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Table of Contents (List) 1 Homeostasis

2 Tissue

2.1 Epithelial

2.2 Connective

2.3 Muscle

2.4 Supportive

3 Heart

3.1 Anatomy of the Heart

3.1.1 Heart Layers

3.2 Cardiac Cycle

3.2.1 Heart Sounds in the Cardiac Cycle

3.2.2 Cardiac Output

3.2.3 Heart Rate

3.3 Conduction of the heart

3.3.1 Gap junctions between all heart cells

3.3.2 Electrocardiogram (ECG)

4 Respiratory System

4.1 Anatomy of the respiratory system

4.1.1 The nose

4.1.2 Pharynx

4.1.3 Larynx

4.1.4 Trachea

4.1.5 Bronchi

4.1.6 Lungs

4.1.7 Pleural Cavities

4.1.8 Lymphatic Supply

4.2 Gas Exchange

4.2.1 Diffusion of gases in the issues

4.3 Respiratory control

5 Bones

5.1 Bone Cells

5.2 Classification of Bones

5.3 Bone Structure

5.3.1 Bone Remodelling

5.3.2 Appositional Bone Growth

5.3.3 Bone Marrow

5.3.4 Joints

5.4 Bone Function

5.5 Illness

6 Muscle

6.1 Structure

6.1.1 Types of Muscle

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6.1.2 Classification

6.1.3 Connective Tissue

6.1.4 Cells

6.2 Function of Muscle

6.2.1 Contraction and the Sarcoplasmic Reticulum

6.2.2 Sliding Filament method of contraction

6.2.3 Muscle Twitch

6.2.4 Contraction Cycle

6.2.5 Types of Contraction

7 Endocrine System

7.1 Hypothalamus and Pituitary Gland

7.1.1 Pituitary Gland

7.1.2 Hypothalamic Hormones

7.1.3 Pituitary Disorders

7.2 Thyroid Gland

7.2.1 Thyroid Gland Disorders

7.3 Parathyroid Glands

7.3.1 Parathyroid Gland Disorders

7.4 Adrenal Gland

7.4.1 Adrenal Cortex

7.4.2 Adrenal Medulla

7.5 Pancreas

7.6 Endocrine Functions of Other Organs

7.6.1 Skin

7.6.2 Liver

7.6.3 Kidneys

8 Nervous System

8.1 Neurons

8.1.1 Structure

8.1.2 Types

8.1.3 Myelination

8.2 Glial Cells

8.3 Function of the Nervous System

8.3.1 Strong and Weak Touch

8.4 Neurotoxins

8.5 The Brain

8.5.1 Cerebrospinal Fluid (CSF)

8.5.2 Brain Stem

8.5.3 Cerebellum

8.5.4 Diencephalon

8.5.5 Cerebrum

8.5.6 Cranial Nerves

8.6 Spinal Cord

8.6.1 External Anatomy

8.6.2 Internal Anatomy

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8.6.3 Spinal Reflex

9 Digestion

9.1 Mouth

9.1.1 Pharynx

9.1.2 Oesophagus

9.1.3 Saliva

9.1.4 Mastication

9.1.5 Swallowing

9.2 Stomach

9.2.1 Stomach secretions

9.2.2 Stomach Movement

9.2.3 Protection of the Stomach

9.3 Small Intestine

9.3.1 Secretions of the Small Intestine

9.3.2 Movement in the Small Intestine

9.4 Liver

9.5 Pancreas

9.5.1 Exocrine secretions of the Pancreas

9.6 Large Intestine

9.7 Liver

9.8 Enteric Nervous System

9.8.1 Reflexes

9.8.2 Regulation

10 Renal System

10.1 Nephrons

10.1.1 Filtration in the Nephrons

10.1.2 Tubular Reabsorption

10.1.3 Tubular secretion

10.1.3.1 Collecting ducts Conserve Water

10.2 Other Organs

10.3 Illness

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HUMAN ANATOMY AND PHYSIOLOGY – 91400 Posterior = behind

Anterior = front

1.1. Anatomy of the respiratory system

1.1.1. The nose: - External nose + nasal cavity

- External nose = visible structure most is hyaline cartilage (bridge of nose is bone)

