1. Assignment Question and Answer (Short)
Course Title & No – Human Physiology and metabolism-5006
Chapter-Blood
Date of exam: 22/11/2013
1. # Q. Define blood. Discuss the functions of blood in detail.
Definition: Blood is a bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to
the cells and transports metabolic waste products away from those same cells.
Functions of Blood:
I. Transport of respiratory gases, eg. O2, lungs → tissue and tissue → lungs
II. Transport of Nutrition eg. Digested food material absorbed from intestine to Tissue cells
III. Acts as a vehicle: eg. Hormones & vitamins are brought to their places of activity.
IV. Drainage of waste products: e.g., kidney, intestine etc.
V. Maintenance of water balance
VI. Maintenance of acid base equilibrium: Blood acts as a buffer to maintain the acid-base balance i.e.
concentration of H+ and OH- ions of the body
VII. Regulation of body temperature
VIII. Defensive action: Blood helps in body defenses against disease, e.g. bacteria.
IX. Property of coagulation:
X. The plasma proteins of blood: The plasma proteins maintain colloid osmotic pressure of the blood
(75% by albumins, 25% by globulins and almost none by fibrinogen).
XI. Regulation of blood pressure
2. # Q. What do you know about plasma protein/blood protein/serum protein?
Definition: Plasma proteins, also termed serum proteins or blood proteins, are proteins present in blood
plasma.
Explanation:
Serum albumin accounts for 55% of blood proteins,
Globulins make up 38% of blood proteins and transport ions, hormones and lipids assisting in immune function.
Fibrinogen comprises- 7% of blood proteins; conversion of fibrinogen to insoluble fibrin is essential for blood
clotting.
The remainder of plasma proteins (1%) is made up of regulatory proteins such as enzymes, pro-enzymes and
hormones.
All blood proteins are synthesized in liver except for the gamma globulins.
Separating serum proteins by electrophoresis is a valuable diagnostic tool as well as a way to monitor clinical
progress. The normal laboratory value of serum total protein is around 7 g /d L.
3. #.Q. What is blood clotting? Mention the names of blood clotting factors.
Blood Clotting:
Blood clotting is a process in which liquid blood is changed into a semisolid mass (blood clot). The ability of the
body to control the flow of blood following vascular injury is paramount to continued survival.
The 13 blood coagulation factors are:
Factor I - Fibrinogen
Factor II - Prothrombin
Factor III - Tissue thromboplastin (tissue factor)
Factor IV - Ionized calcium (Ca++ )
Factor V - Proaccelerin
Factor VI - Accelerin
Factor VII - Proconvertin
Factor VIII - Antihemophilic factor (AHF)
Factor IX - Plasma thromboplastin component (PTC)
Factor X - Prower factor
Factor XI - Plasma thromboplastin antecedent (PTA)
Factor XII - Hageman factor
Factor XIII - Fibrin-stabilizing factor
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2. 4. #. Q. Show the waterfall scheme of intrinsic and extrinsic blood coagulation.
Fig: waterfall scheme
5. #. Q. What is hemoglobin (Hb)? Describe the structure of (Hb)
Definition: Hemoglobin (Hb or Hgb) is the iron-containing oxygen-transport metalloproteinase in the red blood
cells of all vertebrates. Hemoglobin in the blood carries oxygen from the respiratory organs (lungs or gills) to the
rest of the body (i.e. the tissues) where it releases the oxygen to burn nutrients to provide energy to power the
functions of the organism, and collects the resultant carbon dioxide to bring it back to the respiratory organs to be
dispensed from the organism.
Haemoglobin structure: The hemoglobin molecule is made up of 4 poly-peptide chains. There are 2 alpha chains
and 2 beta chains and each chain contains 1 iron-Haem group which binds to an O2 molecules.
Fig: Hemoglobin
2
Deficiency causes a form
of haemophilia
Ca+2 needed for clotting.
Require Vitamin K for
synthesis
A
B
C

3. 6. #. Q. Write a note on Oncotic pressure(Colloidal Osmotic Pressure)
Oncotic pressure, or colloid osmotic pressure, is a form of osmotic pressure exerted by proteins in a blood
vessel's plasma (blood/liquid) that usually tends to pull water into the circulatory system. It is the opposing force
to hydrostatic pressures
In other words, the oncotic pressure tends to pull fluid into the capillaries. In conditions where plasma proteins
are reduced, e.g. from being lost in the urine or from malnutrition.
The total oncotic pressure of an average capillary is about 28 mmHg with albumin contributing approximately 22
mmHg of this oncotic pressure.
Oncotic pressure values are approximately 290 mosm per kg of water, which slightly differs from the osmotic
pressure of the blood that has values approximating 300mmol/l.
7. #. Q. What is bone marrow? Discuss the types of bone marrow
Bone marrow is the soft spongy tissue that lies within the
hollow interior of long bones. Bone marrow forms around 4%
of total body weight (around 2.6 kg in a healthy adult).
Types of bone marrow
There are two types of bone marrow:
1. Red marrow that is responsible for producing
 red blood cells,
 platelets and
 white blood cells divided 5 types
I. Neutrophil: Neutrophils defend against bacterial or
fungal infection.
