Professional Documents
Culture Documents
Pathophysiology:
A Practical Approach
Lachel Story
CHAPTER 1
QUESTIONS
_____ 1. The movement of water or another solvent across the cellular membrane from
an area of low solute concentration to an area of high solute concentration is referred to
as
A. meiosis.
B. osmosis.
C. lysis.
D. mitosis.
_____ 4. The fetus is most vulnerable to environmental influences during which period of
gestation?
A. 10 to 15 days
B. The first 30 days
C. 15 to 60 days
D. The first trimester
_____ 5. Which form of cellular adaptation occurs because of decreased work demands
on the cell?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
_____ 7. Which disorders are passed from an affected parent to an offspring regardless of
sex?
A. Sex-linked disorders
B. Fragile X syndrome
C. Autosomal dominant disorders
D. All of the above
_____ 13. Selective permeability allows free passage in and out of cells to
A. enzymes.
B. glucose.
C. electrolytes.
D. all of the above.
_____ 14. Which type of cellular adaptation is undergone by the muscles of an extremity
that has been in a cast for a long period of time?
A. Hypertrophy
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B. Metaplasia
C. Dysplasia
D. Hyperplasia
_____ 18. A form of cell division that occurs only in mature sperm and ova is
A. mitosis.
B. prophase.
C. oncogene.
D. meiosis.
_____ 20. A cancer patient’s likelihood for surviving a cancer is referred to as his or her
A. remission.
B. prognosis.
C. carcinogenesis.
D. grading.
_____ 22. When caustic enzymes dissolve and liquefy necrotic cells, this is known as
A. coagulative necrosis.
B. liquefaction necrosis.
C. fat necrosis.
D. caseous necrosis.
_____ 24. When cells increase in number in an organ or tissue, this is known is
A. apoptosis.
B. hyperplasia.
C. metaplasia.
D. dysplasia.
_____ 25. In grading cancer cells, which grade has well differentiated cells?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
ANSWER KEY
1. B
2. C
3. D
4. C
5. C
6. A
7. C
8. C
9. A
10. D
11. C
12. B
13. D
14. A
15. A
16. D
17. A
18. D
19. A
6
20. B
21. D
22. B
23. B
24. B
25. A
RATIONALES
1. Osmosis refers to the movement of water or another solvent across the cellular
membrane from an area of low solute concentration to an area of high solute
concentration. Meiosis is a form of cell division that occurs only in mature sperm and
ova. Lysis occurs when too much water enters a cell membrane. Mitosis is the most
common form of cell division.
3. Curative treatment seeks to eradicate the disease. Not all cancer treatment does this.
Palliative treatment treats symptoms to increase comfort. Prophylactic treatment seeks to
prevent cancer.
5. Atrophy is the type of cellular adaptation that occurs because of decreased work
demands on the cell. Hypertrophy is the opposite; it occurs when cells increase in size to
try to meet increased work demand. Hyperplasia is an increase in the number of cells in
an organ or tissue. Metaplasia is the process in which one adult cell is replaced by
another cell type.
6. A female has two X chromosomes. A male has one X and one Y chromosome. No one
has two Y chromosomes. Autosomes make up 22 of the 23 sets of paired chromosomes,
with the remaining pair being the sex chromosomes.
necrotic cells. Fat necrosis happens when lipase enzymes break down triglycerides into
free fatty acids.
9. The genetic information for a cell is contained in the nucleus. The organelles are
internal cellular structures that perform the work that maintains the cell’s life. A lipid
bilayer is what makes up the cell membrane. Cytoplasm is a colorless, viscous liquid in
the cell containing water, nutrients, and other substances.
10. Cancer is the disease state of a neoplasm. Apoptosis is a mechanism of cell death.
Atrophy is one kind of cell adaptation. Exocytosis is the release of materials from a cell.
11. Infection is a possible teratogen. The other terms are distracters for this question.
13. Selective permeability allows free passage in and out of cells to enzymes, glucose,
and electrolytes.
15. Malignant tumors are usually undifferentiated. Benign tumors usually consist of
differentiated, or less anaplastic, cells.
17. Variations of a gene are known as alleles. Autosomes refers to the 22 sets of paired
chromosomes that are not sex chromosomes. A karotype is a representation of a person’s
individual set of chromosomes. DNA makes up the long double-stranded chain of
nucleotides known as chromosomes.
18. A form of cell division that occurs only in mature sperm and ova is meiosis. Mitosis
is the most common form of cell division. Prophase refers to the first phase of mitosis.
An oncogene can cause cancer.
20. A cancer patient’s likelihood for surviving a cancer is referred to as his or her
prognosis. A remission takes place when cancer responds to treatment and is under
8
control. Carcinogenesis is the process by which cancer develops. Grading determines the
degree of differentiation of cancer.
21. Metaplasia refers to the process of one adult cell being replaced by another cell type.
An increase in the number of cells in an organ or tissue is hyperplasia. Cell mutation into
cells of a different size, shape, and appearance is dysplasia. An increase in the size of
cells in an attempt to meet increased demand is hypertrophy.
22. Liquefaction necrosis occurs when caustic enzymes dissolve and liquefy necrotic
cells. Coagulative necrosis usually results as an interruption in blood flow. Fat necrosis
occurs when lipase enzymes break down intracellular triglycerides into free fatty acids.
Caseous necrosis occurs when necrotic cells disintegrate but the cellular debris remains
for months or years.
24. When cells increase in number in an organ or tissue, this is known is hyperplasia.
Apoptosis is a type of cell death. Metaplasia is the process of one adult cell being
replaced by another cell type. In dysplasia, cells mutate into cells of a different size,
shape, and appearance.
25. In grading cancer cells, grade 1 has well-differentiated cells. The other grades have
progressively less differentiation. Grade 4 cells are undifferentiated.
9
CHAPTER 2
QUESTIONS
_____ 2. Molecules released by macrophages that have been exposed to bacteria are
known as
A. pyrogens.
B. interferons.
C. T cells.
D. complement proteins.
_____ 5. Bodily changes that are associated with stress were first described by Hans
Selye in the
A. 1780s.
B. 1860s.
C. 1930s.
D. 1990s.
_____ 9. Small proteins that are released from cells infected by viruses are known as
A. regulator cells.
B. effector cells.
C. interferons.
D. pyrogens.
_____ 10. Catecholamines and cortisol are released, causing the fight-or-flight response,
in which stage of the general adaptation syndrome?
A. The resistance stage
B. Hypersensitivity
C. The exhaustion stage
D. The alarm stage
_____ 11. The skin and mucous membranes are part of the body’s
A. first line of defense.
B. second line of defense.
C. third line of defense.
D. fourth line of defense.
_____ 13. Which of the following is a maladaptive coping strategy for stress?
A. Physical activity
B. Overeating
C. Biofeedback
D. Distraction
_____ 14. Anxiety, depression, insomnia, infections, and cardiovascular disease have
been attributed to
A. killer cell attacks.
11
B. type II hypersensitivity.
C. pyrogen.
D. stress.
_____ 15. Factors that place individuals at risk for an impaired immune system include
A. spending time outdoors.
B. reducing stress.
C. smoking.
D. increasing fluid intake.
_____ 17. The type of rejection reaction that occurs only with bone marrow transplants is
A. graft-versus-host rejection.
B. graft-versus-graft rejection.
C. host-versus-host rejection.
D. host-versus-graft rejection.
_____ 19. The first stage of the general adaptation syndrome is the
A. resistance stage.
B. exhaustion stage.
C. stress response.
D. alarm stage.
_____ 22. Cells that have invaded the body are destroyed by
A. T cells.
B. B cells.
C. cellular immunity.
D. all of the above
_____ 23. Transplants that use tissue from the identical twin of the host are
A. autologous transplants.
B. syngenic transplants.
C. allogenic transplants.
D. all of the above
ANSWER KEY
1. B
2. A
3. C
4. B
5. C
6. D
7. B
8. A
9. C
10. D
11. A
12. A
13. B
14. D
15. C
16. B
17. A
18. C
13
19. D
20. A
21. D
22. D
23. B
24. C
25. C
RATIONALES
2. Molecules released by macrophages that have been exposed to bacteria are known as
pyrogens. Interferons and complement proteins are other components of the second line
of defense. T cells are part of the third line of defense.
