OPE

101
ANAT
OMY &
PHYSIACADEMIC YEAR – 2022-2023

OLOG
Y Prepared by:
Christian I. Almeda RN, MBM
Instructor

Cover designed by: Mr. Medel Valencia

MODULES FOR ANATOMY AND PHYSIOLOGY

Credits : 3 units lecture (1and half hour x 2days) (3 hours/week)
Pre-Requisite : BSOA 1st year standing

Course Title: OA103 ADMINISTRATIVE OFFICE PROCEDURE AND MANAGEMENT

Learning Description: The course will cover different aspects of the human body such as its
structure and function. This course will provide a conceptual background in Anatomy sufficient
to enable students to take more advanced courses in related fields.
Lesson 1 Objective:
At the end of the module, the learners will be able to:
1. Define and explain how anatomy and physiology are related.
2. Name the levels of structural organization that make up the human body and explain how
they are related.
3. List functions that human must perform to maintain life and the survival needs of the
human body.
4. Define homeostasis and explain its importance.
5. Use proper anatomical terminology to describe body directions, surfaces, and body
planes
6. Locate the major body cavities and list the chief organs in each cavity.

COURSE OUTLINE:

Course code: OPE 101

Course title: HUMAN ANATOMY AND PHYSIOLOGY
Credit: 3 units
Pre-requisites:
Course Outline
A. The human body
1. An overview of Anatomy and Physiology
2. Levels of structural organization
3. Maintaining life and Homeostasis
4. The language of anatomy

B. Basic Chemistry
1. Concepts of Matter and Energy
2. Composition of Matter
3. Biochemistry: The chemical composition of living matter
4. Cells and Tissues

C. Skin and Body Membranes and Skeletal System

D. Muscular System
E. Nervous System
F. Special Senses
G. Endocrine System
H. Blood and Cardio Vascular System
I. Reproductive System, Family Planning
TEXT
Elaine N. Marieb, R. P. (2004). Essentials of Human Anatomy & Physiology. Jurong,
Singapore: PEARSON EDUCATION SOUTH ASIA PTE LTD.

ANATOMY – is the study of the structure and shape of the body and body parts and their
relationships to one another. Whenever we look at our own body or study large body structures
such as heart or bones, we are observing gross anatomy, that is, we are studying large, easily
observable structures.
Anatomy derived from the Greek words meaning to cut (tomy) apart (ana), is related most
closely to gross anatomy studies, because in such studies preserved animals or their organs are
dissected (cut up) to be examined.
On the other hand, if microscope or magnifying instrument is used to see very small structures in
the body, we studying microscopic anatomy. The cells and tissues of the body can only be seen
through a microscope.
PHYSIOLOGY – is the study of how the body and its parts work or function. (physio = nature;
ology = the study of). Like anatomy, physiology has many subdivisions. For example,
neurophysiology explains the workings of the nervous system, and cardiac physiology studies
the function of the heart, which acts as a muscular pump to keep blood flowing throughout the
body.

LEVELS OF STRUCTURAL ORGANIZATION

The human body exhibits many levels of structural complexity.
The simplest level of the structural ladder is the chemical level. At this level, atoms, tiny
building blocks of matter, combine to form molecules such as water, sugar, and proteins.
Molecules in turn, associate in specific ways to form microscopic cells, the smallest units of all
living things. The cellular level is examined in individual cells vary widely in size and shape,
reflecting their particular functions in the body.
The simplest living creatures are composed of single cells, but in complex organisms like human
beings, the structural ladder continues on to the tissue level. Tissues consist of groups of similar
cells that have a common function, each of the four basic tissue plays a definite but different role
in the body.
An organ is a structure, composed of two or more tissue types, that performs a specific function
for the body. At the organ level of organization, extremely complex functions become possible.
For example, the small intestine, which digests and absorbs food, is composed of all four tissue
types. All the body’s organs are grouped so that a number of organ systems are formed. An
organ system is a group of organs that cooperate to accomplish a common purpose. For
example, the digestive system includes the esophagus, the stomach and the small and large
intestines. Each organ has its own job to do and working together, they keep food moving
through digestive system so that it is properly broken down and absorbed into the blood,
providing fuel for all the body’s cell. In all 11 organ systems make up the living body, or the
organisms which represents the highest level of structural organization, the organismal level.
MAINTAINING LIFE
To sustain life, an organism must be able to maintain its boundaries.

MOVEMENT
Includes all the activities promoted by the muscular system, such as propelling ourselves from
one place to another by walking, swimming and so forth, and manipulating the external
environment with our fingers. The muscular system is aided by the skeletal system, which
provides the bones that the muscles pull on as they work. Movement also occurs when
substances such as blood, foodstuffs, and urine are propelled through the internal organs of the
cardiovascular, digestive and urinary systems, respectively.

RESPONSIVENESS or irritability is the ability to sense changes (stimuli) in the environment

and then to react to them. Nerve cells are highly irritable and can communicate rapidly with each
other by conducting electrical impulses, the nervous system bears the majority responsibility for
responsiveness. However, all body cells exhibit responsiveness to some extent.

DIGESTION is the process of breaking down ingested food into simple molecules that can be
absorbed into the blood for delivery to all body cells by the cardiovascular system. In a simple,
one-celled organisms like an amoeba, the cell itself is the “digestion factory”, but in complex,
multicellular human body, the digestive system performs this function for the entire body.

METABOLISM is a broad term that refers to all chemical reactions that occur within the body
cells. It includes breaking down complex substances into simpler building blocks, making larger
structures from smaller ones, and using nutrients and oxygen to produce ATP molecules, the
energy-rich molecules that power cellular activities. Metabolism depends on the digestive and
respiratory systems to make nutrients and oxygen available to the blood, and on the
cardiovascular system to distribute these substances throughout the body. Metabolism is
regulated chiefly by hormones secreted by the glands of the endocrine system.

EXCRETION is the process of removing excreta or wastes, from the body. If the body is to
continue to operate as we expect it to, it must get rid of the nonuseful substances produced
during digestion and metabolism.

REPRODUCTION the production of offspring, can occur on the cellular or organismal level. In
cellular reproduction, the original cell divides, producing two identical daughter cells that may
then be used for body growth or repair. Reproduction of the human organism, or making a whole
new person, is the task of the organ of the reproductive system, which produce sperm and eggs.
When a sperm unites with an egg, a fertilized egg forms, which then develops into a bouncing
baby within the mother’s body. The function of the reproductive system is exquisitely regulated
by hormones of the endocrine system.

GROWTH is an increase in size, usually accomplished by an increase in the number of cells.

For growth to occur, cell-constructing activities must occur at a faster rate than cell destroying
ones.

SURVIVAL NEEDS

Survival needs includes

Food – Nutrients, taken in via the diet, contain the chemicals used for energy and cell building
 Carbohydrates – major energy-providing fuel for body cells.
 Proteins and to a lesser extent fats are essential for building cell structures.
 Fats – also cushion body organs and provide reserve fuel.
 Minerals and vitamins – are required for the chemical reaction that go on in cells and for
oxygen transport in the blood.
Oxygen – the chemical reactions that release energy from foods require oxygen. Approximately
20% of the air we breathe is oxygen. It is made available to the blood and body cells by the
cooperative efforts of the respiratory and cardiovascular systems.
Water – accounts for 60 to 80 percent of the body weight. It is the single most abundant chemical
substance in the body and provides the fluid base for body secretions and excretions.
Appropriate Body temperature – must be maintained at around 37℃ (98℉)
Normal atmospheric pressure – The force exerted on the surface of the body by the weight of air
is referred to as atmospheric pressure. Breathing and the exchange of oxygen and carbon
dioxide in the lungs depend on a appropriate atmospheric pressure.

HOMESTASIS
The body’s ability to maintain relatively stable internal conditions even though the outside world
is continuously changing. Body functions interact to maintain homeostasis, or relatively stable
internal environment within the body. Homeostasis is necessary for survival and good health; its
loss results in illness or disease.

HOMEOSTATIC CONTROL MECHANISMS

All homeostatic control mechanisms have a receptor that responds to environmental changes,
and a control center that assesses those changes and produces a response by activating a third
element, the effector, which provides the means for the control center’s response (output) to the
stimulus.
Most homeostatic control systems are negative feedback systems, which act to reduce or stop the
initial stimulus.

THE LANGUAGE OF ANATOMY

Anatomical terminology is relative and assumes that the body is in the anatomical position
(erect, palms facing forward.

Directional Terms

Term Definition Example

Superior (cranial or cephalad) Toward the head end or upper The forehead is superior to
part of a structure or the body the nose
above
Inferior (caudal) Away from the head end or The navel is inferior to the
toward the lower part of a breastbone
structure or the body; below
Anterior (ventral) Toward or at the front of the The breastbone is anterior to
body; in front of the spine
Posterior (Dorsal) Toward or at the backside of The heart is posterior to the
the body; behind breastbone
Medial Toward or at the midline of The heart is medial to the arm
the body; on the inner side of
Lateral Away from the midline of the The arms are lateral to the
body; on the outer side of chest
Intermediate Between a more medial and a The armpit is intermediate
more lateral structure between the breastbone and
shoulder
Proximal Close to the origin of the The elbow is proximal to the
body part or the point of wrist(meaning that the elbow
attachment of a limb to the is closer to the shoulder or
body trunk attachment point of the arm
than the wrist is)
Distal Farther from the origin of a The knee is distal to the thigh
body part or the point of
attachment of a limb to the
body trunk
Superficial Toward or at the body surface The skin is superficial to the
skeleton
Deep Away from the body surface The lungs are deep to the rib
more internal cage.

REGIONAL TERMS

Anterior Body Landmarks Posterior Body Landmarks

Abdominal: anterior body trunk inferior to Cephalic: head
ribs
Acromial: point of shoulder Deltoid: curve of shoulder formed by large
deltoid muscle
Antecubital: anterior surface of elbow Gluteal: buttock
Axillary: armpit Lumbar: area of back between ribs and hips
Brachial: arm Occipital: posterior surface of head
Buccal: cheek area Popliteal: posterior knee area
Carpal: wrist Sacral: area between hips
Cervical: neck region Scapular: shoulder blade region
Coxal: hip Sural: the posterior surface of lower leg; the
calf
Crural: leg Vertebral: area of pine
Digital: fingers, toes
Femoral: thigh
Fibular: lateral part of leg
Inguinal: area where thigh meets body trunk;
groin
Nasal: nose area
Oral: mouth
Orbital: eye area
Patellar: anterior knee
Pelvic: area overlying the pelvis anteriorly
Pubic: genital region
Sternal: breastbone area
Tarsal: ankle region
Thoracic: chest
Umbilical: navel
BODY PLANES AND SECTIONS
When preparing to look at the internal structures of the body, medical students find it necessary
to make a section, or cut. When the section is made through the body wall or through an organ, it
is made along an imaginary line called a plane.

Sagittal section is a cut made along the lengthwise, or longitudinal, plane of the body, dividing
the body into right and left parts. If the cut is made down the median plane of the body, and the
right and left parts are equal in size, it is called a midsagittal, or mid section.

Frontal section is a cut made along a lengthwise plane that divides the body (or an organ) into
anterior and posterior parts. It is also called a coronal section.

Transverse section is a cut made along a horizontal plane, dividing the body or organ into
superior and inferior parts. It is also called a cross section

BODY CAVITIES

1.Dorsal Body Cavity

The dorsal body cavity has two subdivisions which are continuous with each other. The
1.cranial cavity is the space inside the bony skull. The brain is well protected because it
occupies the cranial cavity. The 2. spinal cavity extends from the cranial nearly to the end of the
vertebral column. The spinal cord, which is a continuation of the brain, is protected by the
vertebrae, which surround the spinal cavity.

2.Ventral Body Cavity

The ventral body cavity is much larger than the dorsal cavity. It contains all the structures
within the chest and abdomen. It is also subdivided, the 1. superior thoracic cavity is separated
from the rest of the ventral cavity by a dome-shaped muscle, the diaphragm. The organs in the
thoracic cavity (lungs, heart and others) are somewhat protected by the rib cage.
The cavity inferior to the diaphragm is the 2. abdominopelvic cavity. It is subdivided into
A)superior abdominal cavity, containing the stomach, liver, intestines, and other organs and an
B)inferior pelvic cavity, with the reproductive organ, bladder and rectum

Because the abdominopelvic cavity is quite large and contains many organs, it is helpful to
divide it up into smaller areas for study. A scheme commonly used by medical personnel divides
the abdominopelvic cavity into four more or less equal regions called quadrants.
  The umbilical region is the centermost region, deep to and surrounding the
umbilicus(navel)
 The epigastric region is located superior to the umbilical region (epi = upon, above;
gastric = stomach)
 The hypogastric (pubic) region is inferior to the umbilical region (hypo = below)
 The right and left iliac, or inguinal regions are lateral to the hypogastric region (iliac
=superior part of the hip bone).
 The right and left lumbar regions lie lateral to the umbilical region (lumbus = loin)
 The right and left hypochondriac regions flank the epigastric region and contain the
lower ribs (chondro = cartilage)

Abdominopelvic surface and cavity

a. The four quadrants
b. Nine regions delineated by four planes. The superior horizontal plane is at the inferior aspect
of the ribs; the inferior horizontal plane is at the superior aspect of the hip bones and the vertical
planes are just medial to the nipples
c. Anterior view of the ventral body cavity showing superficial organs.
Lesson 2
TEXT
Elaine N. Marieb, R. P. (2004). Essentials of Human Anatomy & Physiology. Jurong,
Singapore: PEARSON EDUCATION SOUTH ASIA PTE LTD.

CONCEPTS OF MATTER AND ENERGY

Matter
a. Matter is anything that occupies space and has mass.
b. Matter exists in three states: gas, liquid and solid.

