Arellano University College of Nursing / CA 1 Cluster 3

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The Human Body An Orientation

‡ Anatomy ± study of the structure and shape of the body and its parts ‡ Physiology ± study of how the body and its parts work or function

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Slide 21.1

Anatomy Levels of Study
Gross Anatomy ‡ Large structures ‡ Easily observable

Figure 1.1 Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 1.2a 3

Anatomy Levels of Study
‡ Microscopic Anatomy
‡ Very small structures ‡ Can only be viewed with a microscope

Figure 14.4 Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 1.2b 4

LEVELS OF ORGANIZATION

CHEMICAL

CELLULAR

TISSUE

ORGAN

SYSTEM

ORGANIS MAL

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Directional Terms
y INFERIOR (L., lower) ² a structure lower than

another. y SUPERIOR (L., higher) ² a structure higher than another. y ANTERIOR (L., to go before) ² toward the front of the body. y POSTERIOR (L., posterus, following) ² toward the back of the body. y DORSAL (L., dorsum, back) ² synonymous with posterior y VENTRAL (L, ventrum, belly) ² synonymous with anterior. Arellano3University College of Nursing / CA 1 Cluster 6

Directional Terms
y PROXIMAL (L., proximus, nearest) ² closer to the

point of attachment to the body than another structure. y DISTAL (L., di+sto, to be distant) ² farther from the point of attachment to the body than another structure. y LATERAL (L., latus, side) ² away from the midline of the body. y MEDIAL (L., medialis, middle) ² toward the midline of the body.
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Directional Terms
y SUPERFICIAL (L., superficialis) ² toward or on

the surface. y DEEP (Old English, deop, deep) ² away from the surface, internal.

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Planes
y SAGITTAL (´flight of an arrowµ) ² runs vertically

through the body and separates it into right and left portions.
y Midsagittal ² divides the body into equal right and left

halves. y Parasagittal ² towards the side of the midline, divides the body in unequal right and left portions.

y TRANSVERSE (horizontal) ² runs parallel to the

ground and divides the body into superior and inferior parts. y CORONAL (frontal) - runs vertically from right to left and divides the body into anterior and posterior Arellano University College of Nursing / CA 1 9 portions. Cluster 3

Sections
y LONGITUDINAL ² a cut through the

longitudinal axis of an organ. y TRANSVERSE ² a cut at a right angle to the longitudinal axis. y OBLIQUE ² a cut made across the longitudinal axis at angle other than a right angle.

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Body Regions
y APPENDICULAR ² includes the limbs and their

girdles y Upper limb ² arm, forearm, wrist, and hand; attached to the body by the shoulder or pectoral girdle. y Lower limb ² thigh, leg, ankle, and foot; attached to the body by the hip or pelvic girdle. y AXIAL ² consists of the head, neck and trunk. y Trunk ² divided into the trunk (chest), abdomen, and pelvis.
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Body Regions
y APPENDICULAR ² includes the limbs and their

girdles y Upper limb ² arm, forearm, wrist, and hand; attached to the body by the shoulder or pectoral girdle. y Lower limb ² thigh, leg, ankle, and foot; attached to the body by the hip or pelvic girdle. y AXIAL ² consists of the head, neck and trunk. y Trunk ² divided into the trunk (chest), abdomen, and pelvis.
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Abdominal Quadrants
RIGHT UPPER QUADRANT LEFT UPPER QUADRANT

RIGHT LOWER QUADRANT

RIGHT LOWER QUADRANT

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Abdominal Regions
RIGHT HYPOCHONDRIAC EPIGASTRIC LEFT HYPOCHONDRIAC

RIGHT LUMBAR

UMBILICAL

LEFT LUMBAR

RIGHT ILIAC

HYPOGASTRIC

LEFT ILIAC

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Organ System Overview
‡ Integumentary
‡ Forms the external body covering ‡ Protects deeper tissue from injury ‡ Synthesizes vitamin D ‡ Location of cutaneous nerve receptors
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Slide 1.4 16

Organ System Overview
‡ Skeletal
‡ Protects and supports body organs ‡ Provides muscle attachment for movement ‡ Site of blood cell formation ‡ Stores minerals
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Slide 1.5 17

Organ System Overview

‡ Muscular
‡ Allows locomotion ‡ Maintains posture ‡ Produces heat

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Slide 1.6 18

Organ System Overview
‡ Nervous
‡ Fast-acting control system ‡ Responds to internal and external change ‡ Activates muscles and glands
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Slide 1.7 19

Organ System Overview
‡ Endocrine
‡ Secretes regulatory hormones
‡ Growth ‡ Reproduction ‡ Metabolism
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Slide 1.8 20

Organ System Overview
‡ Cardiovascular
‡ Transports materials in body via blood pumped by heart
‡ Oxygen ‡ Carbon dioxide ‡ Nutrients ‡ Wastes
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Slide 1.9 21

Organ System Overview

‡ Lymphatic
‡ Returns fluids to blood vessels ‡ Disposes of debris ‡ Involved in immunity

Figure 1.2g Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 22 1.10

Organ System Overview

‡ Respiratory
‡ Keeps blood supplied with oxygen ‡ Removes carbon dioxide
Figure 1.2h Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 23 1.11

Organ System Overview
‡ Digestive
‡ Breaks down food ‡ Allows for nutrient absorption into blood ‡ Eliminates indigestible material
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Slide 24 1.12

Organ System Overview
‡ Urinary
‡ Eliminates nitrogenous wastes ‡ Maintains acid ± base balance ‡ Regulation of materials ‡ Water ‡ Electrolytes
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Slide 25 1.13

