Exam 1 Flashcards
Anatomy
The structure of the body parts and their relationship to one another
Physiology
How the body parts work (function) and the activities they carry out.
Homeostasis
The stable equilibrium of the body
Positive Feedback
The output enhances the original stimulus so that the response is accelerated BEFORE returning to their equalized state
Ex: Mother Breastfeeding
Stimulus - Baby suckling (Sent to Hypothalumus)
Hypothalymus signals the posterior pituary to release oxytocin
Effector: Breast is stimulated to eject breast milk.
Negative Feedback
The output shuts off the original effect of the stimulus or reduces its intensity
Ex: Body Thermal Regulation
Stimulus: Exercise raises body temp above normal
Sensory Receptors in skin detects heat
Hypothalymus of the brain compares sensory input to the normal body temp
Effectors: Blood vessels in skin dialate, sweat glands sweat (when evaporated - cools skin surface)
Body temp returns to normal
Anatomical Position
Body Erect
Feet Apart
Palms Forward
Thumb Away From Body
List The Anatomical Regions
Axial
Appendicular
Cephalic
Cervical
Thoracic
Abdominal
Pelvic
Upper Extremity
Lower Extremity
Manus
Pedal
Cephalic
head
Frontal
Forehead
Orbital
Eye
Buccal
Cheek
Nasal
Nose
Oral
Mouth
Mental
Chin
Axilary
Armpit
Mammary
Breast
Pectoral
Chest
Sternal
Sternum
Cervical
Neck
Abdominal
Abdomen
Coxal
Hip
Inguinal
Groin
Deltoid
Shoulder
Scapular
Shoulder BLADE
Brachial
Arm
Antecubital
Front of Elbow
Antebrachial
Forearm
Carpal
Wrist
Palmar
Palm
Digital
Finger or Toe
Femoral
Thigh
Patellar
Kneecap
Popliteal
Back of Knee
Crural
Leg
Tarsal
Ankle
Pes
Foot
Sural
Calf
Calcaneal
Heel
Plantar Surface
Sole of Foot
Olecranal
Elbow
Dorsom of the hand
Top of Hand
Dorsom of the Foot
Top of Foot
Manus
Hand
Crainal-Region
Surrounding the brain
Occipital
Back of Head
Auricular
Ear
Vertebral (Region of The Body)
Spinal Column
Lumbar
Lower Back
Gluteal
Buttock
Sacral
Sacrum
Perineal
The area between the anus and the exterior reproductive body part (vagina in females, penis in males
Transverse
Divides the body horizontally into superior and inferior
Coronal (Frontal)
Divides the body into anterior and posterior
Sagital (Midsagital)
Divides the body down the midline
Sagital (Parasagital)
Divided down lateral to the midline into right and left parts
Superior
Towards the head
Ex: The heart is superior to the abdomen (The heart is higher up in the body than the abdomen)
Inferior
Away from the head
Ex: The navel is inferior to the chin (the navel is lower than the chin)
Anterior
Towards the front of the body
The Breastbone is anterior to the spine (the breastbone is in front of the spine)
Posterior
Towards the back of the body
The heart is posterior to the breastbone (the heart is behind the breastbone)
Medial
Towards or at the midline of the body
The heart is medial to the arms (The heart is towards the middle of the body from where the arms extend)
Lateral
Away from the midline of the body
The arms are LATERAL to the chest (The arms are parallel to where the chest is, but towards the outside of the body)
Intermediate
Between a more medial and more lateral structure
The collarbone is intermediate between the breastbone and shoulder
Proximal
Closer to the origin of the body part or the point of attachment of a limb to the body trunk
The elbow is proximal to the wrist (The elbow is closer to the shoulder joint than the wrist)
Distal
Farther from the origin of a body part or the point of attachment of a limb to the body trunk
The knee is distal to the thigh (The knee is farther from the hip joint than the thigh is)
Superficial (external)
Toward or at the body surface
The skin is superficial to the skeletal muscles (the skin is closer to the surface than the muscles are)
Deep (Internal)
Away from the body surface
The lungs are deep to the skin (the lungs are farther away from the surface than the skin)
Ipsilateral
Same side of the body
Right Leg and Right Arm
Contralateral
On the opposite side of the body
