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程序代写案例-202P/2016
时间：2022-05-11
MPHY202P/2016 1 TURN OVER
Answer ALL THREE questions in section A and TWO questions from section B
The numbers in brackets in the right-hand margin indicate the provisional allocation of
maximum marks per sub-section of a question.
SECTION A
1) What is the main organ of the integumentary system? What are its main roles?
[6]
2) Match the microscope slides of muscle tissue to the type (cardiac, skeletal and smooth).
State the anatomical features you used to do this. Where is smooth muscle found?
a) b) c)
Figure 2 (Micrographs provided by the Regents of University of Michigan Medical School
© 2012) By OpenStax College via Wikimedia Commons
[6]
3) What is the physiological role of red blood cells? Describe their anatomy, with the aid of a
diagram, and explain how this is appropriate for their physiological role. What will happen to
red blood cells if they are placed in a hypotonic solution?
[8]
MPHY202P/2016 2 CONTINUED
SECTION B
QUESTION 4
THE NERVOUS SYSTEM
A cyclist collided with a car traveling at 30 PSK)LUVWVKHKLWWKHFDU¶VERQQHWVXVWDLQLQJ
damage to the left anterior quarter of her head, before flying through the air and landing 5 m
away. She has severe bruising to the right patella and a fractured right collarbone. The cyclist
was unconscious for a couple of minutes, then appeared to make a full recovery, but several
hours later developed a severe headache and felt sick. By the time she had reached hospital,
her breathing had become slow and noisy, and she appeared very drowsy.
(a) Draw a sketch like Figure 4.1 and indicate, with a labelled circle, the position of each injury.
Figure 4.1 By Osteomyoamare (Own work)
[3]
(b) Explain the importance of haemostasis and its 3 main stages.
[4]
(c) On reaching hospital, a CT scan of her head was performed which showed a large left sided
frontal parietal subdural hematoma (blood pool) with associated midline shift (Figure 4.2).
The clinician suspected an increase in intracranial pressure.
MPHY202P/2016 3 TURN OVER
Figure 4.2 Large left sided frontal parietal subdural hematoma with associated midline shift
Arrow indicates haematoma. By James Heilman, MD (Own work), via Wikimedia Commons
(i) What is the orientation of the slice shown?
(ii) Name the white structure (i in Figure 4.2). What is its function? Relate its function to
its structure.
(iii) Name the black, fluid filled structures (ii in Figure 4.2). What is this fluid?
(iv) Name the principal tissue type in the grey coloured regions.
[7]
(d) TKHVXEMHFW¶Vnoisy breathing indicates that the medulla oblongata is being compressed.
Deduce how this could be, given that the bleed is over the frontal cortex.
[2]
ŝ
ŝŝ
,ĂĞŵĂƚŽŵĂ
MPHY202P/2016 4 CONTINUED
(e) Using your knowledge and Figure 4.3, compare the anatomy of myelinated and unmyelinated
nerves, noting both the common features and differences, and how they interact with other
neurons. Which will conduct nerve impulses faster? Explain why this happens.
[9]
(f) A passing pedestrian saw the incident and immediately experienced an increased breathing
and pulse rate, dilated pupils, reduced blood flow to the skin and other changes, due to a
combination of inputs from two signalling systems: nerve impulses and adrenalin.
(i) Adrenalin is produced by which organ system?
(ii) State the main difference between the two signalling systems, in terms of their
mode of operation
(iii) Explain using this example why these two systems are complementary
[5]
Figure 4.3 Two types of neuron. By Nick Gorton [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-
sa/3.0)], via Wikimedia Commons
MPHY202P/2016 5 TURN OVER
QUESTION 5
THE URINARY SYSTEM
(a) Name components i-iv in figure 5.1 and state their function
[9]
(b) What is the main difference between male and female urinary systems? From this deduce
why females are more prone to urinary infections by bacteria/yeasts that normally live on the
skin.
[3]
(c) Which other body systems remove waste from the body? What types of waste does each
remove?
