UNIT 1

Anatomy, Physiology and the Human Body

Learning Outcomes

At the end o3123123112f this lesson, you will be able to:

 Defi`12`21`2`1ne the terms anatomy and physiology;

 name the body systems;
 analyze situations regarding homeostasis; and
 identify positions of body parts using directional terms.

Pretest

Match the terms in Column B to the appropriate descriptions provided in Column A. Enter the
correct letter or its corresponding term in the answer blanks.

Column A Column B

_________1. The branch of biological science that Anatomy

studies and describes how body parts
work or function. Homeostasis
_________2. The study of the shape and structure
of body parts. Metabolism
_________3. The tendency of the body’s systems to
maintain a relatively constant or balanced Physiology
internal environment.
_________4. The term that indicates all chemical
reactions occurring in the body.

Content

Anatomy (Greek anatomē, 'dissection') is the branch of biology concerned with the study of the
structure of organisms and their parts.

Physiology is the scientific study of functions and mechanisms in a living system.

Human beings are arguably the most complex organisms on this planet. Imagine billions of
microscopic parts, each with its own identity, working together in an organized manner for the
benefit of the total being. The human body is a single structure but it is made up of billions of
smaller structures of four major kinds:

Cells
The simplest units of living matter that can maintain life and reproduce themselves. The
human body, which is made up of numerous cells, begins as a single, newly fertilized cell.
Tissues
 Are somewhat more complex units than cells. By definition, a tissue is an organization of a
great many similar cells with varying amounts and kinds of nonliving, intercellular substance
between them.

Organs
An organ is an organization of several different kinds of tissues so arranged that together
they can perform a special function.
Systems
A system is an organization of varying numbers and kinds of organs so arranged that
together they can perform complex functions for the body. Ten major systems compose the
human body:

 Skeletal
 Muscular
 Nervous
 Endocrine
 Cardiovascular
 Lymphatic
 Respiratory
 Digestive
 Lymphatic
 Urinary
 Reproductive

Body Functions

Body functions are the physiological or psychological functions of body systems. The body's
functions are ultimately its cells' functions. Survival is the body's most important business. Survival
depends on the body's maintaining or restoring homeostasis, a state of relative constancy, of its
internal environment. In homeostasis, body levels of acid, blood pressure, blood sugar, electrolytes,
energy, hormones, oxygen, proteins, and temperature are constantly adjusted to respond to
changes inside and outside the body, to keep them at a normal level.

 Task: For more details about homeostasis, pls. watch this video.
https://www.youtube.com/watch?v=Iz0Q9nTZCw4

Life Process

All living organisms have certain characteristics that distinguish them from non-living forms. The
basic processes of life include organization, metabolism, responsiveness, movements, and
reproduction. In humans, who represent the most complex form of life, there are additional
requirements such as growth, differentiation, respiration, digestion, and excretion. All of these
processes are interrelated. No part of the body, from the smallest cell to a complete body system,
works in isolation. All function together, in fine-tuned balance, for the wellbeing of the individual and
to maintain life. Disease such as cancer and death represent a disruption of the balance in these
processes.

The following are a brief description of the life process:

Organization
At all levels of the organizational scheme, there is a division of labor. Each component has
its own job to perform in cooperation with others. Even a single cell, if it loses its integrity or
organization, will die.
 Metabolism
Metabolism is a broad term that includes all the chemical reactions that occur in the body.
One phase of metabolism is catabolism in which complex substances are broken down into
simpler building blocks and energy is released.

Responsiveness
Responsiveness or irritability is concerned with detecting changes in the internal or external
environments and reacting to that change. It is the act of sensing a stimulus and responding
to it.
Movement
There are many types of movement within the body. On the cellular level, molecules move
from one place to another. Blood moves from one part of the body to another. The
diaphragm moves with every breath. The ability of muscle fibers to shorten and thus to produce
movement is called contractility.
Reproduction
For most people, reproduction refers to the formation of a new person, the birth of a baby. In
this way, life is transmitted from one generation to the next through reproduction of the
organism. In a broader sense, reproduction also refers to the formation of new cells for the
replacement and repair of old cells as well as for growth. This is cellular reproduction. Both
are essential to the survival of the human race.
Growth
Growth refers to an increase in size either through an increase in the number of cells or
through an increase in the size of each individual cell. In order for growth to occur, anabolic
processes must occur at a faster rate than catabolic processes.
Differentiation
Differentiation is a developmental process by which unspecialized cells change into
specialized cells with distinctive structural and functional characteristics. Through
differentiation, cells develop into tissues and organs.
Respiration
Respiration refers to all the processes involved in the exchange of oxygen and carbon
dioxide between the cells and the external environment. It includes ventilation, the diffusion of
oxygen and carbon dioxide, and the transport of the gases in the blood. Cellular respiration
deals with the cell's utilization of oxygen and release of carbon dioxide in its metabolism.
Digestion
Digestion is the process of breaking down complex ingested foods into simple molecules that
can be absorbed into the blood and utilized by the body.
Excretion
Excretion is the process that removes the waste products of digestion and metabolism from
the body. It gets rid of by-products that the body is unable to use, many of which are toxic
and incompatible with life.

The ten life processes described above are not enough to ensure the survival of the individual. In
addition to these processes, life depends on certain physical factors from the environment. These
include water, oxygen, nutrients, heat, and pressure.

Anatomical Terminology

Three groups of terms are introduced here:

Directional Terms.
Directional terms describe the positions of structures relative to other structures or locations
in the body.
  Superior or cranial - toward the head end of the body; upper (example, the hand is
part of the superior extremity).
 Inferior or caudal - away from the head; lower (example, the foot is part of the inferior
extremity).
 Anterior or ventral - front (example, the kneecap is located on the anterior side of the
leg).
 Posterior or dorsal - back (example, the shoulder blades are located on the posterior
side of the body).
 Medial - toward the midline of the body (example, the middle toe is located at the
medial side of the foot).
 Lateral - away from the midline of the body (example, the little toe is located at the
lateral side of the foot).
 Proximal - toward or nearest the trunk or the point of origin of a part (example, the
proximal end of the femur joins with the pelvic bone).
 Distal - away from or farthest from the trunk or the point or origin of a part (example,
the hand is located at the distal end of the forearm).

Planes of the Body

 Coronal Plane (Frontal Plane) - A vertical plane running from side to side; divides the
body or any of its parts into anterior and posterior portions.
 Sagittal Plane (Lateral Plane) - A vertical plane running from front to back; divides the
body or any of its parts into right and left sides.
 Axial Plane (Transverse Plane) - A horizontal plane; divides the body or any of its
parts into upper and lower parts.
Body Cavities
The cavities, or spaces, of the body contain the internal organs, or viscera. The two main
cavities are called the ventral and dorsal cavities. The ventral is the larger cavity and is
subdivided into two parts (thoracic and abdominopelvic cavities) by the diaphragm, a dome-
shaped respiratory muscle.
 Thoracic cavity
The upper ventral, thoracic, or chest cavity contains the heart, lungs, trachea,
esophagus, large blood vessels, and nerves. The thoracic cavity is bound laterally by
the ribs (covered by costal pleura) and the diaphragm caudally (covered by
diaphragmatic pleura).
 Abdominal and pelvic cavity
The lower part of the ventral (abdominopelvic) cavity can be further divided into two
portions: abdominal portion and pelvic portion. The abdominal cavity contains most of
the gastrointestinal tract as well as the kidneys and adrenal glands. The abdominal
cavity is bound cranially by the diaphragm, laterally by the body wall, and caudally by
the pelvic cavity. The pelvic cavity contains most of the urogenital system as well as
the rectum. The pelvic cavity is bounded cranially by the abdominal cavity, dorsally by
the sacrum, and laterally by the pelvis.
 Dorsal cavity
The smaller of the two main cavities is called the dorsal cavity. As its name implies, it
contains organs lying more posterior in the body. The dorsal cavity, again, can be
divided into two portions. The upper portion, or the cranial cavity, houses the brain,
and the lower portion, or vertebral canal houses the spinal cord.

Learning Activities

I. Body System
Using the key choices, identify the organ systems to which the following organs or functions belong.
Insert the correct letter or term in the answer blanks.

Key Choices

A. Cardiovascular D. Integumentary G. Nervous J. Skeletal

B. Digestive E. Lymphatic/Immune H. Reproductive K. Urinary
C. Endocrine F. Muscular I. Respiratory

_________________________1. Rids the body of nitrogen-containing wastes

_________________________2. Is affected by the removal of the thyroid gland
_________________________3. Provides support and levers on which the muscular system
can act
_________________________4. Includes arteries and veins
_________________________5. Protects underlying organs from drying out and mechanical
damage
_________________________6. Protects the body; destroys bacteria and tumor cells
_________________________7. Breaks down foodstuffs into small particles that can be
absorbed
_________________________8. Removes carbon dioxide from the blood
_________________________9. Delivers oxygen and nutrients to the body tissues
_________________________10. Moves the limbs; allows facial expression
_________________________11. Allows us to regulate body water volumes
_________________________12. Provides for conception and childbearing
_________________________13. Controls the body with chemicals called hormones
_________________________14. Is damaged when you cut your finger or get a severe sunburn

II. Homeostasis
The following statements refer to homeostatic control systems. Complete each statement by
inserting your answers in the answer blanks.

_____________1. There are three essential components of all homeostatic control

mechanisms: control center, receptor, and effector. The
_____________2. __1__ senses changes in the environment and responds by
sending information (input) to the __2__ along the __3__
_____________3. pathway. The __4__analyzes the input, determines the appropriate
response, and activates the __5__ by sending information along the
_____________4. __6__ pathway. When the response causes the initial stimulus to
decline, the homeostatic mechanism is referred to as __7__ feedback
_____________5. mechanism. When the response enhances the initial stimulus, the
mechanism is called a __8__ feedback mechanism. __9__ feedback
_____________6. Mechanisms are much more common in the body.

_____________7.

_____________8.

_____________9.

III. Directional Terms

 From the key choices, select the body cavities where the following surgical procedures would
occur. Insert the correct letter or term in the answer blanks. Be precise. Also select the name
of the cavity subdivision if appropriate.

Key Choices

A. Abdominal C. Dorsal E. Spinal G. Ventral

B. Cranial D. Pelvic F. Thoracic

_________________________ 1. Insertion of a shunt for hydrocephalus (water on the brain)

_________________________ 2. A gall bladder operation
_________________________ 3. Removal of a lung tumor
_________________________ 4. Investigation of an ovarian cyst
_________________________ 5. Removal of a kidney stone

Mastery Test

____1. Which of the following activities would not represent an anatomical study?

A. Making a section through the heart to observe its interior

B. Drawing blood from recently fed laboratory animals at timed intervals to determine their
blood sugar levels
C. Examining the surface of a bone
D. Viewing muscle tissue through a microscope

____2. The process that results in production of small molecules from large ones is:

A. digestion B. excretion C. respiration D. anabolism

____3. Which of the following is (are) involved in maintaining homeostasis?

A. Effector D. Feedback
B. Control center E. Lack of change
C. Receptor

____4. When a capillary is damaged, a platelet plug is formed. The process involves platelets
sticking to each other. The more platelets that stick together, the more the plug attracts
additional platelets. This is an example of:

A. negative feedback B. positive feedback

____5. A sagittal section through the body would pass:

A. through the liver, both kidneys, and pancreas

B. down the body’s midline
C. through the heart and the pancreas
D. across the thoracic cavity

____6. Which of the following statements is correct?

 A. The knee is superior to the ankle.
B. The heart is superficial to the kidneys.
C. The sternum is posterior to the coccyx.
D. The ankles are rostral to the shoulders.
E. The eyes are inferior to the teeth.

