▪

CHAPTER 7: THE NERVOUS SYSTEM

Interprets incoming sensory
Functions of the Nervous System information
1. Sensory input – gathering information ▪ Issues outgoing instructions
o Sensory receptors monitor changes, called
stimuli, occurring inside and outside the body. ● Peripheral nervous system (PNS)
2. Integration o Nerves extending from the brain and spinal
o Nervous system processes and interprets cord
sensory input and decides whether action is
needed. ▪ Spinal nerves – carry impulses to
3. Motor output and from the spinal cord.
o A response, or effect, activates muscles or
▪ Cranial nerves – carry impulses
glands.
to and from the brain
o Functions
▪ Serve as communication lines
among sensory organs, the brain
and spinal cord, and glands or
muscles.

Functional Classification
● Sensory (afferent) division
o Nerve fibers that carry information to the
central nervous system
▪ Somatic sensory (afferent) fibers
carry information from the skin,
skeletal muscles, and joints
▪ Visceral sensory (afferent) fibers
carry information from visceral
Organization of the Nervous System organs
● Nervous system classified are based on: ● Motor (efferent) division
o Structures (structural classification) o Nerve fibers that carry impulses away from
o Activities (functional classification) the central nervous system organs to effector
(muscles and glands)
o Two divisions
▪ 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

Structural Classification ● Support cells in the CNS are grouped together as neuroglia

● Central nervous system (CNS) ● General functions

o Organs o Support
▪
o Insulate
Brain
o Protect neurons
▪ Spinal cord
o Function Nervous Tissue: Structure and Function

▪
● Nervous tissue is made up of two principal cell types
Integration; command center
o Supporting cells (called neuroglia, or glial
cells, or glia)
 o Line cavities of the brain and spinal cord
▪ Resemble neurons
o Cilia assist with circulation of cerebrospinal
▪ Unable to conduct nerve fluid
impulses
▪ Never lose the ability to divide
o Neurons

Nervous Tissue: Supporting Cells

● CNS glial cells: astrocytes
o Abundant, star-shaped cells
o Brace and anchor neurons to blood capillaries
o Determine permeability and exchanges
between blood capillaries and neurons
o Protect neurons from harmful substances in
blood
o Control the chemical environment of the brain

● CNS glial cells: oligodendrocytes

o Wrap around nerve fibers in the central
nervous system
o Produce myelin sheaths

● CNS glial cells: microglia

o Spiderlike phagocytes
o Monitor health of nearby neurons
o Dispose of debris ● PNS glial cells
o Schwann cells
▪ Form myelin sheath around nerve
fibers in the PNS
o Satellite cells
▪ Protect and cushion neuron cell
bodies

● CNS glial cells: ependymal cells

Nervous Tissue: Neurons
● Processes (fibers)
● Neurons = nerve cells o Dendrites – conduct impulses toward the cell
o Cells specialized to transmit messages (nerve body
impulses)
▪ Neurons may have hundreds of
o Major regions of all neurons
dendrites
▪ Cell body – nucleus and o Axons – conduct impulses away from the cell
metabolic center of the cell body
▪ Processes – fibers that extend ▪ Neurons have only one axon
from the cell body arising from the cell body at the
axon hillock
● Cell body is the metabolic center of the neuron
o Nucleus with large nucleolus ▪ End in axon terminals, which
o Nissl bodies contain vesicles with
neurotransmitters
▪ Rough endoplasmic reticulum
▪ Axon terminals are separated
o Neurofibrils
from the next neuron by a gap
▪ Intermediate filaments that o Synaptic cleft – gap between axon terminals
maintain cell shape and the next neuron
o Synapse – functional junction between nerves
where a nerve impulse is transmitted
● Myelin
o White, fatty material covering axons
o Protects and insulates fibers
o Speeds nerve impulse transmission
● Myelin sheaths
o 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
o Oligodendrocytes – produce myelin sheaths
around axons of the CNS
▪ Lack a neurilemma
● Terminology
o Nuclei – clusters of cell bodies in the CNS
o Ganglia – collections of cell bodies outside the
CNS in the PNS
o Tracts – bundles of nerve fibers in the CNS
o Nerves – bundles of nerve fibers in the PNS
o White matter – collections of myelinated
fibers (tracts)
o Gray matter – mostly unmyelinated fibers and
cell bodies
● Functional classification
o Sensory (afferent) neurons
▪ Carry impulses from the sensory
receptors to the CNS
▪ Receptors include:
- Cutaneous sense organs
in skin
- Proprioceptors in
muscles and tendons
 o Bipolar neurons – one axon and one dendrite
▪ Located in special sense organs,
such as nose and eye
o Motor (efferent) neurons ▪ Rare in adults
▪ Carry impulses from the central
nervous system to viscera and/or
muscles and glands
o Interneurons (association neurons)
▪ Cell bodies located in the CNS

▪ Connect sensory and motor

neurons

o Unipolar neurons – have a short single process

leaving the cell body
▪ Sensory neurons found in PNS
ganglia
▪ Conduct impulses both toward
and away from the cell body

● Structural classification
o Based on number of processes extending from
the cell body
o Multipolar neurons – many extensions from
the cell body
▪ All motor and interneurons are
multipolar
▪ Most common structural type

● Functional properties of neurons

 o Irritability
▪ Ability to respond to a stimulus
and convert it to a nerve impulse
o Conductivity
▪ Ability to transmit the impulse to
other neurons, muscles, or glands
● Electrical conditions of a resting neuron’s membrane
o The plasma membrane at rest is inactive
(polarized)
o Fewer positive ions are inside the neuron’s
plasma membrane than outside
▪ K+ is the major positive ion
inside the cell
▪ Na+ is the major positive ion
outside the cell
o As long as the inside of the membrane is more o A graded potential (localized depolarization)
negative (fewer positive ions) than the outside, exists where the inside of the membrane is
the cell remains inactive more positive and the outside is less positive
o If the stimulus is strong enough and sodium
influx great enough, local depolarization
activates the neuron to conduct an action
potential (nerve impulse)

● Action potential initiation and generation ● Propagation of the action potential

o A stimulus changes the permeability of the
neuron’s membrane to sodium ions
o Sodium channels now open, and sodium (Na+)
diffuses into the neuron
o The inward rush of sodium ion changes the
polarity at that site and is called
depolarization
o If enough sodium enters the cell, the action
potential (nerve impulse) starts and is
propagated over the entire axon
o All-or-none response means the nerve impulse
either is propagated or is not
o Fibers with myelin sheaths conduct nerve
impulses more quickly
● Repolarization ● Transmission of the signal at synapses
o Membrane permeability changes again – o Step 1: When the action potential reaches the
becoming impermeable to sodium ions and axon terminal, the electrical charge opens
permeable to potassium ions calcium channels
o Potassium ions rapidly diffuse out of the
neuron, repolarizing the membrane
o Repolarization involves restoring the inside of
the membrane to a negative charge and the
outer surface to a positive charge

o Step 2: Calcium, in turn, causes the tiny

vesicles containing the neurotransmitter
chemical to fuse with the axonal membrane

o Initial conditions of sodium and potassium

ions are restored using the sodium-potassium
pump
o This pump, using ATP, restores the original
configuration
o Three sodium ions are ejected from the cell
while two potassium ions are returned to the
cell
o Until repolarization is complete, a neuron
cannot conduct another nerve impulse

o Step 3: The entry of calcium into the axon

terminal causes pore-like openings to form,
 releasing the neurotransmitter into the o Step 6: The electrical changes prompted by
synaptic cleft neurotransmitter binding are brief
o The neurotransmitter is quickly removed from
the synapse either by reuptake or by
enzymatic activity
o Transmission of an impulse is electrochemical
▪ Transmission down neuron is
electrical
▪ Transmission to next neuron is
chemical

o Step 4: The neurotransmitter molecules

diffuse across the synaptic cleft and bind to
receptors on the membrane of the next neuron

● Reflexes are rapid, predictable, and involuntary responses

to stimuli
● Reflexes occur over neural pathways called reflex arcs

● Two types of reflexes

o Somatic reflexes
o Autonomic reflexes

o Step 5: If enough neurotransmitter is released,

a graded potential will be generated
▪ Eventually an action potential
(nerve impulse) will occur in the
neuron beyond the synapse

● Somatic reflexes
o Reflexes that stimulate the skeletal muscles
o Involuntary, although skeletal muscle is
normally under voluntary control
o Example: puling your hand away from a hot
object
● Autonomic reflexes
o Regulate the activity of smooth muscles, the
heart, and glands
 o Example: regulation of smooth muscles, heart
and blood pressure, glands, digestive system
● Five elements of a reflex arc
1. Sensory receptor – reacts to a stimulus
2. Sensory neuron – carries message to the integration
center
3. Integration center (CNS) – processes information
and directs motor output
4. Motor neuron – carries message to an effector
5. Effector organ – is the muscle or gland to be
stimulated

● Two-neuron reflex arcs

o Simplest type
o Example: patellar (knee-jerk) reflex
● Three-neuron reflex arcs
o Consists of five elements: receptor, sensory
neuron, interneuron, motor neuron, and
effector
o Example: flexor (withdrawal) reflex

Central Nervous System (CNS)

● Functional anatomy of the brain
o Brain regions
▪ Cerebral hemispheres

▪ Diencephalon

▪ Brain stem

▪ Cerebellum

Functional Anatomy of the Brain

● Cerebral hemispheres are paired (left and right) superior
parts of the brain
o Include more than half of the brain mass
 o The surface is made of ridges (gyri) and
grooves (sulci)
o Fissures are deeper grooves
o Lobes are named for the cranial bones that lie
over them
● Three main regions of cerebral hemisphere
1. Cortex is superficial gray matter
2. White matter
3. Basal nuclei are deep pockets of gray matter

● Cerebral cortex
o Primary somatic sensory area
▪ Located in parietal lobe posterior
to central sulcus
▪ Receives impulses from the
body’s sensory receptors
- Pain, temperature, light
touch (except for special
senses)
▪ Sensory homunculus is a spatial
map
▪ Left side of the primary somatic
sensory area receives impulses
from right side (and vice versa)

● Cerebral areas involved in special senses

 o Visual area (occipital lobe)
▪ Speech area (for sounding out
o Auditory area (temporal lobe)
o Olfactory area (temporal lobe) words)

● Cerebral cortex (continued)

o Primary motor area
▪ Located anterior to the central
sulcus in the frontal lobe
▪ Allows us to consciously move
skeletal muscles
▪ Motor neurons form pyramidal
(corticospinal) tract, which
descends to spinal cord
▪ Motor homunculus is a spatial ● Cerebral white matter
map o 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

● Cerebral cortex (continued)

o Broca’s area (motor speech area)
▪ Involved in our ability to speak

▪ Usually in left hemisphere

o Other specialized areas
▪ Anterior association area (frontal
lobe)
▪ Posterior association area
(posterior cortex)
● Basal nuclei
 o “Islands” of gray matter buried deep within o Relay station for sensory impulses passing
the white matter of the cerebrum upward to the cerebral cortex
o Regulate voluntary motor activities by o Transfers impulses to the correct part of the
modifying instructions sent to skeletal muscles cortex for localization and interpretation
by the primary motor cortex
● Diencephalon: hypothalamus
● Diencephalon o Makes up the floor of the diencephalon
o Sits on top of the brain stem o Important autonomic nervous system center
o Enclosed by the cerebral hemispheres
▪ Regulates body temperature
o Made of three structures
1. Thalamus ▪ Regulates water balance
2. Hypothalamus
3. Epithalamus ▪ Regulates metabolism
o Houses the limbic center for emotions
o Regulates the nearby pituitary gland
o Houses mammillary bodies for olfaction
(smell)
● Diencephalon: epithalamus
o Forms the roof of the third ventricle
o Houses the pineal body (an endocrine gland)
o Includes the choroid plexus – forms
cerebrospinal fluid
● Brain stem
o Attaches to the spinal cord
o Parts of the brain stem
1. Midbrain
2. Pons
3. Medulla oblongata

● Brain stem: midbrain

o Extends from the mammillary bodies to the
pons inferiorly
o Cerebral aqueduct (tiny canal) connects the
third and fourth ventricles
o Two bulging fiber tracts, cerebral peduncles,
convey ascending and descending impulses
o Four rounded protrusions, corpora
quadrigemina, are visual and auditory reflex
centers
● Brain stem: pons
o The rounded structure protruding just below
the midbrain
o Mostly composed of fiber tracts
o Includes nuclei involved in the control of
breathing
● Brain stem: medulla oblongata
o The most inferior part of the brain stem that
● Diencephalon: thalamus merges into the spinal cord
o Encloses the third ventricle o Includes important fiber tracts
o Contains important centers that control:
 ▪ Heart rate ▪ Outermost leathery layer

▪ Blood pressure ▪ Double-layered external covering

- Periosteum – attached to
▪ Breathing
inner surface of the skull
▪ Swallowing - Meningeal layer – outer
covering of the brain
▪ Vomiting ▪ Folds inward in several areas
o Fourth ventricle lies posterior to pons and - Falx cerebri
medulla - Tentorium cerebelli
● Brain stem: reticular formation o Arachnoid layer
o Diffuse mass of gray matter along the brain ▪ Middle layer
stem
o Involved in motor control of visceral organs ▪ Weblike extensions span the
o Reticular activating system (RAS) subarachnoid space to attach it to
the pia mater
▪ Plays a role in awake/sleep cycles
and consciousness ▪ Subarachnoid space is filled with
cerebrospinal fluid
▪ Filter for incoming sensory
information ▪ Arachnoid granulations protrude
through the dura mater and
absorb cerebrospinal fluid into
venous blood
o Pia mater
▪ Internal layer

▪ Clings to the surface of the brain

and spinal cord

● Cerebrum
o Two hemispheres with convoluted surfaces
o Outer cortex of gray matter and inner region
of white matter
o Controls balance
o Provides precise timing for skeletal muscle
activity and coordination of body movements

● Cerebrospinal fluid
o Similar to blood plasma in composition
o Formed continually by the choroid plexuses
▪ Choroid plexuses – capillaries in
Protection of the Central Nervous System
the ventricles of the brain
● Meninges o CSF forms a watery cushion to protect the
● Cerebrospinal fluid (CSF) brain and spinal cord
o Circulated in the arachnoid space, ventricles,
● Blood-brain barrier and central canal of the spinal cord

● Meninges (continued) ● Cerebrospinal fluid circulation

o Dura mater 1. CSF is produced by the choroid plexus of each
ventricle
 2. CSF flows through the ventricles and into the
▪ Slight brain injury
subarachnoid space via the median and lateral
apertures. Some CSF flows through the central ▪ Typically little permanent brain
canal of the spinal cord
damage occurs
3. CSF flows through the subarachnoid space
o Contusion
4. CSF is absorbed into the dural venous sinuses via
the arachnoid villi ▪ Marked nervous tissue
destruction occurs
▪ Coma may occur
o Death may occur after head blows due to:
▪ Intracranial hemorrhage

▪ Cerebral edema

● Cerebrovascular accident (CVA), or stroke

o Results when blood circulation to a brain area
is blocked and brain tissue dies
o Loss of some functions or death may result
▪ Hemiplegia – one-sided paralysis

▪ Aphasia – damage to speech

center in left hemisphere
● Transient ischemic attack (TIA)
o Temporary brain ischemia (restriction of
blood flow)
o Numbness, temporary paralysis, impaired
speech

Spinal Cord
● Extends from the foramen magnum of the skull to the first
or second lumbar vertebrae
● Cauda equina is a collection of spinal nerves at the inferior
end
● Provides a two-way conduction pathway to and from the
brain
● 31 pairs of spinal nerves arise from the spinal cord

