Anatomy

and
physiology

Introduction
The Urinary System is a system of organs that produces and excretes urine from the body. Urine is
a transparent yellow fluid containing unwanted wastes, mostly excess water, salts, and nitrogen
compounds.
The major organs of the urinary system are the kidneys, a pair of bean-shaped organs that
continuously filter substances from the blood and produce urine. Urine flows from the kidneys
through two long, thin tubes called ureters. With the aid of gravity and wavelike contractions, the
ureters transport the urine to the bladder, a muscular vessel. The normal adult bladder can store up
to about 0.5 liter (1 pt) of urine, which it excretes through the tubelike urethra.

Via InfoVisual.com

An average adult produces about 1.5 liters (3 pt) of urine each day, and the body needs, at a
minimum, to excrete about 0.5 liter (1 pint) of urine daily to get rid of its waste products. Excessive or

inadequate production of urine may indicate illness and doctors often use urinalysis (examination of
a patients urine) as part of diagnosing disease. For instance, the presence of glucose, or blood
sugar, in the urine is a sign of diabetes mellitus; bacteria in the urine signal an infection of the urinary
system; and red blood cells in the urine may indicate cancer of the urinary tract.

Functions of the urinary system

Excretion. The kidneys are the major excretory organs of the body. They remove waste
products, many of which are toxic, from the blood. Most waste products are metabolic by
products of cells and substances absorbed from the intestine. The skin, liver, lungs, and
intestines eliminate some of these waste products, but they cannot compensate if the kidneys fail
to function.

Blood volume control. The kidneys play an essential role in controlling blood volume by
regulating the volume of water removed from the blood to produce urine.

Ion concentration regulation. The kidneys help regulate the concentrate of the major ion in
the body fluids.

pH regulation. The kidneys help regulate the pH of the body fluids. Buffers in the blood and
the respiratory system also play important roles in the regulation of pH.

Red blood cell concentration. The kidneys participate in the regulation of red blood cell
production and, therefore, in controlling the concentration of red blood cells in the blood.

Vitamin D synthesis. The kidneys, along with the skin and the liver, participate in the
synthesis of vitamin D.

Kidneys
The kidneys are bean-shaped organs, each about the size of a tightly clenched fist. They lie on the
posterior abdominal wall, behind the peritoneum, with one kidney on either side of the vertebral
column. Structures that are behind the peritoneum are said to be retroperitoneal.

Via Wikispaces

The kidneys are abundantly supplied with blood vessels- they process blood the kidneys receive 20
25% of the resting cardiac output via the right and left renal arteries. In adults, blood flow through
both kidneys (renal blood flow) is about 1200 ml per minute

Function of the kidneys

Regulation of blood ionic composition

Regulation of blood pH

Regulation of blood volume

Regulation of blood pressure

Maintenance of blood osmolarity

Production of hormones

Regulation of blood glucose level

Excretion of wastes and foreign substances

Three layers of tissue surround each kidney

The renal capsule. The deep layer, smooth, transparent sheet of dense irregular connective
tissue. Serves as a barrier against trauma and helps maintain the shape of the kidneys.
Continuous with the outer coat of the ureter.

The adipose capsule. Middle layer, a mass of fatty tissue surrounding the renal capsule.
Protects kidney from trauma and holds it firmly in place in the abdominal cavity.

The renal fascia. The superficial layer, thin layer of dense irregular connective tissue.
anchors the kidney to surrounding structures and to the abdominal wall

Internal anatomy of the kidneys

Two regions

The renal cortex - superficial, smooth-textured reddish area

The renal medulla deep, reddish-brown inner region. Consists of 8 to 18 cone-shaped

renal pyramids
Renal pyramids. The base faces the renal cortex. The apex (renal papilla) points toward the renal
hilum
Renal columns. Portions of the renal cortex that extend between renal pyramids
Renal lobe. A renal pyramind + its overlying area of renal cortex + 1/2 of each adjacent renal column
The parenchyma. The functional portion of the kidney. Consists of the renal cortex and renal
pyramids of the renal medulla. Contains about 1 million mircoscopic structures called nephrons.

Ureters
The ureters are two slender tubes that run from the sides of the kidneys to the bladder. Their function
is to transport urine from the kidneys to the bladder.

Bladder
The bladder is a muscular organ and serves as a reservoir for urine. Located just behind the pubic
bone, it can extend well up into the abdominal cavity when full. Near the outlet of the bladder is a
small muscle called the internal sphincter, which contract involuntarily to prevent the emptying of the
bladder?

Urethra
The urethra is a tube that extends from the bladder to the outside world. It is through this tube that
urine is eliminated from the body.

Female Reproductive System Anatomy and

Physiology
The organs of the reproductive systems are concerned with the general process of reproduction, and
each is adapted for specialized tasks. These organs are unique in that their functions are not
necessary for the survival of each individual. Instead, their functions are vital to the continuation of
the human species.
The female reproductive system consists of internal organs and external organs.
The internal organs are located in the pelvic cavity and are supported by the pelvic floor.
The external organs are located from the lower margin of the pubis to the perineum.
The appearance of the external genitals varies greatly from woman to woman, since age, heredity,
race, and the number of children a woman has borne determines the size, shape, and color.

1. Internal Organs
a) Uterus
The uterus is a hollow organ about the size and shape of a pear. It serves two important functions: it
is the organ of menstruation and during pregnancy it receives the fertilized ovum, retains and
nourishes it until it expels the fetus during labor.
The uterus is located between the urinary bladder and the rectum. It is suspended in the pelvis by
broad ligaments.
Divisions of the uterus. The uterus consists of the body or corpus, fundus, cervix, and the isthmus.
The major portion of the uterus is called the body or corpus. The fundus is the superior, rounded
region above the entrance of the fallopian tubes. The cervix is the narrow, inferior outlet that
protrudes into the vagina. The isthmus is the slightly constricted portion that joins the corpus to the
cervix.
Walls of the uterus. The walls are thick and are composed of three layers: the endometrium, the
myometrium, and the perimetrium. The endometrium is the inner layer or mucosa. A fertilized egg
burrows into the endometrium (implantation) and resides there for the rest of its development. When
the female is not pregnant, the endometrial lining sloughs off about every 28 days in response to
changes in levels of hormones in the blood. This process is called menses. The myometrium is the
smooth muscle component of the wall. These smooth muscle fibers are arranged. In longitudinal,
circular, and spiral patterns, and are interlaced with connective tissues. During the monthly female
cycles and during pregnancy, these layers undergo extensive changes. The perimetrium is a strong,
serous membrane that coats the entire uterine corpus except the lower one fourth and anterior
surface where the bladder is attached.

b) Vagina
The vagina is the thin in walled muscular tube about 6 inches long leading from the uterus to the
external genitalia. It is located between the bladder and the rectum.
The vagina provides the passageway for childbirth and menstrual flow; it receives the penis and
semen during sexual intercourse.

c) Fallopian Tubes (Two)

Each tube is about 4 inches long and extends medially from each ovary to empty into the superior
region of the uterus.

