Midterms - Nursing (1st sem)

ANATOMY & PHYSIOLOGY 


muscles

SPECIAL SENSES eyelids (upper and lower; not straight)

eyelashes

GENERAL SENSES OF TOUCH

aka cilia

found at the border of the eyelids

temperature
curled outward

pressure
medial canthus / commissure (where the 2
pain
eyelids meet)

responsible for almond shape of the eye

NOTE!! it also involved proprioceptors palpebral ssure

(musculoskeletal systems)
space between the upper and lower eyelids

becomes the basis for physical

SPECIAL SENSES assessments

to determine SYMMETRY of the face

these are important when administering

smell

ophthalmic medications

taste

sight
MEIBOMIAN GLAND
hearing

equilibrium (balance) - related to hearing

aka TARSAL GLANDS

modi ed sebaceous gland = produce oil

EYE AND VISION to lubricate the eye

prevent the eyelids from sticking together

1 inch or 2.5cm
if they dry up, you can’t open your eyes

you can only see 1/3 of it (anteriorly)

the 2/3 are hidden behind

CILLIARY GLANDS
70% of all sensory receptors are in the eyes

each eye has over 1 million nerve bers

“cilliary” = found in between your eyelashes

modi ed sweat glands

[protection for the eye]

produce white-ish secretions

most are enclosed in a bony orbit (whole in

where “muta” is found

our skull)

cushion of fat surrounds most of the eye

if there’s too much fat, the eye may be CONJUNCTIVA

pushed forward - HYPOTHYROIDISM /
GOITER
membrane that lines the eyelids

covers the eyelids

ACCESSORY STRUCTURE OF THE EYE connects to the surface of the eye

SECRETES MUCUS for lubrication

[divisions]

1. Bulbar conjunctiva
lining under the eyelids

2. Palpebral conjunctiva
covers the white of your eye

found in palpebral ssure

IF INFECTED!! = conjunctivitis

in amed

pink eyes ; layman’s terms = sore eyes

presence of bacteria/virus

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LACRIMAL APPARATUS

produces TEARS

ush into the eyeballs

ow into the canals

go into lacrimal sac - to nasolacrimal duct -

then to the nasal cavity

[FUNTION]
has rectus and oblique muscles

properties of lacrimal uid

uses the cranial nerves - 3, 4, 6

dilute salt solution

LR6 (SO4)

contains antibodies and lysozyme - can lateral rectus - cranial nerve # 6 (Abducens)

destroy bacteria (have protective function)

superior oblique - cranial nerve #4
protects, moistens, and lubricates the eye
(Trochlear)

empties into the nasal cavity

[Rectus Muscle] - 4
lateral

1. Lacrimal Gland medial

produces lacrimal uid

superior

found lateral upper portion of the eye

inferior

2. Lacrimal Canals turns MEDIALLY

drains lacrimal uid from eyes

[Oblique Muscle] - 2
NOTE!! canaliculi = small canals
superior

inferior

have opposite e ect

LACRIMAL SAC
if rectus is inferior, oblique is superior

moves LATERALLY

provides passage for lacrimal uid towards nasal

cavity

where tears would pass through

STRUCTURE OF THE EYE
[tunic] - layer of our eye

we have 3 layers

NASOLACRIMAL DUCT
AND!! 2 chambers (anterior & posterior)

contains humor uid

emits lacrimal uid into nasal cavity

helps maintain the shape of the eye

explains why when we cry, the tears come out

from the nose
Fibrous tunic
and can also cause nasal congestion
outside layer

Choroid tunic
NOTE!! your eyes are connected to the respiratory middle layer

system through the nasolacrimal duct

Sensory tunic
if you contaminate your eyes, it may lead to inside layer

the respiratory system

EXTRINSIC EYE MUSCLES

muscles attached to the outer surface of the eye

produce eye movements (right, up, down, left)

EXTRAOCULAR MUSCLES

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phagocyte (engulf dead cells and receptors)

