Anatomy

(2-mark)

1. Homeostasis

Homeostasis is the process by which physical and chemical conditions within the
internal environment of the body are maintained within tolerable ranges even when
the external environment changes.

The body can regulate its internal environment through many feedback systems; a
feedback system includes 3 basic components receptor, control centre and effector.
A group of receptor and effectors communicating with their control centre forms a
feedback system that can regulate a controlled condition in the body’s internal
environment. If a response reverses the original stimulus, the system is operating
by negative feedback. If a response enhances the original stimulus, the system is
operating by positive feedback.

2. Cell

The cell  is the basic structural, functional, and biological unit of all known living
organisms. Cells are often called the "building blocks of life". The study of cells is
called cell biology or cellular biology.
Cells consist of cytoplasm enclosed within a membrane, which contains
many biomolecules such as proteins and nucleic acids.[2]Organisms can be
classified as unicellular (consisting of a single cell; including bacteria)
or multicellular (including plants and animals).[3] The number of cells in plants and
animals varies from species to species, it has been estimated that humans contain
somewhere around 40 trillion (4×1013) cells.
3. Tissues
Tissues are groups of cells that have a similar structure and act together to perform
a specific function. There are four different types of tissues epithelial, connective,
muscle, and nervous
Epithelial tissue, refers to the sheets of cells that cover exterior surfaces of the
body, lines internal cavities and passageways, and forms certain
glands. Connective tissue binds the cells and organs of the body together and
functions in the protection, support, and integration of all parts of the
body. Muscle tissue is excitable, responding to stimulation and contracting to
provide movement, and occurs as three major types: skeletal (voluntary) muscle,
smooth muscle, and cardiac muscle in the heart. Nervous tissue allow the

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propagation of electrochemical signals in the form of nerve impulses that

communicate between different regions of the body 
4. Types of muscles and their role?

A muscle is a group of muscle tissues which contract together to produce a force.

A muscle consists of fibers of muscle cells surrounded by protective tissue,
bundled together many more fibers, all surrounded in a thick protective tissue. A
muscle uses ATP to contract and shorten; producing a force on the objects it is
connected to. There are 3 types of muscles in the body:  skeletal or striated,
cardiac, and smooth. 
Muscle action can be classified as being either voluntary or involuntary. Cardiac
and smooth muscles contract without conscious thought and are termed
involuntary, whereas the skeletal muscles contract upon command.
Skeletal muscle- Skeletal muscles are the only muscles that can be consciously
controlled. They are attached to bones, and contracting the muscles causes
movement of those bones. Any action that a person consciously undertakes
involves the use of skeletal muscles. Examples of such activities include running,
chewing, and writing.

Smooth muscle- Smooth muscle lines the inside of blood vessels and organs, such
as the stomach, and is also known as visceral muscle. It is the weakest type of
muscle but has an essential role in moving food along the digestive tract and
maintaining blood circulation through the blood vessels. Smooth muscle acts
involuntarily and cannot be consciously controlled.

Cardiac muscle- Located only in the heart, cardiac muscle pumps blood around
the body. Cardiac muscle stimulates its own contractions that form our heartbeat.
Signals from the nervous system control the rate of contraction. This type of
muscle is strong and acts involuntarily.

The main functions of the muscular system are as follows:

i. Mobility

The muscular system's main function is to allow movement. When muscles

contract, they contribute to gross and fine movement. Gross movement refers to
large, coordinated motions and includes:

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 Walking, running, swimming

Fine movement involves smaller movements, such as:

 Writing, speaking, facial expressions

The smaller skeletal muscles are usually responsible for this type of action.

Most muscle movement of the body is under conscious control. However, some
movements are reflexive, such as withdrawing a hand from a source of heat.

ii. Stability

Muscle tendons stretch over joints and contribute to joint stability. Muscle tendons
in the knee joint and the shoulder joint are crucial in stabilization. The core
muscles are those in the abdomen, back, and pelvis, and they also stabilize the
body and assist in tasks, such as lifting weights.

iii. Posture

Skeletal muscles help keep the body in the correct position when someone is sitting
or standing. This is known as posture. Good posture relies on strong, flexible
muscles. Stiff, weak, or tight muscles contribute to poor posture and misalignment
of the body. Long-term, bad posture leads to joint and muscle pain in the
shoulders, back, neck, and elsewhere.

iv. Circulation

The heart is a muscle that pumps blood throughout the body. The movement of the
heart is outside of conscious control, and it contracts automatically when
stimulated by electrical signals. Smooth muscle in the arteries and veins plays a
further role in the circulation of blood around the body. These muscles
maintain blood pressure and circulation in the event of blood loss or dehydration.
They expand to increase blood flow during times of intense exercise when the
body requires more oxygen.

v. Respiration

Breathing involves the use of the diaphragm muscle. The diaphragm is a dome-
shaped muscle located below the lungs. When the diaphragm contracts, it pushes
downward, causing the chest cavity to get bigger. The lungs then fill with air.
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When the diaphragm muscle relaxes, it pushes air out of the lungs. When someone
wants to breathe more deeply, it requires help from other muscles, including those
in the abdomen, back, and neck.

vi. Digestion

Smooth muscles in the gastrointestinal or GI tract control digestion. The GI tract

stretches from the mouth to the anus. Food moves through the digestive system
with a wave-like motion called peristalsis. Muscles in the walls of the hollow
organs contract and relax to cause this movement, which pushes food through the
esophagus into the stomach. The upper muscle in the stomach relaxes to allow
food to enter, while the lower muscles mix food particles with stomach acid and
enzymes. The digested food moves from the stomach to the intestines by
peristalsis. From here, more muscles contract to pass the food out of the body as
stool.
vii. Urination

The urinary system comprises both smooth and skeletal muscles, including those in
the: bladder, kidneys, penis or vagina, prostate, ureters. The muscles and nerves
must work together to hold and release urine from the bladder. Urinary problems,
such as poor bladder control or retention of urine, are caused by damage to the
nerves that carry signals to the muscles.

viii. Childbirth

Smooth muscles in the uterus expand and contract during childbirth. These
movements push the baby through the vagina. Also, the pelvic floor muscles help
to guide the baby's head down the birth canal.

ix. Vision

Six skeletal muscles around the eye control its movements. These muscles work
quickly and precisely, and allow the eye to: maintain a stable image, scan the
surrounding area, track moving objects. If someone experiences damage to their
eye muscles, it can impair their vision.

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x. Organ protection

Muscles in the torso protect the internal organs at the front, sides, and back of the
body. The bones of the spine and the ribs provide further protection. Muscles also
protect the bones and organs by absorbing shock and reducing friction in the joints.

xi. Temperature regulation

Maintaining normal body temperature is an important function of the muscular

system. Almost 85 percent of the heat a person generates in their body comes from
contracting muscles. When body heat falls below optimal levels, the skeletal
muscles increase their activity to make heat. Shivering is one example of this
mechanism. Muscles in the blood vessels also contract to maintain body heat.
Body temperature can be brought back within normal range through the relaxation
of smooth muscle in the blood vessels. This action increases blood flow and
releases excess heat through the skin.

5. Type of muscle contraction

The three different types of muscular contractions, therefore, are:

i. Isotonic contractions (changing the length) a. concentric contractions (shorten)
b. Eccentric contractions (lengthen) ii. Isometric contractions (remain the same)
ii. Isotonic contractions generate force by changing the length of the muscle and
can be concentric contractions or eccentric contractions.
a. A concentric contraction causes muscles to shorten, thereby generating
force
ex:, when you pick up a curl bar and perform a biceps curl, the length of your
biceps muscles shorten.  Your hands start down by your sides, and ends with
your hands up by your shoulders.  The biceps muscles shorten during this
motion. (ex: biceps curl – the muscle shortens under tension while the elbow is
flexing). 

Another example would be if you were to perform a couple of leg curls on a

hamstring machine.  As your knee is flexing, your foot is approaching your
buttocks, and your hamstring muscles shorten in the process.

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.
b. Eccentric contractions cause muscles to elongate (lengthen) in response
to a greater opposing force.
(For example, biceps curl – the muscle lengthens under tension while the
elbow is extending)
iii. Isometric contractions generate force without changing the length of the
muscle.
Another example would be if you were to push against a wall for 10 seconds. The
wall doesn’t move and neither does the length of the muscles in your arms pushing
against it. Again, a force is still being applied.

Isokinetic Contractions
Isokinetic contractions are similar to Isotonic in that the muscle changes length
during the contraction, where they differ is that Isokinetic contractions produce
movements of a constant speed. To measure this a special piece of equipment
known as an Isokinetic dynamometer is required. Examples of using Isokinetic
contractions in day-to-day and sporting activities are rare. The best is breaststroke
in swimming, where the water provides a constant, even resistance to the
movement of adduction.
6. Skin and its functions?

The skin is one of the largest organs in the body in surface area and weight.  The
skin consists of two layers: the epidermis and the dermis. Beneath the dermis lies
the hypodermis or subcutaneous fatty tissue. The skin has three main
functions: protection, regulation and sensation. Wounding affects all the functions
of the skin.

7. Skeleton muscles functions?

The skeleton serves six major functions: support, movement, protection,

production of blood cells, storage of minerals and endocrine regulation.

8. Types of bones?

Bone, is a connective tissue that constitutes the endoskeleton. It contains

specialized cells and a matrix of mineral salts and collagen fibers. Bones are
mostly made of the protein collagen, which forms a soft framework. The mineral

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calcium phosphate hardens this framework, giving it strength. The human

skeleton composed of around 270 bones at birth – this total decreases to around
206 bones by adulthood after some bones get fused together.

The largest bone in the human body is the thighbone or femur, It is almost 19.9
inches long It runs from the hip down to around the knee area and the smallest is
the stapes in the middle ear, which are just 3 millimeters (mm) long.

Bones have many functions. They support the body structurally, protect our vital
organs, and allow us to move. Also, they provide an environment for bone marrow,
where the blood cells are created, and they act as a storage area for minerals,
particularly calcium.

The bones of the human skeleton are classified by their shape: long bones, short
bones, flat bones, Pneumatic bones,, sesamoid bones, and irregular bones

Long Bones :-Support Weight and Facilitate Movement

The long bones, longer than they are wide, include the femur (the longest bone in
the body) as well as relatively small bones in the fingers. Long bones function to
support the weight of the body and facilitate movement. Long bones are mostly
located in the appendicular skeleton and include bones in the lower limbs (the
tibia, fibula, femur, metatarsals, and phalanges) and bones in the upper limbs (the
humerus, radius, ulna, metacarpals, and phalanges).

Short Bones:- Are Cube-shaped

Short bones are about as long as they are wide. Located in the wrist and ankle
joints, short bones provide stability and some movement. The carpals in the wrist
(scaphoid, lunate, triquetral, hamate, pisiform, capitate, trapezoid, and trapezium)
and the tarsals in the ankles (calcaneus, talus, navicular, cuboid, lateral cuneiform,
intermediate cuneiform and medial cuneiform) are examples of short bones.

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Flat Bones:- Protect Internal Organs

There are flat bones in the skull (occipital, parietal, frontal, nasal, lacrimal, and
vomer), the thoracic cage (sternum and ribs), and the pelvis (ilium, ischium, and
pubis). The function of flat bones is to protect internal organs such as the brain,
heart, and pelvic organs. Flat bones are somewhat flattened, and can provide
protection, like a shield; flat bones can also provide large areas of attachment for
muscles.

Irregular Bones Have Complex Shapes

Irregular bones vary in shape and structure and therefore do not fit into any other
category (flat, short, long, or sesamoid). They often have a fairly complex shape,
which helps protect internal organs. For example, the vertebrae, irregular bones of
the vertebral column, protect the spinal cord. The irregular bones of the pelvis
(pubis, ilium, and ischium) protect organs in the pelvic cavity.