II. Basophile: Basophiles are chiefly responsible for
allergic and antigen response by releasing the chemical
histamine causing vasodilatation
III. Eosinophil : Eosinophils primarily deal with parasitic infections. Eosinophils are also the predominant
inflammatory cells in allergic reactions.
IV. Monocytes: Monocytes share the "vacuum cleaner" (phagocytosis) function of neutrophils, but are much longer
lived as they have an additional role
V. Lymphocyte: Lymphocytes are much more common in the lymphatic system. Lymphocytes are distinguished by
having a deeply staining nucleus that may be eccentric in location, and a relatively small amount of cytoplasm.
2. Yellow marrow consisting mainly of fat cells.
At birth and in early childhood most of the marrow is red. As a person ages more and more of it is
converted to the yellow type. About half of adult bone marrow is red.
Functions of bone marrow
• Red blood cells (erythrocytes) carry oxygen to the tissues.
• White blood cells of various kinds make up part of your immune system for fighting infections.
• Platelets (thrombocytes) help prevent bleeding and aid in clotting of blood.
• Granulocytes and macrophages fight infections from bacteria, fungi, and other parasites.
• Granulocytes and macrophages also remove dead cells and remodel tissue and bones.
• B-lymphocytes produce antibodies, while T-lymphocytes can directly kill or isolate invading cells.
8. #. Q. Write down the stages of development of R.B.C.
Red blood cells, also called erythrocytes, are formed from a pluripotent stem cell.
Because of the inability of erythrocytes (red blood cells) to divide to replenish their own numbers, the old
ruptured cells must be replaced by totally new cells. They meet their demise because they don’t have the usual
specialized intracellular machinery, which controls cell growth and repair, leading to a short life span of 120
days. During this time the erythrocytes are continually moved by the blood flow push (in arteries), pull (in veins)
and a combination of the two as they squeeze through micro vessels such as capillaries.
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4. This short life span necessitates the process erythropoiesis, which is the formation of red blood cells. All blood
cells are formed in the bone marrow. This is the erythrocyte factory, which is soft, highly cellar tissue that fills the
internal cavities of bones.
9. #. Q. What are trephines?
Trephine is a hormone that stimulates the growth and division of cells in tissue culture. The term was invented
in 1922 by the French path physiologist
A. Carrel, who noticed that fibroblastic growth, was stimulated by leukocytes, as well as by embryo and tumour
cells. The term later became less common, since substances differing in chemical composition were discovered
to be capable of stimulating cell growth.
This factor, which has a molecular weight of about 30,000, was discovered to be a lipoprotein containing
neuraminic acid. Thus, what was thought to be a trephine is actually a large group of substances, each with its
own name.
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5. Chapter-Heart
1. #. Q. What is circulatory system? Classify circulatory system.
Circulatory system:
The system that’s circulates blood through the body, consisting of the heart and blood vessel. In vertebrates, the
lymphatic system is also considered part of the circulatory system.
I. Closed circulatory system
Closed circulatory systems have the blood closed at all times within vessels of different size and wall
thickness. In this type of system, blood is pumped by a heart through vessels, and does not normally fill
body cavities
II. Open circulatory system
the open circulatory system is common to mollusks and arthropods. Blood is pumped by a heart into the
body cavities, where tissues are surrounded by the blood
III. Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body.
There are three major types of blood vessels:
• The arteries, which carry the blood away from the heart;
• The capillaries, which enable the actual exchange of water and chemicals between the blood
• The tissues, and the veins, which carry blood from the capillaries back toward the heart.
2. #. Q. Define heart .Draw the picture of heart and indicate its different parts.
The heart is a hollow muscle that pumps blood throughout the blood vessels by repeated, rhythmic contractions.
It is found in all animals with a circulatory system, which includes the vertebrates.
The average human heart beat at 72 beats per minute. It weighs approximately 250 to 300 grams in females
and 300 to 350 grams in males
Fig: Human Heart
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6. 3. #. Q. Write down the functions of heart.
Functions of Heart
1. In mammals of the right side of the heart is to collect de-oxygenated blood, in the right atrium, from the body
2. The left side of the heart collects oxygenated blood from the lungs into the left atrium.
3. Carbon dioxide can be dropped off and oxygen picked up (gas exchange).
4. The aorta forks and the blood are divided between major arteries which supply the upper and lower body.
5. The heart is effectively a syncytium
6. The heart relates to electrical stimulation of one cell spreading to neighboring cells.
7. Cardiac muscle cells are electrically coupled by inter-calculated disks
8. The impulses also pass to another region of specialized cardiac muscle tissue,
9. An extremely rapid heartbeat which prevents the heart from effectively pumping blood
10. Cardiac arrest is the sudden cessation of normal heart rhythm which can include a number of pathologies such
as tachycardia,
4. #. Q. Why arteries look red in color?
Arteries are blood vessels that carry oxygenated blood away from the heart
The arteries are perceived as carrying oxygenated blood to the tissues, while veins carry deoxygenated blood
back to the heart.
This is true of the systemic circulation, by far the larger of the two circuits of blood in the body, which transports
oxygen from the heart to the tissues of the body.
