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Slide 1: Nursing Review of Anatomy and Physiology Review for Philippine Nursing Licensure Examination
Slide 3: Outline of Selected Topics in Anatomy and Physiology The Cell Integumentary Musculoskeletal Nervous Endocrine Cardiovascular and Hematologic Gastrointestinal Urinary/Fluids and Electrolytes Reproductive
Slide 4: The Cell BasicStructural and Functional Unit of the body
Slide 5: Functions of the Cell Basic unit of life 1. Protection and support 2. Movement 3. Communication 4. Cell metabolism and energy release 5. Inheritance 6.
Slide 6: The Cell Composed of the Cytoplasm, Cell Membrane, the organelles, the nucleus and the inclusions
Slide 8: The Cell The cytoplasm is the viscous, translucent, watery material where the organelles are located
Slide 9: The Cell The Cell membrane is a semi- permeable membrane that serves as the boundary separating the cellular structures from the external environment
Slide 11: The cell membrane Selectively permeable Bi-lipid layers Functions to regulate passage of substances
Slide 12: The cell membrane Phagocytosis- cell eating Pinocytosis- cell drinking Endocytosis- cell engulfment Exocytosis- cell excretion
Slide 15: Cell connections Tight junction= binds adjacent cell together and form permeability barrier, which regulates what material crosses Desmosome= mechanical link that functions to bind cell to one another Hemidesmosomes= anchor the cell to the basement membrane Gap junction= small channel that allows molecules and ions to pass from one another
Slide 17: The cellular organelles These are the cellular metabolic units with specific functions to maintain the life of the cell These include the mitochondrion, endoplasmic reticulum, ribosome, golgi apparatus, lysosomes, peroxisomes, cytoskeleton and centrosomes
Slide 18: The mitochondrion The POWERHOUSE of the cell Contains enzymes and the complexes responsible for the production of the ATP Also contains mitochondrial DNA Metabolic processes occurring in this organelle include – Kreb’s cycle, beta- oxidation of fats, urea cycle, heme synthesis This organelle is maternally inherited
Slide 20: The endoplasmic reticulum An extensive network of membrane- enclosed tubules There are two types- Rough and Smooth endoplasmic reticulum Rough endoplasmic reticulum is covered with ribosomes site of protein synthesis Smooth endoplasmic reticulum has no ribosome site of lipid synthesis
Slide 22: Ribosome Together with the endoplasmic reticulum is the site of protein synthesis Maybe found in the cytoplasm and in the mitochondria They may be free or attached to the endoplasmic reticulum
Slide 23: Golgi Apparatus This organelle modifies, concentrates and packages proteins This also packages enzymes into lysozomes Proteins and enzymes usually are transported from the rough endoplasmic reticulum to the golgi apparatus
Slide 25: The lysosomes These are membrane-limited digestive bodies that contain enzymes that break down foreign or damaged materials The enzymes digest all materials brought in by phagocytosis
Slide 27: The peroxisomes Similar to lysosomes, these are membrane-bound sacs containing oxidases (not found in the lysosomes) Oxidases are enzymes capable of reducing oxygen to hydrogen peroxide
Slide 28: The cytoskeleton A series of tubules and rods that runs through the cytoplasm supporting the cellular structures This is also responsible for cellular movements
Slide 30: The centrosomes Thiscontains the centrioles short cylinders adjacent to the nucleus responsible for cellular division
Slide 31: The cellular inclusions These are non-functional units made up of chemical substances These may or may not be present in all cells Examples are pigments, granules, and fat globules
Slide 32: Cilia and Flagella Cilia are short, hair-like extensions that occur in large numbers on the outer surface of the cell Flagella are long projections formed by centrioles that propel the cell
Slide 34: The Nucleus The central control of the cell Controls cell growth, metabolisms and reproduction Contains DNA Contains chromosomes DNA + proteins appearing as granules in the non-dividing cell Genes segments of chromosomes
Slide 36: Cell Division Formation of two daughter cell from a single parent cell. Mitosis – formation of new cell d. necessary for growth and tissue repair. Meosis – formation of sex cell e. necessary for the reproduction.
