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Home , Integumentary system

Chapter 1 An Introduction to the Body What Is and Physiology?

• Anatomy: – The study of the structure and shape of the body and the relationships among structures • Physiology: – The study of the functions of the body parts. Anatomy Subdivisions

• Surface anatomy: – Morphology and markings on the surface of the body • Gross anatomy: – Study structures without using microscope • Systemic anatomy: – Study structure of specific system, e.g • Regional anatomy: – Study specific region, e.g head, chest Anatomy Subdivisions

• Radiographic anatomy: – Study the structures of the body using x-ray • Developmental biology: – The development of the body, fertilized egg to adult • Embryology: – Study of development from fertilized egg through the eighth week in utero Anatomy Subdivisions

• Histology: – Microscopic study of the structure of tissues • Cytology: – Chemical and microscopic study of cell structure • : – Gross or microscopic structural changes Physiology Subdivisions • Cell physiology: – Study the functions of cells • Pathophysiology: – Functional changes associated with disease and aging • Exercise physiology: – Study of changes during muscular activity • Neurophysiology: – Functional characteristics of cells Physiology Subdivisions

• Endocrinology: – Hormones and how they control the body functions • Cardiovascular: – Function of the and blood vessels • Immunology: – Body defense mechanism • Respiratory physiology: – Function of air passageways and • Renal physiology: – functions of the kidneys Levels of Structural Organization

• Several structural levels: – Chemical, cellular, , ,system, organism 1. Chemical level: – Smallest components, atoms and molecules – Essential atoms to maintain life:C,H,O,N,Ca,P,Ca, S – Molecules: proteins, carbohydrates, , vitamins 2. Cellular level: • Molecules combine to form cells that vary in size, shape, and function • Cells are the basic structural and functional units of organisms e.g. muscle, nerve, blood cells • Cells contain organelles Levels of Structural Organization 3. Tissue level: – Group of similar cells have common function – Four basic tissue types: • epithelial, muscle, connective, nervous tissue. 4. Organ level: – Two or more different types of tissue make an organ – Have a specific function and shape – Example: heart, , brain…etc. Levels of Structural Organization

5. System level (): – Group of organs cooperate to a accomplish common purpose • 11 organ system (Integumentary, Skeletal, Muscular, nervous, Endocrine, Cardiovascular, lymphatic, Respiratory, digestive, urinary, reproductive) 6. Organismic level: – One living individual – All body parts functioning together Levels of Structural Organization Anatomical position

• The subject erect and facing the observer • The head level, and eyes facing forward • The feet flat on the floor and forward • The arms placed at the sides with palms turned forward Superior (cranial or Toward the head body; The nose is Superior to the Cephalad) above mouth Inferior Toward the lower part of The mouth is inferior to the (Caudal) the body nose Anterior (ventral) Toward the front of the Breastbone anterior to the body spine Posterior Toward the back of the The heart posterior to the (dorsal) body breastbone Medial Toward the midline of the Breastbone medial to the body Lateral Away from the midline of The nipples lateral to the the body breastbone Proximal Close to the origin Elbow is proximal to the wrist Distal Away from the origin Knee is distal to thigh Superficial Toward the body surface is superficial the skeleton Deep Away from the body Skeleton are deep to the skin surface; more internal Cranial Proximal Anterior

Lateral • Planes: Imaginary flat surfaces pass through body parts Planes and Sections • Sagittal plane: Vertical plane divides the body into right and left – Midsagittal plane: Divides the body into equal right and left halves – Parasagittal: Divides the body into two not equal halves • Frontal or coronal plane: – Divides the body into anterior and posterior • Transverse plane: Divides the body into superior and inferior Planes and Sections

• Sagittal, frontal, and transverse planes are perpendicular to each other • Oblique plane, passes through the body or an organ at an angle between the transverse plane and Sagittal or frontal plane. Body Cavities

• Cavities are confined spaces within the body that contain internal organs • Cavities may be separated by muscles, , or ligaments • Two main cavities: dorsal and ventral • Dorsal cavity: located near the back and subdivided into: 1. Cranial cavity contains the brain 2. Vertebral canal contains the Body Cavities

• Ventral cavity subdivided by the diaphragm to – : Contains lungs, heart, , , , and large blood vessels – Abdomenopelvic cavity: Extend from the diaphragm to the groin • Contains , , , gallbladder, , , , portion of large intestine, internal organs of . Thoracic and Abdominal Cavity Membranes

• Membranes cover the viscera and line the walls of the thorax and abdomen • Pleura: covers the lungs • Pericardium: covers the surface of the heart • Peritoneum: covers the abdominal viscera and lines the abdominal wall – Retroperitoneal: located behind the parietal peritoneum such as kidneys, adrenal , • 4 lines divide the abdominal Abdominopelvic Regions cavity into 9 regions • 2 horizontal lines – Subcostal line: Drawn inferior to the cage across the inferior portion of the stomach – Transtrabecular line: Drawn inferior to the tops of the hip bones • 2 vertical lines: – left and right midclavicular lines – Drawn through the mid point of the medial to the Nine Abdominal Regions Quadrants • Vertical and horizontal lines pass through the umbilicus and divide the into 4 quadrants – RUQ, RLQ, LUQ, LLQ – used by clinical staff to locate Abdominopelvic pain, tumor or other abnormality Clinical quadrants of Abdomen • Right upper quadrant-RUQ – Liver (main) – Gallbladder – Head of pancreas – Colon – Right • Left upper quadrant- LUQ – Liver (tip) – Spleen – Left kidney – Stomach – Colon

Lower quadrants of Abdomen • Right lower quadrant- RLQ – Colon, ascending – Small intestines – Right – – Bladder • Left lower quadrant-LLQ – Sigmoid colon – Left Ureter – Small intestines – Aorta – Bladder Match the term with the definition

Organism Cells Tissue Organ System

1. Similar cells act together to perform a common function 2. Group of organs cooperate to accomplish common purpose 3. Tow or more different tissues arranged to perform a special function 4. Smallest living unit of structure and function in the body 5. Denotes a living thing Match the term on the left with the Anatomical position on the right

1. Arms A. Erect 2. Eyes B. At the sides 3. Head C. Flat on the floor 4. Feet D. Level 5. Body E. Facing forward Select the correct answer

Superior Inferior Anterior Posterior Lateral Medial Proximal Distal Superficial Deep

1. The Ankle is _____ to the knee 2. The Nose is _____ to the 3. The Backbone is ____ to the heart 4. The Nose is _____ to the chin 5. The Stomach is ____ to diaphragm 6. The Nose is located on the ______surface of the body 7. The Lungs are ____ to the heart 8. The Elbow is ______to the wrist 9. The Skin is ______to the bones 10. The Bones is ______to the skin Match the term on the left with the definition on the right

1. Coronal plane A. Divides the body into equal 2. Midsagittal plane parts 3. Transverse plane B. Divides the body into anterior and posterior sections 4. Sagittal plane C. Divides the body into superior 5. Frontal and inferior sections D. May also be referred to as coronal plane E. Divides the body into unequal parts Label The Body Cavities Indicate whether the cavities belong to the ventral or dorsal body cavities 1. Thoracic A. Ventral 2. Abdominal B. Dorsal 3. Mediastinum 4. Cranial 5. Pelvic 6. Spinal 7. Pleural Name the Abdominopelvic regions Place the following organs in the appropriate abdominopelvic region

1. Appendix 2. Kidneys 3. 4. Small intestine 5. Urinary bladder 6. 7. Stomach 8. Pancreas 9. Gallbladder 10. 11.Spleen Name the Quadrants Place the following organs in the appropriate Quadrant

1. Sigmoid colon 2. Aorta 3. Left Ureter 4. Small intestines 5. Left Ureter 6. Bladder 7. Right Ureter 8. Ascending Colon 9. Appendix Multiple Choice Questions

1. Which one of the following structures is not located in the abdominal cavity? a. Liver b. Spleen c. Urinary bladder 2. Which of the following is not an abdominopelvic region? a. iliac region b. lumbar region c. Pancreatic region 3. The dorsal body cavity contains components of the ____system. a. Reproductive b. Respiratory c. Nervous 4. The buttocks area is called. a. Sacral b. Lumbar c. Gluteal 5. A study of the functions of living organisms is called. a. Physiology b. Chemistry c. Biology Multiple Choice Questions 6. Which of the following organs or structures does not lie within the mediastinum? a. Aorta b. Liver c. Esophagus 7. In the anatomical position. a. The dorsal body cavity is anterior to the ventral. b. The palms face toward the back of the body. c. The body is erect. 8. In the , the chest region is also called : a. The thoracic cavity c. The dorsal body cavity. b. The ventral body cavity. Chapter 2 Chemistry • Synthesis Reactions- Anabolism A + B  AB – Reactants: A, B – Product: AB – Synthesis = anabolism – Example: amino acids  protein • Decomposition Reaction- Catabolism AB  A + B – Decomposition reaction = catabolism – Example: Digestion of food Chemical Compounds

• Inorganic compounds: – Small simple structure – Lack Carbon – Example: , salt, acids, base…etc. • Organic compounds: – Always contain carbon – Example: carbohydrates, , proteins, ATP. Carbohydrates

• Sugars, starch, glycogen, cellulose • Source of energy • Structural units (DNA) • Stored as glycogen in liver and • Divided into three groups – Monosaccharides: Contain 3 to 7 carbon atoms. – Disaccharides: 2 monosaccharides • Glucose + Fructose Sucrose + H2O (dehydration). – Polysaccharides: Contain 10 or more monosaccharides, glycogen ( glucose monomer) Lipids • Organic compounds • Types: – Triglycerides, Phospholipids, Steroids, Eicosanoids ( 20 carbon ), Fatty acids, Fat soluble vitamins, Lipoproteins • Triglycerides: – Saturated fat (saturated with H atoms) • Solid at room • Mostly in animals, also in few plant product (Coconut oil). – Unsaturated fat • liquid in room temperature Proteins

• Amino acids: – Building blocks of protein. Select the best answer

Carbohydrate lipid Protein Nucleic acid

1. Monosaccharide 6. Glycogen 2. Triglyceride 7. Sucrose 3. DNA 8. Phospholipids 4. Cholesterol 9. RNA 5. Amino acids Multiple choice questions

1. Which of the following is an inorganic compound a. Carbohydrate b. Lipid c. Protein d. Water 2. Which of the following processes requires oxygen and generate more energy a. Anaerobic. b. Aerobic. 3. Which of the following does not contain carbon atom a. Inorganic compounds b. Organic compounds 4. Which of the following is considered a synthesis reaction a. Anabolism b. Catabolism Cells & Tissues Anatomy of The Cell

• Cells are the building block of living things – Plants, animals • All cells have three main regions 1. Nucleus 2. Plasma membrane 3. Cytoplasm Plasma Membrane

• Also called cell membrane • Flexible, fragile outer membrane. • Two layers of lipid separate intracellular components from extra cellular environment • Allows passage of several types of lipid soluble molecules • Acts as a barrier to the entry or exit of polar substances • Has a dynamic role in many cellular activities • Plays a key role in communication. • Site of most cellular activities cytoplasm • Has three major elements • Cytosol: – Semitransparent fluid that suspends other elements – Made of water, nutrients, and solutes • Organelles • Inclusions: – Temporary structures in the cytoplasm, may or may not be present • Means little organs Organelles • Specialized structures have characteristic appearance and specific roles in cellular growth, maintenance, reproduction • Each organelle has set of enzymes to carry out specific reactions • Example: Nucleus Mitochondria

• Main site to generate ATP • Active cells have large number of mitochondria Ribosomes

• Small granules • The site of protein synthesis • Can be free or attached to endoplasmic reticulum Endoplasmic Reticulum

• Membrane-enclosed channels called cisterns or cisternae • The channels carry substances from one part of the cell to another • Two types: • Rough ER: Studded with ribosomes, synthesize proteins • Smooth ER: Has no ribosomes, synthesize steroids, phospholipids, fatty acid Golgi Complex

• Located near the nucleus • Consist of 3-20 curved cisternae • Modifies, sorts, and packages proteins for transport to different destinations. Lysosomes

• Membrane enclosed vesicles contain digestive enzymes that break down a variety of molecules; bacteria, harmful substances …etc • Abundant in WBC • Lysosomal rupture result in self-digestion of the cell Cytoskeleton

• Complex internal network of filamentous proteins in the cytoplasm • Provides structural framework for the cell • Responsible for movement of a whole cell, movement of organelles, and some chemicals within the cell Centrioles

• A pair of cylindrical structure perpendicular to each other • Lie close to the nucleus • Involved in cell division Movement of Materials a Cross the Plasma Membrane

• Passive – No energy required • Active – Require energy ATP • Diffusion – Particles diffuse from high concentration to low concentration until they reach equilibrium; no further diffusion – Random mixing of ions and molecules in a solution due to their kinetic energy – The driving force is kinetic energy • Filtration: – Water and solute are forced through a membrane by fluid or hydrostatic pressure Factors Influence the Diffusion

• Temperature: – the higher the temperature, the faster the rate of diffusion • Concentration gradient: – The greater the difference in concentration between the two sides the higher the rate of diffusion • Mass: – Smaller molecules diffuse faster than large ones • Surface area: – The larger the surface area available , the faster the diffusion rate • Diffusion distance: – The greater the distance over which diffusion must occur, the longer it takes Osmosis

• Diffusion of water through a selectively permeable membrane • From High water concentration (the solutes concentration is lower) to a lower water concentration (solute concentration is higher) • Osmotic pressure – The pressure required to stop movement of pure water into a solution containing solutes when the two are separated by membrane permeable only to water – The higher the concentration of solutes, the higher the osmotic pressure of a solution. Active Processes

• Require protein carrier (solute pumps) • Use ATP to energize a protein carrier • Each of the pumps in the plasma membrane transports only specific substances • In most cases substances move against their concentration gradients; example: – Amino acid, sugar, ions – Example sodium- potassium pump Na-K pump

• Expel Na ions out against its concentration gradient • Bring K ions in against its concentration gradient • Sodium-potassium pump ensures that cells do not shrink or swell due to osmotic movement of water out of or into the cells by osmosis • Phagocytosis – Pseudopods (projections of plasma membrane) surround and engulf the particles – Phagocytes: Neutrophils, macrophages – Phagocytosis is vital defense mechanism; protection • Exocytosis: – Secretory vesicles formed inside the cell are released into the • Nerve cells release neurotransmitters • Secretory cells, secretes digestive enzymes, hormones such as insulin. Type of Tissues 1. 2. Muscle tissue 3. Nerve tissue: – Detects changes inside and outside the body – Generates impulses 4. Epithelial tissue: – Covers body surfaces – Lines hollow organs, body cavities and ducts – Forms glands e.g. sweat glands Connective Tissues • Protect and support body and organs • Store fat • Connect body parts • Connective tissue do not occur on the body surface • Highly vascular, exception ( avascular, and ligaments poor blood supply) • Have nerve supply, except for cartilage • Connective tissue consist of matrix and cells: – Matrix: • Fill the spaces between cells • Secreted by the connective tissue cells • Consist of protein based fibers and ground substance Cell in Connective Tissue • Fibroblasts: – Most numerous cells in connective tissue – Secrete fibers and ground substance of the matrix • Macrophages – Develop from monocytes – Function: Phagocytosis • Plasma cells: Develop from B and Secrete antibodies • Mast cells: Produce histamine • A adipocyte – Fat cells, found below the skin and around organs – Example: heart, kidneys • White blood cells: Found in blood Types of Connective Tissue • 1. Areolar connective tissue • Widely distributed, cushions and protects the organs • Consist of loosely intertwined fibers and many cells 2. : • Stores Triglycerides, forms beneath the skin, and protects and supports organs (kidney, eye), reduces heat loss, energies reserve 3. Reticular connective tissue: • Fine reticular fibers and reticular cells form the stroma (supporting framework) of the liver, spleen and lymph nodes, and help bind together smooth muscle cells Types of Connective Tissue

• Dense connective tissue • A lot of fibers give strength to the structure • Elastic connective tissue • Elastic fibers confer Elasticity- lungs, • Tissue: Two types 1. Spongy: contains red 2. Compact bone • Blood Tissue – Liquid matrix (blood plasma): pale yellow fluid consists mostly of water, and dissolved substances (nutrients, wastes, enzymes, plasma protein, hormone, gases, ions) – Suspended in the blood plasma: RBC, WBC, platelets • Cartilage: three types of cartilage: 1. Hyaline cartilage: – Most abundant and the weakest of the three types – Appears as bluish-white shiny substance – Supports structures of , , end of bones ( ) 2. Fibrocartilage: – Combines strength and rigidity – The strongest of the three – Found in the Intervertebral disc. 3. Elastic cartilage: – Provides strength and elasticity; maintain shape and structure – Found in the external ear • Muscle Tissue – Elongated cells called muscle fibers – Produce movement, maintain posture, generate heat – Three types: 1. Skeletal: • Usually attached to bones of the skeleton, skin • Voluntary muscles 2. Smooth • Located in the wall of hollow internal structures; blood vessels, airways, stomach, gallbladder, urinary bladder • Involuntary; Peristalsis a wavelike motion -> move food 3. Cardiac muscle: • The heart muscle, involuntary • Two types of cells • Neurons: consist of three Nervous Tissue basic parts – Cell body Contain nucleus and other organelles – Axons: Single long thin cylindrical process – Dendrites: Short highly branched processes • Neuoraglia: Have supportive function Tissue repair (wound healing)

• Two major ways to heal wounds Regeneration: – Replacement of destroyed tissue by the same kind of cells 1. Fibrosis: – Repair by dense fibrous connective tissue  scar tissue • Clean cuts heel faster than ragged tears. Cells and Aging

• Geriatrics: – A branch of medicine deals with the medical problems and care of elderly person Label the cell structures

1. Cytoplasm 2. Plasma membrane 3. Cytoskeleton 4. Nucleus 5. Ribosomes 6. Mitochondria 7. Lysosome 8. Golgi apparatus 9. Cilia 10. Rough Endoplasmic reticulum 11. Smooth Endoplasmic reticulum Match the terms with the correct definition

1. Power plants. A. Cytoplasm 2. Contain digestive enzymes. B. Plasma membrane 3. Component of plasma membrane C. Golgi apparatus 4. Controls the cell and contains DNA D. Lysosomes 5. Consists of Cytosol, organelles, and inclusion E. Endoplasmic bodies reticulum 6. Involved in cell reproduction F. Nucleus 7. Surrounds and serves as a boundary for cells G. Ribosomes 8. Processing and packaging center H. Cholesterol 9. Make proteins I. Centriole 10. Smooth and rough J. Mitochondria 11. like extensions on the free surfaces of K. Cilia the cell Match the term with the correct definition

1. Controls the body A. Epithelial tissue 2. Contracts to move B. Muscular tissue substances C. Connective tissue 3. Connects between organs D. Nervous tissue 4. Covers body surfaces and lines body cavities and hollow organs Multiple Choice Questions

1. The energy required for active processes is obtained from: a. ATP b. DNA c. Cilia 2. Movement of substances from high concentration to low concentration is called a. Active transport b. Passive transport c. Cellular energy 3. Osmosis is the ______of water. a. Filtration b. Active transport c. Diffusion 4. Always occurs down a hydrostatic pressure gradient. a. Osmosis b. Filtration c. Dialysis 5. The uphill movement of a substance through a living cell membrane is: a. Diffusion b. Active process c. Passive process 6. A red blood cell becomes engorged with water and will eventually lyse, releasing hemoglobin into the solution. This solution is what to the RBC a. Hypotonic b. Hypertonic c. Isotonic • Body membranes Body membranes

• Classified into two types: 1. Epithelial membranes 2. Connective tissue membranes Epithelial membranes

• Consist of: – Epithelial sheet – Underlying layer of connective tissue • Three type 1.Cutaneous membrane (skin) 2.Mucus membrane (mucosa) 3.serous membranes (serosa) Cutaneous Membrane (Skin)

• dry membrane • exposed to air • Composed of: – Superficial : – Deep : Mucus Membrane (Mucosa)

• Line all body cavities that open to the exterior (GI, respiratory, urinary, reproductive • Secret mucus Serous Membranes (Serosa)

• Line closed body cavities ( except and dorsal body cavities) • Has two layers separated by a thin clear fluid called serous fluid; help in lubrication • Specific names 1. Peritoneum: line the abdominal cavities and its organs 2. Pleural: line the thorax and surrounds the lungs 3. Pericardium: in the thorax surrounds the heart Synovial membranes

• Line the fibrous capsules surrounding joints, bursae, sheaths. • secrete lubricating fluid providing smooth surface Integumentary System Integumentary System

