Knowledge and Care

Welcome

This is your individual workbook which is to be completed as part of the summative assessment for 6HSK1078. The workbook is intended to be completed as an individual piece of work and University rules on plagiarism and collusion must be adhered to.

Please do not put your name on the workbook or in the filename – this is an anonymous submission (the marker will not know who submitted until after the marks are released.

The workbook must be completed using the template given and submitted (in Microsoft Word format) to the module canvas site by 10:00 on the 4th January 2022. Make sure you leave plenty of time for computer delays when you submit. It is your responsibility to make sure you submit the correct file to the correct portal.

The workbook consists of 30 multiple choice questions (MCQs) and a section of three (3) Short Answer Questions (SAQs). Ensure you read each question thoroughly, for the short answer questions make sure you are aware of the word limit. Word limits carry an academic bias of +/- 10%, for instance for a 500 word answer you are expected to write between 450 and 550 words. Any answers with a word count over the 10% limit: the marker will not mark past the limit and any words over the limit will be ignored. As this is a workbook of anatomy and physiology knowledge references are not required.

MULTIPLE CHOICE QUESTIONS

Each question has only one correct answer. Each question is worth one mark.

Please indicate your choice of answer clearly by using the highlighter tool:

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Section one: gastrointestinal system

What is peristalsis?

The effect of gravity in the gastrointestinal system.

Wave like movement in cilia

Wavelike muscle contractions

Suction of the lower gastro-intestinal system

Where does the process of digestion start?

The small intestine

The large intestine

The stomach

The mouth

What is the main role of the liver in digestion?

Makes important enzymes

Neutralises stomach acid

Produces bile

Regulated insulin

Which layer of the intestines contains the lymphatic vessels?

Mucosa

Submucosa

Muscularis

Peritoneum

Which of the following enzymes breaks down carbohydrates in the digestive system?

Bile

Amylase

Lipase

Chymotrypsin

Parasympathetic nervous system outflow (stimulation) does not:

Stimulate gastric secretions

Increase gastric activity

Reduce gastric activity

Open the pyloric sphincter

The chemical digestion of proteins begins in:

The mouth

The stomach

The small intestine

The large intestine

The pH of the stomach is usually between:

1-3

4-6

6-9

1-9

The main artery supplying the liver is:

The hepatic portal artery

The liver artery

The hepatic artery

The portal artery

The gallbladder releases bile in response to which hormone?

Cholecystokinin

Secretin

Motilin

Insulin

Section2: Respiratory system

How many lobes does the left lung consist of?

2

3

1

4

he junction between the two main bronchi is known as:

The terminus

The larynx

The larynx

The carina

Pulmonary ventilation refers to:

The movement of gases in and out of the lungs

T

he exchange of gases to and from the alveoli

The exchange of gases between cells and the blood.

The movement of gases around the body

The primary muscle of respiration is:

The intercostal muscles

The sternocleidomastoid muscles

The diaphragm

The abdominal muscles

During inspiration the thorax:

Expands and the intrapulmonary pressure falls below atmospheric pressure

Expands and the intrapulmonary pressure rises above atmospheric pressure

Contracts and the intrapulmonary pressure falls below atmospheric pressure

Contracts and the intrapulmonary pressure rises above atmospheric pressure

How is the majority of oxygen transported around the human body?

Dissolved in plasma

Attached to haemoglobin

As chloride ions

As bicarbonate ions

The respiratory centres in the medulla oblongata and the pons monitor:

Levels of O2 in the blood

Levels of O2 in the lungs

Levels of CO2 in the blood

Levels of CO2 in the lungs

Internal respiration is:

The exchange of O2 and CO2 across the alveoli wall

The exchange of O2 and CO2 between tissues and blood

The exchange of O2 and CO2 between cell and tissues

The exchange of O2 and CO2 between tissues and alveoli

The lining immediately in contact with the lung is the:

Parietal pleura

Visceral pleura

Epithelium

Pericardium

The transport of gases across the alveolar wall is by:

Facilitated diffusion

Osmosis

Active transport

Simple diffusion

Section three: Cardiac system

The valve located between the left atria and the left ventricle is the:

Aortic valve

Mitral valve

Pulmonary valve

T

ricuspid valve

The outermost layer of the pericardium is:

Parietal pericardium

Serous pericardium

Fibrous pericardium

Visceral pericardium

The conduction system that transmits electrical impulses throughout the ventricles is:

The bundle of His

The SA node

The purkinje system

Bacchman’s bundle

The normal range for a resting heart rate is:

40-100bpm

50-100bpm

60-100bpm

70-100bpm

Which artery predominantly supplies blood to the right ventricle?

