APPLIED ANATOMY AND PHYSIOLOGY THE CELL I.
ESSENTIAL CONCEPTS: A.
Cellular Composition:
1. 2. 3. B. II.
Nucleus Cytoplasm Cell Membrane Home Homeo osta stasis sis – Sta State of Equ Equil ilib ibri riu um
CELLULAR DYSFUNCTION:
A. A.
B. C. 1. 2. 3. 4. D. 1. 2. 3. 4. B. 5. 6. 7. 8. 9.
Flui Fluids ds – Int Intra race cell llul ular ar vs. vs. Ext Extra race cell llul ular ar Electrolytes – K, PO 4, Na, Cl Acid-Base Balance Regulatory Me Mechanisms: Osmosis Diffusion Filtration Active Transport Sources of Normal Fl Fluid Los Loss Kidneys 4. GI Tract Skin Lungs Homeostatic Mechanisms Renal System Cardiovascular System Pulmonary System Buffer System Endocrine System Pituitary Gland (ADH) Adrenal Cortex (Aldosterone) Parathyroid (Parathormone) -
Normal ABG Values - pH: 7.35 to 7.45 - PO2: 80-100 mmHg - PCO2: 35-45 mmHg - HCO3: 22-26 mE /L
THE NERVOUS SYSTEM 1.
BRAIN
a. b. c. d. e.
Cerebrum Cerebellum Basal Ganglia Brainstem Diencephalon
PROTECTIVE STRUCTURES:
a. Men Menin inge ges: s: Dura Dura Mat Mater er Arachnoid Mater Pia Mater b. CSF -
2.
500 – 700 ml/day produced by Choroid Plexus circulates at subarachnoid sp space
SPINAL CORD Cervical Thoracic Lumbar
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Sacral Coccygeal a. Desc Descen endi ding ng Trac Tracts ts b. Ascen scendi ding ng Tra Tract cts s 3. PNS a. CN – 12 pairs b. SN – 31 pairs MUSCULOSKELETAL SYSTEM I.
a.
b.
BONES: (206) Type Types s of Os Osse seou ous s Tis Tissu sue e Compact Bone Spongy Bone -
Class Classifi ificat cation ion Accdg Accdg.. to to Shap Shape e - Long - Flat - Short - Irregular
c.
Parts rts of of Long Long Bon Bone
d.
Bone Marrow Yellow Marrow – storage of adipose tissue Red Marrow – produces RBC & WBC
-
e.
- Sesamoid
Skeleton -
Axial Skeleton – skull, vert. column, thorax Appendicular Appendicular Skeleton – bones of the limbs
-
II.
JOINTS:
Synarthrosis Ampiarthrosis Diarthrosis III. III.
SKEL SKELET ETAL AL MUS MUSCL CLES ES:: (Striated Voluntary Muscle) a. Sarcolemma c. Perimysium b. Endomysium d. Epimysium
IV.
LIGAMENTS:
V.
TENDONS:
V I.
CARTILAGE a. b. c.
Hyaline Cartilage Fibrocartilage Yellow Cartilage
FUNCTIONS: I.
II.
BONES: Protects Vital Organs Support Body Tissues Muscle Attachment Hematopoeisis Storage of Mineral Salts JOINTS: a. Ball & Socket Socket b. Hinge Hinge c. Saddl Saddle e d. Pivot Pivot e. Gliding Gliding f. Co Cond ndyl yloi oid d
i.
SKELETAL MUSCLES
Provide Movement Posture Heat Production
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i.
LIGAMENTS
Jt. Stability & Restriction of Motion
i.
TENDONS
Bind Muscle to Bone
i.
CARTILAGE
Shock Absorption Protects Bones & Joints
RESPIRATORY SYSTEM A.
Structures
1.
Upper Upper Respir Respirat atory ory Tract Tract – nose, nose, sinuses sinuses,, pharyn pharynx, x, larynx larynx..
2.
Lower Lower Respirato Respiratory ry Tract Tract – trachea, trachea, mainst mainstem, em, bronchi bronchi,, segmenta segmentall bronchi, bronchi, termina terminall bronchioles, alveoli.
3.
Lungs (R) Lung
vs
3 Lobes
2 Lobes
thicker, broader shorter 4.
Chest Cavity
5.
Pleura a. b.
(L) Lung
thinner, narrower, longer
Parietal Pleura Visceral Pleura
6.
Respi espira rattory ory Musc Muscle les s a. Diaphragm b. Ext. Intercostals c.Accessory Muscles
7.
Pulm Pulmon onar ary y Bloo Blood d Supp Supply ly
8.
Neuro eurolo log gic Co Cont ntro roll
B.
Functions:
1. Uppe Upperr Respi Respira rato tory ry Trac Tractt a. air air cond conduc ucti tion on b. protec protectio tion n from from forei foreign gn matt matter er c. warm warmin ing/ g/hu humi midi dify fyin ing g air air 2. Lower Lower Resp Respir irat ator ory y Tract Tract a. b. c.
Trachea – connects larynx & lungs Bronchi – conduct air to alveoli Alveoli – gas exchange
3. Lungs a. b. c.
Ventilation Diffusion of Gases Acid-Base Regulation
4. Ches Chestt Ca Cavity vity 5. Pleura
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6. Re Resp spir irat ator ory y Musc Muscle les s 7. Pulm Pulmon onar ary y Blood Blood Sup Suppl ply y 8. Neur Neurol olog ogic ic Co Cont ntrol rol CARDIOVASCULAR SYSTEM I. THE HEART 1. Pericardium – membranous sac that covers the heart a. Visceral Pericardium b. Parietal Pericardium 2. Heart Wall a. Epicar Epicardiu dium m or Viscer Visceral al Perica Pericardi rdium um b. Myocardium c. Endocardium 3. b. c. d. e.
