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Ana Physio Lecture in CA 1 Cluster 3 AUCN Legarda
Ana Physio Lecture in CA 1 Cluster 3 AUCN Legarda
Endocrine Sytsem
ENDOCRINE GLANDS
Figure 9.3
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 9.14
OXYTOCIN &
Pituitary gland
Master gland Located at the base of the brain Influenced by the hypothalamus Directly affects the function of other endocrine glands
The Pituitary Gland The optic chiasm passes over this structure
Is
divided into two partsparts- the anterior or adenohypophysis and the posterior or the neurohypophysis
Secretes the following: 1. Growth hormone 2. Prolactin 3. Gonadotrophins- LH and FSH Gonadotrophins 4. Stimulating hormones and trophic hormones ACTH TSH MSH
the thyroid hormones by the thyroid follicles: 1. Tri-iodothyronine or T3 Tri2. Tetra-iodothyronine or Tetrathyroxine or T4
The PHYSIOLOGY of the Endocrine System: Parathyroid gland Secretes PARATHYROID hormone (PTH) that controls calcium and phosphorus levels PTH is stimulated by a DECREASED Calcium level
ADRENAL CORTEX
Secretes three types of STEROID hormones: 1. Glucocorticoids- like GlucocorticoidsCortisol, cortisone and corticosterone
The PHYSIOLOGY of the Endocrine System: Adrenal Cortex 2. Mineralocorticoids- like MineralocorticoidsAldosterone 3. Sex hormones- like hormonesestrogen and testosterone
The PHYSIOLOGY of the Endocrine System: Adrenal Medulla Essentially a part of the SYMPATHETIC autonomic system Secretes Adrenergic Hormones: 1. Epinephrine 2. Nor-epinephrine Nor-
PANCREAS Insulin Glucagon TESTES AND OVARIES Testosterone Progesterone Estrogen THYMUS Thymosin PINEAL GLAND Melatonin
Respiratory System
The respiratory system consists of two main parts- the upper and the lower partstracts
Respiration is the process by which oxygen enters the body and is utilized by the cells for their metabolic processes. It essentially involves five interdependent steps. Ventilation refers to the entry of air containing oxygen and other gases into the lungs. Ventilation is followed by the diffusion of gases from and into the alveoli and alveolar sacs. Oxygen from the alveoli passes through the respiratory membrane and enter the perialveolar capillaries, while carbon dioxide from the capillaries diffuses through the respiratory membrane to leave the lungs by means of exhalation.
Circulation makes it possible for oxygen to reach the distant tissues, and for carbon dioxide to travel from the tissues back into the lungs. The fourth component of the respiratory process involves another diffusion of gases, this time gases, involving the entry of oxygen into target tissues, and the entry of carbon dioxide into the blood stream for delivery back into the lungs. Cell metabolism and respiration are the final steps of the respiratory process wherein oxygen is utilized by the cells, and carbon dioxide, along with other waste products, is produced.
The UPPER respiratory system consists of: 1. nose 2. mouth 3. pharynx 4. larynx
The LOWER respiratory system consists of: 1. Trachea 2. Bronchus 3. Bronchioles 4. Respiratory unit
The Nose
contains nasal bones and cartilages and numerous hairs called vibrissae There are numerous superficial blood vessels in the nasal mucosa
The Nose
The functions of the nose are: 1. To filter the air 2. To humidify the air 3. To aid in phonation 4. Olfaction
The pharynx
The pharynx is a musculomusculomembranous tube that is composed of three parts 1. Nasopharynx 2. Oropharynx 3. Laryngopharynx
The pharynx
The pharynx functions : 1. As passageway for both air and foods (in the oropharynx) 2. To protect the lower airway
Tonsils
pair of prominent masses of lymphoid tissue that are located opposite each other in the throat
The larynx
Also called the voice box Made of cartilage and membranes and connects the pharynx to the trachea
The larynx
Functions of the larynx: 1. Vocalization 2. Keeps the patency of the upper airway 3. Protects the lower airway
These are four paired bony cavities that are lined with nasal mucosa and ciliated pseudostratified columnar epithelium Named after their location- frontal, locationethmoidal, sphenoidal and maxillary
1. Trachea 2. Main bronchus 3. Bronchial tree 4. Lungs- 3R/ 2L LungsThe trachea to the terminal bronchioles is called the conducting airway The respiratory bronchioles to the alveoli is called the respiratory acinus
The trachea
