Upload
nursereview
View
121
Download
0
Embed Size (px)
DESCRIPTION
http://NurseReview.Org for more medical slides, audio lecture, video animation, test taking tips and lots more.
Citation preview
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 glands- glands 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 PhysiologyMuscle Physiology
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 PhysiologyMuscle Physiology
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
Muscle PhysiologyMuscle Physiology
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
MUSCLE and JOINT MUSCLE and JOINT MOVEMENTSMOVEMENTS
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
MUSCLE and JOINT MUSCLE and JOINT MOVEMENTSMOVEMENTS
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 bones- bones embedded in the Sesamoid bones- bones 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
Synovial jointsSynovial joints
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
Synovial jointsSynovial joints
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
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 Heart: Physiology
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 Heart: Physiology
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 Heart: Physiology
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
The Heart: Physiology
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 Heart: Physiology
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 Heart: Physiology
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
The Heart: Physiology
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 (+)