Sesamoid Bones Reinforce Tendons

Sesamoid bones are bones embedded in tendons. These small, round bones are
commonly found in the tendons of the hands, knees, and feet. Sesamoid bones
function to protect tendons from stress and wear. The patella, commonly referred
to as the kneecap, is an example of a sesamoid bone.

Pneumatic bones:
Pneumatic bones can also be categorized under the irregular bones because they
are also irregular in shape but since there is a difference between the two that is
characteristically very important therefore they are often classified separately. The
characteristic difference is the presence of large air spaces in these bones which
make them light in weight and thus they form the major portion of skull in the
form of sphenoid, ethmoid and maxilla. Besides making the skull light in weight
they also help in resonance of sound and as air conditioning chambers for the
inspired air.

9. Types of joints?

A joint or articulation is the connection made between bones in the body which

link the skeletal system into a functional whole. They are constructed to allow for
different degrees and types of movement. 

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The structural classification is based on 1) the presence or absence of space

between the joint bones, called synovial cavity 2) the type of connective tissue that
binds the bone together.

Structurally, joints are classified as one of the following types:

Fibrous joints: there is no synovial cavity and the bones are held together by
dense irregular connective tissue that is rich in collagen fibers.

Cartilaginous joints: there is no synovial cavity and the bones are held together
by cartilage

Synovial joints:  not directly joined – the bones have a synovial cavity and are
united by the dense irregular connective tissue that forms the articular capsule that
is normally associated with accessory ligaments.

Functionally, joints are classified as one of the following types.

Synarthrosis : immovable joints

Amphiarthrosis: slightly movable joint

Diarthrosis: freely movable joints (Synovial joints)

Immovable or fibrous joints are those that do not allow movement (or allow for
only very slight movement) at joint locations. Bones at these joints have no joint
cavity and are held together structurally by thick fibrous connective tissue, usually
collagen. These joints are important for stability and protection. There are three
types of immovable joints: sutures, syndesmosis, and gomphosis.

 Sutures: These narrow fibrous joints connect bones of the skull (excluding

the jaw bone). In adults, the bones are held tightly together to protect
the brain and help shape the face. In newborns and infants, bones at these
joints are separated by a larger area of connective tissue and are more
flexible. Overtime, cranial bones fuse together providing more stability and
protection for the brain.
 Syndesmosis: This type of fibrous joint connects two bones that are
relatively far apart. The bones are linked by ligaments or a thick membrane
(interosseous membrane). A syndesmosis can be found between the bones of
the forearm (ulna and radius) and between the two long bones of the lower
leg (tibia and fibula).
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 Gomphosis: This type of fibrous joint holds a tooth in place in its socket in

the upper and lower jaw. A gomphosis is an exception to the rule that joints
connect bone to bone, as it connects teeth to bone. This specialized joint is
also called a peg and socket joint and allows for limited to no movement.

Slightly Movable (Cartilaginous) Joints

Slightly movable joints permit some movement but provide less stability than
immovable joints. These joints can be structurally classified as cartilaginous
joints, as bones are connected by cartilage at the joints. Cartilage is a tough, elastic
connective tissue that helps to reduce friction between bones. Two types of
cartilage may be found at cartilaginous joints: hyaline
cartilage and fibrocartilage. Hyaline cartilage is very flexible and elastic, while
fibrocartilage is stronger and less flexible.
Cartilaginous joints formed with hyaline cartilage can be found between certain
bones of the rib cage. Intervertebral discs located between spinal vertebrae are
examples of slightly movable joints composed of fibrocartilage. Fibrocartilage
provides support for bones while allowing for limited movement. These are
important functions as it relates to the spinal column as spinal vertebrae help to
protect the spinal cord. The pubic symphysis (connects the right and left hip bones)
is another example of a cartilaginous joint that unites bones with fibrocartilage.
The pubic symphysis helps to support and stabilize the pelvis.
Freely Movable (Synovial) Joints
Frely movable joints are classified structurally as synovial joints. Unlike fibrous
and cartilaginous joints, synovial joints have a joint cavity (fluid-filled space)
between connecting bones. Synovial joints allow for greater mobility but are less
stable than fibrous and cartilaginous joints. Examples of synovial joints include
joints in the wrist, elbow, knees, shoulders, and hip.

Three main structural components are found in all synovial joints and include a
synovial cavity, articular capsule, and articular cartilage.

 Synovial Cavity: This space between adjacent bones is filled with synovial

fluid and is where bones can move freely in relation to each
another. Synovial fluidhelps to prevent friction between bones.
 Articular Capsule: Composed of fibrous connective tissue, this capsule
surrounds the joint and connects to adjacent bones. The inner layer of the
capsule is lined with a synovial membrane that produces the thick synovial
fluid.

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 Articular Cartilage: Within the articular capsule, the rounded ends of

adjacent bones are covered with smooth articular (relating to joints) cartilage
composed of hyaline cartilage. Articular cartilage absorbs shock and
provides a smooth surface for fluent movements.

Additionally, bones at synovial joints may be supported by structures outside of the

joint such as ligaments, tendons, and bursae (fluid-filled sacs that reduce friction
between supporting structures at joints).
Types of Synovial Joints
Synovial joints allow for a number of different types of body movements. There
are six types of synovial joints found at different locations in the body.

 Pivot Joint: This joint permits rotational movement around a single axis.

One bone is encircled by a ring formed by the other bone at the joint and a
ligament. The bone that pivots may either rotate within the ring or the ring
may rotate around the bone. The joint between the first and second cervical
vertebrae near the base of the skull is an example of a pivot joint. It allows
the head to turn from side to side.

 Hinge Joint: This joint permits bending and straitening movements along

one plane. Similar to a door hinge, movement is limited to a single direction.
Examples of hinge joints include the elbow, knee, ankle, and joints between
the bones of the fingers and toes.
 Condyloid Joint: Several different types of movements are allowed by this
type of joint including bending and straightening, side-to-side, and circular
movements. One of the bones has an oval-shaped, or convex end (male
surface) that fits into the depressed oval-shaped, or concave end (female
surface) of another bone. This type of joint can be found between the radius
bone of the forearm and bones of the wrist.
 Saddle Joint: These distinct joints are very flexible, allowing for bending
and straightening, side-to-side, and circular movements. The bones at these
joints form what look like a rider on a saddle. One bone is turned inward at
one end, while the other is turned outward. An example of a saddle joint is
the thumb joint between the thumb and palm.
 Plane Joint: Bones at this type of joint slide past each other in a gliding
motion. The bones at plane joints are of similar size and the surfaces where
the bones meet at the joint are nearly flat. These joints can be found between

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bones of the wrist and foot, as well as between the collar bone and shoulder
blade.
 Ball-and-Socket Joint: These joints allow the greatest degree of motion
permitting bending and straitening, side-to-side, circular, and rotational
movement. The end of one bone at this type of joint is rounded (ball) and fits
into the cupped end (socket) of another bone. The hip and shoulder joints are
examples of ball-and-socket joints.

https://www.thoughtco.com/types-of-joints-in-the-body-4173736

10. Range of motion?

Range of motion is a measurement of movement around a specific joint or body

part. Each joint has its own level of flexibility, expressed in degrees. Flexibility is
the range of motion around a joint, and can refer to ligaments, tendons, muscles,
bones, and joints.

Normal Values for Range of Motion of Joints*

Joint Motion Range (°)
Knee Extension 120–0
Plantar flexion 0–50
Ankle
Dorsiflexion 0–20
Foot Inversion 0–35

A reduction in a normal range of motion in any of the joints is known as limited

or abnormal range of motion. Joint range of motion naturally declines as you age,
but it can also occur with a number of conditions.

There are three types of ROM that are measured. They are passive (PROM),
active-assistive (AAROM), and active (AROM).

Active Range of Motion

Active ROM occurs when you use your muscles to help move your body part. This
requires no other person or device to help you move. Active ROM is used when
you are able to start moving independently after injury or surgery. Strengthening
exercises are a form of active ROM. 

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Active-Assistive Range of Motion

Active-assistive ROM occurs when you are able to move your injured body part,
but you may require some help to move to ensure further injury or damage does
not occur. The assistance that helps move your body can come from you or from
another person. It may also come from a mechanical device or machine.

Passive Range of Motion

Passive ROM occurs around a joint if you are not using your muscles to move.
Someone else, like your physical therapist, manually moves your body while you
relax. A machine may also be used to provide passive ROM. For example,
after knee replacement surgery, you may not be able to use your muscles to move
the knee. Your physical therapist may bend and straighten your knee for you,
passively moving your leg.

Blood and Circulation

1. Blood components: Blood is a specialized body fluid. It has four main

components: plasma (55%), red blood cells (45%), white blood cells and platelets
(1%). Blood has many different functions, including: transporting oxygen and
nutrients to the lungs and tissues.

Plasma. The liquid component of the blood in which the following blood cells are
suspended:
 Red blood cells (erythrocytes). These carry oxygen from the lungs to the rest
of the body
 White blood cells (leukocytes). These help fight infections and aid in the
immune process. Types of white blood cells include:
o Lymphocytes
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o Monocytes
o Eosinophils
o Basophils
o Neutrophils
 Platelets (thrombocytes). These help in blood clotting.

2. Anaemia: A condition in which the blood doesn't have enough healthy red
blood cells. Anaemia is a condition in which the number of red blood cells or their
oxygen-carrying capacity is insufficient to meet physiologic needs, which vary by
age, sex, altitude, smoking, and pregnancy status. It is the most common blood
disorder in the general population. Symptoms can include headaches, chest pains,
and pale skin.

 Aplastic anemia: fever, frequent infections, and skin rashes

 Folic acid deficiency anemia: irritability, diarrhea, and a smooth tongue

 Hemolytic anemia: jaundice, dark colored urine, fever, and abdominal pains

 Sickle cell anemia: painful swelling of the feet and hands, fatigue, and
jaundice

Types

There are more than 400 types of Anemia currently known, and these are divided
into three main groups according to their cause:

 Anemia caused by blood loss

 Anemia caused by decreased production or production of faulty red blood

cells

 Anemia caused by the destruction of red blood cells

Types of anemia within these categories include:

 sickle cell anemia

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 vitamin deficiency anemia

 iron deficiency anemia

 blood-loss anemia

 Cooley's anemia

 pernicious anemia
Causes
The body needs red blood cells to survive. They carry hemoglobin, a complex
protein that contains iron molecules. These molecules carry oxygen from the lungs
to the rest of the body. Some diseases and conditions can result in a low level of
red blood cells. There are many types of anemia, and there is no single cause. It
can sometimes be difficult to pinpoint the exact cause.

Below is a general overview of the common causes of the three main groups of
anemia:

1) Anemia caused by blood loss

The most common type of anemia—iron deficiency anemia—often falls into this
category. It is caused by a shortage of iron, most often through blood loss.

When the body loses blood, it reacts by pulling in water from tissues outside the
bloodstream in an attempt to keep the blood vessels filled. This additional water
dilutes the blood. As a result, the red blood cells are diluted.

Blood loss can be acute and rapid or chronic.

Rapid blood loss can include surgery, childbirth, trauma, or a ruptured blood
vessel.

Chronic blood loss is more common in cases of anemia. It can result from a
stomach ulcer, cancer, or tumor.

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Causes of anemia due to blood loss include:

 gastrointestinal conditions, such as ulcers, hemorrhoids, cancer, or gastritis

 use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and
ibuprofen
 menstrual bleeding
2) Anemia caused by decreased or faulty red blood cell production

Bone marrow is a soft, spongy tissue found in the center of bones. It is essential for
the creation of red blood cells. Bone marrow produces stem cells, which develop
into red blood cells, white blood cells, and platelets.

A number of diseases can affect bone marrow, including leukemia, where too

many abnormal white blood cells are produced. This disrupts normal production of
red blood cells.

