New Sas

HES 029 ( Human Anatomy and Physiology -
Lecture)
STUDENT ACTIVITY SHEET DOCTOR OF OPTOMETRY
Session # 1
LESSON TITLE: THE HUMAN ORGANISM (Part 1) Materials:

Book, pen and notebook
LEARNING TARGETS:
Upon completion of this lesson, you can:
Reference:
1. Identify the classroom rules and regulations;
1. VanPutte, C., Regan, J., & Russo, A. (2019).
2. Get to know the members of the class for this subject; Seeley’s essentials of anatomy & physiology (10th
ed.). New York, NY: McGraw-Hill Education.
3. Define anatomy and physiology with the significance of 2. Tortora, G., Derrickson, B. (2017). Principles of
structural and functional organization of human body; anatomy & physiology (15th ed.). New Jersey, NJ:
John Wiley and Sons Inc.
4. Enumerate the eleven organ systems and define their vital
role in human body; 3. Marieb, E., Keller S. (2018). Essentials of
Human Anatomy and Physiology (12et ed). New
5. List and define characteristics of life; and, York, NY: Pearson Education, Inc.
6. Explain homeostasis and the mechanisms involved in
human body.
Subject Orientation (30 minutes)

Welcome to Anatomy and Physiology class. Your classroom instructor for this subject is ___________________. Please
take note of the course outline that will be provided as this will serve as your guide for our class schedule. This course will
equip you to become medical professionals with a comprehensive and detailed study of human anatomy of the major
systems in the human body and its functions. This course also provides not only clinical significance, but also
interrelationships of anatomy with other disciplines.
At the end of the semester, the students will be able to:

1. Identify and describe locations of major organs of each system covered.
2. Explain interrelationships among molecular, cellular, tissue and organ functions in each system.
3. Describe the interdependency and interactions of the systems.
4. Explain contributions of organs and systems to the maintenance of homeostasis.
5. Identify various diseases of the different organ systems and the processes that occur during the course of the
disease
MAIN LESSON (40 minutes)
Anatomy – the study of the structures of the body

Physiology – the study of the processes and functions of the body.
6 Levels of Organization for Human Body
1. Chemical – involves how atoms interact and combine into molecules

2. Cell – basic structural and functional units of organisms
3. Tissue – a group of similar cells and the material surrounding them
4. Organ – composed of two or more tissue types that together perform one or more common functions
5. Organ System – a group of organs classified as a unit because of a common function or set of functions
6. Organism – a complex of organ systems that are mutually dependent upon one another
11 Organ Systems of Human Body
This document and the information thereon is the property of

PHINMA Education (Department of Physical Therapy) 1 of 106
System Function Some Organs
Provides protection, regulates temperature, prevents skin, hair, nails, sebaceous glands,
1. Integumentary
water loss, helps produce vitamin D sweat glands
Provides protection and support, allows body movements, bones, associated cartilages,
2. Skeletal
produces blood cells, stores mineral and adipose tissue ligaments, joints
Produces body movements, maintains posture, produces muscles attached to the skeleton by
3. Muscular
body heat tendons
Major regulatory system that detects sensations and
brain, spinal cord, nerves, sensory
4. Nervous controls movements, physiological processes, intellectual
receptors
functions
Major regulatory system that influences metabolism, endocrine glands, such as pituitary,
5. Endocrine
growth, reproduction that secrete hormones
Transports nutrients, waste products, gases, and
6. Cardiovascular hormones throughout the body, plays a role in the heart, blood vessels, and blood
immune response and regulation of body temperature
Removes foreign substances from the blood and lymph,
lymphatic vessels, lymph nodes, and
7. Lymphatic combats disease, maintains tissue fluid balance, absorbs
other lymphatic organs
dietary fats from digestive tract
Exchanges oxygen and carbon dioxide between the blood
8. Respiratory lungs and respiratory passages
and air, regulates blood pH
Performs the mechanical and chemical processes of mouth, esophagus, stomach,
9. Digestive
digestion, absorption of nutrients, elimination of wastes intestines, and accessory organs
Removes waste products from the blood and regulates
10. Urinary kidneys, urinary bladder, ureters
blood pH, ion balance, water balance
Produces oocytes for females and sperm cells for males
female (ovaries, uterus, vagina)
11. Reproductive for reproduction and hormones that influence sexual
male (testes, ducts, penis)
functions and behaviors
Parts of a Cell
Cells – the basic living unit of all organisms; each cell is a highly organized unit.
Organelles – specialized structures in cells that perform specific functions.
Cytoplasm – jelly-like substance that holds organelles and is enclosed by cell membrane (aka plasma membrane).
Functions of the Cell:

1. Cell metabolism and energy use
2. Synthesis of molecules
3. Communication
4. Reproduction and inheritance
Cell Membrane / Plasma Membrane

 It is the outermost component of cell that forms selective barrier between intracellular (materials inside the
cell) and extracellular substances (materials outside the cells).
Molecular Structure:
Major Molecules Definition / Function(s)

 Form a double layer that contains 2 regions:
Phospholipids 1. Polar Region – “heads”, exposed to H2O (hydrophilic)
2. Nonpolar Region – “tails”, away from H2O (hydrophobic)
 Float among the phospholipid molecules and in some, extend from inner to the
outer surface of cell membrane
Protein
 Function as membrane channels, carrier molecules, receptor molecules,
enzymes, or structural supports in membrane
Other Components Definition / Function(s)

Cholesterol  Provide added strength & stability by limiting the amount of movement of

phospholipids.
Carbohydrates  May be bound to some CHON molecules, modifying their functions.
Organelles and Their Functions:
Organelles Function(s)
 Contains generic material of cell (DNA) and nucleoli
Nucleus  Site of RNA synthesis & ribosomal subunit assembly
 “Control center of the cell”
Ribosomes  Site of protein synthesis
Rough Endoplasmic  Has many ribosomes attached
Reticulum  Site of protein synthesis
 (-) Ribosomes
Smooth Endoplasmic
 Site of lipid synthesis and calcium ion storage
Reticulum
 Participates in detoxification
 Modifies, sorts, and packages different substances for secretion out of the
Golgi Apparatus cell, or for use within the cell.
 “Packaging center of the cell”
 Contains materials produced in cell
 Used as “chemical reaction chambers”
Secretory Vesicle
 Formed by the Golgi Apparatus
 Secreted by exocytosis
 Contains enzymes that digest material taken into the cell
Lysosome
 Sites of intracellular digestion. The “stomach” of the cell.
Peroxisome  Breaks down fatty acids, amino acids, and hydrogen peroxide
 Site of aerobic respiration and the major site of ATP synthesis
Mitochondria
 “Powerhouse of the cell”
 Supports cytoplasm
Microtubule
 Assists in cell division and forms components of cilia & flagella
Centrioles  Facilitate the movement of chromosomes during cell division
Cilia  Located on cell surface that move substances over surfaces of certain cells
Flagella  Used to propel the entire cell or the fluids around the cell
Microvilli  Increase surface area of certain cells

The instructor will discuss the major
organelles emphasizing its features,
functions, and locations in the
generalized cell.
Make sure to put an emphasis that no

single cell contains all of these
organelles types. Furthermore, one kind
of cell may contain many organelles of
one type, whereas another kind of cell
may contain very few.
Transport process across the plasma membrane
TRANSPORT DESCRIPTION
PROCESS
PASSIVE Movement of substances down a concentration gradient until equilibrium is reached; do not
PROCESSES require cellular energy in the form of ATP.
I. Diffusion- Movement of molecules or ions down a concentration gradient due to their kinetic
energy until they reach equilibrium.
 Simple diffusion- Passive movement of a substance down its concentration radient
through the lipid bilayer of the plasma membrane without the help of membrane
transport proteins.
 Facilitated diffusion- Passive movement of a substance down its concentration
gradient through the lipid bilayer by transmembrane proteins that function as channels
or carriers.
II. Osmosis- Passive movement of water molecules across a selectively permeable
membrane from an area of higher to lower water concentration until equilibrium is
reached.
ACTIVE PROCESSES Movement of substances against a concentration gradient; requires cellular energy in the form
of ATP.
I. Active Transport- Active process in which a cell expends energy to move a substance
across the membrane against its concentration gradient by transmembrane proteins that
function as carrier.
 Primary active transport- Active process in which a substance moves across the
membrane against its concentration gradient by pumps (carriers) that use energy
supplied by hydrolysis of ATP.
 Secondary active transport- Coupled active transport of two substances across the
membrane using energy supplied by a Na+ or H+ concentration gradient maintained
by primary active transport pumps. Antiporters move Na+ (or H+) and another
substance in opposite directions across the membrane; symporters move Na+ (or H+)
and another substance in the same direction across the membrane.

ENDOCYTOSIS Movement of materials into cells by the formation of a vesicle.
 Receptor-Mediated Endocytosis – involves cell receptors attaching to molecules

 Phagocytosis – movement of solid material into cells (cell-eating)
 Pinocytosis – the materials ingested is much smaller and is in solution (cell-drinking)
EXOCYTOSIS The secretion of materials from cells by vesicle formation.
CHECK FOR UNDERSTANDING (25 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to the
correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in your answer/ratio is not
allowed. You are given 25 minutes for this activity:
Multiple Choice
1. Which of the following activities does NOT represent an anatomical study:
a. making a section through the heart to observe its interior
b. examining the surface of a bone
c. viewing muscle tissue through a microscope
d. studying how the nerves conduct electrical impulses
e. observing the parts of a reproducing cell
ANSWER: D
RATIO: I choose letter D because studying how the nerves conduct electrical impulses is under physiological study since it
talks about the functions of one body part.
2. Which of the following components of control system is responsible for detecting any change and motor the value of
variables?
a.
b. Control Center d. Effector
c. Stimulus e. Receptor
ANSWER: D
RATIO: Receptor detects changes and responds to this changes (stimuli). The control center will be analyzing what
response to give. And the effector will be the one to give a means for the control center to give a response.
3. All are considered negative feedback mechanism, except:

a. Body temperature regulation c. Increase in blood pressure
b. Uterine contractions during delivery d. Doing exercises
ANSWER: B
RATIO: Uterine contractions during delivery is a positive feedback mechanism since it helps push the baby in the birth
canal.
4. Which basic approach to study anatomy is taken in vast majority of medical and dentals schools?
a. Regional Anatomy c. Surface Anatomy
b. Systemic Anatomy d. Anatomical Imaging
ANSWER:B
RATIO: Systemic anatomy since it helps student understand he lessons easier.
5. As a student nurse, you understand that it is important to study how the human body works because:
a. it is fixed and unchanging.
b. it provides a way to understand how the body maintains external conditions.
c. it can predict the responses that the body can do in every stimulus.
d. it has a wide range of values to maintain homeostasis.
ANSWER: D
RATIO: When the body does not maintain balance, nurses must figure out how to restore the body’s equilibrium to help
the patient.
6. Differentiation in an organism depicts a change in cell structure and function from generalize to specialized. This
process is involved in:
a. Growth and development b. Metabolism

c. Growth d. Development
ANSWER: A
RATIO: Differentiation involves growth and development since differentiation occurs during the development of a
multicellular organism and development involves growth.
7. The mechanism of homeostasis is mainly governed by:

a. Cardiovascular and nervous system c. Endocrine and urinary system
b. Nervous and endocrine system d. Urinary and respiratory system
ANSWER: B
RATIO: Nervous system is the major control system of homeostasis. It provides monitoring, response, and regulation of all
systems while the endocrine plays an important role in homeostasis because hormones regulate the activity of body cells.
8. During summer, Pepper and her friends would go on a trip and hike at noon. As a student nurse, Pepper knows that
her body would compensate with the change in core temperature. All of the following are expected, except:
a. The hypothalamus stimulates the blood vessels in the skin to constrict.
b. The sweat glands produce sweat.
c. The blood vessels send more blood to the body’s surface.
d. All the aforementioned statements are correct.
ANSWER: A
RATIO: The hypothalamus stimulates the blood vessels in the skin to dilate not constrict because it helps the blood to flow
near the skin surface.
9. Disruption in normal functioning of cells may result to death. One possible cause of disruption is occurrence of
disease.
a. The first statement is correct. The second statement is wrong.
b. The first statement is wrong. The second statement is correct.
c. Both of the statements are correct.
d. Both of the statements are wrong.
ANSWER: A
RATIO: When the normal functioning of cells would disrupt,it can cause death because this is where cancer starts. The
second statement is wrong because the heat or radiation is the reason of cell disruption.
10. There are four primary types of tissues: epithelial, connective, muscle, and nervous. To be able to perform its function,
each system is composed of only one specific type of tissue.
a. The first statement is correct. The second statement is wrong.
b. The first statement is wrong. The second statement is correct.
c. Both of the statements are correct.
d. Both of the statements are wrong.
ANSWER:
RATIO:___________________________________________________________________________________________
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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
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11 to 20. Label the following organelles accordingly. Wrong spelling and superimpositions are not allowed. Answer in
CAPITAL LETTERS only.
11. PLASMA MEMBRANE 12. MITOCHONDRION

13. MEMBRANE-BOUND RIBOSOMES 17. SECRETORY VESICLES
14. ROUGH ENDOPLASMIC RETICULUM 18. FLAGELLUM
15. SMOOTH ENDOPLASMIC RETICULUM 19. CENTRIOLES
16. GOLGI COMPLEX 20. PROTEASOME
Closure Activity (10 minutes)
LESSON WRAP-UP (5 minutes)
You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.
You are done with the session! Let’s track your progress.
AL Activity: CAT: 3-2-1
This section gives you the opportunity to assess your learning. It also gives you the opportunity to raise certain topics that
you don’t understand too well so we can discuss it better during the face to face sessions. Kindly answer the following
questions:
Three things you learned:
1. Blood rushes near our skin surfaces when temperature is increasing.

2. Nurses study the human body to maintain balance.
3. Homeostasis is mostly govern by the nervous and endocrine system.
Two things that you’d like to learn more about
1. About the changes in our body when temperature is increasing.

2. About cell disruption
One question you still have:
1. How brain gives response or how the stimuli works.

Lecture)
DOCTOR OF OPTOMETRY
STUDENT ACTIVITY SHEET Session # 2
LESSON TITLE: TISSUES (Part 1) Materials:

LEARNING OUTCOMES: Book, pen and notebook
Upon completion of this lesson, you can:
Reference:
1. Describe the general makeup of a tissue and its basic Marieb, E., Keller S. (2018). Essentials of Human
types; Anatomy and Physiology (12et ed). New York,
2. List the general characteristics and major functions of NY: Pearson Education, Inc.
epithelial tissue; VanPutte, C., Regan, J., & Russo, A. (2019).
3. Classify epithelial tissues based on the number of cell Seeley’s essentials of anatomy & physiology (10th
layers and shape of the cells; ed.). New York, NY: McGraw-Hill Education.
4. Describe the structure, functions, and common locations of
each classification of epithelium;
5. Relate the structural specializations of epithelial tissue with
the functions they perform;
6. Define what glands are;
7. Categorize exocrine glands based on their structure,
shape of secretory regions and type of secretions;
8. Identify the major components of extracellular matrix of
connective tissue;
9. Enumerate the functions of connective tissue;
10. Describe each classification of connective tissues with its
structure, functions and locations;
11. Define the types of muscle tissue with their general
structures, locations, and functions; and,
12. Describe the functions of nervous tissue and structure of a
neuron.
LESSON REVIEW 5 minutes)
Identify the following structures, events and processes in each given question:
1. Site of CHON synthesis. Carbohydrates

2. Major site of ATP synthesis. Mitochondria
3. Movement of a solute from an area of higher concentration to an area of lower concentration within a solvent.

Answer: Passive Diffusion
4. Movement of substances from a lower to a higher concentration and requires ATP. Answer: Active transport
5. Type of solution in which the water moves by osmosis out of the cell and into the solution, resulting in shrinkage.
Answer: Hypertonic solution
6. The cell’s framework. Answer: Cytoskeleton
7. A process in which the information in DNA directs protein synthesis. Answer: Translation
8. Known as the programmed cell death. Answer: Apoptosis
9. Process of cell division. Answer: Mitosis
10. Enumerate the four stages of mitosis (in order). Answer: Prophase, Metaphase, Anaphase and Telophase
MAIN LESSON (40 minutes)
Tissue – a group of cells with similar structure and function, along with extracellular substances located between cells.
Changes in tissues can result in development, growth, aging, trauma, or disease.
Histology – the microscopic study of tissue structure.
Four Basic Types of Tissues:

1. Epithelium – covers and protects surfaces, both outside and inside the body.
2. Connective – a diverse primary tissue type that makes up part of every organ in the body.
3. Muscle – makes movement possible by contracting or shortening.
4. Nervous – responsible for coordinating and controlling many body activities.
General Characteristics of Epithelial Tissue:

1. Mostly composed of cells with very little extracellular matrix between them.
2. Covers body surfaces that include the exterior surface, lining of digestive, urinary, reproductive, & respiratory
tracts, heart & blood vessels, and linings of body cavities.
3. Distinct cell surfaces.
 Free / Apical Surface – exposed & not attached to other cells
 Lateral Surface – cells attached to other epithelial cells
 Basal Surface – attached to a basement membrane (a specialized type of extracellular material that
helps attach the epithelial cells to the underlying tissues, and plays important role in supporting & guiding
cell migration during tissue repair.)
4. Cell and matrix connections.
5. Nonvascular. All gases & nutrients carried in the blood reach the epithelium by diffusing from blood vessels across
the basement membrane.
6. Capable of regeneration.
Major Functions of Epithelia:

1. Protecting underlying structures
2. Acting as a barrier
3. Permitting the passage of substances
4. Secreting substances
5. Absorbing substances
Classification of Epithelium:
Based on Number of Cell Layers Shape of Cells
Squamous
Simple – single layer of cells Cuboidal
Columnar
Squamous
Nonkeratinized (moist)
Stratified – more than one layer of cells Keratinized
Cuboidal
Columnar
Pseudostratified – special type of simple epithelium; appears to be
Columnar
stratified but is not
Roughly cuboidal to columnar
Transitional – modification of stratified epithelium that can be greatly
when not stretched and
stretched
squamous-like when stretched.

Types of Epithelium (based on idealized shapes of epithelial cells):
1. Squamous cells are flat or scale-like.
2. Cuboidal cells are cube-shaped – about as wide as they are tall.
3. Columnar cells tend to be taller than they are wide.
Types of Simple Epithelium:

TYPE STRUCTURE FUNCTION LOCATION
blood vessels, heart, lymphatic
Simple 1 layer of flat, tile-like cells,
diffusion & filtration vessels, alveoli, kidney tubules,
Squamous often hexagonal cells
serous membranes
kidney tubules, glands, choroid
1 layer of square-shaped
Simple Cuboidal secretion & absorption plexuses, terminal bronchioles,
cells
ovaries
bronchioles, auditory tubes, uterus,
secrete mucus & fallopian tubes, stomach, intestines,
Simple Columnar 1 layer of tall, narrow cells
absorption gallbladder, bile ducts, ventricles of
brain
1 layer of tall, narrow cells, secrete mucus & propel
Pseudostratified nasal cavity, nasal sinuses, auditory
appears stratified but isn’t, debris out of respiratory
Columnar tubes, pharynx, trachea, bronchi
almost always ciliated tract
Types of Stratified Epithelium:

TYPE STRUCTURE FUNCTION LOCATION
many layers of flat, tile-like cells
 Nonkeratinized – moist, the mouth, throat, larynx,
surface cells retain a nucleus & protect & acts as a esophagus, anus, vagina,
Stratified cytoplasm barrier against inferior urethra, corneas
Squamous  Keratinized – cytoplasm of cells at infection; reduces loss
the surface is replaced by a of water from the body
outer layer of the skin
protein called keratin, and the
cells are dead
Stratified many layers, cube-shaped; relatively absorption, secretion, sweat glands, ovarian follicular
Cuboidal rare & protection cells, salivary glands
many layers, but only the surface cells
Stratified are columnar; secretion, protection, mammary gland ducts, larynx,
Columnar deeper layers are irregular or cuboidal & some absorption portion of male urethra
in shape; relatively rare
special type that changes shape hold fluids & protects
urinary bladder, ureters,
Transitional - stretched: squamous against the caustic
superior urethra
- not stretched: cuboidal effects of urine
Structural and Functional Relationships:

1. Simple epithelium is involved with diffusion, secretion, or absorption. Stratified epithelium serves a protective
role. Squamous cells function in diffusion or filtration. Cuboidal or columnar cells, which contain more
organelles, secrete or absorb.
2. A smooth, free surface reduces friction.