Organ System Overview

‡ Reproductive
‡ Production of offspring

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Slide 26 1.14

Essentials of Human Anatomy & Physiology

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Biochemistry: Essentials for Life
‡ Organic compounds
‡ Contain carbon ‡ Most are covalently bonded ‡ Example: C6H12O6 (glucose)

‡ Inorganic compounds
‡ Lack carbon ‡ Tend to be simpler compounds ‡ Example: H2O (water)
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Slide 28 2.21

Important Inorganic Compounds
‡ Water
‡ Most abundant inorganic compounds ‡ Vital properties ‡ High heat capacity ‡ Polarity/solvent properties ‡ Chemical reactivity ‡ Cushioning
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Slide 29 2.22

Important Inorganic Compounds
‡ Salts ‡ Easily dissociate into ions in the presence of water ‡ Vital to many body functions ‡ Include electrolytes which conduct electrical currents
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Slide 30 2.23

Important Inorganic Compounds
‡ Acids
‡ Can release detectable hydrogen ions

‡ Bases
‡ Proton acceptors

‡ Neutralization reaction
‡ Acids and bases react to form water and a salt
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Slide 31 2.24

pH
‡ Measures relative concentration of hydrogen ions
‡ pH 7 = neutral ‡ pH below 7 = acidic ‡ pH above 7 = basic ‡ Buffers ‡ Chemicals that can regulate pH change
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Slide 32 2.25

Important Organic Compounds
‡ Carbohydrates
‡ Contain carbon, hydrogen, and oxygen ‡ Include sugars and starches ‡ Classified according to size ‡ Monosaccharides ± simple sugars ‡ Disaccharides ± two simple sugars joined by dehydration synthesis ‡ Polysaccharides ± long branching chains of linked simple sugars
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Slide 33 2.26

Important Organic Compounds

‡ Lipids
‡ Contain carbon, hydrogen, and oxygen ‡ Carbon and hydrogen outnumber oxygen

‡ Insoluble in water

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Slide 34 2.29

Important Organic Compounds

‡ Proteins
‡ Made of amino acids ‡ Contain carbon, oxygen, hydrogen, nitrogen, and sometimes sulfur

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Slide 2.33a 35

Important Organic Compounds
‡ Account for over half of the body¶s organic matter ‡ Provides for construction materials for body tissues ‡ Plays a vital role in cell function ‡ Act as enzymes, hormones, and antibodies

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Slide 2.33b 36

Enzymes
‡ Act as biological catalysts ‡ Increase the rate of chemical reactions

Figure 2.16 Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 37 2.34

Important Organic Compounds
‡ Nucleic Acids
‡ Provide blueprint of life ‡ Nucleotide bases ‡ A = Adenine ‡ G = Guanine ‡ C = Cytosine ‡ T = Thymine ‡ U = Uracil ‡ Make DNA and RNA
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Slide 38 2.35

Important Organic Compounds
‡ Deoxyribonucleic acid (DNA)
‡ Organized by complimentary bases to form double helix ‡ Replicates before cell division ‡ Provides instruction for every protein in the body
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Figure 2.17c

Slide 39 2.36

Important Organic Compounds

‡ Adenosine triphosphate (ATP)
‡ Chemical energy used by all cells ‡ Energy is released by breaking high energy phosphate bond ‡ ATP is replenished by oxidation of food fuels
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Slide 40 2.37

Essentials of Human Anatomy & Physiology

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Cells and Tissues
y Carry out all chemical activities needed to sustain life y Cells are the building blocks of all living things y Tissues are groups of cells that are similar in structure and function -epithelial, muscle, nervous, connective
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Slide 3.1 42

Anatomy of the Cell
y Cells are not all the same y All cells share general structures y Cells are organized into three main regions
y Nucleus y Cytoplasm y Plasma membrane
Figure 3.1a Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 3.2 43

The Nucleus
y Control center of the cell
y Contains genetic material (DNA)

y Three regions
y Nuclear membrane y Nucleolus
Figure 3.1b Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

y Chromatin

Slide 3.3 44

Cytoplasmic Organelles

Figure 3.4 Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 45 3.10

Cellular Physiology: Membrane Transport
y Membrane Transport ± movement of substance into and out of the cell Transport is by two basic methods
y Passive transport
- No energy is required

y Active transport
- The cell must provide metabolic energy
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Slide 46 3.20

Solutions and Transport
y Solution ± homogeneous mixture of two or more components
y Solvent ± dissolving medium y Solutes ± components in smaller quantities within a solution

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Slide 47 3.21

Passive Transport Processes
y Diffusion
y Particles tend to distribute themselves evenly within a solution y Movement is from high concentration to low concentration, or down a concentration gradient
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Slide 48 3.23

Diffusion

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Passive Transport Processes
y Types f iff si y i ple iff si yU
ssisted pr ess

y Sol tes re lipid-sol le teri ls or small enough to pass through membrane pores
y Facilitated
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Slide 3.24a 50

Diffusion through the Plasma Membrane

Figure 3.9 Arellano University College of Nursing / CA 1 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Cluster 3

Slide 51 3.25

Passive Transport Processes
Osmosis ± simple diffusion of water

y Highly polar water easily crosses the plasma membrane

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Slide 3.24b 52

Osmosis

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Passive Transport Processes
y Filtration
y Water and solutes are forced through a membrane by fluid, or hydrostatic pressure y A pressure gradient must exist y Solute-containing fluid is pushed from a high pressure area to a lower pressure area
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Slide 54 3.26

