(Finals) Human Anatomy and Physiology Transes

HUMAN ANATOMY AND PHYSIOLOGY | Mr.
Ferdinand Catungal SEM
DIGESTIVE SYSTEM 01
[FINALS 1] THE DIGESTIVE SYSTEM AND BODY METABOLISM
INTRODUCTION
● Digestion
○ Breakdown of ingested food
○ Absorption of nutrients into the blood
● Metabolism
○ Production of cellular energy (ATP)
○ Constructive and degradative cellular
activities
ORGANS OF THE DIGESTIVE SYSTEM

● Two main groups
○ Alimentary canal – continuous coiled hollow
tube
○ Accessory digestive organs
MOUTH (ORAL CAVITY) ANATOMY

● Lips (labia) – protect the anterior opening
● Cheeks – form the lateral walls
● Hard palate – forms the anterior roof
● Soft palate – forms the posterior roof
● Uvula – fleshy projection of the soft palate
● Vestibule – space between lips externally and
teeth and gums internally
● Oral cavity – area contained by the teeth
● Tongue – attached at hyoid and styloid
processes of the skull, and by the lingual
frenulum
● Tonsils
○ Palatine tonsils
○ Lingual tonsil
ORGANS OF THE ALIMENTARY CANAL

● Mouth
● Pharynx
● Esophagus
● Stomach
● Small intestine
● Large intestine
● Anus
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FINALS 1: THE DIGESTIVE SYSTEM AND BODY METABOLISM
PROCESSES OF THE MOUTH ● Submucosa

● Mastication (chewing) of food ○ Just beneath the mucosa
● Mixing masticated food with saliva ○ Soft connective tissue with blood vessels,
● Initiation of swallowing by the tongue nerve endings, and lymphatics
● Allowing for the sense of taste ● Muscularis externa – smooth muscle
○ Inner circular layer
PHARYNX ANATOMY ○ Outer longitudinal layer
● Nasopharynx – not part of the digestive system ● Serosa
● Oropharynx – posterior to oral cavity ○ Outermost layer – visceral peritoneum
● Laryngopharynx – below the oropharynx and ○ Layer of serous fluid-producing cells
connected to the esophagus
PHARYNX FUNCTION
● Serves as a passageway for air and food
● Food is propelled to the esophagus by two
muscle layers
○ Longitudinal inner layer
○ Circular outer layer
● Food movement is by alternating contractions
of the muscle layers (peristalsis)
EPIGLOTTIS
ALIMENTARY CANAL NERVE PLEXUSES

● All are part of the autonomic nervous system
● Three separate networks of nerve fibers
○ Submucosal nerve plexus (Meissner’s
Plexus)
■ regulates the configuration of the luminal
surface, controls glandular secretions,
alters electrolyte and water transport,
and regulates local blood flow
■ Sparse in stomach, small and large
intestines
ESOPHAGUS ○ Myenteric nerve plexus (Auerbach's Plexus)
● Runs from pharynx to stomach through the ■ is the major nerve supply to the
diaphragm gastrointestinal tract and controls GI
● Conducts food by peristalsis tract motility
(slow rhythmic squeezing) ■ esophagus, stomach and small and
● Passageway for food only (respiratory system large intestine
branches off after the pharynx) ○ Subserosa nerve plexus
LAYERS OF ALIMENTARY CANAL ORGANS STOMACH ANATOMY

● Mucosa ● Located on the left side of the abdominal cavity
○ Innermost layer ● Food enters at the cardioesophageal sphincter
○ Moist membrane ● Regions of the stomach
■ Surface epithelium ○ Cardiac region
■ Small amount of connective tissue ○ Fundus
(lamina propria) ○ Body
■ Small smooth muscle layer ○ Pylorus
■ funnel-shaped terminal end
● Food empties into the small intestine at the
pyloric sphincter
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● Rugae – internal folds of the mucosa STOMACH FUNCTIONS

● External regions ● Acts as a storage tank for food
○ Lesser curvature ● Site of food breakdown
○ Greater curvature ● Chemical breakdown of protein begins
● Delivers chyme (processed food) to the small
intestine
● Absorption of alcohol and aspirin
SPECIALIZED MUCOSE OF THE STOMACH

● Simple columnar epithelium
○ Mucous neck cells – produce a sticky
alkaline mucus
○ Gastric glands – secrete gastric juice
○ Chief cells – produce protein-digesting
enzymes (pepsinogens)
○ Parietal cells – produce hydrochloric acid
○ Endocrine cells – produce gastrin
STRUCTURE OF STOMACH MUCOSA

● Gastric pits formed by folded mucosa
● Glands and specialized cells are in the gastric
● Layers of peritoneum attached to the stomach gland region
○ Lesser omentum attaches the liver to the
lesser curvature
○ Greater omentum attaches the greater
curvature to the posterior body wall
○ Contains fat to insulate, cushion, and
protect abdominal organs
HOMEOSTATIC IMBALANCE: PEPTIC ULCER

● Gastric Ulcer
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● Duodenal Ulcer SUBDIVISIONS OF THE SMALL INTESTINE

● Duodenum
○ Attached to the stomach
○ Curves around the head of the pancreas
● Jejunum
○ Attaches anteriorly to the duodenum
● Ileum
○ Extends from jejunum to large intestine
CHEMICAL DIGESTION IN THE SMALL INTESTINE

● Source of enzymes that are mixed with chyme
○ Intestinal cells
○ Pancreas
● Bile enters from the gall bladder
○ What is the function of bile?
● Esophageal Ulcer
VILLI OF THE SMALL INTESTINE

● Fingerlike structures formed by the mucosa
● Give the small intestine more surface area
SMALL INTESTINE
● The body’s major digestive organ MICROVILLI OF THE SMALL INTESTINE
● Site of nutrient absorption into the blood
● Small projections of the plasma membrane
○ proteins within the cell membrane act as
● Found on absorptive cells
“pumps,” using cellular energy (ATP) to
move the substance
○ water-soluble nutrients, lipid-soluble
nutrients can diffuse (facilitated
diffusion/co-transport)
○ absorption of most nutrients through the
mucosa of the intestinal villi requires active
transport fueled by ATP
● Muscular tube extending form the pyloric
sphincter to the ileocecal valve
● Suspended from the posterior abdominal wall
by the mesentery
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STRUCTURES INVOLVED IN ABSORPTION OF STRUCTURES OF THE LARGE INTESTINE

NUTRIENTS ● Cecum – saclike first part of the large intestine
● Absorptive cells ● Appendix
● Blood capillaries ○ Accumulation of lymphatic tissue that
● Lacteals (specialized lymphatic capillaries) sometimes becomes inflamed (appendicitis)
■ Do you give analgesics for pain?
○ Hangs from the cecum
● Colon
○ Ascending
○ Transverse
○ Descending
○ S-shaped sigmoidal
● Rectum
● Anus – external body opening
● Includes optic disc, macula lutea & fovea
FOLDS OF THE SMALL INTESTINE centralis
● Called circular folds or plicae circulares
● Deep folds of the mucosa and submucosa MODIFICATIONS TO THE MUSCULARIS EXTERNA IN
● Do not disappear when filled with food THE LARGE INTESTINE
● The submucosa has Peyer’s patches ● Smooth muscle is reduced to three bands
(collections of lymphatic tissue) (teniae coli)
○ Fxn: monitoring intestinal bacteria ● Muscle bands have some degree of tone
populations and preventing the growth of ● Walls are formed into pocketlike sacs called
pathogenic bacteria in the intestines haustra
LARGE INTESTINE ACCESSORY DIGESTIVE ORGANS

● Larger in diameter, but shorter than the small ● Salivary glands
intestine ● Teeth
● Frames the internal abdomen ● Pancreas
● Liver
● Gallbladder
SALIVARY GLANDS
● Saliva-producing glands
○ Parotid glands – located anterior to ears
○ Submandibular glands
○ Sublingual glands
FUNCTIONS OF THE LARGE INTESTINE

● Absorption of water
● Eliminates indigestible food from the body as
SALIVA
feces
● Does not participate in digestion of food ● Mixture of mucus and serous fluids
● Goblet cells produce mucus to act as a ● Helps to form a food bolus
lubricant ● Contains salivary amylase to begin starch
digestion
● Dissolves chemicals so they can be tasted
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TEETH PANCREAS
● The role is to masticate (chew) food ● Produces a wide spectrum of digestive
● Humans have two sets of teeth enzymes that break down all categories of food
○ Deciduous (baby or milk) teeth ● Enzymes are secreted into the duodenum
○ 20 teeth are fully formed by age two ● Alkaline fluid introduced with enzymes
● Permanent teeth neutralizes acidic chyme
○ Replace deciduous teeth beginning
between the ages of 6 to 12
○ A full set is 32 teeth, but some people do
not have wisdom teeth
CLASSIFICATION OF TEETH
● Incisors
● Canines
● Premolars
● Molars
PANCREAS: EXOCRINE FUNCTION

● Enzymes:
○ trypsin and chymotrypsin digest proteins
○ amylase digestion of carbohydrates
○ lipase break down fats
○ released pancreatic duct
○ joins the common bile duct to form the
ampulla of Vater which is located at the first
portion of the small intestine, called the
duodenum
○ pancreatic juices and bile digest fats,
carbohydrates, and proteins.
PANCREAS: ENDOCRINE FUNCTION (DUCTLESS)

● islet cells (islets of Langerhans)
○ create and release important hormones
REGIONS OF A TOOTH directly into the bloodstream
● Crown – exposed ○ glucagon, which acts to raise blood sugar
part ○ insulin, which acts to lower blood sugar
○ Outer enamel
○ Dentin
○ Pulp cavity
● Neck
○ Region in
contact with the
gum
○ Connects crown
to root
● Root
○ Periodontal membrane attached to the bone
○ Root canal carrying blood vessels and
nerves
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HOMEOSTATIC IMBALANCE ● Kupffer cells

● Pancreatitis is inflammation of the pancreas ○ Kupffer cells are phagocytes
that occurs when pancreatic enzyme secretions ○ Removes aged red blood cells from
build up and begin to digest the organ itself. It circulation
can occur as acute painful attacks lasting a ○ removing blood-borne microbes or
matter of days, or it may be a chronic condition endotoxins absorbed from the
that progresses over a period of years. gastrointestinal tract
● Diabetes Type I (IDDM) ● Oval cells
● Diabetes Type II (NIDDM) ○ differentiate into several different cell
● Gestational Diabetes Mellitus ○ role in the repopulation of hepatocytes and
● Diabetes Insipidus other hepatic cells (e.g. biliary epithelium)
following hepatic injury
LIVER ● Pit cells
● Largest gland in the body ○ short-lived granular lymphocytes that reside
● Located on the right side of the body under the within hepatic sinusoids and contribute to
diaphragm immunity.
● Consists of four lobes suspended from the
diaphragm and abdominal wall by the falciform REGULATION OF BILIRUBIN
ligament
● Connected to the gall bladder via the common
hepatic duct
● Main organ of metabolism
ANATOMY OF THE LIVER
CELLS OF THE LIVER HOMEOSTATIC IMBALANCE: JAUNDICE

● Hepatocytes ● Jaundice
○ The liver parenchyma is primarily comprised ● Physiologic Jaundice
of hepatocytes ● Pathologic Jaundice
○ contain many mitochondria, extensive
smooth and rough endoplasmic reticulum BILE
and Golgi apparatus ● Produced by cells in the liver
● Ito cells ● Composition
○ fat storing cells, or lipocytes ○ Bile salts
○ storage and maintenance of vitamin A ○ Bile pigment (mostly bilirubin from the
(retinol) breakdown of hemoglobin)
○ production of extracellular matrix (collagen ○ Cholesterol
types I and III) ○ Phospholipids
○ regulation of sinusoidal blood flow ○ Electrolytes
○ hepatic tissue repair following injury
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GALLBLADDER ● Mechanical digestion