• Definition: – Skin and its accessory structures – hair, nails, sweat, and oil glands. – Integument means covering • Largest organ • Has the largest surface area and weight, covers two square meters in adults • Have 2 main parts: 1. Superficial epidermis 2. Deep dermis Function of the Skin • Thermoregulation: – Heat loss : activating sweat glands and allowing blood to flush into skin capillary bed – Heat retention: blood not flushing into skin capillary bed • Protection: – protects us from microbes, abrasions, heat, chemicals – Acidic pH of retarded growth of microbes – Melanin provide protection against UV light – Macrophages in the dermis phagocytize bacteria, viruses • Sensations: – touch, pressure, vibration, tickling, temperature, pain • : – Water, small amount salts, CO2, ammonia, urea • Absorption: – Lipid, drugs, toxic materials (acetone) • Synthesis of • from superficial to deep: 1. : Epidermis – Outermost layer, contain dead that shed and replaced by cells from deeper strata – Callus: abnormal thickening of the stratum corneum 2. : – found in thick hairless skin only; palms and soles 3. 4. 5. : – Deepest layer – The cells divide to produce new keratinocytes; daughter cells are pushed upward toward the surface Dermis

• Deeper layer • Vary in thickness (feet, eyelids) • Strong and stretchy; helps hold the body together • Contains fibers, cells, blood vessels, , glands, , embedded in dermis Skin Color

• 3 pigments: Melanin, Carotene, Hemoglobin. • Melanin: – The color vary from pale yellow to tan to black – Exposure to UV increase melanin production – Number of is about the same in all people • Carotene: – Yellow-orange pigment, a precursor of vitamin A. • Hemoglobin: – Red color Imbalance

• Cyanosis: blue • Erythema: redness • Pallor: blanching • Jaundice: yellow cast • Bruises: black and blue marks Skin Types

• Thin skin ( hairy): – Covers all all parts of the body, except palms, palms surfaces of the digit, and soles – Contains hair follicles, arector pili and • Thick skin: – Covers the palms, palmer surface of the fingers, and soles – Thick epidermis – Lack hair follicles, , sebaceous glands. – More sweat glands and sensory receptors. Accessory structures of the skin

• Hair and hair follicles • Skin gland • Nails Skin glands

• Sebaceous glands – Found all over the skin except on the palms and soles – Secrete sebum. The sebum function: • Coats hair surface, prevents excessive evaporation from skin – active in adolescence – : active of sebaceous glands • Sweat glands – Secret sweat; – Sweat function: • inhibit bacterial growth, regulates body temperature, eliminating waste • Insensible perspiration: sweat evaporates before it is seen as moisture • Sensible perspiration: sweat excreted in large amounts; seen as moisture Anatomy of Hair • Shaft: – Superior portion of the hair – Project from the surface of the skin • Root: – Deeper to the shaft – Penetrates into the dermis Anatomy of Hair

• Hair follicle. – Surrounds the root of the hair • Hair bulb matrix – Involved in hair growth • Smooth muscle: arrector pili. – Extend from the dermis to the side of the hair follicle – Contraction cause goose bumps Hair color

• Color is due to the amount and type of melanin in its keratinized cells • Dark colored hair contains mostly true melanin • Blond and red hair contain variants of melanin with more iron and sulfur • Gray hair results from decline in tyrosinase • White hair result from air bubbles in the medullary shaft Functions of Hair

• Protection from sun ray • Decrease heat loss from the scalp • Protect from foreign particles: – Eyebrows, eyelashes, hair in the nostrils, external ear canal • Sensing light touch Nails

• packed keratinized epidermal cells • body: the visible attached portion • Free edge • Nail root: embedded in the skin. • Nail folds: nail borders overlapped by skin folds • : the thick proximal nail fold • Nail bed: the epidermis beneath the nail • : the white crescent • Function: grasp, protect digits, scratching Burns

• tissue damage and cell death caused by intense heat, electricity, UV radiation (), chemicals (acids) • Degree of Burns – First degree: • Epidermal damage only red and swollen • Not serious, heals within two to three days • Example: sunburn – Second degree • Injury to the epidermis and the upper region of the dermis • Red painful skin, blisters • No permanent scars – Third degree • Destroy the entire thickness of the skin • Not painful; black area • Regeneration is not possible First degree (partial thickness) Second Degree First & second degree burns Third degree (full thickness) Third degree burns Skin • Basal cell carcinoma – Least malignant – Most common – Slow-growing, rarely metastasize to other tissues – Surgically removed • Squamous cell carcinoma – Grows rapidly and metastasize to adjacent lymph nods – Removed surgically or radiation therapy, good prognosis • Malignant Melanoma – Cancer of melanocytes – Metastasize rapidly to surrounding lymph and blood vessels – Poor prognosis Risk factors for

• Overexposure to UV • Frequent skin irritation (, chemicals, physical trauma) • Skin type: lighter skin = higher risk • Family history: Genetics plays some role • Age: older = longer exposure. • Compromised immune systems means greater risk ABCDs rule for recognizing melanoma Scar Tissue vs. Normal tissue

• Scar tissue has – Fewer blood vessels – Densely arranged fibers – Do not have the same number of hair, skin glands, sensory structures Integumentary System

Epidermis Arrector pili muscle Hypodermis Hair Bulb Dermis Hair shaft Hair root Sebaceous gland Match the term with the correct answer

1. Outer most layer of skin 2. Deeper of the two layers of the skin A. Hypodermis 3. Allow for rapid absorption of injected B. Arrector pili muscle material C. Epidermis 4. Protective protein D. Dermis 5. Brown-black pigment E. Melanin 6. Also called subcutaneous F. Keratin 7. Contains hair follicle, sweat and sebaceous glands. 8. Tightly packed epithelial cells 9. Connective tissue 10. Goose bumps List three important functions of the skin

1. ______2. ______3. ______Match the term with the correct answer

1. Most abundant sweat glands A. Eccrine glands 2. Located in the axilla, men B. Apocrine glands beard, genitalia C. Sebaceous glands 3. Secret oily substance Label the Nail structures

Nail fold Lunula Nail bed Cuticle Nail root Nail body Free edge Match the part of the Nail with the appropriate definition

1. Visible portion of the nail A. Nail fold 2. Embedded in the skin. B. Lunula 3. Nail borders overlapped by skin C. Nail bed folds D. Cuticle 4. Thick proximal nail fold E. Nail root 5. Epidermis beneath the nail F. Nail body 6. White crescent List two function of the Nail

1. ______2. ______Match the term with the correct answer First degree burn Second degree burn Third degree burn

1. A typical sunburn may be classified as ______2. Blister are typical of a ______3. A burn that is insensitive to pain immediately after injury because of the destruction of nerve endings is most likely a ______4. Partial-thickness burns is a ______5. Burn affect only the epidermis is ______. 6. A burn affecting all the skin layers and the hypodermis is a ______Skeletal System Division of the Skeletal System

• Axial skeleton – 80 bones – Consist of bones arranged along the axis • Appendicular skeleton – 126 bones – The bones of the limb and girdle Functions of Bone

• Support and protect soft tissue (cranial bone, vertebrae, rib cage) • movement : the attached skeletal muscles contract and pull the bones which result in movement • Release and store minerals into the blood ( Ca, P) • Red bone marrow produce blood cells and platelets • Store TG • In the newborn, all bone marrow is red and is involved in homopoiesis • Changes to yellow bone marrow with increasing age Bone cells

Osteoblasts Osteoclasts Osteocytes Classification of bones

• Two types of bone tissue: 1. Compact bone: • Dense, smooth, and homogeneous 2. Spongy bone: • trabiculae ( needle like pieces ) and lots of open spaces • Bones sizes and shapes 1. Long bone. 2. Short bone. 3. Flat Bones. 4. Irregular Bones. 5. Sesamoid Bones Long Bones.

• Longer than wide • Consist of: – Shaft, contains compact bone – Heads at both ends, contain spongy bone • All the bones of the limbs are long bones except the wrist and ankle bones • Example , , …etc. Short Bones.

• Cube – shaped. • nearly equal in length and width. • Consist of spongy bone covered by a thin layer of compact bone Short Bone • Example: bones of the wrist and the ankle Flat Bones. Flat Bones,

• Thin, flattened and usually curved • composed of 2 parallel plates of compact bone tissue enclosing a layer off spongy bone • Example: most cranial bones, ribs, sternum. Irregular Bones.

• Complex shape. • Contain various amount of compact and sponge bones. • Example: vertebrae, hip. Irregular Bones. Long bone structure

• Compact bone • Spongy bone • Articular Cartilage • Matphysis • Medullary cavity • Epiphysis • Diaphysis Factors Affecting Bone Growth

• Adequate dietary intake of vitamins and minerals – calcium, phosphorous, fluoride, magnesium, iron, manganese, Vitamin C (collagen synthesis), K, B12 (protein synthesis), A (stimulates Osteoblasts activity) • Rickets: – the bone fails to calcify  soft bone  bowing – Lack of Ca, or vit D Cranial Bones Cranial Bone Facial Bones Nasal Septum • Divide the nasal cavity into left and right sides • Consist of three bones and cartilage Sutures

• Four Sutures: 1. Coronal: unites frontal bone and both parietal bones 2. Sagittal: unites the two parietal bones 3. Lambdoid: unites both parietal bones to the occipital bone 4. Squamous: unites the parietal and temporal bones on the lateral aspect on each side of the Fontanels

1. Anterior fontanel: between parietal bones and frontal bones 2. Posterior fontanel: between parietal bones and occipital bone 3. Two anterolateral: located laterally between frontal, parietal, temporal, and sphenoid bones 4. Two posterolateral: located laterally between parietal, occipital, and temporal bones. Hyoid Bone

• Single bone does not articulate with any other bone • Suspended in the anterior neck between and larynx • Consist of – Body – Lesser horns – Greater horns

• Flexible, can move forward, backward, sideways, and rotate • Encloses the spinal cord • Supports the head • Provides point of attachment for ribs, pelvic girdle, muscles of the back • Contains 26 vertebrae: – 7 cervical – 12 thoracic – 5 lumber – 1 sacrum – 1 coccyx. Thorax, Thorcic Cage • formed by the sternum, coastal cartilages, ribs, bodies of the thoracic vertebrae. • Flattened from front to back • narrower superiorly and broader inferiorly • Protects thoracic organs and superior abdominal cavity • Provides support for the bones of the shoulder girdle and upper limbs Pectoral (Shoulder) Girdle

• Two pectoral girdle. • Each girdle attach the upper limbs to axial skeleton. • Consist of two bones: – Clavical anteriorly. – Scapula posteriorly. Upper Limb

• Consist of: – – – – 8- carpals – 5- metacarpals – 14 phalanges Elbow Joint

• The head of the radius articulate with the Capitulum of the Humerus • Trochlear notch of the ulna receive the Trochlea of the Humerus. Carpals

• Carpals arranged in two transverse rows; 4 bones each • Proximal row • form lateral to medial: scaphoid, lunate, triquetrum, pisiform • Distal row from lateral to medial trapezium, trapezoid, capitate, hamate. • Most fractures in Scaphoid Pelvic (Hip) Girdle • Two hip bones • Bony : – pubic symphysis, sacrum, hip bones • Hip bone consist of 3 bones – Ilium: Superior – Pubis: Inferior and anterior – Ischium: inferior and posterior Lower Limb

• Each lower limb consist of: 1. Femur 2. 3. Tibia 4. fibula 5. 7 tarsals 6. 5 metatarsals 7. 14 phalanges Tarsal Bones

• Calcaneus: • Cuboid bone • Navicular • cuneiform bones • Talus bone • Intertarsal joints: Bone Fracture

• Simple or closed fracture: – Does not break the skin • Open (compound) fracture: – Broken ends protrude through the skin • Comminuted fracture: – Splinters and small bone fragments lie between the two main fragments • Greenstick fracture – One side of the bone is broken, the other side bends ( in children) • Impacted fracture – one end is forcefully driven into the interior of the other • Pott’s fracture: – Distal end fracture of fibula with serious injury of the distal tibial articulation • Colles’fracture: – Distal end fracture of radius – The distal fragment is displaced posteriorly • Stress fracture: – Microscopic fissures in bone the without evidence of injury to other tissues – Result from repeated strenuous activity; running, jumping…etc. Exercise and Bone Tissue

• Increase mineral salts deposition and production of collagen fibers – athletes bones are thicker and stronger • Without mechanical stress – Affect mineralization and decreased number of collagen fibers Label the long bone structures

Compact bone Spongy bone Articular Cartilage Matphysis Medullary cavity Epiphysis Diaphysis Match the term with the correct answer 1. Dense bone tissue A. Compact 2. Covering the ends of long B. Spongy bones C. Periosteum 3. Hollow area inside the D. Cartilage Diaphysis of a bone. E. Medullary cavity 4. Bone with spaces in it F. Red bone marrow 5. Blood cell formation 6. Fibrous tissue covering the bone Identify the bone cells Match the bone cell with its function

1. Maintain the bone A.Osteoblasts 2. Destruct the bone B.Osteoclasts 3. Make the bone C. Osteocytes Label the Bones

• Parietal • Maxilla • Sphenoid • Mandible • Frontal • Occipital • Zygomatic • Sacrum • Coccyx Label the Bones

• Cervical vertebrae • Lumbar vertebrae • Thoracic vertebrae • Sacrum • Coccyx Label the Bones

• False ribs • Sternum • True ribs • Floating ribs Label the Bones

• • Ulna • Humerus • Scapula • Radius • Carpals • Metacarpals • Phalanges Label the Bones

• Tibia • Femur • Ilium • Ischium • Pubis • Patella • Fibula • Tarsals • Metatarsals Multiple Choice Questions

1. There are ______types of bone a. 1 b. 2 c. 3 d. 4 2. Which one of the following is not a part of the axial skeleton? a. Scapula b. Vertebra c. Ribs d. Sternum 3. Which one of the following is not a cranial bone? a. Frontal b. Parietal c. Sphenoid d. Mandible 4. The bone that runs along the lateral side of your forearm is the: a. Humerus b. Ulna c. Radius d. Tibia 5. The shinbone is also known as the: a. Fibula b. Femur c. Tibia d. Ulna 6. The bones in the palm of the hand are called: a. Metatarsals b. Tarsals c. Carpals d. Metacarpals Multiple Choice Questions

7. Which one of the following is not a bone of the upper extremity? a. Radius b. Clavicle c. Humerus d. Ilium 8. The bone that runs along the medial side of your forearm is the a. Femur b. Ulna c. Humerus d. Carpal 9. There are pairs of true ribs. a. 14 b. 7 c. 5 d. 3 10.The longest bone in the body is the: a. Tibia b. Fibula c. Femur d. Humerus 11.The ______bones form the cheek bone a. Mandible b. Frontal c. Zygomatic d. Nasal Apply Your Knowledge

1. A 60 year old female noticed when she went in for her physical examination that she was a half-inch shorter than she had been on her last visit. Here doctor suggested she begin a regimen of dietary supplements of calcium and vitamin D. What bone disease did the patient has.

2. Mrs. D had advanced bone cancer. As the disease progressed, Mrs. D required several blood transfusions throughout her therapy. One day she asked the doctor to explain the reason for the transfusions. What would you tell here? Muscle System Muscles

• Come from the Latin word mus ( little mouse) • Flexing muscles look like mice scurrying beneath the skin • Muscle characteristics – All muscles contract; essential for all body movements – All have the prefixes- myo-, mys- , or sarco- Function of Muscle Tissue

1. Producing body movement: – Walking, nodding …etc. 2. Stabilizing body positions – Postural muscle _ neck muscle…etc. – Stabilizing joints _ maintain body position. 3. Storing and moving substances within the body: – Intestine, Heart, Arteries 4. Generating heat: – Contraction  heat  thermogenesis. Three types of Muscle Tissue • Skeletal muscles • Smooth Muscles • Cardiac muscle Tendons

• Function – Attach muscles Neuromuscular Junction

• The region of contact between the somatic motor neuron and the sarcolemma of a muscle cell Muscle Fatigue

• Inability of the muscle to contract even though it is still being stimulated – Lack oxygen  lactic acid accumulate – Decrease ATP supply Muscle tone

• Is a small amount of tension in the muscle due to weak, involuntary contraction • Does not produced movement • To sustain muscle tone small groups of motor units are alternately active and inactive in a shifting pattern ( GI, back, neck, vessels • Flaccid: – The muscle tone is lost Effect of exercise on muscle

• Exercise – increases muscle size and strength – immobilization leads to muscle weakness • Aerobic exercise – Increases blood supply to the muscle – Increase mitochondria and store more oxygen – Improve digestion – Enhance neuromuscular coordination • Resistance exercise: – Increase muscle size Regeneration of muscle tissue is

• Hypertrophy – enlargement of existing cells • Hyperplasia: – increase in the number of fibers (uterus) • Fibrosis: – replacement of muscle fibers by fibrous scar tissue Gliding

• Flat bone surfaces move back-and –forth and side-to-side • No significant alteration of the angle between the bones • Limited to range Flexion

• Decreases the angle between articulating bones • Example: – bending the knee, elbow Extension

• Opposite of flexion • Increases the angle between articulating bones • Hyperextension: – extension greater than 180° • Example: – straightening the knee, or elbow Lateral flexion

• Involves intervertebral joints Extension of the shoulder Hyperextension moves a joint beyond the usual extended angle • Abduction: – Movement away from the midline • Adduction – Movement toward the midline • Circumduction: – The continuous sequence of flexion, abduction, extension, adduction. – Example moving the humorous in a circle at the shoulder joint • Rotation: – The bone revolves around its longitudinal axis – Example: • atlanto-Axial Joint (side to side movement). • Limbs medial and lateral rotation. Special movement

• Elevation: – upward movement of a part of the body • Depression: – downward movement of a part of the body • Protraction: – movement of a part of the body anteriorly in the transverse plane • Retraction: – movement of protracted part back to the anatomical position. Special movements of the foot • Inversion: – movement of the soles medially at the intertarsal joints – the soles face each other • Eversion: – Movement of the soles laterally at the intertarsal joints – The soles away from each other • Dorsiflexion: – Bending the foot and ankle in the direction of the dorsum – stand on your heels • Plantar flexion: – Bending the foot and ankle and the direction of the planter surface – Stand on your toes Special movements

• Supination: – a movement of the forearm at the proximal and distal radioulnar joint – the palm is turned anteriorly or superiorly i.e. anatomical position • Pronation – movement of the forearm at the proximal and distal radioulnar joints – the distal end of the radius crosses over the distal end of the ulna – The palms turn posteriorly or inferiorly • Opposition: – The movement of the thumb of the carpometacarpal joint – The thumb moves across the palm to touch the tip of the fingers on the same hand i.e. the ability to grasp Coordination with a muscle groups

• Opposing: – Prime mover (agonists): causing a particular movement. – Antagonist: opposes or reverse a movement; can be prime mover – If the prime mover active, the antagonist relaxes • Synergists: – Help the prime movers List three function of the muscle tissue

1. ______2. ______3. ______Select the correct term answer.

1. Moves food into stomach A. Cardiac muscle 2. Voluntary B. Skeletal muscle 3. Found in hollow internal organs C. Smooth muscle 4. Involuntary 5. Attaches to bone and moves the bone 6. Maintains normal blood pressure 7. Keeps blood circulating through the vessels Match the term on the left with the proper answer on the right.