Active Transport Processes
y Transport substances that are unable to pass by diffusion
y Too large y Insoluble y Against a concentration gradient

y Two common forms of active transport
y Solute pumping y Bulk transport
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Slide 55 3.27

Active Transport Processes
y Solute pumping
y Amino acids, some sugars & ions y ATP energizes protein carriers,

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Slide 3.28a 56

Active Transport Processes
y Bulk transport
y Exocytosis
y Moves materials out of the cell y Material is carried in a membranous vesicle

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Slide 3.29a 57

Active Transport Processes
y Bulk transport
y Endocytosis y Extracellular substances are engulfed by being enclosed in a membranous vescicle y Types of endocytosis y Phagocytosis ± cell eating y Pinocytosis ± cell drinking
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Slide 3.30a 58

Cell Life Cycle
y Cells have two major periods
y Interphase y Cell grows y Cell carries on metabolic processes y Cell division y Cell replicates itself y Function is to produce more cells for growth and repair processes
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Slide 59 3.31

Events of Cell Division
y Mitosis
y Division of the nucleus y Results in the formation of two daughter nuclei

y Cytokinesis
y Division of the cytoplasm y Begins when mitosis is near completion y Results in the formation of two daughter cells
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Slide 60 3.33

Stages of Mitosis
y Interphase
y No cell division occurs y The cell carries out normal metabolic activity and growth

y Prophase
y First part of cell division y Centromeres migrate to the poles
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Slide 3.34a 61

Stages of Mitosis

y Metaphase
y Spindle from centromeres are attached to chromosomes that are aligned in the center of the cell

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Slide 3.34b 62

Stages of Mitosis
y Anaphase
y Daughter chromosomes are pulled toward the poles y The cell begins to elongate

y Telophase
y Daughter nuclei begin forming y A cleavage furrow (for cell division) begins to form
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Slide 63 3.35

Stages of Mitosis

Figure 3.14; 1

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Slide 3.36a 64

Stages of Mitosis

Figure 3.14; 2

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Slide 3.36b 65

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The Integumentary System
y The integumentary

system is composed of the:
y Skin y Appendages
y Largest organ of the

body
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Functions of the Integumentary system
y Gives shape to the body y Protects the body from injury y Serves as a barrier to infection y Sensory reception y Thermoregulation y Maintenance of water balance

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The EPIDERMIS
y Composed mainly of 5 layers:

> stratum corneum: outermost, cornified (keratinized) > stratum lucidum: present only in thick hairless skin > stratum granulosum: impermeable > stratum spinosum > stratum basale: (germinativum) constant cell division y Nerves: found in the epidermis- for pain and temperature sensation
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Epidermal Cell Types (4)
y 1 ± Keratinocytes y 2 ± Melanocytes y ± Langerhans y 4 - Merckel
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Keratinocytes
y most numerous (85%) y secrete keratin y provides the barrier

function of the epidermis

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Melanocytes
y found in the dermis

and basal layer of the epidermis y produce melanin y protect from UV

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Langerhans cells
y members of the immune system, and functioning

as antigen-presenting cells. Found in stratum spinosum.

Merckel cells
y found in the basal layer and functions as

mechanoreceptors.

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The DERMIS
y loose connective tissue, mainly collagen and elastic

and reticular fibers y blood vessels y Nerves
a. Papillary layer- dermal papilla (fingerprints) b. Reticular layer

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Two Dermal Layers

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Subcutaneous Tissue
y Contains adipose tissue and larger blood vessels and

nerves y May contain the base of hair follicles and sweat glands y Functions: caloric reserve, heat insulator, shock absorber

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Sweat glands 2 types
y Eccrine: < 0.5mm

diameter y found anywhere except penis y Function in thermoregulation

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Sweat glands 2 types
y Apocrine: 3-5mm in diameter y Modified sweat gland y found in the axillary, areolar, anal regions y secrete odor-producing discharges called ³pheromones´ y functional at puberty

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Sebaceous or Oil glands
y secrete sebum y anywhere except on the palms and soles y lubricate hair follicles & skin surface y hyperfunctional at puberty

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Hair
y arises from hair follicles which are epidermal invaginations y Associated arrector pili muscle causes ³goosebumps´

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Nails
y like hair, are modified stratum corneum y keratin of nails is harder than that of hair y stratum basale of the nail area continuously proliferates and rapidly keratinizes y white cuticle of nails is called eponychium

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TACTILE SENSATION
y Pacinian Corpuscle y Meissner s

Corpuscle y Ruffini Corpuscle y Krause Corpuscle

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Pacinian corpuscle
y found within the

dermis and hypodermis y surround nerves and look like onions y function as mechanoreceptors for pressure & vibration.

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Meissner s corpuscles
y present in the dermal

papillae y surrounds nerves y function as mechanoreceptors for fine touch

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Ruffini Corpuscle
y Thermoreceptor

for WARM temperature

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Krause Corpuscle
y Thermoreceptor

for COLD temperature

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Skeletal system
y 206 bones y Axial skeleton= 80 y Appendicular

skeletons= 126 upper limbs= 64 lower limbs= 62

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functions
y Supportive framework y Protect vital organs y Hemopoiesis or blood cell formation y Storage of minerals y Act as biomechanical levers

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Types of Bone
y According to location: y Axial found along our midline axis y Appendicular found in our extremities

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diaphysis and metaphysis) Example: (upper) clavicle, humerus, radius, and ulna (lower) femur, tibia, fibula *include metacarpals, metatarsals and phalenges y SHORT BONES- (lack a long axis and are typically cuboidal) Example: ankle and wrist bone *sesamoid bones-embedded in tendons (patella) y FLAT BONES- thin and usually curved, two layers of compact bone separated by spongy bone and marrow Example: sternum, ribs and skull bone y IRREGULAR BONES- don t fit any other classification Example: vertebrae, hip bones,ofsome CA 1 - bones Arellano University College Nursing / skull
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y According to shape: y LONG BONES- (longer than they are wide, epiphysis,

Classification
y
1. 2.

