Fundamentals of body structure Flashcards
What are the 6 body regions?
Head Neck Thorax Abdomen Pelvis Limbo's
What does superior mean?
Towards the head
What does inferior mean?
Towards the feet
What does medial mean?
Towards the centre
What does lateral mean ?
To the side / away from middle of The Body
What does proximal mean?
Nearer to the point of reference
What does distal mean?
Further away from the point of reference
What does superficial mean?
Closer to the surface/ more externally
What does deep mean?
Away from the surface further into the body
What does palmer mean?
Palm of hand
What does planter mean?
Sole of the foot
What is the median sagittal plane?
Middle line down the body
What is the para sagittal plane?
Any plane parallel to the median sagittal plane
What is the axial/ transverse plane?
Separates the upper and lower body (top and bottom)
What is the coronal plane
Separates front and back (anterior and posterior)
How does the number of chromosomes change during reproduction?
2 haploid cells with 23 chromosomes combine to form a zygote (diploid cells with 46)
Describe the sperm (structures)
Haploid cell
Head of the sperm is covered by an acrosome cap which contains enzymes for fertilisation
- middle piece provides energy for swimming
-tail - microiubeles for movement
Describe the ovum structure egg
Haploid cell - cytoplasm holds all organelles used for cell function
- zone pullicida - outer membrane of the cell
- corona radiata = outermost layer of cells
Sperm must penetrate both layers
What layers must the sperm penetrate to fertalise the egg
Corona radiata
Zone pellucida
Describe the process of fertilisation
Intercourse → sperm is in vagina
- Sperm penetrates the corona radiata
- Sperm makes contact with zona pellucida and binds to receptors - initiates acrosomal reaction
- Sperm penetrates zona pellucida by secreting enzymes that breakdown the layer
- Sperm makes contact with oocytes plasma membrane and fuses with oocyte
- Sperm releases its nucleus into oocyte cytoplasm
What is the cleavage of cells?
After fertilisation zygote initiates a rapid series of mitotic divisions
→ cleavage increases the number of cells but the size of the cell remains the same
→ occurs up to morulla stage which is 16 cells
What 3 processes happen during the first week of development?
Cleavage
Blastocyst formation
Initiating implantation
When can totipotency occur and what is it?
Cells ability to divide and produce all differentiated cells in an organism
- it is possible at 8 cell stage
When is toripotency lost?
At 16 cell stage (morulla) as differentiation of cells begins to occur
What happens at day 3 of pre implantation?
- 16 cell morulla is formed
- totipotency is lost
- differentiation starts
Describe the formation of the blastocyst at day 5
Compaction→ blastomeres (cells) flatten and form polarity with each other, reorganisation of cells
- outer blastomere cells (trophoblast) = become polarised, secrete fluid from apical aspect and have ability to form placenta
- inner cell mass = will form embryo
Cavitation → outer blastomere cells secrete fluid into centre blastocoele cavity
Blastocyst is the: inner cell mass, trophoblast, blastocoele all surrounded by zona pellucida
Describe structure of blastocyst
Inner cell mass
Trophoblast (outer cells)
Zone pellucida
Blastocoele
Describe process of implantation (hatching and adhesion)
Hatching → blastocyst hatches from zone pellucida as the trophoblast secretes proteases that digest zone pellucida
Adhesion → exposes the sticky outer cells of blastocyst which adhere to the endometrium
Implantation → blastocyst implants in the posterior wan of uterus and the endometrium grows around it to secure it
What is ectopic implantation?
When blastocyst implants in an abnormal size = life threatening as it may disrupt blood vessels
How do regions differ from systems?
- Regions are where things are in The Body
- Systems are where organs work together
What are the 4 different types of tissue?
Epithelial
Connective
Muscle
Nervous
What is epithelial tissue?
- cover body surfaces
- no blood vessels
- supported by underlining tissues (basement membrane)
- can form glands
What is connective tissue?
- underlie epithelial and support / surround other structures
Eg bone - metabolic support
-structural stability
What is muscle tissue?
Aggregations of contractile cells
Mediate movement
What are nervous tissues?
Gather, transmit and integrate info from internal/external environments
Mount responses
What happens during the second week of development?
- formation of layers in the blastocyst, everything splits into 2, start to form cavities, fully implanted
Bilaminar disc formation
Amniotic and yolk sacs
How is the bilaminar embryonic disc formed?
Inner cell mass →differentiates into epiblast and hypoblast which together form the bilaminar embryonic disc
What is the amniotic cavity?
Cavity between epiblast and the trophoblast
- forms lining of extra embryonic mesoderm
- surrounded by amnion (thin layer from epiblast)
What is the yolk sac and how is it formed?
Hypoblast sends epidermal cells to form the lining of the blastocyst cavity - thin layer, primary yolk sac
Hypoblast sends another layer of cells to change primary yolksac to secondary yolk sac
Inner layer = endoderm
Outer layer= extra embryonic mesoderm
After implantation what does the trophoblast differentiate into?
Cytorrophoblast layer
Synctiotrophoblast layer
What does the extra embryonic mesoderm do?
Forms a new cavity ( extra embryonic / chorionic cavity)
Lines inner surface of trophablast
Lines outer surface of amnion and yolk sac
What happens in the 3rd week of development?
Primitive streak formation
Gastrulations (tri laminar disc)
Neural plate formation
What happens in gastrulation?
Bilaminar → trilaminar
- embryo takes an oval disc shape
- forms indentation in the middle = primitive store
How is the primitive stream formed?
Accumulation of cells
What are the 3 germ layers?
Endoderm
Ectoderm
Mesoderm
Define variation.
No two living organisms are structurally or functionally identical
Define normal range.
Range in which values indicate a healthy population (variation)
Define anomaly
Deviated from the expected normal
Define ‘compatability with life’
Anomalies may not all affect normal life
What are congenital abnormalities?
Structural or functional anomalies that occur during intrauterine life
Can be identified at birth
Most at risk during week 3 to 8
What are teratogens?
Factors that cause malformation of an embryo
Name 4 common teratogens
Medications
Recreational drugs
Chemicals
Alcohol
What is amioscentesis?
Process of having cells from amniotic sac to check for congenital disorders
What is a CT scan computed tomography?
Uses X rays to produce sectional images and 3d reconstructions
- painless and non invasive
- slight risk of cancer
What is an X-ray?
Beam of X rays passes through patient, those that are not absorbed emerge and impact Ona detector.
Different tissues absorb x rays differently
What is an ultrasound?
Sound waves travelling through a median are partly reflected when they hit amedium of different consistency
→ suitable for fluid filled cavities
What is a doppe ultrasound?
When wave motion is radiated from a moving source there is a change in frequency of the wave.
- in is provides more information about blood flow.
What does ventral mean?
At the back (posterior)
What does dorsal mean?
At the front (anterior)
What are chordata?
Animals that have d backbone, have a notochord
Give a congenital disorder
- Anencephaly = brain has come away from surface
- hydrocephalus = swelling of the brain
- spina bifida= vertebrae hasn’t formed round correctly, hernication
What is the notochord?
Plays important role in induction of vertebral bodies together with neural tube
Failure can cause:
- vertebral column abnormalities
- spina bifida and scoliosis
What is neuralation?
Process that converts neural plate into → forms hollow neural tube and crest
- notochord is under neural tube
- somites are on either side of the neural tube for protection
Describe the process of neurulation.
- ectoderm forms primitive streak witha huge accumulation of its cells
2 primitive stream bends downwards → neural tube
3.Somites are paraxial (on either side of) notochord - Somites breakdown into 3 components
- Somites build body of vertebrae, part of notochord remains part of intervertebral disc
- Neural tubes send out nerves into developing muscles - movement
What 3 components do somites breakdown into?
Sclerotome → gives rise to bone
Myotome → gives to muscle
Dermatome → gives rise to skin and connective tissue
What does the function of an organ system depend on?
Integrated activity of its organs
What does the survival of an organism depend on?
Integrated activity of organ systems
What is cytology?
Study of the cell
What is in-vitro study?
Study of cells outside of The Body using a Petri dish and culture medium
→ reflects now cells are grown outside The Body
How are fixed cells studied?
Using a special fixative - chemical material to preserve the cells
Using a special stain to study microscopic features
What is histology?
Study of tissues
What are the 5 steps to study tissues?
Tissue collection and preparation Fixation Sectioning Staining Microscope
What does in vivo mean?
Reflects how cells were in the living tissue
What is tissue sampling /collection?
Taking small slices from different areas of an organ to determine if the organ is clear from disease or if disease is present.
What is fixation?
Samples are fixed with a chemical fixative to allow proper sections to be taken
- formaldehyde to preserve tissue
- boiling
What is sectioning?
Using a microtome machine to cut extremely thin sections of material
- sections are mounted onto glass for light microscopes
- section and mount depend on microscope
- sections are put into a warm water bath, fished out on a slide and arranged to dry in the oven
What is staining? Give 2 stains.
Stain a section to visualise it under a microscope
- hematoxylin = alkali, stains nuclei blue
- eosin= acidic, stains cytoplasm pink
How does the orientation of a section affect the microscopic image?
Longitudinal and transverse sections look different
Depends on level and plane of section
What is an issue with increasing magnification?
Decreases the resolution, less clear
Describe the use of a transmission e electron microscope
→ beams of electrons are transmitted through the structure
1. Fix tissue with a strong fixative (glutaraldenyde)
2. Sectioned very thinly
3. Stained with special stain
4- view under microscope
What is a scanning electron microscope?
Used to see surface of organelles
Higher magnification and better resolution
Tissue fixed with strong fixative
Describe 2 cell shapes
Round/spherical
Long/cylindrical
What is the morphology of an erythrocytes?
No nucleus / spherical
What are the 3 types of cell consistency, give examples?