Chambers Right Atrium Right ght Ventr entric icle le Left Atrium Left eft Ventr entric icle le
4. Heart Valves a. Antr Antrio iove vert rtri ricu cula larr Val Valve ves s Tricuspid Bicuspid or Mitral -
b. Semil emilu unar Valv Valves es -
Pulmonic Valve Aortic Valve
* Papillary Muscles * Chordae Tendinae 5. Cardiac Conduction System a. Electrical pathways Sinoatrial (SA) node) - Pacemaker AV Node - @ Sinus Rhythm 60-100 Dpm Bundle of His Purkinje Fibers b. Electrical Impulse Activity – Measured by ECG Phases of ECG – P, Q, R, S, T * P Wave – atrial depolarization * QRS Complex – ventricular depolarization depolarization * T Wave – Ventricular repolarization repolarization 6. a. b.
Coronary Arteries Right Coronary Artery Left Main Coronary Artery
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Arterial Blood Gases Type Respiratory Respiratory acidosis pH < 7.35 partial pressure of arterial carbon dioxide (Paco2) > 45 mm Hg (too much carbon dioxide (CO2) = too much acid = acidosis
Causes Respiratory failure, respiratory arrest, pulmonary edema, chronic obstructive pulmonary disease, pneumonia, pneumothorax, atelectasis, overdose, aspiration
Clinical Manifestations If sudden onset: increased heart rate, decreased level of consciousness (LOC), feeling of fullness after vasodilation from CO2 in head, dysrhythmias, If chronic: weakness, dull headache
Treatment
Improve ventilation (chest physiotherapy: turn, cough, deep breathe; suction; oxygen (O2) -
Assess vital signs, breath sounds, and neurologic assessment signs. -
Monitor arterial blood gases (ABG) and pulse oximetry readings. Respiratory Respiratory alkalosis pH > 7.45; Paco2, <35 mm Hg (too little CO2= too little acid – alkalosis)
Hyperventilation, pain, anxiety, hypoxemia, ventilators
Metabolic acidosis pH < 7.35; bicarbonate (HCO3) < 22 mEq/L (too little HCO3 = too little base acidosis
Diabetic ketoacidosis; starvation (ketoacidosis), lactic acidosis; renal failure, diarrhea; acetylsalicylic acid poisoning
Metabolic alkalosis pH < 7.35; HCO3 > 26 mEq/L (too much HCO3 = too much base - alkalosis
Vomiting, nasogastric tube; diuretics antacids, too much HCO3; too much IV, HCO3 ordered by health care provider
Lightheadedness, unable to concentrate, numbness, tingling, tinnitus.
-
Treat the cause. -
Encourage slow breaths. Changes in LOC (confusion, drowsiness), headache, nausea and vomiting, Kussmaul’s respirations (increased rate and Increased depth), dysrhythmias)
Tingling, dizziness and bradypnea (conserve O2), hypertonic muscles, dysrhythmias
-
Administer sodium bicarbonate, monitor intake and output, ABGs, vital signs, and dyshythmias; use seizure precautions -
Restore fluid volume and electrolytes. -
Monitor vital signs, intake and output, ABGs, and dysrhythmias. -
Perform a neurology assessment.
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II. FUNCTIONS OF THE HEART 1.
Cardiac Output – SV X HR Stroke Stroke Volu Volume me – amt. amt. of of blood blood ejec ejected ted per beat beat Preload Afterload b. Heart Rate - normal 60 – 100 bpm
a.
2. a. b.
Cardiac Cycle
Systole – contraction phase Diastole – relaxation (filling) phase
3. a.
Heart Sounds – tricuspid & mitral valves closure – aortic & pulmonic valves closure – ventricular gallop – atrial gallop
d.
S1 S2 S3 S4
4. a. b. c. d.
Neurologic Fa Factors Re Regulating He Heart Fu Function Sympat Sympathet hetic ic Stimul Stimulat ation ion Paras Parasymp ympath atheti etic c Stimul Stimulat ation ion Chem Chemor orec ecep epto torr Respo Respons nse e Baro Barore rece cept ptor or Respo Respons nse e
b. c.
THE VASCULAR SYSTEM A. STRUCTURE
1.
Arteries
2.
Arterioles
3.
Capillaries
II. FUNCTIONS OF THE HEART 1.
Cardiac Output – SV X HR Stroke Stroke Volu Volume me – amt. amt. of of blood blood ejec ejected ted per beat beat Preload Afterload b. Heart Rate - normal 60 – 100 bpm
a.
2. a. b.
Cardiac Cycle
Systole – contraction phase Diastole – relaxation (filling) phase
3. a.
Heart Sounds – tricuspid & mitral valves closure – aortic & pulmonic valves closure – ventricular gallop – atrial gallop
d.
S1 S2 S3 S4
4. a. b. c. d.
Neurologic Fa Factors Re Regulating He Heart Fu Function Sympat Sympathet hetic ic Stimul Stimulat ation ion Paras Parasymp ympath atheti etic c Stimul Stimulat ation ion Chem Chemor orec ecep epto torr Respo Respons nse e Baro Barore rece cept ptor or Respo Respons nse e
b. c.
THE VASCULAR SYSTEM A. STRUCTURE
1.
Arteries
2.
Arterioles
3.
Capillaries
4.
Venules
5.
Veins Superficial Veins Deep Veins
-
6.
