Chapter 5 The Integumentary System

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1) Each of the following is a function of the integumentary system except

A) protection of underlying tissue.

B) excretion of salts and wastes.

C) maintenance of body temperature.

D) synthesis of vitamin C.

E) detection of sensations.

D) synthesis of vitamin C.

2

2) The two components of the integumentary system are the

A) epidermis and dermis.

B) cutaneous membrane and hypodermis.

C) cutaneous membrane and accessory structures.

D) integument and hypodermis.

E) epidermis and superficial fascia.

C) cutaneous membrane and accessory structures.

3

3) The type of cells that form the strata in the epidermis are

A) adipocytes.

B) keratinocytes.

C) fibroblasts.

D) melanocytes.

E) dendritic cells.

B) keratinocytes.

4

4) The tough superficial layer of the epidermis is known as the stratum

A) corneum.

B) lucidum.

C) basale.

D) granulosum.

E) spinosum.

A) corneum.

5

5) Large quantities of keratin are found in the epidermal layer called the stratum

A) corneum.

B) lucidum.

C) basale.

D) granulosum.

E) spinosum.

A) corneum.

6

6) Water loss due to evaporation of fluid that has penetrated through the skin is called ________ perspiration.

A) sensible

B) insensible

C) latent

D) active

E) inactive

B) insensible

7

7) The layer of the epidermis that contains abundant desmosomes is the stratum

A) corneum.

B) lucidum.

C) basale.

D) granulosum.

E) spinosum.

E) spinosum.

8

8) The layer of the skin that provides a barrier against bacteria as well as chemical and mechanical injuries is the

A) dermis.

B) subcutaneous layer.

C) epidermis.

D) stratum basale.

E) sebaceous layer.

C) epidermis.

9

9) Characteristics of the epidermis include

A) multilayered.

B) flexible.

C) contains desmosomes.

D) serves as UV radiation protection.

E) All of the answers are correct.

E) All of the answers are correct.

10

10) All of the following are true of epidermal ridges except that they

A) extend into the hypodermis.

B) increase surface area and friction on fingertips.

C) cause ridge patterns on the surface of the skin.

D) produce patterns that are determined partially genetically.

E) interconnect with the dermal papillae.

A) extend into the hypodermis.

11

11) ________ are cells in the epidermis that are part of the immune system.

A) Dendritic cells

B) Basal cells

C) Merkel cells

D) Squamous cells

E) Melanocytes

A) Dendritic cells

12

12) Water loss from insensible perspiration

A) is unaffected by damage to the epidermis.

B) is too small to be measured reliably.

C) is approximately 0.5 liters a day.

D) always exceeds sensible perspiration.

E) depends on apocrine sweat glands.

C) is approximately 0.5 liters a day.

13

13) The epidermis of the skin is composed of what type of tissue?

A) keratinized stratified squamous epithelium

B) simple squamous epithelium

C) transitional epithelium

D) areolar connective tissue

E) nonkeratinized stratified squamous epithelium

A) keratinized stratified squamous epithelium

14

14) The layer of stem cells that constantly divide to renew the epidermis is the

A) stratum corneum.

B) stratum basale.

C) papillary layer.

D) basal lamina.

E) stratum granulosum.

B) stratum basale.

15

15) The protein that reduces water loss at the skin surface is

A) eleidin.

B) collagen.

C) mucin.

D) keratin.

E) melanin.

D) keratin.

16

16) Thin skin contains ________ epidermal layer(s) and thick skin contains ________ layers.

A) 1; 2

B) 2; 3

C) 3; 4

D) 4; 5

E) 5; 6

D) 4; 5

17

17) While walking barefoot on the beach, Joe stepped on a thorn that penetrated through the sole of his foot to the dermis. How many layers of epidermis did the thorn penetrate?

A) 1

B) 2

C) 3

D) 4

E) 5

E) 5

18

18) The primary pigments contained in the epidermis are

A) carotene, hemoglobin, and xanthophyll.