3. Antibody production is turned off by suppressor cells. Effector cells, or killer cells,
work to destroy antigens. Cytotoxic cell is another term used for killer cell.
4. T cells are responsible for hypersensitivity and transplant rejection. They mature in the
thymus, not the thyroid gland or bone marrow. They are part of the body’s third line of
defense.
5. Hans Selye first described bodily changes associated with stress in the 1930s.
6. Characteristics of systemic lupus erythematosus include butterfly rash over the cheeks,
photosensitivity, and arthritis.
9. Small proteins that are released from cells infected by viruses are known as interferons.
Regulator cells and effector cells are types of T cells that work to destroy antigens.
Pyrogens are molecules released by macrophages that have been exposed by bacteria.
10. Catecholamines and cortisol are released, causing the fight-or-flight response, in the
alarm stage of the general adaptation syndrome.
14
11. The skin and mucous membranes are part of the body’s first line of defense.
13. Overeating is a maladaptive coping strategy for stress. Physical activity, biofeedback,
and distraction are positive coping strategies for stress.
14. Anxiety, depression, insomnia, infections, and cardiovascular disease have been
attributed to stress.
15. Smoking is one factor that places individuals at risk for an impaired immune system.
Spending time outdoors, reducing stress, and increasing fluid intake are strategies to build
a healthy immune system.
18. Category 2 of HIV infection progression refers to a CD4 cell count of 200 to 499
cells/mm3. Category 1 refers to a CD4 cell count ≥ 500 cells/mm3. Category 3 refers to a
CD4 cell count < 200 cells/mm3. Asymptomatic HIV infection is one of the categories in
another HIV classification system based on symptom presentation.
19. The first stage of the general adaptation syndrome is the alarm stage. Resistance is the
second stage and exhaustion is the third stage. The whole process is the stress response.
20. Children who are HIV positive may experience problems walking. They may
experience difficulty gaining weight and growing normally, and may have severe forms
of common childhood illnesses.
21. Autoimmune disorders affect women more than men, and can be systemic or can
affect particular organs. Diagnostic procedures for autoimmune disorders often begin
with eliminating all other causes.
22. T cells, B cells, and cellular immunity all destroy cells that have invaded the body.
23. Syngenic transplants use tissue from the identical twin of the host. In autologous
transplants, the host and donor are the same person. Allogenic transplants are those in
which tissue is used from the same species of similar tissue type, but it is not identical.
24. Erythema, edema, heat, and pain characterize the inflammatory response.
CHAPTER 3
QUESTIONS
_____ 2. The most plentiful type of blood cell in the human body is
A. erythrocytes.
B. leukocytes.
C. thrombocytes.
D. stem cells.
_____ 5. With proper management, patients with sickle cell disease live into their
A. teens.
B. 20s.
C. 30s.
D. 50s.
C. hemoglobin.
D. none of the above
_____ 13. Thalassemia patients who are effectively treated can survive into their
A. teens.
B. 30s.
C. 50s.
D. 70s.
_____ 14. There are a number of causes of anemias, but a common clinical manifestation
is
A. weight gain.
B. weakness.
C. bradycardia.
D. bone pain.
17
_____ 17. In which stage of Hodgkin’s lymphoma are the lymphoma cells found in one
lymph node group, or in only one part of a tissue or organ?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
C. leukocytes.
D. thrombocytes.
_____ 24. Which of the following statements is true about disseminated intravascular
coagulation (DIC)?
A. Bleeding of a person with DIC is quickly halted by his or her clotting factors.
B. Few clotting factors are present in the bloodstream of an individual with DIC.
C. Clotting factors become abnormally active in DIC.
D. To treat DIC, it is merely necessary to treat the bleeding.
_____ 25. Hematocrit refers to how much of the blood volume is occupied by
A. thrombocytes.
B. neutrophils.
C. erythrocytes.
D. leukocytes.
ANSWER KEY
1. C
2. A
3. D
4. A
5. D
6. C
7. B
8. B
9. D
10. C
11. D
12. D
13. B
14. B
15. A
16. C
17. A
18. A
19. D
20. B
21. A
19
22. B
23. B
24. C
25. C
RATIONALES
2. Erythrocytes are the most plentiful type of blood cell in the human body. Millions can
be found in a single drop of blood.
5. With proper management, patients with sickle cell disease live into their 50s.
7. Blood formation occurs primarily in the bone marrow. Plasma and hemoglobin are
components of blood.
9. Polycythemia vera is a rare disease. In polycythemia vera, too many blood cells are
produced. It occurs most frequently in men.
10. Another name for white blood cells is leukocytes. Erythrocytes are another name for
red blood cells. Thrombocytes are another name for platelets. Plasmin is an enzyme that
dissolves clots.
11. The immune system destroys its own platelets in idiopathic thrombocytopenic
purpura (ITP). Thrombotic thrombocytopenic purpura (TTP) results from a deficiency of
an enzyme necessary to cleave von Willebrand factor. Disseminated intravascular
coagulation (DIC) is a disorder that uses up the clotting factors. Hemophilia A is an X-
linked recessive bleeding disorder.
12. Acute myeloid leukemia, chronic lymphoid leukemia, and chronic myeloid leukemia
all affect mainly adults. Acute lymphoblastic leukemia affects mainly children.
13. Thalassemia patients who are effectively treated can survive into their 30s.
20
14. There are a number of causes of anemias, but a common clinical manifestation is
weakness.
16. An abnormal type of hemoglobin, called hemoglobin S, is the cause of sickle cell
anemia.
17. In stage I of Hodgkin’s lymphoma, the lymphoma cells are found in one lymph node
group, or in only one part of a tissue or organ. In stage II, the lymphoma cells are in at
least two lymph node groups on the same side of the diaphragm, or in one part of a tissue
or an organ and the lymph nodes near that organ on the same side of the diaphragm. In
stage II, the lymphoma cells are in lymph nodes above and below the diaphragm, and
may also be in one part of a tissue or organ near the lymph node groups and in the spleen.
In stage IV, lymphoma cells are found in several parts of one or more organs or tissues,
or in an organ and in distant lymph nodes.
20. Hemoglobin binds to oxygen. Hemoglobin gives blood its red color.
22. Another name for red blood cells is erythrocytes. Another name for white blood cells
is leukocytes. Another name for platelets is thrombocytes. Stem cells are also called
primitive cells.
25. Hematocrit refers to how much of the blood volume is occupied by erythrocytes, or
red blood cells.
21
CHAPTER 4
QUESTIONS
_____ 2. Which of the following statements is true about the entry of blood into the
heart?
