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Assam Higher Secondary Health Care study materials
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Assam Higher Secondary Health Care practice questions

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Question 1Foundations of Health Care and Health Systems

Under the Indian public health system, which level of government is constitutionally responsible for health care delivery, with the Union government mainly acting in a supporting and policy-setting role?

  1. The State governments Correct answer.
  2. The Union Ministry of Health and Family Welfare
  3. The Panchayati Raj institutions
  4. The district administration

Explanation

Public health and hospitals are State List subjects under the Seventh Schedule, so State governments hold the primary constitutional responsibility for health care delivery. The Union government supports through national programmes, funding and policy guidance rather than direct delivery.

Question 2Foundations of Health Care and Health Systems

In the Indian health system, a Community Health Centre (CHC) is designed to serve as which type of facility?

  1. A tertiary referral hospital for super-specialty care
  2. A referral facility providing specialist outpatient and inpatient care at the block level Correct answer.
  3. A first point of contact for outpatient care in a village
  4. A facility exclusively for maternal and child health services

Explanation

CHCs are block-level referral institutions intended to provide specialist outpatient and inpatient services, including surgery and obstetrics. They sit between primary facilities such as PHCs/SCs and district hospitals in the referral chain.

Question 3Foundations of Health Care and Health Systems

Which of the following best describes the concept of 'primary health care' as articulated in the Alma-Ata Declaration?

  1. Care delivered only by doctors in rural areas
  2. Specialist care provided at the first referral level
  3. Free hospital treatment for all citizens
  4. Essential health care made universally accessible to individuals and families in the community Correct answer.

Explanation

The 1978 Alma-Ata Declaration defined primary health care as essential health care based on practical, scientifically sound and socially acceptable methods, made universally accessible to individuals and families with their full participation. It is broader than just rural doctor care or free hospital treatment.

Question 4Foundations of Health Care and Health Systems

A patient visits a sub-centre and is then referred to a Primary Health Centre for further management. This sequence best illustrates which health system concept?

  1. Social health insurance
  2. The referral system Correct answer.
  3. Out-of-pocket expenditure
  4. Gatekeeping by insurance companies

Explanation

A referral system is the organized process by which patients move from lower to higher levels of care based on need and facility capability. The sub-centre to PHC movement is a typical first-level referral within the public system.

Question 5Foundations of Health Care and Health Systems

Which of the following is the best example of a 'social determinant of health'?

  1. The dose of a prescribed antibiotic
  2. The availability of safe drinking water and sanitation in a community Correct answer.
  3. A person's blood pressure reading
  4. The waiting time in an outpatient department

Explanation

Social determinants of health are the conditions in which people are born, grow, live, work and age, such as water, sanitation, education and income. Safe water and sanitation are classic community-level social determinants.

Question 6Foundations of Health Care and Health Systems

In health systems terminology, 'equity in health' most accurately refers to which of the following?

  1. Equal numbers of doctors in every district
  2. Ensuring equal health outcomes for all groups at all times
  3. Providing identical services to every person regardless of need
  4. Absence of avoidable and unfair differences in health status between population groups Correct answer.

Explanation

Health equity means the absence of avoidable, unfair or remediable differences in health among groups of people. It recognizes that unequal needs may require differential resource allocation rather than identical treatment.

Question 7Foundations of Health Care and Health Systems

A district health officer wants to measure how many new cases of tuberculosis occurred in the district during one year. Which measure is most appropriate?

  1. Incidence rate Correct answer.
  2. Case fatality rate
  3. Point prevalence
  4. Hospital bed occupancy rate

Explanation

Incidence measures new cases arising in a population over a defined period, which matches the officer's question about new TB cases in one year. Prevalence would count all existing cases, while case fatality and bed occupancy measure different phenomena.

Question 8Foundations of Health Care and Health Systems

Which of the following is the most widely used indicator of the overall health status of a population, reflecting the average number of years a newborn is expected to live?

  1. Infant mortality rate
  2. Crude birth rate
  3. Sex ratio
  4. Life expectancy at birth Correct answer.

Explanation

Life expectancy at birth summarizes the average number of years a newborn would live under current mortality conditions and is a standard summary measure of population health. Other listed indicators capture specific demographic or mortality aspects.

