ICD-10

Competency
Assessment
for Coders
Anatomy and Physiology

Also available
as part of
The ICD-10 Training
Toolkit
ICD-10
Competency
Assessment
for Coders
Anatomy and Physiology
ICD-10 Competency Assessment for Coders: Anatomy and Physiology is published by HCPro, Inc.

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Adrianne E. Avillion, DEd, RN, Reviewer

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 Contents

About the Reviewer.......................................................................................... v

Anatomy and Physiology Assessment............................................................. 1

Blood............................................................................................................................................... 1

Cardiac/Circulatory System............................................................................................................... 3

Ear................................................................................................................................................... 5

Endocrine System............................................................................................................................. 6

Eye................................................................................................................................................... 7

Gastrointestinal System..................................................................................................................... 9

Genitourinary System...................................................................................................................... 11

Infectious Diseases.......................................................................................................................... 12

Integumentary System.................................................................................................................... 14

Medical Terminology...................................................................................................................... 16

Musculoskeletal System.................................................................................................................. 18

Neoplasms...................................................................................................................................... 19

Nervous System.............................................................................................................................. 20

Pregnancy...................................................................................................................................... 22

Respiratory System......................................................................................................................... 24

Signs and Symptoms....................................................................................................................... 25

Grab Bag Questions........................................................................................................................ 27

© 2011 HCPro, Inc. iii

 About the Reviewer

Adrianne E. Avillion, DEd, RN

Adrianne E. Avillion is the owner of Avillion’s Curriculum Design in York, PA, and she specializes
in designing continuing education programs for healthcare professionals and freelance medical
writing. She is the editor of the e-newsletter Staff Development Weekly, and is a frequent presenter
at National Nursing Staff Development Organization and various conferences and conventions
devoted to continuing education and staff development. She is the author of Evidence-Based Staff
Development: Strategies to Create, Measure, and Refine Your Program; A Practical Guide to Staff
Development: Evidence-Based Tools and Techniques for Effective Education; and Nurse Educator
Manual: Essential Skills and Guidelines
� for Effective Practice.

© 2011 HCPro, Inc. v

 Anatomy and Physiology Assessment

Blood

1. Which of the following statements is false?

a. Genetic factor V Leiden deficiency is the most common genetic reason for abnormal clot formation.

b. A ntithrombin III (ATIII), protein C, and protein S participate in breaking down clots or inactivat-
ing the coagulation cascade; otherwise clots would form with no apparent cause.

c. Platelets are the smallest cells in the blood and are formed in the bone marrow.

d. Because arterial blood looks red and carries oxygen to the cells, it contains different cells then
venous blood.

2. Which of the following statements is false?

a. Hemolytic anemias can be hereditary or acquired, warm antibody (IgG) or cold agglutinin (IgM);
present at body temperature or in cold temperatures; and idiopathic or secondary to other diseases
like lymphoma and autoimmune disease, as wells as viral infections or medications.

b. Hemolytic anemia can be caused when red blood cells (RBC) are fragile and cannot withstand the
routine stress of the circulatory system and rupture prematurely.

c. Many cancers cause anemia from decreased RBC production by consuming the new RBCs.

d. I n chronic kidney disease (CKD) the kidney stops producing erythropoietin so patients
develop anemia.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

3. Which of the following statements is false?

a. Hemolytic anemia can be an acquired autoimmune disease where the body forms antibodies
against its own RBCs.

b. Peripheral blood is found in the bone marrow.

c. Physicians must not prescribe sulfa drugs to patients with glucose-6-phosphate dehydrogenase
(G6PD) deficiency because it will result in hemolytic anemia.

d. In hereditary spherocytosis, the cell membrane is weak due to lack of structural protein.

4. Which of the following statements provides accurate information about sarcoidosis?

a. Sarcoidosis is an autoimmune disease in which collections of inflammatory cells replace normal

tissue, causing organ dysfunction.

b. Common opportunistic diseases seen in sarcoidosis are pneumocystis pneumonia, cytomegalovi-

rus, mycobacterium avium, and tuberculosis.

c. Sarcoidosis only affects the lungs.

d. Sarcoidosis is a group of genetic immune diseases involving inadequate antibody production to

fight pathogens.

5. Match the following blood conditions to their definitions.

1. Nutritional anemias a. Identified by appearance of microcytic and hypochromic RBCs.

2. Hemolytic anemias b. Destruction in the peripheral blood of fully formed RBCs.

3. Aplastic anemias c. I n megaloblastic anemias, RBCs are abnormally large

and hyperchromic.
4. Iron deficiency anemia
d. A nemia that results from inadequate intake or assimi�lation of
5. Vitamin B12 and folate
materials essential for the production of RBCs and hemoglobin.
deficiency anemias
e. The myeloid stem cell is damaged or destroyed so fewer RBCs
are produced.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

6. Match the following blood conditions with their definitions.

1. Pernicious anemia a. G enetic blood disorder that prevents proper formation of the
hemoglobin molecule
2. G6PD
b. Genetic disease that causes RBCs to change shape, especially
3. Thalassemia
when oxygen is low

