Anatomy & Physiology ch 23
Anatomy & Physiology ch 23 Biol 2301
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Human Anatomy & Physiology, 8e (Marieb/Hoehn) Chapter 23 The Digestive System Matching Questions Figure 23.1 Using Figure 23.1, match the following: 1) Mucosa. Answer: A Diff: 1 Page Ref: 855; Fig. 23.6 2) Duodenal glands found here. Answer: B Diff: 2 Page Ref: 880; Fig. 23.6 3) Smooth muscle layer. Answer: C Diff: 1 Page Ref: 857; Fig. 23.6 4) MALT found here. Answer: B Diff: 1 Page Ref: 856; Fig. 23.6 5) Serosa. Answer: D Diff: 1 Page Ref: 857; Fig. 23.6 6) Area of the lamina propria. Answer: A Diff: 1 Page Ref: 856; Fig. 23.6 1 Copyright © 2010 Pearson Education, Inc. 7) Continuation of the mesentery. Answer: D Diff: 1 Page Ref: 856; Fig. 23.6 Figure 23.2 Using Figure 23.2, match the following: 8) Absorptive cells that line the intestinal tract. Answer: B Diff: 1 Page Ref: 879; Fig. 23.22 9) Cell type specialized to secrete mucus into the lumen of the intestinal tract. Answer: D Diff: 2 Page Ref: 878; Fig. 23.22 10) Structures that increase the absorptive area of the small intestine. Answer: A Diff: 2 Page Ref: 878; Fig. 23.22 11) Wide lymph capillary located in the villus. Answer: C 2 Copyright © 2010 Pearson Education, Inc. Diff: 2 Page Ref: 878; Fig. 23.22 3 Copyright © 2010 Pearson Education, Inc. 12) Paneth cells are found here. Answer: E Diff: 2 Page Ref: 879; Fig. 23.22 Match the following: A) Peristalsis B) Absorption C) Digestion D) Hydrolysis 13) Wavelike smooth muscle contractions that move foodstuffs through the alimentary tube. Diff: 1 Page Ref: 853 14) Chemical or mechanical process of breaking down foodstuffs to substances that can be absorbed. Diff: 1 Page Ref: 853 15) Enzymatic breakdown of any type of food molecule. Diff: 1 Page Ref: 895 16) Process by which the products of digestion pass through the lumen of the gastrointestinal tract into the blood or lymph. Diff: 1 Page Ref: 854 Answers: 13) A 14) C 15) D 16) B 4 Copyright © 2010 Pearson Education, Inc. Figure 23.3 Using Figure 23.3, match the following: 17) Produces enzymes that break down all categories of foodstuffs. Answer: D Diff: 1 Page Ref: 885; Fig. 23.1 18) Increases surface area for absorption via villi and microvilli. Answer: B Diff: 1 Page Ref: 878; Fig. 23.1 19) Bacteria process undigested chyme from the small intestine. Answer: E Diff: 2 Page Ref: 893; Fig. 23.1 20) Only digestive structure with three muscle layers. Answer: C Diff: 1 Page Ref: 869; Fig. 23.1 21) Receives blood via the hepatic portal system. Answer: A 5 Copyright © 2010 Pearson Education, Inc. Diff: 1 Page Ref: 881; Fig. 23.1 22) Contains the brush border enzymes that complete digestion of carbohydrates and proteins. Answer: B Diff: 2 Page Ref: 878; Fig. 23.1 23) Main function is to filter and process the nutrientrich blood delivered to it. Answer: A Diff: 1 Page Ref: 881; Fig. 23.1 24) Produces intrinsic factor. Answer: C Diff: 2 Page Ref: 870; Fig. 23.1 25) Produces a mucoid barrier. Answer: C Diff: 3 Page Ref: 870; Fig. 23.1 True/False Questions 1) Food is contained in the gastrointestinal tract from the time of ingestion until it is completely digested and the waste prepared for elimination. Answer: TRUE Diff: 1 Page Ref: 853854 2) The circular folds of the small intestine enhance absorption by causing the chyme to spiral, rather than to move in a straight line, as it passes through the small intestine. Answer: TRUE Diff: 2 Page Ref: 878 3) As food passes through the digestive tract, it becomes less complex and the nutrients are more readily available to the body. Answer: TRUE Diff: 1 Page Ref: 853 4) Some of the microbes that often invade other organs of the body are rarely found in the stomach. The reason for this is the presence of HCl. Answer: TRUE Diff: 1 Page Ref: 870 5) Kupffer cells are found in the liver and are responsible for removing bacteria and wornout cells. Answer: TRUE Diff: 1 Page Ref: 881 6 Copyright © 2010 Pearson Education, Inc. 6) The pharyngealesophageal phase of swallowing is involuntary and is controlled by the swallowing center in the thalamus and lower pons. Answer: FALSE Diff: 1 Page Ref: 853, 864 7) All the chemical and mechanical phases of digestion from the mouth through the small intestine are directed toward changing food into forms that can pass through the epithelial cells lining the mucosa into the underlying blood and lymphatic vessels. Answer: TRUE Diff: 1 Page Ref: 895 8) Pepsinogen is the precursor to the gastric enzyme for protein digestion and is secreted by the parietal cells. Answer: FALSE Diff: 1 Page Ref: 897 9) The main chemical activity of the stomach is to begin the digestion of proteins. Answer: TRUE Diff: 1 Page Ref: 866 10) The major role of absorption in the ileum is to reclaim bile salts to be recycled back to the liver. Answer: TRUE Diff: 2 Page Ref: 898 11) The peritoneum is the most extensive serous membrane in the body. Answer: TRUE Diff: 1 Page Ref: 855 12) Peyer's patches are found in the submucosa of the distal end of the small intestine. Answer: TRUE Diff: 1 Page Ref: 880 13) The myenteric nerve plexus provides the major nerve supply to the GI tract wall and controls GI motility. Answer: TRUE Diff: 1 Page Ref: 857 14) The first teeth to appear are the deciduous teeth. Answer: TRUE Diff: 1 Page Ref: 862 15) Dentin anchors the tooth in place. 