Nursing Review of Anatomy and Physiology Review for Philippine Nursing Licensure Examination

Outline of Selected Topics in Anatomy and Physiology The Cell Integumentary Musculoskeletal Nervous Endocrine Cardiovascular and Hematologic Gastrointestinal Urinary/Fluids and Electrolytes Reproductive

The Cell

Integumentary

Musculoskeletal

Nervous

Endocrine

Cardiovascular and Hematologic

Gastrointestinal

Urinary/Fluids and Electrolytes

Reproductive

The Cell Basic Structural and Functional Unit of the body

Basic Structural and Functional Unit of the body

Functions of the Cell Basic unit of life Protection and support Movement Communication Cell metabolism and energy release Inheritance

Basic unit of life

Protection and support

Movement

Communication

Cell metabolism and energy release

Inheritance

The Cell Composed of the Cytoplasm, Cell Membrane, the organelles, the nucleus and the inclusions

Composed of the Cytoplasm, Cell Membrane, the organelles, the nucleus and the inclusions

The Cell The cytoplasm is the viscous, translucent, watery material where the organelles are located

The cytoplasm is the viscous, translucent, watery material where the organelles are located

The Cell The Cell membrane is a semi-permeable membrane that serves as the boundary separating the cellular structures from the external environment

The Cell membrane is a semi-permeable membrane that serves as the boundary separating the cellular structures from the external environment

The cell membrane Selectively permeable Bi-lipid layers Functions to regulate passage of substances

Selectively permeable

Bi-lipid layers

Functions to regulate passage of substances

The cell membrane Phagocytosis- cell eating Pinocytosis- cell drinking Endocytosis- cell engulfment Exocytosis- cell excretion

Phagocytosis- cell eating

Pinocytosis- cell drinking

Endocytosis- cell engulfment

Exocytosis- cell excretion

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The cytoskeleton A series of tubules and rods that runs through the cytoplasm supporting the cellular structures This is also responsible for cellular movements

A series of tubules and rods that runs through the cytoplasm supporting the cellular structures

This is also responsible for cellular movements

The centrosomes This contains the centrioles  short cylinders adjacent to the nucleus responsible for cellular division

This contains the centrioles  short cylinders adjacent to the nucleus responsible for cellular division

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

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

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

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

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

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

Cell Division Formation of two daughter cell from a single parent cell. Mitosis – formation of new cell necessary for growth and tissue repair. Meosis – formation of sex cell necessary for the reproduction.

Cell Division

Formation of two daughter cell from a single parent cell.

Mitosis – formation of new cell necessary for growth and tissue repair.

Meosis – formation of sex cell necessary for the reproduction.

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

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

Mitosis All body cell undergo mitosis except sex cell. There are two step in mitosis: Genetic material within the cell is replicated. Cell divided to form two daughter with same amount and type of DNA.

Mitosis

All body cell undergo mitosis except sex cell. There are two step in mitosis:

Genetic material within the cell is replicated.

Cell divided to form two daughter with same amount and type of DNA.

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

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

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.

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.

Four stage of Mitosis Prophase – chromatin condensed into chromosome. 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.

Four stage of Mitosis

Prophase – chromatin condensed into chromosome. 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.

4. Telophase – chromosome disperse. Nuclear membrane and nucleolus formed. Cytoplasm divided into two cell.

4. Telophase – chromosome disperse.

Nuclear membrane and nucleolus formed.

Cytoplasm divided into two cell.

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

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

The cellular division Meiosis is a reduction division occurring in the sex cells Sex cells have only one pair of chromosomes (23)  haploid number

Meiosis is a reduction division occurring in the sex cells

Sex cells have only one pair of chromosomes (23)  haploid number

Cell Physiology

Cell Physiology

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

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

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

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

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

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

Special osmosis A special type of osmotic pressure is exerted by the proteins in the plasma. It is called ONCOTIC PRESSURE

A special type of osmotic pressure is exerted by the proteins in the plasma. It is called ONCOTIC PRESSURE

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

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

Hydrostatic pressure Hydrostatic pressure is the pressure exerted by the fluid against the container Increased hydrostatic pressure is one mechanism producing edema

Hydrostatic pressure is the pressure exerted by the fluid against the container

Increased hydrostatic pressure is one mechanism producing edema

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

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

Tissue Group of cells with similar structure and function There are four (4) Basic types Epithelial Connective Muscle Nervous

Group of cells with similar structure and function

There are four (4) Basic types

Epithelial

Connective

Muscle

Nervous

BODY TISSUES Epithelium Lining, covering and glandular tissues of the body The functions are to protect, absorb, filtrate and secrete substances

Epithelium

Lining, covering and glandular tissues of the body

The functions are to protect, absorb, filtrate and secrete substances

Epithelial tissues Simple epithelium Lined by ONE Layer of cell Stratified epithelium Lined by many layers of cells

Simple epithelium

Lined by ONE Layer of cell

Stratified epithelium

Lined by many layers of cells

Epithelial tissues Simple epithelia 1. Simple squamos- alveoli, BV 2. Simple cuboidal- glands 3. Simple columnar- GI tract 4. Pseudo stratified epithelium- bronchial lining

Simple epithelia

1. Simple squamos- alveoli, BV

2. Simple cuboidal- glands

3. Simple columnar- GI tract

4. Pseudo stratified epithelium- bronchial lining

Epithelial tissues Stratified epithelium 1. Stratified Squamos- skin 2. Stratified cuboidal- reproductive duct 3. Transitional epithelium- bladder and ureter

Stratified epithelium

1. Stratified Squamos- skin

2. Stratified cuboidal- reproductive duct

3. Transitional epithelium- bladder and ureter

Connective tissues Bone Cartilage Muscle Blood Blood vessels Adipose tissue

Bone

Cartilage

Muscle

Blood

Blood vessels

Adipose tissue

The SKIN

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

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

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.

The skin seals off the body from the immediate environment

There are three layers of the skin: Epidermis, dermis, and hypodermis.

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

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

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

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

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

Sweat glands produce sweat to control temperature by evaporation

The piloerector ( arrector pili ) muscles will contract to raise the hairs to trap the heat

Other skin functions Vitamin D synthesis 7-dehydrocholesterol  Cholecalciferol (D3) Route of excretion Insensible fluid loss of about 500 ml/day Sweat contains water, electrolytes, urea and lactic acid

Vitamin D synthesis

7-dehydrocholesterol  Cholecalciferol (D3)

Route of excretion

Insensible fluid loss of about 500 ml/day

Sweat contains water, electrolytes, urea and lactic acid

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.

Skin and mucus membrane are the first line defense of the body in immunity

Skin has receptors for pain, cold, pressure and heat.

