Cells and Tissues

The Cell
 undergo cell division:
o mitosis
 a type of cell division that involves a single round of division where
DNA are duplicated and segregated to form two identical daughter
cells
 these daughter cells are identical to the parent cell that gave rise to
them
 main purpose include growth, repair, and replace dead/worn-out cells
 process:
 prophase
 chromosomes form a tight coil as a result of DNA
replication
 two copies of each chromosome are called chromatids,
and they are connected at the centromere
 spindle fibres extend between the centriole pairs
 prophase ends with the disappearance of the nuclear
envelope
 metaphase
 the chromosomes composed of chromatid pairs now
move to the metaphase plate (a narrow central zone)
 anaphase
 the chromatid pairs separate
 daughter chromosomes move towards opposite ends of
the cell
 anaphase ends when the daughter chromosomes arrive
near the centrioles at the opposite sides of the cell
 telophase
 the nuclear membranes form and the nuclei enlarge as
the chromosomes gradually uncoil
 cytokinesis is the process in which two daughter cells
physically separate
o meiosis
 a type of cell division that occurs in germ cells (which produces the
gametes)
 involves two rounds of division that result in four unique daughter
cells with only one copy of each chromosome
 produce gametes (sex cells) that are genetically unique from the parent
cell that gave rise to them, resulting to genetic variation
 process:

1. meiosis I
 prophase I
 chromosomes shorten and thicken
 the nuclear envelope and the nuclei disappear
  mitotic spindle forms
 two sister chromatids of each pair of
homologous chromosomes (one pair of
chromosomes with the same gene sequence) pair
off; this process is called synapsis
 this results to four chromatids forming a
structure called tetrad
 crossing-over occurs in which genetically
different chromatids exchange parts, resulting to
genetic recombination (formation of new
combinations of genes)
 metaphase I
 tetrad line up along the metaphase plate of the
cell, with the homologous chromosomes side by
side
 anaphase I
 the members of each homologous pair of
chromosomes separate as they get pulled
towards the opposite side of the cell; the paired
chromosomes, held together by a centromere,
remain together
 telophase I & cytokinesis
2. meiosis II
 composed of prophase II, metaphase II, anaphase II, and
telophase II & cytokinesis which are similar to mitosis
 produces four haploid (one set of chromosomes)
gametes that are genetically unique from the original
diploid (two sets of chromosomes) parent cell

The cell
 What is a cell?
o A cell is the basic functional unit of an organism. It is enclosed by
phospholipid bilayer called the cell membrane. A cell contains organelles such
as the nucleus, mitochondria, smooth and rough endoplasmic reticulum etc.
Humans are composed of trillions of different types of cells. Depending on
their classification, they have a specific function. For example: epithelial cells
in the villi have microvilli that increases surface area for more absorption.
 Cells —> tissues —> organs —> system —> organism
 Parts and their function
o nucleus
 controls the cell’s activity
 contains the cell’s genetic information
o mitochondria
 produces ATP or energy through a process called oxidative
phosphorylation
o cell membrane
 controls what goes in and out of the cell
o ribosomes
  synthesise proteins
o rough endoplasmic reticulum
 embedded with ribosomes
 a transport system for molecules that needs modifications
o smooth endoplasmic reticulum
 produces lipids and steroids
o Golgi body
 an enclosed membrane that involves in processing and transportation
of proteins from the ER to other regions of the cell
 produces lysosomes
o microtubule
 Involved in cell division
 Maintain the shape of the cell
o centrioles
 Located in the cytoplasm
 Helps in organising microtubules as well determining the positions of
different organelles within the cell
o lysosome
 Vesicles that are membrane-enclosed formed from the Golgi body
 Contains powerful enzymes that involves in the digestion of various
molecules
 maintains the cell by recycling old structures
o cytoplasm
 Intracellular fluid within the cytoplasm that encircle the organelles

The cell membrane (detailed)

 ion-channel-linked receptors
o Allow continuous and direct conversion of neurotransmitters to electric
current
o the relay of impulses between nerve and muscle cells
o Allows the entrance and exit of ions such as calcium, sodium, potassium etc.
 enzyme-linked receptors
o Receptors for specific hormones that onsets a chemical change
 Contains various receptors that allows communication with other cells
 Mostly made up of phospholipid bilayer that allows certain substances to easily
diffuse, making it semi-permeable
 Contains cholesterol that maintain cell membrane fluidity
 Contains channel proteins that allow certain molecules to get in and out of the cell

Membrane transport
 passive transport
o doesn’t require energy
o Examples:
 Simple diffusion (through the phospholipid bilayer)
 Higher to lower concentration
 Facilitated diffusion (through a membrane channels)
 Carrier-mediated facilitated diffusion
  Larger molecules need carriers to facilitate diffusion
 Provides passage of large molecules such as glucose
 a molecule initially binds to a carrier protein and then
goes through a conformational change which then
deposits the molecule to the other side of the membrane
 Channel-mediated facilitated diffusion
 Highly charged molecules require ion channels to
facilitate diffusion
 Each channel permits a specific passage of ion
 May be gated, only allowing diffusion to occur if open
o filtration
 The process of separating solids from liquids and gasses
 The cell membrane only allows certain substances that fits its pores
 Example: glomerulus filtration
o Osmosis
 water molecules pass through a selectively permeable membrane
 Rate of osmosis increases as the temperature increases; the greater the
concentration gradient, the quicker the rate is
 active transport
o Lower to high concentration
o Requires energy
o Carrier protein needed
o Primary active transport
 To transport a substance, the source of energy is directly used
o Secondary active transport
 Mechanisms harness the energy derived from the primary active
transport of one substance for the co-transport of a second substance
 Key terms:
o Uniport
 A specific molecule passing through a membrane
o Symport
 Two molecules moving in the same direction and passing through a
protein channel
o Antiport
 Two molecules moving in the opposite direction and passing through a
protein channel

Cytosol vs cytoplasm
 Cytosol
o The fluid within the cytoplasm that envelopes the intracellular organelles
 Cytoplasm
o Includes all organelles, except the nucleus

Mitochondria
 matrix
o a fluid-filled chamber
o the site where the Krebs cycle happens
 o enclosed by the inner mitochondrial membrane
 ATP synthase
o enzymes embedded on the cristae junctions that produces ATP the most
through oxidative phosphorylation
 DNA
o inherited from female parent
o a mitochondrion contains 37 genes
o control the production of various RNAs and proteins that are needed to build
mitochondrial components
 cristae junctions
o a chain of folds within the inner mitochondrial membrane that increases
surface area for ATP synthase therefore increasing ATP production
 ribosome
o produces mitochondrial proteins
 outer membrane
o contains porins that allow simple diffusion of tiny molecules

The nucleus
 nuclear envelope
o Encloses the nucleus, giving its shape and structure
 Nuclear pores
o Allow passages of certain small substances to pass through in and out of the
nucleus
 Nucleolus
o Involves in the production of ribosomes subunits
 Chromatin
o Packaged DNA

Key terms:
 proteome
o all of an organism’s proteins
 chromosome
o A long and tightly coiled DNA molecule that contains an organism’s genetic
information
 Genome
o all of an organism’s genes
 Genes
o A particular sequence along the chromosome that instructs a specific protein
o Basic unit of heredity
 Phenotype
o An organism’s observable physical traits
 Genotype
o The whole genetic constitution of an organism
o Evens that represent a particular trait
 Allele
o A gene variant
 o Can be dominant or recessive
 Nucleotide
o Molecules that consist of a Penrose sugar, nitrogenous base and a phosphate
o The monomeric units used to form nucleic acid polymers
 nucleosome
o Structural packaged unit of DNA
 Histones
o By binding to DNA, it helps in packaging DNA
 Homozygous
o Identical
 Heterozygous
o Different
 Mitochondrial genes
o Are passed by mothers to their offspring
 Gland
o A group of cells that produce substances that are then release into the blood
stream
 Tissue
o A collection of cells with embryonic origin that works together to perform a
particular task
 Muscle
o contains contractile proteins: actin and myosin, allowing contraction therefore
giving skeletal muscles the ability to move
 Organ
o Composed of various muscles that liaise together to perform an important and
specific task
 Organ system
o A group of organs that work together to perform a larger and more complex
task
 Connective tissue
o Binds and connects various tissues in the body
 Characteristics of cellular function: (MRS GREN)
o Movement
o Reproduction
o Sensitive to changes
o Growth
o Respiration
o Excretion
o Nutrition
 gene expression
o the transcription and translation of genetic information
 transcription
o the process in which genes are copied to produce RNA (template or
instruction)
 translation
o the process in which the information in RNA is encoded (translated) to form a
specific protein
 base triplet
o a sequence of three nucleotides
  codon
o a sequence of three nucleotides in the mRNA that corresponds to a specific
amino acid
 messenger RNA (mRNA)
o a template that instructs the production of a specific protein
 ribosomal RNA (rRNA)
o involves in the production of ribosomes along with the ribosomal proteins
 transfer RNA (tRNA)
o attaches to an amino acid and holds it in place
 anticodon
o a sequence of three nucleotides in the tRNA that binds to the complimentary
mRNA sequence
 RNA polymerase
o an enzyme that increases the rate of DNA transcription
 promoter
o specifies the start of a gene
 terminator
o specifies the end of a gene
 nervous tissue
o Carries messages to and from regions in the body

Epithelial tissue
 Epithelial tissue
o Creates a sheet that serves to line internal surfaces, cover the body’s outer
surface etc.
o Classification according to the number of layers:
 Simple
 The linings of the pericardial
 Stratified
 Pharynx
 Pseudo-stratified
 Epididymis
o Classification according to shape:
 Squamous
 outer layer of the skin
 Cuboidal
 Lining of the collecting ducts of the kidneys
 Columnar
 Lining of the stomach

Two phases of metabolism

 catabolism
o Complex molecules broken down to simpler ones
o Stored nutrients are broken down to make energy
 Anabolism
o The constructive process of simple molecules to create a more complex
molecule
Different types of body systems and their function
 circulatory/cardiovascular system
o Pumps and circulates blood throughout the body
o Delivers oxygen and nutrients to cells
 Endocrine system
o Involves in homeostasis
o influence an organ’s function using hormones
 Integumentary system
o Consists of the skin, hair, nails, sweat glands, and oil glands
o Involves in the body’s first line of defence
 Immune/lymphatic system
o Adaptive immunisation
o Defends the body against pathogens
 Musculoskeletal system
o Allows movement via the use of the skeletal system and muscles in the body
o Skeletal system
 Haematopoiesis
 Gives the body structure
 Protects organs such as brain etc.
o muscular system
 Contracts to allow movement
 Nervous system
o Relays messages between the brain and the rest of the body
 Urinary/renal system
o filters blood
o Excretes body waste (urine)
 Reproductive system
o Production of offspring and ensures survival of species
 Digestive system
o Breaks down food to essential nutrients
o Absorbs water, nutrients and glucose into the blood stream
o Excretes undigested food as faeces out of the body