4. Sickle-cell disease
c. Deficiency of gastrointestinal (GI) tract secretion called
intrinsic factor

d. C auses older RBCs to break open; a hemolytic anemia

Cardiac/Circulatory System

7. Occlusion of a coronary artery can cause all except which of the following?

a. Angina

b. Arrhythmias

c. Myocardial infarction

d. Phlebitis

8. Which of the following statements about atrial fibrillation is false?

a. Episodic quivering of atrial muscles may be asymptomatic and can cause blood clots to form on
the heart wall.

b. The ECG has no P waves and irregular QRS complexes.

c. The patient has increased risk of death, stroke, heart failure, and heart attack.

d. Treatment may include medication to increase heart rate.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

9. Varicose veins occur in all of the following places except which of the following?

a. Upper esophagus

b. Pelvis

c. Scrotum

d. Stomach

10. Which of the following terms is also known as idiopathic pulmonary arterial hyper-
tension (HTN)?

a. Primary pulmonary HTN

b. Kyphoscoliotic heart disease

c. Secondary pulmonary HTN

d. Cor pulmonale

11. Match the description on the left with the correct condition.

1. One quarter of Americans a. Dissection of blood vessel

have it and it is
b. Coronary artery disease
usually asymptomatic.

c. HTN (high blood pressure)

2. The leading cause of death
in the United States.

3. T he artery wall deteriorates

and the inner layer of the vessel
wall separates and bulges
through the middle layer.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

Ear

12. Malignant otitis externa is a dangerous and potentially life-threatening condition of

the external ear caused by which of the following?

a. Invasive cancer

b. Benign neoplasm

c. Bacterial infection

d. Viral infection

13. The term stenosis refers to which of the following definitions?

a. Bulging canal skin

b. Narrowing of the external canal opening

c. Inflamed canal skin

d. Bone nodules

14. Which of the following is the most medial anatomic portion of the temporal bone?

a. Inner ear

b. Brain

c. Auricle

d. Petrous apex

15. Discontinuity or ankylosis of the ossicles will cause which type of hearing loss?

a. Conductive hearing loss

b. Sensorineural hearing loss (SNHL)

c. Mixed hearing loss (conductive plus SNHL)

d. No hearing loss

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

16. The Eustachian tube connects which two air-filled compartments?

a. External auditory canal and middle ear

b. Mastoid cells and middle ear

c. Epitympanum (attic) and mesotympanum

d. Middle ear and nasopharynx

Endocrine System

17. Complete this statement. The pituitary gland:

a. Is the body’s master gland

b. Produces few “stimulating hormones”

c. Has one section: anterior

d. Does not affect the kidneys

18. Excess secretion of prolactin can result in which of the following?

a. Acromegaly

b. Syndrome of inappropriate antidiuretic hormone hypersecretion

c. Galactorrhea

d. Enlarged testicles

19. Which of the following conditions is not a complication of diabetes?

a. Peripheral vascular disease

b. Neuropathy

c. Blindness

d. Increased susceptibility to cancers

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

20. Which of the following conditions is not a symptom of polycystic ovarian syndrome?

a. Acne

b. Increased fertility

c. Hirsutism

d. Resistance to insulin

21. Which of the following are diagnostic criteria for diabetes? (Select all that apply.)

a. Hemoglobin A1c greater than 5

b. Fasting blood sugar greater than 125

c. Random blood glucose of 200 with the classic signs and symptoms of diabetes

d. A two-hour glucose tolerance test blood sugar of 142

Eye

22. Label the following parts of the eye:

Cornea

Iris

Limbus

Pupil

Image © HCPro, Inc.

Sclera

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

23. Match each term with the correct description.

1. Retina a. Connects either rods or cones, but not both, and ganglion cells

2. Macula b. Cranial nerve II

3. Optic nerve c. C enter of the retina with special light-sensitive cells for vision
of fine details and high acuity
4. Cones
d. Retinal cells located in the center of the eye that respond to
5. Bipolar cell
color and need stronger light

e. L ayer of nerve cells on the back wall of the eye linked to the
brain via the optic nerve

24. Match each disorder with the correct description.

1. Scotoma a. Inflamation of a meibomian gland

2. Hordeolum b. A defect of vision in a specific area of the visual field in one or

both eyes
3. Chalazion
c. Dryness of mouth, eyes, and other mucous membranes;
4. Sjögren’s syndrome
common chronic, autoimmune inflammatory disorder

5. Macular degeneration
d. Leading cause of blindness in adults over 55 in the
United States; blood vessels leak and retina scars; destroys
central vision

e. L ocalized infection that can occur externally in the lumen of

the smaller glands of Zeis or Moll glands or internally in the
larger meibomian gland

25. Which of the following describes keratoconjunctivitis?

a. Noninfectious inflammation of the cornea due to inadequate oxygenation caused by an injury or

wearing contact lenses too long

b. Clouding of the cornea due to vitamin A deficiency in malnutrition

c. Both conjunctiva and cornea are inflamed

d. Most common cause of blindness in the world due to blood vessels growing into the cornea

