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					                         Chapter 1 Introduction
1. Homeostasis(B)
   A. refers to the unwavering control of a physiological setpoint.
   B. refers to maintaining a stable internal environment.
   C. refers to maintaining a stable external environment.
   D. A and B.
   E. A and C.
2. The concept of homeostasis(D)
   A.      includes the concept of an error signal.
   B.      refers to maintaining physiological functions in a stable
   C.      refers only to the regulation of body temperature.
   D.      A and B.
   E.      B and C.
3. The most important regulation of body function is:
           A. local regulation
           B. humoral regulation
           C. autoregulation
           D. neuroregulation
           E. none of them
4 . The internal environment is ________________________, including
___________ and _____________________.

                     Chapter 2     Basic Function Cells
 Fill in the blanks with the best choice
1. Diffusion(A)
   A. depends upon the random motion of molecules.
   B.    results in net movement of molecules from regions of low
        concentration to regions of high concentration.
   C.     is important for moving molecules over large distances in the
   D.      A and B.
   E.      A and C.
2. The resting membrane potential(E)
   A.       occurs only in nerve and muscle cells.
   B.       is the same in all cells.
   C.      is oriented so that the cell's interior is positive with respect to
        the extracellular fluid.
   D.       requires the separation of most of the cell's charged particles.
   E.       none of the above.
3. For an action potential to occur,(D)
   A.       the stimulus must reach or exceed threshold.
   B.       Na+ influx must exceed K+ efflux.
   C.       the membrane must be out of the relative refractory period.
   D.       A and B.
   E.       A, B and C.
4. During the rising phase of an action potential,(A)
   A.      Voltage-gated Na+ channels open.
   B.       Voltage-gated K+ channels open.
   C.       Voltage-gated Na+ channels close.
   D.       Voltage-gated K+ channels close.
   E.       A and D.
5. Which of the following statements concerning the rate of action
   potential propagation is true?(D)
   A.       It is faster in large-diameter axons than in small-diameter
   B.       It is faster for a strong stimulus than for a weak one.
   C.       It is faster in myelinated nerve fibres than in non-myelinated
   D.       A and C.
   E.       A, B and C.
6. Thick filaments in skeletal muscle are composed of(B)
   A.      actin.
   B.      myosin.
   C.      troponin.
   D.      calmodulin.
   E.      tropomyosin.
7. During isotonic contraction of a skeletal-muscle fibre the(D)
   A.      sarcomeres shorten.
   B.      A bands shorten.
   C.      I bands shorten.
   D.      A and C.
   E.      B and C.
8. Which of the following statements regarding the shortening of a
   skeletal-muscle fibre is not true? When a skeletal-muscle fibre
   A.      the sarcomeres shorten.
   B.      the distance between Z lines decreases.
   C.      the myofilaments shorten.
   D.      the myofilaments slide past each other.
   E.      the length of the A bands remains the same.
9. In skeletal muscle, calcium facilitates contraction by binding to(C)
   A.      tropomyosin.
   B.      actin.
   C.      troponin.
   D.      myosin.
   E.      the thick filament.
10. Rigor mortis occurs in a dead animal because(A)
   A.      ATP, which is necessary for the detachment of cross bridges,
        is not being formed.
   B.      ATP, which is necessary for the formation of cross bridges, is
        not being formed
   C.       ATP, which is necessary for the formation of cross bridges,
        continues to be formed for several hours after death.
   D.       deterioration of muscle proteins prevents detachment of cross
   E.       none of the above.
11. “Motor unit” refers to(A)
   A.       a single motor neuron plus all the muscle fibres it innervates.
   B.       a single muscle fibre plus all of the motor neurons that
        innervate it.
   C.       all of the motor neurons supplying a single muscle.
   D.       a pair of antagonistic muscles.
   E.       all of the muscles that affect the movement of any given joint.
12. An action potential in the motor end plate rapidly spreads to the
   central portions of a muscle cell by means of the(D)
   A.       Z lines.
   B.       sarcoplasmic reticulum.
   C.       H zone.
   D.       transverse tubules.
   E.       pores in the plasma membrane.
13. During an isometric contraction of a skeletal muscle,(B)
   A.       the I bands shorten and the A bands stay the same length.
   B.       the thick and thin filaments slide past each other.
   C.       sarcomere length does not change.
   D.       A and B.
   E.       none of the above.
14. Which of the following is not true regarding the comparison of type I
   (slow oxidative) and type II b (fast-glycolytic) skeletal-muscle
   A.       Type I fibres have more abundant mitochondria.
   B.       Type I fibres fatigue more readily.
   C.       Type I fibres have more abundant myoglobin.
   D.        Type I fibres have more abundant capillaries.
   E.        Type I motor units contain fewer fibres than type IIb motor
15. Which of the following statements about different kinds of
   skeletal-muscle fibres is true?(C)
   A.        Slow-oxidative fibres have a greater abundance of glycogen
        than do fast-glycolytic fibres.
   B.        Fast-glycolytic fibres have a greater abundance of myoglobin
        than do slow-oxidative fibres.
   C.        Fast-glycolytic fibres can generate greater tension than can
        slow-oxidative fibres.
   D.        A and B.
   E.        A, B and C.
16. Fast-glycolytic muscle fibres differ from slow-oxidative fibres in
   A.        the former rely on creatine phosphate as an ATP source for
        the first few seconds of contraction whereas the latter do not.
