ORAL EXAMS ON CARDIO/BLOOD, RESPIRATORY and DIGESTIVE SYSTEM

1. Trace the correct sequence of events during complete blood circulation

in adult.
- Deoxygenated blood vena cava right atrium tricuspid valve right
ventricle pulmonary artery lungs oxygenated blood pulmonary vein left
atrium mitral valve left ventricle aortic arch carotid artery (brain)/ auxiliary
artery(arms)/ aorta(torso and legs) arteries capillaries veins heart
2. How many valves does your heart have and give me the location.
tricuspid valve: located between the right atrium and the right ventricle
pulmonary valve: located between the right ventricle and the pulmonary artery
mitral valve: located between the left atrium and the left ventricle
aortic valve: located between the left ventricle and the aorta
3. What signifies P, QRS and T wave in ECG.
P wave represents the initiation of depolarization in the sinus node and
subsequent atrial contraction. It is relatively small due to the small muscle mass
of the atrium. The normal P wave should be upright (positive) in lead II and less
than 2.5mm tall. Finding the P wave (or the lack of P wave) is the first step in
figuring out the rhythm.
The QRS complex represents the conductance and sequential depolarization of
the ventricles. It is a much larger wave form that the P wave due to the large
muscle mass of the ventricles. An initial downwards (negative) deflection in the
QRS is termed the Q wave. A Q wave may or may not be present depending on
the lead and the pathology of the ECG. The R wave is large and upright (positive)
and is easily seen on this example. The S wave follows the R wave and is a
downwards (negative) deflection. The ST segment represents the period of time
in which the ventricles are isoelectric. The T wave represents the repolarization
of the ventricles. Direction of the T wave can provide critical information about
cardiac ischemia and electrolyte abnormalities.
4. What are the structures found in Right and left ventricle?
The left ventricle forms the apex of the heart and is conical in shape. Blood
passes from the left ventricle to the ascending aorta through the aortic semilunar valve. From here some of the blood flows into the coronary arteries, which
branch from the ascending aorta and carry blood to the heart wall. The
remainder of the blood travels throughout the body. The right ventricle forms
most of the anterior surface of the heart and is crescent-shaped in cross-section.
The cusps of the tricuspid valve are connected to tendon-like cords, the chordae
tendinae, which, in turn, are connected to cone-shaped papillary muscles within
the ventricular wall. The right ventricle is separated from the left by a partition
called the interventricular septum. The trabecula septomarginalis is a muscular
band that traverses the lumen of the right ventricle. Deoxygenated blood passes
from the right ventricle through the pulmonary semi-lunar valve to the
pulmonary trunk, which conveys the blood to the lungs.

5. What is the normal range of adult Cardiac Rate in One whole minute

and what is the medical term if there is an increase and decrease of

heart rate?
A normal resting heart rate for adults ranges from 60 to 100 beats a minute.
Generally, a lower heart rate at rest implies more efficient heart function and
better cardiovascular fitness. For example, a well-trained athlete might have
a normal resting heart rate closer to 40 beats a minute. When you feel your

