Anatomy & Physiology

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ISBN-10 1938168135

ISBN-13 978-1-938168-13-0

Revision AP-1-001-DW
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PREFACE
Welcome to Anatomy and Physiology with Concept Coach , an OpenStax resource. We created this textbook with several
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About Concept Coach
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Students will find Concept Coach questions at the end of most non-introductory sections of the web view version of the
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To broaden access and encourage community curation, Anatomy and Physiology is “open source” under a Creative
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About Anatomy and Physiology
Anatomy and Physiology is designed for the two-semester anatomy and physiology course taken by life science and allied
health students. It supports effective teaching and learning, and prepares students for further learning and future careers.
The text focuses on the most important concepts and aims to minimize distracting students with more minor details.
The development choices for this textbook were made with the guidance of hundreds of faculty who are deeply involved
in teaching this course. These choices led to innovations in art, terminology, career orientation, practical applications, and
multimedia-based learning, all with a goal of increasing relevance to students. We strove to make the discipline
meaningful and memorable to students, so that they can draw from it a working knowledge that will enrich their future
studies.
Coverage and Scope
The units of our Anatomy and Physiology textbook adhere to the scope and sequence followed by most two-
semester courses nationwide. 1
Unit 1: Levels of Organization
Chapters 1–4 provide students with a basic understanding of human anatomy and physiology, including its language, the
levels of organization, and the basics of chemistry and cell biology. These chapters provide a foundation for the further
study of the body. They also focus particularly on how the body’s regions, important chemicals, and cells maintain
homeostasis.
Chapter 1 An Introduction to the Human Body
Chapter 2 The Chemical Level of Organization
Chapter 3 The Cellular Level of Organization
Chapter 4 The Tissue Level of Organization
Unit 2: Support and Movement
In Chapters 5–11, students explore the skin, the largest organ of the body, and examine the body’s skeletal and muscular
systems, following a traditional sequence of topics. This unit is the first to walk students through specific systems of the
body, and as it does so, it maintains a focus on homeostasis as well as those diseases and conditions that can disrupt it.
Chapter 5 The Integumentary System
Chapter 6 Bone and Skeletal Tissue
Chapter 7 The Axial Skeleton
Chapter 8 The Appendicular Skeleton
Chapter 9 Joints
Chapter 10 Muscle Tissue
Chapter 11 The Muscular System
Unit 3: Regulation, Integration, and Control
Chapters 12–17 help students answer questions about nervous and endocrine system control and regulation. In a break
with the traditional sequence of topics, the special senses are integrated into the chapter on the somatic nervous system.
The chapter on the neurological examination offers students a unique approach to understanding nervous system function
using five simple but powerful diagnostic tests. Chapter 12 Introduction to the Nervous System
Chapter 13 The Anatomy of the Nervous System
Chapter 14 The Somatic Nervous System
Chapter 15 The Autonomic Nervous System
Chapter 16 The Neurological Exam
Chapter 17 The Endocrine System
Unit 4: Fluids and Transport
In Chapters 18–21, students examine the principal means of transport for materials needed to support the human body,
regulate its internal environment, and provide protection.
Chapter 18 Blood
Chapter 19 The Cardiovascular System: The Heart
Chapter 20 The Cardiovascular System: Blood Vessels and Circulation
Chapter 21 The Lymphatic System and Immunity
Unit 5: Energy, Maintenance, and Environmental Exchange
In Chapters 22–26, students discover the interaction between body systems and the outside environment for the exchange
of materials, the capture of energy, the release of waste, and the overall maintenance of the internal systems that regulate
the exchange. The explanations and illustrations are particularly focused on how structure relates to function. Chapter 22
The Respiratory System
Chapter 23 The Digestive System
Chapter 24 Nutrition and Metabolism
Chapter 25 The Urinary System
Chapter 26 Fluid, Electrolyte, and Acid–Base Balance
Unit 6: Human Development and the Continuity of Life
The closing chapters examine the male and female reproductive systems, describe the process of human development and
the different stages of pregnancy, and end with a review of the mechanisms of inheritance.
Chapter 27 The Reproductive System
Chapter 28 Development and Genetic Inheritance

2
Pedagogical Foundation and Features
Anatomy and Physiology is designed to promote scientific literacy. Throughout the text, you will find features that
engage the students by taking selected topics a step further.
Homeostatic Imbalances discusses the effects and results of imbalances in the body.
Disorders showcases a disorder that is relevant to the body system at hand. This feature may focus on a specific
disorder, or a set of related disorders.
Diseases showcases a disease that is relevant to the body system at hand.
Aging explores the effect aging has on a body’s system and specific disorders that manifest over time.
Career Connections presents information on the various careers often pursued by allied health students, such as
medical technician, medical examiner, and neurophysiologist. Students are introduced to the educational
requirements for and day-to-day responsibilities in these careers.
Everyday Connections tie anatomical and physiological concepts to emerging issues and discuss these in terms
of everyday life. Topics include “Anabolic Steroids” and “The Effect of Second-Hand Tobacco Smoke.”
Interactive Links direct students to online exercises, simulations, animations, and videos to add a fuller context
to core content and help improve understanding of the material. Many features include links to the University of
Michigan’s interactive WebScopes, which allow students to zoom in on micrographs in the collection. These
resources were vetted by reviewers and other subject matter experts to ensure that they are effective and accurate.
We strongly urge students to explore these links, whether viewing a video or inputting data into a simulation, to gain
the fullest experience and to learn how to search for information independently.
Dynamic, Learner-Centered Art
Our unique approach to visuals is designed to emphasize only the components most important in any given illustration.
The art style is particularly aimed at focusing student learning through a powerful blend of traditional depictions and
instructional innovations.
Much of the art in this book consists of black line illustrations. The strongest line is used to highlight the most important
structures, and shading is used to show dimension and shape. Color is used sparingly to highlight and clarify the primary
anatomical or functional point of the illustration. This technique is intended to draw students’ attention to the critical
learning point in the illustration, without distraction from excessive gradients, shadows, and highlights. Full color is used
when the structure or process requires it (for example, muscle diagrams and cardiovascular system illustrations).

By highlighting the most important portions of the illustration, the artwork helps students focus on the most important
points, without overwhelming them.

3
Micrographs
Micrograph magnifications have been calculated based on the objective provided with the image. If a micrograph was
recorded at 40×, and the image was magnified an additional 2×, we calculated the final magnification of the micrograph to
be 80×.
Please note that, when viewing the textbook electronically, the micrograph magnification provided in the text does not
take into account the size and magnification of the screen on your electronic device. There may be some variation.

These glands secrete oils that lubricate and protect the skin. LM × 400. (Micrograph provided by the Regents of
University of Michigan Medical School © 2012)

Learning Resources
The following resources are (or will be) available in addition to main text:
PowerPoint slides: For each chapter, the illustrations are presented, one per slide, with their respective captions.
Pronunciation guide: A subset of the text’s key terms are presented with easy-to-follow phonetic transcriptions. For
example, blastocyst is rendered as “blas'to-sist”

About Our Team

Senior Contributing Authors
J. Gordon Betts Tyler Junior College
Peter Desaix University of North Carolina at Chapel Hill
Eddie Johnson Central Oregon Community College
Jody E. Johnson Arapahoe Community College
Oksana Korol Aims Community College
Dean Kruse Portland Community College
Brandon Poe Springfield Technical Community
College
James A. Wise Hampton University
Mark Womble Youngstown State University
Kelly A. Young California State University, Long Beach
Advisor
Robin J. Heyden
Contributing Authors
Kim Aaronson Aquarius Institute; Triton

4
 College
Lopamudra Augusta Technical College
Agarwal
Gary Allen Dalhousie University
Robert Allison McLennan Community College
Heather Southern Union State
Armbruster Community College
Timothy Ballard University of North Carolina Wilmington
Matthew Barlow Eastern New Mexico University
William Blaker Furman University
Julie Bowers East Tennessee State University
Emily Bradshaw Florida Southern College
Nishi Bryska University of North Carolina, Charlotte
Susan Caley Illinois Valley Community College
Opsal
Boyd Campbell Southwest College of Naturopathic Medicine
and Health Sciences
Ann Caplea Walsh University
Marnie Chapman University of Alaska, Sitka
Barbara Christie-Pope Cornell College
Kenneth Crane Texarkana College
Maurice Culver Florida State College at Jacksonville
Heather Cushman Tacoma Community College
Noelle Cutter Molloy College
Lynnette Danzl-Tauer Rock Valley College
Jane Davis Aurora University
AnnMarie DelliPizzi Dominican College
Susan Dentel Washtenaw Community College
Pamela Dobbins Shelton State Community College
Patty Dolan Pacific Lutheran University
Sondra Dubowsky McLennan Community College
Peter Dukehart Three Rivers Community College
Ellen DuPré Central College
Elizabeth DuPriest Warner Pacific College
Pam Elf University of Minnesota
Sharon Ellerton Queensborough Community College
Carla Endres Utah State University - College of Eastern Utah: San Juan Campus
Myriam Feldman Lake Washington Institute of Technology; Cascadia Community
College
Greg Fitch Avila University
Lynn Gargan Tarant County College
Michael Giangrande Oakland Community College
Chaya Gopalan St. Louis College of Pharmacy
Victor Greco Chattahoochee Technical College
Susanna Heinze Skagit Valley College
Ann Henninger Wartburg College

5
Dale Horeth Tidewater Community College
Michael Hortsch University of Michigan
Rosemary Hubbard Marymount University
Mark Hubley Prince George's Community College
Branko Jablanovic College of Lake County
Norman Johnson University of Massachusetts Amherst
Mark Jonasson North Arkansas College
Jeff Keyte College of Saint Mary

William Kleinelp Middlesex County College

Leigh Kleinert Grand Rapids Community College
Brenda Leady University of Toledo
John Lepri University of North Carolina, Greensboro
Sarah Leupen University of Maryland, Baltimore County
Lihua Liang Johns Hopkins University
Robert Mallet University of North Texas Health
Science Center
Bruce Maring Daytona State College
Elisabeth Martin College of Lake County
Natalie Maxwell Carl Albert State College, Sallisaw
Julie May William Carey University
Debra McLaughlin University of Maryland University
College
Nicholas Mitchell St. Bonaventure University
Shobhana Natarajan Brookhaven College
Phillip Nicotera St. Petersburg College
Mary Jane Niles University of San Francisco
Ikemefuna Nwosu Parkland College; Lake Land College
Betsy Ott Tyler Junior College
Ivan Paul John Wood Community College
Aaron Payette College of Southern Nevada
Scott Payne Kentucky Wesleyan College
Cameron Perkins South Georgia College
David Pfeiffer University of Alaska, Anchorage
Thomas Pilat Illinois Central College
Eileen Preston Tarrant County College
Mike Pyle Olivet Nazarene University
Robert Rawding Gannon University
Jason Schreer State University of New York at Potsdam
Laird Sheldahl Mt. Hood Community College
Brian Shmaefsky Lone Star College System
Douglas Sizemore Bevill State Community College
Susan Spencer Mount Hood Community College
Cynthia Standley University of Arizona
Robert Sullivan Marist College

6
 Eric Sun Middle Georgia State College
Tom Swenson Ithaca College
Kathleen Tallman Azusa Pacific University
Rohinton Tarapore University of Pennsylvania
Elizabeth Tattersall Western Nevada College
Mark Thomas University of Northern Colorado
Janis Thompson Lorain County Community College
Rita Thrasher Pensacola State College
David Van Wylen St. Olaf College
Lynn Wandrey Mott Community College
Margaret Weck St. Louis College of Pharmacy
Kathleen Weiss George Fox University
Neil Westergaard Williston State College
David Wortham West Georgia Technical College
Umesh Yadav University of Texas Medical Branch
Tony Yates Oklahoma Baptist University
Justin York Glendale Community College
Cheri Zao North Idaho College
Elena Zoubina Bridgewater State University; Massasoit
Community College
Shobhana Natarajan Alcon Laboratories, Inc.
Special Thanks
OpenStax wishes to thank the Regents of University of Michigan Medical School for the use of their extensive
micrograph collection. Many of the UM micrographs that appear in Anatomy and Physiology are interactive WebScopes,
which students can explore by zooming in and out.
We also wish to thank the Open Learning Initiative at Carnegie Mellon University, with whom we shared and
exchanged resources during the development of Anatomy and Physiology.

7
 C b. molecule
HAPTER 1 | AN INTRODUCTION TO THE HUMAN BODY 37
c. organ

Chapter 1
d. tissue
9. A collection of similar tissues that performs a specific
function is an ________.
a. organ

Homework b. organelle
c. organism
d. organ system
INTERACTIVE LINK QUESTIONS 10. The body system responsible for structural support and
1. View this animation movement is the ________.
(http://openstaxcollege.org/l/ metabolic) to learn a. cardiovascular system
more about metabolic processes. What kind of catabolism b. endocrine system
occurs in the heart? c. muscular system
2. Water concentration in the body is critical for proper d. skeletal system
functioning. A person’s body retains very tight control on 11. Metabolism can be defined as the ________.
water levels without conscious control by the person. Watch a. adjustment by an organism to external or internal
this video (http://openstaxcollege.org/l/H2Ocon) to changes
learn more about water concentration in the body. Which b. process whereby all unspecialized cells become
organ has primary control over the amount of water in the specialized to perform distinct functions
body? c. process whereby new cells are formed to replace
worn-out cells
3. A CT or CAT scan relies on a circling scanner that
d. sum of all chemical reactions in an organism
revolves around the patient’s body. Watch this video 38 CHAPTER 1 | AN INTRODUCTION TO THE HUMAN BODY
(http://openstaxcollege.org/l/CATscan) to learn
more about CT and CAT scans. What type of radiation does
12. Adenosine triphosphate (ATP) is
a CT scanner use?
an important molecule because it ________.
4. A patient undergoing an MRI is surrounded by a a. is the result of catabolism
tubeshaped scanner. Watch this video b. release energy in uncontrolled bursts
(http://openstaxcollege.org/l/MRI) to learn more c. stores energy for use by body cells
about MRIs. What is the function of magnets in an MRI? d. All of the above
5. PET relies on radioactive substances administered 13. Cancer cells can be characterized as “generic” cells
several minutes before the scan. Watch this video that perform no specialized body function. Thus
(http://openstaxcollege.org/l/PET) to learn more cancer cells lack ________.
about PET. How is PET used in chemotherapy? a. differentiation
REVIEW QUESTIONS b. reproduction
6. Which of the following specialties might focus on c. responsiveness
studying all of the structures of the ankle and foot? d. both reproduction and responsiveness
14. Humans have the most urgent need for a continuous
a. microscopic anatomy supply of ________.
b. muscle anatomy a. food
c. regional anatomy b. nitrogen
d. systemic anatomy c. oxygen
7. A scientist wants to study how the body uses foods and d. water
fluids during a marathon run. This scientist is most 15. Which of the following statements about nutrients is
likely true?
a(n) ________. a. All classes of nutrients are essential to human
a. exercise physiologist survival.
b. microscopic anatomist b. Because the body cannot store any
c. regional physiologist micronutrients, they need to be consumed nearly
d. systemic anatomist every day.
8. The smallest independently functioning unit of an c. Carbohydrates, lipids, and
organism is a(n) ________. proteins are micronutrients.
a. cell d. Macronutrients are vitamins and minerals.

8
16. C.J. is stuck in her car during a bitterly cold blizzard. a. cranial cavity
Her body responds to the cold by ________. b. mediastinum
a. increasing the blood to her hands and feet c. posterior (dorsal) cavity
b. becoming lethargic to conserve heat d. All of the above
c. breaking down stored energy
24. In 1901, Wilhelm Röntgen was the first person to
d. significantly increasing blood oxygen levels win the Nobel Prize for physics. For what discovery
17. After you eat lunch, nerve cells in your stomach did he win?
respond to the distension (the stimulus) resulting
from the food. They relay this information to a. nuclear physics
________. b. radiopharmaceuticals
a. a control center c. the link between radiation and cancer
b. a set point d. X-rays
c. effectors 25. Which of the following imaging techniques would be
d. sensors best to use to study the uptake of nutrients by rapidly
18. Stimulation of the heat-loss center causes ________. multiplying cancer cells?
a. CT
a. blood vessels in the skin to constrict b. MRI
b. breathing to become slow and shallow c. PET
c. sweat glands to increase their output d. ultrasonography
d. All of the above 26. Which of the following imaging studies can be used
19. Which of the following is an example of a normal most safely during pregnancy?
physiologic process that uses a positive feedback a. CT scans
loop? b. PET scans
c. ultrasounds
a. blood pressure regulation d. X-rays
b. childbirth
27. What are two major disadvantages of MRI scans?
c. regulation of fluid balance
d. temperature regulation a. release of radiation and poor quality images
20. What is the position of the body when it is in the b. high cost and the need for shielding from the
“normal anatomical position?” magnetic signals
a. The person is prone with upper limbs, including c. can only view metabolically active tissues and
palms, touching sides and lower limbs touching inadequate availability of equipment
at sides. d. release of radiation and the need for a patient to
b. The person is standing facing the observer, with be confined to metal tube for up to 30 minutes
upper limbs extended out at a ninety-degree
CRITICAL THINKING QUESTIONS
angle from the torso and lower limbs in a wide
stance with feet pointing laterally 28. Name at least three reasons to study anatomy and
c. The person is supine with upper limbs, including physiology.
palms, touching sides and lower limbs touching 29. For whom would an appreciation of the structural
at sides. characteristics of the human heart come more easily:
d. None of the above an alien who lands on Earth, abducts a human, and
dissects his heart, or an anatomy and physiology
21. To make a banana split, you halve a banana into two
student performing a dissection of the heart on her
long, thin, right and left sides along the ________.
very first day of class? Why?
a. coronal plane 30. Name the six levels of organization of the human
b. longitudinal plane body.
c. midsagittal plane 31. The female ovaries and the male testes are a part of
d. transverse plane which body system? Can these organs be members
22. The lumbar region is ________. of more than one organ system? Why or why not?
a. inferior to the gluteal region 32. Explain why the smell of smoke when you are sitting
b. inferior to the umbilical region at a campfire does not trigger alarm, but the smell of
c. superior to the cervical region smoke in your residence hall does.
d. superior to the popliteal region
33. Identify three different ways that growth can occur in
23. The heart is within the ________. the human body.

9
34. When you open a bottle of sparkling water, the
carbon dioxide gas in the bottle form bubbles. If the
bottle is left open, the water will eventually “go flat.”
Explain these phenomena in terms of atmospheric
pressure.
35. On his midsummer trek through the desert, Josh ran
out of water. Why is this particularly dangerous?
36. Identify the four components of a negative feedback
loop and explain what would happen if secretion of a
body chemical controlled by a negative feedback
system became too great.
37. What regulatory processes would your body use if
you were trapped by a blizzard in an unheated,
uninsulated cabin in the woods?
38. In which direction would an MRI scanner move to
produce sequential images of the body in the frontal
plane, and in which direction would an MRI scanner
move to produce sequential images of the body in
the sagittal plane?
39. If a bullet were to penetrate a lung, which three
anterior thoracic body cavities would it enter, and
which layer of the serous membrane would it
encounter first?
40. Which medical imaging technique is most dangerous
to use repeatedly, and why?
41. Explain why ultrasound imaging is the technique of
choice for studying fetal growth and development.

10
 a. electron

Chapter 2 b.
c.
d.
atom
elemental particle
isotope

Homework 6. The characteristic that gives an element its

distinctive properties is its number of ________.
a. protons
b. neutrons
INTERACTIVE LINK QUESTIONS c. electrons
d. atoms
1. Visit this website
(http://openstaxcollege.org/l/ptable) to view the 7. On the periodic table of the elements, mercury (Hg)
periodic table. In the periodic table of the elements, has an atomic number of 80 and a mass number of 200.59.
elements in a single column have the same number of It has seven stable isotopes. The most abundant of these
electrons that can participate in a chemical reaction. These probably have ________.
electrons are known as “valence electrons.” For example, a. about 80 neutrons each
the elements in the first column all have a single valence b. fewer than 80 neutrons each
electron—an electron that can be “donated” in a chemical c. more than 80 neutrons each
reaction with another atom. What is the meaning of a mass d. more electrons than neutrons
number shown in parentheses? 8. Nitrogen has an atomic number of seven. How many
2. Visit this website electron shells does it likely have?
(http://openstaxcollege.org/l/ electenergy) to learn a. one
about electrical energy and the attraction/repulsion of b. two
charges. What happens to the charged electroscope when a c. three
conductor is moved between its plastic sheets, and why? d. four
3. Watch this video 9. Which of the following is a molecule, but not a
(http://openstaxcollege.org/l/ disaccharide) to compound?
observe the formation of a disaccharide. a. H2O
What happens when water encounters a glycosidic bond? 2
b. H
REVIEW QUESTIONS c. H2
+
4. Together, just four elements make up more than 95 d. H
percent of the body’s mass. These include ________. 10. A molecule of ammonia contains one atom of
nitrogen and three atoms of hydrogen. These are linked
a. calcium, magnesium, iron, and carbon with ________.
b. oxygen, calcium, iron, and nitrogen a. ionic bonds
c. sodium, chlorine, carbon, and hydrogen b. nonpolar covalent bonds
d. oxygen, carbon, hydrogen, and nitrogen c. polar covalent bonds
5. The smallest unit of an element that still retains the d. hydrogen bonds
distinctive behavior of that element is an ________. 11. When an atom donates an electron to another atom,
it becomes
a. electron a. an ion
b. atom b. an anion
c. elemental particle c. nonpolar
d. isotope d. all of the above
4. Together, just four elements make up more than 95 12. A substance formed of crystals of equal numbers of
percent of the body’s mass. These include ________. cations and anions held together by ionic bonds is called
a(n) ________.
a. calcium, magnesium, iron, and carbon a. noble gas
b. oxygen, calcium, iron, and nitrogen b. salt
c. sodium, chlorine, carbon, and hydrogen c. electrolyte
d. oxygen, carbon, hydrogen, and nitrogen d. dipole
5. The smallest unit of an element that still retains the 13. Which of the following statements about chemical
distinctive behavior of that element is an ________. bonds is true?

11
 a. Covalent bonds are stronger than ionic bonds. 21. Which of the following is most likely to be found
b. Hydrogen bonds occur between two atoms of evenly distributed in water in a homogeneous
hydrogen. solution?
c. Bonding readily occurs between nonpolar and a. sodium ions and chloride ions
polar molecules. b. NaCl molecules
d. A molecule of water is unlikely to bond with an c. salt crystals
ion. d. red blood cells
14. The energy stored in a foot of snow on a steep roof is 22. Jenny mixes up a batch of pancake batter, then stirs
________. in some chocolate chips. As she is waiting for the
a. potential energy first few pancakes to cook, she notices the chocolate
b. kinetic energy chips sinking to the bottom of the clear glass mixing
c. radiant energy bowl. The chocolatechip batter is an example of a
d. activation energy ________.
15. The bonding of calcium, phosphorus, and other a. solvent
elements produces mineral crystals that are found in b. solute
bone. c. solution
This is an example of a(n) ________ reaction. d. suspension
a. catabolic + –
b. synthesis 23. A substance dissociates into K and Cl in solution.
c. decomposition The substance is a(n) ________.
d. exchange a. acid
b. base
16. AB → A + B is a general notation for a(n) c. salt
________ reaction. d. buffer
a. anabolic 24. Ty is three years old and as a result of a “stomach
b. endergonic bug” has been vomiting for about 24 hours. His
c. decomposition blood pH is 7.48.
d. exchange What does this mean?
17. ________ reactions release energy. a. Ty’s blood is slightly acidic.
a. Catabolic b. Ty’s blood is slightly alkaline.
b. Exergonic c. Ty’s blood is highly acidic.
c. Decomposition d. Ty’s blood is within the normal range
d. Catabolic, exergonic, and decomposition 25. C6H12O6 is the chemical formula for a ________.
18. Which of the following combinations of atoms is
most likely to result in a chemical reaction? a. polymer of carbohydrate
a. hydrogen and hydrogen b. pentose monosaccharide
b. hydrogen and helium c. hexose monosaccharide
c. helium and helium d. all of the above
d. neon and helium 26. What organic compound do brain cells primarily rely
19. Chewing a bite of bread mixes it with saliva and on for fuel?
facilitates its chemical breakdown. This is most a. glucose
likely due to the fact that ________. b. glycogen
a. the inside of the mouth maintains a very high c. galactose
temperature d. glycerol
b. chewing stores potential energy 27. Which of the following is a functional group that is
c. chewing facilitates synthesis reactions part of a building block of proteins?
d. saliva contains enzymes a. phosphate
b. adenine
20. CH4 is methane. This compound is ________. c. amino
d. ribose
a. inorganic
b. organic 28. A pentose sugar is a part of the monomer used to
c. reactive build which type of macromolecule?
d. a crystal a. polysaccharides
b. nucleic acids

12
 c. phosphorylated glucose d. double helix
d. glycogen 31. Uracil ________.
29. A phospholipid ________. a. contains nitrogen
a. has both polar and nonpolar regions b. is a pyrimidine
b. is made up of a triglyceride bonded to a c. is found in RNA
phosphate group d. all of the above
c. is a building block of ATP
32. The ability of an enzyme’s active sites to bind only
d. can donate both cations and anions in solution substrates of compatible shape and charge is known
30. In DNA, nucleotide bonding forms a compound with as ________.
a characteristic shape known as a(n) ________. a. selectivity
a. beta chain b. specificity
b. pleated sheet c. subjectivity
c. alpha helix d. specialty
CRITICAL THINKING QUESTIONS notice that it still has an oily film. Why was the water
alone not effective in cleaning the bowl?
33. The most abundant elements in the foods and
beverages you consume are oxygen, carbon, hydrogen, 38. Could two atoms of oxygen engage in ionic
and nitrogen. Why might having these elements in bonding? Why or why not?
consumables be useful? 39. AB + CD → AD + BE Is this a legitimate
34. Oxygen, whose atomic number is eight, has three example of an exchange reaction? Why or why not?
16 17 18
stable isotopes: O, O, and O. Explain what this 40. When you do a load of laundry, why do you not
means in terms of the number of protons and neutrons. just drop a bar of soap into the washing machine? In other
35. Magnesium is an important element in the words, why is laundry detergent sold as a liquid or
human body, especially in bones. Magnesium’s atomic powder?
number is 12. Is it stable or reactive? Why? If it were to 41. The pH of lemon juice is 2, and the pH of orange
react with another atom, would it be more likely to accept juice is 4. Which of these is more acidic, and by how
or to donate one or more electrons? much?
36. Explain why CH4 is one of the most common What does this mean?
molecules found in nature. Are the bonds between the 42. During a party, Eli loses a bet and is forced to
atoms ionic or covalent? drink a bottle of lemon juice. Not long thereafter, he
37. In a hurry one day, you merely rinse your lunch begins complaining of having difficulty breathing, and his
dishes with water. As you are drying your salad bowl, you friends
take him to the local emergency room. There, he is given an atoms of carbon, hydrogen, and oxygen does maltose intravenous
solution of bicarbonate. Why? contain and why?
43. If the disaccharide maltose is formed from two glucose
44. Once dietary fats are digested and absorbed, why can monosaccharides, which are hexose sugars, how many they not be
released directly into the bloodstream?

13
 Chapter 3 Homework
INTERACTIVE LINK QUESTIONS about DNA replication. DNA replication proceeds
simultaneously at several sites on the same molecule.
1. Visit this link
What separates the base pair at the start of DNA
(http://openstaxcollege.org/l/diffusion) to see
replication?
diffusion and how it is propelled by the kinetic energy of
molecules in solution. How does temperature affect 4. Watch this video
diffusion rate, and why? (http://openstaxcollege.org/l/ ribosome) to learn
about ribosomes. The ribosome binds to the mRNA
2. Watch this video
molecule to start translation of its code into a protein.
(http://openstaxcollege.org/l/ endomembrane1)
What happens to the small and large ribosomal subunits at
to learn about the endomembrane system, which includes
the end of translation?
the rough and smooth ER and the Golgi body as well as
lysosomes and vesicles. What is the primary role of the 5. Visit this link
endomembrane system? (http://openstaxcollege.org/l/mitosis) to learn
about mitosis. Mitosis results in two identical diploid
3. Watch this video
cells. What structures form during prophase?
(http://openstaxcollege.org/l/ DNArep) to learn
REVIEW QUESTIONS 11. The rough ER has its name due to what associated structures?
a. Golgi apparatus
6. Because they are embedded within the membrane, ion
b. ribosomes
channels are examples of ________.
c. lysosomes
a. receptor proteins
d. proteins
b. integral proteins
c. peripheral proteins 12. Which of the following is a function of the rough ER?
d. glycoproteins a. production of proteins
b. detoxification of certain substances
7. The diffusion of substances within a solution tends to
c. synthesis of steroid hormones
move those substances ________ their ________ gradient.
d. regulation of intracellular calcium concentration
a. up; electrical
b. up; electrochemical 13. Which of the following is a feature common to all three
c. down; pressure components of the cytoskeleton?
d. down; concentration a. They all serve to scaffold the organelles within the
8. Ion pumps and phagocytosis are both examples of cell.
________. b. They are all characterized by roughly the same
a. endocytosis diameter.
b. passive transport c. They are all polymers of protein subunits.
c. active transport d. They all help the cell resist compression and
d. facilitated diffusion tension.

9. Choose the answer that best completes the following 14. Which of the following organelles produces large quantities of
analogy: Diffusion is to ________ as endocytosis is to ATP when both glucose and oxygen are available to the cell?
________. a. mitochondria
a. filtration; phagocytosis b. peroxisomes
b. osmosis; pinocytosis c. lysosomes
c. solutes; fluid d. ER
d. gradient; chemical energy 15. The nucleus and mitochondria share which of the following
10. Choose the term that best completes the following analogy: features?
Cytoplasm is to cytosol as a swimming pool containing a. protein-lined membrane pores
chlorine and flotation toys is to ________. b. a double cell membrane
a. the walls of the pool c. the synthesis of ribosomes
b. the chlorine d. the production of cellular energy
c. the flotation toys
16. Which of the following structures could be found within the
d. the water
nucleolus?

14
 a. chromatin a. the carriers that shuffle amino acids to a growing
b. histones polypeptide strand
c. ribosomes b. the ribosome
d. nucleosomes c. the messenger molecule that provides the code for
protein synthesis
17. Which of the following sequences on a DNA molecule would
be complementary to GCTTATAT? d. the intron
a. TAGGCGCG 24. Which of the following phases is characterized by
b. ATCCGCGC preparation for DNA synthesis?
c. CGAATATA a. G 0
d. TGCCTCTC b. G1
18. Place the following structures in order from least to most c. G2
complex organization: chromatin, nucleosome, DNA, d. S
chromosome 25. A mutation in the gene for a cyclin protein might result in
a. DNA, nucleosome, chromatin, chromosome which of the following?
b. nucleosome, DNA, chromosome, chromatin a. a cell with additional genetic material than normal
c. DNA, chromatin, nucleosome, chromosome b. cancer
d. nucleosome, chromatin, DNA, chromosome c. a cell with less genetic material than normal
19. Which of the following is part of the elongation step of DNA d. any of the above
synthesis? 26. What is a primary function of tumor suppressor genes?
a. pulling apart the two DNA strands a. stop all cells from dividing
b. attaching complementary nucleotides b. stop certain cells from dividing
to the template strand c. help oncogenes produce oncoproteins
c. untwisting the DNA helix d. allow the cell to skip certain phases of the cell cycle
d. none of the above
27. Arrange the following terms in order of increasing
20. Which of the following is not a difference between DNA and specialization: oligopotency, pleuripotency, unipotency,
RNA? multipotency.
a. DNA contains thymine whereas RNA contains a. multipotency, unipotency
uracil pleuripotency, oligopotency,
b. DNA contains deoxyribose and RNA contains b. pleuripotency, unipotency
ribose oligopotency, multipotency
c. DNA contains alternating sugar-phosphate c. oligopotency, multipotency
molecules whereas RNA does not contain sugars pleuripotency, unipotency,
d. RNA is single stranded and DNA is double d. pleuripotency, unipotency
stranded multipotency, oligopotency,
21. Transcription and translation take place 28. Which type of stem cell gives rise to red and white blood
in the________ and ________, respectively. cells?
a. nucleus; cytoplasm a. endothelial
b. nucleolus; nucleus b. epithelial
c. nucleolus; cytoplasm c. hematopoietic
d. cytoplasm; nucleus d. mesenchymal

22. How many “letters” of an RNA molecule, in sequence, does 29. What multipotent stem cells from children sometimes banked
it take to provide the code for a single amino acid? by parents?
a. 1 a. fetal stem cells
b. 2 b. embryonic stem cells
c. 3 c. cells from the umbilical cord and from baby teeth
d. 4 d. hematopoietic stem cells from red and white blood
cells
23. Which of the following is not made out of RNA?
CRITICAL THINKING QUESTIONS 32. What do osmosis, diffusion, filtration, and the movement
of ions away from like charge all have in common? In
30. What materials can easily diffuse through the lipid what way do they differ?
bilayer, and why?
33. Explain why the structure of the ER, mitochondria, and
31. Why is receptor-mediated endocytosis said to be more
selective than phagocytosis or pinocytosis? 34. Golgi apparatus assist their respective functions.

15
35. Compare and contrast lysosomes with peroxisomes:
name at least two similarities and one difference.
36. Explain in your own words why DNA replication is said
to be “semiconservative”?
37. Why is it important that DNA replication take place
before cell division? What would happen if cell division
of a body cell took place without DNA replication, or
when DNA replication was incomplete?
38. Briefly explain the similarities between transcription and
DNA replication.
39. Contrast transcription and translation. Name at least
three differences between the two processes.
40. What would happen if anaphase proceeded even though
the sister chromatids were not properly attached to their
respective microtubules and lined up at the metaphase
plate?
41. What are cyclins and cyclin-dependent kinases, and how
do they interact?
42. Explain how a transcription factor ultimately determines
whether or not a protein will be present in a given cell?
43. Discuss two reasons why the therapeutic use of
embryonic stem cells can present a problem.

16
 c. connective tissue, epithelial tissue, and muscle

Chapter 4 tissue
d. epidermis, mesoderm, and endothelium
11. Which of the following lines the body cavities exposed

Homework to the external environment?

a. mesothelium
b. lamina propria
INTERACTIVE LINK QUESTIONS c. mesenteries
1. View this slideshow d. mucosa
(http://openstaxcollege.org/l/ stemcells) to learn 12. In observing epithelial cells under a microscope, the
more about stem cells. How do somatic stem cells differ cells are arranged in a single layer and look tall and
from embryonic stem cells? narrow, and the nucleus is located close to the basal side
2. Watch this video of the cell.
(http://openstaxcollege.org/l/ etissues) to find out The specimen is what type of epithelial tissue?
more about the anatomy of epithelial tissues. Where in the a. columnar
body would one find non-keratinizing stratified squamous b. stratified
epithelium? c. squamous
d. transitional
3. Visit this link
(http://openstaxcollege.org/l/10quiz) to test your 13. Which of the following is the epithelial tissue that lines
connective tissue knowledge with this 10-question quiz. Can the interior of blood vessels?
you name the 10 tissue types shown in the histology slides? a. columnar
b. pseudostratified
4. Watch this video
c. simple squamous
(http://openstaxcollege.org/l/ musctissue) to learn
more about muscle tissue. In looking through a microscope d. transitional
how could you distinguish skeletal muscle tissue from 14. Which type of epithelial tissue specializes in moving
smooth muscle? particles across its surface and is found in airways and
5. Follow this link lining of the oviduct?
(http://openstaxcollege.org/l/nobel) to learn more a. transitional
about nervous tissue. What are the main parts of a nerve b. stratified columnar
cell? c. pseudostratified ciliated columnar
6. Watch this video d. stratified squamous
(http://openstaxcollege.org/l/ healinghand) to see a 15. The ________ exocrine gland stores its secretion until
hand heal. Over what period of time do you think these the glandular cell ruptures, whereas the ________ gland
images were taken? releases its apical region and reforms.
7. Watch this video a. holocrine; apocrine
(http://openstaxcollege.org/l/tumor) to learn more b. eccrine; endocrine
about tumors. What is a tumor? c. apocrine; holocrine
REVIEW QUESTIONS d. eccrine; apocrine
16. Connective tissue is made of which three essential
8. Which of the following is not a type of tissue?
components?
a. muscle
a. cells, ground substance, and carbohydrate fibers
b. nervous
b. cells, ground substance, and protein fibers
c. embryonic
c. collagen, ground substance, and protein fibers
d. epithelial
d. matrix, ground substance, and fluid
9. The process by which a less specialized cell matures into
17. Under the microscope, a tissue specimen shows cells
a more specialized cell is called ________.
located in spaces scattered in a transparent background.
a. differentiation
This is probably ________.
b. maturation
a. loose connective tissue
c. modification
b. a tendon
d. specialization
c. bone
10. Differentiated cells in a developing embryo derive from d. hyaline cartilage
________.
18. Which connective tissue specializes in storage of fat?
a. endothelium, mesothelium, and epithelium
b. ectoderm, mesoderm, and endoderm
a. tendon

17
 b. adipose tissue a. neurons
c. reticular tissue b. oligodendrocytes
d. dense connective tissue c. astrocytes
19. Ligaments connect bones together and withstand a lot of d. microglia
stress. What type of connective tissue should you expect 26. The nerve impulse travels down a(n) ________, away
ligaments to contain? from the cell body.
a. areolar tissue a. dendrite
b. adipose tissue b. axon
c. dense regular connective tissue c. microglia
d. dense irregular connective tissue d. collagen fiber
20. In adults, new connective tissue cells originate from the 27. Which of the following central nervous system cells
________. regulate ions, regulate the uptake and/or breakdown of
a. mesoderm some neurotransmitters, and contribute to the formation
b. mesenchyme of the blood-brain barrier?
c. ectoderm a. microglia
d. endoderm b. neuroglia
21. In bone, the main cells are ________. c. oligodendrocytes
d. astrocytes
a. fibroblasts
28. Which of the following processes is not a cardinal sign
b. chondrocytes
of inflammation?
c. lymphocytes
a. redness
d. osteocytes
b. heat
22. Striations, cylindrical cells, and multiple nuclei are c. fever
observed in ________. d. swelling
a. skeletal muscle only
29. When a mast cell reacts to an irritation, which of the
b. cardiac muscle only
following chemicals does it release?
c. smooth muscle only
a. collagen
d. skeletal and cardiac muscles
b. histamine
23. The cells of muscles, myocytes, c. hyaluronic acid
develop from ________. d. meylin
a. myoblasts
30. Atrophy refers to ________.
b. endoderm
a. loss of elasticity
c. fibrocytes
b. loss of mass
d. chondrocytes
c. loss of rigidity
24. Skeletal muscle is composed of very hard working cells. d. loss of permeability
Which organelles do you expect to find in abundance in
skeletal muscle cell? 31. Individuals can slow the rate of aging by modifying all
a. nuclei of these lifestyle aspects except for ________.
b. striations a. diet
c. golgi bodies b. exercise
d. mitochondria c. genetic factors
d. stress
25. The cells responsible for the transmission of the nerve
impulse are ________.
CRITICAL THINKING QUESTIONS 35. The structure of a tissue usually is optimized for its
function. Describe how the structure of individual
32. Identify the four types of tissue in the body, and cells and tissue arrangement of the intestine lining
describe the major functions of each tissue. matches its main function, to absorb nutrients.
33. The zygote is described as totipotent because it 36. One of the main functions of connective tissue is to
ultimately gives rise to all the cells in your body integrate organs and organ systems in the body.
including the highly specialized cells of your nervous Discuss how blood fulfills this role.
system. Describe this transition, discussing the steps
and processes that lead to these specialized cells. 37. Why does an injury to cartilage, especially hyaline
cartilage, heal much more slowly than a bone
34. What is the function of synovial membranes? fracture?

18
38. You are watching cells in a dish spontaneously
contract. They are all contracting at different rates;
some fast, some slow. After a while, several cells link
up and they begin contracting in synchrony. Discuss
what is going on and what type of cells you are
looking at.
39. Why does skeletal muscle look striated?
40. Which morphological adaptations of neurons make
them suitable for the transmission of nerve impulse?
41. What are the functions of astrocytes?
42. Why is it important to watch for increased redness,
swelling and pain after a cut or abrasion has been
cleaned and bandaged?
43. Aspirin is a non-steroidal anti-inflammatory drug
(NSAID) that inhibits the formation of blood clots and
is taken regularly by individuals with a heart
condition. Steroids such as cortisol are used to control
some autoimmune diseases and severe arthritis by
downregulating the inflammatory response. After
reading the role of inflammation in the body’s
response to infection, can you predict an undesirable
consequence of taking antiinflammatory drugs on a
regular basis?
44. As an individual ages, a constellation of symptoms
begins the decline to the point where an individual’s
functioning is compromised. Identify and discuss two
factors that have a role in factors leading to the
compromised situation.
45. Discuss changes that occur in cells as a person ages.

