Anaphysio Midterm Reviewer

M1: Introduction to Human Anatomy and Physiology
Anatomy - secrete regulatory hormones Survival Needs

- Study of the structure and shape of the -growth, reproduction, metabolism 1.) Nutrients
body and its parts 6.) Cardiovascular system - chemicals for energy and cell-building
- transport nutrients via blood pumped - carbohydrates, lipids, minerals, etc.
2 Levels of Anatomy
by heart 2.) Oxygen
Gross Anatomy (Macroscopic)
- heart, blood vessels, blood - needed for chemical reactions
- deals with large structures
7.) Lymphatic system - we need this to live
- easily observable
- for immunity 3.) Water
Microscopic Anatomy
- returns fluids - 60-80% of our weight
- very small structures
- cleanses the blood - for metabolic reactions
- requires microscope
8.) Respiratory system 4.) Stable body temperature
Physiology - keeps blood supplied with oxygen - ranges form 36.5-37.5 Celsius
- study of how the body and its parts - oxygen removes carbon and is
Homeostasis
work and function essential to our bodies
- dynamic state of equilibrium
9.) Digestive system
Level of Structural Organization - maintenance of a stable internal
- break down food
1.) Chemical level environment
- for nutrient absorption
- atom combine to form molecules - needed for normal body function and
- eliminates substances
2.) Cellular level sustain life
10.) Urinary system
- cell are made up of molecules - eliminates nitrogenous substances Homeostatic Balance
3.) Tissue level - maintains acid-base balance - disturbance in the homeostasis of the
- consist of similar cells - regulates water and electrolytes body
4.) Organ level 11.) Reproductive system - results in disease
- made up of different tissues - for producing offspring
5.) Organ System level Maintaining Homeostasis
- consist of different organs working Necessary Life Functions - through hormonal (endocrine) and
together closely 1.) Maintain boundaries neural system (nervous)
6.) Organismal level - set limits - Receptor
- made up of many organ structures. 2.) Movement : responds to changes in the
- locomotion environment
11 Organ Systems - movement of substances : sends information to control center
1.) Integumentary system - circulation of oxygen and blood - Control center
- form external cover 3.) Responsiveness : determines set point
- protect deeper tissues from injury - ability to sense changes in the : analyzes information
- helps regulate body temperature environment : determines response
- location of cutaneous nerve receptors 4.) Digestion
- Effector
2.) Skeletal system - break down and absorption of : means for response of stimulus
- does not produce movement but nutrients
attachments for muscles 5.) Metabolism Negative Feedback
- stores mineral - chemical reactions in our body - includes most homeostatic control
- cartilage, joints, bones - produces energy mechanism
3.) Muscular system - makes body structure - shuts off original stimulus/ reduces its
- produces movement 6.) Excretion intensity
- produces heat - eliminates waste from metabolic - works like a household thermostat
4.) Nervous system reactions Positive Feedback
- fast acting (rapid) system 7.) Reproduction - increase the original stimulus to push
- internal and external - for offspring variable further
- activates glands and muscles 8.) Growth - occurs during blood clotting and
- brain, spinal cord, nerves - increase of cell size and number. childbirth
5.) Endocrine system
Regional Terms
Body Planes and Sections

Abdominopelvic Regions Abdominopelvic Quadrants
Abdominopelvic Major Organs Body Cavities