Lymphatic System Lymphatic Vessels Lymph Nodes Lymph Ducts -
Right Lymphatic Duct Thoracic Duct
HEMATOLOGIC SYSTEM A. STRUCTURE 1. Bone Marrow a. Red Marrow b. Yellow Ma Marrow row c. Stem Cells
2. Blood Cells normal Hematocrit – 45%
-
a. Erythrocytes (RBC) -
5 million cells/mm 3 of blood Biconcave disks containing hemoglobin normal Life Span is 120 days
-
b. Leukocytes (WBC) -
5,000 – 10,000 cells/mm3 of blood * 2 Major Types 1. Granular Leukocyte
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Artery (Conducting Vessels) 3 layers –Tunica Adventitia Tunica Media Tunica Intima
Thicker & More Elastic Deeper ion Location (-) Valves
VS
Vein (Capacitance Vessels) 3 Layers –Tunica Adventitia Tunica Media Tunica Intima
Thicker & Less Elastic More Superficially located (+) Valves
Carries Oxygenated Blood Higher Pressure
-
Carries Unoxygenated Blood Lower Pressure
70% of all WBCs Subdivided into Neutrophils Eosinophils Basophils
2.
Mononuclear Mononucl ear Leukocyte (Agranular) Subdivided into Lymphocytes Monocytes c. Thrombocytes (Platelets) -
150,000 – 450,000 cells/mm3 produced in bone marrow, Megakaryocytes normal Life Span is 7 to 14 days -
lungs
&
spleen
from
3. Plasma 55% of Blood Volume Contains Plasma Proteins – Albumin Globulin Fibrinogen
-
-
B.
FUNCTIONS
1. -
2. 3.
Gen Functions of Blood: O2 Transportation Waste Transportation Hormonal Transportation Defense Against Infection Chemical, Acid-Base & Thermal Regulation Homeostasis Bone Marrow Blood Cells
a. b. -
Erythrocytes Leukocytes Neutrophils Eosinophils Basophils Monocytes Lymphocytes – B – Lymphocytes T – Lymphoytes
c. Thrombocytes * Coagulation Factors (Table)
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Blood Coagulation proteins Factor I II III IV V VII VIII IX X XI XII XIII Prekallikrein High-molecularweight kininogen 4. a. b.
Synonyms Fibrinogen Prothrombin Tissue thromboplastin, tissue factor Calcium ion Proaccelerin factor, labile factor Serum prothrombin, prothrombin, conversion accelerator, stable factor Antithemophilic factor Christmas Christmas factor Stead-Power factor Plasma thromboplastin antecedent Hageman factor Fibrin stabilizing factor Fletcher factor Fitzgerald factor, Flaujeac factor, Williams factor, contact activation cofactor
Plasma Plasma Proteins Constituent Su Substances in in Pl Plasma Blood Coagulation (Clotting and Hemostasis) 1) Vascular Phase 2) Platelet Phase 3) Coagulation Phase Maintenance Maintenance of Acid-Base Balance -
Clot Lysis Transportation of Nutrients and Hormones
IMMUNE SYSTEM A.
5. 6. 7.
Functions Defense Against Infection Maintenance of Homeostasis Organs & Tissues Bone Marrow Thymus Lymph Nodes Spleen Tonsils/Adenoids Hematopoietic System Nonspecific Immunologic Defense (Natural Immunity) Physical Barriers Chemical Barriers Biologic Response Modifiers Actions of White Blood Cells Neutrophils Eosinophils & Basophils Granulocytes Monocytes & Macrophages Inflammatory Response Natural Killer Cells Complement
1.
Specific Immunologic Defense Types of Immunity
1. 2. B.
1. 2. 3. 4. 5. 6. C.
1. 2. 3. 4. a. b. c. d.
D.
______________________________________________________________
a. b.
Inborn Immunity Acquired Immunity Mechanism of Specific Immunity
2.
2 Types: a. Humoral Immunity (B-Lymphocyte) involves formation of antibodies 5 Types of Antibodies: IgG – activates complement, crosses placenta IgA – present in body fluids (blood, saliva, breast milk, vaginal secretions) IgM – first antibody produced in immune response IgD – important for B cell activation IgE – allergic & hypersensitivity rxns – defense against parasites b. Cell-Mediated Immunity (T-Lymphocytes) delayed hypersensitivity reactions transplant rejection viral, fungal, chronic infections * T-lymphocytes (devised from thymus) Types of T-Cells: Helper T Cells (T4) Suppressor T Cells (T8) Memory T Cells Cytotoxic T Cells 3.
Stages of Specific Immune Responses Recognition Proliferation Response Effector
a. b. c. d.
ENDOCRINE AND METABOLIC SYSTEMS A.
chemicall substanc substances es secreted secreted by endocrine endocrine glands glands Hormones - chemica directly into blood stream. 1. Types of Hormones: e. Protein or Peptide Hormone – insulin, vasopression, GH, ACTH. f. Amine Hormones or Amino Acids – EPI, NE g. Steroids – cortisol, Estrogen, Testosterone 2. Hormone Regulation
B. PITUITARY GLAND
1. Anterior Lobe a. b. c. d. e. f. 2. Posterior Lobe a. b.
GH Prolactin Thyroid-Stimulating Hormone (TSH) ACTH Follicle Stimulating Hormone Leutinizing Hormone Oxytocin ADH/Vasopressin
C. THYROID GLAND
1. Thyroxine (T ) and Triiodothyronine (T ) 4
3
2. Thyrocalcitonin D. PARATHYROID GLAND
1. Parathormone
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E. ADRENAL GLANDS
1. Adrenal Medulla a. Epinephrine (Adrenalin) b. Nonepinephrine 2. Adrenal Cortex a. Mineralocorticoids (i.e. Aldosterore) b. Glucocorticoids (i.e. Cortisol) c. Adrenal Sex Hormones (i.e. Androgen and Estrogen) F.
