V E L E Z C O L L E G E
DEPARTMENT of OCCUPATIONAL THERAPY
Contents
1-2 Intro to Physiology
3-4 Membrane Physiology
5-7 Muscle Physiology
Cardiac Physiology
Circulation
Blood Physiology
Pulmonary Physiology
INTRODUCTION TO PHYSIOLOGY
Physiology – science that seeks to explain the physical
and chemical mechanisms that are responsible for the
origin, development, and progression in life
Human Physiology – attempts to explain the specific
characteristics and mechanisms of the human body that
make it a living thing
Cells as the Living Units of the Body
- General mechanism for changing nutrients into
energy
- Deliver products of their chemical reactions
into the surrounding fluids
- Have the ability to reproduce
Homeostatic Mechanisms of the Major Functional
Systems
Homeostasis
- A condition wherein all organs and tissues of the
body that perform functions to help maintain
the constituent of the extracellular fluid
relatively constant
Extracellular Fluid Transport and Mixing System: The
Blood Circulatory System
About 50% to 70% of the adult human body is fluid, with
approximately two-thirds inside the cells and one-third
in the extracellular fluid surrounding the cells and
circulating in the blood. Extracellular fluid is transported
throughout the body in two stages.
• The first stage is movement of blood throughout
the circulatory system, and
• the second stage is movement of fluid between
the blood capillaries and cells.
• The circulatory system keeps the fluids of the
internal environment continuously mixed by
pumping blood through the vascular system.
As blood passes through the capillaries, a large portion
of its fluid diffuses back and forth into the interstitial
fluid that lies between the cells, allowing continuous
exchange of substances between the cells and the
interstitial fluid and between the interstitial fluid and the
blood.
Origin of Nutrients in the Extracellular Fluid
• The respiratory system provides oxygen for the
body and removes carbon dioxide.
• The gastrointestinal system digests food and
facilitates absorption of various nutrients,
including carbohydrates, fatty acids, and amino
acids, into the extracellular fluid.
• The liver changes the chemical composition of
many of the absorbed substances to more
usable forms, and other tissues of the body (e.g.,
fat cells, kidneys, endocrine glands) help modify
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the absorbed substances or store them until
they are needed.
• The musculoskeletal system consists of skeletal
muscles, bones, tendons, joints, cartilage, and
ligaments. Without this system, the body could
not move to the appropriate place to obtain the
foods required for nutrition. This system also
protects internal organs and supports the body.
Removal of Metabolic End Products
• The respiratory system not only provides
oxygen to the extracellular fluid but also
removes carbon dioxide, which is produced by
the cells, released from the blood into the
alveoli, and then released to the external
environment.
• The kidneys excrete most of the waste products
other than carbon dioxide. The kidneys play a
major role in regulating extracellular fluid
composition by controlling excretion of salts,
water, and waste products of the chemical
reactions of the cells. By controlling body fluid
volumes and compositions, the kidneys also
regulate blood volume and blood pressure.
• The liver eliminates certain waste products
produced in the body, as well as toxic
substances that are ingested.
• The gastrointestinal tract eliminates undigested
materials and some waste products of
metabolism in the feces.
Regulation of Body Functions
• The nervous system directs the activity of the
muscular system, thereby providing locomotion.
It also controls the function of many internal
organs through the autonomic nervous system,
and it allows us to sense our external and
internal environment and to be intelligent
beings so we can obtain the most advantageous
conditions for survival.
• The hormone systems control many metabolic
functions of the cells, such as growth, rate of
metabolism, and special activities associated
with reproduction. Hormones are secreted into
the bloodstream and are carried to tissues
throughout the body to help regulate cell
function
Protection of the Body
• The immune system provides the body with a
defense mechanism that protects against
foreign invaders, such as bacteria and viruses, to
which the body is exposed daily.
• The integumentary system, which is composed
mainly of skin, provides protection against injury
and defense against foreign invaders, as well as
protection of underlying tissues against
dehydration. The skin also serves to regulate
body temperature.
Reproduction
• The reproductive system provides for formation
of new beings like us. Even this function can be
considered a homeostatic function because it
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generates new bodies in which trillions of • HDL – good cholesterol bc it takes away fat; >
additional cells can exist in a well-regulated 60mg/dL
internal environment • LDL – bad cholesterol bc it provides fat in cell;
<100mg/dL
The Cell and Its Function • Triglycerides – lipid ver of glycogen; <165mg/dL
Cell • Total cholesterol – <200mg/dL
- Basic living unit Proteins
- Tries to achieve homeostasis (constant and • 10 to 20% of cell
balanced conditions) • Structural protein – long and thin filaments that
come in bundles and serves as the cytoskeleton
• Functional protein – globular forms that are
mainly the enzymes in the cells
Ions
• Provides inorganic chemicals for cellular
reactions and are necessary for operation for
some of cellular control mechanisms
• K+, Mg, P, S, HCO3, Na+, Cl-, Ca
• Na – most abundant cation in extracellular
• Cl – most abundant anion in extracellular
• K – most abundant cation in intracellular
• Organic Anions – most abundant anion
intracellular

Protoplasm Physical Structure of the Cells

- The different substances that make up the cell
Water
• Comprises 60% of entire body
• 2/3 intracellular (inside of cells); 1/3
extracellular (outside of cells)
Carbohydrates
• 1% of the cell; 3% of muscle; 6% for liver
• Provide little structural function but plays
major role in nutrition
• First energy choice consumed bc easiest to
breakdown and used
• Disaccharides = 2 monosaccharides
• Sucrose = 1mol glucose + fructose
• Lactose = 1mol glucose + galactose
• Maltose = 1 mol glucose + glucose
• Glycogen – carbs in the form of dissolved
glucose readily available for cell; freely floats in
extracellular
Lipids (fats)
• 2% of the cell
• 2nd choice of energy consumed
• Insoluble in water thus used to form the cell
membrane and intracellular membrane barriers
Cell Membrane/Plasma membrane – lipid bilayer
• Phospholipids – most abundant with
hydrophilic(water soluble; phosphate end) and
hydrophobic(fat soluble; fatty acid end)
• Sphingolipids -
• Cholesterol – controls fluidity of membrane
Nuclear membrane/nuclear envelope – surrounds the
ER
Nucleus – contains genes that determines the
characteristics of the cell’s proteins, and promote
reproduction of cell
Cytoplasm – region inside the cell membrane filled with
organelles in the cytosol
Mitochondria – transports ATP throughout the cell
Centrioles
Endoplasmic Reticulum – network of tubular and flat
vesicular structures that transports molecules to other
parts of the cell
• Granular ER – contains ribosomes (site for
protein synthesizes)
• Agranular ER – lipid synthesis
Golgi Apparatus – contains vesicles that transports
substances to the Golgi Apparatus
Lysosomes – provides an intracellular digestive system
Microfilaments – made of a protein called actin that
assists with cell movement, cell division, and
cytoplasmic streaming
Microtubules – provides shape and structure to cell;
helps in cell division; forms an internal transport
network for vesicles

