Anaphy Transes 1stYear1stSemMidTerms

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 70

Emilio Aguinaldo College

Bachelor of Science in Nursing – 1st Year


Anatomy and Physiology with Pathophysiology

Second Semester
Topic 7 Week 7 Structural Classification
NERVOUS SYSTEM  Central nervous system (CNS)
 Organs
Functions of the Nervous System:  Brain
 Spinal cord
1. Sensory input—gathering information. Function
Sensory receptors monitor changes, called  Integration; command center
stimuli,occurring inside and outside the  Interprets incoming sensory
body. information.
2. Integration  Issues outgoing instructions
Nervous system processes and interprets  Peripheral nervous system (PNS)
sensoryinput and decides whether action is  Nerves extending from the brain and
needed. spinal cord.
3. Motor output  Spinal nerves—carry impulses to and
A response, or effect, activates muscles or from the spinal cord.
glands.  Cranial nerves—carry impulses to and
from the brain.
 Functions
 Serve as communication lines among
sensory organs,the brain and spinal
cord, and glands or muscles.
Functional Classification
 Sensory (afferent) division
Nerve fibers that carry information to the
central nervous system
 Somatic sensory (afferent) fibers carry
Organization of the Nervous System
informationfromthe skin, skeletal
Nervous system classifications are based on:
muscles, and joints.
 Structures (structural classification)
 Visceral sensory (afferent) fibers carry
 Activities (functional classification)
information fromvisceral organs.
 Motor (efferent) division
Nerve fibers that carry impulses away from
the centralnervous system organs to
effector organs (musclesand glands)
Two subdivisions
 Somatic nervous system = voluntary
- Consciously (voluntarily) controls
skeletal muscles
 Autonomic nervous system =
involuntary
- Automatically controls smooth and
cardiac muscles and glands
- Further divided into the sympathetic
and parasympathetic nervous
systems
Nervous Tissue: Support Cells

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

- Support cells in the CNS are grouped


together as neuroglia
- General functions
 Support
 Insulate
 Protect neurons
Nervous Tissue: Structure and Function
- Nervous tissue is made up of two principal
cell types  CNS glial cells: ependymal cells
- Supporting cells (called neuroglia, or glial  Line cavities of the brain and spinal cord
cells, or glia)  Cilia assist with circulation of
 Resemble neurons cerebrospinal fluid
 Unable to conduct nerve impulses
 Never lose the ability to divide
- Neurons
Nervous Tissue: Supporting Cells
- CNS glial cells: astrocytes
 Abundant, star-shaped cells
 Brace and anchor neurons to blood
capillaries
 Determine permeability and exchanges
between blood capillaries and neurons
 Protect neurons from harmful  CNS glial cells: oligodendrocytes
substances in blood  Wrap around nerve fibers in the central
 Control the chemical environment of the nervous system
brain  Produce myelin sheaths

 PNS glial cells


 Schwann cells
 CNS glial cells: microglia Form myelin sheath around nerve fibers
 Spiderlike phagocytes in the PNS
 Monitor health of nearby neurons  Satellite cells
 Dispose of debris Protect and cushion neuron cell bodies

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

Nervous Tissue: Neurons  Processes (fibers)


 Neurons = nerve cells  Dendrites—conduct impulses toward
 Cells specialized to transmit messages the cell body
(nerve impulses) Neurons may have hundreds of
 Major regions of all neurons dendrites
- Cell body—nucleus and metabolic center of  Axons—conduct impulses away from
the cell the cell body
- Neurons have only one axon arising from
- Processes—fibers that extend from the cell the cell body at the axon hillock
body - End in axon terminals, which contain
 Cell body is the metabolic center of the vesicles with neurotransmitters
neuron - Axon terminals are separated from the next
 Nucleus with large nucleolus neuron by a gap
 Nissl bodies  Synaptic cleft—gap between axon
Rough endoplasmic reticulum terminals and the next neuron
 Neurofibrils  Synapse—functional junction between
 Intermediate filaments that maintain nerves where a nerve impulse is
cell shape transmitted
 Myelin
 White, fatty material covering axons
 Protects and insulates fibers
 Speeds nerve impulse transmission
 Myelin sheaths
 Schwann cells—wrap axons in a jelly
roll–like fashion (PNS) to form the
myelin sheath
- Neurilemma—part of the Schwann cell
external to the myelin sheath
- Nodes of Ranvier—gaps in myelin sheath
along the axon
 Oligodendrocytes—produce myelin
sheaths around axons of the CNS
- Lack a neurilemma

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Terminology
 Nuclei—clusters of cell bodies in the
CNS
 Ganglia—collections of cell bodies
outside the CNS in the PNS
 Tracts—bundles of nerve fibers in the
CNS
 Nerves—bundles of nerve fibers in the
PNS
 White matter—collections of
myelinated fibers (tracts)
 Gray matter—mostly unmyelinated
fibers and cell bodies

 Functional classification
 Sensory (afferent) neurons
- Carry impulses from the sensory receptors
to the CNS
- Receptors include:
 Cutaneous sense organs in skin
 Proprioceptors in muscles and tendons

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

- Conduct impulses both toward and away


from the cell body

 Functional properties of neurons


 Motor (efferent) neurons  Irritability
- Carry impulses from the central nervous - Ability to respond to a stimulus and convert
system to viscera and/or muscles and glands it to a nerve impulse
 Conductivity
 Interneurons (association neurons)
- Ability to transmit the impulse to other
 Cell bodies located in the CNS
neurons,muscles, or glands
 Connect sensory and motor neurons
 Electrical conditions of a resting neuron’s
membrane
 Structural classification
 The plasma membrane at rest is inactive
 Based on number of processes
(polarized)
extending from the cell body
 Fewer positive ions are inside the
 Multipolar neurons—many extensions
neuron’s plasma membrane than
from the cell body
outside
- All motor and interneurons are multipolar
- K+ is the major positive ion inside the cell
- Most common structural type
- Na+ is the major positive ion outside the
cell

 As long as the inside of the membrane is


more negative (fewer positive ions) than
the outside, the cell remains inactive

 Bipolar neurons—one axon and one


dendrite
- Located in special sense organs, such as
nose and eye  Action potential initiation and generation
- Rare in adults  A stimulus changes the permeability of
the neuron’s membrane to sodium ions
 Sodium channels now open, and sodium
(Na+) diffuses into the neuron
 The inward rush of sodium ions changes
the polarity at that site and is called
depolarization
 Unipolar neurons—have a short single
process leaving the cell body
- Sensory neurons found in PNS ganglia

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Initial conditions of sodium and


potassium ions are restored using the
sodium-potassium pump
 This pump, using ATP, restores the
original configuration
 A graded potential (localized  Three sodium ions are ejected from the
depolarization) exists where the inside cell while two potassium ions are
of the membrane is more positive and returned to the cell
the outside is less positive  Until repolarization is complete, a
 If the stimulus is strong enough and neuron cannot conduct another nerve
sodium influx great enough, local impulse
depolarization activates the neuron to
conduct an action potential (nerve
impulse)

 Transmission of the signal at synapses


 Step 1: When the action potential
reaches the axon terminal, the electrical
 Propagation of the action potential charge opens calcium channels
 If enough sodium enters the cell, the
action potential (nerve impulse) starts
and is propagated over the entire axon
 All-or-none response means the nerve
impulse either is propagated or is not
 Fibers with myelin sheaths conduct
nerve impulses more quickly

 Repolarization
 Membrane permeability changes
again—becoming impermeable to  Step 2: Calcium, in turn, causes the tiny
sodium ions and permeable to vesicles containing the neurotransmitter
potassium ions chemical to fuse with the axonal
 Potassium ions rapidly diffuse out of the membrane
neuron, repolarizing the membrane
 Repolarization involves restoring the
inside of the membrane to a negative
charge and the outer surface to a
positive charge

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Step 3: The entry of calcium into the  Step 5: If enough neurotransmitter is


axon terminal causes porelike openings released, a graded potential will be
to form, releasing the neurotransmitter generated
into the synaptic cleft - Eventually an action potential (nerve
impulse) will occur in the neuron beyond
the synapse

 Step 4: The neurotransmitter molecules


diffuse across the synaptic cleft and bind
to receptors on the membrane of the  Step 6: The electrical changes prompted
next neuron by neurotransmitter binding are brief
 The neurotransmitter is quickly removed
from the synapse either by reuptake or
by enzymatic activity
 Transmission of an impulse is
electrochemical
- Transmission down neuron is electrical
- Transmission to next neuron is chemical

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Two-neuron reflex arcs


 Simplest type
Example: patellar (knee-jerk) reflex

 Reflexes are rapid, predictable, and


involuntary responses to stimuli
 Reflexes occur over neural pathways  Three-neuron reflex arcs
called reflex arcs  Consists of five elements: receptor,
 Two types of reflexes sensory neuron, interneuron, motor
 Somatic reflexes neuron, and effector
 Autonomic reflexes Example: flexor (withdrawal) reflex

 Somatic reflexes
 Reflexes that stimulate the skeletal
muscles
 Involuntary, although skeletal muscle is
Central Nervous System (CNS)
normally under voluntary control
 Functional anatomy of the brain
 Example: pulling your hand away from a
 Brain regions
hot object
- Cerebral hemispheres
 Autonomic reflexes
- Diencephalon
 Regulate the activity of smooth muscles,
- Brain stem
the heart, and glands
- Cerebellum
 Example: regulation of smooth muscles,
Functional Anatomy of the Brain
heart and blood pressure, glands,
 Cerebral hemispheres are paired (left and
digestive system
right) superior parts of the brain
 Five elements of a reflex arc
 Include more than half of the brain mass
1. Sensory receptor—reacts to a stimulus
 The surface is made of ridges (gyri) and
2. Sensory neuron—carries message to the
grooves (sulci)
integration center
 Fissures are deeper grooves
3. Integration center (CNS)—processes
 Lobes are named for the cranial bones
information and directs motor output
that lie over them
4. Motor neuron—carries message to an
 Three main regions of cerebral hemisphere
effect
1. Cortex is superficial gray matter
5. Effector organ—is the muscle or gland to be
2. white matter
Stimulated
3. Basal nuclei are deep pockets of gray matter
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Thalamus:
 Relays sensory impulses to cerebral
cortex
 Relays impulses between cerebral motor
cortex and lower motor centers
 Involved in memory
 Hypothalamus:
 Chief integration center of autonomic
(involuntary) nervous system
 Regulates body temperature, food
intake, water balance, and thirst
 Regulates hormonal output of anterior
pituitary gland and acts as an endocrine
organ (producing ADH and oxytocin)

 Limbic system—A functional system:


 Includes cerebral and diencephalon
structures (e.g., hypothalamus and
anterior thalamic nuclei)
 Mediates emotional response; involved
in memory processing
Cerebral Hemispheres
Cerebral Hemispheres Brain Stem

 Midbrain:
 Cortex: Gray Matter:  Contains visual and auditory reflex
 Localizes and interprets sensory inputs centers
 Controls voluntary and skilled skeletal  Contains subcortical motor centers
muscle activity  Contains nuclei for cranial nerves III and
 Acts in intellectual and emotional IV; contains projection fibers (e.g., fibers
processing of the pyramidal tracts)
 Basal Nuclei:  Pons:
 Subcortical motor centers help control  Relays information from the cerebrum
skeleton muscle movements to the cerebellum
Diencephalon  Cooperates with the medullary centers
to control respiratory rate and depth
 Contains nuclei of cranial nerves V-VII;
contains projection fibers
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Medulla Oblongata:
 Relays ascending sensory pathway
impulses from skin and proprioceptors
 Contains nuclei controlling heart rate,
blood vessel diameter, respiratory rate,
vomiting, etc.
 Relays sensory information to the
cerebellum
 Contains nuclei of cranial nerves VIII-XII;
contains projection fibers
 Site of crossover of pyramids

 Cerebral areas involved in special senses


 Visual area (occipital lobe)
 Auditory area (temporal lobe)
 Reticular formation—A functional system:
 Olfactory area (temporal lobe)
 Maintains cerebral cortical alertness;
 Cerebral cortex
filters out repetitive stimuli
 Primary motor area
 Helps regulate skeletal and visceral
- Located anterior to the central sulcus in the
muscle activity
frontal lobe
Cerebellum:
- Allows us to consciously move skeletal
muscles
- Motor neurons form pyramidal
(corticospinal) tract, which descends to
spinal cord
- Motor homunculus is a spatial map
 Processes information from cerebral
motor cortex, proprioceptors, and visual
and equilibrium pathways
 Provides "instructions" to cerebral
motor cortex and subcortical motor
centers, resulting in smooth,
coordinated skeletal muscle movements
 Responsible for proper balance and
posture
 Cerebral cortex
 Primary somatic sensory area
- Located in parietal lobe posterior to central
sulcus
- Receives impulses from the body’s sensory
receptors
 Pain, temperature, light touch  Broca’s area (motor speech area)
(except for special senses) - Involved in our ability to speak
- Sensory homunculus is a spatial map - Usually in left hemisphere
 Other specialized areas
- Left side of the primary somatic sensory - Anterior association area (frontal lobe)
area receives impulses from right side (and - Posterior association area (posterior cortex)
vice versa) - Speech area (for sounding out words)
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Diencephalon
 Sits on top of the brain stem
 Enclosed by the cerebral hemispheres
 Made of three structures
1. Thalamus
2. Hypothalamus
3. Epithalamus