1. Origin A. The bulk of the muscle 2. Insertion B. Attachment to the more movable bone 3. Body C. Attach muscle to bones 4. Tendons D. Attachment to more stationary bone Label the neuromuscular junction

• Receptors • Vesicles • Presynaptic membrane • Synaptic cleft Match the term on the left with the proper answer on the right 1. Flexion A. movement that makes the angle between 2. Adduction two bones smaller 3. Abduction B. Moving a part toward the midline 4. Rotation C. Moving a part away from the midline 5. Pronation D. Moving your head from side to side 6. Dorsiflexion E. Turning the palm toward the posterior 7. Plantar F. Standing on your feet flexion G. Standing on your toes 8. Inversion H. Turning the sole of your foot inward 9. Eversion I. Turning the sole of your foot outward Multiple Choice Questions

1. Benefits of regular exercise include all of the following except: a. More efficient heart b. Less fatigue c. Atrophy 2. Prolonged inactivity causes muscles to shrink in mass, producing a condition called: a. Hypertrophy b. Disuse atrophy c. Paralysis 3. Muscle hypertrophy can be best enhanced by a program of: a. Walking b. High-protein diet c. Strength training 4. Increase in muscle size is called a. Hypertrophy b. Atrophy c. Fibrosis Nervous System Structural Classification

• Central nervous system (CNS) – Occupies the dorsal body cavity; Brain and spinal cord • Peripheral nervous system (PNS) – Cranial nerve and the branches – Spinal nerves and the branches – Ganglia – Sensory receptors Functional Classification of PNS • Somatic nervous system – Sensory neurons carry information from somatic receptors to the central nervous system – Motor neurons carry impulses from CNS to skeletal muscles • Autonomic nervous system – Sensory neurons carry information from receptors in the visceral organs to CNS – Motor neurons carry impulses from CNS to involuntary muscles and glands Histology of Nervous System

Two cell types: 1. Supporting cell (Also called Neurogliae or glia; glue cells) • Support, nourish, protect neurons, and maintain . • Do not generate or propagate action potential • Can Multiply and divide (most brain tumors are glioma) • Six types – 4 found only in the CNS: Astrocytes, oligodendrocytes, Microglia, epindymal cells – 2 found in the PNS: Schwann cells , and Satellite cells 2. Neurons: Provide unique functions of the nervous system Neurons (nerve cell)

• Transmit nerve impulses and consist of : 1. cell body contains Nucleus, Cytoplasm, Organelles (except centrioles), Nissl bodies( prominent clusters of rough ER, Neurofibrils ( maintain cell shape) 2. dendrites contains Short, and highly branched. The receiving portion of a neuron 3. axon Axons

– Only one axon – Transmit nerve impulses away from the cell body – Axon terminals: – Fine processes at the end of the axon – Contain vesicles that store the neurotransmitters • Myelin sheath: – Multilayered lipid and protein covering the axons – Electrically insulates axons which increase the speed of nerve impulse – node of ranvier • Nuclei: cell bodies in CNS • Ganglia: small collections of cell bodies found in PNS • Bundle of nerve fibers – Tracts: Bundle of nerve fibers running through CNS – Nerves: Bundle of nerve fibers in the PNS • White matter: aggregations of myelinated fibers (tracts) • Gray matter: mostly unmyelinated fibers and cell bodies Characteristics of neurons

• Long-lived – Generally last a life time • Amitotic – neurons do not divide • High metabolic rate – This means high oxygen demand and lots of mitochondria – Neurons require glucose. Integration 3 1 Stimulus 2 center

Skin 4 Motor neuron Interneuron

Receptor 5 Effector

• Reflexes are rapid, predictable, involuntarily responses to stimuli • Types – Autonomic reflexes: • Regulate smooth muscles, heart, glands • Example: pupillary reflex – Somatic reflexes • All reflexes that stimulate skeletal muscles • Reflex arc elements: – Sensory receptor ( reacts to stimuli), Afferent neuron, CNS integration center, Efferent neuron, Effector organ Refractory Period

• Refractory period: – The period during which an excitable cell cannot generate another action potential • Absolute refractory period: – A second action potential can not be initiated even with a very strong stimulus • Relative refractory period: – The period of time during which a second action potential can be initiated by larger than normal stimulus Chemical Synapse Transmits a signal as Follows:

• Nerve impulse reach the synaptic end bulb of presynaptic axon • The vesicles release neurotransmitter into the synaptic cleft • neurotransmitter attach to the receptors in the postsynaptic neurons which result in depolarization. Central Nervous System (CNS)

• Brain – The brain weighs 3 Ib • Cerebral hemispheres • Diencephalons • Brain stem • cerebellum Cerebral Hemispheres • Paired, most superior part of the brain • Encloses most of the brain stem • the elevated ridges of the surface called gyri separated by shallow grooves called sulci • Fissures: – deeper groove separate large regions of the brain – cerebral hemispheres separated by longitudinal fissure • Fissures and sulci divide the hemispheres into lobes Somatic sensory area

• located in the parietal lobe • The left side receives impulses from the right side and vice versa Special sense organs

• Visual area located in the posterior part of the occipital lobe • Auditory area located in the temporal lobe • Olfactory area found inside the temporal lobe. Primary Motor area

• Allow us consciously to move our skeletal muscles • Located in the frontal lobe • The left side receives impulses from the right side and vice versa Broca’s area

• Specialized area involved in our ability to speak • Found at the base of precentral gyrus • Located in only one cerebral hemisphere (usually left) • Damage to this area causes inability to say words properly Speech area

• Located at the junction of the temporal lobe and the parietal lobe, and occipital lobe • Allow us to sound words • Only in one hemisphere, usually the left • Higher intellectual reasoning located in the anterior part of the frontal lobe • Language comprehension (word meaning) located in the frontal bone Diencephalons (interbrain)

• Thalamus: • Hypothalamus • epithalamus • Thalamus – encloses the third ventricle of the brain – Relay station for sensory impulses passing upward to the sensory Hypothalamus

• Under the thalamus • Makeup the floor or the diencephalon • Plays a role in the regulation of body temperature, water balance, metabolism • Connect to the • Center of many drives and emotions; thirst, appetite, sex, pain, pleasure (connected to the limbic system) Epithalamus

• Form the roof of the third ventricle • Parts of the epithalamus: – Pineal body. – Choroids plexus: • within each ventricle • Secret cerebrospinal fluid Brain stem

• Consist of – Midbrain – Pons – oblongata midbrain

• Cerebral aqueduct travels through the midbrain connecting the third ventricle to the fourth ventricle • Corpora quadrigemina: – four protrusions located dorsally – Reflex centers, involved in vision and hearing Pons

• round structure protrudes below the midbrain • Have nuclei involved in breathing Medulla Oblongata

• Most inferior part of the brain stem • Contain centers that control heart rate, blood pressure, breathing, swallowing, vomiting…etc. • Fourth ventricle lies posterior to the Pons and medulla oblongata and anterior to the cerebellum. cerebellum

• Projects dorsally from under the occipital lobe • Has two hemispheres and convoluted surface • Controls our balance Menings • Three connective tissue covering the brain, from superficial to deep: 1. Dura mater: Leathery, outer most layer that covers the brain and continues with spinal dura mater 2. Arachnoid mater: Has extensions span the arachnoid space and attach to the pia mater 3. Pia mater: clings tightly to brain surface and spinal cord following every fold • Arachnoid villi: protrude through dura mater, absorb CSF • Subarachnoid space: between the arachnoid and pia mater filled with CSF

Cerebrospinal Fluid

• Coroid plexus secret CSF in the ventricles • Circulation: – forms and drains at a constant rate ( 150 ml) – From lateral ventricles in the hemispheres to the third ventricle in the diencephalon to the cerebral aqueduct in the midbrain to the fourth ventricle dorsal to the Pons medulla oblongata to the central canal of spinal cord and subarachnoid space to the blood through arachnoid villi • changing in color, appearance, or composition, indicates disease. • Obstruction of circulation causes hydrocephalus

Spinal Cord

• Enclosed in the vertebral column • Extend from the foramen magnum to the first or second lumbar vertebra • Continuation of the brain stem • Cauda equina: collection of spinal nerve at the inferior end of the vertebral canal • Covered by meninges that extend beyond the spinal cord Gray matter of spinal cord and spinal root

• Butterfly shape, surrounds the central canal – Ventral horn: contains somatic motor neurons cell bodies that sends their axons out to the ventral root of the cord – Dorsal horn: contains interneurons • The cell bodies of the sensory neurons are found in the dorsal root ganglion • The fibers enter the cord through the dorsal root White matter of the spinal cord

• Composed of myelinated fiber tracts • Divided into three regions in each side – Posterior column: has ascending tracts ( sensory, efferent) – Lateral and anterior columns: has both ascending and descending (motor or afferent) tracts – Each column contains a number of fiber tracts made up of axons with the same destination and function Peripheral nervous system

• outside the central nervous system • Consist of: – nerves – ganglia Structure of a Nerve

• A nerve is a bundle of neuron fibers outside the CNS. • Mixed nerves: – carry both sensory and motor fibers Cranial Nerves

• 12 pairs serve the head and the neck • Only the vagus nerve extends to the thoracic and abdominal cavities • Most cranial nerves are mixed nerves except: – Optic, olfactory, vestibulocochlear are sensory nerves Spinal nerves and nerve plexuses

• Spinal nerves – 31 pairs – Named for the region of the cord from which they arise (cervical, thoracic, lumbar, sacral) • plexuses: – four plexuses – Innervate the limbs Autonomic Nervous System

• Two divisions have opposite effect – Sympathetic – Parasympathetic • Most organs have both innervations Parasympathetic Division • Also called resting and digesting • Active when the body is at rest • Allows us to conserve energy • Located in the brain nuclei of four cranial nerves (III, VII, XI, X) send their axons out in cranial nerves to serve the organ in the head and neck region. • In the sacral region located in the S2 through S4 level of the spinal cord • Leave the spinal cord to pelvic cavity Sympathetic division

• Also called fight-or- flight system, active threatening situations • in the spinal cord located between T1 through L2 • Increase heart rate, blood pressure, glucose level, dilate the bronchioles in the lungs, dilatation of blood vessels in the skeletal muscle, withdrawal of blood from digestive organs Label the parts of the nerve cell

Dendrites Nucleus Cell body Axon Axon terminals Match the term on the left with the proper selection on the right.

1. Central nervous system A. Controls visceral organs 2. Peripheral nervous system B. Brain and spinal cord 3. Autonomic nervous system C. Cranial and spinal nerves and their branches 4. Dendrite D. Only one long branch per nerve cell 5. Axon E. Multilayer of lipid covering the axon 6. Axon terminal F. Fine processes at the end of axon 7. Myelin sheath G. Branching projections of neuron Label the Reflex Arc

• Motor neuron • Integration center • Receptor • effector organ • Sensory Neurons Match the term on the left with the proper selection on the right.

1. Receptor A. Gland 2. Motor neuron B. Also known as afferent“ 3. Sensory neuron C. Sense stimulation 4. Effector organ D. Also known as Efferent 5. Integration center E. Process information in CNS True or False

1. Neurotransmitters are chemicals that allow neurons to communicate with one another. 2. Neurotransmitters attach to receptors on the organs to stimulate them. 3. There is more than one type of neurotransmitter in the body. 4. The brain is protected by three layers of connective tissue called meninges. 5. There are 12 pairs of cranial nerves. Label the parts of the Brain

• Occipital lobe • Frontal lobe • Parietal lobe • Temporal lobe • Cerebellum • Brainstem Label the parts of the Brain

• Occipital lobe • Frontal lobe • Parietal lobe • Cerebellum • Thalamus • Hypothalamus • Medulla • Pones • Midbrain • Pituitary gland VII. Match the function on the left with the proper are of the brain on the right

1. Interpret sensory information A. Occipital lobe 2. Vision B. Frontal lobe 3. Hearing C. Parietal lobe 4. Consciously control muscle D. Temporal lobe 5. Intellectual reasoning E. Thalamus 6. Controls the pituitary gland F. Hypothalamus 7. Relay station for sensory G. Cerebellum information 8. Controls our balance Match the term on the left with the proper selection on the right.

• Midbrain A. Brainstem • Pones B. Diencephalons • Medulla oblongata • Hypothalamus • Thalamus True or False

1. The spinal cord ends at the bottom of the sacrum. 2. The spinal cord is protected by the meninges. 3. There are 31 pairs of spinal nerves. 4. The sympathetic and parasympathetic are divisions of the autonomic nervous system. 5. The autonomic nervous system controls the viscera. 6. Another name for the parasympathetic nervous system is craniosacral. 7. Another name for the parasympathetic nervous system is Thoracolumbar. Multiple Choices Questions.

1. The portion of the brain stem that joins the spinal cord to the brain is the: a. Pones b. Cerebellum c. Medulla 2. Which one of the following is not part of the diencephalons? a. Cerebrum b. Thalamus c. Hypothalamus 3. The area of the cerebrum responsible for the perception of sound lies in the _____lobe. a. Frontal b. Temporal c. Occipital 4. Visual perception is located in the ______lobe. a. Temporal b. Parietal c. Occipital 5. Which of the following conducts impulses toward the cell body? a. Axons b. Dendrites 6. Which one of the following is a function of the cerebellum? a. Awareness of sensations b. Maintains equilibrium Applying your knowledge

1. Mr. DJ suffered a cerebrovascular accident and it was determined that the damage affected the left side of his cerebrum. On which side of his body will he most likely notice any paralysis?

2. Mrs. DM looked out her window to see a man trapped under the wheel of a car. She rushed to the car, lifted it, and saved the man underneath the wheel. What division of the autonomic nervous system made this seemingly impossible task possible? Special Senses Senses

• Special senses – Taste, Smell, Sight, Hearing – Large, complex sensory organs ( eyes, ) • Eye ball External and – Sphere, enclosed and protected accessory structures by a cushion of fat in the bony orbit • Eyelids: – protect the eyes anteriorly – Meet at the corners of the eye to form medial and lateral canthus • Eyelashes: – projecting from the border of each eyelid • Meibomian glands: – modified sebaceous glands in the eyelid – Produce oily secretion that lubricates the eye Extrinsic Eye Muscles • Six muscles attach to the outer surface of each eye • Produce gross eye movement Lacrimal apparatus • Lacrimal gland – located above the lateral end of each eye – Secret tears into the anterior surface of the eye • Lacrimal canals – located medially • Lacrimal sac • Nasal lacrimal duct: – empties into the nasal cavity Conjunctiva

• lines the eyelids and covers the outer surface of the eyeball • Ends at the edge of the cornea • Secretes mucus that lubricate and moisten the eyeball Sclera • Outermost, fibrous, thick white connective tissue (white of the eye)

Cornea: • The anterior portion of the sclera • transparent, allows light to enters the eye. • Well supplied with nerve endings ; blinking, tearing Choroid

• Middle, blood rich layer • Form two muscles anteriorly: 1. Ciliary body attaches the lens 2. Iris: Pigmented, has a round opening called pupil which regulates the amount of light entering the eye Retina

• inner most layer • Contains photoreceptors distributed over the entire retina except in the optic disc ( blind spot) where the optic nerve exits the eye • Rods: Allow us to see in gray tones in dim light • Cons: for accurate, colored (green, blue, red) vision Lens

• Flexible biconvex structure • Focuses the light on the retina • Held by the suspensory ligament attached to the ciliary body Light Refraction

• The lens refractive power changes to properly focus the light on the retina – More convex  more refraction – Flatter  less refraction Visual fields and visual pathways to the brain

• Optic nerve • Optic chiasm: • Optic tract: • Optic radiation • Occipital lobe Eye reflexes

• Photopupillary reflex: – the pupils constrict immediately when exposed to bright light – Prevent damaging the photoreceptors • Accommodation pupillary reflex: – when viewing close objects; provide acute vision What is?

• Strabismus • Cataracts • Glaucoma • Conjunctivitis • Ophthalmia neonatorum • Presbyopia Label the eye components • Cornea • Sclera • Ciliary muscle • Iris • Vitreous humor • Retina • Pupil • Lens • Optic disc • Choroid • Fovea centralis • Macula lutea • Anterior chamber • Posterior chamber Match the definition on the left with the correct term on the right

1. White of the eye A. Cornea 2. Colored part of the eye B. Sclera 3. Transparent portion of the eye C. Ciliary muscle 4. covers front of D. Iris the eye E. Conjunctiva 5. Opening in the iris allows the light to F. Retina enter the eye G. Pupil 6. Hold the lens of the eye in place. 7. Contains rods and cones photoreceptor True or False

1. When the eye is looking at objects far in the distance, the lens is slightly rounded 2. The area which contains the greatest concentration of cones on the retina is the fovea centralis 3. The fluid in front of the lens that is constantly being replaced in the anterior chamber 4. The cornea is the white of the eye. 5. The optic disc is also known as the blind spot. 6. Tears are formed in the lacrimal gland. Multiple Choice Questions 1. Three layers of tissue form the eyeball. They are the: a. Choroid, iris, and pupil b. Retina, rods, and cones c. Sclera, choroid, and retina 2. The jellylike fluid behind the lens in the posterior chamber of the eye is the: a. Aqueous humor b. Vitreous humor 3. The receptors for night vision are the: a. Rods b. Cones 4. The receptors for colored vision are the: a. Rods b. Cones Anatomy of the Ear

• Three major ears: – External and middle ear involved in hearing only – internal ear involved in hearing and equilibrium External ear

• Auricle: shall-shaped, surrounding the external auditory opening • External auditory canal: – short, narrow ends at the ear drum which separates the outer from the middle ear – Ceruminous glands in the skin secrete cerumen – Sound waves entering the canal and hit the tympanic membrane Middle Ear

• Small air-filled cavity within the temporal bone • Between the eardrum laterally and a bony wall medially • : three bones (hammer, incus, stapes) that transmit vibration from the tympanic membrane to the oval window • Auditory tube: – links the middle ear cavity with the throat – equalizes the pressure in the middle ear with the external ear Inner Ear

• located within the temporal bone behind the eye socket • Three subdivisions: – Cochlea contains organ of Corti (hearing) – Vestibule and semicircular canal for balance Mechanism of hearing

• Sound waves to the external auditory canal to the eardrum to the ossicles to the inner ear to the receptor cells in the organ of corti • The impulse carried by the cochlear nerve to the auditory cortex in the temporal lobe Label the ear components

• Ossicles • Ear lobe • Auricle • Eustachian tube • Tympanic membrane • Cochlea • Semicircular canal • Auditory canal Match the definition on the left with the correct term on the right

1. Ossicles A. External Ear 2. Semicircular canal B. Middle Ear 3. Eustachian tube C. Inner Ear 4. Organ of Corti 5. Cochlea 6. Auditory canal True or False

1. Another name for the tympanic membrane is Eustachian tube 2. The bones of the middle ear are collectively referred to as Ossicles 3. The organs responsible for balance and equilibrium are located in the semicircular canals. 4. Organ of Corti in the cochlea is responsible for hearing. 5. A middle ear infection may also be referred to as Otitis externa Multiple Choice Questions

1. In addition to its role in hearing, the ear also functions as: a. The sense organ of equilibrium and balance b. A sense organ for taste c. The sense organ for smell 2. The Eustachian tube connects the throat with the: a. External ear b. Inner ear c. Middle ear Chemoreceptor

• Two kinds – Olfaction ( smell): wider range – Taste : four types Olfactory receptors & sense of smell

• Olfactory receptors: – Very sensitive; pick up small differences – Olfactory receptors located in the roof of each nasal cavity • Olfactory pathway – Chemicals dissolve in mucus and stimulate the receptors – Then the olfactory nerve carry it to the olfactory cortex • Olfactory pathway tied to limbic system (emotions) • Anosmias: – Loss of smell sensation due to trauma, inflammation, • Olfactory auras: – olfactory hallucinations Olfactory & pathway Taste Buds & Sense of Taste • Four basic taste sensations: – Sweet: respond to sugar, saccharine, amino acids – Sour: acid – Bitter: alkaloids – Salty: metal ions • Other flavors are combination of the four tastes • Affected by sense of smell Taste Buds & Sense of Taste

• Taste Buds – Receptors of taste sensation • Found mostly on the • A few in the soft palate and inner surface of the cheeks. True or False

1. Structures known as papillae are found on the tongue. 2. Chemoreceptor is the term used to describe the type of receptors that generate nervous impulses resulting in the sense of taste or smell. 3. The chemoreceptors of the taste buds are called gustatory cells The endocrine system • The Organs of the endocrine system are small. They Coordinates and directs the activity of the cells • Hormones released into the blood and transported throughout the body • Regulates processes such as: – Reproduction – Growth and development – Mobilizing body defenses against stressors – Maintaining electrolyte, water and nutrient balance of the blood – Regulating cellular metabolism and energy balance – Maintaining body homeostasis. Mechanisms of Hormone Action • Attach to a specific receptors on the cell and alter the cellular activity • Changes result in one or more of the following: – Changes in plasma membrane permeability or electrical state. – Synthesis of proteins or certain regulatory molecules such as enzymes in the cell. – Activation or inactivation of enzymes – Stimulation of mitosis Steroidal hormones • Lipid-soluble molecules • binds to a specific receptor and to a specific sites on the cell’s DNA activating certain genes which result in the synthesis of new proteins. Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer. Nonsteroidal hormones, protein and peptide hormones

• The hormones binds to receptors on the target cell’s plasma membrane Control of Hormone Release

• The stimuli that activate the endocrine organs fall into three major categories 1. Hormonal 2. Humoral 3. Neural Hormonal stimulus

• Hypothalamic hormones stimulate the anterior pituitary gland to secrete its hormones • Anterior pituitary hormones stimulate other endocrine organs to release their hormones into the blood • As the hormones produced by the final target glands increase in the blood, they inhibit the release of anterior pituitary hormones; negative feed back Humoral Stimuli