Other anemias caused by decreased or faulty red blood cells include:

 Sickle cell anemia: Red blood cells are misshapen and break down
abnormally quickly. The crescent-shaped blood cells can also get stuck in smaller
blood vessels, causing pain.
 Iron-deficiency anemia: Too few red blood cells are produced because not
enough iron is present in the body. This can be because of a poor diet,
menstruation, frequent blood donation, endurance training, certain digestive
conditions, such as Crohn's disease, surgical removal of part of the gut, and some
foods.
 Bone marrow and stem cell problems: Aplastic anemia, for example,
occurs when few or no stem cells are present. Thalassemia occurs when red blood
cells cannot grow and mature properly.
 Vitamin deficiency anemia: Vitamin B-12 and folate are both essential for
the production of red blood cells. If either is deficient, red blood cell production
will be too low. Examples include megaloblastic anemia and pernicious anemia.

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3) Anemia caused by the destruction of red blood cells

Red blood cells typically have a life span of 120 days in the bloodstream, but they
can be destroyed or removed beforehand.

One type of anemia that falls into this category is autoimmune hemolytic anemia,
where the body's immune system mistakenly identifies its own red blood cells as a
foreign substance and attacks them.

Excessive hemolysis (red blood cell breakdown) can occur for many reasons,
including:

 infections
 certain drugs, for example, some antibiotics
 snake or spider venom
 toxins produced through advanced kidney or liver disease
 an autoimmune attack, for instance, because of hemolytic disease
 severe hypertension
 vascular grafts and prosthetic heart valves
 clotting disorders
 enlargement of the spleen

Treatment

There is a range of treatments for anemia. They all aim to increase the red blood
cell count. This, in turn, increases the amount of oxygen the blood carries.

Treatment will depend on the type and cause of anemia.

 Iron deficiency anemia: Iron supplements (which are availble to buy

online) or dietary changes. If the condition is due to loss of blood, the bleeding
must be found and stopped.

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 Vitamin deficiency anemias: Treatments include dietary supplements and

B-12 shots.

 Thalassemia: Treatment includes folic acid supplementation, removal of the

spleen, and, sometimes, blood transfusions and bone marrow transplants.

 Anemia of chronic disease: This is anemia associated with a serious,

chronic underlying condition. There are no specific treatments, and the focus is on
the underlying condition.

 Aplastic anemia: The patient will receive blood transfusions or bone

marrow transplants.

 Sickle cell anemia: Treatment includes oxygen therapy, pain relief, and
intravenous fluids. There may also be antibiotics, folic acid supplements, and
blood transfusions. A cancer drug known as Droxia or Hydrea is also used.

 Hemolytic anemias: Patients should avoid medication that may make it

worse and they may receive immunosuppressant drugs and treatment for
infections. Plasmapheresis, or blood-filtering, might be necessary in some cases.

3. Structure and function of heart

The heart is a muscular organ that pumps blood throughout the body. It is located in

the middle cavity of the chest, between the lungs. In most people, the heart is located
on the left side of the chest, beneath the breastbone.
The heart is composed of smooth muscle. It has four chambers which contract in a
specific order, allowing the human heart to pump blood from the body to the lungs
and back again with high efficiency. The heart also contains “pacemaker” cells which
fire nerve impulses at regular intervals, prompting the heart muscle to contract.

The heart consists of four chambers:

 Atria: the two upper chambers (they receive blood).

18
 Anatomy

 Ventricles: the two lower chambers (they discharge blood).

The left atria and left ventricle are separated from the right atria and right ventricle by
a wall of muscle called the septum.
The wall of the heart consists of three layers of tissue:

 Epicardium — protective layer mostly made of connective tissue.

 Myocardium — the muscles of the heart.

 Endocardium — lines the inside of the heart and protects the valves and
chambers.
These layers are covered in a thin protective coating called the pericardium.

Heart works
The heart contracts at different rates depending on many factors. At rest, it might beat
around 60 times a minute, but it can increase to 100 beats a minute or more. Exercise,
emotions, fever, diseases, and some medications can influence heart rate. For more
information on what is "normal," read this article.
The left and right side of the heart work in unison. The right side of the heart receives
deoxygenated blood and sends it to the lungs; the left side of the heart receives blood
from the lungs and pumps it to the rest of the body.
The atria and ventricles contract and relax in turn, producing a rhythmical heartbeat:
Right side

 The right atrium receives deoxygenated blood from the body through veins
called the superior and inferior vena cava (the largest veins in the body).

 The right atrium contracts and blood passes to the right ventricle.

19
 Anatomy

 Once the right ventricle is full, it contracts and pumps the blood through to the
lungs via the pulmonary artery, where it picks up oxygen and offloads carbon
dioxide.
Left side

 Newly oxygenated blood returns to the left atrium via the pulmonary vein.

 The left atrium contracts, pushing blood into the left ventricle.

 Once the left ventricle is full, it contracts and pushes the blood back out to the
body via the aorta.
Each heartbeat can be split into two parts:
Diastole: the atria and ventricles relax and fill with blood.
Systole: the atria contract (atrial systole) and push blood into the ventricles; then, as
the atria start to relax, the ventricles contract (ventricular systole) and pump blood out
of the heart.
When blood is sent through the pulmonary artery to the lungs, it travels through tiny
capillaries on the surface of the lung's alveoli (air sacs). Oxygen travels into the
capillaries, and carbon dioxide travels from the capillaries into the air sacs, where it is
breathed out into the atmosphere.
The muscles of the heart need to receive oxygenated blood, too. They are fed by the
coronary arteries on the surface of the heart.
Where blood passes near to the surface of the body, such as at the wrist or neck, it is
possible to feel your pulse; this is the rush of blood as it is pumped through the body
by the heart. If you would like to take your own pulse, this article explains how.

The valves
The heart has four valves that help ensure that blood only flows in one direction:
Aortic valve: between the left ventricle and the aorta.

20
 Anatomy

Mitral valve: between the left atrium and the left ventricle.
Pulmonary valve: between the right ventricle and the pulmonary artery.
Tricuspid valve: between the right atrium and right ventricle.
Most people are familiar with the sound of a human heartbeat. It is often described as
a "lub-DUB" sound. The "lub" sound is produced by the tricuspid and mitral valves
closing, and the "DUB" sound is caused by the closing of the pulmonary and aortic
valves.

Blood vessels
There are three types of blood vessels:
Arteries: carry oxygenated blood from the heart to the rest of the body. Arteries are
strong and stretchy, which helps push blood through the circulatory system. Their
elastic walls help keep blood pressure consistent. Arteries branch into smaller
arterioles.
Veins: these carry deoxygenated blood back to the heart and increase in size as they
get closer to the heart. Veins have thinner walls than arteries.
Capillaries: they connect the smallest arteries to the smallest veins. They have very
thin walls, which allow them to exchange compounds with surrounding tissues, such
as carbon dioxide, water, oxygen, waste, and nutrients.

4. Blood pressure: Blood pressure is the force that moves blood through our
circulatory system. Blood pressure is recorded with 2 numbers. The systolic pressure
(higher number) is the force at which your heart pumps blood around your body. The
diastolic pressure (lower number) is the resistance to the blood flow in the blood
vessels.
They're both measured in millimetres of mercury (mmHg).

High blood pressure is considered to be 140/90mmHg or higher (or 150/90mmHg or

higher if you're over the age of 80)

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 Anatomy

Ideal blood pressure is usually considered to be between 90/60mmHg and

120/80mmHg

5. Pulse: The rhythmic dilation of an artery that results from beating of the heart.
Pulse is often measured by feeling the arteries of the wrist or neck.

Pulse pressure is the difference between the systolic and diastolic blood pressures.
Pulse Pressure = Systolic Blood Pressure – Diastolic Blood Pressure
It is measured in millimeters of mercury (mmHg). It represents the force that the heart
generates each time it contracts. For example, if resting blood pressure is 120/80
mmHg, then the pulse pressure is 40 mmHg.
6. Exercise tolerance/Exercise intolerance
Exercise tolerance refers to the exercise capacity of an individual as measured by
their ability to endure exercise and/or the maximum workload achieved during the
exercise period. Exercise tolerance can be measured accurately during an exercise
tolerance test.
Exercise intolerance is a condition of inability or decreased ability to
perform physical exercise at what would be considered to be the normally expected
level or duration. It also includes experiences of unusually severe post-
exercise pain, fatigue, nausea, vomiting or other negative effects. Exercise
intolerance is not a disease or syndrome in and of itself, but can result from various
disorders.
Submaximal exercise is any physical activity whose intensity increases at regular
intervals up to but never exceeding 85 percent of your maximum heart 
A maximal exercise is one that is performed with progressively increasing
workloads up to limiting fatigue (tiredness or lack of energy) and/or dyspnea
(Shortness of breath) caused by exhaustion of the capacity for adaptation of the
patient's cardiovascular system

7. Fatigue: Fatigue is generally defined as a feeling of lack of energy and

motivation that can be physical, Fatigue is a common problem involving a physical
and mental state of being extremely tired. Physical and mental fatigue is different,
but they often occur together. Long-term physical exhaustion can also lead to
mental fatigue.

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 Anatomy

Causes of fatigue
There are many potential causes of fatigue. They can be divided into three general
categories:
 lifestyle factors
 physical health conditions
 mental health issues
Lifestyle factors
If you’re experiencing fatigue, your activities and other lifestyle choices may be
the root cause. For example, fatigue can result from:
 physical exertion, lack of physical activity, lack of sleep, being overweight
or obese, periods of emotional stress, grief, taking certain medications, such
as antidepressants or sedatives, using alcohol on a regular basis, using illicit
drugs, such as cocaine, consuming too much caffeine, not eating a nutritious
diet
Physical health conditions
Many medical conditions can also cause fatigue. Examples include:
 anemia, arthritis, infections, such as cold and flu, hypothyroidism, or
underactive thyroid, hyperthyroidism, or overactive thyroid, sleep disorders,
such as insomnia, eating disorders, autoimmune disorders, congestive heart
failure, cancer, diabetes, kidney disease, liver disease, chronic obstructive
pulmonary disease (COPD)
Mental health issues
Mental health conditions can also lead to fatigue. For example, fatigue is a
common symptom of anxiety, depression, and seasonal affective disorder.

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 Anatomy

Treatment
To treat fatigue successfully, it is necessary first to find the underlying cause.
Some examples could be:
 anemia, sleep apnea, poorly controlled blood sugar, underactive or
overactive thyroid, an infection, obesity, depression, an abnormal heart rhythm
Yoga, CBT, and mindfulness for fatigue
In one study, participants reported that fatigue, anxiety and depression fell, while
quality of life improved in those with multiple sclerosis (MS) who underwent 2
months of mindfulness meditation training.
A study on the benefits of yoga, found some improvement of symptoms of fatigue
and sleep quality in cancer survivors. The 4-week program included postures,
meditation, breathing, and some other techniques.
A 2017 study reviewed the benefits of cognitive behavioral therapy (CBT),
mindfulness, and yoga on treating sleep disturbances in breast cancer patients.
Researchers reported those who participated in CBT appeared to have the most
improvement in sleep, with decreased fatigue, depression, and anxiety, along with
improved quality of life.
Results from studies on mindfulness and yoga were not as clear, but seemed to
show slight improvement or at least some benefit, overall.
Eating and drinking habits, Physical activity, good Sleep

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 Anatomy

8. Syncope: Syncope is a temporary loss of consciousness usually related to

insufficient blood flow to the brain. It's also called fainting or "passing out." It
most often occurs when blood pressure is too low (hypotension) and the heart
doesn't pump enough oxygen to the brain.
There are 3 main types of syncope. Reflex syncope is the most common cause of
syncope in any setting, followed by syncope secondary to cardiovascular disease
and third, orthostatic hypotension (OH) is a very frequent cause of syncope.
A drug called fludrocortisone acetate that's normally used to treat low blood
pressure may be helpful in preventing vasovagal syncope. Selective serotonin
inhibitors may also be used
9. BP fall/Low BP: Low blood pressure might seem desirable, and for some
people, it causes no problems. However, for many people, abnormally low blood
pressure (hypotension) can cause dizziness (a sensation of spinning around and
losing one's balance.) and fainting. In severe cases, low blood pressure can be life-

threatening.
A blood pressure reading lower than 90 millimeters of mercury (mm Hg) for the
top number (systolic) or 60 mm Hg for the bottom number (diastolic) is generally
considered low blood pressure.
The causes of low blood pressure can range from dehydration to serious medical or
surgical disorders. It's important to find out what's causing your low blood pressure
so that it can be treated.
Symptoms
For some people, low blood pressure signals an underlying problem, especially
when it drops suddenly or is accompanied by signs and symptoms such as:
 Dizziness or lightheadedness, Fainting (syncope), Blurred vision, Nausea,
Fatigue, Lack of concentration

