BIOL 1300 Final Flipped Exam Questions PDF

1 BIOL 1300: Final Flipped Exam Questions Link to Quizlet: https://quizlet.com/981035697/anatomy-fall-final-student-made-questions-flash-cards/?new Includes all groups Group 1: 1. A 54 year old man suffered an MCA (Middle Cerebral Artery) stroke and has been attempting to recover at the local emergency room. As the emergency staff are monitoring his symptoms post-stroke, they begin to note his symptoms and where they believe the damage lies. The man is able to produce speech, but unable to make sense of the conversation the nurses attempt to hold with him. Prior to his stroke, his wife expresses that he was a chronic alcoholic, and thus has decreased Vitamin B1 or a thiamine deficiency, indicative of a certain injury. With all of these attributes combined, the doctors are confident that they know what specific condition this man is suffering from. What is the name of this condition, and which lobe of the brain does it primarily affect? a. Broca’s Aphasia; Frontal lobe → This answer is incorrect because although Broca’s Aphasia does occur in the Frontal lobe, one would be able to comprehend but not produce speech if they had this condition. This man’s symptoms are the opposite. b. Broca’s Aphasia; Occipital lobe → This answer is incorrect because Broca’s Aphasia does not occur in the Occipital lobe, and this man also is able to produce speech, ruling out this condition. c. Wernicke’s Aphasia; Temporal lobe → This answer is correct because an injury in Wernicke’s Area allows a patient to be able to produce speech, but not comprehend speech or make sense in conversation. Furthermore, Wernicke’s Area is primarily in the Temporal lobe of the brain. d. Wernicke’s Aphasia; Midbrain → This answer is incorrect because although this man is suffering from Wernicke’s Aphasia, this does not occur in the Midbrain part of the brain. 2. During an anatomy lecture, the professor explains a situation where the nerve impulses in the brain are severely delayed due to the absence of myelin sheath around the axons. This could lead to muscle weakness, cognitive impairments and more. Which type of glial cell is responsible in this situation? a. Astrocytes → This answer is incorrect because astrocytes do not produce myelin sheath and are only responsible for giving support and nutrients to the neuron, controlling the chemical environment by cleaning leaked K+, and playing a role in the blood brain barrier in the central nervous system. 2 b. Oligodendrocytes → This answer is correct because oligodendrocytes produce myelin sheath in the central nervous system. c. Schwann cells → This answer is incorrect because even though schwann cells produce myelin sheath, it is not in the central nervous system, but in the peripheral nervous system. d. Microglia → This is incorrect because microglia do not produce myelin sheath and only play a role in the immune system and monitor health in the central nervous system. 3. When a patient sees a doctor for a deep cut, the doctor explains that five layers of the epidermis have been impacted. What parts of the body have an extra layer of the epidermis? a. Forearms and lower legs → the forearms and lower legs are not areas with thicker skin, meaning they only have four layers of the epidermis. b. Fingers and toes → the fingers and toes are not areas with thicker skin, meaning they only have four layers of the epidermis. c. Palms of hands and soles of feet → the palms and soles have thicker skin than the rest of the body, meaning that there is an extra layer, the stratum lucidum, in between the stratum corneum and stratum granulosum. d. The forehead → the forehead is not an area that has thicker skin, meaning it only has four layers of the epidermis. 4. At a meeting with her PCP, a 32 year-old pregnant woman is referred to a physical therapist and sent home with some over-the-counter painkillers to help her manage her sciatica. To help identify her pain as sciatica (pain in the areas innervated by the sciatic nerve), her PCP has her lift her leg while lying down. The patient notices pain when her leg is flexed at around 35 degrees. If the patient’s physical therapist wants to know which myotome is most impacted by her sciatica, what should the primary care physician tell the physical therapist? a. L3 → This answer is incorrect because the L3 myotome, innervated by the spinal nerves branching off of Lumbar Nerve 3, is responsible for the group of muscles that cause knee extension. The patient experiences pain during hip flexion. b. S1 → This answer is incorrect because the S1 myotome, innervated by the spinal nerves branching off of Sacral Nerve 1, is responsible for the group of muscles that cause ankle plantarflexion. The patient experiences pain during hip flexion. 3 c. L5 → This answer is incorrect because the L5 myotome, innervated by the spinal nerves that branch off of Lumbar Nerve 5, are responsible for the group of muscles that cause long toe extension. d. L2 → This answer is correct, because the L2 myotome is the group of muscles — innervated by Lumbar Nerve 2 — that cause hip flexion. The patient experiences pain when lifting her leg, which is hip flexion. 5. A 65 year old male was brought to the emergency department after a MVC (motor vehicle collision). During the crash, he hit his head against the steering wheel and then against the seat. He presented in the emergency department with complete paralysis of all of the muscles of the right side of his face. He was diagnosed with a fracture of the temporal bone and injury to one of his cranial nerves. He was immediately brought to the operating room where the affected cranial nerve was repaired in an end-to-end coaptation procedure. Which cranial nerve was damaged in the MVC? A. CN I -> This is incorrect because CN I is the olfactory nerve, and the function of this nerve is the sense of smell. Damage to this nerve would not cause facial paralysis. B. CN VII -> This answer is correct because CN VII is the facial nerve, and the function of this nerve is control of the muscles of facial expression. Damage to this nerve would cause facial paralysis. C. CN XI -> This is incorrect because CN XI is the accessory nerve, and the function of this nerve is movement of the shoulder and neck muscles. Damage to this nerve would not cause facial paralysis. D. CN III -> This is incorrect because CN III is the oculomotor nerve, and the function of this nerve is eye movement and pupil constriction. Damage to this nerve would not cause facial paralysis. Group 2: 1)The Blood Brain barrier does not allow large bacteria to git though, instead it causes the bacteria to stay in the peripheral blood supply. This is important as it prevents most things like bacteria and viruses from getting through and into the Central Nervous System However it also prevents medication from getting into the CNS. What cell makes up the Blood Brain Barrier? a) Astrocytes Correct! Most abundant, give support and nutrients to the neuron, controls chemical environment through mopping up of leaked K+, part of info processing in the bairn, plays role in blood brain barrier b) Microglial 4 Incorrect! Immune molecules for the PNS are too large to get across the blood brain barrier so we have to put something else in; microglial. c) Ependymal Incorrect! Does not contribute to the blood brain barrier. Helps move the CFS back and forth to keep the brain coated in it. d) Oligodendrocytes Incorrect! Produce myelin Sheath in the CNS https://platform.virdocs.com/read/2229135/86/#/4/2[P7001015106000000000000000002B44]/8[ P7001015106000000000000000002B73]/8[P7001015106000000000000000002B5C] Anatomy & Physiology for Health Professions page 174 2)Action potentials allow for signals to travel for cell to cell communication. Sodium (Na+) and potassium (K+) ions primarily move across the cell membrane to send signals. In the process of an action potential, which of the following accurately describes what happens during the repolarization phase? A) Potassium channels open, allowing K+ to exit the cell Correct: when sodium gates close, potassium channels open, and the cell becomes negative through negative feedback loop (repolarization) B) Sodium ions enter the cell, making it more positive Incorrect: when sodium ions enter the cell, it is a positive feedback loop (depolarization) C) The cell becomes more negative than its resting potential Incorrect: this is hyperpolarization D) Cell at rest has a negative charge (~-70mV) Incorrect: this is considered polarized (resting membrane potential) https://www.ncbi.nlm.nih.gov/books/NBK546639/ 3) A patient comes in with hives and said that they have tried a new fruit that they think may be the cause for this reaction. Hives are usually caused by food or medicine allergies, but can also be caused by autoimmune diseases, infections, stress, cold weather and more. When hives appear, the body releases histamine which causes the capillaries to dilate, fluid to leak into tissue (the fluid being plasma from capillaries), and itching. Based on what happens in the body when hives form, what layer of the skin is affected? A) Epidermis 5 - Incorrect: The epidermis is avascular and therefore doesn’t have capillaries. This means that the dilation of capillaries does not happen in this layer and that the symptoms following cannot be caused from this layer. B) Hypodermis - Incorrect: Although the hypodermis is vascular and can be affected by hives, the dermis is also vascular and is also affected. C) Dermis - Incorrect: Although the dermis is vascular and is affected by hives, the hypodermis is also vascular and can be affected. D) Hypodermis and Dermis - Correct: Both the hypodermis and dermis are vascular therefore the capillaries dilate and fluid leaks out into the dermis and hypodermis. https://health.clevelandclinic.org/chronic-hives-flare-up?utm_source=google&utm_medium=ppc &utm_campaign=cc_cs_ag_170941867567&utm_content=cc_cs_cid_{adid}&gad_source=1&g clid=Cj0KCQiAu8W6BhC-ARIsACEQoDAxz4EBu14D2oPQZOU1rTCrjHWrE6ta9rgHGORsj aY1hlxfcl6FAEQaArkHEALw_wcB https://www.mountsinai.org/health-library/diseases-conditions/hives 4) Sarah is a biology student studying cellular organelles and their functions. During her lab session, she observes a eukaryotic cell under a high-powered microscope. She notes the presence of mitochondria, ribosomes, a nucleus, and a cell membrane. Her professor asks her to identify the role of mitochondria and explain its significance for cellular activities. After the lab, Sarah