Based on dev t. Membranous Cartilaginous Based on histology Compact Spongy
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1. 2.

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Types of cells
yOsteoblast- precursor cells yOsteoclast- bone destroyers yOsteocytes- mature cells

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Classification of Joints
y Synarthroses- barely movable or
nonmovable (SUTURES, GOMPHOSES,
SYNCHONDROSES)

y Amphiarthroses- slightly movable
-syndesmoses= have intervening connective tissue that forms interosseous membrane or ligament (tibiofibular, radioulnar) -symphyses= have intervening pad or fibrocartilage (intervertebral joint, symphisis pubis, joint bet. Manubrium and sternum)

y Diarthroses- freely movable
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TYPES OF MOVEMENT
*origin immovable *insertion movable
y flexion - bending, decreasing the angle between 2 bones y extension - straightening out, increasing the angle between 2 bones y abduction - moving the bone away from the midline y adduction - moving the bone toward the midline y rotation - moving the bone around central axis y circumduction - moving the bone so that the end of it describes a circle
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y supination - moving the bones of the

forearm so that the radius and ulna are parallel, posterior to anterior y pronation - moving the bones of the forearm so that the radius and ulna are not parallel, anterior to posterior position y eversion - moving the sole of the foot outward at the ankle and intertarsal joints y inversion - moving the sole of the foot inward at the ankle and intertarsal joints
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y protraction - moving a part of the body

forward on a plane parallel to the ground y retraction - moving a part of the body backward on a plane parallel to the ground y elevation - raising a part of the body y depression - lowering a part of the body y plantar flexion - pointing toes (as a ballerina) away from the body y dorsiflexion - pointing toes toward the body y opposition move thumb to touch fingertips
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y Bone maintenance
1. Local stress-stimulates bone formation 2. Vit. D- inc Ca by increasing GIT

absorption 3. PTH- inc blood Ca by inc bone resorption 4. Calcitonin- inhibits bone resorption

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Bone repair
y Hematoma & inflammation y Angiogenesis and cartilage formation y Cartilage calcification y Cartilage removal y Bone formation(3-4 mos.) y Remodeling( mos.-yrs)
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Muscles
- tissue composed of fibers or -

cells able to contract causing movements Maintains posture Stabilizes joints Generates heat highly vascular, excitable, conductive and elastic

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GOLDEN RULES OF SKELETAL MUSCLE ACTIVITY
y All muscle cross at least one joint y The bulk of muscle lies proximal to the joint

crossed y Have at least two attachments: ORIGIN (proximal) and INSERTION (distal) y Muscle an only pull; they never push y Contraction moves toward the origin
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Naming Skeletal muscle
1. Direction of Muscle Fibers - RECTUS (straight), OBLIQUE 2. Relative Size -MAXIMUS, MINIMUS, LONGUS, BREVIS 3. Number of Origin - BICEPS, TRICEPS, QUADRICEPS 4. Location of Origin and Insertion - STERNOCLEIDOMASTOID
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Naming Skeletal muscle
5. Location - FRONTALIS, TEMPORALIS 6. Shape of Muscle - DELTOID 7. Action of the Muscle -FLEXOR, EXTENSOR, ADDUCTOR

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SUPERFICIAL MUSCLE
1. FACIAL MUSCLE- facial expression - frontalis: raises brow, wrinkles forehead -obicularis oculi: closes eyes -obicularis oris: kissing muscle -zygoamticus: smiling muscle 2. MUSCLE OF MASTICATION - buccinator -masseter -temporalis Arellano3University College of Nursing / CA 1 Cluster

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SUPERFICIAL MUSCLE
3. NECK MUSCLE -platysma: downward sag of mouth -sternocleidomastoid: rotates head, prayer muscle, head flexion (if both contracts) 4. ANTERIOR TRUNK MUSCLE - pectoralis major -intercoastal muscles: external (for inhalation), internal (for exhalation)
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SUPERFICIAL MUSCLE
- Muscles of abdominal girdle: rectus abdominis, external oblique, internal oblique, transversus abdominis 5. POSTERIOR TRUNK MUSCLE -trapezius -latissimus dorsi -deltoid

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SUPERFICIAL MUSCLE
6. UPPER ARM MUSCLE - biceps brachii- elbow flexor -triceps brachii- elbow extensor 7. FOREARM MUSCLE - anterior compartment: flexors and pronators of wrist and hands - posterior compartment: extensors and suppinators of wrist and hands
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SUPERFICIAL MUSCLE
8. HIP MUSCLES -gluteus maximus: hip extensor -gluteus medius: hip adbuctor -iliopsas: hip flexor - adductor muscle: hip adductor 9. FEMORAL MUSCLE -Quadriceps (knee extensors): rectus femoris, vastus lateralis, vastus medialis, vastus intermedius - hamstring (knee flexors): biceps femoris, semimembranosus, semitendinosus Arellano University College of Nursing / CA 1 Cluster 3 112

SUPERFICIAL MUSCLE
10. MUSCLE OF LOWER LEG - tibialis anetrior: dorsiflexion, inversion -fibularis: plantar flexion, eversion - gastrocnemius: toe dancer muscle, plantar flexion

