MODULE 1: INTRODUCTION, CELLS, TISSUES, LEVELS OF ORGANIZATION

INTEGUMENTARY SYSTEM  Subatomic Particles – electrons, protons, and

neutrons
ANATOMY AND PHYSIOLOGY
 Atom – hydrogen atom, lithium atom, etc.
ANATOMY is the study of body structure.
 Molecule – water molecule, glucose molecule, etc
(science of structure)
 Macromolecule – protein molecule, DNA molecule,
-study of structure
etc.
(Greek – “a cutting tip”)
 Organelle – mitochondrion, Golgi apparatus,
PHYSIOLOGY is the science of body functions. nucleus, etc.
(science of body functions)  Cell – muscle cell, nerve cell, etc.
 Tissue – epithelia, connective, muscle and nerve
-study of function
 Organ – skin, femur, heart, kidney, etc.
(Greek – “relationship to nature”)
 Organ System – skeletal system, digestive system,
“The complementarity of structure and etc.
function.”  Organism – the human
“Structure dictates function.”

STRUCTURE MIRRORS FUNCTIONS

This structure is the liver, which has the

function of filtering blood and producing bile.
Can you see how the function is determined by
the structure, and vice versa? Organelle Cell

SUBDIVISIONS OF ANATOMY

 Surface Anatomy is the study of form and The chemical level of organization
markings of the body surface, often  Atoms
explored through visualization or palpation  Molecules
(without any “cutting”).
The Cell is next in complexity , in fact many billions of
 Gross Anatomy is the study of anatomical
times more complex than molecules.
structures visible to unaided eye. After
Cells are the basic structural and functional units of an
making the appropriate surface marking in
organism.
the prior picture, the gross dissection
proceeds through “cutting”. Tissues are groups of cells that work
Gross Anatomy can be studied by two together to perform a similar
general approaches function
1. Systematic approach (systemic anatomy)
2. Regional approach (regional anatomy) Epithelium
 Developmental Anatomy is the study of the
Connective Tissue
fertilized egg developing into its adult form.
(for e.g. embryology)
 Histology is the study of tissues.
 Cytology, like histology, uses a microscope, Muscle
but restricts the study to individual cellular Nerves
structures.
 Pathology is the study of anatomical
changes due to diseases. Organs are structure composed of
two or more different types of
CLINICAL CONNECTION tissues (all but the simplest forms
An autopsy is a post-mortem (after death) of organs have all 4 basic tissues
examination of the body and internal represented.)
organs performed by a pathologist.

BUENO, M.
 Organ systems work cooperatively to perform Major Body Organs
necessary life functions. (Cardiovascular System)
Digestive system
Respiratory system  Lungs
Takes in nutrients, breaks them
down and eliminates Takes in oxygen and  Trachea
unabsorbed matter (feces) eliminates carbon dioxide
 Superior Vena Cava
Cardiovascular system
via the blood, distributes O2  Inferior Vena Cava
and nutrients to all body
cells and delivers waster and  Aorta
CO2 to disposable organs
 Heart

Urinary system Major Body Organs

Eliminates
nitrogenous Integumentary (Respiratory System)
wastes and system
Interestitial Protects the
Fluid
excess ions
body as a whole
 The diaphragm is a
from the powerful skeletal
external
environment muscle that divides
Nutrients and wastes pass the thorax (thoracic
between blood and cells
via the interestial fluid
activity) from the
abdomen (abdominal
activity).

ORGAN SYSTEM (Digestive System)

Integumentary System
Skeletal System  Trachea
Muscular System  Esophagus
Lymphatic System  Stomach
Respiratory System  Liver
Digestive System  Small Intestine
Nervous System  Large Intestine
Endocrine System
(Urinary System)
Cardiovascular System
Urinary System  Kidneys
Female Reproductive System  Urinary Bladder
Male Reproductive System

Subatomic particles
Organ (Male and Female Reproductive System)
Atoms
Systen
 Ovaries
Molecules
 Uterine tubes
Macromolecules  Uterus Testes

Organelles
Organ

Cells
Tissue
Organism

Major Body Organs

(Nervous and Endocrine System)

 Brain
 Spinal Cord
 Thyroid Gland
 Thymus

BUENO, M.
CHARACTERISTICS OF LIFE
 Movement – change in position; motion
 Responsiveness – reaction to a change
 Growth – increase in body size; no change in
shape
 Reproduction – production of new
organisms and new cells
 Respiration – obtaining oxygen; removing
carbon dioxide; releasing energy from foods
 Digestion – breakdown of food substances
into simpler forms
 Absorption – passage of substances through
membranes and into body fluids
 Circulation – movement of substances in
body fluids
 Assimilation – changing of absorbed
substances into chemically different forms
 Excretion – removal of wastes produced by
metabolic reactions
MAINTENANCE OF LIFE
Life depends on five (5) environmental factors:
 Water
 Food
 Oxygen
 Heat
 Pressure
REQUIREMENTS OF ORGANISMS
 Water
 most abundant substance in body
 required for metabolic processes
 required for transport of substances
 regulates body temperature
 Food
 provides necessary nutrients
 supplies energy
 supplies raw materials
 Oxygen (gas)
 one-fifth of air
 used to release energy from nutrients
 Heat
 form of energy
 partly controls rate of metabolic
reactions
 Pressure
 application of force on an object
 atmospheric pressure – important for
breathing
 hydrostatic pressure – keeps blood
flowing
HOMEOSTASIS
Body fluids are defined as dilute, watery
solutions containing dissolved chemicals inside
or outside of the cell. Maintaining the volume
and composition of body fluid is important.
(total body fluid)
BUENO, M.
 Intracellular fluid (ICF) is the fluid within cells >>
 Extracellular fluid (ECF) is the fluid outside cells
(more accessible)
Interestitial fluid is ECF between cells and tissues
Some important body fluids
 Blood plasma is the ECF within the blood vessels.
 Lymph is the ECF within lymphatic vessels.
 Cerebrospinal fluid (CSF) is the ECF in the brain and
spinal cord.
 Synovial fluid is the ECF in joints.
 Aqueous humor is the ECF in eyes.
HOMEOSTASIS
 Cellular function depends on the regulation of the
composition of the interstitial fluid.
o Composition of interstitial fluid changes as
substances move between plasma and
interstitial fluid.
o Movement back and forth across capillary walls
provides nutrients (glucose, oxygen, ions) to
tissue cells and removes waste (carbon dioxide).
 Control of homeostasis is constantly being
challenged by:
o Physical insults such as intense heart or lack of
oxygen
o Changes in the internal environment such as a
drop in blood glucose due to lack of food
o Physiological stress such as demands of work or
school
HOMEOSTASIS
* Maintaining of a stable internal environment
• Homeostatic Control Mechanisms – monitors
aspects of the internal environment and corrects as
needed. Variations are within limits. There are three
(3) parts:
• Receptor - provides information about the stimuli
• Control Center - tells what a particular value should
be (called the set point)
• Effector - elicits responses that change conditions in
the internal environment
Receptors/Sensors Control center (set point)
(Change is compared to the set point)
Control center (set point) (Change is compared to the
set point.) Effectors (muscles or glands)
Effectors (muscles or glands) Response
(Change is corrected)
HOMEOSTATIC CONTROL MECHANISMS Blood Pressure regulation is a negative feedback
system.
Some stimulus disrupts
Control center (set homeostasis by
point)
(Change is Increasing
compared to the Effectors
Receptors Blood pressure
set point.) (muscles or
glands)
Receptors
Baroreceptors in certain blood
Stimulus (Change vessels send
occurs in internal Input Nerve impulses
Response (Change
environment.) is corrected.) Control Center Return to homeostasis
when response brings
Brain interprets input and sends
blood pressure back to
There are two (2) types:
normal
o Negative feedback mechanisms
Output Nerve impulses
o Positive feedback mechanisms Effector

Negative feedback summary:

 Prevents sudden, severe changes in the Blood vessel
Heart
body
 Reduces the actions of the effectors A decrease in heart
 Corrects the set point rate decreases bp
 Causes opposite of bodily disruption to
Childbirth is an example is a positive feedback system
occur, ie, ‘negates’ the change
 Limits chaos in the body by creating
stability
 Most common type of feedback loop
 Examples: body temperature, blood
pressure & glucose regulation

Positive feedback summary:

 Increases (accelerates) the actions of

the body, ie, ‘positively’ adds to or
continues the change
 Produces more instability in the body
 Produces more chaos in the body
 There are only a few types necessary for
our survival
 Positive feedback mechanisms are
short-lived
 Controls only infrequent events that do
not require continuous adjustments
 Considered to be the uncommon loop
 Examples: blood clotting and child birth
FEEDBACK SYSTEM
Negative Feedback Systems:
 Reverses a change in a controlled
condition
 Regulation of blood pressure
Positive Feedback Systems:
 Strengthens or reinforces a change in
one of the body’s controlled conditions
 Normal child birth
ANATOMICAL TERMINOLOGY
 Anatomical Position
o In the anatomical position, the
subject stands erect facing the
observer with the head level,
the eyes facing forward, feet
flat on the floor directed
forward, and the arms at their
sides, palms forward.
o All anatomical descriptions are
in reference to this position.
Anatomical Terminology:
Orientation and Directional Terms
 Terms of Relative Position (based on anatomical
position):
o Superior versus Inferior
o Anterior versus Posterior
o Medial versus Lateral
o Proximal versus Distal (only in the
extremities)
o Superficial versus Deep
o Internal versus External

BUENO, M.
  Directional  Directional Terms
Terms  Superficial
 Superior Towards
 Inferior the surface
 Above, top,  Deep
toward head Towards
 Below, the core of
bottom, the body
away from  Directional Terms
head  Visceral
Pertaining
 Directional to a
Terms covering
 Anterior over an
(Ventral) organ
 Posterior  Parietal
(Dorsal) Pertaining to a covering against a cavity wall

Regional Names

 Directional
Terms
 Proximal
Nearest to
the
origination
 Distal
Farther from
origination

Midline

Right Left
Superior

Proximal Medial

Lateral

Distal

Anterior Posterior
Proximal (Ventral) (Dorsal)

Inferior
Distal

BUENO, M.
BODY CAVITIES
Embryologically, the human organs develop
within two major body activites:
 The brain and spinal cord develop in
dorsal cavity.
 The remaining body organs are found in
ventral body activity.
 Cranial Activity is formed by the cranial bones.
(protects the brain)
 Vertebral Canal is formed by bones of vertebral
column
(contains the spinal cord)
 Meninges
Layers of protective tissue that line the cranial
activity and vertebral canal

 Thoracic activity is formed by the sternum, ribs and

the thoracic portion of the bony vertebral column
 Also called chest cavity
 Stabilized by the internal and external
muscles of the chest
Vertebral Canal  Other cavities are contained within the thoracic
cavity
 Mediastinal cavity
Located in the central part of the thoracic
cavity
 Left and Right Pleural cavities
Two fluid-filled spaces surround each lung

 Ji
 Pericardial cavity is itself located within the middle
part of the mediastinal cavity in the thoracic cavity
(like a set of Russian nesting dollars of decreasing
size – one placed inside the other).
 Abdominopelvic Cavity extends from the
Vertebral Canal diaphragm to the groin and is encircled by the
abdominal wall and bones and muscles of the pelvis
Divided into two portions:
Abdominal Cavity contains the stomach, spleen,
liver, gallbladder, small and large intestines.
Pelvic Cavity contains the urinary bladder, internal
organs of reproductive system and portions of the
large intestine.

BUENO, M.
THORACIC & ABDOMINAL BODY SECTIONS OT PLANES (3)
SEROUS MEMBRANES
 Sagittal or Median – divides body into left and right
 Visceral layer – covers an organ portions
 Parietal layer – lines a cavity or body wall  Mid-sagittal – divides body into equal left and right
portions
Thoracic Membranes
 Transverse or Horizontal – divides body into
 Visceral pleura superior and inferior portions
 Parietal pleura  Coronal or Frontal – divides body into anterior and
 Visceral pericardium posterior portions
 Parietal pericardium
BODY PLANES
Abdominopelvic Membranes Body planes are imaginary flat surfaces that separate
the body or body part into portions. There are three
 Parietal peritoneum major planes at right angles to one anoter:
 Visceral peritoneum
 Parietal perineum
 Visceral perineum

THORACIC SEROUS MEMBRANES

ABDOMINAL SEROUS MEMBRANES

BUENO, M.
BODY SECTIONS Quadrants (4)
Parasagittal
plane
Median
(midsagittal) Transverse
plane (horizontal)
plane

Frontal
(Coronal)
plane

 Vertical and horizontal lines pass through the

umbilicus
o Right upper quadrant (RUQ)
- liver
o Left upper quadrant (LUQ)
- spleen and left kidney
o Right lower quadrant (RLQ)
- appendix
OTHER BODY SECTIONS o Left lower quadrant (LLQ)
Parasagittal - ovary
plane

ABDOMINOPELVIC QUADRANTS AND REGIONS

 Identification of quadrants and regions in

the abdominopelvic cavity helps clinicians
describe the location of the many
abdominal and pelvic organs.
 There are 4 abdominopelvic quadrants and
9 regions.
- The dividing lines between these are
centered on the umbilicus (“belly button”)
 Techniques and procedures used to create images
of the human body
o Allow visualization of structures inside the body
o Diagnosis of anatomical and physiological
disorders
o Conventional radiography (X-rays) have been in
use since the late 1940’s

ABDOMINAL SUBDIVISIONS MEDICAL IMAGING

Regions (9)  Radiography is done using X-rays to produce an

image of interior structures. They are inexpensive
and quick
o Hollow structures appear black or gray
o Do not pass easily through dense structure
(bonee)
- at low dose, useful for soft tissue (breast)
- Mammography
(breast)
-Bone
densitometry
(bone density)

BUENO, M.
 Magnetic Resonance Imaging (MRI) is done
using an extremely powerful magnetic field.
It is a safe procedure but cannot be used on
patients containing metal.
o Protons in body fluid align with the field
o Used for differentiating normal and
abnormal tissues (tumors, brain
abnormalities, blood flow)
o 2D and 3D color images can be viewed
on a video monitor.
 Computed Tomography or CT-Scans are done
using a computer to organize x-rays to form
a 3D image. It is used to visualize soft tissue
in more detail than conventional
radiography.
o Tissue intensities show varying degrees
of gray.
o Whole-body CT Scans expose the body
to a high dose of x-rays.

 Here are 3 cross sectional images of a head
from the Visible Human Project. They are
done using the three modalities discussed
above.
 From top to bottom:
o Photograph of frozen, sawed head
o CT Scan of the same level/plane
o MRI scan of the same level/plane
BUENO, M.
 Ultrasound Scanning
(sonography) is done
using high frequency
sound waves. It Is
noninvasive and
painless.
 Radionuclide Scanning is done by giving a
radioactive substance (radionuclide) intravenously).
 Gamma rays emitted by tissues that take up the
radionuclide are detected by camera and
displayed on a video monitor. The color
intensity represents the amount of uptake.
 Single-photo-emission-computerized-tomography
(SPECT) is a specialized form of this technique.
 Positron Emission Tomography (PET scan) is done by
injecting a substance emitting positively charged
particles into the body. The collision between
positrons and negatively charged electron in body
tissues produce gamma rays used to form a
computer assisted image.
 Used to study a physiology of body structures
(metabolism)
 Endoscopy is done using a lighted instrument with a
lens projecting image onto a mirror
o Colonoscopy is a study of the interior of the
colon.
o Laparoscopy is a study of the organs in the
abdominopelvic cavity.
o Arthroscopy is the study of the interior of a joint
(knee).
CLINAL CONNECTION CELLS
o vary in size
 Noninvasive Diagnostic Techniques are
o possess distinctive
used to inspect different aspects of the
o shapes
body:
o measured in
Is often done to access structure and
o micrometers
function and to search for the presence of
disease
o Palpation is gently touching body
surfaces with hands.
o Auscultation is listening to body sounds
(stethoscope).
o Percussion is tapping on the body
surface with fingertips and listening to
echoes.

TERMS USED IN PATHOPHYSIOLOGY

 Pathology – study of disease A Composite Cell

 Pathogenesis – the develpement of a disease
o hypothetical cell
- diseases develop in stages
o major parts
- Infectious disease examples:
o nucleus
a. incubation
o cytoplasm
b. disease
o cell membrane
c. convalescence
 Pathophysiology – the study of functional
changes associated with a specific disease
- How the disease affects specific
functions of the body
 Subjective findings
- The patient’s symptoms
- Described by the patient
(the patient’s history)
 Objective findings
- Health provider’s findings
( the physical exam)
 Occurrence of disease defined by 2 factors
Cell Membrane
- Incidence = # new cases per unit of time
- Prevalence = new & old cases per unit of time  outer limit of cell
 controls what moves in and out of cell
DEFINITIONS
 selectively permeable
 How do we know a person is sick? How do  phospholipid bilayer
they look, what are their complaints? Do o water-soluble “heads” form surfaces
they have a fever? Sore throat? If we drew o water-insoluble “tails” form interior
blood work, what would their laboratory o permeable to lipid-soluble substances
results tell us? If we did x-rays, what would  cholesterol stabilizes the membrane
they show?  proteins
 Clinical Manifestations is the way a disease o receptors
manifests, or appears in a person. o pores, channels, carriers
 These Clinical Manifestations appear as Sign o enzymes
and Symptoms:
 Sign and Symptoms
o Sign : Manifestation that is noted by an
observer
Example (reddened throat, fever)
o Symptoms : Subjective complaint that is
noted by the person with a disorder
Example – (Patient states: “My throat
hurts”, “My body aches all over”.

BUENO, M.
  rough ER
o studded with ribosomes
o protein synthesis
 smooth ER
o lipid synthesis
o added to proteins arriving from rough ER
o break down of drugs

Intercellular Junctions

 Tight junctions Ribosomes

o close space between cells
 free floating or connected to ER
o located among cells that form linings
 provide structural support
 Desmosomes
o form “spot welds” between cells Golgi apparatus
o located among outer skin cells
 stack of flattened, membranous sacs
 Gap junctions
 modifies, packages and delivers
o tubular channels between cells
proteins
o located in cardiac muscle cells
Vesicles

 membranous sacs
 store substances
Mitochondria

 membranous sacs with inner partitions

 generate energy

Cell Adhesion Molecules

 guide cells on the move

 selectin – allows white bloodcells to
“anchor”
 integrin – guides white blood cells through
Lysosomes
capillary walls
 important for growth of embryonic tissue  enzyme-containing sacs
 important for growth of nerve cells  digest worn out cell parts or unwanted
substances
Peroxisomes

 enzyme-containing sacs
 break down organic molecules
Centrosome

 two rod-like centrioles

 used to produce cilia and flagella
 distributes chromosomes during cell
division
Cytoplasmic Organelles

Endoplasmic Reticulum
 connected, membrane-bound sacs, canals,
and vesicles
 transport system

BUENO, M.
Cilia Active (Physiological) Processes

 short hair-like  require cellular energy

projections  active transport
 propel  endocytosis
substances  exocytosis
on cellsurface  transcytosis

Flagellum Simple Diffusion

 long tail-like projection  movement of substances from regions of higher

 provides motility to concentration to regions of lower concentration
sperm  oxygen, carbon dioxide and lipid-soluble
substances
Microfilaments and microtubules

 thin rods and tubules

 support cytoplasm
 allows for movement of organelles

Facilitated Diffusion

 diffusion across a
membrane with
the help of a
channel or
Inclusions carrier molecule
 glucose and
 temporary nutrients and pigments amino acids
Cell nucleus Osmosis
 control center of cell
 movement of water through a selectively
 nuclear envelope permeable membrane from regions of higher
o porous double membrane concentration to regions of lower concentration
o separates nucleoplasm from cytoplasm  water moves toward a higher concentration of
 nucleolus solutes
o dense collection of RNA and proteins
o site of ribosome production
 chromatin
o fibers of DNA and proteins
o stores information for synthesis of
proteins

Osmotic Pressure – ability of osmosis to generate

enough pressure to move a volume of water

Osmotic pressure increases as the concentration of

nonpermeable solutes increases
Passive (Physical) Processes
hypertonic – higher osmotic pressure
 require no cellular energy
 simple diffusion hypotonic – lower osmotic pressure
 facilitated diffusion
isotonic – same osmotic pressure
 osmosis
 filtration

BUENO, M.
Filtration Exocytosis

 smaller molecules are forced through  reverse of endocytosis

porous membranes  substances in a vesicle fuse with cell membrane
 hydrostatic pressure important in the body  contents released outside the cell
 molecules leaving blood capillaries  release of neurotransmitters from nerve cells

Active Transport

 carrier molecules transport substances Transcytosis

across a membrane from regions of lower  endocytosis followed by exocytosis
concentration to regions of higher
 transports a substance rapidly through a cell
concentration
 HIV crossing a cell layer
 sugars, amino acids, sodium ions, potassium
ions, etc.

The Cell Cycle

 series of changes a cell undergoes from the

time it forms until the time it divides
 stages
Endocytosis o interphase
 cell engulfs a substance by forming a vesicle o mitosis
around the substance o cytoplasmic division
 three types
o pinocytosis – substance is mostly water
o phagocytosis – substance is a solid
o receptor-mediated endocytosis –
requires the substance to bind to a
membrane-bound receptor

Interphase

 very active period

 cell grows
 cell maintains routine functions
 cell replicates genetic material to prepare for
nuclear division
 cell synthesizes new organelles to prepare for
cytoplasmic division
 phases
o G phases – cell grows and synthesizes
structures other than DNA
o S phase – cell replicates DNA

BUENO, M.
Mitosis Tumors

 produces two daughter cells from an Two types of tumors

original somatic cell  benign – usually remains localized
 nucleus divides – karyokinesis
 malignant – invasive and can
 cytoplasm divides – cytokinesis metastasize; cancerous
 stages
Two major types of genes cause cancer
o prophase – chromosomes form; nuclear
envelope disappears  oncogenes – activate other genes that
o metaphase – chromosomes align increase cell division
midway between centrioles  tumor suppressor genes – normally
regulate mitosis; if inactivated they are
o anaphase – chromosomes separate and
unable to regulate mitosis
move to centrioles
o cells are now known as “immortal”
o telophase – chromatin forms; nuclear
envelope forms

Control of Cell Division TISSUES

• cell division capacities vary greatly among cell Four major types
types 1. Epithelial
o skin and blood cells divide often and 2. Connective (many components)
continually 3. Muscle
o neuron cells divide a specific number of 4. Nervous
times then cease
• chromosome tips (telomeres) that shorten
with each mitosis provide a mitotic clock
• cells divide to provide a more favorable
surface area to volume relationship
• growth factors and hormones stimulate cell
division
o hormones stimulate mitosis of smooth
muscle cells in uterus
o epidermal growth factor stimulates
growth of new skin 1. EPITHELIAL TISSUES
• contact (density dependent) inhibition CHARACTERISTICS
• tumors are the consequence of a loss of cell  Cells are closely
cycle control packed without any
intercellular spaces
 Lie on basement
membrane

BUENO, M.
General characteristics –
• cover organs and the body
• line body cavities
• line hollow organs
• have a free surface
• have a basement membrane
• avascular
• cells readily divide
• cells tightly packed
• cells often have desmosomes
• function in protection, secretion,
absorption, and excretion
• classified according to cell shape and
number of cell layers
TYPES OF SIMPLE EPTHELIUM TISSUES
Simple cubodial –
o single layer of cube-shaped cells
o line kidney tubules
o cover ovaries
o line ducts of some glands
Simple columnar –
o single layer of elongated cells
o nuclei usually near the basement
o membrane at same level
o sometimes possess cilia
o sometimes possess microvilli
o often have goblet cells
o line uterus, stomach, intestines

Pseudostratified columnar –
o single layer of elongated cells
o nuclei at two or more levels
o appear striated
o often have cilia
o often have goblet cells
o line respiratory passageways

DIFFERENT TYPES OF SIMPLE EPITHELIUM TISSUE

Simple squamous –
o single layer of flat cells Type of Structure Location in Function
o substances pass easily through epithelium the body
o line air sacs Cells are thin, Oesophagus, Protects the
o line blood vessels flat, irregular lining of the underlying
cells which fit mouth, tissue from
o line lymphatic vessels
like floor tiles alveoli of the injury grems
Squamous to form lungs, blood
epithelium delicate vessels Exchange of
lining called gases in lungs
Pavement and materials
epithelium between cells
and blood
Nuclei in
centre

BUENO, M.
Type of Structure Location in Function Non-Keratinised Epithelium
epithelium the body
Gives  Protects moist
Cells are Kidney mechanical surfaces subjected
cuboidal tubules, support. to wear and tear
with round duct of At times the
and prevents them
Cuboidal nucleus in salivary epithelial
epithelium centre glands. tissue folds, from drying out.
forms a  Sites
Nuclei in gland that  Conjunctiva of the
center secretes eyes, the lining of
substances. the mouth, the
Such as vagina.
epithelium is
called Stratified squamous –
GLANDULAR
EPITHELIUM  many cell layers
Cells are Inner  top cells are flat
more tall lining of Helps in  can accumulate keratin
and less intestine. absorption
 outer layer of skin
wide (pillar In excretion
Columnar like), respiratory and  line oral cavity, vagina, and anal canal
epithelium placed side tract, cells secretion.
by side. have cilia
Nucleus is (hair like)
situated that move
near the and push
base. the
(Rectangu- mucous
lar base.) to clear it.
Such
Nuclei near epithelium
base is called
CILIATED Stratified cuboidal –
COLUMNAR
EPITHELIUM  2-3 layers
 cube-shaped cells
TYPES OF STRATIFIED EPITHELIAL TISSUES  line ducts of mammary glands, sweat
STRATIFIED EPITHELIAL glands, salivary glands, and the
TISSUE pancreas

Stratified squamous
Transitional
epithelium
epithelium

Keratinised epithelium

Non keratinised epithelium

Keratinised Squamous Epithelium (skin)

Stratified columnar –
 Found on dry
 top layer of elongated cells
surfaces subjected
 cube-shaped cells in deeper layers
to wear and tear.
 line part of male urethra and part of
 Consists of dead
pharynx
epithelial cells that
have lost their
nuclei and contain
the protein keratin.
 Sites
 Skin, hairs and nails

BUENO, M.
Transitional – Cutaneous Synovial
 many cell layers
 cube-shaped and elongated cells - covers body - composed entirely of
- skin connective tissue
 line urinary bladder, ureters, and part of
urethra - lines joints

GLANDULAR EPITHELIUM
Composed of cells that are specialized to produce and
secrete substances
o Endocrine glands are ductless
o Exocrine glands have ducts
o Unicellular exocrine gland
- composed of one cell
- goblet cell
o Multicellular exocrine gland
- composed of many cells
- sweat glands, salivary glands, etc.
- simple and compound

EXOCRINE GLANDS

TRANSITIONAL EPITHELIUM
 Composed
of several
layers of
pear
shaped cells
which are
very elastic
and have TYPES OF GLANDULAR SECRETIONS
the capacity
of dividing Merocrine glands
themselves.
 Sites  fluid product
 salivary glands
 Lines several parts of the urinary tract
including the bladder.  pancreas
 sweat glands
TYPES OF EPITHELIAL MEMBRANES
Apocrine glands
Serous (GI tract?)
 cellular product
 line body cavities that  portions of cells
do not open to the  mammary glands
outside  ceruminous glands
 reduce friction
 inner lining of thorax Holocrine glands
and abdomen  secretory products
 cover organs of thorax  whole cells
and abdomen  sebaceous glands
 secrete serous fluid

Mucous
FUNCTIONS OF EPITHELIAL TISSUES
 line tubes and organs
that open to outside world  Role of defense and protect the body organs
 lining of mouth, nose, throat,  Secrete gastric juice in stomach
etc.  Absorb digested food in intestine
 secrete mucus  Removes waste as sweat in skin

BUENO, M.
2. CONNECTIVE TISSUES (CT) Macrophages
are a group of tissues which connects or
binds other tissues in the body.  wandering cell
GENERAL CHARACTERISTICS -  phagocytic
 most abundant tissue type  important in injury
 many functions  or infection
- bind structures
- provide support and protection
- serve as frameworks
- fill spaces
- store fat
- produce blood cells
- protect against infections
- help repair tissue damage
 have a matrix
F
 have varying degrees of vascularity
 have cells that usually divide Fibroblasts
 They are large cells with irregular processes
COMPOSITION: CONNECTIVE TISSUE Manufacture collagen and elastic fibres and a
matrix of extracellular material.
COMPONENTS
 Functions:
 Active in tissue repair
CELLS MATRIX
Fat cells
 Also known as adipocytes
GROUND  These cells occur singly or in groups in many
FIBERS
SUBSTANCE types of connective tissues and are especially
abundant in adipose tissue.

