Atiq Ur Rehman

MBBS
Saidu Medical College
Swat

Paramount Books (Pvt.) Ltd.

Karachi | Lahore | Islamabad | Sukkur | Faisalabad | Peshawar | Abbottabad
 Paramount Books (Pvt.) Ltd.

Basic Medical Sciences Anatomy, Physiology and Biochemistry with MCQs

by
Atiq Ur Rehman

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, without the prior permission of the Copyright Holders.

This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold,
hired out or otherwise circulated without the publisher’s prior consent in any form of binding or cover
other than that in which it is published and without a similar condition including this condition being
imposed on the subsequent purchaser.

Disclaimer: Readers are strongly advised to confirm that the information, especially with regard to
drug usage, complies with the latest legislation and standards of practice. The publisher and the
author do not assume any responsibility for any loss or injury and/or damage to a person or property
arising out of (or related to) any use of the material contained in this book. Furthermore, it is an
academic responsibility on the readers’ part to inform the Publisher about inaccuracy, misprint or
typographical error (if any).

Copyright © 2019
All Rights Reserved

First Edition ........................................2016

Second Edition...................................2019

Paramount Books (Pvt.) Ltd.

152/O, Block-2, P.E.C.H.S., Karachi-75400.
Tel: +92-21-34310030, info@paramountbooks.com.pk
www.paramountbooks.com.pk

ISBN: 978-969-637-569-2
Printed in Pakistan
 Contents
Preface viii
Acknowledgements ix
Introduction x
Section I ANATOMY 1
Chapter 1 Basic Terminologies 3
Chapter 2 The Cell 13
Chapter 3 Basic Tissues 31
Chapter 4 The Skeleton 33
Chapter 5 The Joint 55
Chapter 6 The Muscle 61
Chapter 7 Gastrointestinal System 75
Chapter 8 Respiratory System 87
Chapter 9 Cardiovascular System 95
Chapter 10 Nervous System 103
Chapter 11 Urinary System 113
Chapter 12 Reproductive System 121
Chapter 13 Endocrine System 129
Chapter 14 Integumentary System 135
Chapter 15 Sensory System 141
Section II PHYSIOLOGY 149
Chapter 16 Introduction to Physiology 151
Chapter 17 Physiology of Cell 153
Chapter 18 Blood and Immunity 163
Chapter 19 Cardiovascular System 179
Chapter 20 Respiratory System 187
Chapter 21 Lymphatic System 193
Chapter 22 Urinary System 197
Chapter 23 Digestive System 201
Chapter 24 Endocrine System 209
Chapter25 Reproductive System 221
Chapter 26 Metabolism and Regulation of Body 225
Temperature
Chapter 27 Nervous System 229
Chapter 28 Special Senses 233
Section III BIOCHEMISTRY 235
Chapter 29 Basics of Biochemistry 237
Chapter 30 Carbohydrates 241
Chapter 31 Proteins 245
Chapter 32 Lipids 249
Chapter 33 Enzymes 253
Chapter 34 Vitamins 257
Chapter 35 Nutrition, Food and Dietetics 263
Chapter 36 Metabolism 271
Chapter 37 Acid-Base Balance 273
Chapter 38 Body Fluids and Minerals 277
Multiple Choice Questions 281
Index 327
And Allah has brought you out from the wombs of your mothers
while you know nothing. And He gave you hearing, sight, and
hearts that you might give thanks (to Allah).
[Holy Qura’n - al-Nahl 16:78]
 Preface
With the great and eternal name of Allah, I’m going to shed some light
on my 3rd book for paramedical and nursing students. Thanks to
Him for blessing me with the strength and will-power to bring forth a
comprehensive writing on the elementary knowledge of basic medical
sciences for introductory-level paramedics and nurses.
This concise but comprehensive and understandable book is written to
make these professions attractive and desirable. They will find it useful
even without an instructor, though the importance of instructor is
undeniable. This book presents every topic in bullets in easy language,
which are followed by simple schemas and clear diagrams. Bullet-style
writing has made every topic easy and the schemas and diagrams further
make the topic clearer and easy to remember.