● Blood-brain barrier
o Includes the least permeable capillaries of the
body
o Allows water, glucose, and amino acids to
● Gray matter of the spinal cord and spinal roots
pass through the capillary walls
o Excludes many potentially harmful substances o Internal gray matter is mostly cell bodies
from entering the brain, such as wastes o Dorsal (posterior) horns house interneurons
o Useless as a barrier against some substances ▪ Receive information from
Brain Dysfunctions sensory neurons in the dorsal
root; cell bodies housed in dorsal
● Traumatic brain injuries root ganglion
o Concussion
 o Anterior (ventral) horns house motor neurons
of the somatic (voluntary) nervous system
▪ Send information out ventral root
o Gray matter surrounds the central canal, which
is filled with cerebrospinal fluid
● White matter of the spinal cord
o Composed of myelinated fiber tracts
o Three regions: dorsal, lateral, ventral columns
o Sensory (afferent) tracts conduct impulses
toward brain
o Motor (efferent) tracts carry impulses from
brain to skeletal muscles

● Mixed nerves
o Contain both sensory and motor fibers
● Sensory (afferent) nerves
o Carry impulses toward the CNS
● Motor (efferent) nerves
o Carry impulses away from the CNS

Cranial Nerves
● 12 pairs of nerves serve mostly the head and neck

● Only the pair of vagus nerves extends to thoracic and

abdominal cavities
● Most are mixed nerves, but three are sensory only
1. Optic
2. Olfactory
3. Vestibulocochlear

Cranial Nerves Mnemonic Device

● Oh – Olfactory

● Oh – Optic

● Oh – Oculomotor
Peripheral Nervous System (PNS) ● To – Trochlear
● PNS consists of nerves and ganglia outside the CNS
● Touch – Trigeminal
Structure of a Nerve ● And – Abducens
● Nerves are bundles of neurons found outside the CNS ● Feel – Facial
● Endoneurium is a connective tissue sheath that surrounds ● Very – Vestibulocochlear
each fiber
● Green – Glossopharyngeal
● Perineurium wraps groups of fibers bound into a fascicle
● Vegetables – Vagus
● Epineurium binds groups of fascicles
● A – Accessory

● H – Hypoglossal
Spinal Nerves
● 31 pairs

● Formed by the combination of the ventral and dorsal 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
o Ramus – branch of a spinal nerve; contains
both motor and sensory fibers
 o Dorsal rami – serve the skin and muscles of
the posterior trunk
o Ventral rami (T1-T12) – form the intercostal
nerves that supply muscles and skin of the ribs
and trunk
o 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
 Anatomy of the Parasympathetic Division
● Parasympathetic division is also known as the craniosacral
division
● Preganglionic neurons originate in:
o Cranial nerves III, VII, IX, and X
o 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
o Consists only of motor nerves
o Controls the body automatically (and is also
known as the involuntary nervous system)
o Regulates cardiac and smooth muscles and
glands

Anatomy of the Sympathetic Division

Somatic and Autonomic Nervous Systems Compared
● Somatic nervous system
o Motor neuron cell bodies originate inside the
CNS
o Axons extends to skeletal muscles that are
served
● Autonomic nervous system
o Chain of two motor neurons
▪ Preganglionic neuron is in the
brain or spinal cord
▪ Postganglionic neuron extends to
the organ
o Has two arms
▪ Sympathetic division
▪ Parasympathetic division
● Sympathetic division is also known as the thoracolumbar
division
● Preganglionic neurons originate from T1 through L2
o Axons pass through a ramus communicans to
enter a sympathetic trunk ganglion
o Sympathetic trunk, or chain, lies near the
spinal cord
● After synapsing at the ganglion, the axon may synapse with
a second neuron at the same or different level
● Or, the preganglionic neuron may pass through the
ganglion without synapsing and from part of the splanchnic
nerves
o Splanchnic nerves travel to the collateral
ganglion
o Collateral ganglia serve the abdominal and
pelvic organs
Autonomic Functioning
● Body organs served by the autonomic nervous system
receive fibers from both division
o Exceptions: blood vessels, structures of the
skin, some glands, and the adrenal medulla
o These exceptions receive only sympathetic
fibers
● When body division serve the same organ, they cause
antagonistic effects due to different neurotransmitters
o Parasympathetic (cholinergic) fibers release
acetylcholine
o Sympathetic postganglionic (adrenergic)
fibers release norepinephrine
o Preganglionic axons of both divisions release
acetylcholine
● Sympathetic – “fight or flight” division
o Response to unusual stimulus when
emotionally or physically stresses or
threatened
o Takes over to increase activities
o Remember as the “E” division
▪ Exercise
▪ Excitement
▪ Emergency
▪ Embarrassment
● Parasympathetic – “housekeeping” activities
o “rest-and-digest” system
o Conserves energy
o Maintains daily necessary body functions
o Remember as the “D” division
▪ Digestion
▪ Defecation
▪ Diuresis
Developmental Aspects of the Nervous System
● The nervous system is formed during the first month of
embryonic development
● Any maternal infection can have extremely harmful effects
● Oxygen deprivation destroys brain cells
● The hypothalamus is one of the last areas of the brain to
develop
● Sever congenital brain diseases include:
o Cerebral palsy
o Anencephaly
o Hydrocephalus
o Spina bifida
● Premature babies have trouble regulating body temperature
because the 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 replaced; thus, brain mass declines
with age
● Orthostatic hypotension is low blood pressure due to
changes in body position
● Healthy aged people maintain nearly optimal intellectual
function
● Disease – particularly cardiovascular disease – is the major
cause of declining mental function with age
o Arteriosclerosis is decreased elasticity of
blood vessels
 CHAPTER 8: THE CARDIOVASCULAR SYSTEM

The Cardiovascular System

● A closed system of the heart and blood vessels
o The heart pumps blood
o Blood vessels allow blood to circulate to all
parts of the body
● The functions of the cardiovascular system
o To deliver oxygen and nutrients to cells and
tissues
o To remove carbon dioxide and other waste
products from cells and tissues

The Heart
● Location
o Thorax between the lungs in the inferior
mediastinum
● Orientation
o Pointed apex directed toward left hip
o Base points toward right shoulder
● About the size of your fist
 ▪ This layer is the visceral
pericardium
▪ Connective tissue layer
o Myocardium
▪ Middle layer

▪ Mostly cardiac muscle

o Endocardium
▪ Inner layer

▪ Endothelium

The Heart: Coverings

● Pericardium – a double-walled sac
o Fibrous pericardium is loose and superficial
o Serous membrane is deep to the fibrous
pericardium and composed of two layers
▪ Visceral pericardium
- Next to heart; also
known as the epicardium The Heart: Chambers
▪ Parietal pericardium ● Right and left side act as separate pumps
- Outside layer that lines
the inner surface of the ● Four chambers
fibrous pericardium o Atria
o Serous fluid fills the space between the layers
▪ Receiving chambers
of pericardium
- Right atrium
- Left atrium
o Ventricles
▪ Discharging chambers
- Right ventricle
- Left ventricle

The Heart: Heart Wall

● Three layers
o Epicardium
▪ Outside layer
 o Blood flows from the left side of the heart
through the body tissues and back to the right
side of the heart
● Pulmonary circulation
o Blood flows from the right side of the heart to
the lungs and back to the left side of the heart

The Heart: Valves

● Allow blood to flow in only one direction to prevent
backflow
● Four valves
o Atrioventricular (AV) valves – between atria
and ventricles
▪ Bicuspid (mitral) valve (left side
of the heart)
▪ Tricuspid valve (right side of the
The Heart: Septa heart)
o Semilunar valves – between ventricle and
● Interventricular septum
artery
o Separates the two ventricles
▪ Pulmonary semilunar valve
● Interatrial septum
o Separates the two atria ▪ Aortic semilunar valve

The Heart’s Role in Blood Circulation

● Systematic circulation

● AV valves
 o Anchored in place by chordae tendineae
(“heart strings”)
o Open during heart relaxation and closed
during ventricular contraction
● Semilunar valves
o Closed during heart relaxation but open during
ventricular contraction
● Notice these valves operate opposite of one another to force
a one-way path of blood through the heart
Cardiac Circulation
● Blood in the heart chambers does not nourish the
myocardium
● The heart has its own nourishing circulatory system
consisting of
o Coronary arteries – branch from the aorta to
supply the heart muscle with oxygenated
blood
o Cardiac veins – drain the myocardium of
blood
o Coronary sinus – a large vein on the posterior
of the heart, receives blood from cardiac veins
● Blood empties into the right atrium via the coronary sinus
Blood Flow Through the Heart
● Superior and inferior venae cavae dump blood into the right
atrium
● From right atrium, through the tricuspid valve, blood
travels to the right ventricle
● From the right ventricle, blood leaves the heart as it passes
through the pulmonary semilunar valve into the pulmonary
trunk
● Pulmonary trunk splits into right and left pulmonary
arteries that carry blood to the lungs
● Oxygen is picked up and carbon dioxide is dropped off by
blood in the lungs
● Oxygen-rich blood returns to the heart through the four
pulmonary veins
● Blood enters the left atrium and travels through the
bicuspid valve into the left ventricle
● From the left ventricle, blood leaves the heart via the aortic
semilunar valve and aorta

The Heart: Associated Great Vessels

● Arteries
o Aorta
▪ Leaves left ventricle
o Pulmonary arteries
▪ Leave right ventricle

● Veins
o Superior and inferior venae cavae
▪ Enter right atrium
o Pulmonary veins (four) The Heart: Conduction System

▪ Enter left atrium ● Intrinsic conduction system (nodal system)

o Heart muscle cells contract, without nerve
impulses, in a regular, continuous way
● Special tissue sets the pace
 o Sinoatrial node = SA node (“pacemaker”), is
in the right atrium
o Atrioventricular node = AV node, is at the
junction of the atria and ventricles
o Atrioventricular bundle = AV bundle (bundle
of His), is in the interventricular septum
o Bundle branches are in the interventricular
septum
o Purkinje fibers spread within the ventricle wall
muscles
a slower heart rate as ventricles contract at
their own rate
o Ischemia – lack of adequate oxygen supply to
heart muscle
o Fibrillation – a rapid, uncoordinated
shuddering of the heart muscle
o Tachycardia – rapid heart rate over 100 beats
per minute
o Bradycardia – slow heart rate less than 60
betas per minutes

The Heart: Cardia Cycle & Heart Sounds

● Atria contracts simultaneously

● Atria relax, then ventricles contract

● Systole = contraction

● Diastole = relaxation

● Cardiac cycle – events of one complete heart beat

o Mid-to-late diastole
▪ Pressure in heart is low

▪ Blood flows from passively into

the atria and into ventricles
▪ Semilunar valves are closed

▪ Atrioventricular valves are open

Heart Contractions
● Contraction is initiated by the sinoatrial node (SA node) ▪ Atria contract and force blood
into ventricles
● Sequential stimulation occurs at other autorhythmic cells o Ventricular systole
● Force cardiac muscle depolarization in one direction – from ▪ Blood pressure builds before
atria to ventricles ventricle contracts
● Once SA node starts the heartbeat ▪ Atrioventricular valves close
o Impulse spreads to the AV node causes first heart sound, “lub”
o Then the atria contract
▪ Semilunar valves open as blood
● At the AV node, the impulse passes through the AV pushes against them
bundle, bundle branches, and Purkinje fibers
▪ Blood travels out of the
● Blood is ejected from the ventricles to the aorta and ventricles through pulmonary
pulmonary trunk as the ventricles contract trunk and aorta
▪ Atria are relaxed
o Early diastole
▪ At the end of systole, all four
valves are briefly closed at the
same time
- Second heart sound is
heard as semilunar valves
close, causing “dup”
sound
▪ Atria finish refilling as pressure
in the heart drops
▪ Ventricular pressure is low

▪ Atrioventricular valves open

● Homeostatic imbalance
o Heart block – damaged AV node releases
them from control of the SA node; result is in
The Heart: Cardiac Output
● Cardiac Output (CO)
o Amount of blood pumped by each side
(ventricle) of the heart in one minute
● Stroke volume (SV)
o Volume of blood pumped by each ventricle in
one contraction (each heartbeat)
o Usually remains relatively constant Blood Vessels: The Vascular System
o About 70 mL of blood is pumped out of the ● Transport blood to the tissues and back
left ventricle with each heartbeat
o Carry blood away from the heart
● Heart rate (HR)
▪ Arteries
o Typically 75 beats per minute
● CO = HR x SV ▪ Arterioles
o Exchanges between tissues and blood
● CO = HR (75 beats/min) x SV (70 mL/beat)
▪ Capillary beds
● CO = 5250 mL/min o Return blood toward the heart
● Starling’s law of the heart – the more the cardiac muscle is ▪ Venules
stretched, the stronger the contraction
▪ Veins
● Changing heart rate is the most common way to change
cardiac output

The Heart: Regulation of Heart Rate

● Increased heart rate
o Sympathetic nervous system
▪ Crisis

▪ Low blood pressure

o Hormones
▪ Epinephrine

▪ Thyroxine
o Exercise
o Decrease blood volume
● Decreased heart rate
o Parasympathetic nervous system Blood Vessels: Microscopic Anatomy
o High blood pressure or blood volume
● Three layers (tunics)
o Decreased venous return
o Tunic Intima
▪ Endothelium
o Tunic media
▪ Smooth muscle

▪ Controlled by sympathetic
nervous system
o Tunic externa
▪ Mostly fibrous connective tissue
 ● Capillary beds consist of two types of vessels
o Vascular shunt – vessel directly connecting an
arteriole to a venule
o True capillaries – exchange vessels
▪ Oxygen and nutrients cross to
cells
▪ Carbon dioxide and metabolic
waste products cross into blood

Structural Differences Among Blood Vessels

● Arteries have a thicker tunica media than veins

● Capillaries are only one cell layer (tunica intima) to allow

for exchanges between blood and tissue
● Veins have a thinner tunica media than arteries
o Veins also have valves to prevent backflow of
blood
o Lumen of veins are larger than arteries

Venous Aids for the Return of Blood to the Heart

● Veins:
o Have a thinner tunica media
o Operate under low pressure
o Have a larger lumen than arteries
● To assist in the movement of blood back to the heart:
o Larger veins have valves to prevent backflow
o Skeletal muscle “milks” blood in veins toward
the heart

Major Arteries of System Circulation

● Aorta
o Largest artery in the body
o Leaves from the left ventricle of the heart
o Regions
▪ Ascending aorta - leaves the left
ventricle
▪ Aortic arch – arches to the left