1. 2.
PANCREAS PANCREA S – both an endocrine and exocrine gland.
Exocri Exocrine ne Functi Function on – secre secrete te pancr pancrea eatic tic digest digestive ive enzyme enzymes s Endocr Endocrine ine Functi Function on – contro controlle lled d by alpha, alpha, beta beta and delta delta cells cells of the islets islets of Langerhans. a. ALPH ALPHA A ce cells lls – secr secret ete e GLU GLUCA CAG GON b. BETA BETA cell cells s – sec secre rete te INSU INSULI LIN N c. DELT DELTA A cell cells s – sec secre rett SOMA SOMATO TOST STAT ATIN IN and and GAS GASTR TRIN IN
G. GONADS
1. Ovarie Ovaries s - Estrog Estrogen en and and Prog Progest estero erone ne 2. Test Testes es - Tes Testo tost ster eron one e GI SYSTEM B.
C.
Structures
1. Oral Oral Stru Struct ctur ures es 2. Esophagus * Esophagea Esophageall Openin Opening g a. Uppe Upperr Esop Esopha hage geal al Sph Sphin inct cter er b. Lower Lower Esoph Esophagea ageall Sphin Sphincter cter (Cardiac (Cardiac Sphincte Sphincter) r) 3. Stomach * 3 Pa Parts rts a. Fundus b. Body c. Antrum trum (Pyl (Pylor orus us)) 4. Sphi Sphinc ncte ters rs 5. Smal Smalll Inte Intest stin ine e a. Duodenum b. Jejunum c. Ileum 6. Larg Large e Inte Intest stin ine e a. Cecum b. Colon c. Rectum 7. Ilio Ilioce ceca call Valv Valve e 8. Appendix 9. GI Tract Tract Layers Layers (5) – 1. Inner Inner Mucosa Mucosall Layer Layer 2. Submucosal layer 3. Circular Smooth Muscle Layer 4. Longitudinal Smooth Muscle Layer 5. Outer Peritoneal Layer - Parietal Peritoneum - Visceral Peritoneum Function 1. 2. rectum.
Digestion – occurs in upper GIT, stomach and small intestines. Elimination – de defecation oc occurs in in th the lla arge iin ntestine a an nd
HEPATIC SYSTEM A.
Structure
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1. Liver – largest largest glandular organ – located in right upper abdominal quadrant – 4 lobes – left, right, caudate and quadrate – Contains HEPATOCYCTES (Liver Cells) and KUPFER’S CELLS (Phagocytic Cells) – BILE is composed of H2O, electrolytes, lecithin, fatty acid, cholesterol, bilirubin and bile salts. – blood supply is from PORTAL VEIN (75%) and HEPATIC ARTERY (25%) 2. Biliary System Canaliculi a. Hepatic Duct b. Oddi’s Sphincter c. Gall Bladder 3. Pancreas
- fish-shaped organ - extends horizontally from duodenum to spleen - the pancreatic exocrine units (ACINI) produce bet. 1,200 – 3,000 ml of pancreatic juice.
B. FUNCTION
2. Liver a. b. c. d. e. f. g. h.
regulates blood glucose levels synth nthesis esis of gluco lucos se fro from m ami amino no acids cids of lacta ctate converting ammonia to urea synt synthe hesi sis s of plas plasma ma prot protei eins ns and and clot clotti ting ng fact factor ors s brea reaking king down own fatt fatty y acids cids into nto ket keton one e bodi odies storing vi vitamin and trace metals drug metabolism and detoxification bile secretion
3. Bili Biliar ary y Sys Syste tem m a. b.
Draining bile Storing bile in gall bladder
4. Pancreas Pancreas – has endocrine endocrine and exocri exocrine ne functi function on a.
Secretes pa pancreatic ju juice fo for di digestion 3 Types of Digestive Enzymes AMYLASE hydrolyzes CHO to disaccharides disaccharides LIPASE hydrolyzes FAT to fatty acids and glycerol TRYPSIN splits protein -
b.
Secretes H2O and bicarbonate to neutralize gastric juice.
URINARY AND RENAL SYSTEM A.
1.
2.
Structure Uri Urinary nary Syste ystem m a. b. c. d.
Kidneys a.
Ureters Bladder Urethra Urinary Meatus
– lie between T 12 – L3 – retroperitoneal in location
External Structures Hilum Renal Capsule -
b.
Internal Structures
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-
c. d.
Medulla Renal Pyramids Papillae Renal Pelvis Nephron – Glomerulus – Proximal Tubule – Loop of Henle – Distal Tubule – Collecting Duct
Renal Ci Circulation – Renal Ar Arteries Neur Neurol olog ogic ic Co Cont ntro roll – Symp Sympha hath thet etic ic/P /Par aras asym ymph pha athet thetic ic
B.
FUNCTION
1. Uri Urinary nary Syste ystem m: a. Ureters – transport urin rine to bladder b. Bladder – reservoir for urine c. Uret Urethr hra a – carr carrie ies s uri urine ne from from blad bladde derr to to the the outs outsid ide e of of the the body body.. d. Urine Formation 3 Processes: 1. Filtra Filtratio tion n – happens happens in Glom Glomeru erulus lus 2. Reabsorpti Reabsorption on – done done by prox prox & distal distal convol convoluted uted tubule tubules. s. 3. Secret Secretion ion – reab reabsor sorpti ption on in revers reverse e e. Micturition (v (voiding) under voluntary and involuntary control 150 – 300 ml – urge to void 400 – 600 ml – normal bladder capacity 1.5 L/day – normal urine output bladder normally contains no residual r esidual urine after voiding. 2.