pulse, count the number of beats in 15 seconds. Multiply this number by 4 to

calculate your beats a minute. Keep in mind that many factors can influence
heart rate, including: Activity level Fitness level Air temperature Body position
Emotions Body size Medications. Tachycardia is a fast heart rate. Bradycardia
is a slow heart rate, defined as below 60 bpm at rest.
6. What is the normal Blood Pressure of an adult, and what is the medical
condition when your Left ventricle is enlarged?
120 over 80 (120/80). (2) Left ventricular hypertrophy is enlargement and
thickening (hypertrophy) of the walls of your heart's main pumping chamber (left
ventricle).
7. What type of blood being delivered in your Left atrium and what blood
vessels carry it?
The left atrium receives the oxygenated blood from the left and right pulmonary
veins.
8. What prevents the back flow of blood and enumerate all these
structures?
Aortic Valve Located between the left ventricle and the aorta (the main artery
of the body). It prevents backflow of blood into the left ventricle.
Mitral Valve Located between the left atrium and left ventricle. It prevents
backflow of blood into the left atrium.
Pulmonary Valve Located between the right ventricle and the pulmonary artery
(the artery leading to the lungs). It prevents backflow of blood into the right
ventricle.
Tricuspid Valve Located between the right atrium and the right ventricle. It
prevents backflow of blood into the right atrium.
9. What are the two most powerful chambers in your heart and what
vessel carries oxygenated blood all throughout the body?
Left ventricle has a strong and thick muscular wall that is responsible for
pumping blood throughout the entire body and right ventricle. (2) The pulmonary
veins carry oxygenated blood from the lungs into the left atrium to be returned
to systemic circulation. The aorta is the largest artery in the body. It carries
oxygenated blood from the left ventricle of the heart into systemic circulation.
10. What is the natural pacemaker of the heart? What is the major blood
supply of the heart?
The sinoatrial (SA) node, or sinus node, is the natural pacemaker of the heart.
The SA node controls the heart rate by sending electrical signals through the
heart muscle, making the heart contract and pump blood throughout the body.
(2) The heart has its own unique blood supply, more commonly known as the
coronary circulation, which encircles the entire surface of the heart to supply its
different regions. This begins with the coronary arteries arising from the
ascending aorta, through openings called coronary Ostia which are located
above the aortic valves. These arteries run along the surface of the heart and so
can also be referred to as epicardial coronary arteries.
11. What blood component provides the major body defense and
enumerate what are those at least four.
Plasma, Red blood cells, White blood cells, Platelets.
12. Give me the other terms for the RBC, WBC, Platelets and the normal
life span of each.
RBC (erythrocytes) WBC(leukocytes) Platelets (thrombocytes)

Plasma is the liquid component of blood, in which the red blood cells, white blood
cells, and platelets are suspended. consists mostly of water that contains
dissolved salts (electrolytes) and proteins. The major protein in plasma is
albumin. Albumin helps keep fluid from leaking out of blood vessels and into
tissues, and albumin binds to and carries substances such as hormones and
certain drugs. Red blood cells contain hemoglobin, a protein that gives blood its
red color and enables it to carry oxygen from the lungs and deliver it to all body
tissues. Oxygen is used by cells to produce energy that the body needs, leaving
carbon dioxide as a waste product. Red blood cells carry carbon dioxide away
from the tissues and back to the lungs. White blood cells are responsible
primarily for defending the body against infection. There are five main types of
white blood cells. Neutrophils, the most numerous type, help protect the body
against infections by killing and ingesting bacteria and fungi and by ingesting
foreign debris. Lymphocytes consist of T cells (T lymphocytes) and natural killer
cells, which both help protect against viral infections and can detect and destroy
some cancer cells, and B cells (B lymphocytes), which develop into cells that
produce antibodies. Monocytes ingest dead or damaged cells and help defend
against many infectious organisms. Eosinophils kill parasites, destroy cancer
cells, and are involved in allergic responses. Basophils also participate in allergic
responses. Platelets help in the clotting process by gathering at a bleeding site
and clumping together to form a plug that helps seal the blood vessel. RBC 120
DAYS. Platelets (Thrombocytes) 5 to 9 days. WBC 3 to 4 DAYS
13. Lack of this factor will lead to mal absorption of what Vitamins and
will lead to what type of anemia?
Intrinsic factor (IF), also known as gastric intrinsic factor (GIF), vitamin B12,
Pernicious anemia
14. Give me the medical term for Elevated and Decrease RBC, WBC and
Thrombocytes counts.
Polycythemia Too many red blood cells. The opposite of anemia. Leukocytosis
High white blood cell count is an increase in disease-fighting cells. Leukopenia a decrease in the total number of white blood cells. Thrombocytosis is a disorder
in which your body produces too many platelets. Thrombocytopenia is a
condition in which you have a low blood platelet count.
15. What is the process of RBC production and where are the RBCs are
being destroyed and recycled?
Erythropoiesis. Liver spleen or bone marrow by macrophages. Throughout the
body.
16. Differentiate the characteristic of the artery and vein.
All blood vessels leading from the heart are called arteries or the blood vessels
which carry blood from the heart to various body organs are arteries. All arteries
carry oxygenated blood except pulmonary artery. Arteries have thick elastic
muscle walls and valves are absent, blood flows under high pressure the vessels
which carry blood from various body organs to the heart is known as veins. All
veins carry deoxygenated blood except pulmonary vein. Veins have thin non
elastic walls and valves are present to prevent backflow of the blood, blood flows
under low pressure
17. What is the medical term for the following Vitamins, ADEKC, B1,B2,
B6, B12?

