MODEL PAPER -2 n 1

MODEL PAPER -1
DIPLOMA IN MEDICAL LAB TECHNICIAN
SECOND YEAR
PAPER - II
Time : 3hrs. Total Marks : 80

SECTION – A

Note: Answer any Ten of the following.

4 × 10 = 40 M
1. Explain about epithelical tissue?
2. Explain about large intestine?
3. Explain about urine chemical analysis?
4. Write about sharpening of microtome knife?
5. Write about decalcification?
6. What is cryostat?
7. Write about the infarction and shock?
8. Write about the preparation and use of whole
blood and blood components?
9. What are the bones in upper extremity?
10. Explain the formation of urine?
11. Write about human pelvis?
12. What is the composition & function of blood.
1. Anticoagulanta
2. Blood cell count.

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ANSWERS
SECTION – A
1. Explain about epithelical tissue?
Ans : Epithelial tissue: It covers body surfaces
and lines hollow organs, body cavities and
ducts. It allows the body to interact with
internal and external environment.
• Epithelial tissue consists of cells arranged in
continuous sheets in single or multiple lay-
ers.
• It has three major functions. They serve as:
- Selective barriers that transfer substances in
and out of the body.
- Secretory surfaces that release products pro-
duced by the cells.
- Protective surfaces.
Structure of Epithelial Tissue:
• Apical surface of an epithelial cell faces the
body surface, body cavity, lumen of an in-
ternal organ recieves cell secretions.
• The lateral surfaces of an epithelial cell fac-
ing the adjacent cells on either side may con-
tain tight junctions and desmosomes.
• The basal surface of an epithelial cell is op-
posite to the apical surface.
• Apical layer refers to most superficial layer
and basal layer is the deepest layer.
• Basement membrane is a thin extracellular
layer commonly consists of two layers. The
basal lamina and reticular lamina.

Fig : Epithelial Tissue.

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 MODEL PAPER -2 n 3

• Basal lamina contains proteins such as gly-

coproteins, proteoglycons and collagen.
• Reticular lamina contains collagen callec fi-
broblasts.
Basement membranes have functions during
wound healing and participate in filteration of
blood in kidneys.
Fig : Simple squamous epithelium
• Epithelial tissues play many different roles
in the body such as protection, filteration, ii. Simple Cuboidal Epithelium : Single layer
secretion, absorption and excretion. of cube-shaped cells, centrally located
• In addition epithelial tissues combine with nucleus.
nervous tissue to form special organs for Location : Covers surface of ovary, secret-
smell, hearing, vision and touch. ing portion of some glands.
• Epithelial tissues may be divided into two Function: Secretion and Absorption
types.
1. Covering epithelium : Forms outer cover-
ing of the skin and some internal organs.
Two characteristics of covering epithelium
are:
• Arrangement of cells in layers.
• Cell shape.
Fig : Simple Cuboidal Epithelium
2. Glandular epithelium: Makes up the se-
iii.Simple Columnar Epithelium (non-cili-
creting portion of glands such as thyroid,
ated): Single layer of columnar cells with
adrenal and sweat glands. All the glands are
oval nuclei near base of cells. It contains
classified into exocrine and endocrine glands.
goblet cells.
Combining the two characteristics in the type
of covering epithelium are: Location: Lines gastro intestinal tract, gall
bladder.
a. Simple Epithelium.
Function: Secretion and absorption.
b. Stratified Epithelium.
a. Simple-epithelium:
i. Simple Squamous Epithelium : It is a single
layered with centrally located nucleus and
is flattened, oval or spherical in shape.
Location: Cardiovascular system and lym-
phatic vessel, kidneys.
Function:
• Blood filteration in kidneys.
Fig : Simple Columnar Epithelium
• Diffusion of O, into blood vessels of lungs

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iv. Pseudo Stratified Columnar Epithelium:
It appears to have several layers. Pseudo
stratified ciliated columnar epithelium con-
tain cells extend to surface and secrete mu-
cus.
Fig : Pseudo Stratified Columnar Eoithelium
v. Pseudo stratified nonciliated columnar
epithelium : It contains cells without cilia
and lacks goblet cells.
Location : Upper respiratory tract and epi-
didymis.
Function : Secretes mucus traps foreign par-
ticles, absorption and protection.
b. Stratified epithelium:
i. Stratified Squamous Epithelium: It
consists of two or more layers of cells:
• Stratified squamous keratinised epithelium
develops tough layer of keratin in apical layer
of cells and several layers deep to it.
• Stratified squamous non-keratinised epithe-
lium does not contain large amounts of kera-
tin in apical layer and several layers deep
and is constantly moistened by mucus from
salivary and mucous glands.
Location : Keratinised is seen in skin. Non-
keratinised is seen in oesophagus, tongue
and vagina.
Function: Protection, water loss and de-
fence.

Fig : Stratified Squamous Epithelium

ii. Stratified Cuboidal Epithelium : It consists of two or more layers of cells.

Location : Ducts of adult sweat gland.
Function : Protection, secretion and absorption