 Microvilli – increase cell’s surface area (ex: small intestines)
 Cilia – move materials across cell’s surface (ex: trachea)
 Goblet Cells – produce mucus (ex: stomach)
3. Cell connections are vital to hold one cell to one another or to the
basement membrane. These structures are:
 Tight Junctions – bind adjacent cell together
 Desmosomes – mechanical links that bind cells
 Hemidesmosomes – bind cells to basement membrane
 Gap Junctions – most common; small channels that allow

molecules to pass between cells & allow cells to communicate
Glands – structures that secrete substances onto a surface, into a cavity, or into blood; primarily composed of epithelium,
with a supporting network of connective tissue.
Two Types of Glands:
1. Exocrine – with ducts (ex: sweat & oil glands)

a. Classification according to Structure of Ducts
Simple Glands single, nonbranched duct (ex: glands in stomach & colon)
Compound Glands multiple, branched ducts (ex: mucous glands of duodenum)
b. Classification according to Shape of Secretory Regions

Tubular shaped as tubules (small tubes); can be straight or coiled
Acinar / Alveolar sac-like structure

Tubuloacinar /
glands with combination of the tubular and acinar / alveolar
Tubuloalveolar
c. Classification according to Type of Secretion

most common; involves the release of secretory products by
Merocrine Secretion exocytosis
ex: water-producing sweat glands, pancreas
release of secretory products as pinched-off fragments of gland cells
Apocrine Secretion
ex: milk-producing mammary glands (combination with merocrine)
involves the shedding of entire cells
Holocrine Secretion
ex: sebaceous glands of skin
2. Endocrine – no ducts (directly into bloodstream); cellular products are called hormones (ex: pituitary glands)
Connective Tissue – distinguished by its extracellular matrix which results from the activity of specialized connective
tissue cells, which are:
 - blast cells: form the matrix (osteoblasts form bone, chondroblasts form cartilage)
 - clast cells: break down the matrix (osteoclasts break down bone)
 - cyte cells: maintain the matrix (osteocytes maintain the bone)
Major Components of Extracellular Matrix:

1. Protein Fibers
a. Collagen Fibers – very flexible but resist stretching
b. Reticular Fibers – very fine, short collagen fibers that branch to form a supporting network
c. Elastic Fibers – have the ability to return to their original shape after being stretched
2. Ground Substance – consists of nonfibrous molecules and has the following major components:
a. Hyaluronic Acid – makes fluid slippery
b. Proteoglycan Aggregates – trap water which gives tissues the capacity to recoil when deformed
c. Adhesive Molecules – hold proteoglycans together & to plasma membrane
3. Fluid – the matrix is liquid that enables blood to flow rapidly through the body
Functions of Connective Tissue:

1. Enclosing & separating other tissues (ex: sheets around organs and muscles)
2. Connecting tissues to one another (ex: tendons: bone to muscle, ligaments: bone to bone)
3. Supporting & moving parts of body (ex: bones)
4. Storing compound (ex: bones store calcium & phosphate)
5. Cushioning & insulating (ex: adipose tissue protects organs & helps conserve heat)
6. Transporting (ex: blood transports gases, nutrients, enzymes, & hormones)

7. Protecting (ex: immune cells)
Classification of Connective Tissues:
1. Connective Tissue Proper

a. Loose Connective Tissue – consists of relatively few protein fibers that form a lacy network, with
numerous spaces filled with ground substance & fluid.
Structure Function Location
Fine network of fibers (mostly packing between glands,
loose packing, support, &
 Areolar collagen with a few elastic fibers) muscles, & nerves; attaches
nourishment
with spaces in between; the skin to underlying tissues
packing material, thermal subcutaneous areas,
Little extracellular matrix; insulator, energy storage, & mesenteries, renal pelvis,
 Adipose
adipocytes are full of lipid protect organs against injury around kidney, surface of
from being jarred colon, mammary glands
provides a superstructure for
Fine network of reticular fibers within lymph nodes, spleen,
 Reticular lymphatic & hematopoietic
irregularly arranged bone marrow
tissues
b. Dense Connective Tissue – has relatively large number of protein fibers that form thick bundles & fill
nearly all of the extracellular space
 Regular Collagen fibers running in
withstand great pulling forces tendons, ligaments
Collagenous same direction
exerted in direction of fiber
orientation due to great tensile dermis of skin, organ
 Irregular Collagen fibers run in
strength & stretch resistance capsules, outer layer of
Collagenous several directions
blood vessels
Matrix composed of collagen elastic ligaments between
capable of stretching and recoiling
 Regular fibers & elastin fibers vertebrae & along dorsal
like a rubber band with strength in
Elastic running the same direction in aspect of neck, vocal
direction of fiber orientation
elastic ligaments cords
Matrix composed of collagen
 Irregular fibers & elastin fibers capable of stretching and recoiling
walls of blood vessels
Elastic oriented in many different in many different directions
directions
2. Supporting Connective Tissue

a. Cartilage – is composed of chondrocytes (cartilage cells); resilient, relatively rigid & enables to spring
back after being compressed; not penetrated by blood vessels; therefore, heals slowly after an injury.
allows growth, provides rigidity growing long bones, cartilage
Collagen fibers are
with some flexibility, forms strong, rings of respiratory system,
small & evenly
 Hyaline smooth, yet somewhat flexible costal cartilage of ribs, nasal
dispersed making it
articulating surfaces, forms the cartilages, articulating surfaces
transparent
embryonic skeleton of bones
Fibers are more somewhat flexible & capable of intervertebral disks, pubic
 Fibrocartilag numerous than in withstanding considerable symphysis, articular disks
e others; arranged in pressure; connects structures (knees, temporomandibular
thick bundles subjected to great pressure joints)
Similar to hyaline, but provides rigidity with even more
external ears, epiglottis, auditory
 Elastic matrix contains elastic flexibility; recoil after being
tubes
fibers stretched
b. Bone – hard connective tissue that consists of living cells & mineralized matrix; composed of osteocytes
(bone cells) which are located within lacunae; the matrix is organized into layers called lamellae.
 Compact Bone – more solid, with almost no space between thin layers of mineralized matrix
 Spongy Bone – has spaces between trabeculae of bone

Function: Provides great strength & support; protects internal organs, provides attachment of muscles &
ligaments; allow movements
3. Fluid Connective Tissue

a. Blood – composed of formed elements & a fluid matrix
Function: Transport gases, hormones, nutrients, waste products; protect body from infections;
temperature regulation
Location: Erythrocytes, leukocytes, platelets
b. Hemopoietic Tissue – composed of red and yellow marrow
Muscle Tissue – main function is to contract, or shorten, making movement possible; length is greater than its diameter.
Type Structure Function Location Image
cells are large, long, attached
cylindrical movement of body to bone or
Skeletal
Nucleus: many, located under voluntary other
Muscle
peripherally control connectiv
e tissue
Striated: YES
cells are cylindrical;
branched & connected to
one another by
Cardiac intercalated disks (contain pumps blood under
heart
Muscle gap junctions) involuntary control
Nucleus: one, located
centrally
Striated: YES
regulates size of
cells are tapered at each in hollow
organs, forces fluids
end organs
through tubes,
such as
Smooth controls the amount of
Nucleus: one, located stomach &
Muscle light entering the eye,
centrally intestines;
produces “goose
skin &
bumps” in skin; under
Striated: NO eyes
involuntary control
Nervous Tissue – specialized to conduct action potentials (electrical signals); located in the brain, spinal cord & ganglia
 Neurons (nerve cell) – transmit information in form of action potentials, store information, & integrate & evaluate data
Three Major Parts:

1. Cell Body – site of general cell functions; contains nucleus
2. Dendrites – receive stimuli leading to electrical changes
3. Axon – send action potential to another neuron
Glia (support cells) – surround the neurons; function to protect, nourish & form specialized sheaths around axons
CHECK FOR UNDERSTANDING (25 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to the
correct answer and another one (1) point for the correct

11. Understanding tissue structure and function is important because:
a. There is a relationship between the structure of each tissue type (how it is organized) and its function (what it
does).
b. There is a relationship between tissue structure and organ function.
c. Many diseases and pathologies are tissue and cell type specific.
d. Changes at the tissue level affect the function of organs.
e. All of these are correct.
f. All are correct except option C.
ANSWER: E
RATIO: There is a relationship between tissue structure and organ function. Diseases are tissue and cell type. Changes at
tissue level affect the function of organ like if connective tissue is stiff, airways will become rigid so many tissues will have
many trouble getting oxygen and many more.
12. Which of these is NOT one of the four basic tissue types?
a. glandular d. epithelium
b. connective e. nervous
c. muscle
ANSWER: A.
RATIO: Glandular is under epithelium.
13. All are true statement about epithelial tissue: (Select all that apply)
a. Epithelial tissue is vascular.
b. Epithelial tissue provides physical protection for organs.
c. Epithelial tissue functions in absorption & secretion.
d. Epithelial tissue controls the permeability into and out of an area/organ.
e. Epithelial tissue consists almost entirely of extracellular material between them thereby forming a barrier
against entry into the body.
ANSWER: B,C,D,E
RATIO: Epithelial tissue is avascular.
14. Basement membranes:

a. function as a filter and barrier to cell or pathogen movement
b. attach epithelial cells to the underlying tissue
c. are secreted partially by epithelial cells and partially by the cells of the underlying tissue.
d. function as a filter and barrier to cell or pathogen movement, attach epithelial cells to the underlying tissue
and are secreted partially by epithelial cells and partially by the cells of the underlying tissue are true of
basement membranes.
e. None of these is correct.
ANSWER: D
RATIO: All of which describes the basement membrane.
15. The most correct classification of an epithelial tissue consisting of many layers of cells, in which the outer layers are
flat and thin, and the basal layers are cuboidal or columnar is:
a. simple columnar epithelium. d. transitional epithelium.
b. pseudostratified epithelium. e. simple squamous epithelium.
c. stratified squamous epithelium.
ANSWER: C
RATIO: Stratified consist of two or more layers. The question said outer and basal layer therefore it is stratified squamous
epithelium.
16. Epithelial cells:

a. cover body surfaces or form glands.
b. usually have a free surface that is not in contact with other cells.
c. have a basement membrane that attaches to underlying tissues.
d. can be somewhat far away from a blood vessel.
e. have all of these properties..
ANSWER: E.

RATIO: All of which are under epithelial cells. It covers body surfaces, has a one free surface that is not in contact with
other cells, its cells are attached to underlying tissue and you cannot find a blood vessel in the epithelial cells.
17. Epithelial cells that appear cube like when an organ is relaxed and flattened when the organ is distended by fluid are
classified as:
a. simple columnar epithelium. d. transitional epithelium.
b. pseudostratified epithelium. e. simple squamous epithelium
c. stratified squamous epithelium.
ANSWER: D
RATIO: It is squamous when stretched and cuboidal when not stretched.
18. Epithelium that consists of a single layer of cells, in which some cells are tall and thin and reach the free surface and
others do not, is classified as:
a. simple columnar epithelium d. transitional epithelium
b. pseudostratified columnar epithelium e. simple squamous epithelium
c. stratified squamous epithelium
ANSWER: B
RATIO: pseudostratified columnar epithelia are formed by a single layer of cells that give the appearance of being made
from multiple layers.
19. Which of the following statements is true? (Select all that apply)
a. Transitional epithelium has cells that change shape when the tissue is stretched.
b. Transitional epithelium is found in the lining of the urinary bladder, the ureters and the superior urethra.
c. Transitional epithelium is pseudostratified.
d. As transitional epithelium is stretched, the number of cell layers increases.
e. Transitional epithelium is found in cavities that can expand greatly in volume.
ANSWER: A,B,C,D,E
RATIO: All are true about transitional.
20. Which of the following characteristics of tissues and cells would aid in diffusion or the movement of materials into and
out of the body through the epithelium?
a. multiple layers of relatively flat, thin cells
b. a single layer of relatively flat, thin cells
c. multiple layers of cuboidal cells
d. a single layer of cuboidal cells
e. multiple layers of columnar cells
ANSWER:B
RATIO: Simple squamous epithelium aids in diffusion or single layer of relatively flat and thin cells.

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write
the correct answer and correct/additional ratio in the space provided.
11. ANSWER: ________

RATIO:_____________________________________________________________________________________________
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12. ANSWER: ________
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14. ANSWER: ________
RATIO:_____________________________________________________________________________________________
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15. ANSWER: ________
RATIO:_____________________________________________________________________________________________
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16. ANSWER: ________
RATIO:_____________________________________________________________________________________________
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17. ANSWER: ________
RATIO:_____________________________________________________________________________________________
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20. ANSWER: ________
RATIO:_____________________________________________________________________________________________
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You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you track
how much work you have accomplished and how much work there is left to do.
This document and the information thereon is the property of PHINMA 17 of 106
Education (Department of Physical Therapy)
This section gives you the opportunity to assess your learning. It also gives you the opportunity to raise certain topics that you
don’t understand too well so we can discuss it better during the face to face sessions. Kindly answer the following questions:
1. The 4 major types of tissues

2. The types of stratified epithelium
3. The basement membrane
1. the characteristics of epithelial cells

2. exocrine and endodrine
The relationship of tissue and organ.
Lecture)
DOCTOR OF OPTOMETRY
STUDENT ACTIVITY SHEET
Session # 3
LESSON TITLE: The Integumentary System Materials:

LEARNING OUTCOMES: Laptop, internet, books, pen and notebook
Upon completion of this lesson, the nursing student can:
1. Expound in molecular level, the physiological References:
processes of the structures found in specific organ system VanPutte, Cinnamon L., Regan, Jennifer L., Russo,
Andrew F. (2013). Seeley’s Essentials of Anatomy
2. Create a schematic diagram of how functions of each
and Physiology. New York, NY. McGraw-Hill
structure of the organ system found on one region related
Education
to the other regions
Marieb, Elaine N (2015). Essentials of Anatomy and
3. Determine how each organ system works to maintain Physiology. Glenview, IL. Pearson Education Inc.
homeostasis
4. Conceptualize the pathological processes that occur

throughout the course of the disease progression
5. Identify signs and symptoms associated with the

disease and determine its complications
Main Lesson (50 minutes)

The students will study and read the topics ahead of time
Anatomy and Physiology of the Integumentary System
I. Functions of the Integumentary System
a. Thermoregulation
b. Blood reservoir
c. Protection
d. Cutaneous Sensations
e. Excretion and Absorption
f. Synthesis of Vitamin D
II. Structure of the Integumentary System
a. Dermis
b. Epidermis
- Layers of the epidermis
o Stratum Basale
o Stratum Spinosum
o Stratum Granulosum
o Stratum Lucidum
o Stratum Corneum
- Keratinization and Growth of the Epidermis
c. Hypodermis
III. Accessory Structure of the Skin
a. Hair
- Anatomy of the hair
- Hair growth
- Types of hairs
- Hair color
b. Skin Glands
- Sebaceous glands
- Sudoriferous glands
o Eccrine sweat glands
o Apocrine sweat glands
- Ceruminous glands
c. Nails
- Parts of the nails and its functions
IV. Functions of the skin
a. Thermoregulation
b. Blood reservoir
c. Protection
d. Cutaneous sensations
e. Excretion and absorption
f. Synthesis of Vitamin D
V. Maintaining homeostasis: Wound Healing
a. Epidermal wound healing
b. Deep wound healing
VI. Pathologies
a. Thermal injuries
- Cold injuries
- Burns
b. Miscellaneous Integumentary Disorders
- Integumentary Ulcers
- Pressure Ulcers
Check for Understanding (45 minutes)

Student will answer these questions and will rationalize this. Teacher will then confirm if answers are correct and synchronously
rationalize with the students. Students will be given 45 minutes to answer the activity sheet.
I. Multiple choice
1. The ʺtanningʺ effect (darkening of the skin) that occurs when a person is exposed to the sun is due to:
A) melanin B) keratin C) oil D) sweat E) Langerhans cells
Answer: A.
Rationalization: Melanin produces brown pigment in a way to protect the skin from burning.
2. Which type of membrane contains fluid between the visceral and perietal layers
A) serous B) cutaneous C) mucous D) connective E) synovial
Answer: A.
Rationalization: Serous membranes have two layers. The parietal layers of the membranes line the walls of the body
cavity. The visceral layer of the membrane covers the organs. Between the parietal and visceral layers is a very thin,
fluid-filled serous space, or cavity.
3. Sudoriferous glands are important for:

A) production of keratin
B) keeping skin and hair cells soft and flexible
C) body heat regulation
D) production of vitamin D
E) production of sweat
Answer: E
Rationalization: sudoriferous glands are also known as sweat glands which produces sweat.
4. Which of the following is an indication of melanoma:

A) a symmetrical mole
B) a pigmented spot that contains areas of different colors
C) a pigmented spot that is black
D) a spot on the skin that is smaller than the size of a pencil eraser
E) a pigmented spot that has smooth borders
Answer: B.
Rationalization: melanoma is indicated by the uneven shading or dark spots on the skin.
5. Sweat glands associated with hair are:

A) sudoriferous glands
B) eccrine glands
C) sudoriferous glands and eccrine glands
D) sebaceous glands and eccrine glands
E) sebaceous glands
Answer: D
Rationalization: sebaceous glands and eccrine glands are both sweat glands and the external outlets are the hair
follicles.
6. What is the first threat to life from a massive third-degree burn

A) blood loss B) infection C) dehydration D) loss of immune function E) unbearable pain
Answer: C
Rationalization: When a person is burned and depending on the severity of burn, the blood vessels including the
capillaries may be affected. Combined with the release of chemical substances into the blood, this will lead to
increased capillary permeability to fluids, leading to the leaking of fluids from the blood vessels into the tissues.
7. The categories of epithelial tissue membranes are:

A) synovial, cutaneous, and serous membranes
B) synovial, mucous, and cutaneous membranes
C) mucous, cutaneous, and serous membranes
D) synovial, mucous, and serous membrane
E) synovial, cutaneous, and mucous membranes
Answer: C
Rationalization: mucous, cutaneous, and serous membranes are all categories of epithelial tissue.
8. Which of the following is NOT a true statement about the papillary layer of the dermis:
A) it is the deepest layer of the skin
B) it is highly vascular
C) it contains nerve endings that respond to touch and temperature stimuli
D) it produces the pattern for fingerprints
E) it is located immediately beneath the epidermis
Answer: A
Rationalization: The deepest layer of our skin is the hypodermis and not the dermis.
9. A physician estimates the volume of fluid lost in a severely burned patient by:
A) measuring urinary output and fluid intake
B) using the ʺrule of nines”
C) performing enzyme studies
D) blood analysis
E) observing the tissues that are usually moist
Answer: B.
Rationalization: The rule of nines is a method doctors and emergency medical providers use to easily calculate the
treatment needs for a person who’s been burned.
10. In order to warm the body up when cold:

A) sudoriferous glands release sweat
B) melanin is produced
C) vitamin D is synthesized
D) the arrector pili muscles contract to stand hairs upright
E) sebaceous glands release oil
Answer: D
Rationalization: In order to generate heat when the body is cold, the arrector pili muscle contract all at once.
TRUE/FALSE. Write ʹTʹ if the statement is true and ʹFʹ if the statement is false.
11. Eccrine and apocrine glands are the two types of sebaceous glands . F_
11. Joe just burned his hand on a hot pot. A blister forms and the burn is painful; Joe ʹs burn would best be described as a
third-degree burn. __ F_
11. The downy type of hair covering a newborn is called vernix caseosa. ____T___
11. Melanin is found in the uppermost layer of skin and helps prevent water loss. ____T___
11. When an individual is exposed to extremely low air temperatures, the capillaries of the skin will dilate so that blood will
flush into skin capillary beds and heat will be dissipated. ____F___
11. The thickened, proximal area of the nail is called the nail matrix, and it is responsible for nail growth.
____T___
11. Membranes that line body cavities that have openings to the exterior of the body are called mucous membranes.
____T___
11. The pinkish hue of healthy individuals with fair skin is the result of the crimson color of oxygenated hemoglobin
circulating in the dermal capillaries and reflecting through the dermis. ___T____
11. The serous membrane that covers the external surface of both lungs is called the visceral pleura. ___F____
11. A serous membrane is composed of a layer of simple squamous epithelium resting on a thin layer of areolar connective
tissue. ____T___
Matching Type
21. Decubitus ulcers - E A) malignancy of the lowest epidermal layer
21. Alopecia -D B) partial-thickness burn
21. Third-degree burns - F C) cancer of skin pigment cells
21. Basal cell carcinoma - C D) hair thinning and some degree of baldness
21. Malignant melanoma - A E) bedsores
F) full-thickness burn
1. Third degree burn is not painful.

2. Melanin is release to protect the skin.
3. Doctors uses the rules of nine in treating.
1. about burns
2. about the layers of skin.
How to differentiate the layers of skin.
Lecture)
DOCTOR OF OPTOMETRY
Session #4
LESSON TITLE: The Nervous Tissue Materials:

1. Expound in molecular level, the physiological processes of
the structures found in specific organ system References:
structure of the organ system found on one region related to VanPutte, Cinnamon L., Regan, Jennifer L., Russo,
the other regions Andrew F. (2013). Seeley’s Essentials of Anatomy
3. Determine how each organ system works to maintain and Physiology. New York, NY. McGraw-Hill
homeostasis Education

throughout the course of the disease progression Marieb, Elaine N (2015). Essentials of Anatomy and
Physiology. Glenview, IL. Pearson Education Inc.
5. Identify signs and symptoms associated with the disease
and determine its complications

Introduction to the Nervous Tissue
I. Organization of the Nervous System
a. Central Nervous System
b. Peripheral Nervous System
II. Functions of the Nervous System
a. Sensory Function
b. Integrative Function
c. Motor Function
III. Histology of the Nervous Tissue
a. Neurons
- Parts of a neuron
- Structural diversity in Neurons
- Classification of Neurons
b. Neuroglia
- Neuroglia of the CNS
o Astrocytes
o Oligodendrocytes
o Ependymal Cells
- Neuroglia of the PNS
o Schwann Cells
o Satellites Cells
c. Myelination
d. Collections of nerve tissue
- Clusters of neuronal body
- Bundles of axons
- Gray and white matter
IV. Division of the Nervous System
V. Cells of the Nervous System
VI. Electrical Signals and Pathways
a. Resting membrane potential
b. Action Potentials
c. The Synapse
d. Reflexes
e. Neuronal Pathways
f. Ion channels
- Leak channel
- Ligand-gated channel
- Mechanically-gated channel
- Voltage-gated channel
g. Resting membrane potential
h. Graded potentials
i. Generation of action potentials
- Depolarizing phase
- Repolarizing phase
- After-hyperpolarizing phase
- Refractory period
j. Propagation of Action Potentials
- Continuous and Saltatory Conduction
- Factors that affect the speed of propagation
- Classification of Nerve Fibers
k. Encoding of stimulus intensity
l. Comparison of electrical signals produced by excitable cells\
VII. Signal Transmission at Synapses
a. Electrical Synapses
b. Chemical Synapses
c. Excitatory and Inhibitory Postsynaptic Potentials
d. Structure of neurotransmitter receptors
- Ionotropic receptors
- Metabotropic receptors
- Different postsynaptic effects for the same neurotransmitter
e. Removal of Neurotransmitter
f. Spatial and Temporal Summation of Postsynaptic potentials
VIII. Neurotransmitters
a. Small-molecule neurotransmitters
- Acetylcholine
- Amino acids
- Biogenic amines
- ATP and other purines
- Nitric oxide
- Carbon monoxide
b. Neuropeptides
IX. Neural Circuits
X. Regeneration and Repair of Nervous Tissue
a. Neurogenesis in the CNS
b. Damage and Repair in the CNS
XI. Brain Organization, Protection and Blood supply
a. Development of the brain
b. Major parts of the brain
- Sensory areas
- Motor areas
- Association Areas
- Hemispheric Lateralization
c. Protective coverings of the brain
d. Brain blood flow and the blood brain barrier
XII. Cerebrospinal fluid
a. Functions of the CSF
b. Formation of CSF in the ventricles
c. Circulation of CSF
XIII. The Brainstem and Reticular formation
a. The diencephalon
b. Thalamus
c. Hypothalamus
d. Circumventricular Organs
XIV. The Cerebrum
a. Cerebral Cortex
b. Lobes of the Cerebrum
c. Cerebral White Matter
d. Basal Nuclei
e. The Limbic System
XV. Spinal Cord
a. Spinal Nerves
b. Tracts
XVI. Cranial Nerves

I. Multiple choice
1. Afferent component of muscle stretch reflex that provides CNS information about the length and rate of change in length
of striated muscles:
a. Extrafusal fiber
b. Muscle spindle
c. Intrafusal fiber
d. NOTA
Answer: C
Rationalization: Intrafusal muscle fibers are skeletal muscle fibers that serve as specialized sensory organs that
detect the amount and rate of change in length of a muscle.
2. Immediately after an action potential is propagated, which one of the following ions rapidly
diffuses out of the cell into the tissue fluid:
a. Potassium
b. calcium
c. sodium
d. chloride
e. magnesium
Answer: A
Rationalization: Immediately after an action potential is propagated, which one of the following ions rapidly
diffuses out of the cell into the tissue fluid.
3. An action potential:
a. involves the outflux of negative ions to depolarize the membrane
b. involves influx of negative ions to depolarize the membrane
c. initiated by potassium ion movements
d. involves the outflux of positive ions to depolarize the membrane
e. essential for nerve impulse propagation
Answer: E
Rationalization: action potentials play a central role in cell-to-cell communication by providing for or with regard to
saltatory conduction, assisting the propagation of signals along the neuron's axon toward synaptic boutons situated
at the ends of an axon.
4. Cell bodies of the sensory neurons of the spinal nerves are located in:
a. The dorsal root ganglia of the spinal cord
b. The thalamus
c. The hypothalamus
d. The ventral root ganglia of the spinal cord
e. Sympathetic ganglia
Answer: D
Rationalization: The Ventral Root of the spinal nerve contains outgoing, efferent fibers that carry information destined
to control motor or glandular function. The cell bodies of these motor neurons are located in the ventral horns of the
spinal cord's central grey region.
5. Which one of the following is the correct sequence in connective tissue sheaths, going from outermost to innermost
layer?
a. Perineurium, endoneurium, epineurium
b. Epineurium, perineurium, endoneurium
c. Perineurium, epineurium, endoneurium
d. Epineurium, endoneurium, perineurium
e. Endoneurium, epineurium, perineurium
Answer: B
Rationalization: the individual nerve fibres are organised by connective tissue that consists of three distinct
components, called endoneurium, perineurium, and epineurium.
I. Essay
a. Briefly explain the Neuroglia of the CNS and PNS and their differences. (10 points)
Neuroglia in the CNS include astrocytes, microglial cells, ependymal cells, and oligodendrocytes. In the human
brain, it is estimated that the total number of glia roughly equals the number of neurons, although the proportions
vary in different brain areas. The PNS has two kinds of neuroglia: schwann cells and satellite cells. Schwann
cells provide myelination to peripheral neurons. They also perform phagocytic functions and clear cellular debris,
allowing for the regrowth of PNS neurons. Functionally, the schwann cells are similar to oligodendrocytes of the
CNS.
II. Illustration
a. Illustrate the neurons, its parts, and list their functions. (10 points)
cell membrane - barrier keeping the constituents of the cell in and

unwanted substances out
Dendrites - are appendages that are designed to receive communications

from other cells.
cell body - carries genetic information, maintains the neuron's structure,

and provides energy to drive activities.
Axon - carries nerve impulses away from the cell body
myelin sheath - allows electrical impulses to transmit quickly and

efficiently along the nerve cells.
nodes of Ranvier - allow the generation of a fast electrical impulse along

the axon.
Synapse - allows one neuron to pass an electrical or chemical signal to

another cell.
1. Action potential is essential for nerve impulse propagation

2. Reflexes are rapid, predictable and involuntary responses to stimuli.
3. The cell body carries out most of the metabolic functions of a neuron, so if damaged, the cell dies and is not replaced.
1. about the supporting cells