The fallopian tubes transport ovum from the ovaries to the uterus. There is no contact of fallopian
tubes with the ovaries.
The distal end of each fallopian tube is expanded and has finger-like projections called fimbriae,
which partially surround each ovary. When an oocyte is expelled from the ovary, fimbriae create fluid
currents that act to carry the oocyte into the fallopian tube. Oocyte is carried toward the uterus by
combination of tube peristalsis and cilia, which propel the oocyte forward. The most desirable place
for fertilization is the fallopian tube.

d) Ovaries
The ovaries are for oogenesis-the production of eggs (female sex cells) and for hormone production
(estrogen and progesterone).
The ovaries are about the size and shape of almonds. They lie against the lateral walls of the pelvis,
one on each side. They are enclosed and held in place by the broad ligament. There are compact
like tissues on the ovaries, which are called ovarian follicles. The follicles are tiny sac-like structures
that consist of an immature egg surrounded by one or more layers of follicle cells. As the developing
egg begins to ripen or mature, follicle enlarges and develops a fluid filled central region. When the
egg is matured, it is called a graafian follicle, and is ready to be ejected from the ovary.

Process of egg productionoogenesis

The total supply of eggs that a female can release has been determined by the time she is born. The
eggs are referred to as oogonia in the developing fetus. At the time the female is born, oogonia
have divided into primary oocytes, which contain 46 chromosomes and are surrounded by a layer of
follicle cells.
Primary oocytes remain in the state of suspended animation through childhood until the female
reaches puberty (ages 10 to 14 years). At puberty, the anterior pituitary gland secretes folliclestimulating hormone (FSH), which stimulates a small number of primary follicles to mature each
month.
As a primary oocyte begins dividing, two different cells are produced, each containing 23 unpaired
chromosomes. One of the cells is called a secondary oocyte and the other is called the first polar
body. The secondary oocyte is the larger cell and is capable of being fertilized. The first polar body is
very small, is nonfunctional, and incapable of being fertilized.
By the time follicles have matured to the graafian follicle stage, they contain secondary oocytes and
can be seen bulging from the surface of the ovary. Follicle development to this stage takes about 14

days. Ovulation (ejection of the mature egg from the ovary) occurs at this 14-day point in response to
the luteinizing hormone (LH), which is released by the anterior pituitary gland.
The follicle at the proper stage of maturity when the LH is secreted will rupture and release its oocyte
into the peritoneal cavity. The motion of the fimbriae draws the oocyte into the fallopian tube. The
luteinizing hormone also causes the ruptured follicle to change into a granular structure called corpus
luteum, which secretes estrogen and progesterone.
If the secondary oocyte is penetrated by a sperm, a secondary division occurs that produces another
polar body and an ovum, which combines its 23 chromosomes with those of the sperm to form the
fertilized egg, which contains 46 chromosomes.

Process of hormone production by the ovaries

Estrogen is produced by the follicle cells, which are responsible secondary sex characteristics and
for the maintenance of these traits. These secondary sex characteristics include the enlargement of
fallopian tubes, uterus, vagina, and external genitals; breast development; increased deposits of fat
in hips and breasts; widening of the pelvis; and onset of menses or menstrual cycle.
Progesterone is produced by the corpus luteum in presence of in the blood. It works with estrogen to
produce a normal menstrual cycle. Progesterone is important during pregnancy and in preparing the
breasts for milk production.

2. External Female Organs

The external organs of the female reproductive system include the mons pubis, labia majora, labia
minora, vestibule, perineum, and the Bartholins glands. As a group, these structures that surround
the openings of the urethra and vagina compose the vulva, from the Latin word meaning covering.

a) Mons Pubis
This is the fatty rounded area overlying the symphysis pubis and covered with thick coarse hair.

b) Labia Majora
The labia majora run posteriorly from the mons pubis. They are the 2 elongated hair covered skin
folds. They enclose and protect other external reproductive organs.

c) Labia Minora

The labia minora are 2 smaller folds enclosed by the labia majora. They protect the opening of the
vagina and urethra.

d) Vestibule
The vestibule consists of the clitoris, urethral meatus, and the vaginal introitus.
The clitoris is a short erectile organ at the top of the vaginal vestibule whose function is sexual
excitation.
The urethral meatus is the mouth or opening of the urethra. The urethra is a small tubular structure
that drains urine from the bladder.
The vaginal introitus is the vaginal entrance.

e) Perineum
This is the skin covered muscular area between the vaginal opening (introitus) and the anus. It aids
in constricting the urinary, vaginal, and anal opening. It also helps support the pelvic contents.

f) Bartholins Glands (Vulvovaginal or Vestibular Glands)

The Bartholins glands lie on either side of the vaginal opening. They produce a mucoid substance,
which provides lubrication for intercourse.

3. Blood Supply
The blood supply is derived from the uterine and ovarian arteries that extend from the internal iliac
arteries and the aorta. The increased demands of pregnancy necessitate a rich supply of blood to
the uterus. New, larger blood vessels develop to accommodate the need of the growing uterus. The
venous circulation is accomplished via the internal iliac and common iliac vein.

4. The Menstrual Cycle

Menstruation is the periodic discharge of blood, mucus, and epithelial cells from the uterus. It usually
occurs at monthly intervals throughout the reproductive period, except during pregnancy and
lactation, when it is usually suppressed.

The menstrual cycle is controlled by the cyclic activity of follicle stimulating hormone (FSH) and LH
from the anterior pituitary and progesterone and estrogen from the ovaries. In other words, FSH acts
upon the ovary to stimulate the maturation of a follicle, and during this development, the follicular
cells secrete increasing amounts of estrogen

Hormonal interactions of the female cycle are as follows

Days 1-5. This is known as the menses phase. A lack of signal from a fertilized egg influences the
drop in estrogen and progesterone production. A drop in progesterone results in the sloughing off of
the thick endometrial lining which is the menstrual flow. This occurs for 3 to 5 days.
Days 6-14. This is known as the proliferative phase. A drop in progesterone and estrogen stimulates
the release of FSH from the anterior pituitary. FSH stimulates the maturation of an ovum with
graafian follicle. Near the end of this phase, the release of LH increases causing a sudden burst like
release of the ovum, which is known as ovulation.
Days 15-28. This is known as the secretory phase. High levels of LH cause the empty graafian
follicle to develop into the corpus luteum. The corpus luteum releases progesterone, which increases
the endometrial blood supply. Endometrial arrival of the fertilized egg. If the egg is fertilized, the
embryo produces human chorionic gonadotropin (HCG). Thehuman chorionic gonadotropin signals
the corpus luteum to continue to supply progesterone to maintain the uterine lining. Continuous
levels of progesterone prevent the release of FSH and ovulation ceases.