7 Copyright © 2010 Pearson Education, Inc. Answer: FALSE Diff: 1 Page Ref: 863 16) The digestive function of the liver is to produce bile. Answer: TRUE Diff: 1 Page Ref: 881 17) The pancreas has both an endocrine and an exocrine function. Answer: TRUE Diff: 1 Page Ref: 885886 18) Another term for swallowing is deglutition. Answer: TRUE Diff: 1 Page Ref: 866 19) The intrinsic ability of visceral smooth muscle to exhibit the stressrelaxation response is termed plasticity. Answer: TRUE Diff: 1 Page Ref: 874 20) The stomach's contractile rhythm is set by pacemaker cells found in the spinal cord. Answer: FALSE Diff: 1 Page Ref: 876 21) The major stimulus for production of intestinal fluid is distention or irritation of the intestinal mucosa by hypertonic or acidic chyme. Answer: TRUE Diff: 1 Page Ref: 880 22) Most nutrients are absorbed through the mucosa of the intestinal villi by active transport. Answer: TRUE Diff: 1 Page Ref: 898 23) Ionic iron is actively transported into the mucosal cells, where it binds to the protein ferritin, a phenomenon called the mucosal iron barrier. Answer: TRUE Diff: 1 Page Ref: 900 24) Mumps is an inflammation of the parotid glands caused by myxovirus. Answer: TRUE Diff: 1 Page Ref: 860 25) Fats significantly delay the emptying of the stomach. Answer: TRUE Diff: 2 Page Ref: 876 8 Copyright © 2010 Pearson Education, Inc. 26) The soft palate rises reflexively to open the nasopharynx when we swallow food. Answer: FALSE Diff: 2 Page Ref: 866 9 Copyright © 2010 Pearson Education, Inc. MultipleChoice Questions 1) The mechanical and chemical receptors that control digestive activity are located ________. A) in the glandular tissue that lines the organ lumen B) in the walls of the tract organs C) in the pons and medulla D) only in the esophagus because this is the only part of the tract that needs to change to accommodate food passage Answer: B Diff: 1 Page Ref: 854 2) The function of the hepatic portal circulation is to ________. A) carry toxins to the venous system for disposal through the urinary tract B) collect absorbed nutrients for metabolic processing or storage C) distribute hormones D) return glucose to the general circulation when blood sugar is low Answer: B Diff: 1 Page Ref: 881 3) The chemical and mechanical processes of food breakdown are called ________. A) digestion B) absorption C) ingestion D) secretion Answer: A Diff: 1 Page Ref: 852853 4) When we ingest large molecules such as lipids, carbohydrates, and proteins, they must undergo catabolic reactions whereby enzymes split these molecules. This series of reactions is called ________. A) absorption B) secretion C) chemical digestion D) mechanical digestion Answer: C Diff: 1 Page Ref: 854 5) The sheets of peritoneal membrane that hold the digestive tract in place are called ________. A) mesenteries B) lamina propria C) serosal lining D) mucosal lining Answer: A Diff: 1 Page Ref: 855 10 Copyright © 2010 Pearson Education, Inc. 6) From the esophagus to the anal canal, the walls of every organ of the alimentary canal are made up of the same four basic layers. Arrange them in order from the lumen. A) muscularis externa, serosa, mucosa, and submucosa B) serosa, mucosa, submucosa, and muscularis externa C) submucosa, serosa, muscularis externa, and mucosa D) mucosa, submucosa, muscularis externa, and serosa Answer: D Diff: 1 Page Ref: 856857 7) Which of the following is not a factor that helps create the stomach mucosal barrier? A) thick coating of bicarbonaterich mucus B) tight junctions of epithelial mucosa cells C) replacing of damaged epithelial mucosa cells D) rennin Answer: D Diff: 2 Page Ref: 870 8) What part of the tooth bears the force of chewing? A) crown B) enamel C) pulp D) cementum Answer: B Diff: 1 Page Ref: 863 9) The capillaries that nourish the epithelium and absorb digested nutrients lie in the ________. A) muscularis mucosae B) serosa C) adventitia D) lamina propria Answer: D Diff: 1 Page Ref: 856 10) Which hormone causes an increased output of enzymerich pancreatic juice and stimulates gallbladder contraction to release bile? A) gastrin B) secretin C) cholecystokinin D) gastric inhibitor peptide Answer: C Diff: 1 Page Ref: 886 11 Copyright © 2010 Pearson Education, Inc. 11) Choose the incorrect statement regarding bile. A) Bile is both an excretory product and a digestive secretion. B) Bile functions to emulsify fats. C) Bile functions to carry bilirubin formed from