Cellular respiration
 O2 (oxygen) + C6H12O6 (glucose) = ATP (energy) + H2O (water) + CO2 (carbon
dioxide) + heat
 produces about 32 ATP
 NADH gives 2.5 ATP
 FADH2 gives 1.5 ATP

1. glycolysis
o takes place in the cytoplasm
o breaks down 6-carbon glucose into two 3-carbon molecules (pyruvate)
o produces 2 ATP
 o produces 2 NADH
2. Krebs cycle
o takes place in the mitochondrial matrix
o converts the pyruvate into a 2-carbon molecule (acetyl coenzyme or acetyl
CoA)
o acetyl coA reacts with oxaloacetate to create citric acid
o produces 3 NADH and 1 FADH2
3. oxidative phosphorylation
o takes place in the inner mitochondrial membrane
o made up of 4 large proteins
o NADH and FADH2 donates their electrons to the electron transport chain
o ATP synthase converts ADP to ATP by harnessing and balancing the gradient
that has a chemical potential energy
o oxygen is the final proton (H+) acceptor

Six major nutrients

 carbohydrates
o source of energy (gets converted into glucose which is essential for cellular
respiration)
 proteins
o source of energy (gets broken down into ketone molecules which is then used
to produce energy)
o enzymes, membrane channels, amino acids etc.
 fats
o source of energy and essential fatty acids such as triglycerides
 vitamins
o helps the body function properly
o some vitamins are directly involve in some of the body’s essential processes
 mineral
o calcium, sodium etc.
o promotes healthy bones, teeth etc.
 water

Endocrine System
Endocrine System:
 hormones are transported to tissues by the bloodstream
 binds to receptors on or in target cells
 onset of action takes seconds to hours or days
 target cells throughout the body
 generally longer in terms of the duration of action
 consists of glands that form and release hormones

Endocrine Glands:
 hypothalamus
o release hormones that stimulate or suppress hormones being released in the
pituitary gland
o thermostat (i.e., body temperature control)
o secretes releasing hormones (RH) and release inhibitory hormones (RIH)
 pituitary
o separate portions:
 anterior pituitary
 composed of epithelial tissue
 the release of hormones are stimulated by releasing hormones
(RH)
 the suppress of hormones are stimulated by inhibiting
hormones (IH)
 example hormones:
 human growth hormone (hGH)
 promotes body growth
 thyroid-stimulating hormone (TSH)
 controls the activities (including secretions) of
the thyroid gland
 follicle-stimulating hormone (FSH)
 stimulates the production of sperm in male
 stimulates the secretion of oestrogen in females
 luteinising hormone (LH)
 stimulates the testes to produce testosterone in
males
 triggers ovulation and stimulates the release of a
mature egg in females
 prolactin (PRL)
 stimulates the mammary glands to produce milk
 plays a role in sperm transport and ejaculation
process in males
 adrenocorticotropic hormone (ACTH)
 stimulates the adrenal cortex to release
glucocorticoids
 posterior pituitary
 composed of neural tissue
 example hormones:
 oxytocin
 stimulates the contraction of the uterine muscles
during childbirth
 stimulates lactation
 antidiuretic hormone (ADH)
 reduces the production of urine
 increases water reabsorption in distal renal
tubules
 pineal
o melatonin
 controls sleep and wake cycle
 influenced by the circadian rhythm
 thyroid
 o hormones released:
 calcitonin
 reduces calcium levels in the body by speeding up the uptake of
calcium and phosphate into the bone matrix, as well as
inhibiting bone resorption by the osteoclasts
 stimulates the kidneys to decrease calcium reabsorption from
the blood
 thyroid hormones (thyroxine or T4 and triiodothyronine or T3)
 increase basal metabolic rate (BMR)
 stimulate the production of additional sodium-potassium pumps
 stimulate the production of protein
 increase the use of glucose and fatty acids to produce ATP
 increase lipolysis and enhance cholesterol excretion (thus
reducing blood cholesterol levels)
 involves in body growth, specially the nervous and skeletal
systems
 parathyroid
o hormones released:
 parathyroid hormones (PTH) or parathormone
 stimulate bone resorption by increasing the number and action
of osteoclasts, resulting to calcium ions being released into the
blood
 decrease phosphate levels but increases blood calcium and
magnesium levels by the kidneys at which are lost from the
blood into the urine
 also stimulate the kidneys to produce calcitriol which increases
the rate of calcium, phosphate, and magnesium ions being
absorb into the blood
 thymus
o produces hormones that stimulates the production and maturation of T-cells:
 thymosin
 thymic humoral factor (THF)
 thymic factor (TF)
 thymopoietin
 adrenal
o two regions:
 adrenal cortex
 mineralocorticoids (aldosterone)
 regulates sodium and potassium ions in the blood
through homeostasis by retaining sodium and excreting
potassium
 promotes elimination of hydrogen ions in the blood,
thus preventing acidosis (blood pH below 7.35)
 helps adjust blood pressure and blood volume by
increasing salt and water reabsorption from the kidney
 glucocorticoids (cortisol)
 increase the rate of protein breakdown, particularly in
muscle fibres, resulting in amino acids being liberated
into the bloodstream which are then used to create new
proteins or ATP
  stimulate the liver to convert certain amino or lactic
acids into glucose which can then be used for ATP
production
 stimulates lipolysis which is the breakdown of
triglycerides and fatty acids from adipose tissue into the
blood
 causes anti-inflammatory effects by inhibiting white
blood cells to partake in an inflammatory response, as
well as slowing immune response
 adrenal medulla
 hormones that are released which are responsible for the fight-
or-flight response:
 adrenaline (epinephrine)
 during stressful times
 increases strength and heart rate, resulting in
increased blood pressure
 rise in blood glucose levels and increased
metabolic rate
 blood moved away from skin and viscera to the
coronary arteries, liver, brain etc.
 bronchi dilate to increase rate of oxygen being
inhaled in the lungs
 pupils dilate
 results in gooseflesh which is an involuntary
reaction that makes hair follicles stand on end
 reduces the rate in which blood coagulates
 increase the secretion of ACTH
 noradrenaline (norepinephrine)
 continuously being released but on lower dosage
 kidney
o renin
 raises blood pressure by constricting blood vessels (vasoconstriction)
o erythropoietin (EPO)
 increases the rate of red blood cells (erythrocytes) formation
 pancreas (pancreatic islets)
o four types of hormone secreting cells:
 alpha cells
 secretes glucagon
 increases the rate of breaking down glycogen into
glucose (glycogenolysis)
 stimulate the conversion of lactic acids and certain
amino acids into glucose (gluconeogenesis)
 main function: increases blood glucose levels
 beta cells
 secretes insulin
 increases facilitated diffusion of glucose into cells
 stimulate the conversion of glucose into glycogen
(glycogenesis)
 stimulate fatty acid formation (lipogenesis)
 inhibits glycogenolysis and gluconeogenesis
  main function: decreases blood glucose levels
 delta cells
 secretes somatostatin
 inhibits the secretion of insulin and glucagon
 slows down the absorption of nutrients from the
gastrointestinal tract
 f cells
 secrete pancreatic polypeptide
 stop somatostatin and pancreatic juice secretion, as well
as gallbladder contraction
 gonads
o testes
 testosterone
 increase libido (male sexual drive)
 growth and distribution of body hair
 enlargement of the larynx results to lower and deeper voice
 increased musculoskeletal growth
 growth and development of male reproductive organ
 inhibin
 inhibits secretion of FSH
o ovaries
 oestrogen
 onsets puberty in females which gives them ‘female
characteristics’
 along with other female sex hormones, play a significant role in
menstrual cycle, pregnancy etc.
 promotes bone health and strength
 growth and development of the reproductive organs, as well as
the mammary cells
 distribution of fat deposit on hips, legs, and breasts
 progesterone
 mainly involves in preparing the body for pregnancy by
thickening the endometrium (lining of the uterus) to allow
implantation
 relaxin (RLX)
 released during pregnancy in which increases the flexibility of
pubic symphysis
 helps in dilating uterine cervix during labor and delivery
 inhibin
 inhibits FSH secretion
o placenta
 produces oestrogen, progesterone, and gonadotrophine
 produces HCG (which indicates positive pregnancy in pregnancy tests)

Transport of hormones:
 freely in the blood stream
 specific transport globulins (from liver)
Hormone action:
 signal molecule (ligands) binds to receptor proteins which activates intracellular
signal molecules to alter target proteins, thus creating a response

Inactivation of hormones:
 target tissue uptake
 metabolic degradation (liver and kidney)
 excretion in urine

Factors affecting hormone production

 rhythms
o circadian (body clock)
o monthly
o seasonal (day length; atavistic)
o development (puberty, menopause)
 pulsations/oscillations
o gonadotropins

Key Terms:
 basal metabolic rate (BMR)
o the rate of oxygen consumption under standard or basal condition by
stimulating the use of cellular oxygen to produce ATP
 gonads
o organs that produce gametes
 androgen
o male sex hormone
 glands
o endocrine glands
 secretes hormones directly into the bloodstream
o exocrine glands:
 secrete products into body cavities, to outer surface of the body, or into
a lumen of an organ
 example glands:
 sudoriferous
 secretes sweat
 sebaceous
 secretes sebum
 pancreas
 produces and secretes pancreatic juice into the
duodenum (of the stomach)
 hormones
o chemical messengers that are secreted by glands into the blood and is
transported to a target organ resulting to a physiological response
 catecholamines
 o hormones that also acts as neurotransmitters
 humoral signalisation:
o endocrine
 from gland via blood to a distance
o neurocrine (nerves)
 via axonal transport and then by blood
o paracrine
 neighbouring cells of different types
o autocrine
 the secreting cell itself or the neighbouring cells of the same type
 globulins
o plasma protein that transport substances within the blood
 phenylketonuria (PKU)
o disables the breakdown of amino acid (phenylalanine) which then builds up in
the blood and brain, leading to brain damage

Control of hormone secretion

 hormones are regulated by the nervous system in which it send out signals resulting to
other hormones and chemical changes in the blood

Other hormone production: less traditional sources

 Endothelium
o endothelins
o prostanoids
 immune system
o cytokines
 platelets, mesenchyme
o growth factors
 adipocytes
o leptin
 causes loss of apetite
 cardiocytes (heart)
o atrial natriuretic peptide (ANP)
 decreases blood pressure
 gastrointestinal tract
o gastrin
 promotes the release of gastric juice
 increases segmentation and peristalsis in the stomach
o cholecystokinin
 stimulates the release of pancreatic juice and bile
 regulates the secretion of bile from the gallbladder
 after eating, it causes the feeling of being full
o secretin
 promotes release of pancreatic juice and bile
o glucose-dependent insulinotropic peptide (GIP)
 stimulates pancreatic beta-cell to secrete insulin
Reproductive System
Reproductive System
 a system composed of external and internal genitalia, complex hormonal response, as
well as sex organs that work together for the purpose of syngenesis
 functions include:
o production of gametes (oocytes/spermatozoa)
o maintain and transport of gametes
o fertilisation of gametes to form a diploid zygote
o promotes growth and development of the fetus by providing a suitable
environment
o produce and secrete hormones that are involve in gamete production,
menstrual cycle, pregnancy etc.
o assist with labour