[4]
(d) The United Nations Population Fund (UNFPA) defines obstetric fistula as:
³$FKLOGELUWKLQMXU\WKDWKDVEHHQODUJHO\QHJOHFWHGGHVSLWHWKHGHYDVWDWLQJLPSDFWLWKDVRQ
the lives of affected girls and women. It is usually caused by prolonged, obstructed labour,
without timely medical intervention²typically an emergency Caesarean section. During
XQDVVLVWHGSURORQJHGREVWUXFWHGODERXUWKHVXVWDLQHGSUHVVXUHRIWKHEDE\¶VKHDGRQWKH
PRWKHU¶VSHOYLFERQHGDPDJHVVRIWWLVVXHVFUHDWLQJDKROH²or fistula²between the { 1 }
and the { 2 } and/or { 3 }. The pressure deprives blood flow to the tissue, leading to
necrosis. Eventually, the dead tissue comes away, leaving a fistula, which causes ..´
Figure 5.1 The Urinary system By Cancer Research UK via Wikimedia Commons,
with added labels
ŝ
ŝǀ
ŝŝŝ
ŝŝ
ƉƌŽƐƚĂƚĞ
MPHY202P/2016 6 CONTINUED
(i) Name parts 1, 2 & 3 which are blanked out in the passage above and in figure 5.2.
[3]
(ii) Describe the location of the common fistula area marked with an arrow, using
anatomical language.
[2]
(iii) Deduce the ending of the last sentence of the definition, which describes the direct
physical consequences and discuss the likely indirect physical and social/psychological
consequences
[4]
Figure 5.2
https://commons.wikimedia.org/wiki/File:Obstetric_Fistula_Locations_Diagram.png with
modified labels
Such fistulas can be often be cured with a relatively simple operation to suture (stitch) the
wound if the woman is aware of that possibility and has access to a suitable hospital. Ideally
she should return for at least one check-up, but often does not, because of the difficulty and
cost of the journey, which may be several days.
(e) Based on the information here, discuss the advantages and disadvantages of the two suture
materials, described in Appendix 1, for this application.
[5]
MPHY202P/2016 7 TURN OVER
QUESTION 6
THE SKELETAL SYSTEM
A mine disposal worker has sustained bi-lateral damage to his feet and lower limbs, resulting
in below-the-knee amputations of both legs.
(a) Name the bones of the lower limb, and the bone groups of the feet, in order from proximal to
distal.
[7]
(b) Draw a midsagittal cross-section of the larger of these bones and label the following
structures:
(i) Compact bone
(ii) Spongy bone
(iii) Marrow cavity
(iv) Epiphyseal line
[5]
(c) Compare the structure and function of the compact and spongy bone, and explain how
structure relates to function.
[3]
(d) Where is red bone marrow found, and what is its role in the body?
[2]
(e) As you assess him, in preparation for fitting prosthetic limbs, he has requested that you
design them to make him 6ft 3in (190 cm) tall, like his friend Bill. Using Appendix 2 and the
information that he was 128 cm tall at the age of 8, determine whether or not this a
reasonable request. Explain your logic.
[4]
MPHY202P/2016 8 CONTINUED
(f) Consider Figure 6, showing the knee joint.
Figure 6 Medial view of the knee showing anatomical features By National Institute of
Arthritis and Musculoskeletal and Skin Diseases (NIAMS), via Wikimedia Commons
(i) What type of joint is the junction between the femur and tibia?
[1]
(ii) What is the purpose of the cartilage? Relate this to its physical properties.
[2]
(iii) Describe the similarity and differences between tendons and ligaments.
[3]
(iv) By analysis of Figure 6 deduce the role of the medial collateral ligament.
Explain what the mechanical consequences would be if it snapped (use diagrams as
appropriate).
[3]
MPHY202P/2016 9 TURN OVER
Appendix 1: Comparison of two suture materials from FUTURA SURGICARE PVT LTD;
BANGALORE ± 22, INDIA
Brand name: LINEX ® PROGUT ®
Material: Monofilament Polyamide
Non ± absorbable surgical suture.
Catgut Plain
Description:
Linex® suture is an extremely strong very
pliable surgical nylon. It has high in vivo
tensile strength, does not support bacterial
growth & has the further advantages of
being remarkably smooth & easy to handle.
Surgical catgut suture is a sterile absorbable suture
composed of purified connective tissue (collagen)
derived from the sub mucosal layer of sheep
(Ovine) intestine.
