride.
86)
7
87) Some potassium ions are reabsorbed from the kidney filtrate via type A intercalated cells, a unique
population of collecting duct cells.
87)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
88) Calcium depletion.
A) Hypocalcemia
88)
Match the electrolyte composition for the following:
89) The concentration of sodium ions is
highest in ________.
A) Blood plasma
89)
Match the following:
90) An atypical accumulation of fluid in
the interstitial space.
A) Edema
90)
Match the electrolyte composition for the following:
91) The concentration of protein anions is
highest in ________.
A) Intracellular fluid
91)
Match the following:
92) Possibly caused by asthma,
pneumonia, or a severe panic attack.
A) Respiratory alkalosis
92)
Match the electrolyte composition for the following:
93) The concentration of bicarbonate ions
is highest in ________.
A) Interstitial fluid
93)
Match the following:
94) Dissociate into ions in water.
A) Electrolytes
94)
Match the following:
95) Fluid loss, either the loss of water or
the loss of water and solutes together.
96) A condition due to excessive water
intake that results in net osmosis into
tissue cells. This leads to severe
metabolic disturbances.
A) Hyponatremia
95)
B) Dehydration
96)
8
Match the following:
97) Do not dissociate in solution.
A) Nonelectrolytes
97)
Match the following:
98) Magnesium excess.
A) Hyperkalemia
99) Potassium excess.
B) Hypermagnesemia
98)
99)
Match the following:
100) Possibly occurring with emphysema,
extreme obesity, or narcotic overdose.
A) Respiratory acidosis
100)
Match the following:
101) Sodium excess.
A) Hypernatremia
101)
Match the electrolyte composition for the following:
102) The concentration of phosphate ions is
highest in ________.
A) Intracellular fluid
102)
Match the following:
103) Possibly caused by severe diarrhea or
untreated diabetes mellitus.
A) Metabolic acidosis
103)
Match the following:
104) Fluid in the spaces between cells.
A) Interstitial
104)
Match the electrolyte composition for the following:
105) The concentration of potassium ions is
highest in ________.
A) Intracellular fluid
105)
Match the following:
106) Possibly caused by vomiting, use of
diuretics, or use of antacids.
A) Metabolic alkalosis
106)
Match the following:
107) Regulates sodium ion concentrations
in the extracellular fluid.
A) Aldosterone
9
107)
Match the following:
108) Sodium depletion.
A) Hyponatremia
108)
Match the following:
109) The main fluid compartment outside
the cells.
110) The main fluid compartment located
within the cell.
A) Intracellular
109)
B) Extracellular
110)
Match the following:
111) A disorder entailing deficient
aldosterone production by the adrenal
cortex.
A) Addison's disease
111)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
112) 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?
113) 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?
114) 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?
115) A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3 - is 20 mEq/L.
What diagnosis would you give and what prognosis? A medical history reveals that this patient is a chronic
alcoholic.
116) 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.
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 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.
10
Answer Key
Testname: 26
1) A
2) A
3) C
4) D
5) B
6) C
7) D
8) C
9) B
10) C
11) B
12) D
13) B
14) D
15) D
16) A
17) D
18) D
19) C
20) D
21) D
22) A
23) A
24) D
25) D
26) D
27) B
28) A
29) A
30) D
31) B
32) C
33) D
34) B
35) B
36) C
37) C
38) C
39) A
40) A
41) B
42) B
43) The release of ADH causes the kidney tubules to reabsorb excess water, resulting in the excretion of concentrated
urine.
44) The respiratory system maintains a constant bicarbonate level in the bloodstream by outgassing carbon dioxide. In the
event of a respiratory problem the CO2 to bicarbonate ratio might change, in turn changing buffering effects on pH.
45) 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.
11
Answer Key
Testname: 26
46) 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.
47) Parathyroid hormone (PTH) activates osteoclasts that break down the bone matrix, resulting in the release of Ca2+ and
PO4 3- to the blood. PTH enhances intestinal absorption of Ca2+ 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.
48) 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.
49) 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.
50) 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. NaH2 PO4
acts as a weak acid; Na2 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 NH3 + when the pH falls.
51) 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.
52) FALSE
53) TRUE
54) TRUE
55) TRUE
56) TRUE
57) TRUE
58) FALSE
59) TRUE
60) TRUE
61) TRUE
62) TRUE
63) FALSE
64) TRUE
65) TRUE
66) TRUE
67) FALSE
68) FALSE
69) FALSE
70) TRUE
71) TRUE
72) TRUE
73) FALSE
74) TRUE
75) TRUE
12
Answer Key
Testname: 26
76) TRUE
77) TRUE
78) TRUE
79) TRUE
80) FALSE
81) TRUE
82) TRUE
83) FALSE
84) FALSE
85) TRUE
86) TRUE
87) TRUE
88) A
89) A
90) A
91) A
92) A
93) A
94) A
95) B
96) A
97) A
98) B
99) A
100) A
101) A
102) A
103) A
104) A
105) A
106) A
107) A
108) A
109) B
110) A
111) A
112) 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.
113) 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 HCO3 - , thus providing renal compensation to her
chronic respiratory acidosis.
114) 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.
115) 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.
13
Answer Key
Testname: 26
116) Instructing the patient to breathe more slowly will reduce the elimination of CO2 . Breathing into a paper bag will
cause retention of CO2.
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) Edema is an atypical accumulation of fluid in the interstitial space, leading to tissue swelling. Heart failure is one cause
of edema.
14
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) 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 create an acid condition in the vagina that acts as a spermicide
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 prevent the proliferative or secretory phase of the menstrual cycle and the
embryo will have no place to implant
D) the hormones cause the woman's body to mimic the activities of a pregnancy and disrupt the
ovarian cycle, preventing ovulation
1)
2) 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) What you really see are two polar bodies and the sperm that will fertilize the egg.
B) The first polar body has also divided to produce two polar bodies.
C) One is an undeveloped primary oocyte that failed to mature.
D) There were originally four polar bodies and one disappeared.
2)
3) 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 endometrium has a functional layer that the embryo will implant into.
C) The narrow portion of the uterus near the cervix is the most typical site of fertilization.
D) The rhythmic, reverse peristalsis of the uterus can propel sperm toward the egg.
3)
4) 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.
4)
5) Secretion of progesterone stimulates ________.
A) preparation of the mammary glands for lactation
B) development of the female secondary sex characteristics
C) proliferation of the uterine myometrium
D) contraction of uterine muscles
5)
6) Select the statement below that is FALSE.
A) A cell undergoing meiosis results in 4 cells while a cell undergoing mitosis results in 2 cells.
B) Meiosis produces genetically unique cells while mitosis produces genetically identical cells.
C) Meiosis results in haploid cells while mitosis results in diploid cells.
D) Meiosis occurs only after the onset of puberty while mitosis occurs throughout an entire
lifetime.
6)
1
7) 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
7)
8) The ability of sperm cells to move along the ductus deferens is due to ________.
A) enzymatic activity
B) gravity
C) peristaltic contractions
D) hormonal action
8)
9) Which is NOT a part of the proliferative phase of the female menstrual cycle?
A) development of endometrial cells
B) late in this phase, cervical mucus becomes thin and crystalline
C) vesicular follicle growth
D) corpus luteum secretion
9)
10) Which of the following glands are responsible for producing 70% of semen volume?
A) the bulbourethral glands
B) the seminal vesicles
C) the pituitary
D) the prostate
10)
11) Why doesn't semen enter the urinary bladder during ejaculation?