● Sac found in hollow fossa of liver ○ Mixing of food in the mouth by the tongue
● Stores bile from the liver by way of the cystic ○ Churning of food in the stomach
duct ○ Segmentation in the small intestine
● Bile is introduced into the duodenum in the ● Chemical Digestion
presence of fatty food ○ Enzymes break down food molecules into
● Gallstones can cause blockages their building blocks
○ Each major food group uses different
enzymes
■ Carbohydrates are broken to simple
sugars
■ Proteins are broken to amino acids
■ Fats are broken to fatty acids and
alcohols
● Absorption
○ End products of digestion are absorbed in
the blood or lymph
○ Food must enter mucosal cells and then into
blood or lymph capillaries
● Defecation
○ Elimination of indigestible substances as
feces
PROCESSES OF THE DIGESTIVE SYSTEM

● Ingestion – getting food into the mouth
● Propulsion – moving foods from one region of
the digestive system to another
● Peristalsis – alternating waves of contraction
● Segmentation – moving materials back and
forth to aid in mixing
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CONTROL OF DIGESTIVE ACTIVITY FOOD BREAKDOWN IN THE STOMACH

● Mostly controlled by reflexes via the ● Gastric juice is regulated by neural and
parasympathetic division hormonal factors
● Chemical and mechanical receptors are located ● Presence of food or falling pH causes the
in organ walls that trigger reflexes release of gastrin
● Stimuli include: ● Gastrin causes stomach glands to produce
○ Stretch of the organ protein-digesting enzymes
○ pH of the contents ● Hydrocholoric acid makes the stomach contents
○ Presence of breakdown products very acidic
● Reflexes include:
○ Activation or inhibition of glandular NECESSITY OF AN EXTREMELY ACID
secretions ENVIRONMENT IN THE STOMACH
○ Smooth muscle activity ● Activates pepsinogen to pepsin for protein
digestion
DISGESTIVE ACTIVITIES OF THE MOUTH ● Provides a hostile environment for
● Mechanical breakdown microorganisms
○ Food is physically broken down by chewing
● Chemical digestion DIGESTION AND ABSORPTION IN THE STOMACH
○ Food is mixed with saliva ● Protein digestion enzymes
○ Breaking of starch into maltose by salivary ○ Pepsin – an active protein digesting enzyme
amylase ○ Rennin – works on digesting milk protein
● The only absorption that occurs in the stomach
ACTIVITIES OF THE PHARYNX AND ESOPHAGUS is of alcohol and aspirin
● These organs have no digestive function
● Serve as passageways to the stomach PROPULSION IN THE STOMACH
● Food must first be well mixed
DEGLUTITION (SWALLOWING) ● Rippling peristalsis occurs in the lower stomach
● Buccal phase ● The pylorus meters out chyme into the small
○ Voluntary intestine (30 ml at a time)
○ Occurs in the mouth ● The stomach empties in four to six hours
○ Food is formed into a bolus
○ The bolus is forced into the pharynx by the
tongue
● Pharyngeal-esophageal phase
○ Involuntary transport of the bolus
○ All passageways except to the stomach are
blocked
■ Tongue blocks off the mouth DIGESTION IN THE SMALL INTESTINE
■ Soft palate (uvula) blocks the
● Enzymes from the brush border
nasopharynx
○ Break double sugars into simple sugars
■ Epiglottis blocks the larynx
○ Complete some protein digestion
● Pharyngeal-esophogeal phase (continued)
● Pancreatic enzymes play the major digestive
○ Peristalsis moves the bolus toward the
function
stomach
○ Help complete digestion of starch
○ The cardioesophageal sphincter is opened
(pancreatic amylase)
when food presses against it
○ Carry out about half of all protein digestion
(trypsin, etc.)
● Pancreatic enzymes play the major digestive
function (continued)
○ Responsible for fat digestion (lipase)
○ Digest nucleic acids (nucleases)
○ Alkaline content neutralizes acidic chyme
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STIMULATION OF THE RELEASE OF PANCREATIC HOMEOSTASIS: UPPER AND LOWER GI BLEEDING

JUICE ● Endoscopy
● Vagus nerve ○ Esophagogastroduodenoscopy (EGD)
● Local hormones ○ Colonoscopy and Sigmoidoscopy
○ Secretin ● Bleeding from GIT may be
○ Cholecystokinin ○ UPPER GIT BLEEDING:
■ Above the ligament of treitz i.e. the
duodenojejunal junction — hematemesis
or melena
○ LOWER GIT BLEEDING
■ Below ligament of Treitz leading to
melena and hematochezia but no
hematemesis
BOUNDARY OF UPPER AND LOWER GI BLEEDING
ABSORPTION IN THE SMALL INTESTINE

● Water is absorbed along the length of the small
intestine
● End products of digestion
○ Most substances are absorbed by active
transport through cell membranes
○ Lipids are absorbed by diffusion
● Substances are transported to the liver by the
hepatic portal vein or lymph
UPPER AND LOWER GI BLEEDING
PROPULSION IN THE SMALL INTESTINE
● Melena
● Peristalsis is the major means of moving food ○ dark sticky feces containing partly digested
● Segmental movements blood.
○ Mix chyme with digestive juices
○ Aid in propelling food
FOOD BREAKDOWN AND ABSORPTION IN THE

LARGE INTESTINE
● No digestive enzymes are produced
● Resident bacteria digest remaining nutrients
○ Produce some vitamin K and B
○ Release gases
● Water and vitamins K and B are absorbed
● Remaining materials are eliminated via feces
● Hematochezia
PROPULSION IN THE LARGE INTESTINE ○ fresh, red blood in your stool
● Sluggish peristalsis
● Mass movements
○ Slow, powerful movements
○ Occur three to four times per day
● Presence of feces in the rectum causes a
defecation reflex
○ Internal anal sphincter is relaxed
○ Defecation occurs with relaxation of the
voluntary (external) anal sphincter
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NUTRITION CELLULAR RESPIRATION

● Nutrient – substance used by the body for ● Oxygen-using events take place within the cell
growth, maintenance, and repair to create ATP from ADP
● Categories of nutrients ● Carbon leaves cells as carbon dioxide (CO2)
○ Carbohydrates ● Hydrogen atoms are combined with oxygen to
○ Lipids form water
○ Proteins ● Energy produced by these reactions adds a
○ Vitamins phosphorus to ADP to produce ATP
○ Mineral ● ATP can be broken down to release energy for
○ Water cellular use
DIETARY SOURCES OF MAJOR NUTRIENTS

● Carbohydrates
○ Most are derived from plants
○ Exceptions: lactose from milk and small
amounts of glycogens from meats
● Lipids
○ Saturated fats from animal products
○ Unsaturated fats from nuts, seeds, and
vegetable oils
○ Cholesterol from egg yolk, meats, and milk
products
● Proteins
○ Complete proteins – contain all essential
amino acids
■ Most are from animal products
○ Legumes and beans also have proteins, but
are incomplete
● Vitamins
○ Most vitamins are used as cofactors and act
with enzymes
○ Found in all major food groups
● Minerals
○ Play many roles in the body
○ Most mineral-rich foods are vegetables,
legumes, milk, and some meats
METABOLISM
● Chemical reactions necessary to maintain life
○ Catabolism – substances are broken down
to simpler substances
○ Anabolism – larger molecules are built from
smaller ones
○ Energy is released during catabolism
CARBOHYDRATE METABOLISM
● The body’s preferred source to produce cellular
energy (ATP)
● Glucose (blood sugar) is the major breakdown
product and fuel to make ATP
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HUMAN ANATOMY AND PHYSIOLOGY | Mr. Ferdinand Catungal SEM
URINARY SYSTEM 01
[FINALS 2] URINARY SYSTEM
FUNCTIONS OF THE URINARY SYSTEM

● Elimination of waste products
○ Nitrogenous wastes
○ Toxins
○ Drugs
● Regulate aspects of homeostasis
○ Water balance
○ Electrolytes
○ Acid-base balance in the blood
○ Blood pressure
○ Red blood cell production KIDNEY STRUCTURES
○ Activation of vitamin D ● Medullary pyramids – triangular regions of
tissue in the medulla
ORGANS OF THE URINARY SYSTEM ● Renal columns – extensions of cortex-like
● Kidneys material inward
● Ureters ● Calyces – cup-shaped structures that funnel
● Urinary bladder urine towards the renal pelvis
● Urethra
BLOOD FLOW IN THE KIDNEYS
NEPHRONS
● The structural and functional units of the
LOCATION OF THE KIDNEYS
kidneys
● Against the dorsal body wall ● Responsible for forming urine
● At the level of T12 to L3 ● Main structures of the nephrons
● The right kidney is slightly lower than the left ○ Glomerulus
● Attached to ureters, renal blood vessels, and ○ Renal tubule
nerves at renal hilus
● Atop each kidney is an adrenal gland GLOMERULUS
● A specialized
COVERINGS OF THE KIDNEYS
capillary bed
● Renal capsule ● Attached to arterioles
○ Surrounds each kidney on both sides
● Adipose capsule (maintains
○ Surrounds the kidney high pressure)
○ Provides protection to the kidney ● Large afferent
○ Helps keep the kidney in its correct location arteriole
● Narrow efferent
REGIONS OF THE KIDNEY arteriole
● Renal cortex – outer region ● Capillaries are
● Renal medulla – inside the cortex covered with podocytes from the renal tubule
● Renal pelvis – inner collecting tube ● The glomerulus sits within a glomerular capsule
(the first part of the renal tubule)
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FINALS 2: URINARY SYSTEM
RENAL TUBULE URINE FORMATION PROCESSES

● Glomerular (Bowman’s) capsule ● Filtration
● Proximal convoluted tubule ● Reabsorption
● Loop of Henle ● Secretion
● Distal convoluted tubule
FILTRATION
● Nonselective passive process
● Water and solutes smaller than proteins are
forced through capillary walls
● Blood cells cannot pass out to the capillaries
● Filtrate is collected in the glomerular capsule
and leaves via the renal tubule
REABSORPTION
TYPES OF NEPHRONS ● The peritubular capillaries reabsorb several
● Cortical nephrons materials
○ Located entirely in the cortex ○ Some water
○ Includes most nephrons ○ Glucose
● Juxtamedullary nephrons ○ Amino acids
○ Found at the boundary of the cortex and ○ Ions
medulla ● Some reabsorption is passive, most is active
● Most reabsorption occurs in the proximal
convoluted tubule
MATERIALS NOT REABSORBED

● Nitrogenous waste products
○ Urea
○ Uric acid
○ Creatinine
● Excess water
PERITUBULAR CAPILLARIES SECRETION — REABSORPTION IN REVERSE

● Arise from efferent arteriole of the glomerulus ● Some materials move from the peritubular
● Normal, low pressure capillaries capillaries into the renal tubules
● Attached to a venule ○ Hydrogen and potassium ions
● Cling close to the renal tubule ○ Creatinine
● Reabsorb (reclaim) some substances from ● Materials left in the renal tubule move toward
collecting tubes the ureter
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FORMATION OF URINE URINARY BLADDER WALL

