ENDOCRINE SYSTEM
• The 2nd control system of the body,
composed of endocrine glands and specialized
endocrine cells
• The endocrine system releases chemicals
called hormones that regulate
complex body processes. Hormones travel
through the blood and alter the activity of target
cells
• Overall, the endocrine system regulates
complex processes such as growth and
development, metabolism, and reproduction.
Chemistry of Hormones
• Hormones are chemical substances
secreted by endocrine cells into the
extracellular fluids that regulate the metabolic
activity of other cells in the body
• Classification/s:
• Amino acid-based molecules
(proteins, peptides and amines)
• Steroids
• Prostaglandins
Hormone Action
• A given hormone affects only certain tissue
cells or organs, referred to as its target cells or
target organs
• Function/s: COASPT
• Change plasma membrane permeability or
membrane potential by
• opening or closing ion channels
• Activate or inactive enzymes
• Stimulate or inhibit cell division
• Promote or inhibit secretion of a product
• Turn on or turn off transcription of certain
genes
HORMONE FUNCTION & REGULATION
 Direct Gene Activation
 Secondary Messenger System
Direct Gene Activation
• Steroid and Thyroid hormones
• Hormones that are lipid-soluble molecules
= diffuse through the plasma membrane
Direct Gene Activation
• Process: OHAMP
1. Once inside, the steroid hormone enters the
nucleus and binds to a specific hormone
receptor
2. Hormone-receptor complex then binds to
specific sites in the cell’s DNA
3. Activates certain genes to transcribe
messenger (mRNA)
4. mRNA is translated in the cytoplasm
5. Protein synthesis
Second- Messenger System
• Protein or peptide hormones
• NOT water-soluble and are unable to enter
target cells directly
• Instead, they bind to hormone receptors
situated on the target cell’s plasma membrane
and use a second-system messenger system
Second- Messenger System
• Process: HAEC
1. Hormone binds to the receptor protein on the
plasma membrane
2. Activated receptor activates an enzyme
3. Enzyme catalyzes reactions to produce
second-messenger molecules (cyclic AMP or
cAMP or cyclic adenosine monophosphate)
4. cAMP stimulates a response/reaction inside
the target cell\
Control of Hormone Release
• The stimuli that activate endocrine glands fall
into three (3) major categories:
1. Hormonal Stimuli – most common;
endocrine glands are stimulated By other
hormones
2. Humoral Stimuli – changes in blood levels of
certain ions and nutrients stimulate hormone
release
3. Neural Stimuli – nerve fibers stimulate
hormone release
PITUITARY GLANDS
• Pea-sized gland hanging by a stalk from the
inferior surface of the hypothalamus
• It has two functional lobes—the anterior
pituitary (glandular tissue) and the posterior
pituitary (nervous tissue)
Posterior Pituitary
•is not an endocrine gland in the strict sense
because it does not make the peptide
hormones it releases.
• Instead, it acts as a storage area for
hormones made by hypothalamic neurons.
OXCYTOCIN – hormone released only during
childbirth and nursing. It stimulates powerful
contractions of uterine muscle during sexual
relations, labor and breast feeding. It also
causes milk ejection (“let-down reflex”) in a
nursing woman.
Posterior Pituitary
• ANTIDIURETIC HORMONE (ADH)
• DIURESES – urine production
• Water is a diuretic fluid and a powerful
inhibitor of ADH release
• It causes the kidneys to reabsorb more water
from the forming urine = urine volume
decreases and blood volume increases
• ADH also increases blood pressure by
causing constriction of arterioles (small
arteries) (Vasopressin)
Diabetes inspidus
• Condition of excessive urine output due to
hyposecretion of ADH
• S/Sx: continually thirsty and drink huge
amounts of water
Anterior Pituitary
• “Master Endocrine Gland”
• All anterior pituitary hormones (1) are proteins
(or peptides), (2) act through second-
messenger systems, and (3) are regulated by
hormonal stimuli
Growth Hormone (GH)
• General metabolic hormone
• Direct effect on growth of skeletal muscles
and long bones of the body, and thus it plays
an important role in determining final body size
• Stimulates most target cells to grow in size
and divide
• Causes breakdown of fats for energy; Saves
glucose to maintain blood sugar homeostasis
Pituitary Dwarfism – Hyposecretion of GH
during childhood; Body proportions are fairly
normal, but the person as a whole is a living
miniature (with a maximum adult height of 4
feet)
• Gigantism – Hypersecretion of GH during
childhood; Individual becomes extremely tall;
height of 8 to 9 feet is common. Again, body
proportions are fairly normal.