researches further and learns that each organelle has a specific function that contributes to the survival and efficiency of the cell. Now, she needs to test her understanding of mitochondria by answering the following question: What is the primary function of mitochondria in a eukaryotic cell? A) Synthesizing proteins to aid in cell growth This is incorrect because protein synthesis occurs in ribosomes, not in mitochondria. Ribosomes assemble amino acids into proteins as instructed by mRNA. https://www.genome.gov/genetics-glossary/Ribosome#:~:text=Ribosome.,reading%20each%20t hree%2Dletter%20codon. B) Producing energy in the form of ATP through cellular respiration This is correct, because mitochondria produce ATP, the cell's main energy source, through cellular respiration. This process converts nutrients into usable energy, powering essential cellular activities like transport and signaling. https://www.genome.gov/genetics-glossary/Mitochondria C) Storing and protecting the cell’s genetic information 6 This is incorrect because the nucleus is the primary location for storing a eukaryotic cell's DNA. Although mitochondria have their own DNA, it is used exclusively for mitochondrial processes and not for the broader genetic protection of the cell. https://www.ncbi.nlm.nih.gov/books/NBK9845/ D) Regulating the movement of water, ions, and other molecules across the cell membrane This is incorrect because the regulation is the function of the plasma membrane or specific membrane proteins, not the mitochondria. https://www.genome.gov/genetics-glossary/Cell-Membrane-Plasma-Membrane Citations: https://www.genome.gov/genetics-glossary/Mitochondria https://www.genome.gov/genetics-glossary/Ribosome#:~:text=Ribosome.,reading%20each%20t hree%2Dletter%20codon. https://www.ncbi.nlm.nih.gov/books/NBK9845/ https://www.genome.gov/genetics-glossary/Cell-Membrane-Plasma-Membrane 5) A patient comes in and is diagnosed with sarcopenia. Sarcopenia is a disease that causes loss of muscle mass, strength and quality. This normally happens with aging. The patient is unable to make quick and explosive movements. What type of muscle is primarily effected by Sarcopenia? 1. slow twitch muscle - not correct because slow twitch muscle is not responsible for explosive and quick movements. 2. Fast twitch muscle - correct because quick twitch muscles are responsible for quick and explosive movements. 3. Reflexive muscle - incorrect because this is not a type of muscle. 4. A and B - incorrect because the question is asking what muscle is primarily responsible for the quick movement which would be quick twitch https://health.clevelandclinic.org/fast-twitch-muscle-fibers 7 Group 3: A 35 year old Male enters the ER with recurring seizures. He is diagnosed with epilepsy, and also notes that he has had difficulty relaxing lately. Which neurotransmitter presents the pathology of seizures, and is it excitatory, inhibitory, or both? 1. Dopamine; Both a. Incorrect because dopamine is linked to Parkinson’s disease 2. GABA; Inhibitory a. Correct because GABA is linked to seizures, and is inhibitory 3. Glutamate; Excitatory a. Incorrect because Glutamate is linked to a stroke 4. Serotonin; Inhibitory a. Incorrect because serotonin is linked to major depression A 67 year old female enters the ER with signs of a potential stroke. She is having trouble with speech, as she understands what people are saying but cannot form her own words. The doctor determines she has suffered an ischemic stroke in the middle cerebral artery (MCA), affecting her frontal lobe. What area of the frontal lobe controls production of speech? a. Wernicke’s Area- This is incorrect because Wernicke’s Area is in the temporal lobe and deals with comprehension of speech b. Broca’s Area- This is correct because Broca’s Area is in the frontal lobe and controls production of speech. She is suffering from Broca’s Aphasia c. Substantia Nigra- This is incorrect because this is in the Basal Ganglia and deals with dopamine production d. Precentral Gyrus- This is incorrect because while it’s located in the frontal lobe, this is not specifically concentrated with production of speech. A patient suffering from mild hypothermia is brought to the hospital for treatment. What happens to the blood vessels in the dermis layer of the skin in response to the cold temperatures? a) Vasodilation (incorrect because this happens when body needs to cool down and increase blood flow) b) Swelling (incorrect because swelling happens during vasodilation) c) Vasoconstriction (correct because the blood vessels constrict to reduce blood flow to your extremities and preserve heat) d) Blood clotting (incorrect because hypothermia does not increase the risk of blood clotting but slows down the process) 8 PhD students are studying the effects of protein manipulation to combat the progression of breast cancer. They’re required to have in-depth knowledge of the functions of protein and its contributions to the cells processes. Which of the following functions and responsibilities do not belong to proteins? a. Catalyze and metabolize reactions (correct, proteins can be enzymes which increase chemical reaction rates) b. Transport molecules within cells and throughout organism (correct, proteins are like mailing parts of the cell, taking already made proteins throughout the cell) c. Helps create action potential for the neuron to send electrical signals (Incorrect, sodium and potassium ions help create the action potential needed to send electrical impulses) d. Essential to DNA replication (Correct, though protein is a part of the DNA itself but the protein DNA Helicase helps separate DNA into two RNA strands) A 41 year old female was admitted to the hospital presenting with numbness in her hands and lips accompanied by general fatigue. Upon further testing, she was diagnosed with severe hypocalcemia. Which of the following interventions would be more effective in addressing her condition? a. increase calcitonin secretion (incorrect because calcitonin would down regulate osteoclasts, lowering calcium levels) b. downregulate osteoclast activity (incorrect because it would result in lower calcium levels) c. suppress PTH secretion (incorrect because PTH is responsible for increasing calcium levels so suppressing would lower them) d. stimulate osteoblast activity (correct because osteoblasts would stimulate osteoclasts to break down old bone resulting in more calcium absorption) Group 4: 1. Question One (Neuro): Irene, a 78 year old female, presents in the emergency room with her daughter. Irene’s daughters explained that over the last two hours, her mother had been very agitated, had both weakness and numbness on her left side, and slurred speech. The daughter also notes that her mother did not used to be like this. Prior to today, she was very reserved and did not get upset easily. Since it has only been two hours since Irene’s symptoms began, she is rushed to CT in order to confirm a suspected diagnosis. Following the scan, it is made clear that she has had or is having an ACA stroke. Based on Irene’s symptoms and CT results, what lobe or region of the brain is likely heavily involved? 9 a. Answer: Frontal Lobe i. Correct: The frontal lobe is the best answer for this question because Irene had a confirmed ACA stroke and personality changes along with other symptoms. The ACA or anterior cerebral artery supplies blood to the frontal lobe of the brain. Additionally, the frontal lobe is responsible for executive functioning and many elements of personality, and Irenene’s daughter has seen an abrupt change in this area of her mother’s life. b. Answer: Occipital Lobe i. Incorrect: The occipital lobe isn’t heavily involved because it’s mainly supplied by the PCA not the ACA. Furthermore, the occipital love handles visual processing rather than personality and motor. c. Answer: Temporal Lobe i. Incorrect: The temporal lobe isn’t a primary target of the ACA, as it’s mostly supplied by the MCA and parts of it by the PCA. The temporal lobe deals with things like hearing, memory and understanding language. Irene’s symptoms don’t match with this. d. Answer: Diencephalon i. Incorrect: The diencephalon is primarily supplied by the PCA and posterior communicating artery, not the ACA. A stroke in this area would not explain her personality changes or her left-sided motor deficits. e. Source: https://www.ncbi.nlm.nih.gov/books/NBK537333/ 2. Question Two (Neuro): Ted, a 41 year old male, presents in the emergency room following a spinal cord injury two months ago. Ted now has hypertension (caused by an overactive sympathetic response), excessive sweating of his arms and neck, and bradycardia when taking a carotid pulse. Following an analysis of Ted’s symptoms and diagnostic testing, Ted is diagnosed with autonomic dysreflexia. Given this diagnosis, where is the injury likely located in the spinal cord? a. Answer: Anywhere in the Spine i. Incorrect: This answer is incorrect because autonomic dysreflexia is specific to injuries at or above T6 due to the disruption of the sympathetic nervous system's regulation of blood pressure and heart rate. Injuries below this level do not usually cause autonomic dysreflexia. b. Answer: At or Above T6 1. Correct: this answer is correct because Ted’s diagnosis of autonomic dysreflexia is specific to injuries at or above T6 due to the disruption of the sympathetic nervous system's regulation of blood pressure and heart rate. None of the other answer choices make sense because they are all far below this threshold. c. Answer: The Lumbar Region 10 i. Incorrect: This answer is incorrect because autonomic dysreflexia is specific to injuries at or above T6 due to the disruption of the sympathetic nervous system's regulation of blood pressure and heart rate. Injuries below this level do not usually cause autonomic dysreflexia. d. Answer: The Sacral Region i. Incorrect: This answer is incorrect because autonomic dysreflexia is specific to injuries at or above T6 due to the disruption of the sympathetic nervous system's regulation of blood pressure and heart rate. Injuries below this level do not usually cause autonomic dysreflexia. e. Source: https://www.ncbi.nlm.nih.gov/books/NBK482434/ 3. Question Three (Integumentary): Jenna, a 64 year old female, has been in the hospital for weeks following a traumatic brain injury, TBI. This TBI has caused her to be in a vegetative state and she is completely dependent on her caretakers. The unit that she is on lacks the necessary staff to