Respiratory System

Unit-1
Part-1

Shabnam
Faculty INS-KMU
Acknowledged by: Muhammad Iqbal
lecturer KMU
Objective
sDefine respiratory system.
 Define respiration.
 Describe the structure and the function of:
• upper respiratory tract (Nose, Pharynx, Larynx)
• lower respiratory tract (Trachea, Bronchial tree, lungs)
 Discuss the physiology of respiration by explaining the mechanism of:
• Pulmonary Ventilation
• External Respiration
• Internal Respiration
 Discuss nervous control of respiration
 Briefly discuss the lung volumes & capacities
 Respiratory System
• Definition:
A system consisting of lungs and air passages specialized for
the intake of oxygen and exchange of gases with the blood.
• Respiration:
The exchange of oxygen and carbon dioxide between the
atmosphere and the cells of the body.
Respiration includes three things:
 1) Pulmonary ventilation (inspiration and expiration),
2) External respiration (the exchange of gases between
lungs and blood) and Internal respiration (between blood
and tissues), and
 3) The use of oxygen in cellular metabolism.
Functions
Respiratory and Non-Respiratory Functions
 Respiratory Functions are:
1. Pulmonary ventilation
2. Diffusion of O2 and CO2 b/w alveoli and blood
3. Transport of O2 and CO2 to and from tissues
4. Regulation of O2 and CO2 in blood and tissues
 N....on Respiratory Functions are:

• Air filtration
• Protective/Cleansing Reflexes (SSC reflexes)
• Olfaction
• Vocalization
• Defense mechanism..... Includes leukocytes, NK cells,
macrophages, dendritic cells, mast cells, defensins and
cathelicidins.
• Maintenance of water
• Regulation of body temperature
• Regulation of PH
• Secretion of ACE
Respiratory Division
Respiratory tract is divided into two:

• Upper Respiratory Tract (URT):

consists of nose, pharynx, and larynx.

• Lower Respiratory Tract (LRT):

consists of Trachea, Bronchi, bronchioles and lungs.
7
 Pharynx:
Is a muscular tube extending about 13 cm (5 inch). It is
divided into three regions:

 Nasopharynx
-- Lies dorsal to the soft palate.
-- Receives the eustachian (auditory) tubes.
-- Houses pharyngeal tonsils.
 Oropharynx

-- The space between the soft palate and root of the tongue
which extends inferiorly to the hyoid bone.
Means it extends from the Uvula to the level of the hyoid
bone.
-- It contains palatine and lingual tonsils.
 Laryngopharynx

It extends from the hyoid bone to the cricoid cartilage.

Oropharynx and laryngopharynx serve as a common
passageway for both food and air.
 Larynx
• The larynx or voice box is a cartilaginous chamber about 4
cm long.
• Its primary function is to keep food and drink out of the
airway, but it also produces sound.
• The superior opening of the larynx, the glottis (at the base
of the tongue) is guarded by a flap of tissue called the
epiglottis.
• During swallowing, extrinsic muscles of the larynx pull the
larynx upward toward the epiglottis, the tongue pushes the
epiglottis downward, and the epiglottis directs food and
drink into the esophagus dorsal to the airway.
• The vestibular folds of the larynx also keeps food and
drink out of the airway even if epiglottis is removed.
 Larynx
• There are nine cartilages, three unpaired and three paired. The
unpaired cartilages of the larynx are
thyroid, cricoid and epiglottis.
• The paired cartilages of the larynx are
the arytenoids, corniculates, and the cuneiforms.
• Thyroid Cartilage: This forms the Adam's apple. It is usually
larger in males than in females. The thyrohyoid membrane is a
ligament associated with the thyroid cartilage that connects the
thyroid cartilage with the hyoid bone.
• Cricoid cartilage: A ring of hyaline cartilage that forms the
inferior wall of the larynx. It is attached to the top of trachea.
• Epiglottis: A large, spoon-shaped piece of elastic cartilage.
During swallowing, the pharynx and larynx rise. Elevation of
the pharynx widens it to receive food and drink; elevation of the
larynx causes the epiglottis to move down and form a lid over
the glottis, closing it off.
 Larynx
cont….
• Paired Arytenoid Cartilage: They are smaller, the
arytenoid cartilages are the most important because they
influence the position and tension of the vocal folds.
These are triangular pieces of hyaline cartilage located at
the posterosuperior border of the cricoid cartilage.
• Paired Corniculate Cartilage: Horn-shaped pieces of
elastic cartilage located at the apex of each arytenoid
cartilage.
• Paired Cuneiform Cartilage: Elastic cartilage located
anteriorly to the corniculate cartilages.
• The first three are relatively large and unpaired. The
superior one, the epiglottic cartilage, is a spoon shaped
supportive plate in the epiglottis. The largest, the thyroid
cartilage. It has an anterior peak, the laryngeal
prominence, commonly called Adam’s apple, which is
larger in males due to testosterone. Inferior to the thyroid
cartilage is ring like cricoid cartilage which connects
larynx to the trachea.
• The remaining cartilages are smaller and occur in three
pairs. Posterior to the thyroid cartilage are paired
arytenoid, paired corniculate, and paired cuneiform
cartilages.
 Lower Respiratory
Tract
 Trachea
The trachea or windpipe is a rigid tube 12 cm long and 2.5
cm wide lying anterior to the esophagus.
It is supported by about 20 C-shaped rings of hyaline
cartilage, some of which we can palpate between larynx
and sternum.
The open part of the C faces posteriorly which allows room
for the esophagus to expand when the swallowed food
passes by.
The cartilages are spanned by trachealis muscles.
 Bronchi and Bronchial Tree
At the level of fifth thoracic vertebra, the trachea divides
into a right primary bronchus and left primary
bronchus.
The right primary bronchus is more vertical, shorter, and
wider than the left.
As a result, an aspirated object is more likely to enter and
lodge in the right primary bronchus than the left.
Like the trachea, the primary bronchi contain incomplete
rings of cartilage and are lined by ciliated pseudostratified
columnar epithelium.
• The point where the trachea divides into right and left
primary bronchi is called carina. The mucous membrane of
the carina is one of the most sensitive areas of the larynx
and trachea for triggering a cough reflex.
• On entering the lungs, the primary bronchi divide to form
smaller bronchi called secondary bronchi. Each lobe in the
lungs receive one secondary (lobar) bronchus.
• The secondary bronchi continue to branch, forming still
smaller bronchi, called tertiary (segmental) bronchi.
Cont
…
• These bronchi further divide into bronchioles (1 mm or
less in diameter).
• The portion of the lung ventilated by one bronchiole is
called a pulmonary lobule.
• The bronchioles further divide to form terminal
bronchioles. This extensive branching from the
trachea resembles an inverted tree and is commonly
referred to as the bronchial tree.
Branches of Bronchial Tree

Trachea
↓
Primary bronchi
↓
Secondary bronchi
↓
Tertiary bronchi
↓
Bronchioles
↓
Terminal bronchioles
↓
Respiratory bronchiole
• The larynx, trachea, and bronchial tree are lined mostly by
ciliated pseudostratified columnar epithelium, which functions
as a mucociliary escalator. That is, the mucous traps the inhaled
particles and then the ciliary beating drives the mucus up to the
pharynx where it is either swallowed or spit out.

• Respiratory unit includes:

• 1. Respiratory bronchioles
• 2. Alveolar ducts
• 3. Alveolar sacs
• 4. Antrum
• 5. Alveoli
 Lungs
• Each lung is a somewhat conical shaped organ with a
broad concave base resting on the diaphragm and a
blunt peak called apex faces upward to clavicles.
The broad costal surface is pressed against the rib cage,
and the smaller concave mediastinal surface faces
medially. The lung receives the bronchus, blood
vessels, and nerves through its hilum, a slit in a
mediastinal surface.
The left lung is a little smaller than the right because of
the heart tilting to the left giving indentation to the
lung called cardiac impression or Cardiac notch.
The left lung has two lobes as superior and inferior lobe with
a deep fissure between them called oblique fissure.
The right lung has three lobes as superior, middle, and
inferior lobe. Superior lobe is separated from the middle
lobe by horizontal fissure and the inferior lobe from the
middle one by oblique fissure.
 Alveoli
• An alveolus (plural alveoli) is pouch about 0.2 to 0.5 mm in
diameter.
• It is lined by simple squamous epithelium.
• An alveolar sac consists of two or more alveoli that share a
common opening.
• The surface area of the alveoli is about 70 m2.The walls of
alveoli consist of two types of alveolar epithelial cells.
• Type I alveolar cells which are numerous and form a
continuous layer. They are simple squamous epithelial cells.
Gaseous exchange occurs here.
• Type II alveolar cells also called septal cells, rounded or
cuboidal, which are fewer in number and found between type I
cells.
 Alveoli
cont….
• They secrete alveolar fluid to keep the surface moist.
• Included the alveolar fluid is surfactant, a mixture of
phospholipids and lipoproteins.
• Surfactant lowers the surface tension of the alveolar fluid,
which reduces the tendency of the alveoli to collapse.
• Associated with the alveolar wall are alveolar
macrophages (dust cells). They are phagocytes which
remove fine dust particles and other debris and pathogens
from the alveolar surface.
• Alveoli are surrounded by a network of blood capillaries
for gaseous exchange.
28
 Capillary

Wall of
the air Oxygen is picked up
sac

Carbon Dioxide
is dropped off

Red Blood Cell

 Plural Membrane
• The lungs are enclosed and protected by two layers of
serous membrane which are collectively called plural
membrane or pleura. The outer layer, called parietal
membrane, lines the wall of the thoracic cavity. The inner
layer, called the visceral membrane, covers the lungs
themselves. Between the visceral and parietal membranes
(pleurae) is a small space called pleural cavity. The
plural cavity contains a small amount of lubricating fluid
secreted by the serous membrane. This pleural fluid
reduces the friction between the membranes when sliding
over one another during breathing.
 Respiratory Muscles
 Muscles of Inspiration:
• Diaphragm (primary/main muscle)
• Sternocleidomastoid (elevates sternum)
• Scalenes (elevates first two ribs)
• External intercostals (move ribs upward and outward)
 Muscles of Expiration:
• Rectus abdominis ( main muscle)
• Internal intercostals (pull ribs downward and inward)
These Abdominal muscles are used when expiration is
active
• External oblique
• Internal oblique
• Transverse abdominis
 Diaphragm

• Is a skeletal muscle separating chest and abdomen

• Inspiration: diaphragm contracts and increases
thoracic space
• air flows in
• Expiration: diaphragm relaxes and decreases
thoracic space
• air flows out
• Innervated by phrenic nerve fibers (C3, C4, C5)
Functions of Diaphragm
• Diaphragm is the muscle of:
• Inspiration
• Abdominal straining
• Thoracoabdominal pump
 Nervous Control of Respiration
Respiration is controlled by the respiratory center in the
central nervous system. The respiratory muscles contract as a
result of nerve impulses transmitted to them from centers in
the brain and relax in the absence of nerve impulses. These
nerve impulses are sent from clusters of neurons located
bilaterally in the medulla oblongata and pones of the brain
stem. This group of neurons, collectively called respiratory
center, which is divided into three areas as:
1. Medullary Rhythmicity Area: It is located in the medulla
oblongata. It controls the basic rhythm of respiration.
• There are inspiratory and expiratory areas. During quiet
breathing, inhalation lasts for about 2 seconds and
exhalation lasts for about 3 seconds.
• Inspiratory area establishes the basic rhythm of breathing
by generating nerve impulses.
 Inspiratory area sends impulses to the external intercostal
muscles through intercostal nerves (T1 to T11) and to the
diaphragm via the phrenic nerves (C3 to C5).
When the nerve impulses reach the diaphragm and external
intercostal muscles, the muscles contract and inhalation
occurs.
At the end of 2 seconds, the inspiratory area becomes inactive
and nerve impulses cease.
With no impulses arriving, the diaphragm and intercostal
muscles relax for about 3 seconds, allowing lungs and
thoracic wall to recoil. Then, the cycle repeats.
Nervous Control of Respiration cont…
• The neurons of the expiratory area remain inactive
during quiet breathing.

• However, during forceful breathing nerve impulses

from the inspiratory area activate the expiratory area
Impulses causing contraction of the internal intercostal
and abdominal muscles and thus forceful expiration
occurs.
2. Pneumotaxic Area: (pneumo= air; taxic= arrangement)
In the upper pons, it transmits inhibitory impulses to the
inspiratory area to turn off the inspiratory phase before the
lungs become too full of air. Breathing rate is more rapid
when the pneumotaxic area is more active. It means that it
shortens the duration of inhalation.
3. Apneustic Area:
In the lower pons of the brain stem, the apneustic area
sends stimulatory impulses to the inspiratory area that
activate it and prolong inhalation. It causes a long and deep
inhalation. Thus pneumotaxic and apneustic area coordinate
the transition between inhalation and exhalation.
 Respiratory
Volumes
• Tidal Volume (TV): The amount of air normally inhaled or
exhaled with one normal breath. (500 ml)
• Inspiratory Reserve Volume (IRV): The amount of
(additional) air forcefully inhaled after a normal tidal volume
inhalation. (3000 ml)
• Expiratory Reserve Volume (ERV): The amount of air
forcefully exhaled after a normal tidal volume exhalation.
(1200 ml)
• Residual Volume (RV): The amount of air remaining in the
lungs after maximum expiration. (1300 ml)
 Respiratory
Capacities
• Inspiratory Capacity (IC): The combination of tidal
volume and inspiratory reserve volume. (3500 ml)
IC= TV+IRV
• Functional Residual Capacity (FRC): The combination of
Expiratory Reserve volume and Reserve volume. (2500 ml)
FRC= ERV+RV
• Vital Capacity (VC): The combination of Tidal volume,
Inspiratory Reserve volume and Expiratory Reserve volume.
(4700 ml)
VC= TV+IRV+ERV
• Total Lung Capacity (TLC): The combination of Vital
capacity and Reserve volume. (6000 ml)
TLC= TV+IRV+ERV+ RV
 Clinical
Conditions
• Inflammation of the pleural membrane is called pleurisy
or pleuritis and as a result the accumulation of excess
fluid in the pleural cavity is called pleural effusion.