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 Anatomy

Respiration and Nervous system

1. Non respiratory function of lungs
The main function of the respiratory system is to facilitate the exchange of gases
between the external environment and the blood, so that these can be transported to
and from the peripheral tissues. However, the respiratory system performs some
other vital functions are:
▪Removal of inhaled foreign particles and infectious organisms
▪Olfaction (sensation of smell)
▪Warming and humidification of air (losing excessive heat)
▪Phonation
▪Filtration of blood at the pulmonary capillaries
▪Acting as a volume reservoir of blood
▪Metabolic functions of the pulmonary tissue
. Removal of Inhaled Foreign Particles and Infectious Organisms
The upper respiratory tract has a moist surface, covered by mucus, so that large
particles get adhered and are therefore prevented from reaching the lower
respiratory tract. The nasal mucosa is lined by a ciliated epithelium, with the cilia
beating towards the pharynx, so that the foreign particles can be swallowed. The
nasal cavity also harbors hair, covered with mucus, acting like a filter. The nasal
cavity is supplied by sensory nerve endings of the trigeminal nerve, which are
sensitive to irritants. If an irritant is inhaled, the sneezing reflex is activated and the
particles are eliminated.
The lower respiratory tract, above the level of the respiratory bronchioles, is also
lined by columnar ciliated epithelium, with a layer of mucus lying over the luminal
surface of the cells. This layer also traps foreign particles and they are expelled by
the co-ordinated movement of the cilia in the lower respiratory tract in an upward
direction (towards the pharynx). The glosso-pharyngeal and vagal nerve endings in
the lower respiratory tract, initiate cough reflex in response to stretching and
irritation to expel foreign particles entering the lower respiratory tract.
The alveoli are inhabited by macrophages which are responsible for engulfing the
foreign particles and the organisms entering the alveoli. In addition, the mucus
covering the nasal, nasopharyngeal and the lower respiratory tract is enriched with

26
 Anatomy

IgA (immunoglobulin A) and lactoferrin , preventing organisms from colonizing

the respiratory epithelium. The tonsils in the pharynx (an aggregation of lymphoid
tissue associated with the musoca) also contribute to the immune function of the
respiratory system.
. Olfaction (Sensation of Smell)
The roof of the nasal cavity has nerve endings which detect different odors. These
nerves traverse the ethmoid plate and form the olfactory bulb. The physiology of
olfaction will be discussed in another hub.
. Warming and Humidification of Air
The inhaled air flows across the warm and moist upper airways. Therefore, by the
time the air reaches the lower airways, the air is saturated with water vapor (i.e. the
air carries the maximum amount of water vapor that it can occupy at the body
temperature) and is warmed up to 37 centigrade. This is very important to prevent
dehydration of the lower respiratory tract and to prevent reflex broncho-
constriction that occurs when the lower respiratory tract is exposed to cold air.
. Phonation
The larynx has two vocal cords lining a central orifice, known as the glottis. The
size of the glottis can be altered by contraction of the laryngeal muscles. The vocal
cords can be brought to a position, at which, they tend to vibrate with the force of
exhaling air. This vibration gives rise to the sound. The pitch of the sound
produced can be varied by the altering the size of the glottis (by contraction and
relaxation of the laryngeal muscles). The produced sound is then modified by the
movements of the oral cavity and the tongue (articulation), forming words.
. Filtration of Blood at the Pulmonary Capillaries
The venous blood entering the right side of the heart is passed through the
pulmonary capillaries, before reaching the left side of the heart to be distributed
through-out the body. When the blood passes through the small caliber of the
pulmonary capillaries, large particles such as emboli, air bubbles, cell debris and
fat globules get trapped in the pulmonary vessels. This prevents such particles
entering the systemic circulation and obstructing an end-artery supplying a vital
organ such as the brain.
. Acting as a Reservoir of Blood
The pulmonary vascular bed is a low pressure system, which can occupy a large
volume of blood. In the presence of a hypovolaemic state, the pulmonary vessels

27
 Anatomy

constrict, releasing the blood into the systemic circulation, in order to increase the
effective circulating volume.
. Metabolic Functions of the Pulmonary Tissue
The lower airways are lined by a large number of neuro-endocrine cells
responsible for the secretion and release of chemical mediators such as bradykinin,
prostaglandins, serotonin, substance P, heparin and histamine. In addition, the
pulmonary tissue is responsible for the conversion of angiotensin I to angiotensin
II and the catabolism of bradykinins, adrenaline and noradrenaline. Many waste
products and metabolites are excreted via the lungs as volatile gases (e.g. –
ethanol, acetone).

2. Functions of respiratory systems

The human respiratory system is a series of organs responsible for taking in
oxygen and expelling carbon dioxide. The primary organs of the respiratory system
are lungs, which carry out this exchange of gases as we breathe. Red blood cells
collect the oxygen from the lungs and carry it to the parts of the body where it is
needed, during the process, the red blood cells collect the carbon dioxide and
transport it back to the lungs, where it leaves the body when we exhale.
The human body needs oxygen to sustain itself. A decrease in oxygen is known as
hypoxia and a complete lack of oxygen is known as anoxia, These conditions can
be fatal; after about four minutes without oxygen, brain cells begin dying, which
can lead to brain damage and ultimately death. 

In humans, the average rate of breathing depends on age. A newborn's normal

breathing rate is about 40 times each minute and may slow to 20 to 40 times per
minute when the baby is sleeping, 

The respiratory system, which includes air passages, pulmonary vessels, the lungs,
and breathing muscles, aids the body in the exchange of gases between the air and
blood, and between the blood and the body’s billions of cells. Most of the organs
of the respiratory system help to distribute air, but only the tiny, grape-like alveoli
and the alveolar ducts are responsible for actual gas exchange.

The respiratory system, which includes air passages, pulmonary vessels, the lungs,
and breathing muscles, aids the body in the exchange of gases between the air and
blood, and between the blood and the body’s billions of cells. Most of the organs

28
 Anatomy

of the respiratory system help to distribute air, but only the tiny, grape-like alveoli
and the alveolar ducts are responsible for actual gas exchange.

In addition to air distribution and gas exchange, the respiratory system filters,
warms, and humidifies the air you breathe. Organs in the respiratory system also
play a role in speech and the sense of smell.
The respiratory system also helps the body maintain homeostasis, or balance
among the many elements of the body’s internal environment.

The respiratory system is divided into two main components:

The respiratory system, which includes air passages, pulmonary vessels, the lungs,
and breathing muscles, aids the body in the exchange of gases between the air and
blood, and between the blood and the body’s billions of cells. Most of the organs
of the respiratory system help to distribute air, but only the tiny, grape-like alveoli
and the alveolar ducts are responsible for actual gas exchange.

In addition to air distribution and gas exchange, the respiratory system filters,
warms, and humidifies the air you breathe. Organs in the respiratory system also
play a role in speech and the sense of smell.The respiratory system also helps the
body maintain homeostasis, or balance among the many elements of the body’s
internal environment.

The respiratory system is divided into two main components:

Upper respiratory tract: Composed of the nose, the pharynx, and the larynx, the
organs of the upper respiratory tract are located outside the chest cavity.

 Nasal cavity: Inside the nose, the sticky mucous membrane lining the nasal
cavity traps dust particles, and tiny hairs called cilia help move them to the
nose to be sneezed or blown out.
 Sinuses: These air-filled spaces along side the nose help make the skull
lighter.
 Pharynx: Both food and air pass through the pharynx before reaching their
appropriate destinations. The pharynx also plays a role in speech.
29
 Anatomy

 Larynx: The larynx is essential to human speech.

Lower respiratory tract: Composed of the trachea, the lungs, and all segments of
the bronchial tree (including the alveoli), the organs of the lower respiratory tract
are located inside the chest cavity.

 Trachea: Located just below the larynx, the trachea is the main airway to
the lungs.
 Lungs: Together the lungs form one of the body’s largest organs. They’re
responsible for providing oxygen to capillaries and exhaling carbon dioxide.
 Bronchi: The bronchi branch from the trachea into each lung and create the
network of intricate passages that supply the lungs with air.
 Diaphragm: The diaphragm is the main respiratory muscle that contracts
and relaxes to allow air into the lungs.

Diseases of the respiratory system

Diseases and conditions of the respiratory system fall into two categories: viruses,
such as influenza, bacterial pneumonia, enterovirus respiratory virus; and chronic
diseases, such as asthma and chronic obstructive pulmonary disease (COPD).. 
COPD

COPD is the intersection of three related conditions — chronic bronchitis, chronic

asthma and emphysema,. It is a progressive disease that makes it increasingly
difficult for sufferers to breath.

Asthma 

Asthma is a chronic inflammation of the lung airways that causes coughing,

wheezing, chest tightness or shortness of breath, These signs and symptoms may
be worse when a person is exposed to their triggers, which can include air
pollution, tobacco smoke, factory fumes, cleaning solvents, infections, pollens,
foods, cold air, exercise, chemicals and medications. 

Lung cancer 

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 Anatomy

Lung cancer is often associated with smoking, but the disease can affect non-
smokers as well.

3. Alveolus: any of the many tiny air sacs of the lungs which allow for rapid
gaseous exchange.

4 common lung diseases include:

 Asthma
 Collapse of part or all of the lung (pneumothorax or atelectasis)
 Swelling and inflammation in the main passages (bronchial tubes) that carry
air to the lungs (bronchitis)
 COPD (chronic obstructive pulmonary disease)
 Lung cancer
 Lung infection (pneumonia)
 Abnormal buildup of fluid in the lungs (pulmonary edema)
 Blocked lung artery (pulmonary embolus)

5. Autonomic nervous system (ANS)

The autonomic nervous system regulates certain body processes, such as the heart
rate, digestion, respiratory rate, pupillary response, urination, and sexual arousal
blood pressure and the rate of breathing. This system works automatically
(autonomously), without a person’s conscious effort. This system is the primary
mechanism in control of the fight-or-flight response.

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 Anatomy

Disorders of the autonomic nervous system can affect any body part or process.
Autonomic disorders may be reversible or progressive.

Anatomy of the autonomic nervous system

The autonomic nervous system  is the part of the nervous system that supplies the
internal organs, including the blood vessels, stomach, intestine, liver, kidneys,
bladder, genitals, lungs, pupils, heart, and sweat, salivary, and digestive glands.
The autonomic nervous system has two main divisions:

 Sympathetic
 Parasympathetic

After the autonomic nervous system receives information about the body and
external environment, it responds by stimulating body processes, usually through
the sympathetic division, or inhibiting them, usually through the parasympathetic
division.

An autonomic nerve pathway involves two nerve cells. One cell is located in
the brain stem or spinal cord. It is connected by nerve fibers to the other cell,
which is located in a cluster of nerve cells (called an autonomic ganglion). Nerve
fibers from these ganglia connect with internal organs. Most of the ganglia for the
sympathetic division are located just outside the spinal cord on both sides of it.
The ganglia for the parasympathetic division are located near or in the organs
they connect with.
Function of the autonomic nervous system
The autonomic nervous system controls internal body processes such as the
following:

 Blood pressure
 Heart and breathing rates
 Body temperature
 Digestion
 Metabolism (thus affecting body weight)
 The balance of water and electrolytes (such as sodium and calcium)
 The production of body fluids (saliva, sweat, and tears)
 Urination
 Defecation
 Sexual response
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 Anatomy

Many organs are controlled primarily by either the sympathetic or the

parasympathetic division. Sometimes the two divisions have opposite effects on
the same organ. For example, the sympathetic division increases blood pressure,
and the parasympathetic division decreases it. Overall, the two divisions work
together to ensure that the body responds appropriately to different situations.