Indications:
Linex® is suitable for closing skin sub
cuticular layers. Its high degree of elasticity
contributes to its great strength in the fine
sizes.
Progut ® is for use in general soft tissue
approximation and/or ligation.
Performance: Linex® suture elicits a minimal initial
inflammatory reaction in tissues which
is followed by gradual encapsulation of the
suture by fibrous connective tissue. Linex®
suture is not absorbed nor is it subjected to
degradation or weakening by the action of
tissue enzymes.
Its lack of adherence to tissue Linex® is
effective as a pull out suture.
When Progut ® suture is implanted, a moderate
tissue inflammation occurs which is a characteristic
of a foreign body response. Loss of tensile strength
and loss of suture mass follows as the proteolytic
enzymatic digestive process resorbs the surgical
catgut. Due to inherent variability of a natural
material, figures for the strength loss and absorption
following implantation are for guidelines only.
Effective strength is usually lost by 15 - 17 days. In
humans, various factors may affect the tensile
strength loss and rate of absorption. Two major
factors are:
Infection: Progut ® is absorbed more rapidly in
infected tissues than in non infected tissues.
Tissue sites: Progut ® is absorbed more rapidly in
tissues where increased levels of proteolytic
enzymes are present, as in the secretions from the
stomach, cervix and vagina.
Contra ±
indications:
None known These sutures, being non absorbable, should not be
used where extended approximation of tissues
under stress is required. Progut ® is contraindicated
for use in cardiovascular and neurological tissues.
Progut ® is contraindicated in patients with known
sensitive or allergies to collagen.
Warnings: As with any foreign body, prolonged
contact of any suture with salt solutions,
such as those found in the urinary or biliary
tracts may result in calculus
formation
This suture may be inappropriate in elderly,
malnourished patients or in patients suffering from
conditions which may delay wound healing. As an
absorbable suture, Progut ® acts transiently as a
foreign body. As with any foreign body, prolonged
contact of any suture with salt solutions, such as
those found in urinary or bilary tracts may result in
calculus formation.
MPHY202P/2016 10 CONTINUED
Appendix 2: WHO height chart for boys age 4-20
WHO Boys HT 4-20yrs(new Style)2pps.pdf
Answer ALL THREE questions in section A and TWO questions from section B
The numbers in brackets in the right-hand margin indicate the provisional allocation of
maximum marks per sub-section of a question.
SECTION A
1) What is the main organ of the integumentary system? What are its main roles?
[6]
2) Match the microscope slides of muscle tissue to the type (cardiac, skeletal and smooth).
State the anatomical features you used to do this. Where is smooth muscle found?
a) b) c)
Figure 2 (Micrographs provided by the Regents of University of Michigan Medical School
© 2012) By OpenStax College via Wikimedia Commons
[6]
3) What is the physiological role of red blood cells? Describe their anatomy, with the aid of a
diagram, and explain how this is appropriate for their physiological role. What will happen to
red blood cells if they are placed in a hypotonic solution?
[8]
MPHY202P/2016 2 CONTINUED
SECTION B
QUESTION 4
THE NERVOUS SYSTEM
A cyclist collided with a car traveling at 30 PSK)LUVWVKHKLWWKHFDU¶VERQQHWVXVWDLQLQJ
damage to the left anterior quarter of her head, before flying through the air and landing 5 m
away. She has severe bruising to the right patella and a fractured right collarbone. The cyclist
was unconscious for a couple of minutes, then appeared to make a full recovery, but several
hours later developed a severe headache and felt sick. By the time she had reached hospital,
her breathing had become slow and noisy, and she appeared very drowsy.
(a) Draw a sketch like Figure 4.1 and indicate, with a labelled circle, the position of each injury.
Figure 4.1 By Osteomyoamare (Own work)
[3]
(b) Explain the importance of haemostasis and its 3 main stages.
[4]
(c) On reaching hospital, a CT scan of her head was performed which showed a large left sided
frontal parietal subdural hematoma (blood pool) with associated midline shift (Figure 4.2).
The clinician suspected an increase in intracranial pressure.
MPHY202P/2016 3 TURN OVER
Figure 4.2 Large left sided frontal parietal subdural hematoma with associated midline shift
Arrow indicates haematoma. By James Heilman, MD (Own work), via Wikimedia Commons
(i) What is the orientation of the slice shown?
