Basic Nursing Art Part I

Provide basic nursing care
Berhanu Wale (BSc and MSc)
Contact me via
4/14/2024
1
Learning outcomes
1. Identify the causes of diseases
2. Introducing to human body structure and function
3. Identify clients need to individualize nursing care
4. Minimize risk of injury
5. Manage patient safety and comfort
6. Provide hygienic care for patients
7. Perform patient transportation
4/14/2024 Berhanu Wale (BSc and MSc) Contact me via 2

References
◊ Kozier and Erb’s fundamentals of nursing, 11th edition, 2022
◊ Mosby’s pocket guide to nursing skills & procedures, 9th edition, 2019
◊ Potter and Perry essentials for nursing practice, 9th edition, 2019
◊ Fundamentals of nursing: human health and function, 8th edition, 2017
◊ Hole's essentials of human anatomy and physiology, 15th edition, 2024
◊ Essentials of Human Anatomy & Physiology, 13th edition, 2022
◊ Textbook of diagnostic microbiology, 6th edition, 2019
◊ Nursing theories and nursing practice, 4th edition, 2015
◊ Microbiology: basic and clinical principles, 2019

Identify the causes of diseases
Objectives
By the end of this learning outcome, the students will be able to:
◊ Define disease.
◊ Describe the causes of disease.
◊ Identify the basic component of disease transmission.
◊ Explain the common characteristics (structure, function and
multiplication) of disease causing microorganisms.
◊ Bacteria
◊ Virus
◊ Fungi
◊ Parasites
◊ Describe the basic concept of immunology.
Introduction to disease and its cause #1
◊ Disease is a structural and/or functional change in the body that is
harmful to the organism.
◊ Some changes in the body are perfectly normal.
E.g., puberty, pregnancy, increasing muscle mass in sport man, ...
◊ The study of disease is called pathology.
◊ The cause of disease and its study is called etiology.
◊ The sequence of events that leads from structural and functional
abnormalities to clinical manifestations is called pathogenesis of
disease and its study is called pathophysiology.
◊ Causes of disease: Diseases of unknown cause are termed idiopathic.
1. Exogenous: external in origin. E.g., physical injury (trauma),
chemical injury (poisoning) and microbiologic injury.
2. Endogenous: internal in origin. E.g., immune deficiency, abnormal
metabolism, deficiency (minerals, vitamins, proteins, …), …etc.
Classification of diseases:
◊ Based on there transmissibility:
1. Communicable disease: diseases that can be transmitted to other
people from an infected person, animal or a source in the
environment.
E.g., HIV, TB, malaria, …etc.
2. Non-communicable disease: disease that cannot be transmitted from
host to host. E.g., heart disease, stroke, kidney disease, …etc.
◊ Based on their alterations or change:
1. Functional diseases: diseases due to physiologic change.
◊ Example: hypertension, diabetes, tension headache, …etc.
2. Structural diseases: diseases characterized by structural changes
within the body, e.g., lesions.
Major categories of structural diseases:
◊ Genetic: caused by abnormalities in the genetic makeup.
◊ Developmental: originated during embryonic and fetal dev’t.
◊ Degenerative and inflammatory diseases and trauma.
 Caused by forces or agents that destroy cells, deposit abnormal
substances in cells, means of inflamatory process.
 External agents: chemical substances, microbes, …etc.
 Internal mechanisms: vascular insuffciency, immunologic
reactions and metabolic disturbances.
 Inflammation: a biological reaction that attempts to localize the
injury and destroy the offending agent.
◊ Hyperplasia and neoplasm: an increase in cell populations.

◊ All the data gathered about a disease as it occurs in a patient is called
manifestation (it is the clinical feature of the disease).
◊ Subjective data: also called symptoms.
◊ Evidence of the disease perceived by the patient, e.g., pain.
◊ Objective data: also called signs.
◊ Evidence of the disease perceived by health professionals.
◊ Physical examination findings, e.g., vital sign, tenderness.
◊ Investigation findings:
 Laboratory: stool test, blood test, urine test, …etc.
 Imaging: x-ray, ultrasound, …etc.
◊ The process of assimilating the data or information to identify the

condition causing the disease is called diagnosis.
◊ Diagnosis also refers to the name given to that disease.
 Diabetes, malaria, typhoid, hypertension, …etc.
◊ A method of analysis of a patient’s information and makes a list of
possible diagnose to arrive at the correct diagnosis is called
differential diagnosis.
◊ Additional investigations are needed to exclude the specific
diagnoses on the list so that in the end one diagnosis is made.
◊ Clusters of findings commonly encountered with more than one

disease are called syndromes.
◊ Secondary problems that emerge as a consequence of a disease

and/or its treatment is called complication.

Infectious disease: disease caused by infectious agent/pathogen/microbes.
◊ The deposition and multiplication of organisms is called infection.
◊ Types of infections: Bacteria, viruses, fungi and parasites.
 Acute: begins abruptly or is severe.
 Chronic: progresses slowly or may last a long time.
 Clinical: symptoms are present.
 Subclinical: inapparent or no symptoms (asymptomatic).
 Endogenous: caused by the person’s own normal flora.
 Exogenous: originates from outside of the host.
 Localized: confined to one area of the body.
 Systemic: spread throughout the body from an initial site.
 Nosocomial: acquired in institutions, usually in hospital.
 Community: contracted outside the health care setting.

Factors involved in the transmission of infectious diseases
A source of a pathogen.
Infectious
agents
Susceptible Reservoir
host
Six major components
(Chain of transmission)
Route of Route of exit
entry
Mode of
The way a pathogen The way a pathogen
transmission
enters a host. leaves a host.
The epidemiological triangle of infectious disease
• Food
• Water
• General health • Vector
• Sex Environmental
factors • Location, …etc.
• Age
• Occupation
• …etc.
Disease • Bacteria
Etiological • Virus
Host factors
agents • Parasites
• Fungi

Infection by a pathogen is influenced by several factors:
1. Mechanism of action: direct damage of cells, interference with
cellular metabolism via toxin production
2. Infectivity: the ability of the pathogen to invade and multiply.
3. Pathogenicity: the ability of an agent to produce disease.
4. Virulence: the potency or severity of a pathogen measured in terms of
the number of microorganisms or toxin required to kill a host.
5. Immunogenicity: the ability of pathogens to induce an immune
response.
6. Toxigenicity: a factor important in determining a pathogen’s
virulence, such as production of soluble toxins or endotoxin.
Reading assignment:
• Contagious disease versus communicable disease versus infectious disease.
Taxonomy or classification of organisms Categories.
◊ Taxonomy is classification and grouping of organisms into taxa.
◊ Based on:
1. Genotype (genetic makeup of an organism).
◊ DNA or RNA or protein sequences.
2. Phenotype (organisms observable physical & functional features):
◊ Morphology: macroscopic and microscopic.
◊ Staining characteristics: gram-positive or gram-negative.
3. Based on cellular type:
◊ Prokaryotic cells: unicellular, lacks a nucleus and nuclear
membrane (mitochondria, endoplasmic reticulum), e.g., bacteria.
◊ Eukaryotes: uni and multi-cellular and contains a nucleus
 Fungi, parasites and animals.