breakdown of wornout RBCs. D) Bile contains enzymes for digestion. Answer: D Diff: 1 Page Ref: 884 12) The absorptive effectiveness of the small intestine is enhanced by increasing the surface area of the mucosal lining. Which of the following accomplish this task? A) plicae circulares and intestinal villi B) the vast array of digestive enzymes C) Brunner's glands D) the rugae Answer: A Diff: 1 Page Ref: 878 13) Select the statement that is true concerning primary teeth. A) There are 27 primary teeth, and the molars are permanent. B) There are 24 primary teeth, and no new primary teeth appear after 13 months. C) There are 20 primary teeth, and by 24 months of age most children have all 20. D) There are 32 primary teeth, and most children lose these teeth due to decay because they are never very strong. Answer: C Diff: 1 Page Ref: 862 14) Which of the following is true concerning the number and type of permanent teeth? A) There are 32 permanent teeth, and the wisdom teeth are the last to emerge. B) There are 27 permanent teeth, and the first molars are usually the last to emerge. C) The number of permanent teeth is always equal to the number of primary teeth. D) The number of upper permanent teeth is not equal to the number of lower permanent teeth. Answer: A Diff: 1 Page Ref: 862 15) Which of the following is not true of saliva? A) cleanses the mouth B) contains enzymes that begin the breakdown of proteins C) moistens food and aids in compacting of the bolus D) dissolves food chemicals so they can be tasted Answer: B Diff: 1 Page Ref: 860 12 Copyright © 2010 Pearson Education, Inc. 16) The salivary glands are composed of which two types of secretory cells? A) goblet cells and squamous epithelial cells B) parietal cells and glial cells C) serous cells and mucous cells D) cuboidal epithelium and ciliated columnar cells Answer: C Diff: 1 Page Ref: 860 17) The solutes contained in saliva include ________. A) only salts and minerals B) only proteases and amylase C) mucin, lysozyme, electrolytes, salts, and minerals D) electrolytes, digestive enzyme, mucin, lysozyme, wastes, and IgA Answer: D Diff: 1 Page Ref: 860861 18) In addition to storage and mechanical breakdown of food, the stomach ________. A) initiates protein digestion and denatures proteins B) is the first site where absorption takes place C) is the only place where fats are completely digested D) is the first site where chemical digestion of starch takes place Answer: A Diff: 1 Page Ref: 866, 871 19) Chyme is created in the ________. A) mouth B) stomach C) esophagus D) small intestine Answer: B Diff: 1 Page Ref: 866 20) Hydrochloric acid is secreted by which of the secretory cells of the stomach? A) chief cells B) parietal cells C) serous cells D) mucous neck cells Answer: B Diff: 1 Page Ref: 870 13 Copyright © 2010 Pearson Education, Inc. 21) Gastrin, histamine, endorphins, serotonin, cholecystokinin, and somatostatin are hormones or paracrines that are released directly into the lamina propria. Which of the following cell types synthesize and secrete these products? A) enteroendocrine cells B) parietal cells C) zymogenic cells D) mucous neck cells Answer: A Diff: 1 Page Ref: 870 22) There are three phases of gastric secretion. The cephalic phase occurs ________. A) before food enters the stomach and is triggered by aroma, sight, or thought B) immediately after food enters the stomach, preparing the small intestine for the influx of a variety of nutrients C) at the end of a large meal, and the juices secreted are powerful and remain in the GI tract for a long period of time D) when the meal is excessively high in acids and neutralization is required Answer: A Diff: 1 Page Ref: 872873 23) Peristaltic waves are ________. A) segmental regions of the gastrointestinal tract B) churning movements of the gastrointestinal tract C) pendular movements of the gastrointestinal tract D) waves of muscular contractions that propel contents from one point to another Answer: D Diff: 1 Page Ref: 853 24) Gastrin is a digestive hormone that is responsible for the stimulation of acid secretions in the stomach. These secretions are stimulated by the presence of ________. A) starches and complex carbohydrates B) protein and peptide fragments C) simple carbohydrates and alcohols D) fatty acids Answer: B Diff: 1 Page Ref: 873 25) Pepsinogen, a digestive enzyme, is secreted by the ________. A) chief cells of the stomach B) parietal cells of the duodenum C) Brunner's glands D) goblet cells of the small intestine Answer: A Diff: 1 Page Ref: 870 14 Copyright © 2010 Pearson Education, Inc. 26) You have just eaten a meal high in complex carbohydrates. Which of the following enzymes will help to digest the meal? A) gastrin B) amylase C) cholecystokinin D) trypsin Answer: B Diff: 1 Page Ref: 895 27) The ducts that deliver bile and pancreatic juice from the liver and pancreas, respectively, unite