ACROMEGALY
• Hypersecretion of GH after long bone growth
has ended during adulthood
• Cause: result from tumor on pituitary gland
• Enlargement of facial bones particularly the
lower jaw and bony ridges of underlying the
eyebrows, feet and hands • Enlargement of
heart and other organs
Prolactin
• Protein hormone structurally similar to growth
hormone
• Target organ/cell: Breast (mammary glands)
• Stimulates and maintains milk production by
the mother’s breasts after childbirth
Gonadotropic Hormones
• They regulate the hormonal activity of the
gonads (ovaries and testes)
Follicle-stimulating hormone (FSH)
• Female: stimulate follicle development in
ovaries in women. As follicles mature, they
produce estrogen and eggs are readied for
ovulation.
• Male: stimulates sperm development
Luteinizing Hormone (LH)
• Female: egg ovulation in women to produce
progesterone and estrogen
• Male: stimulates testosterone production in
the testes
• Sterility
– Hyposecretion of FSH, the lack of ability to
successfully reproduce in both males and
females
• Infertility
– Hyposecretion of LH, inability to complete
one full term of pregnancy
Thyrotropic Hormone (TH or TSH)
• Also called as “thyroid- stimulating
hormone” (TSH) • Influences the growth and
activity of the thyroid gland
Adrenocorticotropic Hormone (ACTH)
• Hormone that regulates the endocrine activity
of the cortex portion of the adrenal gland
Pineal Gland
• Small, cone-shaped gland that hangs from
the roof of the third ventricle of the brain
(EPITHALAMUS)
• Melatonin – primarily responsible for
regulating your body’s circadian rhythm to
manage natural sleep cycle; peak level occurs
at night and make us drowsy and lowest levels
occurs during daylight.
THYROID GLAND
• Located at the base of the throat; just inferior
to the Adam’s apple
• Fairly large gland consisting of two lobes
joined by a central mass or isthmus
• Internally, it is composed of hollow structures
called follicles which store a sticky colloidal
material that form the thyroid hormone
• The thyroid gland makes two (2)
hormones:
• Thyroid hormones
•Calcitonin
Thyroid Hormone
• “Body’s Major Metabolic Hormone”
• It has two (2) iodine- containing hormones:
• Thyroxine (T4)
• Triiodothyronine (T3)
Thyroid Hormone
• It controls the rate at which glucose is
“burned” or oxidized, and converted to body
heat and chemical energy (ATP)
• It is also important for normal tissue growth
and development, especially inthe reproductive
and nervous systems
Goiters
• It is an enlargement of the thyroid gland due
to iodine deficiency in diet
• Thyroid-Stimulating Hormone”calls” for the
release of thyroxine (T4), but as the peptide
part of the molecule is made, the thyroid gland
enlarges because the protein component is
nonfunctional without iodine, thus, a continuous
production of the peptide component
Cretinism
• A type of dwarfism and hypothyroidism in
which adult body proportions remain child-like,
with a proportionally longer torso and shorter
legs compared to normal adults
• Lack of thyroxine from birth or before birth;
could be lack of thyroid gland or lack of iodine
in mother
• severe irreparable mental defects
• Stunted growth
• Reduced growth and function of many organs
• Tx: Hormone replacement therapy in early
diagnosis to prevent mental impairment and
deficiencies
Myxedema
• Hypothyroidism or hyposecretion of thyroxine
(T4) occurring in adults
• Characterized by both physical and mental
sluggishness (but no mental impairment)
• Cause/s: viral infection, cancer, radiation
exposure, autoimmune disease
• S/sx: puffiness of the face, fatigue, poor
muscle tone, low body temperature (the person
is always cold), obesity, and dry skin
• Medx: Oral thyroxine (T4)
Grave’s Disease
• Hyperthyroidism generally from a tumor on
the thyroid gland
• Thyroid gland enlarges
• (+) Exophthalmos – bulging of the eyes
• S/sx: high metabolism, heat intolerant, rapid
heartbeat, weight loss, nervous and agitated
behavior
• Tx: surgical removal of tumor or part of the
affected thyroid gland or use of thyroid-
blocking drugs or radioactive-iodine to destroy
some of the thyroid cells
Calcitonin
• Decreases the blood calcium ion level by
causing calcium to be deposited in the bones
• Released directly to the blood in response to
an increasing level of blood calcium ions
Parathyroid Gland
• Tiny masses of glandular tissue most often
found on the posterior surface of the thyroid
gland
• Typically, there are two (2) parathyroid glands
on each thyroid lobe
• It secretes parathyroid hormone (PTH)
Parathyroid Hormone (PTH)
• Most important regulator of calcium ion (Ca+
+) homeostasis of the blood
• Parathyroids release PTH to stimulate the
osteoclasts when calcium in the bloodstream
drops below a certain level
• PTH also stimulates the kidneys and
intestines to absorb more calcium ions (from
urinary filtrate and food)
• Tetany – uncontrollable spasms or rapid
muscle twitching when calcium ions fall too low
• Severe
Hyperparathyroidism – massive bone
destruction; large punched-out holes in the
bone matrix (X-ray). Fragile and brittle bones.