Dr. Atiq Ur Rehman

atiqsmc89@yahoo.com
 Acknowledgements
To make this book a reality, I constantly received generous contribution–
both practical and emotional, from my family, teachers and friends. I’d
like to thank my family-a source of my existence, my teachers – who
made me strong and my friends–who encouraged me for this project .
I cannot name each and every individual who helped me out but some
names definitely deserve a mention; as I would have never done this
without them.
• Dr. Naveed Alam (Assistant Professor, Punjab Medical College, Faisalabad)
• Mr. Murad Ali Mohmand (Director, National Book Foundation,
Pakistan)
• Dr. Muhammad Javaid Khan (CEO, Faculty of Paramedical & Allied
Health Sciences, Khyber Pakhtunkhwa)
• Dr. Waqas Khan (Hospital Pharmacist, RMI, Peshawar)
• Dr. Waqas Haleem (Resident Surgeon)
• Dr. Muhammad Abbas (Resident Physician, Mardan Medical Complex)
Also my heartfelt gratitude to Dr. Muhammad Idrees, Dr. Sami Ullah,
Dr. Alishan, Dr. Jan Alam, Dr. Arshad Ali, Dr. Mushtaq Ahmad, Dr. Iqbal
Buneri, Dr. Salman Ibrahim, Dr. Syed Ali, Dr. Abdullah, Mr. Arshad
Hussain, Dr. Safi Ullah for their consistent support and encouragement.
 Introduction
Basic Medical Sciences is an instant text for introductory level paramedical
students. It briefly describes all the basics of Anatomy, Physiology &
Biochemistry. For Convenience the book is divided into three sections
viz. Anatomy, Physiology & Biochemistry.
Basic Medical Sciences is authored keeping in view the dire need of
paramedical and nursing students for basic text on the subject. This
book is aimed at conveying information to students in a palatable way to
perform well in their exams and face challenges of practical professional
life. Fresh paramedical and nursing students, for the better part, have
to study complicated reference books, which are far beyond their
comprehension as well as their skill requirements. This book has been
penned to fill this gap particularly keeping these points in mind.
To make each topic clear, interesting and long-lasting in memory, three
enhancements have been made which make this book unique among
all the currently available books on the subject. Firstly, all topics are
marked by bullets. This enhancement provides the readers an instant
and easy to comprehend concept about a particular topic. Good-bye long
and boring paragraphs! Secondly, all the classifications are followed by
lucid and simple schemas, which make the concept easier and clearer.
Good-bye daunting and vague concepts! Thirdly, almost all the topics
are followed by clearly labeled diagrams to instill a long-lasting visual
memory in young brains.
To assess the learning of students, over a hundred multiple choice questions
are added at the end of each section. Though, the book is primarily
focused on paramedical students, yet all freshers in the field of medicine
and pharmacy can find it useful just as well.
 SECTION I
ANATOMY
Chapter 1 Basic Terminologies 3
Chapter 2 The Cell 13
Chapter 3 Basic Tissues 31
Chapter 4 The Skeleton 33
Chapter 5 The Joint 55
Chapter 6 The Muscle 61
Chapter 7 Gastrointestinal System 75
Chapter 8 Respiratory System 87
Chapter 9 Cardiovascular System 95
Chapter 10 Nervous System 103
Chapter 11 Urinary System 113
Chapter 12 Reproductive System 121
Chapter 13 Endocrine System 129
Chapter 14 Integumentary System 135
Chapter 15 Sensory System 141

1
 CHAPTER 01
Basic Terminologies
HUMAN ANATOMY
Branch of medical science concerned with the bodily structure of
human body as revealed by dissection and the separation of parts.

