anatomy & physiology slides

Nursing Review of Anatomy and

PhysiologyReview for Philippine

Nursing Licensure Examination

Outline of Selected Topics in Anatomy and Physiology The Cell Integumentary Musculoskeletal Nervous Endocrine Cardiovascular and Hematologic Gastrointestinal Urinary/Fluids and Electrolytes Reproductive

The Cell

Basic Structural and Functional Unit of the body

Functions of the Cell1. Basic unit of life2. Protection and support3. Movement4. Communication5. Cell metabolism and energy release6. Inheritance

The Cell

Composed of the Cytoplasm, Cell Membrane, the organelles, the nucleus and the inclusions

The Cell The cytoplasm is the viscous,

translucent, watery material where the organelles are located

The Cell The Cell membrane is a semi-

permeable membrane that serves as the boundary separating the cellular structures from the external environment

The cell membrane

Selectively permeableBi-lipid layersFunctions to regulate

passage of substances

The cell membrane Phagocytosis- cell eating Pinocytosis- cell drinking Endocytosis- cell engulfment Exocytosis- cell excretion

Cell connections

Tight junction= binds adjacent cell together and form permeability barrier, which regulates what material crosses

Desmosome= mechanical link that functions to bind cell to one another

Hemidesmosomes= anchor the cell to the basement membrane

Gap junction= small channel that allows molecules and ions to pass from one another

The cellular organellesThese are the cellular metabolic

units with specific functions to maintain the life of the cell

These include the mitochondrion, endoplasmic reticulum, ribosome, golgi apparatus, lysosomes, peroxisomes, cytoskeleton and centrosomes

The mitochondrion The POWERHOUSE of the cell Contains enzymes and the complexes

responsible for the production of the ATP Also contains mitochondrial DNA Metabolic processes occurring in this

organelle include – Kreb’s cycle, beta-oxidation of fats, urea cycle, heme synthesis

This organelle is maternally inherited

The endoplasmic reticulum An extensive network of membrane-

enclosed tubules There are two types- Rough and Smooth

endoplasmic reticulum Rough endoplasmic reticulum is covered

with ribosomes site of protein synthesis Smooth endoplasmic reticulum has no

ribosome site of lipid synthesis

RibosomeTogether with the endoplasmic

reticulum is the site of protein synthesis

Maybe found in the cytoplasm and in the mitochondria

They may be free or attached to the endoplasmic reticulum

Golgi ApparatusThis organelle modifies, concentrates

and packages proteinsThis also packages enzymes into

lysozomesProteins and enzymes usually are

transported from the rough endoplasmic reticulum to the golgi apparatus

The lysosomesThese are membrane-limited

digestive bodies that contain enzymes that break down foreign or damaged materials

The enzymes digest all materials brought in by phagocytosis

The peroxisomesSimilar to lysosomes, these are

membrane-bound sacs containing oxidases (not found in the lysosomes)

Oxidases are enzymes capable of reducing oxygen to hydrogen peroxide

The cytoskeletonA series of tubules and rods that

runs through the cytoplasm supporting the cellular structures

This is also responsible for cellular movements

The centrosomesThis contains the centrioles

short cylinders adjacent to the nucleus responsible for cellular division

The cellular inclusionsThese are non-functional units

made up of chemical substancesThese may or may not be present

in all cellsExamples are pigments, granules,

and fat globules

Cilia and FlagellaCilia are short, hair-like extensions

that occur in large numbers on the outer surface of the cell

Flagella are long projections formed by centrioles that propel the cell

The Nucleus The central control of the cell Controls cell growth, metabolisms and

reproduction Contains DNA Contains chromosomes DNA +

proteins appearing as granules in the non-dividing cell

Genes segments of chromosomes

Cell Division

Formation of two daughter cell from a single parent cell.

a. Mitosis – formation of new cell necessary for growth and tissue repair.

b. Meosis – formation of sex cell necessary for the reproduction.

Cellular division Two types- Mitosis and Meiosis Mitosis- equal division of materials

which yields two exact duplicates of the original cell

The diploid number (46) of chromosomes is maintained

All of the body cells undergo mitosis except the gametes or sex cells

Mitosis

All body cell undergo mitosis except sex cell. There are two step in mitosis:

a. Genetic material within the cell is replicated.

b. Cell divided to form two daughter with same amount and type of DNA.

The cellular division Five steps of cellular division I-P-M-A-T Interphase- inactive or resting state Prophase-Chromatin coils to form

chromosomes, centrioles begin to assemble

Metaphase-chromosomes line the equator, and they split lengthwise

Anaphase-Chromatids separate and move to the opposite poles

Telophase-chromosomes uncoil and nucleoli reappear

INTERPHASE – time between cell division during which DNA replicate. DNA strand separate where old strand joined with new strand of DNA to form two new DNA molecule.

Four stage of Mitosis1. Prophase – chromatin condensed into chromosome.

Chromosome consist of two chromatin join by centromere.

Centriole move to opposite pole. Nucleus and nuclear envelope disappear.2. Metaphase – chromosome aligned at the center, w/

spindle fiber.3. Anaphase – chromatin separate to form two sets of

identified chromosome. Chromosome assisted by spindle fiber.

4. Telophase – chromosome disperse. Nuclear membrane and nucleolus

formed. Cytoplasm divided into two cell.

Differentiation – process by which cell develop with specialized function.

Egg and sperm cell formed single cell during fertilization divided by mitosis to form two cell then become four cell and so forth which differentiate, give rise to different cell. E.g. bone cell, muscle cell

The cellular divisionMeiosis is a reduction division

occurring in the sex cellsSex cells have only one pair of

chromosomes (23)haploid number

Cell Physiology

DIFFUSIONThe movement of SOLUTES or

particles in a solution from a higher concentration to a lower concentration

This is a passive process, no energy is required

OSMOSISThe movement of solvent or water

from a diluted solution into a more concentrated solution through a semi-permeable membrane

The pressure that draws water inside the vessel which is more concentrated is called Osmotic pressure

FiltrationIf a sugar is placed in plain water,

the glucose molecules will dissolve and distribute in the solution

Factors that affect diffusion-concentration gradient, particle size, solubility and temperature

Special osmosis

A special type of osmotic pressure is exerted by the proteins in the plasma. It is called ONCOTIC PRESSURE

FILTRATIONThe movement of both solute

and solvent by hydrostatic pressure, i.e., from an area of a higher pressure to an area of a lower pressure

An example of this process is urine formation

Hydrostatic pressureHydrostatic pressure is the

pressure exerted by the fluid against the container

Increased hydrostatic pressure is one mechanism producing edema

Active transportThis is the movement of solutes

across a membrane from a lower concentration to a higher concentration with utilization of energy

Example is the Sodium-Potassium pump, Endocytosis and Exocytosis

Tissue Group of cells with similar structure and

function

There are four (4) Basic types1. Epithelial2. Connective3. Muscle 4. Nervous

BODY TISSUES

EpitheliumLining, covering and glandular

tissues of the bodyThe functions are to protect,

absorb, filtrate and secrete substances

Epithelial tissuesSimple epitheliumLined by ONE Layer of cell

Stratified epitheliumLined by many layers of cells

Epithelial tissuesSimple epithelia1. Simple squamos- alveoli, BV2. Simple cuboidal- glands3. Simple columnar- GI tract4. Pseudo stratified epithelium-

bronchial lining

Epithelial tissuesStratified epithelium1. Stratified Squamos- skin2. Stratified cuboidal-

reproductive duct3. Transitional epithelium-

bladder and ureter

Connective tissues Bone Cartilage Muscle Blood Blood vessels Adipose tissue

The Integumentary System The largest body system Includes the skin and

accessory structures like the hair, nails, and glands

Function: Protection of body structures and regulation of body temperature

The Skin as first line protection The skin seals off the

body from the immediate environment

There are three layers of the skin: Epidermis, dermis, and hypodermis.

