ANATOMY and PHYSIOLOGY

Darwin Z. Angcahan, RRT, MHPEd, PhDc

INTRODUCTION
Anatomy- Scientific discipline that investigates body structure and their relationship to one another.

● Gross or microscopic
● Microscopic
● Developmental

Physiology – deals with the processes or functions of living things.

 considers the operation of specific organ systems.

Six levels of Organization

1. Chemical level- interaction among atoms and their combinations into molecules
(CHON, P, Ca, S, Mg, Fe, Cl

Two (2) familiar molecules

a. DNA
a. Glucose (blood sugar)

1. Cellular level-molecules from organelles i.e, nucleus and mitochondria w/c make up the cells.
2. Tissue level- similar cells and surrounding materials w/c make up the tissue (ex. Epithelial,
connective, muscle and nervous)
3. Organ level- different types of tissues that are joined together, combined to form an organ
system
4. Organ system level- consists or related organs with a common function (ex. Organs such as the
urinary baldder and kidneys—make up the organ system)
5. Organism- any living thing considered as a whole

Cell organelles and their functions (MITOSIS)

Cell- basic unit of life

 Cell membrane/wall- fluid mosaic
model (bilipid, phospholipid)
-surrounds the cell
-regulates the entrance and exit of
external fluids
Cytoplasm- gel like substance found
inside the cell
-cushions and protects internal
organelles
-contains “cytosol”, a liquid portion of
the cell- contains water, dissolved
solutes and suspended particles
Nucleus- houses the majority of DNA of
a cell.
-BRAIN of all cellular activities
-chromosomes, single molecule of DNA with several proteins.
-contains thousands of hereditary units called “genes” which control most aspects of cellular
structure and function
Ribosomes- carries out manual labor in the form of protein synthesis for nucleus
- Brings together raw ingredients such as RNA
- Site of ribosomal subunit assembly (RSA)—nucleoli
Endoplasmic reticulum- highway and road system
SER- storage of Ca, fatty acids and proteins
RER- lipid synthesis and metabolic processes

Golgi apparatus- ships goods created by ER and ribosomes

- Post office
Mitochondria- site of cellular respiration—conversion of biochemical energy from nutrients to
ATP
- Site of ATP
- -power plant of the cell
Lysosomes- digestive sacs that breaks down macromolecules in the process of hydrolysis—
chemical process of decomposition
-waste disposal and recycling

Cilia-movement of fluids
Flagella- movement of the entire cells

MEIOSIS- reproductive cell division

Planes and Sections

Parts of the body relative to planes, imaginary flat surfaces that pass
through the body parts

a. sagittal plane- divides the body or an organ into right and left
sides.
b. midsagittal plane or a median plane- divides it into equal right
and left sides
c. parasagittal plane- divides the body or an organ into unequal
right and left sides
 d. frontal or coronal plane -divides the body or an organ into anterior (front) and posterior (back)
portions. transverse plane/cross-sectional or horizontal plane - divides the body or an organ into
superior (upper) and inferior (lower) portions
Note: Sagittal, frontal, and transverse planes are all at right angles to one another
e. oblique plane- by contrast, passes through the body or an organ

Body Cavities -are spaces within the body that help protect, separate, and support internal organs.

1. Thoracic cavity- surrounded by the rib cage

-separated from the abdominal cavity by muscular diaphragm= mediastinum

Serous membranes- lines the trunk cavities and covers organs of these

a. Visceral
b. Parietal

Three (3) serous membranes

a. Pericardial cavity-heart
b. Pleural cavity-lungs

2. Abdominal cavity- bounded by abdominal muscle

● houses the stomach, liver, spleen, pancreas and kidneys

Pelvic cavity- small space enclosed by the bones
-urinary bladder, part of the large intestine, internal reproductive organs
Abdominopelvic- peritoneal cavity

Abdominopelvic Regions and Quadrants

 I. INTEGUMENTARY SYSTEM

- aka skin or cutaneous membrane

- largest organ
- composed of skin, hair, oil and sweat glands, nails and
sensory receptors
- serves as protection (in the form of keratin)
- thermoregulation: evaporation and sweating
- transportation of drugs: topical, transdermal
Vit. D synthesis (calcitriol, most active form of vitamin D)=
aides in Ca absorption
- Blood reservoir
- Cutaneous (tactile) sensations: touch, pressure,
vibration, tickling and PAIN ☹

Two (2) layers

Epidermis- outermost layer of the skin

Four (4) types of cells

1. Melanocytes- produces melanin ( contributes to skin color; protects skin from UV light)
2. Keratinocytes- produces keratin protein (protects skin and underlying tissues from abrasion,
heats and chemicals; release water repellant sealant that decreases/inhibits water entry)
3. Langerhans cells- epidermal dendritic cells
- Participates in immune responses
- Destroys invading microbes
4. Merkel cells- responsible for touch sensations/receptors

Five (5) layers of epidermis

1. Corneum-final product of keratin process, comprise of

dead skin
2. Lucidum- present in thick skin i.e., palms, soles, finger
tips
3. Granulosum- contains keratohyalin granules which
binds keratin filaments together
4. Spinosum-strength and flexibility to the skin
5. Basale/germinativum- new cell formation

Dermis- contains major blood vessels

- Thicker innermost layer

Two (2) sublayers

1. Reticular layer-loose connective tissue collagen and elastic fibers; deeper portion of dermis
2. Papillary layer- responsible for skin structures
 i) Mechanoreceptors
a. Free-nerve endings – PAIN
a. Meissner corpuscle-light touch, vibration
b. Pacinian corpuscles-touch, deep pressure
c. Merkel’s disk- touch, static pressure
d. Ruffini’s corpuscles- stretching of skin, heat
e. Krause-end bulbs- cold

ii) Appendages/ Accessory structures of the skin—hair, skin glands, and nails— develop from
the embryonic epidermis.

A. Hairs- growths of epidermis composed of dead, keratinized

epidermal cells
- present on most skin surfaces except the
palms, palmar surfaces of the fingers, the
soles, and plantar surfaces of the feet.
-

Types of hairs

1. Lanugo- covers the body of the fetus

i. -by the fifth month of development, the follicles produce very fine,
nonpigmented, downy hairs.
2. vellus hairs- present during childhood
- covers most of the body except for the hairs of the eyebrows, eyelashes, and
scalp, which are terminal hairs

A. Nails- plates of tightly packed, hard, dead, keratinized epidermal cells that form a
clear, solid covering over the dorsal surfaces of the distal portions of the digits.

● nail body (plate)- is the visible portion of the nail.

● free edge - part of the nail body that may extend past the distal end of the digit. The free
edge is white because there are no underlying capillaries.
● nail root - portion of the nail that is buried in a fold of skin.
● Lunula- whitish, crescent-shaped area of the proximal end of the nail body
● hyponychium or nail bed- Beneath the free edge is a thickened region of stratum corneum
● secures the nail to the fingertip.
● Eponychium- or cuticle is a narrow band of epidermis that extends from and adheres to the
margin (lateral border) of the nail wall.
 Sweat glands/sudoriferous

1. Eccrine glands- numerous, found all over the body

- Produces 99% of perspiration except lips, soles, palms, glans, penis, labia of
females
2. Apocrine glands- found in the armpits, around the nipples, groin, perianal and perineum
- Body odor

Sebaceous glands- oil glands

- Found in the dermis/ all over the body except palms and soles
- Secretes sebum= a mixture of fats and proteins that prevents drying of skin and
hair

-
II. CARDIOVASCULAR SYSTEM
 Three (3) interrelated components (blood, heart, blood vessels)

A. BLOOD- liquid connective tissue that consists of a cell

Functions:

1. Transportation- O2 from the lungs to the cell body

CO2 from the body cells to the lungs= exhalation
Regulates pH, body temperature, and water content of cells
2. Regulation- circulation of all body fluids
body temperature
3. Protection- clotting: inhibits increased loss from CV after injury
WBC: protects the body against disease= phagocytosis

Saturated w/O2- bright red

Unsaturated- dark red

Components of Blood

1. Blood Plasma- 91.5% of water/solvent and 8.5 % of solutes

-contains plasma proteins- (albumin, globulin, fibrinogen) = Ig/ antibodies, help
attack viruses and bacteria.
2. Formed elements
A. Red Blood Cells (RBC)- contains O2 carrying protein called “hemoglobin”
Hemoglobin= regulation of blood flow and blood pressure; releases
N.O/vasodilation which increases blood diameter
- O2 transport
- Lives about 120 days
- Erythropoiesis-starts in the red bone marrow—precursor cell=proerythroblast
- Rate measured by reticulocyte
- d/o hypoxia or cellular O2 deficiency
 B. WBC/leukocytes- responsible for bacterial ingestion
- Do not contain hemoglobin
- Consists neutrophil and macrophages
- Normal level 10000 Ml
- d/o (increased=leukocytosis; decreased=
leukopenia)

1. Granular leukocytes- contains granules visible under microscope after staining

1.1 Neutrophil- granules do not strongly attract either the acidic (red) or basic (blue)
stain
- “neutral loving” (increased=bacterial infection, vitamin B12 deficiency, SLE;
increased=allergic and parasitic infections, autoimmune diseases)
1.2 Eosinophil- stain red-orange with acidic dyes
-“eosin-loving”(increased= drug toxicity)
1.3 Basophil- stain blue-purple with basic dyes, “basic-loving” (increased=
pregnancy, ovulation, stress; decreased= allergic reactions, hypothyroidism,
leukemia, cancer
2. Agranular leukocytes- not visible under light microscope
2.1 lymphocyte- diagnostic significance in acute viral infections
2.2 monocyte- (increased= bone marrow suppression; decreased= viral or fungal
infection)
C. Platelets (thrombocyte)- platelet plug formation in hemostasis (sequence of responses that
stops bleeding)
- Release chemicals that promote vascular spasm (when artery and arterioles are
damaged, it arranges circularly the smooth mm in their walls and contracts
immediately)
- Inhibits blood loss
- Clotting/coagulation