A. When blood enters the heart, it is high in oxygen and low in carbon dioxide.
B. Blood enters the heart from the aorta.
C. When blood enters the heart, it is low in oxygen and rich in carbon dioxide.
D. Blood enters the left side of the heart from the systemic circulation.
_____ 3. The pressure that the left ventricle must exert in order to get the blood out of the
heart and into the aorta is called
A. peripheral vascular resistance (PVR).
B. stroke volume.
C. afterload.
D. preload.
_____ 12. When fluid accumulates in the pericardial cavity to the point that it compresses
the heart, this is known as
A. constrictive pericarditis.
B. infective endocarditis.
C. cardiac tamponade.
D. myocarditis.
_____ 14. The inner epithelial layer of the heart that makes up the valves is called the
A. pericardium.
B. myocardium.
C. endocardium.
23
_____ 20. The middle layer of blood vessel walls is known as the
A. tunica intima.
B. tunica media.
C. tunica adventitia.
D. none of the above
A. hypovolemic shock.
B. cardiogenic shock.
C. distributive shock.
D. neurogenic shock.
_____ 23. When a weakened area of an arterial wall balloons outward, this is known as
A. atherosclerosis.
B. automaticity.
C. aneurysm.
D. dromotopic.
ANSWER KEY
1. B
2. C
3. C
4. B
5. D
6. A
7. B
8. D
9. A
10. D
11. A
12. C
13. C
14. C
15. B
16. A
17. C
18. D
19. D
20. B
25
21. B
22. A
23. C
24. D
25. B
RATIONALES
2. When blood enters the heart, it is low in oxygen and rich in carbon dioxide. Blood
leaves the heart from the aorta. Blood enters the right side of the heart from the systemic
circulation.
3. The pressure that the left ventricle must exert in order to get the blood out of the heart
and into the aorta is called afterload. Peripheral vascular resistance (PVR) is the force
opposing the blood in the peripheral circulation. Stroke volume is the amount of blood
ejected from the heart with each contraction. Preload refers to the amount of blood
returning to the heart.
5. The lymphatic system includes lymph nodes, the spleen, and tonsils.
7. Pulse pressure is the difference between the systolic and diastolic pressures. The top
number in the usual blood pressure notation is the systolic pressure. The bottom number
in the usual blood pressure notation is the diastolic pressure. The force opposing the
blood in the peripheral circulation is called peripheral vascular resistance (PVR).
9. Blood is carried away from the heart by arteries. Veins return blood to the heart.
10. Risk factors for hypertension include race, being overweight or obese, and tobacco
use.
26
12. When fluid accumulates in the pericardial cavity to the point that it compresses the
heart, this is known as cardiac tamponade.
14. The inner epithelial layer of the heart that makes up the valves is called the
endocardium. The pericardium is the sac enclosing the heart. The myocardium is the
muscle.
17. The superior vena cava empties into the right atrium.
18. Electrical impulses can be initiated by all cardiac muscle cells. Normally, however,
they originate in the sinoatrial (SA) node. The atrioventricular (AV) node does not
usually initiate impulses unless the SA node is failing.
19. The initial treatment of a myocardial infraction includes morphine, oxygen, and
nitroglycerin.
20. The middle layer of blood vessel walls is known as the tunica media. The tunica
intima is the inner layer, and the tunica adventitia is the outer layer.
21. Sometimes a myocardial infarction (MI) has no symptoms. Heart attack is another
name for an MI. If a patient survives an MI, physical activity will likely be recommended
to help prevent another MI.
22. Venous return reduces because of external volume losses in hypovolemic shock.
Cardiogenic shock results when the left ventricle can’t maintain adequate cardiac output.
In distributive shock, vasodilatation causes hypovolemia. Neurogenic shock results when
a loss of sympathetic tone in vascular smooth muscle and autonomic function lead to
massive vasodilatation.
23. When a weakened area of an arterial wall balloons outward, this is known as
aneurysm.
25. Stimulating the sympathetic nervous system (SNS) increases the heart rate and blood
pressure.
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CHAPTER 5
QUESTIONS
_____ 3. Acute respiratory distress syndrome (ARDS) develops within about what period
following a systemic inflammatory response?
A. 1 minute.
B. 90 minutes.
C. 5 hours.
D. 1 day.
_____ 13. The site for gas exchange with the bloodstream is the
A. surfactant.
B. alveoli.
C. cilia.
D. epiglottis.
_____ 14. Which of the following is a patchy pneumonia throughout several lobes?
A. Lobar pneumonia
B. Bronchopneumonia
C. Interstitial pneumonia
D. None of the above
30
_____ 15. A dome-shaped muscle that separates the thoracic and abdominal cavities is
the
A. alveolus.
B. bronchus.
C. trachea.
D. diaphragm.
_____ 18. Which of the following is NOT a clinical manifestation of lung cancer?
A. Hoarseness
B. Dyspnea
C. Weight gain
D. Fatigue
_____ 20. Which of the following might be compared to the strings of a guitar or violin?
A. Epiglottis
B. Trachea
C. Larynx
D. Bronchi
C. 57%.
D. 90%
_____ 23. Pneumonia that can occur when the gag reflex is impaired, such as during
anesthesia, is
A. viral pneumonia.
B. aspiration pneumonia.
C. bacterial pneumonia.
D. pneumocystic carinii pneumonia.
ANSWER KEY
1. C
2. C
3. B
4. A
5. C
6. A
7. B
8. A
9. D
10. D
11. D
12. C
13. B
14. B
15. D
16. D
17. C
18. C
19. A
20. C
21. A
32
22. D
23. B
24. A
25. C
RATIONALES
2. Influenza affects both the upper and lower respiratory tract. Type A is the most
common type of influenza. Type C has never been connected with a large epidemic
(types A and B have).
4. The trachea, bronchi, bronchioles, and alveoli comprise the lower respiratory tract.
8. The sum of the tidal volume and reserves is the vital capacity. The minute respiratory
volume is the amount inhaled and exhaled in 1 minute. Residual volume is the air
remaining in the lungs after exhalation. The medulla oblongata controls the process of
breathing.
9. Causes of sinusitis include viral infection, bacterial infection, and fungal infection.
10. Expiration is passive, in that it does not require muscle contraction. But expiration
can also be active when the chest and abdominal muscles are contracted. Inspiration, not
expiration, occurs by the diaphragm contracting, lowering, and flattening.
11. People can recover from legionnaires’ disease without incident , but the disease can
be fatal if untreated.
12. The common cold is an upper respiratory infection. Infectious rhinitis is another name
for the common cold. Coronavirus is one of the many viruses that can cause the common
cold, but the rhinovirus is the most common cause.
13. The site for gas exchange with the bloodstream is the alveoli.
33
15. The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal
cavities.
16. Tuberculosis is increasing globally. It was once on the decline. Tuberculosis can
cause both illness and death. During the active infection phase of the illness, it can spread
to organs other than the lungs.
18. Weight gain is not a clinical manifestation of lung cancer. Weight loss, hoarseness,
dyspnea, and fatigue are clinical manifestations of lung cancer.
20. The larynx can be compared to the strings of a guitar or violin. Also called the voice
box, the larynx plays a central role in swallowing and talking.
23. Pneumonia that can occur when the gag reflex is impaired, such as during anesthesia,
is aspiration pneumonia. Viral pneumonia and bacterial pneumonia are caused by the
organisms of their respective names. Pneumocystic carinii pneumonia is caused by a
yeastlike fungus, Pneumocystosis jiroveci.
CHAPTER 6
QUESTIONS
_____ 8. The electrolyte whose main function is to control serum osmolality and water
balance is
A. potassium.
B. sodium.
C. magnesium.
D. chloride.
_____ 14. Trosseau’s sign and Chvostek’s sign may be seen with
A. hypocalcemia.
B. hypercalcemia.
36
C. hyperphosphatemia.
D. hypomagnesemia.
A. excess bicarbonate.
B. deficient acid.
C. both A and B, above
D. none of the above
_____ 25. Which of the following results from a deficiency of bicarbonate (base) or an
excess of hydrogen (acid).