19
Chapter 5 Homework
INTERACTIVE LINK QUESTIONS
1. The skin consists of two layers and a closely 3. Figure 5.6 If you zoom on the cells of the stratum
associated layer. View this animation spinosum, what is distinctive about them?
(http://openstaxcollege.org/l/ layers) to learn 4. This ABC video follows the story of a pair of fraternal
more about layers of the skin. What are the basic African-American twins, one of whom is albino.
functions of each of these layers? Watch this video
2. Figure 5.4 If you zoom on the cells at the outermost (http://openstaxcollege.org/l/albino) to learn
layer of this section of skin, what do you notice about about the challenges these children and their family
the cells? face. Which ethnicities do you think are exempt from
the possibility of albinism?
REVIEW QUESTIONS 11. The hair matrix contains ________.
a. the hair follicle
5. The papillary layer of the dermis is most closely
b. the hair shaft
associated with which layer of the epidermis?
c. the glassy membrane
a. stratum spinosum
d. a layer of basal cells
b. stratum corneum
c. stratum granulosum 12. Eccrine sweat glands ________.
d. stratum basale a. are present on hair
b. are present in the skin throughout the body and
6. Langerhans cells are commonly found in the
________. produce watery sweat
c. produce sebum
a. stratum spinosum d. act as a moisturizer
b. stratum corneum 13. Sebaceous glands ________.
c. stratum granulosum a. are a type of sweat gland
d. stratum basale b. are associated with hair follicles
c. may function in response to touch
7. The papillary and reticular layers of the dermis are d. release a watery solution of salt and metabolic
composed mainly of ________. waste
a. melanocytes
b. keratinocytes 14. Similar to the hair, nails grow continuously
c. connective tissue throughout our lives. Which of the following is
d. adipose tissue furthest from the nail growth center?
a. nail bed
8. Collagen lends ________ to the skin. b. hyponychium
a. elasticity c. nail root
b. structure d. eponychium
c. color
d. UV protection 15. In humans, exposure of the skin to sunlight is required
for ________.
9. Which of the following is not a function of the
hypodermis? a. vitamin D synthesis
a. protects underlying organs b. arteriole constriction
b. helps maintain body temperature c. folate production
c. source of blood vessels in the epidermis d. thermoregulation
d. a site to long-term energy storage 16. One of the functions of the integumentary system is
protection. Which of the following does not directly
10. In response to stimuli from the sympathetic nervous
contribute to that function?
system, the arrector pili ________.
a. stratum lucidum
a. are glands on the skin surface
b. desmosomes
b. can lead to excessive sweating
c. folic acid synthesis
c. are responsible for goose bumps
d. Merkel cells
d. secrete sebum

20
 17. An individual using a sharp knife notices a small b. can result from deep massages
amount of blood where he just cut himself. Which of c. are preventable by eliminating pressure points
the following layers of skin did he have to cut into in d. are caused by dry skin
order to bleed?
22. An individual has spent too much time sun bathing.
a. stratum corneum
Not only is his skin painful to touch, but small blisters
b. stratum basale
have appeared in the affected area. This indicates that
c. papillary dermis he has damaged which layers of his skin?
d. stratum granulosum a. epidermis only
18. As you are walking down the beach, you see a dead, b. hypodermis only
dry, shriveled-up fish. Which layer of your epidermis c. epidermis and hypodermis
keeps you from drying out? d. epidermis and dermis
a. stratum corneum
23. After a skin injury, the body initiates a wound-healing
b. stratum basale
response. The first step of this response is the
c. stratum spinosum formation of a blood clot to stop bleeding. Which of
d. stratum granulosum the following would be the next response?
19. If you cut yourself and bacteria enter the wound, a. increased production of melanin by melanocytes
which of the following cells would help get rid of the b. increased production of connective tissue
bacteria? c. an increase in Pacinian corpuscles around the
wound
a. Merkel cells
d. an increased activity in the stratum lucidum
b. keratinocytes
c. Langerhans cells 24. Squamous cell carcinomas are the second most
d. melanocytes common of the skin cancers and are capable of
metastasizing if not treated. This cancer affects which
20. In general, skin cancers ________.
cells?
a. are easily treatable and not a major health
a. basal cells of the stratum basale
concern
b. melanocytes of the stratum basale
b. occur due to poor hygiene
c. keratinocytes of the stratum spinosum
c. can be reduced by limiting exposure to the sun
d. Langerhans cells of the stratum lucidum
d. affect only the epidermis
21. Bedsores ________.
a. can be treated with topical moisturizers
CRITICAL THINKING QUESTIONS
25. What determines the color of skin, and what is the process
that darkens skin when it is exposed to UV light?
26. Cells of the epidermis derive from stem cells of the stratum
basale. Describe how the cells change as they become
integrated into the different layers of the epidermis.
27. Explain the differences between eccrine and apocrine
sweat glands.
28. Describe the structure and composition of nails.
29. Why do people sweat excessively when exercising outside
on a hot day?
30. Explain your skin’s response to a drop in body core
temperature.
31. Why do teenagers often experience acne?
32. Why do scars look different from surrounding skin

21
 b. muscles

Chapter 6 9.
c. ligaments
d. tendons
Bones that surround the spinal cord are classified as

Homework ________ bones.

a. irregular
b. sesamoid
REVIEW QUESTIONS c. flat
d. short
1. Which function of the skeletal system would be
especially important if you were in a car accident? 10. Which category of bone is among the most numerous
in the skeleton?
a. storage of minerals a. long bone
b. protection of internal organs b. sesamoid bone
c. facilitation of movement c. short bone
d. fat storage d. flat bone
2. Bone tissue can be described as ________. 11. Long bones enable body movement by acting as a
a. dead calcified tissue ________.
b. cartilage a. counterweight
c. the skeletal system b. resistive force
d. dense, hard connective tissue c. lever
3. Without red marrow, bones would not be able to d. fulcrum
________. 12. Which of the following occurs in the spongy bone of
a. store phosphate the epiphysis?
b. store calcium a. bone growth
c. make blood cells b. bone remodeling
d. move like levers c. hematopoiesis
4. Yellow marrow has been identified as ________. d. shock absorption
13. The diaphysis contains ________.
a. an area of fat storage a. the metaphysis
b. a point of attachment for muscles b. fat stores
c. the hard portion of bone c. spongy bone
d. the cause of kyphosis d. compact bone
5. Which of the following can be found in areas of 14. The fibrous membrane covering the outer surface of the
movement? bone is the ________.
a. hematopoiesis a. periosteum
b. cartilage b. epiphysis
c. yellow marrow c. endosteum
d. red marrow d. diaphysis
6. The skeletal system is made of ________. 15. Which of the following are incapable of undergoing
a. muscles and tendons mitosis?
b. bones and cartilage a. osteoblasts and osteoclasts
c. vitreous humor b. osteocytes and osteoclasts
d. minerals and fat c. osteoblasts and osteocytes
7. Most of the bones of the arms and hands are long d. osteogenic cells and osteoclasts
bones; however, the bones in the wrist are categorized 16. Which cells do not originate from osteogenic cells?
as ________.
a. flat bones a. osteoblasts
b. short bones b. osteoclasts
c. sesamoid bones c. osteocytes
d. irregular bones d. osteoprogenitor cells
8. Sesamoid bones are found embedded in ________. 17. Which of the following are found in compact bone and
cancellous bone?
a. joints

22
 a. Haversian systems c. in the epiphyseal plate
b. Haversian canals d. within the metaphysis
c. lamellae 26. Which of the following represents the correct sequence
d. lacunae of zones in the epiphyseal plate?
18. Which of the following are only found in cancellous a. proliferation, reserved, maturation, calcification
bone? b. maturation, proliferation, reserved, calcification
a. canaliculi c. calcification, maturation, proliferation, reserved
b. Volkmann’s canals d. calcification, reserved, proliferation, maturation
c. trabeculae 27. A fracture can be both ________.
d. calcium salts a. open and closed
19. The area of a bone where the nutrient foramen passes b. open and transverse
forms what kind of bone marking? c. transverse and greenstick
a. a hole d. greenstick and comminuted
b. a facet
28. How can a fractured diaphysis release fat globules into
c. a canal the bloodstream?
d. a fissure a. The bone pierces fat stores in the skin.
20. Why is cartilage slow to heal? b. The yellow marrow in the diaphysis is exposed
a. because it eventually develops into bone and damaged.
b. because it is semi-solid and flexible c. The injury triggers the body to release fat from
c. because it does not have a blood supply healthy bones.
d. because endochondral ossification replaces all d. The red marrow in the fractured bone releases
cartilage with bone fat to heal the fracture.
21. Why are osteocytes spread out in bone tissue? 29. In a compound fracture, ________.
a. the break occurs at an angle to the bone
a. They develop from mesenchymal cells. b. the broken bone does not tear the skin
b. They are surrounded by osteoid. c. one fragment of broken bone is compressed into
c. They travel through the capillaries. the other
d. Formation of osteoid spreads out the osteoblasts d. broken bone pierces the skin
that formed the ossification centers.
30. The internal and external calli are replaced by
22. In endochondral ossification, what happens to the ________.
chondrocytes? a. hyaline cartilage
a. They develop into osteocytes. b. trabecular bone
b. They die in the calcified matrix that surrounds c. osteogenic cells
them and form the medullary cavity. d. osteoclasts
c. They grow and form the periosteum.
31. The first type of bone to form during fracture repair is
d. They group together to form
________ bone.
the primary ossification center.
a. compact
23. Which of the following bones is (are) formed by b. lamellar
intramembranous ossification? c. spongy
a. the metatarsals d. dense
b. the femur
32. Wolff’s law, which describes the effect of mechanical
c. the ribs
forces in bone modeling/remodeling, would predict that
d. the flat bones of the cranium
________
24. Bones grow in length due to activity in the ________. a. a right-handed pitcher will have thicker bones in
his right arm compared to his left.
a. epiphyseal plate b. a right-handed cyclist will have thicker bones in
b. perichondrium her right leg compared to her left.
c. periosteum c. a broken bone will heal thicker than it was
d. medullary cavity before the fracture.
25. Bones grow in diameter due to bone d. a bed-ridden patient will have thicker bones than
formation________. an athlete.
a. in the medullary cavity 33. Calcium cannot be absorbed from the small intestine if
b. beneath the periosteum ________ is lacking.

23
 a. vitamin D 37. When calcium levels are too high or too low, which
b. vitamin K body system is primarily affected?
c. calcitonin a. skeletal system
d. fluoride b. endocrine system
c. digestive system
34. Which one of the following foods is best for bone
health? d. nervous system
a. carrots 38. All of the following play a role in calcium homeostasis
b. liver except
c. leafy green vegetables a. thyroxine
d. oranges b. calcitonin
c. parathyroid hormone
35. Which of the following hormones are responsible for
the adolescent growth spurt? d. vitamin D
a. estrogen and testosterone 39. Which of the following is most likely to be released
b. calcitonin and calcitriol when blood calcium levels are elevated?
c. growth hormone and parathyroid hormone a. thyroxine
d. thyroxine and progesterone b. calcitonin
36. With respect to their direct effects on osseous tissue, c. parathyroid hormone
which pair of hormones has actions that oppose each d. vitamin D
other?
a. estrogen and testosterone
b. calcitonin and calcitriol
c. estrogen and progesterone
d. calcitonin and parathyroid hormone

CRITICAL THINKING 46. If you were a dietician who had a young female
patient with a family history of osteoporosis, what foods
QUESTIONS would you suggest she include in her diet? Why?
37. The skeletal system is composed of bone and 47. During the early years of space exploration our
cartilage and has many functions. Choose three of these astronauts, who had been floating in space, would return
functions and discuss what features of the skeletal system to earth showing significant bone loss dependent on how
allow it to accomplish these functions. long they were in space. Discuss how this might happen
38. What are the structural and functional and what could be done to alleviate this condition.
differences between a tarsal and a metatarsal? 48. An individual with very low levels of vitamin D
39. What are the structural and functional presents themselves to you complaining of seemingly
differences between the femur and the patella? fragile bones. Explain how these might be connected.
40. If the articular cartilage at the end of one of your 49. Describe the effects caused when the parathyroid
long bones were to degenerate, what symptoms do you gland fails to respond to calcium bound to its receptors
think you would experience? Why?
41. In what ways is the structural makeup of
compact and spongy bone well suited to their respective
functions?
42. In what ways do intramembranous and
endochondral ossification differ?
43. Considering how a long bone develops, what are
the similarities and differences between a primary and a
secondary ossification center?
44. What is the difference between closed reduction
and open reduction? In what type of fracture would closed
reduction most likely occur? In what type of fracture
would open reduction most likely occur?
45. In terms of origin and composition, what are the
differences between an internal callus and an external
callus?

24
 become weakened and may fractured due to this disease.

Chapter 7 How may vertebral osteoporosis contribute to kyphosis?

4. Watch this animation
(http://openstaxcollege.org/l/ diskslip) to see what

Homework it means to “slip” a disk. Watch this second animation

(http://openstaxcollege.org/l/ herndisc) to see one
possible treatment for a herniated disc, removing and
INTERACTIVE LINK QUESTIONS replacing the damaged disc with an artificial one that
allows for movement between the adjacent certebrae. How
1. Watch this video
could lifting a heavy object produce pain in a lower limb?
(http://openstaxcollege.org/l/skull1) to view a
rotating and exploded skull with color-coded bones. 5. Use this tool (http://openstaxcollege.org/l/
Which bone (yellow) is centrally located and joins with vertcolumn) to identify the bones, intervertebral discs,
most of the other bones of the skull? and ligaments of the vertebral column. The thickest
portions of the anterior longitudinal ligament and the
2. View this animation
supraspinous ligament are found in which regions of the
(http://openstaxcollege.org/l/ headblow) to see
vertebral column?
how a blow to the head may produce a contrecoup
(counterblow) fracture of the basilar portion of the 6. View this video
occipital bone on the base of the skull. Why may a basilar (http://openstaxcollege.org/l/ skullbones) to
fracture be life threatening? review the two processes that give rise to the bones of the
skull and body. What are the two mechanisms by which
3. Osteoporosis is a common age-related bone
the bones of the body are formed and which bones are
disease in which bone density and strength is decreased.
formed by each mechanism?
Watch this video
(http://openstaxcollege.org/l/osteoporosis) to get
a better understanding of how thoracic vertebrae may
REVIEW QUESTIONS d. lacrimal bone

7. Which of the following is part of the axial skeleton? 11. The lambdoid suture joins the parietal bone to the
a. shoulder bones ________.
b. thigh bone a. frontal bone
c. foot bones b. occipital bone
d. vertebral column c. other parietal bone
d. temporal bone
8. Which of the following is a function of the axial
skeleton? 12. The middle cranial fossa ________.
a. allows for movement of the wrist and hand a. is bounded anteriorly by the petrous ridge
b. protects nerves and blood vessels at the elbow b. is bounded posteriorly by the lesser wing of the
c. supports trunk of body sphenoid bone
d. allows for movements of the ankle and foot c. is divided at the midline by a small area of the
ethmoid bone
9. The axial skeleton ________. d. has the foramen rotundum, foramen ovale, and
a. consists of 126 bones foramen spinosum
b. forms the vertical axis of the body
c. includes all bones of the body trunk and limbs 13. The paranasal sinuses are ________.
d. includes only the bones of the lower limbs a. air-filled spaces found within the frontal,
maxilla, sphenoid, and ethmoid bones only
10. Which of the following is a bone of the brain case? b. air-filled spaces found within all bones of the
a. parietal bone skull
b. zygomatic bone c. not connected to the nasal cavity
c. maxillary bone

25
 d. divided at the midline by the nasal septum b. has the sternal angle located
between the manubrium and body
14. Parts of the sphenoid bone include the ________.
c. receives direct attachments from the costal cartilages
a. sella turcica
of all 12 pairs of ribs
b. squamous portion
d. articulates directly with the thoracic vertebrae
c. glabella
d. zygomatic process 22. The sternal angle is the ________.
a. junction between the body and xiphoid process
15. The bony openings of the skull include the
b. site for attachment of the clavicle
________.
c. site for attachment of the floating ribs
a. carotid canal, which is located in the anterior
cranial fossa d. junction between the manubrium and body
b. superior orbital fissure, which is located at the 23. The tubercle of a rib ________.
superior margin of the anterior orbit a. is for articulation with the transverse process of a
c. mental foramen, which is located just below the thoracic vertebra
orbit b. is for articulation with the body of a thoracic vertebra
d. hypoglossal canal, which is located in the c. provides for passage of blood vessels and a nerve
posterior cranial fossa d. is the area of greatest rib curvature
16. The cervical region of the vertebral column consists 24. True ribs are ________.
of ________. a. ribs 8–12
a. seven vertebrae b. attached via their costal cartilage to the next higher
b. 12 vertebrae rib
c. five vertebrae c. made entirely of bone, and thus do not have a costal
d. a single bone derived from the fusion of five cartilage
vertebrae d. attached via their costal cartilage directly to the
17. The primary curvatures of the vertebral column sternum
________. 25. Embryonic development of the axial skeleton involves
a. include the lumbar curve ________.
b. are remnants of the original fetal curvature a. intramembranous ossification, which forms the facial
c. include the cervical curve bones.
d. develop after the time of birth b. endochondral ossification, which forms the ribs and
18. A typical vertebra has ________. sternum
a. a vertebral foramen that passes through the body c. the notochord, which produces the cartilage models
for the vertebrae
b. a superior articular process that projects
downward to articulate with the superior portion d. the formation of hyaline cartilage models, which give
of the next lower vertebra rise to the flat bones of the skull
c. lamina that spans between the transverse 26. A fontanelle ________.
process and spinous process a. is the cartilage model for a vertebra that later is
d. a pair of laterally projecting spinous processes converted into bone
19. A typical lumbar vertebra has ________. b. gives rise to the facial bones and vertebrae
c. is the rod-like structure that runs the length of the
early embryo
a. a short, rounded spinous process d. is the area of fibrous connective tissue found at birth
b. a bifid spinous process between the brain case bones
c. articulation sites for ribs
d. a transverse foramen
20. Which is found only in the cervical region of the vertebral CRITICAL THINKING QUESTIONS
column? 27. Define the two divisions of the skeleton.
a. nuchal ligament
b. ligamentum flavum 28. Discuss the functions of the axial skeleton.
c. supraspinous ligament 29. Define and list the bones that form the brain case or
d. anterior longitudinal ligament support the facial structures.
21. The sternum ________. 30. Identify the major sutures of the skull, their locations, and
a. consists of only two parts, the manubrium and the bones united by each.
xiphoid process

26
31. Describe the anterior, middle, and posterior cranial fossae
and their boundaries, and give the midline structure that
divides each into right and left areas.
32. Describe the parts of the nasal septum in both the dry and
living skull.
33. Describe the vertebral column and define each region.
34. Describe a typical vertebra.
35. Describe the sacrum.
36. Describe the structure and function of an intervertebral
disc.
37. Define the ligaments of the vertebral column.
38. Define the parts and functions of the thoracic cage.
39. Describe the parts of the sternum.
40. Discuss the parts of a typical rib.
41. Define the classes of ribs.
42. Discuss the processes by which the brain-case bones of the
skull are formed and grow during skull enlargement.
43. Discuss the process that gives rise to the base and facial
bones of the skull.
44. Discuss the development of the vertebrae, ribs, and
sternum.

27
 Chapter 8 Homework
INTERACTIVE LINK QUESTIONS how a fracture of the mid-femur is surgically repaired.
How are the two portions of the broken femur stabilized
1. Watch this video
during surgical repair of a fractured femur?
(http://openstaxcollege.org/l/ fractures) to see
how fractures of the distal radius bone can affect the wrist 6. Visit this site
joint. Explain the problems that may occur if a fracture of (http://openstaxcollege.org/l/ kneesurgery) to
the distal radius involves the joint surface of the perform a virtual knee replacement surgery. The prosthetic
radiocarpal joint of the wrist. knee components must be properly aligned to function
properly. How is this alignment ensured?
2. Visit this site
(http://openstaxcollege.org/l/handbone) to explore 7. Use this tutorial
the bones and joints of the hand. What are the three arches (http://openstaxcollege.org/l/ footbones) to
of the hand, and what is the importance of these during the review the bones of the foot. Which tarsal bones are in the
gripping of an object? proximal, intermediate, and distal groups?
3. Watch this video 8. View this link
(http://openstaxcollege.org/l/colles) to learn about (http://openstaxcollege.org/l/bunion) to learn
a Colles fracture, a break of the distal radius, usually about a bunion, a localized swelling on the medial side of
caused by falling onto an outstretched hand. When would the foot, next to the first metatarsophalangeal joint, at the
surgery be required and how would the fracture be base of the big toe. What is a bunion and what type of
repaired in this case? shoe is most likely to cause this to develop?
4. Watch this video 9. Watch this animation
(http://openstaxcollege.org/l/ 3Dpelvis) for a 3-D (http://openstaxcollege.org/l/ limbbuds) to follow
view of the pelvis and its associated ligaments. What is the development and growth of the upper and lower limb
the large opening in the bony pelvis, located between the buds. On what days of embryonic development do these
ischium and pubic regions, and what two parts of the events occur: (a) first appearance of the upper limb bud
pubis contribute to the formation of this opening? (limb ridge); (b) the flattening of the distal limb to form
5. Watch this video the handplate or footplate; and (c) the beginning of limb
(http://openstaxcollege.org/l/ midfemur) to view rotation.
b. coracoid process
REVIEW QUESTIONS c. supraglenoid tubercle
d. glenoid cavity
10. Which part of the clavicle articulates with the
manubrium? 14. Name the short, hook-like bony process of the scapula
a. shaft that projects anteriorly.
b. sternal end a. acromial process
c. acromial end b. clavicle
d. coracoid process c. coracoid process
d. glenoid fossa
11. A shoulder separation results from injury to the
________. 15. How many bones are there in the upper limbs
a. glenohumeral joint combined?
b. costoclavicular joint a. 20
c. acromioclavicular joint b. 30
d. sternoclavicular joint c. 40
d. 60
12. Which feature lies between the spine and superior
border of the scapula? 16. Which bony landmark is located on the lateral side of
a. suprascapular notch the proximal humerus?
b. glenoid cavity a. greater tubercle
c. superior angle b. trochlea
d. supraspinous fossa c. lateral epicondyle
d. lesser tubercle
13. What structure is an extension of the spine of the
scapula? 17. Which region of the humerus articulates with the
a. acromion radius as part of the elbow joint?
a. trochlea

28
 b. styloid process a. fovea capitis
c. capitulum b. lesser trochanter
d. olecranon process c. head
18. Which is the lateral-most carpal bone of the proximal d. medial condyle
row? 26. What structure contributes to the knee joint?
a. trapezium a. lateral malleolus of the fibula
b. hamate b. tibial tuberosity
c. pisiform c. medial condyle of the tibia
d. scaphoid d. lateral epicondyle of the femur
27. Which tarsal bone articulates with the tibia and
19. The radius bone ________. fibula?
a. is found on the medial side of the forearm
b. has a head that articulates with the radial notch a. calcaneus
of the ulna b. cuboid
c. does not articulate with any of the carpal bones c. navicular
d. has the radial tuberosity located near its distal d. talus
end
28. What is the total number of bones found in the foot
20. How many bones fuse in adulthood to form the hip and toes?
bone? a. 7
a. 2 b. 14
b. 3 c. 26
c. 4 d. 30
d. 5
29. The tibia ________.
21. Which component forms the superior part of the hip a. has an expanded distal end called the lateral
bone? malleolus
a. ilium b. is not a weight-bearing bone
b. pubis c. is firmly anchored to the fibula
c. ischium by an interosseous membrane
d. sacrum d. can be palpated (felt) under the skin only at its
22. Which of the following supports body weight when proximal and distal ends
sitting? 30. Which event takes place during the seventh week of
a. iliac crest development?
b. ischial tuberosity a. appearance of the upper and lower limb buds
c. ischiopubic ramus b. flattening of the distal limb bud into a paddle
d. pubic body shape
23. The ischial spine is found between which of the c. the first appearance of hyaline cartilage models
following structures? of future bones
a. inferior pubic ramus and ischial ramus d. the rotation of the limbs
b. pectineal line and arcuate line 31. During endochondral ossification of a long bone,
c. lesser sciatic notch and greater sciatic notch ________.
d. anterior superior iliac spine and a. a primary ossification center will develop within
posterior superior iliac spine the epiphysis
24. The pelvis ________. b. mesenchyme will differentiate directly into bone
a. has a subpubic angle that is larger in females tissue
b. consists of the two hip bones, but does not c. growth of the epiphyseal plate will produce
include the sacrum or coccyx bone lengthening
c. has an obturator foramen, an opening that is d. all epiphyseal plates will disappear before birth
defined in part by the sacrospinous and 32. The clavicle ________.
sacrotuberous ligaments a. develops via intramembranous ossification
d. has a space located inferior to the pelvic brim b. develops via endochondral ossification
called the greater pelvis c. is the last bone of the body to begin ossification
25. Which bony landmark of the femur serves as a site for d. is fully ossified at the time of birth
muscle attachments?

29
CRITICAL THINKING QUESTIONS
33. Describe the shape and palpable line formed by the
clavicle and scapula.
34. Discuss two possible injuries of the pectoral girdle
that may occur following a strong blow to the shoulder or
a hard fall onto an outstretched hand.
35. Your friend runs out of gas and you have to help push
his car. Discuss the sequence of bones and joints that
convey the forces passing from your hand, through your
upper limb and your pectoral girdle, and to your axial
skeleton.
36. Name the bones in the wrist and hand, and describe or
sketch out their locations and articulations.
37. Describe the articulations and ligaments that unite the
four bones of the pelvis to each other.
38. Discuss the ways in which the female pelvis is
adapted for childbirth.
39. Define the regions of the lower limb, name the bones
found in each region, and describe the bony landmarks
that articulate together to form the hip, knee, and ankle
joints.
40. The talus bone of the foot receives the weight of the
body from the tibia. The talus bone then distributes this
weight toward the ground in two directions: one-half of
the body weight is passed in a posterior direction and one-
half of the weight is passed in an anterior direction.
Describe the arrangement of the tarsal and metatarsal
bones that are involved in both the posterior and anterior
distribution of body weight.
41. How can a radiograph of a child’s femur be used to
determine the approximate age of that child?
42. How does the development of the clavicle differ from
the development of other appendicular skeleton bones?

30

Chapter 9
Homework
INTERACTIVE LINK QUESTIONS
1. Go to this website
(http://openstaxcollege.org/l/ childhand) to view a
radiograph (X-ray image) of a child’s hand and wrist. The
growing bones of child have an epiphyseal plate that forms a
synchondrosis between the shaft and end of a long bone. Being
less dense than bone, the area of epiphyseal cartilage is seen on
this radiograph as the dark epiphyseal gaps located near the
ends of the long bones, including the radius, ulna, metacarpal,
and phalanx bones. Which of the bones in this image do not
show an epiphyseal plate (epiphyseal gap)?
2. Watch this video (http://openstaxcollege.org/l/
synjoints) to see an animation of synovial joints in action.
Synovial joints are places where bones articulate with each
other inside of a joint cavity. The different types of synovial
joints are the ball-and-socket joint (shoulder joint), hinge joint
(knee), pivot joint (atlantoaxial joint, between C1 and C2
vertebrae of the neck), condyloid joint (radiocarpal joint of the
wrist), saddle joint (first carpometacarpal joint, between the
trapezium carpal bone and the first metacarpal bone, at the
base of the thumb), and plane joint (facet joints of vertebral
column, between superior and inferior articular processes).
Which type of synovial joint allows for the widest ranges of
motion?
3. Visit this website
(http://openstaxcollege.org/l/gout) to read about a
patient who arrives at the hospital with joint pain and weakness
in his legs. What caused this patient’s weakness?
4. Watch this animation
(http://openstaxcollege.org/l/ hipreplace) to observe
hip replacement surgery (total hip arthroplasty), which can be
used to alleviate the pain and loss of joint mobility associated
with osteoarthritis of the hip joint. What is the most common
cause of hip disability?
5. Watch this video (http://openstaxcollege.org/l/
rheuarthritis) to learn about the symptoms and treatments
for rheumatoid arthritis. Which system of the body
malfunctions in rheumatoid arthritis and what does this cause?
6. Watch this video (http://openstaxcollege.org/l/
anatomical) to learn about anatomical motions. What
motions involve increasing or decreasing the angle of the foot
at the ankle?
7. Watch this video
(http://openstaxcollege.org/l/TMJ) to learn about TMJ.
Opening of the mouth requires the combination of two motions
at the temporomandibular joint, an anterior gliding motion of
the articular disc and mandible and the downward hinging of
the mandible. What is the initial movement of the mandible
during opening and how much mouth opening does this
produce?
8. Watch this video (http://openstaxcollege.org/l/
shoulderjoint1) for a tutorial on the anatomy of the shoulder
joint. What movements are available at the shoulder joint?
9. Watch this video
(http://openstaxcollege.org/l/
shoulderjoint2) to learn about the anatomy of the shoulder
joint, including bones, joints, muscles, nerves, and blood
vessels. What is the shape of the glenoid labrum in
crosssection, and what is the importance of this shape?
10. Watch this animation
(http://openstaxcollege.org/l/ elbowjoint1) to learn
more about the anatomy of the elbow joint. What structures
provide the main stability for the elbow?
11. Watch this video
(http://openstaxcollege.org/l/ elbowjoint2) to
learn more about the anatomy of the elbow joint, including
bones, joints, muscles, nerves, and blood vessels. What are the
functions of the articular cartilage?
12. Watch this video
(http://openstaxcollege.org/l/ hipjoint1) for a
tutorial on the anatomy of the hip joint. What is a possible
consequence following a fracture of the femoral neck within
the capsule of the hip joint?
13. Watch this video (http://openstaxcollege.org/l/
hipjoint2) to learn more about the anatomy of the hip joint,
including bones, joints, muscles, nerves, and blood vessels.
Where is the articular cartilage thickest within the hip joint?
14. Watch this video (http://openstaxcollege.org/l/
flexext) to learn more about the flexion and extension of the
knee, as the femur both rolls and glides on the tibia to maintain
stable contact between the bones in all knee positions. The
patella glides along a groove on the anterior side of the distal
femur. The collateral ligaments on the sides of the knee
become tight in the fully extended position to help stabilize the
knee. The posterior cruciate ligament supports the knee when
flexed and the anterior cruciate ligament becomes tight when
the knee comes into full extension to resist hyperextension.
What are the ligaments that support the knee joint?
15. Watch this video (http://openstaxcollege.org/l/
kneejoint1) to learn more about the anatomy of the knee
joint, including bones, joints, muscles, nerves, and blood
vessels. Which ligament of the knee keeps the tibia from
sliding too far forward in relation to the femur and which
ligament keeps the tibia from sliding too far backward?
16. Watch this video (http://openstaxcollege.org/l/
kneeinjury) to learn more about different knee injuries and
diagnostic testing of the knee. What are the most causes of
anterior cruciate ligament injury?
17. Watch this video
(http://openstaxcollege.org/l/ anklejoint1) for a
31
tutorial on the anatomy of the ankle joint. What are the three
ligaments found on the lateral side of the ankle joint?
18. Watch this video
(http://openstaxcollege.org/l/ anklejoint2)
to learn more about the anatomy of the ankle joint, including
bones, joints, muscles, nerves, and blood vessels. The ankle
joint resembles what type of joint used in woodworking?
19. Watch this video
(http://openstaxcollege.org/l/ anklejoint3) to learn
about the ligaments of the ankle joint, ankle sprains, and
treatment. During an inversion ankle sprain injury, all three
ligaments that resist excessive inversion of the foot may be
injured. What is the sequence in which these three ligaments
are injured?

REVIEW QUESTIONS c. a fibrous joint that unites parallel bones

d. the type of joint that anchors the teeth in the jaws
20. The joint between adjacent vertebrae that includes an
invertebral disc is classified as which type of joint? 28. A cartilaginous joint ________.
a. has a joint cavity
a. diarthrosis b. is called a symphysis when the bones are united by
b. multiaxial fibrocartilage
c. amphiarthrosis c. anchors the teeth to the jaws
d. synarthrosis d. is formed by a wide sheet of fibrous connective tissue
21. Which of these joints is classified as a synarthrosis? 29. A synchondrosis is ________.
a. found at the pubic symphysis
a. the pubic symphysis b. where bones are connected
b. the manubriosternal joint together with fibrocartilage
c. an invertebral disc c. a type of fibrous joint
d. the shoulder joint d. found at the first sternocostal joint of the thoracic
22. Which of these joints is classified as a biaxial diarthrosis? cage
a. the metacarpophalangeal joint 30. Which of the following are joined by a symphysis?
b. the hip joint
c. the elbow joint a. adjacent vertebrae
d. the pubic symphysis b. the first rib and the sternum
c. the end and shaft of a long bone
23. Synovial joints ________.
d. the radius and ulna bones
a. may be functionally classified as a synarthrosis
b. are joints where the bones are connected to each other 31. The epiphyseal plate of a growing long bone in a child is
by hyaline cartilage classified as a ________.
c. may be functionally classifiedas a. synchondrosis
a amphiarthrosis b. synostosis
d. are joints where the bones articulate with each other c. symphysis
within a fluid-filled joint cavity d. syndesmosis
24. Which type of fibrous joint connects the tibia and fibula? 32. Which type of joint provides the greatest range of motion?
a. syndesmosis a. ball-and-socket
b. hinge
b. symphysis
c. suture c. condyloid
d. gomphosis d. plane
33. Which type of joint allows for
25. An example of a wide fibrous joint is ________.
only uniaxial movement?
a. the interosseous membrane of the forearm a. saddle joint
b. a gomphosis b. hinge joint
c. a suture joint c. condyloid joint
d. a synostosis d. ball-and-socket joint
26. A gomphosis ________. 34. Which of the following is a type of synovial joint?
a. is formed by an interosseous membrane
b. connects the tibia and fibula bones of the leg a. a synostosis
c. contains a joint cavity b. a suture
d. anchors a tooth to the jaw c. a plane joint
d. a synchondrosis
27. A syndesmosis is ________.
a. a narrow fibrous joint 35. A bursa ________.
b. the type of joint that unites bones of the skull

32
 a. surrounds a tendon at the point where the tendon 43. Supination is the motion that moves the ________.
crosses a joint
b. secretes the lubricating fluid for a synovial joint a. hand from the palm backward position to the palm
c. prevents friction between skin and bone, or a muscle forward position
tendon and bone b. foot so that the bottom of the foot faces the midline
d. is the strong band of connective tissue that holds of the body
bones together at a synovial joint c. hand from the palm forward position to the palm
backward position
36. At synovial joints, ________.
d. scapula in an upward direction
a. the articulating ends of the bones are directly
connected by fibrous connective tissue 44. Movement at the shoulder joint that moves the upper limb
b. the ends of the bones are enclosed within a space laterally away from the body is called ________.
called a subcutaneous bursa
c. intrinsic ligaments are located entirely inside of the a. elevation
articular capsule b. eversion
d. the joint cavity is filled with a thick, lubricating fluid c. abduction
d. lateral rotation
37. At a synovial joint, the synovial membrane ________.
45. The primary support for the glenohumeral joint is
a. forms the fibrous connective walls of the joint cavity provided by the ________.
b. is the layer of cartilage that covers the articulating a. coracohumeral ligament
surfaces of the bones b. glenoid labrum
c. forms the intracapsular ligaments c. rotator cuff muscles
d. secretes the lubricating synovial fluid d. subacromial bursa
38. Condyloid joints ________. 46. The proximal radioulnar joint ________.
a. are a type of ball-and-socket joint a. is supported by the annular ligament
b. include the radiocarpal joint b. contains an articular disc that strongly unites the
c. are a uniaxial diarthrosis joint bones
d. are found at the proximal radioulnar joint c. is supported by the ulnar collateral ligament
39. A meniscus is ________. d. is a hinge joint that allows for flexion/extension of
the forearm
a. a fibrocartilage pad that
provides padding between bones 47. Which statement is true concerning the knee joint?
b. a fluid-filled space that prevents friction between a
muscle tendon and underlying bone a. The lateral meniscus is an intrinsic ligament located
c. the articular cartilage that covers the ends of a bone on the lateral side of the knee joint.
at a synovial joint b. Hyperextension is resisted by the posterior cruciate
d. the lubricating fluid within a synovial joint ligament.
c. The anterior cruciate ligament supports the knee
40. The joints between the articular processes of adjacent
when it is flexed and weight bearing.
vertebrae can contribute to which movement?
d. The medial meniscus is attached to the tibial
a. lateral flexion
collateral ligament.
b. circumduction
c. dorsiflexion 48. The ankle joint ________.
d. abduction a. is also called the subtalar joint
b. allows for gliding movements that produce
41. Which motion moves the bottom of the foot away from
inversion/eversion of the foot
the midline of the body?
c. is a uniaxial hinge joint
a. elevation
d. is supported by the tibial collateral ligament on the
b. dorsiflexion
lateral side
c. eversion
d. plantar flexion 49. Which region of the vertebral column has the greatest
range of motion for rotation?
42. Movement of a body region in a circular movement at a
a. cervical
condyloid joint is what type of motion?
b. thoracic
a. rotation
c. lumbar
b. elevation
d. sacral
c. abduction
d. circumduction 50. Intramembranous ossification ________.
a. gives rise to the bones of the limbs

33
 b. produces the bones of the top and sides of the skull 52. Endochondral ossification is ________.
c. produces the bones of the face and base of the skull a. the process that replaces hyaline cartilage with bone
d. d. involves the conversion of a hyaline cartilage tissue
model into bone b. the process by which mesenchyme differentiates
51. Synovial joints ________. directly into bone tissue
a. are derived from fontanelles c. completed before birth
b. are produced by intramembranous ossification d. the process that gives rise to the joint interzone and
c. develop at an interzone site future joint cavit
d. are produced by endochondral ossification
e. 59. Describe the characteristic structures found at all
synovial joints.
CRITICAL THINKING QUESTIONS
53. Define how joints are classified based on function. 60. Describe the structures that provide direct and
Describe and give an example for each functional type of indirect support for a synovial joint.
joint. 61. Briefly define the types of joint movements available
54. Explain the reasons for why joints differ in their at a ball-and-socket joint.
degree of mobility. 62. Discuss the joints involved and movements required
55. Distinguish between a narrow and wide fibrous joint for you to cross your arms together in front of your chest.
and give an example of each. 63. Discuss the structures that contribute to support of the
56. The periodontal ligaments are made of collagen fibers shoulder joint.
and are responsible for connecting the roots of the teeth to 64. Describe the sequence of injuries that may occur if
the jaws. Describe how scurvy, a disease that inhibits the extended, weight-bearing knee receives a very strong
collagen production, can affect the teeth. blow to the lateral side of the knee.
57. Describe the two types of cartilaginous joints and 65. Describe how synovial joints develop within the
give examples of each. embryonic limb.
58. Both functional and structural classifications can be 66. Differentiate between endochondral and
used to describe an individual joint. Define the first intramembranous ossification.
sternocostal joint and the pubic symphysis using both
functional and structural characteristics.

34
Chapter 10 Homework
INTERACTIVE LINK QUESTIONS junction. (a) What is the definition of a motor unit? (b)
What is the structural and functional difference between a
1. Watch this video
large motor unit and a small motor unit? Can you give an
(http://openstaxcollege.org/l/ micromacro) to
example of each? (c) Why is the neurotransmitter
learn more about macro- and microstructures of skeletal
acetylcholine degraded after binding to its receptor?
muscles. (a) What are the names of the “junction points”
between sarcomeres? (b) What are the names of the 3. The release of calcium ions initiates muscle
“subunits” within the myofibrils that run the length of contractions. Watch this video
skeletal muscle fibers? (c) What is the “double strand of (http://openstaxcollege.org/l/ calciumrole) to
pearls” described in the video? (d) What gives a skeletal learn more about the role of calcium. (a) What are “T-
muscle fiber its striated appearance? tubules” and what is their role? (b) Please also describe
how actin-binding sites are made available for cross-
2. Every skeletal muscle fiber is supplied by a
bridging with myosin heads during contraction.
motor neuron at the NMJ. Watch this video
(http://openstaxcollege.org/l/skelmuscfiber) to
learn more about what happens at the neuromuscular
REVIEW QUESTIONS d. the sarcolemma has completely lost any
electrical charge
4. Muscle that has a striped appearance is described as
being ________. 9. In relaxed muscle, the myosin-binding site on actin is
a. elastic blocked by ________.
b. nonstriated a. titin
c. excitable b. troponin
d. striated c. myoglobin
d. tropomyosin
5. Which element is important in directly triggering
contraction? 10. According to the sliding filament model, binding
+
sites on actin open when ________.
a. sodium (Na ) a. creatine phosphate levels rise
++ b. ATP levels rise
b. calcium (Ca )
+ c. acetylcholine levels rise
c. potassium (K )
d. calcium ion levels rise
-
d. chloride (Cl ) 11. The cell membrane of a muscle fiber is called
6. Which of the following properties is not common to ________.
all three muscle tissues? a. myofibril
a. excitability b. sarcolemma
b. the need for ATP c. sarcoplasm
c. at rest, uses shielding proteins to cover d. myofilament
actinbinding sites
d. elasticity 12. Muscle relaxation occurs when ________.
a. calcium ions are actively transported out of the
7. The correct order for the smallest to the largest unit sarcoplasmic reticulum
of organization in muscle tissue is ________. b. calcium ions diffuse out of the sarcoplasmic
a. fascicle, filament, muscle fiber, myofibril reticulum
b. filament, myofibril, muscle fiber, fascicle c. calcium ions are actively transported into the
c. muscle fiber, fascicle, filament, myofibril sarcoplasmic reticulum
d. myofibril, muscle fiber, filament, fascicle d. calcium ions diffuse into the
8. Depolarization of the sarcolemma means ________. sarcoplasmic reticulum

a. the inside of the membrane has become less
negative as sodium ions accumulate
b. the outside of the membrane has become less
negative as sodium ions accumulate
c. the inside of the membrane has become more
negative as sodium ions accumulate
13. During muscle contraction, the cross-bridge detaches
when ________.
a. the myosin head binds to an ADP molecule
b. the myosin head binds to an ATP molecule
c. calcium ions bind to troponin
d. calcium ions bind to actin

35
 14. Thin and thick filaments are organized into 21. The muscles of a professional marathon runner are
functional units called ________. most likely to have ________.
a. myofibrils a. 80 percent fast-twitch muscle fibers and 20
b. myofilaments percent slow-twitch muscle fibers
c. T-tubules b. 20 percent fast-twitch muscle fibers and 80
d. sarcomeres percent slow-twitch muscle fibers
c. 50 percent fast-twitch muscle fibers and 50
15. During which phase of a twitch in a muscle fiber is
percent slow-twitch muscle fibers
tension the greatest?
d. 40 percent fast-twitch muscle fibers and 60
a. resting phase
percent slow-twitch muscle fibers
b. repolarization phase
c. contraction phase 22. Which of the following statements is true?
d. relaxation phase a. Fast fibers have a small diameter.
b. Fast fibers contain loosely packed myofibrils.
16. Muscle fatigue is caused by ________.
c. Fast fibers have large glycogen reserves.
a. buildup of ATP and lactic acid levels
d. Fast fibers have many mitochondria.
b. exhaustion of energy reserves and buildup of
lactic acid levels 23. Which of the following statements is false?
CHAPTER 10 | MUSCLE TISSUE 417 a. Slow fibers have a small network of capillaries.
b. Slow fibers contain the pigment myoglobin.
c. buildup of ATP and pyruvic acid levels c. Slow fibers contain a large
d. exhaustion of energy reserves and buildup of number of mitochondria.
pyruvic acid levels d. Slow fibers contract for extended periods.
17. A sprinter would experience muscle fatigue sooner 24. Cardiac muscles differ from skeletal muscles in that
than a marathon runner due to ________. they ________.
a. anaerobic metabolism in the muscles of the a. are striated
sprinter b. utilize aerobic metabolism
b. anaerobic metabolism in the muscles of the 418 CHAPTER 10 | MUSCLE TISSUE

marathon runner
c. aerobic metabolism in the muscles of the c. contain myofibrils
sprinter d. contain intercalated discs
d. glycolysis in the muscles of the marathon runner
25. If cardiac muscle cells were prevented from
18. What aspect of creatine phosphate allows it to supply undergoing aerobic metabolism, they ultimately would
energy to muscles? ________.
a. ATPase activity
b. phosphate bonds a. undergo glycolysis
c. carbon bonds b. synthesize ATP
d. hydrogen bonds c. stop contracting
d. start contracting
19. Drug X blocks ATP regeneration from ADP and
phosphate. How will muscle cells respond to this 26. Smooth muscles differ from skeletal and cardiac
drug? muscles in that they ________.
a. lack myofibrils
a. by absorbing ATP from the bloodstream b. are under voluntary control
b. by using ADP as an energy source c. lack myosin
c. by using glycogen as an energy source d. lack actin
d. none of the above 27. Which of the following statements describes smooth
20. The muscles of a professional sprinter are most likely muscle cells?
to have ________. a. They are resistant to fatigue.
a. 80 percent fast-twitch muscle fibers and 20 b. They have a rapid onset of contractions.
percent slow-twitch muscle fibers c. They cannot exhibit tetanus.
b. 20 percent fast-twitch muscle fibers and 80 d. They primarily use anaerobic metabolism.
percent slow-twitch muscle fibers
28. From which embryonic cell type does muscle tissue
c. 50 percent fast-twitch muscle fibers and 50
develop?
percent slow-twitch muscle fibers
a. ganglion cells
d. 40 percent fast-twitch muscle fibers and 60
b. myotube cells
percent slow-twitch muscle fibers
c. myoblast cells

36
 d. satellite cells
29. Which cell type helps to repair injured muscle fibers?
a. ganglion cells
b. myotube cells
CRITICAL THINKING
QUESTIONS
30. Why is elasticity an important quality of muscle
tissue?
31. What would happen to skeletal muscle if the
epimysium were destroyed?
32. Describe how tendons facilitate body movement.
33. What are the five primary functions of skeletal
muscle?
34. What are the opposite roles of voltage-gated sodium
channels and voltage-gated potassium channels?
35. How would muscle contractions be affected if
skeletal muscle fibers did not have T-tubules?
36. What causes the striated appearance of skeletal
muscle tissue?
37. How would muscle contractions be affected if ATP
was completely depleted in a muscle fiber?
38. Why does a motor unit of the eye have few muscle
fibers compared to a motor unit of the leg?
39. What factors contribute to the amount of tension
produced in an individual muscle fiber?
c. myoblast cells
d. satellite cells
40. Why do muscle cells use creatine phosphate instead
of glycolysis to supply ATP for the first few
seconds of muscle contraction?
41. Is aerobic respiration more or less efficient than
glycolysis? Explain your answer.
42. What changes occur at the cellular level in response
to endurance training?
43. What changes occur at the cellular level in response
to resistance training?
44. What would be the drawback of cardiac
contractions being the same duration as skeletal
muscle contractions?
45. How are cardiac muscle cells similar to and
different from skeletal muscle cells?
46. Why can smooth muscles contract over a wider
range of resting lengths than skeletal and cardiac
muscle?
47. Describe the differences between single-unit
smooth muscle and multiunit smooth muscle.
48. Why is muscle that has sustained significant
damage unable to produce the same amount of
power as it could before being damaged?
49. Which muscle type(s) (skeletal, smooth, or cardiac)
can regenerate new muscle cells/fibers? Explain
your answer.
37
Chapter 11 Homework
REVIEW QUESTIONS d. The muscle fibers on one side of a tendon
feed into it at a certain angle and muscle
1. Which of the following is unique to the muscles of fibers on the other side of the tendon feed into
facial expression? it at the opposite angle.
a. They all originate from the scalp musculature.
b. They insert onto the cartilage found around 8. The location of a muscle’s insertion and origin can
the face. determine ________.
c. They only insert onto the facial bones. a. action
d. They insert into the skin. b. the force of contraction
c. muscle name
2. Which of the following helps an agonist work? d. the load a muscle can carry

a. a synergist 9. Where is the temporalis muscle located?

b. a fixator a. on the forehead
c. an insertion b. in the neck
d. an antagonist c. on the side of the head
d. on the chin
3. Which of the following statements is correct about
what happens during flexion? 10. Which muscle name does not make sense?
a. The angle between bones is increased. a. extensor digitorum
b. The angle between bones is decreased. b. gluteus minimus
c. The bone moves away from the body. c. biceps femoris
d. The bone moves toward the center of the d. extensor minimus longus
body. 11. Which of the following terms would be used in
4. Which is moved the least during muscle the name of a muscle that moves the leg away
contraction? from the body?

a. the origin a. flexor

b. the insertion b. adductor
c. the ligaments c. extensor
d. the joints d. abductor

5. Which muscle has a convergent pattern of fascicles? 12. Which of the following is a prime mover in head
a. biceps brachii flexion?
b. gluteus maximus a. occipitofrontalis
c. pectoralis major b. corrugator supercilii
d. rectus femoris c. sternocleidomastoid
d. masseter
6. A muscle that has a pattern of fascicles running
along the long axis of the muscle has which of the 13. Where is the inferior oblique
following fascicle arrangements? muscle located?
a. circular
b. pennate a. in the abdomen
c. parallel b. in the eye socket
d. rectus c. in the anterior neck
d. in the face
7. Which arrangement best describes a bipennate
muscle? 14. What is the action of the masseter?
a. The muscle fibers feed in on an angle to a a. swallowing
long tendon from both sides. b. chewing
b. The muscle fibers feed in on an angle to a c. moving the lips
long tendon from all directions. d. closing the eye
c. The muscle fibers feed in on an angle to a
long tendon from one side.