B.HEART- lies in the mediastinum an anatomical region that extends from the
sternum to the vertebral column, from the first rib to the diaphragm, and between
the lungs.
− inverted cone
Base: directed posteriorly, superiorly to the right
Apex: directed anteriorly, inferiorly to the left
− rests on the diaphragm, near the midline of thoracic cavity

Coverings/ membrane-protects the heart

Pericardium- allows sufficient movement of the heart during rapid contraction

Two (2) main parts

1. fibrous pericardium- (superficial) prevents

overstretching of the heart
2. serous pericardium- thinner, more delicate
membrane
a. parietal (outer)
pericardial space
b. visceral (inner)

pericardial fluid- decreases friction between the layers of

serous pericardium as the heart moves

too little: pericarditis (viral infection, chest pain extending to the left shoulder down to the left arm)

too much: cardiac tamponade (cancer/TB: (+) fluid compression, decreased ventricular filling, decreased
cardiac output, decreased BP, (+) DOB)

3 layers of the Heart wall

1. Epicardium- imparts a smooth, slippery texture to the outermost surface of the heart
− visceral layer of the serous pericardium
− composed of two tissue layers visceral and serous
− composed of mesothelium, fibroelastic tissue, adipose tissue
− contains blood vessels and lymphatics
2. myocardium- wrapped/bundles with connective tissue (endomysium and perimysium)
− composed of muscle tissue
− pumping action of the heart
− d/o myocarditis (viral infection, RHF
3. endocardium- innermost layer
− provides smooth lining for chambers and valves
− d/o endocarditis, bacterial infection that involves valves

Chambers of Heart
− 2 superior blood receiving chambers (atria or entry halls)
− 2 inferior pumping chambers (ventricles)

Right border Left border

Right Atrium- receives blood from three veins: Left atrium- receives blood from the lungs
the superior vena cava, inferior vena cava, and through four pulmonary veins
coronary sinus

3 openings: 4 openings
Pulmonary veins:
1. SVC- receives blood from UE (head and
neck) 2R
2L
Only veins that carries oxygenated blood
 2. Coronary sinus (main venous drainage of
the heart) most of the deoxygenated
blood from the myocardium drains
3. IVC- drains venous blood Blood passes from the left atrium into the left
ventricle through the bicuspid (mitral) valve.
Blood passes from the right atrium into the right
ventricle through a valve that is called the
tricuspid valve because it consists of three
leaflets or cusps. It is also called the right
atrioventricular valve.

Interatrial septum- oval

depression= fossa ovalis remnant
of foramen ovale of fetal heart
-closes after birth
*SA node-pace maker (SA node cells do not have a stable resting potential. Rather, they repeatedly
depolarize to threshold spontaneously. The spontaneous depolarization is a pacemaker potential. When
the pacemaker potential reaches threshold, it triggers an action potential)
*AV node-secondary pacemaker

R ventricle L ventricle
trabeculae carneae (right ventricle contains a series of ridges formed by raised bundles of cardiac
muscle fibers) Chordae tendinae (cusps of the tricuspid valve are connected to tendonlike cords)
interventricular septum (right ventricle is separated from the left ventricle by a partition)
Blood passes to the right ventricle via tricuspid Blood passes to the left ventricle via mitral valve
valve to the to the
Pulmonary/ic valve via Aortic valve
Connected to pulmonary trunk Aorta and systemic arteries
R and left pulmonary arteries
Artery= away blood from the heart
Systemic and pulmonary circulations

Operation of the Atrioventricular Valves

When an AV valve is open,

the rounded ends of the
cusps project into the
ventricle. When the ventricles
are relaxed, the papillary
muscles are relaxed, the
chordae tendineae are slack,
and blood moves from a
higher pressure in the atria to
a lower pressure in the
ventricles through open AV
valves.
When the ventricles contract, the pressure of the blood drives the cusps upward until their edges meet
and close the opening. At the
 **This prevents the valve cusps from everting (opening into the atria) in response to the high ventricular
pressure. If the AV valves or chordae tendineae are damaged, blood may regurgitate (flow back) into the
atria when the ventricles contract.

Operation of the Semilunar Valves

− aortic and pulmonary valves are

known as the semilunar (SL) valves
half-lunar moon-shaped
− each cusp attaches to the arterial
wall by its convex outer margin. The
SL valves allow ejection of blood
from the heart into arteries but
prevent backflow of blood into the
ventricles.
− When the ventricles contract, pressure builds up within the chambers. The semilunar valves
open when pressure in the ventricles exceeds the pressure in the arteries, permitting ejection of
blood from the ventricles into the pulmonary trunk and aorta. As the ventricles relax, blood
starts to flow back toward the heart. This backflowing blood fills the valve cusps, which causes
the free edges of the semilunar valves to contact each other tightly and close the opening
between the ventricle and artery.

The conduction system of the heart

− Autorhythmic fibers in the SA node, located in the
right atrial wall
(a) act as the heart’s pacemaker, initiating cardiac action
potentials
(b) that cause contraction of the heart’s chambers

Cardiac action potentials propagate through the conduction

system in the following sequence:

1. Cardiac excitation normally begins in the sinoatrial (SA) node

2. action potential reaches the atrioventricular (AV) node
3. From the AV node, the action potential enters the
atrioventricular (AV) bundle (also known as the bundle of
His, pronounced HIZ). This bundle is the only site where
action potentials can conduct from the atria to the ventricles
4. After propagating along the AV bundle, the action potential
enters both the right and left bundle branches. The bundle
branches extend through the interventricular septum toward
the apex of the heart
5. Purkinje fibers rapidly conduct the action potential beginning at the apex of the heart upward to
the remainder of the ventricular myocardium. Then the ventricles contract, pushing the blood
upward toward the semilunar valves.
Cardiac output=amount of blood pumped by LV/min
CO= SVxHR

Cardiac cycle

a) Systole= contraction/depolarization-
b) Diastole= relaxation/repolarization

Electrocardiogram

Atrial
P systole T
contraction

SA
Q S
S1 LUB S2 DUB

seconds
SA-action potential
P-atrial depolarization
QRS- ventricular depolarization (conduction time)
T- ventricular repolarization

Important indications during ECG abnormalities

Larger Pw= atrial enlargement

Larger Qw= MI
Larger Rw= enlarged ventricle
Flatten Tw= insufficient O2 supply
Increased Tw= hyperkalemia
Lengthened QTw= due to MI
Elevated STw= Acute MI

Heart sounds
S4- atrial gallop
S1-lub
S2-dub
S3-ventricular gallop (not loud enough to be heard)
 II. NERVOUS SYSTEM

− smallest, most complex

− Communication and regulation of most body tissues
− Regulates body activities through nerve impulses
together with endocrine glands

Functions:

Sensory/ Afferent (SA): detects internal stimuli

Motor/ efeferent (ME): carries information from the brain towards
spinal cord

NS Organization

NS

CNS PNS ANS

Brain SC CN SN SNS PNS

− comprises two types of cells—neurons and

neuroglia.

Neuron

Sensory: receptors/afferent
Motor: effectors

− Like muscle cells, neurons (nerve cells) possess

electrical excitability
− the ability to respond to a stimulus and convert
it into an action potential
− A stimulus is any change in the environment that
is strong enough to initiate an action potential.
An action potential (nerve impulse) is an
electrical signal that propagates (travels) along
the surface of the membrane of a neuron
 Three (3) parts

1. cell body- known as “perikaryon”

- contains a nucleus surrounded by cytoplasm that includes typical cellular organelles
such as lysosomes, mitochondria, and Golgi complex
- contain free ribosomes and prominent clusters of rough endoplasmic reticulum called
Nissl bodies
- ribosomes are the sites of protein synthesis
- used to replace cellular components, as material for growth of neurons, and to
regenerate damaged axons in the PNS
2. dendrites- Most neurons have two kinds of processes: multiple dendrites and a single axon
− receiving or input portions of a neuron
− plasma membranes of dendrites (and cell bodies) contain numerous receptor sites for
binding chemical messengers from other cells
3. axon- propagates nerve impulses toward another neuron, a muscle fiber, or a gland cell

Neuroglia

1. Astrocytes- star shaped cells have many processes and are the largest and most numerous of the
neuroglia
− contains microfilaments that give them considerable strength, which enables them to
support neurons
− isolates neurons of the CNS from various
potentially harmful substances in blood by
secreting chemicals that maintain the unique
selective permeability characteristics of the
endothelial cells of the capillaries.
− secretes chemicals that appear to regulate
the growth, migration, and interconnection
among neurons in the brain
− maintains the appropriate chemical
environment for the generation of nerve
impulses
2. Oligodendrocytes- responsible for forming and
maintaining the myelin sheath around CNS axons

myelin sheath- a multilayered lipid and protein covering around some axons that insulates
them and increases the speed of nerve impulse conduction. Such axons are said
to be myelinated

3. Microglia- “phagocytes”
− removes cellular debris formed during normal development of the nervous system and
phagocytize microbes and damaged nervous tissue

4. Ependymal cells- lines the ventricles of the brain and central canal of the spinal cord (spaces filled
with cerebrospinal fluid, which protects and nourishes the brain and spinal cord)
− produces, monitors, and assists in the circulation of cerebrospinal fluid.
 − forms the blood–cerebrospinal fluid barrier

BRAIN
− located inside the skull
− contains 100 billion neurons
− control center for registering sensations, correlating them with one another and with stored
information, making decisions, and taking actions.
− center for the intellect, emotions, behavior, and memory

● brain and spinal cord develop from the ectodermal neural tube.
The anterior part of the neural tube expands, along with the
associated neural crest tissue. Constrictions in this expanded
tube soon appear, creating three regions called primary brain
vesicles: prosencephalon, mesencephalon, and
rhombencephalon
● Both the prosencephalon and rhombencephalon subdivide
further, forming secondary brain vesicles. The prosencephalon,
or forebrain, gives rise to the telencephalon and diencephalon, and the rhombencephalon, or
hindbrain, develops into the metencephalon and myelencephalon.