Energy
a. Energy is the capacity to do work or to put matter into motion. Energy has kinetic (active) and
potential (stored) work capacities.
When energy is actually doing work (moving objects) it is referred to as kinetic energy
When it is inactive or stored (as in the batteries of an unused toy) it is called potential energy

b. Energy forms important in body function include chemical, electrical, mechanical, and
radiant.
Forms of Energy
1. Chemical energy is stored in the bonds of chemical substances. When the bonds are broken,
the stored, or potential energy is unleashed and becomes kinetic energy, or energy in action.
2. Electrical energy results from the movement of charged particles. In our body, an electrical
current generated when charged particles (called ions) move across cell membranes
3. Mechanical energy is directly involved in moving matter.
4. Radiant energy travels in waves, that is energy of the electromagnetic spectrum, which
includes X rays, infrared, light, radio and ultraviolet waves. Light energy, which stimulates the
retinas of our eyes is important in vision.
c. Energy forms are interconvertible, but some energy is always unusable (lost as heat) in such
transformations.

COMPOSITION OF MATTER

1. Elements and atoms

a. All matter is composed of a limited number of substances called element is a unique substance
that cannot be decomposed into simpler substances by ordinary chemical methods. A total of 112
elements exist; they differ from one another in their chemical and physical properties.
b. Four elements (carbon, hydrogen, oxygen, and nitrogen) make up 96 percent of living matter.
Several other elements are present in small or trace amounts.
c. The building blocks of elements are atoms. Each atom is described by an atomic symbol
consisting of one or two letters.
2. Atomic structure
a. Atoms are composed of three subatomic particles: protons, electrons and neutrons. Because all
atoms are electrically neutral, the number of protons in any atom is equal to its number of
electrons.
b. The planetary model of the atom portrays all the mass of the atom (protons and neutrons)
concentrated in a minute central nucleus. Electrons orbit the nucleus along specific orbits. The
orbital model also locates protons and electrons in a central nucleus, but it depicts electrons as
occupying areas of space called orbitals and forming an electron cloud of negative charge around
the nucleus.
c. each atom can be identified by an atomic number, which is equal to the number of protons
contained in the atom’s nucleus.
d. The atomic mass number is equal to the sum of the protons and neutrons in the atom’s
nucleus.
e. Isotopes are different atomic forms of the same element, they differ only in the number of the
neutrons in the nucleus. Many of the heavier isotopes are unstable and decompose to a more
stable form by ejecting particles or energy from the nucleus, a phenomenon called radioactivity.
Such radioisotopes are useful in medical diagnosis and treatment and to biochemical research.
f. The atomic weight is approximately equal to the mass number of the most abundant isotope of
any element.
MOLECULES AND COMPOUNDS
1. A molecule is the smallest unit resulting from the binding of two or more atoms. When two or
more different atoms bind together to form a molecule, the molecule is more specifically referred
to as a molecule of a compound.
2. Compounds exhibit properties different from those of the atoms they comprise.
CHEMICAL BONDS AND CHEMICAL REACTIONS
1. Bond formation
a. Chemical bonds are energy relationships. Electrons in the outermost energy level (valence
shell) of the reacting atoms are active in the bonding.
b. Atoms with a full valence shell (2 electrons in shell 1, or 8 in the subsequent shells) are
chemically inactive. Those with an incomplete valence shell interact by losing, gaining or
sharing electrons to achieve stability (that is, to fill the valence shell)
c. Ions are formed when valence-shell electrons are completely transferred from one atom to
another. The oppositely charged ions formed attract each other, forming an atomic bond, Ionic
bonds are common in salts.
d. Covalent bonds involve the sharing of electron pairs between atoms. If the electrons are
shared equally, the molecule is a nonpolar covalent molecule. If the electrons are not shared
equally, the molecule is a polar covalent molecule. Polar molecule orient themselves toward
charged particle.
e. Hydrogen bonds are fragile bonds that bind together different parts of the same molecule
(intramolecular bonds). They are common in large, complex organic molecules, such as proteins
and nucleic acids.
2. Patterns of chemical reactions
a. Chemical reactions involve the formation or breaking of chemical bonds. They are indicated
by the writing of a chemical equation, which provides information about the atomic composition
(formula) of the reactant(s) and product(s).
b. Chemical reactions that result in larger, more complex molecules are synthesis reactions,
they involve bond formation.
 c. In decomposition reactions, larger molecules are broken down into simpler molecules or
atoms. Bonds are broken.
d. Exchange reactions involve both the making and breaking of bonds. Atoms are replaced by
other atoms.
BIOCHEMISTRY: THE CHEMICAL COMPOSITON OF LIVING MATTER
1. Inorganic compounds
a. Inorganic compounds making up living matter do not contain carbon. They include water,
salts, acids and bases.
b. Water is the single most abundant compound in the body. It acts as a universal solvent in
which electrolytes (salts, acids and bases) ionize and in which chemical reactions occur, and it is
the basis of transport and lubricating fluids. It slowly absorbs and releases heat, thus helping to
maintain homeostatic body temperature, and it protects certain body structures (e.g the brain) by
forming a watery cushion. Water is also a reactant in hydrolysis reactions.
c. Salts in ionic form are involved in nerve transmission, muscle contraction, blood clotting,
transport of oxygen by hemoglobin, cell permeability, metabolism, and many other reactions.
Additionally, calcium salts (bone salts) contribute to bone hardness.
d. Acids are proton donors. When dissolved in water, they release hydrogen ions. Strong acids
dissociate completely, weak acids dissociate incompletely.
e. Bases are proton acceptors. The most important inorganic bases are hydroxides. Bicarbonate
ions are important bases in the body. When bases and acids interact, neutralization occurs – that
is a salt and water are formed.
f. pH is a measure of the relative concentrations of hydrogen and hydroxyl ions in various
body fluids. Each change of one pH unit represents a tenfold change in hydrogen (or hydroxyl)
ion concentration. A pH below of 7 is neutral (that is, the concentrations of hydrogen and
hydroxyl ions are equal). A pH below 7 is acidic; a pH above 7 is alkaline (basic).
g. Normal blood pH ranges from 7.35 to 7.45. Slight deviations outside this range can be fatal.
2. Organic compounds
a. Organic compounds are the carbon-containing compounds that living matter comprises.
Carbohydrates, lipids, proteins, and nucleic acids are examples. They all contain carbon, oxygen,
and hydrogen. Proteins and nucleic acids also contain substantial amounts of nitrogen.
b. Carbohydrates contain carbon, hydrogen and oxygen in the general relationship (CH2O)n;
their building blocks are monosaccharides. Monosaccharides include glucose, fructose,
galactose, deoxyribose and ribose. Disaccharides include sucrose, maltose and lactose; and
polysaccharides include starch and glycogen. Carbohydrates are ingested as sugars and starches.
Carbohydrates and in particular glucose, are the major energy source for the formation of ATP.
c. Lipids include the neutral fats (glycerol plus three fatty acid chains), phospholipids, and
steroids (most importantly, cholesterol). Neutral fats are found primarily in adipose tissue, where
they provide insulation and reserve body fuel. Phospholipids and cholesterol are found in all cell
membranes. Cholesterol also forms the basis of certain hormones, bile salts and vitamin D. Like
carbohydrates, the lipids and degraded by hydrolysis and synthesized by dehydration synthesis.
d. Proteins are constructed from building blocks called amino acids; 20 common types of
amino acids are found in the body. Amino acid sequence determines the proteins constructed.
Fibrous, or structural, proteins are the basic structural materials in the body. Globular proteins
are functional molecules; examples of these includes enzymes, some hormones and hemoglobin.
Disruption of the hydrogen bonds of functional proteins leads to their denaturation and
inactivation.
e. Enzymes increase the rates of chemical reactions by combining specifically with the reactants
and holding them in the proper position to interact. They do not become part of the product.
Many enzymes are produced in an inactive form or are inactivated immediately after use.
f. Nucleic acids includes deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). The
building units of nucleic acids is the nucleotide; each nucleotide consists of a nitrogenous base, a
sugar (ribose or deoxyribose) and a phosphate group. DNA (the “stuff” of the genes) maintains
genetic heritage by replicating itself before cell division and contains the code-specifying protein
structure. RNA acts in protein synthesis to ensure that instructions of the DNA are executed.
g. ATP (adenosine triphosphate) is the universal energy compound used by all cells of the
body. When energy is liberated by the oxidation od the glucose, some of that energy is captured
in the high-energy phosphate bonds of ATP molecules and is stored for later use.

PART 1. CELLS
1. Overview of the Cellular Basis of life
a. A cell is composed primarily of four elements; carbon, hydrogen, oxygen and nitrogen plus
many trace elements. Living matter is over 60 percent water. The major building material of the
cell is protein.
b. Cells vary in size from microscopic to over a meter length. Shape often to have long axis to
allow shortening.
2. Anatomy of a Generalized Cell
a. Cells have three major regions; nucleus, cytoplasm, and plasma membrane.
(1) The nucleus, or control center, directs cell activity and is necessary for reproduction.
The nucleus contains genetic material (DNA), Which carries instructions for synthesis of
proteins.
(2) The plasma membrane limits and encloses the cytoplasm and acts as a selective barrier
to the movement of substances into and out of the cell. It is composed of a lipid bilayer
containing proteins. The water-permeable lipid portion forms the basic membrane structure. The
proteins (many of which are glycoproteins) act as enzymes of carriers in membrane transport,
form membrane channels or pores, provide receptor sites for hormones and other chemicals, or
play a role in cellular recognition and interactions during development and immune reactions.
(3) The cytoplasm is where most cellular activities occur. Its fluid substance, the cytosol ,
contains inclusions, stored and inactive materials in the cytoplasm (fat globules, water vacuoles,
crystals and the like) and specialized bodies called organelles, each with a specific function. For
example, mitochondria sites of ATP synthesis, ribosomes are sites of protein synthesis, and the
Golgi apparatus packages substances for export from the cell. Lysosomes carry out intracellular
digestion, and peroxisomes disarm dangerous chemicals in the cells. Cytoskeletal elements
function in cellular support and motion. The centrioles play a role in cell division and form the
bases of cilia and flagella.
3. Cell Physiology
a. All cells exhibit irritability, digest foods, excrete wastes, and are able to reproduce, grow,
move and metabolize.
b. Transports of substances through cell membrane:
(1) Passive transport processes include diffusion and filtration.
(a) Diffusion is the movement of a substance from an area to its higher concentration to
an area of its higher concentration to an area of its lower concentration. It occurs because of
kinetic energy of the molecules themselves. The diffusion of dissolved solutes through the
plasma membrane is simple diffusion. The diffusion of water through the plasma membrane is
osmosis. Diffusion that requires a protein carrier is facilitated diffusion.
(b) Filtration is the movement of substances through a membrane from an area of high
hydrostatic pressure to an area of lower fluid pressure. In the body, the driving force of filtration
is blood pressure.
(2) Active transport processes use energy (ATP) provided by the cell.
(a) In solute pumping, substances are moved across the membrane against an electrical or
a concentration gradient by proteins called solute pumps. This accounts for the transport of
amino acids, some sugars and most ions.
(b) The two types of ATP-activated bulk transport are exocytosis and endocytosis.
Exocytosis moves secretions and other substances out of cells; a membrane-bound vesicle fuses
with the plasma membrane, ruptures and ejects its contents to the cell exterior. Endocytosis in
which particles are taken up by enclosure in a plasma membrane sac, includes phagocytosis
(uptake of solid particles) and bulk-phase endocytosis (uptake the fluids).
c. Osmotic pressure, which reflects the solute concentration of a solution, determines whether
cells gain or lose water.
(1) Hypertonic solutions contain more solutes (and less water) than do cells. In these solutions,
cells lose water by osmosis and crenate.
(2) Hypotonic solutions contain fewer solutes (and more water) than do the cells. In these
solutions, cells swell and may rupture (Lyse) as water rushes in by osmosis.
(3) Isotonic solution which have the same solute-to-solvent ratio as cells, cause no changes in
cell size or shape.
d. Cell division has two phases, mitosis (nuclear division) and cytokinesis (division of the
cytoplasm).
(1) Mitosis begins after DNA has been replicated; it consists of four stages; prophase,
metaphase, anaphase and telophase. The result is two daughter nuclei, each identical to the
mother nucleus.
(2) Cytokinesis usually begins during anaphase and progressively pinches the cytoplasm in
half.
(3) Mitotic cell division provides an increased number of cells for growth and repair.
e. Protein synthesis involves both DNA (the genes) and RNA.
(1) A gene is a segment of DNA that carries the instructions for building one protein. The
information is in the sequence of bases in the nucleotide strands. Each three base sequence
(triplet) specifies one amino acid in the protein.
 (2) Messenger RNA carries the instructions for protein synthesis from the DNA gene to the
ribosomes. Transfer RNA transports amino acids to the ribosomes. Ribosomal RNA forms part
of the ribosomal structure and helps coordinate the protein building process.
PART 2: BODY TISSUES
1. Epithelium is the covering, lining and glandular tissue. Its functions include protection,
absorption, and secretion. Epithelia are named according to arrangement (simple, stratified) and
cell shape (squamous, cuboidal, columnar).
2. Connective tissue is the supportive, protective and binding tissue. It is characterized by the
presence of a nonliving, extracellular matrix (ground substance plus fibers) produced and
secreted by the cells; it varies in amount and consistency. Fat, ligaments and tendons, bones and
cartilage are all connective tissues or connective tissue structures.
3. Nervous tissues is composed of supporting cells and irritable cells called neurons, which are
highly specialized to receive and transmit nerve impulses and supporting cells. Neurons are
important in control of body processes. Nerve tissue is located in nervous system structures;
brain. Spinal cord and nerves.
4. Muscle tissue is specialized to contract, or shorten, which causes movement. There are three
types skeletal (attached to the skeleton), cardiac (forms the heart) and smooth (in the walls of
hollow organs).
5. Tissue repair (wound healing) may involve regeneration, fibrosis, or both. In regeneration,
the injured tissue is replaced by the same type of cells. In fibrosis, the wound is repaired with
scar tissue. Epithelia and connective tissues regenerate well. Mature cardiac muscle and nervous
tissue are repaired by fibrosis.