A) Ejaculation is a parasympathetic reflex that activates urinary contraction muscles.
B) The smooth muscle sphincter at the base of the urinary bladder closes.
C) There is no urge to urinate during sexual intercourse because of the suppression of LH by
testosterone buildup in the blood.
D) There is no common duct between the reproductive system and the urinary system.
11)
12) Effects of estrogen include ________.
A) growth of the breasts at puberty
C) deepening of the voice
12)
B) increased oiliness of the skin
D) growth of the larynx
13) If a woman has just ended her menstrual phase, when is she most likely to ovulate?
A) in about 14 days
B) in about 10 days
C) in about 24 days
D) within the next 4 days
13)
14) Which of the following does NOT occur in both the male and female sexual response?
A) Blood flow to genital structures increases.
B) Blood pressure and heart rate increase.
C) A refractory period follows orgasm.
D) Muscles of structures in the reproductive duct contract rhythmically.
14)
15) If gametes were diploid like somatic cells, how many chromosomes would the zygote contain?
A) Twice the diploid number, and with every succeeding generation, the chromosome number
would continue to double and normal development could not occur.
B) Half the diploid number with no change in development.
C) Triple the diploid number, and with every succeeding generation, the chromosome number
would continue to triple and normal development would not occur.
D) There is no relationship between gametes and somatic cells.
15)
2
16) 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 have not undergone meiosis and are still diploid.
B) Early spermatids have not undergone spermiogenesis.
C) Early spermatids have not formed flagella.
D) Early spermatids are round and have excessive cytoplasm.
16)
17) Which of the following is a correct statement about uterine tubes?
A) The ampulla is the narrow constricted region.
B) The isthmus is the normal site of fertilization.
C) The infundibulum is the funnel-shaped region near the ovary.
D) The mesometrium supports the uterine tubes along their entire length.
17)
18) During spermiogenesis ________.
A) 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
B) the acrosome migrates towards the anterior end of the spermatid because its pointy shape
helps the sperm to move more efficiently
C) 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
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
18)
19) All but one of the events described below occur during spermiogenesis. Select the event that does
NOT occur during spermiogenesis.
A) Mitochondria form around the proximal end of the flagellum. They will provide the ATP to
drive the motion of the flagellum.
B) Mitochondrial DNA is packaged into the nucleus to be delivered to the egg during
fertilization.
C) Excessive cytoplasm will be shed to reduce unneeded mass of the maturing sperm.
D) The centrioles migrate to the posterior end of the developing sperm to form the microtubules
that make up the flagellum.
19)
20) Prostate cancer is ________.
A) the number one cause of death in men
B) sometimes a slow-growing cancer that may never represent a threat to the patient
C) often the result of a distortion of the urethra
D) most common in Asians
20)
21) Select the statement which is true regarding independent assortment.
A) It only occurs in meiosis II.
B) It is a significant source of genetic variation only during meiosis I.
C) Its effects are significant in meiosis and in mitosis.
D) It is a significant source of genetic variation that occurs in meiosis I and meiosis II.
21)
22) A low secretion of luteinizing hormone (LH) in the normal male adult would cause ________.
A) excessive beard growth
B) decreased testosterone secretion
C) increased spermatogenesis
D) shrinkage of the anterior pituitary gland
22)
3
23) 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 cells that form the blood testis barrier are joined by tight junctions.
C) The barrier prevents the spermatocytes from exposing their unique antigens to the immune
system.
D) The barrier marks the border between the basal compartment and the adluminal
compartment.
23)
24) Which male hormone provides negative feedback for the secretion of FSH?
A) inhibin
B) ACTH
C) ICSH
24)
D) GnRH
25) Select the correct statement about the hormonal events of the ovarian cycle.
A) High estrogen levels result in a surge of LH release.
B) The follicle begins to secrete progesterone in response to estrogen stimulation.
C) The LH surge stimulates further development of the secondary oocyte.
D) Rising levels of estrogen start follicle development.
25)
26) 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
C) be impotent (unable to have an erection)
D) not develop secondary sex characteristics
26)
27) During the secretory phase of the menstrual cycle, ________ reaches its highest levels.
A) progesterone
B) LH
C) FSH
D) estrogen
27)
28) Select the correct statement about the uterine cycle.
A) During the proliferative phase, levels of progesterone rise as the follicle produces more
hormone.
B) If fertilization occurs, the corpus luteum is maintained by a hormone secreted by the
developing embryo.
C) During the secretory phase, estrogen levels are at their highest.
D) The menstrual phase of the cycle is normally from day 1 to day 8.
28)
29) Which of the choices below is NOT a function of the vagina?
A) serves as the birth canal
B) serves as a passageway for the primary oocyte
C) receives semen from the penis during sexual intercourse
D) serves as a passageway for menstrual flow
29)
30) Which of the following is incurable?
A) gonorrhea
B) genital herpes
C) syphilis
31) Human egg and sperm are similar in that ________.
A) about the same number of each is produced per month
B) they are about the same size
C) they have the same number of chromosomes
D) they have the same degree of motility
4
D) trichomoniasis
30)
31)
32) All of the following statements referring to the uterine cycle are true EXCEPT ________.
A) a decrease in the levels of ovarian hormones signals menstruation
B) estrogen is secreted by the developing follicle in the follicular phase of the cycle
C) FSH and LH directly promote development of the uterine endometrium
D) the corpus luteum is formed from the ruptured follicle after ovulation
32)
33) Which of the following female structures is homologous to the male scrotum?
A) clitoris
B) labia minora
C) labia majora
33)
D) vagina
34) Spermatogenesis ________.
A) results in the formation of diploid cells
B) is the process of releasing mature sperm cells into the lumen of the seminiferous tubule
C) involves a two-part process called mitosis I and mitosis II
D) involves a kind of cell division limited to the gametes
34)
35) The hypothalamic-pituitary-gonadal axis ________.
A) involves FSH and LH release from the anterior pituitary
B) involves posterior pituitary release of two regulating hormones
C) involves positive feedback control of spermatogenesis
D) involves the release of testosterone from the anterior pituitary
35)
36) Which of the choices below is NOT a part of the hypothalamic-pituitary-gonadal axis?
A) anterior pituitary gland
B) interstitial cells
C) thalamus
D) hypothalamus
36)
37) 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) genetically identical
B) potentially of different sexes
C) fraternal
D) dizygotic
37)
38) 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) The mammary glands are modified sweat glands that are part of the integumentary system.
C) All lumps identified in breast tissue are malignant.
D) Both sexes are equally prone to breast cancer.
38)
39) All of the following things occur during meiosis I. Select the statement below that does NOT occur
during meiosis I.
A) The homologous chromosomes are separated from each other.
B) Portions of maternal chromosomes crossover with equivalent portions of paternal
chromosomes.
C) A single diploid (2n) nucleus has become two haploid (n) nuclei.
D) The sister chromatids are separated from each other.
39)
40) The most important risk for testicular cancer in young males is ________.
A) smoking
B) failure of the testis to make their normal descent
C) sexually transmitted infections
D) a diet high in fat
40)
5
41) Which hormone is the necessary trigger for ovulation to occur?
A) progesterone
B) FSH
C) estrogen
D) LH
41)
42) A patient with trichomoniasis, if they have any symptoms at all, will most likely exhibit which of
the following?
A) painful lesions on the genitals
B) sterility
C) yellow-green vaginal discharge and strong odor
D) pink rash all over the body
42)
43) The cells that produce testosterone in the testis are called ________.