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DEPARTMENT of OCCUPATIONAL THERAPY
MEMBRANE PHYSIOLOGY AND NERVE
Transport of substances through Cell
- Extracellular Fluid – high Na and Cl conc; low K
conc.
- Intracellular Fluid – low Na and Cl conc.; high K
conc
- Conc. Of phosphates and proteins in
intracellular fluid are greater than those in
extracellular fluid
- selective permeability allows certain substances
with certain criteria to pass through it; has the
ability to regulate the conc of substances(ions)
- Only relatively small nonpolar materials can
move through the lipid bilayer
- Water soluble materials (glucose, amino acids,
electrolytes) need assistance to cross the
membrane bc they are repelled by the
hydrophobic tails of the phospholipid bilayer
- Nutrients (sugars, fatty acids, amino acids,
waste products, CO2,) must leave the cell
- Concentration gradient/difference – moles
diffuse until there is no more conc gradient
Passive Transport
- Does not use ATP(cellular energy) because it
moves the moles downhill
- Goes with the flow
Simple diffusion
• movement of particles from high conc to lower
conc (ex. Exchange of gases in lungs)
• When there is conc gradient on each side
• The structure of lipid bilayer allows only small
nonpolar substances (O2 and CO2) pass
through the cell membrane down their conc
gradient
Facilitated Diffusion
• for substances that cannot cross the lipid
bilayer due to their size and polarity (ex.
Glucose to ATP)
• Requires a specialized carrier protein to assist
the movement of particles down its conc
gradient
• Channel proteins are less selective than carrier
proteins.
Osmosis
• diffusion of water through a semipermeable
membrane
• Used when replacement fluids are needed for a
dehydrated patient
• Tonicity - Conc of solutes creates the osmotic
pressure with determines the movement of
water
• Isotonic – water moves equally out of cell (ex.
RBC in plasma); equal conc on both side
• Hypotonic – water moves in from the outside
(ex. RBC in distilled water); increase in volume;
from low conc to high
• Hypertonic – water moves out of cell (ex. RBC in
seawater); decrease in volume; from low conc
to high
Active Transport
- Uses ATP to move moles against the gradients
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- Goes against the flow
- Uses a transport protein to move a substance
against its conc gradient
Sodium Potassium pump
• Uses ATP to bind with 3Na and changes the
shape of the protein and exits while 2K enters
and binds to the protein causing the phosphate
to release and return back to the original shape
Endocytosis
• uses vesicles to transport fluids out of the cell
• Filtration – from high pressure to low by using
the energy of mechanical pressure
• Pinocytosis – when a stationary cell engulds
something (ex. Cells of kidney tubules);
ingestion of small globules of extracellular fluid,
forming minute vesicles in the cell cytoplasm
• Phagocytosis – when a moving cell engulfs
something (ex. WBC takes in bacteria)
Resting Membrane Potential (RMP)
- Voltage difference between the
inside(negative) and outside(positive) of cells
- Active Na/k pump; closed Na chanel; open K
chanel
- Ions arrange themselves along the outer and.
Inner surfaces of cell membrane
- RMP is different in various tissues
- Nerve cell/neurons: -70mV
- Skeltal muscles: -90mV
- Cardiac muscles: -90 mV
- Important role in deciding the degree and
duration of action potential
- Level of the face of depolarization starts
- Not stable in some tissues (visceral smooth
muscle)
Action Potential (AP)
- How neurons relay messages
- Neural impulse is a series of action potentials
between the inside and outside of neuron
- when the neuron is stimulated, membrane
potential changes and inside of the cell becomes
positive due to depolarization
- Rapid changes in the membrane potential
- Nerve signals are transmitted by AP
- Begins with a sudden change from the RMP
(depolarization) and ends with an almost equally
rapid change back to the RMP (repolarization)
Polarization
- Neuron not carrying an impulse
- Na+ is more outside and K- are more inside
- Na/K pumps maintain the ion concentrations
Depolarization
- A stimulus such as neurotransmitters makes the
membrane very permeable to Na which brings
about the depolarization (A reversal of charges
on the membrane)
- (Propagation of impulse from point of impulse)
Membrane suddenly permeable to Na, allowing
more positively charged Na ions to flow to the
interior of the axon and membrane potential
rises rapidly in the positive direction
- Continues along the membrane to the end of
axon
Repolarization
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- As soon as depolirization takes place, the neuron - neuron is ready to repond to another stimulus
membrane becomes very permeable to K ions and transmit another impulse
which rushes out to the cell and repolarization
happen

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Breakdown of glycogen
MUSCLE PHYSIOLOGY - 1 minute
Composition - Glycogen breaks into pyruvic acid and lactic
- 40% skeletal muscle acid where energy is releases by releasing
- 10% smooth and cardiac muscles phosphate ions to bind to ADP so that it
Physiological Anatomy of skeletal, cardiac, and becomes ATP again
smooth muscles - Release of energy can occur even when Oxygen
Epimysium – tissue covering of muscle belly is absent
Muscle belly – bundle of fasicles - Might be oxygen deficient but still have energy
Perimysium – tissue covering of fasicles to hold a contraction
Fasicle – group of muscle cells - Longer use of energy but short in duration
Perimysium – covering of m - Example: swimming
Endomysium – tissue covering of the muscle fibers Oxidative metabolism
Sarcolemma – thin membrane of endomysium - Breakdown of food
Muscle fibers – individual muscle cell - Oxygen binds to various cellular food (carbs,
Myofibril – contains sarcomeres fats, proteins) to release ATP
Sarcomere – basic functional unit of a muscle fiber - Longer to process energy but more power
Myofilaments – smallest unit of skeletal muscle
• Actin – thin filaments Characteristics of Whole Muscle Contractions
• Myosin – thick filaments Isometric Contractions
Z line – boundary between 2 sarcomeres - Same length
I band – purely actin (only the red parts) - Muscle are contracting but does neither
A band – cotains the myosin and the zone of overlap lengthening or shortening
H zone – purely myosin - Example: planking
M line – midline of entire sarcomere Isotonic contractions
- Holding same tension but changes in length
- Concentric - shortening
- Eccentric - lengthening; extending in a
controlled manner

Types of muscle fibers

Slow twitch (Type 1)
- Aerobic (a lot of oxygen)
- Red
- Small muscle bulks
- High blood supply
- Fatigue slowly; high endurance; use energy
Contraction of skeletal muscle slowly
Sliding Filament Theory - High number of capillaries and mitochondria
Nerve impule > action potential along muscle > cause - Example: marathoners
the release of acetylcholine > causes depolirazation > Fast twitch (Type 2)
causes release of calcium ions in sarcoplasmic reticulum - Anaerobic (uses less oxygen)
> binds to troponin and change its shape to - Bigger muscle bulks
tropomyosin > moves to active site of actin where - Pale
myosin can attach and form a cross bridge - Low blood supply
- Fatigue rapidly; use bursts of energy
ATP breaks down into energy > enables myosin to pull - Low number of capillaries and mitochondria
the actin inwards > ATP binds to myosin head > myosin - Type 2A - oxidative (oxidative metabolism)
dettaches from actin > crossbridge is broken > repeat - Type 2B - glycolytic (glycogen breakdown)
(ratchet mechanism) as long as there is adequate ATP - Example: sprinters, weight lifters
and Ca > causing muscle to contract
Mechanism of skeletal Muscle Contraction (1 twitch=1
Nerve impulse stops > Ca is pumped back to spike)
sarcoplasmic reticulm > actin returns to resting position Multiple motor unit summation
> mucle lengthen and relax - Adding together a series of twitch contractions
to increase intensity of overall multiple
ADP can only hold muscle contraction for 1-2 secs contractions
- Strength of signal increases = larger units begin
3 Main Sources of Energy for muscle contraction to be excited
Phosphocreatine Frequency summation and tetanization
- 5 to 8 seconds - Frequency of contraction increases that they
- Carries high energy bonds similar to ATP but are so close together that they don’t have a
has more free energy chance to go down before a new one starts =
- Causes the release of phosphate ions to bind to
ADP so that it becomes ATP again
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reaches a critical level where successive - Resting muscle is in a partial contraction state
contractions already fuse (muscle tonus)
- Ends when fatigue sets in
Nueromuscular junction – connection between motor
neuron and muscle fiber; chemical synapse between
the nerve terminal and endplate