▪ Thoracic aorta – travels

downward through the thorax
Movement of Blood Through Vessels
▪ Abdominal aorta – passes
● Most arterial blood is pumped by the heart
through the diaphragm into the
● Veins use the milking action of muscles to help move blood abdominopelvic cavity
● Arterial branches of the ascending aorta
o Right and left coronary arteries serve the heart
Capillary Beds
Major Arteries of Systemic Circulation
● Arteria branches of the aortic arch (BCS)
o Brachiocephalic trunk splits into the
▪ Right common carotid artery
▪ Right subclavian artery
o Left common carotid artery splits into the
▪ Left internal and external carotid
arteries
o Left subclavian artery branches into the
▪ Vertebral artery
▪ In the axilla, the subclavian
artery becomes the axillary artery
brachial artery radial and ulnar
arteries
● Arterial branches of the thoracic aorta
o Intercostal arteries supply the muscles of the
thorax wall
o Other branches of the thoracic aorta supply the
▪ Lungs (bronchial arteries)
▪ Esophagus (esophageal arteries)
▪ Diaphragm (phrenic arteries)
● Arterial branches of the abdominal aorta
o Celiac trunk is the first branch of the
abdominal aorta. Three branches are
▪ Left gastric artery (stomach)
▪ Splenic artery (spleen)
▪ Common hepatic artery (liver)
o Superior mesenteric artery supplies most of
the small intestine and first half of the large
intestine
● Arterial branches of the abdominal aorta
o Left and right renal arteries (kidney)
o Left and right gonadal arteries
▪ Ovarian arteries in females serve
the ovaries
▪ Testicular arteries in males serve
the testes
o Lumbar arteries serve muscles of the abdomen
and trunk
● Arterial branches of the abdominal aorta
o Inferior mesenteric artery serves the second
half of the large intestine
o Left and right common iliac arteries are the
final branches of the aorta
▪ Internal iliac arteries serve the
pelvic organs
▪ External iliac arteries enter the
thigh femoral artery
popliteal artery anterior and
posterior tibial arteries
Major Veins of Systemic Circulation
● Superior and inferior vena cava enter the right atrium of the
heart
o Superior vena cava drains the head and arms
o Inferior vena cava drains the lower body
● Veins draining into the superior vena cava
o Radial and ulnar veins brachial vein
axillary vein
o These veins drain the arms
o Cephalic vein drains the lateral aspect of the
arm and empties into the axillary vein
o Basilic vein drains the medial aspect of the
arm and empties into the brachial vein
o Basilic and cephalic veins are jointed at the
median cubital vein (elbow area)
● Veins draining into the superior vena cava
o Subclavian vein receives
▪ Venous blood from the arm via
the axillary vein
▪ Venous blood from the skin and
muscles via external jugular vein
o Vertebral vein drains the posterior part of the
head
o Internal jugular vein drains the dural sinuses
of the brain
● Veins draining into the superior vena cava
o Left and right brachiocephalic veins receive
venous blood from the
▪ Subclavian veins
▪ Vertebral veins
▪ Internal jugular veins
o Brachiocephalic veins join to form the
superior vena cava right atrium of heart
o Azygous vein drains the thorax
● Veins draining into the inferior vena cava
o Anterior and posterior tibial veins and fibial
veins drain the legs
o Posterior tibial vein popliteal vein
femoral vein external iliac vein
o Great saphenous veins (longest veins of the
body) receive superficial drainage of the legs
 o 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 inferior vena cava
o Right gonadal vein drains the right ovary in
females and right testicle in males
o Left gonadal vein empties into the left renal
vein
o Left and right renal veins drain the kidneys
o Hepatic portal vein drains the digestive organs
and travels through the liver before it enters
systemic circulation
● Veins draining into the inferior vena cava
o Left and right hepatic veins drain the liver

Arterial Supply of the Brain

● Internal carotid arteries divide into
o Anterior and middle cerebral arteries
Fetal Circulation
o These arteries supply most of the cerebrum
● Fetus receives exchanges of gases, nutrients, and wastes
● Vertebral arteries join once within the skull to form the
through the placenta
basilar artery
o Basilar artery serves the brain stem and ● Umbilical cord contains three vessels
cerebellum o Umbilical vein – carries blood rich in nutrients
● Posterior cerebral arteries form from the division of the and oxygen to the fetus
o Umbilical arteries (2) – carry carbon dioxide
basilar artery
and debris-laden blood from fetus to placenta
o These arteries supply the posterior cerebrum

Circle of Willis
● Anterior and posterior blood supplies are united by small
communicating arterial branches
● Result – complete circle of connecting blood vessels called
cerebral arterial circle or circle of Willis
 Pulse
● Pulse
o Pressure wave of blood
▪ Monitored at “pressure points” in
● Blood flow by passes the liver through the ductus venosus arteries where pulse is easily
and enters the inferior vena cava right atrium of heart palpated
● Blood flow bypasses the lungs ▪ Pulse averages 70 to 76 beats per
o Blood entering right atrium is shunted directly minute at rest
into the left atrium through the foramen ovale
o Ductus arteriosus connects the aorta and
pulmonary trunk (becomes ligamentum
arteriosum at birth)

Hepatic Portal Circulation

● Veins of hepatic portal circulation drain
o Digestive organs
o Spleen
o Pancreas
● Hepatic portal vein carries this blood to the liver

● Liver helps maintain proper glucose, fat, and protein

concentrations in blood
● Major vessels of hepatic portal circulation
o Inferior and superior mesenteric veins
o Splenic vein
Blood Pressure
o Left gastric vein
● Measurements by health professional are made on the
pressure in large arteries
o Systolic – pressure at the peak of ventricular
contraction
o Diastolic – pressure when ventricles relax
o Write systolic pressure first and diastolic last
(120/80 mm Hg)
● Pressure in blood vessels decreases as distance from the
heart increases
Blood Pressure: Effects of Factors
● BP is blood pressure
o BP is affected by age, weight, time of day,
exercise, body position, emotional state
● CO is the amount of blood pumped out of the left ventricle
per minute
● PR is peripheral resistance, or the amount of friction blood
encounters as it flows through vessels
o Narrowing of blood vessels and increased
blood volume increases PR
● BP = CO x PR

● Neural factors
o Autonomic nervous system adjustment
(sympathetic division)
● Renal factors
o Regulation by altering blood volume
o Renin – hormonal control
● Temperature
o Heat has a vasodilating effect
o Cold has a vasoconstricting effect
● Chemicals
o Various substances can cause increases or
decreases
● Diet
Variations in Blood Pressure
● Normal human range is variable
o Normal
▪ 140 to 110 mm Hg systolic

▪ 80 to 75 mm Hg diastolic
o Hypotension
▪ Low systolic (below 110 mm Hg)

▪ Often associated with illness

o Hypertension
▪ High systolic (above 140 mm
Hg)
▪ Can be dangerous if it is chronic

Capillary Exchange Developmental Aspects of the Cardiovascular System

● Substances exchanged due to concentration gradients ● A simple “tube heart” develops in the embryo and pumps
o Oxygen and nutrients leave the blood by the fourth week
o Carbon dioxide and other wastes leave the ● The heart becomes a four-chambered organ by the end of
cells seven weeks

Capillary Exchange: Mechanisms ● Few structural changes occur after the seventh week

● Direct diffusion across plasma membranes ● Aging problems associated with the cardiovascular system

● Endocytosis or exocytosis include

o Venous valves weaken
● Some capillaries have gaps (intercellular clefts) o Varicose veins
o Plasma membrane not joined by tight o Progressive atherosclerosis
junctions o Loss of elasticity of vessels leads to
hypertension
● Fenestrations (pores) of some capillaries o Coronary artery disease results from vessels
filled with fatty, calcified deposits

Fluid Movements at Capillary Beds

● Blood pressure forces fluid and solutes out of capillaries

● Osmotic pressure draws fluid into capillaries

● Blood pressure is higher than osmotic pressure at the

arterial end of the capillary bed
● Blood pressure is lower than osmotic pressure at the venous
end of the capillary bed
 The Lymphatic System
● Consists of two semi-independent parts
o Lymphatic vessels
o Lymphoid tissues and organs
● Lymphatic system functions
o Transports escaped fluids back to the blood
o Plays essential roles in body defense and
resistance to disease

Lymphatic Characteristics
● Lymph – excess tissue fluid carried by lymphatic vessels

● Properties of lymphatic vessels

o One way system toward the heart
o No pump
o Lymph moves toward the heart
▪ Milking action of skeletal muscle

▪ Rhythmic contraction of smooth

muscle in vessel walls

Lymphatic Vessels
● Lymph capillaries
o Walls overlap to form flap-like mini valves
o Fluid leaks into lymph capillaries
o Capillaries are anchored to connective tissue
by filaments
o Higher pressure on the inside closes mini
valves
o Fluid is forced along the vessel

CHAPTER 9: THE LYMPHATIC SYSTEM

 ● Harmful materials that enter lymph vessels
o Bacteria
o Viruses
o Cancer cells
o Cell debris

Lymph Nodes
● Filter lymph before it is returned to the blood

● Defense cells within lymph nodes

o Macrophages – engulf and destroy foreign
substances
o Lymphocytes – provide immune response to
antigens

Lymph Node Structure

● Most are kidney-shaped and less than 1 inch long

● Cortex
o Outer part
o Contains follicles – collections of lymphocytes
● Medulla
o Inner part
o Contains phagocytic macrophages

● Lymphatic collecting vessels

o Collect lymph from lymph capillaries
o Carry lymph to and away from lymph nodes
o Return fluid to circulatory veins near the heart
▪ Right lymphatic duct

▪ Thoracic duct
Flow of Lymph Through Nodes
● Lymph enters the convex side through afferent lymphatic
vessels
● Lymph flows through a number of sinuses inside the node

● Lymph exits through efferent lymphatic vessels

● Fewer efferent than afferent vessels causes flow to be

slowed

Other Lymphoid Organs

● Several other organs contribute to lymphatic function
o Spleen
o Thymus
o Tonsils
o Peyer’s patches

Lymph
 ● Immunity – specific resistance to disease

● Innate (nonspecific) defense system

o Mechanisms protect against a variety of
invaders
o Responds immediately to protect body from
foreign materials
Spleen ● Adaptive (specific) defense system
● Located on the left side of the abdomen o Specific defense is required for each type of
invader
● Filters blood

● Destroys worn out blood cells Innate (Nonspecific) Body Defenses

● Innate body defenses are mechanical barriers to pathogens
● Forms blood cells in the fetus
such as
● Acts as a blood reservoir o Body surface coverings
▪ Intact skin
Thymus Gland
▪ Mucous membranes
● Located low in the throat, overlying the heart
o Specialized human cells
● Functions at peak levels only during childhood o Chemicals produced by the body

● Produces hormones (like thymosin) to program Surface Membrane Barriers: First Line of Defense
lymphocytes
● Skin and mucous membranes
Tonsils o Physical barrier to foreign materials
o Also provide protective secretions
● Small masses of lymphoid tissue around the pharynx
▪ pH of the skin is acidic to inhibit
● Trap and remove bacteria and other foreign materials
bacterial growth
● Tonsilitis is caused by congestion with bacteria ▪ Sebum is toxic to bacteria
Peyer’s Patches
▪ Vaginal secretions are very acidic
● Found in the wall of the small intestine
● Stomach mucosa
● Resemble tonsils in structure
o Secretes hydrochloric acid
● Capture and destroy bacteria in the intestine o Has protein-digesting enzymes
● Saliva and lacrimal fluid contain lysozymes, an enzyme
Mucosa-Associated Lymphatic Tissue (MALT) that destroy bacteria
● Includes ● Mucus traps microorganisms in digestive and respiratory
o Peyer’s patches pathways
o Tonsils
o Other small accumulations of lymphoid tissue Innate (Nonspecific) Defense System Cells and Chemicals:
● Acts as a sentinel to protect respiratory and digestive tracts Second Line of Defense
● Natural killer cells
Body Defenses
● Inflammatory response
● The body is constantly in contact with bacteria, fungi, and
● Phagocytes
viruses
● The body has two defense systems for foreign materials ● Antimicrobial proteins
o Innate (nonspecific) defense system ● Fever
o Adaptive (specific) defense system
● Natural killer (NK) cells
o Can lyse (disintegrate or dissolve) and kill
cancer cells
o Can destroy virus-infected cells
o Release a chemical called perforin to target the
cell’s membrane and nucleus, causing
disintegration
● Inflammatory response
o Triggered when body tissues are injured
o Four most common indicators of acute
inflammation
▪ Redness

▪ Heat

▪ Swelling ● Phagocytes
▪ Pain o Cells such as neutrophils and macrophages
o Results in a chain of events leading to o Engulf foreign material into a vacuole
protection and healing o Enzymes from lysosomes digest the material
● Phagocytosis
o Neutrophils move by diapedesis to clean up
damaged tissue and/or pathogens
o Monocytes become macrophages and
complete disposal of cell debris

● Functions of the inflammatory response

o Prevents spread of damaging agents
o Disposes of cell debris and pathogens through
phagocytosis
o Sets the stage for repair
● Process of the inflammatory response:
o Neutrophils migrate to the area of
inflammation by rolling along the vessel wall
o They squeeze through the capillary walls by
diapedesis to sites of inflammation
o Neutrophils gather in the precise site of tissue
injury (positive chemotaxis) and consume any
foreign material present.

Cells and Chemicals: Second Line of Defense

● Antimicrobial proteins
o Attack microorganisms
 o Hinder reproduction of microorganisms
● Most important
o Complement proteins
o Interferon
● Complement proteins
o A group of at least 20 plasma proteins
o Activated when they encounter and attach to
cells (complement fixation)
o Damage foreign cell surfaces
o Release vasodilators and chemotaxis
chemicals, cause opsonization
● Interferon
o Proteins secreted by virus-infected cells
o Bind to healthy cell surfaces to interfere with
the ability of viruses to multiply
● Fever
o Abnormally high body temperature
o Hypothalamus heat regulation can be reset by
pyrogens (secreted by white blood cells)
o High temperatures inhibit the release of iron
and zinc from the liver and spleen needed by
bacteria
o Fever also increases the speed of tissue repair
Adaptive Defense System: Third Line of Defense
● Immune response is the immune system’s response to a
threat
● Immunology is the study of immunity
● Antibodies are proteins that protect from pathogens
● Three aspects of adaptive defense
o Antigen specific – recognizes and acts against
particular foreign substances
o Systemic – not restricted to the initial
infection site
o Memory – recognizes and mounts a stronger
attack on previously encountered pathogens
● Types of Immunity
o Humoral immunity = antibody-mediated
immunity
▪ Provided by antibodies present in
body fluids
o Cellular immunity = cell-mediated immunity
▪ Targets virus-infected cells,
cancer cells, and cells of foreign
grafts
● Antigens (non-self)
o Any substance capable of exciting the immune
system and provoking an immune response
o Examples of common antigens
▪ Foreign proteins (strongest)
▪ Nucleic acids
▪ Large carbohydrates
▪ Some lipids
▪ Pollen grains
▪ Microorganisms
● Self-antigens
o Human cells have many surface proteins
o Our immune cells do not attack our own
proteins
o Our cells in another person’s body can trigger
an immune response because they are foreign
▪ Restricts donors for transplants
● Allergies
o Many small molecules (called haptens or
incomplete antigens) are not antigenic, but
link up with our own proteins
o The immune system may recognize and
respond to a protein-hapten combination
o The immune response is harmful rather than
protective because it attacks our own cells
● Cells of the adaptive defense system
o Lymphocytes respond to specific antigens
▪ B lymphocytes (B cells)
▪ T lymphocytes (T cells)
o Macrophages help lymphocytes
● Immunocompetent – cell becomes capable of responding to
a specific antigen by binding to it
● Cells of the adaptive defense system
o Lymphocytes
▪ Originate from hemocytoblasts in
the red bone marrow
▪ B lymphocytes become
immunocompetent in the bone
marrow (remember B for Bone
marrow)
 ▪ T lymphocytes become
immunocompetent in the thymus
(remember T for Thymus)

● Cells of the adaptive defense system (continued)

o Macrophages
▪ Arise from monocytes

▪ Become widely distributed in

lymphoid organs
▪ Secrete cytokines (proteins
important in the immune
response)
▪ Tend to remain fixed in the
lymphoid organs
Active Immunity
Humoral (Antibody-Mediated) Immune Response
● Occurs when B cells encounter antigens and produce
● B lymphocytes with specific receptors bind to a specific
antibodies
antigen
● Active immunity can be
● The binding event activates the lymphocyte to undergo
o Naturally acquired during bacterial and viral
clonal selection
infections
● A large number of clones are produced (primary humoral o Artificially acquired from vaccines
response)
Passive Immunity
Humoral Immune Response ● Occurs when antibodies are obtained from someone else
● Most B cells become plasma cells o Conferred naturally from a mother to her fetus
o Produce antibodies to destroy antigens (naturally acquired)
o Activity lasts for 4 or 5 days o Conferred artificially from immune serum or
gamma globulin (artificially acquired)
● Some B cells become long-lived memory cells (secondary
humoral response) ● Immunological memory does not occur