A) spermatocytes
B) sustentacular cells
C) spermatogonia
D) interstitial endocrine cells
43)
44) The duct system of the male reproductive system includes all but which of the following?
A) urethra
B) epididymis
C) ductus deferens
D) corpus spongiosum
44)
45) The constancy of the chromosome number from one cell generation to the next is maintained
through ________.
A) meiosis
B) DNA synthesis
C) mitosis
D) cytokinesis
45)
46) Which of the following statements about spermatogenesis is NOT true?
A) The primary spermatocyte forms two secondary spermatocytes.
B) The secondary spermatocytes each form two spermatids.
C) Each spermatid forms two sperm.
D) The spermatogonium forms the primary spermatocyte.
46)
47) 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) The sister chromatids line up randomly on the spindle equator with some maternal and
paternal chromatids on both sides of the equator.
C) Joined homologous pair uniformly line up on the equatorial spindle with chromosome one at
the top and chromosome 23 on the bottom.
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.
47)
48) Which of the following is true of testosterone?
A) The release of testosterone surges during ejaculation.
B) The production of testosterone is stimulated by FSH.
C) Testosterone is produced by interstitial endocrine cells.
D) Testosterone provides positive feedback on gonadotropin release.
48)
49) Which of the following will occur immediately after ovulation?
A) The endometrium enters its secretory phase.
B) The corpus luteum secretes estrogen only.
C) The secretion of anterior pituitary gonadotropins is enhanced.
D) The corpus luteum becomes a corpus albicans.
49)
6
50) Erection of the penis results from ________.
A) dilation of the veins in the penis
B) parasympathetic activation of the bulbourethral glands
C) a parasympathetic reflex that promotes release of nitric oxide
D) a sympathetic activation of bulbospongiosus muscles
50)
51) Which of the choices below is NOT a function of testosterone?
A) stimulates the HPG axis
B) stimulates protein synthesis
C) stimulates the male pattern of development
D) contributes to male sexual behavior and spermatogenesis
51)
52) The critical factor that determines gender during development is ________.
A) presence of progesterone
B) inhibition of estrogen
C) lack of an X chromosome
D) the SRY gene
52)
53) 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 contract to push sperm along the ductus deferens.
B) They contract to allow ejaculation.
C) They are responsible for penile erection.
D) They regulate the temperature of the testes.
53)
54) The basic difference between spermatogenesis and oogenesis is that ________.
A) spermatogenesis involves mitosis and meiosis, but oogenesis involves meiosis only
B) during spermatogenesis two more polar bodies are produced
C) the mature ovum is n, while the sperm is 2n
D) in oogenesis, one mature ovum is produced from the parent cell, and in spermatogenesis four
mature sperm are produced from the parent cell
54)
55) The structures that receive the ovulated oocyte, providing a site for fertilization, are called the
________.
A) Graafian follicles
B) infundibula
C) fimbriae
D) uterine tubes
55)
56) Normally menstruation occurs when ________.
A) blood levels of FSH fall off
B) blood levels of estrogen and progesterone increase
C) the corpus luteum secretes estrogen
D) blood levels of estrogen and progesterone decrease
56)
57) Which of these statements about sexually transmitted infections is FALSE?
A) Chlamydia is caused by bacteria that can often be asymptomatic or bring on a wide variety of
symptoms.
B) Syphilis is caused by a virus that may lead to death if untreated.
C) Gonorrhea is caused by a bacterium that can bring on painful discharges in males.
D) Genital herpes is caused by a virus that may cause intermittent lesions.
57)
58) Fertilization generally occurs in the ________.
A) uterus
B) ovary
58)
C) vagina
7
D) uterine tubes
59) Which of the following phases or processes in the monthly reproductive cycle of the female occur
simultaneously?
A) maximal LH secretion and menstruation
B) regression of the corpus luteum and a decrease in ovarian progesterone secretion
C) early follicular development and the secretory phase in the uterus
D) maximal steroid secretion by the corpus luteum and menstruation
59)
60) Which of the following hormones controls the release of anterior pituitary gonadotropins?
A) GnRH
B) FSH
C) LH
D) testosterone
60)
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:
61) Type B daughter cell.
61)
62) First cells with n number of chromosomes.
62)
8
63) A follicle with only a small antrum in it would be classified as a(n) ________ follicle.
63)
Figure 27.3
Using Figure 27.3, match the following:
64) The stage called ovulation.
64)
9
Figure 27.2
Using Figure 27.2, match the following:
65) Area of compacted DNA.
65)
10
Figure 27.1
Using Figure 27.1, match the following:
66) Early spermatids.
66)
67) Treponema pallidum causes the sexually transmitted disease called ________.
67)
68) What is the purpose of the male bulbourethral gland?
68)
11
Figure 27.2
Using Figure 27.2, match the following:
69) Location of nucleus.
69)
70) The ________ of the testis nourish the newly formed sperm cells.
70)
12
Figure 27.2
Using Figure 27.2, match the following:
71) Midpiece.
71)
72) The erectile tissue around the urethra is the corpus ________.
72)
73) The ________ plexus of testicular veins assists in cooling the testis.
73)
74) Explain the function of the myometrium and endometrium.
74)
13
Figure 27.2
Using Figure 27.2, match the following:
75) Location of mitochondria.
75)
76) Surgical cutting of the ductus deferens as a form of birth control is called a(n) ________.
76)
14
Figure 27.2
Using Figure 27.2, match the following:
77) Location of acrosome.
77)
15
Figure 27.3
Using Figure 27.3, match the following:
78) Primary follicles.
78)
79) Corpus luteum.
79)
80) The suspensory ligament and mesovarium are part of the ________ ligament.
80)
81) The portion of the uterine endometrium that is not sloughed off every month is called the
________.
81)
16
Figure 27.3
Using Figure 27.3, match the following:
82) Vesicular (Graafian) follicle.
82)
83) Ovulation occurs when the oocyte is released into the peritoneal cavity. By what means
does it usually enter the uterine tube?
83)
17
Figure 27.1
Using Figure 27.1, match the following:
84) Spermatogonium.
84)
18
Figure 27.3
Using Figure 27.3, match the following:
85) Primordial follicle.
85)
86) Describe the composition and functional roles of semen.
86)
87) What is the physiological importance of the fact that the male testes descend to reside in
the scrotal sac?
87)
88) At what point is the sex of the embryo determined, and what determines it?
88)
19
Figure 27.1
Using Figure 27.1, match the following:
89) Primary spermatocyte.
89)
90) The midpiece of the sperm tail contains mostly ________.
90)
20
Figure 27.2
Using Figure 27.2, match the following:
91) Flagellum.
91)
21
Figure 27.3
Using Figure 27.3, match the following:
92) Mature follicle.
92)
93) What are some risk factors for developing breast cancer?
93)
94) What is the name given to the female homologue to the penis?
94)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
95) The amount of testosterone and sperm produced by the testes is dependent on the influence of FSH
alone.
95)
96) 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.
96)
97) When it is cold, the scrotum is pulled away from the body.
97)
98) Sustentocytes prevent sperm antigens from entering the bloodstream.
98)
99) A scrotal muscle that contracts in response to cold environmental temperature is the cremaster.
99)
100) Sexually transmitted infections are the most important cause of reproductive disorders.
100)
101) A human egg or sperm contains 23 pairs of chromosomes.
101)
102) The first sign of puberty in females is budding breasts.
102)
22
103) The zona pellucida is formed as the follicle becomes a secondary follicle.