• The introduction of air into the plural cavity (either by

surgical opening or stab or gunshot) is called
pneumothorax while blood or pus in it is called
hemothorax. The collapse of lungs is known as
atelectasis (ateles = incomplete; ectasis = expansion).
 Clinical terminology of
ventilation
• Apnea: Temporary cessation of breathing.
• Dyspnea: Difficulty in breathing. Eg. SOB
• Eupnea: Normal breathing. 12 to 15 b/m
• Hyperpnea: Increased rate and depth of breathing.
• Hyperventilation: Increased pulmonary ventilation leading
to low blood level of CO2
• Hypoventilation: Decreased pulmonary ventilation leading
to increased blood level of CO2
• Orthopnea: Dyspnea that occurs when a person is lying
down.
• Tachypnea: Abnormal quick shallow breathing
• Bradypnea: Abnormal slow breathing.
• Hypoxia: Low oxygen level
Urinary System
A&P-II Unit II

M. Iqbal
Lecture
KMU
 Objectives
At the end of this unit, the students will be able to:
• Define the Urinary System.
• Enlist the organs of Urinary system
• Briefly discuss the functions of kidney.
• Discuss kidneys in terms of external anatomy, gross
structure & microscopic structure.
• Describe the role of each component of nephron in
terms of filtration, selective reabsorption & secretion
involved in the formation of urine.
• Discuss the structure and functions of ureters,Urinary
bladder, and Urethra.
• Briefly discuss the process of micturation.
2
 Definitions
• Urinary System: The system which is specialized
to filter the blood plasma, excrete waste
products , and regulate the body’s water, acid-
base, and electrolyte balance.
• Nephrology: The scientific study of the anatomy,
physiology, and pathology of the kidneys.
• Urology: The branch of medicine which deals
with the male and female urinary systems and
the male reproductive system.

3
 Organs of the urinary system

Urinary system consists of six organs:

• Two kidneys
• Two ureters
• One urinary bladder
• One urethra

4
 Functions of the Kidneys
• Excretion of wastes: filter blood plasma to
eliminate waste (like metabolic, drug, toxic) from
body.
• Regulation of blood ionic composition: They help
regulate the blood levels of several ions like Na+,
K+, Ca+, Cl-, PO4 2- etc.
• Regulation of blood PH: The kidneys regulate H+
and HCO3- to maintain blood PH.
• Regulation of blood volume: The kidneys adjust
blood volume by conserving or eliminating water
in the urine. 5
• Regulation of blood pressure: The kidneys regulate
blood pressure by secreting the enzyme renin, which
activate the renin-angiotensin-aldosterone pathway.
• Maintenance of blood osmolarity: By loosing water
and solutes they maintain the blood osmolarity.
• Production of hormones:
• JG cells secrete renin in response to  renal perfusion
• Secrete erythropoietin in response to hypoxia
• Forms calcitriol (1,25 dihydrocholecalceferol)
• Secrete prostaglandin that dilates aa and  GFR
• Regulation of blood glucose level: In times of
starvation, they use the amino acid ‘glutamine’ in
gluconeogenesis.
• Detoxification of drugs: The kidneys detoxify drugs
and free radicals through peroxisome. 6
 Anatomy of the Kidneys
• The paired kidneys are bean-shaped.
• Located between the levels of the last thoracic and
third lumber vertebrae.
• Partially protected by the eleventh and twelfth pairs of
ribs.
• Lying just above the waist between the peritoneum
and the posterior wall of the abdomen, hence they are
said to be retroperitoneal (retro= behind) for their
position.
• The right kidney is slightly lower than the left because
the liver occupies considerable space on the right side
superior to the kidney.
7
 External Anatomy
• A typical adult kidney is 10—12 cm long, 5—6 cm
wide, and 3 cm thick.
• It weighs about 135—150 g.
• The concave border of each kidney faces the
vertebral column.
• Near the center of the concave border is a deep
vertical fissure called the renal hilum, through
which the ureter emerges from the kidney along
with blood vessels, lymphatic vessels, and nerves.
8
• Three layers of tissue surround each kidney.
• The superficial layer, the renal fascia, is a thin layer
of connective tissue that anchors it to the
abdominal wall.
• The middle layer, the adipose capsule or perirenal
fat, is a fatty tissue which protects the kidney from
trauma.
• The deep layer, the renal or fibrous capsule which
is a smooth and transparent sheet of dense
connective tissue. It protects the kidney from
trauma.
9
 Internal Anatomy of the Kidneys
• A frontal section of the kidney shows two distinct
regions: a superficial reddish area called renal cortex
(cortex= bark) and a deep reddish inner region called
renal medulla (medulla= inner part).
• The renal cortex is smooth textured area extending
from the renal capsule to the bases of the renal
pyramids and into the spaces between them.
• The portions of the renal cortex that extend between
renal pyramids are called renal columns.
• Renal cortex is divided into an outer cortical zone and
an inner juxtamedullary zone.
• The renal medulla consists of cone shaped renal
pyramids. The base (wider end) of each pyramid faces
the renal cortex, and its apex (narrower end) called a
renal papilla points toward the hilum. 10
• Together, the renal cortex and renal pyramids
constitute the parenchyma (functional portion) of the
kidney.
• Within the parenchyma are the microscopic functional
units of the kidney called nephrons— about 1 million
in each kidney.
• Urine formed by the nephrons drains into the papillary
ducts of the pyramids.
• The papillary ducts drain into cuplike structures called
minor and major calyces (calyx= cup). Each kidney has
8 to 18 minor calyces and 2 to 3 major calyces.
• From the major calyces, urine drains into a single large
cavity called the renal pelvis (pelv = basin) and then
out through the ureter to the urinary bladder.
11
12
• The renal papilla is the location where the renal
pyramids in the medulla empty urine into the
minor calyx in the kidney.
• Histologically it is marked by medullary collecting
ducts converging to form a papillary duct to
channel the fluid.

13
14
15
16
kidney 1: A longitudinal section, B nephron and adjacent blood vessels;
1 renal papilla, 2 renal column, 3 capsule, 4 renal pyramid, 5 calyx, 6 ureter, 7 renal
pelvis, 8. renal vein, 9 renal artery, 10 interlobar artery, 11 arcuate
artery, 12 interlobular artery, 13 interlobar vein, 14 cortex, 15 interlobular
vein, 16 renal sinus, 17 arcuate vein,18 medulla, 19 vasa recta, 20 loop of
Henle, 21 collecting duct, 22 arcuate vein, 23 arcuate artery, 24 proximal convoluted
tubule, 25 glomerulus, 26 Bowman's capsule, 27 distal convoluted tubule
17
 Blood Flow of Kidney

• Renal artery  Interlobar a.  Arcuate a. 

Interlobular a.  Afferent a.  Glomerulus 
Efferent a.  Peritubular cap. Network and Vasa
recta  Interlobular vein  Arcuate v. 
Interlobar v.  Renal v.

18
 Nephron
• Nephrons are the functional units of the kidneys.
• Each nephron consists of two main parts: a renal
corpuscle, where blood plasma is filtered, and a
renal tubule into which the filtered fluid passes.
• Renal corpuscle consists of glomerulus (capillary
network) and the glomerular (Bowman’s)
capsule, an epithelial cup that surrounds the
glomerular capillaries.

19
 Nephron cont….
• Blood plasma is filtered in the glomerular capsule,
and then the filtered fluid passes into the renal
tubule.
• The renal tubule has three main parts. In the order
that fluid passes through it is:
• 1) proximal convoluted tubule, 2) loop of Henle,
and 3) distal convoluted tubule.
• The distal convoluted tubules of several nephrons
empty into a single collecting duct.
• Collecting ducts then unite and converge into large
papillary ducts, which drain into the minor calyces,
major calyces, renal pelvis and then ureter.
20
21
Nephron of the kidney. The labeled parts are:
1. Glomerulus, 2. Efferent arteriole, 3. Bowman's capsule, 4. Proximal
convoluted tubule, 5. Cortical collecting duct, 6. Distal convoluted tubule,
7. Loop of Henle, 8. Duct of Bellini, 9.Peritubular capillaries, 10. Arcuate
vein, 11. Arcuate artery, 12. Afferent arteriole, 13. Juxtaglomerular
apparatus.
22
23
 Flow of urine

Through Nephron down from Nephron

Bowman’s capsule Collecting ducts

Proximal conv. Tubule Papillary duct
Descending limb of Minor calyces
Major calyces
loop of Henle
Renal pelvis
Ascending limb of loop Ureter
of Henle Bladder
Distal conv. Tubule Urethra

24
 Types of Nephron
Two types:
• Cortical Nephron—Renal corpuscle originates from
the superficial part of the cortex. It has a shorter
loop of Henle.
• Juxtamedullary Nephron—Renal corpuscle
originates from the deeper part of the cortex,
means near the medulla. It has a longer loop of
Henle.

25
26
Cortical and Juxta-medullary Nephrons

27
Cortical and Juxta-medullary Nephrons

28
Histology of Nephron and Collecting Duct
Epithelial cells form the wall of the glomerular
capsule, renal tubule, and ducts.
 Glomerular (Bowman’s) capsule consists of
visceral and parietal layer.
• The visceral layer consists of modified simple
squamous epithelial cells called podocytes—
footlike projections (pedicles) wrap around the
single layer of endothelial cells of the glomerular
capilaries and form the inner wall of the capsule.

29
 Nephron cont…
• The parietal layer of the glomerular capsule
consists of simple squamous epithelium and
forms the outer wall of the capsule.
• Fluid filtered from the glomerular capillaries
enter the capsular (Bowman’s) space, the
space between the two layers of the Bowman
capsule.

30
 Renal Tubule and Collecting Duct: The proximal
convoluted tubule consists of simple cuboidal
epithelial cells with microvilli on their inner surface
facing the lumen to increase its surface area for
reabsorption and secretion.
• The thick ascending limb (last part) of the loop of
Henle is composed of simple columnar epithelium
which comes in contact with the afferent arteriole.
• The columnar epithelial cells in this region are
crowded together and form macula densa
(macula= spot; densa= dense).
31
 Nephron cont…

• Alongside the macula densa, the walls of the

afferent and efferent arterioles contain
smooth muscle fibers called juxtaglomerular
(JG) cells.
• Both macula densa and JG cells form
juxtaglomerular apparatus (JGA) which helps
in regulating blood pressure.

32
33
• The distal convoluted tubule (DCT) begins a short
distance past the macula densa. In the last part of
DCT there are two types of cells.
• The Principal cells, which have receptors for both
antidiuretic hormone (ADH) and aldosterone that
reabsorb Na+, water and secrete K+.
• The intercalated cells, which regulate blood PH by
secreting H+ and reabsorbing HCO3 and K+.
• The collecting ducts drain into the papillary ducts.

34
 Urine Formation in Nephron
• To produce urine, nephron and collecting ducts
perform three basic processes—glomerular
filtration, tubular reabsorption, and tubular
secretion.
• 1. Glomerular Filtration: In the first step of urine
production, water and most solutes in blood
plasma move across the wall of the glomerular
capillaries into the glomerular capsule and then
into the renal tubule.

35
 Urine Formation Cont…

• Glomerular Filtration Rate

• The amount of filtrate formed in all the renal
corpuscles of both kidneys each minute is the
glomerular filtration rate (GFR). In adults, the GFR
averages 125 ml/min (180 liters/day) in males and
105 ml/min (150 liters/day) in females.

36
 Urine Formation Cont…
Net Filtration Pressure
Glomerular filtration depends on three main
pressures. One pressure promotes filtration while
the two pressures oppose filtration as:
i. Glomerular Blood Hydrostatic Pressure (GBHP): It
is the blood pressure in the glomerular capillaries
which is about 55 mmHg. It promotes filtration by
forcing water and solutes from blood plasma
through the filtration membrane.
37
 Urine Formation Cont…

ii. 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 which is
about 15 mmHg.
iii.Blood Colloid Osmotic Pressure (BCOP): is due
to the presence of proteins such as albumen,
globulins, and fibrinogens in the blood plasma. It
also opposes filtration which is about 30 mmHg.
 Net filtration pressure remains 10 mmHg which is
responsible for filtration process.

38
 Urine Formation Cont…

2. Tubular Reabsorption: As the filter fluid flows

along the renal tubule and the collecting duct, the
cells in the tubule reabsorb about 99% of the
filtered fluid and many useful solutes. Thus, the
water and solutes (glucose, amino acids and
electrolytes) return to the blood.
Sites of Reabsorption almost all the segments
PCT: H2O, glucose, amino acids, Na+, K+, Ca++, HCO3-,
Uric acid
Loop of Henle: Na+,Cl-, Ca++
DCT: H2O, Na+, Ca++, HCO3-

39
 Urine Formation Cont…
3. Tubular secretion: As the fluid flows along the renal
tubule and the collecting duct, their cells secrete
other materials, such as wastes, drugs, and excess
ions, into the fluid. Thus tubular secretion removes
waste substances from the blood.
• H+, organic acids and bases in PCT
• Urea in Loop of Henle (thin segment)
• K+, H+, NH3 in DCT and collecting duct

Urine Excretion = Filtration—Reabsorption + Secretion

40
41
 Hormones affecting Renal Function
Hormone Target Effects
Aldosterone Distal tubule, collecting duct  Na reabsorption and K secretion;
 urine volume
Angiotensin II Afferent and efferent Constricts arterioles, reduces GFR;
arterioles stimulates ADH and aldosterone
secretion; stimulates thirst; H2O intake
and urine output
ADH Collecting duct  H2O reabsorption; urine output,
increases concentration
ANP Afferent and efferent Dilates afferent arteriole, constricts
arterioles, collecting duct efferent arteriole, GFR; inhibits
secretion of renin, ADH, and
aldosterone; inhibits NaCl reabsorption
by collecting duct; urine output
Epi and Norepi JG apparatus, affr arteriole Induces renin secretion; constricts
afferent arteriole;  GFR and urine out
PTH Proximal and distal tubules, Ca++ reabsorption by loop and distal
nephron loop tubule and Mg++ reabsorption by PCT;
inhibits phosphate reabsorption by PCT;
promotes calcitriol Synthesis 42
 Histology of Ureter
• The Ureters are thick walled tubes which are 25-30 cm
long and 1 to 10 mm in diameter.
 Layers of ureter
• Adventitia ---- outer fibrous layer (lamina propia)
• Muscularis ----- middle smooth muscle layer. It
consists of outer circular and inner longitudinal layer
in the upper 2/3 while another outer longitudinal layer
is added in the lower 1/3
• Mucosa----- the innermost folded mucous layer
forming star shape.
• The ureters open obliquely through the wall of the
posterior aspect of the urinary bladder.
43
 Urinary Bladder
• The urinary bladder is a hollow, distensible
muscular organ situated in the pelvic cavity
posterior to the pubic symphysis.
• In males it is anterior to the rectum; in females, it is
anterior to the vagina and inferior to the uterus.
• Folds of the peritoneum hold the urinary bladder in
position.
• It rises into the abdominal cavity when it is full.
Urinary bladder capacity averages 700—800 ml.
• it is smaller in females because of the uterus.
44
• In the floor of the urinary bladder is a small triangular
area called the trigone.
• The two posterior corners of the trigone contain the
two ureteral openings and internal urethral orifice.
• The three tissue layers of the wall of the urinary
bladder are the same as those of the ureters. The
muscularis that surrounds the mucosa is also called
detrusor muscle (detrusor= to push down).
• Rugae (the folds in the mucosa) are also present to
permit expansion of the bladder.
• Inferior to the internal urethral sphincter is the
external urethral sphincter which is under voluntary
control.
45
Urinary Bladder