Fluids → blood
Semi solid → adipose tissue (fat)
Solid → cartilage
What is histology?
How to recognise normal structures
What is pathology?
How to recognise abnormal structure
What are the 4 steps to detect abnormalities at tissue level?
Small slices of the body are:
- Fixed
- Sectioned
- Stained
- Microscope
Give examples of connective tissue.
Cartilage Bone Tendon Ligament Blood
Give examples of epithelium.
Liver
Kidney
Skin
Lung
Gives example of muscle tissue.
Heart
Skeletal muscles
Gut wall
Give examples of nervous tissue.
Brain Eye Ear Spinal cord Nerves
What is simple tissue?
Collection of similar cells
What is compound tissue?
Mixture of cell types and matrix
most of our tissues
What is the skin made of?
Epidermis -epithelium tissue
Dermis - connective tissue
What are parenchyma?
Functional cells within the organ
What are stroma?
Supportive cells
Inc. connective tissue, blood vessel, nerves
What are the 3 types of muscular tissue?
Skeletal - contraction of skeletal parts
Smooth - walls of internal organs and blood vessels
Cardiac - walls of heart.
What specialisations do secretory cells have?
Loads of er golgi and secretory vesicles
To process and package
What specialisations do absorptive cells have?
High conc of microvilli - increases sa
How are light microscopes used?
- focus light with a series of glass lenses
- to magnify smaller details
- can’t see a slide without using an appropriate stain
What structures does hematoxylin stain?
Negatively charged structures (nucleus) as it is a stain with a positive charge
What structure does eosin stain?
Positively charged structures (cytoplasm) as the stain is negatively charged
What 4 characteristics of the cell can be noticed using a microscope?
Size of cell
Snape of cell
Nuclear / cytoplasmic ratio
Chromatin condensation (heterochromatin and euchromatin)
What is heterochromatin?
Highly packed chromatin (dense) - nuclei stained darkly
Describe the arrangement of organs in the internal environment.
- Internal organs and body cavities are often covered in serous membrane from mesoderm = it secretes fluid that acts as a lubricant to reduce friction from muscle movement
- internal organs are asymmetrical
What are serous membranes?
Bag like structures that cover the organs
- secrete fluid that acts as a lubricant so things can slide over eachoiner
What parts of The Body have contact with the external environment?
Inner tube of The Body (respiratory and digestive tracts)
- specifically at the oral/nasal orifices and the anus
What is the pericardium?
A serious membrane (sac) that covers the heart
The heart grows into it
What are the 2 parts of serous membranes?
Visceral
Parietal
What is the visceral layer of a serous membrane?
Layer that is closest to the organ system wall
What is the parietal layer of a serous membrane?
The outer layer closest to The Body wall
What happens in gut rotation?
Gut rotates and drags other structures with it?
Gut herniates out of the cavity because the cavity isn’t large enough
Normally body grows to accept gut coming back in should rotate and fold
Where is the serous membrane?
It lines The Body walls and covers organs
Fist t plastic bag
What is a potential space?
Small spaces that have the potential to become much larger
Expandable, not rigid
What is the technical definition of a potential space?
Region of The Body in which 2 surface membranes adjoin, separated only by a small fluid filled layer
Give 3 examples of potential spaces?
Serous membranes
Fascia planes
Collapsible tubes /space
What is a real space?
Spaces that remain open when empty
Rigid, usually consistent in shape
Include airways and rigid tides
Define intraperitoneal.
When organs + structures can be arranged as fully encased by peritoneum
Define retroperitoneal
Organs + structures partially encased in peritoneum
Describe where the sternal angle is.
Little dip / bump between clavicles?
Join between manubrium and sternum
→ marks point where costal cartilages of ribs articulate with sternum
Where is the second costal cartilage?
Lateral to sternal angle
First costal cartilage is difficult to palpate as it is under clavicle
Where is the apex of the heart?
At the 5th intercostal space below the nipple
Give 2 examples of real spaces.
Airways
Rigid tubes I spaces
How to orientate yourself when viewing a Ct scan slice?
Look at the slice as though you are looking up from the feet to the head →
How is connective tissue arranged?
In fascia and fascia planes
What is fascia?
A band or sheet of connective tissue (mainly collagen) beneath the skin that attaches, stabilizes, encloses and seperates muscles and other internal organs
Connective tissue layers which can be thin, thick fatty or loose
What are fascial planes?
Important anatomical communication routes for spread of pathology
What are the 2 types of fascia?
Superficial
Deep
What is superficial fascia?
- beneath the skin
- loose and fatty
- variable thickness
- contains conagen, fat cells + elastic tissue
- goes round
What is deep fascia?
- fibrous, strong and tough sheet
- ensheaths muscles and forms compartments
- forms routes for infection to spread
- consequences during a bleed
Give 5 anatomical landmarks.
Bone Muscle Tendon Ligament Apertures
What is the transpyloric plane?
Horizontal plane at L1 level
- goes through lumbar 1 vertebrae and pylons (value of stomach)
What is the midclavicular plane?
A vertical plane from the midclavicular point
- from clavicle in the middle
What is the mediastinum?
A division of the thoracic cavity
Plane passing from sternal angle to T4 -T5 divides it into:
- superior mediastinum = containing major vessels
- inferior mediastinum = anterior, middle, posterior
What are the 3 regions of the inferior mediastinum and what do they contain?
Anterior → tnymic glands
Middle → under sternal plane, heart + lungs
Posterior → diaphragm and oesphagus
Define foreman
Bony, hollow archway through which nerves + blood vessels pass
Hole
Define fossa
Shallow depression in bone surface
Pit or groove
Define apex
Pointed and of a conical structure
Define prominence
Protrusion or projection
Define adventitia
External chiefly connective tissue covering of an organ
- outer tissue covering
Define aponeurosis
Flat sheet/ribbon of tendon like material
- anchors muscle or connects it with moving parts
Define septum
Dividing wall / membrane between body spaces or masses of soft tissue
Define lumen
Comity or channel with a tube / tubular organ
Define cortex
Outer or superficial part of an organ or body structure
Define Lamina
Flattened or arched part of vertebral area
Define bifurcate
Division into 2 branches
E G. Aortic bifurcation
Define Sulcus
Groove, furrow, trench
Why is knowledge of surface anatomy important?
Allows practitioners to assess what lies beneath skin surface by observation, palpation and manipulation of superficial structures
What fluid is found in the plural space?
Pleural fluid - small amount 10 - 20 ml of thin serous fluid
Lubricant during breathing
What are epithelial tissues?
Sheet of cells that line outer surfaces of organs and blood vessels
→ nearly all substances received or given off by The Body pass through epithelium layer
Give 5 main functions of epithelium tissues.
Protection Secretion Absorption Filtration Sensory reception
What are the characteristics of the epithelial tissue?
Polarised → epithelial cells have apical surface near the top and basal surface near the bottom
Supported by connective tissue
Presence of cell junctions
Attachment → attach basal laminar to connective tissue
Tissue is avascular → no blood vessels, receive nourishment through diffusion
Regenerative
What 2 words indicate the number of cell layers present in the epithelium tissue?
Single= one layer
Stratified - multiple layers
What 3 words indicate the shape of the cell?
Squamous
Cuboidal
Columnar
Describe the structure of simple squamous epithelium
Thin flattened cells
- used for exchange as substances can easily pass through
- located in alveoli, kidney, glomerulus, blood vessels linning, capillaries
Describe the structure of simple cuboidal epithelium.
Cube shaped calls with centrally located spherical nucleus
- used in absorption + secretion
- larger intracellular volume - greater number of contents
- located in secretory glands+ renal tubules
Describe the structure of simple columnar epithelium.
Large elongated column shaped cells, nuclei are usually at same level near basement membrane
- high organelle density used in absorption and secretion
- lines gl tract, uterus and portions of dietary tract
Describe the structure and location of stratified squamous epithelium?
Cells near surface are flat
- seen on outermost layer of skin
- present in areas of wear and tear = skin, vagina and anal cavity
Describe the structure and location of stratified cuboidal cells.
2 to 3 layers of cuboidal cells
- secretory functions lines sweat glands and seminiferous tubules
Describe the location of stratified columnar epithelium.
Protection
- larynx and male urethra
What is keratinized epithelium and where is it found?
Contains keratinized cells
- important for protecting underlying tissue
- found in external areas of wear and tear (skin and vocal cords)
Where is non keratinised epithelium found?
In internal areas of wear and tear
- lines areas like oesophagus and mouth
What is pseudostratified epithelium?
Epithelium that appears stratified as the individual cell nuclei are irregularly positioned
- it is actually just single epithelium as au cells are attached to the basement membrane
Describe pseudostratified columnar epithelium.
Epithelium that usually lines tubes of respiratory system.
- goblet cells scattered throughout tissue - secrete mucus
- cilia - hair like projections
What are absorptive cells?
Simple columnar cells with villi/microvili that increase absorptive surface - goblet cells= secrete mucus
What epithelium is present in the alveoli?
- Flattened squamous epienelium = gas exchange
2. Dome shaped cuboida epithelium in lumen - secretes surfactant to cover alveolar surface and reduce surface tension
What epithelium is present in the trachea?
Pseudo stratified epithelium with goblet cells and cilia, it is useful at clearing the airway
What epithelium is present in the urinary tract?
Bladder = transitional epienelium that changes in response to tension
- when organ walls contract → tissue stretches and appears thinner
- usually lines ureter, bladder and parts of urethra
What is the basement membrane?
Sheets of matrix at interface of functional tissue (parenchyma) and support tissue (stroma)
- composed of type iv collagen, glycoproteins, fibronectin (from fibroblasts) and glycosaminoglycan
What are the 5 functions of the basement membrane?