FIBROUS TUNIC storage for VITAMIN A

contains receptor cells - PHOTORECEPTORS

Sclera Rods

WHITE CONNECTIVE TISSUE layer

Cones

seen anteriorly = “white of the eye”

signals pass from photoreceptors through a two-
thick
neuron chain
Cornea Bipolar neurons

TRANSPARENT (so that light can pass Ganglion neurons

through)
signals leave the retina toward the brain
seen at the center portion of the sclera
through the OPTIC NERVE

repairs itself easily

serves as a “window”
[ ow of signal]

have many nerve endings (pain bers)

1. we see a stimulus (start of the signal)

reason why when we touch the inner 2. passes through the two-neuron chains

portion of our eye, it’s painful and we 3. then passes through the photoreceptors

blink - to PROTECT the eye

4. then to the optic nerve

only human tissue that can be transplanted 5. to the brain (for interpretation)

w/o fear of rejection

bec. it’s not easily reached by the

immune system since cornea doesn’t
have much blood supply

MOST EXPOSED

CHOROID LAYER

aka “vascular layer”

blood-rich nutritive tunic

most POSTERIOR PORTION / REGION

has dark pigments that prevents light from

scattering
NEURONS OF THE RETINA AND VISION
absorbs light

RODS
Ciliary body
smooth muscle
most found toward the EDGES of the retina

attached to a ligament - Ciliary zonule

allow dim light vision & peripheral vision (even
Iris while looking forward, you could see to the side )

pigmented layer that gives EYE COLOR

perception is all in GRAY TONES

more pigment - darker color

esp. when you enter in cinemas, you can’t
pupil = rounded opening in the iris (the see any color, but you only see the color
center area of the iris)
gray

serves as the diaphragm

for night vision
regulate entry of light
if it’s blocked, you will have a problem from night
if too hot, our pupils shrink and our vision = “night blindness”

eyelids close

if its too dark, pupils will become larger

CONES

allows for DETAILED COLOR VISION - blue, red,

SENSORY TUNIC - RETINA
green

densest in the center of the retina

extended anteriorly up to the axillary body

Fovea Centralis

outer layer is pigmented (absorbs light)

area of retina only w/ cones; no rods

inner layer is a neural layer (lots of receptors)

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responsible for day vision and color vision
reabsorbed into venous blood though the canal
we have a CLEAR IMAGE
of Schlemm
also used for focusing
[CANAL OF SCHLEMM]
better visual acuity
aka scleral venous sinus canal

no photoreceptor cells are @ the optic disk

drains the aqueous humor

blind spot = when we can’t see the object helps maintain intraocular pressure

anymore
located between the sclera and cornea
if the pressure in here is high, our eyes become
[CONE SENSITIVITY]
hardened = GLAUCOMA - can lead to blindness

cones = red, blue, or green

hypertension of the eye

sensitive to di . wavelengths (depending on

the color)

“color blindness” VITREOUS HUMOR

when you lack a certain type of cone

occurs usually in males; women are carriers located in the posterior chamber of the eye

only (X-linked)
GEL-LIKE SUBSTANCE behind the lens

keep the eye from collapsing (contains the

shape)

lasts a lifetime & isn’t replaced

LENS ACCOMMODATION

“accommodation” = ability of eye to focus on

close objects

light must be focused to a POINT ON THE

RETINA for optimal vision

eye is set for DISTANCE VISION (over 20 ft

away)

the lens must change shape to focus for closer

LENS objects

it will adjust

Biconvex crystal-like structure

held in place by a suspensory ligament (CILIARY
ZONULE) attached to the ciliary body

strings that keep it in place

lens are capable of bending - to adjust the entry

of image to our eyes

if it’s hardened (CATARACT), we cannot see

INTERNAL EYE CHAMBER FLUIDS

AQUEOUS HUMOR

WATERY FLUID found in between the lens and NOTE!! the image will be bent so that it will all be
cornea
directed to the focal point - to see the image
can be replaced
clearly

similar to blood plasma

helps maintain INTRAOCULAR PRESSURE

pressure inside the eyes

provide nutrients for the lens and the cornea

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the image formed at the retina is a result of