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TYPES OF MUSCLE CONTRACTION
*tension develops in the muscles according to the sliding filament model 1. isotonic - muscle shortens during contraction ie smiling, bending the knee - successful sliding of myofilaments 2.isometric - muscle does not shorten during contraction ie lifting a 400 pound dresser, pushing against the wall with bent elbows - muscle unable to slide because pushed against immovable object
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Tendon
- attaches muscle to bone - provide durability and conservation of space - made up of tough collagenic fiber

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ligament
binds joints together, connects articular bones and cartilage

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cartilage
- non vascular tissue - can be permanent or temporary - found chiefly in the joints, thorax, larynx and trachea

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Bursae
- Sac containing fluid that are located around the joints to prevent friction

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The Skull
y 8 cranial bones y 14 facial bones y 6 small bones in

the middle ear

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Neurocranium

y Frontal y Parietal y Occipital y Ethmoid y Sphenoid y Temporal
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Viscerocranium
y Maxilla y Nasal y Zygomatic y Mandible y Vomer y Lacrimal y Palatine y Inferior nasal concha Arellano University College of Nursing / CA
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skull
Sutures y Coronal- bet. Parietal & frontal bones y Sagittal- bet. 2 parietal bones y Lambdoid- bet. Parietal & occipital y Bregma- intersection of coronal & sagittal- ant. Fontanel y Pterion- where sphenoid, parietal, frontal & temporal bones converge y TMJ

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Fontanelles or soft spots
y Fibrous connective

tissue or cartilage that occur at the angles of the parietal bone y Anterior closes at 1218 months y Posterior closes at 34 months
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The Auditory Ossicles
y sense vibration y 3 inner ear bones: y

malleus or hammer articulates with eardrum incus or anvil articulates with malleus & stapes stapes or stirrup articulates with oval window

y

y

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Face
y Scalp- frontalis & occipitalis y Ear- auricular y Orbital rim- orbicularis oculi y Nose- nasalis y Neck-platysma y Lips- labii superioris, zygomaticusdepressor labii/angularis,

buccinator, orbicularis oris

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Neck
Bones y Cervical vertebrae- atlas,axis & C3-C7 y hyoidy Larynx y cricoid

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Neck
Anterior Triangle y internal jugular v. y Carotid a. y Vagus n. y Hypoglossal n. y Hyoid ms. y Submental nodes Posterior triangle y Accessory n. y Branches of brachial plexus y Subclavian a y Subclavian v.

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The Vertebral Column or Spine
y Supports the body & bears its weight y Regions: y 7 cervical y 12 thoracic y 5 lumbar y Sacrum y Coccygeal y S-shaped y Vertebrae are attached to each other via synovial joints & by intervertebral discs

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The Normal Spine
y Has normal curves: y lordosis cervical, lumbar

concaving y kyphosis thoracic convexity
y intervertebral discs

maintain flexibility, absorb shock; outer annulus fibrosis, inner gelatinous nucleus pulposus

y With age, loss of H2O content

causes decrease in disc height

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Thorax
y ribs

1-7= true 8-10= false 11-12= floating y Sternum Manubrium Sternal angle of louis Body of sternum
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Muscles y Internal intercostals- ant, inf y External intercoastals- post, inf y Subcostalis y Transversus thoracis

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y 12 pairs of thoracic nerves-

11 intercostal n., 1 subcostal n. y Intercostal arteries-12 pairs of post and ant, =11 inter, 1 subcostal y Intercostal vessels y Lymph drainage

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Abdomen
5 lumbar vertebrae y Ilium- iliac fossa, tubercle & crest y Pubis- symphisis, tubercle, crest Surface anatomy: y Linea alba- fr xiphoid to pubis y Linea semilunaris- bilateral, lat to rectus abdominis y Inguinal groove

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y Muscles

Anterior y Extrernal oblique- ant, inf y Internal oblique-post, inf y Transversus abdominis y Rectus abdominis Posterior y Quadratus luborum y Psoas major-chief flexor of hip y Iliacus- joins psoas
y Transversalis fascia- lines abd cavity, deep inguinal

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Parts of the ´Hip boneµ

y Looks like two fish eating a y y y y

y y y y y

butterfly ASIS = anterior superior iliac spine, important landmark PSIS lies deep to a dimple ischial tuberosity part we sit on symphysis pubis fibroelastic connection between two pubic bones acetabulum depression for the head of the femur greater sciatic notch opening for sciatic nerve lesser sciatic notch obturator foramen for obturator nerve linea terminalis, or pelvic brim separates false pelvis above from true pelvis below
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y Pelvic girdle- anteriorly bounded by hip bone, posteriorly by

sacrum and coccyx y Pelvic cavity Major (false)- above pelvic brim Minor (True)- below y Pelvic diaphragm- muscular floor Levator ani- pubococcygeus, puborectalis, iliococcygeus coccygeus

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Female pelvis
y Broader and more shallow y Pelvic inlet is larger & more circular y Ischial spines are shorter with greater distance bet them y Greater angle bet the pubic bones y Adapted for a baby & delivery Arellano University College of Nursing / CA
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T

r Extr

ity

y Consists of 30 bones:
y Humerus y y y y y

upper

arm Ulna - forearm Radius - forearm Carpal bones - wrist Metacarpals - palm Phalanges - fingers