M2: Cells and Tissues
Functions of a cell  Membrane junctions (keeps cells  lysosome (lysosome fuses with
1. Cell metabolism and energy use together) ingested substances)
- chemical reactions occurring in the : tight junctions- impermeable 5. Lysosome
cell is called metabolism (leak-proof) - membrane-bound vesicles pinched-
- after metabolism, energy is released : desmosome- anchoring (prevent off from the golgi apparatus
for cell activity. pulling from stress) - contains enzymes that digest
2. Synthesis of molecule : gap junction- allow worthless materials
- various types of molecule: protein, communication 6. Peroxisome
nucleic acid, lipids 3. Cytoplasm - smaller than lysosome
- structural and functional - outside nucleus, inside plasma - contains enzyme that digest fatty &
characteristics of cells are memebrane amino acids
determined by type of molecules they - 3 elements - detoxifies the body
produce  cytosol: fluid 7. Cytoskeleton
3. Communication  organelles: “little organs” - hold the cell and organelles in place
- achieved through electrical signals  inclusion: chemical substances - provide internal framework
4. Reproduction and inheritance - 3 types of element
- each cells contains genetic info of ORGANELLES  microfilament
self 1. Mitochondrion : smallest, cell motility and cell
- powerhouse of the cell shape
Structures of a cell - spherical, rod-like shape
1. Nucleus  intermediate filament
- cristae; folds in inner membrane : help form desmosomes, hold cell
- control center - provide ATP for cellular energy
- 3 regions together
- site of aerobic respiration
 Nuclear envelope  microtubules
2. Ribosome
: barrier : largest, determines the overall
- made of protein & RNA
: double membrane cell shape
- site of protein synthesis
: contains nuclear pores 8. Centrioles
- formed in nucleolus
- rod-shaped
 Nucleoli - can be found in
- direct formation of mitotic spindle in
: 1 or more nucleoli  cytoplasm (free) cell division
: sites of ribosome assembly  rough ER - facilitate movement of chromosome
: ribosome migrate to cytoplasm 3. Endoplasmic reticulum during cell division
through nuclear pores - fluid-filled tubules, carries 9. Cellular projections
 Chromatin substances - not found in all cells
: DNA & protein - network inside cytoplasm - for movement
: present when cell is not divided - consist of broad, flattened - types
: scattered in nucleus interconnecting sacs and tubules  cilia
: condense to form chromosomes - 2 types : movement of material across cell
during cell division  Rough Endoplasmic Reticulum surface (respiratory system)
: controls gene expression and : many ribosomes attached to it
DNA replication  flagella
: site of protein synthesis : propel cell (sperm cell)
2. Plasma membrane  Smooth Endoplasmic Reticulum
- barrier for cell contents : site of lipid synthesis Cell diversity & Physiology
- double phospholipid layer : detoxify drugs and pesticides 1. Fibroblast
- hydrophilic head (water-loving) 4. Golgi apparatus/ complex - connects body parts
- hydrophobic tail (water-hating) - modifies, packages, distributes 2. Epithelial cells
- contains proteins, cholesterol & proteins and lipids - cover & lines body organs
glycoproteins - produces 3. Skeletal muscle cells
- Specialization  secretory vesicles (vesicle - move organs and body parts
 Microvilli containing protein to be secreted) 4. Fat cells
: finger-like  cell membrane components - stores nutrients
: increase surface area for (golgi fuses with plasma membrane) 5. Macrophage
absorption
- fights disease cannot dissolve in fat core, move DNA Replication
6. Nerve cell against conc. gradient, are - always precedes cell division
- gather information and control body transported that are unable to pass - genetic material is duplicated and
7. Sperm cell through diffusion readies a cell for division in to 2 cells
- reproduction 1. Solute pump - occurs towards the end of
- amino acids, some sugar and ion interphase
Membrane transport
are transported here - DNA uncoils & each side serves as
- movement transport of substances
- substances are moved against a template for new strand
into & out of cell
conc. gradient - nucleotides joins in a
Solutions & Transport - protein carrier are energized by complementary way
- homogenous mixture of 2 or more ATP: Adenine = Thymine
components 2. Vesicular transport Guanine = Cytosine
- solvent: dissolving medium, water in  Exocyctosis - end result, 2 identical DNA
body, mas daghan : out of cell molecules, semi-conservative (1 new
- solute: components of smaller : material is carried by in a and 1 old)
quantities within solution membrane sac, vesicle
Event of Cell Division
- intracellular fluid: nucleoplasm and : vesicle migrates to plasma
1. Mitosis
cytosol, within cell membrane, combines with
- division of nucleus
- extracellular fluid:fluid on the plasma membrane
- produces 2 nuclei
exterior of the cell, outside : material is emptied to the outside
2. Cytokinesis
 Endocytosis
Passive membrane transport - division of cytoplasm
: into the cell
- transport mechanism that does not - begin when mitosis is nearly
: extracellular substance are
require metabolic energy complete
engulfed by being enclosed in a
1. Simple Diffusion - produces 2 identical daughter cells
membranous vesicle
- particles are distributed equally in : occurs when material moves Stages of Mitosis
the solution through the plasma membrane & 1. Prophase
- high conc. to low conc. of solutes into the cytoplasm by the - chromatin thread coils & shorten to
2. Osmosis formation of vesicles chromosomes
- diffusion of water : types - DNA appears double stranded
- highly polar molecules cross the
 phagocytosis; solid particles (replicated)
plasma membrane through
are ingested, WBC takes up - strands (chromatid) are held
aquaporins
and destroys harmful together by centromere
- only solvent diffuses through a
substances that enters the body - centrioles separate and migrate to
selectively permeable membrane
 pinocytosis; small vesicles are poles to direct assembly of mitotic
3. Facilitated diffusion
formed containing liquid spindle fiber (scaffolding for
- require a protein carrier & channel
 receptor-mediated; plasma chromosomes)
(certain doorway for going high conc.
membrane receptor bind only - nuclear envelope breaks down and
to low conc.)
with certain substances, part of disappears during late prophase
- transport lipid- insoluble & large
selective permeability of the cell 2. Metaphase
substances
membrane - chromosomes align in the center on
4. Filtration
the metaphase plate
- water & solutes are forced through a Life cycle of cells 3. Anaphase
membrane by fluid/ hydrostatic - 2 major periods - centromere split and chromosome
pressure  Interphase (metabolic phase) are pulled apart toward opposite ends
- pressure gradient must exist : cell grows and carries own of the cell
- from high pressure to low pressure metabolic process - cell begins to elongate
area  Cell division 4. Cytokinesis
- onbserved in the kidnesy : cell replicates itself in order to - begins at late anaphase, end during
Active membrane transport produce more cell for growth and metaphase
- substances, may be too large, repair processes
- a cleavage furrow forms to pinch the  protection
2 cells into 2 parts 5. DNA ligase seals strands together - Extracellular matrix elements:
6. DNA molecule wind up  ground substance (water) along
Protein synthesis
_____________________________ with adhesion proteins
- gene; DNA segment that carries a
1. Opening of the double helix  fibers: produced by cells
blueprint for building one protein
2. Separation of the DNA strands  collagen, elastic, & reticular
(master blueprint)
3. Priming of the template strand - types:
- proteins have many functions
4. Assembly of the new DNA  Bone (Osseous tissue)
 building material of cell segment.
 act as enzyme (biological : composed of bone cells
catalyst) Body Tissues : hard matrix of calcium salts
- RNA is an essential for protein - collection of specialized cells and : large number of collagen fibers
synthesis the extracellular substance : protect & support body
surrounding them  Cartilage
Role of RNA 1. Epithelial tissue 1. Hyaline
1. Transfer RNA (tRNA) - covers and protect the surfaces, - most common
- transfers appropriate amino acids to both inside and outside the body - abundant in collagen fibers
the ribosome for building the protein - location: body coverings & linings - rubbery matrix
2. Ribosomal RNA (rRNA) - functions: - location: larynx, fetal skeleton
- hekps form the ribosome when  protect 2. Elastic
protein is build - for elasticity
 filtrate
3. Messenger RNA (mRNA) - location: external ear
 absorb
- carries the intructions for building a 3. Fibrocartilage
 secrete
protein from the nucleus to the - highly compressible
- characteristics:
ribosome - location: between vertebrae disk
 mostly composed of cells
3. Dense connective tissue
Transcription & Translation  cover body surface
- maintain matrix
1. Transcription  cell & matrix connection - fibroblast are cells that make fibers
- transfers information from DNA  capable of regeneration - location: tendons, ligaments, dermis
base sequence to the complimentary - layers: 4. Loose connective tissue
base sequence of mRNA  stratifies: more than 1  Areolar
- 3 base sequence (triplet) on mRNA  simple: 1 layer : widely distributed
are called codons
 pseudostratified: single layer but : soft, pliable, like cobwebs
2. Translation
some cells are shorter than : contains all fiber types
- base sequence of nucleic acid is
others : can soak up excess fluid cause of
translated to an amino acid sequence
- shape: edema
- amino acids are building blocks of
 squamous: flat  Adipose tissue
protein
 cuboidal: cube : areolar tissue dominate fat
- amino acid attached to tRNA, tRNA
recognizes a complimentary mRNA  columnar: hair-like globule (matrix)
codon, then goes to ribosme unit in  transitional: depends on amount : contains large amount of lipid
order to bind of stretching deposits
- related amino acids form growing - Glandular epithelium : function insulate, protect & fuel
polypeptide chain  Endocrine gland: secretes storage
directly to the bloodstream, hormone  Reticular
DNA Replication  Exocrine gland: secretes through : delicate network of interwoven
1. Helicase unzips dna strand ducts to epithelial surface, oil glands fibers
2. Ssbp makes sure strand does not 2. Connective tissue : forms stroma (internal supporting
close again - found everywhere in the body network) of lymphoid organs
3. DNA polymerase attaches new - most abundant tissue : lymph noeds, splees, bone
nucleotide - functions: marrow
4. Subunit of DNA polymerase that  binds body tissues  Blood (vascular tissue)
proof read DNA  supports the body : blood cells surround fluid matrix
called blood plasma - delicate pink tissue forms from
: fibers are visible during clotting undamaged blood vessel,
: function as transport vehicle of phagocytes dispose of blood clot &
materials connective tissue
5. Muscle tissue 3. Regeneration & Fibrosis
- contract or shorten to produce - surface epithelium regenerates,
movement granulation tissue replace with new
 skeletal connective tissue
: voluntary
Type of Solutions
: contract to pull on bones/ skin
1. Hypotonic solution
: gross body movement or facilitate
- fewer solutes (more water)
expression
- cells swells and may rupture (lyse)
: characteristics: striated,
as water rushes in by osmosis
multinucleated, long cylindrical
2. Isotonic
 cardiac
- same solute-to-solvent ratio as cells
: involuntary
- no changes in cell size or shape
: found only in heart
3. Hypertonic solution
: pumps blood
- more solutes (less water)
: characteristics: attached to other
- cells shrink (crenation)
cardiac muscles cells at
intercalated disks, striated, 1
nucleus per cell
 smooth
: involuntary
: found in organs
: charcteristics: no striation, 1
nucleus, spindle-shaped cell
6. Nervous tissue
- composed of neurons & nerves to
support cells
- function: send impulse to other
areas of the body
- characteristics: irritability &
conductivity
Tissue repair
1. Regeneration
- replacement of destroyed tissue
2. Fibrosis
- repair by dense (fibrous),
connective tissue (scar tissue)
Determination of Method
- type of tissue damage
- severity of injury
Events of Tissue Repair
1. Inflammation
- release of inflammatory chemicals,
capillary permeability, clotting & scab
formation
2. Granulation tissue formation
M3: Body Membranes and the Integument
Mucous membrane friction and smoothens : cell contains thick bundles of
- line cavities that open to the movement intermediate filaments made of
outside if the body pre-keratine
Functions of Integument
- digestive, respiratory, - stratum granulosum
1. Protection
reproductive tracts : cells are flattened, organelles
- provides protection form
- consist of epithelial cells, their are deteriorating; cytoplasm full
abrasions and ultraviolet light
basement membrane, and a thick of granules
- prevent microorganism from
layer of loose connective tissue - stratum lucidum
entering body
- some contain a layer of smooth : consist of dead cells that left the
- reduces water loss; prevents
muscles stratum granulosum
dehydration
- many contain goblet cells or : not present in all skin regions
2. Sensation
multicellular mucous glands that : occurs on the palms of the
- has sensory receptors that can
secrete mucus hands and soles of the feet
detect heat, cold, touch, pressure
- for protection, absorption and : occurs where skin is hairless
& pain
secretion and extra thick
3. Vitamin D production
: inadequate nutrients and
Serous membrane - skin produces a molecule that
oxygen due to water-repellant
- line cavities that do not open to can be transformed into vitamin
glycolipid in the extracellular
the exterior of the body when exposed to ultraviolet light
space and their increasing
- pericardial, pleural, peritoneal - the molecule is an important
distance to the blood supply
cavities regulator of calcium homeostasis
- stratum corneum
- 3 components 4. Temperature regulation
: most superficial stratum
 a layer of simple squamous - amount of blood flow and
(outermost)
epithelium activity of sweat glands regulate
: consist of dead squamous cells
 its basement membrane body temperature
filled with keratin refered as
 delicate layer of loose 5. Excretion
cornifled or horny cells
connective tissue - small amounts of waste
: keratin gives structural strength
- do not contain glands, but products are lost through the skin
: coated and surrounded by
secrete small amount of fluid and in gland secretion
lipids, which acts as
called serous fluid which Epidermis waterproofing materials, prevent
lubricates - stratified squamous epithelium; fluid loss through the skin
- protect internal organs from in its deepest layers, new cells : callus; skin subjected to friction
friction are produced by mitosis produces a thick area
- help hold them in place - keratinization; cells change : corn; thicken to form cone-
- act as selectively permeable shape and chemical composition shape structure
barrier to prevent large amounts by replacing keratin in the : provides durable overcoat for
of fluid from accumulating within outermost cells of the epidermis the body
the serous cavities. - keratin; makes cells more rigid
Dermis
Synovial membrane and durable
- composed of dense collagenous
- line cavities of freely moving - contains strata four/ five strata
connective tissue containing
joints Epidermal layers & fibroblast, adipocyte, and
- made up of connective tissue Keratinization macrophages
- consist of modified connective - stratum basale - structural strength has been
tissue cells : lies closest to the dermis achieved because of collagen
- either continuous with the dense : contains most adequately and elastic fibers
connective tissue of the joint nourished - strong, stretchy envelope that
capsule or separated from the : contains the stem cells that helps bind the body together
capsule by areolar or adipose constantly divide - cleavage or tension lines; skin is
tissue : stratum germinativum/ most resistant to stretch along
- produce synovial fluid which germinating layer this line
makes joint slippery reducing - stratum spinosum
Factors affecting skin color surface of the skin against bacteria
1. Melanin 3. Hair bulb 2. Sweat glands
- group of pigment primarily - expanded base of the root - 2 types
responsible of the skin, hair and 4. Medulla  Eccrine
eye color - softer center : simple, coiled tubular glands
- provides protection against 5. Cortex : release sweat by merocrine
ultraviolet light from the sun - hard center secretion
- melanocytes are irregularly 6. Cuticle : found in most parts of the
shaped cells with many long - covers the cortex body
processes that extend between - a single layer of overlapping : have ducts that open onto the
the epithelial cells of the deep cells that hold the hair in the hair surface of the skin through sweat
part of the epidermis follicle pores
- Golgi apparatuses package 7. Hair follicle  Apocrine
melanin into vesicles called - invagination of the epidermis : simple, coiled, tubular that
melanosomes which move into that extends deep into the dermis produce a thick secretion rich in
the cell processes of the organic substances
Phases of Hair growth
melanocyte : released by merocrine
1. Anagen (Growing Phase)
- melanin production is secretion though some glands
- the growing phase lasts 2-7
determined by genetic factors, demonstrate holocrine secretion
years and determines the length
exposure to light, and hormones : opens hair follicle, but only
of our hair.
- Skin exposure to sunlight armpits and genitalia
2. Catagen (Transition Phase)
stimulates melanocytes to : sctivates at puberty because
- this is the transitional stage that
produce more melanin pigment, of influence from sex hormones
lasts about 10 days. The hair
resulting in tanning of the skin. 3. Ceruminous glands
follicle shrinks and detaches from
2. Carotene - modified eccrine sweat glands
the dermal papilla.
- yellow pigment found in plants located in the ear canal
3. Telogen (Resting Phase)
that humans usually at as a - cerumen, earwax, is composed
- this is the resting phase which
source of vitamin c of the combined secretions of
lasts around three months.
- lipid-soluble ceruminous glands and
Around 10-15 percent of hairs are
-accumulates lipid of the stratum sebaceous glands
in this phase. Whilst the old hair
corneum and in the adipocytes of - cerumen and hairs in the ear
is resting, a new hair begins the
the dermis and subcutaneous canal protect the tympanic
growth phase.
tissue membrane by preventing dirt and
4. Exogen (New Hair Phase)
- too much would cause the skin insect from moving too deep in
- this is part of the resting phase
to become yellow the ear canal
where the old hair sheds and a
3. Blood 4. Mammary gland
new hair continues to grow.
- The amount of oxygen-rich - modified apocrine sweat glands
Approximately 50 to 150 hairs
hemoglobin (pigment in red blood located in the breast
can fall out daily, this is
cells) in the dermal blood - produces milk
considered to be normal hair
vessels. In light-skinned people,
shedding. Parts of the Nail
the crimson color of oxygen-rich
hemoglobin in the dermal blood 1. Nail root
Skin glands
supply flushes through the - part of the nail covered by the
1. Sebaceous glands
transparent cell layers above and skin
- simple, branched acinar glands
gives the skin a rosy glow. 2. Nail body
- connected by a duct to the
- visible part of the nail
superficial part of the hair follicle
Hair Structures 3. Nail fold
- produce sebum; an oily white
1. Shaft - covers the lateral and proximal
substance rich in lipids
- hair protrudes above the edges of the nail
- released by holocrine secretion;
surface of the skin 4. Nail groove
- lubricates the hair and the
2. Root - hold the edges of the nail in
surface of the skin
- hair that protrudes below the place
- prevent drying and protects
5. Nail matrix - eyelashes protect eyes from remains viable
- nail root extends distally foreign objects - regeneration of the epidermis
6. Cuticle - nails protect and defend the end occurs from within the burn area
- or eponychium of the finger and edges of the burn
- stratum corneum that extends 2. Sensation  1st degree:
onto the nail body - receptors from the skin detects - only the epidermis and are red
7. Hyponychium pain, heat, cold, and pressure and painful
- beneath the free edge of the - dermis and deeper tissues - slight edema, swelling, may be
nail body contain pain, heat, cold, touch present
8. Nail bed and pressure receptor - sunburn, brief exposure to hot
- where the nail is attached - hair follicles are well-innervated or very cold objects
9. Lunula and has sensory receptor s  2nd degree:
- a whitish, crescent-shaped area surrounding its base to detect - both dermis and epidermis
in the base of the nail hair movement - if dermal damage is minimal,
- appears white because blood 3. Temperature regulation redness, pain, edema, and blister
vessels do not show through - regulation is important because occur
thicker nail matrix the rate of chemical reactions in - if it is deep within the dermis,
our body can be increased or wound would appear red, tan,
Nail Growth Process
decreased by changes of white
Growing cells are added to the
temperature 2. Full-thickness burns
base of the nail, the older cells
4.Vitamin D production  3rd degree
are pushed towards the fingertip,
- regulation of calcium and - epidermis and dermis is
and keratin protein in these cells
phosphate homeostasis completely destroyed and
grows harder.
- for bone metabolism recovery occurs from the edges
Physiology of the - Vitamin D synthesis begins of the burn wound
Integumentary system when skin is exposed to the - usually surrounded by partial
1. Protection ultraviolet light thickness burns
- skin protects underlying - the area of this burn is usually
Integumentary system as
structures from mechanical painless because of damaged
diagnostic aid
damage receptors
- can be observed easily
- dermis provides structural
- often reflects events occurring Rule of Nines
strength, preventing skin from
in other parts of the body 1. Adult
tearing
1. Cyanosis
- epidermis protects against
- bluish color in skin caused by Body part Percentage
abrasions
decrease oxygen content
- calluses are formed in friction- Arm (including the 9 percent
2. Jaundice
prone areas hand) each
- yellow skin color due to
- skin prevent microorganism and
damaged liver Anterior trunk
other foreign substance to enter 18 percent
3.Rashes and lesions (front of the body)
the body
- symptoms of problems
- skin reduces water loss Genitalia 1 percent
elsewhere in the body
because its lipids acts as a
4. Vitamin A deficiency Head and neck 9 percent
barrier to the diffusion of water
- skin produces excess keratin
- melanin absorbs ultraviolet light Legs (including 18 percent
and assumes character of sand
and protects underlying the feet) each
paper texture
structures from its damage
5. Iron-deficiency anemia Posterior trunk
effects 18 percent
- nails lose normal contour and (back of the body)
- hair serves as a heat insulator,
become flat or concave
protect against ultraviolet light 2. Children
and abrasions Burns
- eyebrows keeps sweat away 1. Partial-thickness burns
from the eyes - part of the stratum basale
Body part Percent
Arm (including the 9 percent

hand) each
Anterior trunk (front 18

of the body) percent
18
Head and neck
percent
14
Legs (including the
percent
feet)
each
Posterior trunk (back 18

of the body) percent
Skin cancer
1. Basal cell carcinoma
- begins with cell in the stratum
basale and extends in the dermis
to produce an open ulcer
- little danger that this cancer
would metastasize
2. Squamous cell carcinoma
- develops from cell immediately
superficial to the stratum basale
- cells continue to divide as they
produce keratin
- result is nodular, keratinized
tumor confined to the epidermis
3. Malignant melanoma
- rare form of skin cancer that
arise from melanocytes, usually
in pre-existing mole
- mole; aggregation or nest of
melanocytes
Nursing Interventions for