to form the ________. A) portal vein B) pancreatic acini C) bile canaliculus D) hepatopancreatic ampulla Answer: D Diff: 1 Page Ref: 886 28) The enzymatic breakdown of any type of food molecule is called ________. A) diffusion B) active transport C) hydrolysis D) denatured Answer: C Diff: 1 Page Ref: 895 29) Shortchain triglycerides found in foods such as butterfat molecules in milk are split by a specific enzyme in preparation for absorption. Which of the following enzymes is responsible? A) rennin B) pepsin C) lipase D) cholecystokinin Answer: C Diff: 1 Page Ref: 897 30) Parietal cells of the stomach produce ________. A) mucin B) pepsinogen C) hydrochloric acid D) rennin Answer: C Diff: 1 Page Ref: 870 15 Copyright © 2010 Pearson Education, Inc. 31) Hepatocytes do not ________. A) produce digestive enzymes B) process nutrients C) store fatsoluble vitamins D) detoxify Answer: A Diff: 1 Page Ref: 881 32) Which of the following is not a phase of gastric secretion? A) cephalic B) gastric C) intestinal D) enterogastric Answer: D Diff: 1 Page Ref: 872873 33) Which vitamin requires intrinsic factor in order to be absorbed? A) B 12 B) K C) A D) C Answer: A Diff: 2 Page Ref: 871 34) Chief cells ________. A) occur in the intestine B) produce HCl C) are found in the basal regions of the gastric glands D) produce mucin Answer: C Diff: 1 Page Ref: 870 35) Chemical digestion reduces large complex molecules to simpler compounds by the process of ________. A) mastication B) catabolism C) anabolism D) fermentation Answer: B Diff: 1 Page Ref: 854 16 Copyright © 2010 Pearson Education, Inc. 36) The ________ contains lobules with sinusoids (lined with macrophages) that lead to a central venous structure. A) liver B) spleen C) pancreas D) stomach Answer: A Diff: 1 Page Ref: 881 37) If an incision has to be made in the small intestine to remove an obstruction, the first layer of tissue to be cut is the ________. A) serosa B) mucosa C) muscularis externa D) submucosa Answer: A Diff: 1 Page Ref: 857 38) The terminal portion of the small intestine is known as the ________. A) duodenum B) ileum C) jejunum D) pyloric sphincter Answer: B Diff: 1 Page Ref: 877 39) The dental formula for an adult is 2123. What does the 1 stand for? A) incisor tooth B) molar tooth C) premolar tooth D) canine tooth Answer: D Diff: 2 Page Ref: 863 40) Digestion of which of the following would be affected the most if the liver were severely damaged? A) lipids B) carbohydrates C) proteins D) starches Answer: A Diff: 1 Page Ref: 881 17 Copyright © 2010 Pearson Education, Inc. 41) ________ is locally regulated in the blood by the active form of vitamin D, which acts as a cofactor. A) Iron B) Sodium C) Phosphorus D) Calcium Answer: D Diff: 2 Page Ref: 900 42) Important peritoneal folds do not include the ________. A) omenta B) peritoneum C) mesentery D) round ligament Answer: D Diff: 1 Page Ref: 855 43) The lamina propria is composed of ________. A) loose connective tissue B) dense irregular connective tissue C) dense regular connective tissue D) reticular connective tissue Answer: A Diff: 1 Page Ref: 856 44) ________ is (are) not important as a stimulus in the gastric phase of gastric secretion. A) Distension B) Carbohydrates C) Peptides D) Low acidity Answer: B Diff: 1 Page Ref: 873 45) Pancreatic amylase does not get to the small intestine via the ________. A) accessory pancreatic duct B) main pancreatic duct C) cystic duct D) hepatopancreatic ampulla Answer: C Diff: 1 Page Ref: 886 18 Copyright © 2010 Pearson Education, Inc. 46) The function of the goblet cells is to ________. A) absorb nutrients from digested food and store them for future use B) produce mucus that protects parts of the digestive organs from the effects of powerful enzymes needed for food digestion C) secrete buffers in order to keep the pH of the digestive tract close to neutral D) provide protection against invading bacteria and other diseasecausing organisms that enter the digestive tract in food Answer: B Diff: 2 Page Ref: 878 47) Which of the following is an essential role played by large intestine bacteria? A) produce gas B) absorb bilirubin C) synthesize vitamin K and Bcomplex vitamins D) synthesize vitamins C and D Answer: C Diff: 1 Page Ref: 893 48) Nervous control of gastric secretion is provided by ________. A) somatic neurons in the spinal cord B) the vagus nerve and enteric plexus C) the rubrospinal tracts D) the reticulospinal and vestibulospinal tracts Answer: B Diff: 2 Page Ref: 873 49) Which of the following are types of papillae on the tongue that contain taste buds? A) fungiform and circumvallate B) palatine and circumvallate C) circumvallate and filiform D) fungiform, circumvallate, and filiform Answer: A Diff: 2 Page Ref: 859 50) Which of the following produce intrinsic factor? A) parietal cells B) zymogenic cells C) mucous neck cells D) enteroendocrine cells Answer: A Diff: 2 