Kidn Kidney eys s – ove overa rall ll fun funct ctio ion n a.
blood blood press pressure ure regu regula latio tion n by renin renin secr secreti etion on
b.
RBC produc productio tion n by eryth erythrop ropoie oietin tin secr secreti etion on
c.
Meta Me tabo boli lism sm of of vita vitami min n D. INTEGUMENTARY SYSTEM
A.
STRUCTURE 3 Layers of Skin:
1. -
2.
Hypodermis (Subcutaneous Layer) Innermost Layer Loose areolar connective tissue or adipose (fat) tissue
Dermis (Corium) Middle Layer composed of collagen fibers Provide mechanical strength Contains blood vessels, nerves, lymphatics, hair follicles, sebaceous & sweat glands -
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Major Functions of nephron components Nephron Component
Major function
Glomerulus Proximal tubule
- Fitration 65% sodium (Na) and water (H2O) reabsorbed (antidiuretic hormone (ADH) not required) Glucose, potassium (K), amino acids reabsorbed Bicarbonate (HCO 3-) reabsorbed Hydrogen (H+) secreted Urea reabsorbed Filtrate leaves isotonic Countercurrent multiplying exchange mechanism established between long, thin loops of Henle of juxtamedullary nephrons and adjacent vasa recta. Filtrate leaves hypotonic Na+ reabsorbed and K+ secretad in presence of aldosterone; opposite occurs in absence of aldosterone. H2O reabsorbed with Na+; ADH also influences water reabsorption Filtrate leaves hypotonic or isotonic. Na+ reabsorbed and K+ regulated by aldosterone Acid-base regulation; H+ secretion, HCO 3 – reabsorption, ammonia secretion, ammonium excretion. ADH Determine final urine volume.
Henle’s loop
Distal tubule
Collecting duct
2 Layers:
a. b.
Papillary Layer / Upper Layer Reticular Layer / Lower Layer
3. -
-
a. b. -
a. b. c. d.
Epidermis 5 Layers – Stratum Corneum Stratum Lucidum Stratum Granulosum Stratum Spinosum Stratum Basale
Contains 2 Main Types of Cells: Melanocytes – produce melanin Keratinocytes Appendages: Hair Nails Sebaceous Glands Sweat Glands
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1. Apoc Apocri rine ne Gla Gland nds s respond to autonomic rather than thermal stimulation locate located d in axilla axilla,, areola areola,, groin, groin, perin perineum eum,, circum circumana anall and and periumbilical 2. Eccr Eccrin ine e Gla Gland nds s respond to elevated environmental & body temperature distributed in skin all over the body -
-
secretes sweat which is clear, aqueous solution containing 99% H2O & 1% solid
B.
FUNCTIONS:
1.
Protective Function
2.
Water Balance
3.
Sensory Function Receptors: Naked Nerve Endings – mediate all four sensory modalities cold, warmth, pain, touch Free Nerve Endings – mediate pain Merkel’s Disks / Meissner’s – touch Ruffini’s Endings – warmth Pacinian Corpuscles – pressure Krause’s End Bulb – cold Vitamin D Production -
4. 5.
Thermoregulatory Function Heat Production Heat Loss
-
a. Radiation b. Conduction c. Convection 6. b. c. d.
Immunologic Functions Wheal & Flare Reaction Rele elease of Hist Hista amine mine & Bra Brady dyki kin nin Immune Co Complexes
7.
Circulatory Function
8.
Aesthetic Function
REVIEW QUESTIONS 1. Which of the the following following is the study study of the structu structure, re, shape shape of the body and the the body parts, and their relationships to one another? a. Anatomy c. Homeostasis b. Genetics d. Physiology 2. Which of the followi following ng sections sections is made made along a horizontal horizontal plane plane dividing dividing the body or organ into superior and inferior parts? a. Coronal c. Sagittal b. Intermediate d. Transverse 3. Whic Which h of the the foll follow owin ing g cavi caviti ties es is infe inferi rior or to the the diap diaphr hrag agm m and and cont contai ains ns the the digestive, urinary and reproductive organs? a. Abdominopelvic c. Spinal b. Cranial d. Thoracic
4. Which directi directional onal term term is defined defined as more internal internal and away away from the body surface? surface? a. Deep c. Medial b. Lateral d. Superficial
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5.
What is is commonly commonly referre referred d to as the the antecu antecubita bitall region? region? a. Ankle region b. Breast bone area c. Anterior surface of the elbow d. Skin crease where the thigh meets the trunk
6. Abdominope Abdominopelvic lvic cavity cavity is divided divided into nine (9) separat separate e regions. regions. The region located located superior to the umbilical region is called: a. Epigastric c. Iliac b. Hypogastric d. Lumbar 7. It is the the area area of the the back back between between the the ribs and the the hips: hips: a. Deltoid b. Gluteal c. Lumbar d. Occipital 8. In which which part part of the the body do do you find find the the poplitea popliteall area? area? a. Posterior knee area c. Posterior surface of the head b. Posterior thoracic area d. Posterior surface of the lower leg 9. The skin can can increase increase the body temperat temperature ure through through the following following methods, methods, except: except: a. Sweating through the sweat glands b. Activation of the erector pili muscles c. Vasoconstriction of the blood vessels in the skin d. Shunting of blood from the skin to the internal organs 10. Which of the following following glands glands is adjacent adjacent to a hair follicle follicle and produces produces a greasy secretion? a. Sweat glands c. Cerumenous glands b. Sebaceous glands d. Sudoriferous glands 11. Which of the following is not a fun function ction of the skin? a. Enuresis c. Production of Vit. D b. Protection d.Temperature regulation 12. What is the primary primary component of the nail? a. Enamel c. Lamella b. Keratin d. Melanin 13. In what layer of the skin skin can you find the basale? basale? a. Dermis c. Adipose tissue b. Epidermis d. Subcutaneous tissue 14. What is the outermost layer layer of the epidermis? a. Stratum lucidum c. Stratum spinosum b. Stratum corneum d. Stratum granulosum 15. Which of the following structures is found in roughly the same same amount in both darkskinned and light skinned individuals? a. Keratin c. Melanocytes b. Melanin d. Receptors 16. Which of the following organ sys systems tems synthesizes synthesizes vitamin D? a. Digestive c. Integumentary b. Endocrine d. Skeletal 17. The pelvis is composed composed of the following bones? a. Ileum, ischium, pubis c. Ischium, pubis, radius b. Pubis, sacrum, ileum d. Pubis, sacrum, pubis
18. Which of the following cells have the primary function of laying down lamella? lamella? a. Osteoblast c. Osteocytes b. Osteoclast d. Osteophytes 19. What is the largest joint in the body commonly affected with osteoarthritis? osteoarthritis?