A. Metabolic alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Respiratory alkalosis
ANSWER KEY
1. C
2. A
3. B
4. A
5. D
6. C
7. D
8. B
9. B
10. B
11. C
12. B
13. C
14. A
15. D
16. D
17. A
18. A
38
19. D
20. B
21. D
22. C
23. A
24. D
25. C
RATIONALES
1. Hypotonic solutions have a lower (not higher) concentration of solutes than those in
the intravascular compartment. Hypertonic (not hypotonic) solutions cause fluid to shift
from the intracellular to the intravascular space. Isotonic solutions have concentrations of
solutes equal to those in the intravascular compartment.
2. Cations are positively charged. Anions are negatively charged. Cations and anions play
a vital role in homeostasis.
3. The main diagnostic tool for evaluating acid-base balance is arterial blood gas (ABG).
Chvostek’s sign and Trousseau’s sign are used to evaluate for hypocalcemia. Dehydration
is not the main diagnostic tool for evaluating acid-base balance.
4. Fluid that is found between the cells is called interstitial fluid. Intracellular fluid is
found inside the cells. Intravascular fluid is found inside the blood vessels.
5. Hyponatremia results from low serum sodium levels. Hypokalemia results from low
serum potassium levels. Hypernatremia results from high serum sodium levels.
Hypochloremia results from low serum chloride levels.
6. About two-thirds of the body’s water is accounted for by intracellular fluid. The
remaining one-third of the body’s fluid makes up the extracellular fluid. Transcellular
fluid is about 1% of the body’s fluid. Intravascular fluid is one type of extracellular fluid.
7. The causes of fluid deficit include inadequate fluid intake, nephrosis, and excessive
diaphoresis.
8. Sodium is the electrolyte whose main function is to control serum osmolality and water
balance. Potassium plays a role in electrical conduction, acid-base balance, and
metabolism. Magnesium helps maintain normal muscle and nerve function, keeps heart
rhythm steady, supports a healthy immune system, and has other functions. Chloride
assists in fluid distribution by attaching to sodium or water.
39
10. Most of the body’s phosphorus is found in the bones. Smaller amounts of phosphorus
are found in the bloodstream.
13. The most significant cation is considered to be sodium. It is the most prevalent
electrolyte of extracellular fluid. Its main function is to control serum osmolality and
water balance. It also helps maintain acid-base balance.
14. Trosseau’s sign and Chvostek’s sign may be seen with hypocalcemia.
15. A role in acid-base balance is played by body fluids, the lungs, and the kidneys.
16. Major buffer mechanisms include the bicarbonate-carbonic acid system, the
phosphate system, and the hemoglobin system.
17. Edema refers to fluid excess. Fluid deficit can also be referred to as dehydration.
Hypovolemia refers to fluid deficit of the intravascular compartment.
20. Most of the body’s calcium is found in the bones and teeth.
22. Metabolic alkalosis results from excess bicarbonate and deficient acid.
24. Death occurs if serum pH rises above 7.8. Death can also occur if serum pH falls
below 6.8.
and, in turn, decreasing pH. Respiratory alkalosis results from excess exhalation of
carbon dioxide that leads to carbonic acid deficit and pH increase.
41
CHAPTER 7
QUESTIONS
_____ 9. Brain injury, spina bifida, and nervous system tumors might be expected to lead
to
A. neurogenic bladder.
B. polycystic kidney disease (PKD).
C. Wilms’ tumor.
D. none of the above
_____ 10. The microscopic filtering unit of the kidney is known as the
A. calyx.
B. nephron.
C. UTI.
D. renal hilum.
_____ 12. Which of the following is NOT a risk factor for urinary incontinence?
A. Advancing age
B. Smoking
C. Male gender
D. Excess weight
_____ 15. Which of the following statements is true about acute renal failure (ARF)?
A. It is generally reversible.
B. An individual with ARF is symptomatic in the initial phase.
C. The mortality rate is 95%.
D. A low-calorie diet is supportive.
_____ 16. A test to screen for prostate cancer, or to indicate the effectiveness of treatment
for prostate cancer, is
A. IVP.
B. BUN.
C. PSA.
D. all of the above
_____ 20. Approximately how many nephrons does each kidney contain?
A. 300
B. 50,000
C. 125,000
D. 1 to 2 million
B. renal insufficiency.
C. end-stage renal disease.
D. the diuretic phase.
_____ 25. Which of the following statements is true about tumors in the urinary system?
A. Urinary system tumors are confined to the kidneys.
B. Most urinary system tumors are malignant.
C. Being female is a risk factor for renal cell carcinoma.
D. Urinary system tumors tend to be benign.
ANSWER KEY
1. C
2. A
3. B
4. C
5. B
6. B
7. C
8. D
9. A
10. B
11. B
12. C
13. D
14. D
15. A
16. C
17. D
18. A
19. C
20. D
45
21. A
22. C
23. C
24. D
25. B
RATIONALES
2. Renal calculi range in size from as small as a grain of sand to as large as a golf ball.
Both males and females get renal calculi. Kidney stones are a different term for renal
calculi. The development of renal calculi and gallstones is unrelated.
5. The urinary bladder is where urine is stored. The urethra transports urine to the outside
of the body. Kidneys eliminate wastes from the blood and have regulatory functions but
do not store urine.
8. Metabolic waste managed by the kidneys includes ammonia, urea, and uric acid.
9. Brain injury, spina bifida, and nervous system tumors might be expected to lead to
neurogenic bladder. Polycystic kidney disease (PKD) is an inherited disease. Wilms’
tumor is a rare cancer mainly affecting the kidneys of children.
10. The microscopic filtering unit of the kidney is known as the nephron. The calyx is a
tube through which urine drains into the renal pelvis. UTI stands for urinary tract
46
infection. The renal hilum is the opening in the kidneys through which the renal artery
and nerves enter and the renal vein and ureter exit.
11. Among all infections, UTIs are the second most common.
12. Male gender is not a risk factor for urinary incontinence. Advancing age, smoking,
and excess weight are risk factors.
13. The nephron performs three processes that contribute to filtering the blood:
glomerular filtration, tubular reabsorption, and tubular secretion.
14. Renal function tests include BUN, serum creatinine, and urinalysis.
15. Acute renal failure (ARF) is generally reversible. People with ARF are usually
asymptomatic in the initial phase. The mortality rate is 10% to 60%, depending on the
cause. A high-calorie diet, rather than a low-calorie diet, is supportive.
16. A test to screen for prostate cancer, or to indicate the effectiveness of treatment for
prostate cancer, is prostate specific antigen (PSA). Intravenous pyelogram (IVP) allows
visualization of the kidneys, renal pelvis, ureters, and bladder. Blood urea nitrogen is a
test for liver and kidney function.
17. Urine is transported by the ureters and the urethra. The ureters transport urine from
the kidneys to the urinary bladder. The urethra transports urine to the outside of the body.
18. Functional incontinence tends to occur in older adults, especially people in nursing
homes. A physical or mental impairment prevents toileting in time.
22. End-stage renal disease is the third and final phase of chronic renal failure (CRF).
Renal impairment is the first phase, and renal insufficiency is the second phase. The
diuretic phase occurs in acute renal failure (ARF) rather than in CRF.
23. Bowman’s capsule is found in the nephron. The glomerulus and loop of Henle are
also found in the nephron. The urinary bladder is another part of urinary system.
25. Most urinary system tumors are malignant. They are not confined to the kidneys.
Being male, rather than female, is a risk factor for renal cell carcinoma.
