Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date BIOS 256 FINAL EXAM STUDY Q&A | Comprehensive ATI 1. The urinary system does all of the following, EXCEPT it: A. secretes excess glucose moleculesB. regulates blood volumeC. contributes to stabilizing blood pHD. eliminates organic waste productsE. regulates plasma concentrations of electrolytes 2. Conical structures that are located in the renal medulla are called: A. pyramidsB. renal columnsC. renal pelvisesD. nephronsE. calyces 3. The region known as the macula densa is part of: A. the proximal convoluted tubuleB. the distal convoluted tubuleC. the collecting ductD. the ascending loop of HenleE. Bowman’s capsule 4. The cells of the macula densa and the juxtaglomerular cells form the: A. renal corpuscleB. filtration membraneC. loop of HenleD. juxtaglomerular apparatusE. afferent arteriole 5. A glomerulus is: A. the expanded end of a nephronB. a knot of capillaries that lies within the renal corpuscleC. the portion of the nephron closest to the renal corpuscleD. the portion of the nephron that attaches to the collecting ductE. the horseshoe-shaped segment of the nephron 6. The proper order in which blood passes through the kidney vessels is: A. 4, 6, 2, 3, 1, 5, 7, 8B. 4, 3, 2, 6, 1, 5, 7, 8C. 4, 3, 2, 6, 7, 5, 1, 8D. 4, 6, 2, 3, 7, 5, 1, 8E. 4, 3, 6, 2, 1, 5, 7, 8 7. The process of filtration is driven by: A. active transportB. blood osmotic pressureC. blood hydrostatic pressureD. renal pumping 8. The mechanisms for maintaining the solute concentration gradient in the renal medulla require: A. active transport of sodium and chloride ions from the ascending limb of the loop of HenleB. active transport of sodium and chloride ions from the ascending limb of the vasa rectaC. the ascending limb of the loop of Henle to be permeable to waterD. the vasa recta to be impermeable to waterE. both A and B 9. Which of the following is greater? A. the concentration of solute in the filtrate at the beginning of the loop of HenleB. the concentration of solute in the filtrate at the bottom of the descending limb of the loop of Henle 10. The antidiuretic hormone: A. increases the permeability of the collecting ducts to waterB. is secreted in response to low concentrations of potassium ions in the extracellular fluidC. causes the kidneys to produce a larger volume of relatively solute-free urineD. helps regulate the concentration of potassium ion in the interstitial spaceE. is sensitive to changes in the blood concentrations of both sodium and potassium 11. In the loop of Henle: A. water is secreted into the descending limbB. sodium and chloride ions are actively transported out of the ascending limbC. the ascending limb is very permeable to waterD. the filtrate in the descending limb becomes more and more hypotonicE. filtrate is produced 12. Which hormone stimulates the thirst mechanism most? A. ADHB. aldosteroneC. ANPD. BNPE. natriuretic peptide 13. All of the following are components of ECF, EXCEPT: A. cerebral spinal fluidB. peritoneal fluidC. lymphD. aqueous humorE. plasma 14. Which hormone plays a role in determining the rate of sodium absorption and potassium loss? A. ADHB. aldosteroneC. ANPD. BNPE. natriuretic peptide 15. You are caring for a patient who has been vomiting and having diarrhea for the past five days. You suspect that his electrolyte levels are: A. normalB. elevatedC. the same as upon admissionD. decreasedE. noncritical 16. Which hormone affects the osmotic concentration of urine without affecting any ion levels? A. ADHB. aldosteroneC. ANPD. BNPE. natriuretic peptide 17. The most common problems with electrolyte balance are caused by an imbalance between gains and losses of: A. calcium ionsB. chlorine ionsC. potassium ionsD. sodium ionsE. magnesium ions 18. The higher the plasma concentration of aldosterone, the more efficiently the kidney will: A. conserve sodium ionsB. retain potassium ionsC. stimulate urinary water lossD. secrete greater amounts of ADHE. all of the above 19. Angiotensin II produces a coordinated elevation in the ECF volume by: A. stimulating thirstB. causing the release of ADHC. triggering the production and secretion of aldosteroneD. A and BE. A, B, and C 20. Renal failure can result in: A. decreased ureaB. hyponatremiaC. hyperkalemiaD. hypokalemiaE. none of the above 21. Intracellular fluid (ICF) is found in: A. blood vesselsB. lymphC. the cells of the bodyD. the interstitial spaceE. the cerebrospinal fluid 22. The principal cation in intracellular fluid is: A. sodiumB. potassiumC. calciumD. magnesiumE. chloride 23. When water is lost, but electrolytes are retained: A. the osmolarity of the ECF fallsB. osmosis moves water from the ICF to the ECFC. both the ECF and the ICF become more diluteD. there is an increase in the volume of the ICFE. both A and D BIOS 256 Week 8 Final Exam Study 24. Consuming a meal high in salt will: A. drastically increase the osmolarity of the