Fig : Stratified Cuboidal Epithelium

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iii. Stratified Columnar Epithelium : Basal
layers usually consist of shortened irregular
shaped cells, Apical layer has columnar cell.
Location : Lines part of male urethra,
conjuctiva of eye and esophageal glands.
Functions : Protection and secretion
Fig : Stratified Columnar Epithelium
iv. Transitional Epithelium : When relaxed
looks like stratified cuboidal epithelium,
Apical layer is large and umbrella-shaped.
When stretched, cell becomes flattened and
multiple layers are seen
Location: Lines urinary bladder, ureters and
urethra.
Function: Allows urinary organs to stretch
and maintain protective lining.
2. Explain about large intestine?
Ans : Large Intestine : Large intestine extends
from the ileocecal junction to the anus. It is
about 1.5 metres long and is divided into.
1. Cecum with vermiform appendix
2. Ascending colon. 3. Transverse colon.
4. Descending colon. 5. Sigmoid colon.
6. Rectum. 7. Anal canal.
1. Cecum with vermiform appendix : It is
the first part of the colon and is a dilated
region which has a blind end inferiorly and
is continuous with the ascending colon
superiorly.
• Length : 6 cm.
• Width : 7.5cm
MODEL PAPER -2 n 5
Ileocecal Valve : The lower end of the ileum
opens on the posteromedial aspect of the
cecocolic junction. The ileocecal opening is
guarded by the ileocecal valve.
Fig : Caecum
Arterial Supply: It is supplied by anterior and
posterior caecal arteries.
• Venous Drainage : Ileocolic vein in the
portal system
Lymphatic Drainage: Ileocolic group of
lymph nodes
Nerve Supply:
• Sympathetic Supply: Pregnanglionic fibers
T10 - L1 segments of spmal cord.
• Parasympathetic Supply: By vagus nerve.
Appendix : It is also known as vermiform
appendix.
Appendix is worm-like diverticulum, extend-
ing from die posteromedial wall of caecum.
• Length : 2- 20 cm (Average: 9 cm)
Diameter : 5 nm
Appendicular Orifice : The appendicular
orifice is situated on the posteromedial as-
pect of the caecum 12cm below the ileoce-
cal orifice).
McBurney's Point : It is the site of maxi-
mum tenderness in appendicitis. The point
lies at the junction of lateral one-third aind
medial two-thirds of hue joining the right
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anterior superior ilitic spine to umbilicus.
• Arterial supply: It is supplied by appendicu-
lar artery.
• Wenous Drainage: Appendicularvein drains
into superior mescentric vein.
• Lymphatic Drainage: Drains into superior
mesenteric Lymphnodes
• Nerve Supply :
- Sympathetic Supply: Preganglionic fibers
from T10 spinal cord segment.
- Parasympathetic Supply: By vagus nerve.
2. Ascending colon: It extends from the
cecum to the hepatic flexure, where it curves
acutely to left at the hepatic flexure to be-
come transverse colon.
• Length : 12.5 cm.
Right colic flexure : It lies at the junction of
ascending colon and transverse colon.
3. Transverse colon : It is a loop of colon that
extends from hepatic flexure to splenic flex-
ure of colon.
Length : 50 cm.
4. Descending colon : It curves towards the
midline. After it enters the true pelvis, it is
known as the sigmoid colon. The descend-
ing colon is narrower than the ascending
colon.
Length : 25 cm.
Left Colic Flexure: It lies at the junction of
the transverse colon and the descending
colon.
5. Sigmoid colon : It extends from the pelvic
brim to the third piece of sacrum. It is de-
scribed as an Sshaped curve in the pelvis
that continues downward to become the
rectum.
Length 37cm.
Blood supply for Ascending, Descending,
Transverse and Sigmoid colon:
Medical Lab Technician
Arterial Supply : It is supplied by marginal
artery.
Lymphatic Drainage: Drains into epicolic
and paracolic lymph nodes.
Nerve Supply:
• Sympathetic Supply: Preganglionic fibers
from T10 to L11 spinal segments.
• Parasympathetic Supply: Vagus nerves and
pelvic splanchnic nerves.
6. Rectum: It is a slightly dilated section of the
colon, which starts with sigmoid colon and
terminates within the anal canal. It extends
from S13 vertebra to 2-3 cm below the tip
of the coccyx.
Length 12 to 13 cm
Relations:
a. Peritoneal Relations : The upper one-
tliird of the rectum iscovered with perito-
neum in front and on the sides.
• The middle one- third is coveted only in
front.
• The lower one -third, which is dilated to form
the ampmlla, is devo id of peritoneum, and
lias below the rectovesical pouch in moles
and bellow the rectouterine pouoh in fe-
males.
3. Explain about urine chemical analysis?
Ans : Chemical examination :
Protens in urine : Normal urine contains
upto 30-50mg protein per 24hr sample. So
any protein detected by the tests is said to
be abnormal and is called proteinuria. To
do urine protein test, early morning sample
is preferred. The patient should be fasting.
Grading of Proteinuria:
1. Heavy : Concentration, is above 4 gm/24hr
sample.
2. Moderate : When concentration, is between
1- 4gm/24hr sample.

3. Minimal or mild : When concentration, is
less than 1 gm/24hr. sample.
Causes of Proteinuria:
i. Accidental : Due to contamination by pus,
vaginal, fluid, blood or seminal fluid.
ii. Physiological: Seen in pregnancy, infancy,
after muscular exercise, due to exposure to
cold and sometimes relaterd to posture.
Ortho static or postural proteinuria which is
usually during day when patient is upright.
iii. Pathological :
1. Pre-renal: No primary renal disease,
congestive cardiac failure, cerebral injury,
fever and toxemia, intra abdominal ascitis
tumours, drugs and chemical poisoning,
severe anaemia, plasma cell myeloma.
2. Renal: Nephritis, Diabetes mellitus, SLE,
T.B of kidney, Amyloidosis, Hyperten-
sion, Carcinoma of kidney, Uraemia of
pregnancy,
3. Post-renal: Pyelitis, cystitis, urethritis and
prostatitis.
Types of Proteins found in Urine: Albumin,
globulin, mucin, blood proteins (haemoglo-
bin) and Bence - Jones proteins. Albumin is
the chief protein and is the commonest
examinatin asked for in the laboratory
DETECTION OF PROTEINS
Principle:
All methods depend on precipitation of
proteins by chemical agents or coagulation
by heat. If mucin is present in excess, dilute
acetic acid is added and urine is filtered. If
urine is turbid, then it should be filtered as it
interferes with the precipitation of proteins.
Before starting the test, urine is made acidic
by adding 10% of Acetic acid.
1. Semiquantitative test :
a. Heat and Acetic acid Test : Fill 3/4th of
the test tube with urine and heat the upper
part (lower part acts as control). If cloudi-
MODEL PAPER -2 n 7
ness is detected in the upper part, is can
be due to proteins, phosphates, urates.
Add 3-4 drops of CH3COOH (acetic
acid), if it disappears, it is due to phos-
phates and urates. If it persists, it is be-
cause of proteins. If mucin is present (as
ppt), add HN03 (Nitric acid) to dissolve
the precipitate. This can detect proteins
as little as 2-3 mg - 100 ml.
Interpretation:
1. No cloudiness-absence of proteins.
2. Haziness-traces present (upto 10 mg/100 ml)
3. Cloudiness - + (10-50 mg./ml).
4. Granular - + + (50-200 mg/100 ml).
5. Flocculations - +++ (200-500 mg/1 100ml)
6. Thick cloudy precipitate - + + + +
(> 500 mg/100 ml).
b) Contact or Heller’s Test: Take 3 ml of once.
HNO3 in a test tube and run urine slowly
with the help of a pipette along the side of
inclined tube A sharply defined white ring
of varying density appears at the junction
of the two liquids If albumin is present. The
size and density of the ring can be evalu-
ated and reported as 1+, 2+. etc.,
c) Uristix orAlbustix or stix Test: A stix which is
already impregnated with the indicator tetra
bromophenol biie and is dipped into urine
sample. The colour changes is from yellow
to green to blue
2. Quantitative Test for Albumin
Instrument used is Esbach’s Albuminometer.
Sample is 24 hr urine. It is a thick walled
test tube - 15 cm long and 15 mm internal
diameter. Markings are ‘U ’(urine) at bot-
tom and ‘R’ (reagent) at top. Lower part
has markings from 0.5 to 12 gm. The tube
is worked and stood vertically in its special
stand for 24 hours.
Composition of Esbach’s reagent: 5 gm of
picric acid and 10 gm of citric acid in 500
ml of distilled water.
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Value in grams/lit of urine for value in per-
centage - divide by 10 (×gm).
For 24 hrs value (total protein) - (× gm/10
× 24 hr).
Procedure: Slightly acidified and filtered
urine is taken upto ‘U’ and Esbach’s reagent
upto ‘R’ mark.
Close with a rubber stopper and invert for
sometime. Set it aside upright for 24 hrs pro-
tein is deposited at the bottom. This gives
the reading in gms/litre of urine. If protein
concentration exceeds 4 gm/It, then dilute
urine and repeat the test. If less than I gm/
It, it cannot be properly measured
3. Bence - Johnes proteins
These are practically diagnostic of myelom-
atotis.
Test : Urine with B-J proteins becomes tur-
bid at 500C and a viscous precipitate is
formed. On further heating, the ppt is dis-
solved and reappears on cooling between
50-600C. This proteins appears in urine in
multiple myeloma, chornic leukemias and
in osteo sarcoma.
Sugars in urine :
Presence of sugars in urine is known as melli-
turia (met meaning honey), while that of glu-
cose as glycosuria.
The most important disease in which glycosuria
occurs is Diabetes mellitus. Other reducing sub-
stances found in urine are as follows.
a. Carbohydrates (reducing):
i. Lactose: In urine of sucking infants and nurs-
ing mothers.
ii. Fructose: In people taking large amounts of
fruits.
iii. Pentose: Present rarely. It can be found in
congenital disorders.
iv. Glycerates: Found in urine when patient has
been given substances like alkaloids; (opium
and morphine).
Medical Lab Technician
b. Non-carbohydrates (reducing)
i. Uric acid and creatinine.
ii. Salicylic acid; patient on salicylates.
iii. Homogentisic and melanogentisic acidsalka-
ptonuria.
iv. Ascorbic acid.
v. Chloral hydrate.
vi. Morphin.
vii. Paraldehyde.
viii.Anti TB drugs like INH etc.
i. Qualitative or semi-quantitative Test : There
are several test for estimation of sugar/carbo-
hydrates in urine such as Benedicts test, Fehling's
test, Rubner’s test etc. See below for details.
Procedure:
a. Benedict's test:Take 5 ml of Benedict’s re-
agent and heat it. Put 8 drops of (0.5 ml)
urine (which is protein free) with a dropper.
Boil for 3-5 min. and then cool it. Then note
the colour changes.
i. Qualitative Test Principle: It is based on the
property of sugar to reduce CuS04 (cop-
per sulphate) in alkaline solution into in-
soluble yellow cuprous oxide.
ii. Results: The reagent contains CuS04 .
Na2C03 or sodium citrate in distilled water.
Colour changes are as follows:
Negative - No change in colour.
Traces - Solution appears pale green or
slightly cloudy.
- Definite cloudy green (100 - 500
mg%)
2+ - Yellow to orange ppt
(500 - 1400 mg%).
3+ - Orange to red ppt
(1500 - 2000 mg%).
4+ - Brick red ppt (> 2000 mg%).