LIGHT BENDING ACTIVITY
NOTE!! your eyesight is being interpreted in the
other side of the brain

[why is it inverted?]
right side is interpreted in the left side and
bec. it moves from left to right & right to left
vice versa

when it reaches the eye, it’s upside down & (ex) what you see in your right eye crosses
smaller
to the optic chiasma to reach the other side
it can be accommodated unless there are of the brain

abnormalities (near-sighted or far-sighted)

involves the structure of the eyeball

[ ow for eyesight interpretation]
1. light enters in the right eye (ex)

right eye - lateral aspect (half only)

NEARSIGHTEDNESS 2. pass through the optic chiasma

3. pass through optic tract

aka “myopia”
4. then to both the lateral & medial sides of the
have a LONGER EYEBALL
neurons in the thalamus (forms the optic
you have to bring the object closer to make it radiation)

reach the focal point

object will pass through the ganglion (rods and
cones then to the optic nerve) cells & the bipolar
cells

then it will go to the optic tract, then optic

radiation, then to the occipital lobe for
interpretation

OPTIC TRACT

FARSIGHTEDNESS refers to ber tracts (they can either cross or stay

on the same side)

aka “hyperopia” sends signal to the VISUAL TRACTS (found in

SHORTER EYEBALL
occipital lobe)

have to move the object farther to make it reach

the focal point NOTE!! we have a binocular vision

what we see in our right eye can be

interpreted by BOTH the right and left brain

“hemianopia”
loss of visual eld on one side

[ex] when one side of their body is

paralyzed, they can’t use that side of their
eyes

they can only use one side of your eyes

EMMETROPIC EYE

normal eye

VISUAL PATHWAY
photoreceptors of the retina

optic nerve

optic nerve crosses at the OPTIC CHIASMA /

OPTIC CHIASM

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EYE REFLEXES ANATOMY OF THE EAR

internal muscles are controlled by the [divided into 3 areas]

AUTONOMIC NERVOUS SYSTEM

outer (external) ear

bright light = pupils constrict (action of middle ear

radial & ciliary muscles)

inner ear

viewing close objects causes

accommodation

external muscles control eye movement to follow THE EXTERNAL EAR

objects

viewing close objects causes CONVERGENCE involved in hearing only

(eyes moving medially)

[structures]

eyes will move towards the center

1. Pinna (auricle)
BUT!! eyes cannot move laterally
2. External Auditory Canal / “” Acoustic
Meatus
pupillary re ex

when there’s bright light, pupils will constrict

Tympanic Membrane / Eardrum
when the object is near (accommodation), separates the outer ear from the middle ear

you can still focus bec. our eyes adjust

look to a farther place, then place an

object in front of you, you’ll still be able
to focus

IPSILATERAL

when you separate your right and left eyes, the

eye that will receive the light will constrict

ON THE SAME SIDE

CONTRALATERAL
PINNA
even though it’s not the eye that receives the
light, it still constricts (bec. it’s automatic)
for COLLECTING SOUND WAVES

ON THE OPPOSITE SIDE

EXTERNAL AUDITORY CANAL

THE EAR
NARROW CHAMBER found in the temporal
receptors = MECHANORECEPTORS

bone
mechanical receptors

lined w/ skin

inside the ear, there are uids that need to be

CERUMINOUS (wax) GLANDS are present

stirred/move to stimulate the receptors

wax = cerumen

di . organs house receptors for each sense

traps foreign material - for protection

end at the tympanic membrane/eardrum

[houses 2 senses]

pearly gray in color

hearing

should be impact - w/o holes

equilibrium (balance)

once the sound waves are matched by the

eardrums, it will CAUSE A VIBRATION in the
membrane

around 1in long & 1/4 in wide

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since it’s bulging, it will cause pain

THE MIDDLE EAR / TYMPANIC CAVITY [how to release the pressure?]