BRANCHES OF HUMAN ANATOMY

• General anatomy: This branch of human anatomy deals with
the general aspects of human body and its parts. For example
classification of joints or muscles.
• Regional anatomy: This branch of human anatomy deals with
the study of human body based on regions, parts or divisions. For
example: anatomy of the upper limb, lower limb, thorax and head
and neck. This branch of anatomy is useful for surgeons.
• Systemic anatomy: This branch of human anatomy deals with
the study of human body based on systems. For example: anatomy
of digestive system, respiratory system, urogenital system, central
nervous system, etc. This branch of anatomy is useful for physicians.
• Surface anatomy: This branch of human anatomy deals with
the study and identification of various parts of the body through
inspection and palpation.
• Gross anatomy: This branch of human anatomy deals with the
study of parts of human body which are visible to naked eye.
General anatomy, systemic anatomy, regional anatomy and surface
anatomy are considered sub-branches of gross anatomy. Gross
anatomy is also known as macroanatomy or cadaveric anatomy.
• Histology: This branch of human anatomy deals with the study
of various tissues of human body. This study is made by different
scientific methods like microscopy, histochemistry, radioautography,
etc. This branch of human anatomy is also known as microanatomy.
• Clinical anatomy: This branch of human anatomy deals with the
application of facts of human anatomy to the field of medicine and
surgery. This branch of human anatomy is also known as applied
anatomy or practical anatomy.

3
 • Morphology: This branch of human anatomy deals with the
discussion of changes in physical form of human body and its parts.
• Radiological anatomy: This branch of human anatomy deals
with the study of human body and its organs through different
imaging techniques. These imaging techniques include X-rays,
CT-scan, MRI, Ultrasound, etc.
• Comparative anatomy: This branch of human anatomy deals
with the study of morphological difference among humans and
other animals.
• Embryology: This branch of human anatomy deals with the
study of various changes in developing human from the time of
fertilization of ovum till birth. This branch of human anatomy is
also known as developmental anatomy.
• Statistical anatomy: This branch of human deals with various
measurements of human body and its parts.
• Phylogeny: This branch of human anatomy deals with the
developmental changes in ancestors from which the human beings
evolved.
• Cytology: This branch of
human anatomy deals with
the study of cell by various
Section I— Anatomy

biological techniques.
• Cross-sectional anatomy:
This branch of human
anatomy deals with the study
of various regions of the
body through cross-sections.

4 POSITIONS OF THE BODY

• Anatomical Position: Hu-
man body standing erect,
the eyes looking forward,
the arms by the sides and
palms of the hands and toes
directed forwards. This posi-
tion is known as anatomical
position.
• Supine Position: Lying
down position with the face
looking anteriorly.
• Prone Position: Lying
down with the face looking
posteriorly. Fig. 1.1: Anatomical position.
 INFOBOX
Radioautography is the technique of making a radiograph of a body tissue
by recording the radiation emitted by radioactive material on a photographic
plate.

PLANES OF THE BODY

• Midsagittal Plane (Median Plane): This plane bisects the body
vertically through the midline and divides the body exactly into left
and right half. Parasagittal plane is any plane that lies parallel to the
median plane.
• Coronal Plane: It is a vertical plane that lies at right angle to the
sagittal plane. This plane divides the body dorsal (posterior) and
ventral (anterior) parts.
• Transverse Plane: Any plane at right angle to both coronal plane
and sagittal plane is known as transverse plane. It is also called
horizontal plane. It divided the body into superior and inferior
parts.

Chapter 01—Basic Terminologies

• Oblique plane: Any plane of the body which is at angle other than
right angle is known as oblique plane.

Frontal (coronal) Sagittal Transverse

plane plane (horizontal) plane
Fig. 1.2: Planes of the body.
 TERMS OF RELATIONSHIP
• Anterior: Anterior is anything that lies near the front surface of
the body.
• Posterior: Posterior is anything that lies near the back surface of
the body.
• Superior: Superior is anything that lies near the crown of the body.
• Inferior: Inferior is anything that lies near the soles of the feet.
• Medial: Medial is anything that lies near the median plane of the
body.
• Lateral: Lateral is anything that lies away from the median plane
of the body.
• Cranial: Cranial is anything that lies near the head.
• Caudal: Caudal is anything that lies near the tail end.
• Proximal: Proximal is anything that lies near the trunk of the body.
• Distal: Distal is anything that lies away from the trunk.
• Pre-axial: The lateral or radial border of upper limb and medial or
tibial border of the lower limb.
• Post-axial: The medial or ulnar border of the upper limb and
lateral or fibular border of the lower limb.
Section I— Anatomy