RCA

Circumflex

Diagonal

LAD

Which part of the ECG trace of a single cardiac cycle corresponds to ventricular repolarisation?

P wave

QRS complex

T wave

U wave

In the cardiac cycle the isovolumetric contraction phase refers to:

Atrial contraction with no change in blood volume

Ventricular contraction with no change in blood volume

Ventricular relaxation with no change in blood volume

Atrial relaxation with no change in blood volume

The majority of the cells in the heart are:

Cardiomyocytes

Cardiac pacemaker cells

Epithelial cells

Endocardial cells

The node found at the base of the right atrium is known as:

AV Node

Bundle of His

SA Node

Purkinje system

Deoxygenated blood enters the right atrium via:

Vena cavae

Aorta

Pulmonary arteries

Pulmonary veins

PART 2: SHORT ANSWER QUESTIONS

Make sure you read the question and ensure you keep within the word count guidance.

Question 1: Discuss the roles of insulin and glucagon in the maintenance of blood glucose levels. Word count 200 words. (10 marks)

The cells of the body need glucose for creating energy which they are unable to use without assistance from insulin. This is because insulin plays the role of providing access to glucose to the body cells. The insulin attaches to the insulin receptors present om the cell in the entire body which leads to deliver instruction to the cells to open and allow entry of glucose. The lower level of insulin mainly circulates through the body and any spike in the level of insulin level signals the liver to produce increased glucose. The liver acts to absorb the increased glucose in the body to change it into glycogen. During reduction of blood sugar level, glucagon is secreted by the pancreas which has the role to deliver signal to the liver for converting stored glycogen into glucose so that the reduced blood sugar level can be returned to normal. The process of conversion of stored glycogen in glucose to be released in the bloodstream by glucagon is known as glycogenolysis. The role of insulin also includes supporting the healing of wounds after injury by delivering adequate amino acids to the muscles to be used in building protein present in the muscle tissue. It leads the muscle tissues to be rebuilt and the wounds to be managed.

Question 2: Using examples discuss the differences between paracrine, autocrine and endocrine. Word count 200 words. (10 marks).

Paracrine is the cell signalling process in which cell produces any signal to be induced by the neighbouring cells leading to alter the behaviour of the adjacent cells. An example of paracrine signalling is activation of nitric oxide synthase through acetylcholine in the endothelial cells. The activation helps in catalysing the reaction of arginine to nitric oxide causing nitric oxide to enter the smooth muscle cells activate guanylyl cyclase to form cyclin GMP that helps in relaxing the smooth muscle cells for rapid blood flow.

Autocrine is the form of cell signalling where the specific cell secretes a chemical messenger or hormone which binds with the autocrine receptor on the same cell leading the cell to be changed (Richards and Ascoli, 2018). An example of autocrine signalling is production of cytokine interleukin-1 in monocytes that in response from the external stimuli acts to bind with the cell-surface receptors of the same cells responsible for producing it.

Endocrine is the cell signalling process in which chemical messengers or hormones produced by a specific cell targets binding with the receptors on any distant cell in the body through the help of bloodstream to create change in the body functioning. An example of endocrine signalling is the release of thyroxine from thyroid glands to increase cardiac contractility and output.

Discuss the structure and function of the nephron. Word count 500 words (25 marks).

In the kidneys, the basic structural and functional unit is the nephron which functions to regulate water and soluble substances in the blood by filtering the waste materials from the blood, allowing reabsorption of required substances and excreting the waste substances through urine. The function of the nephron is essential for maintaining homeostasis in the blood for blood volume, blood pressure and osmolarity of plasma. The filtering of waste from the body is the primary function of nephron and other actions include conversion of blood into urine, excretion of substances, water reabsorption and others.

The structure of nephron contains glomerulus which is a tuft of capillary receiving blood supply from the afferent arteriole of the renal circulatory system. In the glomerulus, the fluids, as well as solutes from the blood, are filtered out and the substances are transported in the space developed by the Bowmen capsule. A specialised group of cells are present at the afferent arteriole of the nephron that forms the juxtaglomerular apparatus (JGA). The JGA mainly secretes renin and contain macula densa. It lies at the juncture between the Loop of Hele and the distal nephron from where the tubule comes in closer proximity to the afferent arterioles. The Bowmen capsule mainly surrounds the glomerulus and is made of visceral and parietal cells which allow fluids and smaller molecules like ions and glucose to pass through the nephron.