● Three layers of smooth muscle (detrusor
muscle)
● Mucosa made of transitional epithelium
● Walls are thick and folded in an empty bladder
● Bladder can expand significantly without
increasing internal pressure
URETHRA
● Thin-walled tube that carries urine from the
bladder to the outside of the body by peristalsis
● Release of urine is controlled by two sphincters
○ Internal urethral sphincter (involuntary)
○ External urethral sphincter (voluntary)
CHARACTERISTICS OF URINE USED FOR MEDICAL
DIAGNOSIS URETHRA GENDER DIFFERENCES
● Colored somewhat yellow due to the pigment ● Length
urochrome (from the destruction of hemoglobin) ○ Females – 3–4 cm (1 inch)
and solutes ○ Males – 20 cm (8 inches)
● Sterile ● Location
● Slightly aromatic ○ Females – along wall of the vagina
● Normal pH of around 6 ○ Males – through the prostate and penis
● Specific gravity of 1.001 to 1.035 ● Function
○ Females – only carries urine
URETERS ○ Males – carries urine and is a passageway
● Slender tubes attaching the kidney to the for sperm cells
bladder
MICTURITION (VOIDING)
○ Continuous with the renal pelvis
○ Enter the posterior aspect of the bladder ● Both sphincter muscles must open to allow
● Runs behind the peritoneum voiding
● Peristalsis aids gravity in urine transport ○ The internal urethral sphincter is relaxed
after stretching of the bladder
URINARY BLADDER ○ Activation is from an impulse sent to the
● Smooth, collapsible, muscular sac spinal cord and then back via the pelvic
● Temporarily stores urine splanchnic nerves
● Trigone – three openings ○ The external urethral sphincter must be
○ Two from the ureters voluntarily relaxed
○ One to the urethrea
MAINTAINING WATER BALANCE
● Normal amount of water in the human body
○ Young adult females – 50%
○ Young adult males – 60%
○ Babies – 75%
○ Old age – 45%
● Water is necessary for many body functions
and levels must be maintained
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DISTRIBUTION OF BODY FLUID MAINTAINING WATER AND ELECTROLYTE

● Intracellular fluid (inside cells) BALANCE
● Extracellular fluid (outside cells)
○ Interstitial fluid
○ Blood plasma
MAINTAINING ACID-BASE BALANCE IN BLOOD

● Blood pH must remain between 7.35 and 7.45
THE LINK BETWEEN WATER AND SALT to maintain homeostasis
● Changes in electrolyte balance causes water to ○ Alkalosis – pH above 7.45
move from one compartment to another ○ Acidosis – pH below 7.35
○ Alters blood volume and blood pressure ● Most ions originate as byproducts of cellular
○ Can impair the activity of cells metabolism
● Most acid-base balance is maintained by the
MAINTAINING WATER BALANCE kidneys
● Other acid-base controlling systems
● Water intake must equal water output
○ Blood buffers
● Sources for water intake
○ Respiration
○ Ingested foods and fluids
○ Water produced from metabolic processes
BLOOD BUFFERS
● Sources for water output
○ Vaporization out of the lungs ● Molecules react to prevent dramatic changes in
○ Lost in perspiration hydrogen ion (H+) concentrations
○ Leaves the body in the feces ○ Bind to H+ when pH drops
○ Urine production ○ Release H+ when pH rises
● Dilute urine is produced if water intake is ● Three major chemical buffer systems
excessive ○ Bicarbonate buffer system
● Less urine (concentrated) is produced if large ○ Phosphate buffer system
amounts of water are lost ○ Protein buffer system
● Proper concentrations of various electrolytes
THE BICARBONATE BUFFER SYSTEM
must be present
● Mixture of carbonic acid (H2CO3) and sodium
REGULATION OF WATER AND ELECTROLYTE bicarbonate (NaHCO3)
REABSORPTION ● Bicarbonate ions (HCO3–) react with strong
● Regulation is primarily by hormones acids to change them to weak acids
○ Antidiuretic hormone (ADH) prevents ● Carbonic acid dissociates in the presence of a
excessive water loss in urine strong base to form a weak base and water
○ Aldosterone regulates sodium ion content of
extracellular fluid
■ Triggered by the rennin-angiotensin
mechanism
● Cells in the kidneys and hypothalamus are
active monitors
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RESPIRATORY SYSTEM CONTROLS OF ACID-BASE

BALANCE
● Carbon dioxide in the blood is converted to
bicarbonate ion and transported in the plasma
● Increases in hydrogen ion concentration
produces more carbonic acid
● Excess hydrogen ion can be blown off with the
release of carbon dioxide from the lungs
● Respiratory rate can rise and fall depending on
changing blood pH
RENAL MECHANISMS OF ACID-BASE BALANCE

● Excrete bicarbonate ions if needed
● Conserve or generate new bicarbonate ions if
needed
● Urine pH varies from 4.5 to 8.0
DEVELOPMENTAL ASPECTS OF THE URINARY

SYSTEM
● Functional kidneys are developed by the third
month
● Urinary system of a newborn
○ Bladder is small
○ Urine cannot be concentrated
● Control of the voluntary urethral sphincter does
not start until age 18 months
● Urinary infections are the only common
problems before old age
AGING AND THE URINARY SYSTEM

● There is a progressive decline in urinary
function
● The bladder shrinks with aging
● Urinary retention is common in males
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RESPIRATORY SYSTEM 01
[FINALS 3] THE RESPIRATORY SYSTEM
ORGANS OF THE RESPIRATORY SYSTEM ● Lateral walls have projections called conchae
● Nose ○ Increases surface area
● Pharynx ○ Increases air turbulence within the nasal
● Larynx cavity
● Trachea ● The nasal cavity is separated from the oral
● Bronchi cavity by the palate
● Lungs – alveoli ○ Anterior hard palate (bone)
○ Posterior soft palate (muscle)
PARANASAL SINUSES
● Cavities within bones surrounding the nasal
cavity
○ Frontal bone
FUNCTIONS OF THE RESPIRATORY SYSTEM ○ Sphenoid bone
● Oversees gas exchanges between the blood ○ Ethmoid bone
and external environment ○ Maxillary bone
● Exchange of gasses takes place within the ● Function of the sinuses
lungs in the alveoli ○ Lighten the skull
● Passageways to the lungs purify, warm, and ○ Act as resonance chambers for speech
humidify the incoming air ○ Produce mucus that drains into the nasal
cavity
THE NOSE
● The only externally visible part of the respiratory PHARYNX (THROAT)
system ● Muscular passage from nasal cavity to larynx
● Air enters the nose through the external nares ● Three regions of the pharynx
(nostrils) ○ Nasopharynx – superior region behind nasal
● The interior of the nose consists of a nasal cavity
cavity divided by a nasal septum ○ Oropharynx – middle region behind mouth
○ Laryngopharynx – inferior region attached to
UPPER RESPIRATORY TRACT larynx
● The oropharynx and laryngopharynx are
common passageways for air and food
STRUCTURES OF THE PHARYNX

● Auditory tubes enter the nasopharynx
● Tonsils of the pharynx
○ Pharyngeal tonsil (adenoids) in the
nasopharynx
○ Palatine tonsils in the oropharynx
○ Lingual tonsils at the base of the tongue
LARYNX (VOICE BOX)

ANATOMY OF THE NASAL CAVITY ● Routes air and food into proper channels
● Olfactory receptors are located in the mucosa ● Plays a role in speech
on the superior surface ● Made of eight rigid hyaline cartilages and a
● The rest of the cavity is lined with respiratory spoon-shaped flap of elastic cartilage
mucosa (epiglottis)
○ Moistens air
○ Traps incoming foreign particles
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FINALS 3: THE RESPIRATORY SYSTEM
STRUCTURES OF THE LARYNX

● Thyroid cartilage
○ Largest hyaline cartilage
○ Protrudes anteriorly (Adam’s apple)
● Epiglottis
○ Superior opening of the larynx
○ Routes food to the larynx and air toward the
trachea
● Vocal cords (vocal folds)
○ Vibrate with expelled air to create sound
(speech) COVERINGS OF THE LUNGS
● Glottis – opening between vocal cords ● Pulmonary (visceral) pleura covers the lung
surface
TRACHEA (WINDPIPE) ● Parietal pleura lines the walls of the thoracic
● Runs from pharynx to stomach through the cavity
diaphragm ● Pleural fluid fills the area between layers of
● Conducts food by peristalsis pleura to allow gliding
(slow rhythmic squeezing)
● Passageway for food only (respiratory system RESPIRATORY TREE DIVISION
branches off after the pharynx) ● Primary bronchi
● Secondary bronchi
LAYERS OF ALIMENTARY CANAL ORGANS ● Tertiary bronchi
● Connects larynx with bronchi ● Bronchioli
● Lined with ciliated mucosa ● Terminal bronchioli
○ Beat continuously in the opposite direction
of incoming air BRONCHIOLES
○ Expel mucus loaded with dust and other ● Smallest branches of the bronchi
debris away from lungs ● All but the smallest branches have reinforcing
● Walls are reinforced with C-shaped hyaline cartilage
cartilage ● Terminal bronchioles end in alveoli
PRIMARY BRONCHI
● Formed by division of the trachea
● Enters the lung at the hilus
(medial depression)
● Right bronchus is wider, shorter,
and straighter than left
● Bronchi subdivide into smaller
and smaller branches
RESPIRATORY ZONE
LUNGS
● Structures
● Occupy most of the thoracic cavity ○ Respiratory bronchioli
○ Apex is near the clavicle (superior portion)
○ Alveolar duct
■ Base rests on the diaphragm (inferior
○ Alveoli
portion) ● Site of gas exchange
○ Each lung is divided into lobes by fissures
■ Left lung – two lobes ALVEOLI
■ Right lung – three lobes
● Structure of alveoli
○ Alveolar duct
○ Alveolar sac
○ Alveolus
● Gas exchange takes place within the alveoli in
the respiratory membrane
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RESPIRATORY MEMBRANE (AIR-BLOOD BARRIER)

● Thin squamous epithelial layer lining alveolar
walls
● Pulmonary capillaries cover external surfaces of
alveoli
EXPIRATION
● Largely a passive process which depends on
natural lung elasticity
● As muscles relax, air is pushed out of the lungs
GAS EXCHANGE ● Forced expiration can occur mostly by
contracting internal intercostal muscles to
● Gas crosses the respiratory membrane by
depress the rib cage
diffusion
○ Oxygen enters the blood
○ Carbon dioxide enters the alveoli
● Macrophages add protection
● Surfactant coats gas-exposed alveolar surfaces
EVENTS OF RESPIRATION
● Pulmonary ventilation – moving air in and out of
the lungs
● External respiration – gas exchange between
pulmonary blood and alveoli
● Respiratory gas transport – transport of oxygen
and carbon dioxide via the bloodstream PRESSURE DIFFERENCES IN THE THORACIC
● Internal respiration – gas exchange between CAVITY
blood and tissue cells in systemic capillaries ● Normal pressure within the pleural space is
always negative (intrapleural pressure)
MECHANICS OF BREATHING (PULMONARY ● Differences in lung and pleural space pressures
VENTILATION) keep lungs from collapsing
● Completely mechanical process
● Depends on volume changes in the thoracic NONRESPIRATORY AIR MOVEMENTS
cavity ● Can be caused by reflexes or voluntary actions
● Volume changes lead to pressure changes, ● Examples
which lead to the flow of gases to equalize ○ Cough and sneeze – clears lungs of debris
pressure ○ Laughing
● Two phases ○ Crying
○ Inspiration – flow of air into lung ○ Yawn
○ Expiration – air leaving lung ○ Hiccup
INSPIRATION RESPIRATORY VOLUMES AND CAPACITIES

● Diaphragm and intercostal muscles contract ● Normal breathing moves about 500 ml of air
● The size of the thoracic cavity increases with each breath (tidal volume [TV])
● External air is pulled into the lungs due to an
increase in intrapulmonary volume
●
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● Many factors that affect respiratory capacity EXTERNAL RESPIRATION

