ANATOMY

AND
PHYSIOLOGY
 INTEGUMENTARY SYSTEM
• Epithelium: stratified squamous keratinized
• Layers:
• Epidermis
– Stratum basale
– Stratum spinosum
– Stratum granulosum
– Stratum lucidum
– Stratum corneum
• Dermis
– Papillary Layer
– Reticular Layer
• Hypodermis
 INTEGUMENTARY SYSTEM
• Skin pigments • Cutaneous glands
– Melanin – Sebacceous (oil) glands
• Freckles – Sweat glands
• Vitiligo • Eccrine
• Albinism • Apocrine
– Carotene • Hair
– Hemoglobin – Lanugo
– Angora
• Surface patterns – Definitive
– Congenital • Nails
– Acquired
 SKELETAL SYSTEM

• Histology • Hormonal regulation

– Connective tissue – Parathyroid hormone
• Collagenous fibers – Calcitonin
• Calcified ground
substance
• Types of bone tissue
– Bone cells – Compact
• Osteoblast – Cancellous (spongy)
• Osteocyte
• osteoclast
 Classification of bones
• Shape – Short bones
– Long bones • Carpals
– Some Lovers Try
Positions That They
Can't Handle.
– Flat bones
– Irregular bones
– Sesamoid bone
 Divisions
• Axial • Appendicular
– Skull – Upper extremity
• Cranial bones
• Facial bones – Lower extremity

– Hyoid bone
– Trunk
• Vertebrae
• Ribs
• Sternum
 Types of joints
• Fibrous (synarthroses) • Synovial (diarthroses)
• Sutures – Ball and socket joint
– Hinge joint
– Pivot joint
• Cartilagenous – Condyloid joint
(Amphiarthroses) – Saddle joint
• Pubic symphysis – Gliding joint
• Intervertebral disk
 Medical conditions
• Fractures
• Kyphosis
• Lordosis
• Scoliosis
• Herniated intervertebral disc
• Osteomyelitis
• Osteoarthritis
 Muscular system
• Muscle tissue
 Muscular system
• Connective tissue covering
– Endomysium
– Perimysium
– Epimysium

• Types of muscle tissue

– Skeletal
– Smooth
– Cardiac
Muscular contraction
 Muscular system
• Parts of skeletal muscle
– Origin
– Insertion
– Belly

• Primary actions
– Prime mover (agonist)
– Antagonist
– Synergist
 Nomenclature of muscle
• Shape – trapezius, deltoid
• Size – maximus, minor
• Location – formtalis, brachii, femoris
• Point of attachment – sternocleidomastoid
• Position – superior, inferior, internal
• Action – flexor, extensor
• Structure – semitendinosus
• Number of bellies – digastric
• Misc – sartorius
• Combination – external oblique
Muscles of the face
 Axial muscles
• Muscles of the head • Muscles of neck
• Muscles of facial • Muscles of thoracic wall
expression • Diaphragm
• Extraocular • Muscles of abdominal
muscles wall
• Muscles of • Muscles of the back
mastication
• Muscle of tongue
 Appendicular muscles
• Muscle of upper extremity
– Muscles connecting limb to thoracic wall
• Pectoralis major and minor
• Serratus anterior
– Scapulohumeral muscles
• Deltoid
• Rotator cuff muscles
• Supraspinatus, infraspinatus, teres minor,
subscapularis
• Arm muscles
• Biceps brachii, brachialis, triceps brachii
 Appendicular muscles
• Forearm muscles
• Flexor carpi ulnaris, pronator teres, brachioradialis, extensor
carpi radialis, extensor digitiminimi
• Muscles of hand
• Thenar muscles
• Hypothenar muscles

• Muscle of lower extremity

• Thigh muscles
• Quadriceps femoris, Sartorius, adductor muscles, biceps
femoris, semitendinosus
• Leg muscles
• Tibialis anterior, peroneus muscles, gastrocnemius
• Gluteal muscles
 Medical conditions
• Muscular dystrophy
• Myasthenia gravis
• Guillaine-Barre syndrome

Signs and symptoms

myalgia
muscle paralysis
muscle atrophy
 Nervous system
• Divisions
– Morphological
• CNS
• PNS
– Functional
• Efferents: somatic and visceral
• Afferents: somatic and visceral

• Cells
– Neuron
– Neuroglia
• Schwann cell
• Oligodendrocytes
 Nervous system
• Synapse
– Neurotransmitters (epinephrine, acetylcholine)

