FINAL  body's largest serous membrane, and it wraps
around most abdominopelvic organs
DIGESTIVE SYSTEM
Gastroenterology – study of the gastrointestinal system
Functions:
 ingestion
 secretion
 digestion (chemical and mechanical)
 mixing and propulsion
 absorption
 defecation
Also called the gastrointestinal system, composed of
the alimentary canal (GI tract), and the accessory organs
 alimentary canal extends from the mouth to
the anus through the ventral body cavity
(approximately 9m or 30ft)
 accessory organs include teeth, tongue, salivary
glands, liver, gallbladder, and pancreas
The GI tract and accessory organs like the liver and
pancreas, are responsible for facilitating the body's
metabolic processes
 Catabolism - breakdown of large, complicated
molecules into smaller ones in order to produce
energy (e.g. glycolysis – the first step in the
breakdown of glucose to extract energy for
cellular metabolism)
 Anabolism - smaller molecules are used as
building blocks for larger molecules (e.g.
gluconeogenesis – when the liver and kidneys
produce glucose from non-carbohydrate
sources)
Mechanical digestion includes all movements that
facilitate catabolic processes:
 mastication or chewing - teeth
 swallowing - tongue
 mixing - stomach
 peristalsis - movement of muscles within the GI
tract that facilitates downward movement of
food
Chemical digestion is mainly accomplished by using
water to break chemical bonds (hydrolysis)
 fats are broken down into fatty acids and
glycerol
 carbohydrates are broken down from
polysaccharides into monosaccharides
 proteins are broken down into polypeptides
and amino acids
ANATOMY OVERVIEW
The wall of GI tract from the lower esophagus to the
anal canal has the same basic, four-layered
arrangement of tissues
The four layers of the tract, from deep to superficial are:
1. mucosa
2. submucosa
3. muscularis
4. serosa/adventitia
The lumen is the inside of the tube
Peritoneum
 visceral peritoneum forms the "serosa" of the
alimentary canal and covers other intra-
abdominal organs
 then continues around the abdominal wall as
the parietal peritoneum (adhere)
Unlike the pericardium and pleurae, which smoothly
cover the heart and lungs, the peritoneum contains
large folds that bind the organs to one another and to
the cavity walls.
There are five major peritoneal folds:
1. greater omentum - drapes over the transverse
colon and the anterior coils of the small
intestine like a 'fatty apron'
2. falciform ligament - attaches the liver to the
anterior abdominal wall
3. lesser omentum - stomach and duodenum
4. mesentery - small intestines
5. mesocolon - large intestines
Some abdominopelvic organs are covered by visceral
peritoneum only on their anterior surfaces. The portion
of the organ that lies behind the peritoneum is said to
be “retroperitoneal”
Organs in the retroperitoneal space includes:
 kidneys and ureters
 most of the pancreas
 adrenal gland
 aorta and inferior vena cava
PHYSIOLOGIC OVERVIEW
Digestive activities of the gastrointestinal tract occur in
three overlapping phases:
1. Cephalic phase
 smell, sight, though, or initial taste of food
activates neural centers in the cerebral cortex,
hypothalamus, and brain stem to prepare for
digestion
 the brain stem activates the facial (CN VII) and
glossopharyngeal (CN IX) nerves to stimulate
secretion of saliva, while vagus nerves (CN X)
stimulate secretion gastric juice
2. Gastric phase - once food reaches the stomach
3. Intestinal phase - once food enters the small
intestine
MOUTH
 oral or buccal cavity, formed by the cheeks, hard
and soft palates, and the tongue
 mechanical digestion of food through mastication
(chewing) enables it to be mixed with saliva to form
a soft flexible bolus that can be easily swallowed
Saliva starts the process of chemical digestion of food
 Saliva is 99.5% water, with tiny amounts pf
dissolved ions. IgA, lysozyme (a bacteriolytic
enzyme), and salivary amylase (a digestive
enzyme that acts on starch)
 large salivary glands - secrete most of the saliva:
the parotid, submandibular, and sublingual glands
 smaller glands - found on the lips (labial), cheeks
(buccal), palate (palatal), and tongue (lingual)
 daily salivary secretion average 1 – 1 ½ liters
Tongue
 composed of skeletal muscle under voluntary
somatic motor control – it forces the moistened
food bolus into position for swallowing
(deglutition) and places the bolus into contact
with the teeth for chewing
 extrinsic muscles – attach to bones in the area
and move the tongue from side to side
 intrinsic muscle – originate within the tongue
and alter its shape and size for speech and
swallowing
Teeth or Dentes
 located in sockets of the alveolar processes of
the mandible and maxillae
 a typical tooth has three major external regions:
the crown, neck, and root
 humans have two dentitions or sets of teeth
 20 deciduous or "baby teeth" which begin
to erupt around 6 months of age; all are lost
between 6-12 years of age
 32 permanent teeth
Mastication or Chewing
 voluntary process regulated by the CNS and
performed by the muscles above and below
mandible
 during chewing food is cut and ground by teeth
and manipulated by the tongue, lips, and
cheeks
Deglutition
 act of swallowing food
 the oropharynx and laryngopharynx have
digestive as well as respiratory functions, and
swallowed food must transit them both on the
way to the esophagus
 deglutition has 3 stages: voluntary, pharyngeal,
and esophageal
ESOPHAGUS
 only function is propulsion (moving food into the
stomach)
 a muscular tube that begins inferior to the
laryngopharynx, and positioned posterior to the
trachea
 Upper and lower esophageal sphincters (UES and
LES) are situated at each end of the tube
 Lower esophageal sphincters - regulates the
movement of food from the esophagus into the
stomach
 Incompetence of the LES results in
Gastroesophageal Reflux Disease (GERD), which
manifests as 'heart burn'
STOMACH
 J-shaped enlargement of GI tract situated between
the esophagus and the first part of the small
intestines (the duodenum)
 main function: digestion
 Rugae - large folds in the mucosa of the empty
stomach which enable gastric distension, depending
on the amount of stomach contents
 4 main regions: cardia, fundus, body, and pylorus
 because a meal can be eaten much more quickly
than the intestines can digest and absorb it, one of
the functions of the stomach is to serve as a mixing
chamber and the holding reservoir
A variety of specialized exocrine and endocrine cell
types populate the gastric glands and pits.
Exocrine gland cells include:
 mucous neck cells - w hich produce mucus
 parietal cells - which produce intrinsic factor
and HCl
 Also secrete a glycoprotein called the
intrinsic factor (IF). IF is crucial for the
transportation and absorption of vitamin
B12 in the final section of the small
intestine (the ileum)
 chief cells - which secrete the protease
pepsinogen and gastric lipase
Enteroedocrince
 g cells - secrete the hormone gastrin into the
blood stream
 gastrin is a peptide hormone that
stimulates secretion of gastric acid (HCl)
 G cells secrete gastrin into systemic
circulation, which allows delivery of gastrin
to parietal cells and enterochromaffin-like
cells in the gastric fundus and cardia
The strongly acidic nature of gastric juice kills many
microbes, partially denatures proteins in food, and
converts pepsinogen into pepsin
 pepsin – the only proteolytic enzyme in the
stomach
 proteolytic enzymes – group of enzymes
that work to breakdown the molecules of
proteins – amino acids
 gastric lipase – splits triglycerides
 triglycerides – main constituents of natural
fats and oils
 intrinsic factor – needed for absorption of
vitamin B12 in the terminal ileum
 Vitamin B12 is needed for RBC production
Gentle, rippling, peristaltic movements called mixing
waves pass over the stomach every 15 to 25 seconds
 these waves macerate food, mix it with
secretions of the gastric glands, and reduce it to
a soupy liquid called chyme
Within 2 to 4 hours after eating a meal, the stomach has
emptied its contents into the duodenum
 food rich in carbohydrate spend the least time
 high-protein foods remain somewhat longer
 emptying is slowest after a fat-laden meal
containing large amounts of triglycerides
At appropriate intervals, the stomach allows a small
amount of chyme to pass through the pyloric sphincter
and enter the duodenum to begin the intestinal phase
of digestion
 completion of digestion is collective effort of
pancreatic juice, bile, and intestinal juice in the
small intestine
PANCREAS
 About 1-1.5 liters of alkaline pancreatic juice is
secreted into the duodenum each day. It creates
the proper pH for the following digestive enzymes
in the small intestine:
 A starch digesting enzyme called pancreatic
amylase
 Starch is made of chains of glucose molecules -
carbohydrates
 Pancreatic lipase, the major triglyceride (fat)
digesting enzyme in adults
LIVER AND GALLBLADDER
 The liver is the body's largest gland and second
largest organ.
 It has 2 main lobes (right and left - divided by the
falciform ligament) and is covered by visceral
peritoneum.
 Hepatocytes are the major functional cells of the
liver.
 The liver is responsible for filtering the blood in
the body and breaking down harmful
substances like alcohol and drugs. It also
produces bile, which helps to digest fats and
eliminate waste products.
 Hepatocytes secrete about 1 liter of bile per
day
 Gallbladder - A pear-shaped reservoir located just
under the liver that receives and stores bile made in
the liver. The gallbladder sends this stored bile into
the small intestine to aid in the digestion of food.
 Bile, an excretory product that helps emulsify fats
for the watery environment of small intestine
digestive juices.
 Under the influence of the hormone
cholecystokinin (CCK), the gallbladder contracts
and ejects stored bile. Although not necessary for
life, normal gall bladder function is highly desirable.
 Cholecystokinin (CCK) is a hormone secreted by
cells of the upper small intestine in response to
fat, protein.
 After surgical removal of the gall bladder (called
a cholecystectomy), a person would experience
severe indigestion if they ate a large meal high
in fat content
SMALL INTESTINE
 The small intestine is divided into 3 regions:
1. The duodenum (10 in)
2. The jejunum (8 ft)
3. The ileum (12 ft)
 Mechanical digestion in the small intestine is a
localized mixing contraction called segmentations.
 The small intestinal mucosa contains (intestinal
glands) that secrete intestinal juice. Its function is
to complete the digestive process begun by
pancreatic juice.
 90% of intestinal absorption occurs in the small
intestine.
 Most of the enzymatic digestion in the small
intestine occurs inside the epithelial cells or on their
surfaces (rather than in the lumen of the tube) as
intestinal juice comes in contact with the brush
border of the villi.
LARGE INTESTINE
 The large intestine is about 5 feet in length. Starting
at the ileocecal valve, the large intestine has 4
parts:
1. The cecum
2. The colon
a. ascending
b. transverse
c. descending
d. sigmoid
3. The rectum
4. The anal canal
 There are no circular folds or villi in the large
intestine.
 The mucosa is mostly an absorptive epithelium
(mainly for water), and microvilli are plentiful.
 Interspersed goblet cells produce mucous, but no
digestive enzymes are secreted
 Teniae coli are 3 separate longitudinal ribbons of
smooth muscle that run the length of the colon.
 Because the teniae coli is shorter than the
intestine, the colon becomes sacculated into
small pouches called haustra (giving it a
segmented appearance).
 Hanging inferior to the ileocecal valve is the cecum,
a small pouch about 2.5 in long.
 Attached to the cecum is a 3 in coiled tube called
the appendix.
 The open end of the cecum merges with a long tube
called the colon, with its various parts.
 The rectum is the last in of the GI tract and lies
anterior to the sacrum and coccyx.
 The terminal in of the rectum is called the anal
canal
 The opening of the anal canal to the exterior is
called the anus.
The mechanical events associated with defecation
include localized haustral churning and peristalsis.
Two autonomic nervous system reflexes that initiate
strong bouts of mass peristalsis are the gastroileal
reflex and the gastrocolic reflex.
a. The gastroileal reflex causes relaxation of the
ileocecal valve, intensifies peristalsis in the
ileum, and forces any chyme into the cecum.
b. The gastrocolic reflex intensifies strong
peristaltic waves that begin at about the middle
of the transverse colon and quickly drive the
contents of the colon into the rectum.
Feces are the waste leftover after digesting and
absorbing all the nutrients we can from eaten material.
Though it is lower in energy than the food it came from, As with any surgery, complications can occur.
feces may still contain a large amount of energy, often Some complications may include:
50% of that of the original food.  Bleeding
 The characteristic brown coloration comes  Infection
from a combination of bile and bilirubin.  Blockage of the blood vessels to the new kidney
 The distinctive odor is due to bacterial action -  Leakage of urine or blockage of urine in the
both aerobic and anaerobic bacteria participate. ureter
 Lack of function of the new kidney at first.
The defecation reflex is activated by stretch receptors
stimulated by filling of the rectum. The events leading
to defecation include:
 Food in the stomach stimulates mass peristalsis.
 Food moves through the intestine into the
rectum.
 Rectal pressoreceptors respond to distention
and longitudinal muscles shorten the rectum.
 ANS releases the internal anal sphincter and
gives a conscious awareness of distention.
 Release of external sphincter is under conscious
control.

URINARY SYSTEM
 The urinary systems consists of the kidneys, ureters,
bladder, and urethra, along with its associated
nerves and blood vessels.
 The system maintains homeostasis by:
- Regulating blood volume, pressure, pH, and
concentration of electrolytes (Na+, K+, Ca²+, Cl,
HPO4-3, Mg2+, HCO3)
- Reabsorbing glucose and excreting wastes
- Releasing certain hormones like renin and EPO
RENAL ANATOMY
KIDNEY
 The kidneys are bean-shaped organs located just
above the waist between the peritoneum and the
posterior wall of the abdomen (in the
retroperitoneal space).
 They are partially protected by the eleventh and
twelfth pairs of ribs.
 Because of the position of the liver, the right kidney
is slightly lower than the left.
URETER
 A ureter (approximately 25 cm long) originates near
an indented area of each kidney called the hilum
and travels to the base of the bladder.
 The ureters transport urine from the renal pelvis of
the kidneys to the bladder using peristaltic waves,
hydrostatic pressure and gravity to move the urine.
URINARY BLADDER
 The urinary bladder is a hollow, distensible
muscular organ with a capacity that averages 700-
800mL.
 When volume increases, stretch receptors send
signals to a micturition center in the spinal cord
triggering a spinal reflex - the micturition reflex.
 In early childhood, we learn to initiate and stop the
reflex voluntarily.

What is a kidney transplant?

A kidney transplant is a surgery done to replace
a diseased kidney with a healthy kidney from a donor.
The kidney may come from a deceased organ donor or
*pudendal nerve – pons
from a living donor. Family members or others who are
a good match may be able to donate one of their
kidneys. This type of transplant is called a living
URETHRA
transplant. People who donate a kidney can live healthy
 The urethra is the vessel responsible for
lives with one healthy kidney,
transporting urine from the bladder to an external
A person getting a transplant most often gets
opening in the perineum.
just 1 kidney. In rare situations, he or she may get 2
 From the bladder, the urethra (4 cm in length in
kidneys from a deceased donor. The diseased kidneys
women and 24 cm in length in men) allows urine to
are usually left in place. The transplanted kidney is
be excreted.
placed in the lower belly on the front side of the body.
 In males, it is also used to discharge semen.
 Internal Urethral Sphincter (involuntary) to External
Why might I need a kidney transplant?
Urethral Sphincter in deep muscles of the perineum
You may need a kidney transplant if you have
(voluntary)
end stage renal disease (ESRD). This is a permanent
condition of kidney failure it often needs dialysis. This is
a process used to remove wastes and other substances
KIDNEY
from the blood.
 A frontal section through the kidney reveals two
What are the risks for kidney transplant? distinct regions of internal anatomy, the cortex and
medulla.
 The main function of the cortex is filtration to form
urine.
 The main function of the medulla is to collect and
excrete urine.
 The renal pyramids within the medulla that
contain the kidney's secreting apparatus and
tubules.
 The renal papilla is the location where the
medullary pyramids empty urine into cuplike
structures called minor and major calyces.
 Once the filtrate enters the calyces, it becomes
urine because no further reabsorption can occur.
 From the major calyces, urine drains into a single
large cavity called the renal pelvis and then out
through the ureter.
 The hilum expands into a cavity within the kidney
called the renal sinus, which contains part of the
renal pelvis, the calyces, and branches of the renal
blood vessels and nerves.
RENAL BLOOD FLOW
 The renal artery and renal vein pass into the
substance of the kidney at the hilum.
 Arterial blood enters via the renal artery and exits
the renal vein.
THE NEPHRON
 The nephron is the functional unit of the kidney.
 Each nephron is composed of renal corpuscles and
a renal tubule.
The Renal Corpuscle consists of two structures:
1. The glomerular capillaries – tangled, ball-shaped
capillaries
2. The glomerular capsule (Bowman's capsule) – a
double-walled epithelial cup that surrounds the
glomerular capillaries.
 Podocytes (or visceral epithelial cells) are cells of
the visceral epithelium in the kidneys and form a
crucial component of the glomerular filtration
barrier and maintaining a massive filtration
surface.
 The epithelium of the visceral and parietal layers of
the renal corpuscle form fenestrations (pores)
which act as a filtration (dialysis) membrane.
 Protein albumin if present in urinalysis marks
the malfunction of nephrons.
 Fluid filtered from the Bowman's space, (the space
between the two layers of the glomerular capillaries
enters glomerular capsule), which is the lumen of
the urinary tube
1. Fenestration (pore) of glomerular endothelial cell:
prevents filtration of blood cells but allows all
components of blood plasma to pass through
2. Basement membrane of glomerulus: prevents
filtration of larger proteins
3. Slit membrane between pedicels: prevents
filtration of medium sized proteins
Blood plasma is filtered through the glomerular
capillaries into the glomerular capsule. Filtered fluid
passes into the renal tubule, which has three main
sections:
1. the proximal convoluted tubule (PCT)
2. the loop of Henle
3. the distal convoluted tubule (DCT)
 The distal convoluted tubules of several nephrons
empty into a single collecting duct. Collecting ducts
unite and converge into several hundred large
papillary ducts which drain into the minor calyces,
major calyces, renal pelvis, and ureters.
 The first part of the loop of Henle (the descending
limb) dips into the renal medulla. It then makes a
hairpin turn and returns to the renal cortex as the
ascending limb
 Based on the length of the loop of Henle, nephrons
can be sorted into two populations: cortical and
juxtamedullary.
1. Cortical nephrons make up about 80-85% of the 1
million microscopic nephrons that comprise each
kidney. Their renal corpuscles are located in the
outer portion of the cortex, with short loops of
Henle that penetrate only a small way into the
medulla.
 Nephrons with short loops receive their blood
supply from peritubular capillaries
2. The other 15-20% of the nephrons are
juxtamedullary nephrons. Their renal corpuscles lie
deep in the cortex, close to the medulla, and they
have long loops of Henle that extend into the
deepest region of the medulla.
 Nephrons with long loops receive their blood
supply from the vasa recta
 In each nephron, the final part of the ascending
limb of the loop of Henle makes contact with the
afferent arteriole serving that renal corpuscle.
Because the columnar tubule cells in this region are
crowded together, they are known as the macula
densa.
 Alongside the macula densa, the wall of the afferent
arteriole contains modified smooth muscle fibers
called juxtaglomerular (JG) cells.
 Together with the macula densa, they constitute
the juxtaglomerular apparatus (JGA).
 The cells of the macula densa are sensitive to the
ionic content and water volume of the fluid in the
tubule.
 If low water volume is detected by these cells, they
will produce molecular signals that promote renin
 secretion by other cells of the juxtaglomerular
apparatus called the juxtaglomerular cells.
 The release of renin is an essential component of
the renin-angiotensin-aldosterone system (RAAS),
which regulates blood pressure and volume.
blood plasma through the filtration membrane.
(promotes filtration)
2. Capsular hydrostatic pressure (CHP) is the
hydrostatic pressure exerted against the filtration
membrane by fluid already in the capsular space
and renal tubule. CHP opposes filtration and
represents a "back pressure" of about 15 mmHg.
(opposes filtration)