Question 9Foundations of Health Care and Health Systems

A community health worker explains to villagers that immunization protects not only the vaccinated child but also others in the community. This concept is best described as:

  1. Natural immunity
  2. Cross-resistance
  3. Passive immunity
  4. Herd immunity Correct answer.

Explanation

Herd immunity is the indirect protection of unvaccinated individuals that arises when a sufficient proportion of the population is immune, reducing transmission. It is the concept underlying the community benefit described.

Question 10Foundations of Health Care and Health Systems

Under the National Health Mission, the Accredited Social Health Activist (ASHA) primarily functions as:

  1. A medical officer in charge of the sub-centre
  2. An insurance claims officer
  3. A qualified nurse posted at the PHC
  4. A trained community health volunteer who links the community to the health system Correct answer.

Explanation

ASHAs are trained female community health volunteers who act as a bridge between the community and public health services, promoting awareness, referrals and basic care. They are not qualified clinical staff or administrative officers.

Question 11Foundations of Health Care and Health Systems

Which of the following best characterizes 'out-of-pocket expenditure' on health in India?

  1. Direct payments made by households at the point of receiving care Correct answer.
  2. Grants received from international agencies
  3. Payments made by the government to public hospitals
  4. Premiums collected by insurance companies

Explanation

Out-of-pocket expenditure refers to direct payments by households to health providers at the time of care, excluding any third-party reimbursement. High out-of-pocket spending is a recognized cause of financial hardship and is a key health financing concern in India.

Question 12Foundations of Health Care and Health Systems

A State government introduces a scheme that pools contributions and general tax revenue to pay for hospital care of enrolled poor families. This arrangement is best described as:

  1. A social health insurance or publicly financed health protection scheme Correct answer.
  2. Private voluntary health insurance
  3. A pure user-fee system
  4. A community-based drug revolving fund

Explanation

Pooling of contributions or tax revenue to cover hospital costs for enrolled low-income families is a form of social health insurance or publicly financed health protection. It spreads financial risk across a population rather than charging patients at the point of care.

Question 13Foundations of Health Care and Health Systems

Which of the following is a core function of public health rather than clinical medicine?

  1. Monitoring disease trends and implementing population-level prevention programmes Correct answer.
  2. Performing surgery in a district hospital
  3. Diagnosing and treating an individual patient's pneumonia
  4. Prescribing antibiotics for a febrile child

Explanation

Public health focuses on population-level functions such as surveillance, prevention and health promotion, rather than individual diagnosis and treatment. Clinical activities like surgery and prescribing address individual patients.

Question 14Foundations of Health Care and Health Systems

A primary health centre records the number of outpatient visits per month and the proportion of pregnant women who received at least four antenatal check-ups. These are best classified as:

  1. Structural and financial indicators respectively
  2. Input and outcome indicators respectively
  3. Outcome and impact indicators respectively
  4. Process and output indicators respectively Correct answer.

Explanation

Outpatient visit counts reflect service outputs, while the proportion of women receiving antenatal check-ups reflects a process measure of care delivery. Indicators are commonly classified as input, process, output and outcome to track performance at different points in the results chain.

Question 15Foundations of Health Care and Health Systems

Which of the following best explains why 'prevention is better than cure' is emphasized in public health planning?

  1. Prevention requires no trained personnel
  2. Preventing disease avoids suffering and reduces the cumulative burden on health systems Correct answer.
  3. Preventive services are always cheaper per case than treatment
  4. Cure is impossible for most communicable diseases

Explanation

Prevention reduces the incidence of disease and thereby avoids suffering and lowers the long-term demand on curative services. The rationale is the overall reduction in disease burden, not an absolute claim that prevention is always cheaper per case.

Question 16Foundations of Health Care and Health Systems

In the Indian three-tier rural health infrastructure, which facility is intended to provide the first referral level for a group of Primary Health Centres?

  1. District hospital
  2. Sub-centre
  3. Community Health Centre Correct answer.
  4. Medical college hospital

Explanation

The Community Health Centre serves as the first referral unit for a cluster of Primary Health Centres, offering specialist services at the block level. Sub-centres are the most peripheral, while district and medical college hospitals are higher-level referrals.

Question 17Foundations of Health Care and Health Systems

A national programme reports that infant mortality fell from 40 to 32 per 1,000 live births over five years. Which statement about this change is most accurate?

  1. It indicates that the total number of infant deaths must have increased
  2. It demonstrates that maternal mortality also fell by exactly the same proportion
  3. It proves that the programme alone caused the decline
  4. It shows a reduction in the rate, but attribution to the programme requires comparison with trends and other factors Correct answer.