Female reproductive system

 ovaries
o produce oocytes through the process called oogenesis
o produce and secretes hormones:
 progesterone
 eostrogen
 estrone
 estradiol
 estriol
o two distinct layers:
 outer cortex
 consists of developing ovarian follicles
 responsible for the formation of female sex hormones
 ovarian medulla
 composed of blood and lymphatic vessels, nerves, and loosely
arranged connective tissue which gives supportive framework
 fallopian tube
o consists of cilia, tiny hair-like structures, that aids the egg or ovum to the
uterus via wave-like motion
 uterus
o fundus
o lumen
o body
o wall
 endometrium (inner layer)
 composed of mucus membrane that thickens or shreds
depending on the levels of oestrogen and progesterone in the
blood
 myometrium (middle layer)
 consists of smooth muscle that performs coordinated retractions
and contractions during labour
  perimetrium (outer layer)
 composed of serous membrane that forms the vesicouterine
pouch (in the anterior) and the rectouterine pouch (in the
posterior)
 cervix
o protects the uterus from infetcion
o undergoes significant changes (called dilation) during labour
 vagina
o function:
 serves as a passageway to escape menstrual fluid
 receives penis and sperm during intercourse
 acts as a birth canal where foetus exits at birth
o structure
 from the vulva to the cervix, it extends upwards and backward
 lined with squamous epithelium
 walls are structured into rugae (transverse folds) that help in stretching
during childbirth
 protect against infection by maintaining an acidic environment (pH
4.5)
 Vuvla (external genetalia)
o function:
 provides protection for and entry to the uterus
 provides pleasure during sexual stimulation and reflex lubrication
o structure:
 labia majora
 covered by pubic hair and consists of oil and sweat glands, as
well as adipose tissue
 come together between the bagina and anus
 homologous to scrotum
 labia minora
 aren’t covered by pubic hair
 consist of smaller fleshy folds that enclose the clitoris
anteriorly and unite the fourchette posteriorly
 parts in sequential order:

1. ovary
2. fallopian tube
3. uterus

1. endometrium
2. myometrium
3. perimetrium

4. cervix
5. vagina
Menstrual cycle
 two simultaneous hormone cycles:
o ovarian cycle
 ovary matures and prepare an egg for ovulation
 lasts 28 days with ovulation around day 14
 steps:
1. Hypothalamus in the brain releases gonadotrophin releasing
hormone (GnRH) to stimulate the pituitary gland to secrete
FSH and LH
2. increase levels of FSH and LH in the blood results to the
follicular phase in which the ovary prepares an egg to mature,
as a result the follicle secretes oestrogen
3. increase levels of oestrogen inhibits the secretion of FSH and at
the same time, stimulates the pituitary gland to release more
LH resulting to ovulation in which only the most mature oocyte
is released (this is when LH and FSH is at peak)
4. luteal phase begins after ovulation in which the burst follicle
turns into a corpus luteum, at the same time FSH and LH levels
in the blood decreases
5. the egg cell then travels through the fallopian tube to the uterus
via wave-like movement done by the fallopian tube’s cillia
o uterine cycle
 the uterus prepares for implantation
 phases:
1. proliferative
 increase levels of oestrogen stimulates the proliferation
of the endometrium
2. secretory phase
 the corpus luteum release progesterone which stimulates
the thickening of the endometrium (corresponds to the
luteal phase of the ovarian cycle)
3. menstruation
 in an event in which the egg doesn’t get fertilised by a
sperm, both levels of progesterone and oestrogen starts
to drop
 the reduced levels of progesterone and oestrogen causes
the lining of the uterus to shed and regress, resulting to
“period”
 corresponds to the follicular phase of the ovarian cycle
Male reproductive system
 penis
o holds the urethra and serves as the passageway for the elimination of urine and
the ejaculation of semen into the vagina
o structure:
o vascular erectile organ
o 3 columns of erectile tissue
 corpora cavernosa
 2 lateral columns
 corpus spongiosum
 posterior column that contains the urethra
o glans penis
 expansion of the corpus spongiosum
o foreskin
 a moveable bi-fold of skin over the glans penis
 urethra
o divided into 3 sections:
 prostatic urethra
 is surrounded by the prostate
 exits bladder
 membranous urethra
 passes through the urogenital diaphragm
 spongy urethra
 passes through the penis
 prostate gland
o produces and releases a thin, slightly acidic, lubricating fluid that contains
substances such as citric acid that’s used by sperm for ATP production and
seminalplasmin (an antimicrobial protein) that helps in destroying bacteria.
 vas deferens
o carries sperm from the epididymis towards the urethra during a sexual arousal
via peristaltic contractions
 epididymis
o mostly composed of tightly coiled ductus epididymis that serves as the site
where sperms mature and get stored
 testes
o two oval-shaped glands that are located in the scrotum
o 2 basic compartments:
 cells of Leydig
 responsible for producing and secreting androgens, particularly
testosterone
 seminiferous tubules
 site where spermatogenesis occurs
 contains sertoli cells that provides nutrients for germ cells
o blood-testis barrier
  junctions forming an obstacle that isolates developing gametes from
the blood, preventing an immune response therefore preventing
infertility
 maintain optimal chemical environments
 scrotum
o composed of loose skin and subcutaneous tissue that hangs from the attached
portion of the penis, outside the abdominopelvic cavity
o provides optimal environment for the testes by maintaining a temperature of
34° (2-3° lower than normal body temp.) which is essential for
spermatogenesis
o contains a midline septum that separates the scrotum, providing a chamber for
each testis
o also composed of 2 muscles that controls the placement of the scrotum:
 dartos muscle
 consists of smooth muscle that wrinkled the scrotal sac to
intensify thickness for warmth
 cremaster muscle
 consists of skeletal muscle that raises the testes for warmth
 ejaculatory ducts
o transport sperm and vesicle fluid to the urethra
 seminal vesicles
o produce and release an alkaline, thick fluid that helps neutralise the hostile
acidic environment of male’s urethra and female reproductive tract, as well as
providing enough nutrients for ATP production by the sperm
 parts in sequential order:

1. penis
2. urethra
3. vans deferens
4. seminal vesicle
5. prostate
6. epididymis
7. testes
8. scrotum

Male hormones
 gonadotrophin releasing hormone (GnRH)
o produced in the hypothalamus and acts on the anterior pituitary gland to
secrete FSH and LH
 testosterone
o LH acts on the testes to produce testosterone
o mainly responsible for male secondary sex characteristics
 FSH and testosterone both stimulate seminiferous tubule to trigger spermatogenesis

Meiosis vs Mitosis
 mitosis o For growth and repair
o Somatic cells
 o Results to 2 identical o For sexual reproduction
daughter cells o Results to 4 genetically-
o Composed of one cell unique daughter cells
division o Composed of two cell
 Meiosis divisions: meiosis I and II
o Gametes
o

Oogenesis
Fertilisation and implantation
 Fertilisation occurs when the sperm and the egg meet and unite in the fallopian tube to
form
a

zygote. Tiny hair-like structures in the fallopian tube aids with the zygote’s movement
and as it travels down, it becomes a morula—a solid mass of blastomeres. Once it
reaches the uterus, it matures to a blastocyst which then embeds itself on to the
endometrium in a process called implantation.

Spermatogenesis

Key notes:
 syngenesis
o sexual reproduction
 oogenesis
o production of oocytes (egg cells)
 spermatogenesis
o formation of sperms
 eggs in young girls are in meiotic arrest
 ovulation
o release of an egg
 follicular phase
o before ovulation
o egg maturation
 luteal phase
o after ovulation
 menopause
o oestrogen production decreases resulting to osteoporosis
o flushes and night sweats
o disturbed sleep
o low mood
o vaginal dryness and discomfort/pain during sexual intercourse
o sensitive and delicate bladder
o can be managed by:
 hormone replacement therapy
 contraindicated:
 previous blood clots, breast, ovarian, or uterine cancer
 hypertension
 liver disease
 pregnancy
 side effects:
 breast tenderness
 headaches
 nausea
 indigestion
 abdominal pain
 vaginal bleeding
 diet and lifestyle changes can help. improve less severe symptoms
 combined contraceptive pill
o contains synthetic hormones oestrogen and progesterone
o usually administered orally once everyday for 21 days, with 7 -day break to
allow menstruation
o pill should be taken everyday at the same time
o how it works:
 inhibits the release of FSH and LH in the pituitary gland, therefore
preventing the ovaries from releasing an egg
 thickens the mucus in the cervix making it harder for the sperm to
swim through
 the absence of an (released) egg means no progesterone being secreted,
therefore thinning the walls of the endometrium resulting to a reduced
likelihood of implantation
o advantages:
 effective, irreversible, convenient
 user is in control
 provides regular predictable withdrawal bleeds
 reduces period and ovulation pain
 reduces severity of premenstrual symptoms
 reduces risk of ovarian, endometrial and bowel cancers
o disadvantages:
 no protection against STIs
 has to be constantly taken to be effective
  drug interactions may reduce efficacy
 unsuitable in breastfeeding and within 3-6 weeks post partum
 unsuitable with those with a BMI >35, history of hypertension,
previous blood clots, and those who smoke
o reduced efficacy:
 taking it sporadically (irregularly)
 vomiting
 diarrhoea
 some other medications (rifampicin and rifabutin) can make it less
effective
o side effects:
 minor mood swings
 nausea
 breast tenderness
 headaches
 blood clots (low risk)
 breast or cervical cancer (low risk)
o contraindications:
 smoking
 over 35 (due to increased risk of stroke, heart disease and clots)