The nephron contains the Proximal Convoluted Tubule (PCT) which acts as the initial site for reabsorption of water in the bloodstream and occurs as a result of passive diffusion and active transport across basolateral membrane. It mainly lies between the Bowmen’s capsule and the Loop of Henle and function to reabsorb sodium and chloride ions, sugar and other apart from water. The PCT and DCT are lined with simple cuboidal epithelium cells which includes brush border for enhancing the surface area of the apical side. The Loop of Henle is referred to the U-shaped tubular structure that contains the ascending and descending limb of the convoluted tubule. It acts to transfer the fluid from the PCT to Distal Convoluted Tubule (DCT). The permeability of the descending limb of the tubule is extensively permeable to water but is weakly permeable to ions leading to cause large amount of water to be reabsorbed which increases the fluid osmolarity in the body to 1200 mOSm/L. However, the PCT being highly permeable to ions leads to lower osmolarity of the fluid passing through the Loop of Henle.

The DCT and the collecting duct of the nephron are the final site for reabsorption of water. In this part of the nephron, the permeability of the water is considered to be variable and depends on the hormone stimulus to allow regulation of blood osmolarity, pH, pressure and volume. The anti-diuretic hormone acts on the CT to enhance the permeability of the tubules to increased water reabsorption. The nephron also contains peritubular arteries that are tiny blood vessels surrounding the efferent arteriole and travels along the nephron for supporting its function of secretion and reabsorption.

Describe and explore the roles of the sympathetic and parasympathetic nervous systems in maintaining homeostasis. Word count 500 words (25 marks).

The sympathetic and parasympathetic nervous system are two components of the Autonomic Nervous system which supports execution of involuntary actions in the body such as a blood pressure, heart beat and others. The stress which mainly acts as the hyperarousal of the flight-or-fight response of the sympathetic system is counteracted by the parasympathetic system to promote the body to develop homeostasis or rest. In the sympathetic nervous system (SNS), the mediation of the hormonal and neuronal stress is known as the sympatho-adrenal response or flight-or-flight response of the body. It occurs mainly due to the preganglionic sympathetic fibres which are present at the end of the adrenal medulla supporting secretion of acetylcholine that activates the adrenaline secretion and lesser release of the noradrenaline. Thus, the impulses are mainly directed through external or internal impulses that get transmitted through the SNS. It also directs the secretion of catecholamines from the adrenal medulla and act initially on the cardiovascular system to increase its performance in stressful condition to gradually allow the body to return to normal. The messages transmitted through the SNS is done in a bi-directional manner and the efferent messengers get to trigger simultaneous changes in different parts of the body as a result of stress caused by the impulse to allow the body to cope with the stress and return back to normal.

In parasympathetic nervous system (PSNS), the system support reaching homeostasis in the body by slowing responding to the received stimulus that does not require immediate response. The PSNS mainly uses the two key acetylcholine receptors that are muscarinic and nicotinic cholinergic receptors to act as neurotransmitters in allowing the body to act against stress to restore homeostasis. The SNS to promote homeostasis during breathlessness out of exercise causes dilation of the bronchioles of the lungs which allows creation of enhanced environment for greater alveolar oxygen exchange to meet the increased demand for oxygen. However, with the reduction in the need for oxygen, the PSNS acts to constrict the enlarged bronchioles to normal size to support reaching homeostasis. After the meal, the parasympathetic nervous system acts to dilate the blood vessels leading to the gastrointestinal tract to increased blood flow so that the nutrient produced are absorbed in the body to minimise the nutrient deficiency caused in the body to reach homeostasis. Another role of SNS in maintaining body homeostasis is controlling body temperature to normal. During presence of high body temperature, the SNS acts to dilate the blood vessels near the skin to supply increased blood so that the increased heat can be evaporated in the form of sweat to the surface of the skin to create cooling impact in lowering the body temperature to normal. The actions of PSNS in maintaining homeostasis are constriction of enlarged pupil, constriction of bronchi, inhibition of adrenalin production and others. Thus, it can be seen that PSNS in the ANS acts to stimulate the rest-and-digest response and fed-and-breed response compared to the flight-or-fight response of the SNS in reaching homeostasis in the body.

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