46
 Urethra
• The urethra is a small tube leading from the internal
urethral orifice in the floor of the urinary bladder to the
exterior of the body.
• Urethra in female is shorter (4 cm) than that in the
male (20 cm).
• There are two urethral sphincters, internal and
external.
 The internal sphincter muscle of urethra: located at
the bladder's inferior end and the urethra's proximal
end at the junction of the urethra with the urinary
bladder. The internal sphincter is made of smooth
muscle, therefore it is under involuntary or autonomic
control.
47
 The external sphincter muscle of urethra:
• located at the bladder's distal inferior end in females
and inferior to the prostate (at the level of the
membranous urethra) in males.
• Unlike the internal sphincter muscle, the external
sphincter is made of skeletal muscle, therefore it is
under voluntary control of the somatic nervous
system. The male urethra is subdivided into three
regions:
• Prostatic urethra—passes through prostate
• Membranous urethra—the shortest portion which
passes through the deep perineal muscles.
• Spongy urethra—the longest portion which passes
through the penis
48
Urethral sphincters

49
 Micturition
• Discharge of urine from the urinary bladder is called
micturition (mictur=urinate).
• It is also called urination or voiding.
• Micturition occurs through a combination of involuntary and
voluntary muscle contractions.
• When the volume of urine in the bladder reaches 200—400
ml, pressure within the bladder increases , and stretch
receptors in its wall transmit nerve impulses into the spinal
cord.
• These impulses propagate to the micturition center in the
sacral cord segments S2 and S3 and trigger a spinal reflex
called the micturition reflex. In this reflex action,
parasympathetic impulses propagate from the micturition
center to the urinary bladder wall and internal urinary
sphincter.
50
• The parasympathetic nerve impulses cause
contraction of the detrusor muscle and the
relaxation of the internal urethral sphincter
muscle.
• Simultaneously, the micturition center inhibits
somatic motor neurons that innervate skeletal
muscle in the external urethral sphincter.
• Upon contraction of the urinary bladder wall and
relaxation of the sphincters, urination takes place.

51
Nervous System
A&P-II Unit-III

Muhammad Iqbal
Lecturer
KMU
 Objectives
At the end of this unit the learners will be able to:
• Define Nervous system.
• Briefly discuss organization of Nervous system.
• Define nerve & its types.
• Describe the structure and function of Neuron and
neuroglia.
• Identify the principal parts of the brain i.e. Hind brain,
Mid brain & Fore brain.
• Discuss the structure & function of:
--Brain stem (Mid brain, pons & medulla oblongata)
--Cerebellum
• Describe the structure of cerebrum in terms of:
-- Lobes (sulci and gyrus)
--Functional areas
 Objectives
• Describe the three meninges covering the brain &
spinal cord.
• Identify the ventricles of the brain.
• Briefly explain the formation, circulation,
reabsorption & functions of cerebrospinal fluid
(CSF).
 Objectives
• Discuss the general & cross sectional structure of the spinal
cord.
• Describe reflex arc.
• Discuss the distribution of the spinal nerves and spinal
plexus.
• Discuss the cranial nerves in terms of:
• Central connection
• Peripheral connection
• Functions
• Define Autonomic Nervous System
• Discuss the sympathetic and Para sympathetic Nervous
system.
 Nervous System
• Definition: The network of nerves and nerve fibers
that transmits nerve impulses between parts of the
body.
• With a mass of only 2 kg, the nervous system is one
of the smallest and yet the most complex of the 11
body systems. It is an intricate , highly organized
network of billions of neurons and even more
neuroglia.
• The structures that make up the nervous system
include the brain, cranial nerves, and their branches,
the spinal cord, spinal nerves and their branches,
ganglia, enteric plexuses and sensory receptors.
• The skull encloses the brain, which contains about 100
billion (1011) neurons.
• Twelve pairs (right and left) of cranial nerves emerging
from the base of the brain.
• The spinal cord connects the brain through the foramen
magnum of the skull and is protected by the bones of the
vertebral column.
• It contains about 100 million neurons. 31 pairs of spinal
nerves leave the spinal cord for specific region on the right
or left side of the body.
• Ganglia (swelling or knot) are small masses of nervous
tissue, consisting basically of neuron cell bodies that are
located outside the brain and spinal cord.
• Ganglia are closely associated with cranial and spinal
nerves. In the walls of organs of the GIT, extensive
networks of neurons, called enteric plexuses, help
regulate the digestive system.
 Functions of the Nervous System

• The nervous system carries out different functions like

smell, speech, storing, remembering past events. It
controls body movements and regulates the operation
of internal organs. All these diverse activities are
grouped into three basic functions such as sensory,
integrative, and motor.
• Sensory function: Sensory receptors detect internal
stimuli, such as an increase in blood acidity, external
stimuli, such as a housefly sitting on your body part.
Neurons called sensory or afferent neurons (af=toward;
ferrent=carried) carry this sensory information into the
brain and spinal cord through cranial and spinal nerves.
• Integrative Function: The nervous system
integrates (processes) sensory information by
analyzing and by making decisions for appropriate
responses. An important integrative function is
perception, the conscious awareness of sensory
stimuli. Perception occurs in the brain.
• Motor Function: Once the sensory information is
integrated, the nervous system gives an
appropriate motor response such as muscle
contraction or gland secretion.
• The neurons that serve this function are called
motor or efferent neurons.
• Motor neurons carry information from the brain
toward the spinal cord or effectors (muscles and
glands). Stimulation of the effectors by motor
neurons causes muscles to contract and glands
to secrete.
Nervous Supporting Tissues (Neuroglia)
• Neuroglia (glia=glue) are cells of the nervous
system that perform various supportive functions.
• They outnumber neurons.
• In contrast to neurons, they divide and multiply.
• Brain tumors arise from neuroglia, called glioma.
• There are six types of neuroglia.
• Four types found in the CNS are astrocytes,
oligodendrocytes, microglia, and ependymal cells.
• Other two types found in the PNS are Schwann,
and satellite cells.
 Neuroglia of the CNS
Astrocytes (astro=star; cyte=cell)
• These star shaped cells are the largest and most
numerous of the neuroglia.
• The processes of astrocytes make contact with
blood capillaries, neurons, and the pia matter.

• When neurons are damaged, astrocytes form

hardened masses of scar tissue and fill space
formerly occupied by neurons. This process is
called astrocytosis or sclerosis.
• Functions of Astrocytes:
• Astrocytes provide a supportive framework.
• Together with the endothelial cells of blood
capillaries they form a blood brain barrier (BBB) to
isolate harmful materials from CNS.
• They help in nourishing neurons.
• Regulate the chemical composition of tissue fluid.
• Take up excess neurotransmitters.
Astrocyte
Oligodendrocytes: (oligo=few; dendro=tree)
• They resemble astrocytes but have fewer processes.
• Their processes form myelin sheath around axons in
the brain and spinal cord.

Microglia:
• They are small cells with thinner processes.
• They function as phagocytes (macrophages).
 Ependymal Cells (epen=above; dym=garment):
• They are cuboidal to columnar cells.
• Arranged in a single layer.
• Possess microvilli and cilia.
Functions:
• They line cavities of brain and spinal cord.
• Secrete cerebrospinal fluid (CSF) and circulate it.
Neuroglia
 Neuroglia of PNS
Schwann Cells:
• They surround the axons in the PNS.
• Each cell encircles (myelinates) only one axon.
• They form myelin sheath around the axons.
• They aid in regeneration of damaged axons of PNS.
Satellite cells:
• These flat cells surround the cell bodies of neurons of
PNS and form ganglia.
• They regulate the exchange of materials between
neuronal cell bodies and interstitial fluid.
Schwann Cell
PNS Axon Regeneration
Nerve
Nerve
Neuron
 Properties of Neuron
Special characteristics of neurons
– Longevity – can live and function for a lifetime
– Amitotic— Do not divide
– High metabolic rate – require abundant oxygen and
glucose
 Properties of Neuron
– Excitability—the ability to respond to the stimulus
and convert it into an action potential.
– Conductivity: The transmission of nerve impulse.
– Secretion: When the electrical signal reaches the end
of a nerve fiber, the neuron secretes a chemical
neurotransmitter that stimulates the next cell.

Action potential (nerve impulse) is an electrical signal

that propagates (travels) along the surface of the
membrane of a neuron.
 Parts of the Neuron
• Most neurons have three parts
1. A Cell Body
2. Dendrites
3. An Axon
• Cell Body or soma or Perikaryon:
– Contains nucleus and organelles
 Neuron Processes
• Dendrites: short, often highly branched.
– Receptive regions of the neuron
• Axon: Long cytoplasmic process carrying nerve impulse
– Neuron has only one axon
– Transmits impulse away from soma toward another
neuron, muscle fiber or gland
The processes (dendrites and axon) are collectively called
neurites
– Axon hillock: cone shaped elevation of Axon
– Initial segment: the closest part to the axon hillock
Note: Axons vary in length from 1 mm long up to 1
meter.
– Axoplasm: Cytoplasm of axon
– Axolemma: plasma membrane of axon
– Axon terminals or telodendria: Terminal branches of
axon
– synaptic end bulbs or synaptic knobs: Bulb
shaped structures on the tip of axon terminals
with synaptic vesicles filled with neurotransmitters

– Synapse: The site of communication between two

neurons or a neuron and an effector.
 Structural Classification of Neurons
Multipolar – possess more than two processes
• Numerous dendrites and one axon
• Most neurons in the brain and spinal cord are of this type
Bipolar – possess two processes
• One main dendrite and one axon
• Rare neurons – found in some special sensory organs
Unipolar – possess a single short process
Neurons Classified by Structure

Figure 12.10a–c
 Classification of Nerve Fibres
• Structure based
• Myelinated and non-myelinated
• Distribution based
• Somatic and visceral/autonomic
• Origin based
• Cranial and Spinal
• Function based
• Sensory, Motor , and interneuron
• Polarity based
• Multipolar, Bipolar, and Unipolar
• Secretion based
• Adrenergic (secrete noradrenalin) and Cholinergic (Ach)
• Diameter and Conduction based (Erlanger and Gasser)
• Type A, Type B, and Type C
• A and B are myelinated while C is not
• A is the thickest while C is the thinnest
 Functional Classification of Neurons
1. Sensory neurons are sensitive to various stimuli. There are
sensory neurons in the skin, muscles, joints, and organs that
indicate pressure, temperature, and pain. There are more
specialized neurons in the nose and tongue that are sensitive to
the molecular shapes we perceive as tastes and
smells. Neurons in the inner ear are sensitive to vibration, and
provide us with information about sound. And the rods and
cones of the retina are sensitive to light, and allow us to see.
2. Motor neurons are able to stimulate muscle cells
throughout the body, including the muscles of the heart,
diaphragm, intestines, bladder, and glands.
3. Interneurons are the neurons that provide connections
between sensory and motor neurons. The neurons of the
central nervous system, including the brain, are all
interneurons.
Interneuron
Nervous system Division
Brain
 Brain
• The average adult brain weighs about 1600 g in men
and 1400 g in women. The brain is divided into three
major portions—cerebrum, cerebellum, and
brainstem.
• The cerebrum, the largest part of the brain, consists
of two hemispheres. Each hemisphere is marked by
thick folds called gyri (gy= turn, twist) separated by
shallow grooves called sulci (sulc= furrow, groove).
• The right and left hemispheres are separated by a
very deep groove called longitudinal fissure.
• The hemispheres are connected by a thick bundle of
nerve fibers called the corpus callosum (corpus=body;
call=thick).
• The cerebellum (cereb=brain; ellum=little), the
second largest part of the brain, lies inferior to
the cerebrum and occupies the posterior cranial
fossa. It is also marked by gyri, sulci, and fissures.
• The brainstem which is like a vertical stalk with
the cerebrum perched on the top of it like a
mushroom cap on its stalk.
• The major components of the brainstem, from
rostral to caudal, are the diencephalon, midbrain,
pons and medulla oblongata.
 Grey and white matter