10 Drugs
Drugs:

1. risperidone
1. Risperidone is a type of anti-psychotic drug and is used to regulate multiple
mental illness symptoms such as of schizophrenia and bipolar disorder caused
by excessive stimulation of the dopamine 2 receptors. It’s administered orally
(usually at bed time) or through long-acting injection. Risperidone is
metabolised by the CYP2D6 enzyme in the liver (through hydroxylation) into
9-hydroxyrisperidone which is an antagonist for dopamine. This means it
blocks the dopamine 2 receptors in the brain, therefore inhibiting dopamine
from activating. Reduced dopamine activity results to reduced occurrence of
psychosis. It is then eliminated out of the body via the urine. Contraindications
include history of neutropenia and severe heart disease in patients.
2. Side effects include:
 headache
 dizziness, drowsiness or feeling tired
 tremors, twitching or uncontrollable muscle movements
 agitation, anxiety, restlessness
 depressed mood
 dry mouth, upset stomach, diarrhoea, constipation
 weight gain
 cold symptoms such as stuffy nose, sneezing, sore throat
3. evaluation:
 symptoms assessment and monitoring — patients who take risperidone
tends to be sleepy over time as the drug has sedating effects
  monitor weight — if significant amount of weight is gained, it means
the drug is working as it can cause patients to feel frequently hungry,
therefore may cause weight gain
 ECG — high dosage causes adverse heart problems
2. chlorhexidine
1. Chlorhexidine is an antibacterial and antiseptic. It’s used to treat sore throat,
mouth infections such as mouth ulcers and gum disease, skin infections, as
well as preparing body prior surgery. It can be administered as a mouthwash,
cream or ointment. Its main function is to prevent infections caused by
bacteria, viruses, and fungi. It does this by targeting the microorganism’s cell
membrane via increased reactive oxygen species production, causing it to
disrupt therefore killing it and reducing bacterial growth.
2. side effects:
 irritated or itchy skin
 swelling or skin rash
 blister
 skin burn
3. evaluation:
 mouth swab — if mouth ulcer improved, the medication is working
 skin culture test — if results are normal or has improved, the
medication is working
3. lactulose
1. Lactulose is an osmotic laxative, a derivative lactose, that’s used for patients
suffering with faecal impaction, constipation, hepatic encephalopathy, or when
preparing the bowel before endoscopy or surgery. It is usually administered
through the oral or rectal route. In the colon, lactulose is metabolised to form
acetic, lactic, and formic acid, resulting to a hyperosmotic environment. The
increased osmotic pressure in the colon softens the stool (as there are more
water in the colon) and causes the colon to swell, which then stimulates colon
peristalsis thereby increasing bowel movement. At the same time, the
metabolism of lactulose results to an acidic environment. This is helpful for
patients with hepatic encephalopathy (a condition caused by liver failure and
increased ammonia levels in the body). This is because the increased hydrogen
levels in the colon (as result of the acidic environment) allows conversion of
excess ammonia into ammonium which can’t be absorbed and therefore
excreted in the body, along with the excess lactulose, via the stool. Its use is
contraindicated in patients with intestinal obstruction.
2. side effects include:
 diarrhoea
 bloating
 passing wind (fart) and gas (burp)
 nausea
 Vomiting
 stomach pain
3. evaluation:
 increased frequency of passing stool — if bowel movement has
improved, the drug is working
 monitor stool Bristol stool chart, softer stool means lactulose is
effective
  monitor serum electrolytes for long-term use through an electrolyte test
to ensure electrolyte balance — if normal, the drug is working
 ammonia test — decreased levels of ammonia in the blood means that
the drug is working
4. surfactant
1. The lungs contain water vapour and naturally produce surfactant (by the
alveolar type II cells) which help the lungs for easier recoil during exhalation.
Surfactant’s main function is to reduce surface tension, therefore maintaining
the alveoli’s function (gas exchange). Premature infants experience increased
risk of their lungs collapsing due to the fact that they produce less surfactant,
which can then lead to respiratory distress syndrome. As a medication,
surfactant is administered by spraying down the endotracheal tube (of
premature babies with respiratory distress syndrome) with a maximum of two
dosages, 12 hours apart or within minutes of birth. The surfactant is then
catabolised and recycled by the alveolar type II cells and is eliminated out of
the body mostly through respiration (with minorities being excreted through
urine and faeces). The use of surfactant is contraindicated in neonates
weighing less than 700g due to risk of pulmonary haemorrhage.
2. side effects:
 bradycardia
 hypotension
 a risk of immune activation/response
 hypoxemia (upon administration)
 endotracheal tube blockage
3. evaluation:
 check oxygen saturation using pulse oximeter — if normal or
improved oxygen saturation, it means the drug is working
 Xray — less cloudy or improved appearance of the lungs means the
drug is working
5. insulin
1. Insulin is a hormone medication that is used to treat patients with type 1 (for
insulin replacement) and type 2 diabetes (for control of blood sugar levels),
hyperkalaemia, or during a diabetic emergency. Its main function is to
decrease blood glucose levels by accelerating glycogenesis and lipogenesis in
the liver, as well as slowing down glycogenolysis, ketogenesis and
gluconeogenesis in the liver and kidneys. It also stimulates the uptake of
glucose and potassium (K+) into the cells, therefore reducing sugar and
potassium levels in the blood until normal levels. Insulin can be administered
subcutaneously via injections, vials, syringes etc. Its effect begins
approximately 30 minutes after administration. Contraindications include
patients that are allergic to insulin, have insulinomas, or with existing renal
impairments.
2. side effects:
 hypoglycaemia
 lipohypertrophy
 palpitations
 blurred vission
 trembling/shaking
 tingling lips
3. evaluation:
  capillary blood glucose test/monitoring — if blood glucose levels
decreases or stabilises, the medication is effective
 potassium test — insulin decreases the levels of potassium in the blood
 haemoglobin a1c test — if hba1c levels are decreasing, the medication
is working
6. naproxen
1. Naproxen is a type of non-steroidal anti-inflammatory drugs (NSAID) that
relieves inflammatory-induced pain from various conditions such as
tendonitis, arthritis, gout attacks, bursitis etc. It can be administered orally and
comes as a standard tablet, effervescent and gastro-resistant tablet. It then gets
metabolised in the liver into naproxen o-glucuronide and o-
desmethylnaproxen sulfate and exits the body via the urine. Naproxen
functions by inhibiting cyclooxygenase (COX 1 and 2). Both enzymes
produce prostaglandins but COX-1 enzymes are constitutively activated while
COX-2 is activated only in event of tissue damage and is responsible for
producing prostaglandins that mediate fever, pain and promote inflammation.
NSAID reduced prostaglandin production therefore inflammation, pain and
fever is also reduced. Contraindications include NSAID-induced asthma,
pregnancy, severe renal impairment, liver or heart failure.
2. side effects:
 confusion
 headache
 GI bleeding
 ringing in the ears
 changes in vision
 feeling sleepy or tired
 feeling dizzy
 rashes
 hypersensitivity reactions
 fluid retention
3. evaluation:
 patients can be pain assessed through scoring/scaling system, chart
etc., if pain has subsided, it means naproxen worked.
 blood pressure test — if taken chronically, naproxen can increase BP.
Excessive or abnormal increase of BP may have been caused by too
much dosage
 thermometer — if inflammatory-induced fever has gone down, the
drug is working
7. captopril
1. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that treats
hypertension. ACE converts inactive angiotensin (Ang) I to Ang II which
causes vasoconstriction. The constricting of blood vessels narrows the lumen,
which then limits blood flow thereby increasing blood pressure. ACE
inhibitors works by preventing the ACE enzyme from making more Ang II,
resulting to vasodilation. This increases blood flow, thereby lowering the
blood pressure. In patients that are fasting, the absorption rate of captopril is
higher as food decreases the rate absoprtion. It is metabolised in the liver and
excreted via urine. Contraindications include hypersensitivity to ACE
inhibitors, pregnancy, anuria and more.
2. side effects:
  hypotension
 persistent dry cough
 hyperkalaemia
 angioedema
 anaphylactoid reactions
3. evaluation:
 blood pressure test that result to the desired or improved BP means that
the medicine is working
 blood test — hypertension can be caused by increased blood volume. If
result shows normal blood volume (after taking medicine), it means the
drug is working.
8. adrenaline
1. Adrenaline is both a hormone (produced by the adrenal gland) and a
medication used in response to a life-threatening event. It stimulates the
body’s sympathetic response by acting on the alpha and beta receptors on the
smooth muscles. Adrenaline triggers the alpha receptor to contract blood
vessels, therefore maintaining the heart and blood pressure, as well as ensuring
that every cells in the body is provided with oxygen. This also causes the
contraction of the smooth muscle in the skin surface, causing hair to stand up
(goosebumps). It also stimulates the beta receptors to relax airways of the
lungs so that more oxygen can be inhaled. During anaphylaxis, it relieves
these airways to help with wheezing and dyspnea. It also stimulates the liver to
breakdown glycogen into glucose. As a medication, it is usually administered
as a solution via intramuscular injection (for anaphylaxis) or from a pre-filled
syringe (for cardiac arrest patients). It has a fast onset and short duration of
action, in which bronchodilation is achieved within 5 - 10 minutes.
Epinephrine is usually excreted by the kidney via urine. Patients with existing
heart disease should take adrenaline with caution due to epinephrine toxicity
which can cause ischemia or fatal cardiac arrhythmias.
2. Adverse effects include:
 hypertension
 headache
 tachycardia
 sweating
 tremors
 apprehension
 palpitations
 nausea
 arrhythmia
 anxiety
 angina
3. evaluation:
 hemodynamic monitoring — if heart rate is increased, the drug is
working
 for heart attack patients, check pulse
9. vincristine
1. Vincristine is a type of vinca alkaloid used for treating acute leukaemia,
Hodgkin’s disease, malignant lymphoma etc. It main function is to inhibit
tumour or cancer cells from multiplying. It does this by stopping mitosis
(particularly at metaphase) through its reaction with the cancer cell’s
 microtubules. Vincristine is administered only through IV injection or
infusion. Most of the drug gets distributed from the blood into tissue within 15
- 30 minutes. It is metabolised in the liver and is excreted out the body via
faeces or urine. Its used is contraindicated in patients with demyelinating
forms of Charcot-Marie-Tooth disease.
2. side effect:
 risk of infection
 bruising and bleeding
 anaemia
 constipation
 diarrhoea
 stomach pain
 difficulty passing urine
 feeling sick
 loss of appetite
 sore throat/mouth
 hair loss
 headaches
3. evaluation:
 a CBC (complete blood cell) test can be done to evaluate whether
vincristine is working. A drop in blood cell counts signifies drug
efficacy.
 MRI — if tumour is shrinking, the drug is working
10. acetaminophen
1. Acetaminophen (paracetamol) is an analgesic drug used to relieve mild to
moderate pain caused by menstrual periods, cold, sore throats, headaches etc.
It can be administered through IV infusion, oral or rectal route. It is
metabolised by the liver and then mostly absorbed in the gut, resulting to peak
blood concentrations within 30-60 minutes. It enters the CNS, acting on the
hypothalamus to reduce fever. It also inhibits the production of prostaglandins,
thereby relieving pain. It is eliminated out of the body by the kidney via the
urine. Its used is contraindicated in patient’s with hypersensitivity to
acetaminophen, severe liver disease/impairment.
2. side effects:
 nausea
 vomiting
 abdominal pain
 skin rash
3. evaluation:
 temperature monitoring using a thermometer, if fever is reduced it
means the drug is working
 pain assessment using pain assessment tools (numeral pain scale etc.),
if pain subsided it means the drug is working

Question guide:

1. name of drug
1. with reference to anatomy and physiology, explain how this drug works.
2. list side effects of each medication
 3. (at least) two examples of how you might evaluate if the medication is
working or not

Fertilisation, Implantation, and Foetal

Development
Conception

1. ovulation
o the process in which an ovary releases a mature egg
2. fertilisation
o sperm swims to the fallopian tube where it meets and fertilises the ovum to
form a zygote
o as the zygote travels down through the fallopian tube, it undergoes into three
changes:
 early cleavage (4-cell stage)
 morula (3-4 days post-fertilisation)
 blastocyst (4-5 days post-fertilisation)
3. implantation
o when the blastocyst arrives in the (body of the) uterus, it burrows itself on the
endometrium in a process called implantation
Fertilisation
 usually occurs in the fallopian tube
 sperm can stay viable for up to 5 days after ejaculation
 secondary oocyte is viable for 12-24 hours
 for successful conception, timing of intercourse with ovulation cycle us vital

Meiosis II: ovum

 the first sperm to bind to the receptor on the egg membrane will fertilise the egg
 this triggers the hardening of the zona pellucida, preventing polyspermy
 fertilisation triggers meiosis II and the secondary oocyte becomes an ovum

Zygote formation
 once inside the egg, the male genetic material spreads out making the male
pronucleus, eventually reforming into 23 chromosomes
 at the same time, the female genetic material also reforms into 23 chromosomes,
making the female pronucleus
 the two sets of chromosomes unite, finishing fertilisation
 the ovum has now become a zygote
o a single cell union of ovum and spermatozoon with 23 pairs of chromosomes
that contains the genotype

Cleavage and blastulation

 cleavage
o repeated mitotic (identical) cell division
 zygote divides without growing to become a 16-cell structure within the zona
pellucida, becoming the morula (3/7)
 blastocyst cavity forms
o now termed as blastocyst
 zona pellucida begins to degenerate in preparation for implantation in the uterus

Implantation
 blastocyst embeds into the decidua (maternal uterine tissue) of the uterus 6-8 days
after fertilisation
 trophoblast (outer cell mass) turns into the placenta
 the embryoblast (inner cell mass) become the embryo
 10 days after fertilisation, the embryo successfully embedded in the decidua
 12 days after fertilisation, the chorionic villi of the placenta starts to form

Hormonal response
  corpus luteum secretes progesterone that stimulates the endometrium to thicken in
preparation for implantation
 Human Chorionic Gonadotrophin (hCG) is secretes during implantation and
maintains the corpus luteum to continue releasing progesterone until placenta is
develop to take over hormonal support of the pregnancy (usually at 12 weeks)
 hCG is the basis of the pregnancy test and is detectable by the end of the 2nd week

Gastrulation and neurulation

 week 3 after fertilisation
o germ layers
o the embryoblast differentiates into 3 layers, also known as the embyonic plate:
 endoderm
 digestive system, lungs, mucus membranes, thyroid, liver,
pancreas
 mesoderm
 skeletal system, heart, blood, vessels, kidneys, ovaries, testes
 ectoderm
 brain, spinal cord, CNS, skin, hair, nails, eyes, ears, mammary
glands, pituitary gland

Neurulation and embryonic folding

 day 17-30 after fertilisation
 the notochord forms within the mesoderm, causing a thickening in the ectoderm
(neural plate) which then becomes the neural tube
 the embryonic plate (trilaminar disc) folds laterally and longitudinally and joins
together to form a tube-like structure which develops into the foetus
 folic acid can reduce the risk of structural defects (spina bifida and anencephaly)
which occurs if full closure is not achieved

Week 4

 heart begins to pump

 embryo folds and becomes c-shaped
 limb buds form
 beginning of internal ear, lens of the eye
 caudal eminence is prominent
 rudimentary cardiovascular system

Week 5

 growth of head exceeds growth of other organs and body parts

 rapid development of brain and facial features
 beginnings of kidneys
 upper and lower limb buds grow
 paddles/flippers

Week 6
  rudimentary elbows, hands, digits
 spontaneous movements, twitching
 head larger than trunk
 beginnings of auditory canal, external ear
 eye now evident
 reflex response to touch by end of week 6

Week 7

 development of limbs
 partial separation of future digits
 intestines enter space in umbilical cord (abdomen too small to accommodate
developing gut)

Week 8

 becomes a foetus
 digits separate but remain webbed
 toes notched, fan-shaped
 purposeful limb movements
 head still disproportionately large (50% of foetus)
 external ears more developed but low set
 eyelids obvious
 distinct human characteristics

12 Weeks

 foetus is fully formed but needs to grow and develop

 miscarriage is less likely
 the placenta takes over hormonal control
 face appears more human-like and hands can grasp each other
 frequent foetal movement

Placental development
 the blastocyst
o composed of embryoblast
 forms the embryo
o trophoblast (outer layer)
 forms the placenta
 implantation
o usually occurs on the posterior wall near the fundus
 placenta develops to bring oxygen and nutrients to the foetus and move harmful waste
away
o is fully formed and functioning 10 weeks after fertilisation
 maternal and foetal blood supplies although always in close contact do not mix, unless
villi gets damaged
 the membranes continue to grow until 28/40, thereafter they stretch to accommodate
the foetus and amniotic fluid
  mature placenta has 60-70 branching villi providing a large surface area for gaseous
and metabolic exchange
 maternal side is deep red and divided into 15-20 cotyledons
 foetal side has the shiny white surface of amnion

Umbilical cord

 consists of 3 vessels, 2 arteries, and 1 vein (AVA)

 surrounded by Wharton’s jelly, a clear connective tissue that’s covered by a layer of
amnion
 the vein (typically dark red) has a larger lumen than the arteries (almost translucent in
colour)
 cord progressively lengthens during pregnancy (length at term varies but averages
from 50-60 cm)

Calculating gestational age

 weeks in embryology terms differs from weeks of pregnancy which is calculated from
the 1st day of the last menstrual period (LMP)
 Neagles rule:
o add 9 months and 7 days to LMP to give an estimated delivery date (EDD)
o human gestation is 40 weeks long
 affected by length of cycle and timing of ovulation

Trimesters in pregnancy
 1st
o up until 12 weeks gestation
o minor discomforts of pregnancy
o booking appointment with their midwife
o 1st trimester ultrasound — screening test for chromosomal anomalies as well
as measuring the thickness (length of) baby
o internal development
o cardiovascular system fully functional
o all body systems present in rudimentary form
 2nd
o 13-28 weeks gestation
o foetal movements can be felt from around18 weeks
o enlarging abdomen becomes visible
o increasing circulating volume of blood
o haemodilution
 higher blood volume but diluted
o physiological drop in BP
o viable if delivered from about 24 weeks
 3rd
o 29 weeks - delivery
o growth of foetus
o Braxton Hicks contractions
o onset of labour
 o delivery

Factors affecting foetal development

 chromosomal/genetic
o present from formation of the zygote
 teratigens
o any agent that can cause a birth defect
o usually environmental exposure during pregnancy
o prescribed medication, recreational drug, alcohol use
 infections
o foetal effects depend on timing

Foetal Alcohol Syndrome

 foetus can’t process alcohol in the placenta
 damage to the brain, spinal cord may occur
 disrupt development
 can result in miscarriage
 babies that survive can have lifelong problems
 can cause damage during all stages of pregnancy
 early diagnosis and support can make a difference
 package of care including educational strategies
 symptoms:
o head smaller than average
o poor growth in utero and as a child
o distinctive facial structures
o movement and balance problems
o learning difficulties
o poor attention and concentration span, hyperactivity
o liver, kidney and heart problems
o hearing and vision problems

Growth and Development Through the

Lifespan
Life stages
 life course development:
1. infancy
2. childhood
3. adolescence
4. early adult
5. mid to later adulthood

Key transitional and development stages

  2 — 2.5 years old
o communication skills
o gross motor skills
o fine motor skills
o problem solving
o personal social skills
 children learn through play
o psychodynamic play provides catharsis
 social learning lay
o encourages reinforcement, information, and vicarious learning
o enhances emotional and social well-being
 cognitive psychology play
o promotes language and communication skills
o develops visual and intellectual abilities

Nature
 genetics — naturally inherited by parents

Nurture
 refers to the effects of the environment

Epigenetics
 means above genetics
 refers to how both nature and nurture interact and affect an individual

General growth
 rapid increase in body size in first 2 years of life
 growth rate slows after the age of 2 and rapidly increases again at puberty
 on average, a child will add 5 — 7.5 cm in height and about 2.25kg of weight in the
early years of childhood
 by the age of 5, children, will have lost the top heavy, bow legged and pot belly
physique and starts to take on the proportions of an adult

Averages age and sequence of motor (movement)

development
 birth — 4 months
o primitive reflexes
 4 months — 1 year
o improve muscle tone
o reducing flexor and increasing extensor tone improves balance and
coordination
o movement becomes differentiated and functional
  1 — 2 years
o better differentiated and more precise movements
 3 — 5+ years
o improved efficiency in skills such as running, jumping etc.
o applied motor skills for sports and work

Key terms
 growth
o refers physical characteristics such as, the increase in size of body part or the
organism as a whole
 develoopment
o refers to the maturation of cells from embryonic start to the final adult
function occurring at different rates
o could can also refer to the changes in physical/psychomotor, mental and
intellectual, and emotional and social being

Homeostasis
Homeostasis
 Homeostasis is the body’s ability to maintain homeostatic balance in response to
internal or external change, by performing regulatory mechanisms in the body.
 If homeostasis is not maintained, it can result to various homeostatic imbalance
(caused by accumulation of harmful byproducts) leading to cellular and tissue
damage/toxicity.
o For example, water balance is done by the organs hypothalamus, posterior
pituitary gland, and the kidneys. If there’s increased in water levels in the
blood, homeostasis act on these organs to excrete excess water via urine.
Overhydration causes the cell to swell and burst. Meanwhile, if there’s less
water in the blood, homeostasis acts by commanding kidneys to selectively
reabsorbed more water in the nephron. Dehydration causes kidney failure,
dizziness etc.
 constantly monitors changes within the body:
o nervous system
 neurones
 neurotransmitters
o endocrine system
 hormones
 corrects homeostatic imbalance by:
o negative feedback
 a series of response that opposes, reducing, or reversing the initial
change
o positive feedback
 a series of response that increase or amplifies a physiological state
 constant monitoring in health through:
o signal molecule binds to receptor protein, which activates intracellular
molecules which then alters the target proteins, creating a response
5 Components of a feedback system
 receptors
 afferent nerves
 monitor
 efferent nerves
 target organs

Nervous system controlling heart rate

1. accelerator nerve (sympathetic NS) — when stimulated, releases neurotransmitter at

the SA node to increase heart rate
o various sympathetic nerves link to the walls of the two ventricles where they
increase the force of contraction of these chambers
2. vagus nerve (parasympathetic NS) — when stimulated, releases neurotransmitter at
the SA node to decrease heart rate