- Respiratory epithelium lines rest of nasal cavity except vestibule

- Ciliated pseudostratified columnar epithelium with goblet cells

- Works as a filter for particles, and bacteria. Also works to lubricate the trachea and

initiate dissolving process so that gasses such as oxygen can participate in

metabolism (all reactions are aqueous)

- Nares = external openings of the nose

- Choanae = openings into the pharynx

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- Nasal cavity extends from nares to choanae

- Nasal septum = partition dividing nasal cavity into right and left

- Hard palate = floor of nasal cavity (separates from oral cavity)

- Conchae = 3 prominent bony ridges on lateral walls of each side of the nasal cavity

- Increase surface area of nasal cavity and churn air (cleansed, humidified and warmed)

- Paranasal sinuses = air-filled spaces within bone = maxillary, frontal, ethmoidal and sphenoidal sinuses

- Open into the nasal cavity and are lined with mucous membrane (weight, mucus, voice)

- Nasolacrimal ducts carry tears from eyes also open into nasal cavity

1.1.1.1. Nose function:

- Air enters the nasal cavity through the nares

- Lining of cavity = stratified squamous epithelium containing coarse hairs

- Hairs trap some of the large particles of dust

- Rest = pseudo-stratified columnar epithelial cells with cilia and many mucus-producing goblet cells

- Cilia are motile

This is aided by cilia being covered in sodium chloride fluid (problematic in

cystic fibrosis – who will have problems breathing and often experience

bacterial infections)

- Goblet cells secrete mucus and cilia propel the mucous posteriorly toward pharynx

Cilia beat rhythmically and in the same direction

- Cilia sweep mucus posteriorly to pharynx swallowed

- Air flows through nasal cavities = humidified by moisture from mucous epithelium and warmed by blood flowing through superficial capillary network

- Erectile tissue in conchae swells every 30 to 60 minutes with blood.

- Prevents air flow through that nostril and directs majority to the other

- This is to allow this nostril to recover from dryness.

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- Sneeze reflex dislodges foreign substances from nasal cavity = sensory receptors detect,

action potentials along trigeminal nerves to medulla oblongata reflex triggered = uvula and soft palate depressed

- Resonates voice

- Detects smells in the airstream

1.1.2. Pharynx: - Common passageway for respiratory and digestive systems

- Air from nasal cavity + air, food and water from mouth pass through pharynx

- Inferiorly pharynx leads to rest of respiratory system through the opening into the larynx

- Larynx = 3 regions:

- Nasopharynx = posterior to choanae and superior to soft palate (incomplete muscle and connective tissue partition between nasopharynx and oropharynx)

- Uvula = posterior extension of the soft palate (floor of nasopharynx)

Lined with pseudostratified ciliated columnar epithelium

- Auditory tubes extend from middle ears into nasopharynx

- Posterior part contains pharyngeal tonsil

- Oropharynx = from uvula to epiglottis (oral cavity opens into oropharynx

- Lined with stratified squamous epithelium protect against abrasion

- Palatine tonsils and lingual tonsils located near opening between mouth and oropharynx

Palatine tonsils = later walls near border

Lingual tonsil = surface of the posterior part of the tongue

- Laryngopharynx = passes posterior to larynx extends from tip of epiglottis to esophagus

- Food and drink pass through to the esophagus (small amount of air swallowed = burp)

- Lined with stratified squamous epithelium and ciliated columnar epithelium

1.1.3. Larynx: - Located in anterior throat extends from base of tongue to trachea

- = Passageway for air between pharynx and trachea

- Outer casing of 9 cartilages connected by muscles and ligaments

- 3 = unpaired

- 6 = form 3 pairs

- Largest cartilage = unpaired thyroid cartilage (Adam’s apple) attached superiorly to hyoid bone

- Most inferior cartilage = unpaired cricoid cartilage = base of larynx - Thyroid + cricoid cartilages maintain open passageway

- 3rd unpaired = epiglottis consists of elastic cartilage not hyaline cartilage - Inferior margin attached to thyroid cartilage anteriorly, superior part projects

superiorly as free flap toward the tongue - Helps prevent swallowed materials from entering the larynx - Larynx elevates during swallowing and epiglottis tips posteriorly to cover larynx

opening

- 6 paired cartilages = 3 cartilages on each side of the posterior part of the larynx: form attachment site for vocal folds