• Nerve impulse conduction

– Saltatory conduction
 Central nervous system
• Gray matter
– Nucleus
– ganglion
• White matter
– H-shaped in spinal cord with central canal
 Embryonic divisions of brain
• Procensephalon (forebrain)
– Telencephalon
– Diencephalon
• Mesencephalon
• Rhombencephalon
– Metencephalon
– Myelencephalon
 Telencephalon: Cerebrum
• Fissures
– Longitidinal
– Lateral sylvian
– Central sulcus of Rolando
– Parieto-occipital
– Calcarine

• Lobes
– Frontal
– Parietal
– Temporal
– Occipital
– Insula
 Functional areas of the cerebrum

• Primary motor area (pre-central gyrus)

• Pre-frontal gyrus
• Primary sensory area (post-central gyrus)
• Motor speech area
• Sensory speech area
• Auditory area (transverse gyrus of Heschl)
• Visual area
• Olfactory area
• Taste area
 Telencephalo: Basal ganglia
• Four paired of gray matter
– Caudate nucleus (medial part)
– Lentiform nucleus (lateral part)
• Putamen
• Globus pallidus
 Diencephalon

– Thalamus
– Hypothalamus

• Mesencephalon
 Rhombencephalon
• Cerebellum
– Vermis
– Arbor vitae

• Pons
• Medulla oblongata
 Ventricles of the brain
• Lateral ventricle
• Third ventricle
• Fourth ventricle

• Foramen
– Foramen of Monroe (intraventricular foramen)
– Aqueduct of sylvius (iter)
– Foramen of Lucshka and Magendie
 Meninges
• Meninges
– Pachymenix
• Dura mater
– Leptomenix
• Arachnoid mater
• Pia mater

• Cerebrospinal fluid
– Choroid plexus
 Spinal cord

• 45 cm long
• From medulla to L1 (adult), L3 (children)

• Enlargements
• Cervical
• Lumbar
• Conus medullaris
• Cauda equina
• Filum terminale
 Plexuses and cranial nerves
• Plexuses
• Cervical
• Brachial
• Lumbar
• Sacral

• Cranial nerves
• Sensory: CN I,II,VII
• Motor: CN III,IV,VI,XI,XII
• Mixed: CN V, VII,IX, X
 AUTONOMIC NERVOUS SYSTEM

Sympathetic division Parasympathetic division

(thoracolumbar) (craniosacral)
• Eye pupils dilate pupils constrict
• Lacrimal gland none inc secretion
• Sweat gland copious sweating none
• Heart inc HR dec HR
• Lungs bronchodilation bronchoconstriction
• GIT dec motility inc motility, acid sec’n
• Adrenal gland sec’n epinephrine none
• Urinary bladder sphincter constriction sphincter dilation
• Penis ejaculation erection
 Medical conditions
• CVA
• Meningitis
• Seizure disorders
• Petit mal
• Grand mal
• Parkinson’s disease
• Alzheimer’s disease
• Hydrocephalus
• Poliomyelitis
 Special senses
• Eye
– Eyelids
• Meibomian glands
• Ciliary glands

– Conjunctiva
– Lacrimal gland
– Extraocular muscles
 Special senses
• Coats of the eye
– Fibrous coat
• Sclera
• Cornea
– Muscular/vascular coat
• Choroid
• Ciliary body
• Iris
– Nervous coat
• Retina
• Rods (scotopic vision)
• Cones (photopic vision)
Visual pathway
 Auditory sense
• External ear
– Pinna (auricle)
– External auditory canal
– Tympanic membrane
• Middle ear
• Internal ear
– Bony labyrinth with perilymph
• Vestibule, cochlea
• semicircular canals
– Membranous labyrinth with endolymph
• Saccule, utricle, cochlear duct
• Semicircular ducts
 Types of Deafness
• Conduction deafness
• Impacted cerumen
• Otoslerosis

• Sensorineural deafness

• Tests for deafness

• Weber’s
• Rinne’s
 Vestibular sense
• Transmitted via vestibulocochlear nerve
• Receptors
• Cristae ampullaris
– Found in ampulla of semicircular ducts
– Stimulated by angular acceleration
– Gelatinous cupula
– Detect motion of head in space
• Macula
– Found in utricle
– Stimulated by linear acceleration
– Gelatinous otolithic membrane
– Control posture
 Special senses
• Olfactory sense
– Receptor: olfactory epithelium
– Types of basic scents
– Citrus
– Floral
– Spicy
– Pungent
– Putrid