Explanation

A falling rate is a descriptive observation; establishing that a specific programme caused it requires comparison with control trends and adjustment for other influences. The rate change alone does not prove causation or tell us about other indicators.

Question 18Foundations of Health Care and Health Systems

A district has a high number of hospital beds but poor health outcomes. Which interpretation best reflects a systems perspective?

  1. Health outcomes depend entirely on patient behaviour
  2. Resource inputs alone do not ensure good outcomes; quality, access and distribution also matter Correct answer.
  3. The district should reduce beds to improve outcomes
  4. Beds are the only determinant of health outcomes, so the data must be wrong

Explanation

A health system converts inputs such as beds and staff into outcomes through processes including quality, accessibility and equity of distribution. High input levels without good outcomes suggest weaknesses in these intermediate processes rather than a simple arithmetic error.

Question 19Foundations of Health Care and Health Systems

Which of the following scenarios best illustrates 'vertical equity' in health financing?

  1. All citizens receive identical benefit packages
  2. Everyone pays the same flat premium regardless of income
  3. Higher-income groups contribute a larger share of their income to health financing than lower-income groups Correct answer.
  4. Each person pays exactly the cost of the services they use

Explanation

Vertical equity means that those with greater ability to pay contribute more, so financing is progressive. Flat premiums and equal benefit packages reflect horizontal treatment rather than differential contribution by capacity to pay.

Question 20Foundations of Health Care and Health Systems

Which of the following is the most appropriate definition of 'health system' as used in health policy analysis?

  1. Only the network of government hospitals and clinics
  2. All organizations, people and actions whose primary intent is to promote, restore or maintain health Correct answer.
  3. The health budget allocated by the State government
  4. The set of private medical practitioners in a district

Explanation

A health system includes all organizations, institutions, resources and people whose primary intent is to promote, restore or maintain health, covering public and private actors and activities. It is broader than government facilities or a budget line.

Question 21Human Anatomy and Physiology

Which type of muscle tissue is under voluntary control and shows striations under a microscope?

  1. Skeletal muscle Correct answer.
  2. Myoepithelial tissue
  3. Cardiac muscle
  4. Smooth muscle

Explanation

Skeletal muscle is attached to bones and innervated by somatic motor neurons, so it is voluntarily controlled. Its contractile proteins are arranged in regular sarcomeres, which produce the cross-striations seen under a microscope. Cardiac and smooth muscle are involuntary.

Question 22Human Anatomy and Physiology

In the human skeleton, the femur articulates proximally with which bone of the pelvic girdle?

  1. Ilium Correct answer.
  2. Pubis
  3. Ischium
  4. Sacrum

Explanation

The head of the femur fits into the acetabulum, a socket formed by the fusion of ilium, ischium and pubis. The question asks which named bone is the principal contributor at the hip joint region; the ilium forms the upper and largest part of the acetabulum and articulates with the femoral head.

Question 23Human Anatomy and Physiology

A patient's blood report shows a haematocrit of 55 percent. Which interpretation is most appropriate?

  1. The plasma protein concentration is abnormally low
  2. The blood platelet count is elevated
  3. The proportion of blood volume occupied by red cells is above the typical reference range Correct answer.
  4. The number of white blood cells is markedly reduced

Explanation

Haematocrit is the packed cell volume, i.e. the percentage of blood volume made up of erythrocytes. Typical adult values are roughly 40–50 percent in males and 36–46 percent in females, so 55 percent indicates an elevated red cell proportion (polycythaemia or haemoconcentration).

Question 24Human Anatomy and Physiology

Which structure prevents backflow of blood from the right ventricle into the right atrium?

  1. Pulmonary valve
  2. Bicuspid valve
  3. Aortic valve
  4. Tricuspid valve Correct answer.

Explanation

The tricuspid valve lies between the right atrium and right ventricle. During ventricular systole it closes, preventing blood from being pushed back into the atrium. The bicuspid valve serves the left side, while the aortic and pulmonary valves guard ventricular outflow.

Question 25Human Anatomy and Physiology

During which phase of the cardiac cycle does the first heart sound (S1) occur?

  1. Atrial contraction during late diastole
  2. Opening of the atrioventricular valves during ventricular filling
  3. Closure of the atrioventricular valves at the start of ventricular systole Correct answer.
  4. Closure of the semilunar valves at the end of ventricular systole

Explanation

S1 is produced when the mitral and tricuspid valves snap shut as ventricular pressure rises above atrial pressure at the onset of systole. It marks the beginning of isovolumetric ventricular contraction. The second sound arises from semilunar valve closure.