____7. Which of the following body regions is/are associated with the limbs?

A. Popliteal D. Olecranal
B. Acromial E. Inguinal
C. Gluteal

____8. A neurosurgeon orders a spinal tap for a patient. Into what body cavity will the needle be
inserted?

A. Ventral D. Cranial
B. Thoracic E. Pelvic
C. Dorsal

____9. An accident victim has a collapsed lung. Which cavity has been entered?

A. Mediastinal D. Vertebral
B. Pericardial E. Ventral
C. Pleural

____10. Which organ system is affected by the common cold?

A. Endocrine D. Digestive
B. Reproductive E. Cardiovascular
C. Respiratory

____11. The position of the heart relative to the structures around it would be described accurately
as:

A. deep to the sternum (breast bone)

B. lateral to the lungs
C. superior to the diaphragm
D. inferior to the ribs
E. anterior to the vertebral column

____12. What term(s) could be used to describe the position of the nose?

A. Intermediate to the eyes

B. Inferior to the brain
C. Superior to the mouth
D. Medial to the ears
E. Anterior to the ears

____13. The radiographic technique used to provide information about blood flow is:
 A. DSR D. ultrasonography
B. CT E.any X-ray technique
C. PET

____14. A patient complains of pain in the upper left quadrant. Which system is most likely
to be involved?

A. Lymphatic D. Cardiovascular
B. Reproductive E. Nervous
C. Endocrine

____15. Harry was sweating profusely as he ran in the 10-K race. The sweat glands producing
the sweat would be considered which part of a feedback system?

A. Stimulus C. Control center

B. Effectors D. Receptors
 UNIT 2
Cells, Tissues, and Membranes

Learning Outcomes

At the end of this lesson, you will be able to:

 Identify a cell model;

 differentiate active transport from passive transport;
 name four major tissue types and their subcategories; and
 discuss measures to prevent skin problems.

Pretest

_________________________ 1. 1–4. Name the four elements that make up the bulk of living
_________________________ 2. Matter.
_________________________ 3.
_________________________ 4.
_________________________ 5. Name the single most abundant material or substance in living
matter.
_________________________ 6. Name the trace element most important for making bones hard.
_________________________ 7. Name the element, found in small amounts in the body, that is
needed to make hemoglobin for oxygen transport.
_________________________ 8. 8–12. Although there are many specific “jobs” that certain cells
are able to do, name five functions common to all cells.
_________________________ 9.
_________________________10.
_________________________11.
_________________________12.

Content

Cells
The smallest structures capable of maintaining life and reproducing, compose all living things, from
single-celled plants to multibillion-celled animals. The human body, which is made up of numerous
cells, begins as a single, newly fertilized cell.

Almost all human cells are microscopic in size. To give you an idea how small a cell is, one
average-sized adult body, according to one estimate, consists of 100 trillion cells!

Cell Structure & Function

Cell Structure
Ideas about cell structure have changed considerably over the years. Early biologists saw cells as
simple membranous sacs containing fluid and a few floating particles. Today's biologists know that
cells are infinitely more complex than this.
  Task: Research for functions of cell structures above.

Cell Function
The structural and functional characteristics of different types of cells are determined by the nature
of the proteins present. Cells of various types have different functions because cell structure and
function are closely related. It is apparent that a cell that is very thin is not well suited for a
protective function. Bone cells do not have an appropriate structure for nerve impulse conduction.
Just as there are many cell types, there are varied cell functions. The generalized cell functions
include movement of substances across the cell membrane, cell division to make new cells, and
protein synthesis.

Movement of substances across the cell membrane.

The survival of the cell depends on maintaining the difference between extracellular and
intracellular material. Mechanisms of movement across the cell membrane include simple diffusion,
osmosis, filtration, active transport, passive transport, endocytosis, and exocytosis.

Simple diffusion is the movement of particles (solutes) from a region of higher solute concentration
to a region of lower solute concentration. Osmosis is the diffusion of solvent or water molecules
through a selectively permeable membrane. Filtration utilizes pressure to push substances through
a membrane. Active transport moves substances against a concentration gradient from a region of
lower concentration to a region of higher concentration. It requires a carrier molecule and uses
energy. Endocytosis refers to the formation of vesicles to transfer particles and droplets from
outside to inside the cell. Secretory vesicles are moved from the inside to the outside of the cell by
exocytosis.
Cell division
Cell division is the process by which new cells are formed for growth, repair, and replacement in the
body. This process includes division of the nuclear material and division of the cytoplasm. All cells
in the body (somatic cells), except those that give rise to the eggs and sperm (gametes), reproduce
by mitosis. Egg and sperm cells are produced by a special type of nuclear division called meiosis in
which the number of chromosomes is halved. Division of the cytoplasm is called cytokinesis.

Somatic cells reproduce by mitosis, which results in two cells identical to the one parent cell.
Interphase is the period between successive cell divisions. It is the longest part of the cell cycle.
The successive stages of mitosis are prophase, metaphase, anaphase, and telophase. Cytokinesis,
division of the cytoplasm, occurs during telophase.

Meiosis is a special type of cell division that occurs in the production of the gametes, or eggs and
sperm. These cells have only 23 chromosomes, one-
half the number found in somatic cells, so that when
fertilization takes place the resulting cell will again have 46
chromosomes, 23 from the egg and 23 from the sperm.

DNA replication and protein synthesis

Proteins that are synthesized in the cytoplasm function as
structural materials, enzymes that regulate chemical
reactions, hormones, and other vital substances. DNA in
the nucleus directs protein synthesis in the cytoplasm. A
gene is the portion of a DNA molecule that controls the
synthesis of one specific protein molecule. Messenger
RNA carries the genetic information from the DNA in the
nucleus to the sites of protein synthesis in the
cytoplasm.

Body Tissues
Tissue is a group of cells that have similar structure and that function together as a unit. A nonliving
material, called the intercellular matrix, fills the spaces between the cells. This may be abundant in
some tissues and minimal in others. The intercellular matrix may contain special substances such
as salts and fibers that are unique to a specific tissue and gives that tissue distinctive
characteristics. There are four main tissue types in the body: epithelial, connective, muscle, and
nervous. Each is designed for specific functions.
Epithelial Tissue
Epithelial tissues are widespread throughout the body. They form the covering of all body surfaces,
line body cavities and hollow organs, and are the major tissue in glands. They perform a variety of
functions that include protection, secretion, absorption, excretion, filtration, diffusion, and sensory
reception.

The cells in epithelial tissue are tightly packed together with very little intercellular matrix. Because
the tissues form coverings and linings, the cells have one free surface that is not in contact with
other cells. Opposite the free surface, the cells are attached to underlying connective tissue by a
non-cellular basement membrane. This membrane is a mixture of carbohydrates and proteins
secreted by the epithelial and connective tissue cells.

Epithelial cells may be squamous, cuboidal, or columnar in shape and may be arranged in single or
multiple layers.

Simple cuboidal epithelium is found in glandular tissue and in the kidney tubules. Simple columnar
epithelium lines the stomach and intestines. Pseudostratified columnar epithelium lines portions of
the respiratory tract and some of the tubes of the male reproductive tract. Transitional epithelium
can be distended or stretched. Glandular epithelium is specialized to produce and secrete
substances.

Connective Tissue
Connective tissues bind structures together, form a framework and support for organs and the body
as a whole, store fat, transport substances, protect against disease, and help repair tissue damage.
They occur throughout the body. Connective tissues are characterized by an abundance of
intercellular matrix with relatively few cells. Connective tissue cells are able to reproduce but not as
rapidly as epithelial cells. Most connective tissues have a good blood supply but some do not.
Numerous cell types are found in connective tissue. Three of the most common are the fibroblast,
macrophage, and mast cell. The types of connective tissue include loose connective tissue, adipose
tissue, dense fibrous connective tissue, elastic connective tissue, cartilage, osseous tissue (bone),
and blood.

Muscle Tissue
Muscle tissue is composed of cells that have the special ability to shorten or contract in order to
produce movement of the body parts. The tissue is highly cellular and is well supplied with blood
vessels. The cells are long and slender so they are sometimes called muscle fibers, and these are
usually arranged in bundles or layers that are surrounded by connective tissue. Actin and myosin
are contractile proteins in muscle tissue.

Muscle tissue can be categorized into skeletal muscle tissue, smooth muscle tissue, and cardiac
muscle tissue.

Skeletal muscle fibers are cylindrical, multinucleated, striated, and under voluntary control. Smooth
muscle cells are spindle shaped, have a single, centrally located nucleus, and lack striations. They
are called involuntary muscles. Cardiac muscle has branching fibers, one nucleus per cell,
striations, and intercalated disks. Its contraction is not under voluntary control.

Nervous Tissue
Nervous tissue is found in the brain, spinal cord, and nerves. It is responsible for coordinating and
controlling many body activities. It stimulates muscle contraction, creates an awareness of the
environment, and plays a major role in emotions, memory, and reasoning. To do all these things,
cells in nervous tissue need to be able to communicate with each other by way of electrical nerve
impulses. The cells in nervous tissue that generate and conduct impulses are called neurons or
nerve cells. These cells have three principal parts: the dendrites, the cell body, and one axon. The
main part of the cell, the part that carries on the general functions, is the cell body. Dendrites are
extensions, or processes, of the cytoplasm that carry impulses to the cell body. An extension or
process called an axon carries impulses away from the cell body.

Nervous tissue also includes cells that do not transmit impulses, but instead support the activities of
the neurons. These are the glial cells (neuroglial cells), together termed the neuroglia. Supporting,
or glia, cells bind neurons together and insulate the neurons. Some are phagocytic and protect
against bacterial invasion, while others provide nutrients by binding blood vessels to the neurons.

Membranes

Body membranes are thin sheets of tissue that cover the body, line body cavities, and cover organs
within the cavities in hollow organs. They can be categorized into epithelial and connective tissue
membrane.

Epithelial Membranes
Epithelial membranes consist of epithelial tissue and the connective tissue to which it is attached.
The two main types of epithelial membranes are the mucous membranes and serous membranes.

Mucous Membranes
Mucous membranes are epithelial membranes that consist of epithelial tissue that is attached to an
underlying loose connective tissue. These membranes, sometimes called mucosae, line the body
cavities that open to the outside. The entire digestive tract is lined with mucous membranes. Other
examples include the respiratory, excretory, and reproductive tracts.

Serous Membranes
Serous membranes line body cavities that do not open directly to the outside, and they cover the
organs located in those cavities. Serous membranes are covered by a thin layer of serous fluid that
is secreted by the epithelium. Serous fluid lubricates the membrane and reduces friction and
abrasion when organs in the thoracic or abdominopelvic cavity move against each other or the
cavity wall. Serous membranes have special names given according to their location. For example,
the serous membrane that lines the thoracic cavity and covers the lungs is called pleura.

Connective Tissue Membranes

Connective tissue membranes contain only connective tissue. Synovial membranes and meninges
belong to this category.

Synovial Membranes
Synovial membranes are connective tissue membranes that line the cavities of the freely movable
joints such as the shoulder, elbow, and knee. Like serous membranes, they line cavities that do not
open to the outside. Unlike serous membranes, they do not have a layer of epithelium. Synovial
membranes secrete synovial fluid into the joint cavity, and this lubricates the cartilage on the ends
of the bones so that they can move freely and without friction.

Meninges
The connective tissue covering on the brain and spinal cord, within the dorsal cavity, are called
meninges. They provide protection for these vital structures.

Learning Activities

I. Select the key choices that characterize each of the following statements.
Insert the appropriate answers in the answer blanks.