● Secondary humoral responses ● Protection provided by “borrowed antibodies”

o Memory cells are long-lived ● Monoclonal antibodies
o A second exposure causes a rapid response
o Antibodies prepared for clinical testing or
o The secondary response is stronger and longer
diagnostic services
lasting
o Produced from descendants of a single cell
line
o Examples of uses for monoclonal antibodies
▪ Diagnosis of pregnancy

▪ Treatment after exposure to

hepatitis and rabies
 ● Antibody classes
o Antibodies of each class have slightly
Antibodies (Immunoglobulins or lgs) different roles
● Soluble proteins secreted by B cells (plasma cells) o Five major immunoglobulin classes
(MADGE)
● Carried in blood plasma ▪ lgM – can fix complement
● Capable of binding specifically to an antigen ▪ lgA – found mainly in mucus

▪ lgD – important in activation of

B cell
▪ lgG – can cross the placental
barrier and fix complement
▪ lgE – involved in allergies

● Antibody function
o Antibodies inactivate antigens in a number of
ways
▪ Complement fixation

▪ Neutralization

▪ Agglutination

▪ Precipitation

Antibodies
● Antibody structure
o Four amino acid chains linked by disulfide
bonds
o Two identical amino acid chains are linked to
form a heavy chain
o The other two identical chains are light chains
o Specific antigen-binding sites are present

Cellular (Cell-Mediated) Immune Response

● Antigens must be presented by macrophages to an
immunocompetent T cell (antigen presentation)
● T cells must recognize non-self and self (double
recognition
● After antigen binding, clones form as with B cells, but
different classes of cells are produced
● T cell clones
o Cytotoxic (killer) T cells
▪ Specialize in killing infected cells
▪ Insert a toxic chemical (perforin)
o Helper T cells
▪ Recruit other cells to fight the
invaders
▪ Interact directly with B cells
o Regulatory T cells
▪ Release chemicals to suppress the
activity of T and B cells
▪ Stop the immune response to
prevent uncontrolled activity
o A few members of each clone are memory
cells
Organ Transplants and Rejection
● Major types of grafts
o Autografts – tissue transplanted from one site
to another on the same person
o Isografts – tissue grafts from an identical
person (identical twin)
o Allografts – tissue taken from an unrelated
person
o Xenografts – tissue taken from a different
animal species
● Autografts and isografts are ideal donors
● Xenografts are never successful
● Allografts are more successful with a closer tissue match
Disorders of Immunity: Allergies (Hypersensitivity)
● Abnormal, vigorous immune responses
● Types of allergies
o Immediate hypersensitivity
▪ Triggered by release of histamine
from lgE binding to mast cells
▪ Reactions begin within seconds
of contact with allergen
▪ Anaphylactic shock – dangerous,
systemic response
o Delayed hypersensitivity
▪ Triggered by the release of
lymphokines from activated
helper T cells
▪ Symptoms usually appear 1-3
days after contact with antigen
 ● Except for thymus and spleen, the lymphoid organs are
poorly developed before birth
● A newborn has no functioning lymphocytes at birth, only
passive immunity from the mother
● If lymphatics are removed or lost, sever edema results, but
vessels grow back in time

Disorders of Immunity: Immunodeficiencies

● Production or function of immune cells or complement is
abnormal
● May be congenital or acquired

● Includes AIDS (Acquired Immune Deficiency Syndrome)

Disorders of Immunity: Autoimmune Diseases

● The immune system does not distinguish between self and
non-self
● The body produces antibodies and sensitized T
lymphocytes that attack its own tissues
● Examples of autoimmune diseases
o Multiple sclerosis – white matter of brain and
spinal cord are destroyed
o Myasthenia gravis – impairs communication
between nerves and skeletal muscles
o Type 1 diabetes mellitus – destroys pancreatic
beta cells that produce insulin
o Rheumatoid arthritis – destroys joints
o Systemic lupus erythematosus (SLE)
▪ Affects kidney, heart, lung, and
skin
o Glomerulonephritis – impairment of renal
function

Self-Tolerance Breakdown
● Inefficient lymphocyte programming

● Appearance of self-proteins in the circulation that have not

been exposed to the immune system
o Eggs
o Sperm
o Eye lens
o Proteins in the thyroid gland
● Cross-reaction of antibodies produced against foreign
antigens with self-antigens
o Rheumatic fever

Developmental Aspects of the Lymphatic System and Body

Defenses
 1. Direct gene activation
- Used by steroid hormones and
thyroid hormone
2. Second-messenger system
- Used by protein and peptide
hormones
● Direct gene activation
CHAPTER 10: THE ENDOCRINE SYSTEM 1. Steroid hormones diffuse through the plasma
membrane of target cells
2. Once inside the cell, the hormone enters the
The Endocrine System nucleus
3. Then, the hormone binds to a specific protein
● Second controlling system of the body within the nucleus
o Nervous system is the fastest-control system 4. Hormone-receptor complex binds to specific sites
on the cell’s DNA
● Uses chemical messengers (hormones) that are released
5. Certain genes are activated to transcribe messenger
into the blood RNA
● Hormones control several major processes 6. New proteins are synthesized
o Reproduction
o Growth and development
o Mobilization of body defenses
o Maintenance of much of homeostasis
o Regulation of metabolism
● Hormones are produced by specialized cells

● Cells secrete hormones into extracellular fluids

● Blood transfers hormones to target sites

● These hormones regulate the activity of other cells

● Endocrinology is the scientific study of hormones and

endocrine organs

The Chemistry of Hormones

● Hormones are classified chemically as:
o Amino acid-based, which includes:
▪ Proteins

▪ Peptides

▪ Amines
o Steroids – made from cholesterol
o Prostaglandins – made from highly active ● Second-messenger system
lipids that act as local hormones 1. Hormone (first messenger) binds to a membrane
receptor
Hormone Action 2. Activated receptor sets off a series of reactions that
activates an enzyme
● Hormones affect only certain tissues or organs (target cells 3. Enzyme catalyzes a reaction that produces a
or target organs) second-messenger molecule (such as cyclic AMP,
known as cAMP)
● Target cells must have specific protein receptors
4. Oversees additional intracellular changes to
● Hormone binding alters cellular activity promote a specific response in the target cell

● Hormones arouse cells or alter cellular activity

● Typically, one or more of the following occurs:

1. Change plasma membrane permeability or
membrane potential by opening or closing ion
channels
2. Activate or inactivate enzymes
3. Stimulate or inhibit cell division
4. Promote or inhibit secretion of a product
5. Turn on or turn off transcription of certain genes
● Hormones act by two mechanisms
 o 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

Stimuli for Control of Hormone Release

● Hormone levels in the blood are maintained mostly by
negative feedback
● A stimulus or low hormone levels in the blood trigger the
release of more hormone
● Hormone release stops once an appropriate level in the
blood is reached
● Neural stimuli
● The stimuli that activate endocrine glands fall into three
o Nerve fibers stimulate hormone release
major categories o Most are under the control of the sympathetic
1. Hormonal nervous system
2. Humoral o Examples:
3. Neural
▪ Sympathetic stimulation of the
● Hormonal stimuli
adrenal medulla to release
o Most common category of stimulus
epinephrine and norepinephrine
o Endocrine organs are activated by other
hormones
o Example:
▪ Hormones of the hypothalamus
stimulate the anterior pituitary to
secrete its hormones

● Humoral stimuli
o Changing blood levels of certain ions and
nutrients stimulate hormone release The Major Endocrine Organs

▪ Humoral indicates various body ● Hypothalamus

fluids, such as blood and bile ● Pituitary gland
 ● Pineal gland

● Thyroid gland

● Parathyroid gland

● Thymus

● Adrenal glands

● Pancreas

● Gonads (testes and ovaries)

● Posterior pituitary
o Does not make the hormones it releases
o Stores hormones made by the hypothalamus
● Two hormones released
o Oxytocin
o Antidiuretic hormone (ADH)
● Posterior pituitary (continued)
o Oxytocin

● Some glands have purely endocrine functions ▪ Stimulates contractions of the

o Anterior pituitary, thyroid, adrenals, uterus during labor, sexual
relations, and breastfeeding
parathyroids
▪ Causes mil ejection (let-down
● Endocrine glands are ductless glands
reflex) in a breastfeeding woman
● Hormones are released directly into blood or lymph o Antidiuretic hormone (ADH)
● Other glands are mixed glands, with both endocrine and ▪ Inhibits urine production
exocrine functions (pancreas, gonads) (diuresis) by promoting water
reabsorption by the kidneys
Pituitary Gland and Hypothalamus ▪ Urine volume decreases, blood
● Pituitary gland pressure increases
o Pea-sized gland that hangs by a stalk from the ▪ In large amounts, causes
hypothalamus in the brain
constriction of arterioles, leading
o Protected by the sella turcica of the sphenoid
to increased blood pressure (the
bone
reason why ADH is known as
o Has two functional lobes
vasopressin)
▪ Anterior pituitary – glandular ▪ Alcohol inhibits ADH secretion
tissue
● Six anterior pituitary hormones
▪ Posterior pituitary – nervous
o Two hormones affect nonendocrine targets
tissue
1. Growth hormone
o Often called the “master endocrine gland”
2. Prolactin
o Four are tropic hormones
● Hypothalamus produces releasing hormones and inhibiting 1. Follicle-stimulating hormone
hormones 2. Luteinizing hormone
o These hormones are released into portal 3. Thyrotropic hormone
circulation, which connects hypothalamus to 4. Adrenocorticotropic hormone
anterior pituitary
● Hypothalamus also makes two hormones: oxytocin and
antidiuretic hormone
o Carried to posterior pituitary via
neurosecretory cells for storage
 o Believed to trigger the body’s sleep/wake
cycle
o Believed to coordinate the hormones of
fertility in humans and to inhibit the
reproductive system until maturity occurs

Thyroid Gland
● Found at the base of the throat, inferior to the Adam’s apple

● Consists of two lobes and a connecting isthmus

● Follicles are hollow structures that store colloidal material

● Produces two hormones

1. Thyroid hormone
2. Calcitonin

● All anterior pituitary hormones:

o Are proteins (or peptides)
o Act through second-messenger systems
o Are regulated by hormonal stimuli
o Are regulated mostly by negative feedback
● Growth hormone (GH)
o General metabolic hormone
o Major effects are directed to growth of skeletal
muscled and long bones
o Plays a role in determining final body size
o Causes amino acids to be built into proteins
o Causes fats to be broken down for a source of
energy
● Prolactin (PRL)
o Stimulates and maintains milk production ● Thyroid hormone
following childbirth o Major metabolic hormone
o Function in males is unknown o Controls rate of oxidation of glucose to supply
● Gonadotropic hormones body heat and chemical energy
o Needed for tissue growth and development
o Regulate hormonal activity of the gonads o Composed of two active iodine-containing
▪ Follicle-stimulating hormone hormones
(FSH) ▪ Thyroxine (T4) – secreted by the
- Stimulates follicle thyroid follicles
development in ovaries
- Stimulates sperm ▪ Triiodothyronine (T3) –
development in testes conversion to T4 at target tissues
▪ Luteinizing hormone (LH)
- Triggers ovulation of an
egg in females
- Stimulates testosterone
production in males
● Thyrotropic hormone (TH), also called thyroid-stimulating
hormone (TSH)
o Influences growth and activity of the thyroid
gland
● Adrenocorticotropic hormone (ACTH)
o Regulates endocrine activity of the adrenal
cortex

Pineal Gland
● Hangs from the roof of the third ventricle of the brain

● Secretes melatonin ● Calcitonin

 o Decreases blood calcium levels by causing
calcium deposition on bone
o Antagonistic to parathyroid hormone
o Produced by parafollicular cells found
between the follicles

Parathyroid Glands
● Tiny masses on the posterior of the thyroid

● Secrete parathyroid hormone (PTH)

o Most important regulator of calcium ion (Ca 2+)
homeostasis of the blood
o Stimulates osteoclasts to remove calcium from
bone
o Hypercalcemic hormone (increases blood
calcium levels)
o Stimulates the kidneys and intestine to absorb
more calcium
● Hormones of the adrenal cortex
o Mineralocorticoids (mainly aldosterone)
▪ Produced in outer adrenal cortex

▪ Regulate mineral (salt) content in

blood, particularly sodium and
potassium ions
▪ Regulate water and electrolyte
balance
▪ Target organ si the kidney
o Release of aldosterone is stimulated by:
▪ Humoral factors (fewer sodium
ions or too many potassium ions
in the blood)
▪ Hormonal Stimulation (ACTH)

Thymus ▪ Renin and angiotensin II in

● Located in the upper thorax, posterior to the sternum response to a drop in blood
pressure
● Largest in infants and children o Aldosterone production is inhibited by atrial
natriuretic peptide (ANP), a hormone
● Decreases in size throughout adulthood produced by the heart when blood pressure is
● Produces a hormone called thymosin too high

▪ Matures some types of white blood cells

▪ Important in developing the immune system

Adrenal Glands
● Sit on top of the kidneys

● Two regions
1. Adrenal cortex – outer glandular region has three
layers that produce corticosteroids
- Mineralocorticoids are secreted by outermost
layer
- Glucocorticoids are secreted by middle layer
- Sex hormones are secreted by innermost layer
o Glucocorticoids (including cortisone and
2. Adrenal medulla – inner neural tissue region
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 increased

blood levels of ACTH
o Sex hormones
▪ Produced in the inner layer of the
adrenal cortex
▪ Small amounts are made
throughout life
▪ Most of the hormones produced
are androgens (male sex
hormones), but some estrogens
(female sex hormones) are also
formed
● Adrenal medulla
o Produces two similar hormones
(catecholamines)
1. Epinephrine (adrenaline)
2. Norepinephrine (noradrenaline)
o These hormones prepare the body to deal with
short-term stress (“fight or flight”) by:
▪ Increasing heart rate, blood
pressure, blood glucose levels
▪ Dilating small passageways of
lungs

Pancreatic Islets
● Pancreas
o Located in the abdomen, close to stomach
o Mixed gland, with both endocrine and
exocrine functions
● The pancreatic islets (islets of Langerhans) produce
hormones
o Insulin – produced by beta cells ● Insulin
o Glucagon – produced by alpha cells o Released when blood glucose levels are high
o These hormones are antagonists that maintain o Increases the rate of glucose uptake and
blood sugar homeostasis metabolism by body cells
o Effects are hypoglycemic
● Glucagon
o Released when blood glucose levels are low
o Stimulates the liver to release glucose to
blood, thus increasing blood glucose levels
 o Helps in the implantation of an embryo in the
uterus
o Helps prepare breasts for location
● Testes
o Produce several androgens
o 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

Gonads
● Gonads
o Produce sex cells
o Produce sex hormones
● Ovaries
o Female gonads located in the pelvic cavity
o Produce eggs
o Produce two groups of steroid hormones
1. Estrogens
2. Progesterone
● Testes
o Male gonads suspended outside the pelvic
cavity
o Produce sperm
o Produce androgens, such as testosterone