38
 15. The names of the extrinsic tongue muscles a. biceps brachii
commonly end in ________. b. triceps brachii
a. -glottis c. brachialis
b. -glossus d. deltoid
c. -gluteus
22. What is the origin of the wrist flexors?
d. -hyoid
a. the lateral epicondyle of the humerus
16. What is the function of the erector spinae? b. the medial epicondyle of the humerus
a. movement of the arms c. the carpal bones of the wrist
b. stabilization of the pelvic girdle d. the deltoid tuberosity of the humerus
c. postural support
23. Which muscles stabilize the pectoral girdle?
d. rotating of the vertebral column
a. axial and scapular
17. Which of the following abdominal muscles is not b. axial
a part of the anterior abdominal wall? c. appendicular
a. quadratus lumborum d. axial and appendicular
b. rectus abdominis
24. The large muscle group that attaches the leg to
c. interior oblique
the pelvic girdle and produces extension of the
d. exterior oblique hip joint is the ________ group.
18. Which muscle pair plays a role in respiration? a. gluteal
b. obturator
a. intertransversarii, interspinales c. adductor
b. semispinalis cervicis, semispinalis thoracis d. abductor
c. trapezius, rhomboids
25. Which muscle produces movement that allows
d. diaphragm, scalene
you to cross your legs?
19. What is the linea alba? a. the gluteus maximus
a. a small muscle that helps with compression of b. the piriformis
the abdominal organs c. the gracilis
b. a long tendon that runs down the middle of d. the sartorius
the rectus abdominis
26. What is the largest muscle in the lower leg?
c. a long band of collagen fibers that connects
a. soleus
the hip to the knee
b. gastrocnemius
d. another name for the tendinous inscription
c. tibialis anterior
20. The rhomboid major and minor muscles are deep d. tibialis posterior
to the ________.
27. The vastus intermedius muscle is deep to which
a. rectus abdominis
of the following muscles?
b. scalene muscles
a. biceps femoris
c. trapezius
b. rectus femoris
d. ligamentum nuchae
c. vastus medialis
21. Which muscle extends the forearm? d. vastus lateralis
32. Explain the difference between axial and
appendicular muscles.
33. Describe the muscles of the anterior neck.
CRITICAL THINKING QUESTIONS
28. What effect does fascicle arrangement have on a 34. Why are the muscles of the face different from
muscle’s action? typical skeletal muscle?
35. Describe the fascicle arrangement in the muscles
29. Movements of the body occur at joints. Describe of the abdominal wall. How do they relate to each
how muscles are arranged around the joints of the other?
body.
36. What are some similarities and differences
30. Explain how a synergist assists an agonist by between the diaphragm and the pelvic
being a fixator. diaphragm?
31. Describe the different criteria that contribute to 37. The tendons of which muscles form the rotator
how skeletal muscles are named. cuff? Why is the rotator cuff important?

39
38. List the general muscle groups of the shoulders 40. Which muscles form the quadriceps? How do
and upper limbs as well as their subgroups. they function together?
39. Which muscles form the hamstrings? How do
they function together?

40

Chapter 12
Homework
INTERACTIVE LINK
QUESTIONS
1. In 2003, the Nobel Prize in Physiology or
Medicine was awarded to Paul C. Lauterbur and Sir
Peter Mansfield for discoveries related to magnetic
resonance imaging (MRI). This is a tool to see the
structures of the body (not just the nervous system)
that depends on magnetic fields associated with
certain atomic nuclei. The utility of this technique in
the nervous system is that fat tissue and water appear
as different shades between black and white. Because
white matter is fatty (from myelin) and gray matter is
not, they can be easily distinguished in MRI images.
Visit the Nobel Prize website
(http://openstaxcollege.org/l/nobel_2) to play
an interactive game that demonstrates the use of this
technology and compares it with other types of
imaging technologies. Also, the results from an MRI
session are compared with images obtained from x-
ray or computed tomography. How do the imaging
techniques shown in this game indicate the separation
of white and gray matter compared with the freshly
dissected tissue shown earlier?
2. Visit this site
(http://openstaxcollege.org/l/
troublewstairs) to read about a woman that notices
that her daughter is having trouble walking up the
stairs. This leads to the discovery of a hereditary
condition that affects the brain and spinal cord. The
electromyography and MRI tests indicated
deficiencies in the spinal cord and cerebellum, both
of which are responsible for controlling coordinated
movements. To what functional division of the
nervous system would these structures belong?
3. Visit this site (http://openstaxcollege.org/l/
nervetissue3) to learn about how nervous tissue is
composed of neurons and glial cells. The neurons are
dynamic cells with the ability to make a vast number
of connections and to respond incredibly quickly to
stimuli and to initiate movements based on those
stimuli. They are the focus of intense research as
failures in physiology can lead to devastating
illnesses. Why are neurons only found in animals?
Based on what this article says about neuron
function, why wouldn’t they be helpful for plants or
microorganisms?
4. View
Michigan
the University
WebScope
of
at
http://virtualslides.med.umich.edu/Histology/
EMsmallCharts/3%20Image%20Scope%20finals/
054%20-%20Peripheral%20nerve_001.svs/
view.apml?listview=1& (http://openstaxcollege.org/l/
nervefiber) to see an electron micrograph of a
crosssection of a myelinated nerve fiber. The axon
contains microtubules and neurofilaments, bounded
by a plasma membrane known as the axolemma.
Outside the plasma membrane of the axon is the
myelin sheath, which is composed of the tightly
wrapped plasma membrane of a Schwann cell. What
aspects of the cells in this image react with the stain
that makes them the deep, dark, black color, such as
the multiple layers that are the myelin sheath?
5. What happens across the membrane of an
electrically active cell is a dynamic process that is
hard to visualize with static images or through text
descriptions. View this animation
(http://openstaxcollege.org/l/dynamic1) to really
understand the process. What is the difference
between the driving force for Na+ and K+? And what
is similar about the movement of these two ions?
6. Visit this site
(http://openstaxcollege.org/l/neurolab) to see a virtual
neurophysiology lab, and to observe
electrophysiological processes in the nervous system,
where scientists directly measure the electrical
signals produced by neurons. Often, the action
potentials occur so rapidly that watching a screen to
see them occur is not helpful. A speaker is powered
by the signals recorded from a neuron and it “pops”
each time the neuron fires an action potential. These
action potentials are firing so fast that it sounds like
static on the radio. Electrophysiologists can recognize
the patterns within that static to understand what is
happening. Why is the leech model used for
measuring the electrical activity of neurons instead of
using humans?
7. Watch this video (http://openstaxcollege.org/l/
summation) to learn about summation. The process of
converting electrical signals to chemical signals and
back requires subtle changes that can result in
transient increases or decreases in membrane voltage.
To cause a lasting change in the target cell, multiple
signals are usually added together, or summated.
Does spatial summation have to happen all at once, or
can the separate signals arrive on the postsynaptic
neuron at slightly different times? Explain your
answer.
41
8. Watch this video (http://openstaxcollege.org/l/ suppress that activity. In a very short space, the
neurotrans) to learn about the release of a electrical signal of the action potential is changed into
neurotransmitter. The action potential reaches the end the chemical signal of a neurotransmitter, and then
of the axon, called the axon terminal, and a chemical back to electrical changes in the target cell
signal is released to tell the target cell to do membrane. What is the importance of voltage-gated
something, either initiate a new action potential, or to calcium channels in the release of neurotransmitters?
c. axon
REVIEW QUESTIONS d. synaptic end bulb
16. Which of the following substances is least able
9. Which of the following cavities contains a
to cross the blood-brain barrier?
component of the central nervous system?
a. water
a. abdominal
b. sodium ions
b. pelvic
c. glucose
c. cranial
d. white blood cells
d. thoracic
17. What type of glial cell is the resident
10. Which structure predominates in the white
macrophage behind the blood-brain barrier?
matter of the brain?
a. microglia
a. myelinated axons
b. astrocyte
b. neuronal cell bodies
c. Schwann cell
c. ganglia of the parasympathetic nerves
d. satellite cell
d. bundles of dendrites from the enteric nervous
system 18. What two types of macromolecules are the
main components of myelin?
11. Which part of a neuron transmits an electrical
a. carbohydrates and lipids
signal to a target cell?
b. proteins and nucleic acids
a. dendrites
c. lipids and proteins
b. soma
d. carbohydrates and nucleic acids
c. cell body
d. axon 19. If a thermoreceptor is sensitive to temperature
sensations, what would a chemoreceptor be
12. Which term describes a bundle of axons in the
sensitive to?
peripheral nervous system?
a. light
a. nucleus
b. sound
b. ganglion
c. molecules
c. tract
d. vibration
d. nerve
20. Which of these locations is where the greatest
13. Which functional division of the nervous
level of integration is taking place in the
system would be responsible for the
example of testing the temperature of the
physiological changes seen during exercise
shower?
(e.g., increased heart rate and sweating)?
a. skeletal muscle
a. somatic
b. spinal cord
b. autonomic
c. thalamus
c. enteric
d. cerebral cortex
d. central
21. How long does all the signaling through the
14. What type of glial cell provides myelin for the
sensory pathway, within the central nervous
axons in a tract?
system, and through the motor command
a. oligodendrocyte pathway take?
b. astrocyte a. 1 to 2 minutes
c. Schwann cell b. 1 to 2 seconds
d. satellite cell c. fraction of a second
15. Which part of a neuron contains the nucleus? d. varies with graded potential
a. dendrite 22. What is the target of an upper motor neuron?
b. soma a. cerebral cortex

42
 b. lower motor neuron a. a thin, unmyelinated axon
c. skeletal muscle b. a thin, myelinated axon
d. thalamus c. a thick, unmyelinated axon
23. What ion enters a neuron causing d. a thick, myelinated axon
depolarization of the cell membrane? 29. How much of a change in the membrane
a. sodium potential is necessary for the summation of
b. chloride postsynaptic potentials to result in an action
c. potassium potential being generated?
d. phosphate a. +30 mV
+ b. +15 mV
24. Voltage-gated Na channels open upon c. +10 mV
reaching what state? d. -15 mV
a. resting potential
b. threshold 30. A channel opens on a postsynaptic membrane
c. repolarization that causes a negative ion to enter the cell.
d. overshoot What type of graded potential is this?
25. What does a ligand-gated channel require in a. depolarizing
order to open? b. repolarizing
+ c. hyperpolarizing
a. increase in concentration of Na ions
d. non-polarizing
b. binding of a neurotransmitter
+ 31. What neurotransmitter is released at the
c. increase in concentration of K ions neuromuscular junction?
d. depolarization of the membrane a. norepinephrine
26. What does a mechanically gated channel b. serotonin
respond to? c. dopamine
a. physical stimulus d. acetylcholine
b. chemical stimulus 32. What type of receptor requires an effector
c. increase in resistance protein to initiate a signal?
d. decrease in resistance a. biogenic amine
27. Which of the following voltages would most b. ionotropic receptor
likely be measured during the relative c. cholinergic system
refractory period? d. metabotropic receptor
a. +30 mV 33. Which of the following neurotransmitters is
b. 0 mV associated with inhibition exclusively?
c. -45 mV a. GABA
d. -80 mv b. acetylcholine
28. Which of the following is probably going to c. glutamate
propagate an action potential fastest? d. norepinephrine
e. cell would be the most likely target of this disease?
Why?
CRITICAL THINKING
37. Which type of neuron, based on its shape, is
QUESTIONS best suited for relaying information directly from
34. What responses are generated by the nervous one neuron to another? Explain why.
system when you run on a treadmill? Include an
example of each type of tissue that is under nervous 38. Sensory fibers, or pathways, are referred to as
system control. “afferent.” Motor fibers, or pathways, are referred to
as “efferent.” What can you infer about the meaning
35. When eating food, what anatomical and of these two terms (afferent and efferent) in a
functional divisions of the nervous system are structural or anatomical context?
involved in the perceptual experience? 39. If a person has a motor disorder and cannot
36. Multiple sclerosis is a demyelinating disease move their arm voluntarily, but their muscles have
affecting the central nervous system. What type of tone, which motor neuron—upper or lower—is
probably affected? Explain why.

43
40. What does it mean for an action potential to
be an “all or none” event?
41. The conscious perception of pain is often
delayed because of the time it takes for the
sensations to reach the cerebral cortex. Why would
this be the case based on propagation of the axon
potential?
42. If a postsynaptic cell has synapses from five
different cells, and three cause EPSPs and two of
them cause IPSPs, give an example of a series of
depolarizations and hyperpolarizations that would
result in the neuron reaching threshold.
43. Why is the receptor the important element
determining the effect a neurotransmitter has on a
target cell?
44

Chapter 13
Homework
INTERACTIVE LINK QUESTIONS
1. Watch this animation
(http://openstaxcollege.org/l/ that establish the forebrain,
midbrain, and hindbrain. Those braindevel) to examine the
development of the brain, structures continue to develop
throughout the rest of starting with the neural tube. As the
anterior end of the embryonic development and into
adolescence. They are the neural tube develops, it enlarges
into the primary vesicles basis of the structure of the fully
developed adult brain. How would you describe the
difference in the relative sizes of the three regions of the
brain when comparing the early (25th embryonic day)
brain and the adult brain?
2. Watch this video
(http://openstaxcollege.org/l/ whitematter) to
learn about the white matter in the cerebrum that develops
during childhood and adolescence. This is a composite of
MRI images taken of the brains of people from 5 years of
age through 20 years of age, demonstrating how the
cerebrum changes. As the color changes to blue, the ratio
of gray matter to white matter changes. The caption for the
video describes it as “less gray matter,” which is another
way of saying “more white matter.” If the brain does not
finish developing until approximately 20 years of age, can
teenagers be held responsible for behaving badly?
3. Watch this video
(http://openstaxcollege.org/l/ basalnuclei1) to
learn about the basal nuclei (also known as the basal
ganglia), which have two pathways that process
information within the cerebrum. As shown in this video,
the direct pathway is the shorter pathway through the
system that results in increased activity in the cerebral
cortex and increased motor activity. The direct pathway is
described as resulting in “disinhibition” of the thalamus.
What does disinhibition mean? What are the two neurons
doing individually to cause this?
4. Watch this video
(http://openstaxcollege.org/l/ basalnuclei2) to
learn about the basal nuclei (also known as the basal
ganglia), which have two pathways that process
information within the cerebrum. As shown in this video,
the indirect pathway is the longer pathway through the
system that results in decreased activity in the cerebral
cortex, and therefore less motor activity. The indirect
pathway has an extra couple of connections in it, including
disinhibition of the subthalamic nucleus. What is the end
result on the thalamus, and therefore on movement initiated
by the cerebral cortex?
5. Watch this video
(http://openstaxcollege.org/l/ graymatter) to learn
about the gray matter of the spinal cord that receives input
from fibers of the dorsal (posterior) root and sends
information out through the fibers of the ventral (anterior)
root. As discussed in this video, these connections
represent the interactions of the CNS with peripheral
structures for both sensory and motor functions. The
cervical and lumbar spinal cords have enlargements as a
result of larger populations of neurons. What are these
enlargements responsible for?
6. Compared with the nearest evolutionary relative,
the chimpanzee, the human has a brain that is huge. At a
point in the past, a common ancestor gave rise to the two
species of humans and chimpanzees. That evolutionary
history is long and is still an area of intense study. But
something happened to increase the size of the human
brain relative to the chimpanzee. Read this
article(http://openstaxcollege.org/l/hugebrain) in
which the author explores the current
understanding of why this happened. According to one
hypothesis about the expansion of brain size, what tissue
might have been sacrificed so energy was available to grow
our larger brain? Based on what you know about that tissue
and nervous tissue, why would there be a trade-off between
them in terms of energy use?
7. Watch this animation
(http://openstaxcollege.org/l/ bloodflow1) to see
how blood flows to the brain and passes through the circle
of Willis before being distributed through the cerebrum.
The circle of Willis is a specialized arrangement of arteries
that ensure constant perfusion of the cerebrum even in the
event of a blockage of one of the arteries in the circle. The
animation shows the normal direction of flow through the
circle of Willis to the middle cerebral artery. Where would
the blood come from if there were a blockage just posterior
to the middle cerebral artery on the left?
8. Watch this video
(http://openstaxcollege.org/l/
lumbarpuncture) that describes the procedure known as
the lumbar puncture, a medical procedure used to sample
the CSF. Because of the anatomy of the CNS, it is a
relative safe location to insert a needle. Why is the lumbar
puncture performed in the lower lumbar area of the
vertebral column?
9. Watch this animation
(http://openstaxcollege.org/l/ CSFflow) that shows
the flow of CSF through the brain and spinal cord, and how
it originates from the ventricles and then spreads into the
space within the meninges, where the fluids then move into
45
the venous sinuses to return to the cardiovascular NYTmeningitis) to read about a man who wakes with a
circulation. What are the structures that produce CSF and headache and a loss of vision. His regular doctor sent him
where are they found? How are the structures indicated in to an ophthalmologist to address the vision loss. The
this animation? ophthalmologist recognizes a greater
problem and immediately sends him to the
10. Figure 13.20 If you zoom in on the DRG, you
emergency room. Once there, the patient undergoes a large
can see smaller satellite glial cells surrounding the large
battery of tests, but a definite cause cannot be found. A
cell bodies of the sensory neurons. From what structure do
specialist recognizes the problem as meningitis, but the
satellite cells derive during embryologic development?
question is what caused it originally. How can that be
11. Figure 13.22 To what structures in a skeletal cured? The loss of vision comes from swelling around the
muscle are the endoneurium, perineurium, and epineurium optic nerve, which probably presented as a bulge on the
comparable? inside of the eye. Why is swelling related to meningitis
going to push on the optic nerve?
12. Visit this site
(http://openstaxcollege.org/l/
REVIEW QUESTIONS d. frontal
13. Aside from the nervous system, which other organ 19. What region of the diencephalon
system develops out of the ectoderm? coordinates homeostasis?
a. digestive a. thalamus
b. respiratory b. epithalamus
c. integumentary c. hypothalamus
d. urinary d. subthalamus
14. Which primary vesicle of the embryonic nervous
20. What level of the brain stem is the major input to
system does not differentiate into more vesicles at
the cerebellum?
the secondary stage?
a. midbrain
a. prosencephalon
b. pons
b. mesencephalon
c. medulla
c. diencephalon
d. spinal cord
d. rhombencephalon
21. What region of the spinal cord contains motor
15. Which adult structure(s) arises from the
neurons that direct the movement of skeletal
diencephalon?
muscles?
a. thalamus, hypothalamus, retina
a. anterior horn
b. midbrain, pons, medulla
b. posterior horn
c. pons and cerebellum
c. lateral horn
d. cerebrum
d. alar plate
16. Which non-nervous tissue develops
22. Brodmann’s areas map different regions of
from the neuroectoderm?
the________ to particular functions.
a. respiratory mucosa
a. cerebellum
b. vertebral bone
b. cerebral cortex
c. digestive lining
c. basal forebrain
d. craniofacial bone
d. corpus callosum
17. Which structure is associated with the
23. What blood vessel enters the cranium to supply
embryologic development of the peripheral
the brain with fresh, oxygenated blood?
nervous system?
a. common carotid artery
a. neural crest
b. jugular vein
b. neuraxis
c. internal carotid artery
c. rhombencephalon
d. aorta
d. neural tube
24. Which layer of the meninges surrounds and
18. Which lobe of the cerebral cortex is responsible
supports the sinuses that form the route through
for generating motor commands?
which blood drains from the CNS?
a. temporal
a. dura mater
b. parietal
b. arachnoid mater
c. occipital

46
 c. subarachnoid 29. Which ganglion is responsible for cutaneous
d. pia mater sensations of the face?
a. otic ganglion
25. What type of glial cell is responsible for filtering
blood to produce CSF at the choroid plexus? b. vestibular ganglion
a. ependymal cell c. geniculate ganglion
b. astrocyte d. trigeminal ganglion
c. oligodendrocyte 30. What is the name for a bundle of axons within a
d. Schwann cell nerve?
a. fascicle
26. Which portion of the ventricular system is found
within the diencephalon? b. tract
a. lateral ventricles c. nerve root
b. third ventricle d. epineurium
c. cerebral aqueduct 31. Which cranial nerve does not control functions in
d. fourth ventricle the head and neck?
a. olfactory
27. What condition causes a stroke?
b. trochlear
a. inflammation of meninges
c. glossopharyngeal
b. lumbar puncture
d. vagus
c. infection of cerebral spinal fluid
d. disruption of blood to the brain 32. Which of these structures is not under direct
control of the peripheral nervous system?
28. What type of ganglion contains neurons that
a. trigeminal ganglion
control homeostatic mechanisms of the body?
b. gastric plexus
a. sensory ganglion
c. sympathetic chain ganglia
b. dorsal root ganglion
d. cervical plexus
c. autonomic ganglion
d. cranial nerve ganglion
36. Why do the anatomical inputs to the cerebellum
suggest that it can compare motor commands and sensory
CRITICAL THINKING feedback?
QUESTIONS 37. Why can the circle of Willis maintain perfusion of
33. Studying the embryonic development of the the brain even if there is a blockage in one part of the
nervous system makes it easier to understand the structure?
complexity of the adult nervous system. Give one example 38. Meningitis is an inflammation of the meninges that
of how development in the embryonic nervous system can have severe effects on neurological function. Why is
explains a more complex structure in the adult nervous infection of this structure potentially so dangerous?
system.
39. Why are ganglia and nerves not surrounded by
34. What happens in development that suggests that protective structures like the meninges of the CNS?
there is a special relationship between the skeletal
structure of the head and the nervous system? 40. Testing for neurological function involves a series
of tests of functions associated with the cranial nerves.
35. Damage to specific regions of the cerebral cortex, What functions, and therefore which nerves, are being
such as through a stroke, can result in specific losses of tested by asking a patient to follow the tip of a pen with
function. What functions would likely be lost by a stroke their eyes?
in the temporal lobe?

47

Chapter 14
Homework
INTERACTIVE LINK
QUESTIONS
1. Watch this video
(http://openstaxcollege.org/l/DanielleR
eed) to learn about Dr. Danielle Reed of the
Monell Chemical Senses Center in Philadelphia,
PA, who became interested in science at an early
age because of her sensory experiences. She
recognized that her sense of taste was unique
compared with other people she knew. Now, she
studies the genetic differences between people and
their sensitivities to taste stimuli. In the video,
there is a brief image of a person sticking out their
tongue, which has been covered with a colored
dye. This is how Dr. Reed is able to visualize and
count papillae on the surface of the tongue. People
fall into two large groups known as “tasters” and
“non-tasters” on the basis of the density of papillae
on their tongue, which also indicates the number of
taste buds. Non-tasters can taste food, but they are
not as sensitive to certain tastes, such as bitterness.
Dr. Reed discovered that she is a non-taster, which
explains why she perceived bitterness differently
than other people she knew. Are you very sensitive
to tastes? Can you see any similarities among the
members of your family?
2. Figure 14.9 The basilar membrane is the thin
membrane that extends from the central core of the
cochlea to the edge. What is anchored to this
membrane so that they can be activated by
movement of the fluids within the cochlea?
3. Watch this video
(http://openstaxcollege.org/l/ear1) to learn
more about how the structures of the ear convert
sound waves into a neural signal by moving the
“hairs,” or stereocilia, of the cochlear duct.
Specific locations along the length of the duct
encode specific frequencies, or pitches. The brain
interprets the meaning of the sounds we hear as
music, speech, noise, etc. Which ear structures are
responsible for the amplification and transfer of
sound from the external ear to the inner ear?
4. Watch this animation
(http://openstaxcollege.org/l/ ear2) to learn
more about the inner ear and to see the cochlea
unroll, with the base at the back of the image and
the apex at the front. Specific wavelengths of
sound cause specific regions of the basilar
membrane to vibrate, much like the keys of a piano
produce sound at different frequencies. Based on
the animation, where do frequencies—from high to
low pitches—cause activity in the hair cells within
the cochlear duct?
5. Watch this video
(http://openstaxcollege.org/l/ occipital) to
learn more about a transverse section through the
brain that depicts the visual pathway from the eye
to the occipital cortex. The first half of the pathway
is the projection from the RGCs through the optic
nerve to the lateral geniculate nucleus in the
thalamus on either side. This first fiber in the
pathway synapses on a thalamic cell that then
projects to the visual cortex in the occipital lobe
where “seeing,” or visual perception, takes place.
This video gives an abbreviated overview of the
visual system by concentrating on the pathway
from the eyes to the occipital lobe. The video
makes the statement (at 0:45) that “specialized
cells in the retina called ganglion cells convert the
light rays into electrical signals.” What aspect of
retinal processing is simplified by that statement?
Explain your answer.
6. Watch this video
(http://openstaxcollege.org/l/l_3-D1) to
learn more about how the brain perceives 3-D
motion. Similar to how retinal disparity offers 3-D
moviegoers a way to extract 3-D information from
the two-dimensional visual field projected onto the
retina, the brain can extract information about
movement in space by comparing what the two
eyes see. If movement of a visual stimulus is
leftward in one eye and rightward in the opposite
eye, the brain interprets this as movement toward
(or away) from the face along the midline. If both
eyes see an object moving in the same direction,
but at different rates, what would that mean for
spatial movement?
7. The inability to recognize people by their faces
is a troublesome problem. It can be caused by
trauma, or it may be inborn. Watch this video
(http://openstaxcollege.org/ l/faces) to learn
more about a person who lost the ability to
recognize faces as the result of an injury. She
cannot recognize the faces of close family
members or herself. What other information can a
person suffering from prosopagnosia use to figure
out whom they are seeing?
48
8. Watch this video
(http://openstaxcollege.org/l/
motorpathway) to learn more about the
descending motor pathway for the somatic nervous
system. The autonomic connections are mentioned,
which are covered in another chapter. From this
brief video, only some of the descending motor
pathway of the somatic nervous system is
described. Which division of the pathway is
described and which division is left out?
9. Visit this site (http://openstaxcollege.org/l/
NYTmotor) to read about an elderly woman who
starts to lose the ability to control fine movements,
such as speech and the movement of limbs. Many
of the usual causes were ruled out. It was not a
stroke, Parkinson’s disease, diabetes, or thyroid
dysfunction. The next most obvious cause was
medication, so her pharmacist had to be consulted.
The side effect of a drug meant to help her sleep
had resulted in changes in motor control. What
regions of the nervous system are likely to be the
focus of haloperidol side effects?
10. Watch this video
(http://openstaxcollege.org/l/ reflexarc) to
learn more about the reflex arc of the corneal
reflex. When the right cornea senses a tactile
stimulus, what happens to the left eye? Explain
your answer.
11. Watch this video
(http://openstaxcollege.org/l/ newreflex)
to learn more about newborn reflexes. Newborns
have a set of reflexes that are expected to have
been crucial to survival before the modern age.
These reflexes disappear as the baby grows, as
some of them may be unnecessary as they age. The
video demonstrates a reflex called the Babinski
reflex, in which the foot flexes dorsally and the
toes splay out when the sole of the foot is lightly
scratched. This is normal for newborns, but it is a
sign of reduced myelination of the spinal tract in
adults. Why would this reflex be a problem for an
adult?

REVIEW QUESTIONS c. mechanoreceptor

d. nociceptor
12. What type of receptor cell is
responsible for transducing pain stimuli? 17. Which of these sensory modalities does not pass
a. mechanoreceptor through the ventral posterior thalamus?
b. nociceptor a. gustatory
c. osmoreceptor b. proprioception
d. photoreceptor c. audition
d. nociception
13. Which of these cranial nerves is part of the gustatory
system? 18. Which nucleus in the medulla is connected to the
a. olfactory inferior colliculus?
b. trochlear a. solitary nucleus
c. trigeminal b. vestibular nucleus
d. facial c. chief sensory nucleus
d. cochlear nucleus
14. Which submodality of taste is sensitive to the pH of
19. Visual stimuli in the upper-left visual field will be
saliva?
processed in what region of the primary visual cortex?
a. umami
a. inferior right
b. sour
b. inferior left
c. bitter
c. superior right
d. sweet
d. superior left
15. Axons from which neuron in the retina make up the
20. Which location on the body has the largest region of
optic nerve?
somatosensory cortex representing it, according to the
a. amacrine cells
sensory homunculus?
b. photoreceptors a. lips
c. bipolar cells b. thigh
d. retinal ganglion cells c. elbow
16. What type of receptor cell is involved in the d. neck
sensations of sound and balance?
21. Which of the following is a direct target of the
a. photoreceptor
vestibular ganglion?
b. chemoreceptor

49
a. superior colliculus 24. Which region of gray matter in the spinal cord
b. cerebellum contains motor neurons that innervate skeletal muscles?
c. thalamus a. ventral horn
d. optic chiasm b. dorsal horn
c. lateral horn
22. Which region of the frontal lobe is responsible for
initiating movement by directly connecting to cranial and d. lateral column
spinal motor neurons? 25. What type of reflex can protect the foot when a
a. prefrontal cortex painful stimulus is sensed?
b. supplemental motor area a. stretch reflex
c. premotor cortex b. gag reflex
d. primary motor cortex c. withdrawal reflex
23. Which extrapyramidal tract incorporates equilibrium d. corneal reflex
sensations with motor commands to aid in posture and
26. What is the name for the topographical
movement?
representation of the sensory input to the somatosensory
a. tectospinal tract cortex?
b. vestibulospinal tract a. homunculus
c. reticulospinal tract b. homo sapiens
d. corticospinal tract c. postcentral gyrus
d. primary
CRITICAL THINKING QUESTIONS 30. A pituitary tumor can cause perceptual losses in
the lateral visual field. The pituitary gland is located
27. The sweetener known as stevia can replace glucose in directly inferior to the hypothalamus. Why would
food. What does the molecular similarity of stevia to this happen?
glucose mean for the gustatory sense?
31. The prefrontal lobotomy is a drastic—and
28. Why does the blind spot from the optic disc in either largely out of-practice—procedure used to
eye not result in a blind spot in the visual field? disconnect that portion of the cerebral cortex from
29. Following a motorcycle accident, the victim loses the the rest of the frontal lobe and the diencephalon as a
ability to move the right leg but has normal control over psychiatric therapy. Why would this have been
the left one, suggesting a hemisection somewhere in the thought necessary for someone with a potentially
thoracic region of the spinal cord. What sensory deficits uncontrollable behavior?
would be expected in terms of touch versus pain? Explain 32. If a reflex is a limited circuit within the somatic
your answer. system, why do physical and neurological exams
include them to test the health of an individual?

50
 suggest a stroke. He undergoes endless tests and seeks

Chapter 15 input from multiple doctors. In the end, one expert, one
question, and a simple blood pressure cuff answers the
question. Why would the heart have to beat faster when

Homework
the teenager changes his body position from lying down to
sitting, and then to standing?
4. Watch this video
INTERACTIVE LINK QUESTIONS (http://openstaxcollege.org/l/ pupillary) to learn
about the pupillary reflexes. The pupillary light reflex
1. Watch this video
involves sensory input through the optic nerve and motor
(http://openstaxcollege.org/l/ fightflight) to learn
response through the oculomotor nerve to the ciliary
more about adrenaline and the fightor-flight response.
ganglion, which projects to the circular fibers of the iris.
When someone is said to have a rush of adrenaline, the
As shown in this short animation, pupils will constrict to
image of bungee jumpers or skydivers usually comes to
limit the amount of light falling on the retina under bright
mind. But adrenaline, also known as epinephrine, is an
lighting conditions. What constitutes the afferent and
important chemical in coordinating the body’s fight-or-
efferent branches of the competing reflex (dilation)?
flight response. In this video, you look inside the
5. Watch this video
physiology of the fight-or-flight response, as envisioned
(http://openstaxcollege.org/l/ emotions) to learn
for a firefighter. His body’s reaction is the result of the
about physical responses to emotion. The autonomic
sympathetic division of the autonomic nervous system
system, which is important for regulating the homeostasis
causing system-wide changes as it prepares for extreme
of the organ systems, is also responsible for our
responses. What two changes does adrenaline bring about
physiological responses to emotions such as fear. The
to help the skeletal muscle response?
video summarizes the extent of the body’s reactions and
2. Watch this video describes several effects of the autonomic system in
(http://openstaxcollege.org/l/ nervsystem1) to response to fear. On the basis of what you have already
learn more about the nervous system. As described in this studied about autonomic function, which effect would you
video, the nervous system has a way to deal with threats expect to be associated with parasympathetic, rather than
and stress that is separate from the conscious control of sympathetic, activity?
the somatic nervous system. The system comes from a
6. Watch this video
time when threats were about survival, but in the modern
(http://openstaxcollege.org/l/ 3Dmovies) to learn
age, these responses become part of stress and anxiety.
about the side effects of 3-D movies. As discussed in this
This video describes how the autonomic system is only
video, movies that are shot in 3-D can cause motion
part of the response to threats, or stressors. What other
sickness, which elicits the autonomic symptoms of nausea
organ system gets involved, and what part of the brain
and sweating. The disconnection between the perceived
coordinates the two systems for the entire response,
motion on the screen and the lack of any change in
including epinephrine (adrenaline) and cortisol?
equilibrium stimulates these symptoms. Whydo you think
3. Read this article sitting close to the screen or right in the middle of the
(http://openstaxcollege.org/l/ strokespell) to learn theater makes motion sickness during a 3-D movie worse?
about a teenager who experiences a series of spells that
REVIEW QUESTIONS a. epinephrine
b. norepinephrine
7. Which of these physiological changes would not
c. acetylcholine
be considered part of the sympathetic fight-or-
d. adrenaline
flight response?
a. increased heart rate 10. Which of these cranial nerves contains
b. increased sweating preganglionic parasympathetic fibers?
c. dilated pupils a. optic, CN II
d. increased stomach motility b. facial, CN VII
c. trigeminal, CN V
8. Which type of fiber could be considered the
d. hypoglossal, CN XII
longest?
a. preganglionic parasympathetic 11. Which of the following is not a target of a
b. preganglionic sympathetic sympathetic preganglionic fiber?
c. postganglionic parasympathetic a. intermural ganglion
d. postganglionic sympathetic b. collateral ganglion
c. adrenal gland
9. Which signaling molecule is most likely
d. chain ganglion
responsible for an increase in digestive activity?

51
12. Which of the following represents a sensory input c. mammillary bodies
that is not part of both the somatic and autonomic d. prefrontal cortex
systems?
20. What is another name for the
a. vision
preganglionic sympathetic fibers that
b. taste project to the heart?
c. baroreception a. solitary tract
d. proprioception b. vasomotor nerve
13. What is the term for a reflex that does not include c. vagus nerve
a CNS component? d. cardiac accelerator nerve
a. long reflex
21. What central fiber tract connects forebrain and
b. visceral reflex brain stem structures with the hypothalamus?
c. somatic reflex a. cardiac accelerator nerve
d. short reflex b. medial forebrain bundle
14. What neurotransmitter will result in constriction of c. dorsal longitudinal fasciculus
the pupil? d. corticospinal tract
a. norepinephrine
22. A drug that affects both divisions of the autonomic
b. acetylcholine system is going to bind to, or block, which type of
c. epinephrine neurotransmitter receptor?
d. serotonin a. nicotinic
15. What gland produces a secretion that causes fight- b. muscarinic
orflight responses in effectors? c. α-adrenergic
a. adrenal medulla d. β-adrenergic
b. salivatory gland 23. A drug is called an agonist if it ________.
c. reproductive gland a. blocks a receptor
d. thymus b. interferes with neurotransmitter reuptake
16. Which of the following is an incorrect pairing? c. acts like the endogenous neurotransmitter by
a. norepinephrine dilates the pupil binding to its receptor
b. epinephrine increases blood pressure d. blocks the voltage-gated calcium ion channel
c. acetylcholine decreases digestion 24. Which type of drug would be an antidote to
d. norepinephrine increases heart rate atropine poisoning?
a. nicotinic agonist
17. Which of these locations in the forebrain is the
b. anticholinergic
master control center for homeostasis through the
autonomic and endocrine systems? c. muscarinic agonist
a. hypothalamus d. α-blocker
b. thalamus 25. Which kind of drug would have anti-anxiety
effects?
c. amygdala
a. nicotinic agonist
d. cerebral cortex
b. anticholinergic
18. Which nerve projects to the hypothalamus to c. muscarinic agonist
indicate the level of light stimuli in the retina? d. α-blocker
a. glossopharyngeal
b. oculomotor 26. 26. Which type of drug could be used to treat
asthma by opening airways wider?
c. optic
a. sympatholytic drug
d. vagus
b. sympathomimetic drug
19. What region of the limbic lobe is responsible for c. anticholinergic drug
generating stress responses via the hypothalamus? d. parasympathomimetic drug
a. hippocampus
b. amygdala
CRITICAL THINKING QUESTIONS 28. A target effector, such as the heart, receives
input from the sympathetic and parasympathetic systems.
27. In the context of a lioness hunting on the What is the actual difference between the sympathetic and
savannah, why would the sympathetic system not activate parasympathetic divisions at the level of those connections
the digestive system? (i.e., at the synapse)?