• Blood levels of certain ions and nutrients stimulate hormone release • Examples – Decreased blood calcium levels will increase parathyroid hormone (PTH) secretion by the parathyroid glands Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer. Neural Stimuli

• Nerve fibers stimulate hormone release • Example – sympathetic nervous system stimulate the adrenal medulla to release norepinephrine and epinephrine The Major Endocrine Organs 1. Pituitary 2. Thyroid 3. Parathyroid 4. Adrenal 5. Pineal 6. Thymus 7. Pancreas 8. Gonads Pituitary Gland

• Hangs by a stalk from the inferior surface of the hypothalamus • Located in the sphenoid bone • Has two lobes 1. Anterior pituitary secret 6 hormones – Growth hormone and prolactin affect nonendocrine targets – Thyrotropic, adrenocorticotropic hormone, and the two gonadotropic hormones stimulate endocrine glands, to secrete their hormones 2. Posterior pituitary: – Secrets ADH and Oxytocin Growth hormone (GH)

• Affect skeletal muscles and long bones • Plays a role in determining final body size • Imbalance – Hyposecretion during childhood result in dwarfism – Hypersecretion during childhood results in gigantism – Hypersecretion after long bone growth has ended result in acromegaly (enlargement of facial bones, feet and hands, and thickening of soft tissues – Most cases of Hypersecretion result from tumor cells producing the hormones Prolactin (PRL) Adrenocorticotropic • target the hormone (ACTH) • After • Regulates the cortex of the . • stimulates and maintains milk production by the mother’s • Its function in males Thyroid-stimulating is not known hormone (TSH) • Influences the activity of the thyroid gland. Gonadotropic Hormones

• Follicle Stimulating Hormone (FSH) – In female, stimulates follicle development in the ovaries. • As the follicles mature, they produce estrogen – In male, stimulates sperm development by the testes • Luteinizing Hormone (LH) – In female: • triggers ovulation and causes the ruptured follicle to become a corpus luteum • stimulates the corpus luteum to produce progesterone and some estrogen – In male • stimulates testosterone production by the testes. • IMBALANCE – Hyposecretion of FSH or LH leads to sterility in males and females

Hormones of the Posterior Pituitary

• Oxytocin – Stimulates uterine contractions during labor – Causes milk letdown in a nursing woman • Antidiuretic hormone (ADH). – causes the kidneys to reabsorb more water which result in decrease urine volume and increase blood volume – In large amounts causes constriction which increases blood pressure – Alcohol inhibits ADH secretion – Hyposecretion of ADH causes diabetes insipidus Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer. • located at the base of the throat, inferior to the Thyroid adam’s apple • Produce two hormones Gland • Thyroid hormone – controls glucose metabolism – Every cell in the body is a target – Important for normal tissue growth and development, especially the nervous systems • Calcitonin – Decreases blood calcium levels IMBALANCE

• Hyposecretion of thyroxin in early childhood can cause cretinism which results in dwarfism • Hypothyroidism in adults results in myxedema: – mental sluggishness, puffiness of the face, fatigue, poor muscle tone, low body temperature, obesity, and dry skin • overproduction of thyroxin results in – a high basal metabolic rate, intolerance of heat, rapid heartbeat, weight loss, nervous and agitated behavior and a general inability to relax. Goiter

• enlargement of the thyroid gland due to iodine deficiency • TSH stimulate thyroxin secretion • thyroid makes only the peptide part of the molecule which is nonfunctional • Thyroid fails to provide negative feedback to inhibit TSH release Graves’ disease

• Form of hyperthyroidism • the thyroid gland enlarges and the eyes may bulge, or protrude anteriorly Parathyroid Glands

• Four glands on the posterior surface of the thyroid • some may be in other regions of the neck. • secrete parathyroid hormone (PTH) • Decrease blood calcium levels will increase PTH which increase calcium level in the blood • PTH also stimulates the kidneys and intestine to absorb more calcium Adrenal Glands

• Two glands curve over the top of the kidneys • Secret Glucocorticoids : – Mineralocorticoids – Glucocorticoids – Sex hormones. – EP and NE Mineralocorticoids

• Mainly aldosterone. • Regulates sodium and potassium ions concentrations • When aldosterone rises, the kidney reclaim more sodium ions and excrete potassium ions in urine. • Water follows sodium reabsorption; helps regulate body fluids • Hypoaldosteronisim – Sodium and water are lost from the body, which leads to problems with electrolyte and water balance. This in turn, causes the muscles to become weak, and shock is a possibility • Hyperaldosteronisim – More water and sodium are retained, leading to high blood pressure and edema – potassium loss may disrupt heart activity and nervous system Glucocorticoids • include cortisone and cortisol • promote normal cell metabolism • help the body to resist long-term stressors – Increase glucocorticoids level, the and proteins are broken down and converted to glucose, which is released to the blood • control inflammation • response to ACTH secreted from the pituitary gland • Glucocorticoids deficiency can cause – Hypoglycemia – Less ability to cope with stress – suppression of the – increased susceptibility to infection. – Complete lack of glucocorticoids is incompatible with life Cushing’s syndrome

• Excessive output of glucocorticoids • results in a moon face, buffalo hump of fat on the upper back, high blood pressure, hyperglycemia and possible diabetes. • Weakening of the bones as protein is withdrawn to be converted to glucose, and severe depression of the immune system.

Sex hormones

• Mainly androgens (male sex hormones), some estrogens (female sex hormones) are also formed • HOMEOSTATIC IMBALANCE – Hypersecretion of the sex hormones leads to mascuilinization regardless of sex • In adult males, the effect may be masked • In females, a beard develops, and a masculine pattern of body hair distribution occurs, among other things. • epinephrine and norepinephrine – increase heart rate, blood pressure, blood glucose levels, dilate the small passageways of the lungs • IMBALANCE – Hypersecretion of catecholamines leads to symptoms typical of excessive sympathetic nervous system activity • rapidly beating heart, high blood pressure, a tendency to perspire, very irritable Pancreatic • The located behind the stomach in the abdominal cavity Islets • scattered among exocrine cells. The islets produce two hormones 1. Insulin • Increase glucose in the blood stimulate the release of insulin • Insulin increases cell’s ability to transport glucose across the cell membranes • Decrease blood glucose level, the stimulus for insulin release ends 2. Glucagon • Antagonist to insulin • Stimulated by low blood glucose level • In the liver, stimulates glycogenolysis and the release of glucose into the blood Diabetes Mellitus • Insulin deficiency leads to increase blood levels of glucose • Glucose appears in urine because the kidney cannot reabsorb it fast enough and water follows, leading to dehydration • Fats and proteins are broken down and used as energy source • The body weight begins to decline • loss of proteins decreases the ability to fight infections • If large amounts of fats are used for energy, the blood becomes acidic as ketones appear in the blood. Unless corrected coma and death may result • The three cardinal signs of diabetes mellitus are: – Polyuria: urination – Polydipsia: thirst resulting from water loss – Polyphagia: hunger due to inability to use sugars

• Found on the roof of the third ventricle • Secret melatonin – The levels of melatonin rise and fall during the day and night. – Peak levels occur at night and make us drowsy Thymus • Located in the upper thorax, posterior to the sternum. • Large in infants and children • decreases in size in adulthood. • produces a hormone called thymosin • during childhood the thymus involved in the maturation of T Gonads • Ovaries – paired, almond-sized located in the pelvic cavity – produce ova and estrogens and progesterone – The ovaries begin to function at puberty • Testes – Paired, suspended in the , outside the pelvic cavity – produce sperm and male sex hormones, or androgens Hormones of the Ovaries

• Estrogens – Stimulate the development of the secondary sex characteristics in females – Estrogens work with progesterone to prepare the uterus to receive a fertilized egg. This results in cyclic changes in the uterine lining, the menstrual cycle. – Estrogens help maintain and prepare the breasts to produce milk (lactation) • Progesterone – quiets the uterus so the implanted embryo will not be aborted – prepare breast tissue for lactation • Hyposecretion of the ovarian hormones stop the ability of a woman to conceive

Hormones of the Testes

• Testosterone – promotes the growth and maturation of the reproductive system in males – causes development of the male’s secondary sex characteristics (beard, heavy bones and muscles, voice) – stimulating the male sex drive – In adulthood, testosterone is necessary for continuous production of sperm • Hyposecretion, the man becomes sterile. • The function of the testes begin at puberty under the influence of the anterior pituitary gonadotropic hormones – Testosterone production is specifically stimulated by LH

Placenta • Formed in the uterus of pregnant women. • Function: respiratory and nutrition-delivery systems for the fetus and produces hormones • human chronic gonadotropic (hCG) – in early pregnancy, stimulates the corpus luteum to continue producing estrogen and progesterone so that the lining of the uterus is not sloughed off • In the third month, the assumes the production of estrogen and progesterone, and the ovaries become inactive for the rest of the pregnancy • estrogen and progesterone maintain pregnancy and prepare the breasts for producing milk • Human placental lactogen (hPL) works with estrogen and progesterone in preparing the breasts for lactation. • Relaxin: relaxes the mother’s pelvic ligaments and the pubic symphysis, which eases birth passage Aging

• Menopause: – The woman’s reproductive organs begin to atrophy – Inability to bear children – estrogen deficiency lead to arteriosclerosis, osteoporosis, decreased skin elasticity, fatigue, nervousness, and mood changes such as depression are common. • men remain fertile throughout their lifespan Aging, changes occur in both sexes

• The efficiency of the endocrine system gradually declines in old age • growth hormone output declines; explains muscle atrophy in old age • Elderly persons are less able to resist stress and infection • adult-onset diabetes is most common in the elderly Label the endocrine glands

• Hypothalamus • Pituitary • Adrenal • Thyroid • Parathyroid • Testes • Ovaries • Pancreas Match the term on the left with the proper selection on the right.

1. Pituitary A. Pelvic cavity 2. Parathyroid B. Mediastinum 3. Adrenals C. Neck 4. Ovaries D. Cranial cavity 5. Thymus E. Abdominal cavity Match the hormone on the left with its function on the right

1. FSH A. Stimulates the formation of a corpus 2. LH luteum 3. GH B. water reabsorption from urine into the blood 4. Prolactin C. Stimulates the growth of follicles 5. TSH D. stimulates Adrenal cortex 6. ACTH E. Stimulate growth 7. ADH F. Stimulate Thyroid gland 8. Oxytocin G. Stimulates milk secretion after delivery H. Induce labor Match the hormone on the left with the gland on the right.

1. Adrenocorticotropic hormone (ACTH) A. Hypothalamus 2. Luteinizing hormone (LH) B. Thyroid 3. Follicle stimulating hormone (FSH) C. Pituitary 4. Thyroid stimulating hormone (TSH) D. Adrenal cortex 5. Cortisol E. Ovaries 6. Estrogen 7. Progesterone 8. Growth hormone 9. Prolactin 10. Antidiuretic hormone (ADH) 11. Oxytocin 12. Thyroid hormone Match the hormone on the left with the gland on the right.

1. Calcitonin A. Placenta 2. Parathyroid hormone B. Pineal gland 3. Aldosterone C. Pancreas 4. Testosterone D. Thyroid 5. Epinephrine E. Thymus 6. Norepinephrine F. 7. Glucagon G. Testes 8. Insulin H. Adrenal cortex 9. Melatonin I. Adrenal medulla 10. Thymosin 11. Human chorionic gonadotropin VI. Multiple Choice Questions

1. Which one of the following structures would not be stimulated by the anterior pituitary? a. Thyroid b. Adrenals c. Uterus 2. Which one of the following hormones is not released by the anterior pituitary gland? a. ACTH b. TSH c. ADH 3. Which hormone is secreted by the posterior pituitary gland? a. LH b. GH c. ADH 4. What disease is caused by hyposecretion of ADH? a. Diabetes insipidus b. Diabetes mellitus 5. The actual production of AD'H and Oxytocin takes place in which area? a. Pituitary gland b. Hypothalamus 6. Target organ cells a. Respond to a particular hormone b. Cells that secret the hormone VII. Apply your knowledge

1. Mrs. DD has high levels of chorionic gonadotropin in her urine. What did this mean?

2. Mrs. JK was pregnant and was 2 weeks past her due date. Her doctor suggested that she enter the hospital and said he would induce labor. What hormone will he give her? Blood Blood • Blood transports nutrients, wastes, body heat …etc. through blood vessels • It is the only fluid tissue • Consist of blood cells (formed elements) suspended in fluid (plasma) • Hematocrit – In a centrifuged blood sample, the formed elements precipitate and the plasma rises to the top – RBCs account about 45% of the total blood volume – WBCs and platelets contribute less than 1% – The remaining 55% is plasma

Physical Characteristics and Volume

• sticky opaque fluid • metallic taste • The color of blood varies from bright red (oxygen-rich) to a dull red (oxygen-poor) • pH between 7.35 and 7.45 • Accounts for approximately 8% of body weight. • in healthy males is 5 to 6 liters Plasma • Consist of Water (about 90%) and dissolved substances which include: • nutrients, ions, gases, hormones, proteins, and wastes products • Plasma proteins – most plasma proteins made by the liver, except for antibodies and protein-based hormones – Functions: • albumin contributes to the osmotic pressure of blood • clotting proteins stop blood loss in injured vessels • antibodies protect the body from pathogens • the composition of plasma is kept relatively constant Erythrocytes

• Red blood shape • hemoglobin • life span 100 to 120 days. • eliminated by phagocytes in the spleen, liver, and other body tissues. • RBC production is controlled by a hormone called erythropoietin produced by the kidneys IMBALANCE • anemia – A decrease in the oxygen-carrying ability of the blood, whatever the reason. • Sickle-cell anemia – Genetic disorder – abnormal hemoglobin formed – occurs chiefly in black people • Polycythemia – An excessive or abnormal increase in the number of erythrocytes Leukocytes

• Neutrophils: – have multilobed nucleus – phagocytes at sites of acute infection • Eosinophils – have a blue-red nucleus – Their number increases during and infections by parasitic worms • Basophils – Have histamine-containing granules • Histamine is an inflammatory chemical that makes blood vessels leaky and attracts other WBCs to the inflammatory site. Leukocytes

• Lymphocytes – have a large dark purple nucleus that occupies most of the cell volume – reside in lymphatic tissues – play a role in the immune response. • Monocytes – the largest of the WBCs. – They change into macrophages in the tissues. • Macrophages are important in fighting chronic infections, such as tuberculosis. Leukocytes, WBC

• less numerous than red blood cells • crucial to body defense against disease • Leukocytosis: – a total WBC count above 11,000 cells mm3 • Leukopenia: – abnormally low WBC count. – commonly caused by certain drugs, such as corticosteroids and anticancer agents. Platelets

• not cells, but fragments of megakaryocytes • needed for the clotting process Hematopoiesis (Blood Cell Formation)

• occurs in red bone marrow – In adults, found in the bones of the skull, pelvis, ribs, sternum, and proximal end of the humerus and femur. • All formed elements arise from hemocytoblast in the red bone marrow • hemocytoblast forms two descendants – lymphoid stem cell: produces lymphocytes – myeloid stem cell: produce all other formed elements. Homostasis

1. Vascular spasms occur 2. Platelets form plug 3. Coagulation events Undesirable Clotting

• thrombus – A clot in blood vessel that may prevent blood if large enough – may breaks away from the vessel and floats in the bloodstream to become an embolus – a cerebral embolus may cause a stroke Bleeding Disorders

• platelet deficiency (thrombocytopenia) – cause spontaneous bleeding from small blood vessels called petechiae on the skin. – arise from conditions that suppresses , such as bone marrow cancer, radiation, or certain drugs. • clotting factors deficiency – Due to deficiency of vit K, or liver disease • Hemophilia – bleeding disorders result from a lack of clotting factors Transfusion reactions

• The membranes of RBCs have genetically determined proteins (antigens) • RBC proteins will be recognized as foreign if transfused into another person with different RBC antigens • Antibodies will bind RBCs antigens causing agglutination • foreign RBCs rupture and their hemoglobin is released into the bloodstream. • freed hemoglobin may block the kidney tubules and cause kidney failure. • Transfusion reactions can also cause fever, chills, nausea. and vomiting. • An antigen: is a substance that the body recognizes as foreign; it stimulates the immune system to release antibodies; Most antigens are foreign proteins ABO Blood Groups The Rh Blood Groups

• RBCs may carry Rh antigen on their surface • if an Rh negative person receives Rh positive blood, the immune system begins to produce antibodies against the foreign blood type • RBCs hemolysis does not occur with the first transfusion because it takes time to react and making antibodies. But the second time will • Rh negative women carrying Rh positive baby – The first pregnancy usually results in delivery of a healthy baby – If the mother is sensitized, the mother will form antibodies that cross the placenta and destroy the baby’s RBCs Blood Typing IMBALANCE

• Iron-deficiency anemia – common in women due to monthly menses. • With increasing age, chronic leukemias, anemias, and diseases involving undesirable clot formation are more prevalent. • The elderly are particularly at risk for pernicious anemia because the stomach mucosa (which produces intrinsic factor) atrophies with age. Which tube has low Hematocrit and which tube has high Hematocrit. Label the blood formed elements. Match the term in left column with the correct answer in right column

1. Plasma A. RBC volume 2. Erythrocytes B. Abnormally high WBC 3. Myeloid tissue C. Liquid portion of the blood 4. Hematocrit D. Abnormally high RBC count 5. Buffy coat E. No nuclei 6. Leukocytosis F. Abnormally low WBC 7. Polycythemia G. Make clotting proteins. 8. Leukopenia H. WBCs and Platelets 9. Liver I. Hemopoiesis Match the term in left column with its function in right column

1. Erythrocytes A. Defend the body against 2. White blood cells invaders 3. Vitamin K B. Stop bleeding 4. Platelets C. necessary to manufacture clotting factors D. Carry Oxygen Match the term on left column with the correct answer on right column.

1. Erythrocytes A. Another name for 2. Leukocytes platelets. 3. Thrombocytes B. Another name for red blood cells. C. Another name for white blood cells. Match the term on left column with the correct answer on right column.

1. Pernicious anemia A. Lack of vitamin B12 2. Sickle cell anemia B. An abnormal type of 3. Iron deficiency hemoglobin anemia C. Low Iron levels in blood Multiple choice Questions

1. Which one of the following substances is not a part of the plasma? a. Nutrients b. Wastes c. Liver 2. The normal volume of blood in an adult is about ______. a. 2-3 quarts b. 2-3 gallons c. 4-6liters 3. The laboratory test called Hematocrit tells the physician the volume of: a. White cells in a blood sample c. Platelets in a blood sample b. Red cells in a blood sample 4. A critical component of hemoglobin is: a. Calcium b. Vitamin K c. Iron 5. The term used to describe the condition of a circulating blood clot is: a. Anemia b. c. Platelet VII. Multiple choice Questions

6. The "Buffy coat" layer in a Hematocrit tube contains: a. Red blood cells and platelets c. White blood cells and platelets b. Plasma and platelets 7. The Hematocrit value for red blood cells is: a. 75 b. 60 c. 45 8. A blood clot that is stationary and stays in the place where it formed is called a. Thrombus b. Anticoagulant c. Anemia 9. Which blood type is considered the universal donor? a. A b. B c. AB .d. O 10. Which blood type is considered universal donor a. A b. B c. AB d. O VIII. Applying your knowledge

1. After a baby was born, the doctor applied a gauze dressing for a short time on the umbilical cord. He also gave the baby a dose of vitamin K. Why did the doctor perform these two procedures?