DEVELOPMENTAL ASPECTS OF CELLS

1. Growth through cell division continues through puberty. Cell Populations exposed to friction
(such as epithelium) replace lost cells throughout life. Connective tissue remains mitotic and
forms repair (scar) tissue. For the most part, muscle tissue becomes amitotic by the end of
puberty and nervous tissue becomes amitotic shortly after birth. Amitotic tissues are severely
handicapped by injury.
2. The causes of aging is unknown, but chemical and physical insults, as well as genetic
programming are suggested.
3. Neoplasm, both benign and cancerous, represent abnormal cell masses in which normal
controls on cell division are not working. Hyperplasia (increase in size) of tissue or organ may
occur when tissue is strongly stimulated or irritated. Atrophy (decrease in size) of a tissue or
organ occurs when the organ is no longer stimulated normally.
Lesson 3
TEXT
Elaine N. Marieb, R. P. (2004). Essentials of Human Anatomy & Physiology. Jurong,
Singapore: PEARSON EDUCATION SOUTH ASIA PTE LTD.

CLASSIFICATION OF BODY MEMBRANCE

1. Epithelial; Simple Organs, epithelium and connective tissue components
a. Cutaneous (the skin): epidermis (stratified, squamous epithelium) underlain by the dermis
(dense connective tissue); protect body surfaces.
b. Mucous: epithelial sheet underlain by a lamina propria (areolar connective tissue); lines
body cavities open to the exterior)
c. Serous: simple squamous epithelium resting on a scant connective tissue layer; lines the
ventral body cavity.
2. Connective tissue: Synovial, lines join cavities.

INTEGUMENTARY SYSTEM (SKIN)

1. Skin functions include protection of the deeper tissue from chemicals, bacteria, bumps and
drying; regulation of body: temperature through radiation and sweating and synthesis of
defensive proteins and vitamin D. The cutaneous sensory receptors are located in the skin.
2. The epidermis, the more superficial part of the skin, is formed of stratified squamous
keratinizing epithelium and is, avascular. Moving from its superficial to deep region, its layers
are the stratum corneum, stratum lucidum (in thick skin only), stratum granulosum, stratum
spinosum and stratum basal. Cells at its surface are dead and continually flake off. They are
replaced by division of cells in the basal layer, they accumulate keratin and die. Melanin, a
pigment produced by melanocytes, protects the nuclei of epithelial cells from the damaging rays
of the sun.
3. The dermis is composed of dense connective tissue. It is the site of blood vessel, nerves and
epidermal appendages. It has two regions, the papillary and reticular layers. The papillary layer
has ridges, which produce fingerprints.
4. Skin appendages are formed from the epidermis but reside in the dermis.
a. Sebaceous glands produce an oily product (sebum), usually ducted into half follicle. Sebum
keeps the skin and hair soft and contains bacteria-killing chemicals.
b. Sweat (sudoriferous) glands, under the control of the nervous system, produce sweat, which
is ducted to the epithelial surface. These glands are part of the body’s heat-regulating apparatus.
There are two types: eccrine (the most numerous) and apocrine (their product includes fatty acids
and proteins; which skin bacteria metabolize.
c. A hair is primarily dead keratinized cells and is produced by the hair bulb. The root is
enclosed in a sheath, the hair follicle.
d. Nails are hornlike derivatives of the epidermis. Like hair, nails are primarily dead
keratinized cells.
5. Most minor afflictions of the skin result from infections or allergic responses; more serious are
burns and skin cancer. Because they interfere with skin’s protective functions, burns represent a
major threat to the body.
a. Burns result is loss of body fluids and invasion of bacteria: The extent of burns is assessed
by the “rule of nines”. The severity (depth) of burns is described as first degree (epidermal
damage only), second degree (epidermal and some dermal injury) and third degree (epidermis,
dermis totally destroyed). Third degree burns require skin grafting.
b. The most common cause of skin cancer is exposure to ultraviolet radiation. Cure od basal
cell carcinoma and squamous cell carcinoma is complete if they are removed before metastasis.
Malignant melanoma, a cancer of melanocytes, is still fairly rare but is fatal in about half the
cases.

DEVELOPMENTAL ASPECTS OF SKIN AND BODY MEMBRANES

1. The skin is thick, resilient and well hydrated in youth but losses its elasticity and thins as aging
occurs. Skin cancer is a major threat to skin exposed to excessive sunlight.
2. Balding and/or graying occurs with aging. Both are genetically determined, but other factors
(drugs, emotional stress, and so on) can result in either.

BONES: AN OVERVIEW
1. Bones support and protect body organs, serves as lever for the muscles to pull on to cause
movement at joints; store calcium, fats and other substances for the body; and contain red
marrow, the site of blood cell production.
2. Bones are classified into four groups; long, short, flat and irregular on the basis of their shape
and the amount of compact or spongy bone they contain. Bone markings are important
anatomical landmarks that reveal where muscles attach and where blood vessels and nerves pass.
3. A long bone is composed of a shaft (diaphysis) with two ends (epiphyses). The shaft is
compact bone, its cavity contains yellow marrow. The epiphyses are covered with hyaline
cartilages; they contain spongy bone (where red marrow is found).
4. The organic parts of the matrix bone flexible, calcium salts deposited in the matrix make bone
hard.
5. Bones form on hyaline cartilage “models” or fibrous membranes. Eventually these initial
supporting structures are replaced by bone tissue. Epiphyses plates persists to provide for
longitudinal growth of long bones during childhood and become inactive when adolescents end.
6. Bones change in shape throughout life. This remodeling occurs in responses to hormones (.e..,
PTH, which regulates blood calcium levels) and mechanical stresses acting on the skeleton.
7. A fracture is a break in a bone. Common types of fractures include simple, compound,
compression, comminuted and greenstick. Bones fractures must be reduced to heal properly.
AXIAL SKELETON
1. The skull is formed by cranial and facial bones. Eight cranial bones protect the brain: frontal,
occipital, ethmoid and sphenoid bones, and the pairs of parietal and temporal bones. The 14
facial bones are all paired (maxillae, zygomatics, palatines, nasals, lacrimals, and inferior
conchea) except for the vomer and mandible. The hyoid bone, not really a skull bone is
supported in the neck by ligaments.
2. Skulls or newborns contain fontanels (membranous areas), which allow brain growth. The
infants facial bones are very small compared to the size of the cranium.
3. The vertebral column is formed from 24 vertebrae, the sacrum and the coccyx. There are 7
cervical vertebrae, 12 thoracic vertebrae and lumbar vertebrae, which have common as well as
unique features. The vertebrae are separated by fibrocartilage discs that allow the vertebral
column to be flexible. The vertebral column is S-shaped to allow for up-right posture. Spinal
curvatures; secondary curvatures (cervical and lumbar) develop after birth.
4. The bony thorax is formed from the sternum and 12 pairs of ribs. All ribs attach posteriorly to
thoracic vertebrae. Anteriorly, the first 7 pairs attach indirectly or not at all (false ribs). The bony
thorax encloses the lungs, heart and other organs of the thoracic cavity.
HEMEOSTATIC REALTIONSHIPS BETWEEN THE SKELETAL SYSTEM AND OTHER
BODY SYSTEMS
Endocrine System
● Skeletal system provides some bony protection
● Hormones regulates uptake and release of calcium from one; hormones promote long-bone
growth and maturation.
Lymphatic System/Immunity
● Skeletal system provides some protection to lymphatic organs; lymphocytes involved in
immune response originate in bone marrow.
● Lymphatic system drains leaked tissue fluids; immune cells protect against pathogens.
Digestive System
● Skeletal system provides some bony protection to intestines, pelvic organs and liver.
● Digestive system provides nutrients needed for the bone health and growth.
Urinary System
● Skeletal system provides pelvic organs (bladder, etc.)
● Urinary systems activates vitamin D; disposes of the nitrogenous wastes.
Muscular System
● Skeletal system provides levers plus calcium for muscles activity.
● Muscle pull on bones increases bone strength and viability; helps determine bone shape.
Nervous System
● Skeletal system protects brain and spinal cord; depot for calcium ions needed for neutral
function.
● Nerves innervate bone and joint capsules, providing for pain and joint sense.
Respiratory System
● Skeletal system (ribcages) protects lungs by enclosure
● Respiratory system provides oxygen; disposes of carbon dioxide.
Cardiovascular System
● Bone marrow cavities provide site for blood cell formation, matrix stores calcium needed for
cardiac muscle activity
● Cardiovascular system delivers nutrients and oxygen to bones, carries away wastes.
Reproductive System
● Skeletal system protects some reproductive organs by enclosure
● Gonads produce hormones that influence form of skeleton and epiphyseal closure
Integumentary System
● Skeletal system provide provides support for body organs including the skin
● Skin provides vitamin D needed for proper calcium absorption and use
Skeletal System

APPENDICULAR SKELETON
1. The shoulder girdle, composed of two bones- the scapula and the clavicle- attaches the upper
limbs to the axial skeleton. It is a light, poorly reinforced girdle that allows the upper limb a great
deal of freedom.
2. The bones of the upper limb include the humerus of the arm, the radius and ulna of the
forearm, and the carpals, metacarpals and phalanges of the hand.
3. The pelvic girdle is formed by the two coxal bones, or hip bones. Each hip bone is the result of
fusion of the ilium, ischium and pubis bones. The pelvic girdle is securely attached to the sacrum
of the axial skeleton and the socket for the thigh bone is deep and heavily reinforced. This girdle
receives the weight of the upper body and transfers it to the lower limbs. The female pelvic is
lighter and broader than the male’s; its inlet and outlet are larger, which reflects the childbearing
function of the female.
4. The bones of the lower limbs include the femur of the thigh, the tibia and fibula of the leg and
the tarsals, metatarsals, and phalanges of the foot.
JOINTS
1. Joints hold bones together and allow movement of the skeleton.
2. Joints fall into three functional categories: synarthroses (immovable), amphiarthroses (slightly
movement), and diarthroses (Freely movement).
3. Joints also can be classified structurally as fibrous, cartilaginous or synovial joints depending
on the substance separating the articulating bones.
4. Most fibrous joints are synarthrosis and most cartilaginous joints are amphiarthrotic. Fibrous
and cartilaginous joints occur mainly in the axial skeleton.
5. Most joints of the body are synovial joints, which predominate in the limbs. In synovial joints,
the articulating bone surfaces are covered with articular cartilage and enclosed within a synovial
membrane. All synovial joints are diarthroses.
6. The most common joint problem is arthritis or inflammation of the joints. Osteoarthritis or
degenerative arthritis, is a result of the “wear and tear” on joints over many years and is a
common affliction of the aged. Rheumatoid arthritis occurs in both young and older adults; it is
believed to be an autoimmune disease. Gouty arthritis, caused by the deposit of uric acid crystals
in joints, typically affects a single joint.
DEVELOPMENTAL ASPECTS OF THE SKELETON
1. Fontanels, which allow brain growth and ease birth passage, are present in the skull at birth.
Growth of the cranium after birth is related to brain growth; the increase in size of the facial
skeleton follows tooth development and enlargement of the respiratory passageways.
2. The vertebral column is C-shaped at birth (thoracic and sacral curvatures are present); the
secondary curvatures form when the baby begins to lift its head and walk.
3. Long bones continue to grow in length until late adolescence. The UL ratio from 1.7 to 1.1
by the age of 10
4. Fractures are the most common bone problem in elderly persons. Osteoporosis, a condition of
bone wasting that results mainly from hormone deficit or inactivity, is also common in elderly
individuals. 