48
CHAPTER 8
QUESTIONS
_____ 3. The testes, epididymides, and lower spermatic cords are contained in the
A. scrotum.
B. sex accessory glands.
C. vasa deferentia.
D. none of the above
_____ 4. When the rectum protrudes through the posterior wall of the vagina, this is
known as
A. cystocele.
B. rectocele.
C. uterine prolapse.
D. endometriosis.
_____ 7. A hollow, tunnel-like structure that extends from the cervix to the external
genitalia is the
A. vagina.
B. hymen.
C. vestibule.
D. mons pubis.
_____ 12. Paired, almond-shaped organs located on each side of the uterus are the
A. Bartholin’s glands.
B. fallopian tubes.
C. ovaries.
D. none of the above
_____ 13. Which disease is the most commonly reported STI to the CDC?
A. Chlamydia
B. Gonorrhea
C. Syphilis
D. Prostatitis.
_____ 22. A cyst that contains sperm and that develops between the testis and epididymis
is a(n)
A. spermatocele.
B. cystocele.
C. leiomyoma.
D. ampulla.
_____ 23. When the urethral meatus is on the ventral surface of the penis instead of the
end, this is known as
A. epispadias.
B. hypospadias.
C. cryptorchidism.
D. erectile dysfunction.
_____ 25. Which of the following is NOT a clinical manifestation of cervical cancer?
A. Bone fractures.
B. Weight loss.
C. Metrorrhagia.
D. Leaking of urine or feces from the vagina.
ANSWER KEY
1. C
2. C
3. A
4. B
5. D
6. C
7. A
8. C
9. B
10. A
11. B
12. C
13. A
14. B
15. B
16. D
52
17. A
18. D
19. D
20. C
21. D
22. A
23. B
24. D
25. C
RATIONALES
1. Skene’s gland, located in the mucosal lining of the vagina, secretes a protective,
lubricating fluid during sexual intercourse. The labia minora are part of the external
female genitalia. The endometrium is the inner mucosal lining of the uterus that
facilitates and maintains pregnancy.
2. Most women who develop breast cancer do not have a family history of breast cancer.
Wearing underwire bras does not increase the risk of breast cancer. Women of all ages
can develop breast cancer, though the risk does increase with age. Mutations in the
BRCA1 and BRCA2 genes do increase the risk of breast cancer, but most women with
breast cancer do not have this mutation.
3. The testes, epididymides, and lower spermatic cords are contained in the scrotum.
4. When the rectum protrudes through the posterior wall of the vagina, this is known as
rectocele. A cystocele occurs when the bladder protrudes into the anterior wall of the
vagina. Uterine prolapsed is the descent of the uterus or cervix into the vagina.
Endometriosis refers to the growth of the endometrium in areas outside the uterus.
5. Testicular cancer is uncommon, can occur as a slow-growing tumor, and can affect one
or both testicles.
7. The vagina is a hollow, tunnel-like structure that extends from the cervix to the
external genitalia. The hymen is thin connective tissue that may partly cover the external
vaginal opening. The vestibule is the area of the female genitalia that covers the urethral
and vaginal opening. The mons pubis is the pad of fat over the female pubic bone.
8. The scrotum is contracted or relaxed by the cremaster muscle. The ampulla is a pouch
in the duct system, and the penis is unaffected by the cremaster muscle. Testicular torsion
is an abnormal rotation of the testes on the spermatic cord.
53
11. Condylomata acuminata can be fatal if transmitted to infants at birth. Genital warts
and condylomata acuminata are names for the same thing. Condylomata acuminata is
reportable to the CDC. A vaccine is available.
12. The ovaries are paired, almond-shaped organs located on each side of the uterus.
Bartholin’s glands lie just within the labia minor and provide lubrication during
intercourse. The fallopian tubes extend from the fundus of the uterus to near the ovaries.
14. In its early stages, breast cancer is often asymptomatic. Bone pain, weight loss, and
possible change in the size or shape of the breast can come in later stages.
15. The function of the vasa deferentia is to conduct sperm to the urethra. Male sex
steroids are produced by the testes. The scrotum provides a proper temperature for the
testes.
16. The vulva includes the mons pubis, labia minora, and clitoris.
17. A dilated vein in the spermatic cord is known as varicocele. Testicular torsion is an
abnormal rotation of the testes on the spermatic cord. Spermatocele is a sperm-containing
cyst that develops between the testis and the epididymis. Hydrocele is fluid accumulation
between layers of the tunica vaginalis or along the spermatic cord.
18. Conditions that affect the uterus include benign tumors, congenital disorders, and
malignant tumors.
19. The death rate from ovarian cancer is much higher than the death rate from
endometrial cancer. Endometrial cancer is a much more frequent cancer than ovarian
cancer. Cervical cancer rates are not on the increase but on the decline.
21. The first stage of genital herpes is primary herpes genitalis. Then come latent,
shedding, and recurrent herpes genitalis.
22. A cyst that contains sperm and that develops between the testis and epididymis is a
spermatocele. A cystocele occurs when the bladder protrudes in to the anterior wall of the
54
vagina. Leiomyoma is a uterine fibroid. Ampulla is part of the duct system of the male
genitalia.
23. When the urethral meatus is on the ventral surface of the penis instead of the end, this
is known as Hypospadias. Epispadias refers to the opposite—the urethral meatus
occurring on the dorsal (upper) surface of the penis. Cryptorchidism is a condition in
which one or both testes do not descend from the abdomen to the scrotum before birth.
Erectile dysfunction refers to impotence.
24. Treatment strategies for cryptorchidism include testicle implants, testicle removal,
and manual manipulation.
CHAPTER 9
QUESTIONS
_____ 6. For people of age 50 and above, the American Cancer Society and the CDC
recommend
A. flexible sigmoidoscopy every 5 years.
B. colonoscopy every 2 years.
C. flexible sigmoidoscopy every 10 years.
D. colonoscopy every 10 years.
C. intestinal obstruction.
D. none of the above
_____ 8. The type of ulcer caused by a major stressor on the body, such as a large burn, is
a
A. stress ulcer.
B. duodenal ulcer.
C. gastric ulcer.
D. both A and C, above
_____ 9. Approximately how many different functions does the liver perform?
A. 5
B. 50
C. 500
D. 5000
_____ 11. For inflammatory bowel disease and irritable bowel syndrome, who gets these
diseases most frequently?
A. Men
B. Women
C. Infants
D. The elderly
_____ 12. The large, serous membrane that lines the abdominal cavity is the
A. diverticulum.
B. rugae.
C. peritoneum.
D. large intestine.
_____ 13. In the United States, the most frequent cause of cirrhosis is
A. chronic alcohol abuse.
B. hepatitis.
C. autoimmune conditions.
D. medications.
_____ 17. The overall 5-year survival rate for pancreatic cancer is
A. 95%.
B. 50%.
C. 17%.
D. 5%.
_____ 19. Bowel movement frequency among normal, healthy people is in the range of
A. one every two days to two a week.
B. one to two a day.
C. two a day to two a week.
D. three a day to three a week.
C. liver.
D. salivary glands.
_____ 23. Which of the following is NOT a treatment strategy for gastroesophageal
reflux disease?
A. Surgery
B. Reducing stress
C. Eating larger meals at greater intervals
D. Herbal therapies
ANSWER KEY
1. D
2. B
3. A
4. C
5. B
6. D
7. B
8. A
9. C
10. D
11. B
12. C
13. A
14. C
15. B
16. C
17. D
18. A
19. D
20. B
21. C
59
22. B
23. C
24. A
25. A
RATIONALES
1. The upper gastrointestinal tract includes the oral cavity, pharynx, esophagus, and
stomach.
2. The innermost layer of the GI tract is the mucosa. Next come the submucosa, then the
circular muscle, and then the longitudinal muscle.
3. Clinical manifestations of pyloric stenosis usually appear within a few weeks after
birth.
5. When the stomach is empty, its wall shrinks, forming rugae. Chyme is a mixture of
food, acid, and enzymes in the stomach. The pyloric sphincter is the exit route for chyme
from the stomach into the duodenum.
6. For people of age 50 and above, the American Cancer Society and the CDC
recommend colonoscopy every 10 years.