The Right Arm and Left Leg
Posterior OR Dorsal Cavity
Protects the nervous system
- Cranial
- Vertebral/Spinal
Anterior Ventral Cavity
Houses the internal organs (viscera)
- Thoracic Cavity
- Abdominopelvic Cavity
Cranial Cavity
The Skull/Brain
Vertebral Cavity
Spinal Cord
Thoracic Cavity
Mediastinum
Pleural
Pericardial
Abdominal Cavity
Digestive Viscera (Organs) such as the stomach, intestines, spleen, and liver
Pelvic Cavity
Urinary Bladder, Reproductive Organs, and Rectum
Mediastinum
Contains the pericardial cavity and surrounds all thoracic organs
Pleural
Houses one lung per cavity (there are two)
Pericardial
Encloses the Heart
Parietal Membranes
Line the Body Cavity
Visceral Membrane
Covers an Organ Within the Parietal Membrane
Lung Lining
Pleura
Heart Lining
Pericardium
Abdomen Lining
Peritoneum
Abdominopelvic Quadrants (Four)
RUQ
LUQ
RLQ
LLQ
Abdominopelvic Regions
Right Hypochondriac
Epigastric
Left Hypochondriac
Right Lumbar
Umbilical
Left Lumbar
Right Iliac
Hypogastric
Left Iliac
Acromial
Bony tip of the outer edge of your shoulder blade (scapula) that comes off the top of the back side of this bone
Plasma Membrane
An active barrier separates intracellular and extracellular fluid.
Consists of a phospholipid bilayer as well as glycolipids and cholesterol
Glycocalyx
Sugars on the surface of a cell
The glycoproteins and glycolipids on the surface of the cell give the cell an identity
Passive Membrane Transport
No energy is required to move substances across cell membranes
The types of Passive Membrane Transport
Diffusion
- Simple Diffusion
- Facilitated Diffusion
- Osmosis
Diffusion
Molecules move from an area of high concentration to low concentration within the body
Simple Diffusion
Nonpolar and lipid soluble moleculesdiffuse directly
Facilitated Difusion
Molecules pass with carriers or through channels
Osmosis
The diffusion of water from an area of high to low concentration
Water ALWAYS Wants to Dilute
Tonicity
The ability of a solution to change the shape of cells by altering their internal water volume.
Isotonic
The same concentration inside and outside of the cell
Hypotonic
Contains a LOWER concentration of nonpenetrating solutes than are present inside of the cell
Swells
Hypertonic
Contains a HIGHER concentration of nonpenetrating solutes than are present inside of the cell
Shrinks/Shrivels
Active Transport
Moves solutes AGAINST their concentration gradient (from low to high)
Requires ATP
Cytoplasm
The cellular material between the plasma membrane and the nucleus
What makes up the cytoplasm?
Cytosol
Organelles
Inclusions
What are the common organelles?
Mitochondria
Ribosomes
Rough ER
Smooth ER
Golgi Apparatus
Peroxisomes
Microtubules
Microfilaments
Intermediate Filaments
Centrioles
Nucleus
Nuclear Envelope
Nucleolus
Cilia
Microvilli
Nucleus
The control center of the cell is responsible for transmitting genetic information and providing instructions for protein synthesis
Contains the nuclear envelope, nucleolus, and chromatin
Nuclear Envelope
Separates the nucleoplasm from the cytoplasm and regulates the passage of substances to and from the nucleus
Has ribosomes on surface
Nucleolus
The site of ribosome subunit manufacture
Mitochondria
Site of ATP Synthesis –> POWERHOUSE of the cell
Ribosomes
The site of protein synthesis
Rough ER
T/he site of synthesis of proteins that will be secreted outside of the cell.
Sugar groups are attached to proteins within the cisterns
Proteins are bound in vesicles for transport to the Golgi and other sites
Smooth ER
Site of lipid and steroid (cholesterol) synthesis, lipid metabolism, and drug detoxification
Golgi Apparatus
Packages, modifies, and segregates proteins for secretion from the cell, inclusion in lysosomes, and incorporation into the plasma membrane.
Peroxisomes
The enzymes detoxify a number of toxic substances
Ex: Catalase breaks down H2O2
What are the four primary tissue types?
Epithelial
Connective
Muscle
Nervous
Epithelial Tissue-What-Does-It-Do?
Covers
Connective tissue-What-Does-It-Do?