Thymus
• Located in the upper thorax, posterior to the
sternum
• Large in infants and children, decreases in
size throughout adulthood and by old age, it is
composed mostly of fibrous connective tissue
and fat
• Produces a hormone called thymosin
• essential for normal development of a special
group of white blood cells (T lymphocytes) and
the immune response
Adrenal Glands
• Also called “suprarenal glands” are two
glands curved over the top of the kidneys like
triangular hats
• It has two (2) parts:
• Cortex – outer; made of glandular tissue
• Medulla – inner; made of neural tissue
CORTICOSTEROIDS – three major groups of
steroid
hormones produced by the adrenal cortex
1. Mineralocorticoids
2. Glucocorticoids
3. Sex Hormones
1. Aldosterone
• Regulates mineral (or salt) content of the
blood, particularly sodium (Na+) and potassium
(K+) ions
• Water and electrolyte balance
• When aldosterone increases, the kidney
reabsorb increasing amounts of sodium (Na+)
ions and secrete more potassium (K+) into the
urine. When sodium is reabsorbed, water
follows.
Renin – enzyme produced by the kidneys to
release aldosterone when blood pressure
drops
2. Cortisone and Cortisol
• Promote normal cell metabolism and help the
body resist long-term stressors, primarily by
increasing the blood glucose level
• High glucocorticoids = fats and proteins are
broken down and converted to glucose
• Controls inflammation and reduces pain
3. Also called “Adrenal Androgens”
• Androgens – male sex hormones (mostly)
• Estrogens – female sex hormones
• Stimulate pubic and axillary hair growth (both
male and female) and sex drive in females
• Hypersecretion = masculinization regardless
of sex
• Hirsutism – increase in body hair in a
masculine pattern such as a beard in females
ADDISON DISEASE
• Low levels or hyposecretion of all adrenal
cortex hormones, especially aldosterone and
cortisol
CUSHING’S SYNDROME
Hypersecretion of cortisol and androgens due
to a tumor on the adrenal cortex
CATHECOLAMINES
• EPINEPHRINE or adrenaline
• NOREPINEPHRINE or noradrenaline
• Increase heart rate, blood pressure, blood
glucose level and dilate the passageways of
the lungs
• Autonomic Nervous System (ANS)
stimulates the adrenal medulla via sympathetic
nervous system (fight or flight response)
PANCREAS
• Located close to the stomach in the
abdominal cavity
• Both an exocrine gland and an endocrine
gland
• PANCREATIC ISLETS (Islets of Langerhans)
– little masses of endocrine (hormone-
producing) tissue
• Two (2) important hormones produced:
• INSULIN
• GLUCAGON
INSULIN
• Released from the pancreatic islets
• Helps the cells absorb glucose, reducing
blood sugar and providing the cells with
glucose for energy
• Without insulin, cells are unable to use
glucose as fuel and they will start
malfunctioning
Diabetes Mellitus (DM)
• Insulin moves sugar from the blood into your
cells to be stored or used for energy
• With diabetes, your body either doesn’t make
enough insulin or can’t effectively use the
insulin it makes
• (N) blood glucose: 80 to 120 mg/100ml
GLUCAGON
• Released from the pancreatic islets
• Acts an antagonist of insulin
• When blood sugar levels are too low, the
pancreas releases glucagon
GONADS
• Ovaries (female) and Testes (Male)
• Both has endocrine and exocrine function
• The major differences from the adrenal gland
and gonads when producing sex hormones are
the source and relative amounts of hormone
produced
Ovaries – paired, slightly larger than almond-
sized organs located in the pelvic cavity
• Estrogen – development of sex
characteristics in women (growth and
maturation of the reproductive organs)
• Progesterone – menstrual cycle
Testes – paired oval-shaped organs of the
male and are suspended in a sac called the
scrotum, outside the pelvic cavity
• Testosterone – growth and maturation of the
reproductive system organs to prepare the
young man for reproduction. It also causes the
male’s secondary sex characteristics (growth of
facial hair, development of heavy bones and
muscles, and lowering of the voice) to appear
and stimulate the male sex drive.
Placenta
• A temporary organ formed in the uterus of a
pregnant woman
• Produces several protein and steroid
hormones that help maintain the pregnancy
and pave the way for delivery of the baby
• In the 3rd month of pregnancy, the placenta is
the one producing estrogen and progesterone,
while the ovaries become inactive for the rest
of the pregnancy
Human chorionic gonadotropin (hCG) –
early pregnancy; stimulates to continue
production of estrogen and progesterone so
that the lining of the uterus is not sloughed off
during menstruation
• Human placental lactogen (hPL) – hormone
that works with estrogen and progesterone in
preparing the breasts for lactation.
• Relaxin – hormone produced in a pregnant
woman during labor; it causes the mother’s
pelvic ligaments and the pubic symphysis to
relax and become more flexible, which eases
birth passage.