The sympathetic division does the following:

 Prepares the body for stressful or emergency situations—fight or flight

Thus, the sympathetic division increases heart rate and the force of heart
contractions and widens (dilates) the airways to make breathing easier. It causes
the body to release stored energy. Muscular strength is increased. This division
also causes palms to sweat, pupils to dilate, and hair to stand on end. It slows
body processes that are less important in emergencies, such as digestion and
urination.

The parasympathetic division does the following:

 Controls body process during ordinary situations.

Generally, the parasympathetic division conserves and restores. It slows the heart
rate and decreases blood pressure. It stimulates the digestive tract to process food
and eliminates wastes. Energy from the processed food is used to restore and
build tissues.

Both the sympathetic and parasympathetic divisions are involved in sexual

activity, as are the parts of the nervous system that control voluntary actions and
transmit sensation from the skin
Two chemical messengers (neurotransmitters) are used to communicate within
the autonomic nervous system:
 Acetylcholine
 Norepinephrine
Nerve fibers that secrete acetylcholine are called cholinergic fibers. Fibers that
secrete norepinephrine are called adrenergic fibers. Generally, acetylcholine has
parasympathetic (inhibiting) effects and norepinephrine has sympathetic
(stimulating) effects. However, acetylcholine has some sympathetic effects. For
example, it sometimes stimulates sweating or makes the hair stand on end
CAUSE
autonomic disorders may result from disorders that damage autonomic nerves or
parts of the brain that help control body processes, or they may occur on their
own, without a clear cause.
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 Anatomy

Common causes of autonomic disorders are

 Diabetes (the most common cause)

 Peripheral nerve disorders
 Aging
 Parkinson disease

FUNCTIONS
Sympathetic and parasympathetic divisions typically function in opposition to each
other. But this opposition is better termed complementary in nature rather than
antagonistic. For an analogy, one may think of the sympathetic division as the
accelerator and the parasympathetic division as the brake. The sympathetic
division typically functions in actions requiring quick responses. The
parasympathetic division functions with actions that do not require immediate
reaction. The sympathetic system is often considered the "fight or flight" system,
while the parasympathetic system is often considered the "rest and digest" or "feed
and breed" system.
However, many instances of sympathetic and parasympathetic activity cannot be
ascribed to "fight" or "rest" situations. For example, standing up from a reclining
or sitting position would entail an unsustainable drop in blood pressure if not for a
compensatory increase in the arterial sympathetic tonus. Another example is the
constant, second-to-second, modulation of heart rate by sympathetic and
parasympathetic influences, as a function of the respiratory cycles. In general,
these two systems should be seen as permanently modulating vital functions, in
usually antagonistic fashion, to achieve homeostasis. Higher organisms maintain
their integrity via homeostasis which relies on negative feedback regulation which,
in turn, typically depends on the autonomic nervous system. [14] Some typical
actions of the sympathetic and parasympathetic nervous systems are listed below.
Sympathetic nervous system
Promotes a fight-or-flight response, corresponds with arousal and energy
generation, and inhibits digestion

 Diverts blood flow away from the gastro-intestinal (GI) tract

and skin via vasoconstriction
 Blood flow to skeletal muscles and the lungs is enhanced (by as much as
1200% in the case of skeletal muscles)
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 Anatomy

 Dilates bronchioles of the lung through circulating epinephrine, which

allows for greater alveolar oxygen exchange
 Increases heart rate and the contractility of cardiac cells (myocytes), thereby
providing a mechanism for enhanced blood flow to skeletal muscles
 Dilates pupils and relaxes the ciliary muscle to the lens, allowing more light
to enter the eye and enhances far vision
 Provides vasodilation for the coronary vessels of the heart
 Constricts all the intestinal sphincters and the urinary sphincter
 Inhibits peristalsis
 Stimulates orgasm
Parasympathetic nervous system
The parasympathetic nervous system has been said to promote a "rest and digest"
response, promotes calming of the nerves return to regular function, and enhancing
digestion. Functions of nerves within the parasympathetic nervous system include.
Dilating blood vessels leading to the GI tract, increasing the blood flow.

 Constricting the bronchiolar diameter when the need for oxygen has
diminished
 Dedicated cardiac branches of the vagus and thoracic spinal
accessory nerves impart parasympathetic control of the heart (myocardium)
 Constriction of the pupil and contraction of the ciliary muscles,
facilitating accommodation and allowing for closer vision
 Stimulating salivary gland secretion, and accelerates peristalsis, mediating
digestion of food and, indirectly, the absorption of nutrients
 Sexual. Nerves of the peripheral nervous system are involved in the erection
of genital tissues via the pelvic splanchnic nerves 2–4. They are also
responsible for stimulating sexual arousal.
Enteric nervous system
The enteric nervous system is the intrinsic nervous system of the gastrointestinal
system. It has been described as "the Second Brain of the Human Body". [15] Its
functions include:

 Sensing chemical and mechanical changes in the gut

 Regulating secretions in the gut
 Controlling peristalsis and some other movements

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 Anatomy

Neurotransmitters
At the effector organs, sympathetic ganglionic neurons
release noradrenaline (norepinephrine), along with other cotransmitters such
as ATP, to act on adrenergic receptors, with the exception of the sweat glands and
the adrenal medulla:

 Acetylcholine is the preganglionic neurotransmitter for both divisions of the

ANS, as well as the postganglionic neurotransmitter of parasympathetic
neurons. Nerves that release acetylcholine are said to be cholinergic. In the
parasympathetic system, ganglionic neurons use acetylcholine as a
neurotransmitter to stimulate muscarinic receptors.
 At the adrenal medulla, there is no postsynaptic neuron. Instead the
presynaptic neuron releases acetylcholine to act on nicotinic receptors.
Stimulation of the adrenal medulla releases adrenaline (epinephrine) into the
bloodstream, which acts on adrenoceptors, thereby indirectly mediating or
mimicking sympathetic activity.

6. What are Nerves and its functions?

Nerves are cells called neurons, which make up our nervous system. Nerves are
specialised cells - they carry messages from one part of the body to another, as tiny
electrical signals. These messages are also known as nerve impulses.
The nervous system has two main parts:

 The central nervous system is made up of the brain and spinal cord.

 The peripheral nervous system is made up of nerves that branch off from
the spinal cord and extend to all parts of the body.

The nervous system transmits signals between the brain and the rest of the body,
including internal organs. In this way, the nervous system’s activity controls the
ability to move, breathe, see, think, and more.
The basic unit of the nervous system is a nerve cell, or neuron. The human brain
contains about 100 billion neurons. A neuron has a cell body, which includes the
cell nucleus, and special extensions called axons and dendrites . Bundles of axons,
called nerves, are found throughout the body. Axons and dendrites allow neurons
to communicate, even across long distances.
Different types of neurons control or perform different activities. For instance,
motor neurons transmit messages from the brain to the muscles to generate

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movement. Sensory neurons detect light, sound, odor, taste, pressure, and heat and
send messages about those things to the brain. Other parts of the nervous system
control involuntary processes. These include keeping a regular heartbeat, releasing
hormones like adrenaline, opening the pupil in response to light, and regulating the
digestive system.
When a neuron sends a message to another neuron, it sends an electrical signal
down the length of its axon. At the end of the axon, the electrical signal changes to
a chemical signal. The axon then releases the chemical signal with chemical
messengers called neurotransmitters ) into the synapse the space between the end
of an axon and the tip of a dendrite from another neuron. The neurotransmitters
move the signal through the synapse to the neighboring dendrite, which converts
the chemical signal back into an electrical signal. The electrical signal then travels
through the neuron and goes through the same conversion processes as it moves to
neighboring neurons.

There are three different types of neurones, and each has different function.

1. Sensory neurones carry signals from sensory receptors to the spinal cord

and brain. Together, the spinal cord and brain make up the central nervous
system. Sensory receptors are specialised cells. They detect changes in the
environment, called stimuli, and turn them into electrical impulses. Sensory
neurones carry these electrical impulses to the spinal cord and brain.
Receptors are located in organs such as the ear, eye and skin. Each organ has
receptors sensitive to particular kinds of stimulus e.g. sound, movement, and
touch.
2. Relay neurones carry messages from one part of the central nervous system
to another.
3. Motor neurones carry signals from the central nervous system to an effector
- a part of the body that produces the response to the signal. Effectors
include muscles and glands.

ENDOCRINE SYSTEM

The endocrine system is made up of glands that produce and secrete hormones,
chemical substances produced in the body that regulate the activity of cells or
organs. These hormones regulate the body's growth, metabolism (the physical and
chemical processes of the body), and sexual development and function. The
hormones are released into the bloodstream and may affect one or several organs
throughout the body.

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Hormones are chemical messengers created by the body. They transfer information
from one set of cells to another to coordinate the functions of different parts of the
body.

The major glands of the endocrine system are the hypothalamus, pituitary, thyroid,
parathyroids, adrenals, pineal body, and the reproductive organs (ovaries and
testes). The pancreas is also a part of this system; it has a role in hormone
production as well as in digestion.

The endocrine system is regulated by feedback in much the same way that a
thermostat regulates the temperature in a room. For the hormones that are regulated
by the pituitary gland, a signal is sent from the hypothalamus to the pituitary gland
in the form of a "releasing hormone," which stimulates the pituitary to secrete a
"stimulating hormone" into the circulation. The stimulating hormone then signals
the target gland to secrete its hormone. As the level of this hormone rises in the
circulation, the hypothalamus and the pituitary gland shut down secretion of the
releasing hormone and the stimulating hormone, which in turn slows the secretion
by the target gland. This system results in stable blood concentrations of the
hormones that are regulated by the pituitary gland.

7. Insulin /Diabetes
Insulin is a hormone made by the pancreas that allows your body to use sugar
(glucose) from carbohydrates in the food that you eat for energy or to store glucose
for future use. Insulin helps keeps your blood sugar level from getting too high
(hyperglycemia) or too low (hypoglycemia).
The cells in your body need sugar for energy. However, sugar cannot go into most
of your cells directly. After you eat food and your blood sugar level rises, cells in
your pancreas (known as beta cells) are signaled to release insulin into your
bloodstream. Insulin then attaches to and signals cells to absorb sugar from the
bloodstream. Insulin is often described as a “key,” which unlocks the cell to allow
sugar to enter the cell and be used for energy.
If you have more sugar in your body than it needs, insulin helps store the sugar in
your liver and releases it when your blood sugar level is low or if you need more
sugar, such as in between meals or during physical activity. Therefore, insulin
helps balance out blood sugar levels and keeps them in a normal range. As blood
sugar levels rise, the pancreas secretes more insulin.

If your body does not produce enough insulin or your cells are resistant to the
effects of insulin, you may develop hyperglycemia (high blood sugar), which can

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cause long-term complications if the blood sugar levels stay elevated for long
periods of time.

Insulin Treatment for Diabetes

People with type 1 diabetes cannot make insulin because the beta cells in their
pancreas are damaged or destroyed. Therefore, these people will need insulin
injections to allow their body to process glucose and avoid complications from
hyperglycemia.
People with type 2 diabetes do not respond well or are resistant to insulin. They
may need insulin shots to help them better process sugar and to prevent long-term
complications from this disease. Persons with type 2 diabetes may first be treated
with oral medications, along with diet and exercise. Since type 2 diabetes is a
progressive condition, the longer someone has it, the more likely they will require
insulin to maintain blood sugar levels.

