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Outline of Selected Topics in
Anatomy and Physiology
° The Cell
° Integumentary
° Musculoskeletal
° Nervous
° Endocrine
° Cardiovascular and Hematologic
° Gastrointestinal
° Urinary/Fluids and Electrolytes
° Reproductive
 The Cell

° BasicStructural and
Functional Unit of the body
Functions of the Cell
1. Basic unit of life
2. Protection and support
3. Movement
4. Communication
5. Cell metabolism and energy release
6. Inheritance
 The Cell

° Composed of the
Cytoplasm, Cell Membrane,
the organelles, the nucleus
and the inclusions
The Cell
° The cytoplasm is the viscous,
translucent, watery material where the
organelles are located
The Cell
° The Cell membrane is a semi-
permeable membrane that serves as
the boundary separating the cellular
structures from the external
environment
The cell membrane

° Selectively permeable
° Bi-lipid layers

° Functions to regulate
passage of substances
The cell membrane
° Phagocytosis- cell eating
° Pinocytosis- cell drinking
° Endocytosis- cell engulfment
° Exocytosis- cell excretion
Cell connections

ight junction= binds adjacent cell together and

form permeability barrier, which regulates
what material crosses
Desmosome= mechanical link that functions to
bind cell to one another
° þ
 


  
   




hap junction= small channel that allows
molecules and ions to pass from one
another
The cellular organelles
° These are the cellular metabolic
units with specific functions to
maintain the life of the cell
° These include the mitochondrion,
endoplasmic reticulum, ribosome,
golgi apparatus, lysosomes,
peroxisomes, cytoskeleton and
centrosomes
The mitochondrion
° The POWERHOUSE of the cell
° Contains enzymes and the complexes
responsible for the production of the
ATP
° Also contains mitochondrial DNA
° Metabolic processes occurring in this
organelle include ± Kreb¶s cycle, beta-
oxidation of fats, urea cycle, i

synthesis
° This organelle is maternally inherited
The endoplasmic reticulum
° An extensive network of membrane-
enclosed tubules
° There are two types- Rough and
Smooth endoplasmic reticulum
° Rough endoplasmic reticulum is
covered with ribosomes site of protein
synthesis
° Smooth endoplasmic reticulum has no
ribosome site of lipid synthesis
Ribosome
° Together with the endoplasmic
reticulum is the site of protein
synthesis
° Maybe found in the cytoplasm and in
the mitochondria
° They may be free or attached to the
endoplasmic reticulum
Golgi Apparatus
° This organelle modifies,
concentrates and packages proteins
° This also packages enzymes into
lysozomes
° Proteins and enzymes usually are
transported from the rough
endoplasmic reticulum to the golgi
apparatus
The lysosomes
° These are membrane-limited
digestive bodies that contain
enzymes that break down foreign
or damaged materials
° The enzymes digest all materials
brought in by phagocytosis
The peroxisomes
° Similar to lysosomes, these are
membrane-bound sacs containing
oxidases (not found in the
lysosomes)
° Oxidases are enzymes capable of
reducing oxygen to hydrogen
peroxide
The cytoskeleton
° A series of tubules and rods that
runs through the cytoplasm
supporting the cellular structures
° This is also responsible for cellular
movements
The centrosomes
° Thiscontains the centrioles
short cylinders adjacent to the
nucleus responsible for cellular
division
The cellular inclusions
° These are non-functional units
made up of chemical substances
° These may or may not be present
in all cells
° Examples are pigments, granules,
and fat globules
Cilia and Flagella
° Cilia are short, hair-like extensions
that occur in large numbers on the
outer surface of the cell
° Flagella are long projections
formed by centrioles that propel
the cell
The Nucleus
° The central control of the cell
° Controls cell growth, metabolisms and
reproduction
° Contains DNA
° Contains chromosomes DNA +
proteins appearing as granules in the
non-dividing cell
° Genes segments of chromosomes
Cell Division

° K

   i
 



 
 
a. Mitosis ± formation of new cell
necessary for growth and tissue
repair.
b. Meosis ± formation of sex cell
necessary for the reproduction.
Cellular division
° Two types- Mitosis and Meiosis
° Mitosis- equal division of materials
which yields two exact duplicates of
the original cell
° The diploid number (46) of
chromosomes is maintained
° All of the body cells undergo mitosis
except the gametes or sex cells
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The cellular division
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4. Telophase ± chromosome disperse.
° Nuclear membrane and nucleolus
formed.
° Cytoplasm divided into two cell.
Differentiation ± process by which cell develop
with specialized function.