Skin cells There are many other cells aside

from the keratinized squamos cells of the skin.

Melanocytes produce pigment melanin.

Langerhan’s cells participates in the immune system.

Histiocytes are specialized macrophages

Skin as temperature regulator Abundant nerves, blood

vessels and glands are within the skin’s deeper layer

They aid in temperature regulation

Blood vessels constrict or dilate depending on the temperature

Skin functions Sweat glands produce sweat

to control temperature by evaporation

The piloerector (arrector pili) muscles will contract to raise the hairs to trap the heat

Other skin functions Vitamin D synthesis

7-dehydrocholesterolCholecalciferol (D3)

Route of excretion Insensible fluid loss of about 500

ml/day Sweat contains water,

electrolytes, urea and lactic acid

Other skin functions Skin and mucus membrane are

the first line defense of the body in immunity

Skin has receptors for pain, cold, pressure and heat.

The Skin layers: EPIDERMIS The outermost layer with

stratified squamos epithelium Varies in thickness depending

on the body part Thinnest in the eyelids and

thickest in the soles and palms

EPIDERMIS The layers are- C-L-G-S-B The outermost layer is the

stratum corneum with keratin The stratum basale is the layer

which regenerates/replaces new skin cells

Melanocytes in the skin produce melanin

The Skin layers: DERMIS The second layer- cutis vera Is flexible and elastic Two layers- papillary and

reticular Contains blood vessels,

lymphatic vessels, nerves and appendages

The Skin layers: DERMIS The connective tissues in the

dermis contain collagen (gives its strength) elastin (gives its flexibility) and reticular fibers (connect

collagen and elastin)

The Skin layers: Hypodermis This is the subcutaneous tissue

Not strictly a part of the skin

Functions to insulate the body to conserve heat

Hypodermis Serves as the energy storage and mechanical shock absorber

With little vascular supply and scant nerve supply

The Skin appendages Hairs- long shafts composed of

keratin. Expanded lower end is called hair bulb or root. There are extensive nerve and blood supply in the hair bulbs

Nails-flattened structure of specialized type of keratinized surface. The visible part is the nail body.

Fig. 5.5

Appendages Sebaceous glands-glands which

produces an oily material called sebum, found in all body parts except the palms and soles.

Sweat glands or sudoriferous glandsglands which secrete sweat, found in all body parts except in the nipples. Two types exist- Eccrine and Apocrine

Fig. 5.6

The Musculoskeletal SystemThe Musculoskeletal System

This system consists of the This system consists of the muscles, tendons, ligaments, muscles, tendons, ligaments, bones, cartilage, joints, and bones, cartilage, joints, and bursaebursae

The Musculoskeletal SystemThe Musculoskeletal System

Functions:Functions:• Locomotion and protection Locomotion and protection • blood production in the bone blood production in the bone

marrowmarrow• heat generation,heat generation,• maintenance of posture andmaintenance of posture and• storage of mineralsstorage of minerals

The MusclesThe MusclesThree types of muscles exist Three types of muscles exist in our bodyin our body

Voluntary skeletal muscleVoluntary skeletal muscle Involuntary cardiac muscleInvoluntary cardiac muscle Involuntary visceral Involuntary visceral

smooth musclesmooth muscle

The MusclesThe Muscles

Muscles are Muscles are composed of composed of muscle muscle fibersfibers having having numerous numerous nuclei and nuclei and striationsstriations

Properties of MusclesProperties of Muscles Electrical excitabilityElectrical excitability

• Ability to contract to certain stimuliAbility to contract to certain stimuli ContractilityContractility

• Ability to contract forcefully when Ability to contract forcefully when stimulatedstimulated

ExtensibilityExtensibility• Ability to stretch without being Ability to stretch without being

damageddamaged ElasticityElasticity

• Ability to return to its original length Ability to return to its original length and shapeand shape

Muscle PhysiologyMuscle Physiology

Muscle fibers are enclosed Muscle fibers are enclosed sheaths- perimysium, epimysium sheaths- perimysium, epimysium and endomysiumand endomysium

Each muscle cell has actin and Each muscle cell has actin and myosin filaments arranged in a myosin filaments arranged in a sarcomeresarcomere

This sarcomere is the basic This sarcomere is the basic structural unit of the musclestructural unit of the muscle


Muscle contraction occurs as actin Muscle contraction occurs as actin and myosin slide past one another and myosin slide past one another causing the sarcomeres to shortencausing the sarcomeres to shorten

Calcium ion is released by the Calcium ion is released by the muscle endoplasmic reticulum to muscle endoplasmic reticulum to initiate contractioninitiate contraction

ATP is used both for muscle ATP is used both for muscle contraction and muscle relaxationcontraction and muscle relaxation

Fig. 7.5aFig. 7.5a

Fig. 7.6Fig. 7.6

Fig. 7.7aFig. 7.7a

Fig. 7.7bFig. 7.7b


Muscle contraction can be of two typesMuscle contraction can be of two types 1. ISOMETRIC- 1. ISOMETRIC- isoiso= same, = same,

metric=distance: The length of the metric=distance: The length of the muscle does not change, but the muscle does not change, but the tension increasestension increases

2. ISOTONIC- 2. ISOTONIC- isoiso=same, tonus=tone: =same, tonus=tone: The amount of muscle tension is The amount of muscle tension is constant but the length of the constant but the length of the muscle varies muscle varies

Muscle PhysiologyMuscle Physiology Muscle tone= refers to the constant Muscle tone= refers to the constant

tension produced by muscles of the tension produced by muscles of the body for long periods of timebody for long periods of time

FAST-twitch muscles= contract FAST-twitch muscles= contract quickly and fatigue quicklyquickly and fatigue quickly

SLOW-twitch muscles=contract slowly SLOW-twitch muscles=contract slowly and are more resistant to fatigueand are more resistant to fatigue


Smooth Muscle= is not striated, Smooth Muscle= is not striated, contracts more slowly, is contracts more slowly, is autorhythmicautorhythmic and under and under involuntary controlinvoluntary control

Cardiac muscle- is striated, is Cardiac muscle- is striated, is autorhythmicautorhythmic, and under , and under involuntary controlinvoluntary control

MUSCLE and JOINT MUSCLE and JOINT MOVEMENTSMOVEMENTS

Flexion- decreasing the angle Flexion- decreasing the angle between two jointsbetween two joints

Extension- increasing the angle Extension- increasing the angle between two jointsbetween two joints

Abduction- movement of the limb Abduction- movement of the limb away from the midlineaway from the midline

Adduction- movement of the limb Adduction- movement of the limb towards the midlinetowards the midline


Internal rotation- moving the body Internal rotation- moving the body part inward towards the midlinepart inward towards the midline

External rotation- moving the body External rotation- moving the body part outward away from the midlinepart outward away from the midline

Supination- turning a body part Supination- turning a body part upwardupward

Pronation- turning a body part Pronation- turning a body part downwarddownward


Inversion- turning the foot inwardInversion- turning the foot inward Eversion- turning the foot outwardEversion- turning the foot outward Retraction- moving a body part Retraction- moving a body part

backwardbackward Protraction- moving a body aprt Protraction- moving a body aprt

forwardforward

Muscles of the faceMuscles of the face

1. Frontalis1. Frontalis 2. Orbicularis oculi2. Orbicularis oculi 3. orbicularis oris3. orbicularis oris 4. Buccinator4. Buccinator 5. Zygomaticus5. Zygomaticus