B) carotene, melanin, and hemoglobin.

C) melanin, chromatin, and chlorophyll.

D) xanthophyll, hemoglobin, and melanin.

E) melanin, carotene, and chromatin.

B) carotene, melanin, and hemoglobin.

19

19) An albino individual lacks the ability to produce

A) melanin.

B) keratin.

C) carotene.

D) perspiration.

E) eleidin.

A) melanin.

20

20) All of the following are true of the pigment melanin, except that it

A) decreases in concentration within cells during exposure to the sun.

B) is usually some shade of brown or black.

C) protects DNA from the damaging effects of UV radiation.

D) is produced from the amino acid tyrosine.

E) is produced by cells called melanocytes.

A) decreases in concentration within cells during exposure to the sun.

21

21) Cyanosis signifies that a patient has

A) had too much sun.

B) been kept out of the sun.

C) an allergic reaction.

D) oxygen-starved skin.

E) been exposed to cyanide.

D) oxygen-starved skin.

22

22) Jaundice is indicated by a(n) ________ skin coloration.

A) reddish

B) yellowish

C) orange

D) bluish

E) brown

B) yellowish

23

23) Exposure to ultraviolet light (sunlight) causes the skin to darken by increasing the production of

A) hemoglobin.

B) carotene.

C) collagen.

D) keratin.

E) melanin.

E) melanin.

24

24) The ________ in keratinocytes protects the epidermis and dermis from the harmful effects of sunlight.

A) sebum

B) hemoglobin

C) melanin

D) carotene

E) keratin

C) melanin

25

25) Which of the following is not an effect of ultraviolet radiation?

A) increased activity by melanocytes

B) production of cholecalciferol within epidermal cells

C) reduced amounts of elastic fibers in the dermis

D) chromosomal damage in germinative cells or melanocytes

E) loss in skin pigmentation as seen in vitiligo

E) loss in skin pigmentation as seen in vitiligo

26

26) Which of the following is formed in the skin when it is exposed to sunlight?

A) vitamin A

B) vitamin B

C) vitamin C

D) vitamin D

E) vitamin E

D) vitamin D

27

27) Types of skin cancers include

A) squamous cell carcinoma.

B) malignant melanoma.

C) basal cell carcinoma.

D) actinic keratosis.

E) A, B, and C

E) A, B, and C

28

28) Which of the following statements about rickets is not true?

A) It is usually genetic.

B) It leads to weak bones.

C) It leads to skeletal deformity.

D) It is prevented by vitamin D.

E) It is prevented by sunlight.

A) It is usually genetic.

29

29) Children in northern regions experience months of inadequate sunlight exposure on the skin. To prevent possible abnormal bone development, what essential organic nutrient is necessary in the diet?

A) vitamin C

B) calcium

C) cholecalciferol

D) protein

E) retinol-A

C) cholecalciferol

30

30) Epidermal growth factor exerts which of these effects on the epidermis?

A) promotes cell division

B) stimulates keratin synthesis

C) accelerates tissue repair

D) speeds up glandular function

E) All of the answers are correct.

E) All of the answers are correct.

31

31) The layer of the skin that contains the blood vessels and nerves that are closest to the surface of the skin is the ________ layer.

A) papillary

B) reticular

C) epidermal

D) subcutaneous

E) hypodermal

A) papillary

32

32) The layer of the skin that contains bundles of collagen and elastic fibers responsible for the strength of the skin is the ________ layer.

A) papillary

B) reticular

C) epidermal

D) subcutaneous

E) hypodermal

B) reticular

33

33) The protein that permits stretching and recoiling of the skin is

A) collagen.

B) melanin.

C) keratin.

D) elastin.

E) carotene.

D) elastin.

34

34) Skin inflammation that primarily involves the papillary layer is termed

A) papillitis.

B) dermatitis.

C) epidermatitis.

D) superficialis.

E) melanocytis.