Vitamin A (Retinol), VITAMIN D (calciferol), VITAMIN E (alpha-tocopherol) VITAMIN

K, (phylloquinone, menadione) Vitamin C: Ascorbic acid, Vitamin B1: Thiamin
Vitamin B2: Riboflavin, vitamin B6 Pyridoxine, Vitamin B12 (cobalamin)
18. Give me at least 4 major functions of Blood and the normal pH.
-transporting oxygen and nutrients to the lungs and tissues-forming blood clots
to prevent excess blood loss-carrying cells and antibodies that fight infectionbringing waste products to the kidneys and liver, which filter and clean the
blood-regulating body temperature. Arterial and venous blood must maintain a
slightly alkaline pH: arterial blood pH = 7.41 and venous blood pH = 7.36.
Because the normal pH of arterial blood is 7.41, a person is considered to have
acidosis when the pH of blood falls below this value and to have alkalosis when
the pH rises above 7.41.

19.

What are the 3 formed elements of blood. What are the 3 major
plasma proteins in blood?
RBC, WBC, Platelets. 1. Albumin (responsible for maintaining blood osmolarity)
2. Fibrinogen- (important in blood clot formation) 3. Globulins (They carry stuff.
Hormones like steroids that are not soluble in blood.)
20. What is the normal WBC count in adult? And enumerate the types of
WBC and the corresponding type of infection specific for.
Red blood cell count- Male: 4.32-5.72 trillion cells/L* (4.32-5.72 million
cells/mcL**) female: 3.90-5.03 trillion cells/L (3.90-5.03 million cells/mcL)
Hemoglobin- Male: 13.5-17.5 grams/dL*** (135-175 grams/L) Female: 12.0-15.5
grams/dL (120-155 grams/L)
Hematocrit- Male: 38.8-50.0 percent-Female: 34.9-44.5 percent
White blood cell count 3.5-10.5 billion cells/L (3,500 to 10,500 cells/mcL)
Platelet count- 150-450 billion/L (150,000 to 450,000/mcL**)
Neutrophils they play a crucial role in fighting infection. They have a "C" shaped,
segmented nucleus. Neutrophils have a tendency to stick to the blood vessel
walls and block any germs that attempt to enter the bloodstream through an
infection or a wound. Eosinophils is to act against parasites and any antigen
complex present in the bloodstream. These cells are also known to be the cause
of many types of allergic responses within the blood. Basophils secrete
antibodies and anticoagulants. This limits any hypersensitive reactions within the
blood. Basophils are commonly associated with immediate immune reaction
against foreign particles in the bloodstream. Lymphocytes produce antibodies as
a part of the immune system response. The antibodies are secreted into the
blood plasma to act against harmful bacteria and toxins. The antibodies induce
the germs to join together in clusters, enabling the phagocytes to consume
them. The limitation of lymphocytes is that they are able to identify only certain
specific antigens in the bloodstream. Monocytes perform the role of tissue
macrophages that eliminate foreign particles and act against the multiplication
of germs that cannot be successfully combated by the neutrophils.
21. What is the major muscle for respiration and its blood and nerve
supply?
The diaphragm is the major muscle responsible for breathing. It is a thin, domeshaped muscle that separates the abdominal cavity from the thoracic cavity.
Motor nerve supply: The right and left phrenic (C3, 4, 5) Sensory nerve supply:
The parietal pleura and peritoneum covering the central surfaces of the
diaphragm is by phrenic & peripheral part by lower 6 intercostal. Blood supply:

The costal margin of the diaphragm by the lower five intercostal and the
subcostal arteries. The main mass of fibers rising up from the crura are supplied
on their abdominal surface by right and left inferior phrenic arteries from the
abdominal aorta.
22. How manly lobes are your R and L Lung. What covers directly the
lung tissue?
The right lung has three lobes, an upper, middle, and a lower, by two fissures,
one oblique and one horizontal. It has a deep concavity on its inner surface
called the cardiac impression at the level of the heart. This is not as pronounced
as that on the left lung where the heart projects further. The left lung has an
upper and a lower lobe divided by an oblique fissure. The lingula on the left
serves as an anatomic parallel to the right middle lobe, with both areas being
predisposed to similar infections and anatomic complications. It has an angular
indentation on the inner surface of its anterior border called the cardiac notch,
and a concavity called the cardiac impression at the level of the heart. This is
deeper and larger than that on the right, at which level the heart projects to the
left. (2) Pleura The tissue that covers and protects the lungs is called pleura

23.

