AAPC-COC Certified Outpatient Coder - Set 2 - Part 1

Correct Answer: Oxygen

Life depends on certain physical factors from the environment: water, oxygen, nutrients, heat, and pressure. Oxygen is one of these factors, while the other choices are life processes carried out by the body itself. Option a is incorrect because it appears among the additional human life processes, alongside growth and respiration, and is not listed with the physical environmental factors. Option b is incorrect because it is a life process covering all the chemical reactions in the body, so it is an activity of the organism, not an environmental factor. Option c is incorrect because it names a life process concerned with detecting changes in internal or external environments, which makes it a function of the body rather than something supplied by surroundings.

Correct Answer: Supine

Supine is the term for an individual lying down on the back. It is one of the positioning terms used to describe the body during specific procedures, alongside prone and lateral. Option a is incorrect because refers to lying on the side, also called side-lying, so the back is not the resting surface. Option b is incorrect because describes a condition occurring on both sides of the body rather than any body position during a procedure. Option d is incorrect because describes lying on the abdomen, which is the opposite of lying on the back.

Correct Answer: Cytokinesis

Cytokinesis is the term for division of the cytoplasm. It occurs during telophase, completing cell division after the nuclear material has divided, and yields two cells identical to the parent cell in mitosis. Option a is incorrect because names the longest part of the cell cycle, the period between successive divisions, so no division of the cytoplasm takes place in it. Option c is incorrect because is the special nuclear division that halves the chromosome number in egg and sperm production, not the splitting of cytoplasm. Option d is incorrect because is the first stage of mitosis, a step in nuclear division, and it is not the name for cytoplasmic division.

Correct Answer: Epinephrine and norepinephrine

The adrenal medulla develops from neural tissue and secretes epinephrine and norepinephrine in response to sympathetic nerve stimulation. Hypersecretion, usually from a tumor, causes prolonged or continual sympathetic responses. Option b is incorrect because these come from the anterior lobe of the pituitary gland, not from any region of the adrenal gland. Option c is incorrect because these are cortical steroid hormones, a mineralocorticoid and a glucocorticoid, and the cortex is regulated by negative feedback rather than by sympathetic nerve stimulation. Option d is incorrect because these are gonadocorticoids secreted in minimal amounts by the innermost cortex, and their effect is usually masked by hormones from the testes and ovaries.

Correct Answer: Osteoblast

Osteoblasts are the bone-forming cells. In both intramembranous and endochondral ossification, they deposit bony matrix, and they later become osteocytes once surrounded by that matrix. Option a is incorrect because osteocytes are mature bone cells, which are osteoblasts already surrounded by matrix, so they no longer perform the bone-forming work. Option c is incorrect because chondrocytes are cartilage cells; those next to the diaphysis at the epiphyseal plate age and degenerate before osteoblasts ossify the matrix. Option d is incorrect because osteoclasts break down and reabsorb bone, for example opening the medullary cavity, so their role is removal of bone rather than formation.

Correct Answer: Epiphyseal plate

Bones grow in length at the epiphyseal plate, the cartilage region between the epiphysis and diaphysis. Cartilage there grows by mitosis and is ossified by osteoblasts, until the plate completely ossifies and lengthening stops. Option a is incorrect because formed from the perichondrium, it surrounds the developing bone and lays down a collar of compact bone around the diaphysis. Option b is incorrect because it is the hyaline cartilage left over the surface of the epiphysis, not the band between the epiphysis and diaphysis. Option d is incorrect because this space opens inside the diaphysis when osteoclasts break down newly formed spongy bone; it does not produce length.

Correct Answer: Physical barriers

Physical barriers are the body's basic defenses against infection and are called the first line of defense. They include intact skin, mucous membranes, mucus and enzymes, and are part of the innate immune response. Option a is incorrect because it comes from receiving antibodies made by someone else, such as maternal antibodies passed through the placenta, not from skin or membranes. Option b is incorrect because it develops through exposure to various antigens as the immune system builds a defense, so it is not a built-in surface barrier. Option c is incorrect because it is the adaptive response's ability to react stronger and faster on reexposure, using memory B and T cells.