iii. Constituents of Benedict Reagent: 18 gms -
CuS04 in 100 ml of distilled water. 100 gms
- (Na 2C03) Sodium carbonate (anhy-
drous). 200 gms - Na or K citrate. This re-
sults in alkaline copper reagent.
iv. Advantages of Benedict’s Test:
• It uses a single solution which is already
prepared.
• It uses a more stable reagent.
• It is ten times more sensitive.
• It is a more specific test.
b. Fehling's Test: Take equal volumes of
Fehling’s solutions A and B, mix well and
boil. Add a few drops of urine. Boil and ob-
serve the colour change. Colour changes
are same as in Benedict’s test.
Composition of Fehling’s solutions:
Solution A - CuSO4, in distilled water.
Solution B - NaOH, Sodium Potassium
tartarate in distilled water.
c. Test for Lactose: Rubner’s test: Concen-
trated NH40H is used. Lactose gives and
ppt while glucose gives a yellow ppt.
d. Test for Fructose: Selwinoffs test.
e. Test for Pentose: Bial’s test.
Osazone Test: This test is used to differentiate
the various osazones. Acidified urine is used
along with phenyl hydrazine hydrochloride and
sodium acetate. Glucosazone crystals are
straight, needle shaped, arranged in fans or
sheets of spherical clusters. Lactosazone crys-
tals are finely curled with puffball appearance.
Quantitative Test for Glucose:
Procedure: Take 25 ml of Benedict’s reagent
in a flask and add 15 gm of crystal Na2 C03(Na
carbonate) and some broken pieces of porce-
lain. Heat until it boils. Take urine in a burette
and titrate against the contents of the flask. Nor-
mally, 25 ml of reagent requires 0.05 gms of
sugar for reduction. If × is the amount of urine
run down, then × ml contains 0.05 gms of sugar.
MODEL PAPER -2 n 9
Therefore, 1 ml contains 0.05/x gms is calcu-
lated.
Ketone Bodies in urine :
These are intermediate products of fat metabo-
lism. They are acetone, acetoacetic acid (diacetic
acid) and B-hydroxy butyric acid. They occur
in urien when fat metabolism is disordered.
i. Rothera's Test: ( For acetone and also for
acetoacetic acid).
Procedure: For acetone and also for ac-
etoacetic acid. Take 5 ml urine in a test tube
and saturate with Ammonium sulphate. Add
1 crystal of sodium nitroprusside. Let liquid
ammonia run down the sides of the tube,
so that it forms a layer on top of urine. If
acetone is present a permanganate caramel
red colour ring forms at the junction of the
two layers.
ii. Gerhardt's test for Diacetic Acid: Procedure:
Take 5 ml of urine in a test tube and add
10% of aqueous solution of ferric chloride
drop by drop until no further ppt of ferric
phosphate occurs. Filter and add to the fil-
trate more of ferric chloride (FeCIS) solu-
tion. If diacetic acid is present, the filtrate
will develop brownish red colour.
iii. Other tests: Lindeman’s Test: For diacetic
acid.
Hart’s Test: For Beta Hydroxy butyric acid.
Causes for presence of Ketone bodies in
Urine:
1. Diabetes mellitus
2. Infants and children with acute febrile con-
ditions
3. Toxic states accompanied by vomiting and
diarrhoea
4. Vomiting of Pregnancy.
5. Cachexia.
6. Following exposure to cold.
7. Following severe exercise.
8. Following anaesthesia.
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Note : In diabetes, the high proportion of
sugar is not dangerous to the body. But, if
sugar metabolism is upset, Ketone bodies
accumulate in blood which are poisonous
to the body
Blood in urine :
Blood may be found in urine in the form of
red blood cells or blood pigments alone. It
is important to indicate whether RBC are
present or only pigments are present. Nor-
mally, occasional RBC may be found.
Hematuria - Denotes presence of red blood
cells in urine.
Haemoglobinuria - Denotes presence of
blood pigments in urine without associated
presence of RBC’s
Tests for Presence of Blood:
I. Microscopic Examination: Urine is centri-
fuged and the sediment is examined under
microscope. Report as the no. of RBC / High
Power Field.
II. Chemical Tests:
a. Benzidine Test:
i. Principle: The peroxidase activit of hae-
moglobin decomposes hydrogen perox-
ide and the liberated oxygen oxidises the
benzidine. It is very sensitive to even small
amounts of haemoglobin.
ii. Procedure: To two ml of urine (previ-
ously boiled and cooled) add one ml of
clear saturated benzidine solution (Ben-
zidine powder and glacial acetic acid) mix
well. add one ml of freshly prepared 3%
hydrogen peroxide.
iii. Interpretation: The appearance of green
or blue colour within 5 minutes indicate
the presence of blood or haemoglobin
in the urine
Trace - Faint green Colour.
+ - Green.
++ - Greenish blue.
Medical Lab Technician
+++ - Blue.
++++ - Deep Blue.
Other Tests:
b. Guaicum test: It is less sensitive test
c. Orthotolidine test
III. Spectroscopic Examination: Look for typica.
absortion bands with a hand spectroscope.
Causes of Hematuria:
a. Lesion of kidney: Cystitis, acute glomerulo-
nephritis, nephrolithiasis, urethritis, embo-
lic nephritis, Renal TB, malignant nephro-
sclerosis.
b. Neoplasms of kidney: Lesions in lower urinan
tract stones in bladder, urethra, Bilharziasis
and Neoplasms.
Bile Salts and Pigments in urine :
Constituents of bile may be excreted in urine
as bilirubin, urobilin, bile salts and bile pigments.
Bilirubin appears in urine, when it is in excess in
blood i.e. in jaundice. Bile salts and pigments are
present in obstructive jaundice and hepatocellular
carcinomas.
Tests for Bile Salts:
Hay Sulphur Test:
i. Procedure : Take 10 ml of urine in a test
tube and sprinkle sulphur granules. Nor-
mally they float.
In the presence of bile salts, the surface ten-
sion is reduced and the sulphur granules sink
and settle at the bottom.
ii Control: Take 10 ml of water m a test tube
and sprinkle sulphur granules (which float)
Tests for Bile Pigments:
i Foarm test: Take urine in a test tube and
shake it well. A positive result is obtained
with the formation of stable yellow froth,
the stability of which is due to the presence
of bile salts and the colour is due to biliru-
bin.
 MODEL PAPER -2 n 11