What is that condition where there is an accumulation of fluids in the

lung pleura? Give me an example of an infection that is common in the
Philippines that may lead to such condition above?
A pleural effusion is a buildup of fluid in the pleural space, an area between the
layers of tissue that line the lungs and the chest cavity. It may also be referred to
as effusion or pulmonary effusion. The type of fluid that forms a pleural effusion
may be categorized as either transudate or exudate. Transudate is usually
composed of ultra filtrates of plasma due to an imbalance in vascular hydrostatic
and oncotic forces in the chest (heart failure, cirrhosis), while exudate is typically
produced by inflammatory conditions (lung infection, malignancy). Exudative
pleural effusions are usually more serious and difficult to treat.
There are many causes of pleural effusions:
Congestive heart failure, Kidney failure, Infection, Malignancy, Pulmonary
embolism
Hypoalbuminemia, Cirrhosis, Trauma
The development of a pleural effusion occurs from fluid seeping into the pleural
space, a thin area between the visceral and pleural membranes in the chest
cavity, which normally contains a small amount of fluid to facilitate smooth lung
movement. Fluid under pressure, malignant cells, and infectious agents can
occasionally enter this space and cause it to expand with abnormal amounts of
fluid and other compounds

24. Give me the accessory muscles for respiration and exhalation.

- sternomastoid, the scalenus anterior, medius and posterior, the
pectoralis major and minor, the inferior fibres of serratus anterior and
latissimus dorsi.
25. What is the physiologic function of your nose? And what
condition where a person cannot differentiate types of scent.
The physiologic function of the nose includes respiration, conditioning
inspired air, vocal resonance, olfaction, and nasal resistance, protection of
the lower airway, and ventilation and drainage of the sinuses. (2) The
complete loss of smell is called anosmia (an-OHZ-me-uh). Anosmia is due
to an inflammation of the nasal mucosa, blockage of nasal passages or a
destruction of one temporal lobe. Inflammation is due to chronic mucosa
changes in the paranasal sinus lining and the middle and superior
turbinates. Since anosmia causes inflammatory changes in the nasal
passageways, it is treated by simply reducing the presence of
inflammation. Nasal congestion from a cold, allergy, sinus infection, or
poor air quality is the most common cause of anosmia.
26. Where is the location of your trachea and the type of
connective tissue?
The trachea begins at the inferior end of the larynx in the base of the
neck. It is located along the bodys midline, anterior to the esophagus and
just deep to the skin, so that it is possible to feel the larynx through the
skin of the neck. From its origin at the larynx, the trachea extends
inferiorly into the thorax posterior to the sternum in the thorax, the
trachea ends where it splits into the left and right bronchi, which continue
onward toward the lungs/ -begins just under the larynx (voice box) and
runs down behind the breastbone (sternum). (2) Perichondrium

27. What is the normal Respiratory Rate of adult per minute and
what is the term used for decrease or increase of Respiratory
Rate?
The typical respiratory rate for a healthy adult at rest is 1220 breaths per
minute (2)
A normal respiratory rate is termed eupnea, an increased respiratory rate
is termed tachypnea and a lower-than-normal respiratory rate is termed
bradypnea.
28. What are the different zones for respirations and gas
exchange? And what protects the new born infant for the
condition called ARDS or acute respiratory distress syndrome?
The conducting zone consists of the nose, pharynx, larynx, trachea,
bronchi, and bronchioles. These structures form a continuous passageway
for air to move in and out of the lungs. The respiratory zone is found deep
inside the lungs and is made up of the respiratory bronchioles, alveolar
ducts, and alveoli. These thin-walled structures allow inhaled oxygen (O2)
to diffuse into the lung capillaries in exchange for carbon dioxide (CO2).
29. What is the normal lung capacity of an adult in One respiration
and how many percent of the inhaled air are being used during
gas exchange?
average total lung capacity of an adult human male is about 6 litres of air.
(2)
30. Enumerate the major and accessory organ or structure for
digestion?
The major parts of the digestive system: Salivary glands. Pharynx.
Esophagus. Stomach. Small Intestine. Large Intestine. Rectum.
Accessory digestive organs: liver, gallbladder, pancreas.
31. How many layers are your GIT and enumerate those later from
the outermost to innermost?
The GI tract contains four layers: the innermost layer is the mucosa,
underneath this is the submucosa, followed by the muscularis externa and
finally, the outermost layer - the adventitia.
32. Enumerate the different cells found in your Gastric Mucosa and
the enzymes or substance being secreted.
Surface Mucous cells-secrete a mucus, neck mucous cells- secret a mucus
whose acidity is more neutral than that secreted by the cells at the
surface of the stomach lining, chief cells- secrete pepsinogen, parietal
cells- secrete hydrochloric acid and an intrinsic factor, G cells- produce
and secrete the hormone gastrin
33. What is the normal pH of your gastric acid and what type of
Ulcer common to Older population and the younger population.
- 1.5 3.5 pH. Older: stomach ulcers. Younger: mouth ulcers