 + Pericarditis - Inflammation of the
pericardium that often results in a decrease in
the amount of serous fluid. This causes the
pericardial layers to rub, bind and stick to each
other, forming painful adhesions that interfere
with the heart movements.
WALLS OF THE HEART
+The heart walls are composed of three (3)
layers
+ Epicardium (visceral layer of serous
pericardium)
CARDIOVASCULAR SYSTEM
+ Myocardium – consists of thick. Bundles of
+ The major function of the cardiovascular
cardiac muscle; contracting layer
system is transportation. Using blood as the
transport vehicle, the system carries oxygen, + Endocardium – lines the heart chambers
nutrients, cell wastes, hormones, and many
other substances vital for body homeostasis to CHAMBERS OF THE HEART
and from the cells. + The heart has four (4) hollow cavities or
+ The force to move the blood around the body chambers:
is provided by the beating heart and by blood – + Right Atrium
pressure. – + Left Atrium
ANATOMY: HEART – + Right Ventricle
– + Left Ventricle
+A hollow, cone-shaped organ, approximately
the size of a person’s fist and weighs less than + Left Ventricle + Ventricles – discharging
a pound + Interatrial Septum – divides the atria
+It is enclosed within the medial section of the + Interventricular Septum – divides the
thoracic cavity or mediastinum (inferior) ventricles
+It is flanked on each side by the lungs + Atrioventricular Septum – divides the atria
ANATOMY HEART and ventricles

+APEX: directed toward the left hip and rests
on the diaphragm, approximately at the level of
the fifth intercostal space
+BASE: points toward the right shoulder and
lies beneath the second rib
Great Vessels of the Heart
– Superior vena cava (SVC)
– Inferior vena cava (IVC)
– Pulmonary Trunk
– Pulmonary arteries

COVERINGS OF THE HEART Pulmonary veins + Pulmonary Circulation

+ PERICARDIUM – a sac enclosing the heart – carrying of blood for gas exchange;
oxygenation of blood
+ Fibrous pericardium – protects and anchors
the heart to the diaphragm and sternum Great Vessels of the Heart

+ Serous pericardium – inner covering of the + AORTA

heart Fibrous pericardium
+ Parietal pericardium – lines the interior
aspect of the heart
+ Visceral pericardium (Epicardium) – part of
the heart wall
PERICARDIAL CAVITY- Lubricating serous
fluid is produced by the serous pericardial
membranes and collects in the pericardial
cavity between these serous layers
– main artery that carries blood away from your
heart to the rest of the body
+ Systemic Circulation
transport of oxygenated blood from left
ventricle through the body tissues and back to
the right atrium
HEART VALVES
+ Valve – flap or cusp that acts as one-way
inlet for blood coming into a ventricle and one-
way outlet for blood leaving a ventricle
+ The heart is equipped with four (4) valves:\
+ Tricuspid valve, + Pulmonary valve
+ Aortic valve, + Mitral valve (Bicuspid
valve)
+ Chordae Tendinae – “heart strings”; tiny
white cords that anchor the cusps to the walls
of the ventricles
Aortic valves (AV) tricuspid & mitral; prevent
backflow into the atria when the ventricles
contract
+Semilunar valves (SV)
Pulmonary & aortic; Prevents arterial blood
from re- entering the heart
Valvular Stenosis
Condition when valve cusps become stiff and
does not close properly to backflow
Endocarditis – due to repeated bacterial
infection of the endocardium
+ Workload of heart increases = heart failure
+ Tx: Synthetic valve, cryopreserved human
valve or chemically treated valve from a pig
heart
Cardiac Circulation
Functional blood supply of the myocardium is
provided by the right and left Coronary Arteries.
+ Coronary arteries branch from the base of
the aorta and encircles the heart at the
atrioventricular groove.
Cardiac Circulation
+ Right Coronary Artery
– Marginal Artery
– Posterior Interventricular Artery
+Left Coronary Artery
– Anterior Interventricular Artery
– Circumflex Artery
Cardiac Circulation
+Cardiac Veins – return or drain
deoxygenated blood from the myocardium
back to the right atrium. Most venous blood
returns via the
Coronary Sinus.
MYOCARDIAL INFARCTION (MI)
+ Death of oxygen-deprived heart cells
+ Myocardium receives an inadequate blood
supply when the heart beats at a very rapid
rate
Angina Pectoris – Crushing chest pain due to
an oxygen-deprived myocardium; WARNING
SIGN for Myocardial Infarction (MI) or heart
attack
PHYSIOLOGY OF THE HEART
+ In one day, the heart pumps approx. 6 liters
(L) of blood through the blood vessels over
1,000 times or about 1500 gallons of blood in a
single day.
CONDUCTION SYSTEM OF THE HEART
+Two (2) systems act to regulate heart activity:
Intrinsic Conduction System or Nodal
System – built into the heart tissue and sets its
basic rhythm.