Additional Information

The length of the menstrual cycle is highly variable. It may be as short as 21 days or as long
as 39 days.

Only one interval is fairly constant in all females, the time from ovulation to the beginning of
menses, which is almost always 14-15 days.

The menstrual cycle usually ends when or before a woman reaches her fifties. This is known
as menopause.

5. Ovulation
Ovulation is the release of an egg cell from a mature ovarian follicle. Ovulation is stimulated by
hormones from the anterior pituitary gland, which apparently causes the mature follicle to swell
rapidly and eventually rupture. When this happens, the follicular fluid, accompanied by the egg cell,
oozes outward from the surface of the ovary and enters the peritoneal cavity. After it is expelled from
the ovary, the egg cell and one or two layers of follicular cells surrounding it are usually propelled to

the opening of a nearby uterine tube. If the cell is not fertilized by union of a sperm cell within a
relatively short time, it will degenerate.

6. Menopause
As mentioned in paragraph 1-6c, menopause is the cessation of menstruation. This usually occurs in
women between the ages of 45 and 50. Some women may reach menopause before the age of 45
and some after the age of 50. In common use, menopause generally means cessation of regular
menstruation. Ovulation may occur sporadically or may cease abruptly. Periods may end suddenly,
may become scanty or irregular, or may be intermittently heavy before ceasing altogether. Markedly
diminished ovarian activity, that is, significantly decreased estrogen production and cessation of
ovulation, causes menopause.

Respiratory System Anatomy and Physiology

The respiratory system is situated in the thorax, and is responsible for gaseous exchange between
the circulatory system and the outside world. Air is taken in via the upper airways (the nasal cavity,
pharynx and larynx) through the lower airways (trachea, primary bronchi and bronchial tree) and into
the small bronchioles and alveoli within the lung tissue.

The lungs are divided into lobes; The left lung is composed of the upper lobe, the lower lobe and the
lingula (a small remnant next to the apex of the heart), the right lung is composed of the upper, the
middle and the lower lobes.

The Nose
The uppermost portion of the human respiratory system, the nose is a hollow air passage that
functions in breathing and in the sense of smell. The nasal cavity moistens and warms incoming air,
while small hairs and mucus filter out harmful particles and microorganisms. This illustration depicts
the interior of the human nose. The prominent structure between the eyes that serves as the
entrance to the respiratory tract and contains the olfactory organ. It provides air for respiration,
serves the sense of smell, conditions the air by filtering, warming, and moistening it, and cleans itself
of foreign debris extracted from inhalations.

The Trachea, Bronchi Aviolar Ducts and Avioli

The trachea (windpipe) divides into two main bronchi (also mainstem bronchi), the left and the
right, at the level of the sternal angle at the anatomical point known as the carina. The right main
bronchus is wider, shorter, and more vertical than the left main bronchus. The right main bronchus
subdivides into three lobar bronchi while the left main bronchus divides into two. The lobar bronchi
divide into tertiary bronchi, also known as segmental bronchi, each of which supplies a
bronchopulmonary segment. A bronchopulmonary segment is a division of a lung that is separated
from the rest of the lung by a connective tissue septum.. This property allows a bronchopulmonary
segment to be surgically removed without affecting other segments. There are ten segments per
lung, but due to anatomic development, several segmental bronchi in the left lung fuse, giving rise to
eight. The segmental bronchi divide into many primary bronchioles which divide into terminal
bronchioles, each of which then gives rise to several respiratory bronchioles, which go on to divide
into 2 to 11 alveolar ducts. There are 5 or 6 alveolar sacs associated with each alveolar duct. The
alveolus is the basic anatomical unit of gas exchange in the lung.
There is hyaline cartilage present in the bronchi, present as irregular rings in the larger bronchi
(and not as regular as in the trachea), and as small plates and islands in the smaller bronchi.
Smooth muscle is present continuously around the bronchi.
In the mediastinum, at the level of the fifth thoracic vertebra, the trachea divides into the right and
left primary bronchi. The bronchi branch into smaller and smaller passageways until they terminate in
tiny air sacs called alveoli.
The cartilage and mucous membrane of the primary bronchi are similar to that in the trachea. As
the branching continues through the bronchial tree, the amount of hyaline cartilage in the walls
decreases until it is absent in the smallest bronchioles. As the cartilage decreases, the amount of
smooth muscle increases. The mucous membrane also undergoes a transition from ciliated
pseudostratified columnar epithelium to simple cuboidal epithelium to simple squamous epithelium.
The alveolar ducts and alveoli consist primarily of simple squamous epithelium, which permits
rapid diffusion of oxygen and carbon dioxide. Exchange of gases between the air in the lungs and
the blood in the capillaries occurs across the walls of the alveolar ducts and alveoli.

The Lungs
The lungs constitute the largest organ in the respiratory system. They play an important role in
respiration, or the process of providing the body with oxygen and releasing carbon dioxide. The lungs
expand and contract up to 20 times per minute taking in and disposing of those gases.

Air that is breathed in is filled with oxygen and goes to the trachea, which branches off into one of
two bronchi. Each bronchus enters a lung. There are two lungs, one on each side of the breastbone
and protected by the ribs. Each lung is made up of lobes, or sections. There are three lobes in the
right lung and two lobes in the left one. The lungs are cone shaped and made of elastic, spongy
tissue. Within the lungs, the bronchi branch out into minute pathways that go through the lung tissue.
The pathways are called bronchioles, and they end at microscopic air sacs called alveoli. The alveoli
are surrounded by capillaries and provide oxygen for the blood in these vessels. The oxygenated
blood is then pumped by the heart throughout the body. The alveoli also take in carbon dioxide,
which is then exhaled from the body.
Inhaling is due to contractions of the diaphragm and of muscles between the ribs. Exhaling results
from relaxation of those muscles. Each lung is surrounded by a two-layered membrane, or the
pleura, that under normal circumstances has a very, very small amount of fluid between the layers.
The fluid allows the membranes to easily slide over each other during breathing.

Mechanics of Breathing
To take a breath in, the external intercostal muscles contract, moving the ribcage up and out. The
diaphragm moves down at the same time, creating negative pressure within the thorax. The lungs
are held to the thoracic wall by the pleural membranes, and so expand outwards as well. This
creates negative pressure within the lungs, and so air rushes in through the upper and lower airways.
Expiration is mainly due to the natural elasticity of the lungs, which tend to collapse if they are not
held against the thoracic wall. This is the mechanism behind lung collapse if there is air in the pleural
space (pneumothorax).