Adhesion
Partition
Barrier (has selective permeability)
Anchorage for cell organization - basal cells
Controlling growth and differentiation Of basal cells
What are cell junctions?
Junctional complexes that bind cells together and to underlying tissues
What are the 3 classes of cell junction?
Occluding
Anchoring
Communicating
What are occluding cell junctions?
Cells are seized together in sheets forming an impermeable barrier
What are anchoring cell junctions?
Attach cells and their cytoskeletal to other cells and extra cells in matrix
Mechanical support
What are communicating cell junctions?
Allow exchange of chemical and electrical info between cells
Name the 5 types of cell junction.
Tight junction Adherens junction Desmosome Gap junction Hemidesmosome
What is a tight junction?
Impermeable, prevent molecules from passing through intracellalar space
Prevent entrance of extracellular molecules into cell
What are adherens junctions?
Join an actin bundle in one cell to a similar bundle in a neighbouring en
What are desmosomes?
Anchoring junctions join the intermediate filaments in one cell to another - like a molecular Velcro forming an internal tension reducing network Of fibres
What are gap junctions?
Communicating junctions that allow the passage of small ions and molecules for intracellular communication
What is a hemidesmosome?
Extend into extracellular matrix and interact with extracellular membrane material’s and attach to basement membrane
Anchors cells to basement membrane
What is the role of a gland?
To synthesise and secrete complex molecules like hormones.
What are exocrine glands?
Release chemical substances through ducts to the outside of the body or onto another surface eg epithelial surface
What are the 3 types of exocrine secretion?
Mecrocrine= secretion by exocytosis Apocrine = shipping a portion of cytoplasm Holocrine= shipping interior cells from linining of one duct
What are endocrine glands?
Release chemical substances directly into bloodstream or tissues of the body
Secrete hormones
Ductless glands
Eg pituitary + thyroid glands
What forms can exocrine glands take?
Simple or compound (branched)
Tubular, acinar, mixed
What is Adenocarcinoma?
Cancer of glandular epithelium
- invasion of surrounding stromal tissue to spread tumour
- affect or access blood, lymphatic system
How is endocrine function regulated?
Through neural connections in the brain via the hypothalamus and pituitary gland
What is the apical surface of the epithelium?
Faces the external environment/lumen
- has no specialisations
What is the lateral surface of the epithelium?
Faces the sides of adjacent cells, has junctions
What is the basal surface of the epithelium?
Has basement membrane
Name the 3 layers of the skin
Epidermis
Dermis
Hypodermis/subcutis
What is the epidermis?
Outer layer of the skin made up of stratified squamous epithelium which is keratinized - has keratinocytes
- acts as protective shield
- develops from surface ectoderm at 4th week oflife
What is the dermis?
Made of dense connective tissue, contains collagen l, firbroblasis, elastin, blood, nerves and receptors
- divided into 2 types
- provides structure and support
What are the 2 types of dermis?
Papillary
Reticular
What is the papillary dermis?
Uppermost layer of the dermis, intertwines with ridges of the epidermis
- composed of fine + loosely arranged collagen fiber
What is the reticular dermis?
Lower layer of the dermis, found under papillary dermis
- composed of dense irregular connective tissue, densely packed collagen fibres
- primary location of dermal elastic fibres
What is the hypodermis ?
Composed of adipose tissue, is the main blood supply for the rest of the skin (blood vessels and capillaries)
- derived from the mesoderm
- acts as insulation and padding
What is the role of the skin?
Protection
- from uv light, chemical, thermal and mechanical injury, resistance to sheering, invasion
What are the 4 functions of the skin?
Act as a barrier → due to tight junctions in cells that make up skin, barrier is water tight
Sensation → neurons and sensory cells are sensitive to touch, pressure, pain, temperature
Thermoregulation → insulator, contains subcutaneous fats, heat loss via sweat, vasodilation and vasoconstriction
Metabolic functions → synthesises vitamin d3
How are internal tissues protected?
By immune system cells
Name 4 skin appendages
- Hair
- nails
- arrector pills
- sebaceous glands
- sweat glands - apocrine and eccrine
What is the arrector pili?
- Involved in thermoregulation
Muscle that controls the movement of hair follicles when erected hair stands up straight, traps a layer of hair between skin allows heat retention
What are sebaceous glands?
Associated with hair follicles
- secrete sebum (lipid mixture) into hair follicle for waterproofing
What are the 2 types of sweat glands?
Eccrine → ducts open onto skin release sweat for evaporation (thermoregulation)
Apocrine → localised, responsible for scent production (puberty)
What are the 4 recepto-rs?
Pacinian corpuscle = pressure (in connective tissues)
Meissner’s corpuscle= light, touch, pressure (under epidermis)
Ruffini corpuscle= skin stretching. (skin and joints)
Free nerve endling= pain, itch, temp
What are the functions of ground substance in the dermis?
Binds water
- allows nutrients, hormones, waste products to pass through dermis
- acts as lubricant between collagen and elastic fibres during movement
- provides bulk = shock absorber
What are the 4 epidermal cell types?
Keratinocytes
Melanocytes
Langernans cells
Merkel cells
What are keratinocytes?
Make up 95% of cells
- stratified squamous keratinizing epithelial cells
- produce keratin = structural protein
What are melanocytes?
Pigment synthesising cells → skin and hair colour
- neural crest derived cells in basal layers
Melanosomes in cytoplasm contain melanin + passed to keratinocytes - scattering uv light to protect skin
What are langerhans cells?
Present in all layers - mostly in stratum spinosum
- antigen presenting tens - immune cells
What are Merkel cells?
Present in touch areas
- connected to keratinocytes and sensory nerves
What is the role of hemidesmosomes?
To anchor epithelium to basement membrane
What are the 5 layers of the epidermis?
Stratum Corneum (outer) Stratum lucidium Stratum granulosum stratum spinosum Stratum basale
How is the epidermis multilaminar?
Basal cells divide continuously to give rise to the layers above - migratory cycle
- takes 30 days from basal to stratum corner
They become progressively more differentiated
Describe the structure of the nail
Root, nail plate and free edge - plate lies on highly vascularised nail bed
Paroncnyium = soft loose tissue surrounding nail border - susceptible to infection
- physical protection
Onychocryptosis = ingrown toenail
What is cellulitis?
Infection of deeper skin layers
- caused by strep pyogenes specifically affects superficial dermis and subcutaneous fat.
- erysipelas is also an infection caused by strep pyogenes = but it is an infection of superficial skin layers
What is impetigo?
Due to staphylococcus
- sub corneal blisters sometimes with pus
- bursting + spreading results in yellow crusting of skin
- nignly contagions
What is the stratum basale layer of the epidermis.
Deepest layer that is connected to basement membrane by hemidesmosomes
What is the stratum spinosum?
Contains several layers of keratinocytes attached to eachother by desmosomes
What is the stratum granulosum?
Contains cells filled with keratohyalin granules that when secreted are responsible for epidermal waterproof barrier
What is the stratum corneum?
Most superficial layer
No nuclei and are continuously shedding off (desquamating)
What are somatic motor nerves?
Supply skeletal muscles that we can control voluntarily
What are somatic sensory nerves?
Detect sensations that we are consciously aware of
- pain, touch, pressure, temp
What is a dermatome?
Area of skin in which sensory nerves derive from a single spinal nerve root
What are automatic motor nerves?
They stimulate smooth muscle to contract. In response to changes defected by automatic sensory nerves
What are automatic sensory receptors?
Can sense changes in ph and stretch but not pain
What is a partial thickness burn?
-> burns where not all of the skin layers are destroyed
First degree burn - epidermis (outer layer) are damaged
Second degree burn -epidermis and partially epidermis are damaged
What is a full thickness burn?
Third degree burn affecting all layers and some underlying tissues
- tissue oedema - loss of plasma proteins + imbalance of homeostatic mechanisms
- capillary beds off dermis + nerves and receptors of hypodermis are damaged
What is a t?issue
Collection of cells specialised to perform a particular function
Give 4 characteristics of connective tissue
Provide general structure
Mechanical strength
Sculpting - space filling
Physical and metabolic support
What 3 components do all tissues have?
Fibres
Cells
Ground substance
What are the properties of connective tissue?
Cells - commonly fibroblasts Extracellular matrix-components determine physical properties - collagen = strength - elastin = elasticity - ground substance= volume
Describe the structure of loose connective tissue.
- collagen + elastin embedded in amorphous hydrated ground substance (no defined shape, fills space between cells and fibres)
- blood vessels and connecting membrane
- composed of fibroblasts and other cells including those involved in inflammatory allergic and immune response
Describe the structure of dense connected tissue
Composed largely of collagen (tendon) with sparse hydrated ground substance and fibroblasts
- dense regular= fibres line up organised eg tendon
- dense irregular = fibres are less organised eg dermis
Describe structure of blood lit is a connective (issue)
- collection of similar specialised cells with particular functions
RBCs transport oxygen
WBC immune response
Platelets blood clotting
Describe the structure of cartilage.
Chondrocytes embedded in amorphous hydrated ground substance
- cnondrocyces - cells that secrete matrix and become embedded in it
- structural support, resistant to compression
- poorly vascularised - poor blood supply, doesn’t self repair
Give 3 types of cartilage.
Hyaline - lines joints and trachea
Fibro= intervertebral dis
Elastic= external ear ( returns to original shape)
Describe structure Of bone
Osteocytes are embedded in a mineralised matrix
- osteocytes are bone en’s formed when an osteoblasts is embedded in the material it has secreted
What is the function of loose connective tissue?
Packing material between other tissues
What is the function Of dense connective tissue?
Tough support in skin
What is the structure of cartilage and bone?
Major skeletal components - rigid
What is the function of adipose tissue?
Metabolic processes - fat storage
What are the 4 layers of tubes?