Slide 37: Cellular division Two types- Mitosis and Meiosis Mitosis- equal division of materials which yields two exact duplicates of the original cell The diploid number (46) of chromosomes is maintained All of the body cells undergo mitosis except the gametes or sex cells
Slide 38: Mitosis All body cell undergo mitosis except sex cell. There are two step in mitosis: Genetic material within the cell is e. replicated. Cell divided to form two daughter with f. same amount and type of DNA.
Slide 39: The cellular division Five steps of cellular division I-P- M-A-T Interphase- inactive or resting state Prophase-Chromatin coils to form chromosomes, centrioles begin to assemble Metaphase-chromosomes line the equator, and they split lengthwise Anaphase-Chromatids separate and move to the opposite poles Telophase-chromosomes uncoil and nucleoli reappear
Slide 40: INTERPHASE – time between cell division during which DNA replicate. DNA strand separate where old strand joined with new strand of DNA to form two new DNA molecule.
Slide 41: Four stage of Mitosis Prophase – chromatin condensed into chromosome. 2. Chromosome consist of two chromatin join by centromere. Centriole move to opposite pole. Nucleus and nuclear envelope disappear. 2. Metaphase – chromosome aligned at the center, w/ spindle fiber. 3. Anaphase – chromatin separate to form two sets of identified chromosome. Chromosome assisted by spindle fiber.
Slide 42: 4. Telophase – chromosome disperse. Nuclear membrane and nucleolus formed. Cytoplasm divided into two cell.
Slide 43: Differentiation – process by which cell develop with specialized function. Egg and sperm cell formed single cell during fertilization divided by mitosis to form two cell then become four cell and so forth which differentiate, give rise to different cell. E.g. bone cell, muscle cell
Slide 45: The cellular division Meiosis is a reduction division occurring in the sex cells Sex cells have only one pair of chromosomes (23)haploid number
Slide 46: Cell Physiology
Slide 48: DIFFUSION The movement of SOLUTES or particles in a solution from a higher concentration to a lower concentration This is a passive process, no energy is required
Slide 50: OSMOSIS The movement of solvent or water from a diluted solution into a more concentrated solution through a semi-permeable membrane The pressure that draws water inside the vessel which is more concentrated is called Osmotic pressure
Slide 52: Filtration If a sugar is placed in plain water, the glucose molecules will dissolve and distribute in the solution Factors that affect diffusion- concentration gradient, particle size, solubility and temperature
Slide 53: Special osmosis A special type of osmotic pressure is exerted by the proteins in the plasma. It is called ONCOTIC PRESSURE
Slide 54: FILTRATION The movement of both solute and solvent by hydrostatic pressure, i.e., from an area of a higher pressure to an area of a lower pressure An example of this process is urine formation
Slide 55: Hydrostatic pressure Hydrostatic pressure is the pressure exerted by the fluid against the container Increased hydrostatic pressure is one mechanism producing edema
Slide 56: Active transport This is the movement of solutes across a membrane from a lower concentration to a higher concentration with utilization of energy Example is the Sodium-Potassium pump, Endocytosis and Exocytosis
Slide 59: Tissue Group of cells with similar structure and function There are four (4) Basic types 4. Epithelial 5. Connective 6. Muscle 7. Nervous
Slide 60: BODY TISSUES Epithelium Lining, covering and glandular tissues of the body The functions are to protect, absorb, filtrate and secrete substances
Slide 61: Epithelial tissues Simple epithelium Lined by ONE Layer of cell Stratified epithelium Lined by many layers of cells
Slide 62: Epithelial tissues Simple epithelia 1. Simple squamos- alveoli, BV 2. Simple cuboidal- glands 3. Simple columnar- GI tract 4. Pseudo stratified epithelium- bronchial lining
Slide 63: Epithelial tissues Stratified epithelium 1. Stratified Squamos- skin 2. Stratified cuboidal- reproductive duct 3. Transitional epithelium- bladder and ureter
Slide 67: Connective tissues Bone Cartilage Muscle Blood Blood vessels Adipose tissue
Slide 72: The Integumentary System The largest body system Includes the skin and accessory structures like the hair, nails, and glands Function: Protection of body structures and regulation of body temperature
Slide 74: The Skin as first line protection The skin seals off the body from the immediate environment There are three layers of the skin: Epidermis, dermis, and hypodermis.