52
29. Damage to internal organs will present as pain
associated with a particular surface area of the body. Why
would something like irritation to the diaphragm, which is
between the thoracic and abdominal cavities, feel like pain
in the shoulder or neck?
30. Medical practice is paying more attention to the
autonomic system in considering disease states. Why
would autonomic tone be important in considering
cardiovascular disease?
31. Horner’s syndrome is a condition that presents
with changes in one eye, such as pupillary constriction and
dropping of eyelids, as well as decreased sweating in the
face. Why could a tumor in the thoracic cavity have an
effect on these autonomic functions?
32. The cardiovascular center is responsible for
regulating the heart and blood vessels through homeostatic
mechanisms. What tone does each component of the
cardiovascular system have? What connections does the
cardiovascular center invoke to keep these two systems in
their resting tone?
33. Why does smoking increase the risk of heart
disease? Provide two reasons based on autonomic
function.
34. Why might topical, cosmetic application of
atropine or scopolamine from the belladonna plant not
cause fatal poisoning, as would occur with ingestion of the
plant?
53

Chapter 16
Homework
INTERACTIVE LINK QUESTIONS
1. Watch this video
(http://openstaxcollege.org/l/ neuroexam) that
provides a demonstration of the neurological exam—a
series of tests that can be performed rapidly when a patient
is initially brought into an emergency department. The
exam can be repeated on a regular basis to keep a record
of how and if neurological function changes over time. In
what order were the sections of the neurological exam
tested in this video, and which section seemed to be left
out?
2. Watch this video
(http://openstaxcollege.org/l/ neuroexam2) for an
introduction to the neurological exam. Studying the
neurological exam can give insight into how structure and
function in the nervous system are interdependent. This is
a tool both in the clinic and in the classroom, but for
different reasons. In the clinic, this is a powerful but
simple tool to assess a patient’s neurological function. In
the classroom, it is a different way to think about the
nervous system. Though medical technology provides
noninvasive imaging and real-time functional data, the
presenter says these cannot replace the history at the core
of the medical examination. What does history mean in
the context of medical practice?
3. Read this article
(http://openstaxcollege.org/l/3word) to learn about
a young man who texts his fiancée in a panic as he finds
that he is having trouble remembering things. At the
hospital, a neurologist administers the mental status exam,
which is mostly normal except for the three-word recall
test. The young man could not recall them even 30
seconds after hearing them and repeating them back to the
doctor. An undiscovered mass in the mediastinum region
was found to be Hodgkin’s lymphoma, a type of cancer
that affects the immune system and likely caused
antibodies to attack the nervous system. The patient
eventually regained his ability to remember, though the
events in the hospital were always elusive. Considering
that the effects on memory were temporary, but resulted in
the loss of the specific events of the hospital stay, what
regions of the brain were likely to have been affected by
the antibodies and what type of memory does that
represent?
4. Watch the video
(http://openstaxcollege.org/l/2brains) titled “The
Man With Two Brains” to see the neuroscientist Michael
Gazzaniga introduce a patient he has worked with for
years who has had his corpus callosum cut, separating his
two cerebral hemispheres. A few tests are run to
demonstrate how this manifests in tests of cerebral
function. Unlike normal people, this patient can perform
two independent tasks at the same time because the lines
of communication between the right and left sides of his
brain have been removed. Whereas a person with an intact
corpus callosum cannot overcome the dominance of one
hemisphere over the other, this patient can. If the left
cerebral hemisphere is dominant in the majority of people,
why would right-handedness be most common?
5. Watch this short video
(http://openstaxcollege.org/l/ facialnerve) to see
an examination of the facial nerve using some simple
tests. The facial nerve controls the muscles of facial
expression. Severe deficits will be obvious in watching
someone use those muscles for normal control. One side
of the face might not move like the other side. But
directed tests, especially for contraction against resistance,
require a formal testing of the muscles. The muscles of the
upper and lower face need to be tested. The strength test in
this video involves the patient squeezing her eyes shut and
the examiner trying to pry her eyes open. Why does the
examiner ask her to try a second time?
6. Watch this video
(http://openstaxcollege.org/l/2point) to see a quick
demonstration of two-point discrimination. Touching a
specialized caliper to the surface of the skin will measure
the distance between two points that are perceived as
distinct stimuli versus a single stimulus. The patient keeps
their eyes closed while the examiner switches between
using both points of the caliper or just one. The patient
then must indicate whether one or two stimuli are in
contact with the skin. Why is the distance between the
caliper points closer on the fingertips as opposed to the
palm of the hand? And what do you think the distance
would be on the arm, or the shoulder?
7. Watch this video
(http://openstaxcollege.org/l/ reflextest) to see
how to test reflexes in the abdomen. Testing reflexes of
the trunk is not commonly performed in the neurological
exam, but if findings suggest a problem with the thoracic
segments of the spinal cord, a series of superficial reflexes
of the abdomen can localize function to those segments. If
contraction is not observed when the skin lateral to the
umbilicus (belly button) is stimulated, what level of the
spinal cord may be damaged?
8. Watch this short video
(http://openstaxcollege.org/l/ stationtest) to see a
54
test for station. Station refers to the position a person more demanding. The examiner may also push the subject
adopts when they are standing still. The examiner would to see if they can maintain balance. An abnormal finding
look for issues with balance, which coordinates in the test of station is if the feet are placed far apart. Why
proprioceptive, vestibular, and visual information in the would a wide stance suggest problems with cerebellar
cerebellum. To test the ability of a subject to maintain function?
balance, asking them to stand or hop on one foot can be
REVIEW QUESTIONS b. premotor cortex
c. hippocampus
9. Which major section of the neurological exam is
d. Wernicke’s area
most likely to reveal damage to the cerebellum?
a. cranial nerve exam 16. Which is an example of episodic memory?
b. mental status exam a. how to bake a cake
c. sensory exam b. your last birthday party
d. coordination exam c. how old you are
d. needing to wear an oven mitt to take a cake
10. What function would most likely be affected by a
out of the oven
restriction of a blood vessel in the cerebral
cortex? 17. Which type of aphasia is more like hearing a
a. language foreign language spoken?
b. gait a. receptive aphasia
c. facial expressions b. expressive aphasia
d. knee-jerk reflex c. conductive aphasia
d. Broca’s aphasia
11. Which major section of the neurological exam
includes subtests that are sometimes considered a 18. What region of the cerebral cortex is associated
separate set of tests concerned with walking? with understanding language, both from another
a. mental status exam person and the language a person generates
b. cranial nerve exam himself or herself?
c. coordination exam a. medial temporal lobe
d. sensory exam b. ventromedial prefrontal cortex
c. superior temporal gyrus
12. Memory, emotional, language, and sensorimotor
d. postcentral gyrus
deficits together are most likely the result of
what kind of damage? 19. Without olfactory sensation to complement
a. stroke gustatory stimuli, food will taste bland unless it
b. developmental disorder is seasoned with which substance?
c. whiplash a. salt
d. gunshot wound b. thyme
c. garlic
13. Where is language function localized in the
d. olive oil
majority of people?
a. cerebellum 20. Which of the following cranial nerves
b. right cerebral hemisphere is not part of the VOR?
c. hippocampus a. optic
d. left cerebral hemisphere b. oculomotor
c. abducens
14. Which of the following could be elements of
d. vestibulocochlear
cytoarchitecture, as related to Brodmann’s
microscopic studies of the cerebral cortex? 21. Which nerve is responsible for controlling the
a. connections to the cerebellum muscles that result in the gag reflex?
b. activation by visual stimuli a. trigeminal
c. number of neurons per square millimeter b. facial
d. number of gyri or sulci c. glossopharyngeal
d. vagus
15. Which of the following could be a multimodal
integrative area? 22. Which nerve is responsible for taste, as well as
a. primary visual cortex salivation, in the anterior oral cavity?
a. facial

55
 b. glossopharyngeal b. causes skeletal muscle contraction
c. vagus c. projects to a ganglion near the target
d. hypoglossal effector
d. involves an axon in the ventral nerve root
23. Which of the following nerves controls
movements of the neck? 29. Which white matter structure carries information
a. oculomotor from the cerebral cortex to the cerebellum?
b. vestibulocochlear a. cerebral peduncle
c. spinal accessory b. superior cerebellar peduncle
d. hypoglossal c. middle cerebellar peduncle
d. inferior cerebellar peduncle
24. Which of the following is not part of the
corticospinal pathway? 30. Which region of the cerebellum
a. cerebellar deep white matter receives proprioceptive input from the spinal
b. midbrain cord?
c. medulla a. vermis
d. lateral column b. left hemisphere
c. flocculonodular lobe
25. Which subtest is directed at proprioceptive
d. right hemisphere
sensation?
31. Which of the following tests cerebellar function
a. two-point discrimination
related to gait?
b. tactile movement
a. toe-to-finger
c. vibration
b. station
d. Romberg test
c. lah-kah-pah
26. What term describes the inability to lift the arm d. finger-to-nose
above the level of the shoulder?
32. Which of the following is not a cause of
a. paralysis
cerebellar ataxia?
b. paresis
a. mercury from fish
c. fasciculation
b. drinking alcohol
d. fibrillation
c. antibiotics
27. Which type of reflex is the jaw-jerk reflex that is d. hereditary degeneration of the cerebellum
part of the cranial nerve exam for the
vestibulocochlear nerve? 33. Which of the following functions cannot be
a. visceral reflex attributed to the cerebellum?
a. comparing motor commands
b. withdrawal reflex
and sensory feedback
c. stretch reflex
b. associating sensory stimuli with learned
d. superficial reflex
behavior
28. Which of the following is a feature of both c. coordinating complex movements
somatic and visceral senses? d. processing visual information
a. requires cerebral input
CRITICAL THINKING QUESTIONS 38. As a person ages, their ability to focus on near objects
(accommodation) changes. If a person is already
34. Why is a rapid assessment of neurological function myopic (near-sighted), why would corrective lenses
important in an emergency situation? not be necessary to read a book or computer screen?
35. How is the diagnostic category of TIA different from 39. When a patient flexes their neck, the head tips to the
a stroke? right side. Also, their tongue sticks out slightly to the
36. A patient’s performance of the majority of the mental left when they try to stick it straight out. Where is the
status exam subtests is in line with the expected damage to the brain stem most likely located?
norms, but the patient cannot repeat a string of 40. The location of somatosensation is based on the
numbers given by the examiner. What is a likely topographical map of sensory innervation. What does
explanation? this mean?
37. A patient responds to the question “What is your 41. Why are upper motor neuron lesions characterized by
name?” with a look of incomprehension. Which of the “spastic paralysis”?
two major language areas is most likely affected and
42. Learning to ride a bike is a motor function dependent
what is the name for that type of aphasia?
on the cerebellum. Why are the different regions of

56
the cerebellum involved in this complex motor 43. Alcohol intoxication can produce slurred speech. How
learning? is this related to cerebellar function?

57
 and the pituitary gland. Which hormone is released by the

Chapter 17 pituitary to stimulate the thyroid gland?

3. Visit this
(http://openstaxcollege.org/l/ adrenalglands) to
link

Homework view an animation describing the location and function of

the adrenal glands. Which hormone produced by the
adrenal glands is responsible for mobilization of energy
INTERACTIVE LINK QUESTIONS stores?

1. Visit this link 4. Visit this link

(http://openstaxcollege.org/l/ hormonebind) to (http://openstaxcollege.org/l/melatonin) to view
watch an animation of the events that occur when a an animation describing the function of the hormone
hormone binds to a cell membrane receptor. What is the melatonin. What should you avoid doing in the middle of
secondary messenger made by adenylyl cyclase during the your sleep cycle that would lower melatonin?
activation of liver cells by epinephrine? 5. Visit this link
2. Visit this link (http://openstaxcollege.org/l/pancreas1) to view
(http://openstaxcollege.org/l/ roleofhypo) to an animation describing the location and function of the
watch an animation showing the role of the hypothalamus pancreas. What goes wrong in the function of insulin in
type 2 diabetes?
REVIEW QUESTIONS heart rate, and rapid breathing. What type of
endocrine system stimulus did the student receive?
6. Endocrine glands ________. a. humoral
a. secrete hormones that travel through a duct to b. hormonal
the target organs
c. neural
b. release neurotransmitters into the synaptic cleft
d. positive feedback
c. secrete chemical messengers that travel in the
bloodstream 11. The hypothalamus is functionally and anatomically
d. include sebaceous glands and sweat glands connected to the posterior pituitary lobe by a bridge
of ________.
7. Chemical signaling that affects neighboring cells is a. blood vessels
called ________. b. nerve axons
a. autocrine c. cartilage
b. paracrine
d. bone
c. endocrine
d. neuron 12. Which of the following is an anterior pituitary
8. A newly developed pesticide has been observed to hormone?
bind to an intracellular hormone receptor. If a. ADH
ingested, residue from this pesticide could disrupt b. oxytocin
levels of ________. c. TSH
a. melatonin d. cortisol
b. thyroid hormone 13. How many hormones are produced by the posterior
c. growth hormone pituitary?
d. insulin a. 0
9. A small molecule binds to a G protein, preventing its b. 1
activation. What direct effect will this have on c. 2
signaling that involves cAMP? d. 6
a. The hormone will not be able to bind to the 14. Which of the following hormones contributes to the
hormone receptor. regulation of the body’s fluid and electrolyte
b. Adenylyl cyclase will not be activated. balance?
c. Excessive quantities of cAMP will be produced. a. adrenocorticotropic hormone
d. The phosphorylation cascade will be initiated. b. antidiuretic hormone
10. A student is in a car accident, and although not hurt, c. luteinizing hormone
immediately experiences pupil dilation, increased d. all of the above

58
15. Which of the following statements about the thyroid b. neuroglial cells
gland is true? c. follicle cells
a. It is located anterior to the trachea and inferior d. oxyphil cells
to the larynx.
23. Cushing’s disease is a disorder caused by ________.
b. The parathyroid glands are embedded within it.
a. abnormally low levels of cortisol
c. It manufactures three hormones.
b. abnormally high levels of cortisol
d. all of the above
c. abnormally low levels of aldosterone
16. The secretion of thyroid hormones is controlled by d. abnormally high levels of aldosterone
________.
24. Which of the following responses s not part of the
a. TSH from the hypothalamus
fight-or-flight response?
b. TSH from the anterior pituitary
a. pupil dilation
c. thyroxine from the anterior pituitary
b. increased oxygen supply to the lungs
d. thyroglobulin from the thyroid’s parafollicular
c. suppressed digestion
cells
d. reduced mental activity
17. The development of a goiter indicates that
25. What cells secrete melatonin?
________.
a. melanocytes
a. the anterior pituitary is abnormally enlarged
b. pinealocytes
b. there is hypertrophy of the thyroid’s follicle
c. suprachiasmatic nucleus cells
cells
d. retinal cells
c. there is an excessive accumulation of colloid in
the thyroid follicles 26. The production of melatonin is inhibited by
d. the anterior pituitary is secreting ________.
excessive growth hormone a. declining levels of light
18. Iodide ions cross from the bloodstream into follicle b. exposure to bright light
cells via ________. c. the secretion of serotonin
a. simple diffusion d. the activity of pinealocytes
b. facilitated diffusion 27. The gonads produce what class
c. active transport of hormones?
d. osmosis a. amine hormones
19. When blood calcium levels are low, PTH stimulates b. peptide hormones
________. c. steroid hormones
a. urinary excretion of calcium by the kidneys d. catecholamines
b. a reduction in calcium absorption from the 28. The production of FSH by the anterior pituitary is
intestines reduced by which hormone?
c. the activity of osteoblasts a. estrogens
d. the activity of osteoclasts b. progesterone
c. relaxin
20. Which of the following
d. inhibin
can result from hyperparathyroidism?
a. increased bone deposition 29. The function of the placental hormone human
b. fractures placental lactogen (hPL) is to ________.
c. convulsions a. prepare the breasts for lactation
d. all of the above b. nourish the placenta
c. regulate the menstrual cycle
21. The adrenal glands are attached superiorly to which
d. all of the above
organ?
a. thyroid 30. If an autoimmune disorder targets the alpha cells,
b. liver production of which hormone would be directly
c. kidneys affected?
d. hypothalamus a. somatostatin
b. pancreatic polypeptide
22. What secretory cell type is found in the adrenal
c. insulin
medulla?
d. glucagon
a. chromaffin cells

59
31. Which of the following statements about insulin is
true?
a. Insulin acts as a transport protein, carrying
glucose across the cell membrane.
35. Hormones produced by the thymus play a role in the
b. Insulin facilitates the movement of intracellular
glucose transporters to the cell membrane.
c. Insulin stimulates the breakdown of stored
glycogen into glucose.
d. Insulin stimulates the kidneys to reabsorb
glucose into the bloodstream.
36. The anterior pituitary gland develops from which
32. The walls of the atria produce which hormone?
a. cholecystokinin
b. atrial natriuretic peptide
c. renin
d. calcitriol
33. The end result of the RAAS is to ________.
37. In the elderly, decreased thyroid function causes
a. reduce blood volume
b. increase blood glucose
c. reduce blood pressure
d. increase blood pressure
34. Athletes may take synthetic EPO to boost their
________.
a. blood calcium levels
CRITICAL THINKING QUESTIONS
38. Describe several main differences in the communication
methods used by the endocrine system and the nervous
system.
39. Compare and contrast endocrine and exocrine glands.
40. True or false: Neurotransmitters are a special class of
paracrines. Explain your answer.
41. Compare and contrast the signaling events involved with
the second messengers cAMP and IP3.
42. Describe the mechanism of hormone response resulting
from the binding of a hormone with an intracellular
receptor.
43. Compare and contrast the anatomical relationship of the
anterior and posterior lobes of the pituitary gland to the
hypothalamus.
44. Name the target tissues for prolactin.
45. Explain why maternal iodine deficiency might lead to
neurological impairment in the fetus.
46. Define hyperthyroidism and explain why one of its
symptoms is weight loss.
47. Describe the role of negative feedback in the function of
the parathyroid gland.
48. Explain why someone with a parathyroid gland tumor
might develop kidney stones.
b. secretion of growth hormone
c. blood oxygen levels
d. muscle mass
________.
a. development of T cells
b. preparation of the body for childbirth
c. regulation of appetite
d. release of hydrochloric acid in the stomach
embryonic germ layer?
a. oral ectoderm
b. neural ectoderm
c. mesoderm
d. endoderm
________.
a. increased tolerance for cold
b. decreased basal metabolic rate
c. decreased body fat
d. osteoporosis
49. What are the three regions of the adrenal cortex and
what hormones do they produce?
50. If innervation to the adrenal medulla were disrupted,
what would be the physiological outcome?
51. Compare and contrast the short-term and long-term
stress response.
52. Seasonal affective disorder (SAD) is a mood disorder
characterized by, among other symptoms, increased
appetite, sluggishness, and increased sleepiness. It
occurs most commonly during the winter months,
especially in regions with long winter nights. Propose a
role for melatonin in SAD and a possible non-drug
therapy.
53. Retinitis pigmentosa (RP) is a disease that causes
deterioration of the retinas of the eyes. Describe the
impact RP would have on melatonin levels.
54. Compare and contrast the role of estrogens and
progesterone.
55. Describe the role of placental secretion of relaxin in
preparation for childbirth.
56. What would be the physiological consequence of a
disease that destroyed the beta cells of the pancreas?
57. Why is foot care extremely important for people with
diabetes mellitus?
58. Summarize the role of GI tract hormones following a
meal.

60
59. Compare and contrast the thymus gland in infancy and 60. Distinguish between the effects of menopause and
adulthood. andropause on fertility.

61
 3. Figure 18.13 Are you able to recognize and

Chapter 18 identify the various formed elements? You will need to do

this is a systematic manner, scanning along the image. The
standard method is to use a grid, but this is not possible

Homework
with this resource. Try constructing a simple table with
each leukocyte type and then making a mark for each cell
type you identify. Attempt to classify at least 50 and
perhaps as many as 100 different cells. Based on the
INTERACTIVE LINK QUESTIONS percentage of cells that you count, do the numbers
1. Visit this site represent a normal blood smear or does something appear
(http://openstaxcollege.org/l/ normallevels) for a to be abnormal?
list of normal levels established for many of the 4. View these animations
substances found in a sample of blood. Serum, one of the (http://openstaxcollege.org/l/ coagulation) to
specimen types included, refers to a sample of plasma explore the intrinsic, extrinsic, and common pathways that
after clotting factors have been removed. What types of are involved the process of coagulation. The coagulation
measurements are given for levels of glucose in the blood? cascade restores hemostasis by activating coagulation
2. Watch this video factors in the presence of an injury. How does the
(http://openstaxcollege.org/l/doping) to see endothelium of the blood vessel walls prevent the blood
doctors discuss the dangers of blood doping in sports. from coagulating as it flows through the blood vessels?
What are the some potential side effects of blood doping?

REVIEW QUESTIONS a. It facilitates the proliferation and differentiation of

the erythrocyte lineage.
5. Which of the following statements about blood is b. It is a hormone produced by the thyroid gland.
true?
c. It is a hemopoietic growth factor that prompts
a. Blood is about 92 percent water.
lymphoid stem cells to leave the bone marrow.
b. Blood is slightly more acidic than water.
d. Both a and b are true.
c. Blood is slightly more viscous than water.
d. Blood is slightly more salty than seawater. 10. Interleukins are associated primarily with which of the
following?
6. Which of the following statements about albumin is a. production of various lymphocytes
true? b. immune responses
a. It draws water out of the blood vessels and into the
c. inflammation
body’s tissues.
d. all of the above
b. It is the most abundant plasma protein.
c. It is produced by specialized leukocytes called 11. Which of the following statements about mature,
plasma cells. circulating erythrocytes is true?
d. All of the above are true. a. They have no nucleus.
b. They are packed with mitochondria.
7. Which of the following plasma proteins is not
c. They survive for an average of 4 days.
produced by the liver?
d. All of the above
a. fibrinogen
b. alpha globulin 12. A molecule of hemoglobin ________.
c. beta globulin a. is shaped like a biconcave disk packed almost
d. immunoglobulin entirely with iron
b. contains four glycoprotein units studded with
8. Which of the formed elements arise from myeloid oxygen
stem cells?
c. consists of four globin proteins, each bound to a
a. B cells
molecule of heme
b. natural killer cells
d. can carry up to 120 molecules of oxygen
c. platelets
d. all of the above 13. The production of healthy erythrocytes depends upon
the availability of ________.
9. Which of the following statements about a. copper
erythropoietin is true?
b. zinc
c. vitamin B 12

62
 d. copper, zinc, and vitamin B12 20. Thrombocytes are more accurately called ________.
a. clotting factors
14. Aging and damaged erythrocytes are removed from
b. megakaryoblasts
the circulation by ________.
c. megakaryocytes
a. myeoblasts
d. platelets
b. monocytes
c. macrophages 21. The first step in hemostasis is ________.
d. mast cells a. vascular spasm
15. A patient has been suffering for 2 months with a b. conversion of fibrinogen to fibrin
chronic, watery diarrhea. A blood test is likely to c. activation of the intrinsic pathway
reveal ________. d. activation of the common pathway
a. a hematocrit below 30 percent 22. Prothrombin is converted to thrombin during the
b. hypoxemia ________.
c. anemia a. intrinsic pathway
d. polycythemia b. extrinsic pathway
16. The process by which leukocytes squeeze through c. common pathway
adjacent cells in a blood vessel wall is called d. formation of the platelet plug
________.
23. Hemophilia is characterized by ________.
a. leukocytosis
a. inadequate production of heparin
b. positive chemotaxis
b. inadequate production of clotting factors
c. emigration
c. excessive production of fibrinogen
d. cytoplasmic extending
d. excessive production of platelets
17. Which of the following describes a neutrophil?
24. The process in which antibodies attach to antigens,
a. abundant, agranular, especially effective against
causing the formation of masses of linked cells, is called
cancer cells ________.
b. abundant, granular, especially effective against a. sensitization
bacteria
b. coagulation
c. rare, agranular, releases antimicrobial defensins
c. agglutination
d. rare, granular, contains multiple granules packed
d. hemolysis
with histamine
25. People with ABO blood type O ________.
18. T and B lymphocytes ________.
a. have both antigens A and B on their erythrocytes
a. are polymorphonuclear
b. lack both antigens A and B on their erythrocytes
b. are involved with specific immune function
c. have neither anti-A nor anti-B antibodies
c. proliferate excessively in leukopenia
circulating in their blood plasma
d. are most active against parasitic worms
d. are considered universal recipients
19. A patient has been experiencing severe, persistent
26. Hemolytic disease of the newborn is a risk during a
allergy symptoms that are reduced when she takes an
subsequent pregnancy in which ________.
antihistamine. Before the treatment, this patient was
a. a type AB mother is carrying a type O fetus
likely to have had increased activity of which
b. a type O mother is carrying a type AB fetus
leukocyte?
+ −
a. basophils c. an Rh mother is carrying an Rh fetus
b. neutrophils − +
d. an Rh mother is carrying a second Rh fetus
c. monocytes
d. natural killer cells

CRITICAL THINKING QUESTIONS

27. A patient’s hematocrit is 42 percent. 30. Myelofibrosis is a disorder in which inflammation
Approximately what percentage of the patient’s blood is and scar tissue formation in the bone marrow impair
plasma? hemopoiesis. One sign is an enlarged spleen. Why?
28. Why would it be incorrect to refer to the formed 31. Would you expect a patient with a form of cancer
elements as cells? called acute myelogenous leukemia to experience impaired
29. True or false: The buffy coat is the portion of a production of erythrocytes, or impaired production of
blood sample that is made up of its proteins. lymphocytes? Explain your choice.
32. A young woman has been experiencing unusually
heavy menstrual bleeding for several years. She follows a

63
strict vegan diet (no animal foods). She is at risk for what
disorder, and why?
33. A patient has thalassemia, a genetic disorder
characterized by abnormal synthesis of globin proteins and
excessive destruction of erythrocytes. This patient is jaundiced
and is found to have an excessive level of bilirubin in his
blood. Explain the connection.
34. One of the more common adverse effects of cancer
chemotherapy is the destruction of leukocytes. Before his next
scheduled chemotherapy treatment, a patient undergoes a
blood test called an absolute neutrophil count (ANC), which
reveals that his neutrophil count is 1900 cells per microliter.
Would his healthcare team be likely to proceed with his
chemotherapy treatment? Why?
35. A patient was admitted to the burn unit the
previous evening suffering from a severe burn involving his
left upper extremity and shoulder. A blood test reveals that he
is experiencing leukocytosis. Why is this an expected finding?
36. A lab technician collects a blood sample in a glass
tube. After about an hour, she harvests serum to continue her
blood analysis. Explain what has happened during the hour
that the sample was in the glass tube.
37. Explain why administration of a thrombolytic agent
is a first intervention for someone who has suffered a
thrombotic stroke.
38. Following a motor vehicle accident, a patient
is rushed to the emergency department with multiple
traumatic injuries, causing severe bleeding. The patient’s
condition is critical, and there is no time for determining
his blood type. What type of blood is transfused, and
why?
39. In preparation for a scheduled surgery, a patient
visits the hospital lab for a blood draw. The technician collects
a blood sample and performs a test to determine its type. She
places a sample of the patient’s blood in two wells. To the first
well she adds anti-A antibody. To the second she adds anti-B
antibody. Both samples visibly agglutinate. Has the technician
made an error, or is this a normal response? If normal, what
blood type does this indicate?
64
 INTERACTIVE LINK QUESTIONS
Chapter 19 1. Visit this
(http://openstaxcollege.org/l/heartvalve) to observe
site

Homework
an echocardiogram of actual heart valves opening and
closing. Although much of the heart has been “removed”
from this gif loop so the chordae tendineae are not visible,
why is their presence more critical for the atrioventricular
valves (tricuspid and mitral) than the semilunar (aortic and
pulmonary) valves?
REVIEW QUESTIONS 8. In which septum is it normal to find openings in the
adult?
2. Which of the following is not important in a. interatrial septum
preventing backflow of blood?
b. interventricular septum
a. chordae tendineae
c. atrioventricular septum
b. papillary muscles
d. all of the above
c. AV valves
d. endocardium 9. Which of the following is unique to cardiac muscle
cells?
3. Which valve separates the left atrium from the left a. Only cardiac muscle contains a sarcoplasmic
ventricle? reticulum.
a. mitral b. Only cardiac muscle has gap junctions.
b. tricuspid c. Only cardiac muscle is capable
c. pulmonary of autorhythmicity
d. aortic d. Only cardiac muscle has a high concentration of
4. Which of the following lists the valves in the order mitochondria.
through which the blood flows from the vena cava 10. The influx of which ion accounts for the plateau
through the heart? phase?
a. tricuspid, pulmonary semilunar, bicuspid, aortic
semilunar a. sodium
b. mitral, pulmonary semilunar, bicuspid, aortic b. potassium
semilunar c. chloride
c. aortic semilunar, pulmonary semilunar, d. calcium
tricuspid, bicuspid
d. bicuspid, aortic semilunar, tricuspid, pulmonary 11. Which portion of the ECG
semilunar corresponds to repolarization of the atria?
a. P wave
5. Which chamber initially receives blood from the b. QRS complex
systemic circuit? c. T wave
a. left atrium d. none of the above: atrial repolarization is
b. left ventricle masked by ventricular depolarization
c. right atrium
d. right ventricle 12. Which component of the heart conduction system
would have the slowest rate of firing?
6. The ________ layer secretes chemicals that help to a. atrioventricular node
regulate ionic environments and strength of b. atrioventricular bundle
contraction and serve as powerful vasoconstrictors. c. bundle branches
a. pericardial sac d. Purkinje fibers
b. endocardium
c. myocardium 13. The cardiac cycle consists of a distinct relaxation and
d. epicardium contraction phase. Which term is typically used to
refer ventricular contraction while no blood is being
7. The myocardium would be the thickest in the ejected?
________. a. systole
a. left atrium b. diastole
b. left ventricle c. quiescent
c. right atrium d. isovolumic contraction
d. right ventricle
14. Most blood enters the ventricle during ________.
a. atrial systole

65
 b. atrial diastole 21. Which of the following is a positive inotrope?
c. ventricular systole +
a. Na
d. isovolumic contraction +
b. K
15. The first heart sound represents which portion of the
c. Ca2+
cardiac cycle?
+ +
a. atrial systole d. both Na and K
b. ventricular systole
22. The earliest organ to form and begin function within
c. closing of the atrioventricular valves
the developing human is the ________.
d. closing of the semilunar valves
a. brain
16. Ventricular relaxation immediately follows b. stomach
________. c. lungs
a. atrial depolarization d. heart
b. ventricular repolarization
23. Of the three germ layers that give rise to all adult
c. ventricular depolarization
tissues and organs, which gives rise to the heart?
d. atrial repolarization
a. ectoderm
17. The force the heart must overcome to pump blood is b. endoderm
known as ________. c. mesoderm
a. preload d. placenta
b. afterload
24. The two tubes that eventually fuse to form the heart
c. cardiac output
are referred to as the ________.
d. stroke volume
a. primitive heart tubes
18. The cardiovascular centers are located in which area b. endocardial tubes
of the brain? c. cardiogenic region
a. medulla oblongata d. cardiogenic tubes
b. pons
25. Which primitive area of the heart will give rise to the
c. mesencephalon (midbrain)
right ventricle?
d. cerebrum
a. bulbus cordis
19. In a healthy young adult, what happens to cardiac
b. primitive ventricle
output when heart rate increases above 160 bpm?
c. sinus venosus
a. It increases.
d. truncus arteriosus
b. It decreases.
c. It remains constant. 26. The pulmonary trunk and aorta are derived from
d. There is no way to predict. which primitive heart structure?
a. bulbus cordis
20. What happens to preload when there is venous
b. primitive ventricle
constriction in the veins?
c. sinus venosus
a. It increases.
d. truncus arteriosus
b. It decreases.
c. It remains constant.
d. There is no way to predict.

CRITICAL THINKING QUESTIONS 31. How do gap junctions and intercalated disks aid
contraction of the heart?
27. Describe how the valves keep the blood moving in
one direction. 32. Why do the cardiac muscles cells demonstrate
autorhythmicity?
28. Why is the pressure in the pulmonary circulation
33. Describe one cardiac cycle, beginning with both
lower than in the systemic circulation?
atria and ventricles relaxed.
29. Why is the plateau phase so critical to cardiac 34. Why does increasing EDV increase contractility?
muscle function? 35. Why is afterload important to cardiac function?
30. How does the delay of the 36. Why is it so important for the human heart to
impulse at the atrioventricular node develop early and begin functioning within the
contribute to cardiac function? developing embryo?

66
37. Describe how the major pumping chambers, the ventricles, form within the developing heart.

67
Chapter 20 Homework
INTERACTIVE LINK QUESTIONS more than 100 micrometers away. What is the
main component of interstitial fluid?
1. Watch this video 2. Listen to this CDC podcast
(http://openstaxcollege.org/l/ (http://openstaxcollege.org/l/CDCpodcast) to
capillaryfunct) to explore capillaries and how learn about hypertension, often described as a “silent
they function in the body. Capillaries are never killer.” What steps can you take to reduce your risk of a
heart attack or stroke?
REVIEW QUESTIONS a. is compliant
b. reduces blood flow
3. The endothelium is found in the ________.
c. is a resistance artery
a. tunica intima
d. has a thin wall and irregular lumen
b. tunica media
c. tunica externa 10. Which of the following statements is true?
d. lumen a. The longer the vessel, the lower the resistance
and the greater the flow.
4. Nervi vasorum control ________. b. As blood volume decreases, blood pressure and
a. vasoconstriction blood flow also decrease.
b. vasodilation c. Increased viscosity increases blood flow.
c. capillary permeability d. All of the above are true.
d. both vasoconstriction and vasodilation
11. Slight vasodilation in an arteriole prompts a
5. Closer to the heart, arteries would be expected to ________.
have a higher percentage of ________. a. slight increase in resistance
a. endothelium b. huge increase in resistance
b. smooth muscle fibers c. slight decrease in resistance
c. elastic fibers d. huge decrease in resistance
d. collagenous fibers
12. Venoconstriction increases which of the following?
6. Which of the following best describes veins? a. blood pressure within the vein
a. thick walled, small lumens, low pressure, lack b. blood flow within the vein
valves c. return of blood to the heart
b. thin walled, large lumens, low pressure, have d. all of the above
valves
c. thin walled, small lumens, high pressure, have 13. Hydrostatic pressure is ________.
valves a. greater than colloid osmotic pressure at the
d. thick walled, large lumens, high pressure, lack venous end of the capillary bed
valves b. the pressure exerted by fluid in an enclosed
space
7. An especially leaky type of capillary found in the
c. about zero at the midpoint of a capillary bed
liver and certain other tissues is called a ________.
d. all of the above
a. capillary bed
b. fenestrated capillary 14. Net filtration pressure is calculated by ________.
c. sinusoid capillary a. adding the capillary hydrostatic pressure to the
d. metarteriole interstitial fluid hydrostatic pressure
b. subtracting the fluid drained by the lymphatic
8. In a blood pressure measurement of 110/70, the
vessels from the total fluid in the interstitial fluid
number 70 is the ________.
c. adding the blood colloid osmotic pressure to the
a. systolic pressure
capillary hydrostatic pressure
b. diastolic pressure
d. subtracting the blood colloid osmotic pressure
c. pulse pressure from the capillary hydrostatic pressure
d. mean arterial pressure 15. Which of the following statements is true?
9. A healthy elastic artery ________.

68
 a. In one day, more fluid exits the capillary through
filtration than enters through reabsorption.
b. In one day, approximately 35 mm of blood are
filtered and 7 mm are reabsorbed.
c. In one day, the capillaries of the lymphatic
system absorb about 20.4 liters of fluid.
d. None of the above are true.
16. Clusters of neurons in the medulla oblongata that
regulate blood pressure are known collectively as
________.
a. baroreceptors
b. angioreceptors
c. the cardiomotor mechanism
d. the cardiovascular center
17. In the renin-angiotensin-aldosterone
mechanism, ________.
a. decreased blood pressure prompts the release of
renin from the liver
b. aldosterone prompts increased urine output
c. aldosterone prompts the kidneys to
reabsorb sodium
d. all of the above
18. In the myogenic response, ________.
a. muscle contraction promotes venous return to
the heart
b. ventricular contraction strength is decreased
c. vascular smooth muscle responds to stretch
d. endothelins dilate muscular arteries
19. A form of circulatory shock common in young
children with severe diarrhea or vomiting is
________.
a. hypovolemic shock
b. anaphylactic shock
c. obstructive shock
d. hemorrhagic shock
20. The coronary arteries branch off of the ________.
a. aortic valve
b. ascending aorta
c. aortic arch
d. thoracic aorta
21. Which of the following statements is true?
a. The left and right common carotid arteries both
branch off of the brachiocephalic trunk.
b. The brachial artery is the distal branch of the
axillary artery.
c. The radial and ulnar arteries join to form the
palmar arch.
d. All of the above are true.
22. Arteries serving the stomach, pancreas, and liver all
branch from the ________.
a. superior mesenteric artery
b. inferior mesenteric artery
c. celiac trunk
d. splenic artery
23. The right and left brachiocephalic veins ________.
a. drain blood from the right and left internal
jugular veins
b. drain blood from the right and left subclavian
veins
c. drain into the superior vena cava
d. all of the above are true
24. The hepatic portal system delivers blood from the
digestive organs to the ________.
a. liver
b. hypothalamus
c. spleen
d. left atrium
25. Blood islands are ________.
a. clusters of blood-filtering cells in the placenta
b. masses of pluripotent stem cells scattered
throughout the fetal bone marrow
c. vascular tubes that give rise to the embryonic
tubular heart
d. masses of developing blood vessels and formed
elements scattered throughout the embryonic
disc
26. Which of the following statements is true?
a. Two umbilical veins carry oxygen-depleted
blood from the fetal circulation to the placenta.
b. One umbilical vein carries oxygen-rich blood
from the placenta to the fetal heart.
c. Two umbilical arteries carry oxygen-depleted
blood to the fetal lungs.
d. None of the above are true.
27. The ductus venosus is a shunt that allows ________.
a. fetal blood to flow from the right atrium to the
left atrium
b. fetal blood to flow from the right ventricle to the
left ventricle
c. most freshly oxygenated blood to flow into the
fetal heart
d. most oxygen-depleted fetal blood to flow
directly
into the fetal pulmonary trunk
69
 CRITICAL THINKING QUESTIONS colloid osmotic pressure is normal. How would you
expect this situation to affect the patient’s net filtration
28. Arterioles are often referred to as resistance pressure?
vessels. Why?
34. True or false? The plasma proteins suspended in
29. Cocaine use causes vasoconstriction. Is this blood cross the capillary cell membrane and enter the
likely to increase or decrease blood pressure, and why? tissue fluid via facilitated diffusion. Explain your thinking.
30. A blood vessel with a few smooth muscle fibers 35. A patient arrives in the emergency department
and connective tissue, and only a very thin tunica externa with a blood pressure of 70/45 confused and complaining
conducts blood toward the heart. What type of vessel is of thirst. Why?
this? 36. Nitric oxide is broken down very quickly after its
31. You measure a patient’s blood pressure at release. Why?
130/85. Calculate the patient’s pulse pressure and mean
arterial pressure. Determine whether each pressure is low, 37. Identify the ventricle of the heart that pumps
normal, or high. oxygendepleted blood and the arteries of the body that
carry oxygen-depleted blood.
32. An obese patient comes to the clinic complaining
of swollen feet and ankles, fatigue, shortness of breath, 38. What organs do the gonadal veins drain?
and often feeling “spaced out.” She is a cashier in a 39. What arteries play the leading roles in supplying
924 CHAPTER 20 | THE CARDIOVASCULAR SYSTEM: BLOOD VESSELS AND CIRCULATION
grocery store, a job that requires her to stand all day. blood to the brain?
Outside of work, she engages in no physical activity. She 40. All tissues, including malignant tumors, need a
confesses that, because of her weight, she finds even blood supply. Explain why drugs called angiogenesis
walking uncomfortable. Explain how the skeletal muscle inhibitors would be used in cancer treatment.
pump might play a role in this patient’s signs and
symptoms. 41. Explain the location and importance of the
ductus arteriosus in fetal circulation.
33. A patient arrives at the emergency department
with dangerously low blood pressure. The patient’s blood

70
 system and their very specialized jobs. What is the role of

Chapter 21 the dendritic cell in infection by HIV?

3. Visit
(http://openstaxcollege.org/l/
this website
chemotaxis) to

Homework learn about phagocyte chemotaxis.

Phagocyte chemotaxis is the movement of phagocytes
according to the secretion of chemical messengers in the
INTERACTIVE LINK QUESTIONS form of interleukins and other chemokines. By what
means does a phagocyte destroy a bacterium that it has
1. Visit this website
ingested?
(http://openstaxcollege.org/l/ lymphsystem) for
an overview of the lymphatic system. What are the three 4. Immunity can be acquired in an active or passive
main components of the lymphatic system? way, and it can be natural or artificial. Watch this video
(http://openstaxcollege.org/l/immunity) to see an
2. Visit this website
animated discussion of passive and active immunity. What
(http://openstaxcollege.org/l/ immunecells) to
is an example of natural immunity acquired passively?
learn about the many different cell types in the immune
REVIEW QUESTIONS 11. Which of the following is not important in the antiviral
innate immune response?
5. Which of the following cells is phagocytic? a. interferons
a. plasma cell b. natural killer cells
b. macrophage c. complement
c. B cell d. microphages
d. NK cell
12. Enhanced phagocytosis of a cell by the binding of a
6. Which structure allows lymph from the lower right limb to specific protein is called ________.
enter the bloodstream? a. endocytosis
a. thoracic duct b. opsonization
b. right lymphatic duct c. anaphylaxis
c. right lymphatic trunk
d. complement activation
d. left lymphatic trunk
13. Which of the following leads to the redness of
7. Which of the following cells is important in the innate inflammation?
immune response? a. increased vascular permeability
a. B cells b. anaphylactic shock
b. T cells c. increased blood flow
c. macrophages d. complement activation
d. plasma cells
14. T cells that secrete cytokines that help antibody responses
8. Which of the following cells would be most active in early, are called ________.
antiviral immune responses the first time one is exposed to a. Th1
pathogen?
b. Th2
a. macrophage
c. regulatory T cells
b. T cell
d. thymocytes
c. neutrophil
d. natural killer cell 15. The taking in of antigen and digesting it for later
presentation is called ________.
9. Which of the lymphoid nodules is most likely to see food a. antigen presentation
antigens first?
b. antigen processing
a. tonsils
c. endocytosis
b. Peyer’s patches
d. exocytosis
c. bronchus-associated lymphoid tissue
d. mucosa-associated lymphoid tissue 16. Why is clonal expansion so important?
a. to select for specific cells
10. Which of the following signs is not characteristic of
b. to secrete cytokines
inflammation?
c. to kill target cells
a. redness
d. to increase the numbers of specific cells
b. pain
c. cold 17. The elimination of self-reactive thymocytes is called
d. swelling ________.
a. positive selection.

71
 b. negative selection. c. cytotoxic T cells
c. tolerance. d. helper T cells
d. clonal selection. 27. What is the reason that you have to be immunized with a
18. Which type of T cell is most effective against viruses? new influenza vaccine each year?
a. Th1 a. the vaccine is only protective for a year
b. Th2 b. mutation
c. cytotoxic T cells c. macrophage oxidative metabolism
d. regulatory T cells d. memory response
19. Removing functionality from a B cell without killing it is 28. Which type of immune response works in concert with
called ________. cytotoxic T cells against virally infected cells?
a. clonal selection a. natural killer cells
b. clonal expansion b. complement
c. clonal deletion c. antibodies
d. clonal anergy d. memory
20. Which class of antibody crosses the placenta in pregnant 29. Which type of hypersensitivity involves soluble antigen-
women? antibody complexes?
a. IgM a. type I
b. IgA b. type II
c. IgE c. type III
d. IgG d. type IV
21. Which class of antibody has no known function other than 30. What causes the delay in delayed hypersensitivity?
as an antigen receptor? a. inflammation
a. IgM b. cytokine release
b. IgA c. recruitment of immune cells
c. IgE d. histamine release
d. IgD 31. Which of the following is a critical feature of immediate
22. When does class switching occur? hypersensitivity?
a. primary response a. inflammation
b. secondary response b. cytotoxic T cells
c. tolerance c. recruitment of immune cells
d. memory response d. histamine release
23. Which class of antibody is found in mucus? 32. Which of the following is an autoimmune disease of the
a. IgM heart?
b. IgA a. rheumatoid arthritis
c. IgE b. lupus
d. IgD c. rheumatic fever
d. Hashimoto’s thyroiditis
24. Which enzymes in macrophages are important for clearing
intracellular bacteria? 33. What drug is used to counteract the effects of anaphylactic
a. metabolic shock?
b. mitochondrial a. epinephrine
c. nuclear b. antihistamines
d. lysosomal c. antibiotics
d. aspirin
25. What type of chronic lung disease is caused by a
Mycobacterium? 34. Which of the following terms means “many genes”?
a. asthma a. polymorphism
b. emphysema b. polygeny
c. tuberculosis c. polypeptide
d. leprosy d. multiple alleles
26. Which type of immune response is most directly effective 35. Why do we have natural antibodies?
against bacteria? a. We don’t know why.
a. natural killer cells b. immunity to environmental bacteria
b. complement c. immunity to transplants

72
 d. from clonal selection c. suppresses macrophages
36. Which type of cancer is associated with HIV disease? d. suppresses neutrophils
a. Kaposi’s sarcoma 38. What disease is associated with
b. melanoma bone marrow transplants?
c. lymphoma a. diabetes mellitus type I
d. renal cell carcinoma b. melanoma
c. headache
37. How does cyclosporine A work?
d. graft-versus-host disease
a. suppresses antibodies
b. suppresses T cells
CRITICAL THINKING QUESTIONS
39. Describe the flow of lymph from its origins in 44. Describe how secondary B
interstitial fluid to its emptying into the venous cell responses are developed.
bloodstream. 45. Describe the role of IgM in immunity.
40. Describe the process of inflammation in an area that
46. Describe how seroconversion works in HIV disease.
has been traumatized, but not infected.
47. Describe tuberculosis and the innocent bystander
41. Describe two early induced responses and what
effect.
pathogens they affect.
48. Describe anaphylactic shock in someone sensitive to
42. Describe the processing and presentation of an
peanuts?
intracellular antigen.
49. Describe rheumatic fever and how tolerance is broken.
43. Describe clonal selection and expansion.
50. Describe how stress affects immune responses.
51.