 Cerebral white matter


 Composed of fiber tracts deep to the
gray matter
- Corpus callosum connects hemispheres
- Tracts, such as the corpus callosum, are
known as commissures
- Association fiber tracts connect areas within
a hemisphere
- Projection fiber tracts connect the
cerebrum with lower CNS centers

 Diencephalon: thalamus
 Encloses the third ventricle
 Relay station for sensory impulses
passing upward to the cerebral cortex
 Transfers impulses to the correct part of
the cortex for localization and
interpretation
 Diencephalon: hypothalamus
 Makes up the floor of the diencephalon
 Important autonomic nervous system
center
- Regulates body temperature
- Regulates water balance
 Basal nuclei
- Regulates metabolism
 “Islands” of gray matter buried deep
 Houses the limbic center for emotions
within the white matter of the cerebrum
 Regulates the nearby pituitary gland
 Regulate voluntary motor activities by
 Houses mammillary bodies for olfaction
modifying instructions sent to skeletal
(smell)
muscles by the primary motor cortex
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Diencephalon: epithalamus  Vomiting


 Forms the roof of the third ventricle  Fourth ventricle lies posterior to pons
 Houses the pineal body (an endocrine and medulla
gland)  Brain stem: reticular formation
 Includes the choroid plexus—forms  Diffuse mass of gray matter along the
cerebrospinal fluid brain stem
 Brain stem  Involved in motor control of visceral
 Attaches to the spinal cord organs
 Parts of the brain stem  Reticular activating system (RAS)
1. Midbrain - Plays a role in awake/sleep cycles and
2. Pons consciousness
3. Medulla oblongata - Filter for incoming sensory information

 Brain stem: midbrain


 Extends from the mammillary bodies to
the pons inferiorly  Cerebrum
 Cerebral aqueduct (tiny canal) connects  Two hemispheres with convoluted
the third and fourth ventricles surfaces
 Two bulging fiber tracts, cerebral  Outer cortex of gray matter and inner
peduncles, convey ascending and region of white matter
descending impulses  Controls balance
 Four rounded protrusions, corpora  Provides precise timing for skeletal
quadrigemina, are visual and auditory muscle activity and coordination of body
reflex centers movements
 Brain stem: pons Protection of the Central Nervous System
 The rounded structure protruding just  Meninges
below the midbrain  Cerebrospinal fluid (CSF)
 Mostly composed of fiber tracts  Blood-brain barrier
 Includes nuclei involved in the control of  Meninges
breathing  Dura mater
 Brain stem: medulla oblongata - Outermost leathery layer
 The most inferior part of the brain stem - Double-layered external covering
that merges into the spinal cord  Periosteum—attached to inner surface of
 Includes important fiber tracts the skull
 Contains important centers that control:  Meningeal layer—outer covering of the
 Heart rate brain
 Blood pressure - Folds inward in several areas
 Breathing  Falx cerebri
 Swallowing  Tentorium cerebella

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Arachnoid layer 3. CSF flows through the subarachnoid space


- Middle layer 4. CSF is absorbed into the dural venous
- Weblike extensions span the subarachnoid sinuses via the arachnoid villi
space to attach it to the pia mater
- Subarachnoid space is filled with
cerebrospinal fluid
- Arachnoid granulations protrude through
the dura mater and absorb cerebrospinal
fluid into venous blood
 Pia mater
- Internal layer
- Clings to the surface of the brain and spinal
cord

 Cerebrospinal fluid
- Similar to blood plasma in composition
- Formed continually by the choroid plexuses
 Choroid plexuses—capillaries in the
ventricles of the brain
- CSF forms a watery cushion to protect the  Blood-brain barrier
brain and spinal cord - Includes the least permeable capillaries of
- Circulated in the arachnoid space, the body
ventricles, and central canal of the spinal - Allows water, glucose, and amino acids to
cord pass through the capillary walls
 Cerebrospinal fluid circulation - Excludes many potentially harmful
1. CSF is produced by the choroid plexus of substances from
each ventricle - entering the brain, such as wastes
2. CSF flows through the ventricles and into - Useless as a barrier against some
the subarachnoid space via the median and substances
lateral apertures. Some CSF flows through Brain Dysfunctions
the central canal of the spinal cord  Traumatic brain injuries
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Concussion
- Slight brain injury
- Typically little permanent brain damage
occurs

 Contusion
- Marked nervous tissue destruction occurs
- Coma may occur
 Death may occur after head blows due
to:
- Intracranial hemorrhage
- Cerebral edema
 Cerebrovascular accident (CVA), or
stroke
- Results when blood circulation to a brain
area is blocked and brain tissue dies
- Loss of some functions or death may result
 Hemiplegia—one-sided paralysis
 Aphasia—damage to speech center in
left hemisphere  Gray matter of the spinal cord and spinal
 Transient ischemic attack (TIA) roots
 Temporary brain ischemia (restriction of  Internal gray matter is mostly cell bodies
blood flow)  Dorsal (posterior) horns house
 Numbness, temporary paralysis, impaired interneurons
speech  Receive information from
 Spinal Cord sensory neurons in the dorsal
 Extends from the foramen magnum of root; cell bodies housed in dorsal
the skull to the first or second lumbar root ganglion
vertebra  Anterior (ventral) horns house motor
 Cauda equina is a collection of spinal neurons of the somatic (voluntary)
nerves at the inferior end nervous system
 Provides a two-way conduction pathway  Send information out ventral
to and from the brain root
 31 pairs of spinal nerves arise from the  Gray matter surrounds the central canal,
spinal Cord which is filled with cerebrospinal fluid
 White matter of the spinal cord
 Composed of myelinated fiber tracts
 Three regions: dorsal, lateral, ventral
columns
 Sensory (afferent) tracts conduct
impulses toward brain
 Motor (efferent) tracts carry impulses
from brain to skeletal muscles

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Mixed nerves
 Contain both sensory and motor fibers
 Sensory (afferent) nerves
 Carry impulses toward the CNS
 Motor (efferent) nerves
Peripheral Nervous System (PNS)  Carry impulses away from the CNS
 PNS consists of nerves and ganglia outside Cranial Nerves
the CNS  12 pairs of nerves serve mostly the head
and neck
Structure of a Nerve  Only the pair of vagus nerves extends to
 Nerves are bundles of neurons found thoracic and abdominal cavities
outside the CNS  Most are mixed nerves, but three are
 Endoneurium is a connective tissue sheath sensory only
that surrounds each fiber 1. Optic
 Perineurium wraps groups of fibers bound 2. Olfactory
into a fascicle 3. Vestibulocochlea
 Epineurium binds groups of fascicles
Cranial Nerves Mnemonic Device
 Oh – Olfactory
 Oh – Optic
 Oh – Oculomotor
 To – Trochlear
 Touch – Trigeminal
 And – Abducens
 Feel – Facial
 Very – Vestibulocochlear
 Green – Glossopharyngeal
 Vegetables – Vagus
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 A – Accessory
 H – Hypoglossal

Spinal Nerves
 Spinal nerves
 31 pairs
 Formed by the combination of the
ventral and dorsa roots of the spinal
cord
 Named for the region of the spinal cord
from which they arise

 Spinal nerves divide soon after leaving the


spinal cord into a dorsal ramus and a ventral
ramus
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Ramus—branch of a spinal nerve;


contains both motor and sensory fibers
 Dorsal rami—serve the skin and muscles
of the posterior trunk
 Ventral rami (T1–T12) —form the
intercostal nerves that supply muscles
and skin of the ribs and trunk
 Ventral rami (except T1–T12)—form a
complex of networks (plexus) for the
anterior

 Plexus—networks of nerves serving motor


and sensory needs of the limbs
 Form from ventral rami of spinal nerves in
the cervical, lumbar, and sacral regions

 Four plexuses
1. Cervical
2. Brachial
3. Lumbar
4. Sacral

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

Postganglionic neuron extends to


the organ
 Has two arms
 Sympathetic division
 Parasympathetic division

Anatomy of the Parasympathetic Division


 Parasympathetic division is also known as
the craniosacral division
 Preganglionic neurons originate in:
 Cranial nerves III, VII, IX, and X
 S2 through S4 regions of the spinal cord
 Preganglionic neurons synapse with
terminal ganglia; from there, postganglionic
axons extend to organs that are served

Autonomic Nervous System


 Motor subdivision of the PNS
 Consists only of motor nerves
 Controls the body automatically (and is
also known as the involuntary nervous
system)
 Regulates cardiac and smooth muscles
and glands
Somatic and Autonomic Nervous Systems
Compared
 Somatic nervous system
 Motor neuron cell bodies originate
Anatomy of the Sympathetic Division
inside the CNS
 Sympathetic division is also known as the
 Axons extends to skeletal muscles that
thoracolumbar division
are served
 Preganglionic neurons originate from T1
 Autonomic nervous system
through L2
 Chain of two motor neurons
 Axons pass through a ramus
 Preganglionic neuron is in the
communicans to enter a sympathetic
brain or spinal cord
trunk ganglion

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Sympathetic trunk, or chain, lies near  Takes over to increase activities


the spinal cord  Remember as the “E” division
 After synapsing at the ganglion, the axon - Exercise
may synapse with a second neuron at the - Excitement
same or different level - Emergency
 Or, the preganglionic neuron may pass - Embarrassment
through the ganglion without synapsing and  Parasympathetic—“housekeeping”
form part of the splanchnic nerves activites
 Splanchnic nerves travel to the collateral  “Rest-and-digest” system
ganglion  Conserves energy
 Collateral ganglia serve the abdominal  Maintains daily necessary body
and pelvic organs functions
 Remember as the “D” division
- Digestion
- Defecation
- Diuresis

Autonomic Functioning
 Body organs served by the autonomic
nervous system receive fibers from both
divisions
 Exceptions: blood vessels, structures of
the skin, some glands, and the adrenal
Developmental Aspects of the Nervous
medulla
System
 These exceptions receive only
 The nervous system is formed during the
sympathetic fibers
first month of embryonic development
 When body divisions serve the same organ,
 Any maternal infection can have extremely
they cause antagonistic effects due to
harmful effects
different neurotransmitters
 Oxygen deprivation destroys brain cells
 Parasympathetic (cholinergic) fibers
 The hypothalamus is one of the last areas of
release acetylcholine
the brain to develop
 Sympathetic postganglionic (adrenergic)
fibers release norepinephrine  Severe congenital brain diseases include:
 Preganglionic axons of both divisions  Cerebral palsy
release acetycholine  Anencephaly
 Hydrocephalus
 Sympathetic—“fight or flight” division
 Spina bifida
 Response to unusual stimulus when
emotionally or physically stressed or  Premature babies have trouble regulating
threatened body temperature because the

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

hypothalamus is one of the last brain areas


to mature prenatally
 Development of motor control indicates the
progressive myelination and maturation of a
child’s nervous system
 Brain growth ends in young adulthood.
Neurons die throughout life and are not
replaced; thus, brain mass declines with age
 Orthostatic hypotension is low blood
pressure due to changes in body position
External and Accessory Structures
 Healthy aged people maintain nearly
 Eyelids
optimal intellectual function
 Meet at the medial and lateral
 Disease—particularly cardiovascular
commissure (canthus)
disease—is the major cause of declining
 Eyelashes
mental function with age
 Tarsal glands produce an oily secretion
 Arteriosclerosis is decreased elasticity of
that lubricate the eye
blood vessels
 Ciliary glands are located between the
TOPIC 8 WEEK 8 eyelashes
SPECIAL SENSES  Conjunctiva
 Special senses include:  Membrane that lines the eyelids and
 Smell eyeball
 Taste  Connects with the transparent cornea
 Sight  Secretes mucus to lubricate the eye and
 Hearing keep it moist
 Equilibrium  Lacrimal apparatus = lacrimal gland + ducts
 Special sense receptors  Lacrimal gland—produces lacrimal fluid
 Large, complex sensory organs (tears); situated on lateral end of each
 Localized clusters of receptors eye
 Tears drain across the eye into the
Part I: The Eye and Vision lacrimal canaliculi, then the lacrimal sac,
 70 percent of all sensory receptors are in and into the nasolacrimal duct, which
the eyes empties into the nasal cavity
 Each eye has over 1 million nerve fibers
carrying information to the brain
Anatomy of the Eye  Tears contain:
 Accessory structures include the:  Dilute salt solution
 Extrinsic eye muscles  Mucus
 Eyelids  Antibodies
 Conjunctiva  Lysozyme (enzyme that destroys
 Lacrimal apparatus bacteria)
 Function of tears
 Cleanse, protect, moisten, lubricate the
eye

