2

• There are no 1985 objectives for this chapter.
3

• Anatomy
– The study of structures and components of an organism
• Physiology
– The study of the body functions of a living organism
• Pathophysiology
– The study of the body functions of a living organism in an abnormal state
4

(1 of 3)
• Cells
– Most basic component of an organism
• Tissues
– A group of similar cells working together to perform a common function
• Organs
– Different types of tissues working together to perform a particular function
5

(2 of 3)
• Organ systems
– Groups of organs that work together
– May be located together or apart
– Combined, they form an organism
– Carry out vital functions
6

(3 of 3)
• Organ systems include:
– Musculoskeletal, circulatory, respiratory, nervous, gastrointestinal, urinary, reproductive, immune, endocrine, lymphatic, integumentary, and special sensory
• Homeostasis
– Balanced internal environment
– System of checks and balances
7

(1 of 3)
• Anatomic terminology
– Landmarks for guides of internal structures
• The anatomic position
– Universal position from which all body positions and movements are described
• Anatomic planes
– Flat surfaces that pass through the body
8

9

(2 of 3)
• Frontal plane
– Anterior and posterior
• Transverse plane
– Cranial and cephalad
• Median plane
– Medial and lateral
• Sagittal plane
• Proximal and distal
• Midline
• Midaxillary line
• Midclavicular line
10

11

(3 of 3)
• Directional Terms
– Right and left
– Superior and inferior
– Superficial and deep
– Ventral and dorsal
– Palmar and plantar
– Apex
• Other Directional Terms
– Bilateral
– Contralateral
– Ipsilateral
12

• Abdomen
– Two imaginary lines divide this area into four parts
– Inferior tip of sternum to the genital area; iliac crest across the umbilicus
– Right upper quadrant, left upper quadrant, right lower quadrant, left lower quadrant
– Each quadrant contains specific organs
13

14

(1 of 4)
• Prone – face down
• Supine – face up
• Lateral recumbent – lying on left side
15

(2 of 4)
• Fowler’s position and semi-Fowler’s position
– Sitting upright at a 90° angle
– Sitting upright at a 45° angle
16

(3 of 4)
• Trendelenburg’s position
– Supine with the head down and lower extremities elevated approximately 12”
– Helps increase blood flow to the brain
17

(4 of 4)
• Shock position
– Also called modified Trendelenburg’s position
– Head and torso are supine
– Lower extremities elevated 6-12”
18

(1 of 2)
• Movements
– From simple to complicated, movements can be broken down into a series of components and described with specific terms
• Range of Motion (ROM)
– Full distance that a joint can be moved
– Flexion
• Moving a distal part of an extremity toward the trunk
19

(2 of 2)
• ROM
– Extension
– “Hyper”
• Supination and pronation
• Internal and external rotation
• Abduction and adduction
20

• Permeability of the cell membrane
– Selective permeability
• Allows some substances to pass, but not others
• Maintains environments
– Electrolytes
• Chemicals dissolved in blood, made of salt or acid substances that become iconic conductors when dissolved in a solvent
21

• Diffusion
– The movement of solutes, which are particles such as salts, dissolved in a solvent
• Concentration gradient
– Difference in concentrations of the substance on either side of the membrane
– Small molecules diffuse more easily than large ones; watery solutions diffuse faster than viscous solutions
22

• Osmosis
– The movement of a solvent, such as water, from an area of low solute concentration to high concentration
• Osmotic pressure
– Measure of the tendency of water to move by osmosis across a membrane
• Crenation
• Lysis
23

• Facilitated diffusion
– The process in which a carrier molecule moves substances in or out of cells from high to low concentration
• Active transport
– The movement of a substance against a concentration or gradient
24

• Endocytosis
– Uptake of material through the cell membrane by a membrane-bound droplet that forms within the protoplasm of the cell
– Phagocytosis or “cell eating”
– Pinocytosis or “cell drinking”
• Exocytosis
– The release of secretions from the cells
25

• Metabolism
– The sum of all the physical and chemical processes that produce and maintain the body
– Two phases:
• Anabolism or “building phase”
• Catabolism or “break down phase”
– Body’s fuel
• Carbohydrates (mostly glucose), fats, and proteins
26