Mucosa and basal lamina - pseudo stratified epithelium w goblet cells and smooth muscle
Submucosa= contains mucoserous glands, lead to lumen viaduct
Hyaline cartilage - ring or plate
Adventitia - connective tissue sheath (outer layer)
What is conductive part of the bronchial system?
No gas exchange occurs
- trachea, bronchus, bronchi
- wide calibre, trick walled spaces to move and clean air
What is the respiratory part of the bronchial system?
- bronchiole, alveolar duct, sac alveoli
Functional unit - thin walled for gas exchange between membranes
Describe the respiratory epithelium.
Lined with pseudostratified columnar epithelium in larynx and trachea
- ciliated
- goblet cell secrete mucus
Transitions to simple cuboidal nonciliated form in smallest airways
What are the 3 types of circulation?
Systemic
Pulmonary
Portal
What is portal circulation?
Takes blood from intestine to liver for it to be processed
Compare arterial and venous circulation
Arteries maintain and are under greater pressure than venous so arteries have thicker walls
Describe the gut and its lumen
Extends from mouth to anus as a long tube with different twists, it is linked to exocrine glands which secrete substances into ducts
Describe in detail the structure of large airway layers.
Respiratory epithelium
- pseudostratitied columnar ciliated in trachea/larynx and simple cuboidal non ciliated in simple airways
Lamina propria
- fibro elastic connective tissue with blood t lymph
Smooth muscle layer deep to mucosa not in trachea)
- becomes more prominent and more muscular as airway diameter decreases
Submucosa
- underlies smooth muscle layer, contains serous and mucous glands, fewer in the narrower airways
Cartilage
- hyaline csnaped cartilage in trachea and bronchi
- less prominent in - smaller tubes
What is the terminal bronchiole?
Last part of conductive airway
What is the respiratory bronchiole?
Beginning of respiratory airway
What are the 3 layers in blood vessels?
Tunica intima
Tunica media
Tunica external adventitia
Describe structure of the 3 layers of a vein.
Tunica intima- thin layer of endothelial lining
Tunica media - 2 or more layers of circularly arranged smooth muscle fibres
Tunica adventitia/externa - thickest layer of longitudinally arranged thick collagen fibres that merge with surrounding connective tissue
Describe the structure of the 3 layers of an artery.
Tunica intima- thin layer of endoletial lining comprised of little collagenous connective tissue and thin internal elastic Lamina
Tunica medic - composed of smooth muscle in 6 concentric layers or less
Tunica adventitial/external - thick merges with surrounding tissue, composed of collagen
What is vasa vasorum?
Blood supply to the blood supply
- as larger vessels require their own blood supply
Describe the structure of capillaries.
Single layer of endothelium, small diameter to fit 1 RBC at a time
- clefts / slits between endothelial cells allow exchange of material
- formation of interstitial fluid.
What happens to interstitial fluid?
Taken up by blind ending vessels (lymphatics)
Returned to Venus system in thorax t passed through lymph nodes
F wid is filtered to remove microorganisms
What are the 4 layers of a gut tube
Mucosa- divided into 3 Layers: epithelial lining, supporting connective tissue (lamina propria) and thin smooth muscle layer (muscularis mucosaes which produces movements and fording of mucosa
Submucosa - connective tissue layer that supports mucosa, contains blood vessels, nerves and lymphatics
Muscularis proprie - smooth muscle divided into inner circular layer and outer longitudinal layer
Adventitia - conducts major blood vessels and nerves
.
What is serosa?
Outer layer In a tubular structure surrounded by peritoneum. / serous membrane
What is adventitia?
The outer layer in a tubular structure that is not covered by serous membrane peritoneum
What are 4 problems with tubes?
High pressure can damage walls
Low pressure can collapse tube
Inner inning is vulnerable to substance
Blockage of tube / weaken outer layers
What are obstructive disorders?
Narrows tube, increased resistance, impaired exhalation, tubes can collapse
What is copd emphysema / chronic bronchitis)?
Enlarging air scars cause damage and reduce sa
Irritated by cigarette smoke and urban environment
What is asthma?
When airways narrow due to stimuli, difficult exhalation
What is atherosclerotic disease?
Atherosclerotic plaques - build up of cholesterol results in plaque on inside of the vessel, plaque is brittle can cause tear of aorta
What is an arterial aneurysm?
Swelling of artery, reduced resistance decreased blood flow
Wall could burst if stretched extensively
What is diverticula disease?
High pressure in gut may lead to little pockets (diverticuli) on gut wall
- may be out pushes containing faeces that can’t be cleared
- inflammation t infection
What is homeostasis?
Physiological process maintaining internal systems of The Body at equilibrium, despite variation in external conditions
What is metabolism?
Sum of all chemical and physical changes in the body, enable growth and functioning
What is catabolism?
Breakdown of complex molecules to form simpler ones
Eg carbs _ simple sugars
What is anabolism?
Synthesis of complex molecules from simpler one
Eig amino acid -7 protein
Describe regulation of CO 2 levels.
High co2 (hypercapnia) = increased respiratory drive Low co2 (nypocapnia) = decreased respiratory drive
What does the neuroendocrine system (hypothalamus) ‘do?
- maintain homeostasis
- regulate metabolism
- reproduction
- eating and drinking behaviour
- energy utilisation
- osmolarity
- blood pressure
How does hypothalamus communicate with anterior pituitary?
Neurons that secrete hypothalamic releasing = released into local circulation in anterior pituitary
How does hypothalamus communicate with posterior pituitary?
Neutrons the synthesise posterior pituitary hormones go to posterior pituitary
What hormones are released by posterior pituitary?
Oxytocin and ADH
What hormones are released by anterior pituitary?
Stimulating hormone
Describe how food passes through body.
Mouth - ingest food
Teeth -mechanical breakdown
Salivary glands- enzymatic digestion
Oesophagus - moves food to digestive system
Stomach-mechanical and chemical digestion
- mucous cells
- parietal cells =HCL
- chief cells = produce enzyme
- Enteroendocrine = hormones
Small intestine - absorbing molecules
Large intestine - water absorption
Portal vein - transports to liver
Liver - process absorbed molecules
Waste excreted
What is the enteric nervous system?
- gut nervous system
Regulates glandular secretion + smooth muscle contraction
What functions does mucosal layer have?
Absorption - small intestine villi t goblet cells
Protection - oral cavity, pharynx, oesophagus, and canal stratified squamous keratinized epithelium
Secretory - stomach, tubular glands for acid secretion and mucus to protect
Absorptive/protective - large intestine, enterocytes water absorption cells, goblet cells
Describe the oesophagus?
Moves food from pharynx to stomach
- highly folded mucosa stretches when swallowing
- lined by stratified Squamous s epithelium
- skeletal muscle in first third
- smooth muscle in last third
Small intestine
Duodenum- 4 parts - receives chyme acidic + secretions from pancreas are bildury system
Jejenum - blood vessels
Ileum-joins with large intestine
Large intestine _
Absorbs water t salt → solid waste
Caecum, ascending colon, transfers colon, descending colon, rectum
Excretion
Controlled by muscular canal with 2 sphinters
Intern-all sprinter= smooth muscle at end of rectum
External sphincter= skeletal muscles
Retroperitoneal
Partially covered by membrane
Intraperitonedl
Fully covered by membrane
Gut parts
Foregut → to 2nd part of duodenum
Midgut → from 2nd part of duodenum onwards
Hindgut → down to anus
Foregut
Expands from a tube
- abdominal portion of foregut divided into oesophagus, stomach and proximal duodenum
Midgut
Forms distal duodenum, jejunum, ileum, cecum ascending colon and two thirds of transverse colon
6th week = herniates outwards into umbilicus
10th - 12th - intestinal loop herniates into abdominal cavity
Hind gut
Lots third of transverse colon, descending and sigmoid colon, rectum
Sad pucker - retroperitoneal structures
Superneal gland/ adrenal
Aorta / inferior vena cava
Duodenum(only proximal 2cm)
Pancreas (not tail) Ureters Colon (ascending and descending) Kidney Oesophagus Rectum
Peritoneal cavity
Space between parietal and visceral peritoneum
Fluid=50-75mls
Portal triad
Hepatic artery → oxygenated blood to hepatocytes (liver cells)
Portal vein → blood with nutrients from small intestine
Bile duct → carries bile products away from hepatocytes
Pleura
Serous covering on external lung surface
Parietal - lines ribs, sternum, costal cartilage, inter costal muscle, superior surface of diaphragm
Visceral - attaches to lungs covering surfaces passing into fissures separating lung lobes
Mediastinum
Superior= contains major vessels
Inferior- anterior, middle, posterior
Anterior - thymic glands
Middle- under sternal plane, heart, lungs
Posterior - diaphragm, oesophagus
CNS
Central nervous system
- brain and spinal cord.