103)
104) Ovulation occurs near the end of the ovarian cycle.
104)
105) Ovarian follicles contain mature eggs.
105)
106) The secretions of the bulbourethral glands neutralize traces of acidic urine in the urethra and serve
as a lubricant during sexual intercourse.
106)
107) The smaller cell produced by oogenesis meiosis I, called the first polar body, is essentially a packet
of discarded nuclear material.
107)
108) The stage in meiosis where chromosomal exchange takes place is telophase I.
108)
109) The adenohypophyseal hormone that triggers ovulation is estrogen.
109)
110) Female orgasm is required for conception.
110)
111) Extremely stressful physical activity in young females can result in excessive bone mass due to
large amounts of estrogen production.
111)
112) Male erection is a response to a parasympathetic reflex, and ejaculation is a response to a
sympathetic reflex.
112)
113) The soft mucosal lining of the uterus is the endometrium.
113)
114) The corpus luteum secretes progesterone only.
114)
115) Sperm are ejaculated from the corpora cavernosa of the penis.
115)
116) The prostate atrophies as a man ages, and it usually causes no health problems.
116)
117) When a couple is having difficulty conceiving a child, it is necessary to investigate the sperm of the
male.
117)
118) The molecule that enhances the ability of testosterone to promote spermatogenesis is inhibin.
118)
119) Male testicular functions are regulated by FSH and LH.
119)
120) The Pap smear is a test to detect cancerous changes in cells of the cervix.
120)
121) It is necessary for the testes to be kept below body temperature for abundant, viable sperm
formation.
121)
23
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
122) Tetrads align randomly on the spindle
equator.
A) Metaphase I of meiosis
122)
Match the following:
123) Causes urethritis in males.
A) Genital herpes
124) Pathogen responsible for 25-50% of all
diagnosed cases of pelvic
inflammatory disease.
B) Chlamydia
123)
124)
C) Gonorrhea
125) Human herpes simplex virus.
125)
Match the following:
126) Chromosomes that have undergone
crossing over line up individually
along the spindle equator.
A) Metaphase II of meiosis
127) Homologous chromosomes separate.
C) Metaphase of mitosis
127)
128) Chromosomes that have not
undergone crossing over line up
individually along the spindle
equator.
D) Anaphase II of meiosis
128)
126)
B) Anaphase I of meiosis
129) Centromeres separate.
129)
Match the following:
130) Treponema pallidum.
A) Syphilis
130)
Match the following:
131) Part of a process that produces
genetically identical daughter cells.
A) Metaphase of mitosis
131)
Match the following:
132) Human papillomavirus.
A) Genital warts
132)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
133) 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?
24
134) Explain the action of drugs like sildenafil (Viagra) on the male reproductive system.
135) What are some possible complications a patient may have after a radical mastectomy?
136) 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?
137) 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.
138) 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?
139) Based on your knowledge of how the prostate encircles part of the urethra, what are two clinical manifestations
of an enlarged prostate?
25
Answer Key
Testname: 27
1) D
2) B
3) C
4) B
5) A
6) D
7) A
8) C
9) D
10) B
11) B
12) A
13) A
14) C
15) A
16) A
17) C
18) A
19) B
20) B
21) B
22) B
23) A
24) A
25) A
26) A
27) A
28) B
29) B
30) B
31) C
32) C
33) C
34) D
35) A
36) C
37) A
38) B
39) D
40) B
41) D
42) C
43) D
44) D
45) A
46) C
47) A
48) C
49) A
50) C
26
Answer Key
Testname: 27
51) A
52) D
53) D
54) D
55) D
56) D
57) B
58) D
59) B
60) A
61) B
62) D
63) secondary
64) E
65) C
66) E
67) syphilis
68) 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.
69) C
70) sustenocytes
71) A
72) spongiosum
73) pampiniform
74) 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.
75) A
76) vasectomy
77) B
78) B
79) D
80) broad
81) stratum basalis
82) C
83) 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.
84) A
85) A
86) 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.
87) 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.
88) 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.
89) C
90) mitochondria
27
Answer Key
Testname: 27
91) D
92) C
93) 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.
94) 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.
95) FALSE
96) FALSE
97) FALSE
98) TRUE
99) TRUE
100) TRUE
101) FALSE
102) TRUE
103) TRUE
104) FALSE
105) FALSE
106) TRUE
107) TRUE
108) FALSE
109) FALSE
110) FALSE
111) FALSE
112) TRUE
113) TRUE
114) FALSE
115) FALSE
116) FALSE
117) TRUE
118) FALSE
119) TRUE
120) TRUE
121) TRUE
122) A
123) C
124) B
125) A
126) A
127) B
128) C
129) D
130) A
131) A
132) A
133) 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.
28
Answer Key
Testname: 27
134) 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.
135) 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.
136) 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).
137) 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.
138) 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.
139) 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.
29
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) At what point is meiosis II completed for the female gamete?
A) implantation
B) fertilization
C) puberty
D) ovulation
1)
2) What destroys the zona pellucida sperm-binding receptors?
A) human placental lactogen
B) zonal inhibiting proteins
C) the acrosomal reaction
D) the process of capacitation
2)
3) Gastrulation begins when a groove with raised edges called the ________ appears on the dorsal
surface of the embryonic disc.
A) spinal cord
B) primitive streak
C) notochord
D) placenta
3)
4) The placenta, a vitally important metabolic organ, is made up of a contribution from mother and
fetus. Which portion is from the fetus?
A) chorion
B) amnion
C) umbilicus
D) yolk sac
4)
5) Select the correct statement about fertilization.
A) Millions of sperm cells are destroyed by the vagina's acidic environment.
B) If estrogen is present, the pathway through the cervical opening is blocked from sperm entry.
C) Both spermatozoa and the ovulated secondary oocyte remain viable for about 72 hours in the
female reproductive tract.
D) Once inside the uterus, most sperm cells are protected and remain viable.
5)
6) The neonatal period refers to ________.
A) the first trimester of pregnancy
C) the last trimester of pregnancy
6)
B) the first month after birth
D) the first year after birth
7) Which of the choices below occurs if implantation is successful?
A) Increased levels of FSH will be produced.
B) The corpus luteum is maintained until the placenta takes over its hormone-producing
functions.
C) The corpus luteum degenerates and becomes the corpus albicans.
D) The ovarian cycle begins.
7)
8) Which of the following would be the best method for delaying the onset of labor?
A) giving the mother anti progesterone drugs
B) giving the mother oxytocin
C) giving the mother antiprostaglandin drugs
D) giving the mother prostaglandins
8)
9) During which stage of labor is the fetus delivered?
A) dilation stage
B) expulsion stage
9)
C) gastrula stage
1
D) placental stage
10) Relaxin is a hormone produced by the placenta and ovaries. The function of this hormone is to
________.
A) prevent morning sickness
B) relax the pubic symphysis
C) ensure the implantation of the blastula
D) block the pain of childbirth
10)
11) A friend confides that she desires to have children but is having trouble conceiving. Which of the
following is true regarding implantation?
A) An estimated 60% of implanted embryos later miscarry due to genetic defects of the embryo.
B) In cases where implantation fails to occur, a nonreceptive uterus becomes receptive once
again.
C) Detection of human chorionic gonadotropin (hCG) in blood or urine indicates failure of the
blastocyst to implant.
D) 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.
11)
12) 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) rhythm method
C) gamete intrafallopian transfer (GIFT)
D) zygote intrafallopian transfer (ZIFT)
12)
13) Which of the following is NOT a correct matching of a fetal structure with what it becomes at birth?