OVERVIEW OF MUSCLE TISSUES

1. Skeletal muscle forms the muscles attached to the skeleton, which move the limbs and other
body parts. Its cells are long, striated, and multinucleate. Skeletal muscle fibers are subject to
voluntary control. Connective tissue coverings (endomysium, perimysium, and epimysium)
enclose and protect the muscle fibers and increase the strength of skeletal muscles. Skeletal
muscles make up the muscular system.
2. Smooth muscle cells are uninucleate, spindle shape, and arranged in opposing layers in the
walls of hollow organs. When they contract, substances (food, urine, a baby) are moved along
internal pathway. Smooth muscle control is involuntary.
3. Cardiac muscle cells are striated, branching cells that fit closely together and are arranged in
spiral bundles in the heart. Their contraction pumps blood through the blood vessels. Control is
involuntary.
4. The sole function of muscle tissue is to contact or shorten. As it contracts, it causes movement,
maintains posture, stabilizes joints, and generates heat.
MICROSCOPIC ANATOMY OF SKELETAL MUSCLES
1. The multinucleate cylindrical skeletal muscles fibers are packed with unique organelles called
myofibrils. The banding pattern (striations) of the myofibrils and cell as a whole reflects the
regular arrangement of thin (actin-containing) and thick (myosin) filaments within the
sarcomeres, the contractile units composing the myofibrils.
2. Each myofibril is loosely enclosed by a specialized ER, called the sarcoplasmic reticulum
(SR), Which plays an important role in storing and release calcium ions. Calcium ions are the
final “trigger” for muscles fiber contraction.
Chapter 6: The Muscular System
SKELETAL MUSCLE ACTIVITY
1. All skeletal muscle cells are stimulated by motor neurons, when release a neurotransmitter
(acetylcholine), the permeability of the sarcolemma changes, allowing sodium ions to enter the
muscle cells. This produces an electrical current (Action potential), which flows across the entire
sarcolemma, resulting in release of calcium ions from the SR.
2. Calcium binds to regulatory proteins on the thin filaments and exposes myosin binding sites.
Allowing the myosin heads pivot, sliding the filaments toward the center of the sarcomere, and
contraction occurs. ATP provides the energy for the sliding process, which continues as long as
ionic calcium is present.
3. Although individual muscle cells contact completely when adequately stimulated, a muscle
(an organ) responds to stimulant to different degrees. i.e... it exhibits graded responses.
4. Most skeletal muscle contractions are tetanic (smooth and sustained) because rapid nerve
impulse is reaching the muscles. And the muscle cannot relax completely between contracting
(more = stronger).
5. ATP, the immediate source of energy for muscle contraction, is stored in muscle fibers in
small amounts that are quickly used up. ATP is regenerated via three routes, From the fastest to
the slowest, these are via a couple’s reaction of creatine phosphate with ADP, via anaerobic
glycolysis and lactic acid formation, and via aerobic respiration. Only aerobic respiration
requires oxygen.
6. If muscle activity is strenuous and prolonged. Muscle fatigue occurs due to an accumulation of
lactic acid in the muscle and decrease in its energy (ATP) supply. After exercises, the oxygen
debt is repaid by rapid deep breathing.
7. Muscle contractions are isotonic (the muscle shortens, and movement occurs) or isometric (the
muscle does not shorten, but its tension increases).
8.Muscle tone keep muscles healthy are ready to react, It is a result of a staggered series of nerve
impulses delivered to different cells within the muscles. If the nerve supply is destroyed, the
muscle loses tone, becomes paralyzed, and atrophies.
9.Inactive muscles atrophy. Muscles challenged by resistance exercises to respond (almost)
beyond their ability increase in size and strength. Muscles subjected to regular aerobic exercises
become more efficient and stronger and can work longer without tiring. Aerobic exercise also
benefits other body organ systems.
MUSCLE MOVEMENT, TYPES, AND NAMES
1. All muscles are attached to bones at two point. The origin is the immovable attachment; the
insertion is the movable bony attachment. When contraction occurs, the insertion moves toward
the origin.
2. Body movements include flexion, extension, abduction, circumduction, rotation, pronation,
supination, inversion, eversion, dorsiflexion, plantar flexion, and opposition.
3. On the basis of their general function in the body muscles are classified as prime movers,
antagonists, synergists, and fixators.
4. Muscles are named according to several criteria, including muscles size, shape, number and
location of origins, associated bones, and action of the muscles.
GROSS ANATOMY OF SKELETAL MUSCLES
1. Muscles of the head fall into two groups. The muscle of facial expression includes the
frontalis, orbicularis orris and oculi, and zygomaticus. The chewing muscles are the masseter,
temporalis, and buccinator, which is also a muscle of facial expression.
2. Muscles of the trunk and neck move the head, shoulder girdle and trunk and form the
abdominal girdle. Anterior neck and trunk muscles include the sternocleidomastoid, pectoralis
major, intercostals, rectus abdominis, external and internal obliques, and transversus abdominis.
Posterior trunk and neck muscles include the trapezius, latissimus dorsi, and deltoid. Deep
muscles of the back are erector spinae muscles.
3. Muscles of the upper limb include muscles that cause movement at the shoulder joint, elbow,
and hand. Muscles causing movement at the elbow include the brachialis, biceps brachii,
brachioradialis, and triceps brachii.
4. Muscles of the lower extremity cause movement at the hip, knee, and foot. They include the
iliopsoas, gluteus maximus and Medius, adductors, quadriceps and hamstring groups,
gastrocnemius, tibialis anterior, fibularis muscles, soleus, and extensor digitorum longus.
DEVELOPMENTAL ASPECTS OF THE MUSCULAR SYSTEM
1. Increasing muscular control reflects the maturation of the nervous system. Muscle control is
achieved in a cephalic/ caudal and proximal/ distal direction.
2.To remain healthy, muscles must be regularly exercised. Without exercise, they atrophy, with
extremely vigorous exercise, they hypertrophy.
3. As we age, muscle mass decreases and the muscles become sinewy. Exercise helps to retain
muscles mass and strength.
ORGANIZATION OF THE NERVOUS SYSTEM
1. Structural: All nervous system structures are classified as part of the CNS (brain and spinal
cord) or PNS (nerves and ganglia).
2. Functional: Motor nerves of the PNS are classified on the basis of whether they stimulate
skeletal muscle (somatic division) or smooth/ cardiac muscle and glands (autonomic division).
NERVOUS TISSUE: STRUCTURE AND FUNCTION
1. Supportive connective tissue cells
a. Neuroglia support and protect neurons in the CNS. Specific glial cells are.
phagocytes, others myelinate neuron processes in the CNS or line cavities.
b. Schwann cells myelinate neuron processes in the PNS.
2. Neurons
a. Anatomy: All neurons have a cell body containing the nucleus and processes (fibers) of two
types: (1 axons (one per cell) typically generate and conduct impulses away from the cell body
and release a neurotransmitter, and ( 2 ) dendrites ( one to many per cell ) typically carry
electrical currents toward the cell body. Most large fibers are myelinated; myelin increases the
rate of nerve impulse transmission.
b. Classification
(1) On the basis of function (direction of impulse transmission) there are sensory (
afferent) and motor (efferent) neurons and association neurons (interneurons).
 Dendritic endings of sensory neurons are bare (pain receptors) or are associated.
with sensory receptors.

(2) On the basis of structure, there are unipolar, bipolar, and multipolar neurons; the
terminology reveals the number of processes extending from the cell body. Motor
and association neurons are multipolar, most sensory neurons in certain special.
sense organs (ear, eye) which are bipolar.

C. Physiology
(1) A nerve impulse in an electrochemical event (initiated by various stimuli) that
causes a change in neuron plasma membrane permeability, allowing sodium ions.
(Na⁺) to enter the cell (depolarization). Once begun, the action potential, or nerve
impulse continues over the entire surface of the cell. Electrical conditions of the
resting state are restored by the diffusion of potassium ions (K⁺) out of the cell (
repolarization). Ion concentrations of the resting state are restored by sodium.
potassium pump.

(2) A neuron influences other neurons or effector cells by releasing neurotransmitters,

chemicals that diffuse across the synaptic cleft and attach to membrane receptors.
on the postsynaptic cell. The result is opening of specific ion channels and activation.
or inhabitation, depending on the neurotransmitter released and the target cell.

(3) A reflex is a rapid, predictable response to stimulus. There are two types autonomic.
and somatic. The minimum number of components of a reflex are four: receptor,
effector, and sensory and motor neurons (most, however, have one or more
association neurons). Normal reflexes indicate normal nervous system function.

CENTRAL NERVOUS SYSTEM

1. The brain is located within the cranial cavity of the skull and consists of the cerebral
hemispheres, diencephalon, brain stem structures, and cerebellum.

a. The two cerebral hemispheres form the largest part of the brain. Their surface, or
cortex is gray matter, and their interior is white matter. The cortex is convoluted and
has gyri, sulci, and fissures. The cerebral hemispheres are involved in logical.
reasoning, moral conduct, emotional responses, sensory interpretation, and the
 initiation of voluntary muscle activity. Several functional areas of the cerebral lobes
have been identified. The basal nuclei, regions of gray matter deep within the white
matter of the cerebral hemispheres modifies voluntary motor activity. Parkinson ‘s
disease and Huntington ‘s chores are disorders of the basal nuclei.
b. The diencephalon is superior to the brain stem and is enclosed by the cerebral
hemispheres. The major structures include the following.
(1) The thalamus encloses the third ventricle and is the relay station for sensory
impulses passing to the sensory cortex for interpretation.
(2) The hypothalamus makes up the “floor “of the third ventricle and is most
important regulatory center of the autonomic nervous system (regulates water
balance, metabolism, thirst, temperature, and the like).
(3) The epithalamus includes the pineal body (an endocrine gland) and the
choroid plexus of the third ventricle.
c. The brain stem is the short region inferior to the hypothalamus that merges with the
spinal cord.
(1) The midbrain is most superior and is primarily fiber tracts.
(2) the pons is inferior to the midbrain and has fiber trays and nuclei involved in
respiration.
(3) The medulla oblongata is the most inferior part of the brain stem. In addition
to fiber tracts, it contains autonomic nuclei involved in the regulation of vital.
life activities (breathing, heart rate, blood pressure etc.).
d. The cerebellum is a large, cauliflowerlike part of the brain posterior to the fourth.
ventricle. It coordinates muscle activity and body balance.
2. Protect of the CNS.
a. Bones of the skull and vertebral column are the most external protective structures.
b. Meninges are three connective tissue membranes-dura mater (tough outermost),
arachnoid mater (middle weblike). The meninges extend beyond the end of the
spinal cord.
c. Cerebrospinal fluid (CSF) provides a watery cushion around the brain and cord.
CSF is formed by the choroid plexuses of the brain. It is found in the subarachnoid
space, ventricles, and central canal. CSF is continually formed and drained.
d. The blood-brain barrier is composed or relatively impermeable capillaries.
3. Brain dysfunctions
a. Head trauma may cause concussions (reversible damage) or contusions.
(nonreversible damage). When the brain stem is affected unconsciousness (
 temporary or permanent) occurs. Trauma-induced brain injuries may aggravate.
by intracranial hemorrhage or cerebral edema, both of which compress brain tissue

b. Cerebrovascular accidents (CVAs, or strokes) result when blood circulation to brain

neurons are blocked and brain tissue dies. The result may be visual impairment,
paralysis, and aphasias.
c. Alzheimer’s disease is a degenerative brain disease in which abnormal protein deposits.
and other structural changes appear. It results in slow, progressive loss of memory
and motor control plus increasing dementia.
d. Techniques used to diagnose brain dysfunctions include the EGG, simple reflex tests,
pneumoencephalography, angiography, and CT, PET and MRI scans.
4. The spinal cord a reflex center and conduction pathway, Found within the vertebral canal, the
cord extends from the foramen magnum to L1 or L2. The cord has a central bat-shaped area of
gray matter surrounded by columns of white matter, which carry motor and sensory tracts from
and to the brain.
PERIPHERAL NERVOUS SYSTEM
1. A nerve is a bundle of neuron processes wrapping in connective tissue covering (endoneurium,
perineurium, epineurium).
2. Cranial nerves: twelve pairs of nerves that extend from the brain to serve the head and neck
region. The exception is the vagus nerves, which extend into the thorax and abdomen.
3. Spinal nerves: Thirty-one pairs of nerves are formed by the union of the dorsal and ventral
roots of the spinal cord on each side. The spinal nerve proper is very shirt and splits into dorsal
and ventral rami. Dorsal rami nerves. Dorsal rami serve the posterior body trunk; ventral rami
(except T1 through T2) form plexuses (cervical, brachial, lumbar, sacral) that serve the limbs.
4. Autonomic nervous system. Part of the CNS composed of neurons that regulate the activity of
smooth and cardiac muscle and glands. This system differs from the somatic nervous system in
that there is a chain of two motor neurons from the CNS to the effector. Two subdivisions serve
the same organs with different effects.
a. The parasympathetic division is the “house keeping” system and is in control most of
the time. This division maintains homeostasis by seeing that normal digestion ang elimination
occur, and that energy conserved. The first motor neurons are in the brain or the sacral region of
the cord. The second motor neurons are in the terminal ganglia close to the organ served.
Postganglionic axons secrete acetylcholine.
b. The sympathetic division is the “fight or flight” subdivision, which prepares the body to
cope with the same threat. Its activation result in increased heart rate and blood pressure. The
preganglionic neurons are in the gray matter of the cord. The Postganglionic neurons are
sympathetic chains or in collateral ganglia. Postganglionic axons secrete norepinephrine.

DEVELOPMENTAL ASPECTS OF THE NERVOUS SYSTEM

1. Material and environmental factors may impair embryonic brain development. Oxygen
deprivation destroy brain cells. Severe congenital brain decease includes cerebral palsy,
anencephaly, hydrocephalus and spinal bifida.
2. Premature babies have trouble regulating body temperature because the hypothalamus is one
of the last brain areas to mature prenatally.
3. Development of motor control indicates the progressive myelination and maturation of child’s
nervous system. Brain growth ends in young adulthood. Neurons die throughout life and are not
replaced; thus, brain mass declines with age.
4. Healthy, aged people maintain nearly optimal intellectual function. Disease particularly
cardiovascular disease is the major cause of declining mental function with age.

THE EYE AND VISION

1. External/accessory structure of the eye.
a. Extrinsic eye muscle aim the eye for the following moving objects and for convergence.
b. The lacrimal apparatus includes a series of ducts and the lacrimal glands that produce a
saline solution, which washes and lubricates the eyeball.
c. Eyelids protect the eye, Associated with the eyelashes are the ciliary glands, modified sweat
glands and the meibomian gland, which produce an oily secretion that helps keep the eye
lubricated.
d. The conjunctiva is a mucous membrane that covers the anterior eyeball and line the eyelids,
it produces a lubricating mucus.
2. Three tunics form the eyeball.
a. The sclera is the outer tough, protective tunic its anterior portion is the cornea, which is
transparent to allow light to enter the eye.
b. The choroid is the middle coat, which provide nutrition to the internal eye structures and
prevents light’s scattering in the eye. Anterior modification includes two smooth muscle
structures the ciliary body, and the iris (which controls the size of the pupil).

c. the retina is the innermost (sensory) coat, which contain the photoreceptor, rods are dim
light receptors cones are receptors that provide for color vision and high visual acuity. The fovea
centralis, on which acute focusing occurs, contains only cones.

Exercise: Chapter 8, internals structures of the eye.

3. The blind spot optic disc) is the point where the optic never leaves the back of the eyeball.
4. The lens is the major light-bending (refractory) structure of the eye. Its convexity is increased
by the ciliary body for close focus. Anterior to the lens is the aqueous humor: posterior to the
lens is the vitreous humor. Both humors reinforce the eye internally. The aqueous also provides
nutrients to the avascular lens and cornea.
5. Errors of refraction include myopia, hyperopia, and astigmatism. All are correctable with
specially ground lens.
Exercise Chapter 8. Optics of the Eye. Special Senses Case Study.
6. The pathway of light though the eye is cornea aqueous humor (through pupil)
aqueous humor vitreous humor retina.
7. Overlap of the visual fields and inputs from both eyes to each optic cortex provide for depth
perception.
8. The pathway of never impulses from the retina of the eye is optic nerve optic chiasma
optic tract thalamus optic radiation visual cortex in occipital lobe of brain.
9. Eye reflexes include the photo pupillary. Accommodation pupillary. And converge.