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Upper Limb

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Hand bones, Palm: Carpals2 rows y 8 short bones in
y Proximal: (r-u) scaphoid, lunate, triquetrium, pisiform y Distal: (r-u) trapezium, trapezoid, capitate, hamate y Scared Lovers Try Positions That They Can t Handle y If you fall and land on your hand, which bone is most likely to break? y Colle s fx = dinner fork deformity of the wrist due to fx of the radius
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The Lower Extremity
y Consists of 30 bones:
y Femur y y y y y

upper leg or

thigh Patella or kneecap Tibia & fibula lower leg or shin Tarsal bones back part of foot & heel Metatarsals main part of the foot Phalanges - toes
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Lower extremeties

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Physiology of muscle contraction

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Energy Requirements for Muscle Contraction
y Energy is produced by anaerobic (without oxygen) or aerobic (with oxygen) respiration. y After intense exercise, the rate of aerobic metabolism remains elevated to repay the oxygen debt.
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Energy Requirements for Muscle Contraction
ANAEROBIC
RE IRE OX EN NO MINIMAL FA T L CO E ATP + LACTIC ACID

AEROBIC
E MAXIMAL LOW FAT , L CO E, PROTEIN ATP+ CARBON DIOXIDE + WATER

NO. OF ATP PROD CED PEED OF ATP PROD CTION B TRATE END-PROD CT

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The Skeletal Muscle: Structure

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The Skeletal Muscle: Structure

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The Skeletal Muscle: Structure

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The Skeletal Muscle: Structure

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The Skeletal Muscle: Structure

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The Skeletal Muscle: Structure

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The Skeletal Muscle: Structure

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The DIGESTIVE SYSTEM
y Alimentary tract composed of organs, the

primary function of which is the ingestion, digestion and absorption of nutrients

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The GIT
The wall is divided into y Mucosa y Submucosa y Muscularis layer (inner circular and outer longitudinal) y and Serosa/adventitia

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Fig. 16.2

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GENERAL FUNCTIONS
Ingestion of food into the mouth Moves food along the digestive tract Mechanically digests the food into small particles Chemically digests the food into simple molecules y Absorbs nutrients into the portal and lymphatic circulation
y y y y

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The MOUTH
yExtends from the lips to the

orophaynx yInitial digestion of carbohydrates occurs here (salivary amylase) yContains the teeth, tongue, palate, salivary glands and tonsils
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Salivary glands
y 1. Parotid= secretes purely serous,

Stensen¶s duct y 2.Submandibular/submaxillay= secretes mixed saliva, with Wharton¶s duct y 3. Sublingual= secretes mixed saliva, with two ducts- duct of Rivinus and duct of Bartholin

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The Esophagus
yMuscular collapsible tube

extending from the pharynx to the stomach yWith upper esophageal sphincter and lower esophageal sphincter y10 inches long
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The GIT ANATOMY
The Esophagus y The upper third contains skeletal muscles y The middle third contains mixed skeletal and smooth muscles y The lower third contains smooth muscles and the esophago-gastric/ cardiac sphincter is found here
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The Esophagus

yFunction: to propel

food to the stomach
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The Stomach
y J-shaped organ in the

epigastrium y Contains four partsthe fundus, the cardia, the body and the pylorus

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y The cardiac sphincter

prevents the reflux of the contents into the esophagus y The pyloric sphincter regulates the rate of gastric emptying into the duodenum y Capacity is 1,500 ml!
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Cells in the stomach
y1. Mucus cells (mucus) y2. Chief cells ( pepsinogen) y3. Parietal Cells (IF, HCl)

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Small intestine
Characteristics: yProvided with mesentery yPresence of villi yPresence of plicae circularis yLined by simple columnar y20 ft (6m) long
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Parts of Small Intestine
y1. DUODENUM- shortest part y2. Jejunum y3. Ileum- longest part

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Parts of Small Intestine

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y The intestinal glands secrete digestive enzymes

that finalize the digestion of all foodstuff y Enzymes for carbohydrates disaccharidases y Enzymes for proteins dipeptidases and aminopeptidases y Enzyme for lipids intestinal lipase

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Large intestine
Characteristics y Presence of haustra y Presence of taenia coli y Presence of appendices epiploicae y No villi y With mesocolon on the appendix, transverse colon and sigmoid colon y 5 ft (1.5-1.8 meter long)

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Parts of the large intestine
y Cecum y Appendix y Ascending colon y Transverse colon y Descending colon y Sigmoid colon y rectum
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The GIT Physiology
y Absorbs water y Eliminates wastes y Bacteria in the colon synthesize Vitamin K y Appendix participates in the immune system

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Anus
yThe anal canal is the last portion of the tract, surrounded by an internal and external anal sphincter

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The Peritoneum
ySerous membrane lining the abdominal cavity yParietal peritoneumabdominal wall yVisceral peritoneum- visceral organs
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Fig. 16.3

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The Peritoneum
yRetroperitoneal organs are found posterior to the peritoneum- kidney, pancreas, duodenum, ascending and descending colon, rectum

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Mesentery
yThis is a peritoneum folded upon itself extending from the organ to the abdominal wall

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Blood supply of the GIT
yBranches of the celiac trunk yLeft gastric artery yHepatic artery ySuperior mesenteric artery
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Accessory organs
Pancreas yA pistol-shaped organ both an endocrine and exocrine gland yParts: head, body and tail yDucts: major is Wirsung, minor is Santorini
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Pancreatic secretions
1. Bicarbonate- to neutralize the acidic chyme from the stomach- stimulated by secretin 2. Pancreatic amylase- for carbohydrate digestion
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Pancreatic secretions
3. Pancreatic lipase- for fat digestion 4. Trypsin and chymotrypsinfor protein digestion