bloodB. result in a temporary increase in blood volumeC. decrease thirstD. cause hypotensionE. activate the renin-angiotensin mechanism 25. Aldosterone: A. is secreted in response to elevated levels of sodium in the bloodB. promotes sodium retention in the kidneysC. helps decrease blood volumeD. increases the concentration of sodium in urineE. functions in pH regulation 26. When the level of sodium ion in extracellular fluid decreases: A. osmoreceptors are stimulatedB. a person experiences an increased thirstC. more ADH is releasedD. there is an increase in the level of aldosteroneE. there is an increase in the level of atrial natriuretic factor 27. Excess potassium ion is eliminated from the body by: A. sweatingB. the kidneysC. the liverD. the digestive systemE. the spleen 28. The amount of potassium secreted by the kidneys is regulated by: A. ADHB. aldosteroneC. parathormoneD. atrial natriuretic factorE. cortisol 29. Calcium reabsorption by the kidneys is promoted by the hormone: A. calcitoninB. calcitriolC. aldosteroneD. cortisolE. ADH 30. Each of the following statements concerning chloride ions is true, EXCEPT that: A. chloride ions are the most abundant anions in the ECFB. chloride ion concentrations in the ICF are usually lowC. chloride ions are absorbed along the digestive tract in the company of sodium ionsD. large amounts of chloride ions are lost each day in the urineE. chloride ions are

Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date Genetics and Inheritance 1. Define genotype. A genotype refers to the specific genetic makeup of an organism in terms of the alleles inherited from its parents. Alleles are different forms of a gene that can influence particular traits. The combination of these alleles—one from each parent—determines an individual’s genotype. This genetic composition governs whether certain traits will be expressed or remain recessive, even if they are present in the genetic code (Saladin, 2020). 2. Define phenotype. Phenotype refers to the observable physical or biochemical characteristics of an organism that result from the interaction between its genotype and the environment. These traits can include features such as eye color, height, or specific characteristics like the presence or absence of a cleft chin. While the genotype provides the blueprint, the phenotype represents the visible or measurable expression of those genetic instructions (Saladin, 2020). 3. What gene mutation is associated with cystic fibrosis? How does this affect mucus production? Cystic fibrosis (CF) is caused by mutations in the CFTR gene, which stands for cystic fibrosis transmembrane conductance regulator. This gene encodes a protein that helps regulate the movement of salt and water in and out of cells. Mutations in the CFTR gene lead to the production of a malfunctioning protein, disrupting the normal hydration of mucus. As a result, mucus becomes thick and sticky, leading to blockages in various organs. Furthermore, individuals with CF often have saltier sweat due to the disrupted regulation of sodium and chloride ions (U.S. Department of Health and Human Services, n.d.). 4. How is cystic fibrosis inherited? Cystic fibrosis follows an autosomal recessive inheritance pattern. This means that a child must inherit two copies of the mutated CFTR gene—one from each parent—to develop the disease. Individuals who inherit only one defective gene are carriers; they typically do not exhibit symptoms but can pass the gene to their offspring (U.S. Department of Health and Human Services, n.d.). 5. Describe 3 problems that a patient with cystic fibrosis may have—choose 1 problem from 3 different body systems. Body System Problem Associated with Cystic Fibrosis Description Skeletal System Bone Density Loss Individuals with CF often experience reduced bone mass and low body weight due to impaired osteoblast function. The defective CFTR protein indirectly increases osteoclast activity, which weakens bone structure (Stalvey & Clines, 2013). Respiratory System Chronic Lung Infections and Pulmonary Complications The accumulation of thick mucus in the airways leads to persistent respiratory infections, lung damage, and, in severe cases, partial lung collapse (Saladin, 2020). Reproductive System Infertility in Males Up to 95% of males with CF are infertile due to congenital bilateral absence of the vas deferens (CBAVD), a condition directly linked to the disease (Popli & Stewart, 2007). References Popli, K., & Stewart, J. (2007). Infertility and its management in men with cystic fibrosis: Review of literature and clinical practices in the UK. Human Fertility, 10(4), 217–221. https://doi.org/10.1080/14647270701510033 Saladin, K. S. (2020). Anatomy & Physiology: The Unity of Form and Function (9th ed.). McGraw-Hill Higher Education (US). https://ambassadored.vitalsource.com/books/9781260791563 BIOS 256 Week 7 Genetics and Inheritance Stalvey, M. S., & Clines, G. A. (2013). Cystic fibrosis-related bone disease. Current Opinion in Endocrinology, Diabetes & Obesity, 20(6), 547–552. https://doi.org/10.1097/01.med.0000436191.87727.ec U.S. Department of Health and Human Services. (n.d.). Causes. National Heart Lung and Blood Institute. Retrieved December 6, 2022, from https://www.nhlbi.nih.gov/health/cysticfibrosis/causes BIOS 256 Week 7 Genetics and Inheritance

Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date Week 6 Case Study: Reproductive System Required ResourcesPlease refer to the following materials to complete this assignment: Scenario Summary Patient History:A 26-year-old female reports the absence of menstruation for the past three months. She is not using any form of contraception. Physical Examination: Laboratory Results: Diagnosis:Polycystic Ovarian Syndrome (PCOS) resulting in: 1. Describe 3 effects of estrogen on the body. Estrogen is a vital hormone in the female body, influencing a variety of physiological systems. Beyond its role in regulating the menstrual cycle, estrogen contributes to the development and maintenance of the reproductive organs, including the uterus and ovaries. In the ovaries, it promotes the maturation of ovarian follicles, which are essential for ovulation. In the uterus, estrogen supports the thickening of the endometrial lining, preparing it for potential embryo implantation. Additionally, it maintains the health of the urinary tract, cardiovascular system, bones, skin, and brain. Estrogen also plays a key role in the development of secondary sexual characteristics, such as breast tissue, and regulates lactation by suppressing milk production after breastfeeding cessation (Johns Hopkins Medicine, 2021). 2. Describe 3 effects of testosterone on the body. Testosterone is commonly recognized as a male hormone, but it also exists in females in smaller amounts and plays several crucial roles. Firstly, it is essential for the development and maintenance of muscle mass due to its anabolic effects, promoting protein synthesis and reducing muscle degradation. Secondly, testosterone stimulates the production of red blood cells by enhancing erythropoietin (EPO) activity, which helps regulate hemoglobin levels. Lastly, in conjunction with LH and FSH produced by the pituitary gland, testosterone plays a vital role in sperm production and libido. When balanced properly with FSH, it supports the process of spermatogenesis, which is crucial for male fertility. 3. Predict the consequences of not having a menses due to anovulation. Include the effect on the endometrial lining. When ovulation does not occur (anovulation), it can lead to irregular or absent menstrual periods and subfertility or infertility. The most significant impact is the lack of progesterone production, which normally follows ovulation. Without progesterone, the endometrial lining continues to thicken under the influence of unopposed estrogen. This persistent stimulation may result in an abnormally thickened endometrium, which can eventually lead to irregular or heavy uterine bleeding. Over time, this can increase the risk of endometrial hyperplasia and even endometrial cancer if left untreated (England, 2021). 4. Why was a prolactin level checked? Name 2 symptoms a patient with a high prolactin level may have. A prolactin test was conducted to investigate potential causes of menstrual irregularity and infertility. Elevated prolactin levels can indicate the presence of a prolactinoma, a benign pituitary tumor, or other endocrine disorders. In women, high prolactin levels may suppress the secretion of gonadotropin-releasing hormone (GnRH), leading to anovulation and menstrual disturbances. BIOS 256 Week 6 Case Study Symptoms of hyperprolactinemia in women include: Symptom Description Irregular or absent menstruation Disruption in menstrual cycles or complete cessation Galactorrhea Milky discharge from the breasts unrelated to childbirth In men, elevated prolactin levels can cause symptoms such as reduced libido and erectile dysfunction (National Institute of Diabetes and Digestive and Kidney Diseases, 2021). 5. Research to discover, and list, 2 other problems a person with polycystic ovarian syndrome may have. Polycystic Ovarian Syndrome (PCOS) is a multifaceted endocrine disorder affecting various systems in the body. In addition to menstrual irregularities and hirsutism, individuals with PCOS may also experience metabolic and dermatological complications. Two additional complications associated with PCOS include: Problem Description Insulin resistance Many women with PCOS have difficulty using insulin effectively, increasing the risk of Type 2 diabetes. Skin pigmentation changes Acanthosis nigricans, or darkened skin patches, may appear on the neck, groin, or under the breasts. These symptoms may compound weight gain challenges and increase the risk for cardiovascular disease over time. Addressing these metabolic risks is crucial in the management of PCOS (Office of Women’s Health, 2019). References England, C. N. (2021). Anovulation. Women & Infants. Retrieved August 10, 2021, from https://fertility.womenandinfants.org/services/women/anovulation Estrogen’s Effects on the Female Body. (2021). Johns Hopkins Medicine. Retrieved August 10, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/estrogens-effects-on-the-female-body BIOS 256 Week 6 Case Study Prolactinoma. (2021, August 10). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/endocrine-diseases/prolactinoma U.S. Department of Health & Human Services. (2019, April 1). Polycystic ovary syndrome. Office of Women’s Health. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date Week 5: Case Study 2 1. What physiological imbalances are expected from vomiting stomach contents containing hydrochloric acid (HCl)? When hydrochloric acid (HCl) is expelled from the stomach through persistent vomiting, several physiological disturbances are likely to occur. These include dehydration, metabolic alkalosis, hypochloremia, and hypokalemia. The loss of gastric fluids results in significant depletion of body volume and vital electrolytes such as sodium (Na⁺), chloride (Cl⁻), hydrogen ions (H⁺), and potassium (K⁺). In response, the kidneys work to restore equilibrium by retaining sodium and excreting excess bicarbonate (HCO₃⁻). This compensatory mechanism may result in further hydrogen ion loss, thereby worsening alkalosis. The body prioritizes sodium conservation, often at the expense of hydrogen and potassium ions. Therefore, the continued loss of fluids inevitably causes ionic imbalance, pushing the body to adapt by sacrificing less critical ions to preserve homeostasis. 2. How does repeated vomiting affect chloride levels and acid-base balance? Repeated vomiting leads to a pronounced decline in chloride levels, contributing to a condition known as hypochloremic metabolic alkalosis. This occurs because the body loses essential electrolytes—including sodium, potassium, calcium, magnesium, bicarbonate, and chloride—each time gastric contents are expelled. The frequent loss of hydrochloric acid significantly reduces both hydrogen and chloride ions in the body. As bicarbonate builds up in the bloodstream without sufficient counterbalancing hydrogen ions, the blood’s pH rises, making it more alkaline. This shift can disturb multiple physiological functions and, if left untreated, may lead to serious complications (Saladin, 2020). 3. What is the physiological effect of administering normal saline intravenously? Normal saline is an isotonic solution, meaning it has the same salt concentration as cells and blood plasma. When administered via intravenous (IV) infusion, there is no net movement of water into or out of the body’s cells. This helps maintain cellular stability without causing cells to swell (as in hypotonic solutions) or shrink (as in hypertonic solutions). Normal saline is especially effective in restoring fluid volume and electrolyte balance during episodes of dehydration caused by fluid loss, such as vomiting (Tonog & Lakhkar, 2022). 4. What are the most common clinical signs of dehydration? The primary indicators of dehydration include: These signs suggest that the body is experiencing a fluid deficit, potentially affecting organ function and systemic circulation if not corrected promptly. Clinical Sign Implication Dry mouth Inadequate hydration of mucous membranes No tears Reduced fluid volume affecting tear glands Constipation Water reabsorption from the colon Concentrated urine Kidneys conserving water Low urine output Decreased kidney perfusion 5. How does the respiratory system contribute to maintaining acid-base balance? The respiratory system plays a key role in regulating acid-base balance by eliminating carbon dioxide (CO₂), a byproduct of cellular metabolism. Under normal conditions, the rate of CO₂ exhalation matches its production by body cells. The partial pressure of carbon dioxide (PCO₂) in the blood is typically maintained between 35-45 mm Hg. However, if respiratory function becomes impaired, CO₂ is retained, leading to the formation of more carbonic acid (H₂CO₃), which can lower blood pH. The carbonic anhydrase reaction, which converts carbonic acid to CO₂ and water, shifts to the left when PCO₂ decreases. This shift also leads to a decrease in hydrogen ion concentration, thereby raising the blood pH. Conversely, impaired CO₂ removal can push the reaction to the right, increasing hydrogen ions and lowering pH (Chamberlain University eDapt, 2021). References Saladin, K. S. (2020). Anatomy & Physiology: The Unity of Form and Function (9th ed.). McGraw-Hill Higher Education (US). Tonog, P., & Lakhkar, A. D. (2022). Normal Saline. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK545210/ BIOS 256 Week 5 Case Study Chamberlain University eDapt. (2021). Physiology and Homeostasis Learning Module.

Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date Kidney Week 4 Lab Instructions: Urinary System Activity Lab Deliverables and Materials All students are expected to complete Part A of the Week 4 lab, which focuses on the urinary system. This section contributes 30 points to the overall lab grade. Materials Required: Please refer to the course syllabus under “Due Dates for Assignments & Exams” to confirm the submission deadline for this lab. Activity: Kidney Dissection The kidney dissection exercise is adapted from McGraw-Hill resources and includes hands-on practice with anatomical identification. Dissection Instructions: Table 1: Identification of Kidney Structures (10 points) Letter Structure Name A Renal pyramid / Renal medulla B Minor calyx / Renal papilla C Renal pyramid D Renal cortex / Fibrous capsule E Renal sinus F Renal artery / Hilum G Renal column H Major calyx / Interlobar blood vessels I Branch of renal pelvis J Ureter Critical Thinking Questions 1. Trace the path of urine from the renal papilla to the ureter. (5 points) Urine exits the nephron at the renal papilla, then drains into the minor calyx, continues into the major calyx, flows into the renal pelvis, and finally passes into the ureter, which transports it to the bladder for temporary storage. 2. Trace the flow of blood throughout the kidney, starting with the renal artery and ending with the renal vein. (5 points) Blood enters the kidney via the renal artery, which branches into segmental arteries. These divide into interlobar arteries, then pass into arcuate arteries, and further into cortical radiate (interlobular) arteries. Blood then flows into afferent arterioles, enters the glomerulus, and exits through efferent arterioles. From there, blood reaches either peritubular capillaries or vasa recta, depending on nephron type. The return path includes interlobular veins, arcuate veins, interlobar veins, and finally, the renal vein, which drains into the inferior vena cava. 3. Trace the path of filtrate, starting with the glomerulus and ending at the collecting duct. (5 points) Filtrate forms in the glomerulus and enters the proximal convoluted tubule, where most reabsorption occurs. It then passes through the nephron loop (loop of Henle), followed by the distal convoluted tubule, and finally drains into the collecting duct, which carries it toward the renal papilla. 4. List and describe at least five functions of the urinary system/kidneys. (5 points) References Hall, J. E., & Guyton, A. C. (2021). Guyton and Hall Textbook of Medical Physiology (14th ed.). Elsevier. BIOS 256 Week 4 Lab Instructions Urinary System Marieb, E. N., & Hoehn, K. (2019). Human Anatomy & Physiology (11th ed.). Pearson Education.

Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date History BT is a 36-year-old female presenting with complaints of dysuria (painful urination) for the past two days, accompanied by increased urinary frequency. She denies experiencing fever or any other systemic symptoms. BT reports a decrease in her usual water intake. Physical Examination On physical examination, the abdomen is soft, non-tender, and without any palpable masses, indicating no signs of acute abdominal pathology. Laboratory Findings A urinalysis using a dipstick test reveals the presence of leukocytes and nitrites, which are indicative of a urinary tract infection (UTI). Additionally, ketones are detected in the urine (ketonuria), an unexpected finding that requires further investigation to determine the underlying cause of ketone production. Assessment The patient is diagnosed with a urinary tract infection alongside ketonuria. The presence of ketones in the urine suggests that the body is utilizing fat as an energy source due to insufficient glucose availability. Ketones are typically excreted via the lungs and kidneys. Additional patient history and testing are necessary to explore the potential metabolic reasons behind the ketonuria. 1. Identify 2 potential causes of ketonuria. Question: Identify 2 potential causes of ketonuria.Answer:Ketonuria can result from various metabolic conditions. Two potential causes include: Cause Description Diabetes Mellitus In uncontrolled diabetes, especially type 1, the lack of insulin prevents glucose from entering cells. This prompts the body to break down fats for energy, producing ketones as a by-product (Kitabchi et al., 2009). Glycogen Storage Disease This group of inherited disorders affects glycogen metabolism. In some types, the body is unable to access stored glucose, leading to fat metabolism and subsequent ketone production (Chen, 2001). 2. Identify the nutrient involved in the formation of ketones. Question: Identify the nutrient involved in the formation of ketones.Answer:The nutrient primarily involved in ketone formation is fat. When the body lacks sufficient glucose, it begins breaking down fat stores for energy. The fatty acids released are then converted into ketones by the liver (Volek & Phinney, 2011). Thus, ketone production increases when carbohydrate intake is low or glucose availability is impaired. 3. Describe the process of lipolysis and formation of ketones. Question: Describe the process of lipolysis and formation of ketones.Answer:Lipolysis is the catabolic process through which triglycerides, stored in fat cells, are broken down into glycerol and free fatty acids. The glycerol can be used for gluconeogenesis, while the free fatty acids are transported to the liver. In the liver, these fatty acids undergo beta-oxidation, forming acetyl-CoA. When acetyl-CoA accumulates beyond what the Krebs cycle can process, it is converted into ketone bodies (acetoacetate, beta-hydroxybutyrate, and acetone). This typically occurs during prolonged fasting, carbohydrate restriction, or insulin deficiency (Grabacka et al., 2016). 4. Is the process in Q3 anabolic or catabolic? Question: Is the process in Q3 anabolic or catabolic?Answer:The process described in Question 3 is catabolic. Catabolism refers to the breakdown of complex molecules into simpler ones to release energy. Lipolysis and the subsequent formation of ketones involve the degradation of triglycerides and fatty acids for energy production, fitting the definition of a catabolic pathway (Berg et al., 2002). 5. Predict the effect of excess ketones on the blood pH? Question: Predict the effect of excess ketones on the blood pH.Answer:Excessive accumulation of ketones in the blood can lead to a condition known as metabolic acidosis, specifically ketoacidosis. Ketone bodies are acidic in nature, and their overproduction reduces blood pH, making it more acidic. This is especially dangerous in diabetic ketoacidosis (DKA), where insufficient insulin causes unchecked ketone production, potentially leading to life-threatening acid-base imbalance (Kitabchi et al., 2009). References Berg, J. M., Tymoczko, J. L., & Stryer, L. (2002). Biochemistry (5th ed.). W.H. Freeman. Chen, Y. T. (2001). Glycogen storage diseases. In The Metabolic and Molecular Bases of Inherited Disease (pp. 1521–1551). McGraw-Hill. Grabacka, M., Pierzchalska, M., Dean, M., & Reiss, K. (2016). Regulation of ketone body metabolism and the role of PPARα. International Journal of Molecular Sciences, 17(12), 2093. https://doi.org/10.3390/ijms17122093 BIOS 256 Week 3 Case Study Metabolism Kitabchi, A. E., Umpierrez, G. E., Miles, J. M., & Fisher, J. N. (2009). Hyperglycemic crises in adult patients with diabetes. Diabetes Care, 32(7), 1335–1343. https://doi.org/10.2337/dc09-9032 Ketones. (2021). UCSF Diabetes Teaching Center. https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/ketones/Volek, J. S., & Phinney, S. D. (2011). The Art and Science of Low Carbohydrate Living. Beyond Obesity LLC. BIOS 256 Week 3 Case Study Metabolism

Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date Week 2: Case Study 2 1. What happens when the small intestine receives chyme from the stomach? Once the stomach has processed food into chyme, this semi-liquid substance enters the small intestine, beginning with the duodenum. Here, it is blended with bile from the liver and digestive enzymes from the pancreas. These secretions help break down proteins, carbohydrates, and lipids further. The muscular movements known as segmentation churn the chyme, ensuring that it mixes thoroughly with digestive juices and comes into contact with the intestinal lining, or mucosa, to maximize nutrient absorption. Peristaltic contractions subsequently push the chyme through the small intestine, passing through the jejunum and eventually into the ileum. Tiny finger-like projections called villi and even smaller microvilli line the small intestine, dramatically increasing surface area and aiding in the absorption of digested nutrients into the bloodstream. As digestion nears completion in the ileum, most fats, proteins, and carbohydrates have been absorbed. At this stage, hormones such as cholecystokinin and peptide YY are released, signaling satiety, or the sensation of fullness. Remaining undigested food components travel toward the large intestine through the ileocecal valve, entering the cecum, a pouch-like structure that temporarily holds the material. From there, slow peristalsis propels the waste through the colon. Within the colon, bacteria ferment the remaining carbohydrates, generating beneficial substances like vitamin B and K, as well as short-chain fatty acids. As the contents pass into the sigmoid colon, water is absorbed, converting the material into a more solid form. This solidified waste, now known as stool, is stored in the sigmoid colon until mass movements shift it into the rectum. The rectum stretches as it fills, activating the defecation reflex. The anus, controlled voluntarily by external muscles, ultimately allows for the expulsion of feces (Saladin, 2020). 2. What are two important functions of the small intestine? The small intestine plays a pivotal role in digestion and absorption. Its two primary functions are: Week 2: Case Study 3 3. What are two important functions of the large intestine? The large intestine performs essential roles in the body, particularly in the later stages of digestion. Its key functions include: Function Type Description Motility Haustral churning, peristalsis, and mass movements push contents forward Absorption and Bacteria Vitamins are synthesized by bacteria and absorbed; fermentation also occurs 4. Where would the pain be located in this case? If a patient is experiencing pain related to the large intestine, particularly involving the sigmoid colon or descending colon, the discomfort is typically localized to the left lower quadrant (LLQ) of the abdomen (Saladin, 2020). 5. What are two functions of the peritoneum? The peritoneum, a thin membrane lining the abdominal cavity and covering the abdominal organs, has several critical functions: Peritoneal Function Description Organ Protection Cushions and secures abdominal organs Conduit Function Allows passage of blood vessels, lymphatics, and nerves References Children’s Hospital of Pittsburgh. (2022). Differences in small & large intestines: Children’s Pittsburgh. Retrieved November 6, 2022, from https://www.chp.edu/our-services/transplant/intestine/education/about-small-largeintestines BIOS 256 Week 2 Case Study Lower GI Saladin, K. S. (2020). Anatomy & Physiology: The Unity of Form and Function (9th ed.). McGraw-Hill Higher Education (US). BIOS 256 Week 2 Case Study Lower GI

Student Name Chamberlain University BIOS-256: Anatomy & Physiology IV with Lab Prof. Name Date Week 1 Lab Worksheet Lab Manual Exercise 34: Digestive System Structure and Function This worksheet is based on Lab Manual Exercise 34, which focuses on the structure and function of the digestive system. Students are expected to work through Lab Activities 1–9 (pages 561–582), then complete the “Reviewing Your Knowledge” and “Using Your Knowledge” sections. After completing the worksheet, save the file using the naming convention lastname_iLab1 and submit it to the Week 1 Lab Dropbox. Part 1: Reviewing Your Knowledge Layers of the Gastrointestinal Tract The gastrointestinal (GI) tract consists of four primary layers, each with specialized functions: Layer Description Mucosa The innermost layer involved in secretion and absorption; contains the lamina propria. Lamina propria A connective tissue layer within the mucosa that supports capillaries and lymphatic vessels. Muscularis Responsible for peristaltic movement through smooth muscle contractions. Serosa The outermost layer that reduces friction between digestive organs and surrounding structures. Gastrointestinal Tract Organs The following are