Facial Nerve innervationFacial Nerve innervation

Muscles of MasticationMuscles of Mastication

11. Masseter. Masseter 2. Temporalis2. Temporalis 3. Pterygoid muscles3. Pterygoid muscles

Innervated by TRIGEMINAL Innervated by TRIGEMINAL NERVENERVE

Muscles of the neckMuscles of the neck 1. Platysma1. Platysma 2. Sternocleidomastoid2. Sternocleidomastoid

Muscle of the upper limbMuscle of the upper limb 1. Biceps1. Biceps 2. triceps2. triceps 3. deltoid3. deltoid

Muscles of the lower limbMuscles of the lower limb 1. Hamstring muscles1. Hamstring muscles 2. Quadriceps2. Quadriceps 3. Gluteal muscles3. Gluteal muscles 4. calf muscles4. calf muscles

TENDONSTENDONS These are bands of fibrous These are bands of fibrous

connective tissue that attach connective tissue that attach muscles to bonesmuscles to bones

LIGAMENTSLIGAMENTS These are dense, strong, flexible These are dense, strong, flexible

bands of fibrous connective tissue bands of fibrous connective tissue that bind bones to other bonesthat bind bones to other bones

BONESBONES Bone is a living growing tissue made Bone is a living growing tissue made

of porous mineralized structure.of porous mineralized structure. The human skeleton contains 206 The human skeleton contains 206

bonesbones Axial bones are bones on the midline Axial bones are bones on the midline

like the vertebrae, skull, facial bones, like the vertebrae, skull, facial bones, ribs and sternumribs and sternum

Appendicular bones include the Appendicular bones include the scapulae, bones of the arms and legsscapulae, bones of the arms and legs

Classification of BonesClassification of Bones Long bones- - These bones have a shaft Long bones- - These bones have a shaft

and ends. Ex: tibia, humerus, femurand ends. Ex: tibia, humerus, femur Short bones- Small and cubical shaped- Short bones- Small and cubical shaped-

Ex: carpals and tarsalsEx: carpals and tarsals Irregular bones- vertebrae, mandibleIrregular bones- vertebrae, mandible Sesamoid bonesbones embedded in the Sesamoid bonesbones embedded in the

tendons. Ex:patellatendons. Ex:patella Flat bones- with spongy bones inside. Ex: Flat bones- with spongy bones inside. Ex:

scapulae, ribs, claviclescapulae, ribs, clavicle

Structure of the boneStructure of the bone Long bones have a diaphysis Long bones have a diaphysis

( shaft) and epiphysis (ends)( shaft) and epiphysis (ends) Bones consist of layers of calcified Bones consist of layers of calcified

matrix occupied by bone cells.matrix occupied by bone cells. The outer layer of bone is The outer layer of bone is

composed of dense compact bone composed of dense compact bone (cortical bone)(cortical bone)

The inner layer is composed of The inner layer is composed of spongy cancellous bonesspongy cancellous bones

Bone StructureBone Structure Blood supply of bones reaches by Blood supply of bones reaches by

way of arterioles in the haversian way of arterioles in the haversian canal, through the vessels in the canal, through the vessels in the Volkmann's canalVolkmann's canal

Bone formation can be from the Bone formation can be from the cartilage and from the membranecartilage and from the membrane

Bone StructureBone Structure OSTEOBLAST- bone cell responsible OSTEOBLAST- bone cell responsible

for bone formation and calcificationfor bone formation and calcification

OSTEOCLAST- bone cell responsible OSTEOCLAST- bone cell responsible for bone resorption and destructionfor bone resorption and destruction

Bone OssificationBone Ossification

Ossification is the formation of Ossification is the formation of bone by the osteoblasts. This bone by the osteoblasts. This involves the mineralization of involves the mineralization of bones from a cartilage bones from a cartilage (endochondral) and from a (endochondral) and from a membrane (membranousmembrane (membranous).).

Fig. 6.5aFig. 6.5a

Fig. 6.6Fig. 6.6

Bone RemodelingBone Remodeling

Bone remodeling involves the Bone remodeling involves the removal of old bones by cells removal of old bones by cells called osteoclasts and deposition called osteoclasts and deposition of new bones by the osteoblasts. of new bones by the osteoblasts.

Bone is the major storage of Bone is the major storage of calciumcalcium

If calcium levels in the blood falls, If calcium levels in the blood falls, it is removed from the bone it is removed from the bone

Bone repairBone repair When a bone is broken, blood vessels are When a bone is broken, blood vessels are

also damagedalso damaged clot clot 2-3 days after injury, blood vessels and 2-3 days after injury, blood vessels and

cells invade the blood clotcells invade the blood clot callus callus formationformation

Osteoblasts enter the callus and begin to Osteoblasts enter the callus and begin to form a spongy boneform a spongy bone

Immobilization of the bone is required Immobilization of the bone is required because the delicate new matrix of bone is because the delicate new matrix of bone is easily damaged by excessive movementeasily damaged by excessive movement

Fig. 6.8Fig. 6.8

The SkullThe Skull Skeleton of the headSkeleton of the head Made of 21 bonesMade of 21 bones Cranial bones Cranial bones

• FrontalFrontal• ParietalParietal• TemporalTemporal• occipitaloccipital

The SkullThe Skull Facial bonesFacial bones

• MaxillaMaxilla• MandibleMandible• ZygomaZygoma• NasalNasal• VomerVomer• PalatinePalatine

The paranasal sinusesThe paranasal sinuses

These are air-filled cavities in the These are air-filled cavities in the facial bones surrounding the nose facial bones surrounding the nose and open into the nasal cavityand open into the nasal cavity

They decrease the weight of the They decrease the weight of the skull and act as resonator of skull and act as resonator of soundssounds

Frontal, maxillary, ethmoid and Frontal, maxillary, ethmoid and sphenoidsphenoid

The VertebraeThe Vertebrae

Composed of 32-33 bonesComposed of 32-33 bones 7 cervical7 cervical 12 thoracic12 thoracic 5 lumbar 5 lumbar 5 sacral5 sacral 3-4 coccygeal3-4 coccygeal

Functions of the vertebraeFunctions of the vertebrae 1. Supports the weight of the head 1. Supports the weight of the head

and trunkand trunk 2. Protects the spinal cord2. Protects the spinal cord 3. Allows spinal nerves to exit the 3. Allows spinal nerves to exit the

spinal cordspinal cord 4. Provides a site for muscle 4. Provides a site for muscle

attachmentattachment 5. Permits the movement of the head 5. Permits the movement of the head

and trunkand trunk

The Cervical VertebraeThe Cervical Vertebrae 7 in number7 in number C1- atlas C1- atlas C2- axisC2- axis C7- cervical prominenceC7- cervical prominence Atlas and occipital bone=Atlas and occipital bone= “ “yes” motionyes” motion Atlas and Axis=Atlas and Axis= “ “no” motionno” motion

The ThoraxThe Thorax Made up of the sternum and ribsMade up of the sternum and ribs The sternum has 3 partsThe sternum has 3 parts

• ManubriumManubrium• BodyBody• Xiphoid processXiphoid process• The slight elevation in the sternum is The slight elevation in the sternum is

called the called the Sternal Angle of LouisSternal Angle of Louis. It . It identifies the location of the second ribidentifies the location of the second rib

The RibsThe Ribs

The ribs are 12 pairsThe ribs are 12 pairs•True ribs= 1-7True ribs= 1-7•False ribs= 8-10False ribs= 8-10•Floating ribs=11-12Floating ribs=11-12

The shoulder The shoulder The clavicle and scapulae constitute the The clavicle and scapulae constitute the

shouldershoulder The clavicleThe clavicle

• Articulates with the sternumArticulates with the sternum• Most commonly fracture boneMost commonly fracture bone