The various brain vesicles give rise to the following adult structures:

− The telencephalon develops into the cerebrum and lateral ventricles.

• The diencephalon forms the thalamus,
hypothalamus, epithalamus, and third
ventricle.
• The metencephalon becomes the pons,
cerebellum, and upper part of the fourth
ventricle
• The myelencephalon forms the medulla
oblongata and lower part of the fourth
ventricle.

Major Parts of the Brain

1. Cerebrum
2. Diencephalon
3. Cerebellum
4. Brainstem
1. Cerebrum- largest portion of the brain
− “seat of intelligence”
− it provides us with the ability to read, write, and
speak
− make calculations and compose music
− to remember the past and plan for the future; and
to create

Cerebral hemispheres

a. Frontal lobe- only motor lobe

− Thinking brain
− Long term memory; behavior and
personality
− Motor aspect of speech
d/o aphasia= inability to properly
articulate or form words; people
with nonfluent aphasia know what
they wish to say but cannot speak.

Broca’s aphasia Wernicke’s (posterior language) aphasia

(-) speech (+) speech
(+) comprehension (-) comprehension
motor sensory

b. Temporal lobe- sensory lobe

− Sense of hearing
− Austatory or taste; olfactory or smell
− Wernicke’s area (people who suffer strokes in Wernicke’s area can still speak, but
cannot arrange words in a coherent fashion)
c. Parietal lobe- sensory lobe
− “feeling brain”
− Pain, temp, light touch including deep pressure and vibration
− Ability to recognize
− d/o: agnosia- inability to recognize significance of sensory stimuli such as sounds, sights,
smells, tastes, and touch
apraxia: inability to carry out purposeful movements in the absence of paralysis
praxis: ability to perform skill movements
 prosopagnosia - inability to recognize faces, usually caused by damage to the
facial recognition area in the inferior temporal lobe of both cerebral
hemispheres
d. occipital lobe- ocseepital/ vision

Basal Nuclei/ ganglia -deep within each cerebral hemisphere are three nuclei (masses of gray matter)
that are collectively termed the basal nuclei
− Two of the basal nuclei are side-by-side, just lateral to the thalamus
− Cognition of movement (speed of movement, direction and amplitude)
− Maintenance of posture
d/o: tremors (shaking); muscular rigidity (stiffness)

Three (3) parts for movement

1. Globus Pallidus
2. PUTAMEN
3. caudate nucleus

2. Diencephalon

a. Thalamus- sensory relay station

− plays role in maintenance of consciousness.
− Hypothalamus: Controls and integrates activities of
autonomic nervous system
b. Hypothalamus- regulates emotional and behavioral patterns
(together with limbic system)
− feeding and satiety centers (regulate eating), thirst center
(regulates drinking)
− inhibits the ff. (rage and anger, sexual desire- amygdala)
− Controls body temperature (thermoregulation)
Anterior Posterior
Heat loss Heat gain
Decreased body temperature Increased body temperature
(sweating) (shivering)

c. Epithalamus- Consists of pineal gland (secretes melatonin) and habenular nuclei

− M: Dark: contribute to the setting of the body’s biological clock, which is controlled
by the suprachiasmatic nucleus of the hypothalamus. As more melatonin is liberated
during darkness than in light, this hormone is thought to promote sleepiness
− HN: Involves in olfaction and emotional responses to odor

d. Subthalamus- normalize movement

d/o: ballismus= wild/flinging hurling movements
Limbic System- a ring of structures on the inner border of the cerebrum and floor of the diencephalon
that constitutes the limbic system

− Parahippocampus
− Uncus
− Cyngulate gyrus
− Hippocampus
− Amygdala

CEREBELLUM
− Located posterior to medulla and pons
− Small brain
− smooths and coordinates the contractions of skeletal muscles. It also maintains posture and
balance
d/o: Fall; Dysdiodochokinesia: inability to perform alternating movement
ataxia: muscular incoordination
dysmetria: inability to judge distance
(finger nose test: blindfolded, touches the tip of their nose—when they can’t coordinate
movement to sense where their body part is located)

BRAINSTEM

1. Midbrain-controls visual reflexes

− contains several other nuclei, including the left and
right SUBSTANTIA NIGRA (neurons that release
dopamine, extending from the substantia nigra to the
basal nuclei, help control subconscious muscle
activities. Loss of these neurons is associated with
Parkinson disease)
a. Pupillary light reflex-responsible for the constriction of
CN 2 and 3
b. Corneal light reflex- CN5
c. Accommodation reflex

2. Pons- consists of both nuclei and tracts.

− a bridge that connects parts of the brain with one another
− consists of nuclei called

a. pneumotaxic Helps control rate of rhythm

b. apneustic breathing

3. Medulla oblongata- medulla’s white matter contains all sensory (ascending) tracts and motor
(descending) tracts that extend between the spinal cord and other parts of the brain
− Cardiac and respiratory center
− cardiovascular center and the medullary rhythmicity area.
 − regulates the rate and force of the heartbeat and the diameter of blood vessels adjusts
the basic rhythm of breathing
− Besides regulating heartbeat, blood vessel diameter, and the normal breathing rhythm,
nuclei in the medulla also control reflexes for vomiting, swallowing, sneezing, coughing,
and hiccupping. The vomiting center of the medulla causes vomiting, the forcible
expulsion of the contents of the upper gastrointestinal tract

Midbrain- 3,4

Pons- 5,6,7,8

Medulla-
9,10,11,12

SPINAL CORD

− nerve impulse propagation and integration of information

− white matter tracts in the spinal cord are highways for nerve impulse propagation
− gray matter of the spinal cord receives and integrates incoming and outgoing information
Protective Structures

− hard bony skull and vertebral column

− skull encases the brain and the vertebral
column surrounds the spinal cord,
providing strong protective defenses
against damaging blows or bumps.
− meninges, three membranes that lie
between the bony encasement and the
nervous tissue in both the brain and spinal
cord
− a space between two of the meningeal
membranes contains cerebrospinal fluid, a
buoyant liquid that suspends the central
nervous tissue in a weightless environment
while surrounding it with a shock-
absorbing, hydraulic cushion.

Meninges

− three protective, connective tissue coverings that encircle the spinal cord and brain
− spinal cord is also protected by a cushion of fat and connective tissue located in the epidural
space, a space between the dura mater and the wall of the vertebral canal

1. Dura mater- most superficial of the three spinal meninges is a thick strong layer composed of
dense, irregular connective tissue
− forms a sac from the level of the foramen magnum in the occipital bone, where it is
continuous with the meningeal dura mater of the brain, to the second sacral vertebra.
− continuous with the epineurium, the outer covering of spinal and cranial nerve
2. Arachnoid- middle of the meningeal membranes, is a thin, avascular covering comprised of cells
and thin, loosely arranged collagen and elastic fibers.
− called the arachnoid mater because of its spider’s web arrangement of delicate collagen
fibers and some elastic fibers.
− Between the dura mater and the arachnoid mater is a thin subdural space, which
contains interstitial fluid.
3. Pia mater- innermost meninx is a thin transparent connective tissue layer that adheres to the
surface of the spinal cord and brain.
− consists of thin squamous to cuboidal cells within interlacing bundles of collagen fibers
and some fine elastic fibers
− Within the pia mater are many blood vessels that supply oxygen and nutrients to the
spinal cord
Anterior and posterior gray horns divide the white matter on each side into three broad areas:

1. anterior (ventral) white columns

2. posterior (dorsal) white columns
3. lateral white columns

− Each column in turn contains distinct bundles of axons having a common origin or destination
and carrying similar information. These bundles, which may extend long distances up or down
the spinal cord, are called tracts.
− tracts are bundles of axons in the CNS
− nerves are bundles of axons in the PNS Sensory (ascending) tracts consist of axons that conduct
nerve impulses toward the brain
− Tracts consisting of axons that carry nerve impulses from the brain are called motor
(descending) tracts
− Sensory and motor tracts of the spinal cord are continuous with sensory and motor tracts in the
brain

Sensory and Motor Tracts

− anterior corticospinal tract- located in the

anterior white column; it begins in the
cerebral cortex (superficial gray matter of
the cerebrum of the brain) and ends in the
spinal cord
− Nerve impulses from sensory receptors
propagate up the spinal cord to the brain
along two main routes on each side: the
spinothalamic tract and the posterior
column.