the major organs involved in the digestive process: Organ Function Mouth Mechanical and chemical breakdown of food begins here. Pharynx Serves as a pathway for the movement of food from the mouth to the esophagus. Esophagus Transports food to the stomach via peristalsis. Stomach Breaks down food using enzymes and acids. Duodenum The first part of the small intestine where digestion continues. Small intestine Main site for digestion and nutrient absorption. Large intestine Absorbs water and forms feces. Anus Terminal opening of the GI tract for waste excretion. Alimentary canal Continuous tube from mouth to anus where digestion and absorption occur. Digestive Organ Structures Structure Function Villi / Microvilli Increase surface area for absorption in the small intestine. Plica circularis Circular folds that slow food movement to maximize absorption. Rugae Folds in the stomach that allow expansion when food enters. Pyloric valve / Pylorus Regulates passage of chyme from stomach to duodenum. Parietal / Visceral peritoneum Layers of the peritoneum that cover abdominal organs and line the cavity. Ileocecal sphincter Controls movement from the small intestine to the large intestine. Saliva Contains enzymes that initiate digestion in the mouth. Hard / Soft palate Form the roof of the mouth; aid in food manipulation and swallowing. Vestibule Space between the lips/cheeks and the teeth. Cardiac Refers to the cardiac sphincter that prevents reflux of stomach contents. Colon (large intestine) Involved in water absorption and stool formation. Haustra Pouches of the colon that help in segmenting and moving waste. Accessory Digestive Organs and the Peritoneum Organ / Structure Function Teeth / Tongue Aid in mechanical digestion and taste. Salivary glands (Parotid, Sublingual, Submandibular) Produce saliva for digestion and lubrication. Liver Produces bile for lipid digestion and detoxifies blood. Gallbladder Stores and concentrates bile before releasing it into the duodenum. Pancreas Secretes digestive enzymes and hormones such as insulin. Mesentery / Omentum (Greater and Lesser) Hold organs in place and contain blood vessels and nerves. Falciform ligament Anchors the liver to the anterior abdominal wall. Trace Bile from Its Secretion to the Duodenum Question: Trace bile from its secretion to the gallbladder for storage and concentration, and then to the duodenum, listing the structures in order, using Figure 34.9 Answer:Bile is produced in hepatocytes within the liver and travels through bile ducts to the common hepatic duct. From there, it enters the cystic duct and is stored in the gallbladder. Upon stimulation, bile exits via the cystic duct, joins the common bile duct, and is released into the duodenum for fat emulsification. Trace Blood Flow Through the Liver Question: Trace blood from the hepatic portal vein through the liver to the inferior vena cava, listing the structures in order, using Figure 34.11 Answer:Blood enters the liver through the hepatic portal vein and flows into the liver sinusoids for detoxification and nutrient processing. It then passes into the central vein, continues to the hepatic vein, and finally drains into the inferior vena cava. Using Your Knowledge Digestive System Structure Concept Description Digestive enzymes Catalyze the breakdown of macromolecules into absorbable units. Hormonal regulation Involves hormones like gastrin, secretin, and cholecystokinin (CCK) to coordinate digestion by signaling various organs. Identification of Digestive System Structures Structure Role Oral cavity Beginning of digestion; mechanical and enzymatic activity occurs. Esophagus Propels food via peristalsis from the throat to the stomach. Stomach Performs both chemical digestion and mechanical mixing. Small intestine Main site for enzymatic digestion and nutrient absorption. Large intestine Reabsorbs water and prepares undigested food for elimination. Accessory organs Assist digestion (e.g., liver, pancreas, gallbladder, salivary glands). Sphincters Control movement of contents between different digestive segments. Mucosal layers Composed of epithelial tissue aiding in secretion and absorption. Part 2: PowerPhys #14: Effect of Dietary Fiber on Transit Time and Bile This virtual lab investigates how dietary fiber influences digestive transit time and bile recycling. Students are required to complete the lab activity in PowerPhys under Course Home, record their results, and analyze how fiber impacts digestion. The completed file should be saved under the folder lastname_iLab1 and submitted to the Week 1 Lab Dropbox. References Marieb, E. N., & Smith, L. A. (2019). Human Anatomy & Physiology Laboratory Manual (13th ed.). Pearson. OpenStax. (2023). Anatomy and Physiology. OpenStax, Rice University. https://openstax.org/books/anatomy-and-physiology/pages/preface BIOS 256 Week 1 Lab Worksheet Tortora, G. J., & Derrickson, B. (2021). Principles of Anatomy and Physiology (16th ed.). Wiley.