• Gustatory sense
– Receptor: taste buds
– Papillae
• Circumvallate
• Fungiform
• Foliate
• Filiform
 Endocrine system
• Pituitary hormone >> target organ>> hormone>> effect
• Hypophysis cerebri
• Adenohypophysis
• hGH
• TSH
• ACTH
• FSH
• LH
• PRL

• Neurohypophysis
• ADH
• Oxytocin
 Target organs
• Epiphysis cerebri • Pancreas
• melatonin • Islets of Langerhans
– Alpha cells: glucagon
• Thyroid gland
– Beta cells: insuliln
• Tri-iodothyronine – Delta cells: somatostatin
• Thyroxine – F cells: polypeptides
• Adrenal glands
• Cortex
– Mineralocorticoids
• Testes
– Glucocorticoids • Ovaries
– Androgens
• Medulla
– epinephrine
 Medical conditions
• Diabetes mellitus
• Type I (IDDM)
• Type II (NIDDM)

• Cushing’s syndrome
• Addison’s disease
• Hyperthyroidism
 Blood
• Male: 5-6 liters; female: 4-5 liters
• Function
• Transport of gases
• Protection
• Regulation
• Components
• Plasma
– Water
– Plasma proteins
• Albumin
• Globulin
• Fibrinogen
– Electrolytes
– Nutrients and waste products
– gases
 Formed elements

• Erythrocytes (RBC)
– Biconcave, anucleated, no organelles
– Life span 120 days
– Hemoglobin: carboxyhgb, oxyhgb
– Hematocrit
– Disorders
• Anemia
• Hemophilia
 Formed elements
• Leukocytes (white blood cell)
– No hgb, nucleated, larger than RBC
– Chemotaxis, diapedesis

Types of WBC
• Granulated
– Neutrophils
– Eosinophils
– Basophils
• Agranulated
– Lymphocyte
– Monocyte
 Formed elements
• Thrombocytes (Platelets)
– Anucleated, w/ vesicles
– For blood clotting

– Hemostasis
• Vasoconstrictive phase
• Platelet phase
• Coagulative phase
 Blood groups

donate to receive from

Ag Ab
A A Anti-B A,AB A,O

B B Anti-A B,AB B,O

AB A,B none AB A,B,AB,

O
O None Anti-A A,B,AB, O
Anti-B O
 Rh system

• Antigen: D
• 84% are Rh (+)

• Erythroblastosis fetalis
• ABO incompatibility
 Cardiovascular system
• Blood vessels
• Arteries
• Veins
• Capillaries
 Cardiovascular system
• Pulse – Arch
• Brachiocephalic a.
– Tachycardia • Left common carotid a.
– Bradycardia • Left subclavian a.
– Descending/thoracic
• Blood pressure – Abdominal
• Direct unpaired
– Systolic BP
– Celiac a.
– Diastolic BP – Sup. Mesenteric a.
– Inf. Mesenteric a.
• Major arteries • Direct paired
– Renal a.
Aorta
– Gonadal a.
– Ascending – Lumbar a.
• Coronary arteries – Common iliac a.
 Cardiovascular system
• Major venous drainage • Vascular changes at birth
– Sup. Vena Cava – Ductus venosus > ligamentum
– Inf. Vena Cava
– Coronary sinus venosum
– Portal vein
– Foramen ovale > fossa ovalis
• Major vessels of pulmonic
circulation – Umbilical a. > umbilical ligament
– Pulmonary artery
– Pulmonary vein – Umbilical v. > ligamentum teres
hepatis
• Systemic circulation
– Ductus arteriosus > ligamentum
– Arterial division
– Venous division arteriosum
– Pulmonary division
 Heart
• Muscular organ
• At middle mediastinum
• Apex beat at 5th ICS LMCL

• Covering of heart
– Pericardium
• Fibrous
• Serous
– Parietal
– Visceral

• Layers of heart
• Epicardium
• Myocardium
• Endocardium
 Heart
• Blood supply
– Coronary arteries
• Venous drainage
– coronary sinus

• Septa
– Interatrial
– Interventricular

• Valves
– Atrioventricular (AV)
• Tricuspid, bicuspid (mitral)
– Semilunar
• Pulmonic, aortic
 Heart
• Characteristics of heart chambers

• Features RA LA
size wider narrow
auricle bigger smaller
pectinate ms present absent
fossa ovalis present
openings SVC,IVC pulmonary veins
coronary sinus
 Heart
• Features RV LV
lumen crescent shaped circular
wall thin thick
chordae tendinae present present
papillary ms present present
traculae carnae present present
moderator band present
pulmonic valve present
aortic valve present
 Heart
• Conducting system • Cardiac cycle
– Systole
– Diastole

