Anatomy and physiology for the CCMA exam

These run at the same recall depth as the exam. If one stumps you, read the breakdown of the distractor you chose; it usually names the neighboring organ you mixed it up with.

1. Question 1

   The trachea carries air between which two structures?

   • ABronchi and alveoli
   • BLarynx and esophagus
   • CPharynx and larynx
   • DLarynx and bronchi
   Answer & explanation

   Answer: D. Larynx and bronchi

   Inhaled air passes from the pharynx through the larynx into the trachea, which divides into the right and left main bronchi. The esophagus is tempting because it lies directly behind the trachea, but it carries food to the stomach, not air. The pharynx lies above the larynx, and the smaller bronchioles, not the trachea, lead to the alveoli.

   • Bronchi and alveoli lie farther down the airway, connected by the bronchioles, not the trachea.
   • The esophagus carries food, not air, and lies behind the trachea rather than at either end of it.
   • The pharynx connects to the larynx above the trachea; the trachea begins below the larynx.
   • Correct: the trachea, or windpipe, starts just below the larynx and branches at the carina into the two main bronchi.

2. Question 2

   In left-sided heart failure, fluid mainly backs up into the:

   • ALegs and ankles
   • BLungs
   • CNeck veins
   • DAbdomen
   Answer & explanation

   Answer: B. Lungs

   When the left ventricle cannot pump effectively, blood backs up into the pulmonary circulation, causing lung congestion, shortness of breath, and crackles. Swelling of the legs and ankles is the tempting answer, but it is typical of right-sided failure, where blood backs up into the systemic veins. Abdominal fluid and distended neck veins are also right-sided signs.

   • Leg and ankle edema is a sign of right-sided failure, when the right ventricle cannot keep up with venous return.
   • Correct: a failing left ventricle cannot pump forward, so blood backs up into the lungs, causing congestion and shortness of breath.
   • Distended neck veins reflect right-sided failure, with pressure building in the systemic venous system.
   • Abdominal fluid and liver congestion come with right-sided failure, not left-sided.

3. Question 3

   Type 1 diabetes mellitus is caused mainly by:

   • AAutoimmune loss of insulin-making cells
   • BExcess cortisol from the adrenal glands
   • CToo little glucagon from the pancreas
   • DInsulin resistance in muscle and fat cells
   Answer & explanation

   Answer: A. Autoimmune loss of insulin-making cells

   Type 1 diabetes results from autoimmune destruction of the pancreatic beta cells, so the body makes little or no insulin and needs insulin replacement. Insulin resistance is the tempting answer, but it is the main mechanism of type 2 diabetes. Excess cortisol causes Cushing syndrome, and glucagon raises blood glucose, so a shortage would lower glucose rather than cause diabetes.

   • Correct: in type 1 diabetes, the immune system destroys the insulin-producing beta cells of the pancreas.
   • Excess cortisol defines Cushing's syndrome; it can raise glucose but does not cause type 1 diabetes.
   • Glucagon raises blood sugar, so a shortage would push glucose down, not cause diabetes.
   • Insulin resistance is the hallmark of type 2 diabetes, a classic type 1 versus type 2 trap.

4. Question 4

   Red blood cells are primarily produced in the:

   • ABone marrow
   • BLiver tissue
   • CSpleen
   • DKidneys
   Answer & explanation

   Answer: A. Bone marrow

   Red blood cells are made in the red bone marrow. The liver and spleen recycle old red cells, and the kidneys produce erythropoietin that signals the marrow but do not make the cells.

   • Correct: red blood cells are made in red bone marrow, mainly in flat bones like the pelvis and sternum.
   • The liver makes red blood cells before birth, but in adults it is not the main site.
   • The spleen filters and removes old red blood cells rather than producing them.
   • The kidneys release erythropoietin, which signals the marrow to make RBCs, but they do not make them.

5. Question 5

   Which structure carries urine from each kidney to the urinary bladder?

   • ARenal vein
   • BRenal pelvis
   • CUreter
   • DUrethra
   Answer & explanation

   Answer: C. Ureter

   The ureter transports urine from the kidney to the bladder. The urethra drains urine from the bladder to outside the body, the renal vein carries blood, and the renal pelvis collects urine within the kidney before the ureter.

