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Anatomy and Physiology Introduction (Marieb 5th Edition

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Anatomy • “To cut” (tomy) and “ana” (apart). • Study of the shape and structure of the body & body parts and their relation to one another. Studies of Anatomy 1. Gross Anatomy • Study of large, easily observable body structures. • Ex. Our own body; heart, bones 2. Microscopic Anatomy • Study of very small body structures seen through a microscope • Ex. Cells and tissues Physiology • “nature” (Physio); “study of” (ology) • Study how the body and its parts work or function. Studies of Physiology 1. Neurophysiology - workings of nervous system. 2. Cardiac physiology – workings of the heart. Relationship of Anatomy and Physiology are always related • Structure determines what functions can occur; therefore if the structure changes, the function must also change. • Ex. Lungs can’t pump blood like the heart. But because the walls of their air sacs are very thin, gaseous exchange happens. Layers of Structural Organization 1. Chemical Level • Atoms (tiny building blocks of matter) combine to form Molecules (Organic and Inorganic Molecules) 2. Cellular Level • Cells, basic or smallest unit of life are made up of molecules

3. Tissue Level • Group of similar cells that has a common function. • 4 Tissues: Epithelial, Connective, Smooth Muscle, and Nervous Tissue.
4. Organ Level • Different types of tissues that perform together with one or more common functions. • Ex. Stomach Organ System Level • Group of Organs with a common function or set of functions. • Must have an Integration of Organ System for an organism to survive.

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6. Organism Level (Highest Level)

Human Organism is a complex of organ systems that are mutually dependent on one another (11 Organ Systems)

The 11 Organ Systems 1. Integumentary System a. Structure: Skin, hair, nails, sweat glands. b. Functions: • Receives stimuli (changes in the environment; temperature, pressure, and pain) • Protection against pathogens (disease causing microorganism from environment) and chemicals • Protection against injury on deeper tissues. • Regulates body temperature • Prevents water loss • Excretes salts and urea in perspiration • Synthesize Vitamin D (from UV Rays) 2. Skeletal System a. Structure: 206 Bones, Cartilages, Joints, Ligaments b. Functions: • Protects and support the body • Provides Framework to allow movement • Protects internal organs (skull protects the brain) • Produces RBCs (Hematopoiesis) within the cavities • Storage of minerals and fats (calcium deposits on the hard substance of bones) 3. Muscular System a. Structure: Skeletal Muscle, Cardiac Muscle, and Smooth Muscle b. Functions: • To contract or shorten = Produce Body movements • Maintains posture and brings facial expression • Produces body heat • Protection (contain nerves)

4. Lymphatic / Circulatory / Immune System (“Defense System”) a. Structure: Lymphatic Vessels, Lymph Nodes, Spleen, Tonsils, Thoracic Duct b. Functions:

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Removes foreign substances from the blood and lymph Combats diseases (Vitamin C boosts up immune system) Regulates tissue fluid balance Absorb fats from GI tract Lymphatic Vessels  returns fluid leaked from the blood and blood vessels for continuous blood circulation. Lymph Nodes  cleans blood; protects WBCs

Respiratory System a. Structure: Nose, Lungs, Pharynx / Throat, Larynx / Voice Box, Trachea, Bronchial Tubes b. Function: Gaseous exchange (Oxygen in; Carbon Dioxide out)

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Digestive System a. Structure: Mouth / Oral Cavity, Esophagus, Stomach, SI, LI, Rectum, Liver, Pancreas b. Functions • Breakdown of food, absorption of nutrients and elimination of wastes through the anus as “feces or stool” to reclaim water. • Liver  produces bile that helps to break down fats • Pancreas  delivers digestive enzymes to SI

7. Nervous System (“Fast Acting Control System”) a. Structure: CNS (Brain and Spinal Cord), Nerves, Sensory Receptor
b. Functions • Major regulatory system that responds to stimuli; reaction is direct to the organ • Sensory Receptors detects stimulus and sends info thru nerve impulses to CNS. CNS responds by activating appropriate muscles and glands

8. Endocrine System (“Major Metabolic System”; “Slow Acting System”) a. Structure: Glands (Pituitary Gland, Pineal Gland, Thyroid Gland, Hypothalamus, Thymus Gland, b.
Adrenal Gland, Pancreas, Testis, Ovary Functions: • Major regulatory system; secrete HORMONES to regulate target organs. • Growth and Sexual Development • Metabolism • Reproduction • Regulates Water and Minerals

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Cardiovascular System a. Structure: Heart, Blood Vessels, Blood b. Functions • Transporting Fluid, Blood  transports O2, nutrients, wastes, hormones • Blood Pump, Heart • Cleans Immune System • Regulates Body Temp • WBCs  protects body from foreign invaders (bacteria, tumor, toxins)

10. Urinary System a. Structure: Kidney, Ureter, Urinary Bladder, Urethra
b. Functions • Excretes Nitrogen wastes eliminated thru Urine. • Maintains Water and Salt Balance • Regulates Electrolyte and Acid Base balance (Blood Ph) • Production of RBCs

11. Reproductive System (“Organ of Copulation”) a. Structures in Men: Seminal vesicles, prostate gland, vas deferens, penis, testis, scrotum b. Functions
• Production of offspring

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Production of Male Sex Hormone (Testosterone) • Testis produces sperm cells Structures in Women: Mammary glands (breasts), uterine tubes, ovary, uterus, vagina Functions: • Produce Oocytes (Largest Cell; Site of Fertilization) • Fetal Development (Uterus) • Production of Female Sex Hormone (Estrogen)

Life Processes of Humans to Sustain Life • Humans must maintain its boundaries, move, respond to stimuli, digest nutrients, carry metabolism, reproduce it self and grow. 1. Movement 2. Responsiveness or Irritability 3. Digestion of Food 4. Excretion of Wastes 5. Metabolism  sum of all chemical reactions in the body a. Catabolism – provides the energy needed to sustain life by breaking down food. b. Anabolism – uses the energy from catabolism to make various substances that form body structures and enable them to function. 6. Reproduction 7. Growth and Development 8. Respiration and Circulation 9. Absorption Interrelationship of Organ Systems Integumentary System protects body from external environment. The GI and Respiratory System, in contact with the external environment, take in nutrients and O2, which are transported by the blood to all cells. Elimination of metabolic wastes is accomplished by Urinary and Respiratory System. Environmental Factors for Maintenance of Life and Survival Needs 1. Food / Nutrients 2. Water 3. Oxygen – releases energy from food for metabolic processes. 4. Body Temperature and Heat • Product of Metabolic Reactions • Normal BT: 36.5 – 37.5 C • Both High and Low Temperature is dangerous a. ↑ Temp – Body proteins break down. b. ↓ Temp – Metabolic reactions becomes slower; results in Hypothermia 5. Atmospheric Pressure or Levels of O2 • Necessary for Breathing during Gaseous Exchange. • High Altitudes Places = ↓ O2 Homeostasis • Dynamic State of Equilibrium (body’s ability to maintain stable internal condition and respond appropriately to stimulus) • Ex. Maintenance of V/S, Adequate Nutrients, and Wastes must not accumulate. Homeostatic Imbalance

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Abnormal Condition, organs becomes less efficient and internal condition becomes less stable ↑ Risk for Illness Produce changes associated with aging.