Eukaryotic versus prokaryotic cells
Characteristic Eukaryotes Prokaryotes
Organisms Unicellular: protozoa, yeast Unicellular
Multicellular: animal, fungi
Size Larger than prokaryotes Smaller than eukaryotes
Cell division Asexual (mitosis) and Asexual (binary fission)
Sexual (meiosis)
Plasma or cell membrane Often contain sterols Rarely contain sterols
Cell wall Fungi and certain protists Most (except Mycoplasma)
Nucleus Yes No
Ribosomes 80S: Cytoplasm 70S only
70S: Mitochondria
Genetic material DNA DNA
Membrane-bound organelles Yes No

Make proteins Prokaryotic cell structure
Storage Watery medium that

surrounds intracellular
structures and serves as
the location for
biochemical processes.
Main point of interaction

with extracellular env’t
Protection and interface with env’t
Adhesion and protection
from immune system
Adhesion
Motility

Contains
Protection, adhesion, communication hydrolytic
enzymes
Protein modification
Houses DNA Builds cytoskeleton
Builds lipids
Cargo transport,
Makes ATP cell movement
Make proteins
Contains enzymes to
protect cell and break
down fats and amino acids Modifies proteins,
builds lipids
Eukaryotic cell (animal cell)
Bacteria:
◊ Classification of bacteria based on shape:
◊ Bacillus: rod or cylindrical shape.
E.g., corynebacterium, bacillus, listeria, clostridium, …
◊ Coccus: spherical.
E.g., streptococcus, staphylococcus, neisseria, …
◊ Spirillum: spiral.
E.g., bordetella pertussis, treponema pallidum, …
◊ Others: comma-shaped vibrio, star-shaped stella, …
Bacillus Coccus
◊ Classification of bacteria based on oxygen requirement:
◊ Aerobic bacteria: grows only in the presence of oxygen.
E.g., pseudomonas aeruginosa, mycobacterium tuberculosis,
bordetella pertussis, listeria, bacillus, corynebacterium, …etc.
◊ Anaerobic bacteria: grows only in the absence of oxygen.
E.g., clostridium, bacteroides, fusobacterium, cutibacterium, …
◊ Facultative bacteria: grows with or without oxygen.
E.g., streptococci, staphylococci, enterobacteriaceae (salmonella,
escherichia coli, klebsiella, shigella, ...), …etc.
◊ Classification of bacteria based on gram stain characteristics:
◊ Gram-positive: stains blue to purple. Non-gram staining:
E.g., bacillus, listeria, corynebacterium, … • Mycoplasma
◊ Gram-negative: stains pink. • Rickettsia
E.g., neisseria, bordetella pertussis, … • Chlamydia, …
Bacteria with exotoxins and their toxin:
◊ Inhibit protein synthesis:
◊ Corynebacterium diphtheriae: Diphtheria toxin
◊ Pseudomonas aeruginosa: Exotoxin A
◊ Shigella spp: Shiga toxin
◊ Increase fluid secretion:
◊ Enterotoxigenic E.coli: Heat-labile toxin (LT), Heat-stable toxin (ST)
◊ Bacillus anthracis: Anthrax toxin
◊ Vibrio cholerae: Cholera toxin
◊ Inhibit phagocytic ability:
◊ Bordetella pertussis: Pertussis toxin

◊ Inhibit release of neurotransmitter:
◊ Clostridium tetani: Tetanospasmin
◊ Clostridium botulinum: Botulinum toxin
◊ Lyse cell membranes:
◊ Clostridium perfringens: Alpha toxin
◊ Streptococcus pyogenes: Streptolysin O
◊ Superantigens causing shock:
◊ Staphylococcus aureus: Toxic shock syndrome toxin (TSST-1)
◊ Streptococcus pyogenes: Erythrogenic exotoxin A

Viruses:
◊ Obligate intercellular parasites.
i.e., they must be inside living cells to reproduce.
◊ Acellular (not composed of cells), lack cytoplasmic membranes.
◊ Made of deoxyribonucleic acid (DNA) or ribonucleic acid (RNA).
◊ May be double-stranded or single-stranded.
◊ Surrounded by a protein coat.
◊ Viruses are neither prokaryotic nor eukaryotic.
◊ Classification of virus based on their genome:
◊ DNA viruses: Herpes simplex, Hepatitis B, Papilloma, Cytomegalo,
Epstein-Barr, Varicella Zoster, …etc.
◊ RNA viruses: HIV, Rota, polio, Rhino, COVID-19, measles, mumps,
Influenza, respiratory syncytial virus, rabies, Yellow fever, …etc.
Naked virus Morphology of viruses Enveloped virus
Life cycle of virus:

1. Entry: binding and fusion or penetration
2. Reverse transcription
3. Integration
4. Replication: transcription and translation.
5. Assembly
6. Budding and maturation.
Human Immunodeficiency Virus (HIV):
◊ Made from 3 structural genes (protein coded for):
1. Env (gp120 and gp41):
◊ Gp120: attachment to host CD4+ T cell.
◊ Gp41: fusion and entry.
2. gag (p24 and p17): capsid and matrix proteins, respectively.
3. Pol: reverse transcriptase, integrase and protease.
◊ Reverse transcriptase: synthesizes DNA from genomic RNA.
◊ Integrase: HIV genome (DNA) integrates into host genome.
◊ Protease: cleaves viral polyprotein & maturation of new viruses.
◊ Virus binds CD4 and coreceptors (CCR5 and CXCR4).

The structure of HIV

HIV life cycle

Fungi:
◊ Eukaryotes with a higher level of biologic complexity than bacteria.
◊ Fungi that cause human infections are yeast and mold.
◊ Yeasts: primarily grow in a round cellular form.
◊ Molds: grow as filamentous, tube-like structures called hyphae
◊ The science devoted to the study of fungi is called mycology.
◊ Most fungi are multicellular eukaryotes.
◊ Ergosterol (not cholesterol) makes up cell membrane.
◊ All are heterotrophic i.e., acquire nutrients from exogenous sources.
◊ Most fungi are saprophytes i.e., their food is dead organic matter.
◊ Reproduced by sexually (spores) and asexually(conidia by mitosis).
◊ The spore is also used for survival and dissemination.
◊ Diseases caused by fungi are called mycoses.
◊ Classification of medically important fungi:
A. Superficial fungi:
◊ Trichophyton, Microsporum and Epidermophyton.
E.g., Dermatophytes (causes onychomycosis, tinea capitis, tinea
corporis, tinea pedis, …etc.) via metabolize and subsist upon
keratin in the skin, hair and nails.
B. Subcutaneous fungi
◊ Sporothrix (causes sporotrichosis)
C. Opportunistic fungi
◊ Aspergillus, candida, pneumocystis, …etc.
D. Systemic fungi:
◊ Blastomyces, cryptococcus, histoplasma, …
• Cell wall is composed of
mannans, glucans and
chitins
• Mannan linked to
surface proteins.
• Chitin and glucans give
rigidity to cell wall.
Fungal cell
Fungal cell
The fungal cell wall

Parasites:
◊ Organisms that are physiologically dependent upon their host for
survival i.e., live at the expense of their hosts.
◊ Groups of parasites: protozoa, helminths and arthropods (vectors).
◊ The majority of both protozoa and helminths are free living (in H20).
◊ The less common disease-producing species are typically obligate
parasites i.e., depend on hosts and/or arthropod for their survival.
◊ Major cause of disease and death worldwide.
◊ Amebiasis estimated to affect 10% of world population.
◊ Malaria estimated to affect 300 million (3 billion at risk).
◊ Giardiasis and trichomoniasis (each) affects > 200 million.
◊ Schistosomiasis affects 207 million (600 million at risk).
◊ Majority are commensalistic i.e., happy living relationship with host.
Protozoa:
◊ Microscopic unicellular (single-celled) eukaryotes with a membrane-
bound nucleus and organelles.
◊ The cytoplasm is divided into endoplasm and ectoplasm.
◊ Endoplasm contains nutrients.
◊ Ectoplasm has organelles of locomotion.
◊ All protozoa’s are heterotrophic organisms.
◊ Nutrients engulfed by phagocytosis or pinocytosis.
◊ Reproduction usually by binary fission (some also sexually).
◊ Life cycle: trophozoite (active, feeding stage i.e., requires food and
moisture to remain active) and cyst stage (the resistant, dormant
stage, can survive outside a host i.e., able to tolerate unfavorable
condition and environment).