Spinothalamic tract

− conveys nerve impulses for sensing pain, warmth, coolness, itching, tickling, deep pressure, and
crude touch
posterior column- conveys nerve impulses for discriminative touch, light pressure, vibration,
and conscious proprioception (the awareness of the positions and movements of muscles,
tendons, and joints)

Two tracts:
a. gracile fasciculus
b. cuneate fasciculus

Two types of descending pathways: direct and indirect

Direct pathways- conveys nerve impulses that originate in the cerebral cortex and are destined to cause
voluntary movements of skeletal muscles

a. lateral corticospinal
b. anterior corticospinal
 c. corticobulbar tracts

Indirect pathways-conveys nerve impulses from the brain stem to cause automatic movements and
help coordinate body movements with visual stimuli

− maintains skeletal muscle tone, sustain contraction of postural muscles, and play a major role in
equilibrium by regulating muscle tone in response to movements of the head
a. rubrospinal
b. tectospinal
c. vestibulospinal
d. lateral reticulospinal
e. medial reticulospinal tracts

Traumatic Injuries

− Most spinal cord injuries are due to trauma as a result of factors such as automobile accidents,
falls, contact sports, diving, and acts of violence. The effects of the injury depend on the extent
of direct trauma to the spinal cord or compression of the cord by fractured or displaced
vertebrae or blood clots.
− most common sites of injury are in the cervical, lower thoracic, and upper lumbar regions.

Depending on the location and extent of spinal cord damage, paralysis may occur:

a. Monoplegia- paralysis of one limb only.

b. Diplegia- paralysis of both upper limbs and both lower limbs
c. Paraplegia- paralysis of both lower limbs
d. Hemiplegia - paralysis of the upper limb, trunk, and lower limb on one side of the body
e. Quadriplegia-paralysis of all four limbs
PNS

Spinal nerves

− 31 pairs of spinal nerves

− 8 pairs of cervical nerves (C1–C8), 12
pairs of thoracic nerves (T1–T12), 5
pairs of lumbar nerves (L1–L5), 5 pairs
of sacral nerves (S1–S5), and 1 pair of
coccygeal nerves
− connected with the spinal cord by a
posterior root and an anterior root. All
spinal nerves contain both sensory and
motor axons (are mixed nerves).
− L4-L5: site of pain

Three connective tissue coverings :

a. endoneurium
b. perineurium
c. epineurium.

Cranial nerves

− 12 pairs of cranial nerves

− part of the peripheral nervous system (PNS)
− special sensory nerves: CN (I, II, and VIII) carry axons of sensory neurons
− associated with the special senses of smelling, seeing, and hearing
− motor nerves: CN (III, IV, VI, XI, and XII) because they contain only axons of motor neurons as
they leave the brain stem
− mixed nerves CN (V, VII, IX, and X) they contain axons of both sensory neurons entering the
brain stem and motor neurons leaving the brain stem

(CN) Function/s Description d/o

1. olfactory se − Sense of smell Anosmia: loss of

smell

2. optic se − Sense of vision Monocular

− 2 fibers (nasal, blindness: one side
temporal) weakness

3. oculomotor mo − Anterior part of the Strabismus: eyes do

midbrain not fix on the same
 − Extraocular mm ptosis: (drooping) of
(movement of eyeballs the upper eyelid,
and upper eyelid) dilation of the pupil,
− Adjusts lens for near movement of the
vision eyeball downward
(accommodation). and outward on the
− Constriction of pupil damaged side, loss
of accommodation
for near vision
Diplopia: double
vision

4. trochlear mo − Passes to superior

oblique
− Smallest/thinnest
− Stupid nerve (arises
from the post)

5. abducens mi − Abduction of the

eyeball (lateral
rotation)
− Passes thru lateral
rectus

6. trigeminal mo − Largest cranial nerve Neuralgia: tearing

− Se: sensation of face pain that lasts for a
− Mo: mastication mm few seconds to a
minute

7. facial mi − Se: 2/3 of taste buds Bell’s palsy:

− Mo: facial expression (paralysis of the
facial muscles

8. vestibulocochlear se − Se: balance in head Vertigo: one’s body

and neck is rotating
− Mo: hearing Nystagmus: mm
incoordination
Tinnitus: ringing in
the ear

9. glossopharyngeal mi − Se: 1/3 of taste buds Agleusia: loss of

− Mo: stylopharyngeus taste
mm

10. vagus mi − Se: pharynx/larynx Vagal paralysis:

interruptions or
 − Mo: smooth mm of sensations from
internal organs many organs

11. Accessory/spinal mo − Mm: SCM, Traps paralysis of the

sternocleidomastoid
and trapezius
muscles

12. hypoglossal mo − Mo: tongue Dysarthria: difficulty

− initiates swallowing, in chewing
taste and speech Dysphagia: difficulty
in swallowing.

Response of Effector Organs to Autonomic Situation

Autonomic Nervous System (ANS)

− interoceptors : which are sensory receptors located in blood vessels, visceral organs, muscles,
and the nervous system that monitor conditions in the internal environment

Sympathetic (fight-or-flight responses) Parasympathetic (rest-and-digest activities)

− increased alertness and metabolic − conserves energy and replenishes

activities in order to prepare the nutrient stores
body for an emergency situation

− Glands or Adrenal medulla- Secretion − No known effect.

of epinephrine and norepinephrine − Decreased heart rate; decreased
− Cardiac (heart) muscle- Increased force of atrial ventricular
heart rate and force of atrial contractions

− Stomach and intestines- Decreased − Increased motility and tone;

motility and tone relaxation contraction of sphincters
− Urinary bladder- Contraction of − relaxation of internal urethral
muscular wall sphincter
− Ejaculation − Vasodilation; erection of clitoris and
penis
IV. ENDOCRINE SYSTEM

− releases hormones to regulate activity, growth and

metabolism
− control of hormone and its secretion
− includes pituitary, thyroid, parathyroid, adrenal, and pineal
glands

hormone- is a mediator molecule that is released in one part of the

body but regulates the activity of cells in other parts of the body

pituitary gland/ hypophysis - “master” endocrine gland because it secretes several hormones that
control other endocrine glands. We now know that the pituitary gland itself has a master— the
hypothalamus.

Hypothalamus- growth, metabolism, -development and homeostasis

− receives input from limbic system, cerebral cortex, thalamus and reticular activating system

Anterior Pituitary
− secretes hormones that regulate a wide range of bodily activities, from growth to reproduction

1. Somatotrophs/somatotropin- secretes human growth hormone (hGH), Human growth hormone

in turn stimulates several tissues to secrete insulinlike growth factors, hormones that stimulate
general body growth and regulate aspects of metabolism
2. Thyrotrophs/thyrotopin- secretes thyroid-stimulating hormone (TSH)
o controls the secretions and other activities of the thyroid gland (thyroxinem triodothyroxine=
increase metabolism; calcitonin= decreases bone breakdown)
3. Gonadotrophs/gonadotropin- secretes two gonadotropins: follicle-stimulating hormone (FSH)
and luteinizing hormone (LH). FSH and LH both act on the gonads.
o stimulates secretion of estrogens and progesterone and the maturation of oocytes in the
ovaries, and they stimulate sperm production and secretion of testosterone in the testes
4. Lactotrophs- secretes prolactin (PRL), which initiates milk production in the mammary glands
5. Corticotrophs/corticotropin- secretes adrenocorticotropic hormone (ACTH) which stimulates the
adrenal cortex: to secrete glucocorticoids such as cortisol (stress hormone) and aldosterone
(absorption of Na) and medulla: epinephrine and Norepi
o secretes melanocyte-stimulating hormone (MSH)

Posterior Pituitary

− “neurohypophysis”, does not synthesize hormones, it does store and release two hormones
− consists of axons and axon terminals of more than 10,000 hypothalamic neurosecretory cells
 1. Oxytocin- enhances contraction of smooth muscle cells in the wall of the uterus
− after delivery, it stimulates milk ejection (“letdown”) from the mammary glands in
response to the mechanical stimulus provided by a suckling infant
2. Antidiuretic Hormone(ADH)- decreases urine production (causes the kidneys to return more
water to the blood, thus decreasing urine volume)
− H2O absorption
− In the absence of ADH, urine output increases more than tenfold, from the normal 1 to
2 liters to about 20 liters a day
− decreases the water lost through sweating and causes constriction of arterioles, which
increases blood pressure (raises BP by narrowing blood vessels)
− “vasopressin”

V. Digestive System

Six basic processes

1. Ingestion: taking food into mouth

2. Secretion: release of water, acid, buffers, and enzymes into lumen of GI tract
3. Mixing and propulsion: churning and propulsion of food through GI tract
4. Digestion: mechanical and chemical breakdown of food
5. Absorption: passage of digested products from GI tract into blood and lymph
6. Defecation: elimination of feces from GI tract

Digestive process- mechanical and chemical digestion in the mouth

A. Mastication- results from chewing, in which food is manipulated by the tongue, ground by the
teeth, and mixed with saliva= food is reduced to a soft, flexible, easily swallowed mass= bolus

Accessory digestive organs

a. Tongue- composed of skeletal muscle covered with mucous membrane

− forms the floor of the oral cavity
− dorsum (upper surface) and lateral surfaces of the tongue are covered with
papillae
− Many papillae contain taste buds, the receptors for gustation (taste)
− Some papillae lack taste buds, but they contain receptors for touch and
increase friction between the tongue and food, making it easier for the tongue
to move food in the oral cavity
b. Teeth- located in sockets of the alveolar processes of the mandible and maxillae
has three major external regions: the crown, root, and neck.