In addition, deoxygenated blood that is carried from the tissues back to the heart for re-oxygenation in systemic
circulation still carries some oxygen, though it is considerably less than that carried by the systemic arteries.
From the above discussion we understand that arteries look red in color because arteries carried oxygenated
blood and we oxygenated blood is red in colors.
5. #. Q. What do you know about cardiovascular system?
The cardiovascular system is an organ system that encompasses the heart and blood vessels of the body.
The cardiovascular system carries blood, oxygen, and nutrients to organs and tissues of the body, and carries
waste and carbon dioxide from these tissues for removal from the body.
The vertebrate heart is principally composed of cardiac muscle and connective tissue. Cardiac muscle is an
involuntary striated muscle tissue specific to the heart and is responsible for the ability of the heart to pump
blood.
The average human heart beat at 72 beats per minute. It weighs approximately 250 to 300 grams in females
and 300 to 350 grams in males
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7. 6. #. Q. Define cardiac cycle? Describe in brief different events of cardiac cycle?
The cardiac cycle is a term referring to all or any of the events related to the flow or blood pressure that occurs
from the beginning of one heartbeat to the beginning of the next. The frequency of the cardiac cycle is described
by the heart rate.
Each beat of the heart involves five major stages.
The first two stages, often considered together as the "ventricular filling" stage, involve the movement of blood
from the atria into the ventricles.
The next three stages involve the movement of blood from the ventricles to the pulmonary artery and the
aorta
Name of Stages of the
cardiac cycle
AV valves*
Semi lunar
valves† Status of ventricles and atria
1. Early diastole/joint
diastole
Open Closed
• whole heart is relaxed
• ventricles are expanding and filling
2. Atrial systole Open Closed
• atria contract and pump blood
• additional 10–40% filling of ventricles
3.Isovolumic
ventricular
contraction
Closed Closed
• ventricular myocytes begin to
contract
• ventricle volume unchanged
4. Ventricular ejection Closed Open
• ventricles fully contract
• pump blood to rest of body
5.Isovolumic
ventricular relaxation
Closed Closed
• ventricles relax
• ventricle volume unchanged
• atria expand and are filling
7. #. Q. Define heart sound. Describe the classification of human heart sound
Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it.
Specifically, the sounds reflect the turbulence created when the heart valves snap shut.
The cycles of the heart are known as the systole and diastole. The stage occurring when the heart contract is
called the systole and the stage occurring when the heart relaxes is called the diastole.
The heart sounds heard as “lub”, “dub" occur because of the closing of the heart valves.
“lub" is known as the first heart sound (S1) and
“dub" is known as the second heart sound (S2).
The third heart sound (S3) occurs immediately after the S2, and it is of lower energy than the second one. The
fourth heart sound (S4) occurs before the S1 and it has a lower scale of amplitude than the other sounds.
In addition, the sounds due to the flow of blood in the vessels and in the heart are components of the heart
sounds.
8. #. Q. Define cardiovascular (CVD) disease?
Cardiovascular disease (also called heart disease) is a class of diseases that involve the heart, the blood
vessels (arteries, capillaries, and veins) or both.
Cardiovascular disease refers to any disease that affects the cardiovascular system, principally cardiac disease,
vascular diseases of the brain and kidney, and peripheral arterial disease.
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8. Cardiovascular disease is the leading cause of deaths worldwide. Although cardiovascular disease usually
affects older adults, the antecedents of cardiovascular disease, notably atherosclerosis, begin in early life,
making primary prevention efforts necessary from childhood.
9. #. Q. Describe the causes of CVD?
The causes of cardiovascular disease are diverse but atherosclerosis and/or hypertension are the most
common.
Atherosclerosis is a disease in which plaque (plak) builds up inside arteries. Arteries are blood vessels that
carry oxygen-rich blood to your heart and other parts of your body.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque
hardens and narrows your arteries.
This limits the flow of oxygen-rich blood to your organs and other parts of your body.
Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death.
Hypertension or high blood pressure,
Sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries
is elevated. According to medical dictionary, hypertension means "High blood pressure; transitory or sustained
elevation of systemic arterial blood pressure to a level likely to induce cardiovascular damage or other adverse
consequences."
This requires the heart to work harder than normal to circulate blood through the blood vessels. Blood pressure
is summarized by two measurements, systolic and diastolic.
Normal blood pressure at rest is within the range of 100-140mmHg systolic (top reading) and 60-90m Hg
diastolic (bottom reading).
High blood pressure is said to be present if it is persistently at or above 140/90 mmHg. s
Hypertension is a major risk factor for stroke, myocardial infarction (heart attacks), heart failure, aneurysms of
the arteries (e.g. aortic aneurysm), peripheral arterial disease and is a cause of chronic kidney disease.
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9. 10. #. Q. Write notes on Atherosclerosis and hypertension
Atherosclerosis is a disease in which plaque (plak) builds up inside arteries. Arteries are blood vessels that
carry oxygen-rich blood to your heart and other parts of your body.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque
hardens and narrows your arteries.
This limits the flow of oxygen-rich blood to your organs and other parts of your body.
Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death.s
Hypertension or high blood pressure,
Sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries
is elevated. According to medical dictionary, hypertension means "High blood pressure; transitory or sustained
elevation of systemic arterial blood pressure to a level likely to induce cardiovascular damage or other adverse
consequences."