3. Blood colloid osmotic pressure (BCOP), which is

due to the presence of proteins such as albumin,
globulins, and fibrinogen in blood plasma, also
opposes filtration. The average BCOP in glomerular
capillaries is 30 mmHg. (pressure of plasma proteins
“pulling” on water - opposes filtration)

 Net filtration pressure (NFP), the total pressure

that promotes filtration, is determined as follows:
 Net filtration pressure (NFP) = GBHP-CHP -
RENAL PHYSIOLOGY BCOP
 By substituting the values just given, normal NFP
The 3 basic functions performed by nephrons and may be calculated:
collecting ducts are:  NFP = 55 mmHg-15 mmHg-30 mmHg 10 mmHg
 Thus, a pressure of only 10 mmHg causes a normal
1. Glomerular filtration – pressure forces filtration of amount of blood plasma (minus plasma proteins) to
waste-laden blood in the glomerulus. The filter from the glomerulus into the capsular space.
glomerular filtration rate (GFR) is the amount of
filtrate formed in all the renal corpuscles of both Total Amount Amount Amount in
kidneys each minute. Amount in 180 L returned to Urine
in of blood/d (/day)
Plasma filtrate (reabsorbed
2. Tubular reabsorption – the process of returning
(/day) )
important substances from the filtrate back to the Water 3L 180 L 178-179 L 1-2 L
body. Protein 200 g 2g 1.9 g 0.1 g
Glucose 3g 162 g 162 g 0g
3. Tubular secretion – the movement of waste Urea 1g 54 g 24 g (about 30 g (about
materials from the body to the filtrate. ½) ½)
Creatinine 0.03 g 1.6 g 0 g (all 1.6 g (none
filtered) reabsorbed)

GLOMERULAR FILTRATION
 Urea – final end product of protein metabolism
 Glomerular filtration is the formation of a protein- (becomes toxin if not secreted)
free filtrate of plasma across the glomerular
 Complications associated with urea’s high levels
membrane.
include renal insufficiency, liver failure, heart
 Only a portion of the blood plasma delivered to the failure, or neurological disorders.
kidney via the renal artery is filtered.
 Creatine – a chemical that your body uses to supply
 Plasma which escapes filtration, along with its your muscles with energy. As your muscles use
protein and cellular elements, exits the renal energy the tissue that makes up your muscles
corpuscle via the efferent arteriole, perfuses the breaks down.
tubular capillary beds, and is eventually collected in
 This natural breakdown of muscle tissues
the renal venous system
causes creatinine to be released into your
bloodstream. End product of creatine is
creatinine.

REGULATION OF THE GFR

Regulation of the GFR is critical to maintaining
homeostasis and is regulated by an assortment of local
and systemic mechanisms:
a. Renal autoregulation occurs when the kidneys
themselves regulate GFR.
b. Neural regulation occurs when the ANS
regulates renal blood flow and GFR.
c. Hormonal regulation involves angiotensin II and
atrial natriuretic peptide (ANP).

1. Glomerular blood hydrostatic pressure (GBHP) is Neural regulation of GFR is possible because the renal
the blood pressure in glomerular capillaries. blood vessels are supplied by sympathetic ANS fibers
Generally, GBHP is about 55 mmHg. It promotes that release norepinephrine causing vasoconstriction.
filtration by forcing “pushes” water and solutes in
Sympathetic input to the kidneys is most important with
extreme drops of BP (as occurs with hemorrhage).
Hormonal regulation
Two hormones contribute to regulation of GFR
a. Angiotensin II – drop in BP
b. A sudden large increase in BP stretches the
cardiac atria and releases atrial natriuretic
peptide (ANP). ANP causes the glomerulus to
relax, increasing the surface area for filtration.
(vasodilation)
TUBULAR REABSORPTION
 Tubular reabsorption is the process of returning
important substances ("good stuff") from the
filtrate back into the renal interstitium, then into
the renal blood vessels... and ultimately back into
the body.
 The "good stuff" is glucose, electrolytes, vitamins,
water, amino acids, and any small proteins
 Ninety nine percent of the glomerular filtrate is
reabsorbed (most of it before the end of the PCT)!
In the proximal convoluted tubules it’s already
urine.
TUBULAR SECRETION
 Tubular secretion is the movement of substances
from the capillaries which surround the nephron
into the filtrate.
 The process of tubular secretion controls pH.
 Hydrogen and ammonium ions are secreted to
decrease the acidity in the body, and bicarbonate is
conserved.
 Maintaining the body's proper pH requires
cooperation mainly between the lungs and the
kidneys.
 The lungs eliminate CO₂.
 The kidneys eliminate H+ and NH₂+ ions and
conserve bicarbonate.
URINE
 A urinalysis analyzes the physical, chemical and
microscopic properties of urine.
 Water accounts for 95% of total urine volume.
 The solutes normally present in urine are
filtered and secreted substances that are not
reabsorbed.
 If disease alters metabolism or kidney function,
traces of substances normally not present or
normal constituents in abnormal amounts may
appear (bacteria, albumin protein, glucose,
white blood cells, red blood cells to name a
few).
 In addition to a urinalysis, two blood tests are
commonly done clinically to assess the adequacy of
renal function.
 Blood urea nitrogen (BUN) measures nitrogen
wastes in blood from catabolism and
deamination of amino acids (protein).
 Creatinine levels appear in the blood as a result
of catabolism of creatine phosphate in skeletal
muscle.
 The serum creatinine test measures the
amount of creatinine in the blood, which
increases in states of renal dysfunction.
MALE REPRODUCTIVE SYSTEM
REPRODUCTIVE OVERVIEW
 Sexual Reproduction is the process in which
organisms produce offspring by means of uniting
gametes (sperm and egg)
 Male reproductive organs secrete androgen
hormones, produce gametes (sperm), and
facilitate fertilization
 Female reproductive organs secrete female
hormones, produce gametes (ova), facilitate
fertilization and sustain growth of the embryo
and fetus
 UROLOGY is the medical specialty that treats
disorders and diseases of the male reproductive
system
 GYNECOLOGY is the medical specialty that treats
disorders and diseases of the female reproductive
system
 OBSTETRICS focuses on the care of women
during pregnancy
The genitals are all the structures of reproduction
1. Gonads – gamete (sperm) and hormone production
2. Ducts – store and transport gametes
3. Accessory sex glands – produce secretions to
protect the sperm from the acidic environment
4. Supporting structures – deliver and/or assist in
joining gametes (penis in male, vagina and uterus in
female)
ANATOMY
 The MALE GONADS: the testes (singular: testis)
 Male reproductive GLANDS are the:
1. seminal vesicles (2)
2. prostate (1)
3. bulbourethral glands (2)
 The DUCTS of the male reproductive system are
the:
1. vas deferens (ductus deferens)
2. ejaculatory ducts
3. urethra
 The SCROTUM is a supporting structure for the
testes
 It consists of a sac of loose skin and superficial
fascia that hangs from the root of the penis
 The location and contraction of muscle fibers
(dartos and cremaster muscles) regulates the
testicular temp to that required for sperm
production (2-3° below the core temp)

• The SPERMATIC CORD is a supportive structure that
ascends "out of" the scrotum, and consists of:
 The vas deferens
 The testicular artery
 Veins and lymphatics that drain the testes and
carry testosterone to the body
 Autonomic nerve
 The TUNICA ALBUGINEA (collagen) forms septa that
divide each testis into compartments called lobules
 Each lobule contains 1-3 seminiferous tubules
where sperm are produced
 Supporting structure – deliver and/or assist in
joining gametes
 The PENIS contains the urethra and is a passageway
for the ejaculation of semen and the excretion of
urine
 It is cylindrical in shape and consists of a body,
glans penis, and a root
 The two dorsolateral masses are the corpora
cavernosa penis, and the smaller midventral mass is
the corpus spongiosum penis (contains the spongy
urethra and keeps it open during ejaculation)
Arteries and veins carry blood to and from the
penis. These blood vessels play an important role in
erections.
During an erection, the arteries expand to increase
blood flow to the penis. The blood fills two tubes of
spongy tissue in the penis (corpus cavernosa). This
causes them to swell, making the penis larger and stiff,
so it angles out from the body. The veins narrow, which
traps the blood and maintains the erection.
After the man ejaculates or is no longer sexually
aroused, the veins expand and the trapped blood flows
back to the body. The penis returns to its normal size
and becomes soft (flaccid).
 The ACCESSORY GLANDS contribute greatly to the
constituents of the ejaculate
1. SEMINAL VESICLES secrete a viscous, alkaline fluid
(mainly during ejaculation) which makes up 60% of
the total volume.
 It contains fructose (for energy), prostaglandins
(to stimulate smooth muscle contractions), and
clotting proteins (fibrinogen)
 *peristaltic movement of sperm
 the alkalinity neutralizes the acidity of the
male urethra and the female reproductive tract
 The seminal vesicles are a pair of glands along the
back of the bladder base in men and are part of the
male genital system. Their main function is to
produce a fluid that makes up semen, which is
released during ejaculation.
2. PROSTATE is a chestnut-sized, donut-shaped gland
that secretes about 25% of ejaculate volume.
 Prostatic fluid is a milky, slightly acidic solution
containing citric acid (for energy), acid
phosphatase, and proteolytic enzymes (PSA
and hyaluronidase)
3. BULBOURETHRAL (COWPER'S) GLAND is a pea-
sized gland inferior to the prostate.
 It secretes a protective alkaline mucus that
decreases sperm damage in the urethra (pre-
ejaculatory fluid)
PHYSIOLOGY
• Prenatal secretion of testosterone assists testicular
descent and development of male external genital
• Secretion of testosterone at puberty leads to
development of male secondary sexual
characteristics
 stimulation of anabolism (musculoskeletal and
protein growth)
 hair growth patterns
 lowering of the voice
 development of libido (sexual drive)
 cryptorchidism – one or both of the testes fail to
descend from the abdomen into the scrotum
SPERMATOGENISIS
 Spermatozoa are produced in the seminiferous
tubules by sperm stem cells called spermatogonia
 At the beginning of puberty, the anterior pituitary
increases secretion of the gonadotrophs: LH and
FSH
 Follicle-stimulating hormone (FSH) stimulates
Sertoli cells and increases the rate of
spermatogenesis
 LH stimulates Leydig cells, which are located
between seminiferous tubules, to secrete the
hormone testosterone
 Once the degree of spermatogenesis (sperm
formation) required for male reproductive functions
has been achieved, Sertoli cells release inhibin, a
hormone that inhibits FSH
SPERMATOZOA
 Each day about 300 million sperm complete the
process of spermatogenesis.
 A sperm contains several structures that are highly
adapted for reaching and penetrating a secondary
oocyte
 The major parts of a sperm are the head and the
tail
 The nucleus contains 23 highly condensed
chromosomes (half the normal number)
 The acrosome is a cap-like vesicle filled with
enzymes (hyaluronidase and proteases) that help a
sperm to penetrate a secondary oocyte to bring
about fertilization
 The middle piece contains many mitochondria
which provide the energy (ATP) for locomotion
 Before ejaculation, sperm travel via the following
route:
1. Seminiferous tubules
2. Rete testis (network)
3. Efferent ducts
4. Ductus epididymis
5. Vas (ductus) deferens
SEMEN
 Semen is a mixture of sperm and seminal fluid, a
liquid that consists of the secretions of the
seminiferous tubules, seminal vesicles, prostate,
and bulbourethral glands
 The volume of semen in a typical ejaculation is 2.5-5
milliliters (ml), with 50-150 million sperm per mL
  when the number falls below 20 million/mL, the
male is likely to be infertile
MALE SEXUAL RESPONSE
 Upon sexual stimulation (visual, tactile, auditory,
olfactory, or imagined), sacral parasympathetic
fibers initiate and maintain an erection
 Under the influence of nitric oxide released from
parasympathetic neurons (“neurogenic NO”),
arteries that supply the penis dilate and blood
enters penile sinuses in the erectile tissue; NO also
causes the smooth muscle within the erectile tissue
to relax, resulting in widening of the blood sinuses
 After an erection, sympathetic stimulation is
necessary for the rest of the sexual response,
including ejaculation
 The smooth muscle sphincter at the base of the
urinary bladder must close, followed by semen
being propelled into the penile portion of the
urethra (emission)
 Powerful contractions culminate in the release of
semen from the urethra to the exterior
 Sympathetic – male ejaculation
 Parasympathetic – male erection
DISRUPTION OF HOMEOSTASIS
 Benign prostatic hypertrophy is an enlargement of
the prostate gland in the absence of cancer. It is a
very common affliction as men age, resulting in
obstruction of urine flow and inability to completely
empty the bladder
 Impotence is the inability to maintain erection long
enough for sexual intercourse
 Primary infertility describes couples who have
never been able to become pregnant after at least 1
year of unprotected sex
 Most experts define infertility as not being able
to get pregnant after at least one year of trying.
Secondary infertility describes couples who
have been pregnant at least once, but have not
been able to become pregnant again. Women
who are able to get pregnant but then have
repeat miscarriages are also said to be infertile.
FEMALE REPRODUCTIVE SYSTEM
ANATOMY
OVARIES
 The primary role of the ovaries are to produce
mature secondary oocytes (female gametes) and
release one (ovulation)
 Another important function of the ovaries are to
secrete the female hormones estrogen,
progesterone, inhibin, and relaxin
UTERINE (FALLOPIAN TUBE)
 After receiving the secondary oocyte at the
infundibulum the uterine tube (fallopian tube)
provide a site for fertilization, and then transport
for the ovum if fertilization occurs.
The main anchors for the ovaries are the suspensory
ligaments of the ovary (for pelvic wall attachment), and
the ovarian ligament (provides an attachment to the
side wall of the uterus)
UTERUS
 The uterus is a pear shaped organ situated between
the urinary bladder and the rectum
 It serves as part of the pathway for sperm
 It is also the site of implantation of a fertilized
ovum
 During reproductive cycles when implantation does
not occur, the uterus is the source of menstrual
flow
CERVIX
 The cervix is a cylinder-shaped neck of tissue that
connects the vagina and uterus.
VAGINA
 The vagina is a fibromuscular canal lined with
mucous membrane
✓ Serve as a passageway for menstrual flow
✓ Receive sperm
✓ Form the lower birth canal
 The vulva (female external genitalia)
 Mons pubis (created by adipose tissue)
 Erectile tissue of the clitoris
 Labia majora (outer limits of vulva) and labia
minora (covers the vestibule)
 Vestibule, the area between the labia minora
 Vaginal orifice (opening)
GLANDS
 Anterior to the vaginal orifice and posterior to the
clitoris is the opening of the external urethral
orifice
 Mucus-secreting paraurethral glands flank the
orifice (homologous to the prostate gland in
males)
 On either side of the vaginal orifice itself are the
greater vestibular (Bartholin's) glands. They
produce a small quantity of lubricating mucous
during sexual arousal.
PERINIUM
 The perineum denotes the diamond-shaped area
medial to the thighs and buttocks of females (and
males) - the entire undersurface of the pelvis
 It contains the external genitalia and anus
MAMMARY GLANDS
 The breasts (mammary glands) are modified
sudoriferous glands that produce milk: Each
contains 15-20 lobes divided into lobules
 Each lobule is composed of milk-secreting glands
called alveoli. The nipple has a pigmented area
(areola)and openings for the lactiferous ducts
PHYSIOLOGY
 During reproductive years, non-pregnant females
normally exhibit cyclical changes in the ovaries and
uterus
 Each cycle takes about a month and involves
both oogenesis (ovarian cycle) and preparation
of the uterus (uterine cycle) with hormones
secreted by the hypothalamus, anterior
pituitary, and ovaries controlling the main
events
 The hormones secreted in the brain constitute the
part of the cycle called the hypothalamic/pituitary
cycle (GnRH, FSH, and LH)
 The reproductive organs in the female respond to
the brain hormones by cycling at two "lower" levels
 ovarian cycle – occurs in the ovaries where 1°,
2° and 3° follicles are formed
 uterine cycle – refers to the monthly cycling of
the endometrium
OVARIAN CYCLE
 The formation of gametes in the ovaries is termed
oogenesis. In contrast to spermatogenesis, which
begins in males at puberty, oogenesis is more
complex and begins in females before they are even
born
 During early fetal development, primordial germ
cells differentiate into oogonia
 Germ cells are the only cells in the body that
have half the amount of chromosomes,
undergo both mitosis and meiosis and in males
produce the gamete, sperm.
 At birth, ~ 200,000 to 2,000,000 primary oocytes
remain in each ovary.
 Even before birth, most oogonia degenerate,
though a few develop into larger cells called 1°
oocytes
 Of these, about 40,000 are still present at puberty,
and around 400 will mature and ovulate during a
woman's reproductive years. (SECONDARY OOCYTE)
OOGENESIS
OVARIAN CYCLE
 At puberty, under the influence of LH and FSH (the
brain gonadotropins), several primordial follicles
will be stimulated each month
 Maturing oocytes within maturing follicles undergo
a series of developmental stages which ultimately
brings one 2° oocyte
 ***granulosa cells inside the follicle
OVULATION
 At ovulation the 3° follicle (mature Graafian follicle)
ruptures to expel the 2° oocyte into the pelvic
cavity, normally to be swept into the uterine tube if
not fertilized, it degenerates
 if sperm are present and one penetrates the 2°
oocyte, meiosis Il resumes
OVARIAN CYCLE
 In the ovary, the mature Graafian follicle has
become a corpus luteum, a temporary structure
essential for establishing and maintaining
pregnancy in females
 It secretes estrogens and progesterone, which
are responsible for the thickening of the
endometrium and its development and
maintenance
 After approx. 14 days, if the 2° oocyte is not
fertilized, the corpus luteum stops secreting
progesterone and degenerates into a corpus
albicans (just a mass of fibrous scar tissue)
 Without estrogen and progesterone, the uterine
lining cannot be maintained and it sloughs (menses)
menstruation
 On the other hand, pregnancy occurs, the corpus
luteum is "rescued" from degeneration by an LH-
like hormone called human chorionic
gonadotrophin (hCG- produced by the developing
embryo).
 With hCG support, the corpus luteum goes on to
produce hormones well into the 1st trimester until
the placenta can take over
 The window of opportunity for fertilization to
happen is – 2 days before ovulation to 1 day after
ovulation (the sperm can survive 48-72 hrs in the
uterine tube)
 At the moment of conception, the successful sperm
penetrates the plasma membrane of the 2° oocyte
and the nuclear material of the two cells unite to
reconstitute the new diploid cell is called a zygote
UTERINE CYCLE
 In many ways the uterine or menstrual cycle closely
parallels the events happening in the ovaries
 Under the influence of the ovarian hormones, the
uterine lining undergoes cyclic events (4 phases)
every 28 days (on average)
1. Menses (menstruation) marks the beginning of
the cycle, day 1 to day 5
2. This is followed at day 5 by the pre-ovulatory
phase (follicular phase)
3. Ovulation occurs on about day 14
4. After which the post-ovulatory phase (luteal
phase) begins
MENSES
 Menses (MENSTRUATION) manifests as a
degeneration of the endometrium when levels of
progesterone become insufficient
 Prostaglandin released by the "unsupported"
endometrium causes constriction of supply arteries
causing a reduction in blood flow: Bloody
endometrial tissue eventually sloughs, and is passed
out through the two uterine os and into the vagina
 Menstruation lasts 1-7 days with 50-150 ml of fluids
and cells lost
OVARIAN HORMONES
 Estrogen, progesterone, relaxin, and inhibin are all
secreted by ovaries (and the placenta during
pregnancy)
 Estrogen is responsible for the presence of
secondary sex characteristics (adipose tissue in the
breasts, mons pubis, abdomen, and hips, voice
pitch, and broad pelvis)
 Progesterone is the principal hormone responsible
for maturation of the uterine endometrium, as well
as an important player in stimulating breast
development. It inhibits GnRH and LH through a
negative feedback loop
 Relaxin is released by the corpus luteum; it relaxes
the myometrium and the pubic symphysis at the
end of pregnancy
 Inhibin is released by granulosa cells, and then in
large amount by the corpus luteum; it inhibits FSH
and LH