Positive feedback mechanism

 parturition (labour)
1. the head of foetus pushes against the cervix
2. nerve impulses from the cervix transmits signals to the brain
3. hypothalamus (in the brain) acts on the pituitary gland to secret oxytocin
4. oxytocin travels through the bloodstream and acts on the uterus
5. oxytocin stimulates contraction of the uterine walls, pushing the foetus against
the cervix
 lactation
1. baby sucking stimulates the nerves endings in the nipples
2. nerve impulses carry stimuli to the hypothalamus
3. hypothalamus acts on the anterior pituitary gland to secrete prolactin
4. prolactin is carried to the breast where it stimulates the mammary glands to
secrete milk

Negative feedback mechanism

 body temperature regulation (normal = 37°C)
o stimulus: increased body temperature (e.g. warm environment)
1. hypothalamus picks up the change of blood temperature (warmer),
activating its heat-loss centre
2. sweat glands secrete sweat — body heat causes the sweat to evaporate
— surface of the skin cools down
3. vasodilation — capillaries are flushed with warm blood, allowing heat
to radiate from the skin surface
 4. body temperature declines — the heat-loss centre of the hypothalamus
inactivates
5. homeostatic balance achieved
o stimuli: decreased body temperature (e.g. cold environment)
1. hypothalamus picks up the change of blood temperature (cooler),
activating its heat-promoting centre
2. Vasoconstriction — blood is diverted from the capillaries (skin
surface) and withdrawn deeper in the tissues — minimises overall heat
loss
3. skeletal muscles performs “shivering” to produce heat
4. blood temperature increases — the heat-promoting centre of the
hypothalamus inactivates
5. homeostatic balance achieved
 blood glucose regulation
o stimulus: increased blood glucose levels
1. beta cells in the pancreas detect the change and secretes insulin into the
blood
2. insulin stimulates the conversion of glucose into glycogen to be stored
in the liver and skeletal muscles
3. insulin stimulate lipogenesis, storing fatty acids in the adipose tissue
4. insulin increases facilitated diffusion of glucose into cells
5. inhibits glycogenolysis and gluconeogenesis
6. decline in blood glucose levels until homeostatic balance is achieved
o stimulus: decreased blood glucose levels
1. pancreatic alpha cells detect the change and releases glucagon into the
blood
2. glucagon stimulates glycogenolysis and gluconeogenesis in the liver
3. gradual increase in blood sugar levels until homeostatic balance is
achieved
 osmoregulation
o stimulus: low water levels
1. osmoreceptors in the hypothalamus detect change and sends signal to
the pituitary gland to secrete more anti-diuretic hormone (ADH)
2. increased ADH stimulates the kidney (particularly the collecting duct)
to reabsorbed more water from the filtrate, resulting to a concentrated
yet small volume of urine (less water, more urea/solutes etc.)
3. more water gets into the the blood and homeostatic balance is achieved
o stimulus: high water levels in blood
1. osmoreceptors in the hypothalamus detect the change and sends signal
to the pituitary gland to inhibit the production of ADH
2. less ADH results to less water getting absorbed in the kidneys,
resulting to a diluted yet large volume of urine
3. decrease in water as it leaves the body thereby achieving homeostatic
balance

Renal System
Kidneys
 a pair of bean-shaped organs located in the upper abdomen
 composed of nephron units
 roles:
1. regulation of blood ionic composition
2. regulation of blood osmolarity
3. regulation of blood volume
4. removal of metabolic waste products and foreign substances from the blood
5. hormone production:
 erythropoietin (EPO)
 stimulates the bone marrow to produce more erythrocytes
 renin
 involves in increasing blood pressure
6. regulation of blood pH
 parts:

o Nephron
 afferent arteriole
 carries blood to the glomerulus
 Bowmans capsule
 double-walled cup-like structure that surrounds the glomerulus
 collects the filtrate from the glomerulus and transport it to the
proximal convoluted tubule (PCT)
 glomerulus
 a network of capillaries that contain a unique, high-pressure
filtration system between the afferent and the efferent arterioles
 allow smaller molecules, urea, and water to pass (collectively
as filtrate) into the tubule
 larger molecules stay in the blood vessel
 filtrate:
 water, sugar, salts, nitrogenous waste (e.g. urea,
creatinine and uric acid)
 efferent arteriole
 carries filtered blood from the glomerulus
 proximal convoluted tubule
 reabsorbs water, solutes, glucose, amino acids, bicarbonate
 secretes H+ and ammonium that are important for pH
regulation
 descending limb of Henle
 contains aquaporins (water channels) that allow water to get
absorbed into the interstitial fluid (the fluid that surrounds that
nephron) through osmosis
 solute concentration increases as water levels decreases
 ascending loop of Henle
 impermeable to water
 the thin part passively reabsorbs Na+ and Cl+ into the
interstitial fluid through protein channels
 the thick part allow continuous reabsorption of NaCl through
active transport
 as more solute gets reabsorbed, the more dilute the filtrate is
becoming
  distal convulated tubule
 secretes H+, ammonium, potassium
 reabsorbed NaCl, water, bicarbonate
 plays a role in pH regulation and electrolyte balance
 collecting duct
 hormones (ADH) influenced its permeability to water
 filtrate then travel down to the bladder through the ureter where
it gets stored as urine
o ureter
 a pair of muscular tubes lined with mucous membrane that connect the
kidneys to the urinary bladder
o urinary bladder
 a hollow, muscular sac that acts as a temporary reservoir for urine
 involuntary control (autonomic nervous system)
 acts on the internal sphincter
 voluntary control (somatic nervous system)
 acts on the external sphincter
 sympathetic NS promotes bladder filling
 Parasympathetic NS promotes bladder emptying
 in males, it’s located between pubic symphysis and rectum
 in females, it’s located between pubic symphysis and uterus and vagina
o urethra
 a tube-like structure that is lined with mucous membrane, connecting
the bladder to the exterior part of the body
 it acts as a passageway for urine to get eliminated out of the body
 carries both urine and semen in men
 is longer in males because it has to pass through the penis
 female have shorter urethra as it only carries urine
 because of this, females are prone to getting UTI

Control of micturition (urination)

 negative feedback
o stimulus: full bladder

2. urine causes the bladder to swell — stretch receptors initiates rapid signalling
to the spinal cord’s micturition centre and the pons (in the brain)
3. the pons act on the pontine micturition centre to stimulate the micturition
reflex
4. micturition reflex stimulates parasympathetic response through the pelvic
nerve — contracts the detrusor, pushing the urine down the internal urethral
sphincter (IUS)
5. micturition reflex inhibits sympathetic response of the hypogastric nerve —
relaxes the IUS
6. micturition inhibits somatic action of the pudendal nerve — relaxes the
external urethral sphincter (EUS), allowing urine to pass through from the
bladder and IUS thereby performing micturition

o stimulus: empty bladder

 8. stretch receptors of the bladder senses that it is empty and sends signal to the
pons
9. the pons act on the pontine storage centre to inhibit micturition reflex —
decreases the desire for micturition
10. the lack of action in the micturition centre stimulates the sympathetic response
of the hypogastric nerve and the somatic action of pudendal nerve, resulting to
the constriction of the IUS and the EUS respectively, thereby promoting
bladder filling
11. parasympathetic response of the pelvic nerve is inhibited by the lack of action
in the micturition centre — inhibits detrusor contraction

Factors affecting control of bladder function in children

 normal bladder growth

o myelination of the ascending afferents that sense awareness of the bladder
 disorders of cerebral functions
o inability to voluntarily tighten the EUS to prevent incontince
 motivation of the child to stay dry

Urine
 normal urine
o colour — bright to dark yellow
o clarity — clear
o pH — 5.5 - 6.5.
 formation of urine:

1. glomerular filtration
o blood passes through the glomerulus in high pressure, forcing wastes such as
urea and other tiny substances like water, solutes etc.
o influenced by glomerular capillary hydrostatic and osmotic pressure
o hydrostatic and osmotic pressure in the Bowman’s capsule
2. tubular reabsorption
o proximal convoluted tubule
 reabsorbs water, solutes, glucose, amino acids, bicarbonate
 secretes H+ and ammonium that are important for pH regulation
o descending limb of Henle
 contains aquaporins (water channels) that allow water to get absorbed
into the interstitial fluid (the fluid that surrounds that nephron) through
osmosis
 solute concentration increases as water levels decreases
o ascending loop of Henle
 impermeable to water
 the thin part passively reabsorbs Na+ and Cl+ into the interstitial fluid
through protein channels
 the thick part allow continuous reabsorption of NaCl through active
transport
 as more solute gets reabsorbed, the more dilute the filtrate is becoming
o distal convulated tubule
  secretes H+, ammonium, potassium
 reabsorbed NaCl, water, bicarbonate
 plays a role in pH regulation and electrolyte balance
o collecting duct
 hormones (ADH) influenced its permeability to water
 filtrate then travel down to the bladder through the ureter where it gets
stored as urine
3. tubular secretion
o substances that are harmful such as excessive amounts of H+ and K+ is added
into the filtrate

Cardiovascular System
Cardiovascular system
 pulmonary circuit
o circulates blood through the heart and the lungs
 systemic circuit
o circulates blood between the heart and the body
 cardiac cycle
o refers to the events associated with blood flow through the heart
 systole — contraction of myocardium (ventricle)
 pressure of the arteries when heart beats
 diastole — relaxation of myocardium (ventricle) left
 pressure of the arteries when heart is at rest in between beats
 120/80 mmHg — (sys)/(dia) millimetres of mercury
 blood pressure
o the pressure of the circulating blood against the walls of the blood vessels
o factors that influence it:
 unmanageable:
 age
 family history
 race
 gender
 manageble:
 obesity
 diabetes
 smoking
 high LDL (bad cholesterol)
 low HDL (good cholesterol)
 cardiac output (CO) and reserve
o CO (ml/min)
 amount of blood pumped by each ventricle per minute
 CO = HR (heart rate — beats/min) x SV (stroke volume — ml/beat)
o cardiac reserve
 CO = maximal CO - resting CO