ii. Gmelitt’s test: Principle - Bringing yellow ni- Importance: The edge of the microtome
tric acid in contact with urine. Take 2 ml kinfe performs the function of cutting and it
yellow nitric acid in a test tube overlay with should be sharp in order to get good sections
an equal amount of urine. A band of of the tissues.
coloured rings appear, the most prominent Introduction : Sharpening of the knife can
being green colour. This demonstrates the be carried out by:
presence of bile pigments. This can be done
• Mechanically or by
on a filter paper or procelain plate.
iii. Fouchet’s test: Take 10 ml urine in a test • Automated knife charpners.
tube and add 2.5 ml of 10% BaClr Mix well The process of sharpening consists of:
and filter.
• Honing and
Then unfold the filter paper and spread on
• Stropping.
another filter and allow one drop of Fouchef
s reagent on the ppt. A green or blue colour Requirements:
indicates the presence of billirubin. This is a
• A hone (rectangular block of stone cpecially
sensitive test.
made for sharpening of knife).
Composition of reagent - Trichloroacetic
• A properly fitted back of the knife.
acid and 10% FeCl 3 in distilled water.
• Microscope to observe the edge of the knife.
Reaction :
• Knife.
Bile Salts + BaCl2 BaSQ4 ® ( ppt ) acts ®
with fouchef s reagent (colour +) • A strop (flexible or grid).
Tests for Urobilinogen: Excess can be de- Procedure (Honing):
tected by Ehrlich’s aldehyde test or by
• Clean the knife with Xylene soaked cloth.
commerical strip test.
• Put on the proper honing back.
1. Urobilineogen: On reacting with para -
dimethylaminobenzaldehyde forms a pink • Keep a damp cloth under the hone and po-
coloured compound. sition the hone on suitable bench.
ii Ehrlich’s Test: Procedure. Take 10 ml of • Lubricate the surface of hone with coconut
fresh urine in a test tube and add 2.5 ml of oil.
BaCl . Mix well and filter. Take 2.3 ml of
• Place the knife at one end and push it di-
filtrate, add 0.5 ml of aldehyde reagent and
agonally forward with the leading cutting
allow it to stand for 3 mins.
edges in the front.
Then see the top column of urine against a
• Just before the edge reaches the end of the
white background. A pink colour denotes
stone the knife is turned, over on its back
the presence of urobilinogen. Repeat the test
without lifting it. It is steadily pulled back with
with in 10, 20, 50, 100 and 200 dilutions.
the cutting edge leading again along the
The more dilute it is, the more sensivtive
hone towards the operator.
the test becomes. The report should be in
terms of highest dilution with a positive re-
action.
4. Write about sharpening of microtome
knife?
Ans : Sharpening of the Micro tome Kife:
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12 n
5.
Ans : Decalcification: Preparation of bony tissue
Stroping technique
Honing technique
Observe the edge of the knife under micro-
scope to check the progress of the honing.
Precautions :The pressure on the knife
should be just sufficient to maintain its edge
in contact with hone surface.
B. Procedure (Stropping):
Importance: Stropping is done in order to
remove the wire edge caused by the fric-
tion of the steel upon the stone during hon-
ing. The strop is usually made up of leather.
Procedure:
• Take a clean and dry knife.
• Place a rigid strop on the bench.
• Place the knife at one end of the strop and
push it diagonally forward carefully so that,
entire edge receives the polish.
• Maintain the pressure on the knife just suffi-
cient to keep the edge in contact with the
surface of the strop and establish a rhyth-
mic, steady motion.
• When it reaches the end of the strop, turn it
on its back and pull back towards you (to-
wards the operator).
• Observe under microscope for a sharp and
even surface.
Medical Lab Technician
Write about decalcification?
and its components for light microscopy is
different and difficult than for any other
tissue.
• In order to obtain satisfactory paraffin sec-
tions of bone, calcium must be removed
from the organic collagen matrix calcified
cartilage and surrounding tissue.
• Composition of bone consists of 70% min-
eral and 30% organic components due to
which bone is solid, hard and strong.
• Calcium is also present in teeth and in var-
ied amount in the other tissues affected by
tuberculosis and malignancy.
• The process of removal of calcium from tis-
sue for malignancy. The process for removal
of calcium from tissue for subsequent pro-
cessing is known as decalcification
• Decalcifying agents are composed of an acid
and a reagent, which will prevent distortion
of tissue.
• Acids commonly used for decalcification are
nitric acid, formic acid, hydrochloric acid,
and trichloroacetic acid.
• The preparation of good section is preventes
by the presence of calcium salts in the tis-
sue.
• Tom and ragged sections are obtained and
even the cutting edge of the microtome knife
may be damaged.
The technique of decalcification can be
divided into the following stages:
1. Selection of tissue.
2. Fixation.
3. Decalcification.
4. Acid neutralisation and
5. Washing.
1. Selection of tissue:
 MODEL PAPER -2 n 13