Macrophages
 These are large irregular shaped cells
with granules in the cytoplasm
 Important part of the body defence
mechanism because they are actively
phagocytic, engulfing and digesting cell
debris, bacteria and other foreign
bodies.

Leucocytes
 White blood cells are normally found
in small numbers in healthy connective
tissues.
 Synthesis and secret specific defensive
antibodies into the blood and tissue
GAG - glucosaminoglycans
MPS - mononuclear phagocyte system Mast cells
 Similar to basophilic leukocytes
CONNECTIVE TISSUE MAJOR CELL TYPES
 Found in loose connective tissues,
Fibroblasts under the fibrous capsules of some
 fixed cell organs. eg.liver and spleen.
 most common cell
 large, star-shaped
 produce fibers

Mast cells

 fixed cell
(Dermis)
 release heparin
 release histamine

BUENO, M.
 GROUND SUBS
• Amorphous, transparent, semi-fluid gel
• Proteoglycans, hyaluronic acid (GAG), water
• Proteoglycans: chondroitin SO4, chondroitin 6
SO4, dermatan SO4, heparan SO4, heparin SO4,
keratan SO4

CONNECTIVE TISSUE

CONNECTIVE TISSUE FIBERS

Collagenous fibers (strength/dense)

 thick
 composed of collagen
 great tensile strength
 abundant in dense CT
 hold structures together
 tendons, ligaments

Reticular fibers (supportive)

 very thin collagenous fibers
 highly branched
 form supportive networks

BUENO, M.
Elastic fibers (stretch) WHITE ADIPOSE TISSUES
 bundles of microfibrils embedded in  More present in obesity and in less in those
elastin who are underweight
 fibers branch  Found in between muscle fibres and under the
 elastic skin, where it acts as a thermal insulator and
 vocal cords, air passages energy store.
 Sites
Connective tissue proper  Deeper layer of skin, buttocks, breast and
 loose connective tissue
around kidneys
 adipose tissue BROWN ADIPOSE TISSUE (newborns)
 reticular connective tissue  Present in the newborn
 dense connective tissue  Has a more extensive capillary network than
 elastic connective tissue
white adipose tissue.
Specialized connective tissue  Produces less energy and more heat than other
 cartilage fat contributing to the maintenance of body
 bone temperature.
 blood
Reticular connective tissue
Loose connective tissue  composed of reticular fibers
 mainly fibroblasts  supports internal organ walls
 fluid to gel-like matrix  walls of liver, spleen, lymphatic organs
 collagenous fibers
 elastic fibers
 bind skin to structures
 beneath most epithelia
 blood vessels nourish
 nearby epithelial cells
 between muscles Dense connective tissue
 packed collagenous fibers
 elastic fibers
 few fibroblasts
 bind body parts together
 tendons, ligaments, dermis
 poor blood supply
Adipose tissue
 adipocytes
 cushions
 insulates
 store fats
 beneath skin
 behind eyeballs
 around kidneys and heart

Elastic connective tissue

 abundant in elastic fibers
 some collagenous fibers
 fibroblasts
 attachments between bones
 walls of large arteries, airways, heart

BUENO, M.
Bone (Osseous Tissue) calcium lvl 3. Fibrocartilage
 solid matrix
 supports
 protects
 forms blood cells
 attachment for muscles
 skeleton
 osteocytes in lacunae
HYALINE CARTILAGE
 It is a smooth
bluish white
tissues. The
chondrocytes
are arranged in
small groups
within cell
nests and
Cartilage matrix is solid and smooth.
 rigid matrix  Function:
 chondrocytes in lacunae  Provides flexibility, support and smooth
 poor blood supply surfaces for movements at joints.
 three types  Sites:
 hyaline  Ends of long bones
 elastic  Forming the parts of larynx, trachea and
 fibrocartilage bronchi

Hyaline cartilage FIBROCARTLIAGE

 most abundant  Consists of dense
 ends of bones masses of white
 nose, respiratory passages collagen fibres in
 embryonic skeleton a matrix similar
to that of hyaline
Elastic cartilage cartilage with the
 flexible
cells widely
 external ear, larynx dispersed.
Fibrocartilage  It is a tough, slightly flexible, supporting
 very tough tissue.
 shock absorber  Sites
 intervertebral discs  Pads between intervertebral disc
 pads of knee and pelvic girdle  Between pubic bones(symphysis pubis)

CARTILAGE ELASTIC FIBROCARTILAGE

cells are sparse and lei embedded in matrix  Contains
reinforced by collagen and elastic fibres. large amount
of elastin
TYPES CARTILAGE fibres in the
1. Hyaline cartilage chondrin .
 It's highly
flexible
 Sites
 The pinna or lobe of ear, epiglottis

Connective Tissues
2. Elastic cartilage
Blood
 fluid matrix called plasma
 red blood cells
 white blood cells

BUENO, M.
  platelets 4. NERVOUS TISSUES
 transports • found in brain, spinal cord, and
 defends peripheral nerves
 involved in clotting • basic cells are neurons
 throughout body in blood vessels • neuroglial cells support and
 heart • bind nervous tissue components
• sensory reception
• conduction of nerve impulses

3. MUSCLE TISSUES
GENERAL CHARACTERISTICS INTEGUMENTERARY SYSTEM
 muscle cells called muscle fibers
The integumentary system consists of the skin, hair,
 contractile
nails, glands and nerves. Its main function is to act as a
 three types
barrier to protect the body from the outside world.
 skeletal
 smooth  The integumentary system consists of the skin, hair,
 cardiac nails, the subcutaneous tissue below the skin, and
assorted glands.
SKELETAL MUSCLE
 The most obvious function of the integumentary
• attached to bones
system is the protection that the skin gives to
• striated
underlying tissues.
• voluntary
 The skin not only keeps most harmful substances
out, but also prevents the loss of fluids.
 A major function of the substance tissue is to
connect the skin to underlying tissues such as
muscles.
 Hair on scalp provides insulation from cold for the
SMOOTH MUSCLE head
• walls of organs  The hair of eyelashes and eyebrows helps keep dust
• skin and perspiration out of the eyes, and the hair in our
• walls of blood vessels nostrils helps keep dust out of the nasal cavities.
• involuntary  Any other hair in our bodies no longer serves as a
• not striated function, but is an evolutionary remnant.
 Nails protect the tips of fingers and toes from
mechanical injury
 Fingernails give the finger greater ability to pick up
small objects.
ASSOCITAION
 The skin is one the first defense mechanism in your
CARDIAC MUSCLE
immune system.
• heart wall
 Tiny glands in the skin secrete oils that enhance the
• involuntary
barrier function of the skin.
• striated
 Immune cells live in the skin and provide the first
• intercalated discs
line of defense against infections.
 By helping synthesize and absorb vitamin D, the
integumentary system works with digestive system
to encourage the uptake of calcium from our diet.
 This substance enters the bloodstream though the
capillary networks in the skin.
 Healthy functioning of your skin also is related to
the digestive system because the digestion and
assimilation of dietary fats and oils are essential for
the body to be able to make the protective oils for
the skin and hair.

BUENO, M.
 • AKA hypodermis
• Beneath dermis
• Some also call it the superficial fascia
• Some consider it not part of the skin

EPIDERMIS

• Lacks blood vessels

• Keratinized
• Thickest on palms and soles (0.8-
1.4mm)
• Melanocytes provide melanin
• Rests on basement membrane
• Stratified squamous epithelium

SKIN AND ITS TISSUES

 Composed of several tissue types
 Maintains homeostasis
 Protective covering
 Retards water loss
 Regulates body temperature
 Houses sensory receptors
 Contains immune system cells
 Synthesizes chemicals
 Excretes small amounts of wastes There are five (5) layers of the epidermis:

SKIN CELLS 1. Stratum corneum

 Help produce Vitamin D needed for
2. Stratum lucidum
normal bone and tooth development
 Some cells (keratinocytes) produce 3. Stratum granulosum
substances that simulate
development of some white blood 4. Stratum spinosum
cells
5. Stratum basale
Stratified squamous
LAYERS OF SKIN
epithelium
 Epidermis
Dense irregular
 Dermis
connective tissue

Adipose tissue

BUENO, M.
 2. Reticular layer
o 80% of dermis
o Cleavage, tension or Langer’s linesare here

Dermis
• Collagen for strength
• Elastic fibers
• Smooth muscle
• Blood and lymph vessels
• Hair follicles

Keratinocytes – Produce keratin protein a fibrous

protein that helps protect the epidermis

Epidermis Malanocytes – produces the brown pigment melanin, a

-surface layer pigment in the skin, eyes and hair
• Dead cells
• Nonvascular cells

• Heredity and environment determine

skin color
• Sensory cells
• Genetic Factors
• Skin glands
 Varying amounts of melanin
 Varying size of melanin granules
 Albinos lack melanin

• Environmental Factors
 Sunlight
 UV light from sunlamps
 X-rays
 Darkens melanin

• Physiological Factors
 Dilation of dermal blood vessels
 Constriction of dermal blood
vessels
 Accumulation of carotene
 Jaundice

DERMIS
• On average 1.0-2.0mm thick
• Contains dermal papillae
SUBCUTANEOUS LAYER
• Binds epidermis to underlying tissues
• AKA hypodermis
• Irregular dense connective tissue
• Loose connective tissue and
• Muscle cells
• Adipose tissue is present
• Nerve cell processes
• Insulates
• Specialized sensory receptors
• Major blood vessels present
• Blood vessels
• Hair follicles HYPODERMIS – adipose cells
• Glands

There are actually two (2) layers to the dermis:

1. Papillary layer
o Thin
o Superficial
o Dermal papillae found here

BUENO, M.
ACCESSORY STRUCTURES OF THE SKIN Nails
• Thin plates of stratum corneum that contain a very
• Accessory structures of the skin originate hard type of keratin
from the epidermis and include:
• Cover the distal ends of the phalanges
• Hair follicles • Stratum basale grows under the nail to form the
• Nails nail bed. Thickened at the proximal end to form the
• Skin glands matrix, which is responsible for nail growth.
Whitish, crescent shaped region of nail above the
HAIR FOLLICLES
matrix is called the lunula
• Epidermal cells
• Tube-like depression SEBACEOUS GLANDS
• Extends into dermis
• Three (3) parts: • Usually associated
with hair follicles
 Hair root
 Hair shaft • Holocrine glands
 Hair papilla • Secrete sebum (oil)
• Dead epidermal cells • Absent on palms
• Melanin and soles
• Associated with
• Arrector pili muscle
hair follicles
• Sebum (oil) keeps
skin and hair soft
and pliable. Also
inhibits growth of bacteria on skin
• Stimulated by sex hormones, so become
highly active during puberty

SWEAT GLANDS

• Aka sudoriferous
glands Hair shaft
• Widespread in skin
• Originates in
deeper dermis
• or hypodermis
• Eccrine glands
• Apocrine glands
HAIR • Ceruminous glands
• Found on nearly all body surfaces • Mammary glands
• Made of dead, keratinized epithelial cells. • Present
No blood vessels or nerves everywhere except
• Consists of a shaft (portion above scalp) and the lips and nipples. Most numerous on the palms
a root (portion below scalp) • Merocrine sweat glands: widely distributed. Secrete
• Root is surrounded by the hair follicle, water and salts onto the surface of the skin to
which contains stratum basale cells that decrease body temperature
divide to produce the hair • Apocrine sweat glands: present only on axillae
• Hair color is determined by the type of (armpits) and genitalia. Secretions contain fatty
melanin produced (yellow, red, brown, or acids and proteins, which are quickly broken down
black). With age, melanocytes become less by bacteria and cause body odor
active and melanin is replaced with air
HEAT PRODUCTION AND LOSS
bubbles, which appear white
• Heat is a product of cellular metabolism
• The most active body cells are the heat
NAILS
producers and include:
• Protective
 Skeletal muscle
coverings
 Cardiac muscle
• Three (3) parts:
 Cells of certain glands such as the liver
 Nail plate
• The primary means of heat loss is radiation
 Nail bed
• Also there is conduction, convection
 Lunula
and evaporation

BUENO, M.
PROBLEMS IN TEMPERATURE REGULATION RULE OF NINES FOR ADULTS
• Hyperthermia – abnormally high body
temperature (Heat stress and heat stroke)
• Hypothermia – abnormally low body
temperature (frostbite)

HEALING OF WOUNDS AND BURNS

• Inflammation is a normal response to
injury or stress.
• Blood vessels in affected tissues dilate
and become more permeable, allowing
fluids to leak into the damaged tissues.
• Inflamed skin may become:
 Reddened
 Swollen
 Warm
 Painful

TYPES OF BURNS
Lifespan Changes
• First degree burn – superficial, partial-
thickness • Skin becomes • Melanin production
• Second degree burn – deep, partial- scaly slows
thickness • Age spots appear • Hair thins
• Third degree burn – full-thickness
• Epidermis thins • Number of hair follicles
 Autograft
decreases
 Homograft
• Dermis becomes • Nail growth becomes
 Various skin substitutes reduced impaired
• Loss of fat • Sensory receptors
decline
• Wrinkling • Body temperature
unable to be controlled
• Sagging • Diminished ability to
activate Vitamin D
• Sebaceous glands
secrete less oil

When describing a skin lesion, it is important to

note the following features:-

1) size
2) type
3) shape and symmetry
4) colour and pigmentation
Superficial
st
1 Degree
5) surface area
Skin reddened
6) Distribution over the body surface

Primary lesions :- Basic reaction patterns of skin

with a definite morphology.
Partial thickness
2nd Degree Secondary lesion :- Develop during the evolutionary
Blisters process of skin disease or are created by scratching
on infection.

special skin lesion :- Specific for certain disease.

Fulll thickness
3rd Degree
Charring

BUENO, M.
MACULE
• A flat circumscribed lesion showing change
in color without change in its consistency.
Macules are nonpalpable.
• They are 0.5cm-1cm in size.
• Discoloration may be brown, blue ,red and
hypopigmented or hyperpigmented.
PAPULE
 A small, solid lesion, surface,
<0.5cm in diameter, raised
above the surrounding skin &
hence palpable.
 Papules may be of various
colors
BUENO, M.
PLAQUE
It is an indurated area of skin
larger than 0.5 cm in diameter
which may be raised or
depressed from skin surface
Induration:
Localized hardening of soft tissue of the body.
The area becomes firm, but not as hard as bone.
(EXAMPLES)
NODULE
 A large (0.5 - 5.0 cm), firm lesion raised above the
surface of surrounding skin.
 It is the depth of involvement that differentiates a
nodule from a large papule.
 Could be warm, soft, fluctuant, movable, fixed or
painful.
 Surface-smooth, keratotic,ulcerated or fungating.
(EXAMPLES)
VESICLE
 A small, fluid filled lesion, <0.5
cm in diameter, raised above
the plane of surrounding skin.
Fluid is often visible and the
lesions are translucent
(EXAMPLES)
PUSTULE
• A vesicle filled with pus.
• It is formed due to
collection of inflammatory
exudate rich in leucocytes.
• It may contain bacteria or
may be sterile.
(EXAMPLES) SECONDARY SKIN LESIONS
- Scale - Crust
- Erosion - Fissure
- Sinus - Scar
- Atrophy - Lichenification
SCALE
Excess dead epidermal cells
that are produced by
abnormal keratinzation and
ABSCESS shredding.
• A localized collection
E.g. Psoriasis, Icthyosis
of pus deep in dermis
or subcutaneous tissue TYPE OF SCALES
• Due to deep seated
location pus may not be visible on skin
surface but would show sign of
inflammation.

WHEAL
• It is a transient swelling
of skin disappearing
within 24 hrs.
• It is formed due to
sudden extravasation
of fluid in the dermis.
• Eg: urticaria

(EXAMPLES)

CRUST
• Dried exudates of body
CYST
fluids (blood/ serous
• It is a spherical or
fluid).
oval sac of an
• Which might be either
encapsulated cavity
yellow or red.
containing fluid or
semi solid material. (EXAMPLES)
• It is lined with true
epithelium.
• Eg:- mucous retention cyst

BULLA
• A fluid filled, raised, often translucent
lesion >0.5cm on dimater
(EXAMPLES) EROSION
• A focal loss of epidermis
• Erosions do not
penetrate below the
dermoepidermal
junction and therefore
heal without scarring
• E.g. tinea pedis,
candidiasis, eczema-tous
disease, herpes simplex

BUENO, M.
 ULCER KELOID
• Area of overgrowth of
• A focal loss of epidermis and/or dermis
fibrous tissue that usually
• Scarring depends on the depth of the ulcer
develops after healing of
• Eg- chancroid, pyoderma, gangrenosum,
skin injury & extends
decubitus
beyond the original defect.
Normal skin vs Ulceration ATROPHY
• It is reduction in size and
number of skin cells
• It may be limited to
epidermis, dermis or
subcutaneous tissue
• E.g: leprosy,
(EXAMPLES) atrophoderma,
lipoatrophy
LICHENIFICATION
• Repeated rubbing of
skin results in thickening
and hyperpigmentation
of skin
• The skin markings
become prominent.
• Eg. Lichen simplex
FISSURE chronicus, Atopic dermatitis.
• It is a linear loss of continuity of skin due to
excessive tension.
• Eg. Eczema (fingertips, intertrigo)

SCAR
• It is replacement of
normal skin by
fibrous tissue in the
process of healing
of damaged skin
• Scars are two
types-hypertrophic
and atrophic
• Eg: acne, burns, herpes zoster, keloid

BUENO, M.
MODULE 2: SKELETAL SYSTEM BONE CLASSIFICATIN
BASED ON
 Bone is a living tissue, which makes up the ACC TO SHAPE BASED ON MICROSCOPIC
body skeleton and is one of the hardest DEVELOPMENT STRUCTURE
structures of the animal body. Long bones 1 ) Mature Bone
 Bone or osseous tissue represents the Endochondral
highest differentiation among supporting Bones A. COMPACT
Short bones
BONE
tissues.
Intramembranous (CORTICAL/
 It possesses a certain degree of hardness Flat bones Bones LAMELLAR)
and elasticity. B. CANCELLOUS
 Human skeleton initially cartilages and BONE
fibrous membranes (SPONGY)
 Hyaline cartilage is the most abundant Irregular bones 2) IMMATURE/
WOVEN BONE
cartilage
 By age 25 the skeleton is completely Sesamoid
bones
hardened
 206 bones make up the adult skeleton (20%
1. LONG BONE
of body mass)
They found in the limbs. A long bone contains
- 80 bones of the axial skeleton
shaft and two extremities.
- 126 bones of the appendicular skeleton
e.g., Humerus, femur
FUNCTIONS
 It provides shape and support for the body.
 It provides site of attachment for tendons
and muscles, which are essential for
locomotion.
 Protects vital organs of the body.
 Serves as a storage site for minerals.
 Provides the medium, the narrow for the
development and storage of blood cells.
PARTS OF LONG BONE
FUNCTIONS OF BONE Epiphysis
Support, Movement & Protection Distal
o Gives shape to head, etc. Proximal
o Supports body’s weight Diaphysis
o Protects lungs, etc. Compact bone
o Bones and muscles interact Spongy bone
o When limbs or body parts move Articular cartilage
Periosteum
Inorganic Salt Storage Endosteum
o Calcium Medullary cavity
o Phosphate Trabeculae
o Magnesium Bone marrow
o Sodium - Red marrow and
o Potassium yellow marrow

Blood Cell Formation

o Also known as hematopoiesis
o Occurs in the red bone marrow
Diaphysis – the shaft or main portion of the bone
Epiphysis – the extremities or ends of the bone
Metaphysis – the region in a mature bone where
diaphysis join epiphysis
Articular cartilage – a thin layer of hyaline cartilage
covering the epiphysis where
bone forms a joint with another
bone.

BUENO M.
Periosteum – the tissue covering the outer surface inorganic salts
of bone. It consists of two layers. The o Collagen gives bone resilience
outer fibrous layer is rich in blood o Inorganic salts make bone hard
vessels, lymphatic vessels and nerves
that pass into the bone and inner layer
is composed of osteoblasts surrounded
by isteoprogenitor
Endosteum – a layer of osteoprogenitor cells and
osteoblasts that lines medullary cavity
and also contains scattered osteoclasts.

2. SHORT BONE COMPACT BONE

These have no shaft, but they contain a spongy  Osteon
substance covered by a shell of compact bone.  aka Haversian System
e.g. Wrist, ankleEpiphys  Central canal
 Perforating canal
3. FLAT BONE
 aka Volkmann’s canal
Flat bones are as they sound, strong, flat plates
 Osteocytes
of bone with the main function of providing
 Lamellae
protection to the bodies and vital organs and
 Lacunae
being a base for muscular attachment.
 Bone matrix
e.g. Scapula (shoulder blade), sternum (breast
 Canaliculi
bone)

4. IRREGULAR BONE
These are bones in the body which do not fall
into any other category, due to their non-
uniform shape. They primarily consist of
cancellous bone, with a thin outer layer of
compact bone.
e.g. Vertebra, Mandible etc.

5. SESASMOID BONE
Are usually short o irregular bones, embedded
in a tendon. The most obvious example of this is
the Patella.
MICROSCOPIC ANATOMY OF BONE

 Lacunae
- Cavities containing
bone cells (osteocytes)
- Arranged in concentric
rings
 Lamellae
- Rings around the central
canal
- Sites of lacunae
 Canaliculi
- Tiny canals
MICROSCOPIC STRUCTURE - Radiate from the central canal to lacunae
o Bone cells are called osteocytes - From a transport system
o Osteocytes transport nutrients and wastes
o The extracellular matrix of bone is largely
collagen and

BUENO M.
 Concentric lamellae make up the bulk
of compact bone and form the basic metabolic
unit of bone, the osteon (also called the
haversian system).
 The osteon is a cylinder of bone,
generally oriented parallel to the long axis of
the bone. In the center of each is a canal, the
haversian canal, which is lined by a single layer
of bone cells that cover the bone surface; each
canal houses a capillary. Adjacent haversian
canals are interconnected by Volkmann canals,
channels that, like haversian canals, contain
blood vessels, thus creating a rich vascular
network throughout compact bone.
SPONGY BONE
 Spongy bone is aka canceollous bone
BONE DEVELOPMENT AND GROWTH
 Parts of the skeletal system begin to
develop during the first few weeks of
prenatal development
 Bones replace existing connective tissue in
one of two ways:
- As intramembranous bones
- As endochondral bones
INTRAMEMBRANOUS & ENDOCHONDRAL
BONES
 Intramembranous Bones
- These bones originate within sheetlike
layers of connective tissues
- They are the broad, flat bones
- Skull bones (except mandible) are known
as intramembranous bones
 Endochondral Bones
- Bones begin as hyaline cartilage
- Form models for future bones
- These are most bones of the skeleton
- Are known as endochondral bones
ENDOCHONDRAL OSSIFICATION
o Growing cartilage at the epiphyseal plates is
mineralized and resorbed and replaced by
osteoid matrix which undergoes mineralization
to create bone
o Hyaline cartilage model
o Primary ossification center
o Secondary ossification centers
o Epiphyseal plate
o Osteoblasts vs. osteoclasts

CANCELLOUS BONE/ TRABECULAR BONE/

SPONGY BONE
 Looks like poorly organized tissue in
contrast to compact bone.
 Does not contain any true osteon.
 Consists of long, slender spicules called as
trabeculae.
 Marrow spaces are large.
 Trabeculae are oriented along the lines of
stress to withstand the forces applied to
bone.
 Osteocytes in trabeculae receive
nourishment directly from blood circulating
through marrow cavities
 It makes up most of the bone bones tissue
of short, flat and irregular bones and most
of epiphysis of long bones

BUENO M.
GROWTH AT THE EPIPHYSEAL PLATE COMPOISTION OF BONE
First layer of cells
o Closest to the end of epiphysis CELLS  OSTEOPROGENITOR
 CELLS OSTEOBLAST CELLS
o Resting cells
 OSTEOCYTES
o Anchors epiphyseal plate to epiphysis  OSTEOCLAST CELLS
Second layer of cells ORGANIC  COLLAGEN: 88-90% TYPE 1
o Many rows of young cells PART  NON COLLAGEN: 10-11%
o Undergoing mitosis 33% - 35% A) GYLCOPROTEINS 6-9%
Third layer of cells B) PROTEOGLYCANS 8%
o Older cells C)SIALOPROTEINS 35%
D)LIPIDS 4%
o Left behind when new cells appear
INORGANIC  CALCIUM & PHOSPHATE
o Cells enlarging and becoming calcified PART  MAGNESIUM
Fourth layer of cells 65%-67%  TRACE ELEMENTS: Nickel,
o Thin iron, Fluoride, cadmium, zinc
o Dead cells magnesium
o Calcified extracellular matrix FOUR TYPES OF BONE CELLS

FORMATION AND GROWTH OF LONG BONES
BONE REMODELLING
 Is essential if bones are retain normal
proportions and strength during long-
bone growth as the body increases in
size and weight.
 Bones become thicker and form large
projections to increase their strength in
areas where bulky muscles are attached
 Bones are remodelled continually in
response changes in two factors:
- Calcium levels in the blood
- The pull of gravity and muscles on the
skeleton.
 Osteocytes
- Mature bone cells
 Osteoblasts
- Bone-forming cells
 Osteoclasts
- Bone-destroying cells
- Break down bone matrix for remodeling
and release of calcium
Bone remodeling is a process by both
osteoblasts and osteoclasts
BONE CELLS
1. OSTEOPROGENITOR CELLS
o derived from mesenchyme
o all connective tissue is derived
o unspecialized stem cells
o undergo mitosis and develop into
"osteoblasts"
o found on inner surface of periosteum
and endosteum.
2. OSTEOBLASTS
o They are mononucleated cells
responsible for the synthesis and
secretion of the macromolecular
organic constituents of bone matrix.
o Derived from osteoprogenitor cells of
mesenchymal origin, which are present
in the bone marrow and other
connective tissues.