Homeostatic Control Mechanisms • Used to maintain stable internal condition accomplished by Nervous and Endocrine System. 3 Elements of Components of Control System Variable - factors that are regulated in Homeostasis (V/S, Blood Glucose Level, Electrolytes) 1. Stimuli – environmental changes (temperature, pressure, pain); imbalance in variables. 2. Sensory Receptors – detects and responds to stimuli INPUT: Info flows from receptor to the control center along Affarent Pathaway to 2nd Element. 3. Control Center – CNS (Brain and Spinal Cord) analyzes the changes and receives information and gives appropriate action by activating the 3rd element OUPUT: Info flows from control center to 3rd element along Efferent Pathway to 3rd element 4. Effector – response or feedback to stimulus. Types of Response or Feedback 1. Negative Feedback (Most Common Feedback) • Reduce or Stop initial stimulus. • Deviation (difference) from the set point to resist changes • Function: Regulates V/S, Blood Glucose Levels, Electrolytes

2. Positive Feedback (Rarer in the body)

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↑ Original Disturbance from the original value. Control infrequent events that occur explosively and don’t require continuous adjustments. Ex. Birth of Baby, Blood Clotting, Loss of Blood Ex. Accident  ↓ BP due to blood loss (detected by receptor)  needed to ↑ BP to ↑ Heart Rate (POSITIVE FEEDBACK CONSTANTLY ↓ BP)

Anatomical Positions (Standard Position) 1. Body is Erect and Standing Still 2. Face is facing forward 3. Arms are lying on the sides 4. Palms are facing forward 5. Thumb pointing outwardly 6. Feet is parallel Directional Terms • Explains exactly where one body structure is related to another. Regional Terms (Anterior and Posterior Body Regions) Body Planes or Body Sections • A section or cut is made through the body or organ along an imaginary line (PLANE) to look at internal structures. 1. Sagittal Section • Longitudinal Cut that separates left and right parts • Midsagittal or Median Plane – cut made at the middle of the body; left = right

2. Frontal or Coronal Section • Lengthwise Cut that separates posterior and anterior parts
3. Transverse or Cross Section • Horizontal Cut that separates superior and inferior parts

Body Cavities or Trunk Cavities • Lines and sets the organs. 1. Posterior / Dorsal Body Cavity • Small and well protected by the bone • Continuous (No Separation) a. Cranial Cavity – space inside skull; protects the brain. b. Spinal Cavity – protects spinal cord, which is protected by the vertebrae; extends from cranial to the end of vertebral column.

2. Anterior / Ventral Body Cavity
• Larger and less protected • Separated (thoracic and abdomen is separated by the Diaphragm) a. Thoracic Cavity • Contains ♥ and lungs; protected by the rib cage b. Abdominopelvic Cavity • Contains Digestive, Urinary, and Reproductive organs. a. Superior Abdominal Cavity (stomach, liver, intestines) b. Inferior Pelvic Cavity (reproductive organs, bladder, rectum)

Cells (Chapter 2)
• • • • • Cell is the Basic Unit of Life Composed of CHON (Protein is the major building material), small amounts of Na, K, Fe, and 60% Water Humans have 75 trillion cells and belong to Prokaryotic type. Bathed in Extracelullar or Interstitial Fluid. Different in size & shape (often reflects the function of the cell)

The 3 Main Regions of a Generalized Cell 1. Nucleus 2. Cytoplasm 3. Plasma or Cell Membrane

Nucleus
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Location: Often near center of the cell surrounded by cytoplasm “Control Center of the Cell” Contains genetic material (DNA), a blueprint that carries instructions for protein synthesis. Site of Ribosome and Messenger of RNA Synthesis Directs cell activity and necessary for cell reproduction

3 Parts of Nucleus 1. Nuclear Membrane or Envelope • Double barrier membrane with fluid – filled space within called Nucleoplasm • Where nucleoli and chromatin are suspended and nuclear pores penetrate. • Selectively Permeable because of its large pores.

2. Nucleoli / Nucleolus
• • 3. Ribosomal Subunit Assembly Site of Ribosomal RNA Synthesis

Chromatin • When cell is not dividing, its DNA is combined with Protein and forms chromatin. • When cell is dividing to form 2 daughter cells, chromatin forms Chromosomes.

Plasma Membrane or Cell Membrane
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Outermost component of cell; encloses cell and supports cell contents. Boundary between intracellular and extracellular substances. Selective barrier to the movement of substances into and out of the cell.

Lipid Bilayer containing Proteins 1. Phospholipids a. Polar Heads (Hydrophilic or “Water Loving”) b. Non Polar Tails (Hydrophobic or “Water Hating or Fearing”) c. Bimolecular Lipid Layer Containing Proteins (Glycoproteins or Sugar Proteins). 2. Cholesterol • Has Stabilizing effect and helps keep the membrane fluid.

Specializations of Plasma Membrane • Displayed by epithelial cells that form linings of hollow organs (ex. Small Intestine) 1. Microvilli • Location: Extensions of cell surface with many on each cell. • ↑ cells surface area for more absorption Membrane Junctions a. Tight Junctions • Impermeable; bind cells together to prevent substances go inside out the cell. • Ex. In SI, it prevents digestive enzymes to leak into bloodstream

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b. Anchoring Junctions or “Desmosomes” • Prevent cells from being pulled apart or mechanical stress (ex. Skin Cells)

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Gap Junctions • Location: ♥ and between embryonic cells • Allow Communication; nutrients and ions can pass from one cell to another; neighboring cells are connected by CONNEXONS.