ensure that she is turned frequently enough to prevent bed sores. Unfortunately, Jenna developed pressure sores near her tailbone. There is a full-thickness loss of skin that extends to the subcutaneous tissue but does not cross the fascia beneath it. Additionally, the lesions are foul-smelling. However, the tendon and bone are not involved. Based on this information provided, what stage is Jenna’s pressure wound. a. Answer: Stage I Pressure Sore i. Incorrect: This answer choice is incorrect because in a stage I pressure wound, the skin is intact with the presence of non-blanchable erythema. This answer choice does not make sense because Jenna has a full thickness loss of skin that extends through the subcutaneous tissue. This means that her pressure sore has progressed past stage I. b. Answer: Stage II Pressure Sore i. Incorrect: This answer choice is incorrect because in a stage II pressure wound, there. There is partial-thickness skin loss involving the epidermis and dermis. This answer choice does not make sense because Jenna has a full thickness loss of skin that extends through the subcutaneous tissue. This means that her pressure sore has progressed past stage II. c. Answer: Stage III Pressure Sore i. Correct: This is the best answer because Jenna’s pressure sore is a textbook stage III pressure sore. In a stage III pressure sore, there is a full-thickness loss of skin that extends to the subcutaneous tissue but does not cross the fascia beneath it. This is exactly what Jenna has. d. Answer: Stage IV Pressure Sore i. Incorrect: This answer choice is incorrect because in a stage IV pressure sore, there is full-thickness skin loss extending through the fascia with considerable tissue loss. There might be possible involvement of the 11 muscle, bone, tendon, or joint. Jenna’s pressure sore has not yet advanced through the fascia. This is required for a pressure sore to be classified as stage IV. e. Source: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2702.1999.00 4. Question Four (Musculoskeletal): Anna, a 24 year old female is training to run the Boston Marathon this upcoming spring. After a blood test, it is found that she has a high mitochondria count in the blood. Her muscle fiber size is also seen to be extremely small. Which fiber type correlates with Anna’s distance running and test results? a. Answer: Slow twitch fibers type 1 i. Correct: This answer is correct because slow twitch fibers correlate more with endurance training and have the most mitochondria. b. Answer: Fast twitch fibers type 2A i. Incorrect: This answer is incorrect because this type of fiber quickly tires and is mostly for agility training. c. Answer: C fibers i. Incorrect: This is incorrect because it is a sensory fiber that senses secondary spreading pain. d. Answer: Fast twitch fibers type 2B i. Incorrect: This answer is incorrect because this type of fiber tires the fastest, uses little mitochondria and is mostly for agility training. e. Source: https://pubmed.ncbi.nlm.nih.gov/34564332/ 5. Question Five (Cells): A mother brings her son to his primary care doctor. He was recently diagnosed with Trisomy 21, and she wants to understand his condition better so she can care for him effectively. The doctor explains that an abnormality occurred during the division of reproductive cells, causing an extra chromosome to be added to the fertilized egg. Which cell division process and stage does this syndrome affect? a. Answer: Mitosis and Metaphase i. Incorrect: Mitosis is the process by which a non reproductive cell replicates so would not be concerned in this condition. Metaphase is also not concerned since it refers to when the chromosomes line up in the center of the cells. b. Answer: Mitosis and Anaphase i. Incorrect: Mitosis does not concern reproductive cells while anaphase would be concerned since it refers to when the chromosomes split and the spindles pull them apart. c. Answer: Meiosis and Telophase i. Incorrect: Meiosis would be concerned since it does refer to the division of reproductive cells but telophase would not be since it refers to when the chromosomes go to the far ends of the cells when the spindle disappears and the nuclei reappear 12 d. Answer: Meiosis and Anaphase i. Correct: Meiosis refers to the division of reproductive cells and anaphase when the chromosomes split and the sindles pull them apart. Trisomy 21 would occur when an extra chromosome gets pulled into the gamete formed from the cellular division. e. Source: https://www.nichd.nih.gov/health/topics/down/conditioninfo/causes Group 5: Question 1: Neuro Question: A 75 year old woman was brought to the hospital by her caregiver because of her memory-loss, disorientation to her environment and time, and when the neuroimaging came back, it showed dysfunctioning in the hippocampus and temporal lobe part of the brain. Which neurotransmitter is most likely to have been related to this condition? A. Dopamine B. Acetylcholine C. Gamma- aminobutyric acid (GABA) D. Serotonin Answer: B Acetylcholine Explanation of incorrect answers: A. Dopamine: This is incorrect because Dopamine is associated more with motor control, and mood, so for the answer to be Dopamine it would need to include motor difficulties like tremors to associate with Parkinson’s Disease. C. Gamma- aminobutyric acid (GABA): This is incorrect because this is more associated with the excitability of neurons so we would see more of an effect like epilepsy/seizures as symptoms. D. Serotonin: This is not correct because this affects the part of the brain dealing with mood, and sleep/melatonin , so depression would be a dysfunction of it rather than Alzheimer’s. Citations: 1. https://www.aans.org/patients/conditions-treatments/parkinsons-disease/ 2. https://www.epilepsy.com/stories/gaba-receptors-status-epilepticus 3. https://my.clevelandclinic.org/health/articles/22572-serotonin Question 2: Neuro Question: Ian was hiking in the mountains when he suddenly slipped and fell, hitting his head on a rock. After the fall, he experienced dizziness, confusion, and difficulty coordinating his movements. Which part of his brain is most likely affected? Choices: A. Frontal lobe B. Occipital lobe C. Cerebellum D. Temporal lobe 13 Answer: C. Cerebellum Explanation of incorrect answers: A: Frontal lobe: The frontal lobe is involved in decision making, problem-solving, and controlling behavior, not primarily in coordination and balance. B: Occipital lobe: The occipital lobe is responsible for processing visual information, not coordination and balance. C. Temporal lobe: The temporal lobe is involved in processing auditory information and memory, not coordination and balance. Citations: 1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/anatomy-of-the-brain 2. https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics- know-your-brain 3. https://www.verywellhealth.com/brain-anatomy-4780506 Question 3: Integumentary Question: Alyssa has been experiencing redness, swelling, and itching on her skin after spending a long day at the beach. She also noticed some blisters forming on her shoulders. Which part of her body is most likely affected? Choices: A. Hair follicles B. Sweat glands C. Epidermis D. Sebaceous glands Answer: C. Epidermis Explanation of incorrect answers: A: Hair follicles: While hair follicles are part of the integumentary system, they are not associated with the symptoms of redness, swelling, and blisters caused by sun exposure. B: Sweat glands: Sweat glands are involved in thermoregulation and do not directly cause these symptoms. D: Sebaceous glands: Sebaceous glands produce oil to lubricate the skin, but they are not responsible for the symptoms of sunburn. Citations: 1. https://www.mayoclinic.org/diseases-conditions/sun-allergy/symptoms-causes/syc-20378 077 2. https://my.clevelandclinic.org/health/diseases/17681-sun-allergy 3. https://resources.healthgrades.com/right-care/allergies/solar-urticaria Question 4: Musculoskeletal 14 Question: When Nicky does a bicep curl, she notices her arm bends at the elbow as she lifts the weight. Which muscle is acting as the agonist during this movement? Choices: A. Triceps brachii B. Deltoid C. Biceps brachii D. Pectoralis major Answer: C. Biceps brachii Explanation of incorrect answers: A: Triceps brachii: The triceps brachii acts as the antagonist during a bicep curl, opposing the action of the biceps brachii. B: Deltoid: The deltoid muscle is involved in the shoulder movements, not the bending of the elbow during a bicep curl. D: Pectoralis major: The pectoralis major is primarily responsible for movements of the shoulder joint, not the elbow. Citations: 1. https://openstax.org/books/concepts-biology/pages/16-5-musculoskeletal-system 2. https://bio.libretexts.org/Bookshelves/Introductory_and_General_Biology/Concepts_in_ Biology_%28OpenStax%29/16%3A_The_Body's_Systems/16.05%3A_Musculoskeletal_ System 3. https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Anatomy_and_Physiol ogy_1e_%28OpenStax%29/zz%3A_Back_Matter/Key_Terms_Chapter_11%3A_The_M uscular_System Question 5: Cells Question: Tay-Sachs disease is a rare, inherited neurodegenerative disease where the affected person does not have enough beta-hexosaminidase A enzymes. Without this enzyme, there’s an excessive accumulation of lipids known as gangliosides in the brain and nerve cells. The lack of which organelle is responsible for this accumulation of gangliosides? Choices: A: Smooth Endoplasmic Reticulum B: Golgi Apparatus C: Rough Endoplasmic Reticulum D: Lysosomes Answer: D. Lysosomes Explanation of incorrect answers: A: Smooth Endoplasmic Reticulum: Although the SER is responsible for lipid synthesis, and drug detoxification, it does not break down and remove waste. B: Golgi Apparatus: This organelle processes proteins and prepares them for use. It does not break down and remove waste. 