Classification of protozoan parasites:
◊ Protozoa that inhabit the intestine and causes GI infections:
E.g., Giardia lamblia, Entamoeba histolytica, Cryptosporidium, …
◊ Protozoa that causes CNS infections:
E.g., Toxoplasma gondii, Trypanosoma brucei, Naegleria fowleri, …
◊ Protozoa that causes hematologic infections:
E.g., Plasmodium, …
◊ Protozoa that causes visceral infections:
E.g., Leishmania species, Trypanosoma cruzi, …
◊ Protozoa that causes sexually transmitted infections:
E.g., Trichomonas vaginalis

Helminths:
◊ Macroscopic multicellular worms possessing complex organ systems.
◊ On the basis of morphological form, there are two major groups of
parasitic helminths (named for the appearance):
A. Flatworms: a very thin, often segmented body plan.
◊ Subdivided into:
◊ Cestodes or tapeworms: named for their long, ribbonlike
arrangement (cestode: cestus means belt & ode means like).
◊ Trematodes also known as flukes, characterized by flat,
ovoid bodies (trematode: trema means hole).
B. Roundworms (nematodes): an elongate, cylindrical, unsegmented
body (nematode: nemato means thread and eidos means form).
◊ Majority reproduce sexually (mode: embryo, larval and adult stages).

◊ Nematode (roundworms):
◊ Ingested (via feco-oral or undercooked: Enterobius vermicularis
(pinworm), Ascaris lumbricoides (giant roundworm), Toxocara
canis, Trichinella spiralis, Trichuris trichiura (whipworm)
◊ Cutaneous (larvae in soil penetrate skin): Strongyloides stercoralis
(threadworm), Ancylostoma spp (Necator americanus or
hookworms), …
◊ Bites: Loa loa, Onchocerca volvulus, Wuchereria bancrofti, …
◊ Cestodes (tapeworms): transmitted via ingestion of undercooked
foods that contain larva or eggs of the parasite.
◊ Taenia solium, Diphyllobothrium latum, Echinococcus granulosus
◊ Trematodes (flukes): transmitted via food or water that contains larval
forms of the parasite.
◊ Schistosoma, Clonorchis sinensis, …

Life cycle of pinworm,
a roundworm.
Parasitic flatworms (cestode)

Parasitic flatworms (trematode)

Arthropods:
◊ Organisms that endanger humans by:
◊ Application of poison, e.g., scorpions, spiders) or
◊ Injection of agents of diseases, e.g.,:
◊ Ticks: babesiosis, relapsing fever, borreliosis, tularemia, …
◊ Mites and lice: typhus, scabies, relapsing fever , …
◊ Mosquitoes: malaria (anopheles), filariasis (culex), yellow
fever (aedes), dengue fever (aedes), …
◊ Flies: onchocerciasis (black fly), leishmaniasis (sandflies),
trypanosomiasis (tsetse fly), deerfly (loiasis), …
◊ Fleas: plague, typhus, …
• Reading assignment: definitive host, intermediate host, reservoir

host, mechanical vector and transport or paratenic vector.
The human microbiota, formerly called the normal flora.
◊ Microorganisms that are found colonizing various body sites in healthy
individuals (may have symbiotic or commensal relationship).
◊ The constituents and numbers of the microbiota vary in different areas
of the body and sometimes, at different ages and physiologic states.
◊ Flora may stay for short or extended periods.
1. Resident microbiota consists of relatively fixed types of
microorganisms regularly found in a given area at a given age.
◊ If disturbed, it promptly reestablishes itself.
2. Transient microbiota consists of nonpathogenic or potentially
pathogenic microorganisms that inhabit body sites for hours, days
or weeks (transient microbiota is derived from the environment).
• Initial flora is acquired during and immediately after birth.
• Physiologic conditions such as local pH influence colonization.
Predominant and potentially pathogenic microbiota of various body:
◊ Internal organs and body fluids (such as blood) are sterile in health.
◊ Transient bacteremia can result from trauma.
◊ Skin: staphylococcus aureus, corynebacterium, …
◊ More abundant on moist areas (axillae, perineum and b/n toes).
◊ Mouth: candida albicans, viridans streptococci, neisseria, moraxella, …
◊ Nasopharynx: streptococcus pneumoniae, neisseria meningitidis,
haemophilus influenzae, group A streptococci, …
◊ Colon: E.coli, pseudomonas, clostridium (perfringens, difcile), ...
◊ Vagina (prepubertal and postmenopausal): candida albicans,
diphtheroid, staphylococci, …
◊ Childbearing: group B streptococci, C. albicans, lactobacillus, …

Introduction to basic immunology
◊ Immunology is a medical discipline that study the immune systems.
◊ Immunity means a state of being resistant to infectious agents.
◊ The primary mediator of immune function is white blood cell series.
◊ Derived from hematopoietic stem cells in the bone marrow.
◊ The immune system has innate and adaptive components.
A. Innate immunity is a system of rapid immune responses that are
present from birth and the body’s first-line barriers or defense.
◊ Recognizes microbes via pattern recognition receptors (PRRs).
E.g., peptidoglycan, mannans, RNA of viral origin, glucans, …
◊ Nonspecific and rapid (acts within minutes).
◊ Has no memory.

Components of innate immunity:
◊ Physical barriers: skin, epithelial and mucous membrane surfaces).
◊ Antimicrobial enzymes in epithelial and phagocytic cells.
e.g., lysozyme (which digests bacterial walls), HCl, …etc.
◊ Inflammation-related serum proteins (e.g., complement
components, C-reactive protein [CRP]
◊ Cells that release cytokines and other mediators of the
inflammatory response (e.g., mast cells, natural killer [NK] cells,
innate lymphoid cells [ILCs])
◊ Phagocytes: neutrophils, monocytes and macrophages.
◊ Inflammasomes: proteins that signaling inflammatory response.
◊ Biological barriers: the microbiome of the host or normal flora.