Gathers info from PNS processes it and organises responses
PNS
Peripheral nervous system
- cranial nerves and spinal nerves
All parts of nervous system not included in CNS formed by:
- sensory receptors
- primary afferent neurons
- autonomic motor (efferent) neutrons
Divided into somatic and autonomic
Embryology+ nervous system
Ectoderm → gives rise to major components of nervous system by sinking into mesoderm
Notochord
Becomes remnants of intervertebral discs, becomes spinal cord
Spinal cord
Spinal nerves start developing and extending out to muscle
Somites
Sclerotome -> bone
Myotomes -> muscle
Dermatome → skin
Infant brain
Basic reflexes - breathing, rooting, sucking and swallowing Approach reflexes (above)
Avoidance reflexes - coughing, sneezing and blinking
Other reflexes - palma grasp, babinsky toe fanning Moro response
4 lobes of the brain
Frontal
Temporal
Parietal
Occipital
Gyri/ Gyrus
The bumps on brain surface (sticking out folded parts)
Sulci/Sulcus
Dips / grooves in the brain between gyri
Frontal lobe
Motor control - motor cortex
- personality and social behaviour
- problem solving, spelling, recent memory
- fore sight and hindsight
- sequence of behaviour
Decussation
Right side of the brain receives information from left side of body and vice verse
2 nervous pathways
Corpus collosum
Internal capsule
Parietal lobe (top)
Sensory - sensory cortex
- processing of tactile and proprioceptive information
- comprehension of language
- orientation of space and time
Temporal lobe
Homeostasis
- courtship, mating, rearing young, seeking and capturing prey
- complex aspects of learning and long term recall
- auditory
- emotional and visceral responses
Occipital lobe
- Occipital bone
- visual function
- dreaming
Limbic system
Reptilian brain
- sex
- bridge between autonomic and voluntary response
- between hypothalamus and neocortex
Cranial nerves
12 pairs
Relay info to head and neck and don’t use spinal cord
Spinal nerves
31 pairs
Relay info to brain via spinal cord
Efferent neurons
Carry impulses away from CNS to muscle for movement
Afferent neurons
Carry neural impulses from sensory stimuli to CNS
Thoracic cavity - inhalation
- Diaphragm contracts and flattens
- internal intercostal muscles contract
- external intercostal muscles relax
Thoracic cavity - exhalation
- Diaphragm relaxes and bends upwards
- internal intercostal muscles relax
- external intercostal muscles contract
Tracheal bifurication to bronchi
T4
Trachea
C6 to t4
Trans pyloric plane
L1
Hyoid bone
C3
Cricoid cartilage
C6
Upper respiratory tract
Conduction- transport system for bulk movement of air
Lower respiratory tract
Respiratory - exchange site for transfer of respiratory gases between alveoli and capillaries
Trachealis muscle
Controls diameter Of tracked
Carina
Carina is a ridge that lies at the level where trachea bifurcate into bronchi (t4/t5)
Bronchi are asymmetrical
Left has fewer branches (smaller) than right
pericardial sac
For the heart, has 3 layers:
- serous pericardium - close to heart surface, secretes pericardial fluid - allows movement during contraction and relaxation
- pericardial fluid - watery lubricating fluid
- fibrous pericardium - tough, inelastic, dense connective that surrounds serous pericardium (forms a sac) - stabilise and imobalise heart (prevent rapid overfilling of heart) ‘
Phrenic nerve
Supplies fibrous and serous pericardium
Pleural membrane
Serous membrane sac for the lung
- visceral pleural membrane- closely applied to lung surface
- parietal pleural membrane- adhere to thoracic wall and upper surface of diaphragm
Potential space for tre accumulation of excess fluid
Pulmonary edema
Excess fluid in the lungs
Somatic nervous system
- Voluntary control of body movements via skeletal muscles
Afferent sensory nerves
Efferent motor nerves
Autonomic nervous system
-acts unconsciously, supplies smooth muscle and glands and influences internal organ function
Sympathetic- control fight or fight response
Parasympathetic - rest and digest response
4 types of neurogilial cells
→ these cells have a supportive role in looking after neutrons
Astrocytes
Oligodendrocytes
Schwann cells
Microgilia
Astrocytes
- Supply energy to neurons
- regulate synapses
- blood brain barrier
- synthesizing neurotransmitters
Oligodendrocytes
- make and maintain myelin sheath in the CNS
Schwann cells
-make myelin sheath in PNS
Microglia
- like immune cells but in the brain
- phagocytose materials like dead cells in the brain and spinal cord
Neurons structure
Cell body - contains nucleus, making enzymes and other chemical substances needed for specialised function of nerve cells
Dendrite - receives synapses, neuron to neuron communication
Axon- arises from axon hillock in cell body, transmit AP
Myelin
Helps increase the speed of conductance of the action potential
- nerve impulses can skip from node to node so myelinated axons are faster
Axons in CNS tend to be myelinated
4 neuron types
Unipolar → one structure extends from the cell body (soma) - no dendrites
Bipolar → one axon and one dendrite extending from soma (soma in middle)
Multipolar → one axon and many dendrites (normal one)
Pseudounipolar → single structure that extends from cell body and then branches into two distinct structures
Sensory pathway
Usually has 3 neurons - ascends peripheral → central
- Info goes up first order neuron
- When it reaches spinal cord it synapses to a second order neuron
- Travels up to brain at thalamus level it synapses to third order neuron
Dorsal root is responsible for sensory aspects
Motor pathway
Uses 2 neurons, descends from brain → peripheral
- upper motor neuron
- lower motor neuron
- Message starts at upper motor neuron in the brain
- Synapses to the other side of the body - upper motor neuron synapses with lower motor neuron
- Lower motor neuron goes to muscle
- Synapse between neuron and muscle- muscle contraction
Motor info comes out of ventral root
Spinal cord
Dorsal horn- sensory info comes in
Ventral horn- motor info comes out
Lateral- autonomic pathway comes out
4 types of pain and how nervous system detects
Conscious (somatic)
Visceral
Referred pain
Neuropathic
1. Painful stimulus in peripheral 2. Specialized skin picks up signal 3. Moves along sensory afferent to spinal cord 4. Enters posterior part of spine (dorsal horn) 5. Synapses with inter neuron (relay neuron) 6. Inter neuron synapses with motor neuron (on ventral side of spinal cord) 7. Triggers lower motor neuron to travel to muscle and to cause muscle to contract
Conscious (somatic pain)
- pain has an identifiable source and is wen localised
Can-be sharp, dull, acute, chronic
Visceral pain
- Pain originating in organs of chest, abdomen, pelvis
Sensitive to distension, inflammation, ischaemia
Poorly localised
Referred pain
Pain is experienced at a site remote from the source of pain
Eg pain in heart but it goes to jaw
-can be visceral - from internal organs or blood vessels that aren’t well supplied by sensory nerves
- can be somatic- musculoskeletal pain
Neuropathic pain
Disorder within nerves itself
- usually chronic
- shootline or burning sensation eg carpal tunnel
Prioprioception
= awareness of movement and position of the body
Feel where the body is - sense of self
3 main proprioceptors
Muscle spindles - intrafusal fibres that wrap around muscle fibres that detect the stretch on the muscle
Golgi tendon organs- type ib fibres at the junction of tendon and muscle that detect force
Joint receptors -joint capsule
How body senses proprioception
Combination of all 3 proprioceptors
- combination of sensory info
- mechanoreceptors play a protective role - muscle spindles stiffen if muscle is overstretched and Golgi tendons have an inhibitory effect
Endocrine system
→ chemical messenger system consisting of hormones that are secreted by glands and feedback loops modulate hormone release.
3 hormone subcategories
Endocrine - enter blood stream and work at a far distance
Paracrine- work in a part close to where it was synthesised (local)
Autocrine- made directly at one cell and work on the same cell.
Pituitary gland
Master gland, produces hormones that work on other organs
- hormones leave priuitary, enter bloodstream and act on target organs
Anterior pituitary gland
- releases tropic hormones ‘
- made of only oral ectoderm
Communicates with hypothalamus using hypophyseal portal system
- Neutrons communicate to top of pituitary stalk (infandibalurm)
- Release hormones into hypophyseal portal system
- Hormones travel to base of anterior pituitary
- Released into bloodstream
Posterior pituitary
- releases neuro hormones
Communicates with hypothalamus via axons of neurosecretory cells
- nerve cells transmit down infandibulum to posterior pituitary
- Release hormones at base of pituitary
Skeleton
- Plays critical role in protecting major organs from external trauma
2 regions
- axis - important structures for maintaining life sit beneath this
- appendicular - movement
Axial skeleton
Thorax organisation - protects the:
- lung
- heart
- spleen
- stomach
- liver
Head and neck:
- spinal cord
- brain
The skull
22 bones
- 8 cranial bones - form protective parts of brain
- 14 facial bones - mechanics for facial structure, speaking, eating, breathing etc.