• Respiration
– Process of using glucose, fat, and proteins to generate energy
– Creates energy in the form of adenosine triphosphate
(ATP)
– Takes place within the mitochondria
– Krebs cycle
– Glycolysis
27

(1 of 4)
• Epithelial tissue and glands
– Type of tissue that covers all external body surfaces and forms secreting portions of glands
– Lines hollow organs in the body
– Provides a protective barrier
– Functions in absorption of nutrients
– Functions in secretion of body substances
28

(2 of 4)
• Connective tissue
– Connects other types of tissue together
– Extracellular matrix
– Adipose tissue
• Contains large amounts of lipids
– Other types of connective tissues
• Aid in formation of blood vessels
• Part of the body’s self-defenses
29

(3 of 4)
• Muscle Tissue
– Located within the substance of the body and invariably enclosed by connective tissue
– Classified by structure and function
– Structural
• Striated or nonstriated
– Function
• Voluntary and involuntary
– Cardiac muscle
30

(4 of 4)
• Nerve tissue
– Peripheral nerves
• All nerves extending from the brain and spinal cord
• Exiting from between vertebrae to various parts of the body
– Neurons
• Main conducting cells of nerve tissue
– Dendrites
– Axons
– Neuroglia
31

(1 of 2)
• Integumentary system
– Outer surface of the body
– Skin, nails, hair, and sweat and oil glands
– Largest organ in the body; accounts for 15% of body weight
• Function of the skin
– Protection from the environment
– Regulation of body temperature
– Transmission of information to the brain
32

(2 of 2)
• Anatomy of the skin
– Epidermis
– Subcutaneous tissue
– Sebaceous glands
– Dermis
– Sweat glands
– Hair follicles
33

34

• Axial skeleton
– Forms the upright part of the body
– Consists of:
• Hyoid, skull, vertebral column, ribs, and sternum
• Appendicular skeleton
– Attached to the axis as appendages
– Consists of:
• Shoulder and pelvic girdles, upper and lower extremities
35

(1 of 3)
• Skull
– Consists of 28 bones in three anatomic groups: auditory ossicles, cranium, and face
– Cranial vault
• Encases, protects the brain
• Parietal, temporal, frontal, occipital, sphenoid, and ethmoid bones
• Foramen magnum
36

(2 of 3)
• Sutures
– Sagittal suture
– Coronal suture
– Lambdoid suture
• Fontanels
37

(3 of 3)
• Mastoid process
• External auditory meatus
• Ossicles
• Styloid process
• Facial nerve
38

• Cranial vault
– Divided into three compartments:
• Anterior fossa, middle fossa, and posterior fossa
– Structures of note:
• Crista galli
• Cribiform plate
• Foramina
• Olfactory bulb
• Nasal cavity
• Sella turcica
39

• Base of the skull
– Complex and full of foramina
• Structures of note:
– Occipital condyles
– Palatine bone
– Zygomatic arch
40

• Facial bones
– Frontal and ethmoid bones part of the cranial vault and the face
– Composed of 14 bones
– Include:
• Maxillae, mandible, zygoma, palatine, nasal, lacrimal, vomer, and inferior nasal concha bones
– Protect the eyes, nose, and tongue and provide attachment points for muscles involved in mastication
41

• Orbits
– Cone-shaped fossae
– Enclose and protect the eyes
– Contain blood vessels, nerves, and fat
– Created by the frontal, sphenoid, zygomatic, maxilla, lacrimal, ethmoid, and palatine bones
– Blow to the eye can result in fracture of the orbit floor
(blowout fracture)
42

• Nasal bones
– Composed of several portions of the facial bones
• Structures of note:
– Nasal septum
– Paranasal sinuses
43

• Mandible
– Large movable bone
– Composed of the lower jaw and teeth
• Structures of note:
– Rami
– Mandibular notch
– Temporomandibular joint
44

• Hyoid
– “Floats”
– Not actually part of the skull
– Supports the tongue and serves as a point of attachment for neck and tongue muscles
45