Cytoplasm
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Location: Outside nucleus and inside plasma membrane. “Factory Area of Cell”; Site of Most Cellular Activities

3 Major Elements of Cytoplasm 1. Cytosol • Intracellular fluid that suspends other elements and dissolved substances 2. Inclusions • Stored or Inactive materials of cytoplasm • Ex. Nutrients, Fat droplets, glycogen granules, melanin, mucus, crystals

3. Cytoplasmic Organelles • “Metabolic machinery of the cell”; “Little Organs”

a. Mitochondria (“Powerhouse of Cell”) • Major Site of ATP Synthesis


b.

Site of Aerobic Respiration Abundant in: Liver and muscle cells

Ribosomes • Major Site of Protein Synthesis • Made up of Proteins and 1 variety of RNA called Ribosomal RNA.

c. Endoplasmic Reticulum (“Network within the cell”) • Network of channels that carries proteins from one part of cell to another.
2 Types: 1. Rough ER • Many Ribosomes; Site of Protein Synthesis • Abundant in: Pancreas 2. Smooth ER • Little Ribosomes; Site of Lipid / Cholesterol / Steroid Synthesis • Fat metabolism • Detoxification of drugs. • Abundant in: Liver, Male testes for the male hormone testosterone

d. Golgi Apparatus (“Traffic Director”) • Modifies protein structure and packages protein in secretory vesicles
e. Secretory Vesicles • Contains materials produced in the cell and formed by Golgi apparatus • Secreted by Exocytosis

f. Lymosomes (“Cells Demolition Site”) • Lymosomal Enzymes digests damaged cells and foreign substances (contains WBC) • Homeostatic Imbalance (LYMOSOMAL RUPTURE) – self – digestion of cell; damaged
and deprived of 02; excessive amounts of Vitamin A is present.

g. Peroxisomes (“Peroxide Bodies”) • Oxidase enzymes detoxify Free Radicals (highly reactive chemicals that mix up protein and
nucleic acids)

h. Cytoskeleton (“Cells Bones and Muscles”) • For cellular support and motion. • Determines cells shape, supports other organelles, and for intracellular transport and
a. movement. Intermediate Filaments • Helps form Demosomes

b. Microfilaments (Actin and Myosin) • Involved in Cell Motility • Produce changes in cell shape
c. Microtubules • Determines the overall shape of cell • Distribution of organelles. • Supports cytoplasm • Assists in cell division • Forms component of cilia and flagella Centriole • Location: Close to the Nucleus • Directs the formation of MITOTIC SPINDLE during cell division • Form the bases of cilia and flagella

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h. Cilia (“Eyelashes”) • Location: On the cell surface with many on each cell • Moves cell substances away • Ex. Ciliated Cells of Respiratory System moves mucus away from lungs.
i. Flagella • Location: On sperm cell with one per cell • Flagellum or Tail propels sperm cells.

Cell Diversity / Types of Cells

1. CONNECT BODY PARTS
a. Fibroblast • Shape: Elongated • Function: Makes the protein building blocks of fibers.

b. Erythrocyte (RBC) • Shape: concave disk • Function: Carries O2 into the blood.
2. COVER AND LINE BODY ORGANS a. Epithelial Cell • Shape: Hexagonal (allows cells to pack together in sheets) • Function: Many intermediate filaments that resist tearing when epithelium is pulled apart. MOVE BODY ORGANS AND PARTS a. Skeletal Muscle and Smooth Muscle Cell • Shape: Elongated • Function: Produce movement of bones and muscles; change size of internal organs. STORES NUTRIENTS a. Fat Cell • Shape: Huge Spherical • Produced by fat droplet in its cytoplasm FIGHTS DISEASES a. Macrophages (Phagocytic cell) • Has “Pseudopods” or “Long Feet” to reach infection sites • Has Lysosomes GATHERS INFORMATION AND CONTROLS BODY FUNCTIONS a. Nerve Cell or Neuron • Receives and transmits information to body structures (CNS). REPRODUCTION a. Oocytes (female egg cell; largest cell) b. Sperm (male egg cell) • Shape: Long and Stream Lined built for swimming to the egg for fertilization • Its flagellum propels the sperm.

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Various Types of Mixtures 1. Solution • Homogeneous mixture of 2 or more components • Solvent + Solute • Ex. Air is a mixture of gases; alcohol is a mixture of alcohol and water

2. Solvent (Dissolving Medium) • Substances present in largest amount in a solution.
• Ex. Water is the universal solvent of the body

3. Solutes • Substances present in smaller amounts in a solution.
• Ex. Rock of Salt 2 Types of Fluid 1. Intracellular Fluid (Inside the Cell) • Nuceloplasm and Cytosol • Includes small amounts of gases, nutrients, and salts that are dissolved in water.

2. Extracellular or Interstitial Fluid (Outside the Cell; Watery) • Bathes the cells. • Includes nutrients, hormones, neurotransmitters, salts, and waste products.
Homeostatic Imbalance • Cell is Damaged / Died = membrane is PERMEABLE to almost everything (Ex. Severe Burns) Selectively Permeable • Barrier that allows some substances to pass into cell while excluding others. Transport System (Movement of Substances / Molecules across Plasma Membrane) 1. Passive Transport • Movement of substances across the membrane without ATP from the cell. a. Diffusion Movement of substances across membrane where they are MORE CONCENTRATED (numerous) to a LESS CONCENTRATED (fewer) because of KINETIC ENERGY. • Speed of diffusion is affected b Size of molecules (the smaller the faster) Temperature (the warmer the faster) • Molecules will move passively by diffusion if they : 1. Molecules are small enough to pass into membrane pores. 2. Molecules can be dissolved in the fat portion of membrane (Lipid Soluble) • Types of Diffusion Simple Diffusion • Unassisted diffusion of substances across the membrane. • Moves Lipid Soluble Substances (Fats, ADEK,O2, CD) • Moves Small Ions (Chloride Ions) Facilitated Diffusion • Moves Large, Lipid Insoluble (GLUCOSE) substances w/c requires protein carrier. b. Osmosis • Diffusion of Water through a selectively permeable membrane.

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Osmotic Pressure • Solute concentration of a solution • Determines whether cells lose or gain water. • Ability of Osmosis to lift a volume of water. 1. Hypertonic Solutions

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More solutes (and less water) than do cells. Cells lose water by osmosis and burst or crenate.

2. Hypotonic Solutions • Fewer solutes (and more water) than do cells.
• • Cells swell and may rupture (lyse) as water rushes in by osmosis.