A) foramen ovale–fossa ovalis
B) ductus venosus–ligamentum venosum
C) ductus arteriosus–ligamentum teres
D) umbilical arteries–medial umbilical ligaments
13)
14) Select the correct statement about the special fetal blood vessels.
A) The hepatic portal vein forms from the umbilical artery.
B) The fossa ovalis becomes the foramen ovale.
C) The distal parts of the umbilical arteries form the superior vesical arteries.
D) The umbilical vein becomes the ligamentum teres.
14)
15) Which hormone maintains the viability of the corpus luteum?
A) human chorionic gonadotropin
B) human placental lactogen
C) estrogen
D) progesterone
15)
16) 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) scoliosis
B) kyphosis
C) hunchback
D) lordosis
16)
17) Cells of the ________ gather around the notochord and neural tube and produce the vertebra and
rib at their associated level.
A) sclerotome
B) intermediate mesoderm
C) myotome
D) dermatome
17)
18) Muscle tissue is formed by the ________.
A) mesoderm
B) epiderm
18)
C) ectoderm
2
D) endoderm
19) Which of the following is true in reference to what may pass through the placental barriers?
A) respiratory gases, hormones, nutrients, and blood cells
B) hormones, blood cells, and nutrients
C) nutrients and respiratory gases only
D) nutrients, respiratory gases, wastes, and alcohol
19)
20) Implantation of the blastocyst is the result of all of the following EXCEPT ________.
A) settling of the blastocyst onto the prepared uterine lining
B) phagocytosis by the trophoblast cells
C) adherence of the trophoblast cells to the endometrium
D) digestive enzymes and growth factors produced by the trophoblast cells
20)
21) It is impossible for sperm to be functional (able to fertilize the egg) until after ________.
A) they undergo capacitation
B) the tail disappears
C) they have been stored in the uterus for several days
D) they become spermatids
21)
22) Derivatives of the mesoderm include ________.
A) glandular derivatives of the digestive tract
B) epithelium of the digestive tract
C) vertebrae and ribs
D) all nervous tissue
22)
23) 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) phosphate ion
B) sodium ion
C) ATP
D) calcium ion
23)
24) The first major event in organogenesis is ________.
A) gastrulation
B) ossification
24)
C) myelination
D) neurulation
25) How long is the secondary oocyte viable and capable of being fertilized after it is ovulated?
A) 36-72 hours
B) 12-24 hours
C) 24-36 hours
D) a full week
25)
26) Which method of contraception is most reliable?
A) cervical cap
C) rhythm method
26)
B) vasectomy
D) morning-after pills
27) Human chorionic gonadotropin (hCG) is at its highest levels ________.
A) at about the midpoint of pregnancy
B) about 2 months after implantation during the 8th gestational week
27)
28) The corpus luteum prevents loss of the implanted embryo through menstruation by secreting
________.
A) human chorionic gonadotropin
B) estrogens and progesterone
C) luteinizing hormone
D) follicle-stimulating hormone
28)
C) after copulation but before implantation
D) just before birth
3
29) The presence of endoderm, ectoderm, and mesoderm is first seen in the ________ stage.
A) fetal
B) gastrula
C) morula
D) blastocyst
29)
30) Which of the following is NOT assessed as part of the Apgar score?
A) muscle tone
B) temperature
C) respiration
30)
D) heart rate
31) A urine test reveals a positive result for human chorionic gonadotropin (hCG). This indicates
________ was successful.
A) fertilization
B) implantation
C) gastrulation
D) ovulation
31)
32) The trophoblast is mostly responsible for forming the ________.
A) placental tissue
B) archenteron
C) allantois
D) lining of the endometrium
32)
33) Which body system of a pregnant woman undergoes the most dramatic physiological changes
during pregnancy?
A) digestive system
B) urinary system
C) respiratory system
D) cardiovascular system
33)
34) Milk ejection (the letdown reflex) is stimulated by which of the following hormones associated with
pregnancy?
A) prolactin
B) inhibin
C) oxytocin
D) gonadotropin
34)
35) Derivatives of the endoderm include ________.
A) kidneys and gonads
C) heart and blood vessels
35)
B) brain and spinal cord
D) epithelial lining of the respiratory tract
36) Prior to the let-down reflex, the mammary glands secrete a yellowish fluid called ________ that has
less lactose than milk and almost no fat.
A) meconium
B) bilirubin
C) prolactin
D) colostrum
36)
37) 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 foramen ovale between the atria of the fetal heart closes at the moment of birth.
C) The urinary system is activated at birth.
D) The ductus arteriosus constricts and is converted to the ligamentum arteriosum.
37)
38) 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) carcinogen
C) teratogen
D) endocrine disruptor
38)
4
39) 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) the increased temperature in the vagina, which stimulates sperm motility
B) reverse peristalsis of the uterus and uterine tubes
C) the cilia on the apex of the cells lining the endometrium
D) hormonal attraction to the ova
39)
40) Which of the following events does NOT occur during the first 8 weeks of development?
A) formation of a functional cardiovascular system
B) presence of all body systems
C) myelination of the spinal cord
D) beginning of ossification
40)
41) At which stage of labor is the "afterbirth" expelled?
A) full dilation
B) placental
C) dystocia
41)
42) The result of polyspermy in humans is ________.
A) a nonfunctional zygote
C) interruption of meiosis
B) mitotic insufficiency
D) multiple births
D) expulsion
42)
43) The most common assisted reproductive technology process used by couples having difficulty
conceiving is _______.
A) artificial insemination
B) hormone therapy
C) in vitro fertilization
D) cloning of parent stem cells
43)
44) Neural tissue is formed by the ________.
A) endoderm
B) ectoderm
C) mesoderm
44)
45) Which hormone is NOT produced by the placenta?
A) human placental lactogen
C) oxytocin
B) human chorionic gonadotropin
D) relaxin
D) epiderm
45)
46) Which embryonic structure produces human chorionic gonadotropin (hCG)?
A) the cytotrophoblast
B) the epiblast
C) the hypoblast
D) the syncytiotrophoblast
46)
47) Shortly after implantation, ________.
A) the embryo gastrulates (within 3 days)
B) maternal blood sinuses bathe the inner cell mass
C) myometrial cells cover and seal off the blastocyst
D) the trophoblast forms two distinct layers
47)
48) The correct sequence of preembryonic structures is ________.
A) blastocyst, morula, zygote
B) zygote, morula, blastocyst
C) zygote, blastocyst, morula
D) morula, zygote, blastocyst
48)
5
49) The decidua basalis is ________.
A) the tissue that surrounds the uterine cavity face of the implanted embryo
B) not a maternal contribution to the placenta
C) destined to remain in the uterus after the birth of the infant
D) the part of the endometrium that lies beneath the embryo
49)
50) 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
50)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
51) Briefly describe the physiological changes occurring in the mother during pregnancy.
51)
52) List four factors that help to precipitate parturition (birth).
52)
53) At what time in the pregnancy is the placenta fully prepared to fulfill the needs of the
developing fetus?
53)
6
Figure 28.1
Using Figure 28.1, match the following:
54) Esophagus.
54)
7
Figure 28.2
Using Figure 28.2, match the following:
55) Site of early blood cell production, and forms part of the gut (digestive tube).
55)
56) How are the metabolic needs of the implanted embryo provided for?
56)
57) When do we begin to call the developing individual a fetus rather than an embryo? Why?
