Human Anatomy Sessions

THE UNITED REPUBLIC OF TANZANIA
MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERS AND CHILDREN
FACILITATOR’S GUIDE
FOR
BASIC TECHNICIAN CERTIFICATE

IN NURSING AND MIDWIFERY NTA LEVEL 4
NMT 04103 HUMAN ANATOMY AND PHYSIOLOGY

© 2018
The Ministry of Health, Community Development,
Gender, Elderly and Children
ii Facilitator Guide | NMT 04103 Human Anatomy and Physiology

Table of Contents
Abbreviation
iv Facilitator Guide | NMT 04103 Human Anatomy and Physiology

Acknowledgement
v Facilitator Guide | NMT 04103 Human Anatomy and Physiology

vi Facilitator Guide | NMT 04103 Human Anatomy and Physiology
Background
vii Facilitator Guide | NMT 04103 Human Anatomy and Physiology

Rationale
viii Facilitator Guide | NMT 04103 Human Anatomy and Physiology

ix Facilitator Guide | NMT 04103 Human Anatomy and Physiology
Goals and Objectives of the Training Manual
Overall Goal for training manual

The overall goal of these training manual is to provide high quality, standardized and competence-
based training materials for Diploma in nursing (NTA level 4 to 6) program.
Objectives for training manual

 To provide high quality, standardized and competence-based training materials.
 To provide a guide for tutors to deliver high quality training materials.
 Enable students to learn more effectively.
x Facilitator Guide | NMT 04103 Human Anatomy and Physiology

Introduction
Module Overview
This module content has been prepared as a guide for tutors of NTA Level 4 for training students. The
session contents are based on the sub-enabling outcomes of the curriculum of NTA Level 4 Basic
Technician Certificate in Nursing and Midwifery.
The module sub-enabling outcomes are as follows:

3.3.1 Explain basic concepts of anatomy and physiology in relation to human body
3.3.2 Describe respiratory, digestive and cardiovascular systems usingknowledge of anatomy and
physiology
3.3.3 Describe musculoskeletal, urinary and reproductive systems using knowledge of anatomy and
physiology
3.3.4 Describe nervous, endocrine, lymphatic-immune systems and special senses
using knowledge of anatomy and physiology
3.4.1 Explain concepts of biochemistry in relation to human body biochemical functions
3.4.2 Explain functions of macromolecules in relation to human body function
3.4.3 Describe human body enzymes, co-enzymes, fluids, and electrolytes in relation to human body
function
Who is the Module For?

This module is intended for use primarily by tutors of NTA Level 4 in Nuring and Midwifery.
The module sessions give guidance on the time and activities of the session and provide information on
how to teach the session to students. The sessions include different activities which focus on increasing
student’s skills, knowledge and attitudes.
How is the Module Organized?

The module is divided into ----sessions; each session is divided into sections. The following are the
sections of each session:
 Session Title: The name of the session.
 Learning Tasks – Statements which indicate what the student is expected to learn at the end of the
session.
 Session Content – All the session contents are divided into steps. Each step has a heading and an
estimated time to teach that step. Also, this section includes instructions for the tutor and activities
with their instructions to be done during teaching of the contents.
 Key Points – Each session has a step which concludes the session contents near the end of a
session. This step summarizes the main points and ideas from the session.
 Evaluation – The last section of the session consists of short questions based on the learning
objectives to check the understanding of students.
 Handouts are additional information which can be used in the classroom while teaching or later for
students’ further learning. Handouts are used to provide extra information related to the session
topic that cannot fit into the session time. Handouts can be used by the participants to study
material on their own and to reference after the session. Sometimes, a handout will have questions
xi Facilitator Guide | NMT 04103 Human Anatomy and Physiology
or an exercise for the participants. The answers to the questions are in the Facilitator Guide
Handout, and not in the Student Manual Handout.
How Should the Module be used?

Students are expected to use the module in the classroom and clinical settings and during self-study.
The contents of the modules are the basis for learning. Students are therefore advised to learn each
session and the relevant handouts and worksheets during class hours, clinical hours and self-study
time. Tutors are there to provide guidance and to respond to all difficulty encountered by students
xii Facilitator Guide | NMT 04103 Human Anatomy and Physiology

Session 1: Introduction of Anatomy and Physiology of Human Body
Total Session Time: 120 minutes.
Prerequisites
 None
Learning Tasks
By the end of this session, learner is expected to be able to:
 Define common terms in relation to anatomy and physiology
 Identify the orgsanisation of the body as a whole
 Identify human cell
Resources Needed:
 Flip charts, marker pens, and masking tape
 Black/white board and chalk/whiteboard markers
 Projector
 Computer
 Handouts
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Presentation of Session Title and Learning Tasks
Definition of common terms in relations to anatomy and
2 15 minutes Presentation
physiology
Orgsanisation of the body
40 minutes Human cell

4 Presentation
5 05 minutes Presentation Key Points
6 05 minutes Presentation Evaluation
13 Facilitator Guide | NMT 04103 Human Anatomy and Physiology

SESSION CONTENTS
STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

 READ or ASK learners to read the learning tasks and clarify
 ASK leaners if they have any questions before continuing.
STEP 2: Definition of common terms in relation to anatomy and physiology (15 minutes)
The common terms used in anatomy and physiology are as follows
 Anatomy - Is the study of the structure of the body
o Is the study of the structure and shape of the body and body parts and their relationship to one another
 Physiology - Is the study of functions of the body systems

o Is study of the physical and chemical processes that take place in living organisms during the
performance of life functions
o It is concerned with such basic activities as reproduction, growth, metabolism, excitation, and
contraction as they are carried out within the fine structure, the cells, tissues, organs, and organ
systems of the body.
o Is the study of how the body and its parts work or function
 Medial: Toward or at the midline of the body
 Lateral: Away from the midline of the body
 Proximal: Close to the origin of the body part or the point of attachment of a limb to the body trunk
 Distal: Further away from the origin of a body part or the point of attachment of a limb to the body trunk
 Superficial: Toward or at the body surface
 Deep: Away from the body surface; more internal
 Axial: Makes up the main axis of the body. Consists of the head, neck, and trunk
 Appendicular: Consists of the appendages or limbs
 Superior (cranial or cephalad): Toward the head end or upper part of a structure of the body
 Inferior (caudal). Away from the head end or toward the lower part of a structure or the body
STEP 3: Orgsanisation of the Body (45 Minutes)

Level 1 - Chemical Level
 This is the level reserved for the building blocks of human life, including atoms and molecules, which combine
to make organelles, which determine cell function.
 These functions can include cell membranes, mitochondria and ribosomes.
 For the body to function well there must be equilibrium/ balance between internal and external environment
known as homeostasis ( which means unchanging, but in practice it describes a dynamic, never changing
situation kept within narrow limits).
o When this balance is threatened or lost, there is a serious risk to the well-being of the individual.
o Some of the factors which must be maintained within a narrow limits are:-
 Temperature
 Water and electrolyte concentrations.
 Ph (acidity or alkalinity of body fluids)
 Blood glucose level
 Blood and tissue oxygen and carbon dioxide levels
 Blood pressure
 Homeostasis is maintained by control systems which detect and responds to changes in the internal
environment.
 Basic components of control mechanism
 A control system has three basic components
o Detectors
o Control center
o Effectors
 The control center determines the limits within which the variable factors should be maintained.
 It receives an input from the detector or sensor and integrates the incoming information.
 When the incoming signal indicate that an adjustment is needed the control centre responds and its output to
the effectors is changed.
o Mechanism in control system includes:-
 Negative feedback mechanism
 Positive feedback mechanism
 Negative feedback mechanism
 The effectors response decrease or negates the effect of the original stimulus, restoring homeostasis
(thus the term negative feedback)
 Control of the body temperature
o When body temperature falls below the present level, this is detected by specialized temperature sensitive
nerve endings.
o They transmit this information as an input to groups of cells in the hypothalamus of the brain which forms
the control center.
o The output from the control centre activates mechanisms that raise body temperature (effectors). These
include:-
 Stimulation of skeletal muscles causing shivering
 Narrowing of the blood vessels in the skin reducing the blood flow to, and heat loss from the
peripheries
 Behavioral changes e.g. we put on more clothes or curl up
o When body temperature rises to within the normal range, the temperature sensitive nerve endings no
longer stimulates the cells of the control centre and therefore the output of this centre to the effectors
ceases.
o Most of the homeostatic controls in the body use negative feedback mechanisms to prevent sudden and
serious changes in the internal environment.
 Positive feedback mechanism.
o There are only a few of these amplifier or cascade systems in the body.
o In positive feedback mechanisms, stimulus progressively increases the response, so that as long as
stimulus is continued the response is progressively being amplified.
 For example uterine contractions during labour.
Level 2 - Cells
 Are the basic units of structure and function in living things
 May serve a specific function within the organism
o Examples- blood cells, nerve cells, bone cells, etc.
Level 3 - Tissues
 Made up of cells that are similar in structure and function and which work together to perform a specific
activity
o Examples - blood, nervous, bone, etc.
 Humans have 4 basic tissues: connective, epithelial, muscle, and nerve.
Level 4 - Organs
 Made up of tissues that work together to perform a specific activity
o Examples - heart, brain, skin, etc.
Level 5 - Organ Systems

 Groups of two or more tissues that work together to perform a specific function for the organism.
o Examples - circulatory system, nervous system, skeletal system, etc.
o The Human body has 11 organ systems - circulatory, digestive, endocrine, excretory (urinary), immune
(lymphatic), integumentary, muscular, nervous, reproductive, respiratory, and skeletal.
Level 6 - Organisms
 Entire living things that can carry out all basic life processes.
o Meaning they can take in materials, release energy from food, release wastes, grow, respond to the
environment, and reproduce.
o Usually made up of organ systems, but an organism may be made up of only one cell such as
bacteria or protist.
o Examples - bacteria, amoeba, mushroom, sunflower, human
STEP 4: Human Cells (40 minutes)

Activity: Small group activity
 DIVIDE students into 4 groups (depending on the size of the class).
 ASK students as a large group:
o What is the human body cell?
o What are the characteristics of the human body cell?
o What are the Structures of the cell?
o What are the functions of the human body cells?
 ASSIGN each group.
 ASK the groups to work together to come up with answers to the question above questions.
 ALLOW groups 30 minutes for this exercise.
 ASK students to report back their answers to the above questions.
 APPRAISE the students
 PROVIDE feedback by summarizing the students’ answers

The human body cell
 Is the smallest functional unit of the body
 The human body develop from a single cell called the zygote which results from the fusion of the ovum
(female egg cell) and the spermatozoon (male germ cell) cell multiplication follows and as the fetus grows,
cells with different structural and functional specializations develop, all the cell genetic makeup as the zygote.
 Individual cells are too small to been seen with naked eye. However they can be seen when their lies of tissue
are stained in the laboratory and magnified by a microscope
Characteristics of the cell
 Reproduction.
o When cell growth is complete they reproduce.
 Irritability.
o The cell can respond to a stimuli
 Movement.
o Some cell may move from one place to another
 Excretion.
o Waste products of cell metabolism are passed out of the cell through cell membrane.
 Growth.
o Cell are able to grow until they are mature
 Respiration.
o Every cell requires oxygen and gives out carbondioxide
 Metabolism.
o Changes do take place in all living cell e.g. taking in and utilizing nourishment.
Structure of the human cell

 A cell consists of a plasma membrane inside which there are a number of organelles floating in a watery
fluid called cytosol
o Organelles are small structures with high specialized functions many of which are contained within a
membrane they include the:-
 Nucleus
 Mitochondria
 Ribosomes
 Endoplasmic reticulum
 Golgi apparatus
 Lysosomes
 Microfilaments
 Microtubules
Plasma membrane

 The plasma membrane consists of two layers of phospholipids (fatty substances) with some protein
molecule embedded in them.
 Those that extend all the way through the membrane may provide channels that allow the passage of for
example electrolytes and non lipid – soluble substances.
 The phospholipids molecules have a head which is electrically charged and hydrophilic attracting water
and a tail which has no charge and is hydrophobic water repelling.
 The phospholipids bi-layer is arranged like a sandwich the hydrophilic leads aligned on the outer surfaces
of the membrane and the hydrophilic tails forming a central water repelling layer
o These differences influence the transfer of substances across the membrane
 The membrane protein perform several functions these are:-
o They give the cell its immunological identity
o They can act as specific receptors for hormones and other chemical messengers.
o Some are enzymes
o Some are involved in transport across the membrane
 Organelles of the cell

o Nucleus
 Is the largest organelle and is contained with a membrane similar to the plasma membrane but it
has tiny pores through which some substances can pass between it and the cytoplasm i.e. the cell
contents excluding the nucleus,
Every cell in the body has a nucleus with the exception of mature erythrocytes (red blood cells)
The nucleus contains the body’s genetic material, which directs the activities of the cell.
 This is built from D.N.A and proteins called histones coiled together forming a five network of
threads called chromatin
 The functional subunits of chromosomes are called genes.
 Each cell contain the total complement of genes required to synthesizes all the proteins in the
body but most cells synthesis only the defined range of proteins that are appropriate to their own
specialized functions.
 The transfer of information from nuclear DNA to the site where proteins are synthesized in the
cytoplasm is the function of ribonucleic acid (RNA). The formation of RNA is controlled by genes in
the DNA, i.e. genetic information passes from DNA to RNA promoting protein synthesis.
o Mitochondria
 These are sausage shaped structures in the cytoplasm, sometimes describes as “power house”
of the cell.
 They are involved in aerobic respiration, the processes by which chemical energy is made
available in the cell.
 This is in the form of ATP, which release energy when the cell breaks it down.
 Synthesis of ATP is most efficient in the final stages of aerobic respiration, a process requiring
oxygen.
o Ribosomes
 These are tiny granules composed of RNA and protein.

 They synthesize proteins from amino acids, using RNA as the template.
 When present in free units or in small clusters in the cytoplasm, the ribosomes make proteins
for use within the cell.
 Ribosomes are also found on the outer surface of rough endoplasmic reticulum.
o Endoplasmic reticulum.
 Is a series of interconnecting membranous canals in the cytoplasm which are in two types.
 Smooth Endoplasmic reticulum
This synthesizes lipids and steroid hormones, and is also associated with the detoxification of some
drugs.
 Rough Endoplasmic reticulum
These are site of synthesis of proteins that are “exported” from cells, i.e. enzymes and hormones that
pass out of their parent cell to be used by other cells in the body.
o Golgi apparatus.
 Consists of stacks of closely folded flattened membranous sacs.
 Present in all cells but is larger in those that synthesize and export proteins.
 The protein move from the endoplasmic reticulum to the Golgi apparatus where they are
‘packaged’ into membrane bound vesicles called secretory granules.
 The vesicles are stored and, when needed, move to the plasma membrane, through which are
proteins are exported.
o Lysosomes
 These are one type of secretory vesicle formed by the Golgi apparatus.
 They contain a variety of enzymes involved in breaking down fragment of organelles and large
molecules, e.g. (RNA, DNA, carbohydrate, proteins) inside the cell into smaller particles that are
either recycled, or extruded from the cell as waste material.
In white blood cells contain enzymes that digest foreign material such as microbes.
o Microfilaments.
 These are tiny strands of protein that provide structural support and maintain the characteristic
shape of the cell.
o Microtubules
 These are contractile protein structures in the cytoplasm involved in the movement of the cell and
of organelles within the cell, the movement of cilia (small projection from the free border of some
cells) and possibly the organization of proteins in the plasma membrane.
Cell division
 Is the process through which cell do replicate themselves.
 There are two types of cell division.
o Mitosis
o Meiosis
Mitosis
 Occurs when a single cell divides itself into daughter cells, having similar characteristics and attributes.
 Its process passes into four stages which are:-
o Prophase
 During this stage the chromatids become visible within the nucleus and the mitotic apparatus appears.
 This consists of two centrioles separated by mitotic spindle which is formed from microtubules.
 The centrioles migrate one to each end of the cell and nuclear envelop disappears
o Metaphase
During this phase the chromatids align on the center of the spindle attached by their centromeres
o Anaphase
 During anaphase the chromatids in each pair of sister chromatid are separated.
 One chromatid from each then moves towards each pole of the spindle.
o Telophase
The mitotic apparatus disappears, the chromosomes uncoil and the nuclear envelop reforms.
Following Teleophase the cytoplasma and the plasma membrane divide in half forming two identical
cells.
The organelles of the daughter cells are incomplete at the cell division but they develop as the cell
matures during interphase
Meiosis
 This is the process of cell division that occurs in the formation of reproductive cells (gametes – the ova
and spermatozoa)
 In meiosis four daughter cells are formed after two division
 During meiosis the pairs of chromosomes separate and one from each pair moves to opposite poles of
the “parent” cells.
 When it divides each of the “daughter” cells has only 23 chromosomes called the haploid.
 This means that when the ovum is fertilized the resultant zygote has the full complete of 46 chromosomes
(the diploid number), half from the father and half from the mother.
 Thus the child has some characteristics inherited from both parents such as color of hair and eyes, height,
facial features and some diseases.
 Determination of sex depend upon one particular pair of chromosomes (the sex chromosomes)
 In the female both sex chromosomes are called X chromosomes.
 In the male there is one X chromosome and a slightly smaller Y chromosome.
 When the ovum is fertilized by an X bearing spermatozoon the child is female and when by a Y bearing
spermatozoon the child is male.
 Sperm X + Ovum X = child XX = female
 Sperm Y + Ovum X = child XY = male.
Functions of the Human Body Cells
 Basic unit of life
 The cell is the smallest part to which an organism can be reduced that still retains the characteristics of life
 Protection and support
 Produces and secretes various molecules that provide protection and support of the body
 Movement
 Movement of the body occurs because of molecules located within specific cells such as muscle cells
 Communication
 Produces and receives chemicals and electrical signals that allow them to communicate with one another
 Cell metabolism and energy release
 Chemical reaction that occur within cells are referred to collectively as cell metabolism
 Inheritance
 Each cell contains a copy of the genetic information of the individual
STEP 5: Key Points (5 minutes)
 Anatomy is the study of the structure of the body
 Physiology is study of the physical and chemical processes that take place in living organisms during the
performance of life functions
 The human body develop from a single cell called the zygote which results from the fusion of the ovum
(female egg cell) and the spermatozoon (male germ cell)
 Characteristics of the cell includes reproduction, irritability, movement, excretion, growth, respiration
and metabolism
STEP 6: Evaluation (5 minutes)

 What is a anatomy and physiology?
 What is human cell?
 What are the functions of the human body cells?
References
Brook G.F, Butel J.S, Morse S.A, (2004) Medical Microbiology (23rd Ed). Bostomn
Mexico City
Craven, R. F & Hirnle, CJ (2008): Fundamental of Nursing, Human Health and Functions,
(6th Ed), Philadelphia, Lippincott
Rosdahl, C.B. & Kawalski, M.T (2012). Textbook of Basic Nursing (10th Ed). Philadelphia,
USA: Lippincott Williams and Wilkins.
Ross &Wilson (2004). Anatomy and physiology colouring and Work book. (1st Ed) USA:
Elsevier Linked.
Valeria, C. S. & Sanders, T. (2007). Essential of anatomy and physiology, ( 5th Ed) Davis
Company, Philadelphia: UK.
Waugh A. & Grant A. (2001). Anatomy and Physiology in Health and Illness, (9th Ed)
Harcourt Publisher Ltd: London UK
Session 2: Human Body Tissues, Structures and Functions
Total Session Time: 2 hours

Prerequisites
 None
Learning Tasks
By the end of this session, a Learner is expected to be able to:
 Identify human body tissues
 Identify functions of the body parts
 Explain the interactions between human body structure and functions
Resources Needed:
 Projector
 Computer
SESSION OVERVIEW
Activity/
Time Content
Method
65 minutes Presentation Human Body Tissues
2
Group Discussion
3 20 minutes Presentation Functions of the Body Parts
20 minutes Interactions between human body structure and

Presentation functions
4
Brainstorming
SESSION CONTENTS

READ or ASK Learners to read the learning tasks and clarify
ASK Learners if they have any questions before continuing.
STEP 2: Human Body Tissues (65 Minutes)