BUENO M.
 o Osteoblasts are basophillic, plump
cuboidal or slightly clongated cells.
o The cells are found on the forming
surface of growing or remodeling bone.
o They form a protein mixture known as
osteoid (primaril collagen), which
mineralizes to become bone.
INORGANIC PART
Mineral Percentage
Calcium 25%
Phosphorus 12%
Magnesium 0.37%
Potassium 0.7%
Zinc 0.009%
Copper 0.0005%
FUNCTIONS
o Formation of new bone via synthesis of
various proteins and polysaccharides.
o Regulation of bone remodeling and mineral
metabolism.
o It plays significant role in the mineralisation
of osteoid.
o Osteoblasts also secrete small amount of
type V collagen, osteonectin, osteopontin,
RANKL, osteoprotegerin, proteoglycans,
proteases, growth factors etc.
o Osteoblasts recognize the resorptive signal
and transmit it to the osteoclast.
o RANKL is a membrane bound TNF related
factors that is expressed by osteoblast/
stromal cells. The presence of RANKL is vital
in osteoclast differentiation.
3. OSTEOCYTES
o Cells of mature bone & lie in the lacunae of
bone.
o Represents osteoblasts imprisoned in matrix
during bone formation.
o The number of osteoblasts that becomes
osteocytes depends on the apidity of bone
formation.
o Within the bone matrix, the osteocyte
reduces in size, creating a space around it
called the osteocynic lacuna.
o The lacuna can appear ovoid or flattened
BUENO M.
o Narrow extensions of these lanulae form
channels called canaliculi.
o Osteocytic processes are present within
these canaliculi..
o Osteoblasts communicate with osteocytes
through canaliculi
o Old osteocytes retract their processes from
the canaliculi, and when dead, their lacunae
and canaliculi may get plugged with debris
o The death of osteocytes leads to resorption
of the matrix by osteoclasts.
FUNCTIONS
o Maintains the integrity of the lacunae and
canaliculi.
o Keep open the channels for diffusion of
nutrients through bone.
o Play role in removal and deposition of matrix
and of calcium when required.
4. OSTECOLASTS
o Bone resorbing
cells derived from
hematopoetic cells of
monocyle-macrophage
lineage.
o The word
osteoclast is derived
from the Greek words
for "bone and broken ".
o Osteoclasts lie in
resorption bay called
Howship's lacunae.
o These are large cells approx. -40-100um
in diameter with: 15 to 20 closely packed nuclei.
Homeostasis of Bone Tissue
 Bone Resorption – action of osteoclasts
and parathyroid
 hormone aka parathormone aka PTH
 Bone Deposition – action of osteoblasts
and calcitonin
 Occurs by direction of the thyroid and
parathyroid glands
 REGULATION OF BEONE INFORMATI ON
Bone resorption
Ten Cate described the sequence of events in the
resorptive process as follows:
1. Attachment of osteoclasts to mineralized bone
surface.
2. Creation of sealed acidic microenvironment
through proton pump.
3. Demineralizes the bone and exposes the matrix
4. Degradation of exposed matrix by action of
released enzymes like Acid phosphatase and
Cathepsin B.
5. Degraded material undergoes Endocytosis at
the ruffled border.
6. Translocation of degradation products in
transport vesicles and
extracellularreleaseofcontents on opposite side of
ruffled border (TRANSCYTOSIS).
Bone remodeling
o Bone is a highly dynamic connective tissue with
a capacity for Continuous remodeling.
o The two principal cell types osteoclast and
osteoblast are the major effectors in the turnover
of bone matrix.
o At any given time, the process of bone synthesis
and bone breakdown go on simultaneously.
o This phenomenon is called 'COUPLING' of bone
resorption and formation
BUENO M.
Bone mineralization
VITAMIN D METABOLISM
Maintenance of normal plasma levels of
Calcium & Phosphorus
Two forms of Vit D are present
1. Vit D2 (ergocalciferol)
2. Vit D3 (cholecalciferol)
Vitamin D (Functions)
- Intestinal Calcium absorption
- Re-absorption of Calcium from Kidneys
- Interaction with PTH in regulation of blood
Calcium
- Mineralization of Bone
Factors Affecting Bone Development, Growth
and Repair
o Deficiency of Vitamin A – retards bone
development
o Deficiency of Vitamin C – results in fragile
bones
o Deficiency of Vitamin D – rickets,
osteomalacia
o Insufficient Growth Hormone – dwarfism
o Excessive Growth Hormone – gigantism,
acromegaly
o Insufficient Thyroid Hormone – delays bone
growth
o Sex Hormones – promote bone formation;
stimulate ossification of epiphyseal plates
o Physical Stress – stimulates bone growth
Response to Mechanical Stress Skeleton is poorly developed because of defective
calcifications in growing bones.
Wolff’s law – a bone grows or remodels in
response to the forces or demands placed upon it

PATHOLOGIES OF BONE

1. GENETIC DISEASES
 Osteogenesis imperfecta ( abnormal collagen
maturation)
 Osteopetrosis (sclerotic, fragile & dense bone)
 Achondoplasia (failure of normal cartilage
proliferation)
 Infantfile cortical hyperostosis (cortical
thickening)
 Marfan syndrome (collagen is abnormally
soluble)

Osteogenesis imperfecta: Osteomalacia

 Osteogenesis imperfecta heritable disorders
charaterised by impairment of collagen
maturation.
 Disorder arises from mutation in one of two
genes that guide formation of type 1 collagen.
 Abnormal collagen maturation results in bone
with thin cortex, fine trabeculation and
diffuse osteoporosis.
Osteomalacia
 Osteomalacia is the general term for the
softening of the bones due to defective bone
mineralization.
 Osteomalacia in children is known as rickets.
 A common cause of the disease is a
deficiency in vitamin D, which is normally
obtained from the diet and/or sunlight
exposure
Failure of bones to mineralize due to prolonged
deficiency dietary lack of Vitamin D or lack of
ultraviolet rays of sun.
Pathophysiology
Inadequately mineralized bone
The hardness and rigidity of bone is due to the
presence of mineral salt in the osteoid matrix,
which is a crystalline complex of calcium and
phosphate (hydroxyapatite). So deficiency of this
hydroxyapatite leads to osteomalcia.
Causes:
Deficiency of Vitamin D
Dietary
Sun exposure

RICKETS AND OSTEOMALACIA

 Inadequate bone mineralization.
 Excessive unmineralized osteoid.
 Osteomalacia adult version of rickets.
 In rickets epiphyseal involvement
 Different expression of same diease (DHOOM
3) Gastrointestinal Causes
Gastric
RICKETS Intestinal
A disease of growing bones occurs in children Billiary
before fusion of epiphysis due to un mineralized
matrix at the growth plates Renal Causes
Chronic Renal Failure
METABOLIC BONE DISEASE: Renal Tubular Acidosis
Long term Renal Dialysis
RICKETS: Deficiency of vitamin D in early Fanconi Syndrome (Poisoning)
childhood may lead to decreased absorption of
calcium and phosphorus.

BUENO M.
 Presentation OSTEOPOROSIS-PATHOPHYSIOLOGY
o >50 yrs age Bone mass density loss reflects imbalance
o Bone Pain between resorption and formation - - bone
o Muscle Weakness resorption accelerated.
o Kyphosis/scoliosis
o Waddling gait
o Easy fractures

CAUSES:
- Osteomalacia is a generalized bone condition in
which there is inadequate mineralization of the
bone. Many of the effects of the disease overlap
with the more common osteoporosis, but the two
diseases are significantly different.

There are two main causes of osteomalacia:

1. Insufficient calcium absorption from the
intestine because of lack of dietary calcium or
a deficiency of, or resistance to, the action of
vitamin D; and
2. phosphate deficiency caused by increased
renal losses

HYPER PARATHYROIDISM
Execessive secretion of Parathormone from Bone Fractures
parathyroid gland causes hyper parathyroidism  A break in a bone
 Types of bone fractures
Clinical Features Closed (simple) fracture- break that does not
Bone fractures are common in hyperthyroidism. penetrate the skin.
Cyst like spaces in jaw bone. Open (compound) fracture- broken bone
penetrates through the skin
Radiographic Features
Multiple, well defined, unilocular or multilocular  Bone fractures are treated by reduction or
radiolucent areas are seen in jaw bone. immobilization
 Realignment of the bone
OSTEOPOROSIS
 Most common bone disorder
 Compromised bone strength with increased
risk of fracture
 40 million people world wide
 33% of postmenopausal women have
osteoporosis and additional 54% of
postmenopausal women have low bone
density in pip, spine or wrist.
 characterized by low bone mass,
deterioration of bone tissue and disruption
of bone architecture, compromised bone
strength and an increase in the risk of
fracture

BUENO M.
 DIVISIONS OF THE SKELETON

• Axial Skeleton
• Skull
• Spine
• Rib cage
• Appendicular Skeleton
• Upper limbs
• Lower limbs
• Shoulder girdle
• Pelvic girdle

Repair of Bone Fractures

o Hematoma (blood-filled swelling) is formed.
o Break is splinted by fibrocartilage to form a
callus.
o Fibrocartilage callus is replaced by a bony
callus
o Bony callus is remodeled to form a permanent
patch.

The bony callus forms

 As the more osteoblasts and osteoclasts
migrate into the area and multiply, the
fibrocartilage callus is gradually replaced by
one made of spongy bone the bony callus.

Bone remodeling occurs CRANIUM

Over the next few weeks or months, the bony 1. Frontal Bone (1)
o Forehead
callus is remodeled in response to the
o Roof of nasal cavity
mechanical stressed placed on it and it forms
o Roofs of orbits
a strong permanent "patch" at the fracture o Frontal sinuses
sight. o Supraorbital foramen
o Coronal suture

SKELETAL ORGANIZATION
o The actual number of bones in the human
skeleton varies from person to person
o Typically there are about 206 bones
o For convenience the skeleton is divided into 2. Parietal Bones (2)
the: o Side walls of cranium
- Axial skeleton o Roof of cranium
- Appendicular skeleton o Sagittal suture

BUENO M.
3. Occipital Bone (1)
o Back of skull
o Base of cranium
o Foramen magnum
6. Ethmoid Bone (1)
o Occipital condyles
o Roof and walls of nasal cavity
o Lambdoidal suture
o Floor of cranium
o Wall of orbits
o Cribiform plates
o Perpendicular plate
o Superior and middle nasal conchae
o Ethmoid sinuses
o Crista galli

4. Temporal Bones (2)

o Side walls of cranium
o Floor of cranium
o Floors and sides of orbits
o Squamous suture
o External acoustic meatus
o Mandibular fossa
o Mastoid process
o Styloid process
o Zygomatic process
FACIAL SKELETON
1. Maxillary Bones
o Upper jaw
o Anterior roof of mouth
o Floors of orbits
o Sides of nasal cavity
o Floors of nasal cavity
o Alveolar processes
o Maxillary sinuses
o Palatine process

5. Sphenoid Bone (1)

o Base of cranium
o Sides of skull
o Floors and side of orbits
o Sella turcica
o Sphenoid sinuses

BUENO M.
 8. Mandible Bone (1)
2. Palatine Bones (2) o Lower jaw
o ‘L’ shaped bones located behind the o Body
maxillae o Ramus
o Posterior section of hard palate o Mandibular condyle
o Floor of nasal cavity o Coronoid process
o Lateral walls of o Alveolar process
nasal cavity o Mandibular foramen
o Mental foramen

3. Zygomatic Bones (2)

o Prominences of cheeks
o Lateral walls of orbits
o Floors of orbits
INFANTILE SKULL
o Temporal process
Fontanels – fibrous membranes

VERTEBRAL COLUMN
• The vertebral column, or spinal column,
4. Lacrimal Bones (2)
consists of many vertebrae separated
Medial walls of orbits
by cartilaginous intervertebral discs.
Groove from orbit to nasal cavity
• Cervical vertebrae (7)
5. Nasal Bones (2)
• Thoracic vertebrae (12)
Bridge of nose
• Lumbar vertebrae (5)
• Sacral (4-5 fused segments)
6. Vomer Bone
• Sacrum is fused bone
Inferior portion of nasal septum
• Coccygeal (3-4 fused segments)
• Coccyx is fused bone

7. Inferior Nasal Conchae (2)

Extend from lateral
walls of nasal cavity

BUENO M.
 Vertebral Column
• Cervical curvature
• Thoracic curvature
• Lumbar curvature
• Sacral curvature
• Rib facets
• Vertebral prominens
• Intervertebral discs (IVD)
• Intervertebral foramina (IVF)
Typical Vertebrae
• Includes the following parts: YES
• Vertebral body (A)
• Pedicles (B)
• Lamina (C)
• Spinous process (D)
• Transverse processes (E)
• Vertebral foramen (F)
• Facets (G)

Cervical Vertebrae

• Atlas – 1st; supports head

• Axis – 2nd; dens pivots to turn
head
• Transverse foramina
• Bifid spinous processes
• Vertebral prominens – useful
landmark

BUENO M.
THORACIC VERTEBRAE

LUMBAR VERTEBRAE
• Large bodies
• Thick, short (almost square) spinous
processes

SACRUM & COCCYX

 4-5 fused segments
 Median sacral crest
 Posterior sacral
 foramina
 Posterior wall of pelvic
 cavity
 Sacral promontory aka
 base
 Area toward coccyx is
 the apex
 Coccyx aka tailbone
 3-4 fused segments

BUENO M.
 STERNUM
THORACIC CAGE o Three (3) parts of the
The thoracic cage includes the ribs, the thoracic sternum:
vertebrae, the sternum, and the costal cartilages o Manubrium
that attach the ribs to the sternum. o Body
 Ribs (12) o Xiphoid process
 Sternum
 Thoracic vertebrae (12) PECTORAL GIRDLE
 Costal cartilages o Also known as the
 Supports shoulder girdle o shoulder girdle
 and upper limbs o Clavicles
 Protects viscera o Scapulae
 Role in breathing o Supports upper limbs
o True shoulder joint is
o simply the articulation of
o the humerus and scapula

RIBS
Humans have 12 pairs of ribs:
True ribs (7)
False ribs (5), of which:
Floating (2) CLAVICLES
o Articulate with manubrium
RIB STRUCTURE o Articulate with scapulae
(acromion process)
o Shaft
SCAPULAE
o Head – • Spine
posterior end; • Supraspinous fossa
o articulates • Infraspinous fossa
with • Acromion process
vertebrae • Coracoid process
o Tubercle – • Glenoid fossa or cavity
articulates
with
o vertebrae
o Costal
cartilage –
hyaline
o cartilage

UPPER LIMB
o Humerus
o Radius
o Ulna (Interosseous membrane)
o Carpals
o Metacarpals
o Phalanges

BUENO M.

WRIST AND HAND
Metacarpal Bones (10)
Phalangeal Bones (28)
HUMERUS
• HEAD
• GREATER TUBERCLE
• LESSER TUBERCLE
• ANATOMICAL NECK
• SURGICAL NECK
• DELTOID TUBEROSITY
• CAPITULUM
• TROCHLEA
• CORONOID FOSSA
• OLECRANON FOSSA
ULNA
• Medial forearm bone
• Trochlear notch
• Olecranon process
• Coronoid process
• Styloid process
Carpal Bones (16 total bones)
• Scaphoid
• Lunate
• Triquetral
• Pisiform
• Hamate
• Capitate
• Trapezoid
• Trapezium
• Proximal phalanx
• Middle phalanx
• Distal phalanx

PELVIC GIRDLE
Coxal Bones (2)
• Supports trunk of body
• Protects viscera
• Forms pelvic cavity

RADIUS
• LATERAL FOREARM BONE
• HEAD
• RADIAL TUBEROSITY
• STYLOID PROCESS

BUENO M.
HIP BONES DIFFERENCES BETWEEN MALE FEMALE PELVIS
• Also known as the coxae: • Female pelvis
• Acetabulum • Iliac bones more flared
• There are three (3) bones: • Broader hips
• Pubic arch angle greater
1. Ilium
• More distance between ischial spines and
• Iliac crest ischial tuberosities
• Iliac spines • Sacral curvature shorter and flatter
• Greater sciatic notch • Lighter bones
2. Ischium
• Ischial spines LOWER LIMB
• Lesser sciatic notch • Femur
• Patella
• Ischial tuberosity
• Tibia
3. Pubis • Fibula
• Obturator foramen • Tarsals
• Symphysis pubis • Metatarsals
• Pubic arch • Phalanges

FEMUR
 Longest bone of body
 Head
 Fovea capitis
 Neck
GREATER AND LESSER PELVIS  Greater trochanter
• Greater Pelvis
 Lesser trochanter
• Lumbar vertebrae posteriorly
 Linea aspera
• Iliac bones laterally
 Condyles
• Abdominal wall
 Epicondyles

PATELLA
• Lesser Pelvis  Aka kneecap
• Sacrum and coccyx posteriorly  Anterior surface of the knee joint
• Lower ilium, ischium, and pubic bones  Flat sesamoid bone located in the
laterally and anteriorly quadriceps tendon

BUENO M.
TIBIA JOINTS
• Aka shin bone  Articulation of bones
• Medial to fibula  Functions of joints
• Condyles - Hold bones together
• Tibial tuberosity - Allow for mobility
• Anterior crest  Ways joints are classified
• Makes the medial Fibula - Functionally
• malleolus - Structurally
Functional Classical of Joints
FIBULA  Synarthroses – immovable joints
• Lateral to tibia  Amphiarthroses – slightly moveable joints
• Long, slender  Diarthroses – freely moveable joints
• Head
• Makes the lateral STRUCTURAL CLASSIFICATION OF JOINTS
malleolus  Fibrous joints
• Non-weight bearing - Generally immovable
 Cartilaginous joints
- immovable or slightly moveable
FOOT
 Synovial joints
- freely moveable
 Tarsal Bones (14)
1. Fibrous joints
• Calcaneus
Bones united by fibrous tissue-synarthrosis
• Talus
or largely immovable
• Navicular
• Cuboid
• Lateral (3rd) cuneiform
• Intermediate (2nd) cuneiform
• Medial (1st) cuneiform

 Metatarsal Bones (10)

 Phalanges (28)
• Proximal
• Middle 2. Cartilaginous joints
• Distal
 Bones connected by cartilage
 Examples
- Pubic symphysis
- Intervertebral joints

FOOT

3. Synovial joints
 Articulating bones are separated by a joint
cavity
 Synovial fluid is found in the joint cavity

BUENO M.
Features of Synovial Joints-Diarthroses
 Articular cartilage (hyaline cartilage) covers
the ends of bones
 Joint surfaces are enclosed by a fibrous
articular capsule
 Have a joint cavity filled with synovial fluid
 Ligaments reinforce the joint
Structures Associated with the Synovial Joint
 Bursae – flattened fibrous sacs
- lined with synovial membranes
- filled with synovial fluid
- not actually part of the joint
 Tendon sheath
- elongated bursa that wraps around a
tendon
The Synovial Joint
BUENO M.
Inflammatory Conditions Associated with Joints
 Bursitis – inflammation of a bursa usually
caused by a blow or friction
 Tendonitis – inflammation of tendon sheaths
 Arthritis – inflammatory or degenerative
diseases of joints
- Over 100 different types
- The most widespread crippling disease in the
United States
Clinical Forms Arthritis
 Osteoarthritis
- most common chronic arthritis
- probably related to normal aging processes
 Rheumatoid arthritis
- An autoimmune disease- the immune system
attacks the joints
- Symptoms begin with a bilateral
inflammation of certain joints
- Often leads to deformities
Clinical Forms of Arthritis
 Gouty Arthritis
- Inflammation of joints is caused by a
deposition of urate crystals from the blood
- Can usually be controlled with diet
Lifespan Changes
• Decrease in height beginning at about age
30
• Calcium levels fall
• Bones become brittle
• Osteoclasts outnumber osteoblasts
• Spongy bone weakens before compact
bone
• Bone loss rapid in menopausal women
• Hip fractures common
• Vertebral compression fractures common
MODULE 3: MUSCULAR SYSTEM Skeletal Muscle

Three (3) Types of Muscle Tissues

Skeletal Muscle Smooth Muscle

 Usually attached to bones
 Under conscious control
 Somatic nervous control
 Striated Cardiac Muscle
 Voluntary
Cardiac Muscle
 Wall of heart
 Not under conscious control
 Autonomic nervous control Structure of Skeletal Muscle
 Striated Skeletal Muscle
 Involuntary • Organ of the muscular system
Smooth Muscle • Skeletal muscle tissue
 Walls of most viscera, blood vessels and skin • Nervous tissue
 Not under conscious control • Blood
 Autonomic • Connective tissues
 Not striated • Fascia
• Tendons
 Involuntary
• Aponeuroses

SMOOTH MUSCLES
Compared to skeletal muscle fibers, smooth muscle Connective Tissue Coverings
fibers are: Muscle coverings:
o Shorter • Epimysium - Muscle organ
o Single, centrally located nucleus • Perimysium - Fascicles
o Elongated with tapering ends • Endomysium - Muscle cells or fibers
o Myofilaments randomly organized • Myofibrils
o Lack striations • Thick and thin myofilaments
o Lack transverse tubules • Actin and myosin proteins
o Sarcoplasmic reticula (SR) not well developed • Titin is an elastic myofilament

CARDIAC MUSCLE
o Located only in the heart
o Muscle fibers joined together by intercalated
discs
o Fibers branch
o Network of fibers contracts as a unit
o Self-exciting and rhythmic
o Longer refractory period than skeletal muscle Structure:
Skeletal muscles
SKELETAL MUSCLE ACTIONS can be described
o Skeletal muscles generate a great variety of as “bundles within
body movements. bundles within
o The action of each muscle mostly depends upon bundles”. Each
the kind of joint it is associated with and the individual skeletal
muscle fiber
way the muscle is attached on either side of
consists of bundles
that joint. of myofibrils and is encased in a connective tissue
called the endomysium.
Groups of skeletal muscle fibers are in turn gathered into Terminology – A
bundles which are wrapped in more connective tissue specialized
called perimysium. These bundles are in turn grouped terminology is used
together and enclosed in a layer of dense connective
to describe muscles
tissue called the epimysium which forms individual
muscles. or muscle tissue. The
cell membrane is
called the
sarcolemma, the
cytoplasm is called
sarcoplasm, the
endoplasmic
reticulum is called
sarcoplasmic
reticulum , and the
muscle itself is called a muscle fiber. This terminology is
specific to muscles and is derived from the Greek root
“sarkos” which means “flesh”.

Muscle fibers (myocytes or

muscle cells) – Muscle
fibers are the basic unit
of the muscle itself. It is
Each individual muscle is wrapped in a tough layer of the smallest functional
fibrous connective tissue called the fascia. These are unit or cell that a muscle
continuous with tendons and the periostuem of bones. can be divided into. Muscle
fibers are made up of smaller
sub-units called myofibrils.

The T Tubules and Sacroplasmic Reticulum

Skeletal Muscle Fibers

• Sarcolemma -T tubule
• Sarcoplasm - Triad
• Sarcoplasmic reticulum (SR) - Myofibril
• Transverse (‘T’) tubule
• Cisternae of SR
• Actin myofilaments
• Myosin myofilaments
• Sarcomere
These are in turn composed of threadlike myofilaments
which are composed of the proteins actin and myosin.
Actin filaments are thin and appear as light bands under
the microscope, while myosin filaments are thick and
appear dark.
In the middle of the H zone is a structure called the M
line which functions to hold the thick filaments to one
another.

 These have an overlapping

structure and are held
together by chemical cross
bridges. The overlapping
structure gives skeletal
muscle a banded or striped
look under the microscope
 These alternating light and
dark bands are called
striations and give skeletal
muscle its alternate name,
and more name, voluntary,
striated muscle.
 A closer look at the
 Skeletal muscle fibers are not all alike in
striations reveals that
composition and function. For example, muscle
the myofibrils are
fibers vary in their content of myoglobin.
composed of repeating
 Mvoglobin - the red-colored protein that binds
units of actin and myosin
oxygen in musclefibers.
called sarcomeres. A
 Skeletal muscle fibers that have a high myoglobin
sarcomere represents
content are termed red muscle fibers and appear
the smallest individual contractile unit of a muscle
darker (the dark meat in chicken legs and thighs);
fiber. It is measured from the point where actin
those that have a low content of myoglobin are
myofilaments overlap to the next actin overlap. The
called white muscle fibers and appear lighter (the
actin overlap is called the "Z" line, so a complete
white meat in chicken breasts).
sarcomere extends from Z line to Z line.
SARCOMERE Skeletal muscle contraction
 The sarcomere is flanked by 2 protein structures  Movement within the myofilaments
known as Z discs.
 I band (thin)
 The portion of the sarcomere which contains the
thick filament is known as the A band. A stands for  A band (thick and thin)
anisotropic which is a fancy way of saying that it  H zone (thick)
appears dark under the microscope.  Z line (or disc)
- The A band contains a zone of overlap (btwn thick &  M line
thin filaments) and an H zone which contains only thick
filaments

The portion of the sarcomerc which does not contain

any thick filament is known as the I band. The I band Myofilaments
contains only thin filament and is light under the • Thick myofilaments
microscope (it is • Composed of myosin protein
isotropic). -One I • Form the cross-bridges
band is actually part • Thin myofilaments
of 2 sarcomeres at • Composed of actin protein
once. • Associated with troponin and
tropomyosin proteins
Actin Filament Motor Unit
 Single motor
neuron
 All muscle fibers
controlled by
motor neuron
 As few as four
Binding of myosin fibers
head with  As many as 1000’s
active site of
in the presence  muscle fibers
of Ca++
Stimulus for Contraction
 Acetylcholine (ACh)
Myosin Molecule & Filament  Nerve impulse causes release of ACh from
synaptic vesicles
 ACh binds to ACh receptors on motor end
plate
 Generates a muscle impulse
 Muscle impulse eventually reaches the SR
and the cisternae

Myosin filament

Neuromuscular Junction
 Also known as NMJ or myoneural junction
 Site where an axon and muscle fiber meet
 Parts to know: Summary of Steps of General mechanism of muscle
 Motor neuron contraction
 Motor end plate
 Synapse
 Synaptic cleft
 Synaptic vesicles
 Neurotransmitters

Synthesis & Release of Acetylcholine

Excitation-Contraction Coupling
 Muscle impulses cause SR to release calcium ions
into cytosol
 Calcium binds to troponin to change its shape
 The position of tropomyosin is altered
 Binding sites on actin are now exposed
 Actin and myosin molecules bind via myosin cross-
bridges
 Cross Bridge Cycling Energy Sources for Contraction
 Myosin cross-bridge attaches to actin binding site 1) Creatine phosphate and 2) Cellular respiration
 Myosin cross-bridge pulls thin filament • Creatine phosphate – stores energy that quickly
converts ADP to ATP
 ADP and phosphate released from myosin
 New ATP binds to myosin
 Linkage between actin and myosin cross-bridge
break
 ATP splits
 Myosin cross-bridge goes back to original position
Oxygen Supply and Cellular Respiration
• Cellular respiration:
• Anaerobic Phase
o Glycolysis
o Occurs in cytoplasm
o Produces little ATP
• Aerobic Phase
o Citric acid cycle
o Electron transport system
o Occurs in the mitochondria
o Produces most ATP
o Myoglobin stores extra oxygen

The Sliding Filament Model of Muscle Contraction

• When sarcromeres shorten, thick and thin
filaments slide past one another
• H zones and I bands narrow
• Z lines move closer together

Oxygen Debt
• Oxygen debt – amount of oxygen needed by liver cells
to use the accumulated lactic acid to produce
glucose
o Oxygen not available
o Glycolysis continues
o Pyruvic acid converted to lactic acid
o Liver converts lactic acid to glucose

Relaxation
• Acetylcholinesterase – rapidly decomposes Ach
remaining in the synapse
• Muscle impulse stops
• Stimulus to sarcolemma and muscle fiber membrane
ceases
• Calcium moves back into sarcoplasmic reticulum (SR)
• Myosin and actin binding prevented
• Muscle fiber relaxes
Muscle Fatigue Recruitment of Motor Units
• Inability to contract muscle • Recruitment - increase in the number of motor
• Commonly caused from: units
• Decreased blood flow  activated
• Ion imbalances across the sarcolemma
• Whole muscle composed of many motor units
• Accumulation of lactic acid
• Cramp – sustained, involuntary muscle contraction • More precise movements are produced with fewer
Heat Production muscle
• By-product of cellular respiration • fibers within a motor unit
• Muscle cells are major source of body heat • As intensity of stimulation increases, recruitment of
• Blood transports heat throughout body core motor
Muscular Responses • units continues until all motor units are activated
 Muscle contraction can be observed by removing
a single skeletal muscle fiber and connecting it to Sustained Contractions
a device that senses and records changes in the • Smaller motor units (smaller diameter axons) -
overall length of the muscle fiber. recruited first
Threshold Stimulus • Larger motor units (larger diameter axons) -
 Minimal strength required to cause contraction recruited later
Recording of a Muscle Contraction • Produce smooth movements
• Recording a Muscle Contraction • Muscle tone – continuous state of partial
Twitch
contraction
• Latent period
• Period of contraction Here are the stimuli are close enough to one another so
• Period of relaxation
that tetanus is complete and no relaxation occurs until
• Refractory period
• All-or-none response fatigue.