° Egg and sperm cell formed single cell during

fertilization divided by mitosis to form two cell
then become four cell and so forth which
differentiate, give rise to different cell. E.g.
bone cell, muscle cell
The cellular division
° Meiosis is a reduction division
occurring in the sex cells
° Sex cells have only one pair of
chromosomes (23) haploid
number
Cell
Physiology
 DIFFUSION
° The movement of r
r or
particles in a solution from a
higher concentration to a lower
concentration
° This is a passive process, no
energy is required
 OSMOSIS
° The movement of solvent or water
from a diluted solution into a
more concentrated solution
through a semi-permeable
membrane
° The pressure that draws water
inside the vessel which is more
concentrated is called Osmotic
pressure
Filtration
° If a sugar is placed in plain water,
the glucose molecules will
dissolve and distribute in the
solution
° Factors that affect diffusion-
concentration gradient, particle
size, solubility and temperature
Special osmosis

°A special type of osmotic

pressure is exerted by
the proteins in the
plasma. It is called
ONCOTIC PRESSURE
 FILTRATION
° The movement of both solute
and solvent by hydrostatic
pressure, i.e., from an area of a
higher pressure to an area of a
lower pressure
° An example of this process is
urine formation
Hydrostatic pressure
° Hydrostatic pressure is the
pressure exerted by the fluid
against the container
° Increased hydrostatic pressure is
one mechanism producing
edema
 Active transport
° This is the movement of solutes
across a membrane from a lower
concentration to a higher
concentration with utilization of
energy
° Example is the Sodium-Potassium
pump, Endocytosis and Exocytosis
Tissue
° hroup of cells with similar structure and
function

here are four (4) Basic types

1. Epithelial

2. Connective

3. Muscle

4. Nervous
BODY ISSUES
Epithelium
° Lining, covering and glandular
tissues of the body
° he functions are to protect,
absorb, filtrate and secrete
substances
Epithelial tissues
° Simple epithelium
° Lined by ONE Layer of cell

° Stratified
epithelium
° Lined by many layers of cells
Epithelial tissues
° Simple epithelia
° 1. Simple squamos- alveoli, BV

° 2. Simple cuboidal- glands

° 3. Simple columnar- GI tract

° 4. Pseudo stratified epithelium-

bronchial lining
Epithelial tissues
° Stratified epithelium
° 1. Stratified Squamos- skin

° 2. Stratified cuboidal-
reproductive duct
° 3. Transitional epithelium-
bladder and ureter
Connective tissues
° Bone
° Cartilage
° Muscle
° Blood
° Blood vessels
° Adipose tissue
The Integumentary System
  The largest body system
  Includes the skin and accessory
structures like the hair, nails,
and glands
  Function: Protection of body
structures and regulation of
body temperature
The Skin as first line
protection
  The skin seals off the body
from the immediate
environment
  There are three layers of the
skin: Epidermis, dermis, and
hypodermis.
Skin cells
  There are many other cells aside
from the keratinized squamos cells
of the skin.
  Melanocytes produce pigment
melanin.
  Langerhanƍs cells participates in
the immune system.
  Histiocytes are specialized
macrophages
Skin as temperature regulator
  ubundant nerves, blood
vessels and glands are within
the skinƍs deeper layer
  They aid in temperature
regulation
  Blood vessels constrict or
dilate depending on the
temperature
Skin functions
  rweat glands produce sweat to
control temperature by
evaporation
  The piloerector (arrector pili)
muscles will contract to raise the
hairs to trap the heat
 ther skin functions
  ãitamin D synthesis
  7-dehydrocholesterol Cholecalciferol (D3)
  Route of excretion
  Insensible fluid loss of about 500

ml/day
  rweat contains water, electrolytes,

urea and lactic acid

ther skin functions
  rkin and mucus membrane are the
first line defense of the body in
immunity
  rkin has receptors for pain, cold,
pressure and heat.
The Skin layers: EPIDERMIS
  The outermost layer with stratified
squamos epithelium
  ãaries in thickness depending on
the body part
  Thinnest in the eyelids and thickest
in the soles and palms
EPIDERMIS
  The layers are- C-L-G-r-B
  The outermost layer is the stratum
corneum with keratin
  The stratum basale is the layer
which regenerates/replaces new
skin cells
  Melanocytes in the skin produce
melanin
The Skin layers: DERMIS
  The second layer- cutis vera
  Is flexible and elastic
  Two layers- papillary and
reticular
  Contains blood vessels,
lymphatic vessels, nerves and
appendages
The Skin layers: DERMIS
  The connective tissues in the
dermis contain
  collagen (gives its strength)
  elastin (gives its flexibility) and
  reticular fibers (connect collagen
and elastin)
The Skin layers: Hypodermis
  This is the subcutaneous
tissue
  Not strictly a part of the skin