● Estrogens
o Stimulate the development of secondary
female characteristics
o Mature the female reproductive organs
● With progesterone, estrogens also:
o Promote breast development
o Regulate menstrual cycle
● Progesterone
o Acts with estrogen to bring about the
menstrual cycle
Other Hormone-Producing Tissues and Organs
● Other organs that are generally nonendocrine in functions
also secrete hormones
o Stomach
o Small intestine
o Kidneys
o Heart
● Placenta
o Produces hormones that maintain pregnancy
o Some hormones play a part in the delivery of
the baby
o Produces human chorionic gonadotropin Developmental Aspects of the Endocrine System
(hCG) in addition to estrogen, progesterone,
and other hormones ● In the absence of disease, efficiency of the endocrine
o Human placental lactogen (hPL) prepares the system remains high until old age
breasts for lactation ● Decreasing function of female ovaries at menopause leads
o Relaxin relaxes pelvic ligaments and pubic
to such symptoms as osteoporosis, increased chance of
symphysis for childbirth
heart disease, and possible mood changes
● Efficiency of all endocrine glands gradually decreases with
aging, which leads to a generalized increase in incidence of:
o Diabetes mellitus
o Immune system depression
o Lower metabolic rate
o Cancer rates in some areas

CHAPTER 11: THE DIGESTIVE SYSTEM

The Digestive System Functions

● Ingestion – taking in food

● Digestion – breaking food into nutrient molecules

● Absorption – movement of nutrients into the bloodstream

● Defecation – excretes to rid the body of indigestible waste

Anatomy of the Digestive System

● Two main groups of organs
o Alimentary canal (gastrointestinal, or GI,
tract) – continuous, coiled, hollow tube
▪ These organs ingest, digest,
absorb, defecate
 o Accessory digestive organs
▪ Include teeth, tongue, and several
large digestive organs
▪ Assist digestion in various ways

● Functions of the mouth

o Mastication (chewing) of food
o Tongue mixes masticated food with saliva
o Tongue initiates swallowing
o Taste buds on the tongue allow for taste

Pharynx
● Serves as a passageway for foods, fluids, and air

● Food passes from the mouth posteriorly into the:

o Oropharynx – posterior to oral cavity
o Laryngopharynx – below the oropharynx and
continuous with the esophagus
● Food is propelled to the esophagus by two skeletal muscle
Organs of the Alimentary Canal layers in the pharynx
● The alimentary canal is a continuous, coiled, hollow tube o Longitudinal outer layer
o Circular inner layer
that runs through the ventral cavity from stomach to anus
o Mouth ● Alternating contractions of the muscle layers (peristalsis)
o Pharynx propel the food
o Esophagus
o Stomach
o Small Intestine
o Large Intestine
o Anus

Mouth
● Anatomy of the mouth
o Mouth (oral cavity) – mucous membrane –
lined cavity
o Lips (labia) – protect the anterior opening
o Cheeks – form the lateral walls
o Hard palate – forms the anterior roof
o Soft palate – forms the posterior roof
o Uvula – fleshy projection of the soft palate
o Vestibule – space between lips externally and
teeth and gums internally
o Oral cavity proper – area continued by the
teeth Esophagus
o Tongue – attached at hyoid bone and styloid ● Anatomy
processes of the skull, and by lingual frenulum o About 10 inches long
to the floor of the mouth o Runs from pharynx to stomach through the
o Tonsils
diaphragm
▪ Palatine – located at posterior end ● Physiology
of oral cavity o Conducts food by peristalsis (slow rhythmic
▪ Lingual – located at the base of squeezing) to the stomach
the tongue o Passageway for food only (respiratory system
branches off after the pharynx)

Layers of Tissue in the Alimentary Canal Organs

 ● Summary of the four layers from innermost to outermost, ● Alimentary canal wall contains two intrinsic nerve plexuses
from esophagus to the large intestine (detailed next) that are part of the autonomic nervous system
1. Mucosa o Submucosal nerve plexus
2. Submucosa o Myenteric nerve plexus
3. Muscularis externa
4. Serosa ● Regulate mobility and secretory activity of the GI tract
1. Mucosa organs
● Innermost, moist membrane consisting of:
o Surface epithelium that is mostly simple
columnar epithelium (except for esophagus – Stomach
stratified squamous epithelium)
● C-shaped organ located on the left side of the abdominal
o Small amount of connective tissue (lamina
propria) cavity
o Scanty smooth muscle layer ● Food enters at the cardioesophageal sphincter from the
● Lines the cavity (known as the lumen) esophagus
2. Submucosa ● Food empties into the small intestine at the pyloric
● Just beneath the mucosa sphincter (valve)

● Soft connective tissue with blood vessels, nerve endings, ● Regions

mucosa-associated lymphoid tissue, and lymphatic vessels o Cardial (cardia) – near the heart and surrounds
3. Muscularis externa – smooth muscle the cardioesophageal sphincter
o Fundus – expanded portion lateral to the
● Inner circular layer cardiac region
● Outer longitudinal layer o Body – midportion
4. Serosa – outermost layer of the wall; contains fluid-producing cells ▪ Greater curvature is the convex
● Visceral peritoneum – innermost layer that is continuous lateral surface
with the outermost layer ▪ Lesser curvature is the concave
● Parietal peritoneum – outermost layer that lines the medial surface
o Pylorus – funnel-shaped terminal end
abdominopelvic cavity of the mesentery

● Stomach can stretch and hold 4L (1 gallon) of food when

full
o Rugae – internal folds of the mucosa present
when the stomach is empty
● Lesser omentum
o Double layer of the peritoneum
o Extends from liver to the lesser curvature of
stomach
● Greater omentum
o Another extension of the peritoneum
o Covers the abdominal organs
o Fat insulates, cushions, and protects
abdominal organs
● Structure of the stomach mucosa
o Simple columnar epithelium composed almost
entirely of mucous cells
Alimentary Canal Nerve Plexuses o Mucous cells produce bicarbonate-rich
alkaline mucus
 o Dotted by gastric pits leading to gastric glands
that secrete gastric juice, including:
▪ Intrinsic factor, which is needed
for vitamin B12 absorption in the
small intestine
o Chief cells – produce protein-digesting
enzymes (pepsinogens)
o Parietal cells – produce hydrochloric acid that
activates enzymes
o Mucous neck cells – produce thin acidic
mucus (different from the mucus produced by
mucous cells of the mucosa)
o Enteroendocrine cells – produce local
hormones such as gastrin
● Functions
o Temporary storage tank for food
o Site of food breakdown
o Chemical breakdown of protein begins ● Structural modifications
o Delivers chyme (processed food) to the small o Increase surface area for food absorption
intestine o Decrease in number toward the end of the
small intestine
1. Villi – fingerlike projections formed
by the mucosa
- House a capillary bed and
lacteal
2. Microvilli – tiny projections of the
plasma membrane (brush border
enzymes)
3. Circular folds (plicae circulares) –
deep folds of mucosa and submucosa
● Peyer’s patches
o Collections of lymphatic tissue
o Located in submucosa
o Increase in number toward the end of the
small intestine
Small Intestine o More are needed there because remaining food
residue contains much bacteria
● The body’s major digestive organ

● Longest portion of the alimentary tube (2-4 m, or 7-13 feet,

in a living person)
● Site of nutrient absorption into the blood

● Muscular tube extending from the pyloric sphincter to the

ileocecal valve
● Suspended from the posterior abdominal wall by the
mesentery
● Subdivisions
o Duodenum
o Jejunum
o Ileum
● Chemical digestion begins in the small intestine
o Enzymes produced by intestinal cells and
pancreas are carried to the duodenum by
pancreatic ducts Large Intestine
o Bile, formed by the liver, enters the duodenum ● Larger in diameter, but shorter in length at 1.5 m, than the
via the bile duct
o Hepatopancreatic ampulla is the location small intestine
where the main pancreatic duct and bile ducts ● Extends from the ileocecal valve to the anus
join
● Subdivisions
o Cecum
o Appendix
 o Colon
● These bands of muscle cause the wall to pucker into haustra
o Rectum
o Anal canal (pocketlike sacs)

● Cecum – saclike first part of the large intestine Accessory Digestive Organs
o Appendix ● Teeth
▪ Hangs from the cecum
● Salivary glands
▪ Accumulation of lymphoid tissue
● Pancreas
that sometimes becomes
inflamed (appendicitis) ● Liver
● Colon ● Gallbladder
o Ascending – travels up right side of abdomen
and makes a turn at the right colic (hepatic) Teeth
flexure
o Transverse – travels across the abdominal ● Teeth masticate (chew) food into smaller fragments
cavity and turns at the left colic (splenic) ● Humans have two sets of teeth during a lifetime
flexure
o Descending – travels down the left side 1. Deciduous (baby or milk) teeth
o Sigmoid – S-shaped region; enters the pelvis - A baby has 20 teeth by age 2
- First teeth to appear are the lower central
● Sigmoid colon, rectum, and anal canal are located in the Incisors
pelvis 2. Permanent teeth
- Replace deciduous teeth between ages 6 and
● Anal canal ends at the anus 12
- A full set of 32 teeth (with the wisdom teeth)
● Anus – opening of the large intestine
o External anal sphincter – formed by skeletal
muscle and is voluntary
o Internal anal sphincter – formed by smooth
muscle and is involuntary
o These sphincters are normally closed except
during defecation
● The large intestine delivers indigestible food residues to the
body’s exterior

● Teeth are classified according to shape and function

o Incisors – cutting
o Canines (eyeteeth) tearing or piercing
o Premolars (bicuspids) – grinding
o Molars – grinding
● Two major regions of a tooth
1. Crown
2. Root
● Goblet cells produce alkaline mucus to lubricate the 1. Crown – exposed part of tooth above the gingiva (gum)
passage of feces
● Enamel – covers the crown
● Muscularis externa layer is reduced to three bands of
● Dentin – found deep to the enamel and forms the bulk of
muscle, called teniae coli
the tooth, surrounds the pulp cavity
 ● Pulp cavity – contains connective tissue, blood vessels, and
Pancreas
nerve fibers (pulp)
● Soft, pink triangular gland
● Root canal – where the pulp cavity extends into the root
2. Root ● Found posterior to the parietal peritoneum
o Mostly retroperitoneal
● Cement – covers outer surface and attaches the tooth to the
periodontal membrane (ligament) ● Extends across the abdomen from spleen to duodenum
● Periodontal membrane holds tooth in place in the bony jaw ● Produces a wide spectrum of digestive enzymes that break
Note: The neck is a connector between the crown and root down all categories of food
- Region in contact with the gum
● Secretes enzymes into the duodenum

● Alkaline fluid introduced with enzymes neutralized acidic

chyme coming from stomach
● Hormones produced by the pancreas
o Insulin
o Glucagon

Liver
● Largest gland in the body

● Located on the right side of the body under the diaphragm

● Consists of four lobes suspended from the diaphragm and

abdominal wall by the falciform ligament
● Digestive role to produce bile
o Biles leaves the liver through the common
hepatic duct and enters duodenum through the
bile duct
o Bile is yellow-green, watery solution
containing:
▪ Bile salts and bile pigments
(mostly bilirubin from the
breakdown of hemoglobin)
▪ Cholesterol, phospholipids, and
electrolytes
o Bile emulsifies (breaks down) fats

Salivary Glands Gallbladder

● Three pairs of salivary glands empty secretions into the ● Green sac found in a shallow fossa in the inferior surface of
mouth the liver
1. Parotid glands o When no digestion is occurring, bile backs up
- Found anterior to the ears the cystic duct for storage in the gallbladder
- Mumps affect these salivary glands o While in the gallbladder, bile is oncentrated by
2. Submandibular glands the removal of water
3. Sublingual glands o When fatty food enters the duodenum, the
- Both submandibular and sublingual glands gallbladder spurts out stored bile
empty saliva into the floor of the mouth
through Functions of the Digestive System
small ducts
● Overview of gastrointestinal processes and controls
● Saliva o Digestion
o Mixture of mucus and serous fluids o Absorption
o Helps to moisten and bind food together into a
● We will cover more specific processes next
mass called a bolus
o Contains:
Overview of Gastrointestinal processes and Controls
▪ Salivary amylase – begins starch
● Essential processes of the GI tract
digestion
1. Ingestion – placing of food into the mouth
▪ Lysozymes and antibodies – 2. Propulsion – movement of foods from one region
inhibit bacteria of the digestive system to another
o Dissolves chemical so they can be tasted - Peristalsis – alternating waves of contraction
 and relaxation that squeeze food along the GI
tract
- Segmentation – movement of materials back
and forth to foster mixing in the small
intestine

3. Food breakdown: mechanical breakdown

a) Examples
- Mixing of food in the mouth by the
tongue
- Churning of food in the stomach
- Segmentation in the small intestine

b) Mechanical digestion prepares food for

further degradation by enzymes

5. Absorption
a) End products of digestion are absorbed in
the blood or lymph
4. Food breakdown: digestion b) Food must enter mucosal cells and then
a) Digestion occurs when enzymes chemically movie into blood or lymph capillaries
break down large molecules into their 6. Defecation
building blocks a) Elimination of indigestible substances from
b) Each major food group uses different the GI tract in the form of feces
enzymes
- Carbohydrates are broken down to
monosaccharides (simple sugars)
- Proteins are broken down to amino
acids
- fats are broken down to fatty acids and
glycerol
 ● Peristalsis moves the bolus toward the stomach

● The cardioesophageal sphincter is opened when food

presses against it

Activities in the Stomach

Activities Occurring in the Mouth, Pharynx, and Esophagus ● Food breakdown
● Food ingestion and breakdown o Gastric juice is regulated by neural and
o Food is placed into the mouth hormonal factors
o Presence of food or rising pH causes the
▪ Physically broken down by release of the hormone gastrin
chewing o Gastrin causes stomach glands to produce:
▪ Mixed with saliva, which is ▪ Protein-digesting enzymes
released in response to ▪ Mucus
mechanical pressure and psychic
stimuli ▪ Hydrochloric acid
▪ Salivary amylase begins starch o Hydrochloric acid makes the stomach contents
digestion very acidic
o Essentially, no food absorption occurs in the o Acidic pH
mouth ▪ Activates pepsinogen to pepsin
● Food propulsion – swallowing and peristalsis for protein digestion
o Pharynx and esophagus have no digestive ▪ Provides a hostile environment
function
for microorganisms
▪ Serve as passageways to the o Protein-digestion enzymes
stomach ▪ Pepsin – an active protein-
o Pharynx functions in swallowing (deglutition)
digesting enzyme
▪ Two phases of swallowing
▪ Rennin – works on digesting milk
1. Buccal phase
protein in infants; not produced
2. Pharyngeal-esophageal
in adults
phase
o Alcohol and aspirin are virtually the only
1. Buccal phase
items absorbed in the stomach
● Voluntary
● Food propulsion
● Occurs in the mouth 1. Peristalsis: waves of peristalsis occur from the
fundus to the pylorus, forcing food past the pyloric
● Food is formed into a bolus sphincter
2. Grinding: the pylorus meters out chyme into the
● The bolus is forced into the pharynx by the tongue
small intestine (3 ml at a time)
2. Pharyngeal-esophageal phase 3. Retropulsion: peristaltic waves close the pyloric
● Involuntary transport of the bolus by peristalsis sphincter, forcing contents back into the stomach;
the stomach empties in 4-6 hours
● Nasal and respiratory passageways are blocked
Activities of the Small Intestine
● Chyme breakdown and absorption
o Intestinal enzymes from the brush border
function to:
▪ Break double sugars into simple
sugars
▪ Complete some protein digestion
o Intestinal enzymes and pancreatic enzymes
help to complete digestion of all food groups
o Pancreatic enzymes play the major role in the
digestion of fats, proteins, and carbohydrates
o Alkaline content neutralizes acidic chyme and
provides the proper environment for the
pancreatic enzymes to operate
o Release of pancreatic juice from the pancreas
into the duodenum is stimulated by:
▪ Vagus nerves
▪ Local hormones that travel via
blood to influence the release of
pancreatic juice (and bile)
- Secretin
- Cholecystokinin (CCK)
o Hormones (secretin and CCK) also target the
liver and gallbladder to release bile
▪ Bile
- Acts as a fat emulsifier
- Needed for fat absorption
and absorption of fat-
soluble vitamins (K, D,
E, and A)
o A summary table of hormones is presented
next
o Water is absorbed along the length of the
small intestine
o End products of digestion
▪ Most substances are absorbed by
active transport through cell
membranes
▪ Lipids are absorbed by diffusion
o Substances are transported to the liver by the
hepatic portal vein or lymph
● Chyme propulsion
o Peristalsis is the major means of moving food
o Segmental movements
▪ Mix chyme with digestive juices
▪ Aid in propelling food
Activities of the Large Intestine
● Nutrient breakdown and absorption
o No digestive enzymes are produced
o Resident bacteria digest remaining nutrients
▪ Produce some vitamin K and
some B vitamins
▪ Release gases
o Water, vitamins, ions, and remaining water are
absorbed
o Remaining materials are eliminated via feces
o Feces contains:
▪ Undigested food residues
▪ Mucus
▪ Bacteria
▪ Water
● Propulsion of food residue and defecation
o Sluggish peristalsis begins when food residue
arrives
o Haustral contractions are the movements
occurring most frequently in the large intestine
o Mass movements are slow, powerful
movements that occur three to four times per
day
 o Presence of feces in the rectum causes a o Five food groups are arranged by a round plate
defecation reflex
▪ Internal anal sphincter is relaxed