a. Bone: By using fine toothed bone saw or c. 1 g /dl zinc sulfate : 0.2 ml.
hack saw, thin slices of bone are obtained. d. Chloroform : Few drops.
The slices should not exceed 4-5 mm in
Specific features:
thickness.
• Use of this buffered solution causes no per-
• The cut surfaces should be retrimmed to
ceptible damage to cells or tissue fibers.
remove damaged areas after decalcification
and washing. • The decalcification results are much slower
than other establiched fluids.
b. Calcified tissue: A sharp knife is used to cut
calcified tissue (or a saw may be used). • This solution is of use when time is not an
Duration of decalcification will depend on important factor.
the degree of calcification.
3. Jenkin's fluid
2. Fixation:Bone marrow is best fixed in Zenker
a. Absolute alcohol 73ml
formal or any other routine fixative which
may preserve the issue well, e.g. Formalin. b. Distilled water 10ml
3. Decalcification may be carried out as follows: c. Chloroform 10ml
• By using a dilute mineral acid (a simple d. Glacial acetic acid 3ml
solvent of calcium). e. Hydrochloric acid 4ml
• By forming simple combination of calcium The swelling effect of hydrochloric acid is
with ion exchange resins. counter-acted by the shrinking effect of the
• By using chelating agent, which binds the alcohol.
calcium. • Quantity of this fluid should be 40 and 50
• By removal of calcium from tissues using times the bulk of the tissue.
electrophoresis techniques. • Human rib cross sections are decalcified in
4. Acid neutralisation :Tissues should be 4-6 days
neutralised before washing by treatment, 4. Formal nitric acid:
which breal alkali such as 5g/ dl lithium or
sodium sulfate a. Formalin 5ml
5. Washing: It is carried out for 2 to 4 hours in b. Nitric acid (sp. gr. 1.14) 7.5 to 15ml
alcohol or overnight in water to remove al- c. Distilled water 100ml
kali after the neutralization.
Specific features:
Decalcifying fluids:
• Nitric acid develops yellow colour due to the
1. Gooding and Stewart fluid: formation of nitrous acid, which may inter-
a. Formic acid : 5 to 25 ml. fere with the staining reactions.
b Formalin : 5 ml. • The yellow colour can be obviate by the
addition of 0.1 g/dl urea to pure nitric acid.
c. Distilled water : 100 ml.
• Human rib cross section (5 mm) can be de-
2. Citrate-citric acid buffer: calcified in 1-2 days by using 7.5 % (v/v)
a. 7 g/ dl citric acid (monohydrate) : 5 ml. nitric acid.
b. 7.54 g/ dl ammonium citrate Electrophoretic Decalcification: It is based
on the principle of attraction of the calcium
9 anhydrous) : 9.5 ml.
Medical Lab Technician
14 n
ions in solution to a negative electrode, by
passing electrical current. The electrolyte
used in electro phoresis is equal parts of 8%
(v/v) hydrochloric acid and 10% (v/v) for-
mic acid. Brass plate is used as negative elec-
trode and platinum wire as positive elec-
trode. The positive electrode is wound
around the specimen. This is placed in a glass
museum jar. Speed of decalcification may
be increased by moving the electrodes
closer together or decreased by moving them
further part.
6. What is cryostat?
Ans : Working of cryostat: General Procedure:
Fresh tissue is received for frozen section.
All specimens should be considered
potentially dangerous, hence, these should
be handled using gloves.
• Following is a general procedure of cryostat
sectioning:
• The specimen (piece of tissue) is removed
from operation area.
• Tissue must be received with out delay to
avoid drying artifact and it shoul not be
transferred in gauze piece.
• Water content from tissue is absorbed by
gauze, which affects sectioning procedure.
• Size of tissue for frozen section should be
about 3× 3 mm.
• A drop of cryo compound (optimum cooling
medium) or water is added on the disc/
metal chuck. Cryo compound or water can
act as embedding medium.
• Tissue piece is placed on the disc/ metal
chuck with proper orientation.
• The disc is placed on quick freezer shelf.
• Once the specimen is frozen, insert the disc
in the specimen head for sectioning.
• Hand wheel should be locked.
• Knife or blade should be placed appropri-
ately.
Medical Lab Technician
• Clamping screw should be kept loose on the
specimen head.
• Insert the specimen disc/ metal chuck into
opening of specimen head.
• Tighten clamping screw.
• Unlock the hand wheel.
• Trim the specimen using coarse and preci-
sion feed buttons. Use coarse feed button
for moving specimen towards the cutting
edge.
• Set the section thickness to 6 to 10 microns
using sections thickness knob.
• Place the anti-roll guide plate over the knife
holder. Sections have tendency to curl. Anti-
roll plate supports section to form flat sec-
tions.
• Correct adjustment of anti-roll plate is very
important to produce good sections. It
should be placed slightly above the knife
edge.
• Cut serial sections by turning hand wheel
and constant speed.
• Pick up the sections and stain as desired.
• For maintenance of cryostat use the follow-
ing procedure
• Lock the hand wheel
• Remove frozen section waste with a
branch.
• Dispose waste as biohazard waste.
7. Write about the infarction and shock?
Ans : Infraction : Definition - An area of ischemia
in an organ or tissue due to arterial insuffic-
ieicny or venous drainage block.
Cause : Thrombi or thrombo emboli
Types : Based on colour and presence pr
absence of bacterial contamination, there
are two types of infarcts.
• Arterial-white infarct - Anaemic infarct.

• Venous-Red infarct - Haemorrhagic infarct
• Septic infarct (infected).
• Bland infarct
Morphology:
All infarcts are wedge shaped with apex
pointing the site of vascular occlision map
like patterns are also seen.
Margins show rim of hyperemia, surface can
be covered by inflammatory exudate.
Histology:
• Ischemic coagulative necrosis of the tissue
affected.
• Liquefactive type of necrosis in brain.
• Outcome of infarct depend in factors like
general status of cardio vascular system, rate
of occlusion and vulnerability of tissue, e.g.
Myocardial infarction and a cerebral infarcts.
Shock:
Definition: Circulatory collapse and as a re-
sult of wide spread hypoperfusion of tissues,
due to reduction of C.O.P or effective cir-
culatory volume.
Types of Shock:
1. Cardiogenic shock.
2. Hypovolemic shock.
3. Septic shock.
4. Neurogenic shock.
5. Anaphylactic shock - due to type I immune
reaction.
Cardiogenic Shock: Whenever there is fail-
ure of cardiac pump as in myocardial inf-
arction, arrhythmias and after pulmonary
ambolism (or) extrinsic pressure on the heart
due to pericardial effusion-reduction in
C.O.P shock.
Hypovolemic Shock :Due to fluid and
blood loss as severe bums, acute GE,
trauma, where there is reduction in blood
and plasma volume ® shock.
MODEL PAPER -2 n 15
Neurogenic Shock : Vasodilation occuring
in anaesthesia accidents and spinal cord in-
jury.
Septic Shock:
Bacteremic infections by gram negative or-
ganism gram positive or fungi ® vasodila-
tion, pooling of blood DIC ® shock caused
by E. coli, K. pneumomae, pseudomonas,
Bacteriodes and staphylococci.
Pathogenesis: LPS (Lipopolysaccharide) of
Indotoxins of the bacterial wall, combine
with the binding protein in the serum, binds
to CD14 of leukocytes, and endothelial cells
® release of mediators both cytokines ×
other arachidonic acid metabolities ®
intum causes capillary thrombosis intra vas-
cular cogulatism vasodilation.
Role of Nitric oxide and tumour necrosis
factor cause the hemodynamic effects
* Lungs - ARDS.
* Liver - Liver failure.
* DIC
* Microvascular thrombi.
* Finally CNS involvement Coma
Stages of Shock:
Three Stages:
1. Stage I : Non progressive early stage-com-
pensated phase. In this stage, vasoconstric-
tion of arteriolar bed and ADH secretion
occurs. RAA system is activated.
2. Stage II: Progressive stage. If the cause is
still persisting along with additional stress,
shock continues with multisystem failure on-
set. Respiratory symptoms like tachypnea
and ARDS can set in.
3. Stage III : Irreversible phase or stage. There
is marked reduction in cardiac output. Is-
chemic cell death occurs in various organs
® Coma, progressive renal failure and ure-
mia.
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16 n
Morphology : Multisystem failure Treatment:
• Lung - Diffuse alveolar damage and acute • Supportive therapy.
respiratory distress syndrome.
• Control of infection in septic shock.
• Heart - Sub endocardial and sub epicardial
haemorrhages and necroses. • Restoring fluid and electrolyte balance.