• The brain, like the spinal cord, is composed of

grey and white matter.
• Grey matter (cell bodies and dendrites) forms a
surface layer called the cortex over the cerebrum
and cerebellum, and the deeper masses called
nuclei.
• A bundle of axons form tracts in CNS.
 Terms
• Grey matter: A cluster of cell bodies forming grey
matter and is found in the periphery of the brain and
in the center of the spinal cord.
• White matter: Nerve fibers forming white matter.
• Nucleus (plural, nuclei): A group of cell bodies forming
grey matter in CNS is called nucleus.
• Ganglion: A cluster of nerve cell bodies in the PNS
(except basal ganglia in CNS).
• Basal ganglion: A cluster of grey matter deep in each
cerebral hemisphere.
• Tract: A bundle of axons in the CNS.
• Nerve: A bundle of axons in the PNS is called a nerve.
 Major Parts of the Adult Brain
• The adult brain consists of three major parts:
1. Hindbrain— a) Medulla Oblongata, b)Pons, and
c) Cerebellum
2. Midbrain
3. Forebrain
a) Diencephalon
—thalamus
— hypothalamus, and
— Epithalamus
b) Cerebrum
Functions of the medulla:
• Cardiac center, which adjusts the rate and force
of the heartbeat.
• Vasomotor center, which adjusts blood vessel
diameter to regulate blood pressure and reroute
blood from one part to another.
• Respiratory center, which controls the rate and
depth of the breathing through medullary
rithmicity.
• The medulla contains nuclei associated with
five pairs of cranial nerves:
• Vestibulocochlear nerves(VIII)
• Glossopharyngeal nerves (IX)
• Vagus nerves (X)
• Accessory nerves (XI)
• Hypoglosal nerves (XII)
 Pons (=bridge)
• Like medulla, the pons consists of both nuclei and
tracts.
• It is a bridge that connects parts of the brain with one
another through axons.
• The pons contain nuclei that relay signals from the
cerebrum to the cerebellum which are concerned with:
Sleep, hearing, equilibrium, taste, eye movements,
facial sensation, respiration (pneumotaxic and
apneustic), swallowing, bladder control, and posture.
The nuclei of the pons are associated with four
pairs of cranial nerves:
• Trigeminal nerves (V)
• Abducens nerves (VI)
• Facial nerves (VII)
• Vestibulocochlear nerves (VIII)
 Cerebellum
• Cerebellum is the largest part of the hindbrain.
• It lies posterior to the medulla and pons and
inferior to the posterior portion of the cerebrum.
• It consists of the right and left cerebellar
hemispheres.
Midbrain
• It is a short segment of the brainstem that connects
the hindbrain and forebrain.
• It extends from pons to diencephalon.
• It connects the cerebrum with the lower parts of the
brain.
• It contains nuclei and tracts.
• It contains several other nuclei called substantia nigra
(nigra= black) which are darkly pigmented.
• Dopaminergic neurons extend from substantia nigra.
• The loss of these neurons results in parkinson disease.
Reticular Formation
• Running vertically through the core of the midbrain,
pons, and medulla is a loosely organized core of gray
matter called the reticular formation (ret= net),
composed of more than 100 small nuclei,
interspersed among the small bundles of myelinated
axons (white matter). It extends from the upper part
of the spinal cord throughout the brain stem and into
the lower part of the diencephalon. Part of the
reticular formation, called the reticular activating
system (RAS), consists of sensory axons that enter
the cerebral cortex.
Functions
• Coordination of skeletal muscles.
• Coordination of activities controlled by ANS, e.g.
cardiovascular, respiratory and GI activities.
• Selective awareness that selectively blocks or passes
sensory information to the cerebral cortex or the
brain learns to ignore repetitive, inconsequential
stimuli while remaining sensitive to others, e.g. a
person can sleep through a traffic noise but wake
promptly to the sound of an alarm clock.
Similarly, the slight sound made by a child in bed
may arouse his mother but the noise of regularly
passing trains may be suppressed.
 Diencephalon
• The diencephalon extends from the brain stem to the
cerebrum and surrounds the third ventricle.
• It includes the thalamus, hypothalamus, and
epithalamus.
Thalamus
• The thalamus (= inner chamber), which makes up 80%
of the diencephalon, consists of paired oval masses of
grey matter with interspersed tracts of white matter. A
bridge of grey matter called the intermediate mass
(interthalamic adhesion) joins the right and left halves
of the thalamus.
• Thalamus is the gateway to the cerebrum. It is
involved in arousal, eye movement, taste, smell,
hearing, and equilibrium.
Hypothalamus
• It is a small part of diencephalon which lies inferior
to the thalamus.
• The pituitary gland is attached to the
hypothalamus by a stalk (infundibulum).
• It is the major control center of the ANS and
endocrine system and control visceral functions as;
• Hormone secretion, Autonomic effect,
thermoregulation, food and water intake, Sleep
and circadian rhythms, memory, and emotional
behaviors are its functions.
Epithalamus
• It consists mainly of the pineal gland (= pine cone-
like) and habenular nuclei. The pineal gland is
about the size of a small pea. The pineal gland is a
part of the endocrine system which secrets the
hormone melatonin. A more melatonin is liberated
during darkness than in light. It promotes sleep.
• The habenular nuclei are involved in olfaction,
especially emotional responses to odors of food.
 Cerebrum
• Cerebrum is the “seat of intelligence”. It enables us to
read, write, speak, and think. The hemispheres consist
of an outer rim of grey matter called cerebral cortex
(2—4 mm thick). Deep to the cerebral cortex lies the
cerebral white matter.
• The cerebral folds are called gyri (= circles) or
convolutions. The shallower grooves between the
folds (gyri) are called sulci; and, the deepest grooves
between the folds are termed fissures. The most
prominent fissure is the longitudinal fissure that
separates the two hemispheres called falx cerebri.
• The hemispheres are internally connected by white
matter called the corpus callosum.
Lobes of the cerebrum
• Each cerebral hemisphere is further subdivided
into four lobes. They are named after the bones
that cover them: frontal, parietal, temporal, and
occipital lobe. The central sulcus separates the
Frontal lobe from the parietal lobe. The lateral
sulcus separates the frontal lobe from the
temporal lobe. The parieto-occipital sulcus
separates the parietal lobe from the occipital
lobe. A small fifth lobe or part of the cerebrum,
called insula lies deep to the lateral sulcus which
is made visible by retracting or cutting away some
of the overlying cerebrum.
Brain
Basal ganglia or nuclei
• Deep within each cerebral hemisphere are three nuclei
that are collectively called basal ganglia or may also be
called basal nuclei in some textbooks as the word is
best restricted to the clusters of neurons outside the
CNS.
• The three basal ganglia/nuclei are globus pallidus
(globus=ball; pallidus=pale), putamen (=shell, pod or
husk), and caudate nucleus (caud=tail). The putamen
and globus pallidus are collectively called the lentiform
(lens shaped), while the putamen and caudate nucleus
are collectively called corpus straitum.
• The basal ganglia help regulate initiation and
termination of movements.
• Figure 8.12 The motor circuit. The motor circuit is formed by interconnections between motor areas of the
cerebral cortex, the basal nuclei (basal ganglia), and other brain regions. Note the extensive inhibitory, GABA-
ergic effects (shown in red) made by the globus pallidus on other structures of this circuit. The excitatory
neurotransmitters of this circuit are glutamate (green) and dopamine (blue).
The Limbic system
• The limbic (=border or rim) system, named for the
medial border of the temporal lobe, is a ring of
cortical structure surrounding the corpus callosum
and thalamus. The limbic system is sometimes called
the “emotional brain” It includes the nuclei called as:
• Amygdala (almond-shaped): is composed of several
groups of neurons located close to the caudate
nucleus which is concerned with emotions.
• Hippocampus (=seahorse): It extends into the floor
of the lateral ventricle which functions in memory.
 MENINGES
• The cranium and the cranial meninges (made up of
connective tissue) surround and protect the brain.
The cranial meninges are continuous with the spinal
meninges. They have the same basic structure and
names. The three meninges are:
• DURA MATER (=tough mother)—the outer dense
connective tissue cover of the brain. It is also called
pachymeninx.
• Cranial or Cerebral Dura
• Two layers----outer endosteal layer lining cranium,
and inner meningeal layer.
 Meninges cont….

• Two large rigid folds of the meningeal layer

project into the cranial cavity to support the
brain and hold it in position. The two folds are:
• Falx cerebri, and tentorum cerebelli
 Meninges cont....
• In certain places, the meningeal layer of the dura
matter folds inward to separate major parts of the
brain:
• 1) The falx cerebri (falx=sickle) extends into the
longitudinal fissure and separates the two
hemispheres of the cerebrum.
• 2) The falx cerebelli separates the two hemispheres
of the cerebellum.
• 3) the tentorum cerebelli ( tentorum=tent)
separates cerebellum from the overlying cerebrum.
• The two dural layers are fused together but in some
places they are separated by dural sinuses, spaces
that collect venous blood.
• The two major dural sinuses are the superior
sagittal sinus, found just under the cranium along
the mid sagittal line, and the transverse sinus,
which runs horizontally from the rear of the head
toward each ear.
• These sinuses meet like an inverted T at the back of
the brain and ultimately empty into the internal
jugular veins of the neck.
• The space between dura and arachnoid matter is
called subdural space.
 Meninges cont….
• Spinal Dura
• Spinal dura matter is a thick fibrous membrane
extending from foramen magnum to the lower
border of 2nd sacral vertebra.
• The spinal dura matter has only one layer.
• The space between the dura matter and the wall of
the vertebral canal is called the epidural or
extradural space.
• The spinal epidural space is occupied by loose
aereolar tissue, fat and internal vertebral venous
plexus.
• Nerves entering and leaving the spinal cord pass via
the epidural space.
 Meninges cont....
• ARACHNOID MATER
• Cerebral Arachnoid: (arachn=spider; oid= similar
to)—because of its spider’s web arrangement of
delicate collagen and elastic fibers forming the
middle cover.
• It is separated from pia matter by subarachnoid
space, which contains CSF.
• In some areas, the subarachnoid spaces are large
and called cisterns having more CSF. One of them is
cisterna magna lying b/w the undersurface of
cerebellum and medulla.
• It may be used for cisternal puncture by inserting
needle b/w occipital bone and atlas vertebra to get
a sample of CSF.
 Meninges cont...

• Spinal Arachnoid:
• It continues downward to envelop the spinal
cord and ends by merging with the dura mater at
the level of 2nd sacral vertebra.
• Pia mater (pia=delicate)— A thin transparent
connective tissue layer forming the innermost
meninx.
• The spinal cord ends at L1 vertebra.
• Pia mater pierces other meninges and extends as
‘’filum terminale’’ up to the coccyx
 Ventricles
• The brain has four internal interconnected
chambers or cavities called ventricles (=little
cavities):
• Lateral ventricles are two cavities, one located in
each cerebral hemisphere.
• Each ventricle is C-shaped comprising a central part,
anterior, posterior, and inferior horn.
• Anterior horn extends into the frontal lobe;
posterior horn into occipital lobe; and inferior horn
extends downward and forward into temporal lobe.
 Ventricles cont….
• The third ventricle is a narrow medial cavity along the
midline inferior to the corpus callosum, superior to the
hypothalamus and between the right and left halves of the
thalamus. It communicates on either side with the each
lateral ventricle through interventricular foramen. A canal,
called the cerebral aqueduct passes down the core of the
midbrain and leads to the fourth ventricle.
• The fourth ventricle, a small chamber lies between the
pons (of brain stem) and cerebellum. Caudally, this
chamber narrows and forms a central canal that extends
through the medulla oblongata into the spinal cord.
Ventricles (Fox)
 Four Ventricles

• From top to bottom:

Blue - Lateral ventricles
Cyan - Interventricular foramina (Monro)
Yellow - Third ventricle
Red - Cerebral aqueduct (Sylvius)
Purple - fourth ventricle
Green - continuous with the central canal
(Apertures to subarachnoid space are not visible)
 Cerebrospinal Fluid
• The cerebrospinal Fluid (CSF) is a clear, colorless liquid
that fills the ventricles and canals of the CNS and
bathes external surface of brain.
• The total volume of CSF is 80 to 150 ml in an adult.
CSF contains glucose, proteins, lactic acid, urea, cations
(Na+, K+, Ca2+, Mg2+), and anions (Cl- and HCO3-). It also
contains some WBCs.
Formation:
The CSF is produced by the choroid plexuses
(choroid=membrane like), networks of capillaries in the
walls of the ventricles. The blood capillaries are
covered by ependymal cells that form CSF from blood
plasma by filtration and secretion.
Circulation of CSF
• The CSF formed in the choroid plexuses of each lateral
ventricle flows into the third ventricle through two
narrow oval openings, the interventricular foramina.
• More CSF is added by the choroid plexus in the roof of
the third ventricle.
• The fluid then flows through the cerebral aqueduct
which passes through the midbrain into the fourth
ventricle.
• The choroid plexus of the fourth ventricle adds more
fluid. CSF enters the subarachnoid space through
three openings (one median aperture and two lateral
apertures) in the roof of the fourth ventricle. CSF then
circulates in the central canal of the spinal cord and in
the subarachnoid space around the surface of the
brain and spinal cord.
• Reabsorption of CSF
• CSF is gradually reabsorbed into the blood
through arachnoid villi, fingerlike extensions of
the arachnoid that project into the dural sinuses
especially the superior sagittal sinus and finally
into the venous blood. Normally CSF is
reabsorbed as rapidly as it is formed, at a rate of
about 20 ml/hr.
Functions of CSF
1. Mechanical Protection: CSF serves as a shock-
absorbing medium that protects the brain and spinal
cord from mechanical injuries. The fluid also buoys
(keeps afloat) the brain the cranial cavity.
2. Chemical protection: CSF provides an optimal
chemical environment for accurate neuronal
signaling. Even a slight change in the ionic
composition of CSF within the brain can seriously
disrupt production of action potentials.
3. Circulation: CSF keeps flowing through and around
the CNS and ultimately reabsorbing into the blood
stream. It allows exchange of nutrients and waste
products between the blood and nervous tissue.
 Cranial Nerves
• The 12 pairs of cranial nerves are so named because
they pass through various foramina of the cranium.
Like the 31 pairs of spinal nerves, they are part of the
PNS. Each cranial nerve is designated by both a
number (roman numeral, from I to XII) and a name.
the numbers indicate the order, from anterior to
posterior, in which the nerves arise from the brain.
The names designate a nerve’s distribution or
function.
• Cranial nerves emerge from the nose (cranial nerve I),
and the eyes (cranial nerve II). These two pairs of
neurons are sensory. The rest are classified as mixed
nerves as they contain both motor and sensory axons.
 Cranial Nerves
Olfactory Nerve (I)
Composition: Sensory
Function: Smell
Origin: Olfactory mucosa in nasal cavity.
Termination: Olfactory bulbs beneath frontal lobe of
brain

Optic Nerve (II)