THE EAR: HEARING AND BALANCE

1. The ear divide into three major areas.
a. Outer ear is structures are the pinna, external auditory canal. And tympanic membrane.
Sound entering the external auditory canal sets the eardrum into vibration. These structures are
involved with sound transmission only.
b. Middle ear structures are the ossicles and auditory tube within the tympanic cavity. Ossicles
transmit the vibratory motion from the eardrum to the oval window. The auditory tube allows
pressure to be equalized on both side of the eardrum. These structures are also involved with
sound transmission only.
c. Inner ear, or bony labyrinth, consists of bony chambers (cochlea, vestibule, and semicircular
canals) in the temporal bone. The bony labyrinth contains perilymph and membranous sacs filled
with endolymph. Within the membranous sacs of the vestibule and semicircular canals are
equilibrium receptors. Hearing receptors are found within the membranes of the cochlea.
Exercise: Chapter 8. Internal structures of the ear.
2. Hair cell of organ of Corti (the receptor for hearing within the cochlea) are stimulated by
sound vibrations transmitted through air, membranes, bone, and fluids.
3. Deafness is any degree of hearing loss. Conduction deafness result when the transmission of
sound vibration through the external and middle eras is hindered. Sensorineural deafness
occurs when there is damage to the nervous system structures involve in heating.
4. Receptors of the semicircular canals (cristae) are dynamic equilibrium receptors. Which
respond to angular or rational body movements. Receptors of the vestibule (macule) are statics
equilibrium receptors, which respond to the pull of gravity and report on head position. Visual
and proprioceptor input are also necessary for normal balance.
5. Symptoms of equilibrium apparatus problems include involuntary rolling of the eyes, nausea,
vertigo, and an inability to stand erect.

CHEMICAL SENSE: SMELL AND TASTE

1. Chemical substances must be dissolved in water to excite the receptors for smell and taste.
2. The olfactory (smell) receptors are located in the superior aspect of each nasal cavity. Sniffing
helps to bring more air (containing odors) over the olfactory mucosa.
3. Olfactory pathways are closely linked to the limbic system; odors recall memories and arouse
emotional responses.
4. Gustatory (taste) cells are located in the taste buds, primarily on the tongue. The four major
taste sensations are sweet, salt, sour, bitter.
5. Taste and appreciation of foods is influenced by the sense of smell and the temperature and
texture of foods.

DEVELOPMENTAL ASPECTS OF THE SPECIAL SENSES

1. Special sense organs are formed early in embryonic development. Maternal infections during
the first five or six week of pregnancy may cause visual abnormalities as well as sensorineural
congenital eye problem is lack of the external auditory canal.
2. Vision requires the most learning. The infant has poor visual acuity (is farsighted) and lacks
color vision and depth perception at birth. The eye continues to grow and mature until the eighth
or ninth year of life.
3. Problems of aging associated with vision include presbyopia, glaucoma, cataracts, and
arteriosclerosis of the eye’s blood vessels.
4. The newborn infant can hear sound, but initial responses are reflexive, By the toddler stapes.
The child is listening critically and beginning to initiate. Sounds as language development
begins.
5. Sensorineural deafness (presbycusis) is a neutral consequence of aging.
6. Taste and smell are most acute at birth and destructive in sensitivity after the age of 40 as the
number at Olfactory gustatory receptors decrease.

THE ENDOCRINE SYSTEM AND HORMONE FUNCTION

AN OVERVIEW
1. The endocrine system is major controlling system of the body. Through hormones, it
stimulates such long-term processes as growth and development, metabolism, reproduction, and
body defenses.
2. Endocrine organs are small and widely separated in the body. Some are mixed glands (both
endocrine and exocrine in function). Others are purely hormone producing.
3.All hormones are amino acid-base or steroids.
4. Endocrine organs are activated to release their hormones into the blood by hormonal, humoral,
or neural stimuli, Negative feedback is important in regulating hormone levels in the blood.
5. Bloodborne hormones alter the metabolic activities of their target organs. The ability of a
target organs to respond to hormone depends on the presence of receptors in or on its cells to
which the hormone binds or attaches.
6. Amino acid-based hormones act through second messengers. Steroid hormones directly
influence the target cell’s DNA.
 THE MAJOR ENDOCRINE ORGANS
1. Pituitary glands
a. The pituitary glands hangs from the base of the brain by a stalk and is enclosed by bone. It
consists of a glandular (anterior) portion and a neural (posterior) portion.
b. Except for growth hormone and prolactin, hormones of the anterior pituitary are all tropic
hormones.
(1) Growth hormone (GH): An anabolic and protein-conserving hormone that promotes
total body growth. Its most important effect is on skeletal muscles and bones. Untreated
hyposecretion during childhood results in pituitary dwarfism; hypersecretion produces gigantism
(in childhood) and acromegaly (in adulthood).
(2) Prolactin (PRL): Stimulates production of breast milk.
(3) Adrenocorticotropic hormone (ACTH): Stimulates the adrenal cortex to release its
hormones.
(4) Thyroid-stimulating hormones (TSH): Stimulates the thyroid glands to release thyroid
hormone.
(5) Gonadotropic hormones
(a) Follicle-stimulating hormone (FSH): Beginning at puberty, Stimulates follicle
development and estrogen production by the female ovaries; promotes sperm production in the
male.
(b) Luteinizing hormone (LH): Beginning at puberty, stimulates ovulation. Converts
the ruptured ovarian follicle to a corpus luteum and causes the corpus luteum to produce
progesterone; stimulates the male’s testes to produce testosterone.
c. Releasing and inhibiting hormones made by the hypothalamus regulate release of hormones
made by the anterior pituitary. The hypothalamus also makes two hormones that are transported
to the posterior pituitary for storage and later release.
d. The posterior pituitary stores and releases hypothalamic hormones on command.
(1) Oxytocin: Stimulates powerful uterine contractions and causes milk ejection in the
nursing woman.
(2) Antidiuretic hormone (ADH); Causes kidney tubule cells to reabsorb and conserve the
body water and increases blood pressure by constricting blood vessels. Hyposecretion leads to
diabetes insipidus.
2. Thyroid gland
a. The thyroid gland is located in the anterior throat.
b. Thyroid hormone (thyroxine [T4] and triiodothyronine [T3]) is release from the thyroid
follicles when blood levels of TSH rise. Thyroid hormone is the body’s metabolic hormone. It
increases the rate at which cells oxidize glucose and is necessary for normal growth and
development. Lack of iodine leads to goiter. Hyposecretion of thyroxine results in cretinism in
children and myxedema in adults. Hypersecretion results from Graves’ disease or other forms of
hyperthyroidism.
c. Calcitonin is released by C cells surrounding the thyroid follicles in response to high blood
levels of calcium. It causes calcium to be deposited in bones.
3. Parathyroid glands
a. The parathyroid gland are four small glands located on the posterior aspect of the thyroid
gland.
b. Low blood levels of calcium stimulate the parathyroid glands to release parathyroid
hormone (PTH). It causes bone calcium to be liberated into the blood. Hyposecretion of PTH
results in tetany: Hyposecretion leads to extreme bone wasting and fractures.
4. Adrenal glands
a. The adrenal glands are paired gland perched on the kidneys. Each gland perched on the
kidney. Each gland has two functional endocrine portions, cortex and medulla.
b. Three groups of hormones are produced by the adrenal cortex.
(1) Mineralocorticoids, primarily aldosterone, regulate sodium ion ( Na ⁺ ) and potassium
ion ( K⁺ ) reabsorption by the kidneys. Their release is stimulating primarily by low Na ⁺ and /or
high K⁺ levels in blood.
(2) Glucocorticoids enable the body to resist long-term stress by increasing blood glucose
levels and depressing the inflammatory response.
(3) Sex hormones (mainly male sex hormones) are produced in small amounts throughout
life.
c. Generalized hypoactivity of the adrenal cortex results in Addison’s disease.
Hypersecretion can result in hyperaldosteronism. Cushing’s disease and/or masculinization.
d. The adrenal medulla produces catecholamines (epinephrine and norepinephrine) in
response to sympathetic nervous system stimulation. It’s catecholamines enhance and prolong
the effects of the fight-or-flight (sympathetic nervous system) response to short-term stress.
Hypersecretion leads to symptoms typical of sympathetic nervous system overactivity.
5. Pancreatic islets
a. located in the abdomen close to the stomach, the pancreas is both an exocrine and
endocrine gland. The endocrine portion (islets) releases insulin and glucagon to blood.
b. Insulin is released when blood levels of glucose are high. It increases the rate of glucose
uptake and metabolism by body cells. Hyposecretion of insulin results in diabetes mellitus,
which severely disturbs body metabolism. Cardinal signs are polyuria, polydipsia and
polyphagia.
c. Glucagon is released when blood levels of glucose are low. It stimulates the liver to release
glucose to blood, thus increasing blood glucose levels.
6. The pineal gland, located in the third ventricle of the brain, releases melatonin, which affects
biological rhythms and reproductive behavior.
7. The thymus gland, located in the upper thorax, functions during youth but atrophies in old age.
Its hormone, thymosin, promotes maturation of T lymphocytes, important in body defense.
8. Gonads.
a. The ovaries of the female, located in the pelvic cavity, release two hormones.
 (1) Estrogens: Release of estrogens by ovarian follicles begins at puberty under the influence
of FSH. Estrogens stimulate maturation of the female reproductive organs and development of
secondary sex characteristics of the female. With progesterone, they cause the menstrual cycle.
(2) Progesterone: Progesterone is released from the corpus luteum of the ovary in response
to high blood levels of LH. It works with estrogens in establishing the menstrual cycle.
b. The testes of the male begin to produce testosterone at puberty in response to LH
stimulation. Testosterone promotes maturation of the male reproductive organs, male secondary
sex characteristics, and production of sperm by the testes.
c. Hyposecretion of gonadal hormones results in sterility in both females and males.
OTHER HORMONE-PRODUCING TISSUES AND ORGANS
1. The placenta is a temporary organ formed in the uterus of pregnant women. Its primary
endocrine role is to produce estrogen and progesterone, which maintain pregnancy and ready
breasts for lactation.
2. Several organs that are generally nonendocrine in overall function, such as the stomach, small
intestine, kidneys and heart, have cells that secrete hormones.
3. Certain cancer cells secrete hormones.
DEVELOPMENTAL ASPECTS OF THE ENDOCRINE SYSTEM
1. Excluding pathological excesses and lack of hormones, efficiency of the endocrine system
remains high until old age.
2. Decreasing function of female ovaries at menopause leads to osteoporosis, increased chance of
heart disease and possible mood changes.
3. Efficiency of all endocrine glands gradually decrease with aging, which leads to generalized
increase in incidence of diabetes mellitus immune system depression and lower metabolic rate.

COMPOSITION AND FUNCTION OF BLOOD

1. Blood composed of a nonliving fluid matrix (plasma) and formed elements. it is scarlet to dull
red; depending on the amount of oxygen carried normal adult blood volume is 5 to 6 liters.
2. Dissolved in plasma (primary water) are nutrients, gases, hormones waste, proteins, salt and so
on. plasma composition changes are body cells remove or add substances to it. but homeostatic
mechanism act to keep it relatively constant. plasma makes up 55 percent of whole blood.
3.Formed elements the living blood cells that make up about 15 percent of whole blood, include:
a. erythrocytes or RBC -disc- shaped anucleate cells that transport oxygen bound to their
hemoglobin molecules. their lifespan is 100 to 120 days.
b. leukocytes or WBCs- ameboid cells involved in protection of the body.
c. Platelets- cell fragments that act in blood clotting.
4. A decrease in oxygen carrying ability of blood is anemia. Possible cause is decrease in number
of functional RBCs or decrease in amount of hemoglobin they contain. Polycythemia is an
excessive number of RBCs that may result from bone marrow cancer or move to a location
where less oxygen is available in the air (at Hight altitude, for example)
5. leukocytes are nucleated cells, classed into two groups:
 a. granulocytes include neutrophils, eosinophils and basophils.
b. Agranulocytes include monocytes and lymphocytes.
6. When bacteria, viruses or other foreign substances invade the body, WBCs increase in number
(leukocytosis) and fight them in various ways.
7. An abnormal decrease in number of WBCs is leukopenia. an abnormal increase in WBC is
seen in infectious mononucleosis and leukemia (cancer of leukocytes).
8. All forms elements a rise in res bone marrow from a common stem cell. The hemocytoblast.
However, their development pathways differ. The stimulus for hematopoiesis is hormonal
(erythropoietin in case of RBCs).

HEMOSTASIS
1. Stoppage of blood loss from an injured blood vessel or hemostasis involves three steps:
vascular spasm. Platelets plug formation. Blood clot formation.
2.Hemostasisis started by a tear or interruption in the Blood vessel lining. Platelets adhere to the
damaged. site and release serotonin. which causes viscount? striction. Platelet PF, and tissues
cell thromboplastin Initiate the clotting cascade, leading to formation of fibrin threads. Fibrin
traps RBCs as they flow past, Forming the clot.
3. Normally, clots are digested when a vessel has been. Permanently repaired. An attached clot
that forms or Persists in an unbroken blood vessel is a thrombus. A clot travelling in the
bloodstream is an embolus.
4. Abnormal bleeding may reflect a deficit of platelets. (thrombocytopenia), genetic
factors(hemophilia)or inability of the liver to make clotting factors.

BLOODS GROUPS AND TRANSFUSIONS

1. Blood groups are classified on the basic of proteins. (antigens) on RBC membranes.
Complementary an-tribadies may for (or may not) be present in blood An-tribadies act.
to agglutinate (clump) and lye foreign RBCs.
2. The blood groups most typed for is ABO.
Type O is most common least is AB ABO antigens are commonly accompanied by performed
antibodies. In plasma, which act against RBCs with “foreign. Antigens.
3. Rh factor is found in most Americans’ Rh people do not performed antibodies to Rh RBCs but
Form them once exposed to Rh blood.

