Nursing A&P

Cartilaginous joints

two bones joined by cartilage

Symphysis

two bones joined by fibrocartilage

Axillary artery

under armpit. Receives blood from subclavian artery

Diastolic pressure

ventricular relaxation

Stretch (myotatic) reflex

when a muscle is stretched, it "fights back" and contracts, maintaining increased tonus and making it stiffer than unstretched muscle Helps maintain equilibrium and posture Head starts to tip forward as you fall asleep Muscles contract to raise the head Stabilize joints by balancing tension in extensors and flexors smoothing muscle actions Stretch reflex is mediated primarily by the brain Not strictly a spinal reflex

Astrocytosis or sclerosis

when neuron is damaged, astrocytes form hardened scar tissue and fill space formerly occupied by the neuron

Granular Leukocytes

with grain. lysosomes

Radial

wrist

Jaundice

yellowing of skin and sclera due to excess of bilirubin in blood --Cancer, hepatitis, cirrhosis, other compromised liver function

Apoptosis

"Cell Suicide" when a cell destories itself

Lordosis

"hunchback" exaggerated thoracic curvature; caused by osteoporosis/osteomalacia

Kyphosis

"swayback" exaggerated lumbar curvature; caused by pregnancy/obesity

Fusiform

(spindle-shaped)(smooth muscle)

Cervical vertebrae—axis (C2)

-Allows rotation of the head gesturing "no" -Dens or odontoid process—prominent knob on its anterosuperior side -Atlanto-occipital joint: between atlas and cranium -Atlantoaxial joint: between atlas and axis

Cervical vertebrae - atlas (C1)

-Supports the head -Delicate ring surrounding a large vertebral foramen

Golgi tendon organ

1 mm long, nerve fibers entwined in collagen fibers of the tendon

The Effects of Cold and Desiccation

1.Cold Treatment - retards the activities of most microbes; most are not adversely affected by gradual cooling, long-term refrigeration, or deep-freezing 2.Numerous cases of food poisoning from frozen foods that have been defrosted at room temperature and then inadequately cooked. 3.Desiccated - dehydrated or drying out 4.Lyophilization - combination of freezing ad drying; preserving microorganisms in a viable state for many years A.Radiation - energy emitted from atomic activities and dispersed at high velocity through matter or space 1. Gamma rays, X rays, and ultraviolet radiation B.Ionizing Radiation: Gamma Rays, X Rays, and Cathode Rays 1. Irradiation - type of cold (or low temperature) sterilization C.Nonionizing Radiation: Ultraviolet Rays D. Application of Ultraviolet Radiation 1. Ultraviolet radiation usually disinfection rather than sterilization

Important People

1.Hippocrates (Greek Physician): "Father of Medicine" Established a code of ethics 2.Aristotle: Philosopher who coined "theology" and "physiologi" 3.Claudius Galen: Gladiator physician, wrote book from animal dissections 4.Charles Darwin: Wrote "On the Origin of Species" about evolution

Extensions of membrane

1.Microvilli: Increase surface area for absorption 2.Cilia: Move items across cell surface and act as antenna 3.Flagella: Move cell itself (like sperm)

Thoracic curvature

12 vertebrae 12 ribs attach to vertebrae

Right subclavian artery

2nd branch off the aortic arch. Feeds the right arm

Process

A finger-like projection

Synovial Joints

A freely movable joint

Autonomic Nervous System

A motor nervous system that controls glands, and cardiac muscle

Dermatome

A specific area of the skin that receives sensory input from a pair of spinal nerves

Follicular Phase aka Proliferative Phase

AKA Proliferative phase Estrogen is causing the uterine lining to grow or "proliferate" Endometrium is getting ready to receive egg FSH stimulates the follicles An increase in LH stimulates ovulation

Energy for Muscle Contraction

ATP present before strenuous exercise only lasts a few seconds -Muscles acquire new ATP in three ways --Creatine phosphate breakdown ---Does not require oxygen (anaerobic) ---Regenerates ATP by transferring its phosphate to ADP ---Fastest way to make ATP available to muscles ---ATP produced only lasts about 8 seconds -Muscles acquire new ATP in three ways (continued) --Cellular respiration --Usually provides most of a muscle's ATP --Uses glucose from stored glycogen and fatty acids from stored fats --Requires oxygen- aerobic --Myoglobin can make oxygen available to muscle mitochondria --Carbon dioxide and water are end products --Heat is a by-product -Muscles acquire new ATP in three ways (continued) --Fermentation --Anaerobic process --Produces ATP for short bursts of exercise --Glucose is broken down to lactate (lactic acid) Oxygen debt -Occurs when muscles use fermentation to supply ATP -Requires replenishing creatine phosphate supplies and disposing of lactic acid

Abduction and Adduction

Abduction: movement of a body part in the frontal plane away from the midline of the body -Hyperabduction: raise arm over back or front of head Adduction: movement in the frontal plane back toward the midline -Hyperadduction: crossing fingers, crossing ankles

Mineral Deposition and Resorption

Abnormal calcification (ectopic ossification) -May occur in lungs, brain, eyes, muscles, tendons, or arteries (arteriosclerosis) -Calculus: calcified mass in an otherwise soft organ such as the lung Mineral resorption: the process of dissolving bone and releasing minerals into the blood -Performed by osteoclasts at the ruffled border -Hydrogen pumps in membranes secrete hydrogen into space between the osteoclast and bone surface

Supportive Cells (Neuroglia)

About 1 trillion (1012) neurons in the nervous system Neuroglia outnumber the neurons by as much as 50 to 1 Neuroglia or glial cells Support and protect the neurons Bind neurons together and form framework for nervous tissue In fetus, guide migrating neurons to their destination If mature neuron is not in synaptic contact with another neuron it is covered by glial cells Prevents neurons from touching each other Gives precision to conduction pathways

Dwarfism

Achondroplastic dwarfism -Long bones stop growing in childhood --Normal torso --Short limbs -Failure of cartilage growth in metaphysis Pituitary dwarfism -Lack of growth hormone -Normal proportions with short stature

Disorders of Acid-Base Balance

Acidosis - pH below 7.35 What happens? H+ diffuses into cells and drives out K+, elevating K+ conc. in ECF Hyperkalemia!! Symptoms: CNS depression (confusion, disorientation, coma, and possibly death) Alkalosis - pH above 7.45 What happens? H+ diffuses out of cells and K+ diffuses in, membranes depolarized, nerves overstimulated Symptoms: tetany, spasms, respiratory paralysis Acid-base imbalances fall into two categories: respiratory and metabolic Respiratory Respiratory acidosis Cause is apnea/not enough breathing/emphysema Carbon dioxide accumulates in the ECF and lowers its pH Respiratory alkalosis Results from hyperventilation CO2 eliminated faster than it is produced Metabolic Metabolic acidosis Causes: Increased production of organic acids such as lactic acid in anaerobic fermentation, and ketone bodies seen in alcoholism, and diabetes mellitus Ingestion of acidic drugs (aspirin) Loss of base due to chronic diarrhea, laxative overuse Metabolic alkalosis Rare, but can be caused by: Overuse of bicarbonates (antacids and IV bicarbonate solutions) Loss of stomach acid (chronic vomiting)

Action Potentials

Action potential: more dramatic change produced by voltage-regulated ion gates in the plasma membrane Repolarizes the membrane; shifts the voltage back to negative numbers returning toward Resting Membrane Potential

Activation of Complement

Activated by binding of IgG or IgM to antigens Opsonization - enhancing phagocytosis of antigens Chemotaxis - attracting macrophages & neutrophils Lysis - rupturing membranes Clumping of antigen bearing agents Altering the molecular structure of viruses

How Blood Is Produced

Adult production of 400 billion platelets, 200 billion RBCs, and 10 billion WBCs every day Hemopoiesis—production of blood, especially its formed elements Hemopoietic tissues produce blood cells Red bone marrow produces all seven formed elements

Components and General Properties of Blood

Adults have 4 to 6 L of blood A liquid connective tissue consisting of cells and extracellular matrix Plasma: matrix of blood Clear, light yellow fluid Formed elements: blood cells and cell fragments Red blood cells, white blood cells, and platelets Seven kinds of formed elements 1)Erythrocytes: red blood cells (RBCs) 2)Platelets Cell fragments from special cell in bone marrow Leukocytes: white blood cells (WBCs) Five leukocyte types divided into two categories Granulocytes (with granules) 3)Neutrophils 4)Eosinophils 5)Basophils Agranulocytes (without granules) 6)Lymphocytes 7)Monocytes

Three Major Pathways

Aerobic Respiration Anaerobic Respiration Fermentation All three start with glycolysis - glucose is enzymatically converted to pyruvic acid (pyruvate)

Luteal Phase aka Secretory Phase

After ovulation the follicle becomes the Corpus Luteum with the help of LH The Corpus Luteum produces Estrogen and Progesterone This gets uterus ready for implantation of egg

Transfusion reaction

Agglutination of transfused RBCs. Causes many health problems

Hormones Involved in Urinary Function

Aldosterone - the "salt-retaining hormone" Steroid secreted by the adrenal cortex When blood Na+ or K+ concentration falls or Drop in blood pressure renin release angiotensin II formation stimulates adrenal cortex to secrete aldosterone Leads to reabsorption of Na+ and water LESS URINE Renin - raises blood pressure initiates the constriction of blood vessels & triggers aldosterone secretion initiates angiotensin conversion to a vasoconstrictor LESS URINE AND INCREASED BP Atrial natriuretic peptide (ANP) - secreted by atrial myocardium of the heart in response to high blood pressure Prevents aldosterone release MORE URINE, LESS BLOOD PRESSURE Antidiuretic hormone (ADH) - secreted by posterior lobe of pituitary in response to dehydration Makes collecting duct more permeable to water so more water is reabsorbed LESS URINE, HIGHER BP

Circulation

All blood drained from stomach and intestines enters hepatic portal circulation and is filtered through liver before returning to heart

First Trimester: The Baby at 8 Weeks

All major organs and external body structures have begun to form. Your baby's heart beats with a regular rhythm. The arms and legs grow longer, and fingers and toes have begun to form. The sex organs begin to form. The eyes have moved forward on the face and eyelids have formed. The umbilical cord is clearly visible. At the end of 8 weeks, your baby is a fetus and looks more like a human. Your baby is nearly 1 inch long and weighs less than 1/8 of an ounce.

Allergic Reactions

Allergies - over reactions - response to non-harmful substances Allergens - antigens that trigger allergic reactions

Pulmonary Valve

Allows blood to flow from the right ventricle, through the pulmonary trunk to the lungs

Aortic Valve

Allows blood to go from the left ventricle into the aorta. In front of LA

Right AV valve

Allows blood to go from the right atrium to right ventricle

The Sympathetic Division

Also called the thoracolumbar division because it arises from the thoracic and lumbar regions of the spinal cord. Fight or Flight! Preganglionic fibers arise from the thoracic-lumbar portion of the spinal cord Preganglionic fibers are short and postganglionic fibers are long Accelerates heartbeat and dilates the bronchi Inhibits the digestive tract Neurotransmitter released by the postganglionic neuron is primarily norepineprhine (NE)

Maxillary sinus

An air cavity in the body of the maxilla

Theory

An explanatory statement

Anaerobic Respiration

Anaerobic respiration differs from aerobic in that free oxygen is not used as the final electron acceptor Uses oxygen-containing ions rather than free oxygen as in the aerobic process Total process produces 2-36 ATP molecules

Ribosomes

Anatomy: Granule of protein and RNA Physiology: Read mRNA (xerox copy of DNA) and make proteins out of it

Nucleus

Anatomy: Largest organelle, has nuclear envelope around it and DNA in it. Physiology: Serves as the control center of the cell

Lysosomes

Anatomy: Package of enzymes bound by membrane. Physiology: Digests proteins, nucleic acid, carbs, etc. inside the cell; involved in autophagy and apoptosis; cell's incinerator

Endoplasmic Reticulum "ER"

Anatomy: Parallel, flattened sac w/ (rough) or w/o (smooth) ribosomes on them. Physiology: Rough- produces phospholipids & proteins of plasma membrane. Smooth- Makes steroids, detoxes, and makes all membranes of cell

Peroxisomes

Anatomy: Resemble lysosomes. Physiology: Detox and neutralize free radicals; break down fatty acids

Mitochondria

Anatomy: Variety of shapes, highly folded inside, has its own DNA. Physiology: Makes ATP; uses glucose and oxygen to make ATP; powerhouse of cell

Golgi Complex

Anatomy: small system of pancake-like sacs Physiology: Synthesize carbs; sorts, packages and ships things around and to outside of cell; shipping department of cell

The Sphenoid Bone

Anterior floor of cranium, part of the floor, the anterior section brain floats just above it

Nerve Plexuses

Anterior rami branch and anastomose repeatedly to form five nerve plexuses Cervical plexus in the neck, C1 to C5 Supplies neck and phrenic nerve to the diaphragm Brachial plexus near the shoulder, C5 to T1 Supplies upper limb and some of shoulder and neck Median nerve: carpal tunnel syndrome Lumbar plexus in the lower back, L1 to L4 Supplies abdominal wall, anterior thigh, and genitalia Sacral plexus in the pelvis, L4, L5, and S1 to S4 Supplies remainder of lower trunk and lower limb Coccygeal plexus, S4, S5, and Co Somatosensory function—carry sensory signals from bones, joints, muscles, and the skin Proprioception: brain receives information about body position and movements from nerve endings in muscles, tendons, and joints Motor function—primarily to stimulate muscle contraction

Agglutinins

Antibodies

Rh factor

Antigen D. Positive or Negative blood type

Agglutinogens

Antigens

Adaptive (Specific) Defenses or Immunity

Antigens - foreign substances (usually protein) Antigens are usually large molecules Haptens - small molecules that may be antigenic if attached to larger molecules Self & Non-Self Recognition of self - immunotolerance Autoimmune diseases - failure to recognize self

Marrow (medullary) cavity

Area in the middle of bone that contains bone marrow

Brachial

Arm

Knee Injuries and Arthroscopic Surgery

Arthroscopy: procedure in which the interior of the joint is viewed with a pencil-thin arthroscope inserted through a small incision -Less tissue damage than conventional surgery -Recover more quickly -Arthroscopic ACL repair: about 9 months for healing to be complete

Hyaline cartilage

Articular cartilage

Cardiac Arrhythmias

Atrial flutter—ectopic foci in atria Atrial fibrillation Atria beat 200 to 400 times per minute Premature ventricular contractions (PVCs) Caused by stimulants, stress, or lack of sleep Ventricular fibrillation Serious arrhythmia caused by electrical signals reaching different regions at widely different times Heart cannot pump blood and no coronary perfusion Kills quickly if not stopped Defibrillation—strong electrical shock whose intent is to depolarize the entire myocardium, stop the fibrillation, and reset SA nodes to sinus rhythm

Atrial Systole

Atrium contract

Bones Associated with the Skull

Auditory ossicles -Three in each middle-ear cavity -Malleus, incus, and stapes Hyoid bone -Slender U-shaped bone between the chin and larynx -Does not articulate with any other bone -Fractured hyoid bone is evidence of strangulation

The Autonomic Nervous System and Visceral Reflexes

Autonomic means "self-governed" and fully independent It regulates fundamental states and life processes such as heart rate, BP, and body temperature Walter Cannon coined the terms "homeostasis" and the "flight-or-fight" reaction, dedicated to his career in the study of ANS

General Properties of the Autonomic Nervous System

Autonomic nervous system (ANS): a motor nervous system that controls glands, cardiac muscle, and smooth muscle Carries out actions involuntarily: without our conscious intent or awareness Visceral effectors do not depend on the ANS to function; only to adjust their activity to the body's changing needs

Overview of the Skeleton

Axial skeleton is colored tan -Forms central supporting axis of the body -Skull, vertebrae, sternum, ribs, sacrum, and hyoid Appendicular skeleton is colored green -Pectoral girdle -Upper extremity -Pelvic girdle -Lower extremity

DNA Recombination Events

Bacteria can share or recombine DNA with other bacteria in 3 ways: Conjugation (Bacterial Sex): DNA segment (plasmid) transmitted via pili and recombined into recipient chromosome Transformation: Soluble DNA is absorbed into bacterial cell from surrounding environment; donor cell may be dead Transduction: Transfer of genetic material via a virus carrier

Biofilms

Bacteria gather in masses and cling to surfaces Accumulate most easily on damaged tissues, hard tissues (teeth), and foreign materials such as catheters , IUDs , & artificial joints. Estimated to contribute to 80% of chronic infections Resistant to most antibiotic treatments

Flagellum Structure- Prokaryotic Cell

Bacterial locomotion Electric motor Dozens of proteins Rotates rapidly Many are reversible Propels the cell through its environment

Types of Skin Cancer

Basal cell carcinoma -Most common type -Least dangerous because it seldom metastasizes -Forms from cells in stratum basale -Lesion is small, shiny bump with central depression and beaded edges Squamous cell carcinoma -Arise from keratinocytes from stratum spinosum -Lesions usually appear on scalp, ears, lower lip, or back of the hand -Have raised, reddened, scaly appearance later forming a concave ulcer -Chance of recovery good with early detection and surgical removal -Tends to metastasize to lymph nodes and may become lethal Malignant melanoma -Skin cancer that arises from melanocytes; often in a preexisting mole -Less than 5% of skin cancers, but most deadly form -Treated surgically if caught early -Metastasizes rapidly; unresponsive to chemotherapy; usually fatal

Mobilization of Defenses

Basis for the four cardinal signs of inflammation Heat: results from hyperemia Redness: due to hyperemia, and extravasated RBCs in the tissue Swelling (edema): due to increased fluid filtration from the capillaries Pain: from direct injury to the nerves, pressure on the nerves from edema, stimulation of pain receptors by prostaglandins, bacterial toxins, and a kinin called bradykinin

Popliteal

Behind the knee

Prostate Diseases

Benign prostatic hyperplasia (BPH)—noncancerous enlargement of the prostate Compresses urethra and obstructs flow of urine Promotes bladder and kidney infections Prostate cancer Second most common cancer in men after lung cancer Tumors tend to be near the periphery of the gland where they do not obstruct urine flow Go unnoticed until they cause pain Metastasized to nearby lymph nodes and then to the lungs and other organs Digital rectal exam (DRE): palpated through rectal wall to check for tumors Diagnosed from elevated levels of serine protease (PSA) and acid phosphatase in the blood

Bile ducts

Bile made by hepatocytes in liver converge into right and left hepatic ducts Common hepatic duct: formed from convergence of right and left hepatic ducts on inferior side of the liver Cystic duct coming from gallbladder joins common hepatic duct Bile duct: formed from union of cystic and common hepatic ducts

Bile

Bile—yellow-green fluid containing minerals, cholesterol, fats, phospholipids, bile pigments, and bile acids Bilirubin: principal pigment derived from the decomposition of hemoglobin Bacteria in large intestine metabolize bilirubin to urobilinogen Responsible for the brown color of feces Bile acids (bile salts): steroids synthesized from cholesterol Bile acids aid in fat digestion and absorption

fibrocartilage

Bind vertebrae together -Support weight of the body -Absorb shock -Herniated disc ("ruptured" or "slipped" disc) puts painful pressure on spinal nerve or spinal cord

Heart block

Blockage of a cardiac electrical impulse

Varicose Veins

Blood pools in the lower legs in people who stand for long periods stretching the veins Cusps of the valves pull apart in enlarged superficial veins further weakening vessels Blood backflows and further distends the vessels, their walls grow weak and develop into varicose veins Hereditary weakness, obesity, and pregnancy also promote problems Hemorrhoids are varicose veins of the anal canal

Sphygmomanometer

Blood pressure cuff

Negative Feedback

Body senses a change and activates mechanisms to reverse it. *Dynamic equilibrium. It is healthy

Salivation

Bolus—mass swallowed as a result of saliva binding food particles into a soft, slippery, easily swallowed mass

Bones and Osseous Tissue

Bone (osseous tissue): connective tissue with the matrix hardened by calcium phosphate and other minerals Mineralization or calcification: the hardening process of bone

Bone Marrow

Bone marrow: general term for soft tissue that occupies the marrow cavity of a long bone and small spaces amid the trabeculae of spongy boneRed marrow (myeloid tissue) -In nearly every bone in a child -Hemopoietic tissue: produces blood cells and is composed of multiple tissues in a delicate, but intricate arrangement that is an organ to itself -In adults, found in skull, vertebrae, ribs, sternum, part of pelvic girdle, and proximal heads of humerus and femur Yellow marrow found in adults Most red marrow turns into fatty yellow marrow No longer produces blood

Pressure, Resistance, and Airflow

Boyle's law—at a constant temperature, the pressure of a given quantity of gas is inversely proportional to its volume If the lungs contain a quantity of a gas and the lung volume increases, their internal pressure (intrapulmonary pressure) falls (LIKE VACUUM) If the pressure falls below atmospheric pressure (760 mm Hg at sea level), the air moves into the lungs If the lung volume decreases, intrapulmonary pressure rises (LIKE STEPPING ON A BALLOON) If the pressure rises above atmospheric pressure, the air moves out of the lungs

Aortic arch

Brachiocephalic, left common carotid, left subclavian

The Cranial Nerves

Brain must communicate with rest of body Most of the input and output travels by way of the spinal cord 12 pairs of cranial nerves arise from the base of the brain Exit the cranium through foramina Lead to muscles and sense organs located mainly in the head and neck

Arteries of the Abdominal and Pelvic Region

Branches of celiac trunk supply upper abdominal viscera—stomach, spleen, liver, and pancreas

Arteries of the Lower Limb

Branches to the lower limb arise from external iliac branch of the common iliac artery

Breast Cancer

Breast cancer occurs in 1 out of 8 American women Tumors begin with cells from mammary ducts May metastasize by mammary and axillary lymphatics Signs may include palpable lump (the tumor), skin puckering, changes in skin texture, and drainage from nipple Most breast cancer is nonhereditary Two breast cancer genes were discovered in 1990s BRCA1 and BRCA2 Some stimulated by long periods of fertility and estrogen exposure Risk factors Aging, exposure to ionizing radiation, carcinogenic chemicals, excessive alcohol and fat intake, and smoking 70% of cases lack identifiable risk factors Tumor discovery usually during breast self-examination (BSE) - monthly for all women Mammograms (breast X-rays) Late 30s: baseline mammogram Ages 40 to 49: every 2 years Over age 50: yearly Treatment of breast cancer Lumpectomy: removal of tumor only Simple mastectomy: removal of the breast tissue only or breast tissue and some axillary lymph nodes Radical mastectomy: removal of breast, underlying muscle, fascia, and lymph nodes Surgery followed by radiation or chemotherapy Breast reconstruction from skin, fat, and muscle from other parts of the body

Left Atrioventricular valve

Brings blood from the LA to the LV. called bicuspid valve

Disorders of the Skin: Burns

Burns -Usually caused by heat -Burn severity affected by: --Extent of the burned area ---"Rule of nines" is a technique used to estimate the extent of a burn ---Lund-Browder chart is used for children Athlete's foot - fungal infection often involving skin of the toes and soles Impetigo - bacterial infection common in young children Psoriasis - chronic condition where skin develops pink or reddish patches Eczema - inflammation of the skin Dandruff - caused by a dry scalp producing flaking and itching Urticaria (hives) - allergic reaction causing reddish, elevated, and often itchy patches

Third Trimester: The Baby at 37 to 40 Weeks

By the end of 37 weeks, your baby is considered full term. Your baby's organs are ready to function on their own. As you near your due date, your baby may turn into a head-down position for birth. Most babies "present" head down. At birth, your baby may weigh somewhere between 6 pounds, 2 ounces and 9 pounds, 2 ounces and be 19 to 21 inches long. Most full-term babies fall within these ranges. But healthy babies come in many different sizes.

Chemoreceptors

CO2 and O2 levels are monitored by chemoreceptors in carotid artery & in aorta Hyperventilation—anxiety-triggered state in which breathing is so rapid that it expels CO2 from the body faster than it is produced normally, low pH, high blood CO2, or low O2 stimulates deeper breathing hyperventilation suppresses urge to breathe for longer time, which causes: pH to rise, causing the cerebral arteries to constrict constriction of arteries reduces cerebral blood flow which may cause dizziness or fainting can be brought under control by having the person rebreathe the expired CO2 from a paper bag

Calcium Homeostasis

Calcium homeostasis depends on a balance between dietary intake, urinary and fecal losses, and exchanges between osseous tissue

Stage 4 of Sleep

Called slow-wave sleep (SWS): EEG dominated by low-frequency, high-amplitude delta waves

Energy for Cellular Functions

Can come from light (photosynthesis) Released by breaking chemical bonds ATP is the storage molecule for cellular energy

Capillaries

Capillaries—site where nutrients, wastes, and hormones pass between the blood and tissue fluid through the walls of the vessels (exchange vessels) The "business end" of the cardiovascular system Composed of endothelium and basal lamina Absent or scarce in tendons, ligaments, epithelia, cornea, and lens of the eye

Digestion of molecules

Carbohydrates Lactose Proteins Lipids Vitamins

Carbon Monoxide Poisoning

Carbon monoxide (CO)—competes for the O2 binding sites on the hemoglobin molecule Colorless, odorless gas in cigarette smoke, engine exhaust, fumes from furnaces and space heaters CO binds to ferrous ion of hemoglobin Binds 210 times as tightly as oxygen Ties up hemoglobin for a long time Nonsmokers: less than 1.5% of hemoglobin occupied by CO Smokers: 10% in heavy smokers Atmospheric concentrations of 0.2% CO is quickly lethal

The Hindbrain: Medulla Oblongata

Cardiac center Adjusts rate and force of heart Vasomotor center Adjusts blood vessel diameter Respiratory centers Control rate and depth of breathing Reflex centers For coughing, sneezing, gagging, swallowing, vomiting, salivation, sweating, movements of tongue and head

Muscular Tissue: Cardiac Muscle

Cardiac muscle -Limited to the heart Myocytes or cardiocytes are shorter, branched, and notched at ends Contain one centrally located nucleus surrounded by light-staining glycogen Intercalated discs join cardiocytes end to end -Provide electrical and mechanical connection Striated and involuntary (not under conscious control)

Cardiac Output

Cardiac output (CO)—the amount ejected by ventricle in 1 minute Cardiac output = heart rate x stroke volume About 4 to 6 L/min at rest A RBC leaving the left ventricle will arrive back at the left ventricle in about 1 minute Vigorous exercise increases CO to 21 L/min for a fit person and up to 35 L/min for a world-class athlete

Structure of Cardiac Muscle

Cardiocytes—striated, short, thick, branched cells, one central nucleus surrounded by light-staining mass of glycogen Intercalated discs—join cardiocytes end to end Repair of damage of cardiac muscle is almost entirely by fibrosis (scarring) which doesn't contract or transmit electric signals

Overview of the Cardiovascular System

Cardiovascular system Heart and blood vessels Circulatory system Heart, blood vessels, and the blood

New Views of Phylogeny

Carl Woese (1975) Used 16S rRNA Three "Domains" Archaea (all microbes) Bacteria (all microbes) Eukarya (some microbes, plants, fungi, and animals)

fibrocartilage

Cartilage containing elastic fibers Provides flexible, elastic support External ear and epiglottis

elastic cartilage

Cartilage containing large, coarse bundles of collagen fibers Resists compression and absorbs shock Pubic symphysis, menisci, and intervertebral discs

Cataracts and Glaucoma

Cataract: clouding of lens Lens fibers darken with age, fluid-filled bubbles and clefts filled with debris appear between the fibers Induced by diabetes, smoking, drugs, ultraviolet radiation, and certain viruses Replace natural lens with plastic one Glaucoma: elevated pressure within the eye due to obstruction of scleral venous sinus and improper drainage of aqueous humor Death of retinal cells due to compression of blood vessels and lack of oxygen Illusory flashes of light are an early symptom Colored halos around lights are late symptom Lost vision cannot be restored Intraocular pressure measured with tonometer

Addition of Calcium

Causes hypercalcemia. decrease heart rate and contraction strength

Introduction to ch. 24

Cellular function requires a fluid medium with a carefully controlled composition Three types of homeostatic balance Water balance Electrolyte balance Acid-base balance Balances maintained by the collective action of the urinary, respiratory, digestive, integumentary, endocrine, nervous, cardiovascular, and lymphatic systems

The Forebrain: Telencephalon

Cerebrum: largest and most conspicuous part of the human brain Seat of sensory perception, memory, thought, judgment, and voluntary motor actions

Chickenpox

Chickenpox: common disease of early childhood Caused by varicella-zoster virus Produces itchy rash that clears up without complications Virus remains for life in the posterior root ganglia Kept in check by the immune system

Microscopic Anatomy of Stomach

Chief cells—most numerous Secrete gastric lipase and pepsinogen Gastric lipase helps break down fats Pepsinogen is converted to active form and helps break down proteins Parietal cells—found mostly in the upper half of the gland Secrete hydrochloric acid (HCl), intrinsic factor HCl pH as low as 0.8, kills bacteria & denatures proteins Intrinsic factor essential for absorption of vitamin B12 by small intestine

Chronic Obstructive Pulmonary Diseases

Chronic obstructive pulmonary disease (COPD)—refers to any disorder in which there is a long-term obstruction of airflow and a substantial reduction in pulmonary ventilation Major COPDs are chronic bronchitis and emphysema Usually associated with smoking Other risk factors include air pollution or occupational exposure to airborne irritants Chronic bronchitis Inflammation and hyperplasia of the bronchial mucosa Goblet cells enlarge and produce excess mucus Develop chronic cough to bring up extra mucus with less cilia to move it Sputum formed (mucus and cellular debris) Ideal growth media for bacteria Leads to chronic infection and bronchial inflammation Symptoms include dyspnea, hypoxia, cyanosis, and attacks of coughing Emphysema Alveolar walls break down Lung has larger but fewer alveoli Much less respiratory membrane for gas exchange Lungs fibrotic and less elastic Healthy lungs are like a sponge; in emphysema, lungs are more like a rigid balloon Air passages collapse Air trapped in lungs & can't leave Weaken thoracic muscles Expend 3-4x the amount of energy just to breathe Reduce pulmonary compliance and vital capacity Hypoxemia, hypercapnia (too much CO2), respiratory acidosis Hypoxemia stimulates erythropoietin release from kidneys, and leads to polycythemia

Circulatory Shock

Circulatory shock—any state in which cardiac output is insufficient to meet the body's metabolic needs Cardiogenic shock: inadequate pumping of heart (MI) Low venous return (LVR): cardiac output is low because too little blood is returning to the heart Neurogenic shock— loss of vasomotor tone, vasodilation Causes from emotional shock to brainstem injury Septic shock Bacterial toxins trigger vasodilation and increased capillary permeability Anaphylactic shock Severe immune reaction to antigen, histamine release, generalized vasodilation, increased capillary permeability

The Circulatory System

Circulatory system consists of the heart, blood vessels, and blood Cardiovascular system refers only to the heart and blood vessels Functions of circulatory system Transport O2, CO2, nutrients, wastes, hormones, and stem cells Protection Inflammation, limit spread of infection, destroy microorganisms and cancer cells, neutralize toxins, and initiate clotting Regulation Fluid balance, stabilizes pH of ECF, and temperature control

Circumduction

Circumduction: one end of an appendage remains stationary while the other end makes a circular motion Sequence of flexion, abduction, extension, and adduction movements -Baseball player winding up for a pitch

The Clavicle

Clavicle: S-shaped, somewhat flattened bone -Sternal end: rounded head -Acromial end: flattened -Braces shoulder, keeping upper limb away from midline of body -Most frequently fractured bone in the body

Cleft Lip & Cleft Palate

Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They happen early during pregnancy.

The Coccyx

Coccyx—usually consists of four small vertebrae (Co1-Co4); sometimes five Fuse into a single, triangular bone by age 20 to 30 Fractured during difficult childbirth or by hard fall on buttocks Provide attachment for muscles of the pelvic floor

Vertebral foramina

Collectively form vertebral canal for spinal cord

Vertebral arch

Composed of two parts on each side

Pancreas

Composed of two types of tissue Exocrine - secretes digestive juices Endocrine tissue (pancreatic islets or islets of Langerhans) produces: Glucagon Secreted when blood glucose levels are low Targets liver and adipose tissue Stimulates liver to break down glycogen to glucose Insulin Secreted when blood glucose level is high Stimulates the uptake of glucose by most body cells The pancreatic islets Glucagon - secreted by A or alpha () cells Released between meals when blood glucose concentration is falling In liver, stimulates gluconeogenesis, glycogenolysis, and the release of glucose into the circulation raising blood glucose level Insulin secreted by B or beta () cells Secreted during and after meal when glucose and amino acid blood levels are rising Stimulates cells to absorb these nutrients and store or metabolize them lowering blood glucose levels Promotes synthesis glycogen, fat, and protein Suppresses use of already-stored fuels Brain, liver, kidneys, and RBCs absorb glucose without insulin, but other tissues require insulin Insufficiency or inaction is cause of diabetes mellitus Hyperglycemic hormones raise blood glucose concentration Glucagon, growth hormone, epinephrine, norepinephrine, cortisol, and corticosterone Hypoglycemic hormones lower blood glucose Insulin Diabetes Mellitus Insulin-sensitive body cells are unable to take up and/or metabolize glucose Blood glucose level is elevated (hyperglycemia) Symptoms: Polyphagia - extreme hunger Glycosuria - glucose in the urine Polyuria - excessive water loss through urine Polydipsia - extreme thirst Two forms of diabetes mellitus Type I - insulin-dependent diabetes mellitus Pancreas does not produce insulin Immune cells destroy the pancreatic islets Type II - non-insulin-dependent diabetes mellitus Normal or elevated amounts of insulin are present in the blood Receptors on the cells do not respond to insulin Type III - Pregnancy related type II (Gestational Diabetes)

Composition of Air

Composition of air 78.6% nitrogen 20.9% oxygen 0.04% carbon dioxide 0% to 4% water vapor (depending on temperature and humidity) minor gases Argon Neon Helium Methane Ozone

Prenatal Development

Conceptus - all products of conception: the embryo or fetus, the placenta, and associated membranes The fertilized egg, now called the zygote, is ready for its first mitotic division Blastocyst: the developing individual is a hollow ball for the first 2 weeks Embryo: from day 16 through 8 weeks Fetus: from beginning of week 9 to birth Attached by way of an umbilical cord to a disc-shaped placenta Provides fetal nutrition and waste disposal, secretes hormones that regulate pregnancy, mammary development, and fetal development Neonate: newborn to 6 weeks

Homeostasis

Condition of same. The body's ability to detect change, activate mechanisms that oppose it, and thereby maintain relatively stable internal conditions.

Tissue Coverings of Skeletal Muscle

Connective tissue coverings of skeletal muscle -Endomysium --Thin layer of areolar connective tissue --Surrounds each skeletal muscle fiber -Perimysium - surrounds bundles of muscle fibers (fascicles) -Epimysium --Layer that surrounds the entire muscle --Becomes part of the fascia (separates muscles from each other) --Collagen fibers extend from epimysium to form tendons that attach muscles to bone

Connective Tissue: Overview

Connective tissue: a type of tissue in which cells usually occupy less space than the extracellular material Binds organs to each other, supports and protects organs Most cells of connective tissue are not in direct contact with each other Separated by extracellular material Highly vascular: richly supplied with blood vessels Most abundant, widely distributed, and histologically variable of the primary tissues Binding of organs: tendons and ligaments Support: bones and cartilage Physical protection: cranium, ribs, sternum Immune protection: white blood cells attack foreign invaders Movement: bones provide lever system Storage: fat, calcium, phosphorus Heat production: metabolism of brown fat in infants Transport: blood

Epithelial Tissue

Consists of a flat sheet of closely adhering cells One or more cells thick Upper surface usually exposed to the environment or an internal space in the body Covers body surface and lines body cavities Forms the external and internal linings of many organs Constitutes most glands Extracellular material is so thin it is not visible with a light microscope Epithelia allow no room for blood vessels Lie on a layer of loose connective tissue and depend on its blood vessels for nourishment and waste removal Basement membrane: layer between an epithelium and the underlying connective tissue Anchors the epithelium to the connective tissue below it Basal surface: surface of an epithelial cell that faces the basement membrane Apical surface: surface of an epithelial cell that faces away from the basement membrane Simple epithelium: -Contains one layer of cells -Named by shape of cells -All cells touch the basement membrane Stratified epithelium: -Contains more than one layer -Named by shape of apical cells -Some cells rest on top of others and do not touch basement membrane

Integumentary system

Consists of the skin and its accessory organs; hair, nails, and cutaneous glands Receives more medical treatment than any other organ system

The Thoracic Cage

Consists of thoracic vertebrae, sternum, ribs Protect thoracic organs, but also spleen, most of liver, and to some extent the kidneys

Methods of Contraception

Contraception - any procedure or device intended to prevent pregnancy Behavioral methods Abstinence Rhythm method (periodic abstinence) Withdrawal (coitus interruptus) Barrier and spermicidal methods Male and female condom, diaphragm, sponge Hormonal methods "The pill," patch, injection, or vaginal ring: ovarian follicles do not mature "Morning after pills" induce menstruation providing implantation has not occurred RU-486: induces abortion up to 2 months into pregnancy Preventing implantation Intrauterine device (IUD) Surgical sterilization Clamping or cutting the genital ducts (uterine tubes or ductus deferens)

Systole

Contraction

The Cranial Nerves: The Oculomotor Nerve (III)

Controls muscles that turn the eyeball

The Conduction System

Coordinates the heartbeat Composed of an internal pacemaker and nervelike conduction pathways through myocardium Generates and conducts rhythmic electrical signals in the following order: Sinoatrial (SA) node: modified cardiocytes Pacemaker initiates each heartbeat and determines heart rate Pacemaker in right atrium near base of superior vena cava Signals spread throughout atria Atrioventricular (AV) node Located near the right AV valve at lower end of interatrial septum Electrical gateway to the ventricles Atrioventricular (AV) bundle (bundle of His) Bundle forks into right and left Bundle branches Branches pass through interventricular septum toward apex Purkinje fibers Nervelike fibers that spread throughout ventricular myocardium

Cor pulmonale

Cor pulmonale: right ventricular failure due to obstructed pulmonary circulation In emphysema, chronic bronchitis, and black lung disease Lung disease restricts pulmonary circulation

The Hip Joint

Coxal (hip) joint: point at which the head of femur inserts into the acetabulum of the hip bone Bears much more weight, have deeper sockets, more stable than shoulder Dislocation of the hips is rare Some infants suffer congenital dislocation -Acetabulum is not deep enough to hold the head of the femur in place Harness, worn for 2 to 4 months can assist with proper positioning

Cranial Bones

Cranium (braincase)—protects the brain and associated sense organs -Meninges separates brain from direct contact with bones—that is, dura mater -Swelling of the brain inside the rigid cranium may force tissue through foramen magnum (large hole, exit for spinal cord) resulting in death

Cuboidal

Cube shaped or round (like cells or a gland)

Urinary System Disorders:Urinary Tract Infection (UTI)

Cystitis - infection of the urinary bladder Especially common in females due to short urethra Frequently triggered by sexual intercourse Can spread up the ureter causing pyelitis Pyelitis - infection of the renal pelvis Pyelonephritis - infection that reaches the cortex and the nephrons Can result from blood-borne bacteria

Internal - Prokaryotic Cell

Cytoplasm Ribosomes Inclusions Nucleoid/chromosome Actin cytoskeleton Endospore (not shown on diagram)

Flow of Information

DNA → RNA. Exceptions to the rule are found in RNA viruses and RNA molecules that regulate genetic function.

Unencapsulated Nerve Endings

Dendrites not wrapped in connective tissue Free nerve endings For pain and temperature Skin and mucous membrane Hair receptors Wrap around base hair follicle Monitor movement of hair

The Nucleoid - Prokaryotic Cell

Dense area of the cell that contains the genetic material No nuclear membrane Single circular chromosome Plasmids (non-essential strands of DNA) may be present - can be used to produce enzymes and toxins that protect the organism - origin of most acquired antibiotic resistance The DNA is in close proximity to the cytoplasm and ribosomes.