The ScapulaeThe Scapulae• Attached to the ribs and vertebrae by Attached to the ribs and vertebrae by

muscles onlymuscles only• Has an acromion process, where the Has an acromion process, where the

clavicle attachesclavicle attaches

The Upper extremityThe Upper extremity

Composed of the following bonesComposed of the following bones HumerusHumerus UlnaUlna RadiusRadius Carpals (wrist bones)Carpals (wrist bones) MetacarpalsMetacarpals PhalangesPhalanges

The pelvic girdleThe pelvic girdle Composed of Composed of

the 3 fused the 3 fused bones- pubis, bones- pubis, ilium and ilium and ischiumischium

Constitute the Constitute the hip bonehip bone

The pelvic girdleThe pelvic girdle Female pelvis has the following Female pelvis has the following

structure: The pelvic inlet is structure: The pelvic inlet is large/oval, symphysis is shallow. large/oval, symphysis is shallow. obturator foramen is oval or obturator foramen is oval or triangular, sacrum is broadertriangular, sacrum is broader

The male pelvis has the following: The male pelvis has the following: The pelvic inlet is small/round to The pelvic inlet is small/round to heart-shape, symphysis is deep. heart-shape, symphysis is deep. Obturator foramen is roundObturator foramen is round

Fig. 6.32Fig. 6.32

The Lower extremity bonesThe Lower extremity bones

Composed of the Composed of the Thigh bones- femurThigh bones- femur The leg bones- Tibia and FibulaThe leg bones- Tibia and Fibula The ankle- tarsal bonesThe ankle- tarsal bones The foot- metatarsal bonesThe foot- metatarsal bones

CARTILAGECARTILAGE A dense connective tissue that A dense connective tissue that

consists of fibers embedded in a consists of fibers embedded in a strong, gel-like substance.strong, gel-like substance.

Cartilage supports and shapes Cartilage supports and shapes various structures such as the ear various structures such as the ear pinna, intervertebral disks, ear pinna, intervertebral disks, ear canal, larynx, etc.canal, larynx, etc.

It serves as cushion and shock It serves as cushion and shock absorberabsorber

Types of CartilageTypes of Cartilage

Fibrous cartilageFibrous cartilage•Found in the intervertebral disksFound in the intervertebral disks

Hyaline cartilageHyaline cartilage•Found in the symphisis, the Found in the symphisis, the

thyroid cartilagethyroid cartilage Elastic cartilageElastic cartilage

•Found in the ears, the epiglottisFound in the ears, the epiglottis

Fig. 6.39aFig. 6.39a

Fig. 6.39bFig. 6.39b

Fig. 6.40aFig. 6.40a

Fig. 6.40bFig. 6.40b

Fig. 6.40cFig. 6.40c

JointsJoints These are point of attachment or These are point of attachment or

contact between two bones contact between two bones Variously classified according to its Variously classified according to its

movement and flexibilitymovement and flexibility Fibrous joints-Fibrous joints- with fibrous tissue with fibrous tissue

with little or no movementwith little or no movement Cartilaginous joints-Cartilaginous joints- with cartilage with cartilage Synovial joints-Synovial joints- with capsule; freely with capsule; freely

movable jointsmovable joints

Synovial jointsSynovial joints

Freely movable jointsFreely movable joints With joint cavity/capsuleWith joint cavity/capsule Articular surfaceArticular surface Synovial membrane Synovial membrane Synovial fluidSynovial fluid


Plane joint- intercarpal joint of Plane joint- intercarpal joint of wristwrist

Hinge joint- elbow and ankleHinge joint- elbow and ankle Pivot- atlas and axisPivot- atlas and axis Condyloid- “egg-shape” Condyloid- “egg-shape”

metacarpophalengeal jointmetacarpophalengeal joint


Saddle joint- joint of the Saddle joint- joint of the thumbthumb

Ball and socket- hip jointBall and socket- hip joint

BursaeBursae Small synovial fluid sacs Small synovial fluid sacs

located at friction points located at friction points around joints, between around joints, between tendons, ligaments and bonestendons, ligaments and bones

Act as cushions, decrease Act as cushions, decrease stress on adjacent structurestress on adjacent structure

The Nervous SystemThe Nervous System

•The nervous system coordinates The nervous system coordinates all body functions, enabling a all body functions, enabling a person to adapt to changes in person to adapt to changes in internal and external environmentinternal and external environment

•The nervous system is composed The nervous system is composed mainly of the nerve cells (neurons) mainly of the nerve cells (neurons) and supporting cells (neuroglia)and supporting cells (neuroglia)

The neuronThe neuron•This is the basic conducting This is the basic conducting

cell of the nervous systemcell of the nervous system•Highly specialized but Highly specialized but

cannot reproduce itselfcannot reproduce itself•Main parts are the cell Main parts are the cell

body (soma), the fibers: body (soma), the fibers: axon and dendrites.axon and dendrites.

The neuronThe neuron•The axon is a long process with The axon is a long process with

myelin sheath. This conducts myelin sheath. This conducts impulses away from the cell impulses away from the cell bodybody

•The dendrites are short, thick, The dendrites are short, thick, diffuse branching processes that diffuse branching processes that receive impulses and conduct receive impulses and conduct them towards the cell bodythem towards the cell body

The neurogliaThe neuroglia•The supporting cellsThe supporting cells•They supply nutrients to the They supply nutrients to the

neurons and help maintain the neurons and help maintain the electrical potentialelectrical potential

•They also form part of the They also form part of the blood-brain barrierblood-brain barrier

The neurogliaThe neuroglia•Oligodendrocytes produce Oligodendrocytes produce

myelin sheath in the CNmyelin sheath in the CN•Schwann cells produce Schwann cells produce

myelin sheath in the myelin sheath in the peripheral NSperipheral NS

The Organization of the The Organization of the Nervous Nervous SystemSystem•The nervous system is divided The nervous system is divided

functionally and structurally into 2 functionally and structurally into 2 partsparts

•1. Central Nervous System- the 1. Central Nervous System- the Brain and the spinal cordBrain and the spinal cord

•2. Peripheral Nervous System- the 2. Peripheral Nervous System- the cranial nerves and spinal nervescranial nerves and spinal nerves

The Organization of the The Organization of the nervous nervous SystemSystemThe Peripheral Nervous System is further The Peripheral Nervous System is further

classified into THREE Functional classified into THREE Functional DivisionsDivisions

1. The Somatic Nervous System- controls 1. The Somatic Nervous System- controls the skeletal musclesthe skeletal muscles

2. The Autonomic Nervous System- 2. The Autonomic Nervous System- controls the visceral organscontrols the visceral organs

3. The Enteric Nervous System- controls 3. The Enteric Nervous System- controls the functions of the GITthe functions of the GIT

The Central Nervous SystemThe Central Nervous SystemComposed of the brainComposed of the brain•The brain consists of the gross The brain consists of the gross

structures: cerebrum, cerebellum, structures: cerebrum, cerebellum, brainstem and the diencephalon.brainstem and the diencephalon.

•Diencephalon- Thalamus. Diencephalon- Thalamus. Hypothalamus and pineal bodyHypothalamus and pineal body

•Brainstem- Pons, medulla and MidbrainBrainstem- Pons, medulla and Midbrain

Fig. 8.23Fig. 8.23

The CerebrumThe Cerebrum•This is the largest part of the brainThis is the largest part of the brain•Consists of right and left hemisphere Consists of right and left hemisphere

connected by the corpus callosumconnected by the corpus callosum•Each cerebral hemisphere is Each cerebral hemisphere is

composed of different lobes- frontal, composed of different lobes- frontal, temporal, parietal and occipitaltemporal, parietal and occipital

•Embedded in the cerebrum is the Embedded in the cerebrum is the BASAL gangliaBASAL ganglia

The Frontal Lobe of the The Frontal Lobe of the cerebrumcerebrum• Influences the personality of the Influences the personality of the

personperson•Also responsible for judgment, Also responsible for judgment,

abstract reasoning, social abstract reasoning, social behavior, language expression behavior, language expression and motor movement.and motor movement.