57)
8
Figure 28.1
Using Figure 28.1, match the following:
58) Liver.
58)
9
Figure 28.2
Using Figure 28.2, match the following:
59) Extraembryonic membrane that develops from the trophoblast and some extraembryonic
mesoderm, and forms part of the placenta.
59)
60) Describe the events of the oocyte from sperm penetration to first cleavage.
60)
10
Figure 28.1
Using Figure 28.1, match the following:
61) Trachea.
61)
11
Figure 28.2
Using Figure 28.2, match the following:
62) The part of the endometrium that surrounds the uterine cavity face of the implanted
embryo.
62)
63) 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?
63)
12
Figure 28.1
Using Figure 28.1, match the following:
64) Stomach.
64)
65) Briefly describe the events leading to the implantation of the blastocyst in the uterus,
including how it is nourished.
65)
66) Describe the events allowing monospermy.
66)
67) Explain what triggers a baby's first breath.
67)
68) Define Braxton Hicks contractions.
68)
13
Figure 28.1
Using Figure 28.1, match the following:
69) Pancreas.
69)
14
Figure 28.2
Using Figure 28.2, match the following:
70) Protective water-filled embryonic sac surrounding the embryo.
70)
71) The part of the endometrium destined to be a part of the placenta.
71)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
72) Fertilization occurs while the egg is still in the ovarian follicle.
72)
73) A zygote is usually formed within the uterus.
73)
74) Of the three germ layers, the mesoderm forms the most body parts.
74)
75) Acrosomal enzymes trigger exocytosis of cortical granules in the cortical reaction.
75)
76) The embryonic period lasts until the end of the eighth week.
76)
77) By 72 hours after fertilization, the egg has divided into more than 160 cells and is called the morula.
77)
78) True fertilization occurs when the sperm's membrane binds to the oocyte's sperm-binding
receptors.
78)
79) In fetal circulation, one way in which blood bypasses the nonfunctional lungs is by way of the
foramen ovale.
79)
80) Human placental lactogen initiates labor.
80)
15
81) Humans do not have a yolk sac associated with embryonic development.
81)
82) A blastocyst is a hollow ball of cells, while the morula is a solid ball of cells.
82)
83) A pregnancy test involves antibodies that detect growth hormone (GH) levels in a woman's blood
or urine.
83)
84) An episiotomy is an incision made to widen the vaginal orifice, aiding fetal expulsion.
84)
85) 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.
85)
86) Freshly deposited sperm are not immediately capable of penetrating an oocyte.
86)
87) Premature infants often need to be placed on a ventilator because their undeveloped lungs produce
excess surfactant.
87)
88) By the end of the embryonic period, at 8 weeks, all the adult organ systems are recognizable.
88)
89) Implantation begins six to seven days after ovulation.
89)
90) The period from fertilization through week eight is called the embryonic period.
90)
91) The "fluid-filled, hollow ball of cells" stage of development is the blastocyst.
91)
92) The embryo is directly enclosed in and protected by the amnion.
92)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
93) Becomes the embryonic disc.
A) Decidua capsularis
94) Surrounds the uterine cavity face of
the implanted embryo.
B) Inner cell mass
93)
94)
Match the following:
95) Leads to the formation of the first cell
of the new individual.
A) Fertilization
95)
Match the following:
96) Forms the chorion.
A) Trophoblast
96)
Match the following:
97) Embedding of the blastocyst in the
uterine wall.
A) Implantation
16
97)
98) Leads to enhancement of sperm
motility and increasing membrane
fragility to enable enzyme release
from acrosomes.
A) Capacitation
98)
Match the following:
99) Forms the mother's part of the
placenta.
A) Decidua basalis
99)
Match the following:
100) Leads to the development of a morula
and then a blastocyst.
101) Leads to the establishment of the three
primary germ layers.
A) Gastrulation
100)
B) Cleavage
101)
Match the following:
102) A solid sphere of undifferentiated
cells.
A) Morula
102)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
103) 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?
104) 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?
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 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?
107) 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?
17
108) 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?
109) 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?
18
Answer Key
Testname: 28
1) B
2) B
3) B
4) A
5) A
6) B
7) B
8) C
9) B
10) B
11) D
12) C
13) C
14) D
15) A
16) D
17) A
18) A
19) D
20) B
21) A
22) C
23) D
24) D
25) B
26) B
27) B
28) B
29) B
30) B
31) B
32) A
33) D
34) C
35) D
36) D
37) D
38) C
39) B
40) C
41) B
42) A
43) C
44) B
45) C
46) D
47) D
48) B
49) D
50) B
19
Answer Key
Testname: 28
51) 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.
52) 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.
53) The placenta is fully formed and functional as a nutritive, respiratory, excretory, and endocrine organ by the end of the
third month of pregnancy.
54) A
55) D
56) 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.
57) 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.
58) D
59) B
60) 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.
61) B
62) E
63) 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.
64) C
65) 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.
66) 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.
67) 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.
68) 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.
69) E
70) C
71) A
20
Answer Key
Testname: 28
72) FALSE
73) FALSE
74) TRUE
75) FALSE
76) TRUE
77) FALSE
78) FALSE
79) TRUE
80) FALSE
81) FALSE
82) TRUE
83) FALSE
84) TRUE
85) TRUE
86) TRUE
87) FALSE
88) TRUE
89) TRUE
90) TRUE
91) TRUE
92) TRUE
93) B
94) A
95) A
96) A
97) A
98) A
99) A
100) B
101) A
102) A
103) 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.
104) 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.
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.
21
Answer Key
Testname: 28
106) 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.
107) 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.
108) 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.
109) 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.
22
Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) The genotype of a normal man is ________.
A) Y
B) YY
C) XY
D) XX
1)
2) Dominant alleles are so called because under most circumstances they ________.
A) can suppress the expression of other alleles
B) code for the most common phenotypic and genotypic expressions of a trait
C) code for desired traits only
D) code for genes that are never considered harmful or lethal
2)
3) Recessive alleles are best defined as ________.
A) a deleterious or disease-causing allele
B) the least frequently expressed allele in a given population
C) an allele only expressed when the allele is homozygous
D) a weakened or attenuated allele
3)
4) Errors in mitochondrial DNA are likely to cause genetic disorders associated with ________.
A) gametogenesis
B) glycolysis
C) oxidative phosphorylation
D) nondisjunction
4)
5) The variation seen in ABO blood groups is due to ________.
A) sex-linked inheritance
B) incomplete dominance
C) multiple-allele inheritance
D) polygene inheritance
5)
6) A female infant is born with several hundred oocytes, each one genetically unique. This is due to
________.
A) chromosome deletion
B) random fertilization
C) mutation
D) independent assortment and crossing over
6)
7) Select the statement that best describes the difference between a gene and an allele.
A) Genes express a specific trait while alleles are variations of a particular gene that result in the
variation we see in that trait.
B) Alleles are found on chromosomes while genes are independent.
C) Genes code for a single protein or a single trait while an allele can code for many traits or
many proteins.
D) Genes follow Mendelian patterns of inheritance while alleles follow non-Mendelian patterns
of inheritance.
7)
8) The expressed form of a gene is described as the organism's ________.
A) phenotype
B) karyotype
C) genotype
8)
1
D) genome
9) 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 homozygous dominant genotype
C) Steven has a heterozygous genotype
D) that it is impossible to tell Steven's genotype from this information alone
9)
10) Amy's hand was exposed to X-rays. A gene in a skin cell of her hand mutated. This mutant gene
will ________.