Three major external regions

1. crown- visible portion above the level of
 2. root- embedded in the socket
3. neck- constricted junction of the crown and root near the gum line

Three (3) components

1. enamel- consists of CaPo4 and CaCo4)

− hardest substance in the body
− serves to protect the tooth from the wear and tear of chewing
− protects against acids that can easily dissolve dentin
2. dentin- gives the tooth its basic shape and rigidity
3. cementum- attaches the root to the
periodontal ligament

Two (2) dentitions

1. deciduous teeth/primary teeth/milk teeth/baby

teeth—begin to erupt at about 6
months of age, and approximately two
teeth appear each month thereafter,
until all 20 are present
2. permanent (secondary) teeth-
dentition contains 32 teeth that erupt
between age 6 and adulthood.

a. incisors- cutting
b. canine- tearing
c. molars- grinding

B. Swallowing/Deglutition-basic propulsive movement

facilitated by the secretion of saliva and mucus and involves the mouth, pharynx, and esophagus
(mouth-pharynx-esophagus)

Swallowing stages
1. voluntary stage- bolus is passed into the oropharynx
2. pharyngeal stage- involuntary passage of the bolus through the pharynx into the
esophagus; and (when trachea is closed, esophagus must be opened)
3. esophageal stage- involuntary passage of the bolus through the esophagus into the
stomach (peristalsis)
 C. Chemical digestion

Stomach
− Mixing function: mixes saliva, food, and gastric juice to form chyme
− serves as reservoir for food before release into small intestine
− secretes gastric juice, which contains HCl (kills bacteria and denatures protein), pepsin (begins
the digestion of proteins), intrinsic factor (aids absorption of vitamin B12), and gastric lipase
(aids digestion of triglycerides)
− secretes gastrin into blood

Gastric juices:

a. cholecystokinin- facilitates all gastric secretions

b. HCl acid- increases blood flow: decreases chance of peptic ulcers
c. Intrinsic factor- aids in absorption of Vit. B12
d. Pepsin-protein digestion
e. Pancreatic enzymes- helps to digest fats and bile
f. Gastrin- inhibits all gastric secretions

D. Gastric emptying
− Several minutes after food enters the
stomach, gentle, rippling, peristaltic
movements called mixing waves pass over
the stomach every 15 to 25 seconds. These
waves macerate food, mix it with secretions
of the gastric glands, and reduce it to a
soupy liquid called chyme
 Stomach bolus= gastric juices=chime (segmentation: functional movement of SI)
− Segmentations are localized, mixing contractions that occur in portions of intestine distended by
a large volume of chyme
− mixes chyme with the digestive juices and bring the particles of food into contact with the
mucosa for absorption; they do not push the intestinal contents along the tract
a. Small intestine: absorption
a. Duodenum: electrolytes (Na, K, Cl, Ca, Mg)
b. Jejunum: carbs, proteins and fats (ADEK)
c. Ileum: vitamin B complex

*ingested molecules of sucrose, maltose and lactose are not acted until they reach small intestine

a. Sucrose- break sucrose into molecules of glucose and fructose

b. Lactase- glucose and galactose
c. Maltase- splits maltose and maltriose

− d/o: lactose intolerance- undigested lactose in chime which causes fluid to be retained in feces=
increased production of gases
− diarrhea, bloating, abdominal cramps

Defecation

1. Large intestine
− Haustral churning (remain relaxed and become distended while they fill up), peristalsis, and
mass peristalsis drive contents of colon into rectum
− Bacteria in large intestine convert proteins to amino acids, break down amino acids, and
produce some B vitamins and vitamin K
− Absorbing some water, ions, and vitamins
− Forming feces
− Defecating (emptying rectum)

Parts:

a. Ascending
b. Transverse
c. Descending
d. Sigmoid

2. Cecum- appendix
 3. Rectum
4. anus

− By the time chyme has

remained in the large intestine
3–10 hours, it has become
solid or semisolid because of
water absorption and is now
called feces
− feces consist of water,
inorganic salts, sloughed-off
epithelial cells from the mucosa of the gastrointestinal tract, bacteria, products of bacterial
decomposition, unabsorbed digested materials, and indigestible parts of food
− stimulus=defecation reflex=mediated by PSNS
− flatus: H, CO2, methane (nitrogen and sulfur)= gas (flammable)

Accessory organs

1. salivary gland- “salivation” (ANS)

− lubricates the
movement of tongue and
lips
− helps moisten
esophagus
− consists of parotid,
sublingual, submandibular
− saliva- 6.0 (acidic)
− normal pH: 7.4
− below 7.4- acid
− above 7.4-base
2. liver- heaviest gland of the body
− fat metabolism
− Excretion of bilirubin
− Synthesis of bile salts
− storage site for certain vitamins (A, B12, D, E, and K) and minerals (iron and
copper), which are released from the liver when needed elsewhere in the
body
− Phagocytosis. The stellate reticuloendothelial (Kupffer) cells of the liver
phagocytize aged red blood cells, white blood cells, and some bacteria
− Activation of vitamin D

3. Gallbladder- storage and concentration of bile

− bile 4x more concentrated
 4. Pancreas- consists of a head, a body, and a tail and is usually connected to the duodenum by
two ducts
− produces 1200–1500 mL (about 1.2–1.5 qt) of pancreatic juice, a clear, colorless liquid
consisting mostly of water, some salts, sodium bicarbonate, and several enzymes
− sodium bicarbonate gives pancreatic juice a slightly alkaline pH (7.1–8.2) that buffers
acidic gastric juice in chyme, stops the action of pepsin from the stomach, and creates
the proper pH for the action of digestive enzymes in the small intestine

Exocrine Endocrine

Acini Alpha- glucagon

Pancreatic enzymes (mixture of fluid digestive Beta-insulin
enzymes) Delta- somatostatin (inhibits secretion of glucose
and insulin)

VI. RESPIRATORY SYSTEM

− provides for gas exchange: intake of O2 for delivery to body cells and removal of CO2
produced by body cells
− helps regulate blood pH
− contains receptors for sense of smell, filters inspired air, produces vocal sounds (phonation),
and excretes small amounts of water and heat

Two parts

Upper Respiratory Tracts (conducting zone) Nose/external nares, nasal cavity, trachea,
● interconnecting cavities and tubes both larynx, pharynx
outside and within the lungs ● Nasopharynx
● Oropharynx
● laryngopharynx
Lower Respiratory Tracts (respiratory zone) bronchioles, alveolar ducts, alveolar sacs, and
● main sites of gas exchange between air alveoli
and blood

Lungs- paired cone-shaped organs in the thoracic cavity

Coverings: pleural membrane

 a. parietal pleura- lines the wall of the
thoracic cavity; the deep layer
b. visceral pleura- covers the lungs
themselves

pleural cavity- which contains a small

amount of lubricating fluid secreted by
the membranes

− reduces friction between the

membranes, allowing them to slide easily
over one another during breathing
− d/o: pleuritis- decreased fluid
− pleural effusion- increased fluid

Respiration- process of gas exchange

Three (3) steps of Respiration

1. Pulmonary ventilation- exchange of air between the atmosphere and the alveoli of the lungs
2. External (pulmonary) respiration- exchange of gases between the alveoli of the lungs and the
blood in pulmonary capillaries across the respiratory membrane. In this process, pulmonary
capillary blood gains O2 and loses CO2
3. Internal (tissue) respiration - exchange of gases between blood in systemic capillaries and tissue
cells. In this step the blood loses O2 and gains CO2

Muscles for respiration

Inspiration Expiration

Diaphragm: contracts Relaxes

Chest: expands Recoil inward
Lungs: pulled outside
= alveolar pressure decreases = alveolar pressure increases

Pressure Changes during Pulmonary Ventilation

A. Boyle’s law- For air to flow into the lungs, the pressure inside the alveoli must become lower
than the atmospheric pressure. This condition is achieved by increasing the size of the lungs
- Pressure increases=Volume decreases
B. Piston action (diaphragm)-
− If the piston is pushed down, the gas is compressed into a smaller volume, so that the same
number of gas molecules strike less wall area
− Increased in Vertical diameter
 C. Pump handle(sternum)- increased in AP diameter
D. Bucket handle (ribs 1-7)- During inhalation, the ribs
move upward and outward like the handle on a
bucket

E. Caliper motion (ribs 8-10)

Gas exchange and Transport

− When O2 and CO2 enter the blood, certain chemical reactions occur that aid in gas transport
and gas exchange

Gas exchange

− External respiration or pulmonary gas

exchange is the diffusion of O2 from air in
the
− alveoli of the lungs to blood in pulmonary
capillaries and the diffusion of CO2 in the
opposite direction
− External respiration in the lungs converts
deoxygenated blood (depleted of some O2)
coming from the right side of the heart into
oxygenated blood (saturated with O2) that
returns to the left side of the heart
− As blood flows through the pulmonary
capillaries, it picks up O2 from alveolar air and unloads CO2 into alveolar air. Although this
process is commonly called an “exchange” of gases, each gas diffuses independently from the
area where its partial pressure is higher to the area where its partial pressure is lower.
CONTROL OF RESPIRATION

A. Autonomic control
− The respiratory center is composed of neurons in the
medullary rhythmicity area in the medulla oblongata plus the
pneumotaxic and apneustic areas in the pons.
a. Pons- rate and rhythm
b. Medulla- rhythm and generator