A cartilaginous tube measures 10-12 10centimeters Composed of about 20 C-shaped Ccartilages, incomplete posteriorly
The trachea
The function of the trachea is to conduct air towards the lungs The mucosa is lined up with mucus and cilia to trap particles and carry them towards the upper airway
The Bronchus
The right and left primary bronchi begin at the carina The function is for air passage
The bronchioles
The primary bronchus further divides into secondary, then tertiary then into bronchioles The terminal bronchiole is the last part of the conducting airway
The respiratory acinus is the chief respiratory unit It consists of 1. Respiratory bronchiole 2. Alveolar duct 3. alveolar sac
The function of the respiratory acinus is gas exchange through the respiratory membrane
The respiratory membrane is composed of two epithelial cells 1.The type 1 pneumocyte- most pneumocyteabundantabundant- where gas exchange occurs 2. The type 2 pneumocyte- secretes pneumocytelung surfactant
A type III pneumocyte is just the macrophage that ingests foreign material and acts as an important defense mechanism
Accessory Structures
The PLEURA Epithelial serous membrane lining the lung parenchyma Composed of two parts- the visceral and partsparietal pleurae Pleural space
Accessory Structures
The Thoracic cavity The chest wall composed of the sternum and the rib cage The cavity is separated by the diaphragm, the most important respiratory muscle
Pleural Cavities
Costodiaphragmatic recesses : Spaces in the pleural cavities below each lung, superior to the diaphragm.
Gas exchange through ventilation, external respiration and cellular respiration Oxygen and carbon dioxide transport
Accessory Structures
The Mediastinum The space between the lungs, which includes the heart and pericardium, the aorta and the vena cavae.
Mechanics of Ventilation
INSPIRATION EXPIRATION
respiratory muscles contract Respiratory muscles relax (diaphragm,intercostal m.) Decreased thoracic diameter increased thoracic diameter Decreased pressure Air goes out Air goes in
Increased pressure
Mechanics of Breathing
InspirationInspirationexpiration cycle is measured in cpm (cycles per minute) Normal adult RR: 1414-20cpm Children 20-30 20cpm Infants 40-60 40cpm
There are four pulmonary volumes: tidal volume, inspiratory reserve volume, expiratory reserve volume, volume, and residual volume. volume. The tidal volume refers to the volume of air that goes into and out of the lungs during normal respiration (about 500 cc). The inspiratory reserve volume is the amount of air that can be inspired forcefully after inspiration of the normal tidal volume (about 3000 cc). The expiratory reserve volume is the additional amount of air that can be expired forcefully (about 1100 cc).
The residual volume is the volume of air left in the lungs after maximum expiration. This is also known as dead space (about 1200 cc). The pulmonary capacities refer to the sum of two or more pulmonary volumes. The vital capacity is the sum of the IRV, the TV and the ERV. It is the maximum volume of air that a person can expel from his respiratory tract after a maximum inspiration (about 4600 cc). VC = IRV + TV + ERV
The inspiratory capacity is the amount of air that a person can inspire maximally after a normal expiration (about 3500 cc). IC = TV + IRV The functional residual capacity is the amount of air remaining in the lungs at the end of a normal expiration (about 2300 cc). FRC = ERV + RV The total lung capacity is the sum of all the lung volumes (about 5800 cc).
IRV IC VC TV ERV
MAXIMUM EXPIRATION
FRC RV RV
Regulation of Respiration
RESPIRATORY CENTER in the BRAINSTEM. - activated by dec ph CO2 + H20 H2CO3
CAROTID AND AORTIC CHEMORECEPTORS - help regulate breathing - High [pCO2] or low [pO2] ---chemoreceptors ---chemoreceptors ---medulla ---medulla and pons to inform the phrenic nerve Phrenic nerve stimulates the diaphragm to contract
Breathing Patterns
BIOTS: breathing with irregularly alternating periods of apnea and hyperpnea e.g.meningitis and brain disorders that cause ICP
CHEYNE-STOKES: CHEYNE-STOKES: common but usually abnormal periods of apnea lasting 10-60 10seconds followed by gradual increase then decrease e.g. frontal lobe and diencephalic dysfunction
Breathing Patterns
COGWHEEL respiratory murmur, not continuous but broken into waves e.g. bronchitis and possible TB
Circulatory System
Heart
complex muscular pump Size of a clenched fist Beats 60-100 per minute 60The heart pumps about 7200 liters/day.