Page Ref: 870 19 Copyright © 2010 Pearson Education, Inc. 51) Which of the following enzymes is specific for proteins? A) dextrinase B) amylase C) trypsin D) lipase Answer: C Diff: 2 Page Ref: 897 52) Surgical cutting of the lingual frenulum would occur in which part of the body? A) tongue B) esophagus C) nasal cavity D) salivary glands Answer: A Diff: 2 Page Ref: 859 53) A fluid secreted into the small intestine during digestion that contains cholesterol, emulsification agents, and phospholipids is ________. A) bile B) pancreatic juice C) intestinal juice D) gastric juice Answer: A Diff: 2 Page Ref: 884 54) The layer of the digestive tube that contains blood vessels, lymphatic nodes, and a rich supply of elastic fibers is the ________. A) mucosa B) submucosa C) muscularis externa D) serosa Answer: B Diff: 2 Page Ref: 856857 55) Which of the following is not characteristic of the large intestine? It ________. A) does not contain villi B) exhibits external muscular bands called teniae coli C) is longer than the small intestine D) has haustra Answer: C Diff: 2 Page Ref: 890 20 Copyright © 2010 Pearson Education, Inc. 56) What stomach secretion is necessary for normal hemoglobin production in RBCs? A) HCl B) pepsinogen C) intrinsic factor D) gastric lipase Answer: C Diff: 1 Page Ref: 870 57) How are most nutrients absorbed through the mucosa of the intestinal villa? A) simple diffusion B) facilitated diffusion C) active transport driven directly or indirectly by metabolic energy D) bulk flow Answer: C Diff: 2 Page Ref: 878 58) Select the correct statement about the regulation of gastric secretion. A) Vagus stimulation of the stomach results in decreased secretion of gastric juice. B) The presence of food in the stomach prevents hormonal control of gastric secretion. C) Gastric secretion can be stimulated before food has entered the mouth. D) Gastric secretion is enhanced by very low pH (below a pH of 2). Answer: C Diff: 2 Page Ref: 872873 59) Paneth cells ________. A) are more common in the ileum than in the jejunum B) are absorptive cells in the small intestine C) secrete enzymes that kill bacteria D) are located next to the lacteal in a villus Answer: C Diff: 2 Page Ref: 879 60) Select the correct statement about digestive processes. A) Enterogastrone is a hormone that helps increase gastric motility. B) Pepsin is an enzyme produced by the stomach for the purpose of starch digestion. C) Chyme entering the duodenum can decrease gastric motility via the enterogastric reflex. D) All commonly ingested substances are significantly absorbed by the mucosa of the stomach. Answer: C Diff: 2 Page Ref: 887, 889 21 Copyright © 2010 Pearson Education, Inc. 61) Chemical digestion in the small intestine involves ________. A) a significant amount of enzyme secretion by the intestinal mucosa B) cholecystokinin (CCK), an intestinal hormone responsible for gallbladder contraction C) secretions from the spleen that contain all enzymes necessary for complete digestion D) bile salts that help emulsify carbohydrates so that they can be easily digested by enzymatic action Answer: B Diff: 2 Page Ref: 886 62) Select the correct statement about absorption. A) Eighty percent of ingested materials have been absorbed by the end of the large intestine. B) Carbohydrates diffuse across the villus epithelium and are then actively transported into blood capillaries. C) If intact proteins are transported across the villus epithelium, an immune response may be generated. D) Amino acid transport is linked to chloride transport. Answer: C Diff: 2 Page Ref: 899 63) Select the correct statement about electrolyte absorption. A) Chlorine ion absorption is coupled to glucose and amino acid transport. B) Potassium moves across the epithelium by active transport. C) If vitamin B is not present, calcium is not absorbed. D) Iron and calcium are absorbed mostly by the duodenum. Answer: D Diff: 2 Page Ref: 900 64) You have just eaten french fries, buttered toast, ice cream, and whole milk. Which of the following glands would be active in helping you to digest this food? A) the pancreas B) the buccal glands C) the thyroid gland D) the parotid glands Answer: A Diff: 3 Page Ref: 885 65) The ingestion of a meal high in fat content would cause which of the following to occur? A) Severe indigestion would occur, caused by the lack of sufficient digestive enzymes. B) This type of food would cause secretion of gastrin to cease, causing digestive upset. C) Bile would be released from the gallbladder to emulsify the fat in the duodenum. D) The acid secretions from the stomach would be sufficient to digest this food. Answer: C Diff: 3 Page Ref: 885 22 Copyright © 2010 Pearson Education, Inc. 66) The mucosa of the developing alimentary tube comes from ________. A) ectoderm B) mesoderm C) endoderm D) pachyderm Answer: C Diff: 3 Page Ref: 901, 904 67) A baby is admitted to the hospital