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a. Ankle b. Hip
c. Knee d. Shoulder
20. 20. Whic Which h of the the fol followi lowing ng part parts s of the the skel skelet etal al syst system em is asso associ ciat ated ed with ith the the appendicular skeleton? a. Clavicle c. Sacrum b. Radius d. Sternum 21. Paracentesis Paracentesis is the removal of excessive peritoneal fluid such as in cases of ascites. If the cannula is inserted in the flank, which of the following muscles will not be passed through? a. Internal oblique c. Rectus abdominis b. External oblique d. Transversus abdominis 22. Which is not a “true rib”? a. 2nd rib b. 4th rib
c. 6th rib d. 8th rib
23. Which of the following is a voluntary voluntary muscle? a. Cardiac muscle c. Skeletal muscle b. Gastric muscle d. Smooth muscle 24. Which neurotransmitter has the primary function of stimulating stimulating skeletal muscles? a. Acetylcholine c. Dopamine b. Catecholamine d. Serotonin 25. Which of the following bones extends from the pelvis to the knees and is referred to as the largest and longest bone in the body? a. Femur c. Patella b. Fibula d. Tibia 26. According to the food guide pyramid, which of the following foods should have the highest daily servings? a. Cereals c. Meat products b. Fruit group d. Vegetable group 27. The following statements pertaining pertaining to vitamin D are true, except: a. Formed in the kidneys b. Present in natural foods in small amounts c. Water-soluble, essential for bone formation d. Deficiency will result in rickets, osteomalacia and osteoporosis 28. In which of the large intestines is the vermiform appendix attached? attached? a. Cecum c. Ascending colon b. Rectum d. Descending colon 29. Which Which sphinc sphincter ter will open to allow allow the conten contents ts of the stomac stomach h to pass pass to the duodenum? a. Antral c. Duodenal b. Cardiac d. Pyloric 30. Which of the following following refers refers to the rhythmic, rhythmic, wavelike wavelike intestinal intestinal contraction contraction that moves food through the garstointestinal garstointestinal tract? a. Absorption c. Ingestion b. Defecation d. Peristalsis 31. What What struct structure ure serves serves as a common common passa passagew geway ay for both both the respir respirato atory ry and and digestive systems? a. Esophagus c. Mouth b. Larynx d. Pharynx 32. The Cecum can be found in which which quadrant of the abdomen? abdomen? a. Left lower quadrant c. Right lower quadrant b. Left upper quadrant d. Right upper quadrant 33. Which of the following organs is found found in the right upper quadrant? quadrant? a. Liver c. Sigmoid colon b. Rectum d. Spleen
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34. Which of the following statements statements is not true about the circulatory circulatory system? a. There are three principal circulatory divisions namely the pulmonary, coronary and systemic division. b. The coronary arteries branching out from the ascending aorta supplies blood to the myocardium of the heart. c. The systemic circulation includes all blood vessels that transport blood in all the body other than those of the pulmonary circulation d. The pulmonary circulation includes the blood vessels that carry blood from the right ventricle through the lungs and to the left atrium 35. Where is the arterial pulse pulse in the neck best palpated? palpated? a. Carotid triangle c. Submandibular triangle b. Submental triangle d. Supraclavicular triangle 36. Which of the following blood vessels vessels carry unoxygenated unoxygenated blood? a. Arch of aorta c. Hepatic artery b. Carotid artery d. Pulmonary artery 37. Which of the following is the pacemaker pacemaker of the heart? a. Bundle of His c. Atrioventricular node b. Sinoatrial node d. Atrioventricular bundle 38. Which of the following valves separate separate the right atrium from the right ventricle? a. Mitral valve c. Tricuspid valve b. Bicuspid valve d. Seminilunar valve 39. Which of the following following is true about about blood? a. It is a cell c. It is an organ b. It is a tissue d. It is a system 40. Which of the following best defines defines serum? a. Liquid portion of clotted blood b. Mucoid portion of unclotted blood c. Solid and liquid portion of venous blood d. Cells and electrolytes found in arterial blood 41. Which of the following is not a function function of the lymphatic system? system? a. Returns fluid leaked from the blood b. houses the cells involved in immunity c. Disposes debris in the lymphatic stream d. Keeps blood constantly supplied with oxygen and removes carbon dioxides 42. The following are actions of the parasympathetic parasympathetic fibers, except: a. Stimulates peristalsis b. Promote secretion of lacrimal glands c. Induce bile and insulin release d. Constrict peripheral blood vessels 43. Which Which of the follow following ing muscle muscles s (or groups groups of muscle muscles) s) is respon responsib sible le for forced forced expiration? a. Abdominals c. External Intercoastals b. Diaphragm d. None of the above 44. 44. Mo Most st aspi aspira rate tes s comm common only ly go to the the righ rightt main mainst stem em bron bronch chus us.. What What is the the explanation for this? a. The left mainstem bronchus is shorter b. The right mainstem bronchus is narrower c. The right mainstem bronchus is nearly vertical d. The left mainstem bronchus has fewer branches 45. What lobe is found in the right lun lung g but not in the left lung? a. Apical lobe c. Middle lobe b. Lower lobe d. Upper lobe