- Cuneiform cartilage = top on each side - Corniculate cartilage = middle

- Arytenoid cartilage = bottom articulate with cricoid cartilage inferiorly - 2 pairs of ligaments from posterior surface of thyroid cartilage to paired cartilages

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- Superior pair vestibular folds (false vocal cords) - When come together prevent air leaving lungs + prevent food/liquids

entering the larynx

- Inferior pair vocal folds (true vocal cords)

- Primary source of voice production air moving past causes them to vibrate = producing sound

- Muscles control length and tension of vocal cords - Force of air moving past controls loudness - Tension controls pitch of voice

1.1.4. Trachea: - Anterior to oesophagus

- Membranous tube attached to larynx = connective tissue and smooth muscle reinforced with 16-20 C-shaped pieces of hyaline cartilage

- Immediately inferior to cricoid cartilageprojects through mediastinum and divides into right and left primary bronchi at the 5th thoracic vertebra

- Oesophagus lies immediately posterior

- C-shaped cartilages form anterior and lateral side of the trachea protect and maintain open passageway

- Posterior wall = ligamentous membrane and smooth muscle that can alter diameter of the trachea (e.g. for cough reflex [decreases volume, therefore increasing pressure, therefore propelling object causing cough], as well as allowing change in shape when food passes through oesophagus)

- Lined with pseudostratified columnar epithelium (contains numerous cilia and goblet cells) - Constant, long-term irritation by cigarette smoke can change it to stratified squamous

epithelium

1.1.5. Bronchi: - Trachea divides into left and right main bronchi each connects to a lung - Left main bronchus =more horizontal than right as it is displaced by the heart

- Foreign objects usually lodge in right wider, shorter and more vertical and in more direct line with trachea

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- Lined with pseudostratified ciliated columnar epithelium and supported by C-shaped pieces of cartilage

1.1.6. Lungs: - Principal organs of respiration cone shaped, with base resting on diaphragm and apex

extending about 2.5cm above the clavicle - Right lung has 3 lobes (superior, middle and inferior)

- Shorter than left as liver infringes on space - Right main bronchus is slightly wider and more vertical, meaning that things are

more likely to get caught here. - Left lung has 2 lobes (superior, inferior)

- Lobes are separated by deep fissure on lung surface - Has indentation for cardiac impression - Narrower than right lung

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- Left main bronchus is narrower, more horizontal, and longer than right main bronchus.

- Lobes are divided into bronchopulmonary segments separated by connective tissue septa - These are not as visible as surface fissures - Major blood vessels and bronchi do not cross the septa - 9 bronchopulmonary segments in left lung, 10 in right

- Main bronchi branch many times to form the tracheobronchial tree

- Main bronchus lobar bronchi (2 in left, 3 in right) segmental bronchi

bronchioles terminal bronchioles (50 to 80 TB from one bronchiole)

respiratory bronchiolesalveolar ductsalveoli alveolar sacs (chambers connected to 2+ alveoli)

- As air passageways become smaller cartilage decreases and smooth muscle increases at terminal bronchioles = prominent smooth muscle, no cartilage

- Relaxation and contraction of smooth muscle can change diameter - Trachea and bronchi = pseudostratified ciliated columnar epithelium - Bronchioles = ciliated simple columnar epithelium and no cartilage.

- These probably have the most control over how much air is going in your lungs (and can be controlled by parasympathetic nervous system.