FEMALE SEXUAL RESPONSE

 As in the male, the initiation of the sexual response
results in stimulation of sacral parasympathetic
fibers and nitric oxide dilation of the erectile tissue
– in this case, of the clitoris
 Sexual climax culminates in a sympathetic
discharge, accompanied by quick cycles of muscle
contraction in the lower pelvic muscles and an
intense feeling of euphoria
 During this time, release of the neurohormones
oxytocin and prolactin produce a feeling of
relaxation
 Release of these hormones (and others, like
vasopressin) also serves as a reward mechanism
that regulates pair-bonding and sexual imprinting
between the partners

DISRUPTION OF HOMEOSTASIS
MENSTRUAL ABNORMALITIES
 Amenorrhea – absence of menstruation
 Dysmenorrhea – unusual menstrual discomfort
(usually indicates an excess of prostaglandin
secretion)
 Disfunctional Uterine Bleeding (DUB) – abnormal
uterine bleeding in the absence of organic disease
(usually an estrogen/progesterone imbalance)
 Premenstrual Syndrome (PMS) – indicates a mild
distress near end of postovulatory (luteal) phase
 MIDTERM
CARDIOVASCULAR / CIRCULATORY SYSTEM
 heart and blood vessels transport water, gases (O 2,
CO2, N2), proteins, and hormones throughout the
body
 regulates temperature and blood pH, and facilitate
the functions of the immune system
 A closed-circuit system composed of the heart,
blood vessels, and blood.
THREE COMPONENTS:
1. Heart
2. Blood vessels
3. Blood
HEART
 pumps blood throughout the circulatory system
 weighs about 350g (about the size of a closed fist)
 beats more than 10,000 times per day
LOCATION:
 Mediastinum – extends anteriorly in sternum,
posteriorly in vertebral column, and medially
between the two lungs; and the pleural
membranes that cover them
 Space between the lungs where the heart
lies
 heart rest on top of diaphragm
POSITION:
 2/3 of the heart’s mass is just barely to the left
of the midline
 Base of the heart – tipped up medially and
posteriorly right pointing
 Top part of the heart that is broad
 Apex of the heart – inferiorly and laterally left
pointing
 The pointed end of the heart that rests on
the diaphragm (it is directed toward the left
hip)
PERICARDIUM
 membrane that surrounds and protects the
heart and retains its position in the
mediastinum
TWO LAYERS OF PERICARDIUM
1. Fibrous Pericardium
- outermost layer
- prevents overstretch
- serves as an anchor
2. Serous Pericardium
- innermost layer
TWO TYPES OF SEROUS PERICARDIUM
a. Parietal Serous Pericardium – adheres tightly to
fibrous pericardium
b. Visceral Serous Pericardium (Epicardium) –
adheres tightly in the heart
PERICARDIAL FLUID
 Function: decreases the friction of the heart
 Location: between visceral and parietal serous
pericardium (pericardial cavity)
 Amount: 50mL
 Decreased: Pericardial Friction Rub (+)
Pericarditis
 Increased: Cardiac Tamponade (+) Cardiac
Arrest
INTERSTITIAL FLUID
 Fluid between the cells or body parts.
 Fluid that is found outside the circulatory
system and also outside cells
LAYERS OF THE HEART WALL
1. Epicardium (Visceral Serous Pericardium)
- outermost layer
- contains blood vessels, lymphatics, and vessels
that supply the myocardium
2. Myocardium
- pumping action
- contains cardiac muscle tissue (involuntary)
3. Endocardium
- provides a smooth lining for chambers and
covers the valves
- minimizes surface friction as blood passes
through the heart
- thin sheet of endothelium that lines the heart
chambers, it is continuous with the linings of
the blood vessels
CHAMBERS OF THE HEART
Upper Chambers or Receiving Chambers
1. Right Atrium
2. Left Atrium
Lower Chambers or Pumping Chamber
3. Right Ventricle
4. Left Ventricle
RIGHT HEART
 consists of the right atrium and right ventricle
 taking venous (deoxygenated) blood from the
body and pumping it to the lungs for
oxygenation
LEFT HEART
 consists of the left atrium and left ventricle
 taking freshly pulmonary (oxygenated) blood
and pumping it systematically
AORTA
 The major artery of the cardiovascular system;
arises from the left ventricle of the heart.
HEART VALVES
 prevents backflow of the blood
AV (Atrioventicular) Valves / Inlet
 Between the atrial and the ventricular
chambers on each side.
1. Tricuspid Valve at (R) – regulates blood flow
between right atrium and right ventricle
2. Bicuspid/Mitral Valve at (L) – lets oxygen-rich
blood pass from the left atrium into the left
ventricle
SL (Semilunar) Valves / Outlet
 Set of valves that guards the bases of the 2
large arteries leaving the ventricular chambers
3. Pulmonic Valve – controls blood flow from the
right ventricle into the pulmonary arteries
 4. Aortic Valve – opens the way for oxygen-rich
blood to pass from the left ventricle into the
aorta

BLOOD VESSELS

ARTERIES
 A blood vessel that carries oxygenated blood
away from the heart to vital organs and the
extremities.
 always conduct blood away from the heart
 contains oxygenated blood (except fetal
circulation = deoxygenated blood)
 most are thick-walled, and exposed to high
pressures and friction forces

VEINS
 Blood vessels that carry deoxygenated blood
toward the heart from vital organs and the
extremities.
 always bring blood back to the heart
 contains deoxygenated blood (except fetal
circulation = oxygenated blood)
 most are thin-walled, and exposed to low
pressures and friction forces
BLOOD FLOW TRHOUGH THE HEART
1. Systemic Circuit
- ejects blood into the aorta, systemic arteries,
and arterioles
- powered by the left side of the heart
- The circulatory vessels of the body.
2. Pulmonary Circuit
- ejects blood into the pulmonary trunk
- powered by the right side of the heart
- The circulatory vessels of the lungs; involved in
the circulation of blood from the right ventricle
of the heart to the lungs and back to the left
atrium of the heart.
CORONARY CIRCULATION
 innermost tissues lining the chambers of the heart
 myocardium (and other tissues of the thick cardiac
walls) must get nutrients from blood flowing
through the coronary circulation
 only during the relaxation phase of ventricular
diastole, will blood actually flow through the
coronary circulation
CAPILLARIES
 The smallest blood vessels that supply blood to
the tissues, and the site of all gas and nutrient
exchange in the cardiovascular system. They
connect the arterial and venous systems.
ARTERIOLES
 Small-diameter blood vessels that extend and
branch out from an artery and lead to
capillaries; the primary site of vascular
resistance.
VENULES
 Smaller divisions of veins.
SUPERIOR AND INFERIOR VENAE CAVAE
 The veins that bring in blood from the upper
and lower parts of the body to the heart
AUTORHYTHMICITY
 rhythmical electrical activity that produced by
myocytes
 heart muscle is autorhythmic, it does not rely on
the central nervous system to sustain a lifelong
heartbeat
 when transplanted hearts are re-warmed
following cardiopulmonary bypass, they once
again begin to beat without the need to
connect outside nerves or use life-long
pacemaker devices
 75 heart beat per minute

CORONARY ARTERIES
 Starting at the aortic root, the direction of blood
flow is from the aorta to the left and right
coronary arteries
 Left Coronary Artery – to anterior
interventricular and circumflex branches
 Right Coronary Artery – to marginal and
posterior atrioventricular branches
CORONARY VEINS
 Coronary veins all collect into the coronary
sinus on the back part of the heart
 Coronary sinus – empties into the right atrium
where the deoxygenated coronary blood joins
with oxygen-depleted blood from the rest of
the body
CARDIAC CONDUCTION SYSTEM
Cardiac Action Potential
 self-excitable myocytes that "act like nerves"
 forming the conduction system of the heart
and acting as pacemakers within that system
a. Conduction – transmission of impulse
b. Pacemaker – generates electrical activity
which will influence your heart to beat
COMPONENTS
1. Sinoatrial (SA) node
 natural or normal pacemaker of the heart
because it initiates all heartbeat
 has the fastest rate of depolarization
  Location: right atrial wall just below where the
superior vena cava enters the chamber

2. Atrioventricular (AV) node

 Refractory Period – time for the atria to empty
the blood before the ventricles contract
 the signal is slowed, allowing the atrium a
chance to mechanically move blood into the
ventricles
 prevent backflow into the atria when the
ventricles contract
 Location: by propagating throughout the wall of
Cardioacceleratory Center
the atria to the AV node in the interatrial
 nervous system regulation of the heart
septum
originates in the cardiovascular (CV) center
 Interatrial or intraventricular septum –
 found in the medulla oblongata
divides the heart longitudinally
 sensory information from baroreceptors in the
carotid body and in the arch of the aorta relay
3. Atrioventricular (AV) Bundle (Bundle of His)
information about blood pressure and blood
 only site where action potentials can conduct
flow to the cardioacceleratory center
from the atria to the ventricles
Sympathetic
4. Right and Left Bundle Branches
 sympathetic nerves are present throughout the
 extend through the interventricular septum
atria (especially in the SA node) and ventricles
toward the apex of the heart
 sympathetic activity increases the heart rate
 Interventricular Septum – Muscular wall
and the strength of myocardiac contraction to
that separates the right and left sides of the
increase blood flow out of the heart (ejection
heart, preventing the mixing of blood from
fraction)
the two sides of the heart.
Cardioinhibitory Center
5. Purkinje Fibers
 medulla also contains the cell bodies of the
 largest pacemaker
neurons that make up the cardioinhibitory
 conduct the action potential throughout the
center
ventricles
 same sensory information coming in from
 Location: ventricle walls
peripheral baroreceptors goes to this area as
well
Describe how the Intrinsic Conduction System Works
1. 1st the SA node (a tiny cell mass) starts each Parasympathetic
heartbeat and sets the pace.  When cardioinhibitory center is stimulated,
2. 2nd From the SA node, the impulses spreads parasympathetic fibers in CN X, the vagus
through the atria to the AV node to cause a nerve, release acetylcholine that decreases the
contraction heart rate and strength of contraction
3. 3rd Once the AV node is finished contracting it is
passed though the AV bundle, the bundle of his, the
EFFECTS OF ANS TO CONDUCTION SYSTEM (CARDIAC
bundle braches and the purkinjie fibers.
MUSCLE ACTION POTENTIAL)

COORDINATING CONTRACTIONS Contractile Muscle Fibers

 Functional Syncytium – formed when the bands of
muscle wind around the heart and work as a unit,
although anatomically the heart consist of
individual cells
 it allows the top and bottom parts to contract in
their own unique way
 Atrial Muscle Syncytium – contracts as a sing unit
to force blood down into the ventricles
 Syncytium of Ventricular Muscle – starts
contracting at the apex (inferiorly), squeezing blood
upward to exit the outflow tracts
AUTONOMIC NERVOUS SYSTEM (ANS) INNERVATION
 Role of ANS input: regulate changes in blood
pressure, blood flow, and blood volume to maintain
enough cardiac output to provide for all organs at
all times (if possible)
 although the heart does not rely on outside nerves
for its basic rhythm, there is abundant sympathetic
and parasympathetic innervation which alters the
rate and force of heart contractions
 action potential (AP) initiated by the SA node
travels along the conduction system and
spreads out to excite the “working” atrial and
ventricular muscle fibers
 have a stable RMP of -90mV
 The AP propagates throughout the heart
by opening and closing Na+ and K+
channels
 2 K+ out : 3 Na+ in
An action potential occurs in a contractile fiber as
follows:
1. Depolarization / Na+ Influx
 rapid depolarization due to Na+ inflow when
voltage-gated fast Na+ channels open
2. Plateau
 plateau (maintained depolarization) due to
Ca2+ inflow when voltage-gated slow Ca2+
channels open and K+ outflow when some K+
channels open

3. Repolarization / K+ Efflux
 repolarization due to closure of Ca2+ channels
and K+ outflow when additional voltage-gated
K+ channels open
HEMODYNAMICS
Cardiac Cycle
 The period from the beginning of one heartbeat
to the beginning of the next heartbeat; the
systolic and diastolic phases and the interval in
between.
 includes all events associated with one
heartbeat, including diastole (relaxation phase)
and systole (contraction phase) of both the atria
and the ventricles
 in each cycle, atria and ventricles alternately
contract and relax
a. during atrial systole, the ventricles are
relaxed
b. during ventricle systole, the atria are
relaxed
 Two principal events of the cycle:
a. ventricular filling during ventricular diastole
b. ventricular ejection during ventricular
systole
 the blood pressure that we measure in the arm
is a reflection of the pressure developed by the
left ventricle, before and after left ventricular
systole
Systole
 The contraction phase of the cardiac cycle.
 When the ventricles contract
Diastole
 The period of filling of the heart between
contractions; resting phase of the heart.
 When the ventricles relax
Auscultation
 during the cardiac cycle, all 4 of the heart valves
have a chance to open and close
 sounds that the heart makes
S1 “lubb”, closure of AV valve
S2 “dubb”, closure of SL valve
blood turbulence during rapid fillings of
S3
ventricles
S4 blood turbulence during atrial systole
Cardiac Output
 The amount of blood pumped by each side of
the heart (actually each ventricle) in one minute
 volume of blood ejected from the left ventricle
(or the right ventricle) into the aorta (or
pulmonary trunk) each minute
 Resting Cardiac Output: 4 – 6 Liters
 Formula: CO (mL/min) = SV (mL/beat) x HR
(beats/min)
 Cardiac Output – amount of blood ejected
in each minute
 Stroke Volume – amount of blood ejected in
every heart beat
Starling’s Law of the Heart
 the more the heart muscle is stretched (filled)
before contraction (preload), the more
forcefully the heart will contract
 increased preload – increased cardiac
contraction
BLOOD PRESSURE
 usually measured in the larger conducting arteries
where the high and low pulsations of the heart can
be detected – usually the brachial artery
 The pressure the blood exerts against the inner
walls of the blood vessels, it is the only force that
keeps blood circulating continuously even between
heartbeats
a. Systolic BP – is the higher pressure measured
during left ventricular systole when the aortic valve
is open
 pressure in the arteries at the peak of
ventricular contraction
 Normal Systolic BP: 110-140 mm Hg
b. Diastolic BP – is the lower pressure measured
during left ventricular diastole when the valve is
closed
 pressure when the ventricles are relaxing
 Normal Diastolic BP: 70-80 mm Hg
 Normal BP varies by age, but is approximately 120
mmHg systolic over 80 mmHg diastolic in a healthy
young adult (in females, the pressures are often 8–
10 mmHg less.)
 people who are in good physical condition or
who have a favorable genetic predisposition
have lower BPs
Mean Arterial Pressure (MAP)
 average pressure in large arteries
 roughly 1/3 of the way between the diastolic
and systolic BP
 Formula: 1/3 (systolic BP – diastolic BP) +
diastolic BP
ELECTROCARDIODIAGRAM (ECG)
 recording of the electrical changes on the surface of
the body resulting from the depolarization and
repolarization of the myocardium
 ECG recordings measure the presence or absence of
certain waveforms (deflections), the size of the
waves, and the time intervals of the cardiac cycle
 help us determine normal from abnormal cardiac
activity:
 abnormal ECGs show problems within the
conduction pathways, whether or not the heart
is enlarged, or if certain regions are damaged