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

26. A pink or purple color to the white of the eye is known as which of the following?

a. Episcleritis

b. Nodular episcleritis

c. Scleritis

d. Posterior scleritis

27. Match the disorders with their descriptions.

1. Exudative retinopathy
2. Hypertensive retinopathy
3. Diabetic retinopathy
a. Deposits of cholesterin and blood debris from retinal hemor-
rhage leads to destruction of the macula and blindness
b. M icroaneurysms; hemorrhages; yellow, waxy exudates;
cotton-wool patches; and macular edema

c. Narrow retinal arterioles, hemorrhages, exudates and cotton-

wool patches, and arteriosclerotic changes

Gastrointestinal System

28. Which of the following definitions describe secretion?

a. Uses oxygen to change food into energy, carbon dioxide (CO2), and water

b. Chemical breakdown of food into amino acids, sugars, and fatty acids (molecules small enough
to enter the bloodstream)

c. Release of water, acids, enzymes, buffers, and salts by digestive tract epithelium and
glandular organs

d. Movement of amino acids, sugars, electrolytes, vitamins, and water across digestive epithelium
into interstitial fluid

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

29. Match each part of the gastrointestinal tract with its description.

1. Gallbladder a. Final and longest segment of small intestine, ends in the

ileocecal valve that empties into the colon
2. Cystic duct
b. On posterior surface of the liver
3. Ileum
c. A side channel from the intestinal wall approximately 2 inches
4. Meckel diverticulum
long, a congenital malformation at the end of the ileum

5. Sigmoid colon
d. E xits the gallbladder and joins the common hepatic duct to
form the common bile duct

e. The S-shaped segment at the end of the colon that empties into
the rectum

30. Match each number in the illustration with its corresponding description.

Betz cells secrete insulin and glucagon into bloodstream, and

1 excretes four kinds of enzymes into the duodenum.

Carries bile to the duodenum.

2
3
4 Chemical digestion of proteins into amino acids, carbohy-
drates into sugars, and fats into fatty acids and absorption of
7 most nutrients.

Keeps liquid and gas from escaping.

5
6 Mechanically breaks down food, disrupts chemical bonds in
food, and digests proteins with pepsin.
8
Protects the body from infection, absorbs vitamin B12, and
Image © Blamb. Used under license
from Shutterstock.com.
reabsorbs conjugated bile salts.

Production and/or absorption of vitamins K, biotin (B7), panto-

thenic acid (B5), folic acid (B9), minerals, and water.

Stores and compactions of food stuffs and reabsorbs bile salts.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

31. Match each disease with the correct description.

1. Perforation of intestine a. Generally associated with psychological stress

(nontraumatic)
b. May be due to constipation, malnutrition and malabsorption,
2. Anal/rectal prolapse cystic fibrosis, pinworms, whipworms, or injury

3. Irritable bowel syndrome c. Chronic liver disease characterized by destruction of liver cells

4. Cirrhosis d. May be due to appendicitis, diverticulitis, ulcer disease,

gallstones, gallbladder infection, abdominal surgery, or
inflammatory bowel disease, including Crohn’s disease and
ulcerative colitis, or abdominal surgery

Genitourinary System

32. Which of the following describes a renal condition in which the urine may
appear foamy?

a. Nephritic syndrome

b. Pyonephrosis

c. Nephrosis

d. Nephrotic syndrome

33. The term salpingitis refers to which of the following conditions?

a. Inflammation of the fallopian tube(s)

b. Inflammation of the ovaries

c. An accumulation of blood in the fallopian tube

d. The medical procedure resulting in female sterilization

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

34. The corpus is located in which organ?

a. Uterus

b. Ovary

c. Bladder

d. Scrotal sac

35. Which term is used to describe a condition that causes abnormal flow of urine?

a. Hematuria

b. Renal osteodystrophy

c. Renal sclerosis

d. Vesicoureteral reflux

36. Which term refers to the presence of endometrial cells outside the uterus?

a. Pelvic inflammatory disease (PID)

b. Endometritis

c. Endometriosis

d. Intrauterine synechiae

Infectious Diseases

37. Sepsis is a life-threatening systemic condition resulting from a massive immune

response to pathogens and toxins. Which is NOT considered a feature of sepsis?

a. High fever

b. Joint pain

c. Low blood pressure

d. Fast heart rate

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

38. Which bacterial gastrointestinal infection requires identification and antibiotic

treatment because it is considered a healthcare-acquired infection that can be
seen in hospitalized patients or in people recently exposed to antibiotics for an
unrelated infection?

a. Vibrio cholerae

b. Shigella

c. Campylobacter

d. Clostridium difficile

39. Which of the following best describes Creuzfeldt-Jakob disease?

a. The human equivalent of mad cow disease, a type of prion disease with no known treatment

b. A tick-borne illness consisting of fevers and abdominal pain

c. A rare respiratory infection that forced many patients to live in an iron lung

d. The best-known type of skin infection that leads to syphilis

40. Which of the following statements concerning HIV is true?

a. HIV and AIDS are the same disease, and the terms are used interchangeably.

b. HIV attacks RBCs, leading to severe anemia and requiring blood transfusions.

c. HIV decreases the body’s ability to fight infections, and otherwise minor illnesses can be fatal.

d. HIV can be transmitted through casual contact such as shaking hands.

41. Which of the following statements regarding syphilis is accurate?

a. Syphilis is nearly eradicated.

b. Syphilis is a benign infection that goes away on its own.

c. Syphilis begins in the mucous membranes and rapidly becomes systemic, spreading to nearby
lymph nodes and the bloodstream.

d. Syphilis vaccines have helped reduce infection in developing countries.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

Integumentary System

42. Label the dermis in the following illustration.

Artery/arteriole

Fat cell

Meissner’s corpuscle

Pacinian corpuscle

Sweat gland

Vein/venule

Image © Sebastian Kaulitzki. Used under license from Shutterstock.com.