8. The type of ulcer caused by a major stressor on the body, such as a large burn, is a
stress ulcer. A duodenal ulcer is usually caused by excessive acid or Helicobacter pylori
infection. A gastric ulcer is usually associated with malignancy and nonsteroidal anti-
inflammatory drug use.
11. Women most frequently get inflammatory bowel disease and irritable bowel
syndrome.
12. The peritoneum is the large, serous membrane that lines the abdominal cavity. The
diverticulum is an outwardly bulging pouch of the intestinal wall. Rugae are folds in the
stomach wall. The large intestine is that portion of the alimentary canal between the small
intestine and the anus.
60
13. In the United States, the most frequent cause of cirrhosis is chronic alcohol abuse.
Hepatitis, autoimmune conditions, and medications are other causes.
15. A strong, unproductive effort to vomit is called retching. Nausea is a subjective urge
to vomit. Emesis is another term for vomiting.
16. Both smoked tobacco and smokeless tobacco can cause esophageal cancer.
17. The overall 5-year survival rate for pancreatic cancer is 5%.
18. The rectum is part of the large intestine. The colon and cecum are other parts of the
large intestine.
19. Bowel movement frequency among normal, healthy people is in the range of three a
day to three a week.
23. Eating larger meals at greater intervals is not a treatment strategy for
gastroesophageal reflux disease. Surgery, reducing stress, and herbal therapies are
treatments.
24. A The most common chronic cause of pancreatitis is alcohol abuse. Cholelithiasis is
the most common acute cause. Metabolic disorders and pancreatic tumors are other
causes.
25. A fluoroscopic examination of the pharynx and esophagus is the barium swallow.
Cholescintigraphy involves injection of a radioactive dye into an IV line to evaluate
gallbladder and common bile duct function. Colorectal cancer allelotyping for
chromosomes 17p and 18q is a lab test for genes known to suppress tumor development.
A barium enema is a study of colon mucosa to show neoplasms and other structural
abnormalities.
61
CHAPTER 10
QUESTIONS
_____ 6. Gamete production and hormone production by the gonads are stimulated by
A. growth hormone.
B. gonadotropins (FSH and LH).
C. prolactin.
D. melanocyte-stimulating hormone.
_____ 9. Excessive amounts of one or all of the pituitary hormones are secreted in
A. hypopituitarism.
B. hyperglycemia.
C. hyperpituitarism.
D. hyperthyroidism.
_____ 15. The fight-or-flight response of the sympathetic nervous system is mediated by
63
A. epinephrine.
B. norepinephrine.
C. aldosterone.
D. both A and B, above
_____ 16. Increased renal water retention caused by excessive antidiuretic hormone
levels is referred to as
A. hyperprolactinemia.
B. acromegaly.
C. syndrome of inappropriate antidiuretic hormone (SIADH).
D. Cushing’s syndrome.
_____ 19. Increased bone size caused by excessive growth hormone levels in adulthood
is known as
A. gigantism.
B. hyperprolactinemia.
C. acromegaly.
D. SIADH.
_____ 20. Adrenocorticotropin, prolactin, growth hormone, and other hormones are
produced by the
A. posterior pituitary.
B. adrenal gland.
C. gonads.
D. anterior pituitary.
B. gonadotropins.
C. thyroid-stimulating hormone.
D. all of the above
_____ 23. Approximately how many islets of Langerhans are contained in the human
pancreas?
A. 1
B. 100
C. 10,000
D. 1,000,000
ANSWER KEY
1. C
2. A
3. B
4. D
5. B
6. B
7. C
8. A
9. C
10. A
11. D
12. A
13. C
14. D
15. D
16. C
17. A
18. B
19. C
65
20. D
21. C
22. A
23. D
24. B
25. B
RATIONALES
8. Glucagon is secreted in the pancreas by alpha cells. Beta cells secrete amylin and
insulin. Delta cells secrete somatostatin. PP cells secrete a pancreatic polypeptide.
13. The amount of fruit eaten by people with diabetes should be controlled. The other
three statements are false.
16. Increased renal water retention caused by excessive antidiuretic hormone levels is
referred to as syndrome of inappropriate antidiuretic hormone (SIADH).
Hyperprolactinemia is a condition in which excessive prolactin levels result in menstrual
dysfunction and galactorrhea. Acromegaly is increased bone size caused by excessive
growth hormone levels in adulthood. Cushing’s syndrome is a condition caused by
excessive cortisol levels resulting from increased ACTH levels.
19. Increased bone size caused by excessive growth hormone levels in adulthood is
known as acromegaly. Gigantism is tall stature caused by excessive growth hormone
levels before puberty. Hyperprolactinemia is menstrual dysfunction and galactorrhea
caused by excessive prolactin levels. SIADH is increased renal water retention caused by
excessive antidiuretic hormone levels.
20. Adrenocorticotropin, prolactin, growth hormone, and other hormones are produced by
the anterior pituitary.
21. Insulin decreases serum glucose levels. It stimulates cellular uptake of glucose. It is
released when serum glucose levels increase.
23. Approximately 1,000,000 islets of Langerhans are contained in the human pancreas.
67
25. Insulin is secreted in the pancreas by beta cells. Alpha cells secrete glucagon, delta
cells secrete somatostatin, and PP cells secrete a pancreatic polypeptide.
68
CHAPTER 11
QUESTIONS
_____ 3. An aura is
A. actually a simple focal seizure.
B. a repetitive behavior such as blinking.
C. a generalized seizure.
D. an absence seizure.
_____ 4. The type of seizure that originates in just one part of the brain is a
A. generalized seizure
B. focal seizure.
C. petit mal seizure.
D. none of the above
C. a rapid flow into the cell of positively charged sodium ions increases the
charge.
D. none of the above
_____ 10. Which of the following statements is true about the period immediately
following a head injury?
A. Direct pressure should be applied to the bleeding site.
B. Objects sticking out of a wound should be left in place.
C. The wound should be washed.
D. If a helmet is present, it should be removed.
_____ 11. The area of the skin innervated by a given pair of spinal sensory nerves is
known as a(n)
A. dorsal root.
B. axon.
C. dermatome.
D. dendrite.
B. prion.
C. dendrite.
D. pons.
_____ 15. During the postictal period, the person having a generalized seizure may
A. be confused.
B. be fatigued.
C. fall into a deep sleep.
D. all of the above
_____ 20. As the gene that causes Huntington’s disease is transmitted from one
generation to the next,
A. the disease tends to get milder.
B. the number of CAG repeats gets smaller.
C. the faster the disease progresses.
D. the later in life symptoms appear.
C. autonomic hyperreflexia.
D. neurogenic shock.
ANSWER KEY
1. C
2. C
3. A
4. B
5. D
6. A
7. C
8. D
9. C
10. B
11. C
12. A
13. D
14. B
15. D
16. B
72
17. B
18. A
19. B
20. C
21. A
22. C
23. D
24. A
25. D
RATIONALES
4. The type of seizure that originates in just one part of the brain is a focal seizure. A
generalized seizure is a result of abnormal neuronal activity on both sides of the brain. In
what was formerly called a petit mal seizure, and is now called an absence seizure, a
person may appear to be staring into space and/or have jerking or twitching muscles.
7. Depolarization occurs when a rapid flow into the cell of positively charged sodium
ions increases the charge. Resting potential is a charge at rest, because sodium ions are
concentrated on the outside of the cell.
9. The Monro-Kellie hypothesis states that the cranial cavity cannot be compressed, and
the volume inside the cavity is fixed. The hypothesis explains the delicate relationship
between ICP, volume of CSF, and cerebral perfusion.
10. During the period immediately following a head injury, objects sticking out of a
wound should be left in place. Direct pressure should not be applied to the bleeding site.
The wound should not be washed if it is deep or bleeding a lot. If a helmet is present, it
should be left on.