with a history of projectile vomiting after each feeding. On examination, it is found that the sphincter controlling food passage from the stomach to the duodenum is thickened and does not open readily. Because of the baby's loss of gastric juice, his blood probably indicates ________. A) acidosis B) ketosis C) alkalosis D) dysphagia Answer: C Diff: 3 Page Ref: 876878 68) Hormones or paracrines that inhibit gastric secretion include ________. A) ACh B) secretin C) gastrin D) histamine Answer: B Diff: 3 Page Ref: 873; Tbl. 23.1 69) Which of these is not part of the splanchnic circulation? A) hepatic portal vein B) inferior vena cava C) superior mesenteric artery D) celiac artery Answer: B Diff: 2 Page Ref: 856 70) Which of these is not a component of saliva? A) lysozyme B) a cyanide compound C) defensins D) nitric oxide Answer: D Diff: 2 Page Ref: 860 23 Copyright © 2010 Pearson Education, Inc. 71) There are some 20 known pathogens found in the large intestine; our Ig ________ antibody mediated response restricts them from going beyond the mucosa and causing problems. A) D B) A C) M D) E Answer: B Diff: 1 Page Ref: 893 FillintheBlank/Short Answer Questions 1) The longest portion of the small intestine is the ________. Answer: ileum Diff: 1 Page Ref: 877 2) ________ is the principal enzyme for breaking down carbohydrates. Answer: Amylase Diff: 1 Page Ref: 895 3) ________ cells of the stomach secrete HCl. Answer: Parietal Diff: 2 Page Ref: 870 4) The chief bile pigment is ________. Answer: bilirubin Diff: 2 Page Ref: 884 5) ________ is another word for vomiting. Answer: Emesis Diff: 2 Page Ref: 876 6) The portal triad contains ________. Answer: a branch of the hepatic artery, a branch of the hepatic portal vein, and a bile duct. Diff: 2 Page Ref: 881 7) ________ cells are found in the sinusoids of the liver, and they remove debris from the blood as it flows past. Answer: Kupffer Diff: 2 Page Ref: 881 8) ________ peritoneum covers the external surfaces of most digestive organs. Answer: Visceral Diff: 2 Page Ref: 855 9) The ________ ligament anchors a tooth in the alveolus of the jaw. 24 Copyright © 2010 Pearson Education, Inc. Answer: periodontal Diff: 2 Page Ref: 863 10) The ________ phase of gastric secretions occurs before food enters the stomach. Answer: cephalic (or reflex) Diff: 2 Page Ref: 872873 11) The round ligament is a remnant of the fetal ________. Answer: umbilical vein Diff: 2 Page Ref: 881 12) Compare and contrast the structure and function of a premolar and a molar. Answer: Premolars have a broad crown with rounded cusps but have only one root. Molars also have broad crowns with rounded cusps but are larger than premolars. Molars have at least two roots. Diff: 2 Page Ref: 862 13) What are chylomicrons? Answer: Chylomicrons are tiny fatty droplets composed of triglycerides, small amounts of phospholipids, cholesterol, free fatty acids, and some protein. Diff: 1 Page Ref: 900 14) What is heartburn and what causes it? Answer: Heartburn is the discomfort felt in the chest area when the acidic gastric juices get regurgitated into the esophagus. This may happen when someone has eaten or drunk too much, or it can be caused by extreme obesity or the discomfort of pregnancy. It is sometimes due to obstructions or structural faults in the esophagus as well. Diff: 2 Page Ref: 864865 15) Name two regions of the digestive tract where mechanical food breakdown processes are very important. Name two organs that are primarily food conduits. Name the organ where protein digestion is begun. Name the organ where fat digestion begins. Answer: Mechanical food processes are very important in the mouth (mastication) and stomach (contractions causing mixing of food into chyme). The esophagus and pharynx are primarily food conduits. Protein digestion begins in the stomach. Fat digestion begins in the small intestine. Diff: 2 Page Ref: 853854 16) Define constipation and diarrhea. Note possible causes of each. Answer: Watery stools are called diarrhea. Constipation is a condition in which too much water has been absorbed and the stool becomes hard and difficult to pass. Any condition (such as irritation of the colon by bacteria) that rushes food residue through the large intestine before that organ has had sufficient time to absorb the remaining water is known as diarrhea. Constipation may ensue from the lack of fiber in the diet, improper bowel habits, laxative abuse, or anything that decreases motility. 