  Functions to insulate the

body to conserve heat
Hypodermis
  rerves as the energy storage
and mechanical shock
absorber
  With little vascular supply
and scant nerve supply
The Skin appendages
  Hairs- long shafts composed of
keratin. Expanded lower end is called
hair bulb or root. There are extensive
nerve and blood supply in the hair
bulbs
  Nails-flattened structure of
specialized type of keratinized
surface. The visible part is the nail
body.
Kig. 5.5
uppendages
  rebaceous glands-glands which
produces an oily material called
sebum, found in all body parts
except the palms and soles.
  rweat glands or sudoriferous
glands- glands which secrete
sweat, found in all body parts
except in the nipples. Two types
exist- Eccrine and upocrine
Kig. 5.6
 he Musculoskeletal System

     




  
 
 
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 The Nervous System

ƥ The nervous system coordinates all

body functions, enabling a person
to adapt to changes in internal and
external environment
ƥ The nervous system is composed
mainly of the nerve cells (neurons)
and supporting cells (neuroglia)
The neuron
ƥ This is the basic conducting
cell of the nervous system
ƥ Highly specialized but cannot
reproduce itself
ƥ Main parts are the cell body
(soma), the fibers: axon and
dendrites.
The neuron
ƥ The axon is a long process
with myelin sheath. This
conducts impulses away from
the cell body

ƥ The dendrites are short, thick,

diffuse branching processes
that receive impulses and
conduct them towards the
cell body
The neuroglia
ƥ The supporting cells
ƥ They supply nutrients to the
neurons and help maintain the
electrical potential
ƥ They also form part of the blood-
blood-
brain barrier
The neuroglia
ƥ ligodendrocytes produce myelin
sheath in the CN
ƥ rchwann cells produce myelin
sheath in the peripheral Nr
The rganization of the Nervous
System
ƥ The nervous system is divided
functionally and structurally into 2
parts
ƥ 1. Central Nervous System-
System- the
Brain and the spinal cord
ƥ 2. Peripheral Nervous System-
System- the
cranial nerves and spinal nerves
The rganization of the nervous
System
The Peripheral Nervous System is
further classified into THREE
Kunctional Divisions
1. The Somatic Nervous System-
System-
controls the skeletal muscles
2. The uutonomic Nervous System-
System-
controls the visceral organs
3. The Enteric Nervous System-
System-
controls the functions of the GIT
The Central Nervous System
Composed of the brain
ƥ The brain consists of the gross
structures: cerebrum, cerebellum,
brainstem and the diencephalon.
ƥ Diencephalon
Diencephalon-- Thalamus.
Hypothalamus and pineal body
ƥ Brainstem
Brainstem-- Pons, medulla and
Midbrain
Kig. 8.23
The Cerebrum

ƥ This is the largest part of the brain

ƥ Consists of right and left hemisphere
connected by the corpus callosum
ƥ Each cerebral hemisphere is
composed of different lobes-
lobes- frontal,
temporal, parietal and occipital
ƥ Embedded in the cerebrum is the
BuSu ganglia
The Krontal obe of the cerebrum
ƥ Influences the personality of the
person
ƥ ulso responsible for judgment,
abstract reasoning, social behavior,
language expression and motor
movement.
The Temporal lobe of the
Cerebrum
ƥ This part of the cerebrum controls the
hearing, language comprehension, storage
and recall of memories
ƥ The LIMBIC system is deeply located in
the temporal lobe. This controls the basic
drives such as hunger, anger, emotion and
sexual drive.
The Parietal lobe of the cerebrum
ƥ This is the principal center for the
reception and interpretation of
rensation
ƥ This part interprets and integrates
the sensory inputs like touch,
temperature and pain
ƥ It interprets size, shape, distance and
texture
The occipital lobe of the cerebrum

ƥ This functions mainly to interpret

visual stimuli
Speech areas in the cerebrum

ƥ (. Wernickeƍs area-
area- responsible for
the sensory reception of speech.
ƥ 2.Brocaƍs urea
urea-- responsible for the
motor speech
Kig. 8.28
The Cerebellum
ƥ The second largest brain region
ƥ Has also two hemispheres
ƥ Kunctions to maintain muscle tone,
coordinate muscle movement,
posture and control
balance/equilibrium
ƥ If this is damaged, muscle tone
decreases and fine motor movements
become very clumsy
The Brainstem