Key Choices
A. Active transport D. Exocytosis G. Phagocytosis
B. Diffusion, simple E. Facilitated diffusion H. Pinocytosis
C. Diffusion, osmosis F. Filtration I. Receptor-mediated endocytosis

_________________________ 1. Engulfment processes that require ATP.

_________________________ 2. Driven by molecular energy.
_________________________ 3. Driven by hydrostatic (fluid) pressure (typically blood pressure
in the body).
_________________________ 4. Moves down a concentration gradient.
_________________________ 5. Moves up (against) a concentration gradient; requires a carrier.
_________________________ 6. Moves small or lipid-soluble solutes through the membrane.
_________________________ 7. Transports amino acids and Na+ through the plasma membrane.
_________________________ 8. Examples of vesicular transport.
_________________________ 9. A means of bringing fairly large particles into the cell.
_________________________10. Used to eject wastes and to secrete cell products.
_________________________11. Membrane transport using channels or carrier proteins that does
not require ATP.
II. Using the key choices, correctly identify the major tissue types described.

Enter the appropriate letter or tissue type term in the answer blanks.

Key Choices:

A. Connective B. Epithelium C. Muscle D. Nervous

_________________________1. Forms mucous, serous, and epidermal membranes

_________________________2. Allows for organ movements within the body
_________________________3. Transmits electrochemical impulses
_________________________4. Supports body organs
_________________________5. Cells of this tissue may absorb and/or secrete substances
_________________________6. Basis of the major controlling system of the body
_________________________7. The cells of this tissue shorten to exert force
_________________________8. Forms hormones
_________________________9. Packages and protects body organs
_________________________10. Characterized by having large amounts of nonliving matrix
_________________________11. Allows you to smile, grasp, swim, ski, and shoot an arrow
_________________________12. Most widely distributed tissue type in the body
_________________________13. Forms the brain and spinal cord

Master Test
___1. The hydrophobic part of the plasma mem- brane is associated with which molecules?
A. Integral proteins C. Phospholipids
B. Glycoproteins D. Nucleic acids

___2. Which of the following would you expect to find in or on cells whose role is electrical
conduction?
A. Gap junctions C. Desmosomes
B. Cilia D. Microfilaments

___3. Which cytoskeletal element interacts with myosin to produce contractile force in mus- cle
cells?
A. Microtubules
B. Microfilaments
C. Intermediate filaments
D. None of the above

___4. If a 10% sucrose solution within a semiper- meable sac causes the fluid volume in the sac to
increase a given amount when the sac is immersed in water, what would be the effect of replacing
the sac solution with a 20% sucrose solution?
A. The sac would lose fluid.
B. The sac would gain the same amount of fluid.
C. The sac would gain more fluid.
D. There would be no effect.

___5. Which of the following are possible functions of the glycocalyx?

A. Determination of blood groups
B. Binding sites for toxins
C. Aiding the binding of sperm to egg
D. Guiding embryonic development
E. Increasing the efficiency of absorption

___6. The main function of the Golgi apparatus is:

A. packaging newly synthesized proteins.
B. ATP production for protein synthesis.
C. a store for cytotoxic enzymes.
D. production of ribosomess.

___7. A cell’s ability to replenish its ATP stores has been diminished by a metabolic poison. What
organelle is most likely to be affected?
A. Nucleus D. Microtubule
B. Plasma membrane E. Mitochondrion
C. Centriole

___8. The fundamental structure of the plasma membrane is determined almost exclusively by:
A. phospholipid molecules
B. peripheral proteins
C. cholesterol molecules
D. integral proteins
9.–11. Consider the following information for Questions 9–11:
A DNA segment has this nucleotide sequence:
AAGCTCTTACGAATATTC

___ 9. Which mRNA is complementary?

A. A A G C T C T T A C G A A T A T T C
B. T T C G A G A A T G C T T A T A A G
C. A A G C U C U U A C G A A U A U U C
D. U U C G A G A A U G C U U A U A A G

___10. How many amino acids are coded in this segment?

A. 18 C. 6
B. 9 D. 3

___11. What is the tRNA anticodon sequence for the fourth codon from the left?
A. G C. GCU
B. GC D. CGA

___12. The organelle that consists of a stack of 3–10 membranous discs associated with vesicles
is:
A. mitochondrion
B. smooth ER
C. Golgi apparatus
D. lysosome

___13. An epithelium “built” to stretch is:

A. simple squamous
B. stratified squamous
C. simple cuboidal
D. pseudostratified
E. transitional

___14. Which of the following fibrous elements give a connective tissue high tensile strength?
A. Reticular fibers
B. Elastic fibers
C. Collagen fibers
D. Myofilaments

___15. Viewed through the microscope, most cells in this type of tissue have only a rim of
cytoplasm.
A. Reticular connective
B. Adipose connective
C. Areolar connective
D. Osseous tissue
E. Hyaline cartilage

___16. Which type of cartilage is found between the vertebrae?

A. Elastic
B. Hyaline
C. Fibrocartilage
___17. Which of the following terms describe skeletal muscle?
A. Striated
B. Intercalated discs
C. Multinucleated
D. Voluntary
E. Branching

___18. Events of tissue repair include:

A. regeneration
B. organization
C. granulation
D. fibrosis
E. inflammation

___19. Which of the following does not describe nervous tissue?

A. Cells may have long extensions
B. When activated, shortens
C. Found in the brain and spinal cord
D. Involved in fast-acting body control
 UNIT 3
The Skeletal System

Learning Outcomes

At the end of this lesson, you will be able to:

 discuss the function of the skeletal system;

 name the bones of the axial and appendicular skeletons;
 demonstrate type of joint movements; and
 discuss measures on the care of bones and joints.

Pretest

Using the key choices, identify the body systems that relate to bone tissue viability. Enter the
appropriate key terms or letters in the answer blanks.

Key Choices

A. Endocrine C. Muscular E. Reproductive

B. Integumentary D. Nervous F. Urinary

_________________________ 1. Conveys the sense of pain in bone and joints

_________________________ 2. Activates vitamin D for proper calcium usage
_________________________ 3. Regulates uptake and release of calcium by bones
_________________________ 4. Increases bone strength and viability by pulling action
_________________________ 5. Influences skeleton proportions and adolescent growth
of long bones
_________________________ 6. Provides vitamin D for proper calcium absorption

Content

Bones
Humans are vertebrates, animals having a vertabral column or backbone. They rely on a sturdy
internal frame that is centered on a prominent spine. The human skeletal system consists of bones,
cartilage, ligaments and tendons and accounts for about 20 percent of the body weight.

The living bones in our bodies use oxygen and give off waste products in metabolism. They contain
active tissues that consume nutrients, require a blood supply and change shape or remodel in
response to variations in mechanical stress.

Bones provide a rigid framework, known as the skeleton, that support and protect the soft organs of
the body.

The skeleton supports the body against the pull of gravity. The large bones of the lower limbs
support the trunk when standing.
The skeleton also protects the soft body parts. The fused bones of the cranium surround the brain
to make it less vulnerable to injury. Vertebrae surround and protect the spinal cord and bones of the
rib cage help protect the heart and lungs of the thorax.

Bones work together with muscles as simple mechanical lever systems to produce body movement.

Bones contain more calcium than any other organ. The intercellular matrix of bone contains large
amounts of calcium salts, the most important being calcium phosphate.

When blood calcium levels decrease below normal, calcium is released from the bones so that
there will be an adequate supply for metabolic needs. When blood calcium levels are increased, the
excess calcium is stored in the bone matrix. The dynamic process of releasing and storing calcium
goes on almost continuously.

Hematopoiesis, the formation of blood cells, mostly takes place in the red marrow of the bones.

In infants, red marrow is found in the bone cavities. With age, it is largely replaced by yellow
marrow for fat storage. In adults, red marrow is limited to the spongy bone in the skull, ribs,
sternum, clavicles, vertebrae and pelvis. Red marrow functions in the formation of red blood cells,
white blood cells and blood platelets.

Structure of Bone Tissue

There are two types of bone tissue: compact and spongy. The names imply that the two types differ
in density, or how tightly the tissue is packed together. There are three types of cells that contribute
to bone homeostasis. Osteoblasts are bone-forming cell, osteoclasts resorb or break down bone,
and osteocytes are mature bone cells. An equilibrium between osteoblasts and osteoclasts
maintains bone tissue.

Compact Bone
Compact bone consists of closely packed osteons or haversian systems. The osteon consists of a
central canal called the osteonic (haversian) canal, which is surrounded by concentric rings
(lamellae) of matrix. Between the rings of matrix, the bone cells (osteocytes) are located in spaces
called lacunae. Small channels (canaliculi) radiate from the lacunae to the osteonic (haversian)
canal to provide passageways through the hard matrix. In compact bone, the haversian systems
are packed tightly together to form what appears to be a solid mass. The osteonic canals contain
blood vessels that are parallel to the long axis of the bone. These blood vessels interconnect, by
way of perforating canals, with vessels on the surface of the bone.
Spongy (Cancellous) Bone
Spongy (cancellous) bone is lighter and less dense than compact bone. Spongy bone consists of
plates (trabeculae) and bars of bone adjacent to small, irregular cavities that contain red bone
marrow. The canaliculi connect to the adjacent cavities, instead of a central haversian canal, to
receive their blood supply. It may appear that the trabeculae are arranged in a haphazard manner,
but they are organized to provide maximum strength similar to braces that are used to support a
building. The trabeculae of spongy bone follow the lines of stress and can realign if the direction of
stress changes.
Bone Development & Gowth
The terms osteogenesis and ossification are often used synonymously to indicate the process of
bone formation. Parts of the skeleton form during the first few weeks after conception. By the end of
the eighth week after conception, the skeletal pattern is formed in cartilage and connective tissue
membranes and ossification begins.
Bone development continues throughout adulthood. Even after adult stature is attained, bone
development continues for repair of fractures and for remodeling to meet changing lifestyles.
Osteoblasts, osteocytes and osteoclasts are the three cell types involved in the development,
growth and remodeling of bones. Osteoblasts are bone-forming cells, osteocytes are mature bone
cells and osteoclasts break down and reabsorb bone.
There are two types of ossification: intramembranous and endochondral.
Intramembranous
Intramembranous ossification involves the replacement of sheet-like connective tissue membranes
with bony tissue. Bones formed in this manner are called intramembranous bones. They include
certain flat bones of the skull and some of the irregular bones. The future bones are first formed as
connective tissue membranes. Osteoblasts migrate to the membranes and deposit bony matrix
around themselves. When the osteoblasts are surrounded by matrix they are called osteocytes.
Endochondral Ossification
Endochondral ossification involves the replacement of hyaline cartilage with bony tissue. Most of
the bones of the skeleton are formed in this manner. These bones are called endochondral bones.
In this process, the future bones are first formed as hyaline cartilage models. During the third month
after conception, the perichondrium that surrounds the hyaline cartilage "models" becomes
infiltrated with blood vessels and osteoblasts and changes into a periosteum. The osteoblasts form
a collar of compact bone around the diaphysis. At the same time, the cartilage in the center of the
diaphysis begins to disintegrate. Osteoblasts penetrate the disintegrating cartilage and replace it
with spongy bone. This forms a primary ossification center. Ossification continues from this center
toward the ends of the bones. After spongy bone is formed in the diaphysis, osteoclasts break down
the newly formed bone to open up the medullary cavity.
The cartilage in the epiphyses continues to grow so the developing bone increases in length. Later,
usually after birth, secondary ossification centers form in the epiphyses. Ossification in the
epiphyses is similar to that in the diaphysis except that the spongy bone is retained instead of being
broken down to form a medullary cavity. When secondary ossification is complete, the hyaline
cartilage is totally replaced by bone except in two areas. A region of hyaline cartilage remains over
the surface of the epiphysis as the articular cartilage and another area of cartilage remains between
the epiphysis and diaphysis. This is the epiphyseal plate or growth region.
Bone Growth
Bones grow in length at the epiphyseal plate by a process that is similar to endochondral
ossification. The cartilage in the region of the epiphyseal plate next to the epiphysis continues to
grow by mitosis. The chondrocytes, in the region next to the diaphysis, age and degenerate.
Osteoblasts move in and ossify the matrix to form bone. This process continues throughout
childhood and the adolescent years until the cartilage growth slows and finally stops. When
cartilage growth ceases, usually in the early twenties, the epiphyseal plate completely ossifies so
that only a thin epiphyseal line remains and the bones can no longer grow in length. Bone growth is
under the influence of growth hormone from the anterior pituitary gland and sex hormones from the
ovaries and testes.