Physiology of Gas Exchange

Each branch of the bronchial tree eventually sub-divides to form very narrow terminal bronchioles,
which terminate in the alveoli. There are many millions of alveoli in each lung, and these are the
areas responsible for gaseous exchange, presenting a massive surface area for exchange to occur
over.
Each alveolus is very closely associated with a network of capillaries containing deoxygenated blood
from the pulmonary artery. The capillary and alveolar walls are very thin, allowing rapid exchange of
gases by passive diffusion along concentration gradients.
CO2 moves into the alveolus as the concentration is much lower in the alveolus than in the blood,
and O2 moves out of the alveolus as the continuous flow of blood through the capillaries prevents
saturation of the blood with O2 and allows maximal transfer across the membrane.

Digestive System Anatomy and Physiology

The digestive tract consists of the digestive tract, a tube extending from the mouth to the anus, plus
the associated organs, which secrete fluids into the digestive tract. The term gastrointestinal tract
technically only refers to the stomach and intestine but is often used as a synonym for the digestive
tract. The inside of the digestive tract is continuous with the outside environment, where it opens at
the mouth and anus. Nutrients cross the wall of the digestive tract to enter the circulation.
The digestive tract consists of the oral cavity, pharynx, esophagus, stomach, small intestine, large
intestine, and anus. Accessory glands are associated with the digestive tract. The salivary glands
empty into the oral cavity and the liver and pancreas are connected to the small intestine.
Various parts of the digestive tract are specialized for different functions, but nearly all parts consist
of four layers or tunics the mucosa, sub mucosa, muscularis, and serosa or adventitia.
Contents [show]

Digestive Tract Histology

The innermost tunic, the mucosa, consists of mucous epithelium, a loose connective tissue called
the lamina propria, and a thin smooth muscle layer, the muscularis mucosa. The epithelium in the
mouth, esophagus and anus resists abrasion, and epithelium in the stomach and intestine absorbs
and secretes.
The sub mucosa lies just outside the mucosa. It is a thick layer of loose connective tissue containing
nerves, blood vessels, and small glands. An extensive network of nerve cell processes forms a
plexus (network). The plexus is innervated by autonomic nerves.
The muscularis which in most part of the digestive tube consists of an inner layer of circular smooth
muscle and an outer layer of longitudinal smooth muscle. Another nerve plexus, also innervated by
autonomic nerves, lies between the two muscle layers. Together the nerve plexuses of the sub
mucosa and muscularis compose the enteric plexus. This plexus is extremely important in the control
of movement and secretion within the tract.
The fourth, or outermost, layer of the digestive tract is either a serosa or an adventitia. Some regions
of the digestive tract are covered by peritoneum and other regions are not. The peritoneum, which is
a smooth epithelial layer, and its underlying connective tissue are referred to histologically as the
serosa. In regions of the digestive tract not covered by peritoneum, the digestive tract is covered by a
connective tissue layer called the adventitia, which is continuous with the surrounding connective
tissue.

Peritoneum and Mesenteries

The body wall of the abdominal cavity and the abdominal organs are covered with serous
membranes. The serous membrane that covers the organs is the visceral peritoneum, or serosa.
The serous membrane that lines the wall of the abdominal cavity is the parietal peritoneum.
Many of the organs of the abdominal cavity are held in place by connective tissue sheets called
mesenteries. The mesenteries consist of two layers of serous membranes with a thin layer of loose
connective tissue between them. Specific mesenteries are given names. The mesentery connecting
the lesser curvature of the stomach to the liver and diaphragm is the lesser omentum, and the
mesentery connecting the greater curvature of the stomach to the transverse colon and posterior
body wall is the greater omentum. The greater omentum is unusual in that it is a long, double fold of
mesentery that extends inferiorly from the stomach before looping back to the transverse colon to
create a cavity or pocket, called the omental bursa. Fat accumulates in the greater omentum, giving
it the appearance of a fat-filled apron that covers the anterior surface of the abdominal viscera.
Mesentery is a general term referring to the serous membrane attached to the abdominal organs.
The term is also used specifically to refer to the mesentery that attaches the small intestine to the
posterior abdominal wall. This mesentery is also called the mesentery proper.
Other abdominal organs lie against the abdominal wall, have no mesenteries, and are described as
retroperitoneal. The retroperitoneal organs include the duodenum, pancreas, ascending colon,
descending colon, rectum, kidneys, adrenal glands and urinary bladder.

Oral Cavity
The oral cavity, or mouth, is the first part of the digestive tract. It is bounded by the lips and cheeks
and contains the teeth and tongue.

The Oral Cavity

The lips are muscular structures, formed mostly by the orbicularis oris muscle. The outer surfaces of
the lips are covered by skin. The keratinized stratified epithelium of the skin becomes thin at the
margin of the lips. The color from the underlying blood vessels can be seen through the thin,
transparent epithelium, giving the lips a reddish-pink appearance. At the internal margin of the lips,

the epithelium is continuous with the moist stratified squamous epithelium of the mucosa in the oral
cavity. The cheeks form the lateral walls of the oral cavity.
The buccinators muscles are located within the cheeks and flatten the cheeks against teeth. The lips
and cheeks are important in the process of mastication, or chewing. They help manipulate the food
within the mouth and hold the food in place while the teeth crush or tear it. Mastication begins the
process of mechanical digestion, in which large food particles are broken down into smaller ones.
The cheeks also help form words during the speech process.

Tongue
The tongue is a large, muscular organ that occupies most of the oral cavity. The major attachment of
the tongue is in the posterior part of the oral cavity. The anterior part of the tongue is relatively free.
There is an anterior attachment to the floor of the mouth by a thin fold of tissue called the frenulum.
The tongue moves food in the mouth and, in cooperation with the lips and cheeks, holds the food in
place during mastication. It also plays a major role in the process of swallowing. The tongue is a
major sensory organ for taste, as well as being one of the major organs of speech.

Teeth
There are 32 teeth in the normal adult mouth, located in the mandible and maxillae. The teeth can be
divided into quadrants right upper, left upper, right lower, and left lower. In adults, each quadrant
contains one central and one lateral incisor; one canine; first and second premolars; and first,
second, and third molars. The third molars are called wisdom teeth because they usually appear in a
persons late teens or early twenties, when the person is old enough to have acquired some degree
of wisdom.
The teeth of adults are permanent, or secondary, teeth. Most of them are replacements of the 2
primary, or deciduous, teeth.
Each tooth consists of a crown with one or more cusps, a neck and a root. The center of the tooth is
a pulp cavity, which is filled with blood vessels, nerves and connective tissue, called pulp. The pulp
cavity is surrounded by a living, cellular, bonelike tissue called dentin. The dentin of the tooth crown
is covered by an extremely hard, acellular substance called enamel, which protects the tooth against
abrasion and acids produced by bacteria in the mouth. The surface of the dentin in the root is
covered with cementum, which helps anchor the tooth in the jaw.
The teeth are rooted within alveoli along the alveolar processes of the mandible and maxillae. The
alveolar processes are covered by dense fibrous connective tissue and moist stratified squamous
epithelium, referred to as the gingival, or gums. The teeth are held in place by periodontal ligaments,

which are connective tissue fibers that extend from the alveolar walls and are embedded into the
cementum.