Slide 75: Skin cells There are many other cells aside from the keratinized squamos cells of the skin. Melanocytes produce pigment melanin. Langerhan’s cells participates in the immune system. Histiocytes are specialized macrophages
Slide 77: Skin as temperature regulator Abundant nerves, blood vessels and glands are within the skin’s deeper layer They aid in temperature regulation Blood vessels constrict or dilate depending on the temperature
Slide 78: Skin functions Sweat glands produce sweat to control temperature by evaporation The piloerector (arrector pili) muscles will contract to raise the hairs to trap the heat
Slide 79: Other skin functions Vitamin D synthesis 7-dehydrocholesterolCholecalciferol (D3) Route of excretion Insensible fluid loss of about 500 ml/day Sweat contains water, electrolytes, urea and lactic acid
Slide 80: Other skin functions Skin and mucus membrane are the first line defense of the body in immunity Skin has receptors for pain, cold, pressure and heat.
Slide 81: The Skin layers: EPIDERMIS The outermost layer with stratified squamos epithelium Varies in thickness depending on the body part Thinnest in the eyelids and thickest in the soles and palms
Slide 82: EPIDERMIS The layers are- C-L-G-S-B The outermost layer is the stratum corneum with keratin The stratum basale is the layer which regenerates/replaces new skin cells Melanocytes in the skin produce melanin
Slide 83: The Skin layers: DERMIS The second layer- cutis vera Is flexible and elastic Two layers- papillary and reticular Contains blood vessels, lymphatic vessels, nerves and appendages
Slide 84: The Skin layers: DERMIS The connective tissues in the dermis contain collagen (gives its strength) elastin (gives its flexibility) and reticular fibers (connect collagen and elastin)
Slide 85: The Skin layers: Hypodermis This is the subcutaneous tissue Not strictly a part of the skin Functions to insulate the body to conserve heat
Slide 86: Hypodermis Serves as the energy storage and mechanical shock absorber With little vascular supply and scant nerve supply
Slide 87: The Skin appendages Hairs- long shafts composed of keratin. Expanded lower end is called hair bulb or root. There are extensive nerve and blood supply in the hair bulbs Nails-flattened structure of specialized type of keratinized surface. The visible part is the nail body.
Slide 88: Fig. 5.5
Slide 89: Appendages Sebaceous glands-glands which produces an oily material called sebum, found in all body parts except the palms and soles. Sweat glands or sudoriferous glands- glands which secrete sweat, found in all body parts except in the nipples. Two types exist- Eccrine and Apocrine
Slide 90: Fig. 5.6
Slide 91: The Musculoskeletal System This system consists of the muscles, tendons, ligaments, bones, cartilage, joints, and bursae
Slide 92: The Musculoskeletal System Functions: • Locomotion and protection • blood production in the bone marrow • heat generation, • maintenance of posture and • storage of minerals
Slide 93: The Muscles Three types of muscles exist in our body Voluntary skeletal muscle Involuntary cardiac muscle Involuntary visceral smooth muscle
Slide 94: The Muscles Muscles are composed of muscle fibers having numerous nuclei and striations
Slide 98: Properties of Muscles Electrical excitability • Ability to contract to certain stimuli Contractility • Ability to contract forcefully when stimulated Extensibility • Ability to stretch without being damaged Elasticity • Ability to return to its original length and shape
Slide 99: Muscle Physiology Muscle fibers are enclosed sheaths- perimysium, epimysium and endomysium Each muscle cell has actin and myosin filaments arranged in a sarcomere This sarcomere is the basic structural unit of the muscle