B) dermatitis.

35

35) A surgical incision parallel to the lines of cleavage

A) closes and heals with relatively little scarring.

B) has a tendency to reopen.

C) heals slower than incisions made perpendicular to the lines of cleavage.

D) does not affect the healing process.

E) requires no sutures.

A) closes and heals with relatively little scarring.

36

36) While assessing a patient, you discover that after pinching the skin on the back of the hand, it remains peaked. This is a sign of

A) hydration intoxication.

B) water intoxication.

C) dehydration.

D) advanced skin cancer.

E) malfunctioning elastin.

C) dehydration.

37

37) Stretch marks occur when

A) the skin is stretched in normal movements.

B) surgical incisions are made perpendicular to the skin's lines of cleavage.

C) the skin is so extensively stretched that its elastic limits are exceeded.

D) athletes overextend a muscle.

E) individual epidermal layers separate.

C) the skin is so extensively stretched that its elastic limits are exceeded.

38

43) All of the following are true of the subcutaneous layer except it

A) contains many blood vessels.

B) permits independent movement of deeper structures.

C) contains large amounts of adipose tissue.

D) is attached to the dermis by a basement membrane.

E) is well supplied with nerves that pass into the skin.

D) is attached to the dermis by a basement membrane.

39

44) Accessory structures of the skin include all of the following except

A) hair follicles.

B) sebaceous glands.

C) sweat glands.

D) epidermis.

E) nails.

D) epidermis.

40

45) The layer of hard keratin that coats the hair is termed the

A) medulla.

B) cuticle.

C) hair bulb.

D) root.

E) shaft

B) cuticle.

41

46) Variations in hair color reflect differences in the pigment produced by

A) keratinocytes.

B) melanocytes.

C) dermal papillae.

D) soft keratin.

E) carotene cells.

B) melanocytes.

42

47) Which of the following is correct about Lanugo hairs?

A) also known as "peach fuzz"

B) persists throughout the entire life

C) deeply pigmented and somewhat coarse

D) exists primarily in fetuses

E) never found on the feet

D) exists primarily in fetuses

43

48) If the papilla of a hair follicle is destroyed,

A) the hair produced by the follicle will change from terminal to vellus.

B) the color of the hair will become lighter.

C) the texture of the hair will become coarser.

D) the hair matrix will lose its blood supply.

E) hair production will not be affected.

D) the hair matrix will lose its blood supply.

44

49) Which statement about hairs is false?

A) Eyebrows are terminal hairs.

B) Terminal hairs are in the axilla.

C) Vellus hairs are on the limbs of children until puberty.

D) A terminal hair can detach but remain in the hair follicle as a club hair.

E) Club hairs are ingrown hairs.

E) Club hairs are ingrown hairs.

45

50) When the arrector pili muscles contract,

A) "goose bumps" are formed.

B) hairs are shed.

C) sweat is released from sweat glands.

D) shivering occurs.

E) the skin changes color.

A) "goose bumps" are formed.

46

51) Which of the following statements concerning hair is false?

A) The medulla is the soft core of the hair.

B) The cortex of the hair is composed of hard keratin.

C) Terminal hairs are heavy and more darkly pigmented than other types of hair.

D) Club hair is hair that has ceased growing.

E) Scalp hairs grow constantly throughout life.

E) Scalp hairs grow constantly throughout life.

47

52) A common cause of dandruff is

A) inflammation around sebaceous glands.

B) lack of sebaceous glands.

C) too many sebaceous glands.

D) inactive apocrine glands.

E) inactive eccrine glands.

A) inflammation around sebaceous glands.

48

53) Glands that discharge an oily secretion into hair follicles are ________ glands.

A) ceruminous

B) apocrine sweat

C) merocrine sweat

D) sebaceous

E) mammary

D) sebaceous

49

54) The ________ glands in the axilla become active at the time of puberty.