Composition: Sensory
Function: Vision
Origin: Retina
Termination: Thalamus
Oculomotor Nerve (III) (oculo= eye)
Composition: mixed but mainly motor
Function: Eye movements, opening of eyelid,
constriction of pupil, focusing, proprioception
Origin: Midbrain
Termination: Somatic fibers lead to levator
palpebrae superioris, superior, medial, and
inferior rectus, and inferior oblique muscles;
parasympathetic fibers enter eyeball and
constrict iris and ciliary muscles.
Trochlear Nerve (IV) (trochle= pulley)
Composition: mixed but mainly motor
Function: Eye movements and proprioception
Origin: Midbrain
Termination: superior oblique muscle of eye
Trigeminal Nerve (V) (=triple, for its three branches):
The largest of the cranial nerves; consists of three divisions or
branches designated V1(ophthalmic), V2(maxillary), and V3
(mandibular)
Composition: Mixed
Ophthalmic Division (V1)
Composition: Sensory
Function: Sensation from upper eyelid, eyeball, lacrimal
glands, upper part of nasal cavity, and side of nose,
forehead, and anterior half of the scalp.
Origin: superior region of face, eyeball, lacrimal gland, superior
nasal mucosa, frontal and ethmoid sinuses.
Termination: Pons
Effects of damage: loss of sensation
Clinical test: test corneal reflex—blinking in response to light,
touch to eyeball.
Maxillary Division (V2):
Composition: sensory
Function: Same as V1, including lower face sensation
Origin: Middle region of face, nasal mucosa,
maxillary sinus, palate, upper teeth and gums.
Termination: Pons
Effects of damage: Loss of sensation
Clinical test: test sense of touch, pinpricks, hot and
cold touch.
• Mandibular division (V3):
• Composition: Mixed
• Function: Same sensation as V1 and V2 lower on
face; mastication.
• Sensory origin: Inferior region of face, anterior
tongue (but not taste buds), lower teeth and gums,
floor of mouth.
• Sensory termination: Pons
• Effects of damage: Loss of sensation, impaired
chewing
• Clinical test: Test the mobility of mandible and to
open mouth against resistance.
Trigeminal Nerve
Abducens nerve (VI) (ab=away; ducens= to lead)
Composition: predominantly motor
Motor Function: Eye movements
Motor Origin: Inferior pons
Termination: lateral rectus muscle of eye
Effects of damage: Inability to rotate eye laterally.
Clinical test: test eye movement laterally
Facial Nerve (VII)
Composition: Mixed
Sensory Function: Sense of taste
Sensory Origin: Anterior taste buds
Sensory Termination: Thalamus
Motor Function: Facial expression, autonomic
control of tear glands, nasal and palatine glands
submandibular and sublingual salivary glands.
Motor origin: Pons
Effects of damage: Inability to control facial
muscles, sagging (drooping or hanging loosely),
distorted sense of sweet taste
Vestibulocochlear Nerve (VIII): vestibule=small
cavity; cochlea= spiral, snail like
Composition: predominantly sensory
Function: hearing and equilibrium
Sensory origin: Inner ear
Sensory Termination: Pons and medulla
Motor Origin: Pons
• Glossopharyngeal Nerve (IX): glosso=tongue;
pharyngeal= throat
Composition: Mixed
Sensory Function: Taste, sensation from tongue
and pharynx
Motor Function: Swallowing, salivation, gagging
Moto Origin: Medulla Oblongata
• Vagus Nerve (X): vagus= vagrant or wandering
Composition: Mixed
Sensory Origin: Proprioceptors in neck and throat muscles,
baroreceptors in the arc of aorta, chemoreceptors in the
aorta,
Sensory termination: Medulla and Pons
Sensory Function: Taste and somatic sensations, monitoring
BP, and O2 and CO2 in blood,
Motor Origin: Originates from medulla
Innervation: Skeletal muscles in neck and throat,
parasympathetic supply to smooth muscles in the airway,
esophagus, stomach, small intestine, most of large
intestine, gall bladder, cardiac muscles, and GIT glands
Somatic Motor Function: Swallowing, coughing and voice
production
• Autonomic Motor Function (Parasympathetic):
Smooth muscle contraction, and relaxation in
organs of GI tract, GIT secretion, slowing of the
heart rate.
• Accessory Nerve (XI) = Additional, assisting): it
differs from all other cranial nerves because it
originates from both the brain stem and the
segments (C1 through C5)of spinal cord. The cranial
root is motor while the spinal root is mixed. It passes
via the jugular foramen
Composition: Mixed but mainly motor
Motor Function: Swallowing; head, neck , and
shoulder movements
Origin: Medulla oblongata
Termination: palate, pharynx, sternocleidomastoid
and trapezius muscles.
Effects of damage: impaired movement of head, neck,
and shoulders, difficulty in shrugging shoulders,
paralysis of sternocleidomastoid.
Clinical test: test ability to rotate head and shrug
shoulders against resistance.
Accessory Nerve
• Hypoglossal Nerve (XII)
Composition: Mixed but mainly motor
Function: Tongue movements of speech, food
manipulation, and swallowing.
Origin: Medulla oblongata
Termination: Intrinsic and extrinsic muscles of
tongue.
Cranial Nerves
Mnemonics for Cranial Nerves taken from Saladin page 547
 SPECIAL
SENSES
Anatomy &
Physiology-II Unit-V
Shabnam
Faculty INS-
KMU
Acknowledgement: Muhammad
Iqbal Lecturer INS-KMU
 Objective
s
At the end of this unit, the learners will be
able to:
 Define key terms
 Describe the structure and function of Ear
 Discuss the transmission of sound through
the Ear.
 Describe the physiology of hearing and
Balance.
 Classification of

Receptors
Chemoreceptors: respond to chemicals including
odor, taste, and body fluid composition.
 Thermorecptors: respond to heat and cold.
 Nociceptors: are pain receptors which respond to
tissue damage resulting from trauma, ischemia,
etc.
 Mechanoreceptors: respond to physical
deformation caused by vibration, touch, pressure,
stretch, or tension.
 Photoreceptors: respond to light like eyes.
 Proprioceptors: sense the position and movements
of the body or its parts. They are found in muscles,
tendons, and joint capsules.
 Anatomy of the
Ear
The ear has three regions:
1. External ear
2. Middle ear
3. Inner ear
The first two are concerned only with transmitting
the sound to the inner ear.
1. External Ear
 The external ear is a funnel shaped tube called
auditory canal that conducts air vibrations to the
ear drum. The outer part of ear is pinna or auricle.
 The external auditory canal contains a few hairs and
specialized sweat glands called ceruminous glands
that secrete earwax or cerumen. The hair and
ceriman help prevent the entry of dust and microbes
from entering the ear.
2. Middle ear
 It is located in the tympanic cavity of the temporal
bone.
 It begins with the ear drum/tympanic membrane.
 Posterior the tympanic cavity is continuous with the
mastoid air cells in the mastoid process. It is filled with
air that enters by way of the auditory (Eustachian)
tube, a passageway to the nasopharnynx.
 The tympanic cavity, 2 to 3 mm wide between outer
and inner ear, contains the three smallest bones
and two smallest muscles of the body.
 The bones, called the auditory ossicles, connect the
eardrum to the inner ear. Progressing inward, the first
bone is malleus, the second is incus, and the third is
stapes.
 The two muscles are stapedius, connecting stapes
to the posterior wall of the cavity, and tensor
tympani which connects malleus.
3. Internal Ear
The internal ear is also called labyrinth because of its
series of canals.
It consists of two main divisions:
 Bony labyrinth.
 Membranous labyrinth
The bony labyrinth, a series of cavities and
tubes in the temporal bone, divides into three
parts:
1. Three semicircular canals
2. The vestibule, both of them contain
receptors for equilibrium,
3. The choclea (=snail), which contains
receptors for hearing
 The bony labyrinth is lined with periosteum and
contains perilymph, a fluid between the bony
and the membranous labyrinth.
 The membranous labyrinth, a series of sacs
inside the bony labyrinth, is lined by epithelium
and contains endolymph.
 The vestibule is the oval central portion or
chamber of the bony labyrinth.
 Projecting superiorly and posterior from the
vestibule are the three bony semicircular
canals.
 Inner Ear
cont…
Cochlea (=snail):
 The cochlea has three fluid-filled chambers
separated by membranes. The superior one is
called scala (= stair) vestibule, the middle one is
scala media or cochlear duct, and the inferior one
is scala tympani.
 Within the scala media is the organ of corti which is a
thick epithelium with associated structures. It converts
vibrations into nerve impulses.
 The epithelium in the corti is composed of hair cells
and supporting cells.
Ea
r
Organ of
Corti
 Physiology of
Hearing
The following events are involved in the hearing:
 The auricle directs sound waves into the auditory
canal.
 The sound waves strike the eardrum and get it
vibrated.
 The central area of the eardrum is connected with the
malleus which starts to vibrate. The vibration is
transmitted to the incus and then to the stapes.
 As the stapes moves back and forth, it
vibrates the membrane of the oval window.
 The movement of the oval window vibrates the
fluid in the perilymph of the cochlea and the
endolymph inside the cochlear duct.
 The endolymph vibrates the hair cells in the
organ of corti which stimulates the
vestibulocochlear (VIII) nerve to transmit nerve
impulse to medulla
 Physiology of
 Equilibrium
The position of the semicircular canals is vital in
maintaining the equilibrium (both static and
dynamic) particularly of the head.
 In the ampulla, the dilated portion of each canal,
contains a group of hair cells.
 By moving head, the hair cells are bent by the
endolymph in the ampulla.
 Bending of the hair bundles produce receptor
potentials.
 The receptor potential leads to nerve impulses that
pass along the vestibular branch of the
vestibulocochlear (VIII) nerve.
 Both cerebellum and cerebrum give feedback
Ey
e
 Objective
s
At the end of this session, the students will be
able to:
1. Define Key Terms
2. Describe eye in terms of:
— Structure related to vision
— Accessory structures
3. Discuss image formation by describing
refraction, accommodation and constriction
of the pupil.
4. Explain the process of dark adaptation and
light adaptation.
 Accessory structures of the
 Eye
Eyelids: The upper and lower eyelids or palpebrae
protect the eyes.
 Palpebral fissure is the space between the eyelids.
 Conjunctiva is a thin mucous membrane of
stratified columnar epithelium with goblet cells. The
one that lines the inner aspect of the palpebra is
called Palpebral conjunctiva, and the other which
covers the sclera but not the cornea is known as
bulbar conjunctiva.
 Eyelashes and eyebrows: both of them protect
the eyeballs from the foreign objects and sweat.
Sebaceous glands at the base of the hair follicles
of the eyelashes, called the sebaceous cilliary
glands, release sebum. Infection of these glands
 Accessory eye structures
 The cont….
lacrimal apparatus: is a group of structures that
produce and drains lacrimal fluid or tears. The lacrimal
glands secrete tear which drains into the excretory
lacrimal ducts that empty it onto the surface of the
conjunctiva of the upper lid. After passing the anterior
surface of the eyeball it enters into an opening called
lacrimal punctum, to lacrimal canals, to lacrimal
sac, to nasolacrimal duct. This duct carries the tear
into the nasal cavity just inferior to the inferior nasal
concha.
 The infection of the lacrimal sac is called
dacryocystitis (dacryo=lacrimal sac) which results
in the blockage of the nasolacrimal duct.
 Apart from some mucus, the tears contain
Lacrimal
Apparatus
 Extrinsic Eye
Six extrinsicMuscles
eye muscles move the eyes:
 Superior rectus
 Inferior rectus
 Lateral rectus
 Medial rectus
 Superior oblique
 Inferior oblique.
 They control the movement of each eye and
hold the eyes in the orbits.
 They are supplied by cranial nerves III, IV, VI.
Extrinsic Eye
Muscles

Fig
16.6
 Anatomy of the
Eyeball
The adult eyeball measures about 2.5 cm (1
in.) in diameter
The eyeball consists of three layers:
1. Tunica fibrosa or Fibrous tunic (Sclera)
2. Tunica vasculosa or Vascular tunic
(Choroid)
3. Tunica interna (Retina)
I. Tunica Fibrosa
– It is tough outermost eyeball layer, divided into
two regions: the sclera and cornea
– Sclera—(scler=hard)—white of the eye; Covers
most of the eye surface, composed of collagen &
elastic fibers; optic nerve exits from sclera at the
back of eye.
– Cornea – is the anterior transparent region of
modified sclera that admits light into the eye.
– At the junction of sclera and cornea is an opening
called scleral venous sinus or canal of
schlemm. A fluid called aqueous humor drains
into this sinus.
II. Tunica Vasculosa
also called uvea (=grape) is the middle layer,
consists of the choroid, ciliary body, & iris
a. Choroid—thin, dark vascular layer behind the
retina. Choroid also contains melanocytes that
produce the
pigment melanin which absorbs stray light to
prevent reflection and scattering of light within
the eyeball.
Albinos lack melanin and thus need to wear
sunglasses to minimize the perception of bright
glare.
b. Ciliary body—A thick extension of the
choroid that forms a muscular ring around the
lens.
It supports the iris and lens.
The ciliary body consists of ciliary muscle and
ciliary process
The ciliary muscle is a circular band of smooth
muscle. Its contraction and relaxation changes
the tightness of the suspensory ligaments
(zonular fibers), which alter the shape of the
lens, adapting it for near and far vision.
It is controlled by CN III and parasympathetic
nerves
 The ciliary processes are the extensions of the
ciliary body.
 Epithelial cells together with blood capillaries in the
ciliary processes secrete aqueous humor.
 Extending from the ciliary process are
suspensory ligaments attached to the lens.
C. Iris -the colored portion of the eyeball with a
central aperture (pupil), located between the
cornea and lens and is attached at its outer
margin to the ciliary processes.
 It contains melanocytes and circular and radial
smooth muscle fibers.
 The amount of melanin in the iris determines the
eye color.
 The eyes appear brown to black when melanin
concentration is high, green when melanin
concentration is moderate, and blue when
melanin concentration is low.
 Secretion and Drainage of Aqueous
Humour
 Anterior chamber and posterior chamber
 Secreted by ciliary processes (blood vessels and
epithelial cells) in posterior chamber at the rate of 2
to 3 L/min.
 Drained by canal of schlemm in the anterior
chamber.
 Intra ocular pressure (IOP) is 10—20 mmHg
(average 15) measured by tonometer.
Retina (Tunica Interna)
 The third and inner layer of the eyeball is retina,
which lines the posterior three-quarters of the
eyeball.
 It is the beginning of the visual pathway.
 The surface of the retina is the only place in the
body where blood vessels and optic nerve can de
directly seen through the pupil with the help of
opthalmoscope.
 The optic nerve leaves the eyeball at the site known
as the
optic disc.
 The retina consists of a pigmented layer and a neural
layer.
The Optical Components
 The optical components of the eye are transparent
elements that admit light rays, refract (bend) them,
and focus images on the retina. They include the
cornea, aqueous humor, lens, and vitreous body.
 The aqueous humor is a serous fluid secreted by
the ciliary body into the posterior chamber, a
space between the lens and iris. It flows through the
pupil into the anterior chamber between the iris
and cornea. From here it is reabsorbed by a ring like
vessel called the scleral
venous sinus or canal of schlemm.
 The lens is suspended behind the pupil by a ring of
fibers called the suspensory ligament.
 It is about 9 mm in diameter and 3.6 mm thick at
the middle.
 The vitreous body (vitre=glassy) or vitreous
humor is a transparent jelly that fills the large space
behind the lens.
The neural components
 The neural components are the retina and optic nerve.
 Retina is a thin transparent membrane attached at
only two points—the optic disc, where the optic
nerve leaves the rear (fundus) of the eye, and the
ora serrata (the junction b/w retina and cilliary
body).
 The retina is pressed smoothly against the rear of the
eyeball by the pressure of the vitreous body. It can
become detached (buckle away) from the wall of the
eyeball in some circumstances. It causes blurred
vision. It leads to blindness if the retina remains
detached for longer time from the choroid, on which it
depends for oxygen, nutrition, and waste removal.
• Directly posterior to the center of the lens, on the
visual axis of the eye, is a patch of cells called the
macula lutea (macula=spot; lutea=yellow) about 3
mm in diameter. In the center of the macula is a tiny
pit (small depression) called fovea centralis, which
contains only cones. The fovea centralis is the area of
highest visual acuity or resolution (sharpness of
vision).
• About 3 mm medial to the macula lutea is the optic
disc. Nerve fibers from all regions of the retina
converge on this point and exit the eye to form the
optic nerve.
• The optic disc contains no receptor cells, so it
produces a blind spot in the visual field of each
eye.
 Photoreceptor
 Cells
Photoreceptor cells are the cells that absorb light
and generate a chemical or electrical signal.
There are three kinds of photoreceptors in the
retina: rods, cones, and ganglion cells. These are
special nerve cells.
 Rods contain a protein pigment called rhodopsin.
 Rod cells are responsible for night (scotopic)
vision
(scot=dark; op=vision).
 They can’t distinguish colors from each other
because they have only one kind of rhodopsin
which absorbs the light with wave length of 500
nm
 Cone cells are responsible for day (photopic)
vision as well as color vision.
 The cone cells have visual pigment as photopsin.
 There are three kinds of cones that absorb
different kind of wave length lights.
 Ganglion cells are the largest neurons of the
retina. Their axons form the optic nerve. Some of
the ganglion cells absorb light and transmit
signals to brain stem nuclei that control pupillary
diameter.
 Rod and Cone
cell