X-Rays

Dense tissue pros: can see broken bones and dense structures. cons: Can't see soft tissue, dangerous

Responsiveness and movement

Detect and respond to stimuli

Spirometer

Device that measures spirometry

Development

Differentiation and growth

Mnemonic to use when remembering the levels of classification

Don't forget! Kings Play Chess On Fine Green Satin

Special Movements of the Foot

Dorsiflexion: elevation of toes as you do while swinging foot forward to take a step (heel strike) Plantar flexion: extension of foot so that toes point downward as in standing on tiptoe (toe-off) Inversion: movement in which the soles are turned medially Eversion: movement in which the soles are turned laterally Dorsiflexion: elevation of toes as you do while swinging foot forward to take a step (heel strike) Plantar flexion: extension of foot so that toes point downward as in standing on tiptoe (toe-off) Inversion: movement in which the soles are turned medially Eversion: movement in which the soles are turned laterally

Veins of the Abdominal and Pelvic Region

Drains nutrient-rich blood from viscera (stomach, spleen, and intestines) to liver so that blood sugar levels are maintained

3 regions of small intestine

Duodenum: first 25 cm (10 in.) Begins at the pyloric sphincter Receives juices/enzymes/bile from liver, pancreas Jejunum: small intestine beyond duodenum Roughly 1.0 to 1.7 m in a living person Especially rich blood supply which gives it a red color Most digestion and nutrient absorption occurs here Ileum: About 1.6 to 2.7 m Thinner, less muscular, less vascular, and paler pink color Peyer's patches— lymphatic nodules in wall of ileum

The Refractory Period

During an action potential and for a few milliseconds after, it is difficult or impossible to stimulate that region of a neuron to fire again Refractory period: the period of resistance to stimulation Two phases of the refractory period Absolute refractory period No stimulus of any strength will trigger AP As long as Na+ gates are open From action potential to RMP Relative refractory period Only especially strong stimulus will trigger new AP K+ gates are still open and any effect of incoming Na+ is opposed by the outgoing K+

First Trimester

During the first trimester your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. Other changes you may experience during the first trimester include: Extreme tiredness Tender, swollen breasts. Your nipples might also stick out. Upset stomach with or without throwing up (morning sickness) Cravings or distaste for certain foods Mood swings Constipation (trouble having bowel movements) Need to pass urine more often Headache Heartburn Weight gain or loss

Endocrine and Exocrine Glands

Endocrine glands: lose their contact with the surface and have no ducts -Hormones: secretion of endocrine glands -Secrete (hormones) directly into blood -Thyroid, adrenal, and pituitary glands Some organs have both -Liver, gonads, pancreas

Steps in Atherosclerosis

Endothelium damaged by hypertension, virus, diabetes, or other causes Monocytes penetrate walls of damaged vessels and transform into macrophages Absorb cholesterol and fats to be called foam cells Look like fatty streak on vessel wall Can grow into atherosclerotic plaques (atheromas) Inflammation transforms atheroma into a hardened complicated plaque called arteriosclerosis Bulging mass grows to obstruct arterial lumen

Epiphyses

Ends of bone

Schwann cells

Envelope nerve fibers in PNS Wind repeatedly around a nerve fiber Produce a myelin sheath similar to the ones produced by oligodendrocytes in CNS Assist in the regeneration of damaged fibers

Meninges

Epidural space Dura mater Subdural space Arachnoid mater Transparent membrane over brain surface Subarachnoid space separates it from pia mater below Pia mater Very thin membrane that follows contours of brain, even dipping into sulci Not usually visible without a microscope

Structures Of The Larynx

Epiglottis - flap of tissue that guards the superior opening of the larynx At rest, stands almost vertically During swallowing, closes airway like trap-door and directs food to esophagus behind it Thyroid cartilage - largest laryngeal prominence (Adam's apple); shield-shaped Testosterone stimulates growth, larger in males Vestibular folds (superior) Play no role in speech Close the larynx during swallowing Vocal cords (inferior) Produce sound when air passes between them Glottis - the vocal cords and the opening between them Loudness determined by the force of air passing between the vocal cords

Four broad categories of tissues

Epithelial tissue Connective tissue Nervous tissue Muscular tissue

Variations in the Respiratory Rhythm

Eupnea—relaxed, quiet breathing Characterized by tidal volume 500 mL and the respiratory rate of 12 to 15 bpm Apnea—temporary cessation of breathing Dyspnea—labored, gasping breathing; shortness of breath Hyperpnea—increased rate and depth of breathing in response to exercise, pain, or other conditions Hyperventilation—increased pulmonary ventilation in excess of metabolic demand Hypoventilation—reduced pulmonary ventilation Kussmaul respiration—deep, rapid breathing often induced by acidosis Orthopnea—dyspnea that occurs when person is lying down Respiratory arrest—permanent cessation of breathing Tachypnea—accelerated respiration Cheyne-Stokes respiration - periods of apnea followed by hyperventilation in dying/overdose patients

Facial Bones

Facial bones (14)—those that have no direct contact with the brain or meninges -Support the teeth -Give shape and individuality to the face -Form part of the orbital and nasal cavities -Provide attachments for muscles of facial expression and mastication

Functions of the Kidneys

Filter blood plasma, separate waste from useful chemicals, return useful substances to blood, eliminate wastes Regulate blood volume and pressure by eliminating or conserving water Regulate the osmolarity of the body fluids by controlling the relative amounts of water and solutes eliminated

The Lumbar Vertebrae

Five lumbar vertebrae (L1-L5) Thick, stout body

Squamous

Flat (like epidermal cells)

Gliding

Flat surface bones that glide over each other

Special Movements of Head and Trunk

Flexion: forward-bending movements at the waist Extension: straightens trunk or neck Hyperextension: bending over backward Lateral flexion: tilting the head or trunk to the right or left at the midline Right and left rotation of trunk and head Ulnar flexion: tilts the hand toward the little finger Radial flexion: tilts the hand toward the thumb Flexion of fingers: curling them Extension of fingers: straightening them Opposition: moves thumb to touch tips of any of the fingers

Endospore Formation

Formed by some Gram positive soil bacteria

The Zygomatic Bones

Forms angles of the cheekbones and part of lateral orbital wall Zygomatic arch is formed from temporal process of zygomatic bone and zygomatic process of temporal bone

The Nasal Bones

Forms bridge of nose Supports cartilages that shape lower portion of the nose Often fractured by blow to the nose

The Frontal Bone

Forms forehead and part of the roof of the cranium Coronal suture: posterior boundary of frontal bone Glabella: smooth area above root of the nose Contains frontal sinus

Ubiquity of Microorganisms

Found nearly everywhere Occur in large numbers Live in places many other organisms cannot

Abnormal Spinal Curvatures

From disease, paralysis of trunk muscles, poor posture, pregnancy, or congenital defect Scoliosis—abnormal lateral curvature -Most common -Usually in thoracic region -Particularly of adolescent girls -Developmental abnormality in which the body and arch fail to develop on one side of the vertebrae Kyphosis (hunchback)—exaggerated thoracic curvature -Usually from osteoporosis, also osteomalacia or spinal tuberculosis, or wrestling or weight lifting in young boys Lordosis (swayback)—exaggerated lumbar curvature -From pregnancy or obesity

The Cerebrum: The Five Lobes

Frontal lobe Voluntary motor functions Motivation, foresight, planning, memory, mood, emotion, social judgment, and aggression Parietal lobe Receives and integrates general sensory information, taste, and some visual processing Occipital lobe Primary visual center of brain Temporal lobe Areas for hearing, smell, learning, memory, and some aspects of vision and emotion Insula (hidden by other regions) Understanding spoken language, taste and sensory information from visceral receptors

General Features of the Vertebral Column

Functions -Supports the skull and trunk -Allows for their movement -Protects the spinal cord -Absorbs stress of walking, running, and lifting -Provides attachments for limbs, thoracic cage, and postural muscles 33 vertebrae with intervertebral discs of fibrocartilage between most of them Five vertebral groups -7 cervical in the neck -12 thoracic in the chest -5 lumbar in lower back -5 fused sacral at base of spine -4 fused coccygeal Variations in number of lumbar and sacral vertebrae occur in 1 in 20 people Spine exhibits one continuous C-shaped curve at birth Known as primary curvature S-shaped vertebral column with four normal curvatures -Cervical -Thoracic -Lumbar -Pelvic

Physiology of The Nose

Functions of the nose Warms, cleanses, and humidifies inhaled air Detects odors in the airstream Serves as a resonating chamber that amplifies the voice

Sodium

Functions: Principal ion responsible for the resting membrane potential of cells Inflow of sodium through membrane gates is an essential event in the depolarization that underlies nerve and muscle function Principal cation in ECF Sodium salts account for 90% to 95% of osmolarity of ECF Most significant solute in determining total body water and distribution of water among the fluid compartments Helps cotransport molecules like glucose, potassium, calcium Adult needs about 0.5 g of sodium per day, but typical American diet contains 3-7 g/day

Epiphyseal line

Fused bone

The Gallbladder and Bile

Gallstones (biliary calculi)—hard masses in either the gallbladder or bile ducts Composed of cholesterol, calcium carbonate, and bilirubin Gallstones may form if bile becomes excessively concentrated Cholelithiasis—formation of gallstones Most common in obese women over 40 due to excess cholesterol Obstruction of ducts Painful Cause jaundice: yellowing of skin due to bile pigment accumulation, poor fat digestion, and impaired absorption of fat-soluble vitamins Lithotripsy—use of ultrasonic vibration to pulverize stones without surgery

Gas Transport

Gas transport—the process of carrying gases from the alveoli to the systemic tissues and vice versa Oxygen transport 98.5% bound to hemoglobin 1.5% dissolved in plasma Carbon dioxide transport 70% as bicarbonate ion 23% bound to hemoglobin 7% dissolved in plasma

Peptic Ulcer

Gastritis, inflammation of the stomach, can lead to a peptic ulcer as pepsin and hydrochloric acid erode the stomach wall. Most ulcers are caused by acid-resistant bacteria Helicobacter pylori, that can be treated with antibiotics and Pepto-Bismol.

Genetic Terms

Genetics - study of heredity (inheritance) Genome - sum total of genetic material of an organism Chromosome - cellular structure composed of packaged DNA molecule Gene - a unit of heredity responsible for a given trait; a segment of DNA that contains code to make a group of related proteins or RNAs Genotype - distinctive genetic makeup (actual code) Phenotype - physical expression of the genotype

Rho-GAM

Given to pregnant Rh-women. Binds fetal agglutinogens in her blood so she will not form anti-D antibodies

Glands

Gland: cell or organ that secretes substances for use elsewhere in the body or releases them for elimination from the body -Composed of epithelial tissue in a connective tissue framework and capsule -May produce product synthesized by the gland (digestive enzymes) or products removed from tissues and modified by the gland (urine) Secretion: product useful to the body Excretion: waste product

Catabolic and Anabolic Pathways

Glycolysis and the Krebs cycle allow cells to break down different classes of molecules in order to synthesize compounds required by the cell Once enough materials have been produced for two cells the bacterial cell will undergo binary fission to produce two cells from one

Hyperextension

Go beyond the normal angle of extension

Posterior Tibial artery

Goes behind knee

Types of Leukocytes

Granulocytes - granules with defense enzymes Neutrophils (60% to 70%): Barely visible granules in cytoplasm Eosinophils (2% to 4%) Large rosy-orange granules Basophils (less than 1%) Large, abundant, violet granules Agranulocytes Lymphocytes (25% to 33%) Variable amounts of bluish cytoplasm Monocytes (3% to 8%) Largest WBC

Keratinocytes

Great majority of epidermal cells Synthesize keratin

Femoral

Groin

Compact (cortical) bone

Hard casing of bone

Arteriosclerosis

Hardening of the arteries

Red Pulp

Has lymphocytes and macrophages

The Cranial Nerves: The Accessory Nerve (XI)

Head, neck, and shoulder movement

Organization

Higher level of organization than environment

Aortic hiatus

Hole where the descending aorta enter the abdomen

Human Pheromones

Human body odors may affect sexual behavior A person's sweat and vaginal secretions affect other people's sexual physiology Dormitory effect Presence of men seems to influence female ovulation Ovulating women's vaginal secretions contain pheromones called copulines, that have been shown to raise men's testosterone level

Turner's Syndrome

In Turner syndrome, cells are missing all or part of an X chromosome. The condition only occurs in females. Most commonly, the female patient has only one X chromosome. Others may have two X chromosomes, but one of them is incomplete. Sometimes, a female has some cells with two X chromosomes, but other cells have only one. Turner syndrome occurs in about 1 out of 2,000 live births.

Tactile (Merkel) cells

In basal layer of epidermis Touch receptor cells associated with dermal nerve fibers

Introduction to the Endocrine System

In humans, two systems - the nervous and endocrine - communicate with neurotransmitters and hormones Chemical identity How they are made and transported How they produce effects on their target cells The endocrine system is involved in adaptation to stress There are many pathologies that result from endocrine dysfunctions

Layers of Digestive Tract Wall

Include mucosa, submucosa, muscularis, and serosa Mucosa (mucous membrane)—epithelium; lines the lumen Submucosa—thicker layer of loose connective tissue Contains blood vessels, lymphatic vessels, a nerve plexus, and in some places mucus-secreting glands that dump lubricating mucus into the lumen Muscularis - 2 layers of smooth muscle Inner circular layer - sometimes have valves/sphincters to keep food moving Outer longitudinal layer - moves food along like conveyer belt Serosa - outer layer of epithelium & connective tissue (peritoneum)

Addition of Epinephrine

Increase heart rate and contraction strength

The Vomer

Inferior half of the nasal septum -Superior half formed by perpendicular plate of ethmoid Supports cartilage that forms the anterior part of the nasal septum

Memory

Information management entails: Learning: acquiring new information Memory: information storage and retrieval Forgetting: eliminating trivial information; as important as remembering Amnesia: defects in declarative memory Inability to describe past events

Scientific Fact

Information that can be independently verified by a trained person

Prenatal Hormones and Sexual Differentiation

Initially, a fetus is sexually undifferentiated as to which sex it will become Gonads begin to develop at 5 or 6 weeks as gonadal ridges Two sets of ducts adjacent to each gonadal ridge Estrogen levels are always high in pregnancy If estrogen was the hormone that directed the female development, all fetuses would be feminized Female development occurs in absence of androgen hormones

Classification of Immune System

Innate (nonspecific) Immunity Protects body against many different types of foreign agents Adaptive (Specific) Immunity Depends upon a prior encounter with the foreign substance and then recognition on subsequent encounters e.g. Chicken pox

Spongy (cancellous) bone

Inside of bone. Has holes

Metabolism

Internal chemical changes

The Genitalia

Internal genitalia Ovaries, uterine tubes,uterus, and vagina External genitalia Clitoris, labia minora, and labia majora Occupy the perineum Primary sex organs Ovaries Secondary sex organs Other internal and external genitalia

Veins of the Head and Neck

Internal jugular vein receives most of the blood from the brain Branches of external jugular vein drain the external structures of the head Upper limb is drained by subclavian vein

Outline- Types of homeostatic balance

Introduction 1. Water balance - fluid compartments, fluid gains/losses, regulation of output, disorders 2. Electrolyte balance - functions of electrolytes, major electrolytes (functions, regulation, imbalances of each) 3. Acid-base balance - acid vs. base, pH of body, challenges to acid-base balance, major buffering systems, disorders, compensation

Joints and Their Classification

Joint (articulation): any point where two bones meet, whether or not the bones are movable at that interface Arthrology: science of joint structure, function, and dysfunction Kinesiology: the study of musculoskeletal movement -A branch of biomechanics, which deals with a broad variety of movements and mechanical processes in the body, including the physics of blood circulation, respiration, and hearing

Surfactant

Keeps alveoli inflatted an disperses water

Steps in Urine Formation

Kidneys convert blood plasma to urine in 3 stages 1. Glomerular filtration 2. Tubular reabsorption 3. Tubular secretion

The Palatine Bones

L-shaped bone Form the posterior portion of the hard palate Part of lateral nasal cavity wall Part of the orbital floor

The Lacrimal Bones

Lacrimal fossa houses lacrimal sac in life -Tears collect in lacrimal sac and drain into nasal cavity

Lactation

Lactation - the synthesis and ejection of milk from the mammary glands Lasts as little as 1 week in women who do not breast-feed their infants Can continue for many years as long as the breast is stimulated by a nursing infant or a mechanical device (breast pump) Women traditionally nurse their infants until a median age of about 2.8 years

Feces

Large intestine takes about 12 to 24 hours to reduce the residue of a meal to feces Does not chemically change the residue Reabsorbs water and electrolytes Feces consist of 75% water and 25% solids, of which 30% is bacteria, 30% undigested fiber, 10% to 20% fat, small amount of mucus, and sloughed epithelial cells

Agranular Leukocytes

Large white blood cells. No granules on it.

The Maxillae

Largest facial bones Forms upper jaw -Palate: forms roof of mouth and floor of nasal cavity -Palate allows us to chew while breathing -Cleft palate and cleft lip Maxillary sinus fills maxillae bone Larger in volume than frontal, sphenoid, and ethmoid sinuses

Spleen

Largest lymphoid organ Upper left quadrant Spleen filters blood rather than lymph Two types of tissue: White pulp - lymphocytes Red pulp - venous sinuses filled with blood and lymphocytes and macrophages Acts as a reservoir for blood Removes worn out red blood cells RBC production before birth

The Cranial Nerves: The Trigeminal Nerve (V)

Largest of the cranial nerves Most important sensory nerve of the face Forks into three divisions Ophthalmic division (V1): sensory Maxillary division (V2): sensory Mandibular division (V3): mixed

Scoliosis

Lateral curvature of the spine

Elevation

Lifting

Ependymal cells

Line internal cavities of the brain Cuboidal epithelium with cilia on apical surface Secretes and circulates cerebrospinal fluid (CSF) Clear liquid that bathes the CNS

Plasma

Liquid portion of blood. Matrix

Thymus

Located in the upper thorax Most active during early life Plays a crucial role in the development of the immune system before birth and in the first few months of life Secretes thymosins that promote the maturation of lymphocytes

The Femur

Longest and strongest bone of the body Hemispherical head that articulates with the acetabulum of the pelvis --Forms ball-and-socket joint --Fovea capitis: pit in head of femur for attachment of a ligament Greater and lesser trochanters for muscle attachment Medial and lateral condyles and epicondyles found distally Patellar and popliteal surface

The Lower Limb

Lower limb divided into four regions containing 30 bones per limb -Femoral region (thigh): extends from hip to knee region --Contains the femur and patella -Crural region (leg proper): extends from knee to ankle --Contains medial tibia and lateral fibula -Tarsal region (tarsus): ankle—the union of the crural region with the foot --Tarsal bones are considered part of the foot -Pedal region (pes): foot --Composed of 7 tarsal bones, 5 metatarsals, and 14 phalanges in the toes

Korotkoff sounds

Lubb/dub sounds in Bp.

Lymph

Lymph is a clear fluid that resembles plasma Water, electrolytes, waste from metabolizing cells, & some protein It is formed from the plasma during capillary exchange - goes into the tissue space Leaves the tissue space into lymph vessels Lymphatic vessels carry it back toward the heart to return to blood

Lymphatic Pathways

Lymphatic pathways start as lymphatic capillaries that merge to form larger vessels that empty into the circulatory system.

Lymphatic Trunks & Collecting Ducts

Lymphatic trunks lead to two collecting ducts Collecting ducts join the subclavian veins

Lymphatic Vessels

Lymphatic vessels include: Lymphatic capillaries Larger lymphatic vessels Lead to lymph nodes Lymphatic trunks Distribution is similar to veins Walls of lymphatic capillaries are made up of single layer of epithelial cells

Agranulocytes

Lymphocytes—increased numbers in diverse infections and immune responses Destroy cells (cancer, foreign, and virally infected cells) 3 subtypes with specific functions: "Present" antigens to activate other immune cells Coordinate actions of other immune cells Secrete antibodies and provide immune memory Monocytes—increased numbers in viral infections and inflammation Can leave bloodstream and transform into macrophages Phagocytize pathogens and debris "Present" antigens to activate other immune cells

Lymphoid Organs

Lymphoid organs and lymphoid tissue defend the body against disease by: Filtering particles such as pathogens & cancer cells from the lymph, tissue fluid, & blood Supporting the activities of the lymphocytes. They include: Lymph nodes Tonsils Thymus gland Spleen

Cellular Composition

Made of cells

Red Marrow

Makes blood

2 Types of Digestion

Mechanical & Chemical: Mechanical digestion—the physical breakdown of food into smaller particles Cutting and grinding action of the teeth Churning action of stomach and small intestines Exposes more food surface to the action of digestive enzymes Chemical digestion—a series of reactions that break big molecules into their components Carried out by digestive enzymes produced by salivary glands, stomach, pancreas, and small intestine Results Polysaccharides into monosaccharides Proteins into amino acids Fats into monoglycerides and fatty acids Nucleic acids into nucleotides

Ulnar vein

Medial side of wrist

Ulnar artery

Medial side. Receives blood from the brachial artery

Membranes

Membranes line body cavities and cover their viscera -Cutaneous membrane (the skin): largest membrane in the body --Stratified squamous epithelium (epidermis) resting on a layer of connective tissue (dermis) --Relatively dry layer serves protective function -Mucous membrane (mucosa) lines passages that open to the external environment -Serous membrane (serosa): internal membrane --Simple squamous epithelium resting on a layer of areolar tissue --Produces serous fluid that arises from blood --Covers organs and lines walls of body cavities ---Endothelium lines blood vessels and heart ---Mesothelium lines body cavities (pericardium, peritoneum, and pleura) -Synovial membrane: lines joint cavities --Connective tissue layer only, secretes synovial fluid

Metabolic Terms

Metabolism - all chemical & physical workings of the cell Anabolism - biosynthesis or building new, larger molecules from smaller ones Catabolism - breaks molecules into smaller molecules - often releasing energy

The Metacarpal Bones and the Phalanges

Metacarpals—bones of the palm -Metacarpal I proximal to base of thumb -Metacarpal V proximal to base of little finger -Proximal base, body, and distal head Phalanges—bones of the fingers -Thumb or pollex has two phalanges --Proximal phalanx --Distal phalanx -Fingers have three phalanges --Proximal phalanx --Middle phalanx --Distal phalanx

Lymph Nodes and Metastatic Cancer

Metastasis - phenomenon in which cancerous cells break free from the original, primary tumor, travel to other sites in the body, and establish new tumors Metastasizing cancer cells can easily enter the lymphatic vessels Tend to lodge in the first lymph node they encounter Multiply there and eventually destroy the node Swollen, firm, and usually painless Tend to spread to the next node downstream Treatment of breast cancer is lumpectomy, mastectomy along with removal of nearby axillary nodes

Extremophiles

Methonogens - Convert CO2 & H2 into methane gas (CH4) Halophiles - salt loving Psychrophiles - cold loving Hyperthermophile - loving very high temperatures

Milk Ejection

Milk is continually secreted into the mammary acini,but does not easily flow into the ducts Milk ejection (letdown) is controlled by a neuroendocrine reflex Infant's suckling stimulates sensory receptors in nipple, signaling hypothalamus and posterior pituitary to release oxytocin Oxytocin stimulates myoepithelial cells around each acinus Contract to squeeze milk into duct Milk flow within 30 to 60 seconds after suckling begins

Stage 3 of sleep

Moderate to deep sleep About 20 minutes after stage 1 Theta and delta waves appear Muscles relax and vital signs fall (body temperature, blood pressure, heart and respiratory rates)

Astrocytes

Most abundant glial cell in CNS Cover entire brain surface and most nonsynaptic regions of the neurons in the gray matter of the CNS

Brachial Artery

Most common site for BP in the arm

The Cranial Nerves: The Vagus Nerve (X)

Most extensive distribution of any cranial nerve Major role in the control of cardiac, pulmonary, digestive, and urinary function Swallowing, speech, regulation of viscera Damage causes hoarseness or loss of voice, impaired swallowing, and fatal if both are cut

Ecological Associations Among Microorganisms Introduction

Most microbes live in shared habitats. Interactions can have beneficial , harmful , or no particular effects on the organisms involved. They can be obligatory or nonobligatory to the members. They often involve nutritional interactions.

Introduction to ch. 25

Most nutrients we eat cannot be used in existing form Must be broken down into smaller components before the body can make use of them Digestive system—essentially a disassembly line To break down nutrients into a form that can be used by the body To absorb them so they can be distributed to the tissues Gastroenterology—the study of the digestive tract and the diagnosis and treatment of its disorders

The Cranial Nerves: The Facial Nerve (VII)

Motor: major motor nerve of facial muscles: facial expressions; salivary glands and tear, nasal, and palatine glands

Saddle (looks like a saddle)

Moves in the frontal plane

Degenerative Disorders of the Myelin Sheath

Multiple sclerosis: Oligodendrocytes and myelin sheaths in the CNS deteriorate Myelin replaced by hardened scar tissue Nerve conduction disrupted (double vision, tremors, numbness, speech defects) Onset between 20 and 40 and fatal from 25 to 30 years after diagnosis Cause may be autoimmune triggered by virus Tay-Sachs disease: a hereditary disorder of infants of Eastern European Jewish ancestry Abnormal accumulation of glycolipid called GM2 in the myelin sheath Normally decomposed by lysosomal enzyme Enzyme missing in individuals homozygous for Tay-Sachs allele Accumulation of ganglioside (GM2) disrupts conduction of nerve signals Blindness, loss of coordination, and dementia Fatal before age 4

Mutation Terms

Mutation: permanent change in the genetic code Wild type: strain of organism that is considered to be the natural state of the organism; without mutation; the highest number in the population Mutant strains: show variance in characteristic, (e.g. pigment)

Prevention of Inappropriate Clotting

Natural anticoagulants Heparin (from basophils and mast cells) Antithrombin (from liver)

The Small Intestine

Nearly all chemical digestion and nutrient absorption occurs in the small intestine The longest part of the digestive tract 2.7 to 4.5 m (about 23 feet on average) long in a living person "Small" intestine refers to the diameter—not length 2.5 cm (1 in.)

Valsalva maneuver

Neurological test that tests abdominal pressure

Contraction of Skeletal Muscle

Neuromuscular junction -Axon terminals --Come into close proximity to the sarcolemma --Have vesicles that contain acetylcholine (Ach) -Synaptic cleft - a small gap that separates the axon from the sarcolemma

Synaptic Transmission

Neurotransmitters Synthesized by the presynaptic neuron Released in response to stimulation Bind to specific receptors on the postsynaptic cell Alter the physiology of that cell

Phagocytosis

Neutrophils (most numerous) & monocytes (less numerous but larger) Characteristic of the phagocyte Diapedesis Chemotaxis Fixed monocytes are called macrophages Mononuclear phagocytic system or reticuloendothelial system

Granulocytes

Neutrophils—increased numbers in bacterial infections Phagocytosis of bacteria Release antimicrobial chemicals Eosinophils—increased numbers in parasitic infections, collagen diseases, allergies, diseases of spleen and CNS Phagocytosis of antigen-antibody complexes, allergens, and inflammatory chemicals Release enzymes to destroy large parasites Basophils—increased numbers in chickenpox, sinusitis, diabetes Secrete histamine (vasodilator): speeds flow of blood to an injured area Secrete heparin (anticoagulant): promotes the mobility of other WBCs in the area

Water Balance

Newborn baby's body weight is about 75% water Young men average 55% to 60% water Women average slightly less Obese and elderly people as little as 45% by weight Total body water (TBW) of a 70 kg (150 lb) young male is about 40 L

Inclusion Bodies

Non-membrane bound granules Usually for storage of nutrients

Melanocytes

Occur only in stratum basale Synthesize pigment melanin that shields DNA from ultraviolet radiation

Smell

Olfaction: sense of smell Olfactory mucosa Contains 10 to 20 million olfactory cells, which are neurons, as well as epithelial supporting cells and basal stem cells On average 2,000 to 4,000 odors distinguished Humans have a poorer sense of smell than most other mammals Women more sensitive to odors than men Highly important to social interaction

Doral Pedal artery

On top of foot

Regulation of Output

Only way to control water output significantly is through variation in urine volume Kidneys slow rate of water and electrolyte loss until water and electrolytes can be ingested Mechanism of urinary output: "Where sodium goes, water soon follows." ADH - concentrates the urine/ lowers urine volume ADH secretion stimulated by hypothalamus in response to dehydration When secreted it will increase body water volume and blood pressure ADH allows water to be reabsorbed independent of sodium; sodium is thus excreted in a lower volume of water (concentrated urine) When blood volume/pressure too high, ADH release inhibited

Oogenesis

Oogenesis - egg production Produces haploid gametes by means of meiosis Distinctly cyclic event that normally releases one egg each month Accompanied by cyclic changes in hormone secretion Cyclic changes in histological structure of the ovaries and uterus Uterine changes result in monthly menstrual flow

Mutualism

Organisms live in an obligatory but mutually beneficial relationship

Internal iliac vein

Organs in the pelvis give blood too

External carotid artery

Outside of head and neck

Lymph nodes

P shaped lymphatic tissues in small chains

SA node

Pacemaker. made from modified cardiocytes in RA. Makes atrium contract

Articular cartilage

Padding on ends of bone (hyaline cartilage)

Pronation

Palms backward; palms down

Swallowing

Peristalsis—wave of muscular contraction that pushes the bolus ahead of it Entirely involuntary reflex When standing or sitting upright, the food and liquid drops through the esophagus by gravity faster than peristalsis can keep up with it Peristalsis ensures you can swallow regardless of body position Liquid reaches the stomach in 1 to 2 seconds Food bolus in 4 to 8 seconds

Cytoplasmic Membrane- Prokaryotic Cell

Phospholipid Bilayer Phophatidylcholine Hydrophobic Proteins Semi-Fluid Nature

Platelets or thrombocytes

Precursor for clots

Pregnancy and Childbirth

Pregnancy from a maternal standpoint Adjustments of the woman's body to pregnancy Mechanism of childbirth Gestation (pregnancy) Lasts an average of 266 days from conception to childbirth Gestational calendar measured from first day of the woman's last menstrual period (LMP) Birth predicted 280 days (40 weeks) from LMP Term: the duration of pregnancy Trimester: the three 3-month intervals in the term

Organ Rejection

Prevention of organ rejection by the immune system: Organs are matched between donor and recipient based upon tissue typing Drugs that suppress immune system Cyclosporine Patients must be monitored carefully to prevent opportunistic infections

Supination and Pronation

Primarily forearm movements Supination: forearm movement that turns palm to face anteriorly or upward -Forearm supinated in anatomical position Pronation: forearm movement that turns palm to face either posteriorly or downward

Primary and Secondary Responses

Primary - slower and lower levels of antibodies Secondary - quicker and higher levels of antibodies Immunity Antibody titer - measurements that give an indication of an active infection

The Auditory Projection Pathway

Primary auditory cortex lies in the superior margin of the temporal lobe Site of conscious perception of sound

White Pulp

Produce lymphocytes

Reproduction

Producing copies of themselves; pass genes to offspring.

Archaea

Prokaryotic cells No nucleus Many are found in extreme environments Important non-pathogens Share some characteristics with the Domain Eukarya

Antigens

Protein on a cell that makes the cell as a certain type

Antibodies

Proteins secreted by plasma cells that is part of the Antigen-Antibody complex

The Occipital Bone

Rear and base of skull Foramen magnum holds spinal cord Skull rests on atlas at occipital condyles External occipital protuberance (EOP) for nuchal ligament Superior and inferior nuchal lines mark neck muscles

EKG

Record of the electrical activity of the heart

Inferior Vena cava

Responsible for blood return to the heart from the lower body

Right Atrium

Right side carries deoxygenated blood

Sebaceous Glands

Sebum—oily secretion produced by sebaceous glands Keeps skin and hair from becoming dry, brittle, and cracked Lanolin—sheep sebum

Autoimmune Disease

Self attack Many diseases have an autoimmune etiology Cause severe damage to tissues and organs targeted by the "self" antibodies Relationship between stress and autoimmune psychoneuroimmunology

Bundle of his

Sends impulse to bundle branches

Av node

Sends impulse to bundle of his

Bundle Branches

Sends impulse to purkinje fibers

The Cranial Nerves:The Olfactory Nerve (I)

Sense of smell Damage causes impaired sense of smell

The General Senses

Sensory homunculus: diagram of the primary somesthetic cortex which resembles an upside-down sensory map of the contralateral side of the body Somatotopy: point-to-point correspondence between an area of the body and an area of the CNS

Properties and Types of Sensory Receptors

Sensory receptor: a structure specialized to detect a stimulus Some receptors are bare nerve endings Others are true sense organs: nerve tissue surrounded by other tissues that enhance response to a certain type of stimulus Accessory tissues may include added epithelium, muscle, or connective tissue

Diaphysis

Shaft of bone

Kidney - Gross Anatomy

Shape and size About the size of a bar of bath soap Lateral surface is convex, and medial is concave with a slit, called the hilum Receives renal nerves, blood vessels, lymphatics, and ureter

Shingles

Shingles (herpes zoster): localized disease caused by the virus traveling down the sensory nerves by fast axonal transport when immune system is compromised Common after age 50 Painful trail of skin discoloration and fluid-filled vesicles along path of nerve Usually in chest and waist on one side of the body Pain and itching Childhood chickenpox vaccinations reduce the risk of shingles later in life

Endothelium

Simple squamous cells that line the tunica interna

Skin Cancer

Skin cancer—induced by the UV rays of the sun -Most often on the head and neck -Most common in fair-skinned people and the elderly -One of the most common cancer -One of the easiest to treat -Has one of the highest survival rates if detected and treated early Three types of skin cancer named for the epidermal cells in which they originate -Basal cell carcinoma, squamous cell carcinoma, and malignant melanoma

Circadian rhythms

Sleep-Cycles- Events that reoccur at intervals of about 24 hours

Sleep

Sleep occurs in cycles called circadian rhythms Events that reoccur at intervals of about 24 hours Sleep: temporary state of unconsciousness from which one can awaken when stimulated Characterized by stereotyped posture Lying down with eyes closed Sleep paralysis: inhibition of muscular activity Resembles unconsciousness but can be aroused by sensory stimulation Coma or hibernation: states of prolonged unconsciousness where individuals cannot be aroused by sensory stimulation Restorative effect Brain glycogen and ATP levels increase in non-REM sleep Memories strengthened in REM sleep Synaptic connections reinforceFour stages of sleep Stage 1 Feel drowsy, close eyes, begin to relax Often feel drifting sensation, easily awakened if stimulated Alpha waves dominate EEG Stage 2 Pass into light sleep EEG declines in frequency but increases in amplitude Exhibits sleep spindles - high spikes resulting from interactions between neurons of the thalamus and cerebral cortex Stage 3 Moderate to deep sleep About 20 minutes after stage 1 Theta and delta waves appear Muscles relax and vital signs fall (body temperature, blood pressure, heart and respiratory rates) Stage 4 Called slow-wave sleep (SWS): EEG dominated by low-frequency, high-amplitude delta waves Muscles now very relaxed, vital signs at their lowest, and more difficult to awaken About five times a night, a sleeper backtracks from stage 3 or 4 to stage 2 Exhibits bouts of rapid eye movement (REM) sleep, eyes oscillate back and forth Also called paradoxical sleep, because EEG resembles the waking state, but sleeper is harder to arouse than any other stage Sleep has a restorative effect, and sleep deprivation can be fatal to experimental animals Bed rest alone does not have the restorative effect of sleep - why must we lose consciousness? Sleep may be the time to replenish such energy sources as glycogen and ATP REM sleep may consolidate and strengthen memories by reinforcing some synapses, and eliminating others

Muscular Tissue: Smooth Muscle

Smooth muscle -Lacks striations and is involuntary -Relatively short, fusiform cells (thick in middle, tapered at ends) -One centrally located nucleus -Visceral muscle: forms layers of digestive, respiratory, and urinary tract: propels contents through an organ, regulates diameter of blood vessels

Contraction of Smooth Muscle

Smooth muscle fibers contain thick and thin filaments -Filaments are not arranged into myofibrils that create striations -Thin filaments are anchored to the sarcolemma or dense bodies Contraction occurs very slowly Contractions can last for long periods of time without fatigue

Arterial Pressure Points

Some major arteries close to surface allow for palpation for pulse and serve as pressure points to reduce arterial bleeding

Microbial Diseases

Some microbes cause infectious diseases Only a few percent of all microbes are associated with disease

Innate (Nonspecific) Immunity

Species resistance- unique chemical environment or temperature species Mechanical barriers - first line of defense Second line of defense Chemical barriers Fever Inflammation Phagocytosis

General Anatomy of Nerves and Ganglia

Spinal cord communicates with the rest of the body by way of spinal nerves Nerve: a cordlike organ composed of numerous nerve fibers (axons) bound together by connective tissue Mixed nerves contain both afferent (sensory) and efferent (motor) fibers

Spinal Cord: Surface Anatomy

Spinal cord: cylinder of nervous tissue that arises from the brainstem at the foramen magnum of the skull Passes through the vertebral canal Inferior margin ends at L1 or a little beyond Averages 1.8 cm thick and 45 cm long Occupies the upper two-thirds of the vertebral canal Gives rise to 31 pairs of spinal nerves First pair passes between the skull and C1 Rest pass through intervertebral foramina Segment: part of the spinal cord supplied by each pair of spinal nerves Spinal cord divided into the cervical, thoracic, lumbar, and sacral regions Two areas of the cord are thicker than elsewhere Cervical enlargement: nerves to upper limb Lumbar enlargement: nerves to pelvic region and lower limbs Medullary cone (conus medullaris): cord tapers to a point inferior to lumbar enlargement Cauda equina: bundle of nerve roots that occupy the vertebral canal from L2 to S5

Spirometry

Spirometry—the measurement of pulmonary function Aid in diagnosis and assessment of restrictive and obstructive lung disorders Spirometer—a device that recaptures expired breath and records such variables as rate and depth of breathing, speed of expiration, and rate of oxygen consumption

Naming Examples

Staphylococcus aureus staphule-bunch of grapes kokkus- berry aureus - golden Campylobacter jejuni kampylos-curved bakterion- little rod jejunum- part of intestine Giardia lamblia Alfred Giard- Fr. Microbiologist Victor Lambl - Bohemian physician

Stellate

Star-shaped (nerves)

Carbohydrate Digestion

Starch—the most digestible carbohydrate Cellulose is indigestible Starch is first digested to: Oligosaccharides up to eight glucose residues long Then into a disaccharide Finally to glucose which is absorbed by the small intestine Carb digestion begins in the mouth Salivary amylase hydrolyzes starch into oligosaccharides Amylase works best at pH of 6.8 to 7.0 of oral cavity

Stem Cells

Stem cells: undifferentiated cells that are not yet performing any specialized function -Have potential to differentiate into one or more types of mature functional cells Developmental plasticity: diversity of mature cell types to which stem cells can give rise

The Sternum

Sternum (breastbone): bony plate anterior to the heart Divided into three regions --Manubrium --Broad superior portion --Ribs attach along scalloped lateral margins -Body --Longest part of sternum --Sternal angle—point where body joins manubrium --Ribs attach along scalloped lateral margins -Xiphoid --Inferior end of sternum --Attachment for some abdominal muscles --In cardiopulmonary resuscitation, improperly performed chest compressions can drive xiphoid process into the liver and cause a fatal hemorrhage

Layers of the Epidermis

Stratum basale -A single layer of cuboidal to low columnar stem cells and keratinocytes resting on the basement membrane -Melanocytes and tactile cells are scattered among the stem cells and keratinocytes Stem cells of stratum basale divide -Give rise to keratinocytes that migrate toward skin surface -Replace lost epidermal cells Stratum spinosum -Produce more and more keratin filaments which causes cell to flatten; the higher up in this stratum, the flatter the cells appear Stratum granulosum -Consists of three to five layers of flat keratinocytes -Contains coarse dark-staining keratohyalin granules Stratum lucidum -Seen only in thick skin Thin translucent zone superficial to stratum granulosum Stratum corneum -Up to 30 layers of dead, scaly, keratinized cells Form durable surface layer Surface cells flake off (exfoliate) Resistant to abrasion, penetration, and water loss

The Stretch Reflex

Stretch (myotatic) reflex: when a muscle is stretched, it "fights back" and contracts, maintaining increased tonus and making it stiffer than unstretched muscle Helps maintain equilibrium and posture Head starts to tip forward as you fall asleep Muscles contract to raise the head Stabilize joints by balancing tension in extensors and flexors smoothing muscle actions Stretch reflex is mediated primarily by the brain Not strictly a spinal reflex Tendon reflex: reflexive contraction of a muscle when its tendon is tapped Knee-jerk (patellar) reflex is a monosynaptic reflex One synapse between the afferent and efferent neurons Testing somatic reflexes helps diagnose many diseases Reciprocal inhibition: reflex phenomenon that prevents muscles from working against each other by inhibiting the antagonist

Stroke volume (SV)

Stroke volume (SV) of about 70 mL of blood is ejected of the 130 mL in each ventricle Amount of blood ejected from 1 ventricle in 1 stroke Ejection fraction of about 54% As high as 90% in vigorous exercise

Peptidoglycan Cell Wall- Prokaryotic Cell

Sugar backbone Protein side-chain Present in most bacteria Provides strength

The Ethmoid Bone

Superior and middle nasal conchae: scroll-like plates project into the nasal fossa Inferior nasal concha: separate bone Three chonchae occupy most of the nasal cavity, create turbulence of airflow, humidify air before it reaches the lungs

Phrenic Nerve

Supplies the diaphragm

Columnar

Tall rectangles (like lining of GI and respiratory tract)

The Ankle Joint

Talocrural (ankle) joint: includes two articulations -Medial joint: between tibia and talus -Lateral joint: between fibula and talus -Both enclosed by one joint capsule

Microbial Classification

Taxonomy is the science of living things Carl von Linné began systematically classifying living things Every organism has a two-name (binomial) designation - Genus species Note italics and the Capitalization! What constitutes a species?? Microorganisms push at the limits of our ability to create schemes to organize and classify them

What happens when the wrong blood type is transfused?

The antibodies of the recipient clump the RBCs of the donor!!! Responsible for mismatched transfusion reaction Agglutinated RBCs block small blood vessels and hemolyze, spilling out their hemoglobin over the next few hours or days Hb blocks kidney tubules and causes acute renal failure

Homeostasis

The endocrine system and the nervous system work together to maintain homeostasis The endocrine system helps regulate the following: Digestion Fuel metabolism Blood pressure and volume Calcium balance Response to the external environment

Meiosis II

The fertilized egg, now called the zygote, is ready for its first mitotic division

Tooth and Gum Disease

The human mouth is home to more than 700 species of microorganisms, especially bacteria Plaque—sticky residue on the teeth made up of bacteria and sugars can lead to: Dental caries (cavities): caused by enamel- and dentin-dissolving acids are released by bacterial metabolism of sugars Gingivitis: inflammation of the gums Periodontal disease: destruction of the supporting bone around the teeth which may result in tooth loss

Commensalism

The member called the commensal receives benefits, while its coinhabitant is neither harmed nor benefited

Tunica externa

The outer most layer

Fibrous joints

The point where 2 adjacent bones are bound by collagen fibers that merge the two bones

Spine

The raised bony rig

Head

The rounded articulation surface

Introduction

The spinal cord is the "information highway" that connects the brain with the lower body In this chapter we will study the spinal cord and spinal nerves

Introduction to ch. 23

The urinary system rids the body of waste products. Urinary system consists of six organs: two kidneys, two ureters, urinary bladder, and urethra

The Inferior Nasal Conchae

Three conchae in the nasal cavity -Superior and middle are part of the ethmoid bone Inferior nasal concha is a separate bone -Largest of the three

Resistance to Airflow

Three factors influencing airway resistance Diameter of the bronchioles The wider the bronchiole, the less resistance Asthma, chemical irritants, histamine, cold air cause constriction Pulmonary compliance The ease with which the lungs expand (stiffness of lungs) Tuberculosis, black lung stiffens lung Surface tension of alveoli Presence of surfactant - keeps water from binding together Premature infants that lack surfactant suffer from infant respiratory distress syndrome (IRDS) Treated with artificial surfactant until lungs can produce own

Effects of Aging

Thyroid disorders Hypothyroidism Hyperthyroidism Diabetes

The Knee Joint

Tibiofemoral (knee) Primarily a hinge joint -Capable of slight rotation and lateral gliding when knee is flexed -Patellofemoral joint: gliding joint Joint cavity contains two C-shaped cartilages -Lateral meniscus and medial meniscus -Joined by transverse ligament --Absorbs shock on the knee --Prevents femur from rocking side-to-side on the tibia Two intracapsular ligaments deep within joint capsule -Synovial membrane folds around them, so they are excluded from the fluid-filled synovial cavity -Ligaments cross each other to form an X Anterior cruciate ligament (ACL) -Prevents hyperextension of knee when ACL is pulled tight -Common site of knee injury Posterior cruciate ligament (PCL) -Prevents femur from sliding off tibia -Prevents tibia from being displaced backward -Untwists the ligaments Medial and lateralmeniscus absorb shock and shape joint

Prokaryote Ribosome

Tiny particles composed of protein and RNA Site of protein synthesis

Purpose ofDNA Transcription & Translation

To convert information contained in the DNA molecule to direct the production of proteins in the cell.