The Temporal lobe of the The Temporal lobe of the CerebrumCerebrum• This part of the cerebrum controls the This part of the cerebrum controls the

hearing, language comprehension, hearing, language comprehension, storage and recall of memoriesstorage and recall of memories

• The LIMBIC system is deeply located The LIMBIC system is deeply located in the temporal lobe. This controls in the temporal lobe. This controls the basic drives such as hunger, the basic drives such as hunger, anger, emotion and sexual drive.anger, emotion and sexual drive.

The Parietal lobe of the The Parietal lobe of the cerebrumcerebrum• This is the principal center for This is the principal center for

the reception and interpretation the reception and interpretation of Sensationof Sensation

• This part interprets and This part interprets and integrates the sensory inputs integrates the sensory inputs like touch, temperature and painlike touch, temperature and pain

• It interprets size, shape, It interprets size, shape, distance and texturedistance and texture

The occipital lobe of the The occipital lobe of the cerebrumcerebrum•This functions mainly to interpret This functions mainly to interpret

visual stimulivisual stimuli

Speech areas in the Speech areas in the cerebrumcerebrum•1. Wernicke’s area- responsible 1. Wernicke’s area- responsible

for the sensory reception of for the sensory reception of speech. speech.

•2.Broca’s Area- responsible for 2.Broca’s Area- responsible for the motor speechthe motor speech

Fig. 8.28Fig. 8.28

The CerebellumThe Cerebellum•The second largest brain regionThe second largest brain region•Has also two hemispheresHas also two hemispheres•Functions to maintain muscle tone, Functions to maintain muscle tone,

coordinate muscle movement, posture coordinate muscle movement, posture and control balance/equilibriumand control balance/equilibrium

• If this is damaged, muscle tone If this is damaged, muscle tone decreases and fine motor movements decreases and fine motor movements become very clumsybecome very clumsy

The BrainstemThe Brainstem•Lies inferior to the cerebrumLies inferior to the cerebrum•Continuous with the cerebrum and the Continuous with the cerebrum and the

spinal cordspinal cord• It is composed of the midbrain, the It is composed of the midbrain, the

pons and the medulla oblongatapons and the medulla oblongata•Functions: houses the center for Functions: houses the center for

respiration and cardiovascular system respiration and cardiovascular system

The MidbrainThe Midbrain

•This connects with the This connects with the cerebrum cerebrum

•Contains numerous ascending Contains numerous ascending and descending tracts and and descending tracts and fibersfibers

The PonsThe Pons

•Connects the cerebellum with Connects the cerebellum with the cerebrumthe cerebrum

•Houses the respiratory center Houses the respiratory center and cardiovascular centerand cardiovascular center

•Exit points for cranial nerves 5, Exit points for cranial nerves 5, 6 and 76 and 7

The Medulla oblongataThe Medulla oblongata•The most inferior portion of the The most inferior portion of the

brainstembrainstem•Serves as the center for autonomic Serves as the center for autonomic

reflexes to maintain homeostasis, reflexes to maintain homeostasis, regulating respiratory vasomotor and regulating respiratory vasomotor and cardiac functionscardiac functions

•Serves as exit of cranial nerves Serves as exit of cranial nerves 9,10,11 and 129,10,11 and 12

The DiencephalonThe Diencephalon•The thalamus and the hypothalamusThe thalamus and the hypothalamus•The thalamus is the relay station of The thalamus is the relay station of

all sensory stimuli towards the brainall sensory stimuli towards the brain•The hypothalamus controls body The hypothalamus controls body

temperature, appetite, water temperature, appetite, water balance, pituitary secretions and balance, pituitary secretions and sleep-wake cyclesleep-wake cycle

The Basal gangliaThe Basal ganglia

Brain circulation: The circle Brain circulation: The circle of Willisof Willis

The spinal cordThe spinal cord•A long cylindrical structure A long cylindrical structure

extending from the foramen extending from the foramen magnum to the L1 in adult, magnum to the L1 in adult, L3/L4 in pediaL3/L4 in pedia

The spinal cordThe spinal cord•In the cross section of the spinal In the cross section of the spinal

cord, we find the GRAY matter- cord, we find the GRAY matter- contains neurons; and WHITE contains neurons; and WHITE matter-consists of nerve fibersmatter-consists of nerve fibers

•There are 31 pairs of spinal There are 31 pairs of spinal nerves that exit the spinal cordnerves that exit the spinal cord

The spinal cordThe spinal cord•Each spinal nerve is formed by the Each spinal nerve is formed by the

dorsal root (sensory) and the ventral dorsal root (sensory) and the ventral root (motor)root (motor)

•Cervical segments= 8 pairsCervical segments= 8 pairs•Thoracic segments=12 pairsThoracic segments=12 pairs•Lumbar= 5 pairsLumbar= 5 pairs•Sacral=5 pairsSacral=5 pairs•Coccygeal=1 pairCoccygeal=1 pair

The MeningesThe Meninges•These are 3 connective tissue layers These are 3 connective tissue layers surrounding the brain and spinal cord.surrounding the brain and spinal cord.

•1. DURA MATER- the superficial, thickest 1. DURA MATER- the superficial, thickest layer. The area above the dura mater is layer. The area above the dura mater is called epidural spacecalled epidural space

•2. ARACHNOID- second layer, thin and wispy.2. ARACHNOID- second layer, thin and wispy.•3. PIA MATER- the deepest layer, adhered to 3. PIA MATER- the deepest layer, adhered to

the brain and spinal cord substancethe brain and spinal cord substance

The MeningesThe Meninges•The space in between the The space in between the arachnoid and pia mater is called arachnoid and pia mater is called the arachnoid spacethe arachnoid space

•This arachnoid space contains the This arachnoid space contains the cerebro-spinal fluid (CSF)cerebro-spinal fluid (CSF)

• In this space, blood vessels are In this space, blood vessels are also foundalso found

The VentriclesThe Ventricles•These are CSF filled cavities in the These are CSF filled cavities in the

brainbrain•The lateral ventricle- found in the The lateral ventricle- found in the

cerebrumcerebrum•The third ventricle- in the center of the The third ventricle- in the center of the

thalamus and hypothalamusthalamus and hypothalamus•The fourth ventricle- located at the The fourth ventricle- located at the

base of the cerebellumbase of the cerebellum

The CSFThe CSF•This is the fluid found inside the This is the fluid found inside the

ventricles that bathe the brain and ventricles that bathe the brain and spinal cordspinal cord

•Function: provides protective cushion Function: provides protective cushion around the CNSaround the CNS

•Produced by the choroid plexus in the Produced by the choroid plexus in the ventriclesventricles

•Absorbed by the arachnoid granulationsAbsorbed by the arachnoid granulations

Tracing the CSF pathwayTracing the CSF pathwayLateral ventricleLateral ventricle

Interventricular foramen of MonroInterventricular foramen of Monro

Third ventricleThird ventricle

Cerebral aqueduct of SylviusCerebral aqueduct of Sylvius

Fourth ventricleFourth ventricle

Exits trough the median foramen of Magendie or the lateral foramen of Exits trough the median foramen of Magendie or the lateral foramen of LusckaLuscka