caring skin
1. Avoid prolonged sun exposure
2. Apply moisturizer and lotion
with adequate SPF
M4: SKELETAL SYSTEM
Functions of the Skeletal System Bone growth
1. Support 1. Length
- rigid strong bone is suited for bearing weight and - occurs in the epiphyseal plate
- major supporting tissue of the body - occurs through endochondral ossification
- cartilage; provide firm and flexible support  new cartilage is produced in the epiphyseal side of
- ligaments; attaches bone-to-bone the plate as chondrocytes divide and form stacks of cells
2. Protection  chondrocytes mature, enlarge and dies
- bone is hard therefore protects the organs surrounding  matrix is calcified
it  cartilage on diaphyseal side of the plate is replaced
3. Movement by bone
- tendons; attaches muscles to bones - Epiphyseal plate growth involves the interstitial growth
- joints; where 2 or more bones join together for of cartilage followed by appositional bone growth on the
movement cartilage.
4. Storage - Epiphyseal plate growth results in increased length of
- Ca & P stored in our bones the diaphysis and bony processes. Bone growth in length
- adipose tissue is stored between the bones cavity ceases when the epiphyseal plate becomes ossified and
5. Blood cell production forms the epiphyseal line.
- bones contain red marrow which produces RBC and 2. Articular cartilage
platelets - covers the bone ends
Bone Ossification - old ones of these are broken down and replaced by
: ossification- formation of bones by the osteoblasts bony matrix
1. Intramembrous ossification - Articular cartilage growth involves the interstitial growth
- osteoblasts line up on the surface of connective tissue of cartilage followed by appositional bone growth on the
fibers and begin depositing bone matrix to form cartilage.
trabeculae - Articular cartilage growth results in larger epiphyses and
- ex. Skull an increase in the size of bones that do not have
- ossification centers; where this process occurs epiphyseal plates.
- trabeculae may enlarge or be replaced by compact
bone
2. Endochondral ossification
- occurs inside the hyaline cartilage
- develops the base of the skull and most of the skeletal
system from preformed hyaline cartilage models
- cartilage model have the general shape of the mature
bone
- increase of chondrocytes (cartilage cells), increase the
size of bone
- chondrocytes absorb the cartilage matrix, release matrix
vesicles which forms hydroxyapatite crystals, and die to
calcify the cartilage matrix
- blood vessels starts accumulating in the perichondrium,
differentiate unspecified connective tissue cells to
osteoblasts and grows in the center of the diaphysis
which bring osteoblast and stimulating ossification
- osteoblast produce a collar of bone in the outer surface 3. Width
of the diaphysis - osteoblast in the peristeum add bone matrix to the
- perichondrium becomes peristeum outside of the diaphysis as cells called osteoclasts
- primary ossification; where bone first begin to appear in remove bone form the inner face of the diaphysis wall,
the diaphysis medullary cavity.
- secondary ossification; form in the epiphysis - Appositional bone growth beneath the periosteum
increases the diameter of long bones and the size of
M4: SKELETAL SYSTEM
Endochondral ossification
M4: SKELETAL SYSTEM
other bones. 4. Factors affecting bone growth
- Osteoblasts from the periosteum form ridges with - Genetic factors determine bone shape and size. The
grooves between them. The ridges grow together, expression of genetic factors can be modified.
converting the grooves into tunnels filled with concentric - Factors that alter the mineralization process or the
lamellae to form osteons. production of organic matrix, such as deficiencies in
- Osteoblasts from the periosteum lay down vitamins D and C, can affect bone growth.
circumferential lamellae, which can be remodeled. - Growth hormone, thyroid hormone, estrogen, and
testosterone stimulate bone growth.
- Estrogen and testosterone cause increased bone
growth and closure of the epiphyseal plate.
M4: SKELETAL SYSTEM
Bone remodeling of spongy bine
- bone is dynamic and active tissue 4. Bone remodeling
- 2 factors remodels bones - compact bine replaces woven bone
 Calcium ion level in the bones - part of the internal callus is removed
- blood calcium level drops, parathyroid glands - medullary cavity is restored
stimulates the release of parathyroid hormone which - bony callus is remodeled in response to the mechanical
activates osteoclast to break down bone matrix and stress placed on it.
release calcium ions - forms a strong permanent ‘patch’ at the fracture site
- osteoporosis; too little bone formation of too much
Extracellular matrix
removal
1. Collagen
 Pull of gravity and muscles of the skeleton
- a tough, rope-like protein
- bone of bedridden or physically inactive people tend
- makes cartilage, tendons and ligaments tough
to lose mass and to atrophy because it is no longer
2. Proteoglycans
subject to stress
- large molecule consisting of many polysaccharides
- Remodeling converts woven bone to lamellar bone and
attaching to and encircling core proteins
allows bone to change shape, adjust to stress, repair
- attract and retain large amounts of water between
itself, and regulate body calcium levels.
polysaccharide
- Bone adjusts to stress by adding new bone and by
- makes cartilage smooth and resilient
realigning bone through remodeling.
3. Hydroxyapatite
- calcium phosphate crystals found in the bone
- minerals found in the bone
- gives the bone compression (weight-bearing) strength
Histology of bone
1. Compact bone
- or cortical bone
- has more matrix and is denser with fewer spores
- has a predictable pattern of repeating units called
osteons
- each osteon consist of concentric rings of lamellae
surrounding a central canal (Haversian canal)
- osteocytes are located in lacunae between the lamellae
of each osteon
Bone repair
- blood vessels run parallel to the long axis of the bone
1. Hematoma formation
located in the Haversian canal
- blood vessels are ruptured when the bone breaks
- nutrients leave the blood vessels of the central canals
- results to a blood-filled, swelling or bruised called
and diffuses to the osteocytes though the canaliculi
hematoma
2. Spongy bone
- bone cells deprived of nutrition die
- very porous and is located in the epiphyses of long
2. Callus formation
bones and medullary cavity lining
- growth of new capillaries (granulation tissue) into the
- consist of trabeculae; delicate interconnecting rod or
clotted blood at the site of the damage
plates resembling scaffoldings of a building
- disposal of dead tissue by phagocytes
- spaces in the trabeculae are filled with marrow
- formation of internal and external masses of repair
- trabeculae has no blood vessel and central canal
tissue collectively forms fibrocartilage callus
- nutrients exit vessels in the marrow and pass by
- internal callus forms between the ends of the bone
diffusion through canaliculi to the osteocytes of the
- external callus forms a collar around the break
trabeculae
3. Callus ossification
- woven, spongy bone replaces internal and external Bone and Calcium homeostasis
callus - bones stores calcium thus movement of calcium in and
- osteoblast and osteoclast migrate into the area of out of bone helps determined blood calcium level which
damage and callus is replaced by the bony callus made is critical for normal muscle and nervous system function
M4: SKELETAL SYSTEM
Bone Repair
Bone and Calcium Homeostasis

M4: SKELETAL SYSTEM
1. Decreased blood Ca2+ stimulates PTH secretion from

parathyroid glands
2. PTH stimulates osteoclasts to break down bone and
release Ca2+ into the blood
3. In the kidney, PTH increases Ca2+ reabsorption from
urine. PTH also stimulates active Vit D formation
4. Vit D promotes Ca2+ absorption from the small
intestine into the blood
5. Increased blood Ca2+ stimulates calcitonin secretion
from the thyroid gland
6. Calcitonin inhibits osteoclasts, which allows enhanced
osteoblast uptake of Ca2+ from the blood deposit into
bone
Effects of Aging with the skeletal system

1. The tissues of the body become less flexible and less
elastic
2. Tissue repair slows as cells proliferation rates decline
3. The cartilage covering articular surfaces wear down
4. The rates of replacement declines and the matrix
becomes more rigid and brittle
M4: SKELETAL SYSTEM
Appendicular Skeleton
1. Coccyx 18. Carpal

2. Sacrum 19. Tarsal
3. Vertebral column 20. Metacarpal
4. Scapula 21. Metatarsal
5. Skull 22. Phalanges
6. Mandible
7. Hyoid bone
8. Clavicle
9. Sternum
10. Humerus
11. Ribs
12. Hip bone
13. Ulna
14. Radius
15. Fibula
16. Tibia
17. Femur
M4: SKELETAL SYSTEM
Features of a bone
1. Diaphysis
Paranasal sinuses
- central shaft between the bones
2. Epiphysis
- ends part of the bone
3. Articular cartilage
- covers the ends of the bone
4. Epiphyseal plate
- where bone growth occurs
5. Epiphyseal line
- replaces epiphyseal plate when bones stop growing
6. Medullary cavity
- found in the space deep in diaphysis
7. Yellow marrow
- consist of adipose tissue
8. Red marrow
- consist of blood-forming cells 1. Frontal sinus
9. Periosteum 2. Ethmoidal sinus
- surrounds the bone 3. Sphenoidal sinus
- consist of 2 layers and blood vessels and nerves 4. Maxillary sinus
10. Endosteum
- lining of the medullary cavity
- a thinner connective tissue membrane
11. Spongy bone
12. Compact bone
M4: SKELETAL SYSTEM
Bones of the skull
Lateral View
1. Parietal bone
- wall 11. Mastoid process
2. Temporal bone - posterior to the ear
- refers to time - important neck muscles involved in the rotation of the
3. Frontal bone head is attached here
- forehead 12. Zygomatic arch
4. Occipital bone - consist of joined processes of the temporal and
- back of the head zygomatic bone forms a bridge across the face
5. Sphenoid bone - provides a major attachment site for a muscle moving
- anterior to the temporal bone the mandible
6. Zygomatic bone 13. Maxilla
- anterior to the sphenoid bone - forms the upper jaw
- cheek bones 14. Mandible
7. Squamous suture - forms the lower jaw
- joins parietal and temporal bone 15. Ethmoid bone
8. Coronal suture 16. Nasal bone
- joins the parietal and frontal bone 17. Nasolacrimal canal
9. Lambdoid suture 18. Styloid process
- joins the parietal and occipital bone 19. Mandibular condyle
10. External auditory canal/ acoustic meatus 20. Zygomatic arch
- canal that enables sound waves to reach the eardrum 21. Coronoid process
22. Lacrimal bone
23. Mental foramen
M4: SKELETAL SYSTEM
Anterior view
1. Parietal bone 12. Nasal cavity

- wall 13. Nasolacrima canal
2. Temporal bone - passes from the orbit into the nasal cavity
- refers to time - contains a duct that carries tears from the eyes to the
3. Frontal bone nasal cavity
- forehead 14. Nasal septum
4. Sphenoid bone - divides the nasal cavity into right and left halves
- anterior to the temporal bone 14a. Vomer
5. Zygomatic bone - forms the inferior half of the nasal septum
- anterior to the sphenoid bone 14b. Ethmoid bone
- cheek bones - forms the superior half of the nasal septum
6. Lacrimal bone 15. Nasal concha
- seen in the orbit just above the opening of this canal - resembling a conch shell
7. Nasal bone 15a. Inferior nasal concha
- bridge of the nose - separate bone
8. Orbit 15b. Middle and superior nasal concha
- eye sockets - projections from the ethmoid bone
- corn-shaped fossae 16. Paranasal sinuses
- for protection and attachment points for the muscle that - open into the nasal cavity
move the eye - decrease the weight of the skull and acts as the
9. Superior and inferior orbital fissure resonating chamber of the voice
- provide openings through which nerves and blood 17. Mastoid air cells
vessels communicate with the orbit or pass to the face - located inside the mastoid processes of the temporal
10. Optic foramen bone
- where optic nerves passes from the eye 18. Maxilla
11. Infraorbital and supraorbital foramen - forms the upper jaw
19. Mandible
- forms the lower jaw
M4: SKELETAL SYSTEM
Inferior view
1. Nuchal lines
2. Occipital bone
3. Temporal bone
4. Mastoid process
5. Carotid canal
6. Styloid process
7. Mandibular fossa
8. Zygomatic bone
9. Palatine bone
10. Palatine process
11. Maxilla
12. Incisive fossa
13. Vomer
14. Inferior orbital fissure
15. Sphenoid bone
16. Foramen ovale
17. Foramen spinosum
18. External auditory canal
19. Jugular foramen
20. Occipital condyle
21. Foramen magnum
M4: SKELETAL SYSTEM
Superior view
1. Occipital bone
2. Hypoglassal canal
3. Jugular foramen
4. Temporal bone
5. Carotid canal
6. Sella turcica
7. Optic foramen
8. Cribriform plate
9. Crista galli
10. Frontal bone
11. Frontal sinus
12. Sphenoid bone
13. Foramen rotundum
14. Foramen ovale
15. Foramen spinosum 1. Zygomatic bone
16. Foramen magnus 2. Occipital condyle
17. Anterior cranial fossa 3. Superior nuchal line
18. Middle cranial fossa 4. External occipital protuberance
19. Posterior cranial fossa 5. Lambdoid suture
20. Internal auditory canal 6. Sagittal suture
21. Parietal bone 7. Parietal bone
8. Occipital bone
9. Temporal bone
10. Mastoid process
11. Foramen magnum
M4: SKELETAL SYSTEM
Vertebral column Generalized vertebra
Lateral view Superior view
1. Spinous process
2. Articular facet
3. Superior Articular process
4. Transverse process
5. Vertebral foramen
6. Body
7. Pedicle
8. Lamina
Atlas vertebra
Superior view
1. Posterior arch
2. Anterior arch
4. Transverse foramen
1. Cervical (7) 5. Vertebral foramen
2. Thoracic (12) 6. Superior articular facet
3. Lumbar (5) 7. Facets for dens
4. Sacrum
5. Coccyx
6. Sacral promontory
7. Body
8. Intervertebral disk
9. Intervertebral foramen
10. Spinous process
12. Atlas
13. Axis
M4: SKELETAL SYSTEM
Axis vertebra Lumbar vertebra
Superior view Superior view
Cervical vertebra
Superior view 1. Vertebral foramen
2. Superior articular
3. Spinous process
4. Lamina
5. Pedicle
Sacrum
Anterior view
1. Superior articular facet

3. Spinous process
4. Lamina
5. Pedicle
7. Transverse foramen
8. Body
Thoracic vertebra
Superior
2. Anterior sacral foramina
3. Coccyx
Sacrum
Posterior view
1. Facets for rib attachment