Palate and Tonsils

The palate, or roof of the oral cavity, consists of two parts. The anterior part contains bone and is
called the hard palate, whereas the posterior portion consists of skeletal muscle and connective
tissue and is called the soft palate. The uvula is a posterior extension of the soft palate. The palate
separates the oral cavity from the nasal cavity and prevents food from passing into the nasal cavity
during chewing and swallowing.
The tonsils are located in the lateral posterior walls of the oral cavity, in the nasopharynx, and in the
posterior surface of the tongue.
There are three pairs of salivary glands the parotid, submandibular, and sublingual glands. They
produce saliva, which is a mixture of serous and mucous fluids. Saliva helps keep the oral cavity
moist and contains enzymes that begin the process of chemical digestion. The salivary glands are
compound alveolar glands. They have branching ducts with clusters of alveoli, resembling grapes, at
the ends of the ducts.
The largest of the salivary glands, the parotid glands, are serous glands located just anterior to each
ear. Parotid ducts enter the oral cavity adjacent to the second upper molars.
The submandibular glands produce more serous than mucous secretions. Each gland can be felt as
a soft lump along the inferior border of the mandible. The submandibular ducts open into the oral
cavity on each side of the frenulum of the tongue. In certain people, if the mouth is opened and the
tip of the tongue is elevated, saliva can squirt out of the mouth from the ducts of these glands.
The sublingual glands, the smallest of the three paired salivary glands, produce primarily mucous
secretions. They lie immediately below the mucous membrane in the floor of the oral cavity. Each
sublingual gland has 10-12 small ducts opening onto the floor of the oral cavity.

Pharynx
The pharynx, or throat, which connects the mouth with the esophagus, consists of three parts the
nasopharynx, oropharynx, and laryngopharynx. Normally only the oropharynx and laryngopharynx
transmit food. The posterior walls of the oropharynx and laryngopharynx are formed by the superior,
middle, and inferior pharyngeal constrictor muscles.

Esophagus

The esophagus is a muscular tube, lined with moist stratified squamous epithelium that extends from
the pharynx to the stomach. It is about 25 centimeters (cm) long and lies anterior to the vertebrae
and posterior to the trachea within the mediastenum. It passes through the diaphragm and ends at
the stomach. Upper and lower esophageal sphincters, located at the upper and lower ends of the
esophagus, respectively, regulate the movement of food into and out of the esophagus. The lower
esophageal sphincter is sometimes called the cardiac sphincter. Numerous mucous glands produce
thick, lubricating mucus that coats the inner surface of the esophagus.

Stomach
The stomach is an enlarged segment of the digestive tract in the left superior part of the abdomen.
The opening from the esophagus into the stomach is called the cardiac opening because it is near
the heart. The region of the stomach around the cardiac opening is called the cardiac region. The
most superior part of the stomach is the fundus. The largest part of the stomach is the body, which
turns to the right, forming a greater curvature on the left, and a lesser curvature on the right. The
opening from the stomach into the small intestine is the pyloric opening, which is surrounded by a
relatively thick ring of smooth muscle called the pyloric sphincter. The region of the stomach near the
pyloric opening is the pyloric region.

The muscular layer of the stomach is different from other regions of the digestive tract in that it
consists of three layers an outer longitudinal layer, a middle circular layer, and an inner oblique layer.

These muscular layers produce a churning action in the stomach, important in the digestive process.
The sub mucosa and mucosa of the stomach are thrown into large folds called rugae when the
stomach is empty. These folds allow the mucosa and sub mucosa to stretch, and the folds disappear
as the stomach is filled.
The stomach is lined with simple columnar epithelium. The mucosal surface forms numerous, tubelike gastric pits, which are the openings for the gastric glands. The epithelial cells of the stomach can
be divided into five groups. The first group consists of surface mucous cells on the inner surface of
the stomach and lining the gastric pits. Those cells produce mucus which coats and protect the
stomach lining. They are mucous neck cells, which produce mucous; parietal cells, which produce
hydrochloric acids and intrinsic factors; endocrine cells, which produce regulatory hormones; and
chief cells, which produce pepsinogen, a precursor of the protein-digesting enzyme pepsin.

Small Intestines
The small intestine is about 6 meters long and consists of three partsthe duodenum, jejunum, and
ileum. The duodenum is about 25 centimeter (the term duodenum means 12, suggesting that it is 12
inches long). The jejunum is about 2.5 meter long and makes up two-fifths of the total length of the
small intestine. The ileum is about 3.5 meter long and makes up three-fifths of the small intestine.
The duodenum nearly completes a nearly an 18degree arc as it curves within the abdominal cavity.
Part of the pancreas lies within this arc. The common bile duct from the liver and the pancreatic duct
from the pancreas join each other and empty into the duodenum.
The small intestine is the major site of digestion and absorption of food, which are accomplished by
the presence of a large surface area. The surface of the small intestine has three modifications that
increase surface area about 600-foldcircular folds, villi, and microvilli. The mucosa and sub mucosa
form a series of circular folds that run perpendicular to the long axis of the digestive tract. Tiny finger
like projections of the mucosa forms numerous villi, which are 0.5-1.5 mm long. Most of the cells
composing the surface of the villi have numerous cytoplasmic extensions, called microvilli. Each
villus is covered by simple columnar epithelium. Within the loose connective tissue core of each
villus is a blood capillary called lacteal. The blood capillary network and the lacteal are very
important in transporting absorbed nutrients.
The mucosa of the small intestine is simple columnar epithelium with four major cell types:
Absorptive cells, which have microvilli, produce digestive enzymes, and absorb digested food Goblet
cells, which produce a protective mucus Granular cells, (Paneths cells), which may help protect the
intestinal epithelium from bacteria; Endocrine cells, which produce regulatory hormones. The
epithelial cells are produce within tubular glands of the mucosa, called intestinal glands, at the base
of the villi. Granular and endocrine cells are located in the bottom of the glands. The sub mucosa of

the duodenum contains mucous glands, called duodenal glands, which open into the base of the
intestinal glands.
The duodenum, jejunum, and ileum are similar in structure except that there is a granular decrease
in the diameter of the small intestine, in the thickness of the intestinal wall, in the number of circular
folds, and in the number of villi as one progress through the small intestine. Lymph nodules are
common along the entire length of the digestive tract. Clusters of lymph nodules, called Peyers
patches, are numerous in the ileum. These lymphatic tissues in the intestine help protect the
intestinal tract from harmful micro organisms.
The junction between the ileum and the large intestine is the ileocecal junction. It has a ring of
smooth muscle, the ileocecal sphincter, and an ileocecal valve, which allows material contained in
the intestine to move from the ileum to the large intestine, but not in the opposite direction.