The major deflections and intervals in ECG normal
includes:
1. P Wave – atrial depolarization or contraction
2. P-Q Interval – time it takes for the atrial kick to fill
the ventricles (refractory period)
3. QRS Wave/Complex – atrial repolarization and
ventricular depolarization
4. S-T Segment – time it takes to empty the ventricles
before they repolarize
5. T Wave – ventricular repolarization or relaxation
6. Q-T Interval – from contraction to relaxation
VASOCONTRICTION
 Narrowing of the blood, the major action of the
sympathetic nervous system
 Cold has a vasoconstricting effect while heat
has a vasodilating effect
BLOOD
 contributes to homeostasis by transporting
respiratory gasses, nutrients, and hormones to
and from your body’s cells
 helps regulate body pH and temperature, and
provides protection through its clotting
mechanisms and immune defenses
 primary function is transportation
 about 4x more viscous than water
 Temperature: about 1°C higher than measured
body temperature
Constituents of Blood
 blood is a liquid connective tissue that contains:
 cells
 plasma, a liquid ground substance
 dissolved protein fibers
 whole blood can be separated into liquid
component and cellular components using a
machine called a centrifuge
PLASMA
 Plasma is 92% water, with dissolved solutes
consisting mostly of various proteins, electrolytes,
and gasses
 The liquid portion of the blood responsible for
carrying hormones, plasma proteins, food materials
(e.g., carbohydrates, amino acids, lipids), ions (e.g.,
sodium, chloride, bicarbonate), and gases (e.g.,
oxygen, nitrogen, carbon dioxide) throughout the
body.
FORMED ELEMENTS
Red Blood Cells (RBCs) or Erythrocytes
 make up the bulk of the blood cells, with many
fewer white blood cells (WBCs) interspersed in
among them
 Hematocrit (Hct) – normal RBC is between 40-
50% by volume, and corresponds to 4-6 x
106/mm3 by number
White Blood Cells (WBCs) or Leukocytes
 by number, make up between 5-10 x 10 3/mm3
 RBCs outnumbered WBCs by about 700:1
 there are 5 different types of WBCs, all with
varying functions
Megakaryocytes
 huge cells that splinter into 2000 to 3000
fragments while still in the red bone marrow
 Platelet – each fragment, enclosed by a piece of
the plasma membrane
 Platelets leave the red bone marrow and
enter the circulation as an irregularly
shaped disc with many vesicles but no
nucleus
Platelets or Thrombocytes
 more numerous than WBCs (150-400 x
103/mm3)
 have a short life span (5 to 9 days) and don’t
have much mass
 appear as little specks interspersed among the
many red cells
 One of the disc-shaped components of the
blood; involved in clotting.
HEMATOPOIESIS
 process by which the formed elements of blood
develop
 in adults, blood cells are formed in red bone
marrow from pluripotent stem cells, they mature in
bone marrow or lymphoid tissue
 Pluripotent stem cell – is the progenitor of all
the other red bone marrow cells
Erythropoiesis
  part of hematopoiesis that deals with the
production of RBCs
 increases when states of hypoxia (O 2 deficiency)
stimulates the kidneys to release the hormone
erythropoietin (EPO)
 EPO – circulates to the red marrow and
speeds up the maturation and release of
immature red cells
RED BLOOD CELLS
 bi-concave discs
 mature RBCs don't have a nucleus or any protein
making machinery and are destined to die in about
120 days
 not really cells, but remnants of cells with a very
specific purpose – to carry O2 to the tissues of the
body
 the characteristic RBC shape increases the cell
surface area and gives them a high oxygen carrying
capacity
 because they lack mitochondria, they don’t use
any of the oxygen they carry
 their shape also allows them to deform and fit
in small capillary beds
Reticulocytes
 rate of erythropoiesis is measured by the
number of immature RBCs (called reticulocytes
or “retics”) in the peripheral circulation
 a low retic count (<.5%) indicates a low rate
of erythropoiesis while an elevated rate
(>2%) indicates a high rate of erythropoiesis
Hemoglobin (Hgb)
 a protein molecule adapted to carry O 2 (and CO2
as well), and each RBC contains 280 million
molecules of Hgb
 Hgb molecule consists of 4 large globin proteins
(2 alpha and 2 beta chains), each embedding an
iron-containing heme center
Red Blood Cell Life Cycle
 RBCs live only about 120 days
 to maintain normal numbers, new mature cells
must enter the circulation at the astonishing
rate of at least 2 million/second, a pace that
balances the equally high rate of RBC
destruction
 Ruptured RBCs are removed from
circulation and destroyed by fixed
phagocytic macrophages in the spleen and
liver — the breakdown products are
recycled and used in numerous metabolic
processes, including the formation of new
RBCs
 Phagocytosis – eating mechanism of a cell
WHITE BLOOD CELL
 have nuclei and a full complement of other
organelles - but they do not contain the protein Hgb
Two Groups depending on whether they contain
conspicuous chemical-filled cytoplasmic granules (when
stained)
1. Granulocytes – include the neutrophils, eosinophils,
and basophils
2. Agranulocytes – are the monocytes and
lymphocytes
Neutrophils or Polymorphonucleocyte (PMN)
 most numerous WBC in normal blood (60-70%)
 have pinkish cytoplasm, and they are one of the
two major phagocytes in the body
 phagocytic cell
 principle role is to fight bacterial infections
 Chemotaxis – a phenomenon when chemicals
released by microbes and inflamed tissues
attract phagocytes
Eosinophils
 much less numerous than neutrophils (2-4% of
circulating WBCs)
 characterized by their large red granules
 phagocytize antigen-antibody complexes
 also destroy some types of parasitic worms
 but their numbers increase slightly with
parasitic infection
 have also been associated with the
development of allergies
Basophils
 lowest number of circulating WBCs (only 0-1%)
 release histamine (large, dark blue containing
granules) and other chemical defenses
 play important role in inflammatory responses
(allergic reactions)
 Mast cells – when basophils leave the
bloodstream and enter the tissues
Monocytes
 they come from the same immediate precursor
cell as the 3 granulocytes (the myeloid stem
cell)
 major group of phagocytic cell along with
neutrophils
 phagocytize bacteria, cell fragments, dead
cells, and debris
 Macrophages – when monocytes leave the
bloodstream and enter the tissues
 Phagocytize foreign substances and help
activate T-cells
Lymphocytes
 approximately 20-30% of circulating white cells
 the cornerstone of the specific immune
response
 quite different; develop as responders to very
specific foreign antigens
a. T-lymphocytes (T-cells) – manage and
direct an immune response – cancer cells
 Manage the immune response AND
attack and destroy foreign cells
 mature in Thymus Gland
b. B-lymphocytes (B-cells) - stimulated to
become plasma cells and produce
antibodies
 produce plasma cells which secrete
antibodies
 mature in bone marrow
c. Natural killer cells (NK cells) - attack
abnormal and infected tissue cells (tumor)
 These leucocytes kill by "touch killing."
They contact a foreign cell and release
perforins and they also cause apoptosis.
  an increase above this number is called a
lymphocytosis and often represents an acute
viral infection
 most lymphocytes continually move among
lymphoid tissues, lymph, and blood, spending
only a few hours at a time in blood
WBC Indices
 For diagnostic purposes, physicians measure
the total number of circulating WBCs
a. leukocytosis – any WBC count >
10,000/mm3, and usually indicate an
infectious process or a cancer
b. leukopenia – any WBC count < 5,000/mm 3,
and usually indicates a severe disease (AIDS,
bone marrow failure, severe malnutrition,
or chemotherapy)
WBC Differential
 to enhance the diagnostic value of a WBC
count, the percentages of each of the 5 types of
WBCs is determined by using a machine to do a
statistical analysis of the blood sample
PLASMA
 the fluid component of the blood and contains
everything in blood except the formed elements,
which, for collection purposes, have been
centrifuged out
 contains mostly water, with electrolytes, hormones,
proteins, dissolved gasses, and glucose and other
nutrients
Albumin
 most abundant plasma protein which regulates
movement of water between tissue pores and
blood vessels via osmosis
 major protein that has many clotting proteins,
antibodies, and enzymes
 relatively simple, water soluble protein with a
low molecular weight – it forms small heart-
shaped globules just over 8 nm in size
 synthesized in the liver and contributes
significantly to the blood viscosity and the
body’s ability to maintain blood pressure
 plays an important role as a carrier molecule
Globulins
 plasma proteins that acts as a transport
molecule; act as antibodies in response to
antigens
 control blood osmotic pressure and act as
carrier molecules
a. α-globulins – carry bilirubin and steroids
b. β- globulins – carry copper and iron
c. δ-globulins – are immunoglobulins
(antibodies) made by activated B
lymphocytes called plasma cells
Fibrinogen
 Plasma protein that contributes to formation of
blood clots
CARDIOVASCULAR SYSTEM
(BLOOB PART II)
PLASMA PROTEINS
1. Albumin – smallest, most abundant (58%); act as
transport proteins that carry ions, hormones, and
some lipids in the blood.
2. Globulin – 37%; immunoglobulins or antibodies.
3. Fibrinogen – 4%; responsible for blood clot
formation.
4. Regulatory proteins – include enzymes to
accelerate chemical reactions in the blood
PLATELETS
 2 micrometers in diameter (less than one-fourth the
size of an erythrocyte).
 continually produced in the red bone marrow by
cells called megakaryocytes
 activated by severe trauma to a blood vessel causes
the blood to coagulate, or clot
 components in the plasma produce a web of
fibrin that traps erythrocytes and platelets in
the web to halt blood flow (increase the bond
between the platelets)
HEMOSTASIS
 sequence of responses that stops bleeding
 when blood vessels are damaged or ruptured, the
hemostatic response must be quick, localized to the
region of damage, and carefully controlled in order
to be effective
 Calcium (Ca2+) – plays an important role throughout
the clotting system, and many steps have positive or
negative feedback on various other steps to
propagate the process, yet maintain control
THREE MECHANISMS (REDUCE BLOOD LOSS)
1. Vascular Spasm
 occurs as damaged blood vessels constrict
 decrease in blood vessel diameter =
decrease of blood flow
2. Formation of a Platelet Plug
 platelets adhere to damaged endothelium to
form a platelet plug
3. Blood Clotting (Coagulation)
 possible because of the presence of several
clotting proteins
a. Extrinsic Pathway – has few steps and
occurs rapidly, often within seconds, once
the protein “tissue factor” (TF) leaks into
the blood
b. Intrinsic Pathway – more complex and
occurs more slowly in response to damage
to endothelial cells or phospholipids
released by activated platelets
CLOTTING FACTORS
1. Fibrinogen
2. Prothrombin
3. Tissue Factor Or Tissue Thromboplastin
4. Calcuim
5. Proaccelerain
6. Accelerin / Factor 5a
7. Stable Factor or Proconvertin
8. Antihemophilic Factor A
9. Christmass Factor / Antihemophilic Factor B
10. Staurt Prower Factor
11. Plasma Thromboplastin Antecedent
12. Hageman Factor
13. Fibrin Stabilizing Factor
 EXTRINSIC PATHWAY
outside trauma (tissue trauma)
INTRINSIC PATHWAY
trauma to the blood cells (exposure of blood to
collagen)
COMBINATION OF THE PATHWAYS
FIBRINOLYSIS
 after the coagulation process, a clot has a tendency
to enlarge, creating the potential for impairment of
blood flow through undamaged vessels
 Fibrinolytic System – dissolves small, inappropriate
clots; it also dissolves clots at a site of damage once
the damage is repaired
 both body tissues and blood contain substances
that can activate plasminogen to become
plasmin, (the enzyme that actively dissolves
clots)
INTRAVASCULAR CLOTTING
 Blood clots sometimes form unexpectedly within
the cardiovascular system.
 Clotting in an unbroken blood vessel (usually a vein)
is called thrombosis
 the clot itself, called a thrombus
 low density lipoprotein became plaque
 Such clots may be initiated by roughened
endothelial surfaces of a blood vessel resulting from
atherosclerosis, trauma, or infection
 Intravascular clots may also form when blood flows
too slowly (stasis), allowing clotting factors to
accumulate locally and initiate the coagulation
cascade
 Having an undamaged blood vessels with smooth
surfaces, good circulation, and non-sticky platelets
are important factors that inhibit thrombosis
 administration of anticoagulants and platelet
inhibiting drugs (aspirin-like drugs) can also
hinder thrombus formation or reverse a
thrombus that has formed
 A thrombus may become dislodged and be swept
away in the blood
 Embolus – when a blood clot, air bubble, piece
of fat or other debris is transported by the
bloodstream
 Embolic stroke – blockage by embolus can
cause death of the tissue
BLOOD COMPONENTS
Blood Transfusion
 the process of transferring blood or blood products
from one person to another
 Whole blood is fractionated into units of packed
red blood cells (PRBCs), fresh frozen plasma (FFP),
platelets, and WBCs
 Albumin, coagulation factors, and antibodies can be
individually collected
PLASMA VS SERUM
 Serum – if the liquid part of blood is allowed to
coagulate; serum is just plasma without the clotting
factors
 Serum is stable at room temperature and can
be stored on a shelf
 it is also used for diagnostic testing because it
won’t coagulate in the machine
BLOOD GROUPS
 RBC – have proteins on their surface which act as
antigens or surface markers
 Even within the same species, the antigens of one
individual are not necessarily compatible with
those of another.
 For this reason, before donor blood cells can be
transfused to another person the major surface
antigens must be determined
 the most significant of the 100 markers currently
known to exist on RBCs are the A and B antigens
BLOOD TYPE
 In transfusion medicine the presence or absence of
the A and B red cell antigens forms the basis of the
ABO blood group system
 Another major red cell antigen is the Rh antigen,
which 85% of the population have, and comprises
another important blood grouping
 For reason that are not totally clear, serum contains
anti-ABO antibodies of a type opposite to the ABO
antigen on the red cell surface
 By knowing the status of the A antigen, B antigen,
and Rh antigen, most of the major blood
incompatibility issues can be avoided
 Type AB – “universal recipients” because they
has neither anti-A nor anti-B antibodies in their
serum that would destroy transfused RBCs
 Type O – “universal donors” because their RBCs
have no antigens on the cell surface that can
potentially react with the recipients serum
BLOOD TYPING
 Blood typing for ABO status is done using single
drops of blood mixed with different antisera
 Agglutination with an antisera indicates the
presence of that antigen on the RBC
TRANSFUSION REACTION
 Hemolysis – if the recipient receives the wrong
blood type, antigen-antibody reactions will cause a
rapid destruction of the donor red blood cells
 Giving the wrong type blood can cause the patient
to develop a fever, develop serious renal failure, or
go into shock
 Clerical Error – most common cause (i.e. the
wrong unit of blood being given to the patient)
RH INCOMPATIBILITY
 Normally, blood plasma does not contain anti-Rh
antibodies
 individuals whose RBCs have the Rh antigen are
said to be Rh+ while those who lack the Rh
antigen are Rh-
 Rh incompatibility can cause problems with any
blood transfusion, so it is screened just as carefully
as the ABO group
 perhaps the biggest problem with Rh
incompatibility, however, involves mother and
child in pregnancy
 2nd pregnancy - have already Rh antibodies
 fetus = Rh+ and mother = Rh-
 Hemolytic disease of the newborn (HDN) results
when an Rh+ fetus develops in the womb of an
Rh- woman
 To prevent HDN, mothers who are Rh - are given a
injection of RhoGAM - a commercially produced
anti-Rh antibody – at various points in her
pregnancy
 The administered RhoGAM destroys any Rh +
cells from the baby before the mother’s
immune system can become sensitized to them
and produce her own anti-Rh antibody. For this
same reason, RhoGAM is given to Rh - patients
who have abortions or miscarriages
IMBALANCES
ARTERIOSCLEROSIS
 A chronic disease in which thickening,
hardening, and loss of elasticity of the arterial
walls result in impaired blood circulation;
develops with again, and in hypertension,
diabetes, hyperlipidemia, and other conditions.
PERICARDITIS
 Inflammation of the pericardium that results in
the decrease in the serous fluid.
MYOCARDIAL INFRACTION
 Heart Attack, heart cells die because of
prolonges oxygen deprivation
ENDOCARDITIS
 Bacterial infection of endocardium (Enlarges
Heart)
ANGINA PECTORIS
 When the myocardium is deprived of oxygen
and results in a crushing chest pain.
ISCHEMIA
 Lack of blood supply to the heart muscle
FIBRILLATION
 A rapid uncoordinated shuddering of the heart
muscle, major cause of death in heart attacks
TACHYCARDIA
 Rapid Heart Beat (over 100 beats per minute)
BRADYCARDIA
 Slow Hear Beat (less than 60 beats per minute)
PULMONARY EDEMA
 Blood vessels become swollen with blood, fluid
leaks from the circulation into the lung tissue, if
untreated a person suffocates
 Edema If the lymphatic system did not return
fluid to the blood stream
DYSPNEA
 Shortness of breath
LYMPHATIC SYSTEM
 assists in circulating body fluids and helps defend
the body against disease-causing agents
 acts like a drainage system which removes the
excess fluids in body tissues and returns it in the
bloodstream
Functions:
 Fluid and nutrient transport, lymphocyte
development, and the immune response.
 Reabsorbs excess interstitial fluid: returns it to the
venous circulation; maintain blood volume levels;
prevent interstitial fluid levels from rising out of
control.
 Interstitial fluid – fluid inside the cell
 Transport dietary lipids: lymphatic vessels transport
lipids and lipid-soluble vitamins (A, D, E, and K)
absorbed by the gastrointestinal tract
LYMPHATIC SYSTEM COMPONENTS
I. Lymph (fluid)
 “lymph” once the fluid enters the lymphatic
vessels
 A clear fluid that resembles plasma
 made up of water, electrolytes, waste products
and proteins
 Approximately 20 liters of lymph filter through
from the interstitium each day.
 Lymph is returned to the venous blood.
II. Lymphatic Vessels – the distribution of lymphatic
vessels is similar to that of the veins
a. Lymphatic Capillaries
b. Lymphatic Vessels
c. Lymphatic Trunks
d. Lymphatic Ducts
III. Lymphatic Organs/Tissues – proliferation site;
specialized form of reticular connective tissue that
contains large numbers of lymphocytes (B cells & T
cells)
 These cells areresponsible for immune response
a. Thymus
b. Lymph Nodes
c. Spleen
d. Red bone marrow
e. Lymph nodes
f. Lymph nodules
LYMPHATIC CIRCULATION
 The lymphatic network begins with microscopic
vessels called lymphatic capillaries and act as one-
way valves
 Lymphatic capillaries merge to form larger
structures known as lymphatic vessels
 Lymphatic vessels bring lymph to a lymph node
where it is examined for foreign on pathogenic
material
 Lymph node acts like a filter (pathogens)
Trunks
1. Jugular Trunk – drain the excess fluid from the head
2. Subclavian Trunk – drain the excess fluid from both
upper extremities
3. Bronchomediastinal Trunk – drain the excess fluid
from the thoracic area, and intestinal (digestive
organs)
4. Lumbar Trunk – drain the excess fluid from lumbar
area and both lower extremities
Ducts – where lymph flow going
back to heart
1. Right Lymphatic Duct
2. Thoracic Duct – drains most
of the body lymph
 arises from the cisterna
chyli and drains the rest
of the body
 dumped into the left
subclavian.
 The left thoracic duct drains ¾ of the body's lymph.
 The majority of the body's lymph is drained from
the left side
 The remaining lymph is drained from the right
upper quadrant of the body.
 True: Once the fluid from the right side of the body
is dumped into the right subclavian vein, it is no
longer lymph fluid, it is blood.
 True: swollen, tender lymph nodes mean that the
lymph is active
 False (decrease in size):  The lymphoid tissue
gradually increases in size once you hit puberty
 True: The thymus gland involutes (shrinks) with age.
 True: by the end of the lymphatic cycle, lymph fluid
has been cleaned several times
 True: Lymphatic capillaries have more and larger
pores than regular capillaries
 True: lymphatics start blindly at the tissue space
Two Mechanisms in order to circulate:
The same two “pumps” that aid the return of venous
blood to the heart maintain the flow of lymph.
1. Skeletal Muscle Pump – “milking action” of the
skeletal muscles contraction
2. Respiratory Pump – pressure changes that occur
during inhalation and exhalation (abdominal
pressure – thoracic pressure)
LYMPHATIC ORGANS AND TISSUES
1. Primary Lymphatic Organs – site where stem cells
divide (become T cells, B cells, NK cells)
a. Red bone marrow
b. Thymus
2. Secondary Lymphatic Organs – site where immune
responses occur
a. Spleen
b. Lymph nodes
c. Lymphatic nodules
Primary Lymphatic Organs
Thymus
 bilobed organ located in the anterior
mediastinum or between lungs
 T cells maturation occurs
 Increases in size and is most active during
childhood. Stops growing during adolescence
and then gradually atrophies.
 Differs from other lymphoid organs in
important ways.
 It functions strictly in T lymphocyte maturation.
It does not directly fight antigens.
Red Bone Marrow
 site for hematopoiesis
Secondary Lymphatic Organs
Spleen
 Largest lymphoid organs
 largest single mass of lymphatic tissue in the
body
 Site of lymphocyte proliferation and immune
surveillance and response.
 Cleanses the blood of aged cells and platelets
and debris.
 Composed of 2 kinds of tissue:
a. White pulp – consisting mostly of
lymphocytes and macrophages
 around central arteries Mostly
lymphocytes on reticular fibers and
involved in immune functions
  Lymphoid tissue surrounding the blood
vessels
b. Red pulp – consists of blood-filled venous
sinuses and cords of splenic tissue called
splenic cords or Billroth’s cords.
 blood cells, macrophages, lymphocytes,
plasma cells, and granulocytes
 in venous sinuses and splenic cords Rich
in macrophages for disposal of worn-
out RBCs and bloodborne pathogens
 blood -filled venous sinuses that also
contain lymphocytes and macrophages
Four Functions of Spleen
1. Initiates an immune response when antigens
are found in the blood (a white pulp function).
2. Serves as a reservoir for erythrocytes and
platelets (red pulp function).
3. Phagocytizes old, defective erythrocytes and
platelets (red pulp function).
4. Phagocytizes bacteria and other foreign
materials.
Splenectomy
 ruptured spleen causes hemorrhage and shock;
prompt removal of the spleen to prevent death
due to bleeding
 red bone marrow & liver take over the function
spleen
 prone to Sepsis (a blood infection) due to loss
of the filtering and phagocytic functions of
spleen
Lymphatic Nodules (Follicles)
 are egg-shaped masses of lymphatic tissue that
are not surrounded by a capsule
 nodules are solid, spherical bodies of tightly
packed reticular elements and cells
 Because they are scattered throughout the
lamina propria (connective tissue) of mucous
membranes lining the gastrointestinal, urinary,
and reprductive tracts and the respiratory
airways
 lymphatic nodules in these areas are also
referred to as mucosa-associated
lymphatic tissue (MALT)
 Aggregates of B cells and T cells
 Tonsils aggregated lymphatic follicles
 Simplest lymphoid organs
Function of Tonsils
 They consist of multiple germinal centers and
have invaginated outer edges called crypts.
 The crypts help trap material and facilitate
its identification by lymphocytes
Locations:
 Pharyngeal tonsils (or adenoids) - in the
posterior wall of the nasopharynx.
 Palatine tonsils – in the posterolateral region of
the oral cavity.
 Lingual tonsils – along the posterior one third
of the tongue
Tonsillitis
 infection or inflammation of the tonsils
 caused by virus or bacteria that cause strep
throat
 Tonsillectomy – removal of tonsil
 does not interfere with response to
infections
Lymph Nodes
 These lymph system structures are designed to
ensure that foreign cells meet with
lymphocytes. As such, they serve as outposts of
the immune system
 Afferent vessels carry lymph toward the lymph
node
 Efferent vessels carry lymph away from the
lymph node.
 Small pea shaped patches of lymphatic tissue
which filter lymph as it flows through the
vessels.
 Principal lymphoid organs of the body
 filters pathogens
 located along lymphatic vessels are about 600
bean-shaped
 covered by a capsule of dense connective tissue
 group of lymph nodes
a. Axillary lymph nodes receive lymph from the
breast, axilla, and upper limb.
b. Inguinal lymph nodes receive lymph from the
lower limb and pelvis
c. Cervical lymph nodes receive lymph from the
head and neck
IMMUNE SYSTEM
Immune Response
 B lymphocytes produce soluble proteins called
antibodies bind to and immobilize the foreign or
abnormal agent damaging it or identifying it to
other elements of the immune system.
 T lymphocytes attack and destroy the antigen
directly.
 Memory cells (B and T) and remember the past
antigen encounters. This will initiate an even faster
and more powerful response should the same
antigen appear again.
 The Natural Killer (NK Cells) are also called large
granular Lymphocytes.
 They make up the remaining small percentage of
body lymphocytes.
 NK cells (plasma membrane) tend to have CD16
receptors.
 detecting infected cells or cancerous cells
 NK cells can kill a wide variety of infected cells and
some cancerous cells.
Five Classes of Antibodies
1. IgG
 most abundant about 8-% of all antibodies in
blood
 found in blood, lymph, and intestines
 monomer (one-unit) structure
 protects against bacteria and viruses by
enhancing phagocytosis, neutralizing toxins,
and triggering complement system
 the only class of antibody to cross placenta
from mother to fetus, conferring considerable
immune protection in newborns
2. IgA
 found mainly in sweat, tears, saliva, mucus,
breast milk (colostrum), and gastrointestinal
secretions
  smaller quantities are present in blood and
lymph
 makes up 10-15% of all antibodies in blood
 occurs as monomers and dimers (two units)
 levels decrease during stress, lowering
resistance to infection
 provides localized protection of mucous
membranes against bacteria and viruses
3. IgM
 about 5-10% of all antibodies in blood
 found in lymph
 occurs as pentamers (five units)
 first antibody class to be secreted by plasma cell
after initial exposure to any antigen
 activates complement and causes agglutination
and lysis of microbes
 also present as monomers on surfaces of B
cells, where they serve as antigen receptors
 in blood plasma, anti-A and anti-B antibodies of
ABO blood group, which bind to A and B
antigens during incompatible blood transfusion
4. IgD
 mainly found on surfaces of B cells as antigen
receptors
 occurs as monomers
 involved in activation of B cells
 about 0.2% of all antibodies in blood
5. IgE
 less than 0.1% of all antibodies in blood
 occurs as monomers
 located on mast cells and basophils
 involved in allergic and hypersensitivity
reactions
 provides protection against parasitic worms
IMMUNE RESPONSE
 Our immune response includes innate and adaptive
responses:
1. Innate (inborn)
2. Adaptive (acquired)
a. Cell mediated
b. Antibody mediated
Functions:
 Transport air into the lungs and facilitate diffusion
of oxygen into the blood stream, expels CO2
1. Ventilation – act of moving air in and out of the
lungs
 Boyle’s Law: gas law, stating that the pressure
and volume of a gas have an inverse
relationship, when temperature is held
constant.
 pump - vacuum activity that allows for us to
breathe
2. Perfusion – blood flow to the lungs; the greatest
amount of perfusion is at the base of the lungs
pulmonary alveolar ventilation (V )