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

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

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

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

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

The second layer- cutis vera

Is flexible and elastic

Two layers- papillary and reticular

Contains blood vessels, lymphatic vessels, nerves and appendages

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)

The connective tissues in the dermis contain

collagen (gives its strength)

elastin (gives its flexibility) and

reticular fibers (connect collagen and elastin)

The Skin layers: Hypodermis This is the subcutaneous tissue Not strictly a part of the skin Functions to insulate the body to conserve heat

This is the subcutaneous tissue

Not strictly a part of the skin

Functions to insulate the body to conserve heat

Hypodermis Serves as the energy storage and mechanical shock absorber With little vascular supply and scant nerve supply

Serves as the energy storage and mechanical shock absorber

With little vascular supply and scant nerve supply

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 .

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 .

Fig. 5.5

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

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

Fig. 5.6

The Musculoskeletal System This system consists of the muscles, tendons, ligaments, bones, cartilage, joints, and bursae

This system consists of the muscles, tendons, ligaments, bones, cartilage, joints, and bursae

The Musculoskeletal System Functions: Locomotion and protection blood production in the bone marrow heat generation, maintenance of posture and storage of minerals

Functions:

Locomotion and protection

blood production in the bone marrow

heat generation,

maintenance of posture and

storage of minerals

The Muscles Three types of muscles exist in our body Voluntary skeletal muscle Involuntary cardiac muscle Involuntary visceral smooth muscle

Three types of muscles exist in our body

Voluntary skeletal muscle

Involuntary cardiac muscle

Involuntary visceral smooth muscle

The Muscles Muscles are composed of muscle fibers having numerous nuclei and striations

Muscles are composed of muscle fibers having numerous nuclei and striations

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

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

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

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

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

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

Fig. 7.5a

Fig. 7.6

Fig. 7.7a

Fig. 7.7b

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

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

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

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

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

Smooth Muscle= is not striated, contracts more slowly, is autorhythmic and under involuntary control

Cardiac muscle- is striated, is autorhythmic , and under involuntary control

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

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

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

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

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

Inversion- turning the foot inward

Eversion- turning the foot outward

Retraction- moving a body part backward

Protraction- moving a body aprt forward

Muscles of the face 1. Frontalis 2. Orbicularis oculi 3. orbicularis oris 4. Buccinator 5. Zygomaticus Facial Nerve innervation

1. Frontalis

2. Orbicularis oculi

3. orbicularis oris

4. Buccinator

5. Zygomaticus

Facial Nerve innervation

Muscles of Mastication 1 . Masseter 2. Temporalis 3. Pterygoid muscles Innervated by TRIGEMINAL NERVE

1 . Masseter

2. Temporalis

3. Pterygoid muscles

Innervated by TRIGEMINAL NERVE

Muscles of the neck 1. Platysma 2. Sternocleidomastoid

1. Platysma

2. Sternocleidomastoid

Muscle of the upper limb 1. Biceps 2. triceps 3. deltoid

1. Biceps

2. triceps

3. deltoid

Muscles of the lower limb 1. Hamstring muscles 2. Quadriceps 3. Gluteal muscles 4. calf muscles

1. Hamstring muscles

2. Quadriceps

3. Gluteal muscles

4. calf muscles

TENDONS These are bands of fibrous connective tissue that attach muscles to bones

These are bands of fibrous connective tissue that attach muscles to bones

LIGAMENTS These are dense, strong, flexible bands of fibrous connective tissue that bind bones to other bones

These are dense, strong, flexible bands of fibrous connective tissue that bind bones to other bones

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

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

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

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

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

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

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

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

Bone Structure OSTEOBLAST- bone cell responsible for bone formation and calcification OSTEOCLAST- bone cell responsible for bone resorption and destruction

OSTEOBLAST- bone cell responsible for bone formation and calcification

OSTEOCLAST- bone cell responsible for bone resorption and destruction

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 ).

Ossification is the formation of bone by the osteoblasts. This involves the mineralization of bones from a cartilage (endochondral) and from a membrane (membranous ).

Fig. 6.5a

Fig. 6.6

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

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

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

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

Fig. 6.8

The Skull Skeleton of the head Made of 21 bones Cranial bones Frontal Parietal Temporal occipital

Skeleton of the head

Made of 21 bones

Cranial bones

Frontal

Parietal

Temporal

occipital

The Skull Facial bones Maxilla Mandible Zygoma Nasal Vomer Palatine

Facial bones

Maxilla

Mandible

Zygoma

Nasal

Vomer

Palatine

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

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

The Vertebrae Composed of 32-33 bones 7 cervical 12 thoracic 5 lumbar 5 sacral 3-4 coccygeal

Composed of 32-33 bones

7 cervical

12 thoracic

5 lumbar

5 sacral

3-4 coccygeal

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

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

The Cervical Vertebrae 7 in number C1- atlas C2- axis C7- cervical prominence Atlas and occipital bone= “yes” motion Atlas and Axis= “no” motion

7 in number

C1- atlas

C2- axis

C7- cervical prominence

Atlas and occipital bone=

“yes” motion

Atlas and Axis=

“no” motion

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

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

The Ribs The ribs are 12 pairs True ribs= 1-7 False ribs= 8-10 Floating ribs=11-12

The ribs are 12 pairs

True ribs= 1-7

False ribs= 8-10

Floating ribs=11-12

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

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

The Upper extremity Composed of the following bones Humerus Ulna Radius Carpals (wrist bones) Metacarpals Phalanges

Composed of the following bones

Humerus

Ulna

Radius

Carpals (wrist bones)

Metacarpals

Phalanges

The pelvic girdle Composed of the 3 fused bones- pubis, ilium and ischium Constitute the hip bone

Composed of the 3 fused bones- pubis, ilium and ischium

Constitute the hip bone

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

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

Fig. 6.32

The Lower extremity bones Composed of the Thigh bones- femur The leg bones- Tibia and Fibula The ankle- tarsal bones The foot- metatarsal bones

Composed of the

Thigh bones- femur

The leg bones- Tibia and Fibula

The ankle- tarsal bones

The foot- metatarsal bones

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

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

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

Fibrous cartilage

Found in the intervertebral disks

Hyaline cartilage

Found in the symphisis, the thyroid cartilage

Elastic cartilage

Found in the ears, the epiglottis

Joints

Fig. 6.39a

Fig. 6.39b

Fig. 6.40a

Fig. 6.40b

Fig. 6.40c

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

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

Synovial joints Freely movable joints With joint cavity/capsule Articular surface Synovial membrane Synovial fluid

Freely movable joints

With joint cavity/capsule

Articular surface

Synovial membrane

Synovial fluid

Synovial joints Plane joint- intercarpal joint of wrist Hinge joint- elbow and ankle Pivot- atlas and axis Condyloid- “egg-shape” metacarpophalengeal joint

Plane joint- intercarpal joint of wrist

Hinge joint- elbow and ankle

Pivot- atlas and axis

Condyloid- “egg-shape” metacarpophalengeal joint

Synovial joints Saddle joint- joint of the thumb Ball and socket- hip joint

Saddle joint- joint of the thumb

Ball and socket- hip joint

Bursae Small synovial fluid sacs located at friction points around joints, between tendons, ligaments and bones Act as cushions, decrease stress on adjacent structure

Small synovial fluid sacs located at friction points around joints, between tendons, ligaments and bones

Act as cushions, decrease stress on adjacent structure

The Nervous System

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)

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)

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.