Bone structure
→ specialised connective tissue with an extracellular matrix that is able to calcify
- made of type I collagen fibres
- highly vascularised
Trabecular bone = where bone marrow found, branching structure
Region of growing bone= growth plate (epiphysis)
Grown plate (epiphysis)
Chondrocytes (cartilage producing cells) proliferate, grow in size and then die (apoptosis)
-after tens die, calcification of collagen matrix occurs and bone is formed
3 cell types within bone
Osteoblasts
Osteoclasts
Osteocytes
Osteoblasts
Bone forming cells
Eg on trabecular surface they remodel it and lay down new bore
Osteoclasts
Degrade bone (resorption) - for replacement if damage occurs
Osteocytes
Sense mechanical and hypoxia stress
- important for initiation of load induced bone remodelling → signal triggering osteoclasts and osteoblasts
Bone remodelling
RANKL ligand
- Secreted by osteoblasts
- Binds to RANK receptor on osteoclasts
- Activates osteoclasts resorption
Osteoblasts secrete osteoprotegrin (opg) to stop process of breaking down bone
- OPG acts as decoy for RANKL ligand
- Binds to rank receptor to block ligand binding
- No resorption
3 pathways affecting bone remodelling and signalling
BMP pathway
WNT signalling pathway
Introduction of DKK1 and SOST (sclerostin)
Introduction of DKK1 and SOST (sclerostin) pathway
Inhibits WNT pathway
- increase RANKL/OPG ratio = osteoclastgenesis and bone resorption
BMP pathway
BMP ligands bind to receptors
Induce osteoblasts genes → osteoblastsgenesis and bone formation
WNT pathway
Decrease RANKL/OPG ratio → osteoblastgenesis and bone formation
Bone remodelling purpose
Constantly occurring process required for maintenance of healthy bone and growth
- occurs during fraction repair but is not always successful = non union fractures
Cartilage structure
Composed of chondrocytes that lay down a matrix of type ii collagen fibres
4 layered region zones:
Superficial- articulating cartilage sits on top, fibres packed closely
Middle- modification of cartilage matrix, provides strength
Deep - aggrecan is most concentrated here, type ii fibres at lowest concentration - matrix begins to form
Calcified - bone interface
Avascular- relies on diffusion
Cartilage matrix
- aggrecan
- type II collagen
- Hyaluronan- coats chondrocytes of articular cartilage
- chondroitin sulphate - structural support, resistance to compression
Matrix is more closer as you move to apical surface superficial zone
Larynx
- Made of 3 paired and 3 unpaired cartilage
- anchored by hyoid bone c3 that anchors it larynx hangs off it
- anterior to pharynx
- below the muscle of mouth
3 unpaired cartilage that make up larynx
- epiglottis - elastic cartilage
- thyroid cartilage - hyaline
- cricoid cartilage - hyaline
Pharynx
- nasopharynx - behind nasal cavity
- oropharynx - behind oral cavity
- laryngopharynx - behind larynx
At c6 where larynx becomes trachea, the larynggopharynx becomes oesophagus
Larynx - functions
- Breathing - rima glottidis being open
- formation of sound
- protection coughing
Epiglottis
Protective role
→ small flap Of elastic cartilage which prevents food from entering the trachea and forces food into oesophagus = prevents choking
Thyroid cartilage
- Sits at the top of trachea
Laryngeal prominence - Adams apple
Superior thyroid notch c4 - where common corroted artery bifurcated
Cricoid cartilage
Looks like a signet ring = only complete ring of cartilage in larynx
C6
-can be used for emergency intubation by pushing cricoid cartilage back to block oesophagus and prevent vomit spreading into lungs
Larynx used for a landmark
- It is a hard and palpable structure
Landmark for palpating corroted artery
Landmark for locating jugular vein to put a cannula in it
Synovial joint
→ articulating joint consisting of 2 articulating surfaces with a cavity between them containing synovial fluid.
Provides protection and articulation of bone
Synovial fluid
Produced by synovial membrane, lubricates the joint and aids in articulation
-cytokines, adiporines and chemokines are secreted into fluid - important for maintenance of healthy joint
Synovial membrane
- part of joint capsule, only a few cell layers thick contained with outer fibrous capsule
Cartilage turnover
Fats provide signals telling cartilage when to turnover
- maintain integrity and replenish synovial fluid.
Arthritis
→ auto immune disease caused by an inflammation and destruction of the body’s tissues by its own immune response
2 types
Rheumatoid
Osteoarthritis
rheumatoid arthritis
No specific disease-causing antigen has been identified (although antigens such as rheumatoid factor (RF) are found in sero-positive RA patients. – But not all RA patients are sero-positive for RF!).
treatments:
Disease modifying antirheumatic drugs (DMARDs)
Methotrexate – chemotherapy drugs but at low doses is good anti inflammatory
Antibody therapy - therapeutic antibodies flag proteins below, so immune system recognizes that they must be cleared/ or competitive binding
osteoarthritis
Low grade chronic inflammation – persistent and enough to damage joints, lead to remodeling of joint over time
Formation of osteophytes – result of an exaggerated repair response
Loss of joint space, synovial fluid
Synovium thickens to more cell layer
• Radiographically classified based on loss of joint space width (JSW) and presence of osteophytes using the Kellgren-Lawrence (KL) grading system.
treatment:
Analgesics – manage pains
Joint replacement
Appendicular skeleton
Upper and lower limbs
Embryology and limbs
Upper limb buds (raising accumulation of mesoderm) occur earlier than lower limb buds
Limb buds
- elongate - become longer
- distal ends become hand and foot plates
- bones develop from mesenchymal condensation - mesoderm
- cartilaginous models
2 types of osseous tissue
Compact bone
Cancellous bone
Compact bone
Outside of bone
Provides strength.
Made up of haversion systems - next to medullary marrow cavity filled with cancellous bone
Cancellous bone
Middle part
Sponge like appearance
Haversion canals - resemble honeycomb red honey comb within
Haversion system
Can be seen in compact bone
- concentric rings of bone = lamellae strength
- blood vessels in the centre
- like a cut tree trunk
- cluster together
Fibroblasts
Produce collagen fibres
3 types of joints
Joints are places where bones meet and articulate (move) eg sternal angle
Fibrous joints = fixed - can’t move
Cartilaginous joints = slightly moveable
Synovial joints = freely moveable
Structure of a joint
2 opposite bones
- hyaline cartilage to allow smooth movement
- cavity between bones filled with synovial fluid
- joint capsule = synovial membrane (creating cavity where synovial fluid is released) and fibrous capsule
- ligaments -join bones together
Bones of upper limb
Scapula Clavicle Humerus Radius Ulna. Carpals, metacarpals, phalanges
Bones of lower limb
Pelvic bone - broken down into 3 parts that fuse together:
- illium
- ischium
- pubis
Femur Patella Tibia Fibula Tarsals, metatarsals, phalanges
Neurocranium
Rigid immovable casing of the skull that protects the brain, some special sensory organs and nerves
Visceracranium facial skeleton
part of skull that provides protection for important components of digestive and respiratory systems
- number of openings including orbits and oral and nasal cavities
Arteries that supply blood to brain
Internal carotid artery
Vertebral artery
Stroke
Cerebral infarction
- interruption of blood flow to brain, result of occlusion of artery
Global cerebral ischaemia
Different to stroke as it effects the whole brain
-hypoxia
3 parts of brainstem
Midbrain
Pons
Medulla
What structures pass through foreman magnum
Vertebral arteries
Spinal arteries
Inferior part of medulla
Intervertebral foramina
Small space between 2 adjacent vertebrae where nerve root exits spine
12 cranial nerves
Olfactory Optic Oculomotor Trochlear Trigeminal Abducens Facial Vestibulocochlear Glossopharyngeal Vagus Accessory Hypoglossal
Circle of Willis
-made of many blood vessels so if blood vessel becomes blocked, the blood supply can still come from other areas
Anterior triangle
Borders are:
Mandible
Sternaocleidmastoid
Sagittal line down middle of neck
Posterior triangle
Borders are:
Sternocleidmastoid
Trapezius muscle
Middle 1/3 of clavicle
Facet
Small joints between vertebrae
Cervical vertebrae
There are 7
C3-C7 are typical cervical vertebrae
- spinous process (pointy bit)
- spinal cord goes through hole in centre
- transverse processes, smaller holes on both sides
C1 and C2
C1 = no spinous process C2 = spinous process is less pronounced
T10
Umbilicus (belly button
T4
Nipple line
Striated muscle
- Stripey muscle
Eg. Skeletal and cardiac
Non striated muscle
Not stripes
- smooth muscle involuntary muscle
Skeletal muscle
Classification: striated voluntary muscle
- bundles of long, thick, cylindrical, striated, contractile, multinucleate cells that extend length of muscle
Attached to bones of skeleton - movement
Cardiac muscle
Classification: striated involuntary muscle
Interlinked network of short slender cylindrical striated branched contractile cells connected cell to cell by intercalated discs
On wall of heart - pumping blood out
Smooth muscle
Classification: unstridted involuntary muscle
Loose network of snort slender spindle shaped unstriated contractile cells arranged in sheets
- walls of organs and tubes (stomach, blood vessels) - movement of contents
Functions of skeletal muscle
- movement
- stability of joints
- posture
- heat generation
Anatomy of skeletal muscles
Connected to bone by a tendon which is continuous with epimysium
- epimysium - tissue sheath around muscle
- fascile- bundle of muscle fibres
- fascile surrounded by perimysium = connective tissue that surrounds muscle
Skeletal muscle fibre
Single fibres are packed with myofibrils
Myofibril: - striated - banding pattern - dark and light bands Sarcomere- one length of functional unit of muscle
Thick filament = A overlaps the thin filament -I
Contraction - skeletal muscle
I band (thin) and A band (thick) overlap and o interact to shorten sarcomere
- A band remains the same
- I band becomes smaller
- cross bridge bending pulls thin filament to slide past thick
- Myosin head attaches, bends, detaches over and over again - power stroke
- power stroke means that as myosin head bends it pulls thin filament to the centre of sarcomere
Sarcomere
One functional unit of muscle fibre
Myosin
Forms thick filaments
- Consists of 2 subunits shaped like a golf club (long rail and head)
Actin
Main structural component in thin filaments
- spherical
- also associated with troponin and tropomyosin
- interacts with myosin cross bridges
Tropomyosin
Incorporated into actin helix = structural stability
Troponin
Troponin complex consists of:
- TnC - binds to free calcium ions
- TnI - binds to actin
- TnT - binds to tropomyosin
Troponin complex binds to actin and tropomyosin at intervals → forms bridge between tropomyosin and actin
Cross bridges
Project from each thick filament made of myosin - in six directions towards surrounding thin filaments
Thick filament - structure
Myosin molecule:
- 2 rod like structures (tails) that are intertwined = structural rigidity
- 2 heads protrude
Thick filament consists of many myosin molecules whose heads protrude at opposite ends of the filament
Thick filament -function
Head bends at 2 places (hinges):
- at head
- along the cross bridge
Actin binding sites on heads to bind to actin in thin filaments
- ATP ase enzymes on heads breakdown ATP
Thin filaments
- actin filament forms helix
- tropomyosin coils around helix and reinforces it
- troponin complex is attached to each tropomyosin molecules
Calcium ions and contraction
Increased calcium ions
- Increase in calcium binding to TnC
- conformational change
- Causes tropomyosin to move from actin binding sites
- Binding sites are more available, allows myosin head to bind for contraction
Neuromuscular junction
Interface between motor neuron and skeletal muscle
- big sa
- junction between nerve and muscle
- acetylcholine - neurotransmitter
- acetylcholinesterase - enzyme that breaks down acetylcholine
Excitation -contraction coupling
- neuromuscular junction
- AP depolarises membrane
- Allows calcium ions to enter via voltage gated calcium channels
- Vesicles containing acetylcholine fuse with membrane - released into junction
- Acetylcholine binds to nicotinic receptors = conformational change - open ligand gated sodium channels so more sodium moves in
- Action potential
Excitation - contraction coupling
- sarcoplasmic reticulum
1-Ap passes through muscle membrane, down t tubule, through calcium reservoirs (sarcopiasmic reticulum)
2. AP causes release of calcium ions into muscle to bind to troponin = contraction
Relaxation of muscle
- Calcium ions pumped back into sarcoplasmic reticiculm using SERCA ( sarco plastic reticulum calcium atpases
- some calcium ions can bind to calmodulin to prevent binding to troponin
Smooth muscle -location
Found in walls of tracts leading to the outside of the body
-respiratory, digestive, urinary, reproductive tracts
Found in walls of blood vessels
Smooth muscle cells
Small and unstriated
- contraction activated by calciumions dependent on phosphorylation of myosin
Two types of smooth muscle contraction
Phasic - contracts quickly in bursts
Tonic- contracts slowly maintains tone over a period of time
Multi unit smooth muscle
Series of smooth muscle cells innervated by a branch of the autonomic nervous system= neurogenic
Single unit smooth muscle cells
Form functional syncytia = cells working together
- myogenic- signal to contract comes from within muscle
Smooth muscle contraction
Thick and thin filaments are still present but they are not striated and slight overlap
- bunching up of cell, cell squishes to contract
I. Calcium ions bind with calmodullin
- Calcium calmodulin complex binds to and activates myosin light chain kinase
- Phosphorylates myosin cross bridge
- it can bind to matin
Hematopioesis
→ process of formation of new blood cells
progenitor and precursor cells leave the bone marrow via the circulation and are distributed systemically around the body where maturation occurs.