• Heart sounds
– S1
– S2

• ECG tracing
 Medical conditions
• Cardiomegally
• Hypertension
• Myocardial infarction
• Mitral valve regurgitation
• aneurysm
 Lymphatic system
• fluid: lymph • Lymphatic organs
• Lymphatic vessels • Lymphocyte aggregation
• Reticular fibers
– Lymphatic capillaries
• Epithelial cells
– Lymphatic collecting vessels
– Lymphatic trunks
– Lymph nodes
• Lumbar
– Thymus gland
• Intestinal – Spleen
• Bronchomediastinal • Red pulp
• Subclavian • White pulp
• Jugular – Tonsils
– Lymphatic ducts • Palatine
• Pharyngeal
• Right lymphatic duct
• Lingual
• Thoracic duct
– Payer’s patches
 Immunity
• Innate immunity
– Non-specific, inborn
– Examples:
• Surface barrier
– Skin, mucous membrane
• Cellular/chemical defense
– Phagocytes
– NK cells
– Inflammatory response(dolor, calor, rubor)
– Interferon
– Fever

• Acquired immunity
– Specific, adaptive
 Immunity
• Antigens and antibodies • Humoral immunity
– Active
• Natural
• Lymphocytes
• Artificial
– T-cells
– Passive
• Helper • Natural
• Cytotoxic • Artificial
• Suppressor
– B-cells • Immunoglobulins
• Primary immune • Ig G
response • Ig A
• Secondary immune • Ig M
response • Ig E
• Ig D
 Respiratory system
• Pulmonary ventilation
– External respiration
– Internal respiration

• Functional anatomy
– Conducting zone
• Dead space
• Nose >> bronchi
– Respiratory zone
• Bronchioles >> alveoli
 Conducting zone
• Nose • Trachea
– External nares (nostrils)
– Conchae(turbinate), meatus • Primary bronchus
• Pharynx – Right main
– Nasopharynx • Wider diameter
– Oropharynx • Shorter length
– Laryngopharynx • Vertical
• Larynx – Left main
– Unpaired cartilage • Narrower diameter
• Thyroid • Longer length
• Cricoid
• horizontal
• Epiglottis
– Paired cartilage
• Arytenoids
• Cuneiform
• corniculate
 Respiratory Zone
• Terminal bronchioles
• Respiratory bronchioles
• Alveolar duct
• Alveolus

• Cells of respiratory membrane

• Type I pneumocyte
• Type II pneumocyte
• Alveolar macrophages
 Lungs
• Hilus
• Blood supply
– Pulmonary arteries
– Pulmonary veins
– Bronchial arteries

• Pleura
– Parietal
– Visceral

• Pleural cavity
 Lung volumes and capacities
• Lung volumes
– Tidal vol. (TV)
– Inspiratory reserve vol. (IRV)
– Expiratory reserve vol. (ERV)
– Residual vol. (RV)

• Lung capacities
– Inspiratory capacity (IC)
– Functional residual capacity (FRC)
– Vital capacity (VC)
– Total lung capacity (TLC)
 Pulmonary ventilation
• Inspiration • Respiratory centers
– Active phase – Medulla
• Inspiratory center
• Expiration – Rhythm of breathing
– Passive phase • Expiratory center
– Tone of resp. muscles
• Physical factors for ventilation
– Friction
– Pons
– Lung compliance
• Pneumotaxic center
– Surface tension
– Prevent overinflation
• Apneustic center
– Stimulate medulla
 Chemical control of Respiration

• Central Chemoreceptors
– Sensitive to changes in pH
– Carbon dioxide
• Hypercapnia
• Hypocapnia

• Peripheral chemoreceptors
– Carotid and aortic bodies
– Sensitive of arterial oxygen levels
 Digestive system
• Processes • Histology
– Ingestion – Tunica mucosa
– Digestion – Tunica submucosa
• Mechanical
– Tunica muscularis
• chemical
– Tunica serosa
– Absorption
– Elimination

• Alimentary canal
– Mouth >> anus

• Accessory organs
– Salivary glands
– Liver and gallbladder
– pancreas
 Organs of digestive tract
• Oral cavity
– Tongue
• Extrinsic muscles
• Intrinsic muscles
– Teeth
• Deciduous
• Permanent
– Pharynx
– Esophagus
• Upper esophageal sphincter
• Lower esophageal sphincter
 Organs of digestive tract
• Stomach
– Cells
• Parietal cells: HCl, IF
• Chief cell: pepsin
• Mucus cells: mucus
• G cells: gastrin

• Small intestines
– Duodenum
– Jejunum
– Ileum
Plicae circularis
Suspensory ligament of Treitz
 Organs of digestive tract
• Large intestines
– Plicae semilunaris

• Salivary glands
– Parotid
– Submandibular
– sublingual
 Organs of digestive tract
• Liver
– Falciform ligament
– Coronary ligament
– Left triangular lig.