Supports
Muscle Tissue
Produces movement
Nervous tissue
Controls
Histology
The study of tissues
How do we classify epithelial tissue?
Simple or Stratified
Simple epithelium
One row where everything touches the basement membrane
Stratified epithelium
Multiple layers, some cells touch the basement membrane some touch each other
Pseudostratified
Seems to have several rows, but all cells touch the basement membrane
ONLY IN COLUMNAR
What are the epithelial cell shapes?
Squamous
Cuboidal
Columnar
Squamous
Thin, flat, and scaly shaped
Location:
- Lines the esophagus
- Forms the epidermis
- Kidney
- Heart
- Lining of Ventral Body Cavity
Cuboidal
Squarish-looking in frontal tissues with equal height and width
Location:
- Liver Cells
- Kidney Tubules
- Small Glands (Mammary)
Columnar
Cells that are taller than they are wide
Ex: Inner lining cells of the stomach and intestines
Simple Squamous
A single layer of flat ovoid cells
Diffusion and Filtration
Lung, Kidney, Heart, Lining of Ventral Body Cavity
Simple Cuboidal Epithelium
A single layer of cube-like cells
Secretion and Absorption
Kidney Tubules, Small Glands, Ovary Surface
Simple Columnar Epithelium
A single layer of rectangle cells
Absorption, Secretion of Mucus, Enzymes, and Other Substances, Ciliated Type Propels Mucus
Non-Ciliated –> Lining of most of the digestive tract
Cilated –> Small Bronchi, Uterine Tubes
Cilia
hair-like appendages attached to eukaryotic cells that provide locomotion, propel mucus
Microvilli
Tiny projections that exist in, on, and around cells
Function: absorption
Location: of the small intestines
Pseudostratified Columnar Epithelium
A single layer of cells of differing heights (nucleus seen at different levels)
Secretes substances, Primarily Mucus
Non-Ciliated -> Sperm-Carrying Ducts, Ducts of Large Glands
Ciliated –> Lines the Trachea
Transitional Epithelium
A peculiar stratified squamous epithelium formed of round cells with the ability to slide over one another
Only found in the urinary system organs
Allows organs to stretch
Stratified Squamous
Several Layers
Protective Role
Found in areas subject to wear and tear (ESOPHAGUS and SKIN)
Stratified Cuboidal
Rare in the body
2 Layers of Cuboidal Cells
Found in ducts of sweat and mammary glands
Stratified Columnar
Limited amount in the body
The lining of the pharynx, male urethra, and glandular ducts
What are the four types of connective tissue?
Connective Tissue Proper
Cartilage
Bone
Blood
Types of Connective tissue Proper
Loose
Dense
Adipose
Loose Connective Tissue
Mainly ground substance (empty space)
- Areolar Tissue
- Reticular Tissue
Areolar Tissue
Fibers run in different directions
Mostly collagenous with an abundance of open, fluid-filled space
Function: Wraps and Cushions Organs, IMPORTANT IN INFLAMMATION
Skin!
Reticular Tissue
The loose network of reticular fibers in gel-like ground substances.
Forms the structural framework (stroma) of organs such as the lymph nodes, spleen, thymus, and bone marrow
Lymphoid organs (lymph nodes, bone marrow, and spleen)
Dense Connective Tissue
Mainly Fibers
- Regular
- Irregular
Adipose Tissue
Tissue in which adipocytes are the dominant cell type
Function-Provides-reserve-food-fuel
Location: Undersubcutaneous tissue, insulates against heat-loss
Cartilage
Relatively stiff connective tissue with a flexible rubbery matrix
Produced by Chondroblasts
Rarely exhibits blood vessels
What are the three types of cartilage?
Hyaline
Elastic
Fibrocartilage
Hyaline Cartilage
Clear and Glassy
Contains chondrocytes
JOINTS
Elastic Cartilage
Contains lacunae, Chondrocytes, and Elastic Fibers
Walls of large arteries, within the walls of bronchial tubes, the EXTERNAL EAR
Fibrocartilage
Coarse, Readily Visible Bundles of Collagen
Tensile-Strength
VERTEBRAL DISKS
What are the two types of Bone (Osseous tissue)?