   B.        the former have a smaller diameter than the latter.
   C.        the former can generate greater maximal tension than the
   D.        the former generate less lactic acid than do the latter.
   E.        all of the above are true.
17. John is a sprinter who specialises in quick and powerful bursts of
   speed followed by periods of rest. Jim is a marathon runner who
   specializes in long, steady runs. Compared to Jim, John is likely to
   A.        legs with a larger diameter.
   B.        legs with a smaller diameter.
   C.        hypertrophy of type I muscle fibres.
   D.        A and C.
   E.        B and C.
18. The fibres in a muscle spindle(C)
   A.       are not true muscle fibres because they cannot contract.
   B.       are innervated by gamma motor neurons.
   C.       function to maintain tension on spindle receptors.
   D.       B and C.
   E.       A, B and C.
19. Golgi tendon organs(D)
   A.       are located in the tendons joining muscle and bone.
   B.       monitor the strength of muscle contractions.
   C.     are associated with monosynaptic reflexes.
   D.       A and B.
   E.       A, B and C.
20. . The receptor in the end-plate membrane is
   A. M
   B. α
   C. β
   D. N1
   E. N2
21. What can enter the cell by simple diffusion:
   A. Glucose
   B. protain
   C. Ca2+
   D. Na+
   E. CO2
22. IPSP is caused by the ____ influx.
   A. Na+
   B. Ca2+
   C. K+,Na+
   D. Ca2+
   E. Cl-
23. Which is not the physiological characteristic of the receptor:
   A. adequate stimulus
   B. transduction
   C. encoding
   D. adaptation
   E. tiredness
24. Extracellular K+ concentration decreasing causes:
   A. depolarization
   B. repolarization
   C. action potential
   D. hyperpolarization
   E. overshoot
25. Transmission of excitation at neuromuscular junction is mediated by
   ( C ).
   A. epinephrine
   B. norepinephrine
   C. acetylcholine
   D. somatostatin
26. Which component is shared by skeletal muscle and cardiac muscle
   for exitation-contraction coupling ? ( A )
   A. intracellular Ca2+
   B. extracellular Ca2+
   C. intracellular and extracellular Ca2+
   D. Ca2+ in blood
27. Which of the following statements about G protein is correct? ( D )
   A. can bind to ligand directly
   B. there are two subunits
   C. only binds to GTP
   D. active G protein can activate the effector molecules, enzymes or
28. Slow waves in small intestinal smooth muscle cells are ( D ).
   A. phasic contraction
       B. action potential
       C. tonic contraction
       D. fluctuation of membrane potential on RP
 29. The adequate stimulus of the muscle spindle is ( B ).
       A. contraction of the extrafusal muscle
       B. contraction of the intrafusal muscle
       C. relaxation of the extrafusal muscle
       D. relaxation of the intrafusal muscle
     Answer the following using:
     a = becomes more negative
      b = remains the same
      c = becomes more positive
 1. The maximum diastolic potential in a ventricular myocyte ______
 when external [K+] is decreased from 8 to 3 mM. (A)
 2. The maximum diastolic potential in a Purkinje fiber _______ when the
 external [K+] is lowered from 5 to 1 mM. (C)
 3. The maximum diastolic potential in the sinus node ______ when the
 vagus nerve is stimulated. (A)
 4. The maximum diastolic potential of the sinus node action potential
 _______ when the vagus nerve is stimulated. (A)
 5. The overshoot of the sinus node action potential _______ when the
 vagus nerve is stimulated. (A)
 6. The membrane potential of vascular smooth muscle cells ________
 after an increase in Cl- conductance.(C)
 Fill in the blacks
1. Two or more substances connect with a transporter and are transported
     together across the membrane at the same direction, this transport is
     called (symport).
2.    For skeletal muscle cell, the ion with the highest permeability at rest
     which makes greatest contribution to the resting potential is( K+) .
3. In transmission of excitation at neuromuscular junction, the Ca2+ uptake
     of prejunctinal terminal causes (ACh release).
4. The intensity of stimulus can be distinguished by (the frequence) of
     action potential generated on the afferent neuron.
5. The summation of membrane potential caused by successive discharges
     from a single presynaptic terminal is called (temporal summation).
6. The sense organ of the stretch reflex is the (muscle spindle).
7.    The phenomena that a single instantaneous input signal cause a
     sustained signal output usually occurred in (oscillatory) circuit.
8. In the automatic control system, the controlled part send (feedback
     signal) to controlling system to adjust its previous activities.

                                Chapter 3 Blood
 Study Questions
 1. Name the formed elements, and describe the general structure and
 function of each.(p.208)
 2 Describe the life cycle of a red blood cell. What factor controls the
 quantity of blood cell in the cell? (p.208)
 3 State the general function of white blood cells, and categorize the
 different types.(pp.208-12)
 4 What is the function of stem cell in the red bone marrow?(p.212)
 5 Name three plasma proteins, and list a function for each.(p.212)
 6 Draw a diagram of a capillary, illustrating the exchanges that occur in
 the tissues, What forces operate to facilitate exchange of molecules across
 the capillary wall?(p.215)
 7 Name the events that take place after a blood vessel is injured. Which
 substances present in the blood at all times, and which appear during the
 clotting process?(pp.215-16)
 8 Define the terms blood, plasma, tissue fluid, lymph, and serum.(p.216)
 9 What are the four ABO blood types in humans? For each type, list the
 antibodies present in the plasma.(p.217)
 Objective questions
Fill in the blanks
1. The liquid part of blood id called
2. Red blood cells carry
3. hemoglobin that is carrying oxygen is called
4. Human red blood cells lack a                         and only live about
5. the most common granular leukocyte is the                       ,a phagocytic
   white blood cell.
6. B lymphocytes are responsible for                           immunity, and T
   lymphocytes are responsible for                 immunity.
7. At a capillary,             ,            ,and               leave the arterial
   end, and            and                enter the venous end.
8. When a blood clot occurs, fibrinogen has been converted
  to            threads.
9. AB blood has the antigens                  and              on the red blood
   cells and               on the red blood cells and                   of these
   antibodies in the plasma.
