ANATOMY AND PHYSIOLOGY

I. THE HUMAN BODY

Specialized cells are structurally and functionally integrated to form an organism.
 Anatomy: the study of the structure of the living organism.
 Physiology: the study of the function of the living organism
- Development of the electron microscope greatly enhanced the study of molecular biology.
- Water, the fluid medium of the body, accounts for about 65% of the body weight. Three fourths is within the
cells(intracellular fluid) and most of the remainder is between cells(interstitial fluid). The smallest portion is in the
vascular system.
- Homeostasis refers to maintaining the “steady state conditions of the body by coordinated physiological processes.
Among the homeostatic control mechanisms are those maintaining normal concentrations of blood constituents,
body temperature, volume and pH of the body fluids, blood pressure and heart rate.
All homeostatic control mechanisms operate by negative feedback.
 Coordination of the body is primarily under nervous and hormonal control.

II. ORGANIZATION OF THE BODY

 Four basic reference systems of organization are described:
- Direction: All descriptions of location or position assume the body to be erect and facing forward, with the arms at
the sides and the palms anterior. This is the so called anatomic position. Directions include superior, inferior,
anterior, posterior, cephalad, medial, lateral, proximal and distal. Definitions of parietal and visceral are important
also.
- Planes: The body is discussed with respect to planes passing through it; these are the Midsagittal, Sagittal,
Horizontal and Frontal planes.
- Cavities: Ventral – subdivided into thoracic (further divided into pleural and pericardial) and the abdominopelvic
cavities.
Dorsal – divided into the cranial and spinal cavities. The dorsal cavities
contain structures of the nervous system.
- Structural Units:
1. The cell: All living matter is composed of cells and cell products. The cell carries out all activities essential for
maintaining life.
2. Tissue: Composed of cells and intercellular substance. Cells of a tissue are similar in appearance, function and
embryronic in origin. The four types of tissues are epithelial, connective, muscle and nervous.
3. Organs: a group of tissues serving a common function brought together to form a single structure, such as the
heart and lungs.
4. System: Cells, tissues, organs combine to form a system. The body contains the following major systems; skin,
skeletal, articular, muscular, nervous, circulatory, respiratory, digestive, urinary, endocrine and reproductive.

III. BASIC CHEMISTRY AND THE CHEMICAL CONSTITUENTS OF LIVING MATTER

 All matter is composed of elements, each of which is a collection of atoms, an atom representing the smallest
particle that retains the element’s properties.
 Combination of two or more atoms of different elements form compounds. The smallest unit retaining the properties
of a compound is a molecule.

Moles, Equivalents, Molar and Equivalent Concentrations

- One mole of a compound is equal to its molecular weight expressed in grams.
- The number of moles per liter of a compound in solution is its molar concentration.
- An equivalent of an atom, the amount that replaces or combines with 1 gram of hydrogen, is calculated as the atomic
weight divided by its valence.
- The number of equivalents per liter of an ion in solution is its equivalent
concentration.

Electrolytes
- An electrolyte is a substance whose solution contains ions and conducts electricity.
- Strong electrolytes ionize almost completely; weak electrolytes ionize only slightly.
- Free ions are present in solutions of salts, acids and bases.
- An acid is a proton(hydrogen ion) donor; a base is a proton acceptor.

pH
- pH is defined as the negative logarithm of hydrogen ion concentration of a solution.
- A solution with a pH of 7 is neutral. An acidic solution has a pH of less than 7; a basic solution has a pH of greater than
7.
 Chemical Reactions
- In oxidation-reduction reactions, the loss of electrons(or increase in oxidation number) is an oxidation and the gain of
electrons(or decrease in oxidation number) is a reduction.
*Removal of hydrogens is equivalent to oxidation, accepting hydrogens is equivalent to reduction.
- A reaction joining two molecules in which a small molecule such as water, is split out between them is called a
condensation reaction.
- Degrading substances with the addition of water is called hydrolysis.

IV. CHEMICAL CONSTITUENTS OF LIVING MATTER

 The most common organic compounds are classified as a) proteins, b) carbohydrates, c) lipids and d) nucleic acids
and nucleotides. Inorganic substances include water; acids, bases and salts dissolved in body fluids; and salts
deposited in bones and teeth.