○ A person’s size ● Oxygen movement into the blood
○ Sex ○ The alveoli always has more oxygen than
○ Age the blood
○ Physical condition ○ Oxygen moves by diffusion towards the
● Residual volume of air – after exhalation, about area of lower concentration
1200 ml of air remains in the lungs ○ Pulmonary capillary blood gains oxygen
● Inspiratory reserve volume (IRV) ● Carbon dioxide movement out of the blood
○ Amount of air that can be taken in forcibly ○ Blood returning from tissues has higher
over the tidal volume concentrations of carbon dioxide than air in
○ Usually between 2100 and 3200 ml the alveoli
● Expiratory reserve volume (ERV) ○ Pulmonary capillary blood gives up carbon
○ Amount of air that can be forcibly exhaled dioxide
○ Approximately 1200 ml ● Blood leaving the lungs is oxygen-rich and
● Residual volume carbon dioxide-poor
○ Air remaining in lung after expiration
○ About 1200 ml GAS TRANSPORT IN THE BLOOD
● Vital capacity ● Oxygen transport in the blood
○ The total amount of exchangeable air ○ Inside red blood cells attached to
○ Vital capacity = TV + IRV + ERV hemoglobin (oxyhemoglobin [HbO2])
○ Dead space volume ○ A small amount is carried dissolved in the
■ Air that remains in conducting zone and plasma
never reaches alveoli ● Carbon dioxide transport in the blood
■ About 150 ml ○ Most is transported in the plasma as
● Functional volume bicarbonate ion (HCO3–)
○ Air that actually reaches the respiratory ○ A small amount is carried inside red blood
zone cells on hemoglobin, but at different binding
○ Usually about 350 ml sites than those of oxygen
● Respiratory capacities are measured with a
spirometer INTERNAL RESPIRATION
● Respiratory Capacities ● Exchange of gases between blood and body
cells
● An opposite reaction to what occurs in the lungs
○ Carbon dioxide diffuses out of tissue to
blood
○ Oxygen diffuses from blood into tissue
RESPIRATORY SOUNDS
● Sounds are monitored with a stethoscope
● Bronchial sounds – produced by air rushing
through trachea and bronchi
● Vesicular breathing sounds – soft sounds of air
filling alveoli
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EXTERNAL RESPIRATION, GAS TRANSPORT, AND FACTORS INFLUENCING RESPIRATORY RATE AND
INTERNAL RESPIRATION SUMMARY DEPTH
● Physical factors
○ Increased body temperature
○ Exercise
○ Talking
○ Coughing
● Volition (conscious control)
● Emotional factors
● Chemical factors
○ Carbon dioxide levels
■ Level of carbon dioxide in the blood is
the main regulatory chemical for
respiration
■ Increased carbon dioxide increases
respiration
■ Changes in carbon dioxide act directly
on the medulla oblongata
○ Oxygen levels
■ Changes in oxygen concentration in the
blood are detected by chemoreceptors
NEURAL REGULATION OF RESPIRATION in the aorta and carotid artery
● Activity of respiratory muscles is transmitted to ■ Information is sent to the medulla
the brain by the phrenic and intercostal nerves oblongata
● Neural centers that control rate and depth are
located in the medulla RESPIRATORY DISORDERS: CHRONIC
● The pons appears to smooth out respiratory OBSTRUCTIVE PULMONARY DISEASE
rate ● Exemplified by chronic bronchitis and
● Normal respiratory rate (eupnea) is 12–15 emphysema
respirations per minute ● Major causes of death and disability in the
● Hypernia is increased respiratory rate often due United States
to extra oxygen needs ● Features of these diseases
○ Patients almost always have a history of
smoking
○ Labored breathing (dyspnea) becomes
progressively more severe
○ Coughing and frequent pulmonary infections
are common
○ Most victimes retain carbon dioxide, are
hypoxic and have respiratory acidosis
○ Those infected will ultimately develop
respiratory failure
EMPHYSEMA
● Alveoli enlarge as adjacent chambers break
through
● Chronic inflammation promotes lung fibrosis
● Airways collapse during expiration
● Patients use a large amount of energy to exhale
● Overinflation of the lungs leads to a
permanently expanded barrel chest
● Cyanosis appears late in the disease
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CHRONIC BRONCHITIS DEVELOPMENTAL ASPECTS OF THE RESPIRATORY

● Mucosa of the lower respiratory passages SYSTEM
becomes severely inflamed ● Lungs are filled with fluid in the fetus
● Mucus production increases ● Lungs are not fully inflated with air until two
● Pooled mucus impairs ventilation and gas weeks after birth
exchange ● Surfactant that lowers alveolar surface tension
● Risk of lung infection increases is not present until late in fetal development and
● Pneumonia is common may not be present in premature babies
● Hypoxia and cyanosis occur early ● Important birth defects
○ Cystic fibrosis – oversecretion of thick
mucus clogs the respiratory system
○ Cleft palate
AGING EFFECTS
● Elasticity of lungs decreases
● Vital capacity decreases
● Blood oxygen levels decrease
● Stimulating effects of carbon dioxide decreases
● More risks of respiratory tract infection
RESPIRATORY RATE CHANGES THROUGHOUT LIFE

● Newborns – 40 to 80 respirations per minute
● Infants – 30 respirations per minute
● Age 5 – 25 respirations per minute
● Adults – 12 to 18 respirations per minute
● Rate often increases somewhat with old age
LUNG CANCER
● Accounts for 1/3 of all cancer deaths in the
United States
● Increased incidence associated with smoking
● Three common types
○ Squamous cell carcinoma
○ Adenocarcinoma
○ Small cell carcinoma
SUDDEN INFANT DEATH SYNDROME

● Apparently healthy infant stops breathing and
dies during sleep
● Some cases are thought to be a problem of the
neural respiratory control center
● One third of cases appear to be due to heart
rhythm abnormalities
ASTHMA
● Chronic inflamed hypersensitive bronchiole
passages
● Response to irritants with dyspnea, coughing,
and wheezing
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LYMPHATIC SYSTEM 01
[FINALS 4] THE LYMPHATIC SYSTEM AND BODY DEFENSES
THE LYMPHATIC SYSTEM
Special structural features of lymphatic capillaries. (a) Structural

relationship between blood capillaries and lymph capillaries. Black
arrows indicate direction of fluid movement. (b) Lymph capillaries begin
as blind-ended tubes. The endothelial cells forming their walls overlap
one another, forming flaplike minivalves
● Lymphatic collecting vessels
○ Collects lymph from lymph capillaries
○ Carries lymph to and away from lymph
● Consists of two semi-independent parts
nodes
○ Lymphatic vessels
○ Returns fluid to circulatory veins near the
○ Lymphoid tissues and organs
heart
● Lymphatic system functions
■ Right lymphatic duct
○ Transport fluids back to the blood
■ Thoracic duct
○ Play essential roles in body defense and
resistance to disease
LYMPHATIC CHARACTERISTICS
● Lymph – excess tissue fluid carried by
lymphatic vessels
● Properties of lymphatic vessels
○ One way system toward the heart
○ No pump
○ Lymph moves toward the heart
■ Milking action of skeletal muscle
■ Rhythmic contraction of smooth muscle
in vessel walls
The function of the lymphatic vessels is to form an elaborate drainage
system that picks up this excess interstitial fluid, now called lymph
Lymph- clear water. – similar to plasma coz it resembles like plasma
but with much lower conc of suspended proteins.
no basement membrane so allow fluids and solute to flow into the
lymphatic capillary . Includes also entry of bacteria and viruses from Lymph is transported from the lymph capillaries through successively
lymphatic capillary (smallest) lymph fluid will flow larger vessels. larger lymphatic vessels, referred to as lymphatic collecting vessels,
Pressure is low inside vessel, so valves are essential to maintain until it is finally returned to the venous system through one of the two
normal lymph flow, large ducts in the thoracic region.
Diagram: Relationship of lymphatic vessels to blood vessels. Beginning
at the bottom of this figure, we see that lymph, which begins as tissue
LYMPHATIC VESSELS
fluid derived from blood capillaries, enters the lymph capillaries, travels
● Lymph Capillaries through the lymphatic vessels and lymph nodes, As lymph is
○ Walls overlap to form flap-like minivalves transported toward the heart, it is filtered through the thousands of
lymph nodes that cluster along the lymphatic vessels and enters the
○ Fluid leaks into lymph capillaries bloodstream via the great veins at the root of the neck
○ Capillaries are anchored to connective Right lymphatic duct is smaller located on right side above diaphragm
and drains into rt subclavian vein
tissue by filaments Thoracic duct- collects lymph from the lower abdomen, pelvis lower
○ Higher pressure on the inside closes limbs, half of head neck and chest. Empties into junction between the L
minivalves internal jugular vein and L subclavian vein
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FINALS 4: THE LYMPHATIC SYSTEM AND BODY DEFENSES
LYMPH LYMPH NODE STRUCTURE

● Materials returned to the blood ● Most are kidney-shaped, less than 1 inch long
○ Water ● Cortex
○ Blood cells ○ Outer part
○ Proteins ○ Contains follicles – collections of
● Harmful materials that enter lymph vessels lymphocytes
○ Bacteria ● Medulla
○ Viruses ○ Inner part
○ Cancer cells ○ Contains phagocytic macrophages
○ Cell debris Lymph nodes vary in shape and size, but most are kidney-shaped,
about 1 centimeter long, and “buried” in the connective tissue that
surrounds them.
LYMPH NODES The outer part of the node, its cortex, contains collections of
lymphocytes called follicles, many of which have dark-staining centers
● Filter lymph before it is returned to the blood called germinal centers
● Defense cells within lymph nodes
○ Macrophages – engulf and destroy foreign
substances
○ Lymphocytes – provide immune response to
antigens
lymphatic system plays a major role in immunity. Cells in lymph nodes
in particular help protect the body by removing foreign material such as
bacteria and tumor cells from the lymphatic stream and by producing
lymphocytes that function in the immune response
Within the lymph nodes are macrophages, which engulf and destroy
bacteria, viruses, and other foreign substances in the lymph before it is
returned to the blood.
lymphocytes (a type of white blood cell, covered in Chapter 10) are
also strategically located in the lymph nodes and respond to foreign
substances in the lymphatic stream
“swollen glands” (Misnomer) during an active infection. What are
actually swollen in these cases are not glands at all but rather lymph Each node is surrounded by a fibrous capsule from which connective
nodes tissue strands called trabeculae extend inward to divide the node into
Origin of lymphocytes: from division of stem cells from the bone a number of compartments
marrow. Lymph enters the convex side of a lymph node through afferent
lymphocyte production and development- involves bone marrow and lymphatic vessels. It then flows through a number of sinuses (spaces)
thymus. that meander through the lymph node and finally exits from the node at
hemocytoblasts in bone marrow produce lymphoid stem cells . O its indented region, the hilum (hi′lum), via efferent lymphatic vessels.
retians in bone marrow other goes to thymus. many of which have dark-staining centers called germinal centers.
In thymus- under influence of hormone thymosin. Stem cells divide These centers enlarge when specific B lymphocytes (the B cells) are
repeatedly producing 3 different Tcells.( helper, suppressor, cytotoxic. generating daughter cells called plasma cells, which release
As it matures all lymphocytes enter blood stream. antibodies. The rest of the cortical cells are lymphocytes “in transit,” the
cytotoxic- attacks cells infected with viruses. Helper- stimulates so-called T cells that circulate continuously between the blood, lymph
activation of t and b cells. Suppressor are regulatory cells. Those on nodes, and lymphatic stream, performing their surveillance roles.
bone marrow will become B cells( produce antibody) and NK cells or The medullary cords are inward extensions of cortical tissue that
natural killer cells( attack foreign cells so reposible for immunity contain both B and T cells. Phagocytic macrophages are located in the
surveillance. central medulla of the lymph node
Hodgkin's lymphoma is a type of cancer that affects the lymphatic
system, which is part of the body's germ-fighting immune system. In
Hodgkin's lymphoma, white blood cells called lymphocytes grow out of
control, causing swollen lymph nodes and growths throughout the
body.
FLOW OF LYMPH THROUGH NODES