10.Hemolytic disease of the newborn can occur when the mother is
   and the father is
11. Blood coagulation refers to the process of conversion of fibrinogen to
Fill in the blanks with the best choice
1 Plasma colloid osmotic pressure mostly depends on:
    A. albumin
    B. globulin
    C. Na+
    D. Cl-
    E. Hb
2 Which blood clotting factor is different from others:
    F. Ⅰ
    G. Ⅱ
    H. Ⅲ
    I. Ⅳ
    J. Ⅴ
3 Affecting factora of venous return:
    a) mean circulatory
    b) no tetanus
    c) dependence on the extrocellular
4    Which one of the following is not triggered by exposed collagen?
    a) vascular constriction
    b) platelet aggregation
    c) activation of the clotting cascade
    d) activation of plasminogen
5    The main source of plasma colloid osmotic pressure is ( D ) .
    a) fibrinogen
    b) α globulin
    c) β globulin
    d) albumin
6    For the true capillary, ( D ) is not true.
    a) the wall is very thin
    b) the permeability is very high
    c) the blood flow is very slow
    d) the resistance to blood flow is very high

                       Chapter 4       Blood Circlation
Study Questions
1. Describe the structure of the heart, including its chambers and
2. Trace the path of blood in the pulmonary circuit, as it travels from and
    returns to the heart.(p.227)
3. Describe the cardiac cycle(using the terms systole and diastole),and
   explain the heart sounds.( pp.228-29)
4. Describe the circulatory disorders that can lead to a heart
5. What types of blood vessels are in the body? Discuss their structure
   and function.(pp.234-36)
6. Trace the path of blood from the mesenteric arteries to the aorta,
   indicating which of the vessels are in the systemic circulation and
   which are in the pulmonary circulation.(pp.236-38)
7. What is blood pressure, and what does 120/80 mean?(pp.244,245)
8. In which type of vessel is blood pressure highest? In which type of
   vessel is it lowest? In which type of vessel is blood velocity lowest
   and why? What factors assist venous return of the blood?(p.245)

Objective Questions
Fill in the blanks.
1. When the left ventricle contracts, blood enters the                     .
2. The right side of the heart pumps blood to the                      .
3. The                    node is known as the pacemaker.
4. Arteries are blood vessels that take blood                 the heart.
5. The blood vessels that sere the heart are the              arteries and veins.
6. The major blood vessels taking blood to the arms are the
          arteries and veins. Those taking blood to the legs are the
arteries and veins.
7. Blood vessels to the brain end in a circular path known as
   the                .
8. The human body contains a hepatic portal system that takes blood
   from the                  to the
9. The    force   of        blood     against   the   walls   of   a       vessels   is
   termed                     .
10. Blood moves in arteries due to                and in veins due to
11. The blood pressure recorded when the left ventricle contracts is called
   the                   pressure, and the pressure recorded when the left
   ventricle relaxes is called the                      pressure.
12. The    two          factors     that       affect     blood     pressure   are
   and              .
13. In the fetus, the opening between the two atria is called
   the                  ,and the connection between the pulmonary artery and
   the aorta is called the                 .
14. The valve between the left atrium and left ventricle is                    the
   or mitral valve.
15. The ratio of the stroke volume to the ventricular end-diastolic volume
is called (ejection fraction ).
16. Cardiac output =_______________________.
17. To the myocardiac working cell, 2 phase is caused by ___________
   and _________.
For each of the following, choose the single best response.
   1. The pacemaker of the heart is normally the(A)
          A.      sinoatrial node.
          B.      atrioventricular node.
          C.      mitral valve.
          D.      bundle of His.
          E.      left ventricle.
   2. In an electrocardiogram, the QRS complex represents the(C)
          A.      depolarisation of the atria.
          B.      repolarisation of the atria.
          C.      depolarisation of the ventricles.
          D.      repolarisation of the ventricles.
          E.      the delay at the AV node..
   3. The aortic valve(B)
          A.      prevents the backflow of blood into the aorta during
               ventricular diastole.
      B.      prevents the backflow of blood into the left ventricle
           during ventricular diastole.
      C.      prevents the backflow of blood into the left ventricle
           during ventricular ejection.
      D.      prevents the backflow of blood into the aorta during
           ventricular ejection.
      E.      closes when the first heart sound is heard.
4. Cardiac output is the(E)
      A.      volume of blood pumped per minute by both ventricles.
      B.      volume of blood flowing through the systemic
           circulation each minute.
      C.      product of the number of heartbeats per minute and the
           volume pumped per beat.
      D.      A and C.
      E.      B and C.
5. During exercise, there is an increased flow of blood to(C)
      A.      the brain.
      B.      the kidneys.
      C.      the skin.
      D.      B and C.
      E.      A, B and C.
6. Which of the following does not contribute to increased stroke
   volume during exercise?(C)
      A.      Increased contractility of cardiac muscle.
      B.      Increased venous return.
      C.      Increased length of filling time during diastole.
      D.      Increased sympathetic stimulation of ventricular muscle.
      E.      Increased end-diastolic volume.
7. The normal pacemaker of the heart is:
      A. atrioventricular note
      B. sinoatrial note
        C. Perkinje cell
        D. ventricular cell
        E. atrial cell
8.    The ventricular pressure reaches the peak in:
        A. isovolurnetric contraction phase
        B. rapid ejection phase
        C. reduced ejection phase
        D. rapid filling phase
        E. reduced filling phase
9.    When cardiac sympathetic nerve is excited:
        A. heart rate↓
        B. contractility↓
        C. conductivity↓
        D. heart rate↑
        E. K+ influx increase
10. The work performed by the left ventricle is substantially greater
     than that performed by the right ventricle because in the left
     ventricle ( D ).
        A. the contraction is slower
        B. the stroke volume is greater
        C. the preload is greater
        D. the afterload is greater
11. When the peripheral resistance increases, the arterial blood
     pressure, especially ( B ) , will be increased.
        A. the systolic pressure
        B. the diastolic pressure
        C. the pulse pressure
        D. the mean pressure
12.Following activation of 1 receptors on ventricular myocytes, all of
     the following would be expected to increase except: (D)
        A. the rate of pressure increase (i.e., dP/dt)
      B. peak systolic pressure within the left ventricle
      C. ejection fraction
      D. end systolic volume
      E. stroke work
13.In a vascular bed in which the arterioles demonstrate pressure
   autoregulation, a decrease in perfusion pressure will result in: (C)
      A. an increase in nitric oxide release by endothelial cells of the
      B. an increase in cytosolic Ca2+ within vascular smooth muscle
          cells of the arteriole
      C. vasodilation of the arteriole
      D. an increase in vascular resistance
      E. both b and d
14.Which of the following conditions will favor interstitial fluid shifts
   into systemic capillaries? (A)
      A. arteriolar vasoconstriction
      B. a decrease in plasma oncotic pressure
      C. hypertension
      D. right heart failure
      E. none of the above
15.During exercise, which of the following is expected to decrease?
      A. heart rate
      B. total peripheral resistance
      C. stroke work
      D. O2 consumption
      E. none of the above will decrease
16.Which of the following would result in an increase in stroke volume?