Proteins
- They serve among other things, as enzymes, major components of cell membranes, the contractile elements of
muscle, hormones, receptor, antibodies, oxygen carriers, blood clotting factors, a source of energy, and part of the
intercellular fabric of connective tissues.
- They are composed of amino acids linked together into long chains.
- The peptide bond which link two amino acids, is formed by a condensation reaction in which water is split out between
amino group of one amino acid and carboxyl group of another.
- Proteins have one or more polypeptide chains, each having a specific number and sequence of amino acids and
characteristic shape.
- The major protein types, based on shape, are fibrous, in which the chains are linear, and globular, in which the chains
are folded into compact shapes.
- The primary structure of protein is the number and sequence of amino acids in its one or more polypeptide chains;
secondary structure is some regular arrangement of the chain, most commonly a coiling(helix); tertiary structure is the
way polypeptide chains are bent and folded in globular proteins.

Carbohydrates
- They include sugars and starches and were so named because in those originally studied hydrogen and oxygen and
oxygen atoms were linked to carbon atoms in the same ratio as water.
-The monosaccharide glucose is an important nutrient and supplies most of the energy needs of the body during the
absorption of a meal.
*Glucose is the building block of glycogen, a polysaccharide stored principally in the liver and the skeletal muscle.
- Mucopolysaccharides, heteropolysaccharides constructed from two different monosaccharide units, are the major
components of the ground substance of connective tissue matrices.
*The most abundant mucopolysaccharide is hyaluronic acid.
*Mucopolysaccharide combined with small
amounts of protein are called mucoproteins or proteoglycans.

Lipids
- Lipids are substances that readily dissolve in inorganic solvents such as ether. Those of major importance can be
described in four groups; triglycerides, phospholipids, sphingolipids and steroids.
*Triglycerides(fats): A combination of free fatty acids and glycerol. They are the major energy reservoir in the body.
*Phospholipids: Resemble triglycerides, differing by one of the fatty acids replaced by hydrophilic head consisted of
a phosphate group combined with another group, generally a nitrogen containing base. They are major components
of cell membranes.
*Sphingolipids: Have in common a long tail containing sphingosine(or a derivative) combined with tail fatty acid. Are
components of cell surface membranes and are found principally in the central nervous system.
*Steroids: Constructed from four carbon rings.
Cholesterol, the major one, is a component of cell surface membranes, and a precursor of vitamin D, bile acids, and
the sex and adrenal hormones.

Nucleic Acids and Nucleotides

- The nucleic acids consist of nucleotides linked together as long chains. Each nucleotide is composed of a 5 carbon
sugar, a phosphate group, and one of four nitrogen containing bases.
- DNA is the genetic matter of the cell.
- Messenger RNA, transfer RNA and ribosomal RNA participate in transferring information coded in DNA into the
synthesis of proteins.
- Two biologically active nucleotides are ATP and cyclic AMP.

Water
- Its solvent properties are accounted for by its dipole structure.
 - A number of other biologically important properties of water, including a high specific heat and high heat of
vaporization, are explained by internal cohesion due to formation of hydrogen bonds between water molecules.

Inorganic Substances Other than Water

- Ions of electrolytes dissolved in body fluids serve important functions. For example, the distribution of and shifts in the
concentration of sodium and potassium ions give rise to resting membrane potential and propagated impulses in nerve
and muscle tissue. Calcium ions regulate various cell functions by becoming reversibly bound to specialized proteins.
- Calcium salts deposited in the matrices of the bone and the dentin of the teeth contribute to the unique properties of
these tissues.

V. IMPORTANCE OF THE CELL

 The cell is the structural and functional unit of the body.
- The human body develops from a single cell, the fertilized ovum.