43. Which of the following definitions best describes the diagnosis of vesicle?

a. A small blister that contains clear fluid

b. A flat area of abnormal skin, not raised or different in texture from surrounding skin

c. Hardening of the skin, often from chronic inflammation

d. An eruption on the surface of the skin

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

44. What type of lesion is shown in the image below?

Image © fuyu liu. Used under license

from Shutterstock.com.

a. Vegetation

b. Bulla

c. Macule

d. Plaque

45. Which of the following skin conditions causes flaky, white to yellowish scales to
form on oily areas such as the scalp or inside the ear?

a. Psoriasis

b. Atopic dermatitis

c. Seborrheic dermatitis

d. Dyshidrosis

46. Which of the following conditions is not associated with alopecia?

a. Shaving

b. Pulling on the hair

c. Atopic dermatitis

d. Diabetes mellitus

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

Medical Terminology

47. The definition of the suffix -itis is:

a. Pertaining to

b. Condition, disease

c. Swelling

d. Inflammation

48. A prefix that means before is:

a. Dys-

b. Epi-

c. Neo-

d. Pre-

49. What does the suffix -pathy mean?

a. The study of

b. Pertaining to

c. Disease

d. Removal, excision

50. Visual examination of the urinary bladder is known as:

a. Cytology

b. Cystoscopy

c. Cystogram

d. Arthroscopy

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

51. Nerve pain is known as:

a. Neural

b. Neuralgia

c. Neuropathy

d. Encephalitis

52. Hypo- means

a. Out of and away from

b. Below and deficient

c. External, on the outside

d. Under and beneath

53. Suffixes commonly identify:

a. Condition/surgical procedure

b. Presence of a body part

c. Direction or position

d. Size and quantity

54. The term superior refers to:

a. Middle

b. At or near the back of body

c. Midline

d. Above

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

Musculoskeletal System

55. A Smith’s fracture is also known as which of the following?

a. Boxer’s fracture

b. Colles’ fracture

c. Humeral head fracture

d. Nursemaid’s elbow

56. A charcot joint is commonly a complication of which disease?

a. Rheumatoid arthritis

b. Diabetes

c. Systemic lupus erythematosus

d. Gout

57. Spondylolisthesis tends to progress more rapidly in which of the following?

a. Patients with ankylosing spondylitis

b. Young athletes with fractures of the pars interarticularis

c. Patients with spondylosis

d. Paget’s disease of bone

58. Select the correct spinal segment to complete the following statements.
Response options for all of these statements are:
• Cervical spine
• Thoracic spine
• Lumbar spine

a. The spinal cord ends at the level of the:

b. The dowager’s hump is in the:

c. The least robust vertebral bodies are in the:

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

59. Rotator cuff disorders:

a. Are always caused by inflammation

b. May be associated with the shape of the scapula

c. Occur more often in tall individuals of European descent

d. Are usually caused by major trauma due to the depth and stability of the shoulder joint

60. The term lateral epicondylitis refers to which of the following?

a. Golfer’s elbow

b. Tennis elbow

c. Thrower’s elbow

d. Sailor’s elbow

Neoplasms

61. Which term describes a small number of cancer cells that have begun migration,
leading to metastatic disease?

a. Micrometastasis

b. Apoptosis

c. Dysplasia

d. Myelofibrosis

62. What type of surgery would be used for patients who need a pancreatic resection?

a. Whipple procedure

b. Prostatectomy

c. Sigmoid colectomy

d. Distal pancreatectomy

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

63. What are the three parts of the larynx?

a. Supra-larynx, larynx, and sub-larynx

b. Supraglottis, glottis, and subglottis

c. Supra-larynoglottis, larynx, and sub-larynoglottis

d. Supra-larynx, inferior cornu, and larynx

64. What is the functional anatomical unit of the kidney called?

a. Neuron

b. Neutron

c. Nephron

d. Renal artery

65. Leukemia initially affects what portion of the bloodstream?

a. Platelets

b. RBCs

c. White blood cells

d. Plasma

Nervous System

66. The central nervous system includes which of the following?

a. The brain and spinal cord

b. The sympathetic and parasympathetic nervous systems

c. The brain and the somatic nervous system

d. The brain only

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

67. Which would NOT be considered a source of sensory input?

a. Muscular stretch receptors

b. Pressure receptors in the skin

c. Taste receptors in the tongue

d. The cauda equina

68. Which part of the brain controls the most basic functions of life (e.g., breathing,
blood pressure)?

a. The cerebrum

b. The diencephalon

c. The cerebellum

d. The brainstem

69. Which of the following is the toughest outer protective layer, or meninge covering
the brain?

a. The pia mater

b. The arachnoid mater

c. The dura mater

d. The myasthenia mater

70. Is the following statement true or false? Migraine headaches can cause various neu-
rologic symptoms, making them difficult to distinguish from a stroke or transient
ischemic attack.

a. True

b. False

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

71. Paralysis on one side of the body is called which of the following?

a. Hemiplegia

b. Quadriplegia

c. Diplegia

d. Paraplegia

Pregnancy

72. What is agenesis?

a. The absence or incomplete development of an organ due to an absence of embryonic tissue

b. A structure pierced with one or more holes

c. The absence of a normal body opening or the closure of a tubular structure

d. Incomplete development of an organ resulting from too few cells during development