● Lymph enters the convex side through afferent
lymphatic vessels
● Lymph flows through a number of sinuses
inside the node
● Lymph exits through efferent lymphatic vessels
● Fewer efferent than afferent vessels causes
flow to be slowed
Distribution of lymphatic vessels and lymph nodes. Significance why less efferent than afferent- allows lymphoctes and
The right lymphatic duct drains lymph from the right arm and the right macrophages to perform their function.
side of the head and thorax. The large thoracic duct receives lymph
from the rest of the body
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FLOW OF LYMPH THROUGH NODES Pink gland, lies in mediastinum, site of t cells production and
maturation. Reaches greatest size in 1-2 yrs after birth. Maximum size
● Several other organs contribute to lymphatic during puberty (30-40 gms) then decrease in size thereafter. Has 2
function lobes divided into lobules by partitions /septums. Cortex has clusters of
lymphocytes surrounded by cells that produce/ secrete hormone
○ Spleen thymosin.
○ Thymus
○ Tonsils TONSILS
○ Peyer’s ● Small masses of lymphoid tissue around the
patches pharynx
○ Appendix ● Trap and remove bacteria and other foreign
Others are the spleen, thymus,
materials
tonsils, and Peyer’s patches ● Tonsillitis is caused by congestion with bacteria
and the appendix of the
intestine as well as bits of
lymphoid tissue scattered in the
epithelial and connective
tissues. The common feature of
all these organs is a
predominance of reticular
connective tissue and
lymphocytes. Although all lymphoid organs have roles in protecting the
body, only the lymph nodes filter lymph.
THE SPLEEN
● Located on the left side of the abdomen PEYER’S PATCHES
● Filters blood ● Found in the wall of the small intestine
● Destroys worn out ● Resemble tonsils in structure
blood cells ● Capture and destroy bacteria in the intestine
● Forms blood cells in
the fetus
● Acts as a blood
reservoir
Blood rich organ. Graveyard of

dead blood cells.
Filters blood of viruses, bacteria,
and other debris. Site of lymphocyte
proliferation and immune
surveillance..
Also destroy worn out RBC and
return products back to liver. Spleen
also stores platelet. found in the wall of the distal part of the small intestine. Lymphoid
And reservoir for blood. (during follicles are also heavily concentrated in the wall of the appendix, a
bleeding./he. Spleen and liver tubelike offshoot of the first part of the large intestine. The
contract to return blood to circulation = increase blood volume macrophages of Peyer’s patches and the appendix are in an ideal
circulating, to help bring the blood volume back to its normal level position to capture and destroy bacteria (always present in tremendous
In the fetus, the spleen is an important hematopoietic (blood numbers in the intestine), thereby preventing them from penetrating the
cell–forming) site, but as a rule the adult spleen produces only intestinal wall.
lymphocytes. Peyer’s patches, the appendix, and the tonsils are part of the collection
of small lymphoid tissues referred to as mucosa-associated lymphoid
tissue (MALT).
THE THYMUS
● Located low in the throat, overlying the heart MUCOSA-ASSOCIATED LYMPHATIC TISSUE (MALT)
● Functions at peak levels only during childhood ● Includes:
● Produces hormones (like thymosin) to program ○ Peyer’s patches
lymphocytes ○ Tonsils
○ Other small accumulations of lymphoid
tissue
● Acts as a sentinal to protect respiratory and
digestive tracts
MALT acts as a sentinel to protect the upper respiratory and digestive tracts from
the never-ending attacks of foreign matter entering those cavities.
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BODY DEFENSES Skin- being keratinized is a strong physical barrier. Intact mucous
membrane provide mechanical barier to resp, digestive , repro, and
● The body is constantly in contact with bacteria, urinary tracts.
fungi, and viruses specialized human cells- eg. Cilia in nose- traps foreign materials.
chemicals- skin acidic pH 35) prevents bacterial growth. Sebum
● The body has two defense systems for foreign contains substances that are toxic to bacteria, stomach- acidic chon
materials digesting kills pathogens. Saliva contains lysozyme( destroys bacteria).
○ Nonspecific defense system Mucous in resp and digestive traps micro org.
The acidic pH of skin secretions and usually of urine (pH of 3 to 5)
○ Specific defense system inhibits bacterial growth, and sebum contains chemicals that are toxic
● Nonspecific defense system to bacteria. Vaginal secretions of adult females are also very acidic.
○ Mechanisms protect against a variety of 2. The stomach mucosa secretes hydrochloric acid and
protein-digesting enzymes. Both kill pathogens.
invaders 3. Saliva and lacrimal fluid contain lysozyme, an enzyme that destroys
○ Responds immediately to protect body from bacteria.
4. Sticky mucus traps many microorganisms that enter digestive and
foreign materials respiratory passageways.
● Specific defense system
○ Specific defense is required for each type of
invader
○ Also known as the immune system
Together they make up the immune system. Although certain body
organs (lymphoid organs and blood vessels) are intimately involved
with the immune response, the immune system is a functional system
rather than an organ system in an anatomical sense
The most important of the immune cells are lymphocytes, dendritic
cells, and macrophages. Macrophages actually play an important role
in both innate and adaptive mechanisms
The innate defense system, also called the nonspecific defense
system, responds immediately to protect the body from all foreign
substances.
The adaptive defense system, or specific defense system, fights
invaders that get past the innate defenses by mounting an attack
against one or more particular foreign substances
Nonspecific- example intact skin and mucous membranes, the
inflammatory response, and a number of proteins produced by body
cells. preventing the entry and spread of microorganisms throughout
the body
Specific-The immune system does cell attack, and indirectly, by
releasing mobilizing chemicals and protective antibody molecules. The
resulting highly specific resistance to disease is called immunity
(immun = free)
Specific- sombooks call it immunity or specific reisitance
SURFACE MEMBRANE BARRIERS – FIRST LINE OF
DEFENSE
● The skin
○ Physical barrier to foreign materials
○ pH of the skin is acidic to inhibit bacterial
growth
■ Sebum is toxic to bacteria
■ Vaginal secretions are very acidic
● Stomach mucosa
○ Secretes hydrochloric acid
○ Has protein-digesting enzymes
● Saliva and lacrimal fluid contain lysozyme
● Mucus traps microogranisms in digestive and
NONSPECIFIC BODY DEFENSES respiratory pathways
● Body surface coverings
○ Intact skin
○ Mucous membranes
● Specialized human cells
● Chemicals produced by the body
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DEFENSIVE CELLS FUNCTIONS OF THE INFLAMMATORY RESPONSE

● Phagocytes (neutrophils and macrophages) ● Prevents spread of damaging agents
○ Engulfs foreign material into a vacuole ● Disposes of cell debris and pathogens
○ Enzymes from lysosomes digest the ● Sets the stage for repair
material
second line of defense, the body uses an enormous number of cells
and chemicals. These defenses rely on the destructive powers of cells
called phagocytes and natural killer cells, on the inflammatory
response, and on a variety of chemical substances that kill pathogens
and help repair tissue.
Flowing cytoplasmic extensions bind to the particle and then pull it
inside, enclosing it in a vacuole. The vacuole is then fused with the
enzymatic contents of a lysosome, and its contents are broken down,
or digested
● Natural killer cells
○ Can lyse and kill cancer cells Phagocyte mobilization during inflammation.
○ Can destroy virus- infected cells Neutrophils, responding to a gradient of diffusing inflammatory
Natural killer (NK) cells roam the body in blood and lymph. They are a chemicals, enter the blood from the bone marrow and roll along the
unique group of aggressive lymphocytes that can lyse (burst) and kill blood vessel walls, following the “scent.”
cancer cells, virus-infected body cells, and some other nonspecific At the point where the chemical signal is the strongest, they flatten out
targets well before the adaptive arm of the immune system is enlisted and squeeze through the capillary walls, a process called diapedesis
in the fight Still drawn by the gradient of inflammatory chemicals (positive
Type of lymphocyte( 10-15 % of circulating lymphocyte. Less picky chemotaxis), the neutrophils gather at the site of tissue injury, and
type of cells. Function of immunological surveillance. Nk cells within an hour, they are busily devouring any foreign material present
recognize abnormal cells by detecting the presence of antigens.
They attack the target cell’s membrane and release lytic chemicals
called perforin and granzymes (enzymes), which degrade target cell STEPS IN THE INFLAMMATORY RESPONSE
contents. Shortly thereafter, the target cell dies as its membrane and
nucleus disintegrate. kills abnormal cells by creating a large pores in its
cell membrane. NK cells also release powerful inflammatory chemicals.
EVENTS OF PHAGOCYTOSIS
INFLAMMATORY RESPONSE — SECOND LINE OF

DEFENSE
● Triggered when body tissues are injured
The inflammatory process begins with a chemical “alarm.” When cells
● Produces four cardinal signs are damaged, they release inflammatory chemicals, including
○ Redness histamine and kinins (ki′ninz), that (1) cause blood vessels in the area
to dilate, (2) make capillaries leaky, and (3) attract phagocytes and
○ Heat white blood cells to the area. (This third phenomenon is called positive
○ Swelling chemotaxis because the cells are moving toward a high concentration
of signaling molecules.) Dilation of the blood vessels increases the
○ Pain blood flow to the area, accounting for the redness and heat observed.
● Results in a chain of events leading to Increased permeability of the capillaries allows fluid to leak from the
blood into the tissue spaces, causing local edema (swelling) that also
protection and healing activates pain receptors in the area as pressure in the tissues builds. If
Most cells within the affected tissue plays a role in inflammation. The the swollen, painful area is a joint, its function (movement) may be
inflammatory response is a nonspecific response that is triggered impaired temporarily. This forces the injured part to rest, which aids
whenever body tissues are injured. For example, it occurs in response healing. Some authorities consider limitation of joint movement to be
to physical trauma, intense heat, irritating chemicals, and infection by the fifth cardinal sign of inflammation
viruses and bacteria.
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HOMEOSTATIC IMBALANCE ● Interferon

● Pus is a mixture of dead or dying neutrophils, ○ Secreted proteins of virus-infected cells
broken-down tissue cells, and living and dead ○ Bind to healthy cell surfaces to inhibit
pathogens viruses binding
Interferons are small proteins secreted by activated lymphocytes.,
macrophages, and cells nfected by virus..
interferons bind to membranes of still healthy cells to prevent binding
of virus to normal cells. Once binds with stilll healthy cells it stimulates
the synthesis of proteins that interfere wit the ability or virus to
reproduce.
FEVER
● Abnormally high body temperature
● Hypothalmus heat regulation can be reset by
pyrogens (secreted by white blood cells)
● High temperatures inhibit the release of iron
If the inflammatory mechanism fails to fully clear the area of debris, and zinc from liver and spleen needed by
the sac of pus may become walled off, forming an abscess. Surgical
drainage of abscesses is often necessary before healing can occur. I & bacteria
D- incision and drainage ● Fever also increases the speed of tissue repair
Fever, or abnormally high body temperature, is a systemic response to
ANTIMICROBIAL CHEMICALS invading microorganisms.
Body temperature is regulated by the hypothalamus, referred to as the
● Complement body’s “thermostat.” Normally the thermostat is set at approximately
37°C (98.6°F), but it can be reset upward in response to pyrogens
○ A group of at least 20 plasma proteins (pyro = fire), chemicals secreted by white blood cells and macrophages
○ Activated when they encounter and attach exposed to foreign cells or substances in the body.
to cells (complement fixation)
○ Damage foreign cell surfaces SPECIFIC DEFENSE: THE IMMUNE SYSTEM —
○ Has vasodilators, chemotaxis, and THIRD LINE OF DEFENSE
opsonization ● Antigen specific – recognizes and acts against
particular foreign substances
● Systemic – immunity is not restricted to the
initial infection site
● Has memory – recognizes and mounts a
stronger attack on previously encountered
pathogens
the body’s third line of defense , the adaptive, or specific, defense
mechanism is a functional system that recognizes foreign molecules
called antigens and acts to inactivate or destroy them. Normally it
protects us from a wide variety of pathogens, as well as from abnormal
body cells. When it fails, malfunctions, or is disabled, some of the most
devastating diseases—such as cancer, rheumatoid arthritis, and
AIDS—may result.
immunology, the study of immunity
three important aspects of adaptive defense: • It is antigen specific,
systemic, has memory
TYPES OF IMMUNITY
Antimicrobial proteins inhibits reproduction of microorganisms. And ● Humoral immunity
most important antimocrobial proteins are complement and interferon
Mac or membrane attack complexes- produce lesion complete with ○ Antibody-mediated immunity
holes. So water may rush in and result to bursting of the foreign cell. ○ Cells produce chemicals for defense
This complement fixation occurs when complement proteins bind to
certain sugars or proteins (such as antibodies) on the foreign cell’s ● Cellular immunity
surface. One result of complement fixation is the formation of ○ Cell-mediated immunity
membrane attack complexes (MAC) that produce lesions, complete
with holes, in the foreign cell’s surface ○ Cells target virus infected cells
complement has Vasodilator_- enhances inflammatory responses two separate but overlapping arms of the adaptive defense system
has chemotaxis chemicals that attracks the neutrophils and were recognized.(humoral and cellular)
macrophages . Humoral-provided by the bodies humor or fluid.
Opsonization- means foreign cells membranes become sticky making it Cellular- lymphocytes act by causing foreign cells to lyse/ burst by
easier to phagoytize acting directly on it or indirectly by releasing some chemicals that will
trigger inflammatory response or immune response.
J. AYA-AY | 1 - I 6
ANTIGENS (NONSELF) CELLS OF THE IMMUNE SYSTEM