Various types of insulin are used to treat diabetes and include:

 Rapid-acting insulin: It starts working approximately 15 minutes after

injection and peaks at approximately 1 hour but continues to work for two to four
hours. This is usually taken before a meal and in addition to a long-acting insulin.
 Short-acting insulin: It starts working approximately 30 minutes after
injection and peaks at approximately 2 to 3 hours but will continue to work for
three to six hours. It is usually given before a meal and in addition to a long-acting
insulin.
 Intermediate-acting insulin: It starts working approximately 2 to 4 hours
after injection and peaks approximately 4 to 12 hours later and continues to work
for 12-18 hours. It is usually taken twice a day and in addition to a rapid- or short-
acting insulin. 
 Long-acting insulin: It starts working after several hours after injection and
works for approximately 24 hours. If necessary, it is often used in combination
with rapid- or short-acting insulin.
Insulin can be given by a syringe, injection pen, or an insulin pump that delivers a
continuous flow of insulin.

8. Thyroid Gland and its functions

The thyroid gland is a butterfly-shaped organ located in the base of your neck. It
releases hormones that control metabolism—the way your body uses energy. The
thyroid's hormones regulate vital body functions, including:
 Breathing
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 Heart rate
 Central and peripheral nervous systems
 Body weight
 Muscle strength
 Menstrual cycles›
 Body temperature
 Cholesterol levels
 Much more!

The thyroid gland is about 2-inches long and lies in front of your throat below the
prominence of thyroid cartilage sometimes called the Adam's apple. The thyroid
has two sides called lobes that lie on either side of your windpipe, and is usually
connected by a strip of thyroid tissue known as an isthmus. Some people do not
have an isthmus, and instead have two separate thyroid lobe

How the Thyroid Gland Works (functions)

The thyroid is part of the endocrine system, which is made up of glands that
produce, store, and release hormones into the bloodstream so the hormones can
reach the body's cells. The thyroid gland uses iodine from the foods you eat to
make two main hormones:
 Triiodothyronine (T3)
 Thyroxine (T4)
It is important that T3 and T4 levels are neither too high nor too low. Two glands
in the brain—the hypothalamus and the pituitary communicate to maintain T3 and
T4 balance.

The hypothalamus produces TSH Releasing Hormone (TRH) that signals the
pituitary to tell the thyroid gland to produce more or less of T3 and T4 by either
increasing or decreasing the release of a hormone called thyroid stimulating
hormone (TSH).
 When T3 and T4 levels are low in the blood, the pituitary gland releases
more TSH to tell the thyroid gland to produce more thyroid hormones.
 If T3 and T4 levels are high, the pituitary gland releases less TSH to the
thyroid gland to slow production of these hormones.
Why You Need a Thyroid Gland

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T3 and T4 travel in your bloodstream to reach almost every cell in the body. The
hormones regulate the speed with which the cells/metabolism work. For example,
T3 and T4 regulate your heart rate and how fast your intestines process food. So if
T3 and T4 levels are low, your heart rate may be slower than normal, and you may
have constipation/weight gain. If T3 and T4 levels are high, you may have a rapid
heart rate and diarrhea/weight loss.
Listed below are other symptoms of too much T3 and T4 in your body
(hyperthyroidism):
 Anxiety
 Irritability or moodiness
 Nervousness, hyperactivity
 Sweating or sensitivity to high temperatures
 Hand trembling (shaking)
 Hair loss
 Missed or light menstrual periods
The following are other symptoms that may indicate too little T3 and T4 in
your body (hypothyroidism):
 Trouble sleeping
 Tiredness and fatigue
 Difficulty concentrating
 Dry skin and hair
 Depression
 Sensitivity to cold temperature
 Frequent, heavy periods
 Joint and muscle pain

Thyroid Conditions

 Goiter: A general term for thyroid swelling. Goiters can be harmless, or can
represent iodine deficiency or a condition associated with thyroid inflammation
called Hashimoto’s thyroiditis.
 Thyroiditis: Inflammation of the thyroid, usually from a viral infection or
autoimmune condition. Thyroiditis can be painful, or have no symptoms at all.

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 Hyperthyroidism: Excessive thyroid hormone production. Hyperthyroidism is

most often caused by Graves disease or an overactive thyroid nodule.
 Hypothyroidism: Low production of thyroid hormone. Thyroid damage caused
by autoimmune disease is the most common cause of hypothyroidism .
 Graves disease: An autoimmune condition in which the thyroid is
overstimulated, causing hyperthyroidism.
 Thyroid cancer: An uncommon form of cancer, thyroid cancer is usually
curable. Surgery, radiation, and hormone treatments may be used to treat
thyroid cancer.
 Thyroid nodule: A small abnormal mass or lump in the thyroid gland. Thyroid
nodules are extremely common. Few are cancerous. They may secrete excess
hormones, causing hyperthyroidism, or cause no problems. 
 Thyroid storm: A rare form of hyperthyroidism in which extremely high
thyroid hormone levels cause severe illness

Digestive system
The digestive system is made up of the gastrointestinal tract—also called the GI
tract or digestive tract—and the liver, pancreas, and gallbladder. The GI tract is a
series of hollow organs joined in a long, twisting tube from the mouth to the anus.
The hollow organs that make up the GI tract are the mouth, esophagus, stomach,
small intestine, large intestine, and anus. The liver, pancreas, and gallbladder are
the solid organs of the digestive system.
A human digestive system is a group of organs working together in converting
food into energy and basic nutrients required for the body. It is made up of
the gastrointestinal tract, also called a digestive tract along with liver, pancreas,
and gallbladder which constitute the parts of the digestive system. The hollow
organs that make up the gastrointestinal tract (GI tract) include the mouth,
stomach, esophagus, small intestine, and large intestine that contains rectum and
anus.
Human Digestive System and Nutrition involve the intake of food by an organism
and its utilization for energy. This is a vital process which helps living beings to
obtain their energy from various sources. The food which we eat undergoes a lot of
processing before the nutrients present in them are utilized to generate energy. This
processing is known as digestion. Humans and other animals have specialized
organs and system for this process.

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The digestion process involves the alimentary canal along with various accessory
organs and organ systems. In humans, the process is quite simple due to our
monogastric nature. This means that we have a one-chambered stomach, unlike
other animals such as cows, which have four chambers.
Some parts of nervous and circulatory systems also play a major role in the
digestion process. A combination of nerves, bacteria, hormones, blood, and organs
of the digestive system complete the task of digestion that a person consumes in a
day.

Parts of the Digestive System

The digestive system of the human body comprises of a group of organs that work
together in converting food into energy and other basic nutrients to power the
body. The food we take in is digested and utilized by our body and the unused
parts of the food are defecated.
The human digestive system is the sum of the gastrointestinal tract (GIT; also
called alimentary canal) and accessory organs (tongue, liver, pancreas, etc). These
two parts together help in digestion.
The alimentary canal is the long tube through which the food that we eat is passed.
It begins at the mouth (buccal or oral cavity), passes through the pharynx,
esophagus or food pipe, stomach, small intestines, large intestines, rectum and
finally ends at the anus. The food particles get digested gradually as they travel
through various compartments of the alimentary canal.
The digestive system along with its functions:

Mouth
Food starts its journey from the mouth or the oral cavity. There are many other
organs that contribute to the digestion process including teeth, salivary glands, and
tongue. Teeth are designed to grind food particles into small pieces and are
moistened with saliva before the tongue pushes the food into the pharynx.

Pharynx
A fibro muscular y shaped tube attached to the terminal end of the mouth. It is
mainly involved in the passage of chewed/crushed food from the mouth through
the esophagus. It also has a major part in the respiratory system, as air travels
through the pharynx from the nasal cavity on its way to the lungs.

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Esophagus
This is a muscular tube that connects the pharynx which is a part of an upper
section of the gastrointestinal tract. It supplies swallowed food along with its
length.

Stomach
It serves as a muscular bag which is situated towards the left side of the abdominal
cavity, beneath the diaphragm. This vital organ acts as a storage for the food and
provides enough time to digest meals. The stomach also produces digestive
enzymes and hydrochloric acid that maintains the process of digestion.
 Mucous: It is an aqueous secretion produced by the mucous membranes. It
functions by protecting the stomach lining and gastric pits from the acid
which is produced by the glands to destroy the bacteria that entered along
with the food particles.
 Digestive enzymes: They are the group of enzymes which functions by
breaking down polymeric macromolecules like biopolymers into their
smaller and simpler substances.
 Hydrochloric acid: It is the digestive fluid formed by the stomach during
the process of digestion. It functions by destroying harmful microorganisms
present in the food particles.

Small Intestine
The small intestine is a thin, long tube of about 10 feet long and a part of the lower
gastrointestinal tract. It is present just behind the stomach and acquires a maximum
area of the abdominal cavity. The complete small intestine is coiled and inner
surface consists of folds and ridges.

Large Intestine
This is a thick, long tube measuring around 5 feet in length. It is present just
beneath to the stomach and wraps over the superior and lateral edges of the small
intestine. It absorbs water and consists of bacteria (symbiotic) that support in the
break down of wastes to fetch small nutrients.

Rectum
Waste products are passed into the end of the large intestine called the rectum and
eliminated out of the body as a solid matter called stool. It is stored in the rectum

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as semi-solid faeces which later exits from the body through the anal canal through
the process of defecation.

Accessory Organs
Pancreas
It is a larger gland present just inferior to the stomach. It is short with its head
connected to the duodenum and tail pointing towards the left part of the abdominal
cavity. The pancreas releases digestive enzymes to complete the process of
chemical digestion.
Liver
The liver is a roughly triangular, reddish brown accessory organ of the digestive
system located to the right of the stomach. It produces bile, which helps in the
digestion of fat in the small intestine. The bile is stored and recycled in the
gallbladder. It is a small, pear-shaped organ which is located just next to the liver.

Digestion Process
The process of digestion begins from the mouth and ends in the small intestine –
the large intestines’ main function is to absorb the remaining water from the
undigested food and enable bacterial fermentation of materials that can no longer
be digested.
The alimentary canal or the gastrointestinal tract is a series of hollow organs and
tubes that begins from the mouth cavity and continues into the pharynx, through
the stomach, small intestines, large intestines, and finally ending at the anus. Food
particles get digested gradually as they travel through various compartments of the
gastrointestinal tract.
The digestion process takes place in the following steps.

Ingestion
The very first step involves mastication (chewing). The salivary glands, along with
the tongue helps to moisten and lubricate food, before being pushed down into the
food pipe.

Mixing and movement

It involves the process of lubricating and manipulating food and pushing it down
the food through the food pipe (using peristalsis), and into the stomach.
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Secretion
The stomach, small intestine, liver, and pancreas secrete enzymes and acids to aid
the process of digestion. It functions by breaking down food particles into simple
components and easily absorbable components.

Digestion
The process of converting complex food particles into simpler substances in the
presence of enzymes and acids secreted by different digestive organs.

Absorption
This process begins in the small intestine where most of the nutrients and minerals
are absorbed. The excess water in the indigestible matter is absorbed by the large
intestines.

Excretion
The process of removing indigestible substances and waste by-products from the
body through the process of defecation.
In a nutshell, the digestion process consists of the six following steps:
Ingestion ⇒Mixing and
Movement ⇒ Secretion ⇒ Digestion ⇒Absorption ⇒Excretion

Disorders of the Digestive System

1. Jaundice: In this. The liver gets affected, skin and eyes turn yellow due to
the deposit of bile pigment.

2. Vomiting: It is the ejection of stomach contents through the mouth and

controlled by the centre in the medulla oblongata.

3. Diarrhoea: It is the abnormal bowel movement and the faecal discharge

with more liquidity, which leads to dehydration.

4. Constipation: A condition in which the faeces are clutched within the

rectum due to an irregular bowel movement.

5. Indigestion: A pain or discomfort in the stomach which is caused when food

is not digested properly resulting in the feeling of fullness.  Indigestion is
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mainly caused due to inadequate enzyme secretion, food poisoning, anxiety,

overeating and eating spicy foods.