   • The renal vein carries blood from the kidney back to circulation, not urine.
   • The renal pelvis collects urine inside the kidney before it drains into the ureter.
   • Correct: each ureter carries urine from its kidney down to the urinary bladder.
   • The urethra carries urine from the bladder out of the body, the classic ureter-urethra mix-up.

6. Question 6

   Using anatomical directional terms, the elbow is ______ to the wrist.

   • ASuperficial
   • BDistal
   • CMedial
   • DProximal
   Answer & explanation

   Answer: D. Proximal

   Proximal means closer to where a limb attaches to the trunk; the elbow is nearer the shoulder than the wrist, so it is proximal to the wrist. Distal is the tempting reversal: the wrist is distal to the elbow. Medial and lateral describe position relative to the midline, and superficial and deep describe distance from the body surface.

   • Superficial means toward the body surface, which does not describe the elbow-wrist relationship.
   • Distal means farther from the trunk; the wrist is distal to the elbow, not the other way around.
   • Medial means toward the midline, a side-to-side relationship rather than one along the limb.
   • Correct: the elbow is closer to the shoulder and trunk than the wrist is, which makes it proximal.

7. Question 7

   Gas exchange between inhaled air and the blood takes place in the:

   • ATrachea
   • BBronchi
   • CPleura
   • DAlveoli
   Answer & explanation

   Answer: D. Alveoli

   Oxygen and carbon dioxide diffuse across the thin walls of the alveoli and their surrounding capillaries. The bronchi are tempting because they lie deep in the lungs, but they are conducting airways that only carry air. The pleura is the membrane surrounding the lungs, and the trachea conducts air to the bronchi.

   • The trachea only conducts air toward the lungs; its walls are too thick for gas exchange.
   • The bronchi carry air into each lung but do not exchange gases with the blood.
   • The pleura are membranes around the lungs that reduce friction; they do not exchange gases.
   • Correct: thin-walled alveoli are wrapped in capillaries, where oxygen enters the blood and carbon dioxide leaves it.

8. Question 8

   Which organ produces bile?

   • APancreas
   • BLiver
   • CGallbladder
   • DStomach
   Answer & explanation

   Answer: B. Liver

   The liver produces bile, which emulsifies fats in the small intestine. The gallbladder is the tempting answer because it stores and concentrates bile and releases it after a fatty meal, but it does not make it. The pancreas secretes digestive enzymes and bicarbonate, and the stomach secretes acid and pepsin.

   • The pancreas produces digestive enzymes and hormones like insulin, but not bile.
   • Correct: the liver produces bile, which helps break down fats in the small intestine.
   • The gallbladder stores and concentrates bile but does not make it, the most common trap here.
   • The stomach produces acid and pepsin for protein digestion, not bile.

9. Question 9

   What is the largest organ of the human body?

   • ALungs
   • BLiver
   • CSmall intestine
   • DSkin
   Answer & explanation

   Answer: D. Skin

   The skin, part of the integumentary system, is the largest organ by weight and surface area and is the body's first barrier against pathogens. The liver is the tempting answer because it is the largest internal organ. The lungs and small intestine have large internal surface areas but are smaller organs overall.

   • The lungs are large internal organs but smaller in weight and area than the skin.
   • The liver is the largest internal organ, a common trap, but the skin is larger overall.
   • The small intestine is long, but it weighs less than the skin and is one section of the digestive tract.
   • Correct: the skin covers the entire body and makes up roughly 15% of body weight, making it the largest organ.

10. Question 10

    Which chamber of the heart pumps oxygenated blood out to the entire body?

    • ALeft atrium
    • BRight ventricle
    • CRight atrium
    • DLeft ventricle
    Answer & explanation

    Answer: D. Left ventricle

    The left ventricle pumps oxygenated blood into the aorta for systemic circulation. The right ventricle sends blood to the lungs, and the atria receive blood returning to the heart.

    • The left atrium receives oxygenated blood from the lungs and passes it down to the left ventricle.
    • The right ventricle pumps blood to the lungs, not out to the body.
    • The right atrium receives blood returning from the body; it is a receiving chamber.
    • Correct: the thick-walled left ventricle pumps oxygenated blood into the aorta and out to the body.

11. Question 11

    Pain from appendicitis typically localizes to which abdominal quadrant?