● Any substance capable of exciting the immune ● Lymphocytes
system and provoking an immune response ○ Originate from hemocytoblasts in the red
● Examples of common antigens bone marrow
○ Foreign proteins ○ B lymphocytes become immunocompetent
○ Nucleic acids in the bone marrow
○ Large carbohydrates ○ T lymphocytes become immunocompetent
○ Some lipids in the thymus
○ Pollen grains ● Macrophages
○ Microorganisms ○ Arise from monocytes
Foreign antigens are large, complex molecules that are not normally ○ Become widely distributed in lymphoid
present in our bodies. Consequently, they are foreign intruders, or
nonself.
organs
Among examples- proteins are the strongest Antigen (Ag). Like all blood cells, lymphocytes originate from hemocytoblasts in red
bone marrow. The immature (called naive) lymphocytes released from
the marrow are essentially identical.
SELF-ANTIGENS The cells of the adaptive system are lymphocytes and
antigen-presenting cells (APCs).
● Human cells have many surface proteins Lymphocyte account for about 25 % of total WBC population
● Our immune cells do not attack our own 2 major flavor;
B lymphocytes- 10-15 % of circulating lymphocytes. B cells can
proteins differentiate into plasma cells. Note plasma cells produce and secrete
● Our cells in another person’s body can trigger antibodies. Produce antibodies and oversee humoral immunity. ( also
an immune response because they are foreign known as immunoglobulins. These antibodies bind to antigen.
T lymphocytes or t cells: 80% or of circulating lymphocytes. Do not
○ Restricts donors for transplants make antibodies. Maturation process in thymus for 2-3 days
Transplant are given drugs that supresses the immune response does Types:.
resulting to low ability to recognize foreign materials within our body Cytotoxic- directly attacks foreign materials and provides for cell
thu rejection is unlikely to happen. mediated immunity.
Helper t cells- stimulate the activity of both t and b cells
Suppressor t cells inhibit both t and b cells. Also known as regulatory
ALLERGIES cells.
immunocompetent cells means able to react to distinct antigen(
● Many small molecules (called haptens or specific and only 1)
incomplete antigens) are not antigenic, but link Macrophages” from monocyte in bone marrow.
up with our own proteins Function: big eaters antigen presenters in adaptive defense system.(
show off some fragments from those they engulf n phagocytosis
● The immune system may recognize and
respond to a protein-hapten combination ACTIVATION OF LYMPHOCYTES
● The immune response is harmful rather than
protective because it attacks our own cells
Troublesome small molecule is called a hapten (haptein = to grasp) or
incomplete antigen (immune response-Attack that is harmful rather
than protective). haptens are found in poison ivy, animal dander, and
even in some detergents, hair dyes, cosmetics, and other commonly
used household and industrial products.
Because it is a combination of gives a foreign feature so may be

attack by our own body thus it becomes harmful .
Note hapten from haptein meaning to grasp
ALLERGIES ARE in appropriate or excessive response immune
response to antigens.. There sudden increase in leukocyte activity.
Neutrophils or cytotoxic t cells may destroy normal cells and may
trigger an inflammatory response.
4 categories of allergies:
Type 1 / immediate hypersensitivity: due t production of large quantities
of IgE antibodies so with this when exposed to allergens may lead to
release of histamine heparin prostaglandins and other chemicals
sorrounding the tissue resulting to inflammation of affected tissue. ANTIGEN-PRESENTING CELLS
Type 2/ cytotoxic reactions common in exposure to incompatible blood.
IgG and IgM antibodies. autoimmune hemolytic anemia,
● engulf antigens and then present fragments of
immune thrombocytopenia and them, like signal flags, on their own surfaces,
autoimmune neutropenia. where they can be recognized by T cells
Type 3/ immune complex disorder: allergies resulting from phagocytes
that are not able to remove immediately the Ag-Ab complexes resulting ● The major types of cells acting as APCs are
to tissue damage to vessels and kedneys. lupus, dendritic cells, macrophages, and B
Type4/ delayed hypersensitivity: occurs afte 2-3 days after exposure to
allergens resulting to rash that are itchy
lymphocytes
J. AYA-AY | 1 - I 7
HUMORAL (ANTIBODY-MEDIATED) IMMUNE SECONDARY RESPONSE

RESPONSE ● Memory cells are long-lived
● B lymphocytes with specific receptors bind to a ● A second exposure causes a rapid response
specific antigen ● The secondary response is stronger and longer
● The binding event activates the lymphocyte to lasting
undergo clonal selection
● A large number of clones are produced (primary
humoral response)
● Most B cells become plasma cells
○ Produce antibodies to destroy antigens
○ Activity lasts for four or five days
● Some B cells become long-lived memory cells
(secondary humoral response)
Although there is a lag period. They will produce about 200 Ab
molecule per second. But last for only 4-5 days. Coz some cells begin
to die.. Note Ab levels in the blood peak for about 10 days then
slowly decline. Illustration. Primary and secondary humoral responses to an antigen.
b lymphocytes that don’t become plasma cells( those that produce the In the primary response, the level of antibodies in the blood gradually
Ab) will become memory cells responsible for immunological memory rises and then rapidly declines. The secondary response is both more
and this kind of response is called secondary humoral response. rapid and more intense, and the antibody level remains high for a much
comparison:
1: clone production 4-5 days, peak 10 days. With initial lag. Secondary: longer time.
produce much faster. Within hours new army generated, peak 2-3
days. Last for weeks to months peak at higher levels. ACTIVE IMMUNITY
HUMORAL IMMUNE RESPONSE

● Your B cells encounter antigens and produce
antibodies
● Active immunity can be naturally or artificially
acquired
humoral immunity has active and passive.When your B cells encounter

antigens and produce antibodies against them, you are exhibiting
active immunity. Active immunity is (1) naturally acquired during
bacterial and viral infections, during which we may develop the signs
Clonal selection of a B cell. The initial meeting with the antigen and symptoms of the disease and suffer a little (or a lot), and (2)
stimulates the primary response, in which the B cell divides rapidly, artificially acquired when we receive vaccines.
forming many clones (clonal selection), most of which become Most vaccines contain pathogens that are dead or attenuated (living,
antibody-producing plasma cells. Cells that do not differentiate into but extremely weakened). We receive two benefits from vaccines: (1)
plasma cells become memory cells, which are primed to respond to they spare us most of the signs and symptoms (and discomfort) of the
subsequent exposures to the same antigen. Should such a meeting disease that would otherwise occur during the primary response and
occur, the memory cells quickly produce more memory cells and larger (2) the weakened antigens are still able to stimulate antibody
numbers of effector plasma cells with the same antigen specificity. production and promote immunological memory. So-called booster
Responses generated by memory cells are called secondary shots, which may intensify the immune response at later meetings with
responses the same antigen, are also available.
The more children who are vaccinated, the better the herd immunity, a
phenomenon in which a population of people are generally protected
because most of a given population is immune to a disease or
infection. Herd immunity prevents an outbreak of the disease or
infection and thus helps to protect individuals who have not been
immunized.
J. AYA-AY | 1 - I 8
PASSIVE IMMUNITY ANTIBODY CLASSES

● Antibodies are obtained from someone else ● Antibodies of each class have slightly different
○ Conferred naturally from a mother to her roles
fetus ● Five major immunoglobulin classes
○ Conferred artificially from immune serum or ○ IgM – can fix complement
gamma globulin ○ IgA – found mainly in mucus
● Immunological memory does not occur
○ IgD – important in activation of B cell
● Protection provided by “borrowed antibodies”
Passive immunity is artificially conferred when a person receives ○ IgG – can cross the placental barrier
immune serum or gamma globulin (donated antibodies). Gamma ○ IgE – involved in allergies
globulin is commonly administered after exposure to hepatitis. Other There are five major immunoglobulin classes—IgM, IgA, IgD, IgG, and
immune sera are used to treat poisonous snakebites (an antivenom), Ig (Remember the name MADGE to recall the five Ig types.) Antibodies
botulism, rabies, and tetanus (an antitoxin) because these diseases will IgD, IgG, and IgE have the same basic Y-shaped structure described
kill a person before active immunity can be established previously and are referred to as monomers
IgA antibodies occur in both monomer and dimer (two linked
MONOCLONAL ANTIBODIES monomers) forms.
IgM antibodies are called pentamers (penta = five).
● Antibodies prepared for clinical testing or IgG is the most abundant antibody in blood plasma and is the only type
diagnostic services that can cross the placental barrier. Hence, the passive immunity that a
mother transfers to her fetus is “with the compliments” of her IgG
● Produced from descendents of a single cell line antibodies. Only IgM and IgG can fix complement. The IgA dimer,
● Examples of uses for monoclonal antibodies secretory IgA, is found mainly in secretions that bathe body surfaces,
○ Diagnosis of pregnancy such as mucus and tears. It plays a major role in preventing pathogens
from gaining entry into the body. IgE antibodies are the “troublemaker”
○ Treatment after exposure to hepatitis and antibodies involved in allergies
rabies
monoclonal antibodies are being used for early cancer diagnosis and
to track cancers hidden deep within the body. They are also used for
diagnosing pregnancy, hepatitis, and rabies
ANTIBODIES (IMMUNOGLOBULINS) (IGS)