Rod cell
 Image
Formation
• The eye is just like a camera.
• Its optical elements focus an image of an object
on a light-sensitive ‘film’ called retina.
• Image formation involves three processes:
• Refraction—bending of light by the lens and
cornea.
• Accommodation—change in shape of the lens.
• Constriction—narrowing of the pupil.
Refraction of Light Rays
 By entering the light rays into the eyes, they
are refracted by cornea (75%) and lens
(25%) of the eyes so that the light rays may
come into exact focus on the retina.
 Images focused on the retina are real
and inverted.
Accommodation
 Accommodation of the eye refers to the act of
physiologically adjusting lens to alter (increase)
its refractive power the closer objects and
(decrease) for distant objects.
 The lenses of the eyes are convex and so
converge the light rays.
 The near point of vision is the minimum distance
from the eye that an object can be clearly focused
with maximum accommodation. This distance is
about 10 cm (4 in.) in a young adult.
Accommodatio
n
Constriction of the Pupil
 The diameter of the hole (pupil) is narrowed by
the contraction the circular muscles of the iris.
 This autonomic reflex occurs simultaneously with
accommodation and prevents light rays from
entering the eye through the periphery of the lens.
 Light entering the periphery cannot be refracted
and focused on the retina and would result in
blurred vision.
 The pupil also constricts in bright light.
 Pupillary Diameter
control
The diameter of the pupil is controlled by two
sets of contractile elements in the iris:
1. The pupillary constrictor consists of smooth muscle
cells that encircle the pupil. When stimulated by the
parasympathetic nervous system, it narrows the pupil
and admits less light to the eyes.
2. The pupillary dilator consists of contractile epithelial
cells called myoepithelial cells. When stimulated by
the sympathetic nervous system, these cells
contract, widen the pupil, and admit more light to
the eyes.
 Light and Dark
Adaptation
• Light adaptation occurs when you go from the dark
into bright light. Going from dark into bright light it is
difficult to open eyes properly because of a harsh
glare which over stimulates the retinas.
• The pupils quickly constrict to reduce the intensity
of stimulation. The rods bleach quickly in bright
light, and cones take over. It takes 5 to 10
minutes to restore the normal vision in the light.
• Dark adaptation occurs when you go from the
bright light into dark. The rod pigment is
bleached in the light. In the absence of light,
rhodopsin regenerates within 20 minutes.
• Dilation of the pupils also helps by admitting
more light to the eyes.
 Refraction
abnormalities
 For focusing clear image on the retina, the normal
eye, known as emmetropic eye, can sufficiently
refract light rays from an object 6 m (20 ft) away.
Improper Refraction results in:
 Myopia or nearsightedness, when the lens
becomes thicker and the image converges in
front of the retina which allows the myopic
individuals to see closer objects clearly, but
not distant objects.
 Refraction abnormalities
cont….
 Hyperopia or hypermetropia or farsightedness in
which the lens becomes thinner and the image
converges behind
the retina. Hypertropic individuals can see distant
object clearly, but not closer ones.
 Presbyopia (presby =old + opia = vision) is another
age related vision problem in which the lens loses its
elasticity and ability to focus on the nearby objects.
Therefore the older people cannot read the nearby
print.
 Pathological
 Terms
Strabismus is a condition in which the eyes do not
properly align with each other when looking at an
object.
Types:
 Esotropia-The term derives from Greek, where ‘eso-‘
means ‘inward,’ and ‘trope’ means ‘turn it is a form of
strabismus in which one or both eyes turns inward.
The condition can be constantly present, or occur
intermittently, and can give the affected individual a
"cross-eyed" appearance.
 Exotropia- is a form of strabismus (eye misalignment)
in which one or both of the eyes turn outward. It is the
opposite of crossed eyes, or esotropia. Exotropia may
occur from time to time (intermittent exotropia) or may
 Hypertropia:A
hypertrop ia is a form
of vertical strabismus
where one eye is
deviated upwards in
comparison to the
fellow eye.
 Glaucoma- Glaucoma is a group of eye diseases
which result in damage to the optic nerve and
cause vision loss
 Cataracts- is the clouding of the eye's natural lens. It
is the most common cause of vision loss in people
over age 40 and is also the principal cause of
blindness in the world.
 Myosis-is a medical term referring to contraction of
the
eye’s pupil in response to bright light.
 Mydriasis- is the medical term for an unusual
dilation or widening of the pupils
 Pterygium- is a vascular pink tissue that can grow
from the conjunctiva onto the cornea. If it grows into
the line of vision (over the pupillary aperture), it can
Pterygiu Catarac
m ts

•
Mydria
si

Mydriasis
Any
Question?
Endocrine
A & P-II
System
Unit V

Muhammad
Iqbal Lecturer
KMU
 Objective
s
At the end of this unit, the students will be able to:
• Define Endocrine system
• Identify the means of communication among
cells
• Identify Endocrine glands and Endocrine
tissues present in the body
• Discuss types of Hormones, target cells, target
organ
• Briefly discuss Mechanism of Action of Hormone

( protein and steroids)

• Discuss the location and structure of pituitary
 Objective
• shypothalamic hormones in
Discuss the role of
the regulation of pituitary gland secretions.
• Discuss the functions of the hormones secreted by
anterior and posterior pituitary gland.
• Briefly discuss the structure, function & hormones of
the following glands
• Thyroid
• Para Thyroid
• Pineal
• Adrenal
• Pancreas
The Endocrine
System
 Definition
• s the system of glands that
Endocrine system:
produce cellular secretions which help to control
bodily metabolic activities.
• Endocrine gland: A ductless gland that
secretes hormones into the blood stream.
• Exocrine gland: A gland that secretes its
products through a duct.
• Hormone (Gk. "impetus") is a chemical
released by a cell or a group of cells in one part
of the body that usually affects cells in other
parts of the body.
• Ligand: A substance which binds with receptor.
 Communication among
• cells activities are regulated by two
All physiological
major systems as Nervous(autonomic nervous
system) and Endocrine system.
• For the body to maintain homeostasis, cells must be
able to communicate and integrate their activities.
• Cells communicate with each other in the following
ways:
 Cell to Cell Signaling or Cell signaling
• The cells communicate with each other via chemical
messengers which are hormones or hormone like
substances. They may be secreted by endocrine
glands or nerve endings.
 Classification of
chemical
messengers
• Endocrine
Messengers
• Paracrine
Messengers
• Autocrine
Messengers
• Neurocrine
Messengers
 Classification of chemical
messengers cont....
• Endocrine Messengers
• They are classical hormone like GH and Insulin.
• Paracrine Messengers (para =beside/near + crine =secrete)
• They diffuse from control cells to target cells via the
interstitial fluid. Some of them directly enter the
neighboring target cells via gap junctions. Such
messengers are also called juxtacrine or local
messengers.
• e.g. Prostaglandin, histamine, somatostatin, and NO(g)
 Communication among cells cont…
 Autocrines Those that act on the same cells that secrete them.
e.g
Leukotrienes
 Neurocrines
• Neurocrine or neural messengers are neurotransmitters
and neurohormones
o Neurotransmitter -----from nerve cell to another or nerve cell or
muscle
like Ach and dopamine.
o Neurohormone ------ by nerve cell into blood and transported to
the distant target cells like OT, ADH and hypothalamic releasing
hormones.
 Norepinephrine acts both as neurohormone and neurotransmitter.

One example of local hormone is interleukin 2 (IL-2) which is released

by helper T cells during immune responses. IL-2 helps activate
other nearby cells, a paracrine effect. But it also acts as an
 The Role of Hormone
Receptors
• A hormone travels through the body in the
blood. It influences only its target cells by
binding to specific protein receptors.
• Only the target cells recognize that hormone like
key- lock relationship.
• Receptors, like other cellular proteins, are
constantly being synthesized and broken down.
• Generally, a target cell has 2000 to 100,000
receptors for a particular hormone.
• Target cells can modulate (adjust) their sensitivity
to a hormone.
• When a hormone is present in excess, the number of
target cell receptors may decrease. This effect is known
as down- regulation. For example, when certain cells
of the testes are exposed to a high concentration of LH,
the number of LH receptors decreases. Down
regulation makes a target cell less sensitive.
• In contrast, when a hormone is deficient, the number
of receptors may increase. This phenomenon is
known as up- regulation which makes a target cell
more sensitive to a hormone
 Classification of
Hormones
• Classified into three:
• 1. Steroid Hormones
• 2. Protein Hormones
• 3. Derivatives of Amino acid called
Tyrosine
 Steroid
Hormones
• Aldosterone
• Cortisol
• Corticosteron
e
• Testosterone
• Estrogen
• Progesterone
• Vit D
 Protein
• GH
Hormones• Insulin
• TSH • Glucagon
• ACTH
• Somatostati
• FSH
n
• LH
• HCG
• Prolactin
• ADH
• OT
• Parathermon
e
 Derivatives of
Tyrosine
• T3
• T4
• Epinephrine
• Norepinephrin
e
• Dopamin
 Endocrine
• EndocrineGlands
glands include:
• Pituitary
• Pineal
• Thyroid
• Parathyroid
• Adrenal
In addition, several organs and tissues are not
exclusively classified as endocrine glands but
contain cells that secrete hormones. These are:
• Hypothalamus
• Ovaries
• Testes
• Placenta
• Kidneys
• Stomach
• Small intestine
• Liver
• Pancreas
• Heart, Skin, Adipose
tissues
Names and Abbreviations for
Hormones
Abbr. Name Source
ACTH Adrenocorticotropi Anterior
c hormone pituitary gland
ADH Antidiuretic hormone Posterio
r
pituitary
ANP Atrial natriuretic peptide Heart
CRH Corticotropin- Hypothalamus
releasing hormone
EPO Erythopoietin Kidney, liver
Names and Abbreviations for
Hormones
Abbr. Name Source
FSH Follicle stimulating hormone Anterior pituitary
GH Growth hormone Anterior pituitary
GHRH Growth hormone releasing h. Hypothalamus
GnRH Gonadotropin-releasing h. Hypothalamus
IGFs Insulin-like growth Liver, other tissues
factors
(somatomedins)
LH Lutinizing hormone Anterior pituitary
NE Norepinephrine Adrenal medulla
OT Oxytocin Posterior pituitary
Names and Abbreviations for
Hormones
Abbr. Name Source
PIH Prolactin-inhibiting hormone (dopamine) Hypothalamus

PRH Prolactin-releasing hormone Hypothalamus

PRL Prolactin Anterior pituitary
PTH Parathermone Parathyroids
T3 Triiodothyronine Thyroid
T4 Thyroxin (tetraiodothyronine) Thyroid
TH Thyroid hormone Thyroid
TRH Thyrotropin-releasing h. Hypothalamus
TSH Thyroid stimulating hormone Anterior pituitary
 Pituitary
Anterio
Hormones
Target Organ Effect/Function
r
pituitar
y
FSH Ovaries, Testes Female: Growth of
ovarian follicles,
secretion of estrogen.
Male: Sperm production

LH Ovaries, Testes Female: ovulation,

maintenance of
corpus luteum
Male:
Testosterone
secretion
 Pituitary
Anterio Hormones
Target Organ Effect/Function
r
pituitar
y
TSH Thyroid gland Growth of thyroid,
secretion of
thyroid hormone

ACTH Adrenal cortex Growth of

adrenal cortex,
secretion of
corticosteroids
 Pituitary
Anterior Hormones
Target Organ Effect/Function
pituitary
PRL Mammary Female: Milk
glands, testes synthesis. Male:
Increased LH
sensitivity and
testosterone
secretion

GH Liver Somatomedin
secretion,
widespread
tissue growth
 Pituitary
Posteri
Hormones
Target Organ Effect/Function
or
pituitar
y
ADH Kidneys Water retention

OT (Oxytocin) Uterus, Labor

mammar contraction
y glands s, Milk
ejection
 Other Sources of
Hormones
Gland + Target Effect/Function
Hormone
Pineal Influence mood; may regulate
Gland: Brain the timing of puberty.
Melatonin
and
serotonin
Thymus: Stimulates T
Thymosin T lymphocytes lymphocytes proliferation
Thymopoietin Suppresses neuromuscular
or thymin activity by inhibiting Ach
release.
Hypersecretion causes
myesthenia gravis
Thyroid: Most tissues Elevate metabolic rate,
T3, T4 promotes nervous system
and skeletal development.
Reduces blood Ca2+ level,
Calcitonin Bone promotes Ca2+ deposition in
bone
 Other Sources of
Gland +Hormones
Hormone Target Effect/Function
Parathyroids: Increases blood Ca2+
Parathermone Bone, kidneys level by stimulating
bone resorption, and
calcitriol synthesis and
reducing urinary ca2+
excretion.