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Extrinsic eye muscles


Internal Structures: The Eyeball
 Six muscles attach to the outer surface
 Three layers, or tunics, form the wall of the
of the eye
eyeball
 Produce gross eye movements
 Fibrous layer: outside layer
 Vascular layer: middle layer
 Sensory layer: inside layer
 Humors are fluids that fill the interior of the
eyeball
 Lens divides the eye into two chambers

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

1. Outer pigmented layer absorbs light and


prevents it from scattering
2. Inner neural layer contains receptor cells
(photoreceptors)
 Rods
 Cones
 Electrical signals pass from
photoreceptors via a two-neuron chain
 Bipolar neurons
 Ganglion cells
 Signals leave the retina toward the brain
through the optic nerve
 Optic disc (blind spot) is where the optic
nerve leave the eyeball
 Cannot see images focused on
the optic disc

 Fibrous layer = sclera + cornea


 Sclera
 White connective tissue layer
 Seen anteriorly as the “white of
the eye”
 Cornea
 Transparent, central anterior
portion
 Allows for light to pass through
 Repairs itself easily
 The only human tissue that can
be transplanted without fear of
rejection
 Vascular layer
 Choroid is a blood-rich nutritive layer
that contains a pigment (prevents light
from scattering)
 Choroid is modified anteriorly into two
smooth muscle structures
 Ciliary body
 Iris—regulates amount of light
entering eye
o Pigmented layer that
gives eye color
o Pupil—rounded opening
in the iris
 Sensory layer
 Retina contains two layers

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Rods
 Most are found toward the  Lens
edges of the retina  Flexible, biconvex crystal-like
 Allow vision in dim light and structure
peripheral vision  Held in place by a suspensory
 All perception is in gray tones ligament attached to the ciliary
 Cones body
 Allow for detailed color vision
 Densest in the center of the
retina
 Fovea centralis–lateral to blind
spot
o Area of the retina with
only cones
o Visual acuity (sharpest
vision) is here
 No photoreceptor cells are at the optic
disc, or blind spot  Lens divides the eye into two chambers
 Cone sensitivity 1. Anterior (aqueous) segment
 Three types of cones  Anterior to the lens
 Each cone type is sensitive to  Contains aqueous humor, a clear,
different wavelengths of visible watery fluid
light 2. Posterior (vitreous) segment
 Posterior to the lens
 Contains vitreous humor, a gel-like
substance
 Aqueous humor
 Watery fluid found between lens
and cornea
 Similar to blood plasma
 Helps maintain intraocular
pressure

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Provides nutrients for the lens


and cornea
 Reabsorbed into venous blood
through the sclera venous sinus,
or canal of Schlemm
 Vitreous humor
 Gel-like substance posterior to
the lens
 Prevents the eye from collapsing
 Helps maintain intraocular
pressure
 Ophthalmoscope
 Instrument used to illuminate
the interior of the eyeball and
fundus (posterior wall)
 Can detect diabetes,  Image formed on the retina is a real
arteriosclerosis, degeneration of image
the optic nerve and retina  Real images are:
 Reversed from left to right
 Upside down
 Smaller than the object
 Visual fields and visual pathways to the
brain
 Optic nerve
 Bundle of axons that exit the
back of the eye carrying impulses
from the retina
 Optic chiasma
 Location where the optic nerves
cross
 Fibers from the medial side of
each eye cross over to the
opposite side of the brain
Physiology of Vision
 Optic tracts
 Pathway of light through the eye and light
 Contain fibers from the lateral
refraction
side of the eye on the same side
 Light must be focused to a point on the
and the medial side of the
retina for optimal vision
opposite eye
 Light is bent, or refracted, by the cornea,
 Synapse with neurons in the
aqueous humor, lens, and vitreous
thalamus
humor
 Optic radiation
 The eye is set for distant vision (over 20
 Axons from the thalamus run to
feet away)
the occipital lobe
 Accommodation—the lens must change
 Synapse with cortical cells, and
shape to focus on closer objects (less
vision interpretation (seeing)
than 20 feet away)
occurs

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Summary of the pathway of impulses from  Astigmatism


the retina to the point of visual  Images are blurry
interpretation  Results from light focusing as lines, not
1. Optic nerve points, on the retina because of unequal
2. Optic chiasma curvatures of the cornea or lens
3. Optic tract
4. Thalamus
5. Optic radiation
6. Optic cortex in occipital lobe of brain

 Eye reflexes
 Convergence: reflexive movement of the
eyes medially when we focus on a close
object
 Photopupillary reflex: bright light causes
pupils to constrict
 Accommodation pupillary reflex:
viewing close objects causes pupils to
constrict
Part II: The Ear: Hearing and Balance
 Visual fields  Ear houses two senses
 Each eye “sees” a slightly different view 1. Hearing
 Field of view overlaps for each eye 2. Equilibrium (balance)
 Binocular vision results and provides:  Receptors are mechanoreceptors
 Depth perception (three-dimensional  Different organs house receptors for each
vision) sense
 Emmetropia—eye focuses images correctly Anatomy of the Ear
on the retina  The ear is divided into three areas
 Myopia (nearsightedness) 1. External (outer) ear
 Distant objects appear blurry 2. Middle ear
 Light from those objects fails to 3. Internal (inner) ear
reach the retina and are focused in
front of it
 Results from an eyeball that is too
long
 Hyperopia (farsightedness)
 Near objects are blurry, whereas distant
objects are clear
 Distant objects are focused behind the
retina
 Results from an eyeball that is too short
or from a “lazy lens”
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 External (outer) ear  Internal (inner) ear


 Auricle (pinna)  Includes sense organs for hearing
 External acoustic meatus (auditory and balance
canal)  Bony labyrinth (osseous
 Narrow chamber in the temporal labyrinth) consists of:
bone o Cochlea
 Lined with skin and ceruminous o Vestibule
(earwax) glands o Semicircular canals
 Ends at the tympanic membrane  Bony labyrinth is filled
(eardrum) with perilymph
 External ear is involved only in collecting Membranous
sound waves labyrinth is
 Middle ear cavity (tympanic cavity) suspended in
 Air-filled, mucosa-lined cavity within the perilymph and
temporal bone contains endolymph
 Involved only in the sense of hearing Static Equilibrium
 Located between tympanic membrane  Maculae—receptors in the vestibule
and oval window and round window  Report on the position of the head
 Pharyngotympanic tube (auditory tube)  Help us keep our head erect
 Links middle ear cavity with the  Send information via the vestibular
throat nerve (division of cranial nerve VIII) to
 Equalizes pressure in the middle the cerebellum of the brain
ear cavity so the eardrum can  Anatomy of the maculae
vibrate  Hair cells are embedded in the otolithic
 Three bones (ossicles) span the cavity membrane
1. Malleus (hammer)  Otoliths (tiny stones) float in a gel
2. Incus (anvil) around hair cells
3. Stapes (stirrup)  Movements cause otoliths to roll and
 Function bend hair cells
 Transmit vibrations from
tympanic membrane to the
fluids of the inner ear
 Vibrations travel from the
hammer → anvil → stirrup
→oval window of inner ear

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

Dynamic Equilibrium
 Crista ampullaris
 Responds to angular or rotational
movements of the head
 Located in the ampulla of each
semicircular canal
 Tuft of hair cells covered with cupula
(gelatinous cap)
 If the head moves, the cupula drags Hearing
against the endolymph  Spiral organ of Corti
 Hair cells are stimulated, and the  Located within the cochlear duct
impulse travels the vestibular nerve to  Receptors = hair cells on the basilar
the cerebellum membrane
 Gel-like tectorial membrane is capable
of bending hair cells
 Cochlear nerve attached to hair cells
transmits nerve impulses to auditory
cortex on temporal lobe

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Specific hair cells further along the


cochlea are affected

 Pathway of vibrations from sound waves  Deafness is any degree of hearing loss
 Move by the ossicles from the eardrum  Conduction deafness results when the
to the oval window transmission of sound vibrations
 Sound is amplified by the ossicles through the external and middle ears is
 Pressure waves cause vibrations in the hindered
basilar membrane in the spiral organ of  Sensorineural deafness results from
Corti damage to the nervous system
 Hair cells of the tectorial membrane are structures involved in hearing
bent when the basilar membrane  Ménière’s syndrome affects the inner
vibrates against it ear and causes progressive deafness and
 An action potential starts in the cochlear perhaps vertigo (sensation of spinning)
nerve (cranial nerve VIII), and the
impulse travels to the temporal lobe
 High-pitched sounds disturb the short, stiff Part III: Chemical Senses: Smell and Taste
fibers of the basilar membrane  Chemoreceptors
 Receptor cells close to the oval window  Stimulated by chemicals in solution
are stimulated  Taste has five types of receptors
 Low-pitched sounds disturb the long, floppy  Smell can differentiate a wider range of
fibers of the basilar membrane chemicals
 Both senses complement each other and
respond to many of the same stimuli
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Olfactory Receptors and the Sense of Smell


 Olfactory receptors are in roof of nasal
cavity
 Olfactory receptor cells (neurons) with
long cilia known as olfactory hairs detect
chemicals
 Chemicals must be dissolved in mucus
for detection by chemoreceptors called
olfactory receptors
 Impulses are transmitted via the olfactory
filaments to the olfactory nerve (cranial
nerve I)
 Smells are interpreted in the olfactory  Gustatory cells are the taste receptors
cortex  Possess gustatory hairs (long microvilli)
 Gustatory hairs protrude through a taste
pore
 Hairs are stimulated by chemicals
dissolved in saliva

Taste Buds and the Sense of Taste


 Taste buds house the receptor organs
 Locations of taste buds
 Most are on the tongue
 Soft palate
 Superior part of the pharynx
 Cheeks
 The tongue is covered with projections
called papillae that contain taste buds
 Vallate (circumvallate) papillae
 Fungiform papillae
 Impulses are carried to the gustatory
 Filiform papillae
complex by several cranial nerves because
taste buds are found in different areas
 Facial nerve (cranial nerve VII)
 Glossopharyngeal nerve (cranial nerve
IX)
 Vagus nerve (cranial nerve X)
 Taste buds are replaced frequently by basal
cells
 Five basic taste sensations
 Sweet receptors respond to sugars,
saccharine, some amino acids
 Sour receptors respond to H+ ions or
acids
 Bitter receptors respond to alkaloids
 Salty receptors respond to metal ions
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Umami receptors respond to the amino missing external


acid glutamate or the beefy taste of acoustic meatuses
meat  Taste and smell are most acute at birth
Part IV: Developmental Aspects of the Special and decrease in sensitivity after age 40
Senses as the number of olfactory and
 Special sense organs are formed early in gustatory receptors decreases
embryonic development TOPIC 9 WEEK 9
 Maternal infections during the first 5 or 6 ENDOCRINE SYSTEM
weeks of pregnancy may cause visual The Endocrine System
abnormalities as well as sensorineural  Second controlling system of the body
deafness in the developing child  Nervous system is the fast-control
 Vision requires the most learning system
 The infant has poor visual acuity (is  Uses chemical messengers (hormones) that
farsighted) and lacks color vision and depth are released into the blood
perception at birth  Hormones control several major processes
 The eye continues to grow and mature until  Reproduction
age  Growth and development
8 or 9  Mobilization of body defences
 Age-related eye issues  Maintenance of much of homeostasis
 Presbyopia—“old vision” results from  Regulation of metabolism
decreasing lens elasticity that  Hormones are produced by specialized cells
accompanies aging  Cells secrete hormones into extracellular
 Causes difficulty to fluids
focus for close vision  Blood transfers hormones to target sites
 Lacrimal glands become less active  These hormones regulate the activity of
 Lens becomes discoloured other cells
 Dilator muscles of iris become less  Endocrinology is the scientific study of
efficient, causing pupils to remain hormones and endocrine organs
constricted The Chemistry of Hormones
 The newborn infant can hear sounds, * Hormones are classified chemically as:
but initial responses are reflexive  Amino acid–based, which includes:
 By the toddler stage, the child is  Proteins
listening critically and beginning to  Peptides
imitate sounds as language  Amines
development begins  Steroids—made from cholesterol
 Age-related ear problems  Prostaglandins—made from highly
 Presbycusis—type of active lipids that act as local hormones
sensorineural Hormone Action
deafness that may  Hormones affect only certain tissues or
result from organs (target cells or target organs)
otosclerosis  Target cells must have specific protein
 Otosclerosis—ear receptors
ossicles fuse  Hormone binding alters cellular activity
 Congenital ear
 Hormones arouse cells or alter cellular
problems usually
activity
result from missing
 Typically, one or more of the following
pinnas and closed or
occurs:

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

1. Change plasma membrane permeability 3. Enzyme catalyzes a reaction that


or membrane potential by opening or produces a second-messenger molecule
closing ion channels (such as cyclic AMP, known as cAMP)
2. Activate or inactivate enzymes 4. Oversees additional intracellular
3. Stimulate or inhibit cell division changes to promote a specific response
4. Promote or inhibit secretion of a in the target cell
product
5. Turn on or turn off transcription of
certain genes
 Hormones act by two mechanisms
1. Direct gene activation
 Used by steroid hormones and thyroid
hormone
2. Second-messenger system
 Used by protein and peptide hormones
 Direct gene activation
1. Steroid hormones diffuse through the
plasma membrane of target cells
2. Once inside the cell, the hormone enters
the nucleus
Stimuli for Control of Hormone Release
3. Then, the hormone binds to a specific
 Hormone levels in the blood are maintained
protein within the nucleus
mostly by negative feedback
4. Hormone-receptor complex binds to
 A stimulus or low hormone levels in the
specific sites on the cell’s DNA
blood trigger the release of more hormone
5. Certain genes are activated to transcribe
messenger RNA  Hormone release stops once an appropriate
6. New proteins are synthesized level in the blood is reached
 The stimuli that activate endocrine glands
fall into three major categories
1. Hormonal
2. Humoral
3. Neural
 Hormonal stimuli
 Most common category of stimulus
 Endocrine organs are activated by other
hormones
 Example:
 Hormones of the hypothalamus
stimulate the anterior pituitary
to secrete its hormones

 Second-messenger system
1. Hormone (first messenger) binds to a
membrane receptor
2. Activated receptor sets off a series of
reactions that activates an enzyme

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Neural stimuli
 Nerve fibers stimulate hormone release
 Most are under the control of the
 Humoral stimuli
sympathetic nervous system
 Changing blood levels of certain ions
 Examples:
and nutrients stimulate hormone
 Sympathetic stimulation of the
release
adrenal medulla to release
 Humoral indicates various body
epinephrine and norepinephrine
fluids, such as blood and bile
 Examples:
 Parathyroid hormone and
calcitonin are produced in
response to changing levels of
blood calcium levels
 Insulin is produced in response
to changing levels of blood
glucose levels

The Major Endocrine Organs


 Hypothalamus
 Pituitary gland
 Pineal gland

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Thyroid gland  Hypothalamus produces releasing


 Parathyroid glands hormones and inhibiting hormones
 Thymus  These hormones are released into portal
 Adrenal glands circulation, which connects
 Pancreas hypothalamus to anterior pituitary
 Gonads (testes and ovaries)  Hypothalamus also makes two hormones:
oxytocin and antidiuretic hormone
 Carried to posterior pituitary via
neurosecretory cells for storage

 Some glands have purely endocrine


functions  Posterior pituitary
 Anterior pituitary, thyroid, adrenals,  Does not make the hormones it releases
parathyroids  Stores hormones made by the
 Endocrine glands are ductless glands hypothalamus
 Hormones are released directly into blood  Two hormones released
or lymph  Oxytocin
 Stimulates contractions of the
 Other glands are mixed glands, with both
uterus during labor, sexual
endocrine and exocrine functions (pancreas,
relations, and breastfeeding
gonads)
 Causes milk ejection (let-down
Pituitary Gland and Hypothalamus
reflex) in a breastfeeding woman
 Pituitary gland
 Antidiuretic hormone (ADH)
 Pea-sized gland that hangs by a stalk
 Inhibits urine production
from the hypothalamus in the brain
(diuresis) by promoting water
 Protected by the sella turcica of the
reabsorption by the kidneys
sphenoid bone
 Urine volume decreases, blood
 Has two functional lobes
pressure increases
1. Anterior pituitary—glandular tissue
 In large amounts, causes
2. Posterior pituitary—nervous tissue
constriction of arterioles, leading
 Often called the “master endocrine
to increased blood pressure (the
gland”
reason why ADH is known as
vasopressin)
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Alcohol inhibits ADH secretion  Major effects are directed to growth of


skeletal muscles and long bones
 Plays a role in determining final body
size
 Causes amino acids to be built into
proteins
 Causes fats to be broken down for a
source of energy
 Prolactin (PRL)
 Stimulates and maintains milk
production following childbirth
 Function in males is unknown
 Gonadotropic hormones
 Regulate hormonal activity of the
gonads
 Follicle-stimulating hormone
(FSH)
o Stimulates follicle
development in ovaries
 Six anterior pituitary hormones o Stimulates sperm
 Two hormones affect nonendocrine development in testes
targets  Luteinizing hormone (LH)
1. Growth hormone o Triggers ovulation of an
2. Prolactin egg in females
 Four are tropic hormones o Stimulates testosterone
1. Follicle-stimulating hormone production in males
2. Luteinizing hormone  Thyrotropic hormone (TH), also called
3. Thyrotropic hormone thyroid-stimulating hormone (TSH)
4. Adrenocorticotropic hormone  Influences growth and activity of the
thyroid gland
 Adrenocorticotropic hormone (ACTH)
 Regulates endocrine activity of the
adrenal cortex
Pineal Gland
 Hangs from the roof of the third ventricle of
the brain
 Secretes melatonin
 Believed to trigger the body’s
sleep/wake cycle
 All anterior pituitary hormones:  Believed to coordinate the hormones of
 Are proteins (or peptides) fertility in humans and to inhibit the
 Act through second-messenger systems reproductive system until maturity
 Are regulated by hormonal stimuli occurs
 Are regulated mostly by negative Thyroid Gland
feedback  Found at the base of the throat, inferior to
 Growth hormone (GH) the Adam’s apple
 General metabolic hormone  Consists of two lobes and a connecting
isthmus

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Follicles are hollow structures that store


colloidal material
 Produces two hormones
1. Thyroid hormone
2. Calcitonin

 Calcitonin
Thyroid Gland  Decreases blood calcium levels by
 Thyroid hormone causing calcium deposition on bone
 Major metabolic hormone  Antagonistic to parathyroid hormone
 Controls rate of oxidation of glucose to  Produced by parafollicular cells found
supply body heat and chemical energy between the follicles
 Needed for tissue growth and
development
 Composed of two active iodine-
containing hormones
 Thyroxine (T4)—secreted by
thyroid follicles
 Triiodothyronine (T3)—
conversion of T4 at target tissues

 Tiny masses on the posterior of the thyroid


 Secrete parathyroid hormone (PTH)
 Most important regulator of calcium ion
(Ca2+) homeostasis of the blood
 Stimulates osteoclasts to remove
calcium from bone
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Hypercalcemic hormone (increases


blood calcium levels)
 Stimulates the kidneys and intestine to
absorb more calcium

 Hormones of the adrenal cortex


 Mineralocorticoids (mainly aldosterone)
 Produced in outer adrenal cortex
 Regulate mineral (salt) content in
blood, particularly sodium and
potassium ions
 Regulate water and electrolyte
balance
Thymus  Target organ is the kidney
 Located in the upper thorax, posterior to  Hormones of the adrenal cortex (continued)
the sternum  Release of aldosterone is stimulated by:
 Largest in infants and children  Humoral factors (fewer sodium
 Decreases in size throughout adulthood ions or too many potassium ions
 Produces a hormone called thymosin in the blood)
 Matures some types of white blood cells  Hormonal stimulation (ACTH)
 Important in developing the immune  Renin and angiotensin II in
system response to a drop in blood
Adrenal Glands pressure
 Sit on top of the kidneys  Aldosterone production is inhibited by
 Two regions atrial natriuretic peptide (ANP), a
1. Adrenal cortex—outer glandular region hormone produced by the heart when
has three layers that produce blood pressure is too high
corticosteroids
 Mineralocorticoids are secreted
by outermost layer
 Glucocorticoids are secreted by
middle layer
 Sex hormones are secreted by
innermost layer
2. Adrenal medulla—inner neural tissue
region

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Increasing heart rate, blood


pressure, blood glucose levels
 Dilating small passageways of
lungs

 Hormones of the adrenal cortex (continued)


 Glucocorticoids (including cortisone
and cortisol)
 Produced by middle layer of
adrenal cortex
 Promote normal cell metabolism
 Help resist long-term stressors
by increasing blood glucose
levels (hyperglycemic hormone)
 Anti-inflammatory properties
 Released in response to Pancreatic Islets
increased blood levels of ACTH
 Hormones of the adrenal cortex (continued)  Pancreas
 Sex hormones  Located in the abdomen, close to
 Produced in the inner layer of stomach
the adrenal cortex  Mixed gland, with both endocrine and
 Small amounts are made exocrine functions
throughout life  The pancreatic islets (islets of Langerhans)
 Most of the hormones produced produce hormones
are androgens (male sex  Insulin—produced by beta cells
hormones), but some estrogens  Glucagon—produced by alpha cells
(female sex hormones) are also  These hormones are antagonists that
formed maintain blood sugar homeostasis
 Adrenal medulla
 Produces two similar hormones
(catecholamines)
1. Epinephrine (adrenaline)
2. Norepinephrine (noradrenaline)
 These hormones prepare the body to
deal with short-term stress (“fight or
flight”) by:

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 timulates the liver to release glucose to


blood, thus increasing blood glucose
levels

Gonads
 Produce sex cells
 Produce sex hormones
 Ovaries
 Female gonads located in the pelvic
cavity
 Produce eggs
 Produce two groups of steroid
hormones
1. Estrogens
2. Progesterone
 Testes
 Male gonads suspended outside the
pelvic cavity
 Produce sperm
 Produce androgens, such as
testosterone
 Estrogens
 Stimulate the development of secondary
female characteristics
 Mature the female reproductive organs
 Insulin  With progesterone, estrogens also:
 Released when blood glucose levels are  Promote breast development
high  Regulate menstrual cycle
 Increases the rate of glucose uptake and  Progesterone
metabolism by body cells  Acts with estrogen to bring about the
 Effects are hypoglycaemic menstrual cycle
 Glucagon  Helps in the implantation of an embryo
 Released when blood glucose levels are in the uterus
low  Helps prepare breasts for lactation
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Testes
 Produce several androgens
 Testosterone is the most important
androgen
 Responsible for adult male
secondary sex characteristics
 Promotes growth and
maturation of male reproductive
system
 Required for sperm cell
production

Other Hormone-Producing Tissues and Organs


 Other organs that are generally
nonendocrine in function also secrete
hormones
 Stomach
 Small intestine
 Kidneys
 Heart
 Placenta
 Produces hormones that maintain
pregnancy
 Some hormones play a part in the
delivery of the baby
 Produces human chorionic
gonadotropin (hCG) in addition to
estrogen, progesterone, and other
hormones
 Human placental lactogen (hPL)
prepares the breasts for lactation
 Relaxin relaxes pelvic ligaments and
pubic symphysis for childbirth

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Blood is the only fluid tissue, a type of


connective tissue, in the human body
 Components of blood
 Formed elements (living cells)
 Plasma (nonliving fluid matrix)
 When blood is separated:
 Erythrocytes sink to the bottom (45
percent of blood, a percentage known
as the hematocrit)
 Buffy coat contains leukocytes and
platelets (less than 1 percent of blood)
 Buffy coat is a thin, whitish layer
between the erythrocytes and
plasma
 Plasma rises to the top (55 percent of
blood)

Developmental Aspects of the Endocrine System


 In the absence of disease, efficiency of the
endocrine system remains high until old age
 Decreasing function of female ovaries at
menopause leads to such symptoms as
osteoporosis, increased chance of heart
disease, and possible mood changes
 Efficiency of all endocrine glands gradually
decreases with aging, which leads to a
generalized increase in incidence of:
 Diabetes mellitus
Physical Characteristics and Volume
 Immune system depression
 Blood characteristics
 Lower metabolic rate
 Sticky, opaque fluid
 Cancer rates in some areas
 Heavier and thicker than water
 Color range
TOPIC 9 WEEK 9  Oxygen-rich blood is scarlet red
BLOOD  Oxygen-poor blood is dull red or purple
 Metallic, salty taste
Blood  Blood pH is slightly alkaline, between
 Blood transports everything that must be 7.35 and 7.45
carried from one place to another, such as:  Blood temperature is slightly higher
 Nutrients than body temperature, at 38ºC or
 Wastes 100.4ºF
 Hormones  Blood volume
 Body heat  About 5–6 liters, or about 6 quarts, of
blood are found in a healthy adult
Components of Blood
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Blood makes up 8 percent of body


weight
Plasma
 90 percent water
 Straw-colored fluid
 Includes many dissolved substances
 Nutrients
 Salts (electrolytes)
 Respiratory gases
 Hormones
 Plasma proteins
 Waste products
 Plasma proteins
 Most abundant solutes in plasma
 Most are made by the liver