73
 Chapter 22 Homework
INTERACTIVE LINK QUESTIONS learn more about lung volumes and spirometers. Explain
how spirometry test results can be used to diagnose
1. Visit this site respiratory diseases or determine the effectiveness of
(http://openstaxcollege.org/l/asthma) to learn more disease treatment.
about what happens during an asthma attack. What are the
3. Watch this video
three changes that occur inside the airways during an
(http://openstaxcollege.org/l/ oxyblood)
asthma attack?
to see the transport of oxygen from the lungs to the
2. Watch this video tissues. Why is oxygenated blood bright red, whereas
(http://openstaxcollege.org/l/ spirometers) to deoxygenated blood tends to be more of a purple color?

REVIEW QUESTIONS 11. A section of the lung that receives its own tertiary
bronchus is called the ________.
4. Which of the following anatomical structures is not part of a. bronchopulmonary segment
the conducting zone?
b. pulmonary lobule
a. pharynx
c. interpulmonary segment
b. nasal cavity
d. respiratory segment
c. alveoli
d. bronchi 12. The ________ circulation picks up oxygen for cellular
use and drops off carbon dioxide for removal from the
5. What is the function of the conchae in the nasal cavity? body.
a. increase surface area a. pulmonary
b. exchange gases b. interlobular
c. maintain surface tension c. respiratory
d. maintain air pressure d. bronchial
6. The fauces connects which of the following structures to
the oropharynx? 13. The pleura that surrounds the lungs consists of two
a. nasopharynx layers, the ________.
b. laryngopharynx a. visceral and parietal pleurae.
c. nasal cavity b. mediastinum and parietal pleurae.
d. oral cavity c. visceral and mediastinum pleurae.
d. none of the above
7. Which of the following are structural features of the
trachea? 14. Which of the following processes does atmospheric
a. C-shaped cartilage pressure play a role in?
b. smooth muscle fibers a. pulmonary ventilation
c. cilia b. production of pulmonary surfactant
d. all of the above c. resistance
8. Which of the following structures is not part of the d. surface tension
bronchial tree? 15. A decrease in volume leads to a(n) ________ pressure.
a. alveoli a. decrease in
b. bronchi b. equalization of
c. terminal bronchioles c. increase in
d. respiratory bronchioles d. zero
9. What is the role of alveolar macrophages?
16. The pressure difference between the intra-alveolar and
a. to secrete pulmonary surfactant
intrapleural pressures is called ________.
b. to secrete antimicrobial proteins
a. atmospheric pressure
c. to remove pathogens and debris
b. pulmonary pressure
d. to facilitate gas exchange
c. negative pressure
10. Which of the following structures separates the lung
d. transpulmonary pressure
into lobes?
a. mediastinum 17. Gas flow decreases as ________ increases.
b. fissure a. resistance
c. root b. pressure
d. pleura c. airway diameter

74
 d. friction a. Chloride is removed from the erythrocyte.
18. Contraction of the external intercostal muscles causes b. Chloride is exchanged for bicarbonate.
which of the following to occur? c. Bicarbonate is removed from the erythrocyte.
a. The diaphragm moves downward. d. Bicarbonate is removed from the blood.
b. The rib cage is compressed.
27. A low partial pressure of oxygen promotes hemoglobin
c. The thoracic cavity volume decreases. binding to carbon dioxide. This is an example of the
d. The ribs and sternum move upward. ________.
19. Which of the following prevents the alveoli from a. Haldane effect
collapsing? b. Bohr effect
a. residual volume c. Dalton’s law
b. tidal volume d. Henry’s law
c. expiratory reserve volume 28. Increased ventilation that results in an increase in blood
d. inspiratory reserve volume pH is called ________.
20. Gas moves from an area of ________ partial pressure a. hyperventilation
to an area of ________ partial pressure. b. hyperpnea
a. low; high c. acclimatization
b. low; low d. apnea
c. high; high 29. Exercise can trigger symptoms of AMS due to which of
d. high; low the following?
21. When ventilation is not sufficient, which of the a. low partial pressure of oxygen
following occurs? b. low atmospheric pressure
a. The capillary constricts. c. abnormal neural signals
b. The capillary dilates. d. small venous reserve of oxygen
c. The partial pressure of oxygen in the affected 30. Which of the following stimulates the production of
alveolus increases. erythrocytes?
d. The bronchioles dilate. a. AMS
22. Gas exchange that occurs at the level of the tissues is b. high blood levels of carbon dioxide
called ________. c. low atmospheric pressure
a. external respiration d. erythropoietin
b. interpulmonary respiration
31. The olfactory pits form from which of the following?
c. internal respiration
a. mesoderm
d. pulmonary ventilation
b. cartilage
23. The partial pressure of carbon dioxide is 45 mm Hg in c. ectoderm
the blood and 40 mm Hg in the alveoli. What happens to the d. endoderm
carbon dioxide?
32. A full complement of mature alveoli are present by
a. It diffuses into the blood.
________.
b. It diffuses into the alveoli.
a. early childhood, around 8 years of age
c. The gradient is too small for carbon dioxide to
b. birth
diffuse.
c. 37 weeks
d. It decomposes into carbon and oxygen.
d. 16 weeks
24. Oxyhemoglobin forms by a chemical reaction between
33. If a baby is born prematurely before type II cells produce
which of the following?
sufficient pulmonary surfactant, which of the following
a. hemoglobin and carbon dioxide
might you expect?
b. carbonic anhydrase and carbon dioxide
a. difficulty expressing fluid
c. hemoglobin and oxygen
b. difficulty inflating the lungs
d. carbonic anhydrase and oxygen
c. difficulty with pulmonary capillary flow
25. Which of the following factors play a role in the oxygen– d. no difficulty as type I cells can provide enough
hemoglobin saturation/dissociation curve? surfactant for normal breathing
a. temperature
34. When do fetal breathing movements begin?
b. pH
a. around week 20
c. BPG
b. around week 37
d. all of the above
c. around week 16
26. Which of the following occurs during the chloride shift? d. after birth

75
35. What happens to the fluid that remains in the lungs after b. It is expelled shortly after birth.
birth? c. It is absorbed shortly after birth.
a. It reduces the surface tension of the alveoli. d. It lubricates the pleurae.
CRITICAL THINKING QUESTIONS
36. Describe the three regions of the pharynx and their 46. Compare and contrast adult hemoglobin and fetal
functions. hemoglobin.
37. If a person sustains an injury to the epiglottis, what 47. Describe the relationship between the partial
would be the physiological result? pressure of oxygen and the binding of oxygen to
38. Compare and contrast the conducting and respiratory hemoglobin.
zones. 48. Describe three ways in which carbon dioxide can be
39. Compare and contrast the right and left lungs. transported.
49. Describe the neural factors involved in increasing
40. Why are the pleurae not damaged during normal
ventilation during exercise.
breathing?
50. What is the major mechanism
41. Describe what is meant by the term “lung
that results in acclimatization?
compliance.”
51. During what timeframe does a fetus have enough
42. Outline the steps involved in quiet breathing.
mature structures to breathe on its own if born
43. What is respiratory rate and how is it controlled? prematurely? Describe the other structures that
44. Compare and contrast Dalton’s law and Henry’s law. develop during this phase.

45. A smoker develops damage to several alveoli that 52. Describe fetal breathing movements and their
then can no longer function. How does this affect gas purpose.
exchange?

76
 4. Watch this animation

Chapter 23 (http://openstaxcollege.org/l/ stomach1) that depicts

the structure of the stomach and how this structure functions
in the initiation of protein digestion. This view of the

Homework
stomach shows the characteristic rugae. What is the function
of these rugae?
5. Watch this animation
(http://openstaxcollege.org/l/ sintestine) that depicts
INTERACTIVE LINK QUESTIONS the structure of the small intestine, and, in particular, the villi.
1. By clicking on this link Epithelial cells continue the digestion and absorption of
(http://openstaxcollege.org/ l/fooddigestion) , you nutrients and transport these nutrients to the lymphatic and
can watch a short video of what happens to the food you eat circulatory systems. In the small intestine, the products of
as it passes from your mouth to your intestine. Along the food digestion are absorbed by different structures in the
way, note how the food changes consistency and form. How villi. Which structure absorbs and transports fats?
does this change in consistency facilitate your gaining 6. By watching this animation
nutrients from food? (http://openstaxcollege.org/l/foodgroups) , you will
2. Visit this site (http://openstaxcollege.org/l/ see that for the various food groups—proteins, fats, and
fooddigestion2) for an overview of digestion of food in carbohydrates—digestion begins in different parts of the
different regions of the digestive tract. Note the route of non- digestion system, though all end in the same place. Of the
fat nutrients from the small intestine to their release as three major food classes (carbohydrates, fats, and proteins),
nutrients to the body. which is digested in the mouth, the stomach, and the small
intestine?
3. Watch this animation
7. Watch this video
(http://openstaxcollege.org/l/ swallowing) to see
(http://openstaxcollege.org/l/liver) to see the structure
how swallowing is a complex process that involves the
of the liver and how this structure supports the functions of
nervous system to coordinate the actions of upper respiratory
the liver, including the processing of nutrients, toxins, and
and digestive activities. During which stage of swallowing is
wastes. At rest, about 1500 mL of blood per minute flow
there a risk of food entering respiratory pathways and how is
through the liver. What percentage of this blood flow comes
this risk blocked?
from the hepatic portal system?
REVIEW QUESTIONS d. all of the above

8. Which of these organs is not considered an accessory 12. Which of these processes occurs throughout most of the
digestive structure? alimentary canal?
a. mouth a. ingestion
b. salivary glands b. propulsion
c. pancreas c. segmentation
d. liver d. absorption

9. Which of the following organs is supported by a layer of 13. Which of the following stimuli activates sensors in the
adventitia rather than serosa? walls of digestive organs?
a. esophagus a. breakdown products of digestion
b. stomach b. distension
c. small intestine c. pH of chyme
d. large intestine d. all of the above

10. Which of the following membranes covers the stomach? 14. Which of these statements about reflexes in the GI tract
a. falciform ligament is false?
b. mesocolon a. Short reflexes are provoked by nerves near the GI
c. parietal peritoneum tract.
d. visceral peritoneum b. Short reflexes are mediated by the enteric nervous
system.
11. Which of these processes occurs in the mouth? c. Food that distends the stomach initiates long
a. ingestion reflexes.
b. mechanical digestion d. Long reflexes can be provoked by stimuli
c. chemical digestion originating outside the GI tract.

77
15. Which of these ingredients in saliva is responsible for c. distal small intestine
activating salivary amylase? d. ascending colon
a. mucus
24. Which of these is most associated with villi?
b. phosphate ions
a. haustra
c. chloride ions
b. lacteals
d. urea
c. bacterial flora
16. Which of these statements about the pharynx is true? d. intestinal glands
a. It extends from the nasal and oral cavities
25. What is the role of the small intestine’s MALT?
superiorly to the esophagus anteriorly.
a. secreting mucus
b. The oropharynx is continuous superiorly with the
b. buffering acidic chyme
nasopharynx.
c. activating pepsin
c. The nasopharynx is involved in digestion.
d. preventing bacteria from entering the
d. The laryngopharynx is composed partially of
bloodstream
cartilage.
26. Which part of the large intestine attaches to the
17. Which structure is located where the esophagus
appendix?
penetrates the diaphragm?
a. cecum
a. esophageal hiatus
b. ascending colon
b. cardiac orifice
c. transverse colon
c. upper esophageal sphincter
d. descending colon
d. lower esophageal sphincter
27. Which of these statements about bile is true?
18. Which phase of deglutition involves contraction of the a. About 500 mL is secreted daily.
longitudinal muscle layer of the muscularis? b. Its main function is the denaturation of proteins.
a. voluntary phase c. It is synthesized in the gallbladder.
b. buccal phase d. Bile salts are recycled.
c. pharyngeal phase
28. Pancreatic juice ________.
d. esophageal phase
a. deactivates bile.
19. Which of these cells secrete hormones? b. is secreted by pancreatic islet cells.
a. parietal cells c. buffers chyme.
b. mucous neck cells d. is released into the cystic duct.
c. enteroendocrine cells
29. Where does the chemical digestion of starch begin?
d. chief cells
a. mouth
20. Where does the majority of chemical digestion in the b. esophagus
stomach occur? c. stomach
a. fundus and body d. small intestine
b. cardia and fundus
30. Which of these is involved in the chemical digestion of
c. body and pylorus
protein?
d. body
a. pancreatic amylase
21. During gastric emptying, chyme is released into the
b. trypsin
duodenum through the ________.
c. sucrase
a. esophageal hiatus
d. pancreatic nuclease
b. pyloric antrum
c. pyloric canal 31. Where are most fat-digesting enzymes produced?
d. pyloric sphincter a. small intestine
b. gallbladder
22. Parietal cells secrete ________.
c. liver
a. gastrin
d. pancreas
b. hydrochloric acid
c. pepsin 32. Which of these nutrients is absorbed mainly in the
d. pepsinogen duodenum?
a. glucose
23. In which part of the alimentary canal does most
b. iron
digestion occur?
c. sodium
a. stomach
d. water
b. proximal small intestine

78
CRITICAL THINKING QUESTIONS
33. Explain how the enteric nervous system supports the
digestive system. What might occur that could result in
the autonomic nervous system having a negative impact
on digestion?
34. What layer of the alimentary canal tissue is capable
of helping to protect the body against disease, and
through what mechanism?
35. Offer a theory to explain why segmentation occurs
and peristalsis slows in the small intestine.
36. It has been several hours since you last ate. Walking
past a bakery, you catch a whiff of freshly baked bread.
What type of reflex is triggered, and what is the result?
37. The composition of saliva varies from gland to
gland. Discuss how saliva produced by the parotid gland
differs in action from saliva produced by the sublingual
gland.
38. During a hockey game, the puck hits a player in the
mouth, knocking out all eight of his most anterior teeth.
Which teeth did the player lose and how does this loss
affect food ingestion?
39. What prevents swallowed food from entering the
airways?
40. Explain the mechanism responsible for
gastroesophageal reflux.
41. Describe the three processes involved in the
esophageal phase of deglutition.
42. Explain how the stomach is protected from
selfdigestion and why this is necessary.
43. Describe unique anatomical features that enable the
stomach to perform digestive functions.
44. Explain how nutrients absorbed in the small
intestine pass into the general circulation.
45. Why is it important that chyme from the stomach is
delivered to the small intestine slowly and in small
amounts?
46. Describe three of the differences between the walls
of the large and small intestines.
47. Why does the pancreas secrete some enzymes in
their inactive forms, and where are these enzymes
activated?
48. Describe the location of hepatocytes in the liver and
49. Explain the role of bile salts and lecithin in the
how this arrangement enhances their function.
emulsification of lipids (fats).
50. How is vitamin B12 absorbed?
79
80
 8. Aerobic cellular respiration results in the production

Chapter 24 of these two products.

a. NADH and FADH2
b. ATP and pyruvate

Homework
c. ATP and glucose
d. ATP and H2O
+
9. When NAD becomes NADH, the coenzyme has
REVIEW QUESTIONS been________.
1. A monosaccharide is formed from a polysaccharide a. reduced
in what kind of reaction? b. oxidized
a. oxidation–reduction reaction c. metabolized
b. anabolic reaction d. hydrolyzed
c. catabolic reaction
10. Lipids in the diet can be ________.
d. biosynthetic reaction
a. broken down into energy for the body
2. If anabolic reactions exceed catabolic reactions, the b. stored as triglycerides for later use
result will be ________. c. converted into acetyl CoA
a. weight loss d. all of the above
b. weight gain
11. The gallbladder provides ________ that aid(s) in
c. metabolic rate change
transport of lipids across the intestinal membrane.
d. development of disease
a. lipases
3. When NAD becomes NADH, the coenzyme has b. cholesterol
been c. proteins
________. d. bile salts
a. reduced
12. Triglycerides are transported by chylomicrons
b. oxidized
because ________.
c. metabolized
a. they cannot move easily in the blood stream
d. hydrolyzed
because they are fat based, while the blood is
4. Anabolic reactions use energy by ________. water based
a. turning ADP into ATP b. they are too small to move by themselves
b. removing a phosphate group from ATP c. the chylomicrons contain enzymes they need
c. producing heat for anabolism
d. breaking down molecules into smaller parts d. they cannot fit across the intestinal membrane
5. Glycolysis results in the production of two 13. Which molecule produces the most ATP?
________ molecules from a single molecule of a. carbohydrates
glucose. In the absence of ________, the end b. FADH2
product of glycolysis is ________. c. triglycerides
a. acetyl CoA, pyruvate, lactate d. NADH
b. ATP, carbon, pyruvate 14. Which molecules can enter the Krebs cycle?
c. pyruvate, oxygen, lactate a. chylomicrons
d. pyruvate, carbon, acetyl CoA b. acetyl CoA
6. The Krebs cycle converts ________ through a cycle c. monoglycerides
of reactions. In the process, ATP, ________, and d. ketone bodies
________ are produced. 15. Acetyl CoA can be converted to all of the following
a. acetyl CoA; FAD, NAD except ________.
b. acetyl CoA; FADH2; NADH a. ketone bodies
c. pyruvate; NAD; FADH2 b. fatty acids
d. pyruvate; oxygen; oxaloacetate c. polysaccharides
7. Which pathway produces the most ATP molecules? d. triglycerides

a. lactic acid fermentation 16. Digestion of proteins begins in the ________ where
b. the Krebs cycle ________ and ________ mix with food to break
down protein into ________.
c. the electron transport chain
a. stomach; amylase; HCl; amino acids
d. glycolysis
b. mouth; pepsin; HCl; fatty acids

81
 c. stomach; lipase; HCl; amino acids down. What other mechanisms are in place to
d. stomach; pepsin; HCl; amino acids regulate the body temperature?
a. shivering
17. Amino acids are needed to ________.
b. sweating
a. build new proteins
c. erection of the hairs on the arms and legs
b. serve as fat stores
d. all of the above
c. supply energy for the cell
d. create red blood cells 24. The heat you feel on your chair when you stand up
was transferred from your skin via ________.
18. If an amino acid is not used to create new proteins,
a. conduction
it can be ________.
b. convection
a. converted to acetyl CoA
c. radiation
b. converted to glucose or ketones
d. evaporation
c. converted to nitrogen
d. stored to be used later 25. A crowded room warms up through the mechanism
of ________.
19. During the absorptive state,
a. conduction
glucose levels are ________, insulin levels
are ________, and glucagon levels ________. b. convection
a. high; low; stay the same c. radiation
b. low; low; stay the same d. evaporation
c. high; high; are high 26. A deficiency in vitamin A can result in ________.
d. high; high; are low
20. Starvation sets in after 3 to 4 days without food. a. improper bone development
Which hormones change in response to low glucose b. scurvy
levels? c. improper eye development or sight
d. all of the above
a. glucagon and insulin 27. Rickets results in improper bone development in
b. ketones and glucagon children that arises from the malabsorption of
c. insulin, glucose, and glucagon calcium and a deficiency in ________.
d. insulin and ketones a. vitamin D
21. The postabsorptive state relies on stores of b. vitamin C
________ in the ________. c. vitamin B 12
a. insulin; pancreas d. niacin
b. glucagon; pancreas 28. Consuming which type of food will help the most
c. glycogen; liver with weight loss?
d. glucose; liver a. fats
22. The body’s temperature is controlled by the b. vegetables
________. This temperature is always kept between c. lean meats
________. d. fruits
a. pituitary; 36.5–37.5 °C 29. Which of the following is stored in the body?
b. hypothalamus; 97.7–99.5 °F a. thiamine
c. hypothalamus; 36.5–37.5 °F b. phosphorous
d. pituitary; 97.7–99.5 °F c. folic acid
23. Fever increases the body temperature and can d. vitamin
induce chills to help cool the temperature back
33. Explain how glucose is metabolized to yield ATP
CRITICAL THINKING QUESTIONS 34. Discuss how carbohydrates can be stored as fat.
30. Describe how metabolism can be altered. 35. If a diabetic’s breath smells like alcohol, what could
31. Describe how Addison’s disease can be treated. this mean?

32. Insulin is released when food is ingested and
stimulates the uptake of glucose into the cell. Discuss
the mechanism cells employ to create a concentration
gradient to ensure continual uptake of glucose from the
bloodstream.
36. Amino acids are not stored in the body. Describe how
excess amino acids are processed in the cell.
37. Release of trypsin and chymotrypsin in their active
form can result in the digestion of the pancreas or

82
 small intestine itself. What mechanism does the body
employ to prevent its self-destruction?
38. In type II diabetes, insulin is produced but is
nonfunctional. These patients are described as
“starving in a sea of plenty,” because their blood
glucose levels are high, but none of the glucose is
transported into the cells. Describe how this leads to
malnutrition.
39. Ketone bodies are used as an alternative source of fuel
during starvation. Describe how ketones are
synthesized.
40. How does vasoconstriction help increase the core
temperature of the body?
41. How can the ingestion of food increase the body
temperature?
42. Weight loss and weight gain are complex processes.
What are some of the main factors that influence
weight gain in people?
43. Some low-fat or non-fat foods contain a large amount
of sugar to replace the fat content of the food. Discuss
how this leads to increased fat in the body (and weight
gain) even though the item is non-fat.
83
 c. portal system

Chapter 25 9.
d. ureter
The right kidney is slightly lower because ________.

Homework a.
b.
c.
it is displaced by the liver
it is displace by the heart
it is slightly smaller
REVIEW QUESTIONS d. it needs protection of the lower ribs
1. Diabetes insipidus or diabetes mellitus would most 10. Blood filtrate is captured in the lumen of the
likely be indicated by ________. ________.
a. anuria
b. polyuria a. glomerulus
c. oliguria b. Bowman’s capsule
d. none of the above c. calyces
d. renal papillae
2. The color of urine is determined mainly by ________.
11. What are the names of the capillaries following the
a. diet efferent arteriole?
b. filtration rate a. arcuate and medullary
c. byproducts of red blood cell breakdown b. interlobar and interlobular
d. filtration efficiency c. peritubular and vasa recta
d. peritubular and medullary
3. Production of less than 50 mL/day of urine is called
________. 12. The functional unit of the kidney is called ________.
a. normal
b. polyuria a. the renal hilus
c. oliguria b. the renal corpuscle
d. anuria c. the nephron
d. Bowman’s capsule
4. Peristaltic contractions occur in
the ________. 13. ________ pressure must be greater on the capillary
side of the filtration membrane to achieve filtration.
a. urethra a. Osmotic
b. bladder b. Hydrostatic
c. ureters 14. Production of urine to modify plasma makeup is the
d. urethra, bladder, and ureters result of ________.
5. Somatic motor neurons must be ________ to relax the a. filtration
external urethral sphincter to allow urination. b. absorption
a. stimulated c. secretion
b. inhibited d. filtration, absorption, and secretion
15. Systemic blood pressure must stay above 60 so that
6. Which part of the urinary system is not completely
the proper amount of filtration occurs.
retroperitoneal?
a. true
a. kidneys
b. false
b. ureters
c. bladder 16. Aquaporin channels are only found in the collecting
d. nephrons duct.
a. true
7. The renal pyramids are separated from each other by
b. false
extensions of the renal cortex called ________.
a. renal medulla 17. Most absorption and secretion occurs in this part of
b. minor calyces the nephron.
c. medullary cortices a. proximal convoluted tubule
d. renal columns b. descending loop of Henle
8. The primary structure found within the medulla is the c. ascending loop of Henle
________. d. distal convoluted tubule
a. loop of Henle e. collecting ducts
b. minor calyces

84
18. The fine tuning of water recovery or disposal occurs in 25. Which of these beverages does not have a diuretic
________. effect?
a. the proximal convoluted tubule a. tea
b. the collecting ducts b. coffee
c. the ascending loop of Henle c. alcohol
d. the distal convoluted tubule d. milk
19. Vasodilation of blood vessels to the kidneys is due to 26. Progesterone can bind to receptors for which hormone
________. that, when released, activates water retention?
a. more frequent action potentials a. aldosterone
b. less frequent action potentials b. ADH
20. When blood pressure increases, c. PTH
blood vessels supplying the kidney will d. ANH
________ to mount a steady rate of filtration. 27. Renin is released in response to ________.
a. contract a. increased blood pressure
b. relax b. decreased blood pressure
21. Which of these three paracrine chemicals cause c. ACE
vasodilation? d. diuretics
a. ATP 28. Which step in vitamin D production does the kidney
b. adenosine perform?
c. nitric oxide a. converts cholecalciferol into calcidiol
22. What hormone directly opposes the actions of b. converts calcidiol into calcitriol
natriuretic hormones? c. stores vitamin D
a. renin d. none of these
b. nitric oxide 29. Which hormone does the kidney produce that
c. dopamine stimulates red blood cell production?
d. aldosterone a. thrombopoeitin
23. Which of these is a vasoconstrictor? b. vitamin D
a. nitric oxide c. EPO
b. natriuretic hormone d. renin
c. bradykinin 30. If there were no aquaporin channels in the collecting
d. angiotensin II duct, ________.
24. What signal causes the heart to secrete atrial a. you would develop systemic edema
natriuretic hormone? +
b. you would retain excess Na
a. increased blood pressure c. you would lose vitamins and electrolytes
b. decreased blood pressure d. you would suffer severe dehydration
+
c. increased Na levels
+
d. decreased Na levels
35. What anatomical structures provide protection to the
kidney?
CRITICAL THINKING
36. How does the renal portal system differ from the
QUESTIONS hypothalamo–hypophyseal and digestive portal
31. What is suggested by the presence of white blood cells systems?
found in the urine? 37. Name the structures found in the renal hilum.
32. Both diabetes mellitus and diabetes insipidus produce 38. Which structures make up the renal corpuscle?
large urine volumes, but how would other
characteristics of the urine differ between the two 39. What are the major structures comprising the filtration
diseases? membrane?

33. Why are females more likely to contract bladder 40. Give the formula for net filtration pressure.
infections than males? 41. Name at least five symptoms of kidney failure.
34. Describe how forceful urination is accomplished. 42. Which vessels and what part of the nephron are
involved in countercurrent multiplication?

85
43. Give the approximate osmolarity of fluid in the 46. What organs produce which hormones or enzymes in
proximal convoluted tubule, deepest part of the loop the renin–angiotensin system?
ofHenle, distal convoluted tubule, and the collecting 47. PTH affects absorption and reabsorption of what?
ducts.
+ 48. Why is ADH also called vasopressin?
44. Explain what happens to Na concentration in the
nephron when GFR increases. 49. How can glucose be a diuretic?
+ 50. How does lack of protein in the blood cause edema?
45. If you want the kidney to excrete more Na in the
urine, what do you want the blood flow to do? 51. Which three electrolytes are most closely regulated by
the kidney?

86
 2. Watch this video

Chapter 26 (http://openstaxcollege.org/l/ dynamicfluid) to

see an explanation of the dynamics of fluid in the
body’s compartments. What happens in tissues when

Homework
capillary blood pressure is less than osmotic pressure?
3. Watch this video
(http://openstaxcollege.org/l/ saltwater) to see
INTERACTIVE LINK an explanation of the effect of seawater on humans.
What effect does drinking seawater have on the body?
QUESTIONS
4. Watch this video
1. Watch this video (http://openstaxcollege.org/l/ altitude) to see a
(http://openstaxcollege.org/l/ bodyfluids) to demonstration of the effect altitude has on blood pH.
learn more about body fluids, fluid compartments, and What effect does high altitude have on blood pH, and
electrolytes. When blood volume decreases due to why?
sweating, from what source is water taken in by the
blood?
c. excessive sweating
REVIEW QUESTIONS d. vomiting or diarrhea

5. Solute contributes to the movement of water 11. How soon after drinking a large glass of water will a
between cells and the surrounding medium by person start increasing their urine output?
________. a. 5 minutes
a. osmotic pressure b. 30 minutes
b. hydrostatic pressure c. 1 hour
c. Brownian movement d. 3 hours
d. random motion 12. Bone serves as a mineral reserve for which two ions?
6. A cation has a(n) ________ charge.
a. neutral a. sodium and potassium
b. positive b. calcium and phosphate
c. alternating c. chloride and bicarbonate
d. negative d. calcium and bicarbonate

7. Interstitial fluid (IF) is ________. 13. Electrolytes are lost mostly through
a. the fluid in the cytosol of the cells ________.
b. the fluid component of blood
a. renal function
c. the fluid that bathes all of the body’s cells
except for blood cells b. sweating
d. the intracellular fluids found between c. feces
membranes d. respiration

8. The largest amount of water comes into the body via 14. The major cation in extracellular fluid is ________.
________.
a. sodium
a. metabolism
b. potassium
b. foods
c. chloride
c. liquids
d. bicarbonate
d. humidified air
15. The major cation in intracellular fluid is ________.
9. The largest amount of water leaves the body via
________.
a. sodium
a. the GI tract
b. potassium
b. the skin as sweat
c. chloride
c. expiration
d. bicarbonate
d. urine
16. The major anion in extracellular fluid is ________.
10. Insensible water loss is water lost via ________.
a. sodium
a. skin evaporation and in air from the lungs
b. potassium
b. urine

87
 c. chloride 24. Carbonic acid levels are controlled through the
d. bicarbonate ________.
a. respiratory system
17. Most of the body’s calcium is found in ________.
b. renal system
a. teeth c. digestive system
b. bone d. metabolic rate of cells
c. plasma 25. Bicarbonate ion concentrations in the blood are
d. extracellular fluids controlled through the ________.
18. Abnormally increased blood levels of sodium are a. respiratory system
termed ________. b. renal system
a. hyperkalemia c. digestive system
b. hyperchloremia d. metabolic rate of cells
c. hypernatremia 26. Which reaction is catalyzed by carbonic anhydrase?
d. hypercalcemia 2- +
a. HPO 4 +H ↔ H2PO4-
19. The ion with the lowest blood level is ________.
b. CO2 + H2O ↔ H2CO3
a. sodium − 2−
b. potassium
c. H2PO4− +OH ↔ HPO 4 +H2O
c. chloride +
d. bicarbonate d. H2CO3 ↔ HCO3− + H

20. Which two ions are most affected by aldosterone? 27. Which of the following is a cause of metabolic
acidosis?
a. sodium and potassium a. excessive HCl loss
b. chloride and bicarbonate b. increased aldosterone
c. calcium and phosphate c. diarrhea
d. sodium and phosphate d. prolonged use of diuretics
21. Which of the following is the most important buffer 28. Which of the following is a cause of respiratory
inside red blood cells? acidosis?
a. plasma proteins a. emphysema
b. hemoglobin +
b. low blood K
c. phosphate buffers
c. increased aldosterone
d. bicarbonate: carbonic acid buffer
d. increased blood ketones
22. Which explanation best describes why plasma
29. At a pH of 7.40, the carbonic acid ratio is ________.
proteins can function as buffers?
a. Plasma proteins combine with bicarbonate to
a. 35:1
make a stronger buffer.
b. 4:1
b. Plasma proteins are immune to damage from
c. 20:1
acids.
d. 3:1
c. Proteins have both positive and negative charges
on their surface. 30. Which of the following is characterized as metabolic
d. Proteins are alkaline. alkalosis?
–
23. The buffer that is adjusted to control acid-base a. increased pH, decreased pCO2, decreased HCO3
balance is ________. –
b. increased pH, increased pCO2, increased HCO3
a. plasma protein
b. hemoglobin c. decreased pH, decreased pCO2,
c. phosphate buffer decreased HCO3–
d. bicarbonate: carbonic acid buffer –
d. decreased pH, increased pCO2, increased HCO3
CRITICAL THINKING QUESTIONS
31. Plasma contains more sodium than chloride. How can this be if individual ions of sodium and chloride exactly balance each
other out, and plasma is electrically neutral?
32. How is fluid moved from compartment to compartment?
33. Describe the effect of ADH on renal collecting tubules.

88
34. Why is it important for the amount of water intake to equal the amount of water output?
35. Explain how the CO2 generated by cells and exhaled in the lungs is carried as bicarbonate in the blood.
36. How can one have an imbalance in a substance, but not actually have elevated or deficient levels of that substance in the
body?
37. Describe the conservation of bicarbonate ions in the renal system.
38. Describe the control of blood carbonic acid levels through the respiratory system.
39. Case Study: Bob is a 64-year-old male admitted to the emergency room for asthma. His laboratory results are as follows: pH
7.31, pCO2 higher than normal, and total HCO3– also higher than normal. Classify his acid-base balance as acidosis or
alkalosis, and as metabolic or respiratory. Is there evidence of compensation? Propose the mechanism by which asthma
contributed to the lab results seen.
40. Case Study: Kim is a 38-year-old women admitted to the hospital for bulimia. Her laboratory results are as follows: pH 7.48,
pCO2 in the normal range, and total HCO3– higher than normal. Classify her acid-base balance as acidosis or alkalosis, and
as metabolic or respiratory. Is there evidence of compensation? Propose the mechanism by which bulimia contributed to the
lab results seen.

89
 3. Watch this video (http://openstaxcollege.org/l/

Chapter 27 ovulation) to observe ovulation and its initiation in

response to the release of FSH and LH from the pituitary
gland. What specialized structures help guide the oocyte

Homework
from the ovary into the uterine tube?
4. Watch this series of videos
(http://openstaxcollege.org/ l/oocyte) to look
at the movement of the oocyte through the ovary.
INTERACTIVE LINK QUESTIONS The cilia in the uterine tube promote movement of
1. Watch this video (http://openstaxcollege.org/l/ the oocyte. What would likely occur if the cilia were
vasectomy) to learn about vasectomy. As described in paralyzed at the time of ovulation?
this video, a vasectomy is a procedure in which a small
section of the ductus (vas) deferens is removed from the 5. A baby’s gender is determined at conception,
scrotum. This interrupts the path taken by sperm through and the different genitalia of male and female fetuses
the ductus deferens. If sperm do not exit through the vas, develop from the same tissues in the embryo. View
either because the man has had a vasectomy or has not this animation
ejaculated, in what region of the testis do they remain? (http://openstaxcollege.org/l/fetus) that
compares the development of structures of the
2. Watch this video female and male reproductive systems in a growing
(http://openstaxcollege.org/l/ spermpath) fetus. Where are the testes located for most of
to explore the structures of gestational time?
the male reproductive system and the path of
sperm that starts in the testes and ends as the sperm leave
the penis through the urethra. Where are sperm deposited
after they leave the ejaculatory duct?
REVIEW QUESTIONS 11. What are the female gonads called?
a. oocytes
6. What are male gametes called?
b. ova
a. ova
c. oviducts
b. sperm
d. ovaries
c. testes
d. testosterone
12. When do the oogonia undergo mitosis?
7. Leydig cells ________. a. before birth
a. secrete testosterone b. at puberty
b. activate the sperm flagellum c. at the beginning of each menstrual cycle
c. support spermatogenesis d. during fertilization
d. secrete seminal fluid
13. From what structure does the corpus luteum
8. Which hypothalamic hormone contributes to the originate?
regulation of the male reproductive system?
a. luteinizing hormone a. uterine corpus
b. gonadotropin-releasing hormone b. dominant follicle
c. follicle-stimulating hormone c. fallopian tube
d. androgens d. corpus albicans
9. What is the function of the epididymis? 14. Where does fertilization of the egg by the sperm
a. sperm maturation and storage typically occur?
b. produces the bulk of seminal fluid a. vagina
c. provides nitric oxide needed for erections b. uterus
d. spermatogenesis c. uterine tube
10. Spermatogenesis takes place in d. ovary
the ________. 15. Why do estrogen levels fall after
a. prostate gland menopause?
b. glans penis
c. seminiferous tubules a. The ovaries degrade.
d. ejaculatory duct b. There are no follicles left to produce estrogen.

90
 c. The pituitary secretes a menopause- 18. Without SRY expression, an embryo will develop
specific hormone. ________.
d. The cells of the endometrium degenerate. a. male reproductive structures
16. The vulva includes the ________. b. female reproductive structures
a. lactiferous duct, rugae, and hymen c. no reproductive structures
b. lactiferous duct, endometrium, and bulbourethral d. male reproductive structures 50 percent of the
time and female reproductive structures 50
glands
percent of the time
c. mons pubis, endometrium, and hymen
d. mons pubis, labia majora, and Bartholin’s glands 19. The timing of puberty can be influenced by which of
the following?
17. What controls whether an embryo will develop testes
a. genes
or ovaries?
b. stress
a. pituitary gland
c. amount of body fat
b. hypothalamus
d. all of the above
c. Y chromosome
d. presence or absence of estrogen

CRITICAL THINKING QUESTIONS 26. Identify some differences between meiosis in

20. Briefly explain why mature gametes carry only
one set of chromosomes.
21. What special features are evident in sperm cells
but not in somatic cells, and how do these specializations
function?
22. What do each of the three male accessory glands
contribute to the semen?
23. Describe how penile erection occurs.
24. While anabolic steroids (synthetic testosterone)
bulk up muscles, they can also affect testosterone
production in the testis. Using what you know about
negative feedback, describe what would happen to
testosterone production in the testis if a male takes large
amounts of synthetic testosterone.
25. Follow the path of ejaculated sperm from the
vagina to the oocyte. Include all structures of the female
reproductive tract that the sperm must swim through to
reach the egg.
men and women.
27. Explain the hormonal regulation of the phases of
the menstrual cycle.
28. Endometriosis is a disorder in which endometrial
cells implant and proliferate outside of the uterus—in the
uterine tubes, on the ovaries, or even in the pelvic cavity.
Offer a theory as to why endometriosis increases a
woman’s risk of infertility.
29. Identify the changes in sensitivity that occur in
the hypothalamus, pituitary, and gonads as a boy or girl
approaches puberty. Explain how these changes lead to
the increases of sex steroid hormone secretions that drive
many pubertal changes.
30. Explain how the internal female and male
reproductive structures develop from two different duct
systems.
31. Explain what would occur during fetal
development to an XY individual with a mutation causing
a nonfunctional SRY gene.