Even though bones stop growing in length in early adulthood, they can continue to increase in
thickness or diameter throughout life in response to stress from increased muscle activity or to
weight. The increase in diameter is called appositional growth. Osteoblasts in the periosteum form
compact bone around the external bone surface. At the same time, osteoclasts in the endosteum
break down bone on the internal bone surface, around the medullary cavity. These two processes
together increase the diameter of the bone and, at the same time, keep the bone from becoming
excessively heavy and bulky.
Classification of Bones
Long Bones
The bones of the body come in a variety of sizes and shapes. The four principal types of bones are
long, short, flat and irregular. Bones that are longer than they are wide are called long bones. They
consist of a long shaft with two bulky ends or extremities. They are primarily compact bone but may
have a large amount of spongy bone at the ends or extremities. Long bones include bones of the
thigh, leg, arm, and forearm.
Short Bones
Short bones are roughly cube shaped with vertical and horizontal dimensions approximately equal.
They consist primarily of spongy bone, which is covered by a thin layer of compact bone. Short
bones include the bones of the wrist and ankle.

Flat Bones
Flat bones are thin, flattened, and usually curved. Most of the bones of the cranium are flat bones.

Irregular Bones
Bones that are not in any of the above three categories are classified as irregular bones. They are
primarily spongy bone that is covered with a thin layer of compact bone. The vertebrae and some of
the bones in the skull are irregular bones.
All bones have surface markings and characteristics that make a specific bone unique. There are
holes, depressions, smooth facets, lines, projections and other markings. These usually represent
passageways for vessels and nerves, points of articulation with other bones or points of attachment
for tendons and ligaments.

Divisions of the Skeleton

The adult human skeleton usually consists of 206 named bones. These bones can be grouped in
two divisions: axial skeleton and appendicular skeleton. The 80 bones of the axial skeleton form the
vertical axis of the body. They include the bones of the head, vertebral column, ribs and breastbone
or sternum. The appendicular skeleton consists of 126 bones and includes the free appendages
and their attachments to the axial skeleton. The free appendages are the upper and lower
extremities, or limbs, and their attachments which are called girdles. The named bones of the body
are listed below by category.

Axial Skeleton (80 bones)

Skull (28)

Cranial Bones

Parietal (2)
Temporal (2)
Frontal (1)
Occipital (1)
Ethmoid (1)
Sphenoid (1)
_______________________________________________________________________________

Facial Bones

Maxilla (2)
Zygomatic (2)
Mandible (1)
Nasal (2)
Platine (2)
Inferior nasal concha (2)
Lacrimal (2)
Vomer (1)

_______________________________________________________________________________

Auditory Ossicles

Malleus (2)
Incus (2)
Stapes (2)

Hyoid (1)

_______________________________________________________________________________

Vertebral Column

Cervical vertebrae (7)

Thoracic vertebrae (12)
Lumbar vertebrae (5)
Sacrum (1)
Coccyx (1)
_______________________________________________________________________________
Thoracic Cage

Sternum (1)
Ribs (24)

Appendicular Skeleton (126 bones)

Pectoral girdles
Clavicle (2)
Scapula (2)

_______________________________________________________________________________
Upper Extremity
Humerus (2)
Radius (2)
Ulna (2)
Carpals (16)
Metacarpals (10)
Phalanges (28

_______________________________________________________________________________
Pelvic Girdle
Coxal, innominate, or hip bones (2)

_______________________________________________________________________________
Lower Extremity
Femur (2)
Tibia (2)
Fibula (2)
Patella (2)
Tarsals (14)
Metatarsals (10)
Phalanges (28)

Articulations
An articulation, or joint, is where two bones come together. In terms of the amount of movement
they allow, there are three types of joints: immovable, slightly movable and freely movable.
Synarthroses
Synarthroses are immovable joints. The singular form is synarthrosis. In these joints, the bones
come in very close contact and are separated only by a thin layer of fibrous connective tissue. The
sutures in the skull are examples of immovable joints.
Amphiarthroses
Slightly movable joints are called amphiarthroses. The singular form is amphiarthrosis. In this type
of joint, the bones are connected by hyaline cartilage or fibrocartilage. The ribs connected to the
sternum by costal cartilages are slightly movable joints connected by hyaline cartilage. The
symphysis pubis is a slightly movable joint in which there is a fibrocartilage pad between the two
bones. The joints between the vertebrae and the intervertebral disks are also of this type.
Diarthroses
Most joints in the adult body are diarthroses, or freely movable joints. The singular form is
diarthrosis. In this type of joint, the ends of the opposing bones are covered with hyaline cartilage,
the articular cartilage, and they are separated by a space called the joint cavity. The components of
the joints are enclosed in a dense fibrous joint capsule. The outer layer of the capsule consists of
the ligaments that hold the bones together. The inner layer is the synovial membrane that secretes
synovial fluid into the joint cavity for lubrication. Because all of these joints have a synovial
membrane, they are sometimes called synovial joints.
 Learning Activities

I.
Complete the following statements concerning bone formation and destruction, using the terms
provided in the key choices. Insert the key letter or corresponding term in the answer blanks.

Key Choices:
A. Atrophy C. Gravity E. Osteoclasts G. Parathyroid hormone
B. Calcitonin D. Osteoblasts F. Osteocytes H. Stress and/or tension

______1. When blood calcium levels begin to drop below homeostatic levels, (1) is released,
causing calcium to be released from bones.
______2. Mature bone cells, called (2), maintain bone in a viable state.
______3. Disuse such as that caused by paralysis or severe lack of exercise results in muscle and
bone (3).
______4. Large tubercles and/or increased deposit of bony matrix occur at sites of (4).
______5. Immature, or matrix-depositing, bone cells are referred to as (5).
______6. (6) causes blood calcium to be deposited in bones as calcium salts.
______7. Bone cells that liquefy bone matrix and release calcium to the blood are called (7) .
______8. Our astronauts must do isometric exercises when in space because bones atrophy under
conditions of weightlessness or lack of (8).

II.
Group each of the following bones into one of the four major bone categories. Use L for long bone,
S for short bone, F for flat bone, and I for irregular bone. Enter the appropriate letter in the space
provided.
____ 1. Calcaneus ____ 4. Humerus ____ 7. Radius
____ 2. Frontal ____ 5. Mandible ____ 8. Sternum
____ 3. Femur ____ 6. Metacarpal ____ 9. Vertebra

Mastery Test

___1. Important bone functions include:

A. support of the pelvic organs
B. protection of the brain
C. provision of levers for movement of the limbs
D. protection of the skin and limb musculature
E. storage of water

___2. A passageway connecting neighboring osteo cytes in an osteon is a:

A. central canal D. canaliculus
B. lamella E. perforating canal
C. lacuna
___3. What is the earliest event (of those listed) in endochondral ossification?
A. Ossification of proximal epiphysis
B. Appearance of the epiphyseal plate
C. Invasion of the shaft by the periosteal bud
D. Cavitation of the cartilage shaft
E. Formation of secondary ossification centers

___4. The growth spurt of puberty is triggered by:

A. high levels of sex hormones
B. the initial, low levels of sex hormones
C. growth hormone
D. parathyroid hormone
E. calcitonin

___5. Deficiency of which of the following hormones will cause dwarfism?

A. Growth hormone
B. Sex hormones
C. Thyroid hormones
D. Calcitonin
E. Parathyroid hormone

___6. A person who is swung around violently by their arm may sustain which kind of
fracture?
A. Depression D. Spiral
B. Comminuted E. Compound
C. Compression

___7. Which of the following bones are part of the axial skeleton?
A. Vomer D. Parietal
B. Clavicle E. Coxal bone (hip
C. Sternum bone)

___8. A blow to the cheek is most likely to break what superficial bone or bone part?
A. Superciliary arches
B. Zygomatic process
C. Mandibular ramus
D. Styloid process

___9. Which of the following are part of the sphenoid?

 A. Crista galli D. Pterygoid process
B. Sella turcica E. Lesser wings
C. Petrous portion

___10. Structural characteristics of all cervical verte brae are:

A. small body
B. bifid spinous process
C. transverse foramina
D. small vertebral foramen
E. costal facets

___11. Which of the following cartilages is involved in endochondral ossification?

A. Fibrocartilage C. Elastic
B. Synovial D. Hyaline

___12. Coxal bone (hip bone) markings include:

A. ala D. pubic ramus
B. sacral hiatus E. fovea capitis
C. gluteal surface

___13. Cartilaginous joints include:

A. syndesmoses C. synostoses
B. symphyses D. synchondroses

___14. Considered to be part of a synovial joint are:

A. bursae C. tendon sheath
B. articular cartilage D. capsular
Ligaments

___15. Abduction is:

A. moving the right arm out to the right
B. spreading out the fingers
C. wiggling the toes
D. moving the sole of the foot laterally

___16. In comparing two joints of the same type, what characteristic(s) would you use to
determine strength and flexibility?
A. Depth of the depression of the concave bone of the joint
B. Snugness of fit of the bones
C. Size of bone projections for muscle attachments
D. Presence of menisci
___17. Which of the following joints has the great est freedom of movement?
A. Interphalangeal
B. Saddle joint of thumb
C. Distal tibiofibular
D. Coxal (hip)

___18. Which specific joint does the following description identify? “Articular surfaces are
deep and secure, multiaxial; capsule heavily reinforced by ligaments; labrum helps pre
vent dislocation; the first joint to be built artificially; very stable.”
A. Elbow C. Knee
B. Hip D. Shoulder

___19. An autoimmune disease resulting in inflam mation and eventual fusion of diarthrotic
joints is:
A. gout
B. rheumatoid arthritis
C. degenerative joint disease
D. pannus

___20. Plane joints allow:

A. pronation C. rotation
B. flexion D. gliding

___21. Movements made in chewing food are:

A. Flexion D. Depression
B. Extension E. Opposition
C. Elevation

___22. What factor(s) can contribute to osteoporosis?

A. Increased estrogen C. Low calcium diet
B. Inactivity D. Smoking
 UNIT 4
The Muscular System

Learning Outcomes

At the end of this lesson, you will be able to:

 discuss the functions of the muscular system;

 differentiate the three types of muscle tissue;
 explain how muscles are named;
 demonstrate types of body movements; and
 discuss measures on maintaining muscles tone and integrity.

Pretest

Nine characteristics of muscle tissue are listed below. Identify the muscle tissue type described by
choosing the correct response(s) from the key choices. Enter the appropriate term(s) or letter(s) of
the key choice in the answer blank.

Key Choices:
A. Cardiac B. Smooth C. Skeletal

_________________________ 1. Involuntary
_________________________ 2. Banded appearance
_________________________ 3. Longitudinally and circularly arranged layers
_________________________ 4. Dense connective tissue packaging
_________________________ 5. Figure eight packaging of the cells
_________________________ 6. Coordinated activity to act as a pump
_________________________ 7. Moves bones and the facial skin
_________________________ 8. Referred to as the muscular system
_________________________ 9. Voluntary

Content

The muscular system is composed of specialized cells called muscle fibers. Their predominant
function is contractibility. Muscles, attached to bones or internal organs and blood vessels, are
responsible for movement. Nearly all movement in the body is the result of muscle contraction.
Exceptions to this are the action of cilia, the flagellum on sperm cells, and amoeboid movement of
some white blood cells.