(1 of 2)
• Neck
– Contains several important structures
• C1-C7
• Upper portion of the trachea and esophagus
– Useful landmarks
• Adam’s apple (upper part of the thyroid cartilage)
• Cricoid cartilage
• Cricothyroid membrane
• Cartilaginous rings
46

(2 of 2)
• More structures of note:
– Carotid arteries
– Internal jugular veins
– Sternocleidomastoid muscles
– Sternum
– Spines of the cervical vertebrae
• Most prominent is C7
47

(1 of 4)
• Vertebral column
– Cervical (7)
– Thoracic (12)
– Lumbar (5)
– Sacrum (5)
– Coccyx (4)
48

(2 of 4)
• Atlas (C1)
– Point at which the head rotates
• Axis (C2)
– Dens or odontoid process
• Spinal cord
– Extension of the brain
– Carries messages between the body and brain
– Exits skull through foramen magnum
– Protected by the vertebrae
49

(3 of 4)
• The vertebrae
– Anterior portion consists of a solid block called “the body”
– Posterior part called the “bony arch”
– Series of arches form a tunnel that runs the length of the spine called the “spinal canal” which encases and protects the spinal cord
– Vertebrae are connected by ligaments
– Intervertebral discs
50

(4 of 4)
51

(1 of 2)
• Thorax
– Contains the heart, lungs, esophagus, and great vessels
– T1-T12
– Clavicle
– Scapula
– Diaphragm
52

(2 of 2)
• Anterior aspects
– Sternum:
• Manubrium, xiphoid process, angle of Louis
– 12 pairs of ribs
• Costal arch
• Floating ribs
• Posterior aspects
– Costovertebral angle (junction of the spine and the tenth ribs)
53

54
• Diaphragm
– Muscular dome
– Separates thorax and abdomen
– Involved in respiration
– Anteriorly attaches to costal arch; posteriorly to lumbar vertebrae
• Organs and vascular structures
– Pulmonary artery
– Anatomic landmarks

• The Abdomen
– Second major body cavity
– Contains organs of digestion and excretion
– Separated by:
• Diaphragm, muscular walls, imaginary plane extending from the pubic symphysis through the sacrum
– Shares organs with the pelvis (depending on posture)
– Quadrants
55

56

57

(1 of 2)
• RUQ
– Liver, gallbladder, portion of the colon/small intestine
• LUQ
– Stomach, spleen, portion of the colon/small intestine
• RLQ
– Cecum, appendix
• LLQ
– Descending and sigmoid portions of the colon
• Retroperitoneal
– Kidneys
58

(2 of 2)
59

• Landmarks of the abdomen
– Costal arch
– Umbilicus
– Anterior superior iliac spines
– Iliac crest
– Pubic symphysis
• Other structures
– Inguinal ligament
60

(1 of 2)
• Shoulder girdle
– Attaches upper extremity to the body
– Composed of scapula and clavicle
• Shoulder joint
– Acromion process
– Ball and socket joint
– Glenoid fossa
– Motions include: flexion, extension, abduction, adduction, rotation, and circumduction
61

62

63

64

(2 of 2)
• Acromioclavicular joint
• Upper extremity
– Forearm, wrist, hand, and fingers
– Humerus
• Forearm and wrist
– Radius and ulna
– Wrist composed of eight bones called carpals
• Hand
– Metacarpals, phalanges
65

66

(1 of 2)
• Pelvis
– Where the lower extremities attach to the body
– Ring of bones
• Sacrum, pelvic bones
• Coxal bones: ilium, ischium, and pubis
– Contains three joints
• Two posterior sacroiliac joints, interior midline pubic symphysis
67

(2 of 2)
68

• Lower extremity
– Composed of: hip, thigh, knee, leg, ankle, foot, and toes
• Structures of note:
– Femur (longest, strongest bone in the body)
– Femoral head (articulates with pelvic girdle)
– Acetabulum
– Greater trochanter
69

• Leg
– Patella
– Medial malleolus
– Lateral malleolus
• Knee
– Hinge joint
– Contains ligaments within the join
• Ankle
– Phalanges, metatarsals
70

• Cartilage
– All are connective tissues
– Synovial fluid
• Tendons
– Periosteum
– Connects muscle to bone
• Ligaments
– Tough, white bands of tissue
– Connect bone to bone
71