    • ALeft upper quadrant
    • BLeft lower quadrant
    • CRight upper quadrant
    • DRight lower quadrant
    Answer & explanation

    Answer: D. Right lower quadrant

    The appendix hangs from the cecum in the right lower quadrant, so appendicitis pain usually settles there (often after starting near the navel). Left lower quadrant pain is the tempting mirror image and is classic for diverticulitis. Right upper quadrant pain suggests the gallbladder or liver, and left upper quadrant pain the spleen or stomach.

    • Left upper quadrant pain suggests the stomach, spleen or pancreas, not the appendix.
    • Left lower quadrant pain more often relates to the sigmoid colon, as in diverticulitis.
    • Right upper quadrant pain points toward the liver or gallbladder.
    • Correct: the appendix sits in the right lower quadrant, where appendicitis pain classically settles near McBurney's point.

12. Question 12

    Which part of the brain acts as the body's thermostat by regulating body temperature?

    • APituitary gland
    • BCerebellum
    • CHypothalamus
    • DMedulla oblongata
    Answer & explanation

    Answer: C. Hypothalamus

    The hypothalamus senses blood temperature and triggers sweating or shivering to keep body temperature near its set point. The pituitary gland is tempting because it sits just below the hypothalamus and is controlled by it, but it releases hormones rather than setting temperature. The medulla oblongata controls breathing and heart rate, and the cerebellum coordinates balance and movement.

    • The pituitary releases hormones under the hypothalamus's direction but does not set body temperature.
    • The cerebellum coordinates balance and movement, not temperature.
    • Correct: the hypothalamus regulates body temperature along with hunger and thirst, acting as the body's thermostat.
    • The medulla oblongata, in the brainstem, runs automatic functions like breathing rhythm and heart rate, not temperature.

13. Question 13

    Which specific type of anemia occurs when the body lacks sufficient amounts of vitamin B12?

    • AIron-deficiency anemia
    • BPernicious anemia
    • CSickle cell anemia
    • DAplastic anemia
    Answer & explanation

    Answer: B. Pernicious anemia

    Pernicious anemia occurs when the body cannot absorb enough vitamin B12, leading to a deficiency. Vitamin B12 is crucial for red blood cell formation. Iron-deficiency anemia is caused by a lack of iron, while sickle cell anemia is a genetic disorder that affects the shape of red blood cells. Aplastic anemia results from the bone marrow failing to produce adequate blood cells.

    • Iron-deficiency anemia results from too little iron and produces small, pale red cells.
    • Correct: pernicious anemia comes from failing to absorb vitamin B12, usually because intrinsic factor is missing.
    • Sickle cell anemia is an inherited hemoglobin disorder, not a vitamin deficiency.
    • Aplastic anemia results from bone marrow failure, affecting all blood cell lines rather than vitamin levels.

14. Question 14

    Which formed elements of the blood stick to an injured vessel wall and form a plug that begins clotting?

    • AErythrocytes
    • BThrombocytes
    • CLeukocytes
    • DLymphocytes
    Answer & explanation

    Answer: B. Thrombocytes

    Thrombocytes (platelets) adhere to the damaged vessel wall, clump into a plug, and help trigger the clotting cascade. Erythrocytes are tempting because they become trapped in a clot, but their job is carrying oxygen on hemoglobin. Leukocytes, including lymphocytes, defend the body against infection.

    • Erythrocytes are red blood cells that carry oxygen; they do not form the initial plug.
    • Correct: thrombocytes, or platelets, stick to damaged vessel walls and clump into the plug that starts clotting.
    • Leukocytes are white blood cells that fight infection, not plug damaged vessels.
    • Lymphocytes are a type of white blood cell involved in immunity, not clot formation.

15. Question 15

    The heart and both lungs are located in which body cavity?

    • AMediastinum
    • BDorsal cavity
    • CAbdominopelvic cavity
    • DThoracic cavity
    Answer & explanation

    Answer: D. Thoracic cavity

    The thoracic cavity, enclosed by the ribs and sitting above the diaphragm, contains the heart and both lungs. The mediastinum is tempting because the heart lies there, but it is only the central compartment between the lungs and does not contain the lungs themselves. The abdominopelvic cavity lies below the diaphragm, and the dorsal cavity holds the brain and spinal cord.

    • The mediastinum holds the heart but sits between the lungs, so it cannot contain them.
    • The dorsal cavity holds the brain and spinal cord, not the chest organs.
    • The abdominopelvic cavity lies below the diaphragm, under the heart and lungs.
    • Correct: the thoracic cavity, inside the ribs and above the diaphragm, holds the heart and both lungs.