 The principal components of a cell are: a nucleus, containing the genetic material enclosed by a nuclear membrane; a
cytoplasm, the substance outside the nucleus, containing various organelles; and the cell membrane, enclosing the
entire cell.
- The cell membrane composed principally of the lipid bilayer penetrated partially or completely by interdispersed
proteins.
*regulates interchange between the cell and its environment.
*serves as a receptive surface for substances initiating adaptive changes within the cell.
- The cytoplasmic organelles, each enclosed by its own membrane, include the following:
*ribosomes- dense aggregates of RNA and protein, serving the site of protein synthesis.
*endoplasmic reticulum- a network of tubules
2 types:
1. rough endoplasmic reticulum
-with ribosomes scattered over the surface, functions in the synthesis of proteins that are packaged for
secretion or incorporation into lysosomes.
2. smooth endoplasmic reticulum
-functions in the synthesis of non protein substances
*golgi apparatus- saclike vesicles usually found in stacked piles. Completes the synthesis of packages
proteins to be secreted or retained in lysosomes.
*lysosomes- bodies containing digestive enzymes, which function, among other things, in the destruction of
harmful microorganisms following phagocytosis and the breakdown of extracellular matter, as in bone, to release the
stored calcium.
*mitochondria- the so called “powerhouses” where most of the cell’s ATP is synthesized.
*centrioles- paired structures that become the poles of the cell to which chromosomes migrate during cell division.

 Movement of substances across cell membranes is accomplished by;

* diffusion
* osmosis
* active transport
* pinocytosis
* phagocytosis

Energy Metabolism
- Energy metabolism is the degradation of nutrients by the cell, principally glucose and fatty acids, to produce energy
needed to perform such functions as muscular contraction, biochemical synthesis and active transport.
*The energy released by degrading nutrients is not utilized directly but is used to synthesize ATP from ADP,
and the energy contained in the high energy bonds of ATP, principally the terminal one, is the direct source of energy for
work performed by the cell.
*Glucose can be degraded either aerobically to carbon dioxide and water or anaerobically to lactic acid,
whereas fatty acids are degraded aerobically only.
*Maximum ATP yield is obtained by the breakdown of fatty acids, minimum by the anaerobic breakdown of
glucose.
*During the anaerobic breakdown of glucose, ATP is produced in only two steps, in which phosphate is
transferred from high energy compounds to ADP. When glucose is degraded aerobically, most of the ATP is produced by
oxidative phosphorylation, in which the synthesis of ATP is coupled with the transfer of electrons (removed from the
chemical intermediates in several steps) to oxygen via mitochondrial respiratory chain.

Chemical reactions under the conditions of temperature, pressure and pH existing in cells can take place because of
enzyme action.
- Enzymes act as biological catalysts, speeding the rates of reactions but remaining unchanged at the end of the
reaction.
  Cell Reproduction

Cell cycle
Cell cycle is readily observed in populations of continuously dividing cells, such as the skin and the intestines. A
period of growth (interphase) is followed by cell division (mitosis).

- During an interval of interphase known as the S phase, DNA replicates.

*Periods of growth occur prior to (called G1) and following (called G2) the S phase.
- Mitosis, the shortest period, can be divided into four stages: prophase, metaphase, anaphase and telophase.
*As a result of DNA synthesis during the S phase of interphase, each chromosome can be seen during the
prophase to be duplicated into two coiled strands.
*The strands separate and during the anaphase, migrate to opposite sides of the cell so that each daughter cell
receives the same number of chromosomes as the original parent cell.
- Meiosis is the two stage sequence of cell divisions that produces haploid of sex cells. There are 23 pairs of sex
chromosomes in the human body cells (diploid number) and half as many(haploid number) in sperm and egg cells.

 Cellular Genetics
- A gene can be described as a section of DNA containing coded information for the synthesis of a protein or a
polypeptide of a protein made of more than one polypeptide chain.
*The concept that genetic traits are transmitted from parent to offspring by discreet units (genes), each parent
contributing one for each trait, was introduced by Gregor Mendel over a century ago.
- DNA consists of two long strands, formed by alternating units of phosphate and deoxyribose, linked by complementary
pairs of bases(adenine joined to thymine, guanine to cytosine) spiral to form the so called double helix.
*The order of bases in an individual DNA strand determines the sequence of amino acids in proteins.
Sequences of three bases (triplets) code for each of the 20 amino acids constituting the building blocks of proteins.
*The code is carried from DNA to a ribosome in the cytoplasm by messenger RNA.
*The code reading vehicle, transfer RNA, binds and escorts specific amino acids to the ribosome so as to place
each amino acid in the order dictated by the triplet sequence in the messenger RNA.