2about the sensory input and motor output.
How nerve impulses send message to the brain.
HES 029 (Human Anatomy and Physiology -
Lecture)
DOCTOR OF OPTOMETRY
Session #5
LESSON TITLE: The Autonomic Nervous System Materials:



Autonomic Nervous System
I. Comparison of Somatic and Autonomic Nervous Systems
a. Somatic Nervous System
b. Autonomic Nervous System
c. Comparison of Somatic and Autonomic Nervous Systems
II. Anatomy of Autonomic Motor Pathways
a. Anatomical Components
- Preganglionic neurons
- Autonomic ganglia
- Preganglionic neurons
- Autonomic plexuses
b. Structure of the Sympathetic Division
- Pathways from spinal cord to sympathetic trunk ganglia
- Organization of sympathetic trunk ganglia
- Pathways from sympathetic trunk ganglia to visceral effects
c. Structure of the Parasympathetic Division
d. Structure of the enteric division
III. ANS Neurotransmitters and Receptors
a. Cholinergic Neurons and Receptors
b. Adrenergic Neurons and Receptors
c. Receptor Agonists and Antagonists
IV. Physiology of the ANS
a. Autonomic Tone
b. Sympathetic Responses
c. Parasympathetic Responses
V. Integration and Control of Autonomic Functions
a. Autonomic Reflexes
b. Autonomic control by higher centers

I. Multiple Choice
1. The sympathetic and parasympathetic nervous systems are subdivisions of the:

a. autonomic nervous system
b. voluntary nervous system
c. somatic nervous system
d. central nervous system
e. peripheral nervous system
Answer: A
Rationalization: The autonomic nervous system (ANS) contains two subdivisions: the parasympathetic (PSNS) and
sympathetic (SNS) nervous systems.
2. The effects of the sympathetic nervous system are essentially opposite of the:
a. motor division
b. parasympathetic nervous system
c. sensory division
d. central nervous system
e. autonomic nervous system
Answer: B
Rationalization: The parasympathetic nervous system is opposite in its functions generally to the sympathetic
nervous system. It can informally be referred to as the part of the nervous system responsible for “rest and digest,”
that is, responsible for the internal functions when you are sitting resting and relaxing.
3. Which one of the following is the correct sequence of events that follows a threshold
1. the membrane becomes depolarized
2. sodium channels open and sodium ions diffuse inward
3. the membrane becomes repolarized
4. potassium channels open and potassium ions diffuse outward while sodium is actively transported out of the
cell
a. 2, 1, 4, 3
b. 3, 2, 4, 1
c. 2, 1, 3, 4
d. 4, 1, 3, 2
e. 1, 2, 4, 3
Answer: D
Rationalization: major positive ions inside the cell are potassium whereas the major positive ions outside the cell are
sodium. Because sodium is in much higher concentration outside the cell, it then diffuses quickly into the neuron
called depolarization. Potassium ions are allowed to diffuse out of the neuron into the tissue fluid called
repolarization. Sodium channels open and sodium ions diffuse inward.
4. Effects of sympathetic nervous system activity include all of the following, EXCEPT:
a. Pupillary dilation
b. Acceleration of heart rate
c. Secretion from the adrenal medulla
d. Inhibition of gastric motility
e. Dilation of blood vessels of the extremities and the trunk
Answer: D
Rationalization: The effect in the gastric is dry mouth and dry eyes.
5. Parasympathetic action of urinary bladder:

a. Relaxation of bladder, contraction of internal sphincter
b. Relaxation of bladder, relation of internal sphincter
c. Contraction of bladder, contraction of internal sphincter
d. Contraction of bladder, relaxation of internal sphincter
Answer: C
Rationalization: The parasympathetic control of the bladder musculature, the contraction of which causes bladder
emptying. The postganglionic fibers from these ganglia travel in the hypogastric and pelvic nerves to the bladder,
where sympathetic activity causes the internal urethral sphincter to close.
II. Matching type

1. Fight or flight response - A a. sympathetic
2. Cholinergic response - B b. parasympathetic
3. Pupillary dilation -A c. none of these
4. Thoracolumbar division - A
5. Hyperhidrosis - A
6. Vagal stimulation - B
7. Psychogenic erection -B
8. Adrenergic response -A
9. Ejaculation -C
10. Hypertension- A
11. Bronchodilation - A
12. Urinary sphincter relaxation -A
13. Craniosacral division - B
14. Emergency situation -A
15. Miosis -A
16. Defecation -B
17. Exercise - A
18. Increase salivation -B
19. Constipation -B
20. Increased urine output -B
1. The effects of sympathetic nervous system.

2.The effects of parasympathetic nervous system.
3.The automatic nervous system
1. The electrical conditions of a resting neuron’s membrane especially it’s sequence.

2. About preganglionic axon and postganglionic axon.
What is the use of ganglia.
Lecture)
DOCTOR OF OPTOMETRY
Session # 6
LESSON TITLE: Sensory, Motor and Integrative Systems Materials:



Sensory, Motor, and Integrative Systems
I. Sensation
a. Sensory modalities
b. The process of sensation
c. Sensory Receptors
a. Types of Sensory Receptors
b. Adaptation in Sensory Receptors
II. The process of Sensation
a. Stimulation of the Sensory Receptor
b. Transduction of the Stimulus
c. Generation of nerve impulses
d. Integration of sensory input
III. Somatic Sensations
a. Tactile
- Touch
- Pressure
- Vibration
- Itch
- Tickle
b. Thermal Sensations
c. Pain Sensations
- Types of pain
- Localization of pain
d. Proprioceptive Sensations
- Muscle spindles
- Tendon Organs
- Joint Kinesthetic Receptors
IV. Somatic Sensory Receptors
a. Posterior column-medial lemniscus pathway to the cortex
b. Anterolateral pathway to the cortex
c. Trigeminothalamic pathway to the cortex
d. Primary somatosensory area
e. Somatic Sensory pathways to the cerebellum
V. Somatic motor pathways
a. Organization of Upper Neuron Pathways
- Mapping the motor areas
- Direct motor pathways
- Indirect motor pathways
b. Role of the basal nuclei
c. Modulation of movement by the cerebellum
VI. Integrative Functions of the Cerebrum
a. Wakefulness and sleep
- The role of the reticular activating system in awakening
- Sleep
b. Learning and memory
VII. General Senses
a. Pain
b. Referred pain

The Sensory, Motor, and Integrative Systems

I. Illustration
a. Illustrate and briefly explain different somatic sensory pathways (50 points)
A somatosensory pathway will typically have three neurons: primary, secondary, and tertiary.
The cell bodies of the three neurons in a typical somatosensory pathway are located in the dorsal root ganglion, the
spinal cord, and the thalamus. A major target of somatosensory pathways is the postcentral gyrus in the parietal lobe of
the cerebral cortex. A major somatosensory pathway is the dorsal column–medial lemniscal pathway. The postcentral
gyrus is the location of the primary somatosensory area that takes the form of a map called the sensory homunculus.
1. The somatosensory system includes ascending pathways from the body to the brain.
2. The primary somatosensory area in the human cortex is located in the postcentral gyrus of the parietal lobe. This is the
main sensory receptive area for the sense of touch.
3. The primary somatosensory area in the human cortex is located in the postcentral gyrus of the parietal lobe. This is the
main sensory receptive area for the sense of touch.
1. About the major somatosensory pathway in the dorsal column.

2. About the ascending pathway.
I am still confused about the function of the tertiary neurons in the somatic sensory pathway.
Lecture)
DOCTOR OF OPTOMETRY
Session # 7
LESSON TITLE: Special Senses Materials:



Special Senses
I. Olfaction
a. Anatomy of Olfactory receptors
b. Physiology of olfaction
c. Odor thresholds and adaptation
d. The olfactory pathway
II. Taste
a. Anatomy of taste buds and taste buds and papillae
b. Physiology of gustation
c. Taste thresholds and adaptation
d. The gustatory pathway
III. Vision
a. Accessory structures of the eye
- Eyelids
- Eyelashes and eyebrows
- The lacrimal apparatus
- Extrinsic eye muscles
b. Anatomy of the eyeball
- Fibrous tunic
- Vascular tunic
- Retina
- Lens
- Inferior of the eyeball
c. Image formation
- Refraction of light rays
- Accommodation and the near point of vision
- Refraction abnormalities
- Constriction of the pupil
d. Convergence
e. Physiology of Vision
- Photoreceptors and photopigments
- Light and dark adaptation
- Release of neurotransmitter by photoreceptors
f. The visual pathway
- Processing of visual input in the retina
- Brain pathway and visual fields
IV. Hearing and Equilibrium
a. Anatomy and Function of the Ear
- External ear
- Middle ear
- Internal ear
b. The nature of soundwaves
c. Physiology of hearing
d. The auditory pathway
e. Physiology of equilibrium
- Otolithic organs: Saccule and utricle
- Semicircular ducts
f. Equilibrium pathways

I. Multiple Choice
1. Which one of the following correctly lists the order of the parts through which light passes as it enters the eye:
a. Vitreous humor, lens, aqueous humor, cornea
b. Lens, aqueous humor, cornea, vitreous humor
c. Cornea, aqueous humor, lens, vitreous humor
d. Cornea, lens, aqueous humor, vitreous humor
e. Aqueous humor, cornea, lens, vitreous humor
Answer: C
Rationalization: Light passes through the front of the eye (cornea) to aqueous humor to the lens then to vitreous
humor.
2. Sensorineural deafness occurs when there is damage or degeneration of receptor cells of the:
a. spiral organ of Corti or cochlear nerve
b. semicicircular canals
c. spiral organ of Corti
d. round window
e. ossicles
Answer: A
Rationalization: The primary function of the spiral organ of Corti is the transduction of auditory signals.
Sensorineural hearing loss is the most commonly reported cause of auditory deficits.
3. The oily secretions that lubricate the eye are produced by the:
a. ceruminous glands
b. apocrine glands
c. ciliary glands
d. lacrimal glands
e. tarsal glands
Answer: E
Rationalization: Meibomian glands or tarsal glands are holocrine type exocrine glands, along the rims of the eyelid
inside the tarsal plate. They produce meibum, an oily substance that prevents evaporation of the eye's tear film.
4. The greatest visual acuity is found at the:

a. lens
b. fovea centralis
c. ciliary body
d. optic disc
e. iris
Answer: B
Rationalization: The fovea is responsible for sharp central vision which is necessary in humans for reading, driving,
and any activity where visual detail is of primary importance.
5. Tarsal glands associated with the edges of the eyelids are considered modified:
a. sweat glands
b. sebaceous glands
c. ceruminous glands
d. apocrine glands
e. lacrimal glands
Answer: B
Rationalization: The tarsal glands are modified sebaceous glands, each consisting of a single straight tube or
follicle, with numerous small lateral diverticula.
6. The pigmented portion of the eye that has a rounded opening through which light passes is the:
a. cornea
b. sclera
c. iris
d. lens
e. retina
Answer: C
Rationalization: The colored part of the eye which helps regulate the amount of light entering the eye.
7. The gel-like substance that reinforces the eyeball and prevents it from collapsing inward is the:
a. choroid coat
b. canal Schlemm
c. aqueous humor
d. vitreous humor
e. ciliary body
Answer: D
Rationalization: Vitreous humor is the transparent gelatinous tissue filling the eyeball behind the lens.
8. Inflammation of the conjunctiva involves which of the following:

a. portion of the eye that contains the optic nerve
b. extrinsic eye muscles
c. circular band surrounding the pupil
d. delicate membrane lining the eyelids and covering the front of the eyeball
e. glands that produce tears
Answer:
Rationalization:
9. Eyes suddenly exposed to bright light experience:

a. photopupillary reflex
b. convergence
c. accommodation pupillary reflex
d. hemianopia
e. eye strain
Answer: A
Rationalization: photopupillary reflex is a reflex that controls the diameter of the pupil, in response to the intensity of
light that falls on the retinal ganglion cells of the retina in the back of the eye, thereby assisting in adaptation of vision
to various levels of lightness
10. The three sets of color receptors within the retina are sensitive to wavelengths of visible light
that are:
a. blue, green, and red
b. green, yellow, and purple
c. orange, green, purple
d. red, blue, yellow
e. red, green, yellow
Answer: A
Rationalization: These three kinds of cones are referred to as red cones, green cones, and blue cones because of
their respective sensitivity to the wavelengths of light that are associated with red, green and blue.
11. Which cranial nerve is responsible for moving the eye laterally?
a. cranial nerve 8
b. cranial nerve 3
c. cranial nerve 2
d. cranial nerve 4
e. cranial nerve 6
Answer: D
Rationalization: The trochlear nerve, also called the fourth cranial nerve is a motor nerve that innervates only a
single muscle: the superior oblique muscle of the eye, which operates through the pulley-like trochlea.
12. The decreased lens elasticity associated with aging that makes it difficult to focus on near objects
is known as:
a. Myopia
b. Presbyopia
c. Strabismus
d. Hyperopia
e. Hemianopsia
Answer: D
Rationalization: Farsightedness (hyperopia) is a common vision condition in which you can see distant objects
clearly, but objects nearby may be blurry.
13. Equilibrium receptors are located in the:

a. tympanic membrane
b. inner ear
c. external ear
d. middle ear
e. ossicles
Answer: B
Rationalization: Equilibrium receptors are located in the part of the inner ear known as the labyrinth.
14. Which one of the following nerves serves the anterior tongue?
a. cochlear
b. vestibular
c. vagus
d. facial glossopharyngeal
Answer: C
Rationalization: cranial nerve vagus carries taste information from the back of the mouth.
15. The only special sense that is NOT fully functional at birth is:
a. taste
b. vision
c. hearing
d. smell
e. touch
Answer: B
Rationalization: Vision is not fully develop at birth.
16. The middle coat of the eyeball that contains pigment which prevents light from scattering in the
eyeball is the:
a. sclera
b. pupil
c. retina
d. choroid
e. cornea
Answer: D
Rationalization: Choroid: the middle layer of the eye between the retina and the sclera. It also contains a pigment
that absorbs excess light so preventing blurring of vision. Ciliary body: the part of the eye that connects
the choroid to the iris.
17. Stimulation of sour receptors occurs in response to:

a. sugar
b. salt
c. beefsteak
d. saccharine
e. lemons
Answer: E
Rationalization: Lemons are the stimulation of sour receptors.
18. Which layer of the eye contains rods and cones:
a. iris
b. retina
c. sclera
d. choroid
e. optic nerve
Answer: B
Rationalization: Retina: a light sensitive layer that lines the interior of the eye. It is composed of light
sensitive cells known as rods and cones. The human eye contains about 125 million rods, which are necessary for
seeing in dim light.
19. Hair cells that function as hearing receptors are located within the:
a. auditory nerve
b. oval window
c. auricle
d. spiral organ of Corti
e. ossicles
Answer: D
Rationalization: the auditory hair cells are located within the spiral organ of Corti on the thin basilar membrane in the
cochlea of the inner ear.
20. Which one of the following is NOT part of the inner ear?
a. semicircular canals
b. ossicles
c. vestibule
d. cochlea
e. membranous labyrinth
Answer: B
Rationalization: Ossicles is not part of the inner ear.
21. Which one of the following is NOT a primary taste sensation?

a. salty
b. sweet
c. pungent
d. sour
e. bitter
Answer: C
Rationalization: causing a sharp or irritating sensation especially : acrid.
22. Sound waves entering the external auditory canal hit the eardrum, also known as the:
a. oval window
b. ossicles
c. tympanic membrane
d. pinna
e. auricle
Answer: C
Rationalization: Sound waves travel along the auditory canal and strike the tympanic membrane, causing it to
vibrate.
23. The auditory ossicle called the ʺanvilʺ is also called the:
a. incus
b. stapes
c. malleus
d. bony labyrinth
e. cochlea
Answer: A
Rationalization: the middle one of a chain of three small bones in the middle ear of humans and other mammals.
Compare malleus, stapes. Also called anvil, anvil cloud, anvil top, thunderhead.
24. What structure of the eye focuses light on the retina?

a. optic chiasma
b. lens
c. choroid
d. sclera
e. iris
Answer: B
Rationalization: Light passes through the front of the eye (cornea) to the lens. The cornea and the lens help to focus
the light rays onto the back of the eye (retina).
25. The congenital condition of ʺcrossed eyesʺ is also known as:

a. hemianopsia
b. hyperopia
c. presbyopia
d. strabismus
e. myopia
Answer: D
Rationalization: Strabismus is a disorder in which both eyes do not line up in the same direction.
1. I learned that lens helps focus light into the retina.
2. That visions are not fully develop at birth.
3. I also learned that pungent is not a primary taste sensation.
1. About the inner ear

2. About the conditions of the eye.
1. Why blue, green, and red the three sets of color receptors within the retina are sensitive to wavelengths of visible light?

Lecture)
DOCTOR OF OPTOMETRY
Session # 8
LESSON TITLE: The Endocrine System Materials:



The Endocrine System
I. Comparison of control by the Nervous and Endocrine System
II. Principles of Chemical Communication
III. Functions of the Endocrine System
IV. Characteristics of the Endocrine Systems
V. Hormone activity
a. The role of hormone receptor
b. Circulating and local hormones
c. Chemical classes of hormones
- Lipid-soluble hormones
- Water-soluble hormones
d. Hormone transport in the blood
VI. Mechanisms of hormone action
a. Action of lipid-soluble hormones
b. Action of water-soluble
c. Hormone Interactions
VII. Control of hormone secretions
VIII. Hypothalamus and the Pituitary gland
a. Anterior pituitary
- Types of Anterior Pituitary Cells and Their Hormones
- Control of Secretion by the Anterior Pituitary
- Human Growth Hormone and Insulin-like Growth Factors
- Thyroid-stimulating hormone
- Follicle-stimulating hormone
- Luteinizing Hormone
- Prolactin
- Adrenocorticotrophic hormone
- Melanocyte-stimulating hormone
b. Posterior pituitary
- Control of secretion by the posterior pituitary
IX. Thyroid gland
a. Formation, storage and release of thyroid hormones
b. Actions of thyroid hormones
c. Control of thyroid hormone secretion
d. Calcitonin
X. Parathyroid glands
a. Parathyroid hormone
b. Control of calcitonin and parathyroid hormone
- Mineralocorticoids
- Control of Aldosterone Secretion
- Glucocorticoids
- Control of glucocorticoids secretion
- Androgens
- Control of secretion of epinephrine and norepinephrine
XI. Adrenal glands
a. Adrenal Cortex
- Mineralocorticoids
- Control of Aldosterone Secretion
- Glucocorticoids
- Control of glucocorticoids secretion
- Androgens
- Control of secretion of epinephrine and norepinephrine
b. Adrenal Medulla
XII. Pancreatic Islets
a. Cell types in pancreatic islets
b. Control of secretion of glucagon and insulin
XIII. Ovaries and testes
XIV. Pineal gland and thymus
a. Hormones from other endocrine tissues and organs
b. Eicosanoids
c. Hormones that produced by other organs and tissues that contain endocrine cells
d. Growth factors
XV. Other endocrine tissues and organs, eicosanoids and growth factors
a. The flight or fight response
b. The resistance reaction
c. Exhaustion
d. Stress and disease
XVI. Disorders of the Endocrine System

I. Multiple choice
1. Which one of the following is NOT an action of the catecholamines

A) increased heart rate
B) dilation of the small passages of the lungs
C) stimulation of the sympathetic nervous system
D) decreased blood pressure
E) increased blood glucose levels
Answer: D
Rationalization: It increases blood pressure not decrease.
2. Which one of the following is NOT one of the major processes controlled by hormones
A) mobilizing body defenses against stressors
B) growth and development
C) maintaining electrolyte balance
D) body coordination
E) regulating cellular metabolism
Answer: D
Rtionalization: The major processes controlled by hormones are reproduction, growth and development, mobilizing body
defenses against stressors, maintaining electrolyte, water, and nutrient balance of the blood, and regulating cellular metabolism
and energy balance.
3. Alcohol inhibits the secretion of:

A) prolactin (PRL)
B) antidiuretic hormone (ADH)
C) parathyroid hormone (PTH)
D) oxytocin
E) glucagon
Answer: B
Rationalization: Drinking alcohol inhibits the body's release of the hormone vasopressin. Doctors also call
vasopressin anti-diuretic hormone (ADH). Typically, the brain signals the release of ADH in response to an increase
in particles over fluids
4. The hormone that appears to help regulate our sleep-awake cycles is

A) melatonin
B) thyroxine
C) progesterone
D) thymosin
E) glucagon
Answer: A
Rationalization: The pineal gland is a tiny endocrine gland found in the brain. It produces and secretes the
hormone melatonin, which is a hormone that helps regulate biological rhythms such as sleep and wake cycles .
5. Which of these hormones is released by the adrenal medulla

A) sex hormones
B) aldosterone
C) glucocorticoids
D) epinephrine
E) cortisone
Answer: D
Rationalization: The adrenal medulla, the inner part of an adrenal gland, controls hormones that initiate the flight or fight
response. The main hormones secreted by the adrenal medulla include epinephrine (adrenaline)
and norepinephrine (noradrenaline), which have similar functions.
6. The bodyʹs major metabolic hormone is called

A) calcitonin
B) growth hormone
C) thyroid hormone
D) prolactin
E) adrenaline
Answer: C
Rationalization: The body's basal metabolic rate is controlled by the thyroid hormones thyroxine (T4) and
triiodothyronine (T3).
7. The hormone that triggers ovulation of an egg from the female ovary is:
A) luteinizing hormone
B) prolactin
C) interstitial cell-stimulating hormone
D) progesterone
E) follicle-stimulating hormone
Answer: A
Rationalization: Luteinizing hormone (LH), the other reproductive pituitary hormone, aids in egg maturation and
provides the hormonal trigger to cause ovulation and the release of eggs from the ovary.
8. The ʺfight-or-flightʺ response triggers the release of:
A) growth hormone
B) epinephrine
C) melatonin
D) prolactin
E) ADH
Answer: B
Rationalization: During the Fight-or-Flight Response. In response to acute stress, the body's sympathetic nervous system is
activated by the sudden release of hormones. The sympathetic nervous system then stimulates the adrenal glands, triggering
the release of catecholamines or epinephrine (including adrenaline and noradrenaline).
9. Which of these hormones regulate calcium levels in the body