Subarachnoid spaces in the cisterna magna, spinal cord Subarachnoid spaces in the cisterna magna, spinal cord

subarachnoid space of the brainsubarachnoid space of the brain

superior sagittal sinussuperior sagittal sinus

The cranial nervesThe cranial nerves

•Are 12 pairs of nerves that exit Are 12 pairs of nerves that exit the brainthe brain

•Can be classified asCan be classified as– SensorySensory– MotorMotor– Mixed (sensory and motor)Mixed (sensory and motor)

The Autonomic Nervous The Autonomic Nervous SystemSystem•The part of the peripheral nervous The part of the peripheral nervous

system that innervates cardiac system that innervates cardiac muscles, smooth muscles and muscles, smooth muscles and glandsglands

Functionally divided intoFunctionally divided into•Sympathetic Nervous SystemSympathetic Nervous System•Parasympathetic Nervous SystemParasympathetic Nervous System

The SYMPATHETIC systemThe SYMPATHETIC system•Originates from the T1-L2/L3 Originates from the T1-L2/L3

segments of the spinal cord segments of the spinal cord (thoracolumbar)(thoracolumbar)

•Utilized by the body for FLIGHT and Utilized by the body for FLIGHT and FIGHT responseFIGHT response

•Neurotransmitter agents are Neurotransmitter agents are Epinephrine and Norepinephrine Epinephrine and Norepinephrine (coming from the adrenal gland)(coming from the adrenal gland)

•ADRENERGIC systemADRENERGIC system

Sympathetic responsesSympathetic responses• Increased:Increased:

– HRHR– RRRR– BPBP– Visual Acuity (Pupillary Dilation)Visual Acuity (Pupillary Dilation)– Smooth Muscle toneSmooth Muscle tone sphincters are sphincters are

contractedcontracted– VasoconstrictionVasoconstriction– MetabolismMetabolism ↑ glucose, ↑ fatty acids↑ glucose, ↑ fatty acids

Sympathetic responsesSympathetic responses•DecreasedDecreased

– PeristalsisPeristalsis– Salivary secretionsSalivary secretions

•EjaculationEjaculation

Parasympathetic systemParasympathetic system

• CHOLINERGIC systemCHOLINERGIC system• The vegetative systemThe vegetative system• Feed and Breed responsesFeed and Breed responses• Cranio-sacral locationCranio-sacral location• Cranial nerves- 3, 7, 9, 10 and Cranial nerves- 3, 7, 9, 10 and

S2-S4S2-S4• Neurotransmitter is AcetylcholineNeurotransmitter is Acetylcholine

Parasympathetic responsesParasympathetic responses• IncreasedIncreased

– Gastric secretionsGastric secretions– Salivary secretionsSalivary secretions– peristalsisperistalsis

• Pupillary constrictionPupillary constriction• DecreasedDecreased• Smooth muscle toneSmooth muscle tone sphincters are relaxed sphincters are relaxed• erectionerection

Nerve PhysiologyNerve Physiology•The nerve cells are excitable cellsThe nerve cells are excitable cells•Any stimulus will change the Any stimulus will change the

membrane potential and cause an membrane potential and cause an action potential to generateaction potential to generate impulse impulse transmissiontransmission

•The myelin sheath of the nerve cell is The myelin sheath of the nerve cell is responsible for the SALTATORY responsible for the SALTATORY conductionconduction increases the nerve increases the nerve transmissiontransmission

Fig. 8.11Fig. 8.11

Fig. 8.12Fig. 8.12

The SYNAPSEThe SYNAPSE•This is the region where This is the region where

communication occurs between 2 communication occurs between 2 neurons or between a neuron and neurons or between a neuron and a target cella target cell

•A neurotransmitter is released A neurotransmitter is released from the nerve cell towards the from the nerve cell towards the other cell with receptorother cell with receptor

Fig. 8.13Fig. 8.13

The eye and the visual The eye and the visual pathwaypathway•Vision is made possible by the stimulation Vision is made possible by the stimulation

of the photoreceptor cells in the retinaof the photoreceptor cells in the retina•Receptor cells are the RODS and CONESReceptor cells are the RODS and CONES•The eye is made up of three layersThe eye is made up of three layers

– Fibrous layer- sclerae and corneaFibrous layer- sclerae and cornea– Uvea- choroid and iris and ciliary bodiesUvea- choroid and iris and ciliary bodies– Nervous coat- retinaNervous coat- retina

http://rds.yahoo.com/S=96062883/K=+anatomy+of+the+eye/v=2/SID=w/l=IVI/*-http://individual.utoronto.ca/yousef/images/eye.jpg

Fig. 9.13Fig. 9.13

The optic nerveThe optic nerve

•This is the collection of fibers This is the collection of fibers from the cells in the retinafrom the cells in the retina

•It passes through the It passes through the brainstem as the optic chiasmbrainstem as the optic chiasm

• it will reach the occipital lobe it will reach the occipital lobe for visual interpretationfor visual interpretation

The Vestibular apparatusThe Vestibular apparatus

•This is the part of the ear that This is the part of the ear that helps in equilibriumhelps in equilibrium

•Located in the inner earLocated in the inner ear•The saccule and utricle control The saccule and utricle control

LINEAR motionLINEAR motion•The semicircular ducts control the The semicircular ducts control the

Angular movement/ accelerationAngular movement/ acceleration

The Hearing ApparatusThe Hearing Apparatus

The Olfactory apparatusThe Olfactory apparatus•Consists of the nose and the Consists of the nose and the

olfactory nerveolfactory nerve•Stimulation form the olfactory Stimulation form the olfactory

nerves will reach the limbic nerves will reach the limbic system of the brainsystem of the brain

The Gustatory apparatusThe Gustatory apparatus

•The receptor for taste are The receptor for taste are cells in the tongue group cells in the tongue group together called the taste together called the taste budsbuds

•They are numerous in the They are numerous in the vallate and fungiform vallate and fungiform papillaepapillae

The Gustatory apparatusThe Gustatory apparatus

Basic taste modalitiesBasic taste modalities•Sweet- tip of the tongueSweet- tip of the tongue•Salty- over the dorsum of the Salty- over the dorsum of the

tonguetongue•Sour- sides of the tongueSour- sides of the tongue•Bitter- back of the tongueBitter- back of the tongue

The Endocrine System

This system is made up of widely distributed organs whose secretions (called HORMONES) are poured into the blood to reach the target cells

HormonesThese are chemical substances released

by the glands into the bloodEach hormone will go to the target organ

and binds its receptorTwo types exists:1. Peptides or protein hormones2. Lipid or steroid hormones

The hormonal regulation

There exists an inter-related regulation between the HYPOTHALAMUS, Pituitary and the endocrine gland.