2. The mom blood type is O positive. Her husband's blood type is O negative. Her newborn baby's blood type is 0 negative. Is there any need for concern with this combination? IX. Fill in the blank area in the chart

O Blood Antigen Present in Antibody Present in Type RBCs Plasma A Anti-B B, B AB None O None Cardiovascular System The Cardiovascular System

• the cardiovascular system carries substances to and from the cells. • oxygen, nutrients, cell wastes, hormones, and many other • The force to move the blood is provided by the heart The Heart, Location and Size

• Approximately the size of a person’s fist • Hollow, cone-shaped located within the bony thorax between the lungs • The apex – At the level of the fifth intercostal space – Rests on the diaphragm – Pointed toward the left hip • The base – Lies beneath the second rib. – The great vessels of the body emerge from it. – Points toward the right shoulder

The Heart, Coverings and Wall • The heart is enclosed by a double sac, the pericardium • Serous fluid – Produced by the pericardial membranes. – the pericardial layers slide smoothly across each other allowing the heart to beat easily with less friction • Inflammation of the pericardium, pericarditis Results in a decrease in the amount of serous fluid which causes the pericardial layers to stick to each other, forming painful adhesions that interfere with heart movements. Chambers

• The superior atria – blood flows into the atria from the IVC and SVC – Separated by the interatrial septum • The inferior ventricles – Inferior, thick-walled – pump blood out of the heart and into the circulation – The right ventricle forms most of its anterior surface, the left ventricle forms its apex – Separated by interventricular septum Circulation

• Pulmonary circulation – SVC and IVC deliver oxygen-poor blood to right atrium and then to the right ventricle – From the RV to the pulmonary trunk, which splits into the right and left pulmonary arteries which carry blood to the lungs – blood returns to the left atrium via pulmonary • Systemic circulation – From the LA to the LV to the aorta, to the systemic arteries – Oxygen-poor blood circulates from the tissues back to the RA via the systemic veins, which empty into the SVC or IVC. • Because the LV pumps blood over a longer pathway through the body, its walls are thicker than the RV and much more powerful AV Valves Semilunar Valves

• pulmonary and aortic semilunar valves • Prevents arterial blood from reentering the heart. Valves

• AV valves – Open during relaxation and Close during ventricular contraction • semilunar valves – Close during relaxation and open during ventricular contraction • As they open and close, the valves force blood to move forward in the heart IMBALANCE

• Incompetent valve – the valve does not close properly which lead to blood backflow • Valvular stenosis – The valve becomes stiff, forces the heart to contract more vigorously than normal • In each case, the heart’s workload increases, and ultimately the heart weakens and may fail • Faulty valve is replaced with a synthetic valve or a valve taken from a pig heart. Cardiac Circulation

• Blood supply is provided by the right and left coronary arteries. • The coronary arteries branch from the base of the aorta • Coronary arteries are compressed during ventricular contraction and fill during heart relaxation. • The myocardium is drained by cardiac veins, which empty into the coronary sinus. • The coronary sinus empties into the right atrium. IMBALANCE

• angina pectoris – the myocardium is deprived of oxygen – result in crushing chest pain called – if angina is prolonged, the ischemic heart cells may die, forming an infarct, myocardial infarction Conduction System of the Heart

• Some cardiac muscle cells have the ability to contract spontaneously and independently • The spontaneous contractions occur in a regular and continuous way. • Two controlling systems – Autonomic nervous system – Intrinsic conduction system, or nodal system Conduction System of The Heart consist of:

• Sinoatrial (SA) node: located in the right atrium and sets the pace for the whole heart, pacemaker • Atrioventricular (AV) node: at the junction of atria and ventricles • Atrioventricular (AV) bundle, bundle of His • Right and left bundle branches: located in the interventricular septum. • Purkinje fibers: spread within the muscle of the ventricle Conduction System of The Heart

• From the SA node, the impulse spreads through the atria to the AV node, and then the atria contract. • At the AV node, the impulse is delayed briefly to give the atria time to finish contracting • It then passes rapidly through the AV bundle, the bundle branches, and the Purkinje fibers, resulting in contraction of the ventricles which ejects blood into the large arteries IMBALANCE

• Damage to the AV node result in heart block • Damage to the SA node results in a slower heart rate. • Tachycardia – Is a rapid heart rate (over 100 beats per minute). • Bradycardia – Is a heart rate that is less than 60 beats per minute • The electrical currents detected by the electrocardiogram (ECG) ECG • P wave – The first wave, small – depolarization of the atria • QRS – Large complex – depolarization of ventricles • T wave – repolarization of ventricles. – Atrial repolarization is generally hidden by the large ORS complex • Abnormalities in the timing or the shape of the waves may indicate a disease Heart Sounds

• Lub-dup pause lub-dup pauses, and so on. – First sound (lub) • caused by the closing of the AV valves. – The second sound (dup) • Occurs when the semilunar valves close IMBALANCE – Murmur due to turbulent flow – murmurs indicate valve problems • Incompetent valve • Stenosed valve Cardiac Output

• The amount of blood pumped out by each ventricle in one minute. CO = HR (75 beats/min) X SV (70 ml/beat) = 5250 ml/min • Stroke volume: – the volume of blood pumped out by a ventricle in a heartbeat Regulation of Heart Rate

• Sympathetic autonomic nervous system: the heart beats more rapidly. • Parasympathetic nerves system: slow and steady the heart • Epinephrine: mimics the sympathetic nervous system • Thyroxin increase heart rate • Hypocalcaemia depress the heart • Hypercalcemia prolonged contractions and the heart may stop entirely. • Hypokalemia: the heart beats feebly, and abnormal heart rhythms appear. • Gender: Average heart rate is faster in females (72-80 beats/min) than in males (64-72 beats / min). • Temperature: – Heat increases heart rat – Cold has the opposite effect Imbalance

• congestive heart failure – If the left heart fails pulmonary congestion occurs – If the right side of the heart fails peripheral congestion occurs Blood Vessels

• large arteries( leave the heart)  smaller arteries  arterioles  Capillary beds  Venules  Veins  Great veins • Conducting vessels – Arteries carry blood away from the heart – Veins drain the tissues and return the blood to the heart • Capillaries – Extend and branch through the tissues – Connect the arterioles to the venules – The exchanges between the tissue cells and the blood occur through their walls venous return

1. Skeletal muscles activity milk the veins and push the blood toward the heart 2. Respiratory pump: – Inhalation decrease the pressure in the thorax causes the large veins near the heart to expand and fill. 3. venous valves – Prevent backflow of blood 4. Larger lumens IMBALANCE

• Varicose veins – Common in people who stand for a long time, Obese, and pregnant – Dysfunctional valves • Lead to blood pool • Thrombophlebitis, a serious complication, can cause pulmonary embolism; a life threatening condition Major systemic Arteries • The aorta – The largest of the body. • Aortic parts – Ascending aorta aortic arch  thoracic aorta  abdominal aorta • Arterial Branches of the Ascending Aorta – Right and left coronary arteries, which serve the heart. • Brachiocephalic: First branch off the aortic arch splits into: – R. common carotid artery – R. subclavian • Left common carotid artery: Second branch off the aortic arch divides to left internal carotid that serves the brain and left external carotid that serves the head and neck • Left subclavian artery: third branch, gives off: – Vertebral artery, serves part of the brain. – Continues as the Axillary artery which continues as the Brachial artery that supplies the arm and splits to Radial and Ulnar arteries at the elbow to serve the forearm. • Branches of the Thoracic Aorta 1. Intercostal arteries: – supply the muscles of the thoracic wall. 2. Bronchial arteries 3. Esophageal arteries • Arterial Branches of the Abdominal Aorta – Celiac trunk: The first branch, has three branches: – left gastric, splenic, and common hepatic artery – Superior mesenteric artery: supplies small intestine and the first half of the large intestine – Renal arteries: serve the kidneys. – Gonadal: R and L arteries, supply the gonads. – Lumbar arteries: Several pairs serving the muscles of the abdomen and trunk – Inferior mesenteric artery: Serve second half of the large intestine. – Common iliac: R and L, the final branches of the abdominal aorta. • Each divides into internal and an external iliac artery • external iliac artery continue as femoral then Popliteal artery that splits into anterior and posterior tibial arteries – The anterior tibial artery continue as dorsalis pedis artery Arterial Branches of the Abdominal Aorta Major Veins of the Systemic Circulation

• Veins are more superficial • Some are easily seen and palpated on the surface. • Veins draining the head and arms empty into the SVC • Veins draining the lower body empty into the IVC Veins Draining into the SVC • Radial and Ulnar: Deep veins drain the forearm. • Brachial: Drains the arm • Axillary : In the axillary region. • Cephalic vein: superficial, drains the lateral aspect of the arm and empties into the axillary vein. • Basilic vein: superficial, drains the medial aspect of the arm and empties into the brachial vein • Median cubital vein: Join the basilic and cephalic veins at the anterior aspect of the elbow Veins Draining into the SVC

• Subclavian vein; receives venous blood from the arm through the axillary vein and from the head through the external jugular vein • Vertebral vein: Drains the posterior part of the head. • Internal jugular vein: Drains the brain. • Brachiocephalic: R and L veins, receive blood from the subclavian, vertebral, and internal jugular veins • Brachiocephalic veins: Join to form the superior vena cava Veins Draining into the Inferior Vena Cava

• Gonadal veins: – R. gonadal vein empties into the IVC – L. gonadal vein empties into the left renal vein • Renal (R. and L.) veins drain the kidneys. • Hepatic (R. and L.) veins drain the liver. Veins Draining into the Inferior Vena Cava

• Anterior and posterior tibial • fibular vein • Femoral vein • Great saphenous veins: • Common iliac Brain Blood Supply • The internal carotid arteries • Vertebral arteries • circle of Willis Hepatic Portal Circulation

• inferior mesenteric vein • splenic vein • superior mesenteric vein • Hepatic veins Fetal Circulation

• The umbilical cord • umbilical vein • Umbilical arteries • ductus venosus • foramen ovale • ductus arteriosus • Umbilical vein Arterial Pulse Blood Pressure

• Systolic • Diastolic Factors Alter Blood Pressure

• Hemorrhage drops blood pressure and the heart begins to beat faster • Exercise lead to generalized vasoconstriction except in the skeletal muscles • Sympathetic stimulation lead to vasoconstriction • Temperature. – Cold has a vasoconstricting effect – Heat vasodilating effect • Chemicals: – Epinephrine increases heart rate and blood pressure – Nicotine increases blood pressure by causing vasoconstriction – Alcohol and histamine cause vasodilation • Diet low in salt, saturated fats, and cholesterol helps prevent hypertension • Variations in Blood Pressure – Blood pressure varies with • Age, weight, race, mood, physical activity, and posture. • IMBALANCE – Orthostatic hypotension: • An aging sympathetic nervous system reacts more slowly to postural changes. Developmental Aspects of the Cardiovascular System

• The heart start beating by the fourth week of pregnancy. • Infection during the first three month of pregnancy may affect the heart • Pulmonary trunk Label the heart components • Bicuspid valve • Inferior vena cava • Left atrium • Aortic valve • Left ventricle • Right ventricle • Right atrium • Tricuspid valve • Aorta • Interatrial septum • Superior vena cava • Right pulmonary artery • Left pulmonary artery • Left pulmonary veins • Interventricular septum • Right pulmonary veins Match the term on the left with the correct answer on the right

1. Interatrial septum A. Upper chambers of the heart 2. Interventricular septum B. Lining of the heart 3. Atria C. Lower chambers of the heart 4. Ventricles D. Between the atria 5. Myocardium E. Outermost layer of the heart 6. Epicardium F. Between the ventricles 7. Endocardium G. Middle muscular layer of the heart Match the term on the left with the correct answer on the right

1. Tricuspid valve A. Between left atrium and left 2. Bicuspid valve ventricle 3. Aortic semilunar B. Between Aorta and left ventricle valve C. Between right atrium and right 4. Pulmonary semilunar ventricle valve D. Between right ventricle and 5. First heart Sound pulmonary trunk 6. Second Heart sound E. Closer of the AV valves F. Closer of the Semilunar valves Match the term on the left with the correct answer on the right

1. Pulmonary veins A. Carry blood to the systems 2. Pulmonary Trunk B. Feed the heart with blood 3. Aorta C. Carry blood to the lungs 4. Superior and inferior D. Return blood to left atrium vena cava E. Return blood to the right 5. Coronary arteries atrium F. Ejecting chambers 6. Atria 7. Ventricles G. Receiving chambers Label the heart conduction system

• Senatorial node • Bundle of His • Purkinje fibers • Left bundle branch • Atrioventricular node • Right bundle branch Label the EKG

• Q wave • S wave • P wave • R wave • T wave • QRS complex Match the term on the left with the correct answer on the right 1. Repolarization A. Contraction of ventricles 2. Depolarization B. AV bundle 3. Diastole C. Relaxation of ventricle 4. Systole D. Pace maker 5. Bundle of His E. Result in relaxation. 6. SA node F. Result in contraction Match the term on the left with the correct answer on the right 1. Radial artery A. Located at the wrist. 2. Femoral artery B. Located at thigh 3. Carotid artery C. Located at the neck 4. Dorsal pedis D. Located at the dorsum of 5. Brachial artery the foot E. Usually used to measure blood pressure Multiple Choice Questions

1. The ______function as exchange vessels. a. Capillaries b. Arteries c. Heart 2. The structure used to bypass the liver in fetal circulation is the a. Foramen ovale b. Ductus venosus c. Ductus arteriosus 3. The structure used to bypass the lungs in fetal circulation is the a. Ductus venosus b. Ductus arteriosus c. Umbilical vein 4. The structure that connects the aorta with the pulmonary artery in fetal circulation is the: a. Ductus arteriosus b. Ductus venosus c. Aorta Multiple Choice Questions

5. Which of the following has valves to assist the blood flow? a. Veins b. Arteries c. Capillaries 6. Blood rich in oxygen returns from the lungs and enters the left atrium by a. Pulmonary veins b. Superior vena cava c. Aorta 7. Massive hemorrhages result in a. Increase blood pressure b. Decrease blood pressure and Body Defenses Lymphatic System • Consist of – Lymphatic vessels: • Transport fluids back into the blood. – Lymphatic capillaries, vessels – Lymphoid tissues and organs: • Scattered throughout the body • House phagocytic cells and lymphocyte Lymphatic Capillaries

• Between the tissues and blood capillaries • Absorb leaked fluid • Very permeable – Endothelial cells overlap one another forming minivalves. The minivalves open when fluid pressure is higher in the interstitial space, allowing fluid to enter the lymphatic capillary – The minivalves close when pressure inside the lymphatic vessels is higher, preventing lymph to leak back – Bacteria, viruses, and cancer cells can enter the lymphatics Lymphatic Vessels, lymphatics

• lymphatic vessels pick up excess lymph and return it to the bloodstream – failure to do so result in edema • larger ones have valves. Thus lymph flows only toward the heart • transport lymph to two large ducts in the Lymphatic vessels thoracic region. • Right lymphatic duct: Drains lymph from the right arm and the right side of the head and the thorax. • Large thoracic duct: receives lymph from the rest of the body. • Both ducts empty the lymph into the subclavian on the same side Lymphatic System

• Lymph is transported by – Milking action of the skeletal muscles – Pressure changes in the thorax during breathing – Smooth muscle in the walls of the larger lymphatics contracts rhythmically pumping the lymph. • Lymph goes through the lymph nodes to be cleansed of debris and checked by the cells of the immune system • kidney-shaped, Located in the connective tissue that Lymph Nodes surrounds them • Help protect the body by Removing foreign substances form the lymph and Producing lymphocytes • Lymph is filtered through the lymph nodes clustered along the lymphatic vessels • clusters found in the inguinal, axillary, and cervical regions IMBALANCE

• Lymph nodes rid the body of infectious agents and cancer cells – When overwhelmed, the nodes become inflamed and tender to the touch. • The lymph nodes may become cancer sites, especially in that use lymphatic vessels to metastasize Lymphoid Organs • Spleen • thymus gland • Tonsils • Peyer’s patches of the intestine • Some lymphatic tissue scattered in the epithelial and connective tissues. Only the lymph nodes filter lymph. The Spleen

• a blood-rich organ • located in the left hypochondriac region • filters and cleanses blood of bacteria, viruses, and other debris. • Other functions of the spleen include – destroy worn-out red blood cells – storing platelets and acting as a blood reservoir – In the fetus, hematopoiesis The Thymus • Functions at peak levels during youth • found low in the thorax overlying the heart. • Produces hormones, thymosin and others, that function in the programming of T lymphocytes so they can carry out their protective roles in the body. Tonsils • small masses of lymphatic tissue in the • trap and remove bacteria and other pathogens entering the throat • When congested with bacteria, they become red, swollen, and sore, a condition called tonsillitis. Peyer’s patches • found in the wall of small intestine • destroy bacteria, preventing them from penetrating the intestinal wall. Body Defenses

• Protect us from most bacteria, viruses, transplanted organs or grafts, and from our own cells that turned against us. • The immune system does this: – directly, by cell attack – Indirectly, by releasing chemicals and antibodies • Two systems, work hand-in-hand to protect the body – Nonspecific – Specific. Body Defenses

Specific defense system Nonspecific defense system – attack specific foreign – Responds immediately to all substances (antigen) foreign substances – specific resistance to the disease is called – Prevent entry and spread of immunity microorganisms throughout – the immune system must the body have initial exposure to an antigen before it can protect the body against it – lacks speed Nonspecific Body Defenses

• Some nonspecific resistance to disease are inherited – certain diseases do not affect • nonspecific body defense: – Surface Membrane Barriers: • Mechanical barriers cover body surfaces; skin and mucous membranes – Cells and Chemicals • protect the body from invading pathogens skin and mucous membranes • Physical barriers – first line of defense against microorganism • keratinized epidermis • Intact mucous membranes • Protective chemicals: – Acidic pH of skin secretions inhibits bacterial growth – Sebum contains chemicals that are toxic to bacteria. – Vaginal secretions of adult females are very acidic. – Stomach HCl and protein-digesting enzymes. Both kill pathogens. – Saliva and lacrimal fluid contain lysozyme that destroys bacteria. – Sticky mucus traps many microorganisms that enter digestive and respiratory passageways. Cells and Chemicals

• The second line of defense • Phagocytes – engulfs a foreign particle – The vacuole is then fused with the lysosome that brake it down • Natural Killer Cells – kill cancer cells and virus-infected cells

Inflammatory Response • triggered due to body tissues injury – Physical trauma, intense heat, chemicals irritation, infection (viruses, bacteria) • Four signs – redness, heat, swelling, and pain. • Inflammatory response 1. Prevents the spread of damaging agents to nearby tissues. 2. Dispose of cell debris and pathogens. 3. Set the stage for repair. Inflammatory Response: Phagocytic Mobilization 4 Positive chemotaxis Inflammatory chemicals diffusing from the inflamed site act as chemotactic 1 Neutrophils enter agents blood from bone marrow 3 Diapedesis 2 Margination

Endothelium Capillary wall Figure 21.3 IMBALANCE

• In severely infected areas, a creamy yellow pus may form in the wound. – Pus is a mixture of dead or dying neutrophils, broken- down tissue cells, and living and dead pathogens • If the inflammatory mechanism fails to clear the area of debris, the sac of pus may become walled off, forming an abscess. – Surgical drainage of abscesses is often necessary before healing can occur. Antimicrobial Chemicals

• antimicrobial chemicals are: • Complement proteins • Interferon. Complement

• plasma proteins circulating in the blood in an inactive state. • attach to foreign cells and becomes activated and kill bacteria

Interferon

• The infected cells secret interferons. • The interferon molecules diffuse to nearby cells and bind to their membrane receptors which hinders the ability of viruses to multiply within these cells. Fever

• abnormally high body temperature • a systemic response to invading microorganisms. • high fevers are dangerous because it denature enzymes and other body proteins • mild or moderate fever seems to benefit the body. – Bacteria require large amounts of iron and zinc to multiply, but during a fever the liver and spleen gather up these nutrients, making them less available. – Fever increases the metabolic rate of tissue cells which speed up the repair process Specific Body Defenses

• The immune system response to a threat is called immune response • initial exposure to an antigen primes the body to react more vigorously to later encounters with the same antigen • three important aspects of the immune response: 1. Antigen specific: recognizes and acts against particular pathogens or foreign substances. 2. Systemic: Immunity is not restricted to the initial infection site. 3. Memory: recognizes and mounts a stronger attack on previously encountered pathogens. Specific Body Defenses: The Immune System

• Two arms of immunity – Humoral immunity • Also called antibody-mediated immunity • The lymphocytes secret antibodies – Cellular • Also called cell-mediated immunity • lymphocytes themselves defend the body Antigens

• any substance may provoke an immune response • Many substances can act as antigens: – Foreign proteins, nucleic acids, large carbohydrates, and some lipids • Self antigen – Our cells have a variety of protein molecules (self antigens) – Our immune system recognize these proteins as self – Self antigens do not trigger an immune response Haptens or incomplete antigen

• small molecules, not antigenic. • they attach to our own proteins, the immune system may recognize the combination as foreign and mount an attack • Such reactions, called allergies • Chemicals that act as haptens are found in – certain drugs – poison ivy – animal dander – Some detergents, hair dyes, cosmetics, and other commonly used household and industrial products. IMBALANCE

• Drug haptens provoking an immune response involves the binding of penicillin to blood proteins, which causes a penicillin reaction in some people. • The immune system mounts such a vicious attack that the person’s life is endangered. Cells of the Immune System

• The cells of the immune system are lymphocytes and macrophages. • Lymphocytes: exist in two forms – B lymphocytes, or B cells • Produce antibodies and oversee humoral immunity – T lymphocytes, or T cells • Non-antibody-producing lymphocytes • the cell-mediated arm of immunity. • Macrophages – do not respond to specific antigens – play an essential role in helping the lymphocytes that do. Lymphocytes

• Originate from hemocytoblasts in red bone marrow • released from the marrow to become B or a T cell • T Lymphocytes: migrate to the thymus to undergo a maturation process, directed by thymic hormones • B Lymphocytes: develop immunocompetence in bone marrow • After becoming immunocompetent, both T cells and B cells migrate to the lymph nodes, spleen, and loose connective tissues to encounter the antigens • when lymphocytes bind to antigens, they complete their differentiation into fully mature T cells and B cells • lymphocytes, especially T cells, circulate continuously through the body which increases a lymphocyte’s chance to contact antigens Macrophages

• distributed throughout the lymphoid organs and connective tissues • arise from monocytes formed in the bone marrow. • engulf foreign particles and present it to T cells. • Activated T cells, in turn, release chemicals that cause macrophages to become phagocytes, or killer macrophages.