Question 26Human Anatomy and Physiology

Which part of the nephron is the principal site of glucose reabsorption from the filtrate?

  1. Distal convoluted tubule
  2. Descending limb of the loop of Henle
  3. Collecting duct
  4. Proximal convoluted tubule Correct answer.

Explanation

The proximal convoluted tubule reabsorbs nearly all filtered glucose via sodium-dependent cotransport (SGLT) in its brush border. Under normal conditions no glucose remains by the end of this segment. Other nephron parts handle water, ions and fine-tuning of urine composition.

Question 27Human Anatomy and Physiology

Which hormone is secreted by the posterior pituitary gland?

  1. Adrenocorticotropic hormone
  2. Oxytocin Correct answer.
  3. Thyroid-stimulating hormone
  4. Prolactin

Explanation

The posterior pituitary stores and releases oxytocin and antidiuretic hormone, both synthesised in the hypothalamus. It does not manufacture its own hormones. TSH, prolactin and ACTH are anterior pituitary hormones.

Question 28Human Anatomy and Physiology

A person hyperventilates voluntarily for one minute. Which change in blood chemistry is expected?

  1. A fall in arterial carbon dioxide with a rise in blood pH Correct answer.
  2. A fall in arterial oxygen with no change in carbon dioxide
  3. A rise in blood bicarbonate with a fall in pH
  4. A rise in arterial carbon dioxide with a fall in blood pH

Explanation

Hyperventilation increases alveolar ventilation, so more carbon dioxide is washed out and arterial PCO2 falls. Since CO2 forms carbonic acid in blood, reduced CO2 raises pH, producing respiratory alkalosis.

Question 29Human Anatomy and Physiology

Which cells of the gastric mucosa secrete hydrochloric acid?

  1. Goblet cells
  2. Enteroendocrine G cells
  3. Parietal cells Correct answer.
  4. Chief cells

Explanation

Parietal (oxyntic) cells secrete hydrochloric acid using an H+/K+ ATPase proton pump. Chief cells secrete pepsinogen, goblet cells secrete mucus and G cells secrete gastrin.

Question 30Human Anatomy and Physiology

Where does most nutrient absorption occur in the human digestive tract?

  1. Large intestine
  2. Small intestine Correct answer.
  3. Oesophagus
  4. Stomach

Explanation

The small intestine has villi and microvilli that greatly enlarge the absorptive surface, and it is the main site for absorption of carbohydrates, amino acids, fats, vitamins and minerals. The stomach absorbs only limited substances such as some water and alcohol.

Question 31Human Anatomy and Physiology

Which nerve carries the afferent limb of the knee-jerk reflex?

  1. Tibial nerve
  2. Femoral nerve Correct answer.
  3. Sciatic nerve
  4. Obturator nerve

Explanation

The knee-jerk (patellar) reflex is mediated by the femoral nerve, whose sensory fibres carry impulses from the muscle spindle of the quadriceps to the spinal cord. The efferent limb also travels in the femoral nerve to the same muscle.

Question 32Human Anatomy and Physiology

Which region of the brain coordinates balance and fine motor control?

  1. Hypothalamus
  2. Thalamus
  3. Cerebellum Correct answer.
  4. Medulla oblongata

Explanation

The cerebellum receives proprioceptive and vestibular input and compares intended with actual movement, refining coordination and posture. The medulla controls vital autonomic reflexes, the hypothalamus regulates homeostasis and the thalamus relays sensory impulses.

Question 33Human Anatomy and Physiology

Which type of joint is the shoulder joint (glenohumeral joint)?

  1. Ball-and-socket synovial joint Correct answer.
  2. Hinge synovial joint
  3. Fibrous joint
  4. Pivot synovial joint

Explanation

The glenohumeral joint has a rounded humeral head fitting into the shallow glenoid cavity, allowing movement in three axes. This makes it a multiaxial ball-and-socket synovial joint. Hinge and pivot joints permit fewer axes of movement.

Question 34Human Anatomy and Physiology

A patient has a lesion of the left motor cortex affecting the pyramidal tract. Where would weakness appear?

  1. Only the trunk muscles
  2. Right side of the body Correct answer.
  3. Left side of the body
  4. Both sides equally

Explanation

Corticospinal fibres decussate in the lower medulla, so a left hemisphere lesion produces contralateral, that is right-sided, weakness. This is the basis of the classic contralateral pattern in upper motor neuron lesions.