Activity: Small Group Activity (45 minutes)
DIVIDE students into 4 groups (depending on the size of the class).
ASK students as a large group: “What are the parts and structures of human body tissues?
ALLOW students time to respond and then give them the following 4 categories of factors:
• Regimen/drug factors
• Provider-patient relationship factors
• Patient factors
• Health services related factors
ASSIGN each group parts, structure.
ASK the groups to work together to come up with answers to the question above, focusing on their
assigned category.
GIVE students an example, if necessary. For example, say “a patient factor might include readiness
to take ART” “A health services factor might include distance to the clinic.”
ALLOW groups 10 minutes for this exercise.
ASK students to report back three factors per group. The following part of the presentation has more
details on each of these categories.
APPRAISE the students
PROVIDE feedback by summarizing the students’ answers
 Epithelial tissues
o Protect underlying structures
o Act as barriers preventing the movement of many substances
o Permit the passage of substances e.g. carbon dioxide and oxygen
o Secret substances e. g. sweat glands
o Absorb substances as some contains carrier molecules
Connective tissues
o Enclose and separate organs e. g Liver and Kidneys
o Connect tissues to one another e. g Tendons, Ligaments

o Support and allow movements e. g skeletal system
o Storing e.g Adpose tissue stores high energy molecules
o Cushioning and insulating e. g the skin helps to conserve heat
o Transporting. Blood transports substances throughout the body
o Protecting. Immune cells protect the body against toxins and tissue injury
 Muscle tissues
o Attachment
o Aid in movement
o Relaxation and contraction of the body
o Helps in flexion of the body
o Cardiac muscles responsible for pumping action of the heart
o Regulate the size of organs
Nervous tissue
o Coordination of various body activities
o Control body activities
o Conduction of action potential
 Membranes
o Protection
o Absorption
o Secretions of fluids
STEP 3: Functions of Human Body Parts (20 minutes)

 . Head
o Hosts most of the sensory organs (nose, eyes, ears and mouth)
o Protects the brain
o It connects to the neck
 Brain
o Is the center of all vital functions of the body.
o We can survive, think, love, create and remember through the brain
o Controlling center by receiving, analyzing, directing sensory information to various parts of
the body
 Neck
o Connects the head to the trunk
o Helps the head to move up and down, left and right
o Protects the nerves that send sensory and motor information’s from the brain to the rest of the
body
 Trunk
o Connects all the other parts and hosts many internal organs such as heart, lungs, stomach,
liver, kidney and reproductive organs
 Limbs
o Connects to the trunk,
o Arms helps to catch, to hold and carry objects, also helps in fine movements
o Legs helps to walk, jump, and run
o The legs sustain the entire weight of the body and carry it where it needs to go
 Cavities
o Holds and protects internal organs
 Regions and planes
o Helps in allocating, diagnosing anatomical and structural dysfunction of human body organs
STEP 4: Interactions between Human Body Structure and Functions (20minutes)
 Body tissues and membranes have a different mechanism of interacting in the human
body as follows:
o Simple epithelium is involved with diffusions, secretions or absorption.
o Stratified epithelium serves as a protective role.
o Squamous cells function in diffusion or filtration
o Cuboidal or columnar cells which contain more organelles secrete or absorbs.
o A smooth, free surface reduces friction.
o Microvilli increase surface area, and cilia move materials over the cell surface
o Tight junctions bind adjacent cells together and form a permeability barrier.
o Gape junctions allow intercellular communication

 Tissue is a group or collection of similar cells and their intercellular substance that
perform a particular function.
 Tissues are classified according to the size, shape and function of these cells
 The main functions of tissues and membranes are protection; absorption; supporting;
connection of tissues; transportation; and secretion of substances
 What is tissue?
 What are the four types of tissues?
 What are the five main functions of tissue and membranes?
References
Mexico City

Elsevier Linked.

Session 3: Human Body System
Total Session Time: 2hours
Prerequisites
 None
Learning Tasks
By the end of this session, a learner is expected to be able to:
 Define body system
 Identify main body systems
 Explain the functions of body systems
Resources Needed:
 Projector
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
10 minutes Presentation Definition of Body Systems
2
Brainstorming
65 minutes Presentation Main Body System
3
Group Discussion
30 minutes Presentation Functions of Body Systems
4
Buzzing
SESSION CONTENTS

READ or ASK Learners to read the learning tasks and clarify

ASK Learners if they have questions before continuing.
STEP 2: Definition of Body Systems (10 minutes)
Activity: Brainstorming (5 minutes)

Ask Learners to brainstorm on the following question for 2 minutes
 What is a body system?

ALLOW few Learner to respond
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
STEP 3: Main Body Systems (65 minutes)
ASK students as a large group: “What are the main body systems?
ASSIGN each group to discuss on the main body systems.
ASK the groups to work together to come up with answers to the question above.
ASK students to report back main body systems per group. The following part of the presentation has more details
on each of these main body systems.
The human body is made up of 11main systems

 The cardiovascular system
o Has one distinct function; that is to pump the blood
o The central organ in this system is the heart.
 The digestive system
o Is one of the most complex systems of the body
o It provides the body’s means of transforming food to energy.
 The endocrine system
o Is the system that controls the body
o It includes the pituitary, thyroid, adrenal, pineal, and thymus glands
o Uses hormones to stimulate the metabolic activities of the cells.
o These hormones are released into the blood stream
 The immune system
o The body’s main defense against all foreign substances
o Without the immune system, the body would die immediately from foreign bacteria
o Billions of which rest on the skin
 The excretory system
o Get rids of body waste products
o Composed of multiple organs
o The main organs are the kidneys
o The kidneys perform the dual task of filtering out wastes and purifying blood
o Other organs include the urinary bladder, the ureters, and the urethra
 The integumentary system
o Commonly known as the skin enwraps the body and serves several purposes. It is
composed of the epidermis and the dermis
 The muscular system
o Is the largest system in the body
o Muscles are located in practically every region of the body
o The limbs are almost entirely made up of muscles
o Muscles are unique because they can contract
o This contraction sets muscles apart from all other tissues
o There are three different types of muscle tissue: cardiac, skeletal and smooth
 The respiratory system
o Supplies the body with oxygen
o It comprises of the nose/Mouth, larynx, pharynx, trachea, bronchi, bronchioles and the lungs
o Air is inhaled and exhaled through the nose or mouth
 The skeletal System

o The human skeleton consists of more than 200 bones bound together by tough and
relatively inelastic connective tissues called ligaments
o There different types of bones i.e. short bones, long bones, flat bones, and irregular bones
 Reproductive system
o Also known as genital system
o Is a system of organs within an organism which work together for the purpose of reproduction
o The major organs of the human reproductive system include the external genitalia (penis and vulva)
as well as a number of internal organs including the gamete producing gonads (testicles and ovaries)
o Is responsible for the survival of the species by reproduction of the same kind
 Nervous system
o Have two divisions: the central nervous system and the peripheral nervous system
o The central nervous system includes the brain and spinal cord
o The peripheral nervous system includes all neural tissue outside the central nervous system
o It is divided into motor and sensory systems.
Step 5: Key Points (5 minutes)

 The eleven body systems are: - Respiratory, Digestive, Cardiovascular, Muscular, Skeletal,
Nervous, Integumentary. Lymphatic, Endocrine, Reproductive, and Urinary system
Step 6: Evaluation (5 minutes)
 What the eleven (11) body systems?
Session 4: Anatomical and Physiological Function of the Upper Respiratory System
Prerequisites
 None
Learning Tasks
 Identify the organs of the upper respiratory system
 Describe the structure and physiological function of the upper respiratory system
Resources Needed:
 Projector
 Computer
 Handouts
SESSION OVERVIEW
Activity/
Step Time Content
Method
Organs of the upper respiratory system
Presentation Structure and physiological function of the upper

3 65 minutes
Group Discussion respiratory system

SESSION CONTENTS

READ or ASK learners to read the learning tasks and clarify
ASK leaners if they have any questions before continuing.
STEP 2: Organs of Respiratory System (40 minutes)

 The respiratory system is divided into two divisions:
o Upper respiratory tract;
 The organs are located outside of the thorax and consists of the nose, pharynx and
larynx
o Lower respiratory tract;
 The organs are located within the thorax and consists of the trachea, the bronchial
tree and the lungs
STEP 3 : Structure and Physiological Functions of the Upper Respiratory System (65 Minutes)
ASK students as a large group: “What are the structure and functions the upper respiratory system?
ASSIGN each group the structure and functions of upper respiratory system.
ASK the groups to work together to come up with answers to the question above.
ASK students to report back structure and functions the upper respiratory system per group.
 The main function of the respiratory system is to provide gas exchange between the blood
and the environment.

 Oxygen is essential for cells, which use this vital substance to liberate the energy needed
for cellular activities.
 In addition to supplying oxygen, the respiratory system aids in removing of carbon
dioxide, preventing the lethal buildup of this waste product in body tissues.
 Day-in and day-out, without the prompt of conscious thought, the respiratory system
carries out its life-sustaining activities.
 Helps regulate the balance of acid and base in tissues, a process crucial for the normal
functioning of cells.
 Protects the body against disease-causing organisms and toxic substances inhaled with
air.
 The respiratory system also houses the cells that detect smell, and assists in the
production of sounds for speech
o If the respiratory system’s tasks are interrupted for more than a few minutes, serious,
irreversible damage to tissues occurs, followed by the failure of all body systems, and
ultimately, death.
 The respiratory system is divided into two: the upper and the lower respiratory system
 The organs of the upper respiratory system includes the nose, pharynx, and the larynx
 All this organs function together as air passage, and they help in filtering air as well as
playing part in production of voice.
 The respiratory and circulatory systems work together to deliver oxygen to cells and
remove carbon dioxide in a two-phase process called respiration.

 What are the organs forming respiratory system?
What are the functions of respiratory system?
References
Mexico City
Elsevier Linked.
Handout 5.1: External Nose
Source: Tank, Patrick W.; Gest, Thomas R., 2007

Source: Gray’s Anatomy 39 Ed.(2005).

Handout 5.2: Bone Structure of the Nose
Source: Gray’s Anatomy 39 Ed.(2005).

Source: Tank, Patrick W.; Gest, Thomas R., 2007
Handout 5.4: The Pharynx

Session 5: Anatomical and Physiological Function of the Digestive System
Prerequisites
 None
Learning Tasks
 Identify the organs of the digestive system
 Describe the structure and physiological function of the digestive system
Resources Needed:
 Projector
 Computer
 Handouts
SESSION OVERVIEW
Activity/
Step Time Content
Method
Organs of the digestive system
Presentation Structure and physiological function of the digestive

3 65 minutes
Group Discussion system

SESSION CONTENTS

STEP 2: Organs of Digestive System (40 minutes)

The digestive system is the collective name used to describe the alimentary canal, some accessory
organs and a variety of digestive processes which take place at different levels in the diet for
absorption.
 The activities in the digestive system follow five main stages: -
o Ingestion, propulsion digestion, absorption, and elimination.
 Alimentary tract is a long tube through which food passes.
 It starts from the mouth and ends at anus.
The Organs of the Digestive System

 Principle organs
o Mouth
o Pharynx
o Oesophagus
o Stomach
o Small intestine
o Large intestine
o Rectum and anal canal
 Accessory organs
o 3 pairs of salivary glands
o Pancreas
o Liver and the biliary tract
 The organ and glands are linked physiologically as well as anatomically in that digestion and
absorption occur in stages, each stage being dependent upon the previous stage or
stages.
Refer Students to Handout 12.2: Organs of the Alimentary System

STEP 3 : Structure and Physiological Functions of the Digestive System (65 Minutes)
ASK students as a large group: “What are the Structure and physiological functions of the digestive
system?
ALLOW students time to respond :
Structure and physiological functions of the digestive system
ASSIGN each group a parts, structure.
assigned category.
ASK students to report back on the structure and physiological functions of the digestive system
. The following part of the presentation has more details on each of these categories.
The Mouth or Oral Cavity

 Structures associated with the mouth
o Anteriorly - by the lips
o Posteriorly – It is continuous with the oropharynx
o Laterally – By the muscle of the cheeks
o Superiorly – By the bony hard palate and muscular soft palate
o Inferiorly – By the muscular tongue and the soft tissues of the floor of the mouth.
 The oral cavity is lined throughout with mucus membrane, consisting of stratified
squamous mucus secreting gland.
 The part of the mouth between the gums (areolar ridges) and the cheeks is the vestibule and the
remainder of the cavity is the mouth proper.
 The roof of the cavity is formed by the hard palate and the soft palate
 A cone shaped prolongation hangs down in the back of the mouth is called uvula.
 The mucus membrane that covers the whole cavity continues in two folds where we can find the
palatine tonsil.
The Tongue
 This is the voluntary muscular structures which occupies the floor of the mouth.
 It is attached to the hyoid bone in the neck.
 On the surface of the tongue we find the numerous papillae (small projections),
containing nerve endings of the sense of taste buds.
 There are three varieties of papillae.
o Valvate papillae
 Usually between 8 and 12 altogether, are arranged in an inverted, V shaped toward
the base of tongue.
 These are the largest of the papillae and are the most easily seen.
o Fungiform papillae
 It is situated mainly at the tip and the edge of the tongue and are more numerous
than the Valvate papillae
o Fusiform papillae
 Are the smallest of the 3 types
 There are most numerous on the surface of the anterior two – third of the tongue.
Blood Supply
 The main anterior blood supply to the tongue is by the lingual branch of the external carotid
artery.
 Venous drainage is by the lingual vein which joins the internal jugular vein.
Nerve Supply
 The hypoglossal nerves (12th cranial nerves) which supply the voluntary muscle tissue.
 The lingual branch of the mandibular nerves which are the nerves of somatic (ordinary)
 sensation i.e. pain, temperature and touch.
 The facial and glossopharyngeal nerves (7th and 9th cranial nerves) which are the nerves of the
special sensation of taste
 We can feel four tastes
o Sour
o Sweet
o Bitter
o Salt
The Function of the Tongue

 An organ of taste
 Helps in mastication
 Assists in swallowing
 Assists in speech
Sublingual Glands

 Under the surface of the tongue is connected to the floor with a small string called
frenulum on the floor of mouth under the tongue the sublingual glands and the
submandibular glands enter.
 The duct from the 3rd pair of salivary glands – the parotid glands enter the mouth opposite
the 2nd upper molar.
 The 3 pair of glands that secrete:
o Water 90%
o Enzyme – ptyalin – salivary amylase.
o Mucin – lubricant
o Small amount of calcium
Functions of Saliva
 Moisten the food and the mouth.
 Moisten and lubricant the food.
 Ptyalin converts carbohydrates
 Stimulate the taste buds.
 Clean the mouth and the teeth
Teeth
 The teeth are embedded in the alveoli or sockets of the alveolar ridges of the mandible and the
maxilla.
 Each individual develops two set of teeth.
o The temporary teeth or deciduous or the milky teeth, there are 20teeth in number, 10 in
each jaw.
o The first erupt  5-8 months.
o They are complete at  2 years.
o The permanent teeth 32 in number, they replace the milky teeth at the age of 6 years
and usually they are complete at the age  26yrs.
 According to their shape and position they are classified into four groups.
o Incisors. 2 in number on each side of the jaws.
o They are sharp edged for biting the food. One root.
o Canines 1 in number.
o On each side of the jaw. Have large conical crows for grasping the food. One root
o Premolars 2 on each side.
o They have two elevations or cusps on the crown. One root.
o Molars 3 on each side.
o The largest teeth with 4-5cusps for grinding or (chewing) the food.
o The upper molars have 3 roots and the lower has 2 roots.
Structure of a Tooth
 Although the shape of different teeth vary, the structure is the same and consists of:-
o The crown - the part which protrudes from the gum.
o The root – the part embedded in the bone.
o The neck – slightly narrowed region where the crown merges with the root.
 The tooth consists of mainly dentine a very hard material. The enamel covers exposed portion
of the tooth and is even harder than dentine.
 The hallow cavity is called pulp, it consists of connective tissue with blood vessels and nerves
passing down to the root in fine canals.
 The teeth are fixed to the gum by special cement and a strong layer of connective tissue
Blood Supply
 Most of the blood supply to the teeth is by branches of the maxillary arteries.
 The venous drainage is by a number of veins which empty into the internal jugular veins.
Nerve Supply
 The nerve supply to the upper teeth is by branches of the maxillary nerve and to the lower teeth by
branches of the mandibular nerves.
 These are both branches of the trigeminal nerves (5th cranial nerves).
Refer Students to Handout 12.3: Structure of the Mouth and the Tongue
The Pharynx
 The oropharynx and laryngopharynx are passages common to both the respiratory and
digestive system.
 Food passes from the oral cavity into the pharynx then to the oesophagus bellow.
 When food reaches the pharynx swallowing is no longer under voluntary control.
The Oesophagus
 This is a 25cm long muscular tube consists of 4 layers of tissue
 Lies behind trachea extending from the pharynx with an upper sphincter – cricopharyngeal
sphincter which prevents air passing into oesophagus when the act of swallowing takes place
and prevent content from oesophagus enter the trachea.
 When the oesophagus enters through the diaphragm it curves up and into the stomach we can
find the cardiac sphincter that prevents the gastric acid to enter the oesophagus.
NMT 04102 Anatomy and Physiology

NTA Level 4, Semester 1 157 Session 12 Structure and Function of the
Mouth, Oesophagus and Stomach

Blood Supply
 Arterial blood supply:
o The thoracic region of the oesophagus is supplied mainly by the Oesophageal arteries, branches
from the aorta, the abdominal regions is supplied by branches from the inferior phrenic arteries and
the left gastric branch of the coeliac artery.
 Venous drainage:
o From the thoracic region venous drainage is into the azygos and hemiazygos veins, the
abdominal part drains into the left gastric veins.
 Nerve supply:
o Sympathetic and parasympathetic nerves terminate in the myenteric and sub mucosal plexuses.
Parasympathetic fibers are branches of the vagus nerves.
Swallowing or Deglutition
 This occurs in 3 stages after mastication is complete and the bolus has been formed.
 It is initiated voluntarily but completed by a reflex (involuntary) action.
 It takes 9 second for a wave of peristalsis to pass the bolus from the pharynx to the stomach.
 The first stage occurs when the tongue forces the bolus to the pharynx is voluntary.
 The impulses to continue the process are coming from the swallowing center in the brain stem and
these impulses are transferred to the swallowing receptors in the pharynx.
 The soft palate rises and closes the nasopharynx.
 The epiglottis moves backwards to prevent food entering the trachea.
 The cricopharyngeal sphincter relaxes and a wave of peristalsis pushes the bolus into the oesophagus
while larynx is pushed upwards.
 The wave of peristalsis continues and the cardiac sphincter open up and the bolus enters the
stomach.
Refer Students to Handout 12.4: Structure of the Oesophagus
The Stomach
 Is a J shaped dilated portion of the alimentary tract situated in the epigastric, umbilical and left
hypochondriac regions of the abdominal cavity.
 Structures associated with the stomach.
o Anteriorly – Left lobe of liver and anterior abdominal wall.
o Posteriorly – Abdominal aorta, pancreas, spleen, left kidney and adrenal glands.
o Superiorly – Diaphragm, oesophagus and left lobe of liver.
o Inferiorly – Transverse colon and small intestine
o To the left – diaphragm and spleen.
o To the right – liver and duodenum.
Structure of the Stomach

 The stomach is continuous with the eosophagus at the cardiac sphincter and with the duodenum
at the pyloric sphincter.
 It has a greater curvature and a lesser curvature, the upper part of the stomach is called fundus,
middle portion body and the lowest part the antrum.
 The pyloric sphincter relaxes when the food enters the duodenum.
 Inside the stomach there are folds of mucosa membrane called rugae which help the stomach to
extend during eating
NMT 04102 Anatomy and Physiology

NTA Level 4, Semester 1 158 Session 12 Structure and Function of the
Mouth, Oesophagus and Stomach
 Wall of stomach
 The four layers of tissues that comprise the basic structure of the alimentary canal are found in the
stomach.
 Muscle layer.
o This consists of three layers of smooth muscle fibres:-
 An outer layer of longitudinal fibres
 An middle layer of circular fibres
 An inner layer of oblique fibres.
o In this way the stomach is different from other regions of alimentary tract as it has three layers of
muscles instead of two.
o This arrangement allows for peristaltic movement, circular muscle is strongest in the pyloric antrum
and sphincter.
o There are 4 numerous gastric glands situated below the surface in the mucous membrane,
they consist of specialized cells that secrete gastric juice e.g.
 Mucus
 Enzymes
 Hydrochloric acid and intrinsic factor
 Histamine and serotonins
o This production is mainly in the upper part and middle part of the stomach.
o In the lower part the hormone gastrin is produced by the G – cells.
o A large amount of lymph nodes are situated here and prevent the spread of infections
from organs to peritoneum.
o A small omentum hangs between the liver and stomach and between liver and duodenum.
o The stomach may be able to store  1litre of food for 4-6 hrs, peristalsis in the lower part of the
stomach is stronger where the mixture is called chyme.
Refer Students to Handout 12.5: Structure of the Stomach
Blood Supply
 Arterial blood is supplied to the stomach by branches of the celiac artery.
 Venous drainage is into the portal vein
Nerve Supply
 The sympathetic supply to the stomach by branches of the coeliac plexus and the
parasympathetic supply is from the vagus nerves.
 Sympathetic stimulation reduces the motility of the stomach and the secretion of gastric juice, vagal
stimulation has the opposite effect.
Functions of the Stomach

 Temporary storage of food allowing time for digestive enzymes, pepsin to act
 Chemical digestion pepsin converts proteins to polypeptides
 Mechanical breakdown the three smooth muscle layers enable the stomach to act as a chime,
gastric juice is added and the contents are liquefied to chyme
 Limited absorption of water, alcohol and some lipid soluble drugs
 Non specific defense against microbes provided by hydrochloric acid in gastric juice
Vomiting may be a response to ingestion of gastric irritants e.g. microbes or chemicals
Preparation of iron for absorption further along the tract the acid environment of the stomach
solubilizes iron salts, which is required before iron can be absorbed
 Production of intrinsic factor needed for absorption of vitamin B12 in the terminal ileum
 Regulation of the passage of gastric contents into the duodenum, when the chyme is sufficiently
acidified and liquefied, the pyloric antrum forces small jets of gastric contents through the pyloric
sphincter into the duodenum
 Secretion of gastrin hormone
Step 4: Key Point (5 minutes)
 Digestive system is the system that deals with digestion and absorption of food.
 It involves 5 main processes i.e. ingestion, propulsion, digestion, absorption, and elimination.
 The stomach is temporary storing food in the process of digestion.
 The four gastric glands situated below the tongue consist of specialized cells that secrete Mucus,
Enzymes, Hydrochloric acid and intrinsic factor, Histamine and serotonins which help in digestion.
 The tongue is a sensory organ containing special sensation of taste that includes sour, sweet, and
bitter

 What is alimentary system?
 What are the functions of the stomach?
References
Mexico City
Elsevier Linked.

