REYNALDO thirdy Morales III

Anatomy and Physiology – function of body d. Golgi apparatus – packaging of

structures. metabolize (waste)
e. Lysosomes and perosomes – Digestion of
I. Cell metabolize
A. Basic components
Large Small
1. H₂O = 60% TBW
(phagocytosis) (penocytosis)

ECF 20% ICF 60%

C. Transport system
Ex. Interstitial Ex. Cytoplasm
1. Passive: ć/o energy
(between cells)
a. Diffusion: high →low
Intravscular
b. Osmosis: low →high
(blood)
c. Filtration: passing of solution →
Ф dehydration → H₂O → atrophy semipermeable membrane
Solution
2. Ions or electrolytes
Magnesium – activator of enzymes Solute Solvent
Iodine – stimulator of thyroid hormones (tinuturuan) (tumuturo)
Lack: Goiter
Calcium or Phosphate – bone and teeth Ф diffusion →lungs (O₂ diffusion)
maintenance Ф osmosis →between cells
Lack: Ф filtration →kidney (glumelular filtration)
Osteoporosis - ↓bone density 2. Active: ć energy
Osteomalacia - ↓bone maintenance a. Na-K pump (sodium potassium
Osteopenia -↓bone protein pump)
Iron – adherence of O₂ to Hgb Function: maintenance of negativity of positive
Lack: anemia membrane potential
Sodium – kidney; fluid retention Mechanism: 3Na out
Ф hypernatremia → ↑Na blood Action: potential (positive)
dehydration ↓
Ion – charged particles Depolarization – influx of Na⁺
Cation (+) (negative)
Anion (-) PO₄⁻ K⁺ Na⁺ Cl⁻ ↓
Abundant in the cell: Repolarization – outflux of K⁻
3. Carbohydrates - energy
4. Protein – tissue growth or repair D. Homeostasis – state of balance
5. Lipids – fats (fluid retention; cell Hemostasis – blood clothy
membrane) 1. CV system – maintain BP
B. Basic parts (baroceptors)
1. Cell membrane – covering 2. Resp. – maintain O₂ amount
2. Nucleus – chromosomes Ex. Hypoxia → ↓O₂ →hyperventilate
3. Cytoplasm – ICF 3. G.I. – maintain nutrients
a. Mitochondria – powerhouse of 4. Renal – fluid balance
cell (aerobic → endurance) - Acid base balance
b. Rhibosomes – protein synthesis 5. Endocrine – maintain fluoride
(anaerobic →strenghtening) amount
c. Endoplastic reticulum –
transport
 II. Musculoskeletal System
A. Bones – 206 Lower extremities:
1. Bone cells Hip or pelvis Ischium -Posterior (sit
a. Osteocytes – bone cells down)
b. Osteoblast – bone forming cells Illume - lateral
c. Osteoclast – bone resopting Pubes -anterior
Ф bone maintenance →osteocytes Thigh Femur Longest bone
Osteoporosis - ↑osteoclast in body
2. Parts Leg Tibia - largets
Fibula - most slender
Ankle Tarsals -calcemeus
- talos
Foot Metacarpals
Toes phallenges

3. Skeletal B. Joints
a. Axial skeletal 1. Types:
1) Skull - brain a. Synarthroidal – immobile
2) Spine or vertebral column – (sutures)
spinal chord b. Amphiarthroidal – slightly
3) Rias – internal organ (radio-ulna)
4) Sternum c. Diarthroidal – movable (most
- Anterior protection common)
- Manubrium 2. Major
- Dody Upper extremities:
- Xiphoid process Shoulder Glenohoumera Mc dislocated