 Include:
 Albumin—an important blood  Erythrocytes (red blood cells, or RBCs)
buffer and contributes to  Main function is to carry oxygen
osmotic pressure  RBCs differ from other blood cells
 Clotting proteins—help to stem  Anucleate (no nucleus)
blood loss when a blood vessel is  Contain few organelles; lack
injured mitochondria
 Antibodies—help protect the  Essentially bags of hemoglobin
body from pathogens (Hb)
 Blood composition varies as cells exchange  Shaped like biconcave discs
substances with the blood  Normal count is 5 million RBCs per cubic
 Liver makes more proteins when levels millimeter (mm3) of blood
drop  Hemoglobin is an iron-bearing protein
 Respiratory and urinary systems restore  Binds oxygen
blood pH to normal when blood  Each hemoglobin molecule can
becomes too acidic or alkaline bind 4 oxygen molecules
 Plasma helps distribute body heat  Each erythrocyte has 250 million
Formed Elements hemoglobin molecules
 Erythrocytes  Normal blood contains 12–18 g
 Red blood cells (RBCs) of hemoglobin per
 Leukocytes 100 milliliters (ml) of blood
 White blood cells (WBCs)  Homeostatic imbalance of RBCs
 Platelets  Anemia is a decrease in the oxygen-
 Cell fragments carrying ability of the blood due to:
 Lower-than-normal number of
RBCs
 Abnormal or deficient
hemoglobin content in the RBCs
 Sickle cell anemia (SCA) results from
abnormally shaped haemoglobin

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Commonly caused by certain drugs,


such as corticosteroids and anticancer
agents
 Leukemia
 Bone marrow becomes cancerous
 Numerous immature WBC are produced
 Types of leukocytes
 Granulocytes
 Granules in their cytoplasm can
be stained
 Possess lobed nuclei
 Polcythemia  Include neutrophils, eosinophils,
 Disorder resulting from excessive or and basophils
abnormal increase of RBCs due to:  Agranulocytes
 Bone marrow cancer  Lack visible cytoplasmic granules
(polycythemia vera)  Nuclei are spherical, oval, or
 Life at higher altitudes kidney-shaped
(secondary polycythemia)  Include lymphocytes and
 Increase in RBCs slows blood flow and monocytes
increases blood viscosity  List of the WBCs, from most to least
abundant
 Neutrophils
 Lymphocytes
 Monocytes
 Eosinophils
 Basophils
 Granulocytes
 Neutrophils
 Most numerous WBC
 Leukocytes (white blood cells, or WBCs)  Multilobed nucleus
 Crucial in body’s defense against disease  Cytoplasm stains pink and
 Complete cells, with nucleus and contains fine granules
organelles  Function as phagocytes at active
 Able to move into and out of blood sites of infection
vessels (diapedesis)  Numbers increase during
 Respond to chemicals released by infection
damaged tissues (known as positive  3,000–7,000 neutrophils per
chemotaxis) mm3 of blood (40–70 percent of
 Move by amoeboid motion WBCs)
 4,800 to 10,800 WBCs per mm3 of blood  Eosinophils
 Leukocytosis  Nucleus stains blue-red
 WBC count above 11,000 cells per mm3  Brick-red cytoplasmic granules
of blood  Function is to kill parasitic worms
 Generally indicates an infection and play a role in allergy attacks
 Leukopenia  100–400 eosinophils per mm3 of
 Abnormally low WBC count blood (1–4 percent of WBCs)
 Basophils
 Rarest of the WBCs

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Large histamine-containing
granules that stain dark blue
 Contain heparin (anticoagulant)
 20–50 basophils per mm3 of
blood (0–1 percent of WBCs)
 Agranulocytes
 Lymphocytes
 Large, dark purple nucleus
 Slightly larger than RBCs
 Reside in lymphatic tissues
Hematopoiesis (Blood Cell Formation)
 Play a role in immune response
 1,500–3,000 lymphocytes per  Hematopoiesis is the process of blood cell
mm3 of blood (20–45 percent of formation
WBCs)  Occurs in red bone marrow (myeloid tissue)
 Monocytes  All blood cells are derived from a common
 Largest of the white blood cells stem cell (hemocytoblast)
 Distinctive U- or kidney-shaped  Hemocytoblasts form two types of
nucleus descendants
 Function as macrophages when  Lymphoid stem cell, which produces
they migrate into tissues lymphocytes
 Important in fighting chronic  Myeloid stem cell, which can produce all
infection other formed elements
 100–700 monocytes per mm3 of
blood (4–8 percent of WBCs)
 Platelets
 Fragments of megakaryocytes
(multinucleate cells)
 Needed for the clotting process
 Normal platelet count is 300,000
platelets per mm3 of blood

Formation of Red Blood Cells


 Since RBCs are anucleate, they are unable to
divide, grow, or synthesize proteins
 RBCs wear out in 100 to 120 days
 When worn out, RBCs are eliminated by
phagocytes in the spleen or liver
 Lost cells are replaced by division of
hemocytoblasts in the red bone marrow
 Rate of RBC production is controlled by a
hormone called erythropoietin

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Kidneys produce most erythropoietin as a  Platelets become “sticky” and cling to


response to reduced oxygen levels in the fibers
blood  Anchored platelets release chemicals to
 Homeostasis is maintained by negative attract more platelets
feedback from blood oxygen levels  Platelets pile up to form a platelet plug
(white thrombus)

Formation of White Blood Cells and Platelets


 WBC and platelet production is controlled
by hormones  Step 3: coagulation
 Colony stimulating factors (CSFs) and  Injured tissues release tissue factor (TF)
interleukins prompt bone marrow to  PF3 (a phospholipid) interacts with TF,
generate leukocytes blood protein clotting factors, and
 Thrombopoietin stimulates production calcium ions to trigger a clotting cascade
of platelets from megakaryocytes  Prothrombin activator converts
prothrombin to thrombin (an enzyme)
 Thrombin joins fibrinogen proteins into
hairlike molecules of insoluble fibrin
Hemostasis  Fibrin forms a meshwork (the basis for a
 Hemostasis is the process of stopping the clot)
bleeding that results from a break in a blood  Within the hour, serum is squeezed from
vessel the clot as it retracts
 Hemostasis involves three phases  Serum is plasma minus clotting
1. Vascular spasms proteins
2. Platelet plug formation
3. Coagulation (blood clotting)
 Step 1: vascular spasms
 Immediate response to blood vessel
injury
 Vasoconstriction causes blood vessel to
spasm  Blood usually clots within 3 to 6 minutes
 Spasms narrow the blood vessel,  The clot remains as endothelium
decreasing blood loss regenerates
 The clot is broken down after tissue repair
Disorders of Hemostasis
 Undesirable clotting
 Thrombus
 A clot in an unbroken blood
 Step 2: platelet plug formation vessel
 Collagen fibers are exposed by a break  Can be deadly in areas such as
in a blood vessel the lungs
 Embolus

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 A thrombus that breaks away  There are over 30 common red blood cell
and floats freely in the antigens
bloodstream  The most vigorous transfusion reactions are
 Can later clog vessels in critical caused by ABO and Rh blood group antigens
areas such as the brain Human Blood Groups
 Bleeding disorders  ABO blood group
 Thrombocytopenia  Blood types are based on the presence
 Insufficient number of circulating or absence of two antigens
platelets 1. Type A
 Arises from any condition that 2. Type B
suppresses the bone marrow  Presence of both antigens A and B is
 Even normal movements can called type AB
cause bleeding from small blood  Presence of antigen A is called type A
vessels that require platelets for  Presence of antigen B is called type B
clotting  Lack of both antigens A and B is called
 Evidenced by petechiae (small type O
purplish blotches on the skin)  Type AB can receive A, B, AB, and O
 Hemophilia blood
 Hereditary bleeding disorder  Type AB is the “universal
 Normal clotting factors are recipient”
missing  Type B can receive B and O blood
 Minor tissue damage can cause  Type A can receive A and O blood
life-threatening prolonged  Type O can receive O blood
bleeding  Type O is the “universal donor”
 Blood Groups and Transfusions
Blood Groups and Transfusions
 Large losses of blood have serious
consequences
 Loss of 15 to 30 percent causes
weakness
 Loss of over 30 percent causes shock,
which can be fatal
 Blood transfusions are given for substantial
blood loss, to treat severe anemia, or for
thrombocytopenia
Human Blood Groups
 Blood contains genetically determined
proteins known as antigens
 Antigens are substances that the body  Rh blood group
recognizes as foreign and that the immune  Named for the eight Rh antigens
system may attack (agglutinogen D)
 Most antigens are foreign proteins  Most Americans are Rh+ (Rh-positive),
 We tolerate our own “self” antigens meaning they carry the Rh antigen
 Antibodies are the “recognizers” that bind  If an Rh–(Rh-negative) person receives
foreign antibens Rh+ blood:
 Blood is “typed” by using antibodies that  The immune system becomes
will cause blood with certain proteins to sensitized and begins producing
clump (agglutination) and lyse antibodies; hemolysis does not

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

occur, because as it takes time to


produce antibodies
 Second, and subsequent,
transfusions involve antibodies
attacking donor’s Rh+ RBCs, and
hemolysis occurs (rupture of
RBCs)
 Rh-related problem during pregnancy
 Danger occurs only when the mother is
Rh–, the father is Rh+, and the child
inherits the Rh+ factor
 RhoGAM shot can prevent buildup of
anti-Rh+ antibodies in mother’s blood
 The mismatch of an Rh– mother carrying an
Rh+ baby can cause problems for the
unborn child Developmental Aspects of Blood
 The first pregnancy usually proceeds
without problems; the immune system  Sites of blood cell formation
is sensitized after the first pregnancy  The fetal liver and spleen are early sites
 In a second pregnancy, the mother’s of blood cell formation
immune system produces antibodies to  Bone marrow takes over hematopoiesis
attack the Rh+ blood (hemolytic disease by the seventh month
of the newborn)  Congenital blood defects include various
types of hemolytic anemias and
haemophilia
 Incompatibility between maternal and fetal
Blood Typing blood can result in fetal cyanosis, resulting
 Blood samples are mixed with anti-A and from destruction of fetal blood cells
anti-B serum  Fetal hemoglobin differs from hemoglobin
 Agglutination or the lack of agglutination produced after birth
leads to identification of blood type  Physiologic jaundice occurs in infants when
 Typing for ABO and Rh factors is done in the the liver cannot rid the body of hemoglobin
same manner breakdown products fast enough
 Cross matching—testing for agglutination of  Leukemias are most common in the very
donor RBCs by the recipient’s serum, and young and very old
vice versa  Older adults are also at risk for anemia
and clotting disorders

TOPIC 11 WEEK 11
THE CARDIOVASCULAR SYSTEM
The Cardiovascular System
 A closed system of the heart and blood
vessels
 The heart pumps blood
 Blood vessels allow blood to circulate to
all parts of the body
 Functions of the cardiovascular system

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Transport oxygen, nutrients, cell wastes, 1. Parietal pericardium: outside


hormones to and from cells layer that lines the inner
Anatomy of the Heart surface of the fibrous
 Size of a human fist, weighing less than a pericardium
pound 2. Visceral pericardium: next to
 Located in the thoracic cavity, between the heart; also known as the
lungs in the inferior mediastinum epicardium
 Orientation
 Apex is directed toward left hip and  Serous fluid fills the space
rests on the diaphragm between the layers of
 Base points toward right shoulder pericardium, called the
pericardial cavity

 Walls of the heart


1. Epicardium
 Outside layer; the visceral
pericardium
2. Myocardium
 Middle layer
 Mostly cardiac muscle
3. Endocardium
 Inner layer known as
endothelium
Chambers and Associated Great Vessels
 Four chambers of the heart
 Atria (right and left)
 Receiving chambers
 Assist with filling the ventricles
 Blood enters under low pressure
 Ventricles (right and left)
 Discharging chambers
 Thick-walled pumps of the heart
 During contraction, blood is
propelled into circulation

 Coverings of the heart


 Pericardium—a double-walled sac
 Fibrous pericardium is loose and
superficial
 Serous membrane is deep to the
fibrous pericardium and
composed of two layers

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

arteries and takes oxygen-poor


blood to lungs
 Oxygen-rich blood returns to the
heart from the lungs via
pulmonary veins
 Systemic circulation
 Oxygen-rich blood returned to the left
side of the heart is pumped out into the
aorta
 Blood circulates to systemic
arteries and to all body tissues
 Left ventricle has thicker walls
because it pumps blood to the
body through the systemic circuit
 Oxygen-poor blood returns to the right
atrium via systemic veins, which empty
blood into the superior or inferior vena
cava

 Interatrial septum
 Separates the two atria longitudinally
 Interventricular septum
 Separates the two ventricles
longitudinally
 Heart functions as a double pump
 Arteries carry blood away from the
heart
 Veins carry blood toward the heart
 Double pump
 Right side works as the pulmonary
circuit pump
 Left side works as the systemic circuit Heart Valves
pump
 Pulmonary circulation  Allow blood to flow in only one direction, to
 Blood flows from the right side of the prevent backflow
heart to the lungs and back to the left  Atrioventricular (AV) valves—between
side of the heart atria and ventricles
 Blood is pumped out of right side  Left AV valve: bicuspid (mitral)
through the pulmonary trunk, valve
which splits into pulmonary  Right AV valve: tricuspid valve