Correct Answer: Circumduction

Synovial joints provide most of the movement of the body, and the movements they create include flexion, extension, abduction, adduction, circumduction, and rotation. Circumduction is therefore the only listed movement. Option a is incorrect because dislocation refers to displacement of a bone from its normal position in a joint, so it is an injury, not a movement created by synovial joints. Option c is incorrect because articulation is another word for a joint, a place where two bones or bone and cartilage connect, rather than a movement. Option d is incorrect because synarthrosis names an immovable joint classified by amount of movement, so it cannot be a movement produced at synovial joints.

Correct Answer: Gastrocnemius

The gastrocnemius is identified as the chief muscle of the calf of the leg. The Achilles tendon attaches the calf muscles to the heel bone, which fits this location. Option a is incorrect because it is the largest and outermost of the three gluteal muscles in the buttocks, not a muscle of the calf. Option b is incorrect because this paired muscle runs vertically on each side of the anterior abdominal wall, far from the leg. Option c is incorrect because it is a large muscle group on the front of the thigh, which is above the calf region.

Correct Answer: Synapse

A synapse is a junction between two nerve cells, consisting of a tiny gap through which neurotransmitters pass. Electrical impulses signal neurotransmitter release into this gap, so the junction described is the synapse. Option a is incorrect because dendrites conduct information received from other neurons at the contact areas; they are the receiving fibers, while the contact area itself is the synapse. Option b is incorrect because the axon is the fiber that emerges from the cell body and projects to target cells, not the junction between two cells. Option d is incorrect because myelin is an insulating substance made from neuroglia that wraps many axons, comparable to insulation on electrical wires, and is not a gap.

Correct Answer: Sensation remains although the extremity cannot move

When a spinal cord injury damages motor nerves, the sensory nerves may still be intact. The patient can then still feel sensation even though the extremity cannot be moved. Option a is incorrect because the upper limbs and upper back are served by the brachial plexus, and paralysis extent depends on injury level, not on sparing of sensory nerves. Option c is incorrect because anatomy guidance states sensory nerves may still be intact when motor nerves are damaged, so sensation is not necessarily lost along with movement. Option d is incorrect because loss of spontaneous breathing is tied to a cord cut above C3, not to every injury or to the motor-sensory distinction.

Correct Answer: A small region of the nasal cavity

Olfaction is a special sense based on receptors in a small region of the nasal cavity that respond to chemical stimuli. Messages from these receptors travel to the brain, where smells are interpreted. Option b is incorrect because olfactory cells in the nasal epithelium pass their information through this plate, so it serves as a conduit, not the receptor location. Option c is incorrect because the bony orbits surround the eyeballs to protect them and anchor soft eye tissues, which makes them part of the vision system. Option d is incorrect because the papillae hold taste buds with receptor cells for taste transduction, so they belong to the sense of taste rather than smell.

Correct Answer: Melatonin

Melatonin is synthesized by pinealocytes of the pineal gland and secreted into the cerebrospinal fluid. It is not a product of the thyroid or parathyroid glands, which make thyroxine, triiodothyronine, calcitonin and parathyroid hormone. Option a is incorrect because the four parathyroid glands on the thyroid's posterior surface secrete it, and it is the most important regulator of blood calcium. Option b is incorrect because the parafollicular cells of the thyroid gland secrete it, and it lowers blood calcium, opposing the parathyroid glands. Option d is incorrect because the follicles of the thyroid gland produce it, and it makes up about 95 percent of the active thyroid hormone.

Correct Answer: Coronary veins return deoxygenated blood to the left atrium.