Nerve impulse > action potential reaches the nerve

terminal > causes the release of acetylcholine
(neurotransmitter) > binds to nicotinic receptors
(ligated ion channels) on the endplate > channel opens
to allow Na to enter the cells > depolarizes the cell
membrane > produces endplate potential > activates
the Na channels outside the endlate in the neighboring
Treppe (staircase effect) membrane > allows faster influx of Na > furthur
- Sustaining a position for long hours = initial depolarizing and reverse the polarity of cell membrane
strength is lower > K channels release K > return the membrane voltage
- Warming up causes more Ca in sarcoplasmic to resting potential > action potential spreads like a
reticulum wave throughout the muscle fiber via T tubules to
reach the sarcoplasmic reticulum > activates Ca
channels > releases Ca to sarcoplasmic reticulum into
the cytosol of muscle cells > sets of muscle contraction
by the sliding filament mechanism

Acetylcholinesterase (enzyme) > removes ACh that do

Remodeling of Muscle through time to Match
Function
Hypertrophy
- Increase in total mass
- Results from increase in the number of actin
and myosin in each muscle fiber
- hyperplasia is the increase of muscle fibers
- Example: muscle builders; muscle bulks
Atrophy
- Decrease in total mass
- Results when a muscle remains unused for a
long period. The rate of decay of the contractile
proteins occurs more rapidly than the rate of
replacement
- Muscle denervation causes rapid atrophy
Excitation of Skeletal Muscle
Muscle Action Potential
- RMP: -80 to -90 mV
- Duration: 1 to 5 ms (5x as long as large
myelinated nerves)
- Velocity: 3 to 5 m/s (1/18 the velocity of
large myelinated fibers)
Neuromuscular Transmission
Without innervation, muscles become paralized and
atrophy happens
Axon of motor neuron supply mucle fibers that contract
in unison when activated
Motor unit is a group of muscle fibers controlled by 1
motor neuron
- Smaller motor units = small muscles
- Large motor units = large muscles (strength)
- Strength of muscle contraction is determined
by the number of motor units activated
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not immediately bind to the receptor and those done
activating the receptor > terminates synaptic activation
> muscle relaxes and prevent muscle contraction that
result to muscle spasm
Neuromuscular Toxins (prevent activation of muscle
cells and cause flacid paralysis except presticides)
Botulinum toxin (botox) prevents ACh to release from
the presynaptic side of the junction
Curare (plant toxin) and bungarotoxin (snake venom)
blocks ACh from binding but do not open the ion
channel
Certain Drugs lodge into the channel of nicotinic
receptor to block the passage of Na
Pesticides inhibit AChE that prevents degradation of
ACh, causing continuous activation of muscles; induce
muscle spasms and cause spastic paralysis
Excitation and Contraction of Smooth Muscles
Types of Smooth Muscle
Multi-unit
- Each muscle fiber can contract
independently
- Minute muscle contractions
- Example: papillary muscles, pillow erector
muscles, iris
Single-unit
- Unitary that contracts as a whole
- Joined by gap junctions that make sure
impulses are received together; Deliver the
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motor impulses from one fiber to the next
and make sure that they contract in unison
- Example: viscera, walls of gastrointestinal
tract, blood vessels
Contraction and Relaxation
Ca entering the cell from the extracellular fluid
(sarcoplasmic reticulum in skeletal) > signals the
sarcoplasmic reticulum to also release Ca > Intracellular
Ca binds to calmodulin (protein) > activates myosin
light chain kinase (MLCK) > activates the myosin heads
> binds to actin and slides along that increases the
muscle tension and contracts muscle > after, cell is
signaled to release Ca > Calmodulin unbinds from the
Ca > myosin phosphatase removes a phosphate from
the MLCK > ADP becomes ATP > myosin is inactivated >
myosin head unbinds from actin > muscle relaxes
Neuromuscular Junction of Smooth Muscles (NMJ)
Diffuse junctions (multi-unit)
- Junctions are branching out in between every
fiber that allows only one fiber to contract
where impulse can be found
- Site of transmitter release
- Autonomic nerve fibers secrete their
transmitter substance into the matrix, coating
the smooth muscle and then diffuses throught
the cell
Varicosities on the axons
- Most of the terminal axons of multiple
varicosities are distrubuted along their axis
- Contains vesicles loaded with transmitter
substance
Contact junctions (multi-unit)
- Varicosities lie directly on the fiber membrane
- Functions the same with neuromuscular
juntions in skeletal muscles
Neurotransmitters of smooth muscles of NMJ
Acetylcholine (ACh) – excitatory for some, inhibitory for
some; depends on the receptor of the fiber
Norepinephrine – counteracts ACh effects on fibers
Membrane Potential
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- RMP: -50to -60 mV
- Quantitative voltage adjust/depends on the
momentary condition of muscles
Action Potential of Visceral Smooth Muscles
Spike potentials (A) – elicited by electrical stimulation,
stretch, or action of hormones and transmitter
Action potential with plateaus (B) – similar to spike but
repolarization is delayed for several hundred
milliseconds; causes prolonged contraction
Slow rythmical waves (B) – occur spontaneously on
intestinal wall
Depolirization of Multi Unit Smooth Muscles
- No action potentials
- Contract mainly in response to nerve stimuli
- Nerve secrete ACh and Noripinephrine because
fibers are too small to generate an action
potential
Effect of local tissue factors and hormones on smooth
muscles contraction without Action Potential
Local tissue factors
- lack of O, excess CO2, increased H
- causes relaxation of smooth muscles on the
vessels
Circulating Hormones in blood
- affect smooth muscle contraction to some
degree
- Example: excess histamine as a result to allergic
reaction makes smooth muscles contract
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CARDIAC PHYSIOLOGY Cardiac Muscle Anatomy And Physiology