+ Autonomic Nervous System (ANS) – act
like brakes and gas pedals to decrease or
increase the heart, depending on which
division is activated.
INTRINSIC CONDUCTION SYSTEM
+ This system causes heart muscle
depolarization in only one direction – from the
atria to the ventricles. + Sinoatrial (SA) Node –
pacemaker of the heart; starts each heartbeat
+ Atrioventricular (AV) node + Atrioventricular
(AV) bundle (bundle of His)
+ Bundle branches + Purkinje fibers
Intrinsic Conduction System
This transport of impulse results in a “wringing”
contraction of the ventricles that begins at the
heart apex and moves toward the atria
This contraction effectively ejects blood
superiorly into the large arteries leaving the
heart
Heart block – or “AV block” is a damage to the
AV node which blocks the SA node from
controlling the ventricles; beating of heart
becomes slower
Artificial Pacemaker – a medical device that
is surgically installed in the body to generate
electrical impulses to replace and/or regulate
the function of the SA Node or the conducting
system.
HEART CONDITIONS
ISCHEMIA – lack of adequate. Blood supply to – + SL valves closed
the heart muscle
Cardiac Cycle Heart Sounds
FIBRILLATION – a rapid, uncoordinated
When using stethoscope, you can hear
quivering of the ventricles; causes the heart to
two distinct sounds during each cardiac cycle.
not be able to pump any blood and so is a
These heart sounds are often described by the
major cause of death from heart attack in
two syllables “lub” and “dup/dub”
adults
+ First Heart Sound (lub): closing of AV
+Tachycardia – rapid heart rate (over 100
valves
beats per minute)
+ Second Heart Sound (dup): SL valves close
+ Bradycardia – slower heart rate than normal
at the end of ventricular systole
(less than 60 beats per minute)
+ Heart Murmurs – Abnormal or unusual heart
+ Normal (N) Heart Rate: 60 – 100 bpm
sounds when blood
Cardiac Cycle
flow becomes turbulent; usually due to valve
The events of one complete heartbeat, during problems; common and normal in young
which both atria and ventricles contract and children with perfectly healthy hearts.
relax
BLOOD VESSELS
Average Heart Rate: 75 beats per minute
Blood circulates inside the blood vessels,
(60s)
which form a closed transport system called
Length of Cardiac Cycle: 0.8 seconds the vascular system.
Systole – heart contraction There are three (3) main types of blood
vessels:
Diastole – heart relaxation
+ Arteries
Cardiac Cycle & Blood Pressure
+ Capillaries
The cycle is composed of events occurring five
(5) periods: + Veins
– Atrial diastole (ventricular filling) ANATOMY OF BLOOD VESSELS
– Atrial Systole
+ The walls of blood vessels have three (3)
– Isovolumetric contraction
layers:
– Ventricular systole (ejection phase)
– Isovolumetric relaxation + Tunica externa/adventitia – outermost layer
composed largely of fibrous connective tissue
Atrial Systole
and functions to support and project vessels
also known as “active ventricular filling” ++ The
+ Tunica media – bulky middle layer made up
atria contract, increasing atrial pressure and
of smooth muscle and elastic fibers; controlled
completing ventricular filling while the ventricles
by sympathetic nervous system (changing the
are relaxed.
diameter of the vessels)
Isovolumetric Contraction
+ Tunica intima – lines the lumen or the
– + Atrial systole ends, and ventricular interior of the vessels; form a slick surface that
systole begins decrease friction as blood flows through
– + AV valves closed – caused by
Structural Differences in Blood Vessels
increased intraventricular pressure
– + SL valves closed + Walls of arteries are much thicker than those
veins, especially the tunica media. Arteries
Ventricular systole (Ejection Phase)
must be able to expand as blood is forced into
+ Ventricles continue to contract, them
intraventricular pressure increased
+ Lumens of veins tend to be larger than
Isovolumetric Relaxation arteries and thicker tunica externa
– + Intraventricular pressure fails + Larger veins have valves that prevent
– + Ventricular diastole begins backflow of blood like those in the heart
Gross Anatomy of Blood Vessels
– + Aorta – largest artery of the body
– + Ascending aorta
– + Aortic arch
– + Thoracic aorta
– + Abdominal aorta
Major Branches of the Aorta
– +Ascending Aorta
– + (R) Coronary Artery
– + (L) Coronary Artery
– +Supplies the heart
Coronary Artery Disease (CAD) caused by
plaque buildup in the walls of the arteries that
supply blood to theheart (called coronary
arteries) and other parts of the body
Plaque is made up of deposits of cholesterol
and other substances in the artery. Plaque
buildup causes the inside of the arteries to
narrow over time, which can partially or totally
block the blood flow. This process called
atherosclerosis.