The integrated action of joints, bones, and skeletal muscles produces obvious movements such as
walking and running. Skeletal muscles also produce more subtle movements that result in various
facial expressions, eye movements, and respiration.

In addition to movement, muscle contraction also fulfills some other important functions in the body,
such as posture, joint stability, and heat production. Posture, such as sitting and standing, is
maintained as a result of muscle contraction. The skeletal muscles are continually making fine
adjustments that hold the body in stationary positions. The tendons of many muscles extend over
joints and in this way contribute to joint stability. This is particularly evident in the knee and shoulder
joints, where muscle tendons are a major factor in stabilizing the joint. Heat production, to maintain
body temperature, is an important by-product of muscle metabolism. Nearly 85 percent of the heat
produced in the body is the result of muscle contraction.

Structure of Skeletal Muscle

A whole skeletal muscle is considered an organ of the muscular system. Each organ or muscle
consists of skeletal muscle tissue, connective tissue, nerve tissue, and blood or vascular tissue.

Skeletal muscles vary considerably in size, shape, and arrangement of fibers. They range from
extremely tiny strands such as the stapedium muscle of the middle ear to large masses such as the
muscles of the thigh. Some skeletal muscles are broad in shape and some narrow. In some
muscles the fibers are parallel to the long axis of the muscle; in some they converge to a narrow
attachment; and in some they are oblique.

Each skeletal muscle fiber is a single cylindrical muscle cell. An individual skeletal muscle may be
made up of hundreds, or even thousands, of muscle fibers bundled together and wrapped in a
connective tissue covering. Each muscle is surrounded by a connective tissue sheath called the
epimysium. Fascia, connective tissue outside the epimysium, surrounds and separates the
muscles. Portions of the epimysium project inward to divide the muscle into compartments. Each
compartment contains a bundle of muscle fibers. Each bundle of muscle fiber is called a fasciculus
and is surrounded by a layer of connective tissue called the perimysium. Within the fasciculus, each
individual muscle cell, called a muscle fiber, is surrounded by connective tissue called the
endomysium.

Skeletal muscle cells (fibers), like other body cells, are soft and fragile. The connective tissue
covering furnish support and protection for the delicate cells and allow them to withstand the forces
of contraction. The coverings also provide pathways for the passage of blood vessels and nerves.

Commonly, the epimysium, perimysium, and endomysium extend beyond the fleshy part of the
muscle, the belly or gaster, to form a thick ropelike tendon or a broad, flat sheet-like aponeurosis.
The tendon and aponeurosis form indirect attachments from muscles to the periosteum of bones or
to the connective tissue of other muscles. Typically a muscle spans a joint and is attached to bones
by tendons at both ends. One of the bones remains relatively fixed or stable while the other end
moves as a result of muscle contraction.

Skeletal muscles have an abundant supply of blood vessels and nerves. This is directly related to
the primary function of skeletal muscle, contraction. Before a skeletal muscle fiber can contract, it
has to receive an impulse from a nerve cell. Generally, an artery and at least one vein accompany
each nerve that penetrates the epimysium of a skeletal muscle. Branches of the nerve and blood
vessels follow the connective tissue components of the muscle of a nerve cell and with one or more
minute blood vessels called capillaries.

Muscle Types
In the body, there are three types of muscle: skeletal (striated), smooth, and cardiac.

Skeletal Muscle
Skeletal muscle, attached to bones, is responsible for skeletal movements. The peripheral portion
of the central nervous system (CNS) controls the skeletal muscles. Thus, these muscles are under
conscious, or voluntary, control. The basic unit is the muscle fiber with many nuclei. These muscle
fibers are striated (having transverse streaks) and each acts independently of neighboring muscle
fibers.

Smooth Muscle
Smooth muscle, found in the walls of the hollow internal organs such as blood vessels, the
gastrointestinal tract, bladder, and uterus, is under control of the autonomic nervous system.
Smooth muscle cannot be controlled consciously and thus acts involuntarily. The non-striated
(smooth) muscle cell is spindle-shaped and has one central nucleus. Smooth muscle contracts
slowly and rhythmically.

Cardiac Muscle
Cardiac muscle, found in the walls of the heart, is also under control of the autonomic nervous
system. The cardiac muscle cell has one central nucleus, like smooth muscle, but it also is striated,
like skeletal muscle. The cardiac muscle cell is rectangular in shape. The contraction of cardiac
muscle is involuntary, strong, and rhythmical.

Smooth and cardiac muscle will be discussed in detail with respect to their appropriate systems.
This unit mainly covers the skeletal muscular system.

Muscle Groups
There are more than 600 muscles in the body, which together account for about 40 percent of a
person's weight.

Most skeletal muscles have names that describe some feature of the muscle. Often several criteria
are combined into one name. Associating the muscle's characteristics with its name will help you
learn and remember them. The following are some terms relating to muscle features that are used
in naming muscles.

Size: vastus (huge); maximus (large); longus (long); minimus (small); brevis (short).
Shape: deltoid (triangular); rhomboid (like a rhombus with equal and parallel sides); latissimus
(wide); teres (round); trapezius (like a trapezoid, a four-sided figure with two sides parallel).
Direction of fibers: rectus (straight); transverse (across); oblique (diagonally); orbicularis (circular).
Location: pectoralis (chest); gluteus (buttock or rump); brachii (arm); supra- (above); infra- (below);
sub- (under or beneath); lateralis (lateral).
Number of origins: biceps (two heads); triceps (three heads); quadriceps (four heads).
Origin and insertion: sternocleidomastoideus (origin on the sternum and clavicle, insertion on the
mastoid process); brachioradialis (origin on the brachium or arm, insertion on
the radius).
Action: abductor (to abduct a structure); adductor (to adduct a structure); flexor (to flex a structure);
extensor (to extend a structure); levator (to lift or elevate a structure); masseter (a chewer).

Muscles of the Head and Neck

Humans have well-developed muscles in the face that permit a large variety of facial expressions.
Because the muscles are used to show surprise, disgust, anger, fear, and other emotions, they are
an important means of nonverbal communication. Muscles of facial expression include frontalis,
orbicularis oris, laris oculi, buccinator, and zygomaticus.These muscles of facial expressions are
identified in the illustration below.

There are four pairs of muscles that are responsible for chewing movements or mastication. All of
these muscles connect to the mandible and they are some of the strongest muscles in the body.
Two of the muscles, temporalis and masseter, are identified in the illustration above.

There are numerous muscles associated with the throat, the hyoid bone and the vertebral column;
only two of the more obvious and superficial neck muscles are identified in the illustration:
sternocleidomastoid and trapezius.

Muscles of the Trunk

The muscles of the trunk include those that move the vertebral column, the muscles that form the
thoracic and abdominal walls, and those that cover the pelvic outlet.
The erector spinae group of muscles on each side of the vertebral column is a large muscle mass
that extends from the sacrum to the skull. These muscles are primarily responsible for extending
the vertebral column to maintain erect posture. The deep back muscles occupy the space between
the spinous and transverse processes of adjacent vertebrae.

The muscles of the thoracic wall are involved primarily in the process of breathing. The intercostal
muscles are located in spaces between the ribs. They contract during forced expiration. External
intercostal muscles contract to elevate the ribs during the inspiration phase of breathing. The
diaphragm is a dome-shaped muscle that forms a partition between the thorax and the abdomen. It
has three openings in it for structures that have to pass from the thorax to the abdomen.

The abdomen, unlike the thorax and pelvis, has no bony reinforcements or protection. The wall
consists entirely of four muscle pairs, arranged in layers, and the fascia that envelops them. The
abdominal wall muscles are identified in the illustration below.

The pelvic outlet is formed by two muscular sheets and their associated fascia.

Muscles of the Upper Extremity

The muscles of the upper extremity include those that attach the scapula to the thorax and
generally move the scapula, those that attach the humerus to the scapula and generally move the
arm, and those that are located in the arm or forearm that move the forearm, wrist, and hand. The
illustration below shows some of the muscles of the upper extremity.

Muscles that move the shoulder and arm include the trapezius and serratus anterior. The pectoralis
major, latissimus dorsi, deltoid, and rotator cuff muscles connect to the humerus and move the arm.
The muscles that move the forearm are located along the humerus, which include the triceps
brachii, biceps brachii, brachialis, and brachioradialis. The 20 or more muscles that cause most
wrist, hand, and finger movements are located along the forearm.

Muscles of the Lower Extremity

Illustration of the muscles of the lower extremity
The muscles that move the thigh have their origins on some part of the pelvic girdle and their
insertions on the femur. The largest muscle mass belongs to the posterior group, the gluteal
muscles, which, as a group, adduct the thigh. The iliopsoas, an anterior muscle, flexes the thigh.
The muscles in the medial compartment adduct the thigh. The illustration below shows some of the
muscles of the lower extremity.

Muscles that move the leg are located in the thigh region. The quadriceps femoris muscle group
straightens the leg at the knee. The hamstrings are antagonists to the quadriceps femoris muscle
group, which are used to flex the leg at the knee.

The muscles located in the leg that move the ankle and foot are divided into anterior, posterior, and
lateral compartments. The tibialis anterior, which dorsiflexes the foot, is antagonistic to the
gastrocnemius and soleus muscles, which plantar flex the foot.

Learning Activities

I.
Identify the structures in Column B by matching them with the descriptions in Column A.

_____1. Connective tissue surrounding a fascicle A. Endomysium

_____2. Connective tissue ensheathing the entire muscle B. Epimysium
_____3. Contractile unit of muscle C. Fascicle
_____4. A muscle cell D. Fiber
_____5. Thin connective tissue investing each muscle cell E. Myofilament
_____6. Plasma membrane of the muscle cell F. Myofibril
_____7. A long, filamentous organelle found within muscle G. Perimysium
cells that has a banded appearance H. Sarcolemma
_____8. Actin- or myosin-containing structure I. Sarcomere
_____9. Cordlike extension of connective tissue beyond J. Sarcoplasm
the muscle, serving to attach it to the bone K. Tendon
_____10. A discrete bundle of muscle cells

II.
Identify the major muscles described in Column A by choosing a response from Column B. Enter
the correct letter in the answer blank.

