HAP1 Review

Exam
 All topics covered equally; based entirely on lectures and practicals; Anatomy; physiology in 4:6
 10 topics: 10 questions; one answer only for each Q
*Students do not do as well in this lecture (OPAL/PHIZZies; A&P; Quizlet.com)

Lecture 1 (Basics)
 Planes
 Cavities
 Anatomical position
 Terminology: Greek/latin prefixes/suffixes
 Core concepts
Cell communication
Diffusion
Gradients of temperature

Lecture 2 (Cells)
 Organelles
What they do, how and contribution; membrane nucleus, mitochondrion, lysosomes…
 Mitosis vs meiosis: cell division (sex or human body cells)
 Phases IPMAT
 Diffusion, osmosis, receptors and channels: biological and chemical structure
 Bonds: ionic, covalent, hydrogen, valency
 Organic vs inorganic
 DNA vs RNA
Roles of RNA
 Protein synthesis:
2 phases: transcription: copying DNA to mRNA
Translation: turning mRNA into protein via tRNA collecting aa and building protein in ribosome

**Lecture 3 (Tissue and skin)

 Major groups: epithelia, connective, muscle nervous
Categories and functions, how they form
 Skin functions: protection, excretion, metabolism, thermoregulation, sensation
 Cell types and functions: melanocytes, keratinocytes, Langerhans cells

Lecture 4 (Anatomy: Skeleton and bones)

 Axial vs appendicular skeleton
 Major bones that make main joints
 Structure/function: flat/long/short/irregular, histology
Lecture 5 (Joints between bones)
 Stability vs mobility
 Joint movements: diarthrotis, amphiathrotic, synarthrotic
 Joint classification: fibrous, cartilaginous, synovial
 Tendons/ligaments

Lecture 6 (Muscular anatomy)

 Main muscle groups(movement/function), anterior arm/quadriceps and main muscle names, main
movements
 Agonists, synergists and antagonists
 Classification: shape, size, fibre orientation

**Lecture 7 (Muscle physiology)

 Skeletal vs smooth vs cardiac
 Muscle anatomy: actin, myosin, coverings
 Muscle contraction:
Neural mechanisms: from lower neuromuscular junction to cross bridge; how nerves stimulate jucntion
Type: isometric/isotonic; eccentric/concentric; FO/FG/SO

Lecture 8 (Nervous system)

 CNS
 PNS (somatic)
 ANS(visceral motor): react very actively
 Symp NS: 4F’s; Parasymp NS: R&D
 Structure
 Brain, spinal cord
 Brain regions: forebrain(BG), Midbrain, Hindbrain
 Grey vs white matter
 5 cortical lobes: primary areas and function, secondary areas, sulci&gyri
Lecture 9 (Special senses)
 Receptors associated with ss: eyes, ears, nose, taste
 Pathways associated with detection of sight, sound, taste, smell
From brain to ss, vice versa
 Nerves involved

Lecture 10
 Glands and hormones
 Feedback loops
 Homeostasis
Sexual reproduction
Metabolism calcium
How they contribute to homeostasis

Problem areas
Nervous system divisions

Soma: controllable body; Autonomic: involuntary responses/reflexes (some called visceral: opposite soma)
 Sympathetic: extreme situations, dilate pupils and heart rate/bp increases, activate thyroid gland
Own set of ganglion; that has sympathetic chain all the way to either side of the spinal cord
like two small spinal cords:
-one shut down the tissues in the digestive system/stomach, increase bp in blood stream by changing
smooth muscles
-the other is muscle
 Parasympathetic: comfortable safe space, divert energy away from muscle to digestive system; like when
eating/sleeping
 Receive info from brain to spinal cord, out through parasympathetic preganglionic neuron to
ganglion(collection of cell bodies), that holds neurons that innervates tissues in the parasympathetic
system, like gastrointestinal tract, digestive tract

Neuromuscular junction (NMJ)