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Semilunar valves—between ventricle  Blood empties into the right atrium via the
and artery coronary sinus
 Pulmonary semilunar valve Physiology of the Heart
 Aortic semilunar valve  Intrinsic conduction system of the heart
 AV valves  Cardiac muscle contracts spontaneously
 Anchored the cusps in place by chordae and independently of nerve impulses
tendineae to the walls of the ventricles  Spontaneous contractions occur in a
 Open during heart relaxation, when regular and continuous way
blood passively fills the chambers  Atrial cells beat 60 times per
 Closed during ventricular contraction minute
 Semilunar valves  Ventricular cells beat 20−40
 Closed during heart relaxation times per minute
 Open during ventricular contraction  Need a unifying control system—
 Valves open and close in response to the intrinsic conduction system
pressure changes in the heart (nodal system)
 Two systems regulate heart activity
 Autonomic nervous system
 Intrinsic conduction system, or
the nodal system
o Sets the heart rhythm
o Composed of special
nervous tissue
o Ensures heart muscle
depolarization in one
direction only (atria to
ventricles)
o Enforces a heart rate of
75 beats per minute
 Components include:
 Sinoatrial (SA) node
o Located in the right
atrium
o Serves as the heart’s
pacemaker

Cardiac Circulation  Atrioventricular (AV) node is at


 Blood in the heart chambers does not the junction of the atria and
nourish the myocardium ventricles
 The heart has its own nourishing circulatory  Atrioventricular (AV) bundle
system consisting of: (bundle of His) and bundle
 Coronary arteries—branch from the branches are in the
aorta to supply the heart muscle with interventricular septum
oxygenated blood  Purkinje fibers spread within the
 Cardiac veins—drain the myocardium of ventricle wall muscles
blood
 Coronary sinus—a large vein on the
posterior of the heart; receives blood
from cardiac veins

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Isovolumetric contraction
 Atrial systole ends; ventricular
systole begins
 Intraventricular pressure rises
 AV valves close
 For a moment, the ventricles are
completely closed chambers
 Ventricular systole (ejection phase)
 Ventricles continue to contract
 Intraventricular pressure now
surpasses the pressure in the
 The sinoatrial node (SA node) starts major arteries leaving the heart
each heartbeat  Semilunar valves open
 Impulse spreads through the atria to the  Blood is ejected from the
AV node ventricles
 Atria contract  Atria are relaxed and filling with
 At the AV node, the impulse is delayed blood
briefly  Isovolumetric relaxation
 Impulse travels through the AV bundle,  Ventricular diastole begins
bundle branches, and Purkinje fibers  Pressure falls below that in the
 Ventricles contract; blood is ejected major arteries
from the heart  Semilunar valves close
 Tachycardia—rapid heart rate, over 100  For another moment, the
beats per minute ventricles are completely closed
 Bradycardia—slow heart rate, less than chambers
60 beats per minutes  When atrial pressure increases
 Cardiac cycle and heart sounds above intraventricular pressure,
 The cardiac cycle refers to one complete the AV valves open
heartbeat, in which both atria and  Heart sounds
ventricles contract and then relax  Lub—longer, louder heart sound
 Systole = contraction caused by the closing of the AV
 Diastole = relaxation valves
 Average heart rate is approximately 75  Dup—short, sharp heart sound
beats per minute caused by the closing of the
 Cardiac cycle length is normally 0.8 semilunar valves at the end of
second ventricular systole
 Atrial diastole (ventricular filling)
 Heart is relaxed
 Pressure in heart is low
 Atrioventricular valves are open
 Blood flows passively into the
atria and into ventricles  Cardiac output (CO)
 Semilunar valves are closed  Amount of blood pumped by each side
 Atrial systole (ventricle) of the heart in 1 minute
 Ventricles remain in diastole  Stroke volume (SV)
 Atria contract  Volume of blood pumped by each
 Blood is forced into the ventricle in one contraction (each
ventricles to complete heartbeat)
ventricular filling
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 About 70 ml of blood is pumped out of


the left ventricle with each heartbeat
 Heart rate (HR)
 Typically 75 beats per minute
 Cardiac output is the product of the heart
rate (HR) and the stroke volume (SV)
 CO = HR × SV
 CO = HR (75 beats/min) × SV (70
ml/beat)
 CO = 5250 ml/min = 5.25 L/min
 Regulation of stroke volume
 60 percent of blood in ventricles (about Blood Vessels
70 ml) is pumped with each heartbeat  Blood vessels form a closed vascular system
 Starling’s law of the heart that transports blood to the tissues and
 The critical factor controlling SV back to the heart
is how much cardiac muscle is  Vessels that carry blood away from the
stretched heart
 The more the cardiac muscle is  Arteries and arterioles
stretched, the stronger the  Vessels that play a role in exchanges
contraction between tissues and blood
 Venous return is the important factor  Capillary beds
influencing the stretch of heart muscle  Vessels that return blood toward the
 Factors modifying basic heart rate heart
1. Neural (ANS) controls  Venules and veins
 Sympathetic nervous system Microscopic Anatomy of Blood Vessels
speeds heart rate  Three layers (tunics) in blood vessels (except
 Parasympathetic nervous the capillaries)
system, primarily vagus nerve  Tunica intima forms a friction-reducing
fibers, slow and steady the heart lining
rate  Endothelium
2. Hormones and ions  Tunica media
 Epinephrine and thyroxine speed  Smooth muscle and elastic tissue
heart rate  Controlled by sympathetic
 Excess or lack of calcium, nervous system
sodium, and potassium ions also  Tunica externa forms protective
modify heart activity outermost covering
3. Physical factors  Mostly fibrous connective tissue
 Age, gender, exercise, body  Supports and protects the vessel
temperature influence heart rate

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Only one cell layer thick (tunica


intima)
 Allow for exchanges between
blood and tissue
 Form networks called capillary
beds that consist of:
o A vascular shunt
o True capillaries
 Blood flow through a capillary
bed is known as microcirculation
 True capillaries
 Branch off a terminal arteriole
 Empty directly into a
 Structural differences in arteries, veins, and postcapillary venule
capillaries  Entrances to capillary beds are
 Arteries have a heavier, stronger, guarded by precapillary
stretchier tunica media than veins to sphincters
withstand changes in pressure
 Veins have a thinner tunica media than
arteries and operate under low pressure
 Veins also have valves to prevent
backflow of blood
 Lumen of veins is larger than
that of arteries
 Skeletal muscle “milks” blood in
veins toward the heart

Gross Anatomy of Blood Vessels

 Major arteries of systemic circulation


 Aorta
 Capillaries  Largest artery in the body

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Leaves from the left ventricle of becomes the axillary


the heart artery → brachial artery
 Regions → radial and ulnar
o Ascending aorta—leaves arteries
the left ventricle  Arterial branches of the thoracic aorta
o Aortic arch—arches to  Intercostal arteries supply the
the left muscles of the thorax wall
o Thoracic aorta—travels  Other branches of the thoracic
downward through the aorta (not illustrated) supply the:
thorax o Lungs (bronchial arteries)
o Abdominal aorta—passes o Esophagus (esophageal
through the diaphragm arteries)
into the abdominopelvic o Diaphragm (phrenic
cavity arteries)
 Arterial branches of the abdominal
aorta
 Celiac trunk is the first branch of
the abdominal aorta. Three
branches are:
1. Left gastric artery (stomach)
2. Splenic artery (spleen)
3. Common hepatic artery
(liver)
 Superior mesenteric artery
supplies most of the small
intestine and first half of the
large intestine
 Left and right renal arteries
(kidney)
 Left and right gonadal arteries
o Ovarian arteries in females
 Arterial branches of the ascending aorta serve the ovaries
 Right and left coronary arteries o Testicular arteries in males
serve the heart serve the testes
 Arterial branches of the aortic arch  Lumbar arteries serve muscles of
 Brachiocephalic trunk splits into the abdomen and trunk
the:  Inferior mesenteric artery serves
o Right common carotid the second half of the large
artery intestine
o Right subclavian artery  Left and right common iliac
 Left common carotid artery splits arteries are the final branches of
into the: the aorta
o Left internal and external o Internal iliac arteries
carotid arteries serve the pelvic organs
 Left subclavian artery branches o External iliac arteries
into the: enter the thigh →
o Vertebral artery femoral artery
o In the axilla, the → popliteal artery →
subclavian artery
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

anterior and posterior  Cephalic vein drains the lateral


tibial arteries aspect of the arm and empties
into the axillary vein
 Basilic vein drains the medial
aspect of the arm and empties
into the brachial vein
 Basilic and cephalic veins are
joined at the median cubital vein
(elbow area)
 Subclavian vein receives:
o Venous blood from the
arm via the axillary vein
o Venous blood from skin
and muscles via external
jugular vein
 Vertebral vein drains the
posterior part of the head
 Internal jugular vein drains the
dural sinuses of the brain
 Major veins of systemic circulation  Left and right brachiocephalic
 Superior vena cava and inferior vena veins receive venous blood from
cava enter the right atrium of the heart the:
 Superior vena cava drains the o Subclavian veins
head and arms o Vertebral veins
 Inferior vena cava drains the o Internal jugular veins
lower body  Brachiocephalic veins join to
form the superior vena cava →
right atrium of heart
 Azygos vein drains the thorax
 Veins draining into the inferior vena cava
 Anterior and posterior tibial
veins and fibial veins drain the
legs
 Posterior tibial vein → popliteal
vein → femoral vein → external
iliac vein
 Great saphenous veins (longest
veins of the body) receive
superficial drainage of the legs
 Each common iliac vein (left and
right) is formed by the union of
the internal and external iliac
vein on its own side
 Veins draining into the superior vena  Right gonadal vein drains the
cava right ovary in females and right
 Radial and ulnar veins → brachial testicle in males
vein → axillary vein  Left gonadal vein empties into
the left renal vein

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Left and right renal veins drain


the kidneys
 Hepatic portal vein drains the
digestive organs and travels
through the liver before it enters
systemic circulation
 Left and right hepatic veins drain
the liver
 Arterial supply of the brain and the circle of
Willis
 Internal carotid arteries divide into:
 Anterior and middle cerebral
arteries
o These arteries supply
most of the cerebrum
 Vertebral arteries join once within the
skull to form the basilar artery
 Basilar artery serves the brain
stem and cerebellum
 Posterior cerebral arteries form from the
division of the basilar artery
 These arteries supply the
posterior cerebrum
 Anterior and posterior blood supplies
are united by small communicating Physiology of Circulation
arterial branches  Vital signs
 Result—complete circle of connecting  Measurements of arterial pulse, blood
blood vessels called cerebral arterial pressure, respiratory rate, and body
circle, or circle of Willis temperature
 Arterial pulse
 Alternate expansion and recoil of a
blood vessel wall (the pressure wave)
that occurs as the heart beats
 Monitored at pressure points in
superficial arteries, where pulse is easily
palpated
 Pulse averages 70 to 76 beats per
minute at rest, in a healthy person
 Hepatic portal circulation is formed by veins
draining the digestive organs, which empty
into the hepatic portal vein
 Digestive organs
 Spleen
 Pancreas
 Hepatic portal vein carries this blood to the
liver, where it is processed before returning
to systemic circulation

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Measuring blood pressure


 Two arterial blood pressures are
measured
 Systolic—pressure in the arteries
at the peak of ventricular
contraction
 Diastolic—pressure when >
ventricles relax
 Expressed as systolic pressure over
diastolic pressure in millimeters of
mercury (mm Hg)
 For example, 120/80 mm Hg
 Auscultatory method is an indirect
method of measuring systemic arterial
blood pressure, most often in the
brachial artery
 Effects of various factors on blood pressure
 Arterial blood pressure (BP) is directly
related to cardiac output and peripheral
resistance
Blood Pressure  Cardiac output (CO; the amount
 The pressure the blood exerts against of blood pumped out of the left
the inner walls of the blood vessels ventricle per minute)
 The force that causes blood to continue  Peripheral resistance (PR; the
to flow in the blood vessels amount of friction blood
 Blood pressure gradient encounters as it flows through
 When the ventricles contract: vessels)
 Blood is forced into elastic o BP = CO × PR
arteries close to the heart  Neural factors: the autonomic nervous
 Blood flows along a descending system
pressure gradient  Parasympathetic nervous system
 Pressure decreases in blood vessels as has little to no effect on blood
distance from the heart increases pressure
 Pressure is high in the arteries, lower in  Sympathetic nervous system
the capillaries, and lowest in the veins promotes vasoconstriction
(narrowing of vessels), which
increases blood pressure
 Renal factors: the kidneys
 Kidneys regulate blood pressure
by altering blood volume
 If blood pressure is too high, the
kidneys release water in the
urine
 If blood pressure is too low, the
kidneys release renin to trigger
formation of angiotensin II, a
vasoconstrictor
 Angiotensin II stimulates release
of aldosterone, which enhances
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

sodium (and water) reabsorption  Substances move to and from the blood
by kidneys and tissue cells through capillary walls
 Temperature  Exchange is due to concentration
 Heat has a vasodilating effect gradients
 Cold has a vasoconstricting effect o Oxygen and nutrients
 Chemicals leave the blood and move
 Various substances can cause into tissue cells
increases or decreases in blood o Carbon dioxide and other
pressure wastes exit tissue cells
 Epinephrine increases heart rate and enter the blood
and blood pressure  Substances take various routes entering
 Diet or leaving the blood
 Commonly believed that a diet 1. Direct diffusion through membranes
low in salt, saturated fats, and 2. Diffusion through intercellular clefts
cholesterol prevents (gaps between cells in the capillary
hypertension (high blood wall)
pressure) 3. Diffusion through pores of
fenestrated capillaries
4. Transport via vesicles