Coronary veins bring deoxygenated blood back to the right atrium, not the left atrium. The left atrium receives oxygenated blood from the pulmonary veins, so this statement is the incorrect one. Option a is incorrect because anatomy references describe the coronary arteries as vessels that originate from the aorta, so this statement is accurate and cannot be the exception. Option b is incorrect because coronary circulation is described as occurring with every heartbeat, so this statement matches the reference and is not the one that is wrong. Option c is incorrect because delivering oxygenated blood to the myocardium is the defined function of the coronary arteries, which makes this a true statement rather than the exception.

Correct Answer: Pulse pressure

Pulse pressure is the difference between systolic pressure and diastolic pressure. Blood pressure is recorded as systolic over diastolic, so subtracting the lower value from the higher gives the pulse pressure. Option b is incorrect because this is another factor interacting to affect blood pressure, and it does not describe a gap between two recorded pressure readings. Option c is incorrect because it is the force opposing blood flow, mostly set by vessel diameter, and is one of four factors affecting blood pressure, not a subtraction result. Option d is incorrect because this is simply the lower number, occurring during cardiac relaxation, so it is one of the two values being compared rather than their difference.

Correct Answer: Lactic acid

Lactobacillus, the most common normal flora in a healthy vagina, secretes lactic acid. The lactic acid maintains an acidic pH below 4.5 and, with other secretions, makes the vagina self-cleansing. Option a is incorrect because mucus is secreted by the mucous membrane lining to keep the vagina moist, not to maintain the acidic pH. Option b is incorrect because the endometrium is the lining of the uterus, whose functional layer sloughs off during menstruation, and it is not a flora product. Option d is incorrect because peritoneal fluid is described in the context of the fimbriae, where its currents help propel the oocyte toward the Fallopian tube.

Correct Answer: Ureter

The ureters transport urine from the kidney to the urinary bladder. Each ureter is a small tube that descends from the renal pelvis and enters the urinary bladder on its posterior inferior surface. Option a is incorrect because a nephron is the functional unit inside the kidney, made of a renal corpuscle and a renal tubule, so it lies within the organ. Option b is incorrect because the urethra is the final passageway for the flow of urine out of the body, not the link between kidney and bladder. Option c is incorrect because the renal sinus is a large cavity within the kidney reached through the hilum; it is not a tube joining kidney to bladder.

Correct Answer: Passive immunization

Passive immunity is obtained by receiving antibodies produced by someone else, including by injection. Hepatitis B Immune Globulin is an example: it gives immediate protection but does not provide long-lasting protection. Option a is incorrect because it relies on the patient's own lymphocyte T cells destroying abnormal cells, rather than on antibodies formed by another person or animal. Option b is incorrect because it is present from birth and targets pathogens nonspecifically through barriers, inflammation, and fever, so it is not delivered by injection. Option d is incorrect because borrowed antibodies cannot create effector cells or memory cells, so the body does not remember the antigen on later infection.

Correct Answer: hilum

The hilum, or root, on the medial side is the only point of attachment for each lung. The bronchi, blood vessels, lymphatics, and nerves all enter the lung at this site. Option a is incorrect because this is an indentation on the medial surface of the left lung that accommodates the apex of the heart, not an entry point. Option b is incorrect because it is the region that separates the two lungs and contains the heart, so it lies between the lungs rather than at their root. Option c is incorrect because the small space between the visceral and parietal pleurae holds a thin film of lubricating serous fluid and does not serve as an attachment site.

Correct Answer: Haustra

Contraction of the teniae coli, the three longitudinal muscle bands of the colon, exerts pressure on the wall and creates a series of pouches called haustra along the colon. Option b is incorrect because epiploic appendages are fat-filled connective tissue pieces attached to the outer surface of the colon, not pouches formed by muscle contraction. Option c is incorrect because teniae coli are the three bands of longitudinal muscle themselves, whose contraction forms the pouches rather than being the pouches. Option d is incorrect because plicae circulares belong to the small intestine, where they increase absorptive surface area along with villi and microvilli.