73
11. The area of the skin innervated by a given pair of spinal sensory nerves is known as a
dermatome. A dorsal root is formed from about 6 to 8 rootlets. Axons and dendrites are
projections from a neuron that make connections with nearby cells.
13. Cerebrospinal fluid (CSF) fills the space between the arachnoid and the pia mater,
and is produced by choroid plexus cells. Excess CSF drains into the bloodstream.
15. During the postictal period, the person having a generalized seizure may be confused,
fatigued, or fall into a deep sleep.
16. A countercoup injury occurs when the brain strikes one side of the skull and then
rebounds, causing another area of damage. When there is a simple crack in the skull, this
is a linear skull fracture. When there are several fracture lines, this is a comminuted skull
fracture. When brain tissue is exposed, this is a compound skull fracture.
17. Whether benign or malignant, brain tumors can be life threatening. This is because
they often increase ICP and are difficult to access. Most, but not all, brain tumors are
secondary tumors. Prevalence and mortality rates are highest among Caucasians and
males. The 5-year survival rate is almost 35%.
18. In a depressed skull fracture, bone fragments are displaced into the brain. Brain tissue
is exposed in a compound skull fracture. The base of the skull is fractured and usually
CSF leaks with a basilar skull fracture.
19. Tonic seizures cause stiffening of muscles of the body, especially those in the back
and extremities. Clonic seizures cause repeated jerking movements of muscles on both
sides of the body. Atonic seizures cause a loss of normal muscle tone. Myoclonic seizures
cause jerks or twitches of the upper body, arms, or legs.
20. As the gene that causes Huntington’s disease is transmitted from one generation to
the next, the faster the disease progresses. It does not tend to get milder; instead,
symptoms can develop at younger and younger ages. The number of CAG repeats
increases.
22. The peripheral nervous system is made up of the nerves. The brain and spinal cord are
parts of the central nervous system.
23. Colors present in the brain include white, black, and red.
24. An epidural hematoma occurs outside the dura and under the skull. A subdural
hematoma occurs beneath the dura but outside the brain. An intracerebral hematoma
occurs within the substance of the brain tissue.
CHAPTER 12
QUESTIONS
_____ 1. A fracture with multiple fracture lines and bone pieces is a(n)
A. spiral fracture.
B. oblique fracture.
C. comminuted fracture.
D. open fracture.
C. 60%
D. 80%
_____ 8. The type of fracture that results when the skin is broken is a(n)
A. open fracture.
B. complete fracture.
C. oblique fracture.
D. comminuted fracture.
_____ 11. An inflammatory disease resulting from deposits of uric acid crystals is called
A. gout.
B. ankylosing spondylitis.
C. rheumatoid arthritis.
D. osteoarthritis.
_____ 12. An increase in the curvature of the thoracic spine outward is known as
A. kyphosis.
B. scoliosis.
C. lordosis.
D. none of the above
_____ 13. How many bones does the human skeleton contain?
A. 43
B. 110
C. 206
D. 719
_____ 16. The separation of two bones where they meet at a joint is
A. diaphysis.
B. dislocation.
C. incomplete fracture.
D. simple fracture.
_____ 19. Which of the following might be a treatment strategy for rheumatoid arthritis?
A. Physical therapy
B. Regular exercise
C. NSAIDs
D. All of the above
_____ 23. Which of the following statements is true about bone tumors?
A. The overall 5-year survival rate is approximately 31%.
B. The majority are benign.
C. They rarely occur as primary tumors.
D. The overall 5-year survival rate is approximately 95%.
ANSWER KEY
1. C
2. C
3. B
4. A
5. A
6. B
7. B
8. A
9. D
10. D
11. A
12. A
13. C
14. D
15. D
16. B
17. B
18. C
19. D
20. C
21. B
22. B
23. C
24. D
79
25. A
RATIONALES
1. A fracture with multiple fracture lines and bone pieces is a comminuted fracture. A
spiral fracture twists around the bone shaft. An oblique fracture is at an angle to the bone
shaft. An open fracture, or compound fracture, results when the skin is broken.
3. Short bones are approximately as wide as they are long. Long bones have bodies that
are longer than they are wide. The femur and humerus are examples of long bones. Flat
bones provide protection to the body’s vital organs.
4. A sprain would be graded Grade III if there is complete disruption of the ligament.
With minimal damage or disruption, it would be Grade I. With moderate damage, it
would be Grade II.
8. An open fracture is the type of fracture that results when the skin is broken. A
complete fracture occurs when the bone is broken into two or more separate pieces. An
oblique fracture is a fracture at an angle to the bone shaft. A comminuted fracture is a
fracture with multiple fracture lines and bone pieces.
9. None of the statements are true. Cracking your joints, being double-jointed, and
vaccinations do not cause or increase the risk for arthritis.
10. Osteosarcoma begins in the bone cells, usually in the femur, tibia, or fibula.
11. Gout is an inflammatory disease resulting from deposits of uric acid crystals.
Ankylosing spondylitis is a progressive inflammatory disorder affecting the sacroiliac
joints, intervertebral spaces, and costovertebral joints. Rheumatoid arthritis is a systemic,
autoimmune condition involving multiple joints. Osteoarthritis is a localized joint disease
12. An increase in the curvature of the thoracic spine outward is known as kyphosis.
Scoliosis refers to a lateral deviation of the spine. Lordosis is an exaggerated concave of
the lumbar spine.
14. Treatment possibilities for bone tumors include surgical excision, amputation, and
radiation.
15. None of the statements are true about fibromyalgia. Fibromyalgia is not an
autoimmune disease, its symptoms are not caused by depression, and it is not a
psychologic problem.
16. The separation of two bones where they meet at a joint is dislocation.
18. Muscles that connect to bone are called skeletal muscles. Smooth muscles line the
walls of organs and tubes. Cardiac muscles make up the heart. Tendons are bands of
connective tissue.
19. Treatment strategies for rheumatoid arthritis include physical therapy, regular
exercise, and NSAIDs.
20. The “blood cell factory” is red marrow of the bones. Yellow marrow replaces red
marrow as we age. The periosteum is a layer of connective tissue that covers compact
bone surfaces. The synovial joints contain cartilage lubricated by synovial fluid.
21. Some skeletal muscles steady joints, allowing other muscles to act. Not all skeletal
muscles make bones move. Muscle fibers are excitable, with high action potential. Not all
muscles are under voluntary control.
22. Repeated excessive stress can result in a stress fracture. Pathologic fractures result
from a weakness in the bone structure resulting from a condition such as tumors or
osteoporosis. A depressed fracture occurs in the skull when the broken piece is forced
inward on the brain. An open fracture refers to a fracture when the skin is broken.
23. Bone tumors rarely occur as primary tumors. The overall 5-year survival rate is
approximately 68%. The majority are malignant.
25. The smooth muscles are involuntary, which means that they work without conscious
control by the brain. Skeletal muscles are the most frequently occurring muscle type.
81
CHAPTER 13
QUESTIONS
_____ 14. Which statement is true about the most aggressive forms of skin cancer?
A. With early detection, they can be successfully treated.
B. They are uniformly fatal.
C. Cancerous growths are left in place.
D. None of the above.
B. tinea.
C. scabies.
D. ringworm.
_____ 17. The integumentary system accounts for approximately what percentage of the
body’s weight?
A. 5%
B. 10%
C. 15%
D. 28%
_____ 24. A protein that protects the skin from ultraviolet (UV) rays is
A. melanin.
B. lentigo.
C. keratin.
D. tinea.
ANSWER KEY
1. B
2. C
3. B
4. C
5. D
6. A
7. D
8. A
9. B
10. C
11. D
12. B
13. C
14. A
15. C
16. A
17. C
18. C
19. B
20. D
21. A
22. D
23. D
24. A
85
25. B
RATIONALES
1. The outermost layer of the skin is the epidermis. Moving inward from the epidermis
come the dermis and then the hypodermis or subcutaneous tissue.