● Soluble proteins secreted by B cells (plasma
cells)
● Carried in blood plasma
● Capable of binding specifically to an antigen
Antibodies, also referred to as immunoglobulins (im″mu-no-glob′u-linz;
Igs), constitute the gamma globulin part of blood proteins. Antibodies
are soluble proteins secreted by activated B cells or by their
plasma-cell offspring in response to an antigen, and they are capable
of binding specifically with that antigen.
illustration-Basic antibody structure. (a) Computer-generated image. ANTIBODY FUNCTION
● Antibodies inactivate antigens in a number of
ANTIBODY STRUCTURE ways
● Four amino acid chains linked by disulfide ○ Complement fixation
bonds ○ Neutralization
● Two identical amino acid ○ Agglutination
chains are linked to form a ○ Precipitation
heavy chain Antibodies inactivate antigens in a number of ways—by complement fixation,
neutralization, agglutination, opsonization, and precipitation
● The other two identical Complement is the chief antibody ammunition used against cellular antigens,
chains are light chains such as bacteria or mismatched red blood cells.
Neutralization occurs when antibodies bind to specific sites (usually at or close to
● Specific antigen-binding the site where a cell would bind) on bacterial exotoxins (toxic chemicals secreted
sites are present by bacteria) or on viruses that can cause cell injury. In this way, they block the
harmful effects of the exotoxin or virus by preventing them from binding to body
Aminoacid chain which are polypeptide cells.
chain bonded by disulfide (sulfur to When the cross-linking involves cell-bound antigens, the process causes
sulfur) bonds. clumping of the foreign cells, a process called agglutination. This type of
every antibody has a basic structure consisting of four polypeptide antigen-antibody reaction occurs when mismatched blood is transfused (the
chains linked together by disulfide (sulfur-to-sulfur) bonds. Two of the foreign red blood cells are clumped) and is the basis of tests used for blood
four chains are identical; these are the heavy chains. The other two typing.
When the cross-linking process involves soluble antigenic molecules, the
chains, the light chains, are also identical to each other but are only
resulting antigen-antibody complexes are so large that they become insoluble
about half as long as the heavy chains. When the four chains are and settle out of solution. This crosslinking reaction is more precisely called
combined, the antibody molecule formed has two identical halves, precipitation. Such agglutinated bacteria and immobilized (precipitated) antigen
each consisting of a heavy and a light chain, and the molecule as a molecules are much more easily captured and engulfed by the body’s
whole is commonly described as being Y-shaped phagocytes than are freely moving antigen
J. AYA-AY | 1 - I 9
Cytotoxic T cells specialize in killing virus infected, cancer, or foreign

graft cells directly.
Helper T cells are the T cells that act as the “directors” or “managers”
of the adaptive immune response. Once activated, they circulate
through the body, recruiting other cells to fight the invaders. For
example, helper T cells interact directly with B cells (that have already
attached to antigens), prodding the B cells into more rapid division
(clone production) and then, like the “boss” of an assembly line,
signaling for antibody formation to begin.
CELLULAR (CELL-MEDIATED) IMMUNE RESPONSE

● Antigens must be presented by macrophages to
an immunocompetent T cell (antigen
presentation)
● T cells must recognize nonself and self (double
recognition)
● After antigen binding, clones form as with B
cells, but different classes of cells are produced
SUMMARY OF THE IMMUNE RESPONSE
T cell activation and interactions with other cells of the immune

response. Dendritic cells are important antigen presenting cells
(APCs). After they ingest an antigen, they display parts of it on their
surface, where it can be recognized by a helper T cell specific for the
same antigen. During the binding process, the helper T cell binds
simultaneously to the antigen and to the APC (self) receptor, which
leads to helper T cell activation and cloning (not illustrated). If the APC
is a macrophage, it releases cytokines. Cytokine chemicals released
by macrophages and dendritic cells, which enhance helper T cell
activation. Activated helper T cells release cytokines, which stimulate
proliferation and activity of other helper T cells and help activate B cells
and cytotoxic T cells
T CELL CLONES
● Cytotoxic T cells
○ Specialize in killing infected cells
○ Insert a toxic chemical (perforin)
● Helper T cells
○ Recruit other cells to fight the invaders A summary of the adaptive immune responses. In this flowchart, green
○ Interact directly with B cells arrows track the primary response, and blue arrows track the
secondary response
● Suppressor T cells
○ Release chemicals to suppress the activity
of T and B cells
○ Stop the immune response to prevent
uncontrolled activity
● A few members of each clone are memory cells
J. AYA-AY | 1 - I 10
Anaphylactic shock occurs when the allergen directly enters the blood
and circulates rapidly through the body, as might happen with certain
bee stings, spider bites, or an injection of a foreign substance (such as
horse serum, penicillin, or other drugs that act as haptens) into
susceptible individuals. Food allergies (peanut or wheat allergies) may
also trigger anaphylaxis, and can be fatal. The mechanism of
anaphylactic shock is essentially the same as that of local responses,
but when the entire body is involved, the outcome is life-threatening.
For example, it is difficult to breathe when the smooth muscles of lung
passages contract, and the sudden vasodilation (and fluid loss) that
occurs may cause circulatory collapse and death within minutes.
Epinephrine, found in emergency EpiPen® shots, is the drug of choice
to reverse these histamine mediated effects
○ Delayed hypersensitivity
■ Triggered by the release of lymphokines
from activated helper T cells
■ Symptoms usually appear 1–3 days
after contact with antigen
The most familiar examples of delayed hypersensitivity reactions are
those classed as allergic contact dermatitis, which follow skin contact
with poison ivy, some heavy metals (lead, mercury, and others), and
certain cosmetic and deodorant chemicals. These agents act as
haptens; after diffusing through the skin and attaching to body proteins,
they are perceived as foreign by the immune system. The Mantoux and
tine tests, skin tests for detecting tuberculosis, depend on delayed
hypersensitivity reactions. When the tubercle antigens are injected just
under the skin, a small, hard lesion forms if the person has been
sensitized to the antigen
ALLERGY MECHANISMS
ORGAN TRANSPLANTS AND REJECTION

● Major types of grafts
○ Autografts – tissue transplanted from one
site to another on the same person
○ Isografts – tissue grafts from an identical
person (identical twin)
○ Allografts – tissue taken from an unrelated
person
○ Xenografts – tissue taken from a different
animal species
● Autografts and isografts are ideal donors
● Xenografts are never successful
● Allografts are more successful with a closer
tissue match
DISORDERS OF IMMUNITY: ALLERGIES

(HYPERSENSITIVITY)
● Abnormal, vigorous immune responses
● Types of allergies
○ Immediate hypersensitivity
■ Triggered by release of histamine from
IgE binding to mast cells
■ Reactions begin within seconds of
contact with allergen
■ Anaphylactic shock – dangerous,
systemic response
J. AYA-AY | 1 - I 11
DISORDERS OF IMMUNITY: IMMUNODEFICIENCIES DEVELOPMENTAL ASPECTS OF THE LYMPHATIC

● Production or function of immune cells or SYSTEM AND BODY DEFENSES
complement is abnormal ● Except for thymus and spleen, the lymphoid
● May be congenital or acquired organs are poorly developed before birth
● Includes AIDS – Acquired Immune Deficiency ● A newborn has no functioning lymphocytes at
Syndrome birth; only passive immunity from the mother
The immunodeficiencies include both congenital and acquired ● If lymphatics are removed or lost, severe
conditions in which the production or function of immune cells or
complement is abnormal. The most devastating congenital condition is edema results, but vessels grow back in time
severe combined immunodeficiency disease (SCID), in which there is a
marked deficit of both B and T cells.
DISORDERS OF IMMUNITY: AUTOIMMUNE

DISEASES
● The immune system does not distinguish
between self and nonself
● The body produces antibodies and sensitized T
lymphocytes that attack its own tissues
● Examples of autoimmune diseases
○ Multiple sclerosis – white matter of brain
and spinal cord are destroyed
○ Myasthenia gravis – impairs communication
between nerves and skeletal muscles
○ Juvenile diabetes – destroys pancreatic
beta cells that produce insulin
○ Rheumatoid arthritis – destroys joints
○ Systemic lupus erythematosus (SLE) –
affects kidney, heart, lung and skin
○ Glomerulonephritis – impairment of renal
function
the immune system loses its ability to distinguish friend from foe, that
is, to tolerate self-antigens while still recognizing and attacking foreign
antigens. When this happens, the body produces antibodies
(auto-antibodies) and sensitized T cells and damage its own tissues.
This puzzling phenomenon is called autoimmune disease because it is
a person’s own immune system that produces the disorder.
SELF TOLERANCE BREAKDOWN

● Inefficient lymphocyte programming
● Appearance of self-proteins in the circulation
that have not been exposed to the immune
system
○ Eggs
○ Sperm
○ Eye lens
New self-antigens appear. Such “hidden” antigens are found in sperm
cells, the eye lens, and certain proteins in the thyroid gland. In addition,
“new” self-antigens may appear as a result of gene mutations that
change the structure of self-proteins or as a result of alterations in
self-proteins by hapten attachment or by bacterial or viral damage
● Cross-reaction of antibodies produced against
foreign antigens with self-antigens
○ Rheumatic fever
Foreign antigens resemble self-antigens. For instance, antibodies
produced during an infection caused by streptococcus bacteria (such
as strep throat or scarlet fever) are known to cross-react with heart
antigens, causing damage to both the heart muscle and its valves, as
well as to the joints and kidneys. This age-old disease is called
rheumatic fever
J. AYA-AY | 1 - I 12
REPRODUCTIVE SYSTEM 01
[FINALS 5] THE REPRODUCTIVE SYSTEM
THE REPRODUCTIVE SYSTEM TESTES

● Gonads – primary sex organs ● Coverings of the testes
○ Testes in males ○ Tunica albuginea – capsule that surrounds
○ Ovaries in females each testis
● Gonads produce gametes (sex cells) and ○ Septa – extensions of the capsule that
secrete hormones extend into the testis and divide it into
○ Sperm – male gametes lobules
○ Ova (eggs) – female gametes ● Each lobule contains one to four seminiferous
tubules
MALE REPRODUCTIVE SYSTEM ○ Tightly coiled structures
● Testes ○ Function as sperm-forming factories
● Duct system ○ Empty sperm into the rete testis
○ Epididymis ● Sperm travels through the rete testis to the
○ Ductus deferens epididymis
○ Urethra ● Interstitial cells produce androgens such as
● Accessory organs testosterone
○ Seminal vesicle
○ Prostate gland EPIDIDYMIS
○ Bulbourethral gland ● Comma-shaped, tightly coiled tube
● External genitalia ● Found on the superior part of the testis and
○ Penis along the posterior lateral side
○ Scrotum ● Functions to mature and store sperm cells (at
least 20 days)
● Expels sperm with the contraction of muscles in
the epididymis walls to the vas deferens
DUCTUS DEFERENS (VAS DEFERENS)

● Carries sperm from the epididymis to the
ejaculatory duct
● Passes through the inguinal canal and over the
bladder
● Moves sperm by peristalsis
● Spermatic cord – ductus deferens, blood
vessels, and nerves in a connective tissue
sheath
● Ends in the ejaculatory duct which unites with
the urethra
● Vasectomy – cutting of the ductus deferens at
the level of the testes to prevent transportation
of sperm
URETHRA
● Extends from the base of the urinary bladder to
the tip of the penis
● Carries both urine and sperm
● Sperm enters from the ejaculatory duct
J. AYA-AY | 1 - I 1
FINALS 5: THE REPRODUCTIVE SYSTEM
● Regions of the urethra ● Penis

○ Prostatic urethra –surrounded by prostate ○ Delivers sperm into the female reproductive
○ Membranous urethra – from prostatic tract
urethra to penis ○ Regions of the penis
○ Spongy (penile) urethra – runs the length of ■ Shaft
the penis ■ Glans penis (enlarged tip)
■ Prepuce (foreskin)
SEMINAL VESICLES ● Folded cuff of skin around proximal
● Located at the base of the bladder end
● Produces a thick, yellowish secretion (60% of ● Often removed by circumcision
semen) ● Internally there are three areas of spongy
○ Fructose (sugar) erectile tissue around the urethra
○ Vitamin C
○ Prostaglandins SPERMATOGENESIS
○ Other substances that nourish and activate ● Production of sperm cells
sperm ● Begins at puberty and continues throughout life
● Occurs in the seminiferous tubules
PROSTATE GLAND
● Encircles the upper part of the urethra PROCESSES OF SPERMATOGENESIS
● Secretes a milky fluid ● Spermatogonia (stem cells) undergo rapid
○ Helps to activate sperm mitosis to produce more stem cells before
○ Enters the urethra through several small puberty
ducts ● Follicle stimulating hormone (FSH) modifies
spermatogonia division
BULBOURETHRAL GLANDS COWPERS ○ One cell produced is a stem cell
● Pea-sized gland inferior to the prostate ○ The other cell produced becomes a primary
● Produces a thick, clear mucus spermatocyte
○ Cleanses the urethra of acidic urine ● Primary spermatocytes undergo meiosis
○ Serves as a lubricant during sexual ● Haploid spermatids are produced
intercourse ● Spermiogenesis
○ Secreted into the penile urethra ○ Late spermatids are produced with distinct
regions
SEMEN ■ Head – contains DNA covered by the
● Mixture of sperm and accessory gland acrosome
secretions ■ Midpiece
● Advantages of accessory gland secretions ■ Tail
○ Fructose provides energy for sperm cells ○ Sperm cells result after maturing of
○ Alkalinity of semen helps neutralize the spermatids
acidic environment of vagina ● Spermatogenesis takes 64 to 72 days
○ Semen inhibits bacterial multiplication
○ Elements of semen enhance sperm motility
EXTERNAL GENITALIA
● Scrotum
○ Divided sac of skin outside the abdomen
○ Maintains testes at 3°C lower than normal
body temperature to protect sperm viability
J. AYA-AY | 1 - I 2
ANATOMY OF A MATURE SPERM CELL

