Anatomy and Physiology

(EPB 103)

Engelbert Nonterah, MD, MSc, PhD

Clinical Science Department, Navrongo Health Research Centre
Introductions – lets get to know ourselves
 House keeping
• General rules - The course is organized as follows:
• Lectures
• Group and individual assignments
• Quizzes, questions and answers period
– Participation and attendance to class in important
– Complement lectures with self learning/reading
• If you want to schedule an individual meeting
– Text or mail me:
– Dr Nonterah [email protected] +233505989986
– Mr. Ali Moro [email protected] +233247588393
– Dr Gideon Akantuki [email protected] +233542647974
– Subject of mail, “request for consultation”
– Introduce yourself and explain you query and ensure you include
your full name at the end of the mail or text
EPB 103: Anatomy and Physiology
 Objectives of the course
• Describe the anatomical structures systems (respiratory,
circulatory, muscular, digestive system and nervous system)
• State the relationship between blood supply, lymphatic
drainage, nervous system and the organs and structures
• State the metabolic processes and their effects on the body
• Describe the concept of transport in the biological system
• Describe the functions of the major organs of the human
body
• Describe some disorders of the human body
• Outline the pathophysiology of some disorders
• Discuss the reactions of individuals of different age groups
and the family to various disease manifestations and their
coping mechanisms
 References or reading materials

• Grey’s anatomy
• Lucas A O and H M Gilles 2003 Short textbook of public health
for the tropics. 4thEdition
• Beaglehole R. &Bonita R. 1997. Public Health the crossroads.
Cambridge University Press. Cambridge, UK
• Bernard J. Turncock. 2007. Essentials of Public Health. Jones
and Bartlett Publishers
• Jan Kirk Carney 2006. Public Health In Action: Practicing in the
Real World. Jones and Bartlett Publishers
• Bernard J Turncock. 2006. Public Health: Career Choices That
Make a Difference. Jones and Bartlett Publishers
Important persons and origin of the word “anatomy”

• Aristotle
• Hippocrates
• Herophilus
• Erasistratus
• Galen
• Leonardo da Vinci
• Vesalius
• William Harvey
• Anatomy- From Greek “to cut open”
– Study of the structure of the body
 What is human anatomy

• It is a tool in the hands of the practitioners of

– Medicine and related Allied Health Sciences
• It is a living subject or science
• It is a visual science (need a strong sense of vision)
• It is a descriptive science.

• Anatomy refers to the internal and external structures of the

body and their physical relationships, whereas physiology
refers to the study of the functions of those structures.
 Importance of anatomy

• Bedrock or foundation of medicine

• Forms the basis for a systematic approach to patient
examination
• Diagnosis: recognition of pathological changes e.g. swollen
eyes.
• Diagnosis: investigations – radiological/imaging e.g. X-ray,
ultrasound, CT scan, MRI etc.
• Treatment and management: Basis for surgical management
e.g. removal of uterus (hysterectomy) and other diseases
(breast & Prostate cancers, resections etc.)
 Branches of anatomy
• Gross anatomy
• Microscopic anatomy (Histology)
• Comparative anatomy
– Similarities and differences in the body structure of
different species
– To enable you understand adaptive strategies ver the
cause of evolution or common ancestry
• Neuro-anatomy
• Developmental anatomy
• Embryology
 Methods in the study of anatomy

• Anatomy can be approached in different ways:

– Regional Anatomy: studies regions of the human body. E.g.

abdomen, leg, head and neck, thorax.

– Systematic Anatomy: the body structure is studied by

systems. E.g. cardiovascular system etc.

– Surface Anatomy: the study of internal organs as they

relate to the overlying skin surface.
 Terminologies
• Universally accepted or standard terms are used to describe the
body part to avoid ambiguity or misunderstandings

• Universally the human body is divided into three main parts:

– Head and neck regions
• Head (caput/capitis)
• Cranium (skull)
• neck (cervix)
– The trunk
• Chest (pectoral)
• Abdomen
• Pelvis and perineum
– Limbs (lower and upper limbs)
• Upper limbs: shoulder tip (acromion), arm (brachium), elbow (cubital),
forearm (antebrachium), wrist (carpus), hand (manus)
• Lower limbs: thigh (femoral), knee (genu), leg (crus), foot (pes)
Anatomical positions
Body planes

3D visualization of the body

 Sagittal Plane

• Plane splitting the body into

two parts (left and right)

• Sagittal section is a cut made

longitudinally along the body

• If it splits into two equal parts =

mid-sagittal
Coronal Plane
• Plane which splits body
into anterior and
posterior section
 Transverse Plane
• Separates body along
horizontal plane