91
 2. Use this interactive tool

Chapter 28 (http://openstaxcollege.org/
l/embryogenesis) to view the process of
embryogenesis from the perspective of the

Homework
conceptus (left panel), as well as fetal
development viewed from a maternal cross-
section (right panel). Can you identify when
neurulation occurs in the embryo?
INTERACTIVE LINK QUESTIONS
3. Visit this site
1. View this time-lapse movie
(http://openstaxcollege.org/l/pregstages
(http://openstaxcollege.org/l/conceptus)
) for a summary of the stages of pregnancy, as
of a conceptus starting at day 3. What is the first
experienced by the mother, and view the stages
structure you see? At what point in the movie
of development of the fetus throughout
does the blastocoel first appear? What event
gestation. At what point in fetal development
occurs at the end of the movie?
can a regular heartbeat be detected?
REVIEW QUESTIONS c. morulae
d. blastomeres
4. Sperm and ova are similar in terms of ________.
a. size 10. The conceptus, upon reaching
b. quantity produced per year the uterus, first ________.
c. chromosome number a. implants
d. flagellar motility b. divides
c. disintegrates
5. Although the male ejaculate contains hundreds d. hatches
of millions of sperm, ________.
a. most do not reach the oocyte 11. The inner cell mass of the blastocyst is destined
b. most are destroyed by the alkaline environment to become the ________.
of the uterus a. embryo
c. it takes millions to penetrate the outer layers of b. trophoblast
the oocyte c. chorionic villi
d. most are destroyed by capacitation d. placenta

6. As sperm first reach the oocyte, they will contact 12. Which primary germ layer gave rise to the cells
the ________. that eventually became the central nervous
a. acrosome system?
b. corona radiata a. endoderm
c. sperm-binding receptors b. ectoderm
d. zona pellucida c. acrosome
d. mesoderm
7. Fusion of pronuclei occurs during ________.
a. spermatogenesis 13. What would happen if the trophoblast did not
b. ovulation secrete hCG upon implantation of the
c. fertilization blastocyst?
d. capacitation a. The cells would not continue to divide.
b. The corpus luteum would continue to
8. Sperm must first complete ________ to enable produce progesterone and estrogen.
the fertilization of an oocyte. c. Menses would flush the blastocyst out of
a. capacitation the uterus.
b. the acrosomal reaction d. The uterine mucosa would not envelop the
c. the cortical reaction blastocyst.
d. the fast block
14. During what process does the amnion envelop
9. Cleavage produces daughter cells called the embryo?
________. a. embryonic folding
b. gastrulation
a. trophoblasts c. implantation
b. blastocysts

92
 d. organogenesis
15. The placenta is formed from ________.
a. the embryo’s mesenchymal cells
b. the mother’s endometrium only
c. the mother’s endometrium and the
embryo’s chorionic membrane
d. the mother’s endometrium and the
embryo’s umbilical cord
16. The foramen ovale causes the fetal circulatory
system to bypass the ________.
a. liver
b. lungs
c. kidneys
d. gonads
17. What happens to the urine excreted by the fetus
when the kidneys begin to function?
a. The umbilical cord carries it to the
placenta for removal.
b. The endometrium absorbs it.
c. It adds to the amniotic fluid.
d. It is turned into meconium.
18. During weeks 9–12 of fetal development,
________.
a. bone marrow begins to assume
erythrocyte production
b. meconium begins to accumulate in the
intestines
c. surfactant production begins in the fetal
lungs
d. the spinal cord begins to be myelinated
19. Progesterone secreted by the placenta
suppresses ________ to prevent maturation of
ovarian follicles.
a. LH and estrogen
b. hCG and FSH
c. FSH and LH
d. estrogen and hCG
20. Which of the following is a possible culprit of
“morning sickness”?
a. increased minute respiration
b. decreased intestinal peristalsis
c. decreased aldosterone secretion
d. increased blood volume
21. How does the decrease in progesterone at the last
weeks of pregnancy help to bring on labor?
a. stimulating FSH production
b. decreasing the levels of estrogens
c. dilating the cervix
d. decreasing the inhibition of uterine contractility
22. Which of these fetal presentations is the easiest for
vaginal birth?
a. complete breech
b. vertex occiput anterior
c. frank breech
d. vertex occiput posterior
23. Which of these shunts exists between the right and
left atria?
a. foramen ovale
b. ductus venosus
c. ductus arteriosis
d. foramen venosus
24. Why is brown fat important?
a. It is the newborn’s primary source of insulation.
b. It can be broken down to generate heat for
thermoregulation.
c. It can be broken down for energy between
feedings.
d. It can be converted to white fat.
25. Constriction of umbilical blood vessels during
vaginal birth ________.
a. causes respiratory alkalosis
b. inhibits the respiratory center in the brain
c. elevates carbon dioxide levels in the blood
d. both a and b
26. Alveoli are connected to the lactiferous sinuses by
________.
a. lactocytes
b. lactiferous ducts
c. nipple pores
d. lobules
27. How is colostrum most important to a newborn?
a. It helps boost the newborn’s immune system.
b. It provides much needed fat.
c. It satisfies the newborn’s thirst.
d. It satisfies the infant’s appetite.
28. Mature breast milk ________.
a. has more sodium than cow’s milk
b. has more calcium than cow’s milk
c. has more protein than cow’s milk
d. has more fat than cow’s milk
29. Marfan syndrome is inherited in an autosomal
dominant pattern. Which of the following is true?
a. Female offspring are more likely to be carriers
of the disease.
b. Male offspring are more likely to inherit the
disease.
c. Male and female offspring have the same
likelihood of inheriting the disease.
93
 d. Female offspring are more likely to inherit the
disease.
30. In addition to codominance, the ABO blood group
antigens are also an example of ________.
a. incomplete dominance
b. X-linked recessive inheritance
c. multiple alleles
d. recessive lethal inheritance
31. Zoe has cystic fibrosis. Which of the following is the
most likely explanation?
CRITICAL THINKING QUESTIONS
32. Darcy and Raul are having difficulty conceiving
a child. Darcy ovulates every 28 days, and Raul’s sperm
count is normal. If we could observe Raul’s sperm about
an hour after ejaculation, however, we’d see that they
appear to be moving only sluggishly. When Raul’s sperm
eventually encounter Darcy’s oocyte, they appear to be
incapable of generating an adequate acrosomal reaction.
Which process has probably gone wrong?
33. Sherrise is a sexually active college student. On
Saturday night, she has unprotected sex with her
boyfriend. On Tuesday morning, she experiences the
twinge of midcycle pain that she typically feels when she
is ovulating. This makes Sherrise extremely anxious that
she might soon learn she is pregnant. Is Sherrise’s concern
valid? Why or why not?
34. Approximately 3 weeks after her last menstrual
period, a sexually active woman experiences a brief
episode of abdominopelvic cramping and minor bleeding.
What might be the explanation?
35. The Food and Nutrition Board of the Institute of
Medicine recommends that all women who might become
pregnant consume at least 400 µg/day of folate from
supplements or fortified foods. Why?
36. What is the physiological benefit of
incorporating shunts into the fetal circulatory system?
37. Why would a premature infant require
supplemental oxygen?
a. Zoe probably inherited one faulty allele from
her father, who is a carrier, and one normal
allele from her mother.
b. Zoe probably inherited one faulty allele from
her mother, who must also have cystic fibrosis,
and one normal allele from her father.
c. Zoe must have inherited faulty alleles from both
parents, both of whom must also have cystic
fibrosis.
d. Zoe must have inherited faulty alleles from both
parents, both of whom are carriers.
38. Devin is 35 weeks pregnant with her first child
when she arrives at the birthing unit reporting that she
believes she is in labor. She states that she has been
experiencing diffuse, mild contractions for the past few
hours. Examination reveals, however, that the plug of
mucus blocking her cervix is intact and her cervix has not
yet begun to dilate. She is advised to return home. Why?
39. Janine is 41 weeks pregnant with her first child
when she arrives at the birthing unit reporting that she
believes she has been in labor “for days” but that “it’s just
not going anywhere.” During the clinical exam, she
experiences a few mild contractions, each lasting about
15–20 seconds; however, her cervix is found to be only 2
cm dilated, and the amniotic sac is intact. Janine is
admitted to the birthing unit and an IV infusion of pitocin
is started. Why?
40. Describe how the newborn’s first breath alters
the circulatory pattern.
41. Newborns are at much higher risk for
dehydration than adults. Why?
42. Describe the transit of breast milk from
lactocytes to nipple pores.
43. A woman who stopped breastfeeding suddenly is
experiencing breast engorgement and leakage, just like she
did in the first few weeks of breastfeeding. Why?
44. Explain why it was essential that Mendel
perform his crosses using a large sample size?
45. How can a female carrier of an X-linked
recessive disorder have a daughter who is affected?
94
ANSWER KEY
Chapter 1
1 Fatty acid catabolism. 2 The kidneys. 3 X-rays. 4 The magnets induce tissue to emit radio signals that can show differences
between different types of tissue. 5 PET scans can indicate how patients are responding to chemotherapy. 6 C 7 A 8 A 9
A 10 D 11 D 12 C 13 A 14 C 15 A 16 C 17 A 18 C 19 B 20 D 21 C 22 D 23 B 24 D 25 C 26 C 27 B 28 An
understanding of anatomy and physiology is essential for any career in the health professions. It can also help you make choices
that promote your health, respond appropriately to signs of illness, make sense of health-related news, and help you in your roles
as a parent, spouse, partner, friend, colleague, and caregiver. 29 A student would more readily appreciate the structures revealed
in the dissection. Even though the student has not yet studied the workings of the heart and blood vessels in her class, she has
experienced her heart beating every moment of her life, has probably felt her pulse, and likely has at least a basic understanding
of the role of the heart in pumping blood throughout her body. This understanding of the heart’s function (physiology) would
support her study of the heart’s form (anatomy). 30 Chemical, cellular, tissue, organ, organ system, organism. 31 The female
ovaries and the male testes are parts of the reproductive system. But they also secrete hormones, as does the endocrine system,
therefore ovaries and testes function within both the endocrine and reproductive systems. 32 When you are sitting at a campfire,
your sense of smell adapts to the smell of smoke. Only if that smell were to suddenly and dramatically intensify would you be
likely to notice and respond. In contrast, the smell of even a trace of smoke would be new and highly unusual in your residence
hall, and would be perceived as danger. 33 Growth can occur by increasing the number of existing cells, increasing the size of
existing cells, or increasing the amount of non-cellular material around cells. 34 In a sealed bottle of sparkling water, carbon
dioxide gas is kept dissolved in the water under a very high pressure. When you open the bottle, the pressure of the gas above
the liquid changes from artificially high to normal atmospheric pressure. The dissolved carbon dioxide gas expands, and rises in
bubbles to the surface. When a bottle of sparkling water is left open, it eventually goes flat because its gases continue to move
out of solution until the pressure in the water is approximately equal to atmospheric pressure. 35 The primary way that the body
responds to high environmental heat is by sweating; however, sweating requires water, which comes from body fluids, including
blood plasma. If Josh becomes dehydrated, he will be unable to sweat adequately to cool his body, and he will be at risk for heat
stroke as his blood pressure drops too much from the loss of water from the blood plasma. 36 The four components of a negative
feedback loop are: stimulus, sensor, control center, and effector. If too great a quantity of the chemical were excreted, sensors
would activate a control center, which would in turn activate an effector. In this case, the effector (the secreting cells) would be
adjusted downward. 37 Any prolonged exposure to extreme cold would activate the brain’s heat-gain center. This would reduce
blood flow to your skin, and shunt blood returning from your limbs away from the digits and into a network of deep veins. Your
brain’s heat-gain center would also increase your muscle contraction, causing you to shiver. This increases the energy consumption
of skeletal muscle and generates more heat. Your body would also produce thyroid hormone and epinephrine, chemicals that
promote increased metabolism and heat production. 38 If the body were supine or prone, the MRI scanner would move from top
to bottom to produce frontal sections, which would divide the body into anterior and posterior portions, as in “cutting” a deck of
cards. Again, if the body were supine or prone, to produce sagittal sections, the scanner would move from left to right or from
right to left to divide the body lengthwise into left and right portions. 39 The bullet would enter the ventral, thoracic, and pleural
cavities, and it would encounter the parietal layer of serous membrane first. 40 CT scanning subjects patients to much higher
levels of radiation than X-rays, and should not be performed repeatedly. 41 Ultrasonography does not expose a mother or fetus to
radiation, to radiopharmaceuticals, or to magnetic fields. At this time, there are no known medical risks of ultrasonography.

Chapter 2
1 The mass number is the total number of protons and neutrons in the nucleus of an atom. 2 The plastic sheets jump to the nail
(the conductor), because the conductor takes on electrons from the electroscope, reducing the repellant force of the two sheets. 3
The water hydrolyses, or breaks, the glycosidic bond, forming two monosaccharides. 4 D 5 B 6 A 7 C 8 B 9 C 10 C 11
A 12 B 13 A 14 A 15 B 16 C 17 D 18 A 19 D 20 B 21 A 22 D 23 C 24 B 25 C 26 A 27 C 28 B 29 A 30 D 31
D 32 B 33 These four elements—oxygen, carbon, hydrogen, and nitrogen—together make up more than 95 percent of the mass
of the human body, and the body cannot make elements, so it is helpful to have them in consumables. 34 Oxygen has eight
protons. In its most abundant stable form, it has eight neutrons, too, for a mass number of 16. In contrast, 17O has nine neutrons,
and 18O has 10 neutrons. 35 Magnesium’s 12 electrons are distributed as follows: two in the first shell, eight in the second shell,
and two in its valence shell. According to the octet rule, magnesium is unstable (reactive) because its valence shell has just two
electrons. It is therefore likely to participate in chemical reactions in which it donates two electrons. 36 A carbon atom has four
electrons in its valence shell. According to the octet rule, it will readily participate in chemical reactions that result in its valence
shell having eight electrons. Hydrogen, with one electron, will complete its valence shell with two. Electron sharing between an
atom of carbon and four atoms of hydrogen meets the requirements of all atoms. The bonds are covalent because the electrons are
shared: although hydrogen often participates in ionic bonds, carbon does not because it is highly unlikely to donate or accept four
electrons. 37 Water is a polar molecule. It has a region of weakly positive charge and a region of weakly negative charge. These
regions are attracted to ions as well as to other polar molecules. Oils are nonpolar, and are repelled by water. 38 Identical atoms
have identical electronegativity and cannot form ionic bonds. Oxygen, for example, has six electrons in its valence shell. Neither
donating nor accepting the valence shell electrons of the other will result in the oxygen atoms completing their valence shells. Two
atoms of the same element always form covalent bonds. 39 It is not. An exchange reaction might be AB + CD → AC + BD or
95
 AB + CD → AD + BC . In all chemical reactions, including exchange reactions, the components of the reactants are identical
to the components of the products. A component present among the reactants cannot disappear, nor can a component not present
in the reactants suddenly appear in the products. 40 Recall that the greater the surface area of the reactants, the more quickly and
easily they will interact. It takes energy to separate particles of a substance. Powder and liquid laundry detergents, with relatively
more surface area per unit, can quickly dissolve into their reactive components when added to the water. 41 Lemon juice is
one hundred times more acidic than orange juice. This means that lemon juice has a one hundred-fold greater concentration of
hydrogen ions. 42 Lemon juice, like any acid, releases hydrogen ions in solution. As excessive H+ enters the digestive tract and
is absorbed into blood, Eli’s blood pH falls below 7.35. Recall that bicarbonate is a buffer, a weak base that accepts hydrogen
ions. By administering bicarbonate intravenously, the emergency department physician helps raise Eli’s blood pH back toward
neutral. 43 Maltose contains 12 atoms of carbon, but only 22 atoms of hydrogen and 11 atoms of oxygen, because a molecule
of water is removed during its formation via dehydration synthesis. 44 All lipids are hydrophobic and unable to dissolve in the
watery environment of blood. They are packaged into lipoproteins, whose outer protein envelope enables them to transport fats in
the bloodstream.

Chapter 3
1 Higher temperatures speed up diffusion because molecules have more kinetic energy at higher temperatures. 2 Processing,
packaging, and moving materials manufactured by the cell. 3 an enzyme 4 They separate and move and are free to join
translation of other segments of mRNA. 5 the spindle 6 B 7 D 8 C 9 B 10 D 11 B 12 A 13 C 14 A 15 B 16 C 17 C 18
A 19 B 20 C 21 A 22 C 23 B 24 B 25 D 26 B 27 D 28 C 29 C 30 Only materials that are relatively small and nonpolar
can easily diffuse through the lipid bilayer. Large particles cannot fit in between the individual phospholipids that are packed
together, and polar molecules are repelled by the hydrophobic/nonpolar lipids that line the inside of the bilayer. 31 Receptor-
mediated endocytosis is more selective because the substances that are brought into the cell are the specific ligands that could
bind to the receptors being endocytosed. Phagocytosis or pinocytosis, on the other hand, have no such receptor-ligand specificity,
and bring in whatever materials happen to be close to the membrane when it is enveloped. 32 These four phenomena are similar
in the sense that they describe the movement of substances down a particular type of gradient. Osmosis and diffusion involve
the movement of water and other substances down their concentration gradients, respectively. Filtration describes the movement
of particles down a pressure gradient, and the movement of ions away from like charge describes their movement down their
electrical gradient. 33 The structure of the Golgi apparatus is suited to its function because it is a series of flattened membranous
discs; substances are modified and packaged in sequential steps as they travel from one disc to the next. The structure of Golgi
apparatus also involves a receiving face and a sending face, which organize cellular products as they enter and leave the Golgi
apparatus. The ER and the mitochondria both have structural specializations that increase their surface area. In the mitochondria,
the inner membrane is extensively folded, which increases surface area for ATP production. Likewise, the ER is elaborately
wound throughout the cell, increasing its surface area for functions like lipid synthesis, Ca++ storage, and protein synthesis. 34
Peroxisomes and lysosomes are both cellular organelles bound by lipid bilayer membranes, and they both contain many enzymes.
However, peroxisomes contain enzymes that detoxify substances by transferring hydrogen atoms and producing H2O2, whereas
the enzymes in lysosomes function to break down and digest various unwanted materials. 35 DNA replication is said to be
semiconservative because, after replication is complete, one of the two parent DNA strands makes up half of each new DNA
molecule. The other half is a newly synthesized strand. Therefore, half (“semi”) of each daughter DNA molecule is from the parent
molecule and half is a new molecule. 36 During cell division, one cell divides to produce two new cells. In order for all of the
cells in your body to maintain a full genome, each cell must replicate its DNA before it divides so that a full genome can be allotted
to each of its offspring cells. If DNA replication did not take place fully, or at all, the offspring cells would be missing some or
all of the genome. This could be disastrous if a cell was missing genes necessary for its function and health. 37 Transcription
and DNA replication both involve the synthesis of nucleic acids. These processes share many common features—particularly, the
similar processes of initiation, elongation, and termination. In both cases the DNA molecule must be untwisted and separated,
and the coding (i.e., sense) strand will be used as a template. Also, polymerases serve to add nucleotides to the growing DNA
or mRNA strand. Both processes are signaled to terminate when completed. 38 Transcription is really a “copy” process and
translation is really an “interpretation” process, because transcription involves copying the DNA message into a very similar RNA
message whereas translation involves converting the RNA message into the very different amino acid message. The two processes
also differ in their location: transcription occurs in the nucleus and translation in the cytoplasm. The mechanisms by which the
two processes are performed are also completely different: transcription utilizes polymerase enzymes to build mRNA whereas
translation utilizes different kinds of RNA to build protein. 39 One or both of the new daughter cells would accidently receive
duplicate chromosomes and/or would be missing certain chromosomes. 40 A cyclin is one of the primary classes of cell cycle
control molecules, while a cyclin-dependent kinase (is one of a group of molecules that work together with cyclins to determine
progression past cell checkpoints. By interacting with many additional molecules, these triggers push the cell cycle forward unless
prevented from doing so by “stop” signals, if for some reason the cell is not ready. 41 Transcription factors bind to DNA and
either promote or inhibit the transcription of a gene. If they promote the transcription of a particular gene, then that gene will
be transcribed and the mRNA subsequently translated into protein. If gene transcription is inhibited, then there will be no way
of synthesizing the gene’s corresponding protein. 42 Embryonic stem cells derive from human embryos, which are destroyed to
obtain the cells. The destruction of human embryos is an ethical problem. And, the DNA in an embryonic stem cell would differ
from the DNA of the person being treated, which could result in immune problems or rejected of tissue.

96
Chapter 4
1 Most somatic stem cells give rise to only a few cell types. 2 The inside of the mouth, esophagus, vaginal canal, and anus. 3
Click at the bottom of the quiz for the answers. 4 Skeletal muscle cells are striated. 5 Dendrites, cell body, and the axon. 6
Approximately one month. 7 A mass of cancer cells that continue to grow and divide. 8 C 9 A 10 B 11 D 12 A 13 C 14
B 15 A 16 B 17 D 18 B 19 C 20 B 21 D 22 A 23 A 24 D 25 A 26 B 27 D 28 C 29 B 30 B 31 C 32 The four
types of tissue in the body are epithelial, connective, muscle, and nervous. Epithelial tissue is made of layers of cells that cover
the surfaces of the body that come into contact with the exterior world, line internal cavities, and form glands. Connective tissue
binds the cells and organs of the body together and performs many functions, especially in the protection, support, and integration
of the body. Muscle tissue, which responds to stimulation and contracts to provide movement, is divided into three major types:
skeletal (voluntary) muscles, smooth muscles, and the cardiac muscle in the heart. Nervous tissue allows the body to receive
signals and transmit information as electric impulses from one region of the body to another. 33 The zygote divides into many
cells. As these cells become specialized, they lose their ability to differentiate into all tissues. At first they form the three primary
germ layers. Following the cells of the ectodermal germ layer, they too become more restricted in what they can form. Ultimately,
some of these ectodermal cells become further restricted and differentiate in to nerve cells. 34 Synovial membranes are a type
of connective tissue membrane that supports mobility in joints. The membrane lines the joint cavity and contains fibroblasts that
produce hyaluronan, which leads to the production of synovial fluid, a natural lubricant that enables the bones of a joint to move
freely against one another. 35 Columnar epithelia, which form the lining of the digestive tract, can be either simple or stratified.
The cells are long and narrow. The nucleus is elongated and located on the basal side of the cell. Ciliated columnar epithelium is
composed of simple columnar epithelial cells that display cilia on their apical surfaces. 36 Blood is a fluid connective tissue, a
variety of specialized cells that circulate in a watery fluid containing salts, nutrients, and dissolved proteins in a liquid extracellular
matrix. Blood contains formed elements derived from bone marrow. Erythrocytes, or red blood cells, transport the gases oxygen
and carbon dioxide. Leukocytes, or white blood cells, are responsible for the defense of the organism against potentially harmful
microorganisms or molecules. Platelets are cell fragments involved in blood clotting. Some cells have the ability to cross the
endothelial layer that lines vessels and enter adjacent tissues. Nutrients, salts, and waste are dissolved in the liquid matrix and
transported through the body. 37 A layer of dense irregular connective tissue covers cartilage. No blood vessels supply cartilage
tissue. Injuries to cartilage heal very slowly because cells and nutrients needed for repair diffuse slowly to the injury site. 38 The
cells in the dish are cardiomyocytes, cardiac muscle cells. They have an intrinsic ability to contract. When they link up, they form
intercalating discs that allow the cells to communicate with each other and begin contracting in synchrony. 39 Under the light
microscope, cells appear striated due to the arrangement of the contractile proteins actin and myosin. 40 Neurons are well suited
for the transmission of nerve impulses because short extensions, dendrites, receive impulses from other neurons, while a long
tail extension, an axon, carries electrical impulses away from the cell to other neurons. 41 Astrocytes regulate ions and uptake
and/or breakdown of some neurotransmitters and contribute to the formation of the blood-brain-barrier. 42 These symptoms
would indicate that infection is present. 43 Since NSAIDs or other anti-inflammatory drugs inhibit the formation of blood clots,
regular and prolonged use of these drugs may promote internal bleeding, such as bleeding in the stomach. Excessive levels of
cortisol would suppress inflammation, which could slow the wound healing process. 44 The genetic makeup and the lifestyle
of each individual are factors which determine the degree of decline in cells, tissues, and organs as an individual ages. 45 All
cells experience changes with aging. They become larger, and many cannot divide and regenerate. Because of alterations in cell
membranes, transport of oxygen and nutrients into the cell and removal of carbon dioxide and waste products are not as efficient
in the elderly. Cells lose their ability to function, or they begin to function abnormally, leading to disease and cancer.

Chapter 5
1 The epidermis provides protection, the dermis provides support and flexibility, and the hypodermis (fat layer) provides insulation
and padding. 2 Figure 5.4 These cells do not have nuclei, so you can deduce that they are dead. They appear to be sloughing
off. 3 Figure 5.6 These cells have desmosomes, which give the cells their spiny appearance. 4 There are none. 5 D 6 A 7
C 8 B 9 C 10 C 11 D 12 B 13 B 14 B 15 A 16 C 17 C 18 A 19 C 20 C 21 C 22 D 23 B 24 C 25 The pigment
melanin, produced by melanocytes, is primarily responsible for skin color. Melanin comes in different shades of brown and black.
Individuals with darker skin have darker, more abundant melanin, whereas fair-skinned individuals have a lighter shade of skin and
less melanin. Exposure to UV irradiation stimulates the melanocytes to produce and secrete more melanin. 26 As the cells move
into the stratum spinosum, they begin the synthesis of keratin and extend cell processes, desmosomes, which link the cells. As the
stratum basale continues to produce new cells, the keratinocytes of the stratum spinosum are pushed into the stratum granulosum.
The cells become flatter, their cell membranes thicken, and they generate large amounts of the proteins keratin and keratohyalin.
The nuclei and other cell organelles disintegrate as the cells die, leaving behind the keratin, keratohyalin, and cell membranes that
form the stratum lucidum and the stratum corneum. The keratinocytes in these layers are mostly dead and flattened. Cells in the
stratum corneum are periodically shed. 27 Eccrine sweat glands are all over the body, especially the forehead and palms of the
hand. They release a watery sweat, mixed with some metabolic waste and antibodies. Apocrine glands are associated with hair
follicles. They are larger than eccrine sweat glands and lie deeper in the dermis, sometimes even reaching the hypodermis. They
release a thicker sweat that is often decomposed by bacteria on the skin, resulting in an unpleasant odor. 28 Nails are composed
of densely packed dead keratinocytes. They protect the fingers and toes from mechanical stress. The nail body is formed on the
nail bed, which is at the nail root. Nail folds, folds of skin that overlap the nail on its side, secure the nail to the body. The
crescent-shaped region at the base of the nail is the lunula. 29 Sweating cools the body when it becomes warm. When the body
temperature rises, such as when exercising on a hot day, the dermal blood vessels dilate, and the sweat glands begin to secrete
more sweat. The evaporation of the sweat from the surface of the skin cools the body by dissipating heat. 30 When the core
body temperature drops, the body switches to heat-conservation mode. This can include an inhibition to excessive sweating and
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a decrease of blood flow to the papillary layers of the skin. This reduction of blood flow helps conserve body heat. 31 Acne
results from a blockage of sebaceous glands by sebum. The blockage causes blackheads to form, which are susceptible to infection.
The infected tissue then becomes red and inflamed. Teenagers experience this at high rates because the sebaceous glands become
active during puberty. Hormones that are especially active during puberty stimulate the release of sebum, leading in many cases to
blockages. 32 Scars are made of collagen and do not have the cellular structure of normal skin. The tissue is fibrous and does not
allow for the regeneration of accessory structures, such as hair follicles, and sweat or sebaceous glands.

Chapter 6
1 B 2 D 3 C 4 A 5 B 6 B 7 B 8 D 9 A 10 A 11 C 12 C 13 B 14 A 15 C 16 D 17 C 18 C 19 A 20 C 21 D 22
B 23 D 24 A 25 B 26 C 27 B 28 B 29 D 30 B 31 C 32 A 33 A 34 C 35 A 36 D 37 D 38 A 39 B 40 It supports
the body. The rigid, yet flexible skeleton acts as a framework to support the other organs of the body. It facilitates movement. The
movable joints allow the skeleton to change shape and positions; that is, move. It protects internal organs. Parts of the skeleton
enclose or partly enclose various organs of the body including our brain, ears, heart, and lungs. Any trauma to these organs has
to be mediated through the skeletal system. It produces blood cells. The central cavity of long bones is filled with marrow. The
red marrow is responsible for forming red and white blood cells. It stores and releases minerals and fat. The mineral component
of bone, in addition to providing hardness to bone, provides a mineral reservoir that can be tapped as needed. Additionally, the
yellow marrow, which is found in the central cavity of long bones along with red marrow, serves as a storage site for fat. 41
Structurally, a tarsal is a short bone, meaning its length, width, and thickness are about equal, while a metatarsal is a long bone
whose length is greater than its width. Functionally, the tarsal provides limited motion, while the metatarsal acts as a lever. 42
Structurally, the femur is a long bone, meaning its length is greater than its width, while the patella, a sesamoid bone, is small
and round. Functionally, the femur acts as a lever, while the patella protects the patellar tendon from compressive forces. 43 If
the articular cartilage at the end of one of your long bones were to deteriorate, which is actually what happens in osteoarthritis,
you would experience joint pain at the end of that bone and limitation of motion at that joint because there would be no cartilage
to reduce friction between adjacent bones and there would be no cartilage to act as a shock absorber. 44 The densely packed
concentric rings of matrix in compact bone are ideal for resisting compressive forces, which is the function of compact bone. The
open spaces of the trabeculated network of spongy bone allow spongy bone to support shifts in weight distribution, which is the
function of spongy bone. 45 In intramembranous ossification, bone develops directly from sheets of mesenchymal connective
tissue, but in endochondral ossification, bone develops by replacing hyaline cartilage. Intramembranous ossification is complete
by the end of the adolescent growth spurt, while endochondral ossification lasts into young adulthood. The flat bones of the face,
most of the cranial bones, and a good deal of the clavicles (collarbones) are formed via intramembranous ossification, while bones
at the base of the skull and the long bones form via endochondral ossification. 46 A single primary ossification center is present,
during endochondral ossification, deep in the periosteal collar. Like the primary ossification center, secondary ossification centers
are present during endochondral ossification, but they form later, and there are two of them, one in each epiphysis. 47 In closed
reduction, the broken ends of a fractured bone can be reset without surgery. Open reduction requires surgery to return the broken
ends of the bone to their correct anatomical position. A partial fracture would likely require closed reduction. A compound fracture
would require open reduction. 48 The internal callus is produced by cells in the endosteum and is composed of a fibrocartilaginous
matrix. The external callus is produced by cells in the periosteum and consists of hyaline cartilage and bone. 49 Since maximum
bone mass is achieved by age 30, I would want this patient to have adequate calcium and vitamin D in her diet. To do this, I would
recommend ingesting milk and other dairy foods, green leafy vegetables, and intact canned sardines so she receives sufficient
calcium. Intact salmon would be a good source for calcium and vitamin D. Other fatty fish would also be a good vitamin D
source. 50 Astronauts floating in space were not exerting significant pressure on their bones; they were “weightless.” Without
the force of gravity exerting pressure on the bones, bone mass was lost. To alleviate this condition, astronauts now do resistive
exercise designed to apply forces to the bones and thus help keep them healthy. 51 Vitamin D is required for calcium absorption
by the gut. Low vitamin D could lead to insufficient levels of calcium in the blood so the calcium is being released from the
bones. The reduction of calcium from the bones can make them weak and subject to fracture. 52 Under “normal” conditions,
receptors in the parathyroid glands bind blood calcium. When the receptors are full, the parathyroid gland stops secreting PTH.
In the condition described, the parathyroid glands are not responding to the signal that there is sufficient calcium in the blood and
they keep releasing PTH, which causes the bone to release more calcium into the blood. Ultimately, the bones become fragile and
hypercalcemia can result.

Chapter 7
1 The sphenoid bone joins with most other bones of the skull. It is centrally located, where it forms portions of the rounded brain
case and cranial base. 2 A basilar fracture may damage an artery entering the skull, causing bleeding in the brain. 3 Osteoporosis
causes thinning and weakening of the vertebral bodies. When this occurs in thoracic vertebrae, the bodies may collapse producing
kyphosis, an enhanced anterior curvature of the thoracic vertebral column. 4 Lifting a heavy object can cause an intervertebral
disc in the lower back to bulge and compress a spinal nerve as it exits through the intervertebral foramen, thus producing pain
in those regions of the lower limb supplied by that nerve. 5 The anterior longitudinal ligament is thickest in the thoracic region
of the vertebral column, while the supraspinous ligament is thickest in the lumbar region. 6 Bones on the top and sides of the
skull develop when fibrous membrane areas ossify (convert) into bone. The bones of the limbs, ribs, and vertebrae develop when
cartilage models of the bones ossify into bone. 7 D 8 C 9 B 10 A 11 B 12 D 13 A 14 A 15 D 16 A 17 B 18 C 19 A 20
A 21 B 22 D 23 A 24 D 25 B 26 D 27 The axial skeleton forms the vertical axis of the body and includes the bones of the
head, neck, back, and chest of the body. It consists of 80 bones that include the skull, vertebral column, and thoracic cage. The
appendicular skeleton consists of 126 bones and includes all bones of the upper and lower limbs. 28 The axial skeleton supports

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the head, neck, back, and chest of the body and allows for movements of these body regions. It also gives bony protections for
the brain, spinal cord, heart, and lungs; stores fat and minerals; and houses the blood-cell producing tissue. 29 The brain case is
that portion of the skull that surrounds and protects the brain. It is subdivided into the rounded top of the skull, called the calvaria,
and the base of the skull. There are eight bones that form the brain case. These are the paired parietal and temporal bones, plus
the unpaired frontal, occipital, sphenoid, and ethmoid bones. The facial bones support the facial structures, and form the upper and
lower jaws, nasal cavity, nasal septum, and orbit. There are 14 facial bones. These are the paired maxillary, palatine, zygomatic,
nasal, lacrimal, and inferior nasal conchae bones, and the unpaired vomer and mandible bones. 30 The coronal suture passes
across the top of the anterior skull. It unites the frontal bone anteriorly with the right and left parietal bones. The sagittal suture runs
at the midline on the top of the skull. It unites the right and left parietal bones with each other. The squamous suture is a curved
suture located on the lateral side of the skull. It unites the squamous portion of the temporal bone to the parietal bone. The lambdoid
suture is located on the posterior skull and has an inverted V-shape. It unites the occipital bone with the right and left parietal
bones. 31 The anterior cranial fossa is the shallowest of the three cranial fossae. It extends from the frontal bone anteriorly to the
lesser wing of the sphenoid bone posteriorly. It is divided at the midline by the crista galli and cribriform plates of the ethmoid
bone. The middle cranial fossa is located in the central skull, and is deeper than the anterior fossa. The middle fossa extends from
the lesser wing of the sphenoid bone anteriorly to the petrous ridge posteriorly. It is divided at the midline by the sella turcica.
The posterior cranial fossa is the deepest fossa. It extends from the petrous ridge anteriorly to the occipital bone posteriorly. The
large foramen magnum is located at the midline of the posterior fossa. 32 There are two bony parts of the nasal septum in the dry
skull. The perpendicular plate of the ethmoid bone forms the superior part of the septum. The vomer bone forms the inferior and
posterior parts of the septum. In the living skull, the septal cartilage completes the septum by filling in the anterior area between the
bony components and extending outward into the nose. 33 The adult vertebral column consists of 24 vertebrae, plus the sacrum
and coccyx. The vertebrae are subdivided into cervical, thoracic, and lumbar regions. There are seven cervical vertebrae (C1–C7),
12 thoracic vertebrae (T1–T12), and five lumbar vertebrae (L1–L5). The sacrum is derived from the fusion of five sacral vertebrae
and the coccyx is formed by the fusion of four small coccygeal vertebrae. 34 A typical vertebra consists of an anterior body and
a posterior vertebral arch. The body serves for weight bearing. The vertebral arch surrounds and protects the spinal cord. The
vertebral arch is formed by the pedicles, which are attached to the posterior side of the vertebral body, and the lamina, which
come together to form the top of the arch. A pair of transverse processes extends laterally from the vertebral arch, at the junction
between each pedicle and lamina. The spinous process extends posteriorly from the top of the arch. A pair of superior articular
processes project upward and a pair of inferior articular processes project downward. Together, the notches found in the margins
of the pedicles of adjacent vertebrae form an intervertebral foramen. 35 The sacrum is a single, triangular-shaped bone formed by
the fusion of five sacral vertebrae. On the posterior sacrum, the median sacral crest is derived from the fused spinous processes,
and the lateral sacral crest results from the fused transverse processes. The sacral canal contains the sacral spinal nerves, which
exit via the anterior (ventral) and posterior (dorsal) sacral foramina. The sacral promontory is the anterior lip. The sacrum also
forms the posterior portion of the pelvis. 36 An intervertebral disc fills in the space between adjacent vertebrae, where it provides
padding and weight-bearing ability, and allows for movements between the vertebrae. It consists of an outer anulus fibrosus and
an inner nucleus pulposus. The anulus fibrosus strongly anchors the adjacent vertebrae to each other, and the high water content of
the nucleus pulposus resists compression for weight bearing and can change shape to allow for vertebral column movements. 37
The anterior longitudinal ligament is attached to the vertebral bodies on the anterior side of the vertebral column. The supraspinous
ligament is located on the posterior side, where it interconnects the thoracic and lumbar spinous processes. In the posterior neck,
this ligament expands to become the nuchal ligament, which attaches to the cervical spinous processes and the base of the skull.
The posterior longitudinal ligament and ligamentum flavum are located inside the vertebral canal. The posterior longitudinal
ligament unites the posterior sides of the vertebral bodies. The ligamentum flavum unites the lamina of adjacent vertebrae. 38
The thoracic cage is formed by the 12 pairs of ribs with their costal cartilages and the sternum. The ribs are attached posteriorly to
the 12 thoracic vertebrae and most are anchored anteriorly either directly or indirectly to the sternum. The thoracic cage functions
to protect the heart and lungs. 39 The sternum consists of the manubrium, body, and xiphoid process. The manubrium forms the
expanded, superior end of the sternum. It has a jugular (suprasternal) notch, a pair of clavicular notches for articulation with the
clavicles, and receives the costal cartilage of the first rib. The manubrium is joined to the body of the sternum at the sternal angle,
which is also the site for attachment of the second rib costal cartilages. The body receives the costal cartilage attachments for ribs
3–7. The small xiphoid process forms the inferior tip of the sternum. 40 A typical rib is a flattened, curved bone. The head of a
rib is attached posteriorly to the costal facets of the thoracic vertebrae. The rib tubercle articulates with the transverse process of a
thoracic vertebra. The angle is the area of greatest rib curvature and forms the largest portion of the thoracic cage. The body (shaft)
of a rib extends anteriorly and terminates at the attachment to its costal cartilage. The shallow costal groove runs along the inferior
margin of a rib and carries blood vessels and a nerve. 41 Ribs are classified based on if and how their costal cartilages attach to
the sternum. True (vertebrosternal) ribs are ribs 1–7. The costal cartilage for each of these attaches directly to the sternum. False
(vertebrochondral) ribs, 8–12, are attached either indirectly or not at all to the sternum. Ribs 8–10 are attached indirectly to the
sternum. For these ribs, the costal cartilage of each attaches to the cartilage of the next higher rib. The last false ribs (11–12) are
also called floating (vertebral) ribs, because these ribs do not attach to the sternum at all. Instead, the ribs and their small costal
cartilages terminate within the muscles of the lateral abdominal wall. 42 The brain-case bones that form the top and sides of the
skull are produced by intramembranous ossification. In this, mesenchyme from the sclerotome portion of the somites accumulates
at the site of the future bone and differentiates into bone-producing cells. These generate areas of bone that are initially separated by
wide regions of fibrous connective tissue called fontanelles. After birth, as the bones enlarge, the fontanelles disappear. However,
the bones remain separated by the sutures, where bone and skull growth can continue until the adult size is obtained. 43 The facial
bones and base of the skull arise via the process of endochondral ossification. This process begins with the localized accumulation
of mesenchyme tissue at the sites of the future bones. The mesenchyme differentiates into hyaline cartilage, which forms a cartilage
model of the future bone. The cartilage allows for growth and enlargement of the model. It is gradually converted into bone over
time. 44 The vertebrae, ribs, and sternum all develop via the process of endochondral ossification. Mesenchyme tissue from the
sclerotome portion of the somites accumulates on either side of the notochord and produces hyaline cartilage models for each

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vertebra. In the thorax region, a portion of this cartilage model splits off to form the ribs. Similarly, mesenchyme forms cartilage
models for the right and left halves of the sternum. The ribs then become attached anteriorly to the developing sternum, and the
two halves of sternum fuse together. Ossification of the cartilage model into bone occurs within these structures over time. This
process continues until each is converted into bone, except for the sternal ends of the ribs, which remain as the costal cartilages.

Chapter 8
1 A fracture through the joint surface of the distal radius may make the articulating surface of the radius rough or jagged. This
can then cause painful movements involving this joint and the early development of arthritis. Surgery can return the joint surface
to its original smoothness, thus allowing for the return of normal function. 2 The hand has a proximal transverse arch, a distal
transverse arch, and a longitudinal arch. These allow the hand to conform to objects being held. These arches maximize the amount
of surface contact between the hand and object, which enhances stability and increases sensory input. 3 Surgery may be required
if the fracture is unstable, meaning that the broken ends of the radius won’t stay in place to allow for proper healing. In this case,
metal plates and screws can be used to stabilize the fractured bone. 4 The obturator foramen is located between the ischium and
the pubis. The superior and inferior pubic rami contribute to the boundaries of the obturator foramen. 5 A hole is drilled into the
greater trochanter, the bone marrow (medullary) space inside the femur is enlarged, and finally an intramedullary rod is inserted
into the femur. This rod is then anchored to the bone with screws. 6 Metal cutting jigs are attached to the bones to ensure that
the bones are cut properly prior to the attachment of prosthetic components. 7 The proximal group of tarsal bones includes the
calcaneus and talus bones, the navicular bone is intermediate, and the distal group consists of the cuboid bone plus the medial,
intermediate, and lateral cuneiform bones. 8 A bunion results from the deviation of the big toe toward the second toe, which
causes the distal end of the first metatarsal bone to stick out. A bunion may also be caused by prolonged pressure on the foot from
pointed shoes with a narrow toe box that compresses the big toe and pushes it toward the second toe. 9 (a) The upper limb bud
initially appears on day 26 as the upper limb ridge. This becomes the upper limb bud by day 28. (b) The handplate and footplate
appear at day 36. (c) Rotation of the upper and lower limbs begins during the seventh week (day 48). 10 B 11 C 12 D 13 A 14
C 15 D 16 A 17 C 18 D 19 B 20 B 21 A 22 B 23 C 24 A 25 B 26 C 27 D 28 C 29 C 30 D 31 C 32 A 33 The
clavicle extends laterally across the anterior shoulder and can be palpated along its entire length. At its lateral end, the clavicle
articulates with the acromion of the scapula, which forms the bony tip of the shoulder. The acromion is continuous with the spine
of the scapula, which can be palpated medially and posteriorly along its length. Together, the clavicle, acromion, and spine of the
scapula form a V-shaped line that serves as an important area for muscle attachment. 34 A blow to the shoulder or falling onto
an outstretched hand passes strong forces through the scapula to the clavicle and sternum. A hard fall may thus cause a fracture of
the clavicle (broken collarbone) or may injure the ligaments of the acromioclavicular joint. In a severe case, the coracoclavicular
ligament may also rupture, resulting in complete dislocation of the acromioclavicular joint (a “shoulder separation”). 35 As you
push against the car, forces will pass from the metacarpal bones of your hand into the carpal bones at the base of your hand. Forces
will then pass through the midcarpal and radiocarpal joints into the radius and ulna bones of the forearm. These will pass the force
through the elbow joint into the humerus of the arm, and then through the glenohumeral joint into the scapula. The force will travel
through the acromioclavicular joint into the clavicle, and then through the sternoclavicular joint into the sternum, which is part
of the axial skeleton. 36 The base of the hand is formed by the eight carpal bones arranged in two rows (distal and proximal)
of four bones each. The proximal row contains (from lateral to medial) the scaphoid, lunate, triquetrum, and pisiform bones. The
distal row contains (from medial to lateral) the hamate, capitate, trapezoid, and trapezium bones. (Use the mnemonic “So Long
To Pinky, Here Comes The Thumb” to remember this sequence). The rows of the proximal and distal carpal bones articulate with
each other at the midcarpal joint. The palm of the hand contains the five metacarpal bones, which are numbered 1–5 starting on
the thumb side. The proximal ends of the metacarpal bones articulate with the distal row of the carpal bones. The distal ends of the
metacarpal bones articulate with the proximal phalanx bones of the thumb and fingers. The thumb (digit 1) has both a proximal
and distal phalanx bone. The fingers (digits 2–5) all contain proximal, middle, and distal phalanges. 37 The pelvis is formed by
the combination of the right and left hip bones, the sacrum, and the coccyx. The auricular surfaces of each hip bone articulate
with the auricular surface of the sacrum to form the sacroiliac joint. This joint is supported on either side by the strong anterior
and posterior sacroiliac ligaments. The right and left hip bones converge anteriorly, where the pubic bodies articulate with each
other to form the pubic symphysis joint. The sacrum is also attached to the hip bone by the sacrospinous ligament, which spans
the sacrum to the ischial spine, and the sacrotuberous ligament, which runs from the sacrum to the ischial tuberosity. The coccyx
is attached to the inferior end of the sacrum. 38 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. This angle, formed by the anterior convergence of the right
and left ischiopubic rami, is larger in females (greater than 80 degrees) than in males (less than 70 degrees). The female sacral
promontory does not project anteriorly as far as it does in males, which gives the pelvic brim (pelvic inlet) of the female a rounded
or oval shape. The lesser pelvic cavity is wider and more shallow in females, and the pelvic outlet is larger than in males. Thus, the
greater width of the female pelvis, with its larger pelvic inlet, lesser pelvis, and pelvic outlet, are important for childbirth because
the baby must pass through the pelvis during delivery. 39 The lower limb is divided into three regions. The thigh is the region
located between the hip and knee joints. It contains the femur and the patella. The hip joint is formed by the articulation between
the acetabulum of the hip bone and the head of the femur. The leg is the region between the knee and ankle joints, and contains
the tibia (medially) and the fibula (laterally). The knee joint is formed by the articulations between the medial and lateral condyles
of the femur, and the medial and lateral condyles of the tibia. Also associated with the knee is the patella, which articulates with
the patellar surface of the distal femur. The foot is found distal to the ankle and contains 26 bones. The ankle joint is formed by
the articulations between the talus bone of the foot and the distal end of the tibia, the medial malleolus of the tibia, and the lateral
malleolus of the fibula. The posterior foot contains the seven tarsal bones, which are the talus, calcaneus, navicular, cuboid, and the
medial, intermediate, and lateral cuneiform bones. The anterior foot consists of the five metatarsal bones, which are numbered 1–5
starting on the medial side of the foot. The toes contain 14 phalanx bones, with the big toe (toe number 1) having a proximal and
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a distal phalanx, and the other toes having proximal, middle, and distal phalanges. 40 The talus bone articulates superiorly with
the tibia and fibula at the ankle joint, with body weight passed from the tibia to the talus. Body weight from the talus is transmitted
to the ground by both ends of the medial and lateral longitudinal foot arches. Weight is passed posteriorly through both arches to
the calcaneus bone, which forms the heel of the foot and is in contact with the ground. On the medial side of the foot, body weight
is passed anteriorly from the talus bone to the navicular bone, and then to the medial, intermediate, and lateral cuneiform bones.
The cuneiform bones pass the weight anteriorly to the first, second, and third metatarsal bones, whose heads (distal ends) are in
contact with the ground. On the lateral side, body weight is passed anteriorly from the talus through the calcaneus, cuboid, and
fourth and fifth metatarsal bones. The talus bone thus transmits body weight posteriorly to the calcaneus and anteriorly through
the navicular, cuneiform, and cuboid bones, and metatarsals one through five. 41 A radiograph (X-ray image) of a child’s femur
will show the epiphyseal plates associated with each secondary ossification center. These plates of hyaline cartilage will appear
dark in comparison to the white imaging of the ossified bone. Since each epiphyseal plate appears and disappears at a different
age, the presence or absence of these plates can be used to give an approximate age for the child. For example, the epiphyseal plate
located at the base of the lesser trochanter of the femur appears at age 9–10 years and disappears at puberty (approximately 11
years of age). Thus, a child’s radiograph that shows the presence of the lesser trochanter epiphyseal plate indicates an approximate
age of 10 years. 42 Unlike other bones of the appendicular skeleton, the clavicle develops by the process of intramembranous
ossification. In this process, embryonic mesenchyme accumulates at the site of the future bone and then differentiates directly into
bone-producing tissue. Because of this direct and early production of bone, the clavicle is the first bone of the skeleton to begin to
ossify. However, the growth and enlargement of the clavicle continues throughout childhood and adolescence, and thus, it is not
fully ossified until 25 years of age.