l (glendid
b. Appendicular fossa: scapula)
Upper extremities: Elbow Ulnohumeral
Arm Humerus Longest in Wrist Radiocarpal
upper
extremities Lower extremities:
Forarm Radius -gallazi’s Hip Iliofemoral Pedia:
fracture congenital hip
(foosh injury) dislocation
Ulna -monteggia’s Tx: burlow’s
fracture (dislocate),
(nightstick ortolam’s
injury) (revocatable)
Wrist Carpals Knee Tibiofemoral
Hand Metacarpals Ankle Talocrunal
Fingers Phallenges (talo: talus,
crunal:
calaneus)
 C. Muscles -620 III. Nervous System
1. Basic anatomy A. General organization
1. Central nervous system
- Brain and spinal chord
Lesion:
Fasciculation – ć visible contraction - Spasticity
Tx: EMG - Babinski sign
Фventricular fibrillation: ECG - Clonus (compartments)
Contractions: - Contralaterals
- Twitch: quick Ex. stroke
- Tremors: continuous 2. Peripheral nervous system
- Tetanus: sustained - Cranial nerve
2. Muscle fibers - Spinal nerve
I II Lesions:
Names: Slow twitch Flat twitch - Flaccidity
Mitocunteria - Fasciculations
Capillarity - Fibrillation
Myoglobin - Epsilateral
Function Endurance Strength Ex. Bell’s palsy
Ф postural muscle: abundant in M. Fiber? = B. CNS
slow 1. Brain
3. Muscle group a. Cerebral cortex – 1,2
Upper extremities: Anterior: frontal – motor
Shoulder Deltoids Site of injection: Superior: parietal – sensory
abductor lateral Lateral: temporal – deafness
Shoulder Pectoralis major chest Posterior: occipital – blindness
flexor Dx: mastectomy Фbroca’s aphasia – effectiveness aphasia
-simple: breast (frontal)
tissue Фwernick’s aphasia – receptive aphasia
-radical: pectoralis b. Cerebellum – balance and
major coordination
Elbow flexor Bicepts brachii Manifestations ć cerebellum lesion:
Hypotonid – no muscle tone
Elbow Tricepts brachii
Ataxia – gait problem (balance)
extensors
Nystagmus – oscillation
Dysmetraia – no distance
Lower extremities:
Dysartria – articulation
Hip extensors Glutesmaximus Site for
Dysdiadochokinesia – rapid, alternating
injection
Area: LUQ
movement
Hip flexors Abdominals
Dyssynergia – no sequencing
Knee extensors Quadratriceps
Stewart holmes phenomenon – no
femoris
Knee flexor Mamstrings coordination
Ankle dorsi flexor Tibialis anterior Staggering gait – “putol” (double tap)
Ankle platar flexor Gastronemius

c. Brainstem
1) Midbrain – 3, 4
2) Pons – 5,6,7,8
3) Medulla – 9,10,11,12
- Respiratory center
d. Basalganglia – refinement of
movement
Movement disorder: tremors (parkingson’s
disease: rigidity
e. Diencephacon (thalamus) –
sensory
Hypothalamus: functions
1) Temperature regulation
- Heat loss (warm) – interior
WHY!!!!?
- Heat production (cold) -
anterior
2) Satiety center – medial
3) Hunger center – lateral
(anorema)
f. Ventricles – CSF flow
2. Spinal chord
Visual deficit:
Scotoma – central blindness, blind spot
Glaucoma – peripheral blindness, tunnel vision
Cataraci – opaque of cloudy vision
3. Ocullomotor – eye muscle
WHAT IF!