Secretions of the Small Intestines

Secretions from the mucosa of the small intestine mainly contain mucus, ions and water. Intestinal
secretions lubricate and protect the intestinal wall from the acidic chime and the action of the
digestive enzymes. They also keep the chime in the small intestine in a liquid form to facilitate the
digestive process. Most of the secretions entering the small intestine are produced by the intestinal
mucosa, but the secretions of the liver and the pancreas also enter the small intestine and play
important roles in the process of digestion.
The epithelial cells in the walls of the small intestine have enzymes bound to their free surfaces that
play a significant role in the final steps of digestion. Peptidases break the peptide bonds in proteins
to form amino acids. Disaccharidases break down dissacharides, such as maltose and isomaltose,
into monosaccharide. The amino acids and monosaccharides can be absorbed by the intestinal
epithelium.
Mucus is produced by duodenal glands and by goblet cells, which are dispersed throughout the
epithelial lining of the entire small intestine and within intestinal glands. Hormones released from the
intestinal mucosa stimulate liver and pancreatic secretions. Secretion by duodenal glands is
stimulated by the vagus nerve, secretin release, and chemical or tactile irritation of the duodenal
mucosa.

Movement of Small Intestines

Mixing and propulsion of chime are the primary mechanical events that occur in the small intestine.
Peristaltic contractions proceed along the length of the intestine for variable distances and cause the
chime to move along the small intestine. Segmental contractions are propagated for only short
distances and function to mix intestinal contents.

The ileocecal sphincter at the juncture of the ileum and the large intestine remains mildly contracted
most of the time, but peristaltic contractions reaching the ileocecal sphincter from the small intestine
cause the sphincter to relax and allow movement of chime from the small intestine into the cecum.
The ileocecal valve allows chime to move from the ileum into the large intestine, but tends to prevent
movement from the large intestine back into the ileum.

Absorption in the Small Intestines

A major function of the small intestine is the absorption of nutrients. Most absorption occurs in the
duodenum and jejunum, although some absorption also occurs in the ileum.

Liver
The liver weighs about 1.36 kilograms and is located in the right upper quadrant of the abdomen,
tucked against the inferior surface of the diaphragm. The posterior surface of the liver is in contact
with the right ribs 5-12. it is divided into two major lobes, the right and left lobes, separated by a
connective tissue septum, the falciform ligament. Two smaller lobes, the caudate and quadrate, can
be seen from an inferior view. Also seen from the inferior view is the porta, which is the gate through
which blood vessels, ducts and nerves enter or exit the liver.

The liver receives blood from two sources. The hepatic artery brings oxygen-rich blood to the liver,
which supplies liver cells with oxygen. The hepatic portal vein carries blood that is oxygen-poor but
rich in absorbed nutrients and other substances from the digestive tract to the liver. Liver cells
process nutrients and detoxify harmful substance from the blood. Blood exits the liver through
hepatic veins, which empty into the inferior vena cava.
Many delicate connective tissue septa divide the liver into lobules with portal triads at the corners of
the lobules. The portal triads contain three structuresthe hepatic artery, hepatic portal vein, and
hepatic duct. Hepatic cords, formed by platelike groups of cells called hepatocytes, are located
between the center and the margins of each lobule. The hepatic cords are separated from one
another by blood channels called hepatic sinusoids. The sinusoid epithelium contains phagocytic
cells that help remove foreign particles from the blood. Blood from the hepatic portal vein and the
hepatic artery flows into the sinusoids and becomes mixed. The mixed blood flows towards the
center of each lobule into a central vein. The central veins from all the lobes unite to form the hepatic
veins, which carry blood out of the liver to the inferior vena cava.
A cleft-like lumen, the bile canaliculus, is between the cells of each hepatic cord. Bile, produced by
the hepatocytes, flows through the bile canaliculi to the hepatic ducts in the portal triads. The hepatic
ducts converge and empty into the right and left hepatic ducts, which transport bile out of the liver.
The right and left hepatic ducts unite to form a single common hepatic duct. The common hepatic
ducts is joined by the cystic duct from the gallbladder is a small sac on the inferior surface of the liver
that stores and concentrates bile. The common bile duct joins the pancreatic duct and opens into the
duodenum at the duodenal papilia. The opening into the duodenum is regulated by a sphincter.
The liver performs important digestive and excretory functions, store and processes nutrients,
synthesizes new molecules, and detoxifies harmful chemicals.
The liver secretes about 70mL of bile each day. Bile contains no digestive enzymes, but it plays an
important role in digestion by diluting and neutralizing stomach acid and by dramatically increasing
the efficiency of fat digestion and absorption. Digestive enzyme cannot act efficient on large fat
globules. Bile salts emulsify fats, breaking the fat globules into smaller droplets, much like the action
of detergent in dish-water. The small droplets are more easily digested by the digestive enzymes.
Bile also contains excretory products such as bile pigments, cholesterol and fats. Bilirubin is a bile
pigment that results from the breakdown of hemoglobin.
Bile excretion by the liver is stimulated by secretin, which is released from the duodenum.
Cholecystokinin stimulates the gall bladder to contract and release bile into the duodenum.
Parasympathetic stimulation through the vagus nerve also stimulates bile secretion and release.

Most bile salts are reabsorbed in the ileum, and the blood carries them back to the liver, where they
stimulate additional bile salts secretion and are once again secreted into the bile. The loss of bile
salts in the feces is reduced by this recycling process.
The liver can remove sugar from the blood and store it in the form of glycogen. It can also store fat,
vitamins, copper and iron. This storage function is usually short term.
The liver transforms some nutrients into more readily usable substances. Many ingested substances
are harmful to the cells of the body. In addition, the body itself produces many by-products of
metabolism that, if accumulated, are toxic. The liver is an important line of defense against many of
those harmful substances. It detoxifies them by altering their structure, making their excretion easier.
The liver can also produce its own unique new compounds. Many of the blood proteins, such as
albumin, fibrinogen, globulins, and clotting factors, are synthesized in the liver and released into the
circulation.

Pancreas
Pancreas is a fish-shaped spongy grayish-pink organ about 6 inches (15 cm) long that stretches
across the back of the abdomen, behind the stomach. The head of the pancreas is on the right side
of the abdomen and is connected to the duodenum (the first section of the small intestine). The
narrow end of the pancreas, called the tail, extends to the left side of the body.
The pancreas makes pancreatic juices and hormones, including insulin. The pancreatic juices are
enzymes that help digest food in the small intestine. Insulin controls the amount of sugar in the
blood.
As pancreatic juices are made, they flow into the main pancreatic duct. This duct joins the common
bile duct, which connects the pancreas to the liver and the gallbladder. The common bile duct, which
carries bile (a fluid that helps digest fat) connects to the small intestine near the stomach.
The pancreas is thus a compound gland. It is compoundin the sense that it is composed of both
exocrine and endocrine tissues. The exocrine function of the pancreas involves the synthesis and
secretion of pancreatic juices. The endocrine function resides in the million or so cellular islands (the
islets of Langerhans) embedded between the exocrine units of the pancreas. Beta cells of the
islands secrete insulin, which helps control carbohydrate metabolism. Alpha cells of the islets secrete
glucagon that counters the action of insulin.