Chapter 9
1 Although they are still growing, the carpal bones of the wrist area do not show an epiphyseal plate. Instead of elongating,
these bones grow in diameter by adding new bone to their surfaces. 2 Ball-and-socket joint. 3 Gout is due to the accumulation
of uric acid crystals in the body. Usually these accumulate within joints, causing joint pain. This patient also had crystals that
accumulated in the space next to his spinal cord, thus compressing the spinal cord and causing muscle weakness. 4 The most
common cause of hip disability is osteoarthritis, a chronic disease in which the articular cartilage of the joint wears away, resulting
in severe hip pain and stiffness. 5 The immune system malfunctions and attacks healthy cells in the lining of your joints. This
causes inflammation and pain in the joints and surrounding tissues. 6 Dorsiflexion of the foot at the ankle decreases the angle
of the ankle joint, while plantar flexion increases the angle of the ankle joint. 7 The first motion is rotation (hinging) of the
mandible, but this only produces about 20 mm (0.78 in) of mouth opening. 8 The shoulder joint is a ball-and-socket joint that
allows for flexion-extension, abduction-adduction, medial rotation, lateral rotation, and circumduction of the humerus. 9 The
glenoid labrum is wedge-shaped in cross-section. This is important because it creates an elevated rim around the glenoid cavity,
which creates a deeper socket for the head of the humerus to fit into. 10 The structures that stabilize the elbow include the
coronoid process, the radial (lateral) collateral ligament, and the anterior portion of the ulnar (medial) collateral ligament. 11 The
articular cartilage functions to absorb shock and to provide an extremely smooth surface that makes movement between bones
easy, without damaging the bones. 12 An intracapsular fracture of the neck of the femur can result in disruption of the arterial
blood supply to the head of the femur, which may lead to avascular necrosis of the femoral head. 13 The articular cartilage
is thickest in the upper and back part of the acetabulum, the socket portion of the hip joint. These regions receive most of the
force from the head of the femur during walking and running. 14 There are five ligaments associated with the knee joint. The
tibial collateral ligament is located on the medial side of the knee and the fibular collateral ligament is located on the lateral
side. The anterior and posterior cruciate ligaments are located inside the knee joint. 15 The anterior cruciate ligament prevents
the tibia from sliding too far forward in relation to the femur and the posterior cruciate ligament keeps the tibia from sliding too
far backward. 16 The anterior cruciate ligament (ACL) is most commonly injured when traumatic force is applied to the knee
during a twisting motion or when side standing or landing from a jump. 17 The ligaments of the lateral ankle are the anterior
and posterior talofibular ligaments and the calcaneofibular ligament. These ligaments support the ankle joint and resist excess
inversion of the foot. 18 Because of the square shape of the ankle joint, it has been compared to a mortise-and-tendon type
of joint. 19 An inversion ankle sprain may injure all three ligaments located on the lateral side of the ankle. The sequence of
injury would be the anterior talofibular ligament first, followed by the calcaneofibular ligament second, and finally, the posterior
talofibular ligament third. 20 C 21 B 22 A 23 D 24 A 25 A 26 D 27 C 28 B 29 D 30 A 31 A 32 A 33 B 34 C 35
C 36 D 37 D 38 B 39 A 40 A 41 C 42 D 43 A 44 C 45 C 46 A 47 D 48 C 49 B 50 B 51 C 52 A 53 Functional
classification of joints is based on the degree of mobility exhibited by the joint. A synarthrosis is an immobile or nearly immobile
joint. An example is the manubriosternal joint or the joints between the skull bones surrounding the brain. An amphiarthrosis is
a slightly moveable joint, such as the pubic symphysis or an intervertebral cartilaginous joint. A diarthrosis is a freely moveable
joint. These are subdivided into three categories. A uniaxial diarthrosis allows movement within a single anatomical plane or axis
of motion. The elbow joint is an example. A biaxial diarthrosis, such as the metacarpophalangeal joint, allows for movement
along two planes or axes. The hip and shoulder joints are examples of a multiaxial diarthrosis. These allow movements along
three planes or axes. 54 The functional needs of joints vary and thus joints differ in their degree of mobility. A synarthrosis,
which is an immobile joint, serves to strongly connect bones thus protecting internal organs such as the heart or brain. A slightly
moveable amphiarthrosis provides for small movements, which in the vertebral column can add together to yield a much larger
overall movement. The freedom of movement provided by a diarthrosis can allow for large movements, such as is seen with most
joints of the limbs. 55 Narrow fibrous joints are found at a suture, gomphosis, or syndesmosis. A suture is the fibrous joint that
joins the bones of the skull to each other (except the mandible). A gomphosis is the fibrous joint that anchors each tooth to its bony
socket within the upper or lower jaw. The tooth is connected to the bony jaw by periodontal ligaments. A narrow syndesmosis
is found at the distal tibiofibular joint where the bones are united by fibrous connective tissue and ligaments. A syndesmosis can
also form a wide fibrous joint where the shafts of two parallel bones are connected by a broad interosseous membrane. The radius
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and ulna bones of the forearm and the tibia and fibula bones of the leg are united by interosseous membranes. 56 The teeth
are anchored into their sockets within the bony jaws by the periodontal ligaments. This is a gomphosis type of fibrous joint. In
scurvy, collagen production is inhibited and the periodontal ligaments become weak. This will cause the teeth to become loose or
even to fall out. 57 Cartilaginous joints are where the adjacent bones are joined by cartilage. At a synchondrosis, the bones are
united by hyaline cartilage. The epiphyseal plate of growing long bones and the first sternocostal joint that unites the first rib to
the sternum are examples of synchondroses. At a symphysis, the bones are joined by fibrocartilage, which is strong and flexible.
Symphysis joints include the intervertebral symphysis between adjacent vertebrae and the pubic symphysis that joins the pubic
portions of the right and left hip bones. 58 The first sternocostal joint is a synchondrosis type of cartilaginous joint in which
hyaline cartilage unites the first rib to the manubrium of the sternum. This forms an immobile (synarthrosis) type of joint. The
pubic symphysis is a slightly mobile (amphiarthrosis) cartilaginous joint, where the pubic portions of the right and left hip bones
are united by fibrocartilage, thus forming a symphysis. 59 All synovial joints have a joint cavity filled with synovial fluid that is
the site at which the bones of the joint articulate with each other. The articulating surfaces of the bones are covered by articular
cartilage, a thin layer of hyaline cartilage. The walls of the joint cavity are formed by the connective tissue of the articular capsule.
The synovial membrane lines the interior surface of the joint cavity and secretes the synovial fluid. Synovial joints are directly
supported by ligaments, which span between the bones of the joint. These may be located outside of the articular capsule (extrinsic
ligaments), incorporated or fused to the wall of the articular capsule (intrinsic ligaments), or found inside of the articular capsule
(intracapsular ligaments). Ligaments hold the bones together and also serve to resist or prevent excessive or abnormal movements
of the joint. 60 Direct support for a synovial joint is provided by ligaments that strongly unite the bones of the joint and serve to
resist excessive or abnormal movements. Some joints, such as the sternoclavicular joint, have an articular disc that is attached to
both bones, where it provides direct support by holding the bones together. Indirect joint support is provided by the muscles and
their tendons that act across a joint. Muscles will increase their contractile force to help support the joint by resisting forces acting
on it. 61 Ball-and-socket joints are multiaxial joints that allow for flexion and extension, abduction and adduction, circumduction,
and medial and lateral rotation. 62 To cross your arms, you need to use both your shoulder and elbow joints. At the shoulder, the
arm would need to flex and medially rotate. At the elbow, the forearm would need to be flexed. 63 The shoulder joint allows for
a large range of motion. The primary support for the shoulder joint is provided by the four rotator cuff muscles. These muscles
serve as “dynamic ligaments” and thus can modulate their strengths of contraction as needed to hold the head of the humerus in
position at the glenoid fossa. Additional but weaker support comes from the coracohumeral ligament, an intrinsic ligament that
supports the superior aspect of the shoulder joint, and the glenohumeral ligaments, which are intrinsic ligaments that support the
anterior side of the joint. 64 A strong blow to the lateral side of the extended knee will cause the medial side of the knee joint
to open, resulting in a sequence of three injuries. First will be damage to the tibial collateral ligament. Since the medial meniscus
is attached to the tibial collateral ligament, the meniscus is also injured. The third structure injured would be the anterior cruciate
ligament. 65 Mesenchyme gives rise to cartilage models of the future limb bones. An area called the joint interzone located
between adjacent cartilage models will become a synovial joint. The cells at the center of the interzone die, thus producing the
joint cavity. Additional mesenchyme cells at the periphery of the interzone become the articular capsule. 66 Intramembranous
ossification is the process by which mesenchymal cells differentiate directly into bone producing cells. This process produces the
bones that form the top and sides of the skull. The remaining skull bones and the bones of the limbs are formed by endochondral
ossification. In this, mesenchymal cells differentiate into hyaline cartilage cells that produce a cartilage model of the future bone.
The cartilage is then gradually replaced by bone tissue over a period of many years, during which the cartilage of the epiphyseal
plate can continue to grow to allow for enlargement or lengthening of the bone.

Chapter 10
1 (a) Z-lines. (b) Sarcomeres. (c) This is the arrangement of the actin and myosin filaments in a sarcomere. (d) The alternating
strands of actin and myosin filaments. 2 (a) It is the number of skeletal muscle fibers supplied by a single motor neuron. (b)
A large motor unit has one neuron supplying many skeletal muscle fibers for gross movements, like the Temporalis muscle,
where 1000 fibers are supplied by one neuron. A small motor has one neuron supplying few skeletal muscle fibers for very
fine movements, like the extraocular eye muscles, where six fibers are supplied by one neuron. (c) To avoid prolongation of
muscle contraction. 3 (a) The T-tubules are inward extensions of the sarcolemma that trigger the release of Ca++ from SR during
an Action Potential. (b) Ca++ binds to tropomyosin, and this slides the tropomyosin rods away from the binding sites. 4 D 5
B 6 C 7 B 8 A 9 D 10 D 11 B 12 C 13 C 14 D 15 C 16 B 17 A 18 B 19 D 20 A 21 B 22 C 23 A 24 D 25
C 26 A 27 A 28 C 29 D 30 It allows muscle to return to its original length during relaxation after contraction. 31 Muscles
would lose their integrity during powerful movements, resulting in muscle damage. 32 When a muscle contracts, the force of
movement is transmitted through the tendon, which pulls on the bone to produce skeletal movement. 33 Produce movement of the
skeleton, maintain posture and body position, support soft tissues, encircle openings of the digestive, urinary, and other tracts, and
maintain body temperature. 34 The opening of voltage-gated sodium channels, followed by the influx of Na+, transmits an Action
Potential after the membrane has sufficiently depolarized. The delayed opening of potassium channels allows K+ to exit the cell,
to repolarize the membrane. 35 Without T-tubules, action potential conduction into the interior of the cell would happen much
more slowly, causing delays between neural stimulation and muscle contraction, resulting in slower, weaker contractions. 36 Dark
A bands and light I bands repeat along myofibrils, and the alignment of myofibrils in the cell cause the entire cell to appear
striated. 37 Without ATP, the myosin heads cannot detach from the actin-binding sites. All of the “stuck” cross-bridges result
in muscle stiffness. In a live person, this can cause a condition like “writer’s cramps.” In a recently dead person, it results in
rigor mortis. 38 Eyes require fine movements and a high degree of control, which is permitted by having fewer muscle fibers
associated with a neuron. 39 The length, size and types of muscle fiber and the frequency of neural stimulation contribute to the
amount of tension produced in an individual muscle fiber. 40 Creatine phosphate is used because creatine phosphate and ADP
are converted very quickly into ATP by creatine kinase. Glycolysis cannot generate ATP as quickly as creatine phosphate. 41
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Aerobic respiration is much more efficient than anaerobic glycolysis, yielding 36 ATP per molecule of glucose, as opposed to
two ATP produced by glycolysis. 42 Endurance training modifies slow fibers to make them more efficient by producing more
mitochondria to enable more aerobic metabolism and more ATP production. Endurance exercise can also increase the amount of
myoglobin in a cell and formation of more extensive capillary networks around the fiber. 43 Resistance exercises affect muscles
by causing the formation of more actin and myosin, increasing the structure of muscle fibers. 44 An action potential could reach
a cardiac muscle cell before it has entered the relaxation phase, resulting in the sustained contractions of tetanus. If this happened,
the heart would not beat regularly. 45 Cardiac and skeletal muscle cells both contain ordered myofibrils and are striated. Cardiac
muscle cells are branched and contain intercalated discs, which skeletal muscles do not have. 46 Smooth muscles can contract
over a wider range of resting lengths because the actin and myosin filaments in smooth muscle are not as rigidly organized as those
in skeletal and cardiac muscle. 47 Single-unit smooth muscle is found in the walls of hollow organs; multiunit smooth muscle
is found in airways to the lungs and large arteries. Single-unit smooth muscle cells contract synchronously, they are coupled by
gap junctions, and they exhibit spontaneous action potential. Multiunit smooth cells lack gap junctions, and their contractions are
not synchronous. 48 If the damage exceeds what can be repaired by satellite cells, the damaged tissue is replaced by scar tissue,
which cannot contract. 49 Smooth muscle tissue can regenerate from stem cells called pericytes, cells found in some small blood
vessels. These allow smooth muscle cells to regenerate and repair much more readily than skeletal and cardiac muscle tissue.

Chapter 11
1 D 2 A 3 B 4 A 5 C 6 C 7 A 8 A 9 C 10 D 11 D 12 C 13 B 14 B 15 B 16 C 17 A 18 D 19 B 20 C 21 B 22
B 23 A 24 A 25 D 26 B 27 B 28 Fascicle arrangements determine what type of movement a muscle can make. For instance,
circular muscles act as sphincters, closing orifices. 29 Muscles work in pairs to facilitate movement of the bones around the joints.
Agonists are the prime movers while antagonists oppose or resist the movements of the agonists. Synergists assist the agonists, and
fixators stabilize a muscle’s origin. 30 Agonists are the prime movers while antagonists oppose or resist the movements of the
agonists. Synergists assist the agonists, and fixators stabilize a muscle’s origin. 31 In anatomy and physiology, many word roots
are Latin or Greek. Portions, or roots, of the word give us clues about the function, shape, action, or location of a muscle. 32 Axial
muscles originate on the axial skeleton (the bones in the head, neck, and core of the body), whereas appendicular muscles originate
on the bones that make up the body’s limbs. 33 The muscles of the anterior neck are arranged to facilitate swallowing and
speech. They work on the hyoid bone, with the suprahyoid muscles pulling up and the infrahyoid muscles pulling down. 34 Most
skeletal muscles create movement by actions on the skeleton. Facial muscles are different in that they create facial movements
and expressions by pulling on the skin—no bone movements are involved. 35 Arranged into layers, the muscles of the abdominal
wall are the internal and external obliques, which run on diagonals, the rectus abdominis, which runs straight down the midline of
the body, and the transversus abdominis, which wraps across the trunk of the body. 36 Both diaphragms are thin sheets of skeletal
muscle that horizontally span areas of the trunk. The diaphragm separating the thoracic and abdominal cavities is the primary
muscle of breathing. The pelvic diaphragm, consisting of two paired muscles, the coccygeus and the levator ani, forms the pelvic
floor at the inferior end of the trunk. 37 Tendons of the infraspinatus, supraspinatus, teres minor, and the subscapularis form the
rotator cuff, which forms a foundation on which the arms and shoulders can be stabilized and move. 38 The muscles that make up
the shoulders and upper limbs include the muscles that position the pelvic girdle, the muscles that move the humerus, the muscles
that move the forearm, and the muscles that move the wrists, hands, and fingers. 39 The biceps femoris, semimembranosus, and
semitendinosus form the hamstrings. The hamstrings flex the leg at the knee joint. 40 The rectus femoris, vastus medialis, vastus
lateralis, and vastus intermedius form the quadriceps. The quadriceps muscles extend the leg at the knee joint.

Chapter 12
1 MRI uses the relative amount of water in tissue to distinguish different areas, so gray and white matter in the nervous system can
be seen clearly in these images. 2 They are part of the somatic nervous system, which is responsible for voluntary movements such
as walking or climbing the stairs. 3 Neurons enable thought, perception, and movement. Plants do not move, so they do not need
this type of tissue. Microorganisms are too small to have a nervous system. Many are single-celled, and therefore have organelles
for perception and movement. 4Lipid membranes, such as the cell membrane and organelle membranes. 5 Sodium is moving into
the cell because of the immense concentration gradient, whereas potassium is moving out because of the depolarization that sodium
causes. However, they both move down their respective gradients, toward equilibrium. 6 The properties of electrophysiology are
common to all animals, so using the leech is an easier, more humane approach to studying the properties of these cells. There
are differences between the nervous systems of invertebrates (such as a leech) and vertebrates, but not for the sake of what these
experiments study. 7 A second signal from a separate presynaptic neuron can arrive slightly later, as long as it arrives before
the first one dies off, or dissipates. 8 The action potential depolarizes the cell membrane of the axon terminal, which contains
the voltage-gated Ca2+ channel. That voltage change opens the channel so that Ca2+ can enter the axon terminal. Calcium ions
make it possible for synaptic vesicles to release their contents through exocytosis. 9 C 10 A 11 D 12 D 13 B 14 A 15 B 16
D 17 A 18 C 19 C 20 D 21 C 22 B 23 A 24 B 25 B 26 A 27 D 28 D 29 B 30 C 31 D 32 D 33 A 34 Running on
a treadmill involves contraction of the skeletal muscles in the legs, increase in contraction of the cardiac muscle of the heart, and
the production and secretion of sweat in the skin to stay cool. 35 The sensation of taste associated with eating is sensed by nerves
in the periphery that are involved in sensory and somatic functions. 36 The disease would target oligodendrocytes. In the CNS,
oligodendrocytes provide the myelin for axons. 37 Bipolar cells, because they have one dendrite that receives input and one axon
that provides output, would be a direct relay between two other cells. 38 Afferent means “toward,” as in sensory information
traveling from the periphery into the CNS. Efferent means “away from,” as in motor commands that travel from the brain down
the spinal cord and out into the periphery. 39 The upper motor neuron would be affected because it is carrying the command from
the brain down. 40 The cell membrane must reach threshold before voltage-gated Na+ channels open. If threshold is not reached,
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those channels do not open, and the depolarizing phase of the action potential does not occur, the cell membrane will just go back
to its resting state. 41 Axons of pain sensing sensory neurons are thin and unmyelinated so that it takes longer for that sensation
to reach the brain than other sensations. 42 EPSP1 = +5 mV, EPSP2 = +7 mV, EPSP 3 = +10 mV, IPSP1 = -4 mV, IPSP2 =
-3 mV. 5 + 7 + 10 – 4 – 3 = +15 mV. 43 Different neurotransmitters have different receptors. Thus, the type of receptor in the
postsynaptic cell is what determines which ion channels open. Acetylcholine binding to the nicotinic receptor causes cations to
cross the membrane. GABA binding to its receptor causes the anion chloride to cross the membrane.

Chapter 13
1 The three regions (forebrain, midbrain, and hindbrain) appear to be approximately equal in size when they are first established,
but the midbrain in the adult is much smaller than the others—suggesting that it does not increase in size nearly as much as the
forebrain or hindbrain. 2 This is really a matter of opinion, but there are ethical issues to consider when a teenager’s behavior
results in legal trouble. 3 Both cells are inhibitory. The first cell inhibits the second one. Therefore, the second cell can no longer
inhibit its target. This is disinhibition of that target across two synapses. 4 By disinhibiting the subthalamic nucleus, the indirect
pathway increases excitation of the globus pallidus internal segment. That, in turn, inhibits the thalamus, which is the opposite
effect of the direct pathway that disinhibits the thalamus. 5 There are more motor neurons in the anterior horns that are responsible
for movement in the limbs. The cervical enlargement is for the arms, and the lumbar enlargement is for the legs. 6 Energy is
needed for the brain to develop and perform higher cognitive functions. That energy is not available for the muscle tissues to
develop and function. The hypothesis suggests that humans have larger brains and less muscle mass, and chimpanzees have the
smaller brains but more muscle mass. 7 If blood could not get to the middle cerebral artery through the posterior circulation, the
blood would flow around the circle of Willis to reach that artery from an anterior vessel. Blood flow would just reverse within
the circle. 8 The spinal cord ends in the upper lumbar area of the vertebral column, so a needle inserted lower than that will not
damage the nervous tissue of the CNS. 9 The choroid plexuses of the ventricles make CSF. As shown, there is a little of the
blue color appearing in each ventricle that is joined by the color flowing from the other ventricles. 10 Figure 13.20 They derive
from the neural crest. 11 Figure 13.22 The endoneurium surrounding individual nerve fibers is comparable to the endomysium
surrounding myofibrils, the perineurium bundling axons into fascicles is comparable to the perimysium bundling muscle fibers into
fascicles, and the epineurium surrounding the whole nerve is comparable to the epimysium surrounding the muscle. 12 The optic
nerve enters the CNS in its projection from the eyes in the periphery, which means that it crosses through the meninges. Meningitis
will include swelling of those protective layers of the CNS, resulting in pressure on the optic nerve, which can compromise
vision. 13 C 14 B 15 A 16 D 17 A 18 D 19 C 20 B 21 A 22 B 23 C 24 A 25 A 26 B 27 D 28 C 29 D 30 A 31
D 32 B 33 The retina, a PNS structure in the adult, grows from the diencephalon in the embryonic nervous system. The mature
connections from the retina through the optic nerve/tract are to the hypothalamus and thalamus of the diencephalon, and to the
midbrain, which developed directly adjacent to the diencephalon as the mesencephalon in the embryo. 34 The neural crest gives
rise to PNS structures (such as ganglia) and also to cartilage and bone of the face and cranium. 35 The temporal lobe has sensory
functions associated with hearing and vision, as well as being important for memory. A stroke in the temporal lobe can result
in specific sensory deficits in these systems (known as agnosias) or losses in memory. 36 A copy of descending input from the
cerebrum to the spinal cord, through the pons, and sensory feedback from the spinal cord and special senses like balance, through
the medulla, both go to the cerebellum. It can therefore send output through the midbrain that will correct spinal cord control of
skeletal muscle movements. 37 The structure is a circular connection of blood vessels, so that blood coming up from one of the
arteries can flow in either direction around the circle and avoid any blockage or narrowing of the blood vessels. 38 The nerves
that connect the periphery to the CNS pass through these layers of tissue and can be damaged by that inflammation, causing a loss
of important neurological functions. 39 The peripheral nervous tissues are out in the body, sometimes part of other organ systems.
There is not a privileged blood supply like there is to the brain and spinal cord, so peripheral nervous tissues do not need the same
sort of protections. 40 The contraction of extraocular muscles is being tested, which is the function of the oculomotor, trochlear,
and abducens nerves.

Chapter 14
1 Answers will vary, but a typical answer might be: I can eat most anything (except mushrooms!), so I don’t think that I’m that
sensitive to tastes. My whole family likes eating a variety of foods, so it seems that we all have the same level of sensitivity. 2
Figure 14.9 The hair cells are located in the organ of Corti, which is located on the basilar membrane. The stereocilia of those
cells would normally be attached to the tectorial membrane (though they are detached in the micrograph because of processing
of the tissue). 3 The small bones in the middle ear, the ossicles, amplify and transfer sound between the tympanic membrane
of the external ear and the oval window of the inner ear. 4 High frequencies activate hair cells toward the base of the cochlea,
and low frequencies activate hair cells toward the apex of the cochlea. 5 Photoreceptors convert light energy, or photons, into an
electrochemical signal. The retina contains bipolar cells and the RGCs that finally convert it into action potentials that are sent from
the retina to the CNS. It is important to recognize when popular media and online sources oversimplify complex physiological
processes so that misunderstandings are not generated. This video was created by a medical device manufacturer who might be
trying to highlight other aspects of the visual system than retinal processing. The statement they make is not incorrect, it just
bundles together several steps, which makes it sound like RGCs are the transducers, rather than photoreceptors. 6 Whereas the
video shows opposite movement information in each eye for an object moving toward the face on the midline, movement past one
side of the head will result in movement in the same direction on both retinae, but it will be slower in the eye on the side nearer
to the object. 7 Even if a person cannot recognize a person’s face, other cues such as clothing, hairstyle, or a particular feature
such as a prominent nose or facial hair, can help make an identification. 8 The video only describes the lateral division of the
corticospinal tract. The anterior division is omitted. 9 The movement disorders were similar to those seen in movement disorders

104
of the extrapyramidal system, which would mean the basal nuclei are the most likely source of haloperidol side effects. In fact,
haloperidol affects dopamine activity, which is a prominent part of the chemistry of the basal nuclei. 10 The left eye also blinks.
The sensory input from one eye activates the motor response of both eyes so that they both blink. 11 While walking, the sole of
the foot may be scraped or scratched by many things. If the foot still reacted as in the Babinski reflex, an adult might lose their
balance while walking. 12 B 13 D 14 B 15 D 16 C 17 C 18 D 19 A 20 A 21 B 22 D 23 B 24 A 25 C 26 A 27 The
stevia molecule is similar to glucose such that it will bind to the glucose receptor in sweet-sensitive taste buds. However, it is not
a substrate for the ATP-generating metabolism within cells. 28 The visual field for each eye is projected onto the retina as light is
focused by the lens. The visual information from the right visual field falls on the left side of the retina and vice versa. The optic
disc in the right eye is on the medial side of the fovea, which would be the left side of the retina. However, the optic disc in the left
eye would be on the right side of that fovea, so the right visual field falls on the side of the retina in the left field where there is
no blind spot. 29 The right leg would feel painful stimuli, but not touch, because the spinothalamic tract decussates at the level of
entry, which would be below the injury, whereas the dorsal column system does not decussate until reaching the brain stem, which
would be above the injury and thus those fibers would be damaged. 30 As the tumor enlarges, it would press against the optic
chiasm, and fibers from the medial retina would be disrupted. These fibers carry information about the lateral visual field because
the visual scene is reversed as the light passes through the pupil and lens. 31 The prefrontal cortex is involved in decision-making
functions that lead to motor responses through connections to the more posterior motor regions. These early aspects of behavior are
often associated with a person’s personality, so disrupting those connections will lead to severe changes in behavior. 32 Though
reflexes are simple circuits within the nervous system, they are representative of the more involved circuits of the somatic nervous
system and can be used to quickly assess the state of neurological function for a person.

Chapter 15
1 The heart rate increases to send more blood to the muscles, and the liver releases stored glucose to fuel the muscles. 2 The
endocrine system is also responsible for responses to stress in our lives. The hypothalamus coordinates the autonomic response
through projections into the spinal cord and through influence over the pituitary gland, the effective center of the endocrine
system. 3 The effect of gravity on circulation means that it is harder to get blood up from the legs as the body takes on a
vertical orientation. 4 The optic nerve still carries the afferent input, but the output is from the thoracic spinal cord, through
the superior cervical ganglion, to the radial fibers of the iris. 5 The release of urine in extreme fear. The sympathetic system
normally constricts sphincters such as that of the urethra. 6 When the visual field is completely taken up by the movie, the brain
is confused by the lack of vestibular stimuli to match the visual stimuli. Sitting to the side, or so that the edges of the screen
can be seen, will help by providing a stable visual cue along with the magic of the cinematic experience. 7 D 8 A 9 C 10
B 11 A 12 C 13 D 14 B 15 A 16 C 17 A 18 C 19 B 20 D 21 B 22 A 23 C 24 C 25 D 26 B 27 Whereas energy
is needed for running away from the threat, blood needs to be sent to the skeletal muscles for oxygen supply. The additional
fuel, in the form of carbohydrates, probably wouldn’t improve the ability to escape the threat as much as the diversion of
oxygen-rich blood would hinder it. 28 The postganglionic sympathetic fiber releases norepinephrine, whereas the postganglionic
parasympathetic fiber releases acetylcholine. Specific locations in the heart have adrenergic receptors and muscarinic receptors.
Which receptors are bound is the signal that determines how the heart responds. 29 The nerves that carry sensory information
from the diaphragm enter the spinal cord in the cervical region where somatic sensory fibers from the shoulder and neck would
enter. The brain superimposes this experience onto the sensory homunculus where the somatic nerves are connected. 30 Within
the cardiovascular system, different aspects demonstrate variation in autonomic tone. Heart rate is under parasympathetic tone,
and blood pressure is under sympathetic tone. Pharmaceuticals that treat cardiovascular disorders may be more effective if they
work with the normal state of the autonomic system. Alternatively, some disorders may be exacerbated by autonomic deficits and
common therapies might not be as effective. 31 Pupillary dilation and sweating, two functions lost in Horner’s syndrome, are
caused by the sympathetic system. A tumor in the thoracic cavity may interrupt the output of the thoracic ganglia that project to
the head and face. 32 The heart—based on the resting heart rate—is under parasympathetic tone, and the blood vessels—based
on the lack of parasympathetic input—are under sympathetic tone. The vagus nerve contributes to the lowered resting heart rate,
whereas the vasomotor nerves maintain the slight constriction of systemic blood vessels. 33 Blood vessels, and therefore blood
pressure, are primarily influenced by only the sympathetic system. There is no parasympathetic influence on blood pressure, so
nicotine activation of autonomic ganglia will preferentially increase blood pressure. Also, cardiac muscle tissue is only modulated
by autonomic inputs, so the conflicting information from both sympathetic and parasympathetic postganglionic fibers will cause
arrhythmias. Both hypertension and arrhythmias are cardiac risk factors. 34 Drops of these substances into the eyes, as was once
done cosmetically, blocks the muscarinic receptors in the smooth muscle of the iris. The concentration of this direct application is
probably below the concentration that would cause poisoning if it got into the bloodstream. The possibility of that concentration
being wrong and causing poisoning is too great, however, for atropine to be used as a cosmetic.

Chapter 16
1 Coordination and gait were tested first, followed by mental status, motor, sensory, and reflexes. There were no specific tests
of the cranial nerves. 2 History is the report from the patient, or others familiar with the patient, that can assist in diagnosis
and formulation of treatment and care—essentially the result of an interview with the patient. 3 The patient was unable to form
episodic memories during the events described in the case, so the medial temporal lobe structures might have been affected by
the antibodies. 4 The left hemisphere of the cerebrum controls the right side of the body through the corticospinal tract. Because
language function is largely associated with the dominant hemisphere, the hand with which a person writes will most likely be the
one controlled by the left hemisphere. 5 She has just demonstrated voluntary control by closing her eyes, but when he provides
the resistance that she needs to hold tight against, she has already relaxed the muscles enough for him to pull them open. She needs

105
to squeeze them tighter to demonstrate the strength she has in the orbicular oculi. 6 The fingertips are the most sensitive skin
on the hand, so the points of the caliper can be closer together and still be recognized as two separate points. On the palm, the
sensitivity is less, so the points need to be farther apart. This will continue on the arm and shoulder, as sensitivity decreases, the
discrimination of separate stimuli will be wider. 7 The region lateral to the umbilicus is innervated by T9–T11, approximately.
A lack of contraction following that stimulation would therefore suggest damage at those levels. 8 A wide stance would suggest
the person needs to maintain balance by broadening their base. Instead of continuous correction to posture, this can keep the
body stable when the cerebellum cannot. 9 D 10 A 11 C 12 B 13 D 14 C 15 D 16 B 17 A 18 C 19 A 20 A 21 D 22
A 23 C 24 A 25 D 26 B 27 C 28 D 29 C 30 A 31 B 32 C 33 D 34 If an ischemic event has occurred, nervous tissue
may be compromised, but quick intervention—possibly within a few hours—may be the critical aspect of recovery. 35 The main
difference between a stroke and TIA is time. If the result of a cerebrovascular accident lasts longer than 24 hours, then it is
considered a stroke. Otherwise, it is considered transient and is labeled a TIA. 36 The patient has suffered a stroke to the prefrontal
cortex where working memory is localized. 37 Wernicke’s area is associated with the comprehension of language, so the person
probably doesn’t understand the question being asked and cannot respond meaningfully. This is called a receptive aphasia. 38 If
the person already has problems focusing on far objects, and wears corrective lenses to see farther objects, then as accommodation
changes, focusing on a reading surface might still be in their naturally near-sighted range. 39 The medulla is where the accessory
nerve, which controls the sternocleidomastoid muscle, and the hypoglossal nerve, which controls the genioglossus muscle, are
both located. The weakness of the left side of the neck, and the tendency of the tongue to point to that side, both show that
the damage is on the left side of the brain stem. 40 Where spinal nerves innervate the skin is represented by “slices” of the
body surface referred to as dermatomes. The fibers originating in each region are contained within the same spinal nerve, which
relates to the perception of that localization. 41 Paralysis means that voluntary muscle control is not possible because of the
interruption of descending motor input. Spasticity refers to what could be called “hypercontractility” of the muscles in the absence
of the descending input. 42 The spinocerebellum is related to controlling the axial muscles and keeps the body balanced on the
bike. The cerebrocerebellum is related to controlling the appendicular muscles and keeps the legs moving to pedal the bike. The
vestibulocerebellum receives input about equilibrium to help keep everything balanced as the bike is moving forward. 43 Rapid
alternating movements in speech relate to how the lips, tongue, and palate move to produce speech sounds. The cerebrocerebellum
is required for the proper implementation of these movements.

Chapter 17
1 cAMP 2 Thyroid-stimulating hormone. 3 Cortisol. 4 Turning on the lights. 5 Insulin is overproduced. 6 C 7 B 8 B 9
B 10 C 11 B 12 C 13 A 14 B 15 D 16 B 17 C 18 C 19 D 20 B 21 C 22 A 23 B 24 D 25 B 26 B 27 C 28
D 29 A 30 D 31B 32 B 33 D 34 C 35 A 36 A 37 B 38 The endocrine system uses chemical signals called hormones
to convey information from one part of the body to a distant part of the body. Hormones are released from the endocrine cell
into the extracellular environment, but then travel in the bloodstream to target tissues. This communication and response can
take seconds to days. In contrast, neurons transmit electrical signals along their axons. At the axon terminal, the electrical signal
prompts the release of a chemical signal called a neurotransmitter that carries the message across the synaptic cleft to elicit a
response in the neighboring cell. This method of communication is nearly instantaneous, of very brief duration, and is highly
specific. 39 Endocrine glands are ductless. They release their secretion into the surrounding fluid, from which it enters the
bloodstream or lymph to travel to distant cells. Moreover, the secretions of endocrine glands are hormones. Exocrine glands
release their secretions through a duct that delivers the secretion to the target location. Moreover, the secretions of exocrine glands
are not hormones, but compounds that have an immediate physiologic function. For example, pancreatic juice contains enzymes
that help digest food. 40 True. Neurotransmitters can be classified as paracrines because, upon their release from a neuron’s
axon terminals, they travel across a microscopically small cleft to exert their effect on a nearby neuron or muscle cell. 41 In
both cAMP and IP3–calcium signaling, a hormone binds to a cell membrane hormone receptor that is coupled to a G protein.
The G protein becomes activated when the hormone binds. In the case of cAMP signaling, the activated G protein activates
adenylyl cyclase, which causes ATP to be converted to cAMP. This second messenger can then initiate other signaling events,
such as a phosphorylation cascade. In the case of IP3–calcium signaling, the activated G protein activates phospholipase C, which
cleaves a membrane phospholipid compound into DAG and IP3. IP3 causes the release of calcium, another second messenger,
from intracellular stores. This causes further signaling events. 42 An intracellular hormone receptor is located within the cell.
A hydrophobic hormone diffuses through the cell membrane and binds to the intracellular hormone receptor, which may be in
the cytosol or in the cell nucleus. This hormone–receptor complex binds to a segment of DNA. This initiates the transcription
of a target gene, the end result of which is protein assembly and the hormonal response. 43 The anterior lobe of the pituitary
gland is connected to the hypothalamus by vasculature, which allows regulating hormones from the hypothalamus to travel to
the anterior pituitary. In contrast, the posterior lobe is connected to the hypothalamus by a bridge of nerve axons called the
hypothalamic–hypophyseal tract, along which the hypothalamus sends hormones produced by hypothalamic nerve cell bodies to
the posterior pituitary for storage and release into the circulation. 44 The mammary glands are the target tissues for prolactin. 45
Iodine deficiency in a pregnant woman would also deprive the fetus. Iodine is required for the synthesis of thyroid hormones,
which contribute to fetal growth and development, including maturation of the nervous system. Insufficient amounts would impair
these functions. 46 Hyperthyroidism is an abnormally elevated blood level of thyroid hormones due to an overproduction of T3
and T4. An individual with hyperthyroidism is likely to lose weight because one of the primary roles of thyroid hormones is to
increase the body’s basal metabolic rate, increasing the breakdown of nutrients and the production of ATP. 47 The production
and secretion of PTH is regulated by a negative feedback loop. Low blood calcium levels initiate the production and secretion
of PTH. PTH increases bone resorption, calcium absorption from the intestines, and calcium reabsorption by the kidneys. As a
result, blood calcium levels begin to rise. This, in turn, inhibits the further production and secretion of PTH. 48 A parathyroid
gland tumor can prompt hypersecretion of PTH. This can raise blood calcium levels so excessively that calcium deposits begin to

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accumulate throughout the body, including in the kidney tubules, where they are referred to as kidney stones. 49 The outer region
is the zona glomerulosa, which produces mineralocorticoids such as aldosterone; the next region is the zona fasciculata, which
produces glucocorticoids such as cortisol; the inner region is the zona reticularis, which produces androgens. 50 Damage to the
innervation of the adrenal medulla would prevent the adrenal glands from responding to the hypothalamus during the fight-or-
flight response. Therefore, the response would be reduced. 51 The short-term stress response involves the hormones epinephrine
and norepinephrine, which work to increase the oxygen supply to organs important for extreme muscular action such as the
brain, lungs, and muscles. In the long-term stress response, the hormone cortisol is involved in catabolism of glycogen stores,
proteins, and triglycerides, glucose and ketone synthesis, and downregulation of the immune system. 52 SAD is thought to occur
in part because low levels and duration of sunlight allow excessive and prolonged secretion of melatonin. Light therapy—daytime
exposure to very bright lighting—is one common therapy. 53 The retina is important for melatonin production because it senses
light. Bright light inhibits the production of melatonin, whereas low light levels promote the production of melatonin. Therefore,
deterioration of the retinas would most likely disturb the sleep-wake pattern because melatonin production would be elevated. 54
Both estrogens and progesterone are steroid hormones produced by the ovaries that help regulate the menstrual cycle. Estrogens
play an important role in the development of the female reproductive tract and secondary sex characteristics. They also help
maintain pregnancy. Progesterone prepares the body for pregnancy and helps maintain pregnancy. 55 Relaxin produced by the
placenta is thought to soften and widen the pubic symphysis. This increases the size of the pelvic outlet, the birth canal through
which the fetus passes during vaginal childbirth. 56 The beta cells produce the hormone insulin, which is important in the
regulation of blood glucose levels. All insulin-dependent cells of the body require insulin in order to take up glucose from the
bloodstream. Destruction of the beta cells would result in an inability to produce and secrete insulin, leading to abnormally high
blood glucose levels and the disease called type 1 diabetes mellitus. 57 Excessive blood glucose levels damage the blood vessels
and nerves of the body’s extremities, increasing the risk for injury, infection, and tissue death. Loss of sensation to the feet means
that a diabetic patient will not be able to feel foot trauma, such as from ill-fitting shoes. Even minor injuries commonly lead to
infection, which , can progress to tissue death without proper care, requiring amputation. 58 The presence of food in the GI tract
stimulates the release of hormones that aid in digestion. For example, gastrin is secreted in response to stomach distention and
causes the release of hydrochloric acid in the stomach. Secretin is secreted when acidic chyme enters the small intestine, and
stimulates the release of pancreatic bicarbonate. In the presence of fat and protein in the duodenum, CCK stimulates the release
of pancreatic digestive enzymes and bile from the gallbladder. Other GI tract hormones aid in glucose metabolism and other
functions. 59 The thymus gland is important for the development and maturation of T cells. During infancy and early childhood,
the thymus gland is large and very active, as the immune system is still developing. During adulthood, the thymus gland atrophies
because the immune system is already developed. 60 Menopause occurs as the result of a progressive decline in the function of the
ovaries, resulting in low estrogen and progesterone levels. Ovulation ceases, and postmenopausal woman can no longer conceive
a child. In contrast, andropause is a much more gradual and subtle decline in testosterone levels and functioning. A man typically
maintains fertility until very old age, although the quantity, quality, and motility of the sperm he produces may be reduced.