25 Copyright © 2010 Pearson Education, Inc. Diff: 2 Page Ref: 895 26 Copyright © 2010 Pearson Education, Inc. 17) Assume you have been chewing a piece of bread for 5 or 6 minutes. How would you expect its taste to change during this time? Why? Answer: The bread will begin to taste sweet as some of the starch is broken down into sugar due to the chemical digestion of carbohydrates by salivary amylase. Diff: 1 Page Ref: 895 18) Name the three pairs of major salivary glands. Describe their relative locations and their microscopic differences. Answer: The parotid glands lie anterior to the ears between the masseter muscle and the skin. They open into the vestibule next to the second molars of the upper jaw. The submandibular glands lie along the medial aspect of the mandibular body. Their ducts run beneath the mucosa of the oral cavity floor and open at the base of the lingual frenulum. The small sublingual glands lie anterior to the submandibular glands under the tongue. They open via many ducts into the floor of the mouth. Parotid glands contain only serous cells; submandibular glands have equal numbers of serous and mucous cells; and sublingual glands are mostly mucous cells. Diff: 3 Page Ref: 860 19) Why is it necessary for the stomach contents to be so acidic? How does the stomach protect itself from digestion? Answer: HCl is necessary for the activation and optimal activity of pepsin, and it kills many of the bacteria ingested with food. Mucous cells in the lining of the stomach secrete an alkaline mucus that clings to the stomach wall and helps to shield it from the acid. The epithelial cells of the mucosa are joined together by tight junctions that prevent gastric juice from leaking into underlying tissue layers. Damaged epithelial cells are shed and quickly replaced by cell division. Diff: 3 Page Ref: 870 20) Identify three ways the small intestine is modified to increase the surface area for digestion and absorption. Answer: The plicae circulares, villi, and microvilli are modifications of the small intestine for digestion and absorption. The plicae circulares are circular folds of the mucosa and submucosa. They force chyme to move spirally through the lumen. The villi are fingerlike projections of the mucosa. They increase the absorptive surface area. Microvilli are projections of the plasma membrane of the absorptive cells of the mucosa that bear intestinal digestive enzymes. They also increase surface area and enhance absorption. Diff: 3 Page Ref: 878 21) How is digestive activity provoked after eating? What activates the secretion of digestive juices into the lumen or hormones into the blood? Answer: Sensors (mechanoreceptors and chemoreceptors) located in the walls of the gastrointestinal tract respond to stretching by the introduction of food into the lumen. Also, the sensors are able to respond to changes in solute concentration and pH as well as the presence of substrates and end products of digestion. Diff: 2 Page Ref: 854 27 Copyright © 2010 Pearson Education, Inc. 22) How is salivation controlled? Answer: When we ingest food, chemoreceptors and pressoreceptors in the mouth send signals to the salivatory nuclei in the brain stem. The parasympathetic nervous system activity increases and motor fibers trigger the increase in serous, enzymerich saliva. Diff: 2 Page Ref: 861 23) What is bile and where is it produced? What is its digestive function? Where is it stored and concentrated? Answer: Bile is an alkaline solution containing bile salts, bile pigments, cholesterol, neutral fats, phospholipids, and a variety of electrolytes. It is produced in the liver. Its digestive function is to emulsify fats. It is stored and concentrated in the gallbladder. Diff: 2 Page Ref: 884 Clinical Questions 1) Richard is told by his family doctor that he is bleeding from either the colon or the rectum, and he should see a specialist as soon as possible. Which specialist should he go see? Answer: Richard should see a proctologist. Diff: 1 Page Ref: 905 2) Mrs. Wong goes to the emergency room with the following symptoms: severe pain in the umbilical region, loss of appetite, nausea, and vomiting. While she was waiting to see a doctor, the pain moved to the lower right abdominal quadrant. What is the diagnosis and treatment? Answer: The diagnosis is appendicitis. The accepted treatment is immediate surgical removal of the appendix. Diff: 2 Page Ref: 890 3) Jose is brought to the emergency room complaining of a burning sensation in his chest, increased salivation, and difficulty in swallowing. He is having difficulty breathing and feels the presence of a "lump in his throat." The diagnosis is gastroesophageal reflux disease. Explain. Answer: Gastroesophageal reflux disease is a disorder in which the rate of reflux is greater than in normal individuals and causes clinical symptoms and/or histological changes. Reflux and regurgitation may result in aspiration of gastric contents into the air passages, causing respiratory distress such as hoarseness, asthma, and pneumonia. The sensation of a lump in his throat may be due to esophageal sphincter pressure. Diff: 2 Page Ref: 864865 4) Sami has been hospitalized with acute gastritis. Her symptoms were epigastric pressure (just above the stomach), headache, nausea, and vomiting. She revealed that she had been