Innate immunity Location Activity
Cell
Macrophage Circulation, tissues Phagocytosis
Dendritic cell Tissues Phagocytosis
Neutrophil Circulation, tissues Phagocytosis
M cell Mucus membranes Endocytosis
Inflammation
Selectins Endothelium Attract & attach neutrophils
Integrins Neutrophils Attach to selectins
Release bradykinin,
Kallikrein Extracellular fluid
prostaglandin
Chemical mediators
Complement Serum, extracellular fluid Phagocyte receptors
M cell
◊ Inflammation is a reaction to tissue injury caused by the release of
chemical mediators (histamines, bradykinins and prostaglandins).
◊ Causes:
◊ Vasodilation (dilate arterioles) => Redness or erythema.
◊ Increased capillary permeability => swelling or edema.
◊ Pain
The five responses to tissue injury are called
◊ Fever the cardinal signs of inflammation: redness,
◊ Loss of function swelling, pain, heat and loss of function.
◊ Inflammation can be:
◊ Acute: a series of events take hours to days.
◊ Initiated by the release of chemical signals (chemokines).
◊ Chronic: a series of events take weeks to months.
◊ Bridges the innate and adaptive immune responses.
B. Adaptive immunity: also called acquired and second line defense.
◊ Specific and slow (requires several days before becoming effective).
◊ Has memory.
◊ Components: B and T (helper T and cytotoxic T) lymphocytes.
◊ B cell produce antibodies (enhance innate immunity).
◊ Potentially antigenic particles must be captured, processed and
presented in recognizable form to T cells.
◊ The cells that perform these functions are antigen-presenting cells.
◊ Macrophages, dendritic cells and B lymphocytes.
◊ Helper T cell: stimulate macrophages, eosinophils, neutrophils, …
◊ Characteristic cell-surface marker is CD4+
◊ Cytotoxic T cell: lyse antigen-expressing cells (e.g., virally infected
cells or allografts) & the characteristic cell-surface marker is CD8+.

◊ The immune system can also classified as:
1. Cell-mediated: immunologic responses that primarily orchestrated
by T lymphocytes, initiated by antigen-presenting cells (APCs).
2. Humoral: immunologic responses that are mediated by antibodies
and complement proteins (enhance the activity of antibodies).
◊ Humoral immunity
◊ Active immunity: antibodies are produced when B cells
encounter antigen and respond by undergoing activation,
proliferation and differentiation.
◊ Passive immunity: the transfer of active (ready-made)
antibodies, e.g., neonates rely heavily on maternal
immunoglobulin G (IgG) passed through the placenta and on
IgA transferred through colostrum and breast milk.

◊ Antibody is also known as immunoglobulin (Ig).
◊ There are several classes of immunoglobulin:
◊ IgG: main antibody in the secondary response, opsonizes bacteria
(making them easier to phagocytize), neutralizes bacterial toxins
and viruses, the only Ig hat crosses the placenta.
◊ IgM: produced in the primary response to an antigen, antigen
receptor on the surface of B cells.
◊ IgA: found in mucosal areas: gut, respiratory tract & urogenital
tract and prevents colonization by pathogens (prevents
attachment of bacteria and viruses to mucous membranes).
◊ Also found in saliva, tears and breast milk.
◊ IgD: Uncertain, found on the surface of many B cells and in serum.
◊ IgE: binds to allergens and triggers histamine release from mast
cells and basophils (IgE primarily related to allergies).

Immunity Second line defense
First line defense
Innate Adaptive
Artificial Natural
• Physical barrier
Active Passive Active Passive
• Chemical barrier
Infection
•
Breast
Inflammation
Vaccine
TAT
milk
• Phagocytosis, …

Organization of the immune system
◊ Primary immune organs:
◊ Bone marrow
◊ Immune cell production
◊ B cell maturation
◊ Thymus
◊ T cell maturation
◊ Secondary immune organs:
◊ Spleen, lymph nodes, tonsils, Peyer patches
◊ Allow immune cells to interact with antigen

Human blood cells

Red bleed cell Platelet Neutrophil Basophil Eosinophil

Agranulocytes
Monocyte
Lymphocyte
WBC = Granulocytes + Agranulocytes

Macrophage Dendritic cell
B and T lymphocytes

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4/14/2024
Basic anatomy and physiology #1
◊ Anatomy is the study of structure of the body and its part.
◊ Their forms and how they are organized.
◊ Classification of anatomy:
◊ Gross/macroscopic anatomy: the study of structures that can
be seen by the naked eye (without the aid of magnification).
◊ Microscopic anatomy: the study of structures that can be seen
with the aid of magnification (e.g., cells and tissues).
 Subdivided in to histology (tissue) and cytology (cells).
◊ Physiology is the study of the function of the body and its part.
◊ Describes how the body and its parts work or function.
• Anatomy and physiology are closely related and/or intertwined.
• The function or physiology of each body part and the body as a
whole is dependent on the anatomy of those parts:
i.e., structure determines function.
The language of anatomy:
A. Anatomical position (body orientation used to describe location):
◊ Anterior: toward the front (corresponding terms ventral).
◊ Posterior: toward the back (corresponding terms dorsal).
or bilateral (on each side).

◊ Superior: above the reference point or another part.
◊ Inferior: below the reference point or another part.
◊ Proximal: towards the reference point or body trunk.
◊ Distal: away from the reference point or body trunk.
◊ Deep: away from the surface of the body.
◊ Superficial: towards the surface of the body.
◊ Medial: towards the midline than another part.
◊ Lateral: toward the side away from the midline.
• Ipsilateral (on same side) or contralateral (on opposite side)

Anatomic position Right Left

B. Body planes and sections
• Plane is the imaginary line used to divide the body in to sections.
1. Coronal planes: oriented vertically and divide the body into
anterior and posterior parts.
2. Sagittal planes: oriented vertically and divide the body into right
and left parts.
3. Transverse, horizontal, or axial planes: divide the body into
superior and inferior parts.
◊ The portions of the body created by the plane is called sections.
• Stand with the body erect.

Normal or standard • Arms at the side.
anatomical position: • Feet flat on the ground.
• Face and palms directed forward.

Some terms
used to describe
Posterior
regions.
Anterior
body regions
regions

Level of human, with increasing complexity

Cell: • Protein is the major building material in a cell.
◊ The structural and functional unit of life.
◊ An organism’s activities depend on its cells’ activities.
◊ Examples of specialized cells:
◊ Cells that connect body parts: e.g., red blood cells and fibroblast.
◊ Epithelial cell: cells that cover and line body organs.
◊ Cells that move organs and body parts.
◊ Skeletal, cardiac and smooth muscle cells.
◊ Cell that stores nutrients: fat cell.
◊ Cell that fights disease: WBCs (macrophage or phagocytic cell).
◊ Cell that gathers information & controls body functions: nerve cells.
◊ Cells of reproduction: Oocyte (female) and Sperm (male).