Heart - Appear striated
Functions: - Myofibrils contain actin and myosin that act in
- Propels blood through an estimated 10,000 km the same manner as in skeletal muscle
of blood vessels - Differences with skeletal muscle
- 5L is pumped to the lungs and the same volume • The presence of the protein Titin
to the rest of the body • Definition = a protein that allows
- Heart pumps more than 1400 L of blood in a passive elastic elongation of the
day or 10 million L a year sarcomeres after contraction
Dimensions and Specific Characteristics • Importance = required as there is no
- Hollow, cone-shaped, about the size of a antagonist muscle contracting to help
person’s closed fist elongate the heart muscle
- Weighs about 300 g in an adult - Cardiac muscle as a syncytium
- Contains 4 chambers and rests on the • Intercalated discs = gap junctions that
diaphragm, in the mediastinum lie between the cardiac muscle fibers
- About 12cm long, 9cm wide and 6cm thick connected in series (such that cardiac
- Pointed inferior end is formed by the tip of the muscle fibers are much shorter than
left ventricle and tilts obliquely toward the left skeletal muscle fibers) and parallel
hip and is referred to as the Apex • Function = allow an action potential
- Wide superior and posterior margin of the transmitted through one muscle fiber
heart is called base and is formed by the atria, to be transmitted to an adjacent
mostly of the left atrium muscle fiber
• Atrial vs. ventricular syncytia
Chambers of the Heart o Separated from each other by
- 2 superior chambers: Right and Left Atrium fibrous tissue that surrounds
- Anterior wall is rough due to presence of the AV openings
internal muscular ridges called pectinate o Action potentials pass between
muscle the atria and ventricles only
- Each atrium has an appendage called an auricle through specialized conduction
which increases tissue called the AV bundle
- Both atria are separated by the intraatrial (Importance = allows the atria
septum to contract a short time ahead
- 2 inferior chambers: Right and Left Ventricles of the ventricles)
- Both ventricles are separated from the atria by The Cardiac Cycle
the coronary sulcus 1. Commences in the sinoatrial node which is in
- Anterior interventricular sulcus and posterior the Right atrial wall inferior to the opening of
interventricular sulcus separates both the superior vena cava
ventricles externally o Intraventricular septum 2. Cardiac action potentials extend from the SA
separates both ventricles internally node down to the Atrioventricular node (AV)
which is in the septum between the two atria
Right Ventricle Left Ventricle 3. From the AV nodes, the action potential pierces
Thinner muscular wall 2 to 4x thicker than the the AV Bundle of His, the only electrical
right connection between the atria and the
Pumps at a fairly low Pumps at a higher ventricles.
pressure only to the pressure to all other 4. Action potential then enters both the right and
lungs parts of the body left bundle branches that course through the
Pulmonary circulation Systemic Circulation interventricular septum toward the apex of the
Works at a minimal value Works harder to heart
maintain blood flow 5. Large diameter conduction myofibers (Purkinje
fibers) briskly conduct the Action potential first
Valves of the Heart to the apex and then upward to the remainder
Atrioventricular Valve of the ventricular myocardium
- Lies between the atria and the ventricles
- The Chordae Tendineae are tendon like cords Cardiac Action Potentials
that connect the pointed ends and Fast Response AP
undersurfaces to papillary muscles on the inner - Found both in the contracting cells of the atrial
surface of the ventricles (tricuspid valves and and ventricular myocardium and in the
the bicuspid or mitral valves) specialized conducting network of Purkinje
Semilunar Valves fibers
- Allows ejection of blood from the heart but - Characterized by rapid Na influx during phase 0
prevents backflow of blood into the heart depolarization
- Consists of semilunar cusps and each susp - Responsible for transmission of the action
attaches to the artery wall by its convex outer potential along the conduction network and for
margin
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depolarization of the entire myocardium, resulting in P wave – atrial depolarization