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46. What part of the lung will most likely likely be damaged by penetrating penetrating injuries injuries in the Supraclavicular Supraclavicular area? a. Lingula c. Upper lobe b. Apical lobe d. None of the above 47. Which of the following following lung volumes volumes and capacitie capacities s tend to increase with old age and during cases of obstructive lung disease? a. Vital capacity c. Total lung capacity b. Residual volume d. Expiratory reserve volume 48. Which of the following lobes of the right lung are separated by the horizontal fissure? a. Upper and lower lobes c. Upper and middle lobes b. Middle and lower lobes d. Upper, middle and lower lobes 49. Which of the following following refers to the collection collection of multipolar multipolar nerve cells along the course of the sympathetic trunk? a. Sympathetic ganglion c. Sympathetic irritation b. Sympathetic imbalance d. Sympathetic nerve 50. Why is urinary incontinence incontinence normal in infants? infants? a. Urinary bladder cannot “hold in” the urine. b. Internal urethra sphincter is not yet developed. c. External urethra sphincter is not yet developed. d. The pressure in the urinary bladder is too strong. 51. The following statements pertaining pertaining to the kidneys are true, except: a. The kidneys are located retroperinoneally. b. Each kidney moves 1 inch during full inspiration c. The left kidney is palpable in the left lumbar region. d. The right kidney is lower due to the bulk of the liver. 52. Which of the following statements statements about the urethra is incorrect? incorrect? a. The male urethra is about 8 inches long. b. The female urethra is only about 1.5 inches long. c. The paraurethral glands are found in both males and females. d. The male urethra serves both as the passage for urine and semen. 53. What hormones do the kidneys secrete secrete in response to a lowered lowered blood pressure? a. Aldosterone c. Anti-diuretic hormone b. Angiotensin d. Renin 54. How many percen percentt of blood blood volume volume is passe passed d throug through h the kidneys kidneys with each each heartbeat? a. 20% b.25% c.30% d.50% 55. Which of the following is not a fun function ction of a nephron? a. Tubular secretion c. Glomerular filtration b. Hormonal synthesis d. Tubular reabsorption 56. Which of the following is true about about the anatomy of the renal system? system? a. The kidneys are located anteroperitoneally. b. The kidney has an outer renal cortex and inner medulla. c. It consists of two kidneys, two ureters, two urethras and one urinary bladder. d. The renal cortex is composed of the renal pyramid separated by the renal column. 57. Which organ system system is responsible responsible for eliminat eliminating ing nitrogenous nitrogenous wastes wastes from the body and regulating water and electrolytes? a. Urinary system c. Lymphatic system b. Digestive system d. Integumentary system 58. What is the covering of most long nerve fibers that protects and insulates insulates the fibers and increases the transmission rate of nerve impulses? a. Cell body c. Myelin b. Dendrite d. Nucleus 59. What structure is not part of the brain brain stem?
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a. Hypothalamus b. Medulla oblongata
c. Midbrain d. Pons
60. Following a tonsillectomy, tonsillectomy, a patient noted loss of taste taste on the posterior one-third of the tongue. Which of the following cranial nerves was probably injured? a. Facial nerve c. Lingual nerve b. Vagus nerve d. Glossopharyngeal nerve 61. When a patient attempts attempts to protrude protrude his tongue, it is deviates deviates to the right. right. What nerve is affected? a. Lingual nerve c. Hypoglossal nerve b. Accessory nerve d. Glossopharyngeal nerve 62. When When inject injecting ing an anesth anestheti etic c agent agent into into the subara subarachn chnoid oid space, space, which which of the following is an important landmark for determining where to insert the needle through the skin of the back? a. Coccyx c. 3rd sacral vertebra b. Iliac crest d. Inferior angle of the scapula 63. Bell’s palsy is characterized characterized by a unilateral paralysis paralysis of what nerve? a. Tibial nerve c. Peroneal nerve b. Facial nerve d. Obturator nerve 64. The end of the spinal spinal cord is an apex apex to which which a prolon prolongat gation ion of the pia mater mater descends to be attached to the back of the coccyx. What do you call this extension of the pia mater? a. Cauda equine c. Conus medullaris b. Filium terminale d. Ligamentum dendiculatum 65. Which of the following is not a function function of the hypothalamus? hypothalamus? a. Body temperature regulation b. Sleep and wakefulness regulation regulation c. Proprioception and discriminative touch d. Water and electrolytes balance regulation 66. Which of the following following lobes of the brain functions functions for the conscious conscious perception perception of vision? a. Frontal c. Parietal b. Occipital d. Temporal 67. Sore-eyes, Sore-eyes, which which is common common in the summer months, months, affects affects which of the following following parts of the eyes? a. Cornea c. Vitreous humor b. Conjunctiva d. Aqueous humor 68. Which of the following statements is true about sysnapsis? a. It is the pairing of heterogenous chromosomes during the early meiotic phase b. It is the forming of a single chromosome c. It is the pairing of heterogenous chromosomes during the late meiotic prophase d. It is the pairing of homologous chromosomes during the early meiotic prophase 69. Photoreceptors are found all throughout the retina, except where the optic nerve leaves the eyeball. This “blindspot” corresponds to which of the following sites? a. Choroid c. Optic chiasma b. Optic disc d. Fovea centralis 70. Which of the following bones comprise the ossicle? a. Incus, malleus, stirrup c. Stapedius, hammer, anvil b. Malleolus, anvil, stirrup d. Hammer, incus, malleolus 71. Which of the following statements best describes the middle ear? a. Lines with ceruminous glands b. Contains hairs, hair cells and nerve fibers c. Flanked medially by oval and round windows d. Subdivided into 3: cochlea, vestibule and semicircular canals