Endocardium innermost layer Myocardium middle, thickest; contracting layer Epicardium outer layer
1. 2.
4 chambers 2 atria act as collecting reservoirs. 2 ventricles act as pumps. 4 valves for: Pumping action of the heart. Maintaining unidirectional blood flow.
PAPILLARY MUSCLES - found within the chamber walls Extend into CHORDAE TENDINAE attached to valves
Blood Vessels
1. Right coronary artery a. posterior interventricular b. marginal artery - RA, RV, inferior portion of the LV, the posterior septal wall and AV (90%) and SA node (55%)
anterior interventricular circumflex arteries LA and the post. LV Left ant. descending artery ant. wall of the LV, the anterior septum and the Apex of the left ventricle
3. cardiac veins -drain into the coronary sinus w/c in turn drain into right atrium
Neural regulation autonomic nervous system SympatheticSympathetic- accelerates & strengthen heartbeat\ heartbeat\ ParasympatheticParasympathetic- slows down
Conduction system
Electrical Conduction System/Nodal System - network of nerve fibers coordinate the contraction and relaxation of the cardiac muscle tissue to obtain an efficient, wave-like wavepumping action of the heart.
CARDIAC CYCLE
sequence of events that occur when the heart beats SystoleSystole- diastole cycle
Left LUNGS LA mitral valve opens LV mitral valve closes LV muscles contract AV opens aorta distribution Right BODY RA tricuspid valve opens RV tricuspid valve closes RV muscles contract pulmonary valves open lungs
HEART SOUNDS
Aortic valve: second ICS(intercostal space) R PSL(parasternal line) Pulmonic valve: second ICS L PSL Tricuspid valve: fourth ICS L PSL Mitral valve: fifth ICS L MCL(midclavicular line)
STROKE VOLUME amount of blood ejected per heartbeat HEART RATE affected by ANS, baroreceptor activity, cathecolamines, thyroid hormone CARDIAC OUTPUT - amount of blood pumped out by each ventricle in 1 minute - product of heart rate and stroke volume
STROKE VOLUME
1.
Preload degree of stretch at the end of diastole Inc volume inc stretch inc preload greater contraction and inc stroke volume
2. Afterload amount of resistance to ejection of blood from ventricle Also called systemic vascular resistance Inverse relationship with stroke volume 3. Contraction- force generated by contracting Contractionmyocardium
ECG INTERPRETATION
P wave- arterial depolarization wave- indicate SA node function - normal: 0.04-0.11 0.04PR wave interval- indicate AV node intervalconduction - normal: 0.12-0.20 0.12QRS complex- ventricular complexdepolarization - normal: 0.06-0.10 0.06-
ECG INTERPRETATION
ST segment- indicates time between segmentcomplete depolarization and repolarization of ventricle T waves- venticular repolarization waves-
The lymphatic system collects the extravasated fluid from the tissues and returns it to the blood
Slide 11.23
Pulse
y Pulse pressure wave of blood y Monitored at pressure points where pulse is easily palpated
Figure 11.16
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 11.35
Blood components
Formed elements: RBC WBC Platelets Unformed plasma
Slide 10.6
NV: RBC:4.0RBC:4.0-5.5 (F) 4.54.5-6.2 (M) hgb:12hgb:12-14 (F) 1414-16 (M) Hct- 35Hct- 35-45 (F) 42-52 42(M)
Hemoglobin
y Iron-containing protein y Binds strongly, but reversibly, to oxygen y Each hemoglobin molecule has four oxygen binding sites y Each erythrocyte has 250 million hemoglobin molecules
Slide 10.7
Slide 10.8
1. granular leukocytes a. neutrophil 60-70% 60- primary line of cellular defense against bacterial invasion b. eosinophil 2-5 % - inc in allergic reaction c. basophil 0-1 % -supplement function of mast cells
2. agranular leukocytes a. lymphocytes: B and T lymphocytes 202030% - respond to invasion of the body by foreign substances and organism, newer phagocytes b. monocyte 3-8%
c. Platelets/Thrombocytes - 150,000 450,000 per cu mm blood - Thromboxane A2 plug formation - Prostacyclin platelet plug promotes platelet
limits formation of
Hematopoiesis
y Occurs in bone marrow y All blood cells are derived from a common stem cell (hemocytoblast) y Hemocytoblast differentiation
y Lymphoid stem cell produces lymphocytes y Myeloid stem cell produces other formed elements
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 10.14
Fate of Erythrocytes
y Unable to divide, grow, or synthesize proteins y Wear out in 100 to 120 days y When worn out, are eliminated by phagocytes in the spleen or liver y Lost cells are replaced by division of hemocytoblasts
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 10.15
Slide 10.16
Slide 10.31
The lymphatic system consists of lymph, lymph vessels, lymphocytes, lymph nodes, tonsils, the spleen and the thymus gland. It maintains tissue fluid balance in tissues, absorbs fats from the small intestine, and defends against foreign substances.