Humoral (Antibody-Mediated) Immune Response

• B lymphocytes bind to antigen • This binding activates the lymphocyte begin to grow and multiply rapidly • the descendant cells have the same antigen-specific receptors • Most B cells become plasma cells that produce specific antibodies at high rate • Some B cell become memory cells capable of responding to the same antigen at later encounters • Memory cells are responsible for the secondary responses which are much faster, more prolonged, and more effective

Active and Passive Humoral Immunity

• Active immunity – naturally acquired during bacterial and viral infections – artificially acquired by vaccination • Passive immunity – antibodies are obtained from the serum of an immune human or animal – B cells are not challenged by the antigen – immunological memory does not occur – the temporary protection end when the antibodies naturally degraded in the body – acquired naturally from the mother to the fetus through the placenta – artificially when one receives immune serum or gamma globulin vaccine

• Most vaccine contain dead or attenuated (live but weak) pathogens. • Booster shots intensify the immune response at later meetings with the same antigen

Antibodies

• soluble proteins secreted by activated B cells or by their plasma cell offspring in response to an antigen • capable of binding a specific antigen • five classes, each slightly different in structure and function, IgM, IgA, IgD, IgG, and IgE. – IgG is the most abundant antibody in blood plasma and is the only type that crosses the placenta; the passive immunity from the mother to the fetus is IgG antibodies – IgA found mainly in mucus and other secretions; preventing pathogens from entering the body. – IgE antibodies involved in allergies Basic Antibody Structure

• Two identical heavy chains: contain about 400 amino acids each • Two identical light chains: about half as long. • Each chain had a variable (v) region at one end a larger constant (C) region at the other end. • the variable regions of the heavy and light chains in each arm form an antigen-binding site that fits specific antigen. – Y shape, each antibody has two antigen-binding regions. Basic Antibody Structure

Cellular (Cell-Mediated)

• immunocompetent T cells are activated to form a clone by binding with a recognized antigen. • Macrophages present antigen to T cells • T cell must recognize the antigen • Without macrophage presenters, the immune response is severely impaired.

Classes of T cell • cytotoxic (killer) T cells – specialized in killing virus-infected, cancer, or foreign graft cells. – Bind and insert a toxic chemical (perforin) into the foreign plasma membrane • Helper T cells – interact directly with B cells prodding them into clone production and antibody formation • suppressor T cells – suppress the activity of both T and B cells. – vital for stopping the immune response after an antigen has been inactivated or destroyed. This helps prevent uncontrolled or unnecessary immune system activity. Organ Transplants and Rejection

• Four major types of grafts: 1. Autografts • tissue grafts transplanted from one site to another in the same person. 2. Isografts – tissue grafts donated by a genetically identical person, the only example being an identical twin 3. Allografts – tissue grafts taken from an unrelated person. – Graft taken from a recently deceased person. 4. Xenografts – Graft taken from different species • Autografts and isografts are ideal donor organs or tissues and are almost always successful Allergies

• Allergies or hypersensitivities – Abnormal immune responses in which the immune system causes tissue damage • immediate hypersensitivity. – the most common type, also called acute hypersensitivity – triggered by the release of histamine when IgE antibodies bind to mast cells. – Histamine causes small blood vessels in the area to dilate and leak – Symptoms: runny nose, watery eyes, itching, reddened skin (hives), asthma – Most reactions begin within seconds after contact with the allergen and last about half an hour. Allergies

• anaphylactic shock – systemic acute allergic response, occurs when the allergen directly enters the blood and circulates rapidly through the body • bee stings, spider bites, injection of horse serum, penicillin, or other drugs that act as haptens – The mechanism is the same as that of local responses; but when the entire body is involved, the outcome is life threatening. – Symptoms: difficulty breathing, vasodilation (circulatory collapse and death within minutes.

Allergies

• Delayed hypersensitivities – take much longer to appear (1 to 3 days) than the acute reactions produced by antibodies. – antihistamine drugs are not helpful – Corticosteroid drugs are used to provide relief. – examples of delayed hypersensitivity reactions • allergic contact , which follow skin contact with poison ivy, heavy metals (lead, mercury, and others), certain cosmetic and deodorant chemicals. • Skin tests for detection of tuberculosis, depend on delayed hypersensitivity reactions. When the tubercle antigens are injected just under the skin, a small, hard lesion forms if the person has been sensitized to the antigen. Immunodeficiencies

• Can be congenital and acquired conditions • Abnormal production or function of immune cells or complement • severe combined immunodeficiency disease (SCID) – a congenital condition – there is deficiency in B and T cells. – afflicted children have no protection against pathogens of any type. – Minor infections are lethal • acquired immune deficiency syndrome (AIDS). – Affect the immune system by interfering with the activity of helper T cells Autoimmune Diseases

• the body produces antibodies and sensitized T cells that attack its own tissues. • Multiple sclerosis (MS): destroys the white matter of the brain and spinal cord • Myasthenia gravis: impairs communication between nerves and skeletal muscles • Graves’ disease: the thyroid gland produces excessive amounts of thyroxin • Juvenile (type I diabetes mellitus): destroys pancreatic cells, resulting in deficient production of insulin • Systemic lupus erythematosus (SLE): a systemic disease occurs mainly in young females and affects the kidneys, heart, lungs, and skin • Glomerulonephritis: affect the kidney • Rheumatoid arthritis (RA): systemically destroys joints Label the structure

• Lymphatic capillaries • Afferent lymph vessel • Thymus • Right lymphatic duct • Thoracic duct • Spleen • Efferent lymph vessel • Cisterna chili • Label the structure • Lymphatic capillaries • Afferent lymph vessel • Thymus • Right lymphatic duct • Thoracic duct • Spleen • Efferent lymph vessel • Cisterna chili • Lymph node Label the structure

• Lymphatic capillaries • Afferent lymph vessel • Thymus • Right lymphatic duct • Thoracic duct • Spleen • Efferent lymph vessel • Cisterna chili • Lymph node Label the structure

• Lymphatic capillaries • Afferent lymph vessel • Thymus • Right lymphatic duct • Thoracic duct • Spleen • Efferent lymph vessel • Cisterna chili • Lymph node Match the items on the left with the best answer on the right

1. Specialized fluid formed in the tissue A. Cisterna chili spaces B. Efferent vessel 2. Tiny blind-ended tubes among the C. Lymph tissues D. lymph nodes 3. Eventually empties into blood on the left E. thoracic duct 4. Eventually empties into blood on the F. Lymph capillaries right G. afferent lymph 5. thoracic duct has enlarged pouch-like vessels. 6. Filters the lymph H. Right lymphatic duct 7. Lymph enters the node 8. Lymph exits the node Match the term on the left with the proper selection on the right.

1. Active naturally acquired immunity A. Antibodies 2. Passive naturally acquired immunity B. Vaccine 3. Active artificially acquired immunity C. Obtained from the mother 4. Passive artificially acquired immunity D. Bacterial or viral infection 5. Specific immunity E. Fever 6. Nonspecific immunity F. Gamma globulin 7. Humeral immunity G. B lymphocytes 8. Cellular immunity H. T lymphocytes Multiple Choice Questions

1. The kind of cell that produces large numbers of antibodies is the: a. Stem cell b. T cell c. Plasma cell 2. T cell development begins in the: a. Lymph nodes b. Pancreas c. Thymus 3. B cells are responsible for a. Humoral immunity b. Cell-mediated immunity c. Nonspecific immunity 4. T cells responsible for : a. Humoral immunity b. Cell-mediated immunity c. Nonspecific immunity Multiple Choice Questions

5. The spleen: a. Is the largest lymphoid organ in the body b. Filter the lymph c. is located in the upper right quadrant 6. Lymph nodes are responsible for: a. Filtering blood b. Filtering lymph c. Very large organs 7. Which of the following is not an example of tonsils? a. Palatine b. Humoral c. Pharyngeal Multiple Choice Questions

8. Active immunity occurs when: a. Immunity to a disease that has developed in another individual is transferred to someone not previously immune b. An infant receives antibodies in her mother's milk c. A vaccination confers immunity 9. Which of the following is an example of nonspecific immunity? a. Skin b. humoral c. cellular 10. In general, antibodies produce ______immunity. a. Phagocytic b. Humoral c. none specific The The Respiratory System

• The cardiovascular and respiratory systems supply the body with oxygen and dispose of carbon dioxide. – The respiratory system organs oversee the gas exchanges – Cardiovascular system organs transport the O2 and CO2 • The organs of the respiratory system include – Nose, pharynx, larynx, trachea, bronchi and their smaller branches, and the lungs which contain the alveoli – Gas exchanges happen only in the alveoli • Functionally consist of: Respiratory System • Conducting portion: • Respiratory portion: Nose

• Divided into right and left sides • hard and soft palate • Superior, middle, and inferior conchae • superior, middle, and inferior meatus. • the conchae increase surface area and air turbulences Paranasal Sinuses

• Frontal, sphenoid, ethmoid, and maxillary • Help decrease the weight of the skull • Act as a resonance chamber • Produce mucus to trap debris • Drain into the nasal cavity • Nasolacrimal ducts and paranasal sinuses ducts open in the nasal cavity Nose, Function

• Warm incoming air by the blood in the capillaries • The mucus secreted by the goblet cells moisten and filter incoming air • Cilia move mucus toward the pharynx • Detecting olfactory stimuli: receptors lie in the membrane lining of the superior nasal conchae and adjacent septum • Modifying speech vibration ( resonance) Pharynx, throat

• funnel-shaped muscular tube • Extend from the internal nares to the cricoid cartilage level • Divided into three parts: Nasopharynx, oropharynx, laryngopharynx • Function – Passageway for air and food – Resonating chamber for speech sounds – House the tonsils Nasopharynx • Location • Five openings in its wall – 2 internal nareses: pharyngeal tonsils or adenoids can cut off air if swollen. – 2 pharyngotympanic – opening to the oropharynx. • Function: breathing only Oropharynx

• Location • Function: • Tonsils: Palatine and Lingual Laryngopharynx • Location • Function Larynx, Voice box

• Short passageway connects the Laryngopharynx to the trachea. • Composed of 9 cartilages : ( thyroid, cricoid, Epiglottis, 2 arytenoids, 2 cuneiform, 2 corniculate) • Location: – In the midline of the neck anterior to C4 through C6 Larynx, Voice box

• Thyroid cartilage (Adams apple) – Two fused plates of hyaline cartilage form the anterior wall of the larynx – Larger in mal than female – Connected to hyoid bone by thyrohyoid membrane Larynx, Voice box

• Epiglottis: – Large leaf-shaped attached to the thyroid cartilage anteriorly – free edge posteriorly that moves up and down like a trap door • forms a lid protecting the superior opening of the larynx Structures of Voice Production • Two pair of folds: – Superior pair: false vocal cords, hold breath against pressure in the thoracic cavity (left heavy object) – Inferior: true vocal cords Trachea

• tubular passageway for air • anterior to the esophagus, and extends from the larynx to T5 where it divides into right and left bronchi at the Carina Bronchi

• Sympathetic dilates airway • Parasympathetic  constriction • Histamine  constriction • Pleural membrane – Two layers enclose and Pleura protect the lungs • Pleural cavity: – Small space between the two layers – Contains small amount of lubricating fluid that helps to reduce friction between the membranes and adheres the membrane to each another – Separate pleural cavities surround the left and right lungs lungs

• Cone shaped separated by the mediastinum • Extend from the diaphragm to just slightly superior to the clavicles • Anterior, lateral, and posterior surfaces of the lung lies against the ribs • The base concave and fits over the convex diaphragm • The apex is the narrow superior portion of the lung • Mediastinal (medial) surface contains the hilus ( bronchi, blood vessels, lymphatic vessels, nerves) Primary Bronchi

• Primary bronchi • Secondary bronchi • Bronchioles • terminal bronchioles Bronchioles

• Terminal bronchioles • Respiratory bronchioles • alveolar ducts • Alveolar sac • alveoli The lower lung Alveoli

• Millions of clustered alveoli make up the bulk of the lungs • Alveolus: – cup-shaped out pouching – Alveolar pores • connect neighboring air sacs and provide alternate routs for air Respiratory Membrane

• Exchange of O2 and CO2 between the air spaces and the blood • Alveolar wall – Epithelial underlying alveolar wall – Capillary basement membrane that is often fused to the epithelial basement membrane – Endothelial cells of the capillary Blood Supply to the lungs

• Pulmonary arteries carry deoxygenated blood from the heart to the lungs – pulmonary trunk  right and left pulmonary arteries • Oxygenated blood return to the heart via pulmonary veins that drain into the left atrium Inspiration (inhalation)

• The contraction of diaphragm and external intercostal muscles increase the vertical dimension and the anterior posterior diameter • The thoracic cavity expands and the pleura is pulled outward in all directions pulling with it the lungs • alveolar pressure decrease below atmospheric pressure and forces air into the lung • eupnea: normal quiet breathing • apnea: temporary cessation of breathing • Dyspnea: painful or difficult • tachypnea: rapid breathing • Brady-pnea Mechanics of Breathing: Inspiration Expiration (exhalation)

• The inspiratory muscles relax and the thoracic cage recoils to its normal size compressing the lungs increasing the alveoli pressure that result in exhalation Pulmonary Ventilation

• – The process of gas exchange in the body – Occurs in three basic steps: 1. Pulmonary ventilation (breathing): • the flow of air into (inhalation) and out of (exhalation) the lungs 2. External respiration: • The blood gains O2 and loses CO2. • Exchange O2 and CO2 between the alveoli and pulmonary capillaries 3. Internal respiration: • The blood loses O2 and gains CO2 • exchange of O2 and CO2 between blood and tissues. Transporting O2 • Oxygen transported in two ways 1. Only 1.5% of the oxygen is dissolved in blood plasma 2. 98.5% of oxygen is bound to hemoglobin in RBC – O2 and hemoglobin bind in a reversible reaction • Only dissolved oxygen can diffuse out of issue capillaries into tissue cells Lung Volume and Capacities

• Respiratory rate in adults is 12 breaths per min • Spirometer (respirometer): is the apparatus used to measure the volume of air exchanged during breathing, and the respiratory rate. • The record is called Spirogram Lung Volume and Capacities

• Tidal volume (TV): – The volume of one breath – Varies from one person to another • Inspiratory reserve volume: – The amount of air forcibly inhaled after a TV • Expiratory reserve volumes: – The amount of air forcibly exhaled after a TV • Residual volume: – The air remains in the lungs after the expiratory reserve volume is exhaled – Cannot be measured by spirometry • Vital capacity : – The total amount of exchangeable air – ISRV + TV + EXRV = ( 4800) Transporting Carbon dioxide

• CO2 transported in three forms 1. Dissolved: • CO2 diffuses into alveolar air upon reaching the lung. 2. Carbamino compounds • 20-30% combines with globin of Hb 3. Bicarbonate ion • CO2 enters RBC, reacts with H2O to form H2CO3 which dissociates into H ion and HCO3. This is a reversible reaction. • HCO3 ion leaves RBC and enters plasma CO2 Transport & Exchange: at the tissues CO2 Transport & Exchange: in the lungs Exercise and The Respiratory system

• Exercise increase O2 consumption and CO2 production • Increase cardiac output will lead to increase in pulmonary perfusion which increase surface area available for diffusion of oxygen into pulmonary blood capillaries Regulation of The Respiratory Center

• Inspiratory center more strongly stimulated when PCO2 is rising above normal than when PO2 is falling below normal • Hyperventilation decrease PCO2 • Hypoventilation  Increase PCO2 Label the structures of • Conchea the respiratory system • External naris • Larynx • Primary • Alveolus • Alveolar sac • Trachea • Secondary bronchus • Esophagus • Nasal cavity • Pharynx • Respiratory bronchiole • Respiratory membrane • Terminal bronchiole • Red blood cells Label the structures of the Larynx

• Epiglottis True vocal cords Cricoid cartilage • Trachea Thyroid cartilage Arytenoids cartilage • Glottis False vocal cords Match the term with the definition.

• Upper respiratory System Lower Respiratory System

1. Nose 5. Bronchi 9. Alveoli 2. Pharynx 6. Alveolar duct 10. Respiratory bronchiole 3. larynx 7. Terminal bronchiole 4. Trachea 8. Alveolar sac Match the term with the definition.

• Functional Zone Conducting portion

1. Nose 5. Pharynx 8. larynx 2. Trachea 6. Bronchi 9. Terminal bronchiole 3. Alveolar duct 7. Alveolar sac 10. alveoli 4. Respiratory bronchiole List 4 functions of the nose

1. ______2. ______3. ______4. ______Match the term with its function

1. Nasopharynx A. Passageway for air 2. Oropharynx and food and fluid 3. Laryngopharynx B. Passageway for air True or False

1. The first branch of the trachea leading to the lungs is the bronchioles. 2. Each alveolar duct ends in several alveolar sacs. 3. The narrow part of each lung, up under the collarbone, is its apex. 4. For inspiration to take place, the diaphragm and other respiratory muscles relax. 5. The exchange of gases between the blood and the lungs occurs through the respiratory membrane. Multiple Choice

1. The term that means the same thing as breathing is: a. Respiration b. Inspiration c. Expiration 2. Iron in the hemoglobin binds to ______. a. Oxygen b. Carbon dioxide c. Nitrogen 3. The globin in the hemoglobin binds to a. Oxygen b. Carbon dioxide c. Nitrogen 4. Which of the following would not assist inspiration? a. Elevation of the ribs b. Elevation of the diaphragm c. Chest cavity becomes longer from top to bottom 5. Which of the following is not a paranasal sinus? a. Frontal b. Temporal c. Maxillary Multiple Choice

6. Select the correct pathway that air takes on the way to the lungs. a. Primary bronchi, secondary bronchi, alveolar sacs, alveolar ducts b. Primary bronchi, secondary bronchi, alveolar sacs, alveoli c. Primary bronchi, bronchioles, secondary bronchi, alveolar ducts 7. During expiration: a. The thoracic cavity decreases in size b. The lungs expand c. The diaphragm flattens out and contracts 8. Eupnea is a term used to describe: a. Labored breathing b. Rapid respirations c. A normal respiratory rate Apply Your Knowledge

1. Kim was 5 years old and was a mouth breather. She had repeated episodes of tonsillitis and the pediatrician suggested removal of her tonsils and adenoids. He further suggested that the surgery would probably cure her mouth-breathing problem. Why is this possibility? Digestive System • Extend form the mouth to the anus include Overview of the  Mouth Digestive System  Pharynx  Esophagus  Stomach  Small intestine  Large intestine  Anus • Accessory digestive organs – directly or indirectly contact the food Tongue Salivary glands Gall bladder Liver Pancreas Teeth Mouth • Cheeks: – form the lateral walls of the oral cavity • : – surround the opening of the mouth • Hard palate: – the anterior 2/3 of the roof of the mouth – Separate the oral from the nasal cavity • Soft palate: – the posterior portion of the roof of the mouth • Oral cavity: – the area between the teeth Tongue

• skeletal muscle covered with mucous membrane • Form floor of oral cavity • Lingual frenulum – A fold of mucous membrane connect the tongue to the floor of the mouth – Limits the posterior movements of tongue • Tongue Function – Taste – Manipulating and mixing food with saliva Pharynx • funnel-shaped muscular tube lined by mucous membrane • extends from the internal nares to the esophagus posteriorly and to the larynx anteriorly • Nasopharynx: has respiratory function only • Oropharynx and Laryngopharynx have digestive and respiratory functions. • Oropharynx lie posterior to the oral cavity • Laryngopharynx continuous with the esophagus below Esophagus

• collapsible muscular tube. • Begins at the laryngopharynx, passes through the mediastinum anterior to vertebral columns, pierces the diaphragm to the superior portion of stomach • Passageway conducts food and fluid Stomach