▪ Defecation occurs with relaxation

of the voluntary (external) anal
sphincter

Part II: Nutrition and Metabolism

● Most foods are used as metabolic fuel
o Foods are oxidized and transformed into
adenosine triphosphate (ATP)
o ATP is chemical energy that drives cellular
activities
● Energy value of food is measured in kilocalories (kcal) or
Calories (C)
Dietary Sources of the Major Nutrients
Nutrition
● Carbohydrates
● Nutrient – substance used by the body for growth,
o Dietary carbohydrates are sugars and starches
maintenance, and repair o Most are derived from plants such as fruits
● Major nutrients and vegetables
o Exceptions: lactose from milk and small
o Carbohydrates
amounts of glycogens from meats
o Lipids
o Proteins ● Lipids
o Water o Saturated fats from animal products (meats)
● Minor nutrients o Unsaturated fats from nuts, seed, and
vegetable oils
o Vitamins o Cholesterol from egg yolk, meats, and milk
o Minerals products (dairy products)
● A diet consisting of foods from the five food groups ● Proteins
normally guarantees adequate amounts of all the needed o Complete proteins – contain all essential
nutrients amino acids
● The five groups are summarized next in Table 14.2 ▪ Most are from animal products
(eggs, milk, meat, poultry, and
fish)
▪ Essential amino acids: those that
the body cannot make and must
be obtained through diet
o Legumes and beans also have proteins, but the
proteins are incomplete

Dietary Recommendations
● Healthy Eating Pyramid
o Issued in 1992
o Six major food groups arranged horizontally
● Vitamins
● MyPlate
o Most vitamins function as coenzymes
o Issued in 2011 by the USDA
 o Found mainly in fruits and vegetables
● Minerals
o Mainly important for enzyme activity
o Foods richest in minerals: vegetables,
legumes, milk, and some meats

Metabolism
● Metabolism is all of the chemical reactions necessary to
maintain life
o Catabolism – substances are broken down to
simpler substances; energy is released and
captured to make adenosine triphosphate
(ATP)
o Anabolism – larger molecules are built from
smaller ones

Carbohydrate Metabolism
● Carbohydrates are the body’s preferred source to produce
cellular energy (ATP)
● Glucose (blood sugar)
o Major breakdown product of carbohydrate
digestion
o Fuel used to make ATP
● Cellular respiration
o As glucose is oxidized, carbon dioxide, water,
and ATP are formed

● Hyperglycemia – excessively high levels of glucose in the

blood
o Excess glucose is stored in body cells as
● Events of three metabolic pathways of cellular respiration glycogen or converted to fat
1. Glycolysis ● Hypoglycemia – low levels of glucose in the blood
- Occurs in the cytosol
- Energizes a glucose molecule so it can be split o Glycogenolysis, gluconeogenesis, and fat
into two pyruvic acid molecules and yield ATP breakdown occur to restore normal blood
2. Citric acid cycle (Krebs cycle) glucose levels
- Occurs in the mitochondrion
- Produces virtually all the carbon dioxide and
water resulting from cellular respiration
- Yields a small amount of ATP
3. Electron transport chain
- Hydrogen atoms removed during glycolysis
and
the citric acid cycle are delivered to protein carriers
- Hydrogen atoms are split into hydrogen ions
and
electrons in the mitochondria
- Electrons give off energy in a series of steps to
enable the production of ATP Fat Metabolism
● Fats
o Insulate the body
o Protect organs
o Build some cells structures (membranes and
myelin sheaths)
o Provide reserve energy
● Excess dietary fat is stored in subcutaneous tissue and other
fat depots
● When carbohydrates are in limited supply, more fats are
oxidized to produce ATP
 o Excessive fat breakdown causes blood to
become acidic (acidosis or ketoacidosis)
▪ Breath has a fruity odor
▪ Common with:
- “No Carbohydrate” diets
- Uncontrolled diabetes
mellitus
- Starvation
Protein Metabolism
● Proteins form the bulk of cell structure and most functional
molecules
● Proteins are carefully conserved by body cells
● Amino acids are actively taken up from blood by body cells
● Amino acids are oxidized to form ATP mainly when other
fuel sources are not available
● Ammonia, released as amino acids are catabolized, is
detoxified by liver cells that combine it with carbon dioxide
to form urea
The Central Role of the Liver in Metabolism
● Liver is the body’s key metabolic organ
● Roles in digestion
o Manufactures bile
o Detoxifies drugs and alcohon
o Degrades hormones
o Produces cholesterol, blood proteins (albumin
and clotting proteins)
o Plays a central role in metabolism
● Liver can regenerate if part of it is damaged or removed
● To maintain homeostasis of blood glucose levels, the liver
performs:
o Glycogenesis – “glycogen formation”
▪ Glucose molecules are converted
to glycogen and stored in the
liver
o Glycogenolysis – “glycogen splitting”
▪ Glucose is released from the liver
after conversion from glycogen
o Gluconeogenesis – “formation of new sugar”
▪ Glucose is produced from fats
and proteins
● Fats and fatty acids are picked up by the liver
o Some are oxidized to provide energy for liver
cells
o The rest are either stored or broken down into
simpler compounds and released into the
blood
● Blood proteins made by the liver are assembled from amino
acids
o Albumin is the most abundant protein in blood
o Clotting proteins
● Liver cells detoxify ammonia
o Ammonia is combined with carbon dioxide to
form urea, which is flushed from the body in
urine
● Cholesterol metabolism and transport
o Cholesterol is not used to make ATP
o Functions of cholesterol:
▪ Structural basis of steroid
hormones and vitamin D
▪ Building block of plasma
membranes
o Most cholesterol (85%) is produced in the
liver; only 15% is from the diet
o Cholesterol and fatty acids cannot freely
circulate in the bloodstream
o They are transported by lipoproteins (lipid-
protein complexes) known as LDLs and HDLs
o Low-density lipoproteins (LDLs) transport
cholesterol to body cells
▪ Rated “bad lipoproteins” since
they can lead to atherosclerosis
o High-density lipoproteins (HDLs) transport
cholesterol from body cells to the liver
 ▪ Rated “good lipoproteins” since
cholesterol is destined for
breakdown and elimination

Body Energy Balance

● Energy intake = Total energy output
(heat + work + energy storage)
o Energy intake is the energy liberated during
food oxidation
▪ Energy produced during
glycolysis, citric acid cycle, and
the electron transport chain
o Energy output
▪ Energy we lose as heat (60%)
▪ Energy stored as fat or glycogen
● Interference with the body’s energy balance leads to:
o Obesity
o Malnutrition (leading to body wasting)
● Regulation of food intake
o Body weight is usually relatively stable
▪ Energy intake and output remain
about equal
o Mechanisms that may regulate food intake
▪ Levels of nutrients in the blood
▪ Hormones
▪ Body temperature
▪ Psychological factors
● Metabolic rate and body heat production
o Nutrients yield different amounts of energy
o Energy value is measured in kilocalories
(kcal)
▪ Carbohydrates and proteins yield
4 kcal/gram
▪ Fats yield 9 kcal/gram
● Total metabolic rate (TMR) – total amount of kilocalories
the body must consume to fuel ongoing activities
● TMR increases dramatically with an increase in muscle
activity
● TMR must equal calories consumed to maintain
homeostasis and maintain a constant weight
● Body temperature regulation
o When foods are oxidized, more than 60% of
energy escapes as heat, warming the body
o The body has a narrow range of homeostatic
temperature
▪ Must remain between 35.6 °C
and 37.8 °C
▪ (96 °F and 100 °F)
o The body’s thermostat is in the hypothalamus
o Hypothalamus initiates mechanisms to
maintain body temperature
▪ Heat loss mechanisms involve
radiation of heat from skin and
evaporation of sweat
▪ Heat-promoting mechanisms
involve vasoconstriction of skin
blood vessels and shivering

● Basic metabolic rate (BMR) – amount of heat produced by

the body per unit of time at rest
● Average BMR is about 60 to 72 kcal/hour for an average
70-kg (154-lb) adult
● Factors that influence BMR
o Surface area – a small body usually has a
higher BMR
o Gender – males tend to have higher BMRs
o Age – children and adolescents have higher
BMRs
o The amount of thyroxine produced is the most
important control factor
▪ More thyroxine means a higher
metabolic rate
 ● Later middle-age problems
o Obesity
o Diabetes mellitus
● Activity of the digestive tract in old age
o Fewer digestive juices
o Peristalsis slows
o Diverticulosis and gastrointestinal cancers are
more common

● Fever – controlled hyperthermia

o Results from infection, cancer, allergic
reactions, CNS injuries
o If the body thermostat is set too high, body
proteins may be denatured, and permanent
brain damage may occur

Part II: Developmental Aspects of the Digestive System and

Metabolism
● The alimentary canal is a continuous, hollow tube present
by the fifth week of development
● Digestive glands bud from the mucosa of the alimentary
tube
● The developing fetus receives all nutrients through the
placenta
● In newborns, feeding must be frequent, peristalsis is
inefficient, and vomiting is common
● Newborn reflexes
o Rooting reflex helps the infant find the nipple
o Sucking reflex helps the infant hold on to the
nipple and swallow
● Teething begins around age 6 months

● Problems of the digestive system

o Gastroenteritis – inflammation of the
gastrointestinal tract; can occur at any time
o Appendicitis – inflammation of the appendix;
common in adolescents
● Metabolism decreases with old age

● Middle-age digestive problems

o Ulcers
CHAPTER 12: THE URINARY SYSTEM
o Gallbladder problems
Functions of the Urinary System
Kidney Features
● Elimination of waste products
o Nitrogenous wastes ● Renal hilum
o Toxins o A medial indentation where several structures
o Drugs enter or exit the kidney (ureters, renal blood
vessels, and nerves)
● Regulate aspects of homeostasis
● An adrenal gland sits atop each kidney
o Water balance
o Electrolytes
o Acid-base balance in the blood Coverings of the Kidneys
o Blood pressure ● Fibrous capsule
o Red blood cell production o Surrounds each kidney
o Activation of vitamin D
● Perirenal fat capsule
Organs of the Urinary System o Surrounds the kidney and cushions against
● Kidneys blows
● Renal fascia
● Ureters
o Outermost capsule that helps hold the kidney
● Urinary bladder in place against the muscles of the trunk wall

● Urethra Regions of the Kidney

● Renal cortex – outer region

● Renal medulla – inside the cortex

● Renal pelvis – inner collecting tube

Kidney Structures
● Renal or medullary pyramids – triangular regions of tissue
in the medulla
● Renal columns – extensions of cortex-like material inward
that separate the pyramids
● Calyces – cup-shaped structures that funnel urine towards
the renal pelvis

Locations of the Kidneys

● Against the dorsal body wall in a retroperitoneal position
(behind the parietal peritoneum)
● At the level of the T12 to L3 vertebrae

● The right kidney is slightly lower than the left (due to

position of the liver)
 o Glomerulus sits within a glomerular
(Bowman’s) capsule (the first part of the renal
tubule)
▪ Inner layer of the capsule
contains podocytes
▪ Podocytes have filtration slits
and foot processes that stick to
the glomerulus

Blood Supply
● One-quarter of the total blood supply of the body passes
through the kidneys each minute
● Renal artery provides each kidney with arterial blood
supply
● Renal artery divides into segmental arteries – interlobar
arteries – arcuate arteries – cortical radiate arteries
● Venous blood flow
o Cortical radiate veins – arcuate veins –
interlobar veins – renal vein
● There are no segmental veins

Nephron Anatomy and Physiology

● The structural and functional units of the kidneys

● Responsible for forming urine

● Main structures of the nephrons

o Glomerulus
o Renal tubule

● Renal tubule extends from glomerular capsule and ends at

the collecting duct
o Glomerular (Bowman’s) capsule
o Proximal convoluted tubule (PCT)
o Loop of Henle
o Distal convoluted tubule (DCT)

Nephron Anatomy
● Glomerulus
o Knot of capillaries
o Capillaries are covered with podocytes from
the renal tubule
 ● High pressure forces fluid and solutes out of blood and into
the glomerular capsule

Types of Nephrons
● Cortical nephrons
o Located entirely in the cortex Peritubular Capillary Beds
o Includes most nephrons ● Arise from efferent arteriole of the glomerulus
● Juxtamedullary nephrons
● Normal, low-pressure capillaries
o Found at the boundary of the cortex and
medulla ● Adapted for absorption instead of filtration

● Cling close to the renal tubule to reabsorb (reclaim) some

substances from collecting tubes

Urine Formation
● Glomerular filtration

● Tubular reabsorption

● Tubular secretion

Glomerular Filtration
● Nonselective passive process

● Water and solutes smaller than proteins are forced through

capillary walls
● Proteins and blood cells are normally too large to pass
Collecting Duct
through the filtration membrane
● Receives urine from many nephrons
● Filtrate is collected in the glomerular capsule and leaves via
● Run through the medullary pyramids the renal tubule
● Deliver urine into the calyces and renal pelvis Tubular Reabsorption
● The peritubular capillaries reabsorb useful substances
Nephron Anatomy
o Water
● Nephrons are associated with two capillary beds o Glucose
o Glomerulus o Amino acids
o Peritubular capillary bed o Ions

Glomerulus ● Some reabsorption is passive, most is active

● Fed and drained by arterioles ● Most reabsorption occurs in the proximal convoluted tubule
o Afferent arteriole – arises from a cortical
radiate artery and feeds the glomerulus
o Efferent arteriole – receives blood that has
passed through the glomerulus
● Specialized for filtration
 o Bicarbonate ions
● Solutes NOT normally found in urine
o Glucose
o Blood proteins
o Red blood cells
o Hemoglobin
o White blood cells (pus)
o Bile

● What materials are not reabsorbed?