73. Which of the following terms describes a common, benign, temporary condition
that occurs during birth as a result of contact between the head (presenting part)
and cervix?

a. Caput succedaneum

b. Cephalhematoma

c. Chignon

d. Epicranial subaponeurotic hemorrhage

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

74. Which term describes a woman pregnant with her first child?

a. Multigravida

b. Nulligravida

c. Primigravida

d. Unipartium

75. Which of the following describes the condition that occurs when the placenta grows
in the lowest part of the uterus and covers all or part of the opening to the cervix?

a. Placenta accreta

b. Placenta increta

c. Placenta percreta

d. Placenta previa

76. Match the following descriptions with the correct terms.

1. The umbilical cord wraps a. Nuchal cord

around the neck of the fetus
b. Torsion
2. Abnormal attachment to
c. Prolapsed umbilical cord
the placenta

d. Velamentous cord
3. The umbilical cord twists
upon itself

4. The umbilical cord precedes

the fetus during delivery

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

Respiratory System

77. Match each term in Column A with the correct description in Column B:

Column A: Part of the Column B: Function

respiratory system

1. Alveoli a. Contain cilia that brush debris up and out of the lungs

2. Bronchi and trachea
3. Epiglottis
4. Mucous membrane
b. Cleans, warms, and humidifies oxygen-rich air for the alveoli
by providing enzymes, immunoglobulins, infection-fighting
cells, moisture, and heat to the air
c. Exchange gas between air and blood

d. Prevents aspiration by closing over the opening at the top of

the larynx

78. Chronic bronchitis is best described as which of the following?

a. A cough with mucous most days for more than three months

b. An upper respiratory infection

c. Disease due to the lung’s attempt to clean up inhaled organic and inorganic dust, usually causing
permanent damage to lungs when the immune system becomes overwhelmed

d. A common cold

79. Which of the following describes emphysema?

a. Cough with mucus most days for more than three months due to continuing irritation by allergens
and pollutants that stimulate mucus production and hyperplasia of mucus-producing glands

b. Progressive, irreversible destruction of alveolar walls, supporting tissue, and pulmonary

capillary bed

c. Disease due to the lung’s attempt to clean up inhaled organic and inorganic dust, usually causing
permanent damage to lungs when the immune system becomes overwhelmed

d. Constriction of muscles lining airways in response to allergens, prolonging expiration and causing
accessory muscle use

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

80. Which of the following describes asthma?

a. Cough with mucous most days for more than three months due to continuing irritation by 
allergens and pollutants that stimulate mucous production and hyperplasia of mucous-�
producing glands

b. Disease due to the lung’s attempt to clean up inhaled organic and inorganic dust, usually causing
permanent damage to lungs when the immune system becomes overwhelmed

c. Progressive, irreversible destruction of alveolar walls, supporting tissue, and pulmonary

capillary bed

d. Constriction of muscles lining airways in response to allergens, prolonging expiration and causing
accessory muscle use

81. Which of the following diseases describes an infection or inflammation of the tonsils?

a. Allergic rhinitis

b. Nasal polyps

c. Tonsillitis

d. Vasomotor rhinitis

Signs and Symptoms

82. Fluid accumulation in the body may be related to all except which of the following?

a. Chronic heart failure (CHF)

b. Hypoalbuminemia

c. Renal failure

d. Parkinson’s disease

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

83. Bones are used for all except which of the following?

a. Structural support

b. Protection of internal organs

c. Storage of minerals

d. Neuro synapses’ location of muscles

84. All of the following are true with respect to blood pressure except that it:

a. Has an effect on the pressure of the vessel walls

b. Is regulated by the kidneys

c. Is affected by medications

d. Has a diastolic resting pressure of less than 60 mmHg when the heart contracts

85. Which of the following laboratory tests is not affected by a disease of the bone?

a. Alkaline phosphatase

b. Amylase

c. White blood cells

d. RBCs

86. Abnormal bowel sounds can indicate all of the following gastrointestinal
problems except:

a. Ileus

b. Aphasiac

c. Perforated bowel

d. Ischemic bowel

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

87. Which of the following exams is conducted to study the electrical component of
the brain?

a. Mammogram

b. Computed tomography

c. Echocardiogram

d. Electroencephalogram

Grab Bag Questions

88. Which of the following definitions best describes the rod of the eye?

a. Cell axon runs over the retina to the optic disk and makes up the second cranial nerve

b. Part of the uvea that carries arteries, veins, and nerves to the cells of the eye and can be a source
of bleeding

c. Retinal cell located predominantly in the peripheral retina; detects light

d. Fibrous outer layer of the entire eyeball; protects the inner layers and gives the eyeball its shape

89. Hyphema is best described as which of the following?

a. Blood in the anterior chamber

b. Pus in the anterior chamber

c. Insufficient red cell mass

d. Noncancerous overproduction of red cells

90. Which of the following protects the lungs from infection?

a. Nasal sinuses

b. Nasal turbinates

c. Thymus

d. Tonsils and adenoids

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

91. An upper respiratory infection is also known as which of the following?

a. Asthma

b. Common cold

c. Emphysema

d. Pneumoconiosis

92. The suffix -cele means:

a. Cell

b. Condition

c. Hernia

d. Pain

93. Which suffix means surgically fixate?

a. -centesis

b. -desis

c. -ectomy

d. -plasty

94. What does the term encephalopathy mean?

a. Abnormal discharge from the brain

b. A hardening of the brain

c. An enlargement of the brain

d. A disease of the brain

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

95. Bones are which of the following?

a. Static and unchanging

b. Regulated by hormones

c. Simple organs that provide only structural support

d. Remodeled only by breaking and resetting

96. Which of the following occurs in autoimmune diseases?

a. The body reacts to a bite, such as from an insect or snake.

b. The body lacks the capacity to mount an immune response.

c. The body has an allergic reaction to a food or other allergen.

d. The body’s immune system targets its own tissues.

