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Abdominal pain
Harry, a 51-year-old painter and decorator, collapsed at work with severe pain in his right upper quadrant. In hospital, the
doctor localized the pain to the right hypochondriac region, and noted that the abdominal wall muscles were very tense.
1. Explain how the abdomen is divided into quadrants.
1. The abdomen is divided into quadrants by a line drawn
down the midline of the body (median sagittal line) and by
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a horizontal (axial) line drawn through the umbilicus.
2. Based on the normal contents of the right upper
2. The right upper quadrant contains the following organs,
quadrant, which organ(s) might be diseased and therefore which might be causing the pain: liver, gallbladder, right
causing Harry's pain?
kidney, duodenum, ascending colon, transverse colon, and
small intestine.
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3. Explain the location of the right hypochondrium (what
3. The abdomen can be divided into nine regions by four
are the lines that form the boundaries of the region?).
lines. Two midclavicular (sagittal) lines (one left and one
right) pass vertically down and are intersected by two
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horizontal lines. The upper horizontal line, the subcostal
line, is level with the lower border of the costal margin at
the tenth costal cartilage. The lower horizontal line, the
intertubercular line, is positioned at the level of the
tubercles of the iliac crest of the hip bone.
4. Which of Harry's body systems is detecting the problem 4. The nervous system is detecting the problem via
in his right upper quadrant?
peripheral nerves and the central nervous system. The
problem is interpreted as pain.
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5. Explain how the body system that you name in answer 5. The functionality of the nervous system can be split into
to question 4 is functioning such that Harry is experiencing three main stages:
pain and tensing his abdominal wall muscles (there are
several stages to consider).
(i) Sensory function: changes in the internal environment
have been detected, encoded into electrical impulses, and
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transmitted along the nerves to the spinal cord and brain
where they are perceived as pain.
(ii) Integrative function: electrical impulses have been
processed by the central nervous system and conscious
and/or unconscious decisions are made in response to the
pain stimulus.
(iii) Motor function: effectors have been activated to induce
tensing of the muscles of the abdominal wall in an attempt
to protect the area.
Arthur, an 89-year-old man, went to see his doctor with a number of complaints. His doctor told him that the problems he
was complaining of were just normal physical presentations associated with aging.
1. State three of the common physical presentations of
1. Any of the following can commonly be associated with
aging: reduced hearing, visual deterioration, loss of skin
elasticity, joint stiffening, reduced lung elasticity, and
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reduced immune system efficiency.
2. What happens to cellular components with aging?
2. Cellular components, such as proteins, lipids, and
nucleic acids are progressively damaged with age. Such
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damage increases with age and can eventually interfere
with the normal functions of the cell.
3. State one of the speculated causes of aging.
3. Aging may be caused by free radical damage to cells
and tissues, or by telomere shortening (erosion) and the
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associated shortening of chromosomes with each cell

4. How many parts and components of the body does

aging affect?
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5. Why might Arthur be more susceptible to getting
infections as he gets older?
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4. Aging occurs in all parts, cells, tissues, organs and
systems of the body.
5. Aging will reduce the efficiency of Arthur's immune
system, thus leaving him more vulnerable to infection by
bacterial, viral, or fungal pathogens.