• Also called a cross-section

• Will divide an organism into

superior and inferior parts
 Anatomical terms
• Superior – towards head

• Inferior (caudal) – towards the lower part of a body part

• Anterior (ventral) – front

• Posterior (dorsal) – back

• Medial – toward the midline of the body

• Lateral – Away from the midline

• Intermediate – between a more medial and lateral position

(center)
 Anatomical terms

• Proximal – Closer to the origin of the body part

• Distal – closer to the end of the body part

• Superficial – Toward the body surface

• Deep – Away from the body surface

 Positions and Directions

Prone
• Lying face down
Supine
• Lying face up

Unilateral
• Pertaining to one side of the body

Bilateral
• Pertaining to both sides of the body
 Movements

Flexion
• Bending a joint or decreasing the
angle between two bones

Extension
• Straightening a joint or increasing the
angle between two bones

Hyperextension
• Excessive extension of the parts at a
joint beyond anatomical position.
Flexion & Extension
 Movements
Adduction
• Moving a body part towards the
midline of the body

Abduction
• Moving a body part away from the
midline of the body
Thank you
 Recap of lecture 1

• What is anatomy?
• Name some historical figures?
• In what forms can anatomy be studied?
– Regional anatomy
– Systematic anatomy
• Positions and directions
• Range of motions
Systematic anatomy
Integumentary system
 Introduction
• What is the skin?
• The Skin, sometimes called cutaneous membrane or the
integument
• Forms the continuous external surface
• Largest organ in the body
• Main layers are the epidermis, dermis and hypodermis
• One inch of your skin has approximately 19 million skin cells
and 60,000 melanocytes (cells that make melanin or skin
pigment).
• It also contains 1,000 nerve endings and 20 blood vessels.
• Clinical concerns?
– Burns and carcinomas
 Anatomical classification of skin

• Thin skin:
– Very hairy, e.g. over the abdomen, thigh etc.

• Thick skin:
– Hairless and with several sweat glands,
– e.g. palms of hand and soles of the feet.
Thick and thin skin
 Functions of skin
• The following are the functions of the skin:

– Protection

– Sensation

– Thermoregulation

– Metabolic function

– Excretory and aesthetic function

 Protection
• Note: Protection is optimum when the skin is intact
• Protective barrier against injury
• Fluid and electrolyte balance
– Protection from excessive water loss and dehydration
– Keratinocytes make a protein called keratin which is waterproof
– Sebum retards fluid loss from skin
• Plays a role in electrolyte homeostasis by controlling sodium
excretion
• Physical barrier to protect against invasion by micro-
organisms (fungi, bacteria and fungi)
• Protection from ultraviolet (UV) rays from the sun (vitamin D3
plays a role)
• Sebum has antibacterial properties and hence help to shed of
topical bacteria
 Sensation

• Communication between internal & external conditions

– using sensory receptors

• Largest sensory organ in the body

• Contains variety of sensory receptors and corpuscles

– Nerve endings
– Respond to touch, pressure, pain, chemical changes,
humidity and temperature.
 Thermoregulation
• Regulation of heat loss.
• Body insulated against heat loss by
– the presence of hairs and
– subcutaneous adipose tissue (hypodermal fat).

• Heat loss facilitated by

– Evaporation of sweat from the surface of the skin
(sweating)
– And increased blood flow through the skin
– The rich vascular network of the dermis.
• Shivering
• Reading assignment: Why do neonates easily get
hypothermia? Comment also on their surface area
 Metabolic Function
• Nutrition and storage organ

• Nutrition:
– Synthesis of vitamin D3 in the epidermis
– Also secrete variety of products.

• Storage
– Adipocytes from the hypodermis are stored in the skin
– 5% of blood volume is retained in the skin

• Vitamin D3 produced by the skin supplements that which is

derived from dietary sources.
 Excretory and aesthetic function

• Excretion
– Water, salts, organic wastes (nitrogenous wastes – urea,
uric acid)
– Amount of nitrogenous waste excreted by skin is small
compared with kidneys

• Aesthetic
– Beauty, body image and personality identification
 Identification of individuals

• Finger print
– Each person has a unique fingerprint marking
 Structure of the skin

• All types of skin have the

same basic structure
irrespective of where it is
located
• In the different regions of
the body, skin varies in
– Thickness
– Color and presence of
hair
– Glands and
– Nails
Basic structure of the skin
 Basic structure of the skin

• External surface of skin consists of a keratinized, flattened

epithelium called the epidermis

• The epidermis is supported & nourished by a thick layer of

dense, fibro-elastic tissue called dermis
– The dermis is highly vascular and contains many sensory receptors

• The dermis is attached to underlying tissues by a layer of

loose tissue called hypodermis or subcutaneous layer which
contains variable amounts of adipose tissue.