A) replicate itself when the cell divides but will not be passed on to Amy's offspring
B) not form an exact duplicate of itself when the cell divides
C) replicate itself and be passed on to Amy's children
D) very likely cause skin cancer
10)
11) Two alleles expressing exactly the same information for a trait are described as ________.
A) hemizygous
B) homozygous
C) monogamous
D) heterozygous
11)
12) For which of the following are newborn infants NOT routinely screened at birth?
A) imperforate anus
B) color blindness
C) PKU
D) congenital hip dysplasia
12)
13) Which of the following statements is true concerning genetic screening?
A) Screening is illegal in over half of the world.
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 can be done only in the first trimester of pregnancy.
13)
14) If a person is homozygous for a particular trait this means ________.
A) the person will not have a recessive condition
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 cannot pass on that trait
14)
15) Recessive genes are usually expressed in humans only when ________.
A) they are coding for genetic diseases
B) they are coding for skin color
C) the organism is in the embryonic stage
D) both alleles for the gene are exactly the same, or homozygous
15)
16) The reason recessive genetic disorders are more frequent than dominant genetic disorders is that
________.
A) people carrying dominant genetic disorders always die before birth
B) dominant genetic disorders are never expressed in males
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
16)
2
17) CRISPR-Cas9 refers to a(n) ________.
A) locus on a chromosome where the trait for sickle-cell anemia is carried
B) technique used to change and edit sequences of DNA
C) technique for creating a karyotype of one's chromosomes
D) enzyme responsible for self-destructing mutated cells
17)
18) 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
18)
19) How many alleles exist for a given gene?
A) Only two alleles can exist per gene.
B) Each gene can have a different number of alleles.
C) Only one allele can exist per gene.
D) Four alleles exist per gene, two from each parent.
19)
20) The epigenetic mark that silences the expression of a gene is ________ bound to the DNA or histone
proteins.
A) a methyl group
B) an amine group
C) a carboxyl group
D) an acetyl group
20)
21) The epigenetic mark that indicates that a gene is available for transcription is ________ bound to
the DNA or histone proteins.
A) a methyl group
B) an amine group
C) an acetyl group
D) a small RNA-enzyme complex
21)
22) 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) 75% chance, the same probability for all of their children
B) 100% chance because the mother and father both have cleft chins
C) 0% because the two previous children have cleft chins already
D) 25% chance, the same probability for all of their children
22)
23) 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) destroying the target mRNA
C) inhibiting translation of the target mRNA into a peptide
D) blocking the transcription of the gene that codes for the target mRNA
23)
24) 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) incomplete dominance
C) sex-linked inheritance
D) dominance
24)
3
25) Mitochondrial DNA (mDNA) is inherited ________.
A) from neither the father or the mother
C) from both the father and the mother
B) only from the mother
D) only from the father
25)
26) Gene mutations in the X chromosome would tend to become visibly expressed ________.
A) equally frequently in both sexes
B) more frequently in females
C) more frequently in males
D) in neither males nor females
26)
27) 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) sex-linked recessive
B) autosomal dominant
C) autosomal recessive
D) sex-linked dominant
27)
28) A couple whose blood types are AB (IAIB) and B (IBi) may have a child with which of the following
blood types?
A) A, B, or AB only
B) AB only
C) A, B, AB, or O
D) A or B only
28)
29) Which event can directly produce one chromosome containing both maternal and paternal genes?
A) crossing-over only
B) independent assortment only
C) crossing-over and independent assortment
D) one chromosome can never have genes from both parents
29)
30) The main way a recessive allele would be fully expressed even when only one copy is present
would be ________.
A) co-dominance
B) incomplete dominance
C) recessive inheritance
D) sex-linked inheritance
30)
31) 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) genotype
C) karyotype
D) phenotype
31)
32) A dominant allele is best defined as ________.
A) the allele that is most frequently expressed in a given population
B) the healthy allele sometimes referred to as the wild type allele
C) an allele that stops or hides the expression of another allele
D) the stronger of two matched alleles
32)
33) 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) mutation
B) crossing over
C) independent assortment
D) random fertilization
33)
34) 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) 50%
C) 100%
D) 25%
34)
4
35) The gene responsible for the condition known as sickle-cell anemia demonstrates ________.
A) a recessive genetic disorder
B) incomplete dominance
C) a sex-linked genetic disorder
D) a dominant genetic disorder
35)
36) ________ is the most common type of fetal testing.
A) Amniocentesis
C) CVS
36)
B) A DNA probe
D) Blood chemistry
37) 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) crossing over
B) independent assortment
C) mutation
D) random fertilization
37)
38) Which of the following best describes genotypes and phenotypes?
A) A trait that is expressed such as eye color is the phenotype and the gene responsible for eye
color is the genotype.
B) A person's genotypes and phenotypes are typically unchanging during their lifetime.
C) A person's genotypes and phenotypes often both change during their lifetime.
D) A person's genotypes often change during their lifetime, but their phenotypes typically do
not.
38)
39) 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) mutation
B) crossing over
C) independent assortment
D) random fertilization
39)
40) 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 dominant genotype
B) Steven has a homozygous recessive genotype
C) Steven has a heterozygous genotype
D) that it is impossible to tell Steven's genotype from this information alone
40)
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
41) The 23rd pair of human chromosomes are called ________ chromosomes.
41)
42) The ABO blood type is a good example of a(n) ________ inheritance.
42)
43) Define phenocopy.
43)
44) What possible genotype(s) could the second-generation, fuzzy-longhaired individuals
possess?
44)
5
Figure 29.1
Use Figure 29.1 to answer the following:
45) Is the trait sex-linked?
45)
46) Define karyotype.
46)
47) The X and Y chromosomes are considered the ________ chromosomes.
47)
48) Color blindness is a(n) ________ trait.
48)
6
Figure 29.1
Use Figure 29.1 to answer the following:
49) Are there any afflicted females?
49)
50) An allele that completely masks the expression of the other alleles is called ________.
50)
51) How might carriers of deleterious genes be recognized?
51)
52) When might amniocentesis be appropriate?
52)
53) ________ disease is a disorder of brain lipid metabolism and is an example of a recessive
trait.
53)
7
Figure 29.1
Use Figure 29.1 to answer the following:
54) Identify, by numbers, any other possible carriers.
54)
55) What would the parental gametes be from a cross of two second-generation,
straight-shorthaired individuals?
55)
56) What is (are) the phenotype(s) of the first-generation offspring?
56)
Figure 29.1
Use Figure 29.1 to answer the following:
57) Are there any male carriers?
57)
8
58) Describe briefly the three mechanisms that lead to genetic variability.
58)
59) The second-generation phenotypes would follow what ratio? (Pair the number with a
phenotype in each case.)
59)
60) Removing a sample of the fluid surrounding the fetus for the purpose of studying the
chromosomes is a procedure called ________.
60)
61) 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?
61)
62) Albinism is a good example of a(n) ________ trait.
62)
63) The second-generation types would have what phenotypes?
63)
64) Observable characteristics expressed by the genes for a trait are called the ________.
64)
65) What were the genotypes of the parental (P1) individuals?
65)
66) A cross of two second-generation, straight-shorthaired individuals would yield what
phenotype?
66)
67) What is (are) the genotype(s) of the first-generation offspring?
67)
Figure 29.1
Use Figure 29.1 to answer the following:
68) Is the trait dominant or recessive?
68)
9
69) Identify, by numbers, any known carriers.
69)
70) What would be the gametes of the first-generation individuals?