A) T3 and T4
B) calcitonin and parathyroid hormone
C) melatonin and glucocorticoids
D) oxytocin and prolactin
E) insulin and glucagon
Answer: B
Rationalization: There are at least three hormones intimately involved in the regulation of the level of calcium in the
blood: parathyroid hormone (PTH), calcitonin and calcitriol (1, 25 dihydroxyvitamin D, the active form of vitamin D).
10. Tetany resulting from uncontrolled muscle spasms may indicate a malfunction of the:
A) pineal gland
B) adrenal cortex
C) thymus
D) posterior pituitary
E) parathyroid glands
Answer: E
Rationalization: Tetany resulting from uncontrolled muscle spasms may indicate a malfunction of the: parathyroid glands.
11. Which one of the following is NOT a symptom of Cushing ʹs syndrome

A) bronze skin tones
B) high blood pressure
C) buffalo hump
D) moon face
E) water retention
Answer: A
Rationalization: It is pink or purple color on skin not bronze.
12. Which one of the following is NOT an anterior pituitary hormone

A) prolactin
B) antidiuretic hormone
C) follicle-stimulating hormone
D) adrenocorticotropic hormone
E) luteinizing hormone
Answer: B
Rationalization: The anterior pituitary gland produces six major hormones:prolactin, growth hormone,
adrenocorticotropic hormone, luteinizing hormone, follicle-stimulating hormone, and thyroid-stimulating hormone
13. Insulin works as an antagonist to
A) oxytocin
B) glucagon
C) testosterone
D) thyroid hormone
E) thymosin
Answer: B
Rationalization: Insulin and glucagon make up an antagonistic hormone pair; the action of insulin is opposite that of glucagon.
For example, your blood glucose concentration rises sharply after you eat food that contains simple carbohydrates, such as the
chocolate chip muffin
14. Which one of the following is NOT produced by the adrenal cortex
A) mineralocorticoids
B) glucocorticoids
C) sex hormones
D) aldosterone
E) epinephrine
Answer: E
Rationalization:It is produce by the adrenal medulla.
15. The element necessary in the diet for proper thyroid function is:
A) sodium
B) potassium
C) iodine
D) bromine
E) calcium
Answer: C
Rationalization: Iodine is an element that is needed for the production of thyroid hormone. The body does not
make iodine, so it is an essential part of your diet.
16. After menopause, hormone replacement therapy with estrogen-like compounds is effective in
preventing the progression of osteoporosis. What is the mechanism of their protective effect?
A) They stimulate the activity of osteoblasts
B) They increase absorption of calcium from the gastrointestinal tract
C) They stimulate calcium reabsorption by the renal tubules
D) They stimulate parathyroid hormone (PTH) secretion by the parathyroid gland
Answer: A
Rationalization: when amount of estrogen in blood falls to very low levels after menopause, balance between bone-
building activity of osteoblasts and bone-degrading activity of osteoclasts is tipped toward bone degradation. estrogen
compounds added as part of hormone replacement therapy = bone-building activity of osteoblasts = increased =
balances osteoclastic activity.
17. Which hormones antagonize the effect of NO and cause the penis to become flaccid after
A) Endothelin and norepinephrine
B) Estrogen and progesterone
C) Luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
D) Progesterone and LH
Answer: A
Rationalization: The flaccid penis is in a moderate state of contraction and the somatic nerves are
primarily responsible for sensation and the norepinephrine from sympathetic nerve endings and endothelins.
18. Which of the following increases secretion of GH?

A) Senescence
B) Insulin-like growth factor-1 (IGF-1)
C) Somatostatin
D) Hypoglycemia
E) Exogenous GH administration
Answer: C
Rationalization: GH secretion is stimulated by growth hormone-releasing hormone (GHRH) and is inhibited by
somatostatin.
19. Which of the following could inhibit the initiation of labor?

A) Administration of an antagonist of the actions of progesterone
B) Administration of LH
C) Administration of an antagonist of PGE2 effects
D) Mechanically dilating and stimulating the cervix
E) Administration of oxytocin
Answer: C
Rationalization: Several mRNAs encoding proteins involved in PGE2 synthesis, metabolism and signaling increase (P < 0.05) in
the periovulatory follicle after administration of an ovulatory hCG bolus. PGE2 signaling through PTGER2 induces cumulus cell
expansion and production of hyaluronic acid, which are critical events for fertilization.
20. Which of the following is both synthesized and stored in the hypothalamus?
A) ADH
B) Thyroid-stimulating hormone (TSH)
C) LH
D) Somatostatin
E) Somatomedin
Answer: A
Rationalization: Antidiuretic hormone (ADH) and oxytocin are produced in the hypothalamus and transported by
axons to the posterior pituitary where they are dumped into the blood. ADH controls water balance in the body and
blood pressure.
21. If a radioimmunoassay is properly conducted and the amount of radioactive hormone bound to
antibody is low, what would this result indicate?
A) Plasma levels of endogenous hormone are high
B) Plasma levels of endogenous hormone are low
C) More antibody is needed
D) Less radioactive hormone is needed
Answer: C
Rationalization: In radioimmunoassay, there is too little antibody to completely bind radioactively tagged hormone in fluid (plasma)
to be assayed, competition between labeled endogenous hormone for binding site on antibody. If amount of radioactive hormone
bound to antibody is low, plasma levels of endogenous hormone are high
22. By which mechanism do LH and FSH return to base- line levels?

A) LH surge
B) Negative feedback on gonadotropin-releasing hormone (GnRH) by progesterone
C) Negative feedback on GnRH by estradiol
D) Negative feedback on GnRH from testosterone
Answer:
Rationalization:
23. PTH does what directly?

A) Controls the rate of 25-hydroxycholicalciferol formation
B) Controls the rate of calcium transport in the mucosa of the small intestine
C) Controls the rate of formation of calcium-binding protein
D) Controls the rate of formation of 1,25-dihydroxycholicalciferol
E) Stimulates renal tubular phosphate reabsorption
Answer: B
Rationalization: In the bones, PTH stimulates the release of calcium in an indirect process through osteoclasts which
ultimately lead to resorption of the bones.
24. Which substances are most likely to produce the greatest increase in insulin secretion?
A) Amino acids
B) Amino acids and glucose
C) Amino acids and somatostatin
D) Glucose and somatostatin
Answer: B
Rationalization:
25. Which statement about antidiuretic hormone (ADH) is true?

A) It is synthesized in the posterior pituitary gland
B) It increases salt and water reabsorption in the collecting tubules and ducts
C) It stimulates thirst
D) It has opposite effects on urine and plasma osmolality
Answer: D
Rationalization: It's a hormone made by the hypothalamus in the brain and stored in the posterior pituitary gland. It
tells your kidneys how much water to conserve. ADH constantly regulates and balances the amount of water in your
blood. Higher water concentration increases the volume and pressure of your blood.
1. I have learned that the element necessary in the diet for proper thyroid medulla is Iodine.
2. That insulin works as an antagonist to glucagon.
3. That the flight or fight response triggers the release of epinephrine.
1. About the major metabolic hormones.

2. About the hormone that triggers the ovulation of an egg from the female ovary.
More about melanin.
Lecture)
DOCTOR OF OPTOMETRY
Session # 9
LESSON TITLE: The Cardiovascular System: The Heart Materials:



Cardiovascular System: The Heart
I. Functions of the heart
II. Size, form, and location of the heart
III. Anatomy of the heart
a. Location of the heart
b. Pericardium
c. Layers of the Heart Wall
d. External Anatomy
e. Heart Chambers and Internal Anatomy
a. Right atrium
b. Right ventricle
c. Left atrium
d. Left ventricle
f. Myocardial Thickness and Function
g. Fibrous Skeleton of the Heart
IV. Heart Valves and Circulation of Blood
a. Operation of the atrioventricular valves
b. Operation of the semilunar valves
c. Systemic and Pulmonary Circulations
d. Coronary Circulations
a. Coronary arteries
b. Coronary veins
V. Route of blood flow through the heart
VI. Blood flow to the heart
VII. Histology of the heart
a. Heart wall
b. Cardiac muscle
VIII. Electrical Activity of the heart
a. Action potentials and contraction of contractile fibers
b. Autorhythmic Fibers: Conduction system of the heart
c. ATP production in Cardiac Muscle
d. Correlation of ECG Waves with Atrial and Ventricular Systole
e. Electrocardiogram
IX. The Cardiac cycle
a. Pressure and Volume Changes during the Cardiac Cycle
- Atrial systole
- Ventricular systole
- Relaxation Period
X. Heart sounds
XI. Regulation of heart function
a. Intrinsic regulation of the heart
b. Extrinsic regulation of the heart
XII. The Cardiac Output
a. Regulation of Stroke Volume
- Preload: Effect of stretching
- Contractility
- Afterload
b. Regulation of Heart Rate
- Autonomic Regulation of Heart Rate
- Chemical Regulation of Heart Rate
- Other factors in Heart Rate Regulation
XIII. Exercise and the Heart

I. Multiple Choice
1. Which age has the lowest normal blood pressure?
a. 6 years old
b. 4 years old
c. Newborn
d. 2 years old
Answer:
Rationalization:
2. If the heart rate is 60 beats per minute and the stroke volume is 90mL, then cardiac output is:
a. 5.4 L
b. 5.2 L
c. 6.2 L
d. 5.5 L
Answer:
Rationalization:
3. Determinant of heart rate:

a. Changes in HCO3
b. Changes in CO2
c. Changes in K
d. Changes in NA
Answer:
Rationalization:
4. The first heart sound is associated with the closure of:

a. Aortic and pulmonic valve
b. Pulmonic and tricuspid valves
c. Tricuspid and mitral valves
d. Aortic and mitral valves
Answer: C
Rationalization: The first heart sound (S1) represents closure of the atrioventricular (mitral and tricuspid) valves as
the ventricular pressures exceed atrial pressures at the beginning of systole
5. One of the following are true of coronary circulation:

a. Rapidly boating heart prolongs diastole and promotes filling of the coronary arteries
b. Studies show that smoking has nothing to do with the coronary arteries
c. A low cardiac output may give rise to angina pectoris as when the aortic valve does not close properly
d. Its physiological importance lies in the fact that the total anaerobic conditions are adequate in sustaining ventricular
contraction
Answer:
Rationalization:
6. Acetylcholine is released at the vagal nerve endings through the stimulation of the parasympathetic nerves to the heart.
Effects of this hormone include:
a. Slow transmission of cardiac impulse to the ventricles
b. Both of these
c. None of these
d. Decreases the rate of rhythm of the sinus node
Answer:
Rationalization:
7. The following statements apply to the auscultatory method measuring systolic and diastolic pressure, EXCEPT:
a. The auscultatory method is very accurate, values are within 11 percent compared to direct arterial measurements
b. When the Korotkoff sounds become muffled, the pressure on the manometer is approximately equal to the diastolic
pressure
c. Tapping sounds are heard after cuff pressure falls below systolic pressure in the antecubital artery synchronizing
with the heartbeat
d. Korotkoff sound is heard with each pulsation cycle as he cuff pressure closes the artery during the arterial pressure
cycle
Answer:
Rationalization:
8. The most serious cardiac arrythmia resulting from cardiac impulses re-exciting the same ventricular muscles over and
over:
a. Premature ventricular contractions
b. Ventricular paroxysmal tachycardia
c. Stokes-Adams syndrome
d. Ventricular fibrillation
Answer: B
Rationalization: In ventricular tachycardia, an abnormal electrical impulse originating in the lower chambers of the
heart (ventricles) causes the heart to beat faster. The problem may involve either a small cluster of cells or a large
area of scar tissue.
9. The major modifiable risk factors for the development and progression of coronary artery disease include the following,
EXCEPT:
a. Habitual smoking
b. Hypertension
c. Physical activity
d. Hypercholesterolemia
Answer: C
Rationalization: Its not physical activity but lack of physical activity.
10. In a normal electrocardiogram, this wave is caused by potentials generated as the ventricles depolarize:
a. T wave
b. QRS complex
c. Q wave
d. P wave
Answer: D
Rationalization: P wave is the first wave on the ECG because the action potential for the heart is generated in the
sinoatrial (SA) node, located on the atria, which sends action potentials directly through Bachmann's bundle
to depolarize the atrial muscle cells.
11. A cardiac cycle is from the beginning of one heartbeat to the beginning of the next. Each cycle is initiated by:
a. Atrioventricular node
b. Purkinje fibers
c. Sinoatrial node
d. Atrioventricular bundle
Answer: C
Rationalization: Your heartbeat is triggered by electrical impulses that travel down a special pathway through your
heart: SA node (sinoatrial node) – known as the heart's natural pacemaker.
12. During the isovolumetric contraction phase:

a. The aortic and tricuspid valves are closed
b. The aortic valve is open while the pulmonic valve is closed
c. The mitral valve is open but the tricuspid valve is closed
d. The mitral valve is open while the aortic valve is closed
e. The mitral and aortic valves are closed
Answer: E
Rationalization: The isovolumetric contraction causes left ventricular pressure to rise above atrial pressure, which
closes the mitral valve and produces the first heart sound. The aortic valve opens at the end of isovolumetric
contraction when left ventricular pressure exceeds aortic pressure. aortic and pulmonary valves closed.
13. The sinu-atrial node is the normal pacemaker in the human heart because:
a. It has the highest intrinsic rate of automaticity
b. It receives both sympathetic and parasympathetic innervation
c. It is far from the ventricles
d. It is located near the entry to the right atrium
e. It is located near the entry to the right ventricle
Answer:
Rationalization:
14. The aorta leaves this chamber of the heart:

a. Right ventricle
b. It bypasses the heart
c. Right auricle
d. Left ventricle
e. Left auricle
Answer: D
Rationalization: The left ventricle is one of the four chambers of the heart. It pumps oxygen-rich blood out to the rest
of the body. Blood leaves the left ventricle through the aortic valve and enters the aorta, the largest artery in the
body.
15. Which of the following factors affect blood pressure?

I. size and condition of arteries
II. Cardiac output
III. Blood volume
IV. Arm position
a. I and III only
b. II and IV only
c. IV only
d. I, II, III only
e. All are correct
Answer: D
Rationalization: The size and elasticity of the artery walls also affect blood pressure. Each time the heart beats
(contracts and relaxes), pressure is created inside the arteries. Blood pressure increases with increased cardiac
output, peripheral vascular resistance, volume of blood, viscosity of blood and rigidity of vessel walls. Blood pressure
decreases with decreased cardiac output. Changes in blood volume affect arterial pressure by changing cardiac
output.
II. Illustration
a. Illustrate and label the chambers and
valves of the heart. (10 points)
b. Briefly explain the conduction System. (5 points)
The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send
signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA
node, AV node, bundle of His, bundle branches, and Purkinje fibers.
1. __________________________________________________________
2. __________________________________________________________
3. __________________________________________________________
1. __________________________________________________________
2. __________________________________________________________
__________________________________________________________

Lecture)
DOCTOR OF OPTOMETRY
Session # 10
LESSON TITLE: The Cardiovascular System: The blood Materials:

and hemodynamics
Laptop, internet, books, pen and notebook
LEARNING OUTCOMES:
1. Expound in molecular level, the physiological processes of References:
the structures found in specific organ system
and Physiology. New York, NY. McGraw-Hill
3. Determine how each organ system works to maintain Education
homeostasis

Cardiovascular System: The Blood and Hemodynamics
I. Structure and Functions of blood vessels
a. Basic Structure
- Tunica Interna (Intima)
- Tunica Media
- Tunica Externa
b. Arteries
- Elastic Arteries
- Muscular Arteries
c. Anastomoses
d. Arterioles
e. Capillaries
f. Venules
g. Veins
II. Capillary Exchange
a. Diffusion
b. Transcytosis
c. Bulk flow: Filtration and Reabsorption
d. Blood Pressure
e. Vascular Resistance
f. Venous Return
g. Velocity of Blood Flow
h. Blood Distribution
h. Functions of the blood
III. Physical characteristic of blood
IV. Components of blood
V. Formation of blood cells
- Red blood cells
- White blood cells
- Platelets
VI. Control of Blood Pressure and Blood Flow
a. Role of the Cardiovascular Center
b. Neural Regulation of Blood Pressure
- Baroreceptor Reflexes
- Chemoreceptor Reflexes
c. Hormonal Regulation of Blood Pressure
d. Autoregulation of blood flow
VII. Circulatory Routes
a. The systemic circulation
b. The Hepatic Portal Circulation
c. The Pulmonary Circulation
VIII. Checking Circulation
a. Pulse
b. Measuring Blood pressure
IX. Composition of blood
X. Plasma
XI. Formed elements
a. Production of formed elements
b. Red blood cells
c. White blood cells
d. Platelets
XII. Hemostasis / Preventing blood loss

I. Multiple Choice
1. Which of the statements is true of the blood?
a. Human blood is composed of red and white blood cells, platelets, and plasma
b. Some human population lack the ability to produce plasma
c. Proteins are not normal components of human blood
d. NOTA
Answer: A
Rationalization: Blood is a specialized body fluid. It has four main components: plasma, red blood cells, white blood
cells, and platelets. Blood has many different functions, including: transporting oxygen and nutrients to the lungs and
tissues.
2. Erythrocyte is another name for:

a. Red blood cell
b. White blood cell
c. Platelet
d. Plasma
Answer: A
Rationalization: Its also called red blood corpuscle. Erythrocyte literally means red cell in Greek.
3. This blood component provides the major components provide the major defense for our bodies against invading
bacteria and viruses.
a. Red blood cell
b. White blood cell
c. Platelet
d. NOTA
Answer: B
Rationalization: There are numerous types of white cells, many of which function to seek out and destroy alien
microbes in our bodies. Some other types of white cells have the function of getting rid of old unneeded blood cells.
4. The relatively clear liquid medium which carries the other cells of blood is called:
a. Lipid
b. Antibody
c. Plasma
d. NOTA
Answer: C
Rationalization: Most of blood`s volume is made up of plasma. As the heart pumps blood to cells throughout the
body, the plasma brings them nourishment and removes the waste products of metabolism. It also transports the
red and white cells as well as the platelets.
5. Which of the following are likely to increase in quantities when the body is under attack from bacteria?
a. Erythrocytes
b. Leukocytes
c. Thrombocytes
d. NOTA
Answer: B
Rationalization: In response to such an attack, the leukocytes, or white cells, normally appear at the site of infections
in increasing numbers. They attack the invading bacteria and ultimately get rid of them if they are successful.
6. When blood clumps or forms visible island in the still liquid plasma, it is called
a. Clotting
b. Agglutination
c. NOTA
d. AOTA
Answer: B
Rationalization: In response to such an attack, the leukocytes, or white cells, normally appear at the site of infections
in increasing numbers. They attack the invading bacteria and ultimately get rid of them if they are successful.
7. Antigens are:
a. Found on the surface of red cells
b. Kinds of red cells that identify a blood type
c. Relatively large carbohydrate molecules
d. A and B
Answer: A
Rationalization: They are relatively large molecules that identify a blood type. Each antigen type has unique traits
that make it like a lock that only a specific antibody key can fit.
8. Which of the following statements is true of antigen-antibody interactions?

a. They are used by our bodies only to identify blood types
b. They are used to identify and reject microorganisms, such as viruses and bacteria, that invade our bodies
c. They are the way our blood clots when we are bleeding from an open wound
d. B and C
Answer: B
Rationalization: Microorganisms carry foreign antigens on their surfaces which stimulate the production of white cell
antibodies that attack the antigens as a way of getting rid of the invading parasites and subsequently develop an
immunity to future attacks.
9. Most of the volume of normal human blood is composed of:

a. Red cells
b. Hemoglobin
c. Plasma
d. White cells
Answer: C
Rationalization: The liquid component of blood that we call plasma is the most abundant substance in blood.
However, red cells are a close second.
10. Some of the leukocytes have granules in their cytosol that consists of a variety of chemicals involved in defending the
body. Which of the following cells typically do not granules?
a. Basophils
b. Neutrophils
c. Lymphocytes
d. NOTA
Answer: C
Rationalization: Lymphocytes are the second most common white blood cell and are easy to find in blood smears.
11. Histamine is a chemical that causes blood vessels to dilate in an effort to increase the flow of blood and subsequently
leukocytes to the infected site. Which of the following leukocytes release the most histamine?
a. Basophils
b. Neutrophils
c. Eosinophils
d. Airphils
Answer: A
Rationalization: Basophils migrate to injury sites and cross the capillary endothelium to accumulate in the damaged
tissue, where they discharge granules that contain histamine.
12. Neutrophils are referred to as polymorphonuclear leukocytes because:

a. They have many nuclei
b. Their nucleus can take on variety of shapes
c. Some have a single nucleus and some have many nuclei
d. NOTA
Answer: B
Rationalization: They are also called polymorphonuclear leukocytes (PMN, PML, or PMNL) because of the varying
shapes of the nucleus, which is usually lobed into three segments.
13. Which of the following characteristics of erythrocytes allow for the easy exchange of oxygen and carbon dioxide?
a. Flattened shape
b. Lack of a nucleus
c. Lack of organelles
d. NOTA
Answer: A
Rationalization: Flattened shape has no nucleus. It transport oxygen and some carbon dioxide between tissue and
lungs.
14. Megakaryocytes leave the bone marrow and enter the bloodstream by passing through the walls of capillaries. In the
process of passing through the pores in the capillaries, the megakaryocytes fragment. These fragments are:
a. Platelets
b. Plasma proteins
c. Circulating antigens
d. NOTA
Answer: A
Rationalization: Platelets are small, colorless cell fragments in our blood that form clots and stop or prevent bleeding.
Platelets are made in our bone marrow, the sponge-like tissue inside our bones. Bone marrow contains stem cells
that develop into red blood cells, white blood cells, and platelets.
15. Which of the following is the greatest component of plasma?
a. Ions
b. Water
c. Protein
d. NOTA
Answer: B
Rationalization: Plasma is 90 water and makes up more than half of the total blood volume.
II. Essay
a. Illustrate and briefly explain the functions of the coronary arteries. (10 points)
Coronary arteries send blood to the heart muscle. All tissues in the body need oxygen-rich blood to function. The
heart muscle also needs it. And, oxygen-depleted blood must be carried away. The coronary arteries wrap
around the outside of the heart. They send oxygen-rich blood into the heart's muscle tissues. The 2 main
coronary arteries are: the left main coronary artery and the right coronary artery.
1. The formation of blood cells.