A) ceruminous

B) apocrine sweat

C) merocrine sweat

D) sebaceous

E) axillary

B) apocrine sweat

50

55) Sensible perspiration is produced by ________ glands.

A) ceruminous

B) apocrine sweat

C) merocrine sweat

D) sebaceous

E) mammary

C) merocrine sweat

51

56) Earwax is produced by ________ glands.

A) sebaceous

B) apocrine sweat

C) merocrine sweat

D) ceruminous

E) eccrine sweat

D) ceruminous

52

57) Merocrine sweat contains ________ to protect against bacteria.

A) metabolic wastes

B) water

C) penicillin

D) dermicidin

E) organic nutrients

D) dermicidin

53

58) The highest concentration of merocrine sweat glands is found

A) in the axillae.

B) on the chest.

C) on the palms of the hands.

D) on the upper back.

E) surrounding the genitals.

C) on the palms of the hands.

54

59) Which of the following statements concerning sebaceous glands and sebum is false?

A) Most sebaceous glands are coiled tubular glands.

B) Most sebaceous glands open into hair follicles.

C) Sebum functions to lubricate the hair and skin.

D) Sebum can function as an antibiotic.

E) Acne involves inflammation of sebaceous glands.

A) Most sebaceous glands are coiled tubular glands.

55

60) ________ sweat glands are widely distributed across the body surface, ________ glands are located wherever hair follicles exist, and ________ sweat glands are found only in a few areas.

A) Sebaceous; merocrine; apocrine

B) Apocrine; merocrine; sebaceous

C) Merocrine; sebaceous; apocrine

D) Merocrine; apocrine; sebaceous

E) Apocrine; sebaceous; merocrine

C) Merocrine; sebaceous; apocrine

56

61) Which of the following happens if body temperature rises above normal?

A) Circulation in the skin decreases.

B) Sweat gland activity decreases.

C) Evaporative cooling stops.

D) Blood flow to the skin increases.

E) The activity of melanocytes increases.

D) Blood flow to the skin increases.

57

62) Merocrine sweat glands

A) are compound alveolar glands.

B) produce organic secretions that are metabolized by bacteria to produce body odor.

C) secrete a watery fluid directly onto the surface of the skin.

D) increase in number and activity with aging.

E) primarily function in lubricating the hairs.

C) secrete a watery fluid directly onto the surface of the skin.

58

63) All of the following are true of perspiration produced by merocrine sweat glands except that it

A) is more than 99 percent water.

B) contains electrolytes and waste products.

C) helps cool the body when it evaporates.

D) helps to prevent bacteria from colonizing the skin.

E) produces the body odor characteristic of "sweating."

E) produces the body odor characteristic of "sweating."

59

64) The nail body covers the

A) nail root.

B) nail bed.

C) lunula.

D) free edge.

E) hyponychium.

B) nail bed.

60

65) Nail production occurs at the nail

A) body.

B) bed.

C) root.

D) cuticle.

E) hyponychium.

C) root.

61

66) The cuticle around a nail is the

A) eponychium.

B) hyponychium.

C) free edge.

D) perinychium.

E) lunula.

A) eponychium.

62

67) The stratum corneum just under the free edge of a nail is the

A) hyponychium.

B) lunula.

C) eponychium.

D) nail root.

E) cuticle.

A) hyponychium.

63

68) A child who skins his knee in a fall has a(n)

A) abrasion.

B) laceration.

C) puncture.

D) incision.

E) contusion.

A) abrasion.

64

69) In a penetrating wound, ________ divide to produce mobile cells that repair the dermis.

A) granulation cells

B) dendritic cells

C) macrophages

D) fibroblasts

E) muscle cells

D) fibroblasts

65

70) The type of burn that may require a skin graft is a ________ burn.

A) first-degree

B) second-degree

C) third-degree

D) partial-thickness

E) epidermal

C) third-degree

66

71) If a fair-skinned person is sunburned, why does his or her skin turn red?

A) The blood flow to the skin increases.