 Genetic Biology
- Many clinical disorders result from a malfunctioning or missing enzyme or other protein caused by a defective gene.
- Some genetic diseases can be detected in early pregnancy by amniocentesis.
- Gene therapy, the replacement of the defective genes in humans, is the long range aim of recombinant DNA
technology.

 Cancer
- Cancer cells have escaped the normal mechanisms controlling normal cell division. Whereas in normal continuously
renewing tissues, only one of two daughter cells retains the capacity to divide(the other after replacing the dead cell, in
turn dies), in cancer populations all of the cells divide without restraint.

 Cell Differentiation
- During embryological development, cells come to differ in structure and function, and the specialized types become
organized into tissues.
- Differentiation is accomplished by switching genes off and on as a result of the binding and release of regulatory
proteins at specific sites on DNA.

 Tissues
Types of Tissues
1. epithelial
2. connective
3. muscular
4. nervous

 Epithelial Tissues
*Classified According to Shape
1. squamous
2. cuboidal
3. columnar

*Classified according to arrangement

1. simple, one cell layer
2. stratified, several cell layers
 3. pseudostratified, apparently several cell layers, but actually all cells are attached to the cell basement
membrane.
4. transitional, several layers of closely packed cells, easily stretched

*Named according to the layer on the free surface

1. simple squamous(surface layer of serous membranes, endothelial lining of the heart
and blood vessels and respiratory surface of the lungs)
2. simple cuboidal(many glands and ducts, kidney tubules, germinal covering of the
ovaries and the pigmented layer of the retina of the eye)
3. simple columnar(digestive tract)
4. simple ciliated columnar(bronchioles)
5. stratified squamous(epidermis)
6. pseudostratified columnar(ductus deferens)
7. pseudostratified ciliated columnar(nasopharynx, trachea and bronchi)
8. transitional(urinary tract)

*Classified according to function

1. surface layers of mucous membranes(overlying a layer of connective tissue) lining the digestive, respiratory,
urinary and reproductive tracts
2. glandular epithelium
3. endothelium, lining heart, blood vessels and lymphatics
4. mesothelium, the surface layers of the serous membranes(overlying a sheet of connective tissue), lining the
great cavities of the body, peritoneum, pericardium and pleura; they include a parietal portion(lining the cavity wall) and
the visceral layer(covering the organs). Epithelial tissues function in protection, absorption, secretion and excretion.

 Connective Tissue

- Characterized by widely separated cells and abundance of intercellular material consisting of glycoprotein fibers and
an amorphous ground substance composed principally of mucopolysaccharides.
*Supportive function to provide nourishment for overlying epithelial tissue, link muscle and bone as tendons,
allowing movement.
*Special functions in bone, teeth and reticuloendothelial(macrophage) system.
- Loose connective tissue
*Areolar tissue: the most widely dispersed connective tissue- fine, plicable, resistant, elastic; contains
fibroblast, macrophages, and mast cells. Areolar tissue is the basic supporting substance around the brain and
the spinal cord; it composes the superficial fascia.
*Adipose tissue: specialized areolar tissue with fat containing cells; adipose tissue act as a firm, resilient
packing around and between organs and between bundles of muscle fibers. In its subcutaneous location, it protects
the body from excessive heat loss and excessive increases in temperature.
*Reticular tissue: a framework of delicate, branching fibrils, found in the lymphoid organs, bone marrow and
the liver.