Session 6: Anatomical and Physiological Function of the Cardiovascular System
Prerequisites
 None
Learning Tasks
 Identify the organs of the cardiovascular system
 Describe the structure and physiological functions of the cardiovascular system
Resources Needed:
 Projector
 Computer
 Handouts
SESSION OVERVIEW
Activity/
Step Time Content
Method
Organs of the cardiovascular system
Presentation Structure and physiological functions of the

3 65 minutes
Group Discussion cardiovascular system

SESSION CONTENTS

STEP 2: Organs of cardiovascular System (40 minutes)
STEP 3 : Structure and Physiological Functions of the Cardiovascular System (65 Minutes)
ASK students as a large group: “What are the structure and functions of cardiovascular system?
ALLOW students time to respond and then give them the following 4 categories of factors:
• Regimen/drug factors
• Provider-patient relationship factors
• Patient factors
• Health services related factors
ASSIGN each group a parts, structure.
assigned category.
GIVE students an example, if necessary. For example, say “a patient factor might include readiness
to take ART” “A health services factor might include distance to the clinic.”
ASK students to report back three factors per group. The following part of the presentation has more
details on each of these categories.


 What are the organs forming cardiovascular system?
References
Mexico City
Elsevier Linked.

Session 7: Concepts of Biochemistry in Relation to Human Body Biochemical Functions
Prerequisites
 None
Learning Tasks
 Define biochemistry, atom, molecules, elements, compounds, acids alkali, mixture solution, solute, solvents,
vitamins, and PH
 Describe common vitamins
 Explain common disorders related to deficiency of vitamins
Resources Needed:
 Projector
 Computer
 Handouts
SESSION OVERVIEW
Activity/
Step Time Content
Method
Definition of biochemistry, atom, molecules, elements,
compounds, acids alkali, mixture solution, solute,
solvents, vitamins, and PH
Presentation Common vitamins

3 65 minutes
Group Discussion
4 30 minutes Presentation Common disorders related to deficiency of vitamins
SESSION CONTENTS

STEP 2: Definition of Biochemistry, Atom, Molecules, Elements, Compounds, Acids Alkali, Mixture Solution, Solute,
Solvents, Vitamins, and PH (10 minutes)
STEP 3 : Common Vitamins (65 Minutes)
STEP 4: Common Disorders Related to Deficiency of Vitamins(30 minutes)
References
Session 8: Functions of Macromolecules in Relation to Human Body
Prerequisites
 None
Learning Tasks
By the end of this session learner are expected to be able to:
 Explain functions of carbohydrates
 Explains functions of proteins
 Explains functions of lipids
 Explains functions of Nucleic acids (DNA and RNA)
Resources Needed:
 Projector
 Computer
 Handouts
SESSION OVERVIEW
Activity/
Step Time Content
Method
2 10 minutes Presentation Functions of carbohydrates

Presentation Functions of proteins
3 65 minutes
Group Discussion
4 30 minutes Presentation Functions of Nucleic acids (DNA and RNA)
SESSION CONTENTS

STEP 2: Functions of Carbohydrates (35 Minutes)

STEP 3 : Functions of Proteins (35 Minutes)
STEP 4: Functions of Lipids (30 minutes)

STEP 5: Functions of Nucleic Acids (DNA and RNA)
References
Session: 9 Anatomical and Physiological Functions of Musculosceletal System

Total Session Time: 2 Hours
Prerequisites
 None
Learners Learning Tasks

By the end of this session learners are expected to be able to:
 List organs that forming musculoskeletal system
 Describe the anatomy of musculoskeletal system
 Describe the physiology of musculoskeletal system
Resources Needed:
 Black/white board and chalk/whiteboard markers.
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
2 20 minutes Presentation Organs that forming musculoskeletal system
3 45 minutes Presentation Anatomy of musculoskeletal system
4 40 minutes Presentation Physiology of musculoskeletal system
SESSION CONTENTS

READ or ASK learners to read the learning Tasks and clarify
ASK learners if they have questions before continuing.
STEP 2: Organs that forming musculoskeletal system ( 20 minutes)

STEP 3: Anatomy of musculoskeletal system (45 minutes)
STEP 4: Physiology of musculoskeletal system (40 minutes)
Activity: Small Group Discussion ( 30 minutes)
DIVIDE learners into small manageable groups
ASK learners to discuss on the following question

ALLOW learners to discuss for 15 minutes
ALLOW few groups to present and the rest to add points not mentioned
CLARIFY and SUMMARIZE by using the contents below
References
Session 9 : Structure and Functions of Musculosceletal System
Total Session Time: 120 Minutes
Prerequisite
 None
Learning Tasks
 List organs that forming musculoskeletal system
 Identify the types of muscle tissue

 Describe the structure of muscle
 Mention the general functions of muscles
 Explain the chief muscle of the body
Resources Needed
 Flipcharts, Marker pens and Masking tape
 LCD
 Computer/laptop
 Anatomical charts
 Handout ----.1: Muscles of the Body
SESSION OVERVIEW
Step Time Activity/Method Content
1 05 Minutes Presentation Presentation of the Session Learning Tasks

Organs that forming musculoskeletal system
Types of Muscle Tissue and Their Structure

2 30 Minutes Presentation
Presentation, General Functions of Muscles
3 15 Minutes
Buzz
Presentation, Chief Muscle of the Body
4 60 Minutes
Group Discussion
5 05 Minutes Presentation Key Point
6 05 Minutes Presentation Evaluation
SESSION CONTENT
Step 1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the Learning tasks and clarify
ASK students if they have any questions before proceeding
Step 2: Types of Muscle Tissue and Structure (30 minutes)
 The muscular system consists of a large number of muscles concerned with movements of the body
 Voluntary muscles are attached to bone, cartilages, ligaments, skin or to other muscles in order to
stimulate movements
Types of Muscle Tissue

 Skeletal muscle (also called striated muscle)
 Cardiac muscle (the muscle of the heart)
 Visceral muscle (also called smooth muscle)
 Skeletal Muscle
 Is the most abundant type of muscle
 t attaches to bone and so is important in producing movements in our joints and
maintaining our posture.
 Under the microscope, skeletal muscle cells look like long fibres and have a striped
(striated) appearance.
 We generally think of skeletal muscle as being under voluntary control.
Cardiac Muscle
 Is the muscle of the heart
 Under the microscope, cardiac muscle cells also appear striated; however the striations are
not as well organized as in skeletal muscle.
 The activity of cardiac muscle is controlled to a large degree by the autonomic nervous
system.
 We generally think of cardiac muscle as being involuntary.
Visceral Muscle
 Is the muscle which lines our blood vessels and internal organs
 Under the microscope, visceral muscle cells do not have the obvious striations of skeletal or
cardiac muscle hence called smooth muscle
 Visceral muscle cells are often relatively short, and usually they each have only one
nucleus
 We generally think of visceral muscle as being involuntary
 The ability of muscle to contract depends on the presence of two protein molecules: actin and
myosin
 Bundles of actin and myosin molecules are arranged end to end in muscle cells
 It is these bundles that give skeletal and cardiac muscle their striated appearance
 When a muscle is properly stimulated, the actin and myosin bundles slide together and so the
muscle cell gets shorter
 This process requires calcium and ATP for energy
 Muscles, especially skeletal muscle, may be stimulated to contract by motor nerves.
 Depolarization from a motor nerve causes calcium to move from the sarcoplasmic
reticulum into the sarcoplasm
 This release of calcium causes actin and myosin to slide together and shorten the muscle
Step 3: Functions of Muscle Tissue (15 minutes)

General Functions of Muscle Tissue
 Initiation of contraction being stimulated autonomic nerve impulses –smooth and cardiac muscle
tissue
 Moving bones by skeletal muscle tissue
 Covering body cavities
 Protecting somebody structures

 Shaping of body (morphology)
Muscle Tone
 Muscle tone is a state of partial contraction of muscle
 Few muscle fibres contract at a time
 Skeletal muscle tone is essential for maintenance of posture in sitting and standing
position
Muscle Fatigue
 If a muscle is stimulated to contract at very frequent intervals, the responses gradually
becomes depressed and ceases.
Step 4: The Chief Muscles of the Body(60minutes)
Muscle of the Head

 The muscle of the head are divided into two groups: Muscles of expression and muscles of
mastication
Name Name Position Origin Insertion Action
Muscle of Orbiculis oculi Skin Eye Closes eye
expression (circular Screws up the eye
muscles)
Closes lip
Obicularis oris Mouth Shapes mouth
- Zygomatic
Muscles of i) Masseter arch to the - Draws mandible
mastication (broad right angle of and maxilla
muscles) jaw - Closes jaw
ii) Temporalis Temporal
muscle bone -Draws mandible
Muscle of the Neck

Name Position Origin Insertion Action
Sternocleidomastoid Side of the Sternum and Mastoid process Turns head to

neck clavicle the side
Tilts to same
shoulder
Flex of the neck
Clavicle Draws scapula

Trapezius Back of the Occiput Spine of back
neck and Spines of scapula Raises and
shoulder thoracic lowering of
vertebra shoulder
Extending neck
Zygomatic arch
to the right - Draws mandible
Muscles of mastication i) angle of jaw and maxilla
- Closes jaw
Masseter (broad Temporal bone
muscles)
- Draws
mandible
ii) Temporalis muscle
 Muscles of the Trunk

o Muscle moving shoulder
o They are powerful muscles
o They also connect the upper limb and the trunk

i) Pectoralis Front of chest - Sternum Humerus Adducts shoulder
major and clavicle (bicipital Draws the arm
- Cartilages of groove) across front chest
true ribs Rotates shoulder
internallis
ii) Lattissimus Crosses the Lower Humerus Adducts the

dorsi back from thoracic (bicipital shoulder
lumbar region lumbar and groove) Draws arm back
to shoulder sacral wards and downs
vertebrae in bell pulling
Iliac crest Internal rotation of
shoulder
iii) Serratus - Over the side Front of the Medial Draws scapula
anterior of the thorax eight upper border of forwards;
- Under scapula ribs scapula antagonistic to the
trapezius
Muscle of Respiration
i) Diaphragm Between - Tip of Central - Involved in the

(dome shaped thoracic and sternum, aponeurosis mechanism of
sheet) abdominal lower ribs respiration
cavity - Thee lumber
vertebrae
ii) External Between the - Lower Upper - Draw ribs upwards

intercostals ribs border of border of the and downwards
muscle rib above rib below
iii) Internal Between the - Lower Upper - Draw ribs downwards

intercostals ribs border of border of the and inwards to
muscle the rib rib below decrease the size of the
above thorax in force expiration
- Antagonistic external
intercostals muscle
Muscle of the Abdominal Wall

i) Rectus Anterior - Pubis, Abdominal - Forms the anterior
abdominis abdominal sternum and wall wall of abdominal
(Resctus = wall costal wall
straight) cartilage
ii) External Lateral - Lower ribs Iliac crest and - Attaches muscle
oblique abdominal inguinal - Forms lateral wall of
wall ligament the abdominal wall
iii) Internal Lateral - Lower ribs Iliac crest and - Form firm wall of
oblique abdominal inguinal abdomen
wall ligament - Give attachment to
muscle
iv) Transversus Under the - Illiac crest Aponeurosis - Forms the lateral
abdominis internal and lumber across the wall of the
oblique fascia front wall of abdominal wall
abdomen
v) Quadratus Lateral and - Iliac crest Iliac crest and - Forms the posterior
lumborum posterior to 12th rib inguinal canal wall of the abdominal
wall - Upper wall
lumbar - Holds the 12th rib
vertebrae during breathing
Muscle of the Hip

These are muscles of the trunk moving the hip
i) Psoas Crosses the region Transverse Lesser o femur Flexes the hip
major behind inguinal processes of
ligament lumber vertebrae
ii) Iliucus Crosses the groin Front surface of Lesser Flexes the hip
behind the inguinal the iliac bone trochanter of
ligament with psoa femur
iii) Gluteal Cross the back of Posterior surface Greater - Extends,

muscles the hip of ilium and trochanter and abducts hip
sacrum gluteal line of laterally
femus - Rotates hip
Muscle of the Pelvic Diaphragm
 The pelvic diaphragm consists of muscles forming the support of the pelvic organs
 Runs from the pubis in front back to sacrum and coccyx

 The pelvic diaphragm is composed of the levator ani and coccygeus muscles
 In the female it is pierced in the middle by three openings for the urethra, vagina and rectum. In the
male there are two openings, for the urethra and the recturm respectively
Muscle of the Arm
i) Biceps Front of the - Coracoid Radial - Flexes elbow,

arm process tuberosity shoulder
- Above glenoid - Supinates the
cavity of scapula hand
ii) Triceps Back of the - One head the Olecramon of - Extends elbow
(three arm axillary border of ulna and shoulder
heads) scapula
iii) Deltoid Over the - Acromion and Detoid - Abducts the

shoulder spine of scapula, tuberosity of shoulder to a
the clavicle humerus right angle
iv) Brachialis Crosses the - Humerus - Anterior - Flexes the

front elbow surface of elbow
coronoid process
of ulna
Muscle of the Forearm and Hand

 The muscles for the forearm are numerous powerful muscles for movement of the wrist and
digits
o The muscle are:
 Pronator teres  Pronator quadratus
 Flexor carpiulnalis  Flexor renaculum
 Flexar carpi radialis  Thenar eminence
 Hypothenar eminence
Muscles of the Lower Limb
Muscles of the lower limb are much larger and more powerful than those of the upper limb
Muscle of the Thigh

i) Quadriceps Front of thigh - Ilium Patella - Extension of knee

femoris - Femur - Flexes hip

ii) Harm Back of thigh - Ischial - Tibia - Flexion of the knee
strings tubeosity - Fibula - Extension of the hip
- Femur
iii) Sartorius Crosses front of Anterior - Tibia at inner - Assist in flexion of

thigh superior iliac side hip, knee
spine - Abduction and
external rotation of
hip
iv) Abductor of Inner side of Pubis and - Linea aspera - Abducts the hip
the hip thigh ischium - Medial
condyle of
femur
Muscle of the leg and foot

i) Gastrolnemius The calf - Condyles of Calcaneum - Plantar flexion of

the femus the ankle raising
the head
ii) Solens The calf - Tibia Calcaneum - Plantar flexion of

- Fibula the ankle raising
the head
iii) Tibialis anterior Side of the leg - Tibia - Tarsals - Dorsiflexion of

- Metatarsals the ankle raining
the toe, inversion
of foot
iv) Interosseous Foot - Tibia Between the Abducts and

muscles metatarsals adducts digits
Step 5: Key Point (5 minutes)
 There are three basic types of muscle in the human body:

o Skeletal muscle (also called striated muscle)
o Cardiac muscle (the muscle of the heart)
o Visceral muscle (also called smooth muscle)
 General functions of muscle tissue
o Initiation of contraction being stimulated autonomic nerve impulses –smooth and cardiac
muscle tissue
o Moving bones by skeletal muscle tissue
o Covering body cavities
o Protecting somebody structures
o Shaping of body (morphology)
 What are the types of muscle tissue?

 What are the five functions of muscles?
 Which are the chief muscles of the body?
References
Mexico City
Elsevier Linked.

Handout 6.1: Muscles of the Body

Session 10: Structure and Functions of the Skeletal
System and Joints
Total Session Time: 120 Minutes
Prerequisite
 None
Learning Tasks
At the end of this session a learner is expected to be able to:
 Describe the structure and functions of the skeletal system
 Describe the structure and functions of joints
Resources Needed
 Flipcharts, Marker pens and Masking tape
 Anatomical charts
 Anatomical models and atlas
 LCD and Computer
 Handout --.: The Human Skeleton
 Handout ---: The Human Skull
 Handout --:The Vertebral Column
 Handout --: Bones of the Lower and Upper Limbs
 Handout --: Pelvic Bones
 Handout --: The Joint
SESSION OVERVIEW
1 05 Minutes Presentation Presentation of the Session and Learning Tasks

Presentation,
2 60 Minutes Structure and Functions of the Skeletal System
Group Discussion
Presentation,
3 45 Minutes Structure and Functions of the Joints
Group Discussion
4 05 Minutes Presentation Key Points
5 05 Minutes Presentation Evaluation
SESSION CONTENT
Step 1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before proceeding
Step 2: Structure and Functions of the Skeleton (60 minutes)
 The skeleton is composed of 206 separate bones in the adult, and the cartilages and
ligaments, which help to unite the bones at the joints.
DIVIDE students into small manageable groups
ASK students to work in groups and list the functions of the skeleton for 10 minutes
ALLOW groups ask students to provide their response for 2 minutes each
CLARIFY and summaries by using the contents below
Types of Bones
 Bone is a strong and durable type of connective tissue consisting of:
o Water
o Organic constituents including osteoid (carbon containing part) and bone cells (25%)
o Inorganic constituents – calcium phosphate 50%
 Bones are classified as long, short, irregular, flat and sesamoid
o Long bones: These are longer than they are wide, examples includes the femur, tibia and
fibula
o Flat bones: includes the ribs, shoulder blades, and most skull bones
o Irregular bones: Such as the bones of the face and the spine.
o Sesamoid bones: It includes patella
Structure of Skeletal Tissue

 Periostium: This is the outer covering of bones consisting blood vessels and nerves.
 Compact Bone: Mainly composed of calcium and phosphorus, is the hard outer layer of bone
tissue.
 Cancellous Bone: Inside is a porous type of bone with many tiny spaces, helps to make the
bones light. It includes;
o Red Marrow:
 This fills the spaces in calcellous bone helps to produces red blood cells and some
white blood cells.
o Yellow Marrow:
 This is mainly composed of fat cells.
 Yellow bone marrow fills the shaft of the long bone making them light.
o Cartilage:
 A strong plain tissue like hard rubbers are attached to some bones e.g. the end of the
nose, and of its ribs.
 In babies and children’s bone consists of more cartilage, which is replaced by hard
bone as the child grows.