   (B is the correct answer; this question was thrown out but for
   purpose of grading, all choices are accepted)
      A. hypovolemia
      B. application of propranolol at the sinoatrial node
      C. an increase in total peripheral resistance
      D. an increase in heart rate from 70 to 130 bpm
      E. administration of Verapamil (Ca2+ channel blocker)
17.Which of the following cardiac effects does NOT occur during a
   sympathetic stimulation? (C )
      A. The speed of contraction of a ventricular myocyte increases.
      B. The speed of relaxation of a ventricular myocyte increases.
      C. Intracellular Ca2+ concentrations increase due to a decrease
         in the activity of the Na+/Ca2+ exchanger.
      D. Central venous pressure will decrease.
      E. The membrane potential of a ventricular myocyte during
         phase 2 becomes more positive.
18.Which of the following will enhance vascular tone? ( C )
      A. a Ca2+ channel blocker
      B. a 2 agonist
      C. inositol triphosphate (IP3)
      D. hyperpolarization of cell membrane
      E. none of the above
19.In a blood vessel that displays pressure autoregulation, a decrease
   in perfusion pressure will result in: (B )
      A. constriction of the arteriole.
      B. a decrease in vascular resistance.
      C. release of nitric oxide (NO) from the endothelium.
      D. release of NO from the smooth muscle cells.
      E. both b and c
20.Within vascular smooth muscle, Ca2+ binds to: ( D )
      A. actin.
      B. myosin.
      C. myosin light chain kinase.
      D. calmodulin.
         E. troponin C.
Answer the following using:
   a = increases
   b = remains unchanged
   c = decreases
1. The slope of the diastolic depolarization in the Purkinje fiber ______
when a beta agonist is added to the bathing solution. (A)
2. The duration of the absolute refractory period in a Purkinje fiber
______ if the plateau duration increases by 50 msec. (A)
3. The R-R interval of the EKG ______ when the vagus nerve is
stimulated. (A)
4. The duration of systole ________ following infusion of dobutamine
(1 agonist) into the coronary circulation. (C)
5. Heart rate _______ following infusion of atropine (non-specific
muscarinic antagonist) into the coronary circulation. (A)
6. Assuming no change in cardiac output, central venous pressure
_________ following the development of hypervolemia in mild cases of
congestive heart failure. (A)
7. Assuming no change in cardiac output, central venous pressure
_________ following a decrease in arterial vascular resistance. (A)
8. Vascular smooth muscle tone _______ following an increase in Cl-
conductance across the membranes of smooth muscle cells. (A)
9. Shear rate __________ as the velocity of blood flow decreases. (C)
10. Vascular resistance _______ in cerebral blood vessels following
hyperventilation. (A)
11. Venous return to the right atrium _____ following venoconstriction
of splanchnic veins. (A)
12. Total peripheral resistance ________ following an infusion of a
therapeutic dose of epinephrine. (C)
13. The activity of the sodium-potassium pump in ventricular muscle will

14 . A decrease in the interval between successive heart beats will
__________ the residual volume of the left ventricle. (C)
15 . An increase in preload will __________ velocity of contraction. (A)
16 . Shear rate will __________ as blood flows from the aorta to
arterioles. (C)
17 . Increased filling of the cardiac atria above normal will _________
sodium permeability of the apical membranes of inner medullary principal

                     Chapter 5 The Respiration System
Study Questions
1 What are the four part of respiration? In which of these is oxygen
actually used up and carbon dioxide produced? (p.237)
2 List the parts of the respiratory tract. What are the special functions of
the nasal cavities, larynx, and alveoli? (pp. 273-78)
3 What are steps in inspiration and expiration? How in the breathing rate
controlled? (pp. 278-81)
4 Why is it impossible to breathe through a very long tube? (p.282)
5 what physical process is believed to explain gas exchange? (pp. 282-83)
6 Explain gas exchange for both internal and external respiration? (pp.
7How is carbon dioxide carried in the blood? How is oxygen carried? (pp.
8 Name and describe some infections of the respiratory tract.(285-89)
9What are emphysema and pulmonary fibrosis, and how do they affect a
person’s health? (p.287)
10 What is the most common cause of lung cancer? Why is the incidence
of lung cancer rising among women? (pp. 289-91)
Objective Question
Fill in the blanks
1. In tracing the path of air, the _____ immediately follows the pharynx.
2. The lungs contain air sacs called ________
3. The breathing rate is primarily regulated by the amount
of_____________ in the blood.
4. Air enters the lungs after they have _____________
5. Gas exchange is dependent on the physical process of ___________
6. During external respiration, oxygen _________the blood.
7. During internal respiration, carbon dioxide _________ the blood.
8. carbon dioxide is carried in the blood as ___________ ions.
9. The most likely cause of emphysema and chronic bronchitis is ____
10. Most cases of lung cancer actually begin in the ____________
11. The amount of air moved in and out of the respiratory system with
each normal breath is called the ____________
12. The total amount of air that can be moved in and out of the lungs
during a single breath is called the ____________________
13. The_______closes the opening into the larynx during swallowing.
14. The respiratory membrane consists of the walls of the ____ and
15. Respiratory chemoreceptors in the medulla are mainly responsive to
alteration in arterial (PCO2).
16. The vast majority of carbon dioxide is carried by (HCO3-) in blood.
17. The volume which has to be ventilated but does not participate in gas
exchange is called (dead space).
18 . alveolar ventilation = _____________________________________.
19 . VA/Q =________________________________________.

For each of the following, choose the single best response.
   21.Inhalation/inspiration occurs as a result of(C)
          A.     an upward movement of the diaphragm.
      B.      movement of the ribs closer together due to contraction
           of the inspiratory/inhalatory intercostal muscles.
      C.      a downward movement of the diaphragm.
      D.      A and B.
      E.      B and C.
22.In order for the lungs to function normally, the intrapleural
   pressure must(A)
      A.      be lower than alveolar pressure.
      B.      be between +5 and +10 mmHg above atmospheric
      C.      alternate between being less than and greater than
           atmospheric pressure.