contraction - Ventricular filling
Slow Response AP - Impulses from SA node propagates to atrium
- Found in the pacemaker cells of the sinoatrial - 0.10 secondas
and atrioventricular nodes QRS complex – ventricular depolarization
- Shows slow Ca influx during phase 0 - Ventricular contraction
depolarization - Ventricular systole
- Generates the pacemaker potential from within - Impulse towards AV bundle
SA node - <0.12 seconds
T wave – ventricular repolarization
Fast and Slow Response AP - Relative refractory state
Fast Slow - Proto diastole (0.04 seconds)
Phase Rapid Upstroke: Slow Upstroke: SA and - Resting State
0 Rapid flow of Na AV nodal cells PR interval – from atrial contraction up to ventricular
mediated by Ca contraction
channels - Impulse from the AV node
Phase Partial Absent - Conduction delay (0.11 seconds)
1 Repolarization: Na - Isovolumetric contraction
channels are QT interval – ventricular systole (0.35 seconds)
deactivated, and ST segment – ventricular repolarization
depolarization - Absolute refractory state
stops. Small efflux - Heart is unexcitable (isovolumetric relaxation)
of K occurs.
Absolute Phases of Cardiac Cycle
Refractory Period Period of - Quiescent period when the
Phase Plateau: Slow Plateau: The plateau is Relaxation ventricles start to relax and
2 efflux of K is less prominent than in all 4 chambers are in
counter acted by the conducting and diastole
voltage-gated contracting cells of the - Repolarization of the
inward Ca current myocardium ventricular muscle fibers set
Phase Rapid Same as first response off relaxation which drops
3 repolarization: the pressure within the
gradual increase in chambers. Allows blood flow
K efflux and from pulmonary trunk and
inactivation of the aorta back toward the
voltage gated Ca ventricle with blood getting
channels of Phase trapped in the semilunar
2. cusps (ventricular diastole)
Relative - Represented by T wave
Refractory Period - Isovolumetric relaxation
Phase Diastole: Fully Diastolic Ventricular - Immediately after opening
4 recovered cell depolarization: SA and Filling of valves
remains at the AV nodes, and to some - First 1/3 rapid ventricular
resting potential extent the Purkinje filling, Middle 1/3 much
until a fibers, are capable of small volume of blood and is
depolarization spontaneous referred to as diastasis, last
event occurs depolarization due to 1/3 is Atrial systole and
the interplay of at least accounts for the final 20-25
three ion flows ml of blood
(increased Ca and Na - Indicated by the P wave
influx and decreased K Period of - Ventricular contraction
efflux) Ventricular starts pushing blood against
Accounts for Systole or the AV valves forcing them
automaticity and is Contraction shut (ventricular systole)
referred to as - Isovolumetric contraction
pacemaker potential - When L ventricular pressure
exceeds aortic pressure and
THE ELECTROCARDIOGRAM R ventricular pressure
- A non-invasive trans-thoracic interpretation of - exceeds pulmonary trunk,
the electrical activity of the heart over a period both semilunar valves open
of time, as detected by electrodes attached to and ejection of blood from
the outer surface of the skin - the heart starts
- Assess heart rate, rhythm, conduction delay, - End systolic volume
coronary perfusion.
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- Represented by QRS
complex
Phases of Cardiac Cycle
S1 - AV valve closure
(lub) - Beginning of systole
- Vibration is low in pitch and
relatively long lasting
S2 - Semilunar valve closure
(dub) - End of systole
- Rapid snaps
S3 - Ventricular Gallop
- After s2 and associated with
congestive heart failure
S4 - Atrial Gallop
- Occurs before S1
- Associated with myocardial
infarction or chronic hypertension
BLOOD PHYSIOLOGY
Heart
- Cells within the human body are susceptible to
changes in temperature, pH, and to toxic
chemicals. Since most cells in the body are fixed
within tissues, they must have nutrients and
oxygen brought to them and waste removed.
Blood serves this transportation function.
- The blood is classified as a fluid matrix
connective tissue consisting of cells and cell
fragments surrounded by a liquid matrix which
circulates through the heart and blood vessels.
The cells and cell fragments are the formed
elements and the matrix of the blood is fluid.
Therefore, blood can be divided like other
connective tissues into a cellular component
and a matrix component. Formed elements
make up about 45% and plasma 55% of the
total blood volume. Blood volume: 4-5 L in
females, 5-6 L in males
Functions of the Blood
Distribution and transport (estimate 60,000 miles of
vessels in body)
- Respiration - RBC transport Oxygen, CO2,
- Nutritive - Carries absorbed nutrients,
electrolytes and water from intestines:
- Excretory - Metabolic Waste -urea, excess
water, ions are carried to the kidney.
- Negative - also transports bacteria, viruses,
toxins etc.
Regulation and maintenance
- Hormonal regulation
• From glands to target organs
• Transport of various enzymes
- Thermoregulation
• Diversion of blood from deeper to
superficial cutaneous vessels to cool
body or vice versa to retain heat
- pH / acid-base balance
• Blood acts as a buffering system for the
body.
• pH 7.35-7.45
- Fluid volume
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Protection
- Clotting - Protects against blood loss when
tissues / vessels are damaged
- Immunity - Leukocytes protect against disease
causing agents. (toxins, bacteria)
Major Components of the Circulatory System
Cardiovascular: Heart, blood vessels
Lymphatic
- lymphatic vessels and lymphoid tissues in
spleen, thymus, tonsils, and lymph nodes.
• The fluid portion of the blood (plasma)
passes through the capillary walls
under hydrostatic pressure (interstitial
fluid). o Some interstitial fluid returns
to the blood and some enters the
lymphatic system
• Lymphatic vessels carry interstitial fluid
now called lymph back to the venous
blood.
• Lymph nodes along the way filter and
cleanse the blood before it is returned.
- Components of the blood (Fluid components)
• Plasma - straw colored liquid composed
of water and dissolved solutes.
• 90% water - solvent and suspending
medium for blood components
• Over 100 different solutes - proteins,
ions, nutrients, gases and waste
products
• 7%Proteins
o Albumins (58%) - buffer /
maintains osmotic pressure /
viscosity
o Globulins (38%) - transport
lipids and hormones. (-Act as
antibodies)
o Fibrinogen (4%) - Blood clotting
• 2%Othersolutes
o Ions - Na+, K+, Ca++, etc.
o Nutrients - Glucose, amino
acids, cholesterol, triaclglyerol
o Waste products - Urea, uric
acid, creatinine, ammonia salts.
o Gases - Oxygen, CO2, Nitrigen
o Regulatory substances-
enzymes, hormones.
Formed Elements (Cells)
Erythrocytes (RBC)
- Hematocrit = % of blood composed of RBC
- red blood cells (RBC’s) Characteristics:
- Numbers: Female - 4.3 to5.2 million / mm3 and
Male 5.1 to 5.8 million / mm3.
- Shape “biconcave disks” - increases surface
area
- 7 um in diameter and 2.2 um thick.
- Contains hemoglobin and iron.
- No nucleus, very few organelles
- Carry oxygen to tissues and carbon dioxide
away from tissues.
- Function dependent on hemoglobin
- Hemoglobin Structure:
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• Composed of 4 protein chains, 2 alpha
chains and 2 beta chains.
• Each chain contains an iron containing
heme group.
• iron in these heme groups is critical for
oxygen to bind to the hemoglobin
• Each hemoglobin is capable of binding
4 oxygens.
- Considerations: Each blood cell contains 280
million hemoglobin molecules. Each RBC
therefore has the capability to bind over 1
billion oxygen molecules
- The majority of CO2 (70%) is carried in the
blood as bicarbonate ions (HCO3-)
- Carbon monoxide binds to Hemoglobin forming
a stable carboxyhemoglobin - result O2 can’t
bind to hemoglobin and death occurs.
- RBC Production:
• RBC’s are produced within the bone
marrow. Through a process called
erythropoesis.
• Most blood cells derive from a common
ancestor cell known as a
hemocytoblast.
• Under appropriate conditions the
hemocytoblast differentiates into a cell
known as a proerythroblast (early
erythrocyte forming cell) etc.
• Stem cell > proerythroblast > early
(basophilic) erythroblast > intermediate
(polychromatic)erythroblast >
(hemoglobin production begins) late
erythroblast (loss of nucleus) >
reticulocyte > erythrocyte
• Changes that occur during RBC
development-decrease in size, loose
nucleus and many of its organelles
including mitochondria
• Regulation of production
o production requires: folate and
B12 for cell division and iron for
hemoglobin to be produced.
o Erythrocyte production is
stimulated by low blood
oxygen
o (Causes: decreased or defective
erythrocytes, diseases of the
lungs, high altitude,
cardiovascular delivery
problems, increased demands
for oxygen (endurance
exercise).
• Decreased blood oxygen causes
increased erythropoietin release from
the kidneys.
o erythropoietin stimulates bone
marrow to produce more
erythrocytes and increase the
rate of maturation.
- Fate and destruction of RBC’s:
• As RBC circulate they eventually
become ragged and worn out as they
squeeze through capillaries. (RBC
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cannot produce new proteins - no
nucleus)
• Typical life span 100 - 120 days.
• As RBC’s squeeze through the narrow
capillaries of the spleen (or liver) the
worn out cells become trapped and
broken down by fixed macrophages.
• Breakdown products are recycled as
follows:
o Macrophages engulf and
destroy worn out RBCs in
spleen and liver.
o Hemoglobin is split into heme
and globin
o Globin is broken down into
amino acids which can be used
to synthesize other proteins.
o Heme (iron + porphyrin)
liberates its iron core which is
recycled.
o Fe3+ is picked up and
transported in blood by a
plasma protein called
transferrin
o Fe is carried to marrow for
synthesis of Hb in new RBC or
o Is stored in muscle or liver
where iron detaches from
transferrin and binds to an iron
o storage protein called ferritin.
o Upon release from storage,
iron can reattaches to
transferrin
o Iron is then transported to
bone marrow where RBC
precursors take it up through
receptor mediated endocytosis
for use in producing new
hemoglobin molecules.
o Erythropoiesis in red bone
marrow results in the
production of RBC which enter
the circulation
• Porphyrin
o Non iron portion of heme
(prophyrin) is converted to
biliverdin (green pigment) o
biliverdin is converted to
bilirubin (orange pigment)
o bilirubin enters the blood
stream and is transported to
the liver.
o Within the liver, bilirubin is
secreted by the liver cells into
bile which passes into the small
intestine
o o In the large intestine bacteria
convert bilirubin into
urobilinogen
o o Some of the Urobilinogen is
absorbed back into the blood
and converted to urobilin
o (yellow pigment) and is
excreted in the urine
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o o Most urobiligen is eliminated
in feces in the form of
stercobilin which gives feces its
o characteristic color.
o Jaundice - yellowish staining of
skin and sclera causes by
buildup of bilirubin.
- Disorders of Erythrocytes
• anemias – deficiency of hemoglobin in
blood. The result of either a decrease in
hemoglobin / RBC or in the number of
RBCs.
• Symptoms: pale, lethargic, shortness of
breath, tired.
• Aplastic anemia – inability of red bone
marrow to produce RBCs caused by
damage to Red bone marrow by
chemicals, drugs, radiation; Iron
deficiency - RBCs are smaller than
normal; folate deficiency - necessary
for DNA replication - poor pregnant
women and alcoholics
• Pernicious anemia – Vitamin B12
deficiency - Vitamin B12 is necessary
for production of folate.
• Hemorrhagic anemia – results from loss
of blood. (Ulcers, menstruation).
• Hemolytic anemia – erythrocytes
rupture or are destroyed at an
increased rate. caused by: genetic
membrane problems; snake venom;
immune diseases; heart valve
problems.
• Thalasemia - defective hemoglobin
production; insufficient globin
production - genetic disorder
• Sickle cell anemia - abnormal shaped
hemoglobin; Cells are rigid, fragile and
sickle shaped; death by age 30.
Leukocytes (WBC)
- Broad classification of white blood cells. 4,000-
11,000 / mm3 (5-9,000 considered normal
range
- Characteristics:
• Diapedesis – can cross capilary
bounderies to fight infection
• Ameboid motion – cytoplasmic fluid
movement
• Positive chemotaxis – ability to follow
chemical trail through the body
- Granulocytes (twice the size of RBC,
cytoplasmic granules present, survive 12h to 3
days)
• Neutrophils
o Appearance: 2-5 lobes,
cytoplasmic granules that stain
slightly pink, 10-12um
o 54 to 62% of white cells
o most common WBC
o chemically attracted to sites of
infection
o Good at fighting bacterial and
fungal infections
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• contain peroxidases and other
hydrolytic enzymes
• Ccontain defensins which act to digest
foreign substances and puncture holes
in bacteria
• Numbers increase rapidly with
meningitis and appendicitis
- Eosinophils
• Appearance: bilobed nucleus,
cytoplasmic granules that stain red or
bright red, 11-14 um
• 1-3% of white blood cells
• most effective in working against
parasitic worms such as tape worms,
flukes, pinworms, and hookworms
• release chemical that reduce
inflammation (c) secrete enzymes that
break down clots.
- Basophils
• Appearance: two indistinct lobes,
cytoplasmic granules stain blue-purple,
10-12 um
• Less than 1% of white cells
• Contain and release histamine
• act as a chemoattractant to attract
other WBC
• Release heparin - prevents clots
- Agranulocytes
• Lymphocytes
o Appearance: only slightly larger
than RBC, round nucleus nearly
fills cells, 6-14um 􏳧 25-33% of
white blood cells
o Generally found in lymphoid
tissues
o provides specific immune
response
o T-lymphocytes act directly
against virus infected cells and
tumor cells
o B-Lymphocytes produce plasma
cells which give rise to
antibodies.
• Monocytes
o Appearance: Nucleus round,
kidney of horseshoe
shaped,contains more
cytoplasm than lymphocyte,
o 12-20um
o 3-9% of white cells
o Once activated transform into
macrophages which attack and
digest everything in their way
(dead cells, bacteria, etc.)
Thrombocytes (platelets)
- Responsible for blood clot formation and are
not cells at all but are fragments of cells.
- Characteristics: Cytoplasmic fragment
surrounded by a plasma membrane containing
granules, 2-4um 130,000 to 400,000 / mm3
- Enables clotting
- Releases serotonin which causes
vasoconstriction
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- Hemostasis (prevention of blood loss) by
clotting
- Can be divided into three stages.
• Vascular spasm: Once a blood vessel
has been injured the first and most
immediate response is for the blood
vessel to start to spasm through
smooth muscle contraction. Vascular
spasm is caused by nervous system
reflexes and by chemicals
(thromboxanes, endothelin)
• Platelet plug formation: Seals up small
breaks in blood vessels
o platelet adhesion: Von
willibrand’s factor from
endothelial wall. Binds platelets
to collagen in vessel wall.
o Platelet activation : release
ADP and thromboxanes;
cascade of chemical release by
other platelets
o Activated platelets also bind
fibrinogen which causes
platelet aggregation and forms
a plug
o Platelets also release platelet
factor III and coagulation factor
V which are important in clot
formation o Aspirin inhibits
plug formation by blocking
prostiglandin and thromboxane
production.
- Coagulation – blood clot formation
• fibrin protein fibers trap blood cells,
platelets and fluid.
• Formation depends of a number of
factors
• Coagulation factors are normally
inactive
• Injury causes activation of clotting
factors
• Activation depends on surface proteins
on activated platelets.
• Process: (three main stages)
o formation of prothrombinase
by two pathways
o conversion of prothrombin to
thrombin (by prothrombinase)
o conversion of fibrinogen to
fibrin by thrombin
• 2 pathways for the formation of
prothrombinase
o Extrinsic pathway - begins with
factors released outside of
plasma in damaged tissue.
Thromboplastin (tissue factors)
released by damaged tissue.
Thromboplastin complexes
with Factor VII to activate
Factor X. Factor X complexes
with Factor V platelet
phospholipids and Ca+ to
activate prothrombinase.
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o Intrinsic pathway - begins with
factors inside (intrinsic to ) the
blood. Damage to blood vessels
exposes collagen in connective
tissues. Factor XII is activated
by collagen which then
activates Factor XI. IX joins with
factor VIII, platelet
phospholipids and Ca+ to
activate factor X. Factor X
complexes with Factor V
platelet phospholipids and Ca+
to activate prothrombinase.
- Control of clot formation: Anticoagulants
prevent blood from clotting outside of the
injury area. Anticoagulants can counteract low
levels of clotting factors. Anticoagulants
include: antithrombin and heparin
- Clot retraction
• Fibrin meshwork adheres to the walls
of the vessel
• Clot condenses
• Platelets contain actin and myosin
• bind to fibrin and pull it tight causing
retraction Serum (=plasma - clotting
factors) is extruded
• Consolidation pulls the edges of the
vessel together to stop blood flow,
reduce infection and enhance healing.
• Healing - fibroblasts multiply and
produce new C.T., epithelial cells
proliferate to fill in torn area
- Clot and dissolution (Fibrinolysis)
• Clot is dissolved by plasmin which
hydrolyzes fibrin.
• Plasmin is formed from inactive
plasminogen
• plasminogen is activated by tissue
plasminogen activator (t-PA) or
urokinase.
• t-PA and urokinase can be injected as
clot busters in case of blockage of
major vessels due to inappropriate
clotting.
• streptokinase (produced by bacterial
enzyme) can also be injected at the clot
site as a clot dissolving drug
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INTRO TO PHYS SHORT QUIZ
1. The following substances make up the protoplasm,
except: Vitamins
2. A condition wherein all organs and tissues of the
body that perform functions to help maintain the
constituent of the extracellular fluid relatively
constant. Homeostasis
3. A substance which is primarily used for energy
consumption and plays a major role in the nutrition
of the cell. Carbohydrates
4. Which of the following cell organelles is responsible
for producing adenosine triphosphate (ATP), the
energy currency of the cell? B) Mitochondria
5. Which of the following is not a major function of
the endoplasmic reticulum (ER)? Secretion of
proteins synthesized in the cell
6. This is the most abundant anion extracellularly.
Chloride
7. This is the most abundant cation intracellularly.
Potassium
8. This is the ingestion of small globules of
extracellular fluid, forming minute vesicles in the
cell cytoplasm. Pinocytosis
9. The following are major cellular functions of the
ATP, except: Locomotion
10. This cell organelle functions as the site for protein
synthesis. Ribosomes
LONG EXAM ON INTRO AND MEMBRANE PHYS
1. This cell organelle act as a passageway for transport
of materials within the cell. It is also responsible for
the synthesis of lipids. Endoplasmic reticulum
2. This cell organelle contains enzymes to digest
ingested material or damaged tissue. Lysosomes
3. Compared with the intracellular fluid, the
extracellular fluid has higher sodium ion
concentration, lower potassium ion concentration,
higher chloride ion concentration, and lower
phosphate ion concentration.
4. Which statement is incorrect?
a. The term “homeostasis” describes the
maintenance of nearly constant
conditions in the body.
b. In most diseases, homeostatic
mechanisms are no longer operating in
the body.
c. The body’s compensatory mechanisms
often lead to deviations from the
normal range in some of the body
functions.
d. Disease is generally considered to be a
state of disrupted homeostasis.
5. Which of the following cell organelles is responsible
for producing adenosine triphosphate (ATP), the
energy currency of the cell? Mitochondria
6. Worn-out organelles are transferred to lysosomes
by which of the following?Autophagosomes
7. Which of the following is not a major function of
the endoplasmic reticulum (ER)? Secretion of
proteins synthesized in the cell
8. Which statement is true for both pinocytosis and
phagocytosis?
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OT 212 – Human Physiology in Occupational
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a. Involves the recruitment of actin
filaments
b. Occurs spontaneously and
nonselectively
c. Endocytotic vesicles fuse with
ribosomes that release hydrolases into
the vesicles
d. Is only observed in macrophages and
neutrophils
e. Does not require ATP
9. Simple diffusion and facilitated diffusion share
which of the following characteristics? Do not
require adenosine triphosphate (ATP)
10. Which cell organelle is composed of a series of
channels throughout the cytoplasm that functions
in the transport of molecules? Endoplasmic
Reticulum
11. The Golgi Body’s function is to: Modifies, sorts, and
ships lipids for export or for insertion into the cell
membrane.
12. If the ribosomes of a cell were destroyed, what
effect would this most likely have on the cell? The
cell would be unable to synthesize proteins.
13. Amino Acids are molecules that are strung together
to make proteins. What organelle places amino
acids in the correct order to make proteins?
Ribosomes
14. Times are tough, and your cell needs to get some
nutrients and proteins out of storage, but
unfortunately nothing has been stored. Which
organelle failed? Ribosome
15. Your ribosomes are trying to make proteins, but
they don't have a good place to attach to in order
to make them. Which organelle is malfunctioning?
Endoplasmic reticulum
16. Your cell has forgotten how to make a particular
protein? Which organelle may be damaged?
Nucleus
17. Old, unwanted molecules aren't being broken down
and recycled! What organelle isn't working
properly? Lysosome
18. 18.A typical neuron has a resting membrane
potential of about: −70 mV
19. The following ion(s) is/are involved in the neuronal
action potential: Sodium (Na+) , Potassium (K+)
20. When an inside of an axon is more positively
charged than the outside, it is called the action
potential.
21. Diffusion takes place: From an area of low
concentration to an area of high concentration.
22. The cell membrane contains channels and pumps
that help move materials from one side to the
other. What are these channels and pumps made
of? Proteins
23. Which of the following does not expend energy?
Diffusion
24. A scientist places a cell in a solution, and over time
the cell gains mass and swells. What is the most
likely explanation for the cell’s gain in mass? The
solution is hypotonic to the cell
25. The diffusion of water across a selectively
permeable membrane is called Facilitated diffusion
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26. As a result of diffusion, the concentration of many