3. Spinous process
4. Lamina
5. Pedicle
7. Superior articular facet
8. Body
1. Coccyx
2. Sacral hiatus
3. Median sacral crest
4. Articular facet
5. Vertebral canal
6. Posterior sacral foramina
M4: SKELETAL SYSTEM
Rib cage Scapula
Anterior view Anterior & Posterior view
1. True ribs (1-7)

2. False ribs (8-12)
3. Floating ribs (11-12)
4. Clavicle
5. Atlas
6. Axis 1. Inferior angle
7. Jugular notch 2. Lateral border
8. Sternal angle 3. Glenoid cavity
9. Costal cartilage 4. Coracoid process
10. Manubrium 5. Acromian process
11. Body 6. Subscapular fossa
12. Xiphoid process 7. Medial border
__________________________________
Pectoral girdle & Upper limb
1. Lateral border
2. Infraspinous fossa
3. Glenoid cavity
4. Coracoid process
5. Acromian process
6. Supraspinous fossa
7. Spine
8. Medial fossa
Clavicle
Superior view
1. Distal end
1. Clavicle & scapula 2. Body of clavicle
2. Humerus 3. Proximal end
3. Radius & Ulna
4. Carpal, Metacarpal, Phalanges
M4: SKELETAL SYSTEM
Humerous Radius & Ulna
Anterior and Posterior view Anterior and Superior view
1. Medial epicondyle
2. Surgical neck
3. Anatomical neck
4. Head
5. Greater tubercle
6. Lesser tubercle
7. Deltoid tuberosity 1. Styloid process
8. Lateral epicondyle 2. Radius
9. Capitulum 3. Radial tuberosity
10. Trochlea 4. Head
___________________________ 5. Olecranon process
1. Medial epicondyle 6. Trochlear notch
2. Surgical neck 7. Coronoid process
3. Anatomical neck 8. Ulna
4. Head 9. Head
5. Greater tubercle 10. Styloid process
6. Olecranon fossa __________________________
7. Lateral epicondyle 1. Head of radius
8. Trochlea 2. Olecranon process
3. Trochlear notch
4. Coronoid process
M4: SKELETAL SYSTEM
Wrist and Hand Pelvic girdle & Lower limb
Anterior view Anterior view
1. Sacrum
1. Proximal row
2. Hip bone
- Scaphoid
3. Femur
- Lunate
4. Patella
- Triquetrum
5. Tibia
- Pisiform
6. Fibula
2. Distal row
7. Tarsal
- Trapezium
8. Metatarsals
- Trapezoid
9. Phalanges
- Capitate
- Hamate
3. Metacarpal
4. Proximal & Distal phalanx (thumb)
5. Proximal, Middle, & Distal phalanx
M4: SKELETAL SYSTEM
Hip bone 6. Ilium
Anterosuperior view 7. Iliac fossa
8. Pelvic brim
9. Pubis
10. Pubic symphysis
Femur
Anterior and Posterior view
1. Ischium
2. Pubis
3. Ilium
4. Sacrum
5. Sacroiliac joint
6. Iliac crest
8. Anterior superior iliac spine
9. Coccyx
10 Acetabulum
11. Pubic symphysis
12. Obturator foramen 1. Patellar groove
13. Subpubic angle 2. Lateral epicondyle
Lateral and Medial view 3. Neck
4. Greater trochanter
5. Head
6. Lesser trochanter
7. Body
8. Medial epicondyle
_________________________________
1. Linea aspera
2. Intercondylar fossa
1. Ischial tuberosity
2. Ischium
3. Ischial spine
4. Greater sciatic notch
5. Iliac crest
6. Ilium
7. Acetabulum
8. Pubis
9. Obturator formen
____________________________
1. Ischium
2. Ischial spine
3. Greater sciatic notch
4. Articular surface
5. Iliac crest
M4: SKELETAL SYSTEM
Fibula and Tibia 7. Proximal & Distal phalanx (thumb)
Anterior view 8. Proximal, Middle, & Distal phalanx
Classification of joints
1. Fibrous joints
- articulating surfaces of two bones united by fibrous
connective tissue
- no joint cavity and exhibit little or no movement.
- Joints in this group are further subdivided on the basis
of structure as sutures, syndesmoses, or gomphoses.
2. Cartilaginous joints
- unite two bones by means of cartilage.
- Only slight movement can occur at these joints.
- can be either hyaline cartilage or fibrocartilage.
Sutures
- fibrous joints between the bones of the skull
- In a newborn, some parts of the sutures are quite wide
and are called fontanels
- allows flexibility in the skull during the birth process, as
well as growth of the head after birth.
1. Syndesmoses
1. Medial malleolus - fibrous joints in which the bones are separated by some
2. Tibia distance and held together by ligaments
3. Tibial tuberosity - example is the fibrous membrane connecting most of
4. Media condyle the distal parts of the radius and ulna.
5. Lateral condyle 2. Gomphoses
6. Head - consist of pegs fitted into sockets and held in place by
7. Fibula ligaments.
8. Lateral malleolus - The joint between a tooth and its socket is a gomphosis.
3. Synchondroses
Foot - contain hyaline cartilage
Superior view - little or no movement occurs synovial joints at those
junctions
- most costal cartilages no longer qualify as
synchondroses
4. Symphyses
- contain fibrocartilage
- Some of these joints are slightly movable because of
the somewhat flexible nature of fibrocartilage
- especially important for the intervertebral disks because
the disk also acts as a shock absorber between the
vertebrae
1. Calcaneus
2. Talus
3. Cuboid
4. Navicular
5. Medial, Intermediate, & lateral cuneiform
6. Metatarsal bones
M4: SKELETAL SYSTEM
center.
- Joints with menisci include the knee and wrist,
4. Fibrous capsule
- where the circumference of the articular disk is attached
5. Synovial membrane
- lines the joint cavity everywhere except over the
articular cartilage The membrane
- produces synovial fluid, which is a complex mixture of
polysaccharides, proteins, lipids, and cells.
- Synovial fluid forms a thin, lubricating film covering the
surfaces of the joint.
6. Bursa
- extend as a pocket, or sac
- located between structures that rub together, such as
where a tendon crosses a bone
- reduce friction, which could damage the structures
involved
- Inflammation of a bursa, often resulting from abrasion,
is called bursitis.
7. Tendon sheath
- may extend as a tendon sheath along some tendons
associated with joints
- Other bursae extend along tendons for some distance
forming this
Synovial joints
- contain synovial fluid and allow considerable
movement between articulating bones
- anatomically more complex than fibrous cartilaginous
joints.
- unite the bones of the appendicular skeleton
- greater mobility of the appendicular skeleton compared
with the axial skeleton
1. Articular cartilage
- The articular surfaces of bones within synovial joints are
covered with a thin layer of articular cartilage
- provides a smooth surface where the bones meet.
2. Articular disk
- a flat pad of fibrocartilage
- provides a smooth surface where the bones meet
- lies between the articular cartilages of bones.
3. Meniscus
- type of articular disk that only partially spans the
synovial cavity such that there is an opening in the
M4: SKELETAL SYSTEM
Classification of Synovial joints
M4: SKELETAL SYSTEM
1. Plane joints, or gliding joints - Dorsiflexion is movement of the foot toward the shin, as
- consist of two opposed flat surfaces that glide over each when walking on the heels
other.
- articular facets between vertebrae.
2. Saddle joints
- consist of two saddle-shaped articulating surfaces
oriented at right angles to each other.
- Movement in these joints can occur in two planes
- metacarpal bone and the carpal bone (trapezium) of the
thumb
3. Hinge joints
- permit movement in one plane only
- consist of a convex cylinder of one bone applied to a
corresponding concavity of the other bone
- elbow and knee joints 2. Abduction and Adduction
4. Pivot joints - Abduction (to take away) is movement away from the
- restrict movement to rotation around a single axis midline
- consists of a cylindrical bony process that rotates within - Adduction (to bring together) is movement toward the
a ring composed partly of bone and partly of ligament. midline
- axis and atlas when shaking the head “no” & articulation
between the proximal ends of the ulna and radius
5. Ball-and-socket joints
- consist of a ball (head) at the end of one bone and a
socket in an adjacent bone into which a portion of the ball
fits.
- allows a wide range of movement in almost any
direction.
- shoulder and hip joints (figure 6.42c,d).
6. Ellipsoid or condyloid joints
- elongated ball-and-socket joints.
- shape of the joint limits its range of movement nearly to
that of a hinge motion, but in two planes
4. Pronation and Supination
- joint between the occipital condyles of the skull and the
atlas of the vertebral column and the joints between the - Pronation is rotation of the forearm so that the palm
faces posteriorly in relation to the anatomical position.
metacarpal
- Supination is rotation of the forearm so that the palm
Range of Motions faces anteriorly in relation to the anatomical position.
1. Flexion and Extension
- Flexion bending movement that decreases the angle of
the joint to bring the articulating bones closer together.
- Extension is a straightening movement that increases
the angle of the joint to extend the articulating bones.
2. Plantar flexion and Dorsiflexion 5. Elevation and Depression

- Plantar flexion is movement of the foot toward the - Elevation moves a structure superiorly
plantar surface, as when standing on the toes - Depression moves it inferiorly
M4: SKELETAL SYSTEM
- Eversion turns the ankle so that the plantar surface
faces laterally, with the weight on the inside edge of the
foot
6. Protraction and Retraction

- Protraction is a gliding motion that moves a structure in
an anterior direction.
- Retraction is a gliding motion that moves a structure in
a posterior direction General Nursing care of the Skeletal system
1. Increase nutritional intake of calcium by drinking milk
2. Observe proper body mechanics
3. Perform regular exercise
4. Conduct active and passive ROM exercise
5. Promote adequate rest
7. Opposition and Reposition

- Opposition is a movement unique to the thumb
- occurs when the thumb and the tip of a finger on the
same hand are brought toward each other across the
palm
- Reposition returns the thumb to the neutral, anatomical
position
8. Inversion and Eversion