 In children injured bones bends instead of breaking, and this is called a “Greenstick
fracture”
 Ligaments are made of strong fibrous tissue and they hold bones together at the joints,
allowing some movement.
 When ligaments around a joint are stretched and torn without injury to bone this is called a “sprain”
Functions of the Bones

 Provision of the framework of the body.
 Giving attachment to muscles and tendons.
 Allowing movement of the body as a whole.
 Forming the boundaries of the cranial, thoracic and pelvic cavities.
 Protecting the internal organs.
 Production of blood cell formation.
 Storage of minerals especially calcium phosphate.
 The bones of the skeleton are divided into groups:-

o The axial skeleton: Consisting of the skull, vertebral column, ribs and sternum.
o The appendicular skeleton: Consist of bones of the upper limb, lower limb and pelvis.
Refer Students to Handout --.1: Diagram of Human Body

The Skull
 Consists of two parts the cranium (is like a box in which the brain is well protected) and the bones of
the face.
 The cranium: Is made up of eight bones as follows;
 Frontal bone- forms the forehead and helps to protect the eyes.
 Parietal bones- one at each side of the top of the skull, joined in to the middle.
 Temporal bones- one on each side below the parietal bones these protect the inner parts of the ears
 Occipital bone- This forms the back of the head and part of the base of the skull, has a large
opening for the spinal cord to pass through.
 Sphenoid- a hat shaped bone, which also forms part of the base of the skull. It has a little seat for the
pituitary gland, and some holes for blood vessels and cranial nerves pass through.
 Ethmoid- forms the roof of the nose and in between the eyes. It has many small holes for the nerves
of small to pass through the brain.
 The face has the following bones
o 2 Nasal bones, which form the bridge of the nose.
o 2 Lacrimal bones, near the eyes, which contain the rear ducts.
o 2 Cheek bone(zygomatic bones); forms the prominences of the cheek and part of the
flow and lateral wall of the orbital cavities
o 1 Upper jawbones, with upper teeth.
o 1Palate bones , which join with the upper jaw bones forming the hard palate
o 2 inferior conchae, one in each side of wall of the nose.
o 1 Vomer bone, which rests on the palate and helps to form the nasal septum
o 1 Mandible: this is the lower jaw, the only movable bone of the skull
o 2 Hyoid Bones, this is a horse shaped little bone in the upper part of the neck. The
tongue muscle is attached to this bone.
o The “angle of the jaw” on each side is important.
o All the bones of the skull except the lower jaw are joined firmly together by fixed joints called “Sutures”
o Some skull bones have hollow spaces called. “Sinuses” which connect with the nose and are filled with air
o Sinuses make the skull lighter, and help in the sound of the voice. ‘Sinusitis” is
infection in these spaces
o The main sinuses are the frontal ones above the eyes, and large antrum sinuses, one in each of
the upper jawbones
Refer Students to Handout --.2: Diagram the Diagram of the Skull
The Vertebral Column

 Spine or backbone is the central part of the skeleton.
 It supports the head and encloses the spinal cord.
 It consists of 33irregular bones called “Vertebrae” but some are fused together and so these
are actually 26 separate bones forming the spine.
 The parts of the vertebral column are as follows:
o 7 Cervical vertebrae column in the neck region.
o The first two, called atlas and axis are important for nodding and turning the head
o 12 Thoracic vertebrae at the back of the chest.
o 5 Lumber vertebrae in the waist region.
o These are big and strong for giving support.
o 5 Sacral vertebrae are fused together to form the sacrum, a triangular shaped bone with a hollow anteriorly
the sacrum helps to form the pelvis
o 4 Coccyx small vertebrae in the tail region are fused to form a small triangular bone called the
coccyx attached to the lower part of the sacrum
Refer Students to Handout 24.3: Diagram of the Vertebral Column
The Thorax
 The Thorax or chest is formed by the sternum (Breast-bone) and costal cartilages in front, the ribs at
the sides, and the twelve dorsal vertebral bones at the back
The Sternum
 Is a flat bone, shaped like a dagger pointing down-wards
 The tip consists of a cartilage known as the xiphisternum
 The upper part, like the handle is joined to the two collar bones.
 The costal cartilages are joined to the sides of the sternum and to the true ribs.
The Ribs
 Are twelve pairs of the long curved bones
 The upper seven pairs are called true ribs, attached to the sternum by its costal cartilages.
 The next five pairs of ribs are called false ribs because they are joined by their cartilages to those
of the ribs above and not directly to the sternum.
 The last two pairs are not connected to the sternum at all, and are called floating ribs
Functions of the Thorax

 Protection for the heart, lungs, liver, stomach and spleen
 Support for the bones of the shoulder girdle and for the breast
 Important in respiration
Bones of the Upper Limbs

o Each upper limb consists of 32 bones;
o The collar bone (clavicle)

 One on each side is a long bone with two curves.
 Its inner end is attached to the sternum, and outer end with the shoulder blade.
 The collar bone is easily felt at the lower and front part of the neck.
 It keeps the shoulder blade in place.
 When it is broken the shoulder drops forward and downwards.
o The shoulder blade (scapula)
 One on each side at the upper and outer part of the back of the thorax.
 It is a large flat, triangular shaped bone with a ridge or spine at the back.
 It takes part in the shoulder joint.
 The 2 scapula and 2 collar bones form shoulder girdle
o The humerus
 Is a long bone with a rounded head at the shoulders and a broad lower end at the elbow joint
o The radius and ulnar

 Bones of the forearm reach from the elbow joint to the wrist.
o The wrist consists of eight carpal bones.
 These short bones are arranged in two rows, proximal and distal,with four bones in each row
o Metacarpal (bones of the hand)
 These five bones forms the palm of the hand
 These articulate with the distal row of carpal bones and with the proximal row of phalanges.
o The phalanges are long bones.
 There are 14 phalanges
 The thumb has only two phalanges while the fingers have three each
Refer Students to Handout --.4: Diagram of the Upper and Lower Limb
Bones of the Pelvis and Lower Limbs

o Each lower limb consists of 31 bones
o One innominate or hip bone
o One femur, the thigh bone,
o One patella or knee cap,
o One tibia
o One fibula
o Seven tarsal bones of the ankle,
o Five metatarsal bones of the foot,
o Fourteen phalanges of the toes.
o The innominate bones;
 One on each side, join with the sacrum to form the pelvis.
 Besides protecting the pelvic organs, the pelvis supports the abdomen and provides the
deep sockets for the hip joints.
 In the female, the true pelvis (lower part) is round so that the head, of the baby can pass
through during delivery.
 In the male the true pelvis is long, narrow and heart – shaped.
 The innominate bone in a child is separated into three bones, which are fused
together in the adult.
o Therefore the bone has three parts as follows:-
 Ilium
 The upper flat part forms the false pelvis.
 Its upper ridge is called the iliac crest.
 Ischium
 The heavy lower part, which supports the body when sitting
 Pubis
 The front part.
 The pubic bones from the joint called symphysis pubis.
 The femur (thigh bone)
 Is the longest and strongest bone in the body.
o The patella (kneecap)
 Is a small bone at the front of the knee joint.
o The tibia
 Is the long bone on the inner side of the lower 1eg
o The fibula
 Is a long thin bone on the outer side of the leg
o The tarsal bones of the ankle
 These are seven short bones
 The largest is the heel bone (calcaneus)
 The upper bone takes part in the ankle joint
o The metatarsal bones
 Are five long bones in front of the feet
 They support the toes.
o The toe bones (phalanges)
 Are fourteen in number
 Like the finger bones, they are small long bones, two in the big toe and three in each of
the other toe
Refer Students to Handout --.5: Diagram of the Pelvic Bones
Step 3: Structure and Functions of the Joints (45 minutes)

DIVIDE students into small manageable groups
ASK students to work in groups and list the functions of the joints for 10 minutes
ALLOW groups ask students to provide their response for 2 minutes each
CLARIFY and summaries by using the contents below
The Joints
 Is the point at which two or more bones meet
 Bones are held together at the joints by other connective tissue such as fibrous tissue, cartilage,
ligaments and tendons
 Muscles are the means by which all movement in the body takes place including the movement
of bones at some of the joints
Types of Joints
 Fibrous joints
o In which there is no movement. eg. The sutures of the skull.
o The bones are joined together closely as though they were stitched (sutured) together.
 Cartilaginous joints
o In which two bones are joined by a pad of fibrous cartilage, which allows slight movement
o They are found in the vertebral column and pelvis.
 Synovial joints
o Are freely movable, are found in the limbs and jaw.
 Ball and Socket joint
o The round head of one bone fits into the cavity of another bone: e.g. shoulder and hip joints.
 Hinge joint
o The only movements are flexion and extension. e.g. elbow, knee.
 Gliding joint
o The bones glide on one another and allow fairly free movements. e.g. wrist and ankle joint.
 Pivot joint
o Turning is the only movement e.g. the movement between the atlas and axis for turning
the head
The Main Functions of the Joints

 Mobility
 Support
 Give the necessary support and security, the band-like ligament uniting the bones are strong and
the extent of the movements is restricted.
Refer Students to Handout --.6: Diagram of the Joint
 The skeleton is composed of 206 separate bones in the adult, and the cartilages and

ligaments, which help to unite the bones at the joints.
 Bones are classified as long, short, irregular, flat and sesamoid
 The main functions of the joints are;
o Mobility
o Support.
o Give the necessary support and security, the band-like ligament uniting the bones are strong and the
extent of the movements is restricted
 What are the functions of the bones?
 What are the types of joints?
References
Mexico City
Elsevier Linked.

Handout.1: Human Skeleton

Handout --.2: Human Skull

Handout --.3: Vertebral Column

Handout --.4: Bones of the Leg and Hand

Handout --.5: Pelvic Bones

Session: 11 Anatomical and Physiological Functions of Urinary System
Prerequisites
 None

By the end of this session a learner is expected to be able to:
 List organs that forming urinary system
 Describe the anatomy of urinary system
 Describe the physiology of urinary system
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
2 20 minutes Presentation Organs that forming urinary system
3 45 minutes Presentation Structure of urinary system
4 40 minutes Presentation Physiological functions of urinary system

120 minutes
SESSION CONTENTS

STEP 2: Organs that forming urinary system ( 20 minutes)
Activity: Buzzing (15 minutes)
ASK the students to pair up and list the principal and accessory organs of the urinary system for five
minutes
ALLOW few student to responses and let other pairs to provide unmentioned responses
CLARIFY and summaries by using the information below
 Urinary system is the system which regulates the content of blood plasma to maintain the homeostasis
of the internal fluid environment within normal limits (control the composition of blood and blood
volume)
 It removes waste products from the blood, of which many of them are toxic.
 The urinary system is the main excretory system and consist the following organs
o 2 kidneys - principal organs of the urinary system which secrete urine
o Accessory organs which includes: -
 Ureters, which convey the urine from the kidney to the urinary bladder
 Urinary bladder where urine collects and is temporary stored
 Urethra, through which the urinary is discharged from the urinary bladder to the exterior
STEP 3: Anatomical structure and physiological functions of urinary system (85 minutes)
 What are the structures and physiological functions of urinary system?

The Kidneys
 Anatomical location
o The kidneys lie in retroperitoneal position i.e. lies posterior to parietal peritoneum.
o They are located in either side of the vertebral column and extend from the level of the last
thoracic vertebra (T12) to the third lumbar (L3) usually the right kidney is a little lower than the left,
because of the liver which lies superior to the right kidney
o The kidney is encased with the cushion of fat which help it to be in position
o Structure of the kidney
 The kidneys are bean shaped organs with a medial indentation.
 An average size is approximately 11cm by 7cm by 3 cm.
 The left kidney is often slightly larger than the right.
 The medial surface of each kidney has a concave notch called the hilum, where the
renal artery and nerves enter and renal vein ureter exit the kidney
 The kidney is covered by a thin connective tissue membrane called capsule.
 The renal capsule is a smooth, transparent, fibrous membrane that surrounds,
encloses, and protects the kidney.
 The renal capsule is itself surrounded by a mass of fatty tissue that also helps to
protect the kidney by damage by cushioning it in cases of impact or sudden movement
small part of the superior pole, on its medial side, is covered by the left suprarenal
gland
o Cross-section of the kidney
 There are three major regions of the kidney, renal cortex, renal medulla and the renal pelvis.
 The Renal cortex is the outer part of the kidney
 It has a smooth texture and is the location of the Bowman's Capsules and the
glomeruli, in addition to, the proximal and distal convoluted tubules and their
associated blood supplies
 The Renal medulla is the inner part of the kidney. "Medulla" means "inner
portion"
 This area has striated triangular structures called "Renal Pyramids”.
 The appearance of striations is due to many straight tubules and blood vessels
within the renal pyramids
 The Renal pelvis is the funnel-shaped basin (cavity) that receives the urine drained
from the kidney nephrons via the collecting ducts and then the (larger) papillary ducts
 The Renal hilus is an indentation near to the centre of the concave area of the
kidney
 This is the area of the kidney through which the ureter and the other structures
including blood vessels (illustrated), lymphatic vessels, and nerves enter/leave the
kidney
Refer Students to Handout --.1: The Kidney
o Kidneys are highly vascular.

 The large branch which bring blood to the kidney is the renal artery a branch of abdominal
aorta
 Entering the kidney it divides into segmental arteries, then interlobar arteries
between the pyramids, these arteries extend toward the cortex, arch over the base
of the pyramid and form arcuate arteries. From arcuate arteries the interlobular
arteries penetrate the cortex.
 Branches of interlobular arteries are the afferent arterioles branching into capillary
network called glomeruli
 Efferent arterioles are formed from the glomerular capillaries. The efferent arterioles
give rise to peri-tubular capillaries (vasa recta), around the proximal and distal
tubules.
 The peritubular capillaries drain into the interlobular vein then the interlobar vein
then into the renal vein.
 The renal vein connects to the inferior venacava
Refer students to Handout --: Kidney Blood Supply
o Functions of the Kidney

 The kidneys are the major excretory organs of the body.
 The skin, liver, lung and intestine eliminate some waste products, but if the
kidneys fail to function, these other excretory organs cannot adequately
compensate.
o The following functions are performed by the kidney:
 Filtering of blood.
 Protein and blood cells are retained in the blood, while a large volume of filtrate is
produced.
 Most of the filtrates volume is reabsorbed back into the blood along with useful
molecules and ions.
 Small volume of water, metabolic wastes, toxic molecules, and excess ions remain in
the filtrates and the result is the formation of urine
 Regulation of blood pressure
 The kidneys regulate blood pressure by adjusting the volume of blood in the body
through, renin-angiotensin-aldosterone mechanism and the action of Ant diuretic
hormone
 Regulation of blood volume.
 The kidneys play a major role in controlling the extracellular fluid volume in the
body by producing either large volume of dilute urine or small volume of
concentrated urine.
 Regulation of the plasma electrolytes.
 The kidneys also regulate the quantities of plasma solutes.
 Important examples of such electrolytes regulated by the kidney are sodium ions
(Na+), potassium ions (K+), calcium ions (Ca2+), chloride ions (Cl-), and phosphate
ions (HPO4-2).
 Regulation of the pH of the blood.
 The kidneys secrete H+ ions to help regulate blood pH.
 At the same time, the kidneys also conserve bicarbonate ions (HCO3-), which are an
important buffer of H+.
 Synthesis of Vitamin D.
 The kidneys synthesize calcitrol, which is the active form of vitamin D.
 Production of Red blood cells.
 The kidneys contribute to the production of red blood cells by releasing the hormone
erythropoietin which stimulates Erythropoiesis (the production of red blood cells).
 Excretion of waste products and foreign substances.
 The kidneys excrete waste products of metabolism in form urine.
 Examples of waste products from metabolic reactions within the body include Urea (from
the breakdown of amino acids), bilirubin in a form of Urobilinogen (from the breakdown of
hemoglobin), and creatinine (from the breakdown of creatinine phosphate in muscle fibers)
Structure and Functions of Nephron
 Kidney nephrons are the functional units of the kidneys.
 That is, it is the kidney nephrons that actually perform the kidney's main functions.
 There are approximatly a million nephrons within each kidney
 There are two parts of a kidney nephron:
 Renal corpuscle which has; (the renal corpuscle is the part of the kidney nephron in which
blood plasma is filtered). It has two parts:
 Glomerulus which is a network of small blood vessels called capillaries
 Within the glomerulus are glomerular capillaries that are located between the afferent
arteriole (bringing blood into the glomerulus) and the efferent arteriole (draining blood away
from the glomerulus).
 For filtration to occur, the (outgoing) efferent arteriole has a smaller diameter than the
(incoming) afferent arteriole.
 This difference in arteriole diameters helps to raise the blood pressure in the glomerulus
 Bowman’s capsule which is the double-walled epithelial cup within which the glomerulus is
contained.
 Bowman's capsule is the blind expanded end of a renal tubule. It is a double- walled epithelial
cup lined by a simple squamous epithelium on its outer (parietal) wall; its glomerular,
juxtacapillary (visceral) wall is composed of specialized epithelial the podocytes.
 The area between the double-walls of the Bowman's capsule is called the capsular space; a
continuous with the proximal convoluted tubule
 The glomerular endothelium is finely fenestrated This membrane is formed by several
layers of cells clustered together
 Its function is Filtration of blood.
 Renal tubules; is the part of the kidney nephron into which the glomerular filtrate passes after
it has reached the Bowman's capsule. Portions of the renal tubules are:
 Proximal convoluted tubule
 Loop of henle, it has got two parts, namely:-
 Descending limb
 Ascending limb
 Distal convoluted tubule
 Collecting duct
 The main function of nephron is filtration and reabsorption of essential elements required by
the body. In doing so it maintains the homeostasis.
 Urine Formation
Process of forming Urine
Filtration
 The first part of the process of urine formation occurs in the glomeruli.
 The glomeruli act as filters, allowing water, glucose, salt and waste materials to pass through to the
Bowman's capsule, which surrounds each glomerulus, but preventing the red blood cells from
passing.
 The fluid in the Bowman's capsule is referred to as the nephric filtrate and resembles blood
plasma.
 It also includes urea, produced from the ammonia which accumulates when the liver
processes amino acids and is filtered out by the glomeruli.
Reabsorption
 About 43 gallons of fluid goes through the filtration process, but most is subsequently reabsorbed
rather than being eliminated.
 Reabsorption occurs in the proximal tubules of the nephron, which is the portion beyond the capsule,
in the loop of Henle, and in the distal and collecting tubules, which are further along the nephron
beyond the loop of Henle.
 Water, glucose, amino acids, sodium and other nutrients are reabsorbed into the
bloodstream in the capillaries surrounding the tubules.
 Water moves via the process of osmosis: movement of water from an area of higher
concentration to one of lower concentration.
 Usually all the glucose is reabsorbed, but in diabetic individuals, excess glucose remains in the filtrate.
 Sodium and other ions are reabsorbed incompletely, with a greater proportion remaining
in the filtrate when more is consumed in the diet, resulting in higher blood concentrations.
 Hormones regulate the process of active transport by which ions like sodium and phosphorus
are reabsorbed.
Secretion
 Secretion is the final step in the process of urine formation.
 Some substances move directly from the blood in capillaries around the distal and collecting
tubules into those tubules.
 Secretion of hydrogen ions via this process is part of the body's mechanism for maintaining
proper pH, or acid-base balance.
 More ions are secreted when the blood is acidic, less when it is alkaline.
 Potassium ions, calcium ions and ammonia also are secreted at this stage, as are some
medications.
 The urine created by this process then passes to the central part of the kidney called the pelvis,
where it flows into the ureters and then the bladder.
Refer students to:

 Handout 7.3: The Nephron
 Handout 7.4: Functions of Nephron Components
 Handout 7.5: Steps of Urine Formation
The Ureters
 The ureters are the tubes that convey urine from kidneys to urinary bladder.
 They are about 25-30 cm long with a diameter of about 3mm.
 Is continuous with the funnel shaped renal pelvis
 It passes behind the peritoneum in front of the psoas muscles into the pelvic cavity, and passes
obliquely through the posterior walls of the bladder.
 When urine accumulates, the pressure in the bladder rises.
 The ureters are compressed and openings are occluded, this prevents reflex of urine from the ureters
to the kidney
 Ureters consist of three layers:
o An outer covering layer of fibrous tissues which continues with fibrous capsule of the kidney
Middle muscular layer; consist of interlacing smooth muscle fibers that form a functional unit spiraling
around the ureters in clockwise and ant clockwise direction. The lower third of the ureters contains
longitudinal muscles
o The inner mucosa layer, is composed of transitional epithelium
 Ureters propel urine from the kidneys to the bladder by peristaltic contraction of the smooth
muscle layer.
 This originates in the pacemaker in minor calyces and not under autonomic nerve control.
 Blood supply is through testicular and ovarian arteries, branches internal iliac artery.
Refer Students to Handout 7.6: Kidneys and Ureters Blood Supply
 Urinary Bladder
o Is the reservoir for urine
o It lies in the pelvic cavity
o Its size and position varies depending on the volume of urine it contains, when
distended it rises into the abdominal cavity.
o Is pear shaped, but becomes oval when filled with urine
o It opens to the urethra at its lowest point-neck
o Superiorly it is covered by peritoneum, posteriorly it surrounds the uterus in female
and rectum in male
o The urinary bladder is composed of three layers;
 Outer layer of loose connective tissues, containing blood lymphatic vessels and
nerves
 The middle layer, consist of interlacing smooth muscle fibers and elastic tissue arranged in
three layers.
 This is called destrusor muscle which when contracts empty the bladder.
 The mucosa layer composed of transitional epithelium.
o The three orifices in the bladder wall form a triangle or trigon; the upper 2 orifices are ureters and the
lower opening is for Urethra.
o The internal urethra sphincter (thickening of the urethral smooth muscle layer)
controls outflow of urine from the bladder.
Refer Students to Handout 7.7: The Urinary Bladder
 Urethra
o Is a canal extending from the neck of the bladder to the exterior at the external urethra orifice
o In male is longer (19-20cm) than in females (4cm)
o The male urethra is associated with the urinary and the reproductive system, it consist
of three parts;
 Prostatic urethral, which originate from the bladder and pass through the prostate gland
 Membranous Urethral, is the shortest and narrowest extend from the prostate gland to
the bulb of the penis
 Penile or spongiose, lies within the corpus spongiosum of the penis and terminates at the
external urethral orifice in the glans penis.
o Female urethral runs behind the symphysis pubis and opens at the external urethral orifice infront
of the vagina.
o The external urethral orifice is guarded by external urethral sphincter which is under voluntary
control.
Refer Students to Handout 7.8: The Urethra
 Urinary system is the system which regulates the content of blood plasma to maintain the homeostasis
of the internal fluid environment within normal limits.
 Urinary system is the main system of excretion where the principal organ of excretion is the kidney
 Kidney Nephron is the functional units of the kidneys.
 The accessory organs of urinary system includes the ureters, bladder, and urethra
 The male urethra is associated with the urinary and the reproductive system
 What is the process of urine formation?

 what are the parts of the nephron?
 What are functions of the Kidney?
References
Mexico City
Elsevier Linked.
Handout -.1: The Kidney

Handout -.2: Kidney Blood Supply

1 – Renal corpuscle 10 – Efferent artery
4 – Ascending limb 12 – Vasa recta
6 – Collecting duct 24 – Papillary duct
7 – Arcuate artery 25 – Interlobar artery
8 – Interlobular artery A – Medulla
9 – Afferent artery B – Cortex

Handout 7.3: The Nephron
Handout 7.4: Functions of Nephron Components
Handout 7.5: Urine Formation Steps

Filtration
 The first step in formation of urine is filtration.
 Filtration is the process by which the blood that passes through the glomerulus is
filtered out, so that only certain structures pass through into the proximal convoluted
tubule.
 The rate at which the blood is filtered is known as the glomerular filtration rate, which is
normally 125 ml/minute or 180 liters/day!
 The glomerulus lining is such that it only allows small molecules to filter through, like
glucose, plasma, ions like sodium and potassium, urea, etc.
 The larger molecules, like blood cells and protein cannot pass through the glomerulus.
 This is the reason that when there are kidney diseases, the glomerulus lining is
affected, due to which the protein molecules also pass through, leading to blood and
protein in urine.
Selective Reabsorption
 As mentioned above, in filtration step of urine formation, there is only crude and
elementary separation of waste products and a lot of water, glucose and other
important
 materials also pass through.
 Thus, there is need for reabsorption of these important elements back into the body,
which is where the second step, that is reabsorptions, comes in.
 This step is known as selective reabsorption because only some elements are
reabsorbed back into the body.
 Reabsorption occurs in two steps, which is active reabsorption (which requires energy)
 and passive reabsorption (which does not require energy).
 Due to the difference in concentration of the fluid inside and outside the tubules, 99%
of the water returns into circulation and thus, is passively absorbed, which is
important for urine formation and flow.
 Provided the glucose levels are normal, almost all of the glucose is reabsorbed back
into the blood from the proximal tubules.
 This glucose is actively transported into the peritubular capillaries.
 However, when there is a very large amount of glucose in the blood, then some
of it passes into the urine, which is one of the signs of diabetes.
 Sodium ions are the only ions that are partially absorbed from the renal tubules back
into the blood.
Tubular Secretion
 The last step in urine formation is tubular secretion.
 This is the step where the urine is made concentrated by increasing the concentration
of waste elements.
 Thus, in this stage, substances move into the distal and collecting tubules from blood
in the capillaries around these tubules.
 These substances are secreted by the mechanism of active transport
The substances secreted include hydrogen ions, potassium ions, ammonia, and certain
drugs or metabolic end products.
 Thus, the kidney tubules play a crucial role in maintaining the body's acid-base balance and
maintaining the electrolyte balance in the body
 The distal convoluted tubules then drain the urine into the collecting tubules.
 Then, several collecting tubules join together to drain their contents into the
collecting duct, which finally, after urine formation, flows into the ducts of Bellini.
 This then eventually reaches the renal pelvis, from where the urine flows into the ureter
to reach the urinary bladder.
 Thus, these were the various urine formation steps that take place right from the
time when blood flows into the kidneys, till urine is passed into the ureters
 The various urinary system diseases occur when there are problems with the
functioning of the kidneys, which reflects in the final urine color, odor and
concentration
Handout -.7: The Urinary Bladder

Source US National Cancer Institute
Handout -.8: The Urethra

Source Tank, Patrick W.; Gest, Thomas R (2007)
Session:12 Anatomical and Physiological Functions of Reproductive System
Prerequisites
 None

 List organs that forming reprodutive system
 Describe the anatomy of reproductive system
 Describe the physiology of reproductive system
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation of Session Title and Learning
Tasks
2 20 minutes Presentation Organs that forming reproductive system
3 45 minutes Presentation Anatomy of reproductive system
4 40 minutes Presentation Physiology of reproductive system
SESSION CONTENTS

STEP 2: Organs that forming reproductive system ( 20 minutes)

Without the reproductive system, the human species could not survive.
 The female reproductive system produces oocytes and can receive sperm
cells, which one of them may unite with an oocyte (female gamete) to form the
first cell of an offspring
 It is also involved in nurturing the development of a new individual until birth and
usually for some considerable time after birth i.e. it provide protection and nutrition to
the developing offspring for up to several years after conception.
 Female and male reproductive system all are derived from the same
embryologic structures
 In human being, essence of sexual reproduction is that each offspring has
parents and a combination of genes from both.
The Organs of the Female Reproductive System

 Primary organs : the ovaries (gonads), which produce ova (gametes) which are
also internal organs
 Accessory organs
o External genitalia – the vulva (Labia majora, labia minora, Clitoris, Hymen,
and vestibular glands)
o Internal genitalia – uterine tubes, uterus and vagina
o Additional sex glands such as the mammary gland
o Primary organ for female reproductive system (the ovary) has the main functions of:
 Production of female gametes or oocytes
 Secretion of female sex hormones including oestrogen and progesterone
STEP 3: Anatomy of reproductive system (45 minutes)
The External Genitalia (Vulva)

 Female external genital organ is known as the vulva.
 This consists of the following structures:
o Perineum is the skin-covered muscular region between the vaginal orifice and
the anus
 It is a roughly diamond shaped area between the thighs; extend from
the symphysis pubis interiorly to the coccyx posteriorly.
 The perineum has great clinical importance because of the danger of being
torn during childbirth.
 Such tears are often deep, have irregular edges, to avoid these tears
sometime is necessary to do a surgical incision known as episiotomy during
childbirth if there is a threat for tear to occur
o The Mons pubis is the rounded fatty eminence anterior to the pubic symphysis,
pubic tubercle, and superior pubic rami.
o After puberty, the Mons pubis is covered with coarse pubic hairs.
o The labia majora are prominent folds of skin that bound the pudendal cleft, the slit
between the labia majora and indirectly provide protection for the urethral and vaginal
orifices
o The labia minora are folds of fat-free, hairless skin.
o They have a core of spongy connective tissue containing erectile tissue and many
small blood vessels.
o Internal surface of each labium minus consists of thin moist skin; it has the typical
pink color of a mucous membrane and contains many sensory nerve endings.
o The labia minora are enclosed in the pudendal cleft within the labia majora and
surround the vestibule into which the external urethral and vaginal orifices
open
o The clitoris is an erectile organ located where the labia minora meet anteriorly.
o The clitoris consists of a root and a body, which are composed of two crura, two
corpora cavernosa, and the glans of the clitoris.
o The glans is covered by the prepuce of the clitoris.
o The clitoris is highly sensitive and enlarges on tactile stimulation.
o The glans is the most highly innervated part of the clitoris.
o It is engorges with blood during sexual arousal and derived from the same embryonic
structures as penis in males
o The vestibule is the space surrounded by the labia minora, which contains the
openings of the urethra, vagina, and ducts of the greater and lesser vestibular
glands
o Urinary meatus is the small opening of the urethra, situated between the clitoris
and vaginal orifice.
o On each side of the external urethral orifice are the openings of the ducts of
the paraurethral glands.
o Vaginal orifice is an opening that s larger than the urinary meatus. It is
located posterior to the meatus.
o The size and appearance of the vaginal orifice vary with the condition of the hymen, a
thin fold of mucous membrane within the vaginal orifice surrounding the lumen.
o After its rupture, only remnants of the hymen, hymenal caruncles (tags) are visible
o The bulbs of the vestibule are paired masses of elongated erectile tissue that lie along
the sides of the vaginal orifice under cover of the bulbospongiosus muscles.
o The bulbs are homologous with the bulb of the penis and the corpus spongiosum.
o The greater vestibular glands (Bartholin glands) are located on each side of the
vestibule, posterolateral to the vaginal orifice.
o These glands are round or oval and are partly overlapped posteriorly by the bulbs of
the vestibule, and both are partially surrounded by the bulbospongiosus muscles.
o The slender ducts of these glands pass deep to the bulbs and open into the vestibule
on each side of the vaginal orifice.
o These glands secrete mucus into the vestibule during sexual arousal.
o The lesser vestibular glands are smaller glands on each side of the vestibule that open
into it between the urethral and the vaginal orifices.
o These glands secrete mucus into the vestibule, which moistens the labia and vestibule.
Blood and Nerve Supply of the Vulva

 The arterial supply to the vulva is from the external and internal pudendal arteries.
 The internal pudendal artery supplies most of the skin, external genitalia, and
perineal muscles.
 The labial arteries are branches of the internal pudendal artery, as are those of the clitoris.
 The labial veins are tributaries of the internal pudendal veins and accompanying
veins. (venae comitantes).
 Venous engorgement during the excitement phase of the sexual response
causes an increase in the size and consistency of the clitoris and the bulbs of
the vestibule.
 As a result the clitoris becomes turgid.
 The vulva contains a rich network of lymphatic vessels that pass laterally to
the superficial inguinal lymph nodes.
 The glans of the clitoris and anterior labia minora may also drain to the deep
inguinal nodes or internal iliac nodes.
 The anterior aspect of the vulva is supplied by anterior labial nerves, derived from
the ilioinguinal nerve and the genital branch of the genitofemoral nerve.
 The posterior aspect is supplied by the perineal branch of the posterior cutaneous nerve
of the thigh laterally and the pudendal nerve centrally.
 The pudendal nerve is the main nerve of the perineum.
 Its posterior labial nerves supply the labia; deep and muscular branches supply the
orifice of the vagina and superficial perineal muscles; and the dorsal nerve of the clitoris
supplies deep perineal muscles and sensation to the clitoris.
 The bulb of the vestibule and erectile bodies of the clitoris receive parasympathetic
fibers via cavernous nerves from the uterovaginal plexus.
 Parasympathetic stimulation produces increased vaginal secretion, erection of the
clitoris, and engorgement of erectile tissue in the bulbs of the vestibule.
Refer Students to Handout 9.1: The Female External Genitalia
The Internal Genitalia

 Ovaries
o Ovaries are oval shaped small organs measuring approximately 3 cm x 1.5 cm
o The ovary is located in the lateral wall of the pelvis in a region called the ovarian
fossa
The ovaries develop high on the posterior abdominal wall and then descend before
birth, bringing with them their vessels, lymphatic’s, and nerves.
o Unlike the testes, the ovaries do not migrate through the inguinal canal into the
perineum, but stop short and assume a position on the lateral wall of the pelvic
cavity
o Ovaries are located near the attachment of the broad ligament to the lateral pelvic
walls, suspended from both by peritoneal folds, the mesovarium from the postero-
superior aspect of the broad ligament and the suspensory ligament of the ovary
from the pelvic wall.
o The ovary also attaches to the uterus by the ligament of ovary, which runs within
the mesovarium.
Structure of Ovary and Formation of Primordial Follicles

 The ovaries have two layers of tissues, the medulla and the cortex.
o The medulla lies in the centre and consists of fibrous tissue, blood vessels and nerves.
o The cortex surrounds the medulla.
o It has connective tissue or stroma covered by germinal epithelium.
o It contains ovarian follicles in various stages of maturity
 Ovum production or oogenesis begins before a woman’s birth, accelerates at puberty
and ends at menopause.
 Between puberty and menopause oogenesis occurs on a monthly basis as part of
the ovarian cycle.
 The stem cells of female complete their mitotic division before birth.
 Between the third and seventh months of fetal development
 The primary oocytes remain in a state of suspended development until the
individual reaches puberty, when rising levels of FSH trigger the start of the
ovarian cycle.
 Primary oocyte and its follicle cells form a primordial follicle.
 Not all primary oocytes produced during developmental survive until puberty.
 The ovaries have roughly 2 million primordial follicles at birth, by at time of puberty the
number has dropped to about 400,000, the rest of the primordial follicles degenerates in
a process called atresia
Blood Supply, Lymph Drainage and Nerve Supply

 Arterial supply - The ovarian arteries arise from the abdominal aorta just below the
renal arteries and descend along the posterior abdominal wall
 Venous drainage - The right ovarian vein opens into the inferior vena cava and the
left into the left renal vein
 Lymph drainage – this is by lateral aortic and preaortic lymph node
 Nerve supply – By the parasympathetic nerve from the sacral out flow
Refer Students to:

 Handout 7.2: Ovarian Ligaments
 Handout 7.3: Ovarian Blood Supply
 Lymph drainage – by deep and superficial lymph vessels

 Nerve Supply – Consists of the parasympathetic fibers from the sacral outflow
and sympathetic fibers from the lumbar outflow
Supporting Structures
 The uterus is supported in the pelvis by surround ding organs, muscles of the pelvic
floor and the following ligaments to that suspend it from the wall of the pelvis
o Broad ligaments
 Uterosacral ligaments
 Transverse cervical
ligaments
 Pubocervical fascia
The Vagina
 The vagina is a fibromuscular tube lined with stratified squamous epithelium,
connecting the external and internal organs of reproduction.
 It runs obliquely upwards and backwards at an angle of about 45 between the bladder
in front and rectum and anus behind.
Structure of the Vagina
 The vagina has three layers
o The outer covering of areolar tissue.
o The middle layer of smooth muscle.
o The inner layer of stratified squamous epithelium that forms ridges of rugae
o Between puberty and the menopause, lactobacillus acidophilus bacteria are normally
present, which secrete lactic acid, maintaining the Ph between 4.9 and 3.5.
o The acidity inhibits the growth of most other microbes that may enter the vagina from
the perineum.
Blood Supply, Lymph Drainage and Nerve Supply
 Arterial supply.
o An arterial plexus is formed round the vagina, derived from uterine and vaginal
arteries, which are branches of the internal iliac arteries.
 Venous drainage.
o A venous plexus situated in the muscular wall drains into the internal iliac veins.
 Lymph drainage.
o This is through the deep and superficial iliac glands.
 Nerve supply.
o This consists of parasympathetic fibers from the sacral outflow, sympathetic fibers from the
lumbar outflow and somatic sensory fibers from the pudendal nerves
STEP 4: Physiology of reproductive system (40 minutes)

Functions of the Vulva

 Cover the deeper structures of the female perineum
 Labia’s maintain the closure of the vaginal introitus
 Integument of the vulva has specialized nerve ending
 Secrete mucous that maintain the epithelial moisture of the vagina
Functions vagina
 Acts as a receptacle for the penis during coitus
 During sexual intercourse, the lining of the vagina lubricates and stimulates the
glans penis, which in turn triggers the ejaculation of semen
 Provides an elastic passageway through which the fetus and placenta passes during
child birth
 Provide a path for menstrual fluid to leave the body
Functions of the Uterus

 Serves to receive the sperm in mares
 Allow passage of sperm from site of deposition to uterine tubes for fertilization
 Provides suitable environment for
o Implantation of the embryo
o Nourishment of the embryo and fetus during pregnancy
 Provides mechanical protection of the fetus
 Expels the mature fetus at the end of pregnancy
 Plays role in menstruation if pregnancy do not occur
Functions of the Ovaries

 Produces female gametes or ova
 Secretes female sex hormones (estrogen and progesterone)
 Regulate reproductive functions in the female
 Primary organ for female reproductive system is the ovary whose main functions are
production of female gametes or oocytes and secretion of female sex hormones
including oestrogen and progesterone
 The perineum has great clinical importance because of the danger of being torn during
childbirth
 Maturation of the follicle is stimulated by follicle stimulating hormone (FSH) from the
anterior pituitary, and oestrogen secreted by the follicle lining cells.
 What are the structures of the vulva?

 what are the blood supply of the ovary
 Name 5 features of female puberty
References
Session: 13 Anatomical and Physiological Functions of Nervous System
Prerequisites
 None

 List organs that forming nervous system
 Describe the anatomy of nervous system
 Describe the physiology of nervous system
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Tasks
2 20 minutes Presentation Organs that forming nervous system
3 45 minutes Presentation Anatomy of nervous system
4 40 minutes Presentation Physiology of nervoussystem
SESSION CONTENTS

STEP 2: Organs that forming nervous system ( 20 minutes)

STEP 3: Anatomy of nervous system (45 minutes)
 The nervous system consists of the brain, the spinal cord and peripheral nerves.
 The structure and organisation of the tissues that form these components enables rapid
communication between different parts of the body.
 the parts of the nervous system are grouped as follows:
o The central nervous system (CNS), consisting of the brain and the spinal cord
o The peripheral nervous system (PNS) consisting of all the nerves outside the brain and spinal
cord.
 The peripheral nervous system is a network of nerve fibres, which are:

o Sensory or afferent, providing the brain with 'input' from organs and tissues,
o Motor or efferent, which convey nerve impulses carrying 'output' from the brain to effector
organs: the muscles and glands
STEP 4: Physiology of nervous system (40 minutes)

 DIVIDE learners into small manageable groups
 ASK learners to discuss on the following question
 ALLOW learners to discuss for 15 minutes
 ALLOW few groups to present and the rest to add points not mentioned
 CLARIFY and SUMMARIZE by using the contents below
 The somatic (common) senses are pain, touch, heat and cold, and they arise following stimulation
of specialised sensory receptors at nerve endings found throughout the skin.
 There are different receptors in muscles and joints that respond to changes in the position and
orientation of the body, maintaining posture and balance. Yet other receptors are activated by
stimuli in internal organs and maintain control of vital body functions, e.g. heart rate, respiratory rate
and blood pressure.
 Stimulation of any of these receptors sets up impulses that are conducted to the brain in sensory
(afferent) nerves. Communication along nerve fibres (cells) is by electrical impulses that are
generated when nerve endings are stimulated.
 Communication between nerve cells is also required, since more than one nerve is involved in the
chain of events occurring between the initial stimulus and the physiological reaction to it.
 Nerves communicate with each other by releasing a chemical (the neurotransmitter) into tiny gaps
between them.
 The neurotransmitter quickly travels across the gap and either stimulates or inhibits the next nerve
cell, thus ensuring the message is transmitted.
 Sensory nerves and chemical substances circulating in the blood provide information to appropriate
parts of the brain, which collates it and then responds via motor nerves to effector organs, often
through a negative feedback mechanism (Fig. 1.3). Some of these activities are understood and
perceived, e.g. pain, whereas others take place subconsciously, e.g. changes in blood pressure.
Nerve impulses travel at great speed along nerve fibres leading to rapid responses; adjustments to
many body functions occur within a few seconds.
Communication with the external environment