types of substances: Eventually becomes balanced
on both sides of a membrane
27. Which of the following is not characteristic of
facilitated diffusion? It moves substances against a
concentration gradient
28. Molecules that are too large to be moved through
the membrane can be transported into the cell by?
Endocytosis
29. The sodium-potassium pump usually pumps
Potassium into the cell
30. What would you expect to happen to a piece of
celery you put into a hypertonic solution? It would
shrivel up
MUSCLE PHYSIOLOGY SHORT QUIZ
1. Muscle makes up 50% of your entire body's
composition. False
2. Smallest unit of a muscle. Myofibiril
3. The A band is composed of. Both actin and myosin
4. Upon contraction of the muscle, the following
disappears on the sarcomere. H zone
5. The process by which muscles uses energy from
carbohydrates. Oxidative metabolism
6. When you push up, your Biceps brachii is
performing which type of contraction? Eccentric
7. The muscle fibers the help with extreme power and
speed - short bursts of energy. Type 2b fast twitch
glycolytic
8. Muscle innervations speeds up atrophy. False
9. Muscle action potential. -80 to -90 mv
10. Iris reaction towards light is the action of
contraction of. multi unit smooth muscle
CARDIAC PHYSIOLOGY SHORT QUIZ
1. The human heart is composed of 2 pumps the right
which pumps blood into the organs and the left
which receives blood to pump to the lungs. false
2. RMP of Cardiac Muscle -85 - -95
3. Cause of action potential plateau in cardiac muscle
a. Slow entry of calcium ions
b. Decreased permeability to Potassium Ions
c. Both
4. Presence of titin is one of the key differences
between cardiac muscle and skeletal muscle. True
5. Where does the action potential initiate to start a
cardiac cycle? SA Node
6. In a BP of 120 / 80, which one is the systole? 120
7. Caused by depolarization across the atria P wave
8. When does the outflow of blood from the
ventricles occur? Systole
9. Described as the Phase IV of the cardiac cycle.
Period of isovolumic relaxation
10. Regulates cardiac pumping, except:
a. Frank Starling Mechanism
b. Autonomic Nervous System
c. NOTA