• Kidneys - Acute tubular necrosis. • Proper ventilation to prevent respiratory dis-

• Adrenals - Stress response with lipid deple-
tion.
• Liver - Central haemorrhagic necrosis
ATN Kidney (Shock kidney)
tress preventing renal shut down.
8. Write about the preparation and use of
whole blood and blood components?
Ans : Preparation and Selection of Blood Com-
ponents : Large refrigerated centrifuges are
to be used to prepare blood components
from whole blood. High speed centrifuga-
tion separates liquid plasma and different
cells (Red blood cells, white blood cells and
platelets). Preparations of various blood
components are used by using the follow-
ing centrifugations speed.

Preparation Minutes Speed

Packed red blood 5 5000×g
cells. (Heavy spin).

Cell free plasma 7 5000g

(cryoprecipitate). (Heavy×gspin).

Platelet rich 3 2000 ×g

plasma (PRP) ( Lightxg spin)

Protocol for Producing Blood Components:

• First whole blood unit (about 500 ml) is centrifuged by using a light spin.
• Upper portion containing platelet rich plasma (PRP), about 250 ml and it is to be collected in a
satellite bag.
• Lower portion containing red blood cells (RBCs) and it is to be collected in a primary bag.
• Portion containing platelet rich plasma (PRP) is to be centrifuged using heavy spin. Lower por-
tion contain about 200 ml of platelet poor plasma (PPP).
• 200 ml of platelet poor plasma may be used to make fresh frozen plasma (FFD) or returned to
the RBCs to make modified whole boold.
• The portion containing concentrated platelets (about 50 ml) is to be kept at room temperature
(25°C ± 5°C) as undisturbed to enhance platelet disaggregation.
• Continuous agitation of the platelet concentrate at controlled room temperature is necessary to
maintain optimum platelet function.
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 MODEL PAPER -2 n 17

Selection of Blood Components: • There is a progressive loss of the labile co-

Whole Blood: agulation factor V and factor VII when blood
is stored at k°C to 6°C.
• It contains red blood cells and plasma.
9. What are the bones in upper extremity?
• Self life at 1°C to 6°C is 35 days (CPDA-1
anticoagulant) and 21 days (CPD, ACD or Ans : Upper extremity : The skeleton of the
CP2D anticoagulants) respectively. upper limbs or arm may be divided into five
main regions. An upper arm bone, the
• The platelet and granulocytes present in forearm (radius and ulna) the wrist the palm
whole blood are not active after 24 to 48 of the hand and the fingers.
hour storage at 1°C to 6°C. They require
immediate separation after blood collection
and specific storage conditions for storage
to maintain their viability and function.
a. Humerus: The humerus is the bone of the arm. It is the longest bone of the upper limb. It has
one upper end shaft and lower end.
i. Upper End:
• Head is directed medially, backwards and upwards. It articulates with glenoid cavity of the
scapula to form shoulder joint.
• Line separating the head from the rest of the upper end is called anatomical neck.
• Lesser tubercle is an elevation on the anterior aspect of upper end.
• Greater tubercle is an elevation that forms the lateral part of upper end.
• Intertubercular sulcus separates both the tubercles.
• Narrow line separating the upper end of humerus from shaft is called surgical neck.
• Anterior lateral surface consists of deltoid tuberosity, which is the insertion for deltoid muscle.
Behind the tuberosity, the radial groove runs downwards.

ii. Shaft :Shaft is rounded in the upper half and triangular in the lower half.

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18 n

Borders: c. Tubular secretion.