(1 of 2)
• Bones
– Specialized form of connective tissue
– Protect internal organs
– Storage site for minerals
– Consist of collagen and hydroxyapatite
– Living substances that require blood supply
– Terms:
• Osteoblasts, osteocyte, osteoclasts, lamellae, lacuna, canaliculi
72

(2 of 2)
• Bones
– Classified according to shape
• Long, short, and flat
– Long bones
• Consist of diaphysis, epiphyses, and physis
– Two main types:
• Compact and cancellous
– Growth
• Appositional and endochondral
73

• Joints
– When two bones contact
– Consist of ends of bones and connective and supporting tissue
– Named by combining names of the two bones
• Joint capsule
• ROM
– Determined by extent ligaments hold together
74

75

• Skeletal muscle
– Voluntary, striated
– Under control of the nervous system
• Smooth muscle
– Involuntary
– Responds to stretching, heat, and waste removal
• Cardiac muscle
– Involuntary, rich blood supply, own electrical system
– “automaticity”
76

(1 of 2)
• Nervous system
– Complex array of structures
– Controls voluntary and involuntary body functions
– Major divisions include:
• Central, peripheral, and autonomic
– Composed of specialized tissue that conducts electrical impulses between the brain and body
77

(2 of 2)
• Nervous system terminology:
– Synapse
– Presynaptic terminal
– Synaptic cleft
– Postsynaptic cleft
– Neurotransmitters
– Synaptic vesicles
– Nerve fibers
– “Fight or flight” and “Feed or breed”
78

(1 of 2)
• The central nervous system
– Brain and spinal cord
• Cerebrum
– Left and right
– Longitudinal fissure
– Lobes
• Frontal
• Parietal
• Occipital
• Temporal
79

(2 of 2)
80

• Diencephalon
– Located between brain stem and cerebrum
– Contains thalamus, subthalamus, hypothalamus, and epithalamus
81

(1 of 2)
• Brainstem
– Connects spinal cord and brain
– Consists of medulla, pons, and midbrain
– Vital for basic body functions
– Basal ganglia
– Limbic system
– Pons
– Ascending reticular activating system
82

(2 of 2)
83

• Cerebellum
– Communicates with other regions of the CNS
– Cerebellar peduncles
– Essential for coordinating muscle movements
• Meninges
– Encloses the CNS
– Dura mater
– Arachnoid
– Pia mater
84

• Spinal cord
– Continuation of the CNS
– Composed of nerve fibers
– Extends to the level of L2
– Cauda equina
– Vertebral canal
– Ascending fibers (afferent tracts)
– Action potentials
– Descending fibers (efferent tracts)
85

• Peripheral nervous system
– Consists of nerves from CNS to peripheral structures
– Ganglia
– Spinal nerves
– Ventral root, dorsal root, dorsal root ganglion
– Intervertebral foramen
– Dermatomes
86

• Cervical plexus
– Most important nerve is the phrenic nerve
• Brachial plexus
– Divided into rami, trunks, divisions, cords, and branches
– Axillary, radial, musculocutaneous, median, and ulnar
• Lumbosacral Plexus
– Six major nerves: obturator, femoral, tibial, common peroneal, sciatic, deep peroneal, and superficial peroneal
87

88

(1 of 2)
• Cranial nerves
– 12 pairs
– Functions:
• Olfactory (I) – smell
• Optic – (II) sight
• Oculomotor (III) – motion of the eyeballs/upper lid
• Trochlear (IV) – downward gaze
• Trigeminal (V) – sensation to scalp, face, and lower jaw
89

(2 of 2)
• Functions continued:
– Abducens (VI) – lateral eye movement
– Facial (VII) – facial expression, sense of taste
– Vestibulocochlear (VIII) – hearing, balance
– Glossopharyngeal (IX) – pharyngeal muscles
– Vagus (X) – parasympathetic fibers of thorax/abdominal organs
– Spinal accessory (XI) – soft palate
– Hypoglossal (XII) – tongue, C1-C3
90