 Neuromuscular junction, where nerves meet the muscle fibre; but does not touch, synaptic cleft in btwn
 The mechanism of an electrical impulse transfer from the nerve to muscle via chemical movements; high
to low concentration
1. An action potential (AP) triggered by the brain and travels down to the end bowl
2. The shape of voltage-gated calcium channel is changed
3. Channels allow the Calcium to flush into the nerve fibre in the neuron
4. Calcium interact with synaptic vesicles inside
5. Vesicles fused with neurotransmitter Acetylcholine
6. When calcium hits the vesicles, they fused with base of neuron and release Acetylcholine into synaptic
cleft
7. Through diffusion from high to low conc., Acetylcholine fused with ligand-gated channel and they open
8. Sodium is allowed to enter through the channel into muscle fibre
9. Meanwhile, movement of potassium is allowed from same type of impulse and AP that moves along
the surface of the muscle (sarcolemma)
10. AP then moves from sarcolemma down to T-tubules, in contact with voltage-gated calcium channels
11. These channels release calcium into sarcoplasm(fluid)
12. Calcium then change the shape/conformation of myosin head on thick filament of muscle fibre
(sacromere)
13. Calcium comes in and change the shape of the actin, while ATP changes the shape of the myosin head
14. Myosin head binds to actin
15. Detached of ADP and phosphate from myosin head create a power stoke, where myosin pulls actin to
the centre of sarcomereSliding of filaments

Levers

Muscle spindle
 Collection of muscle structures/types of muscle fibres in the centre of skeletal muscle; but separate from
the rest with a thin membrane
Provide muscle with stretch reflex
Provide proprioception: ability to give nervous system information on muscle location/ how
contract/extend the muscle is in any given time
 Similar to fishing, afferent muscle fibres (line) must be tight
Fisherman (spinal cord/brain) could feel vibration (AP) thru line
that being sent to NS
When line are tighter, brain knows muscles are stretched
 If fibres go slack, take in line a bit to make it tense again
 Whole muscle flex/react to react pulling

The Nervous System

Terminology
 Afferent signals/fibres: Approach the CNS; Axons convey info to the CNS
 Efferent signals/fibres: Evade the CNS; Axons convey info away from the CNS
 Ganglion: collection of cell bodies in PNS with similar function
 Nucleus: collection of cell bodies in CNS with similar function
 Tract, funiculus, fasiculus, column: bundles of CNS axon in white matter
Associated with a-/de-scending pathways; or connecting brain cells
 Nerve: bundle of PNS only axons (cranial/somatic)
 Motor unit: lower motoneuron and associated muscle fibres
 Lower motoneuron: cell body in the ventral horn of spinal cord and axon innervates skeletal muscle
 Upper motoneuron: cell bodies in the forebrain/brainstem and axons activate lower motoneuron
 Somatic: of the body, voluntary(controllable) part of the ‘wall’ of the body
 Visceral: deep inner organs
 Grey matter: neuronal cell bodies (Ganglion)
 White matter: neuronal cell axons (Nerve), stems

CNS
Brain: Skull and Meninges
 Protected by skull
 Covered by meninges (membrane): three layered connective tissues
Dura mater (superficial, leathery): stabilize the position of the brain
Arachnoid mater (middle, cheese clot)
Pia mater (inner, thin membrane): separate CSF from brain cells; contain nerves and blood vessels
 Dural folds produce venous sinuses to drain blood from brain
Brain: Cortex
 Heavily folded surface of the brain
 Gyri(us): Inward folded brain tissues (ridges of cortex)
 Sulci(us): shallow grooves between gyri
 Fissures: deep grooves that separate brain regions
Longitudinal: sagittal; two halves
Lateral: Separate cerebrum, important for shape
Transverse
 Folding provide more space for cells and grey matter outside (higher computing power)

Main components of CNS

 Diencephalon (blue): deep in brain/core

 Cerebellum (red): cauliflower
Most movement are smoothed out and controlled
 Brainstem: three parts
Connects spinal cord to brain
Examples of homeostasis: heart rate, breathing, state of arousal
, response to light/environment
 Cerebrum: vast folded part; divided into lobes
Frontal: Movement; primary motor cortex; executive functions
Parietal: Somatosensory; sensation felt at voluntary part of body
Temporal: Hearing and memory; language perception
Occipital: Vision exclusivelyLimbic (tucked; medial side of hemisphere): Linking emotions and
memory (bad event/trauma)
Brain: Hemispheric specialization
 Left (categorical hemisphere): scientific, analytical and organisational brain
 Right (representational hemisphere): artistic, creative