(ii) Name the white structure (i in Figure 4.2). What is its function? Relate its function to
its structure.
(iii) Name the black, fluid filled structures (ii in Figure 4.2). What is this fluid?
(iv) Name the principal tissue type in the grey coloured regions.
[7]
(d) TKHVXEMHFW¶Vnoisy breathing indicates that the medulla oblongata is being compressed.
Deduce how this could be, given that the bleed is over the frontal cortex.
[2]
ŝ
ŝŝ
,ĂĞŵĂƚŽŵĂ
MPHY202P/2016 4 CONTINUED
(e) Using your knowledge and Figure 4.3, compare the anatomy of myelinated and unmyelinated
nerves, noting both the common features and differences, and how they interact with other
neurons. Which will conduct nerve impulses faster? Explain why this happens.
[9]
(f) A passing pedestrian saw the incident and immediately experienced an increased breathing
and pulse rate, dilated pupils, reduced blood flow to the skin and other changes, due to a
combination of inputs from two signalling systems: nerve impulses and adrenalin.
(i) Adrenalin is produced by which organ system?
(ii) State the main difference between the two signalling systems, in terms of their
mode of operation
(iii) Explain using this example why these two systems are complementary
[5]
Figure 4.3 Two types of neuron. By Nick Gorton [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-
sa/3.0)], via Wikimedia Commons
MPHY202P/2016 5 TURN OVER
QUESTION 5
THE URINARY SYSTEM
(a) Name components i-iv in figure 5.1 and state their function
[9]
(b) What is the main difference between male and female urinary systems? From this deduce
why females are more prone to urinary infections by bacteria/yeasts that normally live on the
skin.
[3]
(c) Which other body systems remove waste from the body? What types of waste does each
remove?
[4]
(d) The United Nations Population Fund (UNFPA) defines obstetric fistula as:
³$FKLOGELUWKLQMXU\WKDWKDVEHHQODUJHO\QHJOHFWHGGHVSLWHWKHGHYDVWDWLQJLPSDFWLWKDVRQ
the lives of affected girls and women. It is usually caused by prolonged, obstructed labour,
without timely medical intervention²typically an emergency Caesarean section. During
XQDVVLVWHGSURORQJHGREVWUXFWHGODERXUWKHVXVWDLQHGSUHVVXUHRIWKHEDE\¶VKHDGRQWKH
PRWKHU¶VSHOYLFERQHGDPDJHVVRIWWLVVXHVFUHDWLQJDKROH²or fistula²between the { 1 }
and the { 2 } and/or { 3 }. The pressure deprives blood flow to the tissue, leading to
necrosis. Eventually, the dead tissue comes away, leaving a fistula, which causes ..´
Figure 5.1 The Urinary system By Cancer Research UK via Wikimedia Commons,
with added labels
ŝ
ŝǀ
ŝŝŝ
ŝŝ
ƉƌŽƐƚĂƚĞ
MPHY202P/2016 6 CONTINUED
(i) Name parts 1, 2 & 3 which are blanked out in the passage above and in figure 5.2.
[3]
(ii) Describe the location of the common fistula area marked with an arrow, using
anatomical language.
[2]
(iii) Deduce the ending of the last sentence of the definition, which describes the direct
physical consequences and discuss the likely indirect physical and social/psychological
consequences
[4]
Figure 5.2
https://commons.wikimedia.org/wiki/File:Obstetric_Fistula_Locations_Diagram.png with
modified labels
Such fistulas can be often be cured with a relatively simple operation to suture (stitch) the
wound if the woman is aware of that possibility and has access to a suitable hospital. Ideally
she should return for at least one check-up, but often does not, because of the difficulty and
cost of the journey, which may be several days.
(e) Based on the information here, discuss the advantages and disadvantages of the two suture
materials, described in Appendix 1, for this application.
[5]
MPHY202P/2016 7 TURN OVER
QUESTION 6
THE SKELETAL SYSTEM
A mine disposal worker has sustained bi-lateral damage to his feet and lower limbs, resulting
in below-the-knee amputations of both legs.
(a) Name the bones of the lower limb, and the bone groups of the feet, in order from proximal to
distal.