- Inversion turns the ankle so that the plantar surface of
the foot faces medially, toward the opposite foot, with the
weight on the outside edge of the foot (rolling out)
M5: Muscular System
Function the plasma membrane is higher 3. Diffusion of ACh across the
1. Movement of the body than that inside the plasma synaptic cleft and binding of ACh to
- responsible for the overall membrane Ach receptors on the postsynaptic
movement of the body - The plasma membrane is more muscle fiber membrane opens Na+
2. Maintenance of Posture permeable to K+ than Na+ channels.
- constantly maintain tone
- PISO (Potassium INSIDE, Sodium 4. Sodium ions (Na+) diffuse down
3. Respiration
OUTSIDE)
- muscle of the thorax carry out
2. Action potential
breathing movement
- Reversal of resting membrane
4. Production of Body heat
potential
- as muscles contract, heat is
- Inside of the plasma membrane
produced
becomes positively charged
5. Communication
compared with the outside
- involved in all aspects of
- Phases:
communication like speaking,
○ Depolarization; inside of the
writing, typing, gesturing, and facial
cell
expression
becomes positively charged; NA
6. Constriction of organs and
channels are open and Na
vessels
diffuses down its conc. gradient
- smooth muscles contract in
making the cell membrane
internal organs
positively charged compared to
7. Contraction of the heart
the outside
- cardiac muscles causes heart to
○ Repolarization; return of the
beat and pump blood
membrane to its resting value;
Properties of Muscles their concentration gradient, which
Na channels are closed, K channels
results in depolarization of the
1. Contractility open and K moves out of the cell
muscle fiber membrane; if threshold
- ability to shorten forcefully or making the cell membrane
contract negatively charged compared to the has been reached, a postsynaptic
action potential results.
2. Excitability outside.
- capacity of muscles to respond to Muscle contraction (Sliding
Neuromuscular Junction
stimulus filament model)
- acetylcholine (Ach) is released
3. Extensibility
from presynaptic terminals
- a muscles can be stretched
(neuron)
beyond its resting length and still be
- allows sodium ions to
able to contract
enter post synaptic cells
4. Elasticity
(muscle)
- ability of muscle to recoil to its
- Creates action potential
original resting length
through muscle contraction
Excitability of Muscle fibers 1. An action potential
1. Resting membrane potential arrives at the presynaptic
- Na channels and some, but not all terminal, causing Ca2+
K channels are closed. K diffuses channels to open.
down its conc. gradient through the 2. Calcium ions (Ca2+)
open K channels making the cell enter the presynaptic
membrane negatively charged terminal and initiate the
compared to the outside release of a
- Concentration of K+ inside the neurotransmitter,
plasma membrane is higher than acetylcholine (ACh), from
that outside the plasma membrane synaptic vesicles into the
- The concentration of Na+ outside presynaptic cleft.
M5: Muscular System
Muscle relaxation Muscle fiber types 2. Anaerobic respiration
- Occurs when acetylcholine is no 1. Slow-Twitch (Type I) - Does not require oxygen
longer released at the - Contract more slowly; Respond - Breaks down glucose to produce
neuromuscular junction slowly to nervous stimulation ATP and lactate
- Calcium ion is actively transported - Have a better-developed blood
Major types of Fatigue
back into the sarcoplasmic supply
- fatigue; temporary state of
reticulum - Have more mitochondria
reduced work capacity
- Because the reuptake of Ca+ into - More fatigue-resistant
- Multiple mechanism underlying
the sarcoplasmic reticulum is much - Aerobic respiration is the primary
muscular fatigue:
slower than diffusion of Ca+ out of source for ATP synthesis
○ Acidosis and ATP depletion due
the sarcoplasmic reticulum, a 2. Fast-Twitch (Type II)
to either an increased ATP
muscle fiber takes at least twice as - Respond rapidly to nervous
consumption or a decreased ATP
long to relax as it does to contract. stimulation
production
- Tend to contract rapidly for a
Connective tissue covering ○ Oxidative stress, characterized
shorter time and fatigue relatively
- fascicles; Muscle is composed of by the build-up of excess reactive
quickly
numerous visible bundles oxygen species (ROS; Free
■ Type IIa (fast-twitch oxidative
1. Epimysium Radicals)
glycolytic fibers) - aerobic and
- covers each skeletal muscle ○ Local inflammatory system
anaerobic respiration
2. Perimysium 1. Psychological fatigue
■ Type IIb (fast-twitch glycolytic
- separates muscles fascicles from - Most common type of fatigue
fibers) - anaerobic respiration
each other - Involves the central nervous
3. Endomysium Energy sources for muscle system rather than the muscles
- surrounds each muscles fiber contraction - Muscles are still capable of
1. Aerobic respiration contracting, but the individual
Nerves and blood vessels
- Occurs mostly in mitochondria “perceives” that continued muscle
- has rich supply of blood vessels
- Requires oxygen and breaks contraction is impossible
and nerves
down glucose to produce ATP, 2. Muscular fatigue
- motor neuron; specialized nerve
carbon dioxide and water. - Fatigue due to a depletion of ATP
cells that stimulates the muscles
- Can process lipids and amino within the muscle fibers
- each muscle is in contact with a
acids to make ATP
motor neuron
Skeletal muscle fiber
1. Sarcomere
- Basic structural and functional
unit of skeletal muscle because it is
the smallest portion of skeletal
muscle capable of contracting
2. Actin myofilament
- Two fibrous actin (F acting)
■ Tropomyosin; block the myosin
filament binding sites on the actin
filament
■ Troponin; where site of Ca is
found
- Globular actin
3. Myosin filament
- Composed of many elongated
myosin molecules
M5: Muscular System
■ Tension is maintained in a in accomplishing the desired
3. Synaptic fatigue muscle, but the opposing movement
- Fatigue due to depletion of resistance is great enough to
neurotransmitter vesicles in the cause the muscle to increase in
presynaptic terminals length
Types of Muscle contractions Definition
1. Isometric contraction 1. Origin
- Length of the muscle does not - most stationary or fixed end of the
change but the amount of tension muscle
increases during contraction 2. Insertion
- Responsible for the constant - end of the muscle attached to the
length of the postural muscles of bone undergoing the greatest
the body movement
2. Isotonic contraction - ex.
- Amount of tension produced by 3. Agonist
the muscle is constant during - action of a single muscle or group
contraction but the length of the of muscle
muscle changes 4. Antagonist
- CONCENTRIC CONTRACTION - action of a single muscle or group
■ Tension in the muscle is great is opposed by other group of
enough to overcome the muscle
opposing resistance, and the 5. Prime mover
muscle shortens - one muscle that plays a major role
- ECCENTRIC CONTRACTION
M5: Muscular System
M5: Muscular System
M5: Muscular System
M5: Muscular System
Mastication
- 4 pairs of muscles for chewing
2. Thoracic muscle
- temporalis, masseter, pterygoid - scalenes (elevate ribs), ext
Tongue movement and intercostals (elevate ribs), int.
intercostal (depress ribs), diaphragm
swallowing
(depress floor of thorax)
- tongue is for speech and
mastication
- tongue consist of intrinsic muscles
Muscles of the trunk