Treating Erectile Dysfunction

Treatments—Viagra, Levitra, and Cialis Phosphodiesterase inhibitors Sexual stimulation triggers nitric oxide secretion, which activates cGMP, which then increases blood flow into erectile tissue This drug slows breakdown of cGMP by phosphodiesterase type 5 (PDE5) and prolongs duration of erection

Urine Formation Step 3: Secretion

Tubular secretion - process in which renal tubule extracts chemicals from capillary blood and secretes them into tubular fluid Two purposes in proximal convoluted tubule and nephron loop Waste removal Urea, uric acid, bile acids, ammonia, catecholamines, prostaglandins, and a little creatinine are secreted into the tubule Secretion of uric acid compensates for its reabsorption earlier in PCT Clears blood of pollutants, morphine, penicillin, aspirin, and other drugs Explains need to take prescriptions three to four times/day to keep pace with the rate of clearance Acid-base balance Secretion of hydrogen and bicarbonate ions help regulate pH of body fluids

Divisions of the Autonomic Nervous System (ANS)

Two divisions innervate same target organ Sympathetic division and parasympathetic division May have cooperative or contrasting effect Prepares body for physical activity: exercise, trauma, arousal, competition, anger, or fear Increases heart rate, BP, airflow, blood glucose levels, etc. Reduces blood flow to the skin and digestive tract

Meiosis

Two forms of cell division Mitosis: a body cell doubles its DNA and then divides to produce two genetically identical daughter cells Basis for division of the single-cell fertilized egg, growth of an embryo, all postnatal growth, and tissue repair Meiosis produces four gametes (haploid cells), each with only half the DNA of the diploid body cells Combining male and female gametes with half the genetic material produces an embryo with the same number of chromosomes as each of the parents Meiosis is sometimes called reduction division

Erythrocytes

Two principal functions Carry oxygen from lungs to cell tissues Pick up CO2 from tissues and bring to lungs Insufficient RBCs may kill in minutes due to lack of oxygen to tissues

The Physiology of Hearing

Tympanic membrane Has 18 times area of oval window Ossicles concentrate the energy of the vibrating tympanic membrane on an area 1/18 that size Ossicles create a greater force per unit area at the oval window and overcome the inertia of the perilymph Ossicles and their muscles have a protective function Lessen the transfer of energy to the inner ear

Types of Antibodies

Types of antibody Immunoglobulin - Ig IgG - plasma & body fluids - can cross the placenta IgA - secretions of the sweat glands IgM - blood plasma - does not cross the placenta IgD - important in activating B cells IgE - Associated with allergic reactions

Axillary vein

Under the armpit. Receives blood from the brachial vein

The Ureters

Ureters - retroperitoneal, muscular tube that extends from the kidney to the urinary bladder Passes posterior to bladder and enters it from below Flap of mucosa acts as a valve into bladder Keeps urine from backing up in the ureter when bladder contracts

Radiopaque substances

Uses: Blood vessels, GI tract Pros: Can see if there are obstructions or stenosis in a hollow structure Cons: x-rays still used, dangerous

Ovulation Phase

Usually day 14 Mature egg is released from the follicle to the fallopian tube then into the uterus An increase of LH triggers ovulation Fertilization of egg must happen within 24 hours of ovulation

Great saphenous vein

Vein located of the foot and goes to the femoral vein. used in bypass

Ventricular Systole

Ventricles contract

ST segment

Ventricular contraction

QRS complex

Ventricular depolarization

T wave

Ventricular repolarization and contraction

The Pleurae

Visceral pleura—serous membrane that covers lungs Parietal pleura—adheres to mediastinum, inner surface of the rib cage, and superior surface of the diaphragm Pleural cavity—potential space between pleurae Normally no room between the membranes, but contains a film of slippery pleural fluid

Blood Viscosity and Osmolarity

Viscosity—resistance of a fluid to flow, resulting from the cohesion of its particles (Thickness of fluid) Whole blood 4.5 to 5.5 times as viscous as water Plasma is 2.0 times as viscous as water Osmolarity of blood—the total molarity (e.g., concentration) of those dissolved particles that cannot pass through the blood vessel wall If too high, blood absorbs too much water, increasing the blood pressure If too low, too much water stays in tissue, blood pressure drops, and edema occurs Optimum osmolarity is achieved by the body's regulation of sodium ions, proteins, and red blood cells

Intrinsic Factor

Vitamin B12 is needed to synthesize hemoglobin Prevents pernicious anemia Secretion of intrinsic factor is the only indispensable function of the stomach Digestion can continue if stomach is removed (gastrectomy), but B12 supplements will be needed

Vitamins

Vitamins Absorbed unchanged Fat-soluble vitamins: A, D, E, and K absorbed with other lipids If they are ingested without fat-containing food, they are not absorbed at all, but are passed in the feces and wasted Water-soluble vitamins, B complex and C, absorbed by simple diffusion and B12 if bound to intrinsic factor from the stomach Minerals absorbed by small intestine as needed

Leukocytes

WBCs

Water

Water is absorbed by osmosis following the absorption of salts and organic nutrients 98% of water we take in per day is absorbed by intestines Diarrhea—occurs when large intestine absorbs too little water Feces pass through too quickly if intestine is irritated Feces contain high concentrations of a solute (lactose) Constipation—occurs when fecal movement is slow, too much water gets reabsorbed, and feces become hardened

The Cytoplasm- Prokaryotic Cell

Water-based gelatinous solution filling the entire cell Many soluble proteins are present Carbohydrates and other intermediates are abundant This is the site of nearly all chemical reactions

Local Potentials

When neuron is stimulated by chemicals, light, heat, or mechanical disturbance Opens the Na+ gates and allows Na+ to rush into the cell Na+ inflow neutralizes some of the internal negative charge Voltage measured across the membrane drifts toward zero Depolarization: case in which membrane voltage shifts to a less negative value

Capillary Beds

When sphincters open Capillaries are well perfused with blood and engage in exchanges with the tissue fluid When sphincters closed Blood bypasses the capillaries Flows through thoroughfare channel to venule Three-fourths of the body's capillaries are shut down at a given time

Exponential Growth(Logarithmic or log) Phase

When the growth curve increases geometrically Cells reach the maximum rate of cell division Will continue as long as cells have adequate nutrients and the environment is favorable

Respiratory Control of pH

When you breathe slowly/less, more CO2 builds up in your blood CO2 is converted to carbonic acid, which lowers pH This decrease in pH stimulates you to breathe more When you breathe quickly/more, CO2 is removed from your blood Carbonic acid is thus removed, which raises pH This increase in pH stimulates you to breathe

Tract

a bundle of nerve fibers (axons) wrapped in fibrous connective tissue (CNS)

Nerve

a bundle of nerve fibers (axons) wrapped in fibrous connective tissue (PNS)

Dermatome map

a diagram of the cutaneous regions innervated by each spinal nerve

Tay-Sachs disease

a hereditary disorder of infants of Eastern European Jewish ancestry

Ganglion

a knotlike swelling in a nerve where neuron cell bodies are concentrated

Autonomic nervous system (ANS)

a motor nervous system that controls glands, cardiac muscle, and smooth muscle

Infundibulum

a stalk that attaches the pituitary gland to the hypothalamus. Connects nerves to endocrine system

Cardiac arrhythmias

abnormal cardiac rhythm

Erythema

abnormal redness of the skin due to dilated cutaneous vessels --Exercise, hot weather, sunburn, anger, or embarrassment

Learning

acquiring new information

parietal pleura

adheres to mediastinum, inner surface of the rib cage, and superior surface of the diaphragm

Anatomic Dead Space

airway where there is no gas exchange

Suture

an immobile joint

Myelin sheath

an insulating layer around a nerve fiber

Descending aorta, abdominal.

aorta below diaphragm

Descending aorta, thoracic

aorta in chest. Above diaphragm

Vertebral arteries

arteries that come off the subclavian artery

Coronal

at anterior margin

Squamous

at lateral border

Lambdoid

at posterior margin

Left Ventricle

attached to aorta

Atlanto-occipital join

between atlas and axis

Respiratory alkalosis

blood ph above 7.45

Lymphatic vessels

carry lymph to and from the lymph nodes

Chondrocytes

cartilage cells in lacunae

Left hemisphere

categorical hemisphere Specialized for spoken and written language Sequential and analytical reasoning (math and science) Breaks information into fragments and analyzes it in a linear way

Lymph nodules

clean lymph and made up of clusters. compartments inside the lymph node

Cerebrospinal fluid (CSF)

clear, colorless liquid that fills the ventricles and canals of CNS

Pulmonary veins

come from lungs. pump O2 to LA

Ascending aorta

comes from the left ventricle. carries O2

Pulmonary veins

comes from the lungs and carry oxygenated blood to the LA

Chickenpox (term)

common disease of early childhood. Part of the herps family

Circumduction

cone shaped motion

Posterior (dorsal) root ganglion

contains the cell bodies of sensory neurons carrying signals to the spinal cord

Longitudinal fissure

deep groove that separates cerebral hemispheres

Amnesia

defects in declarative memory

Sensory homunculus

diagram of the primary somesthetic cortex in the parietal lobe, resembles an upside-down sensory map of the body

Pulse pressure

difference between systolic and diastolic

Interventricular Septum

divides the heart left and right

Depression

down

Thoracic duct

drains into the left subclavian vein. 3/4 of body

Right lymphatic duct

drains into the right subclavian vein. 1/4 of the body

Forgetting

eliminating trivial information; as important as remembering

Stimuli

environmental changes that cause changes in neurons

Hyperventilation

excessive breathing

Ventricles

four internal chambers within the brain

Node of Ranvier

gap between segments

Nodes of Ranvier

gap between segments

Albinism

genetic lack of melanin that results in white hair, pale skin, and pink eyes --Have inherited recessive, nonfunctional tyrosinase allele

Tendon reflex

in response to excessive tension on the tendon Inhibits muscle from contracting strongly

Brachial artery

in the arm. Receives blood from the axillary

Brachial vein

in the arm. receives blood from radial and ulnar

Common iliac vein

in the hip

Pharyngeal tonsils

in the nasopharynx

Anemia

increase blood production

Extension

increase the joint angle

Memory

information storage and retrieval

Anterior tibial artery

infront of knee

Sleep paralysis

inhibition of muscular activity

Tunica interna

inner most layer

Open reduction

involves surgical exposure of the bone and the use of plates, screws, or pins to realign the fragments

Heme globin

iron is here. O2 binds here

Neck

just pass the head (usually below)

Cyanosis

lack of O2 and tissue turns blue

Tuberosity

larger version of a tubercle

Cerebrum

largest and most conspicuous part of the human brain Seat of sensory perception, memory, thought, judgment, and voluntary motor actions

Radial vein

lateral side of arm

Trabeculae

little bony part of spine

Synaptic knob (terminal button)

little swelling that forms a junction (synapse) with the next cell

Shingles (term)

localized disease caused by the virus traveling down the sensory nerves when immune system is compromised

Lymph organs

made up of the lymph nodes, tonsils, thymus gland and spleen

Lymphatic tissue

makes up lymph nodes

The Sternum is divided into 3 regions

manubrium Broad superior portion

Hematoma (bruise)

mass of clotted blood showing through skin

Tumors

masses of rapidly dividing cells

Hemoglobin

molecule inside RBC. Transports O2

Action potential

more dramatic change produced by voltage-regulated ion gates in the plasma membrane Repolarizes the membrane; shifts the voltage back to negative numbers returning toward Resting Membrane Potential

Melanin

most significant factor in skin color -Produced by melanocytes -Accumulate in the keratinocytes of stratum basale and stratum spinosum People of different skin colors have the same number of melanocytes -Dark-skinned people --Produce greater quantities of melanin --Melanin granules in keratinocytes more spread out than tightly clumped --Melanin breaks down more slowly --Melanized cells seen throughout the epidermis

Hinge

move freely with limited movement in one plane

Internodes

myelin-covered segments from one gap to the next

Common carotid

neck

Saltatory conduction

nerve signal seems to jump from node to node

Ependymal cells

neuroglia that lines the ventricles and covers choroid plexus

Ependyma

neuroglia that lines the ventricles and covers choroid plexus Produces cerebrospinal fluid

No centrioles

no further cell division

Cast

normally used to stabilize and immobilize healing bone

Protective Proteins

nterferons - hormone-like peptides that serve as antiviral substances, are produced by cells when they are infected with viruses and induce nearby cells to produce antiviral enzymes that protect them from infection. Prevent further viral replication Complement Aids in phagocytosis & the inflammatory response

Nutrient foramina

on bone surface

Respiratory Cycle

one cycle of normal breathing

Orthopedics

originated as the name implies, as the treatment of skeletal deformities in children Deals with the prevention and correction of injuries and disorders of bones, joints, and muscles Includes the design of artificial joints and limbs and the treatment of athletic injuries

Axon (nerve fiber)

originates from a mound on one side of the soma called the axon hillock

Acids, Bases, and Buffers

pH of a solution is determined solely by its hydrogen ions (H+) Acid - any chemical that releases H+ in solution Strong acids such as hydrochloric acid (HCl) ionize freely Gives up most of its H+ Markedly lowers pH of a solution Weak acids such as carbonic acid (H2CO3) ionize only slightly Keeps most H+ chemically bound Does not affect pH Base - any chemical that accepts H+ Strong bases, such as the hydroxide ion (OH−), have a strong tendency to bind H+, markedly raising pH Weak bases, such as the bicarbonate ion (HCO3−), bind less available H+ and have less effect on pH 7.35 to 7.45 is the normal pH range of blood and tissue fluid Challenges to acid-base balance Metabolism constantly produces acid Lactic acid from anaerobic fermentation Phosphoric acid from nucleic acid catabolism Fatty acids and ketones from fat catabolism Carbonic acid from carbon dioxide Buffer - any mechanism that resists changes in pH Convert strong acids or bases to weak ones Physiological buffer - system that controls output of acids, bases, or CO2 2 major body systems that buffer body fluids: Urinary system buffers greatest quantity of acid or base Takes several hours to days to exert its effect Expel H+ from the body Respiratory system buffers within minutes Cannot alter pH as much as the urinary system

Palatine tonsils

pair of posterior margin of oral cavity. Most often infected

Pallor

pale or ashen color when there is so little blood flow through the skin that the white color of dermal collagen is visible --Emotional stress, low blood pressure, circulatory shock, cold, anemia

Quadriplegia

paralysis of all four limbs

Paraplegia

paralysis of both lower limbs

Hemiplegia

paralysis on one side of the body

Abdominal aorta

part of the descending aorta in the abdomen

Paresis

partial paralysis or weakness of the limbs

Pedicle

pillarlike

lamina

platelike

Somatotopy

point-to-point correspondence between an area of the body and an area of the CNS

Coronal suture

posterior boundary of frontal bone

Pleural Cavity

potential space between pleurae

Megakaryoctyes

precursor to platelets

Closed reduction

procedure in which the bone fragments are manipulated into their normal positions without surgery

Myelination

production of the myelin sheath

Tendon organs

proprioceptors in a tendon near its junction with a muscle

Blood-brain barrier

protects blood capillaries throughout brain tissue

Cranium (braincase)

protects the brain and associated sense organs

Globin

proteins chains. CO2 binds here

Retraction

push back

Protraction

push forward

Alveolar ventilation rate

rate of CO2 and O2 exchange

Superior vena cava

receives blood from upper part of body. Takes blood to RA of heart

Hemoglobin

red pigment of red blood cells -Adds reddish to pinkish hue to skin Carotene—yellow pigment acquired from egg yolks and yellow/orange vegetables --Concentrates in stratum corneum and subcutaneous fat Colors of diagnostic value

Right hemisphere

representational hemisphere Perceives information in a more integrated holistic way Seat of imagination and insight Musical and artistic skill Perception of patterns and spatial relationships Comparison of sights, sounds, smells, and taste Highly correlated with handedness Left hemisphere is the categorical one in 96% of right-handed people Right hemisphere in 4%

Left-handed people

right hemisphere is categorical in 15% and left in 70% Lateralization develops with age Males exhibit more lateralization than females and suffer more functional loss when one hemisphere is damaged

Inversion

rolling foot in

Rotation

rolling of extremity

Lingual tonsils

root or back of tongue

Dermatology

scientific study and medical treatment of the integumentary system

cerebrospinal fluid

secreted by Ependymal cells, clear liquid that bathes the CNS

Visceral pleura

serous membrane that covers the lungs

Sulci

shallow grooves

Perichondrium

sheath of dense irregular connective tissue

Ball and socket

shoulder-joint. can move in multiple directions

micron

small

Tubercle

small rough raised bump where muscles attach

Lymph capillaries

smallest lymphathic vessels

Glabella

smooth area above root of the nose

Frontal sinus

space within the frontal bone above the nasal bridge

Proprioceptor

specialized sense organ to monitor position and movement of body parts; stretch receptor is this

Choroid plexus

spongy mass of blood capillaries on the floor of each ventricle

Coma or hibernation

states of prolonged unconsciousness where individuals cannot be aroused by sensory stimulation

coma or hibernation

states of prolonged unconsciousness where individuals cannot be aroused by sensory stimulation

Organ

structure with discrete boundaries that is composed of two or more tissue types

biologia

study of living things

Microbiology

study of small living things

Abduction

take away from mid-line

Efferent lymphatic vessels

take lymph from the lymph nodes

Sleep

temporary state of unconsciousness from which one can awaken when stimulated

Sleep (term)

temporary state of unconsciousness from which one can awaken when stimulated

Soma (cell body)

the control center of the neuron

Heart

the heart

Gomphosis

the joint teeth join

Cognition

the range of mental processes by which we acquire and use knowledge

Gray matter

the seat of neuron cell bodies, dendrites, and synapses Dull white color when fresh, due to little myelin Forms surface layer (cortex) over cerebrum and cerebellum Forms nuclei deep within brain

Histology (microscopic anatomy)

the study of tissues and how they are arranged into organs

Gyri

thick folds

Corpus callosum

thick nerve bundle at bottom of longitudinal fissure that connects hemispheres

Meninges (term)

three fibrous connective tissue membranes that enclose the brain and spinal cord

Perforating (Volkmann) canals

transverse or diagonal canals

Sub-Disciplines of Microbiology

-Bacteriology: Study of prokaryotes -Mycology: Study of fungi -Phycology: Study of algae -Protozoology: The study of protozoa -Virology: The study of viruses -Immunology: The study of the immune system

Facets

-Flat articular surfaces covered with hyaline cartilage

Ways to study human anatomy

1. Feels a structure of the body, inspection, palpation, auscultation, percussion 2. Cadaver dissection 3. Comparative anatomy 4. Exploratory surgery 5. Medical imaging

3 Components to a negative feedback loop

1. Receptor: detects drop in bp caused by sitting up suddenly from bed (sensory nerve ending = thermometer) 2. Integrating (control) center: Control center that processes the sensory information, "make a decision" and directs the response (e.g. cardiac center of the brain)(thermostat) 3.Effector: carries out the final corrective action to restore homeostasis (e.g. gland or muscle)(furnace)

Cell Shapes

1. Squamous: Flat (like epidermal cells) 2. Cuboidal: Cube shaped or round (like cells or a gland) 3. Columnar: Tall rectangles (like lining of GI and respiratory tract) 4. Polygonal: Like polygon 5. Stellate: Star-shaped (nerves) 6. Spheroid: Like sphere (WBCs) 7.Discoid: Like disc (RBCs) 8.Fusiform (spindle-shaped)(smooth muscle) 9.Fibrous: Like fiber (skeletal and cardiac muscle)

Hierarchy of Complexity

1.Organism is composed of organ systems: Living 2.Organ systems are composed of organs: Living 3.Organs composed of tissues: Living 4.Tissues are composed of cells: Living 5.Cells composed of organelles: Living 6.Organelles composed of molecules: Non-living 7.Molecules are composed of atoms: Non-living

Characteristics of life

1.Organization: Higher level of organization than environment 2.Cellular Composition: Made of cells 3.Metabolism: Internal chemical changes 4.Responsiveness and movement: Detect and respond to stimuli 5.Homeostasis: Maintain relatively stable internal conditions 6.Development: Differentiation and growth 7.Reproduction: Producing copies of themselves; pass genes to offspring. 8.Evolution: Mutations: changes in genetic structure over time

Basic components of a cell and their subcomponents

1.Plasma membrane-Lipids, proteins, extensions 2.Cytoplasm-Organelles, cytoskeleton, cytosol

Types of medical imaging

1.X-rays: uses: Dense tissue pros: can see broken bones and dense structures. cons: Can't see soft tissue, dangerous 2.Radiopaque substances: Uses: Blood vessels, GI tract Pros: Can see if there are obstructions or stenosis in a hollow structure Cons: x-rays still used, dangerous 3.Computer Tomography (CT Scan): Uses: Slice-Type image Pros: Increased sharpness of image and low x-ray Cons: Can't see things in 3-D 4.Magnetic Resonance Imaging (MRI): Uses: Slice-type image for soft tissue Pros: Superior quality to CT scan Best for soft tissue Cons: Can't have metals things in the body 5.Sonography: Uses: Fetuses and internal tissues Pros: Avoids x-rays Cons: Image not very sharp 6.Positron Emission Tomography (PET) Scan: Uses: Metabolic state of tissue Pros: Can see most metabolic active tissue Cons: Not a sharp image

Alzheimer Disease

100,000 deaths/year 11% of population over 65; 47% by age 85 Memory loss for recent events, moody, combative, lose ability to talk, walk, and eat Show deficiencies of acetylcholine (ACh) and nerve growth factor (NGF) Diagnosis confirmed at autopsy Atrophy of gyri (folds) in cerebral cortex Neurofibrillary tangles and senile plaques Formation of β-amyloid protein from breakdown product of plasma membranes Treatment - halt β-amyloid production Research halted due to serious side effects Give NGF or cholinesterase inhibitors

The Ribs

12 pairs of ribs -No difference between sexes -Costal cartilages composed of hyaline cartilage attach anterior ends to sternum Head—portion of rib that articulates with thoracic vertebrae Neck—narrow portion distal to the head Angle—lateral curve of rib Shaft—long, gentle sloping, bladelike portion of rib True ribs (ribs 1-7) -Each has own costal cartilage connecting to sternum False ribs (ribs 8-12) -Lack independent cartilaginous connection to sternum -Floating ribs (ribs 11-12) --Articulate with bodies of vertebrae T11 and T12 --Do not have tubercles --Do not attach to transverse processes of the vertebra --No cartilaginous connection to the sternum or any of the higher costal cartilages

The Thoracic Vertebrae

12 thoracic vertebrae (T1-T12) -Corresponds to the 12 pairs of ribs attached to them

Alveoli

150 million alveoli in each lung, providing about 70 m2 of surface for gas exchange Cells of the alveolus 1. Squamous (type I) alveolar cells Thin, broad cells that allow for rapid gas diffusion between alveolus and bloodstream Cover 95% of alveolus surface area 2. Great (type II) alveolar cells Repair the alveolar epithelium when type I cells damaged Secrete pulmonary surfactant Coats alveoli and prevents them from collapsing during exhalation . Alveolar macrophages (dust cells) Most numerous of all cells in the lung Wander the lumen and the connective tissue between alveoli Keep alveoli free from debris by phagocytizing dust particles 100 million dust cells perish each day as they ride up the mucociliary escalator to be swallowed and digested with their load of debris

Celiac Artery

1st branch off the abdominal aorta. supplies the lower body

Brachiocephalic artery

1st branch off the aortic arch

Hepatic portal system

2 capillary bed filtration system

Eosinophils

2-40%.. Increase in the presence of parasitic infections, collagen disease, allergies, disease of spleen and CNS

Erythrocyte Production

2.5 million RBCs are produced per second Average lifespan of about 120 days Development takes 3 to 5 days Iron—key nutritional requirement Lost daily through urine, feces, and bleeding

Superior Mesenteric Artery

2nd branch off the abdominal aorta. Supplies upper GI tract and mesentaries

Sodium Homeostasis

3 major mechanisms affecting sodium concentration 1. Aldosterone: "salt-retaining hormone" Primary role in adjusting sodium excretion Elevated blood pressure inhibits the renin-angiotensin-aldosterone system & kidneys reabsorb almost no sodium 2. ADH: "water-retaining hormone" Retains water independent of sodium Concentrates urine with sodium while keeping water volume High Na+ in blood causes ADH release lowers blood Na+ Low Na+ in blood inhibits ADH release increases blood Na 3. Atrial natriuretic hormone (ANH) and brain natriuretic peptide (BNP) Inhibits sodium and water reabsorption, and the secretion of renin and ADH Kidneys eliminate more sodium and water, lowering blood pressure

Spinal Nerves

31 pairs of spinal nerves (mixed nerves) 8 cervical (C1-C8); C1 between skull and atlas Others exiting at intervertebral foramen 12 thoracic (T1-T12) 5 lumbar (L1-L5) 5 sacral (S1-S5) 1 coccygeal (Co) Posterior (dorsal) root is sensory input to spinal cord Posterior (dorsal) root ganglion: contains the somas of sensory neurons carrying signals to the spinal cord Anterior (ventral) root is motor output out of spinal cord These merge to form spinal nerve proper that enters intervertebral foramen

Left subclavian artery

3rd branch off of the aortic arch. Feeds the left arm

Inferior mesenteric Artery

3rd branch off the abdominal aorta. Supplies mesenteries and colon

Sacral curvature

5 fused vertebrae. Forms posterior wall of pelvic cavity; has median sacral crest formed from fusion of spinous processes

Lumbar curvature

5 vertebrae. Have thick, stout body

The Coronary Circulation

5% of blood pumped by heart is pumped to the heart itself through the coronary circulation to sustain its strenuous workload 250 mL of blood per minute Needs abundant O2 and nutrients

Neutrophils

60-70%%. small. First responders. Increase in number in bacterial infections. wonders and doesnt leave blood

Cervical curvature

7 Vertebrae. C1-Atlas: support head. Delicate ring surrounding a large "vertebral forman". C2-Axis: Allows rotation of head.

Phospholipids

75% of molecules in plasma membrane

Basophils

<1%.. increase in number in chickenpox, sinusitis, diabetes, secretes heparin and histime

Symbiosis

A general term used to denote a situation in which two organisms live together in a close partnership

Trochanter

A giant lump of bone

Foramen

A hole in a bone

Sinus

A hollowed out area

Synchondrosis

A joint in which the bones are bound by hyaline cartilage

Pivot

A joint that is uniaxial and the bone spins on its longitudinal axis

Synapses

A nerve signal can go no further when it reaches the end of the axon Triggers the release of a neurotransmitter Stimulates a new wave of electrical activity in the next cell across the synapse Synapse between two neurons First neuron in the signal path is the presynaptic neuron Releases neurotransmitter Second neuron is postsynaptic neuron Responds to neurotransmitter A neuron can have an enormous number of synapses Spinal motor neuron covered by about 10,000 synaptic knobs from other neurons 8,000 ending on its dendrites 2,000 ending on its soma In the cerebellum of brain, one neuron can have as many as 100,000 synapses

Stages in the Normal Growth Curve

A population of bacteria displays a predictable pattern called a growth curve Lag Phase Exponential Growth Phase Stationary Growth Phase Death Phase

The Population Growth Curve

A population of bacteria does not maintain its potential growth rate and double endlessly A population displays a predictable pattern called a growth curve The method to observe the population growth pattern: Place a tiny number of cells in a sterile liquid medium Incubate this culture over a period of several hours Sampling the broth at regular intervals during incubation Plating each sample onto solid media Counting the number of colonies present after incubation

Parasitism

A relationship in which the host organism provides the parasitic species with nutrients and a habitat and the host is harmed in the relationship.

Widowmaker

A sudden occlusion of the proximal left anterior descending coronary artery (LAD) has very grave consequences due to the large size of myocardium perfused by the LAD. (an occlusion anecdotally termed "the widow maker" due to its occurrence in elderly males)

Meatus or Canal

A tunnel (ear)

Fossa

A valley or indentation in a bone

Osmotic Pressure

A. Adding large amounts of salt or sugar to foods creates a hypertonic environment for bacteria causing plasmolysis ad making it impossible for the bacteria to multiply

Germicidal Categories According to Chemical Group

A. The Halogen Antimicrobial Chemicals 1. Halogens - fluorine, bromine, chlorine, and iodine; microbicidal; sporicidal with longer exposure B. Iodine and Its Compounds 1. Free iodine and iodophors C. Application of Iodine Solution 1. Aqueous iodine 2. Iodine tincture is 2% solution of iodine and sodium iodide in 70% alcohol 3. Iodophors - complexes of iodine and alcohol; these compounds have largely replaced free iodine solutions in medical antisepsis because they are less prone to staining or irritating tissues a.Betadine b.Povidone (PVP) c.Isodine D. Phenol and Its Derivatives 1. Phenol (carbolic acid) E. Applications of Phenolics 1. Phenol - used for general disinfection of drains, cesspools, and animal quarters, but it is seldom applied as a medical germicide F.Chlorhexidine 1. Chlorhexidine - complex organic base containing chlorine and two phenolic rings 2. Alcoholic or aqueous solutions of chlorhexidine are now commonly used for hand scrubbing, preparing skin site for surgical incisions and injections, and whole-body washing G. Alcohols as Antimicrobial Agents 1. Alcohols - colorless hydrocarbons with one or more - OH functional groups; only ethyl and isopropyl are suitable for microbial control H. Applications of Alcohols 1. Ethyl alcohol 2. Skin degerming agents 3. Isopropyl alcohol 4. Disinfection or skin cleansing I. Hydrogen Peroxide and Related Germicides 1. Hydrogen Peroxide (H₂O₂) - colorless, caustic liquid that decomposes in the presence of light, metals, or catalase into water and oxygen gas a. Bactericidal, virucidal, fungicidal, and, in higher concentrations, sporicidal J. Applications of Hydrogen Peroxide 1. Skin and wound cleansing, bedsore care, and mouth washing 2. Low temperature sterilizing cabinets that contain liquid chemical sterilants 3. Hydrogen Peroxide (35%) and Peracetic acid (35%) 4. Vaporized hydrogen peroxide can also be used as a sterilant in enclosed areas K.Chemical with Surface Action: Detergents 1. Detergents are polar molecules that act as surfactants 2. Anionic detergents have limited microbicidal power 3. (Cationic) detergents a. Quaternary ammonium compounds L.Applications of Detergents and Soaps 1. Quaternary ammonium compounds (quats) a. Benzalkonium chloride, Zephiran, and cetylpyridinium chloride b. Disinfect and sanitize floors, furniture, equipment surfaces, and restrooms 2. Soaps are weak microbicides 3. Sudsing and wetting properties of soap help mechanically remove large amounts of surface soil, greases, and other debris that contains microorganisms M. Heavy Metal Compounds 1. Mercury, silver, gold, copper, arsenic, and zinc N. Applications of Heavy Metals 1. Mercury tinctures such as thimerosal and nitro-mersol (Metaphen) are fairly effective antiseptics and infection preventives, but they should never be used on broken skin because they are harmful and can delay healing 2. Silver nitrate (AgNO₃) solution a. Used in late 19th century for preventing gonococcal infections in the eyes of newborn infants who had been exposed to an infected birth canal b. Replaced by antibiotics in most instances O.Aldehydes as Germicides 1. Aldehydes a. Glutaraldehyde b. Formaldehyde 2. Glutaraldehyde - officially accepted as a sterilant and high-level disinfectant. Kills spores in 3 hours and fungi and vegetative bacteria in a few minutes 3. Formaldehyde - gas aqueous solution called formalin; disinfectant, acts slower than glutaraldehyde; extremely toxic 4. Ortho-phthalaldehyde - faster acting than flutaraldehyde; disadvantages are an inability to reliably destroy spores P. Applications of the Aldehydes 1. Glutaraldehyde - sterilizing materials that are damaged by heat 2. Formalin tincture (8%) has limited use as a disinfectant for surgical instruments Q. Gaseous Sterilants and Disinfectants 1. Ethylene oxide - is a colorless substance that exists as a gas at room temperature 2. One of a few gases generally accepted for chemical sterilization because it is a sporicide a. 90 minutes to 3 hours 3. Chlorine dioxide - another gas; used as a sterilant a. Decontamination of Senate offices after the anthrax attack of 2001 R.Applications of Gases and Aerosols 1. Ethylene oxide - sterilize and disinfect plastic materials and delicate instruments in hospitals and industries S. Dyes as Antimicrobial Agents 1. Aniline dyes 2. Crystal violet 3. Malachite green 4. Yellow acridine dyes a. Acriflavine b. Proflavine T. Acids and Alkalis 1. Low or high pH can destroy or inhibit microbial cells; limited in applications due to their corrosive, caustic, and hazardous nature 2. Base ammonium hydroxide 3. Organic acids used in food preservation a. Vinegar - pickling agent

Naturally Acquired Immunity

Active immunity Exposed to live pathogens - get the disease Result: long-term immunity; make antibodies; Passive immunity Antibodies are passed from mother to infant Result: short-term immunity; does not make antibodies

Artificially Acquired Immunity

Active immunity Vaccination; simulates getting the disease Long-term immunity; make antibodies Passive immunity Injection of gamma globulin (antibodies produced by another) Short-term immunity; does not stimulate the production of antibodies Anti-toxin - antibodies against toxins Antivenoms - antibodies against snake venom

Adipose Tissue

Adipose tissue (fat): tissue in which adipocytes are the dominant cell type Space between adipocytes is occupied by areolar tissue, reticular tissue, and blood capillaries Fat is the body's primary energy reservoir Energy storage, insulation, cushioning -Subcutaneous fat and organ packing -Brown fat (Infants & hibernating animals) produces heat Empty-looking cells with thin margins; nucleus pressed against cell membrane

Lymphocytes

All originate from the bone marrow stem cell T lymphocytes - differentiated in the thymus gland (70-80 percent of circulating lymphocytes) T-cells - cell-mediated immunity B lymphocytes -- differentiated in the fetal liver and bone marrow (20-30 percent of circulating lymphocytes) B-cells - antibody-mediated immunity

Muscle Responses in the Laboratory

All-or-none law: a muscle fiber contracts completely or not at all A whole muscle shows degrees of contraction -Muscle twitch: a single contraction that lasts only a fraction of a second --Latent period --Contraction period --Relaxation period -Summation: increased muscle contraction -Tetanic contraction: maximal sustained contraction Fatigue -Muscle relaxes even though stimulation continues -Reasons for fatigue --ATP is depleted --Accumulation of lactic acid in the sarcoplasm inhibits muscle function --ACh may become depleted

Aneurysm

Aneurysm— weak point in an artery or the heart wall Forms a thin-walled, bulging sac that pulsates with each heartbeat and may rupture at any time Dissecting aneurysm: blood accumulates between the tunics of the artery and separates them, usually because of degeneration of the tunica media Most common sites: abdominal aorta,(AAA) renal arteries, and arterial circle at base of brain. Can cause pain by putting pressure on other structures Can rupture causing hemorrhage Result from congenital weakness of the blood vessels or result of trauma or bacterial infections such as syphilis Most common cause is atherosclerosis and hypertension

Angina and Heart Attack

Angina pectoris—chest pain from partial obstruction of coronary blood flow Pain caused by ischemia of cardiac muscle Obstruction partially blocks blood flow Myocardium shifts to anaerobic fermentation, producing lactic acid and thus stimulating pain Myocardial infarction (MI)—sudden death of a patch of myocardium resulting from long-term obstruction of coronary circulation Cardiac muscle downstream of the blockage dies Heavy pressure or squeezing pain radiating into the left arm Some painless heart attacks may disrupt electrical conduction pathways, leading to fibrillation and cardiac arrest Silent heart attacks occur in diabetics and the elderly MI responsible for about half of all deaths in the United States

External-Prokaryotic Cell

Appendages -Flagella - attached to the cell by a basal body; movement pushes cell forward; provides motility -Pili - Used for transfer of DNA to other cells -Fimbriae - Help provide adhesion to other cells and surfaces Glycocalyx - Coating external to cell wall. Protects cell, adheres to other surfaces, and performs receptor functions -Slime (loose); Capsule (tight)

Bone Widening and Thickening

Appositional growth: bones increase in width throughout life -Deposition of new bone at the surface Bone remodeling occurs throughout life: 10% per year -Repairs microfractures, releases minerals into blood, reshapes bones in response to use and disuse -Wolff's law of bone: architecture of bone determined by mechanical stresses placed on it and bones adapt to withstand those stresses --Remodeling is a collaborative and precise action of osteoblasts and osteoclasts --Bony processes grow larger in response to mechanical stress

Arteries

Arteries are sometimes called resistance vessels because they have a relatively strong, resilient tissue structure that resists high blood pressure Conducting (elastic or large) arteries Biggest arteries Aorta, common carotid, subclavian, pulmonary trunk, and common iliac arteries Expand during systole, recoil during diastole which lessens fluctuations in blood pressure Distributing (muscular or medium) arteries Distributes blood to specific organs Brachial, femoral, renal, and splenic arteries Smooth muscle layers constitute three-fourths of wall thickness Resistance (small) arteries Arterioles: smallest arteries Control amount of blood to various organs Thicker tunica media in proportion to their lumen than large arteries and very little tunica externa

General Anatomy of the Blood Vessels

Arteries carry blood away from heart Veins carry blood back to heart Capillaries connect smallest arteries to veins

Arthritis and Artificial Joints

Arthritis: a broad term for pain and inflammation of a joint Most common crippling disease in the United States Rheumatologists: physicians who treat arthritis and other joint disorders Osteoarthritis (OA): most common form of arthritis "Wear-and-tear arthritis" -Results from years of joint wear -Articular cartilage softens and degenerates -Accompanied by crackling sounds called crepitus -Bone spurs develop on exposed bone tissue causing pain Rheumatoid arthritis (RA): autoimmune attack against the joint tissues -Misguided antibodies (rheumatoid factor) attack synovial membrane, enzymes in synovial fluid degrade the articular cartilage, joint begins to ossify -Ankylosis: solidly fused, immobilized joint -Remissions occur, steroids and aspirin control inflammation Arthroplasty: replacement of diseased joint with artificial device called prosthesis

Hyaline cartilage

Articular cartilage, costal cartilage, trachea, larynx, fetal skeleton Eases joint movement, holds airway open, moves vocal cords during speech

General Anatomy of Synovial Joints

Articular cartilage: layer of hyaline cartilage that covers the facing surfaces of two bones -Usually 2 or 3 mm thick Joint (articular) cavity: separates articular surfaces Synovial fluid: slippery lubricant in joint cavity -Gives it a viscous, slippery texture like raw egg whites -Nourishes articular cartilage and removes waste -Makes movement of synovial joints almost friction free Joint (articular) capsule: connective tissue that encloses the cavity and retains the fluid In a few synovial joints, fibrocartilage grows inward from the joint capsule -Articular disc forms a pad between articulating bones that crosses the entire joint capsule --Temporomandibular joint, distal radioulnar joints, sternoclavicular and acromioclavicular joints -Meniscus: in the knee, two cartilages extend inward from the left and right but do not entirely cross the joint --Absorb shock and pressure --Guide bones across each other --Improve the fit between bones --Stabilize the joints, reducing the chance of dislocation Accessory structures associated with synovial joints -Tendon: a strip or sheet of tough collagenous connective tissue that attaches muscle to bone --Most important structures in stabilizing a joint -Ligament: similar tissue that attaches one bone to another -Bursa: a fibrous sac filled with synovial fluid, located between adjacent muscles, where tendon passes over bone, or between bone and skin --Cushions muscles, helps tendons slide more easily over joints, modifies direction of tendon pull --Bursitis Range of motion (ROM): the degrees through which a joint can move -Aspect of joint performance -Physical assessment of a patient's joint flexibility

Spina Bifida Occulta

As the most common form, This form of spina bifida happens when one or a couple of vertebrae are not completely closed.. Nothing protrudes from the vertebral cleft and so there is rarely a physical disability associated with this form of spina bifida.

Third Trimester: Changes as the Due Date Approaches

As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited — the final countdown has begun!

Second Trimester: The Baby at 16 Weeks

As your body changes to make room for your growing baby, you may have: Body aches, such as back, abdomen, groin, or thigh pain Stretch marks on your abdomen, breasts, thighs, or buttocks Darkening of the skin around your nipples A line on the skin running from belly button to pubic hairline Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. Patches often match on both sides of the face. This is sometimes called the mask of pregnancy. Numb or tingling hands, called carpal tunnel syndrome Itching on the abdomen, palms, and soles of the feet. (Call your doctor if you have nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These can be signs of a serious liver problem.) Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.) Muscle tissue and bone continue to form, creating a more complete skeleton. Skin begins to form. You can nearly see through it. Meconium develops in your baby's intestinal tract. This will be your baby's first bowel movement. Your baby makes sucking motions with the mouth (sucking reflex). Your baby reaches a length of about 4 to 5 inches and weighs almost 3 ounces.