B. Chemoreceptor Mechanism
− response to specific stimuli
− CNS= pons and Medulla= increase RR
− PNS-Aortic arch and carotid bodies= increase HR and BP

C. Control of respiration during sleeping

− Increased CO2= CNS= chemoreceptor= reticular

activating system= awake= increased in RR

VII. URINARY SYSTEM

− maintains blood osmolarity

− Kidneys regulate blood volume and composition; help regulate blood pressure, pH, and glucose
levels; produce two hormones (calcitriol and erythropoietin); and excrete wastes in urine
− Ureters transport urine from kidneys to urinary bladder
− Urinary bladder stores urine and expels it into urethra
− Urethra discharges urine from body
1. Kidneys
− Bean-shaped organ, located above the
waist between peritoneum and post wall of
the abdomen
− regulates blood ionic composition
− regulates blood pH.
− regulates blood volume.
− regulates blood pressure
− maintains blood osmolarity
− produces hormones
− regulates blood glucose level
− extretes wastes and foreign substances

nephrons: functional unit of kidney

a. renal corpuscle: glomerulus and glomerular (bownman’s) capsule= filtration of blood plasma
b. renal tubule: passage of filtered fluid

− To produce urine, nephrons and collecting ducts perform three basic processes—glomerular
filtration, tubular reabsorption, and tubular secretion

− Glomerular filtration occurs in the renal corpuscle. Tubular reabsorption and tubular
secretion occur all along the renal tubule and collecting duct

Net Filtration Pressure three main pressures. One pressure promotes filtration and two pressures
oppose filtration):
1. Glomerular blood hydrostatic pressure (GBHP)- is the blood pressure in glomerular capillaries.
Generally, GBHP is about 55 mmHg. It promotes filtration by forcing water and solutes in blood
plasma through the filtration membrane
 2. Capsular hydrostatic pressure (CHP)-
is the hydrostatic pressure exerted
against the filtration membrane by
fluid already in the capsular space and
renal tubule. CHP opposes filtration
and represents a “back pressure” of
about 15 mmHg
3. Blood colloid osmotic pressure
(BCOP)- which is due to the presence
of proteins such as albumin, globulins,
and fibrinogen in blood plasma, also
opposes filtration. The average BCOP
in glomerular capillaries is 30 mmHg.
4. Net filtration pressure (NFP)- the total pressure that promotes filtration, is determined as
follows:

Net filtration pressure (NFP)= GBHP CHP BCOP By substituting the values just given, normal NFP may
be calculated: NFP 55 mmHg 15 mmHg 30 mmHg 10 mmHg

Glomerular Filtration Rate- amount of filtrate formed in all the renal corpuscles of both kidneys
each minute is the glomerular filtration rate (GFR).

Adults= GFR averages 125 mL/min in males and 105 mL/min in females.
− If the GFR is too high, needed substances may pass so quickly through the renal tubules that
some are not reabsorbed and are lost in the urine
− If the GFR is too low, nearly all the filtrate may be reabsorbed and certain waste products
may not be adequately excreted
− Glomerulus: impermeable= proteinuria, hematuria, albuminuria

Renal Autoregulation of GFR

− kidneys themselves help maintain a constant renal blood flow and GFR despite normal, everyday
changes in blood pressure, like those that occur during exercise
− This capability is called renal autoregulation and consists of two mechanisms—the myogenic
mechanism and tubuloglomerular feedback.
− Working together, they can maintain nearly constant GFR over a wide range of systemic blood
pressures.

a. Myogenic mechanism- occurs when stretching triggers contraction of smooth muscle cells in
the walls of afferent arterioles

BP, GFR= because renal blood flow increases

− However, the elevated blood pressure stretches the walls of the afferent arterioles
− In response, smooth muscle fibers in the wall of the afferent arteriole contract, which
narrows the arteriole’s lumen
 − As a result, renal blood flow decreases, thus reducing GFR to its previous level
− Conversely, when arterial blood pressure drops, the smooth muscle cells are stretched
less and thus relax
− The afferent arterioles dilate, renal blood flow increases, and GFR increases.
− The myogenic mechanism normalizes renal blood flow and GFR within seconds after a
change in blood pressure.

b. Tubuloglomerular feedback- because part of the renal tubules—the macula densa—provides

feedback to the glomerulus.
− When GFR is above normal due to elevated systemic blood pressure, filtered fluid flows
more rapidly along the renal tubules
− As a result, the proximal convoluted tubule and loop of Henle have less time to reabsorb
Na, Cl and water
− Macula densa cells are thought to detect the increased delivery of Na, Cl, and water and
to inhibit release of nitric oxide (NO) from cells in the juxtaglomerular apparatus (JGA)

2. Ureter- transports urine from the renal pelvis of the kidney to the urinary bladder

− Peristaltic contractions of the muscular

walls of the ureters push urine toward the
urinary bladder, but hydrostatic pressure
and gravity also contribute
− Peristaltic waves that pass from the renal
pelvis to the urinary bladder vary in
frequency from one to five per minute,
depending on how fast urine is being
formed
− ureters are 25–30 cm (10–12 in.) long and are thickwalled, narrow tubes that vary in diameter
from 1 mm to 10 mm along their course between the renal pelvis and the urinary bladder
− Like the kidneys, the ureters are retroperitoneal

3. Urinary Bladder – a hollow, distensible muscular organ situated

in the pelvic cavity posterior to the pubic symphysis
− Males: it is directly anterior to the rectum
− Females: it is anterior to the vagina and inferior to the
uterus
− Folds of the peritoneum hold the urinary bladder in
position.
− When slightly distended due to the accumulation of urine, the urinary bladder is
spherical. When it is empty, it collapses.
− As urine volume increases, it becomes pear-shaped and rises into the abdominal cavity.
− Urinary bladder capacity averages 700–800 mL
− It is smaller in females because the uterus occupies the
space just superior to the urinary bladder
The Micturition Reflex

− “urination or voiding”
− occurs via a combination of involuntary
and voluntary muscle contractions
− When the volume of urine in the urinary
bladder exceeds 200–400 mL, pressure
within the bladder increases considerably,
and stretch receptors in its wall transmit
nerve impulses into the spinal cord
− These impulses propagate to the
micturition center in sacral spinal cord segments S2 and S3 and trigger a spinal reflex called the
micturition reflex
− In this reflex arc, parasympathetic impulses from the micturition center propagate to the urinary
bladder wall and internal urethral sphincter
− The nerve impulses cause contraction of the detrusor muscle and relaxation of the internal
urethral sphincter muscle

VIII. MUSCULAR SYSTEM

− produces movements of body parts

− stabilizes bones so that other skeletal muscles can execute a movement more effectively
− heat production that requires ATP
− maintains posture
− consists of skeletal and smooth muscle tissues

Four special properties that enable it to function and contribute to homeostasis:

1. Electrical excitability - the ability to respond to certain stimuli by producing electrical

signals called action potentials (impulses).
2. Contractility - ability of muscular tissue to contract forcefully when stimulated by an
action potential. When a skeletal muscle contracts, it generates tension (force of
contraction) while pulling on its attachment points.
3. Extensibility -ability of muscular tissue to stretch, within limits, without being damaged
4. Elasticity - ability of muscular tissue to return to its original length and shape after
contraction or extension
muscle fibers=hundreds to thousands of cells

muscle cell: sarcomere- contractile unit

sarcolemma - plasma membrane of a muscle cell
− contains sarcoplasm: includes a substantial amount of glycogen, which is a large molecule
composed of many glucose molecules
− Glycogen can be used for synthesis of ATP
− sarcoplasm contains a red-colored protein called myoglobin: found only in muscle, binds oxygen
molecules that diffuse into muscle fibers from interstitial fluid
 − releases oxygen when it is needed by the mitochondria for ATP production

Layers of muscle

1. Epimysium The outermost layer of dense, irregular connective tissue, encircling the entire muscle
2. Perimysium is also a layer of dense, irregular connective tissue, but it surrounds groups of 10 to 100 or
more muscle fibers, separating them into bundles called fascicles
− Many fascicles are large enough to be seen with the naked eye. They give a cut of meat its characteristic
“grain”; if you tear a piece of meat, it rips apart along the fascicles
3. Endomysium-penetrates the interior of each fascicle and separates
individual muscle fibers from one another. The endomysium is mostly
reticular fibers.