97. Which of the following best describes a thrombus?

a. An abnormal bulging of a weak vessel wall that may be fatal if it ruptures.

b. A blood clot that forms on the wall of a blood vessel.

c. A blood clot, piece of tissue, or other substance that travels through the bloodstream until it
becomes lodged in an artery.

d. A tear in the inner layer of a vessel that is made worse as the blood separates the layers.

98. Which of the following is a function of the skin?

a. Producing blood cells

b. Synthesizing vitamin D

c. Detoxifying chemical poisons

d. Regulating calcium metabolism

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology

99. Pressure on the sciatic nerve from inflammation or a bulging disc can cause symp-
toms down the entire leg because of which of the following?

a. The sciatic nerve is a very thick nerve.

b. When the pressure is close to the spinal cord, the symptoms can be more widespread, affecting an
entire limb.

c. Sciatic is Latin for “pain in the whole leg.”

d. The sciatic nuclei in the brain get activated.

100. Which of the following conditions describes the inability to swallow?

a. Anarthria

b. Anosmia

c. Aphasia

d. Aphagia

30 © 2011 HCPro, Inc.

 Also available as part of The ICD-10 Training Toolkit

ICD-10
Competency Assessment for Coders
Anatomy and Physiology
The ICD-10 Competency Assessment for Coders: Anatomy and Physiology
features 100 questions designed to assess coders’ fundamental anatomy and
physiology knowledge in preparation for ICD-10.

These questions will help coders to gauge their knowledge of the following
anatomy and physiology topics:
• Blood • Integumentary system
• Cardiac/circulatory system • Medical terminology
• Ear • Musculoskeletal system
• Endocrine system • Neoplasms
• Eye • Nervous system
• Gastrointestinal system • Pregnancy
• Genitourinary system • Respiratory system
• Infectious diseases • Signs and symptoms
———————————————————
The ICD-10 Training Toolkit provides the building blocks for your training
programs for physicians, as well as coding, HIM, documentation, and billing
professionals in both inpatient and outpatient settings.

ICD10CACAP

75 Sylvan Street, Suite A-101 | Danvers, MA 01923

www.hcmarketplace.com
ICD-10
Competency
Assessment
for Coders
Anatomy and Physiology

Answer key
 Contents

Blood............................................................................................................................................... 5

Cardiac/Circulatory System............................................................................................................... 6

Ear................................................................................................................................................... 6

Endocrine System............................................................................................................................. 7

Eye................................................................................................................................................... 7

Gastrointestinal System..................................................................................................................... 8

Genitourinary System........................................................................................................................ 9

Infectious Diseases............................................................................................................................ 9

Integumentary System.................................................................................................................... 10

Medical Terminology...................................................................................................................... 10

Musculoskeletal System.................................................................................................................. 11

Neoplasms...................................................................................................................................... 12

Nervous System.............................................................................................................................. 12

Pregnancy...................................................................................................................................... 13

Respiratory System......................................................................................................................... 13

Signs and Symptoms....................................................................................................................... 14

Grab Bag Questions........................................................................................................................ 14

© 2011 HCPro, Inc. 3

 Answer Key

Blood

1. d. Arterial blood and venous blood contain the same cells. The RBCs in the systemic arter-
ies carry oxygen to the cells. In systemic venous blood, the RBCs have given up their oxy-
gen and take on a bluer color.

2. c . Cancers do not consume RBCs, but many cancers cause anemia from decreased RBC
production by decreasing the function of the bone marrow or by consuming the building
blocks required to make new RBCs.

3. b. Peripheral blood is found in the blood vessels, not bone marrow.

4. a. Sarcoidosis is an autoimmune disease in which collections of inflammatory cells replace

normal tissue, causing organ dysfunction.

5. 1. d; 2. b; 3. e; 4. a; 5 c

6. 1. c; 2. d; 3. a; 4. b

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

Cardiac/Circulatory System

7. d. Phlebitis is inflammation of a vein and is not caused by coronary artery occlusion.

8. d. Treatment of atrial fibrillation (A-fib) may include medications to decrease heart rate, to
convert the rhythm, or for anticoagulation (e.g., Coumadin®) to prevent stroke.

â•⁄ 9. a. Varicose veins do not occur in the upper esophagus. However, the lower part of the
esophagus can develop varicosities when there is portal hypertension, usually from liver
disease.

10. a. Primary pulmonary hypertension is also known as idiopathic pulmonary arterial HTN.