Blood
 function:
o transportation of oxygen, carbon dioxide, food, heat, waste, hormones,
disease, clotting
 components:
o blood cells (45%)
 erythrocytes: transport of oxygen and assist with CO2 removal from
cells
 biconcave, no nucleus — increase surface area
 contains haemoglobin that bonds to oxygen
 primary function
 leucocytes
 body’s defence mechanism against microorganisms
 types:
 agranulocytes
 lymphocyte
 T-cells
 fight viruses
 B-cells
 produce antibodies
 monocyte
 destroy damaged cells
 phagocytic
 becomes macrophages after diapedesis
 granulocytes
 eosinophil
 kill parasites, cancer cells
 involved in body’s allergic response
 basophil
 involved in allergic response
 release histamine
 neutrophil
 kill bacteria, fungi, and foreign
substances
 involves in inflammatory response
 phagocytic
 thrombocytes
 stop bleeding by coagulation
 haemostasis by 3 steps:
 vascular spasm
 vessels constricts to prevent loss of blood
 formation of a platelet plug
 a platelet plug forms to prevent further loss of
blood
 blood coagulation
 fibrin mesh clot serves as a temporary patch
until tissue completely heals
o blood plasma (55%)
 water
 transport medium for nutrients, hormones, wastes etc.
 carries heat
  electrolytes
 membrane excitability
 osmotic distribution of fluid
 buffering of pH
 Blood groups
o Dr Karl Landsteiner
o phenotypes:
 A
 B
 AB
 universal recipient
 no Anti-A or Anti-B present
 cannot lyse (destory) transfused cells
 caution: other antibodies (Rh factor) may be present
 O
 universal donor
 doesn’t contain A or B antigens
o ABO gene found on the long arm of chromosome 9
o importance:
 ABO mismatched transfusion
 rare
 may be life threatening
 can be used by technical or clerical error
 intravascular haemolysis
 more severe in group O patients
o Rh(D) antigen
 Rh(D) negative (e.g., A-, B-, AB-)
 Rh(D) positive (e.g., A+, B+, AB+)
 blood transfusion must be the same as the recipient

Heart
 a muscular organ that pumps blood throughout the body
 located in the thorax, behind the sternum in pericardial sac
 anatomy:
o layers:
 pericardium (outer)
 composed of fibrous tissue
 myocardium (middle)
 composed of myocytes
 mainly responsible for the cardiac contraction
 endocardium (inner)
 composed of endothelium
 chambers:
 left and right atria
 left and right ventricles
 septum
 separates the left and right chambers of the heart
 valves:
  tricuspid valve (right atrioventricular valve)
 pulmonary valve (right semilunar valve)
 bicuspid valve (mitral valve)
 aortic valve (left semilunar valve)
 Circulation:

1. Both superior and inferior vena cava carries deoxygenated blood (from the upper and
lower parts of the body respectively) into the right atrium
2. the right atrium pumps blood to the tricuspid valve and into the right ventricle
3. the right ventricle pumps blood to the pulmonary valve and into the pulmonary artery
which carries deoxygenated blood to the lungs for gas exchange
4. oxygenated blood from the lungs travels to the left atrium via the pulmonary veins
5. the left atrium pumps blood to the bicuspid valve and into the left ventricle
6. the left ventricle pumps blood to the aortic valve and into the aorta which transports
oxygenated blood to all parts of the body

Innervation (neural control) of the heart

 control centre in medulla oblongata

 heart rate is increased by the sympathetic cardio-acceleratory centre
 heart comes down by the parasympathetic cardio-inhibitory centre

ECG
 P — atrial depolarisation
 QRS — ventricular depolarisation
 T — ventricular repolarisation

Blood vessels
 anatomy:
o layers
 tunica intima
 lined with endothelial cells
 tunica media
 composed of smooth muscle cells
 tunica adventitia
 composed of loose connective tissue
o veins
 have valves to prevent back flow of blood
 carries blood in low pressure
 wide lumen
 thin muscle layer
o arteries
 carries blood in high pressure
 narrow lumen
 thicker muscle layer
 doesn’t have valves
Genes and Genomics
Genes
 basic unit of heredity
 a specific sequence of DNA that corresponds for a specific protein
 composed of DNA
o deoxyribonucleic acids
 cytosine
 guanine
 thymine
 adenine
 uracil — RNA
 genetic codons make proteins and packed in the Golgi body
 DNA polymerase
o checks the gene for any mistakes during DNA replication
 mutagenesis
o may happen in somatic cells or germ cells
o caused by agents:
 physical
 heat
 radiation
 chemical
 alkylating agents
 biological
 viruses
 bacteria

Key terms:
 trait
o a specific characteristic of an organism
 genotype
o an individual’s set of gene deprived from both parents
 phenotype
o visible physical characteristic of a gene
 XY — male
 XX — female
Genetics
 study of heredity
 study of function and composition of single genes
 gene
o specific sequence of DNA

Genomics
 study of an organism’s whole set of genetic information
 includes both coding genes and non-coding DNA
 genome
o the complete set of genes of an organism

Musculoskeletal System
Bones
 osteoblasts
o bone-forming cells
 osteoclasts
o resorb or breakdown bone matrix
 osteiod
o unmineralised bone matrix
o composed of proteoglycans, glycoproteins, and collagen
 osteocytes
o mature bone cells
 hydroxyapatite (mineral salts e.g., calcium phosphate)
o responsible for calcification
 influences that alters bone growth:
o genes
o calcium and phosphorous
o calcitonin, vitamin D, parathyroid, growth hormones
o glucocorticoids, oestrogen and androgen, thyroxine and insulin
o lifestyle
 exercise, eating etc.
 function of bones:
o support
 provides the body with framework and shape
o protection
 provides protection for soft organs such as the lungs (ribcage) and the
brain (skull)
o movement
 provides anchor points and levers for muscle to allow movement
 o mineral storage
 particularly calcium and phosphorus
o hemopoiesis
 bone marrow — responsible for the formation of blood cells
 classification
o axial skeleton
 bones of the skull
 vertebral column
 rib cage
o appendicular skeleton
 shoulder
 hip
 bones of upper limbs
 bones of the lower limbs
 classification by shape:
o long
 its length is greater than its width
 structure:
 diaphysis
 middle part of the bone
 composed of compact bone
 epiphyses
 end of the bone
 spongy
 joint surface is layered with hyaline (articular) cartilage
to aid pressure
 consists of a epiphyseal line that separates the diaphysis
and the epiphyses
 growth plate for bone growth during puberty
 periosteum
 double-layered protective membrane
 endosteum
 fragile membrane that covers the internal surface of the
bone
o short
 bones that form within tendons
 cube-shaped bones
o flat
 thin and flat
o irregular
 doesn’t particularly follow a specific shape
 has a complex shape

Hematopoietic Tissue (red marrow)

 in infants
o can be found in the medullary cavity and all regions of spongy bone
 in adults
 o can be found in the diploë of flat bones (e.g., sternum) and the head of the
femur and humerus

Joints
 ball and socket — in shoulders
o rotary movement
 hinge — knee
 condylar — elbow
 biaxial — metacarpophalangeal
 pivotal — neck
o back-forth and sideways movement

Muscle
 types
o cardiac
 influenced by nerves
 involuntary
 contracts as a unit
 functional characteristic:
 contractibility
 ability to contract by force
 excitability
 responds to stimulation done by hormones or nervs
 extensibility
 can be stretched to a degree
 elasticity
 ability to recoil after stretched to go back to its original
resting length
o smooth
 involuntary
 peristalsis — GI tract
 passageway — blood vessels
o skeletal
 voluntary
 work together (agonist) or in opposition (antagonist)
 only pull, never push
 as the muscle shorten, the insertion generally moves toward the origin
 whatever a group of muscle “does”, another group “undoes”
 can be named based on their:
 location
 shape
 relative size
 direction of fibres
 number of origins
 action
 neuromuscular junction
  excitation-contraction coupling

Key terms:
 tendons
o connect muscle to bone
 ligaments
o connect bone to bone

Microbiology
Microbiology
 the study of microorganisms (e.g., bacteria, fungi, protozoa, viruses etc.)
 commensals
o Microorganisms that develop a relationship with the host which benefit both
of them
o example:
 some gut bacteria produces bacteriocin which is harmful for other
bacteria
 lactobacillus in the vagina produce lactic acid, causes the vagina’s
acidic environment thereby killing bacteria
 virulence
o the ability of a microorganism to infect host and cause disease
 colonisation
 in the host
 immunoevasion
 evasion from the host’s immune response
 immunosuppression
 inhibition of the host’s immune response
 obtain nutrition
o elements:
 morphology
 nutrition
 physiology
 reproduction
 growth

Routes of transmission
  direct contact
o touching, kissing etc.
 indirect contact
o vehicle-borne
 toys, handkerchief, blood etc.
o vector-borne
 animal bites, insect bites, faeces
 airborne transmission

Chain of infection — COVID 19 — stop chain

 infectious agent
o corona virus
 diagnosis and treatment
 reservoir
o requires a host, usually lives in the mouth, nose, throat and the respiratory tract
o the virus can also live on objects
 use of disinfectant air spray
 separate and wash contaminated laundry
 portal of exit
o through small droplets from mouth or nose, usually expelled via sneezing or
coughing
 sneeze/cough on a tissue and throw it immediately after use
(respiratory etiquette)
 mode of transmission
o airborne, direct contact with an infected person
o indirect contract with contaminated objects such as door handles etc.
 sterilisation — use of disinfectant on surfaces that are frequently used
by others
 social distancing
 portal of entry
o breathing in air (in a distance) that some with COVID-19 had coughed or
sneezed in
o contaminated hands and then touching the eyes, nose, and mouth
 handwash
 mask
 susceptible host
o anyone, especially those who are immunocompromised (e.g., elderly)
 isolation
 vaccination

Virus
 smaller than other organisms
 needs a host
 multiply by overwriting the cell host’s DNA with its own
 examples
o measles
o HIV
 o herpes zoster — shingles
o herpes simplex — type 1
o herpes zoster
o hepatitis ABC

Bacteria
 classification
o morphology (shape)
 cocci — round
 bacilli — rod-shaped
 coccobacilli — very short rods
 spirachaetes — spiral
o Gram Stain
 negative
 lose dye stain — pink
 positive
 retain dye — violet
 multiplication
o aerobes — some bacteria requires oxygen to grow
o anaerobes — some bacteria can’t tolerate oxygen

Fungi
 can be uni— or multicellular cell
 cell with DNA in an envelope of chitin
 example of infection:
o Athlete’s foot, thrush, ringworm

Protozoa
 unicellular microorganisms
 can be beneficial to mean by feeding on bacteria gut
 others are parasitic to humans and animals and can cause serious diseases

Hospital surveillance
 ward nurses
 infection control nurse
o implements best practices at work that can halt the spread of viruses and
bacteria
o delivers top care to patients who have contracted infectious diseases
o roles:
 collect information
 infection prevention education and protocols
 isolating and treating infected individuals to contain the spread
 development of action plans to minimise outbreak impact
 collaborating with agencies to implement infection control practices
  studying pathogens to prevent future outbreaks
 assist in development of treatment/vaccines
 microbiologist
 hand hygiene
 disinfectant
 fumigation
 sterilisation

Key terms
 pathogen
o microorganisms that can causes infection and harmful effects in the body
 infective dose
o refers to the initial
amount of pathogen
required to start an
infection in the host
 incubation period
o refers to the time between
exposure to the pathogen
and the appearance of
symptoms
 spore
o tough and durable coat
that surrounds the
bacteria, making it harder
to destroy
 toxins
o enhance bacteria’s virulence
o 2 types:
 endotoxins
 within the vicinity of the bacteria
 exotoxins
 can travel in the blood stream to other sites in the host