- Constriction of these = a symptom of cancer. - 1 mm or less in diameter

- Terminal bronchioles = simple cuboidal epithelium (few are ciliated), no mucus and goblet cells

- Secrete surfactant to break apart water molecules Keeps tubes open and prevents their collapse

- Secreted by Clara cells in the epithelium - 0.5 mm or less in diameter

- Walls become thinner after terminal bronchioles alveolar ducts and alveoli = simple squamous epithelium

- 150 million alveoli in each lung, providing about 70 m2 of surface for gas exchange

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- Elastic fibers around alveoli allow it to expand during inspiration and recoil during expiration - About 300 million alveoli in lungs

- cells of the alveolus (pneumocytes)

- Squamous (type I) alveolar cells

thin, broad cells that are involved with gas exchange and allow for rapid gas

diffusion between alveolus and bloodstream

cover 95% of alveolus surface area

- Great (type II) alveolar cells - pneumocytes type II (septal cells)

round to cuboidal cells that cover the remaining 5% of alveolar surface

repair the alveolar epithelium when the squamous (type I) cells are

damaged

secrete pulmonary surfactant

a mixture of phospholipids and proteins that coats the alveoli and

prevents them from collapsing when we exhale

- 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

- Respiratory membrane of lungs = mainly walls of alveoli and surrounding capillaries = where gas exchange occurs (alveolar ducts and respiratory bronchioles also contribute

- Respiratory membrane = very thin 6 layers: - Thin layer of fluid lining the alveolus - Alveolar epithelium (simple squamous epithelium) - Basement membrane of the alveolar epithelium - Interstitial space

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- Basement membrane of the capillary endothelium - Capillary endothelium = simple squamous epithelium

- Except for a thin film of moisture on alveolar wall, alveoli are kept dry by absorption of

excess liquid by blood capillaries

- lungs have a more extensive lymphatic drainage than any other organ in the body

- low capillary blood pressure also prevents the rupture of the delicate respiratory

membrane

1.1.6.1. Lung function:

- Autonomic Control

- Regulates smooth muscle Controls diameter of bronchioles Controls airflow and resistance in lungs

- Bronchoconstriction

- Constricts bronchi, caused by: histamine, parasympathetic nerves, cold air, and chemical irritants stimulate

bronchoconstriction suffocation from extreme bronchoconstriction brought about by

anaphylactic shock and asthma

- Bronchodilation

- Dilation of bronchial airways

- Reduces resistance / increasing airflow

- Caused by: epinephrine and sympathetic stimulation stimulate bronchodilation

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1.1.6.1.1. PULMONARY VENTILATION

- Gas molecules move from higher concentrations to lower until equilibrium is achieved

- F α P / R equal to I = V/R

- 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 falls

- if the pressure falls below atmospheric pressure the air moves into the lungs

- if the lung volume decreases, intrapulmonary pressure rises

- if the pressure rises above atmospheric pressure the air moves out of the lungs

- P ~ 1/V

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- Inspiratory effort causes:

- Fall in intrapleural pressure

- Fall in Alveolar pressure

- Pressure gradient from mouth to alveoli

- Gas flow down pressure gradient

- Expiration causes: - relaxed breathing

- passive process achieved mainly by the elastic recoil of the thoracic cage

- recoil compresses the lungs

- volume of thoracic cavity decreases

- raises intrapulmonary pressure to about +3 mm Hg

- air flows down the pressure gradient and out of the lungs

- Forced breathing

- accessory muscles raise intrapulmonary pressure as high as +30 mmHg

- massive amounts of air moves out of the lungs

- rate of O2 diffusion into capillaries increases because difference in partial pressure is increased

- Expiratory muscles will engage in forced breathing to expire - Partial pressure = pressure exerted by a specific gas in a mixture of gases

- Dalton’s Law – the total atmospheric pressure is the sum of the contributions of the

individual gases

PN2 = 78.6% x 760 mm Hg = 597 mm Hg

PO2 = 20.9% x 760 mm Hg = 159 mm Hg

PH2O = 0.5% x 760 mm Hg = 3.7 mm Hg

PCO2 = 0.04% x 760 mm Hg = 0.3 mm Hg

PN2 + PO2 + PH2O + PCO2 = 760 mmHg

- Compliance = an indicator of expandability. Factors that affect compliance:

- Connective tissue structure of the lungs - Level of surfactant production - Mobility of the thoracic cage

- Low compliance means that increased pressure is required to breathe (e.g. arthritis). - High compliance means that its very difficult to breathe out (e.g. emphysema).