Here we have the phenomenon known as treppe

(German for staircase). Notice that the subsequent
Length-Tension Relationship
contractions grow stronger. There 2 reasons for this:
1. Slight increase in sarcoplasmic [Ca2+]
2. Heat liberated by working muscle increases the
rate and efficiency of enzymes function within

Summation
• Process by which individual twitches combine
Types of Contractions
• Produces sustained contractions • Isotonic – muscle contracts and changes length
• Can lead to tetanic contractions • Eccentric – lengthening contraction
• Concentric – shortening contraction
• Isometric – muscle contracts but does not
change length
 Muscle Tone:
• Some of the motor units w/i particular muscle are
always active, even when the muscle is not
contracting.
- Their contractions do not produce enough
tension to cause movement, but they do tense
and firm the muscle.
- This resting tension in a skeletal muscle is called
tone.
- The identity of the motor units involved changes
constantly. .
• Why do you suppose this is?
• Resting muscle tone stabilizes the position of Smooth Muscle Fibers
bones and joints. • Visceral Smooth Muscle
Fast Twitch and Slow Twitch Muscle Fibers • Single-unit smooth muscle
• Slow-twitch fibers (Type I) • Sheets of muscle fibers
• Always oxidative • Fibers held together by gap junctions
• Resistant to fatigue • Exhibit rhythmicity
• Red fibers • Exhibit peristalsis
• Most myoglobin • Walls of most hollow organs
• Good blood supply • Multi-unit Smooth Muscle
• Fast-twitch glycolytic fibers (Type IIa) • Less organized
• White fibers (less myoglobin) • Function as separate units
• Poorer blood supply • Fibers function separately
• Susceptible to fatigue • Iris of eye
• Fast-twitch fatigue-resistant fibers (Type IIb) • Walls of blood vessels
• Intermediate fibers Smooth Muscle Contraction
• Oxidative • Resembles skeletal muscle contraction in that:
• Intermediate amount of myoglobin o Interaction between actin and myosin
• Pink to red in color o Both use calcium and ATP
• Resistant to fatigue o Both are triggered by membrane impulses
• Different from skeletal muscle contraction in that:
o Smooth muscle lacks troponin
o Smooth muscle uses calmodulin
o Two neurotransmitters affect smooth muscle
o Acetlycholine (Ach) and norepinephrine (NE)
o Hormones affect smooth muscle
o Stretching can trigger smooth muscle contraction
o Smooth muscle slower to contract and relax
o Smooth muscle more resistant to fatigue
o Smooth muscle can change length without changing
tautness
Rigor Mortis
Upon death, muscle
cells are unable to
prevent calcium entry.
This allows myosin to
bind to actin. Since there is no ATP made postmortem,
the myosin cannot unbind and the body remains in a
state of muscular rigidity for almost the next couple
days
Characteristics of Muscle Tissue
Myasthenia Gravis
• My-muscle, asthen=weakness, gravi-heavy ?
• Autoimmune disease where antibodies attack the
ACh receptors on neuromuscular junctions.
• Results in progressive weakening of the skeletal
muscles. Why?
• Treated w/ anticholinesterases such as
neostigmine or physostigmine. These decrease the
activity of acteylcholinesterase.
Why would this help someone with myasthenia
gravis?
MuscularDystrophy
• Group of inherited muscle-destroying diseases that
generally appear during childhood.
• Dys=faulty; Troph=growth
• Most common is Duchenne muscular dystrophy
o DMD is caused by an abnormal X-linked
recessive gene
o Diseased muscle fibers lack the protein
dystrophin which normally links the
cytoskeleton to the ECM and stabilizes the
sarcolemma Age of onset is btwn 2 and 10.
Muscle weakness progresses. Afflicted
individuals usually die of respiratory failure,
usually by age 25.
Other Important Terms
 Flaccid paralysis - Weakness or loss of muscle tone
typically due to injury or discase of motor neurons.
 Spastic paralysis - Sustained involuntary contraction
of muscle(s) with associated loss of function
How do flaccid and spastic paralysis differ?
 Spasm - A sudden, involuntary smooth or skeletal
muscle twitch. Can be painful. Often caused by
chemical imbalances
 Cramp - A prolonged spasm that causes the muscle
to become taut and painful.
 Hypertrophy - Increase in size of a cell, tissue
or anorgan.
- In muscles, hypertrophy of the organ is
always due to cellular hypertrophy (increase
in cell size) rather than cellular hyperplasia
(increase in cell number)
- Muscle hypertrophy occurs due to the
synthesis of
more
myofibrils and
synthesis of
larger
myofibrils.
 Atrophy - Reduction in size of a cell, tissue, or organ.
- In muscles, its often caused by disuse. Could a
nerve injury result in disuse? Why might astronauts
suffer muscle atrophy?
 Fibrosis - Replacement of normal tissue with heavy
fibrous connective tissue (scar tissue). How would
fibrosis of skeletal muscles affect muscular strength?
How would it affect muscle flexibility?
 Single Unit Smooth Muscle –
o More common
o Cells contract as a unit because they are all
connected by gap junctions - protein complexes that
span the PM's of 2 cells allowing the passage of ions
between them, i.e ., allowing the depolarization of
one to cause the depolarization of another.
o Some will contract rhythmically due to pacemaker
cells that have a spontaneous rate of depolarization.
 Multi-Unit Smooth Muscle
o Innervated in motor units comparable to those of
skeletal muscles
o No gap junctions. Each fiber is independent of all
the others.
o Responsible to neural & hormonal controls
o No pacemaker cells
 o Less common by Shape:
o Found in large airways to the lungs large arteries,  deltoid (triangle)
arrector pili, internal eye muscles (e.g ., the  trapezius (trapezoid, 2
muscles that cause dilation of the pupil) parallel sides)
o Why is good to have the digestive smooth muscle  serratus (sawtoothed)
single unit and the internal eye muscles multi-unit?  rhomboideus (rhomboid,
4 parallel sides)
Origin and Insertion
 orbicularis and sphincters
 Origin – immovable end
(circular)
 Insertion – movable end
by Size
 maximus (largest)
 minimis (smallest)
 longus (longest)
 brevis (short)
 major (large)
 minor (small)

Interaction of Skeletal Muscle by Direction of Fibers

 Prime mover (agonist) – primarily responsible for
movement
 Synergists – assist prime mover
 Antagonist – resist prime mover’s action and
cause movement in the opposite direction of the
prime mover.

Categories of skeletal muscle actions

Categories Actions by Number of Origins
Extensor Increases the angle at a joint
Flexor Decreases the angle at a joint .  Biceps (2)
Abductor Moves limb away from midline of body  Triceps (3)
Adductor Moves limb toward midline of body  Quadriceps (4)
Levator Moves insertion upward
Depressor Moves insertion downward
Rotator Rotates a bone along its axis
Sphincter Constricts an opening
For Origin and Insertion
Sternocleidomastoid originates
from sternum and clavicle
and inserts on mastoid process
of termporal bone

For Action
 Flexor carpi radialis (extensor
carpi radialis) - flexes wrist
 Abductor pollicis brevis
(adductor pollicis) - flexes
thumb
Naming Skeletal Muscles
o Location of the muscle  Abductor magnus - abducts
o Shape of the muscle thigh
o Relative Size of the muscle  Extensor digitorum m extends
o Direction/Orientation of the muscle fibers/ cells fingers
o Number of Origins Location of the Attachments ?
o Action of the muscle

Muscles named by Location

o Epicranius – (around cranium)
o Tibilais anterior – (front of tibia)
Arrangement of Fascicles
 Parallel
- strap-like
- sartorius
 Fusiform
- spindle shaped
- ex. biceps femoris

 Convergent
- ex- pectoralis major
 Circular
- sphincters
- ex. orbicularis oris

There are about 60 muscles in the face.

Smiling is easier than frowning
It takes 20 muscles to smile and over 40 to frown .
Lifespan Changes
• Myoglobin, ATP, and creatine phosphate decline
• By age 80, half of muscle mass has atrophied
• Adipose cells and connective tissues replace
muscle tissue
• Exercise helps to maintain muscle mass and
function
MODULE 4: NERVOUS SYSTEM
A. The nervous system is composed of neurons and
neuroglia.
1. Neurons transmit nerve impulses along nerve fibers
to other neurons. Neurons typically have a cell body,
axons and dendrites.
2. Nerves are made up of bundles of nerve fibers.
3. Neuroglia carry out a variety of functions to aid and
protect components of the nervous system.
(Astrocytes, Microglial, Ependymal cells and
Oligodendrocytes – CNS)
(Satellite cells and Schwann cells – PNS)
B. Organs of the nervous system can be divided into the
central nervous system (CNS), made up of the brain
and spinal cord, and the peripheral nervous system
(PNS), made up of peripheral nerves that connect the
CNS to the rest of the body.
C. The nervous system provides sensory, integrative,
and motor functions to the body.
1. Motor functions can be divided into the consciously
controlled somatic nervous (voluntary) system and the
unconscious autonomic system.
Gray matter – without myelin sheaths
White matter – with myelin sheaths (faster electrical impulse)
✵General Functions of the Nervous System
A. Sensory receptors at the ends of peripheral nerves gather
information and convert it into nerve impulses.
B. When sensory impulses are integrated in the brain as
perceptions, this is the integrative function of the
nervous system.
C. Conscious or subconscious decisions follow, leading
to motor functions via effectors.
✵Supporting cells
A. Classification of Neuroglial Cells
Neuroglial cells fill spaces, support neurons, provide
structural frameworks, produce myelin, and carry on
phagocytosis. Four are in the CNS and the last in the
PNS.
1. Microglial cells are small cells that phagocytize
bacterial cells and cellular debris.
2. Oligodendrocytes form myelin in the brain and
spinal cord.
3. Astrocytes are near blood vessels and support
structures, aid in metabolism, and respond to brain
injury by filling in spaces.
4. Ependyma(l) cover the inside of ventricles and form
choroid plexuses within the ventricles. (CSF)
5. Schwann cells are the myelin-producing neuroglia
of the peripheral nervous system.
✵Neuron Structure
A. A neuron has a cell body with
mitochondria, lysosomes, a Golgi apparatus,
chromatophilic substance (Nissl bodies)
containing rough endoplasmic reticulum, and
neurofibrils.
B. Nerve fibers include a solitary axonand numerous
dendrites.
1. Branching dendrites carry impulses from other
neurons (or from receptors) toward the
cell body.
2. The axon transmits the impulse away from the
axonal hillock of the cell body and may give offside
branches.
3. Larger axons are enclosed by sheaths of myelin
provided by Schwann cells and are myelinated
fibers.
a. The outer layer of myelin is surrounded by a
neurilemma (neurilemmal sheath) made up of
the cytoplasm and nuclei of the Schwann cell.
b. Narrow gaps in the myelin sheath between
Schwann cells are called nodes of Ranvier.
4. The smallest axons lack a myelin sheath and are
unmyelinated fibers.
5. White matter in the CNS is due to myelin sheaths in
this area.
6. Unmyelinated nerve tissue in the CNS comprise the
gray matter.
7. Peripheral neurons are able to regenerate because
of the neurilemma but the CNS axons are
myelinated by oligodendrocytes thus lacking
neurilemma and usually do not regenerate.
✵Classification of Neurons
A. Neurons can be grouped in two ways: on the basis
of structural differences (bipolar, unipolar, and
multipolar neurons), and by functional differences
(sensory neurons, interneurons, and motor
neurons).
B. Classification of Neurons
1. Bipolar neurons are found in the eyes, nose, and
ears, and have a single axon and a single dendrite
extending from opposite sides of the cell body.
2. Unipolar neurons are found in ganglia outside the
CNS and have an axon and a dendrite arising from a
single short fiber extending from the cell body.
3. Multipolar neurons have many nerve fibers arising
from theircell bodies and are commonly found in
the brain and spinal cord.
4. Sensory neurons (afferent neurons) conduct
impulses from peripheral receptors to the CNS and
are usually unipolar, although some are bipolar
neurons.
5. Interneurons are multipolar neurons lying within
the CNS that form links between otherneurons.
6. Motor neurons are multipolar neurons that conduct
impulses from the CNS to effectors.
✵Cell Membrane Potential
A. A cell membrane is usually polarized, with an
excess of negative charges on the inside of the
membrane; polarization is important to the
conduction of nerve impulses.
Neuromuscular Junction
 Also known as NMJ or myoneural junction
 Site where an axon and muscle fiber meet
 Parts to know:
 Motor neuron
 Motor end plate
 Synapse
 Synaptic cleft
 Synaptic vesicles
 Neurotransmitters
B. Distribution of Ions
1. The distribution of ions is determined by the
membrane channel proteins that are selective for
certain ions.
2. Potassium ions pass through the membrane more
readily than do sodium ions, making potassium ions
a major contributor to membrane polarization.
4. This rapid sequence of events is the action
potential.
5. The active transport mechanism then works to
maintain the original concentrations of sodium and
potassium ions.

C. Resting Potential
1. Due to active transport, the cell maintains a greater
concentration of sodium ions outside and a greater
concentration of potassium ions inside the
membrane.

2. The inside of the membrane has excess negative

charges, while the outside has more positive
charges.

3. This separation of charge, or potential difference, is

called the resting potential.

D. Potential Changes
1. Stimulation of a membrane can locally affect its
resting potential.
2. 2When the membrane potential becomes less ✵ Nerve Impulse
negative, the membrane is depolarized.
3. If sufficiently strong depolarization occurs, a A. A nerve impulse is conducted as an action potential
threshold potential is achieved as ion channels is reached at the trigger zone. This spreads by a
open. local current flowing down the fiber, and adjacent
4. At threshold, an action potential is reached. areas of the membrane reach action potential.
5. Action potentials may be reached when a series of
subthreshold stimuli summate and reach
threshold.

E. Action Potential
1. At threshold potential, membrane permeability to
sodium suddenly changes in the region of
stimulation.
2. As sodium channels open, sodium ions rush in, and
the membrane potential changes and becomes
depolarized.
3. At the same time, potassium channels open to
allow potassium ions to leave the cell, the
Membrane becomes repolarized, and resting
potential is reestablished.
B. Impulse Conduction
1. Unmyelinated fibers conduct impulses over their
entire membrane surface.
2. Myelinated fibers conduct impulses from one Node
of Ranvier to the next, a phenomenon called
salutatory conduction.
3. Saltatory conduction is many times faster than
conduction on unmyelinated neurons.
C. All-or-None Response
1. If a nerve fiber responds at all to a stimulus, it
responds completely by conducting an impulse (all-
or-none response).
2. Greater intensity of stimulation triggers more
impulses per second, not stronger impulses.
✵ The Synapse
A. Nerve impulses travel from neuron to neuron along
complex nerve pathways.
B. The junction between two communicating neurons
is called a synapse; there exists a synaptic cleft
between them across which the impulse must be
conveyed.
C. Synaptic Transmission
1. The process by which the impulse in the
presynaptic neuron is transmitted across the
synaptic cleft to the postsynaptic neuron is
called synaptic transmission.
2. When an impulse reaches the synaptic knobs of
an axon, synaptic vesicles release a
neurotransmitter into the synaptic cleft.
3. The neurotransmitter reacts with specific
receptors on the postsynaptic membrane.
D. Excitatory and Inhibitory Process
1. Neurotransmitters that increase postsynaptic
membrane permeability to sodium ions may
trigger impulses and are thus excitatory.
2. Other neurotransmitters may decrease
membrane permeability to sodium ions,
reducing the chance that it will reach threshold,
and are thus inhibitory.
3. The effect on the postsynaptic neuron depends
on which presynaptic knobs are activated.
E. Neurotransmitters
1. At least 50 kinds of neurotransmitters are
produced by the nervous system, most of which
are synthesized in the cytoplasm of the synaptic
knobs and stored in synaptic vesicles.
2. When an action potential reaches the synaptic
knob, calcium ions rush inward and, in
response, some synaptic vesicles fuse with the
membrane and release their contents to the
synaptic cleft.
3. Enzymes in synaptic clefts and on postsynaptic
membranes rapidly decompose the
neurotransmitters after their release.
4. Destruction or removal of the neurotransmitter
prevents continuous stimulation of the
postsynaptic neuron.
✵ Impulse Processing
A. How impulses are processed is dependent upon
how neurons are organized in the brain and spinal
cord.
B. Neuronal Pools
1. Neurons within the CNS are organized into
neuronal pools with varying numbers of cells.
2. Each pool receives input from afferent nerves
and processes the information according to the
special characteristics of the pool.
C. Facilitation
1. A particular neuron of a pool may receive
excitatory or inhibitory stimulation; if the net
effect is excitatory but subthreshold, the
neuron becomes more excitable to incoming
stimulation (a condition called facilitation).
D. Convergence
1. A single neuron within a pool may receive
impulses from two or more fibers
(convergence), which makes it possible for the
neuron to summate impulses from different
sources.
E. Divergence
1. Impulses leaving a neuron in apool may be
passed into several output fibers (divergence), a
pattern that serves to amplify an impulse.
MODULE 4B

 The central nervous system (CNS) consists of the

brain and spinal cord.
 The brainstem connects the brain to the spinal cord.
 Communication to the peripheral nervous system
(PNS) is by way of the spinal cord.

Meninges
 The meninges
 Membranes of CNS
 Protect the CNS
 Three (3) layers:
o Dura mater
o “Tough mother”
o Venous sinuses
o Falx
o Arachnoid mater
o “Spiderweb-like”
o Space contains
o cerebrospinal fluid(CSF)
o Pia mater Cerebrospinal Fluid
o “Faithful mother” • Secreted by the choroid plexus
• Circulates in ventricles, central canal of
spinal cord, and the subarachnoid space
• Completely surrounds the brain and
spinal cord
• Excess or wasted CSF is absorbed by
the arachnoid villi
• Clear fluid similar to blood plasma
• Volume is 150 ml.
• Nutritive and protective
• Helps maintain stable ion
concentrations in the CNS
Meninges of the Spinal Cord

Ventricles and Cerebrospinal Fluid

• There are four (4) ventricles
• The ventricles are interconnected cavities within
cerebral hemispheres and brain stem
• The ventricles are continuous with the central
canal of the spinal cord
• They are filled with cerebrospinal fluid (CSF)
• Ependymal
• The four (4) ventricles are:
• Lateral ventricles (2)
- Known as the first and second ventricles
• Third ventricle
• Fourth ventricle
• Interventricular foramen
• Cerebral aqueduct
Spinal Cord Parts of a reflex arc
• Extends downward through vertebral canal
• Begins at the foramen magnum and terminates at
the first and second lumbar vertebrae (L1/L2)
interspace

General Components of a Spinal Reflex

Structure of the Spinal Cord

Patellar Reflex
• Example is the knee-jerk reflex
• Simple monosynaptic reflex
• Helps maintain an upright posture &
prevents overstretching

Functions of Spinal Cord

• Conduit for nerve impulses to and from the brain
and brainstem
• Center for spinal reflexes

Reflex Arcs
• Reflexes are automatic, subconscious responses to
stimuli within or outside the body
• Simple reflex arc (sensory – motor)
• Most common reflex arc (sensory – association –
motor) Withdrawal Reflex
Crossed Extensor Reflex Descending Tracts
• Contralateral reflex • Major descending (motor) spinal cord tracts:
• Maintain balance • Corticospinal tracts
• Lateral and anterior
• Reticulospinal tracts
• Lateral, anterior and medial
• Rubrospinal tract

Tracts of the Spinal Cord

• Ascending tracts conduct sensory impulses to the
brain
• Descending tracts conduct motor impulses from
the brain to motor neurons reaching muscles and
glands

Peripheral Nervous System

• Cranial nerves arising from the brain
• Somatic fibers connecting to the skin
and skeletal muscles
• Autonomic fibers connecting to viscera
• Spinal nerves arising from the spinal cord
Ascending Tracts • Somatic fibers connecting to the skin
• Major ascending (sensory) spinal cord tracts: and skeletal muscles
• Fasciculus gracilis and fasciculus cuneatus • Autonomic fibers connecting to viscera
• Spinothalamic tracts
• Lateral and anterior Structure of a Peripheral Nerve
• Spinocerebellar tracts
• Posterior and anterior
Nerve and Nerve Fiber Classification Spinal Nerves
• Sensory nerves • Dorsal root (aka posterior root)
Conduct impulses into brain or spinal cord • Sensory root
• Motor nerves • Axons of sensory neurons are in the dorsal
Conduct impulses to muscles or glands root ganglion
• Mixed (both sensory and motor) nerves • Dorsal root ganglion
Contain both sensory nerve fibers and motor nerve • Aka DRG
fibers • Cell bodies of sensory neurons whose
Most nerves are mixed nerves axons conduct impulses inward from
ALL spinal nerves are mixed nerves (except the first peripheral body parts
pair)

Nerve Fiber Classification

• General somatic efferent (GSE) fibers
Carry motor impulses from CNS to skeletal muscles

• General somatic afferent (GSA) fibers

Carry sensory impulses to CNS from skin and
skeletal muscles

• General visceral efferent (GVE) fibers

Carry motor impulses away from CNS to smooth
muscles and glands

• General visceral afferent (GVA) fibers Dermatome

Carry sensory impulses to CNS from blood vessels • An area of skin that the sensory nerve fibers of
and internal organs a particular spinal nerve innervate

• Special somatic efferent (SSE) fibers

Carry motor impulses from brain to muscles used in
chewing, swallowing, speaking and forming facial
expressions

• Special visceral afferent (SVA) fibers

Carry sensory impulses to brain from olfactory and
taste receptors

• Special somatic afferent (SSA) fibers

Carry sensory impulses to brain from receptors of
sight, hearing and equilibrium

Spinal Nerves
• ALL are mixed nerves (except the first
pair)
• 31 pairs of spinal nerves:
• 8 cervical nerves
• (C1 to C8) Spinal nerves
• 12 thoracic nerves • Ventral root (aka anterior root)
• (T1 to T12) • Motor root
• 5 lumbar nerves • Axons of motor neurons whose cell bodies
• (L1 to L5) are in the spinal cord
• 5 sacral nerves • Spinal nerve
• (S1 to S5) • Union of ventral root and dorsal roots
• 1 coccygeal nerve • Hence we now have a “mixed” nerve
• (Co or Cc)
Nerve Plexuses
• Nerve plexus
• Complex networks formed by anterior branches
(ventral rami) of spinal nerves
• The fibers of various spinal nerves are sorted and
recombined
• There are three (3) nerve plexuses:
• (1) Cervical plexus
• Formed by anterior branches of C1-C4 spinal
nerves
• Lies deep in the neck
• Supply to muscles and skin of the neck
• C3-C4-C5 nerve roots contribute to phrenic
nerves bilaterally
Plexuses

Lumbosacral Plexus
• (3) Lumbosacral plexus
• Formed by the anterior branches of L1-S5
roots
• Can be a lumbar (L1-L5) plexus and a
Brachial Plexus sacral (S1-S5) plexus
• (2) Brachial plexus • Extends from lumbar region into pelvic
• Formed by anterior branches C5-T1 cavity
• Lies deep within shoulders • Obturator nerve
• There are five (5) branches: • Supply motor impulses to
1. Musculocutaneous nerve adductors of thighs
• Supply muscles of anterior arms and skin of forearms • Femoral nerve
2. Ulnar and 3. Median nerves • Supply motor impulses to
• Supply muscles of forearms and hands muscles of anterior thigh and
• Supply skin of hands sensory impulses from skin of
4. Radial nerve thighs and legs
• Supply posterior muscles of arms and skin of • Sciatic nerve
forearms and hands • Supply muscles and skin of
5. Axillary nerve thighs, legs and feet
• Supply muscles and skin of anterior, lateral, and
posterior arms
 Brain Development
• Neural tube
• Three primary vesicles:
• Forebrain
(Prosencephalon)
• Midbrain
(Mesencephalon)
• Hindbrain
(Rhombencephalon)
• Five secondary vesicles:
• Telencephalon
• Diencephalon
• Mesencephalon
• Metencephalon
• Myelencephalon

Brain
Functions of the brain:
• Interprets sensations
• Determines perception
• Stores memory
• Reasoning
• Makes decisions
• Coordinates muscular movements
• Regulates visceral activities
• Determines personality
Structure of the Cerebrum
Major parts of the brain: • Corpus callosum
• Cerebrum • Connects cerebral hemispheres (a
o Frontal lobes commissure)
o Parietal lobes • Gyri
o Occipital lobes • Bumps or convolutions
o Temporal lobes • Sulci
o Insula • Grooves in gray matter
• Diencephalon • Central sulcus of Rolando
• Cerebellum • Fissures
• Brainstem • Longitudinal: separates the cerebral
o Midbrain hemispheres
o Pons • Transverse: separates cerebrum from
o Medulla oblongata cerebellum
• Lateral fissure of Sylvius
Lobes of the Cerebrum
Five (5) lobes bilaterally:
• Frontal lobe
• Parietal lobe
• Temporal lobe
• Occipital lobe
• Insula aka ‘Island of Reil’

Association Areas
• Regions that are not primary motor or primary
Functions of the Cerebrum sensory areas
• Interpreting impulses • Widespread throughout the cerebral cortex
• Initiating voluntary movements • Analyze and interpret sensory experiences
• Storing information as memory • Provide memory, reasoning, verbalization,
• Retrieving stored information judgment, emotions
• Reasoning • Frontal lobe association areas
• Seat of intelligence and personality • Concentrating
• Planning
Functional Regions of the • Complex problem solving
Cerebral Cortex • Parietal lobe association areas
Cerebral cortex • Understanding speech
• Thin layer of gray matter that constitutes the • Choosing words to express
outermost portion of cerebrum thought
• Contains 75% of all neurons in the nervous system • Temporal lobe association areas
• Interpret complex sensory
experiences
• Store memories of visual scenes,
music, and complex patterns
• Occipital lobe association areas
• Analyze and combine visual
images with other sensory
experiences

Sensory Areas
(post-central sulcus)
• Cutaneous sensory area
• Parietal lobe
• Interprets sensations on skin
• Visual area
• Occipital lobe
• Interprets vision
• Auditory area
• Temporal lobe
• Interprets hearing
• Sensory area for taste
• Near base of the central sulcus
• Sensory area for smell
• Arises from centers deep within
the cerebrum
Motor Areas
(pre-central sulcus)
• Primary motor areas
• Frontal lobes
• Control voluntary muscles
• Broca’s area
• Anterior to primary motor cortex
• Usually in left hemisphere
• Controls muscles needed for
speech
• Frontal eye field
• Above Broca’s area
• Controls voluntary movements of
eyes and eyelids
Hemisphere Dominance
• The left hemisphere is dominant in most
individuals
• Dominant hemisphere controls:
 Speech
 Writing
 Reading
 Verbal skills
 Analytical skills
 Computational skills
• Nondominant hemisphere controls:
 Nonverbal tasks
 Motor tasks
 Understanding and interpreting musical
and visual patterns
 Provides emotional and intuitive thought
processes
Diencephalon
Memory • Thalamus
• Short term memory  Gateway for sensory impulses heading to
 Working memory cerebral cortex
 Closed neuronal circuit  Sensory relay station
 Circuit is stimulated over and over  Receives all sensory impulses (except
 When impulse flow ceases, memory smell)
does also unless it enters long-term  Channels impulses to appropriate part of
memory via memory consolidation cerebral cortex for interpretation
 Long term memory • Hypothalamus
 Changes structure or function of  Maintains homeostasis by regulating
neurons visceral activities (such as HR, BP,
 Enhances synaptic transmission temperature, H2O & electrolyte balance,
hunger, thirst, sleep & wakefulness)
Basal Nuclei  Links nervous and endocrine systems
• Masses of gray matter (hence some say the neuroendocrine
• Deep within cerebral hemispheres system
• Caudate nucleus, putamen, and globus pallidus • The Limbic System
• Produce dopamine
• Control certain muscular activities Consists of:
• Primarily by inhibiting motor functions o Portions of frontal lobe
o Portions of temporal lobe
o Hypothalamus
o Thalamus
o Basal nuclei
o Other deep nuclei
Functions:
o Controls emotional experiences
& produces feelings like rage,
anger, pleasure
o survival behavior
o Interprets sensory impulses
associated with smell
Diencephalon Brainstem
• Between cerebral hemispheres and above the Three parts:
brainstem 1. Midbrain
• Surrounds the third ventricle 2. Pons
• Thalamus 3. Medulla
• Epithalamus Oblongata
• Hypothalamus
• Optic tracts
• Optic chiasm
• Infundibulum
• Posterior pituitary
• Mammillary bodies
• Pineal gland
 Cerebellum
• Inferior to occipital lobes
• Posterior to pons and medulla
oblongata
• Integrates sensory information
concerning position of body parts
• Coordinates skeletal muscle activity
• Maintains posture

Midbrain
• Between diencephalon and pons
• Contains bundles of fibers that join lower parts of
brainstem and spinal cord with higher part of brain
• Corpora quadrigemina (centers for visual and
auditory reflexes)
Pons Cranial Nerves
• Rounded bulge on underside of brainstem
• Between medulla oblongata and midbrain
• Helps regulate rate and depth of breathing
• Relays nerve impulses to and from medulla
oblongata and cerebellum
Medulla Oblongata
• Enlarged continuation of spinal cord
• Conducts ascending and descending impulses
between brain and spinal cord
• Contains cardiac, vasomotor, and respiratory
control centers
Remember:
• Contains various nonvital reflex control centers o Cranial nerves are designated ‘C N’
(coughing, sneezing, swallowing, and vomiting) o Cranial nerves are designated with Roman
Reticular Formation numerals (I – XII)
• Complex network of nerve fibers scattered
throughout the brain stem Functions of Cranial Nerves
• Extends into the diencephalon CN Olfactory Olfactory Smell
I epithelium
• Connects to centers of hypothalamus, basal nuclei, CN Optic Retina Vision
cerebellum, and cerebrum II
• Filters incoming sensory information CN Occulomotor Midbrain Eye movement;
III accommodation
• Arouses cerebral cortex into state of wakefulness CN Trochlear Midbrain Eye movement
IV (superior
Types of Sleep oblique)
Slow wave CN Trigeminal Pons Sensation to
• Non-REM sleep V face; chewing
CN Abducens Pons Eye movement
• Person is tired
VI ( lateral rectus)
• Decreasing activity of reticular system CN Facial Pons Facial
• Restful VII expression;
• Dreamless taste to anterior
• Reduced blood pressure and respiratory rate 2/3 of tongue
• Ranges from light to heavy CN Acoustic Pons Hearing &
VIII balance
• Alternates with REM sleep
CN Glossopharyngeal Medulla Salivation;
IX swallowing;
Paradoxical sleep taste to
• Rapid Eye Movement(REM) posterior 1/3 of
• Some areas of brain active tongue
CN Vagus Medulla Digestion; taste
• Heart and respiratory rates irregular
X to pharynx
• Dreaming occurs CN Accessory Medulla Movement of
XI trapezius &
SCM
CN Hypoglossal Medulla Movement of
XII tongue
Autonomic Nervous System
• Functions without conscious effort
• Controls visceral activities
• Regulates smooth muscle, cardiac muscle, and
glands
• Efferent fibers typically lead to ganglia outside of
the CNS

Two autonomic divisions regulate:

o Sympathetic division (speeds up)
Prepares body for ‘fight or flight’ situations
o Parasympathetic division (slows down)
Prepares body for ‘resting and digesting’
activities

Autonomic Nerve Fibers

• All of the neurons are motor (efferent)
• Preganglionic fibers
 Axons of preganglionic neurons
 Neuron cell bodies in CNS
• Postganglionic fibers
 Axons of postganglionic neurons
 Neuron cell bodies in ganglia
Sympathetic Division
o Postganglionic fibers extend from sympathetic
ganglia to visceral organs
o Postganglionic fibers usually pass through gray
rami and return to a spinal nerve before
proceeding to an effector
o Exception: preganglionic fibers to adrenal
medulla do not synapse with postganglionic
neurons

Sympathetic Division

Sympathetic Division
• Thoracolumbar division – location of preganglionic
neurons
o Preganglionic fibers leave spinal nerves
through white rami and enter paravertebral
ganglia
o Paraverterbral ganglia and fibers that
connect them make up the sympathetic trunk
Parasympathetic Division CHOLINERGIC ADRENERIC
• Craniosacral division – location of preganglionic
neurons
• Ganglia are near or within various organs
- Terminal ganglia
• Short postganglionic fibers
- Continue to specific muscles or glands
• Preganglionic fibers of the head are included in
nerves III, VII, and IX
• Preganglionic fibers of thorax and abdomen are parts
of nerve X

Autonomic Neurotransmitters
• Cholinergic fibers
• Release acetylcholine
• Preganglionic sympathetic and
parasympathetic fibers
• Postganglionic parasympathetic
fibers
• Adrenergic fibers
• Release norepinephrine
• Most postganglionic sympathetic
fibers

Actions of AutonomicNeurotransmitters
• Result from binding to protein
receptors in the membrane of effector
cells:
• Cholinergic receptors
• Bind acetylcholine (Ach)
• Muscarinic
• Excitatory
• Slow
• Nicotinic
• Excitatory
• Rapid
• Adrenergic receptors
• Bind epinephrine and
norepinephrine
• Alpha and beta
• Both elicit different
responses on various
effectors
Terminating Autonomic Neurotransmitter Actions
• The enzyme acetylcholinesterase rapidly
decomposes the acetylcholine that cholinergic
fibers release.
• Norepinephrine from adrenergic fibers is removed
by active transport.