The Aorta and Its Major Branches

Ascending aorta Right and left coronary arteries supply heart Aortic arch Brachiocephalic Right common carotid supplying right side of head Right subclavian supplying right shoulder and upper limb Left common carotid supplying left side of head Left subclavian supplying shoulder and upper limb Descending aorta Thoracic aorta above diaphragm Abdominal aorta below diaphragm

The Hindbrain: Pons

Ascending sensory tracts Descending motor tracts Pathways in and out of cerebellum Cranial nerves V, VI, VII, and VIII Sensory roles: hearing, equilibrium, taste, facial sensations Motor roles: eye movement, facial expressions, chewing, swallowing, urination, and secretion of saliva and tears Reticular formation in pons contains additional nuclei concerned with sleep, respiration, posture

Spinal Tracts

Ascending tracts: carry sensory information up the spinal cord Descending tracts: carry motor information down the spinal cord All nerve fibers in a given tract have a similar origin, destination, and function

Binary Fission

Asexual process Binary - one cell becomes two Fission - by separating One complete cycle - 1 mother 2 daughter cells is called a generation or doubling time Within 4 hours, one cell could result in 4,096 bacteria if the organism's generation time equaled 20 minutes

Tissue Degeneration and Death

Atrophy: shrinkage of a tissue through a loss in cell size or number -Senile atrophy through normal aging -Disuse atrophy from lack of use (astronauts) Necrosis: premature, pathological death of tissue due to trauma, toxins, or infections -Infarction: sudden death of tissue when blood supply is cut off -Gangrene: tissue necrosis due to insufficient blood supply -Decubitus ulcer: bed sore or pressure sore --Pressure reduces blood flow to an area --Form of dry gangrene -Gas gangrene: anaerobic bacterial infection Apoptosis: programmed cell death -Normal death of cells that have completed their function and best serve the body by dying and getting out of the way -Phagocytized by macrophages and other cells -Billions of cells die by apoptosis -Every cell has a built-in "suicide program"

Heart Sounds

Auscultation—listening to sounds made by body First heart sound (S1), louder and longer "lubb," occurs with closure of AV valves, turbulence in the bloodstream, and movements of the heart wall Second heart sound (S2), softer and sharper "dupp," occurs with closure of semilunar valves, turbulence in the bloodstream, and movements of the heart wall S3—rarely heard in people over 30; slosh after S1/S2; indicative of heart failure when heard late in life

Myasthenia Gravis

Autoimmune disease in which antibodies attack neuromuscular junctions and bind ACh receptors together in clusters -Disease of women between 20 and 40 -Fiber becomes less and less sensitive to Ach -Effects usually first appear in facial muscles --Drooping eyelids and double vision, difficulty swallowing, and weakness of the limbs -Strabismus: inability to fixate on the same point with both eyes

Bacterial Flora and Intestinal Gas

Bacterial flora populate large intestine About 800 species of bacteria Digest cellulose and other undigested carbohydrates Body absorbs resulting sugars Help in synthesis of vitamins B and K Flatus—intestinal gas Average person produces 500 mL per day (flatus) from 7 to 10 L of gas present but reabsorbed Most is swallowed air, but hydrogen sulfide, indole, and skatole produce odor Hydrogen gas may explode during electrical cauterization used in surgery

Classes of Synovial Joints

Ball-and-socket joints -Smooth, hemispherical head fits within a cuplike socket -Shoulder joint: head of humerus into glenoid cavity of scapula -Hip joint: head of femur into acetabulum of hip bone -Only multiaxial joints in the body Condylar (ellipsoid) joints -Oval convex surface on one bone fits into a complementary-shaped depression on the other -Radiocarpal joint of the wrist -Metacarpophalangeal joints at the bases of the fingers -Biaxial joints—movement in two planes Saddle joints -Both bones have an articular surface that is shaped like a saddle, concave in one direction and convex in the other -Biaxial joint -More movable than a condyloid or hinge joint forming the primate opposable thumb Plane (gliding) joints -Flat articular surfaces in which bones slide over each other with relatively limited movement -Usually biaxial joint Hinge joints -One bone with convex surface that fits into a concave depression on other bone -Elbow joint: ulna and humerus -Knee joint: femur and tibia -Finger and toe joints -Monoaxial joint: move freely in one plane Pivot joints -Atlantoaxial joint (dens of axis and atlas) -Monoaxial joint

Neural Control

Baroreflex—an automatic, negative feedback response to changes in blood pressure Increases in BP detected by carotid sinuses Signals sent to brainstem by way of glossopharyngeal nerve Inhibit the sympathetic cardiac and vasomotor neurons reducing sympathetic tone, and excite vagal fibers to the slowing of heart rate and cardiac output, thus reducing BP. Vaso- Vagal Response Decreases in BP have the opposite effect Baroreflexes important in short-term regulation of BP but not in cases of chronic hypertension They work well for adjustments for rapid changes in posture

Skeletal Muscles of the Body

Basic principles -Origin - attachment of a muscle to the immovable bone -Insertion - attachment of a muscle to the bone that moves -Agonist (Prime mover) - muscle that does most of the work in a movement -Synergist - muscles that assist the prime mover -Antagonists - muscles that work opposite one another to bring about movement in opposite directions Naming muscles -Size -Shape -Direction of fibers -Location -Attachment -Number of attachments -Action Muscles of the head -Muscles of Facial Expression --Frontalis- raise eye brows --Orbicularis oculi- Close eye --Orbicularis oris- Close lips --Buccinator- adduct cheeks --Zygomaticus- elevate conner of mouth -Muscles of Mastication --Masseter muscles- elevate mandible --Temporalis muscles- elevate mandible Muscles of the neck and head -Muscles that move the head --Sternocleidomastoid (SCM) - lateral flex and rotate head --Trapezius muscles - lateral flex neck and head, elevate shoulder, bilateral extend head and neck. Muscles of the trunk -Muscles of the thoracic wall- assist in respiration --External intercostal muscles --Diaphragm --Internal intercostal muscles -Muscles of the abdominal wall- flexion of the torso --External and internal obliques --Transversus abdominis --Rectus abdominis Muscles of the shoulder -Muscles that move the scapula --Trapezius - elevates and rotates the scapula --Serratus anterior- abducts scapula -Muscles that move the arm --Deltoid - flex, extend, & abduct arm --Pectoralis major - flex and adducts arm --Latissimus dorsi - extends and adducts arm --Rotator cuff muscles ---Supraspinatus - abduct arm ---Infraspinatus - lateral (external) rotation ---Teres minor - lateral (external) rotation ---Subscapularis - medial (internal) rotation Muscles of the arm -Biceps brachii - flex elbow -Brachialis - flex elbow -Triceps brachii - extend elbow Muscles of the forearm -Flexors anterior surface -Extensor posterior surface Muscles of the Hip and Lower Limb -Muscles that move the thigh --Iliopsoas- flex hip --Gluteus maximus- extend hip --Gluteus medius- abduct hip --Adductor group muscles- groin Muscles of the Hip and Lower Limb (continued) -Muscles that move the leg --Quadriceps femoris group- extend the knee ---Rectus femoris ---Vastus lateralis ---Vastus medialis ---Vastus intermedius --Hamstring group- flex the knee ---Biceps femoris ---Semimembranosus ---Semitendinosus Muscles of the Hip and Lower Limb (continued) -Muscles that move the ankle and foot --Gastrocnemius- plantar flexion --Tibialis anterior- dorsi flexion

Biotechnology and Bioremediation

Biotechnology- when humans manipulate microorganisms to make products in an industrial setting -Genetic engineering- create new products and genetically modified organisms (GMOs) -Recombinant DNA technology- allows microbes to be engineered to synthesize desirable proteins (i.e. drugs, hormones, and enzymes) Bioremediation- introducing microbes in to the environment to restore stability or clean up toxic pollutants -Oil spills -Chemical spills -Water and sewage treatment

Blood Pressure

Blood pressure (BP)—the force that blood exerts against a vessel wall Measured at brachial artery of arm using sphygmomanometer Two pressures are recorded Systolic pressure: peak arterial BP taken during ventricular contraction (ventricular systole) Diastolic pressure: minimum arterial BP taken during ventricular relaxation (diastole) between heart beats Normal value, young adult: 120/75 mm Hg Pulse pressure—difference between systolic and diastolic pressure Important measure of stress exerted on small arteries by pressure surges generated by the heart Hypertension—high blood pressure Chronic is resting BP > 140/90 Consequences Can weaken small arteries and cause aneurysms Hypotension—chronic low resting BP Caused by blood loss, dehydration, anemia BP rises with age Arteries less distensible and absorb less systolic force

Blood Types

Blood types and transfusion compatibility are a matter of interactions between plasma proteins and erythrocytes blood types A, B, AB, and O Blood types are based on interactions between antigens and antibodies Antigens Complex molecules on surface of cell membrane that are unique to the individual Used to distinguish self from foreign matter Foreign antigens generate an immune response Antibodies Proteins secreted by plasma cells Part of immune response to foreign matter Bind to antigens and mark them for destruction Forms antigen-antibody complexes You do not form antibodies against your antigens Agglutinogens -antigens on the surface of the RBC that is the basis for blood typing Agglutinins—antibodies in the plasma that bring about transfusion mismatch Agglutination - when agglutinin binds to agglutinogen, causing clumping of red blood cells

Blood Supply and the Brain Barrier System

Blood-brain barrier: protects blood capillaries throughout brain tissue Brain is only 2% of the adult body weight, and receives 15% of the blood 750 mL/min. Neurons have a high demand for ATP, and therefore, oxygen and glucose, so a constant supply of blood is critical to the nervous system A 10-second interruption of blood flow may cause loss of consciousness A 1- to 2-minute interruption can cause significant impairment of neural function Going 4 minutes without blood causes irreversible brain damage

General Structure of Vertebra

Body -Mass of spongy bone that contains red bone marrow -Covered with thin shell of compact bone -Weight-bearing portion -Rough superior and inferior surfaces provide firm attachment for intervertebral discs Vertebral foramina -Collectively form vertebral canal for spinal cord Vertebral arch -Composed of two parts on each side -Pedicle: pillarlike and lamina: platelike (Laminaectomy- Back surgery). Spinous process -Projection extending from the apex of arch -Extends posteriorly and downward Transverse process -Extends laterally from point where pedicle and lamina meet Superior articular processes -Project upward from one vertebra and meets inferior articular processes from the vertebra above Facets -Flat articular surfaces covered with hyaline cartilage Intervertebral foramen -When two vertebrae are joined they exhibit an opening between their pedicles -Passageway for spinal nerves Intervertebral discs (23) -First one between C2 and C3 -Last one between L5 and sacrum -Pad consisting of: --Nucleus pulposus: inner gelatinous mass --Anulus fibrosus: outer ring of fibrocartilage -Bind vertebrae together -Support weight of the body -Absorb shock -Herniated disc ("ruptured" or "slipped" disc) puts painful pressure on spinal nerve or spinal cord

Second Trimester: The Baby at 24 Weeks

Bone marrow begins to make blood cells. Taste buds form on your baby's tongue. Footprints and fingerprints have formed. Real hair begins to grow on your baby's head. The lungs are formed, but do not work. The hand and startle reflex develop. Your baby sleeps and wakes regularly. If your baby is a boy, his testicles begin to move from the abdomen into the scrotum. If your baby is a girl, her uterus and ovaries are in place, and a lifetime supply of eggs have formed in the ovaries. Your baby stores fat and has gained quite a bit of weight. Now at about 12 inches long, your baby weighs about 1½ pounds.

Bony Joints

Bony joint, or synostosis: an immovable joint formed when the gap between two bones ossifies, and the bones become, in effect, a single bone -Frontal and mandibular bones in infants -Cranial sutures in elderly -Attachment of first rib and sternum with old age Can occur in either fibrous or cartilaginous joint Fibrous Joints: Fibrous joint, synarthrosis, or synarthrodial joint: a point at which adjacent bones are bound by collagen fibers that emerge from one bone, cross the space between them, and penetrate into the other -Sutures: immovable or slightly movable fibrous joints that closely bind the bones of the skull to each other Cartilaginous Joints: Cartilaginous joint, amphiarthrosis, or amphiarthrodial joint: two bones are linked by cartilage -Symphyses Synchrondrosis: Synchrondrosis: bones are bound by hyaline cartilage -Temporary joint in the epiphyseal plate in children --Binds epiphysis and diaphysis -First rib attachment to sternum --Other costal cartilages are joined to sternum by synovial joints Symphysis: Symphysis: two bones joined by fibrocartilage -Pubic symphysis in which right and left pubic bones joined by interpubic disc -Bodies of vertebrae and intervertebral discs --Only slight amount of movement between adjacent vertebrae --Collective effect of all 23 discs gives spine considerable flexibility

Poliomyelitis and ALS

Both diseases cause destruction of motor neurons and production of skeletal muscle atrophy from lack of innervation Poliomyelitis Caused by the poliovirus Destroys motor neurons in brainstem and anterior horn of spinal cord Signs of polio include muscle pain, weakness, and loss of some reflexes Followed by paralysis, muscular atrophy, and respiratory arrest Virus spreads by fecal contamination of water Amyotrophic lateral sclerosis (ALS) or Lou Gehrig disease Destruction of motor neurons and muscular atrophy Also sclerosis (scarring) of lateral regions of the spinal cord Astrocytes fail to reabsorb the neurotransmitter glutamate from the tissue fluid Accumulate to toxic levels Early signs: muscular weakness, difficulty speaking, swallowing, and use of hands Sensory and intellectual functions remain unaffected

Uterine Contractility

Braxton Hicks contractions - relatively weak contractions of the uterus over the course of gestation Strengthen late in pregnancy: false labor Contractions transform suddenly into more powerful labor contractions Parturition - the process of giving birth Marked by the onset of true labor contractions As pregnancy nears full term - posterior pituitary releases more oxytocin (OT), uterus produces more OT receptors Oxytocin promotes labor in two ways Directly stimulates muscles of myometrium Stimulates fetal membranes to produce prostaglandins, which are synergists of oxytocin in producing labor contractions

The Breasts and Mammary Glands

Breast - mound of tissue overlying pectoralis major Enlarges at puberty and remains so for life Most of the time it contains very little mammary gland Mammary gland - develops within the breast during pregnancy Remains active in the lactating breast Atrophies when a woman ceases to nurse Two principal regions of the breast Body: conical to pendulous, with nipple at its apex Axillary tail: extension toward the armpit Lymphatics in axillary tail are important as a route for breast cancer metastasis Nipple surrounded by circular colored zone, called the areola Blood capillaries and nerves closer to skin surface: more sensitive Sensory nerve fibers of areola trigger a milk ejection reflex when an infant nurses The nonlactating breast consists mostly of adipose and collagenous tissue Breast size determined by amount of adipose tissue

Breast Milk

Breast milk changes composition over the first 2 weeks Varies from one time of day to another At the end of a feeding there is less lactose and protein, but six times the fat Cow's milk not a good substitute One-third less lactose but three times as much protein Harder to digest and more nitrogenous waste (diaper rash) Colostrum and milk have a laxative effect that clears intestine of meconium (green, bile-filled fecal material in newborn) Supplies antibodies and colonizes intestine with beneficial bacteria Nursing woman can produce 1.5 L per day

The Puerperium

Breast-feeding promotes involution Suppresses estrogen secretion which would make the uterus more flaccid Stimulates oxytocin secretion which causes myometrium to contract and firm up the uterus sooner

Mammary Glands

Breasts (mammae) of both sexes contain very little glandular material Mammary glands—milk-producing glands that develop only during pregnancy and lactation -Modified apocrine sweat gland -Richer secretion released by ducts opening into the nipple Mammary ridges or milk lines -Two rows of mammary glands in most mammals -Primates kept only anteriormost glands

Pulmonary Ventilation

Breathing (pulmonary ventilation)—consists of a repetitive cycle: one cycle of inspiration (inhaling) and expiration (exhaling) Respiratory cycle—one complete inspiration and expiration Quiet respiration: while at rest, effortless, and automatic Forced respiration: deep, rapid breathing, such as during exercise Must be pressure difference between air pressure within lungs and outside body Breathing muscles change lung volume and air pressure (diaphram, ext. & int. intercostals)

Coronary arteries

Brings blood to the heart to use. Feeds the heart

The Bronchial Tree

Bronchial tree - a branching system of air tubes in each lung From main bronchus to 65,000 terminal bronchioles Main (primary) bronchi - supported by C-shaped hyaline cartilage rings Right bronchus slightly wider and more vertical than left Aspirated (inhaled) foreign objects lodge right bronchus more often than the left Secondary & tertiary bronchi are smaller in diameter Bronchioles Lack cartilage 1 mm or less in diameter Well-developed layer of smooth muscle Branch into smaller bronchioles with alveoli budding from their walls

Homeostasis

Cardiac muscle contraction forces blood into the arteries and arterioles Smooth muscle in arteries and arterioles help maintain blood pressure Smooth muscle contraction moves food along the digestive tract and assists in the voiding of urine Skeletal muscles protect internal organs and stabilizes joints Skeletal muscles are active during breathing Heat produced by skeletal muscle contraction helps maintain normal body temperature Skeletal muscle contraction allows us to relocate our bodies

Anemia

Causes of anemia fall into three categories Inadequate erythropoiesis or hemoglobin synthesis Iron-deficiency anemia- Lack of Iron for use in erythropoiesis Pernicious anemia-Inadequate vitamin B12 from poor nutrition or lack of intrinsic factor Hypoplastic anemia—slowing of erythropoiesis Aplastic anemia—complete cessation of erythropoiesis Hemorrhagic anemias from bleeding Hemolytic anemias from RBC destruction (ex: sickle-cell anemia, erythroblastosis fetalis) Anemia has three potential consequences Tissue hypoxia and necrosis Patient is lethargic Shortness of breath upon exertion Life-threatening necrosis of brain, heart, or kidney Blood osmolarity is reduced producing tissue edema Blood viscosity is low Heart races and pressure drops Cardiac failure may ensue

The Importance of Chemical Signals

Cells and organs communicate with one another using chemical signals Chemical signals between individuals Called pheromones Humans produce airborne chemicals from a variety of areas

Fibrous Connective Tissue

Cells: -Fibroblasts produce fibers and ground substance -Macrophages phagocytize foreign material and activate immune system when they sense foreign matter (antigen) -Leukocytes, or white blood cells --Neutrophils wander about attacking bacteria --Lymphocytes react against bacteria, toxins, and other foreign material -Plasma cells synthesize disease-fighting antibodies --Arise from lymphocytes -Mast cells are found alongside blood vessels --Secrete heparin to inhibit clotting --Secrete histamine to dilate blood vessels -Adipocytes store triglycerides (fat molecules) Fibers -Collagenous fibers --Most abundant of the body's proteins - 25% --Tough, flexible, and resist stretching --Tendons, ligaments, and deep layer of the skin are mostly collagen --Less visible in matrix of cartilage and bone -Reticular fibers --Thin collagen fibers coated with glycoprotein --Form framework of such organs as spleen and lymph nodes -Elastic fibers --Thinner than collagenous fibers --Branch and rejoin each other --Made of protein called elastin --Allows stretch and recoil Ground substance -Usually a gelatinous to rubbery consistency resulting from three classes of large molecules

Blood Plasma

Centrifuge blood to separate components: Hematocrit - ratio of the volume of red blood cells to the total volume of blood Erythrocytes are heaviest and settle first 37% to 52% total volume White blood cells and platelets 1% total volume Buffy coat- middle layer Plasma The remainder of volume on top 47% to 63% Complex mixture of water, proteins, nutrients, electrolytes, nitrogenous wastes, hormones, and gases Plasma—liquid portion of blood (Above the Buffy Coat) Serum: remaining fluid when blood clots and the solids are removed Identical to plasma except for the absence of fibrinogen Three major categories of plasma proteins Albumins: smallest and most abundant Contribute to viscosity and osmolarity; influence blood pressure, flow, and fluid balance Globulins (antibodies) Provide immune system functions Alpha, beta, and gamma globulins Fibrinogen Precursor of fibrin threads that help form blood clots

Cerebral Lateralization

Cerebral lateralization: the difference in the structure and function of the cerebral hemispheres Left hemisphere: categorical hemisphere Specialized for spoken and written language Sequential and analytical reasoning (math and science) Breaks information into fragments and analyzes it in a linear way Right hemisphere: representational hemisphere Perceives information in a more integrated holistic way Seat of imagination and insight Musical and artistic skill Perception of patterns and spatial relationships Comparison of sights, sounds, smells, and taste Highly correlated with handedness Left hemisphere is the categorical one in 96% of right-handed people Right hemisphere in 4% Left-handed people: right hemisphere is categorical in 15% and left in 70% Lateralization develops with age Males exhibit more lateralization than females and suffer more functional loss when one hemisphere is damaged

PAP Smears and Cervical Cancer

Cervical cancer common among women ages 30 to 50 Smoking, early-age sexual activity, STDs, and human papillomavirus Usually begins in epithelial cells of lower cervix Best protection against cervical cancer is early detection by PAP smear Cells removed from cervix and vagina and microscopically examined Three grades of cervical intraepithelial neoplasia Class I is mild dysplasia Class II calls for a biopsy Class III results may call for radiation therapy or hysterectomy

The Cervical Vertebrae

Cervical vertebrae - atlas (C1) -Supports the head -Delicate ring surrounding a large vertebral foramen Cervical vertebrae—axis (C2) -Allows rotation of the head gesturing "no" -Dens or odontoid process—prominent knob on its anterosuperior side -Atlanto-occipital joint: between atlas and cranium -Atlantoaxial joint: between atlas and axis C7 vertebra prominens - spinous process not bifid and especially long -Prominent bump on lower back of neck; convenient landmark for counting vertebrae

Effects of Chemicals

Chemicals affect heart rate as well as neurotransmitters from cardiac nerves Blood-borne adrenal catecholamines (NE and epinephrine) are potent cardiac stimulants Drugs that stimulate heart Nicotine Thyroid hormone Caffeine Electrolytes K+ has greatest chronotropic effect Hyperkalemia—excess K+ in cardiocytes Myocardium less excitable, heart rate slows and becomes irregular Hypokalemia—deficiency K+ in cardiocytes Cells hyperpolarized, harder to stimulate emergency Calcium Hypercalcemia—excess of Ca2+ Decreases heart rate and contraction strength Hypocalcemia—deficiency of Ca2+ Increases heart rate and contraction strength

Cognition

Cognition: the range of mental processes by which we acquire and use knowledge Such as sensory perception, thought, reasoning, judgment, memory, imagination, and intuition Association areas of cerebral cortex have above functions Constitute about 75% of all brain tissue

Colostrum and Milk Synthesis

Colostrum forms in late pregnancy Similar to breast milk in protein and lactose, but contains one-third less fat First 1 to 3 days after birth Thin watery consistency and a cloudy yellow color Contains IgA to protect baby from gastroenteritis Prolactin (from anterior pituitary) promotes milk synthesis Synthesis of hormone begins 5 weeks into pregnancy, by full term it is 10 to 20 times normal level Little effect on mammary glands until after birth

Pulmonary arteries

Comes from the RV to the lungs carrying deoxygenated blood

Pulmonary trunk

Comes from the RV to the lungs carrying deoxygenated blood

Common carotid arteries

Comes from the brachiocephalic

Ascending Aorta

Comes off the left ventricle. Pumps blood to system

Heat as an Agents of Microbial Control

Common Methods of Moist Heat Control 1.Autoclave - a comparable home appliance is the pressure cooker 2.Most efficient pressure - temperature combination to achieving sterilization is 15 psi, which yields 121°C 3.Holding times vary from 10 minutes to 40 minutes, depending on the load; the average time is 20 minutes Nonpressurized Steam 1.Intermittent sterilization or tyndallization Pasteurization: Disinfection of Beverages 1.Pasteurization - heat is applied to liquids to kill potential agents while retaining liquid's flavor and food value Boiling Water: Disinfection 1.Exposing materials to boiling water for 30 minutes Dry Heat: Hot Air and Incineration 1. Incineration - flame or electric heating coil a.Bunsen burner flame b.Furnaces/incinerators 2. Large incinerators complete destruction and disposal of infectious materials 3. In a dry oven sterilization requires exposure to 150°C to 180°C for 2 to 4 hours

Arteries of the Head and Neck

Common carotid divides into internal and external carotids External carotid supplies most external head structures

Overview of Volume Changes

Congestive heart failure (CHF)—results from the failure of either ventricle to eject blood effectively Usually due to a heart weakened by myocardial infarction, chronic hypertension, valvular insufficiency, or congenital defects in heart structure Left ventricular failure—blood backs up into the lungs causing pulmonary edema Shortness of breath or sense of suffocation Right ventricular failure—blood backs up in the vena cava causing systemic or generalized edema Enlargement of the liver, ascites (pooling of fluid in abdominal cavity), distension of jugular veins, swelling of the fingers, ankles, and feet Left or Right ventricular failure eventually leads to total heart failure

Coronary Artery Disease

Coronary artery disease (CAD)—a constriction of the coronary arteries Usually the result of atherosclerosis: an accumulation of lipid deposits that degrade the arterial wall and obstruct the lumen Unavoidable risk factors: heredity, aging, being male Preventable risk factors: obesity, smoking, lack of exercise, anxious personality, stress, aggression, and diet Treatment Coronary bypass surgery Great saphenous vein (footgroin vein) harvested to replace coronary arteries Balloon angioplasty Laser angioplasty

Tissue Repair

Damaged tissues can be repaired in two ways: -Regeneration: replacement of dead or damaged cells by the same type of cell as before --Restores normal function --Skin injuries and liver regenerate Fibrosis: replacement of damaged cells with scar tissue -Holds organs together -Does not restore normal function Severe cuts and burns, healing of muscle injuries, scarring of lungs in tuberculosis

Menstrual Phase

Day 1 is your period Menstrual bleeding (menses) Lining is shedding the menstrual blood from the uterus through the cervix, vagina and out of the vaginal opening Day 1 is your period Menstrual bleeding (menses) Lining is shedding the menstrual blood from the uterus through the cervix, vagina and out of the vaginal opening

Deafness

Deafness: hearing loss Conductive deafness: conditions interfere with transmission of vibrations to inner ear Damaged tympanic membrane, otitis media, blockage of auditory canal, and otosclerosis Otosclerosis: fusion of auditory ossicles that prevents their free vibration Sensorineural (nerve) deafness: death of hair cells or any nervous system elements concerned with hearing Factory workers, musicians, construction workers

Aging and Sexual Function

Decline in testosterone secretion Peak secretion at 7 mg/day at age 20 Declines to one-fifth of that by age 80 Decline in the number and activity of interstitial cells (testosterone) and sustentacular cells (inhibin) Rise in FSH and LH secretion after age 50 produces male climacteric (andropause) Most have little or no effect Some experience mood changes, hot flashes, "illusions of suffocation" Erectile dysfunction (impotence)—the inability to produce or maintain an erection sufficient for intercourse 20% of men in 60s to 50% of those in 80s

The Major Systemic Veins

Deep veins run parallel to arteries while superficial veins have many anastomoses

Clotting Disorders

Deficiency of any clotting factor can shut down the coagulation cascade Hemophilia—family of hereditary diseases characterized by deficiencies of one factor or another Hematoma—mass of clotted blood in the tissues

Allergic Reactions - Delayed Reaction

Delayed-reaction allergy Takes 48 hours to occur Repeated exposure to substances

Atherosclerosis

Deposits of fats in the arteries

Cutaneous Innervation and Dermatomes

Dermatome: a specific area of the skin that receives sensory input from a pair of spinal nerves Dermatome map: a diagram of the cutaneous regions innervated by each spinal nerve Dermatomes overlap their edges as much as 50% Necessary to sever or anesthetize three successive spinal nerves to produce a total loss of sensation in one dermatome

The Dermis

Dermis—connective tissue layer beneath the epidermis -Ranges from 0.2 mm (eyelids) to 4 mm (palms, soles) -Composed mainly of collagen with elastic fibers, reticular fibers, and fibroblasts -Well supplied with blood vessels, sweat glands, sebaceous glands, and nerve endings Hair follicles and nail roots are embedded in dermis -Smooth muscle (piloerector muscles) associated with hair follicles -Contract in response to stimuli such as cold, fear, and touch—goose bumps Dermal papillae—upward fingerlike extensions of the dermis -Friction ridges on fingertips that leave fingerprints

Descent of the Gonads

Descent of the testes begins as early as 6 weeks In seventh month, testes abruptly pass through the inguinal canal into the scrotum guided by the gubernaculum Testes accompanied by elongating testicular arteries and veins, lymphatic vessels, nerves, spermatic ducts, and extensions of internal abdominal oblique muscle Cryptorchidism—boys born with undescended testes Occurs in about 3% of male births Most cases the testes descend during the first year of infancy If not, testosterone injection or simple surgery can draw testes into the scrotum Uncorrected cases lead to sterility or testicular cancer Ovaries descend to lesser extent Lodge on inferior brim of the lesser pelvis Gubernaculum becomes a pair of ligaments that supports the ovary and the uterus

The Respiratory Muscles

Diaphragm Prime mover of respiration Contraction flattens diaphragm, enlarging thoracic cavity and pulling air into lungs Relaxation allows diaphragm to bulge upward again, compressing the lungs and expelling air Internal and external intercostal muscles Synergist to diaphragm Between ribs Stiffen the thoracic cage during respiration & prevent it from caving inward when diaphragm descends Contribute to enlargement and contraction of thoracic cage Normal quiet expiration A passive process achieved by the elasticity of the lungs and thoracic cage As muscles relax, thoracic cavity is smaller and causes airflow out of the lungs Forced expiration Rectus abdominis, internal intercostals, and other lumbar, abdominal, and pelvic muscles Greatly increased abdominal pressure pushes viscera up against diaphragm increasing thoracic pressure, forcing air out Valsalva maneuver — consists of taking a deep breath, holding it by closing the glottis, and then contracting the abdominal muscles to raise abdominal pressure and push organ contents out Childbirth, urination, defecation, vomiting

Adjustments to Pregnancy

Digestive system Morning sickness: nausea especially arising from bed in first few months of gestation Unknown cause Constipation and heartburn due to: Reduced intestinal motility Pressure on stomach causing reflux of gastric contents into esophagus Metabolism Basal metabolic rate (BMR): rises about 15% in second half of gestation Appetite may be strongly stimulated Healthy average weight gain: 24 lb Nutrition Placenta stores nutrients in early gestation and releases them in the last trimester Demand especially high for protein, iron, calcium, and phosphates Needs extra iron during late pregnancy or will become anemic Vitamin K given in late pregnancy to promote prothrombin synthesis in the fetus Minimizes risk of neonatal hemorrhage especially in the brain Vitamin D supplements help ensure adequate calcium absorption to meet fetal demand Folic acid reduces the risk of neurological fetal disorders Spina bifida, anencephaly Supplements must be started before pregnancy Circulatory system By full term, placenta requires 625 mL of blood per minute from the mother Mother's blood volume rises about 30% during pregnancy Due to fluid retention and hemopoiesis Mother has about 1 to 2 L of extra blood

General Anatomy

Digestive system consists of two major parts: Digestive tract (alimentary canal) 30 ft long tube food passes through these organs Mouth, pharynx, esophagus, stomach, small intestine, and large intestine Accessory organs Food doesn't pass through these Teeth, tongue, salivary glands, liver, gallbladder, and pancreas

Digestive Function

Digestive system—the organ system that processes food, extracts nutrients from it, and eliminates the residue Five stages of digestion Ingestion: selective intake of food Digestion: mechanical and chemical breakdown of food into a form usable by the body Absorption: uptake of nutrient molecules into the epithelial cells of the digestive tract and then into the blood and lymph Compaction: absorbing water and consolidating the indigestible residue into feces Defecation: elimination of feces

Antibody Actions

Directly attack antigens Activate complement Stimulate changes in local areas to prevent the spread of pathogens or cells

Form and Function-Erythrocytes

Disc-shaped cell with thick rim Gas transport—major function 33% of cytoplasm is hemoglobin (Hb) 280 million hemoglobin molecules on one RBC O2 delivery to tissue and CO2 transport to lungs Carbonic anhydrase (CAH) in cytoplasm Produces carbonic acid from CO2 and water Important role in gas transport and pH balance

Lymphocytes

Diverse immune response

The Renal Tubule

Divided into four regions Proximal convoluted tubule (PCT) - arises from glomerular capsule Nephron loop (loop of Henle) - long U-shaped portion of renal tubule Descending limb and ascending limb Distal convoluted tubule (DCT) - begins shortly after the ascending limb reenters the cortex Collecting duct - receives fluid from the DCTs of several nephrons Flow of fluid from the point where the glomerular filtrate is formed to the point where urine leaves the body: glomerular capsule → proximal convoluted tubule → nephron loop → distal convoluted tubule → collecting duct → papillary duct → minor calyx → major calyx → renal pelvis → ureter → urinary bladder → urethra

Levels of Classification

Domain Kingdom Phylum or division Class Order Family Genus Species

Down Syndrome

Down syndrome (also called Trisomy 21) is a genetic disorder that occurs in approximately 1 of 800 live births. It is the leading cause of cognitive impairment. Down syndrome is associated with mild to moderate learning disabilities, developmental delays, characteristic facial features, and low muscle tone in early infancy. Many individuals with Down syndrome also have heart defects, leukemia, early-onset Alzheimer's disease, gastro-intestinal problems, and other health issues. The symptoms of Down syndrome range from mild to severe. Life expectancy for individuals with Down syndrome has dramatically increased over the past few decades as medical care and social inclusion have improved. A person with Down syndrome in good health will on average live to age 55 or beyond

Hemoglobin-Erythrocytes

Each Hb molecule consists of: Four protein chains—globins Four heme groups Heme groups Nonprotein moiety that binds O2 to ferrous ion (Fe2+) at its center Globins—four protein chains Two alpha and two beta chains 5% CO2 in blood is bound to globin moiety

Anatomy of the Ear

Ear has three sections: outer, middle, and inner ear First two are concerned only with the transmission of sound to the inner ear Inner ear: vibrations converted to nerve signals Outer ear: a funnel for conducting vibrations to the tympanic membrane (eardrum) Auricle (pinna) directs sound down the auditory canal Shaped and supported by elastic cartilage Auditory canal: passage leading through the temporal bone to the tympanic membrane External acoustic meatus: slightly S-shaped tube that begins at the external opening and courses for about 3 cm Middle ear: located in the air-filled tympanic cavity in temporal bone Tympanic membrane (eardrum) closes the inner end of the auditory canal Auditory (eustachian) tube connects middle-ear cavity to nasopharynx Equalizes air pressure on both sides of tympanic membrane Normally flattened and closed, and swallowing and yawning opens it Allows throat infections to spread to the middle ear Auditory ossicles Malleus: attached to inner surface of tympanic membrane Incus: articulates in between malleus and stapes Stapes: footplate rests on oval window - inner ear begins Middle ear (continued) Otitis media (middle-ear infection) Common in children Auditory tube is short and horizontal Infections easily spread from throat to tympanic cavity and mastoid air cells Symptoms Fluid accumulates in tympanic cavity producing pressure, pain, and impaired hearing Can spread leading to meningitis Can cause fusion of ear ossicles and hearing loss Tympanostomy: lancing tympanic membrane and draining fluid from tympanic cavity Inner ear Labyrinth: vestibule and three semicircular ducts Cochlea: organ of hearing Winds 2.5 coils around a screwlike axis of spongy bone, the modiolus Threads of the screw form a spiral platform that supports the fleshy tube of the cochlea

Ectopic Pregnancy

Ectopic pregnancy - blastocyst implants somewhere other than the uterus 1 out of 300 pregnancies Tubal pregnancies - implantation in the uterine tube Usually due to obstruction such as constriction resulting from pelvic inflammatory disease, tubular surgery, previous ectopic pregnancies, or repeated miscarriages Tube ruptures within 12 weeks Abdominal pregnancy - 1% of implantations occur in abdominopelvic cavity 1 out of 7,000 Can threaten mother's life 9% result in live birth by cesarean section

Edema

Edema—the accumulation of excess fluid in a tissue Occurs when fluid filters into a tissue faster than it is absorbed

Luteal Phase (If pregnant)

Egg fertilization during ovulation 5 days later, fertilized egg enters uterus and embeds This leads to and increase of hCG human Chorionic gonadotropin (hCG) is a hormone produced by the syncytiotrophoblast, a component of the fertilized egg, after conception hCG interrupts the menstrual cycle By having the Corpus Luteum produce Progesterone Which helps keep the endometrium alive for egg

The Carpal Bones

Eight bones form wrist -Allow movements of flexion, extension, abduction, and adduction Two rows (four bones each) -Proximal row: scaphoid, lunate, triquetrum, and pisiform -Distal row: trapezium, trapezoid, capitate, and hamate Scaphoid Fractures (Lunate displacement CTS)

The Elbow Joint

Elbow is a hinge joint composed of two articulations -Humeroulnar joint: where the trochlea of the humerus joins the trochlear notch of the ulna -Humeroradial joint: where the capitulum of the humerus meets the head of the radius

The Electrocardiogram

Electrocardiogram (ECG or EKG) Composite of all action potentials of nodal and myocardial cells detected, amplified and recorded by electrodes on arms, legs, and chest P wave SA node fires, atria depolarize and contract Atrial systole begins 100 ms after SA signal QRS complex Ventricular depolarization Complex shape of spike due to different thickness and shape of the two ventricles ST segment—ventricular systole Plateau in myocardial action potential T wave Ventricular repolarization and relaxation

Elevation and Depression

Elevation: movement that raises a body part vertically in the frontal plane Depression: movement that lowers a body part in the same plane

The Embryonic and Fetal Stages

Embryonic stage - begins when all three primary germ layers are present Usually 16 days after conception Placenta forms on uterine wall over the next 6 weeks Becomes the embryo's primary source of nutrition

Overview of the Nervous System

Endocrine and nervous systems maintain internal coordination -Endocrine system: communicates by means of chemical messengers (hormones) secreted into to the blood -Nervous system: employs electrical and chemical means to send messages from cell to cell Nervous system carries out its task in three basic steps -Sense organs receive information about changes in the body and the external environment, and transmit coded messages to the spinal cord and the brain -Brain and spinal cord process this information, relate it to past experiences, and determine what response is appropriate to the circumstances -Brain and spinal cord issue commands to muscles and gland cells to carry out such a response Nervous system has two major anatomical subdivisions -Central nervous system (CNS) --Brain and spinal cord enclosed in bony coverings --Enclosed by cranium and vertebral column -Peripheral nervous system (PNS) --All the nervous system except the --brain and spinal cord; composed of nerves and ganglia --Nerve: a bundle of nerve fibers (axons) wrapped in fibrous connective tissue --Ganglion: a knotlike swelling in a nerve where neuron cell bodies are concentrated Peripheral nervous system has two major functional subdivisions -Sensory (afferent) division: carries sensory signals from various receptors to the CNS --Informs the CNS of stimuli within or around the body --Somatic sensory division: carries signals from receptors in the skin, muscles, bones, and joints --Visceral sensory division: carries signals from the viscera of the thoracic and abdominal cavities ---Heart, lungs, stomach, and urinary bladder -Motor (efferent) division: carries signals from the CNS to gland and muscle cells that carry out the body's response --Effectors: cells and organs that respond to commands from the CNS --Somatic motor division: carries signals to skeletal muscles ---Output produces muscular contraction as well as somatic reflexes - involuntary muscle contractions --Visceral motor division (autonomic nervous system) ---Carries signals to glands, cardiac muscle, and smooth muscle ---Involuntary, and responses of this system and its receptors are visceral reflexes ---Sympathetic division ----Tends to arouse body for action ----Accelerating heart beat and respiration, while inhibiting digestive and urinary systems ---Parasympathetic division ----Tends to have calming effect ----Slows heart rate and breathing ----Stimulates digestive and urinary systems

Endocrine Glands

Endocrine glands are ductless Secrete hormones Chemical signals that influence: Metabolism Growth and development Homeostasis Categories of hormones Peptides (proteins, glycoproteins, and modified amino acids) Steroid hormones Hormone function Second messenger system Peptide hormone binds to a receptor protein on the plasma membrane Peptide hormone ("first messenger") activates a "second messenger" (cyclic AMP and calcium) Second messenger sets in motion an enzyme cascade that leads to a cellular response Change in cellular behavior Formation of an end product that leaves the cell Intracellular mechanism of hormone function Steroid hormones (lipids) diffuse across the plasma membrane Once inside the cell, steroid hormones bind to receptor proteins Hormone-receptor complex binds to DNA, activating particular genes Gene activation leads to production of cellular enzymes that cause cellular changes Hormones and Homeostasis Many hormones affect concentrations of certain substances in the blood Other hormones are involved in normal function of various organs Release of hormones controlled by one or more of the following: The nervous system The action of other hormones Negative feedback mechanisms

Overview of the Endocrine System

Endocrine system: glands, tissues, and cells that secrete hormones Endocrinology: the study of this system and the diagnosis and treatment of its disorders Endocrine glands: organs that are traditional sources of hormones Hormones: chemical messengers that are transported by the bloodstream and stimulate physiological responses in cells of another tissue or organ, often a considerable distance away

Chemical Barriers

Enzymes Pepsin - found in stomach Lysozyme - found in tears and other secretions - disrupt bacterial cell wall Acid

The Epidermis

Epidermis—keratinized stratified squamous epithelium -Dead cells at the surface packed with tough protein called keratin -Lacks blood vessels -Depends on the diffusion of nutrients from underlying connective tissue -Sparse nerve endings for touch and pain

Bone Elongation

Epiphyseal plate: a region of transition from cartilage to bone -Functions as growth zone where the bones elongate -Consists of typical hyaline cartilage in the middle -With a transition zone on each side where cartilage is being replaced by bone -Metaphysis is the zone of transition facing the marrow cavity

Equilibrium

Equilibrium: coordination, balance, and orientation in three-dimensional space Vestibular apparatus: constitutes receptors for equilibrium Three semicircular ducts Detect only angular acceleration Two chambers Anterior saccule and posterior utricle Responsible for static equilibrium and linear acceleration Static equilibrium: the perception of the orientation of the head when the body is stationary Dynamic equilibrium: perception of motion or acceleration Linear acceleration: change in velocity in a straight line (elevator) Angular acceleration: change in rate of rotation (car turns a corner) The Semicircular Ducts Rotary movements detected by the three semicircular ducts Bony semicircular canals of temporal bone hold membranous semicircular ducts Each duct is filled with endolymph and opens up as a dilated sac (ampulla) next to the utricle Each ampulla contains crista ampullaris - mound of hair cells and supporting cells