      D.      change as the respiratory demands of the body change.
      E.      be the same as atmospheric pressure.
23.During a physical examination, Joe learns that his resting tidal
   volume is 500 mL; his average resting respiratory rate is 12 breaths
   per minute; his total lung capacity is 6000 mL; and his anatomic
   dead space is 150 mL. Joe's resting alveolar ventilation is(C)
      A.      72.0 L×min-1.
      B.      6.0 L×min-1.
      C.      4.2 L×min-1.
      D.      1.8 L×min-1.
      E.      0.5 L×min-1
24.Oxygen is carried in blood(E)
      A.      bound to haemoglobin.
      B.      dissolved in the plasma.
      C.      dissolved in the cytosol of erythrocytes.
      D.      A and C.
      E.      A, B and C.
25.Which of the following would cause a decrease in the binding
   affinity of haemoglobin for oxygen?(B)
      A.      Increased pH of the blood.
      B.      Increased temperature of the blood.
      C.      Decreased DPG levels in erythrocytes.
      D.      A and B.
      E.      B and C.
26.Most of the CO2 that is transported in blood(D)
      A.      is dissolved in the plasma.
      B.      is bound to hemoglobin.
      C.      is in carbonic acid.
      D.      is in bicarbonate ion.
      E.      is in carbonic anhydrase
27.To alveolar exchange, the most effective respiration is:
      A. slow and deep
      B. slow and shallow
      C. fast and deep
      D. fast and shallow
      E. none of them
28.The residual gas in the lung after normal expriation is:
      A. residual volume
      B. functional residual capacity
      C. inspiratory capacity
      D. timed vital capacity
      E. tidal volume
29.Concerning airflow in the lung, (B)
      A. Flow is more likely to be turbulent in small airways than in
           the trachea
      B. In pure laminar flow, halving the radius of the airway
           increases its resistance sixteen-fold
      C. The higher the Reynolds number, the less likely is turbulence
           to occur
      D. For inspiration to occur, pressure at the mouth must be less
         than alveolar pressure
      E. For expiration to occur, intrapleural pressure must fall
         (become more negative)
30.During resting conditions, for normal expiration to occur, (B)
      A. The alveoli must actively contract
      B. The alveolar pressure must be greater than atmospheric
      C. The diaphragm must forcefully contract
      D. The pressure inside the pulmonary capillaries must fall
      E. There needs to be increased sympathetic stimulation of
         bronchial smooth muscle
31.Some newborn infants lack pulmonary surfactant; therefore, (A)
      A. Their lungs are difficult to inflate
      B. Their work of breathing is reduced due to increased surface
         tension forces
      C. Their lungs are over-inflated
      D. Their lung compliance is increased
      E. Their respiratory muscles atrophy
32.Which of the following cannot be measured with a simple
   spirometer and a stopwatch? (C)
      A. Tidal volume
      B. Vital capacity
      C. Residual volume
      D. FEV1
      E. Breathing frequency
33.Which patient has the highest alveolar ventilation? (D)
      A. Tidal volume = 1000 ml; Frequency = 6 breaths/min; Dead
         space volume = 200 ml
      B. Tidal volume = 500 ml; Frequency = 16 breaths/min; Dead
         space volume = 200 ml
      C. Tidal volume = 350 ml; Frequency = 24 breaths/min; Dead
         space volume = 150 ml
      D. Alveolar ventilation is the same in all cases
34.You plan to climb Mt. Everest (PB = 247 mmHg) but you want to
   have the same PO2 in moist inspired gas on the summit as at sea
   level. What does the O2 concentration of the inspired gas (in %)
   need to be? [Assume the inspired air is saturated with H2O](D)
      A. 33
      B. 55
      C. 67
      D. 75
      E. 86
35.If a climber on the summit of Mt. Everest (PB = 247 mmHg)
   maintains an alveolar PO2 of 37 mmHg and is in a steady state
   (R=1.0), his alveolar PCO2 cannot be any higher than: [Assume the
   inspired air is saturated with H2O] (E)
      A. 15 mmHg
      B. 12 mmHg
      C. 10 mmHg
      D. 8 mmHg
      E. 5 mmHg
36.Which of the following is not true regarding the pulmonary
   circulation as compared to the systemic circulation? (D)
      A. Pulmonary arterial vessels have lower intravasclar pressures
         than those found in systemic arteries
      B. Pulmonary arterial vessels have thinner walls and greater
         internal diameters than corresponding branches of the
         systemic vessels
      C. Pulmonary circulation has the same blood flow per minute
      D. Pulmonary vascular resistance is approximately tenfold
37.When a patient’s lungs are inflated by positive pressure using a
   mechanical ventilator, (C)
      A. The caliber of the extra-alveolar vessels decreases
      B. The caliber of the pulmonary capillaries is increased
      C. The likelihood of zone 1 conditions occurring is increased
      D. Pulmonary vascular resistance decreases
      E. c and d
38.Factors that might lead to a diffusion limitation of oxygen transfer
   across the blood-gas barrier include: (E)
      A. Exercise
      B. High cardiac output
      C. Pulmonary fibrosis
      D. Breathing a 50% oxygen mixture
      E. a, b, and c
39.An increase in which of the following shifts the hemoglobin-oxygen
   dissociation curve to the left? (A)
      A. Oxygen affinity of hemoglobin
      B. H+ concentration
      C. PCO2
      D. Temperature
      E. 2,3-DPG concentration
40.In peripheral capillaries, (B)
      A. CO2 loading is similar to that seen in the lungs
      B. More CO2 can be loaded into the blood because PO2 is
      C. More O2 can be unloaded from the blood when PCO2 is low
      D. More O2 can be unloaded from the blood when pH is
      E. O2 unloading is similar to that seen in the lungs
41.A patient was admitted to the hospital with an acute exacerbation of
   COPD. When given 100% O2, his arterial PCO2 increased from 60
   to 85 mmHg. The most likely causative factor was: (B)
      A. Increased in airway resistance
      B. Depression of ventilation
      C. Hypoxic pulmonary vasoconstriction in poorly ventilated
         areas of the lung
      D. Reduced levels of 2,3-DPG in the blood
      E. Depression of cardiac output
42.During exercise of progressive intensity, (A)
      A. Minute ventilation and CO2 production rise sharply at
         “anaerobic threshold”
      B. Increased minute ventilation reduces PCO2 levels
      C. Oxygen consumption decreases slightly
      D. Blood lactate levels remain constant
      E. a and d
43.At functional residual capacity (end expiration), (D )
      A. the elastic recoil of both the lung and chest wall are directed
      B. the elastic recoil of both the lung and chest wall are directed
      C. the inward directed elastic recoil of the lung is greater than
         that of the outward directed elastic recoil of the chest wall.