ƥ ies inferior to the cerebrum

ƥ Continuous with the cerebrum and the
spinal cord
ƥ It is composed of the midbrain, the
pons and the medulla oblongata
ƥ Kunctions: houses the center for
respiration and cardiovascular system
The Midbrain

ƥ This connects with the cerebrum

ƥ Contains numerous ascending and
descending tracts and fibers
The Pons

ƥ Connects the cerebellum with the

cerebrum
ƥ Houses the respiratory center and
cardiovascular center
ƥ Exit points for cranial nerves 5, 6
and 7
The Medulla oblongata

ƥ The most inferior portion of the

brainstem
ƥ Serves as the center for autonomic
reflexes to maintain homeostasis,
regulating respiratory vasomotor and
cardiac functions
ƥ Serves as exit of cranial nerves
9,10,11 and 12
The Diencephalon
ƥ The thalamus and the hypothalamus
ƥ The thalamus is the relay station of all
sensory stimuli towards the brain
ƥ The hypothalamus controls body
temperature, appetite, water balance,
pituitary secretions and sleep-
sleep-wake
cycle
The Basal ganglia
Brain circulation: The circle of
Willis
The spinal cord
ƥ u long cylindrical structure
extending from the foramen
magnum to the 1 in adult, 3/
in
pedia
The spinal cord
ƥ In the cross section of the spinal
cord, we find the GRu matter-
matter-
contains neurons; and WHITE
matter--consists of nerve fibers
matter

ƥ There are 31 pairs of spinal nerves

that exit the spinal cord
The spinal cord

ƥ Each spinal nerve is formed by the

dorsal root (sensory) and the ventral
root (motor)
ƥ Cervical segments= 8 pairs
ƥ Thoracic segments=12 pairs
ƥ umbar= 5 pairs
ƥ Sacral=5 pairs
ƥ Coccygeal=1 pair
The Meninges
ƥ These are 3 connective tissue layers
surrounding the brain and spinal cord.
ƥ 1. DURu MuTER-
MuTER- the superficial,
thickest layer. The area above the dura
mater is called epidural space
ƥ 2. uRuCHNID-
uRuCHNID- second layer, thin and
wispy.
ƥ 3. PIu MuTER-
MuTER- the deepest layer,
adhered to the brain and spinal cord
substance
The Meninges
ƥ The space in between the arachnoid
and pia mater is called the arachnoid
space
ƥ This arachnoid space contains the
cerebro--spinal fluid (CSK)
cerebro
ƥ In this space, blood vessels are also
found
The Ventricles

ƥ These are CSK filled cavities in the brain

ƥ The lateral ventricle-
ventricle- found in the
cerebrum
ƥ The third ventricle-
ventricle- in the center of the
thalamus and hypothalamus
ƥ The fourth ventricle-
ventricle- located at the base
of the cerebellum
The CSK

ƥ This is the fluid found inside the

ventricles that bathe the brain and
spinal cord
ƥ Kunction: provides protective cushion
around the CNS
ƥ Produced by the choroid plexus in the
ventricles
ƥ ubsorbed by the arachnoid granulations
Tracing the CSK pathway
ateral ventricle

Interventricular foramen of Monro

Third ventricle

Cerebral aqueduct of Sylvius

Kourth ventricle

Exits trough the median foramen of Magendie or the lateral foramen of

uscka

Subarachnoid spaces in the cisterna magna, spinal cord

subarachnoid space of the brain

superior sagittal sinus

The cranial nerves

ƥ ure 12 pairs of nerves that exit the

brain
ƥ Can be classified as
ƛ Sensory
ƛ Motor
ƛ Mixed (sensory and motor)
The uutonomic Nervous System

ƥ The part of the peripheral nervous

system that innervates cardiac
muscles, smooth muscles and glands
d
e 

K

 
e
ƥ Sympathetic Nervous System
ƥ Parasympathetic Nervous System
 The SMPuTHETIC system
ƥ riginates from the T1-
T1- 2/ 3 segments of
the spinal cord (thoracolumbar)
ƥ Utilized by the body for K IGHT and
KIGHT response
ƥ Neurotransmitter agents are Epinephrine
and Norepinephrine (coming from the
adrenal gland)
ƥ uDRENERGIC system
Sympathetic responses
ƥ Increased:
ƛ þR
ƛ RR
ƛ BP
ƛ ãisual ucuity (Pupillary Dilation)
ƛ rmooth Muscle tone sphincters are
contracted
ƛ ãasoconstriction
ƛ Metabolism >
&>