All human cells

have three main
Generalized human cell regions or parts.
Structure of the generalized cell
Major organelles and their specific function:
◊ Specialized cellular compartments that are the metabolic machinery
of the cell (organelles are the major components of cytoplasm).
◊ Mitochondria: ATP synthesis (the “powerhouses” of the cell)..
◊ Ribosomes: the actual sites of protein synthesis in the cell.
◊ Endoplasmic reticulum: serves as a mini circulatory system for the
cell (provides a network of channels for carrying substances).
◊ Golgi apparatus: the principal “traffic director” (modify, package,
and ship substance (proteins and phospholipids).
◊ Lysosome: intracellular digestion (contains phagocytes).
◊ Peroxisomes: detoxify poisons and disarm dangerous free radicals.
◊ Cytoskeleton (micro & intermediate filament): cell support & motion.
Nucleus:
◊ The largest organelle and surrounded by the nuclear envelope.
◊ Function: control center of the cell, responsible for transmitting
genetic information and providing instructions for protein synthesis.
◊ Contains:
◊ Fluid nucleoplasm: intracellular fluid compartments.
◊ Nucleolus: composed of ribosomal RNA and proteins. Chromatin
◊ Site of ribosome subunit manufacture.
◊ Chromatin: threadlike material composed of DNA and histone
proteins (beads on a string).
◊ DNA constitutes the genes, which carry instructions for building
proteins.
◊ The structure of chromatin keeps DNA organized and prevents
breakage.
Tissue:
◊ Tissue is a group of cells that are similar in structure and function.
◊ There are four types of tissue:
1. Epithelial tissue: covers or lines surfaces and their main function is
protection, absorption, filtration and secretion.
E.g., the lining of the stomach and the epidermis of the skin.
2. Connective tissue: connect, support, transport or store materials.
E.g., Bone, tendon, ligament, cartilages and blood.
3. Muscle tissue: contracts or shortness and brings about movement.
E.g., skeletal, cardiac and smooth muscle tissue.
4. Nervous tissue: control (transmit impulse that regulate body
function). E.g., brain, spinal cord, nerve and neuroglia.

◊ Organization of the human body
1. Body cavities:
◊ Cranial cavity, vertebral canal, thoracic & abdominopelvic cavity.
2. Lining and covering membranes:
◊ Thoracic membranes: pleural and pericardial membranes
◊ Abdominopelvic membranes: peritoneal membranes
3. Organ system:
◊ Body covering: integumentary system
◊ Support and movement: skeletal and muscular system
◊ Integration and coordination: nervous and endocrine system
◊ Transport: cardiovascular and lymphatic system
◊ Absorption and excretion: digestive, respiratory & urinary system
◊ Reproduction: reproductive system
Body cavities, lateral view

Body cavities, anterior view

◊ Thoracic and abdominopelvic membranes
A. Thoracic membranes
◊ Pleural membranes line the thoracic cavity (parietal pleura) and
cover each lung (visceral pleura).
◊ Pericardial membranes surround the heart (parietal
pericardium) and cover its surface (visceral pericardium).
◊ The pleural and pericardial cavities are the potential spaces
between the respective parietal and visceral membranes.
B. Abdominopelvic membranes
◊ Peritoneal membranes line the abdominopelvic cavity (parietal
peritoneum) and cover the organs inside (visceral peritoneum).
◊ The peritoneal cavity is the potential space between the parietal
and visceral peritoneal membranes.

Integumentary Skeletal Muscular

System System System
Nervous Endocrine Cardiovascular

Lymphatic Respiratory Digestive

Lymphatic Respiratory Digestive

Integumentary system #1
◊ Integumentary system consists of the skin and its appendages.
1. Skin (cutaneous membrane) is the largest organ of human body.
◊ Composed of two main layers: epidermis and dermis.
◊ Epidermis: the outer layer and accounts 5% of the skin thickness.
◊ Epidermis contains:
◊ Keratinocytes: produce keratin, makes epidermis tough.
◊ Merkle cells: sensory nerve endings, serve as touch receptors.
◊ Melanocytes: produce and store melanin.
◊ Langerhans or dendritic cells: activate immune system.
◊ Dermis: the inner layer & accounts 95% of the skin thickness.
◊ Dermis contains: fibroblasts (produce collagen, which provide
strength and elastin, which provide elasticity), macrophages
(engulf), mast cells (produce histamine and heparin), …etc.

◊ Function of the skin:
◊ A barrier between the internal and external environments.
◊ Protect the body from damage and microbial invasion.
◊ Detection of stimuli (pain, pressure, temperature and touch).
◊ Maintenance of normal body temperature.
◊ Mini-excretory system: urea, salts and water via sweat.
◊ Chemical plant: produce proteins and synthesizes vitamin D.
◊ The accessory structures or appendages associated with the skin:
◊ Nail: a scalelike modification of the epidermis that corresponds
to the hoof or claw of other animals.
◊ Cutaneous glands: exocrine glands that release their secretions
to the skin surface via ducts: sebaceous or oil and sweat glands.
◊ Hair (a flexible epithelial structure) and hair follicles (folli = bag).

◊ Sebaceous glands:
◊ Produce sebum, which is oily substances (lubricant) that keeps the
skin soft & moist & prevents the hair from becoming brittle.
◊ Sebum also contains chemicals that kill bacteria, so it is important
in preventing bacterial infection of the skin.
◊ Sebaceous glands become very active when androgens are
produced in increased amounts during adolescence.
◊ Sweat glands: produce sweat (colorless, odorless & acidic (4 to 6 PH)).
◊ Sweat contains water, salts (sodium chloride), vitamin C, metabolic
wastes (ammonia, urea, uric acid) and lactic acid.
◊ Eccrine glands: found all over the body.
◊ Apocrine: confined to the axillary (armpit) and genital areas.
◊ Their secretion also contains fatty acids and proteins.
• Consequently, it may have a milky or yellowish color.

Anatomy of the skin

Structure of a nail
Cross section of hair bulb
Hair in hair follicle

Muscular system #1
◊ Muscles are organs composed of specialized cells that generate
forces, allowing all types of movements (walking, speaking,
breathing, pumping blood and moving food via the digestive tract).
◊ The three types of muscle:
1. Skeletal muscle tissue: attached to bones and skins.
◊ It voluntary and regulated by nervous system controls.
2. Cardiac muscle tissue: forms the wall of the heart.
◊ It is involuntary and regulated by:
• Heart pacemaker, nervous system controls and hormones.
3. Smooth muscle tissue: located in walls of hollow organs.

◊ It is involuntary and regulated by:
• Nervous system controls, hormones, chemicals and stretch.

Muscular system #2
Functions of muscular system:
◊ Production of movement
◊ Maintenance of posture and body position
◊ Stabilization of joints
◊ Generation of heat
• All muscles have actin and myosin.

• The two major neurotransmitters that affect muscle contraction are
acetylcholine and norepinephrine.
• Skeletal muscle composition:
• Fascia: covers the surface of the muscle.
• Epimysium: lies beneath fascia.
• Perimysium: where it groups muscle cells into fascicles.
• Endomysium: separate individual muscle fibers within fascicles.
Muscular system #3
Characteristics of muscle tissue:
◊ Excitability: also called responsiveness.
◊ The cells’ ability to receive and respond to stimuli.
◊ Cells accomplish this by changing their membrane potential.
◊ Stimuli within muscles neurotransmitters released by nerve cells.
◊ Contractility:
◊ The ability to reduce in size or becomes shorter.
◊ Extensibility:
◊ The ability of muscle tissue to stretch or extend.
◊ Elasticity:
◊ The ability of muscle tissues to recoil.