B) The number of red melanocytes in the skin increases.

C) Melanocytes increase production of red pigments.

D) Carotene production greatly increases.

E) Decreased heat causes the skin to turn red.

A) The blood flow to the skin increases.

67

72) Skin can regenerate effectively even after considerable damage has occurred because

A) the epidermis of the skin has a rich supply of small blood vessels.

B) stem cells persist in the skin even after injury.

C) fibroblasts in the dermis can give rise to new germinal cells in the epidermis.

D) contraction in the area of the injury brings cells of adjacent strata together.

E) cells of the stratum basale cannot migrate to other positions in the skin.

B) stem cells persist in the skin even after injury.

68

73) The following are stages in the regeneration of skin following an injury. What is the correct order for these events?

1. inflammation

2. cellular migration

3. epidermis covers granulation tissue

4. epidermis covers scar tissue

A) 1, 2, 3, 4

B) 4, 3, 2, 1

C) 4, 3, 1, 2

D) 3, 4, 1, 2

E) 2, 4, 1, 3

A) 1, 2, 3, 4

69

74) Scar tissue is the result of

A) large numbers of collagen fibers and relatively few blood vessels in the injured area.

B) increased numbers of keratinocytes in the epidermal layers in the area of the injury.

C) a thickened stratum basale in the area of the injury.

D) increased numbers of fibroblasts in the reticular layer of the injured area.

E) a lack of sebaceous glands in the injured area.

A) large numbers of collagen fibers and relatively few blood vessels in the injured area.

70

75) During repair of the integument, fibroblasts follow areas of new capillary growth and produce ________ tissue.

A) scar

B) epithelial

C) granulation

D) pus

E) keloid

C) granulation

71

76) Treatment of full-thickness burns includes which of the following?

A) replacing fluids

B) increasing caloric intake

C) preventing infection

D) assisting tissue repair

E) All of the answers are correct.

E) All of the answers are correct.

72

77) Charlie is badly burned in an accident. When he reaches the emergency room, the examining physician finds that he can remove entire hair follicles from Charlie's arm when he gently pulls on a hair with his forceps. Charlie is suffering from a(n) ________ burn.

A) first-degree

B) second-degree

C) third-degree

D) partial-thickness

E) epidermal

C) third-degree

73

78) A full-thickness burn injury can be life threatening. A physician treating a burn victim would likely order all of the following except

A) IV (intravenous) fluids and electrolytes.

B) ice packs applied to the burn area.

C) a high-calorie diet.

D) skin grafts.

E) antibiotics.

B) ice packs applied to the burn area.

74

79) The effects of aging on the skin include

A) a decline in the activity of sebaceous glands.

B) increased production of vitamin D.

C) thickening of the epidermis.

D) an increased blood supply to the dermis.

E) a decreased number of sweat glands.

A) a decline in the activity of sebaceous glands.

75

80) Wrinkles in individuals are the result of

A) increased production of epidermal layers.

B) loss of elastic fibers in the reticular layer of the dermis.

C) increased keratinization of the epidermis.

D) the loss of glands and hair follicles from the skin.

E) decreased thickness of the dermis.

B) loss of elastic fibers in the reticular layer of the dermis.

76

81) Why would an elderly person be more prone to skin infections than a younger person?

A) Skin repairs take longer in the elderly.

B) The epidermis is thinner in the elderly.

C) There are fewer dendritic cells in the skin of the elderly.

D) Basal cell activity is reduced in the elderly.

E) All of the answers are correct

E) All of the answers are correct

77

1) Accumulations of fluid within the epidermis or between the epidermis and the dermis is/are called

A) keloids.

B) scabs.

C) blisters.

D) scars.

E) pus.

C) blisters.

78

2) Rapid water loss from burned skin is an extreme form of ________ perspiration.

A) imprudent

B) non-sense

C) impractical

D) vacuous

E) insensible

E) insensible

79

3) The pigment found in vegetables that can make the skin appear orange or yellow is called

A) cadmium.