pulmonary capillary perfusion (Q)
4 liters per minute
 V/Q =
5 liters per minute
 V/Q = 0.8
3. Respiration
 Diffusion of gas across the alveolar-capillary
membrane
 Transport of O2 and CO2
 Diffusion of O2 and CO2 from a higher to lower
concentration
Two Types of Respiration:
a. External Respiration – between alveoli and
capillaries
b. Internal Respiration – between tissues and
capillaries
Pleura - Membrane surrounding the lungs that help the
organ slide smoothly against the ribs and muscles
UPPER RESPIRATORY TRACT
1. Nose (Nasal Cavity)
 lined with mucosa, a mucous membrane that
humidifies the air and produces mucus.
 filters, warms, and humidifies air
 Vibrissae – hair in the nose that filters the air
2. Pharynx (Throat)
 Pharynx serves as both respiratory and digestive
system
 a common passageway for inhaled air, exhaled
air, and food
 Nasopharynx – same function as the nose; lined
by ciliated epithelium that helps circulate
mucus & filter/moisten air
 Oropharynx and Laryngopharynx – conduits of
air *channel

3. Larynx (Voice Box)

 remains open during respiration and speech,
allowing air to pass in and out thru the vocal
cords
  connects upper and lower airways
 voice or sound production
 ensures that air will pass through the trachea
THREE LINES OF DEFENSE Cartilages:
1. First Line of Defense – physical barrier (skin) a. Thyroid
2. Second Line of Defense – innate b. Corniculate
3. Third Line of Defense – acquired c. Cricoid
d. Cuneiform
e. Arytenoid
RESPIRATORY/ PULMONARY SYSTEM f. Epiglottis
  Closes during swallowing to prevent food
from entering the nasal cavity. THORACIC BOUNDARIES
 leaf shape cartilage that has a sphincter a. Anterior – sternum
function b. Posterior – thoracic cage
 protects larynx from aspiration c. Lateral – ribs
 “guardian of the airways” d. Superior – thoracic outlet
e. Inferior – diaphragm muscle

LOWER RESPIRATORY TRACT

A. Conducting Zone – passageway for air MUSCLES FOR RESPIRATION
1. Trachea – flexible and can flatten to make room 1. Relaxed Inspiration
when food passes thru the esophagus, a. Diaphragm (Phrenic Nerve)
passageway for inhaled and exhaled air  Primary muscle for respiration
2. Main Bronchi b. External Intercostals
3. Lobar Bronchi  Increase intercostal space between ribs 1, 2
4. Segmental Bronchi and 3
5. Terminal Bronchi
2. Foced Inspiration
Bronchi - lumen is central opening where air passes,  SCM
provide support, smallest bronchioles have smooth  Upper Trapezius
muscle around them but no cartilage  Pectoralis Major, Minor
 Ant, Mid & Post Scalenes
B. Respiratory Zone – exchange of gases (ACINUS)  Serratus Ant, S. Post Sup
1. Respiratory Bronchioles
2. Alveolar Ducts 3. Relaxed Expiration
3. Alveolar Sacs  No muscles involved because
4. Alveoli - Clusters of thin-walled sacs surrounded
by capillaries that allow for quick exchange of 4. Forced Expiration
oxygen and carbon dioxide.  Abdominal
5. Capillaries - Smallest of the blood vessels  Serratus Posterior Inf
through which exchanges take place between  Internal intercostals
the blood and cells of the body  (decrease intercostal space)

CONTROLS OF RESPIRATION
Lungs  Midbrain and Pons – controls respiration
 Right Lung – has three lobes  Medulla Oblongata – autonomic respiratory center
 Left Lung – has two lobes
 Pleural Space – contains pleural fluid that A. Dorsal Respiratory Group
serves as a shock absorber  Location: Dorsal Respiratory medulla
 Pressure: -4 mmHg  Function: Inspiration
 (+) pressure: gunshot wound = pneumothrax  Inspiratory Ramp Signal: 2 sec on, 3 seconds off
Layers:
a. Parietal Pleura B. Ventral Respiratory Grp
 outer covering  Location: Ventrolateral medulla
 also covers the thoracic cavity  Function: Expiration & Inspiration
 sensitive to pain
b. Visceral Pleura C. Pneumotaxic Center
 membrane covering the lungs and tissues  Location: Upper pons
 sensitive to stretch  Function: Limits inspiration by switching off the
IRS

CELLS D. Apneustic Center

1. TYPE 1 PNEUMOCYTES/ALVEOLAR CELLS  Location: Lower pons
 Flat cells that lines the alveoli  Function: prevents switching off IRS
 Responsible for gas exchange between alveoli
and capillary
2. TYPE 2 PNEUMOCYTES /ALVEOLAR CELLS
 Synthesizes ‘surfactant’
 Reduces the surface tension
 Prevents atelectasis

Hering-Breuer Reflex
 A stretch/inflation reflex that prevents over
inflation of the lungs
Respiratory Distress Syndrome/Hyaline Membrane
Disease
 Condition of newborn where surfactant in the
lungs is inadequate
 SIGNS AND SYMPTOMS COPD – CHRONIC OBSTRUCTIVE PULMONARY DISEASE
1. Respiratory Alkalosis: Alveolar hyperventilation; 1. Emphysema
Hyperventilation syndrome  over distention of air spaces distal to the
 dizziness terminal bronchioles with destruction of
 early tetany alveolar septa
 numbness  May be genetic in origin (alpha-1 Antitrypsin
 tingling protein deficiency)
 syncope  There is progressive destruction of alveolar
walls and adjacent capillaries
2. Repiratory Acidosis: COPD, ALS, GBS. MG
 headache EMPHYSEMA VS. CHRONIC BRONCHITIS
 anxiety
 reslessness
 dyspnea
 disorientation
 somnolence
 coma

3. Metabolic Alkalosis: loss of chloride due to

prolonged vomiting
 weakness
 early tetany
 mental dullness 2. Asthma
 increased DTRs  hypersensitivity of bronchial smooth muscle
 muscle twitching due to various stimuli resulting to widespread
bronchoconstriction
4. Metabolic Acidosis: diabetes, ketoacidosis  TRIAD: Coughing, Wheezing, Dyspnea
 nausea Triggering factors:
 lethargy a. Intrinsic – exercise, inhaled irritant, stress, cold,
 coma ingestion of certain drugs
 Kussmaul's breathing b. Extrinsic – food, pollen, dust

Status Asthmaticus
LUNG VOLUME  severe form of asthma
1. Tidal Volume - gas inhaled/exhaled during normal  Persist from days to weeks; fatal
resting breath  Px requires mechanical ventilator
2. Inspiratory reserve volume - gas that can be
inhaled beyond a normal tidal inhalation (inhale 3. Broncheictasis
inhale)  Permanent dilation of bronchioles d/t recurrent
3. Expiratory Reserve volume - gas that can be pulmonary infection
exhaled beyond normal resting tidal exhalation
 Most common area affected: terminal
(exhale exhale)
bronchioles
4. Residual Volume - gas that remains in the lungs
 S/Sx – Hemoptysis, dyspnea, fever, coughing
afyer ERV has been exhaled
4. Cystic Fibrosis
LUNG CAPACITY
 Autosomal-recessive; defect of long arm of
1. Functional Residual Capacity - amount of air left
chromosome 7
inside the lungs after normal exhalation
 Widespread abnormalities of the exocrine
2. Inspiratory Capacity - amount of air that can be
glands
maximally inspired after normal expiration
 Triad: Bronchial Mucus Glands; Exocrine cells of
3. Vital Capacity - amount of air that can be maximally
the pancreas; Sweat glands
expired after maximal inspiration
 S/SX: (+) honeycomb lungs in x-ray, Productive
4. Total Lung Capacity - amount of air that can be
cough
contained inside the lungs after a forceful/maximal
inspiration
CRPD – CHRONIC RESTRICTIVE PULMONARY DISEASE
1. Tuberculosis
 caused by mycobacterium tubercculae
 Incubation period: 2-10 wks
 Maximally infectious at first 2 weeks
 *Primary Complex - Tuberculosis of children
DRUGS
 Rifampicin
 Isoniazid
 Pyrazinamide
 Ethambutol
 Streptomycin

2. Atelectasis
 Partial or total collapse of alveoli, lung
segments or lobes.
 Usually from hypoventilation or ineffective
pulmonary secretion clearance

3. Interstitial Pulmonary Fibrosis (Human-Rich

Disease)
 Idiopathic
 Associated with smoking, family history,
collagen disease
 CARDINAL SIGN: Progressive dyspnea
 DEATH usually in 5-6 years after dx

4. Pneumonia
 Multi-staged inflammatory reaction airways of
the distal from:
a. Bacterial (Streptococcal)
b. Viral
c. Aspiration
S/SX:
 Fever
 Chills
 Chest pain
 May be single or multiple lobes
 Clearance of pneumonia can take up to 6 weeks

5. Pulmonary Embolism
 Lodging of large or small particles into the
pulmonary venous circulation
 Commonly from a dislodged DVT
S/SX:
 Sudden acute pain
 Cough
 dyspnea
 PRELIM
INTRODUCTION TO THE HUMAN BODY
Human Anatomy
 science of body structures and relationships
 derived from Greek, means “to cut” or “cutting
backwards” (putting things together from slices)
 imaging techniques
Human Physiology
 science of body functions, including the study of
homeostasis
Structure and Function
 structure mirrors function
 structure of a part of the body allows
performance of certain functions
Subdivision of Anatomy
1. Surface Anatomy – study of form and marking of
the body surface, often explored through
visualization or palpation (without any “cutting”)
2. Gross Anatomy – study of anatomical structures
visible to unaided eye. After making the
appropriate surface marking in the prior picture, the
gross dissection proceeds through “cutting.”
a. Systematic Approach/Anatomy – study of the
blood vessels, or all of the muscles, or all of the
bones
b. Regional Approach/Anatomy – study of all
anatomical structures of a specific region (e.g.
the thorax, or the head and neck)
3. Developmental Anatomy – study of the fertilized
egg developing into its adult form
a. Embryology – subcategory of a developmental
anatomy (conception of 8th week of gestation)
4. Histology – study of tissues by using a microscope,
but restricts the study to individual cellular
structures
5. Pathology – study of anatomical changes due to
disease
Clinical Correlation
 Autopsy – a postmortem (after death)
examination of the body and internal organs
performed by a pathologist
 An autopsy is usually done to:
1. Determine the cause of death
2. Identify diseases not detected during life
3. Determine the extent of injuries and
contribution to death
4. Identify hereditary conditions
Level of Organization
1. Chemical Level
a. Atoms – smallest unit of matter
b. Molecules – two or more atoms joined together
2. Cellular Level
 Cells – basic structural and functional units of
an organism
 cytologist can recognize under light microscopy
about 210 different kinds of cells
3. Tissue Level
 Tissues – group of cells and materials
surrounding them
 Four Basic Types of Tissues:
a. Epithelial
b. Connective
c. Muscular
d. Nervous
4. Organ Level
 Organs – structures that are composed of two
or more different types of tissues
 specific functions and recognizable shapes
5. System Level
 System – consists of related organs with a
common function
 Organ-system Level
- eleven systems of the human body
6. Organismal Level
 Organism – living individual
 all parts of the body functioning together
Noninvasive Diagnostic Techniques
 Inspection of the body to observe any changes
1. Palpation – gently touching body surfaces
with hands
2. Auscultation – listening to body sounds
using stethoscope
3. Percussion – tapping on the body surface
with fingertips and listening to echoes
Characteristics of Living Human Organism:
Life Processes
1. Metabolism – sum of all the chemical process that
occur in the body
a. Catabolism – breakdown of complex chemical
substances into simpler components
b. Anabolism – building up of complex chemical
substances from smaller, simpler components
2. Responsiveness – body’s ability to detect and
respond to changes
3. Movement – motion of the whole body
4. Growth – increase in body size
5. Differentiation – development of a cell from an
unspecialized to specialized state
 Stem cells – give rise to cells that undergo
differentiation
6. Reproduction – formation of new cells (growth,
repair, or replacement) or the production of a new
individual
Homeostasis
 a condition of equilibrium (balance) in the
body’s internal movement
 a dynamic condition meant to keep body
functions in the narrow range compatible with
maintaining life
 Maintaining the volume and composition of
body fluids are important
Body Fluids
 dilute, watery solutions containing dissolved
chemicals inside or outside of the cell
 a. Intracellular Fluid (ICF) – fluid within cells 4. Oblique Plane – passes through the body or an
b. Extracellular Fluid (ECF) – fluid outside cells organ at an angle
 Interstitial Fluid – ECF between cells
Directional
and tissues Meaning
Terms
 Blood Plasma – ECF within blood vessels
toward the hear or upper part of a
 Lymph – ECF within lymphatic vessels superior
structure
 Cerebrospinal Fluid (CSF) – ECF in the away from head, or lower part of
brain and spinal cord inferior
a structure
 Synovial Fluid – ECF in joints nearer to or at the front of the
anterior
 Aqueous Humor – ECF in eyes body
nearer to or at the back of the
Homeostasis is constantly being disrupted by: posterior
body
 Physical insults – intense hear of lack of oxygen an imaginary vertical line that
 Changes in the internal environment – drop in midline
divides the body equally
glucose due to lack of food medial nearer to midline
 Physiological stress – demands of work or lateral farther from midline
school intermediate between two structures
 Disruptions on the same side of the body as
ipsilateral
a. Mild Disruptions – temporary; balance is another structure
quickly restored on the opposite side of the body
contralateral
b. Intense Disruptions – prolonged; poisoning from another structure
or severe infections nearer to the origination of a
proximal
structure
farther to the origination of a
Feedback System distal
structure
Three Basic Components: toward or close to the surface of
1. Receptor – monitors changes in a controlled superficial
the body
condition and sends input to the control center deep away from the surface of the body
2. Control Center (Brain) – sets the range values
to be maintained; receives input from receptors
Body Cavities
and generates output command to the effector
 Spaces within the body that help to protect,
3. Effector – receives output from the control
separate, and support internal organs
center and produces a response or effect
Types of Body Cavities
Types of Feedback System
1. Cranial Cavity – protects brain
1. Negative Feedback System – reserves a change
2. Thoracic Cavity – chest cavity
in controlled condition
a. Pericardial Cavity – fluid-filled space that
2. Positive Feedback System – strengthen or
surround the heart
reinforce a change in one of the body’s
b. Pleural Cavity – two fluid-filled spaces that that
controlled conditions
surround each lung
3. Abdominopelvic Cavity
Anatomical Terminologies a. Abdominal Cavity – stomach, liver, gallbladder,
small and large intestines
Anatomical Position
b. Pelvic Cavity – urinary bladder, internal organs
 body is standing erect
of reproductive system, and portions of the
 face facing upward
large intestine
 feet are flat on the floor and forward
4. Oral Cavity – mouth
 upper limbs to the sides
5. Nasal Cavity – nose
 palms turned forward
6. Orbital Cavities – eyeball
a. Prone Position – body is lying face down
7. Middle Ear Cavities – small bones of the middle ear
b. Supine Position – body is lying face up
8. Synovial Cavities – joints