Special senses These senses arise following stimulation of specialised sensory receptor cells located in
sensory organs or tissues in the head. The senses and the special organs involved are shown in Box
1.2. Although these senses are usually considered separate and different from each other, one sense is
rarely used alone For example, when the smell of smoke is perceived then other senses such as sight
and sound are used to try and locate the source of a fire. Similarly, taste and smell are closely
associated in the enjoyment, or otherwise, of food. The brain collates incoming information with
information from the memory and initiates a response by setting up electrical impulses in motor
(efferent) nerves to effector organs, muscles and glands. Such responses enable the individual to
escape from the fire, or to prepare the digestive system for eating.
Verbal communication Sound is a means of communication and is produced in the larynx as a result of
blowing air through the space between the vocal cords during expiration. Speech is the manipulation of
sound by contraction of the muscles of the throat and cheeks, and movements of the tongue and lower
jhaw.
Non-verbal communication Posture and movements are associated with non-verbal communication,
e.g. nodding the head and shrugging the
References
Session:14 Anatomical and Physiological Functions of Endocrine System
Prerequisites
 None

 List organs that forming endocrine system
 Describe the anatomy of endocrine system
 Describe the physiology of endocrine system
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Tasks
2 20 minutes Presentation Organs that forming endocrine system
3 45 minutes Presentation Anatomy of endocrine system
4 40 minutes Presentation Physiology of endocrine system
SESSION CONTENTS

STEP 2: Organs that forming endocrine system ( 20 minutes)

STEP 3: Anatomy of endocrine system (45 minutes)
 Endocrine glands consist of groups of secretory cells surrounded by an extensive network of
capillaries which facilitates diffusion of hormones (chemical messengers) from the secretory cells
into the bloodstream.
 They are commonly referred to as the ductless glands because the hormones are secreted and
diffuse directly into the bloodstream.
 A hormone is formed in one organ or gland and carried in the blood to another organ (target organ
or tissue), probably quite distant, where it influences cellular activity, especially growth and
metabolism.
 Most hormones are synthesised from amino acids (amines, polypeptides and proteins;) or are
cholesterol-based lipids (steroids).
 Homeostasis of the internal environment is maintained partly by the autonomic nervous system and
partly by the endocrine system.
 The autonomic nervous system is concerned with rapid changes, while hormones of the endocrine
system are mainly involved in slower and more precise adjustments.
 The endocrine system consists of a number of distinct glands and some tissues in other organs.
Although the hypothalamus is classified as a part of the brain and not as an endocrine gland it
controls the pituitary gland and has an indirect effect on many others.
 The endocrine glands are:
o 1 pituitary gland
o 1 thyroid gland
o 4 parathyroid glands
o 2 adrenal (suprarenal) glands
o the pancreatic islets (islets of Langerhans)
o 1 pineal gland or body
o 1 thymus gland
o 2 ovaries in the female
o 2 testes in the male.
Hypothalamus
 The hypothalamus is located in the lower central part of the brain. This part of the brain is important
in regulation of satiety, metabolism, and body temperature.
 In addition, it secretes hormones that stimulate or suppress the release of hormones in the pituitary
gland.
 Many of these hormones are releasing hormones, which are secreted into an artery (the
hypophyseal portal system) that carries them directly to the pituitary gland.
 In the pituitary gland, these releasing hormones signal secretion of stimulating hormones.
 The hypothalamus also secretes a hormone called somatostatin, which causes the pituitary gland
to stop the release of growth hormone.
Pituitary Gland
 The pituitary gland is located at the base of the brain beneath the hypothalamus and is no larger
than a pea. It is often considered the most important part of the endocrine system because it
produces hormones that control many functions of other endocrine glands. When the pituitary gland
does not produce one or more of its hormones or not enough of them, it is called hypopituitarism.
The pituitary gland is divided into two parts: the anterior lobe and the posterior lobe. The anterior lobe
produces the following hormones, which are regulated by the hypothalamus:
 Growth hormone: Stimulates growth of bone and tissue (Growth hormone deficiency results in
growth failure. Growth hormone deficiency in adults results in problems in maintaining proper
amounts of body fat and muscle and bone mass. It is also involved in emotional well-being.)
 Thyroid-stimulating hormone (TSH): Stimulates the thyroid gland to produce thyroid hormones
(A lack of thyroid hormones either because of a defect in the pituitary or the thyroid itself is
called hypothyroidism.)
 Adrenocorticotropin hormone (ACTH): Stimulates the adrenal gland to produce several related
steroid hormones
 Luteinizing hormone (LH) and follicle-stimulating hormone (FSH): Hormones that control sexual
function and production of the sex steroids, estrogen and progesterone in females or
testosterone in males
 Prolactin: Hormone that stimulates milk production in females
The posterior lobe produces the following hormones, which are not regulated by the hypothalamus:
 Antidiuretic hormone (vasopressin): Controls water loss by the kidneys
 Oxytocin: Contracts the uterus during childbirth and stimulates milk production
The hormones secreted by the posterior pituitary are actually produced in the brain and carried to the
pituitary gland through nerves. They are stored in the pituitary gland.
Thyroid Gland
The thyroid gland is located in the lower front part of the neck. It produces thyroid hormones that
regulate the body's metabolism. It also plays a role in bone growth and development of the brain and
nervous system in children. The pituitary gland controls the release of thyroid hormones. Thyroid
hormones also help maintain normal blood pressure, heart rate, digestion, muscle tone, and
reproductive functions.
Parathyroid Glands
The parathyroid glands are two pairs of small glands embedded in the surface of the thyroid gland, one
pair on each side. They release parathyroid hormone, which plays a role in regulating calcium levels in
the blood and bone metabolism.
Adrenal Glands
The two adrenal glands are triangular-shaped glands located on top of each kidney.
The adrenal glands are made up of two parts. The outer part is called the adrenal cortex, and the inner
part is called the adrenal medulla. The outer part produces hormones called corticosteroids, which
regulate the body's metabolism, the balance of salt and water in the body, the immune system, and
sexual function. The inner part, or adrenal medulla, produces hormones called catecholamines (for
example, adrenaline). These hormones help the body cope with physical and emotional stress by
increasing the heart rate and blood pressure.
Pineal Body
The pineal body, or pineal gland, is located in the middle of the brain. It secretes a hormone called
melatonin, which may help regulate the wake-sleep cycle of the body.
Reproductive Glands
The reproductive glands are the main source of sex hormones. In males, the testes, located in the
scrotum, secrete hormones called androgens; the most important of which is testosterone. These
hormones affect many male characteristics (for example, sexual development, growth of facial hair and
pubic hair) as well as sperm production. In females, the ovaries, located on both sides of the uterus,
produce estrogen and progesterone as well as eggs. These hormones control the development of
female characteristics (for example, breast growth), and they are also involved in reproductive functions
(for example, menstruation, pregnancy).
Pancreas
The pancreas is an elongated organ located toward the back of the abdomen behind the stomach. The
pancreas has digestive and hormonal functions. One part of the pancreas, the exocrine pancreas,
secretes digestive enzymes. The other part of the pancreas, the endocrine pancreas, secretes
hormones called insulin and glucagon. These hormones regulate the level of glucose (sugar) in the
blood.
Pictures of the Endocrine System

Picture of the Thyroid Gland
Picture of the Pituitary Gland

Picture of the Parathyroid Glands
Picture of the Pancreas
STEP 4: Physiology of endocrine system (40 minutes)

 When a hormone arrives at its target cell, it binds to a specific receptor, where it acts as a switch
influencing chemical or metabolic reactions inside the cell.
 The receptors for peptide hormones are situated on the cell membrane and those for lipid-based
hormones are inside the cell.
 When a hormone arrives at its target cell, it binds to a specific area, the receptor, where it acts as a
switch influencing chemical or metabolic reactions inside the cell.
 The receptors for water-soluble hormones are situated on the cell membrane and those for lipid-
soluble hormones are inside the cell.
 The level of a hormone in the blood is variable and self-regulating within its normal range.
 A hormone is released in response to a specific stimulus and usually its action reverses or negates
the stimulus through a negative feedback mechanism.
 This may be controlled either indirectly through the release of hormones by the hypothalamus and
the anterior pituitary gland, e.g. steroid and thyroid hormones, or directly by blood levels of the
stimulus, e.g. insulin and glucagon.
 The effect of a positive feedback mechanism is amplification of the stimulus and increasing release
of the hormone until a particular process is complete and the stimulus ceases, e.g. release of
oxytocin during labour
References
Session: 15 Anatomical and Physiological Functions of Lymphatic - Immune System
Prerequisites
 None

 List organs that forming lymphatic - immune system
 Describe the anatomy of lymphatic - immune system
 Describe the physiology of lymphatic - immune system
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Tasks
2 20 minutes Presentation Organs that forming lymphatic - immune system
3 45 minutes Presentation Anatomy of lymphatic - immune system
4 40 minutes Presentation Physiology of lymphatic - immune system
SESSION CONTENTS

STEP 2: Organs that forming lymphatic - immune system ( 20 minutes)

STEP 3: Anatomy of lymphatic - immune system (45 minutes)
Lymphatic system
 The lymphatic system consists of a series of lymph vessels, which begin as blind-ended tubes in
the spaces between the blood capillaries and tissue cells
 Structurally they are similar to veins and blood capillaries but the pores in the walls of the lymph
capillaries are larger than those of the blood capillaries.
 Lymph is tissue fluid containing large molecules, e.g. proteins, fragments of damaged tissue cells
and microbes. It is transported along lymph vessels and is returned to the bloodstream.
 There are collections of lymph nodes situated at various points along the length of the lymph
vessels.
 Lymph is filtered as it passes through the lymph nodes, and microbes, noxious substances and
some waste materials are removed.
 The lymphatic system provides the sites for formation and maturation of lymphocytes, the white
blood cells involved in immunity.
 All body tissues are bathed in tissue fluid, consisting of the diffusible constituents of blood and
waste materials from cells.
 Some tissue fluid returns to the capillaries at their venous end and the remainder diffuses through
the more permeable walls of the lymph capillaries and becomes lymph.
 Lymph passes through vessels of increasing size and a varying number of lymph nodes before
returning to the blood.
 The lymphatic system consists of:
o Lymph
o Lymph vessels
o Lymph nodes • lymph organs, e.g. spleen and thymus
o diffuse lymphoid tissue, e.g. tonsils
o Bone marrow.
Figure: A. Major parts of the lymphatic system. B. Regional drainage of lymph.
Lymph
Lymph is a clear watery fluid, similar in composition to plasma, with the important exception
of plasma proteins, and identical in composition to interstitial fluid. Lymph transports the
plasma proteins that seep out of the capillary beds back to the bloodstream. It also carries
away larger particles, e.g. bacteria and cell debris from damaged tissues, which can then be
filtered out and destroyed by the lymph nodes. Lymph contains lymphocytes, which circulate
in the lymphatic system allowing them to patrol the different regions of the body. In the
lacteals of the small intestine, fats absorbed into the lymphatics give the lymph (now called
chyle), a milky appearance.
Lymph capillaries
These originate as blind-end tubes in the interstitial spaces. They have the same structure
as blood capillaries, i.e. a single layer of endothelial cells, but their walls are more
permeable to all interstitial fluid constituents, including proteins and cell debris. The tiny
capillaries join up to form larger lymph vessels.
Nearly all tissues have a network of lymphatic vessels, important exceptions being the central nervous
system, the cornea of the eye, the bones and the most superficial layers of the skin.
Larger lymph vessels
Lymph vessels are often found running alongside the arteries and veins serving the area. Their walls
are about the same thickness as those of small veins and have the same layers of tissue, i.e. a fibrous
covering, a middle layer of smooth muscle and elastic tissue and an inner lining of endothelium. Like
veins, lymph vessels have numerous cup-shaped valves to ensure that lymph flows in a one-way
system towards the thorax . There is no ‘pump’, like the heart, involved in the onward movement of
lymph, but the muscle layer in the walls of the large lymph vessels has an intrinsic ability to contract
rhythmically (the lymphatic pump).
Figure 6.3 A lymph vessel cut open to show valves.
In addition, lymph vessels are compressed by activity in adjacent structures, such as contraction of
muscles and the regular pulsation of large arteries. This ‘milking’ action on the lymph vessel wall helps
to push lymph along.
Lymph vessels become larger as they join together, eventually forming two large ducts, the thoracic
duct and right lymphatic duct, which empty lymph into the subclavian veins.
Thoracic duct
This duct begins at the cisterna chyli, which is a dilated lymph channel situated in front of the bodies of
the first two lumbar vertebrae. The duct is about 40 cm long and opens into the left subclavian vein in
the root of the neck. It drains lymph from both legs, the pelvic and abdominal cavities, the left half of the
thorax, head and neck and the left arm .
Right lymphatic duct
This is a dilated lymph vessel about 1 cm long. It lies in the root of the neck and opens into the right
subclavian vein. It drains lymph from the right half of the thorax, head and neck and the right arm.
Lymphatic organs and tissues
Learning outcomes
Lymph nodes
Lymph nodes are oval or bean-shaped organs that lie, often in groups, along the length of lymph
vessels. The lymph drains through a number of nodes, usually 8 to 10, before returning to the venous
circulation. These nodes vary considerably in size: some are as small as a pin head and the largest are
about the size of an almond.
Structure
Lymph nodes (Fig. 6.4) have an outer capsule of fibrous tissue that dips down into the node substance
forming partitions, or trabeculae. The main substance of the node consists of reticular and lymphatic
tissue containing many lymphocytes and macrophages.
Figure 6.4 Section through a lymph node. Arrows indicate the direction of lymph flow.
As many as four or five afferent lymph vessels may enter a lymph node while only one efferent vessel
carries lymph away from the node. Each node has a concave surface called the hilum where an artery
enters and a vein and the efferent lymph vessel leave.
The large numbers of lymph nodes situated in strategic positions throughout the body are arranged in
deep and superficial groups.
Lymph from the head and neck passes through deep and superficial cervical nodes .
Figure 6.5 Some lymph nodes of the face and neck.
Lymph from the upper limbs passes through nodes situated in the elbow region, then through the deep
and superficial axillary nodes.
Lymph from organs and tissues in the thoracic cavity drains through groups of nodes situated close to
the mediastinum, large airways, oesophagus and chest wall. Most of the lymph from the breast passes
through the axillary nodes.
Lymph from the pelvic and abdominal cavities passes through many lymph nodes before entering the
cisterna chyli. The abdominal and pelvic nodes are situated mainly in association with the blood vessels
supplying the organs and close to the main arteries, i.e. the aorta and the external and internal iliac
arteries.
The lymph from the lower limbs drains through deep and superficial nodes including groups of nodes
behind the knee and in the groin (inguinal nodes).
Functions
Filtering and phagocytosis
Lymph is filtered by the reticular and lymphoid tissue as it passes through lymph nodes. Particulate
matter may include bacteria, dead and live phagocytes containing ingested microbes, cells from
malignant tumours, worn-out and damaged tissue cells and inhaled particles. Organic material is
destroyed in lymph nodes by macrophages and antibodies. Some inorganic inhaled particles cannot be
destroyed by phagocytosis. These remain inside the macrophages, either causing no damage or killing
the cell. Material not filtered out and dealt with in one lymph node passes on to successive nodes and
by the time lymph enters the blood it has usually been cleared of foreign matter and cell debris. In some
cases where phagocytosis of bacteria is incomplete they may stimulate inflammation and enlargement
of the node (lymphadenopathy).
Proliferation of lymphocytes
Activated T- and B-lymphocytes multiply in lymph nodes. Antibodies produced by sensitised B-

lymphocytes enter lymph and blood draining the node.
Cell population includes reticular cells (brown), macrophages (pink) and lymphocytes (yellow).
Spleen
The spleen contains reticular and lymphatic tissue and is the largest lymph organ.
The spleen.
The spleen lies in the left hypochondriac region of the abdominal cavity between the fundus of the
stomach and the diaphragm. It is purplish in colour and varies in size in different individuals, but is
usually about 12 cm long, 7 cm wide and 2.5 cm thick. It weighs about 200 g.
Organs associated with the spleen

Superiorly and posteriorly – diaphragm
Inferiorly – left colic flexure of the large intestine
Anteriorly – fundus of the stomach
Medially – pancreas and the left kidney
Laterally – separated from the 9th, 10th and 11th ribs and the intercostal muscles by the diaphragm
The spleen is slightly oval in shape with the hilum on the lower medial border. The anterior surface is
covered with peritoneum. It is enclosed in a fibroelastic capsule that dips into the organ, forming
trabeculae. The cellular material, consisting of lymphocytes and macrophages, is called splenic pulp,
and lies between the trabeculae. Red pulp is the part suffused with blood and white pulp consists of
areas of lymphatic tissue where there are sleeves of lymphocytes and macrophages around blood
vessels.
The structures entering and leaving the spleen at the hilum are:
 splenic artery, a branch of the coeliac artery
 splenic vein, a branch of the portal vein
 lymph vessels (efferent only)
 nerves.
Blood passing through the spleen flows in sinusoids. which have distinct pores between the endothelial
cells, allowing it to come into close association with splenic pulp.
Functions
Phagocytosis
As described previously old and abnormal erythrocytes are mainly destroyed in the spleen, and the
breakdown products, bilirubin and iron, are transported to the liver via the splenic and portal veins.
Other cellular material, e.g. leukocytes, platelets and bacteria, is phagocytosed in the spleen. Unlike
lymph nodes, the spleen has no afferent lymphatics entering it, so it is not exposed to diseases spread
by lymph.
Storage of blood
The spleen contains up to 350 ml of blood, and in response to sympathetic stimulation can rapidly
return most of this volume to the circulation, e.g. in haemorrhage.
Immune response
The spleen contains T- and B-lymphocytes, which are activated by the presence of antigens, e.g. in
infection. Lymphocyte proliferation during serious infection can cause enlargement of the spleen
(splenomegaly).
Erythropoiesis
The spleen and liver are important sites of fetal blood cell production, and the spleen can also fulfil this
function in adults in times of great need.
Thymus gland
The thymus gland lies in the upper part of the mediastinum behind the sternum and extends upwards
into the root of the neck It weighs about 10 to 15 g at birth and grows until puberty, when it begins to
atrophy. Its maximum weight, at puberty, is between 30 and 40 g and by middle age it has returned to
approximately its weight at birth.
Organs associated with the thymus

Anteriorly – sternum and upper four costal cartilages
Posteriorly – aortic arch and its branches, brachiocephalic veins, trachea
Laterally – lungs
Superiorly – structures in the root of the neck
Inferiorly – heart
Structure
The thymus consists of two lobes joined by areolar tissue. The lobes are enclosed by a fibrous capsule
which dips into their substance, dividing them into lobules that consist of an irregular branching
framework of epithelial cells and lymphocytes.
Function
Lymphocytes originate from stem cells in red bone marrow Those that enter the thymus develop into
activated T-lymphocytes
Thymic processing produces mature T-lymphocytes that can distinguish ‘self’ tissue from foreign tissue,
and also provides each T-lymphocyte with the ability to react to only one specific antigen from the
millions it will encounter . T-lymphocytes then leave the thymus and enter the blood. Some enter
lymphoid tissues and others circulate in the bloodstream. T-lymphocyte production, although most
prolific in youth, probably continues throughout life from a resident population of thymic stem cells.
The maturation of the thymus and other lymphoid tissue is stimulated by thymosin, a hormone secreted
by the epithelial cells that form the framework of the thymus gland. Shrinking of the gland begins in
adolescence and, with increasing age, the effectiveness of the T-lymphocyte response to antigens
declines.
Mucosa-associated lymphoid tissue (MALT)
Throughout the body, at strategically placed locations, are collections of lymphoid tissue which, unlike
the spleen and thymus, are not enclosed within a capsule. They contain B- and T-lymphocytes, which
have migrated from bone marrow and the thymus, and are important in the early detection of invaders.
However, as they have no afferent lymphatic vessels, they do not filter lymph, and are therefore not
exposed to diseases spread by lymph. MALT is found throughout the gastrointestinal tract, in the
respiratory tract and in the genitourinary tract, all systems of the body exposed to the external
environment.
The main groups of MALT are the tonsils and aggregated lymphoid follicles (Peyer’s patches).
Tonsils
These are located in the mouth and throat, and will therefore destroy swallowed and inhaled antigens
Aggregated lymphoid follicles (Peyer’s patches)
These large collections of lymphoid tissue are found in the small intestine, and intercept swallowed
antigens
STEP 4: Physiology of lymphatic - immune system (40 minutes)