Muscle Proteins

Myofibrils:
a. contractile proteins- which generate force during contraction
b. regulatory proteins- which help switch the contraction
process on and off
c. structural proteins- which keep the thick and thin filaments
in the proper alignment, give the myofibril elasticity and extensibility, and link the myofibrils to
the sarcolemma and extracellular matrix

Two contractile proteins

− Contractile proteins (myosin and actin) generate force during contraction; regulatory proteins
(troponin and tropomyosin) help switch contraction on and off

1. Myosin- thick filaments and functions as a motor protein in all three types of muscle tissue
2. Actin- thin filaments are anchored to Z discs Individual actin molecules join to form an actin
filament that is twisted into a helix
− on each actin molecule is a myosin-binding site, where a myosin head can attach

Two regulatory proteins

tropomyosin and troponin-are also part of the thin filament

− In relaxed muscle, myosin is
blocked from binding to actin
because strands of
tropomyosin cover the myosin-
binding sites on actin
 − The tropomyosin strands in turn are held in place by troponin molecules

Structural proteins

Proteins that keep thick and thin filaments of

myofibrils in proper alignment, give myofibrils
elasticity and extensibility, and link myofibrils to
sarcolemma and extracellular matrix:

a. Titin- structural protein that connects Z disc to

M line of sarcomere, thereby helping to
stabilize thick filament position; can stretch
and then spring back unharmed, and thus accounts for much of the elasticity and extensibility of
myofibrils.
b. Actinin- protein of Z discs that attaches to actin molecules of thin filaments and to titin
molecules.
c. Myomesin - forms M line of sarcomere; binds to titin molecules and connects adjacent thick
filaments to one another.
d. Nebulin -wraps around entire length of each thin filament; helps anchor thin filaments to Z discs
and regulates length of thin filaments during development.
e. Dystrophin - links thin filaments of sarcomere to integral membrane proteins in sarcolemma,
which are attached in turn to proteins in connective tissue matrix that surrounds muscle fibers;
is thought to help reinforce sarcolemma and help transmit tension generated by sarcomeres to
tendons

Levels of Organization within a Skeletal Muscle

Endomysium

M Filaments: contractile proteins= myosin and actin

Fibrils: threadlike contractile elements within sarcoplasm of mm fiber
Fiber: Long cylindrical cell covered by endomysium and sarcolemma; contains
sarcoplasm, myofibrils, many peripherally located nuclei, mitochondria, transverse

Y tubules, sarcoplasmic reticulum, and terminal cisterns

Perimysium
Fascicle: bundle of muscle fibers wrapped in perimysium

O Epimysium
Skeletal mm: Organ made up of fascicles that contain muscle fibers (cells), blood
vessels, and nerves; wrapped in epimysium
Muscle attachment sites

− When a skeletal muscle contracts, it pulls one of the articulating bones toward the other. The
two articulating bones usually do not move equally in response to contraction
− One bone remains stationary or near its original position, either because other muscles stabilize
that bone by contracting and pulling it in the opposite direction or because its structure makes it
less movable
Origin- mm tendon is stationary bone (proximal)
Insertion- mm tendon is movable bone (distal)

TRIVIA:

− Masseter: strongest muscle

− Sartorius: longest and thin mm
− Soleus: most forceful
− Stapedius: weakest and smallest mm, located in the ear
− G-max: largest, most powerful mm
− Hamstring: most strained mm
− ANTAFI: most strained ligament

IX. SKELETAL SYSTEM

− supports soft tissue and provides attachment for skeletal muscles

− protects internal organs
− assists in movement, along with skeletal muscles
− stores and releases minerals
− contains red bone marrow, which produces blood cells
− contains yellow bone marrow, which stores triglycerides (fats)

1. diaphysis- bone’s shaft or body—the long, cylindrical, main portion

of the bone
2. epiphyses-proximal and distal ends of the bone
3. metaphyses- regions between the diaphysis and the epiphyses
− In a growing bone, each metaphysis contains an epiphyseal
(growth) plate, a layer of hyaline cartilage that allows the
diaphysis of the bone to grow in length
− when a bone ceases to grow in length at about ages 18–21,
the cartilage in the epiphyseal plate is replaced by bone;
the resulting bony structure is known as the epiphyseal line
4. articular cartilage- a thin layer of hyaline cartilage covering the part of the epiphysis where the
bone forms an articulation (joint) with another bone
− reduces friction and absorbs shock at freely movable joints
5. periosteum- a tough connective tissue sheath and its associated blood supply that surrounds
the bone surface wherever it is not covered by articular cartilage
− protects the bone, assists in fracture repair, helps nourish bone tissue, and serves as an
attachment point for ligaments and tendons.
− attached to the underlying bone by perforating (Sharpey’s) fibers, thick bundles of
collagen that extend from the periosteum into the bone extracellular matrix
6. medullary cavity or marrow cavity- a hollow, cylindrical space within the diaphysis that contains
fatty yellow bone marrow and numerous blood vessels in adults.
− minimizes the weight of the bone by reducing the dense bony material where it is least
needed. The long bones’ tubular design provides maximum strength with minimum
weight
Four types of cells in bone tissue:

1. Osteogenic cells- are unspecialized bone stem cells derived from mesenchyme, the tissue from
which almost all connective tissues are formed. They are the only bone cells to undergo cell
division; the resulting cells develop into osteoblasts. Osteogenic cells are found along the inner
portion of the periosteum, in the endosteum, and in the canals within bone that contain blood
vessels
2. Osteoblasts - bone-building cells. They synthesize and secrete collagen fibers and other organic
components needed to build the extracellular matrix of bone tissue, and they initiate
calcification (described shortly).
3. Osteocytes- mature bone cells, are the main cells in bone tissue and maintain its daily
metabolism, such as the exchange of nutrients and wastes with the blood. Like osteoblasts,
osteocytes do not undergo cell division
4. Osteoclasts- “break”, huge cells derived from
the fusion of as many as 50 monocytes (a type
of white blood cell) and are concentrated in the
endosteum

***Blasts Build bone: osteoClasts Carve out bone

Bone Classification

1. Compact bone tissue- strongest form of the

bone
− dense/calcified bone
− found inside the cortex of the bone

2. Spongy bone tissue- found in the medulla

− site of hematopoiesis
− does not contain osteons
compact bone-osteon= osteocyte and bony matrix
(hydroxyapatite and CaPo4)

Axial:

Cranial: PESTOF
Facial: VCNMMZPL (Vomer=1 and Mandible=1)

Auditory ossicles: MIS (HAS)= Malleus, Incus, Stapes; Hammer, Anvil, Stapes

Hyoid bone: 1

VC: 26 (33) bones T-cage

C-7 True-7 pairs
T-12 False- 3 pairs
L-5 Floating- 2pairs
 S-1(5)
C-1 (4)

Clavicle: most fractured bone

− only app bone attached to the axial

S Navicular
L Semi lunar
T C
P Lentiform
T GM
T LM
C Os magnum
H Unciform
Wrist-

Calcaneus- Os calcis
Talus-Astragalus

X. REPRODUCTIVE SYSTEMS

 produces offspring (sexual reproduction)

 sustains the growth of embryos and fetus

MALE REPRODUCTIVE SYSTEM

 includes testes, system of ducts (including the epididymis, ductus deferens, ejaculatory ducts,
and urethra), accessory sex glands (seminal vesicles, prostate, and bulbourethral glands), and
several supporting structures, including the scrotum and the penis
 testes produce sperm and the male sex hormone testosterone
 ducts transport, store, and assist in maturation of sperm
 accessory sex glands secrete most of the liquid portion of semen
 penis contains the urethra, a passageway for ejaculation of semen and excretion of urine

a. Scrotum- supporting structure for the testes, consists of loose skin and underlying subcutaneous
layer that hangs from the root (attached portion) of the penis

-scrotal septum divides the scrotum into two sacs, each containing a single testis
 septum is made up of a subcutaneous layer and muscle tissue called the dartos muscle,
which is composed of bundles of smooth muscle fibers.
 dartos muscle is also found in the subcutaneous layer of the scrotum
 associated with each testis in the scrotum is the cremaster muscle (suspender), a series
of small bands of skeletal muscle that descend as an extension of the internal oblique
muscle through the spermatic cord to surround the testes.
  location of the scrotum and the
contraction of its muscle fibers
regulate the temperature of the
testes
 normal sperm production
requires a temperature about
2–3C below core body
temperature
 In response to cold
temperatures, the cremaster
and dartos muscles contract.
 Contraction of the cremaster
muscles moves the testes closer
to the body, where they can
absorb body heat. Contraction of the dartos muscle causes the scrotum to become tight
(wrinkled in appearance), which reduces heat loss

b. Testes/testicles- are paired oval glands in the scrotum measuring about 5 cm (2 in.) long and 2.5
cm (1 in.) in diameter

 Tunica vaginalis- a serous membrane, which is derived from the peritoneum and forms
during the descent of the testes, partially covers the testes
 Hydrocele- collection of serous fluid in the tunica vaginalis
 tunica albuginea- a white fibrous capsule composed of dense irregular connective tissue,
it extends inward, forming septa that divide the testis into a series of internal
compartments called lobules
 each of the 200–300 lobules contain one to three tightly coiled tubules, the
seminiferous tubules-where sperm are produced

spermatogenesis- process by which the seminiferous

tubules of the testes produce sperm

seminiferous tubules two types of cells:

1. spermatogenic cells
2. Sertoli cells

Leydig (interstitial) cells- in the paces between

adjacent seminiferous tubules are clusters of cells
 these cells secrete testosterone, the most
prevalent androgen

androgen- is a hormone that promotes the development of masculine characteristics.

 testosterone also promotes a man’s libido (sexual drive)
Sperm

 Each day about 300 million sperm complete the process of

spermatogenesis
 about 60 um long and contains several structures that are highly
adapted for reaching and penetrating a secondary oocyte
 major parts of a sperm are the head and the tail
 about 300 million sperm mature each day

Functions:
 Development of sexual function. Androgens contribute to male
sexual behavior and spermatogenesis and to sex drive (libido) in
both males and females
 Stimulation of anabolism. Androgens are anabolic hormones; that is, they stimulate protein
synthesis. This effect is obvious in the heavier muscle and bone mass of most men as compared
to women.
 Prenatal development. Before birth, testosterone stimulates the male pattern of development
of reproductive system ducts and the descent of the testes. Dihydrotestosterone stimulates
development of the external genitals.
 Testosterone also is converted in the brain to estrogens (feminizing hormones), which may play
a role in the development of certain regions of the brain in males.
 Development of male sexual characteristics. At puberty, testosterone and dihydrotestosterone
bring about development and enlargement of the male sex organs and the development of
masculine secondary sexual characteristics.