The Esophagus

Esophagus—a straight muscular tube 25 to 30 cm long Extends from pharynx to cardiac orifice of stomach passing through esophageal hiatus in diaphragm Upper esophageal sphincter Prevents swallowing of air Lower esophageal sphincter Prevents stomach contents/acid from regurgitating into the esophagus Heartburn— burning sensation produced by acid reflux into the esophagus

The Two Sexes

Essence of sexual reproduction: biparental, meaning offspring receives genes from two parents Offspring is not genetically identical to either one We will die, but our genes will live on in a different container—that is, our offspring Gametes (sex cells) produced by each parent Zygote (fertilized egg) has combination of both parents' genes Male and female gametes (sex cells) combine their genes to form a zygote (fertilized egg) One gamete has motility: sperm (spermatozoon) Parent producing sperm considered male Parent with a Y chromosome is male Other gamete contains nutrients for developing embryo: egg (ovum) Parent producing eggs considered female Anyone lacking a Y chromosome is female In mammals, female is the parent that provides a sheltered internal environment and prenatal nutrition of the embryo

Fluid Replacement Therapy

Excessive blood loss Normal saline (isotonic, 0.9% NaCl) Raises blood volume while maintaining normal osmolarity Takes three to five times the normal saline to rebuild normal blood volume because much of the saline escapes blood and enters interstitial fluid compartment Correct pH imbalances Acidosis treated with Ringer's lactate Alkalosis treated with potassium chloride Plasma volume expanders - hypertonic solutions or colloids that are retained in the bloodstream and draw interstitial water into it by osmosis Used to combat hypotonic hydration (water intoxication) by drawing water out of swollen cells Can draw several liters of water out of the intracellular compartment within a few minutes Patients who cannot eat Isotonic 5% dextrose (glucose) solution Patients with renal insufficiency Given slowly through I.V. drip

Universal Properties

Excitability (irritability) -Respond to environmental changes called stimuli Conductivity -Neurons respond to stimuli by producing electrical signals that are quickly conducted to other cells at distant locations -Secretion When electrical signal reaches end of nerve fiber, a chemical neurotransmitter is secreted that crosses the gap and stimulates the next cell

Nervous and Muscular Tissues: Excitable Tissues

Excitability: a characteristic of all living cells -Developed to highest degree in nervous and muscular tissues Membrane potential: electrical charge difference (voltage) that occurs across the plasma membranes is the basis for their excitation -Respond quickly to outside stimulus by means of changes in membrane potential -Nerves: changes result in rapid transmission of signals to other cells -Muscles: changes result in contraction, shortening of the cell

Venous Return and Physical Activity

Exercise increases venous return in many ways Heart beats faster and harder, increasing CO and BP Vessels of skeletal muscles, lungs, and heart dilate and increase flow Increased respiratory rate, increased action of thoracic pump Increased skeletal muscle pump Venous pooling occurs with inactivity Venous pressure not enough to force blood upward Prevented by tensing leg muscles, activate skeletal muscle pump Jet pilots wear pressure suits

Exercise and Cardiac Output

Exercise makes the heart work harder and increases cardiac output Proprioceptors signal cardiac center At beginning of exercise, signals from joints and muscles reach the cardiac center of brain Sympathetic output from cardiac center increases cardiac output Increased muscular activity increases venous return Increases preload and ultimately cardiac output Increases in heart rate and stroke volume cause an increase in cardiac output Exercise produces ventricular hypertrophy Increased stroke volume allows heart to beat more slowly at rest Athletes with increased cardiac reserve can tolerate more exertion than a sedentary person

The Hindbrain and Midbrain

Expected Learning Outcomes List the components of the hindbrain and midbrain and their functions Describe the location and functions of the reticular formation

The External Genitalia

External genitalia are collectively called the vulva or pudendum Mons pubis: mound of fat over pubic symphysis bearing most of the pubic hair Labia majora: pair of thick folds of skin and adipose tissue inferior to the mons Pudendal cleft - slit between labia majora Labia minora: medial to labia majora are thin hairless folds Space between forms vestibule which contains urethral and vaginal openings Anterior margins of labia minora join to form hoodlike prepuce over clitoris Clitoris: erectile, sensory organ with no urinary role Primary center for erotic stimulation Glans, body, and crura Vestibular bulbs: erectile tissue deep to the labia majora Cause the vagina to tighten around the penis, enhancing sexual stimulation Greater and lesser vestibular and paraurethral glands open into vestibule for lubrication

The Scrotum

External genitalia of the male—scrotum and penis Occupy the perineum: diamond-shaped area between the thighs Bordered by the pubic symphysis, ischial tuberosities, and coccyx Scrotum—pouch of skin, muscle, and fibrous connective tissue containing the testes Left testicle usually descends lower than the right so the two are not compressed against each other Skin has sebaceous glands, sparse hair, rich sensory innervation, somewhat darker pigmentation than skin elsewhere Internal median septum divides scrotum into right and left compartments Perineal raphe: medial seam located on the scrotum extending anteriorly along ventral side of penis and posteriorly to anus Spermatic cord—bundle of fibrous connective tissue containing the ductus deferens, blood and lymphatic vessels, and testicular nerve Continues through 4 cm inguinal canal into the pelvic cavity External inguinal ring: inferior entrance to inguinal canal Internal inguinal ring: superior exit to pelvic cavity The human testes reside in the scrotum because they have adapted to this cooler environment Cannot produce sperm at core body temperature of 37°C Must be held at about 35°C

The Cranial Nerves: The Trochlear Nerve (IV)

Eye movement

Accessory Structures of the Orbit

Eyebrows provide facial expression Protect eyes from glare and perspiration Eyelids (palpebrae) Block foreign objects, help with sleep, blink to moisten Meet at corners (commissures) Consist of orbicularis oculi muscle and tarsal plate covered with skin outside and conjunctiva inside Conjunctiva: a transparent mucous membrane that lines eyelids and covers anterior surface of eyeball, except cornea Richly innervated and vascular (heals quickly) Secretes a thin mucous film that prevents the eyeball from drying Tears flow across eyeball to help wash away foreign particles, deliver O2 and nutrients, and prevent infection with a bactericidal lysozyme Tears flow through lacrimal punctum (opening on edge of each eyelid) to the lacrimal sac, then into the nasolacrimal duct emptying into nasal cavity Six extrinsic muscles attached to exterior surface of eyeball Superior, inferior, lateral, and medial rectus muscles, superior and inferior oblique muscles Innervated by cranial nerves III, IV, and VI Superior, inferior, medial, and lateral rectus muscles move the eye up, down, medially, and laterally Superior and inferior obliques turn the "twelve o'clock pole" of each eye toward or away from the nose Orbital fat surrounds sides and back of eye, cushions eye, allows free movement, protects blood vessels and nerve Anatomy of the eye Three principal components of the eyeball Three layers (tunics) that form the wall of the eyeball Optical component admits and focuses light Neural component: retina and optic nerve

Yellow Marrow

Fat

Adaptations

Features that have evolved in response to selection pressure & helps organism cope

Common iliac arteries

Feed lower extremities and Pelvis

Femoral artery

Feeds lower extremities and the knee

External iliac arteries

Feeds the legs

Internal iliac arteries

Feeds the pelvis and lower abdomen

Stage 1 of sleep

Feel drowsy, close eyes, begin to relax Often feel drifting sensation, easily awakened if stimulated Alpha waves dominate EEG

The Urethra

Female urethra: 3 to 4 cm long Bound to anterior wall of vagina External urethral orifice Between vaginal orifice and clitoris Internal urethral sphincter Detrusor muscle thickening Smooth muscle under involuntary control External urethral sphincter Where the urethra passes through the pelvic floor Skeletal muscle under voluntary control Male urethra: 18 cm long Three regions Prostatic urethra (2.5 cm) Passes through prostate gland BPH- restricted urine flow Membranous urethra (0.5 cm) Passes through muscular floor of pelvic cavity Spongy (penile) urethra (15 cm) Passes through penis in corpus spongiosum Internal urethral sphincter Detrusor muscle thickening, involuntary External urethral sphincter Voluntary, skeletal muscle

Fibula

Fibula: slender, lateral strut that helps stabilizes ankle Does not bear any body weight -Spare bone tissue for grafts Head: proximal end Lateral malleolus: distal expansion, bony knob on lateral side of ankle

Decontamination by Filtration: Techniques for Removing Microbes

Filtration - method to remove microbes from air and liquids Application of Filtration 1. Filtration is used to prepare liquids that cannot withstand heat, including serum and other blood products, vaccines, drugs, IV fluids, enzymes, and media. 2. High-efficiency particulate air (HEPA) filters - used to provide flow of decontaminated air to hospital rooms and sterile rooms

Nails

Fingernails and toenails—clear, hard derivatives of the stratum corneum -Composed of very thin, dead cells packed with hard keratin Flat nails allow for more fleshy and sensitive fingertips -Tools for digging, grooming, picking apart food, and other manipulations Nail plate—hard part of the nail -Free edge: overhangs the fingertip -Nail body: visible attached part of nail -Nail root: extends proximally under overlying skin Nail fold—surrounding skin rising a bit above the nail Nail groove—separates nail fold from nail plate Nail bed—skin underlying the nail plate Hyponychium—epidermis of the nail bed Nail matrix—growth zone of thickened stratum basale at the proximal end of nail -Mitosis here accounts for nail growth -1 mm per week in fingernails, slightly slower on toenails Lunule—an opaque white crescent at proximal end of nail Eponychium (cuticle)—narrow zone of dead skin that commonly overhangs this end of the nail

Cells of the Epidermis

Five types of cells of the epidermis Stem cells -Undifferentiated cells that give rise to keratinocytes -In deepest layer of epidermis (stratum basale) Keratinocytes -Great majority of epidermal cells -Synthesize keratin Melanocytes -Occur only in stratum basale -Synthesize pigment melanin that shields DNA from ultraviolet radiation Tactile (Merkel) cells -In basal layer of epidermis -Touch receptor cells associated with dermal nerve fibers Dendritic (Langerhans) cells -Macrophages originating in bone marrow that guard against pathogens -Found in stratum spinosum and granulosum -Stand guard against toxins, microbes, and other pathogens that penetrate skin

General Features of Bones

Flat bones Protect soft organs Curved but wide and thin Long bones Longer than wide Rigid levers acted upon by muscles Short bones Equal in length and width Glide across one another in multiple directionsIrregular bones -Elaborate shapes that do not fit into other categories Compact (dense) bone: outer shell of long bone Diaphysis (shaft): cylinder of compact bone to provide leverage Medullary cavity (marrow cavity): space in the diaphysis of a long bone that contains bone marrowEpiphyses: enlarged ends of a long bone -Enlarged to strengthen joint and attach ligaments and tendons Spongy (cancellous) bone: covered by more durable compact bone -Skeleton three-fourths compact and one-fourth spongy bone by weight -Spongy bone in ends of long bones, and middle of nearly all others Articular cartilage: layer of hyaline cartilage that covers the joint surface where one bone meets another; allows joint to move more freely and relatively friction free Nutrient foramina: minute holes in the bone surface that allows blood vessels to penetrate Periosteum: external sheath that covers bone except where there is articular cartilageEndosteum: thin layer of reticular connective tissue lining marrow cavity -Has cells that dissolve osseous tissue and others that deposit it Epiphyseal plate (growth plate): area of hyaline cartilage that separates the marrow spaces of the epiphysis and diaphysis -Enables growth in length -Epiphyseal line: in adults, a bony scar that marks where growth plate used to be Sandwich-like construction Two layers of compact bone enclosing a middle layer of spongy bone -Both surfaces of flat bone covered with periosteum Diploe: spongy layer in the cranium -Absorbs shock -Marrow spaces lined with endosteum

Flexion and Extension

Flexion: movement that decreases joint angle -Common in hinge joints Extension: movement that straightens a joint and generally returns a body part to the zero position Hyperextension: further extension of a joint beyond the zero position -Flexion and extension occur at nearly all diarthroses, hyperextension is limited to a few

Water Gain and Loss

Fluid balance—when daily gains and losses are equal (about 2,500 mL/day) Gains come from two sources Preformed water (2,300 mL/day) Ingested in food (700 mL/day) Drink (1,600 mL/day) Metabolic water (200 mL/day) By-product of aerobic metabolism and dehydration synthesis C6H12O6 + 6 O2 6 CO2 + 6 H2O

Blood

Fluid connective tissue Transports cells and dissolved matter from place to place Plasma: blood's liquid ground substance Formed elements: cells and cell fragments -Erythrocytes: red blood cells - transport O2 and CO2 -Leukocytes: white blood cells - defense against infection and other diseases -Platelets: cell fragments involved in clotting and other mechanisms

Aerobic Respiration

Following glycolysis the pyruvic acid forms acetyl coenzyme (acetyl CoA) that feeds into the Krebs cycle The Krebs cycle (The Carbon and Energy Wheel ) produces NADH and FADH2 - resulting in energy production through electron transport Oxygen is the final electron acceptor Total process produces 38 ATP molecules

The Skull in Infancy and Childhood

Fontanels—spaces between unfused bones -Filled with fibrous membrane -Allow shifting of bones during birth and growth of brain -Anterior, posterior, sphenoid (anterolateral), and mastoid (posterolateral) fontanels Skull reaches adult size by 8 or 9 years of age

The Forebrain

Forebrain consists of two parts Diencephalon Encloses the third ventricle Most rostral part of the brainstem Has three major embryonic derivatives Thalamus Hypothalamus Epithalamus Telencephalon Develops chiefly into the cerebrum

The Parietal Bones

Form most of cranial roof and part of its lateral walls Bordered by four sutures -Sagittal: between parietal bones -Coronal: at anterior margin -Lambdoid: at posterior margin -Squamous: at lateral border Two temporal lines serve as attachment of the temporalis muscle

Oligodendrocytes

Form myelin sheaths in CNS Each armlike process wraps around a nerve fiber forming an insulating layer that speeds up signal conduction

Ceruminous Glands

Found only in external ear canal Their secretion combines with sebum and dead epithelial cells to form earwax (cerumen) -Keeps eardrum pliable -Waterproofs the canal -Kills bacteria -Makes guard hairs of ear sticky to help block foreign particles from entering auditory canal

Capsule or Glycocalyx- Prokaryotic Cell

Found outside of outer membrane Commonly polysaccharides (carbohydrates) A few are polypeptides Variable in thickness Used to avoid phagocytosis These are usually important for pathogenesis

The Chambers

Four chambers Right and left atria Two superior chambers Receive blood returning to heart Right and left ventricles Two inferior chambers Pump blood into arteries Interatrial septum Wall that separates atria Interventricular septum Muscular wall that separates ventricles

ventricles

Four internal chambers within the brain

Types of Neuroglia

Four types occur only in CNS Oligodendrocytes: Form myelin sheaths in CNS Each armlike process wraps around a nerve fiber forming an insulating layer that speeds up signal conduction Ependymal cells: Line internal cavities of the brain Cuboidal epithelium with cilia on apical surface Secretes and circulates cerebrospinal fluid (CSF) Clear liquid that bathes the CNS Microglia: Small, wandering macrophages formed white blood cell called monocytes Thought to perform a complete checkup on the brain tissue several times a day Wander in search of cellular debris to phagocytize Astrocytes: Most abundant glial cell in CNS Cover entire brain surface and most nonsynaptic regions of the neurons in the gray matter of the CNS Diverse functions Form a supportive framework of nervous tissue Have extensions (perivascular feet) that contact blood capillaries that stimulate them to form a tight seal called the blood-brain barrier Convert blood glucose to lactate and supply this to the neurons for nourishment Nerve growth factors secreted by astrocytes promote neuron growth and synapse formation Astrocytosis or sclerosis: when neuron is damaged, astrocytes form hardened scar tissue and fill space formerly occupied by the neuron Two types occur only in PNS Schwann cells: Envelope nerve fibers in PNS Wind repeatedly around a nerve fiber Produce a myelin sheath similar to the ones produced by oligodendrocytes in CNS Assist in the regeneration of damaged fibers Satellite cells: Surround the neurosomas in ganglia of the PNS Provide electrical insulation around the soma Regulate the chemical environment of the neurons

Color Vision

Fovea contains only 4,000 tiny cone cells (no rods) No neuronal convergence Each foveal cone cell has "private line to brain" High-resolution color vision Little spatial summation: less sensitivity to dim light Color blindness: have a hereditary alteration or lack of one photopsin or another Most common is red - green color blindness Results from lack of either L or M cones Causes difficulty distinguishing these related shades from each other Occurs in 8% of males, 0.5% of females (sex linkage)

Skin Markings

Freckles and moles—tan to black aggregations of melanocytes -Freckles are flat, melanized patches -Moles (nevus) are elevated melanized patches often with hair --Moles should be watched for changes in color, diameter, or contour --May suggest malignancy (skin cancer) Hemangiomas (birthmarks)—patches of discolored skin caused by benign tumors of dermal blood capillaries -Some disappear in childhood, others last for life -Capillary hemangiomas, cavernous hemangiomas, port-wine stain

Calcium

Functions Lends strength to the skeleton Activates sliding filament mechanism of muscle contraction Essential factor in blood clotting Homeostasis regulated by: PTH, calcitriol (vitamin D), and calcitonin (in children) These hormones affect bone deposition/resorption of Ca2+, as well as intestinal absorption and urinary excretion

Potassium (K)

Functions Produces (with sodium) the resting membrane potentials and action potentials of nerve and muscle cells Most abundant cation of ICF Greatest determinant of intracellular osmolarity and cell volume Essential cofactor for protein synthesis

Physiology of the Respiratory System

Functions Provides O2 and CO2 exchange between blood and air Serves for speech and other vocalizations Provides the sense of smell Affects pH of body fluids by eliminating CO2 Affects blood pressure by synthesis of vasoconstrictor, angiotensin II Pulmonary ventilation & respiratory cycle Respiratory muscles Neural control of breathing & receptors Boyle's Law Inspiration Expiration Disorders of breathing Resistance to airflow Spirometry Respiratory volumes & capacities Variation in respiratory rhythm Air, gas transport, oxygen Acidosis vs. alkylosis Oxygen imbalances Chronic obstructive pulmonary diseases Smoking and lung cancer

Chloride

Functions Required for the formation of stomach acid (hydrochloric acid (HCl)) Helps CO2 loading and unloading in RBCs Major role in regulating body pH Homeostasis Primary homeostasis achieved as an effect of Na+ homeostasis Chloride passively follows Na+, K+, and Ca2+ As sodium is retained, chloride ions passively follow

Physiology of The Pleurae

Functions of pleurae and pleural fluid Reduce friction Create pressure gradient Lower pressure than atmospheric pressure; assists lung inflation Compartmentalization Prevents spread of infection from one organ in mediastinum to others

Functions

Functions of skeletal muscles -Support the body -Make bones and other body parts move -Help maintain a constant body temperature -Assists movement in cardiovascular and lymphatic vessels -Help protect bones and internal organs, and stabilize joints

Law of Nature

Generalization about the predictable way matter and energy behave -Results from inductive reasoning and repeated observations. -Written as verbal statements or mathematical formulae

Evolution

Genetic change overtime

The Shoulder Joint

Glenohumeral (humeroscapular) joint: hemispherical head of humerus articulates with glenoid cavity of scapula -Most freely movable joint in body -Glenoid labrum: fibrocartilage ring that deepens glenoid cavity. --Labrum tear

Urine Formation Step 1: Filtration

Glomerular filtration - a special case of the capillary fluid exchange process in which water and some solutes in the blood plasma pass from the capillaries of the glomerulus into the capsular space of the nephron Almost any molecule smaller than 3 nm can pass freely through the filtration membrane Water, electrolytes, glucose, fatty acids, amino acids, nitrogenous wastes, and vitamins Glomerular filtrate - the fluid in the capsular space Similar to blood plasma except that it has almost no protein Kidney infections and trauma can damage the filtration membrane and allow albumin or blood cells to filter Proteinuria (albuminuria): presence of protein in urine Hematuria: presence of blood in the urine Distance runners and swimmers often experience temporary proteinuria or hematuria Prolonged, strenuous exercise greatly reduces profusion of kidney Glomerulus deteriorates under prolonged hypoxia Blood hydrostatic pressure (BHP) Much higher in glomerular capillaries (60 mm Hg compared to 10 to 15 in most other capillaries) Because afferent arteriole is larger than efferent arteriole Net pressure of 10 mm Hg forces water out of capillaries into Bowman's capsule High BP in glomerulus makes kidneys vulnerable to hypertension It can lead to: Rupture of glomerular capillaries & eventual renal failure

Clinical Management of Blood Clotting

Goal—prevent formation of clots or dissolve existing clots Preventing clots Vitamin K is required for formation of clotting factors Coumarin, warfarin (Coumadin)—vitamin K antagonists Aspirin suppresses thrombus formation Other anticoagulants discovered in animal research Medicinal leeches used since 1884 (hirudin) Snake venom from vipers (arvin) Dissolving clots that have already formed Streptokinase: enzyme made by streptococci bacteria Used to dissolve clots in coronary vessels Digests almost any protein Tissue plasminogen activator (TPA): works faster, is more specific, and now made by transgenic bacteria Hementin: produced by giant Amazon leech

Gray and White Matter

Gray matter: the seat of neuron cell bodies, dendrites, and synapses Dull white color when fresh, due to little myelin Forms surface layer (cortex) over cerebrum and cerebellum Forms nuclei deep within brain White matter: bundles of axons: Lies deep to cortical gray matter, opposite relationship in the spinal cord Pearly white color from myelin around nerve fibers Composed of tracts, or bundles of axons, that connect one part of the brain to another, and to the spinal cord

Veins

Greater capacity for blood containment than arteries Thinner walls, flaccid, less muscular and elastic tissue Collapse when empty, expand easily Have steady blood flow Merge to form larger veins Subjected to relatively low blood pressure Remains 10 mm Hg with little fluctuation venules— smallest veins Even more porous than capillaries so also exchange fluid with surrounding tissues Tunica interna with a few fibroblasts and no muscle fibers Most leukocytes emigrate from the bloodstream through venule walls Medium veins—up to 10 mm in diameter Thin tunica media and thick tunica externa Tunica interna forms venous valves Varicose veins result in part from the failure of these valves Skeletal muscle pump propels venous blood back toward the heart Large veins—larger than 10 mm Some smooth muscle in all three tunics Thin tunica media with moderate amount of smooth muscle Tunica externa is thickest layer Contains longitudinal bundles of smooth muscle Venae cavae, pulmonary veins, internal jugular veins, and renal veins

Epiphyseal plate

Growth pad in bone

Microbial Growth

Growth takes place on two levels: Cell synthesizes new cell components and increases in size The number of cells in the population increases The Basis of Population Growth: Binary Fission

Taste

Gustation (taste): sensation that results from action of chemicals on taste buds 4,000 taste buds mainly on tongue Inside cheeks, and on soft palate, pharynx, and epiglottis To be tasted, molecules must dissolve in saliva and flood the taste pore Five primary sensations Salty: produced by metal ions (sodium and potassium) Sweet: associated with carbohydrates and other foods of high caloric value Sour: acids such as in citrus fruits Bitter: associated with spoiled foods and alkaloids such as nicotine, caffeine, quinine, and morphine Umami: "meaty" taste of amino acids in chicken or beef broth

Hair Growth and Loss

Hair growth—scalp hairs grow at a rate of 1 mm per 3 days (10-18 cm/yr) Alopecia—thinning of the hair or baldness Hirsutism—excessive or undesirable hairiness in areas that are not usually hairy Pattern baldness—the condition in which hair loss occurs from specific regions of the scalp rather than thinning uniformly -Combination of genetic and hormonal influence -Baldness allele is dominant in males and expressed only in high testosterone levels -Testosterone causes terminal hair in scalp to be replaced by vellus hair

Structure of the Hair and Follicle

Hair is divisible into three zones along its length -Bulb: a swelling at the base where hair originates in dermis or hypodermis --Only living hair cells are in or near bulb -Root: the remainder of the hair in the follicle -Shaft: the portion above the skin surface Follicle—diagonal tube that dips deeply into dermis and may extend into hypodermis Hair receptors -Nerve fibers that entwine each follicle -Respond to hair movement Piloerector muscle (arrector pili) -Bundles of smooth muscle cells -Extends from dermal collagen to connective tissue root sheath -Goose bumps

Hair

Hair is found almost everywhere on the body except: -Palms and soles -Ventral and lateral surfaces of fingers and toes -Distal segment of the finger -Lips, nipples, and parts of genitals

Hair and Nails

Hair, nails, and cutaneous glands are accessory organs of the skin Hair and nails are composed of mostly dead, keratinized cells -Pliable soft keratin makes up stratum corneum of skin -Compact hard keratin makes up hair and nails --Tougher and more compact due to numerous cross-linkages between keratin molecules Pilus—another name for hair; pili—plural of pilus Hair—a slender filament of keratinized cells that grows from an oblique tube in the skin called a hair follicle

Hearing and Equilibrium

Hearing: a response to vibrating air molecules Equilibrium: the sense of motion, body orientation, and balance Both senses reside in the inner ear, a maze of fluid-filled passages and sensory cells Fluid is set in motion and the sensory cells convert this motion into an informative pattern of action potentials

Position, Size, and Shape of the Heart

Heart located in mediastinum, between lungs Base—wide, superior portion of heart, blood vessels attach here Apex—inferior end, tilts to the left, tapers to point

The Complete Blood Count

Hematocrit Hemoglobin concentration Total count for RBCs, reticulocytes, WBCs, and platelets Differential WBC count RBC size and hemoglobin concentration per RBC

Oxygen

Hemoglobin—molecule specialized in oxygen transport Four protein (globin) portions Each with a heme group which binds one O2 to the ferrous ion (Fe2+) One hemoglobin molecule can carry up to 4 O2 100% saturation Hb with 4 O2 molecules 50% saturation Hb with 2 O2 molecules Hemoglobin can transport O2 and CO2 simultaneously

Platelets and Hemostasis—The Control of Bleeding

Hemostasis—the cessation of bleeding Stopping potentially fatal leaks Hemorrhage: excessive bleeding Three hemostatic mechanisms Vascular spasm Platelet plug formation Blood clotting (coagulation) Platelets play an important role in all three

Sickle-Cell Disease

Hereditary hemoglobin defects that occur mostly among people of African descent Caused by a recessive gene that modifies the structure of the hemoglobin molecule (HbS) in oxygen-poor blood RBCs become rigid, sticky, pointed at ends in oxygen-poor blood Clump together and block small blood vessels causing intense pain Can lead to kidney or heart failure, stroke, rheumatism, or paralysis

Hormonal Control

Hormones influence blood pressure Some through their vasoactive effects Some by regulating water balance Angiotensin II—potent vasoconstrictor Raises blood pressure Promotes Na+ and water retention by kidneys Increases blood volume and pressure Atrial natriuretic peptide—increases urinary sodium excretion Reduces blood volume and promotes vasodilation Lowers blood pressure ADH promotes water retention and raises BP Pathologically high concentrations; also a vasoconstrictor Epinephrine and norepinephrine effects Most blood vessels —vasoconstriction Skeletal and cardiac muscle blood vessels —vasodilation

Hormones of Pregnancy

Hormones with strongest influence on pregnancy are: Estrogens Progesterone Human chorionic gonadotropin Human chorionic somatomammotropin All primarily secreted by the placenta Corpus luteum is important source for first several weeks If corpus luteum removed before 7 weeks, abortion From week 7 to week 17, the corpus luteum degenerates and placenta takes over its endocrine function Human chorionic gonadotropin (HCG) Secreted by blastocyst and placenta Detectable in urine 8 to 9 days after conception by home pregnancy test kits Stimulates growth of corpus luteum Secretes increasing amounts of progesterone and estrogen Estrogens Increases to 30 times normal by the end of gestation Corpus luteum is source for first 12 weeks until placenta takes over gradually during weeks 7 to 17 Causes tissue growth in the fetus and the mother Mother's uterus and external genitalia enlarge Mammary ducts grow, breasts increase to nearly twice normal size Relaxes pubic symphysis and widens pelvis Progesterone Secreted by placenta and corpus luteum Suppresses secretion of FSH and LH, preventing follicular development during pregnancy

Climacteric and Menopause

Hot flashes: spreading sense of heat from the abdomen to the thorax, neck, and face Hormone replacement therapy (HRT) - low doses of estrogen and progesterone to relieve some of these symptoms Risks and benefits are still being debated

Urine Concentration

How concentrated the urine becomes depends on body's state of hydration Water diuresis - drinking large volumes of water will produce a large volume of hypotonic urine Hypertonic urine Dehydration causes the urine to become scanty and more concentrated/dark yellow

Embryonic Tissues

Human development begins as single cell, the fertilized egg -Divides to produce scores of identical, smaller cells -First tissues appear when these cells start to organize themselves into layers

Human Use of Microorganisms

Humans have been using microorganisms for thousands of years -Baker's and brewer's yeast -Cheeses -Moldy bread on wounds

Sodium Imbalances

Hypernatremia Causes: administration of IV saline / hormone imbalance Effects are water retention, hypertension, and edema Hyponatremia - rare Causes: excess body water (ex: person replaces water lost through sweat/urine by drinking lots of water) Usually quickly corrected by excreting excess water If uncorrected, produces symptoms of hypotonic hydration (cell swelling, pulmonary/cerebral edema)

Hypertension—The "Silent Killer"

Hypertension—most common cardiovascular disease affecting about 30% of Americans over 50 "The silent killer" Major cause of heart failure, stroke, and kidney failure Damages heart by increasing afterload Myocardium enlarges until overstretched and inefficient Renal arterioles thicken in response to stress Drop in renal BP leads to salt retention (aldosterone) and worsens the overall hypertension Primary hypertension Obesity, sedentary behavior, diet, nicotine Secondary hypertension—secondary to other disease Kidney disease, hyperthyroidism

The Hypodermis

Hypodermis -Subcutaneous tissue -More areolar and adipose than dermis -Pads body -Binds skin to underlying tissues Drugs introduced by injection -Highly vascular and absorbs them quickly Subcutaneous fat -Energy reservoir -Thermal insulation -8% thicker in women

Plasma Protein Deficiency

Hypoproteinemia Deficiency of plasma proteins Extreme starvation Liver or kidney disease Severe burns Kwashiorkor Children with severe protein deficiency Fed on cereals once weaned Thin arms and legs Swollen abdomen

Hypothalamus

Hypothalamus Controls secretions of the pituitary gland Neurosecretory cells produce Antidiuretic hormone (ADH) Oxytocin

Oxygen Imbalances

Hypoxia—a deficiency of oxygen in a tissue or the inability to use oxygen Hypoxemic hypoxia—state of low arterial [O2] Usually due to inadequate pulmonary gas exchange Oxygen deficiency at high elevations, impaired ventilation: drowning, aspiration of a foreign body, respiratory arrest, degenerative lung diseases Ischemic hypoxia—inadequate circulation of blood Congestive heart failure Anemic hypoxia—due to anemia resulting from the inability of the blood to carry adequate oxygen Oxygen toxicity—pure O2 breathed at 2.5 atm or greater Safe to breathe 100% oxygen at 1 atm for a few hours Generates free radicals and H2O2 Destroys enzymes & damages nervous tissue Leads to seizures, coma, death

Luteal Phase (Not pregnant)

If not pregnant (no egg fertilization) Corpus Luteum degenerates This leads to a decrease in Progesterone This leads to a decrease in lining stimulation This leads to no implantation This starts a new cycle Pre Menstrual cycle

Relative Microbial Sizes

If poliovirus (27 nm) was the size of a quarter... Staphylococcus aureus (0.8 µm) Beach ball Escherichia coli (0.7 x 2.5 µm) Adult human Saccharomyces cerevisiae (5 µm) Elephant Paramecium caudatum (50 x 250 µm) Large yard (2.5 acres) Amoeba proteus (800 µm) 10 city blocks (100 acres)

Pulmonary Edema

If the left ventricle pumps less blood than the right, the blood pressure backs up into the lungs and causes pulmonary edema

Systemic edema

If the right ventricle pumps less blood than the left, pressure backs up in the systemic circulation and causes systemic edema

Ileocecal junction

Ileocecal junction—end of the small intestine Where the ileum joins the cecum of the large intestine Ileocecal valve—a sphincter formed by the thickened muscularis of the ileum Protrudes into the cecum Regulates passage of food residue into the large intestine

Calcium Imbalances

Imbalances Hypercalcemia: greater than 5.8 mEq/L Causes: Alkalosis, hyperparathyroidism, hypothyroidism Reduces membrane Na+ permeability, inhibits depolarization (excitation) of nerve and muscle cells Concentrations greater than 12 mEq/L cause muscular weakness, depressed reflexes, cardiac arrhythmias Hypocalcemia: less than 4.5 mEq/L Causes: Vitamin D deficiency, diarrhea, pregnancy, acidosis, lactation, hypoparathyroidism, hyperthyroidism Increases membrane Na+ permeability, causing nervous and muscular systems to be abnormally excitable Very low levels result in tetanus, laryngospasm, death

Chloride Imbalances

Imbalances primarly effects are disturbances in acid-base balance Hyperchloremia Causes: Dietary excess or administration of IV saline Hypochloremia Causes: Side effect of hyponatremia Sometimes from hyperkalemia or acidosis

Allergic Reactions - Immediate Reactions

Immediate-reaction allergy - inherited tendency to overproduce IgE Anaphylactic shock - severe form - symptoms may include: Itching & red hives Vomiting & diarrhea Swelling of face, tongue, and larynx Breathing may become difficult Treatment - epinephrine & sometimes tracheotomy

Potential Importance of the Growth Curve

Implications in microbial control , infection , food microbiology, and culture technology Growth patterns in microorganisms can account for the stages of infection (early/middle stages of infection more contagious) Understanding the stages of cell growth is crucial for working with cultures In some applications, closed batch culturing is inefficient, and instead, must use a chemostat or continuous culture system (steady stream of nutrients & waste removal) prevents bacteria from entering death phase

Spinal Cord Trauma

In United States, 10,000 to 12,000 people paralyzed each year by spinal cord trauma Usually by vertebral fractures Highest risk group: males 16 to 30 years old 55% occur in automobile or motorcycle accidents Complete transection: complete severance of cord Immediate loss of motor control below level of injury Above C4 poses the threat of respiratory failure Spinal shock Paralysis Paraplegia—paralysis of both lower limbs Quadriplegia—paralysis of all four limbs Hemiplegia—paralysis on one side of the body Paresis—partial paralysis or weakness of the limbs

The Neural Components

Include retina and optic nerve Retina Forms as an outgrowth of the diencephalon Attached to the rest of the eye only at optic disc Pressed against rear of eyeball by vitreous humor Detached retina causes blurry areas in field of vision and leads to blindness Examine retina with opthalmoscope Macula lutea: patch of cells on visual axis of eye Fovea centralis: pit in center of macula lutea Blood vessels of the retina Macula lutea: cells on visual axis of eye (3 mm) Fovea centralis: center of macula; finely detailed images due to packed receptor cells Opthalmoscope: examines direct evaluation of blood vessels Optic disc: blind spot Optic nerve exits posterior surface of eyeball No receptor cells at that location Blind spot: use test illustration above Close eye, stare at X and red dot disappears Visual filling: brain fills in green bar across blind spot area

Fermentation

Incomplete oxidation of glucose in the absence of oxygen Krebs Cycle is not used and only 2 ATPs are produced The end-products of fermentation can be either alcohol, acid, or mixed acids

Monocytes

Increase in number in viral; infections and inflammation

During exercise

Increased perfusion of lungs, myocardium, and skeletal muscles Decreased perfusion of kidneys and digestive tract

Addition of Acetylcholine

Increases heart rate and contraction strength

Addition of Caffeine

Increases heart rate and contraction strength

Natural Selection

Individuals w/ hereditary advantage passes on traits

Isometric and Isotonic Contraction

Isometric muscle contraction -Muscle is producing internal tension while an external resistance causes it to stay the same length or become longer -Important in postural muscle function and antagonistic muscle joint stabilization Isotonic muscle contraction -Muscle changes in length with no change in tension -Concentric contraction: muscle shortens as it maintains tension -Eccentric contraction: muscle lengthens as it maintains tension

Potassium Imbalances

K+ imbalances are the most dangerous imbalances of electrolytes!! Hyperkalemia (HyperK)- effects depend on whether the potassium concentration rises quickly or slowly Causes: crush injury, hemolytic anemia, acidosis, renal failure High-K+ solutions used for euthanasia & capital punishment Quick onset- If concentration rises quickly (crush injury), the sudden increase in extracellular K+ makes nerve and muscle cells abnormally excitable Slow onset- inactivates voltage-regulated Na+ channels, nerve and muscle cells become less excitable Can produce cardiac arrest Hypokalemia (HypoK) Causes: Rarely results from dietary deficiency From sweating, chronic vomiting, or diarrhea, diuretic overuse Nerve and muscle cells less excitable Muscle weakness, loss of muscle tone, decreased reflexes, and arrhythmias from irregular electrical activity in the heart

The Life History of a Keratinocyte

Keratinocytes are produced deep in the epidermis by stem cells in stratum basale -Some deepest keratinocytes in stratum spinosum also multiply and increase their numbers In 30 to 40 days a keratinocyte makes its way to the skin surface and flakes off -Slower in old age -Faster in injured or stressed skin --Calluses or corns—thick accumulations of dead keratinocytes on the hands or feet

Klinefelter's Syndrome

Klinefelter syndrome, also known as the XXY condition, is a term used to describe males who have an extra X chromosome in most of their cells Scientists believe the XXY condition is one of the most common chromosome abnormalities in humans. About one of every 500 males has an extra X chromosome, but many don't have any symptoms As babies, many XXY males have weak muscles and reduced strength. They may sit up, crawl, and walk later than other infants. After about age four, XXY males tend to be taller and may have less muscle control and coordination than other boys their age. As XXY males enter puberty, they often don't make as much testosterone as other boys. This can lead to a taller, less muscular body, less facial and body hair, and broader hips than other boys. As teens, XXY males may have larger breasts, weaker bones, and a lower energy level than other boys. By adulthood, XXY males look similar to males without the condition, although they are often taller

Stages of Labor

Labor occurs in three stages Dilation Expulsion Placental stage Dilation stage, longest stage - lasting 8 to 24 hours Dilation of cervical canal and effacement (thinning) of cervix to reach 10 cm, the diameter of fetal head Rupture of fetal membranes and loss of amniotic fluid "Breaking of the waters" Expulsion begins when baby's head enters vagina and lasts until baby is expelled, up to 30 minutes Crowning - when the baby's head is visible Delivery of the head is the most difficult part Nose and mouth suctioned before delivery to clear airway After expulsion, attendant drains blood from umbilical vein into baby Clamps umbilical cord in two places; cuts cord between clamps Uterine contractions continue causing placental separation Membranes (afterbirth) inspected to be sure everything has been expelled

Lactose Intolerance

Lactose passes undigested into large intestine Causes water retention in the colon and diarrhea Gas production by bacterial fermentation of the lactose Occurs in many parts of the population 15% of American whites, 90% of American blacks, 70% of Mediterraneans; and nearly all of Asian descent Can consume yogurt and cheese since bacteria have broken down the lactose

Language

Language include several abilities: reading, writing, speaking, and understanding words assigned to different regions of the cerebral cortex Wernicke area Permits recognition of spoken and written language and creates plan of speech Transmits plan of speech to Broca area Broca area Generates motor program for the muscles of the larynx, tongue, cheeks, and lips Transmits program to primary motor cortex for commands to the lower motor neurons that supply relevant muscles Aphasia: Unable to speak

The Large Intestine

Large intestine receives about 500 mL of indigestible residue per day Reduces it to about 150 mL of feces by absorbing water and salts Eliminates feces by defecation

The Thyroid Gland

Largest endocrine gland Composed of two lobes and an isthmus below the larynx Dark reddish brown color due to rich blood supply Two forms of thyroid hormone Triiodothyronine (T3) contains 3 iodine atoms Thyroxine (T4) contains 4 iodine atoms Effects of thyroid hormone Increase the metabolic rate Stimulate all cells of the body Development of nervous system

Spleen

Largest lymph organ. Filters blood

The Larynx

Larynx (voice box) - cartilaginous chamber about 1.5 in. long Functions: Primary function is to keep food and drink out of the airway Additional role in speech Structures: Epiglottis Thyroid cartilage (Adam's apple) Vestibular folds Vocal cords (glottis)

The Temporal Bones

Lateral wall and part of floor of cranial cavity -External auditory meatus -Styloid process -Mastoid process --Mastoiditis from ear infection

White Blood Cell Form and Function

Least abundant formed element 5,000 to 10,000 WBCs/L Protect against infectious microorganisms and other pathogens

Arterial Supply

Left coronary artery (LCA) branches off the ascending aorta Two branches of LCA that often have blockages Left Anterior Descending (LAD) or Anterior interventricular branch Supplies blood to both ventricles and anterior two-thirds of the interventricular septum Circumflex branch Supplies left atrium and posterior wall of left ventricle Right coronary artery (RCA) branches off the ascending aorta Supplies right atrium and sinoatrial node (pacemaker)

Left Atrium

Left side of the heart. carries O2 blood to the left ventricle

Leukocyte Disorders

Leukopenia—low WBC count: below 5,000 WBCs/L (micro liter) Causes: radiation, poisons, infectious disease Effects: elevated risk of infection Leukocytosis—high WBC count: above 10,000 WBCs/L Causes: infection, allergy, disease Differential WBC count: identifies what percentage of the total WBC count consist of each type of leukocyte Leukemia—cancer of hemopoietic tissue that usually produces an extraordinary high number of circulating leukocytes and their precursors Myeloid leukemia: uncontrolled granulocyte production Lymphoid leukemia: uncontrolled lymphocyte or monocyte production Acute leukemia: appears suddenly, progresses rapidly, death within months Chronic leukemia: undetected for months, survival time 3 years

The Leukocyte Life Cycle

Leukopoiesis—production of white blood cells Circulating WBCs do not stay in bloodstream Granulocytes leave in 8 hours and live 5 days longer Monocytes leave in 20 hours, transform into macrophages, and live for several years Lymphocytes provide long-term immunity (decades), being continuously recycled from blood to tissue fluid to lymph and back to the blood

Sensory Transduction in the Retina

Light-absorbing cells Rods and cones, derived from same stem cells as ependymal cells of the brain Rod cells Night, or scotopic, vision or monochromatic vision Cone cells Color, photopic, or day vision

Discoid

Like disc (RBCs)

Fibrous

Like fiber (skeletal and cardiac muscle)

Polygonal

Like polygon

Spheroid

Like sphere (WBCs)

Lipids

Lipid digestion and absorption more complicated than carbs & proteins Lipases—fat-digesting enzymes 10-15% lipids digested by: Lingual lipases secreted by the intrinsic salivary glands of the tongue; most active in stomach Gastric lipase made by stomach Most lipids digested by: Pancreatic lipase in small intestine What does bile do? Emulsifies fats to expose more of their surface to lipases!