Control of Autonomic Activity

• Controlled largely by CNS
• Medulla oblongata regulates cardiac, vasomotor
and respiratory activities
• Hypothalamus regulates visceral functions, such as
body temperature, hunger, thirst, and water and
electrolyte balance
• Limbic system and cerebral cortex control
emotional responses

Lifespan Changes
• Brain cells begin to die before birth
• Over average lifetime, brain shrinks 10%
• Most cell death occurs in temporal lobes
• By age 90, frontal cortex has lost half its neurons
• Number of dendritic branches decreases
• Decreased levels of neurotransmitters Glioma
• Fading memory Begin in then glial cells, the gluey supportive
• Slowed responses and reflexes cells that surround nerve cells and help them
• Increased risk of falling function. (TUMOR)
• Changes in sleep patterns that result in fewer
sleeping hours Cell of origin can be

• Symptoms of gliomas
Have a lot of similarity have a lot of similarity to
the cells that produced by other malignant brain
tumors and mainly depend on the area of the
brain headache. Other symptoms of glioma
include loss of memory, physical weakness, loss of
muscle control, language problem, visual
symptoms, personality changes, cognitive decline.
These symptoms may change according to the
part of the brain affected.

Huntington's disease (HD)

• Is a fatal genetic disorder that causes the
Alzheimer's disease progressive breakdown of nerve cells in the
Is an irreversible, progressive brain disorder that slowly
brain.
destroys memory and thinking skills and, eventually, the
ability to carry out the simplest tasks. • It deteriorates a person's physical and mental
• Signs and Symptoms abilities usually during their prime working
 Memory loss for recent events years and has no cure
 Progresses into dementia – almost total
memory loss
 Inability to converse, loss of language ability
 Affective/personality disturbance
 Death from opportunistic infections etc.
Multiple sclerosis (MS)
• Is a potentially disabling disease of the brain and
spinal cord (central nervous system).
• In MS , the immune system (autoimmune) attacks
the protective sheath (myelin) that covers nerve
fibers Parkinson's disease
• and causes communication problems between your • Is a progressive (chronic) nervous system disorder
brain and the rest of your body. that affects movement.
• Symptoms start gradually, sometimes starting with a
barely noticeable tremor in just one hand.
• Tremors are common, but the disorder also
commonly causes stiffness or slowing of movement.
Pathogenesis of Parkinson ’s disease
 MODULE 4C • Thermoreceptors
Respond to changes in
temperature

• Mechanoreceptors
Respond to mechanical forces

• Photoreceptors
Respond to light

• General senses Sensory Impulses

 Receptors that are widely distributed
throughout the body
 Skin, various organs and joints
• Special senses
 Specialized receptors confined to structures in
the head
 Eyes, ears, nose and mouth
Receptors, Sensation, and Perception
• Sensory receptors
 Specialized cells or multicellular structures that
collect information from the environment
 Stimulate neurons to send impulses along
sensory fibers to the brain
• Sensation
 A feeling that occurs when brain becomes
aware of sensory impulse
• Perception
 A person’s view of the stimulus; the way the
brain interprets the information
Pathways From Sensation to Perception
(Example of an Apple)
• Stimulation of receptor causes local change in its
receptor potential
• A graded electrical current is generated that
reflects intensity of stimulation
• If receptor is part of a neuron, the membrane
potential may generate an action potential
• If receptor is not part of a neuron, the receptor
potential must be transferred to a neuron to trigger
an action potential
• Peripheral nerves transmit impulses to CNS where
they are analyzed and interpreted in the brain
Sensory Adaptation
• Ability to ignore unimportant stimuli
• Involves a decreased response to a particular
stimulus from the receptors (peripheral adaptation)
or along the CNS pathways leading to the cerebral
cortex (central adaptation)
• Sensory impulses become less frequent and may
cease
• Stronger stimulus is required to trigger impulses
General Senses

• Senses associated with skin, muscles,

joints and viscera

Three (3) groups:

• Exteroceptive senses (exteroceptors)
Senses associated with body surface
such as touch, pressure, temperature,
and pain

• Visceroceptive senses (interoceptors)

Senses associated with changes in the
viscera such as blood pressure
stretching blood vessels and ingestion
Receptor Types of a meal
• Chemoreceptors • Proprioceptive senses
 Respond to changes in chemical concentrations Senses associated with changes in muscles and
(acidity,alkalinity, (detection of level of toxic products or tendons such as at joints
CO2/O2)
Touch and Pressure Senses
• Pain receptors (nociceptors) Free nerve endings
Respond to tissue damage • Common in epithelial tissues
• Simplest receptors
• Sense itching
Tactile (Meissner’s) corpuscles
• Abundant in hairless portions of skin and lips
• Detect fine touch; distinguish between two points
on the skin
Lamellated (Pacinian) corpuscles
• Common in deeper subcutaneous tissues, tendons
and ligaments
• Detect heavy pressure and vibrations

Touch and Pressure Receptors

Pain Nerve Pathways

Acute pain fibers
 A-delta fibers
 Thin, myelinated
 Conduct impulses rapidly
 Associated with sharp pain
 Well localized
Chronic pain fibers
 C fibers
Temperature Senses (differentiate only)  Thin, unmyelinated
Warm receptors  Conduct impulses more slowly
 Sensitive to temperatures above 25 oC (77o F)  Associated with dull, aching pain
 Unresponsive to temperature above 45 oC (113oF)  Difficult to pinpoint
Cold receptors
 Sensitive to temperatures between 10oC (50oF) Regulation of Pain Impulses
and 20oC (68oF) Thalamus
Pain receptors • Allows person to be aware of pain
 Respond to temperatures below 10oC • Cerebral cortex
 Respond to temperatures above 45 oC • Judges intensity of pain
• Locates source of pain
SENSE OF PAIN • Produces emotional and motor responses
• Free nerve endings to pain
• Widely distributed • Pain inhibiting substances:
• Nervous tissue of brain lacks pain receptors • Enkephalins
• Stimulated by tissue damage, chemical, mechanical • Serotonin
forces, or extremes in temperature • Endorphins
• Adapt very little, if at all
Proprioception (mobile organs)
Visceral Pain • Mechanoreceptors
• Pain receptors are the only receptors in viscera whose • Send information to spinal cord and CNS
stimulation produces sensations about body position and length, and
• Pain receptors respond differently to stimulation tension of muscles
• Pain receptors are not well localized • Main kinds of proprioceptors:
• Pain receptors may feel as if coming from some other part of • Pacinian corpuscles – in joints
the body • Muscle spindles – in skeletal muscles*
Known as referred pain… • Golgi tendon organs – in tendons*
*considered to be stretch receptors
Referred Pain
• May occur due to sensory impulses from two regions
following a common nerve pathway to brain
 CN Abducens Pons Eye movement
Stretch Receptors VI ( lateral rectus)

CN Facial Pons Facial

VII expression;
taste to
anterior 2/3 of
tongue

CN Acoustic Pons Hearing &

VIII balance

CN Glossopharyngeal Medulla Salivation;

IX swallowing;
taste to
Visceral Senses
posterior 1/3 of
• Receptors in internal organs
tongue
• Convey information that includes the sense of
fullness after eating a meal as well as the
CN Vagus Medulla Digestion; taste
discomfort of intestinal gas and the pain that
X to pharynx
signals a heart attack
CN Accessory Medulla Movement of
Summary of Receptors of the General Senses
XI trapezius &
Receptors Associated with General Senses
SCM

CN Hypoglossal Medulla Movement of

XII tongue

Special Senses
• Sensory receptors are within large, complex
sensory organs in the head
• Smell in olfactory organs
• Taste in taste buds
• Hearing and equilibrium in ears
• Sight in eyes

SENSE OF SMELL
• Olfactory receptors
• Chemoreceptors
• Respond to chemicals dissolved in liquids
• Olfactory organs
Functions of Cranial Nerves (memorize) • Contain olfactory receptors and supporting
epithelial cells
• Cover parts of nasal cavity, superior nasal
CN I Olfactory Olfactory Smell
conchae, and a portion of the nasal septum
epithelium

CN Optic Retina Vision Olfactory Receptors

II

CN Occulomotor Midbrain Eye movement;

III accommodation

CN Trochlear Midbrain Eye movement

IV (superior
oblique)

CN Trigeminal Pons Sensation to

V face; chewing
Olfactory Nerve Pathways SENSE OF HEARING
• Once olfactory receptors are stimulated, nerve • Ear
impulses travel through • Organ of hearing
• Olfactory nerves olfactory bulbs olfactory • Three (3) sections:
tracts limbic system (for emotions) and • External ear
olfactory cortex (for interpretation) • Middle ear
• Inner ear
Olfactory Stimulation
• Olfactory organs located high in the nasal cavity EXTERNAL EAR
above the usual pathway of inhaled air
• Olfactory receptors undergo sensory adaptation
rapidly
• Sense of smell drops by 50% within a second after
stimulation

SENSE OF TASTE
• Taste buds
• Organs of taste
• Located on papillae of tongue, roof of mouth,
linings of cheeks and walls of pharynx
• Taste receptors
• Chemoreceptors
• Taste cells – modified epithelial cells that
function as receptors EXTERNAL EAR
• Taste hairs –microvilli that protrude from taste • Auricle
cells; sensitive parts of taste cells • Collects sounds waves
• External auditory meatus 1
Taste Receptors • Lined with ceruminous glands
• Carries sound to tympanic membrane
• Terminates with tympanic membrane
• Tympanic membrane (eardrum) 2
• Vibrates in response to sound waves
MIDDLE EAR
• Tympanic cavity
• Air-filled space in temporal bone
• Auditory ossicles (smallest bone)
• Vibrate in response to tympanic membrane
• Malleus, incus and stapes
• Hammer, anvil and stirrup
• Oval window 3
• Opening in wall of tympanic cavity
• Stapes vibrates against it to move fluids in inner
ear
AUDITORY TUBE
• Also known as the Eustachian tube
• Connects middle ear to throat
• Helps maintain equal pressure on both sides of
Taste Sensations tympanic membrane
Four primary taste sensations • Usually closed by valve-like flaps in throat
• Sweet – stimulated by carbohydrates INNER EAR
• Sour – stimulated by acids
• Salty – stimulated by salts
• Bitter – stimulated by many organic compounds

Taste Nerve Pathways

Sensory impulses from taste receptors travel along:
• Cranial nerves to…
• Medulla oblongata to…
• Thalamus to…
• Gustatory cortex (for interpretation)

INNER EAR
• Complex system of labyrinths
• Osseous labyrinth
• Bony canal in temporal bone
• Filled with perilymph
• Membranous labyrinth
• Tube within osseous labyrinth
• Filled with enadolymph
Auditory Nerve Pathways
• Three (3) parts of labyrinths:
• Cochlea (fluid)
• Functions in hearing
• Semicircular canals
• Functions in equilibrium
• Vestibule
• Functions in equilibrium
Cochlea Organ of Corti
• Scala vestibuli
• Upper compartment
• Leads from oval window to apex of spiral
• Part of bony labyrinth
• Scala tympani
• Lower compartment
• Extends from apex of the cochlea to round window
• Part of bony labyrinth

Summary of the Generation of Sensory Impulses from

the Ear
Steps in the Generation of Sensory Impulses from the
Ear

• Cochlear duct
• Portion of membranous labyrinth in cochlea
• Vestibular membrane
• Separates cochlear duct from scala vestibuli
• Basilar membrane
• Separates cochlear duct from scala tympani

SENSE OF EQUILIBRIUM
• Static equilibrium
• Vestibule
• Senses position of head when body is not
moving
Standing onleh
• Dynamic Equilibrium
• Semicircular canals
• Senses rotation and movement of head
and body
Moving (semicircular canal)
Organ of Corti Vestibule
• Group of hearing receptor cells (hair cells) • Utricle
• On upper surface of basilar membrane • Communicates with saccule and
• Different frequencies of vibration move different parts of membranous portion of semicircular canals
basilar membrane • Saccule
• Particular sound frequencies cause hairs of receptor cells to • Communicates with cochlear duct
bend • Macula
• Nerve impulse generated • Hair cells of utricle and saccule
Macula (gel like)
• Responds to changes in head position
• Bending of hairs results in generation of nerve impulse

Semicircular Canals
• Three (3) canals at right angles
• Ampulla
• Swelling of membranous labyrinth that communicates
with the vestibule
• Crista ampullaris
• Sensory organ of ampulla
• Hair cells and supporting cells
• Rapid turns of head or body stimulate hair cells

Crista Ampullaris

SENSE OF SIGHT
• Visual accessory organs
• Eyelids
• Lacrimal apparatus
• Extrinsic eye muscles
Eyelid
• Palpebra
• Composed of four (4) layers:
• Skin
• Muscle
• Connective tissue
• Conjunctiva
• Orbicularis oculi – closes eyelid
• Levator palpebrae superioris – opens eyelid
• Tarsal glands – secrete oil onto eyelashes
• Conjunctiva – mucous membrane; lines eyelid and covers
portion of eyeball

Structure of the Eye

Lacrimal Apparatus
• Lacrimal gland -- nose
• Lateral to eye
• Secretes tears • Wall has three (3) layers:
• Canaliculi • Outer fibrous tunic
• Collect tears retains shape
• Lacrimal sac • Middle vascular tunic
• Collects from canaliculi • Inner nervous tunic
Retina. Optic nevce
• Nasolacrimal duct
• Collects from lacrimal sac
OUTER TUNIC
• Empties tears into nasal cavity
• Cornea
• Anterior portion
• Transparent
• Light transmission
• Light refraction
• Sclera
• Posterior portion
• Opaque
• Protection
MIDDLE TUNIC
• Sclera
• Posterior portion
• Opaque
Extrinsic Eye Muscles
• Protection
• Superior rectus
• Ciliary body
• Rotates eye up and medially
• Anterior portion
• Inferior rectus
• Pigmented
• Rotates eye down and medially
• Holds lens
• Medial rectus
• Moves lens for focusing
• Rotates eye medially
• Choroid coat
• Lateral rectus
• Provides blood supply
• Rotates eye laterally
• Pigments absorb extra light
• Superior oblique
• Rotates eye down and laterally
• Inferior oblique
• Rotates eye up and laterally
 Iris circular muscle/radial
Anterior Portion of Eye
Filled with aqueous humor • Composed of connective tissue and
smooth muscle
• Pupil is hole in iris
• Dim light stimulates radial muscles and
pupil dilates
• Bright light stimulates circular muscles
and pupil constricts

Lens
• Transparent
• Biconvex
• Lies behind iris
• Largely composed of lens fibers
• Elastic
• Held in place by suspensory ligaments of ciliary body

Ciliary Body hold lens

• Forms internal ring around the front of the eye
• Ciliary processes – radiating folds
• Ciliary muscles – contract and relax to move lens
Aqueous Humor
• Fluid in anterior cavity of eye
• Secreted by epithelium on inner surface of the
ciliary body
• Provides nutrients
• Maintains shape of anterior portion of eye
• Leaves cavity through Canal of Schlemm

Accommodation INNER TUNIC

Changing of lens shape to view objects
• Retina
• Contains visual receptors
• Continuous with optic nerve
• Ends just behind margin of the ciliary body
• Composed of several layers
• Macula lutea – yellowish spot in retina
• Fovea centralis – center of macula lutea;
produces sharpest vision
• Optic disc – blind spot; contains no visual
receptors
• Vitreous humor – thick gel that holds retina flat
against choroid coat

Posterior Cavity
• Contains vitreous humor – thick gel that holds
retina flat against choroid coat
 Types of Lenses
Major Groups of Retinal Neurons • Convex lenses cause light waves to converge
• Receptor cells, bipolar cells, and ganglion cells - • Concave lenses cause light waves to diverge
provide pathway for impulses triggered by
photoreceptors to reach the optic nerve
• Horizontal cells and amacrine cells – modify
impulses

Focusing On Retina
• As light enters eye, it is refracted by:
• Convex surface of cornea
• Convex surface of lens
• Image focused on retina is upside down and
reversed from left to right

Layers of the Eye Visual Receptors

• Rods
• Long, thin projections
• Contain light sensitive pigment called
rhodopsin
• Hundred times more sensitive to light than
cones
• Provide vision in dim light
• Produce colorless vision
• Produce outlines of objects
• Cones
• Short, blunt projections
• Contain light sensitive pigments called
erythrolabe, chlorolabe, and cyanolabe
• Provide vision in bright light
• Produce sharp images
Light Refraction • Produce color vision
• Refraction
• Bending of light Rods and Cones
• Occurs when light waves pass at an oblique
angle into mediums of different densities
Clinical Applications Rod Cells
Refraction Disorders

Stereoscopic Vision
Concave lens corrects nearsightedness • Provides perception of distance and depth
• Results from formation of two slightly different
retinal images

Convex lens corrects farsightedness

Visual Nerve Pathway

Visual Pigments
• Rhodopsin
• Light-sensitive pigment in rods
• Decomposes in presence of light
• Triggers a complex series of reactions that
initiate nerve impulses
• Impulses travel along optic nerve
• Pigments on cones
• Each set contains different light-sensitive
pigment
• Each set is sensitive to different wavelengths
• Color perceived depends on which sets of cones
are stimulated
• Erythrolabe – responds to red
• Chlorolabe – responds to green
• Cyanolabe – responds to blue
 Lifespan Changes
• Age related hearing loss due to:
• Damage of hair cells in organ of Corti
• Degeneration of nerve pathways to the
brain
• Tinnitus
• Age-related visual problems include:
• Dry eyes
• Floaters (crystals in vitreous humor)
• Loss of elasticity of lens
• Glaucoma
• Cataracts
• Macular degeneration

Components
 Introduction
• The endocrine system assists the nervous system with
communication and control of the body
• The cells, tissues, and organs are called endocrine glands
• They are ductless
• They use the bloodstream
• They secrete hormones
• There are also similar glands called paracrine and
autocrine glands that are quasi-endocrine
• Other glands that secrete substances are the exocrine glands
• They have ducts
• They deliver their products directly to a specific site
1
 Thyroid
gland
Endocrine
gland

Hormone secretion
Endocrine
cell

Blood flow
(a) Skin

Duct

Exocrine gland
(sweat gland)
Exocrine
cells

(b)
2
 General Characteristics of the
Endocrine System

• The endocrine and nervous systems communicate using

chemical signals
• Neurons release neurotransmitters into a synapse
affecting postsynaptic cells
• Endocrine glands release hormones into the
bloodstream to specific target cell receptors

3
 Nerve impulse

Neuron Neurotransmitter Post-

transmits released into synaptic
nerve synapse cell responds
impulse

(a)

Target cells
(cells with hormone
Glandular receptors) respond
cells secrete Bloodstream to hormone
hormone into
bloodstream Hormones have no
effect on other cells
(b) 4
 A comparison between the nervous
system and the Endocrine System

Nervous System Endocrine System

Cells Neurons Glandular epithelium

Chemical signal Neurotransmitter Hormone

Specificity of action Receptors on postsynaptic Receptors on target cell

cell

Speed of onset Seconds Seconds to hours

Duration of action Very brief neuronal May be brief or may last

activity continues for days even if secretion
ceases

5
 Hormone Action
• Hormones are released into the extracellular spaces surrounding
endocrine cells
Hypothalamus

Pituitary gland Pineal gland

Parathyroid gland
Thyroid gland

Thymus

Adrenal gland
Kidney
Pancreas

Ovary
(in female)

Testis
(in male) 6
Hormones names and abbreviations

7
 Control of
Hormonal Secretions
• Primarily controlled by negative feedback mechanism
• Hormones can be short-lived or may last for days
• Hormone secretions are precisely regulated

8
Control Sources
Control center
Endocrine gland
inhibited.

Receptors
Effectors
Hormone control
Hormone secretion
mechanism senses
decreased.
change.

Stimulus Response
Hormone levels rise or Hormone levels
controlled process return toward
increases. normal.
too high

Normal
hormone
levels

too low
Stimulus
Response
Hormone levels drop or
Hormone levels
controlled process
return toward
decreases.
normal.
Receptors
Hormone control Effectors
mechanism senses Hormone secretion
change. increased.

Control center 9
Endocrine gland
stimulated.
 Control Sources

– Hypothalamus – Nervous system – Changing level

of substance
in plasma
– Anterior pituitary gland

Peripheral Endocrine Endocrine

endocrine gland gland
gland

Target cells Target cells Target cells

Action Action Action

(a) (b) (c)

10
 Pituitary Gland
• Lies at the base of the brain in the sella turcica
• Consists of two distinct portions:
• Anterior pituitary (adenohypophysis)
• Posterior pituitary (neurohypophysis)

11
 Third ventricle

Hypothalamus
Anterior cerebral
artery Optic chiasma
Optic nerve Oculomotor
Pituitary stalk nerve
(Infundibulum) Trochlear nerve
Anterior lobe Posterior lobe
of pituitary gland of pituitary gland
Sphenoidal Sella turcica
sinus
Sphenoid bone Basilar artery

12
 Anterior Pituitary Hormones
• Hypothalamic releasing hormones stimulate cells of anterior pituitary to release
hormones
• Nerve impulses from hypothalamus stimulate nerve endings in the anterior
pituitary gland to release hormones

Third ventricle
Optic chiasma Neurosecretory cells
that secrete posterior
Neurosecretory pituitary hormones
cells that secrete
Hypothalamus
releasing hormones

Hypophyseal
portal veins
Superior hypophyseal
Secretory cells artery
of anterior
pituitary gland Capillary bed Inferior hypophyseal
artery
Capillary bed
Hypophyseal veins
Sella turcica of
sphenoid bone 13
Anterior lobe of pituitary gland Posterior lobe of pituitary gland
– Hypothalamus –

Releasing
hormone
Secretory
(Hormone 1)
cells
+
– Anterior pituitary

Anterior pituitary
hormone
(Hormone 2)
+
Peripheral endocrine gland

(Hormone 3)
Stimulation

+ Inhibition
Target cells

14
 Hormones from Hypothalamus

GHRH SS PRF PIH TRH CRH GnRH

Growth Somatostatin Prolactin- Prolactin- Thyrotropin- Corticotropin- Gonadotropin-
hormone- releasing release releasing releasing releasing
releasing factor inhibiting hormone hormone hormone
hormone hormone

Hormones fromAnterior Pituitary

GH PRL TSH ACTH LH FSH

Growth Prolactin Thyroid- Adrenocorticotropic Luteinizing Follicle-
hormone stimulating hormone hormone stimulating
hormone hormone

Bone Muscle Adipose Mammary gland Thyroid Adrenal Ovary Testis

tissue cortex

15
 Posterior Pituitary Hormones
• Structurally consists of nerve fibers and neuroglia v.
glandular epithelial cells of the posterior pituitary gland
• The nerve fibers originate in the hypothalamus
• Two hormones are produced:
• Antidiuretic hormone (vasopressin)
• Oxytocin

16
Hormones of Pituitary Gland

17
 Thyroid Gland
• The thyroid gland has two lateral lobes and lies just below
the larynx
• It produces three hormones:
• T4 (thyroxine)
• T3 (triiodothyronine)
• Calcitonin

18
 Structure of the Gland

Larynx
Colloid

Thyroid
Follicular
gland
cell

Follicular cells

Colloid Isthmus
Extrafollicular
cell
(a)

(b)
Extrafollicular
cells
© Fred Hossler/Visuals Unlimited

19
Thyroid Gland Hormones

20
21
 Disorders of Thyroid Glands

© Mediscan/Visuals Unlimited © Mediscan/Visuals Unlimited © Mediscan/Visuals Unlimited

22
 Parathyroid Glands
bone development (osteblast)

• The parathyroid glands are on

the posterior surface of the
thyroid gland
• There are typically four
parathyroid glands
• It secretes one hormone:
• PTH (parathyroid hormone
or parathormone)

23
Structure of the Glands

Secretory cells Pharynx

Thyroid
gland
Capillaries Parathyroid
glands

Esophagus
Trachea

Posterior view 24
Parathyroid Hormone
Foods

Cholesterol

Intestinal enzymes

Provitamin D

Ultraviolet light in skin

Vitamin D
(Cholecalciferol)

Also obtained directly

from foods
Liver

Hydroxycholecalciferol

Kidney Stimulated by PTH

Dihydroxycholecalciferol
(active form of vitamin D)
Controls absorption of
calcium in intestine
Ca+2
25
Ca+2
Ca+2
 Parathyroid glands (on
posterior of thyroid gland)
Release into
bloodstream
Decreased blood calcium Increased blood
Stimulation stimulates parathyroid – calcium inhibits
hormone secretion PTH secretion
Inhibition
PTH

Bloodstream

PTH Ca+2 PTH Ca+2 Ca+2

+ +

Bone Kidneys Intestine

releases Ca+2 conserve Ca+2 and absorbs Ca+2
activate Vitamin D
Active
Vitamin D
26
Disorders of Parathyroid Glands

27
 Adrenal Glands

• The adrenal glands are closely associated with the kidneys

• The gland sits like a cap on each kidney
• Hormones are secreted from two different areas of the
gland, the adrenal cortex and the adrenal medulla
• Numerous hormones are secreted by the adrenal glands

28
 Structure of the Glands

Capsule Surface of
adrenal gland
Connective
Zona Adrenal gland tissue capsule
glomerulosa Zona
Kidney
lomerulosa
Zona
fasciculata
Cortex