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.

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

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

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

The supporting cells

They supply nutrients to the neurons and help maintain the electrical potential

They also form part of the blood-brain barrier

The neuroglia Oligodendrocytes produce myelin sheath in the CN Schwann cells produce myelin sheath in the peripheral NS

Oligodendrocytes produce myelin sheath in the CN

Schwann cells produce myelin sheath in the peripheral NS

The Organization of the Nervous System The nervous system is divided functionally and structurally into 2 parts 1. Central Nervous System- the Brain and the spinal cord 2. Peripheral Nervous System- the cranial nerves and spinal nerves

The nervous system is divided functionally and structurally into 2 parts

1. Central Nervous System- the Brain and the spinal cord

2. Peripheral Nervous System- the cranial nerves and spinal nerves

The Organization of the nervous System The Peripheral Nervous System is further classified into THREE Functional Divisions 1. The Somatic Nervous System- controls the skeletal muscles 2. The Autonomic Nervous System- controls the visceral organs 3. The Enteric Nervous System- controls the functions of the GIT

The Peripheral Nervous System is further classified into THREE Functional Divisions

1. The Somatic Nervous System- controls the skeletal muscles

2. The Autonomic Nervous System- controls the visceral organs

3. The Enteric Nervous System- controls the functions of the GIT

The Central Nervous System Composed of the brain The brain consists of the gross structures: cerebrum, cerebellum, brainstem and the diencephalon. Diencephalon- Thalamus. Hypothalamus and pineal body Brainstem- Pons, medulla and Midbrain

Composed of the brain

The brain consists of the gross structures: cerebrum, cerebellum, brainstem and the diencephalon.

Diencephalon- Thalamus. Hypothalamus and pineal body

Brainstem- Pons, medulla and Midbrain

Fig. 8.23

The Cerebrum This is the largest part of the brain Consists of right and left hemisphere connected by the corpus callosum Each cerebral hemisphere is composed of different lobes- frontal, temporal, parietal and occipital Embedded in the cerebrum is the BASAL ganglia

This is the largest part of the brain

Consists of right and left hemisphere connected by the corpus callosum

Each cerebral hemisphere is composed of different lobes- frontal, temporal, parietal and occipital

Embedded in the cerebrum is the BASAL ganglia

The Frontal Lobe of the cerebrum Influences the personality of the person Also responsible for judgment, abstract reasoning, social behavior, language expression and motor movement.

Influences the personality of the person

Also responsible for judgment, abstract reasoning, social behavior, language expression and motor movement.

The Temporal lobe of the Cerebrum This part of the cerebrum controls the hearing, language comprehension, storage and recall of memories The LIMBIC system is deeply located in the temporal lobe. This controls the basic drives such as hunger, anger, emotion and sexual drive.

This part of the cerebrum controls the hearing, language comprehension, storage and recall of memories

The LIMBIC system is deeply located in the temporal lobe. This controls the basic drives such as hunger, anger, emotion and sexual drive.

The Parietal lobe of the cerebrum This is the principal center for the reception and interpretation of Sensation This part interprets and integrates the sensory inputs like touch, temperature and pain It interprets size, shape, distance and texture

This is the principal center for the reception and interpretation of Sensation

This part interprets and integrates the sensory inputs like touch, temperature and pain

It interprets size, shape, distance and texture

The occipital lobe of the cerebrum This functions mainly to interpret visual stimuli

This functions mainly to interpret visual stimuli

Speech areas in the cerebrum 1. Wernicke’s area- responsible for the sensory reception of speech. 2.Broca’s Area- responsible for the motor speech

1. Wernicke’s area- responsible for the sensory reception of speech.

2.Broca’s Area- responsible for the motor speech

Fig. 8.28

The Cerebellum The second largest brain region Has also two hemispheres Functions to maintain muscle tone, coordinate muscle movement, posture and control balance/equilibrium If this is damaged, muscle tone decreases and fine motor movements become very clumsy

The second largest brain region

Has also two hemispheres

Functions to maintain muscle tone, coordinate muscle movement, posture and control balance/equilibrium

If this is damaged, muscle tone decreases and fine motor movements become very clumsy

The Brainstem Lies inferior to the cerebrum Continuous with the cerebrum and the spinal cord It is composed of the midbrain, the pons and the medulla oblongata Functions: houses the center for respiration and cardiovascular system

Lies inferior to the cerebrum

Continuous with the cerebrum and the spinal cord

It is composed of the midbrain, the pons and the medulla oblongata

Functions: houses the center for respiration and cardiovascular system

The Midbrain This connects with the cerebrum Contains numerous ascending and descending tracts and fibers

This connects with the cerebrum

Contains numerous ascending and descending tracts and fibers

The Pons Connects the cerebellum with the cerebrum Houses the respiratory center and cardiovascular center Exit points for cranial nerves 5, 6 and 7

Connects the cerebellum with the cerebrum

Houses the respiratory center and cardiovascular center

Exit points for cranial nerves 5, 6 and 7

The Medulla oblongata The most inferior portion of the brainstem Serves as the center for autonomic reflexes to maintain homeostasis, regulating respiratory vasomotor and cardiac functions Serves as exit of cranial nerves 9,10,11 and 12

The most inferior portion of the brainstem

Serves as the center for autonomic reflexes to maintain homeostasis, regulating respiratory vasomotor and cardiac functions

Serves as exit of cranial nerves 9,10,11 and 12

The Diencephalon The thalamus and the hypothalamus The thalamus is the relay station of all sensory stimuli towards the brain The hypothalamus controls body temperature, appetite, water balance, pituitary secretions and sleep-wake cycle

The thalamus and the hypothalamus

The thalamus is the relay station of all sensory stimuli towards the brain

The hypothalamus controls body temperature, appetite, water balance, pituitary secretions and sleep-wake cycle

The Basal ganglia

Brain circulation: The circle of Willis

The spinal cord A long cylindrical structure extending from the foramen magnum to the L1 in adult, L3/L4 in pedia

A long cylindrical structure extending from the foramen magnum to the L1 in adult, L3/L4 in pedia

The spinal cord In the cross section of the spinal cord, we find the GRAY matter- contains neurons; and WHITE matter-consists of nerve fibers There are 31 pairs of spinal nerves that exit the spinal cord

In the cross section of the spinal cord, we find the GRAY matter- contains neurons; and WHITE matter-consists of nerve fibers

There are 31 pairs of spinal nerves that exit the spinal cord

The spinal cord Each spinal nerve is formed by the dorsal root (sensory) and the ventral root (motor) Cervical segments= 8 pairs Thoracic segments=12 pairs Lumbar= 5 pairs Sacral=5 pairs Coccygeal=1 pair

Each spinal nerve is formed by the dorsal root (sensory) and the ventral root (motor)

Cervical segments= 8 pairs

Thoracic segments=12 pairs

Lumbar= 5 pairs

Sacral=5 pairs

Coccygeal=1 pair

The Meninges These are 3 connective tissue layers surrounding the brain and spinal cord. 1. DURA MATER- the superficial, thickest layer. The area above the dura mater is called epidural space 2. ARACHNOID- second layer, thin and wispy. 3. PIA MATER- the deepest layer, adhered to the brain and spinal cord substance

These are 3 connective tissue layers surrounding the brain and spinal cord.