Lymph vessels carry lymph away from tissues. Valves in the vessels ensure the oneoneway flow of lymph. Skeletal muscle contraction, contraction of lymph vessel smooth muscle, and thoracic pressure changes move the lymph through the vessels. The thoracic duct and the right lymphatic duct, duct, empty lymph into the blood.
Lymphatic tissue produces lymphocytes when exposed to foreign substances, and it filters lymph and blood. The tonsils protect the openings between the nasal and oral cavities and the pharynx. Lymph nodes, located along lymph vessels, filter nodes, lymph. The white pulp of the spleen responds to foreign substances in the blood, whereas the red pulp phagocytizes foreign substances and worn out erythrocytes. The spleen also functions as reservoir for blood. The thymus processes lymphocytes that move to other lymphatic tissue to respond to foreign substances.
NonNon-Specific Immunity
MECHANICAL MECHANISMS Skin and mucous membranes Tears, saliva and urine CHEMICAL Lysozyme in tears Complement in plasma Interferon
NonNon-Specific Immunity
CELLULAR Chemotaxis Neutrophils Macrophages Basophils and mast cells Eosinophils INFLAMMATORY RESPONSES
Specific Immunity
ANTIGENS are molecules that stimulate specific immunity. B cells are responsible for humoral immunity. T cells are responsible for cell-mediated cellimmunity.
AntibodyAntibody-Mediated Immunity
ANTIBODIES are proteins. It has a variable region and a constant region. The variable region combines with antigens and is responsible for antibody specificity. The constant region activates complement or attaches the antibody to cells. The five classes of antibodies are IgG, IgM, IgA, IgE, and IgD. IgE, IgD.
AntibodyAntibody-Mediated Immunity
Antibodies directly inactivate antigens or cause them to clump together. They indirectly destroy antigen by promoting phagocytosis and inflammation. The primary response results from the first exposure to an antigen. B cells form plasma cells, cells, which produce antibodies, and memory cells. The secondary (memory) response results from exposure to an antigen after a primary response. Memory cells quickly form plasma cells and memory cells.
CellCell-Mediated Immunity
Exposure to an antigen activates cytotoxic T cells and produces memory cells. Cytotoxic T cells lyse virus-infected cells, virustumor cells, and tissue transplants. Cytotoxic T cells produce lymphokines which promote inflammation and phagocytosis.
Acquired Immunity
ACTIVE NATURAL IMMUNITY Exposure to an infectious agent ACTIVE ARTIFICIAL IMMUNITY Vaccination PASSIVE NATURAL IMMUNITY Transplacental transfer of antibodies PASSIVE ARTIFICIAL IMMUNITY Immunization
PRINCIPAL DIVISIONS:
1. Central Nervous System (CNS)
a.
brain & the spinal cord control mechanism for the entire organism
The Neuron
functional unit dendrites receive neural msgs & transmit towards cell body axon transmits neural msgs away from cell body cell body contains nucleus, mitochondria, & other organelles myelin & cellular sheath produced by Schwann cells nodes of Ranvier
TYPES OF NEURONS
Sensory neurons typically have a long dendrite and short axon, carry messages from sensory receptors central nervous system. system. Motor neurons have a long axon and short dendrites, transmit messages from central nervous system muscles (or to glands). Interneurons are found only in the central nervous system where they connect neuron to neuron.
nerve a large bundle of axons wrapped in CT tracts or pathways bundle of axons within the CNS ganglia aggregation of nerve cell bodies w/in the PNS nuclei collection of cell bodies w/in the CNS
Reflex Action
simplest example of a neural response predictable, automatic response to stimuli 4 processes: -reception of the stimuli, - transmission of information, -integration (interpretation & determination of appropriate response), & - actual response
weighs about 3 pounds (1300-1400 (1300g). At birth, the human brain weighs less than a pound (0.78-0.88 (0.78pounds or 350-400 350g). The human brain reaches its full size at about 6 years of age.