2. The composition of blood
3. The role of cardiovascular center.
1. Measuring blood pressure.

2. About the antigens and antibodies
How antibodies fight foreign substances.
Lecture)
DOCTOR OF OPTOMETRY
Session # 11
LESSON TITLE: The Respiratory System Materials:



The Respiratory System
I. Functions of the respiratory system
II. Anatomy of the respiratory system
a. Nose
b. Pharynx
c. Larynx
d. The structures of voice productions
e. Trachea
f. Bronchi
g. Lungs
- Lobes, fissures, and lobules
- Alveoli
- Blood Supply to the lungs
h. Patency of respiratory system
III. Pulmonary ventilation
- Pulmonary Ventilation
- External Respiration
- Internal Respiration
a. Pressure changes during pulmonary ventilation
- Inhalation
- Exhalation
b. Other factors affecting pulmonary ventilation
- Surface tension of alveolar fluid
- Compliance of the lungs
- Airway Resistance
c. Breathing patterns and modified respiratory movements
d. Lung volumes and capacities
IV. Exchange of oxygen and carbon dioxide
a. Gas laws
b. External and internal inspiration
V. Transport of oxygen and carbon dioxide
a. Oxygen transport
- The relationship between Hemoglobin and oxygen partial pressure
- Other factors affecting the affinity of hemoglobin for oxygen
- Oxygen affinity of fetal and adult hemoglobin
b. Carbon dioxide transport
c. Summary of gas exchange and transport in lungs and tissues
VI. Control in breathing
a. Respiratory center
- Medullary respiratory center
- Pontine respiratory group
b. Regulation of respiratory center
- Cortical influences on breathing
- Chemoreceptor regulation of breathing
- Proprioceptor stimulation of breathing
- The inflation reflex
- Other reflexes of breathing
c. Exercise and the respiratory system
VII. Development of the respiratory system

I. Multiple choice
1. Cilia of the trachea that beat continually propel contaminated mucus

A) toward the glottis to be hiccupped out
B) toward the lungs to be encapsulated
C) toward the nose to be sneezed out
D) toward the epiglottis to be coughed out
E) toward the throat to be swallwed or spat out
Answer: E
Rationalization: Mucus produced in the trachea and bronchial tubes to keep air passages moist and aid in
intercepting dust, bacteria and other substances; The sweeping motion of cilia (small hairs in the trachea) to keep air
passages clean. If substances such as cigarette smoke are inhaled, the cilia stop functioning properly.
2. Which one of the following is NOT a function of the paranasal sinuses

A) they are olfactory receptors for smell
B) they produce mucus
C) they lighten the skull
D) they act as resonance chambers for speech
E) they help to moisten air
Answer: A
Rationalization: functions of the paranasal sinuses are lightening the weight of the head, humidifying and heating
inhaled air, increasing the resonance of speech, and serving as a crumple zone to protect vital structures in the
event of facial trauma.
3. The most important chemical stimuli leading to increased rate and depth of breathing is
A) decreased carbon dioxide in the blood
B) increased blood pH
C) increased hydrogen ion in the blood
D) increased carbon dioxide in the blood
E) decreased oxygen level in the blood
Answer: A
Rationalization: The most important factors that modify respiratory rate and depth are chemical- the levels of carbon
dioxide and oxygen in the blood; increased levels of carbon dioxide and decreased blood pH are the most important
stimuli leading to an increase in the rate and depth of breathing
4. Which of the following are currently the most damaging and disabling respiratory diseases in the
U.S.:
A) lung cancer and asthma
B) COPD and lung cancer
C) tuberculosis and pneumonia
D) tuberculosis and COPD
E) asthma and tuberculosis
Answer: B
Rationalization: Both COPD and lung cancer are major worldwide health concerns owing to cigarette smoking, and
represent a huge, worldwide, preventable disease burden. Whilst the majority of smokers will not develop either
COPD or lung cancer, they are closely related diseases, occurring as co-morbidities at a higher rate than if they
were independently triggered by smoking.
5. Hypoventilation dramatically increases carbonic acid concentration and involves

A) extremely slow breathing
B) extremely fast breathing
C) extremely deep breathing
D) intermittent breathing
E) irregular breathing
Answer: A
Rationalization: Hypoventilation: The state in which a reduced amount of air enters the alveoli in the lungs, resulting
in decreased levels of oxygen and increased levels of carbon dioxide in the blood. Hypoventilation can be due to
breathing that is too shallow (hypopnea) or too slow (bradypnea), or to diminished lung function.
6. When oxygen enters the respiratory system, what is the next structure to which it travels
immediately upon leaving the trachea:
A) tertiary bronchi
B) main (primary) bronchi
C) bronchioles
D) pleura
E) alveoli
Answer: B
Rationalization: The air that we breathe in enters the nose or mouth, flows through the throat (pharynx) and voice
box (larynx) and enters the windpipe (trachea). The trachea divides into two hollow tubes called bronchi
7. The respiratory movement representing the total amount of exchangeable air is the
A) inspiratory reserve volume
B) expiratory reserve volume
C) vital capacity
D) dead space volume
E) tidal volume
Answer: C
Rationalization: The vital capacity is defined as the volume of air that an individual can breathe in after forcefully
breathing air out. It is also referred to as the "total amount of exchangeable air".
8. Which one of the following is NOT true of cystic fibrosis:

A) it causes oversecretion of thick mucus that clogs the respiratory passages
B) it is the most common lethal genetic disease in the U.S.
C) it causes sweat glands to produce an extremely salty perspiration
D) it impairs food digestion
E) it is rarely fatal
Answer: E
Rationalization: Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and
other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These
secreted fluids are normally thin and slippery.
9. Which one of the following is NOT a feature of COPD:

A) most patients have a genetic predisposition to COPD
B) most COPD victims are hypoxic
C) dyspnea becomes progressively more severe
D) frequent pulmonary infections are common
E) most patients have a history of smoking
Answer: A
Rationalization: chronic obstructive pulmonary diseases, exemplified by chronic bronchitis and emphysema are a
major cause of death and disability in the United States. These diseases have certain features in common: (1)
Patients almost always have a history of smoking; (2) dyspnea difficult or labored breathing, often referred to as “air
hunger,” occurs and becomes progressively worse; (3) coughing and frequent pulmonary infections are common;
and (4) most COPD victims are hypoxic, retain carbon dioxide and have respiratory acidosis, and ultimately develop
respiratory failure.
10. The molecule that prevents lung collapse by lowering the surface tension of the water film lining
each alveolar sac is called:
A) fibrosin
B) renin
C) surfactant
D) lecithin
E) resorbin
Answer: C
Rationalization: Surfactant greatly reduces the surface tension on the inner surface of the alveoli, thus preventing the
alveoli from collapsing during expiration.
11. The amount of air that can be forcibly exhaled after a tidal expiration is about
A) 6000 mL
B) 2100 mL
C) 500 Ml
D) 4800 mL
E) 1200 mL
Answer:B
Rationalization:
12. Which one of the following is NOT true of inspiration:
A) relaxation of the external intercostal muscles helps increase the size of the thoracic cavity
B) the decreased gas pressure produces a partial vacuum that forcibly sucks air in
C) increased intrapulmonary volume causes inhaled gases to spread out
D) contraction of the diaphragm muscle helps increase the size of the thoracic cavity
E) air continues to move into the lungs until intrapulmonary pressure equals atmospheric pressure
Answer: C
Rationalization: During inspiration, the diaphragm and external intercostal muscles contract, causing the rib cage to
expand and move outward, and expanding the thoracic cavity and lung volume. This creates a lower pressure within
the lung than that of the atmosphere, causing air to be drawn into the lungs.
13. Hyperventilation leads to all of the following EXCEPT

A) dizziness
B) buildup of carbon dioxide in the blood
C) cyanosis
D) brief periods of apnea
E) fainting
Answer: D
Rationalization: Brief periods of apnea leads to hyperventilation.
14. The walls of the alveoli are composed largely of

A) stratified cuboidal epithelium
B) simple cuboidal epithelium
C) stratified squamous epithelium
D) pseudostratified epithelium
E) simple squamous epithelium
Answer: E
Rationalization: The alveolar ducts and alveoli consist primarily of simple squamous epithelium, which permits rapid
diffusion of oxygen and carbon dioxide. Exchange of gases between the air in the lungs and the blood in the capillaries
occurs across the walls of the alveolar ducts and alveoli.
15. In order to inspire:

A) the external intercostal muscles relax
B) the intrapulmonary volume must decrease
C) the intrapulmonary volume must increase
D) the diaphragm relaxes
E) gas pressure in the lungs must increase
Answer: C
Rationalization: As intrapulmonary volume increases, the gases within the lungs spread out to fill the larger space.
The resulting decrease in gas pressure in the lungs produces a partial vacuum (pressure less than atmospheric
pressure outside the body), which causes air to flow into the lungs. Air continues to move into the lungs until the
intrapulmonary pressure equals atmospheric pressure. This series of events is called inspiration (inhalation).
16. Emphysema results in all of the following EXCEPT

A) expanded barrel chest
B) moon face
C) decreased lung elasticity
D) enlarged alveoli
E) lung fibrosis
Answer: B
Rationalization: emphysema, the walls of some alveoli are destroyed, causing the remaining alveoli to be enlarged.
In addition, chronic inflammation promotes fibrosis of the lungs. As the lungs become less elastic, the airways
collapse during expiration and obstruct outflow of air. As a result, these patients use an incredible amount of energy
to exhale, and they are always exhausted. Because air is retained in the lungs, oxygen exchange is surprisingly
efficient, and cyanosis does not usually appear until late in the disease. Consequently, emphysema sufferers are
sometimes referred to as “pink puffers.” However, overinflation of the lungs leads to a permanently expanded barrel
chest.
17. A healthy, 25-year-old medical student participates in a 10-kilometer charity run for the American
Heart Asso- ciation. Which muscles does the student use (contract) during expiration?
A) Diaphragm and external intercostals
B) Diaphragm and internal intercostals
C) Diaphragm only
D) Internal intercostals and abdominal recti
E) Scaleni
F) Sternocleidomastoid muscles
Answer: D
Rationalization: Contraction of the internal intercostals and abdominal recti pull the rib cage downward during
expiration. The abdominal recti and other abdominal muscles compress the abdominal contents upward toward the
diaphragm, which also helps to eliminate air from the lungs. The diaphragm relaxes during expiration. The external
intercostals, sternocleidomastoid muscles, and scaleni increase the diameter of the chest cavity during exercise and
thus assist with inspiration, but only the diaphragm is necessary for inspiration during quiet breathing.
18. Which of the following would be expected to increase the measured airway resistance?
A) Stimulation of parasympathetic nerves to the lungs
B) Low lung volumes
C) Release of histamine by mast cells
D) Forced expirations
E) All of the above
Answer: E
Rationalization: Stimulation of parasympathetic nerves results in a bronchoconstriction.
With low lung volumes a collapse of the airways occurs, leading to decreased diameter and increased resistance.
Histamine is a bronchoconstrictor. Forced exhalations will increase pleural pressure, decreasing airway diameter,
and thus increasing resistance.
19. Several students are trying to see who can generate the highest expiratory flow. Which muscle is
most effective at producing a maximal effort?
A) Diaphragm
B) Internal intercostals
C) External intercostals
D) Rectus abdominis
E) Sternocleidomastoid
Answer: D
Rationalization: The diaphragm and external intercostals are used for inhalation. The sternocleidomastoid is a
muscle in the neck and is not used for inhalation or exhalation. The rectus abdominis and internal intercostals are
used for exhalation. The majority of the force for exhalation is generated by the rectus abdominis.
20. With a slow decrease in left heart function, which of the following will minimize the formation of
pulmonary edema?
A) An increase in plasma protein concentration due to fluid loss
B) Increase in the negative interstitial hydrostatic pressure
C) Increased pumping of lymphatics
D) Increase in the concentration of interstitial proteins
Answer: C
Rationalization: A slow increase in left heart function will lead to a gradual increase in pulmonary capillary pressure, and
thus greater fluid filtration.
Over time there will be an increase in lymphatics and lymphatic pumping to remove the fluid from the interstitial space. With
heart failure there is an increase in fluid retention, and thus no decrease in plasma protein concentration.
An increase in interstitial hydrostatic pressure will result in an increase in edema
An increase in interstitial proteins will cause an increase in interstitial osmotic pressure, leading to an increase in net filtration
pressure and increased filtration.
21. A person with normal lungs has an oxygen (O2) consumption of 750 ml O2/min. The
hemoglobin (Hb) concentration is 15 g/dl. The mixed venous saturation is 25%. What is the
cardiac output?
A) 2500 ml/min
B) 5000 ml/min
C) 7500 ml/min
D) 10,000 ml/min
E) 20,000 ml/min
Answer: B
Rationalization: Arterial content = 15 g/dl × 1.34 ml O2/gm Hb = 20 ml O2/dl (1 dl = 100 ml)
Venous saturation is 25%, so venous content is 20 ml O2/dl × 0.25 = 5 ml O2/dl
Fick's principal is O2 consumption = cardiac output (arterial content − venous content)
750 ml O2/min = cardiac output × (20 ml O2/dl − 5 ml O2/dl)
Cardiac output = (750 ml O2/min)/(15 ml O2/dl) = 5000 ml/min
22. A cardiac catheterization is performed in a healthy adult. The blood sample withdrawn from the
catheter shows 60% O2 saturation, and the pressure recording shows oscillations from a
maximum of 27 mm Hg to a minimum of 12 mm Hg. Where was the catheter tip located?
A) Ductus arteriosus
B) Foramen ovale
C) Left atrium
D) Pulmonary artery
E) Right atrium
Answer: D
Rationalization: The pulmonary artery pressure ranges from 25 systolic to ∼12 to 14 mm Hg diastolic. The right atrial
pressure is ∼0 to 2 mm Hg.
Ductus arteriosus is present in a fetus, not a healthy adult, in the segment that connects the pulmonary artery to the
aorta. Either this is not present in an adult or the pressures would be higher than measured because this is
connected to the aorta. The foramen ovale is a cardiac shunt in the fetal heart from right atrium to left atrium, so
pressures would be very low. The left atrial pressure should be between 1 and 5 mm Hg.
23. A man fell asleep in his running car. He was unconscious when he was brought into the
emergency department. With carbon monoxide (CO) poisoning, you would expect his alveolar
O2 partial pressure (Pao2) would be _______, while his arterial O2 content (Cao2) would be
______.
A) Normal, decreased
B) Decreased, decreased
C) Increased, normal
D) Increased, normal
Answer: A
Rationalization: CO binds to the Hb, displacing the O2 bound to Hb, leading to a decrease in content. The normal
particle pressure of CO is a couple of mm Hg. However, arterial Po2 is a measure of dissolved Po2; therefore, the
Po2 will be normal.
24. An anesthetized man is breathing with no assistance. He then undergoes artificial ventilation for
10 minutes at his normal VT but at twice his normal frequency. He undergoes ventilation with a
gas mixture of 60% O2 and 40% nitrogen. The artificial ventilation is stopped and he fails to
breathe for several minutes. This apneic episode is due to which of the following?
A) High arterial Po2 suppressing the activity of the peripheral chemoreceptors

B) Decrease in arterial pH suppressing the activity of the peripheral chemoreceptors
C) Low arterial Pco2 suppressing the activity of the medullary chemoreceptors
D) High arterial Pco2 suppressing the activity of the medullary chemoreceptors
E) Low arterial Pco2 suppressing the activity of the peripheral chemoreceptors
Answer: E
Rationalization: This patient would have increased Va, therefore resulting in a decrease in arterial Pco2. The effect of
this decrease in Pco2 would be an inhibition of the chemosensitive area and a decrease in ventilation until Pco2 was
back to normal. Breathing high O2 does not decrease nerve activity sufficient to decrease respiration. The response
of peripheral chemoreceptors to CO2 and pH is mild and does not play a major role in the control of respiration.
25. At a fraternity party a 17-year-old male places a paper bag over his mouth and breathes in and
out of the bag. As he continues to breathe into this bag, his rate of breathing continues to
increase. Which of the following is responsible for the increased ventilation?
A) Increased alveolar Po2
B) Increased alveolar Pco2
C) Decreased arterial Pco2
D) Increased pH
Answer: B
Rationalization: In a normal person the alveolar gases are the same as the arterial blood. With rebreathing, the
exhaled CO2 is never removed and continues to accumulate in the bag. This increase in alveolar and thus arterial
Pco2 will be the stimulus for the increased breathing. The alveolar Po2 will be decreased, not increased, with the
decreased Po2 stimulating breathing. A decreased Pco2 will not stimulate ventilation. An increased pH, alkalosis, will
not stimulate ventilation.
1. The structures of voice production.

2. The functions of the respiratory systems
3. About Hyperventilation and apnea.
1. the process of Inspiration

2. About the breathing patterns
Does breathing patterns affect the respiratory?

Lecture)
DOCTOR OF OPTOMETRY
Session # 12
LESSON TITLE: The Digestive System Materials:


5. Identify signs and symptoms associated with the disease Physiology. Glenview, IL. Pearson Education Inc.

The Digestive System
I. Overview of the digestive system
a. Six basic processes in digestive system
- Ingestion
- Secretion
- Mixing and propulsion
- Digestion
- Absorption
- Defecation
II. Peyer's patches associated with the small intestine prevent overwhelming amounts of bacteria from entering the
blood stream Anatomy and histology of the digestive system
III. Layers of the GI tract
a. Mucosa
b. Subcmucosa
c. Muscularis
d. Serosa
IV. Neural Innervation of the GI tract
a. Enteric Nervous System
b. Autonomic Nervous System
c. Gastrointestinal Reflex Pathways
V. Peritoneum
VI. Oral cavity, pharynx and esophagus
a. Mouth
- Salivary Gland
o Composition and functions of saliva
o Salivation
- Tongue
- Teeth
- Mechanical and Chemical Digestion in the Mouth
b. Mastication
c. Pharynx
d. Esophagus
- Histology of the esophagus
- Physiology of the esophagus
e. Deglutition
VII. Stomach
a. Anatomy of the stomach
b. Secretions of the stomach
c. Regulation of stomach secretions
d. Movement in the stomach
VIII. Small intestine
a. Anatomy of the small intestine
b. Movement in the small intestine
c. Absorption in the small intestine
IX. Liver and pancreas
a. Anatomy of the liver
b. Functions of the liver
c. Anatomy of the pancreas
d. Functions of the pancreas
X. Large intestine
a. Anatomy of the large intestine
b. Functions of the large intestine
XI. Phases of digestion
a. Cephalic phase
b. Gastric phase
c. Intestinal phase
d. Other hormones of the digestive system
XII. Digestion, absorption and transport
a. Carbohydrates
b. Lipids

I. Multiple Choice
1. Which one of the following is NOT true of cholesterol
A) only about 15 percent comes from the diet
B) it provides energy fuel for muscle contraction
C) it serves as the structural basis of vitamin D
D) it is a major building block of plasma membranes
E) it serves as the structural basis of steroid hormones
Answer: B
Rationalization: cholesterol is not used as an energy fuel. Instead, it serves as the structural basis of steroid
hormones and vitamin D and is a major building block of plasma membranes. Because we hear so much about
“cutting down our cholesterol intake” in the media, it may be surprising to learn that only about 15 percent of blood
cholesterol comes from the diet.
2. The primary function of the small intestine is

A) absorption of nutrients
B) mineral secretion
C) vitamin conversion
D) waste secretion
E) absorption of water
Answer: A
Rationalization: Nearly all nutrient absorption occurs in the small intestine. The small intestine is well suited for its
function. Its wall has three structures that increase the absorptive surface tremendously— villi, microvilli, and circular
folds.
3. The submucosal and myenteric nerve plexuses that help regulate the mobility and secretory
activity of the GI tract organs are both part of the:
A) fight-or-flight mechanism
B) somatic nervous system
C) central nervous system
D) autonomic nervous system
E) sympathetic nervous system
Answer: D
Rationalization: The alimentary canal wall contains two important intrinsic nerve plexuses—the submucosal nerve
plexus and the myenteric nerve plexus. These networks of nerve fibers are actually part of the autonomic nervous
system. They help regulate the mobility and secretory activity of GI tract organs.
4. Which one of the following is NOT true of the sensors involved in digestive reflexes
A) they respond to stretch of the organ by the volume of food within its lumen
B) they respond to the relative pH content within that particular digestive organ
C) they start reflexes that either activate or inhibit digestive glands
D) they activate or inhibit lacteal absorption
E) they respond to the presence of breakdown products of digestion
Answer: D
Rationalization: The walls of the alimentary canal contain a variety of sensors that help regulate digestive functions.
These include mechanoreceptors, chemoreceptors, and osmoreceptors, which are capable of detecting mechanical,
chemical, and osmotic stimuli, respectively. For example, these receptors can sense when the presence of food has
caused the stomach to expand, whether food particles have been sufficiently broken down, how much liquid is
present, and the type of nutrients in the food (lipids, carbohydrates, and/or proteins). Stimulation of these receptors
provokes an appropriate reflex that furthers the process of digestion. This may entail sending a message that
activates the glands that secrete digestive juices into the lumen, or it may mean the stimulation of muscles within the
alimentary canal, thereby activating peristalsis and segmentation that move food along the intestinal tract.
5. The hereditary inability of tissue cells to metabolize the amino acid phenylalanine, which can
result in brain damage and retardation unless a special diet low in phenylalanine is followed, is
called:
A) tracheoesophageal fistula
B) cystic fibrosis
C) cleft lip
D) phenylketonuria
E) cleft palate
Answer: D
Rationalization: Phenylketonuria is a genetic disorder inherited from a person's parents. It is due to mutations in the
PAH gene, which results in low levels of the enzyme phenylalanine hydroxylase. This results in the buildup of dietary
phenylalanine to potentially toxic levels.
6. Which one of the following represents the correct order through which food passes in the
alimentary canal:
A) mouth, pharynx, esophagus, stomach, large intestine, small intestine
B) pharynx, mouth, esophagus, stomach, large intestine, small intestine
C) mouth, pharynx, esophagus, small intestine, stomach, large intestine
D) mouth, esophagus, pharynx, stomach, small intestine, large intestine
E) mouth, pharynx, esophagus, stomach, small intestine, large intestine
Answer: E
Rationalization: The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus.
The hollow organs that make up the GI tract are the mouth, pharynx, stomach, small intestine, large intestine, and
anus.
7. The enzyme responsible for converting milk protein in the stomach to a substance that looks like
sour milk in infants is:
A) salivary amylase
B) renin
C) bile
D) pancreatic amylase
E) pepsin
Answer: B
Rationalization: renin efficiently converts liquid milk to a semisolid like cottage cheese, allowing it to be retained for
longer periods in the stomach.
8. The small intestine extends from the:

A) pyloric sphincter to the ileocecal valve
B) ileocecal valve to the appendix
C) cardioesophageal sphincter to ileocecal valve
D) appendix to the sigmoid colon
E) cardioesophageal sphincter to the pyloric sphincter
Answer: A
Rationalization: The small intestine extends from the pyloric sphincter to the ileocecal valve, where it empties into the
large intestine. The small intestine finishes the process of digestion, absorbs the nutrients, and passes the residue
on to the large intestine.
9. The sequence of steps by which large food molecules are broken down into their respective
building blocks by catalytic enzymes within hydrolysis reactions is called:
A) mechanical digestion
B) propulsion
C) ingestion
D) absorption
E) chemical digestion
Answer: E
Rationalization: Chemical digestion involves breaking down the food into simpler nutrients that can be used by the
cells. Chemical digestion begins in the mouth when food mixes with saliva. Saliva contains an enzyme (amylase)
that begins the breakdown of carbohydrates.
10. The liver metabolizes fats for all of the following reasons EXCEPT
A) synthesis of lipoproteins
B) synthesis of vitamin K
C) ATP production
D) synthesis of thromboplastin
E) synthesis of cholesterol
Answer: B
Rationalization: Fats are insoluble in blood and water and so the liver produces special, fat-carrying proteins called
lipoproteins. These lipoproteins circulate in the blood, carrying essential fatty acids between the liver and body
tissues. Cholesterol only becomes a problem when it builds up in the body in places it should not be. A healthy liver
ensures that it is transported to tissues where it is needed and away from the tissues where it is not needed and may
cause damage.
11. The hormone responsible for causing the stomach to release pepsinogens, mucus, and
hydrochloric acid is:
A) bile
B) amylase
C) renin
D) gastrin
E) pepsin
Answer: D
Rationalization: Gastrin is a hormone produced by G-cells in the stomach. Gastrin stimulates parietal cells to secrete
acid and also stimulates pepsinogen secretion, stomach motility and blood circulation in gastric vessels.
12. Intrinsic factor in digestion is a stomach secretion needed for absorption of __________ from the
small intestine.
A) vitamin K
B) vitamin B12
C) vitamin C
D) vitamin A
E) vitamin D
Answer: B
Rationalization: Intrinsic factor is a glycoprotein necessary for the absorption of vitamin B12 in the small intestine.
13. When full, the average adult stomach can hold approximately
A) 2 gallons of food
B) 2 liters of food
C) 4 liters of food
D) 3 liters of food
E) 1 liter of food
Answer: C
Rationalization: The human stomach, distended, holds 2 to 4 liters of food.
14. Which one of the following is NOT a modification (which is designed to increase surface area for
absorption) within the small intestine:
A) circular folds
B) plicae circulares
C) microvilli
D) villi
E) Peyerʹs patches
Answer: E
Rationalization: These features, which increase the absorptive surface area of the small intestine more than 600-
fold, include circular folds, villi, and microvilli. The function of the plicae circulares is to increase the amount of
surface area available for the absorption of nutrients.
15. Which one of the following is NOT a main role of the liver
A) to add ammonia to the blood
B) to process nutrients during digestion
C) to detoxify drugs and alcohol
D) to make cholesterol
E) to degrade hormones
Answer: A
Rationalization: Main role in the liver is the production of bile, which helps carry away waste and break down fats in
the small intestine during digestion. Production of certain proteins for blood plasma. Production of cholesterol and
special proteins to help carry fats through the body.
16. Watery stools that result when food residue is rushed through the large intestine before sufficient
water has been reabsorbed, causing dehydration and electrolyte imbalance, is called
constipation. F
17. Optimal health of tissues is achieved when HDL and LDL are present in equal amounts within the
bloodstream. F
18. Diverticulosis occurs when mucosa become inflamed and protrude through the wall of the small
intestine. F
19. Absence of either bile or pancreatic juice indicates that no fat digestion or absorption is occurring.
This can lead to blood-clotting problems because the liver needs vitamin K to make prothrombin. T
20. Small pocketlike sacs within the large intestine that most often are partially contracted are called
haustra. T
21. The enamel found on teeth is heavily mineralized with calcium salts and comprises the hardest
substance within the entire body. T
22. Mass movements are slow-moving contractile waves that move over large areas of the colon
three or four times each day. T
23. Bile is produced by the liver but stored in the gallbladder. T
24. The segment of the colon to which the appendix is attached is the cecum. T
25. Fat metabolism can result in acidosis (ketoacidosis). T
1. Peyer's patches associated with the small intestine prevent overwhelming amounts of bacteria from entering the blood
stream
2. Cholesterol does not fuel energy.
3. Functions of the digestive system
1. More about the role of the liver.