1. DURA MATER- the superficial, thickest layer. The area above the dura mater is called epidural space

2. ARACHNOID- second layer, thin and wispy.

3. PIA MATER- the deepest layer, adhered to the brain and spinal cord substance

The Meninges The space in between the arachnoid and pia mater is called the arachnoid space This arachnoid space contains the cerebro-spinal fluid (CSF) In this space, blood vessels are also found

The space in between the arachnoid and pia mater is called the arachnoid space

This arachnoid space contains the cerebro-spinal fluid (CSF)

In this space, blood vessels are also found

The Ventricles These are CSF filled cavities in the brain The lateral ventricle- found in the cerebrum The third ventricle- in the center of the thalamus and hypothalamus The fourth ventricle- located at the base of the cerebellum

These are CSF filled cavities in the brain

The lateral ventricle- found in the cerebrum

The third ventricle- in the center of the thalamus and hypothalamus

The fourth ventricle- located at the base of the cerebellum

The CSF This is the fluid found inside the ventricles that bathe the brain and spinal cord Function: provides protective cushion around the CNS Produced by the choroid plexus in the ventricles Absorbed by the arachnoid granulations

This is the fluid found inside the ventricles that bathe the brain and spinal cord

Function: provides protective cushion around the CNS

Produced by the choroid plexus in the ventricles

Absorbed by the arachnoid granulations

Tracing the CSF pathway Lateral ventricle Interventricular foramen of Monro Third ventricle Cerebral aqueduct of Sylvius Fourth ventricle Exits trough the median foramen of Magendie or the lateral foramen of Luscka Subarachnoid spaces in the cisterna magna, spinal cord subarachnoid space of the brain superior sagittal sinus

Lateral ventricle

Interventricular foramen of Monro

Third ventricle

Cerebral aqueduct of Sylvius

Fourth ventricle

Exits trough the median foramen of Magendie or the lateral foramen of Luscka

Subarachnoid spaces in the cisterna magna, spinal cord

subarachnoid space of the brain

superior sagittal sinus

The cranial nerves Are 12 pairs of nerves that exit the brain Can be classified as Sensory Motor Mixed (sensory and motor)

Are 12 pairs of nerves that exit the brain

Can be classified as

Sensory

Motor

Mixed (sensory and motor)

The Autonomic Nervous System The part of the peripheral nervous system that innervates cardiac muscles, smooth muscles and glands Functionally divided into Sympathetic Nervous System Parasympathetic Nervous System

The part of the peripheral nervous system that innervates cardiac muscles, smooth muscles and glands

Functionally divided into

Sympathetic Nervous System

Parasympathetic Nervous System

The SYMPATHETIC system Originates from the T1-L2/L3 segments of the spinal cord (thoracolumbar) Utilized by the body for FLIGHT and FIGHT response Neurotransmitter agents are Epinephrine and Norepinephrine (coming from the adrenal gland) ADRENERGIC system

Originates from the T1-L2/L3 segments of the spinal cord (thoracolumbar)

Utilized by the body for FLIGHT and FIGHT response

Neurotransmitter agents are Epinephrine and Norepinephrine (coming from the adrenal gland)

ADRENERGIC system

Sympathetic responses Increased: HR RR BP Visual Acuity (Pupillary Dilation) Smooth Muscle tone  sphincters are contracted Vasoconstriction Metabolism  ↑ glucose, ↑ fatty acids

Increased:

HR

RR

BP

Visual Acuity (Pupillary Dilation)

Smooth Muscle tone  sphincters are contracted

Vasoconstriction

Metabolism  ↑ glucose, ↑ fatty acids

Sympathetic responses Decreased Peristalsis Salivary secretions Ejaculation

Decreased

Peristalsis

Salivary secretions

Ejaculation

Parasympathetic system CHOLINERGIC system The vegetative system Feed and Breed responses Cranio-sacral location Cranial nerves- 3, 7, 9, 10 and S2-S4 Neurotransmitter is Acetylcholine

CHOLINERGIC system

The vegetative system

Feed and Breed responses

Cranio-sacral location

Cranial nerves- 3, 7, 9, 10 and S2-S4

Neurotransmitter is Acetylcholine

Parasympathetic responses Increased Gastric secretions Salivary secretions peristalsis Pupillary constriction Decreased Smooth muscle tone  sphincters are relaxed erection

Increased

Gastric secretions

Salivary secretions

peristalsis

Pupillary constriction

Decreased

Smooth muscle tone  sphincters are relaxed

erection

Nerve Physiology The nerve cells are excitable cells Any stimulus will change the membrane potential and cause an action potential to generate  impulse transmission The myelin sheath of the nerve cell is responsible for the SALTATORY conduction  increases the nerve transmission

The nerve cells are excitable cells

Any stimulus will change the membrane potential and cause an action potential to generate  impulse transmission

The myelin sheath of the nerve cell is responsible for the SALTATORY conduction  increases the nerve transmission

Fig. 8.11

Fig. 8.12

The SYNAPSE This is the region where communication occurs between 2 neurons or between a neuron and a target cell A neurotransmitter is released from the nerve cell towards the other cell with receptor

This is the region where communication occurs between 2 neurons or between a neuron and a target cell

A neurotransmitter is released from the nerve cell towards the other cell with receptor

Fig. 8.13

Special Senses

The eye and the visual pathway Vision is made possible by the stimulation of the photoreceptor cells in the retina Receptor cells are the RODS and CONES The eye is made up of three layers Fibrous layer- sclerae and cornea Uvea- choroid and iris and ciliary bodies Nervous coat- retina

Vision is made possible by the stimulation of the photoreceptor cells in the retina

Receptor cells are the RODS and CONES

The eye is made up of three layers

Fibrous layer- sclerae and cornea

Uvea- choroid and iris and ciliary bodies

Nervous coat- retina

Fig. 9.13

The optic nerve This is the collection of fibers from the cells in the retina It passes through the brainstem as the optic chiasm it will reach the occipital lobe for visual interpretation