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72. Smell sensation is transmitted by the brain by the olfactory nerve. Which of the following cranial nerves is the olfactory nerve? a. 1st cranial nerve c. 3 rd cranial nerve nd b. 2 cranial nerve d. 7th cranial nerve 73. The only function of the 4 th cranial nerve is to innervate which of the following muscles in the eyes? a. Medial rectus c. Inferior oblique b. Lateral rectus d. Superior oblique 74. The following cranial nerves transmit taste sensations from the tongue except: a. Facial nerve c. Trigeminal nerve b. Vagus nerve d. Glossopharyngeal nerve 75. Which of the following is part of both endocrine and reproductive systems? a. Pancreas c. Testis b. Pituitary d. Uterus 76. Which o f the following is considered both an endocrine and exocrine glad? a. Ovary c. Adrenal glands b. Pancreas d. Thyroid gland 77. Which of the following hormones decreases blood calcium level? a. Calcitonin c. Parathormone b. Insulin d. Triiodothyronine 78. Which of the following is known as the “master gland”? a. Adrenal gland c. Thymus gland b. Pituitary gland d. Thyroid gland 79. What is the site of synthesis of antidiuretic hormone (ADH)? a. Adenohypophysis c. Hypothalamus b. Neurohypophysis d. Adrenal medulla 80. Which of the following structures secretes the male hormone testosterone to maintain spermatogenesis? a. Leydig cells c. Sertoli cells b. Seminal vesicles d. Spermatogenic cells 81. Which of the following is the chief means of regulating hormonal blood levels? a. Baroreception c. Positive feedback b. Chemoreception d. Negative feedback 82. Which of the following endocrine glands also functions as the site of maturation of a special type of white blood cells? a. Adrenals c. Thymus b. Pancreas d. Thyroid 83. The following hormones are released by the anterior lobe of the pituitary gland and are regulated by hypothalamic hormones, except: a. Oxytocin c. Luteinizing hormone b. Prolactin d. Adrenocorticotrophic hormone 84. To which part of the female reproductive system does the cervix belong? a. Fallopian tube c. Vagina b. Uterus d. Vulva 85. In what part of the fallopian tube does fertilization commonly occur? a. Ampulla c. Isthmus b. Infundibulum d. Fimbriae
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86. Which Which of the followin following g hormon hormones es from from the anteri anterior or pituit pituitary ary gland gland is requir required ed to stimulate spermatogenesis? spermatogenesis? a. Growth hormone c. Follicle stimulating hormone b. Luteinizing hormone d. Adrenocorticotrophic hormone 87. What term is used to refer to the female external genitalia? a. Vulva c. Vestibule b. Vagina d. Fourchette 88. In which of the following structures of a sperm can you find the mitochondria? a. Head c. Body b. Neck d. Tail 89. How many chromosomes are there in the female egg cell and male spermatozoa? a. 18 chromosomes c. 23 chromosomes b. 20 chromosomes d. 26 chromosomes 90. In which phase of the sexual contact does the sympathetic branch of the autonomic nervous system take a major role? a. Excitement c. Ejaculation b. Plateau d. Resolution 91. Sperm and egg cells have 23 pairs of chromosomes. The father’s (sperm) chromosome will determine the sex of the baby. a. Both statements are true b. Both statements are false c. First statement is true; the second is false d. First statement is false; the second is true 92. Which of the following urogenital muscles primarily cause erection of the female clitoris? a. Bulbocavernosus c. Ischiocavernosus b. Bulbospongiosus d. Deep transverse perineal muscle 93. Which of the following structures found in the female breast is not located superficially? superficially? a. Ampulla c. Nipple b. Areola d. Tubercles 94. What term is used to refer to the basic nerve cell of the nervous system which contains a nucleus within a cell body? a. Nephron c. Cranial nerves b. Neuron d. Peripheral nerves 95. What hypersensitivity reaction appears immediately immediately after exposure to an allergen and is considered as the most common type of allergic reaction? a. Type I (Anaphylactic (Anaphylactic reaction) b. Type II (Cytotoxic reaction) c. Type III (Immune complex reaction) d. Type IV (Cell-mediated (Cell-mediated or delayed hypersensitivity) hypersensitivity) 96. Which of the following statements pertaining pertaining to polymorphonuclear leukocytes is false? a. They mature in the spleen b. They survive for less than a week c. They make up the majority of WBC’s d. Eosinophils and neutriphils are an example 97. Which of the following cells is the immunologic system’s chief site of filtering response to antigens? a. Spleen c. Thymus b. Tonsils d. Peyer’s patches 98. Which of the following following cells is responsible responsible for the production of antibodies antibodies and acts as as mediator of the body’s humoral response?
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a. B cells b. T cells
c. Basophils d. Macrophages
99. Which of the following WBC’s do not function as phagocytes? a. Basophils c. Monocytes b. Eosinophils d. Neutrophils 100. What is the best way to establish artificially acquired active immunity? a. Vaccination b. Transplacental route c. Contact with pathogen d. Injection of immune serum
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