      D. the inward directed elastic recoil of the lung balances the
         outward directed elastic recoil of the chest wall.
44.Lung compliance (C )
      A. can only be measured when air is flowing into or out of the
      B. increases in restrictive pulmonary disease (i.e., pulmonary
      C. represents the relationship between changes in the pressure
         distending the alveoli and the corresponding changes in lung
      D. is greatest at high lung volumes.
      E. a, b, and c
45.Airway resistance (C )
      A. is extremely high at low lung volumes because bronchial
         smooth muscle actively contracts at low lung volumes.
      B. is minimized by dynamic compression of the airways.
      C. can only be measured when air is flowing into or out of the
      D. decreases during stimulation of the parasympathetic
         postganglionic fibers innervating the bronchial smooth
      E. is higher in the small airways than in the medium sized
         bronchi because the small airways are arranged in parallel.
46.Which of the following lung volumes can NOT be measured with a
   simple spirometer?(D)
      A. tidal volume
      B. inspiratory reserve volume
      C. expiratory reserve volume
      D. residual volume
47.Which of the following is FALSE regarding diffusion of O2 and
   CO2 in the lungs? (E)
      A. CO2 is approximately 20 times more diffusible than O2.
      B. Under normal conditions, diffusion of both O2 and CO2
         follow a similar time course.
      C. The partial pressure gradient for diffusion of O2 is greater
         than the partial pressure gradient for diffusion of CO2.
      D. If the blood-gas barrier is markedly thickened, diffusion of
         O2 is impaired.
      E. The surface area available for diffusion is reduced during
          exercise due to increased blood flow.
48.Which of the following has the greatest effect on the ability of
   blood to transport oxygen? (B)
      A. capacity of the blood to dissolve oxygen
      B. amount of hemoglobin in the blood
      C. carbon dioxide content of the red blood cells
      D. pH of the plasma
      E. temperature of the blood
49.In peripheral capillaries, more O2 can be unloaded from blood at a
   given PO2 when: (A)
      A. PCO2 is raised.
      B. blood pH is raised.
      C. blood temperature is reduced.
      D. the concentration of 2,3-DPG in the red blood cell is
50.Most of the CO2 in blood is carried as: (D)
      A. physically dissolved.
      B. carbamino compounds with plasma proteins.
      C. carbamino Hb.
      D. bicarbonate ions (HCO ) in the plasma.
      E. bicarbonate ions in red blood cells.
51.The surface tension of the alveoli ( A ).
      A. tends to decrease lung compliance
      B. is increased by the presence of surfactant
      C. tends to increase as alveoli shrink
      D. is the only collapsing force in the lungs
52. The forced expiratory volume in 1 second (FEV 1 ) ( B ).
      A. is likely to be increased in obstructive lung disease
      B. is likely to be reduced in obstructive lung disease
      C. is likely to be normal in restrictive and obstructive lung
         D. is the maximum of air volume which can be expeled
            following a maximal inspiration
   53. Which one of the following statements is false about oxygen
      dissociation curve ( C ).
         A. it describes the relationship between the PO2 and the
            concentration of O2 in blood
         B. is sigmoidal (S-shaped),indicating that saturation in the O2
            -binding in the plateau
         C. is shifted to the right,which means the O2 affinity of
            haemoglobin is increased, which facilitates unloading of O2
         D. is shifted to the left ,which means the O2 affinity of
            haemoglobin is increased, which facilitates loading of O2
   54. Which one of the following is higher at the apex of the lung than
      that at the base when person is standing?( A )
         A. V A /Q ratio
         B. blood flow
         C. ventilation
         D. lung compliance
   55.Which of the following conditions is most likely to shift the
      oxyhemoglobin curve to left? ( D )
         A. increased temperature
         B. excrcise
         C. metabolic acidosis
         D. decrease in 2,3-DPG
  Answer the following using:
   a = increases
   b = remains unchanged
   c = decreases
1. A young man who was previously well was admitted to the emergency
room with barbiturate poisoning that caused severe hypoventilation.
During administration of 100% oxygen to breathe, his arterial PCO2
__________. (B)
2. Within zone 2 of the upright lung, the pressure difference responsible
for blood flow _________ with distance toward the base of the lung. (A)
3. When a bronchodilator is administered to a patient with asthma during
an attack, the FEV1/FVC _______________. (A)
4. At low lung volumes, expiratory flow (as measured on an expiratory
flow-volume curve) __________with increasing expiratory effort. (B)
 5. During an operation, the arterial PCO2 of an anesthetized patient is
monitored. The patient is being ventilated by a mechanical ventilator, and
the initial value is normal (PCO2 = 40 mmHg). When the tidal volume is
increased by 200 mL, PCO2 __________. (C)
6. At low lung volumes, expiratory flow (as measured on an expiratory
flow-volume curve) will _________ with increasing expiratory effort. (B)
7. At high lung volumes, expiratory flow (as measured on an expiratory
flow-volume curve) will __________ with increasing expiratory effort.
8. During an operation, the arterial PCO2 of an anesthetized patient is
monitored. A mechanical ventilator is ventilating the patient, and the
initial value (PCO2 40 mmHg) is normal. If the ventilation is increased,
PCO2 will __________.(C)
9. Recruitment and distension in response to increased pulmonary
arterial or pulmonary venous pressure will __________ pulmonary
vascular resistance.(C)
10. If alveolar pressure is raised during positive pressure ventilation, the
amount of lung functioning under “Zone 1” conditions will _________.