This is the collection of fibers from the cells in the retina

It passes through the brainstem as the optic chiasm

it will reach the occipital lobe for visual interpretation

The Vestibular apparatus This is the part of the ear that helps in equilibrium Located in the inner ear The saccule and utricle control LINEAR motion The semicircular ducts control the Angular movement/ acceleration

This is the part of the ear that helps in equilibrium

Located in the inner ear

The saccule and utricle control LINEAR motion

The semicircular ducts control the Angular movement/ acceleration

The Hearing Apparatus

The Olfactory apparatus Consists of the nose and the olfactory nerve Stimulation form the olfactory nerves will reach the limbic system of the brain

Consists of the nose and the olfactory nerve

Stimulation form the olfactory nerves will reach the limbic system of the brain

The Gustatory apparatus The receptor for taste are cells in the tongue group together called the taste buds They are numerous in the vallate and fungiform papillae

The receptor for taste are cells in the tongue group together called the taste buds

They are numerous in the vallate and fungiform papillae

The Gustatory apparatus Basic taste modalities Sweet- tip of the tongue Salty- over the dorsum of the tongue Sour- sides of the tongue Bitter- back of the tongue

Basic taste modalities

Sweet- tip of the tongue

Salty- over the dorsum of the tongue

Sour- sides of the tongue

Bitter- back of the tongue

Endocrine System

The Endocrine System This system is made up of widely distributed organs whose secretions (called HORMONES) are poured into the blood to reach the target cells

This system is made up of widely distributed organs whose secretions (called HORMONES) are poured into the blood to reach the target cells

Hormones These are chemical substances released by the glands into the blood Each hormone will go to the target organ and binds its receptor Two types exists: 1. Peptides or protein hormones 2. Lipid or steroid hormones

These are chemical substances released by the glands into the blood

Each hormone will go to the target organ and binds its receptor

Two types exists:

1. Peptides or protein hormones

2. Lipid or steroid hormones

The hormonal regulation There exists an inter-related regulation between the HYPOTHALAMUS, Pituitary and the endocrine gland.

There exists an inter-related regulation between the HYPOTHALAMUS, Pituitary and the endocrine gland.

The hormonal regulation We call it the Hypothalamic-pituitary-endocrine axis The exception are the pancreas and the parathyroid gland

We call it the Hypothalamic-pituitary-endocrine axis

The exception are the pancreas and the parathyroid gland

The endocrine glands The pituitary- anterior and posterior The pineal gland The thyroid gland The parathyroid gland The adrenal gland The pancreas The gonads- testes and ovary

The pituitary- anterior and posterior

The pineal gland

The thyroid gland

The parathyroid gland

The adrenal gland

The pancreas

The gonads- testes and ovary

The pituitary gland : anterior lobe Also called Adenohypophysis Hormones produced Growth hormone The stimulating hormones- ACTH, TSH, FSH and LH Prolactin

Also called Adenohypophysis

Hormones produced

Growth hormone

The stimulating hormones- ACTH, TSH, FSH and LH

Prolactin

The pituitary gland: posterior lobe Also called the neurohypophysis This lobe does not secrete hormones but only stores hormones Antidiuretic hormone (vasopressin) Oxytocin

Also called the neurohypophysis

This lobe does not secrete hormones but only stores hormones

Antidiuretic hormone (vasopressin)

Oxytocin

The pineal gland Also called epiphysis cerebri Secretes melatonin

Also called epiphysis cerebri

Secretes melatonin

The thyroid gland Located in the lower part of the anterior neck With two lobes connected by the isthmus

Located in the lower part of the anterior neck

With two lobes connected by the isthmus

The thyroid gland Secretes thyroxine (T4) and tri-iodothyronine (T3) The T3 is the most active hormone Function of T3/T4: Increase metabolic rate, essential for normal growth and maturation

Secretes thyroxine (T4) and tri-iodothyronine (T3)

The T3 is the most active hormone

Function of T3/T4: Increase metabolic rate, essential for normal growth and maturation

The thyroid gland It also secretes CALCITONIN This is released in response to an INCREASED calcium level in the blood Function: decreases bone resorption and increases calcium excretion in the kidney to decrease the calcium levels

It also secretes CALCITONIN

This is released in response to an INCREASED calcium level in the blood

Function: decreases bone resorption and increases calcium excretion in the kidney to decrease the calcium levels

The parathyroid glands 2 pairs (4) of yellowish glands closely related to the posterior surface of the thyroid gland Secretes parathyroid hormone (PTH)

2 pairs (4) of yellowish glands closely related to the posterior surface of the thyroid gland

Secretes parathyroid hormone (PTH)

The parathyroid glands Functions of the hormone: Increases bone breakdown by osteoclasts Increases Vitamin D synthesis Increases Calcium level in the blood Causes retention of calcium in the kidney

Functions of the hormone:

Increases bone breakdown by osteoclasts

Increases Vitamin D synthesis

Increases Calcium level in the blood

Causes retention of calcium in the kidney

The Adrenal glands a pair of gland resting on top of each kidney with 2 layers ADRENAL CORTEX Secretes mineralocorticoids Secretes glucocorticoids Secretes androgens- sex hormones ADRENAL MEDULLA Secretes the cathecolamines- Epinephrine, and norepinephrine

a pair of gland resting on top of each kidney with 2 layers

ADRENAL CORTEX

Secretes mineralocorticoids

Secretes glucocorticoids

Secretes androgens- sex hormones

ADRENAL MEDULLA

Secretes the cathecolamines- Epinephrine, and norepinephrine

Fig. 10.17

Fig. 10.18

The Adrenal Cortex Mineralocorticoid- Aldosterone Increases sodium retention, water retention secondarily Causes excretion of potassium

Mineralocorticoid-

Aldosterone

Increases sodium retention, water retention secondarily

Causes excretion of potassium

The Adrenal Cortex Glucocorticoids- cortisol Increases fat and protein breakdown Increases glucose synthesis Inhibit inflammation and immune response

Glucocorticoids- cortisol

Increases fat and protein breakdown

Increases glucose synthesis

Inhibit inflammation and immune response

The Adrenal Cortex Adrenal androgens Estrogens, androgens and progestins Insignificant in males Increase female sexual drives, pubic hair and axillary hair growth

Adrenal androgens

Estrogens, androgens and progestins

Insignificant in males

Increase female sexual drives, pubic hair and axillary hair growth

The pancreas The endocrine portion of the pancreas is the ISLETS of LANGERHANS This islet is composed of three types of cells- alpha, beta and delta