Brain: Cerebral ventricles and CSF circulation

 Set of 4 linked chambers (2 lateral, third, fourth), empty space that filled with CSF (Cerebrospinal fluid):
Provide buoyancy and protection to brain: 1/30th of its actual weight (3-4 kg)
Transports nutrients, chemical messengers and waste produces
CSF freely exchanges with brain extracellular fluid
 CSF produced by choroid plexuses of each ventricle, at a constant rate over lifetime
 It flows around CNS and is reabsorbed into venous circulation via arachnoid villi that pierce dura
Bathed in CNS for thermoregulation
 It blockage in the ventricle, CSF is continually produced and result in hydrocephalus

Brain: Others
 Basal ganglia: collection of 5 nuclei involved in initiation and modulation of movements
 Thalamus (golf ball in core of brain of either side of 3rd ventricle): gateway to the cortex from rest of NS;
connect brain and body: receives input
 Hypothalamus (anterior+inferior to the thalamus): controls ANS function
Basically homeostasis: hunger, thirst, sexual feelings, hormone and temperature regulation
Directly connect to pituitary gland
 Corpus callosum: massive axon bundles, connect cerebrum hemispheres; bridge of frontal, parietal,
occipital lobes
If damage/absence: Split brain syndrome: no communication between left and right
-Language localization; strange ability to control inner side of their ability, like play diff. instruments
 Epilepsy: An intervention to cut corpus callosum into halves to stop epileptic seizures
 Cranial nerves (12 pairs): do not arise from spinal cord but from brain/brain stem
Governs all senses and function
Protect certain damages of spinal cord, like quadriplegic: injury in lower body

Spinal cord (31 pairs)

 Encased in vertebral column and meninges for protection
 Buffered by CSF for buoyancy and thermoregulation
 Extends to L2 vertebra only
 Different regions have specific functions

Anatomy
 Sensory nerve afferent: info enter dorsal root and synapse in dorsal hornSpinal cordBrain
 Motor afferent axons: BrainSpinal cordventral root to re-enter spinal nerve to reach muscles
 Ganglion: in spinal cord
 Vertebral foramen: hole where movement moves in and out of spinal cord
 Dorsal horn: neurons process afferent input from somatic and visceral tissue
 Ventral horn: motor output to skeletal tissue
 Lateral horn: ANS visceral motor output (Present at thoracic and sacral levels only)
 Grey matter: resembles butterfly, in distinct region inside, body; White matter: outside, axon
Functional organisation
 Homeostasis
Specify stimulus modality and location
Integrate centre for spinal reflexes
 Relay conduit
Impulse propagation to/from the brain via a/descending tracts; more processing/axons required
Different tracts located in different areas of white matter
-Tract name: where it starts and ends

Main afferent pathway

Main descending pathway

 Upper motoneurons (in cortex/brainstem)
Never innervate muscle
Simplest: stretch reflex
 Lower motoneuron (in brainstem/spinal cord)
 Corticospinal (in lateral funiculus)
Voluntary control of movement at frontal lobe, at spinomedullary junction

PNS
Spinal nerve anatomy
 Enter/exit via nerve at intervertebral foramen
 Formed by dorsal and ventral roots (except for cranial)
 Afferent: DRG; Efferent: in spinal cord
 Dorsal ramus: axons innervate muscles, skin and joints of the back
 Ventral ramus: innervate limbs (plexus), anterior trunk regions (intercostal nerves)
 Communicating rami: autonomic fibres, only in thoracic levels
31 pairs of spinal nerves
 Cervical (neck): 8
 Thoracic: 12
 Lumbar (legs): 5
 Sacral (pelvis): 5
 Coccygeal: 1
Important nerves arise from plexuses- Brachial Plexus, Lumbosacral plexus
Distribution of peripheral nerves of different plexuses

Dermatomes and Afferent peripheral Receptive Fields

 Area of skin innervated by a single spinal nerve
For clinically detect the nerve damaged underneath the skin that detect sensory signal using a pin
 Size of receptive fields depends on location; inversely proportional to proximodistal position on body
-smallest on body for sensory discrimination/finer touches, like finger/lips
-largest on axial body, like abdomen/back
RFs of individual afferents overlap, allows for 2 point discrimination
 Damage to sensory nerve produces changes in sensation of the relevant dermatome
 Myotome: muscles innervated by motoneurons of a single spinal segment