11. The Haldane effect demonstrates that decreased O2 saturation (i.e.,
low PO2) will _________ the CO2 content of the blood.(A)
12. A patient with congenital heart disease has a right-to-left shunt and
an arterial PO2 of 60 mmHg during air breathing. When he is given
100% O2, you would expect his arterial PO2 to __________.(A and B)
13. The magnitude of the ventilatory response to hypoxia will
_________ following an increase in PCO2 from 40 to 50 mmHg. (A)

                      Chapter 6 The Digestive System
Study Questions
1 List the parts of the digestive tract, anatomically describe them, and
state the contribution of each to the digestive process. (pp. 298-303,
2 What is peristalsis, and when does it begin? (p.300)
3 What are gastrin, secretin, and CCK? Where are they secreted? What
are their functions? (p.301)
4 Describe the wall of the small intestine, and explain its role in nutrient
absorption. (p.302)
5 List the accessory organs of digestion, and describe their roles in food
digestion. (p.304)
6 List seven functions of the liver. How dose the liver maintain a constant
blood glucose level? (p.304)
7 What is the common intestinal bacterium? What do these bacteria do
for the body? (pp. 307-08)
8 Give a step-by-step explanation of the digestion of starch, protein, and
fat. (p.310)
Objective Questions
Fill in the blanks
1 In the mouth, salivary ______ digests starch.
2 When we swallow, the _______covers the opening to the larynx.
3 The_______ takes food to the stomach, where______ is primarily
4 The gastric juices are _____ and, therefore, they usually destroy any
bacteria in the food.
5 The large intestine has a colon with four _____ and a(n) _____,which
leads to the ______.
6 The pancreas transports digestive juices to the ______, the first part of
the small intestine.
7 After a meal, the liver stores glucose as_______
8 The gallbladder stores ______, a substance that ______ fat.
9 Pancreatic juice contains ______ and ______ for digesting protein,
______ for digesting fat, and ______ for digesting starch.
10 The products of digestion are absorbed into the cells of the ______,
fing erlike projections of the intestinal wall.
11. The digestion of proteins begins at (stomach).
Fill in the blanks with the best choice
1. Which statement about food emptying velocity is right: (D)
A. protain>fat>sugar B. sugar>fat>protain C. fat>sugar >protein D.
3. The main part of absorption is:
A. stomach B. small intestine C. large intesting D. mouth E. none
of them
4. What factors can promote the gastric juice secretion:
A. Ach B. gastrin C. histamine D. HCl E. fat
Answer the following using:
   a = increase
   b = remain unchanged
   c = decrease
1. During the cephalic phase of acid secretion, the Na+ concentration in
the stomach will __________. (C)
2. During the gastric phase of acid secretion, the C1 - concentration in
the stomach will __________. (A)
3. The diameter of the Sphincter of Oddi will __________ in response
to secretin. (B)
4.   Chief cell secretion of pepsinogen will       _________ as secretin
levels increase in the blood. (A)
5. Segmentation and peristalsis within the small intestine will ________
in the presence of VIP. (C)

                      Chapter 7 The urinary system
Study Questions
1 Name several excretory organs and the substances they excrete. (p.322)
2 List and explain six urinary system functions carried out by the kidneys
3 Describe the macroscopic anatomy of the kidney.(pp.322-23)
4 Name the parts of the nephron, and describe the anatomy of each part.
(pp. 322-24)
5 Name the urinary organs, and describe each organ’s role in eliminating
urine from the body. (pp. 322-24)
6 Describe how urine is made by explaining what happens at each part of
the nephron.(pp.325-27)
7 Explain the following terms: glomerular filtration, tubular reabsorption,
and tubular excretion. (pp. 325-26)
8 What is the composition of urine? (p.327)
9Name three nitrogenous end products and explain how each is formed in
the body. (p.327)
10 Describe how hormones regulate the fluid balance in the body. (pp.
11 How does the nephron regulate the PH of the blood? (p.331)
Objective Questions
Fill in the blanks
1 The lungs are organs of excretion because they rid the body of___
2 The capillary tuft inside the glomerular capsule is called the_____
3 Urine leaves the bladder in the ______
4 ______ is a substance that is found in the filtrate , is reabsorbed, and is
in urine.
5 Tubular secretion takes place at the_____, a portion of the nephron.
6 The primary nitrogenous end product of humans is ______.
7 _____ is a substance that is found in filtrate , is not reabsorbed , and is
concentrated in urine.
8 In addition to excreting nitrogenous wastes, the kidneys adjust the
______, _______and _______balance of the blood.
9 Reabsorption of water from the collecting duct is regulated by the
hormones______ and _______.
10 A ______ is a chemical that can combine with either hydrogen ions or
hydroxide ions, depending on the PH of the solution.
11 The accumulation of uric acid crystals in a joint cavity produce a
condition called _________.
12 Urine is carried from the kidneys to the urinary bladder by a pair of
organs called _____________.
13 The outer granulated layer of the kidneys the renal _____ whereas the
inner striated layer is the renal _________.
14.     The    effective   filtation   pressure    of   glomerular    filtration=
For each of the following, choose the single best response.
1. Which of the following statements is FALSE? (B)
      a. Increased renal sympathetic nerve activity will increase afferent
         arteriolar resistance.
      b. A rise in the systemic plasma [protein] will tend to increase net
         filtration pressure in the glomerulus.
      c. Dilation of the efferent arteriole will tend to reduce filtration
      d. A rise in filtration fraction will increase the net rate of proximal
         tubular Na+ reabsorption
2. Which of the following characteristics of the glomerular capillary wall
is TRUE? (C)
   a. It consists of 2 distinct layers: a basement membrane and a layer of
      epithelial cells called podocytes.
   b. Its permselectivity properties with respect to plasma proteins are
      determined primarily by the fenestrations in the capillary
   c. It is freely permeable to uncharged solutes with MW’s less than
      approximately 5 kD.
   d. Large anionic solutes are more permeable than cationic solutes of
      the same effective molecular radius.
3. Which of the following statements about autoregulation of RBF and
GFR is FALSE?        (B)
   a. Autoregulation is mediated, in part, by a myogenic reflex intrinsic to
      vascular smooth muscle.
   b. An important autoregulatory mechanism involves the effect in
      which increased GFR will result in a substantially increased tubular
   c. Tubuloglomerular feedback contributes to renal autoregulation by
      increasing afferent arteriolar resistance when GFR increases and the
      flow of tubular fluid through Henle’s loop rises.
   d. Renal autoregulation does not prevent changes in RBF in response
      to vasoactive hormones.