2. Six basic processes in digestive system
What is the use of the increase surface of the small intestine?
Lecture)
DOCTOR OF OPTOMETRY
Session # 13
LESSON TITLE: The Urinary System Materials:



The Urinary System
I. Functions of the kidneys
a. Regulation of blood ionic composition
b. Regulation of blood pH
c. Regulation of blood volume
d. Regulation of blood pressure
e. Maintenance of blood osmolarity
f. Production of hormones
g. Regulation of blood glucose level
h. Excretion of wastes and foreign substances
II. Anatomy of kidneys
a. External anatomy of the kidneys
b. Internal anatomy of the kidneys
- Blood and nerve supply of the kidneys
c. Blood and nerve supply of the kidneys
d. The nephron
- Parts of a neuron
- Histology of nephron and collecting duct
III. Overview of renal physiology
a. Glomerular filtration
b. Tubular reabsorption
c. Tubular secretion
IV. Glomerular filtration
a. The filtration membrane
b. Net filtration pressure
c. Glomerular filtration rate
- Renal autoregulation of GFR
- Neural regulation of GFR
- Hormonal Regulation of GFR
V. Tubular reabsorption and tubular secretion
a. Principles of tubular reabsorption and secretion
- Reabsorption routes
- Transport mechanisms
b. Reabsorption and secretion the proximal convoluted tubule
c. Reabsorption in the nephron loop
d. Reabsorption in the early distal convoluted tubule
e. Reabsorption and secretion in the late distal convoluted tubule
f. Homeostatic regulation of tubular reabsorption and tubular secretion
- Antidiuretic hormone
- Atrial natriuretic
- Parathyroid hormone
VI. Production of dilute and concentrated urine
a. Formation of dilute urine
b. Formation of concentrated urine
VII. Evaluation of kidney function
a. Urinalysis
b. Blood tests
c. Renal plasma clearance
VIII. Urine transportation, storage and elimination
a. Ureters
b. Urinary bladder
c. Urethra
IX. Waste management in other body systems

I. Multiple Choice
1. The noninvasive treatment for kidney stones that uses ultrasound waves to shatter calculi is
called:
A) lithotomy
B) lithotripsy
C) lithiasis
D) lithoscopy
E) lithectomy
Answer: B
Rationalization: Because lithotripsy is noninvasive and highly effective, it is one of the most common treatments for
kidney stones in the United States.
2. Which one of the following is NOT one of the major roles of the kidneys in normal healthy adults:
A) excretion of nitrogen-containing wastes
B) ensuring proper blood pH
C) maintenance of water balance of the blood
D) maintenance of electrolyte balance of the blood
E) conversion of ammonia to bicarbonate ion
Answer: E
Rationalization: the kidneys bear the major responsibility for eliminating nitrogenous (nitrogencontaining) wastes,
toxins, and drugs from the body. the kidneys also regulate blood volume and maintain the proper balance between
water and salts, and between acids and bases.
3. In one 24-hour period, the kidneys of an average-sized healthy adult filter approximately
__________ through their glomeruli into the tubules.
A) 50-75 liters of blood plasma
B) 10-15 liters of blood plasma
C) 100-125 liters of blood plasma
D) 200-240 liters of blood plasma
E) 150-180 liters of blood plasma
Answer: E
Rationalization: GFR is approximately 120 ml per min (180 L per day). Average urine output, on the other hand,
averages only about 1.5 L daily. The reabsorption of 178.5 L requires a sophisticated tubular network.
4. Antidiuretic hormone prevents excessive water loss by promoting water reabsorption in the
A) distal convoluted tubule
B) collecting duct
C) glomerulus
D) proximal convoluted tubule
E) bladder
Answer: B
Rationalization: Antidiuretic hormone binds to receptors on cells in the collecting ducts of the kidney and promotes
reabsorption of water back into the circulation.
5. Control of the voluntary urethral sphincter in normal children is related to

A) hormone regulation
B) nervous system development
C) enzymatic regulation
D) muscular development
E) intelligence
Answer: B
Rationalization: Micturition, or urination, occurs involuntarily in infants and young children until the age of 3 to 5
years, after which it is regulated voluntarily. The neural circuitry that controls this process is complex and highly
distributed: it involves pathways at many levels of the brain, the spinal cord and the peripheral nervous system and
is mediated by multiple neurotransmitters. Diseases or injuries of the nervous system in adults can cause the re-
emergence of involuntary or reflex micturition, leading to urinary incontinence.
6. A simple rule concerning water and electrolyte regulation is:

A) salt actively follows water
B) water passively follows salt
C) salt passively follows water
D) water actively follows salt
E) potassium passively follows sodium
Answer: B
Rationalization: water passively follows salt. This principle is used in maintaining the water - regulation in the body. If
there is too much salt in the body, it needs to be excreted out.
7. Hypospadias is a condition of male children that involves
A) atrophied prostate
B) opening of the urethra on the ventral surface of the penis
C) inflammation of the glomerulus
D) closing of the foreskin over the end of the penis
E) cysts on the kidneys
Answer: B
Rationalization: Hypospadias (pronounced hype-oh-spay-dee-us) is a birth defect in boys where the opening of the
urethra (the tube that carries urine from the bladder to the outside of the body) is not located at the tip of the penis.
8. The results of the renin-angiotensin mechanism mediated by the juxtaglomerular apparatus of the
renal tubules include all of the following EXCEPT:
A) increased peripheral resistance
B) blood pressure increase
C) blood volume increase
D) suppression of aldosterone
E) vasoconstriction
Answer: D
Rationalization: aldosterone is suppressed by sodium loading. Urinary sodium excretion, lithium clearance and
plasma atrial natriuretic peptide increased and plasma renin activity decreased after saline infusion, whether or not
aldosterone was infused.
9. When carbon dioxide enters the blood from tissue cells, it is converted to __________ for
transport within blood plasma.
A) sodium bicarbonate
B) bicarbonate ion
C) carbonic anhydrase
D) sodium hydroxide
E) ammonia
Answer: B
Rationalization: Carbon dioxide can be transported through the blood via three methods. It is dissolved directly in the
blood, bound to plasma proteins or hemoglobin, or converted into bicarbonate.
10. From childhood through late middle age, one of the most common bacteria to infect and inflame
the urinary tract and cause urethritis and cystitis is:
A) streptococcus
B) Clostridium botulinum
C) Escherichia coli
D) staphylococcus
E) Mycobacterium tuberculosis
Answer: C
Rationalization: Escherichia coli is a type of bacteria that normally lives in your intestines. It's also found in the gut of
some animals. Most types of E. coli are harmless and even help keep your digestive tract healthy. But some strains
can cause diarrhea if you eat contaminated food or drink fouled water.
11. The proper pH for the blood is
A) 6.8-6.9
B) 7.0-7.35
C) 7.35-7.45
D) 7.5-8.0
E) 6.5-8.0
Answer: C
Rationalization: The pH scale, ranges from 0 (strongly acidic) to 14 (strongly basic or alkaline). A pH of 7.0, in the
middle of this scale, is neutral. Blood is normally slightly basic, with a normal pH range of about 7.35 to 7.45. Usually
the body maintains the pH of blood close to 7.40.
12. In a healthy young adult female, water accounts for

A) less than one-half of body weight
B) 99% of body weight
C) approximately one-half of body weight
D) three-quarters of body weight
E) one-quarter of body weight
Answer: C
Rationalization: Water accounts for about one half to two thirds of an average person's weight. Fat tissue has a lower
percentage of water than lean tissue and women tend to have more fat, so the percentage of body weight that is
water in the average woman is lower (52 to 55%) than it is in the average man (60%).
13. The voluntarily controlled sphincter fashioned by skeletal muscle at the point where the urethra
passes through the pelvic floor is called the:
A) trigone
B) internal anal sphincter
C) external urethral sphincter
D) detrusor sphincter
E) internal urethral sphincter
Answer: C
Rationalization: A second sphincter, the external urethral sphincter, is fashioned by skeletal muscle as the urethra
passes through the pelvic floor and is voluntarily controlled.
14. Starting from the glomerular capsule, the correct order of the renal tubule regions is
A) proximal convoluted tubule, loop of Henle, distal convoluted tubule
B) distal convoluted tubule, loop of Henle, proximal convoluted tubule
C) distal convoluted tubule, proximal convoluted tubule, loop of Henle
D) loop of Henle, proximal convoluted tubule, distal convoluted tubule
E) proximal convoluted tubule, distal convoluted tubule, loop of Henle
Answer: A
Rationalization: After leaving the renal corpuscle, the filtrate passes through the renal tubule in the following order,
as shown in the diagram:
proximal convoluted tubule (red: found in the renal cortex)
loop of Henle (blue: mostly in the medulla)
distal convoluted tubule (purple: found in the renal cortex)
15. As venous blood is drained from the kidney, which path does it follow
A) cortical radiate veins, arcuate veins, interlobar veins, renal vein
B) arcuate veins, cortical radiate veins, interlobar veins, renal vein
C) renal vein, segmental veins, interlobar veins, arcuate veins, cortical radiate veins
D) renal vein, interlobar veins, segmental veins, arcuate veins
E) cortical radiate veins, arcuate veins, interlobar veins, segmental veins, renal vein
Answer: A
Rationalization: as venous blood is drained from the kidney, which path does it follow: cortical radiate veins > arcuate
veins > interlobar veins > renal vein.
16. After receiving a kidney transplant, a patient has severe hypertension (170/110 mm Hg). A renal
arteriogram indicates severe renal artery stenosis in his single remaining kidney, with a reduction
in glomerular filtration rate (GFR) to 25% of normal. Which of the following changes, compared
with normal, would be expected in this patient, assuming steady-state conditions?
A) A large increase in plasma sodium concentration
B) A reduction in urinary sodium excretion to 25% of normal
C) A reduction in urinary creatinine excretion to 25% of normal
D) An increase in serum creatinine to about four times normal
E) Normal renal blood flow in the stenotic kidney
Answer: D
Rationalization: A severe renal artery stenosis that reduces GRF to 25% of normal would also decrease the renal
blood flow but would cause only a transient decrease in urinary creatinine excretion. The transient decrease in
urinary creatinine excretion would increase serum creatinine ( to about four times normal) , which would restore the
filtered creatinine load to normal and therefore return urinary creatinine to normal levels under steady-state
condition.
17. In normal kidneys, which of the following is true of the osmolarity of renal tubular fluid that flows
through the early distal tubule in the region of the macula densa?
A) Usually isotonic compared with plasma
B) Usually hypotonic compared with plasma
C) Usually hypertonic compared with plasma
D) Hypertonic, compared with plasma, in antidiuresis
Answer: C
Rationalization: As water flows up the ascending limb of the loop of Henle, solutes are reabsorbed, but this segment
is relatively impermeable to water; progressive dilution of the tubular fluid occurs so that the osmolarity decreases to
approximately 100 mOsm/L by the time the fluid reaches the early distal tubule. Even during maximal antidiuresis,
this portion of the renal tubule is relatively impermeable to water and is therefore called the diluting segment of the
renal tubule.
18. A 48-year-old woman reports severe polyuria (producing about 0.5 liter of urine each hour) and
polydipsia (drinking two to three glasses of water every hour). Her urine contains no glucose, and
she is placed on overnight water restriction for further evaluation. The next morning, she is weak
and confused, her sodium concentration is 160 mEq/L, and her urine osmolarity is 80 mOsm/L.
Which of the following is the most likely diagnosis?
A) Diabetes mellitus
B) Diabetes insipidus
C) Primary aldosteronism
D) Renin-secreting tumor
E) Syndrome of inappropriate ADH
Answer: B
Rationalization: The most likely diagnosis for this patient is diabetes insipidus, which can account for the polyuria
and the fact that her urine osmolarity is very low (80 mOsm/L) despite overnight water restriction. In many patients
with diabetes insipidus, the plasma sodium concentration can be maintained relatively close to normal by increasing
fluid intake (polydipsia). When water intake is restricted, however, the high urine flow rate leads to rapid depletion of
extracellular fluid volume and severe hypernatremia, as occurred in this patient. The fact that she has no glucose in
her urine rules out diabetes mellitus. Neither primary aldosteronism nor a renin-secreting tumor would lead to an
inability to concentrate the urine after overnight water restriction. Syndrome of inappropriate antidiuretic hormone
would cause excessive fluid retention and increased urine osmolarity
19. A 22-year-old woman runs a 10-kilometer race on a hot day and becomes dehydrated. Assuming
that her ADH levels are very high and that her kidneys are functioning normally, in which part of
the renal tubule is the most water reabsorbed?
A) Proximal tubule
B) Loop of Henle
C) Distal tubule
D) Cortical collecting tubule
E) Medullary collecting duct
Answer: A
Rationalization: Under normal conditions as well as during antidiuresis, most of the filtered water is reabsorbed in the
proximal tubule (approximately 60% to 65%). Although dehydration markedly increases water permeability in the
cortical and medullary collecting ducts, these segments reabsorb a relatively small (albeit important) fraction of the
filtered water.
20. Which statement is correct?

A) Urea reabsorption in the medullary collecting tubule is less than in the distal convoluted
tubule during antidiuresis
B) Urea concentration in the interstitial fluid of the renal cortex is greater than in the interstitial
fluid of the renal medulla during antidiuresis
C) The thick ascending limb of the loop of Henle reabsorbs more urea than the inner medullary
collecting tubule during antidiuresis
D) Urea reabsorption in the proximal tubule is greater than in the cortical collecting tubule
Answer: D
Rationalization: Approximately 40% to 50% of the filtered urea is reabsorbed in the proximal tubule. The distal
convoluted tubule and the cortical collecting tubules are relatively impermeable to urea, even under conditions of
antidiuresis; therefore, little urea reabsorption takes place in these segments. Likewise, very little urea reabsorption
takes place in the thick ascending limb of the loop of Henle. Under conditions of antidiuresis, the concentration of
urea in the renal medullary interstitial fluid is markedly increased because of reabsorption of urea from the collecting
ducts, which contributes to the hyperosmotic renal medulla.
21. Acute metabolic acidosis tends to _____ intracellular K+ concentration and _____ K+ secretion
by the cortical collecting tubules.
A) Increase, increase
B) Increase, decrease
C) Decrease, increase
D) Decrease, decrease
E) Cause no change in, increase
F) Cause no change in, cause no change in
Answer: D
Rationalization: Acute metabolic acidosis tends to decrease intracellular K+ concentration and decrease K+
secretion. Potassium homeostasis during intermittent ingestion of K+ involves rapid redistribution of K+ into the
intracellular space to minimize increases in extracellular K+ concentration, and ultimate elimination of the K+ load by
renal excretion. Recent years have seen great progress in identifying the transporters and channels involved in renal
and extrarenal K+ homeostasis.
22. Which statement is true?

A) ADH increases water reabsorption from the ascending loop of Henle
B) Water reabsorption from the descending loop of Henle is normally less than that from the
ascending loop of Henle
C) Sodium reabsorption from the ascending loop of Henle is normally less than that from the
descending loop of Henle
D) Osmolarity of fluid in the early distal tubule would be less than 300 mOsm/L in a dehydrated
person with normal kidneys and increased ADH levels
E) ADH decreases the urea permeability in the medullary collecting tubules
Answer: D
Rationalization: In a dehydrated person, osmolarity in the early distal tubule is usually less than 300 mOsm/L
because the ascending limb of the loop of Henle and the early distal tubule are relatively impermeable to water, even
in the presence of ADH. Therefore, the tubular fluid becomes progressively more dilute in these segments,
compared with plasma. ADH does not influence water reabsorption in the ascending limb of the loop of Henle. The
ascending limb, however, reabsorbs sodium to a much greater extent than does the descending limb. Another
important action of ADH is to increase the urea permeability in the medullary collecting ducts, which contributes to
the hyperosmotic renal medullary interstitium in antidiuresis.
23. At which renal tubular sites would the concentration of creatinine be expected to be highest in a
normally hydrated person?
A) The concentration would be the same in all renal tubular segments because creatinine is
neither secreted nor reabsorbed
B) Glomerular filtrate
C) End of the proximal tubule
D) End of the loop of Henle
E) Distal tubule
F) Collecting duct
Answer: F
Rationalization: Because creatinine is not reabsorbed significantly in the renal tubules, the concentration of
creatinine progressively increases as water is reabsorbed along the renal tubular segments. Therefore, in a normally
hydrated person the concentration of creatinine would be greatest in the collecting ducts.
24. The most serious hypokalemia would occur in which condition?

A) Decrease in potassium intake from 150 to 60 mEq/ day
B) Increase in sodium intake from 100 to 200 mEq/ day
C) Fourfold increase in aldosterone secretion plus high sodium intake
D) Fourfold increase in aldosterone secretion plus low sodium intake
E) Addison’s disease
Answer:A
Rationalization: Hypokalemia is a low level of potassium (K+) in the blood serum.
25. Which change would you expect to find in a patient who developed acute renal failure after
ingesting poisonous mushrooms that caused renal tubular necrosis?
A) Increased plasma bicarbonate concentration
B) Metabolic acidosis
C) Decreased plasma potassium concentration
D) Decreased blood urea nitrogen concentration
E) Decreased hydrostatic pressure in Bowman’s capsule
Answer: B
Rationalization: Renal failure can be due to severe dehydration or to specific toxin damage. Metabolic acidosis is a
serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has
three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to
excrete excess acids.
1. Functions of the kidneys

2. Anatomy of kidneys
3. Escherichia coli is a type of bacteria that normally lives in your intestines.
1.About filtration membrane

2. About Net filtration pressure
Is it bad to drink volumes of water that is greater than the intake capacity of human?
Lecture)
DOCTOR OF OPTOMETRY
Session # 14
LESSON TITLE: The Lymphatic System Materials:



I. Lymphatic System Structure and Function
a. Function of the lymphatic System
- Drains excess interstitial fluid
- Transport dietary lipids
- Carries out immune responses
b. Lymphatic Vessels and Lymph Circulation
- Lymphatic Capillaries
- Lymph Trunks and ducts
- Formation and flow of lymph
c. Lymphatic Organs and Tissues
- Thymus
- Lymph nodes
- Spleen
- Lymphatic nodules
II. Lymphatic circulation
III. Development of lymphatic tissues
IV. Innate immunity
a. First line of defense: Skin and mucous membranes
b. Second line of defense: Internal defenses
- Antimicrobial substances
- Natural Killer and phagocytes
- Inflammation
- Fever
V. Adaptive Immunity
a. Maturation of T cells and B cells
b. Types of adaptive immunity
c. Clonal selection: The principle
d. Antigen and Antigen receptors
- Chemical nature of antigens
- Diversity of antigen receptors
e. Major histocompatibility complex antigens
f. Pathways of antigen processing
- Processing of exogenous antigens
- Processing of endogenous antigens
g. Cytokines
VI. Cell-mediated immunity
a. Activation of T-cells
b. Activation and clonal selection of helper T-cells
c. Activation and clonal selection of cytotoxic T-cells
d. Elimination of invaders
e. Immunological surveillance
VII. Antibody-mediated immunity
a. Activation and clonal selection of B cells
b. Antibodies
- Antibody structure
- Antibody action
- Role of the complement systems in Immunity
c. Immunological Immunity