• Hair follicles, sweat glands and nails are appendages of the

epidermis but they take their origin from the hypodermis
during early development.
 Epidermis
• The epidermis provides tough, outer barrier for the body.
• Keratinized and become very thick in areas that receive use or
wear.
• It is the thinnest layer and is Avascular (no blood vessels)
usually in thick skin
• It is firmly attached to the dermis by a basement membrane
• 5 layers can be distinguished.
– stratum corneum
– stratum lucidum
– stratum granulosum
– stratum spinosum and
– stratum basale (germinativum).
 Epidermis - Layers and cell types
• Stratum corneum: surface layer of the skin and consists of
several layers of dead cells.
• Stratum germinativum (basale): is the germinal layer of
the epidermis
– Whose cells divide to produce the cells in the superficial
layers.
– This layer contains the basal cells (keratinocytes) &
– The melanocytes that produce the pigment melanin.
• Cell types of the epidermis
– Keratinocytes
– Melanocytes
– Langerhans cells
– Merkel’s cells
Layers
 Cell types of the epidermis
1. Keratinocytes (basal cells): predominant cells.
• They occur in the stratum germinativum.
• They undergo differentiation from stratum germinativum to stratum
corneum in a process known as keratinization.

2. Melanocytes
• Rounded cells, scattered among the keratinocytes of the stratum
germinativum.
• They produce the pigment melanin and contribute to skin, eye and hair
color.

3. Langerhan’s cells
• These are star-shaped cells which occur mainly in the stratum spinosum.
• Antigen-presenting cells, initiate cutaneous contact hypersensitivity
reactions (Contact allergic dermatitis).
 Cell types of the epidermis

4. Modified keratinocytes
• These are located in the s.
germinativum.
• They are associated with
mechanoreceptor
mechanisms. And turn to be
numerous in thick skin.
 Clinical implication or correlates - epidermis
• In albinism, melanocytes are inactive and unable to produce melanin.
– Gene recessive.
– Partial or complete absence of melanin
– Absence or defect of tyrosinase, a cupper containing enzyme involved in
the production of melanin
• Melanocytes of albinos are more sensitive to UV radiation and have
greater risks of developing skin cancers
• Albinos mat have eye problems (like photophobia and nystagmus)
• Development of optical system is largely dependent on
• Finger print:
• Stratum basale helps form finger prints
– Embryological basis
• Finger prints shows the pattern of your epidermal ridges
• Finger print are different in identical twins
• Applications
 Class assignment:

Write a short easy describing the mechanism of

bleaching and the layers of the skin that are
affected the most?

State three the health effects of bleaching?

Dermis
 Dermis
• Middle layer of skin
– Border between dermis and epidermis is basement
membrane – Border between dermis and hypodermis not
well defined
• Blood vessels
– Smaller than those in hypodermis
– Capillaries in dermis goes up to the basement membrane
but does not protrude into epidermis.
• Sweat glands
– Eccrine: Extensive distribution; Heat regulation via
sweating
– Apocrine: Activated around puberty; nipple, axilla, groin
 Dermis

• Sebaceous Gland
– Associated with hair follicle and secretes sebum
– Sebum nourishes hair
– Sebum has antibacterial properties
• Hair follicle and shaft
• Arrector pilli muscles
• Lymphatics
• Cutaneous receptors
– Are nerve endings
– Respond to touch, pressure, heat, pain, chemical changes,
humidity, etc.
 Problems or disorders of the dermis
• Sweat from apocrine glands are viscous and contains proteins and fats.
• Body odor is as a result of bacteria acting on sweat (esp. from apocrine
sweat glands)
• Antiperspirants block sweat from glands
– Aluminum ions in antiperspirants are absorbed by cells lining the sweat
glands ducts.
– Water absorption by osmosis follows aluminum ion absorption.
– Epithelial lines that line ducts swell, closing them off.
• A blister occurs when the dermis has been separated from the epidermis.
• Plasma then leaks out of the capillaries and this separation becomes a
fluid-filled pocket.
• Tattoos are difficult to remove because the dyes are injected into the
dermis.
• Scars and stretch marks are also permanent because they involve the
dermis.
• A hereditary disease of the elastic fibres in which the skin does not snap
back into place when stretched is known as cutis elaxa.
 Hypodermis