The endocrine portion of the pancreas is the ISLETS of LANGERHANS

This islet is composed of three types of cells- alpha, beta and delta

Fig. 10.19

The pancreas The Alpha cells secrete GLUCAGON The Beta cells secrete INSULIN The delta cells secrete SOMATOSTATIN

The Alpha cells secrete GLUCAGON

The Beta cells secrete INSULIN

The delta cells secrete SOMATOSTATIN

Pancreatic insulin Causes Hypoglycemia by two mechanisms: Glucose breakdown- glycolysis Glycogen production- glycogenesis

Causes Hypoglycemia by two mechanisms:

Glucose breakdown- glycolysis

Glycogen production- glycogenesis

Pancreatic insulin Needed by most body cells to allow Glucose to enter the cell membrane The brain cells, intestinal cells, the red blood cells and the islet cells do not need insulin for glucose entry

Needed by most body cells to allow Glucose to enter the cell membrane

The brain cells, intestinal cells, the red blood cells and the islet cells do not need insulin for glucose entry

Pancreatic glucagon Causes increased level of Glucose by: Glycogen breakdown- glycogenolysis Glucose production- glucogenesis

Causes increased level of Glucose by:

Glycogen breakdown- glycogenolysis

Glucose production- glucogenesis

The Gonads : Male- Testes The testes houses the Interstitial cells of Leydig which secrete ANDROGENS Testosterone Dehydrotestosterone Androsterone

The testes houses the Interstitial cells of Leydig which secrete ANDROGENS

Testosterone

Dehydrotestosterone

Androsterone

The Androgens Aid in spermatogenesis Maintain functional reproductive organs Responsible for secondary sex characteristics Responsible for male sexual drives

Aid in spermatogenesis

Maintain functional reproductive organs

Responsible for secondary sex characteristics

Responsible for male sexual drives

The Gonads: Female- Ovary The Follicular cells of the ovarian follicle secrete ESTROGEN and the corpus luteum secretes PROGESTERONE

The Follicular cells of the ovarian follicle secrete ESTROGEN and the corpus luteum secretes PROGESTERONE

The estrogen Aids in uterine and mammary gland development Maintains the structure of the external genitalia Produces the secondary sexual characteristics in female Maintains normal menstrual cycle

Aids in uterine and mammary gland development

Maintains the structure of the external genitalia

Produces the secondary sexual characteristics in female

Maintains normal menstrual cycle

The progesterone Together with estrogen, maintains normal menstruation Increases body temperature Decreases muscle tone and peristalsis Maintains pregnancy

Together with estrogen, maintains normal menstruation

Increases body temperature

Decreases muscle tone and peristalsis

Maintains pregnancy

The CARDIOVASCULAR SYSTEM

The CARDIOVASCULAR SYSTEM This system is composed of the heart and the blood vessels The main functions of this system are: to transport oxygen, hormones and nutrients to the tissues and to transport waste products to the lungs and kidneys for excretion

This system is composed of the heart and the blood vessels

The main functions of this system are:

to transport oxygen, hormones and nutrients to the tissues

and to transport waste products to the lungs and kidneys for excretion

The Gross Anatomy of the Heart The heart is located within the thorax behind the sternum in the compartment called MEDIASTINUM The heart is commonly described as the size of a clenched fist

The heart is located within the thorax behind the sternum in the compartment called MEDIASTINUM

The heart is commonly described as the size of a clenched fist

The Gross Anatomy of the Heart The shape is conical, with a base and an apex The base is directed upward The apex is directed downward to the left at the level of the 5 th ICS LMCL

The shape is conical, with a base and an apex

The base is directed upward

The apex is directed downward to the left at the level of the 5 th ICS LMCL

Heart Surface ANTERIOR SURFACE Right ventricle POSTERIOR SURFACE Left ventricle

ANTERIOR SURFACE

Right ventricle

POSTERIOR SURFACE

Left ventricle

The Heart : Anatomy The heart has three layers The epicardium The myocardium The endocardium The heart is covered by the pericardium with a parietal and visceral layers The pericardial sac is a potential space in between the two pericardial layers with a minimal (15 cc) fluid

The heart has three layers

The epicardium

The myocardium

The endocardium

The heart is covered by the pericardium with a parietal and visceral layers

The pericardial sac is a potential space in between the two pericardial layers with a minimal (15 cc) fluid

Fig. 12.4

The Heart: Anatomy The heart has four chambers The right atrium The right ventricle The left atrium The left ventricle

The heart has four chambers

The right atrium

The right ventricle

The left atrium

The left ventricle

The Heart: Anatomy The heart also has four valves that guard the openings in the chambers The tricuspid valve – between the right atrium and right ventricle The mitral or bicuspid valve- between the left atrium and left ventricle The pulmonic valve- between the right ventricle and the pulmonary trunk The aortic valve- between the left ventricle and the aorta

The heart also has four valves that guard the openings in the chambers

The tricuspid valve – between the right atrium and right ventricle

The mitral or bicuspid valve- between the left atrium and left ventricle

The pulmonic valve- between the right ventricle and the pulmonary trunk

The aortic valve- between the left ventricle and the aorta

The Heart: Anatomy The blood supply of the heart: The coronary arteries are the blood supply There are two main coronary arteries- the right coronary artery and the left coronary artery The venous drainage of the heart is the coronary sinus; the anterior cardiac vein and the smallest cardiac vein

The blood supply of the heart:

The coronary arteries are the blood supply

There are two main coronary arteries- the right coronary artery and the left coronary artery

The venous drainage of the heart is the coronary sinus; the anterior cardiac vein and the smallest cardiac vein

Blood Supply

Venous Drainage Coronary sinus will collect all the venous blood from the heart into the RIGHT atrium The anterior cardiac vein drains NOT into the coronary sinus but DIRECTLY into the right atrium

Coronary sinus will collect all the venous blood from the heart into the RIGHT atrium

The anterior cardiac vein drains NOT into the coronary sinus but DIRECTLY into the right atrium

Circulation

Fig. 12.11

The Heart : Physiology This consists of The conducting system The cardiac cycle The cardiac output and Blood pressure The preload and afterload The Starling’s law of the heart

This consists of

The conducting system

The cardiac cycle

The cardiac output and Blood pressure

The preload and afterload

The Starling’s law of the heart

The Heart: Physiology The conducting system of the heart is a group of specialized heart cells that functions to conduct electrical impulses independent of any nerve supply

The conducting system of the heart is a group of specialized heart cells that functions to conduct electrical impulses independent of any nerve supply

The Heart: Physiology The parts of the conducting system of the heart are: The SA (sino-atrial) node The AV (atrio-ventricualr) node The Bundle of His with its right and left bundle The Purkinje fibers

The parts of the conducting system of the heart are:

The SA (sino-atrial) node

The AV (atrio-ventricualr) node

The Bundle of His with its right and left bundle

The Purkinje fibers

The Heart: Physiology The intrinsic conduction system causes the heart muscle to depolarize in one direction The rate of depolarization is around 75 beats per minute The SA node sets the pace of the conduction This electrical activity is recorded by the Electrocardiogram (ECG)

The intrinsic conduction system causes the heart muscle to depolarize in one direction

The rate of depolarization is around 75 beats per minute

The SA node sets the pace of the conduction

This electrical activity is recorded by the Electrocardiogram (ECG)

The Heart: Physiology The cardiac cycle consists of the contraction phase and the relaxation phase in each heartbeat The SYSTOLE is the contraction phase The DIASTOLE is the relaxation phase

The cardiac cycle consists of the contraction phase and the relaxation phase in each heartbeat

The SYSTOLE is the contraction phase

The DIASTOLE is the relaxation phase

The Heart: Physiology Heart sounds can be auscultated S1, S2, S3, and S4 S1 is due to the closure of the AV valves S2 is due to the closure of the semilunar valves S3 is due to the rushing of blood through the AV opening S4 is due to contraction of the atrium

Heart sounds can be auscultated

S1, S2, S3, and S4

S1 is due to the closure of the AV valves

S2 is due to the closure of the semilunar valves

S3 is due to the rushing of blood through the AV opening

S4 is due to contraction of the atrium

The Heart: Physiology The amount of blood the heart pumps out in each beat is called the STROKE VOLUME When this volume is multiplied by the number of heart beat in a minute (heart rate), it becomes the CARDIAC OUTPUT When the Cardiac Output is multiplied by the Total Peripheral Resistance, it becomes the BLOOD PRESSURE

The amount of blood the heart pumps out in each beat is called the STROKE VOLUME

When this volume is multiplied by the number of heart beat in a minute (heart rate), it becomes the CARDIAC OUTPUT

When the Cardiac Output is multiplied by the Total Peripheral Resistance, it becomes the BLOOD PRESSURE

The Heart: Physiology The PRELOAD is the degree of stretching of the heart muscle when it is filled-up with blood The AFTERLOAD is the resistance to which the heart must pump to eject the blood

The PRELOAD is the degree of stretching of the heart muscle when it is filled-up with blood

The AFTERLOAD is the resistance to which the heart must pump to eject the blood

The Heart: Physiology Starling’s Law of the Heart states that the force of contraction is proportional to the degree of stretching of the cardiac muscle fibers As the length of the muscle fiber is stretched, the contractile force increases But when the maximum length has been reach, any further stretching will impair the contraction

Starling’s Law of the Heart states that the force of contraction is proportional to the degree of stretching of the cardiac muscle fibers

As the length of the muscle fiber is stretched, the contractile force increases

But when the maximum length has been reach, any further stretching will impair the contraction

The Blood vessel: Anatomy This consists of the artery, vein and capillary together with the lymphatic vessels The ARTERY has thicker wall, deeply located, pulsating, reddish, with abundant smooth muscles and elastic tissues that carries oxygenated blood away from the heart towards the body tissues

This consists of the artery, vein and capillary together with the lymphatic vessels

The ARTERY has thicker wall, deeply located, pulsating, reddish, with abundant smooth muscles and elastic tissues that carries oxygenated blood away from the heart towards the body tissues

The Blood vessel: Anatomy The VEIN is thin-walled, superficially located, non-pulsating, bluish vessel that carries unoxygenated/deoxygenated blood towards the heart Arterioles are small arteries Venules are small veins CAPILLARIES are diffuse network of thin- walled tubules that connect arterioles and venules together

The VEIN is thin-walled, superficially located, non-pulsating, bluish vessel that carries unoxygenated/deoxygenated blood towards the heart

Arterioles are small arteries

Venules are small veins

CAPILLARIES are diffuse network of thin- walled tubules that connect arterioles and venules together

The Blood vessel: Physiology The diameter of the arterioles is the main contributor of the peripheral resistance In the presence of epinephrine, cold temperature and irritation, the smooth muscles of the blood vessels will contract making the lumen smaller  ↑ resistance In the presence of histamine , warm temperature, the vessels will dilate  ↓ resistance

The diameter of the arterioles is the main contributor of the peripheral resistance

In the presence of epinephrine, cold temperature and irritation, the smooth muscles of the blood vessels will contract making the lumen smaller  ↑ resistance

In the presence of histamine , warm temperature, the vessels will dilate  ↓ resistance

Anatomy & Physiology Refers to a change in heart rate A positive chronotropic effect refers to an increase in heart rate A negative chronotropic effect refers to a decrease in heart rate Refers to a change in the speed of conduction through the AV junction A positive dromotropic effect results in an increase in AV conduction velocity A negative dromotropic effect results in a decrease in AV conduction velocity Refers to a change in myocardial contractility A postive inotropic effect results in an increase in myocardial contractility A negative inotropic effect results in a decrease in myocardial contractility Chronotropic effect Dromotropic effect Inotropic effect Terminology

Refers to a change in heart rate

A positive chronotropic effect refers to an increase in heart rate

A negative chronotropic effect refers to a decrease in heart rate

Refers to a change in the speed of conduction through the AV junction

A positive dromotropic effect results in an increase in AV conduction velocity

A negative dromotropic effect results in a decrease in AV conduction velocity

Refers to a change in myocardial contractility

A postive inotropic effect results in an increase in myocardial contractility

A negative inotropic effect results in a decrease in myocardial contractility

Basic Electrophysiology Primary Property Contractility Automaticity Conductivity Where Found Myocardium Electrical conduction system Primary Function Contraction and Relaxation Generation and conduction of electrical impulses Kinds of Cardiac Cells Myocardial cells Specialized cells of the electrical conduction system Myocardial Cell Types

Systemic circulation The aorta- leaves the left ventricle to form the ascending aorta, aortic arch, descending aorta, thoracic aorta and abdominal aorta The Vena cava ( superior and inferior) drains the whole body and returns the blood to the right atrium

The aorta- leaves the left ventricle to form the ascending aorta, aortic arch, descending aorta, thoracic aorta and abdominal aorta

The Vena cava ( superior and inferior) drains the whole body and returns the blood to the right atrium

Vascular System

Physiology of circulation Blood pressure is the measure of force exerted by blood against the blood vessel wall Measured by sphygmomanometer Normally BP is measured as systolic pressure and diastolic pressure PULSE PRESSURE = SP-DP

Blood pressure is the measure of force exerted by blood against the blood vessel wall

Measured by sphygmomanometer

Normally BP is measured as systolic pressure and diastolic pressure

PULSE PRESSURE = SP-DP

Physiology of circulation Capillary exchange Most exchange of gas and substances occur across the wall of the capillary Usually, the exchange is due to the filtration difference and diffusion