1. Anterior border. • Filtration is the function of the glomerulus,
2. Medial border. reabsorption and secretion are the functions
of tubular portion of Nephron
3. Lateral border.
Surfaces:
1. Anterolateral surface (Lies between anterior
and lateral borders).
2. Anteriomedial surface (Lies between ante-
rior and medial borders).
3. Posterior surface (Lies between medial and
lateral borders).
iii. Lower End : It forms the condyle which ex-
pand from side to side articular parts: 1.
Capitulum, 2. Trochlea. The trochlea of the
humerus articulates with the ulna (and part
of the radius) at the elbow joint.
Non articular parts :
• Medial epicondyle.
A. GLOMERULAR FILTRATION
• Lateral epicondyle.
The renal process, where the fluid in the blood
• Coronoid fossa is a depression just above is filtered across the capillaries of the glomeru-
the anterior aspect of the trochlea which ac- lus and into the urinary space of Bowman’s
commodates coronoid process of ulna, capsule.
when elbow is flexed.
1. Glomerular Filtrate: The filtrate or liquid that
• Radial fossa is a depression present just passes from the lumen of the glomerular cap-
above the anterior aspect of capitulum. illary to the space of Bowman’s capsule. Fil-
• Olecranon fossa lies just above the poste- tration takes place in the glomerulus and
rior aspect of trochlea. Bowman’s capsule and it is influenced by
various forces acting in opposite direction.
10. Explain the formation of urine?
Glomerular filtration is dependant on the
Ans : Formation of Urine/Mechanism of urine following pressures:
formation: Normally, about 1 . 5 - 2 liters
2. Hydrostatic Pressure: It is the pressure ex-
of urine is formed every day. Approximately,
erted by fluid on the walls of blood vessel. It
180 liters of filtrate is formed per day.
depends on the systemic arterial blood pres-
Among that 99% of the filtrate of urin is re- sure and helps to push fluid out of capillar-
absorbed, when it passes through the neph- ies.
ron. Urine formation involves three basic
3. Colloidal Osmotic Pressure: Colloidal os-
processes:
motic pressure is the force that draw's fluid
a. Glomerular filtration. due to the presence of plasma protein, es-
b. Tubular reabsorption and pecially albumin and colloids. It is exerted
by the plasma proteins and opposes the out-
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ward movement of fluid.
4. Bowmann's Capsule Pressure: Bowmann’s
capsule resists the movement of fluid from
the blood vessel to exterior.
Pressures in Normal Individuals:
* Hydrostatic pressure 45 mm Hg.
* Colloidal osmatic pressure 25 mm Hg.
* Bowmann’s capsular pressure 10 mm Hg
Effective filtration pressure:
= Hydrostatic pressure - (Colloidal osmotic
pressure + Bowmann’s capsular pressure).
= 45 - (25+10).
= 10mmHg.
• In this process a protein-free filterate is
formed in proximal convoluted tubule called
ultrafiltration. Filtration occurs through fil-
tration membrane .
Layers of Filtration Membrane:
* Endothelium of the glomerular capillary.
* Basement membrane of capillary endothe-
lium.
* Interstitial layer.
* Epithelial lining of bowman’s capsule.
* Basement membrane of epithelial lining.
- Although by the presence of this many lay-
ers filtration occurs because, the capillary
endothelium has pores termed as fenestrae.
Epithelial cells have foot processes having
gaps called slit pores.
Glomerular Filtration Rate:
Definition: Glomerular filtration rate is the
volume of fluid filtered from the renal glom-
erular capillaries into the Bowman’s capsule per
unit time.
Urine concentration×urine flow
Value of GFR=
Plasma concentration
Glomerular filtration rate is 125 ml/min and
amounts to 180 L/day.
MODEL PAPER -2 n 19
Normal value of GFR - 125 ml/min.
Factors Influencing Glomerular Filtration:
• An increase in capillary hydrostatic pressure
enhances the effective filtration pressure.
• Colloidal osmotic pressure opposes the ef-
fective filtration at glomerulus.
• Bowman’s capsular pressure also opposes
the effective filtration.
• Rate of thickness of filtration membrane is
inversely proportional to effective filtration.
• Rate of filtration depends on surface area.
Barriers of Filtration: There are two major
barriers for the process of filtration.
a. Mechanical Barrier: The main mechanical
barrier is the glomerular basement mem-
brane.
b. Electrical Barrier: Large negatively charged
particles are repelled by this barrier.
Measurement of Glomerular Filtration
Rate: Inulin clearance is used to measure glom-
erular filtration rate.
Properties of Substance and measuring
Glomerular Filtration Rate:
• Should be filtered freely.
• Should not be toxic.
• Should not alter kidney functions.
Principle : Amount of Inulin filtered =
Amount of Inulin excreted.
( P ´ GFR ) = U ´ V
P = concentration of Inulin in plasma,
u = concentration of Inulin in urine,
v = volume of urine produced in unit time.
U´V
i.e., GFR =
P
Creatinine Clearance:
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20 n
• It is also used to estimate glomerular filtra-
tion rate.
• Filtered load = GFR × Plasma concentra-
tion of solute.
Variations in Glomerular Filtration Rate: Glom-
erular Filtration Rate is reduced due to fall in
blood pressure below 60 mm Hg as in circula-
tory shock, emotion, pain, cold and loss of
blood.
Glomerular Filtration Rate is increased, when
extracellular fluid and blood volume are in-
creased.
Renal Clearance : It is the volume of plasma
from which the substance is completely re-
moved by both kidneys in unit time
Mass of the substance
excreted in unit time
Clearance of a substance =
Plasma concetration
of substance.
Urea Clearance: It is the volume of plasma
from which urea is removed in one min.
B. TUBULAR REABSORPTION
The filtrate contains physiologically useful
substances namely glucose, amino acids,
bicarbonates, phosphates, potassium and
water which are absorbed in different parts
of nephron.
Tubular Reabsorption occurs by two types:
• Active Reabsorption: It is the movement of
molecules against the electrochemical gra-
dient (up hill). This needs expenditure of
energy which is derived from Adenosine
Triphosphate (ATP).
* Passive Reabsorption: In this, molecules
move along the electrochemical (down hill)
gradient.
This process does not need energy. Sub-
stances like chloride, urea and water are
reabsorbed passively
Site of Reabsorption:
Medical Lab Technician
a. In Proximal Convoluted Tubule:
• 65% of Na+ reabsorption takes place
through active transport.
• Water because of the solute gradient follows
the Na+
• Cotransported with Na+ are glucose and
amino acids, K+, Ca, chlorides and bicar-
bonates.
• Cations crosses the membrane through
cotransport mechanism, while anions
transfer through passive diffusion.
• Urea and lipid soluble solutes gets diffused
passively across electrochemical gradient.
• Proteines are absorbed through endocytosis
b. In Loop of Henle:
• Water moves along with NaCl as a concu
rrent mechanism.
• Na+ and chloride are the common ions
reabsorbed at loop of henle.
c. In Distal Convoluted Tubule:
• Here, the reabsorption depends on the
hormones.
• Aldosterone promotes the excretion of K+
and reabsorption of Na+,Aldosterone
mediated active transport cotransports H+,
K+,Hco and C1‘ions and Antiduretic
hormone activates the reabsorption of
water.
Collecting Duct: Urea in response to the
concentration gradient and water in
response to ADH is absorbed
C. TUBULAR SECRETION
• In addition to reabsorption from renal tu-
bules some substances are also secreted into
lumen from peritubular capillaries through
the tubular epithelial cells known as tubular
secretion or excretion.
The substances that are not required such
as foreign materials such as drugs (pencillin,
 MODEL PAPER -2 n 21

aspirin), which are not filtered from the
blood are excreted from the body in the
form of urine.
H+, K+, creatinine, ammonium ion, marine
drugs moves from the blood through the
tubular wall into the filtrate.
11. Write about human pelvis?
Ans : Pelvic Girdle (Human Pelvis) : In human
anatomy, the pelvis (plural pelves) is either
the lower part of the trunk, between the
abdomen and the thighs (sometimes also
called pelvic region of the trunk), or the
skeleton embedded in it(sometimes also
called bony pelvis or pelvic skeleton).
The pelvic region of the trunk includes the
bony pelvis, the pelvic cavity (the space
enclosed by the bony pelvis), the pelvic floor
below the pelvic cavity, and the perineum
below the pelvic floor.
The pelvic skeleton is formed in the area of
the back, by the sacrum and the coccyx and
anteriorly and to the left and right sides, by
a pair of hip bones. The two hip bones
connect the spine with the lower limbs.

They are attached to the sacrum posteriorly, connected to each other anteriorly, and joined with
the two femurs at the hip joints.
The gap enclosed by the bony pelvis, called the pelvic cavity, is the section of the body underneath
the abdomen and mainly consists of the reproductive organs (sex organs) and the rectum.
Difference between male and female pelvis:
The female pelvis is adapted for pregnancy and child birth. It differs from male pelvis in the
following aspects:
• Bones are lighter and smoother.
• Body of pubis is broad and square.
• Pubic arch is wider.
• Pelvic cavity is broad and round.
• Sacrum is short and wide, coccyx is more movable.