34. What enzyme is responsible for the initial process of

digestion of carbohydrates and where does it takes place.
Amylase. In the mouth
35.
Enumerate the different types of salivary glands and the
location where the individual duct opens?
- Parotid: wrapped around the mandibular ramus, submandibular:
beneath the lower jaws, superior to the digastric muscles, and
sublingual: inferior to the tongue, anterior to the submandibular
glands
36. How many segments is your Small intestine and what
ligament divides the Lower and Upper GI Tract?
- 3 segments. Ligament of Treitz
37. What is the location of your appendix and enumerate the
parts of your Large Intestines?
- sits at the junction of the small intestine and large intestine. (2)
Cecum - ascending colon - transverse colon - descending colon sigmoid colon.
38. What part of your GI tract where majority of water are being
absorbed. What gives color to your urine and stool?
Ileum. (2) Urine gets its yellow color from a pigment called urochrome.
That color normally varies from pale yellow to deep amber, depending
on the concentration of the urine. Darker urine is usually a sign that
you're not drinking enough fluid.
Bilirubin and bile give poop its normal brown color. Bilirubin is a byproduct
of your red blood cells. Its produced in the liver and then moves to the
gallbladder, where it mixes with bile. From there, most of the bilirubin
passes into your intestines where its broken down by bacteria and
discarded in your feces or urine.
39. What is Glycolysis, Glycogenesis, glyconeogenesis and
lipolysis?
Glycolysis: metabolic pathway that converts glucose into pyruvate.
Glycogenesis: process of glycogen synthesis, in which glucose molecules
are added to chains of glycogen for storage. Gluconeogenesis: metabolic
pathway that results in the generation of glucose from non-carbohydrate
carbon substrates such as pyruvate, lactate, glycerol, and glucogenic
amino acids. Lipolysis: breakdown of lipids and involves hydrolysis of
triglycerides into glycerol and free fatty acids.
40. What are the type of cells located in your pancreas and
what is the hormones being produced by each cells necessary
for regulation of blood sugar.
- Alpha - glucagon, beta insulin & amylin, delta - somatostatin , PP
pancreatic polypeptide and epsilon - ghrelin.
41. What is the reservoir for your bile and how does the bile
helps in absorption of fats?

- Gallbladder. Emulsification of lipid aggregates: Bile acids have

detergent action on particles of dietary fat which causes fat globules
to break down or be emulsified into minute, microscopic droplets.
Emulsification is not digestion per se, but is of importance because it
greatly increases the surface area of fat, making it available for
digestion by lipases, which cannot access the inside of lipid droplets.
Solubilization and transport of lipids in an aqueous environment: Bile
acids are lipid carriers and are able to solubilize many lipids by forming
micelles - aggregates of lipids such as fatty acids, cholesterol and
monoglycerides - that remain suspended in water. Bile acids are also
critical for transport and absorption of the fat-soluble vitamins.
42. What is the general term for yellowish discoloration of your
skin and give me at least one disease or condition that may
lead to this.
- Jaundice. Hepatitis.

43. What is the largest gland in your body and give me at least
4 major function necessary for life survival.
- Liver. Bile production and excretion, Excretion of bilirubin,
cholesterol, hormones, and drugs, Metabolism of fats, proteins, and
carbohydrates, Enzyme activation.
44. What CN responsible for taste, Gag reflex and movement of
your tongue?
- Taste: Cranial nerve IX (glossopharyngeal nerve). Gag reflex Cranial nerve X (vagus nerve). Movement of tongue - Cranial nerve XII
(hypoglossal nerve).
45. What enzymes responsible for final breakdown of Fats,
proteins and carbohydrates?
- trypsin - protein; pancreatic lipase - fat; and, pancreatic amylase carbohydrates.