• Gallbladder
– Spiral valves of heister
– Ampulla of vater
– Storage of bile

• Pancreas
– Duct of wirsung
– Duct of santorini
 Urinary system
• Kidney
– Retroperitoneal
– T12 – L2

– Coverings
• Renal capsule
• Perirenal fat
• Renal fascia

– Internal anatomy
• Cortex
• Medulla
• pelvis
 Nephron
• Glomerulus
– Bowman’s capsule
• Outer parietal
• Inner visceral

– Malphigian corpuscle
• Glomerulus + BC

– Juxtaglomerular apparatus

• Proximal convoluted tubules

• Loop of henle
• Distal convoluted tubules
• Collecting ducts
 Nephron
• Glomerular filtration
– Filters plasma

• Tubular reabsorption
– Reabsorption of water, sodium ions, nutrients
– Controlled by aldosterone and ADH

• Tubular secretion
– Elimination of urea, excession and drugs
– Maintain acid-base balance
 Urinary system
• Ureter • Urethra
– Constrictions – Internal urethral
• Ureteropelvic
sphincter
• Bifurcation of common
iliac vessels
– External urethral
• Pelvic brim sphincter

• Urinary bladder • micturation

– Transitional epithelium
– Trigone
• Two inlets : ureter
• One outlet: urethra
 Male reproductive system
• External genitalia
– Scrotum
• Dartos muscle
– Penis
• Body
– Corpora cavernosa
– Corpora spongiosa
• Root
– Bulb
– Crura
• Glans penis
 Male reproductive system
• Internal genitalia • Vas deferens
– Testis – Ampulla
• Tunica vaginalis
• Tunica albuginea • Ejaculatory duct
• Cells:
– Spermatogenic • Urethra
– Sertoli cells – Prostatic
– Leydig cells – Membranous
– spongy
– Epididymis
• Head, body, tail
Male reproductive system
 Accessory sex glands
• Seminal vesicle
– Constitute 60% of seminal volume
– Secretions
• Alkaline viscous fluid
• Prostaglandin
• Clotting protein

• Prostate gland
– Secretions
• Citric acid
• Acid phosphatase
• Proteolytic enzymes

• Cowper’s gland
– Secretoins
• Alkaline fluid
• mucus
 Semen
• Seminal fluid
– Milky-white secretion

• Sperm
• Acrosome cap
• Mid-piece
• tail
 Medical conditions
• Cryptorchidism

• Micropenis

• Priapism
Female reproductive system
 Female reproductive system
• Perineum
– Diamond shaped
• Anterior: pubic symphysis
• Lateral: ischial tuberosity
• Posterior: coccyx
– Urogenital triangle
– Anal triangle
 Female external genitalia
• Mons pubis

• Labia majora
– Pudendal cleft
– Oil and sweat glands

• Labia minora
– Vestibule
• Clitoris
• External urethral meatus
• Skene’s gland
• Vaginal orifice
• Bartholins gland
 Female internal genitalia
• Vagina – Ligaments
– Rugae • Broad ligament
– Hymen • Round ligament
– External cervical os • Uterosacral ligament
• Cardinal ligament
• Uterus
– Anteverted • Fallopian tubes
– Parts: fundus, body, isthmus, – Interstitial/intramural
cervix
– Isthmus
– Layers:
– Ampulla
• Perimetrium
– infundibulum
• Myometrium
• Endometrium
– Stratum basalis
– Stratum functionalis
Female internal genitalia
 Female internal genitalia

• Ovary • Hormones
– Ligaments – Estrogen
• Mesovarium – Progesterone
• Ovarian ligament
– Inhibin
• Suspensory ligament
– Relaxin
– Oxytocin
 Female reproductive cycle
• Ovarian cycle

• Menstrual cycle
– Menstrual phase
– Pre-ovulatory phase
– ovulation
– Post-ovulatory phase
 Medical conditions
• Hysterectomy

• Salphingitis

• Ectopic pregnancy

• Ovarian cyst

• Tubal ligation