This requires the heart to work harder than normal to circulate blood through the blood vessels. Blood pressure
is summarized by two measurements, systolic and diastolic.
Normal blood pressure at rest is within the range of 100-140mmHg systolic (top reading) and 60-90m Hg
diastolic (bottom reading).
High blood pressure is said to be present if it is persistently at or above 140/90 mmHg. s
Hypertension is a major risk factor for stroke, myocardial infarction (heart attacks), heart failure, aneurysms of
the arteries (e.g. aortic aneurysm), peripheral arterial disease and is a cause of chronic kidney disease.
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10. Chapter: Cell
1. #. Q. Define cell. Write down the principal of cell theory.
A cell is the very smallest unit of living matter. All living things including plants and animals are made up of cells.
Cells are made of atoms, which are the smallest units of matter. There are many different kinds of cells. The two
kinds you are most likely to be familiar with are animal and plant cells.
Some of the differences between them are that plant cells have a cell wall and chloroplasts.
Cell Theory consists of three principles:
a. All living things are composed of one or more cells.
b. Cells are the basic units of structure and function in an organism.
c. Cells come only from the replication of existing cells
2. #. Q. Difference between prokaryotic and Eukaryotic cell
SL# Items Prokaryotic Cell Eukaryotic cell
01 Nucleus: Absent Present
02 Number of chromosomes: One--but not true
chromosome: Plasmids
More than one
03 Cell Type: Usually unicellular Usually multi cellular
04 True Membrane bound
Nucleus:
Absent Present
05 Lysosome Absent Present
06 Microtubules: Absent or rare Present
07 Endoplasmic reticulum: Absent Present
08 Mitochondria: Absent Present
09 Cytoskeleton: May be absent Present
10 Ribosome’s: Smaller Larger
11 Plasma membrane with steroid: Yes Usually no
12 Golgi apparatus: Absent Present
13 Chloroplasts: Absent Present (in plants)
14 Permeability of Nuclear
Membrane:
Selective not present
15 Cell wall: Chemically simpler Chemically complexes
16 Cell size: 10-100um 1-10um
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11. 3. #. Q. Explain why mitochondria is called the power house of the cell
The powerhouse of the cell is called the mitochondrion. It is responsible for producing energy that is used by the
cells on its cellular activities.
When the breaks down products from the digestion of food find their way into the cell, a series of chemical
reactions occur in the cytoplasm. This allows some of the energy locked up in these products to be released and
incorporated into the universal energy supplier in cells known as ATP (adenosine tri-phosphate).
Remaining molecular fragments from this process then enter the mitochondria, and in a complex series of steps,
they are finally converted into carbon dioxide and water. The energy locked up in these fragments is
incorporated into more ATP.
The ATP molecules produced in this way can then be used by the cell to supply the energy needed to function.
ATP → ADP + P + energy to function
4. #. Q. why lysosome are called the pocked of enzyme?
Lysosome are membrane-enclosed organelles that contain an array of enzymes capable of breaking down all
types of biological polymers—proteins, nucleic acids, carbohydrates, and lipids.
Lysosomes function as the digestive system of the cell, serving both to degrade material taken up from outside
the cell and to digest obsolete components of the cell itself. In their simplest form, lysosome are visualized as
dense spherical vacuoles, but they can display considerable variation in size and shape as a result of
differences in the materials that have been taken up for digestion. Lysosomes thus represent morphologically
diverse organelles defined by the common function of degrading intracellular material.
5. #. Q. Write down the function of Lysosome, Mitochondria & Golgi complex
Lysosome Function:
1. Lysosomes are small spherical organelles that enclose hydrolytic enzymes within a single membrane.
2. Lysosomes are the site of protein digestion – thus allowing enzymes to be re-cycled when they are no
longer required. They are also the site of food digestion in the cell, and of bacterial digestion in
phagocytes.
3. Lysosomes are formed from pieces of the Golgi apparatus that break off.
4. Lysosomes are common in the cells of Animals, Protoctista and even Fungi, but rare in plants
Mitochondria Function:
1. Mitochondria are tiny organelles inside cells that are involved in releasing energy from food.
2. It is for this reason that mitochondria are often referred to as the powerhouses of the cell. Cells that need a
lot of energy, like muscle cells, can contain thousands of mitochondria.
3. Apart from cellular respiration, mitochondria also play a key role in the ageing process as well as in the
onset of degenerative.
Golgi complex
1. The Golgi apparatus is the processing, packaging and secreting organelle of the cell,
2. The Golgi apparatus is a system of membranes,
3. Made of flattened sac-like structures called cisternae.
4. It works closely with the smoother, to modify proteins for export by the cell.
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12. Chapter: Digestive System
1. #. Q. Define: Digestion and absorption
Digestion is the mechanical and chemical breakdown of food into smaller components that are more
easily absorbed into a blood stream, for instance. Digestion is a form of catabolism: a breakdown of large food
molecules to smaller ones.