Sympathetic responses

ƥ Decreased
ƛ Peristalsis
ƛ Salivary secretions
ƥ Ejaculation
Parasympathetic system

ƥ CþINERGIC system

ƥ The vegetative system
ƥ Feed and Breed responses
ƥ Cranio
Cranio--sacral location
ƥ Cranial nerves-
nerves- 3, 7, 9, (0 and r2
r2--r
ƥ Neurotransmitter is ucetylcholine
Parasympathetic responses
ƥ Increased
ƛ Gastric secretions
ƛ ralivary secretions
ƛ peristalsis
ƥ Pupillary constriction
ƥ Decreased
ƥ Smooth muscle tone sphincters are
relaxed
ƥ erection
Nerve Physiology
ƥ The nerve cells are excitable cells
ƥ uny stimulus will change the
membrane potential and cause an
action potential to generate impulse
transmission
ƥ The myelin sheath of the nerve cell is
responsible for the Su TuTR
conduction increases the nerve
transmission
Kig. 8.11
Kig. 8.12
The SNuPSE
ƥ This is the region where communication
occurs between 2 neurons or between a
neuron and a target cell
ƥ u neurotransmitter is released from the
nerve cell towards the other cell with
receptor
Kig. 8.13
The eye and the visual pathway
ƥ Vision is made possible by the
stimulation of the photoreceptor cells in
the retina
ƥ Receptor cells are the RDS and CNES
ƥ The eye is made up of three layers
ƛ Kibrous layer-
layer- sclerae and cornea
ƛ Uvea-
Uvea- choroid and iris and ciliary
bodies
ƛ Nervous coat-
coat- retina
Kig. 9.13
The optic nerve

ƥ This is the collection of fibers from

the cells in the retina
ƥ It passes through the brainstem as
the optic chiasm
ƥ it will reach the occipital lobe for
visual interpretation
The Vestibular apparatus

ƥ This is the part of the ear that helps

in equilibrium
ƥ ocated in the inner ear
ƥ The saccule and utricle control
INEuR motion
ƥ The semicircular ducts control the
ungular movement/ acceleration
The Hearing upparatus
The lfactory apparatus
ƥ Consists of the nose and the olfactory
nerve
ƥ Stimulation form the olfactory nerves
will reach the limbic system of the
brain
The Gustatory apparatus

ƥ The receptor for taste are cells in

the tongue group together called
the taste buds
ƥ They are numerous in the vallate
and fungiform papillae
The Gustatory apparatus
Basic taste modalities
ƥ rweet
rweet-- tip of the tongue
ƥ ralty
ralty-- over the dorsum of the
tongue
ƥ rour
rour-- sides of the tongue
ƥ Bitter
Bitter-- back of the tongue
The Endocrine System

° This system is made up of

widely distributed organs
whose secretions (called
HORMONES) are poured into
the blood to reach the target
cells
 Hormones

° These are chemical substances

released by the glands into the blood
° Each hormone will go to the target
organ and binds its receptor
 
  
°
  

 i

 
°  


i

 
The hormonal regulation

° There exists an inter-

related regulation between
the HYPOTHALAMUS,
Pituitary and the endocrine
gland.
The hormonal regulation

° We call it the Hypothalamic-

pituitary-endocrine axis
° The exception are the
pancreas and the parathyroid
gland
The endocrine glands
° The pituitary- anterior and
posterior
° The pineal gland
° The thyroid gland
° The parathyroid gland
° The adrenal gland
° The pancreas
° The gonads- testes and ovary
The pituitary gland
: anterior lobe

° Also called u  i
 i

° Hormones produced
± Growth hormone
± The stimulating hormones-
ACTH, TSH, FSH and LH
± Prolactin
The pituitary gland: posterior lobe

° Also called the  
i

 i

° This lobe does not secrete hormones but
only stores hormones
± Antidiuretic hormone (vasopressin)
± Oxytocin
The pineal gland

° Alsocalled i



° Secretes melatonin
The thyroid gland

° Located in the lower part

of the anterior neck
° With two lobes connected
by the isthmus
The thyroid gland

° Secretes thyroxine (T4) and tri-

iodothyronine (T3)
° The T3 is the most active
hormone
° Function of T3/T4: Increase
metabolic rate, essential for
normal growth and maturation
The thyroid gland

° Italso secretes CALCITONIN

° This is released in response to an
INCREASED calcium level in the
blood
° Function: decreases bone
resorption and increases calcium
excretion in the kidney to
decrease the calcium levels
The parathyroid glands