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Diffusion
• it is the movement of particles(solutes) from and area of higher concentration to an area of lower
concentration, which does not require cellular energy. It relies on the concentration gradient, size of the
particles, and temperature that affect the rate of diffusion.
o Simple Diffusion – happens when there is a concentration difference on each side of the lipid bilayer.
The particles move through the cell membrane down their concentration gradient. This type of diffusion
only allows small non-polar substances to pass such as Oxygen and Carbon Dioxide.
o Facilitated Diffusion – requires a specialized carrier protein to assist the movement of the larger
particles with a different polarity that cannot cross the lipid bilayer down its concentration gradient.

Osmosis
• water diffusion across a semipermeable membrane. The tonicity creates an osmotic pressure so that the water
will diffuse or move towards the side with the higher solute concentration.
o Isotonic – water moves equally out of the cell so that there is equal concentration on both sides of the
plasma membrane;
o Hypotonic – water moves into the cell from the outside causing an increase of volume, making the cell
flaccid/swell and then burst causing homolysis
o Hypertonic – water moves out from the cell causing a decrease in volume, making the cell turgid/shrink

Osmotic Hemolysis
Loss of hemoglobin in response to reduced osmotic pressure.. Generally, in the clinical setting, general dehydration
caused by lack in intake of fluids is common. It can be treated with oral rehydration mixed with a minimal amount of salt
and sugar. Maintaining proper hydration with clients is vital since dehydration can cause thickening of the blood, and in
turn, low blood pressure occurs in order for the body to compensate. This might also lead to fainting
• hypotonic dehydration occurs when sodium loss is greater than water loss. An intravenous line may be
attached, containing a hypertonic solution or using 5% dextrose in 0.9% NaCI
• In isotonic dehydration, intravenous fluid administration may be opted but oral rehydration with an isotonic
solution can also treat this type of dehydration.
• Hypertonic dehydration occurs when too much water is lost while it keeps a lot of salt in the fluids. This can be
treated by oral rehydration with a hypotonic solution like water. Also, it is recommended to mix a little bit of salt
to prevent swelling.
As Occupational Therapists, it is our job to encourage our clients have enough water intake, ensuring that the water
should undergo filtration system making it contaminant-free. Letting our clients stay hydrated helps to maintain the
balance of the body fluids. Digestion, absorption, circulation, saliva production, nutrient transfer, and body temperature
regulation are all activities of various physiological fluids.