Body fluid infections

Two patients were rushed to the emergency room with body fluid infections. Patient 1: Gordon, a 75-year-old man, had a
severe headache, photophobia, and a rash on his skin. Lumbar puncture showed that Gordon had meningitis.
1. What body fluid surrounds the brain and spinal cord and 1. Cerebrospinal fluid surrounds the brain and spinal cord.
where is it produced?
It is produced by the choroid plexuses of the ventricles.
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2. What is the normal role of the fluid surrounding the brain 2. The cerebrospinal fluid bathes the brain and spinal cord
and spinal cord?
tissues in a chemically stable environment that provides it
with nutrients. It also protects the brain from mechanical
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injury by stopping it jolting into the cranium.
3. What might happen to the nerve cells of the brain and
3. The cells of the nervous system might start to
spinal cord if the infection causes the contents of the fluid malfunction since the regulation of body fluid composition
surrounding them to change?
is important in maintaining the movement of dissolved ions,
nutrients, gases, and waste products between tissues and
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blood. The malfunctioning could present as a loss or gain
of function.
Patient 2: Nichola, an 88-year-old voluntary worker, had a swollen, tender, red leg that was hot to the touch. Nichola
was diagnosed with cellulitis of the leg (an infection of connective tissues of the skin) and was put on an antibiotic that
accumulated in the interstitial fluid.
4. Where is the interstitial fluid located?
4. Interstitial fluid is found within the tissues of the body. It
is an extracellular fluid located outside of the cells and
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capillaries of a tissue.
5. What is the normal role of interstitial fluid?
5. Interstitial fluid supplies the cells and components of a
tissue with nutrients, oxygen, and water, and removes
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urea, carbon dioxide, and water. The fluid therefore helps
maintain normal cell and tissue function by providing a
stable environment.
6. Explain how an antibiotic injected into Nichola's blood
6. An antibiotic injected into the blood would travel around
would find its way to the interstitial fluid.
the body in the blood plasma. It would be filtered out of the
capillary vessels of a tissue and would pass into the
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interstitial fluid of tissues where it could take effect.
Danny, a 47-year-old man, had an itchy, red rash on his skin. The rash was restricted to a dermatome. His doctor
diagnosed shingles. Shingles is caused by a virus that lives in the sensory nerves. The doctor also noticed that Danny
had been scratching the rash, which had resulted in an infection of the underlying skin.
1. What is a dermatome?
1. A dermatome is a specific area of skin that receives
sensory innervation from a single spinal nerve.
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2. How many of Danny's spinal nerves were affected by the 2. One spinal nerve was affected as the rash was limited to
virus causing shingles?
a single dermatome.
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3. Which body system does skin belong to? What other
3. The skin is part of the integumentary system. The
components are found in this body system?
integumentary system consists of skin, nails, and the
associated skin components, which include hair, hair
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follicles, sweat glands, oil (sebaceous) glands, and nails.
4. What are the normal roles of skin?
4. The skin has several functions, including: production of
vitamin D; protection against pathogens; excretion of
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5. Why can excess scratching of the skin lead to an
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metabolic waste; and the detection of pain, touch, and

changes in temperature.
5. Excessive scratching can damage the barrier layer of
the skin. This will allow pathogens into deeper tissues of
the skin where they can cause an infection.

Endocrine system tumors

Katy, a 29-year-old investment banker, presented with tumors that were affecting multiple parts of her endocrine system.
The tumors were causing parts of Katy's endocrine system to bypass their normal negative feedback mechanisms.
1. What glands are found in the endocrine system and
1. The endocrine system consists of the pituitary, thyroid,
where therefore could the tumors be located?
pineal, parathyroid and adrenal glands, pancreas, testis,
and ovaries.
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2. How does the endocrine system exert its effect?
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3. Based on how the endocrine system exerts its effect,
how could you test the functionality of the system within
Katy's body?
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4. What is a negative feedback loop or system?
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2. The endocrine system exerts its effect through the

secretion and regulation of hormones. Hormones are
secreted into the blood and act at distant sites.
3. As endocrine hormones are secreted into the blood,
hormone levels could be measured using a blood test.

4. A negative feedback loop or system is able to reduce the

output of a system. In the endocrine system, negative
feedback loops or systems will help prevent the release of
excess hormone and therefore maintain homeostasis.
5. What will be the effect of bypassing the normal negative 5. Bypassing normal negative feedback will lead to Katy
feedback system of the endocrine system?
having excess levels of endocrine-related hormones in her
body, since increased levels will not induce the normal
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negative feedback loop.
6. What are the normal roles of the endocrine system?
6. Endocrine hormones control and regulate the growth,
development, and maintenance of the body and also help
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to establish biological rhythms, such as waking and
sleeping, and reproductive cycles. Hormones also play a
role in the regulation of many bodily functions such as the
chemical composition of the internal environment of the
7. What general problems might Katy present with given
7. Katy might have the following problems:
that the tumors are bypassing the normal negative
feedback mechanisms?
(i) Homeostatic imbalance.
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(ii) Disturbance of biological rhythms such as the
reproductive cycle and waking and sleeping.
(iii) Abnormal maintenance of body tissues.
(iv) Alteration of the normal chemical composition of the
body and blood.
(v) Changes to the internal environment of the body.
Gunshot wound
Martha, a 22-year-old student, was accidentally shot while walking over farmland during a shooting competition. She was
taken to hospital where she was found to have bullet fragments in her mediastinum and abdominal cavity.
1. Explain the location of the abdominal cavity and the
1. The abdominal cavity is one of the divisions of the
region of the body to which it belongs.
ventral body cavity. It is located below the diaphragm and
above the pelvic cavity. The abdominal cavity is part of the
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axial region of the body.
2. What are the boundaries of the abdominal cavity?
2. The abdominal cavity is bound anteriorly, laterally, and
posteriorly by the body wall, superiorly by the diaphragm,
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and inferiorly by the pelvic cavity.