Lesion CN3: exotropia – banlag
Lesion CN6: esotropia - duling
4. Trochlear – SO₄
5. Trigeminal
Sensory: sense of face
Masseter – muscle for mastication (chewing)
6. Abducens – LRG; if LRG is
destroyed, the eye goes medally
7. Facial
Sensory: anterior 2/3 of tongue
Motor: facial muscle →belly dalsy
8. Vestivulococulear – balance
Romberg’s test
9. Glossopharyngeal – tongue
S: post 1/3 of the tongue
M: pharyne muscle
Parotid gland – salivary gland
10. Vagus nerve
S: parasymphathetic function
M: pharynx muscle and larynx (hoarseness)
11. Spinal accessories
M: neck muscle (sternocleid omastoid)
M: shoulder muscle
12. Hypoglossav: tongue muscle
Evaluation: ask the patient to protrude the
tongue
13. CSF
Function: for protection, source of nutrients
Fornds: choroid diexos (lateral ventricle)
Absorb: arachnoid villi
↑CSF in brain: hydromyalous
↑CSF in spinal chord: hydromyelia
Ear: otorrhea
Nose: rhinorhea
Taste: sweet (glucose), clear
14. Meninges – covering of nervous
system
Duramater: outer (pachymenix)
Arachnoid mater: 2nd archnoidilli
Pia mater: inner (leptomeninges)
Meningitis: most common postnatal infection
IV. Cardiovascular System
A. Heart anatomy
1. Walls
a. Epicardium – outer
b. Myocardium – cardiac muscle
(ischemia)
c. Endocardium - inner
2. Chamber
a. Right atrium
b. Right ventricle
c. Left atrium
d. Left ventricle
Inferior vena cava – largest vein
Aorta – largest artery or blood vessel
3. Valves
a. Atrial ventricular valve (AV
valve)
R: tricuspid
L: bicuspid/ mitral
b. Semilunar valves (exit the
heart)
R: pulmonic – before pulmonary artery
L: aortic – before aorta
 B. Heart physiology 6. Auscultation site
1. Eleptical activities (conduction) Aortic Pulse - R chest 2nd ICS sternal
60/100 SA node R atrium border
40/60 AV node Between atira Pulmonic Pulse - L chest 2nd ICS sterna
and ventricle border
Bundle of hiss Between Tricuspid pulse -L 4th ICS sterna border
ventricles Mitral pulse -L 5th midclavicular line
Pukinje fibers Wall of Apical pulse- most audible
ventricle
V. Endocrine system
2. ECG A. Anatomy
- The endocrine system is composed of ductless glands that
₃ release their hormones directly into the bloodstream
- The Hypothalamus cntrols most of the endocrinal activity of
₁ ₅ the pituitary gland
- The pituitary gland controls most of the activities of the
other endocrine glands
₂ 1. The adrenal Glands
₄
- Located above the kidneys
1. P-WAVE –atrial depolarization Composed of two parts:
234. QRS complex- ventricular depolarization a. Adrenal Cortex (outer)
- Secretes three types of STERIOD hormones:
5. T-WAVE- ventricular repolarization
i. Glucocorticoids- like Cortisol,
cortisone and corticosterone
3. ECG reading ii. Mineralocorticoids- like
ST depression -myocardial ischemia (no oxygen) Aldosterone
ST elevation - myocardial imfarction iii. Sex hormones- like estrogen and
Twave inversion - ischemia testosterone
Flat T-wave - hypokalemia b. Adrenal Medulla (inner)
Peal T-wave - hyperkalemia - Essentially a part of the SYMPATHETIC autonomic system
QRS elevation - ventricular hyperthrophy - Secretes Adrenergic Hormones:
QRS depression - ventricular failure i. Epinephrine
ii. Nor-epinephrine
4. Blood supply 2. The pancreas
R coronary artery- R side of the heart - This retroperitoneal organ has both endocrine and exocrine
L coronary artery- L side of the heart functions
- The endocrine function resides in the ISLETS of
5. Heart sounds Langerhans
S1-lub-AV closure N - The islets have three types of cells- alpha, beta
S2-Dub-SL closure auscultation and delta cells
S3-ventricular gallop-blood rush AB - The ALPHA cells secrete GLUCAGON
S4-atrial gallop auscultation - The BETA cells secrete INSULIN
Sign of gurgitation - The DELTA cells secrete SOMATOSTATIN
 3. Gonands 3. Thyroid gland
2 types: - Located in the anterior neck lateral to the
a. Ovaries trachea
- These two almond-shaped glands are found in - Contains two lobes connected by the isthmus
the pelvic cavity attached to the uterus by the - Microscopically composed of thyroid follicles
ovarian ligament where the hormones are produced and stored
- The Ovaries contains Granulosa and Theca - Produces the thyroid hormones:
cells which secrete ESTROGEN and a. Tri-iodothyronine or T3
Progesterone b. Tetra-iodothyronine or thyroxine or T4
b. Testes - The Parafollicular cells secrete CALCITONIN
- These two oval-shaped glands are found in the 4. PARAthyroid glands
scrotum - Located at the back of the thyroid glands
- The testes contains Leydig cells that secrete - Four in number
Testosterone - Secretes PARATHYROID hormone (PTH) that
B. Hypothalamus controls calcium and phosphorus levels
- This part of the DIENCEPHALON is located
below the thalamus and is connected to the VI. Gastro-Intestinal System
pituitary gland by a stalk A. Mouth
C. Physiology - Anterioly bounded by lips
1. Hypothalamus - Posteriorly bounded by the Oropharynx
- Secretes RELEASING HORMONES for the - Mechanical and chemical digestion (secretion of saliva by
pituitary gland salivary glands)
- Secretes OXYTOCIN that is stored in the B. Pharynx & Esophagus
Posterior pituitary gland - The pharynx is the common passageway for both food and
- Secretes Anti-Diuretic Hormone or air
VASOPRESSIN that is stored also in the posterior - Contracts when food enters.