Planes
Abdominopelvic Regions
1. Sagittal Plane – vertical plane divides the body
1. Tic-Tac-Toe Grid
into right and left sides
a. Right and Left Hypochondriac Region
a. Midsagittal Plane – divides body into equal
b. Epigastric Region
right and left sides
c. Right and Left Lumbar Region
b. Parasagittal Plane – divides body into
d. Umbilical Region
unequal right and left sides
e. Right and Left Inguinal (Ilicac) Region
2. Frontal or Coronal Plane – divides the body or
f. Hypogastric (pubic) Region
an organ into anterior (front) and posterior
i. Subcostal Line – top horizontal
(back) portions
ii. Transtubercular Line – bottom horizontal
3. Transverse Plane (Cross-Sectional or Horizontal
iii. Midclavicular Lines – two vertical lines
Plane) – divides the body or an organ into
2. Quadrants
superior (upper) and inferior (lower) portions
 a. Right Upper Quadrant (RUQ)
b. Left Upper Quadrant (LUQ)
c. Right Lower Quadrant (RLQ)
d. Left Lower Quadrant (LLQ) Epidermal Layers
1. Stratum Basale or Stratum Germinativum –
INTEGUMENTARY SYSTEM
deepest layer, where continuous cell division occurs
Includes the skin and its derivatives including which produces all the other layers
hair, nails, sweat glands, and sebaceous glands. 2. Stratum Spinosum – layer of 8-10 keratinocytes
3. Stratum Granulosum – includes keratohyalin
Skin
(keratin) and lamellar granules; non-dividing cells
 cutaneous membrane that covers the body
(apoptosis)
 largest organ of the body by surface area and
4. Stratum Lucidum – only present in thick skin
weight
(fingertips, palms, and soles)
Functions 5. Stratum Corneum - composed of many sublayers of
 protection flat, dead keratinocytes (20 layers of flat cell-
 prevention of water loss remnants that are like “bags of turtle wax”) called
 temperature regulation corneocytes or squames that are continuously shed
 secretion of Vitamin D and replaced by cells from deeper strata
 immune defense
 sensory reception Dermis
 excretion  composed of cells of the connective tissue
proper and primarily of collagen fibers,
Tissue Component although both elastic and reticular fibers are
1. Epithelium – surface covering also present
2. Connective Tissue – provides nutrients, strength,
Two Major Regions
and resilience
1. Papillary Region (superficial)
3. Smooth Muscle – controls blood vessels diameter
- consists of areolar connective tissue (1/5 of the
and hair position
thickness of the total layer)
4. Neural Tissue – sensory receptors in the skin
- containing thin collagen and elastic fibers,
Layers of the Skin dermal papillae (including capillary loops),
1. Epidermis – keratinized stratifies squamous corpuscles of touch, nerve ending, and free
epithelium nerve endings
2. Dermis – deeper layer; dense irregular connective 2. Reticular Region (deeper)
3. Hypodermis/Subcutaneous – deep to dermis; - attached to subQ layer
areolar and adipose connective tissue - consists of dense irregular connective tissue
containing collagen and elastic fibers adipose
Structural Basis of the Skin
cells, hair follicles, nerves, sebaceous (oil)
1. Hemoglobin – oxygen-binding protein present in
glands, and sudoriferous (sweat) glands
red blood cells (bright red)
2. Melanin – pigment produced and stored in cells Skin Color as DX Clue
called melanocytes (yellow, reddish, tan, brown, 1. Cynotic – bluish; decreased in O2
and black shades) 2. Jaundice – yellowish; build-up of pigment
3. Carotene – comes primarily from diet (yellow- bilirubin
orange) 3. Erythema – redness; engorgement of capillaries
4. Pallor – paleness; shock or anemia
Epidermis: Four Types of Cell
1. Keratinocytes (90%) – produce keratin and lamellar
granules, which is tough fibrous protein that Accessory Structures of the Skin
provides protection 1. Nail
2. Melanocytes (9%) – produce the pigment melanin - scale-like modifications of the epidermis that
(color) that protects against damage by ultraviolet form on the dorsal surfaces of the tips of the
radiation fingers and toes
a. Albinism – inherited inability to produce - protects the exposed distal tips and prevent
melanin damage or distortion during jumping, kicking,
b. Vitiligo – condition In which there is a partial or catching, or grasping
complete loss of melanocytes from patches of - made up of a hard derivatives formed from the
skin stratum corneum layer of the epidermis
3. Intraepidermal Macrophages “Langerhans Cells” –  free edge
involved in immune responses (guard from  transparent nail body (plate) with a whitish
microbes), arise from red bone marrow lunula at its base (white because of the
4. Tactile Epithelial “Merkel Cells” (least numerous) – thick end region of epithelium)
function in the sensation of touch along with the  nail root embedded in a fold of skin
adjacent tactile discs
2. Hair (pili)
 - guards the scalp from injury and sun’s rays perineum 1%
- decrease heat loss from the scalp Rule of 9s (Child)
- touch receptors (hair root plexuses) front back total
- Hirsutism - excessive hair growth; tumor; head 9% 9% 18%
increase in androgens chest 18% 18% 36%
- Alopecia - partial or loss of hair right arm 4.5% 4.5% 9%
left arm 4.5% 4.5% 9%
a. Lanugo – fine, non-pigmented, downy hairs
right leg 6.75% 6.75% 13.5%
that cover the body of the fetus
left leg 6.75% 6.75% 13.5%
b. Vellus Hair – short, fine, pale hairs and
perineum 1%
barely visible
Skin Grafting
c. Terminal Hair – long, coarse, heavily
 done by surgeon when there is a severe
pigment hairs
damage in skin (cannot regenerate)
a. Autograft – getting skin from self
3. Skin Glands
b. Isograft – from identical donor
 Sweat (Sudoriferous) Gland
- regulates body temperature
a. Eccrine – cold sweat (fear or Skin Wound Healing
embarrassment) Skin damage – sets in motion a sequence of events that
b. Apocrine – located mainly in the skin of repairs the skin to its normal (or near-normal) structure
the axilla, groin, areolae, and bearded and function
facial regions (emotional stress and
Epidermal Wound Healing
sexual excitement)
 Common types: abrasion and minor burns
 Oil (Sebaceous) Gland
1. Basal cells – contact with the basement
- oily material that coats hairs shafts; prevent
membrane
hairs from drying out, prevent water loss
2. Enlarge and migrate across the wound
from skin, keeps skin soft, inhibit growth of
3. When epidermal cells encounter one another,
some bacteria
they stop migrating due to a cellular response
 Ceruminous Gland
called contact inhibition
- secretes cerumen (earwax); impede
4. As the basal epidermal cells migrate, a
entrance of foreign bodies and insects into hormone called epidermal growth factor
external ear canal stimulates basal stem cells to divide and replace
the ones that have moved into the wound
Burns 5. The relocated basal epidermal cells divide to
 major cause of accidental death, primarily as a build new strata, thus thickening the new
result of their effects on the skin epidermis
 results primarily from fluid loss, infection, and
Deep Wound Healing
the effects of burned, dead tissue
 Deep wound healing occurs when an injury extends
Classification of Burns Based on Depth to the dermis and subcutaneous layer.
Partial Thickness Burn: 1. Inflammatory phase
1. First Degree (3-6 days) “Superficial Burn” - blood clot forms and loosely unites the
- involves only epidermis wound edges
- characterized by redness, pain, and slight - vascular and cellular response
edema 2. Migratory Phase
- sunburn - clot becomes a scab, and epithelial cells
2. Second Degree (3-4 weeks) “Deep Partial Burn” migrate beneath the scab to bridge the
- involves the epidermis and part of the dermis wound
- skin appears red, tan, or white, and is blistered - fibroblasts migrate along fibrin threads and
and painful begin synthesizing scar tissue and damaged
- scald blood vessels begin to regrow
Full Thickness Burn: 3. Proliferative phase
3. Third Degree Burn - extensive growth of epithelial cells beneath
- involves the epidermis, dermis, and the scab, deposition by fibroblasts of
subcutaneous layer, which are often destroyed collagen fiber and continued growth of
blood vessels
Classification of Burns Based on Body Surface Area 4. Maturation phase
Rule of 9s (Adult) - scab sloughs off once the epidermis has
front back total been restored to normal thickness
head 4.5% 4.5% 9% - collagen fibers become more organized,
chest 18% 18% 36% fibroblasts decrease in number, and blood
right arm 4.5% 4.5% 9% vessels are restored to normal
left arm 4.5% 4.5% 9%
Scars
right leg 9% 9% 18%
left leg 9% 9% 18%
  Keloid Scars – result of an overly aggressive
healing process
 Hypertrophic Scars – are raised, red scars that
are similar to keloids but do not go beyond the
boundary of the injury
Skin Disorders
Skin Cancer
 excessive exposure to ultraviolet radiation from
the sun or tanning beds
a. Basal Cell Carcinomas
b. Squamous Cell Carcinomas
c. Basal and Squamous Cell Carcinomas (Non-
Melanoma Skin Cancer)
d. Malignant Melanomas (neoplasm of
melanocytes) – most dangerous type
Burns
 tissue damage caused by excessive heat,
electricity, radioactivity, or corrosive chemical
that denature (breakdown) proteins in the skin
a. First Degree Burn (Superficial Partial
Thickness Burn)
b. Second Degree Burn (Deep Partial Thickness
Burn)
c. Third Degree Burn (Full Thickness Burn)
Pressure Ulcers (Decubitus Ulcers or Bedsores)
 caused by a constant deficiency of blood flow to
tissues
 bedridden people are prone to this disease
Psoriasis
 chronic skin disorder in which keratinocytes
divide and move more quickly than normal from
the stratum basale to the stratum corneum
Pruritus
 most common dermatological disorder
 itching, caused by skin disorders (infections),
systemic disorder (cancer, kidney failure),
psychogenic factors (emotional stess), or
allergic reactions
Tinea Corporis (Ringworm)
 fungal infection characterized by scaling,
itching, and sometimes painful lesions
 may appear on any part of the body
Wart
 mass produce by uncontrolled growth of
epithelial skin cells
 caused by papillomavirus
 non-cancerous
Contact Dermatitis
 Inflammation of the skin characterized by
redness, itching, and swelling
 Caused by exposure of the skin to chemicals
that bring about an allergic reaction
Comedo or Blackhead
 collection of sebaceous material and dead cells
in the hair follicle and excretory duct of the
sebaceous (oil) gland
 usually found over the face, chest, and back;
commonly occur during adolescence
Corn
 painful conical thickening of the stratum
corneum of the epidermis
 found over toe joints and between the toes
 caused by friction or pressure
Eczema
 inflammation of the skin characterized by
patches of red, blistering, dry, extremely itchy
skin
 occurs mostly in skin creases in the wrists, back
of the knees, and front of the elbows
Frostbite
 local destruction of skin and subcutaneous
tissue on exposed surfaces as a result of
extreme cold
 hands and feet are prone to frostbite because
they are distal to our body
Hemangioma
 localized benign tumor of the skin and
subcutaneous layer
 results from an abnormal increase in the
number of blood vessels
Hives or Urticaria
 reddened elevated patches of skin that are
often itchy
 caused by infections, physical trauma,
medications, emotional stress, food additives,
and certain food allergies
Keloid
 elevated, irregular darkened area of excess scar
tissue
 caused by collagen formation during wound
healing
Papule
 small, round skin elevation less than 1 cm in
diameter
SKELETAL SYSTEM: BONE TISSUE
A bone is an organ made up of several different
tissues working together. The entire framework of
bones and their cartilages constitute the skeletal
system.
Functions:
 Supports soft tissue and provides attachment
for skeletal muscles
 Protects internal organs
 Assists in movement, along with skeletal
muscles
 Stores and releases minerals to maintain
homeostasis
 Contains red bone marrow, which produces
blood cells (process called hemopoiesis)
 Contains yellow bone marrow, which stores
triglycerides (fats)
Compact Bone Tissue
 contains few spaces and strongest form of bone
tissue
  protection and support and resists the stresses
produced by weight and movement
Spongy Bone Tissue (Trabecular/Cancellous Bone
Tissue)
 interior of a bone, protected by a covering of
compact bone
 consists of trabeculae
Structure of Bone
1. Diaphysis – bone’s shaft or body; long cylindrical,
main portion of the bone
2. Epiphyses – proximal and distal ends of the bone
3. Metaphyses
a. Epiphyseal (growth) plate are visible in a
growing bone
b. Epiphyseal lines are the remnants of epiphyseal
plates in a mature bone
4. Articular Cartilage – thin layer of hyaline cartilage
covering the part of the epiphysis; reduces friction
and absorbs shocks
5. Periosteum – tough connective tissue sheath and its
associated blood supply; attached to perforating
fibers or “Sharpey’s fibers”
a. Outer fibrous layer of dense irregular
connective tissue
b. Inner osteogenic layer that consist of cells
6. Medullar Cavity (Marrow Cavity) – hollow space
within the diaphysis that contains fatty yellow bone
marrow
7. Endosteum – lines the medullary cavity; contains a
single layer of bone-forming cells
Four Types of Cells
1. Osteoprogenitor Cells – only bone cells to undergo
cell divison; develop into osteoblasts
2. Osteoblasts – bone-building cells; build the
extracellular matrix (bone deposition)
3. Osteocytes (main cells) – mature bone cells and
maintain its daily metabolism
4. Osteoclasts – breakdown of bone extracellular
matrix (bone resorption)
Factors Affecting Bone Growth
1. Minerals
a. Calcium and Phosphorus – make bone
extracellular matrix hard
b. Magnesium – helps form bone extracellular
matrix
c. Fluoride – helps strengthen bone extracellular
matrix
d. Manganese – synthesis of bone extracellular
matrix
2. Vitamins
a. Vitamin A – stimulates activity of osteoblast
b. Vitamin C – synthesis of collagen (main bone
protein)
c. Vitamin D – increase absorption of calcium
from gastrointestinal into blood
d. Vitamin K and B12 – synthesis of bone protein
3. Hormones
a. Growth Hormone (GH) – promotes general
growth of all body tissues
b. Insulin-like Growth Factors (IGFs) – stimulates
growth hormone
c. Thyroid hormones (T2 and T4) – stimulates
osteoblasts
d. Insulin – increase the synthesis of bone proteins
e. Sex Hormones (Estrogens and Testosterone) –
stimulates osteoblasts and promote “growth
spurt”
f. Parathyroid Hormone (PTH) – promotes bone
resorption by osteoclasts
g. Calcitonin (CT) – inhibits bone resorption
4. Exercise – weight-bearing activities stimulate
osteoblasts
5. Aging – level of sex hormones diminishes during
middle age to older adulthood; bone resorption by
osteoclasts outplaces bone deposition by
osteoblasts
SKELETAL SYSTEM: AXIAL SKELETON
Axial Skeleton
 80 bones
 bones that lie around the longitudinal axis of
the body
 skull (8 cranium, 14 face), 1 hyoid bone, 6
auditory ossicles, 26 vertebral column, thorax (1
sternum, 24 ribs)
Types of Bone
1. Long Bones
- greater length than width
- slightly curved for strength
- femur (thigh bone), tibia and fibula (leg bones),
humerus (arm bone), ulna and radius (forearm
bones), phalanges (finger and toe bones
2. Short Bones
- somewhat cube-shaped and consists of spongy
bone tissue
- most carpal (wrist bones) and tarsal (ankle
bones)
3. Flat Bones
- thin and composed of two nearly parallel plates
of compact bone
- cranial bones, sternum (breastbone), ribs,
scapulae (shoulder blades)
4. Irregular Bones
- complex shapes
- vertebrae (back bones), hip bones, certain facial
bones, calcaneus
5. Sesamoid Bones
- develop in certain tendons where there is
considerable friction, tension, and physical
stress
- protect tendons from excessive wear and tear
- palms and soles
6. Sutural Bones
- small bones and their numbers varies greatly
from person to person
- sutures (joints), certain cranial bones
Skull
  bony framework of the head
 contains 22 bones (cranial and facial bones)
Two Categories of the Skull
1. Cranial Bones
- encloses and protects the brain
- frontal bone, 2 parietal bones, 2 temporal
bones, occipital bone, sphenoid bone, ethmoid
bone
2. Facial Bones
- 2 nasal bones, 2 maxillae, 2 zygomatic bones,
mandible, 2 lacrimal bones, 2 palatine bones, 2
inferior nasal conchae, vomer
Cranial Bones
1. Frontal Bone – forehead, roofs of the orbits (eye
sockets) and most of the anterior part of the cranial
floor
2. Parietal Bones – greater portion of the sides and
roof of the cranial cavity
3. Temporal Bones – inferior lateral aspects of the
cranium and part of the cranial floor
4. Occipital Bone – posterior part and most of the
base of the cranium
5. Sphenoid Bone – middle part of the base of the
skull, it’s the keystone of the cranial floor
6. Ethmoid Bone – anterior part of the cranial floor
medial to the orbits
Facial Bones
1. Nasal Bones – small, flattened, rectangular-shaped;
form the bridge of the nose
2. Lacrimal Bones – smallest, thin and roughly
resemble a fingernail; form a part of the medial wall
of each orbit
3. Palatine Bones – form the posterior portion of the
hard palate, part of the floor and lateral wall of the
nasal cavity, and a small portion of the floors of the
orbits
4. Inferior Nasal Conchae – form a part of the inferior
lateral wall of the nasal cavity
5. Vomer – triangular bone on the floor of the nasal
cavity; forms the inferior portion of the bony nasal
septum (partition that divides the nasal cavity)
6. Maxillae – form the upper jawbone
7. Zygomatic Bones (cheekbones) – form the
prominences of the cheeks
8. Mandible (lower jawbone) – largest, strongest
facial bone; only movable skull bone
Hyoid Bone
 does not articulate with any other bone
 supports tongue, providing attachment sites for
some tongue muscles and for muscles of the
neck and pharynx
Vertebral Column
 also called spine, backbone, or spinal column
 composed of series of bones called vertebrae
 supports the head and serves as a point of
attachment for the ribs, pelvic girdle, and
muscles of the back and upper limbs
a. 7 cervical vertebrae (neck region)
b. 12 thoracic vertebrae (posterior to the
thoracic cavity)
c. 5 lumbar vertebrae (supporting the lower
back)
d. 1 sacrum (five fused sacral vertebrae)
e. 1 coccyx (four fused coccygeal vertebrae)
Vertebral Regions
1. Cervical Vertebrae (C1-C7)
- smaller than all other vertebrae except those
that form the coccyx
a. Atlas (C1) – ring of bone with anterior and
posterior arches and large lateral masses
b. Axis (C2) – have vertebral body
c. Vertebra Prominens (C7) – may be seen
and felt at the base of the neck
2. Thoracic Vertebrae (T1-T12)
- larger and stronger than cervical vertebrae
a. T1 to T10 – long, laterally flattened, and