3. What structures could have been damaged by the
3. The following structures are contained within the
gunshot wound to the abdominal cavity?
abdominal cavity and could therefore have been damaged
by the gunshot injury: gastrointestinal tract (stomach,
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duodenum, jejunum, ileum, cecum, appendix, and colon),
liver, gallbladder, pancreas, spleen, kidneys, adrenal
glands, inferior vena cava, and aorta.
4. Where is the mediastinum?
4. The mediastinum is the region or space found between
the pleural cavities within the central region of the thoracic
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5. What are the boundaries of the mediastinum?
5. The mediastinum is bound anteriorly by the sternum and
costal cartilages, posteriorly by the vertebral column,
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inferiorly by the diaphragm, and superiorly by the thoracic
inlet, which is formed by the first rib and costal cartilage.
6. What are the contents of the mediastinum?
6. The mediastinum contains the esophagus, trachea,
primary bronchi, thymus, pericardial cavity and its
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contents, the great vessels of the heart, and thoracic
lymph nodes.
7. Explain whether you think that Martha's life is in danger 7. Martha's life is in danger as she may have suffered
from the gunshot wound to her mediastinum (in your
damage to her cardiovascular or respiratory system.
answer state which systems are at risk of damage and
what the effect of the damage to that system would be).
If the bullet has damaged the heart or the great vessels of
the cardiovascular system, Martha is at risk of bleeding.
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Damage to the cardiovascular system will lead to a
reduced ability to deliver oxygen and nutrients to cells and
remove metabolic waste. This can be life-threatening.
If the bullet has damaged the trachea or primary bronchi,
she may have compromised the function of her respiratory
system and have air leaking into her mediastinum. This
could lead to reduced pulmonary ventilation, abnormal acidbase balance, and reduced oxygenation of the blood.
Susan, a 23-year-old student, went on a trip to a health spa with friends. Susan sat in a sauna at a temperature of 170F
(77C) for ten minutes. During this time, homeostatic mechanisms led to her body temperature remaining relatively
1. What is homeostasis?
1. Homeostasis refers to a process that maintains
relatively stable conditions within the body.
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2. What factors or conditions of the internal body
environment are monitored and regulated as part of
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3. What is meant by the terms 'set point' and 'set point
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4. What is the set point temperature for the body?
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5. Describe the basic components that form a homeostatic
feedback system.
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6. What type of feedback system would be involved in
regulating Susan's temperature?
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7. What are the effectors that help to reduce Susan's body

2. Homeostasis requires the monitoring and regulation of

body temperature, salinity, ion concentration, oxygen
levels, and pH.
3. 'Set point' refers to the normal value for a controlled
condition within the body. 'Set point range' refers to the
normal range of values for a controlled condition within the
4. The set point temperature for the body is 98.6F (37C).
5. A homeostatic feedback system involves a stimulus, a
receptor, a control center, and an effector which carries out
the response to the stimulus.
6. Thermoregulation is carried out by means of a negative
feedback system.
7. The effectors that help to reduce Susan's body

temperature? What is their response to increased body

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temperature are blood vessels and sweat glands in the

skin. Blood vessels dilate to increase blood flow near to the
surface of the skin. Sweat glands secrete sweat onto the
surface of the skin to increase evaporative heat loss. This
combined mechanism acts to increase heat loss.

Structural organization
Three patients were being examined in hospital by their doctors. The patients had the following disorders at the following
structural levels of their bodies: Joe had an infected tissue, Wendy had a tumor in an organ, and Harriet had a disorder
affecting a body system.
1. What is a tissue?
1. A tissue is a collection of cells that share a similar
function. The cells found within a simple tissue are
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generally similar (e.g. an epithelium).
2. What are the four basic types of tissue in the body?
2. The four basic tissue types are epithelial, connective,
muscular, and nervous.
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3. What is an organ?
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4. Give examples of some possible locations of an organbased problem.
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5. What is a system?
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6. Give examples of two body systems.
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3. An organ is a distinct structure with a definite shape that

is composed of two or more types of tissue.
4. Possible locations include the heart, lung, brain, skin,
and bones.
5. A system refers to a group of related organs that work
together to bring about a common function.

6. The body is made up from several different systems

including the cardiovascular, respiratory, digestive, and
nervous systems.
7. Could Wendy experience problems associated with
7. Yes, an organ can be a part of more than one body
more than one body system, even though only one organ is system, therefore a problem in a single organ can cause
affected? Explain your answer.
problems in more than one body system.
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