 Variations in blood pressure


 Normal human range is variable
 Systolic pressure ranges from
110 to 140 mm Hg
 Diastolic pressure ranges from 70
to 80 mm Hg
 Hypotension (low blood pressure)  Fluid movements at capillary beds
 Low systolic (below 100 mm Hg)  Fluid movement out of or into a
 Often associated with illness capillary depends on the difference
 Acute hypotension is a warning between the two pressures
sign for circulatory shock 1. Blood pressure forces fluid and
 Hypertension (high blood pressure) solutes out of capillaries
 Sustained elevated arterial 2. Osmotic pressure draws fluid into
pressure of 140/90 mm Hg capillaries
 Warns of increased peripheral  Blood pressure is higher than osmotic
resistance pressure at the arterial end of the
 Capillary exchange of gases and nutrients capillary bed
 Interstitial fluid (tissue fluid) is found
between cells
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Blood pressure is lower than osmotic


pressure at the venous end of the
capillary bed
 Thus, fluid moves out of the capillary at
the beginning of the bed and is
reclaimed at the opposite (venule) end

 Shunts bypassing the lungs and liver are


present in a fetus
 Blood flow bypasses the liver through
the ductus venosus and enters the
inferior vena cava → right atrium of
heart
 Blood flow bypasses the lungs
 Blood entering right atrium is
shunted directly into left atrium
through foramen ovale (becomes
Developmental Aspects of the Cardiovascular fossa ovalis at or after birth)
System  Ductus arteriosus connects aorta
and pulmonary trunk (becomes
 In an embryo ligamentum arteriosum at birth)
 The heart develops as a simple tube and
pumps blood by week 4 of pregnancy
 The heart becomes a four-chambered
organ capable of acting as a double
pump over the next 3 weeks
 Umbilical cord
 Carries nutrients and oxygen from
maternal blood to fetal blood
 Fetal wastes move from fetal blood to
maternal blood
 Houses:
 Age-related problems associated with the
 One umbilical vein, which carries
cardiovascular system include:
nutrient- and oxygen-rich blood
 Weakening of venous valves
to the fetus
 Varicose veins
 Two umbilical arteries, which
 Progressive arteriosclerosis
carry wastes and carbon dioxide–
 Hypertension resulting from loss of
rich blood from the fetus to
elasticity of vessels
placenta

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Coronary artery disease resulting from CORON CROWN OR CIRCLE;


fatty, calcified deposits in the vessels HEART
Constructed medical terms: TENS PRESSURE
- Many medical terms are ‘constructed’ from ISCH HOLD BACK
a combination of word parts… prefixes, PHLEB VEIN
Greek or Roman root words, and suffixes. VARIC DILATED VEIN
Determine the meaning of the whole word SPHYGM HEARTBEAT
by first deciphering the meaning of the VASCUL LITTLE BLOOD VESSEL
suffix, then the prefix, and finally the root MEDICAL PREFIXES FOR THE CIRCULATORY
word. Then combine the 3 parts. SYSTEM
 MICRO / SCOP / IC PREFIX DEFINITION
Prefix meaning ‘small’ / root word meaning HYPER- EXCESSIVE;
‘viewing instrument’ / suffix meaning ABNORMALLY HIGH;
‘pertaining to’ ABOVE
HYPO- DEFICIENT;
- When you start with a root word and add a ABNORMALLY LOW;
BELOW
suffix that starts with a consonant OR
MEDICAL SUFFIXES FOR THE CIRCULATORY
another root word, then you have to
SYSTEM
connect the two word parts with a vowel.
This is called a ‘combining vowel’, and is SUFFIX DEFINITION
usually an ‘o, i, or e’. -EMIA CONDITION OF BLOOD
-SPASM SUDDEN INVOLUNTARY
MUSCLE CONTRACTION
 HEM / O / PHILIA
-OMA TUMOR
Root word meaning ‘blood’ / combining
-PATHY DISEASE
vowel / suffix meaning ‘love of’
-OSIS CONDITION OF
Nonconstructed medical terms:
-ION PROCESS
- If a medical term is not constructed from a
-ITIS INFLAMMATION
combination of word parts, then it is called
-GRAPHY RECORDING PROCESS
‘nonconstructed’. These are words derived
MEDICAL TERMS, SIGNS, & SYMPTOMS OF THE
from other languages, words derived from
CIRCULATORY SYSTEM…
names of people, from initials that form
 Angiospasm (AN jee oh spazm)
acronyms, or from abbreviations. To learn
 Abnormal muscular contractions of the
the meanings of nonconstructed terms, you
smooth muscles that form the blood
must simply commit them to memory.
vessel walls.
- The term ‘pasteurize’ refers to the process
 Angiostenosis (an jee oh sten OH siss)
of heating milk to a temperature that kills
 Narrowing of a blood vessel, which in
harmful microorganisms. The term is
turn causes a reduction of blood flow to
derived from the name of its inventor…
the body. This is one sign of
Louis Pasteur (1822-1895).
cardiovascular disease.
MEDICAL ROOT WORDS OF THE CIRCULATORY
MEDICAL TERMS, SIGNS, & SYMPTOMS OF THE
SYSTEM:
CIRCULATORY SYSTEM…
ROOT WORD DEFINITION
 Cyanosis (sigh ah NOH siss)
ANGI BLOOD VESSEL
 A blue tinge of the skin and mucous
CYAN BLUE
membranes, usually caused by oxygen
STEN NARROW
deficiency in the tissue. This may be a
CARDI HEART
sign of cardiovascular disease.
AORT AORTA
DISEASES AND DISORDERS OF THE CIRCULATORY
ARTER; ARTERI ARTERY
SYSTEM…
SCLER THICK OR HARD; SCLERA
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Aneurysm (AN yoo rism)  Hemorrhoids (HEM oh roydz)


 This is a non-constructed word. It is an  These are dilated veins in the anal area.
abnormal bulging of an arterial wall. They are painful and cause itching.
An aneurysm may be a congenital defect  People who are seated a lot, such as
(present at birth) or a weakness that has truck drivers and secretaries, and people
formed over time. If an aneurysm bursts, it who lift heavy weights or jump up and
can be life-threatening. down, such as an athlete, are at risk.
 Angiocarditis (An jee oh kar DYE tiss)  Hypertension (HIGH per TEN shun)
 An inflammation of the heart and blood  Persistently high blood pressure.
vessels. It is often the result of a
widespread bacterial infection.  Essential hypertension is not traceable
 Angioma (an jee OH mah) to a single cause; secondary
 This is a term that describes a tumor hypertension is caused by another
arising from a blood vessel. It forms a disease.
benign mass or coloring of the skin.
 It may be called an hemangioma (heh  Hypotension (HIGH poh TEN shun)
MAN jee OH mah). A mass may restrict  Persistently low blood pressure.
the flow of blood OR a red/purple  Ischemia (iss KEE mee ah)
birthmark on the skin does not restrict  An abnormally low flow of blood to the
blood flow. tissues, which may be congenital or
 Aortitis (ay or TYE tiss) caused by an occlusion.
 Inflammation of the aorta, often caused  Phlebitis (fleh BYE tiss)
by a bacterial infection.  An inflammation of a vein.
 Arteriopathy (ahr tee ree AH path ee)  Varicosis (vair ih KOH siss)
 This is a general term referring to any  An abnormally dilated vein. When blood
disease of the arteries. flow valves do not work correctly, blood
 Arteriosclerosis (ahr tee ree oh skleh ROH pools due to gravitational forces, a
siss) varicose vein results.
 This is commonly called ‘hardening of TREATMENTS AND PROCEDURES OF THE
the arteries’. The artery walls may CIRCULATORY SYSTEM
become thickened and lose their  Angiography (AN jee OG rah fee)
elasticity with age, reducing blood flow.  A contrast medium is introduced into
 Atherosclerosis (ATH er oh skleh ROH siss) the bloodstream, and images called an
 This is a specific type of arteriosclerosis, ‘angiogram’ are taken by X-ray, MRI, or
where a fatty plaque forms on the inner CAT scan. It is a diagnostic procedure.
walls of the artery. This plaque may  Angioplasty (AN jee oh plass tee)
reduce or block the flow of blood; it can  This is the surgical repair of a blood
be caused by too much cholesterol in vessel. A balloon angioplasty involves
the diet. the insertion and inflation of a balloon
 Coronary Occlusion (ah CLUE zhun) to unblock a vessel. In laser angioplasty
 This is a general term for blockage in an a laser beam is used to unblock an
artery. artery.
 Embolism (EM boh lizm)  Coronary Stent
 This is a blockage in an artery that forms  An artificial ‘spacer’ or ‘form’ that is
when a blood clot or air bubble or fat used to hold open a vessel or prevent
particle moves through the circulatory closure of an artery after angioplasty.
system. The actual clot or particle or bubble  Endarterectomy (END ahr teh REK toh mee)
is called an ‘embolus’.

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 The surgical removal of the inner lining


of an artery to remove fatty plaque.
 Sphygmomanometry (SFIG moh mah NOM
eh tree)
 The process of measuring arterial blood
pressure using an instument called a
sphygmomanometer. While it is
replaced by digital technology in many
cases, technology sometimes fails.
 Phlebectomy (fleh BEK toh mee)
 The surgical removal of a vein.
 Phlebotomy (fleh BOT toh mee)
 Puncturing a vein to remove blood or for Functional Anatomy of the Respiratory System
a donation of blood. Often called  Gas exchanges between the blood and
venipuncture. A healthcare professional external environment occur only in the
who performs this procedure is called a alveoli of the lungs
phlebotomist.  Upper respiratory tract includes
ABBREVIATIONS ASSOCIATED WITH THE passageways from the nose to larynx
CIRCULATORY SYSTEM  Lower respiratory tract includes
 CAD Coronary Artery Disease passageways from trachea to alveoli
 A general term for any disease that  Passageways to the lungs purify,
affects the coronary arteries supplying humidify, and warm the incoming air
the heart with blood. The Nose
 CPR Cardiopulmonary Resuscitation  The only externally visible part of the
 The use of manual chest compressions respiratory system
to maintain circulation and artificial  Nostrils (nares) are the route through
ventilation to restore breathing in order which air enters the nose
to revive a patient.  Nasal cavity is the interior of the nose
 CABG Coronary Artery Bypass Graft  Nasal septum divides the nasal cavity
 Removing a blood vessel from one part
of the body and inserting it in place of a
blocked artery in another part of the
body in order to restore circulation.