Chapter 18
1 There are values given for percent saturation, tension, and blood gas, and there are listings for different types of hemoglobin. 2
Side effects can include heart disease, stroke, pulmonary embolism, and virus transmission. 3 Figure 18.13 This should appear to
be a normal blood smear. 4 Clotting factors flow through the blood vessels in their inactive state. The endothelium does not have
thrombogenic tissue factor to activate clotting factors. 5 C 6 B 7 D 8 C 9 A 10 D 11 A 12 C 13 D 14 C 15 D 16 C 17
B 18 B 19 A 20 D 21 A 22 C 23 B 24 C 25 B 26 D 27 The patient’s blood is approximately 58 percent plasma (since
the buffy coat is less than 1 percent). 28 The formed elements include erythrocytes and leukocytes, which are cells (although
mature erythrocytes do not have a nucleus); however, the formed elements also include platelets, which are not true cells but cell
fragments. 29 False. The buffy coat is the portion of blood that is made up of its leukocytes and platelets. 30 When disease
impairs the ability of the bone marrow to participate in hemopoiesis, extramedullary hemopoiesis begins in the patient’s liver
and spleen. This causes the spleen to enlarge. 31 The adjective myelogenous suggests a condition originating from (generated
by) myeloid cells. Acute myelogenous leukemia impairs the production of erythrocytes and other mature formed elements of the
myeloid stem cell lineage. Lymphocytes arise from the lymphoid stem cell line. 32 She is at risk for anemia, because her unusually
heavy menstrual bleeding results in excessive loss of erythrocytes each month. At the same time, her vegan diet means that she
does not have dietary sources of heme iron. The non-heme iron she consumes in plant foods is not as well absorbed as heme
iron. 33 Bilirubin is a breakdown product of the non-iron component of heme, which is cleaved from globin when erythrocytes are
degraded. Excessive erythrocyte destruction would deposit excessive bilirubin in the blood. Bilirubin is a yellowish pigment, and
high blood levels can manifest as yellowed skin. 34 A neutrophil count below 1800 cells per microliter is considered abnormal.
Thus, this patient’s ANC is at the low end of the normal range and there would be no reason to delay chemotherapy. In clinical
practice, most patients are given chemotherapy if their ANC is above 1000. 35 Any severe stress can increase the leukocyte count,
resulting in leukocytosis. A burn is especially likely to increase the proliferation of leukocytes in order to ward off infection, a
significant risk when the barrier function of the skin is destroyed. 36 When blood contacts glass, the intrinsic coagulation pathway
is initiated. This leads to the common pathway, and the blood clots. Within about 30 minutes, the clot begins to shrink. After an
hour, it is about half its original size. Its heavier weight will cause it to fall to the bottom of the tube during centrifugation, allowing
the lab technician to harvest the serum remaining at the top. 37 In a thrombotic stroke, a blood vessel to the brain has been
blocked by a thrombus, an aggregation of platelets and erythrocytes within a blood vessel. A thrombolytic agent is a medication
that promotes the breakup of thrombi. 38 In emergency situations, blood type O− will be infused until cross matching can be
done. Blood type O− is called the universal donor blood because the erythrocytes have neither A nor B antigens on their surface,
and the Rh factor is negative. 39 The lab technician has not made an error. Blood type AB has both A and B surface antigens, and
neither anti-A nor anti-B antibodies circulating in the plasma. When anti-A antibodies (added to the first well) contact A antigens

107
on AB erythrocytes, they will cause agglutination. Similarly, when anti-B antibodies contact B antigens on AB erythrocytes, they
will cause agglutination.

Chapter 19
1 The pressure gradient between the atria and the ventricles is much greater than that between the ventricles and the pulmonary
trunk and aorta. Without the presence of the chordae tendineae and papillary muscles, the valves would be blown back (prolapsed)
into the atria and blood would regurgitate. 2 D 3 A 4 A 5 C 6 B 7 B 8 C 9 C 10 D 11 D 12 D 13 D 14 B 15 C 16
B 17 B 18 A 19 B 20 A 21 C 22 D 23 C 24 D 25 A 26 D 27 When the ventricles contract and pressure begins to rise
in the ventricles, there is an initial tendency for blood to flow back (regurgitate) to the atria. However, the papillary muscles
also contract, placing tension on the chordae tendineae and holding the atrioventricular valves (tricuspid and mitral) in place to
prevent the valves from prolapsing and being forced back into the atria. The semilunar valves (pulmonary and aortic) lack chordae
tendineae and papillary muscles, but do not face the same pressure gradients as do the atrioventricular valves. As the ventricles
relax and pressure drops within the ventricles, there is a tendency for the blood to flow backward. However, the valves, consisting
of reinforced endothelium and connective tissue, fill with blood and seal off the opening preventing the return of blood. 28
The pulmonary circuit consists of blood flowing to and from the lungs, whereas the systemic circuit carries blood to and from
the entire body. The systemic circuit is far more extensive, consisting of far more vessels and offers much greater resistance to
the flow of blood, so the heart must generate a higher pressure to overcome this resistance. This can be seen in the thickness
of the myocardium in the ventricles. 29 It prevents additional impulses from spreading through the heart prematurely, thereby
allowing the muscle sufficient time to contract and pump blood effectively. 30 It ensures sufficient time for the atrial muscle
to contract and pump blood into the ventricles prior to the impulse being conducted into the lower chambers. 31 Gap junctions
within the intercalated disks allow impulses to spread from one cardiac muscle cell to another, allowing sodium, potassium, and
calcium ions to flow between adjacent cells, propagating the action potential, and ensuring coordinated contractions. 32 Without
a true resting potential, there is a slow influx of sodium ions through slow channels that produces a prepotential that gradually
reaches threshold. 33 The cardiac cycle comprises a complete relaxation and contraction of both the atria and ventricles, and lasts
approximately 0.8 seconds. Beginning with all chambers in diastole, blood flows passively from the veins into the atria and past
the atrioventricular valves into the ventricles. The atria begin to contract following depolarization of the atria and pump blood into
the ventricles. The ventricles begin to contract, raising pressure within the ventricles. When ventricular pressure rises above the
pressure in the two major arteries, blood pushes open the two semilunar valves and moves into the pulmonary trunk and aorta in
the ventricular ejection phase. Following ventricular repolarization, the ventricles begin to relax, and pressure within the ventricles
drops. When the pressure falls below that of the atria, blood moves from the atria into the ventricles, opening the atrioventricular
valves and marking one complete heart cycle. 34 Increasing EDV increases the sarcomeres’ lengths within the cardiac muscle
cells, allowing more cross bridge formation between the myosin and actin and providing for a more powerful contraction. This
relationship is described in the Frank-Starling mechanism. 35 Afterload represents the resistance within the arteries to the flow of
blood ejected from the ventricles. If uncompensated, if afterload increases, flow will decrease. In order for the heart to maintain
adequate flow to overcome increasing afterload, it must pump more forcefully. This is one of the negative consequences of high
blood pressure or hypertension. 36 The human embryo is rapidly growing and has great demands for nutrients and oxygen, while
producing waste products including carbon dioxide. All of these materials must be received from or delivered to the mother for
processing. Without an efficient early circulatory system, this would be impossible. 37 After fusion of the two endocardial tubes
into the single primitive heart, five regions quickly become visible. From the head, these are the truncus arteriosus, bulbus cordis,
primitive ventricle, primitive atrium, and sinus venosus. Contractions propel the blood from the sinus venosus to the truncus
arteriosus. About day 23, the heart begins to form an S-shaped structure within the pericardium. The bulbus cordis develops into
the right ventricle, whereas the primitive ventricle becomes the left ventricle. The interventricular septum separating these begins
to form about day 28. The atrioventricular valves form between weeks five to eight. At this point, the heart ventricles resemble the
adult structure.

Chapter 20
1 Water. 2 Take medications as prescribed, eat a healthy diet, exercise, and don’t smoke. 3 A 4 D 5 C 6 B 7 C 8 B 9 A 10
B 11 D 12 D 13 B 14 D 15 A 16 D 17 C 18 C 19 A 20 B 21 C 22 C 23 D 24 A 25 D 26 B 27 C 28 Arterioles
receive blood from arteries, which are vessels with a much larger lumen. As their own lumen averages just 30 micrometers or
less, arterioles are critical in slowing down—or resisting—blood flow. The arterioles can also constrict or dilate, which varies their
resistance, to help distribute blood flow to the tissues. 29 Vasoconstriction causes the lumens of blood vessels to narrow. This
increases the pressure of the blood flowing within the vessel. 30 This is a venule. 31 The patient’s pulse pressure is 130 – 85 = 45
mm Hg. Generally, a pulse pressure should be at least 25 percent of the systolic pressure, but not more than 100 mm Hg. Since 25
percent of 130 = 32.5, the patient’s pulse pressure of 45 is normal. The patient’s mean arterial pressure is 85 + 1/3 (45) = 85 + 15 =
100. Normally, the mean arterial blood pressure falls within the range of 70 – 110 mmHg, so 100 is normal. 32 People who stand
upright all day and are inactive overall have very little skeletal muscle activity in the legs. Pooling of blood in the legs and feet is
common. Venous return to the heart is reduced, a condition that in turn reduces cardiac output and therefore oxygenation of tissues
throughout the body. This could at least partially account for the patient’s fatigue and shortness of breath, as well as her “spaced
out” feeling, which commonly reflects reduced oxygen to the brain. 33 The patient’s blood would flow more sluggishly from
the arteriole into the capillary bed. Thus, the patient’s capillary hydrostatic pressure would be below the normal 35 mm Hg at the
arterial end. At the same time, the patient’s blood colloidal osmotic pressure is normal—about 25 mm Hg. Thus, even at the arterial
end of the capillary bed, the net filtration pressure would be below 10 mm Hg, and an abnormally reduced level of filtration would
occur. In fact, reabsorption might begin to occur by the midpoint of the capillary bed. 34 False. The plasma proteins suspended

108
in blood cannot cross the semipermeable capillary cell membrane, and so they remain in the plasma within the vessel, where they
account for the blood colloid osmotic pressure. 35 This blood pressure is insufficient to circulate blood throughout the patient’s
body and maintain adequate perfusion of the patient’s tissues. Ischemia would prompt hypoxia, including to the brain, prompting
confusion. The low blood pressure would also trigger the renin-angiotensin-aldosterone mechanism, and release of aldosterone
would stimulate the thirst mechanism in the hypothalamus. 36 Nitric oxide is a very powerful local vasodilator that is important
in the autoregulation of tissue perfusion. If it were not broken down very quickly after its release, blood flow to the region could
exceed metabolic needs. 37 The right ventricle of the heart pumps oxygen-depleted blood to the pulmonary arteries. 38 The
gonadal veins drain the testes in males and the ovaries in females. 39 The internal carotid arteries and the vertebral arteries provide
most of the brain’s blood supply. 40 Angiogenesis inhibitors are drugs that inhibit the growth of new blood vessels. They can
impede the growth of tumors by limiting their blood supply and therefore their access to gas and nutrient exchange. 41 The ductus
arteriosus is a blood vessel that provides a passageway between the pulmonary trunk and the aorta during fetal life. Most blood
ejected from the fetus’ right ventricle and entering the pulmonary trunk is diverted through this structure into the fetal aorta, thus
bypassing the fetal lungs.

Chapter 21
1 The three main components are the lymph vessels, the lymph nodes, and the lymph. 2 The dendritic cell transports the virus to
a lymph node. 3 The bacterium is digested by the phagocyte’s digestive enzymes (contained in its lysosomes). 4 Breastfeeding
is an example of natural immunity acquired passively. 5 B 6 A 7 C 8 D 9 A 10 C 11 D 12 B 13 C 14 B 15 B 16 D 17
B 18 C 19 D 20 D 21 D 22 A 23 B 24 D 25 C 26 B 27 B 28 A 29 C 30 C 31 D 32 C 33 A 34 B 35 B 36 A 37
B 38 D 39 The lymph enters through lymphatic capillaries, and then into larger lymphatic vessels. The lymph can only go in
one direction due to valves in the vessels. The larger lymphatics merge to form trunks that enter into the blood via lymphatic
ducts. 40 The cell debris and damaged cells induce macrophages to begin to clean them up. Macrophages release cytokines that
attract neutrophils, followed by more macrophages. Other mediators released by mast cells increase blood flow to the area and
also vascular permeability, allowing the recruited cells to get from the blood to the site of infection, where they can phagocytose
the dead cells and debris, preparing the site for wound repair. 41 Interferons are produced in virally infected cells and cause them
to secrete signals for surrounding cells to make antiviral proteins. C-reactive protein is induced to be made by the liver and will
opsonize certain species of bacteria. 42 The antigen is digested by the proteasome, brought into the endoplasmic reticulum by the
TAP transporter system, where it binds to class I MHC molecules. These are taken to the cell surface by transport vesicles. 43
Antigen-specific clones are stimulated as their antigen receptor binds to antigen. They are then activated and proliferate, expanding
their numbers. The result is a large number of antigen-specific lymphocytes. 44 B cells activated during a primary response
differentiate either into terminally differentiated plasma cells or into memory B cells. These memory B cells are what respond
during a secondary or memory antibody response. 45 IgM is an antigen receptor on naïve B cells. Upon activation, naïve B cells
make IgM first. IgM is good at binding complement and thus has good antibacterial effects. IgM is replaced with other classes
of antibodies later on in the primary response due to class switching. 46 Seroconversion is the clearance of virus in the serum
due to the increase in specific serum antibody levels. Seroconversion happens in the early stages of HIV disease. Unfortunately,
the antibody cannot completely clear the virus from the body and thus it most often progresses to AIDS. 47 Tuberculosis is
caused by bacteria resistant to lysosomal enzymes in alveolar macrophages, resulting in chronic infection. The immune response to
these bacteria actually causes most of the lung damage that is characteristic of this life-threatening disease. 48 The peanuts cause
high levels of mast cell degranulation in the throats of these individuals. The histamine released increases vascular permeability,
causing edema and (swelling), making breathing difficult. This must be treated with epinephrine as soon as possible. 49 Antibody
response to the cell walls of β-Streptococcus cross-reacts with the heart muscle. Complement is then activated and the heart
is damaged, leading to abnormal function. Tolerance is broken because heart myosin antigens are similar to antigens on the β-
Streptococcus bacteria. 50 Stress causes the release of hormones and the activation of nerves that suppress the immune response.
Short-term stress has little effect on the health of an already healthy individual, whereas chronic stress does lead to increases in
disease in such people.

Chapter 22
1 Inflammation and the production of a thick mucus; constriction of the airway muscles, or bronchospasm; and an increased
sensitivity to allergens. 2 Patients with respiratory ailments (such as asthma, emphysema, COPD, etc.) have issues with airway
resistance and/or lung compliance. Both of these factors can interfere with the patient’s ability to move air effectively. A spirometry
test can determine how much air the patient can move into and out of the lungs. If the air volumes are low, this can indicate that
the patient has a respiratory disease or that the treatment regimen may need to be adjusted. If the numbers are normal, the patient
does not have a significant respiratory disease or the treatment regimen is working as expected. 3 When oxygen binds to the
hemoglobin molecule, oxyhemoglobin is created, which has a red color to it. Hemoglobin that is not bound to oxygen tends to
be more of a blue–purple color. Oxygenated blood traveling through the systemic arteries has large amounts of oxyhemoglobin.
As blood passes through the tissues, much of the oxygen is released into systemic capillaries. The deoxygenated blood returning
through the systemic veins, therefore, contains much smaller amounts of oxyhemoglobin. The more oxyhemoglobin that is present
in the blood, the redder the fluid will be. As a result, oxygenated blood will be much redder in color than deoxygenated blood. 4
C 5 A 6 D 7 A 8 C 9 C 10 B 11 A 12 C 13 A 14 A 15 C 16 D 17 A 18 D 19 A 20 D 21 A 22 C 23 B 24 C 25
D 26 B 27 A 28 A 29 D 30 D 31 C 32 A 33 B 34 A 35 C 36 The pharynx has three major regions. The first region is
the nasopharynx, which is connected to the posterior nasal cavity and functions as an airway. The second region is the oropharynx,
which is continuous with the nasopharynx and is connected to the oral cavity at the fauces. The laryngopharynx is connected to
the oropharynx and the esophagus and trachea. Both the oropharynx and laryngopharynx are passageways for air and food and

109
drink. 37 The epiglottis is a region of the larynx that is important during the swallowing of food or drink. As a person swallows,
the pharynx moves upward and the epiglottis closes over the trachea, preventing food or drink from entering the trachea. If a
person’s epiglottis were injured, this mechanism would be impaired. As a result, the person may have problems with food or drink
entering the trachea, and possibly, the lungs. Over time, this may cause infections such as pneumonia to set in. 38 The conducting
zone of the respiratory system includes the organs and structures that are not directly involved in gas exchange, but perform
other duties such as providing a passageway for air, trapping and removing debris and pathogens, and warming and humidifying
incoming air. Such structures include the nasal cavity, pharynx, larynx, trachea, and most of the bronchial tree. The respiratory zone
includes all the organs and structures that are directly involved in gas exchange, including the respiratory bronchioles, alveolar
ducts, and alveoli. 39 The right and left lungs differ in size and shape to accommodate other organs that encroach on the thoracic
region. The right lung consists of three lobes and is shorter than the left lung, due to the position of the liver underneath it.
The left lung consist of two lobes and is longer and narrower than the right lung. The left lung has a concave region on the
mediastinal surface called the cardiac notch that allows space for the heart. 40 There is a cavity, called the pleural cavity, between
the parietal and visceral layers of the pleura. Mesothelial cells produce and secrete pleural fluid into the pleural cavity that acts
as a lubricant. Therefore, as you breathe, the pleural fluid prevents the two layers of the pleura from rubbing against each other
and causing damage due to friction. 41 Lung compliance refers to the ability of lung tissue to stretch under pressure, which is
determined in part by the surface tension of the alveoli and the ability of the connective tissue to stretch. Lung compliance plays a
role in determining how much the lungs can change in volume, which in turn helps to determine pressure and air movement. 42
Quiet breathing occurs at rest and without active thought. During quiet breathing, the diaphragm and external intercostal muscles
work at different extents, depending on the situation. For inspiration, the diaphragm contracts, causing the diaphragm to flatten
and drop towards the abdominal cavity, helping to expand the thoracic cavity. The external intercostal muscles contract as well,
causing the rib cage to expand, and the rib cage and sternum to move outward, also expanding the thoracic cavity. Expansion of
the thoracic cavity also causes the lungs to expand, due to the adhesiveness of the pleural fluid. As a result, the pressure within
the lungs drops below that of the atmosphere, causing air to rush into the lungs. In contrast, expiration is a passive process. As
the diaphragm and intercostal muscles relax, the lungs and thoracic tissues recoil, and the volume of the lungs decreases. This
causes the pressure within the lungs to increase above that of the atmosphere, causing air to leave the lungs. 43 Respiratory
rate is defined as the number of breaths taken per minute. Respiratory rate is controlled by the respiratory center, located in
the medulla oblongata. Conscious thought can alter the normal respiratory rate through control by skeletal muscle, although one
cannot consciously stop the rate altogether. A typical resting respiratory rate is about 14 breaths per minute. 44 Both Dalton’s and
Henry’s laws describe the behavior of gases. Dalton’s law states that any gas in a mixture of gases exerts force as if it were not in a
mixture. Henry’s law states that gas molecules dissolve in a liquid proportional to their partial pressure. 45 The damaged alveoli
will have insufficient ventilation, causing the partial pressure of oxygen in the alveoli to decrease. As a result, the pulmonary
capillaries serving these alveoli will constrict, redirecting blood flow to other alveoli that are receiving sufficient ventilation. 46
Both adult and fetal hemoglobin transport oxygen via iron molecules. However, fetal hemoglobin has about a 20-fold greater
affinity for oxygen than does adult hemoglobin. This is due to a difference in structure; fetal hemoglobin has two subunits that
have a slightly different structure than the subunits of adult hemoglobin. 47 The relationship between the partial pressure of
oxygen and the binding of hemoglobin to oxygen is described by the oxygen–hemoglobin saturation/dissociation curve. As the
partial pressure of oxygen increases, the number of oxygen molecules bound by hemoglobin increases, thereby increasing the
saturation of hemoglobin. 48 Carbon dioxide can be transported by three mechanisms: dissolved in plasma, as bicarbonate, or as
carbaminohemoglobin. Dissolved in plasma, carbon dioxide molecules simply diffuse into the blood from the tissues. Bicarbonate
is created by a chemical reaction that occurs mostly in erythrocytes, joining carbon dioxide and water by carbonic anhydrase,
producing carbonic acid, which breaks down into bicarbonate and hydrogen ions. Carbaminohemoglobin is the bound form of
hemoglobin and carbon dioxide. 49 There are three neural factors that play a role in the increased ventilation observed during
exercise. Because this increased ventilation occurs at the beginning of exercise, it is unlikely that only blood oxygen and carbon
dioxide levels are involved. The first neural factor is the psychological stimulus of making a conscious decision to exercise. The
second neural factor is the stimulus of motor neuron activation by the skeletal muscles, which are involved in exercise. The third
neural factor is activation of the proprioceptors located in the muscles, joints, and tendons that stimulate activity in the respiratory
centers. 50 A major mechanism involved in acclimatization is the increased production of erythrocytes. A drop in tissue levels
of oxygen stimulates the kidneys to produce the hormone erythropoietin, which signals the bone marrow to produce erythrocytes.
As a result, individuals exposed to a high altitude for long periods of time have a greater number of circulating erythrocytes than
do individuals at lower altitudes. 51 At about week 28, enough alveolar precursors have matured so that a baby born prematurely
at this time can usually breathe on its own. Other structures that develop about this time are pulmonary capillaries, expanding
to create a large surface area for gas exchange. Alveolar ducts and alveolar precursors have also developed. 52 Fetal breathing
movements occur due to the contraction of respiratory muscles, causing the fetus to inhale and exhale amniotic fluid. It is thought
that these movements are a way to “practice” breathing, which results in toning the muscles in preparation for breathing after birth.
In addition, fetal breathing movements may help alveoli to form and mature.

Chapter 23
1 Answers may vary. 2 Answers may vary. 3 Answers may vary. 4 Answers may vary. 5 Answers may vary. 6 Answers
may vary. 7 Answers may vary. 8 A 9 A 10 D 11 D 12 B 13 D 14 A 15 C 16 B 17 A 18 D 19 C 20 A 21 D 22
B 23 B 24 B 25 D 26 A 27 D 28 C 29 A 30 B 31 D 32 B 33 The enteric nervous system helps regulate alimentary
canal motility and the secretion of digestive juices, thus facilitating digestion. If a person becomes overly anxious, sympathetic
innervation of the alimentary canal is stimulated, which can result in a slowing of digestive activity. 34 The lamina propria of the
mucosa contains lymphoid tissue that makes up the MALT and responds to pathogens encountered in the alimentary canal. 35
The majority of digestion and absorption occurs in the small intestine. By slowing the transit of chyme, segmentation and a
reduced rate of peristalsis allow time for these processes to occur. 36 The smell of food initiates long reflexes, which result
110
in the secretion of digestive juices. 37 Parotid gland saliva is watery with little mucus but a lot of amylase, which allows it
to mix freely with food during mastication and begin the digestion of carbohydrates. In contrast, sublingual gland saliva has a
lot of mucus with the least amount of amylase of all the salivary glands. The high mucus content serves to lubricate the food
for swallowing. 38 The incisors. Since these teeth are used for tearing off pieces of food during ingestion, the player will need
to ingest foods that have already been cut into bite-sized pieces until the broken teeth are replaced. 39 Usually when food is
swallowed, involuntary muscle contractions cause the soft palate to rise and close off the nasopharynx. The larynx also is pulled
up, and the epiglottis folds over the glottis. These actions block off the air passages. 40 If the lower esophageal sphincter does not
close completely, the stomach’s acidic contents can back up into the esophagus, a phenomenon known as GERD. 41 Peristalsis
moves the bolus down the esophagus and toward the stomach. Esophageal glands secrete mucus that lubricates the bolus and
reduces friction. When the bolus nears the stomach, the lower esophageal sphincter relaxes, allowing the bolus to pass into the
stomach. 42 The mucosal barrier protects the stomach from self-digestion. It includes a thick coating of bicarbonate-rich mucus;
the mucus is physically protective, and bicarbonate neutralizes gastric acid. Epithelial cells meet at tight junctions, which block
gastric juice from penetrating the underlying tissue layers, and stem cells quickly replace sloughed off epithelial mucosal cells. 43
The stomach has an additional inner oblique smooth muscle layer that helps the muscularis churn and mix food. The epithelium
includes gastric glands that secrete gastric fluid. The gastric fluid consists mainly of mucous, HCl, and the enzyme pepsin released
as pepsinogen. 44 Nutrients from the breakdown of carbohydrates and proteins are absorbed through a capillary bed in the villi of
the small intestine. Lipid breakdown products are absorbed into a lacteal in the villi, and transported via the lymphatic system to
the bloodstream. 45 If large quantities of chyme were forced into the small intestine, it would result in osmotic water loss from the
blood into the intestinal lumen that could cause potentially life-threatening low blood volume and erosion of the duodenum. 46
The mucosa of the small intestine includes circular folds, villi, and microvilli. The wall of the large intestine has a thick mucosal
layer, and deeper and more abundant mucus-secreting glands that facilitate the smooth passage of feces. There are three features
that are unique to the large intestine: teniae coli, haustra, and epiploic appendages. 47 The pancreas secretes protein-digesting
enzymes in their inactive forms. If secreted in their active forms, they would self-digest the pancreas. These enzymes are activated
in the duodenum. 48 The hepatocytes are the main cell type of the liver. They process, store, and release nutrients into the blood.
Radiating out from the central vein, they are tightly packed around the hepatic sinusoids, allowing the hepatocytes easy access to
the blood flowing through the sinusoids. 49 Bile salts and lecithin can emulsify large lipid globules because they are amphipathic;
they have a nonpolar (hydrophobic) region that attaches to the large fat molecules as well as a polar (hydrophilic) region that
interacts with the watery chime in the intestine. 50 Intrinsic factor secreted in the stomach binds to the large B12 compound,
creating a combination that can bind to mucosal receptors in the ileum.

Chapter 24
1 C 2 B 3 A 4 B 5 C 6 B 7 C 8 D 9 A 10 D 11 D 12 A 13 C 14 B 15 C 16 D 17 A 18 B 19 D 20 A 21 C 22
B 23 D 24 A 25 C 26 C 27 A 28 C 29 B 30 An increase or decrease in lean muscle mass will result in an increase or
decrease in metabolism. 31 Addison’s disease is characterized by low cortisol levels. One way to treat the disease is by giving
cortisol to the patient. 32 Glucose is oxidized during glycolysis, creating pyruvate, which is processed through the Krebs cycle
to produce NADH, FADH2, ATP, and CO2. The FADH2 and NADH yield ATP. 33 Upon entry into the cell, hexokinase or
glucokinase phosphorylates glucose, converting it into glucose-6-phosphate. In this form, glucose-6-phosphate is trapped in the
cell. Because all of the glucose has been phosphorylated, new glucose molecules can be transported into the cell according to its
concentration gradient. 34 Carbohydrates are converted into pyruvate during glycolysis. This pyruvate is converted into acetyl
CoA and proceeds through the Krebs cycle. When excess acetyl CoA is produced that cannot be processed through the Krebs
cycle, the acetyl CoA is converted into triglycerides and fatty acids to be stored in the liver and adipose tissue. 35 If diabetes is
uncontrolled, the glucose in the blood is not being taken up and processed by the cells. Although blood glucose levels are high,
there is no glucose available to the cells to be converted into energy. Because glucose is lacking, the body turns to other energy
sources, including ketones. A side effect of using ketones as fuel is a sweet alcohol smell on the breath. 36 Amino acids are not
stored in the body. The individual amino acids are broken down into pyruvate, acetyl CoA, or intermediates of the Krebs cycle, and
used for energy or for lipogenesis reactions to be stored as fats. 37 Trypsin and chymotrypsin are released as inactive proenzymes.
They are only activated in the small intestine, where they act upon ingested proteins in the food. This helps avoid unintended
breakdown of the pancreas or small intestine. 38 Insulin stimulates the uptake of glucose into the cells. In diabetes, the insulin
does not function properly; therefore, the blood glucose is unable to be transported across the cell membrane for processing. These
patients are unable to process the glucose in their blood and therefore must rely on other sources of fuel. If the disease is not
controlled properly, this inability to process the glucose can lead to starvation states even though the patient is eating. 39 When
triglycerides and fatty acids are broken down, acetyl CoA is created. If excess acetyl CoA is generated in this process, the excess is
used in ketogenesis or the creation of ketones. This creation results from the conversion of acetyl CoA by thiolase into acetoacetyl
CoA. This acetoacetyl CoA is subsequently converted into β-hydroxybutyrate, the most common ketone in the body. 40 When
blood flows to the outer layers of the skin or to the extremities, heat is lost to the environment by the mechanisms of conduction,
convection, or radiation. This will cool the blood and the body. Vasoconstriction helps increase the core body temperature by
preventing the flow of blood to the outer layer of the skin and outer parts of the extremities. 41 The ingestion of food stimulates
digestion and processing of the carbohydrates, proteins, and fats. This breakdown of food triggers glycolysis, the Krebs cycle,
the electron transport chain, fatty acid oxidation, lipogenesis, and amino acid oxidation to produce energy. Heat is a byproduct of
those reactions. 42 Factors that influence weight gain are food intake (both quantity and quality), environmental factors, height,
exercise level, some drugs or disease states, and genes. 43 Although these foods technically do not have fat added, many times a
significant amount of sugar is added to sweeten the food and make it taste better. These foods are non-fat; however, they can lead
to significant fat storage or weight gain because the excess sugar is broken down into pyruvate, but overloads the Krebs cycle.
When this happens, the sugar is converted into fat through lipogenesis and stored in adipose tissues.

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Chapter 25
1 B 2 C 3 D 4 C 5 B 6 C 7 D 8 A 9 A 10 B 11 C 12 C 13 B 14 D 15 B 16 B 17 A 18 B 19 B 20 A 21 C 22
D 23 D 24 A 25 D 26 A 27 B 28 B 29 C 30 D 31 The presence of white blood cells found in the urine suggests urinary
tract infection. 32 Diabetes mellitus would result in urine containing glucose, and diabetes insipidus would produce urine with
very low osmolarity (low specific gravity, dilute). 33 The longer urethra of males means bacteria must travel farther to the bladder
to cause an infection. 34 Forceful urination is accomplished by contraction of abdominal muscles. 35 Retroperitoneal anchoring,
renal fat pads, and ribs provide protection to the kidney. 36 The renal portal system has an artery between the first and second
capillary bed. The others have a vein. 37 The structures found in the renal hilum are arteries, veins, ureters, lymphatics, and
nerves. 38 The structures that make up the renal corpuscle are the glomerulus, Bowman’s capsule, and PCT. 39 The major
structures comprising the filtration membrane are fenestrations and podocyte fenestra, fused basement membrane, and filtration
slits. 40 Net filtration pressure (NFP) = glomerular blood hydrostatic pressure (GBHP) – [capsular hydrostatic pressure (CHP) +
blood colloid osmotic pressure (BCOP)] 41 Symptoms of kidney failure are weakness, lethargy, shortness of breath, widespread
edema, anemia, metabolic acidosis or alkalosis, heart arrhythmias, uremia, loss of appetite, fatigue, excessive urination, and
oliguria. 42 The vasa recta and loop of Henle are involved in countercurrent multiplication. 43 The approximate osmolarities
are: CT = 300; deepest loop = 1200; DCT = 100; and collecting ducts = 100–1200. 44 Sodium concentration in the filtrate
increases when GFR increases; it will decrease when GFR decreases. 45 To excrete more Na+ in the urine, increase the flow
rate. 46 The liver produces angiotensinogen, the lungs produce ACE, and the kidneys produce renin. 47 PTH affects absorption
and reabsorption of calcium. 48 When first discovered, it was named for its known activity—vasoconstriction. 49 In cases of
diabetes mellitus, there is more glucose present than the kidney can recover and the excess glucose is lost in the urine. It possesses
osmotic character so that it attracts water to the forming urine. 50 Protein has osmotic properties. If there is not enough protein in
the blood, water will be attracted to the interstitial space and the cell cytoplasm resulting in tissue edema. 51 The three electrolytes
are most closely regulated by the kidney are calcium, sodium, and potassium.

Chapter 26
1 The interstitial fluid (IF). 2 Fluid enters the capillaries from interstitial spaces. 3 Drinking seawater dehydrates the body as the
body must pass sodium through the kidneys, and water follows. 4 Because oxygen is reduced, the respiratory rate increases to
accommodate, and hyperventilation removes CO2 faster than normal, resulting in alkalosis. 5 A 6 B 7 C 8 C 9 D 10 A 11
B 12 B 13 A 14 A 15 B 16 C 17 B 18 C 19 B 20 A 21 B 22 C 23 D 24 A 25 B 26 B 27 C 28 A 29 C 30 B 31
There are additional negatively charged molecules in plasma besides chloride. The additional sodium balances the total negative
charges. 32 Fluid is moved by a combination of osmotic and hydrostatic pressures. The osmotic pressure results from differences
in solute concentrations across cell membranes. Hydrostatic pressure results from the pressure of blood as it enters a capillary
system, forcing some fluid out of the vessel into the surrounding tissues. 33 ADH constricts the arterioles in the peripheral
circulation, limiting blood to the extremities and increasing the blood supply to the core of the body. ADH also causes the epithelial
cells lining the renal collecting tubules to move water channel proteins called aquaporins from the sides of the cells to the apical
surface. This greatly increases the passage of water from the renal filtrate through the wall of the collecting tubule as well as
the reabsorption of water into the bloodstream. 34 Any imbalance of water entering or leaving the body will create an osmotic
imbalance that will adversely affect cell and tissue function. 35 Very little of the carbon dioxide in the blood is carried dissolved
in the plasma. It is transformed into carbonic acid and then into bicarbonate in order to mix in plasma for transportation to the
lungs, where it reverts back to its gaseous form. 36 Without having an absolute excess or deficiency of a substance, one can have
too much or too little of that substance in a given compartment. Such a relative increase or decrease is due to a redistribution of
water or the ion in the body’s compartments. This may be due to the loss of water in the blood, leading to a hemoconcentration or
dilution of the ion in tissues due to edema. 37 Bicarbonate ions are freely filtered through the glomerulus. They cannot pass freely
into the renal tubular cells and must be converted into CO2 in the filtrate, which can pass through the cell membrane. Sodium ions
are reabsorbed at the membrane, and hydrogen ions are expelled into the filtrate. The hydrogen ions combine with bicarbonate,
forming carbonic acid, which dissociates into CO2 gas and water. The gas diffuses into the renal cells where carbonic anhydrase
catalyzes its conversion back into a bicarbonate ion, which enters the blood. 38 Carbonic acid blood levels are controlled through
the respiratory system by the expulsion of CO2 from the lungs. The formula for the production of bicarbonate ions is reversible if
the concentration of CO2 decreases. As this happens in the lungs, carbonic acid is converted into a gas, and the concentration of
the acid decreases. The rate of respiration determines the amount of CO2 exhaled. If the rate increases, less acid is in the blood;
if the rate decreases, the blood can become more acidic. 39 Respiratory acidosis is present as evidenced by the decreased pH and
increased pCO2, with some compensation as shown by the increased total HCO3–. His asthma has compromised his respiratory
functions, and excess CO2 is being retained in his blood. 40 Metabolic alkalosis is present as evidenced by the increased pH and
increased HCO3–, without compensation as seen in the normal pCO2. The bulimia has caused excessive loss of hydrochloric acid
from the stomach and a loss of hydrogen ions from the body, resulting in an excess of bicarbonate ions in the blood.

Chapter 27
1 Sperm remain in the epididymis until they degenerate. 2 Sperm enter the prostate. 3 The fimbriae sweep the oocyte into the
uterine tube. 4 The oocyte may not enter the tube and may enter the pelvic cavity. 5 The testes are located in the abdomen. 6
b 7 a 8 b 9 a 10 c 11 d 12 a 13 b 14 c 15 b 16 d 17 c 18 b 19 d 20 A single gamete must combine with a gamete from
an individual of the opposite sex to produce a fertilized egg, which has a complete set of chromosomes and is the first cell of a new

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individual. 21 Unlike somatic cells, sperm are haploid. They also have very little cytoplasm. They have a head with a compact
nucleus covered by an acrosome filled with enzymes, and a mid-piece filled with mitochondria that power their movement. They
are motile because of their tail, a structure containing a flagellum, which is specialized for movement. 22 The three accessory
glands make the following contributions to semen: the seminal vesicle contributes about 60 percent of the semen volume, with
fluid that contains large amounts of fructose to power the movement of sperm; the prostate gland contributes substances critical
to sperm maturation; and the bulbourethral glands contribute a thick fluid that lubricates the ends of the urethra and the vagina
and helps to clean urine residues from the urethra. 23 During sexual arousal, nitric oxide (NO) is released from nerve endings
near blood vessels within the corpora cavernosa and corpus spongiosum. The release of NO activates a signaling pathway that
results in relaxation of the smooth muscles that surround the penile arteries, causing them to dilate. This dilation increases the
amount of blood that can enter the penis, and induces the endothelial cells in the penile arterial walls to secrete NO, perpetuating
the vasodilation. The rapid increase in blood volume fills the erectile chambers, and the increased pressure of the filled chambers
compresses the thin-walled penile venules, preventing venous drainage of the penis. An erection is the result of this increased blood
flow to the penis and reduced blood return from the penis. 24 Testosterone production by the body would be reduced if a male
were taking anabolic steroids. This is because the hypothalamus responds to rising testosterone levels by reducing its secretion
of GnRH, which would in turn reduce the anterior pituitary’s release of LH, finally reducing the manufacture of testosterone in
the testes. 25 The sperm must swim upward in the vagina, through the cervix, and then through the body of the uterus to one
or the other of the two uterine tubes. Fertilization generally occurs in the uterine tube. 26 Meiosis in the man results in four
viable haploid sperm, whereas meiosis in the woman results in a secondary oocyte and, upon completion following fertilization
by a sperm, one viable haploid ovum with abundant cytoplasm and up to three polar bodies with little cytoplasm that are destined
to die. 27 As a result of the degradation of the corpus luteum, a decline in progesterone concentrations triggers the shedding
of the endometrial lining, marking the menses phase of the menstrual cycle. Low progesterone levels also reduce the negative
feedback that had been occurring at the hypothalamus and pituitary, and result in the release of GnRH and, subsequently, FSH
and LH. FSH stimulates tertiary follicles to grow and granulosa and theca cells begin to produce increased amounts of estrogen.
High estrogen concentrations stimulate the endometrial lining to rebuild, marking the proliferative phase of the menstrual cycle.
The high estrogen concentrations will eventually lead to a decrease in FSH because of negative feedback, resulting in atresia
of all but one of the developing tertiary follicles. The switch to positive feedback that occurs with elevated estrogen production
from the dominant follicle stimulates the LH surge that will trigger ovulation. The luteinization of the granulosa cells of the
collapsed follicle forms the progesterone-producing corpus luteum. Progesterone from the corpus luteum causes the endometrium
to prepare for implantation, in part by secreting nutrient-rich fluid. This marks the secretory phase of the menstrual cycle. Finally,
in a non-fertile cycle, the corpus luteum will degrade and menses will occur. 28 Endometrial tissue proliferating outside of the
endometrium—for example, in the uterine tubes, on the ovaries, or within the pelvic cavity—could block the passage of sperm,
ovulated oocytes, or a zygote, thus reducing fertility. 29 As an individual approaches puberty, two changes in sensitivity occur.
The first is a decrease of sensitivity in the hypothalamus and pituitary to negative feedback, meaning that it takes increasingly
larger concentrations of sex steroid hormones to stop the production of LH and FSH. The second change in sensitivity is an increase
in the sensitivity of the gonads to the FSH and LH signals, meaning that the gonads of adults are more responsive to gonadotropins
than are the gonads of children. As a result of these two changes, the levels of LH and FSH slowly increase and lead to the
enlargement and maturation of the gonads, which in turn leads to secretion of higher levels of sex hormones and the initiation of
spermatogenesis and folliculogenesis. 30 The internal reproductive structures form from one of two rudimentary duct systems in
the embryo. Testosterone secretion stimulates growth of the male tract, the Wolffian duct. Secretions of sustentacular cells trigger
a degradation of the female tract, the Müllerian duct. Without these stimuli, the Müllerian duct will develop and the Wolffian duct
will degrade, resulting in a female embryo. 31 If the SRY gene were not functional, the XY individual would be genetically a
male, but would develop female reproductive structures.

Chapter 28
1 The first structure shown is the morula. The blastocoel appears at approximately 20 seconds. The movie ends with the hatching
of the conceptus. 2 Neurulation starts in week 4. 3 A regular heartbeat can be detected at approximately 8 weeks. 4 C 5 A 6
B 7 C 8 A 9 D 10 B 11 A 12 B 13 C 14 A 15 C 16 B 17 C 18 A 19 C 20 B 21 D 22 B 23 A 24 B 25 C 26 B 27
A 28 D 29 C 30 C 31 D 32 The process of capacitation appears to be incomplete. Capacitation increases sperm motility and
makes the sperm membrane more fragile. This enables it to release its digestive enzymes during the acrosomal reaction. When
capacitation is inadequate, sperm cannot reach the oocyte membrane. 33 Sherrise’s concern is valid. Sperm may be viable for
up to 4 days; therefore, it is entirely possible that capacitated sperm are still residing in her uterine tubes and could fertilize the
oocyte she has just ovulated. 34 The timing of this discomfort and bleeding suggests that it is probably caused by implantation
of the blastocyst into the uterine wall. 35 Folate, one of the B vitamins, is important for the healthy formation of the embryonic
neural tube, which occurs in the first few weeks following conception—often before a woman even realizes she is pregnant. A
folate-deficient environment increases the risk of a neural tube defect, such as spina bidifa, in the newborn. 36 Circulatory shunts
bypass the fetal lungs and liver, bestowing them with just enough oxygenated blood to fulfill their metabolic requirements. Because
these organs are only semifunctional in the fetus, it is more efficient to bypass them and divert oxygen and nutrients to the organs
that need it more. 37 Premature lungs may not have adequate surfactant, a molecule that reduces surface tension in the lungs
and assists proper lung expansion after birth. If the lungs do not expand properly, the newborn will develop hypoxia and require
supplemental oxygen or other respiratory support. 38 Devin is very likely experiencing Braxton Hicks contractions, also known
as false labor. These are mild contractions that do not promote cervical dilation and are not associated with impending birth.
They will probably dissipate with rest. 39 Janine is 41 weeks pregnant, and the mild contractions she has been experiencing “for
days” have dilated her cervix to 2 cm. These facts suggest that she is in labor, but that the labor is not progressing appropriately.
Pitocin is a pharmaceutical preparation of synthetic prostaglandins and oxytocin, which will increase the frequency and strength
of her contractions and help her labor to progress to birth. 40 The first breath inflates the lungs, which drops blood pressure
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throughout the pulmonary system, as well as in the right atrium and ventricle. In response to this pressure change, the flow of blood
temporarily reverses direction through the foramen ovale, moving from the left to the right atrium, and blocking the shunt with
two flaps of tissue. The increased oxygen concentration also constricts the ductus arteriosus, ensuring that these shunts no longer
prevent blood from reaching the lungs to be oxygenated. 41 The newborn’s kidneys are immature and inefficient at concentrating
urine. Therefore, newborns produce very dilute urine—in a sense, wasting fluid. This increases their risk for dehydration, and
makes it critical that caregivers provide newborns with enough fluid, especially during bouts of vomiting or diarrhea. 42 Milk
is secreted by lactocytes into alveoli. Suckling stimulates the contraction of myoepithelial cells that squeeze milk into lactiferous
ducts. It then collects in lactiferous sinuses and is secreted through the nipple pores. 43 It takes time to establish a balance between
milk supply and milk demand. When breastfeeding stops abruptly, it takes time for the supply to fall. Excessive milk supply creates
breast engorgement and leakage. 44 By using large sample sizes, Mendel minimized the effect of random variability resulting
from chance. This allowed him to identify true ratios corresponding to dominant–recessive inheritance. 45 The only way an
affected daughter could be born is if the female carrier mated with a male who was affected. In this case, 50 percent of the daughters
would be affected. Alternatively, but exceedingly unlikely, the daughter could become affected by a spontaneous mutation.

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