Note: gonadotropin-releasing hormone (GnRH)

This hormone in turn stimulates gonadotrophs in the anterior pituitary to
increase their secretion of the two gonadotropins, luteinizing hormone (LH)
and follicle-stimulating hormone (FSH).

Reproductive System Ducts in Males

a. Ducts of the Testis

Pressure generated by the fluid secreted by Sertoli cells pushes
sperm and fluid along the lumen of seminiferous tubules and
then into a series of very short ducts called straight tubules

The straight tubules lead to a network of ducts in the testis called

the rete testis
From the rete testis, sperm move into a series of coiled efferent
ducts in the epididymis that empty into a single tube called the
ductus epididymis.
 b. Epididymis- site of sperm maturation, the process by
which sperm acquire motility and the ability to fertilize an
ovum.
 This occurs over a period of about 14 days
 helps propel sperm into the ductus (vas) deferens
during sexual arousal by peristaltic contraction of
its smooth muscle.
 stores sperm, which remain viable here for up to
several months
c. Ductus Deferens or vas deferens -
 conveys sperm during sexual arousal from the
epididymis toward the urethra by peristaltic
contractions of its muscular coat. Like the epididymis,
the ductus deferens also can store sperm for several months. Any stored sperm that are not
ejaculated by that time are eventually reabsorbed.
d. Spermatic Cord - a supporting structure of the male reproductive system that ascends out of the
scrotum
d/o varicocele - refers to a swelling in the scrotum due to a dilation of the veins that drain the
testes. It is usually more apparent when the person is standing and typically does not require
treatment.
e. Ejaculatory Ducts - terminate in the prostatic urethra, where they eject sperm and seminal
vesicle secretions just before the release of semen from the urethra to the exterior
f. Urethra- serves as a passageway for both semen and urine

Note: Male urethra has three subdivisions: the prostatic, membranous, and spongy (penile) urethra

1. seminal vesicles- secretes an alkaline, viscous fluid that helps neutralize acid in the female
reproductive tract, provides fructose for ATP production by sperm, contributes to sperm motility
and viability, and helps semen coagulate after ejaculation.
2. Prostate- secretes a milky, slightly acidic fluid that helps semen coagulate after ejaculation and
subsequently breaks down the clot.
3. bulbourethral (Cowper’s) glands -secretes an alkaline fluid that neutralizes the acidic
environment of the urethra and mucus that lubricates the lining of the urethra and the tip of the
penis during sexual intercourse.

Semen- a mixture of sperm and seminal fluid, a liquid that consists of the secretions of the seminiferous
tubules, seminal vesicles, prostate, and bulbourethral glands
 volume of semen in a typical ejaculation is 2.5–5 milliliters (mL), with 50–150 million sperm
per mL
 When the number falls below 20 million/mL, the male is likely to be infertile
 very large number of sperm is required for successful fertilization because only a tiny
fraction ever reaches the secondary oocyte
d/o: hemospermia- presence of blood in semen; caused by inflammation of the blood vessels
lining the seminal vesicles

g. Penis- contains the urethra and is a passageway for the ejaculation of semen and the excretion
of urine
 Upon sexual stimulation (visual, tactile, auditory, olfactory, or imagined), parasympathetic fibers
from the sacral portion of the spinal cord initiate and maintain an erection, the enlargement and
stiffening of the penis. The parasympathetic fibers produce and release nitric oxide (NO). The
NO causes smooth muscle in the walls of arterioles supplying erectile tissue to relax, which
allows these blood vessels to dilate. This in turn causes large amounts of blood to enter the
erectile tissue of the penis.

d/o: priapism- refers to a persistent and usually painful erection of the penis that does not involve
sexual desire or excitement

Ejaculation- powerful release of semen from the urethra to the exterior, is a sympathetic reflex
coordinated by the lumbar portion of the spinal cord

d/o premature ejaculation: is ejaculation that occurs too early, for example, during foreplay or on
or shortly after penetration. It is usually caused by anxiety, other psychological causes, or an
unusually sensitive foreskin or glans penis. For most males, premature ejaculation can be overcome
by various techniques (such as squeezing the penis between the glans penis and shaft as ejaculation
approaches), behavioral therapy, or medication.

FEMALE REPRODUCTIVE SYSTEM

 include the ovaries (female gonads); the uterine (fallopian) tubes, or oviducts; the uterus; the
vagina; and external organs, which are collectively called the vulva, or pudendum.
 mammary glands are considered part of both the integumentary system and the female
reproductive system
 ovaries- produces secondary oocytes and hormones, including progesterone and estrogens
(female sex hormones), inhibin, and relaxin.
 uterine tubes- transporst a secondary
oocyte to the uterus and normally are
the sites where fertilization occurs.
 Uterus- site of implantation of a
fertilized ovum, development of the
fetus during pregnancy, and labor.
 Vagina- receives the penis during sexual
intercourse and is a passageway for
childbirth.
 mammary glands- synthesize, secrete,
and eject milk for nourishment of the
newborn.
 a. ovaries- are the female gonads, are paired glands that resemble unshelled almonds in size and
shape; they are homologous to the testes. (Here homologous means that two organs have the
same embryonic origin.) The ovaries
produce (1) gametes, secondary
oocytes that develop into mature ova
(eggs) after fertilization, and (2)
hormones, including progesterone
and estrogens (the female sex
hormones), inhibin, and relaxin
b. uterine (fallopian) tubes, or oviducts-
provides a route for sperm to reach
an ovum and transport secondary
oocytes and fertilized ova from the
ovaries to the uterus

oogenesis- formation of gametes in the ovaries is egg). In contrast to spermatogenesis, which

begins in males at puberty, oogenesis begins in females before they are even born.
 occurs in essentially the same manner as spermatogenesis; meiosis takes place and the
resulting germ cells undergo maturation.
Fertilization- can occur up to about 24 hours after ovulation
 The diploid fertilized ovum is now called a zygote and begins to undergo cell divisions
while moving toward the uterus.
 It arrives in the uterus 6 to 7 days after ovulation.

c. Uterus-serves as part of the pathway for sperm deposited in the vagina to reach the uterine
tubes. It is also the site of implantation of a fertilized ovum, development of the fetus during
pregnancy, and labor

d/o: uterine prolapse-may result from weakening of supporting ligaments and pelvic
musculature associated with age or disease, traumatic vaginal delivery, chronic straining from
coughing or difficult bowel movements, or pelvic tumors

cervical mucus- secretory cells of the mucosa of the cervix produce a secretion
 a mixture of water, glycoproteins, lipids, enzymes, and inorganic salts

Hysterectomy-the surgical removal of the uterus, is the most common gynecological operation

d. Vagina- is a tubular, 10-cm (4-in.) long fibromuscular canal lined with mucous membrane that
extends from the exterior of the body to the uterine cervix
 receptacle for the penis during sexual intercourse, the outlet for menstrual flow,
and the passageway for childbirth
hymen- thin fold of vascularized mucous membrane
 forms a border around and partially closes the inferior end of the vaginal opening to
the exterior, the vaginal orifice
 After its rupture, usually following the first sexual intercourse, only remnants of the
hymen remain
 vulva or pudendum - refers to the
external genitals of the female

components of vulva:

a. mons pubis - anterior to the vaginal and

urethral openings, an elevation of adipose
tissue covered by skin and coarse pubic
hair that cushions the pubic symphysis

From the mons pubis, two longitudinal

folds of skin

b. labia majora - extend inferiorly and posteriorly.

 covered by pubic hair and contain an
abundance of adipose tissue, sebaceous
(oil) glands, and apocrine sudoriferous
(sweat) glands.
 homologous to the scrotum

Medial to the labia majora are two smaller folds of skin:

c. labia minora- unlike the labia majora, the labia minora are devoid of pubic hair and fat and have
few sudoriferous glands, but they do contain many sebaceous glands.
 labia minora are homologous to the spongy (penile) urethra.
d. clitoris- is a small cylindrical mass composed of two small erectile bodies, the corpora
cavernosa, and numerous nerves and blood vessels.
 located at the anterior junction of the labia minora

e. vestibule- region between the labia minora

 Within the vestibule are the hymen (if still present)
f. vaginal orifice- external urethral orifice, and the openings of the ducts of several glands.
 vestibule is homologous to the membranous urethra of males.
 The vaginal orifice, the opening of the vagina to the exterior, occupies the greater
portion of the vestibule and is bordered by the hymen
g. perineum- diamond-shaped area medial to the thighs and buttocks of both males and females
 It contains the external genitals and anus

Mammary Glands- synthesis, secretion, and ejection of milk

(lactation)
a. Breast- is a hemispheric projection of variable size
anterior to the pectoralis major and serratus anterior
muscles and attached to them by a layer of fascia
composed of dense irregular connective tissue.
b. nipple - has a series of closely spaced openings of ducts
called lactiferous ducts where milk emerges.
 c. areola- circular pigmented area of skin surrounding the nipple, it appears rough because it
contains modified sebaceous (oil) glands.
d. Strands of suspensory ligaments of the breast (Cooper’s ligaments) - connective tissue, runs
between the skin and fascia and support the breast.

Hormonal Regulation of the Female Reproductive Cycle

 The uterine and ovarian cycles are controlled by gonadotropin-releasing hormone

(GnRH) and ovarian hormones (estrogens and progesterone).

“A dream does not become reality through magic; it takes sweat,

determination, and hard work. ’’ - Colin Powell