I. Multiple Choice
1. The primary function of the erythrocytes is to ferry oxygen in the blood to all cells of the
body. RBC contains nucleus.
a. First statement is true, second statement is false
b. First statement is false, second statement is true
c. Both are correct
d. Both are incorrect
Answer: A
Rationalization: RBC are involved in oxygen transport through the body and have features that distinguish them from
every other type of human cell. red blood cells contain no nucleus, protein biosynthesis is currently assumed to be
absent in these cells.
2. The leukocytes are anucleated cells and doesn’t contain hemoglobin. The function of the WBC is to defend the body
from foreign invaders.
a. First statement is true, second statement is false
b. First statement is false, second statement is true
c. Both are correct
d. Both are incorrect
Answer:C
Rationalization: WBC flow through your bloodstream to fight viruses, bacteria, and other foreign invaders that
threaten your health. When your body is in distress and a particular area is under attack, white blood cells rush in to
help destroy the harmful substance and prevent illness. White blood cells are made in the bone marrow. White blood
cell, also called leukocyte or white corpuscle, a cellular component of the blood that lacks hemoglobin.
3. What is hemostasis?
a. Sequence of responses that stops bleeding
b. Sequence of blood formation
c. Sequence of iron storage
d. Sequence of heme and globin breakdown
Answer: A
Rationalization: Hemostasis is the natural process that stops blood loss when an injury occurs.
4. The clotting factor that converts fibrinogen to fibrin is:

a. Prothrombin factor
b. Thrombin
c. Prothrombin
d. Von Wildebrand Factor
Answer: B
Rationalization: Thrombin, in turn, catalyzes the conversion of fibrinogen (factor I)—a soluble plasma protein into
long, sticky threads of insoluble fibrin (factor Ia). The fibrin threads form a mesh that traps platelets, blood cells, and
plasma.
5. Which of the following is the first to occur during blood clot formation?
a. Damage to the blood vessel
b. Prothrombin is catalyzed to thrombin
c. Fibrinogen is converted to fibrin threads
d. Formation of platelet plug
Answer: D
Rationalization: Platelet Plug Formation. At the site of vessel injury, platelets stick together to create a plug, which is
the beginning of blood clot formation.
6. The most common manifestation of hemophilic disease is:

a. X-linked recessive gene
b. Pain mimicking appendicitis
c. Weight loss
d. Joint bleeding
Answer: D
Rationalization: Common signs of hemophilia include:
Bleeding into the joints. ...
Bleeding into the skin (which is bruising) or muscle and soft tissue causing a build-up of blood in the area (called a
hematoma).
Bleeding of the mouth and gums, and bleeding that is hard to stop after losing a tooth.
7. A patient with vitamin K deficiency described purplish blotches on her skin which may indicate the presence of:
a. Ecchymosis
b. Melena
c. Purpura
d. Petechiae
Answer: D
Rationalization: Red or purple spots typically appear on the skin (petechiae).
8. Which of the following symptoms are characteristics of thrombocytopenia?

a. Cyanosis, SOB, early fatiguability
b. Nausea, dizziness and blurred vision
c. Severe sore throat, bacteremia
d. Petechiae, ecchymosis, epistaxis
Answer:D
Rationalization: Patients are often asymptomatic
Mucosal bleeding
-may manifest as epistaxis and gingival bleeding, and large bullous hemorrhages may appear on the buccal
mucosa because of the lack of vessel protection by the submucosal tissue.
Cutaneous bleeding
-Petechiae - microhemorrhages
-Purpura - bruise from numerous petechiae
-Ecchymoses - larger lesions from hemorrhage
9. During blood transfusions, the blood type that can be given to recipients of other blood type is:
a. Type A
b. Type B
c. Type AB
d. Type O
Answer: D
Rationalization: In transfusions of packed red blood cells, individuals with type O Rh D negative blood are often
called universal donors.
10. You were observing a blood-typing procedure and noticed that the blood was tested for an Anti-A antibody. This could
mean that
a. The donor is a universal donor
b. The volunteer is universal recipient
c. The volunteer has a blood type A
d. The volunteer has a blood type B
Answer: D
Rationalization: The liquid part of your blood without cells (serum) is mixed with blood that is known to be type A and
type B. People with type A blood have anti-B antibodies. People with type B blood have anti-A antibodies. Type O
blood contains both types of antibodies.
11. Erythroblastosis fetalis can result when:

a. Rh positive mother, Rh negative father leads to Rh positive child
b. Rh negative mother, Rh negative father leads to Rh positive child
c. Rh negative mother, Rh negative father leads to Rh positive child
d. Rh negative mother, Rh negative father leads to Rh negative child
Answer: A
Rationalization: Erythroblastosis fetalis can occur when different Rh factor blood types mix during pregnancy.
Problems can arise even if small amounts of Rh-positive and Rh-negative blood mix.
12. The body’s first line of defense against the invasion of disease-causing microorganisms is:
a. Phagocytes
b. Skin and mucous membranes
c. Natural killer cells
d. Fever
e. Inflammatory response
Answer: B
Rationalization: Skin, tears and mucus are part of the first line of defence in fighting infection. They help to protect us
against invading pathogens.
13. which of these lymphoid organs is found along the left side of the abdominal cavity?
a. Peyer’s patches
b. Axillary lymph nodes
c. Tonsils
d. Thymus gland
e. Spleen
Answer: E
Rationalization: Spleen: the largest lymphatic organ located on the left side of abdominal cavity.it is structurally
identical to lymph nodes, where nodules (containing macrophages and lymphocytes) and sinuses occur.
14. Which one of the following is NOT an autoimmune disease?

a. AIDS
b. Rheumatoid arthritis
c. Type I diabetes mellitus
d. Grave’s disease
e. Multiple sclerosis
Answer: A
Rationalization: AIDS is Acquired Immune Deficiency Syndrome which is the final and most serious stage of HIV
disease, which causes severe damage to the immune system.
15. Which one of the following is NOT true of macrophages?

a. They are considered the “big eaters” of the immune system
b. They engulf foreign particles
c. They circulate continuously throughout the body
d. They secrete monokines
e. They act as antigen presenters
Answer: D
Rationalization: Macrophages are the body's first line of defense and have many roles. A macrophage is the first cell
to recognize and engulf foreign substances. Think of macrophages as cell-eating machines. They are constantly
roaming around, searching for and destroying dead cells and foreign particles that don't belong in the body.
Professional antigen-presenting cells, including macrophages, B cells and dendritic cells, present foreign antigens to
helper T cells, while virus-infected cells (or cancer cells) can present antigens originating inside the cell to cytotoxic T
cells.
1. Macrophages are constantly roaming around, searching for and destroying dead cells and foreign particles that don't
belong in the body.
2. Type O is a universal donor
3. The leukocytes are enucleated cells and doesn’t contain hemoglobin
1. About the lymphatic circulation.

2. About the Antigen and Antigen receptors
Can antibodies fight foreign substances even if it’s weak?
Lecture)
DOCTOR OF OPTOMETRY
Session # 15
LESSON TITLE: The Skeletal System Materials:



The Skeletal System
I. Functions of the skeletal system
II. Extracellular matrix
III. General features of the bone
IV. Bone and calcium homeostasis
V. Joints
a. Joint classifications
b. Fibrous joints
- Sutures
- Syndesmoses
- Interosseous membranes
c. Cartilaginous joints
- Synchondroses
- Symphyses
d. Synovial joints
- Structure of synovial joints
- Nerve and blood supply
- Bursae and tendon sheaths
e. Types of movements at synovial joints
- Gliding
- Angular movements
- Rotation
- Special movements
f. Types of synovial joints
VI. Functions of the muscular system
VII. Characteristics of skeletal muscle
a. Skeletal muscle structure
b. Excitability of muscle fibers
c. Nerve supply and muscle fiber stimulation
d. Muscle contraction
VIII. Energy requirements for muscle contraction
IX. The Skeletal System: Axial Skeleton
a. Skull
b. Hyoid Bone
c. Vertebral column
X. The Skeletal System: Appendicular Skeleton
a. Shoulder girdle
b. Upper limb
c. Pelvic girdle
d. False and true pelvis
e. Comparison of female and male pelvis
f. Lower limb
d. Immunological Immunity

I. Multiple Choice
1. Articulations permitting only slight degrees of movement are __________, whereas articulations permitting no movement
are called __________.
A) amphiarthroses; synarthroses
B) amphiarthroses; diarthroses
C) diarthroses; amphiarthroses
D) diarthroses; synarthroses
E) synarthroses; amphiarthroses
Answer: A
Rationalization: The Articulations or the joints are the structures, where two bones are joined together. In our body
there are three types of articulations: Synarthrosis - The articulations, which do not permit any kind of movements.
Amphiarthrosis - The articulations, which permit a slight movement, generally in a particular direction. Diarthrosis or
synovial joint - The articulations, which permit free movement.
2. The hyoid bone is unique because:

A) it has no specific function
B) it largely consists of cartilage
C) it has an unusual shape
D) it is covered with mucosa
E) it is the only bone of the body that does not directly articulate with any other bone
Answer: E
Rationalization: The hyoid bone is the only bone of the body that does not articulate with any other bone. Its function
is to support the tongue and elevate the larynx when one talks or swallow.
3. The presence of an epiphyseal plate indicates that:

A) bone is dead
B) bone diameter is decreasing
C) bone diameter is increasing
D) bone length is increasing
E) bone length is no longer increasing
Answer: D
Rationalization: The presence of an epiphyseal plate indicates that a person is still growing.
4. A round or oval opening through a bone is a:

A) fossa
B) fissure
C) facet
D) foramen
E) trochanter
Answer: D
Rationalization: A foramen is a round or oval opening through a bone.
5. A fracture that is common in children, whose bones have relatively more collagen in their matrix
and are more flexible than those of adults, is a(n):
A) depressed fracture
B) spiral fracture
C) open fracture
D) impacted fracture
E) greenstick fracture
Answer: E
Rationalization: A greenstick fracture is a fracture in a young, soft bone in which the bone bends and breaks.
Greenstick fractures occur most often during infancy and childhood when bones are soft. The name is by analogy
with green wood which similarly breaks on the outside when bent.
6. The small cavities in bone tissue where osteocytes are found are called:
A) lacunae
B) lamellae
C) trabeculae
D) Volkmannʹs canals
E) Haversian canals
Answer: A
Rationalization: one of the numerous minute cavities in the substance of bone, supposed to contain nucleate cells.
7. The periosteum is secured to the underlying bone by dense connective tissue fibers called:
A) endochondral bone
B) Sharpeyʹs fibers
C) articular cartilage
D) a bony matrix with hyaline cartilage
E) Volkmannʹs canals
Answer: B
Rationalization: The periosteum is secured to the underlying bone by dense connective tissue called perforating
(Sharpey's) fibers. These are comprised of a structure called collagen.
8. Which of the following bone categories is composed of two layers of compact bone sandwiching a
layer of spongy bone between them:
A) flat bone
B) irregular bone
C) compact bone
D) long bone
E) sesamoid bone
Answer: A
Rationalization: Flat bones consist of two layers of compact bone surrounding a layer of spongy bone.
9. There are four stages in the healing of a bone fracture. Which of the following best illustrates the
sequence of these stages:
1. bony callus formation 3. fibrocartilage callus formation
2. bone remodeling 4. hematoma formation
A) 1,3,2,4
B) 4,3,1,2
C) 1,2,3,4
D) 1,3,4,2
E) 4,3,2,1
Answer: B
Rationalization: There are four stages in the repair of a broken bone: 1) the formation of hematoma at the break, 2)
the formation of a fibrocartilaginous callus, 3) the formation of a bony callus, and 4) remodeling and addition of
compact bone.
10. Bone formation can be referred to as:

A) osteoarthritis
B) gout
C) osteoporosis
D) ossification
E) rickets
Answer: D
Ratio: The process of bone formation is called osteogenesis or ossification.
11. The axial skeleton contains:

1. Skull
2. arms and legs
3. ribs and sternum
4. Vertebrae
5. pelvic girdles
A) 1,2,3,5
B) 1,3,4
C) 1,3,4,5
D) 2,5
E) 2,3,4,5
Answer: C
Rationalization: The axial skeleton consists of: the skull, hyoid bones, vertebral column, ribs, and sternum. the
framework that consist of extremities, shoulders, pelvic and gridle.
12. Osteons are characteristic of __________.

A) compact bone
B) articular cartilage
C) yellow marrow
D) spongy bone
E) Sharpeyʹs fibers
Answer: A
Rationalization: Compact bone forms the hard external layer of all bones and surrounds the medullary cavity, or
bone marrow. It provides protection and strength to bones. Compact bone tissue consists of units called osteons or
Haversian systems.
13. Which of the following is an example of a bone that forms from fibrous membranes:
A) the parietal bone
B) the femur
C) the humerus
D) the radius
E) the tibia
Answer: A
Rationalization: The parietal bones are two bones in the skull which, when joined together at a fibrous joint, form the
sides and roof of the cranium. In humans, each bone is roughly quadrilateral in form, and has two surfaces, four borders,
and four angles.
14. Transverse foramina are found in the:
A) lumbar vertebrae
B) thoracic vertebrae
C) cervical vertebrae
D) sacrum
E) coccyx
Answer: C
Rationalization: Transverse foramina are only present in the cervical vertebrae. These foramina allow the passage of
the vertebral artery and vein. The vertebral arteries arise from the first part of the subclavian artery.
15. The factor(s) that determine where bone matrix is to be remodeled is (are):
A) sex hormones
B) stresses of gravity and muscle pull on the skeleton
C) calcium level of the blood
D) growth hormone
E) parathyroid hormone (PTH)
Answer: B
Rationalization: Skeletal muscle cells are particularly sensitive to mechanical stress, or load, which is why exercise
stimulates the growth of these muscles. This sensitivity could also explain why microgravity causes muscles to
atrophy, or waste away. Previous research suggests that skeletal muscle cells have unique ways of detecting
mechanical stress. Scientists believe that the lack of mechanical stress on cells from gravity may decrease tension
in the cell membrane and affect the expression of key proteins and genes, ultimately leading to muscle atrophy.
16. Which of the following is correct of the female pelvis when comparing it with the male pelvis:
A) the distance between the female ischial spines is greater
B) the angle of the female pubic arch is smaller
C) the female pelvis as a whole is deeper, and the bones are heavier and thicker
D) the female iliac bones are less flared
E) the distance between the female ischial tuberosities is less
Answer: A
Rationalization: Compared to the male, the female pelvis is wider to accommodate childbirth. Thus, the female pelvis
has greater distances between the anterior superior iliac spines and between the ischial tuberosities. The greater
width of the female pelvis results in a larger subpubic angle.
17. All of the following facial bones are paired except one. Which of the following is the unpaired?
facial bone:
A) maxillae
B) lacrimal
C) zygomatic
D) palatine
E) vomer
Answer: E
Rationalization: The vomer is a small, thin, plow-shaped, midline bone that occupies and divides the nasal cavity. It
articulates inferiorly on the midline with the maxillae and the palatines, superiorly with the sphenoid via its wings, and
anterosuperior with the ethmoid.
18. The sella turcica is part of the __________ bone.

A) ethmoid
B) parietal
C) frontal
D) sphenoid
E) temporal
Answer: D
Rationalization: The sella turcica is a saddle-shaped depression in the body of the sphenoid bone of the human skull
and of the skulls of other hominids including chimpanzees, orangutans and gorillas. It serves as a cephalometric
landmark.
19. In adults, the function of the yellow marrow is to:

A) decrease friction at joint surfaces
B) store adipose tissue
C) form blood cells
D) store calcium and phosphorus
E) cause lengthwise growth in long bones
Answer: B
Rationalization: Yellow bone marrow contains mesenchymal stem cells (marrow stromal cells), which produce
cartilage, fat and bone. Yellow bone marrow also aids in the storage of fats in cells called adipocytes. This helps
maintain the right environment and provides the sustenance that bones need to function.
20. The sternum is the result of fusion of three bones called the:
A) ischium, ilium, coccyx
B) true ribs, manubrium, xiphoid process
C) manubrium, body, xiphoid process
D) jugular notch, sternal angle, xiphisternal joint
E) pubis, ischium, ilium
Answer: C
Rationalization: The sternum or breastbone is a long flat bone located in the central part of the chest. It connects. Its
three regions are the manubrium, the body, and the xiphoid process.
21. The master gland of the body (pituitary gland) is housed in a saddlelike depression in the
temporal bone called the sella turcica. F
22. Spinal curvatures that are present at birth are called primary curvatures (the cervical and lumbar
curvatures) and those that develop later are secondary curvatures (the thoracic and sacral
curvatures). F
23. Hematopoiesis refers to the formation of blood cells within the red marrow cavities of certain
bones. T
24. Osteoblasts respond to the parathyroid hormone (PTH). F
25. Most of the stress on the vertebral column occurs on the sturdiest vertebrae in the sacral region.F
1. Functions of the skeletal system

2. General features of the bone
3. Joint classifications
1. About synovial joints

2. About the different movements of synovial joints
Can a mature bone be remodeled after an injury?

Lecture)
DOCTOR OF OPTOMETRY
Session # 16
LESSON TITLE: The Muscular System Materials:


The Muscular System
I. Functions of the Muscular system
a. Movement of the body
b. Maintenance of posture
c. Respiration
d. Production of body heat
e. Communication
f. Constrictions of organs and vessels
g. Contraction of the heart
II. Characteristics of Skeletal Muscle
a. Skeletal Muscle Structure
- Connective Tissue Coverings of muscle
- Muscle fiber structure
- Actin and myosin myofilaments
- Sarcomeres
b. Excitability of Muscle Fibers
c. Nerve supply and muscle fiber stimulation
d. Muscle Contraction
- Muscle twitch, summation, tetanus, and recruitment
- Fiber types
e. Energy Requirements for energy for Muscle Contraction
f. Fatigue
- Acidosis and ATP regulation
- Oxidative Stress
- Inflammation
g. Effect of fiber type on activity level
- Types of muscle contractions
- Muscle tone
III. Smooth muscle and Cardiac Muscle
IV. Skeletal Muscle Anatomy
a. General Principles
b. Muscles of the head and neck
- Mastication
- Tongue and Swallowing muscles
- Neck Muscles
c. Trunk muscles
- Muscles moving the vertebral column
- Thoracic muscles
- Abdominal wall muscles
- Pelvic floor and perineal muscles
d. Upper Limb Muscles
- Scapular movements
- Arm movements
- Forearm movements
- Supination and pronation
- Wrist and finger movements
e. Lower limb muscles
- Thigh movements
- Leg movements
- Ankle and toe movements
e. Immunological Immunity

1. Which of the following best describes an attribute of visceral smooth muscle not shared by
skeletal muscle?
A) Contraction is ATP dependent
B) Contracts in response to stretch
C) Does not contain actin filaments
D) High rate of cross-bridge cycling
E) Low maximal force of contraction
Answer: B
Rationalization: Stretch results in depolarization and potentially the generation of action potentials. An important
characteristic of visceral smooth muscle is its ability to contract in response to stretch.
2. A single contraction of skeletal muscle is most likely to be terminated by which of the following
actions?
A) Closure of the postsynaptic nicotinic acetylcholine receptor
B) Removal of acetylcholine from the neuromuscular junction ++
C) Removal of Ca from the terminal of the motor neuron
D) Removal of sarcoplasmic Ca++
E) Return of the dihydropyridine receptor to its resting conformation
Answer: D
Rationalization: Skeletal muscle contraction is tightly regulated by the concentration of Ca++ in the sarcoplasm.
3. The resting potential of a myelinated nerve fiber is primarily dependent on the concentration
gradient of which of the following ions?
A) Ca++
B) Cl−
C) HCO3−
D)K+
E) Na+
Answer: D
Rationalization: the resting membrane potential in nerve cells results primarily from the gradient of K+ ions that is
generated and maintained by the Na+/K+ ATPase. This ATPase plays no direct role in impulse conduction.
4. The delayed onset and prolonged duration of smooth muscle contraction, as well as the greater
force generated by smooth muscle compared with skeletal muscle, are all consequences of
which of the following?
A) Greater amount of myosin filaments present in smooth muscle
B) Higher energy requirement of smooth muscle
C) Physical arrangement of actin and myosin filaments
D) Slower cycling rate of the smooth muscle myosin cross-bridges ++
E) Slower uptake of Ca ions after contraction
Answer: D
Rationalization: The slower cycling rate of the cross-bridges in smooth muscle means that a higher percentage of
possible cross-bridges is active at any point in time. The more active cross-bridges there are, the greater the force
that is generated. Although the relatively slow cycling rate means that it takes longer for the myosin head to attach to
the actin ﬁlament, it also means that the myosin head remains attached longer, prolonging muscle contraction.
Because of the slow cross-bridge cycling rate, smooth muscle actually requires less energy to maintain a contraction
compared with skeletal muscle.
5. Tetanic contraction of a skeletal muscle fiber results from a cumulative increase in the
intracellular concentration of which of the following?
A) ATP
B) Ca++
C) K+
D) Na+
E) Troponin
Answer: B
Rationalization: Muscle contraction is dependent on an elevation of intracellular Ca++ concentration. As the twitch
frequency increases, the initiation of a subsequent twitch can occur before the previous twitch has subsided. As a
result, the amplitude of the individual twitches is summed. At very high twitch frequencies, the muscle exhibits tetanic
contraction. Under these conditions, intracellular Ca++ accumulates and supports sustained maximal contraction.
6. Weight lifting can result in a dramatic increase in skeletal muscle mass. This increase in muscle
mass is primarily attributable to which of the following?
A) Fusion of sarcomeres between adjacent myofibrils
B) Hypertrophy of individual muscle fibers
C) Increase in skeletal muscle blood supply
D) Increase in the number of motor neurons
E) Increase in the number of neuromuscular junctions
Answer: B
Rationalization: Prolonged or repeated maximal contraction results in a concomitant increase in the synthesis of
contractile proteins and an increase in muscle mass. This increase in mass (hypertrophy) is observed at the level of
individual muscle fibers.
7. Smooth muscle that exhibits rhythmical contraction in the absence of external stimuli also
necessarily exhibits which of the following?
A) “Slow” voltage-sensitive Ca++ channels
B) Intrinsic pacemaker wave activity
C) Higher resting cytosolic Ca++ concentration
D) Hyperpolarized membrane potential
E) Action potentials with “plateaus”
Answer: B
Rationalization: Intrinsic pacemaker wave activity is being exhibited in the absence of external stimuli and rhythmical
contraction of smooth muscle.
8. A 17-year-old soccer player sustained a fracture to the left tibia. After her lower leg has been in a
cast for 8 weeks, she is surprised to find that the left gastrocnemius muscle is significantly smaller
in circumference than it was before the fracture. What is the most likely explanation?
A) Decrease in the number of individual muscle fibers in the left gastrocnemius
B) Decrease in blood flow to the muscle caused by constriction from the cast
C) Temporary reduction in actin and myosin protein synthesis
D) Increase in glycolytic activity in the affected muscle
E) Progressive denervation
Answer: C
Rationalization: Skeletal muscle continuously remodels in response to its level of use. When a muscle is inactive for
an extended period, the rate of synthesis of the contractile proteins in individual muscle fibers decreases, resulting in
an overall reduction in muscle mass. This reversible reduction in muscle mass is called atrophy.
9. Smooth muscle contraction is terminated by which of the following?