Adrenal medulla: Complement effects of

Epinephrine, Most tissues sympathetic nervous
norepinephrine, system.
dopamine
 Other Sources of
Gland +Hormones
Hormone Target Effect/Function
Adrenal cortex: Promotes Na+ retention
Mineralocorticoid Kidneys and K+ excretion,
maintains BP and
s( Aldosterone) volume.
Stimulate fat and protein
Glucocorticoi Most tissues catabolism,
ds (Cortisol gluconeogenesis, stress
and resistance and tissue
repair;
corticosterone Suppress immunity.
)
Pubic and axillary hair
Androgen Bone, growth, bone growth, libido
(DHEA) and muscle, (sex drive).
estrogen skin, many
other tissues
 Other Sources of
Organ +Hormones
Hormone Target Effect/Function
Pancreas: Stimulates glucose and
Insulin (by Most tissues amino acids uptake;
lowers blood glucose level;
Beta cells) promotes glycogen, fat,
and protein synthesis.

Glucagon (by Primarily liver Stimulates

Alpha cells) glycogenolysis,gluconeoge
nesi s; Increases blood
glucose level.

Somatostatin Intestine Identical to GHIH which is

(by delta cells) and other secreted by hypothalamus
tissues
 Other Sources of
Hormones
Organ + Target Effect/Function
Hormone
Ovaries: Stimulates female
Estrogen Many tissues reproductive
development, Regulates
menstrual cycle and
pregnancy, prepares
mammary glands for
lactation.

Progesterone Uterus, Regulates menstrual

cycle and pregnancy,
mammar prepares mammary
y glands glands for lactation.
 Other Sources of
OrganHormones
+ Target Effect/Function
Hormon
e
Testes: Stimulates male
Testosterone Many reproductive
development,
tissues
Musculoskeletal
development, Sperm
production, and
Heart: libido.
ANP
Kidney Lowers blood
volume and
pressure by
promoting Na+ and
 Pituitary
• The pituitary Gland
gland or hypophysis is a pea-
shaped structure that measures about 1 cm
in diameter and lies in the hypophyseal
fossa (sella tercica) of the sphenoid bone.
• It attaches to the hypothalamus by a stalk,
called
infundibulum (=funnel).
• It has two lobes, the anterior lobe or
adenohypophysis, and the posterior lobe
or neurohypophysis. The posterior
pituitary gland contains about 10,000 axon
terminals whose cell bodies are lying in the
• Anterior pituitary gland secretes seven
different hormones which are stimulated by
releasing hormones and suppressed by
inhibiting hormones from the
hypothalamus.
• It regulates other endocrine glands.
• There are Five types of pituitary cells.
• hypophyseal portal system
• a set of vessels (arteries and capillaries)
that carry blood and regulatory hormones
from the hypothalamus to the
adenohypophysis, where the target cells
of the releasing hormones are located.
• Posterior pituitary gland or
Neurohypophysis:
• It does not synthesizes hormones but stores
(coming from hypothalamus) and release
two hormones: ADH (vasopressin) and
Oxytocin (OT)

–Antidiuretic hormone (ADH):

responsible for fluid retention
–Oxytocin: contraction of the uterus
and ejection of milk
 Pituitary
disorders
Hyperactivity
Hypoactivi
• Gigantism
ty • Dwarfism
• Acromegaly • Acromicria
• Cushing • Diabetes
disease insipidus
 Thyroid
Anatomy
• The thyroid lies over the trachea below
larynx.
• The thyroid gland consists of two lobes
of endocrine tissue joined in the middle
by a narrow portion of the gland called
isthmus.
• The major Hormone secretory
Cells: are Follicular cells
 HORMONES OF THYROID
GLAND
Thyroid gland secretes three hormones:
• 1. Tetraiodothyronine or T4 (thyroxine)
• 2. Tri-iodothyronine or T3
• 3. Calcitonin
Both T4 and T3 are iodine-containing
derivatives of amino acid tyrosine.
• T4 forms about 90% of the total
secretion, whereas T3 is about 10%.
FUNCTIONS OF THYROID
HORMONES
• Thyroid hormones have two major effects
on the body:
• I. To increase basal metabolic rate
• II. To stimulate growth in children.
Thyroid Hormone:
• T3 (Triiodothyronine) and T4 (Thyroxin)—
Increase BMR, stimulate synthesis of
protein, Increase glucose and fat
consumption for ATP production,
accelerate body growth, and contribute to
the development of nervous system.
• Calcitonin (CT): High blood Ca++ levels
stimulate its secretion and low levels inhibit
it.
• It lowers blood Ca++ and HPO4 2- level by
uptake into bone and inhibiting bone
 Thyroid
Disorders
 Hypothyroidis
m
• Myxedema
• Critinism
• Non toxic goiter

 Hyperthyroidi
sm
• Grave’s Disease
 Calciton
in
• Calcitonin is secreted by the parafollicular
cells or clear cells (C cells), situated
among the follicles in thyroid gland.
• Plasma Level and Half-life
• Plasma level of calcitonin is 1 to 2 ng/dL. It
has a half life of 5 to 10 minutes.
 ACTIONS OF
• CALCITONIN
1. On Blood Calcium Level
• Calcitonin plays an important role in controlling the blood
calcium level. It decreases the blood calcium level and
thereby counteracts parathormone. Calcitonin reduces
the blood calcium level by acting on bones, kidneys and
intestine.
• i. On bones
• Calcitonin stimulates osteoblastic activity and
facilitates the deposition of calcium on bones. At the
same time, it suppresses the activity of osteoclasts
and inhibits the resorption of calcium from bones. It
inhibits even the development of new osteoclasts in
bones.
• ii. On kidney
• Calcitonin increases excretion of calcium through
urine, by inhibiting the reabsorption from the renal
tubules.
into the
• iii. On intestine
Educational
Platform
 Parathyroid
• Human Gland
beings have four parathyroid glands,
which are situated on the posterior surface of
upper and lower poles of thyroid gland.
• Parathyroid glands are very small in size,
measuring about 6 mm long, 3 mm wide
and 2 mm thick, with dark brown color.
• Parathormone (PTH) is secreted by the chief
cells of the parathyroid glands.
• Half-life and Plasma Level
• Parathormone has a half-life of 10 minutes.
• Normal plasma level of PTH is about 1.5
to 5.5 ng/dL.
 Functions of
PTH
• PTH maintains blood calcium level by
acting on:
• 1. Bones
• 2. Kidney
• 3. Gastrointestinal tract.
• PTH Regulates the levels of Ca++, Mg2+, and
HPO4 2-
ions in blood.
• Osteoclastic activity is specific (bone
resorption)
• It promotes the formation of calcitriol (active
form of Vit D)by kidneys which increases
dietary Ca++, HPO4 2- and Mg+2absorption.
 Adrenal
Glands
• There are two adrenal glands. Each
gland is situated on the upper pole of
each kidney. Because of the situation,
adrenal glands are otherwise called
suprarenal glands.
• Each gland weighs about 4 g.
 Functional
Anatomy
• PARTS OF ADRENAL GLAND
• Adrenal gland is made of two distinct
parts:
• 1. Adrenal cortex: Outer portion,
constituting 80% of the gland
• 2. Adrenal medulla: Central
portion, constituting 20% of the
gland.
 Functional
Anatomy
• HISTOLOGY OF ADRENAL CORTEX
• Adrenal cortex is formed by three
layers of structure.
• Each layer is distinct from one another.
• 1. Outer zona glomerulosa
• 2. Middle zona fasciculata
• 3. Inner zona reticularis.
 Physiolog
y
• HORMONES OF ADRENAL CORTEX
• Adrenocortical hormones are steroids
in nature, hence the name
‘corticosteroids’.
• Based on their functions, corticosteroids
are classified into three groups:
• 1. Mineralocorticoids
• 2. Glucocorticoids
• 3. Sex hormones.
Adrenal Glands:
• Adrenal Cortex—
Mineralocorticoids(affect minerals
homeostasis—Na+ and K+ and also
excrete H+ in the urine)
• Glucocorticoids (affect glucose
homeostasis), sectretes cortisone,
corticosterone, cortsol and small amount
of Androgens.
• It causes glucose formation, protein break
down, lipolysis, resistance to stress, anti-
 Adrenal Cortex
cont..
• .
FUNCTIONS OF MINERALOCORTICOIDS
• Ninety percent of mineralocorticoid
activity is provided by aldosterone.
• Life-saving Hormone
• Aldosterone is very essential for life and it
maintains the osmolarity and volume of ECF.
It is usually called life-saving hormone
because, its absence causes death within 3
days to 2 weeks. Aldosterone has three
important functions.
Adrenal Cortex cont... Aldosterone
Functions
• It increases:
• 1. Reabsorption of sodium from renal
tubules
• 2. Excretion of potassium through renal
tubules
• 3. Secretion of hydrogen into renal tubules.
 Actions of
Aldosterone
• It reduces the hydrogen ion concentration in
the ECF.
• In normal conditions, aldosterone is
essential to maintain acid base balance in
the body.
• In hypersecretion, it causes alkalosis
• and in hyposecretion, it causes acidosis.
• Adrenal Medulla hormone:
• Epinephrine and norepinephrine—
sympathetic response
 Pancre
as
• Alpha cells—Glucagon
• Beta cells—Insulin
• Delta cells--
Somatostatin
 Pancre
as
• insulin decreases the blood glucose level by:
• i. Facilitating transport and uptake of
glucose by the cells
• ii. Increasing the peripheral utilization of
glucose
• iii. Increasing the storage of glucose by
converting it into glycogen in liver and
muscles
• iv. Inhibiting glycogenolysis
 Pineal
Gland
• Pineal gland is a small cone shaped body
measuring 10 mm in length that projects
posteriorly from the posterior end of the roof
of the third ventricle of the brain.
• Melatonin
• Serotonin
Female Reproductive System
A&P-II
Unit VI

Shabnam
Faculty INS-KMU
Acknowledegment: Muhammad Iqbal
Lecturer INS-KMU
 Objectives
1. List the functions of female reproductive
system.
2. Categorize the Female Reproductive organs
into:
-- Essential organs and Accessory organs
3. Discuss the location and structure of Female
External Genitalia (VULVA).
4. Describe the location, Structure & function of
Female Internal Genitalia
5. Discuss the Female Reproductive Cycles
(ovarian and menstrual cycles)
 Terminology
 Puberty: The period of life marked by the
development of secondary sexual characteristics and
the attainment of sexual reproduction.
 Menarche: the appearance of the first menstrual
period which usually occurs between 12 to 15 years.
 Menopause: Permanent cessation of menstruation
due to decreased secretion of sex hormones.
 Usually occurs at the age of 45-55 years. This period is
called climacteric.
 Functions of the Female Reproductive System

1. The ovaries produce oocytes and hormones

including female sex hormones (estrogen and
progesterone).
2. The uterine tubes transport oocytes to the uterus.
3. The uterus is the site of fertilization and implantation of
the fertilized ovum.
4. The vagina is a passageway for childbirth.
5. The mammary glands synthesize, secrete, and eject milk
for nourishment of the newborn.
 Female Reproductive System
 Internal Genitalia:
 Ovaries—female gonads
 Fallopian Tubes or Uterine Tubes or Oviducts
 Uterus
 Vagina
 External Genitalia:
--Vulva (collective name of external organs)
 Primary and Accessory Sex Organs
Primary Sex Organs
---A pair of ovaries
Accessory Sex Organs
 Fallopian tubes
 Uterus and cervix
 Vagina
 Vulva comprising Labia majora, labia minora and clitoris
 Female Reproductive System

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

 Ovaries
 Composed of
ovarian follicles
(sac-like structures)
 Structure of an
ovarian follicle
 Oocyte
 Follicular cells

Figure 16.7
 Ovarian Follicle Stages
 Primary follicle – contains an immature oocyte
 Graafian (vesicular) follicle – growing follicle with a
maturing oocyte
 Ovulation – when the egg is mature the follicle
ruptures to release ovum
---Occurs about every 28 days
 The ruptured follicle is transformed into corpus
luteum
 Support for Ovaries
 Suspensory ligaments – secure ovary to lateral walls of
the pelvis
 Ovarian ligaments – attach ovaries to uterus
 Broad ligament – a fold of the peritoneum, encloses
suspensory ligament
Uterus and Ovaries
 Uterus or Womb
 Lies in pelvic cavity between the rectum and urinary
bladder
 Virgin uterus is 7.5 cm long, 5 cm wide (at its upper
part), and 2.5 cm thicker.
Division
 Fundus
 Body (b/w fundus and isthmus)
 Cervix (below isthmus)
 Uterus

 Located between the urinary bladder and rectum

 Hollow organ
 Functions of the uterus
• Receives a fertilized ovum
• Retains the fertilized ovum
• Nourishes the fertilized ovum
 Regions of the Uterus
 Fundus – area where uterine tube enters
 Body – main portion
 Cervix – narrow outlet that protrudes into the vagina
 Cervix has internal and external OS
 Support for the Uterus

 Broad ligament – attached to the pelvis

 Round ligament – anchored anteriorly
 Uterosacral ligaments – anchored posteriorly
 Walls of the Uterus
 Perimetrium or Serous layer – outer visceral peritoneum
 Myometrium – middle layer of smooth muscle
 Endometrium—inner layer ( consists of 2 layers)
 It is devided functionally into two layres:
--Functional layer
--Basal layer
• Allows for implantation of a fertilized ovum
• Sloughs off if no pregnancy occurs (menses/catamenia)
Walls of the Uterus
 Uterine (Fallopian) Tubes

 Receive the ovulated oocyte

 Provide a site for fertilization
 Attaches to the uterus
 Does not physically attach to the ovary
 Supported by the broad ligament
 Uterine Tube Functions

 Fimbriae – finger-like projections at the distal end that

receive the oocyte
 Cilia inside the uterine tube slowly move the oocyte
towards the uterus
 Fertilization occurs inside the uterine tube usually at its
ampulla.
 Ectopic pregnancy (occurs in uterine tube which is
abnormal)
 Vagina
 Extends from cervix to exterior of body
 Behind bladder and in front of rectum
 Serves as the birth canal
 Hymen – is vaginal mucosa which folds inward
and forms a membrane that partially closes
the vagina on its lower end until it is ruptured.
 External Genitalia (Vulva)

 Mons pubis
• Fatty area overlying the pubic symphysis
• Covered with pubic hair after puberty

 Labia – skin folds

• Labia majora
• Labia minora
 External Genitalia cont….
Vestibule
Enclosed by labia majora
It Contains:
• urethral and vaginal orifice
• Bartholin glands which secrete mucus as lubricant.
Clitoris
Contains erectile tissue
 Oogenesis
 The total supply of oocytes are present at birth.
 Only 2 million oocytes remain at birth.
 Most of them undergo a process of degeneration called
atresia during childhood.
 By puberty, only 400,000 oocytes remain for lifetime.
 A female may ovulate about 480 gametes in life.
 Ability to release ova begins at puberty.
 Reproductive ability ends at menopause.
 Oocytes are matured in developing ovarian (graafian)
follicles.
 Reproductive Cycle
Consists of Ovarian and Menstrual Cycle
Ovarian Cycle:
 Consists of follicular and luteal phase
 Follicles are stimulated by FSH
 The primordial follicles ultimately develop into tertiary
follicles
 The follicles secrete estrogen
 When estrogen level attains a peak it stimulates LH
 Ovulation occurs in response to LH as a result of
graffian follicle rupture at about 14th day
 Reproductive Cycle cont...