The Liver & Gallbladder

Liver— Anatomy: reddish brown gland located immediately inferior to the diaphragm; body's largest gland Physiology: Secretes bile which contributes to digestion Cleans & detoxifies blood from the other digestive organs Gallbladder— Anatomy: pear-shaped sac that adheres to a depression on the inferior surface of the liver, between right and quadrate lobes Physiology: Stores and concentrates bile

Electrical Potentials and Currents

Living cells are polarized Resting membrane potential (RMP): charge difference across the plasma membrane Negative value means there are more negatively charged particles on the inside of the membrane than on the outside

Protection of the Stomach

Living stomach is protected in three ways from the harsh acidic and enzymatic environment it creates Mucus coat: thick, highly alkaline mucus resists action of acid and enzymes Tight junctions: between epithelial cells prevent gastric juice from seeping between them and digesting the stomach Living stomach is protected in three ways from the harsh acidic and enzymatic environment it creates Mucus coat: thick, highly alkaline mucus resists action of acid and enzymes Tight junctions: between epithelial cells prevent gastric juice from seeping between them and digesting the stomach . Epithelial cell replacement: stomach epithelial cells live only 3 to 6 days Sloughed off into the chyme and digested with the food Replaced rapidly by cell division Breakdown of these protective measures can result in inflammation and peptic ulcer

Types of Fibrous Connective Tissue

Loose connective tissue -Much gel-like ground substance between cells -Types --Areolar --Reticular -Dense connective tissue --Fibers fill spaces between cells --Types vary in fiber orientation ---Dense regular connective tissue ---Dense irregular connective tissue -Areolar tissue --Loosely organized fibers, abundant blood vessels, and a lot of seemingly empty space --Underlies all epithelia, in serous membranes, between muscles, passageways for nerves and blood vessels -Reticular tissue --Mesh of reticular fibers and fibroblasts --Forms supportive stroma (framework) for lymphatic organs --Found in lymph nodes, spleen, thymus, and bone marrow -Dense regular connective tissue --Densely packed, parallel collagen fibers --Compressed fibroblast nuclei --Elastic tissue/fibers, wavy sheets ---Tendons attach muscles to bones and ligaments hold bones together -Dense irregular connective tissue --Densely packed, randomly arranged, collagen fibers and few visible cells --Withstands unpredictable stresses Deeper layer of skin; capsules around organs

The Reticular Formation

Loosely organized web of gray matter that runs vertically through all levels of the brainstem Clusters of gray matter scattered throughout pons, midbrain, and medulla Occupies space between white fiber tracts and brainstem nuclei Has connections with many areas of cerebrum More than 100 small neural networks without distinct boundaries Networks Somatic motor control Adjust muscle tension to maintain tone, balance, and posture Especially during body movements Relays signals from eyes and ears to the cerebellum Integrates visual, auditory, and balance and motion stimuli into motor coordination Gaze center: allows eyes to track and fixate on objects Central pattern generators: neural pools that produce rhythmic signals to the muscles of breathing and swallowing Cardiovascular control Includes cardiac and vasomotor centers of medulla oblongata Pain modulation One route by which pain signals from the lower body reach the cerebral cortex Origin of descending analgesic pathways - fibers act in the spinal cord to block transmission of pain signals to the brain Sleep and consciousness Plays central role in states of consciousness, such as alertness and sleep Injury to reticular formation can result in irreversible coma Habituation Process in which the brain learns to ignore repetitive, inconsequential stimuli while remaining sensitive to others

The Lungs and Bronchial Tree

Lung - has broad, concave base, rests on the diaphragm, and has a blunt peak called the apex projecting slightly above the clavicle Hilum - slit through which the lung receives the main bronchus, blood vessels, lymphatics, and nerves Lungs are crowded by adjacent organs; they neither fill the entire ribcage, nor are they symmetrical Right lung Shorter than left because the liver rises higher on the right Has three lobes - superior, middle, and inferior Left lung Taller and narrower because the heart tilts toward the left and occupies more space on this side of mediastinum Has two lobes - superior and inferior

Smoking and Lung Cancer

Lung cancer accounts for more deaths than any other form of cancer Most important cause is smoking (15 carcinogens) Squamous cell carcinoma (most common) Begins with transformation of bronchial epithelium into stratified squamous from ciliated pseudostratified epithelium Dividing cells invade bronchial wall, cause bleeding lesions & fibrous scarring Adenocarcinoma Originates in mucous glands Small-cell carcinoma Least common, most dangerous 90% originates in primary bronchi, metastasizes quickly to other organs Often first sign is coughing up blood Only 7% of patients survive 5 years

Movement Through the Lymphatic Vessels

Lymph moves in response to: Milking action of the skeletal muscles Movement of the chest during respiration Rhythmic contraction of the smooth muscle in the lymphatic vessels

Lymph Nodes

Lymph nodes are small pea-shaped patch of lymphatic tissue They are placed throughout the lymph system occur in chains along large lymph vessels. The larger nodes are: Cervical - head and neck area Axillary - armpit Inguinal - groin Tonsils - partially encapsulated lymph nodes in the throat area Peyer's patches - scattered throughout the mucosal lining of the ileum regions of the small intestine

Dendritic (Langerhans) cells

Macrophages originating in bone marrow that guard against pathogens Found in stratum spinosum and granulosum Stand guard against toxins, microbes, and other pathogens that penetrate skin

Aorta

Main artery that carries blood from the heart

Hematocrit

Mainly RBCs

Homeostasis

Maintain relatively stable internal conditions

Significance of DNA Structure

Maintain the code during reproduction - constancy of the base pairing Provides variety - 1,000 nucleotide segment can provide - 1.5 x 10602 - basically endless degrees of variation

Major Electrolytes

Major cations (positively charged ions) Na+, K+, Ca2+, and H+ Major anions (negatively charged ions) Cl−, HCO3− (bicarbonate), and PO43−

The Pulmonary and Systemic Circuits

Major divisions of circulatory system Pulmonary circuit: right side of heart Carries blood to lungs for gas exchange and back to heart Systemic circuit: left side of heart Supplies oxygenated blood to all tissues of the body and returns it to the heart Left side of heart Fully oxygenated blood arrives from lungs via pulmonary veins Blood sent to all organs of the body via aorta Right side of heart Lesser oxygenated blood arrives from inferior and superior venae cavae Blood sent to lungs via pulmonary trunk

Fluid Compartments

Major fluid compartments of the body 65% intracellular fluid (ICF) 35% extracellular fluid (ECF) 25% tissue (interstitial) fluid 8% blood plasma and lymphatic fluid 2% transcellular fluid "catch-all" category Cerebrospinal, synovial, peritoneal, pleural, and pericardial fluids Vitreous and aqueous humors of the eye Bile, and fluids of the digestive, urinary, and reproductive tracts Fluid continually exchanged between compartments Water moves by osmosis If imbalance arises, osmosis restores balance within seconds so the intracellular and extracellular osmolarity are equal If osmolarity of the tissue fluid rises, water moves out of the cell If it falls, water moves in Osmosis from one fluid compartment to another is determined by the relative concentrations of solutes in each compartment Electrolytes: the most abundant solute particles, by far Sodium salts in ECF (outside cell) Potassium salts in ICF (inside cell) Electrolytes play the principal role in governing the body's water distribution and total water content

The Nose

Major structures in nose 3 nasal conchae Project from lateral walls toward septum Cleans, warms, and moistens the air Olfactory epithelium - detects odors, found in small area Covers a small area of the roof & cilia bind chemicals Ciliated pseudostratified columnar epithelium with goblet cells Respiratory epithelium - lines rest of nasal cavity except vestibule Ciliated pseudostratified columnar epithelium with goblet cells Goblet cells secrete mucus and cilia propel the mucus toward pharynx

Introduction to ch.18 blood

Many myths about blood Mysterious "vital force" Drained "bad blood" for medical reasons Hereditary traits were once thought to be transmitted through blood Blood cells were seen with the first microscopes Hematology—the study of blood Recent developments in this field help save lives

Body of vertebra

Mass of spongy bone that contains red bone marrow Covered with thin shell of compact bone Weight-bearing portion Rough superior and inferior surfaces provide firm attachment for intervertebral discs

The Teeth

Masticate (chew) food into smaller pieces Makes food easier to swallow Exposes more surface area for action of digestive enzymes speeding chemical digestion 32 adult teeth; 20 deciduous (baby) teeth 16 in mandible 16 in maxilla From midline to the rear of each jaw 2 incisors—chisel-like cutting teeth used to bite off a piece of food 1 canine—pointed and act to puncture and shred food 2 premolars—broad surface for crushing and grinding 3 molars—even broader surface for crushing and grinding Regions of a tooth Crown: portion above the gum Root: the portion below the gum, embedded in alveolar bone Neck: the point where crown, root, and gum meet Apical foramen: where nerves/blood vessels enter tooth Root canal: in root leading to pulp cavity in the crown Nerves and blood vessels Dentin—hard yellowish tissue that makes up most of the tooth Enamel—hardest tissue in body, covers crown and neck Cementum—covers root Cementum and dentin are living tissue and can regenerate Enamel is noncellular secretion formed during development 20 deciduous teeth (milk teeth or baby teeth) Teeth develop beneath the gums and erupt in a predictable order Erupt from 6 to 30 months Beginning with incisors Between 6 and 32 years of age, are replaced by 32 permanent teeth Third molars (wisdom teeth) erupt from age 17 to 25 years May be impacted: crowded against neighboring teeth and bone so they cannot erupt

The Matrix

Matrix of osseous tissue is, by dry weight, about one-third organic and two-thirds inorganic matter Organic matter: synthesized by osteoblasts -Collagen, carbohydrate-protein complexes, such as glycosaminoglycans, proteoglycans, and glycoproteins Inorganic matter -85% hydroxyapatite (crystallized calcium phosphate salt) -10% calcium carbonate -Other minerals (fluoride, sodium, potassium, magnesium) Rickets: soft bones due to deficiency of calcium salts Osteogenesis imperfecta or brittle bone disease: excessively brittle bones due to lack of protein, collagen

Skin Color

Melanin—most significant factor in skin color -Produced by melanocytes -Accumulate in the keratinocytes of stratum basale and stratum spinosum People of different skin colors have the same number of melanocytes -Dark-skinned people --Produce greater quantities of melanin --Melanin granules in keratinocytes more spread out than tightly clumped --Melanin breaks down more slowly --Melanized cells seen throughout the epidermis Hemoglobin—red pigment of red blood cells -Adds reddish to pinkish hue to skin Carotene—yellow pigment acquired from egg yolks and yellow/orange vegetables --Concentrates in stratum corneum and subcutaneous fat Colors of diagnostic value -Cyanosis—blueness of the skin from deficiency of oxygen in the circulating blood --Airway obstruction (drowning or choking) --Lung diseases (emphysema or respiratory arrest) --Cold weather or cardiac arrest -Erythema—abnormal redness of the skin due to dilated cutaneous vessels --Exercise, hot weather, sunburn, anger, or embarrassment -Pallor—pale or ashen color when there is so little blood flow through the skin that the white color of dermal collagen is visible --Emotional stress, low blood pressure, circulatory shock, cold, anemia -Albinism—genetic lack of melanin that results in white hair, pale skin, and pink eyes --Have inherited recessive, nonfunctional tyrosinase allele -Jaundice—yellowing of skin and sclera due to excess of bilirubin in blood --Cancer, hepatitis, cirrhosis, other compromised liver function -Hematoma (bruise)—mass of clotted blood showing through skin

Meninges of the Spinal Cord

Meninges: three fibrous connective tissue membranes that enclose the brain and spinal cord Separate soft tissue of central nervous system from bones of cranium and vertebral canal From superficial to deep: dura mater, arachnoid mater, and pia mater

Meningitis

Meningitis: inflammation of the meninges Serious disease of infancy and childhood Especially between 3 months and 2 years of age Caused by bacterial and virus invasion of the CNS by way of the nose and throat Pia mater and arachnoid are most often affected Bacterial meningitis can cause swelling of the brain, enlargment of the ventricles, and hemorrhage Signs include high fever, stiff neck, drowsiness, and intense headache; may progress to coma then death within hours of onset Diagnosed by examining the CSF for bacteria Lumbar puncture (spinal tap) draws fluid from subarachnoid space between two lumbar vertebrae

The Menstrual Cycle

Menstrual cycle - consists of a buildup of the endometrium during most of the sexual cycle, followed by its breakdown and vaginal discharge Divided into four phases: proliferative phase, secretory phase, premenstrual phase, and menstrual phase First day of noticeable vaginal discharge is defined as day 1 of the sexual cycle Average: 5 days

Taxonomy: Naming, Classifying, and Identifying Microorganisms

Microbial nomenclature- naming microorganisms Taxonomy- classifying living things -Originated over 250 years ago with the work of Carl von Linné Identification- discovering and recording the traits of organisms so they can be named and classified Levels of Classification

The Scope of Microbiology

Microbiology: The study of living things too small to be seen without magnification -Microorganisms or microbes- these microscopic organisms -Commonly called "germs, viruses, agents..." but not all cause disease and many more are useful or essential for human life

Voiding Urine

Micturition - the act of urinating Micturition reflex - spinal reflex that partly controls urination Emptying reflex - as bladder wall stretches, nerve impulses sent to sacral region of spinal cord; causes contraction of bladder wall, relaxation of the internal urethral sphincter, & entrance of urine to the urethra (then, voluntary contraction of the external urethral sphincter allows for urination) There are times when the bladder is not full enough to trigger the micturition reflex but one wishes to "go" anyway Valsalva maneuver used to compress bladder Excites stretch receptors early to get the reflex started

Tunica media

Middle layer (has smooth muscle)

Hemoglobin

Molecule in RBC that carries O2

Flagellar Arrangements- Prokaryotic Cell

Monotrichous - single flagellum Amphitrichous - flagella at both poles of the cell Lophotrichous - a tuft of flagella from same site Peritrichous - flagella dispersed randomly over the surface of the cell

Neurotransmitters and Related Messengers

More than 100 neurotransmitters have been identified Fall into four major categories according to chemical composition Acetylcholine In a class by itself Amino acid neurotransmitters Include glycine, glutamate, aspartate, and -aminobutyric acid (GABA) Monoamines Synthesized from amino acids by removal of the -COOH group Retaining the -NH2 (amino) group Major monoamines Epinephrine, norepinephrine, dopamine (catecholamines) Histamine and serotonin Neuropeptides

The Cerebral White Matter

Most of the volume of cerebrum is white matter Glia and myelinated nerve fibers transmitting signals from one region of the cerebrum to another and between cerebrum and lower brain centers

Second Trimester -Week 13 - Week 28

Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months. You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move!

Muscle Responses in the Body

Motor unit -A nerve fiber together with all of the muscle fibers it innervates -Obeys the all-or-none law Recruitment -As the intensity of nervous stimulation increases, more motor units are activated -Results in stronger muscle contractions Tone -Some muscle fibers are always contracting -Important in maintaining posture Athletics and muscle contraction -Size of muscles --Atrophy - a decrease in muscle size --Hypertrophy - an increase in muscle size -Slow-twitch fibers (Type I fibers) --Tend to be aerobic --Have more endurance --Have many mitochondria --Dark in color because they contain myoglobin --Highly resistant to fatigue Athletics and muscle contraction (continued) -Fast-twitch fibers (Type II fibers) --Tend to be anaerobic --Designed for strength --Light in color --Have fewer mitochondria, little or no myoglobin, and fewer blood vessels than fast-twitch fibers --Vulnerable to accumulation of lactic acid and can fatigue easily

Motor Neurons and Motor Units

Motor unit: one nerve fiber and all the muscle fibers innervated by it Muscle fibers of one motor unit -Dispersed throughout the muscle -Contract in unison -Produce weak contraction over wide area -Provides ability to sustain long-term contraction as motor units take turns contracting (postural control)

The Mouth

Mouth (oral cavity) Functions Ingestion (food intake) Other sensory responses to food: chewing and chemical digestion Swallowing, speech, and respiration Tongue— skeletal muscle in mouth Functions Manipulates food between teeth while it avoids being bitten Can extract food particles from the teeth after a meal Sensitive enough to feel a stray hair in a bite of food

Organs of the GI tract

Mouth (teeth, tongue, salivary glands) Pharynx Esophagus Stomach Small Intestine Large intestine

Microscopic Anatomy

Muscle fiber components -Sarcolemma - plasma membrane -Sarcoplasm - cytoplasm --Contains glycogen that provides energy for muscle contraction --Contains myoglobin which binds oxygen until needed -Sarcoplasmic reticulum - endoplasmic reticulum -T (transverse) tubules --Formed by the sarcolemma penetrating into the cell --Come into contact with expanded portions of the sarcoplasmic reticulum Myofibrils and sarcomeres -Myofibrils run the length of the muscle fiber -Composed of numerous sarcomeres --Extends between two vertical Z lines --Contains two types of protein myofilaments ---Thick filaments - made up of myosin ---Thin filaments - made up of actin, tropomyosin, and troponin --I band contains only thin filaments --A band in the center of the sarcomere contains thick and thin filaments --H zone in the center of the A band has only myosin filaments Myofilaments -Thick filaments --Composed of several hundred of molecules of myosin --Myosin molecules end in a cross-bridge -Thin filaments --Two strands of actin --Has Tropomyosin & Troponin -Sliding filaments --Occurs when sarcomeres shorten (during muscle contraction) --Actin filaments slide past the myosin filaments --Thick and thin filaments remain the same length

The Muscle Spindle

Muscle spindle: stretch receptors embedded in skeletal muscles Proprioceptors: specialized sense organs to monitor position and movement of body parts Muscle spindles inform the brain of muscle length and body movement Enables brain to send motor commands back to the muscles that control coordinated movement, corrective reflexes, muscle tone, and posture

Muscular Dystrophy

Muscular dystrophy: group of hereditary diseases in which skeletal muscles degenerate and weaken, and are replaced with fat and fibrous scar tissue Duchenne muscular dystrophy is caused by a sex-linked recessive trait (1 of 3,500 live-born boys) -Most common form -Disease of males; diagnosed between 2 and 10 years of age -Rarely live past 20 years of age due to effects on respiratory and cardiac muscle; incurable

Evolution

Mutations: changes in genetic structure over time

Myelin

Myelin sheath: an insulating layer around a nerve fiber Formed by oligodendrocytes in CNS and Schwann cells in PNS Consists of the plasma membrane of glial cells 20% protein and 80% lipid Myelination: production of the myelin sheath Begins at week 14 of fetal development Proceeds rapidly during infancy Completed in late adolescence Dietary fat is important to CNS development Many Schwann cells or oligodendrocytes are needed to cover one nerve fiber Myelin sheath is segmented Nodes of Ranvier: gap between segments Internodes: myelin-covered segments from one gap to the next Saltatory conduction: nerve signal seems to jump from node to node

DNA Replication - Purpose

Necessary for passing the information to each new cell & future off-spring

Erythrocyte Homeostasis

Negative feedback control Drop in RBC count causes kidney hypoxemia Kidney production of erythropoietin stimulates bone marrow RBC count increases in 3 to 4 days Stimuli for increasing erythropoiesis Low levels O2 (hypoxemia) High altitude Increase in exercise Loss of lung tissue in emphysema

The Nephron

Nephron - functional unit of the kidney Each kidney has about 1.2 million nephrons Each composed of two principal parts Renal corpuscle: filters the blood plasma. Consists of the glomerulus and a two-layered glomerular (Bowman) capsule that encloses glomerulus Renal tubule: long coiled tube that converts the filtrate into urine

The Cranial Nerves: The Vestibulocochlear Nerve (VIII)

Nerve of hearing and equilibrium Damage produces deafness, dizziness, nausea, loss of balance, and nystagmus (involuntary rhythmic oscillation of the eyes from side to side)

Sallatory Conduction

Nerve signal seems to jump node to node

General Anatomy of Nerves and Ganglia

Nerves of peripheral nervous system are ensheathed in Schwann cells Forms neurilemma Myelin sheath around the axon Endoneurium Fascicles: nerve fibers gathered in bundles Perineurium Epineurium Blood vessels penetrate connective tissue coverings Nerves have high metabolic rate and need plentiful blood supply Ganglion: cluster of neurosomas (Cell Body) outside the CNS Enveloped in an endoneurium continuous with that of the nerve Among neurosomas are bundles of nerve fibers leading into and out of the ganglion Posterior root ganglion associated with spinal nerves

Nervous Tissue

Nervous tissue: specialized for communication by electrical and chemical signals Consists of neurons (nerve cells) -Detect stimuli -Respond quickly -Transmit coded information rapidly to other cells Neuroglia (glial) -Protect and assist neurons -"Housekeepers" of nervous system Neuron parts -Neurosoma (cell body) --Houses nucleus and other organelles --Cell's center of genetic control and protein synthesis -Dendrites --Multiple short, branched processes --Receive signals from other cells --Transmit messages to neurosoma -Axon (nerve fiber) --Sends outgoing signals to other cells --Can be more than a meter long Muscular tissue: elongated cells that are specialized to contract in response to stimulation Primary job is to exert physical force on other tissues and organs Creates movements involved in body and limb movement, digestion, waste elimination, breathing, speech, and blood circulation Important source of body heat Three types of muscle: skeletal, cardiac, and smooth

Neural Control of Breathing

Neurons in medulla oblongata and pons control unconscious breathing Automatic, unconscious cycle of breathing is controlled by three pairs of respiratory centers in the reticular formation of the medulla oblongata and the pons Most potent stimulus to breathe is blood pH! Voluntary control provided by motor cortex Innervation Fibers of phrenic nerve supply diaphragm Intercostal nerves supply intercostal muscles

Lag Phase

Newly inoculated cells require a period of adjustment , enlargement, and synthesis The cells are not yet multiplying at their maximum rate Although numbers are not increasing, the organisms are metabolically active Length of lag period varies from one population to another

Structure of Lymph Nodes

Nodes are divided into compartments called nodules separated by sinuses Nodules are masses of lymphocytes & macrophages Defensive cells that are concerned with immunity and phagocytosis Afferent lymphatic vessels bring lymph into node for cleaning Efferent continues its journey to the heart

Normal Flora

Normal flora (microbiotia): microbes that normally live on the skin, in the alimentary tract, and in other sites in humans Usually mutualistic or commensal, but can sometimes become parasitic - opportunistic pathogen - more about this in Chapter 13.

Urine Volume

Normal volume for average adult - 1 to 2 L/day Polyuria - output in excess of 2 L/day Oliguria - output of less than 500 mL/day Anuria - 0 to 100 mL/day Low output from kidney disease, dehydration, circulatory shock, prostate enlargement Low urine output of less than 400 mL/day, the body cannot maintain a safe, low concentration of waste in the plasma Diabetes - any metabolic disorder resulting in chronic polyuria At least four forms of diabetes Diabetes mellitus type 1, type 2, and gestational diabetes (type3) Glycosuria - glucose in the urine Diabetes insipidus ADH hyposecretion causes not enough water to be reabsorbed in the collecting duct More water passes in urine Diuretics - any chemical that increases urine volume Some increase GFR Caffeine dilates the afferent arteriole Reduce tubular reabsorption of water Alcohol inhibits ADH secretion Commonly used to treat hypertension and congestive heart failure by reducing the body's fluid volume and blood pressure

Bones of the Skeletal System

Number of bones -206 in typical adult skeleton --Varies with development of sesamoid bones (patella) ---Bones that form within some tendons in response to stress --Varies with presence of sutural (wormian) bones in skull --Extra bones that develop in skull suture lines -270 bones at birth, decreases with fusion Surface markings -Ridges -Spines -Bumps -Depressions -Canals -Pores -Slits -Cavities -Articular surfaces

Erythroblastosis Fetalis

Occurs if Rh- mother has formed antibodies and is pregnant with second Rh+ child Anti-Rh antibodies can cross placenta and attack fetus's RBCs Prevention RhoGAM given to pregnant Rh- women Binds fetal Rh antigen in her blood so she will not form anti-Rh antibodies

Multiple sclerosis

Oligodendrocytes and myelin sheaths in the CNS deteriorate Myelin replaced by hardened scar tissue Nerve conduction disrupted (double vision, tremors, numbness, speech defects) Onset between 20 and 40 and fatal from 25 to 30 years after diagnosis Cause may be autoimmune triggered by virus

Alveolar Ventilation

Only air that enters the alveoli is available for gas exchange Not all inhaled air gets there Anatomic dead space Conducting division of airway where there is no gas exchange (bronchi, bronchioles) A person inhales 500 mL of air, and 150 mL stays in anatomical dead space, then 350 mL reaches alveoli Alveolar ventilation rate (AVR) Air that ventilates alveoli (350 mL) X respiratory rate (12 bpm) = 4,200 mL/min. Of all the measurements, this one is most directly relevant to the body's ability to get oxygen to the tissues and dispose of carbon dioxide Residual volume—1,300 mL that cannot be exhaled with maximum effort; air remaining in alveoli after expiration

Bone Disorders

Orthopedics: originated as the name implies, as the treatment of skeletal deformities in children Deals with the prevention and correction of injuries and disorders of bones, joints, and muscles Includes the design of artificial joints and limbs and the treatment of athletic injuries

Bone Development

Ossification or osteogenesis: the formation of bone In the human fetus and infant, bone develops by two methods -Intramembranous ossification- Produces flat bones of skull and clavicle -Endochondral ossification Endochondral Ossification: During infancy and childhood, the epiphyses fill with spongy bone Cartilage limited to the articular cartilage covering each joint surface, and to the epiphyseal plate -A thin wall of cartilage separating the primary and secondary marrow cavities -Epiphyseal plate persists through childhood and adolescence By late teens to early 20s, Gap between epiphyses and diaphysis closes and becomes epiphyseal line

Bone Cells

Osteogenic (osteoprogenitor) cells: stem cells found in endosteum, periosteum, and in central canals -Arise from embryonic mesenchymal cells; multiply continuously to produce new osteoblasts Osteoblasts: bone-forming cells -Line up as single layer of cells under endosteum and periosteum -Stress and fractures stimulate osteogenic cells to multiply more rapidly and increase number of osteocytes to reinforce or rebuild boneOsteocytes: former osteoblasts that have become trapped in the matrix they have deposited -Lacunae: tiny cavities where osteocytes reside -Canaliculi: little channels that connect lacunae Osteoclasts: bone-dissolving cells found on the bone surface -Osteoclasts develop from same bone marrow stem cells that give rise to blood cells -Different origin from rest of bone cells

Tissues and Organs of the Skeletal System

Osteology: the study of bone Skeletal system: composed of bones, cartilages, and ligaments Form strong, flexible framework of the body Cartilage: forerunner of most bones Covers many joint surfaces of mature bone Ligaments: hold bones together at the joints Tendons: attach muscle to bone

Osteoporosis

Osteoporosis: the most common bone disease -Severe loss of bone density Bones lose mass and become brittle due to loss of organic matrix and minerals -Affects spongy bone the most since it is the most metabolically active -Subject to pathological fractures of hip, wrist, and vertebral column -Kyphosis (widow's hump): deformity of spine due to vertebral bone loss -Complications of loss of mobility are pneumonia and thrombosis Estrogen maintains density in both sexes; inhibits resorption by osteoclasts -Testes and adrenals produce estrogen in men -In women, rapid bone loss after menopause since ovaries cease to secrete estrogen Osteoporosis is common in young female athletes with low body fat causing them to stop ovulating and ovarian estrogen secretion is low Treatments -Estrogen replacement therapy (ERT) slows bone resorption, but increases risk of breast cancer, stroke, and heart disease -Drugs Fosamax, Actonel destroy osteoclasts -PTH slows bone loss if given as daily injection -Forteo (PTH derivative) increases density by 10% in 1 year --May promote bone cancer so use is limited to 2 years -Best treatment is prevention: exercise and a good bone-building diet between ages 25 and 40

Chromosomal Sex Determination

Our cells contain 23 pairs of chromosomes 22 pairs of autosomes 1 pair of sex chromosomes (XY males: XX females) Males produce half Y-carrying sperm and half X-carrying sperm All eggs carry the X chromosome Sex of child determined by type of sperm that fertilizes mother's egg X-carrying sperm fertilizes the egg: female Y-carrying sperm fertilizes the egg: male

Cell Envelope- Prokaryotic Cell

Outer Membrane - In some organisms surrounds the cell wall; similar to cell membrane Cell Wall - A semi-rigid casing that provides structural support and shape for the cell Cell Membrane - A thin sheet of lipid and protein that surround the cytoplasm and controls the flow of materials into and out of the cell pool.

External iliac vein

Outside of hip. Receives blood from femoral vein

The Ovarian Cycle

Ovarian cycle - three principal steps Follicular phase, ovulation, and luteal phase This cycle reflects what happens in the ovaries and their relationship to the hypothalamus and pituitary Much remains unknown about the timing of folliculogenesis Follicular phase extends from the beginning of menstruation until ovulation Day 1 to day 14 of an average cycle Preovulatory phase: from the end of menstruation until ovulation Most variable part of the cycle; seldom possible to reliably predict the date of ovulation Ovulation - the rupture of the mature follicle and the release of its egg and attendant cells Typically around day 14 Uterine tube prepares to catch the oocyte when it emerges It swells with edema Its fimbriae envelop and caress the ovary in synchrony with the woman's heartbeat Cilia create gentle current in the nearby peritoneal fluid Many oocytes fall into the pelvic cavity and die LH surge occurs about 24 hours prior to ovulation Detected with home testing kit Twinges of ovarian pain (mittelschmerz) Lasts from a few hours to a day or so at the time of ovulation Best time for conception Within 24 hours after the cervical mucus changes and the basal temperature rises (.5 degree) Luteal (postovulatory) phase - day 15 to day 28, from just after ovulation to the onset of menstruation. If pregnancy does not occur, events happen as follows: Ovulated follicle has now become the corpus luteum Named for a yellow lipid that accumulates in the theca interna cells Cells now called lutein cells Transformation from ruptured follicle to corpus luteum is regulated by LH LH stimulates the corpus luteum to continue to grow and secrete rising levels of estradiol and progesterone 10-fold increase in progesterone is the most important aspect of the luteal phase Progesterone has a crucial role in preparing the uterus for the possibility of pregnancy LH and FSH secretion declines over the rest of the cycle The corpus luteum begins the process of involution (shrinkage) Beginning about day 22 (8 days after ovulation) By day 26 involution is complete and becomes inactive bit of scar tissue, the corpus albicans With diminishing ovarian steroid secretion, FSH levels rise ripening a new cohort of follicles Ovaries usually alternate from month to month

The Ovaries

Ovaries - female gonads that produce egg cells (ova) and sex hormones Almond-shaped and nestled in the ovarian fossa Depression in the posterior pelvic wall Ovulation: bursting of the follicle and releasing the egg Ovarian ligaments Attached to uterus by ovarian ligament Attached to pelvic wall by suspensory ligament Contains ovarian artery, vein, and nerves Anchored to broad ligament by mesovarium

Pain

Pain: discomfort caused by tissue injury or noxious stimulation, and typically leading to evasive action Important since it helps protect us Lost in diabetes mellitus - diabetic neuropathy Nociceptors: two types providing different pain sensations Somatic pain: from skin, muscles, and joints Visceral pain: from the viscera Stretch, chemical irritants, or ischemia of viscera (poorly localized)

The Palate

Palate—separates the oral cavity from the nasal cavity; consists of 2 parts (hard & soft) Makes it possible to breathe while chewing food Hard (bony) palate— Anterior portion that is supported by the maxillae and the palatine bones Palatine rugae: transverse ridges that help the tongue hold and manipulate food Soft palate— posterior with a more spongy texture; skeletal muscle & gland only Uvula: conical medial projection visible at the rear of the mouth Blocks nasopharynx from receiving food

Supination

Palms forward; palms up

The Pancreas

Pancreas—spongy retroperitoneal gland posterior to the greater curvature of the stomach Measure 12 to 15 cm long, and 2.5 cm thick Both an endocrine and exocrine gland Endocrine portion—pancreatic islets that secrete insulin and glucagon Exocrine portion—99% of pancreas that secretes 1,200 to 1,500 mL of pancreatic juice per day Juices made by pancreas go into pancreatic duct

Parathyroid

Parathyroid Glands Posterior surface of the thyroid gland Produces parathyroid hormone (PTH) Causes blood phosphate (HPO42-) level to decrease Causes blood calcium (Ca2+) level to increase Promotes the release of calcium from the bones Osteoporosis Promotes the reabsorption of calcium by the kidneys Activates vitamin D in the kidneys, which stimulates the reabsorption of calcium from the intestines Hypocalcemic tetany results when there is insufficient secretion of PTH

Stage 2 of sleep

Pass into light sleep EEG declines in frequency but increases in amplitude Exhibits sleep spindles - high spikes resulting from interactions between neurons of the thalamus and cerebral cortex

The Patella

Patella: triangular sesamoid bone embedded in tendon of knee Cartilaginous at birth -Ossifies at age 3 to 6 years Quadriceps femoris tendon extends from anterior muscle of thigh to patella -Continues as the patellar ligament from patella to tibia Base: broad, superior portion Apex: pointed, inferior portion Articular facets: shallow, posterior portion

Body Defenses Against Infection

Pathogen - disease causing agent Infection - presence & multiplication of pathogens Types of pathogens Viruses Bacteria Fungi Protozoans & Helminths (worms)

The Nature of Reflexes

Pathway of reflex arc Somatic receptors In skin, muscles, or tendons Afferent nerve fibers Carry information from receptors to posterior horn of spinal cord or the brainstem Integrating center A point of synaptic contact between neurons in gray matter of spinal cord or brainstem Determines whether efferent neurons issue signal to muscles Efferent nerve fibers Carry motor impulses to skeletal muscle Effectors The somatic effectors carry out the response

Systolic pressure

Peak pressure when the ventricles contract

The Pectoral Girdle

Pectoral girdle (shoulder girdle) supports the arm Consists of two bones on each side of the body -Clavicle (collarbone) and scapula (shoulder blade) Clavicle articulates medially to the sternum and laterally to the scapula -Sternoclavicular joint -Acromioclavicular joint Scapula articulates with the humerus -Glenohumeral joint: shoulder joint -Easily dislocated due to loose attachment

The Pelvic Girdle

Pelvis: bowl-shaped structure composed of the two coxal bones and sacrum as well as their ligaments and muscles that line the pelvic cavity and form its floor -Supports trunk on the lower limbs and protects viscera, lower colon, urinary bladder, and internal reproductive organs Sacroiliac joint: joins hipbone to the vertebral column (SI Joint- Back pain) Pelvic girdle: consists of a complete ring composed of three bones -Two hip (coxal) bones, also called ossa coxae or innominate bones -Sacrum is also part of the vertebral column Anteriorly, interpubic disc: pad of fibrocartilage joins pubic bones Pubic symphysis: the interpubic disc and adjacent regions of the pubic bone on each side Three distinct features of hip bone -Iliac crest: superior crest of hip -Acetabulum: hip socket -Obturator foramen: large hole below acetabulum Each adult hip bone is formed by the fusion of three childhood bones: -Illeum -Ishchium -Pubis Ileum -Largest -Extends from the iliac crest to the center of the acetabulum Ischium -Inferioposterior portion of hip -Heavy body with prominent spine -Ischial tuberosity Pubis (pubic bone) --Most anterior portion of the hip bone -Body -Superior ramus -Inferior ramus Male - heavier and thicker due to forces exerted by stronger muscles Female - wider and shallower, and adapted to the needs of pregnancy and childbirth, larger pelvic inlet and outlet for passage of infant's head

The Penis

Penis serves to deposit semen in the vagina Half of the penis is an internal root Half is an externally visible shaft External portion 4 in. long when flaccid (nonerect) 5 to 7 in. long when erect Skin over shaft loosely attached allows expansion Extends over glans as prepuce (foreskin) Removed by circumcision Smegma—waxy secretion produced by the sebaceous glands in the glans and facing surface of the prepuce Three cylindrical bodies of erectile tissue which fill with blood during sexual arousal and account for its enlargement and erection

The Heart Wall

Pericardium— double-walled sac (pericardial sac) that encloses the heart Allows heart to beat without friction, provides room to expand, yet resists excessive expansion Anchored to diaphragm inferiorly and sternum anteriorly Parietal pericardium—outer wall of sac Visceral pericardium (epicardium)—heart covering Serous lining of sac turns inward at base of heart to cover the heart surface Pericardial cavity—space inside the pericardial sac filled with 5 to 30 mL of pericardial fluid Pericarditis—inflammation of the membranes Painful friction rub with each heartbeat Epicardium (visceral pericardium) Serous membrane covering heart Adipose in thick layer in some places Coronary blood vessels travel through this layer Myocardium Layer of cardiac muscle proportional to work load Muscle spirals around heart which produces wringing motion Endocardium Smooth inner lining of heart and blood vessels Covers the valve surfaces and is continuous with endothelium of blood vessels Frictionless surface prevents blood clotting

Peripheral Resistance

Peripheral resistance—the opposition to flow that blood encounters in vessels away from the heart Resistance hinges on three variables Blood viscosity ("thickness") RBC count and albumin concentration elevate viscosity the most Decreased viscosity with anemia and hypoproteinemia speed flow Increased viscosity with polycythemia and dehydration slow flow Resistance hinges on three variables (cont.) Vessel length The farther liquid travels through a tube, the more cumulative friction it encounters Pressure and flow decline with distance Vessel radius: most powerful influence over flow Only significant way of controlling peripheral resistance Vasomotion—change in vessel radius Vasoconstriction: by muscular effort that results in smooth muscle contraction Vasodilation: by relaxation of the smooth muscle Arterioles are most significant point of control over peripheral resistance and flow On proximal side of capillary beds and best positioned to regulate flow into the capillaries Outnumber any other type of artery, providing the most numerous control points More muscular in proportion to their diameter Highly capable of vasomotion Arterioles produce half of the total peripheral resistance

Mesenteries

Peritoneum - serous membrane that covers the organs & walls of the abdominal cavity Mesenteries—connective tissue/peritoneum sheets that loosely suspend/connect the stomach and intestines to the abdominal wall Allows stomach and intestines to undergo strenuous contractions Allow freedom of movement in the abdominal cavity Hold abdominal viscera in proper relationship to each other Greater omentum—hangs from the greater curvature of the stomach Covers the small intestines like an apron - "lace apron" The inferior margin turns back on itself and passes upward Forming a deep pouch between its deep and superficial layers Other mesenteries not mentioned here Lesser omentum—attaches stomach to liver Greater omentum—covers small intestines like an apron

Leukocytes and Macrophages

Phagocytes—phagocytic cells with a voracious appetite for foreign matter Five types of leukocytes Neutrophils (g) Eosinophils (g) Basophils (g) Monocytes (ag) Lymphocytes (ag) Neutrophils Wander in connective tissue killing bacteria Phagocytosis and digestion Produce a cloud of bactericidal chemicals Create a killing zone Degranulation Lysosomes discharge into tissue fluid Eosinophils Found especially in the mucous membranes Stand guard against parasites, allergens (allergy-causing agents), and other pathogens Kill tapeworms and roundworms by producing superoxide, hydrogen peroxide, and toxic proteins Promote action of basophils and mast cells Phagocytize antigen-antibody complexes Limit action of histamine and other inflammatory chemicals Basophils Secrete chemicals that aid mobility and action of other leukocytes Leukotrienes: activate and attract neutrophils and eosinophils Histamine: a vasodilator, which increases blood flow Speeds delivery of leukocytes to the area Heparin: inhibits clot formation Would impede leukocyte mobility Mast cells also secrete these substances Type of connective tissue cell very similar to basophils Monocytes—emigrate from the blood into the connective tissue and transform into macrophages Macrophage system—all the body's avidly phagocytic cells, except leukocytes Wandering macrophages: actively seeking pathogens Widely distributed in loose connective tissue Fixed macrophages: phagocytize only pathogens that come to them Microglia—in central nervous system Alveolar macrophages—in lungs Hepatic macrophages—in liver Lymphocytes Three basic categories Circulating blood contains 80% T cells 15% B cells 5% NK cells Many diverse functions Immune surveillance and specific immunity

The Pharynx

Pharynx (throat) - a muscular funnel extending about 13 cm (5 in.) from the nasal cavity to the larynx Three regions of pharynx 1. Nasopharynx Posterior to nasal cavity and above soft palate Receives auditory (Eustachian) tubes and contains pharyngeal tonsil 2. Oropharynx Space between soft palate and epiglottis Contains palatine tonsils Food, drink and air pass through here 3. Laryngopharynx Epiglottis to esophagus Food, drink and air pass through here

The Pharynx

Pharynx—a muscular funnel that connects oral cavity to esophagus and allows entrance of air from nasal cavity to larynx Digestive and respiratory tracts intersect

Accidental Lobotomy

Phineas Gage: railroad construction worker; severe injury with metal rod Injury to the ventromedial region of both frontal lobes Extreme personality change Fitful, irreverent, grossly profane Opposite of previous personality Prefrontal cortex functions Planning, moral judgment, and emotional control

Electrolyte Balance

Physiological functions of electrolytes Chemically reactive and participate in metabolism Determine electrical potential (charge difference) across cell membranes Strongly affect osmolarity of body fluids Affect body's water content and distribution

B-cells - Antibody-Mediated Immunity

Plasma cells - produce antibody Memory cells - for future attacks Antibodies cause antigens to agglutinate (clump) - making it easier for the phagocytes Activate complement - increase cell lysis