Muscular system #4
Skeletal muscle
is composed of:
◊ Fascia
◊ Epimysium
◊ Perimysium
◊ Endomysium
• Muscle fiber
is composed
of myofibrils.
• Myofibrils is
composed of
proteins:
myosin and Cell membrane
actin
Muscular system #5
Superficial muscles of the head and neck

Muscular system #6
Muscles of
posterior shoulder
Muscular system #7
Muscles of the anterior

chest and abdominal wall

Muscular system #8
Muscles of the right thigh

Muscular system #9
Muscles of the
right thigh
Muscles of the right arm

Muscular system #10

Muscular system #11
Commonly used anatomical terms of body motion:
◊ Extension: movement increasing the angle between two body parts.
◊ Flexion: movement decreasing the angle between two body parts.
◊ Abduction: movement away from the midline.
◊ Adduction: movement towards the midline.
◊ External rotation: rotation away from the midline.
◊ Internal rotation: rotation towards the midline.
◊ Protraction: forward movement of a part of body.
◊ Retraction: backward movement of a part of body.
◊ Supination: arms extended at the side and palms facing anteriorly.
◊ Pronation: arms extended at the side and palms facing posteriorly.
Muscular system #12
Body movements
Muscular system #13
Body movements
Muscular system #14
Body movements
Muscular system #15
Body movements
Skeletal system #1
◊ Skeletal system is the internal frame of the body and includes bones,
cartilages, joints and ligaments.
◊ The skeleton can be divided into two subgroups:
A. Axial skeleton: the bones that form the longitudinal axis of the body &
includes: skull/cranium, vertebral column, ribs and sternum.
B. Appendicular skeleton: the bones of the limbs & girdles that attach
them to the axial skeleton and includes: upper & lower limbs bones.
◊ Functions of the bones:
◊ Support, e.g., leg bones are pillars to support the body trunk.
◊ Protection, e.g., skull, vertebrae, rib cage, …etc.
◊ Allow movement.
◊ Storage: minerals (calcium, phosphorus), fat in bone cavity.
◊ Blood cell formation or hematopoiesis.

Skeletal system #2

Skeletal system #3

Skeletal system #4
Skull
Skeletal system #5
Fontanels
Skeletal system #6
Paranasal sinuses
Skeletal system #7
The thoracic cage

Skeletal system #8
Classification of bones:
◊ The adult skeleton is composed of 206 bones.
◊ There are two basic types of osseous or bone tissue:
A. Compact bone is dense and looks smooth and homogeneous.
B. Spongy bone has a spiky, open appearance like a sponge.
◊ On the basis of shape:
◊ Long bones, e.g., humerus in upper limb & femur in lower limb.
◊ Short bones, e.g., bones of the wrist and ankle or talus.
◊ Flat bones, e.g., skull, ribs and sternum.
◊ Irregular bones, e.g., bones of the face and vertebrae.
◊ Sesamoid bones: round/oval bones, a special type of short bone.
◊ Example: patella, os trigonum (back of ankles)

Skeletal system #9
Structure of long bone:
A. Diaphysis or shaft:
covered and protected
by a membrane,
periosteum.
B. Epiphyses: the ends
portion of bones and
covered by articular
(hyaline) cartilage.
C. Metaphysis: the neck
portion between the
epiphysis and the
diaphysis.

Skeletal system #10

Skeletal system #11
Joints: also called articulations.
◊ The sites where two or more bones meet.
◊ They are the weakest components of the skeleton.
◊ Functional classification of joints:
A. Synarthroses: immovable joints.
B. Amphiarthroses: slightly movable joints.
C. Diarthroses: freely movable joints.
The two primary functions of joints are:

• To hold the skeleton together.
• To make the skeleton mobile.

Skeletal system #12
◊ Structural classification of joints:
A. Fibrous joint: the bones are united by fibrous tissue.
• The best examples are the sutures of the skull.
B. Cartilaginous joint: linked by hyaline cartilage (e.g., epiphyseal
plates of long bones, ribs and the sternum) and discs of
fibrocartilage (e.g., intervertebral discs of the spinal column
and the pubic symphysis of the pelvis).
C. Synovial joints: articulating bone ends are separated by a joint
cavity containing synovial fluid.
◊ All joints of the limbs are synovial joints.
• Ligament is a connective tissue that connects bones to other bones.

• Tendon is a connective tissue that connects muscle to bone.

Skeletal system #13
Synovial joint

Respiratory system #1
◊ Respiratory system is a body system responsible for gas exchange.
◊ Anatomical classification of the respiratory system:
1. The upper respiratory tract:
◊ Nose, nasal cavity, paranasal sinuses, pharynx and larynx.
2. The lower respiratory tract:
◊ Trachea, bronchi and lung (bronchioles and alveoli).
◊ Functional classification of the respiratory system:
1. Conducting zone: all respiratory passageways from the nose to
the respiratory bronchioles.
◊ Provide conduits for air to reach the gas exchange sites.
◊ Also cleanse, humidify and warm incoming air.
2. Respiratory zone: where actual gas exchange occurs and include
the respiratory bronchioles, alveolar ducts and alveoli.
Nose • Larynx = voice box
• Trachea = windpipe
Pharynx
Larynx
Trachea
Bronchi
Bronchiole
Alveoli

• Cilia move mucus and
trapped particles Mucus secreting cells
from the nasal cavity
to the pharynx.

Adam’s apple


◊ The primary function of the respiratory system is to supply the body
with oxygen, dispose of carbon dioxide and helps regulate blood pH.
◊ To achieve the function of the respiratory system, four distinct
processes, collectively called respiration occur in the body.
1. Pulmonary ventilation (also called breathing): movement of air
into and out of the lungs (involving inspiration and expiration).
2. External respiration: oxygen diffuses from the lungs to the blood
and carbon dioxide diffuses from the blood to the lungs (oxygen
loading and carbon dioxide unloading).
3. Transport of respiratory gases: transport of oxygen to tissue cells
and carbon dioxide to lungs (the transporting fluid is blood).
4. Internal respiration: oxygen diffuses from blood to tissue cells
and carbon dioxide diffuses from tissue cells to blood.

Oxygen is loaded into the blood Oxygen is unloaded and carbon
and carbon dioxide is unloaded. dioxide is loaded into the blood.

Lung
◊ The primary organs of the respiratory system and its function is:
◊ Extract oxygen from the air and transfer it into the bloodstream.
◊ Release carbon dioxide from the bloodstream into atmosphere.
◊ Humans have two lungs, a right lung and a left lung.
◊ They are situated within the thoracic cavity of chest.
◊ The right lung is bigger than the left.
◊ Because the left lung has cardiac notch.
◊ Each lung is divided into sections called lobes by fissures.
◊ Right lung has three lobes and two lobes in the left lung.

◊ Each lung is enclosed within a pleural sac of two membranes called
pleurae and this serous membrane has two layers:
1. Visceral pleura: the inner pleura & lines all surfaces of the lungs.
2. Parietal pleura: the outer layer and lines the pulmonary cavities.
◊ The potential space between two layers is called pleural cavity.
◊ The pleural space is normally filled with a serous fluid (< 10 mL),
which lubricates the pleural surfaces and allows the layers of pleura
to slide smoothly over each other during respiration.