directed inferiorly; articulate with the ribs
b. T11 and T12 – shorter, broader, and
directed more posteriorly
- Vertebrocostal joints are the articulations
between the thoracic vertebrae and ribs
a. Facet – formed when the head of a rib
articulates with the body of one vertebra
b. Demifacet – formed when the head of a rib
articulates with two adjacent vertebral
bodies
3. Lumbar Vertebrae (L1-L5)
- largest and strongest of the unfused bones
- amount of body weight supported by the
vertebrae increases toward the inferior end of
the backbone
4. Sacrum
- formed by union of five sacral vertebrae (S1-S5)
- serves as a strong foundation for the pelvic
girdle
5. Coccyx
- formed by the fusion of usually four coccygeal
vertebrae (Co1-Co4)
Thorax
 entire chest region
 Throcic Cage – bony enclosure formed by the
sternum, ribs, and their costal cartilages, and
the bodies of the thoracic vertebrae
a. Sternum (breastbone)
– flat, narrow bone located in the center
of the thoracic wall that measures
about 15 cm
– sternal angle formed by junction of the
manubrium and body
– suprasternal notch is the depression on
its superior surface of the manubrium
– clavicular notches that articulate with
the medial ends of the clavicles to form
the sternoclavicular joints
b. Ribs
 - numbered 1-12 from superior to
inferior
- True Ribs (Vertebrosternal) are first
through seventh pairs of ribs
 direct anterior attachment to the
sternum by costal cartilage (strip of
hyaline cartilage)
 costal cartilage contribute elasticity
– False Ribs (Vertebrochondral) are
eleventh and twelfth pairs of ribs
 designated as floating ribs
 does not attach to the sternum at
all
Normal Curves of the Vertebral Column
1. Thoracic and Sacral Curves – primary curves
because they retain; concave (cupping in)
2. Cervical and Lumbar Curves – secondary curves
because they begin to form later; convex (bulging
out)
Abnormal Curves of the Vertebral Column
1. Scoliosis – most common; lateral bending of the
vertebral column
2. Kyphosis – increase in the thoracic curve; produces
a “hunchback” look
3. Lordosis (hollow back) – increase in the lumbar
curve
Spina Bifida
Spina Bifida – congenital defect of the vertebral
column, which laminae of L5 and/or S1 fail to develop
Fractures
1. Open (Compound) – broken ends of the bone
protrude through the skin
2. Close (Simple) – fracture does not break the skin
3. Greenstick – partial fracture that only occurs in
children; one side is broken and other side bends
4. Impacted – forcefully driven into the interior of
other
5. Pott – fracture of the distal end of the lateral bone
(fibula); serious injury of the distal tibial articualtion
6. Colles – fracture of the distal end of the lateral
forearm bone (radius); distal fragment is displaced
posteriorly
SKELETAL SYSTEM: APPENDICULAR SKELETON
Appendicular Skeleton
 126 bones
 primary function is movement
 upper and lower limbs (extremities or
appendages), two girdles
Pectoral (Shoulder) Girdle
 attach the bones of the upper limbs to the axial
skeleton
Two Pectoral (Shoulder) Girdle
1. Clavicle (Collarbone)
- s-shaped
- articulates with the manubrium of the sternum
at the sternoclavicular joint
2. Scapula (Shoulder Blade)
- large, triangular, flat bone
- articulates with the clavicle at the
acromioclavicular joint and with the humerus at
the glenohumeral (shoulder) joint
Upper Limb (Extremity)
 has 30 bones in three locations
- humerus in the arm
- ulna and radius in the forearm
- 8 carpals in the carpus (wrist)
- 5 metacarpals in the metacarpus (palm)
- 14 phalanges (bones of the digits) in the
hand
Components Upper Limb (Extremity)
1. Humerus (arm bone) – longest and largest bone of
the upper limb
2. Ulna – medial aspect (little-finger side) of the
forearm and is longer than radius
3. Radius – smaller bone of the forearm and located
on the lateral aspect (thumb side) of the forearm
4. Carpus (wrist) – proximal region of the hand and
consists of eight small bones called carpals
Proximal row, from lateral to medial:
a. Scaphoid – boat-like
b. Lunate – moon shaped
c. Triquetrum – three cornered
d. Pisiform – pea shaped
Distal row, from lateral to medial:
e. Trapezium – four-sided figure with no two sides
parallel
f. Trapezoid – four-sided figure with two sides
parallel
g. Capitate – head shaped
h. Hamate – hooked
5. Metacarpus (palm) – intermediate region of the
hand and consists of five bones called metacarpals
6. Phalanges (bones of the digits) – make up the distal
part of the hand; phalanx (single bone of a digit)
a. Pollex (thumb) – proximal and distal phalanges
b. Other four digits – proximal, middle, and distal
phalanges
Pelvic (Hip) Girdle
- unite anteriorly at a joint called pubic symphysis
- consists of two hip bones also called coxal, or
pelvic bones, or os coxa
Components of Pelvic (Hip) Girdle
1. Ilium (hip pointer) – superior; largest hip bone
2. Ischium – inferior and posterior of the hip bone
3. Pubis (pubic bone) – inferior and anterior of the hip
bone
True and False Pelvis
1. False (greater) Pelvis – portion of the bony pelvis
superior to the pelvic brim
2. True (lesser) Pelvis – portion of the bony pelvis
inferior to the pelvic brim
Lower Limb (Extremity)
  consists of 30 bones in four location  Blood vessels, airways, and most organs in the
- femur in the thigh abdominopelvic cavity
- patella (kneecap)  Controlled by autonomic (involuntary) division
- tibia and fibula in the leg  Looks non-striated, which is why it is referred to
- 7 tarsals in the metatarsus as smooth
- 14 phalanges (bones of the digits) in the
foot FUNCTIONS OF MUSCULAR TISSUE
Components of Lower Limb (Extremity) 1. Producing body movements – movement of the
1. Femur (thigh bone) – longest, heaviest, and whole body
strongest bone in the body 2. Stabilizing body positions – skeletal muscle
2. Patella (kneecap) – located anterior to the knee contractions stabilize joints and help maintain body
joint; sesamoid bone positions
3. Tibia (shin bone) - larger, medial, weight-bearing 3. Storing and moving substances within the body
bone of the leg; means flute - smooth muscles “sphincters” for storage
4. Fibula – parallel and lateral to the tibia, (urinary bladder, stomach);
considerably smaller - cardiac muscles for moving substances
5. Tarsus (ankle) – proximal region of the foot and (contractions of the heart pump blood through
consists of 7 tarsal bones the blood vessels of the body)
Posterior part: 4. Generating heat “Thermogenesis” – involuntary
a. Talus – ankle bone contractions of skeletal muscles, known as
b. Calcaneus – heel; strongest tarsal shivering, can increase the rate of heat production
Anterior part:
c. Navicular – like a little boat PROPERTIES OF MUSCULAR TISSUE
d. Three Cuneiform Bones – wedge shaped 1. Electrical excitability
 third (lateral), second (intermediate), and - Respond to stimulus “action potential”
first (medial) - Two main types: autorhythmic (electrical signal)
e. Cuboid – cube-shaped such as heart’s pacemaker; and chemical stimuli
6. Metatarsus – intermediate region of the foot and such as neurotransmitters
consists of 5 metatarsal bones (I-V or 1-5) 2. Contractility
a. proximal base – Ability to contract forcefully when stimulated by
b. intermediate shaft an action potential
c. distal head – Generates tension (force of contraction)
7. Phalanges – distal component of the foot and 3. Extensibility
resemble those of the hand both in number and - Ability to stretch within limits without being
arrangement damaged
a. Hallux (great or big) toe - Normally, smooth muscle is subject to the
b. Other four toes
greatest amount of stretching (e.g., stomach)
Arches of the Foot - Cardiac muscle also is stretched each time the
1. Longitudinal Arch – tarsal and metatarsal bones heart fills with blood
arranged to form an arch from the anterior to the 4. Elasticity – ability to return to its original length and
posterior part of the foot shape after contraction or extension
2. Transverse Arch – medial and lateral aspects of the
foot and is formed by the navicular, three
cuneiforms, and the bases of the five metatarsals THREE LAYERS OF CONNECTIVE TISSUE
1. Epimysium – outer layer, encircling the entire
muscle
MUSCULAR SYSTEM 2. Perimysium – surrounds groups of 10 to 100 or
more muscle fibers called “fascicles”
TYPES OF MUSCULAR TISSUE 3. Endomysium – penetrates the interior of each
1. Skeletal Muscle Tissue fascicle and separates individual muscle fibers
 Bones of the skeleton
 Controlled by somatic (voluntary) division The epimysium, perimysium, and endomysium are all
 Most are controlled subconsciously continuous with the connective tissue that attaches
 e.g., diaphragm – continues to alternately skeletal muscle to other structures.
contract and relax; and skeletal muscles –
 Tendon (ropelike) – formed when all three
maintain posture or stabilize body position
layers extend beyond the muscle fibers that
2. Cardiac Muscle Tissue
attaches the muscle to the periosteum of a
 Forms the heart wall
bone
 Controlled by autonomic (involuntary) division;
 Aponeurosis – when the connective tissue
 Autorhythmicity (built-in rhythm) – ability to
elements extend as a broad, flat sheet
contract on its own
3. Smooth Muscle Tissue
 Located in walls of hollow internal structures MICROSCOPIC ORGANIZATION OF SKELETAL MUSCLE
Skeletal Muscle Fiber
- Most important components of skeletal muscle
- Arises during embryonic development from the
fusion of small mesodermal cells called
“myoblasts”
Sarcolemma, Transverse Tubules, and Sarcoplasm
 Sarcolemma – plasma membrane of a muscle
cell
 Transverse (T) Tubules – tiny invaginations of
sarcolemma; “highway” of action potential or
stimulus
 Sarcoplasm – presence of glycogen (used for
synthesis of ATP); and myoglobin (protein that
binds oxygen molecules)
Myofibrils and Sarcoplasmic Reticulum
 Myofibrils – contractile organelles of skeletal
muscle
 Sarcoplasmic Reticulum (SR) – fluid-filled
system of membranous sacs that encircles each
myofibrils
Filaments and the Sarcomere
 Filaments or Myofilaments
- Within myofibrils are smaller protein
structures
- Arranged in compartments called
“sarcomeres”
 Sarcomere
- Basic functional units of myofibril
- Z Discs: separate one sarcomere from
the next
- A Band: dark, extends the entire length
of the thick filaments (myosin); zone of
overlap
- I Band: lighter, less dense area that
contains the rest of the thin filaments
(actin) but no thick filaments
- H Zone: center of each A band contains
thick filaments but not thin filaments
- M Line: middle of the sarcomere
MUSCLE PROTEINS
Contractile Proteins – generate force during
contraction; responsible for muscles to move
1. Myosin – thick filaments; motor protein
2. Actin – thin filaments; myosin-binding site
Regulatory Proteins – help switch the contraction
process on and off; also part of the actin (thin filament)
1. Tropomyosin – cover the actin “myosin-
binding”
2. Troponin – molecule; undergoes
conformational change (change in shape)
Structural Proteins – keep proper alignment
1. Titin – helping to stabilize thick filament
position
2. α-Actin – attaches to actin molecules of thin
filaments and to titin molecules
3. Myomesin – forms M line of sarcomere
4. Nebulin – wraps around entire length of each
thin filament
5. Dystrophin – links thin filaments of sarcomere
to integral membrane proteins in sarcolemma
MUSCULAR CONTRACTION (SLIDING FILAMENT
MECHANISM)
Contraction Cycle
- Repeating sequence of events that causes the
filaments to slide
- Only continues if ATP is available and Ca2+ level
in sarcoplasm is high
- Key of the cycle: Calcium ions (Ca2+)
1. ATP hydrolysis – larger molecules breakdown to
smaller molecules; myosin head hydrolyzes ATP and
becomes energized and oriented
2. Attachment of myosin to actin – myosin head binds
to actin, forming a “cross-bridge”
3. Power stroke – myosin head rotate, pulling the thin
filament past the thick filament toward center of
the sarcomere
4. Detachment of myosin from actin – as myosin head
binds ATP, the cross-bridge detaches from actin
NEUROMUSCULAR JUNCTION (NMJ)
Somatic Motor Neurons – the neurons that stimulate
skeletal muscle fibers to contract
Neuromuscular Junction (NMJ) – synapse between a
somatic motor neuron and a skeletal muscle fiber
Synapse – region where communication occurs
between a somatic motor neuron and a muscle fiber
 Presynaptic Membrane
 Postsynaptic Membrane
Synaptic Cleft – small gap that separates the two cells
Neurotransmitter – chemical messenger
A nerve impulse (nerve action potential) elicits a muscle
action potential in the following way:
1. Release of acetylcholine – Ach is released from
synaptic vesicle
 Axon terminal – end of the motor neuron and
divides into a cluster of synaptic end bulbs
 Synaptic end bulbs – neural part of the NMJ
 Acetylcholine – neurotransmitter released at
the NMJ
2. Activation of ACh receptors – ACh binds to ACh
receptor
 Motor end plate - muscular part of the NMJ
 Acetylcholine receptors – integral trans-
membrane proteins to which ACh specifically
binds; abundant in junction folds
a
 Junction folds – deep grooves in the motor end
plate that provide a large surface area for Ach
3. Production of muscle action potential – change in
the membrane potential triggers a muscle action
potential
4. Termination of ACh activity - effect of ACh binding
lasts only briefly
 Acetylcholinesterase (AChE) – breakdown
Ach
SOURCES OF ENERGY FOR MUSCLE CONTRACTION
1. Phosphocreatine – energy-rich molecule that is
found in muscle fibers
2. Glycolysis (Anaerobic Cellular Respiration) –
breakdown of glucose gives rise to lactic acid when
oxygen is absent or at a low concentration
3. Oxidative Metabolism (Aerobic Cellular
Respiration) – series of oxygen-requiring reactions
(the Krebs cycle and the electron transport chain)
that produce ATP, carbon dioxide, water, and heat
TYPES OF SKELETAL MUSCLE FIBER
1. Slow Oxidative Fibers
- Small, appear dark red, and least powerful type
- Fatigue resistant
- Used for endurance like running a marathon;
maintaining posture
2. Fast Oxidative-Glycolytic Fiber
- Intermediate in size, appear dark red
- Moderately resistant to fatigue
- Used for walking, sprinting
3. Fast Glycolytic Fibers
- Large, white, and powerful
- Suited to intense anaerobic activity of short
duration
- Rapid, intense movement in short duration
 Red muscle fibers (the dark meat in chicken legs)
have a high myoglobin content, more mitochondria,
more energy stores, and a greater blood supply
 White muscle fibers (the white meat in chicken
breasts) have less myoglobin, mitochondria, and
blood supply
TYPES OF MUSCLE CONTRACTION
1. Isometric Muscle Contraction
- Important for maintaining posture and
supporting objects in a fixed position
- Tension or force: increase greatly
- Muscle length: no change
- Movements: none
- Example: holding a book steady
2. Isotonic Muscle Contraction
- Important for body movements and for moving
objects
- Tension or force: remains constant
- Muscle length: increases or decreases
- Movements: yes
- Example: picking or lowering a book
IMBALANCE OF HOMEOSTASIS
Myasthenia Gravis
- Autoimmune chronic disease
- Progressive destruction of NMJ
Muscular Dystrophy
- Inherited
- Muscle destroying disease
- Progressive degeneration of skeletal muscle
- Mutation of protein dystrophin (structural
protein)
Abnormal Contraction of Skeletal Muscles
- Spasm – sudden involuntary contraction of a
single group of muscles
- Cramp – painful spasmodic contraction
(inadequate blood flow, overuse of muscle,
dehydration, decrease in potassium level)
- Tremor – rhythmic, involuntary, purposeless
contraction that produced shaking movements
(problem in nervous stem)
- Fasciculation – involuntary, quick twitch; visible
under the skin
- Fibrillation – spontaneous contraction but not
visible under the skin (detected by
Electromyography or EMG)
NERVOUS SYSTEM
Nervous system is one of the smallest and yet
the most complex of the 11 body systems.
Functions:
 Sensory Function – detect internal stimuli or
external stimuli
 Integrative Function – process sensory
information by making decision for response
(integration)
 Motor Function – may elicit an appropriate
motor response by activation effectors (muscles
and glands)
 Transmits information, and controls coordinates
all essential functions of the body
Two Main Subdivision of Nervous System
1. Central Nervous System
- consists of the brain and spinal cord
 Brain – contains about 85 billion neurons
 Spinal Cord – contains about 100 million
neurons
- main centers: meninges, CSF, skull and vertebral
column
- composed of neurons which are supported by
neuroglia
2. Peripheral Nervous System
- consists of all nervous tissue outside the CNS
(cranial nerves, spinal nerves, and associated
ganglia)
 Nerve – bundle of hundreds to thousands
of axons (nerve fibers)
 12 pairs of cranial nerves
 31 pairs of spinal nerves
- conduct information to and from the CNS and
fibrous sheats
Basic Cell of the Nervous System
Neuroglia
 smaller cells, but they greatly outnumber
neurons—perhaps by as much as 25 times
 support, nourish, and protect neurons, and
maintain the interstitial fluid that bathes them
Neuron
 basic functional cell of nervous system
 transmits impulses up to 250 mph
  sensing, thinking, remembering, controlling
muscle activity, and regulating glandular
secretion
 Electrical Excitability – ability to respond to a
stimulus and convert into action potential
 Stimulus – any change in the environment
that initiate an action potential
 Action Potential – electrical signal
Parts of a Neuron
1. Dendrite – receive stimulus and carries it impulses
toward the cell body
2. Soma (cell body) – contains nucleus and most
cytoplasm
3. Axon – fiber which carries impulses away from the
cell body toward another neuron
4. Schwann Cells – produce myelin sheath (fat layer in
the peripheral nervous system); oligodendrocytes
(fat layer in the central nervous system)
5. Myelin Sheath – dense lipid layer which insulates
the axon
6. Node of Ranvier – gaps or nodes in the myelin
sheath
Three Types of Neurons
1. Sensory Neuron or Afferent Neuron – bring
messages to CNS (brain and spinal cord)
2. Motor Neuron or Efferent Neuron – carry messages
from CNS
3. Interneurons – between sensory and motor
neurons in the CNS
A. Impulse
 Stimulus – change in the environment with
sufficient strength to initiate a response
 Excitability – ability of neuron to respond to the
stimulus and convert it into a nerve impulse
 All of Nothing Rule – stimulus Is either strong
enough to start an impulse or nothing happens
 impulses are always the same strength along a
given neuron and they are self-propagation –