Platelet Form and Function

Platelets—small fragments of megakaryocyte cells with long tendrils of cytoplasm (proplatelets) that break off in capillary blood flow forming platelets. Normal platelet count—130,000 to 400,000 platelets/L (micro liter) Functions Stick together to form platelet plugs to seal small breaks Secrete procoagulants or clotting factors to promote clotting

Disorders of Breathing

Pneumothorax—presence of air in pleural cavity Thoracic wall is punctured Inspiration sucks air through the wound into the pleural cavity Potential space becomes an air-filled cavity Loss of negative intrapleural pressure (vacuum) allows lungs to recoil and collapse Atelectasis—collapse of part or all of a lung Can also result from an airway obstruction

Erythrocyte Disorders

Polycythemia—an excess of RBCs Primary polycythemia (polycythemia vera) Cancer of erythropoietic cell line in red bone marrow RBC count as high as 11 million RBCs/L; hematocrit 80% Secondary polycythemia From dehydration, emphysema, high altitude, or physical conditioning RBC count up to 8 million RBCs/L Dangers of polycythemia Increased blood volume, pressure, viscosity Can lead to embolism, stroke, or heart failure

Labor Contractions

Positive feedback theory of labor Labor induced by stretching of cervix Triggers a reflex contraction of the uterine body Pushes the fetus downward Stretches the cervix even more Self-amplifying cycle of stretch and contraction As fetus enters the vaginal canal, the pain becomes stronger Stretching of the cervix, vagina, and perineum Sometimes tearing of the vaginal tissue Episiotomy may be necessary: an incision in the vulva to widen the vaginal orifice to prevent random tearing

Images of the Brain

Positron emission tomography (PET) and MRI Visualize increases in blood flow when brain areas are active Injection of radioactively labeled glucose Busy areas of brain "light up" Functional magnetic resonance imaging (fMRI) Looks at increase in blood flow to an area (additional glucose is needed in active area) magnetic properties of hemoglobin depend on how much oxygen is bound to it (additional oxygen is there due to additional blood flow) Quick, safe, and accurate method to see brain function

The Stem-Cell Controversy

Possible treatment for diseases caused by loss of functional cell types by embryonic stem cells -Cardiacmuscle cells, injured spinal cord, insulin-secreting cells Skin and bone marrow stem cells have been used in therapy for years Adult stem cells have limited developmental potential -Difficult to harvest and culture

Pituitary Gland

Posterior pituitary Stores hypothalamic hormones ADH and oxytocin ADH Released when neurons in the hypothalamus detect that the blood is too concentrated with salt Causes more water to be reabsorbed into kidney capillaries Raises blood pressure by vasoconstriction of blood vessels Diabetes insipidus results from the inability to produce ADH Polyuria - excessive water loss through urine Polydipsia - extreme thirst Odorless, colorless, tasteless urine! Oxytocin Causes uterine contraction during childbirth Causes milk letdown when a baby is nursing Release of oxytocin is controlled by positive feedback Anterior pituitary Controlled by hypothalamic hormones Hormones that affect other glands Thyroid-stimulating hormone (TSH) Adrenocorticotropic hormone (ACTH) Gonadotropic hormones Effects of other hormones Prolactin (PRL) Growth hormone (GH) Effects of growth hormone Affects the height of an individual Pituitary dwarfism results if too little GH is produced during childhood Small person normal intellect. If too much GH is produced during childhood, a person can become a giant Gigantism- Giant person Acromegaly results when too much GH is secreted in adulthood Normal size with features distorted

The Resting Membrane Potential

Potassium ions (K+) have the greatest influence on RMP Plasma membrane is more permeable to K+ than any other ion K+ is about 40 times as concentrated in the ICF as in the ECF Cytoplasmic anions cannot escape due to size or charge (phosphates, sulfates, small organic acids, proteins, ATP, and RNA) Membrane much less permeable to high concentration of sodium (Na+) found outside the cell Some leaks and diffuses into the cell down its concentration gradient Na+ is about 12 times as concentrated in the ECF as in the ICF Resting membrane is much less permeable to Na+ than to K+ Na+/K+ pumps out 3 Na+ for every 2 K+ it brings in Works continuously to compensate for Na+ and K+ leakage, and requires great deal of ATP 70% of the energy requirement of the nervous system Necessitates glucose and oxygen be supplied to nerve tissue (energy needed to create the resting potential) Na+ concentrated outside of cell (ECF) K+ concentrated inside cell (ICF)

Parkinson Disease

Progressive loss of motor function beginning in 50s or 60s - no recovery Degeneration of dopamine-releasing neurons Dopamine normally prevents excessive activity in motor centers (basal nuclei) Involuntary muscle contractions Pill-rolling motion, facial rigidity, slurred speech Illegible handwriting, slow gait Treatment - drugs and physical therapy Dopamine precursor (L-dopa) crosses brain barrier; bad side effects on heart and liver MAO inhibitor slows neural degeneration Surgical technique to relieve tremors

Spinous process

Projection extending from the apex of arch Extends posteriorly and downward Transverse process Extends laterally from point where pedicle and lamina meet Superior articular processes Project upward from one vertebra and meets inferior articular processes from the vertebra above

Protein Digestion

Proteases (peptidases)—enzymes that digest proteins Begin their work in the stomach in optimum pH of 1.5 to 3.5

Periosteum

Protective covering of the bone (Fiberous)

Enzymes

Protein biocatalysts Increase the rate of a chemical reaction without becoming a part of the products or being consumed in the reaction Indispensable to life Terminology: -ase

Protraction and Retraction

Protraction: the anterior movement of a body part in the transverse (horizontal) plane Retraction: posterior movement

The Cranial Nerves: The Abducens Nerve (VI)

Provides eye movement

The Cranial Nerves: The Optic Nerve (II)

Provides vision Damage causes blindness in part or all of visual field

The Humerus

Proximal end -Hemispherical head that articulates with the glenoid cavity of scapula -Anatomical neck -Greater and lesser tubercles and deltoid tuberosity -Surgical neck: thinner region inferior to tubercles Distal end -Rounded capitulum articulates with head of radius -Trochlea articulates with ulna -Lateral and medial epicondyles -Olecranon fossa holds olecranon process of ulna

Pseudostratified Epithelium

Pseudostratified epithelium Looks multilayered; some not reaching free surface; all touch basement membrane Nuclei at several layers With cilia and goblet cells Secretes and propels mucus Respiratory tract and portions of male urethra

Endocrine Control of Puberty

Puberty Enlargement of secondary sexual organs Penis, testes, scrotum, ducts, glands Testosterone stimulates a burst of generalized body growth Limbs elongate, muscle mass increases, and the larynx enlarges Erythropoiesis, basal metabolic rate, and increase in appetite Pubic hair, scent and sebaceous glands develop in response to dihydrotestosterone (DHT) Stimulates sperm production and libido (sex drive) Adulthood Testosterone sustains the male reproductive tract, sperm production, and libido

Puberty

Puberty begins at age 8 to 10 for most girls in United States FSH stimulates developing ovarian follicles and they begin to secrete estrogen, progesterone, inhibin, and a small amount of androgen Estrogens are feminizing hormones with widespread effects on the body Menarche - first menstrual period Requires at least 17% body fat in teenager, 22% in adult Improved nutrition has lowered age of onset to age 12 First few menstrual cycles are anovulatory (no egg ovulated) Girls begin ovulating regularly about a year after they begin menstruating Estradiol Stimulates vaginal metaplasia Stimulates growth of ovaries and secondary sex organs Stimulates growth hormone secretion Increase in height and widening of the pelvis Responsible for feminine physique because it stimulates the deposition of fat Makes a girl's skin thicker But remains thinner, softer, and warmer than males of the corresponding age Progesterone Primarily acts on the uterus preparing it for possible pregnancy in the second half of the menstrual cycle

Pulmonary trunk

Pulmonary artery from right venticle

Heart Rate

Pulse—surge of pressure produced by each heart beat that can be felt by palpating a superficial artery with the fingertips Infants have HR of 120 bpm or more Young adult females average 72 to 80 bpm Young adult males average 64 to 72 bpm Heart rate rises again in the elderly Tachycardia—resting adult heart rate above 100 bpm Stress, anxiety, drugs, heart disease, or fever Loss of blood or damage to myocardium Bradycardia—resting adult heart rate of less than 60 bpm In sleep, low body temperature, and endurance-trained athletes

Right Ventricle

Pumps blood to the lungs

Quantities of Erythrocytes and Hemoglobin

RBC count and hemoglobin concentration indicate amount of O2 blood can carry Hematocrit (packed cell volume): percentage of whole blood volume composed of RBCs Men 42% to 52% cells; women 37% to 48% cells RBC count Men 4.6 to 6.2 million/L women 4.2 to 5.4 million/L

Erythrocytes

RBCs

Erythrocyte Death and Disposal

RBCs lyse in narrow channels in spleen Macrophages in spleen Digest membrane bits Separate heme from globin Globins hydrolyzed into amino acids Iron removed from heme Heme pigment converted to biliverdin (green) Biliverdin converted to bilirubin (yellow) Released into blood plasma (kidneys-yellow urine) Liver removes bilirubin and secretes into bile -Concentrated in gallbladder: released into small intestine; bacteria create urobilinogen (brown feces) Jaundice - Yellowish skin/eyes caused by rapid hemolysis, a liver disease or a bile duct obstruction Urochrome (yellow urine)

Nerve Injuries

Radial nerve injury Passes through axilla Crutch paralysis Wrist drop Sciatic nerve injury Sciatica: sharp pain that travels from gluteal region along the posterior side of the thigh and leg to ankle 90% of cases result from herniated intervertebral disc or osteoporosis of lower spine

The Radius

Radius -Head: disc-shaped, allows for rotation around the longitudinal axis of the bone during pronation and supination of hand --Superior surface articulates with capitulum on humerus -Neck -Radial tuberosity for biceps muscle -Styloid process can be palpated near thumb

Stratified Epithelia

Range from 2 to 20 or more layers of cells Some cells resting directly on others -Only the deepest layer attaches to the basement membrane Three stratified epithelia are named for the shapes of their surface cells -Stratified squamous -Stratified cuboidal -Stratified columnar (rare) Fourth type -Transitional epithelium Most widespread epithelium in the body Deepest layers undergo continuous mitosis -Their daughter cells push toward the surface and become flatter as they migrate farther upward -Finally die and flake off—exfoliation or Two kinds of stratified squamous epithelia -Keratinized—found on skin surface, abrasion resistant -Nonkeratinized—lacks surface layer of dead cells Stratified cuboidal epithelium: -Two or more cell layers; surface cells square or round -Secretes sweat; sperm production and ovarian hormone production -Sweat gland ducts; ovarian follicles and seminiferous tubules Transitional epithelium: -Multilayered epithelium surface cells that change from round to flat when stretched -Allows for filling of urinary tract -Ureter and bladder

Inferior vena cava

Receives blood from lower part of body. Takes blood to RA of heart

Internal jugular vein

Receives blood from the brain

Femoral vein

Receives blood from the legs

Brachiocephalic vein

Receives blood from the subclavian vein. Takes blood to the superior vena cava

Projection Pathways for Pain

Referred pain: pain in viscera often mistakenly thought to come from the skin or other superficial site Results from convergence of neural pathways in CNS Brain "assumes" visceral pain is coming from skin Brain cannot distinguish source Heart pain felt in shoulder or arm because both send pain input to spinal cord segments T1 to T5

Regeneration of Nerve Fibers

Regeneration of a damaged peripheral nerve fiber can occur if: Its soma is intact At least some neurilemma remains Fiber distal to the injury cannot survive and degenerates Macrophages clean up tissue debris at the point of injury and beyond Regeneration of damaged nerve fibers in the CNS cannot occur at all

Potassium Homeostasis

Regulation 90% of K+ in glomerular filtrate is reabsorbed by the PCT, rest excreted in urine DCT and collecting duct secrete K+ if needed, in response to blood levels Aldosterone stimulates renal secretion of K+ at same time that it stimulates reabsorption of Na+

Diastole

Relaxation

Expiration

Relaxed breathing Passive process achieved by elastic recoil of the thoracic cage Volume of thoracic cavity decreases & compresses the lungs Air flows down the pressure gradient and out of the lungs Forced breathing Accessory muscles raise intrapulmonary pressure Massive amounts of air move out of the lungs

Vestigial organs

Remnants of organs that apparently were better developed and more functional in the ancestors of a species, and now serve little or no purpose

Urinary System Disorders: Kidney Stones

Renal calculus (kidney stone)—hard granule of calcium phosphate, calcium oxalate, uric acid, or a magnesium salt called struvite Form in the renal pelvis Usually small enough to pass unnoticed in the urine flow Large stones might block renal pelvis or ureter and can cause pressure buildup in kidney which destroys nephrons Passage of large jagged stones is excruciatingly painful and may damage ureter causing hematuria Causes include: hypercalcemia, dehydration, pH imbalances, frequent urinary tract infections, or enlarged prostate gland causing urine retention Treatment includes: stone-dissolving drugs, often surgery, or lithotripsy (nonsurgical technique that pulverizes stones with ultrasound)

Renal Insufficiency and Hemodialysis

Renal insufficiency - a state in which the kidneys cannot maintain homeostasis due to extensive destruction of their nephrons Causes of nephron destruction Hypertension, chronic kidney infections, trauma, prolonged ischemia and hypoxia, poisoning by heavy metals or solvents, blockage of renal tubules in transfusion reaction, atherosclerosis, or glomerulonephritis Nephrons can regenerate and restore kidney function after short-term injuries Other nephrons hypertrophy to compensate for lost kidney function Can survive with one-third of one kidney When kidney function is insufficient Azotemia (high BUN), acidosis, and uremia develops Hemodialysis - procedure for artificially clearing wastes from the blood Blood leaves the body Wastes leave bloodstream and enter the dialysis fluid as blood flows through a semipermeable cellophane tube; also removes excess body water

Overview of the Reproductive System

Reproductive system consists of primary and secondary sex organs Primary sex organs (gonads) Produce gametes (testes or ovaries) Secondary sex organs: organs other than the gonads that are necessary for reproduction Male—system of ducts, glands; penis delivers sperm cells Female—uterine tubes, uterus, and vagina receive sperm and harbor developing fetus Secondary sex characteristics—features that further distinguish the sexes and play a role in mate attraction Develop at puberty to attract a mate Both sexes Pubic and axillary hair and their associated scent glands, and the pitch of the voice Male Facial hair, coarse and visible hair on the torso and limbs, relatively muscular physique Female Distribution of body fat, breast enlargement, and relatively hairless appearance of the skin

Puberty and Climacteric

Reproductive system remains dormant for several years after birth 10 to 12 years in most boys; 8 to 10 years in most girls Surge of pituitary gonadotropins awakens the reproductive system, leading to onset of puberty Adolescence—the period from the onset of gonadotropin secretion and reproductive development to when a person attains full adult height Puberty—first few years of adolescence, until the first menstrual period in girls or the first ejaculation of viable sperm in boys Typically around age 12 in girls and age 13 in boys

Compensation for acid-base imbalances

Respiratory acidosis Low pH (more CO2) stimulates more breathing Respiratory alkylosis High pH (less CO2) inhibits breathing Metabolic acidosis Kidney makes more acidic urine (as low as 4.5) to get rid of H+ Metabolic alkylosis Kidney makes more basic urine (as high as 8.2) to keep H+ Kidneys better at compensating long-term

Acidosis vs. Alkalosis

Respiratory acidosis—blood pH lower than 7.35 (too much CO2) Can be caused by holding one's breath for long time or hypoventilation Hyperventilation reverses acidosis (gets rid of CO2) Respiratory alkalosis—blood pH higher than 7.45 (too little CO2) Alkalosis can be caused by hyperventilation Hypoventilation is a corrective homeostatic response to alkalosis (keeps CO2 in blood) Ketoacidosis—acidosis brought about by rapid fat oxidation releasing acidic ketone bodies (diabetes mellitus) Induces Kussmaul respiration: hyperventilation cannot remove ketone bodies, but it does reduce CO2 and compensates for the ketone bodies to some degree

Inflammation

Response to irritant Signs - redness, heat, swelling, & pain Steps: Release of histamine by injured cells Vasodilation - increased blood flow Phagocytes arrive at the scene Coagulation takes place if there is injury Fever Phagocytes release pyrogens Fever has protective properties

Superior vena cava

Responsible for blood returning to the heart from the upper body

Parasympathetic Division

Rest and Digest" Includes a few cranial nerves and preganglionic fibers that arise from the sacral portion of the spinal cord Craniosacral Division Promotes digestion of food, slows heart rate, and decreases the strength of cardiac contraction

Tachycardia

Rest heart rate above 100

Bradycardia

Rest heart rate below 60. usually sleeping or trained athele

Spirometry - Disorders

Restrictive disorders—those that reduce pulmonary compliance Limit lung inflation because of lung stiffness Any disease that produces pulmonary fibrosis (scarring) Black lung disease, tuberculosis Obstructive disorders—those that interfere with airflow by narrowing or blocking the airway Make it harder to inhale or exhale a given amount of air Asthma, chronic bronchitis Emphysema combines elements of restrictive and obstructive disorders

Lymphatic System - Function

Return tissue fluid to the blood Specialized lymphatic vessels play a role in intestinal absorption Protection against disease

Reye Syndrome

Reye syndrome—serious disorder in children younger than 15 following an acute viral infection such as chickenpox or influenza Swelling of brain neurons Fatty infiltration of liver and other viscera Pressure of swelling brain Nausea, vomiting, disorientation, seizures, and coma 30% die, survivors sometimes suffer mental retardation Can be triggered by the use of aspirin to control fever Never give aspirin to children with chickenpox or flulike symptoms

The Rh Group

Rh agglutinogens discovered in rhesus monkey in 1940 A patient is considered blood type Rh+ if having Rh antigen on RBCs Anti-Rh agglutinins - not normally present but they will form in Rh- individuals exposed to Rh+ blood When does this become an issue? Rh- woman with an Rh+ fetus or Rh- person transfused with Rh+ blood No problems with first transfusion or pregnancy, major problems with second exposure to Rh+ blood

Hemolytic disease of the newborn or erythroblastosis fetalis

Rh antibodies attack fetal blood causing severe anemia and toxic toxic brain syndrome in Rh-mothers

Rigor Mortis

Rigor mortis: hardening of muscles and stiffening of body beginning 3 to 4 hours after death -Muscle relaxation requires ATP, and ATP production is no longer produced after death --Fibers remain contracted until myofilaments begin to decay Rigor mortis peaks about 12 hours after death, then diminishes over the next 48 to 60 hours

The Five Kingdom Model

Robert Whittaker (1959) Animals Plants Fungi (microbes) Protists (microbes) Monera (microbes)

Eversion

Rolling foot out

Medial Rotation

Rolling towards midline (internal)

Lateral Rotation

Rolling towards side (external)

Rotation

Rotation: movement in which a bone spins on its longitudinal axis -Rotation of trunk, thigh, head, or arm Medial (internal) rotation turns the bone inward Lateral (external) rotation turns the bone outward

P wave

SA node tells atria to contract. Atrial depolarization

Sexually Transmitted Diseases

STDs have an incubation period in which the pathogen multiplies with no symptoms and a communicable period in which the disease can be transmitted to others Symptomless carriers do exist Bacterial STDs Chlamydia: may cause urethral discharge and testicular pain Gonorrhea: pain and pus discharge; may result in sterility from pelvic inflammatory disease Syphilis: hard lesions (chancres) at site of infection Disappearance of chancres ends first stage Second stage is widespread pink rash Neurosyphilis is third stage with cardiovascular damage and brain lesions Viral STDs Genital herpes: most common STD in United States Blisters and pain Genital warts: warts on perineal region, cervix, anus Hepatitis B and C: inflammatory liver disease

The Sacrum

Sacrum: bony plate that forms posterior wall of pelvic cavity Once considered seat of the soul In children, five separate sacral vertebrae (S1-S5) Posterior surface very rough Median sacral crest -Formed from fusion of spinous processes

Saliva and the Salivary Glands

Saliva Functions: Moistens mouth Begins starch digestion Cleanses teeth Inhibits bacterial growth Moisten food and bind it together into bolus to aid in swallowing Hypotonic solution of 97.0% to 99.5% water and the following solutes: Salivary amylase: enzyme that begins starch digestion in the mouth Lingual lipase: enzyme that is activated by stomach acid and digests fat after the food is swallowed Mucus: binds and lubricates the mass of food and aids in swallowing Lysozyme & IgA: inhibit bacterial growth pH: 6.8 to 7.0 Extrinsic salivary glands—three pairs connected to oral cavity by ducts Parotid: located beneath the skin anterior to the earlobe Mumps is an inflammation and swelling of the parotid gland caused by a virus Submandibular gland Sublingual glands

The Scapula

Scapula: named for its resemblance to a spade or shovel -Spine: transverse ridge on posterior surface --Supraspinous fossa: indentation superior to the spine --Infraspinous fossa: broad surface inferior to the spine -Acromion: platelike extension of the spine Forms apex of the shoulder --Articulates with the clavicle—the sole point of attachment of the scapula and the upper limb to the rest of the skeleton. (AC Joint Seperation) -Glenoid cavity: shallow socket that articulates with the head of the humerus --Forming glenohumeral joint

Semen

Semen (seminal fluid)—fluid expelled during orgasm 2 to 5 mL of fluid expelled during ejaculation 60% seminal vesicle fluid, 30% prostatic fluid, and 10% sperm and spermatic duct secretions Normal sperm count 50 to 120 million/mL Lower than 20 to 25 million/mL: infertility Prostate produces a thin, milky white fluid Contains calcium, citrate, and phosphate ions Clotting enzyme Protein-hydrolyzing enzyme called serine protease (prostate-specific antigen) Seminal vesicles contribute viscous yellowish fluid Two requirements for sperm motility: elevated pH and an energy source Prostatic fluid buffers vaginal acidity from pH 3.5 to 7.5 Seminal vesicles provide fructose and other sugars to the mitochondria Contains fructose and other carbohydrates, citrate, prostaglandins, and protein called proseminogelin

Purkinje fibers

Sends impulse to ventricles and makes them contract

General Properties of Receptors

Sensation: a subjective awareness of the stimulus Most sensory signals delivered to the CNS produce no conscious sensation Filtered out in the brainstem Some do not require conscious awareness like pH and body temperature Location: encoded by which nerve fibers are issuing signals to the brain Receptive field: area that detects stimuli for a sensory neuron Receptive fields vary in size - fingertip versus skin on back Two-point touch discrimination

Water Loss

Sensible water loss is observable 1,500 mL/ day is in urine 200 mL/day is in feces 100 mL/day is sweat in resting adult Insensible water loss is unnoticed 300 mL/day in expired breath 400 mL/day is cutaneous transpiration Diffuses through epidermis and evaporates Does not come from sweat glands Loss varies greatly with environment and activity

Arterial Sense Organs

Sensory structures in the walls of certain vessels that monitor blood pressure and chemistry Carotid sinuses: baroreceptors (pressure sensors) In walls of internal carotid artery Monitors blood pressure—signaling brainstem Decreased heart rate and vessel dilation in response to high blood pressure Carotid bodies: chemoreceptors Oval bodies near branch of common carotids Monitor blood chemistry Mainly transmit signals to the brainstem respiratory centers Adjust respiratory rate to stabilize pH, CO2, and O2 Aortic bodies: chemoreceptors One to three in walls of aortic arch Same function as carotid bodies

Types of Secretions

Serous glands -Produce thin, watery secretions --Perspiration, milk, tears, digestive juices Mucous glands -Produce glycoprotein, mucin, which absorbs water to form a sticky secretion called mucus -Goblet cells: unicellular mucous glands Mixed glands -Contain both cell types and produce a mixture of the two types of secretions Cytogenic glands -Release whole cells, sperm and egg cells

The Sexual Cycle

Sexual cycle averages 28 days, varies from 20 to 45 days Hormones of the hypothalamus regulate the pituitary gland Pituitary hormones regulate the ovaries Ovaries secrete hormones that regulate the uterus Basic hierarchy of hormonal control Hypothalamus -> pituitary -> ovaries -> uterus Ovaries exert feedback control over hypothalamus and pituitary Cycle begins with 2-week follicular phase Menstruation occurs during first 3 to 5 days of cycle Uterus replaces lost tissue by mitosis and cohort of follicles grow Ovulation around day 14: remainder of follicle becomes corpus luteum Next 2 weeks: luteal phase Corpus luteum stimulates endometrial secretion and thickening If pregnancy does not occur, endometrium breaks down in the last 2 days Menstruation begins and the cycle starts over

Thyroid

Simple goiter Caused by a lack of iodine Thyroid enlarges in response to constant stimulation by the anterior pituitary Congenital hypothyroidism (cretinism) Thyroid fails to develop properly Undersecretion of thyroid hormone Lack brain development Individuals are short and stocky Myxedema Hypothyroidism in adults Characterized by Lethargy Weight gain Loss of hair Slower pulse rate Lowered body temperature Thick and puffy skin Hyperthyroidism (Grave's Disease) Oversecretion of thyroid hormone Exophthalmic goiter forms Edema in eye socket tissues Swelling of the muscles that move the eyes Symptoms include Hyperactivity, thin Nervousness and irritability Insomnia Weight loss More common in middle age women Calcitonin Helps control blood calcium levels Secreted when the blood calcium levels rise Brings about the deposit of calcium in the bones

Simple Epithelia

Simple squamous epithelium: -Single row of thin cells -Permits rapid diffusion or transport of substances -Secretes serous fluid -Alveoli, glomeruli, endothelium, and serosa Simple cuboidal epithelium: -Single layer of square or round cells -Absorption and secretion, mucus production and movement -Liver, thyroid, mammary and salivary glands, bronchioles, and kidney tubules Simple columnar epithelium: -Single row of tall, narrow cells -Oval nuclei in basal half of cell -Brush border of microvilli, ciliated in some organs, may possess goblet cells -Absorption and secretion; secretion of mucus -Lining of GI tract, uterus, kidney, and uterine tubes

Circulatory Routes

Simplest and most common route Heart arteries arterioles capillaries venules veins Passes through only one network of capillaries from the time it leaves the heart until the time it returns Portal system Blood flows through two consecutive capillary networks before returning to heart Between hypothalamus and anterior pituitary In kidneys Between intestines to liver Anastomosis—the point where two blood vessels merge Arteriovenous anastomosis (shunt) Artery flows directly into vein by passing capillaries Venous anastomosis Most common One vein empties directly into another This is the reason vein blockage is less serious than arterial blockage Arterial anastomosis Two arteries merge Provides collateral (alternative) routes of blood supply to a tissue Coronary circulation and around joints

The Cardiac Rhythm

Sinus rhythm—normal heartbeat triggered by the SA node Set by SA node at 60 to 100 bpm Adult at rest is 70 to 80 bpm (vagal tone) At rest, fires every 0.8 second or 75 bpm Each depolarization of the SA node sets off one heartbeat Ectopic focus—another part of heart fires before the SA node Caused by hypoxia, electrolyte imbalance, or caffeine, nicotine, and other drugs Nodal rhythm— if SA node is damaged, heart rate is set by AV node, 40 to 50 bpm Intrinsic ventricular rhythm—if both SA and AV nodes are not functioning, rate set at 20 to 40 bpm Requires pacemaker to sustain life Arrhythmia—any abnormal cardiac rhythm Failure of conduction system to transmit signals (heart block) Bundle branch block Total heart block (damage to AV node)

Muscular Tissue: Skeletal Muscle

Skeletal muscle -Long, threadlike cells called muscle fibers Most attach to bone Exceptions: -In tongue -Upper esophagus -Facial muscles -Some sphincter muscles (ringlike or cufflike muscles that open and close body passages) Contains multiple nuclei adjacent to plasma membrane Striations: alternating dark and light bands Voluntary: conscious control over skeletal muscles

The Skull

Skull—the most complex part of the skeleton 22 bones joined together by sutures (immovable joints) 8 cranial bones surround cranial cavity which encloses the brain Other cavities—orbits, nasal cavity, oral (buccal) cavity, middle- and inner-ear cavities, and paranasal sinuses Paranasal sinuses—frontal, sphenoid, ethmoid, and maxillary -Lined by mucous membrane and air-filled -Lighten the anterior portion of the skull -Act as chambers that add resonance to the voice Foramina—holes that allow passage for nerves and blood vessels 14 facial bones support teeth, facial, and jaw muscles

Adrenal Glands

Small gland that sits on top of each kidney They are retroperitoneal like the kidney Adrenal cortex and medulla formed by merger of two fetal glands with different origins and functions Adrenal Medulla Inner portion Under nervous control Secretes epinephrine (adrenaline) and norepinephrine (noradrenaline) Causes "fight or flight" responses Provide a short-term response to stress Adrenal Cortex Outer portion Under the control of ACTH Hormones Provide a long-term response to stress Mineralcorticoids Glucocorticoids Male and female sex hormones Glucocorticoids (cortisol) Raises the blood glucose level in at least 2 ways: Counteracts the inflammatory response and can relieve swelling and pain Can also make a person susceptible to injury and infection Mineralcorticoids (aldosterone) Targets the kidney Promotes renal absorption of sodium and water Promotes renal excretion of potassium Renin-Angiotensin mechanism stimulates aldosterone secretion when the blood sodium level and blood pressure are low Renin-Angiotensin-Aldosterone system raises blood pressure in two ways: Angiotensin II constricts arterioles Aldosterone causes the kidneys to reabsorb sodium Atrial natriuretic hormone (ANH) is antagonistic to aldosterone Malfunction of the Adrenal Cortex Addison Disease Hyposecretion of adrenal cortex hormones Excessive (but ineffective) ACTH causes bronzing of the skin Because glucose cannot be replenished without cortisol, individuals are susceptible to infection Lack of aldosterone results in the development of low blood pressure and possibly severe dehydration Cushing Syndrome Hypersecretion of adrenal cortex hormones Tendency towards diabetes mellitus Excess aldosterone leads to hypertension Excessive torso fat deposits, "Buffalo Humps"

Gross Anatomy

Small intestine—coiled mass filling most of the abdominal cavity inferior to the stomach and the liver Small intestine divided into three regions Duodenum Jejunum Ileum Large intestine Measures 5 ft long and 2.5 in. in diameter in cadaver Parts: cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum Appendix attached to lower end of cecum Densely populated with lymphocytes & bacteria and is a significant source of immune cells & normal flora Rectum has 3 valves Anal canal: final 3 cm of the large intestine Hemorrhoids—permanently distended veins that protrude into the anal canal or form bulges external to the anus

Microglia

Small, wandering macrophages formed white blood cell called monocytes Thought to perform a complete checkup on the brain tissue several times a day Wander in search of cellular debris to phagocytize

Types of Muscles

Smooth muscle -Located in the walls of hollow organs and blood vessels -Involuntary contraction -Moves materials through organs and regulates blood flow Cardiac muscle -Forms the heart wall. Fibers are striated, tubular, and branched -Involuntary contractions -Fibers interlock at intercalated disks, which permit contractions to spread quickly throughout the heart -Contraction does not require outside nervous stimulation -Nerves do affect heart rate and strength of contraction Skeletal muscle -Fibers are tubular, multinucleated, and striated -Make up muscles attached to the skeleton -Contraction is voluntary

Structure of a Neuron

Soma (cell body): the control center of the neuron. No centrioles: no further cell division Also called neurosoma, cell body, or perikaryon Has a single, centrally located nucleus with large nucleolus Dendrites: vast number of branches coming from a few thick branches from the soma Resemble bare branches of a tree Primary site for receiving signals from other neurons The more dendrites the neuron has, the more information it can receive and incorporate into decision making Provide precise pathway for the reception and processing of neural information Axon (nerve fiber): originates from a mound on one side of the soma called the axon hillock Cylindrical, relatively unbranched for most of its length Axon collaterals—branches of axon Branch extensively on distal end Specialized for rapid conduction of nerve signals to points remote to the soma Only one axon per neuron Schwann cells and myelin sheath enclose axon Distal end, axon has terminal arborization: extensive complex of fine branches Synaptic knob (terminal button): little swelling that forms a junction (synapse) with the next cell Contains synaptic vesicles full of neurotransmitter

Neuromuscular Toxins and Paralysis

Some pesticides contain cholinesterase inhibitors -Bind to acetylcholinesterase and prevent it from degrading Ach -Spastic paralysis: a state of continual contraction of the muscles; possible suffocation Tetanus (lockjaw) is a form of spastic paralysis caused by toxin clostridium tetani -Glycine in the spinal cord normally stops motor neurons from producing unwanted muscle contractions -Tetanus toxin blocks glycine release in the spinal cord and causes overstimulation and spastic paralysis of the muscles Flaccid paralysis: a state in which the muscles are limp and cannot contract -Curare: compete with ACh for receptor sites, but do not stimulate the muscles -Plant poison used by South American natives to poison blowgun darts Botulism: type of food poisoning caused by a neuromuscular toxin secreted by the bacterium clostridium botulinum -Blocks release of ACh causing flaccid paralysis -Botox cosmetic injections for wrinkle removal

The Nature of Sound

Sound: any audible vibration of molecules A vibrating object pushes on air molecules In turn push on other air molecules Air molecules hitting eardrum cause it to vibrate

Anterior (frontal) fontanel

Space that is unfused between the frontal and parietal bone

Posterior (occipital) fontanel

Space that is unfused between the parietal and occipital bone

The Special Senses

Special senses: limited to the head and employ relatively complex sense organs Primary cortices and association areas Vision Visual primary cortex in far posterior region of occipital lobe Hearing Primary auditory cortex in the superior region of the temporal lobe. Equilibrium Signals for balance and sense of motion project mainly to the cerebellum Taste and smell Gustatory (taste) signals received by primary gustatory cortex in parietal lobe and anterior region of insula Olfactory (smell) signals received by the primary olfactory cortex in temporal lobe

Natural Killer Cells

Special type of lymphocyte that act non-specifically to kill certain cells Microbes & certain cancer cells

The Spermatic Ducts

Spermatic ducts from testis to the urethra Efferent ductules About 12 small ciliated ducts collecting sperm from rete testes and transporting it to epididymis Duct of the epididymis (head, body, and tail) Site of sperm maturation and storage (fertile for 40 to 60 days) Contains a single coiled duct, 6 m long, adhering to posterior of testis Sperm mature as they travel through the duct If not ejaculated, they disintegrate and epididymis reabsorbs them Ductus (vas) deferens Muscular tube, 45 cm long, passing up from scrotum through inguinal canal to posterior surface of bladder Duct widens behind the bladder and widens into the terminal ampulla Duct ends by uniting with duct of the seminal vesicle Thick wall of smooth muscle well innervated by sympathetic nerve fibers Ejaculatory duct 2 cm duct formed from ductus deferens and seminal vesicle; passes through prostate to empty into urethra Male urethra (18 cm long) is shared by reproductive and urinary systems Consists of three regions Prostatic Membranous Spongy (penile) urethra

Sperm and Semen

Spermatogenesis—process of sperm production in seminiferous tubules

Spina Bifida

Spina bifida occurs when the neural tube of the fetus does not completely close in the first 28 days post conception. Three Types: Spina Bifida Occulta Spina Bifida Meningocele Spina Bifida Mylomeningocele

Spina Bifida

Spina bifida: congenital defect in which one or more vertebrae fail to form a complete vertebral arch for enclosure of the spinal cord In 1 baby out of 1,000 Common in lumbosacral region Spina bifida occulta and spina bifida cystica Folic acid (a B vitamin) as part of a healthy diet for all women of childbearing age reduces risk Defect occurs during the first 4 weeks of development, so folic acid supplementation must begin 3 months before conception

Causes of Mutations

Spontaneous mutation - random change that occurs naturally Induced mutation - result of exposure to a mutagen (physical or chemical agent that produces mutations)

Terminology and Methods of Microbial Control

Sterilization Sterilization - the complete removal or destruction of all viable microorganisms. Used on inanimate objects. Sterilants - chemicals classified as sterilizing agents Disinfection - the destruction or removal of vegetative pathogens but not bacterial endospores. Usually used only on inanimate objects. a.5% Bleach b. Boiling c.Immersing thermometers in iodine solution Sepsis - growth of microorganisms in the blood and other tissues Asepsis - prevents entry of infectious agents into sterile tissues Antiseptics - chemicals applied to body surfaces to destroy or inhibit vegetative pathogens The Agents Versus the Processes 1. Bactericide - chemical that destroys bacteria 2. Fungicide - chemical that can kill fungal spores, hyphae, and yeasts 3. Virucide - chemical known to inactivate viruses 4.Sporicide - agent capable of destroying bacterial endospores 5. Germicide and Microbicide - chemical agents that kill microorganisms 6. Stasis and Static - Greek for "stand still" 7. Bacteristatic - agents prevent growth of bacteria on tissues 8. Fungistatic - inhibit fungal growth Decontamination 1.Decontamination - The mechanical removal of most microbes. 2.Sanitation - cleansing technique that mechanically removes microorganisms and other debris

Digestion and Absorption

Stomach does not absorb any significant amount of nutrients Aspirin Some lipid-soluble drugs Alcohol is absorbed mainly by small intestine Intoxicating effects depend partly on how rapidly the stomach is emptied

Gross Anatomy

Stomach—J-shaped muscular organ with lesser and greater curvatures Nearly vertical in tall people, and horizontal in short people Divided into four regions Cardiac region (cardia)—small area within about 3 cm of the cardiac orifice Fundic region (fundus)—dome-shaped portion superior to esophageal attachment Body (corpus)—makes up the greatest part of the stomach Pyloric region (pyloris) - at inferior end of stomach Note the bulge of fundus, narrowing of pyloric region, thickness of pyloric sphincter, and greater and lesser curvatures Longitudinal wrinkles called rugae can be seen in empty stomach wall

The Stomach

Stomach—a muscular sac in upper left abdominal cavity immediately inferior to the diaphragm Primarily functions as a food storage organ Internal volume of about 50 mL when empty 1.0 to 1.5 L after a typical meal Up to 4 L when extremely full and extend nearly as far as the pelvis Mechanically breaks up food particles, liquefies the food, and begins chemical digestion of protein and fat Chyme: soupy or pasty mixture of semidigested food in the stomach Most digestion occurs after the chyme passes on to the small intestine

Cessation of the Signal

Stop adding neurotransmitter and get rid of that which is already diffusion Neurotransmitter escapes the synapse into the nearby ECF Astrocytes in CNS absorb it and return it to neurons Reuptake Synaptic knob reabsorbs amino acids and monoamines by endocytosis Break neurotransmitters down with monoamine oxidase (MAO) enzyme Some antidepressant drugs work by inhibiting MAO Degradation in the synaptic cleft Enzyme acetylcholinesterase (AChE) in synaptic cleft degrades ACh into acetate and choline Choline reabsorbed by synaptic knob

Fractures and Their Repair

Stress fracture: break caused by abnormal trauma to a bone -Falls, athletics, and military combat Pathological fracture: break in a bone weakened by some other disease -Bone cancer or osteoporosis -Usually caused by stress that would not break a healthy bone Fractures classified by structural characteristics -Direction of fracture line -Break in the skin -Multiple pieces Fractures and Their RepairThe Treatment of Fractures: Closed reduction: procedure in which the bone fragments are manipulated into their normal positions without surgery Open reduction: involves surgical exposure of the bone and the use of plates, screws, or pins to realign the fragments Cast: normally used to stabilize and immobilize healing bone

Other Receptors

Stretch receptors—found in the smooth muscles of bronchi and bronchioles, and in the visceral pleura Respond to inflation of the lungs and prevents lungs from overinflating Irritant receptors—nerve endings amid the epithelial cells of the airway Respond to smoke, dust, pollen, chemical fumes, cold air, and excess mucus Trigger protective reflexes such as bronchoconstriction, shallower breathing, breath-holding (apnea), or coughing

The Mandible

Strongest bone of the skull -Only bone of skull that moves noticeably -Supports lower teeth Provides attachments for muscles of facial expression and mastication Condylar process bears the mandibular condyle—oval knob that articulates with the mandibular fossa of the temporal bone forming the hinge temporomandibular joint (TMJ Syndrome)

Birth Defects

Structural Birth defects Nervous System Birth Defects Degenerative Birth Defects

Harnessing the Power of Microbes

Studies of Industrial Microbiology and Food Microbiology -Microbes can be used to make or preserve food products (e.g. yogurt, salami, cheeses) -Microbes can produce important compounds (e.g. antibiotics, MSG, ethanol)

Microbes in the Environment

Study of Environmental Microbiology Microbial photosynthesis account for most of the atmospheric oxygen on Earth Microbes are essential for decomposition of dead organisms Many biologically important elements (S, N, P) are cycled by microbes

Working definition

Study of entities too small to be seen with the unaided human eye. A.(< 0.2 mm = 200 µm = 200,000 nm)

Physiology

Study of the function of the body

Anatomy

Study of the structures of the body

Arteries of the Upper Limb

Subclavian passes between clavicle and first rib Vessel changes names as it passes to different regions Subclavian to axillary to brachial to radial and ulnar Brachial used for BP and radial artery for pulse

Functions of the Skeleton

Support: holds up the body, supports muscles, mandible and maxilla support teeth Protection: brain, spinal cord, heart, lungs Movement: limb movements, breathing, action of muscle on bone Electrolyte balance: calcium and phosphate ionsAcid-base balance: buffers blood against excessive pH changes Blood formation: red bone marrow is the chief producer of blood cells

Cartilage

Supportive connective tissue with flexible, rubbery matrix Gives shape to ear, tip of nose, and larynx Chondroblasts produce matrix and surround themselves until they become trapped in little cavities (lacunae) Chondrocytes: cartilage cells in lacunae Perichondrium: sheath of dense irregular connective tissue that surrounds elastic and most hyaline cartilage (not articular cartilage) Contains a reserve population of chondroblasts that contribute to cartilage growth throughout life No blood vessels Diffusion brings nutrients and removes wastes Heals slowly Types of cartilage Vary with fiber types Hyaline cartilage, fibrocartilage, and elastic cartilage Hyaline cartilage Articular cartilage, costal cartilage, trachea, larynx, fetal skeleton Eases joint movement, holds airway open, moves vocal cords during speech Elastic cartilage Cartilage containing elastic fibers Provides flexible, elastic support External ear and epiglottis Fibrocartilage Cartilage containing large, coarse bundles of collagen fibers Resists compression and absorbs shock Pubic symphysis, menisci, and intervertebral discs