Common myeloid progenitor cells
→ mature in the tissues, dispersed around the body and mature at final destination
- erythrocyte
- mast cell
- myeloblast
Common lymphoid progenitor cells
- mature in the lymphoid system
Natural killer cells
Lymphocytes T and B
Process of forming mature cells
- Unipotent stem cells from bone marrow – undergo self renewal
- Mature to produce progenitor cells – range of cell types
- Precursor cells – form one or two cells max
- Mature cells at the end – effector cells
2 types of bone marrow
Red
Yellow
Red bone marrow
→ contains red blood cells and white blood cells
- in adults found at the ends of bones (epiphysis)
- large content in children for growth and protection
Yellow bone marrow
→ found int the canal of long bones
Structure of bone
- Cautical bone (compact bone) = thick outer shell gives the bone its core strength
- Trabecular bone = honeycomb network where bone marrow lives
- Arteries and veins, blood supply within bone and carry product of bone marrow to rest of the body
2 Arms of the immune system
- Innate
- adaptive
Innate immune system
→ cells from myloid lineage and cyroxic t cells and natural killer cells
• Cells that can function independently, receive a signal and act on their own to alter the situation
Adaptive immune system
→ cells from lymphoid lineage - more specific immune response
• Helper T cells and B cells – work closely to elicit antibody response
• Cytotoxic T cells and natural killer cells can also take direction
Immune response review
- Innate immune cells sense problem
- Invoke adaptive immune system – innate immune system flags to adaptive system that there is a problem
- Adaptive immunity – T cell matches pathogen, activates B cell = specific antibody
- Infection clearance Antibody flags to innate immune system to clear up flagged cells
Maturation of innate immune system
mature in the bone marrow or soon after bone marrow exit in the circulation
• e.g. Monocytes act as a precursor cell for macrophages.
• Monocytes are found in the circulation whereas macrophages are (almost) exclusively tissue resident.
Monocytes differentiation
- Depends on the cell signalling
- Macrophages for Th1 cell activation, immunisation, microbial, tumoricidal activity
- Macrophages responsible for Th2 cell activation, angiogenesis, phagocytotic activity (clear dead neutrophils), tissue repairing and remodelling
Phagocytic cells
- Monocytes (circulation)
- Macrophages (tissue resident)
- Neutrophils (circulation, but enter tissues)
- Osteoclasts (phagocytose bone, so not pathogens, but still part of the system!)
Chemoattractants
→ signalling for phagocytes
direct neutrophils to site of activity - attract phagocytes towards the site of infection or injury
Phagocytosis
- PAMPS – pathogen associated molecular patterns e.g. flagellar are identified by neutrophile/ macrophage
- neutrophile/ macrophage remodel cell membrane its cell membrane to engulf pathogen
- Forms phagosome
- Phagosome —> lysosome
- Lysosome breaks down/ cleaves bacteria until they are debris
- Phagolysosome contains bacterial debris
- The contents of phagolysosome are either secreted out or presented on the cell
Maturation of adaptive immune system
- Maturation of t and B cells
- to ensure immune tolerance
Maturation of T cells
Major Histocompatibility Complex (MHC) is critical for T cell maturation and function.
– MHC Class I (MHC I) is present on all nucleated cells. allows proteins to be put onto cell surface for immune system to recognise it as a self-cell
– MHC Class II (MHC II) is present only on antigen presenting cells Like macrophages – MHC class II detects the processed pathogen on macrophages – interacts with adaptive immune system for specific response
MHC class I
T cell becomes CD8 -cytotoxic
Allows proteins to be put onto cell surface for immune system to recognise it as a self-cell
MHC class II
T cells become CD4 -(talk to innate immune system to figure out how to produce response)
- present on antigen presenting cells
Maturation of T cells - steps
- T cells – mature in thymus – develop into lymphoid progenitor in the cortex of the thymus
- T cells start to produce cell surface characteristics e.g.:
• CD25 – receptor or Il2 – growth factor for T cells - Eventually T cells are processed and released to interact with cortical epithelial cells with MHC molcules on surface
• If MHC class I is recognised = T cells become CD8 cells (cytotoxic T cells)
• If MHC class II is recognised = T cells become CD4 (talk to innate immune system to figure out how to produce response) - As T cells (CD4 and CD8 pass into medulla of thymus – they interact with medulla cells that express self proetins – if they interact with them = apoptosis
- T cells start to produce cell surface characteristics e.g.:
CD4
- Recognises antigens presented to them by APCs (antigen presenting cells)
- CD4 binds to MHC class II on APC
- CD4 anchors the T cell to MHC class II
- If antigen is recognised by T cell receptor = co stimulation/ second stimulation (IL2 growth factor)
CD8
- Cytotoxic T cells recognise infected cells – viral infections
- Viral genome integrated into cell genome – cell produces viral proteins/ antigens on membrane
- CD8 doesn’t recognise the proteins – recognises them as viral antigens
- CD8 anchors cytotoxic T cell to MHC class I
- Search for complimentary T cell
Maturation of B cells
- B cell maturation within bone
- B cell leaves bone as naïve B cell – can form B cell receptor but hasn’t seen a B cell or antigen
- Travels to lymph node and becomes resident
- B cell comes in contact with T cell with complementary antigen
- Activated B cell - plasma cell that enters germinal centre ( dark zone) - proliferate and secrete antibodies
2 parts of germinal centre in lymph node
- Dark zone = where B cells undergo large scale proliferation
- Light zone = where B cell mets anything presenting antigen
Protective soft tissues
• Lymphatic system • Waldeyer’s Ring Tonils • Peyer’s patches • Spleen
Wadleyer’s ring
Located in the upper airway, the Waldeyer’s ring consists of tonsil tissue.
• It is a lymphoid tissue and thus contains lymphocytes (T and B cells) - present at site of potential infection
- produce local quick immune response
Tonsils
- Coated in microfolds (M cells) - process antigens
- Form part of mucosa-associated lymphoid tissue (MALT)
- U shaped and contain different types of immune cells - T cells, B cells and APCs can enter (rapidly process and foreign objects)
Peyer’s patches.
Lymphoid tissue found in gut epithelium
• Form gut associated lymphoud tissue (GALT)
• They have a very similar function and layout to that found in the tonsil.
• Behind the epithelium sits mesenteric lymph nodes which supply the gut with B cells.
Spleen
- filter for blood
- recycle old erythrocytes to synthesis new proteins
- stores platelets and other lymphocytes
- clears old cells eg non functional red blood cells
- antibody synthesis - opsonisation coating bacteria with antibodies
Acute inflammation
- Recruits immune cells to the site.
- These clear the infection and/or damaged tissue or repair damaged tissue
• Inflammation is resolved when the infection or damaged tissue is cleared. maximum of 2 weeks.
Chronic inflammation
• Immune cells are recruited to the site of infection or injury but are never instructed to stop their activity
- --> They keep ‘looking’ for damaged tissue or pathogens. - --> This causes more tissue damage (remember video of neutrophil – it pushed other cells out of the way, tunnels through tissure).