°2 pairs (4) of yellowish

glands closely related to the
posterior surface of the
thyroid gland
° Secretes parathyroid
hormone (PTH)
The parathyroid glands

° Functions of the hormone:

± Increases bone breakdown by
osteoclasts
± Increases Vitamin D synthesis
± Increases Calcium level in the blood
± Causes retention of calcium in the
kidney
The Adrenal glands

° a pair of gland resting on top of each

kidney with 2 layers
° ADRENAL CORTEX
± Secretes mineralocorticoids
± Secretes glucocorticoids
± Secretes androgens- sex hormones
° ADRENAL MEDULLA
± Secretes the cathecolamines-
Epinephrine, and norepinephrine
Fig. 10.17
Fig. 10.18
The Adrenal Cortex

° Mineralocorticoid-
Aldosterone
± Increases sodium retention,
water retention secondarily
± Causes excretion of potassium
The Adrenal Cortex

° Glucocorticoids- cortisol
± Increases fat and protein
breakdown
± Increases glucose synthesis
± Inhibit inflammation and
immune response
The Adrenal Cortex

Adrenal androgens
° Estrogens, androgens and
progestins
° Insignificant in males
° Increase female sexual drives,
pubic hair and axillary hair
growth
The pancreas

° The endocrine portion of the

pancreas is the ISLETS of
LANGERHANS
° This islet is composed of three
types of cells- alpha, beta and
delta
Fig. 10.19
The pancreas

° The Alpha cells secrete

GLUCAGON
° The Beta cells secrete
INSULIN
° The delta cells secrete
SOMATOSTATIN
Pancreatic insulin

° Causes Hypoglycemia by two

mechanisms:
° Glucose breakdown-
glycolysis
° Glycogen production-
glycogenesis
Pancreatic insulin

° Needed by most body cells to

allow Glucose to enter the cell
membrane
° The brain cells, intestinal cells,
the red blood cells and the
islet cells do not need insulin
for glucose entry
Pancreatic glucagon

° Causes increased level of

Glucose by:
° Glycogen breakdown-
glycogenolysis
° Glucose production-
glucogenesis
The Gonads : Male- Testes

° The testes houses the Interstitial

cells of Leydig which secrete
ANDROGENS
° Testosterone
° Dehydrotestosterone
° Androsterone
The Androgens

° Aid in spermatogenesis
° Maintain functional reproductive
organs
° Responsible for secondary sex
characteristics
° Responsible for male sexual
drives
The Gonads: Female- Ovary

° The Follicular cells of the ovarian

follicle secrete ESTROGEN and the
corpus luteum secretes
PROGESTERONE
The estrogen

° Aids in uterine and mammary

gland development
° Maintains the structure of the
external genitalia
° Produces the secondary sexual
characteristics in female
° Maintains normal menstrual cycle
The progesterone

° Together with estrogen, maintains

normal menstruation
° Increases body temperature
° Decreases muscle tone and
peristalsis
° Maintains pregnancy
The CARDIOVASCULAR
SYSTEM
 he CARDIOVASCULAR
SYSEM

°his system is composed of the heart

and the blood vessels
°he main functions of this system are:

to transport oxygen, hormones
and nutrients to the tissues

and to transport waste products to
the lungs and kidneys for excretion
he hross Anatomy of the Heart

°The heart is located within the

thorax behind the sternum in
the compartment called
MEDIASTINUM
°The heart is commonly
described as the size of a
clenched fist
he hross Anatomy of the Heart

°The shape is conical, with a

base and an apex
°The base is directed upward
°The apex is directed downward
to the left at the level of the 5th
ICS LMCL
Heart Surface

°ANTERIOR SURFACE

Right ventricle

POSTERIOR SURFACE

Left ventricle
he Heart : Anatomy
° he heart has three layers

The epicardium

The myocardium

The endocardium
° he heart is covered by the pericardium
with a parietal and visceral layers
° he pericardial sac is a potential space in
between the two pericardial layers with a
minimal (15 cc) fluid
Kig. 12.4
he Heart: Anatomy

°he heart has four chambers

°he right atrium
°he right ventricle
°he left atrium
°he left ventricle
he Heart: Anatomy
° he heart also has four valves that guard
the openings in the chambers
° he tricuspid valve ± between the right
atrium and right ventricle
° he mitral or bicuspid valve- between the
left atrium and left ventricle
° he pulmonic valve- between the right
ventricle and the pulmonary trunk
° he aortic valve- between the left ventricle
and the aorta
he Heart: Anatomy

he blood supply of the heart:

°he coronary arteries are the blood
supply
°here are two main coronary arteries-
the right coronary artery and the left
coronary artery
°he venous drainage of the heart is the
coronary sinus; the anterior cardiac vein
and the smallest cardiac vein
Blood Supply
Venous Drainage

° Coronary sinus will collect all the

venous blood from the heart into the
RIGHT atrium

° The anterior cardiac vein drains NOT

into the coronary sinus but DIRECTLY
into the right atrium
Circulation
Kig. 12.11
he Heart : Physiology

his consists of
°he conducting system
°he cardiac cycle
°he cardiac output and Blood
pressure
°he preload and afterload
°he Starling¶s law of the heart
he Heart: Physiology

°The conducting system of

the heart is a group of
specialized heart cells that
functions to conduct
electrical impulses
independent of any nerve
supply
he Heart: Physiology

°The parts of the conducting

system of the heart are:
°The SA (sino-atrial) node
°The AV (atrio-ventricualr) node
°The Bundle of His with its right
and left bundle
°The Purkinje fibers
he Heart: Physiology

°he intrinsic conduction system

causes the heart muscle to depolarize
in one direction
°he rate of depolarization is around 75
beats per minute
°he SA node sets the pace of the
conduction
°his electrical activity is recorded by
the Electrocardiogram (ECh)
he Heart: Physiology

°he cardiac cycle consists of the

contraction phase and the
relaxation phase in each heartbeat
°he SYSOLE is the contraction
phase
°he DIASOLE is the relaxation
phase
he Heart: Physiology

° Heart sounds can be auscultated

° S1, S2, S3, and S4
° S1 is due to the closure of the AV valves
° S2 is due to the closure of the semilunar
valves
° S3 is due to the rushing of blood through
the AV opening
° S4 is due to contraction of the atrium
he Heart: Physiology

°he amount of blood the heart pumps

out in each beat is called the r


°·hen this volume is multiplied by the
number of heart beat in a minute (heart
rate), it becomes the ï
 ï


°·hen the Cardiac Output is multiplied
by the otal Peripheral Resistance, it
becomes the _

rr

he Heart: Physiology

°he PRELOAD is the degree of

stretching of the heart muscle when it
is filled-up with blood
°he AKERLOAD is the resistance to
which the heart must pump to eject
the blood
he Heart: Physiology

°r    þ  states that

the force of contraction is proportional
to the degree of stretching of the
cardiac muscle fibers
°As the length of the muscle fiber is
stretched, the contractile force
increases
°But when the maximum length has been
reach, any further stretching will impair
the contraction
he Blood vessel: Anatomy

°his consists of the artery, vein and

capillary together with the lymphatic
vessels
°he ARERY has thicker wall, deeply
located, pulsating, reddish, with
abundant smooth muscles and elastic
tissues that carries oxygenated blood
away from the heart towards the body
tissues
he Blood vessel: Anatomy

°he VEIN is thin-walled, superficially

located, non-pulsating, bluish vessel
that carries
unoxygenated/deoxygenated blood
towards the heart
°Arterioles are small arteries
°Venules are small veins
°CAPILLARIES are diffuse network of
thin- walled tubules that connect
arterioles and venules together
he Blood vessel: Physiology

° he diameter of the arterioles is the main

contributor of the peripheral resistance
° In the presence of epinephrine, cold
temperature and irritation, the smooth
muscles of the blood vessels will contract
making the lumen smaller >p


° In the presence of histaminewarm
temperature, the vessels will dilate
Èp


Terminology
Anatomy & Physiology
Chronotropic ° Refers to a change in heart rate
effect ° A positive chronotropic effect refers to an
increase in heart rate
° A negative chronotropic effect refers to a
decrease in heart rate
Dromotropic ° Refers to a change in the speed of conduction
effect through the AV junction
° A positive dromotropic effect results in an
increase in AV conduction velocity
° A negative dromotropic effect results in a
decrease in AV conduction velocity
Inotropic ° Refers to a change in myocardial contractility
effect ° A postive inotropic effect results in an increase in
myocardial contractility
° A negative inotropic effect results in a decrease
in myocardial contractility
 Basic Electrophysiology
Myocardial Cell Types
üinds of Where Primary Primary
Cardiac Cells Found Function Property

Myocardial cells Myocardium Contraction and Contractility

Relaxation

Specialized cells Electrical heneration and Automaticity

of the conduction conduction of Conductivity
electrical system electrical
conduction impulses
system
Systemic circulation

°he aorta- leaves the left ventricle to

form the ascending aorta, aortic arch,
descending aorta, thoracic aorta and
abdominal aorta
°he Vena cava ( superior and inferior)
drains the whole body and returns the
blood to the right atrium
Physiology of circulation