once it starts it continues to the end of the
neuron in only one direction- from dendrite to
cell body to axon
 nerve impulse causes a movement of ions
across the cell membrane of the nerve cell
B. Synapse
 small gap or space between the axon of one
neuron and the dendrite of another
 the neurons do not actually touch at the
synapse
 it is junction between neurons which uses
neurotransmitters to start the impulse in the
second neuron or an effector (muscle or gland)
 synapse insures one-way transmission of
impulses
C. Neurotransmitters
 chemicals in the junction which allow impulses
to be started in the second neuron
 Inhibitory – GABA (Gamma-Aminobutyric
Acid)
 Excitatory – Acetylcholine, Glutamate
Primitive Structure of Neuron
1. Ectoderm – outermost; composed of columnar
epithelium and forms the nervous system
2. Mesoderm – gives rise to muscles, connective
tissues, and vascular system
3. Endoderm – innermost; gives rise to
gastrointestinal tract, lungs, and the liver
Development of the Nervous System
Neurulation
 marks the beginning of the formation of the
central nervous system
 process whereby neural plate forms into a
neural tube
 begins in 3rd week of development and
completes in the 4th week
Peripheral Nervous System
A. Somatic Nervous System (Voluntary)
 relays information from skin, sense organs and
skeletal muscles to CNS
 bring responses back to skeletal muscles for
voluntary responses
a. Cranial Nerves
- 12 pairs
- attached to undersurface of brain
- classified as sensory, motor, or mixed
sensory and motor
b. Spinal Nerves
- 31 pairs
- attached to spinal cord
c. Meninges
Cranial Nerves
 Olfactory (I) – sensory; olfaction (smell)
 Optic (II) – sensory; vision (sight)
 Oculomotor (III), Trochlear (IV), Abducens (VI) –
motor; extraocular muscles of the eye
 Trigeminal (V) – mixed; masseter
 Facial (VII) – mixed; taste on the 2/3 of tongue,
swallowing, and phonation (produce certain
sounds)
 Vestibulocochlear (VIII) – sensory; equilibrium and
hearing
 Glossopharyngeal (IX) – mixed; taste on the
posterior 1/3 of the tongue
 Vagus (X) – mixed; wanderer
 Spinal Accessory (XI) – motor; trapezius muscles
and sternocleidomastoid (SCM); assist movement of
head and pectoral girdle
 Hypoglossal (XII) – motor; tongue movement
Spinal Nerves
Mixed nerve, which carries motor, sensory, and
autonomic signals between the spinal cord and the
body
 Cervical Nerves (C1 – C8)
 Thoracic Nerves (T1 – T12)
 Lumbar Nerves (L1 – L5)
 Sacral Nerves (S1 – S5)
 Coccygeal Nerve (C0)
B. Autonomic Nervous System (Involuntary)
 concerned with the innervation of involuntary
structures; heart, smooth muscles, and glands
a. Sympathetic
- prepare the body for an emergency
- “fight of flight response”
b. Parasympathetic
- conserving and restoring energy
- “rest and digest”
Sympathetic Autonomic Nervous System
 increase heart rate, cardiac output, stroke volume
 increase in blood pressure (peripheral
vasoconstriction)
 decrease in digestion (constipation)
 bronchodilation
 mydriasis (pupillary dilation)
 dilates pupils; inhibits salivation; relaxes bronchi;
accelerates heartbeat; inhibits digestive activity;
stimulates glucose release by liver; relaxes bladder
Parasympathetic Autonomic Nervous System
 decrease in heart rate, cardiac output, stroke
volume
 increase in digestion
 increase in juice production
 bronchoconstriction
 miosis (pupillary constriction)
 contracts pupils; stimulates salivation; contracts
bronchi; slows heartbeat; stimulates digestive
activity; stimulates gallbladder; contracts bladder
Central Nervous System
Meninges (Protection)
Composed of neurons supported by specialized
neuroglial cell
 Gray Matter – consists of nerve cells and the
proximal portions of their processes (projections),
embedded in the neuroglia (cell body)
 White Matter – consist of nerve fibers (axons)
embedded in neuroglia; myelin sheath
Layers of the Meninges
1. Dura Mater – outermost layer, very tough
2. Arachnoid Mater – middle layer; adheres to the
dura mater and has web-like attachments to the
innermost layer (pia mater)
a. Pia Mater – very thin, transparent, but
tough; covers the entire brain, following it
into all its crevices (sulci) and spinal cord
Cerebrospinal Fluid (80 – 150mL) – buffers, nourishes,
and detoxifies the brain and spinal cord; flows through
the subarachnoid space, between arachnoid mater and
pia mater
Regions of Central Nervous System
1. Cerebral Cortex/ Cerebrum
- receives sensory information
- sends messages to move skeletal muscles
- integrates incoming and outgoing nerve
impulses
- performs activities such as thinking, learning,
and remembering
2. Basal Ganglia
- helps coordinate slow, sustained movements
- suppresses useless patterns of movement
3. Thalamus
- relays most sensory information from the spinal
cord and certain parts of the brain to the
cerebral cortex
- interprets certain sensory messages such as
those of pain, temperature, and pressure
4. Hypothalamus
- controls various homeostatic functions such as
body temperature, respiration, and heartbeat
- directs hormone secretions of the pituitary
5. Cerebellum
- coordinates subconscious movements
- contributes to muscle tone, posture, and
balance
6. Brain Stem
- origin of many cranial nerves
- reflex center for movements of eyeballs, head,
and trunk
- regulates heartbeat and breathing
- plays a role in consciousness
- transmits impulses between brain and spinal
cord
Cerebral Cortex/ Cerebrum
 largest portion of the brain, encompasses about
two-thirds of the brains mass
 consists of two hemisphere (left and right) divided
by a medial longitudinal fissure, connected by the
corpus callosum
 includes cerebral cortex, medullary body, and basal
ganglia
Lobes of Cerebrum
1. Frontal – motor area involved in movement and
in planning and coordinating behavior
2. Parietal – sensory processing, attention, and
language
3. Temporal – auditory perception, speech, and
complex visual perceptions
4. Occipital (visual center) – plays a role in
processing visual information
Medullary Body – white matter if the cerebrum and
consists of myelinated axons
a. Commissural Fibers – conduct impulses
between the hemispheres and form corpus
callosum
b. Projection Fibers – conduct impulse in and out
of the cerebral hemispheres (thalamus,
brainstem, and spinal cord)
c. Association Fibers – conduct impulses within
the hemispheres
Hemispheres of the Brain
1. Left Hemisphere (Dominant Hemisphere)
- left brain; right side of body control
- number skills
- math/scientific skills
- written language
 - spoken language Guillain-Barre Syndrome (GBS)
- objectivity - acute demyelinating disorder in which
- analytical macrophages strip myelin from axons in the
- logic PNS (myelin sheath: Schwann cells)
- reasoning - may result from the immune system’s response
2. Right Hemisphere (Non-Dominant Hemisphere) to a bacterial infection
- right brain; left side of body control
- 3D shapes
- music/art awareness ENDOCRINE SYSTEM
- intuition
Endocrine System
- creativity  2nd great controlling system in the body
- imagination  composed of ductless glans and produce
- subjectivity hormones in the blood or lymph system
- synthesizing
- emotion Functions:
- face recognition  regulating almost body functions, including
metabolism, growth and development, water
and electrolyte balance, reproduction, and
Diseases of the Nervous System behavior
Multiple Sclerosis  endocrine system is controlled by the feedback
- progressive destruction of myelin sheaths mechanism
surrounding neurons in the CNS
(oligodendrocyte); autoimmune disease Feedback Mechanism
- usually appears between the ages of 20 and 40 1. Negative Feedback Mechanism
- females twice as often as males - major mechanism of hormone action; its effects
causes the process to slow down or turn off
2. Positive Feedback Mechanism
- accelerates the original process. It can ensure
that the pathway continues to run can speed up
Epilepsy its activities
- characterized by short, recurrent attacks of
Three General Types of Hormones
motor, sensory, or psychological malfunction
1. Proteins and Polypeptides
- initiated by abnormal, synchronous electrical
- anterior and posterior pituitary gland:
discharges from millions of neurons
- the pancreas (insulin and glucagon)
- causes, including brain damage at birth (the
- parathyroid gland (parathyroid hormone)
most common cause); metabolic disturbances
2. Steroids
(hypoglycemia, hypocalcemia, uremia, hypoxia);
- adrenal cortex (cortisol and aldosterone)
infections (encephalitis or meningitis); toxins
(alcohol, tranquilizers, hallucinogens); vascular - ovaries (estrogen and progesterone)
disturbances (hemorrhage, hypotension); head - testes (testosterone)
injuries; and tumors and abscesses of the brain - placenta (estrogen and progesterone)
3. Derivatives of Amino Acids Tyrosine
Excitotoxicity - thyroid (thyroxine and triiodothyronine)
- high level of glutamate (excitatory - adrenal medullae (epinephrine and
neurotransmitter) in the interstitial fluid of the norepinephrine)
CNS
- most common cause of excitotoxicity is oxygen
deprivation of the brain due to ischemia Glands
(inadequate blood flow), as happens during a A. Hypothalamus
stroke  master control center of the endocrine system
- Decreased Oxygen = Increased Glutamate =  indirect control
Brain Cell Damage  Functions: temperature regulation, control the
Myasthenia Gravis (MG) body weight, drive to eat and drink, emotions.
- chronic autoimmune, neuromuscular disease
B. Pituitary Gland (Hypophysis)
(neuromuscular junction)
 Lies inferior to the hypothalamus
-  antibodies (immune proteins produced by the
 Connected thru the infundibulum
body’s immune system) block, alter, or destroy
the receptors for acetylcholine at the Division of Pituitary Gland
neuromuscular junction, which prevents the 1. Anterior Pituitary Gland/ Adenohypophysis
muscle from contracting a. Growth Hormone (GH) / Somatotropin –
-  hallmark of myasthenia gravis is muscle stimulates protein synthesis and overall growth
weakness that worsens after periods of activity of most cell (i.e. osteoblast) and tissues
and improves after periods of rest b. Thyroid Stimulating Hormone (TSH) – thyroid
gland; stimulates synthesis and secretion of
 thyroid hormones (thyroxine and
triiodothyronine)
c. Adrenocorticotropic (ACTH) – renal or kidney;
stimulates synthesis and secretion of
adrenocortical hormones (cortisol, androgens,
and aldosterone)
d. Prolactin – promotes development of the
female breasts and secretion of milk
e. Follicle Stimulating Hormone (FSH) – male:
stimulates release of sperm; female: initiates
development of oocytes and induces ovarian
release of estrogen
f. Luteinizing Hormone (LH) – male: stimulates
testosterone synthesis in Leydig cells of testes;
female: stimulates ovulation, formation of
corpus luteum, and estrogen and progesterone
synthesis in ovaries
g. Melanocyte Stimulating Hormone (MSH) –
increases skin pigmentation
2. Posterior Pituitary Gland/ Neurohypophysis
a. Antidiuretic Hormone (ADH) / Vasopressin –
increases water reabsorption by the kidneys
and causes vasoconstriction and increased
blood pressure
b. Oxytocin – stimulates milk ejection from
breasts and uterine contractions; milk ejection
via sucking reflex
C. Pineal Gland
 small endocrine gland attached to the roof of
the third ventricle of the brain at the midline
 Part of the epithalamus, it is positioned
between the two superior colliculi, has a mass
of 0.1–0.2g
 Melatonin: controls the body's biological clock
D. Thymus Gland
 located behind the sternum between the lungs
 thymosin, thymic humoral factor (THF), thymic
factor (TF), and thymopoietin — promote the
maturation of T cells (a type of white blood cell
that destroys microbes and foreign substances)
and may retard the aging process
E. Thyroid Gland
 located immediately below the larynx on each
side and anterior to the trachea
 one of the largest of the endocrine glands,
normally weighing 15 to 20 grams in adults
a. T3 (Triiodothyronine) and T4 (Thyroxine) –
increase body metabolic rate; important in
growth and development
b. Calcitonin – parafollicular cells of the
thyroid gland; reduces blood calcium levels
by acting on osteoclasts in the process of
bone resorption
F. Parathyroid Gland
 embedded in the posterior surface of the lateral
lobe of the thyroid gland
 small, brownish-red glands
 Parathyroid Hormone
- stimulates osteoclasts to resorb bone and
release calcium ions from bone matrix into
the bloodstream
- stimulates calcitriol hormone synthesis in
the kidney
- promotes calcium absorption in the small
intestine
- prevents the loss of calcium ions during the
formation of urine
G. Adrenal Gland (Suprarenal)
 The two adrenal glands, each of which weighs
about 4 grams, lie at the superior poles of the
two kidneys
Kinds of Adrenal Gland
1. Adrenal Medulla
- the central 20 percent of the gland, is
functionally related to the sympathetic nervous
system;
- Secretes catecholamine hormones:
a. the hormones epinephrine (slightly more of
an effect on your heart); and
b. norepinephrine (more of an effect on your
blood vessels)
- They are the flight-or-fight hormones that are
released when the body is under extreme
stress.
2. Adrenal Cortex
- secretes an entirely different group of
hormones, called corticosteroids
a. ZONA GLOMERULOSA – Mineralocorticoids
(Aldosterone)
- Increases renal sodium reabsorption,
potassium secretion, and hydrogen ion
secretion;
- increase water and electrolyte
reabsorption
b. ZONA FASCICULATA – Glucocorticoids
(Cortisol)
- Has multiple metabolic functions for
controlling metabolism of proteins,
carbohydrates, and fats;
- also has anti-inflammatory effects;
- resistance to stress
c. ZONA RETICULARIS Androgen (Secondary
sex characteristics of males)
- Stimulate growth of axillary and pubic
hair
- If more in females they develop male
characteristics, clitoris develops
- similar to penis
H. Pancreas
 flattened organ that measures about 12.5–15
cm (5–6 in.) in length, the pancreas is located in
the curve of the duodenum (first part of the
small intestine) and consists of a head, a body,
and a tail
 Pancreatic Islet (Islet of Langerhans)
1. Alpha Cells – glucagon, increases blood sugar levels
2. Beta Cells – insulin, decreases blood glucose levels
3. Delta Cells – somatostatin, balance/controls the
number of insulin and glucagon (acts like mediator);
inhibit both insulin and glucagon release from
neighboring beta and alpha cells
4. F Cells – pancreatic polypeptide, inhibits
somatostatin secretion, gallbladder contraction, and
secretion of digestive enzymes by the pancreas
I. Gonads
 Ovaries (Female)
a. Estrogens: Promotes growth and
development of female reproductive
system, female breasts, and female
secondary sexual characteristics
b. Progesterone: Stimulates secretion of
“uterine milk” by the uterine endometrial
glands and promotes development of
secretory apparatus of breasts
c. Relaxin: Increases flexibility of pubic
symphysis during pregnancy; helps dilate
uterine cervix during labor and delivery
d. Inhibin: Inhibits secretion of FSH from
anterior pituitary
 Testes (Male)
a. Testosterone: Promotes development of
male reproductive system and male
secondary sexual characteristics
b. Inhibin: Inhibits secretion of FSH from
anterior pituitary.
ORGANS
A. Placenta
 Pregnancy:
1. Human chorionic gonadotropin (hCG)
Stimulates corpus luteum in ovary to
continue production of estrogens and
progesterone to maintain pregnancy
2. Human somatomammotropin (hCS):
Stimulates development of mammary
glands for lactation
3. Estrogen: help prepare mammary glands to
secrete milk.
4. Progesterone
B. Stomach
1. Gastrin : Promotes secretion of gastric juice;
increases movements of the stomach (dissolves
what we eat)
2. Glucose-dependent insulinotropic peptide
(GIP): Stimulates release of insulin by pancreatic
beta cells (to balance the blood sugar level)
3. Ghrelin: hunger hormone
C. Kidney
1. Renin: part of reaction sequence that raises
blood pressure by bringing about
vasoconstriction (constriction of blood vessels)
and secretion of aldosterone
2. Erythropoietin: increases rate of red blood cell
formation
3. Calcitriol : Aids in absorption of dietary calcium
and phosphorus
D. Heart
a. Atrial natriuretic peptide: Increases sodium
excretion by kidneys, reduces blood pressure
E. Adipose Tissue
a. Leptin: Inhibits appetite and thermogenesis
(body heat)
Homeostatic Imbalances of Endocrine System
Diabetes Insipidus (DI)
 most common abnormality associated with
dysfunction of the posterior pituitary
 This disorder is due to defects in antidiuretic
hormone (ADH) receptors or an inability to
secrete ADH
 Neurogenic diabetes insipidus & Nephrogenic
diabetes insipidus
 A common symptom of both forms of DI is
excretion of large volumes of urine
Diabetes Mellitus (DM)
 deficiency or absence of insulin secretion of the
beta cells of the pancreas or by defects of the
insulin receptors
 Type 1 diabetes mellitus (T1DM); also known
as insulin-dependent, juvenile-onset diabetes
while
 Type 2 diabetes mellitus (T2DM), also known as
non-insulin dependent, adult onset diabetes.
 Characteristics: polyuria, excessive urine
production due to an inability of the kidneys to
reabsorb water; polydipsia, excessive thirst;
and polyphagia, excessive eating
Thyroid Gland Diseases
• Graves Disease “Hyperthyroidism “
• autoimmune disorder in which the person
produces antibodies that mimic the action of
thyroid-stimulating hormone (TSH)
• Characteristics: Goiter is simply an enlarged
thyroid gland. It may be associated with
hyperthyroidism, hypothyroidism, or
euthyroidism which means normal secretion of
thyroid hormone.
• Myxedema “Hypothyroidism”
Parathyroid Gland Disorders
 Hypoparathyroidism (Hyporcalcemia) - too
little parathyroid hormone which leads to a
deficiency of blood Ca2++ ; leads to twitches,
spasms, and tetany (maintained contraction) of
skeletal muscle
 Hyperparathyroidism (Hypercalcemia) -
excessive resorption of bone matrix, raising the
blood levels of calcium and phosphate ions and
causing bones to become soft and easily
fractured
Adrenal Gland Diseases
 Cushing’s Syndrome - hypersecretion of cortisol
by the adrenal cortex;
- Symptoms: elevated level of cortisol causes
hyperglycemia, osteoporosis, weakness,
hypertension, increased susceptibility to
infection, decreased resistance to stress, and
mood swings
 Addison’s Disease - hyposecretion of
glucocorticoids and aldosterone;
- Symptoms: which typically do not appear until
90% of the adrenal cortex has been destroyed,
include mental lethargy, anorexia, nausea and
vomiting, weight loss, hypoglycemia, and
muscular weakness