Major Branches of the Aorta
+ Aortic Arch
Brachiocephalic Trunk
Common Carotid Artery
Internal Carotid Artery – supplies the brain
+ External Carotid Artery – skin and muscles
of head and neck
Subclavian Artery
+ Vertebral artery – supplies the cerebellum,
brainstem, spinal cord
– + Axillary Artery
– + Brachial Artery – arm
– + Radial Artery – FA
– + Ulnar Artery – FA
CIRCLE OF WILLIS an anatomical structure
that provides connection between arteries of
the brain
+ Thoracic Aorta arteries for trunk muscles,
lungs, esophagus and diaphragm
+ Abdominal Aorta arteries for internal organs
(stomach, liver, intestines, kidneys, gonads)
and abdomen and lower trunk muscles.
Arteries for bladder and rectum and for the
entire leg.
ARTERIES OF THE BODY
MAJOR VEINS OF THE SYSTEMIC
CIRCULATION
Compared to arteries located in deep areas,
veins are more superficial and some are easily
seen or palpated.
+ Superior Vena Cava – upper body (head &
arms)
+ Inferior Vena Cava – lower body
Veins draining the SVC
Cephalic vein - superficial drainage of the
lateral aspect of the arm and empties into the
axillary vein
Basilic vein – superficial drainage of the
medial aspect of the arm and empties into the
brachial vein
Median Cubital vein – cephalic and basilic join
at the elbow (often chosen as the site for
withdrawing blood for the purpose of blood
testing)
External Jugular vein – receives venous
blood from the skin and muscles of the head
Brachiocephalic veins – large veins that
receive venous drainage from the subclavian,
vertebral, and internal jugular veins to form the
SVC
Great Saphenous veins – longest veins in
the body; superficial drainage of the leg
Common Iliac Vein – formed by the union of
external and internal iliac vein to form the IVC
Varicose Veins
Enlarged, swollen, twisted veins often caused
by damaged or faulty valves that allow blood to
travel in the wrong direction
Common factors: pooling of blood in the feet
and legs and inefficient venous return resulting
from inactivity or pressure on the vein
+ Common in people who stand for long
periods of time (for example, cashiers and
hairdressers) and in obese (or pregnant)
individuals
CAPILLARIES
– Smallest and most numerous of the
blood vessels
– Connects arteries and veins to
exchange materials between blood and
tissue cells
Physiology of Circulation
ARTERIAL PULSE BLOOD PRESSURE
Arterial Pulse
– The alternating expansion and recoil of
an artery that occurs with each beat of
the left ventricle creates a pressure
wave– a pulse– that travels through the
entire arterial system
– (N) Pulse Rate: 60-100bpm
– It can be influenced by activity, postural
changes, and emotions
Arterial Pulse
+ You can feel a pulse in any artery lying close
to the body surface by compressing the artery
against firm tissue; this provides an easy way
of counting heart rate.
+ Radial pulse – radial surfaces at the wrist is
routinely used to take a pulse measurement
Pressure Points – specific areas compressed
to stop blood flow into distal tissues during
significant blood loss or hemorrhage
Blood Pressure - It is the pressure of blood
pushing against the walls of your arteries.
Arteries carry blood from your heart to other
parts of your body.
+ Blood pressure is measured using two
numbers:
Systolic blood pressure – measures the
pressure in your arteries when your heart beats
Diastolic blood pressure – measures the
pressure in your arteries when your heart rests
between beats.
Blood Pressure Ranges
+ Normal: less than 120 systolic and 80
diastolic
+ Elevated: 120–129 systolic and less than 80
diastolic
+ Stage 1 hypertension: 130-139 systolic or
80-89 diastolic
+ Stage 2 hypertension: at least 140 systolic
or at least 90 diastolic
+Hypertensive crisis: higher than 180 systolic
and/or higher than 120 diastolic
+Hypotension: can be 90 or less systolic, or 60
or less diastolic, but these numbers can vary
because symptoms help determine when blood
pressure is too low
RESPIRATORY SYSTEM
+ It provides oxygen to the body, disposes
carbon dioxide and helps regulate blood pH
+ Gas exchange occurs in the air sacs of the
lungs, called alveoli, and at capillary beds
around the body
+ Without oxygen, cells will eventually die. Too
much carbon dioxide in the blood will cause the
blood pH to become acidic, which will interfere
with cellular function.
UPPER RESPIRATORY TRACT – from the
nose to the larynx
LOWER RESPIRATORY TRACT – from the
trachea to the alveoli (lungs)
UPPER RESPIRATORY
TRACT: NOSE- The only externally visible part
of the respiratory system
Parts:
• Nostrils or nares
• Nasal cavity
– Olfactory receptors
– Conchae
– Meatuses
• Hard palate
• Soft palate
CLEFT LIP AND PALATE - Failure of the
palatine bones to fuse medially; results in
breathing difficulty and problems with oral
cavity functions, such as eating and speaking.