Slide 100: Muscle Physiology Muscle contraction occurs as actin and myosin slide past one another causing the sarcomeres to shorten Calcium ion is released by the muscle endoplasmic reticulum to initiate contraction ATP is used both for muscle contraction and muscle relaxation
Slide 103: Fig. 7.5a
Slide 104: Fig. 7.6
Slide 105: Fig. 7.7a
Slide 106: Fig. 7.7b
Slide 107: Muscle Physiology Muscle contraction can be of two types 1. ISOMETRIC- iso= same, metric=distance: The length of the muscle does not change, but the tension increases 2. ISOTONIC- iso=same, tonus=tone: The amount of muscle tension is constant but the length of the muscle varies
Slide 108: Muscle Physiology Muscle tone= refers to the constant tension produced by muscles of the body for long periods of time FAST-twitch muscles= contract quickly and fatigue quickly SLOW-twitch muscles=contract slowly and are more resistant to fatigue
Slide 109: Muscle Physiology Smooth Muscle= is not striated, contracts more slowly, is autorhythmic and under involuntary control Cardiac muscle- is striated, is autorhythmic, and under involuntary control
Slide 110: MUSCLE and JOINT MOVEMENTS Flexion- decreasing the angle between two joints Extension- increasing the angle between two joints Abduction- movement of the limb away from the midline Adduction- movement of the limb towards the midline
Slide 111: MUSCLE and JOINT MOVEMENTS Internal rotation- moving the body part inward towards the midline External rotation- moving the body part outward away from the midline Supination- turning a body part upward Pronation- turning a body part downward
Slide 112: MUSCLE and JOINT MOVEMENTS Inversion- turning the foot inward Eversion- turning the foot outward Retraction- moving a body part backward Protraction- moving a body aprt forward
Slide 113: Muscles of the face 1. Frontalis 2. Orbicularis oculi 3. orbicularis oris 4. Buccinator 5. Zygomaticus Facial Nerve innervation
Slide 114: Muscles of Mastication 1. Masseter 2. Temporalis 3. Pterygoid muscles Innervated by TRIGEMINAL NERVE
Slide 115: Muscles of the neck 1. Platysma 2. Sternocleidomastoid
Slide 116: Muscle of the upper limb 1. Biceps 2. triceps 3. deltoid
Slide 117: Muscles of the lower limb 1. Hamstring muscles 2. Quadriceps 3. Gluteal muscles 4. calf muscles
Slide 118: TENDONS These are bands of fibrous connective tissue that attach muscles to bones
Slide 119: LIGAMENTS These are dense, strong, flexible bands of fibrous connective tissue that bind bones to other bones
Slide 120: BONES Bone is a living growing tissue made of porous mineralized structure. The human skeleton contains 206 bones Axial bones are bones on the midline like the vertebrae, skull, facial bones, ribs and sternum Appendicular bones include the scapulae, bones of the arms and legs
Slide 122: Classification of Bones Long bones- - These bones have a shaft and ends. Ex: tibia, humerus, femur Short bones- Small and cubical shaped- Ex: carpals and tarsals Irregular bones- vertebrae, mandible Sesamoid bones- bones embedded in the tendons. Ex:patella Flat bones- with spongy bones inside. Ex: scapulae, ribs, clavicle
Slide 123: Structure of the bone Long bones have a diaphysis ( shaft) and epiphysis (ends) Bones consist of layers of calcified matrix occupied by bone cells. The outer layer of bone is composed of dense compact bone (cortical bone) The inner layer is composed of spongy cancellous bones
Slide 125: Bone Structure Blood supply of bones reaches by way of arterioles in the haversian canal, through the vessels in the Volkmann's canal Bone formation can be from the cartilage and from the membrane
Slide 126: Bone Structure OSTEOBLAST- bone cell responsible for bone formation and calcification OSTEOCLAST- bone cell responsible for bone resorption and destruction
Slide 127: Bone Ossification Ossification is the formation of bone by the osteoblasts. This involves the mineralization of bones from a cartilage (endochondral) and from a membrane (membranous).