TOPIC 14 WEEK 14
THE RESPIRATORY SYSTEM
Organs of the Respiratory System
 Nose
 Pharynx
 Larynx
 Trachea  Olfactory receptors are located in the
 Bronchi mucosa on the superior surface
 Lungs—alveoli  The rest of the cavity is lined with
respiratory mucosa, which
 Moistens air
 Traps incoming foreign particles
 Enzymes in the mucus destroy bacteria
chemically
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Conchae are projections from the lateral  Pharyngotympanic tubes open into the
walls nasopharynx
 Increase surface area  Drain the middle ear
 Increase air turbulence within the nasal
cavity
 Increased trapping of inhaled particles
 The palate separates the nasal cavity from
the oral cavity
 Hard palate is anterior and supported by
bone
 Soft palate is posterior and unsupported
 Paranasal sinuses
 Cavities within the frontal, sphenoid,
ethmoid, and maxillary bones
surrounding the nasal cavity
 Sinuses:
 Lighten the skull
 Act as resonance chambers for  Tonsils are clusters of lymphatic tissue that
speech play a role in protecting the body from
 Produce mucus infection
 Pharyngeal tonsil (adenoid), a single
tonsil, is located in the nasopharynx
 Palatine tonsils (2) are located in the
oropharynx at the end of the soft palate
 Lingual tonsils (2) are found at the base
of the tongue
The Larynx
 Commonly called the voice box
 Functions
 Routes air and food into proper
channels
The Pharynx  Plays a role in speech
 Commonly called the throat  Located inferior to the pharynx
 Muscular passageway from nasal cavity to  Made of eight rigid hyaline cartilages
larynx  Thyroid cartilage (Adam’s apple) is the
 Continuous with the posterior nasal largest
aperture  Epiglottis
 Three regions of the pharynx  Spoon-shaped flap of elastic cartilage
1. Nasopharynx—superior region behind  Protects the superior opening of the
nasal cavity larynx
2. Oropharynx—middle region behind  Routes food to the posteriorly situated
mouth esophagus and routes air toward the
3. Laryngopharynx—inferior region trachea
attached to larynx  During swallowing, the epiglottis rises
 Oropharynx and laryngopharynx serve as and forms a lid over the opening of the
common passageway for air and food> larynx
Epiglottis routes food into the posterior  Vocal folds (true vocal cords)
tube, the esophagus  Vibrate with expelled air

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Allow us to speak  Occupy the entire thoracic cavity except for


 The glottis includes the vocal cords and the the central mediastinum
opening between the vocal cords  Apex of each lung is near the clavicle
The Trachea (superior portion)
 Commonly called the windpipe  Base rests on the diaphragm
 4-inch-long tube that connects to the larynx  Each lung is divided into lobes by fissures
 Walls are reinforced with C-shaped rings of  Left lung—two lobes
hyaline cartilage, which keep the trachea  Right lung—three lobes
patent (open)  Serosa covers the outer surface of the lungs
 Lined with ciliated mucosa  Pulmonary (visceral) pleura covers the
 Cilia beat continuously in the opposite lung surface
direction of incoming air  Parietal pleura lines the walls of the
 Expel mucus loaded with dust and other thoracic cavity
debris away from lungs  Pleural fluid fills the area between layers
 Allows the lungs to glide over the thorax
 Decreases friction during breathing
 Pleural space (between the layers) is more
of a potential space

The Main Bronchi


 Formed by division of the trachea
 Each bronchus enters the lung at the hilum
(medial depression)
 Right bronchus is wider, shorter, and
straighter than left
 Bronchi subdivide into smaller and smaller
branches

 The bronchial tree


 Main bronchi subdivide into smaller and
smaller branches
 Bronchial (respiratory) tree is the
network of branching passageways
 All but the smallest passageways have
reinforcing cartilage in the walls
 Conduits to and from the respiratory
The Lungs
zone

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Bronchioles (smallest conducting  Secreted by cuboidal surfactant-


passageways) secreting cells
Respiratory Zone Structures and the Respiratory Respiratory Physiology
Membrane  Functions of the respiratory system
 Terminal bronchioles lead into respiratory  Supply the body with oxygen
zone structures and terminate in alveoli  Dispose of carbon dioxide
 Respiratory zone includes the:  Respiration includes four distinct events
 Respiratory bronchioles (discussed next)
 Alveolar ducts  Pulmonary ventilation
 Alveolar sacs  External respiration
 Alveoli (air sacs)—the only site of gas  Respiratory gas transport
exchange  Internal respiration
 Conducting zone structures include all other  Four events of respiration
passageways 1. Pulmonary ventilation—moving air into and
out of the lungs (commonly called
breathing)
2. External respiration—gas exchange
between pulmonary blood and alveoli
 Oxygen is loaded into the blood
 Carbon dioxide is unloaded from the
blood
3. Respiratory gas transport—transport of
oxygen and carbon dioxide via the
bloodstream
4. Internal respiration—gas exchange
between blood and tissue cells in systemic
capillaries
Mechanics of Breathing
 Alveoli
 Pulmonary ventilation
 Simple squamous epithelial cells largely
 Mechanical process that depends on
compose the walls
volume changes in the thoracic cavity
 Alveolar pores connect neighboring air
 Volume changes lead to pressure
sacs
changes, which lead to the flow of gases
 Pulmonary capillaries cover external
to equalize pressure
surfaces of alveoli
 Two phases of pulmonary ventilation
 Respiratory membrane (air-blood barrier)
 Inspiration = inhalation
 On one side of the membrane is air, and
 Flow of air into lungs
on the other side is blood flowing past
 Expiration = exhalation
 Formed by alveolar and capillary walls
 Air leaving lungs
 Gas crosses the respiratory membrane by
 Inspiration (inhalation)
diffusion
 Diaphragm and external intercostal
 Oxygen enters the blood
muscles contract
 Carbon dioxide enters the alveoli
 Intrapulmonary volume increases
 Alveolar macrophages (“dust cells”)
 Gas pressure decreases
 Add protection by picking up bacteria,
 Air flows into the lungs until
carbon particles, and other debris
intrapulmonary pressure equals
 Surfactant (a lipid molecule) atmospheric pressure
 Coats gas-exposed alveolar surfaces

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Expiration (exhalation)
 Largely a passive process that depends
on natural lung elasticity
 Intrapulmonary volume decreases
 Gas pressure increases
 Gases passively flow out to equalize the
pressure
 Forced expiration can occur mostly by
contraction of internal intercostal
muscles to depress the rib cage
 Intrapleural pressure
 The pressure within the pleural space) is
Respiratory Volumes and Capacities
always negative
 Factors affecting respiratory capacity
 Major factor preventing lung collapse
 Size
 If intrapleural pressure equals
 Sex
atmospheric pressure, the lungs recoil
 Age
and collapse
 Physical condition
 Tidal volume (TV)
 Normal quiet breathing
 500 ml of air is moved in/out of lungs
with each breath
 Inspiratory reserve volume (IRV)
 Amount of air that can be taken in
forcibly over the tidal volume
 Usually around 3,100 ml
 Expiratory reserve volume (ERV)

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Amount of air that can be forcibly


exhaled after a tidal expiration
 Approximately 1,200 ml
 Residual volume
 Air remaining in lung after expiration
 Cannot be voluntarily exhaled
 Allows gas exchange to go on
continuously, even between breaths, Respiratory Sounds
and helps keep alveoli open (inflated)  Sounds are monitored with a stethoscope
 About 1,200 ml
 Two recognizable sounds can be heard with
 Vital capacity a stethoscope:
 The total amount of exchangeable air 1. Bronchial sounds—produced by air
 Vital capacity = TV + IRV + ERV rushing through large passageways such
 4,800 ml in men; 3,100 ml in women as the trachea and bronchi
 Dead space volume 2. Vesicular breathing sounds—soft
 Air that remains in conducting zone and sounds of air filling alveoli
never reaches alveoli External Respiration, Gas Transport, and Internal
 About 150 ml Respiration
 Functional volume  Gas exchanges occur as a result of diffusion
 Air that actually reaches the respiratory  External respiration is an exchange of
zone gases occurring between the alveoli and
 Usually about 350 ml pulmonary blood (pulmonary gas
 Respiratory capacities are measured with a exchange)
spirometer  Internal respiration is an exchange of
gases occurring between the blood and
tissue cells (systemic capillary gas
exchange)
 Movement of the gas is toward the area of
lower concentration

Nonrespiratory Air Movements


 Can be caused by reflexes or voluntary
actions
 Examples
 Cough and sneeze—clears lungs of
debris
 Crying—emotionally induced
mechanism
 Laughing—similar to crying
 Hiccup—sudden inspirations
 Yawn—very deep inspiration

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

Gas Transport in the Blood


 Oxygen transport in the blood
 Most oxygen travels attached to
hemoglobin and forms oxyhemoglobin
(HbO2)
 A small dissolved amount is carried in
the plasma

External Respiration
 Oxygen is loaded into the blood
 Oxygen diffuses from the oxygen-rich air
of the alveoli to the oxygen-poor blood
of the pulmonary capillaries
 Carbon dioxide is unloaded out of the blood  Carbon dioxide transport in the blood
 Carbon dioxide diffuses from the blood  Most carbon dioxide is transported in
of the pulmonary capillaries to the the plasma as bicarbonate ion (HCO3–)
alveoli  A small amount is carried inside red
blood cells on hemoglobin, but at
different binding sites from those of
oxygen
 For carbon dioxide to diffuse out of blood
into the alveoli, it must be released from its
bicarbonate form:
 Bicarbonate ions enter RBC
 Combine with hydrogen ions
 Form carbonic acid (H2CO3)
 Carbonic acid splits to form water + CO2
 Carbon dioxide diffuses from blood into
alveoli
Internal Respiration
 Exchange of gases between blood and tissue
cells
 An opposite reaction from what occurs in
the lungs
 Carbon dioxide diffuses out of tissue
cells to blood (called loading)
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Oxygen diffuses from blood into tissue


(called unloading)

Control of Respiration
 Non-neural factors influencing respiratory
rate and depth
 Physical factors
 Increased body temperature
 Exercise
 Talking
 Coughing
 Volition (conscious control)
 Emotional factors such as fear, anger,
Control of Respiration and excitement
 Neural regulation: setting the basic rhythm  Chemical factors: CO2 levels
 Activity of respiratory muscles is  The body’s need to rid itself of
transmitted to and from the brain by CO2 is the most important
phrenic and intercostal nerves stimulus for breathing
 Neural centers that control rate and  Increased levels of carbon
depth are located in the medulla and dioxide (and thus, a decreased or
pons acidic pH) in the blood increase
 Medulla—sets basic rhythm of the rate and depth of breathing
breathing and contains a  Changes in carbon dioxide act
pacemaker (self-exciting directly on the medulla
inspiratory center) called the oblongata
ventral respiratory group (VRG)  Chemical factors: oxygen levels
 Pons—smoothes out respiratory  Changes in oxygen concentration
rate in the blood are detected by
 Normal respiratory rate (eupnea) chemoreceptors in the aorta and
 12 to 15 respirations per minute common carotid artery
 Hyperpnea  Information is sent to the
 Increased respiratory rate, often due to medulla
extra oxygen needs  Oxygen is the stimulus for those
whose systems have become
accustomed to high levels of
carbon dioxide as a result of
disease
 Hyperventilation

CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

o Rising levels of CO2 in the  Sufferers are often called “pink puffers”
blood (acidosis) result in because oxygen exchange is efficient
faster, deeper breathing  Overinflation of the lungs leads to a
o Exhale more CO2 to permanently expanded barrel chest
elevate blood pH  Cyanosis appears late in the disease
o May result in apnea and
dizziness and lead to
alkalosis
 Hypoventilation
o Results when blood
becomes alkaline
(alkalosis)
o Extremely slow or
shallow breathing
o Allows CO2 to
accumulate in the blood
Respiratory Disorders
 Chronic obstructive pulmonary disease
(COPD)
 Exemplified by chronic bronchitis and
emphysema
 Shared features of these diseases
1. Patients almost always have a
history of smoking  Lung cancer
2. Labored breathing (dyspnea)  Leading cause of cancer death for men
becomes progressively worse and women
3. Coughing and frequent pulmonary  Nearly 90 percent of cases result from
infections are common smoking
4. Most COPD patients are hypoxic,  Aggressive cancer that metastasizes
retain carbon dioxide and have rapidly
respiratory acidosis, and ultimately  Three common types
develop respiratory failure 1. Adenocarcinoma
2. Squamous cell carcinoma
 Chronic bronchitis
3. Small cell carcinoma
 Mucosa of the lower respiratory
Developmental Aspects of the Respiratory System
passages becomes severely inflamed
 Excessive mucus production impairs  Lungs do not fully inflate until 2 weeks after
ventilation and gas exchange birth
 Patients become cyanotic and are  This change from nonfunctional to
sometimes called “blue bloaters” as a functional respiration depends on
result of chronic hypoxia and carbon surfactant
dioxide retention  Surfactant lowers surface tension so the
alveoli do not collapse
 Emphysema
 Surfactant is formed late in pregnancy,
 Alveoli walls are destroyed; remaining
around 28 to 30 weeks
alveoli enlarge
 Chronic inflammation promotes lung  Respiratory rate changes throughout life
fibrosis, and lungs lose elasticity  Newborns: 40 to 80 respirations per
 Patients use a large amount of energy to minute
exhale; some air remains in the lungs  Infants: 30 respirations per minute
 Age 5: 25 respirations per minute
CBG<3
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Anatomy and Physiology with Pathophysiology

 Adults: 12 to 18 respirations per minute


 Rate often increases again in old age
 Asthma
 Chronically inflamed, hypersensitive
bronchiole passages
 Respond to irritants with dyspnea,
coughing, and wheezing
 Youth and middle age
 Most respiratory system problems are a
result of external factors, such as
infections and substances that physically
block respiratory passageways
 Aging effects
 Elasticity of lungs decreases
 Vital capacity decreases
 Blood oxygen levels decrease
 Stimulating effects of carbon dioxide
decrease
 Elderly are often hypoxic and exhibit
sleep apnea
 More risks of respiratory tract infection

CBG<3

You might also like