Question 35Human Anatomy and Physiology

Which plasma protein is chiefly responsible for maintaining the colloid osmotic pressure of blood?

  1. Prothrombin
  2. Albumin Correct answer.
  3. Fibrinogen
  4. Globulin

Explanation

Albumin is the most abundant plasma protein and, because of its small size and high concentration, exerts most of the colloid osmotic (oncotic) pressure. This draws tissue fluid back into capillaries and helps prevent oedema.

Question 36Human Anatomy and Physiology

Which change occurs in the lungs during exercise?

  1. Decreased tidal volume with increased respiratory rate
  2. Decreased tidal volume and decreased respiratory rate
  3. Increased tidal volume and increased respiratory rate Correct answer.
  4. Increased tidal volume with unchanged respiratory rate

Explanation

During exercise, both depth and rate of breathing rise to increase alveolar ventilation and meet the higher oxygen demand and carbon dioxide production. Tidal volume and respiratory rate increase together.

Question 37Human Anatomy and Physiology

Which structure is the functional unit of the kidney?

  1. Loop of Henle
  2. Renal pelvis
  3. Glomerulus
  4. Nephron Correct answer.

Explanation

The nephron is the structural and functional unit of the kidney, comprising the renal corpuscle and the tubule. Each kidney contains about a million nephrons. The glomerulus and loop of Henle are parts of the nephron, not the whole unit.

Question 38Human Anatomy and Physiology

Which hormone raises blood glucose by promoting glycogen breakdown in the liver?

  1. Insulin
  2. Aldosterone
  3. Glucagon Correct answer.
  4. Calcitonin

Explanation

Glucagon, secreted by pancreatic alpha cells, stimulates hepatic glycogenolysis and gluconeogenesis, raising blood glucose. Insulin has the opposite effect, promoting glucose uptake and storage.

Question 39Human Anatomy and Physiology

A patient's ECG shows a prolonged PR interval. Which event is most likely delayed?

  1. Closure of the semilunar valves
  2. Depolarisation of the atrial muscle
  3. Repolarisation of the ventricular muscle
  4. Conduction from the atria to the ventricles through the AV node Correct answer.

Explanation

The PR interval represents the time from atrial depolarisation to the start of ventricular depolarisation, including conduction delay at the AV node. A prolonged PR interval therefore indicates slowed atrioventricular conduction, as in first-degree heart block.

Question 40Human Anatomy and Physiology

Which type of epithelium lines the alveoli of the lungs and why is it suited to its function?

  1. Stratified squamous epithelium, because it resists abrasion during breathing
  2. Simple cuboidal epithelium, because it secretes surfactant in large amounts
  3. Simple squamous epithelium, because it provides a thin barrier for gas diffusion Correct answer.
  4. Ciliated columnar epithelium, because it moves mucus out of the alveoli

Explanation

Alveoli are lined mainly by type I pneumocytes, which form a simple squamous layer only about a micrometre thick. This minimises diffusion distance so oxygen and carbon dioxide can exchange rapidly across the respiratory membrane.

Question 41Human Anatomy and Physiology

Which component of a reflex arc transmits the impulse from the receptor towards the central nervous system?

  1. Efferent motor neuron
  2. Afferent sensory neuron Correct answer.
  3. Effector organ
  4. Interneuron

Explanation

The reflex arc begins at a receptor and travels along the afferent (sensory) neuron to the spinal cord or brain. The efferent neuron carries the response outward, and interneurons connect the two within the CNS.

Question 42Human Anatomy and Physiology

Which statement best explains why oxygen moves from alveolar air into pulmonary capillary blood?

  1. The partial pressure of oxygen is higher in capillary blood than in alveolar air
  2. Carbon dioxide carries oxygen across the membrane by cotransport
  3. The partial pressure of oxygen is higher in alveolar air than in deoxygenated capillary blood Correct answer.
  4. Oxygen is actively pumped across the alveolar membrane by ATP-driven carriers

Explanation

Gas exchange is passive diffusion along partial pressure gradients. Alveolar PO2 is about 100 mmHg while deoxygenated pulmonary capillary blood is about 40 mmHg, so oxygen diffuses into the blood. Carbon dioxide moves in the opposite direction.

Question 43Human Anatomy and Physiology

Which bone of the forearm is located on the thumb side in the anatomical position?