Functions of the Digestive System

Digestion and absorption are the two main functions of the digestive system.
Digestion is necessary for breaking down food particles into nutrients that are used
by the body as an energy source, cell repair, and growth.
Food and drink need to be converted into smaller molecules of nutrients before it is
absorbed by the blood and carried to the cells throughout the body. The body
breaks the nutrients present in the drinks and food into carbohydrates, vitamins,
fats, and proteins.
2. Digestive glands
Most of the glands associated with the digestive tract are embryonic outgrowths of
endoderm although in the stomodeal and proctodeal regions they are derived from
ectoderm. This laboratory is concerned only with the gall bladder and the large,
extramural glands such as liver, pancreas and the major salivary glands. The
intramural glands are considered together with the digestive tract proper.

The liver is the largest internal organ in the body and the most diverse in function.
It serves as a major storage organ (e.g. glycogen) and has numerous metabolic
functions. Furthermore, it is both an endocrine and an exocrine gland. As an
endocrine gland the liver releases lipids, glucose, proteins, glycoproteins and
glycolipids into the bloodstream. Major blood proteins such as albumin,
fibrinogen, complement, transferrin, and the apoproteins of the lipoproteins, are
synthesized and secreted by this organ. As an exocrine gland the liver secretes bile
into a system of canaliculi and ducts convey their content to the gall bladder,
where it is stored and concentrated, before release into the digestive tract.

The pancreas is a large gland that is connected to the duodenum via an excretory

duct. The organ contains several distinct cell types: some exocrine, some
endocrine. The main function of pancreatic exocrine cells is secretion of various
hydrolytic enzymes needed for digestion in the intestine (see accompanying Table,
DG-7). The pancreatic ducts secrete bicarbonate ions and water to neutralize the
pH of the chyme as it enters the duodenum. The endocrine portion of the pancreas
is organized in well-deliniated cell aggregates (islets of Langerhans) that are
interspersed among the acini formed by the exocrine cells. The hormones secreted
by the endocrine pancreas regulate metabolic functions throughout the body, in the
digestive tract, or in the islets themselves. The islets of Langerhans contain three
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 Anatomy

major cell types, alpha, beta and delta cells, that secrete glucagon, insulin and
somatostatin, respectively. The minor cell types secrete hormones having effects
on the digestive tract and glands, including the pancreas itself. Subpopulations of
delta cells (D1) secrete vasoactive intestinal peptide; F cells (PP cells) secrete
pancreatic polypeptide; EC cells produce secretin, motilin and substance P. Gastrin
is secreted by G cells in the pancreas of some animals, but has not been localized
in the human pancreas.

The major salivary glands, the parotid, submandibular and sublingual

(hormones secreted), are found as paired sets. Their ducts empty into the oral
cavity. Their main function is to secrete saliva, which contains mucin, water and
ions, as well as a few digestive enzymes, such as amylase and RNAse (see
accompanying Table, DG-7). Salivary glands are distinguished by the morphology
of their secretory elements and duct structure, as well as by the predominant type
of product they synthesize. They are called serous, protein secreting, or mucous,
glycoprotein secreting (mucin secreting). Although serous cells do secrete
glycosylated proteins and, therefore, can be considered to be seromucous cells, this
morphological terminology is still used because of the much greater amount of
carbohydrate in the mucous secretions synthesized by the mucous cells.

3. Hemorrhoids
Swollen and inflamed veins in the rectum and anus that cause discomfort and
bleeding is Hemorrhoids also called piles, are swollen veins in your anus and lower
rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum
(internal hemorrhoids) or under the skin around the anus (external hemorrhoids).
Symptoms

Signs and symptoms of hemorrhoids usually depend on the type of hemorrhoid.

External hemorrhoids

These are under the skin around your anus. Signs and symptoms might include:

 Itching or irritation in your anal region

 Pain or discomfort

 Swelling around your anus

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 Bleeding
Internal hemorrhoids

Internal hemorrhoids lie inside the rectum. You usually can't see or feel them, and
they rarely cause discomfort. But straining or irritation when passing stool can
cause:

 Painless bleeding during bowel movements. You might notice small

amounts of bright red blood on your toilet tissue or in the toilet.

 A hemorrhoid to push through the anal opening (prolapsed or protruding

hemorrhoid), resulting in pain and irritation.
Thrombosed hemorrhoids

If blood pools in an external hemorrhoid and forms a clot (thrombus), it can result
in:

 Severe pain

 Swelling

 Inflammation

 A hard lump near your anus

Causes: The veins around your anus tend to stretch under pressure and may bulge
or swell. Hemorrhoids can develop from increased pressure in the lower rectum
due to:

 Straining during bowel movements

 Sitting for long periods of time on the toilet
 Having chronic diarrhea or constipation
 Being obese
 Being pregnant

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 Having anal intercourse

 Eating a low-fiber diet
 Regular heavy lifting
Complications: Complications of hemorrhoids are rare but include:

 Anemia. Rarely, chronic blood loss from hemorrhoids may cause anemia, in which you
don't have enough healthy red blood cells to carry oxygen to your cells.

 Strangulated hemorrhoid. If the blood supply to an internal hemorrhoid is cut off, the
hemorrhoid may be "strangulated," which can cause extreme pain.

 Blood clot. Occasionally, a clot can form in a hemorrhoid (thrombosed hemorrhoid).

Although not dangerous, it can be extremely painful and sometimes needs to be lanced
and drained.

Prevention

The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To
prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:

 Eat high-fiber foods. Eat more fruits, vegetables and whole grains. Doing so softens
the stool and increases its bulk, which will help you avoid the straining that can cause
hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.

 Drink plenty of fluids. Drink six to eight glasses of water and other liquids (not alcohol)
each day to help keep stools soft.

 Consider fiber supplements. Most people don't get enough of the

recommended amount of fiber — 20 to 30 grams a day — in their diet. Studies
have shown that over-the-counter fiber supplements, such as psyllium (Metamucil)
or methylcellulose (Citrucel), improve overall symptoms and bleeding from
hemorrhoids.

If you use fiber supplements, be sure to drink at least eight glasses of water or
other fluids every day. Otherwise, the supplements can cause or worsen
constipation.

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 Don't strain. Straining and holding your breath when trying to pass a stool creates
greater pressure in the veins in the lower rectum.

 Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge
goes away, your stool could dry out and be harder to pass.

 Exercise. Stay active to help prevent constipation and to reduce pressure on veins,

which can occur with long periods of standing or sitting. Exercise can also help you lose
excess weight that might be contributing to your hemorrhoids.

 Avoid long periods of sitting. Sitting too long, particularly on the toilet, can increase
the pressure on the veins in the anus.

4. Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a common disorder that affects the large
intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas,
and diarrhea or constipation, or both. IBS is a chronic condition that you'll need
to manage long term.
Only a small number of people with IBS have severe signs and symptoms.
Some people can control their symptoms by managing diet, lifestyle and stress.
More-severe symptoms can be treated with medication and counseling. IBS
doesn't cause changes in bowel tissue or increase your risk of colorectal cancer.
Symptoms
The signs and symptoms of IBS vary. The most common include:

 Abdominal pain, cramping or bloating that is typically relieved or partially

relieved by passing a bowel movement
 Excess gas
 Diarrhea or constipation — sometimes alternating bouts of diarrhea and
constipation
 Mucus in the stool
 Weight loss
 Diarrhea at night
 Rectal bleeding
 Iron deficiency anemia
 Unexplained vomiting
 Difficulty swallowing
 Persistent pain that isn't relieved by passing gas or a bowel movement

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Causes
The precise cause of IBS isn't known. Factors that appear to play a role include:

 Muscle contractions in the intestine. The walls of the intestines are lined

with layers of muscle that contract as they move food through your digestive
tract. Contractions that are stronger and last longer than normal can cause gas,
bloating and diarrhea. Weak intestinal contractions can slow food passage and
lead to hard, dry stools.
 Nervous system. Abnormalities in the nerves in your digestive system may
cause you to experience greater than normal discomfort when your abdomen
stretches from gas or stool. Poorly coordinated signals between the brain and
the intestines can cause your body to overreact to changes that normally occur
in the digestive process, resulting in pain, diarrhea or constipation.
 Inflammation in the intestines. Some people with IBS have an increased
number of immune-system cells in their intestines. This immune-system
response is associated with pain and diarrhea.
 Severe infection. IBS can develop after a severe bout of diarrhea
(gastroenteritis) caused by bacteria or a virus. IBS might also be associated
with a surplus of bacteria in the intestines (bacterial overgrowth).
 Changes in bacteria in the gut (microflora). Microflora are the "good"
bacteria that reside in the intestines and play a key role in health. Research
indicates that microflora in people with IBS might differ from microflora in
healthy people.
Triggers
Symptoms of IBS can be triggered by:

 Food. The role of food allergy or intolerance in IBS isn't fully understood. A

true food allergy rarely causes IBS. But many people have worse IBS
symptoms when they eat or drink certain foods or beverages, including wheat,
dairy products, citrus fruits, beans, cabbage, milk and carbonated drinks.
 Stress. Most people with IBS experience worse or more frequent signs and
symptoms during periods of increased stress. But while stress may aggravate
symptoms, it doesn't cause them.
 Hormones. Women are twice as likely to have IBS, which might indicate
that hormonal changes play a role. Many women find that signs and
symptoms are worse during or around their menstrual periods.

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Risk factors
Many people have occasional signs and symptoms of IBS. But you're more likely
to have the syndrome if you:

 Are young. IBS occurs more frequently in people under age 50.

 Are female. In the United States, IBS is more common among women.
Estrogen therapy before or after menopause also is a risk factor for IBS.
 Have a family history of IBS. Genes may play a role, as may shared factors
in a family's environment or a combination of genes and environment.
 Have a mental health problem. Anxiety, depression and other mental
health issues are associated with IBS. A history of sexual, physical or
emotional abuse also might be a risk factor.
Complications
Chronic constipation or diarrhea can cause hemorrhoids.
In addition, IBS is associated with:

 Poor quality of life. Many people with moderate to severe IBS report poor
quality of life. Research indicates that people with IBS miss three times as
many days from work as do those without bowel symptoms.
 Mood disorders. Experiencing the signs and symptoms of IBS can lead to
depression or anxiety. Depression and anxiety also can make IBS worse.

Prevention
Finding ways to deal with stress may help prevent or ease symptoms of IBS.
Consider trying:

 Counseling. A counselor can help you learn to modify or change your

responses to stress. Studies have shown that psychotherapy can provide
significant and long-lasting reduction of symptoms.
 Biofeedback. Electrical sensors help you receive information (feedback) on
your body's functions. The feedback helps you focus on making subtle
changes, such as relaxing certain muscles, to ease symptoms.
 Progressive relaxation exercises. These exercises help you relax muscles in
your body, one by one. Start by tightening the muscles in your feet, then
concentrate on slowly letting all of the tension go. Next, tighten and relax

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your calves. Continue until the muscles in your body, including those in your
eyes and scalp, are relaxed.
 Mindfulness training. This stress-reduction technique helps you focus on
being in the moment and letting go of worries and distractions.
Anxiety and stress

The following may help reduce or relieve symptoms:

 relaxation techniques, including exercises or meditation

 some specific physical activities, such as Tai Chi or yoga
 regular physical exercise
 stress counseling or cognitive behavioral therapy (CBT)

5. Peptic ulcers /acid peptic diseases

Peptic ulcers are open sores that develop on the inside lining of your stomach and
the upper portion of your small intestine. The most common symptom of a peptic
ulcer is stomach pain.

Peptic ulcers include:

 Gastric ulcers that occur on the inside of the stomach

 Duodenal ulcers that occur on the inside of the upper portion of your small
intestine (duodenum)
The most common causes of peptic ulcers are infection with the bacterium
Helicobacter pylori (H. pylori) and long-term use of aspirin and nonsteroidal anti-
inflammatory drugs (NSAIDs) (Advil, Aleve, others). Stress and spicy foods do
not cause peptic ulcers. However, they can make your symptoms worse.