70)
TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
71) Hereditary characteristics are transmitted to offspring by genes.
71)
72) It is possible for a baby to have type O blood if neither parent is type O.
72)
73) Y chromosomes contain far more genes than X chromosomes.
73)
74) The same allele can have a different effect depending on which parent it comes from.
74)
75) A diagram of human relatives with specific genetic traits is called a pedigree.
75)
76) Genetic segregation implies that the members of the allele pair determining each trait are
distributed to different gametes during mitosis.
76)
77) Environmentally produced phenotypes that mimic conditions that may be caused by genetic
mutation are called phenocopies.
77)
78) Hemophilia is an X-linked condition caused by a recessive gene.
78)
79) When genes are on the X or Y chromosomes, they are considered X-linked.
79)
80) Genetic variation results from the crossing over and exchange of chromosomal parts that occur
during meiosis II.
80)
81) The expression of all physical traits is strictly due to the inheritance of specific genes.
81)
82) Mitochondrial genes are free of errors. As a result, all genetic problems are due exclusively to
nuclear genes.
82)
83) The term lethal dominant gene indicates that the gene causes death only when the individual is
homozygous dominant.
83)
84) Down syndrome is an example of nondisjunction of chromosomes.
84)
85) 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.
85)
86) A Punnett square is a diagram that may be used to figure out the possible combinations of genes
for a trait.
86)
87) Height in humans is determined by polygene inheritance.
87)
88) Small RNAs control the timing of programmed cell death during development.
88)
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89) Alleles may code for alternative expressions of a genetic trait.
89)
90) In incomplete dominance, the heterozygote has an intermediate phenotype between that of
homozygous dominant and homozygous recessive individuals.
90)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
91) Results in chromosomes that have
mixed contributions from each parent.
A) Gene recombination
91)
Match the following:
92) The gene allele that suppresses or
masks the expression of the other
allele.
A) Dominant
92)
Match the following:
93) Inheritance of the ABO blood group
type is an example of this type of
inheritance.
A) Multiple-allele inheritance
93)
Match the following:
94) A condition of drier excessively sticky
mucus production.
A) Cystic fibrosis
94)
Match the following:
95) The heterozygote has a phenotype
intermediate between those of the
homozygous dominant and
homozygous recessive.
A) Incomplete dominance
95)
Match the following:
96) Means by which genes trade places,
some maternal and some paternal, on
each chromosome.
A) Independent assortment
97) Distribution of chromosomes to
different gametes.
C) Chromosome segregation
96)
B) Chromosome crossover
98) A particular gene's allele received by a
gamete has no influence over selection
of a different gene's allele.
97)
98)
11
Match the following:
99) Situation in which an individual
requires identical alleles for that
particular trait to be expressed.
A) Homozygous
99)
Match the following:
100) An unremitting, fatal nervous system
disease involving degeneration of the
basal nuclei.
A) Huntington's disease
100)
B) Albinism
101) Lack of skin pigmentation.
101)
Match the following:
102) Inheritance that results in continuous
or qualitative phenotypic variations
between two extremes; an example is
skin color.
A) Polygenic inheritance
102)
B) Sex-linked inheritance
103) Inherited traits determined by genes
on the X or Y chromosomes.
103)
Match the following:
104) Rare type of dwarfism resulting from
an impaired ability of the fetus to
lengthen long bones by endochondral
ossification.
A) Achondroplasia
104)
Match the following:
105) A chromosome pair that may be very
different in size.
A) Sex chromosomes
105)
Match the following:
106) A disorder of brain lipid metabolism.
A) Tay-Sachs disease
106)
Match the following:
107) Genes for the same trait that have
different expressions.
108) Chromosomes regulating most body
characteristics.
A) Allele
107)
B) Autosomes
108)
12
Match the following:
109) Actual genetic makeup.
A) Genotype
109)
Match the following:
110) Situation in which an individual has
different alleles making up the
genotype for a particular trait.
A) Heterozygous
110)
Match the following:
111) Genes not expressed unless they are
present in homozygous condition.
A) Recessive
111)
Match the following:
112) The dominant gene is expressed when
present; the recessive gene is
expressed only in the absence of the
dominant gene.
A) Dominant-recessive
112)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
113) A patient is heterozygous for sickle-cell anemia. Explain why the patient would have few or no symptoms of
sickle-cell anemia.
114) 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?
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) 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.
117) 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?
13
118) 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?
119) 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?
120) A family has four offspring belonging respectively to ABO blood groups A, B, O, and AB. Give the genotypes
and phenotypes of the parents.
121) 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.
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) 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?
124) 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?
14
Answer Key
Testname: 29
1) C
2) A
3) C
4) C
5) C
6) D
7) A
8) A
9) C
10) A
11) B
12) B
13) B
14) C
15) D
16) D
17) B
18) D
19) B
20) A
21) C
22) A
23) A
24) B
25) B
26) C
27) A
28) A
29) A
30) D
31) C
32) C
33) D
34) A
35) B
36) A
37) C
38) A
39) C
40) D
41) sex
42) multiple-allele
43) Environmentally produced phenotypes that mimic conditions that may be caused by genetic mutations.
44) The second-generation, fuzzy-longhaired individuals could be FFTT, FfTT, FFTt, or FfTt.
45) Yes.
46) Karyotype is the chromosomal content of a cell.
47) sex
48) sex-linked
49) No.
50) dominant
15
Answer Key
Testname: 29
51) 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.
52) 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.
53) Tay-Sachs
54) 14, 16, 23, and 25.
55) The parental gametes from the cross would all be ft.
56) The phenotypes of the first-generation offspring are all fuzzy-longhaired.
57) No.
58) 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.
59) The second-generation phenotypes would appear in the following ratios: 9 fuzzy-longhaired, 3 fuzzy-shorthaired, 3
straight-longhaired, and 1 straight-shorthaired.
60) amniocentesis
61) 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.
62) recessive
63) The second-generation recombination types would have the following phenotypes: fuzzy-longhaired,
fuzzy-shorthaired, straight-longhaired, and straight-shorthaired.
64) phenotype
65) The genotypes of the parental individuals were FFTT and fftt.
66) A cross of two second-generation, straight-shorthaired individuals would yield a straight-shorthaired phenotype.
67) The genotypes of the first-generation offspring are all FfTt.
68) Recessive.
69) 2, 5, 7, and 18.
70) The gametes of the first-generation individuals from the original cross would be FT, fT, Ft, and ft.
71) TRUE
72) TRUE
73) FALSE
74) TRUE
75) TRUE
76) FALSE
77) TRUE
78) TRUE
79) FALSE
80) FALSE
81) FALSE
82) FALSE
16
Answer Key
Testname: 29
83) FALSE
84) TRUE
85) TRUE
86) TRUE
87) TRUE
88) TRUE
89) TRUE
90) TRUE
91) A
92) A
93) A
94) A
95) A
96) B
97) C
98) A
99) A
100) A
101) B
102) A
103) B
104) A
105) A
106) A
107) A
108) B
109) A
110) A
111) A
112) A
113) 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.
114) 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.
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) 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.
117) One-half of their children would be expected to be farsighted.
17
Answer Key
Testname: 29
118) 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.
119) 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.
120) The parents have the following genotypes and phenotypes: One parent is IAi (heterozygous for A) with type A blood;
the other parent is IBi (heterozygous for B) with type B blood.
121) 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%.
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) (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.
124) The man has a BbRr genotype, while the woman has a bbRr genotype.
18