Ovarian Cycle consists of:

1. Follicular Phase
2. Luteal Phase
Follicular Phase
• This is the phase of maturation of ovum with
development of ovarian follicle which extends from the
5th day of menstrual cycle.
• Ovarian Folllicles are glandular structures present in the
cortex of ovary. Each follicle consists of the ovum
surrounded by the epithelial cells.
 Ovarian Cycle----- Follicular Phase cont

Different Follicles are:

 Primordial follicle
 Primary follicle
 Secondary or vesicular or
antral follicle
 Tertiary or Graffian or
Matured follicle
 Ovarian Cycle----- Luteal Phase
Luteal Phase
 Luteal phase begins after ovulation.
 Graffian follicle develops into corpus luteum.
 Corpus luteum now begins the secretion of
progesterone
 If pregnancy does not occur, the corpus luteum
degenerates otherwise it persists for 3-4 months
otherwise menstruation starts.
 Menstrual Cycle or Uterine Cycle
 After ovulation, if pregnancy does not occur, the
thickened endometrium is shed or desquamated.
 This desquamated endometrium is expelled out through
vagina along with blood and tissue fluid.
 The process of shedding and exit of uterine lining along
with blood and fluid is called menstruation or menstrual
bleeding.
 It lasts for about 4 to 5 days. This period is called
menstrual phase or menstrual period.
 Menstrual Cycle cont...
• The day when bleeding starts is considered as the first
day of the menstrual cycle.
• Two days before the onset of bleeding, that is on 26th or
27th day of the previous cycle, there is a sudden
reduction in the release of estrogen and progesterone
from ovary as a result of degeneration of corpus luteum.
• Decreased level of these two hormones is responsible for
menstruation.
 Menstrual Cycle cont...
UTERINE CHANGES DURING MENSTRUAL CYCLE
During each menstrual cycle, along with ovarian changes,
uterine changes also occur simultaneously.
Menstrual cycle is divided into three phases:
1. Menstrual phase
2. Proliferative phase
3. Secretory phase
 Menstrual Cycle cont...
Menstrual Phase
 It follows the secretary phase of the last menstrual cycle
 Menstruation usually starts on 29th day of the menstrual
cycle.
 It lasts for about 3—5 days.
 It is characterized by the shedding of stratum
compactum and spongiosum along with about 60 ml of
blood during menstruation.
 The onset of menstruation occurs as a result of
decreased level of estrogen and progesterone due to the
degeneration of corpus luteum.
 Menstrual Cycle cont...
• Lack of estrogen and progesterone causes sudden
involution of endometrium.
• Uterine contractions expel the blood along with
desquamated uterine tissues to the exterior through
vagina.
• It leads to reduction in the thickness of endometrium,
up to 65% and reduces to its original size of about 1
mm.
 Menstrual Cycle cont...
Proliferative Phase
 This is also known as follicular phase. This phase follows
the menstrual phase.
 It is characterized by the active proliferation of
endometrium which grows 3 to 4 mm in thickness.
Uterine glands increase in length and remain straight.
 Proliferation occurs under the influence of estrogen
secreted by maturing ovarian follicles in the ovary.
 This phase generally lasts from 5th to 14th day in a 28
days menstrual cycle.
 On 14th day, ovulation occurs under the influence of
LH. This is followed by secretary phase.
 Menstrual Cycle cont...
Secretary Phase
• This is also known as progestational phase.
• Endometrium further grows up to 5—7 mm.
• Increase in size is due to the accumulation of glycogen and
lipid in stromal cells and tissue fluid in the stroma.
• Many new blood vessels appear within endometrial stroma.
• Endometrial glands become dilated and tortuous.
• This phase is influenced by progesterone.
• Secretory phase extends between 15th and 28th day of the
menstrual cycle, i.e. between the day of ovulation and the day
when menstruation of next cycle commences.
• This phase lasts for 14 days in a 28 days cycle.
 Clinical Correlation
Anovulatory Cycle
Sometimes ovulation does not occur and the
corpus luteum is not formed. There is no effect
of progesterone on the endometrium. However,
under the influence of estrogen, the
endometrium proliferates enough to breakdown
and slough during menstruation.
 Hormones of Pregnancy
Human Chorionic Gonadotropin (HCG)
8 to 9 days after conception to test pregnancy
Peaks around 10-12 weeks of gestation
Like LH, it stimulates the growth of corpus luteum to
increase the amounts of estrogen and progesterone
Without HCG, the corpus luteum will atrophy
 ABNORMAL MENSTRUATION

 Amenorrhea: Absence of menstruation

 Hypomenorrhea: Decreased menstrual bleeding
 Menorrhagia: Excess menstrual bleeding
 Oligomenorrhea: Decreased frequency of menstrual
bleeding
 Polymenorrhea: Increased frequency of menstruation
 Dysmenorrhea: Menstruation with pain
 Metrorrhagia: Uterine bleeding in between
menstruations.
 Clinical Correlation
 Cesarean Section
 Tubal Ligation
 IUCD--intrauterine contraceptive device is a small,
often T-shaped birth control device that is inserted into
a woman's uterus to prevent pregnancy.
 Fibroids-- are of large masses of smooth muscles
myometrium
 Hysterectomy—Removal of uterus
 Salpingitis---inflammation of the fallopian tubes
 IVF--In vitro Fertilization
 Mittelschmerz---- painful ovulation
Male Reproductive System
A&P-II
Unit-V

Shabnam
Faculty INS-KMU
Acknowledegement:Muhamma Iqbal
Lecturer INS-KMU
 Objectives
At the end of this unit, the students will be able to:
1. Define Reproduction and Reproductive System.
2. List the functions of male reproductive system.
3. Categorize the male reproductive organs into
4. Essential organs
5. Accessory organs
6. Location and structures involved in the male
reproductive system.
7. Describe the structure and function of testis and
accessory organs.
 Introduction
 Reproduction: The process of producing new
individual.
 Reproductive System: An organ system
specialized for the production of offspring.
Functions of the male Reproductive System

1. The testes produce sperm and male sex hormone

testosterone.
2. The ducts transport, store, and assists in maturation of
sperm.
3. The accessory sex glands secrete most of the liquid
portion of semen.
4. The penis contains urethra which is a passageway for
ejaculating semen and excreting urine.
 Male Reproductive Organs

1. Primary Sex Organs

-Testes or Gonads
2. Accessory Sex Organs
- Seminal vesicle
- Prostate gland
- Bulb urethral gland
- Penis and Urethra
 Male Reproductive System
Gonads produce gametes (sex cells) and secrete
hormones
Sperm – male gametes

Testes
 Duct system
-Epididymis
-Ductus deferens
-Urethra
Organs of the Male Reproductive System
 External genital organs
• Scrotum
• Penis
 Internal genital organs
• Seminiferous tubules
• Epididymis
• Vas Deferens or Ductus Deferens or spermatic deferens
• Ejaculatory Ducts
• Urethra
• Seminal vesicles
• Prostate gland
• Bulbourethral (Cowper) gland
 Functional Anatomy of Testes
• Scrotum---Supporting structure for the testes.
• Maintains testes at 3°C lower than normal body temp.
• Testes or testicles---- paired oval glands
• They descend into the scrotum during the seventh
month of fetal development.
• Each testis has 250—300 lobules.
• Each lobule contains 1—3 seminiferous tubules
• Seminiferous tubules have spermatogenic cells to form
sperms.
• In the spaces between seminiferous tubules are clusters
of cells called Leydig (interstitial) cells which secrete
testosterone (androgen hormone).
 Functional Anatomy of Testes cont...
• Testosterone promotes masculine characteristics and
libido.
• Seminiferous tubules open into a network called rete
testis.
• Rete testis form 8 to 15 efferent ductules and finally
form epididymis.
 Reproductive duct system in males
• Epididymis
• -- convoluted tubule around 4 meter.
• -- receives sperm from the efferent ducts of testes.
• -- the site of sperm maturation is around 14 days.
• -- can store viable sperm for about two months.
• -- propels sperms into vas deferens.
• Vas Deferens or Ductus Deferens
• -- 45 cm long and 2.5 mm wide
• -- Conveys sperm towards urethra.

 Vasectomy—a portion of each ductus deferens is

removed as a family planning.
Testis and its internal structures
 Duct system cont…
Ejaculatory Ducts:
• -- Formed by the union of seminal vesicle ducts and the
ampulla of the ductus deferens.
• -- pass through the prostate gland
• -- Terminate in the prostatic urethra
Urethra:
• -- Urinogenital duct (ejects both semen and urine)
• -- Divided into 3 parts as:
- Prostatic urethra – surrounded by prostate
- Membranous urethra – from prostatic urethra to penis
- Spongy (penile) urethra – runs the length of the penis
 Accessory Sex Glands
 Seminal Vesicles or seminal glands
• Paired glands lying posterior to bladder.
• About 5 cm long
• One is associated with each vas deferens.
• Secrete an alkaline viscous fluid having fructose, prostaglandins,
and clotting proteins.
• Forms about 60 % of semen volume
 Prostate gland:
• Single gland surrounds urethra and ej. Duct immediately inferior
to bladder
• About 4 cm
• Surrounds prostatic urethra
• Thick milky alkaline secretion about 30% is added to semen.
• The gland further grows in size after age 50---BPH
 Accessory Sex Glands cont..

• Secretes milky slightly acidic fluid having citric

acid, proteolytic enzyme, lysozyme, seminal
plasmin (antibiotic) etc.
• Contribute to sperm motility and viability
• Make up about 25 % of the semen volume
• Bulbourethral Glands or Cowper’s Glands
• Paired glands
• About pea size
• Located inferior to the prostate on either side to
the membranous urethra.
• Secretes alkaline fluid having lubricating mucous.
 Semen (=seed)
• A mixture of sperm and seminal fluid.
• Seminal fluid consists of the secretions of the
seminiferous tubules, seminal vesicles, prostate, and
bulbourethral glands.
• Each ejaculation of semen is 2.5—5 ml with 50—150
million sperms/ml.
• When the number falls below 20 million/ml, the male
is likely to be infertile.
• Semen is slightly alkaline (PH 7.2—7.7).
 Sperm
• Each day about 300 million sperm complete the
process of spermatogenesis.
• At the top of nucleus on the head of sperm there is
acrosome filled with enzyme that helps the sperm to
penetrate oocyte during fertilization.
• May remain viable from 12—48 hours in female
reproductive tract.
 Hormonal Control of Spermatogenesis
• GnRH from hypothalamic neurosecretory cells
stimulates gonadotrophs in the anterior pituitary
gland to increase their secretion of the two
gonadotropins as LH and FSH.
• LH stimulates Leydig cells to secrete testosterone
which ultimately stimulates spermatogenesis.
• FSH acts to stimulate spermatogenesis.
 Functions of Testosterone hormone
• It stimulates the secondary sex characteristics
• It stimulates spermatogenesis
• Protein anabolism
• It stimulates muscles to in increase in mass
• It stimulates erythropoeisis
• Develops Libido (sexual desire)
Male Reproductive System
 External Genitalia
Penis
Delivers sperm into the female reproductive tract
Regions of the penis:
 Shaft
 Glans penis (enlarged tip)
 Prepuce (foreskin)
--Often removed by circumcision

Phemosis---- clinical condition

 Congenital Abnormality of Urethral Meatus

• Epispadiasis -----Congenital defect in which urethra

opens on dorsum of penis
• Hypospadiasis -----Birth defect in which urethra opens
on ventral side of penis
• Cryptorchidism------- cryptorchidism (crypt= hidden;
orchid=testes)…….Undescended testes
• Found in 3 % of full term while 30% in preterm
• Untreated cases result in sterility.
 SEMEN ANALYSIS

Analysis of semen evaluates the qualities of semen,

which is useful to investigate the infertility.
Parameters of semen analysis:
1. Volume
2. Reaction and pH
3. Liquefaction
4. Sperm count
5. Morphology of sperm
6. Motility of sperms
7. Pus cells and RBCs
8. Fructose level.
 QUALITIES OF SEMEN REQUIRED FOR
FERTILITY
Minimum required qualities of semen for fertility are:
1. Volume of semen per ejaculation must be at least 2 mL
2. Sperm count must be at least 20 million/mL
3. Number of sperms in each ejaculation must be at least 40
million
4. 75% of sperms per ejaculation must be alive
5. 50% of sperms must be motile
6. 30% of sperms must have normal shape and structure
7. Sperms with head defect must be less than 35%
8. Sperms with midpiece defect must be less than 20%
9. Sperms with tail defect must be less than 20%.
 Terms
• Azoospermia .......lack of sperm
• Oligospermia .....  20 million/mL
• Aspermia.....lack of semen...retrograde ejaculation in
bladder
• Oligozoospermia--Oligospermia is a male fertility issue
characterized by a low sperm count.
• Teratozoospermia or teratospermia... Abnormal
morphology
• Hematospermia--is the presence of blood in
ejaculation.