  1. Scaphoid
  2. Ulna
  3. Radius Correct answer.
  4. Humerus

Explanation

In the anatomical position with palms facing forward, the radius lies laterally, on the thumb side, while the ulna lies medially. The radius rotates around the ulna during pronation and supination.

Question 44Human Anatomy and Physiology

Which mechanism primarily regulates breathing rate in a healthy person at rest?

  1. Chemoreceptor sensitivity to arterial carbon dioxide and pH Correct answer.
  2. Stretch receptors in the diaphragm measuring muscle length only
  3. Conscious control from the cerebral cortex
  4. Direct sensing of blood glucose by the medulla

Explanation

Central chemoreceptors in the medulla respond to changes in CSF hydrogen ion concentration derived from arterial CO2, and peripheral chemoreceptors in the carotid and aortic bodies respond to oxygen, CO2 and pH. CO2 is the most powerful normal stimulus to ventilation.

Question 45Human Anatomy and Physiology

Which structure in the male reproductive system secretes a fructose-rich fluid that nourishes sperm?

  1. Bulbourethral gland
  2. Epididymis
  3. Prostate gland
  4. Seminal vesicle Correct answer.

Explanation

The seminal vesicles secrete a viscous, fructose-rich fluid that forms most of the semen volume and provides an energy substrate for sperm. The prostate and bulbourethral glands contribute different secretions.

Question 46Human Anatomy and Physiology

Which formed element of blood is described as a membrane-bound cell fragment containing no nucleus and is chiefly responsible for haemostasis?

  1. Neutrophil
  2. Platelet Correct answer.
  3. Lymphocyte
  4. Erythrocyte

Explanation

Platelets are anucleate cytoplasmic fragments budded from megakaryocytes in the bone marrow, and they adhere to damaged endothelium to form the primary haemostatic plug. Erythrocytes are whole cells specialised for gas transport, while neutrophils and lymphocytes are nucleated leucocytes of the immune response.

Question 47Human Anatomy and Physiology

In the cardiac cycle, which event directly follows the closure of the atrioventricular valves at the start of ventricular systole?

  1. Ventricular filling
  2. Opening of the atrioventricular valves
  3. Isovolumetric ventricular contraction Correct answer.
  4. Closure of the semilunar valves

Explanation

Once the AV valves shut, the ventricles contract with all valves closed, so pressure rises while volume stays constant; this is isovolumetric contraction. When ventricular pressure exceeds aortic and pulmonary pressure, the semilunar valves open and ejection begins.

Question 48Human Anatomy and Physiology

A patient's blood report shows a haematocrit of 60 percent with normal plasma protein levels. Which interpretation best explains the increased blood viscosity?

  1. An elevated red cell mass increases resistance to flow through small vessels Correct answer.
  2. Increased platelet numbers thicken the blood by adding cell volume
  3. A reduced plasma volume concentrates the white cell population
  4. A fall in plasma fibrinogen reduces the resistance of the blood

Explanation

Haematocrit reflects the proportion of blood occupied by red cells, and red cells contribute most to viscosity because they deform and crowd the flow stream. A haematocrit of 60 percent, well above the normal adult range, therefore raises resistance and cardiac workload.

Question 49Human Anatomy and Physiology

During a laboratory test, a skeletal muscle fibre is stimulated with a second shock before it has finished relaxing from the first. What is the expected mechanical outcome?

  1. The fibre becomes refractory and ignores the second shock
  2. The second contraction sums with the first, producing greater tension Correct answer.
  3. The fibre relaxes fully before responding to the second shock
  4. Tension falls below the level produced by a single twitch

Explanation

When a second stimulus arrives during the relaxation phase, cytosolic calcium has not yet been fully re-sequestered, so the second twitch adds to the residual tension. Repeated stimulation at short intervals produces summation and eventually a fused tetanic contraction.

Question 50Human Anatomy and Physiology

A patient has damage to the dorsal columns of the spinal cord on one side. Which sensory deficit is most consistent with this lesion?

  1. Loss of voluntary movement on the opposite side of the body
  2. Loss of pain and temperature sense on the same side as the lesion
  3. Loss of pain and temperature sense on the opposite side of the body
  4. Loss of fine touch and vibration sense on the same side as the lesion Correct answer.

Explanation

Dorsal column fibres ascend ipsilaterally and cross in the medulla, so a unilateral lesion abolishes fine touch, vibration and proprioception on the same side below the lesion. Pain and temperature travel in the spinothalamic tract, which crosses near the level of entry and is unaffected here.