1. Muscles moving the Vertebral
column
- erector spinae (extend vertebral
column, maintains posture), deep back
muscles ( help laterally bend vertebral)
M5: Muscular System
3. Abdominal wall muscle abdomen) penis or clitoris),
- rectus abdominis (flex vertebral 4. Pelvic floor and Perineal muscles - ext. anal spincter (keeps orifice of
column, compress abdomen) - levator ani | pelvic floor (elevates anal canal closed),
- ext abdominal oblique (copress anus, supports pelvic viscera) - deep transverse perinei (support
abdomen, flex & rotate vertebral), - bulbospangiosus | perineum pelvic floor),
- int. abdominal oblique (same with (constrict urethra, erects penis, - superficial transverse perinei
ext), erects clitoris) (fixes central tendon)
- transverse abdominis (copress - ischiocavernosus (copress base of
M5: Muscular System
Arm, forearm, & hand
1. Arm
- biceps brachii (flexes elbow,
supinates forearm, flexes shoulder)
- deltoid (flexes and extends
shoulder. Abducts and medially and
laterally rotates arm)
- latissimus dorsi (extends shoulder,
adducts and medially rotates arm)
- Pectoralis major (flex shoulder,
extends shoulder from flexed
position, adducts and medially
rotates arm
- Teres major (extends shoulder,
adducts and medially rotates arm
- Infraspinatus | rotator cuff
(stabilizes and extends shoulder
and laterally rotates arm)
- subscapularis | rotator cuff
(stabilizes and extends shoulder
and medially rotates arm)
- supraspinatus | rotator cuff
(stabilizes shoulder and abducts
arm)
- teres minor | rotator cuff (stabilizes
and extends shoulder, adducts and
laterally rotates arm)
2. Forearm and hands
M5: Muscular System
Thigh and Leg
1. Thigh
2. Leg
M5: Muscular System
M5: Muscular System
M5: Muscular System
Effects of aging on the muscular
system
- reduced muscle mass
- increased time that muscle takes
to contract in response to nervous
stimuli
- less precise muscle control
General nursing care of the
muscular system
- perform regular exercise
- encourage a high protein diet
- observe proper body mechanics
- promote adequate sleep
M6: The Nervous System
Functions of N.S. Support cells (Neuroglia) contains vesicles with
1. Sensory input 1. Astrocyte neurotransmitters
- gathering info; to monitor changes - Abundant, star-shaped cells - axonal terminal has synaptic cleft
occurring inside and outside the - Brace neurons (gap between adjacent neuron) and
body. - Form barrier between capillaries synapse (junction between nerves)
2. Integration and neurons 4. Nerve fiber covering
- processing; to process and - Control the chemical environment - schwann cells; produce myelin
interpret sensory input and decide if of the brain (CNS) sheaths in jelly-roll like fashion
action is needed. 2. Microglia - nodes of ranvier; gaps in myelin
3. Motor output - Spider-like phagocytes sheath along the axon
- response; to integrate stimuli, - Disposal of debris
Multiple sclerosis
activates muscles or glands 3. Ependymal cells (CNS)
- when myelin sheath is destroyed
- Line cavities of the brain and
Classification of N.S. - the myelin sheath hardens to a
spinal cord
1. Central nervous system tissue called sclerosis
- Circulate cerebrospinal fluid
- brain and spinal cord - autoimmune disease
4. Oligodendrocyte (CNS)
- develops from embryonic neural
- Produce myelin sheath around Neuron cell body location
tube
nerve fibers in the central nervous 1. Most are found in the CNS
- opening of neural tube becomes
system - gray matter; cell bodies and
ventricles
unmyelinated fibers
- has 4 chambers that is filled with Neuroglia vs Neuron
- nuclei; cluster of cell bodies within
Cerebrospinal fluid (CSF) 1. Neuroglia
the white matter of the CNS
2. Peripheral nervous system - divide
2. Ganglia
- nerve and ganglia outside the - glioma; brain tumor from glial cells
- collections of cell bodies outside
CNS 2. Neuron
the CNS
- nerve= bundle of neuron fibers - do not divide
- neuron fibers are bundled b Functional Classification of
Support Cells of the PNS
connective tissue Neurons
1. Satellite cells
- Sensory (afferent) division 1. Sensory (afferent) neurons
- Protect neuron cell bodies
; nerve fibers that carry information - carry impulse from the sensory
2. Schwann cells
to the central nervous system receptors
- Form myelin sheath in the
- Motor (efferent) division - cutaneous sense organs
peripheral nervous system
; Nerve fibers that carry impulses - proprioceptors; detect stretch or
away from the central nervous Nervous tissue tension
system 1. Neuron 2. Motor (efferent) neurons
; Two subdivisions - or nerve cells - carry impulse from the CNS
· Somatic nervous system = - cells specialized to transmit 3. Interneuron (association
voluntary messages neurons)
· Autonomic nervous system = - major regions are cell body - found in neural pathways in the
involuntary (nucleus and metabolic center of CNS
- consist of only motor nerves the cell) and processes (fibers that - connect sensory and motor
- sympathetic division (fight or extend from the cell body) neurons
flight, response to unusual
stimuli, takes over to increase Neuron anatomy Structural classification of
activities, exercise, excitement 1. Cell body neuron
emergency, embarrassed) - nucleus and large nucleolus 1. Multipolar neuron
- parasympathetic division 2. Dendrites - many extensions from the cell
(housekeeping acts, conserves - conducts impulse toward the cell body
energy, maintain necessary body body 2. Bipolar neuron
functions, digestion, defecation, 3. Axons - 1 axon, 1 dendrite
diuresis) - conducts impulse away from the 3. Unipolar neuron
cell body - have a short single process
- end in axonal terminal which leaving the cell body
Function of Neuron mass for vision and hearing
1. Irritability - surface is made of ridges (gyri) ; pons- bulging center of the
- ability to respond to stimuli and grooves (sulci) brainstem, composed of fiber tracts,
2. Conductivity - fissures divide the lobes includes nuclei involve in the control
- ability to transmit an impulse - frontal lobe, parietal lobe, of breathing
3. Polarized plasma membrane temporal lobe, and occipital lobe ; medulla oblongata- lowest part of
when at rest - specialized areas the spinal cord, merges the spinal
- fewer positive ions are inside the ; somatic sensory area- receives cord, includes important fiber tracts,
cell than outside the cell impulses from the body’s sensory control center (heart rate control,
receptors BP regulation, breathing,
Nerve impulse
; primary motor area- sends swallowing, and vomiting)
1. Depolarization
impulse to skeletal muscles 4. Cerebellum
- a stimulus depolarizes the
; broca’s area- involved in our ability - 2 hemisphere with convoluted
neuron’s membrane
to speak surfaces
- allows sodium (Na+) to flow inside
; special senses- gustatory area - provides involuntary coordination
the membrane
(taste), visual area (sight), auditory of body movements
- The exchange of ions initiates an
area (speak), olfactory area
action potential in the neuron Protection of the CNS
(hearing)
2. Action potential 1. Scalp and skin
; interpretation areas- speech/
- If the action potential (nerve 2. Skull and vertebral column
language region, language
impulse) starts, it is propagated 3. Meninges
comprehension region, and general
over the entire axon - dura mater
interpretation area
- Potassium ions rush out of the ; double layered external covering,
- layers
neuron after sodium ions rush in, periosteum (attached to the surface
; gray matter- outer layer,
which repolarizes the membrane of the skull), and meningeal layer
composed mostly of neuron cell
- The sodium-potassium pump (outer covering of the brain)
bodies
(requires ATP) restores the original - arachnoid mater
; white matter- fiber tracts inside the
configuration ; middle layer, web-like
gray matter
- pia mater
Reflex arc 2. Diencephalon
; internal layer, clings to the surface
1. Reflex - sits on top of the brainstem
of the brain
- rapid, predictable, and involuntary - enclosed by cerebral hemisphere
4. Cerebrospinal fluid (CSF)
responses to stimuli - made of 3 parts
- similar to blood plasma
2. Reflex arc ; thalamus- surround the third
composition
- direct route from a receptor, ventricle, relay station for sensory
- formed by choroid plexus
sensory neuron, to an interneuron, impulses, transfer impulses to the
- forms a watery cushion to protect
motor neuron, and to an effector correct part of the cortex for
the brain
organ localization and interpretation
- circulated in arachnoid space,
; hypothalamus- under the
Types of Reflexes and ventricles, and central canal of the
thalamus, regulate body
Regulation spinal cord
temperature, control water balance,
1. Autonomic reflex 5. Blood brain barrier (BBB)
regulates metabolism, important in
- smooth muscle regulation - includes the least permeable
the limbic system (emotion), and
- heart and blood pressure capillaries of the body
pituitary gland is attached here
regulation - excludes many potentially harmful
; epithalamus- forms the roof of the
- regulation of glands substances
3rd ventricle, houses the pineal
- digestive system regulation - useless against fats, respiratory
gland, includes the choroid plexus
2. Somatic reflex gases, nicotine, alcohol, and
(forms CSF)
- activation of skeletal muscle anesthesia
3. Brainstem
Regions of the brain - attaches the spinal cord Spinal cord
1. Cerebrum - parts of the brain stem - Extends from the medulla
- paired superior parts of the brain ; midbrain- mostly composed of oblongata
- include more than half of the brain tracts of nerve fiber, reflex centers - cauda equina (collection of spinal
nerves) found below T12 Development aspect of the NS
- enlargements occur in the cervical - formed during the first month of
and lumbar regions embryonic development
1. Exterior white matter - Any maternal infection can have
- conduction tracts extremely harmful effects
2. Internal gray matter - The hypothalamus is one of the
- mostly cell bodies last areas of the brain to develop
- dorsal and ventral horns - No more neurons are formed after
3. Central canal birth, but growth and maturation
- filled with CSF continues for several years.
4. Meninges - Brain reaches maximum weight as
- cover the spinal cord a young adult
5. Dorsal root
Homeostatic imbalances of NS
- associated with the dorsal root
1. Traumatic Brain Injury (TBI)
ganglia – collections of cell bodies
- concussion; slight or mild brain
outside the central nervous system
injury, bleeding & tearing of nerve
6. Ventral root
fibers happened, recovery likely
Structure of a Nerve with some memory loss
1. Endoneurium - contusion; more severe TBI,
- surrounds each fiber nervous tissue destruction occurs,
2. Perineurium nervous tissue does not regenerate
- group of fibers bounded by - cerebral edema; swelling from the
fascicles inflammatory response, may
3. Epineurium compress and kill brain tissue
- bound together fascicles 2. Cerebrovascular Accident (CVA)
- commonly called a Stroke
Classification of Nerves
- result of a ruptured blood vessel
1. Mixed nerve
supplying a region of the brain
- both sensory and motor fibers
- brain tissue supplied with oxygen
2. Afferent (sensory) nerves
from that blood source dies
- carry impulse toward CNS
- loss of some functions or death
3. Efferent (motor) nerve
may result
- carry impulse away for the CNS
3. Alzheimer’s disease
Cranial nerves - progressive degenerative brain
1. Olfactory disease
2. Optic - mostly seen in the elderly, but
3. Oculomotor may begin in middle age
4. Trochlear - structural changes in the brain
5. Trigeminal include abnormal protein deposits
6. Abducens and twisted fibers within neurons
7. Facial - victims experience memory loss,
8. Vestibulococohlear irritability, confusion and ultimately,
9. Glossopharyngeal hallucinations and death
10. Vagus
11. Accessory
12. Hypoglossal
Spinal nerves
- there is a pair of spinal nerves at
the level of each vertebrae
- cervical (7), thoracic (12), lumbar
(5), sacral (1)
Divisions of the N.S. Structures of neurons concentration of Na+ immediately
1. Central nervous system (CNS) 1. Neuron (nerve cell) outside the cell membrane, and a
- consists of the brain and spinal - receive stimuli, conduct action greater permeability of the cell
cord potentials, and transmit signals to membrane to K+ than to Na+
- process, intgrates, stores, and other neurons or effector organs. - 2 types of ion channels; leak ion
responds to information from the 2. Nucleus channel (always open, responsible
- contains cell DNA and nucleolus for permeability of the plasma
PNS
3. Cell body membrane to ions when the plasma
2. Peripheral nervous system (PNS)
- the metabolic center of the membrane is unstimulated or at
- consists of all the nervous tissueneuron. rest) and gated ion channels
outside the CNS, including nerves, - contains the mitochondria, golgi, (closed until opened by specific
ganglia, receptors and plexus nucleus, and rough ER signals, voltage-gated channels use
- is the communication link between 4. Process (fibers) neurotransmitters, ligand-gated
the CNS and the various parts of - Dendrites; convey incoming channels)
the body messages (electrical signals) - Na+ channels (pink) and most, but
- carries information about the toward the cell body not all, K+ channels (purple) are
different tissues of the body to the- Axons; generate nerve impulses closed. The outside of the cell
CNS and delivers commands from and typically conduct them away membrane is positively charged
the CNS to other body tissues that from the cell body; (nerve tract) compared to the inside.
alter body activities bundle of axons
- Axon hillock; arises from a Action potential
- compose od motor division
conelike region of the cell - Depolarization; Na+ channels
(efferent div; away) and sensory Body open. K+ channels begin to open.
division (afferent div; toward) - Axon terminals; contain hundreds Depolarization results because the
Divisions of Autonomic N.S. of tiny vesicles, or membranous inward movement of Na+ makes
1. Sympathetic sacs, that contain chemicals called the inside of the membrane
- “fight or flight” neurotransmitters positive.
- dominates under stress, including - Synaptic cleft; each axon terminal - Repolarization; Na+ channels
emergencies is separated from the next neuron close and additional K+ channels
- release neurotransmitters by a tiny gap open. Na+ movement into the cell
norepinephrine and epinephrine 5. Myelin sheath stops, and K+ movement out of the
(adregernic) - nerve fibers are covered with a
2. Parasympathetic whitish, fatty material called myelin
- “rest and repose” - protects and insulates the fibers
- returns body systems to normal and increases the transmission rate
- release neurotransmitters of nerve impulses
acetylcholine (cholinergic) - encloses the axon
- Nodes of Ranvier; gaps in the
Motor Divisions myelin sheath
1. Autonomic N.S 6. Schwann cells (neuroglia)
- transmits action potentials from - the supportive cells of the CNS
the CNS to cardiac muscle, smooth and PNS
muscle, and glands. - carry out different functions that
- regulates events that are enhance neuron function and
involuntary such as the activity of maintain normal conditions within
smooth muscle, cardiac muscle, nervous tissue
and glands - ganglion; network of cells
- innervate involuntary muscles
2. Somatic N.S. Resting membrane potential
- transmits action potentials from - negative charge inside, positive
the CNS to skeletal muscles charge outside
- carries signal from the brain to - polarized; uneven distribution of
voluntary skeletal muscle charge
- innervate voluntary muscles - generated by 3 factors; a higher
concentration of K+ immediately
inside the cell membrane, a higher
cell increases, causing effector organs), effector organ Parts of the brain
repolarization. (respond to the action potentials). 1. Brain stem
- In summary, the resting - connects the spinal cord to the
membrane potential is set by the Neural pathways remainder of the brain
activity of the leak channels. On 1. Converging pathways - consists of the medulla oblongata,
stimulation, chemically gated - two or more neurons synapse with the pons, and the midbrain
channels are opened and initiate the same postsynaptic neuron - contains nuclei involved in the
local potentials. If sufficiently - allows information transmitted in control of heart rate, blood
strong, the local potentials activatemore than one neuronal pathway to pressure, and breathing
voltage-gated channels to initiate converge into a single pathway 2. Medulla oblongata
an action potential. 2. Diverging pathways - most inferior portion of the
- the axon from one neuron divides brainstem
Synapse and synapses with more than one - extends from the level of the
- a junction where the axon of one other postsynaptic neuron foramen magnum to the pons
neuron interacts with another - allows information transmitted in - contains ascending and
neuron or with cells of an effector one neuronal pathway to diverge descending nerve tracts, which
organ, such as a muscle or gland into two or more pathways convey signals to and from other
1. Presynaptic terminal 3. Summation regions of the brain
- found at the end of the axon - many presynaptic action potentials - regulation of heart rate and blood
2. Postsynaptic terminal are needed vessel diameter, breathing,
- membrane of the dendrite or - allows integration of multiple swallowing, vomiting, coughing,
effector cell subthreshold local potentials sneezing, balance, and
3. Synaptic cleft - can bring the membrane potential coordination
- space separating the presynaptic to threshold and trigger an action 3. Pons
and postsynaptic membranes potential - superior to the medulla oblongata