NASAL MUCOSA
+ Mucosa lining made up of ciliated cells that
line the nasal cavity
+ Produces sticky mucus to moisten the air and
trap incoming bacteria and other foreign debris
PARANASAL SINUSES - Sinuses act as
resonance chambers for speech and produce
mucus draining into the nasal cavities
+ Four (4) paranasal sinuses: frontal,
ethmoid, maxillary and sphenoid
+ Nasal septum – a wall of tissue separating
the two halves nasal cavities
RHINITIS – inflammation of the nasal mucosa
due to cold viruses or allergens; excessive
mucus production = nasal congestion and
postnasal drip
SINUSITIS – inflammation of a sinus; same
symptoms as rhinitis but with pain and
headache; more difficult to treat
PHARYNX- Muscular passageway commonly
called the throat
-Serves as a common passageway for food
and air and is continuous with the nasal cavity
anteriorly
+ Three (3) regions:
– Nasopharynx
– Oropharynx
– Laryngopharynx
Pharyngotympanic or Eustachian tubes –
canals connecting the pharynx to the middle
ear
Tonsils – clusters of lymphatic tissue that play
a role in protecting the body from infection;
becomes inflamed and swollen which obstructs
the nasopharynx (tonsilitis).
LARYNX - Also known as the “voicebox”;
routes air and food into the proper channels
and plays a role in speech.
Formed by eight (8) rigid hyaline cartilages
and a spoon-shaped flap or elastic cartilage
called the epiglottis
Thyroid Cartilage – largest of the 8 hyaline
cartilages which protrudes anteriorly (Adam’s
apple)
VOCAL FOLDS or true vocal cords – pair of
folds inside the larynx that vibrate with expelled
air which allows the ability to speak
The vocal folds and the passageway between
them are called the glottis
LOWER RESPIRATORY TRACT:
TRACHEA - A windpipe made of C-shaped
rings of hyaline cartilage extending from the
larynx to the level of the 5th thoracic vertebra
(mid chest)
It is lined with ciliated mucosa and is
surrounded by goblet cells
Smoking destroys cilia and without them =
coughing is the only means of preventing
mucus from accumulating in the lungs
COUGH REFLEX- Triggered to prevent a
substance from continuing into the lungs
+ This protective reflex DOES NOT WORK
when we are unconscious
EMERGENCY PROTOCOL: TRACHEA
+ HEIMLICH MANEUVER – a procedure in
which air in a person’s own lungs is used to
“pop out” or expel an obstructing piece of food
with back blows and abdominal thrusts
+ TRACHEOSTOMY – emergency surgical
opening of the trachea to provide an alternative
route for air to reach the lungs
THE MAIN BRONCHI - The right and left main
(primary) bronchi are formed by the division of
the trachea and each bronchi branches into the
lungs.
– Primary bronchi
– Secondary (lobar) bronchi
– Tertiary (Segmental) bronchi
– Bronchioles
– Terminal Bronchioles
LUNGS
A large organ occupying the entire thoracic
cavity except the most central area
(mediastinum)
• Apex: deep in the clavicle
• Base: above the diaphragm
+ Each lung is divided into lobes by fissures;
left lung has two (2) lobes and the right has
three (3)
Lung tissue is mainly elastic connective tissue
that allows it to stretch and recoil as we
breathe
+ They only weigh only about 2 1⁄2 lbs and are
soft and spongey
COVERINGS OF THE LUNGS
+ Pulmonary/Visceral
Pleura/Pleural sac – serous membrane
covering the surface of each lung
Parietal Pleura – lining of the walls of the
thoracic cavity
Pleural space/cavity – potential space
between the pleural sac and the lung
• Pleural fluid – slippery serous fluid which
allows the lungs to glide easily over the thorax
wall during breathing
Pleurisy
Inflammation of the pleurae that can be
caused by:
(1) insufficient secretion of pleural fluid =
surfaces become dry and rough, resulting to
friction and stabbing pain with each breath (can
mimic angina);
(2) excessive amounts of pleural fluid = which
exerts pressure on the lungs.
BRONCHIAL TREE
- A network formed by the branching and re-
branching of the respiratory passageways
within the lungs
RESPIRATORY ZONE STRUCTURES AND
MEMBRANES
CONDUCTING ZONE- passageways toward
the respiratory zone (trachea, bronchi, terminal
bronchioles)
+ RESPIRATORY ZONE
• Respiratory bronchioles
• Alveolar ducts
• Alveiolar sacs
• Alveoli – ”air sacs”
An air sac or air space; one of millions of
hollow distensible cup-shaped cavities in the
lungs where oxygen (O2) is exchanged for
carbon dioxide (CO2)
ALVEOLI
Alveolar pores – holes on the walls of the
alveoli connecting air sacs and provide
alternate routes for air to reach the alveoli
Macrophages – “dust cells”; final line of
defense for the respiratory system
Surfactant – a complex mixture of specific
lipids, proteins and carbohydrates, produced by
the epithelial cells of the alveoli to reduce
surface tension
RESPIRATORY MEMBRANE (Air-Blood
Barrier) -A membrane formed by the alveolar
and capillary walls where gas (air) flows past
on one side and blood on the other.