o Nitrogenous waste products
▪ Urea – protein breakdown

▪ Uric acid – nucleic acid

breakdown
▪ Creatinine – associated with
creatine metabolism in muscles

Tubular Secretion: Reabsorption in Reverse

● Some materials move from the blood of the peritubular
capillaries into the renal tubules Ureters
o Hydrogen and potassium ions
o Creatinine ● Slender tubes attaching the kidney to the bladder
o Continuous with the renal pelvis
● Process is important for getting rid of substances not
o Enter the posterior aspect of the bladder
already in the filtrate
● Runs behind the peritoneum
● Materials left in the renal tubule move toward the ureter
● Peristalsis aids gravity in urine transport
Characteristic of urine
● In 24 hours, about 1.0 to 1.8 liters of urine are produced

● Urine and filtrate are different

o Filtrate contains everything that blood plasma
does (except proteins)
o Urine is what remains after the filtrate has lost
most of its water, nutrients, and necessary ions
through reabsorption
o Urine contains nitrogenous wastes and
substances that are not needed
● Yellow color due to the pigment urochrome (from the
destruction of hemoglobin) and solutes
o Dilute urine is a pale, straw color
● Sterile

● Slightly aromatic

● Normal pH of around 6 Urinary Bladder

● Specific gravity of 1.001 to 1.035
● Solutes normally found in urine
o Sodium and potassium ions
o Urea, uric acid, creatinine
o Ammonia
● Smooth, collapsible, muscular sac
● Temporarily stores urine
● Trigone – triangular region of the bladder base
o Three openings
▪ Two from the ureters
 ▪ One to the urethra ▪ Spongy urethra
o In males, the prostate gland surrounds the
● Function
neck of the bladder
o Females – only carries urine
Urinary Bladder Wall o Males – carries urine and is passageway for
sperm cells and semen
● Three layers of smooth muscle collectively called the
detrusor muscle Micturition (Voiding)
● Mucosa made of transitional epithelium ● Both sphincter muscles must open to allow voiding
● Walls are thick and folded in an empty bladder ● The internal urethral sphincter is relaxed after stretching of
● Bladder can expand significantly without increasing the bladder
internal pressure ● Pelvic splanchnic nerves initiate bladder to go into reflex
contractions
Urinary Bladder Capacity
● Urine is forced past the internal urethra sphincter and the
● A moderately full bladder is about 5 inches long and holds person feels the urge to void
about 500 mL of urine
● The external urethral sphincter must be voluntarily relaxed
● Capable of holding twice that amount of urine to void

Fluid, Electrolyte, and Acid-Base Balance

● Blood composition depends on three factors
o Diet
o Cellular metabolism
o Urine output
● Kidneys have four roles in maintaining blood composition
o Excretion of nitrogen-containing wastes
(previously discussed)
o Maintaining water balance of the blood
o Maintaining electrolyte balance of the blood
o Ensuring proper blood pH

Maintaining Water Balance

● Normal amount of water in the human body
o Young adult females – 50 percent
o Young adult males = 60 percent
o Babies = 75 percent
Urethra o The elderly = 45 percent
● Thin-walled tube that carries urine from the bladder ot the ● Water is necessary for many body functions, and levels
outside of the body by peristalsis must be maintained
● Release of urine is controlled by two sphincters
Distribution of Body Fluid
o Internal urethral sphincter
● Intracellular fluid (ICF)
▪ Involuntary and made of smooth o Fluid inside cells
muscle o About two-thirds of body fluid
o External urethral sphincter
● Extracellular fluid (ECF)
▪ Voluntary and made of skeletal
o Fluids outside cells that includes
muscle
▪ Interstitial fluid
Urethra Gender Differences
▪ Blood plasma
● Length
o Females is 3 to 4 cm (1 inch)
o Males is 20 cm (8 inches)
● Location
o Females – anterior to the vaginal opening
o Males – travels through the prostate and penis
▪ Prostatic urethra

▪ Membranous urethra
 ● Dilute urine is produced if water intake is excessive

● Less urine (concentrated) is produced if large amounts of

water are lost
● Proper concentrations of various electrolytes must be
present

Regulation of Water and Electrolyte Reabsorption

● Osmoreceptors
o Sensitive cells in the hypothalamus
o React to small changes in solute blood
composition by becoming more active
o When activated, the thirst center in the
hypothalamus is notified
o A dry mouth due to decreased saliva also
promotes the thirst mechanism

The Link Between Water and Salt

● Solutes in the body include electrolytes like sodium,
potassium, and calcium ions
● Changes in electrolyte balance causes water to move from
one compartment to another
o Alters blood volume and blood pressure
o Can impair the activity of cells

Maintaining Water balance

● Water intake must equal water output

● Sources for water intake

o Ingested foods and fluids
o Water produced from metabolic processes
● Thirst mechanism is the driving force for water intake
● Regulation occurs primarily by hormones
● Sources for water output
o Antidiuretic hormone (ADH)
o Vaporization out of the lungs (insensible since
we cannot sense the water leaving) ▪ Prevents excessive water loss in
o Lost in perspiration urine
o Leaves the body in the feces ▪ Causes the kidney’s collecting
o Urine production
ducts to reabsorb more water
o Diabetes insipidus
▪ Occurs when ADH is not
released
 ▪ Leads to huge outputs of dilute ● Acids are proton (H+) donors
urine o Strong acids dissociate completely and
o Aldosterone liberate all of their H+ in water
o Weak acids, such as carbonic acid, dissociate
▪ Regulates sodium ion content of
only partially
ECF
● Bases are proton (H+) acceptors
▪ Sodium is the electrolyte most
o Strong bases dissociate easily in water and tie
responsible for osmotic water up H+
flows o Weak bases, such as bicarbonate ion and
▪ Aldosterone promotes ammonia, are slower to accept H+
reabsorption of sodium ions
▪ Remember, water follows salt!

● Renin-angiotensin mechanism
o Mediated by the juxtaglomerular (JG)
apparatus of the renal tubules
o When cells of the JG apparatus are stimulated
by low blood pressure, the enzyme renin is
released into blood
o Renin produces angiotensin II
o Angiotensin causes vasoconstriction and
aldosterone release
o Result is increase in blood volume and blood
pressure

● Molecules react to prevent dramatic changes in hydrogen

ion (H+) concentrations
o Bind to H+ when pH drops
o Release H+ when pH rises
● Three major chemical buffer systems
o Bicarbonate buffer system
o Phosphate buffer system
o Protein buffer system

The Bicarbonate Buffer System

● Mixture of carbonic acid (H2CO3) and sodium bicarbonate
(NaHCO3)
Maintaining Acid-Base Balance in Blood o Carbonic acid is a weak acid that does not
● Blood pH must remain between 7.35 and 7.45 to maintain dissociate much in neutral or acid solutions
homeostasis o Bicarbonate ions (HCO3-) react with strong
o Alkalosis – pH above 7.45 acids to change them to weak acids
o Acidosis – pH below 7.35
o Physiological acidosis – pH between 7.35 and
7.0
● Most ions originate as by-products of cellular metabolism ● Carbonic acid dissociates in the presence of a strong base to
form a weak base and water
● Acids produced by the body
o Phosphoric acid, lactic acid, fatty acids
o Carbon dioxide forms carbonic acid
o Ammonia
Respiratory System Controls of Acid-Base Balance
● Most acid-base balance is maintained by the kidneys
● Carbon dioxide in the blood is converted to bicarbonate
● Other acid-base controlling systems ions and transported in the plasma
o Blood buffers ● Increases in hydrogen ion concentration produces more
o Respiration
carbonic acid
Blood Buffers
 ● Excess hydrogen ion can be blown off with the release of
carbon dioxide from the lungs
● Respiratory rate can rise and fall depending on changing
blood pH

Renal Mechanisms of Acid-Base Balance

● Excrete bicarbonate ions if needed

● Conserve (reabsorb) or generate new bicarbonate ions if

needed
● When blood pH rises
o Bicarbonate ions are excreted
o Hydrogen ions are retained by kidney tubules
● When blood pH falls
o Bicarbonate ions are reabsorbed
o Hydrogen ions are secreted
● Urine pH varies from 4.5 to 8.0

Developmental Aspects of the Urinary System

● Functional kidneys are developed by the third month of
fetal life
● Urinary system of a newborn
o Bladder is small
o Urine cannot be concentrated for first 2
months
o Void 5 to 40 times per day
● Control of the voluntary urethral sphincter does not start
until age 18 months
● Complete nighttime control may not occur until the child is
4 years old
● Urinary infections are the only common problems before
old age
o Escherichia coli (E. coli), a type of bacteria
accounts for 80 percent of UTI (urinary tract
infections)

Aging and the urinary System

● There is a progressive decline in urinary function

● The bladder shrinks and loses bladder tone with aging

● Associated problems with aging

o Urgency – feeling that it is necessary to void
o Frequency – frequent voiding of small
amounts of urine
o Nocturia – need to get up during the night to
urinate
o Incontinence – loss of control
o Urinary retention – common in males, often
the result of hypertrophy of the prostate gland
 o Penis
o Scrotum

Testes
● Each testis is connected to the trunk via the spermatic cord,
which houses:
CHAPTER 13: THE REPRODUCTIVE SYSTEM
o Blood vessels
o Nerves
The Reproductive System
o Ductus deferens
● Gonads – primary sex organs
● Coverings of the testes
o Testes in males
o Ovaries in females o Tunica albuginea – capsule that surrounds
each testis
● Gonads produce gametes (sex cells) and secrete hormones o Septa – extensions of the capsule that extend
o Sperm – male gametes into the testis and divide it into lobules
o Ove (eggs) – female gametes
● Remaining structures are accessory reproductive organs

● Reproductive systems
o Produce offspring via gametes
o Sperm and egg fuse to form a zygote
o Female uterus houses the embryo, and later
the fetus, until birth

Anatomy of the Male Reproductive System

● Testes

● Duct system
o Epididymis
o Ductus (vas) deferens
● Each lobule contains one to four seminiferous tubules
o Urethra
o Tightly coiled structures
● Accessory organs o Function as sperm-forming factories
o Seminal glands (vesicles) o Empty sperm into the rete testis
o Prostate
● Sperm travels from the rete testis to the epididymis
o Bulbourethral glands
● External genitalia
 ● Interstitial cells in the seminiferous tubules produce ● Bulbourethral glands
androgens such as testosterone
Accessory Glands and Semen
Duct System
● Seminal vesicles
● The duct system transports sperm from the body and o Located at the base of the bladder
includes: o Produce a thick, yellowish secretion (60% of
o Epididymis semen) that contains:
o Ductus deferens
▪ Fructose (sugar)
o Urethra
● Epididymis ▪ Vitamin C
o Highly convoluted tube 6m (20ft) long ▪ Prostaglandins
o Found along the posterior lateral side of the
testis ▪ Other substances that nourish and
o First part of the male duct system activate sperm
o Temporary storage site for immature sperm o Duct of each seminal vesicle joins that of the
o Sperm mature as they journey though the ductus deferens on each side to form the
epididymis ejaculatory duct
o During ejaculation, sperm are propelled to the
● Prostate
ductus deferens
o Encircles the upper (prostatic) part of the
● Ductus (vas) deferens urethra
o Runs from the epididymis via the spermatic o Secretes a milky fluid
cord through the inguinal canal and arches
▪ Helps to activate sperm
over the urinary bladder
▪ Ampulla – end of the ductus ▪ Fluid enters the urethra through
deferens, which empties into the several small ducts
ejaculatory duct ● Bulbourethral glands
▪ Ejaculatory duct – passes through o Pea-sized glands inferior to the prostate
the prostate to merge with the o Produce a thick, clear mucus
urethra ▪ Mucus cleanses the spongy
o Moves sperm by peristalsis into the urethra
o Ejaculation – smooth muscle in the walls of (penile) urethra f acidic urine
prior to ejaculation
the ductus deferens create peristaltic waves to
squeeze sperm forward ▪ Mucus serves as a lubricant
o Vasectomy – cutting of the ductus deferens during sexual intercourse
prevents transportation of sperm (form of birth
control) ● Semen

▪ Promotes sterility o Milky white mixture of sperm and accessory

gland secretions
▪ Male retains secondary sex o Components of accessory gland secretions
characteristics ▪ Liquid portion acts as a transport
● Urethra medium to dilute sperm
o Extends from the base of the urinary bladder ▪ Sperm are streamlined cellular
to the tip of the penis “tadpoles”
o Carries both urine and sperm
o Sperm enters from the ejaculatory duct ▪ Fructose provides energy for
sperm cells
● Urethra regions
1. Prostatic urethra – surrounded by prostate gland ▪ Alkalinity of semen helps
2. Membranous urethra – prostatic urethra to penis neutralize the acidic environment
3. Spongy (penile) urethra – runs the length of the of vagina
penis to the external urethral orifice
▪ Semen inhibits bacteria
● Ejaculation causes the internal urethra sphincter to close
o Prevents urine from passing into the urethra External genitalia
o Prevents sperm from entering the urinary ● Scrotum
bladder
● Penis
Accessory Glands and Semen
● Seminal vesicles External genitalia

● Prostate ● Scrotum
 o Divided sac of skin outside the abdomen that
● Meiosis
houses the testes
o Viable sperm cannot be produced at normal o Special type of nuclear division that differs
body temperature from mitosis
o Maintains testes at 3°C lower than normal o Occurs in the gonads
body temperature o Includes two successive divisions of the
nucleus (meiosis I and II)
● Penis o Results in four daughter cells (gametes)
o Male organ of copulation that delivers sperm
● Gametes are spermatids with 23 chromosomes
into the female reproductive tract
o Regions of the penis o 23 chromosomes are half the usual 46 found in
other body cells 23 is known as the haploid
▪ Shaft number (n) – half the genetic material as other
body cells
▪ Glans penis (enlarged tip)
● Union of a sperm (23 chromosomes, n) with an egg (23
▪ Prepuce (foreskin)
chromosomes, n) creates a zygote (2n, or 46 chromosomes)
- Folded cuff of skin
around proximal end
- Often removed by
circumcision
o Internally there are three areas of spongy
erectile tissue around the urethra
o Erections occur when this erectile tissue fills
with blood during sexual excitement
▪ Serves as male organ of
copulation

Male Reproductive Functions

● Chief roles of the male in the reproductive process
o Produce sperm
o Produce a hormone, testosterone
● Spermiogenesis
Spermatogenesis
● Sperm production
o Begins at puberty and continues throughout
life
o Millions of sperm are made every day
● Sperm are formed in the seminiferous tubules of the testis
o Spermatogonia (primitive stem cells) begin
the process by dividing rapidly
o During puberty, follicle-stimulating hormone
(FSH) is secreted in increasing amounts
o Spermatids are nonmotile and not functional
as sperm
o A streamlining process is needed to strip
excess cytoplasm from a spermatid and
modify it into a sperm
o A sperm has three regions: head, midpiece,
tail
o Acrosome sits anterior to the sperm head
(nucleus)
o The entire process of spermatogenesis,
including spermiogenesis, takes 64 to 72 days

● Each division of a spermatogonium stem cell produces:

o Type A daughter cell, a stem cell, that
continues the stem cell population
o Type B daughter cell, which becomes a
primary spermatocyte, destined to undergo
meiosis and form four sperm
Testosterone Production
● During puberty:
Ovaries
o Follicle-stimulating hormone (FSH) begins
prodding seminiferous tubules to produce ● Ovaries
sperm o Produce eggs (ova) and hormones (estrogen
o Luteinizing hormone (LH) begins activating and progesterone)
the interstitial cells to produce testosterone o Each ovary houses ovarian follicles consisting
of:
● Testosterone
o Most important hormonal product of the testes ▪ Oocyte (immature egg)
o Stimulates reproductive organ development ▪ Follicle cells – layers of different
o Underlies sex drive
cells that surround the oocyte
o Causes secondary sex characteristics
▪ Deepening of voice