4. Which of the following statements about reabsorption in the second
    half of the proximal tubule is FALSE? (D)
   a. The transport of sodium and chloride into the cells involves the
      cycling of organic bases across the apical membrane.
   b. By the time the tubular fluid leaves this segment and enters Henle’s
      loop, tubular fluid flow has been reduced to about 1/3 of the flow
      entering the proximal tubule from Bowman’s space.
   c. The chloride ion concentration in this segment is higher than in
      arterial plasma, owing to the preferential reabsorption of
      bicarbonate in the first part of the proximal tubule.
   d. There is no passive diffusion of ions through the tight junctions
5. Which of the following mechanisms is not significantly involved in
sodium reabsorption in the principal cells in the late distal tubules and
collecting ducts? (C)
   a. Passive sodium diffusion through apical membrane sodium
   b. Active extrusion of sodium from the cell via Na,K-ATPase located
      in the basolateral membrane
   c. Passive sodium diffusion through the tight junctions
   d. There is variable expression of apical membrane cation channels, a
      process controlled by aldosterone.
6. Using the information on the graph shown above, what can you
conclude about the renal handling of this freely filtered substance? (B)
   a. it is subjected to net secretion with a Tm of 300 mg/min.
   b. it is subjected to net reabsorption with a Tm of 300 mg/min.
   c. it is subjected to net reabsorption with a Tm of 3 mg/mL.
   d. it is subjected to net secretion, but the transport is not Tm limited.
7. A person is infused with PAH and, after equilibration, PPAH is 0.02
     mg/mL.      At this time, urine flow is 2 mL/min and UPAH is 3 mg/mL.
     What is renal plasma flow? (B)
   a. 200 mL/min
   b. 300 mL/min
   c. 500 mL/min
   d. 1000 mL/min
8. Which of the following statements is FALSE? (B)
   a. A rise in plasma ADH levels will not influence proximal tubular
      water reabsorption.
   b. A 2% reduction in blood volume will increase ADH secretion.
   c. A rise in plasma osmolarity will lead to an increase in the water
         permeability of apical membranes in principle cells in the collecting
   d. Inhibition of ADH action will reduce urea reabsorption in inner
         medullary collecting ducts.
9. Which of the following statements about renal medullary
countercurrent multiplication is FALSE? (C)
   a. The high concentrations of sodium and chloride in the medullary
         interstitium result from the reabsorption of theses ions by the cells of
         the ascending limb of Henle’s loop.
   b. Countercurrent multiplication does not occur in the vasa recta.
   c. Urea is passively secreted into the tubular fluid along the entire
         length of the ascending limb of Henle’s loop.
   d. When ADH levels are low, the low osmolarity of the excreted urine
         is the result of the transport processes in the ascending limb of
         Henle’s loop.
10. Which of the following statements is FALSE? (A)
   a. An increase in tubular fluid flow in the thick ascending limb will
         tend to increase renin secretion.
   b. Inhibition of angiotensin converting enzyme will tend to reduce
         proximal tubular sodium reabsorption.
   c. Increasing dietary sodium intake from a low to a high level will
         reduce plasma [aldosterone].
   d. An increase in plasma angiotensin II concentration will decrease the
         renal renin secretion rate.
11. Which of the following events would not occur as a result of
doubling sodium chloride intake in a healthy person with free access to
water.     (A)
   a. a 25% rise in plasma sodium concentration
   b. a modest gain in body weight
   c. an increase in extracellular fluid volume
   d. a reduction in plasma renin levels
12. Which of the following statements about potassium transport in
principal cells is FALSE? (B)
   a. High tubular fluid potassium concentrations will retard passive
      potassium diffusion through potassium channels in the apical
   b. Potassium secretion will tend to fall when tubular fluid flow rate
   c. Aldosterone stimulates both potassium secretion and sodium
   d. A rise in plasma potassium concentration will increase potassium
      secretion even when aldosterone levels are constant.
13. Which of the following statements about renal epithelial H+ secretion
is FALSE? (D)
   a. H+ secretion will rise when either plasma bicarbonate concentration
      falls or plasma PCO2 rises.
   b. H+ secretion in the proximal tubule occurs via both a Na+-H+
      antiporter and an H+-ATPase.
   c. H+ secretion into the lumen of the proximal tubule reduces the
      tubular fluid bicarbonate concentration.
   d. A relatively small fraction of the secreted protons are buffered in the
      tubular fluid.
14. AVP can increase the permeability of distal tubule and collecting
tubule to:
   a. K+     b. Ca2+ c. Na+ d. Cl- e. H2O
15. When can absorpted or reabsorpted by contransport:
   a. glucose b. protein c. amino acid       d. fatty acid e. K+
16. What factor can make oxygen dissociation curve right shift :
   a. PCO2↑ b. PO2↓       c. pH↓ d. 2,3-DPG↑ e. T↑
17 . Renal tubule and collecting tubule can secrete:
     a. H+ b. Na+ c. NH3 d. K+ e. Ca2+
18. The proximal tubule ( B ).
     a. reabsorbs water along concentration gradient
     b. reabsorbs glucose and amino acids by the special symports
     c. reabsorbs Cl - by secondary active transport
     d. reabsorbs HCO 3 - by Na- HCO 3 - symport on the luminal
19. According to statement about the formation of high osmolality in
renal medulla,which one is incorrect? ( C )
     a it is relation to passive reabsorption of urea in the inner medullary
     collecting duct
     b. it is relation to passive reabsorption of NaCl in the thin ascending
     loop of Henle
     c. it is relation to active reabsorption of NaCl in the descending loop
     of Henle
     d. it is relation to urea recycling
19. Which of the following is not the principal factor affecting thermal
sweating? ( C )
     a. humidity of the air
     b. wind
     c. psychic activity
     d. muscle activity
20 . The best marker for determination of GFR is ( A ).
     a. inulin
     b. para-aminohippuric acid
     c. endogenous creatinine
     d. urea
Answer the following using:
     a = increases
     b = remains unchanged
     c = decreases
1.     Treatment with an angiotensin-converting enzyme inhibitor will
________ proximal tubular sodium reabsorption.(C)
2. Infusion of HCl will ________ renal ammonia production.(A)
3. Increased flow through the distal tubule during diuretic treatment will
___________ potassium secretion in this segment. (A )
4. Increased excretion of solutes will __________ the excretion of water.
(A )
5. Increased afferent arteriolar resistance will __________ the value of
the filtration fraction. (B)