in an airplane, you would yawn or chew

AIR-FILLED cavity within the temporal bone
smth to equalize the pressure

only involved in the sense of hearing

has 2 tubes associated w/ the inner ear

THE INNER EAR / BONY LABYRINTH

the opening (oval window & round window)
from the auditory canal is covered by the
tympanic membrane
bony labyrinth = osseous labyrinth

found between the middle and inner ear

includes sense organs for hearing & balance

the auditory tube / pharyngotympanic tube lled w/ PERILYMPH

connecting the middle ear w/ the throat

has uid inside

allows for EQUALIZING PRESSURE during it’s like plasma

yawning / swallowing
there’s another membrane (membraneous
when we yaws, it’s painful to the ears labyrinth) within the prilymph

bec. there’s a di . between the inside the membraneous labyrinth is

pressure inside and outside of the ear
known as ENDOLYMPH

collapsed
where the organ of corti is found

[children] - horizontal; prone to form otitis located within the temporal bone

media during feeding

reason why children shouldn’t be fed maze of bony chambers within the temporal
while they are lying down - may ow to bone

the ear and cause infection

treated through myringotomy - insert [divisions of the inner ear]

a tube
cochlea
snail like portion; spiral

[oval window] - top portion

pea sized

[round window] - bottom portion vestibule

center of the cochlea

semicircular canals

BONES OF THE TYMPANIC CAVITY

THE ORGANS OF HEARING
smallest bones of the body

[there are 3 bones]

Malleus (hammer)
ORGAN OF CORTI
from the external ear

Incus (anvil)
located within the cochlea

Stapes (stirrip) receptors = HAIR CELLS on the basilar

membrane

NOTE!! movement of these bones are initiated by gel-like tectorial membrane is capable of
the eardrums - since they’re attached to it
bending hair cells

it starts from the malleus, then to the incus, COCHLEAR NERVE is attached to the hair cells

then to the stapes

transmits nerve impulses to auditory
from the stapes, it will proceed to the oval cortex on temporal bone

window (located superiorly)

vibrations from the eardrum move to the malleus

these bones transfer sound to the inner ear

NOTE!! pressure in the middle ear and outer ear is

not equal = lesser vibrations

can cause bulging of the eardrum inward or

outward

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MECHANISMS OF HEARING STATIC EQUILIBRIUM

vibrations from sound waves move the tectorial MACULAE

membrane macula - singular

hair cells are bent by the membrane

receptors in the vestibule

action potential starts in the cochlear nerve

report on the position of the head (in
the impulse will be transported to the relation to gravity)

temporal area for auditory interpretation

helps us to KEEP OUR HEAD ERECT &
HIGH-PITCH stimulates the shorter hair maintain that speci c position

cells (close to the oval window)

vestibular nerve is involved (portion of
LOW-PITCH sounds stimulate the longer vestibulocochlear nerve of the cranial
hair cells (near the oval window)
nerve)

continued stimulation can lead to ADAPTATION

vestibular portion = balance; cochlear
when there is continued stimulation, the nerve = hearing

send info. via vestibular nerve

auditory receptors will stop responding to

signi cant part of the ear for swimmers -
them - making the person unaware

help them determine the direction upwards

[ex] if may motor na sign daan, halos di mo

na say mapansin

for STRAIGHT LINE MOVEMENT

[ANATOMY OF THE MALUCAE]

NOTE!! sense of hearing is the last to fade at death

hair cells are embedded in the OTOLITHIC
& it’s the rst to return when we wake up

MEMBRANE

you can still talk to the dead or comatose

jelly-like substance w/ tiny stones

person

otoliths

tiny stones

made up of calcium

oat in a gel around the hair cells

causes the movement of the hair cells

POSITIONING!!

movements cause otoliths to bend the hair

cells

would send a signal to the brain (esp. the

cerebellum) that the head is not held at rest

balance would be acquired through

REPOSITIONING THE HEAD back to its normal
ORGANS OF EQUILIBRIUM
erect position

receptor cells are in 2 structures

vestibule

semicircular canals

[has 2 functional parts]

static equilibrium

dynamic equilibrium

NOTE!! equilibrium receptos = VESTIBULAR

APPARATUS

monitors the 2 types of equilibrium

the otoliths are moving towards the front

it will realize that something is wrong and

will immediately give a signal to bring it
back to the original position (to maintain
balance)