Alveoli:
◊ Make up the functional tissue of the lungs (parenchyma).
◊ The site where gas exchange takes place.
◊ The walls of alveoli are made up of three cells:

1. Type I alveolar cells also called squamous epithelial cells: permits
gas exchange and surrounded by a basement membrane.
2. Type II alveolar cells also called septal cells: produce surfactant
which reduces surface tension and keeps alveoli from collapsing.
3. Dust cells also known as alveolar macrophages: patrol the surface of
the alveolar epithelium and phagocytize (removes) any particles.
◊ Respiratory volumes and capacities:
1. Tidal volume (TV): the volume of air that moves (in then out) during
a single respiratory cycle (about 500 milliliters).
2. Inspiratory reserve volume (IRV): an extra volume of air enters the
lung during forced maximal inspiration (about 3,000 mL).
3. Expiratory reserve volume (ERV): the amount of air expel during
forced maximal expiration (about 1,100 mL).
4. Residual volume (RV): the amount of air remains in the lungs after
forceful expiration (about 1,200 mL).
5. Vital capacity (VC): the maximum volume of air a person can exhale
after taking the deepest breath (= TV + IRV + ERV = 4,600 mL).
6. Inspiratory capacity (IC): the maximum volume of air a person can
inhale following a resting expiration (TV + IRV = 3, 500 mL).
7. Functional residual capacity (FRC): the volume of air that remains in
the lungs following a resting expiration (ERV + RV = 2,300 mL).
8. Total lung capacity (TLC): Total volume of air that the lungs can hold
(TLC = VC + RV = 5,800 mL).

Total ventilation:
◊ Also referred to as minute volume or minute ventilation.
◊ It is the total volume of air entering the lungs per minute.
◊ Total ventilation = tidal volume × respiratory rate per minute.
E.g., an individual with a respiratory rate of 12 breath per minute
would be a total ventilation of 6, 000 mL (12 bpm × 500 mL).
◊ Tidal volume = dead space ventilation + alveolar ventilation.
◊ Dead space: regions of the respiratory system that contain air,
but are not exchanging O2 and CO2 with blood (i.e., conducting
zone).
◊ Accounts about 150 mL of tidal volume.
◊ Alveolar ventilation represents the room air delivered to the
respiratory per breath (accounts about 350 mL of tidal volume).
Mechanics of breathing
◊ Inspiration:
◊ Muscles: diaphragm (the main muscle) and external intercostals.
◊ Atmospheric pressure provides the force that moves air into lungs.
◊ Inspiration occurs when the pressure inside alveoli decreases.
◊ Pressure within alveoli decreases when the diaphragm moves
downward and the thoracic cage moves upward and outward.
◊ The moist pleural membranes aid lung expansion.
◊ Expiration:
◊ Elastic recoil of lung tissues and surface tension within alveoli
provide the forces of resting expiration.
◊ Internal intercostals and abdominal wall muscles (rectus
abdominis, transversus abdominis, internal abdominal oblique,
external abdominal oblique) forced expiration.

Cardiovascular system #1
◊ Cardiovascular system is a body system that permits blood to circulate
and transport between the body cells and organs.
◊ Components of CVS: heart, blood and blood vessels.
1. Heart: anatomical pump (pumps blood through blood vessels).
◊ Heart is located between lungs in the mediastinum (the central region
of the thorax) and a bit to the left of the body’s midline.
◊ The inferior portion of heart is called apex (at 5th intercostal space) and
the superior portion of heart is called base (beneath second rib).
◊ The heart wall is made up of three layers:
1. Endocardium: the innermost layer of the heart.
2. Myocardium: the middle layer of the heart wall, which is the
cardiac muscle (thickest layer and pumps blood via the vessels).
3. Epicardium: the outermost layer of the heart wall.
◊ The heart is enclosed by a sac called pericardium.
Location of the heart within the thorax


◊ The heart has four chambers: two atria and two ventricles.
A. Atrium: the upper chambers, are blood-receiving chambers.
◊ Right atrium: receives blood returning from body tissues.
◊ Left atrium: receives oxygen-rich blood from the lungs.
B. Ventricle: the lower chambers, are blood pump chambers.
◊ Right ventricle: receives blood from the right atrium and pumps it
to the lungs.
◊ Left ventricle: the chamber with the thickest wall, pumps highly
oxygenated blood to all parts of the body.
◊ The heart is equipped with four valves:
◊ Allow blood to flow in only one direction via the heart chambers.
◊ Valves are located at the entrance and exit of each ventricle.
◊ The entrance valves are the atrioventricular valves.
◊ The exit valves are the semilunar valves.
◊ The atrioventricular (AV) valves:
A. Bicuspid valve (has three cusps or flaps), also called mitral valve:
◊ Located between left atrium and ventricle.
◊ Prevent blood from returning to the left atrium.
B. Tricuspid valve (has three cusps or flaps):
◊ Located between the right atrium and ventricle.
◊ Prevent blood from returning to the right atrium.
◊ Semilunar valves:
A. Pulmonary valve:
◊ Located between right ventricle and pulmonary artery.
◊ Prevent the blood from returning to the ventricle.
B. Aortic valve:
◊ Located between the left ventricle and the aorta.
◊ Prevent the backflow of blood from aorta into ventricle.
Anatomy of the heart
Frontal section showing interior chambers and valves
Blood flow through the
chambers of the heart
◊ The events of one complete heartbeat are called cardiac cycle.
◊ A cardiac cycle consists of two periods:
◊ Diastolic period: the heart muscle relaxes and fills with blood.
◊ Systolic period: the heart muscle contracts and pumps the blood.
◊ With an average heartbeat of 75 beats per minute, a complete
cardiac cycle requires 0.8 seconds.
◊ The noise generated during each cardiac cycle is called heart sound.
◊ The 1st heart sound (lub): caused by the closing of the AV valves.
◊ The 2nd heart sound (dup): caused by closure of semilunar valves.
◊ The first sound is longer and louder than the second heart sound.

◊ The amount of blood pumped out by the left ventricle into the aorta
(or by the right ventricle into the pulmonary trunk) in 1 minute is
called cardiac output (CO).
◊ It is the product of the heart rate (HR) and the stroke volume (SV).
◊ Heart rate means the number of times the heart beats per minute.
◊ Stroke volume is the volume of blood pumped out by a ventricle with
each heartbeat (70 to 80 ml).
◊ Example: the person with a normal resting values of heart rate (75
beats per minute) and stroke volume (70 ml per beat), the average
adult cardiac output can be calculated:
◊ CO = HR (75 beats per minute) * SV (70 ml per beat)
◊ CO = 5, 250 ml per minute = 5.25 liter per minute.

Cardiac circulation
◊ The heart itself is supplied with oxygen and nutrients through a
small loop of the systemic circulation called coronary circulation.
◊ The functional blood supply that oxygenates and nourishes the
myocardium is provided by the right and left coronary arteries.
◊ The coronary arteries branch from the base of the aorta and
encircle the heart in the coronary sulcus (atrioventricular groove) at
the junction of the atria and ventricles.
◊ After nourishing the heart muscle, blood returns via the coronary
veins into the coronary sinus and from this one into right atrium.
◊ Coronary circulation blood back flow is prevented by thebesian
valve.

Blood vessels:
◊ Transport blood throughout the body.
◊ The general types (classes) of blood vessels:
1. Artery: carry the blood away from the heart.
◊ The largest artery of the body is called aorta.
◊ The smallest artery of the body is called arterioles.
2. Capillaries: the minute blood vessels that convey blood from the
arterioles to venules i.e., where nutrients & wastes are exchanged.
3. Vein: carry the blood toward the heart.
◊ The smallest veins of the body is called venules.
◊ The largest veins of the body is called vena cava.

The wall of blood vessel

Major branches
of the aorta. “a.” stands for artery.
“aa.” stands for arteries.