Spongy
Compact
Compact Bone
Denser calcified tissue with no spaces visible to the naked eye
Involves the Haversian canal (Where blood vessels are, the circle in the middle of a bone)
LOOKS LIKE WOOD
Spongy Bone
Calcified and Hard, its delicate slivers and plates give it a spongy appearance
Cartilage Cells
Chondroblasts
Chondrocytes
Chondroblasts
Baby immature Cartilage cells
Chondrocytes
Mature Cartilage Cells
Osteoblast
Baby immature bone cells
Osteocytes
Mature Bone Cells
Osteoclast
Breaking Down of Bone
Adipose Tissue Cell
Adipocytes
Blood’s Function in the Body
Only fluid connective tissue
Its function is to transport substances
What are the three types of muscle tissue?
Skeletal
Cardiac
Smooth
Skeletal Muscle
Long cylindrical, multinuclear cell, with obvious striations
Voluntary Movement
SKELETAL = (FISH) SCALES
Cardiac Muscle
Branching, striated, uninucleate, cells that interdigitate at junctions
Involuntary Control
Function - As it contracts it propels blood into circulation
Location - Walls of the heart
Smooth Muscle
Spindle Shaped (elongated) cells with central nuclei; no striations; cells form sheets
Function: Propels substances or objects
Involuntary Control
Location - Walls of Hollow Organs
Nervous tissue
Branching Cells
Function: Transmission of electrical signals from sensory receptors and to effectors
Location: Brain, Spinal Cord, and Nerves
Supine Position
Laying Facing Upward
Prone Position
Laying Facing Downwards
What Are The Organ Systems?
Integumentary
Skeletal
Muscle
Nervous
Endocrine
Cardiovascular
Lymphatic
Respriatory
Urinary
Digestive
Reproductive
Integumentary System
Forms external body covering, and protects deeper tissues from injury.
Synthesizes Vitamin D
Contains important glands for pain, pressure, etc as well as sweat and oil glands
Integumentary System Organs
Skin
Hair
Nails
Skeletal System
Protects and supports body organs while also providing a framework for the muscles used to cause movement.
Blood cells are created through here and bones store minerals
Skeletal System Organs
Joints
Bones
Muscular System
Allows manipulation of the environment, locomotion, and facial expression.
Maintains posture and produces heat
Muscle System Organs
Skeletal Muscles
Nervous System
As the fast-acting control system of
the body, it responds to internal and
external changes by activating
appropriate muscles and glands
Nervous System Organs
Dorsal Cavity (Brain and Spinal Cord)
Nerves
Endocrine System
Glands secrete hormones that
regulate processes such as growth,
reproduction, and nutrient use
(metabolism) by body cells.
Endocrine System Organs
Thyroid Glands
Pituitary Glands
Pineal Glands
Pancreas
Adrenal Glands
Thymus
Ovaries
Testis
Cardiovascular System
Blood vessels transport blood,
which carries oxygen, carbon
dioxide, nutrients, wastes, etc.
The heart pumps blood
Cardiovasular Organs
Heart and Blood Vessels
Lymphatic System
Picks up fluid leaked from blood vessels and
returns it to blood. Disposes of debris in the
lymphatic stream. Houses white blood cells
(lymphocytes) involved in immunity.
The immune response mounts the attack
against foreign substances within the body.
Lymphatic System Organs
Spleen
Lymph Nodes
Red Bone Marrow
Thymus
Thoracic Duct
Lymphatic Vessels
Respriatory System
Keeps blood constantly supplied with oxygen
and removes carbon dioxide. The gaseous
exchanges occur through the walls of the air
sacs of the lungs
Respriatory System Organs
Nasal cavity
Pharynx
Larynx
Lung
Trachea
Bronchus
Urinary System
Eliminates nitrogenous wastes from the body.
Regulates water, electrolyte, and acid-base
balance of the blood
Urinary System Organs
Kidney
Ureter
Urinary Bladder
Urethra
Digestive System
Breaks down food into absorbable units
that enter the blood for distribution to
body cells. Indigestible foodstuffs are
eliminated as feces.
Digestive System Organs
Oral Cavity
Esophagus
Liver
Stomach
Intestines
Rectum
Anus
Reproductive System
Overall function is production of offspring.
Reproductive System Organs
Penis
Testis
Scrotum
Ductus Deferens
Prostate
Mammary Glands
Uterus
Vagina
Ovary
Uterine Tubes
What are the levels of organization in biology?