2. Acne vulgaris can affect people of any age. Tea tree oil and brewer’s yeast are
sometimes used for treatment. A high level of humidity is a risk factor
4. The highest prevalence rates for skin cancer are in African Americans.
5. None of the statement about birthmarks is true. Birthmarks do not result from
something the mother ate or did while pregnant, and they are not related to trauma to the
skin during childbirth.
6. Sweat is secreted through skin pores by eccrine glands. Apocrine glands open into hair
follicles. Keratin is a protein that strengthens the skin. Melanin is a pigment that protects
the skin from UV rays.
7. It is not a good idea to blow on a burn, apply ointment to a severe burn, or remove
clothing stuck to burned skin.
9. First-degree burns affect the epidermis only. Second-degree burns affect the epidermis
and dermis. Third-degree burns affect deeper tissues.
10. A boil is also called a furuncle. Folliculitis is an infection of the hair follicles.
Impetigo and cellulitis are skin infections.
11. Chédiak-Higashi syndrome, tuberous sclerosis, and Waardenburg’s syndrome are all
examples of localized albinism.
13. Herpes simplex (HSV) type 1 is transmitted by contact with infected saliva.
14. With early detection, the most aggressive forms of skin cancer can be successfully
treated. They are uniformly fatal. Cancerous growths are removed.
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15. A mite infestation causes scabies. Pediculosis is caused by a lice infestation. Tinea is
a fungal infection; when it occurs on the body, it is called ringworm.
17. The integumentary system accounts for approximately 15% of the body’s weight.
18. Impetigo is highly contagious. It is common. It is not an infection of the hair follicles
(folliculitis is). Typically impetigo is caused by a staphyloccal, rather than streptococcal,
infection.
19. Birthmarks the color of coffee with milk are café au lait spots. Port-wine stains,
hemangiomas, and macular stains are types of vascular birthmarks.
20. Eating shellfish or nuts might trigger urticaria. Contact dermatitis is caused by direct
exposure to an irritant or allergen-producing substance. The cause of psoriasis is
unknown, but may be an autoimmune reaction. Tinea pedis (athlete’s foot) is a fungal
infection.
21. Foods that increase blood sugar may play a role in acne. Acne is not caused by greasy
foods. Hard scrubbing with strong soaps should be avoided.
22. Skin tags are more common in older people, and often occur on the neck. They also
often occur in people who are overweight.
24. A protein that protects the skin from ultraviolet (UV) rays is melanin. Lentigo refers
to age spots, or liver spots. Keratin is a protein that strengthens the skin. Tinea is a fungal
infection.
25. Albinism often impairs vision. It does not affect intellectual development.
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CHAPTER 14
QUESTIONS
_____ 3. In the ear, which structure vibrates when struck by sound waves?
A. Cochlea
B. Ossicles
C. Tympanic membrane
D. External auditory canal
D. retina.
_____ 8. Pain that exists after the removal of a body part is known as
A. neuropathic pain.
B. phantom pain.
C. somatic pain.
D. pain tolerance.
_____ 10. Which of the following statements is true about the eye?
A. Each eye contains about 150 million cones.
B. Each eye contains approximately 400,000 cones and rods.
C. Each eye contains fewer than 6 million rods.
D. Each eye contains about 150 million rods.
_____ 11. When your ears pop while taking off in an airplane, this is a result of pressure
being released from the
A. eustachian tube.
B. cochlea.
C. auricle.
D. semicircular canal.
_____ 12. In what percentage of elderly persons are vision deficits severe enough to
impair driving ability?
A. 5%
B. 15% to 20%
C. 30%
D. 65% to 70%
_____ 16. In the eye, images are focused on the retina by the
A. sclera.
B. optic nerve.
C. lens.
D. choroid.
_____ 18. The dark opening in the center of the eye is the
A. sclera.
B. iris.
C. pupil.
D. retina.
_____ 20. Pacinian corpuscles are the receptors used for the sense of
A. light touch.
B. temperature.
C. pressure.
D. pain.
D. cataract.
_____ 24. Hearing receptors, the hair cells, are contained in the
A. cochlear duct.
B. organ of Corti.
C. tympanic duct.
D. vestibular duct.
ANSWER KEY
1. A
2. C
3. C
4. D
5. A
6. C
7. B
8. B
9. C
10. D
11. A
12. B
13. B
14. D
15. D
16. C
17. D
18. C
19. A
20. C
21. D
22. A
23. A
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24. B
25. B
RATIONALES
1. Noxious stimuli to internal organs causes visceral pain. Somatic pain results from
noxious stimuli to the skin, joints, muscles, and tendons. Referred pain is visceral pain
sensed on body surfaces at different locations. Neuropathic pain results from damage to
peripheral nerves by disease or injury.
2. A gaze deviation of one eye is known as strabismus. Retinal detachment occurs when
the retina separates from its supporting structures. A Cataract is opacity or clouding of
the lens of the eye.
3. In the ear, the tympanic membrane vibrates when struck by sound waves. The cochlea
converts fluid waves to nerve impulses. The ossicles transmit sound to the cochlea.
4. Pain is a protective mechanism, and is the most common reason people seek medical
attention. It is affected by affective and cognitive factors.
5. Age-related hearing loss is called presbycusis. Anotia refers to the absence of the
auricle. Atresia refers to the lack of an external ear canal. Congenital hearing loss can be
caused by maternal rubella or syphilis during pregnancy.
7. The colored portion of the eye is called the iris. The cornea is the clear lens. The pupil
is the dark opening in the center of the iris. The retina is the innermost layer of the eye.
8. Pain that exists after the removal of a body part is known as phantom pain.
Neuropathic pain results from damage to peripheral nerves. Somatic pain results from
stimuli to the skin, joints, muscles, and tendons. Pain tolerance can result from unrelieved
pain.
10. Each eye contains about 150 million rods. In contrast, each eye contains “only” about
6 million cones.
11. When your ears pop while taking off in an airplane, this is a result of pressure being
released from the eustachian tube.
12. Vision deficits are severe enough to impair driving ability in 15% to 20% of elderly
people.
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14. With age, the senses tend to become less able to distinguish details and less acute.
15. A function of the ear is helping maintain balance and detecting and processing sound.
Detecting light touch is the responsibility of Meissner’s corpuscle, found just below the
epidermis.
16. In the eye, images are focused on the retina by the lens.
17. Somatic pain is the result of noxious stimuli to the skin, joints, muscles, and tendons.
Visceral pain is the result of noxious stimuli to internal organs. Referred pain is pain
sensed at locations distant from the originating organ. Chronically progressing pain is
intractable pain.
18. The dark opening in the center of the eye is the pupil. The sclera is the white area of
the outermost layer of the eye. The iris is the colored portion of the eye. The retina is the
innermost layer of the eye.
19. Any sensory organ can develop cancer. Cancer of the ear is uncommon.
20. Pacinian corpuscles are the receptors used for the sense of pressure. Light touch is
detected by Meissner’s corpuscles. Temperature and pain are detected by naked nerve
endings.
22. An acute condition of the eye is retinal detachment. Amblyopia is the loss of one
eye’s ability to see details. Strabismus is gaze deviation of one eye. A cataract is opacity
or clouding of the lens of the eye.
23. An abnormal bone growth in the middle ear is known as otosclerosis. Meniere’s
disease is a disorder of the inner ear. Otitis externa (swimmer’s ear) is an infection or
inflammation of the external ear canal or auricle. Otitis media is an infection or
inflammation of the middle ear.
24. Hearing receptors, the hair cells, are contained in the organ of Corti.