______ 1. Used to show you’re happy A. Buccinator

______ 2. Used to suck in your cheeks B. Frontalis
______ 3. Used in winking C. Masseter
______ 4. Wrinkles the forehead horizontally D. Orbicularis oculi
______ 5. The “kissing” muscle E. Orbicularis oris
______ 6. Prime mover of jaw closure F. Sternocleidomastoid
______ 7. Synergist muscle for jaw closure G. Temporalis
______ 8. Prime mover of head flexion; a two-headed H. Trapezius
Muscle I. Zygomaticus

Mastery Test

___1. Select the type of muscle tissue that fits the following description: selfexcitable,
pacemaker cells, gap junctions, limited sar coplasmic reticulum.
A. Skeletal muscle C. Smooth muscle
B. Cardiac muscle D. Involuntary muscle

___2. What is the skeletal muscle useful for?

A. Pump blood to the lungs
B. Body movement
C. Widen blood vessels
D. Narrow airways
___3. Where would you find perimysium?
A. Around myofibrils C. Covering the whole muscle
B. Covering D. Covering
myofilamen fas cicles

___4. Where would you find the ATP binding site in a myofibril?
A. In the SR C. At the Z line
B. On globular D. In the myosin
actin heads

___5. Transmission of the stimulus at the neuromuscular junction involves:

A. synaptic vesicles C. ACh
B. sarcolemma D. axon terminal
___6. A smooth graph showing the degree of muscle contraction is:
A. fused tetanus C. unfused tetanus
B. summation of contraction D. twitch

___7. A product of aerobic metabolism is:

A. carbon dioxide
B. oxygen
C. lactic acid
D. creatine phosphate

___8. The first energy source used to regenerate ATP when muscles are extremely active
is:
A. fatty acids C. creatine phosphate
B. glucose D. pyruvic acid
___9. Head muscles that insert on a bone include the:
A. zygomaticus C. buccinator
B. masseter D. temporalis

___10. Lateral flexion of the torso involves:

A. erector spinae
B. rectus abdominis
C. quadratus lumborum
D. external oblique
___11. Muscles attached to the vertebral column include:
A. quadratus lumborum
B. external oblique
C. diaphragm
D. latissimus dorsi

___12. Muscles that help stabilize the scapula and shoulder joint include:
A. triceps brachii C. trapezius
B. biceps brachii D. pectoralis major

___13. Which of these thigh muscles causes move ment at the hip joint?
A. Rectus femoris
B. Biceps femoris
C. Vastus lateralis
D. Semitendinosus

___14. Leg muscles that can cause movement at the knee joint include:
A. tibialis anterior
 B. fibularis longus
C. gastrocnemius
D. soleus

___15. The main muscles used when doing chin ups are:
A. triceps brachii and pectoralis major
B. infraspinatus and biceps brachii
C. serratus anterior and external oblique
D. latissimus dorsi and brachialis

___16. The major muscles used in doing pushups are:

A. biceps brachii and brachialis
B. supraspinatus and subscapularis
C. coracobrachialis and latissimus dorsi
D. triceps brachii and pectoralis major

___17. Arm and leg muscles are arranged in antag onistic pairs. How does this affect their
functioning?
A. It provides a backup if one of the mus cles is injured.
B. One muscle of the pair pushes while the other pulls.
C. A single neuron controls both of them.
D. It allows the muscles to produce oppos ing movements.

___18. Muscle A and muscle B are the same size, but muscle A is capable of much finer
con trol than muscle B. Which of the following is likely to be true of muscle A?
A. It is controlled by more neurons than muscle B.
B. It contains fewer motor units than mus cle B.
C. It is controlled by fewer neurons than muscle B.
D. Each of its motor units consists of more cells than the motor units of muscle B.
___19. Medial and lateral movements of the foot are known as:
A. dorsiflexion and plantarflexion
B. inversion and eversion
C. supination and pronation
D. medial and lateral opposition
 UNIT 5
The Nervous System

Learning Outcomes

At the end of this lesson, you will be able to:

 name and distinguish the basic divisions and component organs and functions of the
nervous system;
 describe transmission of the synapse;
 explain the reflex arc and reflex act;
 differentiate between general and special sense; and
 discuss measures on the care of special senses.

Pretest

List the three major functions of the nervous system.

1._____________________________________________________________________________
______________________________________________________________________________.

2._____________________________________________________________________________
______________________________________________________________________________.

3._____________________________________________________________________________
______________________________________________________________________________.

Content

The nervous system is the major controlling, regulatory, and communicating system in the body. It
is the center of all mental activity including thought, learning, and memory. Together with the
endocrine system, the nervous system is responsible for regulating and maintaining homeostasis.
Through its receptors, the nervous system keeps us in touch with our environment, both external
and internal.

Like other systems in the body, the nervous system is composed of organs, principally the brain,
spinal cord, nerves, and ganglia. These, in turn, consist of various tissues, including nerve, blood,
and connective tissue. Together these carry out the complex activities of the nervous system.

The various activities of the nervous system can be grouped together as three general, overlapping
functions:

Sensory
Integrative
Motor

Millions of sensory receptors detect changes, called stimuli, which occur inside and outside the
body. They monitor such things as temperature, light, and sound from the external environment.
Inside the body, the internal environment, receptors detect variations in pressure, pH, carbon
dioxide concentration, and the levels of various electrolytes. All of this gathered information is called
sensory input.

Sensory input is converted into electrical signals called nerve impulses that are transmitted to the
brain. There the signals are brought together to create sensations, to produce thoughts, or to add to
memory; Decisions are made each moment based on the sensory input. This is integration.

Based on the sensory input and integration, the nervous system responds by sending signals to
muscles, causing them to contract, or to glands, causing them to produce secretions. Muscles and
glands are called effectors because they cause an effect in response to directions from the nervous
system. This is the motor output or motor function.

Nerve Tissue
Although the nervous system is very complex, there are only two main types of cells in nerve tissue.
The actual nerve cell is the neuron. It is the "conducting" cell that transmits impulses and the
structural unit of the nervous system. The other type of cell is neuroglia, or glial, cell. The word
"neuroglia" means "nerve glue." These cells are nonconductive and provide a support system for
the neurons. They are a special type of "connective tissue" for the nervous system.

Neurons
Neurons, or nerve cells, carry out the functions of the nervous system by conducting nerve
impulses. They are highly specialized and amitotic. This means that if a neuron is destroyed, it
cannot be replaced because neurons do not go through mitosis. The image below illustrates the
structure of a typical neuron.

Each neuron has three basic parts: cell body (soma), one or more dendrites, and a single axon.

Cell Body
In many ways, the cell body is similar to other types of cells. It has a nucleus with at least one
nucleolus and contains many of the typical cytoplasmic organelles. It lacks centrioles, however.
Because centrioles function in cell division, the fact that neurons lack these organelles is consistent
with the amitotic nature of the cell.

Dendrites
Dendrites and axons are cytoplasmic extensions, or processes, that project from the cell body.
They are sometimes referred to as fibers. Dendrites are usually, but not always, short and
branching, which increases their surface area to receive signals from other neurons. The number of
dendrites on a neuron varies. They are called afferent processes because they transmit impulses to
the neuron cell body. There is only one axon that projects from each cell body. It is usually
elongated and because it carries impulses away from the cell body, it is called an efferent process
Axon
An axon may have infrequent branches called axon collaterals. Axons and axon collaterals
terminate in many short branches or telodendria. The distal ends of the telodendria are slightly
enlarged to form synaptic bulbs. Many axons are surrounded by a segmented, white, fatty
substance called myelin or the myelin sheath. Myelinated fibers make up the white matter in the
CNS, while cell bodies and unmyelinated fibers make the gray matter. The unmyelinated regions
between the myelin segments are called the nodes of Ranvier.

In the peripheral nervous system, the myelin is produced by Schwann cells. The cytoplasm,
nucleus, and outer cell membrane of the Schwann cell form a tight covering around the myelin and
around the axon itself at the nodes of Ranvier. This covering is the neurilemma, which plays an
important role in the regeneration of nerve fibers. In the CNS, oligodendrocytes produce myelin, but
there is no neurilemma, which is why fibers within the CNS do not regenerate.

Functionally, neurons are classified as afferent, efferent, or interneurons (association neurons)

according to the direction in which they transmit impulses relative to the central nervous system.
Afferent, or sensory, neurons carry impulses from peripheral sense receptors to the CNS. They
usually have long dendrites and relatively short axons. Efferent, or motor, neurons transmit
impulses from the CNS to effector organs such as muscles and glands. Efferent neurons usually
have short dendrites and long axons. Interneurons, or association neurons, are located entirely
within the CNS in which they form the connecting link between the afferent and efferent neurons.
They have short dendrites and may have either a short or long axon.

Neuroglia
Neuroglia cells do not conduct nerve impulses, but instead, they support, nourish, and protect the
neurons. They are far more numerous than neurons and, unlike neurons, are capable of mitosis.

Tumors
Schwannomas are benign tumors of the peripheral nervous system which commonly occur in their
sporadic, solitary form in otherwise normal individuals. Rarely, individuals develop multiple
schwannomas arising from one or many elements of the peripheral nervous system.

Commonly called a Morton's Neuroma, this problem is a fairly common benign nerve growth and
begins when the outer coating of a nerve in your foot thickens. This thickening is caused by irritation
of branches of the medial and lateral plantar nerves that results when two bones repeatedly rub
together.

Organization of the Nervous System

Although terminology seems to indicate otherwise, there is really only one nervous system in the
body. Although each subdivision of the system is also called a "nervous system," all of these
smaller systems belong to the single, highly integrated nervous system. Each subdivision has
structural and functional characteristics that distinguish it from the others. The nervous system as a
whole is divided into two subdivisions: the central nervous system (CNS) and the peripheral
nervous system (PNS).

The Central Nervous System

The CNS consists of the brain and spinal cord, which are located in the dorsal body cavity. The
brain is surrounded by the cranium, and the spinal cord is protected by the vertebrae. The brain is
continuous with the spinal cord at the foramen magnum. In addition to bone, the CNS is surrounded
by connective tissue membranes, called meninges, and by cerebrospinal fluid.
Meninges

There are three layers of meninges around the brain and spinal cord. The outer layer, the dura
mater, is tough white fibrous connective tissue. The middle layer of meninges is arachnoid, which
resembles a cobweb in appearance, is a thin layer with numerous threadlike strands that attach it to
the innermost layer. The space under the arachnoid, the subarachnoid space, is filled with
cerebrospinal fluid and contains blood vessels. The pia mater is the innermost layer of meninges.
This thin, delicate membrane is tightly bound to the surface of the brain and spinal cord and cannot
be dissected away without damaging the surface.

Meningiomas are tumors of the nerve tissue covering the brain and spinal cord. Although
meningiomas are usually not likely to spread, physicians often treat them as though they were
malignant to treat symptoms that may develop when a tumor applies pressure to the brain.

Brain
The brain is divided into the cerebrum, diencephalons, brain stem, and cerebellum.

Cerebrum
The largest and most obvious portion of the brain is the cerebrum, which is divided by a deep
longitudinal fissure into two cerebral hemispheres. The two hemispheres are two separate entities
but are connected by an arching band of white fibers, called the corpus callosum that provides a
communication pathway between the two halves.

Each cerebral hemisphere is divided into five lobes, four of which have the same name as the bone
over them: the fontal lobe, the parietal lobe, the occipital lobe, and the temporal lobe. A fifth lobe,
the insula or Island of Reil, lies deep within the lateral sulcus.

Diencephalon
The diencephalons is centrally located and is nearly surrounded by the cerebral hemispheres. It
includes the thalamus, hypothalamus, and epithalamus. The thalamus, about 80 percent of the
diencephalons, consists of two oval masses of gray matter that serve as relay stations for sensory
impulses, except for the sense of smell, going to the cerebral cortex. The hypothalamus is a small
region below the thalamus, which plays a key role in maintaining homeostasis because it regulates
many visceral activities. The epithalamus is the most dorsal portion of the diencephalons. This
small gland is involved with the onset of puberty and rhythmic cycles in the body. It is like a
biological clock.

Brain Stem
The brain stem is the region between the diencephalons and the spinal cord. It consists of three
parts: midbrain, pons, and medulla oblongata. The midbrain is the most superior portion of the brain
stem. The pons is the bulging middle portion of the brain stem. This region primarily consists of
nerve fibers that form conduction tracts between the higher brain centers and spinal cord. The
medulla oblongata, or simply medulla, extends inferiorly from the pons. It is continuous with the
spinal cord at the foramen magnum. All the ascending (sensory) and descending (motor) nerve
fibers connecting the brain and spinal cord pass through the medulla.

Cerebellum
The cerebellum, the second largest portion of the brain, is located below the occipital lobes of the
cerebrum. Three paired bundles of myelinated nerve fibers, called cerebellar peduncles, form
communication pathways between the cerebellum and other parts of the central nervous system.