[7]
(b) Draw a midsagittal cross-section of the larger of these bones and label the following
structures:
(i) Compact bone
(ii) Spongy bone
(iii) Marrow cavity
(iv) Epiphyseal line
[5]
(c) Compare the structure and function of the compact and spongy bone, and explain how
structure relates to function.
[3]
(d) Where is red bone marrow found, and what is its role in the body?
[2]
(e) As you assess him, in preparation for fitting prosthetic limbs, he has requested that you
design them to make him 6ft 3in (190 cm) tall, like his friend Bill. Using Appendix 2 and the
information that he was 128 cm tall at the age of 8, determine whether or not this a
reasonable request. Explain your logic.
[4]
MPHY202P/2016 8 CONTINUED
(f) Consider Figure 6, showing the knee joint.
Figure 6 Medial view of the knee showing anatomical features By National Institute of
Arthritis and Musculoskeletal and Skin Diseases (NIAMS), via Wikimedia Commons
(i) What type of joint is the junction between the femur and tibia?
[1]
(ii) What is the purpose of the cartilage? Relate this to its physical properties.
[2]
(iii) Describe the similarity and differences between tendons and ligaments.
[3]
(iv) By analysis of Figure 6 deduce the role of the medial collateral ligament.
Explain what the mechanical consequences would be if it snapped (use diagrams as
appropriate).
[3]
MPHY202P/2016 9 TURN OVER
Appendix 1: Comparison of two suture materials from FUTURA SURGICARE PVT LTD;
BANGALORE ± 22, INDIA
Brand name: LINEX ® PROGUT ®
Material: Monofilament Polyamide
Non ± absorbable surgical suture.
Catgut Plain
Description:
Linex® suture is an extremely strong very
pliable surgical nylon. It has high in vivo
tensile strength, does not support bacterial
growth & has the further advantages of
being remarkably smooth & easy to handle.
Surgical catgut suture is a sterile absorbable suture
composed of purified connective tissue (collagen)
derived from the sub mucosal layer of sheep
(Ovine) intestine.
Indications:
Linex® is suitable for closing skin sub
cuticular layers. Its high degree of elasticity
contributes to its great strength in the fine
sizes.
Progut ® is for use in general soft tissue
approximation and/or ligation.
Performance: Linex® suture elicits a minimal initial
inflammatory reaction in tissues which
is followed by gradual encapsulation of the
suture by fibrous connective tissue. Linex®
suture is not absorbed nor is it subjected to
degradation or weakening by the action of
tissue enzymes.
Its lack of adherence to tissue Linex® is
effective as a pull out suture.
When Progut ® suture is implanted, a moderate
tissue inflammation occurs which is a characteristic
of a foreign body response. Loss of tensile strength
and loss of suture mass follows as the proteolytic
enzymatic digestive process resorbs the surgical
catgut. Due to inherent variability of a natural
material, figures for the strength loss and absorption
following implantation are for guidelines only.
Effective strength is usually lost by 15 - 17 days. In
humans, various factors may affect the tensile
strength loss and rate of absorption. Two major
factors are:
Infection: Progut ® is absorbed more rapidly in
infected tissues than in non infected tissues.
Tissue sites: Progut ® is absorbed more rapidly in
tissues where increased levels of proteolytic
enzymes are present, as in the secretions from the
stomach, cervix and vagina.
Contra ±
indications:
None known These sutures, being non absorbable, should not be
used where extended approximation of tissues
under stress is required. Progut ® is contraindicated
for use in cardiovascular and neurological tissues.
Progut ® is contraindicated in patients with known
sensitive or allergies to collagen.
Warnings: As with any foreign body, prolonged
contact of any suture with salt solutions,
such as those found in the urinary or biliary
tracts may result in calculus
formation
This suture may be inappropriate in elderly,
malnourished patients or in patients suffering from
conditions which may delay wound healing. As an
absorbable suture, Progut ® acts transiently as a
foreign body. As with any foreign body, prolonged
contact of any suture with salt solutions, such as
those found in urinary or bilary tracts may result in
calculus formation.
MPHY202P/2016 10 CONTINUED
Appendix 2: WHO height chart for boys age 4-20
WHO Boys HT 4-20yrs(new Style)2pps.pdf