RESPIRATION
Process of supplying oxygen (O2) to the body
by the respiratory system
+ Four (4) distinct events:
1. Pulmonary Ventilation – “Breathing”; Air
moves into and out of the lungs so that the
gases in the alveoli are continuously refreshed
2. External respiration – Gas exchange
between the pulmonary blood and alveoli
3. Respiratory Gas Transport – Oxygen and
carbon dioxide are transported to and from the
lungs via bloodstream
4. Internal Respiration – Gas exchange
between the blood and tissue cells via the
capillaries
Cellular Respiration – use of oxygen to
produce ATP and carbon dioxide
MECHANICS OF BREATHING
+ Breathing or pulmonary ventilation is a
mechanical process that depends on volume
changes occurring in the thoracic cavity
+ PRINCIPLE: Changes in volume lead to
changes in pressure, which causes the flow of
gases to equalize the pressure.
TWO (2) PHASES OF BREATHING:
Inspiration – when air is flowing into the lungs
Expiration – when air is leaving the lungs
RESPIRATORY TERMS
Intrapulmonary volume – volume of air within
the lungs
Intrapulmonary pressure (IPU) – pressure of
the air inside the body
Atmospheric pressure (AP) – pressure of the
air outside the body
Intrapleural pressure (IPL) – pressure within
the pleural cavity; normally, always negative;
major factor for preventing lung collapse.
Expiration (Exhalation)
A passive process that depends more on the
natural elasticity of the lungs than on muscle
contraction
Forced Expiration – active process of
expiration due to narrowed respiratory
passageways (asthma, chronic bronchitis,
pneumonia
+ Rib cage descends, the diaphragm relaxes
superiorly, and the lungs recoil
+Intrapulmonary volume decreases as
intrapulmonary pressure rises (IPU↑) and
causes the gases to passively flow out to
equalize the pressure with the outside.
ATELECTASIS – lung collapse when air enters
the pleural space via chest wound
+ PNEUMOTHORAX – lung collapse when air
escapes the lung
EXTERNAL RESPIRATION
+ Actual exchange of gases between the
alveoli and blood via simple diffusion
INTERNAL RESPIRATION
+ Exchange of gases between the blood and
the tissue cells
+ Oxygen (O2) leaves and carbon dioxide
(CO2) enters the blood
+ Hypoxia – inadequate oxygen delivery to
body tissues. Skin becomes bluish or cyanotic.
CONTROL OF RESPIRATION
+ Respiratory muscles (diaphragm &
intercostals): phrenic nerves & intercostal
nerves
• MEDULLA OBLONGATA (MO)- Controls the
rhythm of breathing; stimulates the respiratory
muscles
Emotional factors – initiated by emotional
stimulus via hypothalamus
Chemical factors – oxygen and carbon
dioxide levels
Bronchial – breathing sounds produced by air
rushing through the large respiratory
passageways (trachea and bronchi)
Vesicular – breathing sounds produced as air
fills the alveoli; soft murmurs like a muffled
breeze
Crackles – bubbling sounds due to presence
of fluid in the lungs
Wheezes – whistling sound when air moves
through a narrowed passageway (asthma)
Rales – abnormal bronchial sounds produced
by the presence of mucus or exudate in the
lung passageways or by thickening of the
bronchial walls.
CHRONIC OBSTRUCTIVE
PULMONARY DISEASE (COPD)

• Normal Quiet Breathing Rate: 12–15

respirations/minute (Eupnea)
+ A group of chronic inflammatory lung
PONS diseases that causes obstructed airflow from
the lungs
• Communicates with MO to modify timing
between inhalation and exhalation during – History of smoking
activities such as singing, sleeping or – Dyspnea of difficulty of breathing
exercising. – Coughing and frequent pulmonary
infections
CONTROL OF RESPIRATION: AUTONOMIC – Hypoxic and may develop respiratory
NERVOUS SYSTEM failure
– + Sympathetic: bronchodilation
– + Parasympathetic: broncho constriction
– + Coughing reflex
ASTHMA
+ Smooth muscles of the bronchi tighten in
reaction to certain stimulants. Airways become
narrower, which blocks the flow of air and
makes it harder to breathe.
Bronchodilators (Albuterol, Theophylline,
Ipratropium
FACTORS AFFECTING RESPIRATORY
RATE AND DEPTH
Physical Factors – talking, coughing and
exercising LUNG CANCER

Volition (Conscious control) – singing, The leading cause of cancer death for both
swimming and swallowing men and women, causing more deaths than
breast, prostate and colorectal cancer
combined
+ It is largely preventable – nearly 90% of
lung cancers result from smoking
+ It is an aggressive type of cancer and
metastasizes rapidly and widely
+ Cure rate is notoriously low; most victims die
within 1 year of diagnosis