Absorption: The simple molecules that result from chemical digestion pass through cell membranes of the
lining in the small intestine into the blood or lymph capillaries. This process is called absorption
2. #. Q. Write down the name of enzyme of protein digestion
Protein digestion occurs in the stomach and duodenum in which 3 main enzymes,
Pepsin secreted by the stomach and trypsin and chymotrypsin secreted by the pancreas,
The digestive enzymes however are mostly secreted as their inactive precursors, the zymogens. For example,
trypsin is secreted by pancreas in the form of trypsinogen, which is activated in the duodenum
by enterokinase to form trypsin. Trypsin then cleaves proteins to smaller polypeptides.
3. #. Q. which enzyme is more powerful salivary Alfa amylase or pancreatic Alfa amylase
As the chyme moves into the duodenum, the pancreas is stimulated to produce additional digestive enzymes.
Pancreatic secretions include enzymes for the digestion of proteins, carbohydrates and fats. Secreted
proteolytic enzymes break proteins into peptides of various sizes and free amino acids.
Pancreatic amylase hydrates starches, simple sugars and other digestible carbohydrates into di- and tri-
saccharides. Similar in action to salivary amylase, pancreatic amylase is several times more powerful and is the
major agent in the digestion of starches and other complex carbohydrates.
4. #. Q. Brief discus about digestion and absorption of CHO
Sweetness is one of the five basic taste sensations of foods and beverages and is sensed by protein receptors
in cells of the taste buds. Fast-releasing carbohydrates stimulate the sweetness taste sensation, which is the
most sensitive of all taste sensations. Even extremely low concentrations of sugars in foods will stimulate the
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13. sweetness taste sensation. Sweetness varies between the different carbohydrate types—some are much
sweeter than others. Fructose is the top naturally occurring sugar in sweetness value.
Table: Sweetness Comparison of Carbohydrates
Carbohydrate Sweetness (percentage of sucrose)
Sucrose 100
Glucose 74
Galactose 33
Fructose 173
Maltose 33
Lactose 16
Starch 0
Fiber 0
A sweetness comparison among different naturally-occurring carbohydrates that’s Sweetness is a pleasurable
sensation and some people enjoy the taste more than others. In a colloquial sense we identify such people as
having a “sweet tooth.” This does not mean that the less-sweet whole grains containing more starches and fiber
are less satisfying. Whole grains take longer to chew and get sweeter the more you chew them. Additionally,
once in the stomach, whole-grain foods take longer to digest, and keep you full longer. Remember too that they
contain fiber which makes elimination much smoother. Whole-grain foods satisfy the body the entire way
through the digestive tract and provide the nutrients that also better satisfy the body’s functional needs.
5. #. Q. What are the end products of CHO, Protein & Lipids
Proteins --> amino acids
Carbohydrates --> monosaccharide’s (mainly glucose) and dextrin’s
Fat --> fatty acids and glycerol
6. #. Q. why pancreas dose not digested by its own proteolytic enzymes
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14. Chapter: Kidney
1. #. Q. What is the Component of urinary system?
• A pair of Kidneys: Form urines
• A pair of ureters: Convey urine from kidney to bladder
• A urinary bladder: Temporary reserviour of urine
• Urethra: Excrete urine from bladder to
Fig: urinary system
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15. 2. #. Q. What is Nepron?
Nepron is a Structural and functional unit of kidney, two major parts of nepron: Glomerulus and Renal tubules
3. #. Q. What are the function of kidney
A. Homeostatic Functions
1. Waste excretion (urine formation)
a. Nitrogenous end products: urea, creatinine, uric acid, etc.
b. Metabolic degradation of peptide hormones: glucagon, insulin, PTH, growth hormone, FSH, and gastrin.
2. Fluid/electrolyte balance (Na+, K+, water)
3. Acid/base regulation: Kidneys generate and reclaim filtered bicarbonate, as well as secrete excess acid to
maintain balance.
4. Balance of other electrolytes (Ca++, Mg++, Phosphate PO4
3-
)
B. Non-excretory functions
1. Renin-angiotensin mechanism to control BP
a. Kidney senses decreased BP
b. Secretes renin (enzyme), which converts Angiotensin I to angiotensin II
c. Angiotensin II is a vasoconstrictor à increased BP
d. Angiotensin II also stimulates aldosterone secretion
e. Aldosterone increases Na+ and H2O reabsorption, increased plasma volume, and increased BP
(Aldosterone also stimulates potassium secretion into tubules)
2. Produces erythropoietin
a. Stimulates erythropoiesis in bone marrow
b. The anemia of CRF is primarily caused by impaired erythropoiesis
c. ↓ RBC formation is mainly due to ↓ erythropoietin production in the diseased kidneys, although other
compounds that accumulate in renal failure may also suppress erythropoiesis.
3. Maintains Calcium-Phosphorus bone homeostasis
a. Activates Vitamin D (Hydroxylation of 25-OH-D3 to 1,25-OH-D3) in kidney disease, can
supplement calcitriol, but very expensive Low vit. D à less Ca++ absorbed
b. Inverse relationship between Ca++ and P, so when P is retained by diseased kidney, Ca++
levels decline (less calcium reabsorbed by the kidney).