11. 1. c; 2. b; 3. a

Ear

12. c . Malignant otitis externa is a severe bacterial infection of the external auditory canal,
commonly found in patients with uncontrolled diabetes or other immune compromise that
spreads to involve underlying bone and cartilage.

13. b. Stenosis of the external auditory canal is a chronic narrowing or constriction of the
ear passage.

14. d. The petrous apex is the most medial portion of the inner ear and temporal bone.

15. a. Conductive hearing loss is caused by problems of the outer and/or middle ear, which con-
tain the ossicles.

16. d. The Eustachian tube is a mucosa-lined cartilaginous tube whose inferior end is located in
the nasopharynx and whose superior end opens into the tubotympanum of the middle ear.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

Endocrine System

17. a. The pituitary gland is the body’s master gland. It produces many stimulating hormones
and has two sections (anterior and poster), and the hormones secreted have an effect on
the kidneys.

18. c. Excess secretions of prolactin can result in galactorrhea.

19. d. Effects of diabetes can include peripheral vascular disease, neuropathy, blindness, and
heart disease.

20. b. Polycystic ovarian syndrome is characterized by acne, hirsutism, resistance to insulin,
and fertility problems.

21. b and c. Diagnostic criteria for diabetes include fasting blood sugar greater than 125 and
random blood glucose of 200 with the classic signs and symptoms of diabetes.

Eye

22. Sclera
Iris
Pupil

Cornea Limbus

Image © HCPro, Inc.

23. 1. e; 2. c; 3. b; 4. d; 5. a

24. 1. b; 2. e; 3. a; 4. c; 5. d

25. c. Both conjunctiva and cornea are inflamed when a patient has keratoconjunctivitis.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

26. a. Episcleritis is a pink or purple color to the white of the eye.

27. 1. a; 2. c; 3. b

Gastrointestinal System

28. c . Secretion is the release of water, acids, enzymes, buffers, and salts by digestive tract epi-
thelium and glandular organs.

29. 1. b; 2. d; 3. a; 4. c; 5. e

30.
1. Mechanically breaks down food, disrupts chemical bonds in
1 food, and digests proteins with pepsin.

2. Betz cells secrete insulin and glucagon into bloodstream, and

2
3 excretes four kinds of enzymes into the duodenum.
4
3. Carries bile to the duodenum.
7
4. Chemical digestion of proteins into amino acids, carbohydrates
into sugars, and fats into fatty acids and absorption of
5
most nutrients.
6
5. Protects the body from infection, absorbs vitamin B12, and
8 reabsorbs conjugated bile salts.
Image © Blamb. Used under license
from Shutterstock.com. 6. Stores and compactions of food stuffs and reabsorbs bile salts.

7. Production and/or absorption of vitamins K, biotin (B7),

pantothenic acid (B5), folic acid (B9), minerals, and water.

8. Keeps liquid and gas from escaping.

31. 1. d; 2. b; 3. a; 4. c

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

Genitourinary System

32. d. Nephrotic syndrome. The excess protein in the urine (proteinuria) causes the urine to
appear foamy.

33. a. Salpingitis refers to inflammation of the fallopian tube(s).

34. a. The uterus. It refers to the body of the uterus.

35. d. This describes a condition where a congenital defect leads to an ineffective valve flap,
causing urine to flow back into the kidneys.

36. c. Endometrial tissue occurring on other pelvic organs/structures outside the uterus is
called endometriosis.

Infectious Diseases

37. b. A myriad of symptoms can occur during sepsis, but joint pain is not one that would
immediately make a healthcare provider consider systemic sepsis.

38. d. This requires identification and appropriate treatment. C. difficile, or C. diff, is �considered
a healthcare-acquired infection as it can occur after an antibiotic treatment for an unrelated
infection disrupts the balance in the gut flora.

39. a. Creuzfeldt-Jakob disease is the human equivalent of mad cow disease.

40. c. For patients with HIV, infections that would display no signs or symptoms in an other-
wise healthy person can be fatal.

41. c. Syphilis begins in the mucous membranes and rapidly becomes systemic spreading to
nearby lymph nodes and the bloodstream.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

Integumentary System

42.

Meissner’s corpuscle

Artery/arteriole

Vein/venule

Sweat gland

Fat cell
Pacinian corpuscle

Image © Sebastian Kaulitzki. Used under license from Shutterstock.com.

43. a. A vesicle is a small blister that contains clear fluid.

44. b. The lesion shown is a blisterlike lesion, or bulla.

45. c. Seborrheic dermatitis causes flaky, white to yellowish scales to form on oily areas such as
the scalp or inside the ear.

46. a. Shaving alone is not associated with alopecia.

Medical Terminology

47. d. The suffix -itis refers to inflammation.

48. d. The prefix pre means before.

49. c. The suffix -pathy means disease.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

50. b. The suffix -scopy indicates the use of an instrument for observing. Cysto indicates uri-
nary bladder.

51. b. Neuralgia is nerve pain. The suffix -algia means pain. Neur means nerve.

52. b. The prefix hypo- means below, deficient.

53. a. Suffixes often identify a condition or surgical procedure.

54. d. Superior means above.

Musculoskeletal System

55. b. A Smith’s fracture is also known as a Colles’ fracture.

56. b. The nerves to joints in the foot and ankle can be severely diseased in diabetes, leading to
joint destruction based on loss of nerve supply.