Nervous System
Nervous system
 cell types
o neurone
o responsible for relaying electrical signals over long distances
o basic unit of function of the brain and CNS
o amitotic — can’t divide
o high metabolic rate
o glial cells
 help connect, support and protect neurones
 function
 o sensory input
 sensory receptors react to stimuli inside and outside of the body
o integration
 processes and interprets changes
o motor output
 response upon activation of activated gland or muscle/organ
 central nervous system
o brain
 cerebrum
 grey matter
 composed of tightly packed neurones
 consist of:
 frontal lobe
 expressive language (Broca area)
 motor tasks
 emotion, decision making, social interactions,
personality etc.
 motor cortex
 controls voluntary movement of the body
 send messages to skeletal muscles
 sensory cortex
 receives registers and process sensation
 parietal lobe
 perception and sensation
 integrating sensory input with the visual system
 temporal lobe
 hearing
 comprehension of language (Wernicke’s area)
 memory
 occipital lobe
 sight
 visual perception
 receives visual information
 brain stem
 consists of:
 midbrain
 conveys motor and sensory impulses
 pons
 sleep cycles
 biting, chewing, swallowing
 face sensory
 medulla oblongata
 breathing
 heart rate
 reticular formation
 extending through core of brain stem
 alertness, attention
 cerebellum
 responsible for complex and coordinated movement, balance
and posture
  diencephalon
 relays sensory information
 hypothalamus
 main integration centre of autonomic NS
 involves in homeostasis — acts on the pituitary gland
 thalamus
 relays sensory impulses to the cerebral cortex (except for smell)
 olfactory bulb
 relay smell impulses
 hippocampus
 gateway to memory
 amygdala
 coordinates emotional response
 evaluates sensory information
 corpus callosum
 connects the two brain hemisphere
 composed of thick bundle of axons
 meninges
 membranes that surrounds the brain and spinal cord
 3 maters:
 pia mater
 arachnoid matter
 dura mater
 Circle of Willis
 blood supply to the brain
 Blood brain barrier
 protective layer composed of endothelial cells joined by tight
junctions
 maintained by glial cells
 prevents foreign substances away from the CNS
 only highly lipid soluble drugs can pass through
o spinal cord
 control reflexes
 relays message from the brain to the body and vice versa

o cells
 neurones
 basic unit of function of the brain and CNS
 astrocytes
 found in the blood brain barrier
 ongliodendrocytes
 creates myelin which allows efficient electrical impulses
 peripheral nervous system
o ganglia
 cell body clusters
o somatic NS
 voluntary control
 sensory input — afferent division
 relay impulses from receptors in the skin, skeletal
muscles, and joints to the CNS
  motor output — efferent division
 carries impulses from CNS to target/effector
organs/glands
o autonomic NS
 sympathetic
 fight-or-flight
 prepares the body during stressful events such as danger
 parasympathetic
 rest and digest
 stabilises or returns the body to its normal state

Electrical impulse
 neurones
o excitability
 the ability to respond to stimulus and produce and impulse
o conductivity
 the ability to relay and transmit impulse to other neurones, muscles etc.
 at rest, plasma membrane is polarised (less positive ions inside than outside)
o K+ (inside)
o Na+ (outside)
 when stimulated, cell membrane facilities exchange of ions resulting to depolarisation
o sodium channel opens and Na+ comes into the cell, creating an action
potential
 potassium channels open, allowing K+ to leave the cell until no more sodium can
enter the cell
o results to repolarisation

Synapses
  action potential arrives at the axon terminal, forcing the calcium channels to open
 calcium ions cause vesicles that contain neurotransmitters to bind with the cell
membrane (endocytosis), releasing neurotransmitters into the synapse which then bind
to the receptors on the cell membrane of the neighbouring neurone
 or:
1. synaptic vesicles reach the axon terminal, releasing neurotransmitters into the
synaptic cleft
2. neurotransmitters then cross the synaptic cleft to the neighbouring neurone
3. neurotransmitters binds to the receptors located on the dendrites of the
neighbouring neurone

Neurotransmitters
 examples
o gamma-aminobutyric acid (GABA)
 calm, reduces anxiety and agitation
o acetylcholine
 learning, cognitive function, memory, muscle action
 low levels — associated with Alzheimer’s disease
o serotonin
 mood, appetite, sleep, happiness, pain supression
o dopamine
 pleasure, movement, emotion, memory, learning
 low levels — associated with ADHD and Parkinson’s disease
 high levels — associated with psychosis
  effect:
o excitatory
 increases the likelihood of firing an action potential
o inhibitory
 decreases the likelihood of firing an action potential

Digestive System
Digestive system
 anatomy
o GI tract
 mouth
 ingestion of food
 mechincal digestion — chewing
 softens food for easier swallowing
 pharynx
 facilitate both food/water and air so that they go through the
right tube (oesophagus and trachea respectively)
 oesophagus
 peristalsis (involuntary propulsion)
 pushes down food deeper into the GI tract
 lined with mucus for easier peristalsis
 stomach
 acts as a temporary reservoir for chyme (partially undigested
food)
 chemical digestion — pepsin digest protein into amino acids,
gastric lipase continues breakdown of lipid
 mechanical digestion — peristalsis (involuntary)
 anatomy:
 parietal cells secrete HCl which provides acidic
environment in the stomach, which allows enzymes
such as pepsin to efficiently breakdown protein
 stimulated by the production of gastrin
(hormone) in the G-cells and acetylcholine (in
the brain)
 cells are lined with mucus that neutralises HCl,
protecting cells from its harmful effects
 small intestine
 mechanical digestion — segmentation
 contains villi for absorption of nutrients via active transport
 specialised to have microvilli (finger-like structures) to
increase surface area
 chemical digestion — pancreatic amylase continues
carbohydrate hydrolysis
 vitamins are mainly absorbed in the jejunum and ileum
 consists of 3 sections
 duodenum
  jejunum
 ileum
 large intestine
 absorption of water, electrolytes and vitamins
 involuntary propulsion by peristalsis, haustral churning and
mass movement
 acts as a temporary storage for undigested food
 rectum
 anus
 layers:
 mucosa
 innermost
 layered with mucous membrane
 epithelial cells
 adapted to secrete digestive juices
 stratified — providing extra protection against abrasion
 submucosa
 contains blood vessels, nerves, elastic fibres and
collagen
 controls the tract’s secretory activities
 sits in between the mucosa and the muscularis externa
 muscularis externa
 outermost layer of longitudinal smooth muscles
 inner sheet of circularly arranged muscles
 serosa
 part of the visceral peritoneum
 lines the wall of the abdominal cavity (parietal
peritoneum counterpart)
 the space in between them is called peritoneal cavity
and is filled with fluid
o accessory organs — support the function of the GI tract
 lips
 ingestion of food
 teeth
 canine helps in mechanically breaking down food
 tongue
 swallowing (voluntary propulsion)
 soft and hard palette
 salivary glands
 salivary amylase break down starch to disaccharides
 lingual lipase starts lipid digestion
 liver
 produces bile that helps in breaking down lipid by
emulsification
 bile increases the solubility of lipid droplets and
digestibility
 liver converts amino acids into glucose or fat
 gall bladder
 pancreas
 produce and secretes pancreatic juice that neutralises the chyme
 o sphincters
 regulate passage of food through the GI tract
 prevents acid reflux
 function:
o ingestion
o propulsion
 voluntary
 swallowing
 involuntary
 peristalsis
o digestion
 mechanical
 chewing
 chemical
 enzymes
o absorption
o secretion
o excretion (defaecation)
o storage

Hormones controlling digestion

 cholecystokinin (CKK)
o secreted from the wall of the duodenum
o regulates GI function like gall bladder contraction, bile flow, stomach motility
etc.
 secretin
o secreted in response to high lipid levels
o reduce gastric motility
 gastric inhibitory peptide
o secreted in response to high lipid levels
o inhibits gastric motility
 gastrin
o stimulates the production and secretion of gastric HCl

Immune System
Immune system
 Innate immunity
o present at birth
o nonspecific
o no memory
 o example:
 physical and chemical barriers of the body (1st line of defence)
 skin
 consists of many layers that provides physical barrier
against microbes outside the body
 cilia
 lines the upper respiratory tract
 traps debris and microbes from the air that’s inhaled
 pushes phlegm out
 lacrimal apparatus
 tears
 defaecation/vomiting
 expel microbes
 antimicrobial substances (2nd line of defence)
 natural killer cells
 attack body cells that are abnormal by binding to it and
releasing toxic substances that burst and self-destruct
the abnormal cells
 low pH in the stomach
 kills microbes that can cause diseases such as bacteria
and stomachache
 phagocytes
 attracted to infection sites due to chemicals secreted by
injured cells (chemotaxis)
 main types:
 neutrophils
 Macrophages
 interferons
 a group of proteins formed by a virally infected cell that
limit the spread of infection through inducing a state of
resistance in healthy cells
 fever
 inhibits growth of some pathogens
 promotes immune response
 inflammatory response
 vasodilation and increased permeability due to the
release of histamine allows easier migration of
phagocytes to the injured area
 Adaptive immune system — third line of defence
o refers to the antibody and cell-mediated immune response by lymphocytes:
 B-cells (lymphocytes matured in the bone marrow)
 produce antibodies that counterattack specific antigens
 some B-cells become memory B-cells, which remembers the
antigen the antibodies were made for
 T-cells (lymphocytes matured in the thymus)
 binds to a specific antigen
 destroys virus-infected cells by lysing it perforin

Key terms:
 immunity
o the body’s ability to resist or counteract an infection caused by pathogens
 lymphocyte proliferation
o lymphocytes develop, mature and stay dormant until activated
 vaccine
o a type of preventative medicine that helps the immune system by:
 exposing the body to the weakened version of a virus, stimulating an
immune response
 T-cells and B-cells destroy the weakened virus while the memory B-
cells memories the antigen the antibodies were made for
 in case the body is exposed to the virus (after vaccination), the immune
system knows exactly what to do to destroy it
 antigen
o foreign substance that triggers than immune response
 antibodies
o produced by B-cells in response to an immune response
o counteracts a specific antigen
 toxin
o harmful chemicals released by microorganisms
 pathogens
o microorganisms that causes an infection or harmful effects in the body
 infection to tissues can cause
o redness
o heat
o oedema or swelling
o pain
o pus and exudate
o shape, depth and odour
o loss of function
 dendritic cells
o acts as messengers between innate and the adaptive immune system
o present in tissues exposed to external environment
o process antigen
 monera
o a kingdom that contains unicellular organisms such as bacteria
 protista
o a kingdom of unicellular eukaryotes
 plantae
o a kingdom of multicellular organisms that produce food via photosynthesis
 fungi
o a group of simple plants that have no chlorophyll
 animalia
o the kingdom to which all animals, including humans, belong to