Capillary exchange

Most exchange of gas and substances occur across the wall of the capillary

Usually, the exchange is due to the filtration difference and diffusion

BP regulation Central Pons and medulla Sympathetic nervous system– Increases heart rate Parasympathetic nervous system (vagus)– decreases heart rate

Central

Pons and medulla

Sympathetic nervous system– Increases heart rate

Parasympathetic nervous system (vagus)– decreases heart rate

BP regulation Baroreceptors Receptors sensitive to stretch located in the carotid sinuses and aortic arch ↓ stretch  reflex increase in heart rate  ↑BP ↑ stretch  reflex decrease in heart rate  ↓BP

Baroreceptors

Receptors sensitive to stretch located in the carotid sinuses and aortic arch

↓ stretch  reflex increase in heart rate  ↑BP

↑ stretch  reflex decrease in heart rate  ↓BP

BP regulation Hormonal Epinephrine  vasoconstriction  increased resistance  increased BP Angiotensinogen A1 Angiotensin 2 ADH  water reabsorption  ↑Blood volume  increased BP ANF  increase sodium excretion  increased urine  decreased blood volume  decreased BP blood lung

Hormonal

Epinephrine  vasoconstriction  increased resistance  increased BP

Angiotensinogen A1 Angiotensin 2

ADH  water reabsorption  ↑Blood volume  increased BP

ANF  increase sodium excretion  increased urine  decreased blood volume  decreased BP

Fig. 13.22

Fetal circulation

Cardiac assessment Inspection Palpation of the apical pulse and PMI at the 5 th ICS LMCL Auscultation for the heart sounds S1 and S2 Auscultation for the heart valves TV MV PV AV

Inspection

Palpation of the apical pulse and PMI at the 5 th ICS LMCL

Auscultation for the heart sounds

S1 and S2

Auscultation for the heart valves

TV

MV

PV

AV

Fig. 13.23

Blood Blood is a special connective tissue Total blood volume is about 5 liters Blood is composed of two portions: 1. Formed elements- RBC, WBC, Platelets 2. Plasma- the liquid portion Hematocrit is the percentage of RBC per unit volume of blood

Blood is a special connective tissue

Total blood volume is about 5 liters

Blood is composed of two portions:

1. Formed elements- RBC, WBC, Platelets

2. Plasma- the liquid portion

Hematocrit is the percentage of RBC per unit volume of blood

Fig. 11.2

The RED Blood Cell Non-nucleated cellular element in the blood Biconcave Transports Oxygen loosely bound to Hemoglobin Red pigment is due to hemoglobin Lifespan is 120 days Reticulocytes are immature RBC

Non-nucleated cellular element in the blood

Biconcave

Transports Oxygen loosely bound to Hemoglobin

Red pigment is due to hemoglobin

Lifespan is 120 days

Reticulocytes are immature RBC

Fig. 11.4

The Leukocytes or WBC Nucleated, larger than the RBC Divided into Granulocytes and Agranulocytes

Nucleated, larger than the RBC

Divided into Granulocytes and Agranulocytes

The Leukocytes or WBC GRANULOCYTES Neutrophils- most abundant WBC, 60-70%. This is the first cell to arrive in injury/inflammation. Increased in bacterial infection In females, there is the presence of the Barr bodies, the condensed X chromosome

GRANULOCYTES

Neutrophils- most abundant WBC, 60-70%. This is the first cell to arrive in injury/inflammation.

Increased in bacterial infection

In females, there is the presence of the Barr bodies, the condensed X chromosome

The WBC 2. Eosinophils- cell type that is capable of limited phagocytosis, with granules containing peroxidase. This is increased during parasitic and allergic reactions

2. Eosinophils- cell type that is capable of limited phagocytosis, with granules containing peroxidase.

This is increased during parasitic and allergic reactions

The WBC 3. Basophils- a WBC that is capable of releasing Histamine, heparin and serotonin during anaphylaxis . The rarest type of WBC.

3. Basophils- a WBC that is capable of releasing Histamine, heparin and serotonin during anaphylaxis . The rarest type of WBC.

The WBC Agranulocytes: 1. Lymphocyte- second most abundant (next to neutrophils) Found increased in Viral infection and chronic infection. This can be: T-lymphocyte B-lymphocyte

Agranulocytes:

1. Lymphocyte- second most abundant (next to neutrophils)

Found increased in Viral infection and chronic infection. This can be:

T-lymphocyte

B-lymphocyte

The WBC Agranulocytes: T-lymphocyte - mediator of Cellular Immunity B-lymphocyte - mediator of Humoral immunity because this cell secretes ANTIBODIES when transformed into plasma cells.

Agranulocytes:

T-lymphocyte - mediator of Cellular Immunity

B-lymphocyte - mediator of Humoral immunity because this cell secretes ANTIBODIES when transformed into plasma cells.

The WBC 2. Monocyte- has kidney-shaped nucleus, a very large WBC that stays only for 2-3 days in the circulation. This becomes the MACROPHAGE in the tissues.

2. Monocyte- has kidney-shaped nucleus, a very large WBC that stays only for 2-3 days in the circulation. This becomes the MACROPHAGE in the tissues.

The Platelets Also called thrombocytes Smallest formed element, lifespan is 8-10 days Involves in clot formation Forms the platelet plug in an injured vessel Releases chemicals that can cause activation of the clotting mechanism

Also called thrombocytes

Smallest formed element, lifespan is 8-10 days

Involves in clot formation

Forms the platelet plug in an injured vessel

Releases chemicals that can cause activation of the clotting mechanism

Table. 11.2

The Blood groups Blood types are grouped into A, B, AB and O based on the presence of the antigen on the surface of the RBC If antigen A is present, then the blood is type A If antigen B is present, then the blood is type B If antigen A and antigen B is present, then the type is AB If no antigen is present, then blood type is O

Blood types are grouped into A, B, AB and O based on the presence of the antigen on the surface of the RBC

If antigen A is present, then the blood is type A

If antigen B is present, then the blood is type B

If antigen A and antigen B is present, then the type is AB

If no antigen is present, then blood type is O

Fig. 11.11

The Blood groups Blood group A has Antibody B, that can react to blood type B and AB Blood group B has antibody A, that can react to blood type A and AB Blood group AB has no antibody Blood group O has no antigen, but has Both antibody A and B

Blood group A has Antibody B, that can react to blood type B and AB

Blood group B has antibody A, that can react to blood type A and AB

Blood group AB has no antibody

Blood group O has no antigen, but has Both antibody A and B

Rh group Along with the ABO group, there is an Rh system in the blood The “D” antigen is the most prevalent A person with “D” antigen is Rh (+) A person with no “D” antigen is Rh (-) Most Filipinos are Rh (+)

Along with the ABO group, there is an Rh system in the blood

The “D” antigen is the most prevalent

A person with “D” antigen is Rh (+)

A person with no “D” antigen is Rh (-)

Most Filipinos are Rh (+)