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16. c. Low serum calcium à parathyroid gland releases PTH: Parathyroid Hormone: works to elevate
serum Ca++ by pulling it from the bones à fragility, muscular weakness, decreased muscular tone, and
general neuromuscular hypoexcitability.
Three hormones produce by the kidney- i) 1, 25-dihydroxycholecalsiferol, Renin and Erythropoietin.
4. #. Q. Define the following term
A. Glomerular filtrate (GF)
The filtration of blood that occurs through the glomerular capillary is called GF. It occurs due to effective
filtration pressure in the glomeruler capillary. It results from two types of pressure-
Inward force or glomerular capillary pressure= 60 mm of Hg
Outward force = Capsular pressure + Colloidal osmotic pressure= 8 + 42 = 50mm of Hg
So the effective filtration pressure= 60-50= 10mm of Hg
B. Renal threshold:
Renal threshold of any substance may be defined as the critical concentration of that substance in plasma below
which none of it appears in urine but above which proportionally larger amount of it appears in the urine.
Renal threshold level for glucose 180mg% (10mmol)
C. Plasma clearance:
The plasma clearance is the virtual volume of plasma in ml that contains the amount of any constituent which
excreted out through the urine in every minute.
Conc. of any substance in urine X Vol. of urine (ml/min)
Plasma clearance= --------------------------------------------------------------------------------
Conc. of substance in plasma in ml
5. #. Q. What factor effect GER?
Glomerular filtration rate (GFR): The quantity of glomerular filtrate formed in each minute by all nephron of both
kidneys is called the GFR. It is about 125ml/min
Factors affecting GFR: The major factors-
• Glomerular capillary pressure (↑GFR)
• Plasma colloidal osmotic pressure (↓ GFR)
• Bowman’s capsular pressure (↓ GFR)
6. #. Q. What are different between Glomerular filtrate and Urine?
SL # Glomerular Filtrate Urine
01 It is alkaline pH-7.4 It is always acidic pH-5.5-6.5
02 It is isotonic to plasma It is hypertonic to plasma
03 It is about 180 l/day It is about 1.2- 1.5 l/day
04 GFR 125ml/min Urine 1 ml/min
05 It’s composition nearly to plasma (no
RBC, 0.03%protein of plasma)
Very different composition to plasma
7. #. Q. Why serum albumin dose not filtrate by kidney?
Serum Albumin (6nm) does not filtrate by kidney because of G pores lined with highly negatively charged
glycosylated proteins and serum proteins also negatively charged repulse from excretion.
8. #. Q. Define diuresis and dehydration?
Diuresis: Excretion of larger volume of diluted urine i.e. hypotonic urine it may be two types-
 Water diuresis
 Osmotic diuresis
Various diuretics and their actions:
 Water-Inhibit vasopressin secretion
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17.  Ethanol-Inhibit vasopressin secretion
 V2vesopresin receptor antagonist- Inhibit vasopressin action on collecting duct
 Drugs interfere with tubular re-absorption such as acetazolamide, thiazides, amiloride etc.
Dehydration: Dehydration is a condition resulting from excessive loss of body fluids. It may cause as a result of
 Excessive loss of water from the body such as sweating, diarrhea, hemorrhage etc
 Reduction of total quantity of electrolytes
 Injection of hypertonic solution.
9. #. Q. What are the sign of dehydration?
Sign of dehydration: Sunken of eyeball, dryness of tongue wrinkles of skin, dryness and rough of skin etc.
10. #. Q. Give name and function of hormone active in kidney?
The hormones which acts on kidney-
 Aldosterone- control Na+
re-absorption and secretion of K+
 Anti diuretic hormone (ADH)/vasopressin- control permeability of late distal tubules, cortical and medullar
collecting tubules
 Para hormone- The parathyroid hormone acts to increase tubular re-absorption of Ca++
and tubular secretion
of phosphate.
 Growth hormone- acts on kidney to release somatomedins that causes bone and cartilage growth.
Chapter: Body Fluids & Lymphatic’s
1. #. Q. Classify Body Fluids Compartments?
A. Intracellular = Cytoplasmic (inside cells)
B. Extracellular (outside cells)- Three type
1. Interstitial,
2. Plasma (fluid portion of the blood),
3. Trans cellular Fluid,
17

18. I. CSF
II. Intra ocular
III. Pleural
IV. Peritoneal
V. Synovial
VI. Digestive Secretions
2. #. Q. What are the compositions of body fluid?
Organic substances
I. Glucose
II. Amino acids
III. Fatty acids
IV. Hormones
V. Enzymes
Inorganic substances
I. Sodium
II. Potassium
III. Calcium
IV. Magnesium
V. Chloride
VI. Phosphate
VII. Sulphate
3. #. Q.Difference between ECF and ICF?
ECF ICF
ECF contains large amount of sodium chloride
and bicarbonate ion in addition to ions plus
nutrients for the cells such as oxygen glucose,
amino acids and fatty acids
ICF contains large amount of potassium,
magnesium and phosphate ions.
It is necessary for the maintenance of cellular
function and called the internal environment of
the body or milieu interior.
It is essential for intra cellular volume and
function. Doesn’t contribute much for the internal
environment of the body.
Higher amount of glucose, fatty acids and
creatinine
Higher amount of protein and amino acids.