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Accessory organ
Liver yLargest internal organ yLocated on the right upper quadrant yWith right and left lobes
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Liver physiology Normal Function
1. Stores glycogen

and Pathophysiology function Abnormality in
= Hypoglycemia = Hypo-proteinemia Hypo=Decreased Antibody formation risk for INFECTION = Bleeding tendencies = Jaundice and pruritus =Hyper-ammonemia =Hyper=Deficiencies of Vit and min = Gynecomastia, testes atrophy
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2. Synthesizes proteins 3. Synthesizes globulins 4. Synthesizes Clotting factors 5. Secreting bile 6. Converts ammonia to urea 7. Stores Vitamims and minerals 8. Metabolizes estrogen

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Accessory organ
Gallbladder yPear-shaped organ on the right upper quadrant below the liver yParts: fundus, body and neck ystore & concentrate bile
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PHYSIOLOY OF THE GIT
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Movements
Mouth and esophagus: Deglutition y 1. Voluntary phase- food bolus is pushed by tongue to the pharynx y 2. Pharyngeal phase- reflex action y 3. Esophageal phase- peristaltic waves moves the food towards the stomach

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Stomach movement

yMixing waves yPeristaltic movements

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Fig. 16.12

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Regulation of stomach secretions 1. Cephalic phase- stomach secretions are initiated by the sight, smell, thought and taste of food

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Regulation of stomach secretions 2. Gastric phase- secretions are produced upon stomach distention

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Regulation of stomach secretions
3. Intestinal phase- acidic chyme from the stomach passes into the duodenum causing inhibition of gastric secretions
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Fig. 16.22

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Large Intestine: secretion and movement
Mucus for mucosal protection Mass movement- short peristaltic movement
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Large Intestine: secretion and movement
Defecation reflex- moves the feces to the internal anal sphincter, mediated by the parasympathetic nerves Distention causes the reflex
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Major functions
yEliminates wastes yControls blood and fluid

volume yRegulates acid-base balance yRegulates RBC production by erythropoietin
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The Kidney
y Retroperitoneal organ surrounded by

capsule and fats y renal cortex ( where nephrons are located) y renal medulla ( where collecting ducts are found)

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The Nephron
y Functional unit of the kidney that produces urine by filtration Composed of
y Efferent arteriole y Glomerulus y Afferent arteriole y Bowman s capsule y Convoluted tubules- proximal, loop of Henle and

distal
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Special cells in the nephron
Juxtaglomerular cells- secretes renin and erythropoietin Podocytes
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Blood supply of the kidney
yRenal artery- branch of the

abdominal aorta yRenal vein- drains into the inferior venal cava

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Renal pelvis
y Funnel-shaped expanded portion of

the ureter y Formed by the calyces y Collects urine from the kidney

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The Ureter
Left and right y long slender tube y w/ smooth muscles and transitional epithelium y w/ innervations from the sympathetic and parasympathetic
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The urinary bladder
y Hollow pyramid shaped organ located in

the pelvis y Lined with transitional epithelium y With thick detrusor muscles

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Fig. 18.17

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Urethra
y Tube extending from the urinary bladder to the

external urethral orifice
y 1 ½ inches in females

y 3 parts in Males
1. Prostatic urethra- most dilatable 2. Membranous urethra- least dilatable and shortest 3. Penile urethra- longest

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Renal Physiology
Urine formation y 1. Urinary blood flow y 2. Glomerular filtration y 3. Tubular reabsorption y 4. tubular secretion
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yFiltration- water and smaller

solutes ySecretion- water, glucose and amino acids ySecretion- H, K, crea, drugs
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Internal Male Reproductive Organs
1. Testes 2. Ducts- epididymis, vas deferens and ejaculatory duct 3. Glands- prostate and Cowper s 4. Seminal vesicle
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The testes
y Male gonad housed in the scrotum y Divided into lobules containing tubules

and cells y Sperm cells are produced in the seminiferous tubules y Leydig cells secrete testosterone
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Spermatogenesis
y Begins during puberty y Occurs in the seminiferous tubules y Spermatogonia---MITOSIS ---primary spermatocytes---MEOSIS---secondary spermatocyte---spermatids---go to the epididymis--- spermatozoa

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Ducts
1. Epididymis- coiled tube 2. Vas deferens- long tube from the epididymis to the seminal vesicle 3. Ejaculatory duct- formed by the union of the vas deferens and the duct of the seminal vesicle
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Glands
1. Prostate gland- glandular and muscular tissue produces slightly acidic fluid (20% of semen) 2. Seminal Vesicle- convoluted pouch, secretes alkaline fluid and fructose (bulk of the semen) 3. Cowper s glands- secrete mucus for lubrication
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Fig. 19.5a

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External genitalia
1. Scrotum- two chambered sac contains the testes 2. Penis- erectile tissue consists of two corpora cavernosa and one corpora spongiosa y With 3 parts- bulb, shaft and glans
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SEMEN: y contains spermatozoa and fructose-rich nutrients. y During ejaculation, semen receives contributions of fluid from
y y y y

Prostate gland Seminal vesicle Epididymis Bulbourethral gland

y Average pH = 7.5 y Ave. amt.= 2.5 -5 ml. It can live with in the female genital

tract for about 24 to 72 hours. y (60-200 million/ml of ejaculation ave. of 400 million/ ejaculation ) y 90 seconds- cervix y 5 minutes.- end of fallopian tube
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Parts of the Female Reproductive System
y EXTERNAL (vulva) y 1. Mons pubis y 2. Labia majora y 3. Labia majora y 4. Clitoris y 5. Hymen y 6. Vestibule y 7. Pudendal cleft University College of Nursing / CA 1 Arellano
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y INTERNAL y 1. Ovary y 2. Fallopian tubes y 3. Uterus y 4. Vaginal canal