1.Dense Connective Tissue

*Contains closely packed collagenous and elastic fibers in regular array(tendons and ligaments) or irregular
array(the dermis).
*Where elastic fibers predominate(as in the walls of large arteries, the trachea and the bronchi), they
are referred to as elastic tissue.
- Specialized Connective Tissue
*Cartilage: yields a firm matrix between cells; cells of cartilage are called chondrocytes. There are
three types of cartilage;

a. Hyaline: The precursor of the skeletal system, during embryonic development much of it is gradually
replaced by bone through the process of ossification. At termination of bone growth, it remains on articular surfaces.
Also found in trachea, bronchi, larynx, costal cartilages and nose.
b. Fibrous: Contains dense masses of unbranching collagenous fibers lying in bundles. It is dense and
resistant to stretching. The cells are located in rows between the collagenous bundles.
c. Elastic: The most resilient type of cartilage; found in the auricles of the ear, auditory tube, epiglottis and
larynx.
* Bone: Firm structure of living tissue formed by the impregnation of the intercellular material with inorganic
salts. Bone is constantly being remodeled.
*Dentin: Dentin of the teeth is similar to bone. It is covered with enamel.
*Blood: A fluid tissue circulating through the body, carrying nutrients to cells and removing waste products.
*Hematopoietic Tissue: Red bone marrow is the blood forming(hematopoietic) tissue.
*Lymphoid Tissue: Found in lymph nodes, thymus, spleen, tonsils, and adenoids; unctions in immunity.
 *Reticuloendothelial System: Composed of connective tissue cells carrying on the process of phagocytosis.
Strong line of defense against infection.

 Muscle Tissue
- Three Types of Muscle Tissue:
1. Voluntary or Striated
2. Involuntary or Smooth
3. Cardiac

 Nervous Tissue
- Division of Nervous Tissue
* Nervous tissue proper, consisting of neurons, the specialized conducting cells.
* Tissue composed of various accessory cells(neuroglia).

 Tissue transplantation
- Types of Transplants
1. autotransplants
2. isotransplants
3. homotransplants
4. heterotransplants
- Transplanted tissues are usually rejected because the immune system recognizes proteins on the surfaces of cells of
the grafted tissue as foreign (histocompatibility antigens) and destroy the graft.
- Nature provides at least four exceptions to the concept that the skin grafts between individuals are invariably
destroyed.
*Identical twins accept grafts.
*Grafts between embryos are accepted.
*Patients with certain diseases accept grafts from each other.
*Chimeras accept grafts.

THE SKELETAL SYSTEM

 Functions of the Skeletal System
1. Providing a support for the body.
2. Protecting vital organs
3. Assisting in accomplishing body movements
4. Hematopoiesis
5. Providing a storage area for calcium

 Organization of the Skeletal System

- There are 206 bones in the skeleton
*The axial skeleton consists of the skull (cranium and facial bones), hyoid bone, vertebral column, ribs and
sternum.
*The appendicular skeleton consists of
1. the shoulder girdle and bones of the upper arm, forearm, wrist and the hands
2. The pelvic girdle and the bones of the thighs, legs, ankles and feet.

 Bone is a connective tissue consisting of cells and matrix composed of collagenous fibers embedded in a calcified
ground substance of which the principal constituents are mucopolysaccharides and salts which closely resemble the
structure of hydroxyapatite.

 Bone Cells
- Osteoblasts, active in synthesizing the bone matrix.
- Osteoclasts, functioning in bone resorption(breakdown of the matrix)
- Osteocytes, the principal cells of mature bone.
*Osteoblasts and Osteoclasts are responsible for the formation and the growth of bone but remain active
throughout life and repairing and remodeling fully formed bone.
*Osteocytes are Osteoblasts that become surrounded by bone matrix during bone formation.
>Although Osteocytes no longer rapidly synthesize matrix constituents, they are apparently involved in maintenance of
the matrix.
>Osteocytes participate also in bone resorption upon stimulation by the parathyroid hormone (part of the regulatory
mechanism for maintaining normal blood calcium)

 Types of Bone
- 2 types of bone are seen:
1. compact bone: dense and strong
 2. cancellous(spongy) bone: consists of plates of bone, called trabeculae which form open networks. The open (marrow)
spaces give the tissue a spongy appearance without the aid of a microscope.
- Classification of Bone
*Bones are identified as five types according to shape:
>Long bones(such as the humerus and tibia) consist of shaft(diaphysis) and two extremities, each called an epiphysis.
The inferior of the shaft has a marrow cavity(medullary canal). The shaft is composed largely of compact bone. The flared
ends of the shaft and each epiphysis, as well as the other bone types, consists of a central core of cancellous bone
surrounded by a thin layer of compact bone.
>Short Bones(such as the carpals and tarsals), not only shorter but also irregular in shape.
>Flat Bones(such as the ribs, scapula, parietal bones and pelvic bones)
>Irregular Bones(such as the vertebrae)
>Sesamoid Bones(such as the patella) are small rounded bones, enclosed in tendons and fascial tissue, found adjacent
to joints.