The hormonal regulation

We call it the Hypothalamic-pituitary-endocrine axis

The exception are the pancreas and the parathyroid gland

The endocrine glandsThe pituitary- anterior and posteriorThe pineal glandThe thyroid glandThe parathyroid glandThe adrenal glandThe pancreasThe gonads- testes and ovary

The pituitary gland : anterior lobe

Also called AdenohypophysisHormones produced

– Growth hormone– The stimulating hormones-

ACTH, TSH, FSH and LH– Prolactin

The pituitary gland: posterior lobe

Also called the neurohypophysis This lobe does not secrete hormones but

only stores hormones– Antidiuretic hormone (vasopressin)– Oxytocin

The pineal gland

Also called epiphysis cerebriSecretes melatonin

The thyroid gland

Located in the lower part of the anterior neck

With two lobes connected by the isthmus

The thyroid gland

Secretes thyroxine (T4) and tri-iodothyronine (T3)

The T3 is the most active hormoneFunction of T3/T4: Increase

metabolic rate, essential for normal growth and maturation

The thyroid gland

It also secretes CALCITONINThis is released in response to an

INCREASED calcium level in the bloodFunction: decreases bone resorption

and increases calcium excretion in the kidney to decrease the calcium levels

The parathyroid glands

2 pairs (4) of yellowish glands closely related to the posterior surface of the thyroid gland

Secretes parathyroid hormone (PTH)

The parathyroid glands

Functions of the hormone: – Increases bone breakdown by

osteoclasts– Increases Vitamin D synthesis– Increases Calcium level in the blood– Causes retention of calcium in the kidney

The Adrenal glands

a pair of gland resting on top of each kidney with 2 layers

ADRENAL CORTEX– Secretes mineralocorticoids– Secretes glucocorticoids– Secretes androgens- sex hormones

ADRENAL MEDULLA– Secretes the cathecolamines- Epinephrine, and

norepinephrine

Fig. 10.17

Fig. 10.18

The Adrenal Cortex

Mineralocorticoid- Aldosterone

– Increases sodium retention, water retention secondarily

– Causes excretion of potassium

The Adrenal Cortex

Glucocorticoids- cortisol– Increases fat and protein

breakdown– Increases glucose synthesis– Inhibit inflammation and

immune response

The Adrenal Cortex

Adrenal androgensEstrogens, androgens and

progestinsInsignificant in malesIncrease female sexual drives,

pubic hair and axillary hair growth

The pancreas

The endocrine portion of the pancreas is the ISLETS of LANGERHANS

This islet is composed of three types of cells- alpha, beta and delta

Fig. 10.19

The pancreas

The Alpha cells secrete GLUCAGON

The Beta cells secrete INSULINThe delta cells secrete

SOMATOSTATIN

Pancreatic insulin

Causes Hypoglycemia by two mechanisms:

Glucose breakdown- glycolysisGlycogen production-

glycogenesis

Pancreatic insulin

Needed by most body cells to allow Glucose to enter the cell membrane

The brain cells, intestinal cells, the red blood cells and the islet cells do not need insulin for glucose entry

Pancreatic glucagon

Causes increased level of Glucose by:

Glycogen breakdown- glycogenolysis

Glucose production- glucogenesis

The Gonads : Male- Testes

The testes houses the Interstitial cells of Leydig which secrete ANDROGENS

TestosteroneDehydrotestosteroneAndrosterone

The Androgens

Aid in spermatogenesisMaintain functional reproductive

organsResponsible for secondary sex

characteristicsResponsible for male sexual

drives

The Gonads: Female- Ovary

The Follicular cells of the ovarian follicle secrete ESTROGEN and the corpus luteum secretes PROGESTERONE

The estrogen

Aids in uterine and mammary gland development

Maintains the structure of the external genitalia

Produces the secondary sexual characteristics in female

Maintains normal menstrual cycle

The progesterone

Together with estrogen, maintains normal menstruation

Increases body temperatureDecreases muscle tone and

peristalsisMaintains pregnancy

The CARDIOVASCULAR The CARDIOVASCULAR SYSTEMSYSTEM

The CARDIOVASCULAR SYSTEM

This system is composed of the heart and the blood vessels

The main functions of this system are:to transport oxygen, hormones and

nutrients to the tissues and to transport waste products to

the lungs and kidneys for excretion

The Gross Anatomy of the Heart

The heart is located within the thorax behind the sternum in the compartment called MEDIASTINUM

The heart is commonly described as the size of a clenched fist

The Gross Anatomy of the Heart

The shape is conical, with a base and an apex

The base is directed upwardThe apex is directed downward

to the left at the level of the 5th ICS LMCL

Heart Surface

ANTERIOR SURFACERight ventricle

POSTERIOR SURFACELeft ventricle

The Heart : Anatomy

The heart has three layersThe epicardiumThe myocardiumThe endocardium

The heart is covered by the pericardium with a parietal and visceral layers

The pericardial sac is a potential space in between the two pericardial layers with a minimal (15 cc) fluid

Fig. 12.4

The Heart: Anatomy

The heart has four chambersThe right atriumThe right ventricleThe left atriumThe left ventricle

The Heart: Anatomy

The heart also has four valves that guard the openings in the chambers

The tricuspid valve – between the right atrium and right ventricle

The mitral or bicuspid valve- between the left atrium and left ventricle

The pulmonic valve- between the right ventricle and the pulmonary trunk

The aortic valve- between the left ventricle and the aorta

The Heart: Anatomy

The blood supply of the heart:The coronary arteries are the blood supplyThere are two main coronary arteries- the

right coronary artery and the left coronary artery

The venous drainage of the heart is the coronary sinus; the anterior cardiac vein and the smallest cardiac vein

Blood Supply

Venous Drainage

Coronary sinus will collect all the venous blood from the heart into the RIGHT atrium

The anterior cardiac vein drains NOT into the coronary sinus but DIRECTLY into the right atrium

Circulation

Fig. 12.11

The Heart : Physiology

This consists of The conducting systemThe cardiac cycleThe cardiac output and Blood

pressureThe preload and afterloadThe Starling’s law of the heart

The Heart: Physiology

The conducting system of the heart is a group of specialized heart cells that functions to conduct electrical impulses independent of any nerve supply


The parts of the conducting system of the heart are:

The SA (sino-atrial) nodeThe AV (atrio-ventricualr) nodeThe Bundle of His with its right and

left bundleThe Purkinje fibers


The intrinsic conduction system causes the heart muscle to depolarize in one direction

The rate of depolarization is around 75 beats per minute

The SA node sets the pace of the conduction

This electrical activity is recorded by the Electrocardiogram (ECG)


The cardiac cycle consists of the contraction phase and the relaxation phase in each heartbeat

The SYSTOLE is the contraction phase

The DIASTOLE is the relaxation phase


Heart sounds can be auscultatedS1, S2, S3, and S4S1 is due to the closure of the AV valvesS2 is due to the closure of the semilunar

valvesS3 is due to the rushing of blood through

the AV openingS4 is due to contraction of the atrium


The amount of blood the heart pumps out in each beat is called the STROKE VOLUME

When this volume is multiplied by the number of heart beat in a minute (heart rate), it becomes the CARDIAC OUTPUT

When the Cardiac Output is multiplied by the Total Peripheral Resistance, it becomes the BLOOD PRESSURE


The PRELOAD is the degree of stretching of the heart muscle when it is filled-up with blood

The AFTERLOAD is the resistance to which the heart must pump to eject the blood


Starling’s Law of the Heart states that the force of contraction is proportional to the degree of stretching of the cardiac muscle fibers

As the length of the muscle fiber is stretched, the contractile force increases

But when the maximum length has been reach, any further stretching will impair the contraction

The Blood vessel: Anatomy

This consists of the artery, vein and capillary together with the lymphatic vessels

The ARTERY has thicker wall, deeply located, pulsating, reddish, with abundant smooth muscles and elastic tissues that carries oxygenated blood away from the heart towards the body tissues

The Blood vessel: Anatomy

The VEIN is thin-walled, superficially located, non-pulsating, bluish vessel that carries unoxygenated/deoxygenated blood towards the heart

Arterioles are small arteriesVenules are small veinsCAPILLARIES are diffuse network of thin-

walled tubules that connect arterioles and venules together

The Blood vessel: Physiology

The diameter of the arterioles is the main contributor of the peripheral resistance

In the presence of epinephrine, cold temperature and irritation, the smooth muscles of the blood vessels will contract making the lumen smaller ↑resistance

In the presence of histamine, warm temperature, the vessels will dilate ↓ resistance