Cell -> Tissue -> Organ -> Organ System -> Organism
Axial Region
Head
Neck
Trunk
Appendicular
Appendages (Limbs)
Serousa (Serous Membrane)
A double-layered membrane that covers surfaces in the ventral body.
Filled with Serous Fluid
What organs are located in the RUQ?
Liver
Right Kidney
Gall Bladder
Colon
Pancreas
What organs are located in the LUQ?
Stomach
Left Kidney
Spleen
Colon
Pancreas
What organs are located in the RLQ?
Appendix
Colon
Small Intestine
Ureter
Ovaries
Uterus
What organs are located in the LLQ?
Ovaries
Uterus
Ureter
Small Intestine
What organs are in the right hypochondriac region?
Liver
Gallbladder
What organs are in the left hypochondriac?
Spleen
Left Kidney
Stomach
Pancreas
Colon
What organs are in the epigastric?
Stomach
Liver
Pancreas
Spleen
Adrenal Glands
What organs are in the left lumbar region?
Descending colon
Left Kidney
Spleen
What organs are in the umbilical region?
Small Intestine
Transverse Colon
Bottom portions of the right and left kidney
What organs are part of the right iliac
Appendix
What organs are in the left iliac?
Descending colon
Sigmoid Colon
What organs are in the hypogastric region?
Bladder
Sigmoid Colon
Anus
Uterus
Ovaries
Prostate
What part of the plasma membrane is hydrophobic and hydrophilic?
Hydrophilic Head
Hydrophobic Tail
How does cholesterol affect the fluidity of membranes
Reduces membrane fluidity at moderate temps.
At low temps, it hinders solidification
What are the functions of membrane proteins?
Transport
Enzymatic Activity
Intercellular Joining
Cell-Cell Recognition
Attachment to the cytoskeleton and extracellular matrix
Receptors for signal transduction
What is the sodium potassium pump?
Na+ is pumped out of the cell and K+ is pumped back into the cell
What is secondary active transport/coupled transport?
Energy is obtained INDIRECTLY from ionic gradients
Low Na+ concentration that is maintained inside the cell by the Sodium Potassium Pump strengthens sodium’s drive to enter the cell
Na+ an drag other molecules with it as it flows into the cell with carrier proteins)
What solutes require secondary active transport to transport aross the membrane?
Some sugars, amino acids, and ions
Vesticular active transport
Involves the transport of large particles, macromolecules, and fluids across membranes in vesicles
What are the many types of vesicular transport?
Endocytosis
Transcytosis
Vesicular Trafficking
Exocytosis
Endocytosis
Transports INTO the cell
What are the three types of endocytosis?
Phagocytosis
Pinocytosis
Receptor-Mediated Endocytosis
Exocytosis
Transport OUT of the cell
Vesicular Trafficking
Transport from one area or organelle in a cell to another
Pinocytosis
Takes in fluids and solutes
Cell Drinking
Phagocytosis
Takes in larger substances such as bacteria
Cell Eating
Receptor-Mediated Endocytosis
The way that a membrane imports macromolecules
Membrane Potential
The difference in voltage (electrical potential) between the inside and outside of the cell.
Caused by the unequal concentration and permeability of ions across a membrane
Changes in the membrane elicit action potentials (electrical signals) send messages around the body
If there is a potential difference across the cell membrane –> the membrane is said to be
Polarized
If the membrane potential becomes more POSITIVE than it is at the resting potential, the membrane is said to be what?
Depolarized
If the membrane potential beomes more NEGATIVE than it is at the resting potential, the membrane is said to be what?
Hyperpolarized
Flagella
Largest projections that are only found in sperm cells
Cell Cycle
Interphase + Mitosis
Interphase
Metabolic Phase
G1 –> Growth
S –> Synthesis of DNA and Growth
G2 –> Growth and Final Prep for Division
Mitosis
Prophase
Metaphase
Anaphase
Telophase
Prophase
Chromosomes Condense
Preprometaphase
Chromosomes Attach Together
Metaphase
Chromosomes Line Up At Equator
Anaphase
Sister Chromatids Separate (Become the chromosomes of the daughter nuclei)
Teleophase
Chromosomes Relax and Cell Pinches In The Middle
Protein Synthesis Involves What Two Processes?