 Membranes of Bone
- Periosteum, a fibrous connective tissue, covers the outer surface of bone except at the
articular surfaces(which are layered with hyaline cartilage).
- Endosteum, a delicate connective tissue, lines all the cavities of bone, including the marrow spaces, marrow cavities and
Haversian canals.
- Both contain osteoblast precursor cells and therefore have osteogenic potentials.

 Bone Marrow
- In adults, the marrow spaces of the ribs, vertebrae, sternum, and pelvis contain red bone marrow.
*Functions in Hematopoiesis- the formation of the red and white blood cells and megakaryocytes(which
disintegrate to form platelets).
- The marrow cavities (medullary canals) of long bones are filled with yellow marrow (essentially adipose tissue).
 Histology of Bone
- The microscopic, functional unit of compact bone is known as the Haversian system.
*In each system, a central Haversian canal containing blood vessels is surrounded by concentric rings
of bone matrix called lamellae.
*Osteocytes lie between lamellae, each in a space called lacunae.
*Canaliculi connect lacunae with each other and with the central Haversian canal.
- The structure of the cancellous bone is sometime called incomplete Haversian system, since Osteocytes in the bony
plates reside in lacunae between lamellae and are interconnected by canaliculi.
*Haversian blood vessels are absent.
*The canaliculi communicate directly with the blood vessels of the endosteum.

 Bone Formation and Growth

- There are two types of bone formation.
*Intermembranous ossification: bone forms directly in the embryonic connective tissue.
*Endochondral ossification: a “scale model” of hyaline cartilage is replaced by bone.
- Most bone are formed by endochondral bone formation. Only the cranial bones are formed completely by
intermembranous ossification.
*In the endochondral process, the cartilage skeleton is formed in the embryo at the end of three months.
*During subsequent months, ossification and growth occur.
*When endochondral bone formation is completed, growth in length occurs in the epiphyseal, or growth plate, a
transverse disc of cartilage remaining between the epiphysis and diaphysis.
*The plate is widened by multiplication of cartilage cells, and cancellous bone replaces dying cartilage cells.
*Growth in width occurs by the deposition of compact bone beneath the periosteum and the enlargement of the
marrow cavity by bone resorption.
*Bone growth ceases when the growth plate is replaced by bone (epiphysis).

 Regulation of Bone Formation and Growth by Vitamins and Hormones

- Vitamin D now called a hormone increases the rate of calcium absorption from the intestine.
*In the deficiency condition, rickets in children and osteomalacia in adults, calcification of bone is
inadequate.
*The active substance (1,25 dihydroxyvitamin D3) is formed by the action of ultraviolet radiation on a
precursor on the skin, followed by subsequent changes in the liver and in the kidneys.
- Growth hormone: secreted by hypophysis
*Induces the liver to release a substance which stimulates proliferation of cartilage cells at the epiphyseal disc.
- Vitamin C is required for the synthesis of collagen.
- Thyroxine: secreted by the thyroid gland.
*Increases the rate of replacement of bone at the growth at the growth plate.
*Also required for the synthesis of growth hormone.
- Estrogens and androgens promote ossification and the maintenance of the bone matrix throughout life.
- Vitamin A stimulates the resorption of bone.

 Calcium Release from Bone

- Severe reduction in blood concentrations of calcium can cause:
1. muscular spasms
2. weakened cardiac muscle
3. deficiency in blood clotting
- Two hormones, the parathyroid hormones and calcitonin(secreted by the thyroid gland) regulate the release of calcium
from the bone.
*Low blood calcium can trigger the release of parathyroid hormone, which increases bone resorption, thereby
raising the concentration of blood calcium.
*High blood calcium stimulates the release of calcitonin. This hormone lowers blood calcium concentration by
inhibiting bone resorption.