DEVELOPMENTAL ASPECTS OF BLOOD

1. Congenital blood defects include various types of
Hemolytic anemias and bleeder’s disease. Incompatibility between, maternal and fetal blood
can result. In fetal cyanosis, resulting from destruction of fetal blood cells.
2. Fetal hemoglobin (hbf) binds more readily with oxygen that does Hba.
3. Physiologic jaundice in a newborn reflects immaturity of the infant’s liver.
4. Exclusive leukocytosis may be indicative of malignancy.
of blood-forming organs or leukemia. Leukemias are most common in the very young and very
old.
5. The elderly is at rest for anemia and clotting disorders.

CARDIOVASCULAR SYSTEM: THE HEART

1. The heart. Located in the thorax. is flaked laterally.
by the lungs enclosed in a pericardium.
2. The bulk of the heart (myocardium) is composed of
Cardiac muscle. The heart has four hallow clambers two atria (receiving chambers) and two
ventricles (discharging chambers) each lined with endocardium. The heart is divided
longitudinally by septum.

3. The heart functions as a double pump. The right heart is a pulmonary pump (right heart to
lungs to left heart). The left heart is the systemic pump (left heart to body tissues to right heart).
4. four valves prevent back flow of blood in the heart The AV valves (mitral and tricuspid)
prevent back- flow into the atria when the ventricles are contracting the semilunar valves prevent
backflow into the ventricles when the heart are relaxing. The valves open and close in response
to pressure changes in the heart.
5. The myocardium is nourished by the coronary circulation. Which consist of the right and left
coronary arteries and their branches. And is drained by the cardiac veins and the coronary sinus.
6. Cardiac muscle can initiate its own contraction. in a regular way, but is rate is influenced by
both intrinsic and extrinsic factors. The intrinsic conduction
system increases the rate of heart construction. and ensures that the heartbeat as a unit. The SA
node is the heart’s pacemaker.
7. The time and events occurring from one heartbeat to the next are the cardiac cycle.
8. As the heartbeat, sounds resulting from the clotting of the valves (“lob-dup) can be heard
faulty valves reduce the efficiency of the heart as a pump and result in abnormal heart sounds
(murmurs).
9. Cardiac output the amount of blood pumped out by each ventricle in one minute.is product of
heart rate (HR) x stroke volume (SV) SV is the amount of blood ejected by a ventricle with
each beat.
10. SV rises or falls with the volume of venous return HR is influenced by the nerves of the
autonomic nervous system. (and other chemicals), and
Ion levels in the blood.

CARDIOVASCULAR SYSTEM; BLOOD VESSELS

1. Arteries which transport blood form the heart and veins, which carry blood back to the heart,
are con-ducting vessels Only capillaries play a role in actual exchanges with tissue cells.
2. Expert of capillaries blood vessels are composed of three tunics The tunica interna forms a
friction. Reducing lining for the vessels. The tunica media is the bulky middle layer muscle and
elastic tissue. The tunica externa is the protective. outermost con-native tissue layer. Capillary
walls are formed of the interna only.
3. Artery walls are thinking and strong to withstand pressure. fluctuations. They expand and
recoil as the heart beats, vein wall is thinner. Their lumbers are larger they are equipped with
valves these modifications reflect the low-pressure nature of veins.

4. Capillary beds have two types of vessels -a vascular shunt and true capillaries the entrance
which are guarded by precapillary sphincters. Exchanges with tissue cells occur across the walls
of the true capillaries. When the precapillary sphincters are closed, blood bypasses the local are
avia vascular shunt.
5. Varicose vein, a structural defect due to incompetent valves is a common vascular problem,
especially in the obese and people who stand for long hours. It isA predisposing factor for
thrombophlebitis
6. All the major arteries of the synthetic circulation are branches of the aorta, which leaves the
left ventricle they branch into smaller arteries and then into the arterioles, which feed the
capillary beds of the Body tissues, for the names and locations of the Systemic arteries,
7. The major veins of the syntomic circulation ultimately converge on one of the venae cavae.
All veins above the diaphragm drain into superior vena cava, and those below the diaphragm
drain into inferior vena cava. Both venae cavae enter the names and locations of the systemic
veins.
8.The arterial circulation of the brains is formed by branches of paired vertebral and internal
carotid arteries. The circle of Will is providing alternate routes for blood flow in case of
blockage in the brain’s arterial supply.
9.The hepatic portal circulation is formed by veins draining the digestive organs, which empty
into the hepatic portal vein. The hepatic portal veins carry the nutrient-rich blood to the liver,
where it is processed before the blood is allowed to enter the system circulation.
10.the fetal circulation is a temporary circulation seen only in the fetus. It’s consisted primarily
of three special vessels: The single umbilical vein that carries nutrient- oxygen -laden blood to
the fetus from the placenta, and the two umbilical arteries that carry the carbon dioxide and
waste -laden blood from the fetus to the placenta. Shunt bypassing the lungs and liver are also
present.
11. The pulse is the alternate expansion and recoil of a
Blood vessels. It is that force wall (the pressure wave) that occurs as The heartbeat s. It may be
felt easily over any superficial artery; Such sites are called pressure points.
12. Blood pressure is the pressure that blood excerpts on
the walls of the blood vessels. It is force that causes blood to continue to flow in the blood
vessels. It is high in the arteries, lower in the capillaries, and lowest in the veins, Blood is forced
along a descending pressure gradient. Both systolic and diastolic pressure recorder.
13. Arterial blood pressure is directly influenced by.
the heart activity (increased heart rate leads to increased blood pressure) and by resistance to
blood flow, the most important factors increasing the peripheral resistance are a decrease in the
diameter or stretchiness of the arteries and arterioles, and an increase in blood viscosity.
14. Many factors influence blood pressure. Some of these
factors are activity of the sympathetic nerves and kidney, drugs, and diet.
15. Hypertension which reflects an increase in peripheral resistance,
strains the heart damages blood vessels. In most cases the precise cause is unknown.
16. Substance moves to and from the blood and tissue cells.
through capillary walls. Some substances are transported in vesicles, but most move by
diffusion- directly through the endothelial cell plasma membranes, though intercellular clefts or
though fenestration. Fluid is forced from the bloodstream by blood pressure and drawn back into
the blood by osmotic pressure.

DEVELOPMENT ASPECTS OF THE CARDIOVASCULAR SYSTEM

1. The heart begins as a tube structure that is beating.
and pumping blood by the fourth week of embryonic development.
2. Congenital heart defects account for half of all infant
deaths resulting from congenital problems.
3. Arteriosclerosis is an expected consequence of aging.
Gradual loss of elasticity in the arteries leads to hypertension and hypertensive heart disease and
clogging of the vessels with fatty substances leads to coronary artery disease and stroke
Cardiovascular diseases is an important cause of death in individuals over age65.
4. Modifications in diet (decreased fats, cholesterol,
and salt) stopping smoking. Regular aerobic exercise may help to reverse the atherosclerotic
process and prolong life.

MODULES FOR ANATOMY AND PHYSIOLOGY

Credits : 3 units lecture (1and half hour x 2days) (3 hours/week)
Pre-Requisite : BSOA 1st year standing

Course Title: OA103 ADMINISTRATIVE OFFICE PROCEDURE AND MANAGEMENT

Learning Description: The course will cover different aspects of the human body such as its
structure and function. This course will provide a conceptual background in Anatomy sufficient
to enable students to take more advanced courses in related fields.
Lesson Objective:
At the end of the module, the learners will be able to:
1. Describe the major types of structures composing the lymphatic system and explain how
the lymphatic system is functionally related to the cardiovascular and immune systems
2. Describe several protective mechanisms of the respiratory system and the structure &
function of the lungs and the pleural coverings
3. Identify the overall function of the digestive system as digestion and absorption of
foodstuffs, and describe the general activities of each digestive system organ
4. Describe the general structure and function of the ureters, bladder and urethra
5. Discuss the common purpose of the reproductive system organs

COURSE OUTLINE:

Course code: OPE 101

Course title: HUMAN ANATOMY AND PHYSIOLOGY
Credit: 3 units
Pre-requisites:
Course Outline
A. Lymphatic System and Body Defenses
B. The Respiratory System

C. Digestive System and Body Metabolism

D. Urinary System

E. Reproductive System

TEXT
Elaine N. Marieb, R. P. (2004). Essentials of Human Anatomy & Physiology. Jurong,
Singapore: PEARSON EDUCATION SOUTH ASIA PTE LTD.
PART I: LYMPHATIC SYSTEM
1. The lymphatic system consists of the lymphatic vessels, lymph nodes, and certain other
lymphoid organs in the body.

2. Extremely porous blind-ended lymphatic capillaries pick up excess tissue fluid leaked from
the blood capillaries. The fluid (lymph) flows into the larger lymphatics and finally into the
blood vascular system through the right lymphatic duct and the left thoracic duct.

3. Lymph transport is aided by the muscular and respiratory pumps and by contraction of smooth
muscle in the walls of the lymphatic vessels.

4. Lymph nodes are clustered along lymphatic vessels, and the lymphatic stream flows through
them. Lymph nodes form agranular WBCs (lymphocytes), and phagocytic cells within them
remove bacteria, viruses, and the like from the lymph stream before it is returned to the blood.

5. Other lymphoid organs include the tonsils (in the throat), which remove bacteria trying to
enter the digestive or respiratory tracts; the thymus, a programming region for some lymphocytes
of the body; Peyer’s patches, which prevent bacteria in the intestine from penetrating deeper into
the body; and the spleen, a RBC graveyard and blood reservoir.

PART II: BODY DEFENSES

NONSPECIFIC BODY DEFENSES
1. Surface membranes (skin and mucous membranes) provide mechanical barriers to pathogens.
Some produce secretions and/or have structural modifications that enhance their defensive
effects. The skin’s acidity, lysozyme, mucus, keratin, and ciliated cells are examples.
2. Phagocytes (macrophages and neutrophils) engulf and destroy pathogens that penetrate
epithelial barriers. This process is enhanced when the pathogen’s surface is altered by
attachments of antibodies and or complement.
3. Natural killer cells are nonimmune cells that act nonspecifically to lyse virus-infected and
malignant cells.
4. The inflammatory response prevents spread of harmful agents, disposes of pathogens and dead
tissue cells, and promotes healing. Protective leukocytes enter the area; the area is walled off by
fibrin; and tissue repair occurs.
5. When complement (a group of plasma proteins) becomes fixed on the membrane of a foreign
cell, lysis of the target cell occurs. Complement also enhances phagocytosis and the
inflammatory and immune responses.
6. Interferon is a group of proteins synthesized by virus-infected cells and certain immune cells.
It prevents viruses from multiplying in the other body cells.
7. Fever enhances the fight against infectious microorganisms by increasing metabolism, which
speeds up repair processes; and by causing the liver and spleen to store iron and zinc, which are
needed for bacterial multiplication.
THE IMMUNE SYSTEM
1. The immune system recognizes something as foreign and acts to inactive or remove it.
Immune response is antigen- specific, is systemic, and has memory. The two arms of immune
response are humoral immunity, mediated by living cells (lymphocytes).
2. Antigens
a. Antigens are large, complex molecules (or parts of them) recognized as foreign by the body.
Foreign proteins are the strongest antigens.
b. Complete antigens provoke an immune response and bind with products of that response
(antibodies or sensitized lymphocytes)
c. Incomplete antigens, or haptens, are small molecules that are unable to cause an immune
response by themselves bot do so when they bind to body proteins and the complex is recognized
as foreign.
3. Cells of the immune system: An overview
a. Two main cell populations, lymphocytes and macrophages, provide for immunity.
b. Lymphocytes arise from hemocytoblasts of bone marrow. T cells develop
immunocompetence in the thymus and oversee cell-mediated immunity. B cells develop
immunocompetence in bone marrow and provide humoral immunity. Immunocompetent
lymphocytes see lymphoid organs, where antigen challenge occurs, and circulate through blood,
lymph, and lymphoid organs.
c. Immunocompetence is signaled by the appearance of antigen-specific receptors on surfaces of
lymphocytes.
d. Macrophages arise from monocytes produced in bone marrow. They phagocytize pathogens
and present parts of the antigens on their surfaces, for recognition by T cells.

4. Humoral (antibody-mediated) immune response.

a. Clonal selection of B cells occurs when antigens bind to their receptors, causing them to
proliferate. Most clone members become plasma cells, which secrete antibodies. This is called
the primary immune response.
b. Other clone members become memory B cells, capable of mounting a rapid attack against the
same antigen in subsequent meetings (secondary immune responses). These memory cells
provide immunological “memory”.
c. Active humoral immunity is acquired during an infection or via vaccination and provides
immunological memory. Passive immunity is conferred when a donor’s antibodies are injected
into the bloodstream, or when the mother’s antibodies cross the placenta. It does not provide
immunological memory.
d. Basic antibody structure
(1) Antibodies are proteins produced by sensitized B cells or plasma cells in response to an
antigen, and they are capable of binding with that antigen.
(2) An antibody is composed of four polypeptide chains (two heavy and two light) that form a
Y-shaped molecule.
(3) Each polypeptide chain has a variable and a constant region. Variable regions form antigen-
binding sites, one on each arm of the Y. Constant regions determine antibody function and class.
(4) Five classes of antibodies exist: IgA, IgG, lgM, lgf; They differ structurally and functionality.
(5) Antibody functions include complement fixation, neutralization, precipitation and
agglutination.
(6) Monoclonal antibodies are pure preparations of a single antibody type useful in diagnosis of
various infectious disorders and cancer, and in treatment of certain cancers.