3. Isotonic Solutions •
Solute = Solvent No changes in cell size and shape.

c. Filtration • Movement of substances across membrane from an area of High Hydrostatic Pressure to an
• 2. area of Lower Fluid Pressure exerted by blood. (Pressure Gradient) Ex. Kidney Filtration

Active Transport • Movement of substances across membrane with the use of ATP from the cell. • Substances are large to pass into pores • Substances can’t be dissolved in the fat portion of membrane (Lipid Insoluble) • Concentration: Lower to Higher a.

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Solute Pumping Movement of substances across membrane against a concentration gradient by protein carriers called Solute Pumps Transport of Amino Acids, Sugars, and Ions Ex. Sodium Potassium Pump- move sodium ions out and potassium ions into the cell for normal transmission of nerve impulses Bulk Transport Substances that cannot move across the membrane are transported with the use of ATP OUT of or INTO cells.

1. Exocytosis (“Out of the Cell”) • Moves substances out of the cell (hormones, mucus, and eject wastes) • Secretory Vesicle fuses with membrane, ruptures, and eject its contents outside cell.
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Endocytosis (“Into the Cell”) • Moves substances into the cell. • Uses ATP that engulfs extra cellular substances by enclosing them in secretory vesicles.

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Phagocytosis (“Cell Eating”) • Uptake of Solids • Ex. WBCs and Phagocytes act as scavengers to protect body from foreign invaders. Pinocytosis / Bulk Phase Endocytosis (“Cell Drinking”) • Uptake of fluids or liquids • Ex. Cells for absorption (Cells that forms lining of SI and Kidney Tubule Cells)

Cell Life Cycle Phases (Interphase and Cell Division)

• Series of changes a cell goes through from the time it is formed until it divides. 1. Interphase or Metabolic Phase • Longest phase; cell grows and carries normal metabolic activities. • DNA Replication occurs at the end of this period.
DNA Replication • DNA is composed of building blocks called NUCLEOTIDES, each consisting of Deoxyribose Sugar, Phosphate Group, and Nitrogen – containing base • DNA Replication begins as DNA HELIX COILS and SEPARATES into 2 NUCLEOTIDE STRANDS. Each Nucleotide strand serves as TEMPLATE (set of instructions) for BUILDING NEW NUCLEOTIDE STRAND. *** • Nucleotides join in a complementary way: * Adenine (A) - Thymine (T) * Guanine (G) - Cytosine (C) • The order of the Nucleotides on the template determines the order one the new strand. Ex. TACTGC sequence on a template strand will bond to new nucleotides w/ order of ATGACG. 2. Cell Division • Produce cells for growth and repair process Events of Cell Division 1. Mitosis • Division of Nucleus that results the formation of 2 daughter nuclei with exactly the same genes as mother nucleus. • Begins after the DNA Replication Stages of Mitosis 1. Prophase 1st Chromatin coil and shorten and Chromosomes appear. Each chromosome is made up of 2 strands called Chromatid, held together by Centromere. 2nd Centrioles separate from each other and move toward opposite sides of the cell, directing formation of Mitotic Spindle or Spindle Fibers which provides “scaffolding” for attachment and movement of chromosomes during the end of mitosis. 3rd Nuclear envelope and nucleoli are broken down and disappeared 4th Chromosomes attached to Mitotic Spindle by their centromeres. 2. 3. Metaphase 1st Chromosomes gather and become aligned at the center of mitotic spindle. Anaphase 1st Chromosomes begin to move toward opposite ends of the cell. 2nd When chromosome movement ends Anaphase period is over. Telophase 1st Chromosomes at the opposite end of the cell uncurl to become chromatin again. 2nd Mitotic Spindle spindle breaks down and disappears 3rd Nuclear envelope forms around each chromatin and nucleoli appear in each of the daughter nuclei.

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2. Cytokinesis - Division of cytoplasm; begins during late anaphase and completes during Telophase. Role of DNA in Protein Synthesis • DNA: in Nucleus; serves as the master blueprint for Protein Synthesis.

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GENE is a DNA segment that carries instructions for building 1 protein. Proteins are the key substances for all aspects of cell life. DNA’s information is “encoded” in the sequence of bases in the nucleotide strands. Each sequence of 3 bases (triplet) specifies one Amino Acid in the protein. (Example. A DNA sequence of AAA specifies an amino acid called PHENYLALANINE, while CCT is GLYCINE.) Variations in the arrangements of A, C, T, and G in each gene allow cells to make different kinds of protein)

Role of RNA in Protein Synthesis • RNA: In Cytoplasm • RNA acts as a messenger to achieve DNAs task of specifying the structure of Proteins to be built at Ribosomes. • 3 Varieties of RNA a. Transfer RNA (tRNA) • Transports Amino Acids to Ribosomes b. Ribosomal RNA (rRRNA) • Forms part of the Ribosomal structure and coordinates protein building process. c. Messenger RNA (mRNA) • Carries instructions for Protein Synthesis from DNA gene to Ribosomes. 2 Major Phases of Protein Synthesis 1. Transcription • Transfer of info from DNA’s based sequence into complementary base sequence of mRNA. • Site: Nucleus • Involves DNA and mRNA. • Each 3 base sequence specifying a particular Amino Acid is called TRIPLET. The corresponding 3 base sequences on mRNA are called CODONS. The form is different but the same information is conveyed. (If the partial sequence of DNA Triplets is AAT – CGT – TCG, the related codons on mRNA would be UUA – GCA – AGC)

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Translation Nucleic acids (base sequence) are “translated” into proteins (amino acid sequence). Site: Cytoplasm. Involves 3 Varieties of RNA (tRNa, rRRNA, mRNA) Events in Translation (see picture)

BODY TISSUES
Tissues – Group of cells that is similar in structures and function. The 4 Primary Body Tissues 1. Epithelial Tissue or Epithelium (covering) 2. Connective Tissue (support) 3. Nervous Tissue (control) 4. Muscle Tissue (movement) Epithelial Tissue or Epithelium • Lining, covering, and glandular tissue of the body. • Acts as a boundary that separates us from the external environment. Functions of Epithelial Tissue 1. Protection – protects skin against pathogens and chemicals; lining of respiratory tract contains cilia that sweeps dust and debris from lungs; lines digestive tract such as stomach and small intestine 2. Absorption – absorbs nutrients from food. 3. Filtration – filters kidney 4. Secretion (Glandular Tissue) – secrets perspiration and oil, digestive enzymes, mucus Special Characteristics Epithelial Tissue • Fit closely together to form continuous sheets. • Has one free surface or edge called Apical Surface. • Lower surface rests on a basement membrane • Avascular (No Blood Supply)

Regenerates themselves easily if well nourished.