Satellite cells

Surround the neurosomas in ganglia of the PNS Provide electrical insulation around the soma Regulate the chemical environment of the neurons

The Cranial Nerves: The Glossopharyngeal Nerve (IX)

Swallowing, salivation, gagging

Neurotransmitters and Their Receptors

Sympathetic effects tend to last longer than parasympathetic effects ACh released by parasympathetics is broken down quickly at synapse NE by sympathetics is reabsorbed by nerve, diffuses to adjacent tissues, and much passes into bloodstream

Nerve Supply to the Heart

Sympathetic nerves (increase heart rate) Fibers terminate in SA and AV nodes allowing for an instantaneous increase in heart rate. Parasympathetic nerves (slows heart rate) Fibers come from the Vagus Nerve to SA node and AV node

Nonsymbiotic Relationships

Synergism - an interrelationship between two or more free-living organisms that benefits them but is not necessary for their survival Antagonism - an association between free-living species that arises when members of a community compete

Synovial Joints

Synovial joint, diarthrosis, or diarthrodial joint: joint in which two bones are separated by a space called a joint cavity Most familiar type of joint Most are freely movable Most structurally complex type of joint

Neurotransmitters

Synthesized by the presynaptic neuron Released in response to stimulation Bind to specific receptors on the postsynaptic cell Alter the physiology of that cell

T-Cells - Cell Mediated Immunity

T-cells produce cytokines (lymphokines) that enhance cellular response to antigens. T-cells also secrete: Toxins Growth-inhibiting factors Interferon T-cells interact with antigens attached to the surface of another kind of cell - antigen-presenting cell T-cells types & Function Helper - stimulates B-cell to produce antibody Cytotoxic (killer) - Direct cell-to-cell battle Regulatory (suppressor) - suppresses activation of the immune system to maintain homeostasis and prevent autoimmune reaction Memory - remain for immediate response to secondary attacks of same antigen

Encapsulated Nerve Endings

Tactile (Meissner) corpuscles Light touch and texture Dermal papillae of hairless skin Krause end bulbs Tactile; in mucous membranes Lamellar (pacinian) corpuscles - phasic Deep pressure, stretch, tickle, and vibration Periosteum of bone, and deep dermis of skin Bulbous (Ruffini) corpuscles - tonic Heavy touch, pressure, joint movements, and skin stretching

The Ankle and Foot

Tarsal bones: arranged in proximal and distal groups -Tarsal bones are shaped and arranged differently from carpal bones due to load-bearing role of the ankle Calcaneus: largest tarsal bone -Forms heel -Distal portion is point of attachment for calcaneal (Achilles) tendon -Bony Spurs Talus is most superior tarsal bone -Forms ankle joint with tibia and fibula -Sits upon calcaneus and articulates with navicular Remaining bones of foot are similar in name and arrangement to the hand -Metatarsals -Phalanges Metatarsals -Metatarsal I is proximal to the great toe (hallux) -Metatarsal V is proximal to the little toe -Proximal base, intermediate shaft, and distal head Phalanges -Two in great toe --Proximal and distal phalanx -Three in all other toes --Proximal, middle, distal phalanx Sole of foot is not flat on ground Three springy arches absorb stress -Medial longitudinal arch --From heel to hallux -Lateral longitudinal arch --From heel to little toe -Transverse arch --Across middle of foot -Pes planus (flat feet): excessive weight, repetitious stress, or congenital weakness

The Midbrain (Mesencephalon)

Tectum: rooflike part of the midbrain posterior to cerebral aqueduct Exhibits four bulges, the corpora quadrigemina Upper pair, the superior colliculi, function in visual attention, tracking moving objects, and some reflexes Lower pair, the inferior colliculi, receives signals from the inner ear Relays them to other parts of the brain, especially the thalamus

The Tendon Reflex

Tendon organs: proprioceptors in a tendon near its junction with a muscle Golgi tendon organ: 1 mm long, nerve fibers entwined in collagen fibers of the tendon Tendon reflex: in response to excessive tension on the tendon Inhibits muscle from contracting strongly Moderates muscle contraction before it tears a tendon or pulls it loose from the muscle or bone

The Testes

Testes (testicles)—combined endocrine and exocrine glands that produce sex hormones and sperm Oval and slightly flattened, 4 cm long x 2.5 cm in diameter Seminiferous tubules One to three in each lobule Each tubule lined with a thick germinal epithelium for sperm generation Interstitial (Leydig) cells between tubules produce testosterone Sustentacular (Sertoli) cells in between germ cells Protect the germ cells, and promote their development Germ cells depend on them for nutrients, waste removal, growth factors, and other needs

Other Endocrine Glands

Testes and ovaries Testes produce androgens (testosterone) Ovaries produce estrogens and progesterone Secretion is controlled by the hypothalamus and the pituitary Androgens Increased testosterone secretion during puberty stimulates the growth of the penis and the testes Brings about and maintains the male secondary sex characteristics Facial, axillary, and pubic hair Enlargement of larynx and the vocal cords Muscular strength Stimulates oil and sweat glands of the skin Estrogen and Progesterone Required for breast development Regulation of the uterine cycle Estrogens Stimulate the growth of the uterus and the vagina during puberty Necessary for egg maturation Responsible for secondary sex characteristics Female body hair Fat distribution Thymus Gland Most active during childhood Transforms lymphocytes into thymus-derived lymphocytes (T-lymphocytes) Epithelial cells secrete hormones called thymosins Pineal Gland Located in the brain Produces the hormone melatonin Melatonin is involved in daily sleep-wake cycle Hormones from Other Tissues Leptin Produced by adipose tissue Growth Factors - stimulate cell division and mitosis Granulocyte and macrophage colony-stimulating factor Platelet-derived growth factor Epidermal growth factor and nerve growth factor Tumor angiogenesis factor Prostaglandins Potent chemical signals Act locally Some effects of prostaglandins include: Uterine contractions Mediate the effects of pyrogens Reduce gastric secretion Lower blood pressure Inhibit platelet aggregation

The Forebrain: Diencephalon

Thalamus "Gateway to the cerebral cortex": Nearly all input to the cerebrum passes by way of synapses in the thalamic nuclei, filters information on its way to cerebral cortex Plays key role in motor control Relays signals from cerebellum to cerebrum Provides feedback loops between the cerebral cortex and the basal nuclei Involved in the memory and emotional functions of the limbic system Limbic system: a complex of structures that include some cerebral cortex of the temporal and frontal lobes and some of the anterior thalamic nuclei Hypothalamus Infundibulum: a stalk that attaches the pituitary gland to the hypothalamus Major control center of autonomic nervous system and endocrine system Plays essential role in homeostatic regulation of all body systems Functions of hypothalamic nuclei Hormone secretion Controls anterior pituitary Regulates growth, metabolism, reproduction, and stress responses Food and water intake Hunger and satiety centers monitor blood glucose and amino acid levels Produce sensations of hunger and satiety Thirst center monitors osmolarity of the blood Rhythm of sleep and waking Controls 24-hour (circadian) rhythm of activity Memory Mammillary nuclei receive signals from hippocampus Emotional behavior Anger, aggression, fear, pleasure, and contentment

The Skin and Subcutaneous Tissue

The body's largest and heaviest organ -Covers area of 1.5 to 2.0 m2 -15% of body weight -Most skin is 1 to 2 mm thick Two layers -Epidermis: stratified squamous epithelium -Dermis: connective tissue layer Hypodermis—another connective tissue layer below the dermis Thick skin—on palms and sole, and corresponding surfaces on fingers and toes -Has sweat glands, but no hair follicles or sebaceous (oil) glands -Epidermis 0.5 mm thick Thin skin covers rest of the body -Epidermis about 0.1 mm thick -Possesses hair follicles, sebaceous glands, and sweat glands

Metabolism

The cell metabolizes by using enzymes to catalyze reactions that break down (catabolize) organic materials (precurser molecules) that cells can then use to build (anabolize) larger, more complex molecules.

How Antimicrobial Agents Work: Their Modes of Action

The cellular targets of physical and chemical agents fall into four general categories: 1. The cell wall, 2. The cell membrane, 3. Cellular synthetic processes (DNA, RNA), and 4. Proteins.

Death Phase

The curve dips downward Because of the toxic effects of their own waste , cells begin to die at an exponential rate

Fetal Development

The fetus is the final stage of prenatal development From the start of week 9 until birth Organs mature to support life outside the mother Unique aspects of fetal circulation Umbilical - placental circuit Presence of three circulatory shortcuts: shunts

The Three Stages of Pregnancy(1st, 2nd, and 3rd Trimester)

The first trimester is measured from conception to about the 12th week of pregnancy; the second trimester, from about 13 to 27 weeks of pregnancy; and the third trimester, from about 28 weeks of pregnancy until birth. Let's see what happens with you and your baby during each of the three stages

DNA Transcription Process

The messenger RNA (mRNA) is formed by synthesizing a strand of RNA based upon the DNA code mRNA is a single strand Uracil is used in place of thymine, but (like thymine) will pair with adenine in the translation process mRNA goes from the transcription site in the cytoplasm to the ribosomes. The amino acids that are present in the ribosomes will be built up into proteins based upon the transcription of the DNA found in the mRNA. The translation into the amino acid sequence for the protein requires transfer RNA (tRNA) that interprets the nucleotide sequences in groups of 3 (codon) Each codon directs the inclusion of a specific amino acid or gives other instructions for the formation of the protein (e.g. Start, Stop)

First Trimester: The Baby at 12 Weeks

The nerves and muscles begin to work together. Your baby can make a fist. The external sex organs show if your baby is a boy or girl. A woman who has an ultrasound in the second trimester or later might be able to find out the baby's sex. Eyelids close to protect the developing eyes. They will not open again until the 28th week. Head growth has slowed, and your baby is much longer. Now, at about 3 inches long, your baby weighs almost an ounce.

Stationary Growth Phase

The population enters a survival mode in which cells stop growing or grow slowly The rate of cell inhibition or death balances out the rate of multiplication Depleted nutrients and oxygen Excretion of organic acids and other biochemical pollutants into the growth medium

Third Trimester: The Baby at 36 Weeks

The protective waxy coating called vernix gets thicker. Body fat increases. Your baby is getting bigger and bigger and has less space to move around. Movements are less forceful, but you will feel stretches and wiggles. Your baby is about 16 to 19 inches long and weighs about 6 to 6½ pounds.

Anatomy of the Respiratory System

The respiratory system consists of a system of tubes that delivers air to the lung Oxygen diffuses into the blood, and carbon dioxide diffuses out Respiratory system works closely with other systems: Cardiovascular - delivers oxygen to tissues and removes CO2 Urinary - regulates body's acid-base balance Tubes: Nose, pharynx, larynx, trachea, bronchi Serve only for airflow; no gas exchange Gas exchange: Lungs (alveoli) Millions of thin-walled, microscopic air sacs in lungs Exchange gases with the bloodstream through the alveolar wall, and then flows back out Upper vs. lower respiratory tract Upper is located outside of chest (nose, pharynx, larynx) Lower is located in thorax (trachea, bronchi & lungs) Respiratory organs Major structures, tissues, anatomy, physiology Nose Pharynx Larynx Trachea Bronchi Bronchioles Alveoli/Lung Pleura

Tropomyosin & Troponin

The role of actin and myosin -Myosin binding sites on actin molecules --Covered by tropomyosin when muscle is relaxed --Released calcium combines with troponin and myosin binding sites are exposed -Cross-bridges of myosin have two binding sites --One site binds to ATP --Second binding site binds to actin

The Cerebellum

The second largest part of the brain as a whole Consists of right and left cerebellar hemispheres Contains more than half of all brain neurons - about 100 billion Monitors muscle contractions and aids in motor coordination Evaluation of sensory input Comparing textures without looking at them Spatial perception and comprehension of different views of three-dimensional objects belonging to the same object Timekeeping center Predicting movement of objects Helps predict how much the eyes must move in order to compensate for head movements and remain fixed on an object Hearing Distinguish pitch and similar-sounding words Planning and scheduling tasks Lesions may result in emotional overreactions and trouble with impulse control

Importance of Microbes

The study of microbiology is relevant to our everyday life in many different ways. -Microbes are the earliest organisms found in the fossil record -They perform essential reactions in the environment -Microbes can be harnessed to work for us -They sometimes cause infectious diseases

Bone

The term bone has two meanings: An organ of the body: femur, mandible; composed of multiple tissue types Bone tissue (osseous tissue) makes up most of the mass of bone Two forms of osseous tissue Spongy bone: spongy in appearance Delicate struts of bone: trabeculae Covered by compact bone Found in heads of long bones and in middle of flat bones such as the sternum Compact bone: denser, calcified tissue with no visible spaces More complex arrangement Cells and matrix surround vertically oriented blood vessels in long bones

Lymphatic Ducts

The thoracic duct drains into the left subclavian vein, while the right lymphatic duct drains into the right subclavian vein.

Inspiration

The two pleural layers, their cohesive attraction to each other, and their connections to the lungs and their lining of the rib cage bring about inspiration When the ribs go upward and outward during inspiration, the parietal pleura follows them The visceral pleura clings to it by the cohesion of water and it follows the parietal pleura It stretches the alveoli within the lungs The entire lung expands As it increases in volume, its internal pressure drops (vacuum), and air flows in In quiet breathing, the dimensions of the thoracic cage increase only a few millimeters in each direction Enough to increase its total volume by 500 mL (2.1 cups) Thus, 500 mL of air flows into the respiratory tract

Spina Bifida Meningocele

This is the rarest form of this neural tube defect. This type is characterized by a protrusion of the protective coating around the spinal cord through the cleft or hole in the vertebrae. Sometimes just the membrane protrudes, but more often the spinal fluid fills the protrusion causing a cyst-like structure on the child's back. Surgeons can repair and remove this cyst, although there may still be some damage to the spinal cord. There are usually minor physical disabilities associated with this form of spina bifida including incontinence issues.

Spina Bifida Mylomeningocele

This type is the most serious form of the birthdefect. Not only does the membrane protrude from the vertebral cleft, but the spinal cord also pushes through the hole. This buckling of the spinal cord causes a great deal of damage and creates lifelong physical disabilities. Because the spinal cord is not one straight cord through the spinal canal, the hindbrain is often pulled downward into the canal, causing severe compression of the cord and at times, brain damage. A child with this form of spina bifida will usually have learning disabilities as well as paralysis or major physical difficulties.

Functional Classes

Three general classes of neurons (sensory, interneuron, motor) based on function Sensory (afferent) neurons Specialized to detect stimuli Transmit information about them to the CNS Begin in almost every organ in the body and end in CNS Afferent—conducting signals toward CNS Three general classes of neurons (continued) Interneurons (association neurons) Lie entirely within the CNS Receive signals from many neurons and carry out the integrative function Process, store, and retrieve information and "make decisions" that determine how the body will respond to stimuli 90% of all neurons are interneurons Lie between and interconnect the incoming sensory pathways and the outgoing motor pathways of the CNS Motor (efferent) neuron Send signals out to muscles and gland cells (the effectors) Motor because most of them lead to muscles Efferent neurons conduct signals away from the CNS

Tonsils

Three main sets of tonsils Palatine tonsils Pair at posterior margin of oral cavity Most often infected Lingual tonsils Pair at root of tongue Pharyngeal tonsil (adenoids) Single tonsil on wall of nasopharynx

Major Landmarks

Three major portions of the brain Cerebrum is 83% of brain volume; cerebral hemispheres, gyri and sulci, longitudinal fissure, corpus callosum Cerebellum contains 50% of the neurons; second largest brain region, located in posterior cranial fossa Brainstem is the portion of the brain that remains if the cerebrum and cerebellum are removed; diencephalon, midbrain, pons, and medulla oblongata Longitudinal fissure: deep groove that separates cerebral hemispheres Gyri: thick folds Sulci: shallow grooves Corpus callosum: thick nerve bundle at bottom of longitudinal fissure that connects hemispheres Brainstem: what remains of the brain if the cerebrum and cerebellum are removed Major components Diencephalon Midbrain Pons Medulla oblongata

The Accessory Glands

Three sets of glands in male reproductive system Seminal vesicles Pair of glands posterior to bladder Empties into ejaculatory duct Forms 60% of semen Prostate gland Surrounds urethra and ejaculatory duct just inferior to the bladder 30 to 50 compound tubuloacinar glands Empty through about 20 pores in the prostatic urethra Thin milky secretion forms 30% of semen Bulbourethral (Cowper) glands Near bulb of penis During sexual arousal, they produce a clear slippery fluid that lubricates the head of the penis in preparation for intercourse Protects the sperm by neutralizing the acidity of residual urine in the urethra

Clotting Disorders

Thrombosis—abnormal clotting in unbroken vessel Thrombus: clot that stays put Most likely to occur in leg veins of inactive people Pulmonary embolism: clot may break free, travel from veins to lungs Embolus—anything that can travel in the blood and block blood vessels a way from its location of origin. Infarction (tissue death) may occur if clot blocks blood supply to an organ (MI or stroke) 650,000 Americans die annually of thromboembolism (traveling blood clots)

Tibia

Tibia: thick, medial, weight-bearing bone -Only weight-bearing bone of the crural region -Broad superior head -Medial and lateral condyles --Fairly flat articular surfaces --Articulate with condyle of femur -Tibial tuberosity: attachment of quadricep muscles -Medial malleolus: bony knob on inside of ankle

Respiratory Volumes and Capacities

Tidal volume (TV) Volume of air inhaled and exhaled in one cycle during quiet breathing (500 mL) Inspiratory reserve volume (IRV) Air in excess of tidal volume that can be inhaled with maximum effort (3,000 mL) Expiratory reserve volume (ERV) Air in excess of tidal volume that can be exhaled with maximum effort (1,200 mL) Residual volume (RV) Air remaining in lungs after maximum expiration (1,300 mL) Vital capacity (VC) Total amount of air that can be inhaled and then exhaled with maximum effort VC = ERV + TV + IRV (4,700 mL) Important measure of pulmonary health Inspiratory capacity (IC) Maximum amount of air that can be inhaled after a normal tidal expiration IC = TV + IRV (3,500 mL) Functional residual capacity (FRC) Amount of air remaining in lungs after a normal tidal expiration FRC = RV + ERV (2,500 mL) Total lung capacity (TLC) Maximum amount of air the lungs can contain TLC = RV + VC (6,000 mL)

Tissue Engineering

Tissue engineering: artificial production of tissues and organs in the lab for implantation in the human body -Framework of collagen or biodegradable polyester fibers -Seeded with human cells -Grown in "bioreactor" (inside of mouse) --Supplies nutrients and oxygen to growing tissue Skin grafts already available -Research in progress on heart valves, coronary arteries, bone, liver, tendons -Human outer ear grown on back of mouse and recent replacement of urinary bladder wall sections

Tissue Growth

Tissue growth: increasing the number of cells or the existing cells grow larger Hyperplasia: tissue growth through cell multiplication Hypertrophy: enlargement of preexisting cells -Muscle growth through exercise -Accumulation of body fat Neoplasia: development of a tumor (neoplasm) -Benign or malignant -Composed of abnormal, nonfunctional tissue

Edema Can Lead to:

Tissue necrosis Oxygen delivery and waste removal impaired Pulmonary edema Suffocation threat Cerebral edema Headaches, nausea, seizures, and coma Severe edema or circulatory shock Excess fluid in tissue spaces causes low blood volume and low blood pressure

The Primary Tissue Classes

Tissue: A group of similar cells and cell products that arise from the same region of the embryo and work together to perform a specific structural or physiological role in an organ Matrix (extracellular material) is composed of: -Fibrous proteins -Clear gel called ground substance, tissue fluid, extracellular fluid (ECF), interstitial fluid, or tissue gel

Polycythemia

To many RBCs. Primary polycythemia, secondary polycythemia, can cause heart attacks,stokes, increase bp, increase blood volume, increase viscosity, increase risk of embolism

Mouth

Tongue Palate (hard & soft) Teeth Saliva Salivary glands

The Cranial Nerves: The Hypoglossal Nerve (XII)

Tongue movements for speech, food manipulation, and swallowing

Dorsal pedal

Top of foot

Brain

Total blood flow to the brain fluctuates less than that of any other organ (700 mL/min.) Seconds of deprivation causes loss of consciousness Four to 5 minutes causes irreversible brain damage Blood flow can be shifted from one active brain region to another Transient ischemic attacks (TIAs)—brief episodes of cerebral ischemia Caused by spasms of diseased cerebral arteries Dizziness, loss of vision, weakness, paralysis, headache, or aphasia Lasts from a moment to a few hours Often early warning of impending stroke Stroke, or cerebral vascular accident (CVA) Sudden death of brain tissue caused by ischemia Atherosclerosis, thrombosis, ruptured aneurysm Effects range from unnoticeable to fatal Blindness, paralysis, loss of sensation, loss of speech common Recovery depends on surrounding neurons, collateral circulation

The Trachea

Trachea (windpipe) - a rigid tube about 4.5 in. long and 1 in. in diameter Anterior to esophagus Supported by 16 to 20 C-shaped rings of hyaline cartilage Reinforces the trachea and keeps it from collapsing when you inhale Opening in rings faces posteriorly toward esophagus Makes mucus that is beat upward by cilia

Tracheostomy

Tracheostomy - to make a temporary opening in the trachea inferior to the larynx and insert a tube to allow airflow Prevents asphyxiation due to upper airway obstruction Inhaled air bypasses the nasal cavity and is not humidified If left for long will dry out the mucous membranes of the respiratory tract & can lead to infection

The Optical Components

Transparent elements that admit light rays, refract (bend) them, and focus images on the retina Cornea Transparent cover on anterior surface of eyeball Aqueous humor Serous fluid posterior to cornea, anterior to lens Reabsorbed by scleral venous sinus (canal of Schlemm) Produced and reabsorbed at same rate Aqueous humor is released by ciliary body into posterior chamber, passes through pupil into anterior chamber, then reabsorbed into canal of Schlemm Lens Lens fibers: flattened, tightly compressed, transparent cells that form lens Suspended by suspensory ligaments from ciliary body Changes shape to help focus light Rounded with no tension or flattened with pull of suspensory ligaments Vitreous body (humor) fills vitreous chamber Jelly fills space between lens and retina

Cranial Nerve Disorders

Trigeminal neuralgia (tic douloureux) Recurring episodes of intense stabbing pain in trigeminal nerve area (near mouth or nose) Pain triggered by touch, drinking, washing face Treatment may require cutting nerve Bell palsy Degenerative disorder of facial nerve causes paralysis of facial muscles on one side May appear abruptly with full recovery within 3 to 5 weeks

Urine Formation Step 2: Reabsorption

Tubular reabsorption - process of reclaiming water and solutes (glucose, sodium, vitamins, calcium, magnesium, nitrogenous wastes) from the tubular fluid and returning them to the blood PCT reabsorbs about 65% of glomerular filtrate, removes some substances from the blood, and secretes them into the tubular fluid for disposal in urine Sodium reabsorption is the key to everything else

Glial Cells and Brain Tumors

Tumors: masses of rapidly dividing cells Mature neurons have little or no capacity for mitosis and seldom form tumors Brain tumors arise from: Meninges (protective membranes of CNS) Metastasis from nonneuronal tumors in other organs Often glial cells that are mitotically active throughout life Gliomas grow rapidly and are highly malignant Blood - brain barrier decreases effectiveness of chemotherapy Treatment consists of radiation or surgery

The Tunics

Tunica fibrosa: outer fibrous layer Sclera: dense, collagenous white of the eye Cornea: transparent area of sclera that admits light into eye Tunica vasculosa (uvea): middle vascular layer Choroid: highly vascular, deeply pigmented layer behind retina Ciliary body: extension of choroid that forms a muscular ring around lens Supports lens and iris Secretes aqueous humor Iris: colored diaphragm controlling size of pupil, its central opening Melanin in chromatophores of iris—brown or black eye color Reduced melanin—blue, green, or gray color Tunica interna—retina and beginning of optic nerve

The Vessel Wall

Tunica interna (tunica intima) Lines the blood vessel and is exposed to blood Endothelium: simple squamous epithelium overlying a basement membrane and a sparse layer of loose connective tissue Acts as a selectively permeable barrier Secretes chemicals that stimulate dilation or constriction of the vessel Normally repels blood cells and platelets that may adhere to it and form a clot When tissue around vessel is inflamed, the endothelial cells produce cell-adhesion molecules that induce leukocytes to adhere to the surface Tunica media Middle layer Consists of smooth muscle, collagen, and elastic tissue Strengthens vessels and prevents blood pressure from rupturing them Vasomotion: changes in diameter of the blood vessel brought about by smooth muscle Tunica externa (tunica adventitia) Outermost layer Consists of loose connective tissue that often merges with that of neighboring blood vessels, nerves, or other organs

The Cerebrum

Two cerebral hemispheres divided by longitudinal fissure Connected by white fibrous tract, the corpus callosum Gyri and sulci: increase amount of cortex in the cranial cavity Gyri increases surface area for information-processing capability Some sulci divide each hemisphere into five lobes named for the cranial bones overlying them

Sweat Glands

Two kinds of sweat (sudoriferous) glands Merocrine (eccrine) sweat glands -Most numerous skin glands—3 to 4 million in adult skin -Simple tubular glands -Watery perspiration that helps cool the body Apocrine sweat glands -Occur in groin, anal region, axilla, areola, bearded area in mature males -Ducts lead to nearby hair follicles -Produce sweat that is thicker, milky, and contains fatty acids -Scent glands that respond to stress and sexual stimulation -Develop at puberty -Pheromones—chemicals that influence the physiology of behavior of other members of the species -Bromhidrosis—disagreeable body odor produced by bacterial action on fatty acids Sweat: begins as a protein-free filtrate of blood plasma produced by deep secretory portion of gland -Potassium ions, urea, lactic acid, ammonia, and some sodium chloride remain in the sweat, most sodium chloride reabsorbed by duct -Some drugs are also excreted in sweat -On average, 99% water, with pH range of 4 to 6 --Acid mantle—inhibits bacterial growth -Insensible perspiration—500 mL/day --Does not produce visible wetness of skin -Diaphoresis—sweating with wetness of the skin -Exercise—may lose 1 L sweat per hour

Burns

UVA and UVB are improperly called "tanning rays" and "burning rays" -Both thought to initiate skin cancer Sunscreens protect you from sunburn but unsure if they provide protection against cancer -Chemical in sunscreen damage DNA and generate harmful free radicals Burns—leading cause of accidental death -Fires, kitchen spills, sunlight, ionizing radiation, strong acids or bases, or electrical shock -Deaths result primarily from fluid loss, infection, and toxic effects of eschar (burned, dead tissue) -Debridement: removal of eschar Classified according to the depth of tissue involvement -First-degree burn: partial-thickness burn; involves only the epidermis --Marked by redness, slight edema, and pain --Heals in a few days --Most sunburns are first-degree burns -Second-degree burn: partial-thickness burn; involves the epidermis and part of the dermis --Leaves part of the dermis intact --Red, tan, or white --Two weeks to several months to heal and may leave scars --Blistered and very painful -Third-degree burn: full-thickness burn; the epidermis and all of the dermis, and often some deeper tissues (muscles or bones) are destroyed --Third-degree burns require skin grafts --Needs fluid replacement and infection control

The Ulna

Ulna -Trochlear notch articulates with trochlea of humerus -Olecranon: bony point at back of elbow -Styloid process Interosseous membrane -Ligament attaches radius to ulna along interosseous margin of each bone -Enables the two elbow joints to share the load

DNA Replication - Process

Uncoil the parent DNA molecule Separate strands & expose nucleotide sequence of each strand Synthesize two new strands

Subclavian vein

Under the collar bone. Receives blood from the axillary vein

Stem cells

Undifferentiated cells that give rise to keratinocytes In deepest layer of epidermis (stratum basale)

The Upper Limb

Upper limb is divided into four regions containing a total of 30 bones per limb -Brachium (arm proper): extends from shoulder to elbow --Contains only 1 bone—humerus -Antebrachium (forearm): extends from elbow to wrist --Contains 2 bones—radius and ulna -Carpus (wrist) --Contains 8 small bones arranged in two rows -Manus (hand) --19 bones in two groups ---5 metacarpals in palm ---14 phalanges in fingers

Nitrogenous Wastes

Urea Proteins-> amino acids-> NH2 removed->forms ammonia, liver converts to urea Uric acid Product of nucleic acid catabolism Creatinine Product of creatine phosphate catabolism Blood urea nitrogen (BUN) - expression of the level of nitrogenous waste in the blood Normal concentration of blood urea is 10 to 20 mg/dL Azotemia: elevated BUN Indicates renal insufficiency Uremia: syndrome of diarrhea, vomiting, dyspnea, and cardiac arrhythmia stemming from the toxicity of nitrogenous waste Treatment - hemodialysis or organ transplant

Composition and Properties of Urine

Urinalysis - the examination of the physical and chemical properties of urine Appearance - clear, almost colorless to deep amber-yellow color due to urochrome pigment from breakdown of hemoglobin (RBCs); other colors from foods, drugs, or diseases Cloudiness or blood could suggest urinary tract infection, trauma, or stones Pyuria: pus in the urine Hematuria: blood in urine due to urinary tract infection, trauma, or kidney stones Odor - bacteria degrade urea to ammonia, some foods impart aroma Osmolarity (blood = 300 mOsm/L) Ranges from 50 mOsm/L to 1,200 mOsm/L in dehydrated person pH - range: 4.5 to 8.2, usually 6.0 (mildly acidic) Chemical composition: 95% water, 5% solutes Normal to find: urea, NaCl, KCl, creatinine, uric acid, phosphates, sulfates, traces of calcium, magnesium, and sometimes bicarbonate, urochrome, and a trace of bilirubin Abnormal to find: glucose, free hemoglobin, albumin, ketones, bile pigments

The Urinary Bladder

Urinary bladder - muscular sac located on floor of pelvic cavity Inferior to peritoneum and posterior to pubic symphysis Information on layers Muscularis: detrusor muscle: three layers of smooth muscle Mucosa: transitional epithelium Rugae - conspicuous wrinkles in relaxed bladder Trigone - smooth-surfaced triangular area marked with openings of ureters and urethra Capacity - moderate fullness is 500 mL, maximum fullness is 700 to 800 mL Highly distensible As it fills, it expands superiorly

Sonography

Uses: Fetuses and internal tissues Pros: Avoids x-rays Cons: Image not very sharp

Positron Emission Tomography (PET) Scan

Uses: Metabolic state of tissue Pros: Can see most metabolic active tissue Cons: Not a sharp image

Computer Tomography (CT Scan)

Uses: Slice-Type image Pros: Increased sharpness of image and low x-ray Cons: Can't see things in 3-D

Magnetic Resonance Imaging (MRI)

Uses: Slice-type image for soft tissue Pros: Superior quality to CT scan Best for soft tissue Cons: Can't have metals things in the body

The Parathyroid Glands

Usually four glands partially embedded in posterior surface of thyroid gland Can be found from as high as hyoid bone to as low as aortic arch Secrete parathyroid hormone (PTH) Increases blood Ca2+ levels Promotes synthesis of calcitriol Increases absorption of Ca2+ Decreases urinary excretion

The Uterine Tubes

Uterine tube (oviduct) or (fallopian tube) Canal about 10 cm long from ovary to uterus Muscular tube lined with ciliated cells Highly folded into longitudinal ridges

The Uterus

Uterus - thick muscular chamber that opens into roof of the vagina Usually tilts forward over the urinary bladder Harbors fetus, provides a source of nutrition, and expels the fetus at the end of its development Pear-shaped organ Fundus—broad superior curvature Body (corpus)—middle portion Cervix—cylindrical inferior end Lumen is roughly triangular Upper two corners are openings to uterine tube Lower apex is internal os Not a hollow cavity, but a potential space in nonpregnant uterus Cervical canal connects lumen to vagina Internal os - superior opening of canal into body of uterus External os - inferior opening of canal into vagina Cervical glands: secrete mucus that prevents spread of microorganisms from vagina to uterus Perimetrium - external serosa layer Myometrium - middle muscular layer Constitutes most of the uterine wall Composed mainly of smooth muscle Sweep downward from fundus; spiral around body Less muscular and more fibrous near cervix Produces labor contractions, expels fetus Endometrium - inner mucosa Simple columnar epithelium, compound tubular glands, and a stroma populated with leukocytes, macrophages, and other cells During pregnancy, the endometrium is the site of attachment of the embryo and forms the maternal part of the placenta from which the fetus is nourished

The Vagina

Vagina (birth canal) - 8 to 10 cm distensible muscular tube Allows for discharge of menstrual fluid, receipt of penis and semen, and birth of baby Tilted posteriorly between rectum and urethra Vagina has no glands Transudation lubricates vagina - "vaginal sweating" Serous fluid through its walls and by mucus from the cervical gland above it

The Valves

Valves ensure a one-way flow of blood through the heart Atrioventricular (AV) valves—control blood flow between atria and ventricles Right AV valve has three cusps (tricuspid valve) & is between RA & RV Left AV valve has two cusps (mitral/bicuspid valve) & is between LA & LV Semilunar valves—control flow into great arteries; open and close because of blood flow and pressure; look like Mercedes symbol Pulmonary semilunar valve: in opening between right ventricle and pulmonary trunk Aortic semilunar valve: in opening between left ventricle and aorta

Valvular Insufficiency Disorders

Valvular insufficiency (incompetence)—any failure of a valve to prevent reflux (regurgitation), the backward flow of blood Valvular stenosis: valve cusps are stiffened and opening is constricted by scar tissue Result of rheumatic fever, autoimmune attack on the mitral and aortic valves Heart overworks and may become enlarged Heart murmur—abnormal heart sound produced by regurgitation of blood through incompetent valves Major reason for valve replacement Mitral valve prolapse: insufficiency in which one or both mitral valve cusps bulge into atria during ventricular contraction Hereditary in 1 out of 40 people May cause chest pain and shortness of breath Can be clinically insignificant to also being a reason for valve replacement surgery.

Hemostasis

Vascular spasm—prompt constriction of a broken vessel Most immediate protection against blood loss Causes Pain receptors Some directly innervate blood vessels to constrict Smooth muscle injury Platelets release serotonin (vasoconstrictor) Endothelium smooth, coated with prostacyclin—a platelet repellant Toxins and environmental poisons (cigarette smoke)can destroy this layer allowing for blood vessel blockages. Platelet plug formation Broken vessel exposes collagen beneath prostacylin allowing the platelet stick forming plug. Coagulation (clotting)—last and most effective defense against bleeding Conversion of plasma protein fibrinogen (a plasma protein) into insoluble fibrin threads to form framework of clot Procoagulants (clotting factors)—usually produced by the liver; are present in plasma Activate one factor and it will activate the next to form a reaction cascade

Regulation of Blood Pressure and Flow

Vasomotion is a quick and powerful way of altering blood pressure and flow Three ways of controlling vasomotion Local control Neural control Hormonal control

Mechanisms of Venous Return

Venous return—the flow of blood back to the heart Pressure gradient Blood pressure is the most important force in venous return 7 to 13 mm Hg venous pressure toward heart Venules (12 to 18 mm Hg) to central venous pressure: point where the venae cavae enter the heart (~5 mm Hg) Gravity drains blood from head and neck Skeletal muscle pump in the limbs Contracting muscle squeezed out of the compressed part of the vein Get up and get your blood moving!

Blood Flow Through the Chambers

Ventricles relax Pressure drops inside the ventricles Semilunar valves close as blood attempts to back up into the ventricles from the vessels AV valves open Blood flows from atria to ventricles Ventricles contract AV valves close as blood attempts to back up into the atria Pressure rises inside of the ventricles Semilunar valves open and blood flows into great vessels

Ventricles and Cerebrospinal Fluid

Ventricles: four internal chambers within the brain Choroid plexus: spongy mass of blood capillaries on the floor of each ventricle Ependyma: neuroglia that lines the ventricles and covers choroid plexus Produces cerebrospinal fluid Cerebrospinal fluid (CSF): clear, colorless liquid that fills the ventricles and canals of CNS Functions of CSF Buoyancy Allows brain to attain considerable size without being impaired by its own weight If it rested heavily on floor of cranium, the pressure would kill the nervous tissue Protection Protects the brain from striking the cranium when the head is jolted Shaken child syndrome and concussions do occur from severe jolting Chemical stability Flow of CSF rinses away metabolic wastes from nervous tissue and homeostatically regulates its chemical environment

Light and Vision

Vision (sight): perception of objects in the environment by means of the light that they emit or reflect Light: visible electromagnetic radiation Human vision: limited to wavelengths of light from 400 to 750 nm Ultraviolet radiation: < 400 nm; has too much energy and destroys macromolecules Infrared radiation: > 750 nm; too little energy to cause photochemical reaction, but does warm the tissues Light must cause a photochemical reaction to produce a nerve signal

Disorders of Water Balance

Volume depletion (hypovolemia) Occurs when proportionate amounts of water and sodium are lost without replacement Total body water declines, but osmolarity remains normal Causes: Hemorrhage, severe burns, chronic vomiting, or diarrhea Dehydration (negative water balance) Body eliminates significantly more water than sodium Total body water declines, osmolarity rises Causes: Lack of drinking water, diabetes, ADH hyposecretion (diabetes insipidus), profuse sweating, overuse of diuretics Infants more vulnerable to dehydration than adults Affects all fluid compartments (ICF, blood, and tissue fluid) Fluid excess - less common than fluid deficiency because kidneys are highly effective in compensating for excessive intake by excreting more urine Renal failure can lead to fluid retention Hypotonic hydration (water intoxication) - more water than sodium is ingested and ECF becomes hypotonic Fluid sequestration - a condition in which excess fluid accumulates in a particular location Total body water may be normal, but volume of circulating blood may drop to the point of causing circulatory shock 3 major forms of sequestration: Edema - abnormal accumulation of fluid in the interstitial spaces, causing swelling of the tissues Hemorrhage - another cause of fluid sequestration Blood that pools in the tissues is lost to circulation Pleural effusion - several liters of fluid can accumulate in the pleural cavity Caused by some lung infections

Intervertebral foramen

When two vertebrae are joined they exhibit an opening between their pedicles -Passageway for spinal nerves Intervertebral discs (23) -First one between C2 and C3 -Last one between L5 and sacrum

Third Trimester -Week 29 - Week 40

You're in the home stretch! Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Don't worry, your baby is fine and these problems will lessen once you give birth. Some new body changes you might notice in the third trimester include: Shortness of breath Heartburn Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.) Hemorrhoids Tender breasts, which may leak a watery pre-milk called colostrum Your belly button may stick out Trouble sleeping The baby "dropping", or moving lower in your abdomen Contractions, which can be a sign of real or false labor

The ABO Group

Your ABO blood type is determined by presence or absence of antigens (agglutinogens) on RBCs Blood type A person has A antigens (wave an red "A" flag) Blood type B person has B antigens (wave a yellow "B" flag) Blood type AB has both A and B antigens (wave both "A & B" flags) Blood type O person has neither antigen (wave no flag) Most common: type O Rarest: type AB Universal donor Type O: most common blood type Has no antigens for the recipient's antibodies to attack so can be given to anyone!! Donor's plasma may have both antibodies against recipient's RBCs (anti-A and anti-B) May give packed cells (minimal plasma) Universal recipient Type AB: rarest blood type Has no antibodies to attack A or B antigens

Second Trimester: The Baby at 20 Weeks

Your baby is more active. You might feel slight fluttering. Your baby is covered by fine, downy hair called lanugo and a waxy coating called vernix. This protects the forming skin underneath. Eyebrows, eyelashes, fingernails, and toenails have formed. Your baby can even scratch itself. Your baby can hear and swallow. Now halfway through your pregnancy, your baby is about 6 inches long and weighs about 9 ounces.

Third Trimester: The Baby at 32 Weeks

Your baby's bones are fully formed, but still soft. Your baby's kicks and jabs are forceful. The eyes can open and close and sense changes in light. Lungs are not fully formed, but practice "breathing" movements occur. Your baby's body begins to store vital minerals, such as iron and calcium. Lanugo begins to fall off. Your baby is gaining weight quickly, about ½ pound a week. Now, your baby is about 15 to 17 inches long and weighs about 4 to 4½ pounds.

First Trimester: The Baby at 4 Weeks

Your baby's brain and spinal cord have begun to form. The heart begins to form. Arm and leg buds appear. Your baby is now an embryo and 1/25 of an inch long.

Sagittal

between parietal bones

Condyloid

biaxial joints capable of movement in two planes

Respiratory acidosis

blood ph below 7.35

Pulmonary circuit

blood to lungs to become oxygenated and to left atrium

Cyanosis

blueness of the skin from deficiency of oxygen in the circulating blood --Airway obstruction (drowning or choking) --Lung diseases (emphysema or respiratory arrest) --Cold weather or cardiac arrest

Internal carotid artery

brain, eyes, ears

Axon collaterals

branches of axon

Stress fracture

break caused by abnormal trauma to a bone -Falls, athletics, and military combat

Pathological fracture

break in a bone weakened by some other disease -Bone cancer or osteoporosis -Usually caused by stress that would not break a healthy bone

Adduction

bring back to mid-line

Afferent lymphatic vessels

bring lymph to the lymph nodes

White matter

bundles of axons Lies deep to cortical gray matter, opposite relationship in the spinal cord Pearly white color from myelin around nerve fibers Composed of tracts, or bundles of axons, that connect one part of the brain to another, and to the spinal cord

tracts

bundles of axons, that connect one part of the brain to another, and to the spinal cord

Depolarization

case in which membrane voltage shifts to a less negative value

Sensory homunculus

diagram of the primary somesthetic cortex which resembles an upside-down sensory map of the contralateral side of the body

Radial artery

lateral side. Receives blood from the brachial artery

Flexion

reducing the angle of the joint

Reciprocal inhibition

reflex phenomenon that prevents muscles from working against each other by inhibiting the antagonist

Tendon reflex

reflexive contraction of a muscle when its tendon is tapped

Dendrites

vast number of branches coming from a few thick branches from the soma

Central canals

vertical canals

Brainstem

what remains of the brain if the cerebrum and cerebellum are removed