5. Cellular (cell-mediated) immune response

a. T cells are sensitized by binding simultaneously to an antigen and a self-protein displayed on
the surface of a macrophage. Clonal selection occurs, and clone members differentiate into
effector T cells or memory T cells.
b. There are several different classes of effector T cells. Cytotoxic (killer) T cells directly attack
and lyse infected and cancerous cells. Helper t cells interact directly with B cells bound to
antigens. They also liberate lymphokines, chemicals that enhance the killing activity of
macrophages, attract other leukocytes, or act as helper factors that stimulate activity of B cells
and cytotoxic T cells. Delayed hypersensitivity T cells release chemicals that enhance
inflammation and promote a delayed allergic reaction. Suppressors T cells terminate that normal
immune response by releasing suppressors chemicals.
c. Organs transplants include autografts, isografts, allografts and xenografts. The most usual graft
is an allograft. Blood group and tissue matching are done to assure the best match possible and
organ transplants is followed by immunosuppressive therapy.
6. Disorders of immunity
a. In allergy or hypersensitivity the immune system overreacts to an otherwise harmless antigen,
and tissue destruction occurs. Immediate (acute) hypersensitivity, as seen in hay fever, hives, and
anaphylaxis, is due to lgl; antibodies. Delayed hypersensitivity (for example; contact dermatitis)
reflects activity of T cells and lymphokines.
b. Immunodeficiencies result from abnormalities in any immune element. Most serious is severe
combined immunodeficiency disease (a congenital disease) and AIDS, an acquired
immunodeficiency disease caused by a virus that attacks and cripples the helper T cells.
c. Autoimmune disease occurs when the body’s self-tolerance breaks down, and antibodies
and/or T cells attack the body’s own tissues. Most forms of autoimmune disease result from
inefficient lymphocyte programming in the fetus, changes in structure of self-antigens or
appearance of formerly hidden self-antigens in blood, and cross-reactions with self-antigens and
antibodies formed against foreign antigens.

DEVELOPMENTAL ASPECTS OF THE LYMPHATIC SYSTEM AND BODY

DEFENSES
1. Lymphatic vessel form by budding off veins. The thymus gland is the first lymphoid organ to
appear in the embryo. Other lymphoid organ remains relatively undeveloped until after birth.
2. Development of immune response occurs around the time of birth.
3. The ability of immunocompetent cells to recognize foreign antigens is genetically determined.
Stress appears to interfere with normal immune response.
4. Efficiency of immune response wanes in old age, and infections, cancer, immunodeficiencies
and autoimmune disease become more prevalent.
FUNCTIONAL ANATOMY OF THE RESPIRATORY SYSTEM

1. The nasal cavity, the chamber within the nose, is divided medially by a nasal septum and
separated from the oral cavity by the palate. The nasal cavity is lined with a mucosa also contains
receptors for sense of smell. Paranasal sinuses and nasolacrimal ducts drain into the nasal cavity.
2. The pharynx (throat) is a mucosa-lined, muscular tube with three regions—nasopharynx,
oropharynx, and laryngopharynx. The nasopharynx functions in respirations only; the others
serve both respiratory and digestive functions. The pharynx contains tonsils, which act as a part
of the body’s defense system.
3. The larynx (voice box) is a cartilage structure, most prominent is the thyroid cartilage
(Adam’s apple). The larynx connects the pharynx with the traches below. The laryngeal opening
(glottis) is hooded by the epiglottis, which prevents entry of food or drink into respiratory
passages when swallowing. The larynx contains the true vocal cords, which produce sounds used
in speech.
4. The trachea (windpipe) extends from larynx to primary bronchi. The trachea is a smoothly-
muscle tube lined with a ciliated mucosa and reinforced with C-shaped cartilage rings, which
keep the trachea patent.
5. Right and left primary bronchi result of subdivision of the trachea. Each plunges into the hilus
of the lungs on its side.
6. The lungs are paired organs flanking the mediastinum in the thoracic cavity. The lungs are
covered with visceral pleura; the thorax wall is lined with parietal pleura. Pleural secretions
decrease friction during breathing. The lungs are primarily elastic tissue, plus passageways of the
respiratory tree. The smallest passageways end in clusters of alveoli.
7. The conducting zone includes all respiratory passages from the nasal cavity to the terminal
bronchioles; they conduct air to and from the lungs. Respiratory bronchioles, alveolar ducts and
sacs, and alveoli—which have thin walls through which gas exchanges are made with pulmonary
capillary blood- are respiratory zone structures.

RESPIRATORY PHYSIOLOGY
1. Mechanics of breathing: Gas travels from high-pressure to low-pressure areas. Pressure
outside the is atmospheric pressure; pressure inside the lungs is intrapulmonary pressure;
pressure in the intrapleural space is intrapleural pressure (which is always negative). Movement
of air into and out of the lungs is called pulmonary ventilation, or breathing. When inspiratory
muscles contact, intrapulmonary volume increase, its pressure decreases and air rushes in
(inspiration). When inspiratory muscles relax, the lungs recoil and air rushes out (expiration).
Expansion of the lungs is helped by cohesion between pleurae and by the presence of surfactant
in alveoli.
2. Nonrespiratory air movements; Nonrespiratory air movements are voluntary or reflex
activities that move air into or out of the lungs. These include coughing,
3. Respiratory volumes and capacities; Air volumes exchanged during breathing are TV, IRV,
ERV, and VC (see page 415 for values). Residual volume is nonexchangeable respiratory
volume and allows gas exchange to go on continually.
4. Respiratory sounds; Bronchial sounds are sounds of air passing through large respiratory
passageways. Vesicular breathing sounds occur as air fills alveoli.
5. External respiration, gas transport and internal respiration: Gases move according to laws of
diffusion. Oxygen moves from alveolar air into pulmonary blood. Most oxygen is transported
bound to hemoglobin inside RBC’s. Carbon dioxide moves from pulmonary blood into alveolar
air. Most carbon dioxide is transported as bicarbonate ion in plasma. At body tissues, oxygen
moves from blood to the tissues, whereas carbon dioxide moves from the tissues to blood.

6. Control of respiration
a. Nervous control. Neural centers for control of respiratory rhythm are in the medulla and
pons. Reflex arcs initiated by stretch receptors in the lungs also play a role in respiration by
notifying neural centers of excessive overinflation.
b. Physical factors; Increased body temperature’ exercise. speech, singing and nonrespiratory
air movements modify both rate and depth of breathing.
c. Volition: To a degree, breathing may be consciously controlled if it does not interfere depth
of breathing.
d. Emotional factors: Some emotional stimuli can modify breathing. Examples are fear, anger
and excitement.
e. Chemical factors: Changes in blood levels of carbon dioxide are the most important stimuli
affecting respiratory rhythm and depth. Carbon dioxide acts directly on the medulla via its effect
on reducing blood pH. Rising levels of carbon dioxide in blood result in faster, deeper breathing;
falling levels lead to shallow, slow breathing. Hyperventilation may result in apnea and
dizziness, due to alkalosis. Oxygen is less important as a respiratory stimulus in normal healthy
people, but it is the stimulus for those whose systems have become accustomed to high levels of
carbon dioxide.

RESPIRATORY DISORDERS

1. The major respiratory disorders are COPD (emphysema and chronic bronchitis) and lung
cancer. A significant cause is cigarette smoking.
2. Emphysema is characterized by permanent enlargement and destruction of alveoli. The lungs
lose their elasticity, and expiration becomes an active process.
3. Chronic bronchitis is characterized by excessive mucus production and its pooling in lower
respiratory passageways, which severely impairs ventilation and gas exchange. Patients may
become cyanotic as a result of chronic hypoxia.
4. Lung cancer is extremely aggressive and metastasize rapidly. The three most common lung
cancers are squamous cell carcinoma, adenocarcinoma and small cell carcinoma.

DEVELOPMENTAL ASPECTS OF THE RESPIRATORY SYSTEM

1. Premature infants have problems keeping their lungs inflated due to lack of surfactant in their
alveoli. (Surfactant is formed late in pregnancy)
2. The most important birth defects of the respiratory system are cleft palate and cystic fibrosis.
3. The lungs continue to mature until young adulthood.
4. During youth and middle age, most respiratory system problems are a result of external factors
such as infections and substances that physically block respiratory passageways.
5. In old age, the thorax becomes more rigid and lungs become less elastic, leading to decreased
vital capacity. Protective mechanisms of the respiratory system decrease in effectiveness in
elderly persons, predisposing them to more respiratory tract infections.
ANATOMY AND PHYSIOLOGY OF THE DIGESTIVE SYSTEM
ANATOMY OF DIGESTIVE SYSTEM

1. The digestive system consists of the alimentary canal (a hollow tube extending from mouth to
anus) and several accessory digestive organs. The wall of the alimentary canal has four main
tissues layers—mucosa, submucosa, muscularis externa serosa. The serosa (visceral peritoneum)
is continuous with the parietal peritoneum, which lines the abdominal cavity wall.
2. Organs of the alimentary canal.
a. The mouth or oral cavity contains teeth and tongue and is bounded by lips, cheeks and
palate. Tonsils guard its posterior margin.
b. The pharynx is a muscular tube that provides a passageway for food and air.
c. The esophagus is a muscular tube that completes the passageway from the pharynx to the
stomach.
d. The stomach is a C-shaped organ located on the left side of the abdomen beneath the
diaphragm. Food enters it through the cardio-esophageal sphincter and leaves it to enter the small
intestine through the pyloric sphincter. The stomach has a third oblique layer of muscle in its
wall allows it to perform mixing or churning movements. Gastric glands produce hydrochloric
acid, pepsin, renin, mucus, gastrin, and intrinsic factor. Mucus protects the stomach itself from
being digested.
e. The tube-like small intestine is suspended from the posterior body wall by the mesentery. Its
subdivisions are the duodenum, jejunum and ileum. Food digestion and absorption are completed
here. Pancreatic juice and bile enter the duodenum through a sphincter at the distal end of the
bile duct. Microvilli, villi, and circular folds increases the surface area of the small intestine for
enhanced absorption.
f. The large intestine frames the small intestine. Subdivisions are the cecum, appendix;
ascending, transverse and descending colon; sigmoid colon, rectum and canal. The large intestine
delivers undigested food residue feces) to the body exterior.
3. Salivary glands (three pairs—parotid, submandibular, sublingual) secrete saliva into the oral
cavity. Saliva contains mucus and serous fluids. The serous components contain salivary
amylase.
4. Two sets of teeth are formed. The first set consists of 20 deciduous teeth that begin to appear
at 6 months and are lost by 12 years. Permanent teeth (32) begin to replace deciduous teeth
around 7 years. A typical tooth consists of crown covered with enamel and root consists of
crown covered with cementum. Most of the tooth is bonelike dentin. The pulp cavity contains
blood vessels and nerves.

5. Several accessory organs duct substances into the alimentary tube.

a. The pancreas is a soft gland lying in the mesentery between the stomach and small intestine.
Pancreatic juice contains enzymes (which digest all categories of foods) in an alkaline fluid.
b. The liver is a four-lobed organ overlying the stomach. Its digestive function is to produce
bile, which it ducts into the small intestine.
c. The gallbladder is a muscular sac that stores and concentrates bile. When fat digestion is not
occurring, the continuously made bile backs up the cystic duct and enters gallbladder.
FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Foods must be broken down to their building block to be absorbed. Building blocks of
carbohydrates are simple sugars are simple sugars, or monosaccharides. Building blocks of
protein are amino acids. Building blocks of fats or lipids, are fatty acids and glycerol.
2. Both mechanical (chewing) and chemical food breakdown begin in the mouth. Saliva contains
mucus, which helps bind food together into a bolus and salivary amylase, which begins the
chemical breakdown of starch. Saliva is secreted in response to food in the mouth, mechanical
pressure and psychic stimuli. Essentially no food absorption occurs in the mouth.
3. Swallowing gas two phases. The buccal phase is voluntary; the tongue pushes the bolus into
the pharynx. The involuntary pharyngeal-esophageal phase involves the closing off of nasal and
respiratory passages and the conduction of food to the stomach by peristalsis.
4. When food enters the stomach, gastric secretion is stimulated by vagus nerves and by gastrin
( a local hormone). Hydrochloric acid activates the protein digesting enzyme pepsin and
chemical digestion of protein begins. Food is also mechanically broken down by the churning
activity of stomach muscles. Movement of chryme into the small intestine is controlled by the
enterogastric reflex.
5. Chemical digestion of fats, proteins and carbohydrates is completed in the small intestine by
intestinal enzymes and more importantly, pancreatic enzymes. Alkaline pancreatic juices
neutralize acid chyme and provides the proper environment for the operation of enzymes. Both
pancreatic juice (the liver) are necessary for normal fat breakdown and absorption. Bile acts as a
fat emulsifier, secretin and cholecystokinin, hormones produced by the small intestine, stimulate
release of bile and pancreatic juice. Segmental movements mix foods; peristaltic movements
move foodstuffs along the small intestine. Most nutrient absorption occurs by active transport
into the capillary blood of the villi. Fats are absorbed by diffusion into both capillary blood and
lacteals in the villi.
6. The large intestine receives bacteria-laden indigestible food residue. Activities of the large
intestine are absorption of water and salts and of vitamins made by resident bacteria. When feces
are delivered to the rectum by peristalsis and mass peristalsis, the defecation reflex is initiated.