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- Charles’s Law – the given quantity of a gas is directly proportional to its absolute

temperature V ~ T

- 3 things affecting air resistance:

- Diameter of bronchioles

- Pulmonary compliance

- Surface tension

- Respiratory volumes

- Tidal volume - volume of air inhaled and exhaled in one cycle during quiet breathing

(500 mL)

- Inspiratory reserve volume - air in excess of tidal volume that can be inhaled with

maximum effort (3000 mL)

- Expiratory reserve volume - air in excess of tidal volume that can be exhaled with

maximum effort (1200 mL)

- Residual volume - air remaining in lungs after maximum expiration (1300 mL)

- Anatomical dead space = air that stays in conducting passageways (about 150ml) - Total (physiologic) dead space = anatomical dead space + alveolar dead space (alveolar dead

space only occurs in people with underlying conditions) - Respiratory minute volume = respiratory rate x tidal volume measures pulmonary ventilation - Alveolar ventilation = (tidal volume – anatomical dead space) x respiratory rate measures

amount of air reaching alveoli each minute - Blood entering lungs = decreased PO2 and increased PCO2 relative to alveolar air

- O2 diffuses in, and CO2 diffuse out - By time blood flows through 1st 3rd of pulmonary capillary an equilibrium is achieved

- During breathing atmospheric air mixes with alveolar air keeps PO2 higher than in the capillaries

- Increasing breathing rate makes PO2 even higher than during slow breathing

1.1.6.1.2. RESPIRATORY CAPACITIES

Vital capacity - total amount of air that can be inhaled and then exhaled with maximum effort - VC = ERV + TV + IRV (4700 mL)

important measure of pulmonary health

Inspiratory capacity - maximum amount of air that can be inhaled after a normal tidal expiration - IC = TV + IRV (3500 mL)

Functional residual capacity - amount of air remaining in lungs after a normal tidal expiration - FRC = RV + ERV (2500 mL)

Total lung capacity – maximum amount of air the lungs can contain - TLC = RV + VC (6000 mL)

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1.1.6.1.3. MEASURING VENTILATION

Spirometer – measuring lung function, specifically the measurement of the amount (volume) and/or

speed (flow) of air that can be inhaled and exhaled.

- A device that recaptures expired breath and records such variables such as rate and depth of

breathing, speed of expiration, and rate of oxygen consumption

- Forced Vital capacity (FVC) is the volume of air that can forcibly be blown out after full

inspiration, measured in litres

- Forced expiratory volume (FEV1)

- percentage of the vital capacity that can be exhaled in one second

- healthy adult reading is 75 - 85% in 1 sec

1.1.7. Pleural Cavities: - Lungs contained in thoracic cavity + surrounded by separate pleural cavity

- Lined with pleura (serous membrane) parietal and visceral parts - Parietal pleura (lines walls of thorax, diaphragm and mediastinum, i.e. chest wall) =

continuous with visceral pleura (covers surface of lung) - Pleural cavity = between parietal and visceral pleurae is filled with small volume of pleural

fluid = lubricant + holds pleural membranes together (like thin film of water between two pieces of plastic)

- reduce friction

- create pressure gradient

- lower pressure than atmospheric pressure and assists lung inflation

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- compartmentalization

- prevents spread of infection from one organ in the mediastinum to others

- Pleural pressure keeps lungs against the chest wall by negative pleural pressure “suction” due to a vacuum seal between the parietal (attached to chest wall) and visceral (attached to lung) pleural layers

1.1.7.1. Other pressures in the Lungs: - Intrapulmonary pressure:

- Intra-alveolar pressure (pressure in the alveoli). - Intrapleural pressure:

- Pressure in the intrapleural space. - Pressure is negative, due to lack of air in the intrapleural space.

- Transpulmonary pressure: - Pressure difference across the wall of the lung. - Intrapulmonary pressure – intrapleural pressure.

Keeps the lungs against the chest wall.

1.1.8. Lymphatic supply: - 2 supplies:

- Superficial lymphatic vessels (deep to visceral pleura) drain lymph from superficial lung tissue + visceral pleura

- Deep lymphatic vessels (follow the bronchi) drain lymph from bronchi and associated connective tissues

- Both exit lungs at main bronchi - Phagocytic cells within the lungs phagocytize most carbon particle and other debris and

move them to lymphatic vessels