Zona
Adrenal fasciculata
Adrenal cortex cortex
Adrenal
medulla
Zona
reticularis
Zona
reticularis (a) Adrenal
Medulla

medulla
(b)
Chromaffin
cells
© Ed Reschke

29
Hormones of the Adrenal Medulla

30
31
Hormones of the Adrenal Cortex

32
 Pancreas
• The pancreas has two major types of secretory tissue
• This is why it is a dual functioning organ as both an
exocrine gland and endocrine gland
• Three hormones are secreted from the islet cells:
• Alpha cells secrete glucagon
• Beta cells insulin
• Delta cells secrete somatostatin

33
 Structure of the Gland
Pancreatic islet (Islet of Langerhans) Gallbladder Common bile duct

Pancreatic duct

Duct Pancreas

Small
intestine

Digestive enzyme-
secreting cells
Pancreatic islet
(Islet of Langerhans)
Capillary
Hormone-secreting
islet cells

34
Hormones of the Pancreatic Islets

35
 Control center
Beta cells secrete
insulin

Effectors
Receptors Insulin
Beta cells detect a rise • Promotes movement of glucose
in blood glucose into certain cells
• Stimulates formation of glycogen
from glucose
Stimulus Response
Rise in blood glucose Blood glucose drops toward
normal (and inhibits insulin
secretion)
too high

Normal
blood glucose
concentration

too low

Response
Stimulus
Blood glucose rises toward
Drop in blood glucose
normal (and inhibits glucagon
secretion)

Receptors Effectors
Alpha cells detect a drop Glucagon
in blood glucose • Stimulates cells to break down
glycogen into glucose
• Stimulates cells to convert
noncarbohydrates into glucose
Control center
Alpha cells secrete 36
glucagon
 Other Endocrine Glands
Pineal Gland
• Secretes melatonin
• Regulates circadian rhythms
Thymus Gland
• Secretes thymosins
• Promotes development of certain lymphocytes
• Important in role of immunity
Reproductive Organs
• Ovaries produce estrogens and progesterone
• Testes produce testosterone
• Placenta produces estrogens, progesterone, and
gonadotropin
37
Other organs: digestive glands, heart, and kidney
38
39
 Stress and Its Effects
• Survival depends on maintaining homeostasis
• Factors that change the internal environment are
potentially life-threatening
• Sensing such dangers directs nerve impulses to the
hypothalamus
• This can trigger a loss of homeostasis

40
 Types of Stress

• Two types of stress:

• Physical stress
• Psychological stress

41
 Responses to Stress
Stress results from changes
Hormonal signals
in the external environment
Neural signals
Signals from
sensory receptors

Sympathetic impulses

Hypothalamus
CRH released

Adrenal medulla Anterior pituitary

Epinephrine and Norepinephrine ACTH released

norepinephrine released
released
Adrenal cortex
Short-term “fight or flight” or alarm stage.
Cortisol released
• Blood glucose increases.
• Blood glycerol and fatty acids increase. Long-term adjustment or resistance stage
• Heart rate increases.
• Blood pressure rises. • Increase in blood concentration of amino acids.
• Breathing rate increases. • Increased release of fatty acids.
• Air passages dilate. • Increased glucose formed from
• Pupils dilate. noncarbohydrates—amino acids (from 42
• Blood flow redistributes. proteins) and glycerol (from fats).
 Lifespan Changes

• Endocrine glands decrease in size

• Muscular strength decreases as GH levels decrease
• ADH levels increase due to slower break down in liver
and kidneys
• Calcitonin levels decrease; increase risk of osteoporosis
• PTH level changes contribute to risk of osteoporosis
• Insulin resistance may develop
• Changes in melatonin secretion affect the body clock
• Thymosin production declines increasing risk of infections

43
 MODULE 6A: CARDIOVASCULAR SYSTEM

Size of the Heart (size of your fist)

Average Size of Heart
 14cm long
 9 cm wide
 About 300 g

Location of Heart
 posterior to Endocardium
sternum
Myocardium
 medial to lungs
 anterior to Epicardium
(visceral pericardium)
vertebral column
 base lies beneath
2nd rib Heart Chambers
 apex at 5th gr

intercostal space Right Atrium Left Atrium

 lies upon diaphragm - receives blood from - receives blood from
- inferior vena cava pulmonary veinds
Coverings of Heart - superior vena cava
- coronary sinus
TV PV MV
Right Ventricle Left Ventricle
- receives blood from - receives blood from
right atrium left atrium
AV
Heart Valves
Valve Location Function
Tricuspid Right Prevents blood from
Valve atrioventicular moving right ventricle
[ Atrioventricular orifice into right atrium during
valves (AV) ] ventricular contraction
Pulmonary Entrance to Prevents blood from
Walls of the Heart
Valve pulmonary trunk moving from pulmonary
[ Semilunar trunk into right ventricle
Layer Composition Function during ventricular
valves]
contraction
Epicardium Serous membrane Forms a protective
(visceral of connective outer covering; Mitral Valve Left Prevents blood from
pericardium) tissue covered with secretes serous [ Atrioventricular atrioventicular moving left ventricle
epithelium and fluids valves (AV) ] orifice into left atrium during
including blood ventricular contraction
capillaries, lymph
Aortic Valve Entrance to Prevents blood from
capillaries, and
[ Semilunar aorta moving from aorta into
nerve fibers
valves] left ventricle during
Myocardium Cardiac muscle Contracts to pump ventricular relaxation
tissue separated by blood from the
connective tissues heart chambers
and including blood Coronal Section of the Heart
capillaries, lymph
capillaries, and
nerve fibers
Endocardium Membrane of Forms a protective
epithelium and inner lining of the
underlying chambers and
connective tissue, valves
including blood
vessels and
specialized muscle
fibers

Bueno, Maybeline
 Heart Actions

Skeleton of Heart
 fibrous rings to which the heart valves are attached
Cardiac Cycle
Atrial Systole/ Ventricular Diastole
 blood flows passively into ventricles
 remaining 30% of blood pushed into ventricles
 A-V valves open/semilunar valves close
 ventricles relaxed
 ventricular pressure increase

Ventricular Diastole/ Atrial Systole

 A-V valves close
 Chordate tendinae prevent cusps of valves from
bulging too far into atria
 atra relaxed
Heart Valves  blood flows into atria
 ventricular pressure increases and opens semilunar
valves
 blood flows into pulmonary trunk and aorta

Heart Sounds
Lubb
o first heard sound
o occurs during ventricular systole
o A-V valves closing
Dupp
Path of Blood through the Heart o second heart sound
o occurs during ventricular diastole
o pulmonary and aortic semilunar valves closing
Murmur
 abnormal heart sound

Blood from systemic circuit Cardiac Conduction System

Tricuspid valve
Pulmonary valve

Mitral valve
Aortic valve

Bueno, Maybeline
 Regulation of Cardiac Cycle
Autonomic nerve impulses alter the activities of the S-A
and A-V nodes

Electro diagram
 recording of electrical changes that occur in the
myocardium
 used to assess heart’s ability to conduct impulses

P wave – atrial
depolarization Additional Factors that Influence Heart Rate
QRS wave – o physical exercise
ventricular o body temperature
depolarization o concentration of various ions
T wave – ventricular - potassium
repolarizarion - calcium
o parasympathetic impulses decreases heart action
Depolarize- contract / o sympathetic impulses increase heart action
Repolarize - relax o cardiac center regulates autonomic impulses to the
heart
A prolonged QRS may result from damage to the A-V
bundle fibers Blood Vessels
 arteries
- carry blood away from ventricles of heart
 arterioles
- receive blood from arteries
- carry blood to capillaries
 capillaries
- sites of exchange of substances between
Clinical Application blood and body cells
ARRYTHMIAS
 venules
 Ventricular fibrillation
Rapid, uncoordinated depolarization of ventricles - receive blood from capillaries
 veins
- carry blood toward ventricle of heart

Arteries and Arterioles

Artery
 Tachycardia  thick strong wall
Rapid heartbeat  endothelial lining
 middle layer of
smooth muscle and
elastic tissue
 outer layer of
connective tissue
 carries blood under
 Atrial flutter relatively high
Rapid rate of atrial depolarization pressure
Arterioles
 thinner wall than
artery
 endothelial lining
 some smooth muscle
tissue
 small amount of
connective tissue
 helps control blood
flow into a capillary

Bueno, Maybeline
 Walls of Artery and Vein Capillary Network

Venules and Veins

 Venule
o thinner wall than arteriole
o less smooth muscle and elastic tissue
than arteriole
 Vein
o thinner wall than artery
o three layers to wall but middle layer is poorly
developed
o some have flaplike valves
o carries blood under relatively low pressure
o serves as blood reservoir

Venous Valves
Arteriole
o smallest arterioles only have a few smooth muscle
fibers
o capillaries
lack
muscle
fibers

Arterial Blood Pressure

Metarteriole
Blood Pressure - force the blood exerts against the
Connects inner walls of the blood vessels
arteriole
directly Arterial Blood Pressure
venule o rises when ventricles contract
o falls when ventricles relax
o systolic pressure - maximum pressure
o diastolic pressure - minimum pressure

Pulse
Capillaries Alternate expanding and recoiling of the arterial wall
o smallest diameter blood vessels that can be felt
o extensions of inner lining of arterioles
o walls are
endothelium
only
o semipermeable
o sinusoids-leaky
capillaries

Bueno, Maybeline
 Factors that Influence Arterial Blood Pressure Systemic Circuit
o composed of vessels that lead from the heart to all
body parts (except the lungs) and back to the heart
o include the aorta and its branches
o includes the system of veins that return blood to
the right atrium

Major Vessels of Arterial System

Controls of Blood Pressure

Controlling cardiac output and peripheral resistance
regulates blood pressure

Venous Blood Flow

o not a direct result of heart action
o dependent on
- skeletal muscle contraction
- breathing Major Vessels of the Heart
- venoconstriction

Central Venous Pressure

 pressure in the right atrium
 factors that influence it alter flow of blood into the
right atrium Principal Branches of Aorta
 affects pressure within the peripheral veins
 weakly beating heart increases central venous Portion of Aorta Major Branch General Regions
or Organs
pressure Supplied
 increase in central venous pressure causes blood to Ascending Aorta Right and left Heart
back up into peripheral vein coronary arteries
Arch of aorta Brachiocephalic artery Right upper limb,
right side of head
Pulmonary Circuit
consists of vessels that carry blood from the heart to the Left common carotid Left upper limb
lungs and back to the heart artery
Superior
Descending aorta
Right pulmonary vena Left pulmonary Thoracic aorta Bronchial artery Bronchi
artery cava Aorta artery Pericardial artery Peridcardium
Esophageal artery Esophagus
Pulmonary Mediastinal artery Mediastinum
Pulmonary
capillaries Posterior intercostals Thoracic wall
capillaries
artery
Right pulmonary
veins Left pulmo-
nary veins
Pulmonary
trunk Left lung
Right lung

Inferior vena
cava

Bueno, Maybeline
 Portion of Aorta Major Branch General Regions Veins that Drain the Abdominal Viscera
or Organs
Supplied
Abdominal aorta Celiac artery Organs of upper
digestive tract
-Phrenic artery -Diaphragm
-Superior - Portions of small
mesenteric artery and artery large
- Suprarenal artery intestines
- Renal artery - Adrenal gland
-Gonadal artery - Kidney
- Inferior - Ovary or testis
mesenteric artery - Lower portions
- Lumbar artery of large intestines
- Middle sacral - Posterior
artery abdominal wall
- Common - Sacrum and
Lacarteny coccyx
- Lower abdominal
wall, pelvic Veins from the Abdominal Viscera: Hepatic Portal Vein
organs, and lower
limb Hepatic portal vein drains one set of capillaries and
leads to another set
Abdominal Aorta and Its Major Branches

Life Span Changes

Cerebral Arterial Circle
 Circle of Willis
 Formed by anterior and posterior cerebral arteries,
which join the internal carotid arteries
 Cholesterol deposition in blood vessels
 Heart enlargement
 Death of cardiac muscle cells
 Increase in fibrous connective tissue of the heart
 Increase in adipose tissue of the heart
 Increase in blood pressure
 Decreasing in resting heart rate

MODULE 6B: BLOOD

Blood:
 Is connective tissue
 Transports vital substances
 Maintains stability of interstitial fluid
 Distributes heat

 The amount of blood varies with body size,

changes in fluid concentration, changes in
Major Vessels of the Venous System electrolyte concentration, and amount of adipose
tissue
 Blood is about 8% of body weight Adult blood
volume is about 5 liters

Blood cells:
 Form mostly in red bone marrow and are:
 Red blood cells (RBCs)
 White blood cells ( WBCs)
 Platelets (cell fragments)

Bueno, Maybeline
 Characteristics of Red Blood Cells
Red blood cells are:
 Erythtocytes
Serum- blood is
already clotted  Biconcave discs
 One third hemoglobin or:
- oxyhemoglobin
- deoxyhemoglobin
 Able to readily squeeze through capillaries
 Lack nuclei and mitochondria

Characteristics of Red Blood Cells

 RBC counts is the number of RBCs in a cubic
millimeter or microliter of blood
 It may vary depending on age and health
 Typical ranges include:
 4,600,000 - 6,200,000 in males
 4,200,000 - 5,400,000 in adult females
 4,500,000 - 5,100,000 in children
 RBC counts reflect blood's oxygen carrying capacity

Red Blood Cell Production and Its Control

 Low blood oxygen causes the kidneys and the liver
to release erythropoietin (EPO) which stimulates
Ratio of rbc RBC production
 This is a negative feedback mechanism
 Within a few days many new blood cells appear in
the circulating blood

common least clot

Blood Cells
 Blood cells originate in red marrow from
hemocytoblasts or hematopoietic stem cells
 Stem cells cant then:
- Give rise to more stem cells
- Specialize or differentiate
Each hemoglobin protein is made up subunits called
The Origin of Blood Cells hemes, which are what give blood its red color.
More specifically, the hemes can bind iron molecules,
and these iron molecules bind oxygen.
The blood cells are red because of the interaction
between iron and oxygen. (4 irons in each chain)

Responsible of carrying RBC

300,000 hemoglobins in every rbc = 1.2M oxygen carrying capacity

Bueno, Maybeline
 Hematocrit – ratio of rbc to total blood volume
Reflects the amount of rbc
The number of rbc reflects hemoglobin
The hemoglobin reflects the oxygen carrying capacity

Hemoglobin
 Tetrametric, two alpha chains and two beta chains
 Binds a total of 4 molecules
 Carries O2 from lungs to tissues
 Cooperative binding of O2
 Required to increase the solubility of O2 in blood

Adult hemoglobin
Hb A Hb A2 Hb F
Destruction of Red Blood Cells
Structure a2B2 a2S2 a2V2
Major Events in Red Blood Cell Destruction
Normal % 96-98 % 1.5-3.2% 0.5-0.8% 1. Squeezing through the capillaries of active tissues
damages red blood cells.
Derivatives of hemoglobin 2. Macrophages in the spleen and blood cell phagocytize
 Oxyhemoglobin (oxyHb) = Hb with O2 damaged red blood cells.
 Deoxyhemoglobin (deoxyHb) = Hb without O2 3. Hemoglobin from the red blood cells is decomposed
 Methemoglobin (metHb) contains Fe3+. instead of into heme and globin.
Fe2+ in heme groups 4. Heme is decomposed into iron and biliverdin.
 Carbonylhemoglobin (HbCO) - CO binds to Fe2+ in 5. Iron is made available for reuse in the synthesis of
heme in case of CO poisoning or smoking. CO has new hemoglobin or is stored in the liver as ferritin.
200x higher affinity to Fe2+ than O2. 6. Some biliverdin is converted into bilirubin.
 Carbaminohemoglobin (HbCO2) - CO2 is non- 7. Biliverdin and bilirubin are excreted in bile as bile
covalently bound to globin chain of Hb. HbCO2 pigments.
transports CO2 in blood (about 23%). 8. The globin is broken down into amino acids
 Glycohemoglobin (HbA1c) is formed spontaneously metabolized by macrophages or released into the
by nonenzymatic reaction with Glc. People with DM blood.
have more HbA1c than normal (> 7%). Measurement
Types of Anemia
of blood HbA1c is useful to get info about long-term
control of glycemia .

Dietary Factors Affecting Red Blood Cell Production

 Vitamin B12 and folic acid are necessary 12
- They are required for DNA synthesis, making them
necessary for the growth and division of all cells
 Iron is also necessary
- It is required for hemoglobin synthesis

Substance Source Function

Vitamin B12 Absorbed from DNA synthesis Types of White Blood Cells
(requires intrinsic small intestine
White blood cells:
factor for
 Are leukocytes
absorption via
small intestine)  Protect against disease
Iron Absorbed from Hemoglobin  WBC hormones are interleukins and colony-stimulating
small intestine, synthesis factors which stimulate development
conserved during  There are five types of WBCs in two categories:
red blood cells Granulocytes : Neutrophils , Eosinophils , Basophils
destruction and
Agranulocytes : Lymphocytes, Monocytes
made available for
reuse
Folic acid Absorbed from DNA synthesis
small intestine

Bueno, Maybeline
  Neutrophils
o Light purple granules in
acid-base (neutral) stain
o Lobed nucleus
o Other names
- Segs
- Polymorphonuclear leukocyte
- Bands (young neutrophils)
o First to arrive at infections
o Phagocytic
o 54% - 62% of leukocytes
o Elevated in bacterial infections
 Eosinophils White Blood Counts
o Deep red granules in acid  A procedure used to count number of WBCs per cubic
stain millimeter of blood
o Bi-lobed nucleus - Typically 5,000 - 10,000 per cubic millimeter of blood
o Moderate allergic  Leukopenia:
reactions o Low WBC count (below 5,000)
o Defend against parasitic worm infestations o Typhoid fever, flu, measles, mumps, chicken pox,
o 1% - 3% of leukocytes AIDS
o Elevated in parasitic worm infections and allergic  Leukocytoses:
reactions o High WBC count (above 10,000)
 Basophils o Acute infections, vigorous exercise, great loss of
o Deep blue granules in body fluids
basic stain  Differential WBC count
o Release histamine o Lists percentages of types of leukocytes
o Release heparin o May change in particular diseases 27
o Less than 1% of leukocytes
o Similar to eosinophils in size and shape of nuclei Abnormal White Blood Cell Numbers
 Monocytes While Blood Cell Population Illness
o Largest of all blood cells Change
Elevated lymphocytes Hairy cell leukemia, whooping
o Spherical, kidney-shaped, cough, mononucleosis
oval or lobed nuclei
Elevated eosinophils Taperworm infestation,
o May leave bloodstream hookworm infestation, allergic
to become macrophages reactions
o 3% - 9% of leukocytes Elevated monocytes Typhoid fever, malaria,
o Phagocytize bacteria, dead cells, and other tuberculosis
debris Elevated neutrophils Bacterial infections
 Lymphocytes Too few hyper T-cells AIDS
o Slightly larger than RBC (lymphocytes)
o Large spherical nucleus
surrounded by thin rim of Blood Platelets
cytoplasm
o T cells and B cells  Platelets are also known as thrombocytes
- Both important in immunity  They are cell fragments of megakarvocytes
o B cells produce antibodies  They lack a nucleus and are roughly half the size of
o 25% - 33% of leukocytes a RBC
o  There are approximately 130,000 - 360,000 per
Functions of White Blood Cells cubic millimeter of blood
 WBCs protect  They help repair damaged blood vessels by sticking
against infection to broken surfaces
 These leukocytes
can squeeze
between the
cells of a capillary
wall and enter the tissue space outside the blood
vessel (called diapedesis)

Bueno, Maybeline
 Blood Plasma Plasma Electrolytes
 Straw colored  Plasma contains a variety of these ions called
 The liquid portion of blood electrolytes
 55% of blood volume  They are absorbed from the intestine or released as
 92% water by-products of cellular metabolism
 Function includes transporting nutrients, gases, and  They include:
vitamins o Sodium (most abundant with chloride)
 Helps regulate fluid and electrolyte balance and o Potassium
maintain pH. o Calcium
o Magnesium
Plasma Proteins o Chloride (most abundant with sodium)
These are the most abundant dissolved substances o Bicarbonate
(solutes) in plasma o Phosphate
Protein Percentage Origin Function o Sulfate
of Total
Albumin 60 % Liver Helps maintain Hemostasis
colloid osmotic
pressure  Hemostasis refers to the stoppage of bleeding
Globulin 36% Liver  Actions that limit or prevent blood loss include:
Alpha Liver Transport lipids  Blood vessel spasm
globulin and fat-soluble  Platelet plug formation
vitamins
Beta Liver Transport lipids  Blood coagulation
globulin and fat-soluble
vitamins Blood Vessel Spam
Gamma Lymphatic Constitute the  Triggered by pain receptors, platelet release or
globulin tissues antibodies of serotonin
immunity  Smooth muscle in blood vessel contracts
Fibrinogen 4% Liver Plays a key role
in blood Platelet Plug Formation
coagulation
 Triggered by exposure of platelets to collagen
Gases and Nutrients  Platelets adhere to rough surface to form a plug
 The most important blood gases:
o Oxygen
o Carbon dioxide
 Plasma nutrients include:
o Amino acids
o Simple sugars
o Nucleotides
o Lipids
- Fats (triglycerides)
- Phospholipids
- Cholesterol

Non-protein Nitrogenous Substances

 These are molecules containing nitrogen but are not
proteins .
 In plasma they include:
Blood Coagulation
o Urea - product of protein catabolism; about 50%
 Triggered by cellular damage and blood contact
of nonprotein nitrogenous substances
with foreign surfaces
o Uric acid - product of nucleic acid catabolism  A blood clot forms
o Amino acids - product of protein catabolism  This is a:
o Creatine - stores phosphates o Hemostatic mechanism
o Creatinine - product of creatine metabolism o Causes the formation of a blood clot via a series
o BUN - blood urea nitrogen; indicates health of of reactions which activates the next in a
kidney cascade
o Occurs extrinsically or intrinsically

Bueno, Maybeline
 Hemostatic mechanism Clotting Factors

Mechanism Stimulus Effect Clotting factor Source Mechanism

Blood vessel Direct stimulus to Smooth muscles in I fibrinogen Syntesized in liver Extrinsic and
Spasm vessel wall or to pain vessel wall contract Intrinsic
receptors; platelets reflexly;
release serotonin, a vasoconstriction II prothrombin Syntesized in liver, Extrinsic and
vasoconstrictor helps maintain requires vitamin K Intrinsic
prolonged vessel
III tissue Damaged tissue Extrinsic
spasm
thromboplastin
Platelet plug Exposure of platelets Platelets adhere IV Calcium ions Diet, bone Extrinsic and
Formation to rough surfaces or to rough surfaces Intrinsic
to collagen of and to each other,
connective tissue forming a plug V proaccelerin Syntesized in liver, Extrinsic and
released by Intrinsic
platelets
Blood Cellular damage Blood clot forms as
coagulation and blood contact a result of a series VI unassigned
with foreign of reactions,
surfaces activate terminating in the
VII Serum Syntesized in liver, Extrinsic
factors that favor conversion of
prothrombin requires vitamin K
coagulation fibrinogen into
conversion
fibrin
accelerator
VIII antihemophilic Released by Intrinsic
Extrinsic Clotting Mechanism factor platelets and
 Chemical outside of blood endothelial cells
vessel triggers blood IX plasma Syntesized in liver, Intrinsic
coagulation thromboplastin requires vitamin K
 Triggered by tissue component
X Stuart-Prower Syntesized in liver, Extrinsic and
thromboplastin (factor III)
factor requires vitamin K Intrinsic
(not found in blood)
XI plasma Syntesized in liver Intrinsic
 A number of events occur that includes factor VII,
thromboplastin
factor X, factor V, factor IV, and factor II antecedent
(prothrombin) XII Hageman factor Syntesized in liver Intrinsic
 Triggered when blood contacts damaged blood
XIII fibrin- Syntesized in liver, Extrinsic and
vessel walls or tissues stabilizing released by Intrinsic
 This is an example of a positive feedback factor platelets
mechanism

Intrinsic Clotting Mechanism

 Chemical inside blood triggers blood coagulation
 Triggered by Hageman factor XII (found inside
blood)
 Factor XII activates factor XI which activates IX
which joins with factor VIII to activate factor X
 Triggered when blood contacts a foreign surface

Blood Coagulation
Stages Extrinsic Clotting Intrinsic Clotting
Mechanism Mechanism
Trigger Damage to vessel or Blood contacts
tissue foreign surface
Initiation Tissue thromboplastin Hageman factor

Series of reactions Prothrombin activator Prothrombin

involving several activator
clotting factors and
calcium ions lead to
the production of:
Prothrombin Prothrombin to Prothrombin to
activator and thrombin thrombin
calcium ions cause
the conversion of:
Thrombin causes Fibrinogen to fibrin Fibrinogen to fibrin
fragmentation, then
joining of:

Bueno, Maybeline
 Fate of Blood Clots Antigens and Antibodies
 After a blood clot forms it retracts and pulls the  Terms to become familiar with:
edges of a broken blood vessel together while o Agglutination - clumping of red blood cells in
squeezing the fluid serum from the clot response to a reaction between an antibody
 Platelet-derived growth factor stimulates smooth and an antigen
muscle cells and fibroblasts to repair damaged o Antigens - a chemical that stimulates cells to
blood vessel walls produce antibodies
 Plasmin digests the blood clots o Antibodies - a protein that reacts against a
 A thrombus is an abnormal blood clot specific antigen
 An embolus is a blood clot moving through the
ABO Blood Group
blood vessels
 Based on the presence or absence of two major
Prevention of Coagulation antigens on red blood cell membranes
 The smooth lining of blood vessels discourages the o Antigen A
accumulation of platelets and clotting factors o Antigen B
 As a clot forms fibrin absorbs thrombin and prevents
the clotting reaction from spreading Antigens and Antibodies of the ABO Blood Group
 Anti-thrombin inactivates additional thrombin by Blood Type Antigen Antibody
binding to it and blocking its action on fibrinogen A A anti-B
 Some cells such as basophils and mast cells secrete B B anti-A
heparin ( an anticoagulant) AB (universal A and B Neither anti-A
recipient) nor anti-B
O Neither A Both anti-A
nor B nor anti-B

Factors that inhibit Blood Clot Formation

Factors Action
Smooth lining of blood Prevents activation of
vessel intrinsic blood clotting
mechanism
Prostacyclin Inhibits adherence of
platelets to blood vessel
wall
Fibrin threads Adsorbs thrombin

Antithrombin in plasma Interferes with the action

of thrombin
Heparin from mast cells Interferes with the
and basophils formation of prothrombin
activator Where the agglutination is, that is the blood type.
Preferred and Permissible Blood Types for Transfusions
Blood Groups and Transfusions
Blood Type Preferred Blood Permissible (in an
type of Donor Extreme energy)
 In 1910, identification of the ABO blood antigen gene
A A O
explained the observed blood type incompatibilities
B B O
 Today there are 31 different genes known to
contribute to the surface features of RBCs AB A and B A,B,O
determining compatibility between blood types
O O No alternate types
What is the rarest blood type?

Bueno, Maybeline
 - Rhythmic contraction of smooth muscle in
vessel wall
Lymphatic Vessels

Rh Blood Group
o The Rh blood group was named for the rhesus
monkey .
o The group includes several Rh antigens or factors
o Rh positive - presence of antigen D or other Rh  Lymphatic collecting
antigens on the red blood cell membranes vessels
o Rh negative - lack of these antigens o Collect lymph
o The seriousness of the Rh blood group is evident in a from lymph
fetus that develops the condition erythroblastosis capillaries
fetalis or hemolytic disease of the newborn o Carries lymph to
and away from
lymph nodes
o Returning fluid to
circulatory veins
near the heart
- Right lymphatic
duct
- Thoracic duct
Lymphatic ducts

What is Rhogam vaccination sa RH – nga mother?