PART II: NUTRITION AND METABOLISM

NUTRITION
1. Most foods are used as fuels to form ATP; the exception is proteins.
2. A nutrient is a substance in food used to promote growth, maintenance and repair of the body.
3. The major nutrients are carbohydrates, lipids and proteins. Vitamins and minerals are required
in minute amounts.
4. Dietary carbohydrates (sugars and starch) are included in fruits and vegetables (plant
products).
5. Dietary lipids are found in meats, dairy products, and vegetable oils.
6. Eggs, milk, meats, poultry and fish are rich sources of protein.
7. Vitamins found mainly in fruits, vegetables and milk; function mainly as coenzymes in the
body.
8. Minerals, most of plentiful in vegetables and legumes are mainly important for enzyme
activity. Calcium is important for building bone, blood clotting and secretory activities.
METABOLISM
1. Metabolism includes all chemical breakdown (catabolic) and building (anabolic) reactions
needed to maintain life.
2. Carbohydrates, most importantly glucose; are the body’s major energy fuel. As glucose is
oxidized, carbon dioxide, water and ATP are formed. The sequential pathways of glucose
catabolism are glycolysis, which occurs in the cytosol and the Krebs cycle and electron transport
chain (in the mitochondria). During hyperglycemia, glucose is stored as glycogen or converted to
fat breakdown occur to restore normal blood glucose levels.
3. Fats insulate the body, protect organs, build some cell structures (membranes and myelin
sheaths) and provide reserve energy. When carbohydrates are not available, more fats are
oxidized by produce ATP. Excess dietary fat is stored in subcutaneous tissue and other fat
depots.
4. Proteins form the bulk of cell structure and most functional molecules. They are carefully
conserved by body cells. Amino acids are actively taken up from blood by tissue cells those that
cannot be made by body cells are called essential amino acids. 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.
5. The liver is the body’s key metabolic organ. Its cells remove nutrients from hepatic portal
blood. It performs glycogenesis, glycogenolysis and gluconeogenesis to maintain homeostasis of
blood glucose levels. Its cells make blood proteins and other substances and release them to
blood. Fats are burned by liver cells to provide some of their energy (ATP); excesses are stored
or released to blood in simpler forms that can be used by other tissue cells. Phagocytic cells
remove bacteria from hepatic portal blood. Most cholesterol is made by the liver; cholesterol
breakdown products are secreted in bile. Fats and cholesterol are transported in the blood by
lipoproteins. LDL’s transport cholesterol to body cells. HDL’s carry cholesterol to the liver for
degradation. Cholesterol is used to make functional molecules and for some structural purposes,
it is not used for energy.
6. A dynamic balance exists between energy intake and total energy output (heat + work +
energy storage). Interference with this balance results in obesity or malnutrition leading to body
wasting.
7. When the three major types of foods are oxidized for energy, they yield different amounts of
energy. Carbohydrates and proteins yield 4 kcal/gram; fats yield 9 kcal/grams. Basal metabolic
rate (BMR) is the total amount of energy used by the body when one is in a basal static. Age,
sex, body surface area, and amount of thyroxine produced influence BMR.
8. Total metabolic rate (TMR) is number of calories used by the body to accomplish all ongoing
daily activities. It increases dramatically as muscle activity increases. When TMR equals total
caloric intake; weight remains constant.
9. As foods are catabolized to form ATP, more than 60 percent of energy released escapes as
heat, warming the body. The hypothalamus initiates heat-loss processes (radiation of heat from
skin and evaporation of sweat) or heat-promoting processes (vaso-constriction of skin blood
vessels and shivering) as necessary to maintain body temperature within normal limits. Fever
(hyperthermia) represents body temperature regulated at higher-than-normal levels.
DEVELOPMENTAL ASPECTS OF THE DIGESTIVE SYSTEM AND METABOLISM
1. The alimentary tract forms as a hollow tube. Accessory glands form as outpocketings from
this tube.
2. Common congenital defects include cleft palate, cleft clip and tracheoesophageal fistula, all of
which interfere with normal nutrition. Common inborn errors of metabolism are phenylketonuria
(PKU) and cystic fibrosis.
3. Various inflammatory conditions plague the digestive system throughout life. Appendicitis is
common in adolescents, gastroenteritis and food poisoning can occur at any time (given the
proper irritating factors), ulcers and gallbladder problems increase in middle age. Obesity and
diabetes mellitus are bothersome during later middle age.
4. Efficiency of all digestive system processes decreases in the elderly. Gastrointestinal cancers,
such as stomach and colon cancer, appear with increasing frequency in an aging population.

KIDNEYS
1. The paired kidneys are retroperitoneal in the superior lumbar region. Each kidney has a medial
indentation (hilus), where the renal artery, renal vein, and ureter are seen. Each kidney is
enclosed in a tough fibrous capsule. A fatty cushion holds the kidneys against the trunk wall.
2. A longitudinal of a kidney reveals an outer cortex, deeper medulla and medial pelvis.
Extensions of the pelvis (calyces) surround the ups of medullary pyramids and collect urine
draining from them.
3. The renal artery, which enters the kidney, breaks up into segmental, lobar and then interlobar
arteries that travel outward through the medulla. Interlobar arteries split into arcuate arteries,
which serve the to produce interlobar arteries, which serve the cortex.
4. Nephrons are structural and functional units of the kidneys. Each consists of a glomerulus and
a renal tubule. Subdivisions of the renal tubule (from the glomerulus) are glomerular capsule,
proximal convoluted tubule, loop of Henle, and distal convoluted tubule. A second (peritubular)
capillary bed is also associated with each nephron.
5. Nephron functions include filtration, reabsorption and secretion. Filtrate formation is the role
of the high-pressure glomerulus. Filtrate is essentially plasma without blood proteins. In
reabsorption, done by tubule cells, needed substances are removed from filtrate (amino acids,
glucose, water, some ions) and returned to blood. The tubule cells also secrete additional
substances into filtrate. Secretion is important to rid the body of drugs and excess ions and to
maintain acid-base balance of blood.
6. Urine is clear, yellow and usually slightly acid but its pH value varies widely. Substances
normally found in urine are nitrogenous wastes, water, various ions (always sodium and
potassium) Substances normally absent from urine include glucose, blood proteins, blood, pus
(WBC’s), bile.

URETERS, URINARY BLADDER AND URETHRA

1. The ureters are slender tubes running from each kidney to the bladder. They conduct urine by
peristalsis from kidney to bladder.
2. The bladder is a muscular sac posterior to the pubic symphysis. It has two (ureters) and one
outlet (urethra). In males, the prostate gland surrounds its outlet. The function of the bladder is to
store urine.
3. The urethra is a tube that leads urine from the bladder to the body exterior. In females it is 3-4
cm long and conducts only urine. In males, it is 20 cm long and conducts both urine and sperm.
The internal sphincter of smooth muscle is at the bladder-urethra junction. The external sphincter
of skeletal muscle is located more inferiorly.
4. Micturition is emptying of the bladder. The micturition reflex causes the involuntary internal
sphincter to open when stretch receptors in the bladder wall are stimulated. Since the external
sphincter is voluntarily controlled, micturition can ordinarily be temporarily delayed.
Incontinence is the inability to control micturition.

FLUID, ELECTROLYTE AND ACID-BASE BALANCE

1. Blood composition depends on diets, cellular metabolism and urinary output. To maintain
blood composition, the kidneys must:
a. Allow nitrogen-containing wastes (urea, ammonia, creatinine, uric acid) to go out in the
urine.
b. Maintain water and electrolyte balance by absorbing more or less water and reclaiming ions
in response to hormonal signals. ADH increases water reabsorption and conserves body water.
Aldosterone increases reabsorption of sodium and water and decreases potassium reabsorption.
c. Maintain acid-base balance by actively secreting bicarbonate ions (and retaining H) and by
absorbing bicarbonate ions (and secreting H). Chemical buffers tie up excess H or bases
temporarily; respiratory centers modify blood pH by retaining CO2 (decreases pH) or by
eliminating more CO2 from the blood (increases blood pH or by eliminating more CO2 from the
blood (increases blood pH). Only the kidney can remove metabolic acids and excess bases from
the body.

DEVELOPMENTAL ASPECTS OF THE URINARY SYSTEM

1. The kidneys begin to develop in the first few weeks of embryonic life and are excreting urine
by the third month.
2. Common congenital abnormalities include polycystic kidney and hypospadias.
3. Common urinary system problems in children and young to middle-aged adults are infections
caused by fecal microorganisms, sexually transmitted disease-causing microorganisms, and
streptococcus.
4. Renal failure is an uncommon, but extremely serious, problem in which kidneys are unable to
concentrate urine, and dialysis must be done to maintain chemical homeostasis of blood.
5. With age, filtration rate decreases and tubule cells become less efficient at concentrating urine,
leading to urgency, frequency and incontinence. In males, urinary retention is another common
problem.
ANATOMY OF THE MALE REPRODUCTIVE SYSTEM
1. The paired testes, the male gonads, reside in the scrotum outside the abdominopelvic cavity.
Testes have both an exocrine (sperm-producing) function.
2. The male duct system includes the epididymis, ductus deferens and urethra. Sperm maturation
occurs in the epididymis. When ejaculation occurs, sperm are propelled through duct
passageways to the body exterior.
3. Accessory glands of the male include the seminal vesicles, prostate gland, and bulbourethral
glands. Collectively, these glands produce a fluid that activates and nourishes sperm.
4. External genitalia:
a. Scrotum – a skin that hangs outside the abdominopelvic cavity and provides the proper
temperature for producing viable sperm.
b. Penis – consists of three columns of erectile tissue surrounding the urethra. Erectile tissue
provides a way for the penis to become rigid so it may better serve as a penetrating device during
sexual intercourse.
MALE REPRODUCTIVE FUNCTIONS
1. Spermatogenesis (sperm production) begins at puberty in seminiferous tubules in response to
FSH. Spermatogenesis involves meiosis, a special nuclear division that halves the chromosomal
number in resulting spermatids. An additional process that strips excess cytoplasm from the
spermatid, called spermiogenesis, is necessary for production of functional, motile sperm.
2. Testosterone production begins in puberty in response to LH. Testosterone is produced by
interstitial cells of the testes. Testosterone causes the appearance of male secondary sex
characteristics and is necessary for sperm maturation.

ANATOMY OF THE FEMALE REPRODUCTIVE SYSTEM

1. The ovaries, the female gonads are located against the lateral walls of the pelvis. They produce
female sex cells (exocrine function) and hormones (endocrine function)
2. The duct system:
a. Uterine (fallopian) tubes extend from the vicinity of an ovary to the uterus. Ends are fringed
and “wave” to direct ovulated oocytes into uterine tubes, which conduct the oocyte (embryo) to
the uterus by peristalsis and ciliary action.
b. The uterus is a pear shape organ in which the embryo implants and develops. Its mucosa
(endometrium) sloughs off each month in menses unless an embryo has become embedded in it.
The myometrium contracts rhythmically during the birth of a baby.
c. The vagina is a passageway between the uterus and the body exterior that allows a baby or the
menstrual flow to leave the body. It also receives the penis and semen during sexual intercourse.

FEMALE REPRODUCTIVE FUNCTIONS AND CYCLES

1. Oogenesis (production of female sex cells) occurs in ovarian follicles, which are activated at
puberty by FSH an LH to mature and eject oocytes (ovulation) on a cyclic basis. The female egg
(ovum) is formed only if sperm penetrates the secondary oocyte. In females, meiosis produces
only one functional ovum (plus three nonfunctional polar bodies) as opposed to the four
functional sperm per meiosis produced by males.
2. Hormones productions: Estrogens are produced by ovarian follicles in response to FSH.
Progesterone produced in response to LH is the main hormonal product of the corpus luteum.
Estrogens stimulate development of female secondary sex characteristic.
3. The menstrual cycle concerns changes in the endometrium in response to fluctuating blood
vessels of ovarian hormones. The phases are:
a. Menses. Endometrium sloughs off and bleeding occurs, Ovarian hormones are at their lowest
levels.
b. Proliferative phase. Endometrium is repaired, thickens and becomes well vascularized in
response to increasing levels of estrogens.
c. Secretory phase. Endometrial glands begin to secrete nutrients and lining becomes more
vascular in response to increasing levels or progesterone.

MAMMARY GLANDS
1. Mammary glands are milk producing glands found in the breasts. After the birth of a baby,
they provide milk in response to hormonal stimulation.

SURVEY OF PREGNANCY AND EMBRYONIC DEVELOPMENT

1. An oocyte is fertilized for up to 24 hours, sperm are viable within he female reproductive tract
for up to 72 hours. Hundreds of sperm must release their acrosomal enzymes to break down the
gg’s corona radiata.
2. Following sperm penetration, the secondary oocyte completes meiosis II. Then ovum and
sperm nuclei fuses (fertilization) forming a zygote.
3. If fertilization occurs, embryonic development begins immediately. Cleavage, a rapid series of
mitotic divisions without intervening growth, begins with the zygote and ends with a blastocyst.
4. By day 14 after ovulation, the young embryo (blastocyst) has implanted in the endometrium
and the placenta is being formed, hCG released by the blastocyst maintains hormone production
of the corpus luteum, preventing menses until the placenta assumes its endocrine role.
5. The placenta serves respiratory, nutritive and excretory needs of the embryo and produces
hormones of pregnancy.
6. All major organ systems have been laid down by 8 weeks, and at 9 weeks the embryo is called
a fetus. Growth and tissue organ specialization are the major events of the fetal period.
7. A pregnant woman has increased respiratory, circulatory and urinary demands placed on her
system by the developing fetus. Good nutrition is necessary to produce a healthy baby.
8. Childbirth (parturition) includes a series of events called labor. It is initiated by several factors,
but most importantly by using levels of oxytocin and prostaglandins, which promote vigorous
uterine contractions. The three stages of labor are dilation, expulsion, placental.
DEVELOPMENTAL ASPECTS OF THE REPRODUCTIVE SYSTEM
1. Reproductive system structures of males and females are identical during early development.
Gonads begins to develop in eight weeks. The presence or absence of testosterone determines
whether male or female accessory reproductive organs are formed.
2. Important congenital defects result from abnormal separation of ex chromosomes during sex
cell formation.
3. The reproductive system is inactive during childhood. Reproductive organs mature and
become functional for childbearing at puberty.
4. Common reproductive problems during young adulthood are infections of the reproductive
tract. Neoplasm of breast and cervix are major threats to females. Prostate cancer is the most
common reproductive system cancer seen in males.
5. During menopause, female’s reproductive capabilities end and reproductive organs begin to
atrophy. Hot flashes and mood change may occur. Reproductive capacity does not appear to
decline significantly in aging males.