ECF is more important than ICF ICF is Less important than ECF
4. #. Q. What are the routes of body fluid system?
18

19. Route Range (l/day) Regulatory influences
Insensible – lungs 0.3-0.4 Atmospheric vapor pressure
(temperature)
Insensible – skin 0.35-0.4 10x increase in burn victims
Sweat 0.1-2 (per hour) Temperature, exercise
Feces 0.1-0.2 Diarrheal disease
Urine 0.5-1.4-20 Body fluid composition
5. #. Q. How can you measure ECE, TBW and ICF?
ECF can be measured by using the indicators-
Such as –Sucrose, Insulin, Radioactive Na, Manitol etc.
Inject the indicators to the body and allow for complete distribution throughout the body (more than one and half
hour) collect extra cellular fluid and centrifuge to separate the plasma. Determine the plasma concentration of
the indicators.
Plasma Volume= Quantity of the test substances/ conc. per ml of dispersed fluid.
ECF= Plasma Volume X 5 (as plasma is 1/5th
volume of ECF)
TBW: Indicators- Antipyrine, D2O (heavy water )
TBW= Quantity of administered D2O – Quantity excreted/ equilibrium concentration.
ICF= TBW- ECF
6. #. Q. What is lymphatic system?
Lymphatic system is part of the circulatory system, comprising a network of lymphatic vessels that carry a clear
fluid called lymph directionally towards the heart. Lymphatic organs play an important part in the immune
system, having a considerable overlap with the lymphoid system
19

20. 7. #. Q. What are the function of lymphatic system
Functions
1.It is responsible for the removal of interstitial fluid from tissues
2. It absorbs and transports fatty acids and fats as cycle from the digestive System
3. It transports white blood cells to and from the lymph nodes into the bones
4.The lymph transports antigen-presenting cells (APCs), such as dendritic cells, to the
Lymph nodes where an immune response is stimulated
8. #. Q. What are factor of lymphatic system
I. There is no central pump in the lymphatic system
II. Forward flow is due to a pressure gradient within lymph vessels aided by one-way valves which
prevent backflow
III. Lymph enters lymph capillaries when the pressure in the tissue in low (up to 2mmHg) as the flap valves
between lymph capillary cells are open
IV. ISF enters lymphatic capillaries in the phase after the external pressure has passed as external
connective tissue fibers tend to tent open the lymph capillaries, opening the flap valves
V. When ISF pressure increases beyond +2 mmHg then these flap valves close
VI. With flap valves closed, the increased external (ISF) pressure tends to promote forward lymph flow
provided pressure is not too high (eg <=2 mmHg). At higher pressures, the unevenness of the pressure
tends to close proximal lymph channels and lymph does not flow (Starling resistor effect)
VII. The main sources of suitable levels of external pressure to promote flow are arterial pulsations and
muscular contractions
VIII. The close association of lymph channels with arteries tends to favor flow
IX. Larger lymph vessels have smooth muscle in their walls. 'Intrinsic contraction' of these smooth muscle
cells assists forward flow
X. Lymph vessels have bi-leaflet valves every few mm and these are extremely important: no forward flow
is ever lost
9. #. Q. What dose Immune system do?
 Immune system protects us from infections with:
a. viruses
b. bacteria
c. fungi
d. worms
20

21. e. parasitic protozoa
 It promotes normal functioning of the body (tissue cleanup, wound repair)
 It removes abnormal cells including malignant ones
 But the immune system can also cause disease when it is not doing the right thing (allergies, autoimmunity,
transplant rejection, etc.)
Chapter: Hormone
1. #. Q. What is hormone? write down the general characteristics of hormone?
A hormone is a chemical released by a cell, a gland, or an organ in one part of the body that affects cells in
other parts of the organism. Generally, only a small amount of hormone is required to alter cell metabolism. In
essence, it is a chemical messenger that transports a signal from one cell to another.[1]
All multi cellular
21

22. organisms produce hormones; plant hormones are also called phytohormones. Hormones in animals are often
transported in the blood.
General Characteristic of Hormones
 Synthesized by specific glands
 Secreted directly into the blood, which carries them to their sites of action
 They specifically alter the activities of certain responsive tissues.
 Easy solubility
 Low molecular weight
 Easy diffusible
 No cumulative actions
2. #. Q. What is endocrine gland? Write down the name of endocrine gland?
Endocrine glands are glands of the endocrine system that secrete their products, hormones, directly into
the blood rather than through a duct.
The name main endocrine glands include the
1) Pineal gland
2) Pituitary gland
3) Thyroid glands
4) Thymus
5) Adrenal glands
6) Pancreas
7) Ovaries
8) Testes
3. #. Q. Write the function of following hormone?
Function of Growth hormone
I. GH increasing height in children and adolescents, growth hormone has many other effects on the body:
II. Increases calcium retention, and strengthens
III. Increases the mineralization of bone
IV. Increases muscle mass through sarcomere hypertrophy
V. Promotes lipolysis
VI. Increases protein synthesis
VII. Stimulates the growth of all internal organs excluding the brain
VIII. Plays a role in homeostasis
IX. Reduces liver uptake of glucose
X. Promotes gluconeogenesis in the liver
XI. Contributes to the maintenance and function of pancreatic islets
XII. Stimulates the immune system
XIII. GH exerts some of its effects by binding to receptors on target cells,
XIV. GH directly stimulates division and multiplication of chondrocytes of cartilage.
XV. GH also stimulates, through the JAK-STAT signaling pathway,
Function of Insulin hormone
The function of insulin is too maintaining the blood glucose level.