BRAIN
2% of the body's weight, it uses 20% of the oxygen supply gets 20% of the blood flow. If brain cells do not get oxygen for 3 to 5 minutes, they begin to die. Cerebrospinal fluid (CSF) surrounds the brain.
Spinal Cord
Spinal nerves 31 pairs Posterior roots- Efferent(motor) rootsAnterior roots- Afferent(sensory) roots-
made up of the sense organs, the sensory neurons, & the nerves that link the CNS with the effectors 2 systems:
1. somatic system responsible for body balance in relation to outside world 2. autonomic system responsible for internal body balance
Cranial Nerves
12 pairs emerge from the brain transmit information from sense receptors to the brain
I-olfactory- sensory for smell olfactory II- optic-sensory for vision II- optic III-oculomotor- motor to III-oculomotorSR,IR,MR &IO; to internal eye ms which controls lens shape and pupil size IV- motor to SO IV VI- motor to LR VI V- Trigeminal-sensory to skin Trigeminalof face, motor to ms of chewing
VII-FacialVII-Facial- motor to mS of facial expression, senory to taste(ant. Tongue) VIIIVIII- sensory to hearing and balance IX- glossopharyngealIX- glossopharyngeal- motor to pharynx & saliva production, sensory to tase( post. Tongue) X- Vagus- sensory & motor to pharynx, Vaguslarynx, abdominal and thoracic viscera XI- AccessoryXI- Accessory- motor to sternocleidomastoid and trapezius XII-HypoglossalXII-Hypoglossal-motor and sensory to tongue
senses
EYE structures
1. 2. 3. 4. 5. 6. 7. 8. 9.
Pupil Conjunctiva Cornea Sclera Choroid Iris Ciliary body Lens aqueous chamber aqueous humor
10. vitreous chamber 11. vitreous humor 12. Retina 13. rods & cones 14. optic nerve 15. optic disc 16. macula 17. fovea centralis
CORNEA
the transparent, avascular layer that covers the iris & the pupil at the front of the eye frequently referred to as the window of the eye function: to bend, or refract the rays of the light
Sclera
the white of the eye tough, fibrous, connective tissue that extends from the cornea on the anterior surface of the eyeball to the optic nerve
Choroid
a layer inside the sclera made of black pigment cells that absorb light rays so that they are not reflected back rich in blood vessels that supply nutrients to the eye
Iris
the colored portion of the eye that surrounds the pupil smooth ms constrict the pupil in bright light & vice-versa vicecolor is determined by the amount of pigment present (blue has the least, brown has the most)
located on each side of the lens, contains ms that can adjust the shape & thickness of the lens lens is a clear, crystalline body that may be thinned or flattened for distant vision & thickened for close vision refractive power of the lens is called accommodation
the lens lies at the rear of the anterior chamber filled with a fluid called aqueous humor that maintains shape & nourishes the structures within behind the lens is the vitreous chamber that is filled with a soft, jelly-like jellymaterial, the vitreous humor
Retina
the thin, delicate, and sensitive nerve layer of the eye contains specialized sensory cells, the rods & cones
rods: rods: 120M, for vision in dim light or darkness & peripheral vision cones: cones: 6.5M, for vision in bright light, color vision, & central vision
cones are most concentrated in the fovea centralis and is the region of sharpest vision
light energy, when focused on the retina, causes a chemical change in the rods & cones nerve impulses travel to the brain via optic nerve region where optic nerve meets the retina is called optic disc ( also known as blind spot due to absence of rods & cones)
Eye
Ears
Eustachian Tube
connects the middle ear & the external environment through the throat equalizes the pressure on the two sides of the eardrum susceptible to bacterial infection middle ear infection
Nose
Nose
TASTE
The sense of taste is perceived through the taste buds on the tongue and in various parts of the mouth. average of 10,000 taste buds in the normal adult mouth. As an individual gets older the number of taste buds gradually decreases. The taste buds are able to discriminate among four primary tastes: sweet, sour, salty, and bitter. bitter. Both the facial (CN VII) and the glossopharyngeal (CN IX) nerves transmit the sensory input to the brain.