15 C: Rough Endoplasmic Reticulum: This organelle is studded with ribosomes which make proteins and process them. It does not break down and remove waste. Citations: 1. https://rarediseases.info.nih.gov/diseases/7737/tay-sachs-disease 2. https://rarediseases.org/rare-diseases/tay-sachs-disease/ 3. https://bio.libretexts.org/Bookshelves/Human_Biology/Human_Biology_(Wakim_and_G rewal)/05%3A_Cells/5.06%3A_Cell_Organelles Group 6: Two Questions on Unit 3/Neuro: Question: A patient enters the clinic for a check-up and informs you that they were previously diagnosed with human immunodeficiency virus (HIV). Exposure to HIV enhances monocyte migration across the blood brain barrier, leading to alterations in the expression and function of certain transport proteins. The breakdown of the blood brain barrier by the migrating monocytes can lead to neurocognitive dysfunctions, such as decreased concentration, memory, information processing, learning, psychomotor speed, incoordination, and tremor. Which neuroglia is responsible for maintaining the blood brain barrier? a. Astrocyte - Correct, this neuroglia plays a role in the blood brain barrier and is the most abundant, gives support and nutrients to the neuron, controls the chemical environment through mopping up of leaked K+, and plays a role in processing info in the brain. b. Microglial - Incorrect, this neuroglia plays an immune system role in the CNS and monitors health, but does not play any role in the blood brain barrier. c. Ependymal - Incorrect, this neuroglia aids in circulation on CFS through their cilia, but does not play any role in the blood brain barrier. d. Oligodendrocyte - Incorrect, this neuroglia produces myelin sheath in the CNS, but does not play any role in the blood brain barrier. Source: https://www.ncbi.nlm.nih.gov/books/NBK519556/ Question: A 65 year old male presents in the ED after a minor fall, though he believes to have hit his head. The patient can speak fluently with normal rhythm and grammar, but the words he is using do not seem to make sense, or sound like “word salad.” Which area of the brain likely was affected by this injury? a. Temporal Lobe- This answer does not make sense because the temporal lobe is used in processing auditory information. b. Broca’s Area- This answer is incorrect because the Broca's area deals with speech production, which the patient does not have difficulty with. c. Parietal Lobe- This answer is incorrect because the parietal lobe processes sensory information, and does not deal with language comprehension. 16 d. Wernicke’s Area- This answer is correct because it plays a key role in language comprehension, which is the area most likely to be affected, as the patient can produce speech, but what he is saying doesn’t make sense. Source: https://www.nidcd.nih.gov/health/aphasia One Question on Integumentary: Question: A 6 year old boy presents to the ER with serious blistering, redness, and pain surrounding a burn from a direct flame on a family camping trip. After further examination, it is determined he has no localized pain to the injury, but serious pain surrounding the burn. It was also found that there was damage all the way through the epidermis and dermis, down to the subcutaneous tissue. What classification would this burn fall under? a. First degree burn- this is incorrect because a first degree burn would just be some redness and pain but no blistering. b. Second degree burn- this is incorrect because 2nd degree burns only go through the epidermis and part of the dermis, while this one reached the subcutaneous tissue. c. Third degree burn- this is correct because third degree burns burn to the subcutaneous tissue and blister, and the patient cannot feel localized pain but does feel pain around the injury. d. Fourth degree burn- this is incorrect because the burn did not reach bone and cause damage, which is what defines a fourth degree burn. Source: https://stanfordhealthcare.org/medical-conditions/skin-hair-and-nails/burns/stages.html. One Question on Unit 2/Musculoskeletal: Question: A 25 year old female presents to the clinic with skin nodules and following her consultation, her physician diagnoses her with squamous cell carcinoma. Her physician determines that excessive exposure to UV radiation from tanning beds is most likely the cause and recommends she begin treatment immediately. The physician is concerned with the rapid spread of the cancer because what type of cell is being affected? a. Permanent cells: This is incorrect because permanent cells are unable to proliferate and epithelial cells are not classified as such. b. Labile cells: This is the correct answer because epithelial cells are constantly proliferating. This raises concern for the rapid spread of the cancerous cells. c. Quiescent cells: This is incorrect because epithelial cells are constantly proliferating and are never in a nondividing state. d. Endothelial cells: This is incorrect because endothelial cells line the inside of blood vessels and are not concerned with the epidermis of the skin. Source: https://www.mayoclinic.org/diseases-conditions/squamous-cell-carcinoma/symptoms-causes/syc -20352480#:~:text=Most%20squamous%20cell%20carcinomas%20of,other%20forms%20of%2 0skin%20cancer. 17 One Question on Unit 1/Cells: Question: The endoplasmic reticulum plays a pivotal role in lipid and protein biosynthesis and calcium store regulation, determining its essential role in cell function. The maintenance of ER homeostasis is critical to cell survival. When homeostasis of the rough endoplasmic reticulum is disrupted, ER stress ensues, and adaptive processes occur. Which of the following is NOT a result of a change in Homeostasis in the Rough endoplasmic reticulum? a. Increased protein synthesis exceeding folding capacity: Proteins are produced in the rough endoplasmic reticulum, so when there is a change in homeostasis, that would correlate to protein synthesis exceeding folding capacity b. Accumulation of misfolded proteins- Proteins are produced in the rough endoplasmic reticulum, so there would be an excess of proteins if there was a change in homeostasis c. Lipid synthesis increases- this is the correct answer because lipid synthesis only occurs in the smooth endoplasmic reticulum and would not have a relation to a change in homeostasis in the rough endoplasmic reticulum. d. Calcium imbalance- this occurs when the ER is under stress calcium levels are out of equilibrium. Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC3942890/ Group 7: Question 1 (Unit 1): After experiencing repeated seizures, the doctors run genetic testing on their 15-year-old male patient to find that the patient has inherited a mitochondrial disease that inhibits his body from producing proper levels of ATP. As the brain has one of the highest energy requirements to function, the symptoms manifest in the form of seizures. Without a functioning mitochondria, small amounts of ATP can still be produced via anaerobic respiration that takes place in the cytoplasm. What is the name of this process and how many net ATP are produced per cycle? a. Citric Acid Cycle; 30-32 ATP i.This is the incorrect answer as the citric acid cycle is a part of aerobic respiration; therefore it takes place in the mitochondria. Additionally, 30-32 is closer to a normal range of ATP produced when mitochondria is functioning normally. b. Citric Acid cycle: 2 ATP i. This is the incorrect answer as the citric acid cycle takes place in mitochondria and is aerobic. c. Glycolysis; 2 ATP i. This is the correct answer as glycolysis is the anaerobic process that takes place in the cytoplasm of the cell and only produces net 2 ATP. d. Glycolysis: 4 ATP 18 i. This is incorrect because while glycolysis is the right process and 4 total ATP are produced, two ATP go into the process. Therefore, there are not 4 net ATP produced but instead 2 net ATP. https://pubmed.ncbi.nlm.nih.gov/34158150/ Question 2 (Unit 2): A patient is brought into the emergency room. He is experiencing muscle aches, muscle spasm in his throat making it difficult for him to breath. After some tests are run he is diagnosed with hypocalcemia which causes very low levels of calcium in your blood. What would be needed to increase the levels of calcium in the patient's body? a. Osteoclast - this is the incorrect answer because osteoclast is released when calcitonin is released, which is used when attempting to decrease calcium levels not increase. b. Parathyroid hormone (PTH) - this is the correct answer because the role of the parathyroid hormone is to increase serum levels of calcium. c. Calcium - this is the incorrect answer because we can’t just add calcium to increase calcium d. Calcitonin - this is the incorrect answer because Calcitonin is needed to be released when the calcium levels are too high and must be brought down. https://my.clevelandclinic.org/health/diseases/23143-hypocalcemia Question 3 (Integumentary): A patient presents to the ER with a burn that penetrates the hypodermis. What type of burn would this be classified as? a. 1st degree i. Incorrect, because a first degree burn only penetrates the first layer of skin (epidermis) b. 2nd degree i. Incorrect, because a second degree burn only penetrates the first two layers of skin (epidermis and dermis) c. 3rd degree i. Correct, because a third degree burn penetrates the epidermis, dermis, and hypodermis. ii. https://www.ncbi.nlm.nih.gov/books/NBK539773/ d. 4th degree i. Incorrect, because 4th degree burns penetrate beyond the hypodermis and into the bone. Question 4 (Unit 3): Which of the following describes the function of CN VIII? 19 a. Vision I. This is incorrect because vision is a function of CN II(optic nerve) and not CN VIII. b. Eye movements(lateral movements and abduction) i. This is incorrect because lateral eye movements and abduction are functions of CN VI(Abducens). c. Hearing and a sense of balance i. https://www.ncbi.nlm.nih.gov/books/NBK537359/ ii. This is correct because CN VIII refers to the vestibulocochlear nerve. Based on the functions of the cranial nerves, the vestibulocochlear nerve which is CN VIII is responsible for hearing by transmitting auditory signals from the cochlea to the inner ear. Also, CN VIII is responsible for balance because of its ability to transmit information from the vestibular apparatus to the brain to interpret spatial orientation and balance. d. Movements of the tongue i. This is incorrect because movements of the tongue is a function of CN XII(Hypoglossal nerve) and not CN VIII. Question 5 (Unit 3): What is the difference between action potential and graded potential? a. Action potential is all or nothing, whereas graded potential response reflects the size of the stimulus. i. https://www.sciencedirect.com/science/article/abs/pii/S1567423107080021 ii. This is correct because action potential needs to reach a stimulus threshold to react, whereas graded potentials have different strength reactions depending on the size of the stimulus. b. Graded potential is all or nothing, whereas action potential reflects the size of the stimulus. i. This is incorrect. The reverse is true. Action potential is all or nothing, whereas graded potential response reflects the size of the stimulus c. Graded potential occurs in the PSN whereas action potential occurs in the CNS i. This is incorrect because the location does not determine what type of potential it is. d. There is no difference between action potential and graded potential. i. This is incorrect because action potential and local potential are not the same thing. 20 Group 8: Nervous and Skeletal 1. The nervous system contains several classes of neuroglial cells which help to support and maintain the function of both the central and peripheral nervous system. The depositing of α-synuclein or α-syns are key markers for neurological disease like Parkinsons. Recent studies have shown that one key neuroglial cell within the central nervous system is crucial in the uptake of α-syns intracellularly. Therefore, their mechanism of action is through intracellular clearing of proteins to reduce disease transmission associated with α-syns. For clinical context, α-syn protein aggregation evokes both the innate immune response and the adaptive immune response. This presentation may lead to neuroinflammation which the neuroglial cell also responds to. Based on this information, which type of neuroglial cell is implicated in maintaining homeostasis and reducing disease presentation? Link: https://link.springer.com/article/10.1186/s12964-023-01402-y a. Astrocytes i. Incorrect: While these cells do support and provide nutrients they are not the ones responsible for coordinating immune responses in the CNS. b. Ependymal i. Incorrect: This answer is incorrect because these cells are responsible for aiding in the circulation of CSF c. Microglia i. Correct: Microglia is the correct answer because it is the neuroglial cell typically responsible for monitoring health and plays a role in the immune response of the CNS. d. Satellite Cells i. Incorrect: This answer is incorrect because these cells are part of the PNS and their function is not well characterized. 2. Injuries during childbirth can cause long term complications to motor movement and sensory perception at the appendages. Injuries at a plexus during birth may be the result of stretching, compression, or tearing at the branch. Brachial plexus birth palsy or BPBO causes paralysis at one site of the body and is the result of tractional injury during childbirth. When diagnosing, physicians typically conduct a clinical examination that does not require secondary cross-sectional imaging. What movements would be impacted based on damage to the brachial plexus? Link:https://link.springer.com/article/10.1007/s12178-016-9374-3 21 a. Arm Abduction i. This answer is correct because the brachial plexus innervates the entire upper extremity. b. Leg Flexion i. This answer is incorrect because the brachial plexus does not innervate the leg and would not impact leg flexion. c. Hip Extension i. This answer is incorrect as the upper extremity is not inclusive of the hip; instead it would be the lumbosacral plexus. d. Dorsiflexion of Foot i. Dorsiflexion is incorrect as the foot is innervated by the sacral plexus and is considered part of the lower extremity. Integumentary System: Question: A 25-year-old marathon runner develops a painful blister on their heel after buying and breaking in a new pair of running shoes. The blister is filled with clear fluid and has formed on the back of their foot where there was the most friction. What layer of the skin is primarily involved in this response, and further, what is its purpose? A) Hypodermis: Protecting the muscles from damage B) Dermis: Producing melanin to protect against UV rays C) Epidermis: Providing a cushion to prevent further damage D) Epidermis: Initiating the inflammatory response Correct Answer: C) Epidermis: Providing a cushion to prevent further damage A) Hypodermis: Protecting the muscles from damage: The hypodermis is a deeper layer primarily involved in fat storage and insulation, not directly responsible for blister formation. B) Dermis; Producing melanin to protect against UV rays: The dermis does not produce melanin, that is a function of melanocytes in the epidermis. That is also unrelated to blister formation. D) Epidermis; Initiating the inflammatory response: While the epidermis plays a role in protection, the clear fluid in blisters serves to cushion and heal, not directly initiate inflammatory response. Explanation: Blisters form in the epidermis to protect the underlying tissues from further friction and allow healing. https://my.clevelandclinic.org/health/diseases/16787-blisters Musculoskeletal System: 22 Question: A 30-year-old male sustains a fracture to his femur after falling from a height. He is brought to the emergency room with significant pain and difficulty moving his leg. Why is this injury considered particularly serious compared to other fractures? A) The femur is a small, delicate bone and breaks easily. B) The femur does not play a major role in weight-bearing. C) The femur fracture can lead to severe blood loss and damage to surrounding tissues. D) A femur fracture does not require immediate medical intervention. Correct Answer: C) The femur fracture can lead to severe blood loss and damage to surrounding tissues. A) The femur is a small, delicate bone and breaks easily: The femur is the largest and strongest bone in the body, so calling it small and delicate would definitely be false. It is also rather difficult to break. B) The femur does not play a major role in weight-bearing: The femur is the primary weight-bearing bone in the thigh. D) A femur fracture does not require immediate medical intervention: Femur fractures are serious and often require urgent treatment due to the risk of complications such as blood loss and damage to surrounding tissues. https://my.clevelandclinic.org/health/diseases/22299-broken-femur Explanation: The femur is the largest bone in the body, and a fracture can damage nearby arteries and tissues, making it a medical emergency. Cellular Level: Question: A 40-year-old patient presents with fatigue and muscle weakness. Laboratory tests reveal a mitochondrial disorder that impairs the production of ATP. Why does this primarily affect muscle cells? A) Muscle cells rely heavily on ATP for contraction and energy. B) Muscle cells do not contain mitochondria and depend on other cells for energy. C) Mitochondrial disorders only affect muscle tissue in the body. D) Mitochondria are not necessary for muscle cell function. Correct Answer: A) Muscle cells rely heavily on ATP for contraction and energy. B) Muscle cells do not contain mitochondria and depend on other cells for energy: Muscle cells contain a high number of mitochondria to create and maintain all their energy needs. C) Mitochondrial disorders only affect muscle tissue in the body: Mitochondrial disorders can affect multiple tissues, not just muscle. 23 D) Mitochondria are not necessary for muscle cell function: Mitochondria are crucial for muscle function because they produce ATP, which is required for muscle contractions. https://www.ninds.nih.gov/health-information/disorders/mitochondrial-disorders Explanation: Mitochondria produce ATP, which is critical for muscle contractions. A lack of ATP results in muscle weakness and fatigue. Group 9: Two Questions on Neuro A few weeks after a motor vehicle accident, a 40-year old patient came into the hospital with abnormal sharp and stabbing pain in their upper limbs. The doctor diagnosed them with Central Pain Syndrome which is a neurological condition that affects the way you feel pain and is caused by damage to the spinal cord or brain. What tract is most likely affected by this condition? A. Dorsal Column Tract a. This is incorrect because this tract carries fine touch, vibration, and proprioception. B. Corticobulbar Tract a. This is incorrect because this tract carries motor signals to the cranial nerves. C. Spinothalamic Tract a. This is correct because this tract carries pain, temperature, and crude touch. D. Spinocerebellar Tract a. This is incorrect because this tract carries posture, position sense, and coordination. Post Traumatic Stress Disorder (PTSD) is a common disorder that can affect any individual who has experienced trauma in which there was bodily injury, therefore establishing a disturbance in their thought processing. Those affected may feel frightened, helpless, or afraid as a result of a catastrophic event. Even a certain touch or sound can trigger severe emotions in those with PTSD. What part of the brain plays a significant role in PTSD and anxiety? A. Frontal lobe a. This answer is incorrect because the frontal lobe deals more with motor skills and executive thinking, therefore not making this the best answer. B. Amygdala a. This answer is correct because the amygdala detects danger, emotion, memory (including unconscious memory), and learned behavior, therefore playing a significant role in PTSD and anxiety. C. Pituitary gland a. This answer is incorrect because the pituitary gland produces hormones that regulate important bodily functions, therefore not making this the best answer. D. Cerebellum 24 a. This answer is incorrect because the cerebellum is responsible for coordination, posture, balance, and motor skills, therefore not making this the best answer. One Question on Integumentary ○ A patient who is 8 years old comes into the hospital with painful burns with blisters on his arms and face after being rescued from a fire. The doctor decided to use pressure wound therapy (a method of putting gauze on the burn and using a machine to make the gauze airtight). Pressure wound therapy is known for helping deeper dermis burns that take around a month to fully heal and help improve circulation and blood flow, and the reduction of scarring. What type of burn does pressure wound therapy best help? A) 1st degree burns 1st-degree burns are not deep in the dermis. 1st degree burns damage the outer layer of the epidermis, and can also heal quickly in only a few days B) 2nd degree burn 2nd-degree burns go through the epidermis and most of the dermis. 2nd degree burns can have blisters and deep second burns can take around 1-3 months to fully heal, which is why pressure wound therapy can best help 2nd degree burns on patients. C) 3rd degree burns 3rd-degree burns go through all layers of skin, have a leathery feel, and are not blistering anymore. Along with this, people with 3rd-degree burns don’t feel any pain, this patient has a lot of pain still because it has not burned through the pain receptors yet. D) 4th degree burn This burn goes through the bone, and this patient would need a more intensive treatment than pressure wound therapy. One Question on Cells A patient is experiencing extreme fatigue, muscle weakness, and an inability to sustain physical activity. Which cellular organelle is most likely malfunctioning? A) Ribosome ○ Ribosomes are responsible for protein synthesis. While proteins are essential for muscle repair and growth, they do not directly produce the energy required for immediate physical activity. B) Mitochondria ○ The mitochondria generates energy in the form of ATP, which is essential for muscle contraction and overall physical activity. Malfunction of the mitochondria can result in symptoms like fatigue and muscle weakness. C) Golgi Apparatus ○ The Golgi apparatus modifies and packages proteins and lipids, preparing them for transport. Its dysfunction could affect protein secretion but would not directly cause energy-related symptoms. D) Lysosomes 25 ○ Lysosomes break down waste and cellular debris. A malfunction in lysosomes might cause a buildup of waste in cells, but it is not directly related to the production of energy for muscle activity. One Question on Musculoskeletal ○ A 35 year old presents to the clinic complaining of pain in his right shoulder after lifting a heavy object at work. He describes the pain as sharp and localized near the shoulder joint. In his physical examination, the pt has difficulty raising his arm overhead. There is noticeable swelling and tenderness in the upper arm and shoulder area. The doctor suspects an injury to a structure that connects muscle to bone. What structure is affected? A) Ligament Connects bone to bone; no signs of abnormal joint movement, pt did not say their shoulder felt “loose”. B) Tendon Connects muscle to bone; pt lifts a heavy object, difficulty moving arm and swelling, indicating a tear or strain in the rotator cuff tendon. C) Bone A lot more severe and sharp pain. Fractures are also more visible to deformities or swelling. D) Cartilage Usually associated with joint instability, clicking, or popping sensations and pt did not mention these symptoms. Group 10: 1. Which part of the brain is primarily responsible for regulating heart rate and breathing? a. Cerebellum Incorrect: The cerebellum is primarily responsible for motor control and coordination, not for regulating heart rate and breathing. b. Medulla Oblongata Correct: The medulla oblongata controls autonomic functions such as heart rate, breathing, and blood pressure. It is the most responsible part of the brain for regulating these processes. c. Hippocampus Incorrect: The hippocampus is involved in memory formation, not in regulating heart rate or breathing. d. Thalamus Incorrect: The thalamus acts as a relay station for sensory and motor signals to the cerebral cortex, but it does not regulate heart rate or breathing. 26 2. What is the main function of the myelin sheath in neurons? A) To generate action potentials Incorrect: Action potentials are generated by the movement of ions across the neuron membrane, not by the myelin sheath. The myelin sheath helps propagate these action potentials faster. B) To protect the cell body Incorrect: The myelin sheath surrounds the axon of the neuron, not the cell body. It’s the cell membrane that protects the cell body. C) To speed up the transmission of electrical signals Correct: The myelin sheath insulates the axon and allows for faster transmission of electrical signals via saltatory conduction, where the action potential jumps between the nodes of Ranvier. D) To store neurotransmitters Incorrect: Neurotransmitters are stored in synaptic vesicles at the synapse, not within the myelin sheath. 3. Which layer of the skin is responsible for producing new skin cells? A) Epidermis Correct: The epidermis is the outermost layer of the skin, and the stratum basale (a sublayer of the epidermis) contains stem cells that continuously produce new skin cells. B) Dermis Incorrect: The dermis is located beneath the epidermis and contains connective tissue, blood vessels, and nerve endings. It does not directly produce skin cells. C) Hypodermis Incorrect: The hypodermis (also known as the subcutaneous layer) lies below the dermis and is involved in fat storage and insulation, not in producing skin cells. D) Stratum corneum Incorrect: The stratum corneum is the outermost layer of the epidermis, made of dead, flattened cells that have already been produced by deeper layers, not a site of new cell production. 4. What is the primary function of osteoblasts? 27 A) To break down bone tissue Incorrect: Osteoblasts are responsible for building bone, not breaking it down. Bone breakdown is performed by osteoclasts. B) To store calcium Incorrect: While osteoblasts are involved in bone formation, calcium storage is a secondary function of bone tissue itself, not directly the role of osteoblasts. C) To produce new bone tissue Correct: Osteoblasts are specialized cells that synthesize the organic components of bone matrix, leading to the formation of new bone tissue. D) To transmit nerve signals to the muscles Incorrect: This is the function of neurons, not osteoblasts. Osteoblasts are involved in bone formation, not neural transmission. 5. Which organelle is responsible for producing energy in the form of ATP? A) Nucleus Incorrect: The nucleus contains genetic material and controls cellular activities but does not produce ATP. It is the control center of the cell. B) Mitochondrion Correct: Mitochondria are known as the powerhouses of the cell. They generate ATP through cellular respiration, providing energy to the cell. C) Ribosome Incorrect: Ribosomes are responsible for protein synthesis, not energy production. They assemble amino acids into proteins. D) Golgi Apparatus Incorrect: The Golgi apparatus is involved in modifying, sorting, and packaging proteins and lipids for transport, not ATP production. 6. A patient is recovering from a severe burn and is struggling with a weak immune system and disrupted homeostasis of the body. Damage to which layer of the skin is most likely causing these issues? (https://www.ncbi.nlm.nih.gov/books/NBK554386/) a) Epidermis i) This answer is incorrect because while the epidermis does serve as a barrier to protect the body, it is avascular, meaning its impact on the body system as a whole would be much less than that of the dermis. b) Dermis 28 i) This answer is correct because the dermis contains cells that are important for immune response and blood vessels and glands that help with thermoregulation and fluid balance - essentially helping to maintain homeostasis. c) Subcutaneous Layer i) This answer is incorrect because it is mainly responsible for insulation, shock absorption, and energy storage. d) Stratum Basale i) This is incorrect because this is just a layer of the epidermis. Group 11: 1. A 77-year-old female suffers an ischemic stroke that results in brain damage on the left side of her brain. The woman develops aphasia and has trouble producing coherent language. What important brain area is damaged? - Broca’s Area → This is incorrect because this area is characterized by fluency of speech; not comprehension - Substantia Nigra → This is incorrect because this area produces dopamine and plays a role in movement - Pineal Gland → This is incorrect because this area produces melatonin and plays a role in the sleep/wake cycle - Wernicke's Area → This is correct because it is linked to comprehension of language https://aphasia.org/aphasia-resources/stroke/?gad_source=1&gclid=CjwKCAiA9bq6BhAKEiwA H6bqoM5SuG4l-CPTBxbnRVVe5o1XoWCkqoHTItv77L5uFP7g1_5l8750CRoClWcQAvD_BwE 2. A 20-year-old female is stung by a bee while out for a jog. She feels an immediate sharp pain that is attributed to A-Delta fibers. A few minutes later, the site of the bee sting begins to swell and the woman feels a throbbing pain. What sensory fibers are attributed to this secondary pain? - A-Alpha → This is incorrect, these fibers are responsible for proprioception - A-Beta → This is incorrect because these fibers are responsible for light touch - A-Delta Again → This is incorrect because these fibers serve as a warning and a precursor to pain - C-Fibers → This is correct because these fibers are responsible for slower onset pain sensations https://www.ncbi.nlm.nih.gov/books/NBK539846/ 3. A 75-year-old male patient presents with burns on both his anterior and posterior legs, as well as his anterior trunk. What is the total body surface area percentage that is burned? 29 a. 36% → This is incorrect because only 4 out of the 5 regions were accounted for in the total percentage. b. 9% → This is incorrect because only 1 out of the 5 regions was accounted for in the total percentage. c. 27% → This is incorrect because only 3 out of the 5 regions were accounted for in the total percentage. d. 45% → This is correct because all of the 5 regions mentioned were accounted for and their correct percentages; all regions were 9% and 9x5=45. https://www.weber.edu/casestudies/rule-of-nines.html 4. The human body sheds one and a half pounds of skin cells every year. Which type of cell in the epidermis allows the shed skin to be replaced? a. Labile Cells → This is correct because these cells are constantly proliferating. b. Stable Cells → This is incorrect because these cells do not usually proliferate unless a specific outside stimulus causes them to. c. Quiescent Cells → This is incorrect because they are the same as stable cells. d. Permanent Cells → This is incorrect because these cells do not proliferate. https://www.britannica.com/science/gamete 5. A 13-year-old male sprained his elbow while playing football. The doctor has advised him not to move his elbow for the time being to lead to a quicker recovery. Which type of joint is affected and what movements can he no longer perform? a. Ball and socket joint; all types of motion → This is incorrect because the elbow is not a ball and socket joint. b. Hinge joint; flexion and extension → This is correct because the elbow is a hinge joint, which allows for flexion and extension only; hinge joints are found in the knees and elbows. c. Pivot joint; rotation → This is incorrect because the elbow is not a pivot joint. d. Gliding joint; sliding back and forth → This is incorrect because the elbow is not a gliding joint. https://www.ncbi.nlm.nih.gov/books/NBK507893/ Group 12: 1. What is the primary function of the parasympathetic nervous system in maintaining homeostasis and how does it achieve this within the body? A) Regulates voluntary muscle movements, such as lifting an arm or walking, through conscious control. This answer is incorrect because it describes the function of the somatic nervous system, which controls voluntary muscle movements through conscious effort, not the autonomic nervous system. 30 B) Triggers the body’s "fight or flight" responses, preparing the body to handle stress or emergencies by increasing heart rate and redirecting blood flow. This answer choice is incorrect because it describes the sympathetic nervous system, which is responsible for the body's response to stress or danger, not the parasympathetic nervous system. C) Promotes "rest and digest" activities, including lowering heart rate, stimulating digestive processes, and conserving energy, thereby restoring the body to a state of calm and balance after stressful events. This answer choice is correct because the parasympathetic nervous system is responsible for "rest and digest" functions, helping the body relax, lower heart rate, and promote digestion, thereby maintaining homeostasis. D) Coordinates conscious actions such as speaking, thinking, and decision-making, ensuring efficient cognitive function during daily activities. This answer choice is incorrect because it describes cognitive functions typically managed by the central nervous system, specifically the brain, rather than the autonomic nervous system. Source: What Does The Parasympathetic Nervous System Do? 2. The vagus nerve comes with specific functions in the nervous system. Which of the following accurately describes its roles and contributions? It is both sensory and motor and contributes to the posterior sensation of the tongue and pharynx. This is wrong due to the vagus nerve not primarily involved with tongue sensation. The answer is describing the glossopharyngeal nerve, which controls sensation, taste, salivary gland, etc. It is both sensory and motor and controls the muscles of facial expressions and taste from the anterior tongue. While the vagus nerve is both sensory and motor, it does not relate to the face. This answer is describing the facial nerve due to the facial expression muscles and taste from the anterior tongue. It is strictly motor and contributes to eye movements,pupil constriction,and the muscle of the upper eyelid. The vagus nerve is not strictly motor. This answer is describing the oculomotor nerve, due to the eye movements and pupil constriction. It is both sensory and motor and contributes to the autonomic functions of the gut; contributes to heart rate and vocal cord muscles/swallowing. This is correct because the vagus nerve relates to both sensory and motor, and because it contributes directly with the parasympathetic roles of the gut/heart rate; damage can also lead to difficulty swallowing. CORRECT ANSWER: D 31 Source: https://my.clevelandclinic.org/health/body/22279-vagus-nerve 3. The integumentary system is incredibly important for the body and has many functions. The integumentary system is composed of three layers which include the epidermis, dermis, and subcutaneous layer. These three layers are different in their vascularity which affects their function and role in the body. In a situation where someone’s skin was flaking, what layer would the skin cells be falling from and why? a. The dermis layer because this layer is composed of dead cells called the stratum corneum which are scaly keratinized epithelial cells This answer is incorrect because although the dead cells that fall off are called the stratum corneum and are scaly keratinized epithelial cells, they are found in the epidermis layer which is the outermost layer and not the dermis layer. b. The epidermis layer because this layer is the deepest layer. This answer is incorrect because although the epidermis layer would be where the dead cells were falling from, the epidermis layer is the most superficial layer, not the deepest. c. The subcutaneous layer because this layer provides cushion and insulation as well as connecting skin to underlying layers. This answer is incorrect because it is irrelevant to the problem. We are looking for the most superficial layer, and the subcutaneous layer is the deepest layer providing cushion and insulation, but not hosting the dead cells called the stratum corneum that would fall off. d. The epidermis layer because this layer is composed of dead cells called the stratum corneum which are scaly keratinized epithelial cells. This answer is correct because the epidermis layer is the tough outer layer which is avascular and has dead cells called the stratum corneum which fall off. Correct answer: D Explanation: This answer is correct because the epidermis layer is the tough outer layer which is avascular and has dead cells called the stratum corneum which fall off. Source: https://my.clevelandclinic.org/health/body/21901-epidermis 4. Osteoblasts, Osteoclasts, and Osteocytes are three different types of bone cells that have different functions in the body. Which answer choice below correctly describes the bone cell that would have a large amount of ribosomes and why? 32 a. Osteocytes because they are the most abundant bone cell and are responsible for mechanosensing and responding to strain, thus they need large amounts of ribosomes. This is incorrect because although osteocytes are very abundant and are responsible for mechanosensing and responding to strain, this would not lead to large amounts of ribosomes. Protein synthesis causes there to be large amounts of ribosomes. b. Osteoblasts because they are responsible for the construction of osteoids. Although this is correct a better answer would be letter C which mentions mature osteoblasts and describes their role in protein synthesis which ribosomes play a direct role in. c. Mature osteoblasts because they are responsible for protein synthesis. This would be the best answer because it describes the osteoblasts as mature and the mature osteoblasts play a role in protein synthesis. Protein synthesis takes place in the ribosomes so you would expect there to be large amounts of ribosomes on these bone cells. d. Osteoclasts because they help with bone reabsorption, so they need enzymes to degrade the bone. This is incorrect because although osteoclasts do help with bone reabsorption and need enzymes to degrade the bone, they are not responsible for protein synthesis and thus do not need many ribosomes. Correct answer: C. Mature osteoblasts because they are responsible for protein synthesis. This would be the best answer because it describes the osteoblasts as mature and the mature osteoblasts play a role in protein synthesis. Protein synthesis takes place in the ribosomes so you would expect there to be large amounts of ribosomes on these bone cells. Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC10648520/ 5. Cellular reproduction or mitosis is the process of making new cells in order to sustain life. There are 4 main phases of this process; which phase involves the formation of a nuclear envelope and the formation of two nuclei? Cytokinesis (this is incorrect as this is not a part of mitosis; this is when 2 cells are produced) 33 Telophase(thisisthecorrectanswerasthenuclearenvelopearebeginningtoassociate with the chromosomes which ultimately builds a new nuclear envelope that can house a new nucleus) Anaphase(thisisincorrect;chromosomesmovetowardsoppositepolesofspindle, allowing the spindle to become longer) Prophase (this is incorrect because this is the beginning of mitosis where chromosomes become visible; this also encompasses prophase compaction, where chromosomes become more thick) Group 13: 1. A parent brings her daughter into the ER due to a sports-induced head trauma. She is diagnosed with a mild concussion to the frontal lobe. The patient is sent home with instructions to rest and gradually return to normal activities. Throughout her recovery, the patient noticed that she had lost her sense of smell. Knowing this, which concussion impacted the cranial nerve? a. Cranial nerve X i. Incorrect: the vagus nerve controls the swallowing reflex. b. Cranial nerve I i. Correct: this is the olfactory nerve responsible for our sense of smell. c. Cranial nerve VII i. Incorrect: this is the vestibulocochlear nerve, which controls hearing and sense of balance d. Cranial nerve IV i. Incorrect: this is the trochlear nerve that controls eye movements. https://pmc.ncbi.nlm.nih.gov/articles/PMC6051255/#:~:text=Olfactory%20impairm ent%20is%20a%20well,%2C%20or%20mucosal%20edema/hematoma. 2. Jewel is going on a hike with her friends from Boston College. It seems dark, so they decide it is time to return home. However, they run into a wild coyote upon leaving the hiking trail. The coyote starts lunging at them, and they immediately frantically run away. Which of the following is activated, and what would be the result? a. Parasympathetic - increased digestion i. Incorrect: Although the parasympathetic nervous system would increase digestive activity, it would not be activated in this scenario. b. Parasympathetic - bronchi constrict. i. Incorrect: Although the parasympathetic would constrict the bronchi, the parasympathetic nervous system would not be activated in this scenario. c. Sympathetic - increased heart rate i. Correct: In this situation, the sympathetic nervous system would be activated, increasing an individual’s heart rate. d. Sympathetic - increased salivation 34 i. Incorrect: Although the sympathetic nervous system would be activated in this situation, it would not lead to increased salivation. The sympathetic nervous system decreases salivation. Citation: https://www.ncbi.nlm.nih.gov/books/NBK542195/ 3) Which cell organelle is responsible for packaging and transporting proteins? A)Ribosome - this would be wrong because this organelle function is synthesizing proteins B)Rough Endoplasmic reticulum - this organelle's function is to produce proteins for the rest of the cell to function C) Lysosomes - this organelle's function is to break down waste materials within the cell D) Golgi Apparatus - This would be correct because the function of this organelle is to package proteins for exports. Cites)https://www.genome.gov/genetics-glossary/golgi-body#:~:text=A%20Golgi%20body%2C %20also%20known,be%20exported%20from%20the%20cell. 4. Vitiligo is a skin condition, specifically a chronic autoimmune disease, that causes patches of the skin to lose their pigment, making the patches appear lighter than the rest of the body’s skin color. What kind of cell does the immune system target and damage? a) Keratinocytes i) Incorrect - Keratinocytes do not produce pigment; they are epidermal cells that produce keratin. b) Melanocytes i) Correct—Melanocytes produce the pigment melanin, which is responsible for the color of skin. c) Stratum Corneum i) Incorrect - This is the most superficial layer of the epidermis and contains dead keratinocytes, providing a first layer of protection from the external environment. d) Squamous Cells i) Incorrect - They make up the epidermis and are keratinocytes, making it further up the epidermal layer. These cells will eventually become the stratum corneum layer. Citation: https://pubmed.ncbi.nlm.nih.gov/32778407/ 5. Osteoporosis is when bones weaken, resulting in an increased risk of fractures. An elderly patient is seen in the ER for a hip fracture. As the doctor reviews their medical history, she notes that the patient’s diet is regular with low sodium, and the patient’s HCP mentions that they have a large glass of milk with every meal. Labs drawn appeared normal, although the patient’s serum calcium and vitamin D levels have not returned yet. Given the above information, what medication change would this patient’s PCP most likely make while following up on fracture treatment? a) Increased vitamin D supplementation 35 i) Correct - Vitamin D assists in the absorption of calcium, thereby maintaining bone density and strength. b) Increased calcium supplementation i) Incorrect—The patient already consumes a large amount of calcium in their diet. Given what we know, it seems more likely that the patient’s body is not absorbing the calcium adequately. c) Increased iron supplementation i) Incorrect—Iron is involved in bone strength, but given the information we have been provided, we cannot ascertain whether iron deficiency or overload is the most likely source of this patient’s osteoporosis. d) New thyroid medication i) Incorrect—Similar to the incorrect answers above, we have no direct evidence that this patient’s thyroid is not functioning properly. Also, the parathyroid is more directly involved with calcium regulation than the thyroid, making this answer less ideal. Source: https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health Group 14: Group 14 Flipped Questions Anatomy and Physiology Final Exam Two Questions on Neuro 1. A patient complains to her family doctor with difficulty smelling. After examinations she is diagnosed with anosmia, a complete loss of smell. Which cranial nerve is damaged? A. CN 10- Vagus B. CN 1- Olfactory C. CN 12- Hypoglossal D. CN 11- Accessory Source: https://my.clevelandclinic.org/health/body/23081-olfactory-nerve Answer: B- CN 1- Olfactory Explanation A- Incorrect- cranial nerve 10 (vagus nerve) regulates digestion, heart rate, blood pressure, and breathing. It does not deal with our sense of smell. B- Correct- cranial nerve 1 (olfactory) transmits sensory information from the olfactory receptors in the nasal cavity to the brain, which allows us to perceive and interpret smells. C- Incorrect- cranial nerve 12 (hypoglossal) enables tongue movements. D- Incorrect- cranial nerve 11 (accessory) is the spinal accessory nerve which controls shoulder shrugging movements. 2. A young boy was extremely careless and was not wearing a helmet while riding his bike. Unfortunately he was in a bad biking accident and weeks later is experiencing difficulty with 36 spatial awareness (proprioception) and processing sensory information (especially touch). The doctor determines this boy is experiencing brain damage, which lobe of the brain is affected? A. Occipital lobe B. Cerebellum C. Temporal lobe D. Parietal lobe Source: https://my.clevelandclinic.org/health/body/24628-parietal-lobe Answer: D- Parietal lobe Explanation A- Incorrect- the occipital lobe is responsible for processing visual information. B- Incorrect- the cerebellum is not a lobe of the brian. The cerebellum is below the occipital lobe and controls balance. C- Incorrect- the temporal lobe is responsible for auditory processing. D- Correct- the parietal lobe processes sensory information and proprioception (where the body is in space). If the boy is having difficulty with interpreting senses and proprioception the parietal lobe is damaged. One Question on Integumentary 1. A college student returning from spring break in the Bahamas presents to the clinic with burns on her shoulders and upper body. These burns are blistering, extremely red, and are painful to the touch. Upon examination, you observe both the epidermis and dermis are damaged. What degree burns is she experiencing? A. First degree B. Second degree C. Third degree D. Fourth degree Source: https://www.mayoclinic.org/diseases-conditions/burns/symptoms-causes/syc-20370539#:~:text= Second%2Ddegree%20burn%2C%20also%20called,and%20pain%20can%20be%20terrible. Answer: B- Second degree Explanation A- Incorrect- first degree burns only affect the epidermis and do not blister. B- Correct- the patient’s physical description matches those of second degree burns and the layers of the integumentary system described. C- Incorrect- third degree burns appear charred and can be dry and leathery skin, there is also a lack of pain sensation because the nerves have been completely damaged. D- Incorrect- fourth degree burns would be even more severe than third degree burns. Also, we did not cover fourth degree burns in class. One Question on Musculoskeletal 37 1. A 70 year old woman presents to the clinic with severe muscle weakness (myopathy) and low muscle tone (hypotonia) in her arms, legs, and stomach. She is concerned for her overall muscle and bone health. She lives a very active life and eats properly. What biological imbalance explains her myopathy and hypotonia? A. Excess potassium B. Excess dopamine C. Excess actin D. Excess norepinephrine Source: https://medlineplus.gov/download/genetics/condition/actin-accumulation-myopathy.pdf Answer: C- Excess actin Explanation A- Incorrect- excess calcium in the body would lead to hyperkalemia which leads to heart problems, shortness of breath, and chest pains. B- Incorrect- dopamine is a hormone and neurotransmitter. Dopamine imbalances lead to schizophrenia, a neurological disorder. C- Correct- the protein actin plays a crucial role in muscle functioning. Proteins actin and myosin work together during muscle contraction. Excess actin will lead to myopathy and hypotonia. D- Incorrect- norepinephrine is a neurotransmitter and hormone. Elevated levels of norepinephrine in the body can likely contribute to anxiety. One Question on Cells 1. A young 10 year old presents to the ER with impaired kidney functioning and increased sensitivity to light. She is diagnosed with cystinosis, a disorder where the amino acid cystine is excessively stored in all body cells. The cells are struggling to keep up with cleaning and filtering out cystine. Which cellular organelle is malfunctioning? A. Nucleus B. Ribosomes C. Smooth endoplasmic reticulum D. Lysosomes Source: https://rarediseases.org/rare-diseases/lysosomal-storage-disorders/ Answer: D- Lysosomes Explanation A- Incorrect- the nucleus stores the cell’s DNA and is the cell control center. B- Incorrect- the ribosomes synthesize proteins. C- Incorrect- the smooth endoplasmic reticulum synthesizes lipids. D- Correct- the lysosomes clean up cell debris and filter out waste. 38 Group 15: 1. A patient presents with weakness and loss of voluntary movement in their right leg following a spinal cord injury. Which of the following best explains the damage they might experience due to their spinal cord injury? a. Damage to the right lateral corticospinal tract below the level of pain. i. The lateral corticospinal tract is responsible for voluntary motor control of the limbs. b. Damage to the left lateral corticospinal tract below the level of pain i. Incorrect because damage to the left lateral corticospinal tract would result in motor weakness on the left side, not the right. c. Damage to the spinothalamic tract on the right side i. Incorrect because the spinothalamic tract is responsible for pain and temperature sensation, not voluntary motor control. d. Damage to the medial vestibulospinal tract on the right side i. Responds to input regarding head motion, not the legs. https://www.kenhub.com/en/library/anatomy/lateral-corticospinal-tract 2. A patient presents with a burn that affects the entire epidermis and part of the dermis. The area is red, painful, and has blisters. Which type of burn is this most likely to be? a. First-degree burn i. only the epidermis is damaged and they don’t cause blisters b. Second-degree burn i. this burn affects the epidermis and part of the dermis and causes blisters which is key to second-degree burns c. Third-degree burn i. this burns all three layers not only 2 d. Superficial burn i. is a synonym for a first-degree burn which is not what the patient experienced because they have blisters https://my.clevelandclinic.org/health/symptoms/24527-second-degree-burn 3. A patient presents with a pimple near the nose and upper lip, and upon squeezing it, develops symptoms of a severe headache and is having difficulty making facial expressions. Which of the following is the most likely explanation for the spread of infection in this case? a. Infection in the danger triangle of the face, where the facial vein connects to the cavernous sinus i. Squeezing of pimples in this area can allow infection to spread into the intracranial venous system 39 b. The proximity of the facial nerve to the infection site causes neurological symptoms i. The facial nerve is involved in facial muscle movement and sensation, not in spreading the infection to the brain. c. Infection of the force used to pop the pimple. i. The force might make things worse but is not the primary reason why they are experiencing those symptoms, it is due to the danger triangle of the face d. Infection of the force causes it to go into the bloodstream. i. The pressure increases but the infection does not necessarily go into the bloodstream https://health.clevelandclinic.org/danger-triangle 4. A patient goes in for their annual eye appointment and is told by the ophthalmologist that they need to dilate their pupil to perform a retina visualization. The doctors uses the drug atropine to dilate the pupils as it is an involuntary nervous system blocker. If atropine dilates the pupil, what system is being blocked? a. Sympathetic nervous syst

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