MODULE 6C: THE LYMPHATIC SYSTEM AND BODY

DEFENSE
Components
 Lymph fluid
 Lymph vessels
 Lymphatic organs
o Lymph nodes
o Tonsils
o Spleen Lymph
o Thymus  Materials returned to the blood
Lymphoid tissue, cells and organs that make up the  Water
lymphatic system, such as white blood cells, bone  Blood cells
marrow, and the thymus, spleen and lymph nodes.  Proteins
The lymphatic System  Composition of lymph
 Two parts 1. H2O 94%
o Lymphatic vessels 2. Solids 6%
o Lymphoid tissues and organs 3. Cells lymphocytes , plasma cells,
 Lymphatic system functions
4. Electrolytes same as that of plasma
o Transport fluids back to the blood
o Play essential roles in body defense and 5. Urea, creatinine . amino acid
resistance to disease 6. Ca++, phosphrous
o Absorb digested fat at the intestinal villi 7. Chlorides and glucose
Lymphatic characteristics 8. Clotting factors ,plasma enzymes &antibodies are
 Lymph – excess tissue fluid carried by lymphatic present.
vessels  Lymph
 Properties of lymphatic vessels Harmful materials that enter lymph vessels
o One way system toward the heart o Bacteria
o No pump o Viruses
o Lymph moves toward the heart o Cancer cells
- Milking action of skeletal muscle o Cell debris

Bueno, Maybeline
 Lymph nodes Thymus
 Filter lymph before it is returned to the blood  Located low in the throat, overlying the heart
 Defense cells within lymph nodes  Functions at peak levels only during childhood
o Macrophages – engulf and destroy foreign  Produces hormones (like thymosin) to program
substances lymphocytes
o Lymphocytes – provide immune response to  Primary lymphatic organ in the body; it is located
antigens over the heart and/or in the neck area, anterior to
the ascending aorta and posterior to the sternum.
 The thymus consists of two lobes enclosed in a
capsule and is further divided internally
 Function of the thymus is the processing and
maturation of special lymphocytes (white blood
cells) called T-lymphocytes or T-cells, which are
associated with antibody production.
Tonsils
 Small masses of lymphoid tissue around the
pharynx
 Trap and remove bacteria and other foreign
materials
 Tonsillitis is caused by congestion with bacteria
Peyer's Patches
 Found in the wall of the small intestine
 Resemble tonsils in structure
Lymph Node Structure  Capture and destroy bacteria in the intestine
Mucosa-Associated Lymphatic Tissue (MALT)
Includes:
o Peyer's patches
o Tonsils
o Other small accumulations of lymphoid tissue
Acts as a guard to protect respiratory and
digestive tracts
Body Defenses
 The body is constantly in contact with bacteria,
fungi, and viruses (pathogens)
 The body has two defense systems for foreign
materials
 Nonspecific defense system
Other Lymphoid Organs o Mechanisms protect against a variety of
invaders
 Spleen o Responds immediately to protect body from
 Thymus
foreign materials
 Tonsils
 Peyer’s patches  Specific defense system
o Specific defense is required for each type of
invader
o Also known as the immune system
Surface Membrane Barriers – First Line of Defense
 The skin
o Physical barrier to foreign materials
o pH of the skin is acidic to inhibit bacterial
growth
- Sebum is toxic to bacteria
Spleen - Vaginal secretions are very acidic
o Located on the left side of the abdomen o Stomach mucosa
o Filter s blood
- Secreted hydrochloric acid
o Destroys worn out blood cells
o Forms blood cells in the fetus - Has protein-digesting enzymes
o Acts as a blood reservoir o Saliva and lacrimal fluid contain lysozyme
o Mucus traps microorganism in digestive and
respiratory pathways

Bueno, Maybeline
 Classes of innate immune cells Dendritic cells
Innate immune cells are classified as following: are APC (antigen presenting cells) derived from bone
o Monocyte/Macrophage marrow precursors and form a widely distributed
o Dendritic cell (DC) cellular system throughout the body. DCS exert
o Polymorphonuclear granulocyte (PMN; Neutrophil, immune-surveillance for exogenous ad endogenous
Eosinophil, Basophil) antigens and the later activation of naive T lymphocytes
o Mast cell giving rise to various immunological responses.
Cell Activated function
Macrophage Phagocytosis and activation of
bacterial mechanisms
Antigen presentation
Dendrite cell Antigen uptake is peripheral sites
Antigen presentation in lymph
nodes
Neutrophil Phagocytosis and activation of
bacterial mechanisms
Eosinophil Killing of antibody-coated
parasites
Basophil Uknown
Inflammatory Response – Second Line of Defense
Mast cell Release of granules containing
 Triggered when body tissues are injured
histamine and other active
agents  Produces four cardinal signs
o Redness (Rubor)
Defensive cells
o Heat (Calor)
 Phagocytes (neutrophils and macrophages)
o Swelling (Tumor)
o Engulfs foreign material into a vacuole
o Pain (Dolor)
o Enzymes from lysosomes digest the material
 Results in a chain of events leading to protection
 Natural killer cells
and healing
o also known as NK cells, K cells, and killer cells Functions of the Inflammatory Response
are a type of lymphocyte (a white blood cell)  Prevents spread of damaging agents
o Can lyse and kill cancer cells  Disposes of cell debris and pathogens
o Can destroy virus infected cells  Sets the stage for repair
Steps in the Inflammatory Response

Bueno, Maybeline
 Antimicrobial Chemicals
 Complement
o complement system are synthesized by
hepatocytes.
o also produced by tissue macrophages, blood
monocytes
o A group of at least 20 plasma proteins
o Activated when they encounter and attach to
cells (complement fixation)
o Damage foreign cell surfaces
o Will rupture or lyse the foreign cell membrane
Action of the complement system against bacterium
Antimicrobial Chemicals
 Interferon
o Secreted proteins of virus-infected cells
o Bind to healthy cell surfaces to inhibit viruses
binding
o ability to interfere with viral proliferation
 Fever
o Abnormally high body temperature
o Hypothalmus heat regulation can be reset by
pyrogens (secreted by white blood cells)
o High temperatures inhibit the release of iron and
zinc from liver and spleen needed by bacteria
o Fever also increases the speed of tissue repair
Specific Defense: The Immune System – Third Line of
Defense
 Antigen specific - recognizes and acts against
particular foreign substances
 Systemic - not restricted to the initial infection site
 Has memory - recognizes and mounts a stronger
attack on previously encountered pathogens
Bueno, Maybeline
Types of Immunity
 Humoral immunity
o Antibody-mediated immunity
o Cells produce chemicals for defense
 Cellular immunity
o Cell-mediated immunity
o Cells target virus infected cells
Anitgens (Nonself)
 Any substance capable of exciting the immune
system and provoking an immune response
 Examples of common antigens
o Foreign proteins
o Nucleic acids
o Large carbohydrates
o Some lipids
o Pollen grains
o Microorganisms
Self-Antigens
 Human cells have many surface proteins
 Our immune cells do not attack our own proteins
 Our cells in another person's body can trigger an
immune response because they are foreign
o Restricts donors for transplants
Allergies
 Many small molecules (called haptens or
incomplete antigens) are not antigenic, but link up
with our own proteins
 The immune system may recognize and respond to
a protein-hapten combination
 The immune response is harmful rather than
protective because it attacks our own cells
Haptens
 Small organic molecules
 Not antigenic but may become antigenic when
bound to larger carrier molecule
o E.g., penicillin
o May elicit hapten specific and carrier specific
responses
Danders
Refers to tiny flakes of dead skin. Cat dander is what
causes an allergic reaction, not the cart’s fur.
Some Symptoms of an Allergic Reaction
 Hives, itching and swelling in areas other than the
siting site.
 Tightness in the chest and difficulty in breathing
 Hoarse voice or swelling of the tongue
 Dizziness or a sharp drop in blood pressure
 Unconsciousness or cardiac arrest.
 Cells of the Immune System Active Immunity
 Lymphocytes  Your B cells encounter antigens and produce
o Originate from hemocytoblasts in the red bone antibodies
marrow
 Active immunity can be naturally orartificially
o B lymphocytes become immunocompetent in
the bone marrow acquired
o T lymphocytes become immunocompetent in
Acquired immunity
the thymus
Naturally acquired Artificially acquired
 Macrophages
o Arise from monocytes Active Passive Active Passive
o Become widely disturbed in lymphoid organs Infection; Antibodies Vaccine; Injection of
Humoral immunity Cell-mediated immunity: contact with pass from dead or immune
pathogen mother to attenuated serum
 secretes  secretes cytokines
fetus via pathogens (gamma
antibodies to fight (interferons, interleukins,
placenta; or globulin)
against antigens lymphokines, tumour
to infant in
 rapid or quick in necrosis factor)
her milk
their action  delay though permanent
against antigens action against any
 B cells are pathogens.
primarily  activation of phagocytes, Passive Immunity
responsible for antigen-specific cytotoxic  Antibodies are obtained from someone else ?
humoral immunity T-lymphocytes
- Conferred naturally from a mother to her fetus
 T cells are involved in cell-
mediated immunity - Conferred artificially from immune serum or
Activation of Lymphocytes gamma globulin
 Immunological memory does not occur
 Protection provided by "borrowed antibodies'
Antibodies (Immunoglobulins) (Igs)
 Soluble proteins secreted by B cells (plasma cells)
 Carried in blood plasma
 Capable of binding specifically to an antigen
Antibody Classes
 Antibodies of each class have slightly different roles
 Five major immunoglobulinclasses
o IgM - can fix complement
o IgA - found mainly in mucus
o IgD - important in activation of B cell
Humoral (Anti-body Mediated Immune Response
o IgG - can cross the placental barrier
 B lymphocytes with specific receptors bind to a o IgE - involved in allergies
specific antigen
 The binding event activates the lymphocyte to Basic Structure of Antibody
undergo clonal selection
 A large number of clones are produced (primary
humoral response)
 Most B cells become plasma cells
- Produce antibodies to destroy antigens
- Activity lasts for four or five days
 Some B cells become long-lived memory cells
(secondary humoral response)
Humoral Immune Response

Sites of Immunoglobin

Bueno, Maybeline
 Structures of Antibodies 5. IgE
 It was discovered in 1966 by K. Ishizaka.
 It is very low concentration in blood (17-450ng/ml)
 It contain small percentage of Lympocytes
Functions
i. Responsible for Immediate hypersensitivity
ii. Binds to Fc receptor on basophils and mast cells
iii. Release of substance like histamine , vasoactive
mediators
The five immunoglobin Ig Classes

1. IgG
 They makes up approximately 80% of the serum
antibodies
 They has a half-life of 7-23 days
 lgG is a monomer and has 2-epitope binding sites
 This is the only class of antibodies that can cross the
placenta and enter the fetal circulation
Functions
i. Immunity to new born
ii. Neutralisation of Toxins
iii. lgG3 binds to Fc receptor by Phagocytosis
2. IgM
 They makes up approximately 13% of the serum
antibodies
 They has a half-life of about 5 days
 Most of the lgM are pentamer and has 10 - epitope
binding sites. some are monomer
 It is the first immunoglobuline class produced in a
primary response to antigen
Functions
i. Activation of classical pathway
ii. Defence against multivalent antigens
iii. Act as Opsonin
3. IgA
 They makes up approximately 6% of the serum
antibodies
 They has a half-life of approximately 5 days
 lgA is a dimer and has 4-epitope binding sites
 They found mainly in body secretions such as saliva,
mucous, tears, colostrum and milk
Function
+ IGM + IGG = ongoing imo sakit, ga build palang
i. It as a Secretory antibody i
immunity
ii. Effective against virus that causing Influnza
- IGM + IGG = nag ayo ka sa masakit or immune
iii. Production to Infant gut
ka sa masakit or gn vaccine kana
4. IgD sna nga sakit
 They makes up approximately 0.2% of the serum + IGM - IGG = recovering palang sa sakit
antibodies - IGM - IGG = wala ka ka experience sakit
 IgD is a monomer and has 2-epitope binding sites Types of Specific Immunity
 This class antibodies are found on the surface of B-  Naturally acquired active immunity
lymphocytes - type of specific immunity a host develops after
Function exposure to foreign substance
i. B cell activation  Naturally acquired passive immunity
ii. Act a receptor for antigen binding - transfer of antibodies, e.g ., mother to fetus across
placenta, mother to infant in breast milk

Bueno, Maybeline
 • Artificially acquired active immunity (vaccination)
- intentional exposure to a foreign material
 Artificially acquired passive immunity
- preformed antibodies or lymphocytes produced by
one host are introduced into another host
o Lethal to TISSUE CELLS invaded by VIRUSES.
o Important role in destroying CANCER CELLS, HEART
TRANSPLANT CELLS, or other cells foreign to body.
Activation and action of cytotoxic T-cells

Acquired immunity
Natural immunity Artificially immunity
Is acquired through the Is that produced purposely
normal life experiences of through medical
human and is not induced procedures (also called
through medical means immunization)
Active Passive Active Passive
Consequence Consequence Consequence Consequence
of a person of one of a person of a person
developing person developing receiving
his or her receiving his or her preformed
own immune performed own immune immunity
response immunity response to made by
made by a microbe another T Cell Clones
another person Helper T cells
person  help activate B cells to secrete antibodies, activate
Cellular (Cell-Mediated) Immune Response macrophages and cytotoxic cells
 Antigens must be presented by macrophages to an  special subpopulation of CD4 cells
immunocompetent T cell (antigen presentation)  Recruit other cells to fight the invaders
 T cells must recognize nonself and self (double  Interact directly with B cells
recognition) FUNCTIONS OF HELPER CELLS;
 After antigen binding, clones form as with B cells, but  Stimulation of cytotoxic and suppressor T cells.
different classes of cells are produced  Stimulation of B-cell growth and differentiation to
form plasma cell clones
 Activation of Macrophage system
 Feedback stimulatory effect on helper T cells
themselves.
Helper T cell Activation and Action

Types of T Lymphocytes
 CD 4-helper T Cells
 CD 8-cytotoxic T cells
 Suppressor T Cells
 Memory cells
T Cell Clones
 Cytotoxic T cells
o also known as Tc, cytotoxic T lymphocyte, CTL, T-
killer cell, cytolytic T cell, CD8+ T-cell or killer T
cell) is a T lymphocyte Suppresor T cells
o Specialize in killing infected cells ? Insert a toxic  Release chemicals to suppress the activity of T and
chemical(perforin) B cells
CYTOTOXIC T CELLS  Stop the immune response to prevent uncontrolled
o Killer cells ; CD8 activity
o Direct attack on micro-organisms  Less known cells
o PERFORINS : hole-forming proteins  Suppress function of cytotoxic and helper T cells.
o Release of cytotoxic substances into the attacked  Prevent damage to body itself
cells  REGULATORY CELLS along with helper cells
o Cell swell and thus destroy.  IMMUNE TOLERANCE:

Bueno, Maybeline
 Disorders of Immunity : Immunodeficiences
 Production or function of immune cells or
complement is abnormal
 May be congenital or acquired
 Includes AIDS - Acquired Immune Deficiency
Syndrome

Disorders of Immunity : Autoimmune Diseases

 The immune system does not distinguish between
self and nonself
 The body produces antibodies and sensitized T
lymphocytes that attack its own tissues
 Examples of autoimmune diseases
o Multiple sclerosis - white matter of brain and
spinal cord are destroyed
Memory T cells
 These are activated by antigens but do not enter in o Myasthenia gravis - impairs communication
circulation. between nerves and skeletal muscles
o Juvenile diabetes - destroys pancreatic beta
 Remain in lymphoid organs
cells that produce insulin
 Migrate to various lymphoid tissues throughout the
o Rheumatoid arthritis - destroys joints
body
o Systemic lupus erythematosus (SLE) affects
 If attacked by same antigen again, immediate
kidney, heart, lung and skin
response.
o Glomerulonephritis - impairment of renal
 More POWERFUL response
function
Summary of the Immune Response
Immune Deficiency: AIDS
 HIV target cells
 Retrovirus attaches to CD4 receptors of T helper
cells
- Transmission: Body fluids, i.e ., blood, semen,
breast milk, vaginal secretions
Structure of HIV

The Course of the Progression of AIDS after HIV

Organ Transplant and Rejection
Infection
 Major types of grafts
o Autografts - tissue transplanted from one site to
another on the same person
o Isografts - tissue grafts from an identical person
(identical twin)
o Allografts - tissue taken from an unrelated person
o Xenografts - tissue taken from a different animal
species
o Autografts and isografts are ideal donors
o Xenografts are never successful ?
o Allografts are more successful with a closer tissue
match

Bueno, Maybeline
 AIDS Pandemic
 More than 36 million infected with HIV worldwide
 Most infections in sub-Sahara of Africa
 Increasing spread in Asia and India
 Most often spread by heterosexual contact outside
U.S.
Edema
 Occasionally the balance of filteration and
reabsorption between interstitial fluid and plasma is
disrupted. This results in edema.
Lymphadenopathy
 Enlargement of lower limb and scrotum due to
obstruction of lymphatic vessels by microfilaria.
Elephantiasis (Filariasis)
 Enlargement of lower limb and scrotum due to
obstruction of lymphatic vessels by microfilaria.

Bueno, Maybeline
 MODULE 7: RESPIRATORY SYSTEM 2. These spaces open to the nasal cavity and are lined
with mucus membrane that is continuous with that
Respiratory System Functions lining the nasal cavity.
1. Supplies the body with oxygen and disposes of 3. The sinuses reduce the weight of the skull and serve
carbon dioxide as a resonant chamber to affect the quality of the
2. Filter inspired air voice.
3. Produces sound
4. Clears the body from excess water and heat
5. Control blood pH

B.
The entire process of exchanging gases between the
atmosphere and body cells is called respiration and
consists of the following: ventilation, gas exchange
between blood and lungs, gas transport in the
bloodstream, gas exchange between the blood and body
cells, and cellular respiration.
Normal Values
 Normal respiration: 12-16 breathes/min
 Normal arterial blood gas values
- pH: 7.35 – 7.45
- Pa O2 : (80 to 100 mm Hg and Sa O2 (95% to 98%) Pharynx
- P CO2 : 35 – 45 mm Hg 1. The pharynx is a common passageway for air and
- HCO3 : 22-27 mEq/L food.
Phases of pulmonary ventilation 2. The pharynx aids in producing sounds for
 Inspiration, or inhalation - A very active process speech.
that requires input of energy. The diaphragm
contracts, moving downward and flattening.
 Expiration, or exhalation - A passive process that
takes advantage of the recoil properties of elastic
fiber. The diaphragm relaxes. The elasticity of the
lungs and the thoracic cage allows them to return to
their normal size and shape.
 This two processes are happens when phrenic
nerves Stimulates.
Organs of the Respiratory System
A. The organs of the respiratory tract can be divided
into two groups: the upper respiratory tract (nose,
nasal cavity, Sinuses, and pharynx ), and the lower
respiratory tract (larynx, trachea, bronchial tree,
and lungs). Larynx
Nose
1. The larynx is an enlargement in the airway superior
1. The nose, supported by bone and cartilage,
provides an entrance for air in which air is filtered to the trachea and inferior to the pharynx.
by coarse hairs inside the nostrils. 2. It helps keep particles from entering the trachea
Paranasal Sinuses and also houses the vocal cords.
3. The larynx is composed of a framework of muscles
1. Sinuses are air-filled spaces within the maxillary,
and cartilage bound by elastic tissue.
frontal, ethmoid, and sphenoid bones of the skull.

Bueno, Maybeline

4. Inside the larynx, two pairs of folds of muscle and
connective tissue covered with mucous membrane
make up the vocal cords.
a. The upper pair is the false vocal cords.
b. The lower pair is the true vocal cords.
c. Changing tension on the vocal cords controls
pitch, while increasing the loudness depends
upon increasing the force of air vibrating the
vocal cords.
5. During normal breathing, the vocal cords are
relaxed and the glottis is a triangular slit. 6. During
swallowing, the false vocal cords and epiglottis close
off the glottis.
Bronchial Tree
1. The bronchial tree consists of branched tubes
leading from the trachea to the alveoli.
2. The bronchial tree begins with the two primary
bronchi, each leading to a lung.
3. The branches of the bronchial tree from the trachea
are right and left primary bronchi; these further
subdivide until bronchioles give rise to alveolar
ducts which terminate in alveoli.
4. It is through the thin epithelial cells of the alveoli
that gas exchange between the blood and air occurs.
Structure
 The bronchi are composed of the same issues as the
trachea.
 Are lined with ciliated columnar epithelium.
Division of bronchi

Bronchioles

Terminal bronchioles

Respiratory bronchioles

Alveolar ducts Alveoli

Trachea
 The trachea extends downward anterior to the
esophagus and into the thoracic cavity, where it
splits into right and left bronchi.
 The inner wall of the trachea is lined with ciliated
mucous membrane with many goblet cells that
serve to trap incoming particles.
 The tracheal wall is supported by 20 incomplete
cartilaginous rings.
Bueno, Maybeline

 A layer of serous membrane, the visceral pleura,
folds back to form the parietal pleura.
 The visceral pleura is attached to the lung, and the
parietal pleura lines the thoracic cavity; serous fluid
lubricates the "pleura cavity" between these two
membranes.
Breathing Mechanism
A. Ventilation (breathing), the movement of air in and
out of the lungs, is composed of inspiration and
expiration.
Bueno, Maybeline
B. Inspiration
1. Atmospheric pressure is the force that moves air into
the lungs.
2. When pressure on the inside of the lungs decreases,
higher pressure air flows in from the outside.
3. Air pressure inside the lungs is decreased by
increasing the size of the thoracic cavity; due to surface
tension between the two layers of pleura, the lungs
follow with the chest wall and expand.
4. Muscles involved in expanding the thoracic cavity
include the diaphragm and the external intercostal
muscles.
5. As the lungs expand in size, surfactant keeps the
alveoli from sticking to each other so they do not
collapse when intemal air pressure is low.
C. Expiration
1. The forces of expiration are due to the elastic recoil
of lung and muscle tissues and from the surface tension
within the alveoli.
2. Forced expiration is aided by thoracic and abdominal
wall muscles that compress the abdomen against the
diaphragm.
D. Respiratory Air Volumes and Capacities
1. The measurement of different air volumes is called
spirometry, and it describes four distinct respiratory
volumes.
2. One inspiration followed by expiration is called a
respiratory cycle; the amount of air that enters or
leaves the lungs during one respiratory cycle is the
tidal volume.
3. During forced inspiration, an additional volume, the
inspiratory reserve volume, can be inhaled into the
lungs. IRV + TV gives us the inspiratory capacity.
4. During a maximal forced expiration, an expiratory
reserve volume can be exhaled, but there remains a
residual volume in the lungs. Adding the two
together gives us the functional reserve capacity.
 5. Vital capacity is the tidal volume plus inspiratory
reserve and expiratory reserve volumes combined.
6. Vital capacity plus residual volume is the total lung
capacity.
7. Anatomic dead space is air remaining in the
bronchial tree.
Lung Volumes
 Minute ventilation (MV): MV 12 breaths/min 500
mL /breath = 6 liters/min. total lung capacity.
 TIDAL VOLUME (TV): Volume inspired or expired
with each normal/breath. = 500 ml
 INSPIRATORY RESERVE VOLUME (IRV): Maximum
volume that can be inspired over the inspiration of
a tidal volume/normal breath. Used during
exercise/exertion .= Male 3100 ml/ Female 1900 ml
 EXPIRATRY RESERVE VOLUME (ERV): Maximal
volume that can be expired after the expiration of a
tidal volume/normal breath. = Male 1200 ml/
Female 700 ml
 RESIDUAL VOLUME (RV): Volume that remains in
the lungs after a maximal expiration. Male 1200 ml/
Female 1100 ml
 Inspirational capacity is the sum of tidal volume
and inspiratory reserve volume, IRV + TV (500 ml
3100 ml 3600 ml in males and 500 ml 1900 ml 2400
ml in females).
 Functional residual capacity is the sum of residual
volume and expiratory reserve volume, ERV + RV
(1200 ml 1200 ml 2400 ml in males and 1100 ml 700
ml 1800 ml in females).
 Vital capacity is the sum of inspiratory reserve
volume, tidal volume, and expiratory reserve
volume, IRV + TV + ERV = IC + ERV (4800 ml in males
and 3100 ml in females).
 Total lung capacity is the sum of vital capacity and
residual volume IRV+ TV + ERV + RV = IC + FRC (4800
ml 1200 ml 6000 ml in males and 3100 ml 1100 ml
4200 ml in females).
Bueno, Maybeline
Spirometer
A spirometer is an apparatus for measuring the volume
of air inspired and expired by the lungs. A spirometer
measures ventilation, the movement of air into and out
of the lungs. The spirogram will identify two different
types of abnormal ventilation patterns, obstructive and
restrictive.
Control of Breathing
A. Normal breathing is rhythmic, involuntary act even
though the muscles are under voluntary control
Respiratory Center
1. Groups of neurons in the brain stem comprise the
respiratory center, which controls breathing by
causing inspiration and expiration and by adjusting
the rate and depth of breathing. 2
2. The components of the respiratory center include
the rhythmicity center of the medulla and the
pneumotaxic area of the pons.
3. The medullary rhythmicity center includes two
groups of neurons: the dorsal respiratory group
and the ventral respiratory group.
a. The dorsal respiratory group is responsible for
the basic rhythm of breathing.
b. The ventral respiratory group is active when
more forceful breathing is required.
4. Neurons in the pneumotaxic area control the rate
of breathing.
 Factors Affecting Breathing
1. Chemicals, lung tissue stretching, and emotional
state affect breathing.
2. Chemosensitive areas (central chemoreceptors)
are associated with the respiratory center and are
sensitive to changes in the blood concentration of
carbon dioxide and hydrogen ions.
a. If either carbon dioxide or hydrogen ion
concentrations rise, the central
chemoreceptors signal the respiratory center,
and breathing rate increases.
3. Peripheral chemoreceptors in the carotid sinuses
and aortic arch sense changes in blood oxygen
concentration, transmit impulses to the respiratory
center, and breathing rate and tidal volume
increase.
4. An inflation reflex, triggered by stretch receptors in
the visceral pleura, bronchioles, and alveoli, helps to
prevent overinflation of the lungs during forceful
breathing.
5. Hyperventilation lowers the amount of carbon
dioxide in the blood.
Alveolar Gas Exchanges
A. The alveoli are the only sites of gas exchange
between the atmosphere and the blood.
B. Alveoli
1. The alveoli are tiny sacs clustered at the distal
ends of the alveolar ducts.
C. Respiratory Membrane
1. The respiratory membrane consists of the
epithelial cells of the alveolus, the endothelial
cells of the capillary, and the two fused
basement membranes of these layers.
Bueno, Maybeline
2. Gas exchange occurs across this respiratory
membrane.
D. Diffusion across the Respiratory Membrane
1. Gases diffuse from areas of higher pressure to
areas of lower pressure.
2. In a mixture of gases, each gas accounts for a
portion of the total pressure; the amount of
pressure each gas exerts is equal to its partial
pressure.
3. When the partial pressure of oxygen is higher in
the alveolar air than it is in the capillary blood,
oxygen will diffuse into the blood.
4. When the partial pressure of carbon dioxide is
greater in the blood than in the alveolar air,
carbon dioxide will diffuse out of the blood and
into the alveolus.
5. A number of factors favor increased diffusion;
more surface area, shorter distance, greater
solubility of gases, and steeper partial pressure
gradient.
Gas Transport
A. Gases are transported in association with molecules in
the blood or dissolved in the plasma.
B. Oxygen Transport
1. Over 98% of oxygen is carried in the blood bound
to hemoglobin of red blood cells, producing
oxyhemoglobin.
2. Oxyhemoglobin is unstable in areas where the
concentration of oxygen is low, and gives up its
oxygen molecules in those areas. T
3. More oxygen is released as the blood
concentration of carbon dioxide increases, as the
blood becomes more acidic, and as blood
temperature increases.
 4. A deficiency of oxygen reaching the tissues is
called hypoxia and has a variety of causes.
3. Bicarbonate ions. The greatest percentage of
CO2 about 70%-is transported in blood plasma
as bicarbonate ions (HCO3-).
 CO2 diffuses into systemic capillaries and
enters red blood cells, it reacts with water
in the presence of the enzyme carbonic
anhydrase (CA) to form carbonic acid, which
dissociates into H+ and HCO3-.