Slide 128: Fig. 6.5a
Slide 129: Fig. 6.6
Slide 130: Bone Remodeling Bone remodeling involves the removal of old bones by cells called osteoclasts and deposition of new bones by the osteoblasts. Bone is the major storage of calcium If calcium levels in the blood falls, it is removed from the bone
Slide 131: Bone repair When a bone is broken, blood vessels are also damaged clot 2-3 days after injury, blood vessels and cells invade the blood clot callus formation Osteoblasts enter the callus and begin to form a spongy bone Immobilization of the bone is required because the delicate new matrix of bone is easily damaged by excessive movement
Slide 132: Fig. 6.8
Slide 133: The Skull Skeleton of the head Made of 21 bones Cranial bones • Frontal • Parietal • Temporal • occipital
Slide 134: The Skull Facial bones • Maxilla • Mandible • Zygoma • Nasal • Vomer • Palatine
Slide 135: The paranasal sinuses These are air-filled cavities in the facial bones surrounding the nose and open into the nasal cavity They decrease the weight of the skull and act as resonator of sounds Frontal, maxillary, ethmoid and sphenoid
Slide 137: The Vertebrae Composed of 32-33 bones 7 cervical 12 thoracic 5 lumbar 5 sacral 3-4 coccygeal
Slide 138: Functions of the vertebrae 1. Supports the weight of the head and trunk 2. Protects the spinal cord 3. Allows spinal nerves to exit the spinal cord 4. Provides a site for muscle attachment 5. Permits the movement of the head and trunk
Slide 139: The Cervical Vertebrae 7 in number C1- atlas C2- axis C7- cervical prominence Atlas and occipital bone= “yes” motion Atlas and Axis= “no” motion
Slide 140: The Thorax Made up of the sternum and ribs The sternum has 3 parts • Manubrium • Body • Xiphoid process • The slight elevation in the sternum is called the Sternal Angle of Louis. It identifies the location of the second rib
Slide 141: The Ribs The ribs are 12 pairs • True ribs= 1-7 • False ribs= 8-10 • Floating ribs=11-12
Slide 143: The shoulder The clavicle and scapulae constitute the shoulder The clavicle • Articulates with the sternum • Most commonly fracture bone The Scapulae • Attached to the ribs and vertebrae by muscles only • Has an acromion process, where the clavicle attaches
Slide 145: The Upper extremity Composed of the following bones Humerus Ulna Radius Carpals (wrist bones) Metacarpals Phalanges
Slide 147: The pelvic girdle Composed of the 3 fused bones- pubis, ilium and ischium Constitute the hip bone
Slide 148: The pelvic girdle Female pelvis has the following structure: The pelvic inlet is large/oval, symphysis is shallow. obturator foramen is oval or triangular, sacrum is broader The male pelvis has the following: The pelvic inlet is small/round to heart-shape, symphysis is deep. Obturator foramen is round
Slide 149: Fig. 6.32
Slide 152: The Lower extremity bones Composed of the Thigh bones- femur The leg bones- Tibia and Fibula The ankle- tarsal bones The foot- metatarsal bones
Slide 154: CARTILAGE A dense connective tissue that consists of fibers embedded in a strong, gel-like substance. Cartilage supports and shapes various structures such as the ear pinna, intervertebral disks, ear canal, larynx, etc. It serves as cushion and shock absorber
Slide 156: Types of Cartilage Fibrous cartilage • Found in the intervertebral disks Hyaline cartilage • Found in the symphisis, the thyroid cartilage Elastic cartilage • Found in the ears, the epiglottis
Slide 158: Fig. 6.39a
Slide 159: Fig. 6.39b
Slide 160: Fig. 6.40a
Slide 161: Fig. 6.40b
Slide 162: Fig. 6.40c
Slide 163: Joints These are point of attachment or contact between two bones Variously classified according to its movement and flexibility Fibrous joints- with fibrous tissue with little or no movement Cartilaginous joints- with cartilage Synovial joints- with capsule; freely movable joints
Slide 165: Synovial joints Freely movable joints With joint cavity/capsule Articular surface Synovial membrane Synovial fluid
Slide 166: Synovial joints Plane joint- intercarpal joint of wrist Hinge joint- elbow and ankle Pivot- atlas and axis Condyloid- “egg-shape” metacarpophalengeal joint
Slide 167: Synovial joints Saddle joint- joint of the thumb Ball and socket- hip joint
Slide 168: Bursae Small synovial fluid sacs located at friction points around joints, between tendons, ligaments and bones Act as cushions, decrease stress on adjacent structure
Slide 171: The Nervous System • The nervous system coordinates all body functions, enabling a person to adapt to changes in internal and external environment • The nervous system is composed mainly of the nerve cells (neurons) and supporting cells (neuroglia)
Slide 172: The neuron • This is the basic conducting cell of the nervous system • Highly specialized but cannot reproduce itself • Main parts are the cell body (soma), the fibers: axon and dendrites.
Slide 173: The neuron • The axon is a long process with myelin sheath. This conducts impulses away from the cell body • The dendrites are short, thick, diffuse branching processes that receive impulses and conduct them towards the cell body
Slide 175: The neuroglia • The supporting cells • They supply nutrients to the neurons and help maintain the electrical potential • They also form part of the blood- brain barrier
Slide 176: The neuroglia • Oligodendrocytes produce myelin sheath in the CN • Schwann cells produce myelin sheath in the peripheral NS
Slide 180: The Organization of the Nervous System • The nervous system is divided functionally and structurally into 2


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