4. Synaptic vesicles - spatial summation; occurs when - contains ascending and
- stores neurotransmitter the local potentials originate from descending nerve tracts
different locations on the - contains nuclei that relays info
Reflex postsynaptic neuron between cerebrum and cerebellum
- an involuntary reaction in - temporal summation; occur from a - breathing, swallowing, balance,
response to a stimulus applied to single input that fires rapidly, which chewing, and salivation.
the periphery and transmitted to the allows the resulting local potentials 4. Midbrain
CNS to overlap briefly - superior to the pons
- do not require conscious thought, - smallest region of the brainstem
they produce a consistent and Spinal cord and Spinal nerves - colliculi; 4 mounds found in the
predictable result. - The inferior end of the spinal cord dorsal part, 2 inferior colliculi major
- homeostatic and the spinal nerves exiting there relay centers for the auditory nerve
- integrated within the brain and resemble a horse’s tail and are pathways in the CNS, 2 superior
spinal cord. Higher brain centers collectively called the cauda equina colliculi involved in visual reflexes
can suppress or exaggerate 1. Spinal cord and receive touch and auditory
reflexes. - extends from the foramen input
- reflex arc; neuronal pathway by magnum at the base of the skull to - substantia nigra; part of the basal
which a reflex occurs, the smallest, the second lumbar vertebra nuclei, involved in regulating
simplest pathway capable of 2. Spinal nerve general body movements
receiving a stimulus and yielding a - communicate between the spinal 5. Reticular formation
response. cord and the body - a group of nuclei collectively
- Reflex arc has 5 basic scattered throughout the brainstem
components; sensory receptor Cross-section of the Spinal cord - involved in regulating cyclical
(respond to stimuli and produce - reveals that the spinal cord motor functions, such as
action potentials in sensory consists of a superficial white respiration, walking, and chewing
neurons), sensory neuron matter portion and a deep gray - reticular activating system; plays
(propagate action potentials to the matter portion an important role in arousing and
CNS), interneurons (synapse with 1. White matter maintaining consciousness and in
sensory neurons and with motor - consists of myelinated axons regulating the sleep-wake cycle.
neurons), motor neuron (carry 2. Gray matter 6. Cerebellum
action potentials from the CNS to - a collection of neuron cell bodies
- is attached to the brainstem by surface area of the cerebral cortex) - transmits action potentials dealing
several large connections called and sulci (grooves) with touch, position, and pressure
cerebellar peduncles 4. Spinocerebellar tract
- provide routes of communication Lobes of the Cerebrum - carry proprioceptive information to
between the cerebellum and other 1. Frontal lobe the cerebellum, where information
parts of the CNS - control of voluntary motor concerning actual movements can
functions, motivation, aggression, be monitored and compared with
Parts of the brainstem mood, and olfactory (smell) cerebral information representing
1. Diencephalon reception intended movements.
- part of the brain between the - central sulcus; separates frontal - transmit information about body
brainstem and the cerebrum and parietal lobe position to the cerebellum
- contains the thalamus, 2. Parietal lobe
epithalamus, and hypothalamus - principal center for receiving and Primary somatic sensory cortex
2. Thalamus consciously perceiving most - primary sensory areas; ascending
- the largest part of the sensory information, such as touch, tracts project to specific regions of
diencephalon pain, temperature, and balance the cerebral cortex where
- consists of a cluster of nuclei and 3. Occipital lobe sensations are perceived
is shaped somewhat like a yo-yo, - functions in receiving and - primary somatic sensory cortex; or
with two large, lateral parts perceiving visual input and is not general sensory area, is located in
connected in the center by a small distinctly separate from the other the parietal lobe posterior to the
interthalamic adhesion lobes central sulcus
- influences mood and registers an 4. Temporal lobe - sensory fibers carrying general
unlocalized, uncomfortable - involved in olfactory (smell) and sensory input, such as pain,
perception of pain auditory (hearing) sensations and pressure, and temperature,
3. Epithalamus plays an important role in memory, synapse in the thalamus, and
- small area superior and posterior - contains psychic cortex for thalamic neurons relay the
to the thalamus abstract thought and judgement, information to the primary somatic
- consists of a few small nuclei - separated from the rest by lateral sensory cortex
- involved in the emotional and fissure (deep within it is the insula/ - visual cortex in the occipital lobe,
visceral response to odors, and the fifth lobe) primary auditory cortex in the
pineal gland temporal lobe, and the taste area in
- pineal gland; an endocrine gland Ascending tracts the insula
that may influence the onset of - transmit information via action - associate area; cortical areas
puberty and may play a role in potentials from the periphery to immediately adjacent to the primary
controlling some long-term cycles various parts of the brain sensory areas, involved in the
that are influenced by the light-dark 1. Anterolateral system process of recognition
cycle - one of the two major systems that
4. Hypothalamus convey cutaneous sensory Somatic motor area
- most inferior part of the information to the brain - responsible for maintaining the
diencephalon - includes three tracts: body’s posture and balance, as well
- homeostasis (body temperature, spinothalamic, spinoreticular, and as moving the trunk, head, limbs,
hunger, thirst), sensations spinomesencephalic tongue, and eyes and
(sexual pleasure, rage, fear, and 2. Spinothalamic tract communicating through facial
relaxation), emotional responses - transmits action potentials dealing expressions and speech
(“nervous perspiration” with pain and temperature to the 1. Primary motor cortex
or “emotional eating”, odors and in thalamus and on to the cerebral - located in the posterior portion of
memory), and secretions (pituitary cortex the frontal lobe, directly anterior to
gland) - allows conscious perception of the central sulcus
- infundibulum; funnel-shaped stalk pain and temperature information, - control voluntary movements of
that extends from the floor of the as well as light touch and pressure, skeletal muscles
hypothalamus to the pituitary gland tickle, and itch sensations 2. Premotor area
5. Cerebellum 3. Dorsal-column system - where motor functions are
- largest part of the brain - consists of two pathways that organized before they are actually
- longitudinal fissure; divides the left carry the sensations of two-point initiated in the primary motor cortex
and right hemisphere discrimination, proprioception, 3. Prefrontal area
- gyri (folds, greatly increases the pressure, and vibration - the motivation and foresight to
plan and initiate movements occur 1. Vestibulocerebellum - lasts longer than working memory
in the anterior portion of the frontal - receives direct input from the and can be retained for a few
lobes vestibular structures, especially the minutes to a few days
- well-developed in humans semicircular canals and sends - stored by a mechanism involving
- involved in motivation and axons to the vestibular nuclei of the increased synaptic transmission
regulation of emotional behavior brainstem 2. Long-term memory
and mood - maintain muscle tone in postural - short-term is transferred to long-
4. Upper motor neuron muscle, control balance, and term where it may be stored for only
- connect the cerebral cortex to coordinate eye movement a few minutes or become
lower motor neurons directly or 2. Spinocerebellum permanent, by consolidation, a
through interneurons - consists of the vermis and the gradual process involving the
5. Lower motor neuron medial portion of the lateral formation of new and stronger
- connect upper motor neurons to hemisphere synaptic connections
skeletal muscles - helps accomplish fine motor - length of time memory is stored
coordination of simple movements may depend on how often it is
Descending tracts by means of its comparator function retrieved and used
1. Direct pathway (pyramidal 3. Cerebrocerebellum - declarative(/explicit) memory;
system) - consists of the lateral two-thirds of involves the retention of facts, such
- upper motor neurons in the the lateral hemispheres as names, dates, and places, as
cerebral cortex, whose axons form - communicates with the motor, well as related emotional
these pathways, synapse directly premotor, and prefrontal portions of undertones
with lower motor neurons in the the cerebral cortex in planning and - procedural(/reflexive) memory;
brainstem or spinal cord practicing rapid, complex motor involves the development of motor
- forms the medullary pyramid actions that require coordination skills, only a small amount of
2. Indirect pathways and training procedural memory is lost over time
(extrapyramidal system) - memory engrams; involved in the
- no direct connection exists Cerebral hemisphere long-term retention of a given piece
between the cortical and spinal 1. Right cerebral hemisphere of information, a thought, or an idea
neurons - controls muscular activity in and
- axons from motor neurons of the receives sensory input from the left Meningeal layers
cerebrum and cerebellum do not half of the body - surrounds and protects the brain
directly synapse with lower motor 2. Left cerebral hemisphere and spinal cord
neurons instead, they synapse in - controls muscles in and receives 1. Dura mater
an intermediate nucleus in the sensory input from the right half of - most superficial and thickest of the
brainstem. the body meninges
- cerebral cortex, basal nuclei, and 2. Arachnoid mater
cerebellum Speech - very thin, wispy, cobweb-like
3. Basal nuclei 1. Wernicke area (sensory speech - subdural space; space between
- group of functionally related nuclei area) dura mater and arachnoid mater
- important in planning, organizing, - a portion of the parietal lobe 3. Pia mater
and coordinating motor movements - necessary for understanding - very tightly bound to the surface of
and posture and formulating coherent speech the brain and spinal cord
- corpus striatum; located deep 2. Broca area (motor speech area) - subarachnoid space; space
within the cerebrum - in the inferior part of the frontal between arachnoid mater and pia
- substantia nigra; a group of darkly lobe mater
pigmented cells in the midbrain - initiates the complex series of
movements necessary for speech Ventricles
Cerebellum - fluid-filled cavities which are quite
- attached by cerebellar peduncles Working memory small in some areas and large in
to the brainstem - brain briefly stores information others
- composed of gray matter and has required for the immediate 1. Lateral ventricle (1st and 2nd)
gyri and sulci, but the gyri are much performance of a task - separated from each other by a
smaller than those of the cerebrum - transient, lasting only a few thin membrane called the septum
- involved in maintaining balance seconds to minutes, but highly pellucidum
and muscle tone and in detailed. 2. 3rd ventricle
coordinating fine motor movement 1. Short-term memory - smaller cavity located at the
midline between the two halves of eyeball - perform regular exercise
the thalamus 5. Somatic motor, sensory, and
- two lateral ventricles are parasympathetic
connected with the third ventricle - Facial (VII); controls all the
through two interventricular muscles of facial expression, a
foramina small muscle in the middle ear, and
3. 4th ventricle two hyoid muscles.
- inferior part of the pontine region - Glossopharyngeal (IX); supplies
and the superior region of the parasympathetic innervation to the
medulla oblongata at the base of parotid salivary glands, somatic
the cerebellum motor to one muscle of the pharynx,
and sensory for the sense of taste
Cerebrospinal fluid in the posterior one-third of the
- a clear fluid similar to blood serum tongue.
but without most of the proteins - Vagus (X); Most muscles of the
- bathes the brain and the spinal soft palate, pharynx, and larynx are
cord and provides a protective innervated in this nerve
cushion around the CNS
Effects of aging on the nervous
Cranial nerves system
1. Sensory - general decline in sensory
- Olfactory (I); exclusively sensory (because of decreases in the
and are involved in the special number of sensory neurons,
senses of smell and vision reduced function of the remaining
- Optic (II); exclusively sensory and neurons, and decreased CNS
are involved in the special senses processing) and motor function
of smell and vision (muscle fibers innervated
- Vestibulocohlear (VIII); transmits by the lost motor neurons are also
action potentials from the inner ear lost, resulting in a general
responsible for the special senses decline in muscle mass and more
of hearing and balance rapid fatigue)
2. Somatic motor - short-term memory decreases in
- Trochlear (IV); innervates one of most older people (Older people
the six eye muscles responsible for have the most difficulty assimilating
moving the eyeball information that is unfamiliar and
- Abducens (VI); innervates one of presented verbally and rapidly),
the six muscles responsible for thinking ability does not decrease in
moving the eyeball (lateral rectus) most older people (Long-term
- Accessory (XI); somatic motor memory appears to be unaffected
nerve that has both cranial and or even improved in older people)
spinal roots. - physical (size and weight of the
- Hypoglossal (XII); supplies the brain decrease) and psychological
intrinsic tongue muscles, three of (Older people tend to require more
the four extrinsic tongue muscles, time to fall asleep and experience
and the thyrohyoid and the more periods of waking during the
geniohyoid muscles night, which are also of greater
3. Somatic motor and sensory duration) functions deteriorate.
- Trigeminal (V); supplies motor
innervation to the muscles of General nursing care of the
mastication, one middle ear muscle, Nervous System
one palatine muscle, and two throat - maintain an adequate intake of vit
muscles. B complex
4. Somatic motor and - encourage use of stress
parasympathetic management skills such as
- Oculomotor (III); innervates four relaxation techniques
of the six muscles that move the - promote adequate sleep
M7: SPECIAL SENSES
Sensation organ (eyes and ears)  both senses complement each
- the process initiated by stimulating  localized clusters of receptors other and respond to many same
sensory receptors (taste buds and the olfactory stimuli
epithelium)
General senses Olfaction: Sense of Smell
- receptor types:
- have receptors distributed over a 1. Olfactory epithelium
 smell- chemoreceptors
large part of the body  specialized epithelium that lines the
- touch  taste- chemoreceptors
nasal cavity
- divided into 2 categories:  sight- photoreceptors
 approx. 10 mil olfactory neurons
1. Somatic senses  hearing- mechanoreceptors
 long specialized cilia lie in a thin
- provide sensory information about  balance- mechanoreceptors mucous film on the epithelial surface
the body and the environment Touch receptors 2. Mucus
2. Visceral senses 1. Merkel disks  keeps nasal epithelium moist
- provide information about various - small, superficial nerve endings  traps, dissolves odorants
internal organs, primarily involving involved in detecting light touch and
 facilitates removal of molecules and
pain and pressure superficial pressure particles from the nasal epithelium
Sensory receptors 2. Hair follicle receptor  chemicals must be dissolved in
- sensory nerve endings or - associated with hairs, are also mucus for detection
specialized cells capable of involved in detecting light touch 3. Olfactory receptors
responding to stimuli by developing 3. Meissner corpuscles  found in the roof of the nasal cavity
action potentials - located just deep to the epidermis  binds with multiple odorants
- different sensory receptors: - very specific in localizing tactile  desensitizes once an odorant is
1. Mechanoreceptors- respond to sensations bound and does not respond to
mechanical stimuli, such as the 4. Ruffini corpuscles another odorant for some time
bending or stretching of receptors - deeper tactile receptors [Adaptation]
2. Chemoreceptors- respond to - detecting continuous pressure in
chemicals. For example, odor the skin Pathway of Olfaction
molecules bind to chemoreceptors, 5. Pacinian corpuscles 1. Processes of the olfactory nerves
allowing us to perceive smells - relay information concerning deep formed by the axons of the olfactory
3. Photoreceptors- responds to pressure, vibration, and position neurons, project through the
light (proprioception) foramina in the cribriform plate to the
4. Thermoreceptors- respond to olfactory bulb (impulse is transmitted
Pain via the olfactory nerve 1)
temperature changes - characterized by a group of
5. Nocireceptors- respond to 2. Axons of the neurons in the
unpleasant perceptual and emotional olfactory bulb project through the
stimuli that result in the sensation experiences
of pain olfactory tract to the olfactory areas
- receptor types: Referred pain of the cerebrum (interpretation of
 touch- mechanoreceptors - perceived to originate in a region of smells is made in the cerebral cortex
 pressure- mechanoreceptors the body that is not the source of the specifically olfactory area of temporal
pain stimulus lobe which does not pass through the