• Located in the epigastric, umbilical, and left hypochondriac regions. • J-shaped inferior to the diaphragm connects esophagus to duodenum • Distensible; accommodates large quantity of food. Function of the Stomach

• Function – a temporary storage for food – Mechanical digestion – Chemically breakdown food • The mucosa produces – mucus – gastric juice: • hydrochloric acid • intrinsic factor (needed vitamin B12 absorption) • Pepsinogen • gastrin Small Intestine

• Twisted, muscular tube • extends from the stomach to the ileocecal valve • suspended from the posterior abdominal wall by the mesentery • has three subdivisions – duodenum • curves around the head of the pancreas – jejunum • extends from the duodenum to the ileum – ileum • the terminal part, joins the large intestine at the ileocecal valve. Function

• Chemical digestion of foods • Pancreatic juice secreted into the duodenum through the pancreatic ducts • Bile enters the duodenum through the bile duct in the same area Large Intestine • larger in diameter than the small intestine • extends from the ileocecal valve to anus • absorb water, and eliminate residues from the body as feces • produce mucus that lubricate the passage of feces • subdivisions – Cecum: first part of the large intestine – Appendix: hanging from cecum – ascending colon travels up the right side of the abdominal cavity – transverse colon travels across the abdominal cavity – descending colon: continues down the left side to enter the pelvis, where it becomes the sigmoid colon and then the which becomes anal canal that opens to the external Salivary glands

• Parotid: – inferior and anterior to the ear – Parotid duct pierces the buccintor muscle and opens opposite to the second upper molar tooth • Submandibular: – Beneath the base of the tongue in the posterior floor of the mouth – Submandibular duct opens lateral to the lingual frenulum • Sublingual glands: – Superior to the Submandibular gland – Its duct open into the floor of the mouth in the oral cavity Composition and Function of Saliva • Saliva dissolves food chemicals to be tasted • bind food together into a mass called a bolus which makes chewing and swallowing easier. • salivary amylase: digest starch in the mouth. • lysozyme kills bacteria • IgA that inhibit bacteria Teeth • Function: – tear and grind the food, breaking it down into smaller pieces • the deciduous (baby teeth or milk teeth) – begin to erupt around six months – The baby has a full set (20 teeth) by the age of 2 years. – The first teeth to appear are the lower central incisors • the permanent teeth – between 6 and 12 years – All permanent teeth, except the third molars, have erupted by the end of adolescence – The third molars, wisdom teeth, emerge between the ages of 17 and 25. – there are 32 permanent teeth in a full set – the wisdom teeth often fail to erupt; completely absent. Human dental formula: Permanent teeth • three major regions Anatomy of a – Crown: visible portion – Neck: constricted junction near gum Tooth line – Roots: embedded in the socket • Enamel: – Hard substance protects tooth • Dentin – Underlie the enamel – Enclose the tooth pulp cavity • Pulp cavity: – contains connective tissue, blood vessels, nerves, lymphatic vessels • Root canals: – Narrow extension of the pulp cavity runs through the root of the tooth • extends across from the spleen to Pancreas the duodenum • retroperitoneal. • produces enzymes that break down digestible foods • The enzymes secreted into the duodenum • produces insulin and glucagon hormones Liver

• located under the diaphragm, more to the right side of the body • overlies and covers the stomach. • Produce bile • Bile – a yellow-to-green, watery solution – leaves the liver to enters the duodenum through the bile duct – Helps digesting fat Gallbladder

• green sac in a shallow fossa in the inferior surface of the liver • Store and concentrate bile Imbalance

• If bile is stored in the gallbladder too long or too much water is removed, may result in gallstones. • gallstones cause pain • Blockage of bile ducts prevents bile from entering the small intestine, and it begins to back up into the liver. And the bile pigments begin to enter the bloodstream causing jaundiced. Function of the Digestive system

• Ingestion food and fluid – Placing the food into the mouth – This is an active voluntary process • Propulsion – Moving food along the tract – Peristalsis is involuntary and involves alternating waves of contraction and relaxation of the muscles in the organ wall Function of the Digestive system • Food breakdown: mechanical digestion – Mixing food in the mouth – churning food in the stomach – Segmenting in the small intestine – Mechanical digestion prepares food for further degradation by enzymes. • Food breakdown: chemical digestion – food molecules are broken down by enzymes • Absorption – Transporting digested food from the GI tract to the blood or lymph • Defecation – the elimination of indigestible substances from the body via the anus in the form of feces The Digestive Process

Ingestion Propulsion Mechanical Digestion Chemical Digestion Absorption Defecation GERD

• GERD results in – heartburn – inflammation of the esophagus – ulceration of the esophagus • A common cause is a hiatal hernia • Treatment: – restricting food intake after the evening meal, taking antacids, and sleeping with the head elevated. Imbalance

• Pancreatitis – inflammation of the pancreas that results in break down pancreatic tissue and duct – Result in nutritional deficiencies, because pancreatic enzymes are essential to digestion in the small intestine. • If either bile or pancreatic juice is absent, no fat digestion or absorption occur, and fatty, bulky stools are the result. Activities of the Large Intestine

• Bacteria in the large intestine make vitamin K and some B vitamins Imbalance

• Diverticulas – when inflamed cause diverticulitis • Diarrhea – Result from conditions that rushes food residue through the large intestine before absorbing the water • Constipation – too much water is absorbed, and the stool becomes hard and difficult to pass. – May result from lack of fiber in the diet, poor bowel habits Nutrition • A nutrient is a substance used by the body to promote normal growth, maintenance, and repair. • nutrients are used to build cellular molecules, structures, and used as a fuel to make ATP • Nutrients divide into six categories. – carbohydrates, lipids, proteins, vitamins and minerals, water • Most foods offer a combination of nutrients • energy value of foods is measured in units called kilocalories (kcal) or Calories. Dietary Sources of Nutrients • Carbohydrates – All the carbohydrates are derived from plants. • Except for lactose in milk, and glycogen in meat – Sugars come mainly from fruits, sugar cane, and milk – polysaccharide • Starch is found in grains, legumes, and root vegetables • Cellulose is found in vegetables, not digested by humans, provides roughage that aids in defecation. • Lipids – Cholesterol, phospholipids, and triglycerides (most dietary lipids) – saturated fats found in animal products (meat, dairy) and in a plant products (coconut) – Unsaturated fats are present in seeds, nuts, and most vegetable oils – Major sources of cholesterol are egg yolk, meats, and milk products. Dietary Sources of the Nutrients • Proteins – Proteins needed for tissue maintenance and growth. – Found in eggs, milk, meat – Legumes, nuts. and cereals are protein-rich, but incomplete because they lack one or more essential amino acid – cereal grains and legumes when ingested together provide all the essential amino acids • Vitamins – are nutrients that the body requires in small amounts – No one food contains all vitamins. Thus, a balanced diet is required to ensure a full vitamin complement – vitamins A, C, and E have anticancer effects – Broccoli, Cabbage, and Brussels sprouts are good sources of vitamins A and C. – Most vitamins function as coenzymes Dietary Sources of the Major Nutrients • Minerals – inorganic substances – seven required • calcium, phosphorus, potassium, sulfur, sodium, chloride, and magnesium – Trace amounts of about a dozen others. – Mineral-rich foods are vegetables, legumes, milk, and some meats. Metabolism • Metabolism is all chemical reactions necessary to maintain life • involves: – Catabolism: • substances are broken down to simpler substances • energy is released and captured to make ATP – Anabolism: • larger molecules or structures are built from smaller ones Carbohydrate Metabolism

• Glucose is the major fuel used to make ATP in most body cells. – Except the liver, routinely uses fats as well, thus saving glucose for other body cells. • The energy released is captured to make ATP • The carbon atoms released leave the cells as CO2 • The hydrogen atoms removed are combined with oxygen to form water. • Glycolysis: – yield a small amount of ATP • Krebs cycle: – produces all the CO2 and H2O – yields a large amount of ATP • When blood glucose levels are high – Some glucose is stored in body cells (particularly liver and muscle cells) as glycogen. – Some converted to fat • When blood glucose levels are too low – the liver breaks down stored glycogen and releases glucose to the blood for cellular use. • Fat Metabolism – the liver handles most fat metabolism in the body – The liver cells use some fats to make ATP, synthesize lipoproteins, thromboplastin (a clotting protein), and cholesterol – release the rest to the blood – Body cells remove the fat products and cholesterol from the blood and build them into their membranes or steroid hormones as needed – Fats are also used to form myelin sheaths of neurons and fatty cushions around body organs. Fat Metabolism • If there is not enough glucose to use, larger amounts of fats are used to produce ATP. • Fat oxidation is incomplete, some intermediate products accumulate and causes the blood to be acidic – Ketosis is a common consequence of • no carbohydrate diets, uncontrolled diabetes mellitus, and starvation in which the body is relying on fats as a fuel • Cholesterol – not used as a fuel – used as functional and structural molecules • Excess fats are stored in fat deposits such as the hips, abdomen, breasts, and subcutaneous tissues. • Fat in subcutaneous tissue is important as insulation for the deeper body organs • excessive amount restrict movement and place greater demands on the cardiovascular system. • Protein Metabolism – Proteins are broken down to amino acids. – The liver use some amino acids, and the remaining amino acids circulate to the body cells. – The cells remove amino acids from the blood and use them to build enzymes, hormones, and others. Protein Metabolism

• essential amino acids cannot be made by the cells. • Amino acids are used to make ATP only when: – carbohydrates and fats are not available – proteins are in excess • Oxidizing amino acids – The amine groups are removed as ammonia • Ammonia is toxic to body cells • In the liver, ammonia converted to urea • Urea is flushed in urine. The Central Role of the Liver in Metabolism

• Without the liver we would die within 24 hours. • The liver – manufacture of bile – detoxify drugs and alcohol – degrade hormones – make many substances vital to the body as a whole (cholesterol, blood proteins such as albumin and clotting proteins, and lipoproteins – Play a central role in metabolism . – Liver tissue can regenerate rapidly and easily. • Circulation – Hepatic portal brings nutrient-rich blood draining from the digestive viscera directly to the liver Cholesterol Metabolism and Transport

• Used to make steroid hormones, vitamin D, and help making plasma membrane • Lipoproteins – Fats, in blood, are transported bound to lipoproteins made by the liver – Low-density lipoproteins, or LDLs ( bad lipoproteins). • transport cholesterol and other lipids to body cells • If large amounts of LDLs are circulating, fatty substances will be deposited on the arterial walls, causing atherosclerosis – high-density lipoproteins, or HDLs ( good lipoprotein) • transport cholesterol from tissue cells to liver for disposal in bile – the relative ratio of LDL and HDL in the blood determines bad effect of cholesterol • Aerobic exercise, low saturated fat and cholesterol diet, stop smoking and drinking coffee favor a desirable HDL to LDL ratio. Regulation of Food Intake

• body weight remains stable when energy intake balances energy outflow • Carbohydrates and proteins yield 4 kcal/ gram each • Fats yield 9 kcal/ gram • if we eat more than we need, excess calories appear in the form of fat • if we eat less than we need, we begin to break down fat reserves and even tissue proteins • The total calories needed are calculated on the basis of body size and age. During Young Age

• rooting reflex: helps the infant find the nipple • sucking reflex: Helps the baby to hold on to the nipple and swallow. • Teething – begins around age 6 months and continues until about the age of 2 • Appetite – decreases in the elementary school-age child – increases again during the rapid growth of adolescence, • Appendicitis: common in teenagers for some unknown reason. Between middle age and early old age. Old age • Activity of the GI tract declines • Fewer digestive juices are produced • peristalsis slows. • Taste and smell become less acute. • periodontal disease often develops. • Diverticulosis and cancer of the are fairly common problems in the elderly Label the components of the digestive system

• Mouth Descending colon • Liver Ileum • Stomach Ascending colon • Pharynx Sigmoid colon • Anus Gallbladder • Esophagus Pancreas • Pharynx common bile duct • Cecum • Appendix • Duodenum • Transverse colon • Rectum • Jejunum Label the Components of the digestive system

• Parotid gland • Submandibular gland • Sublingual gland • Crown • Dentin • Enamel • Pulp • Root • Root canal Match the definition of the left with the correct term on the right

1. Breakdown food by digestive enzymes A. Defecation 2. Churning of food in the stomach B. Ingestion 3. Waste material C. Absorption 4. Elimination of waste material D. Mechanical digestion 5. Putting food in your mouth E. Chemical digestion 6. Absorbing food from the intestine F. Feces 7. Segmentation in the small intestine 8. Mixing food in the mouth Choose the correct term from the choices given and write the answer.

A. Main organ B. Accessory organ

1. Mouth 5. Large intestine 9. Teeth 2. 6. Esophagus 10. Small intestine 3. Liver 7. Pharynx 11. Gallbladder 4. Stomach 8. Appendix 12. Pancreas Choose the correct term from the choices given and write the answer. • A. Large intestine B. Small intestine

1. Duodenum 4. Cecum 7. Transverse colon 2. Jejunum 5. Ascending colon 8. Sigmoid colon 3. Ileum 6. Descending colon 9. rectum Match the term on the left with the proper selection of the right.

1. Triglycerides A. Carbohydrates 2. Preferred energy food B. Fats 3. Amino acids C. Vitamins 4. Inorganic elements found D. Proteins naturally in the earth E. Minerals 5. Organic molecules required in small amounts Multiple Choice Questions

1. The first baby tooth, on an average, appears at age: a. 1 month b. 3 months c. 6 months 2. The portion of the tooth that is covered with enamel is the: a. Pulp cavity b. Root c. Crown 3. The wall of the pulp cavity is surrounded by: a. Enamel b. Dentin c. Root 4. The ducts of the ______glands open into the floor of the mouth. a. Sublingual b. Submandibular c. Parotid 5. Mumps are an infection of this gland : a. Parotid b. Sublingual c. Submandibular 6. After food has been chewed, it is formed into a small rounded mass called a: a. Pellet b. Chyme c. Bolus VII. Multiple Choice Questions

7. Which one is not part of the small intestine? a. Jejunum b. Ileum c. Cecum 8. Which one of the following substances does not contain any enzymes? a. Saliva b. Bile c. Intestinal juice 9. Cane sugar is the same as: a. Lactose b. Sucrose c. Glucose 10. Fats are broken down into: a. Amino acids b. sugars c, Fatty acids 11. Proteins are broken down into: a. Amino acids b. sugars c. Fatty acids 12. Amylase enzyme breakdown a. Fat b. Protein c. carbohydrate Multiple Choice Questions

13. lactase enzyme breakdown a. Fat b. Protein c. Lactose in milk 14. The digestive tube is also called the: a. Alimentary canal b. Colon c. Esophagus 15. There are ______pairs of salivary glands. a. 2 b. 3 c. 4 16. A(n) ____ is the amount of energy needed to raise the temperature of 1 gram of water 10 C. a. Calorie b. Kilocalorie c. ATP 17. Metabolism is a term that refers to the: a. Sweating b. Use of foods c. Building blocks 18. Which of the following hormones lowers blood glucose levels? a. Insulin b. cortisone c. Epinephrine Multiple Choice Questions

19. Fats not needed for catabolism are anabolized to form: a. Triglycerides b. Glycogen c. ATP 20. A good source of iron in the diet is: a. Meat b. Dairy products c. Seafood 21. Essential amino acids: a. Must be in the diet c. Make up the majority vitamins b. Can be made by the body 22. An anaerobic process: a. Is an oxygen-using process c. Uses no oxygen b. Is an oxygen-storing process Apply your knowledge

1. The patient daily food intake provided fewer calories than her TMR. If this continues, what will be the result? If it continues over a long period of time, what eating disorder might develop? 2. The patient was experiencing fatigue and the blood test revealed that she is slightly anemic. What mineral will her doctor most likely prescribe? What dietary sources might you suggest that she emphasize in her daily intake? Urinary System • Functions of the kidneys include: – Regulating blood ionic composition • Most importantly Sodium, Potassium, calcium, Chloride, and Phosphate ions – Regulating blood pH • excrete variable amount of H  helps control blood pH. – Regulating blood volume • Producing urine  eliminating water – Regulating blood pressure • secret the enzyme renin which activates the renin-angiotensin pathway  increase in blood pressure and blood volume. – Maintaining blood Osmolarity • By regulating loss of water and solutes – Producing hormones • Calcitrol (vit D), erythropoietin. – Regulating blood glucose level • Use amino acid glutamine in gluconeogenesis – Excreting wastes and foreign substances Anatomy of the kidneys

• Paired, reddish kidney-bean-shaped organ • Retroperitoneal: located just above the waist between the levels of T12-L3 • the right kidney is slightly lower than the left because of the liver • Longitudinal section shows three regions Internal anatomy of 1. Cortex: the kidneys – Between the renal capsule and the bases of the pyramids and between the pyramids (renal column) 2. Medulla: Contains renal pyramids • The base faces the renal cortex 3. Renal pelvis: continuous with the ureter leaving the hilus • Calyces: Each kidney has 8- 18 minor calyces, and 2-3 major calyces Internal anatomy of the kidneys

• The urine formed by the Nephrons drains into large papillary ducts which extend into the renal papillae of the pyramid and drains into minor and the major calyces (a cuplike), which drains into the renal pelvis (large cavity) and then out through the Ureter to the urinary bladder • Structural and functional unit Nephrons • consists of two portions: 1. renal corpuscle: – lie in the renal cortex – Filters blood plasma 2. renal tubule – filtered fluid passes into the renal tubule. • Collecting Ducts – receives urine from many Nephrons – deliver the final urine product into the calyces and renal pelvis

RENAL PHYSIOLOGY • Three basic process to produce urine 1. Glomerulat filtration • The filtrate is blood plasma without blood proteins • proteins and blood cells are too large to pass through the filtration membrane 2. Tubular reabsorption: Useful substances (water, glucose, amino acids, and ions), are reclaimed from the filtrate and returned to the blood 3. Tubular secretion: important for getting rid of substances not already in the filtrate, such as certain drugs, or as an additional means for controlling blood pH • Oliguria – abnormally low urinary output, 100 and 400 ml/day • Anuria – Output less than 100 mI/day Characteristics of Urine • The yellow color is due to urochrome (results from destruction of hemoglobin) • the more solutes are in the urine, the deeper yellow its color • dilute urine is a pale color • abnormal color my result from eating certain foods (beets), or the presence of bile or blood in the urine. • odor is slightly aromatic. • pH slightly acid, but: – High protein diet and whole-wheat products causes urine to become acidic – a vegetarian diet makes urine alkaline – Bacterial infection of the urinary tract may cause the urine to be alkaline. Characteristics of Urine

• the presence of abnormal substances in urine is helpful in diagnosing the problem – Substances not normally found in urine are glucose, blood proteins (primarily albumin), red blood cells, hemoglobin, white blood cells, and bile. Ureter

• Retroperitoneal, curves medially and passé completely through the wall of the posterior wall of urinary bladder • Transport urine from the pelvis to the bladder • Kidney stones – Cause pain that radiate to the flank – Due to ureter peristalsis – Treatment: Surgery, ultrasound Urinary Bladder

• a hollow, distensible muscular organ • located posterior to the pubic symphysis • thin-walled tube carries urine from the bladder to the outside of the body. • Internal urethral sphincter – smooth muscle at the bladder-urethra junction – involuntary keeps the urethra closed when urine is not being passed. • external urethral sphincter – skeletal muscle, voluntarily controlled. • in female: – about 3-4 cm long, directly posterior to the pubic symphysis – external urethral orifice located between the clitoris and the vaginal opening • In males: – 15 -20 cm long, URETHRA carry urine and sperm – Three anatomical regions 1. prostatic urethra passes through the prostate 2. membranous urethra: short, passes through the urogenital diaphragm: 3. spongy urethra: the longest, passes through the penis IMBALANCE

• In female, the urinary orifice is close to the anal opening • improper toileting habits can carry bacteria into the urethra. • an inflammation of the urethra can ascend and cause bladder inflammation or kidney inflammation • Symptoms of urinary tract infection include – Dysuria, urinary urgency, frequency, fever, and sometimes cloudy or blood tinged urine, back pain and a severe headache IMBALANCE

• Incontinence – unable to voluntarily control the external sphincter – normal in children 2 years or less – may also occur in older children during sound sleep – emotional problems, pressure (as in pregnancy), or nervous system problems (stroke or spinal cord injury). • Urinary retention – the bladder is unable to expel urine – Often occurs after surgery – in elderly men due to enlargement of the prostate gland. Aging and The Urinary System • The kidneys shrink in size • filtration decrease 50% • kidney stones and urinary tract infections are associated with aging. • Other include – polyuria :excessive urine production – nocturia : excessive urination at night – increased frequency of urination – Dysuria : painful urination – Retention: failure to release urine from the urinary bladder – Hematuria: blood in the urine IMBALANCE • Poly cystic kidney disease – run in families – one or both kidneys are enlarged and have many containing urine • Hypospadias – found in male babies only – the urethral orifice is located on the ventral surface of the penis. • Glomerulonephritis – Due to childhood streptococcal (strep throat and scarlet fever) Body Fluid and Fluid Compartment and

• Body Fluids constitute: – 50% to 60% in adults – Infants have the highest water percentage 75% of body mass • Fatter people have less water • Fluid compartments – Intracellular (ICF) • The cytosol, two third of body fluid – Extracelluar (ECF) • One third of body fluid, all other body fluid – 80% interstitial fluid (between the cells) – 20% plasma – Also include lymph, CSF, fluids in joint, eye, endolymph, perilymph, cavities (pleural, peritonum, pericardial) Sources of Body Water Gain and Loss • Water gain: – Ingestion of liquid and moist food – metabolic water produced in aerobic respiration • Water loss: – kidneys excrete urine – skin evaporation – lungs exhale water vapor – Eliminates in feces – additional loss in menstruated women • water loss of each rout vary depend on the situation ( diarrhea, exertion) • Total loss = total gain =2500 mL. Electrolytes and water regulation

• Water – If large amounts of water are lost, the kidneys compensate by excreting less urine to conserve body water. – when water intake is excessive, the kidneys excrete good amounts of urine • Electrolytes – electrolytes enter the body in foods and mineral-rich water. – small amounts are lost in perspiration and in feces – The kidneys play a major role in regulating the electrolyte composition of body fluids • Reabsorption of water and electrolytes by the kidneys is regulated primarily by hormones Label the structures

Kidney Ureter Urinary bladder Urethra Cortex Medulla Pyramid Minor calyx Major calyx Renal pelvis Label the structures

Proximal convoluted tubule Distal convoluted tubule Collecting duct Descending loop Ascending loop Glomerulus Bowman’ capsule Renal corpuscle Match the definition of the left with the correct term on the right.