Major arteries of the systemic
circulation, anterior view

Major veins of the systemic
circulation, anterior view

Veins that drain the
abdominal viscera

Blood
◊ The cell-containing and life saving fluid that pumped by heart and
circulates in the body through the blood vessels.
◊ The main functions of blood:
A. Transportation: gas, nutrients and wastes.
B. Regulation: PH, fluid balance and heat.
C. Protection: disease and blood loss.
◊ Blood volume accounts for 7 to 8% of total body weight.
◊ Adult men contains about 75 mL/kg of blood.
◊ Adult women contains about 65 mL/kg of blood.

Components of blood
1. Formed elements: includes cells and its cell fragments.
A. Red blood cells (erythrocytes): transport oxygen
B. White blood cells (leucocytes): protect against infection
C. Platelets (thrombocytes): participate in blood clotting
2. Plasma: the liquid portion of blood.
◊ 92% water, 7% protein and 1% nutrients and electrolytes.
◊ Plasma proteins: their primary origin is liver and includes:
A. Albumins: primary controller of colloid osmotic pressure.
B. Globulins: contributes to control of osmotic pressure.
C. Fibrinogen: plays key roles in blood coagulation.
◊ The combination plasma and formed elements is called whole blood.

Blood composition
Between the plasma and erythrocytes
lies the buffy coat, which consists of
white blood cells and platelets.

Red blood cell (RBC):
◊ Norma value in adult male: 4,700,000 - 6,100,000 cells per microliter.
◊ Norma value in adult female: 4,200,000 - 5,400,000 cells per microliter.
◊ Red blood cell formation (a process called erythropoiesis):
◊ During fetal development occurs in the liver and spleen.
◊ After birth in red bone marrow.
◊ The rate of red blood cell formation is controlled by erythropoietin
(a hormone released by kidney & liver in response to O2 deficiency).
◊ Takes three to five days for development from a hemocytoblast to
a mature red blood cell.
◊ The average life span of a red blood cell is 120 days.
• The formation of blood cellular components is called hematopoiesis.
• All cellular blood components are derived from hematopoietic stem
cells (blood-forming stem cells, also called hemocytoblasts).
• Low blood oxygen causes

the kidneys and liver to
release erythropoietin.
• Erythropoietin stimulates
target cells in the red
bone marrow to increase
the production of red
blood cells, which carry
oxygen to tissues.

Blood cell formation (hematopoiesis)

Hemoglobin:
◊ An RBC protein that carries oxygen and some carbon dioxide.
◊ A normal, healthy concentration of hemoglobin in the blood is:
◊ 13 to 18 g/100 mL in adult males.
◊ 12 to 16 g/100 mL in adult females.
◊ The structure of the hemoglobin molecule includes
◊ Four polypeptide chains (the globin portion)
◊ Heme pigment: contains iron that binds to oxygen.
◊ When oxygen is bound to hemoglobin => oxyhemoglobin.
• The color of blood is a bright red.
◊ When the oxygen is released => deoxyhemoglobin.
• Makes blood a darker red color.

◊ Breakdown of red blood cells:
1. Nutrients are absorbed by the small intestine.
2. Nutrients and erythropoietin are used by red bone marrow to
produce red blood cells.
3. Red blood cells circulate in the bloodstream for about 120 days.
4. Macrophages in liver & spleen phagocytize & break down old RBCs.
5. Hemoglobin is broken down into globin and heme.
◊ Globin is further degraded into amino acids that may be reused.
◊ Heme is further broken down into iron (which is either stored or
recycled to produce hemoglobin and myoglobin) and biliverdin.
◊ Most biliverdin is converted into bilirubin:
• Become part of bile or
• Carried by the blood to the kidneys to be eliminated in urine.


White blood cells: the normal range is 3,500 to 10,500 cells per microliter.
◊ Hormones that affect leukocyte development fall into two groups:
◊ Interleukins and colony-stimulating factors (CSFs)
◊ Stimulate red bone marrow to synthesize specific WBCs.
◊ The are five major types (also called WBC differentials):
◊ Neutrophil: responsible for bacteria infection (kill bacteria).
◊ Eosinophil: a role for parasites (worms) and allergic reactions.
◊ Basophils: allergic reactions & release heparin and histamine.
◊ Monocytes: mainly responsible for viral infection & engulf
bacteria, dead cells and other debrides (its life span is weeks to
months).
◊ Lymphocytes: important for immunity (T cell, B cell & NK cell).
• Their may live for years.
• Neutrophils, eosinophils and basophils have a short life span (12 hours).
Platelet:
◊ The formation of platelets in bone marrow is called thrombopoiesis.
◊ Thrombopoietin is the main regulator hormone of thrombopoiesis.
◊ Platelets may live for about ten days.
◊ The normal range is 150,000 to 400,000 per microliter.
◊ Helps control blood loss from broken vessels.

Platelet plug formation & blood coagulation steps
Blood group or type:
◊ A blood type is a classification of blood, based on the presence and
absence of antibodies and antigens on the surface of red blood cells.
◊ Antigen is any molecule that triggers an immune response.
◊ Antigens also called agglutinogens.
◊ Usually carbohydrates attached on glycolipids on RBC surface.
◊ Antibody is a protein produced by our body to response to antigens.
◊ Antibodies also called agglutinins.
◊ Basically, there are two types of blood grouping system:
◊ ABO blood group: based on the presence or absence of two
major antigens on RBC membranes: antigen A and antigen B.
◊ Rh blood group: based on the presence or absence of Rh
antigens (factors) (the most prevalent antigen is D).
Blood type RBC antigen Plasma antibody
A A Anti B
B B Anti A
AB A and B Neither anti-A nor anti-B
O Neither A nor B Both anti-A and anti-B
• If the Rh antigens are present on the red blood cell membranes, the
blood is said to be Rh positive.
• If the red blood cells do not have Rh antigens, the blood is called Rh
negative.
• Anti-Rh antibodies (anti-Rh) form only in individuals with Rh-
negative blood in response to the presence of red blood cells with
Rh antigens.


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Provide basic nursing care

Berhanu Wale (BSc and MSc)

2. Introducing to human body structure and function

3. Identify clients need to individualize nursing care

4. Minimize risk of injury

5. Manage patient safety and comfort

6. Provide hygienic care for patients

7. Perform patient transportation

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◊ Fundamentals of nursing: human health and function, 8th edition, 2017

◊ Hole's essentials of human anatomy and physiology, 15th edition, 2024

◊ Essentials of Human Anatomy & Physiology, 13th edition, 2022

◊ Textbook of diagnostic microbiology, 6th edition, 2019

◊ Nursing theories and nursing practice, 4th edition, 2015

◊ Microbiology: basic and clinical principles, 2019

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◊ The process of assimilating the data or information to identify the

◊ Clusters of findings commonly encountered with more than one

◊ Secondary problems that emerge as a consequence of a disease

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Storage Watery medium that

Main point of interaction

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Houses DNA Builds cytoskeleton

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Naked virus Morphology of viruses Enveloped virus

Life cycle of virus:

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The structure of HIV

HIV life cycle

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• Reading assignment: definitive host, intermediate host, reservoir

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Red bleed cell Platelet Neutrophil Basophil Eosinophil

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WBC = Granulocytes + Agranulocytes

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 Every experience is good experience !!!

Berhanu Wale (BSc and MSc)