Pectoral girdle
Clavicle
Scapula
- connected to axial skeleton via clavicle bone
Retinaculum
Several fibrous bands of fascia that pass over/under tendons to help keep them inplace
Carpal tunnel syndrome
Affects median nerve
- shooting pain
- numbness
- pins and needles
Scoliosis
- sideways curvature of the spine
Location of the heart
- Inferior Middle mediastinum
- left of mid sternal line
Behind the sternum, directly above the diaphragm (sits on the diaphragm)
• Extends obliquely from 2nd rib to the 5th intercostal space
• Apex of heart lies in the 5th left intercostal space in the mid-clavicular line
• Points to left hip
4 chambers of the heart t position
– Right atrium – Left atrium – Right ventricle – Left ventricle
* Ventricles are anterior * Atria are posterior
Right atrium
receives deoxygenated blood from IVC, SVC, and coronary sinus
• Covered with right atrial appendage
Right ventricle
- pump deoxygenated blood to pulmonary arteries
* C shaped
Left atrium
→ receives oxygenated blood from 4 pulmonary veins (2 from right and 2 from left lungs)
Left ventricle
- pump oxygenated blood to aorta
- Left ventricles are much more thicker than right = pump blood to aorta – to entire body
- More circular shaped
3 types of circulation
Pulmonary
Systemic
Coronary
Pulmonary circulation
• Doxy blood from right ventricles –> lungs —> pulmonary veins –> left atrium
Systemic circulation
• Oxy blood into right atrium –> left ventricles–> aorta
Coronary circulation
- Blood supply to heart
- Opening of aorta – has the opening of coronary artery
- Coronary artery branches and supply specific cardiac muscles
- Deoxy blood from cardia muscles drain into cardiac veins
- Cardiac veins drain into coronary sinus
- Coronary sinus dumps deoxy blood into right atrium
Interartrial septum
separates right and left atrium
• Interatrial septa has fossa ovale on its wall: remnant of foramen ovale (left and right atria connected in intrauterine life)
Ventricles
Ventricular walls have trabeculae carnae
Tapering part of right ventricle: infundibulum or conus
Chordae tendina: Strands of tendon like material attach the valves with papillary muscle
• Ensures valves remain tightly shut – no backflow of blood
4 values
Tricuspid / atrioventricular
Bicuspid /mitral
Aortic
Pulmonary
Tricuspid/atrioventricular value
Between right atria and ventricle
• Has three cusps
Bicuspid /mitral value
• Between left atria and ventricle
– Has two cusps
Aortic value
- Base of aorta
* tricuspid
Pulmonary value
- Base of pulmonary artery
* tricuspid
4 main vessels
Located in mediastinum • Aorta • Pulmonary arteries • Pulmonary veins • Superior and inferior vena cavae
Aorta
Ascending aorta – From it branch the coronary arteries
• Opening of coronary arteries
Arch of aorta
3 vessels on arch of aorta
– Brachiocephalic trunk – splits into right subclavian artery and right common carotid arteries
– Left common carotid artery
– Left subclavian artery
3 layers of the heart
- Endocardium
- myocardium
- pericardium (visceral, parietal fibrous)
Endocardium
Innermost layer
• Loose connective tissue and simple squamous epithelial tissue
• Lines inside of heart, cavities and valves of heart
Myocardium
- Cardiac muscle
- Involuntary striated muscle
- Responsible for heart contractions
Pericardium
3 Layers:
• Visceral layer/ epicardium
• Parietal layer
Pericardial layer between visceral and parietal layers filled with pericardial fluid
• Fibrous – dense irreugular connective tissue – protects heart, prevent over filling and stretching
Heart sounds
Caused by closing of heart values
• The first ‘lub’ sound indicates closure of mitral and triscuspid valves
• The second ‘dub’ indicates closure of aortic and pulmonary valves
2 periods of cardiac cycle
- systole = contraction
- diastole= relaxation
Systole
Contracts
Pumping blood out
Diastole
Relaxation
Filling
Autopsy
Examination of a body after death to determine now when and why someone died
- performed by pathologist, coroner or medical examiner
Purpose of autopsy
To determine:
- the causes of death
- contributing factors to death
- where, when and how
2 types of autopsy
- Hospital post mortem = require consent from patient’s family to determine more about patients disease
- coroners post. Mortem = mandatory, determine cause of death
Pathology
Study mechanism of disease
- especially dealing with laboratory examination of samples for diagnosis
- Includes both macroscopic and microscopic appearance
Histopathology
Helping form a diagnosis using lab reports and tests
3 steps in pathology
- tissue samples taken
- Allow diagnosis or identification
- Use diagnosis to decide appropriate treatment
Transplantation
- Can come from a live donor or cadaveric donor
- transplanted liver assumes functions of explanted organ
Acquired
Disease that they are not born with - not present at time of birth
Congenital disorder
Is present at time of birth
- can be genetic or non genetic
Aetiology / eitology
Causative factors or disease
- may have a single clearly defined cause
- May have different causative factors
Pathogenesis
Mechanisms of a disease
-Initial disease processes and produces functional and structural abnormalities (symptoms)
Sequelae
Secondary knock on effects of a disease
Idiopathic
Condition of uncertain or unknown cause
Iatrogenic
Condition caused by medical personnel or procedures or the environment of a health care facility
Epidemiology
Study and analysis of distribution and determinants of health and disease conditions in defined populations
Demographics
Study of statistics
Cellular adaptive mechanism
Homeostasis - cells constantly adapt to changes in environment to maintain equilibrium in response to normal and pathological stimuli
Cellular adaptive mechanism - normal
Hypertrophy - increase in size of cells without increases cell number
Hyperplasia - increase cell number
Involutions - shrinkage
3 symptoms of cellular adaptive failures
Atrophy - wasting away of tissue organ due to degradation of cells
Metaplasia - abnormal change in the nature of a tissue eg. Transformation to different cell type that can-better with stand environment
Neoplasia - uncontrolled growth of cells formation of new, abnormal growth of tissue
Anatomical location
-Affects presentation of pathology
Squamous cell Carcinoma
- Easily detected in skin
- not easily detected in lung
Metastasis (spread) of tumour depends on locution
Adrenal adenoma
- Increase in size for many years = but have no symptoms
- anatomical location
Pituitary adenoma
- Closely involved in base of skull
- Increase in mass = presents symptom due to squishing other structures
- early detection
5 causes of cell death
- physical agents
- chemical and biological agents
- blockage of metabolic pathways
- failure of membrane integrity I damage
- DNA damage or loss
What happens when a cell sustains an injury
- Cell moves to recovery process, damaged components are phagocytosed and removed, cell returns to normal
Or
- recovery isn’t possible = cell death
Apoptosis
→ programmed cell death
- Cell comits suicide due to lack of growth hormones or DNA damage
- active process - requires energy
Necrosis
→ traumatic injury
- severe damage to cell membranes
- Enzymes leak from lysosomes into cytoplasm and digest cell
- cellular contents leak out of cell - local reaction
- pathologic
Infarction
Death (necrosis) of tissue due to ischaemia
Obstruction of blood supply to an organ or region of tissue
-Typically by thrombus or embolus causing local death of tissue
Ischaemia
Restriction in blood supply to tissues, causing a shortage of oxygen needed for cellular metabolism
2 regions in the neck
Anterior triangle
Posterior triangle
Anterior triangle
Sternocleidomastoid muscle
Mandible
Mid line of neck
Posterior triangle
Sternocleidomastoid muscle
Trapezius
Clavicle
Body systems
• Cardiovascular System • Digestive System • Endocrine System • Immune system • Integumentory system (skin) • Lymphatic system • Muscular System • Nervous System • Respiratory System • Reticuloendothelial System • Skeletal System Above are all present in neck
Reproductive system
Urinary system
Parts of the body that contribute to more than one system
- Breast – reproductive (lactation and nutrition of new-born) and integumentary system (mammary tissue)
- Hyoid bone – skeletal (bone) and digestive system (swallowing)
- Hypothalamus – nervous and endocrine system
- Ovary/testis - reproductive/ endocrine (feedback of hormones)
- Spleen – reticuloendothelial/immune
- Tongue – skeletal/ digestive (swallowing)
- Pharynx – respiratory/ digestive
- Urethra – male reproductive system/ urinary system in both male and female
System vs region approach
Patient present pain/lump by telling you the region that it is in
- history taking - applying an understanding of anatomy in all steps
Pain
- site
- onset
- character
- Radiation
- Associated symptoms
- times
- Exacerbating/ relieving factors
- Severity
Fibrous skeleton of heart
Protection
Anchors values of heart
Located at base of ventricular mass
End arteries
Artery that is the only supply of oxygenated blood to tissues
Anastomosis - example
Circle of willis
- if an artery is blocked other arteries can supply blood to the same crea
T12
Level where descending thoracic aorta pierces diaphragm to become abdominal aorta
Hematocrit
Measurement of proportion of blood that is made up of cells
Haemoptysis
Coughing up blood from lungs or bronchial tubes
Haematoma
Where trauma or injury damages veins or arteries blood escapes and collects outside the blood vessel = form a localised hard mass
Haemorrhage
Bleeding- blood loss
Sepsis
- When immune system overreacts to infection damages body’s own cells
3 functions of lymphatic system
Maintaining body fluid levels
Absorbing digestive tract fats
Removing cellular waste
Lymph nodes
- Kidney or oval shaped
- may become enlarged or painful due to infection or lymphoma
Hair follicles absent
Palms and soles
Periosteum
Envelops bone
Anchorage
Supplies blood to bone
Compartment syndrome
Build up of pressure behind fascia I compartment
Achilles tendon attaches to
Calcaneum
2nd costal cartilage
Palpable at manubriosternal joint
Umbilicus
Lies between xiphisternum and symphysis pubis
Peritoneal folds
Mesenteries
Omenta
Ligaments
→ arrangement of folds = compartments or recesses (blind ended passageway )
Compartments = greater t lesser sacs
Cartilaginous joints- 2 examples
Pubic symphysis
Median intervertebral joints
Shoulder joint
Ball and socket
Humerus, scapula
Flexion, abduction adduction, rotation, extension, circumducution
Greater range of movement than hip-not as stable
Hip joint
-Ball and socket
Femur, pelvis
Flexion, abduction adduction, rotation, extension, circumducution
Less range of movement than hip- more stable
Knee joint
Hinge
Femur, tibia
Flexion, extension
Moved by quadriceps and hamstrings
3 serous membranes
Pleura
Pericardium
Peritoneal