Large Intestines
The colon is made up of 6 parts all working collectively for a single purpose. Their purpose is ridding
the body of toxins that have entered the body from food sources, environmental poisons, or toxins

produced within the body. The colons role is to transfer nutrients into the bloodstream through the
absorbent walls of the large intestine while pushing waste out of the body. In this process, digestive
enzymes are released, water is absorbed by the stool, and a host of muscle groups and beneficial
microorganisms work to maintain the digestive system.

Large Intestines/Colon

The colon is approximately 4.5 feet long, 2.5 inches wide, and is a muscular tube composed of
lymphatic tissue, blood vessels, connective tissue, and specialized muscles for carrying out the tasks
of water absorption and waste removal. The tough outer covering of the colon protects the inner layer
of the colon with circular muscles for propelling waste out of the body in an action called peristalsis.
Under the outer muscular layer is a sub-mucous coat containing the lymphatic tissue, blood vessels,
and connective tissue. The innermost lining is highly moist and sensitive, and contains the villi- or
tiny structures providing blood to the colon.
The colon is actually just another name for the large intestine. The shorter of the two intestinal
groups, the large intestine, consists of parts with various responsibilities. The names of these parts
are the transverse colon, ascending colon, appendix, descending colon, sigmoid colon, and the
rectum and anus.

Transverse Colon

The transverse, ascending, and descending colons are named for their physical locations within the
digestive tract, and corresponding to the direction food takes as it encounters those sections. Within
these parts of the colon, contractions from smooth muscle groups work food material back and forth
to move waste through the colon and eventually, out of the body. The intestinal walls secrete alkaline
mucus for lubricating the colon walls to ensure continued movement of the waste.
The ascending colon travels up along the right side of the body. Due to waste being forced upwards,
the muscular contractions working against gravity are essential to keep the system running smoothly.
The next section of the colon is termed the transverse colon due to it running across the body
horizontally. Then, the descending colon turns downward and becomes the sigmoid colon, followed
by the rectum and anus.

Ileocecal and Cecum Valves

The ileocecal valve is located where the small and large intestines meet. This valve is an opening
between the small intestine and large intestine allowing contents to be transferred to the colon. The
cecum follows this valve and is an opening to the large intestine.

Rectum and Anus

The rectum is about eight inches long and serves, basically, as a warehouse for poop. It hooks up
with the sigmoid colon to the north and with the anal canal to the south.
The rectum has little shelves in it called transverse folds. These folds help keep stool in place until
youre ready to go to the bathroom. When youre ready, stool enters the lower rectum, moves into the
anal canal, and then passes through the anus on its way out.
The rectum intestinum acts as a temporary storage facility for feces. As the rectal walls expand due
to the materials filling it from within, stretch receptors from the nervous system located in the rectal
walls stimulate the desire to defecate. If the urge is not acted upon, the material in the rectum is often
returned to the colon where more water is absorbed. If defecation is delayed for a prolonged period
of time constipation and hardened feces results.
When the rectum becomes full, the increase in intrarectal pressure forces the walls of the anal canal
apart, allowing the fecal matter to enter the canal. The rectum shortens as material is forced into the
anal canal and peristaltic waves propel the feces out of the rectum. The internal and external
sphincter allows the feces to be passed by muscles pulling the anus up over the exiting feces.

Cardiovascular System Anatomy and

Physiology
Explore the anatomy and physiology of the cardiovascular system and learn the effects of each
structure to our body.
Contents [show]

The Heart
The heart is surrounded by fibroserous sac, the pericardium. This is composed of two layers and
anchors it to the surrounding structures. The other layer adheres to the surface of the heart. The two
sacs are separated that as space called the pericardial cavity. This space contains a serious
lubricating fluid that lubricates the heart as it beats.

The heart is made up of three layers of distinctively different tissue. The epicardium is the outer
layer of the heart. It is equivalent to this visceral of the pericardium. The myocardium is the
muscular portion of the heart. It is the pump part of the heart and is also the thickest.
The endocardium is that inner membrane it is the surface of the heart, it lands the chambers of the
heart. It contains elastic fibers, smooth muscle fibers, blood vessels and nerves. Within the
myocardium you have capillary muscles which arise from the myocardial surface of the ventricles
and attach the chordea tendineae, which prevents regurgitation of the valves.

The Chambers of the heart

The heart may be considered as a four-chambered pump. There are two atria may end the
ventricles. The atria are thin wall, low-pressure, receiving chambers. They act as reservoirs for the
blood for their respective ventricles. The right atrium receives systemic venous blood from the
superior and inferior vene cava, the coronary sinus. The left atrium receives oxygenated blood
returning to the heart from the lungs via way of the four pulmonary veins. Seventy percent of the
blood flows passively from the atria to the ventricles during early ventricular diastole. When the atria
contract forcefully, another 10-20 % of blood is supplied for ventricular output.

Chambers of the Heart

The ventricles are the major pumps of the heart. The right ventricle (RV) contracts and propels
the poorlyoxygenated blood into the pulmonary circulation via the pulmonary artery (PA). This is a
low-pressure system. The left ventricle (LV) is the main pump. They eject blood into the systemic

circulation via the aorta during ventricular systole. It is a high-pressure system. The interventricular
septum separates the left and right ventricle as the left and right atrium.
The atrial ventricular valves are located between the atria and the ventricles. They allow for
unidirectional blood flow from their respective atria to the respective ventricle during diastole and
prevent retro grade flow during ventricular systole. The tricuspid valve, which is located on the right
side of the heart, separates the right atrium from the right ventricle. The mitral valve, located on the
left side of the heart, separates the left atrium from the left ventricle. With ventricular diastole, the
ventricles and capillary muscles relax and the valve leaflets open. The valves closing produces a
sound that constitutes the first heart sound (S1), consisting of the Mike trail an tricuspid component
(M1, T1), M1 is an initial and the major component of S1. The semilunar valves, located between the
ventricles and vessel, allowing unidirectional blood down from the outflow tract dairy and ventricular
system late and prevent retrograde blood down in the ventricular diastole the pulmonic valves are
located between the right ventricle and pulmonary artery. The aortic valve is located between the left
ventricle and the aorta. Opening of each of these valves occur when the respective ventricle
contracts and when the pressure is greater than in the artery the valve will open. After ventricular
systole, pressure in the artey exceeds pressure in the respective ventricle. This retrograde blood flow
now causes the valve to close. Valve closure produces a sound that constitutes the second part
sound (S2), consisting of an aortic component (A2,P2). A2 is the initial and major component of S2.