 Fractures
- A break in a bone or cartilage is termed a fracture.
- A fracture can be compound or simple depending on whether or not the skin is broken.

- It is described as complete or incomplete depending on whether or not the fracture

extends partially or entirely through the bone.
- Classified according to direction, a fracture is transverse, longitudinal or spiral.
- In a comminuted fracture, the bone is divided into more than two fragments.
- The stages of fracture healing include:
1. clot formation
2. formation of dense fibrous tissue, which is converted to a fibrocartilagenous mass(temporary callus)
3. this in turn is converted to a bony callus
4. reconstruction of the bony callus into compact bone

 Vertebral Column Injuries

- Exaggeration of the spinal curvature are termed;
*Kyphosis- when the posterior curvature is accentuated in the thoracic area
*Lordosis- when the anterior curvature is accentuated in the lumbar region
*Scoliosis- when there is lateral curvature and rotation of the vertebrae
- The vertebral disc can become herniated when the outer covering(annulus fibrosus) ruptures owing to trauma and the
inner core(the nucleus pulposus) protrudes.

THE ARTICULAR SYSTEM

 Classification of Joints
- Traditionally the joints are grouped according to the degree of movement permitted;
1. synarthroses- immovable
2. amphiarthroses- slightly movable
3. diarthroses- freely movable
- On the basis of mechanical properties, the third group can be distinguished from the first two. In diarthroses, also
called synovial joints, the joint is enclosed in a fibrous capsule lined with a membrane (the synovial membrane) that
secretes a lubricant(the synovial fluid), and the lubricated articular surfaces slide over one another. Movement in the
other two types of joints, on the other hand, occurs between bones connected by fibrous tissue or cartilage.
- Fibrous and Cartilaginous Nonsynovial Joints
1. sutures- fibrous tissue unites bone
2. synchondroses- cartilage joins bone
3. symphyses- a fibrocartilage disc connects bone
4. syndesmoses- ligaments link bones
- Synovial Joints

*Anatomy of synovial joints:

1. Joint cavity enclosed by fibrous connective tissue, the joint capsule.
2. A vascular connective tissue, the synovial membrane, lining the capsule secretes a viscous lubricant, the synovial
fluid.
3. Articular cartilage covering the opposing surfaces of bone is lubricated with synovial fluid and provides a smooth
sliding surface.
4. Capsular ligaments strengthen joints and restrain motion.
5. Muscles maintain stability of joints by relaxation and contraction to keep articular surfaces in firm contact.
6. Articular discs, when present within the joints, serves to buffer shock.
- Types of Synovial Joints
1. ball and socket
2. hinge
3. pivot
4. ellipsoid
5. saddle
6. gliding

 Bursae
- Bursae are found in close proximity to joints and are usually associated with spaces between connective tissue.
- Bursae are closed sacs with synovial membrane lining.

 Disorders of Joints
- Bursitis is the inflammation of the synovial bursa. It may result from excess stress, local inflammation, or systemic
disease.
- Arthritis is the general term for inflammation of joints.
*The stages of rheumatoid arthritis are the inflammation of the synovial membrane, inward growth of the
pannus(thickened synovial tissue) along the surface of the articular cartilage, fibrous ankylosis and bony ankylosis.
*Gouty arthritis is a metabolic disorder of purine metabolism which leads to the depositing of urate crystals in
and around the joints.
- Degenerative joint disease comes from the prolonged wear and tear on joints. The articular cartilage degenerates,
becoming fitted, frayed, and eroded and outgrowths of bone form on the degenerating articular surfaces.
- Rheumatic disease is a disease in which the synovial tissues become inflamed and then rapidly return to normal.
- Primary fibrositis(rheumatism or lumbago) in the lower back region is an inflammation of the fibrous connective tissue
of joints.
- Tenosynovitis: The tendon sheaths become inflamed and may deter movement of the involved joints.