57. b. Spondylolisthesis can progress rapidly in young athletes who have spondylolisthesis due
to fracture of the pars interarticularis.

58. a. Lumbar spine. The spinal cord usually ends at the level of the second lumbar vertebra.
b. Thoracic spine. The dowager’s hump is an abnormal, exaggerated thoracic kyphosis.
c. Cervical spine. The pressures on the cervical spine are the least of any spinal segment.
The thickness and sturdiness of vertebral bodies reflect the magnitude of forces acting on
those vertebral bodies, so the lumbar and thoracic vertebrae are more robust than the cervi-
cal vertebrae.

59. b. Type II and Type III (hooked) acromion processes of the scapula are more often associ-
ated with rotator cuff disorders than the flatter Type I acromion process.

60. b. The term lateral epicondylitis is commonly known as tennis elbow.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

Neoplasms

61. a. Micrometastasis refers to the disruption of the cellular basement membrane. Growth out-
side this membrane indicates a high level of neoplastic growth and ultimately elevates the
severity of the cancer.

62. a. The Whipple procedure removes part of the pancreas and connects a portion of the pan-
creas to the duodenum (small intestine).

63. b. The supraglottis, glottis, and subglottis are the three parts of the larynx.

64. c. The nephron is the functional filtration unit of the kidney that manufactures urine.

65. c. Leukemia is directly linked with white blood cells.

Nervous System

66. a. The central nervous system includes the brain and the spinal cord. Everything else com-
prises the peripheral nervous system.

67. d. The cauda equina is a specific part of the spinal cord that includes both efferent and
afferent nerves, so named because of its “horse tail” appearance. Muscular stretch recep-
tors, pressure receptors, and taste receptors are all sources of sensory input.

68. d. The brainstem, which includes the medulla oblongata, pons, and midbrain, is at the very
top of the spinal cord, so virtually all information passes through here. This region handles
most of the things the body needs to stay alive, such as regulating breathing, heart rate,
and blood pressure.

69. c. The dura mater, or “tough mother,” is the outermost and toughest meninge.

70. True. Migraine headaches can cause various neurologic symptoms, making them difficult to
distinguish from a stroke or transient ischemic attack.

71. a. Hemiplegia is paralysis on one side of the body.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

Pregnancy

72. a. Agenesis is the absence or incomplete development of an organ due to an absence of
embryonic tissue.

73. a. Caput succedaneum is a common, benign, temporary condition that occurs during birth
as a result of contact between the head (presenting part) and cervix.

74. c. Primigravida is the correct term for a woman pregnant with her first child.

75. d. Placenta previa refers to the condition when the placenta grows in the lowest part of the
uterus and covers all or part of the opening to the cervix.

76. 1. a; 2. d; 3. b; 4. c

Respiratory System

77. 1. c; 2. a; 3. d; 4. b

78. a. Chronic bronchitis is a cough with mucous most days for more than three months due to
continuing irritation by allergens and pollutants that stimulate mucus production.

79. b. Emphysema is a progressive, irreversible destruction of alveolar walls, supporting tissue,
and pulmonary capillary bed.

80. d. Asthma is the constriction of muscles lining airways in response to allergens, prolonging
expiration and causing accessory muscle use.

81. c . Tonsillitis may be acute or chronic, is accompanied by inflammation of the mucosa, and
should be treated with antibiotics for bacterial infections. Symptoms include sore throat and
enlarged tonsils but do not include runny nose, stuffiness, and nasal congestion.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

Signs and Symptoms

82. d. Fluid accumulation in the body may be related to chronic heart failure, hypoalbumin-
emia, renal failure, and chronic liver disease.

83. d. Bones are used for structural support, protection of internal organs, storage of minerals,
and production of blood cells.

84. d. Blood pressure has an effect on the pressure of the vessel walls, is regulated by the kid-
neys, and is affected by medications.

85. b. Disease of the bone may affect the laboratory tests for alkaline phosphatase, white blood
cells, and RBC.

86. b. Abnormal bowel sounds don’t typically indicate aphasia.

87. d. An electroencephalogram is test used to study the electrical component of the brain
(brain waves).

Grab Bag Questions

88. c. The rod is the retinal cell located predominantly in the peripheral retina detects light.

89. a. Hyphema is blood in the anterior chamber.

90. d. Tonsils and adenoids protect the lungs from infection.

91. b. The common cold is one form of upper respiratory infection. Other forms of upper respi-
ratory infection include nasopharengitis, sinusitis, pharyngitis, and tonsillitis.

92. c. The suffix -cele refers to hernia or rupture.

93. b. The suffix -desis means surgically fixate.

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 ICD-10 Competency Assessment for Coders: Anatomy and Physiology—Answer Key

94. d. Encephalopathy means a disease (-pathy = disease) of the brain (encephal/o-.)

95. b. Hormones including calcitonin and calcitriol regulate bone function.

96. d. In autoimmune diseases, the body’s immune system targets its own tissues.

97. b. A thrombus is a blood clot that forms on the wall of a blood vessel.

98. b. Synthesis of vitamin D is one of the functions of the skin. The skin also regulates body
temperature, protects internal structures, and feels sensation.

99. b. If the nerve damage is closer to the brain or spinal cord, more areas of the body
are affected.

100. d. Aphagia is a condition in which the patient is unable to swallow.

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ICD10CACAP