Functions of the lymphatic system include the following.
Tissue drainage
 Every day, around 21 litres of plasma fluid, carrying dissolved substances and some plasma
protein, escape from the arterial end of the capillaries and into the tissues.
 Most of this fluid is returned directly to the bloodstream via the capillary at its venous end, but 3-4
litres of fluid are drained away by the lymphatic vessels. Without this, the tissues would rapidly
become waterlogged, and the cardiovascular system would begin to fail as the blood volume falls.
Absorption in the small intestine

 Fat and fat-soluble materials, e.g. the fat-soluble vitamins, are absorbed into the central lacteals
(lymphatic vessels) of the villi.
Immunity
 The lymphatic organs are concerned with the production and maturation of lymphocytes, the white
blood cells that are primarily responsible for provision of immunity.
 Bone marrow is therefore considered to be lymphatic tissue, since lymphocytes are produced
there.
References
Session: 16 Anatomical and Physiological Functions of Eye
Prerequisites
 None

 List organs that forming eye
 Describe the anatomy of eye
 Describe the physiology of the eye
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Tasks
2 20 minutes Presentation Organs that forming the eye
3 45 minutes Presentation Anatomy of the eye
4 40 minutes Presentation Physiology of eye

SESSION CONTENTS

 READ or ASK learners to read the learning Tasks and clarify
 ASK learners if they have questions before continuing.
STEP 2: Organs that forming eye ( 20 minutes)
STEP 3: Anatomy of eye (45 minutes)

 The eye is the organ of the sense of sight situated in the orbital cavity and it is supplied by the optic
nerve (2nd cranial nerve).
 It is almost spherical in shape and is about 2.5 cm in diameter. The space between the eye and the
orbital cavity is occupied by adipose tissue.
 The bony walls of the orbit and the fat help to protect the eye from injury
 Structurally the two eyes are separate but, unlike the ear, some of their activities are coordinated so
that they function as a pair. It is possible to see with only one eye but three-dimensional vision is
impaired when only one eye is used, especially in relation to the judgement of distance.
Structure of the eye

 There are three layers of tissue in the walls of the eye. They are:
o The outer fibrous layer: sclera and cornea
o The middle vascular layer or uveal tract: choroid, ciliary body and iris
o The inner nervous tissue layer: retina.
 Structures inside the eyeball are the lens, aqueous fluid (humour) and vitreous body (humour).
Sclera and cornea

 The sclera, or white of the eye, forms the outermost layer of tissue of the posterior and lateral
aspects of the eyeball and is continuous anteriorly with the transparent cornea.
 It consists of a firm fibrous membrane that maintains the shape of the eye and gives attachment to
the extraocular or extrinsic muscles of the eye.
 Anteriorly the sclera continues as a clear transparent epithelial membrane, the cornea. Light rays
pass through the cornea to reach the retina. The cornea is convex anteriorly and is involved in
refracting or bending light rays to focus them on the retina.
Choroid
 The choroid lines the posterior five-sixths of the inner surface of the sclera. It is very rich in blood
vessels and is deep chocolate brown in colour.
 Light enters the eye through the pupil, stimulates the nerve endings in the retina and is then
absorbed by the choroid.
Ciliary body
 The ciliary body is the anterior continuation of the choroid consisting of ciliary muscle (smooth
muscle fibres) and secretory epithelial cells.
 It gives attachment to the suspensory ligament which, at its other end, is attached to the capsule
enclosing the lens.
 Contraction and relaxation of the ciliary muscle changes the thickness of the lens which bends, or
refracts light rays entering the eye to focus them on the retina.
 The epithelial cells secrete aqueous fluid into the anterior segment of the eye, i.e. the space
between the lens and the cornea (anterior and posterior chambers).
 The ciliary body is supplied by parasympathetic branches of the oculomotor nerve (3rd cranial
nerve). Stimulation causes contraction of the smooth muscle and accommodation of the eye.
Iris
 The iris is the visible coloured part of the eye and extends anteriorly from the ciliary body, lying
behind the cornea in front of the lens.
 It divides the anterior segment of the eye into anterior and posterior chambers which contain
aqueous fluid secreted by the ciliary body. It is a circular body composed of pigment cells and two
layers of smooth muscle fibres, one circular and the other radiating.
 In the centre there is an aperture called the pupil. The iris is supplied by parasympathetic and
sympathetic nerves.
 Parasympathetic stimulation constricts the pupil and sympathetic stimulation dilates it. The colour of
the iris is genetically determined and depends on the number of pigment cells present.
 Albinos have no pigment cells and people with blue eyes have fewer than those with brown eyes.
Lens
 The lens is a highly elastic circular biconvex body, lying immediately behind the pupil. It consists of
fibres enclosed within a capsule and it is suspended from the ciliary body by the suspensory
ligament. Its thickness is controlled by the ciliary muscle through the suspensory ligament.
 The lens bends (refracts) light rays reflected by objects in front of the eye. It is the only structure in
the eye that can vary its refractory power, achieved by changing its thickness.
 When the ciliary muscle contracts, it moves forward, releasing its pull on the lens, increasing its
thickness. The nearer is the object being viewed the thicker the lens becomes to allow focusing.
Retina
 The retina is the innermost layer of the wall of the eye. It is an extremely delicate structure and is
especially adapted for stimulation by light rays.
 It is composed of several layers of nerve cell bodies and their axons, lying on a pigmented layer of
epithelial cells which attach it to the choroid.
 The layer highly sensitive to light is the layer of sensory receptor cells: rods and cones. The retina
lines about three-quarters of the eyeball and is thickest at the back and thins out anteriorly to end
just behind the ciliary body.
 Near the centre of the posterior part is the macula lutea, or yellow spot .In the centre of the area
there is a little depression called the fovea centralis, consisting of only cone-shaped cells. Towards
the anterior part of the retina there are fewer cone- than rod-shaped cells
 The rods and cones contain photosensitive pigments that convert light rays into nerve impulses
About 0.5 cm to the nasal side of the macula lutea all the nerve fibres of the retina converge to form
the optic19
STEP 4: Physiology of the eye (40 minutes)

 Light waves travel at a speed of 186 000 miles (300 000 kilometres) per second. Light is reflected
into the eyes by objects within the field of vision. White light is a combination of all the colours of
the visual spectrum (rainbow), i.e. red, orange, yellow, green, blue, indigo and violet.
 This is demonstrated by passing white light through a glass prism which refracts or bends the rays
of the different colours to a greater or lesser extent, depending on their wavelengths.
 Red light has the longest wavelength and violet the shortest. This range of colour is the spectrum of
visible light. In a rainbow, white light from the sun is broken up by raindrops which act as prisms
and reflectors.
The electromagnetic spectrum

 The electromagnetic spectrum is broad but only a small part is visible to the human eye.
 Beyond the long end there are infrared waves (heat), microwaves and radio waves. Beyond the
short end there are ultraviolet (UV), X-rays and gamma rays. UV light is not normally visible
because it is absorbed by a yellow pigment in the lens.
 Following removal of the lens (cataract extraction), UV light is visible and it has been suggested
that longterm exposure may damage the retina. A specific colour is perceived when only one
wavelength is reflected by the object and all the others are absorbed, e.g. an object appears red
when only the red wavelength is reflected.
 Objects appear white when all wavelengths are reflected, and black when they are all absorbed. In
order to achieve clear vision, light reflected from objects within the visual field is focused on to the
retina of each eye.
 The processes involved in producing a clear image are refraction of the light rays, changing the
size of the pupils and accommodation of the eyes.
Refraction of the light rays
 When light rays pass from a medium of one density to a medium of a different density they are
refracted or bent; for example in the eye the biconvex lens bends and focuses light rays.
 This principle is used to focus light on the retina. Before reaching the retina light rays pass
successively through the conjunctiva, cornea, aqueous fluid, lens and vitreous body.
 They are all more dense than air and, with the exception of the lens, they have a constant
refractory power, similar to that of water. Abnormal refraction within the eye is corrected using
biconvex or biconcave lenses,
Figure: Refraction of light rays passing through a biconvex lens
 Lens The lens is a biconvex elastic transparent body suspended behind the iris from the ciliary
body by the suspensory ligament. It is the only structure in the eye that changes its refractive
power. Light rays entering the eye need to be bent (refracted) to focus them on the retina. Light
from distant objects needs least refraction and, as the object comes closer, the amount of refraction
needed is increased.
 To increase the refractive power the ciliary muscle contracts, releasing its pull on the suspensory
ligament and the anterior surface of the lens bulges forward, increasing its convexity. This focuses
light rays from near objects on the retina.
 When the ciliary muscle relaxes it slips backwards, increasing its pull on the suspensory ligament,
making the lens thinner. This focuses light rays from distant objects on the retina.
Figure: Section of the eye showing the focusing of light rays on the retina
Size of the pupils

 Pupil size influences accommodation by controlling the amount of light entering the eye. In a bright
light the pupils are constricted.
 In a dim light they are dilated. If the pupils were dilated in a bright light, too much light would enter
the eye and damage the sensitive retina. In a dim light, if the pupils were constricted, insufficient
light would enter the eye to activate the photosensitive pigments in the rods and cones which
stimulate the nerve endings in the retina.
 The iris consists of one layer of circular and one of radiating smooth muscle fibres. Contraction of
the circular fibres constricts the pupil, and contraction of the radiating fibres dilates it.
 The size of the pupil is controlled by the autonomic nervous system. Sympathetic stimulation dilates
the pupils and parasympathetic stimulation causes constriction.
References
Session: 17 Anatomical and Physiological Functions of the Ear
Prerequisites
 None

 List organs that forming ear
 Describe the anatomy of he ear
 Describe the physiology of ear
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Tasks
2 20 minutes Presentation Organs that forming ear
3 45 minutes Presentation Anatomy of the ear
4 40 minutes Presentation Physiology of of th ear
SESSION CONTENTS

STEP 2: Organs that forming the ear ( 20 minutes)

STEP 3: Anatomy of ear (45 minutes)
 The ear is the organ of hearing. It is supplied by the 8th cranial nerve, i.e. the cochlear part of the
vestibulocochlear nerve which is stimulated by vibrations caused by sound waves.
 With the exception of the auricle (pinna), the structures that form the ear are encased within the
petrous portion of the temporal bone.
Structure
 The ear is divided into three distinct parts
o Outer ear
o Middle ear (tympanic cavity)
o Inner ear.
Outer ear
 The outer ear consists of the auricle (pinna) and the external acoustic meatus.
 The auricle (pinna) The auricle is the expanded portion projecting from the side of the head. It is
composed of fibroelastic cartilage covered with skin.
 It is deeply grooved and ridged and the most prominent outer ridge is the helix.
 The lobule (earlobe) is the soft pliable part at the lower extremity, composed of fibrous and adipose
tissue richly supplied with blood.
 External acoustic meatus (auditory canal) This is a slightly 'S'-shaped tube about 2.5 cm long
extending from the auricle to the tympanic membrane (eardrum).
 The lateral third is cartilaginous and the remainder is a canal in the temporal bone. The meatus is
lined with skin containing hairs continuous with that of the auricle.
 There are numerous sebaceous and ceruminous glands in the skin of the lateral third. Ceruminous
glands are modified sweat glands that secrete cerumen (wax), a sticky material containing
lysozyme and immunoglobulins.
 Foreign materials, e.g. dust, insects and microbes, are prevented from reaching the tympanic
membrane by wax, hairs and the curvature of the meatus.
 Movements of the temporomandibular joint during chewing and speaking 'massage' the
cartilaginous meatus, moving the wax towards the exterior.
 The tympanic membrane (eardrum) completely separates the external acoustic meatus from the
middle ear. It is oval-shaped with the slightly broader edge upwards and is formed by three types of
tissue: the outer covering of hairless skin, the middle layer of fibrous tissue and the inner lining of
mucous membrane continuous with that of the middle ear.
Middle ear (tympanic cavity)

 This is an irregular-shaped air-filled cavity within the petrous portion of the temporal bone. The
cavity, its contents and the air sacs which open out of it are lined with either simple squamous or
cuboidal epithelium.
 The lateral wall of the middle ear is formed by the tympanic membrane. The roof and floor are
formed by the temporal bone.
 The posterior wall is formed by the temporal bone with openings leading to the mastoid antrum
through which air passes to the air cells within the mastoid process.
 The medial wall is a thin layer of temporal bone in which there are two openings:
o oval window
o round window
 The oval window is occluded by part of a small bone called the stapes and the round window, by a
fine sheet of fibrous tissue.
 Air reaches the cavity through the pharyngotympanic (auditory or Eustachian) tube which extends
from the nasopharynx. It is about 4 cm long and is lined with ciliated epithelium.
 The presence of air at atmospheric pressure on both sides of the tympanic membrane is
maintained by the pharyngotympanic tube and enables the membrane to vibrate when sound
waves strike it. The pharyngotympanic tube is normally closed but when there is unequal pressure
across the tympanic membrane, e.g. at high altitude, it is opened by swallowing or yawning and the
ears 'pop', equalising the pressure again.
Auditory ossicles
 These are three very small bones that extend across the middle ear from the tympanic membrane
to the oval window. They form a series of movable joints with each other and with the medial wall of
the cavity at the oval window. They are named according to their shapes.
 The malleus. This is the lateral hammer-shaped bone. The handle is in contact with the tympanic
membrane and the head forms a movable joint with the incus.
 The incus. This is the middle anvil-shaped bone. Its body articulates with the malleus, the long
process with the stapes, and it is stabilised by the short process, fixed by fibrous tissue to the
posterior wall of the tympanic cavity
 The stapes. This is the medial stirrup-shaped bone. Its head articulates with the incus and its
footplate fits into the oval window.
 The three ossicles are held in position by fine ligaments.
Inner ear
 The inner (internal) ear or labyrinth (meaning 'maze') ear contains the organs of hearing and
balance. It is generally described in two parts, the bony labyrinth and the membranous labyrinth.
 Bony labyrinth This is a cavity within the temporal bone lined with periosteum. It is larger than, and
encloses, the membranous labyrinth of the same shape which fits into it, like a tube within a tube.
Between the bony and membranous labyrinth there is a layer of watery fluid called perilymph and
within the membranous labyrinth there is a similarly watery fluid, endolymph.
 The bony labyrinth consists of:
o 1 vestibule
o 1 cochlea
o 3 semicircular canals.
The vestibule
This is the expanded part nearest the middle ear. It contains the oval and round windows in its lateral
wall.
The cochlea
This resembles a snail's shell. It has a broad base where it is continuous with the vestibule and a
narrow apex, and it spirals round a central bony column.
The semicircular canals

These are three tubes arranged so that one is situated in each of the three planes of space. They are
continuous with the vestibule.
 Membranous labyrinth contains endolymph and lies within its bony counterpart.
 It comprises:
o The vestibule, which contains the utricle and saccule
o The cochlea
o Three semicircular canals.
The cochlea
 A cross-section of the cochlea contains three compartments:
o The scala vestibuli
o The scala media, or cochlear duct
o The scala tympani.
STEP 4: Physiology of ear (40 minutes)

Physiology of hearing
 Every sound produces sound waves or vibrations in the air, which travel at about 332 metres (1088
feet) per second.
 The auricle, because of its shape, concentrates the waves and directs them along the auditory
meatus causing the tympanic membrane to vibrate.
 Tympanic membrane vibrations are transmitted and amplified through the middle ear by movement
of the ossicles.
 At their medial end the footplate of the stapes rocks to and fro in the oval window, setting up fluid
waves in the perilymph of the scala vestibuli.
 Some of the force of these waves is transmitted along the length of the scala vestibuli and scala
tympani, but most of the pressure is transmitted into the cochlear duct.
 This causes a corresponding wave motion in the endolymph, resulting in vibration of the basilar
membrane and stimulation of the auditory receptors in the hair cells of the spiral organ.
 The nerve impulses generated pass to the brain in the cochlear (auditory) portion of the
vestibulocochlear nerve (8th cranial nerve).
 The fluid wave is finally expended into the middle ear by vibration of the membrane of the round
window.
 The vestibulocochlear nerve transmits the impulses to the hearing area in the cerebrum where
sound is perceived and to various nuclei in the pons and the midbrain.
 Sound waves have properties of pitch and volume, or intensity.
 Pitch is determined by the frequency of the sound waves and is measured in hertz (Hz).
 The volume depends on the amplitude of the sound waves and is measured in decibels (dB).
 Very loud noise is damaging to the ear, particularly when prolonged because it damages the
sensitive hair cells of the spiral organ.
 Because of the structure of the inner ear, sounds of different frequencies stimulate the basilar
membrane at different places along its length allowing discrimination of pitch.
 Additionally, the greater the amplitude of the wave created in the endolymph, the greater the
stimulation of the auditory receptors in the hair cells in the spiral organ, enabling perception of
volume
In the walls of the utricle, saccule and ampullae there are fine specialised epithelial cells with minute
projections, called hair cells. Amongst the hair cells there are sensory nerve endings which combine
forming the vestibular part of the vestibulocochlear nerve.
Physiology of balance
 The semicircular canals have no auditory function although they are closely associated with the
cochlea.
 They provide information about the position of the head in space, contributing to maintenance of
posture and balance.
 There are three semicircular canals, one lying in each of the three planes of space. They are
situated above and behind the vestibule of the inner ear and open into it.
 The semicircular canals, like the cochlea, are composed of an outer bony wall and inner
membranous tubes or ducts.
 The membranous ducts contain endolymph and are separated from the bony wall by perilymph.
The utricle is a membranous sac which is part of the vestibule and the three membranous ducts
open into it at their dilated ends, the ampullae.
 The saccule is a part of the vestibule and communicates with the utricle and the cochlea.
 The semicircular canals and the vestibule (utricle and saccule) are concerned with balance.
 Any change of position of the head causes movement in the perilymph and endolymph, which
bends the hair cells and stimulates the sensory nerve endings in the utricle, saccule and ampullae.
The resultant nerve impulses are transmitted by the vestibular nerve which joins the cochlear nerve
to form the vestibulocochlear nerve.
 The vestibular branch passes first to the vestibular nucleus, then to the cerebellum. The cerebellum
also receives nerve impulses from the eyes and proprioceptors (sensory receptors) in the skeletal
muscles and joints.
 Impulses from these three sources are coordinated and efferent nerve impulses pass to the
cerebrum and to skeletal muscles.
 This results in awareness of body position, maintenance of upright posture and fixing of the eyes
on the same point, independently of head movements.
References
Session: 18 Anatomical and Physiological Functions of a Nose and Tongue
Prerequisites
 None

 List organs that forming nose and tongue
 Describe the anatomy of nose
 Describe the anatomy of the tongue
 Describe the physiology of nose
 Describe the functions of the tongue
Resources Needed:
 Projectors
 Computer
Session Overview
1. Presentation of Session Title and Learning
05 minutes Presentation
Tasks
2. 20 minutes Organs that forming nose and tongue
Presentation
3. 25 minutes Anatomy of nose

Presentation
4. 20 munutes Anatomy of the tongue

Presentation
5. 40 minutes Presentation Physiology of nose
6. 20 minutes presentation Functions of the tongue
7. 05 minutes
Presentation Key Points
8. 05 minutes
Presentation Evaluation
SESSION CONTENTS

 READ or ASK learners to read the learning Tasks and clarify
 ASK learners if they have questions before continuing.
STEP 2: Organs that forming nose ( 20 minutes)
STEP 3: Anatomy of nose (25 minutes)

Position and structure
 The nasal cavity is the main route of air entry, and consists of a large irregular cavity divided into
two equal passages by a septum.
 The posterior bony part of the septum is formed by the perpendicular plate of the ethmoid bone and
the vomer. Anteriorly, it consists of hyaline cartilage
STEP 4: Anatomy of tongue (20 minutes)
 The tongue is a voluntary muscular structure that occupies the floor of the mouth.
 It is attached by its base to the hyoid bone and by a fold of its mucous membrane covering, called
the frenulum, to the floor of the mouth.
 The superior surface consists of stratified squamous epithelium, with numerous papillae (little
projections).
 Many of these contain sensory receptors (specialised nerve endings) for the sense of taste in the
taste buds.
 There are several types of papilla; however no clear relationship between these and discrimination
of different tastes has been found.
Blood supply
 The main arterial blood supply to the tongue is by the lingual branch of the external carotid artery.
Venous drainage is by the lingual vein, which joins the internal jugular vein.
Nerve supply
 The nerves involved are:
o the hypoglossal nerves (12th cranial nerves), which supply the voluntary muscle
o the lingual branch of the mandibular nerves , which arise from the 5th cranial nerves, are the
nerves of somatic (ordinary) sensation, i.e. pain, temperature and touch
o the facial and glossopharyngeal nerves (7th and 9th cranial nerves), the nerves of taste.
Functions of the tongue