Classification of Epithelial Tissue according to Cell Shape 1. Squamous Cells (thin and flattened) 2. Cuboidal Cells (cube shape) 3. Columnar Cells (column shape) Classification of Epithelial Tissue according to Cell Layers or Arrangement 1. Simple Epithelium • Single layer of Cells resting on a basement membrane • Functions: Absorption, Secretion, and Filtration. a. Simple Squamous Epithelium • Gaseous exchange in the Lungs. • Filtration occurs in the Kidneys • Forms Serous Membranes that lines Ventral Body Cavities (Thoracic and Abdominoplevic) Simple Cuboidal Epithelium • Common in glands and ducts (Salivary Glands and Pancreas) • Forms walls in Kidney Tubules • Covers surface of Ovaries Simple Columnar Epithelium • Has Goblet Cells that secretes mucus to trap dust and debris • Forms Mucous Membranes that lines external cavities (entire digestive tract from stomach to anus, respiratory, excretory, and reproductive tract) Pseudostratified (Ciliated) Columnar Epithelium • Gives a pseudo or false impression that it’s stratified. • Lines Respiratory Tract (Has Goblet Cells; Cilia propels mucus away from lungs) •

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2. Stratified Epithelium •
Contains 2 or more cell layers; at the free edge Function: Protection

o Stratified Squamous Epithelium (Most Common Stratified Epithelium) • Found in sites that receives abuse or friction Ex. Mouth, Throat, Esophagus, Epidermis
o Stratified Cuboidal Epithelium Found in Ducts of Large Glands Lines Mammary Glands, Sweat Glands, Salivary Glands, Pancreas Stratified Columnar Epithelia

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Found in Ducts of Large Glands Found in Vas Deferens, Parts of Male Urethra, Parts of Pharynx Transitional Epithelium / Highly Modified Stratified Squamous Epithelium

Lines Urinary System

Has ability to slide past one another and change cell shape (Allows uterine wall to stretch as a greater volume of urine flows; allows more urine to be stored in the urinary bladder)

Glandular Epithelium Gland consists of 1 or more cells that secrete a particular product called Secretion. a. Endocrine Gland • “Ductless Gland”; Ductless = Blood • Secrete Hormones (Thyroid Gland, Adrenal Gland, Pituitary Gland) Exocrine Gland • Empty their secretions through their ducts in epithelial surface. • Ex. Sweat and oil glands, liver, and pancreas

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Connective Tissues
* The most abundant of all Tissues. Functions 1. Main Function: Connects Body Parts / Binds body tissues. 2. Protection 3. Support Common Characteristics of Connective Tissues

1. Variations in Blood Supply • Mostly Vascular except Tendons and Ligaments have a poor blood supply. Cartilages are
Avascular. All these structures heal slowly when injured 2. Extracellular Matrix • Non living substance found outside the cells that contains ground substance and fibers. • Because of this, connective tissues are able to withstand stretching and other abuses such as abrasions that no other tissue could endure.

Types of Connective Tissues 1. Bone or Osseous Tissue • Most hard connective tissue; protects and supports body organs (ex. Skull protects the brain) • Composed of bone cells sitting in cavities called Lacunae and surrounded by hard matrix that contains Calcium Salts and Collagen Fibers. 2. Cartilage • Less hard and more flexible than bone. a. Hyaline Cartilage • Most abundant type of cartilage and has abundant collagen fibers • Found in larynx (voice box), attaches ribs to the breastbone, and covers the ends of bones where they form joints. • Ex. Skeleton of Fetus, but by time the baby is born most of this cartilage is replaced by bone.

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Fibrocartilage • Between vertebrae of the spinal column Elastic Cartilage • Found where elasticity is desired; Supports External Ear

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Dense Connective Tissue • Have collagen fibers as its main matrix. b. Tendons – attach skeletal muscles to bones c. Ligaments – connect bones to bones at joints d. Epidermis Loose Connective Tissue  Softer and has fewer fibers than all other tissues except blood. a. Areolar Tissue • Universal Packaging Tissue; helps hold internal organs together in their proper positions. • Act as a sponge when there’s edema • Contains Phagoctyes

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b. Adipose Tissue (Fat) • Forms subcutaneous tissue beneath the skin, where it insulates body and protects it from •
c. temperature extremes. Protects some organs individually (Kidneys, eye balls in their sockets, hips, breast)

Reticular Tissue • Consist of reticular fibers • Forms the stroma – mattress • Supports Lymphocytes in Lymphoid Organs such as Lymph Nodes, Spleen and Bone Marrow.

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Vascular Tissue or Blood • Consists of blood cells surrounding by a non living fluid matrix called BLOOD PLASMA. • TRANSPORTING FLUID for nutrients, respiratory gases, wastes, etc

MUSCLE TISSUE
1. Skeletal Muscle • Location: Attached to bones or for some facial muscles to skin • Cell Shape and Appearance: Long, cylindrical, and multinucleate; With very obvious Striations • Regulation of Contraction: Voluntarily (consciously) • Function: Movement

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Cardiac Muscle • Location: Heart • Function: Blood Pump • Cell Shape and Appearance: Branching chains of cells; Uninucleate; With Striations • Regulation of Contraction: Involuntary, Has a pacemaker; controlled by Nervous System

3. Smooth Muscle or Visceral Muscle • Location: Hollow Visceral Organs (Stomach, bladder, uterus, blood vessels) • Function: When they contract, the cavity of an organ becomes smaller (constricts) or • •

enlargen (dilates) so that substances are propelled through an organ. (Ex. Persistalis a wave like motion that keeps food moving through the small intestine) Cell Shape and Appearance: Fusiform or Spindle Shape, Uninucleate, No Striations Regulation of Contraction: Involuntary controlled by Nervous System

Nervous Tissue
Neuron Cells • Receives and conduct nerve impulses from one part of the body to another • Major Functions: Irritability and Conductivity Tissue Repair (Wound Healing) • Stimulates the ff: a. Inflammation • Generalized body response that attempts to prevent further injury. b. Immune Response • Extremely specific and mount a vigorous attack against recognized foreign invaders. Tissue Repair or Wound Healing occurs in 2 Ways: 1. Regeneration • Replacement of destroyed tissue by the same kind of cells. 2. Fibrosis • Repair by dense (fibrous) connective tissue by the formation of scar tissue Series of Events in Tissue Repair 1. Capillaries becomes permeable • Clotting proteins seeps into the injured area to form a clot which stops the loss of blood and holds the edges of the wound to prevent bacteria from spreading. When clot is exposed to air, it dries quickly and hardens, forming a SCAB 2. Granulation Tissue Forms • Pink tissue composed of new capillaries grows into the damaged area; fragile and bleed when scab is picked from the wound; contains phagocytes that eventually dispose blood clot and connective tissue cells (fibroblasts) that produce collagen fibers (scar tissue) to permanently bridge the 3. Surface Epithelium Regenerates • Granulation tissue detaches; final result is a fully regenerated surface epithelium that covers underlying are of fibrosis (the scar)