• Deepest skin layer

• Composed of connective tissue
– Adipocytes (fat storage)
– important in thermoregulation.
– Blood vessel: arteries, veins,
– Lymphatics
• Blood vessels in hypodermis are larger
– Application: you bleed more when you have a deeper cut
Appendages of the skin
 Hair
• 5million hair in an adult human
• Is a thin keratinized structure
• Derived from an invagination of the epidermal epithelium.
• Hair follicles secrete hair, which consists cornified epithelial
cells.
• Color, size and disposition of hair varies
• According to race, color, age, sex and region of the body.
• Each hair is derived from an epithelial invagination known as
the hair follicle, with a terminal dilatation called the hair bulb.
• Two types of Hairs
– Vellus hair: thin soft fine hair; covers limbs and most body parts
– Terminal hair: thicker longer and stiffer; beard, mustache, eyebrows and
head/scalp.
 Scalp hair
• About 100 000 in number
• Grows at a rate of about 1.3cm per month
• Live about 3-4 years
• You loose about 50-100 hairs a day.
– They grow back
– Exception: Male pattern baldness – due to changes in sex
hormones
• Rate of hair loss
– Gender,
– Age,
– Genetics,
– Nutrition
 Clinical correlates of hair

• Hair loss – baldness

• General hair loss or male pattern hair loss
• Causes:
– androgenic alopecia (from dihydrotestosterone)
– male pattern baldness
– Infection – fungal (ringworm)
– radiotherapy
– chemotherapy
– Trauma
– Nutritional deficiency – e.g. Iron, zinc, etc.
– Autoimmune diseases
Nails
• Nails are cornified plates that present on the dorsal surfaces of the terminal
phalanges of fingers and toes and form in nail beds.
• The nail plate consists of a compact layer of highly adherent and keratinized
epithelial cells.
• The thickened epithelial surfaces of the phalanges on which the nail plate rests
are called the nail beds.
• Nails grow in a distal direction, sliding over the skin of the nail bed which is
called hyponychium.
• The hyponychium is continuous with the skin that covers the ventral surface of
the digits.
• The nail body shows near the root, a white, crescent-shaped area called lunula.
• The proximal part of the nail which is hidden in the nail groove is known as the
nail root.
• Epithelial proliferation and differentiation which gradually produces the nail is
the nail root.
• The nail root acts as a support for growing nails.
• The horny epidermal extension of the tip of the proximal nail fold is called the
eponychium or cuticle
• Hair and nail both formed from epidermis through the process of keratinization
• but nail is generally seen as broad, flat hairs.
 Correlates of the nails

• Broadly
– Surface texture abnormalities
– Nail color changes
– Defects of nail plate attachment shedding
– Nail thickening and periungual tissue
– Skin disorders with nail involvement
– Nail disorders relating to cosmetics
– Benign and malignant tumors
• Clubbing
• Ingrown toe nail
• Brittle nails
• Onycholysis
• Paronychia
• Psoriasis
• Onychomycosis
Sweat glands
 Sweat glands

• Sweat glands are either eccrine or apocrine glands.

• Eccrine sweat glands cool the skin and are independent of
hair follicles.
• The secretion of eccrine glands is known as perspiration.
– clear, hypotonic solution containing various electrolyte.
• Apocrine sweat glands are associated with hair follicle.
• They secrete a watery substance containing proteins,
carbohydrates, ammonia, lipids and fatty acids.
Sebaceous glands
 Sebaceous glands

• Sebaceous glands secrete an oily substance

• That lubricates and protects the skin.
 Burns

• Caused by heat, chemical, electricity, friction etc.

• Types of Burns:
– First degree affects epidermis only and are also known as
superficial burns
– Second degree affects epidermis and dermis and are
known as partial thickness burns
– Third degree affects epidermis, dermis and hypodermis
and are known as full thickness burns. These will require a
skin graft
– Fourth degree affects epidermis, dermis, hypodermis,
muscles, bones and have a high risk of leading to deaths or
recovery with significant lifelong disabilities
 Changes in skin color

• Bleu skin – cyanosis

– Heart failure, poor circulation, severe respiratory problems
• Yellow skin – Jaundice
– Liver disease
• Red skin – Erythema
– Inflammation, fever, allergy
• Pale or white skin (pale palm, sole of feet, & face)
– Anaemia, anxiety,

• Artificial: Bleaching
 Group assignment

Divide yourselves into 12 groups with 10 people

per group. Submit a report on the below
question on Friday, 5th February, 2023

Discuss seven (7) problems that patients with

burns are likely to experience and explain the
mechanism?
Questions?