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for it to be smelled, it should rst mix
DYNAMIC EQUILIBRIUM with mucus

CRISTA AMPULLARIS
impulses are transmitted via OLFACTORY
receptors in the semicircular canals
NERVE

dilated / enlarged portion

interpretation of smells is made in the cerebral
tuft of hair cells
cortex

scapula (gelatinous cap)

covers the hair cells

responds to the angular / rotational OLFACTORY EPITHELIUM

movements

for ROTATIONAL MOVEMENT

action for angular head movement

the cupula stimulates the hair cells

impulse is sent via the vestibular nerve to

the cerebellum

[how does it work?]

it moves in an opposite
direction

like in a motorcycle
movement should be MOVING UP for it to be
when you go right, you determined

bend to the left side so olfactory never are made up of bundles of

you won’t fall
OLFACTORY FILAMENTS

if the direction of body NOTE!! the smell is related to the limbic system
movement is to the right, (emotions) & memory

the cupula moves to the smell also has adaptation !!

left
at a certain point, you don’t get to notice
the smell anymore

SENSE OF TASTE
CHEMICAL SENSES - TASTE & SMELL
taste buds houses the receptor organ

both senses use CHEMORECEPTORS

taste = taxare (latin word)

stimulated by chemicals in solution

means to touch, estimate, and judge

taste has 4 types of receipts

[location of taste buds]

most are on the tongue

smell can di erentiate a large range of

soft palate (roof or our mouth

chemicals

cheeks

taste & smell COMPLIMENT EACH OTHER &

respond to many of the same stimuli

sometimes, if you can’t smell, you can’t THE TONGUE AND THE TASTE
taste either

tongue is covered w/ projections called

OLFACTION - THE SENSE OF SMELL PAPILLAE

[types of papillae]

Filiform papillae

olfactory receptors are in the roof of the nasal

sharp w/o taste buds

cavity (cranial nerve #1)

Fungiform papillae

neurons here have LONG CILIA rounded w/ taste buds

chemicals must be dissolved in mucus for most abundant

detection
Circumvallate / Vallate papillae

large papillae w/ taste buds

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taste buds are at the side of the papillae
NOTE!! our tongue is very exposed; very prone to
forms the “V” portion of the tongue (pointing damage

anteriorly)
BUT!! our tongue can easily produce new
taste buds are found on the SIDES OF THE cells (in 7-10 days, basalt cells are
PAPILLAE
produced)

TASTE SENSATIONS

SWEET RECEPTORS

sugars

saccharine

some amino acids

located anteriorly

SOUR RECEPTORS

acids

STRUCTURE OF TASTE BUDS located posteriorly

BITTER RECEPTORS

GUSTATORY CELLS are the receptors

alkaloids

have gustatory hairs - long microvilli

located posteriorly

pores in our taste buds

bitter = taste common in poisons
hairs are stimulated by chemicals (protection for our part)

DISSOLVED IN SALIVA
SALTY RECEPROS

must be dissolved in saliva rst before it metal ions

can be detected

NOTE!! sensory input are processed in the

impulses are carried to the GUSTATORY hypothalamus (for water-receptors)

COMPLEX by several cranial nerves bed. taste

buds are found in di . areas
[additional]

UMAMI

[INTERPRETATION AREAS]
for delicious food

facial nerves
elicited by amino acids glutamate &
for the anterior 2/3 of the tongue
responsible for the bee ng taste of steak

glossopharyngeal nerve
in the pharynx area

posterior 1/3 of the tongue

also guides the intake of protein

vagus nerve

for the taste buds in the soft palate and NOTE!! we also have ate receptors in our tongue &
cheeks
is also located ion the pharynx

DEVELOPMENTAL ASPECTS OF THE

SPECIAL SENSES

found early in embryonic development

eyes are OUTGROWTHS OF THE BRAIN

all special senses are functional at birth

gustatory hairs are connected to the sensory

nerve bers - stimulate the 2 areas

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