● The only human flagellated cell
● DNA is found in the head
FEMALE REPRODUCTIVE SYSTEM
TESTOSTERONE PRODUCTION
● The most important hormone of the testes
● Produced in interstitial cells
● Functions of testosterone
○ Stimulates reproductive organ development
○ Underlies sex drive
○ Causes secondary sex characteristics
■ Deepening of voice
■ Increased hair growth
■ Enlargement of skeletal muscles
■ Thickening of bones
REGULATION OF MALE ANDROGENS
VULVA
● structures that form the entire female external
reproductive genitalia
● from the latin word meaning for covering
●
●
J. AYA-AY | 1 - I 3
EXTERNAL REPRODUCTIVE ORGANS CLITORIS

● highly sensitive and erectile tissue situated
under the prepuce of the labia minora
● Known as the “seat of woman’s sexual
arousal and orgasm” being the most sensitive
part of the female external genitalia
● Covered by a fold of skin called prepuce;
Sensitive to both touch and temperature
VESTIBULE
● Triangular space between the labia minora
where the six (6) openings are located:
MONS PUBIS ○ 1) Urethral Opening
● pad of adipose tissue located over the ○ 2) Vaginal Opening
symphysis pubis (pubic bone joint) ○ 3) Opening of Bartholin’s Glands
○ -function: protect the junction of pubic ○ 4) Opening of Skene’s Glands
bone from trauma
VAGINAL OPENING
○ - richly supplied with sebaceous glands
○ - Childhood: hairless and smooth ● the external opening of the vagina located just
○ - Puberty: covered by a triangular coarse below the urethral meatus
of curly hairs (escutheon) ● Grafenberg or G spot is a very sensitive area
○ - Pattern of hair growth: Female: located at the inner anterior surface of the
Triangular; Male:Diamond- shaped vagina
○ - Growth of pubic hair is stimulated by
Testosterone while the pattern of hair URETHRAL OPENING
growth is governed by estrogen ● external opening of the female urethra located
in the midline of the vestibule just below the
LABIA MAJORA clitoris
● Two thick folds of adipose tissues originating ● shortness of the female urethra makes women
from the mons pubis and terminating in the more susceptible to UTI than men
perineum
○ - It unites anteriorly to form the anterior HYMEN
commissure and posteriorly to form the ● thin but tough and elastic semicircular
posterior commissure membrane that covers the opening of the
○ - Its outer surface is thick and covered by vagina; often torn during the first sexual contact
hair; inner surface is smooth and moist ● women may be born without a hymen; can be
○ - Main function: provide covering and torn by active sports and tampon insertion
protection to the external organs located ● Imperforate Hymen – a hymen that completely
under it covers the vaginal opening preventing coitus
○ - Nulliparous women: in close apposition to and passage of menstrual discharge
each other; but tends to gape wider after ○ - Hymenotomy/Hymenectomy – is
birth the surgical incision of an imperforate
hymen
LABIA MINORA
● Two thin folds of connective tissue that joins SKENE’S GLANDS
anteriorly to form the prepuce and posteriorly to ● paraurethral glands; minor vestibular glands
form the fourchette ● A pair of glands situated on each side of the
● It is most highly vascular, sensitive and richly urethral meatus
supplied with sebaceous glands ● Its secretion help to lubricate the external
● Nulliparous women: covers the vaginal genitalia during coitus
introitus, vestibule and urethra
● Obliterated during vagina
J. AYA-AY | 1 - I 4
BARTHOLIN’S GLANDS UTERUS

● vulvovaginal glands; major vestibular glands; ● a hollow muscular canal resembling an inverted
paravaginal glands pear that is situated in the true pelvis
● Situated on each inner side of the vagina ● Functions:
● Lubricates the external vulva during coitus with ○ a) Organ of reproduction (main) – serves
an alkaline secretions that enhances sperm for reception, implantation, retention and
survival nutrition of the fetus
○ b) Organ of menstruation
FOURCHETTE ○ c) Uterine contraction for the expulsion of
● the ridge of tissue formed by the posterior the fetus during delivery and to seal torn
joining of the two labia minora and majora; blood vessels after placental deliver
sometimes cut during episiotmomy ● Intrinsic motility – capable of contraction even if
● Episiotomy – perineotomy; surgically planned the nerves that supply them is being cut
incision on the perineum and the posterior ● Parts of the uterus
vaginal wall during the second stage of labor ○ 1) Fundus –
○ 2) Cornua
INTERNAL REPRODUCTIVE ORGANS ○ 3) Corpus
○ 4) Isthmus
○ 5) Cervix
● 1…FUNDUS - uppermost convex triangular

portion between the points of insertion of the
fallopian tubes
● Most muscular part
● Ideal site: Zygote implantation
● Obstetrical landmark:
○ A) palpation of fundic height to assess fetal
growth
○ B) assess uterine contractions and progress
of labor
○ C) assess uterine involution
● 2…CORNUA – area where the fallopian tubes

are attached
VAGINA ● 3…CORPUS – body of the uterus; houses the

● a tubular musculomembranous structure about fetus
8-12 cm long that extends from the vulva to the
uterus ● 4…ISTHMUS - becomes only prominent near
● Functions: the end of pregnancy and during labor to form
○ a) excretory canal of the uterus through the LOWER UTERINE SEGMENT together
which uterine secretions and menstrual flow with the cervix
escape
○ b) Female organ of copulation ● 5…CERVIX - neck of the uterus
○ c) Forms part of the birth canal ○ chiefly composed of elastic and
● Rugae – transverse folds of skin in the vaginal collagenous tissues and only 10 % muscle
wall - absent in childhood tissues
○ - appear at puberty ○ parts:
○ - disappear at menopause ■ a) Internal cervical os – opens into the
○ - function: allow the vaginal canal to corpus
stretch and enlarge during deliver ■ b) Cervical Canal – Continuation of the
uterine cavity
■ c) external Cervical os – opens into
the vagina
J. AYA-AY | 1 - I 5
LAYERS OF THE UTERUS

● 1) Perimetrium – outermost serosal layer
attached to the broad ligament
● 2) Myometrium – Middle muscular layer
● - responsible for uterine contractions
and thickest at the fundal area
● 3) Endometrium – innermost ciliated mucosal
layer
○ - contains numerous glands
that secretes thin alkaline fluid that keep the
uterine cavity moist
○ - undergoes changes in
response to hormones at different phases of LAYERS OF THE OVARY
menstrual cycle ● 1) Tunica Albuginea - outermost protective layer
● 2) Medulla – contains blood vessels, nerves
and lymphatics
● 3) Cortex - functional layer; site for ovum
formation and maturation
● - becomes thinner in advancing age
and the follicles decreases in number
FALLOPIAN TUBES
● pair of tube like structures originating from the
cornua of the uterus with distal ends located
near the ovaries
● Parts:
○ 1) INTERSTITIAL/INTRAMURAL
○ 2) ISTHMUS – narrowest portion; site for
tubal ligation
○ 3) AMPULLA – middle, widest part; site for
fertilization
○ 4) INFUNDIBULUM – has fimbrae (funnel
shaped opening at the distal end)
OVARIES
● almond shaped glandular organs located on
each side of the uterus; movable on palpation
● Functions:
○ 1) OOGENESIS – growth, development and
maturation of the egg cell
○ 2) OVULATION – release of the mature egg
cell
○ 3) HORMONE PRODUCTION – synthesis
and secretion of steroid hormones
J. AYA-AY | 1 - I 6

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HUMAN ANATOMY AND PHYSIOLOGY | Mr.

Ferdinand Catungal SEM

ORGANS OF THE DIGESTIVE SYSTEM

MOUTH (ORAL CAVITY) ANATOMY

ORGANS OF THE ALIMENTARY CANAL

PROCESSES OF THE MOUTH ● Submucosa

ALIMENTARY CANAL NERVE PLEXUSES

LAYERS OF ALIMENTARY CANAL ORGANS STOMACH ANATOMY

● Rugae – internal folds of the mucosa STOMACH FUNCTIONS

SPECIALIZED MUCOSE OF THE STOMACH

STRUCTURE OF STOMACH MUCOSA

HOMEOSTATIC IMBALANCE: PEPTIC ULCER

● Duodenal Ulcer SUBDIVISIONS OF THE SMALL INTESTINE

CHEMICAL DIGESTION IN THE SMALL INTESTINE

VILLI OF THE SMALL INTESTINE

STRUCTURES INVOLVED IN ABSORPTION OF STRUCTURES OF THE LARGE INTESTINE

LARGE INTESTINE ACCESSORY DIGESTIVE ORGANS

FUNCTIONS OF THE LARGE INTESTINE

PANCREAS: EXOCRINE FUNCTION

PANCREAS: ENDOCRINE FUNCTION (DUCTLESS)

HOMEOSTATIC IMBALANCE ● Kupffer cells

ANATOMY OF THE LIVER

CELLS OF THE LIVER HOMEOSTATIC IMBALANCE: JAUNDICE

GALLBLADDER ● Mechanical digestion

PROCESSES OF THE DIGESTIVE SYSTEM

CONTROL OF DIGESTIVE ACTIVITY FOOD BREAKDOWN IN THE STOMACH

STIMULATION OF THE RELEASE OF PANCREATIC HOMEOSTASIS: UPPER AND LOWER GI BLEEDING

BOUNDARY OF UPPER AND LOWER GI BLEEDING

ABSORPTION IN THE SMALL INTESTINE

FOOD BREAKDOWN AND ABSORPTION IN THE

NUTRITION CELLULAR RESPIRATION

DIETARY SOURCES OF MAJOR NUTRIENTS

FUNCTIONS OF THE URINARY SYSTEM

RENAL TUBULE URINE FORMATION PROCESSES

MATERIALS NOT REABSORBED

PERITUBULAR CAPILLARIES SECRETION — REABSORPTION IN REVERSE

FORMATION OF URINE URINARY BLADDER WALL

DISTRIBUTION OF BODY FLUID MAINTAINING WATER AND ELECTROLYTE

MAINTAINING ACID-BASE BALANCE IN BLOOD

RESPIRATORY SYSTEM CONTROLS OF ACID-BASE

RENAL MECHANISMS OF ACID-BASE BALANCE

DEVELOPMENTAL ASPECTS OF THE URINARY

AGING AND THE URINARY SYSTEM

STRUCTURES OF THE PHARYNX

LARYNX (VOICE BOX)

STRUCTURES OF THE LARYNX

RESPIRATORY MEMBRANE (AIR-BLOOD BARRIER)

INSPIRATION RESPIRATORY VOLUMES AND CAPACITIES

● Many factors that affect respiratory capacity EXTERNAL RESPIRATION

CHRONIC BRONCHITIS DEVELOPMENTAL ASPECTS OF THE RESPIRATORY

RESPIRATORY RATE CHANGES THROUGHOUT LIFE

SUDDEN INFANT DEATH SYNDROME

THE LYMPHATIC SYSTEM

Special structural features of lymphatic capillaries. (a) Structural

LYMPH LYMPH NODE STRUCTURE

FLOW OF LYMPH THROUGH NODES

Blood rich organ. Graveyard of

DEFENSIVE CELLS FUNCTIONS OF THE INFLAMMATORY RESPONSE