°Blood pressure is the measure of

force exerted by blood against the
blood vessel wall
°Measured by sphygmomanometer
°Normally BP is measured as systolic
pressure and diastolic pressure
°PULSE PRESSURE = SP-DP
Physiology of circulation

°Capillary exchange
°Most exchange of gas and
substances occur across the wall of
the capillary
°Usually, the exchange is due to the
filtration difference and diffusion
BP regulation

Central
° Pons and medulla
° Sympathetic nervous system± Increases
heart rate

° Parasympathetic nervous system (vagus)±

decreases heart rate
BP regulation

Baroreceptors
°Receptors sensitive to stretch located
in the carotid sinuses and aortic arch
°È  #
> 
°>  #
È 
BP regulation

° # 

° j



 











 
blood lung
° 
 




(

 



°  # 

  
> 




 
°  


  






 




 




 
Kig. 13.22
Ketal circulation
Cardiac assessment
° Inspection
° Palpation of the apical pulse and PMI
at the 5th ICS LMCL
° Auscultation for the heart sounds

S1 and S2
° Auscultation for the heart valves

TV

MV

PV

AV
Kig. 13.23
 Blood
  Blood is a special connective tissue
  Total blood volume is about 5 liters
  Blood is composed of two portions:
1. Kormed elements-
elements- RBC, WBC,
Platelets
2. Plasma-
Plasma- the liquid portion
ƛ Hematocrit is the percentage of RBC per
unit volume of blood
Kig. 11.2
 The RED Blood Cell
  Non
Non--nucleated cellular element in the
blood
  Biconcave
  Transports xygen loosely bound to
Hemoglobin
  Red pigment is due to hemoglobin
  ifespan is 120 days
  Reticulocytes are immature RBC
Kig. 11.

 The eukocytes or WBC

 Nucleated, larger than the

RBC
 Divided into Granulocytes
and ugranulocytes
 The eukocytes or WBC
  GRuNUCYTEr
(. Neutrophils-- most abundant
Neutrophils
WBC, 60-
60-70%. This is the first
cell to arrive in
injury/inflammation.
  Increased in bacterial infection
In females, there is the
presence of the Barr bodies,
the condensed X
chromosome
 The WBC
  2.
Eosinophils-- cell type that is
Eosinophils
capable of limited phagocytosis,
with granules containing
peroxidase.
ƛ This is increased during parasitic
and allergic reactions
 The WBC
  3.Basophils-- a WBC that is
Basophils
capable of releasing
þistamine, heparin and
serotonin during anaphylaxis
. The rarest type of WBC.
 The WBC
ugranulocytes:
ymphocyte- second most
  (. ymphocyte-
abundant (next to
neutrophils)
ƛ Found increased in ãiral infection
and chronic infection. This can be:
ƛ T-lymphocyte
ƛ B-lymphocyte
 The WBC
ugranulocytes:
ƛ T-lymphocyte
lymphocyte-- mediator of Cellular
Immunity
lymphocyte-- mediator of
ƛ B-lymphocyte
Humoral immunity because this cell
secretes uNTIBDIEr when
transformed into plasma cells.
 The WBC
  2.Monocyte-- has kidney-
Monocyte kidney-shaped
nucleus, a very large WBC that stays
only for 2-
2-3 days in the circulation. This
becomes the MuCRPHuGE in the
tissues.
 The Platelets
  ulso called thrombocytes
  Smallest formed element, lifespan is
8-10 days
  Involves in clot formation
  Korms the platelet plug in an injured
vessel
  Releases chemicals that can cause
activation of the clotting mechanism
Table. 11.2
 The Blood groups
  Blood types are grouped into u, B, uB and 
based on the presence of the antigen on the
surface of the RBC
  If antigen u is present, then the blood is type
u
  If antigen B is present, then the blood is type
B
  If antigen u and antigen B is present, then the
type is uB
  If no antigen is present, then blood type is 
Kig. 11.11
 The Blood groups
  Blood group u has untibody B, that
can react to blood type B and uB
  Blood group B has antibody u, that
can react to blood type u and uB
  Blood group uB has no antibody
  Blood group  has no antigen, but
has Both antibody u and B
 Rh group
  ulong with the uB group, there is
an Rh system in the blood
  The ƠDơ antigen is the most
prevalent
  u person with ƠDơ antigen is Rh (+)
  u person with no ƠDơ antigen is Rh
(-)
  Most Kilipinos are Rh (+)