• Flexor surface: The anterior surface of the upper limb and

posterior surface of the lower limb.
• Extensor surface: The posterior surface of the upper limb and
the anterior surface of the lower limb.
• Palmer: The anterior surface of the hand.
6 • Planter: The inferior surface of the foot.
• Superficial: Anything that is near the skin is superficial.
• Deep: Anything that is away from skin is deep.
• Ipsilateral: Ipsilateral refers to the same side of the body. Left arm
and left leg are ipsilateral.
• Contralateral: Contralateral refers to the opposite side of the
body. Left arm and right leg are contralateral.
• Bilateral: Bilateral refers to both sides of the body.
• Unilateral: Unilateral refers to one side of the body.
• Interior: Inner part of a hollow organ is interior.
• Exterior: Outer part of a hollow organ is exterior.
• Invagination: Inward protrusion of a hollow organ is invagination.
• Evagination: Outward protrusion of a hollow organ is evagination.
 Cranial Superior Right Left

Proximal
Posterior Anterior
or dorsal or ventral
Medial Lateral

Proximal

Caudal Distal

Inferior Distal

Fig. 1.3: Terms of relationship.

Chapter 01—Basic Terminologies

7
Unilateral Bilateral Ipsilateral Contralateral

Fig. 1.4: Laterality.

FLEXION, EXTENSION AND HYPEREXTENSION

Flexion is a movement that decreases the angle between two parts of
the body. Extension is a movement that increases the angle between
two parts of the body. Hyperextension is an excessive movement of
a joint, in which the angle formed by the bones of a particular joint is
opened, or straightened, beyond its healthy, normal, range of motion.
 ABDUCTION AND
ADDUCTION
Flexion Hyperextension Abduction is a movement away
from the midline. Adduction is
a movement towards the midline.
Flexion
PRONATION AND
SUPINATION
Supination is the rotation
Extension Hyperextension
of the hand and forearm so
Flexion that the palm faces forward
or upward. Pronation is the
rotational movement where the
Extension hand and upper arm are turned
inwards. Pronation is opposite of
supination.

INVERSION AND EVERSION

Eversion is the movement of the
Fig. 1.5: Flexion, extension and
Hyperextension. sole of the foot away from the
Section I— Anatomy

Abduction

Adduction
Abduction
Abduction

Adduction

Adduction

Fig. 1.6: Adduction and abduction.

 Pronation Supination
(Radius (Radius and
rotates ulna are
over ulna) parallel)

P
S

Inversion Eversion

Fig. 1.7: Supination and pronation. Fig. 1.8: Inversion and eversion.

Chapter 01—Basic Terminologies

median plane. Inversion is the
movement of the sole of the foot
towards the median plane.
Dorsiflexion
DORSIFLEXION AND
PLANTAR FLEXION
Planta flexion is the movement
at the ankle joint that points
the foot downwards away from
the leg. This term may also be
9
used for movement of the toes
that curl them down towards Plantar flexion
the sole. Dorsiflexion is the
upward movement of the foot
or toes or of the hand or finger.
Dorsiflexion is the opposite of
Fig. 1.9: Dorsiflexion and plantar
plantar flexion. flexion.

DEPRESSION AND ELEVATION

Depression is the downward
movement of structures of the
body or its parts. Elevation is
the upward movement of structure of the body or its parts.
 Elevation of Retraction
mandible of mandible Protraction of
mandible
Depression
of mandible

Fig. 1.10: Elevation and depression. Fig. 1.11: Protraction and retraction.

Abduction

Flexion
Section I— Anatomy

Extension

10

Adduction
Circumduction

Fig. 1.12: Circumduction. Note that it is a combination of flexion, extension,

adduction and abduction.
PROTRACTION AND
RETRACTION
Protraction is the extension
of the jaw or tongue forward or
outward.
Retraction is the opposite of
protraction. It is bringing the jaw
or tongue backward or inward.

CIRCUMDUCTION
Circumduction is the circular
movement of a limb such that
the distal end makes an arc. Lateral
circumduction is the combination rotation
of flexion, extension, adduction
and abduction. Medial
rotation

Chapter 01—Basic Terminologies

MEDIAL ROTATION AND
LATERAL ROTATION
Medial Rotation is a movement
in which hands or feet point
towards the midline. Lateral Fig. 1.13: Medial and Lateral rotation.
rotation is the movement in
which hands or feet point away
from the midline.

11