Symptoms

 Burning stomach pain

 Feeling of fullness, bloating or belching

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 Fatty food intolerance

 Heartburn
 Nausea
The most common peptic ulcer symptom is burning stomach pain. Stomach acid
makes the pain worse, as does having an empty stomach. The pain can often be
relieved by eating certain foods that buffer stomach acid or by taking an acid-
reducing medication, but then it may come back. The pain may be worse between
meals and at night.

Nearly three-quarters of people with peptic ulcers don't have symptoms.

Less often, ulcers may cause severe signs or symptoms such as:

 Vomiting or vomiting blood — which may appear red or black

 Dark blood in stools, or stools that are black or tarry
 Trouble breathing
 Feeling faint
 Nausea or vomiting
 Unexplained weight loss
 Appetite changes
Causes

Peptic ulcers occur when acid in the digestive tract eats away at the inner surface
of the stomach or small intestine. The acid can create a painful open sore that may
bleed.

Your digestive tract is coated with a mucous layer that normally protects against
acid. But if the amount of acid is increased or the amount of mucus is decreased,
you could develop an ulcer. Common causes include:

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 A bacterium. Helicobacter pylori bacteria commonly live in the mucous

layer that covers and protects tissues that line the stomach and small intestine.
Often, the H. pylori bacterium causes no problems, but it can cause
inflammation of the stomach's inner layer, producing an ulcer.
It's not clear how H. pylori infection spreads. It may be transmitted from
person to person by close contact, such as kissing. People may also contract
H. pylori through food and water.
 Regular use of certain pain relievers. Taking aspirin, as well as certain
over-the-counter and prescription pain medications called nonsteroidal anti-
inflammatory drugs (NSAIDs) can irritate or inflame the lining of your
stomach and small intestine. These medications include ibuprofen (Advil,
Motrin IB, others), naproxen sodium (Aleve, Anaprox, others), ketoprofen and
others. They do not include acetaminophen (Tylenol).
Peptic ulcers are more common in older adults who take these pain
medications frequently or in people who take these medications for
osteoarthritis.

 Other medications. Taking certain other medications along with NSAIDs,

such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake
inhibitors (SSRIs), alendronate (Fosamax) and risedronate (Actonel), can
greatly increase the chance of developing ulcers.
Risk factors

In addition to taking NSAIDs, you may have an increased risk of peptic ulcers if
you:

 Smoke. Smoking may increase the risk of peptic ulcers in people who are
infected with H. pylori.
 Drink alcohol. Alcohol can irritate and erode the mucous lining of your
stomach, and it increases the amount of stomach acid that's produced.
 Have untreated stress.
 Eat spicy foods.

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Alone, these factors do not cause ulcers, but they can make them worse and more
difficult to heal.

Complications

Left untreated, peptic ulcers can result in:

 Internal bleeding. Bleeding can occur as slow blood loss that leads to

anemia or as severe blood loss that may require hospitalization or a blood
transfusion. Severe blood loss may cause black or bloody vomit or black or
bloody stools.
 Infection. Peptic ulcers can eat a hole through (perforate) the wall of your
stomach or small intestine, putting you at risk of serious infection of your
abdominal cavity (peritonitis).
 Obstruction. Peptic ulcers can block passage of food through the digestive
tract, causing you to become full easily, to vomit and to lose weight through
either swelling from inflammation or scarring.

 Scar tissue: This is thick tissue that develops after an injury. This tissue
makes it difficult for food to pass through your digestive tract. Signs of
scar tissue include vomiting and weight loss.
Prevention

You may reduce your risk of peptic ulcer if you follow the same strategies
recommended as home remedies to treat ulcers. It may also be helpful to:

 Protect yourself from infections. It's not clear just how H. pylori spreads,
but there's some evidence that it could be transmitted from person to person or
through food and water.
You can take steps to protect yourself from infections, such as H. pylori, by
frequently washing your hands with soap and water and by eating foods that
have been cooked completely.

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 Use caution with pain relievers. If you regularly use pain relievers that
increase your risk of peptic ulcer, take steps to reduce your risk of stomach
problems. For instance, take your medication with meals.
Work with your doctor to find the lowest dose possible that still gives you
pain relief. Avoid drinking alcohol when taking your medication, since the
two can combine to increase your risk of stomach upset.
If you need an NSAID, you may need to also take additional medications such
as an antacid, a PPI, an acid blocker or cytoprotective agent. A class of
NSAIDs called COX-2 inhibitors may be less likely to cause peptic ulcers, but
may increase the risk of heart attack.

6. Obesity
Obesity is a complex disorder involving an excessive amount of body fat. Body
mass index (BMI) is a simple index of weight-for-height that is commonly used to
classify overweight and obesity in adults. It is defined as a person's weight in
kilograms divided by the square of his height in meters (kg/m 2). It increases your
risk of diseases and health problems, such as heart disease, diabetes and high blood
pressure.

Being extremely obese means you are especially likely to have health problems
related to your weight, the health problems associated with obesity are Dietary
changes, increased physical activity and behavior changes can help you lose
weight.

Symptoms

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. Your
body mass index is calculated by dividing your weight in kilograms (kg) by your
height in meters (m) squared.

 Normal weight = 18.5-24.9

 Overweight = 25.0-29.9

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 Obese(Class I) = 30 -34.9

 Obese (Class II)= 35-39.9

 Morbidly obese = 40 or greater

Causes

Although there are genetic, behavioral and hormonal influences on body weight,
obesity occurs when you take in more calories than you burn through exercise and
normal daily activities. Your body stores these excess calories as fat.

Obesity can sometimes be traced to a medical cause, such as Prader-Willi

syndrome, Cushing's syndrome, and other diseases and conditions. However, these
disorders are rare and, in general, the principal causes of obesity are:

 Inactivity. If you're not very active, you don't burn as many calories. With a
sedentary lifestyle, you can easily take in more calories every day than you
use through exercise and normal daily activities.
 Unhealthy diet and eating habits. Weight gain is inevitable if you
regularly eat more calories than you burn. And most Americans' diets are too
high in calories and are full of fast food and high-calorie beverages.
Risk factors

Obesity usually results from a combination of causes and contributing factors,

including:

 Genetics. Your genes may affect the amount of body fat you store, and
where that fat is distributed. Genetics may also play a role in how efficiently
your body converts food into energy and how your body burns calories during
exercise.
 Family lifestyle. Obesity tends to run in families. If one or both of your
parents are obese, your risk of being obese is increased. That's not just
because of genetics. Family members tend to share similar eating and activity
habits.

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 Inactivity. If you're not very active, you don't burn as many calories. With a
sedentary lifestyle, you can easily take in more calories every day than you
burn through exercise and routine daily activities. Having medical problems,
such as arthritis, can lead to decreased activity, which contributes to weight
gain.
 Unhealthy diet. A diet that's high in calories, lacking in fruits and
vegetables, full of fast food, and laden with high-calorie beverages and
oversized portions contributes to weight gain.
 Medical problems. In some people, obesity can be traced to a medical
cause, such as Prader-Willi syndrome, Cushing's syndrome and other
conditions. Medical problems, such as arthritis, also can lead to decreased
activity, which may result in weight gain.
 Certain medications. Some medications can lead to weight gain if you don't
compensate through diet or activity. These medications include some
antidepressants, anti-seizure medications, diabetes medications, antipsychotic
medications, steroids and beta blockers.
 Social and economic issues. Research has linked social and economic
factors to obesity. Avoiding obesity is difficult if you don't have safe areas to
exercise. Similarly, you may not have been taught healthy ways of cooking, or
you may not have money to buy healthier foods. In addition, the people you
spend time with may influence your weight — you're more likely to become
obese if you have obese friends or relatives.
 Age. Obesity can occur at any age, even in young children. But as you age,
hormonal changes and a less active lifestyle increase your risk of obesity. In
addition, the amount of muscle in your body tends to decrease with age. This
lower muscle mass leads to a decrease in metabolism. These changes also
reduce calorie needs, and can make it harder to keep off excess weight. If you
don't consciously control what you eat and become more physically active as
you age, you'll likely gain weight.
 Pregnancy. During pregnancy, a woman's weight necessarily increases.
Some women find this weight difficult to lose after the baby is born. This
weight gain may contribute to the development of obesity in women.
 Quitting smoking. Quitting smoking is often associated with weight gain.
And for some, it can lead to enough weight gain that the person becomes

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obese. In the long run, however, quitting smoking is still a greater benefit to
your health than continuing to smoke.
 Lack of sleep. Not getting enough sleep or getting too much sleep can cause
changes in hormones that increase your appetite. You may also crave foods
high in calories and carbohydrates, which can contribute to weight gain.
Even if you have one or more of these risk factors, it doesn't mean that you're
destined to become obese. You can counteract most risk factors through diet,
physical activity and exercise, and behavior changes.

Complications

If you're obese, you're more likely to develop a number of potentially serious

health problems, including:

 High triglycerides and low high-density lipoprotein (HDL) cholesterol

 Type 2 diabetes
 High blood pressure
 Metabolic syndrome — a combination of high blood sugar, high blood
pressure, high triglycerides and low HDL cholesterol
 Heart disease
 Stroke
 Cancer, including cancer of the uterus, cervix, endometrium, ovaries, breast,
colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate
 Breathing disorders, including sleep apnea, a potentially serious sleep
disorder in which breathing repeatedly stops and starts
 Gallbladder disease
 Gynecological problems, such as infertility and irregular periods
 Erectile dysfunction and sexual health issues
 Nonalcoholic fatty liver disease, a condition in which fat builds up in the
liver and can cause inflammation or scarring

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 Osteoarthritis
Quality of life

When you're obese, your overall quality of life may be diminished. You may not
be able to do things you used to do, such as participating in enjoyable activities.
You may avoid public places. Obese people may even encounter discrimination.

Other weight-related issues that may affect your quality of life include:

 Depression
 Disability
 Sexual problems
 Shame and guilt
 Social isolation
 Lower work achievement
Prevention

Whether you're at risk of becoming obese, currently overweight or at a healthy

weight, you can take steps to prevent unhealthy weight gain and related health
problems. Not surprisingly, the steps to prevent weight gain are the same as the
steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to
watch what you eat and drink.

 Exercise regularly. You need to get 150 to 300 minutes of moderate-

intensity activity a week to prevent weight gain. Moderately intense physical
activities include fast walking and swimming.
 Follow a healthy eating plan. Focus on low-calorie, nutrient-dense foods,
such as fruits, vegetables and whole grains. Avoid saturated fat and limit
sweets and alcohol. Eat three regular meals a day with limited snacking. You
can still enjoy small amounts of high-fat, high-calorie foods as an infrequent
treat. Just be sure to choose foods that promote a healthy weight and good
health most of the time.

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 Know and avoid the food traps that cause you to eat. Identify situations
that trigger out-of-control eating. Try keeping a journal and write down what
you eat, how much you eat, when you eat, how you're feeling and how hungry
you are. After a while, you should see patterns emerge. You can plan ahead
and develop strategies for handling these types of situations and stay in
control of your eating behaviors.
 Monitor your weight regularly. People who weigh themselves at least
once a week are more successful in keeping off excess pounds. Monitoring
your weight can tell you whether your efforts are working and can help you
detect small weight gains before they become big problems.
 Be consistent. Sticking to your healthy-weight plan during the week, on the
weekends, and amidst vacation and holidays as much as possible increases
your chances of long-term success.

A lymph node or lymph gland is an ovoid or kidney-shaped organ of

the lymphatic system and the adaptive immune system. Lymph nodes are widely
present throughout the body and are linked by the lymphaticvessels as a part of the
circulatory system. They are major sites of B and T lymphocytes and other white
blood cells.
The lymphatic system is part of the vascular system and an important part of the
immune system, comprising a large network of lymphatic vessels that carry a clear
fluid called lymph directionally towards the heart

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