91

• ANS
– Operates without conscious control
– Sympathetic and parasympathetic
– Terms: sympathetic pathway and adrenal glands
• Preganglionic and postganglionic neurons
– Separated by ganglionic synapse
– Neuroeffector cells
92

• Sympathetic and parasympathetic
– Secrete one of two neurotransmitters
– Both secrete acetylcholine from preganglionic fibers; diffuse across nicotinic receptors
– Acetylcholine destroyed by acetylcholinesterase
– Muscarinic receptors
– Alpha and beta receptors
93

• Endocrine system
– Made of various glands
– Hormones regulate body functions
– Targets tissues
– Endocrine versus exocrine glands
– Prostaglandins
– Steroids and thyroid hormones
– Negative feedback or positive feedback
94

(1 of 2)
• Pituitary gland
– Known as the the “master gland”
– Located at the base of the brain
• Hypothalamus
– Basal portion of diencephalon
– Regulates function of pituitary gland
95

(2 of 2)
• Posterior pituitary lobe
– Antidiuretic hormone or vasopressin
• Constricts blood vessels and raises BP
• Target tissue is the kidney
– Oxytocin
• Causes smooth muscles (uterus) to contract
• Lactation
• Anterior pituitary lobe
– Not considered part of the CNS
96

• Growth hormone
– Stimulates growth (long bones)
– Produced by hypothalamus
• Thyroid-stimulating hormone
• Adrenocorticotropic hormone
– Corticosteroids stimulated by stress
• Reproduction-regulating hormones
– Regulate production of eggs and sperm
97

• Thyroid
– Large gland at the base of the neck
– Two lobes connected by the isthmus
– Contains follicles filled with thyroglobulin
– Between the follicles are parafollicular cells
• Produce calcitonin
– Thyroid gland produces triiodothyronine and tetraiodothyronine
98

• Usually four in number
• Produce and secrete parathyroid hormone
– Maintains normal levels of calcium in the blood and normal neuromuscular function
99

• Pancreas
– Belongs to both endocrine and digestive systems
– Retroperitoneum
– Produces insulin and glucagon
– Islet of Langerhans
• Alpha and beta cells
– Glycogen
100

(1 of 2)
• Adrenal glands
– Supra-renal glands
– Manufacture and secrete certain sex hormones
– Medulla
• Epinephrine and norepinephrine
– Adrenal cortex
• Divided into three zones
• Aldosterone
101

(2 of 2)
• Zona fasiculata
– Glucocorticoids
• Cortisol: regulates blood glucose, metabolizes fat tissue, inhibits inflammation
– Hypothalamic-pituitary-adrenal axis
• Regulates secretion of corticosteroids
• Zona reticularis
– Androgens
• Androstendedione
102

• Gonads
– Testes
• Testosterone
– Ovaries
• Estrogen
• Progesterone
• Human chorionic gonadatropin (hCG)
103

• Blood
– Substance consists of plasma and formed elements
• Red blood cells, white blood cells, and platelets
– Adult male contains about 5 liters of blood
– Plasma
• Watery, straw-colored fluid
• Accounts for >50% of total blood volume
• Made of 92% water and 8% other substances
104

• RBCs
– Disc-shaped
– Most numerous of the formed elements
– Contain hemoglobin
– Erythropoiesis
• WBCs
– Called leukocytes
– Fight infection
– Granulocytes and agranulocytes
105

• Platelets
– Necessary in clot formation
– Hemostasis
– Chemicals are released, activation of platelets
– Formation of thrombin
– Conversion of fibrinogen to fibrin
– Binds to platelet plug forming a clot
– Activation of t-PA
106

(1 of 2)
• Location and major structures of the heart
– Located behind the sternum
– About the size of the closed fist of the person it belongs to
• Mediastinum
• Myocardium
107

(2 of 2)
• The pericardium surrounds the heart
– Visceral and parietal layer
– Pericardial fluid
108

(1 of 2)
• Superior and inferior vena cava
– Return deoxygenated blood from the body to the right atrium
• Blood passes into the right ventricle
• Blood is pumped through the pulmonic valve into the pulmonary artery and to the lungs
109