Conduction of nerve action potential

1. Resting
• all gated Na+ and K+ channels are closed
• -70mV until it becomes -55mmV
2. Depolarization
• Na+ channels open
• +35 mV is the peak of the action potential
3. Repolarization
• Na+ channels are inactivating; K+ channels open
4. Hyperpolarization
• Na+ channels reset or pumped back; Some K+ channels remain open and continue to leave the celll

Sliding Filament Theory

1. The filaments are at a relaxed state until a nerve impulse arrives. The action potential travels along the muscle
fibers where it releases acetylcholine that enables Calcium ions to be released from the sarcoplasmic reticulum.
2. The Calcium ions surround the myofibrils and activate the forces between the actin and myosin. The myosin
head can now attach to the actin, forming a cross-bridge.
3. ATP breaks down into ADP + P + energy where the energy enables the myosin filaments to pull the actin inwards
so that their ends overlap resulting to a muscle contraction. Z disks are pulled and the actin begins to overlap
the myosin and the M line disappears. The ADP and P are now lost and another ATP is replaced which causes the
myosin to release from the actin filament.
4. Once the nerve impulse stops, the Calcium ions are pumped back to the sarcoplasmic reticulum resulting it to go
back to a relaxed state.

Isometric contraction
• Planking
• Wall sit
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• Farmers walk
• High plank
• Side bridge
Isotonic contraction
• Shoulder lateral raises
• Squats
• Deadlift
• Bicep curls
• Tricep overhead press

Excitation and contraction of skeletal vs. smooth muscles

Skeletal Smooth
Excitation of cross bridge Faster cycle Slower cycle
Energy requirement More energy Less energy (1 ATP)
Onset of contraction and relaxation Quick Slow
Maximum force of contraction Less (3 to 4 kg/cm2) High (4 to 6 kg/cm2)

Cardiac physiology
• Pulse rate = heart rate (60 to 100 bpm)
• Maximum HR = HR reserve for cardiovascular fitness of a person
• HR reserve = maximum safe HR
• Target HR = level of exertion necessary for cardiovascular fitness
• Perform activities for 3 minutes and take HR for 15 s without having a break
• Strenous activity = increased heart rate bc muscle need more oxygen to convert into energy to which the heart
compensates and pumps faster to get more blood flowing to our bodies.
• In OT, vital signs such as pulse rate is important to assess if client is physically healthy and capable enough to
perform actiities. It serves as a basis for us to compare, assess, and monitor the client’s condition as the sessions
progress. Also assess the client’s health condition whether there are heart issues or not to make interventions
that are suitable for client without compromising their health.

Circulation
• Normal bp: 120/80 mm/Hg
• Sphygmomanometer
o Bulb to pump air to cuff
o Valve to control deflation
o Tube
o Monameter to measure the pressure in mmHg
o Cuff to hold the bladder around arm during measurement
o Bladder/inflatable bag to compress the arm and occlude the artery
• Stethoscope
o Chestpiece
o Diapgragm for buffer
o Stem connects chestpiece to tubing
o Headset is metal portion
o Ear tubes connects headset and ear piece
o Ear piece

Arterial blood pressure

• From supine to sitting to standing = BP increases bc pressure is needed so brain and heart arteries can continue
to receive blood, nutrients, oxygen
• Valvasa maneuver = lower cardiac output
o a breathing method that slows the heart and can be used to help diagnose a problem with the
autonomic nervous system

Venous valves
• Rubber torniquet above elbow can help us locate the swelling walves.
• First finger presses on the distal part of the vein and Second finger presses forward to empty the vein = vein
flattened
• When removed, vein protuded again like usual and went back to normal
• Venous valves prevent backflow of blood to promote easier flow of blood to heart against the force of gravity

Ischemic Pain

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• Vascular insuffering and burning pain after being relieved from an uncomfortable position
• Forearm flat on surface while lifting 1kg until fatigued
• Without cuff = longer duration, wrist hurt due to gravity, movements are constrained since only the wrist is free
• With cuff = shorter duration, constrained blood flow, can’t move since it hurts
• When removed = increasing dull-feeling pain, fatigued

Blood physiology
• Type A = clumps in anti-a seruym
• Type B = clumps in anti-b serum
• Type AB = clumps in both serums
• Type O = no reaction
• Anti serums provide passive immunnity against diseases where it binds to antibodies to the antigens and
stimulate the immune system to carry out a stronger immune response

Clot formation process

1. Damaged blood vessel lining triggers the release of clotting factors (pathrombin,thrombin, fibrinogen, fibrin)
2. Formation of activated sticky platelet plug for vasoconstriction to limit blood flow
3. Development of clot as fibrin strands adhere to the plug to form an insoluble clot

Pulmonary Physiology

Lung Volume
Tidal Volume (TV): 500 ml
Inspiratory Reserve Volume (IRV): 1.9 – 3.3 liters
Expiratory Reserve Volume (ERV): 0.7 – 1.2 liters
Residual Volume (RV): 1.1 – 1.2 liters
Lung Capacities
Vital Capacity (VC): 3.0 – 4.0 liters
Inspiratory Capacity (IC): 3.5 liters
Functional Residual Capacity (FRC): 2.2 – 2.5 liters
Total Lung Capacity (TLC): 4.2 – 6 liters

Spirometry
• Purpose: diagnose and monitor lung conditions by measuring how much are you can forcibly breathe out using a
sprometer machine attached by a cable to a mouthpiece
• Preparations: no smoking, drinking, eating, tight clothes, exercise, medications
• Rationale: diagnose asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect
breathing. Spirometry may also be used periodically to monitor your lung condition and check whether a
treatment for a chronic lung condition is helping you breathe better
• Procedure: closed nose; take a deep breath and hold it in and then exhale into the breathing mask; repeated for
consistent results and use highest value as final result
• Forced Vital Capacity (FVC) = >80% when normal and <80% when abnormal
• Forced Expiratory Volume (FEV) = >80% when normal and <80% when abnormal

Regulation of Respiration
• Procedure: hold breath after inspiration/expiration
• After quiet inspiration > quiet expiration > quiet inspiration in paper bag > inspiration after exercise
• CO2 as a point of reference
• leads to acidosis bc holding breath keeps CO2 in and depends on balance of Co2 and O2
• There is still reserve O2 in lungs doing gas exchange so Co2 level is not dangerous yet to lead acidosis
• Paperbag = exhaled Co2, also inhaled Co2
• After exercise, might be both acidosis and alkalosis; faster expel of Co2 and build up of acidosis; fast HR and
respiration, fast expel of CO2 for alkalosis

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