 The tongue plays an important part in:
o chewing (mastication)
o swallowing (deglutition)
o speech
o taste
STEP 5: Physiology of nose (20 minutes)

 The sense of smell in human beings is generally less acute than in other animals. Many animals
are known to secrete odorous chemicals called pheromones that play an important part in chemical
communication in, for example, territorial behaviour, mating and the bonding of mothers and their
newborn offspring.
 The role of pheromones in human communication is unknown. All odorous materials give off
volatile molecules, which are carried into the nose with the inhaled air and stimulate the olfactory
chemoreceptors when dissolved in mucus.
 The air entering the nose is warmed and convection currents carry eddies of inspired air to the roof
of the nasal cavity. 'Sniffing' concentrates volatile molecules in the roof of the nose.
 This increases the number of olfactory receptors stimulated and thus the perception of the smell.
The sense of smell may affect the appetite.
 If the odours are pleasant the appetite may improve and vice versa. When accompanied by the
sight of food, an appetising smell increases salivation and stimulates the digestive system
 The sense of smell may create long-lasting memories, especially to distinctive odours, e.g. hospital
smells, favourite or least-liked foods.
 Inflammation of the nasal mucosa prevents odorous substances from reaching the olfactory area of
the nose, causing loss of the sense of smell (anosmia).
 The usual cause is the common cold. Adaptation. When an individual is continuously exposed to an
odour, perception of the odour decreases and ceases within a few minutes.
 This loss of perception only affects that specific odour and adaptation probably occurs both in the
cerebrum and in the sensory receptors in the nasal cavity.
STEP 6: Functions of the tongue (20 minutes)

 Taste buds contain sensory receptors (chemoreceptors) that are found in the papillae of the tongue
and widely distributed in the epithelia of the tongue, soft palate, pharynx and epiglottis.
 They consist of small sensory nerve endings of the glossopharyngeal, facial and vagus nerves
(cranial nerves VII, IX and X).
 Some of the cells have hair-like microvilli on their free border, projecting towards tiny pores in the
epithelium.
 The sensory receptors are stimulated by chemicals that enter the pores dissolved in saliva. Nerve
impulses are generated and conducted along the glossopharyngeal, facial and vagus nerves before
synapsing in the medulla and thalamus.
 Their final destination is the taste area in the parietal lobe of the cerebral cortex where taste is
perceived
Physiology of taste
 Four fundamental sensations of taste have been described — sweet, sour, bitter and salt.
 This is probably an oversimplification because perception varies widely and many 'tastes' cannot be
easily classified.
 However, some tastes consistently stimulate taste buds in specific parts of the tongue
o Sweet and salty, mainly at the tip
o Sour, at the sides
o Bitter, at the back.
 The sense of taste triggers salivation and the secretion of gastric juice. It also has a protective
function, e.g. when foul-tasting food is eaten then reflex gagging or vomiting may be induced.
 The sense of taste is impaired when the mouth is dry because substances can be 'tasted' only if
they are in solution.
References
Session: 19 Anatomical and Physiological Functions of Skin
Prerequisites
 None
 List organs that forming skin
 Describe the anatomy of the skin
 Describe the physiology of the skin
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Tasks
2 20 minutes Presentation Organs that forming skin
3 45 minutes Presentation Anatomy of the skin
4 40 minutes Presentation Physiology of the skin
SESSION CONTENTS

STEP 2: Organs that forming skin ( 20 minutes)

STEP 3: Anatomy of the skin (45 minutes)
The skin is the largest organ of the body, with a total area of about 20 square feet. The skin protects us
from microbes and the elements, helps regulate body temperature, and permits the sensations of
touch, heat, and cold.
Skin has three layers:
 The epidermis, the outermost layer of skin, provides a waterproof barrier and creates our skin tone.
 The most abundant cells in the epidermis are the keratinocytes, which are arranged in layers. The
keratinocytes in the upper part of the epidermis contain a protein called keratin.
 Keratin makes the epidermis strong and waterproof.
 Cells called melanocytes, which produce a protective pigment named melanin, are also present in
the epidermis.
 Merkel cells, which detect light touches to the skin, and Langerhans cells, which are part of the
immune system, are located in the epidermis.
The dermis
 The dermis, beneath the epidermis, contains tough connective tissue, hair follicles, and sweat
glands. The dermis contains collagen and elastin fibers, hair follicles, sebaceous glands, the coiled sections
of the sweat glands, blood and lymph vessels, nerves, sensory receptors, and cells from the immune
system. The sebaceous glands produce an oily substance called sebum. Most sebaceous glands are
connected to a hair follicle.
 Attached to each hair follicle is an arrector pili muscle which causes the hair to become erect when
the skin is cold or when we experience strong emotions. The erect hairs produce a "goose bumps"
or "goose flesh" appearance on the surface of the skin.
Hypodermis
 The hypodermis — also called subcutaneous fat is the deepest layer of skin. This layer is made up
mostly of fatty tissue, which helps to insulate the body from heat and cold.
 The hypodermis also serves as an energy storage area for fat.
 This fat provides padding to cushion internal organs as well as muscle and bones, and protects the
body from injuries
STEP 4: Physiology of the skin (40 minutes)
The skin has very important vital functions for keeping the physiological and biochemical conditions of
the body in its optimum state.
 The most important functions of the skin are:
o Regulates body temperature.
o Prevents loss of essential body fluids, and penetration of toxic substances.
o Protection of the body from harmful effects of the sun and radiation.
o Excretes toxic substances with sweat.
o Mechanical support.
o Immunological function mediated by Langerhans cells.
o Sensory organ for touch, heat, cold,.
o Vitamin D synthesis from its precursors under the effect of sunlight and introversion of steroids

 Skin is the body’s largest organ contributing to one sixth of the total body weight
 The skin has three layers, the epidermis the dermis, and the subcutaneous layer (hypodermis)
 The skin protects us from microbes and the elements, helps regulate body temperature, and
permits the sensations of touch, heat, and cold.

 What are the organs that forming skin?
 What is the physiology of the skin?
References
Session: 20 Human Body Enzymes, Co- Enzymes and Functions
Total Session Time: 1 Hour
Prerequisites
 None

 Define the terms enzyme and coenzyme
 Describe functions of enzyme
 Describe the functions of coenzyme
Resources Needed:
 Projectors
 Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
Tasks
10 minutes Presentation Definition of the terms Enzyme and Co- enzyme
2
Buzzing
3 20 minutes Presentation Functions of Enzyme
4 15 minutes Presentation Functions of Co- Enzyme
SESSION CONTENTS

STEP 2: Definition of theTerms Enzymes and Co- enzyme ( 10 minutes)

 Enzymes are proteins that act as catalysts for biochemical reactions – that is, they speed the
reaction up but are not themselves changed by it, and therefore can be used over and over again.
STEP 3: Functions of Enzyme (20 minutes)
 Digestion: Enzymes are the key molecules which process the digestion in the body. Amylase
breaks down carbohydrates; proteases break down protein and lipases break down lipids. Due to
this breakdown, they are easily absorbed into the bloodstream.
 Metabolism: Metabolism is the important process to remove toxic waste from our body. When we
consume so many foods and beverage items, they are broken down and excreted in urine or
another route.
 This breakdown is done by many enzymes in the liver. The liver is the major organ where most of
the function occurs due to many enzymes. It is only organ with the highest number of enzymes and
its dysfunction can be easily diagnosed by blood enzyme tests. Enzymes play a key role in
metabolism.
 Blood pressure control: The pressure of blood in the vessels is to some extent controlled by
hormone angiotensin from the renin-angiotensin system. This is converted from angiotensin-1 to
angiotensin-11 by an enzyme angiotensin converting enzyme. Inhibition of this enzyme helps
decrease the blood pressure in high blood pressure patients.
 Excretion in the kidney: Excretion through kidney is done by nephron. Nephron filters the blood and
also the loop of it secretes few substances. Some enzymes are present on the nephron which
prevent excretion of useful substances like aminoacids, polysaccharides, by breaking them and
help in reabsorption. Ex: y-Glutamyl transpeptidase, leucine aminopeptidase, cysteine
aminopeptidase, etc.
 Also, carbonic anhydrase is the major enzyme which helps in excretion of acid and reabsorption of
bicarbonate.
 There is also sodium-potassium ATPase enzyme which helps to regulate sodium and potassium
levels in the body.
 Blood clotting: Clotting is a protective feature to prevent loss of blood in case of injury. This is a part
of blood hemostasis. Thrombin is the enzyme which activates clotting factors and enables
coagulation. It specifically converts fibrinogen to fibrin thereby forming insoluble clot strands.
 Nervous system control: Nervous system regulates the whole body and physiology.
Neurotransmitters are the substances which help in the process. These neurotransmitters once
released would help in nerve conduction and other functions. Their action is terminated once they
are broken down by enzymes. For example, neurotransmitter acetylcholine acts on nicotinic
receptors and is broken down by acetylcholine esterase enzyme. If it is not broken there would be
persistent effects like seen in pesticide poisoning.
 Repair and wound healing: Proteolytic enzymes are also involved in wound healing process. They
help to breakdown the necrotic debris of tissue and enhance new cell formation leading to wound
healing.
 Reproduction: Sperm is a part of the male reproductive system. The male gamete unites with the
ova in the uterus. This sperm when released travels through the uterine tissue and reaches the
ova.
 An enzyme namely hyaluronidase is released from the sperm tip (acronym) and this helps in
tearing and penetration of sperm through the tissue to reach the ova. Without this enzyme, it would
not be possible for the sperm to reach ova and fertilize. Sperm lives in the female reproductive tract
for a span of 48 hours once released from man.
 Respiration: Enzymes are also helpful in the physiology of respiration. There is an enzyme namely
carbonic anhydrase in the red blood cells. This enzyme helps to convert carbon-dioxide to carbonic
acid and bicarbonate ions.
 Secretion: Enzymes are also responsible for few secretions in the body. For example, an enzyme
called Proton potassium ATPase enzyme is involved in the secretion of gastric acid (HCl) in the
stomach which aids in digestion. In case of acidity, physicians prescribe drugs which can arrest this
enzyme and thereby inhibit acid secretion leading to decrease in acidity.
STEP 4: Functions of Co- Enzyme (15 minutes)

 Some enzymes need assistance so that the catalytic process goes smoothly.
 Molecules, which can provide this assistance, are either cofactors or coenzymes.
Function of coenzymes
 Coenzymes are organic carrier molecules.
 They are non-protein components of an enzyme that are required for the catalytic process to occur
smoothly.
 They bind to the active sites of enzymes when the substrate molecules bind, and although they are
not substrate molecules they participate in the catalysis process.
 They can be carriers or electrons or groups of atoms,which enables the catalytic reaction to occur.
 Some examples include:
o NADH which is an electron carrying coenzyme
o CoA (coenzyme A) is an acyl group (COR) carrying coenzyme
 Coenzymes act as group transfer reagents.

 Most coenzymes are linked to enzymes by noncovalent forces.
 Coenzymes may be separated from the enzyme by dialysis.
 Essential ions are inorganic cofactors which is again classified as- activator ions (loosely bound)
and metalloenzymes (tightly bound).
 An enzyme without cofactor is called apoenzyme and the enzyme-cofactor complex is called
holoenzyme. Apoenzyme is enzymatically inactive protein.
Coenzyme classification:
 There are two types of coenzymes-
o Metabolite Coenzyme
o Vitamin derived Coenzyme
Metabolite coenzymes e.g. adenosine triphosphate (ATP)

 These are generally derived from common metabolites usually from nucleotides.
Vitamin derived coenzyme e.g. NAD+and NADP+
 These are synthesized by microorganisms and plants, generally obtained from nutrients.
 Most vitamins must be enzymatically transformed to the coenzyme.
 Some vitamins directly act as coenzymes but some vitamins help the body to produce coenzymes

 Enzyme – Usually a protein, acting as catalyst in specific biochemical reaction
 Conenzymes - Compound derived from a vitamin (e.g. NAD+) that assists an enzyme in facilitating
a chemical reaction

 What is enzyme
 What is coenzyme
 What are the functions of enzyme
 What are the functions of coenzyme
References
Waugh A., Grant A. (2010) Ross and Wilson Anatomy and Physiology in Health and Illness -11th ed, UK.
Elsevier
SESSION XX: FUNCTION OF MACROMOLECULES IN RELATION TO
HUMAN BODY
Total Session Time: 120 minutes
Prerequisite: None
Learning Tasks
At the end of this session a learner is expected to be able to:
Definition of carbohydrate, Protein, Lipids and Nucleic acids (RNAs &DNAs)
Explain the functions of Carbohydrates
Explain the functions of Proteins
Explain the functions of Lipids
Explain theNeeded
Resources functions of Nucleic acids (RNAs & DNAs)
 LCD Projector and computer
 Note Book and Pen
Session Overview
Step Time (min) Activity/ Content
Method
1 05 lecture Presentation of Session Title and
Student Learning Tasks
2 40 Lecture/Discussion Definition of carbohydrate, Protein, Lipids and Nucleic
acids (RNAs &DNAs)
3 10 Lecture/Discussion Explain the functions of Carbohydrates
4 10 Lecture/Discussion Explain the functions of Proteins
5 15 Lecture/Discussion Explain the functions of lipids
6 30 Lecture/Discussion Explain the functions of Nucleic acids (RNAs & DNAs)
7 5 Presentation Key Points

8 5 Presentation Session Evaluation
SESSION CONTENTS
 READ or ASK participants to read the learning tasks
 ASK participants if they have any questions before continuing
STEP 2: Definition of carbohydrate, Protein, Lipids and Nucleic acids (RNAs &DNAs)
(40 Minutes)
Activity:
ACTIVITY: Brain storming (10 minutes)

ASK students to brainstorm on Definition of carbohydrate, Protein, Lipids and Nucleic acids (RNAs
&DNAs)
ALLOW few students to respond and let others provide unmentioned responses
WRITE the responses on the flip chart or board
CLARIFY and summarize using the content below
Carbohydrates are a type of macronutrient that provides energy in cells. The basic unit of
carbohydrates is a monosaccharide. Example glucose or sugar.
Proteins are a type of macronutrients that are body building blocks, they make up the cell structure.
Proteins are made from smaller monomers called amino acids
Lipids are macronutrients made up long chains of carbon and hydrogens, they store up a lot of energy
in the the chemical bond.
Nucleic acids chemical compounds and the main information-carrying molecules of the cell and, by
directing the process of protein synthesis, they determine the inherited characteristics of every living
thing.
Nucleic acids are of two types:
Deoxyribonucleic acid (DNA) these the centre of life, constitutes the genetic material in all free-living
organisms and most viruses
Ribonucleic acid (RNA) these are genetic material of certain viruses, but it is also found in all living
cells, where it plays an important role in certain processes such as the making of proteins.
STEP 3: Explain the functions of Carbohydrates (10 Minutes)
Activity:
ACTIVITY: Buzz (10 minutes)

ASK students to buzz on functions of carbohydrate
Functions of carbohydrates
 For energy and provide body’s main source of energy (4 calories per gram)
 Form the major part of stored food in the body for later use of energy and exist in three form:
sugar, starch and fiber.
 Provides the brain with glucose for brain functioning.
 Carbohydrates are also important for fat oxidation and can also be converted into protein
STEP 4: explain the functions of Proteins 10 Minutes)

Protein provide amino acids and make up most of the cell structure including the cell membrane.
Provides energy for body functions in cases of extreme starvation
They form the muscle of the body
STEP 5 explain the functions of Lipids (15 Minutes)
 Fats are used in making steroids and hormones and serve as solvents for hormones.
 Enhances metabolism of fat soluble vitamins.
 Fats have the highest caloric content and provide the largest amount of energy when burnt. -
When measured by a calorimeter, fats provide about 9 calories per gram of fat, making them
twice as energy-rich than protein and carbohydrates.
 Extra fat is stored in adipose tissue and is burnt when the body has run out of carbohydrates
 Fats are important in our body to cushion organs, protect our cells
STEP 6: Explain the functions of nucleic acids (DNA & RNSs) (20 Minutes)
Activity:
ACTIVITY: Group discussion (10 minutes)

ASK students to groups of 6-8 people and discuss the functions of nucleic acids
Functions of Nucleic acids (DNAs & RNAs)

 Nucleic acids directs the process of protein synthesis
 Determine the inherited characteristics of every living thing.
Deoxyribonucleic acid (DNA)
 Preserve the base sequence of genetic information during the life time of a cell.
 Is important for cell replication and heredity
 Directing physiological activities of the cell such as RNA transcription
 Important in genetic engineering
 Enables mutation and evolution of genes when required
Ribonucleic acid (RNA)

 Forms the ribosomes of the cells
 Functions as adaptors for amino acids in the course of protein synthesis
 Restores nerve to nerve signal hence contributes in healing of some debilitating diseases
 Are used for transfer and expression of the genetic information
 Enables the sequencing of amino acids in each different protein in the cell
 The macronutrients found in food are Carbohydrates, proteins and lipids

 Carbohydrate and fats are energy giving macronutrients and protein are body building blocks of
body cells
 Nucleic acids are chemical compounds and the main information-carrying molecules of the cell
and, by directing the process of protein synthesis, they determine the inherited characteristics
of every living thing.
STEP 8: Session Evaluation (05 minutes)

Assignment
Name the functions of macronutrients in the body

Mention the food in which these macronutrients are found
How many kilocalories can be provided by carbohydrates, protein and lipids
What is the difference between food and nutrients
References
Bryce C.F.A et al. (1991). The structure and functions of Nucleic acids(Revised ed.).
Portsmouth. UK
Richard J. Robert. (2018). Nucleic acid chemical compound, encyclopedia Britannica.Inc
Can be found in https://www.britannica.com/science/nucleicacid accessed 15.12.2018
www.fao.org/docrep/017/i3261e/i3261e05.pdf
www.foodpyramid.com/6-essential-nutrients

Human Anatomy Sessions

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Human Anatomy Sessions

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THE UNITED REPUBLIC OF TANZANIA

MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERS AND CHILDREN

BASIC TECHNICIAN CERTIFICATE

NMT 04103 HUMAN ANATOMY AND PHYSIOLOGY

ii Facilitator Guide | NMT 04103 Human Anatomy and Physiology

iv Facilitator Guide | NMT 04103 Human Anatomy and Physiology

v Facilitator Guide | NMT 04103 Human Anatomy and Physiology

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Overall Goal for training manual

Objectives for training manual

x Facilitator Guide | NMT 04103 Human Anatomy and Physiology

The module sub-enabling outcomes are as follows:

Who is the Module For?

How is the Module Organized?

How Should the Module be used?

xii Facilitator Guide | NMT 04103 Human Anatomy and Physiology

Total Session Time: 120 minutes.

40 minutes Human cell

5 05 minutes Presentation Key Points

6 05 minutes Presentation Evaluation

13 Facilitator Guide | NMT 04103 Human Anatomy and Physiology

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

 Physiology - Is the study of functions of the body systems

STEP 3: Orgsanisation of the Body (45 Minutes)

Level 5 - Organ Systems

STEP 4: Human Cells (40 minutes)

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Structure of the human cell

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 Organelles of the cell

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STEP 6: Evaluation (5 minutes)

Session 2: Human Body Tissues, Structures and Functions

Total Session Time: 2 hours

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20 minutes Interactions between human body structure and

7 05 minutes Presentation Key Points

8 05 minutes Presentation Evaluation

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

ASK Learners if they have any questions before continuing.

STEP 2: Human Body Tissues (65 Minutes)

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DIVIDE students into 4 groups (depending on the size of the class).

ASSIGN each group parts, structure.

ALLOW groups 10 minutes for this exercise.

APPRAISE the students

PROVIDE feedback by summarizing the students’ answers

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STEP 3: Functions of Human Body Parts (20 minutes)

STEP 4: Interactions between Human Body Structure and Functions (20minutes)

STEP 5: Key Points (5 minutes)

STEP 6: Evaluation (5 minutes)

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Total Session Time: 2hours

6 05 minutes Presentation Evaluation

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

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STEP 2: Definition of Body Systems (10 minutes)

Activity: Brainstorming (5 minutes)

 What is a body system?

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below