Body Membranes
Functions

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Covers body surfaces Lines Body Cavities Forms protective (often) lubricating sheets around the organs

2 Major Body Membranes 1. Epithelial Membrane 2. Connective Membrane Epithelial Membranes 1. Cutaneous Membrane • The Skin; Dry Membrane • Composed of keratinizing squamous epithelium (epidermis) underlain by dense fibrous connective tissue. • Function: Protects and Covers Body Surfaces 2. Mucous Membrane • Composed of epithelial tissue resting on areolar connective tissue called Lamina Propria. • Wet or Moist; Secretes protective lubricating mucus. • Function: Line body cavities open to the exterior (respiratory tract – mucosa of mouth, mucosa of nasal cavity, mucosa of esophagus, mucosa of lung bronchi; digestive tract; urinary tract; reproductive tract) Serous Membranes • Composed of simple suamous epithelial tissue resting on areolar connective tissue. • Function: Lines body cavities closed to exterior. • 2 Pairs of Serous Membranes: a. Parietal Layer – lines ventral cavities (abdominopelvic & thoracic); folds itself to form visceral layer b. Visceral Layer – covers outside of the organs of ventral cavities * Separated by Serous Fluid secreted by both; allows organs to slide with each other w/o friction.

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Peritoneum a. Parietal Peritonium – lines abdominoplevic cavitgy b. Visceral Peritonium – covers abdominopelvic cavity organs Pleura a. Parietal Pleura – lines thorax b. Visceral Pleura – covers lungs Pericardium – covers the heart Connective Tissue Membrane 1. Synovial Membranes • Composed of areolar connective tissue and no epithelial tissues. • Function: Lines the joint cavities (ex. Bursae and Tendons) • Secretes Synovial Fluid that lubricates the end of bones during muscle activity.

Integumentary System (Skin)
Integument = covering Functions of the Skin 1. Protects deeper tissues from a. Mechanical Damage (bumps) • contains keratin that toughens cells • contains pressure receptors that alerts Nervous System from possible damage • Skin should be intact. b. Chemical Damage (acids and bases) • Contains keratin and pain receptors that alert Nervous System from possible damage. c. Bacterial Damage (pathogens) • Has unbroken surface and acid mantle (Skin secretions are acidic thus inhibit bacteria). Phagocytes ingest foreign invaders and pathogens. d. Ultraviolet Radiation • Melanocytes cells produce Melanin for protection against sunlight. e. Thermal (Heat or Cold) Damage • Contains heat / cold / pain receptors. (Cutaneous Sensory Receptors) f. Desiccation (drying out) • Contains waterproofing substances (Lamena Granules)

2. Aids in Heat Loss or Heat Retention (Regulates Body Temperature) • Heat Loss – by activating sweat glands; allowing blood to flush into skin capillaries. • Heat Retention – not allowing blood flush into capillaries. 3. Aids in Excretion of Salts and Nitrogen Waste Materials (Urea and Uric Acid) • Contained in perspiration by sweat glands
4. Synthesizes Vitamin D • Modified Cholesterol molecules in skin converted to Vitamin D by sunlight. • Stimulates Calcium and Phosphate absorption.

Structures of the Skin 1. Epidermis 2. Dermis Epidermis • The more superficial part of the skin is formed of Stratified Squamous Keratinizing Epithelium and is Avascular. • Composed of Keratinocytes Cells which produces Keratin, a fibrous protein that makes epidermis a tough protective layer. • Keratinization – cells change shape and chemical composition Epidermis is composed of 5 Layers called Strata 1. Stratum Corneum • Superficial or Outermost Layer of Epidermis is 20 to 30 layers thick. The dead cell remnants, are filled with keratin, are referred to as Cornified or Horny Cells.

Keratin allows the layer to be tough and protect deeper cells from external environment, water loss, and biological, chemical, and physical assaults. • Cells are dead and flakes off and is replaced by Cell Division in Stratum Basale Cells. Indeed, we have a NEW EPIDERMIS every 25 – 45 days. 2. Stratum Lucidum – in thick skin and no hairs (palms of hand and soles of feet) 3. Stratum Granulosum 4. Stratum Spinosum 5th – Stratum Basale / Germinativum • Deepest Layer that lies closest to the dermis • Contains Epidermal Cells that receive adequate nutrients and oxygen (blood supply) from dermis and undergo Mitosis (Cell Division). The daughter cells move away from dermis and become part of Stratum Spinosum and Stratum Granulosum wherein they keratinized and finally die, forming Stratum Lucidum, this layer occurs only where skin is thick and has no hair (palms of the hand and soles of the feet). Because of Keratin and distance from the Dermis, Stratum Lucidum and Superficial Epidermal Cells dooms because of inadequate nutrients and oxygen. Melanin • Skin Pigment that changes in color from yellow  brown  black produced by Melanocytes Cells in Stratum Basale. • When skin is exposed to sunlight, Melanocytes are stimulated to produce more Melanin, and tanning occurs. • Stratum Basale cells phagocytize (eat) the pigment and as it accumulates within them, melanin forms a protective pigment over the superficial side of their nuclei, that shields their genetic material (DNA) from the damaging effects of the Sun. • Freckles and Moles are seen where melanin is concentrated in one spot. Homeostatic Imbalance due to Overexposure to Sun • Depresses immune system (ex. Persons with Herpes Simplex or Cold Sore are more likely to have an eruption after sunbathing) • Alters DNA Skin Cells and may lead to Cancer. Black people seldom have skin cancer. Dermis • Helps to hold the body together. • Made of Dense (Fibrous) Connective Tissue and Varies in Thickness (ex. Thick on Palms of the Hands and Soles of feet) • Abundant with Blood Supply that Maintains Homeostasis of Body Temperature. a. When BT is ↑, capillaries of dermis becomes dilated or swollen, with heated blood and becomes reddened and warmed that allows body heat to radiate in surface. b. If environment is cool and body heat must be conserved, the blood bypasses the dermis capillaries temporarily, allowing internal BT to stay ↑ 2 Major Regions of Dermis 1. Papillary Layer • Upper dermal region that have fingerlike projections from its superior surface called Dermal Papillae, which contains: a. Capillaries that furnish nutrients to epidermis. b. Pain Receptors (Free Nerve Endings) c. Touch Receptors (soft touch) called MEISNERR’S CORPUSCLES. • On the palms of the hands and soles of the feet, the papillae are arranged in definite patterns that increase friction and enhance gripping ability of the fingers and feet.