Anatomy & PhysiologyTerminologyChronotropic

effect

Dromotropic effect

Inotropic effect

Refers to a change in heart rateA positive chronotropic effect refers to an

increase in heart rateA negative chronotropic effect refers to a

decrease in heart rateRefers to a change in the speed of conduction

through the AV junctionA positive dromotropic effect results in an

increase in AV conduction velocityA negative dromotropic effect results in a

decrease in AV conduction velocityRefers to a change in myocardial contractilityA postive inotropic effect results in an increase in

myocardial contractilityA negative inotropic effect results in a decrease

in myocardial contractility

Basic ElectrophysiologyMyocardial Cell TypesKinds of

Cardiac Cells

Myocardial cells

Specialized cells of the electrical conduction system

Where Found

Myocardium

Electrical conduction system

Primary Function

Contraction and Relaxation

Generation and conduction of electrical impulses

Primary Property

Contractility

AutomaticityConductivity

Systemic circulation

The aorta- leaves the left ventricle to form the ascending aorta, aortic arch, descending aorta, thoracic aorta and abdominal aorta

The Vena cava ( superior and inferior) drains the whole body and returns the blood to the right atrium

Physiology of circulation

Blood pressure is the measure of force exerted by blood against the blood vessel wall

Measured by sphygmomanometerNormally BP is measured as systolic

pressure and diastolic pressurePULSE PRESSURE = SP-DP

Physiology of circulation

Capillary exchangeMost exchange of gas and

substances occur across the wall of the capillary

Usually, the exchange is due to the filtration difference and diffusion

BP regulation

CentralPons and medullaSympathetic nervous system– Increases

heart rate

Parasympathetic nervous system (vagus)– decreases heart rate

BP regulation

BaroreceptorsReceptors sensitive to stretch located

in the carotid sinuses and aortic arch↓ stretch reflex increase in heart rate

↑BP↑ stretch reflex decrease in heart rate

↓BP

BP regulation

HormonalEpinephrine vasoconstriction

increased resistance increased BPAngiotensinogen A1

Angiotensin 2ADH water reabsorption ↑Blood

volume increased BPANF increase sodium excretion

increased urine decreased blood volume decreased BP

blood lung

Fig. 13.22

Fetal circulation

Cardiac assessmentInspectionPalpation of the apical pulse and PMI at

the 5th ICS LMCLAuscultation for the heart sounds

S1 and S2Auscultation for the heart valves

TVMVPVAV

Fig. 13.23

BloodBlood Blood is a special connective tissueBlood is a special connective tissue Total blood volume is about 5 litersTotal blood volume is about 5 liters Blood is composed of two portions:Blood is composed of two portions:1. Formed elements- RBC, WBC, 1. Formed elements- RBC, WBC,

PlateletsPlatelets2. Plasma- the liquid portion2. Plasma- the liquid portion

– Hematocrit is the percentage of RBC Hematocrit is the percentage of RBC per unit volume of bloodper unit volume of blood

Fig. 11.2Fig. 11.2

The RED Blood CellThe RED Blood Cell Non-nucleated cellular element in the Non-nucleated cellular element in the

bloodblood BiconcaveBiconcave Transports Oxygen loosely bound to Transports Oxygen loosely bound to

HemoglobinHemoglobin Red pigment is due to hemoglobinRed pigment is due to hemoglobin Lifespan is 120 daysLifespan is 120 days Reticulocytes are immature RBCReticulocytes are immature RBC

Fig. 11.4Fig. 11.4

The Leukocytes or WBCThe Leukocytes or WBC

Nucleated, larger than Nucleated, larger than the RBCthe RBC

Divided into Divided into Granulocytes and Granulocytes and AgranulocytesAgranulocytes

The Leukocytes or WBCThe Leukocytes or WBC GRANULOCYTESGRANULOCYTES1.1. Neutrophils- most abundant Neutrophils- most abundant

WBC, 60-70%. This is the first WBC, 60-70%. This is the first cell to arrive in cell to arrive in injury/inflammation.injury/inflammation.

Increased in bacterial infectionIncreased in bacterial infection In females, there is the In females, there is the

presence of the Barr bodies, presence of the Barr bodies, the condensed X chromosomethe condensed X chromosome

The WBCThe WBC 2. Eosinophils- cell type that 2. Eosinophils- cell type that

is capable of limited is capable of limited phagocytosis, with granules phagocytosis, with granules containing peroxidase. containing peroxidase. – This is increased during This is increased during

parasitic and allergic reactionsparasitic and allergic reactions

The WBCThe WBC3. Basophils- a WBC that 3. Basophils- a WBC that

is capable of releasing is capable of releasing Histamine, heparin and Histamine, heparin and serotonin during serotonin during anaphylaxis . The rarest anaphylaxis . The rarest type of WBC.type of WBC.

The WBCThe WBCAgranulocytes:Agranulocytes:1. Lymphocyte- second most 1. Lymphocyte- second most

abundant (next to abundant (next to neutrophils)neutrophils)– Found increased in Viral infection Found increased in Viral infection

and chronic infection. This can be:and chronic infection. This can be:– T-lymphocyteT-lymphocyte – B-lymphocyteB-lymphocyte

The WBCThe WBCAgranulocytes:Agranulocytes:

– T-lymphocyteT-lymphocyte- mediator of - mediator of Cellular ImmunityCellular Immunity

– B-lymphocyteB-lymphocyte- mediator of - mediator of Humoral immunityHumoral immunity because this because this cell secretes ANTIBODIES when cell secretes ANTIBODIES when transformed into plasma cells.transformed into plasma cells.

The WBCThe WBC 2. Monocyte- has kidney-shaped 2. Monocyte- has kidney-shaped

nucleus, a very large WBC that nucleus, a very large WBC that stays only for 2-3 days in the stays only for 2-3 days in the circulation. This becomes the circulation. This becomes the MACROPHAGE in the tissues. MACROPHAGE in the tissues.

The PlateletsThe Platelets Also called thrombocytesAlso called thrombocytes Smallest formed element, lifespan is Smallest formed element, lifespan is

8-10 days8-10 days Involves in clot formationInvolves in clot formation Forms the platelet plug in an injured Forms the platelet plug in an injured

vesselvessel Releases chemicals that can cause Releases chemicals that can cause

activation of the clotting mechanismactivation of the clotting mechanism

Table. 11.2Table. 11.2

The Blood groupsThe Blood groups Blood types are grouped into A, B, AB and O Blood types are grouped into A, B, AB and O

based on based on the presence of the antigen on the the presence of the antigen on the surface of the RBCsurface of the RBC

If antigen A is present, then the blood is type AIf antigen A is present, then the blood is type A If antigen B is present, then the blood is type BIf antigen B is present, then the blood is type B If antigen A and antigen B is present, then the If antigen A and antigen B is present, then the

type is ABtype is AB If no antigen is present, then blood type is OIf no antigen is present, then blood type is O

Fig. 11.11Fig. 11.11

The Blood groupsThe Blood groups Blood group A has Antibody B, that Blood group A has Antibody B, that

can react to blood type B and ABcan react to blood type B and AB Blood group B has antibody A, that Blood group B has antibody A, that

can react to blood type A and ABcan react to blood type A and AB Blood group AB has no antibodyBlood group AB has no antibody Blood group O has no antigen, but Blood group O has no antigen, but

has Both antibody A and B has Both antibody A and B

Rh groupRh group Along with the ABO group, there is Along with the ABO group, there is

an Rh system in the bloodan Rh system in the blood The “D” antigen is the most The “D” antigen is the most

prevalentprevalent A person with “D” antigen is Rh (+)A person with “D” antigen is Rh (+) A person with no “D” antigen is Rh A person with no “D” antigen is Rh

(-)(-) Most Filipinos are Rh (+)Most Filipinos are Rh (+)

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