Ventricles and Cerebrospinal Fluid

A series of interconnected, fluid-filled cavities are found within the brain. These cavities are the
ventricles of the brain, and the fluid is cerebrospinal fluid (CSF).

Spinal Cord
The spinal cord extends from the foramen magnum at the base of the skull to the level of the first
lumbar vertebra. The cord is continuous with the medulla oblongata at the foramen magnum. Like
the brain, the spinal cord is surrounded by bone, meninges, and cerebrospinal fluid.

The spinal cord is divided into 31 segments with each segment giving rise to a pair of spinal nerves.
At the distal end of the cord, many spinal nerves extend beyond the conus medullaris to form a
collection that resembles a horse's tail. This is the cauda equina. In cross section, the spinal cord
appears oval in shape.

The spinal cord has two main functions:

1. Serving as a conduction pathway for impulses going to and from the brain. Sensory impulses
travel to the brain on ascending tracts in the cord. Motor impulses travel on descending tracts.

2. Serving as a reflex center. The reflex arc is the functional unit of the nervous system. Reflexes
are responses to stimuli that do not require conscious thought and consequently, they occur more
quickly than reactions that require thought processes. For example, with the withdrawal reflex, the
reflex action withdraws the affected part before you are aware of the pain. Many reflexes are
mediated in the spinal cord without going to the higher brain centers.

Brain Tumor
Glioma refers to tumors that arise from the support cells of the brain. These cells are called glial
cells. These tumors include the astrocytomas, ependymomas and oligodendrogliomas. These
tumors are the most common primary brain tumors.

The Peripheral Nervous System

The peripheral nervous system consists of the nerves that branch out from the brain and spinal
cord. These nerves form the communication network between the CNS and the body parts. The
peripheral nervous system is further subdivided into the somatic nervous system and the autonomic
nervous system. The somatic nervous system consists of nerves that go to the skin and muscles
and is involved in conscious activities. The autonomic nervous system consists of nerves that
connect the CNS to the visceral organs such as the heart, stomach, and intestines. It mediates
unconscious activities.

Structure of a Nerve
A nerve contains bundles of nerve fibers, either axons or dendrites, surrounded by connective
tissue. Sensory nerves contain only afferent fibers, long dendrites of sensory neurons. Motor nerves
have only efferent fibers, long axons of motor neurons. Mixed nerves contain both types of fibers.
A connective tissue sheath called the epineurium surrounds each nerve. Each bundle of nerve
fibers is called a fasciculus and is surrounded by a layer of connective tissue called the
perineurium. Within the fasciculus, each individual nerve fiber, with its myelin and neurilemma, is
surrounded by connective tissue called the endoneurium. A nerve may also have blood vessels
enclosed in its connective tissue wrappings.

Cranial Nerves
Twelve pairs of cranial nerves emerge from the inferior surface of the brain. All of these nerves,
except the vagus nerve, pass through foramina of the skull to innervate structures in the head,
neck, and facial region.

The cranial nerves are designated both by name and by Roman numerals, according to the order in
which they appear on the inferior surface of the brain. Most of the nerves have both sensory and
motor components. Three of the nerves are associated with the special senses of smell, vision,
hearing, and equilibrium and have only sensory fibers. Five other nerves are primarily motor in
function but do have some sensory fibers for proprioception. The remaining four nerves consist of
significant amounts of both sensory and motor fibers.

Acoustic neuromas are benign fibrous growths that arise from the balance nerve, also called the
eighth cranial nerve or vestibulocochlear nerve. These tumors are non-malignant, meaning that
they do not spread or metastasize to other parts of the body. The location of these tumors is deep
inside the skull, adjacent to vital brain centers in the brain stem. As the tumors enlarge, they involve
surrounding structures which have to do with vital functions. In the majority of cases, these tumors
grow slowly over a period of years. In other cases, the growth rate is more rapid and patients
develop symptoms at a faster pace. Usually, the symptoms are mild and many patients are not
diagnosed until some time after their tumor has developed. Many patients also exhibit no tumor
growth over a number of years when followed by yearly MRI scans.

Spinal Nerves
Thirty-one pairs of spinal nerves emerge laterally from the spinal cord. Each pair of nerves
corresponds to a segment of the cord and they are named accordingly. This means there are 8
cervical nerves, 12 thoracic nerves, 5 lumbar nerves, 5 sacral nerves, and 1 coccygeal nerve.

Each spinal nerve is connected to the spinal cord by a dorsal root and a ventral root. The cell
bodies of the sensory neurons are in the dorsal root ganglion, but the motor neuron cell bodies are
in the gray matter. The two roots join to form the spinal nerve just before the nerve leaves the
vertebral column. Because all spinal nerves have both sensory and motor components, they are all
mixed nerves.

Autonomic Nervous System

The autonomic nervous system is a visceral efferent system, which means it sends motor impulses
to the visceral organs. It functions automatically and continuously, without conscious effort, to
innervate smooth muscle, cardiac muscle, and glands. It is concerned with heart rate, breathing
rate, blood pressure, body temperature, and other visceral activities that work together to maintain
homeostasis.

The autonomic nervous system has two parts, the sympathetic division and the parasympathetic
division. Many visceral organs are supplied with fibers from both divisions. In this case, one
stimulates and the other inhibits. This antagonistic functional relationship serves as a balance to
help maintain homeostasis.
 Learning Activities

I.
Choose the key responses that best correspond to the descriptions provided in the following
statements. Insert the appropriate letter or term in the answer blanks.

Key Choices
A. Autonomic nervous system C. Peripheral nervous system (PNS)
B. Central nervous system (CNS) D. Somatic nervous system

_________________________ 1. Nervous system subdivision that is composed of the brain

and spinal cord.
_________________________ 2. Subdivision of the PNS that controls voluntary activities such
as the activation of skeletal muscles.
_________________________ 3. Nervous system subdivision that is composed of the cranial
and spinal nerves and ganglia.
_________________________ 4. Subdivision of the PNS that regulates the activities of the heart
and smooth muscle, and of glands; it is also called the involuntary
nervous system.
_________________________ 5. A major subdivision of the nervous system that interprets
incoming information and issues orders.
_________________________ 6. A major subdivision of the nervous system that serves as
communication lines, linking all parts of the body to the CNS.

II.
This exercise emphasizes the difference between neurons and neuroglia. Indicate which cell type is
identified by the following descriptions. Insert the appropriate letter or term in the answer blanks.

Key Choices:

A. Neurons B. Neuroglia

_________________________ 1. Support, insulate, and protect cells.

_________________________ 2. Demonstrate irritability and conductivity, and thus transmit
electrical messages from one area of the body to another area.
_________________________ 3. Release neurotransmitters.
_________________________ 4. Are amitotic.
_________________________ 5. Able to divide; therefore are responsible for most brain
neoplasms.

III.
If a statement is true, write the letter T in the answer blank. If a statement is false, correct the
underlined word(s) and write the correct word(s) in the answer blank.

_________________________ 1. The primary somatosensory area of the cerebral hemisphere(s)

is found in the precentral gyrus.
_________________________ 2. Cortical areas involved in audition are found in the occipital lobe.
_________________________ 3. The primary motor area in the temporal lobe is involved in the
initiation of voluntary movements.
_________________________ 4. The specialized motor speech area is located at the base of the
precentral gyrus in an area called Wernicke’s area.
_________________________ 5. The right cerebral hemisphere receives sensory input from the
 right side of the body.
_________________________ 6. The pyramidal tract is the major descending voluntary motor
tract.
_________________________ 7. The primary motor cortex is located in the postcentral gyrus.
_________________________ 8. Centers for control of repetitious or stereotyped motor skills are
found in the primary motor cortex.
_________________________ 9. The largest parts of the motor homunculi are the lips, tongue,
and toes.
_________________________10. Sensations such as touch and pain are integrated in the primary
sensory cortex.
_________________________11. The primary visual cortex is in the frontal lobe of each cerebral
hemisphere.
_________________________12. In most humans, the area that controls the comprehension of
language is located in the left cerebral hemisphere.
_________________________13. A flat electroencephalogram (EEG) is evidence of clinical death.
_________________________14. Beta waves are recorded when an individual is awake
and relaxed.

Mastery Test

___1. A neuron which has a single process from the cell body is:
A. multipolar C. bipolar
B. unipolar D. monopolar

___2. Which of the following skin cells would form a junction with a motor neuron?
A. Keratinocyte
B. Sudoriferous glandular epithelial cell
C. Arrector pili muscle cell
D. Fibroblast
___3. A synapse between an axon terminal and a neuron cell body is called:
A. axodendritic C. axosomatic
B. axoaxonic D. axoneuronic

___4. Which is an incorrect association of brain region and ventricle?

A. Mesencephalon—third ventricle
B. Cerebral hemispheres—lateral ventricles
C. Pons—fourth ventricle
D. Medulla—fourth ventricle
___5. The pineal gland is located in the:
A. hypophysis cerebri
B. mesencephalon
C. epithalamus
D. corpus callosum

___6. Which molecule enters the axon to cause depolarization?

 A. Acetylcholine C. Sodium
B. Calcium D. Potassium

___7. When neurons in Wernicke’s area send impulses to neurons in Broca’s area, the white
matter tracts utilized are:
A. commissural fibers
B. projection fibers
C. association fibers
D. anterior funiculus

___8. Reflexes that regulate smooth muscle and glands are:

A. monosynaptic
B. somatic
C. voluntary
D. autonomic

___9. Which structures are directly involved with formation, circulation, and drainage of CSF?
A. Ependymal cilia
B. Ventricular choroid plexuses
C. Arachnoid villi
D. Serous layers of the dura mater
___10. Golgi tendon organs can be classified as:
A. visceroreceptors C. proprioreceptors
B. exteroreceptors D. mechanoreceptors

___11. Cranial nerves that have some function in vision include the:
A. trochlear C. abducens
B. trigeminal D. facial

___12. Eating difficulties would result from damage to the:

A. mandibular division of trigeminal nerve
B. facial nerve
C. glossopharyngeal nerve
D. vagus nerve

___13. If the right trapezius and sternocleidomas- toid muscles were atrophied, you would
suspect damage to the:
A. vagus nerve
B. motor branches of the cervical plexus
C. facial nerve
D. accessory nerve
___14. Which nerve stimulates muscles that flex the forearm?
A. Ulnar C. Radial
B. Musculocutaneous D. Median

___15. Motor functions of arm, forearm, and fingers would be affected by damage to which
one of these nerves?
A. Radial C. Ulnar
B. Axillary D. Median

___16. An inability to extend the leg would result from a loss of function of the:
A. lateral femoral cutaneous nerve
B. ilioinguinal nerve
C. saphenous branch of femoral nerve
D. femoral nerve

Use the following choices to respond to questions 17–28:

A. sympathetic division
B. parasympathetic division
C. both sympathetic and parasympathetic
D. neither sympathetic nor parasympathetic

______ 17. Typically has long preganglionic and short postganglionic fibers
______ 18. Some fibers utilize gray rami communicantes
______ 19. Courses through spinal nerves

______ 20. Has splanchnic nerves

______ 21. Courses through cranial nerves

______ 22. Originates in cranial nerves

______ 23. Effects enhanced by direct stim-ulation of a hormonal mechanism
______ 24. Includes otic ganglion
______ 25. Includes celiac ganglion
______ 26. Hypoactivity of this divisionwould lead to decrease in meta- bolic rate
______ 27. Has widespread, long-lasting effects
______ 28. Sets the tone for the heart

___29. Which contains only motor fibers?

A. Dorsal root C. Ventral root
B. Dorsal ramus D. Ventral ramus
 UNIT 6
The Cardiovascular System

Learning Outcomes

At the end of this lesson, you will be able to:

 describe the heart as to location, position;

 trace the flow of blood in the pulmonary and systemic circulations;
 differentiate arteries, veins, and capillaries in terms of structure and function;
 discuss the control of blood pressure and pulse rate; and
 discuss measures on the care of heart and blood vessels.