B) carotene

C) hemoglobin.

D) keratin.

E) melanin.

B) carotene

80

4) Melanin is produced by melanocytes within the stratum

A) corneum.

B) lucidum.

C) granulosum.

D) spinosum.

E) basale.

E) basale.

81

5) The skin appearance that results from dark-red hemoglobin is called

A) erythema.

B) cyanosis.

C) jaundice.

D) freckles.

E) pallor.

B) cyanosis.

82

6) Four signs useful for determining if a suspicious mark on the skin is melanoma follow the ABCD mnemonic. Which pairing is incorrect?

A) A - asymmetry

B) B - border

C) C - circumference

D) D - diameter

E) They are all correct

C) C - circumference

83

7) A deficiency disease that illustrates the effect of integumentary system function on the structure of the skeletal system is

A) osteoporosis.

B) seborrheic dermatitis.

C) decubitus ulcers.

D) rickets.

E) beriberi.

D) rickets.

84

8) The most dangerous type of skin cancer is called

A) keratosis.

B) psoriasis.

C) squamous cell carcinoma.

D) melanoma.

E) basal cell carcinoma.

D) melanoma.

85

9) Vitamin D3 is important for proper ________ development.

A) skin

B) bone

C) muscle

D) vision

E) neural

B) bone

86

10) Skin cancer that starts in the mitotically most active epidermal layer is called

A) keratosis.

B) psoriasis.

C) squamous cell carcinoma.

D) melanoma.

E) basal cell carcinoma

E) basal cell carcinoma

87

11) A bruise turns "black and blue" because of ________ in the dermis.

A) hyperactive sebaceous glands

B) apparent cyanosis

C) the accumulation of pus

D) broken blood vessels

E) a lack of oxygen

D) broken blood vessels

88

12) The clinical term for a bruise is a(n)

A) infarction.

B) contusion.

C) hemorrhage.

D) sclerotome.

E) thrombus.

B) contusion.

89

13) The drug tretinoin (Retin-A)

A) reduces the appearance of fine wrinkles.

B) minimizes scarring after surgery.

C) stimulates hair growth.

D) improves night vision.

E) is used to treat dandruff.

A) reduces the appearance of fine wrinkles.

90

14) Fine hairs (like "velvet") that lack pigment and cover much of the body surface are called ________ hairs.

A) veneer

B) gossamer

C) lanugo

D) vellus

E) terminal

D) vellus

91

15) Coarse pigmented hairs are called ________ hairs.

A) veneer

B) gossamer

C) lanugo

D) vellus

E) terminal

E) terminal

92

16) The substance called sebum is commonly known as

A) sweat.

B) earwax.

C) skin oil.

D) pus.

E) dandruff.

C) skin oil.

93

17) In the condition known as erythema, the skin takes on a ________ color.

A) reddish

B) bluish

C) greenish

D) yellowish

E) grayish

A) reddish

94

18) A thickened area of scar tissue that is covered by a shiny, smooth epidermal surface is called a

A) keloid.

B) contusion.

C) hematoma.

D) psoriasis.

E) sclerotome.

A) keloid.

95

19) A fibrin clot that is formed over a skin wound is called a

A) scar.

B) keloid.

C) graft.

D) scab.

E) plug.

D) scab.

96

20) The combination of blood clot, fibroblasts, and extensive capillary network that is formed in injured skin is called ________ tissue.

A) germinative

B) spinous

C) fibrocytic

D) granulation

E) abscess

D) granulation

97

21) If epithelial cell migration cannot cover a wound, ________ may be required.

A) radiation therapy

B) skin grafts

C) chemotherapy

D) amputation

E) a biopsy

B) skin grafts

98

22) A bacterial infection that is often fatal in burn patients is called

A) sepsis.

B) necrosis.

C) toxis.

D) pernicious.

E) noxious.

A) sepsis.


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