The Internal Organs
y OVARY
y Firm almond shaped

organ covered by the peritoneum y Two parts: y CORTEX- follicles are found y Medulla- connective tissue
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Fallopian tubes y Bilateral ducts extends laterally from the uterus 4 parts 1. Infundibulum- funnel shape, with fimbriae 2. Ampulla- widest part; usual site of FERTILIZATION 3. Isthmus- narrowest part 4. Interstitial or Intramural- embedded in the uterine wall FUNCTION: Transport of ovum
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The Internal Organs

Fig. 20.2

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The Uterus
y Pear-shaped organ with a cavity

3 main parts 1. Fundus- upper dome-shape part 2. Corpus or Body- broad part 3. Cervix- narrow lower part
y Isthmus- junction between the body and the cervix

POSITION: Anteverted and Anteflexed

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The Uterus
The uterine wall is made up of three layers 1. Epimetrium- superficial part surrounded by the perimetrium 2. Myometrium- thickest muscular part 3. Endometrium- inner layer y FUNCTION: Fetal development in pregnancy

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The endometrium
3 layers of the endometrium 1. Stratum Functionale
y Stratum compactum y Stratum spongiosum

2. Stratum basale or germinativum

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Uterine ligaments
y Broad ligament y Round ligament y Cardinal ligament y Utero-sacral ligament

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Fig. 19.8

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Vaginal canal
y Connects the cervix to the vestibule y Fibromuscular canal lined with mucus and covered with hymen y The remnant of hymen is called CARUNCULAE MYRTIFORMIS

Function: organ of copulation and passageway of baby
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External genitalia
1. Vestibule- space between the labia minora 2. Pudendal cleft- space between the labia majora 3. Clitoris- erectile tissue, homologue of penis

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External genitalia
4. Labia majora- thick fold of skin, homologue of scrotum 5. Labia Minora- thin fold of skin devoid of hairs 6. Mons pubis/veneris- elevated area above the labia
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Mammary gland
Modified sweat gland y Consists of glandular and adipose tissue y P-rolactin y O-xytocin y P-rogesterone y E-strogen
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MENSTRUATION:
y Menstrual cycle/ female reproductive cycle- 30-80 cc (60 cc ave.) of blood, epithelial cells and mucus are being discharged y 21-35 days

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Maturation of Oocytes:
y first formed in utero

- 5 to7 million; y first 5 months in utero - 2 million immature oocytes per ovary y at birth - 2 million in BOTH ovaries y 7 yrs of age only - 500,000/ovary y 22y/o only - 300,000/ovary y Reproductive age only - 300 400 oocytes y Menopause - none

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Fig. 19.14

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The uterine cycle
Consists of 3 phases 1. Menstrual phase 2. Proliferative phase 3. Secretory phase

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Uterine Cycle: Menstrual phase
y Day 1- day 5 y Stratum functionale (compactum

and spongiosum) is shed

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Uterine cycle: proliferative Phase
y Day 5- day 14 y Epithelial cells of functional multiply

and form glands y Due to the influence of estrogen

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Uterine cycle: Secretory phase
y Day 15- day 28 y Endometrium becomes thicker and glands secrete nutrients y Uterus is prepared for implantation y Due to progesterone y If no fertilization constriction vessels menstruation
Arellano University College of Nursing / CA 1 Cluster 3 279

Arellano University College of Nursing / CA 1 Cluster 3

280

OVARIAN Cycle
Consists of three phases y 1. Pre-ovulatory : follicular phase y 2. Ovulatory phase y 3. Post-ovulatory : Luteal phase

Arellano University College of Nursing / CA 1 Cluster 3

281

Ovarian Cycle; preovulatory/follicular
y Variable in length: day 6- day 13 y Dominant follicle matures and

becomes grafian follicle with primary oocyte y FSH increases initially then decreases because of estrogen increase
Arellano University College of Nursing / CA 1 Cluster 3 282

Ovarian cycle: Ovulatory phase
y Day 14 y Rupture of the grafian follicle

releasing the secondary oocyte y Due to the LH surge y MITTELSCHMERZ- pain during rupture of follicle
Arellano University College of Nursing / CA 1 Cluster 3 283

OVARIAN cycle: Post-ovulatory: luteal phase
y Day 15- day 28 y MOST CONSTANT 14 days after ovulation y Corpus luteum secretes Progesterone y If no fertilization, corpus luteum will become

corpus albicans then degenerate y Decreased estrogen and progesterone
Arellano University College of Nursing / CA 1 Cluster 3

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Fig. 19.11

Arellano University College of Nursing / CA 1 Cluster 3

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Hormonal cycle
1. Menstrual phase y Decreased Estrogen, decreased progesterone, decreased FSH and decreased LH 2. Proliferative/ Pre-ovulatory phase y Increased FSH and Estrogen in small amounts
Arellano University College of Nursing / CA 1 Cluster 3 286

Hormonal Cycle
3. Ovulatory phase y Increased FSH, Increased LH (surge) Increased Estrogen 4. Post ovulatory/luteal Phase y Increased Estrogen, increased progesterone, decreased FSH and LH
Arellano University College of Nursing / CA 1 Cluster 3 287

Arellano University College of Nursing / CA 1 Cluster 3

288

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