So, really, it controls the level of sugar in your body. People with diabetes have trouble controlling their blood
glucose level as their insulin doesn't work very well.
People with Type 1 Diabetes have to take insulin medications,
While people with type 2 diabetes can control their blood glucose levels with diet.
4. #. Q. What is hyper pituitary gland? Discus it’s briefly?
22

23. 23

24. Chapter: Metabolism
1. What is metabolism? Its classification?
Metabolism is the sum total of the chemical processes that occur in the living organisms including digestion and
the transport of substances into and between different cells, in which case the set of reactions within the cells is
called intermediary or intermediate metabolism. These enzyme-catalyzed reactions allow organisms to grow and
reproduce, maintain their structures, and respond to their environments. In metabolism some substances are
broken down to yeild energy for vital process while other substances necessary for life are synthesized.
Metabolism is usually divided into two categories.
Catabolism: Catabolism is degraded or breaks down phase of metabolism.
Anabolism: Anabolism is the building-up or biosynthetic phase of metabolism.
2. Write down the function of metabolism.
Metabolism has following specific functions:
a. To obtain chemical energy from fuel molecules or from absorbed sunlight,
b. To convert exogenous nutrients into building blocks or precursors of cell component,
c. To assemble such building blocks into protein, nucleic acids, lipids
3. What is glycolysis? Discus the glycolysis pathway?
Glycolysis is the metabolic pathway that converts glucose into pyruvate. The free energy released
in this process is used to form the high-energy compounds ATP and NADH. It is a purely anaerobic Reaction
24

25. .
4. Which steps are one way and two way in glycolysis path way?
Ans: One way step path way of glycolysis are as follows:
 Glucose + ATP à glucose-6-P + ADP
 fructose-6-P + ATP à fructose-1,6-bisP + ADP
 phosphoenolpyruvate + ADP à pyruvate + ATP
Two way step path way of glycolysis are as follows:
 glucose-6-P (aldose) ßà fructose-6-P (ketose)
 fructose-1,6-bisphosphate ßà dihydroxyacetone-P + glyceraldehyde-3-P
 dihydroxyacetone-P ßà glyceraldehyde-3-P
 glyceraldehyde-3-P + NAD+
+ Pi ßà 1,3-bisphosphoglycerate + NADH + H+
 1,3-bisphosphoglycerate + ADP ßà 3-phosphoglycerate + ATP
 3-phosphoglycerate ßà 2-phosphoglycerate
 2-phosphoglycerate ßà phosphoenolpyruvate + H2O
25

26. 5. Which step is produce ATP and NADP in glycolysis path way?
Ans: ATP producing step are given bellow:
 1,3-bisphosphoglycerate + ADP ßà 3-phosphoglycerate + ATP
 phosphoenolpyruvate + ADP à pyruvate + ATP
NADH producing step are given bellow:
26
phosphoenolpyruvate enolpyruvate pyruvate
Pyruvate Kinase
C
C
CH2OPO3
2−
O OPO3
2−
H OH
C
C
CH2OPO3
2−
O O−
H OH
ADP ATP
1
22
3 3
1
Mg2+
1,3-bisphospho- 3-phosphoglycerate
glycerate
Phosphoglycerate Kinase
C
C
CH2OPO3
2−
H O
H OH
C
C
CH2OPO3
2−
O OPO3
2−
H OH
+ Pi
+ H+
NAD+
NADH 1
2
3
2
3
1
glyceraldehyde- 1,3-bisphospho-
3-phosphate glycerate
Glyceraldehyde-3-phosphate
Dehydrogenase

27.  glyceraldehyde-3-P + NAD+
+ Pi ßà 1,3-bisphosphoglycerate + NADH + H+
6. Which step expense ATP in glycolysis path way.
Ans:
 Glucose + ATP à glucose-6-P + ADP
 fructose-6-P + ATP à fructose-1,6-bisP + ADP
7. Write short note on cori cycle.
Cori cycle is also known as lactic acid cycle. The metabolic pathway in which lactate produced by anaerobic
glycollysis in the muscles moves to the liver and is converted to glucose, which then returns to the muscles and
is metabolized back to lactate.
27
H O
OH
H
OHH
OH
CH2OH
H
OH
H H O
OH
H
OHH
OH
CH2OPO3
2−
H
OH
H
23
4
5
6
1 1
6
5
4
3 2
ATP ADP
Mg2+
glucose glucose-6-phosphate
Hexokinase
CH2OPO3
2−
OH
CH2OH
H
OH H
H HO
O
6
5
4 3
2
1 CH2OPO3
2−
OH
CH2OPO3
2−
H
OH H
H HO
O
6
5
4 3
2
1
ATP ADP
Mg2+
fructose-6-phosphate fructose-1,6-bisphosphate
Phosphofructokinase