Oxygen Transport
 Oxygen does not dissolve easily in water, so only
about 1.5% of inhaled O2 is dissolved in blood
plasma, which is mostly water. About 98.5% of
blood O2 is bound to hemoglobin in red blood Cells.
Each 100 ml of oxygenated blood contains the
equivalent of 20 ml of gaseous O2.
 The heme portion of hemoglobin contains four
atoms of iron, each capable of binding to a molecule
of O2. The 98.5% of the O2 that is bound to
hemoglobin. Oxygen and hemoglobin bind in an
easily reversible reaction to form oxyhemoglobin.
O2 +Hgb = 4Hgb O2
 As blood flows through tissue capillaries, the iron-
oxygen reaction reverses. Hemoglobin releases
oxygen, which diffuses first into the interstitial fluid
and then into cells.
CO2 Transportation
Normal resting conditions, each 100 ml of
deoxygenated blood contains the equivalent of53 mL of
gaseous CO2, which is transported in the blood in three
main forms
1. Dissolved CO2, The smallest percentage about 7%- Chemical regulation of respiration
is dissolved in blood plasma. On reaching the
lungs, it diffuses into alveolar air and is exhaled. There are three important chemical factors controlling
2. Carbamino compounds: - About 23% of CO2, respiration
combines with the amino groups of amino acids
1. Concentration of CO2 in blood
and proteins in blood to form carbamino
compounds. The main CO2 binding sites are the 2. Concentration of H+ ions or pH
terminal amino acids in the two alpha and two
beta globin chains. Hemoglobin that has bound 3. Concentration of oxygen In blood
CO, is termed carbaminohemoglobin (Hb-CO2):
 Concentration of CO2 in blood Respiratory System Terminologies
 When CO2 concentration in blood increases, it  Apnea: temporary cessation of breathing
stimulates the chemoreceptors. There are two  Tachypnea: abnormally rapid respirations
group of chemoreceptors 1  Bradypnea: abnormally slow respiration
1. Peripheral chemoreceptors - situated at the
 Dyspnea: labored breathing or shortness of breath
carotid body and aortic body
2. Central chemoreceptors - situated at the  Hypoxemia: decrease in arterial oxygen tension in
medulla oblongata the blood
When CO2 concentration in blood increases  Hypoxia: decrease in oxygen supply to the tissues
and cells
Stimulates the chemoreceptors  Hypercapnia: an increase in the partial pressure of
carbon dioxide in the blood.
Transmission of sensory impulses to respiratory centers  Hypocapnia: a decreased amount of carbon dioxide
in the blood.
Activation of respiratory centers
 Physiologic dead space: portion of the
Increases the activities of respiration (rate and Depth) tracheobronchial tree that does not participate in
gas exchange.
Increase alveolar ventilation  Central cyanosis: bluish discoloration of the skin or
mucous membranes due to hemoglobin carrying
Expulsion of CO2 and decreases the level of CO2 in blood reduced amounts of oxygen.
 Intrapleural (intrathoracic) pressure: pressure
Concentration of H+ ions or pH
between the two pleural layers in the pleural cavity.
When Concentration of H+ ions increases, it stimulates
the peripheral chemoreceptors. H+ ions diffuses with DISORDERS OF RESPIRATORY TRACT
CO2 and form carbonic acid, to cross the blood brain
ASTHMA
barrier then dissociates into H+ and HCO3. There by H+
It is a common long term
ions stimulates the central chemoreceptors then the inflammatory disease of the
respiratory centers, resulting a reduction in the level of airways of the lungs. The
CO2, in blood. This will inturn decrease concentration of mucous membrane &
H+ in blood or increase the pH in to normal. muscle layers of the
bronchi become thickened.
Concentration of oxygen in blood

When O2 concentration in blood decreases

Stimulates the peripheral chemoreceptors EMPHYSEMA

A lung condition
Transmission of impulses to respiratory centers that causes
shortness of
Activation of respiratory centers Increases the activities breath. In people,
of respiration ( rate and Depth) with emphysema,
the air sacs in the
Increase alveolar ventilation lungs (alveoli) are
damaged.
Increases the uptake of O2

Thereby increases the level of O2in blood

Bueno, Maybeline
 PNEUMONIA
An inflammatory
condition of the lung
affecting primarily the
small air sacs known as
alveoli.

LUNG ABSCESS
Lung abscess is a type of
liquefactive necrosis of
the lung tissue and
formation of cavities
(more than 2 cm)
containing necrotic
debris or fluid caused by
microbial infection

LUNG COLLAPSE
A collapsed lung occurs
when air escapes from
the lung. The air then
fills the space outside of
the lung, between the
lung and chest wall.

APNEA
Apnea or apnoea is
suspension of
breathing. During
apnea, there is no
movement of the
muscles of inhalation,
and the volume of the
lungs initially remains
unchanged.
LUNG TUMOURS
Lung cancer, also known as
lung carcinoma, is a
malignant lung tumor
characterizes d by
uncontrolled cell growth in
tissues of the lung.

Bueno, Maybeline
 MODULE 8: DIGESTIVE SYSTEM Papillae of Tongue

Functions of the System

 Ingestion
 Movement of food
 Digestion
 Absorption
 Defecation
Parts of Digestive System
1. Mouth
2. Pharynx
3. Oesophagus
4. Stomach
5. Small intestine
6. Large intestine
7. Rectum
8. Anus Teeth
are concerned with mastication. Depending on the age
Major Organs at which they are arises, teeth can be classified as
a) Permanent teeth- 32
b) Temporary teeth- 20
Each half of the upper and lower jaw contains 8 Teeth.
They are:
2 incisors, 1 canine, 2 premolars, 3 molars
Palate
 Roof of oral cavity

Movements of the Tube (parasympathethic)

 Mixing movements (churning of foods)

Pharnyx
1. Nasopharynx- It is not the part of digestive system
2. Oropharynx- It is situated posterior to oral cavity.
3. Laryngopharynx- It is situated below the oropharynx
and connected to the oesophagus.

Innervation of the Tube

 submucosal plexus - controls secretions myenteric
plexus - controls gastrointestinal motility
 parasympathetic impulses - increase activities of Salivary Glands
digestive system
 sympathetic impulses - inhibit certain digestive
actions
MOUTH
Upper extended portion which forms the beginning of
alimentary canal. The important structures of mouth
are:
a. Tongue
b. Teeth
c. Salivary gland

Bueno, Maybeline
Secretions of Salivary Glands Esophagus
 Parotid glands
clear
water, serous fluid
rich in amylase
 Submandibular glands
primarily serous fluid some mucus
 Sublingual glands
primarily mucus
most viscous
Process of the mouth
 Mastication (chewing) of food.
 Mixing masticated food with saliva to produce easy
digested food called bolus.
 Saliva contain enzyme amylase which convert starch
into maltose.
 Initiation of swallowing by tongue.
 Allowing for the sense of taste.
Swallowing Mechanism
 soft palate and uvula raise
 hyoid bone and larynx elevate .
 epiglottis closes off top of trachea Stomach
 longitudinal muscles of pharynx contract  It is located on the left side of the abdominal cavity.
 inferior constrictor muscles relax and esophagus  Region of stomach
opens  Cardiac region
 peristaltic waves push food through pharynx  Fundus region
 Body Pyloric
 region
 Food empties into the small intestine at the py loric
sphincter.
 Lining of Stomach Regulation of Gastric Secretions

Cells in Stomach: Gastric Absorption

1. Mucus cells- It secrete the alkaline mucous for  Some water
protecting the epithelium from hydrochloric acid.  Certain salts
2. Parietal cells- It secrete hydrochloric acid; the acid  Certain lipid-soluble drugs
activates release of pepsin for protein digestion.  Alcohol
The acid also kills micro-organisms swallowed with
the food. Mixing and Emptying Actions
3. Chief cells- It secrete pepsin. These cells are located
in the fundic region.
4. G-Cells- It secrete gastrin which stimulates the
secretion of hydrochloric acid.
Gastric Secretions
 pepsinogen
- from chief cells
- iinactive form of pepsin
 pepsin
- from pepsinogen in presence of HCI
- protein splitting enzyme Enterogastric Reflex
 hydrochloric acid Regulates the rate at which chyme leaves the stomach
- from parietal cells
- needed to convert pepsinogen to pepsin
 mucus
- from goblet cells and mucous glands
- protective to stomach wall ?
 intrinsic factor
- from parietal cells
- required for vitamin B 12 absorption
Phases of Gastric Secretion
 Cephalic phase
- triggered by smell, taste, sight, or thought of food
- parasympathetic impulses trigger gastric juice
secretion
 Gastric phase Pancreas
- triggered by presence of food in stomach  The pancreas is closely associated with duodenum
- gastrin released of the small intestine.
- gastric juice secreted  The head of pancreas is located in C-shaped curve
 Intestinal phase of the duodenum and its tail is against the spleen.
- triggered by movement of food into small intestine
- intestinal cells release intestinal gastrin
- secretion of gastric juice

Bueno, Maybeline

Pancreatic Juice
 pancreatic amylase - splits glycogen into
disaccharides
 pancreatic lipase - breaks down triglycerides
 trypsin, chymotrypsin, and carboxypeptidase
digest proteins
 nucleases - digest nucleic acids
 bicarbonate ions - make pancreatic juice alkaline
Regulation of Pancreatic Secretions
 acidic chyme stimulates release of secretin
 secretin stimulate release of pancreatic juice
Liver
Hepatic Lobule
Bueno, Maybeline
The Paths of Blood and Bile in Hepatic Lobule
Liver Functions
 produces glycogen from glucose
 breaks down glycogen into glucose
 converts noncarbohydrates to glucose
 oxidizes fatty acids
 synthesizes lipoproteins, phospholipids, and
cholesterol
 converts carbohydrates and proteins into fats
 deaminates amino acids
 forms urea
 synthesizes plasma proteins
 converts some amino acids to other amino acids
 stores glycogen, vitamins A,D, B12, iron, and blood
 phagocytosis of worn out RBCs and foreign
substances
 removes toxins from blood
 produces and secretes
a. It store glycogen, iron, and vitamins A, B1, and D. It
can also store 200-400ml of blood.
b. Liver's role in digestion is formation of bile.
BILE- It is yellowish green liquid that hepatic cells
continuously secrete. Bile emulsify fats and aid in
absorption of fatty acids.
Gall bladder
It is pear shaped sac like structure
locater in a depression on the inferior
surface of liver. It store approx. 30-50
ml bile.
 Composition of Bile
 water
 bile salts
- emulsification of fats
- absorption of fatty acids, cholesterol, and fat-
soluble vitamins
 bile pigments
 cholesterol
 electrolytes
Regulation of Bile Release
 Fatty cyhyme entering duodenum stimulate
gallbladder to release bile

Intestinal Villus

Small Intestine
 Small intestine is the part of alimentary canal which
extended from the pyloric end of stomach to
caecum (first part of large intestine ). Intestinal Epithelium
 Following are the parts of small intestine-
a. Duodenum
b. Jejunum
c. Ileum
Three Parts of small Intestine

Wall of Small Intestine

1. Duodenum- It is C-shaped fixed structure which is
attached to posterior abdominal wall by
peritoneum. The bile duct and pancreatic duct open
together at duodenum.
2. Jejunum- It is the continuation of duodenum and it
is the middle portion of small intestine.
3. lleum- It forms the last part of small intestine.
Mesentery
 suspends portions of the small intestine from the
posterior abdominal wall
 a fold of the peritoneum which attaches the
stomach small intestine, pancreas, spleen, and
other organs to the posterior wall of the abdomen.

Bueno, Maybeline
Secretions of Small Intestine Movements of the Small Intestine
 peptidase - breaks down peptides into amino acids  mixing movements
 sucrase, maltase, lactase - break down  peristalsis - pushing movements
disaccharides into monosaccharides ?  segmentation - ringlike contractions
 lipase - breaks down fats into fatty acids and
 overdistended wall triggers peristaltic rush resulting
glycerol
 enterokinase - converts trypsinogen to trypsin in diarrhea
 somatostatin - hormone that inhibits acid secretion LARGE INTESTINE
by stomach It extends from the end of ileum to rectum. Large
 cholecystokinin - hormone that inhibits gastric intestine consist of following parts
glands, stimulates pancreas to release enzymes in a) Caecum
pancreatic juice, stimulates gallbladder to release b) Appendix
bile c) Ascending colon
 secretin - stimulates pancreas to release d) Transverse colon
bicarbonate ions in pancreatic juice e) Descending colon
Regulation of Small Intestinal Secretions f) Sigmoid colon
 mucus secretion stimulated by presence of chyme
in small intestine
 distension of intestinal wall activates nerve plexuses
in wall of small intestine
 parasympathetics trigger release of intestinal
enzymes
Absorption in small intestine- The absorption of
digested food occurs in small intestine through
intestinal villi.
Villi- They are minute finger like projections which are
present in the inner mucous coat of the intestine

Large Intestine Wall

Absorption in the Small Intestine

 monosaccharides and amino acids
 through facilitated diffusion and active
Functions of Large Intestine
transport
 little or no digestive function
 absorbed into blood
 absorbs water and electrolytes
 electrolytes and water
 secretes mucus
 through diffusion, osmosis, and active transport
 houses intestinal flora
 absorbed into blood
 forms feces
 fatty acids and glycerol
 carries out defecation
 several steps
1. Digestion- This is carried out by microorganism of
 absorbed into lymph and blood
colon. They are act on the undigested and
unabsorbed residue from small intestine.
2. Absorption- All carbohydrate, proteins and fat are
already absorbed in small intestine. Only water and
glucose are absorbed in the colon.
3. Secretion- Mucin is the only secretion. It lubricates
the colon and facilitates the passage of fecal matter.
4. Excretion- Iron and some purgatives are excreted in
Large intestine
 Movements of Large Intestine Dysphagia
 slower and less frequent than those of small
intestine
 mixing movements
 peristalsis
 mass movements usually follow meals

Esophagitis
 Esophagitis (or oesophagitis) is inflammation of the
esophagus. It may be acute or chronic.
 Esophagitis is irritation or inflammation of the
esophagus. The esophagus is the tube that carries
food from throat to stomach. Esophagitis can be
painful and can make it hard to swallow.

Functions of Peritoneum
 Movement of Viscera:
o Provide slippery surface -
permit free movements like?
o Peristalsis, movements
during respiration & Filling
& evacuation of hollow
viscera
 Protection of Viscera:
o Phagocytic cells & lymphocytes
o Greater omentum - move towards infection site &
seal it
o Policeman of Abdomen
Names of Folds
Mes/Meso Name of Organ
Small Intestine / Enteron: Mesentery

Large Intestine/ Colon: Mesocolon

Stomach Omentum/Omenta

Organs - organ / Ligaments

Abdominal wall
Feces
 water Gastritis
 electrolytes Gastritis is an inflammation, irritation, or erosion of the
 mucus lining of the stomach. It can occur suddenly (acute) or
 bacteria gradually (chronic)
 bile pigments altered by bacteria provide color
 smell produced by bacterial compounds
Parotitis

Bueno, Maybeline
 Who is at risk for Acute Gastritis? Ulcerative Colitis
 Factors that increase your risk of acute gastritis Immune system tries to fight off an invading virus or
include: bacterium, an abnormal immune response causes the
o taking NSAIDs immune system to attack the cellsin the digestive tract
o taking corticosteroids Crohn’s Disease
o drinking a lot of alcohol
Chronic inflammatory disease of the intestines,
o having a major surgery
o kidney failure especially the colon and ileum, associated with ulcers
o liver failure aund fistulae
o respiratory failure Appendicitis
Peptic Ulcer Disease
 Peptic ulcer disease (PUD), also known as a peptic
ulcer or stomach ulcer, is a break in the lining of the
stomach, first part of the small intestine, or
occasionally the lower esophagus.
 An ulcer in the stomach is known as a gastric ulcer
while that in the first part of the intestines is known
as a duodenal ulcer.
 Peptic ulcer disease refers to ulcerations in the
mucosa of the lower esophagus, stomach, or
duodenum Types of Hernia
 Inguinal (groin)
 Femoral
 Umbilical
 Incisional
 Epigastric
Hemorrhoids

Causes of Peptic Ulcer:

 H. Pylori
 Non-Steroidal Anti-Inflammatory Drugs
 Mental Stress
 Smoking
 Alcohol Consumption
 Genetics
Ulcerative Colitis vs Crohn’s Disease
Ulcerative Colitis affects the entire large intestine
(colon).
Crohn’s Disease can affect any part of the digestive
tract from mouth to anus.

Bueno, Maybeline
 Hepatitis
 inflammation of the liver
 most commonly caused by viral infection
 can be caused by reactions to drug, alcoholism or
autoimmunity

Signs and Symptoms

 Headache
 Low fever
 Fatigue
 Vomiting
 Rash
 Foamy urine
 Pale feces
 Jaundice
 Pain

Hepatitis A - not washing hands or eating raw shellfish

Hepatitis B - chronic; serum
Hepatitis C - serum
Hepatitis D - very severe; only produces symptoms if
infected with B; serum
Hepatitis E. F. G - more rare

Bueno, Maybeline
 MODULE 9: URINARY SYSTEM
 A major part of homeostasis is maintaining the
composition, pH, and volume of body fluids within
normal limits
 The urinary system removes metabolic wastes and
substances in excess, including foreign substances
like drugs and their metabolites that may be toxic
 It consists of a pair of kidneys, a pair of ureters, a
urinary bladder and a urethra
Kidneys
 The kidney is a reddish brown, bean-shaped organ
with a smooth surface
 In the adult it is about 12 centimetres long, 6
centimetres wide and 3 centimetres thick
 It is enclosed in a tough, fibrous capsule
Location of the Kidney

General Structure of the Urinary System Kidney Structure

 Organs of the Urinary System:
o Kidneys
o Ureters
o Urinary Bladder
o Urethra
 Primary organs: kidneys
o filter waste products from the bloodstream
o convert the filtrate into urine.
 The Urinary Tract:
Includes:
o ureters
o urinary bladder
o urethra
o Because they transport the urine out of the
body

Bueno, Maybeline
 ]  In both kidneys: approximately 2.5 million
nephrons.
 Are microscopic: measure about 5 centimeters in
length.
Renal corpuscle

Function of the Kidneys

 The main function of the kidneys is to regulate the
volume, composition, and pH of body fluids.
 The kidneys remove metabolic wastes from the Glomerular Filtration
blood and excrete them to the outside of the body,
including nitrogenous and sulfur-containing
products of protein metabolism .
 The kidneys also help control the rate of red blood
cell production, regulate blood pressure, and
regulate calcium ion absorption
 - Regulation of erythrocyte production
o as the kidneys filter the blood, they are also
indirectly measuring the oxygen level in the
blood
o Erythropoietin (EPO): hormone produced by Tubules
kidney
- Released if blood oxygen levels fall
- Stimulates RBC production in red bone
marrow
Renal Blood Vessels

Juxtaglomerular Apparatus

Nephrons
 The functional filtration unit in the kidney.
 Consists of the following:
 Renal corpuscle
o Glomerulus
Cortical and Juxtamedullary Nephrons
o Glomerular capsule (Bowman's capsule)
 Proximal convoluted tubule (PCT)
 Nephron loop (loop of Henle)
o Ascending loop of Henle
o Descending loop of Henie
 Distal convoluted tubule (DCT)
 collectively called the renal tubule

Bueno, Maybeline
Blood Supply of a Nephron Glomerular Filtration
Renal Artery  As blood flows through the glomerulus protein-free
plasma filters through the glomerular capillaries
Interlobar Artery
into Bowman's capsule
Arcuate Artery  Normally about 20% of the plasma that enters the
glomerulus is filtered
Interlobular Artery
 This process is known as glomerular filtration which
Afferent Anteriole is the first step in urine formation

Glomerular Capillaries

Efferent Anteriole

Petritubular Capillaries

Interlobular Vein

Arcuate Vein

Interlobal Vein

Renal Vein

Urine Formation
 The main function of the nephrons and collecting
ducts is to control the composition of body fluids
and remove wastes from the blood, the product Filtrate Pressure
being urine
 The main pressure that moves substances by
 Urine contains wastes, excess water, and
electrolytes filtration through the glomerular capillary wall is
 Urine is the final product of the processes of: hydrostatic pressure of the blood inside.
 Glomerular filtration
 Tubular reabsorption
 Tubular secretion
 Three processes
 Filtration
 Renal corpuscle: forms filtrate
 From blood to tubule
 Reabsorption
 Mostly PCT
 Water and salt: rest of nephron
 From tubule to blood
 Secretion
 From blood to tubule

Filtrate Rate
 Glomerular filtration rate (GFR) is directly
proportional to the net filtration pressure.
 Net filtration pressure

 Normally the glomeular net filtration pressure is

positive causing filtration
Glomerular Filtration
 The forces responsible include hydrostatic pressure
and osmotic pressure of plasma and the
hysdrostatic pressure of the fluid in the glomerular
capsule.
 Control of Filtrate Rate
 GFR remains relatively constant through a process
called autoregulation
 Certain conditions override autoregulation,
including when GFR increases
 Primarily three mechanisms are responsible for
keeping the GFR constant:
o Autoregulation
o Increased sympathetic impulses that decrease
GFR by causing afferent arterioles to constrict
o The hormone-like renin-angiotensin system
o There also is the hormone atrial natriuretic
peptide (ANP) which affects sodium, causing an
increase in GFR
Renin-angiotensin system
Urine Formation
Tubular reabsorption
 Substances move from the renal tubules into the
interstitial fluid where they then diffuse into the
peritubular capillaries
 The proximal convoluted tubule reabsorbs (70%):
o Glucose, water, urea, proteins, and creatine
o Amino, lactic, citric, and uric acids Phosphate,
sulfate, calcium, potassium, and sodium ions
Bueno, Maybeline
Tubular Secretion
 Substances move from the plasma of the
peritubular capillaries into the fluid of the renal
tubules
 Active transport mechanisms function here
 Secretion of substances such as drugs and ions
Tubular secretion
(reabsorption in
reverse) moves
substances from the
blood into the
tubular lumen (urine)
1. Getting rid of
substances not
already in filtrate
2. Eliminating
undesirable
substances reclaimed by
passive process, e.g ., urea
3. Ridding body of excess K
4. Controlling blood pH
Regulation of Urine Concentration and Volume
 Hormones such as aldosterone and ANP affect the
solute concentration of urine, particularly sodium.
 The ability of the kidneys to maintain the internal
environment rests in a large part on their ability to
concentrate urine by reabsorbing large volumes of
water
 The distal convoluted tubule and the collecting duct
are impermeable to water, so water may be
excreted as dilute urine
 If ADH is present, these segments become
permeable, and water is reabsorbed by osmosis into
the extremely hypertonic medullary interstitial fluid
 A countercurrent mechanism in the nephron loops
(the descending and the ascending limbs) ensures
that the medullary interstitial fluid becomes
hypertonic
 This mechanism is known as the countercurrent
multiplier
 The vasa recta also contributes as a countercurrent
mechanism
 Loop of Henle Reabsorption of chloride ions and
other negatively charged
ions by electrochemical attraction
Active secretion of substances
such as penicillin, histamine,
creatinine and hydrogen ions
Descending limb of Reabsorption of water by osmosis
nephron loop
Ascending limb of Reabsorption of Na, K, Cl ions by
Nephron loob active transport
Distal convulated Reabsorption of Na ions by active
tubule transport
Reabsorption of water by
osmosis
Active secretion of H ions
Secretion of K ions both actively
and by electrochemical attraction
Collecting duct Reabsoprtion of water by
osmosis

Urea and Uric Acid Excretion

Urea:
 A by-product of amino acid catabolism
 The plasma concentration reflects the amount or
Role of ADH in Regulating Urine Concentration and protein in diet
Volume  It enters the renal tubules through glomerular
1. Concentration of water in the blood decreases. filtration
2. Increase in the osmotic pressure of body fluids  It contributes to the reabsorption of water from
the collecting duct
stimulates osmoreceptors in the hypothalamus.
 About 80% is recycled
3. Hypothalamus signals the posterior pituitary gland Uric acid:
to release ADH.  Is a product of nucleic acid metabolism
4. Blood carries ADH to the kidneys.  It enters the renal tubules through glomerular
5. ADH causes the distal convoluted tubules and filtration
collecting ducts to increase water reabsorption by  Most reabsorption occurs by active transport
osmosis.  About 10% is secreted and excreted
6. Urine becomes more concentrated, and urine Urine Composition
volume decreases.  Urine composition reflects the volumes of water
and solutes that the kidneys must eliminate from
Function of Nephron Components
the body or retain in the internal environment to
maintain homeostasis
Part Function  It varies from time to time due to dietary intake and
Renal Corpuscle physical activity, but is:
- Glomerulus Filtration of water and o About 95% water
dissolved from the plasma o Usually contains urea, uric acid, and creatinine
o May contain trace amounts of amino acids and
- Glomerular Capsule Receives the glomerular filtrate
varying amounts of electrolytes
Renal Tube o Volume varies with fluid intake and
- Proximal convulated Reabsorption of glucose, amino environmental factors
tubule acids, creatine; lactic, citric, uric, Renal Clearance
and ascorbic acids; phosphate,  This is the rate at which a chemical is removed from
sulfate, calclium, potassium, and the plasma
sodium ions by active transport  It indicates kidney efficiency
Reabsorption of water by  Tests of renal clearance:
Insulin clearance test
endocytosis
Creatinine clearance test
Reabsoprtion of water by Para-aminohippuric acid (PAH) test
osmosis  These tests of renal clearance are used to calculate
the GFR (glomerular filtration rate)

Bueno, Maybeline
 Elimination of Urine
 After forming along the nephrons, urine:
 Passes the collecting ducts to:
 Openings of the renal papillae:
o Enters the minor and major calyces:
o Passes through the renal pelvis:
o Enters into the ureters:
o Enters into the urinary bladder:
o The urethra carries the urine out of the body
Ureters
 The ureters:
o Each is about 25 centimeters long
o Extends downward posterior to the parietal
peritoneum
o Runs parallel to vertebral column
o Join the urinary bladder in the pelvic cavity
o The wall of ureter has three layers: ?
 The inner mucous coat
 The middle muscular coat
 The outer fibrous coat

Urinary Bladder
 The urinary bladder is a hollow, distensible,
muscular organ located within the pelvic cavity,
posterior to the symphysis pubis and inferior to the
parietal peritoneum
 It contacts the anterior walls of the uterus and
vagina in the female, and lies posteriorly against the
rectum in the male
 The openings for the ureters is the area of trigone
 It has four layers: inner mucous coat, a submucous
coat, a muscular coat, and an outer serous coat
 Smooth muscle fibers comprise the detrusor muscle
which is the muscle of the bladder wall

Bueno, Maybeline
 Urethra Developmental Abnormalities of the Urinary System
 The urethra is a tube that conveys urine from the  Crossed fused ectopia
urinary bladder to the outside of the body - Fused kidneys that lie on one side of the midline
 Its wall is lined with a mucous membrane and it has  Horseshoe kidney
a thick layer of longitudinal smooth muscle fibers ? - Fusion of kidneys at one pole, usually lower, with
 In a female: most of each kidney on opposing side of midline
- It is about 4 centimeters long  Nephrotic syndrome
- It runs obliquely - Proteinuria (protein in urine) due to abnormal
 In a male: glomeruli
- It is about 17.5 centimeters long  Oligomeganephronia
- It has a dual function for both urination and - Reduced number of nephrons that are abnormally
reproduction large
- It has three sections:  Polycystic kidney
o Prostatic urethra - Cysts form in renal tubules and/or collecting
o Membranous urethra disease ducts
o Penile urethra 55  Renal agenesis
- Absence of a kidney
 Renal dysplasia
- Abnormal kidney structure
 Renal hypoplasia
- Small kidney with fewer nephrons, but
development normal
 Tubular dysgenesis
- Abnormal formation of proximal tubules
 Vesicoureteral reflux
- Urine backs up from bladder to ureter or kidney
Lifespan Changes
 The urinary system is sufficiently redundant, in both
Micturition structure and function, to mask age-related changes
Urine leaves the urinary bladder by micturition or  The kidneys become slower to remove nitrogenous
urination reflex wastes and toxins and to compensate for changes
Major events of Micturition that maintain homeostasis
1. Urinary bladder distends as It fills with urine.  Changes include:
2. Stretch receptors in the bladder wall are stimulated, o The kidneys appear scarred and grainy
and they signal the micturition center in the sacral o Kidney cells die
spinal cord. o By age 80 the kidneys have lost a third of their
3. Parasympathetic nerve impulses travel to the mass
detrusor muscle, which responds by contracting o Kidney shrinkage is due to loss of glomeruli
rhythmically. o Proteinuria may develop
4. The need to urinate is urgent. o The renal tubules thicken
5. Voluntary contraction of the external urethral o It is harder for the kidneys to clear certain
sphincter and inhibition of the micturition reflex by substances
impulses from the brainstem and the cerebral o The bladder, ureters, and urethra lose elasticity
cortex prevent urination o The bladder holds less urine
6. Following the decision to urinate, the external
urethral sphincter is relaxed, and impulses from the
pons and the hypothalamus facilitate the
micturition reflex.
7. The detrusor muscle contracts, and urine is expelled
through the urethra
8. Neurons of the micturition reflex center fatique, the
detrusor muscle relaxes, and the bladder begins to
fill with urine again.

Bueno, Maybeline