A) Dephosphorylation of myosin kinase
B) Dephosphorylation of myosin light chain
C) Efflux of Ca++ ions across the plasma membrane
D) Inhibition of myosin phosphatase
E) Uptake of Ca++ ions into the sarcoplasmic reticulum
Answer: B
Rationalization: Dephosphorylation of myosin light chains terminates smooth muscle contraction. Unlike skeletal
muscle, smooth muscle is phosphorylated during its activation, which creates a potential difficulty in that simply
reducing calcium levels will not produce muscle relaxation.
10. A physiology experiment is conducted in which a mo- toneuron that normally innervates a
predominantly fast type II muscle is anastomosed to a predominantly slow type I muscle. Which
of the following is most likely to decrease in the type I muscle after the transin- nervation surgery?
A) Fiber diameter
B) Glycolytic activity
C) Maximum contraction velocity
D) Mitochondrial content
E) Myosin ATPase activity
Answer: D
Rationalization: Mitochondrial content of skeletal muscle varies among fiber types and changes in
complex ways during aging.
11. Neurotransmitters are released upon stimulation from a nerve impulse by the
A) thick filaments
B) motor unit
C) axon terminals of the motor neuron
D) sarcolemma of the muscle cell
E) myofibrils
Answer: C
Rationalization: The presynaptic terminal is an axonal terminal of a motor neuron. The axonal terminal contains a
number of synaptic vesicles. These vesicles contain the neurotransmitters that are released upon receiving a nerve
impulse. The presynaptic terminal also has calcium channels.
12. What type of membrane wraps a fascicle

A) perimysium B) aponeuroses C) tendons D) epimysium E) endomysium
Answer: A
Ratio The endomysium is the connective tissue that surrounds each muscle fiber (cell). The perimysium encircles a
group of muscle fibers, forming a fascicle. The epimysium encircles all the fascicles to form a complete muscle.
13. An elaborate and specialized network of membranes in skeletal muscle cells that function in
calcium storage is the:
A) sarcolemma
B) mitochondria
C) sarcoplasmic reticulum
D) myofibrillar network
E) intermediate filament network
Answer: C
Rationalization: Sarcoplasmic reticulum, intracellular system of closed saclike membranes involved in the storage of
intracellular calcium in striated (skeletal) muscle cells.
14. A sarcomere is:

A) the area between two intercalated discs
B) the nonfunctional unit of skeletal muscle
C) the wavy lines on the cell, as seen in a microscope
D) the contractile unit between two Z discs
E) a compartment in a myofilament
Answer: D
Rationalization: Sarcomeres. are composed of regularly arranged contractile proteins (actin, myosin) that are
responsible for skeletal muscle contraction. Their very regular, orderly arrangement is what gives skeletal muscle
fibers a striated appearance. One sarcomere extends from one Z-line to the next Z-line.
15. The gap between the axon terminal of a motor neuron and the sarcolemma of a skeletal muscle
cell is called the:
A) cross bridge
B) motor unit
C) neuromuscular junction
D) sarcomere
E) synaptic cleft
Answer: E
Rationalization: Synaptic cleft - the space between the axon terminal (synaptic end bulb) and the sarcolemma (motor
end plate) Page 11 Neuromuscular Junction It is the the region formed by the axon terminal of the motor neuron and
the motor end plate of the muscle fiber.
16. Which of these pathways to regenerate ATP during muscle activity is the fastest
A) direct phosphorylation of ADP by creatine phosphate
B) aerobic respiration
C) both aerobic respiration and anaerobic glycolysis
D) oxidative phosphorylation
E) anaerobic glycolysis and lactic acid formation
Answer: E
Rationalization: Anaerobic glycolysis is the transformation of glucose to lactate when limited amounts of oxygen (O2)
are available. When sufficient oxygen is not present in the muscle cells for further oxidation of pyruvate and NADH
produced in glycolysis, NAD+ is regenerated from NADH by reduction of pyruvate to lactate.
17. Which of the following muscles inserts on the calcaneus

A) soleus
B) iliopsoas
C) tibialis anterior
D) sartorius
E) semitendinosus
Answer: A
Rationalization: Three muscles insert on the calcaneus: the gastrocnemius, soleus, and plantaris. These muscles
are part of the posterior compartment of the leg and aid in walking, running and jumping.
18. Which one of the following functions do calcium ions perform during skeletal muscle contraction:
A) release the inhibition on Z discs
B) bind to regulatory proteins on the myosin filaments, changing both their shape and the
position on the thick filaments
C) increase the action potential transmitted along the sarcolemma
D) cause ATP binding to actin
E) expose myosin binding sites on the actin
Answer: E
Rationalization: When Ca2+ binds to troponin, it alters the position of the tropomyosin on the actin filament, exposing
the myosin binding sites (see diagram on next page). When the binding sites are exposed, “myosin heads” on the
myosin filament can then bind to the exposed sites on the actin filament.
19. The striations that give skeletal muscle its characteristic striped appearance are produced, for the
most part, by:
A) a difference in the thickness of the sarcolemma
B) the sarcoplasmic reticulum
C) the arrangement of myofilaments
D) the ʺcockedʺ positions of the heads of the thick filaments
E) the T tubules
Answer: C
Rationalization: Skeletal muscle tissue encompasses a striped or striated appearance. The striations are caused by
the regular course of action of contractile proteins: actin and myosin or myofilaments.
20. Which one of the following muscle actions would NOT be classified as an ISOTONIC contraction:
A) tying your shoe
B) throwing a ball
C) lifting a glass of water to your mouth
D) pushing against a stationary wall
E) writing a letter
Answer: D
Rationalization: In an isotonic contraction, tension remains the same, whilst the muscle's length changes. Hence,
pushing against a stationary wall is not classified.
21. The major function of the sarcoplasmic reticulum in skeletal muscle contraction is to
A) make and store phosphocreatine
B) provide a source of myosin for the contraction process
C) synthesize actin and myosin myofilament
D) regulate intracellular calcium concentration
E) store ATP
Answer: D
Rationalization: Sarcoplasmic reticulum (SR) regulates the cytoplasmic calcium ions (Ca2+) concentration of skeletal
muscle cells, and thereby controls muscular contraction and relaxation. In connection with these functions, the Ca2+
pump mechanism of the SR has been established as the cause of relaxation.
22. Creatine phosphate (CP) functions within the muscle cells by

A) forming a chemical compound with actin
B) storing energy that will be transferred to ATP to resynthesize ADP as needed
C) inducing a conformational change in the myofilaments
D) storing energy that will be transferred to ADP to resynthesize ATP as needed
E) forming a temporary chemical compound with myosin
Answer: B & D
Rationalization: Muscle cells utilize this phosphorylated shape of creatine to store vitality; the phosphate group can be
rapidly exchanged to ADP to recover the ATP vital for muscle compression.
23. Which of the following does not describe cardiac muscle tissue
A) rhythmic contractions
B) involuntary
C) striations
D) uninucleate
E) attached to bones
Answer: E
Rationalization: Cardiac muscle cells are found only in the heart, and are specialized to pump blood powerfully and
efficiently throughout our entire lifetime. Four characteristics define cardiac muscle tissue cells: they are involuntary
and intrinsically controlled, striated, branched, and single nucleated.
24. Which of these events must occur first to trigger the skeletal muscle to generate an action
potential and contract:
A) acetylcholine (ACh) causes temporary permeability to sodium
B) acetylcholinesterase (AchE) breaks down acetylcholine (ACh)
C) diffusion of potassium ions out of the cell
D) sodium ions rush into the cell
E) operation of the sodium-potassium pump
Answer: A
Rationalization: When acetylcholine comes to receptors on the layers of muscle strands, membrane channels open and
the method that contracts a loose muscle filaments starts: Open channels permit an influx of sodium particles into the
cytoplasm of the muscle fiber.
25. Place these structures of the skeletal muscle in order from largest to smallest:
1. fascicle
2. myofilament
3. muscle fiber (cell)
4. myofibril
5. sarcomere
A) 1,3,4,5,2
B) 2,5,4,3,1
C) 1,4,3,2,5
D) 3,1,2,4,5
E) 3,2,5,4,1
Answer: A
Rationalization: Fascicle is the biggest, taken after by the muscle fiber, myofibril, sarcomere and the smallest,
myofilament.
1. Movement of body
2. Maintenance of posture
3. respiration
1. more about sacromeres

2. more about oxidative stress
Can a person be able to change the posture he/she is used to since childhood?

Lecture)
DOCTOR OF OPTOMETRY
Session # 17
LESSON TITLE: The Reproductive System Materials:


The Reproductive System
I. Functions of the reproductive system
II. Formation of gametes
III. Male reproductive system
a. Scrotum
b. Testes
c. Spermatogenesis
d. Ducts
- Epididymis
- Ductus deferens
- Seminal Vesicle
- and Ejaculatory Duct
- Urethra
e. Penis
f. Glands
g. Secretions
IV. Physiology of Male Production
a. Regulation of Reproductive Hormone secretion
b. Puberty in males
c. Effects of testosterone
d. Male sexual behavior and the male sex act
e. Infertility in males
XI. Female Reproduction system
a. Ovaries
b. Oogenesis and Fertilization
- Follicle development
c. Uterine tubes
d. Uterus
e. Vagina
f. External genitalia
g. Mammary glands
XII. Physiology of Female Reproduction
a. Puberty in females
b. Menstrual cycle
c. Menopause
d. Female sexual behavior and the female sex act
e. Infertility in females

I. Multiple Choice
1. A baby is born with a penis, a scrotum with no testes, no vagina, and XX chromosomes. This
condition is referred to as hermaphroditism. What could cause this abnormality?
A) Abnormally high levels of human chorionic gonadotropin (HCG) production by the trophoblast
cells
B) The presence of a testosterone-secreting tumor in the mother’s right adrenal gland
C) Abnormally high levels of LH in the maternal blood
D) Abnormally low levels of testosterone in the maternal blood
E) Abnormally low rates of estrogen production by the placenta
Answer: B
Rationalization: If a genetic female is exposed to testosterone (as might happen if the mother has an androgen-
producing tumor of her adrenal gland), the embryo has ovaries but develops male accessory ducts and glands, as
well as a penis and an empty scrotum. Individuals with external genitalia that do not “match” their gonads are called
pseudohermaphrodites to distinguish them from true hermaphrodites, rare individuals who possess both ovarian and
testicular tissues.
2. A young woman is given daily injections of a substance beginning on the sixteenth day of her
normal menstrual cycle and continuing for 3 weeks. As long as the injections continue, she does
not menstruate. The injected substance could be which of the following?
A) Testosterone
B) FSH
C) An inhibitor of progesterone’s actions
D) A PGE2 inhibitor
E) HCG
Answer: E
Rationalization: The uterine endometrium is still not fully prepared to receive the embryo at this point, so the embryo
floats free in the uterine cavity, temporarily using the uterine secretions for nutrition. While still unattached, the
embryo continues to develop until it has about 100 cells, and then it hollows out to form a ball-like structure called a
blastocyst. At the same time, it secretes an LH like hormone called human chorionic gonadotropin (HCG), which
prods the corpus luteum of the ovary to continue producing its hormones.
3. What accompanies sloughing of the endometrium during the endometrial cycle in a normal
woman?
A) An increase in progesterone
B) The LH “surge”
C) A decrease in both progesterone and estrogen
D) An increase in estradiol
Answer: C
Rationalization: Progesterone prepares the endometrium to receive and nourish a fertilized egg. If pregnancy does
not occur, estrogen and progesterone levels decrease. The decrease in progesterone triggers menstruation, or
shedding of the lining. Once the lining is completely shed, a new menstrual cycle begins.
4. When do progesterone levels rise to their highest point during the female hormonal cycle?
A) Between ovulation and the beginning of menstruation
B) Immediately before ovulation
C) When the blood concentration of LH is at its highest point
D) When 12 primary follicles are developing to the antral stage
Answer: A
Rationalization: During the luteal phase, luteinizing hormone and follicle-stimulating hormone levels decrease. The
ruptured follicle closes after releasing the egg and forms a corpus luteum, which produces progesterone. During
most of this phase, the estrogen level is high. Progesterone and estrogen cause the lining of the uterus to thicken
more, to prepare for possible fertilization. If the egg is not fertilized, the corpus luteum degenerates and no longer
produces progesterone, the estrogen level decreases, the top layers of the lining break down and are shed, and
menstrual bleeding occurs (the start of a new menstrual cycle).
5. During the first few years after menopause, FSH levels are normally extremely high. A
56-year-old woman completed menopause 3 years ago. However, she is found to have low levels
of FSH in her blood. What is the best explanation for this finding?
A) She has been receiving hormone replacement therapy with estrogen and progesterone since
she completed menopause
B) Her adrenal glands continue to produce estrogen
C) Her ovaries continue to secrete estrogen
D) She took birth control pills for 20 years before menopause
Answer: A
Rationalization: HRT stands for hormone replacement therapy. It is also abbreviated as MHT for menopausal
hormone therapy. It consists of the hormone estrogen either alone or combined with the hormone progesterone or
therapy with other drugs such as tibolone. The aim is to replace some of the actions of estrogen that the body has
stopped making at menopause. More importantly, a low FSH level in a woman who is having hot flashes and
changing periods does not eliminate the likelihood that she is still in perimenopause though what is illustrated by the
case the woman's low FSH is cause by the treatment.
6. The primitive stem cell of spermatogenesis, which is found on the periphery of each seminiferous
tubule, is called:
A) primary spermatocyte
B) secondary spermatocyte
C) spermatid
D) sperm
E) spermatogonia
Answer: E
Rationalization: The primitive stem cell of spermatogenesis, which is found on the periphery of each seminiferous
tubule, is called: Spermatogonia.
7. All the organ systems are laid down, at least in rudimentary form, and the embryo looks distinctly
human by the __________ of embryonic development.
A) first week
B) second week
C) fourth week
D) eighth week
E) twelfth week
Answer: D
Rationalization: This week, hands and feet are forming tiny fingers and toes, and those arms are able to flex at the
elbows and wrists. At this point, eyes begin to develop pigment, and genitals are forming too, although it's still too
soon to know whether you're expecting a boy or a girl.
8. Which one of the following is NOT true of the proliferative state of the menstrual cycle
A) it is stimulated by rising estrogen levels
B) the basal layer of the endometrium regenerates
C) endometrial blood supply is increased
D) the endometrium becomes thin and shiny in appearance
E) glands are formed in the endometrium
Answer: D
Rationalization: While the ovaries are working on developing the egg-containing follicles, the uterus is responding to
the estrogen produced by the follicles, rebuilding the lining that was just shed during the last period. This is called
the proliferative phase because the endometrium (the lining of the uterus) becomes thicker. The endometrium is
thinnest during the period, and thickens throughout this phase until ovulation occurs. The uterus does this to create a
place where a potential fertilized egg can implant and grow.
9. Which one of the following is NOT one of the secondary sex characteristics in young women
A) widening and lightening of the pelvis
B) appearance of axillary and pubic hair
C) enlargement of the accessory organs of reproduction
D) decreased fat deposits beneath the skin
E) breast development
Answer: D
Rationalization: secondary sex characteristics are features which appear at puberty. These secondary characteristics
are features such as pubic hair, breast development in females, less pronounced body hair characteristics,lighter
musculature,rounded features,wider hips, more pronounced breasts with more fatty tissue ,more fat tissue overall
and higher voice
10. Which one of the following is NOT one of the secondary sex characteristics typical of males
A) thickening of bones
B) increased growth of body hair
C) deepening voice
D) enlargement of skeletal muscle mass
E) increased sex drive
Answer: E
Rationalization: Testosterone, the hormone responsible for the secondary sexual characteristics that develop in the
male during adolescence, stimulates spermatogenesis. These secondary sex characteristics include a deepening of
the voice, the growth of facial, axillary, and pubic hair, enlargement of skeletal muscle mass and the beginnings of
the sex drive.
11. The entire process of spermatogenesis takes approximately

A) 64-72 days
B) 120 days
C) 25-50 days
D) 15 years
E) 1 year
Answer: A
Rationalization: For humans, the entire process of spermatogenesis is variously estimated as taking 74 days
(according to tritium-labelled biopsies) and approximately 120 days (according to DNA clock measurements).
Including the transport on ductal system, it takes 3 months.
12. The actual ʺsperm-forming factoriesʺ of the male reproductive system that empty sperm into the
rete testes are called the:
A) interstitial cells
B) ductus deferens
C) epididymis
D) seminiferous tubules
E) bulbourethral glands
Answer: D
Rationalization: spermatogenesis occurs in the seminiferous tubules that form the bulk of each testis. The process
begins at puberty, after which time sperm are produced constantly throughout a man's life.
13. Irregular uterine contractions called Braxton Hicks

A) are a symptom of placenta previa
B) signal impending labor
C) are also known as false labor
D) are a symptom of abruptio placenta
E) are a symptom of toxemia
Answer: C
Rationalization: Several events work together to trigger labor. During the last few weeks of pregnancy, estrogens
reach their highest levels in the mother’s blood. This has two important consequences: it causes the myometrium to
form abundant oxytocin receptors (so that it becomes more sensitive to the hormone oxytocin), and it interferes with
progesterone’s quieting influence on the uterine muscle. As a result, weak, irregular uterine contractions begin to
occur. These contractions, called Braxton Hicks contractions, have caused many women to go to the hospital, only to
be told that they were in false labor and sent home.
14. The correct descending order of the male duct system (from inside to outside) is:
A) ejaculatory duct, epididymis, ductus deferens, urethra

B) epididymis, ductus deferens, urethra, ejaculatory duct
C) ductus deferens, epididymis, ejaculatory duct, urethra
D) ejaculatory duct, ductus deferens, epididymis, urethra
E) epididymis, ductus deferens, ejaculatory duct, urethra
Answer: E
Rationalization: Sperm cells pass through a series of ducts to reach the outside of the body. After they leave the
testes, the sperm passes through the epididymis, ductus deferens, ejaculatory duct, and urethra.
15. Which one of the following is NOT true of the spermatic cord
A) it contains nerves
B) it contains blood vessels
C) it encloses the epididymis
D) it is a connective tissue sheath
E) it encloses the ductus deferens
Answer: C
Rationalization: The spermatic cord refers to a collection of vessels, nerves and ducts that run to and from the
testes. They are surrounded by fascia, forming a cord-like structure. The spermatic cord consists of (1) ductus
deferens, (2) cremaster muscle, (3) external spermatic artery, internal spermatic artery, and arteria ductus deferentis,
(4) spermatic nerve, (5) lymph of the spermatic cord, and (6) fascia. It is not enclosed in an epididymis
16. Why is milk produced by a woman only after delivery, not before?
A) Levels of LH and FSH are too low during pregnancy to support milk production
B) High levels of progesterone and estrogen during pregnancy suppress milk production
C) The alveolar cells of the breast do not reach matu- rity until after delivery
D) High levels of oxytocin are required for milk production to begin, and oxytocin is not secreted
until the baby stimulates the nipple
Answer: D
Rationalization: There are two hormones that directly affect breastfeeding: prolactin and oxytocin. A number of other
hormones, such as oestrogen, are involved indirectly in lactation (2). When a baby suckles at the breast, sensory
impulses pass from the nipple to the brain. In response, the anterior lobe of the pituitary gland secretes prolactin and
the posterior lobe secretes oxytocin.
17. A 20-year-old woman is not having menstrual cycles. Her plasma progesterone concentration is
found to be minimal. What is the explanation for the low level of progesterone?
A) LH secretion rate is elevated
B) LH secretion rate is suppressed
C) FSH secretion rate is suppressed
D) No corpus luteum is present
E) High inhibin concentration in the plasma has suppressed progesterone synthesis
Answer: D
Rationalization: The corpus luteum is the only source of progesterone, and if she is not having menstrual cycles no
corpus luteum is present.
18. Men who take large doses of testosterone-like andro- genic steroids for long periods are sterile in
the reproductive sense of the word. What is the explanation for this finding?
A) High levels of androgens bind to testosterone receptors in the Sertoli cells, resulting in
overstimulation of inhibin formation
B) Overstimulation of sperm cell production results in the formation of defective sperm cells
C) High levels of androgen compounds inhibit the secretion of GnRH by the hypothalamus,
resulting in the inhibition of LH and FSH release by the anterior pituitary
D) High levels of androgen compounds produce hy- pertrophic dysfunction of the prostate gland
Answer: C
Rationalization: Testosterone secreted by the testes in response to luteinizing hormone (LH) inhibits hypothalamic
secretion of gonadotropin-releasing hormone (GnRH), thereby inhibiting anterior pituitary secretion of LH and follicle-
stimulating hormone. Taking large doses of testosterone-like steroids also suppresses the secretion of GnRH and
the pituitary gonadotropic hormones, resulting in sterility
19. Birth control pills containing combinations of syn- thetic estrogen and progesterone compounds
that are given for the first 21 days of the menstrual cycle are effective in preventing pregnancy.
What is the explanation for their efficacy?
A) Prevention of the preovulatory surge of LH secretion from the pituitary gland
B) Prevention of development of the ovarian follicles
C) Suppression of the function of the corpus luteum soon after it forms
D) Prevention of normal development of the endometrium
Answer: A
Rationalization: Birth control pills maintain a high concentration of estrogen and progesterone in the bloodstream,
thereby preventing the hormones from peaking mid-cycle and thus blocking the release of FSH and LH from the
pituitary gland and inhibiting ovulation.
20. PTH does what directly?

A) Controls the rate of 25-hydroxycholicalciferol formation
B) Controls the rate of calcium transport in the mucosa of the small intestine
C) Controls the rate of formation of calcium-binding protein
D) Controls the rate of formation of 1,25-dihydroxycholicalciferol
E) Stimulates renal tubular phosphate reabsorption
Answer: D
Rationalization: Parathyroid hormone acts in the renal cortex to stimulate the reaction forming 1,25-
dihydroxycholicalciferol from 25-hydroxycholicalciferol. It has no effects on other the other reactions.
Identification
21. The follicle-cell capsule surrounding an ovulated secondary oocyte is called the Corona Radiata
22. The fibrous ʺwhite coatʺ connective tissue capsule surrounding each testis is called the Tunica albuginea
23. The ligament that anchors the anterior portion of the uterus is called the Round ligament.
24. Another term for the foreskin that is surgically removed during circumcision is the Prepuce.
25. The process of creating female gametes is called Oogenesis
1. Formation of gametes
2. About male reproductive system
3. About female reproductive system
1. about the effects of testosterone

2. Infertility in females
Can a female still give birth after abortion?

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HES 029 ( Human Anatomy and Physiology -

LESSON TITLE: THE HUMAN ORGANISM (Part 1) Materials:

Subject Orientation (30 minutes)

At the end of the semester, the students will be able to:

MAIN LESSON (40 minutes)

Anatomy – the study of the structures of the body

1. Chemical – involves how atoms interact and combine into molecules

11 Organ Systems of Human Body

This document and the information thereon is the property of

Functions of the Cell:

Cell Membrane / Plasma Membrane

Major Molecules Definition / Function(s)

Other Components Definition / Function(s)

This document and the information thereon is the property of

Organelles and Their Functions:

This document and the information thereon is the property of

Make sure to put an emphasis that no

Transport process across the plasma membrane

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 Receptor-Mediated Endocytosis – involves cell receptors attaching to molecules

EXOCYTOSIS The secretion of materials from cells by vesicle formation.

CHECK FOR UNDERSTANDING (25 minutes)

3. All are considered negative feedback mechanism, except:

This document and the information thereon is the property of

7. The mechanism of homeostasis is mainly governed by:

This document and the information thereon is the property of

11. PLASMA MEMBRANE 12. MITOCHONDRION

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Closure Activity (10 minutes)

LESSON WRAP-UP (5 minutes)

AL Activity: CAT: 3-2-1

Three things you learned:

1. Blood rushes near our skin surfaces when temperature is increasing.

Two things that you’d like to learn more about

1. About the changes in our body when temperature is increasing.

One question you still have:

1. How brain gives response or how the stimuli works.

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LESSON TITLE: TISSUES (Part 1) Materials:

LESSON REVIEW 5 minutes)

1. Site of CHON synthesis. Carbohydrates

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MAIN LESSON (40 minutes)

Four Basic Types of Tissues:

General Characteristics of Epithelial Tissue:

Major Functions of Epithelia:

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Types of Simple Epithelium:

Types of Stratified Epithelium:

Structural and Functional Relationships:

2. A smooth, free surface reduces friction.

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Two Types of Glands:

1. Exocrine – with ducts (ex: sweat & oil glands)

Compound Glands multiple, branched ducts (ex: mucous glands of duodenum)

b. Classification according to Shape of Secretory Regions

Acinar / Alveolar sac-like structure

c. Classification according to Type of Secretion

Major Components of Extracellular Matrix:

Functions of Connective Tissue:

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Classification of Connective Tissues: