2024 Workbook 1 ANSWERS.pdf

Te Hoe Ora Ki Manawa Department of Health Practice Te Hoe Ora Ki Manawa Department of Health Practice WORKBOOK 1 ANSWERS Bachelor of Nursing BNNS501 Student Name _______________________________ Workboo...

Te Hoe Ora Ki Manawa Department of Health Practice Te Hoe Ora Ki Manawa Department of Health Practice WORKBOOK 1 ANSWERS Bachelor of Nursing BNNS501 Student Name _______________________________ Workbook 1 This workbook has been designed to assist your learning and help to focus your study. The topics covered in this workbook include weeks one to five of the semester (refer to course outline) and will help to prepare you for exam one. You are encouraged to complete the relevant sections as part of your preparation work, and as we explore subjects in more depth in the tutorials and lectures. Please be aware this is only a guide and you must supplement your learning as required. This workbook is not assessed, and you will not be required to submit this on completion. The answers will be made available on Moodle at the end of each corresponding week so that you can check you are on the right track. 1 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  TUTORIAL ONE Anatomy is the study of body structure. Physiology is the study of body function. Write a sentence which defines the following terms: Cells: Basic structural and functional units of an organism Tissues: Group of similar cells (and the substances surrounding them) that perform a special function Organs: Composed of two or more different tissues and have specific functions Body Systems: Consist of related organs that have a common function Homeostasis: A condition of equilibrium (stability or balance) in the body’s internal environment If a person is standing in ANATOMICAL POSITION they are standing how? If the body is lying face DOWN, it is in the prone position. If the body is lying face UP, it is in the supine position. Directional Terms Superior: means “towards the head” Medial: nearer to the midline of the body Inferior: away from the head Lateral: further from the midline of the body Anterior (ventral): at the front of the body Proximal: nearer the attachment of the limb to the trunk Posterior (dorsal): at the rear of the body Distal: further from the attachment of the limb to the trunk Superficial: on or near the surface of body or organ Central: towards the body core, usually the head & trunk Deep: further away from the surface of body or organ Peripheral toward the body peripheries or extremities 2 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  BODY REGIONS AND CAVITIES The abdominopelvic region of the body has been separated into four quadrants and/or nine regions. Label these below. Useful to know for when you are performing abdominal assessments on your patients 3 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced. Body Cavities are spaces that help to protect, separate, and support internal organs Which cavities do the following organs belong in? Organ Cavity Stomach Abdominal Heart Thoracic Lungs Thoracic Brain Cranial Small Intestine Abdominal Urinary Bladder Pelvic Kidneys Abdominal Liver Abdominal You can use boundaries to describe where each cavity is: Cranial cavity - Cranial bones Vertebral cavity – Spinal column Thoracic cavity – Superior boundary: base of neck; inferior: diaphragm; anterior: sternum and costal cartilage of ribs; posterior: thoracic vertebrae and ribs. Abdominal cavity Superior boundary: diaphragm, Anterior boundary: abdominal muscles Posterior boundary: vertebrae Pelvic cavity - Superior boundary: symphysis pubis and sacrum; inferior: pelvic floor muscles; anterior: symphysis pubis and pelvic bone; posterior: pelvic bones/sacrum and coccyx; lateral: pelvic bones PLANES are imaginary flat surfaces that are used to divide the body or organs into definite areas. Parasagittal plane divides the body or an organ into left and right side. Midsagittal plane divides the body or an organ into two equal sized portions (left and right) through the midline. Frontal plane divides the body or an organ into front (anterior) and back (posterior) portions. Transverse (horizontal) plane divides the body or an organ into upper (superior) or lower (inferior) portions. 4 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  BODY SYSTEMS It is important to know the main components of each body system as well as the functions. Complete the table below (the integumentary system is done for you). Body System Consists of: Function Integumentary Skin, hair nails and glands Protection, detects sensation, excretes some System wastes, synthesis of Vitamin D, storage of fat, regulation of temperature. Skeletal System Protects supports body organs. Bones, ligaments, and joints Provides a framework muscles use to cause movement. Blood cells formed in bone marrow within bones, mineral and fat storage Muscular Participates with skeletal system to facilitate System Skeletal muscles, smooth muscle, and movement & maintain posture. cardiac muscle Generates heat necessary for warm-blooded organisms to maintain a constant body temp. Nervous System detects and responds to body internal & Brain, spinal cord, nerves, and sensory external changes by activating muscles & organs glands through nerve impulses. It provides rapid control of body systems. Endocrine Hormone-producing cells and glands Regulates the body through chemical System scattered throughout the body. mechanisms (by releasing hormones into the blood) Cardiovascular Heart, blood, & blood vessels. Carries oxygen, carbon dioxide, nutrients, wastes etc. Regulates body temperature, and water balance. Lymphatic Lymphatic fluid, lymph nodes, and Protects against disease. System lymphocytes – and the other associated Fluid balance organs of the immune system (tonsils, spleen, and thymus gland.) Respiratory Airways, trachea bronchi, & lungs Keeps the blood constantly supplied with System oxygen & removes carbon dioxide. Acid-base balance Digestive System Oesophagus, stomach, intestines & Physical & chemical breakdown of food, digestive glands like the salivary glands, absorption of nutrients & elimination of waste liver & gallbladder Urinary System Kidneys, ureters, bladder, and urethra Filters the blood & excretes waste products in urine, Regulation of fluid, electrolyte, & acid/base balance 5 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  HOMEOSTASIS Homeostasis is a condition of equilibrium within the body’s internal environment. The nervous system and endocrine system are the most important contributors to maintaining homeostasis. The two types of Feedback mechanisms are negative feedback and positive feedback. Components of a feedback system. Fill in the gaps using the words provided: A stimulus is any disruption to a controlled Effector condition. Shut off A receptor is a sensor that monitors the environment and responds by sending information to a control centre. Stimulus The control centre/integrator determines the set point to be maintained, analyses input and Muscle sends response to…. Sensor the effector which can be a muscle or gland brings about the response. Gland Feedback is received by the control centre/integrator and once equilibrium is restored the effectors are shut off. Receptor Control centre/integrator Write an example for each of these: Negative Feedback: thermoregulation, blood sugar regulation Positive Feedback: blood clotting, onset of uterine contractions and childbirth 6 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  THE CELL Cells are composed of three main parts: Cell membrane forms the cell’s outer boundary and separates the cell’s internal environment from the outside environment. It covers and protects the cell. It is a selectively permeable barrier, allowing the passage of some things and not others. It links to other cells and plays a role in cellular communication. Cytoplasm contains all the cellular contents between the plasma membrane and the nucleus. Consists of: The cytosol is the fluid portion (mostly water). This is intra-cellular fluid. This is the site of many chemical reactions. Reactions provide the building blocks for cell maintenance, structure, function, and growth. Organelles are subcellular structures embedded in the cytosol, having characteristic shapes & specific functions. The nucleus is a large organelle that contains DNA in molecules called chromosomes. Each chromosome consists of a single molecule of DNA and associated packaging proteins. A chromosome contains thousands of hereditary units called genes. 7 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  ORGANELLES Fill in the blanks for the following table to describe the organelle, structure, or function. Component Structure Function Provides structural support for the Cytoskeleton Network of protein filaments cell throughout the cytosol Aids in the transport of Microfilaments substances within the cell Intermediate filaments The cytoskeleton Microtubules The cytoskeleton forms: - centrosomes - specialised cell membrane projections (cilia, flagella, microvilli) Centrosome Consists of two centrioles directs movement of DNA during cell located near the nucleus division. Cilia Short, hair-like projections from move substances across the cell the cell surface surface. Flagella Longer than cilia, move an entire cell; only example is the sperm cell’s tail. Ribosomes Very small structures within the join amino acids together to make cell proteins (this is the first stage of making proteins) Endoplasmic reticulum Network of membranes in the shape of flattened sacs or There are two tubules types of ER Rough ER Connected to the nuclear site of protein folding and their envelope. The surface is studded synthesis. with ribosomes making it look (this is the final stage of making rough. proteins) Smooth ER A network of membrane tubules synthesis of lipids which does not have ribosomes Processing and packaging. Modify, Golgi complex / 3–20 flattened, membranous sort, and package proteins for apparatus sacs. transport to different destinations. 8 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced. Secretory A sac containing proteins Transport proteins from the Golgi to Vesicle the plasma membrane where they are discharged by exocytosis into the extracellular fluid. Lysosomes Membrane bound ‘packages’ contain powerful enzymes which (vesicles) pinched off from the digest: Golgi complex. unwanted cellular organelles and other molecules (e.g., unwanted mitochondria & mRNA) particles or cells the cell has ingested (e.g., bacteria) Mitochondria Sausage-shaped structures. Produce ATP which provides cellular More prevalent in physiologically energy active cells: muscles, liver, and kidneys. Nucleus Spherical or oval shaped Controls what cellular events structure which is usually most happen and when. prominent feature of a cell. Contains genetic information in the Nuclear envelope - a double form of chromosomes: membrane that separates the Structurally chromosomes are nucleus from the cytoplasm. long molecules of DNA combined with protein Nuclear pores - numerous molecules. openings in the nuclear Each chromosome consists of envelope, control movement of thousands of genes. A gene is a substances between nucleus short section of the chromosome and cytoplasm which contains information for synthesis of part of a protein. In Nucleolus - spherical body that turn, proteins are the workforce produces ribosomes. that operate cell activities and make its structure. 9 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  MOVEMENT ACROSS A CELL MEMBRANE Fill in the table to describe how each of the following molecules can move into and out of the cell. Type of molecule Type of transport (passive or active)? Type of movement? Concentration gradient? An oxygen molecule Passive transport Simple diffusion High to low concentration A carbon dioxide molecule Passive Simple diffusion High to low concentration A molecule of water Passive Osmosis High to low concentration Most water moves using aquaporins A sodium ion moving from the outside to the Passive inside of a cell. Facilitated diffusion via Na+ ion channel. High to low concentration A sodium ion moving from the inside to the Active outside of a cell Sodium-potassium transporter pump Low to high concentration A potassium ion moving from the inside to the Passive outside of a cell. Facilitated diffusion via K+ ion channel. High to low concentration A potassium ion moving from the outside to Active the inside of a cell. Sodium-potassium transporter pump Low to high concentration A glucose molecule Passive Facilitated diffusion via protein carrier. High to low concentration An amino acid Passive Facilitated diffusion via protein carrier. High to low concentration A fatty acid Passive Facilitated diffusion via protein carrier. High to low concentration A large protein It cannot enter the cell – trick question! A protein which the cell has made for export. Active Via secretory vesicle - exocytosis Fluid droplets move into the cell. Active Pinocytosis Solid particles move into the cell. Active Phagocytosis 10 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  CHEMISTRY OF LIFE What is the difference between an atom and an ion? An ion is an atom that has a positive or negative charge because it has lost or gained electrons. Complete the following table with the correct chemical symbol for each ion. Sodium Na+ Potassium K+ Chloride Cl- Calcium Ca2+ Hydrogen H+ Consider the movement of water molecules in relation to the surrounding environment. What type of solution is represented by each picture? This Photo by Unknown Author is licensed under CC BY (a) HYPOTONIC (b) ISOTONIC (c) HYPERTONIC 11 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  CELLULAR RESPIRATION Fill in the blanks using the words provided. Metabolism refers to all biochemical reaction in the body including catabolic reactions (which break larger molecules into smaller ones) and anabolic reactions (which build larger molecules). ATP provides the cell with small amounts of energy. The energy in ATP can be released by breaking high-energy bonds to release phosphate. This forms ADP. ADP can be recycled to form ATP again by the addition of a phosphate. Glycolysis (the breakdown of a glucose molecule) occurs in the cytoplasm and produces 2 molecules of ATP and pyruvic acid. Pyruvic acid moves into the mitochondrion and another ATP are released in the citric acid cycle which also generates carbon dioxide and heat. Most of the cell’s ATP is gained from the electron transport train where upwards of 28 molecules of ATP is produced, along with water and heat. If there is insufficient oxygen available, the citric acid cycle and electron transport chain will not operate. Instead, anaerobic respiration occurs. This produces significantly less ATP and will also produce lactic acid which travels to the liver for storage. Lactic acid can be recycled to pyruvic acid when there is oxygen available. Anabolic Glycolysis Catabolic ATP ADP Metabolism Citric Acid Cycle Electron Transport Chain Anaerobic Respiration Lactic acid Summary table. Aerobic Anaerobic Oxygen required? Y N Amount of energy released? Lots Little Organelles involved? Mitochondrion N End products? 32 ATP 2 ATP CO2/H20/heat Lactic acid 12 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  TUTORIAL TWO THE SKIN Label the skin diagram using the words provided. You may need to add some arrows! Sebaceous gland. 1.) __________ Epidermis. 4) ________ Hair follicle. 2.) ___________ Sweat gland. 3.) ___________ Dermis. 5) ________ Subcutaneous/ hypodermis Nerve fibre. Arrector pili muscle. Nerve. 13 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced. Describe six functions of the skin. 1. Skin protects the underlying tissues from damage due to microbes, abrasion, chemicals, water loss or water entry & UV light. 2. Sensory Receptors detect touch, pressure, vibration, tickle, heat, cold, and pain. 3. Excretion Excretes approximately 400 mL of water/day, a small amounts salt, CO2, ammonia & urea. 4. Synthesis of Vitamin D. Cholesterol is converted to Vitamin D in the skin when it is exposed to UV light. 5. Stores blood. The skin has an extensive network of blood vessels which can constrict during shock. Blood is re-directed to supply vital organs. 6. Assists in temperature regulation. The skin contains receptors to detect temperatures changes. The skin excretes sweat which then evaporates, cooling the body. Dermal blood vessels dilate in hot weather increasing heat loss from the skin, constrict in cold weather preventing heat loss. New cells are produced in the lower layer of the epidermis. As new cells are pushed towards the surface, they lose contact with blood vessels in the dermis. What does this lack of nourishment and oxygen have on them? Cell death Fill in the gaps. The epidermis consists mostly of cells containing a tough fibrous protein called keratin that protects the skin and underlying tissues from abrasions, heat, microbes, and chemicals. It consists of cells that have died to protect the underlying dermis. Dead skin cells are shed from the surface (50,000 dead cells every minute). Other cells, melanocytes, produce melanin which absorbs UV radiation to protect the skin. The single most important risk factor for skin cancer is over-exposure to UV radiation. The deeper dermis is composed of connective tissue containing collagen fibers (for strength) and elastic fibers (to return its’ original position after stretching). Deep to the dermis is the sub-cutaneous layer/ hypodermis composed of areolar and adipose tissues. Its function is to attach the skin to underlying tissue and store fat. 14 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  MEMBRANES Fill in the gaps. Mucous membranes line body cavities that open to the exterior. Serous membranes line body cavities that do not open to the exterior. The thoracic and abdominal cavities are lined by thin, slippery, double-layered membranes called serous membranes. These membranes adhere to the outer surface of the organs or ‘viscera, and then double-back to line the body cavity wall. Visceral layer covers the organs within the cavities e.g., heart, lungs, and digestive organs. Parietal layer lines the cavity walls. Serous fluid between the two layers of the serous membrane reduces friction and allows the viscera to slide somewhat during movements. MICROBIOLOGY Write a short sentence to define or explain each of the following key terms. Microbiology: Study of organisms too small to be seen without a microscope. Disease: an infection which harms the host causing damage to cells and tissues Microorganism: Microscopic organism includes bacteria, viruses, fungi, protozoa, and prions Pathogen: a microorganism or infectious agent that causes disease Colonisation: presence, growth, and multiplication of an organism without observable clinical symptoms (disease) or immune reaction in a patient – so they don’t have the disease, but they have the microorganism. 15 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  Contagious: an infectious disease that spreads from person to person. Is a person who is colonised with an organism contagious? Yes. Carrier: people or animals with no symptoms of illness but with pathogens in their body who can transfer to others Infection: invasion of a pathogenic microorganism into the tissues of a host where they multiply causing an immune response with or without symptoms Symptomatic: a pathogen multiplies within a host and causes injury to cells or tissues so host has clinical signs and symptoms Asymptomatic: a pathogen multiplies within a host but does not cause injury to cells or tissues so has no signs or symptoms. Virulence: the potency of a pathogen to infect a host and cause death in the host CHAIN OF INFECTION The presence of a pathogen does not always result in disease. Different elements form a chain linking together to enhance this process. This is called the Chain of Infection. An infection will develop if the chain remains intact. (Crisp, Taylor, Douglas and Rebeiro, 2013) Breaking this chain protects patients and prevents 16 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced. Work through answering these questions on each of the elements from the chain of infection. Define ‘Reservoir’: Habitat in which an agent can live, grow and multiply. Identify six reservoirs of microorganisms and state which is the most likely to cause disease in humans. 1. Humans 2. Zoonoses (animals) 3. Soil 4. Water 5. Air 6. Food What are the six factors which provide the best environment for survival of a pathogen in the reservoir? 1. Warm or moist environment 2. Isotonic surroundings (to avoid cell shrinkage/bursting) 3. Oxygen (depending on bacteria) 4. Temperature close to 37 deg C 5. pH close to 7 6. Availability of nutrients What is a Fomite? Object or materials likely to carry an infection. Define ‘Portal of Exit’: Path by which a pathogen leaves a host. Identify six portals of exit from a human. 1. Blood 2. Respiratory tract 3. Broken skin 4. Anus 5. Mucous membranes 6. GI tract Define ‘Mode of transmission’: The way in which an infectious agent may be transmitted from its’ reservoir to a susceptible host. 17 All images from Patton K.T., & Thibodeau G.A. (2016). Anatomy & Physiology (9 ed.). Elsevier., unless otherwise referenced.  Explain how each of the following modes spreads disease. Direct contact: skin-to-skin contact, kissing, and sexual intercourse. Direct contact also refers to contact with soil or vegetation harbouring infectious organisms. Within direct contact we also consider Vertical Transmission – from mother to baby through blood) Indirect: transfer of an infectious agent from a reservoir to a host by suspended air particles, inanimate objects (vehicles), or animate intermediaries (vectors). Droplet: spray with relatively large, short-range aerosols produced by sneezing, coughing, or even talking (direct contact if