Transcription and Translation
Transcription
Copying DNA sequences to make an messanger RNA molecule
Translation
mRNA deoded to assemble polypeptides
Cytokinesis
The division of the cytoplasm to form the daughter cells
Dense Regular Connective Tissue
Parallel collagen fibers with a few elastic fibers
Function: Attaches muscles to bones and bones to bones
Location: Tendons, and Most Ligaments
Dense Irregular
Primarily irregularly arranged collagen fibers
Function: Withstand tension exerted in many directions
Location: Fibrous capsules of organs and joints. The dermis of the skin
Cytoskeleton
An elaborate network of rods that run throughout the cytosol
• Hundreds of different kinds of proteins link rods to other cell structures
• Also act as cell’s “bones, ligaments, and muscle” by
playing a role in the movement of cell components
What are the three types of cytoskeleton?
Microfilaments
Intermediate Filaments
Microtubules
Microfilaments
Strengthen cell surface and helps to resist compression
Intermediate Filaments
Helps the cell resist pulling forces
Microtubules
Determine overall shape of cell and organelle distribution
Centrosomes/Centrioles
Microtubule organizing center, aid in cell division, and some form cytoskeletal track system
Form the basis of cilia and flagella
Proteasomes
Protein complexes that degrade unneeded or damaged proteins
Lysosomes
A membrane-bound cell organelle that contains digestive enzymes.
They break down excess or worn-out cell parts. They may be used to destroy invading viruses and bacteria
Fibroblasts Are Found Where?
Connective Tissue
What makes up the integumentary system?
Skin
Hair
Nails
Sweat Glands
Sebaceous (oil) glands
What are the functions of the skin?
Protection
Barrier Functions (To UV, Water, Etc)
Metabolic Functions (Vitamin D Synthesis)
Sensation
Thermoregulation
Nonverbal Communication (Facial Expressions)
Structure of the Skin
Epidermis
Dermis
Epidermis
Superficial Region
Stratified Squamous Epithelium
AVASCULAR
Dermis
Underlies Epidermis
Most fibrous connective tissue
VASCULAR
Top –> Areolar Tissue (Papillary Layer)
Bottom –> Dense Irregular (Reticular Layer)
Hypodermis
Superficial Fascia
Subcutaneous layer deep to skin
NOT part of the skin, but shares functions
Mostly adipose tissue
Anchors the skin to underlying structures
Cells Found In The Epidermis
Stem Cells
Keratinocytes
Melanocyes
Dedritic
Tactile
Stem Cells
Undifferentiated cells that divide and give rise to the keratinocytes
Melanocytes
Produce the pigment melanin
Keratinocytes
Produce keratin (protective protein)
Dendritic
Produces Macrophages (immune cells)
Tactile
Sensory Receptors (touch)
Layers of the Epidermis
Stratum Corneum
Stratum Lucidum
Stratum Granulosum
Stratum Spinosum
Stratum Basale
Stratum Basale
One Layer
Cells that actively divide
10-25% melanocytes
Where stem cells are located
Stratum Spinosum
8-10 Prickly Layers
Produce more keratin filaments which causes cell to flatten
Stratum Grandulosum
3-5 Layers
Keratinization Begins
Cells above this die
Stratum Lucidum
2-3 Layers
Flat, Dead Keratinocytes
Only in thick skin
Stratum Corneum
20-30 layers
Cells are flat and keratinized, but dead
Resistant to abrasion, penetration, and water loss
Cyanosis
The blueness of the skin resulting from a deficiency of oxygen
Erythema
Abnormal Redness of the skin (Sunburns, Anger, Exercise)
Albanism
Genetic Lack of Melanin due to a recessive allele that usually results in milky while hair and skin, with blue-grey eyes
Pallor
Pale or ashen color that occurs when there is so little blood flow through the skin that the while color of the dermal collagen shows through
Jaundice
Yellowing of the skin and whites of the eyes resulting from high levels of bilirubin in the blood
Hematoma
Bruises
Mass of clotted blood showing through the ski
First Degree Burns
Epidermal Damage Only
Localized redness, edema (swelling), and pain
Second Degree
Epidermal and Upper Dermal Damage
Blisters Appear
Third Degree
The entire thickness of skin involved
Skin is grey/white, cherry red, or blackened
Not painful (nerve endings destroyed) or swollen
Skin graphing is usually necessary