1. Functioning unit of urinary system A. Renal corpuscle 2. Large amounts of proteins in the urine B. Glycosuria 3. Uremic poisoning C. Nephrons 4. Outer part of kidney D. Medulla 5. Glomerulus and Bowman's capsule E. Uremia 6. Inner portion of kidney F. Proteinuria 7. Extension of proximal tubule G. Cortex 8. Glucose in the urine H. Loop of Henle 9. Connects to the Ureter I. Pelvis 10. Cup shape J. Calyx Match the definition of the left with the correct term on the right.

1. Lower most part of urinary tract A. Ureter 2. Lies behind pubic symphysis B. Urethra 3. Dual function in male C. Bladder 4. 1 1/2 inches long in female D. Calculus 5. Drains renal pelvis E. external urethral 6. Surrounded by prostate in male orifice 7. Another name for kidney stones 8. external opening of the urethra is the Multiple Choice Questions 1. The saclike structure that surrounds the Glomerulus is the: a. Calyx b. Bowman's capsule c. Cortex 2. Which of the following functions is not performed by the kidneys? a. Production of ADH c. Maintenance of homeostasis b. Removal of wastes from the blood 3. Glucose is reabsorbed in the: a. Loop of Henle c. Distal convoluted tubule b. Proximal convoluted tubule 4. Which of the following is not true of the kidneys? a. The right kidney is lower than the left. b. Makes vitamin A b. Makes vitamin D 5. A well-known sign of diabetes mellitus is: a. Oliguria b. Glycosuria c. Anuria 6. These two hormones absorb water from the on the kidneys a. ADH and Aldosterone c. Growth hormone and Oxytocin. b. Thyroid and cortisone The Reproductive Systems Anatomy of the • Testes – The primary reproductive organs of the male – Produce Sperms, and Testosterone • accessory reproductive structures – Ducts: • Ductus deferens, Ejaculatory ducts, Urethra – glands Testes

• Surrounded by fibrous connective tissue that extends inward to divide the testis into lobules, each contains somniferous tubules • Seminiferous tubules empty sperm into the rete testis, located at one side of the testis • Sperm travel through the rete testis to enter the epididymis, which is located on the posterior surface of the testis. • Leydig cells – cells In the spaces between adjacent somniferous tubules – Secrete testosterone hormones Epididymis • Epididymis lies along the posterior border of each testis and has head, body, tail – The head • The superior portion of the epididymis – The body • The narrow midportion of the epididymis – The tail • The smaller inferior portion Ductus Deferens • Ascends along the posterior border of the epididymis, passes through the inguinal canal and enters the pelvic cavity. • Functionally. – Stores sperm – Conveys sperms from the epididymis to the urethra – Sperms that are not ejaculated are reabsorbed • consist of: Spermatic Cord 1. Ductus deferens 2. Testicular artery 3. Autonomic nerves 4. Veins ( pampiniform plexus) The veins carry testosterone to the circulation 5. Lymphatic vessels 6. Cremaster muscle. • Spermatic cord pass through the inguinal canal Ejaculatory Ducts

• Tow ducts formed by the union of seminal vesicle duct and the ductus deferens • Terminate in the prostatic urethra • Eject sperm and seminal vesicle • A passageway for both semen Male and urine Urethra • A bout 20 cm long and has three parts: • Urine and sperm never pass at the same time • When sperms enter prostatic urethra, the bladder sphincter constricts Accessory Sex Glands

• secrete most of the liquid portion of the semen • Include: – – Prostate – Bulbourethral glands Seminal Vesicles

• convoluted pouch like structures • Posterior to the urinary bladder • Secretions – Thick, yellowish, rich in fructose, and other substances, which nourish the sperm – sperm and seminal fluid enter the urethra together during ejaculation. Prostate

• A single doughnut-shaped gland inferior to the urinary bladder, and surrounds the prostatic urethra • located immediately anterior to the rectum, its size and texture can be palpated by digital examination • Secretes a milky slightly acidic fluid plays a role in activating sperm • During ejaculation, prostatic secretions enter the urethra through several small ducts Bulbourethral (Cowper’s) Glands

• Paired, about the size of a pea. • Located inferior to the prostate on either side of the membranous urethra • Their ducts open into the spongy urethra • Secretion – is the first to pass down the urethra when a man becomes sexually excited to cleanse the urethra and lubricant during sexual intercourse Semen • 2.5-5 mL, with 50-150 million sperm per ejaculation (infertile if less than 20 million) • Consists of sperm, secretions from seminiferous tubules, seminal vesicles, prostate, and bulbourethral glands. • Slightly alkaline • Milky appearance • Sticky consistency • Function – Provides sperm with a transportation medium, and nutrients – Neutralizes the environment of the male’s urethra and the female’s . – destroys certain bacteria – dilutes sperm • A sac of skin Scrotum hangs from the root of the penis • Internally – Divided by a septum into two sacs, each containing a single testis Penis

• Copulatory organ, delivers semen into female reproductive tract • Externally consist of – Root ( bulb of the penis) – Shaft (body): ends in an expanded tip called glans – Prepuce (foreskin) loose skin covering the glans • Internally Penis – Three cylindrical erectile tissue – Corpora spongiosum • Midventral, surrounds the urethra – 2 Corpora cavernosa: • Bilateral dorsal bodies Spermatogenesis • the process of producing sperms. • Occurs in the somniferous tubules • Begins in puberty and continues throughout life • Each sperm contain 23 chromosome • Most do not survive more than Sperm 48 hours within the female reproductive tract after ejaculation • A sperm cell consists of three structures – Head: releases enzymes that help penetrating the Oocyte – Midpiece: has any mitochondria providing ATP for locomotion – Tail: Propels the sperm cell Testosterone Production

• interstitial cells produce testosterone • Secondary sex characteristics include: – Deepening of the voice due to enlargement of the larynx – Increased hair growth all over the body, particularly in the axillary, pubic, and face – Enlargement of skeletal muscles, typical of the male physique – Increased heaviness of the skeleton due to thickening of the bones FEMALE REPRODUCTIVE SYSTEM

• Include – Ovaries – Uterine (Fallopian) tubes – Uterus – Vagina – External organs ( or pudendum) – Mammary glands ( also part of the integumentary system) Ovaries, Female Gonads • The size and shape of an almond, one on either side of the uterus • Contain ovarian follicles. Each follicle consists of an immature Oocyte, surrounded by one or more layers of follicle cells. • As a developing egg begins to mature, the follicle enlarges, matures and ready to rupture ( ovulation) • the ruptured follicle is transformed into a corpus luteum, which eventually degenerates. • Ovulation occurs every 28 days Ovarian Follicles Female Reproductive anatomy Uterine Tubes (Fallopian tubes, oviducts)

• receive the ovulated oocyte and provide a site where fertilization can occur. • Each uterine tube extends medially from an to empty into the superior region of the uterus • a hollow organ located in the pelvis between the urinary bladder and rectum Uterus • receive, retain, and nourish a fertilized egg. • Expand during pregnancy to accommodate the growing fetus • Three parts – The body is the major portion of the uterus – The fundus is the superior rounded region – the cervix is the narrow outlet that protrudes into the vagina Uterus

• The wall of the uterus composed of three layers: • Endometrium; the inner layer – the fertilized egg burrows into the endometrium ( implantation) – In non pregnant women, the endometrial lining sloughs off ( menses) periodically( every 28 days) • Myometrium: the middle layer of the uterus – plays an active role during the delivery of a baby • Perimetrium: The outermost serous layer of the uterus Vagina

• a thin-walled tube lies between the bladder and rectum • extends from the cervix to the body exterior • a passageway for the delivery of an infant and menstrual flow • female organ of copulation • The distal end is partially closed by the hymen • The hymen is very vascular, bleeds when ruptured during the first sexual intercourse • Mons pubis – a fatty, rounded area overlying the pubic symphysis External Genitalia – covered with hair after puberty • labia majora – two elongated hair-covered skin folds • labia minora – two smaller folds of skin medial to the labia majora • Vestibule – the region between the labia minora – contains the external openings of the urethra and the vagina • the greater vestibular glands External – A pair of mucus-producing glands flank the vagina Genitalia – lubricate the distal end of the vagina during intercourse. • clitoris – Small, anterior to the vestibule – corresponds to the male penis. • the perineum – The diamond-shaped region between the anterior end of the labial folds, the anus posteriorly, and the ischial tuberosities laterally • female urethra – passageway for urine only Follicular Development Menstrual Cycle • female cycle about 28 days; ovulation occurs on day 14 • The three stages of menstrual cycle are • Days 1-5: Menses: – This is accompanied by bleeding for 3 to 5 days • Days 6-14: Proliferative stage – Stimulated by rising estrogen levels produced by the growing follicles – the basal layer of the endometrium regenerates • Days 15-28: Secretory stage. – Increase progesterone production by the corpus luteum which increase endometrium blood supply even more. • If fertilization occurs, the embryo produces hCG which causes the corpus luteum to continue producing hormones • If fertilization does not occur, the corpus luteum degenerate • Lack of ovarian hormones causes menses Mammary Glands • two modified sweat glands that produce milk. • Nipple: a pigmented projection contains lactiferous ducts • Areola: circular pigmented skin surrounding the nipple contains modified oil glands • Suspensory ligaments (Cooper’s ligaments): – connective tissue support the breast • – 15 to 20 lobes separated by adipose tissue • Lactation: is the synthesis, secretion and ejection of milk • Prolactin: stimulate milk production • Oxytocin: cause milk ejection The Breast Fertilization

• The oocyte is viable 24 hours after ovulation • The sperm is viable in the female reproductive tract 12 to 48 hours after ejaculation • the genetic material of a sperm combines with that of an ovum to form a fertilized egg, or zygote. • The zygote represents the first cell of the new individual, Cleavage of the Zygote • After fertilization, the zygote undergoes rapid divisions that eventually produce a solid sphere of cells called the morula • The morula enters the uterine cavity Implantation • occurs usually on the posterior portion of the uterus • Attach to the endometrium and erode the lining in a small area, embedding itself in the endometrium Embryo

• by the third week, the placenta is functioning. • All exchanges are made through the placental barrier • By the end of the second month of pregnancy, the placenta produce estrogen, progesterone, and other hormones that help to maintain the pregnancy. At this time, the corpus luteum becomes inactive. True labor False labor

• Uterine contractions • Pain is felt in the occur at regular abdomen at irregular intervals, usually intervals producing pain • Does not intensify and • Localization of pain in walking does not alter the back that is it significantly. intensified by walking. • There is no show • Dilation of the cervix • No cervical dilation. and the show Labor

• True labor can be divided into three stages – Stage of dilation • from the onset of labor to the complete dilation of the cervix • Regular contractions of the uterus • rupture of the amniotic sac • complete dilation of the cervix (10 cm) – Stage of expulsion • From complete cervical dilation to delivery of the baby – Placental stage • after delivery until the placenta is expelled BIRTH CONTROL METHODS

• Surgical Sterilization – vasectomy • a portion of each ductus deferens is removed • sperm can not pass. Instead, they degenerate and are destroyed by phagocytosis. • The blood testosterone level is normal  no effect on sexual desire or performance. – tubal ligation in females • both uterine tubes are tied closed and then cut • secondary oocyte cannot pass through the uterine tubes, and sperm cannot reach the oocyte. Hormonal Methods (oral contraceptives)

• most effective means of birth control • contain various mixtures of synthetic estrogens and progestins • Not advised with: – history of blood clotting disorders, cerebral blood vessel damage, hypertension, liver malfunction, or heart disease – Smoking increase risk of heart attack or stroke Hormonal Methods (oral contraceptives) • Norplant – Hormone containing capsules surgically implanted under the skin of the arm – last for 5 year • Depo-Provera. – intramuscular injection once every 3 months • vaginal ring: – a doughnut-shaped ring fits in the vagina – worn for 3 weeks and removed for 1 week to allow menstruation to occur BIRTH CONTROL METHODS • Intrauterine Devices – a small object made of plastic, copper, or stainless steel inserted into the cavity of the uterus. • Spermicides – Various foams, creams, jellies, suppositories, and douches contain sperm-killing agents BIRTH CONTROL METHODS • Barrier Methods – prevent sperm from gaining access to the uterine • Condom, vaginal pouch, diaphragm, • Periodic Abstinence – abstain from intercourse on the days when pregnancy is likely • Coitus Interruptus – withdrawal of the penis from the vagina just before ejaculation. Abortion

• premature expulsion of the products of conception from the uterus • usually before the 20th week of pregnancy. • Can be: – spontaneous naturally occurring () – induced (intentionally performed) Aging and The Reproductive System

• Puberty: is the development of secondary sexual characteristics and the potential for sexual reproduction • Menarche: the first menses – Ovulation occur in 10% of the cycles, luteal phase is short • Menopause: – hot flashes and heavy sweating coincide with bursts of GnRH release – headache, hair loss, muscular pains, vaginal dryness, insomnia, depression, weight gain, and mood swings, – atrophy of the ovaries, uterine tubes, uterus, vagina, external genitalia, and breasts occurs in postmenopausal • osteoporosis • Men retain sexual capacity into their eighties or nineties • decline testosterone synthesis leads to reduced muscle strength, fewer viable sperm, and decreased sexual desire. • enlargement of the prostate over age 60. Label the Structures • Testes • Epididymis • Bulbourethral gland • Prostate • Seminal vesicle • Ejaculatory duct • Vas Deferens • Scrotum • Foreskin • Glans penis • Shaft of penis • Urethra Label the Structures

• Bulbourethral gland • Prostate • Seminal vesicle • Ejaculatory duct • Vas Deferens • Prostatic urethra • Membranous urethra • Spongy urethra Label the Structures

• Head • Midpiece • Tail (flagellum) Label the Structures

• Vas deferens • Epididymis • Rete testis • Seminiferous tubule Label the Structures

• Corpus Spongiosum • Left corpus cavernosum • Right corpus cavernosum • Glans penis • External urethral orifice Match the term on the left with the correct answer on the right

1. Testes A. Accessory organ 2. Spermatozoa (sperm) B. Male sex cell 3. Bulbourethral gland C. Gonads 4. Prostate 5. seminal vesicle VIII. Match the term on the left with the correct answer on the right.

1. Epididymis A. Doughnut-shaped gland beneath bladder 2. Vas deferens B. Also known as "bulbourethral” 3. Ejaculatory duct C. Continuation of ducts that start in 4. Prepuce Epididymis 5. Prostate gland D. Mixture of sperm and secretions of 6. Cowper's gland accessory sex glands 7. Semen E. Union of vas deferens and seminal vesicle duct F. Removed during circumcision G. Narrow tube lies behind the testes Multiple Choice Questions 1. The testes ______a. Are located in the scrotum c. Secret estrogen b. Are located in the abdomen 2. The cells in the ______make sperms a. Ductus deferens b. Prostate c. Seminiferous tubules 3. ______in the testes secret the hormone testosterone. a. Leydig cells b. Sperm c. Seminiferous tubules 4. Sperms have ______chromosomes a. 23 b. 23 pairs c. 46 5. Sperm production is called: a. Spermatogenesis b. Spermatogonia c. Sperm 6. The section of the sperm that propel the sperm is the: a. Midpiece b. Tail c. Stem Multiple Choice Questions 7. Which one of the following is not a function of testosterone? a. It causes a deepening of the voice. b. Stimulate development of male physique. c. Decrease bone formation. 8. which of the following is not a sex accessory organ in men a. Prostate b. Seminal vesicle c. Testes 9. the main erectile organs in men are (is) a. Urethra b. Corpora spongiosum c. Corpora cavernosa 10.The longest male urethra is the a. Spongy b. Membranous c. Prostatic 11.the foreskin is also called a. Prepuce b. Shaft c. Root 12.the seminal vesicle is located a. behind the bladder b. behind the prostate c. in scrotum Apply your knowledge

• If a patient remove his testes, would he be impotent or sterile and why? Label the structure

• Ovary • Uterus Cervix • Labia major • Uterine tube • Vagina Label the structure

• Ovum • Corpus luteum • Ruptured follicle • Mature follicle Label the structure

• Mons pubis • Clitoris • Urethral orifice • Labia major • Foreskin • Anus • Vaginal orifice • Labia minor Label the structure

• Lobes • Ducts • Nipple • Areola Match the term on the left with the correct answer on the right 1. Ovaries A. Genitals 2. Ova B. Accessory sex gland 3. Bartholin C. female Sex cells 4. Vulva D. Gonads 5. Uterine tube E. Also known as oviduct 6. Areola F. Colored area around the nipple 7. Alveoli G. Drain alveoli 8. Lactiferous ducts H. have cells the secret milk 9. Menarche I. the first female menses Match the term on the left with the correct answer on the right

1. Mons pubis A. Large lips 2. Labia major B. Area between labia minor 3. Clitoris C. Fat over the pubis 4. Vestibule D. Composed of erectile 5. Labia minor tissue E. Small Match the term on the left with the correct answer on the right 1. Mons pubis A. External structure 2. Vagina B. Internal structure 3. Labia major 4. Uterine tubes 5. Vestibule 6. Clitoris 7. Labia minor True or false

1. Ovulation occurs 28 days before the next menstrual period begins. 2. The first day of ovulation is considered the first day of the cycle. 3. A woman's fertile period lasts only a few days out of each month. 4. LH is responsible for ovulation 5. FSH secreted during first days of menstrual cycle 6. Prolactin stimulate milk production, whereas oxytocin causes milk ejection Multiple Choice Questions

1. A mature ovum is sometimes called a(n): a. Corpus luteum b. Oocyte c. Oogenesis 2. Progesterone: a. Is produced by the corpus luteum b. Is produced by the uterus c. Is produced by the mature follicle 3. The external genitalia include all of the following except: a. Hymen b. Clitoris c. Lactiferous ducts 4. The ______is the pigmented projection that contain the lactiferous ducts a. Nipple b. Areola c. Fat 5. in non pregnant women, the ______sloughs off to produce the menses a. Endometrium b. Myometrium c. Perimetrium Multiple Choice Questions

6. Fertilization most often occurs in the: a. Oviduct b. Uterus c. Vagina 7. The embryonic phase of development extends from fertilization until the end of week ____of gestation. a. 2 b. 4 c. 8 8. The stage of labor that begins from the onset of uterine contractions until dilation of the cervix is complete is called: a. Stage of dilation b. Stage of expulsion c. Placental stage 9. The Zygote is a. A fertilized ovum b. Mature egg c. The process of making sperms 10.Placenta provides ______to the fetus a. Nutrients b. Blood c. Milk