Systemic Vasculature
The function of the vascular system of the heart is to supply tissues with blood nutrients and
hormones and to remove metabolic waste. This system consists of arteries, arterioles, the capillary
system, and the venous system. The arteries are strong, compliant, elastic wall vessels that carry
blood away from the heart and distribute it to capillary beds throughout the body. This is a highpressure circuit. The elastic fibers located within arterial wall stretch during systole and recoil during
diastole. Arterioles maintain blood pressure. They contain smooth muscle and are innervated by the
autonomic nervous system. This stimulation causes constriction of the vessels. Decreased
adrenergic discharge dilates vessels, best controlling the lead distribution to various capillary beds.
They comprise the major vessels controlling vascular resistance. They may give rise directly to either
capillaries to or metarterioles (precapillaries).
The capillary system allows for exchange of oxygen, carbon dioxide and solutes between the blood
and tissues as well as permitting fluid volume transfer between plasma and interstitial cells, the
capillaries do not have smooth muscles, control of their diameter is depending on changes in
precapillary and post capillary resistance. The venous system stores approximately 65% of the total
volume of blood in the circulatory system. Within a low-pressure system, it conducts blood back to
the heart. The skeletal muscles act as a venous pump. The veins surrounded by skeletal muscles
contract thus compressing the veins and moving blood towards the heart. Valves in the veins prevent
retrograde blood flow. The superior vena cava returns blood from the body area above the

diaphragm. The inferior vena cava returns blood from the body below the diaphragm. The coronary
sinus drains blood from the heart.

Systemic and Coronary Circulation

Pulmonary circulation begins with the right heart. It is here that the oxygenated blood from the
venous system enters the right atrium through two large veins, the superior and inferior vena cava.
Blood is transported to the lungs via the pulmonary atery and its branches. Oxygen rich blood
returns to the left atrium through cerebral pulmonary veins.

With systemic circulation blood is pumped out of the left ventricle through the aorta and major
branches to supply all of the body tissues. Coronary circulation, on the other hand, supply the heart
with its own network of vessels. The left and right coronary arteries originate at the base of the aorta
and branch out to encircled the myocardium.

Conduction System of the Heart

The sinoatrial node or SA node is commonly called the pacemaker of the heart because it possesses
the fastest inherent rate of automaticity. This is the part of the heart that initiates the risk medical
impulse. It is a specialized area located near the superior vena cava and right atrial junction.
Normally it generates impulses at 60-100 times per minute. These impulses travel across the atria
via the internodal pathways to the atrial ventricular node or AV node. These intranodal atrial
pathways conduct the impulse from the SA node to the right atria musculatureto the atrial ventricular
node.
Specialized areas, Bockmans bundle conducts impulses from the SA node to the left atrium.
Located on the floor of the interatrial septum is the atrioventricular (AV) node. The small junctional
fibers of the AV node slow the velocity of the impulse from the atria before it goes to the ventricles.
This allows time for both ventricles to fill prior to ventricular systole. It then passes through the bundle
of his at the AV junction and continues down the intraventricular septum to the right and left bundle
branches and out to the Purkinje fibers and a ventricular muscle wall. These fibers transmit the
impulse into the subendocardial layers of both ventricles; provides for depolarization from the
endocardium to the epicardium, followed by ventricular contraction and ejection of blood out of the
ventricles.
The bundle of his arises from the AV node and conducts impulses to the bundle branch system. This
system is composed of the left bundle branch and the right bundle branch. The right bundle branch
transmits the impulse down the right side of the intraventricular septum to the right ventricular
myocardium. The left bundle branch separates into the left posterior fascicle, which transmits the
impulse over the posterior and inferior endocardial surface of the left ventricle, and left anterior
fascicle, which transmits the impulse to the anterior and superior endocardial surface of the ventricle.
Depolarization results in myocardial contraction. The ion exchange reverses and the cell returns to its
resting state of electro-negativity, the cell repolarize and the cardiac muscle relaxes.
The coronary arteries branch off at the base of the aorta supplying blood to the conduction system
and to the myocardium of the heart. The right coronary arteries supply blood to the SA node in 55
percent of the heart, to the AV node in 90 percent of the heart. It also supplies blood to the right
atrium and right ventricular heart muscle as well as to the inferior posterior wall of the left ventricle
and in 80 percent of the heart; the right coronary artery provides a branch top the posterior
descendent artery.
The left main coronary artery branches into the left anterior descending (LAD) artery which supplies
blood to the anterior part of the intraventricular septum, the anterior wall of the left ventricle, the right
bundle branch, and the anterior superior division of the left bundle branch. The left main coronary
artery branches to the circumflex (CF) which supplies blood to the anterior ventricular node in 10

percent of the heart, that SA node in 45 percent of the heart, and the lateral posterior surface of the
left ventricle by the obtuse marginal branch.

Control of Peripheral Blood Flow

Control of peripheral blood flow by local mechanisms is the ability of the tissues to control their own
blood flow. This is known as autoregulation. With the Vasodilatory Theory, as metabolism increases,
oxygen usage is also increased. With this increased oxygen use there is an increase in a production
of vasodilator substances, which increases blood supply. With the Oxygen Demand Theory, oxygen
is required to maintain vascular contraction. When oxygen level decreases, dilatation of the blood
vessels occurs. This increases blood flow. With autonomic regulation of the vessels, adrenergis
sympathetic nervous system regualtion secretes norepinephrine at the nerve endings, which
produces vasoconstriction. Arterioles help to regulate blood flow and arterial pressure. Veins help to
regulate the amount of blood flow. Vasoconstriction causes the increase in venous return to the
heart. The parasympathetic nervous system secretes acetylcholine at the nerve ending producing
vasodilation.
Stretch receptors or baroreceptors are located at the aortic arch, carotid sinus, vena cava, pulmonary
arteries, and atria. They are activated by elevated blood pressure usually greater than 60 millimeters
mercury or blood volume. They respond to the stretch of arterial walls. Activation results in inhibitions
of sympathetic action. The vagal reflects will always dominate. A decrease in blood pressure results
in decreased vital tone and sympathetic nervous system becomes dominant.
The vasomotor center, which is located in the medulla of the brain, is called the cardioaccelerator
center or cardiac center. This may act as vasoconstriction or when stimulation causes secretion of
norepinephrine, which increases heart rate, stroke volume, cardiac output, and ultimately blood
pressure. At times, it may act as a vasodepressor when it is stimulated by inhibition of the
vasoconstriction or area producing vasodilation, which decreases heart rate and blood pressure. It
works with the stretch receptors and chemoreceptors.