(2 of 2)
• Freshly oxygenated blood is returned to the left atrium through the pulmonary veins
• Blood flows through the mitral valve into the left ventricle, which pumps the oxygenated blood through the aortic valve into the aorta and then the entire body
110

111
• Electrical stimulus
– Caused by a set of chemical changes within the myocardial cells
– “Automaticity”
• Conduction system
– Six parts: SA node, AV node, bundle of His, right and left bundle branches, and Purkinje fibers

112

• Atrioventricular valves
– Tricuspid valve
– Mitral valve
• Cusps
• Papillary muscles
• Chordae tendineae cordis
– Semilunar valves
• Pulmonic valve
• Aortic valve
113

• Chronotropic state
– Contraction
• Dromotropic state
– Rate of conduction
• Inotropic state
– Strength of contraction
• Baroreceptors and chemoreceptors
• Alpha and beta effects
114

• Cardiac cycle
– Contraction results in pressure changes in the chambers
– Systole
– Cardiac output
– Circulatory system
– Ejection fraction: CO = SV x HR
– Starling’s Law of the Heart
– Preload and afterload
115

• The general scheme of blood circulation
– Transported through arteries and veins
– Arterioles, capillaries, and venules
• Circulation to the heart
– Coronary arteries
– LAD
– Circumflex coronary arteries
116

117

• Pulmonary circulation
– Carries blood from the right side of the heart to the lungs and back
• Systemic arterial circulation
– head and neck
– upper extremity
– thoracic aorta
– abdominal aorta
– pelvis and lower extremity
118

• Head and neck
• Upper extremity
• Thorax
• Abdomen and pelvis
– Hepatic portal system
• Lower extremity
– Femoral, popliteal, dorsalis pedis, and posterior tibial arteries
119

120

• Terms:
– Pulse, radial artery, blood pressure, diastole
• Normal circulation in adults
– Vessels adjust to hold 100% of the blood volume
– Perfusion: meets the cell needs
• Inadequate circulation in adults
– Automatic adjustment during blood loss to maintain adequate pressure
121

• Lymphatic vessels
– Diffuse lymphatic tissue and lymph nodules
– Axillary nodes, cervical nodes, and inguinal nodes
• Lymph organs
– Tonsils
– Spleen
– Thymus
122

• Respiratory system
– Breathing, gas exchange, and entrance of air
• Upper airway
– Mouth, nasal cavity, and oral cavity
– Uvula, epiglottis, nares, conchae, and turbinates
• Lower airway
– Larynx, vocal cords, glottis, bronchi, alveoli, lungs, pleura, and bronchial arteries and veins
123

• Physiology
– Primary function to exchange gases at the alveolocapillary membrane
– 21% oxygen in the air
– Pulmonary function tests and spirometry
– Tidal volume, residual volume, vital capacity, and
FEVI
• Respiratory center
– Located in the medulla oblongata
124

(1 of 2)
• How digestion works
– Complex chemical process
• Anatomy of the digestive system
– Mouth
– Salivary glands
– Oropharynx
– Esophagus
– Stomach
– Pancreas
125

(2 of 2)
• More anatomy of the digestive system
– Liver
– Bile ducts
– Small intestine
– Large intestine
– Appendix
– Rectum
126

• Urinary system
– Controls the discharge of waste materials filtered from the blood by the kidneys
– Kidneys
– Ureter
– Urinary bladder
– Urethra
127

128

• Genital system
– Controls reproductive processes
• Male reproductive system and organs
– Testicles, vas deferens, seminal vesicles, prostate gland, urethra, and penis
• Female reproductive system and organs
– Ovaries, fallopian tubes, uterus, cervix, and vagina
129

(1 of 2)
• Body fluid balance
– Total body water averages 50-70% of total body weight
– Intracellular and extracellular fluid
– Intravascular fluid and interstitial fluid
– Fluid balance is the process of maintaining homeostasis through equal intake and output
– ADH, thirst, kidneys, and water shifts
130

(2 of 2)
• Acid-base balance
– Acids and bases
– Alkalotic versus acidotic
– pH range 0-14 with 7.0 being neutral
• Buffer systems
– Act as fast defenses for acid-base challenges
– Absorb hydrogen ions when they are in excess
131