pituitary gland - Forces food into the esophagus
2. The Pituitary Gland - The esophagus is the passageway that connects mouth to
- Is a gland located below the hypothalamus at the stomach
the base of the brain - Cardiac Sphincter muscle
- The optic chiasm passes over this structure C. Stomach
- Is divided into two parts: - Fundus (top) →body →pylorus
a. Anterior Pituitary secretes the - Pyloric sphincter
following hormones: - Mechanical and chemical digestion: Mixing food and acid
i. Growth hormone and enzymes to create chyme
ii. Prolactin - Goblet Cells
iii. Gonadotrophins- LH and FSH - Parietal Cells
iv. Stimulating hormones and trophic - Chief Cells
hormones - ACTH, TSH, MS - G Cells
b. Posterior Pituitary stores and - Blood supply : Celiac artery
releases: - Venous drainage in to portal vein
i. OXYTOCIN
ii. ADH/Vasopressin
 D. Small intestine H. Biliary Ducts
- From Pyloris to Ileocecal Valve - Ducts of the Billiary tract very imp in proper functioning of
- Duodenum →jejunum →Ileum GIS
- Circular folds and villae to ↑surface area - Bile Calculli Left →Right Hepatic duct →Common hepatic
- Most digestion and absorption takes duct
place here via intestinal enzymes and - Cystic Duct + Common hepatic duct →Common Bile
exocrine secretions from the liver and →Duct duodenum
pancreas (which enter the duodenum via I. Pancreas
ducts) - Endocrine Functions
E. Large intestine: extends form terminal  Production of Insulin, glucagon,
ileum to rectum somatostatin
- Ascending colon, transverse Colon - Exocrine Function
- descending colon, sigmoid colon and the  Pancreatic enzymes: Trypsin, lipase
rectum and amylase
- Appendix extends from the lower portion  Bicarbonate: help neutralize the
of the cecum and is a blind sac acidity of the chime
- chyme generated ends up entering the - Blood Supply: Hepatic and cystic artery
colon
- H₂O and electrolytes are absorbed out of VII.
the chime
 Absorbs 1.5 L of water per Day
 Also absorbs Na, K & Cl
- Blood Supply: superior & inferior
mesenteric arteries
F. Liver
- Located in the upper rt. Abdomen
- Rt, Lt.& caudate lobes ,subdivided into
segments
- Blood supply: Portal Vein, Hepatic Artery
- Roles of the liver:
 Conjugation of billurubin
 Synthesis and deactivation of clotting
factors
 Phagocytosis
 Detoxification
 Processes nutrients
G. Gallbladder
- Sac like organ attached to Liver
- Storage facility for bile(50ml.)
- CCK stimulates contraction of Gall bladder
- Bile composition: water, bile salts
(emulsify lipids), bile pigments]
- Blood Supply: Cystic & hepatic artery