▪ Increased hair growth

▪ Enlargement of skeletal muscles

▪ Increased bone growth and

density

● Ovarian follicles
o Primary follicle – contains an immature
Anatomy of the Female Reproductive System oocyte
● Ovaries o Vesicular (Graafian) follicle – growing follicle
with a maturing oocyte
● Duct system o Ovulation – the follicle ruptures when the egg
o Uterine (fallopian) tubes is mature and ready to be ejected from the
o Uterus ovary; occurs about every 28 days
o Vagina o The ruptured follicle is transformed into a
corpus luteum
● External genitalia
● Ovary support
 o Suspensory ligaments secure the ovaries to the o Uterosacral ligament anchors the uterus
lateral walls of the pelvis posteriorly
o Ovarian ligaments anchor ovaries to the uterus
● Regions of the uterus
medially
o Broad ligaments, a fold of peritoneum, enclose o Body – main portion
and hold the ovaries in place o Fundus – superior rounded above where
uterine tube enters
o Cervix – narrow outlet that protrudes into the
vagina
● Layers of the uterus
o Endometrium
▪ Inner layer (mucosa)

Duct System
● Uterine (fallopian) tubes
● Uterus
● Vagina
Duct System
● Uterine (fallopian) tubes
o Form the initial part of the duct system
o Receive the ovulated oocyte from the ovaries
o Usual site for fertilization
o Empty into the uterus
o Little or no contact between ovaries and
uterine tubes
o Supported and enclosed by the broad ligament
● Uterine (fallopian) tube structure
o Infundibulum
▪ Distal, funnel-shaped end
o Fimbriae
▪ Fingerlike projections of the
infundibulum
▪ Receive the oocyte from the
ovary
▪ Cilia located inside the uterine
tube transport the oocyte
● Uterus
o Situated between the urinary bladder and
rectum
o Size and shape of a pear, in a woman who has
never been pregnant
o Receives, retains, nourishes a fertilized egg
● Uterine support
o Broad ligament suspends the uterus in the
pelvis
o Round ligament anchors the uterus anteriorly
▪ Site of implantation of a
fertilized egg
▪ Sloughs off if no pregnancy
occurs (menstruation or menses)
o Myometrium is the middle layer of smooth
muscle that contracts during labor
o Perimetrium (visceral peritoneum) is the
outermost serous layer of the uterus
● Vagina (birth canal)
o Passageway that extends from cervix to
exterior of body and is located between
urinary bladder and rectum
o Serves as the canal that allows a baby or
menstrual flow to leave the body
o Female organ of copulation
o Receives the penis during sexual intercourse
o Hymen – partially closes the vagina until it is
ruptured
External genitalia and Female Perineum
● The female external genitalia, or vulva, includes:
o Mons pubis
o Labia
o Clitoris
o Urethral orifice
o Vaginal orifice
o Greater vestibular glands
● Mons pubis
o Fatty area overlying the pubis symphysis
o Covered with pubic hair after puberty
● Labia – skin folds
o Labia majora
▪ Hair-covered skin folds
▪ Enclose the labia minora
 ▪ Also encloses the vestibule ● Secondary oocyte is released and surrounded by a corona
o Labia minora – delicate, hair-free folds of skin radiata
● Clitoris ● Meiosis is completed after ovulation only if sperm
o Contains erectile tissue penetrates the oocyte
o Corresponds to the male penis o Ovum is produced
o The clitoris is similar to the penis in that is it: o Two additional polar bodies are produced
▪ Hooded by a prepuce ● Once ovum is formed, the 23 chromosomes can be
combined with the 23 chromosomes of the sperm to form
▪ Composed of sensitive erectile the fertilized egg (zygote)
tissue
● If the secondary oocyte is not penetrated by a sperm, it dies
▪ Swollen with blood during sexual and does not complete meiosis to form an ovum
excitement
o The clitoris lacks a reproductive duct
● Vestibule
o Enclosed by labia majora
o Contains external openings of the urethra and
vagina
● Greater vestibular glands
o One is found on each side of the vagina
o Secretions lubricate vagina during intercourse
● Perineum
o Diamond-shaped region between the anterior
ends of the labial folds, anus posteriorly, and
ischial tuberosities laterally

Female Reproductive Functions and Cycles ● Mature follicles that are not ovulated will deteriorate
● The total supply of eggs is determined by the time a female ● Luteinizing hormone (LH)
is born o Triggers ovulation
● Ability to release eggs begins at puberty with the onset of o Causes the ruptured follicle to transform into a
the menstrual cycle corpus luteum

● Reproductive ability ends at menopause (in female’s
fifties)
Oogenesis and the Ovarian Cycle
● Oogenesis is the process of producing ova (eggs) in a
female
o Oogonia are female stem cells found in a
developing fetus
o Oogonia undergo mitosis to produce primary
oocytes that are surrounded by cells that form
primary follicles in the ovary
● Primary oocytes are inactive until puberty
● Meiosis differences between males and females
o Males – produces four functional sperm
o Females – produces one functional ovum and
three tiny polar bodies
● Sex cell size and structure differences between sperm and
eggs
o Sperm are tiny, motile, and equipped with
nutrients in seminal fluid
o Egg is large, is nonmotile, and has nutrient
reserves to nourish the embryo until
implantation

● Follicle-stimulating hormone (FSH) causes some primary

follicles to mature each month
● Cyclic monthly changes constitute the ovarian cycle

● Meiosis starts inside maturing follicle

o First meiotic division produces a larger
secondary oocyte and a smaller first polar
body
o A vesicular follicle contains a secondary
oocyte (maturation from a primary follicle
takes about 14 days)
● Ovulation of a secondary oocyte occurs with the release of
luteinizing hormone (LH)
Hormone Production by the Ovaries
 ● Estrogens are produced by follicle cells
o Cause secondary sex characteristics
▪ Enlargement of accessory organs
of the female reproductive
system
▪ Development of breasts
▪ Appearance of axillary and pubic
hair
▪ Increase in fat beneath the skin,
particularly in hips and breasts
▪ Widening and lightening of the
pelvis
● Days 15-28: secretory phase
o Levels of progesterone rise and increase the
blood supply to the endometrium
o If implantation does occur:
▪ Embryo produces a hormone that
causes the corpus luteum to
continue producing its hormones
o If fertilization does not occur:
▪ Corpus luteum degenerates as LH
blood levels decline
▪ Lack of ovarian hormones causes
endometrial cells to die and
menses to begin on day 28

▪ Onset of menses (menstrual

cycle)
● Progesterone is produced by the corpus luteum
o Production continues until LH diminishes in
the blood
o Does not contribute to the appearance of
secondary sex characteristics
o Other major effects
▪ Helps maintain pregnancy

▪ Prepares the breasts for milk

production
o Placenta is the major source of progesterone
by the second month of pregnancy

Uterine (menstrual) Cycle

● Cyclic changes of the endometrium, about 28 days in
length
● Regulated by cyclic production of estrogens and
progesterone by the ovaries
● FSH and LH, from the anterior pituitary, regulate the
production of estrogens and progesterone by the ovaries
● Ovulation typically occurs about midway through cycle, on
day 14
● Stages of the menstrual cycle
o Menstrual phase
o Proliferative stage
o Secretory stage
● Days 0-4: menstrual phase
o Functional layer of the endometrium if
sloughed off
o Bleeding occurs for 3 to 5 days
o By day 4, growing ovarian follicles are
producing more estrogen
● Days 5-14: proliferative stage
o Regeneration of functional layer of the
endometrium
▪ Endometrium is repaired,
thickens, and becomes well
vascularized
o Ovulation occurs in the ovary at the end of
this stage
 \

Mammary Glands
● Present in both sexes, but function only in females
o Modified sweat glands
● Function is to produce milk to nourish a newborn
Mammography
● Stimulated by sex hormones (mostly estrogens) to increase
● Mammography is X-ray examination that detects breast
in size
cancers too small to feel
● Parts of the mammary gland that form the breast
● American Cancer Society recommends mammography
o Areola – central pigmented area of the breast
annually for women between 45 and 54 years old and every
o Nipple – protruding central area of areola
2 years thereafter if the results are normal
o Lobes – internal structures that radiate around
nipple ● Breast cancer is often signaled by a change in skin texture,
o Lobules – located within each lobe and puckering, or leakage from the nipple
contain clusters of alveolar glands
o Alveolar glands – produce milk when a
woman is lactating (producing milk)
o Lactiferous ducts – connect alveolar glands to
nipple
o Lactiferous sinus – dilated portion where milk
accumulates

Pregnancy and Embryonic Development

● Pregnancy – time from fertilization until infant is born

● Conceptus – developing offspring

 o Embryo – period of time from fertilization
until week 8
o Fetus – week 9 until birth
● Gestation period – from date of last period until birth
(approximately 280 days)
Accomplishing Fertilization
● An oocyte is viable up to 24 hours after ovulation
● Sperm are viable up to 48 hours after ejaculation
o For fertilization to occur, sexual intercourse
must occur no more than 2 days before
ovulation and no later than 24 hours after
● Sperm cells must make their way to the uterine tube for
fertilization to be possible
o Sperm cells are attached to the oocyte by
chemicals
● When sperm reach the oocyte:
o Enzymes break down the follicle cells of the
corona radiata around the oocyte
o Sperm undergo an acrosomal reaction
▪ Enzymes are released that digest
holes in the oocyte membrane
o Membrane receptors on the oocyte pull in the
head of the first sperm cell to make contact
o Oocyte undergoes second meiotic division to
produce an ovum and a polar body
● Fertilization occurs when the genetic material of a sperm
combines with that of an ovum to create a fertilized egg or
zygote
Events of Embryonic & Fetal Development
● Zygote
o First cell of a new individual
o The zygote is the result of the fusion of DNA
from sperm and ovum
o The zygote begins rapid mitotic cell divisions,
known as cleavage, 24 hours after fertilization
o The zygote journeys down the uterine tube,
moving toward the uterus
● Cleavage
o Rapid series of mitotic divisions that begins
with the zygote
o Provides a large number of cells to construct
the embryo
o 3 days after ovulation, the embryo reaches the
uterus and floats as a morula, a ball of 16 cells
● Blastocyst
o Hollow, ball-like structure of 100 cells or
more
o Secretes human chorionic gonadotropin (hCG)
to induce the corpus luteum to continue
producing hormones, preventing menses, until
the placenta assumes its role
● Functional areas of the blastocyst
1. Trophoblast – large fluid-filled sphere
2. Inner cell mass – cluster of cells to one side
● By day 7 after ovulation, the blastocyst has attached to the
endometrium and implantation is complete by day 14 after
ovulation
● Inner cell mass of blastocyst develops into:
o Primary germ layers
▪ Ectoderm – outside layer, which
gives rise to nervous system and
epidermis of skin
 ▪ Endoderm – inside layer, which ● Fetal changes are summarized in Table 16.1
forms mucosae and associated
glands
▪ Mesoderm – middle layer, which
gives rise to everything else

● After implantation, the trophoblast of the blastocyst

develops chorionic villi (projections)
o Chorionic villi combine with tissue of the
uterus to form the placenta
● Once the placenta has formed, the amnion is attached to the
placenta by an umbilical cord
o Amnion is a fluid-filled sac that surrounds the
embryo
o Umbilical cord is a blood vessel – containing
stalk of tissue

● Placenta
o Forms a barrier between mother and embryo
(blood is not exchanged)
o Delivers nutrients and oxygen
o Removes wastes from embryonic blood
o Becomes an endocrine organ and takes over
for the corpus luteum (by end of second
month); produces estrogen, progesterone, and
other hormones that maintain pregnancy
● All organ systems are formed by the end of the eight week

● Activities of the fetus are growth and organ specialization

● The fetal stage is one of tremendous growth and change in

appearance
 ▪ Nasal mucosa becomes congested
and swollen
▪ Vital capacity and respiratory
rate increase
▪ Dyspnea (difficult breathing)
occurs during later stages of
pregnancy
o Cardiovascular system
▪ Blood volume increases by 25%
to 40%
▪ Blood pressure and pulse
increase
▪ Varicose veins are common

Effect of Pregnancy on the Mother Childbirth (Parturition)

● Pregnancy – period from conception until birth ● Initiation of labor
● Anatomical changes o Labor – the series of events that expel the
o Enlargement of the uterus infant from the uterus
o Accentuated lumbar curvature (lordosis) ▪ Rhythmic, expulsive contractions
o Relaxation of the pelvic ligaments and pubic
symphysis due to production of the hormone ▪ Operates by the positive feedback
relaxin mechanism
o False labor – Braxton Hicks contractions are
weak, irregular uterine contractions
o Estrogen levels rise
o Uterine contraction begins
o The placenta releases prostaglandins
o Oxytocin receptors increase in the
myometrium
▪ Oxytocin is released by the
posterior pituitary
o Combined effects of rising levels of hormones
– oxytocin and prostaglandins – initiates
contractions and forces the baby deeper into
the mother’s pelvis

● Physiological changes
o Gastrointestinal system
▪ Morning sickness is common and
is due to elevated progesterone
and estrogens
▪ Heartburn is common because of
organ crowding by the fetus
▪ Constipation is caused by
declining motility of the digestive
tract
o Urinary system
▪ Kidneys have additional burden
Stages of Labor
and produce more urine
● Stage 1: Dilation stage
▪ The uterus compresses the
o Cervix becomes dilated
bladder, causing stress o Full dilation is 10 cm
incontinence o Uterine contractions begin and increase
o Respiratory system o Cervix softens and effaces (thins)
 o The amnion ruptures (“breaking the water”)
o Longest stage, at 6 to 12 hours
● Stage 2: Expulsion stage
o Infant passes through the cervix and vagina
o Can last as long as 2 hours, but typically is 50
minutes in the first birth and 20 minutes in
subsequent births
o Normal delivery is head-first (vertex position)
o Breech presentation is buttocks-first
● Stage 3: Placental stage
o Delivery of the placenta
o Usually accomplished within 15 minutes after
birth of infant
o Afterbirth – placenta and attached fetal
membranes
o All placental fragments should be removed to
avoid postpartum bleeding
Developmental Aspects of the Reproductive System
● Gender is determined at fertilization
o Males have XY sex chromosomes
o Females have XX sex chromosomes
● Reproductive system structures of males and females are
identical during early development (indifferent stage)
● Gonads do not begin to form until the eight weeks
● The presence or absence of testosterone determines whether
male or female accessory reproductive organs will form
● The reproductive system is inactive during childhood
● Reproductive system organs do not function for
childbearing until puberty
● Puberty usually begins between ages 10 and 15
● Puberty
o Males
▪ Enlargement of testes and
scrotum signals onset of puberty
(often around age 13)
o Females
▪ Budding breasts signal puberty
(often around age 11)
▪ Menarche – first menstrual
period (usually occurs about 2
years later)
● Menopause – a whole year has passed without menstruation
o Ovaries stop functioning as endocrine organs
o Childbearing ability ends
o Hot flashes and mood changes may occur
● There is a no equivalent of menopause in males, but there is
a steady decline in testosterone
A Closer Look: Contraception
● Contraception – birth control
● Birth control pill – most-used contraceptive
o Relatively constant supply of ovarian
hormones from pill is similar to pregnancy
o Ovarian follicles do not mature, ovulation
ceases, menstrual flow is reduced
● Morning-after pill (MAP) or emergency contraceptive pill
(EC)
o Taken within 3 days of unprotected
intercourse
o Disrupts normal hormonal signals to the point
that fertilization is prevented
● Sterilization techniques
o Tubal ligation (females) – cut or cauterize
uterine tubes
o Vasectomy (males) – cut or cauterize the
ductus deferens
● Barrier methods
o Diaphragms
o Condoms
● Abstinence
o Only birth control method that is 100%
effective