suffering back pain and drank four shots of gin and took three aspirin to "kill the pain." What led the physician to make this diagnosis, and what may have caused the sudden attack? Answer: Gastritis is an inflammation of the mucosal lining of the stomach. The probable reason for the abrupt onset of symptoms is due to rapid and heavy ingestion of alcohol and aspirin. Acute gastritis is often due to chemical irritants, particularly alcohol or salicylate. Diff: 2 Page Ref: 870 28 Copyright © 2010 Pearson Education, Inc. 29 Copyright © 2010 Pearson Education, Inc. 5) A woman is brought to an emergency room complaining of severe pain in her left iliac region. She claims previous episodes and says that the condition is worse when she is constipated, and is relieved by defecation. A large, tender mass is palpated in the left iliac fossa and a barium study reveals a large number of diverticula in her descending and sigmoid colon. What are diverticula, and what is believed to promote their formation? Does this woman have diverticulitis or diverticulosis? Explain. Answer: Diverticula are small herniations of the mucosa through the colon walls, a condition called diverticulosis. They are believed to form when the diet lacks bulk and the volume of residue in the colon is small. The colon narrows contractions of its circular muscles and they become more powerful, increasing the pressure on its walls. Diverticulitis is a condition in which the diverticula become inflamed. This woman has diverticulitis due to the inflammation of her diverticula. Diff: 3 Page Ref: 894 6) A patient is 67 years old and has had a hiatal hernia for three years. In the last year, she has complained of worsening heartburn, especially at night. What are the characteristic symptoms of a hiatal hernia and which of these symptoms did the patient have? Answer: Heartburn and regurgitation from gastroesophageal reflux are the most common clinical manifestations of hiatal hernia. This patient complained of heartburn. Diff: 2 Page Ref: 865 7) A patient was admitted to the hospital because of severe epigastric pain. He has noted that his stools were darker than the usual brown color. He appears pale and very anxious. The history reports that he drinks 23 beers per day and smokes 2 packs of cigarettes a day. Based on the assessment data, what condition might the nurse determine this patient has? Explain why. Answer: The patient most likely has a gastric ulcer. The most distressing symptom of a gastric ulcer is gnawing epigastric pain that seems to bore through to the back. The danger posed by ulcers is perforation of the stomach wall followed by peritonitis and massive hemorrhage. Because the patient's stools are darker than usual and he is pale and anxious, the nurse suspects a bleeding ulcer. Factors such as smoking and alcohol increase hypersecretion of hydrochloric acid and low secretion of mucus. Diff: 3 Page Ref: 870 8) A patient has esophageal cancer and must have a feeding tube inserted. The nurse tells the patient that the tube will be inserted surgically into the duodenum. The patient's wife asks why the tube will not be inserted into the stomach. What should the nurse say? Answer: The duodenum is part of the small intestine, which is the body's major digestive organ. Digestion is completed and absorption is best in the small intestine. There is also less risk for vomiting, which may cause complications. Diff: 3 Page Ref: 877 30 Copyright © 2010 Pearson Education, Inc. 9) A 45yearold patient was admitted to the hospital with a diagnosis of cirrhosis of the liver. He is thin and malnourished. His abdomen is very large due to an accumulation of fluid in the abdominal cavity. His lower extremities are very swollen. Explain why these changes have occurred. Answer: Cirrhosis is a diffuse and progressive chronic inflammation of the liver that typically results from chronic alcoholism or severe chronic hepatitis. Cirrhosis is characterized by extensive degeneration and destruction of the liver parenchymal cells. Edema and ascites (accumulation of fluid in the peritoneal cavity) are the clinical manifestations of the portal hypertension. Diff: 3 Page Ref: 884 10) A 45yearold patient was admitted to the hospital with a diagnosis of cirrhosis of the liver. The nurse is observing him closely for the possibility of gastrointestinal bleeding. Why is this considered a possible complication? Answer: As scar tissue eventually shrinks, it obstructs blood flow throughout the hepatic portal system, causing portal hypertension. Some veins of the portal system anastomose with veins that drain into the venae cavae. However, these connecting veins are small and tend to burst when forced to carry large volumes of blood. Signs of their failure include vomiting blood. Diff: 3 Page Ref: 884 31 Copyright © 2010 Pearson Education, Inc.
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