Ridges of fingertips are provided with sweat pores and leaves films of sweat called FINGERPRINTS.

2. Reticular Layer • Deepest Skin Layer that contains blood vessels, sweat, oil glands, and DEEP PRESSURE RECEPTORS called PACINIAN CORPUSCLES. • Contains Phagocytes • Contains Collagen Fibers for the toughness of dermis and helps skin hydrated. • Contains Elastic Fibers that give elasticity of the skin. • As we age, the number of collagen fibers and elastic fibers decreases and the subcutaneous tissue loses fat. As a result the skin becomes less elastic and begins to sag and wrinkle. Homeostatic Imbalance Decubitus Ulcers or “Bed Sores” Occur in bedridden patients who are not turned regularly or dragged or pulled across the bed repeatedly. The weight of the body puts pressure on bony projections. Because this restricts blood supply and skin becomes pale or blanched. The skin reddens when pressure is released, but if not, the cells die and small cracks or breaks in the skin appear at compressed sites. Permanent damage to the superficial blood vessels and tissue eventually results in degeneration and ulceration of the skin. 3 Pigments that Contributes to Skin Color 1. Amount and kind (yellow, reddish brown, and black) of Melanin in Epidermis. • People who produce a lot of melanin have brown toned skin. • In Caucasians (light toned skin), who have less melanin, the crimson color of Oxygen rich hemoglobin in the dermal blood supply flushes gives skin a rosy glow. 2. Amount of Carotene (Orange yellow pigment found in carrots and other orange, deep yellow, or leafy green vegetables) 3. Amount of Oxygen bound to Hemoglobin (pigment in RBC) in the dermal blood vessels. Homeostatic Imbalance 1. Cyanosis • Hemoglobin is poorly oxygenated, blood and skin becomes bluish (Caucasians) • Common during ♥ failure and severe breathing disorders. • In Black People, skin doesn’t appear cyanotic because of melanin • Apparent in nail beds and mucous membranes. 2. Erythema or Redness • Reddened Skin signifies blushing, fever, hypertension, inflammation or allergy. Pallor or Blanching • Signifies Emotional Stress, Anemia, Low BP, or Impaired blood flow into the area. Jaundice or Yellow Cast • Abnormal Yellow Skin Tone that Signifies Liver Disorder which in excess bile pigments are absorbed in the blood. Bruises or Black & Blue Marks • Sites where blood has escaped from the circulation and clotted in tissue spaces. • HEMATOMAS are clotted blood mass. • Signifies Vitamin C deficiency or Hemophilia (Bleeders Disease)

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Appendages of the Skin 1. Cutaneous Glands 2. Hair 3. Hair Follicles 4. Nails Cutaneos Glands • Exocrine Glands that release their secretions to the skin surface via ducts. 1. Sebaceous (Oil) Glands • Found all over the skin except Palms of Hands and Soles of feet • Active when Male Sex Hormones (Progesterone) are produced in ↑ amounts (both sexes) during adolescence • Produces SEBUM a. Keeps the Skin Soft and Moist b. Prevents Hair Brittle c. Contains chemicals that kill bacteria.

. Homeostatic Imbalance 1. Whitehead – when sebaceous gland becomes blocked by sebum. 2. Blackhead – if the material oxidizes, dies, and darkens 3. Acne – infection of sebaceous glands accompanied by pimples. 4. Seborrhea – “cradle cap” in infants; over activity of sebaceous glands. Begins on the scalp as Pink, raised lesion that gradually form a yellow to brown crust that sloughs off as oily dandruff. Careful washing to remove excessive oil.

2. Sweat Glands or Sudoriferous (Sudor = Sweat) a. Eccrine Sweat Gland
• Numerous and found all over the body. Produce SWEAT (water, salts, vitamin C, metabolic wastes (ammonia, urea, and uric acid), and lactic acid that attracts mosquitos Acidic from PH 4 – 6 that inhibits growth of bacteria Body‘s heat regulating system. They are supplied with nerve endings that cause them to secrete sweat when temperature is high.

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Apocrine Sweat Gland • Confined in Axillary and Genitals • Their ducts empty into hair follicles. • Secretions contain fatty acids and proteins and all the substances present in eccrine. • Produces Body Odor when bacteria lives on skin and uses its fats as a source for their growth. • Functions during puberty under the influence of ANDROGENS. • Activated by nerve fibers during pain and stress and sexual foreplay.

Hair and Hair Follicles Functions: 1. Guards head against bumps

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Shields eyes via eyelashes Keeps out foreign substances out of Respiratory Tract via nose hairs Provides insulation in cold weather

Hair • Produced by HAIR FOLLICLE. • Part of the hair enclosed in the follicle is ROOT • Part projecting from the surface of the scalp or skin is SHAFT. The Bulk of the Shaft is dead material and entirely Protein. • Formed by the division of the Stratum Basale in the growth zone called HAIR BULB MATRIX located at the inferior end of follicle. • Each hair consists of central core called MEDULLA surrounded by CORTEX which is enclosed by CUTICLE. • The arrangement of CUTICLE helps keep the hair apart and keep them from matting. It is the most heavily Keratinized Region that provides strength and helps keep inner layers compact. Because it is subject to abrasion, it tends to wear away at the tip of the shaft allowing keratin in the inner hair regions to frizz out called SPLIT ENDS • Hair Pigment is made by MELANOCYTES in the Hair Bulb and varying types of Melanin (Yellow, Rust, Brown, and Black) combine to produce all varieties of hair color. • Comes in variety of sizes and shapes. a. If Hair shaft is oval, Hair is SMOOTH and SILKY and the person has WAVY HAIR. b. If Hair Shaft is flat and Ribbonlike, Hair is CURLY or KINKY. c. If Hair Shaft is Round, Hair is Straight and Coarse. Hair Follicles 1. Inner Epidermal Sheath – composed of epithelial tissue and forms the hair. 2. Outer Dermal Sheath – dermal connective tissue; supplies blood vessels to the epidermal portion and reinforces it. Its papilla provides the blood supply to the matrix in hair bulb. • Arrector Pilli Muscle – small band of smooth muscle cells; when these muscles contract if we are cold or frightened, this hair is pulled upright and produces GOOSEBUMPS. Nails • Each nail has a FREE EDGE, BODY and ROOT • Borders of nails are overlapped by skin folds called NAIL FOLDS. • CUTICLE is the thick proximal nail fold. • Stratum Basale of the epidermis extends beneath the nail as the NAIL BED. Its thickened proximal area is NAIL MATRIX which is responsible for NAIL GROWTH. As the nail cells are produced by the nail matrix, they become keratinized and die. • Nails PINK in color because of the rich blood supply of the dermis. • LUNULA is the white crescent . • When the Oxygen is low, NAIL BED becomes CYANOTIC. Homeostatic Imbalance (Allergies and Infections) 3. Athletes Foot or Tinea Pedis • Itchy, red, and peeling condition between toes that results in fungal infection. 4. Boils and Carbuncles • Inflammation of Hair Follicles and Sebaceous Glands • Common on the Dorsal Neck • Caused by Bacterial Infection (often Staphylococcus Aureus)