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22 n

Difference between male and female pelvic bone:

Bony Pelvis Male Female
General structure. Thick and heavy. Thin and light.
Greater pelvis (pelvis major). Deep. Shallow.
Lesser pelvis (pelvis minor). Narrow and deep. Wide and shallow.
Pelvic inlet Heart-shaped. Oval or rounded.
(superior pelvic aperture).
Pelvic outlet Comparatively small. Comparatively large.
(inferior pelvic aperture).
Pubic arch and Narrow (<70°). Wide (>80°).
subpubic angle (A).
Obturator foramen. Round. Oval.
Acetabulum. Large. Small

Structure of the Hip Bone (or) Innominate
bone:
The hip bone is made up of the three parts:
a. Ilium
b. Ischium and
c. Pubis.
Prior to puberty, the triradiate cartilage sepa-
rates these constituents. At the age of 15-17,
the three parts begin to fuse. Their fusion forms
a cup-shaped socket known as the acetabulum,
which becomes complete at 20- 25 years of
Medical Lab Technician
age. The head of the femur articulates with the
acetabulum to form the hip joint.
a. Ilium:
• The superior part of the hip bone is formed
by the ilium, the widest and largest of the
three parts.
The body of the ilium forms as the superior
part of the acetabulum. Immediately above
the acetabulum, the ilium expands to form
the wing (or) ala.
• The wing of the ilium has two surfaces. The
inner surface is concave, and known as the
iliac fossa, providing origin to the iliacus

muscle. The external surface is convex, and
provides attachments to the gluteal muscles.
Hence it is known as the gluteal surface.
• The superior margin of the wing is thick-
ened, forming the iliac crest. It extends from
the anterior superior iliac spine to the pos-
terior superior iliac spine
b. The Ischium:
* The posteroinferior part of the hip bone is
formed by the ischium. Much like the pu-
bis, it is composed of a body, an inferior
and a superior ramus.
* The inferior ischial ramus combines with the
inferior pubic ramus forming the ischiopu-
bic ramus, which encloses part of the obtu-
rator foramen. The posteroinferior aspect
of the ischium forms the ischial tuberosities
and when sitting, it is on this tuberosities on
which our body weight falls. On the poste-
rior aspect of the ischium there is an inden-
tation known as the greater sciatic notch,
with the ischial spine at its most inferior edge,
c. The Pubis:
• The pubis is the most anterior portion of
the hip bone. It consists of a body and su-
perior and inferior rami (branches).
• The body is located medially, articulating
with its opposite pubic body, at the pubic
symphysis.
• The superior rami extends laterally from the
body, forming part of the acetabulum. The
inferior rami projects towards and joins the
ischium.
• Together, the two rami enclose part of the
obturator foramen, through which the ob-
turator nerve, artery and vein pass through
to reach the lower limb.
12. What is the composition & function of
blood.
1. Anticoagulanta
2. Blood cell count.
MODEL PAPER -2 n 23
Ans : Blood volume and variations : The aver-
age volume of blood in a normal adult is 5
litres.
• Females have a lower blood volume than
males.
Physiological Variations: Blood volume in-
creases during pregnancy and after meals
and decreases on prolonged standing.
Pathological Variations : Blood volume
increases in polycythemia and cardiac fail-
ure and decreases after hemorrhage, bums
and diarrhoea.
Composition of blood :
Blood contains a nonliving fluid matrix
(plasma) in which living cells (formed ele-
ments) are suspended. Blood contains 55%
of plasma and 45% of formed elements.
* Plasma is over 90% of water. It also con-
tains electrolytes (salts), plasma proteins, and
substances transported by blood (i.e. nutri-
ents, hormones, etc.).
* The three types of formed elements are
Erythrocytes (RBCs), Leukocytes (WBCs),
and Platelets.
BLOOD pH
It is a connective tissue in fluid form. Due to
the presence of haemoglobin, blood is red
in colour. pH is 7.4, Specific gravity is 1.055
- 1.065.
FUNCTIONS OF BLOOD
Blood has three main functions: Transport,
Protection and Regulation.
a. Transport: Blood transports the following
substances:
• Gases namely oxygen (02) and carbon di-
oxide (CO), between the lungs and rest of
the body.
• Nutrients from the digestive tract and stor-
age sites to the rest of the body.
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24 n
• Waste products to be detoxified or removed
by the liver and kidneys.
• Hormones from the glands in which they
are produced to their target cells.
• Heat to the skin to regulate body tempera-
ture.
b. Protection : Blood has several roles in in-
flammation:
• Leukocytes or white blood cells, destroy in-
vading microorganisms and cancer cells.
• Antibodies and other proteins destroy
pathogenic substances.
• Platelet factors initiate blood clotting and
help to minimise blood loss.
c. Regulation: Blood helps to regulate:
• pH by interacting with acids and bases.
• Water balance by transferring water to and
from tissues.
BLOOD PLASMA
Blood plasma is a mixture of proteins, en-
zymes, nutrients, wastes, hormones and
gases. The specific composition and func-
tion of its components are as follows:
FUNCTIONS OF PLASMA PROTEINS
These are the most abundant substances in
plasma by weight and play a part in a vari-
ety of roles including clotting, defence and
transport.
• They are important reserve supply of amino
acids for cell nutrition.
• Plasma proteins also serve as carriers for
other molecules.
• The proteins also help to keep the blood
slightly basic at a stable pH. They do this by
functioning as weak bases themselves to bind
excess H" ions.
• The plasma proteins interact in specific ways
to cause the blood to coagulate.
Medical Lab Technician
• Plasma proteins govern the distribution of
water between the blood and tissue fluid by
producing what is known as a colloid os-
motic pressure.
There are three major categories of plasma
proteins and each individual type of pro-
teins has its own specific properties and func-
tions in addition to their overall collective
role:
a. Albumins, which are the smallest and most
abundant plasma proteins.
• Reductions in plasma albumin content can
result in a loss of fluid from the blood and a
gain of fluid in the interstitial space.
• Albumin also helps many substances to dis-
solve in the plasma by binding to them.
b. Globulins, which can be subdivided into
three classes from smallest to largest in mo-
lecular weight into alpha, beta and gamma
globulins. The globulins include High Den-
sity Lipoproteins (HDL), an alpha- 1 globu-
lin, and Low Density Lipoproteins (LDL), a
beta-1 globulin.
• HDL functions in lipid transport carrying fats
to cells for use in energy metabolism, mem-
brane reconstruction and hormone func-
tion.
• ADLs also appear to prevent cholesterol
from invading and settling in the walls of
arteries LDL carries cholesterol and fats to
tissues for use in manufacturing steroid hor-
mones and building cell membranes, but it
also favours the deposition of cholesterol in
arterial walls and thus, appears to play a role
in disease of the blood vessels and heart.
c. Fibrinogen, which is a soluble precursor of
a sticky protein called fibrin, which forms
the framework of blood clot. Fibrin plays a
key role in coagulation of blood.