Peripheral nerves
 Surrounded by connective tissue
 Numerous fascicles that contain individual nerve fibres
Epineurium: outer covering of nerve
Perineurium: covers individual fascicles
Endoneurium: covers single axon cells
Physiology classification
 Myelin: cellular material that used to insulate nerve fibre, main speed of AP transmission
Fastest: thickly myelinated, Group 1/A-alpha that mediate postural reflexes
Slowest: unmyelinated, Group4/C
 Axon diameter is proportional to conduction velocity
Stimulation to perception
1. Transduction: Stimuli to electrical activity at sensory nerve endings
2. Transmission: Conduction along nerves and transfer to ascending pathways
3. Perception: Affective/motivation
4. Behaviour: Response

Reflex classification
 Reflex: simplest movement; involuntary, automatic, stereotyped reaction
 Employ reflex arc (neural circuits): one nerve in/out; no direct brain control but regulates size
 Require stimulus
 Difficult to suppress
 Muscle contraction
 4 types

Stretch reflexes: muscles stretched fight back: contract and increase tone
 Main posture and balance Constant tension
 Dynamic of agonist, synergists and antagonists
 When triggered, contraction on the side triggers a response on other side
Joint flexion triggers stretch reflex in extensor, then in flexors
Feedback control for stabilise joints and smooth muscle action

Muscle spindles responsible for stretch reflexes

 Sensory afferent; encapsulated: wraps around intrafusal fibres (separate structure with muscle fibre)
 Actual muscle within the spindle contracts, which maintain tension (tone) normally
 Proprioceptor detects change in muscle length (joint position) and object weight
Amount of stretch putting out
Longer stretch, more frequent AP
Unstretched: APs are generated at a constant rate in sensory fibre
Stretched: rate of APs increased, activates the spindle
 Muscle spindle has own motoneuron supply to intrafusal fibre
 Single spindle afferent synapses within an alpha/gamma motoneuron
Muscle spindle activates alpha motoneuron to contract extrafusal fibres
-If only alpha were activated, muscle slack and no APs/cannot get thru
-Because brain cannot detect position w/o signal of further length change
Tendon reflexes: knee-jerk reflex as an example
 Mediated by direct synaptic connection in spinal cord btwn sensory and motor neuron
 Monosynaptic: no interneurons involved, i.e. Stretch of quadriceps activates same muscle to contract
6 monosynaptic reflexes in our body:
-Biceps, Triceps, Supinator, Quadriceps, Achilles, Masster
Brain controls magnitude of reflex and whether you are aware of reflex
-Distraction: jendrassic manoeuvre
 Reciprocal inhibition: activation of extensor contraction inhibits the antagonist flexor
Via an inhibitory interneuron

Other reflexes: Flexion reflexes

 Polysynaptic reflex: involving several excitatory/inhibitory interneurons
Facilitate withdrawal from painful stimulus in extreme circumstances
 Like foot stepped away from a pin, shifts of weight to another foot
 Reflexes give information about health of body
Monosynpatic: info about specific spinal cord segment
 PNS damage: decreases reflex size
 CNS damage: increases reflex size, like Bakbinski sign/hyper-reflexia

ANS: visceral motor system

 For homeostasis in digestion, respiration, circulation, secretion, body temp., sexual fn via reflexes
Mainly visceral organs of anterior cavities, like vessels, hair and sweat gland
 Not under conscious control from brain
 Regulated by hypothalamus and brainstem
 Functions are largely antagonistic
 Parasympathetic (RD: Rest and digest): Divert blood from skeletal to gastric muscle under comfort
 Sympathetic (4F:Fight & flight): Divert blood from internal organ to skeletal muscle under stress

Parasympathetic vs sympathetic

Sympathetic anatomy
 Separate chain of nerves down spinal cord
T1-L2: preganglionic motoneurons (Axon: white ramus/thinly mylination)
-Project to sympathetic chain ganglia adj. to vertebrae
Chain gangalia: postganglionic motoneurons (Axon: grey ramus/unmyelianted)
-Project to target organs, blood vessels and skin

Parasympathetic anatomy
 Cranial and sacral nerves
 Slow heart rate: bradycardia and decrease contraction force
 Constrict airway: bronchoconstriction