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Cold Sores or Fever Blisters • Small fluid filled blisters that itch and sting caused by HERPES SIMPLEX infection. • The virus localizes in a cutaneous nerve when it remains dormant until activated by emotional upset, fever, UV Radiation. • Occurs usually around the LIPS and Mucosa of the Mouth Contact Dermatitis’ • Itching, redness, and swelling of the skin, progressing to blistering caused by exposure of skin to chemicals (ex. Poison Ivy) Impetigo • Pink, water filled, raised lesions that develop a yellow crust and eventually rupture. • Commonly around the mouth and nose • Caused by Staph • Common in Elementary School Aged Children Psoriasis • Chronic condition characterized by reduced epidermal lesions covered with dry, silvery scales • Maybe disfiguring when severe. • Cause is UNKNOWN but hereditary in some. • Attacks triggered by TRAUMA, INFECTION, HORMONAL CHANGES and STRESS.

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BURNS • Tissue damage and cell death caused by: a. Intense Heat b. Electricity c. UV Radiation (Sunburn) d. Chemicals (Acids) • When skin is burned, 2 life threatening problems result: c. Loss Of Body Fluids that contains proteins and electrolytes d. Dehydration and Electrolyte Imbalance follows and can lead to Shutdown of Kidneys and Circulatory Shock (inadequate circulation of blood caused by Low Blood Volume) To save the patient, lost fluids must be replaced ASAP. • The volume of fluid lost can be estimated by determining the how much body surface is burned (extent of burns) using the RULE OF NINES. This method divcides the body in 11 areas, each accounting 9% of the total body surface area surrounding face area, plus surrounding the genitals 1%. INFECTION is the most important threat and the LEADING CAUSE OF DEATH in burn victims Burned Skin is STERILE for 24 hours but after that, pathogens invade areas and multiply in the destroyed skin IMMUNE SYSTEM BECOMES DEPRESSED within 1 – 2 days after SEVERE burn injury

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Burns are classified according to their severity (depth) 1. 1st degree burn 2. 2nd degree burn 3. 3rd degree burn A. PARTIAL THICKNESS BURNS 1st Degree Burn

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Epidermis is damaged (area becomes RED and SWOLLEN) Are not usually serious and generally heal 2 – 3 days without any special attention. Ex. SUNBURN

2nd Degree Burns • Epidermis and Upper Region of Dermis is damaged. (area becomes RED, PAINFUL, and with BLISTERS) • Regeneration can occur because of the epithelial cells are present. B. FULL THICKNESS BURNS 3rd Degree Burn • • • • • Destroy the entire thickness of the skin Burned area appears BLANCHED (gray – white) and BLACKNED Since the nerve endings are destroyed it is NOT PAJNFUL REGENERATION IS IMPOSSIBLE. Treatment is SKIN GRAFTING to cover exposed tissues

In General, Burns are considered CRITICAL if: 1. 25% OF THE BODY HAS 2ND DEGREE BURNS 2. Over 10% of the BODY HAS 3rd DEGREE BURN 3. 3Rd DEGREE BURNS on FACE, HANDS, or FEET. Facial Burns are dangerous because of the possibility of burned Respiratory Passageways which can swell and cause SUFFOCATION. Joint Injuries are troublesome because the scar tissue that forms can severely limit JOINT MOBILITY. SKIN CANCER Most skin tumors are BENIGN and doesn’t spread (metastasize) to other body areas. (ex. WART, a neoplasm)

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• Basal Cell Carcinoma Least Malignant and Most Common Skin Cancer Cells of the Stratum Basale altered so they can’t form Keratin. Cancer Lesions occurs most often on SUN EXPOSED AREAS of the FACE and appear as shiny, dome shaped nodules that later develop a central ulcer with a pearly beaded edge. Slow Growing and Metastasis seldom occurs before noticed. Full Cure is the rule in 99 percent of cases where the lesion is removed surgically.
• • • • • • • • • Squamous Cell Carcinoma Arises from the Stratum Spinosum Lesions appear as scaly, reddened papule that gradually forms and shallow ulcer with a firm raised border. Appears on SCALP, EARS, DORSUM OF HANDS, and LOWER LIP. Grows rapidly and metastasize to adjacent Lymph Nodes if not removed. SUN INDUCED If caught early and removed surgically or by radiation, the chance of cure is high. • Malignant Melanoma CANCER OF MELANOCYTES Appears as spreading brown to black patch that metastasizes rapidly to surrounding lymph node and blood vessels.

ABCD RULE TO RECOGNIZE MELANOMA ASSYMETRY – 2 SIDES OF PIGMENTED MOLE DOESN’T MATCH BORDER IRREGULARITY – BORDERS OF LESIONS ARE NOT SMOOTH BUT WITH INDENTATIONS c. COLOR – DIFFERENT COLORS (BLACKS, BROWNS, TANS, AND SOMETIMES REDS) d. DIAMETER – SPOT LARGER THAN 6MM SIZE OF PENCIL ERASER. Treatmeant is wide surgical incision along with immunotherapy. ALOPECIA – Baldness or Thinning of Hair MALE PATTERN BALDNESS – men become obviously bald CAUSES OF HAIR LOSS and GRAYING OF HAIR 1. Anxiety 3. Protein deficiency diet 4. Chemotherapy 5. Radiation 6. Excessive Vitamin A Intake 7. Ringworm Baldness and Graying of Hair occurs with AGING.

• a. b.