 proprioception- mechanoreceptors
thalamus)
 temperature- thermoreceptors Special senses 3. The central olfactory cortex areas
 pain- nocireceptors - smell, taste, sight, hearing, and located in the temporal and frontal
Special senses balance lobes are involved in the complex
- more specialized in structure and processing of olfactory stimuli
Chemical Senses
are localized to specific parts of the perception (olfaction cortex is
 taste and smell
body involved in the conscious perception
 both use chemoreceptors;
- smell, taste, sight, hearing, and of smell and the visceral and
stimulated by chemicals in solution
balance emotional reactions often link odors)
 taste has 5 types of receptors [prolonged exposure= adaptation,
- special sense receptors:
 smell can differentiate a large range feedback loops between olfactory
 specific large, complex sensory
of chemicals bulb and complex]
M7: SPECIAL SENSES
Sense of Taste  alkaloids (crease)
 tongue is covered with projections 4. Salty receptors - palpebral fissure; space between
called papillae  metal ions the 2 eyelids
- filiform papillae (sharp w/ no taste 5. Umami - canthus; angles where the eyelids
buds)  glutamate, aspartate, MSG, meat join at the medial lateral margins of
- vallate (leaf-shaped) the eye
- fungiform papillae (rounded w/ Pathway of Taste 3. Caruncle
taste buds) 1. Cranial nerves transmits taste - small, reddish-pink mound which
- circumvallate papillae (large impulses houses modified sweat and
papillae w/ taste buds)  facial 7- anterior 2/3 of the tongue, sebaceous gland
 taste buds are found on the sides taste sensations is transmitted 4. Ciliary glands
of papillae through chorda tympani - modified sweat glands
 glossopharyngeal 9- posterior 1/3 - stye (inflamed ciliary gland)
Taste buds  vagus 10- root of the tongue, 5. Meibomian/ Tarsal glands
 oval structures located on the epiglottis - modified sebaceous glands
surface of certain papillae which are 2. Brainstem (medulla oblongata) - produce oily secretion (sebum) to
enlargements on the surface of the  axons synapse in the taste portion lubricate the eye
tongue of the brainstem nuclei (Tractus 6. Conjunctiva
 house the taste receptors solitarius) - a thin, transparent mucous
 location: 3. Thalamus membrane covering the inner surface
- most are on the tongue 4. Impulse are carried to the of the eyelids and the anterior
- soft palate gustatory complex in the insula of surface of the eye
- epiglottis the cerebrum - connects to the surface of eye
- pharynx  between temporal and parietal - secretes mucus to lubricate eye
- cheeks lobes - conjunctivitis [sore eyes]; inflamed
conjunctiva
Structurs of Taste Buds Developmental aspects - palpebral conjunctiva; covers the
1. Gustatory/ Taste cells  formed early in the embryonic inner surface of the eyelids
 are the receptors development - bulbar conjunctiva; covers the
 have gustatory hairs (long  eyes are outgrowths of the brain anterior white surface of the eye
microvilli) extending from the taste  all special senses are functional at 7. Lacrimal apparatus
pore birth - lacrimal gland and duct; located
 hairs are stimulated by tastants above the lateral end of each eye,
dissolved in saliva External and Accessory structures
releases dilute salt solution through
 all taste buds can detect all 5 tastes of the eye several small ducts, innervated by
but are most sensitive to one class - adult eyes is spherical, 1” in
parasympathetic facial nerve 7
 strongly influenced by olfaction diameter
- pathway of tears:
- 1/6th is only visible part
 other factors that influence taste: 1. Lacrimal gland through ducts
- cushion of fat encloses and protects
- texture of food 2. Superior and inferior canaliculi
the eye and the walls of the bony
- food temp through punctum
orbit
- adaptation may begin within 1 or 2 3. Lacrimal sac
1. Eyebrows
seconds 4. Nasolacrimal duct
- protect the eyes by preventing
- complete adaptation may occur in
perspiration from running down the Extrinsic Eye Muscles
5 minutes
forehead and into the eyes, causing - 6 cardinal gazes:
Taste sensations irritation 1. Lateral rectus 
1. Sweet receptors - help shade the eyes from direct - moves eye away from the center/
 sugars, saccharine, some amino sunlight laterally
acids 2. Eyelids - controlled by abducens 6
2. Sour receptors - protect the eyes from foreign 2. Medial rectus 
 acids objects - moves eye toward the center/
3. Bitter receptors - meets at medial and lateral canthus medially
M7: SPECIAL SENSES
- controlled by oculomotor 3 is not reflected inside the eye rhodopsin (contain a photosensitive
3. Superior rectus  - ciliary body pigment), edges of the retina, more
- elevates the eye and turns it  continuous with the choroid, iris is sensitive to light, low vision, all grey
medially attached at its lateral margins tones, problem night blindness
- controlled by oculomotor 3  contains smooth muscles called ; cones (6/7 mil)- colored, iodopsin,
4. Inferior rectus  ciliary muscles which attaches to the densest center of retina, fovea
- depress eye and turns it medially suspensory ligaments centralis (area where there are
- controlled by oculomotor 3  consist of an outer ciliary ring and cones), bright light, visual acuity, 3
5. Inferior oblique  an inner group of ciliary processes types (blue for short, green for
- elevates eye and turns it laterally which is held by the suspensory medium, green red for long),
- controlled by oculomotor 3 ligaments problem color blindness
6. Superior oblique  - iris  pathway of light
- depress eye and turns it laterally  pigmented part of the eye 1. Ganglion cells (form optic nerve
- controlled by trochlear 4  contracts to adjust pupil size fiber)
[LR6-SO4-R3]  more melanin= darker, less 2. Bipolar cells
melanin= lighter 3. Photoreceptors (rods and cones)
Tunics of the eye 4. Pigment epithelium
- pupil
1. Fibrous tunic - lens
- sclera  round opening in the iris where light
enters  held in place by suspensory
 firm, white, connective tissue layer ligament
 smooth muscles:
 “white of the eye”  transparent (crystal-like) and
1. Sphincter pupillae; constricts
 help maintain the shape of the biconvex
pupil size, controlled by
eyeball  refracts light greatly
parasympathetic fiber of oculomotor
 protects internal structures  change shape to focus for closer
2. Dilator pupillae; dilates the pupil,
 provides attachment point for controlled by sympathetic fibers objects
muscles  muscles contract as a result of
 together with ciliary muscles,
- cornea parasympathetic simulation form
intrinsic eye muscle; regulate the
 transparent central anterior portion light that gets in the eye oculomotor 3
 allows passage of light 3. Nervous tunic  convex (far), concave (near)
 self-repair - retina  myopia (nearsighted), hyperopia
 can be easily transplanted due to  sensory layer (farsighted), presbyopia (40’s),
no rejection  covers the inner surface of the astigmatism (irregular curvature of
 extensive injury to this cause eyeball posterior to the ciliary body eye)
connective tissue deposition making  signals leave retina toward the
it opaque brain through the optic nerve 1
2. Vascular tunic  innermost tunic
- blood rich, nutritive tunic
 composed of two layers:
- contains the following arteries:
1. outer pigmented retina
 ophthalmic artery; branch of the ; keeps light from reflecting back
internal carotid artery into the eye
 short ciliary arteries ; composed of pigmented simple
- large number of melanin- containing cuboidal epithelium
pigment cells prevent light from ; absorbs light and prevent it from posterior region of the retina
scattering scattering 1. Macula
- uvea: iris, ciliary body, choroid ; cells act as phagocytes that  small, yellow spot near the center
- choroid remove dead receptor cells and of the posterior in the retina
 very thin structure consists of a store vit A for vision 2. Fovea centralis-
vascular network and many melanin- 2. inner sensory retina  where light is focused
containing pigment cells, causing it to ; responds to light  contains only cone cells, cells are
appear black ; rods (120 mil)- non-color, tightly packed
 black color absorbs light, so that it
M7: SPECIAL SENSES
 high number of photoreceptors= 4. Lens (accommodation) Structures of the Outer Ear
greatest visual acuity (see fine 5. Retina (real image)  for hearing only
images) 6. Photoreceptors of the retina 1. Pinna (Auricle)
3. Optic disk 7. Bipolar and ganglion cells  fleshy part of the external ear on
 white spot medial to the macula 8. Optic nerve 2 the outside of the head
through which the central retinal 9. Optic nerve crosses optic chiasma  shape helps collect sounds
artery enters and the central retinal 10. Optic tracts 2. External auditory canal
vein exits the eyeball 11. Thalamus (axons form optic  where auricle opens into a
 where neural layer and retina meet radiations) passageway that leads to the
 exits eye as optic nerve 12. Visual cortex of the occipital lobe eardrum
 no photoreceptor cells Eye reflexes  channels sound inward
 called the blind spot 1. Internal muscles  narrow chamber in temporal bone
 controlled by the autonomic N.S. through the external auditory meatus
Chambers of the eye
 photopupillary reflex; constricts  lined with skin and hair
1 Anterior chamber
pupils due to bright light through  presence of ceruminous (earwax)
 located between cornea and lens
action of iris and ciliary muscles, from ceruminous glands that prevent
 both are separated by the iris
protects retina from damage due to foreign objects from reaching delicate
 filled with aqueous humor helps tympanic membrane
excess light, oculomotor 3
maintain pressure within the eye,  ends at the tympanic membrane
refracts light, and provides nutrients  accommodation pupilliary reflex;
to the inner surface of the eye viewing close obj causes Structures of the middle ear
accommodation, pupils constrict
 aqueous humors; thin and watery,  auditory tube connecting middle ear
reflexively when viewing close
helps maintain intraocular pressure with the throat allows equalizing
objects for more acute vision, lens
for stability in shape, refracts light pressure during yawning and
accommodation
and provide anterior chamber swallowing, collapsed
2. External muscles
structures, produced by ciliary  distorted tympanic membrane
process as blood filtrate, canal of  control eye movement to follow obj
dampens vibrations making hearing
schlemme returns to the circulation at  voluntary, controlled at the frontal difficult and pain stimulated
base of cornea eye field 1. Tympanic membrane [eardrum]
 inhibition of circulation: glaucoma  viewing close obj causes  small, air-filled, mucosa-lined cavity
2. Posterior chamber convergence (eyes moving medially) within the temporal bone
- between eyelids and lens  for hearing only
- aqueous humor 2. Ossicles
3. Vitreous chamber  three bones span the cavity:
- posterior to the lens  malleus (hammer)
- filled with transparent, jellylike  incus (anvil)
substance called vitreous humor  stapes (stirrup)
- vitreous humor; between lens and
 transmit vibration from tympanic
retina, helps maintain pressure within
membrane to inner ear through the
the eye and holds the lens and the Ear oval window
retina in place, maintain intraocular  houses 2 senses
pressure 1. Hearing – temporal lobe Structures of the inner ear
 cornea, aqueous, humor, lens and 2. Equilibrium – cerebellum  known as osseus labyrinth (twisted
vitreous humor act as small lenses  mechanoreceptors bony tubes)
and refract light to focus on the retina  divided into 3 areas: outer, middle,  hearing and balance
and inner ear  line w/ endosteum
Visual pathway
 external and middle ear are for 1. Labyrinth
1. Conjunctiva
2. Cornea hearing only  bony labyrinth- within is a similarly
3. Iris and pupil (pupil constriction,  inner ear is for hearing and shaped but smaller set of
depth of focus= pupil constriction) balance membranous tunnels and chambers
called membranous labyrinth
M7: SPECIAL SENSES
 membranous labyrinth- covered Organs of equilibrium ganglion
with thin layer of perilymphatic cells,  receptor cells are in 2 structures: 3. Join with the cochlear ganaglion to
filled with endolymph, space between 1. Vestibule- static equilibrium form the vestibulocochlear nerve 8
both labyrinths is filled with 2. Semicircular canals- dynamic 4. Vestibular nucleus within the
perilymphs equilibrium medulla oblongata
 stapes push and pull on the - Static equilibrium 5. Axons run to numerous areas of
membranous oval window, moving  state of balance relative to the force the CNS such as the spinal cord,
the perilymph through the cochlea of gravity cerebellum, cerebral cortex, nuclei
 round window is a membrane at the  structures involved: controlling extrinsic eye muscles
opposite end relieves pressure 1. Vestibule Hearing and Equilibrium Deficits
2. Spiral organ/ organ of corti - Utricle macula (oriented parallel 1. Deafness
 located within the Cochlea to the base of the skull) - hearing loss of any degree
 hair cells are sensory cells for - Saccule macula (perpendicular
 conductive hearing loss
hearing, located in the basilar to the base of the skull)
- mechanical deficit in transmission
membrane, have no axons by each 2. Maculae
of sound waves from external ear to
basilar region is covered by synaptic - receptors in the vestibule
spiral organ
terminal of sensory neurons - report on the position of the head at
- can still hear through bone
 endolymph found in the rest (static)
conduction even if ability to hear air
membranous labyrinth of the - send info to vestibular nerve 8
conducted sounds is decreased or
cochlear duct flows over it and - hair cells are embedded in the
lost
pushes on the membrane otolithic membrane
- can be corrected through hearing
 tectorial membrane is capable of - otoliths, tiny stones made of Ca
aids
bending hair cells salts, float in a gel around the hair
 sensorineural hearing loss
 cochlear nerve is attached to the cells
- deficit of spiral organ or nerve
hair cells, transmits nerve impulse, - movement causes otoliths of bend
pathways; often result from extended
joining with vestibular nerve to the hair cells
listening to excessively loud sounds
become vestibulocochlear nerve 7 - gravity moves “rocks” over and pulls
- cannot hear better, by either,
transverses the internal auditory the hairs
conduction route
canal and enters the cranial cavity - Dynamic equilibrium
2. Otosclerosis
 involves the maintenance of
Mechanism of hearing - type of conductive hearing loss
balance during sudden movement
1. External ear resulting form fusion of ossicles
 structures involved:
2. Tympanic membrane 1. Semicircular canals
3. Vibration of ossicles - respond to angular and rotary
4. Oval window movement rather than straight-line
5. Cochlea movements
- endolymph and perilymph - whole structure is the ampulla
- round window (sound is dampen) - crista ampullaris; receptors at the
- basilar membrane (bent hair cells) base of the semicircular canals, tuft
6. Action potential in cochlear nerve of hair cells covered in cupula
7. Neuron synapse in or pass - action of angular head movements
through the superior olivary nucleus  cupula stimulates the hair cells
(terminating neurons may synapse to 1. Movement of endolymph (pushes
efferent neuron to return to the the cupula over and pulls the hairs)
cochlea to modulate pitch perception 2. Impulse is sent via the vestibular
8. Thalamus nerve 8 to the cerebellum
9. Signal is transmitted to the brain
(auditory cortex of the temporal lobe), Mechanism of Balance
continued stimulation can lead to 1. Neurons on the hair cells in the
adaptation maculae and crista ampullaris
2. Converge into the vestibular
M7: SPECIAL SENSES
3. Tinnitus
- phantom sound sensations such as
ringing in the ears
4. Presbycusis/ prebyacusis
- as people age, the number of hair
cells in the cochlea decreases
leading to age-related hearing loss
5. Otitis media
- infection in middle ear, usually in
young children
6. Otitis interna
- infection in inner ear, may be cause
by otitis media, can decrease
detection of sound and maintainance
of balance
7. Motion sickness
- nausea and weakness caused
when info to the brain from the
semicircular canal conflicts with the
info in the eyes and position sensors
in the back and lower limbs
8. Meniere disease
- vertigo, hearing loss, dizziness,
tinnitus, and a feeling of fullness in
the affected ear, unknown causes but
may involve a fluid abnormality in
ears
Effects of Aging on the senses
- functional decline in all the special
senses: olfactory, taste, vision,
hearing, and balance
- loss of appetite, visual impairment,
disorientation, and risk of falling
General Nursing Care of the
Special sense
- provide proper and adequate
nutrition
- perform proper cranial nerve
assessment
- promote adequate rest and sleep

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M1: Introduction to Human Anatomy and Physiology

Anatomy - secrete regulatory hormones Survival Needs

Body Planes and Sections

Abdominopelvic Regions Abdominopelvic Quadrants

Abdominopelvic Major Organs Body Cavities

Arm (including the 9 percent

Anterior trunk (front 18

Posterior trunk (back 18

Nursing Interventions for

Bone and Calcium Homeostasis

1. Decreased blood Ca2+ stimulates PTH secretion from

Effects of Aging with the skeletal system

1. Coccyx 18. Carpal

1. Parietal bone 12. Nasal cavity

1. Superior articular facet

1. Facets for rib attachment

1. True ribs (1-7)

2. Plantar flexion and Dorsiflexion 5. Elevation and Depression

6. Protraction and Retraction

7. Opposition and Reposition

8. Inversion and Eversion

Muscles of the trunk

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