Pretest

Complete the following statements by inserting your answers in the answer blanks.

The heart is a cone-shaped muscular organ located within the __________________. Its apex rests
on the _______________________, and its base is at the level of the__________________rib. The
coronary arteries that nourish the myocardium arise from the __________________. The coronary
sinus empties into the______________________. Relative to the roles of the heart chambers, the
____________________ are receiving chambers, whereas the______________________ are
discharging chambers. The membrane that lines the heart and also forms the valve flaps is called
the______________________. The outermost layer of the heart is called the_________________.
The fluid that fills the pericardial sac acts to decrease_____________________during heart activity.
The heart muscle, or myocardium, is composed of a specialized type of muscle tissue called
____________________.

Content

The cardiovascular system is sometimes called the blood-vascular, or simply the circulatory,
system. It consists of the heart, which is a muscular pumping device, and a closed system of
vessels called arteries, veins, and capillaries. As the name implies, blood contained in the
circulatory system is pumped by the heart around a closed circle or circuit of vessels as it passes
again and again through the various "circulations" of the body.
As in the adult, survival of the developing embryo depends on the circulation of blood to maintain
homeostasis and a favorable cellular environment. In response to this need, the cardiovascular
system makes its appearance early in development and reaches a functional state long before any
other major organ system. Incredible as it seems, the primitive heart begins to beat regularly early
in the fourth week following fertilization.

The vital role of the cardiovascular system in maintaining homeostasis depends on the continuous
and controlled movement of blood through the thousands of miles of capillaries that permeate every
tissue and reach every cell in the body. It is in the microscopic capillaries that blood performs its
ultimate transport function. Nutrients and other essential materials pass from capillary blood into
fluids surrounding the cells as waste products are removed.

Numerous control mechanisms help to regulate and integrate the diverse functions and component
parts of the cardiovascular system in order to supply blood to specific body areas according to
need. These mechanisms ensure a constant internal environment surrounding each body cell
regardless of differing demands for nutrients or production of waste products.

Heart
The heart is a muscular pump that provides the force necessary to circulate the blood to all the
tissues in the body. Its function is vital because, to survive, the tissues need a continuous supply of
oxygen and nutrients, and metabolic waste products have to be removed. Deprived of these
necessities, cells soon undergo irreversible changes that lead to death. While blood is the transport
medium, the heart is the organ that keeps the blood moving through the vessels. The normal adult
heart pumps about 5 liters of blood every minute throughout life. If it loses its pumping effectiveness
for even a few minutes, the individual's life is jeopardized.

Structure of the Heart

The human heart is a four-chambered muscular organ, shaped and sized roughly like a man's
closed fist with two-thirds of the mass to the left of midline.

The heart is enclosed in a pericardial sac that is lined with the parietal layers of a serous
membrane. The visceral layer of the serous membrane forms the epicardium.

Layers of the Heart Wall

Three layers of tissue form the heart wall. The outer layer of the heart wall is the epicardium, the
middle layer is the myocardium, and the inner layer is the endocardium.

Chambers of the Heart

The internal cavity of the heart is divided into four chambers:

Right atrium
Right ventricle
Left atrium
Left ventricle

The two atria are thin-walled chambers that receive blood from the veins. The two ventricles are
thick-walled chambers that forcefully pump blood out of the heart. Differences in thickness of the
heart chamber walls are due to variations in the amount of myocardium present, which reflects the
amount of force each chamber is required to generate.

The right atrium receives deoxygenated blood from systemic veins; the left atrium receives
oxygenated blood from the pulmonary veins.

Valves of the Heart

Pumps need a set of valves to keep the fluid flowing in one direction and the heart is no exception.
The heart has two types of valves that keep the blood flowing in the correct direction. The valves
between the atria and ventricles are called atrioventricular valves (also called cuspid valves), while
those at the bases of the large vessels leaving the ventricles are called semilunar valves.

The right atrioventricular valve is the tricuspid valve. The left atrioventricular valve is the bicuspid, or
mitral, valve. The valve between the right ventricle and pulmonary trunk is the pulmonary semilunar
valve. The valve between the left ventricle and the aorta is the aortic semilunar valve.

When the ventricles contract, atrioventricular valves close to prevent blood from flowing back into
the atria. When the ventricles relax, semilunar valves close to prevent blood from flowing back into
the ventricles.

Pathway of Blood through the Heart

While it is convenient to describe the flow of blood through the right side of the heart and then
through the left side, it is important to realize that both atria and ventricles contract at the same
time. The heart works as two pumps, one on the right and one on the left, working simultaneously.
Blood flows from the right atrium to the right ventricle, and then is pumped to the lungs to receive
oxygen. From the lungs, the blood flows to the left atrium, then to the left ventricle. From there it is
pumped to the systemic circulation.

Blood Supply to the Myocardium

The myocardium of the heart wall is a working muscle that needs a continuous supply of oxygen
and nutrients to function efficiently. For this reason, cardiac muscle has an extensive network of
blood vessels to bring oxygen to the contracting cells and to remove waste products.

The right and left coronary arteries, branches of the ascending aorta, supply blood to the walls of
the myocardium. After blood passes through the capillaries in the myocardium, it enters a system of
cardiac (coronary) veins. Most of the cardiac veins drain into the coronary sinus, which opens into
the right atrium.

Physiology of the Heart

The conduction system includes several components. The first part of the conduction system is the
sinoatrial node . Without any neural stimulation, the sinoatrial node rhythmically initiates impulses
70 to 80 times per minute. Because it establishes the basic rhythm of the heartbeat, it is called the
pacemaker of the heart. Other parts of the conduction system include the atrioventricular node,
atrioventricular bundle, bundle branches, and conduction myofibers. All of these components
coordinate the contraction and relaxation of the heart chambers.

Cardiac Cycle
The cardiac cycle refers to the alternating contraction and relaxation of the myocardium in the walls
of the heart chambers, coordinated by the conduction system, during one heartbeat. Systole is the
contraction phase of the cardiac cycle, and diastole is the relaxation phase. At a normal heart rate,
one cardiac cycle lasts for 0.8 second.

Heart Sounds
The sounds associated with the heartbeat are due to vibrations in the tissues and blood caused by
closure of the valves. Abnormal heart sounds are called murmurs.

Heart Rate
The sinoatrial node, acting alone, produces a constant rhythmic heart rate. Regulating factors are
reliant on the atrioventricular node to increase or decrease the heart rate to adjust cardiac output to
meet the changing needs of the body. Most changes in the heart rate are mediated through the
cardiac center in the medulla oblongata of the brain. The center has both sympathetic and
parasympathetic components that adjust the heart rate to meet the changing needs of the body.

Peripheral factors such as emotions, ion concentrations, and body temperature may affect heart
rate. These are usually mediated through the cardiac center.
Blood
Blood is the fluid of life, transporting oxygen from the lungs to body tissue and carbon dioxide from
body tissue to the lungs. Blood is the fluid of growth, transporting nourishment from digestion and
hormones from glands throughout the body. Blood is the fluid of health, transporting disease-
fighting substances to the tissue and waste to the kidneys. Because it contains living cells, blood is
alive. Red blood cells and white blood cells are responsible for nourishing and cleansing the body.

Without blood, the human body would stop working.

Classification & Structure of Blood Vessels

Blood vessels are the channels or conduits through which blood is distributed to body tissues. The
vessels make up two closed systems of tubes that begin and end at the heart. One system, the
pulmonary vessels, transports blood from the right ventricle to the lungs and back to the left atrium.
The other system, the systemic vessels, carries blood from the left ventricle to the tissues in all
parts of the body and then returns the blood to the right atrium. Based on their structure and
function, blood vessels are classified as either arteries, capillaries, or veins.

Arteries
Arteries carry blood away from the heart. Pulmonary arteries transport blood that has a low oxygen
content from the right ventricle to the lungs. Systemic arteries transport oxygenated blood from the
left ventricle to the body tissues. Blood is pumped from the ventricles into large elastic arteries that
branch repeatedly into smaller and smaller arteries until the branching results in microscopic
arteries called arterioles. The arterioles play a key role in regulating blood flow into the tissue
capillaries. About 10 percent of the total blood volume is in the systemic arterial system at any given
time.
The wall of an artery consists of three layers. The innermost layer, the tunica intima (also called
tunica interna), is simple squamous epithelium surrounded by a connective tissue basement
membrane with elastic fibers. The middle layer, the tunica media, is primarily smooth muscle and is
usually the thickest layer. It not only provides support for the vessel but also changes vessel
diameter to regulate blood flow and blood pressure. The outermost layer, which attaches the vessel
to the surrounding tissue, is the tunica externa or tunica adventitia. This layer is connective tissue
with varying amounts of elastic and collagenous fibers. The connective tissue in this layer is quite
dense where it is adjacent to the tunic media, but it changes to loose connective tissue near the
periphery of the vessel.

Capillaries
Capillaries, the smallest and most numerous of the blood vessels, form the connection between the
vessels that carry blood away from the heart (arteries) and the vessels that return blood to the heart
(veins). The primary function of capillaries is the exchange of materials between the blood and
tissue cells.

Capillary distribution varies with the metabolic activity of body tissues. Tissues such as skeletal
muscle, liver, and kidney have extensive capillary networks because they are metabolically active
and require an abundant supply of oxygen and nutrients. Other tissues, such as connective tissue,
have a less abundant supply of capillaries. The epidermis of the skin and the lens and cornea of the
eye completely lack a capillary network. About 5 percent of the total blood volume is in the systemic
capillaries at any given time. Another 10 percent is in the lungs.

Smooth muscle cells in the arterioles where they branch to form capillaries regulate blood flow from
the arterioles into the capillaries.

Veins
Veins carry blood toward the heart. After blood passes through the capillaries, it enters the smallest
veins, called venules. From the venules, it flows into progressively larger and larger veins until it
reaches the heart. In the pulmonary circuit, the pulmonary veins transport blood from the lungs to
the left atrium of the heart. This blood has a high oxygen content because it has just been
oxygenated in the lungs. Systemic veins transport blood from the body tissue to the right atrium of
the heart. This blood has a reduced oxygen content because the oxygen has been used for
metabolic activities in the tissue cells.

The walls of veins have the same three layers as the arteries. Although all the layers are present,
there is less smooth muscle and connective tissue. This makes the walls of veins thinner than those
of arteries, which is related to the fact that blood in the veins has less pressure than in the arteries.
Because the walls of the veins are thinner and less rigid than arteries, veins can hold more blood.
Almost 70 percent of the total blood volume is in the veins at any given time. Medium and large
veins have venous valves, similar to the semilunar valves associated with the heart, that help keep
the blood flowing toward the heart. Venous valves are especially important in the arms and legs,
where they prevent the backflow of blood in response to the pull of gravity.

Physiology of Circulation

Roles of Capillaries
Illustration of capillary microcirculation
In addition to forming the connection between the arteries and veins, capillaries have a vital role in
the exchange of gases, nutrients, and metabolic waste products between the blood and the tissue
cells. Substances pass through the capillary wall by diffusion, filtration, and osmosis. Oxygen and
carbon dioxide move across the capillary wall by diffusion. Fluid movement across a capillary wall is
determined by a combination of hydrostatic and osmotic pressure. The net result of the capillary
microcirculation created by hydrostatic and osmotic pressure is that substances leave the blood at
one end of the capillary and return at the other end.

Blood Flow
Blood flow refers to the movement of blood through the vessels from arteries to the capillaries and
then into the veins. Pressure is a measure of the force that the blood exerts against the vessel walls
as it moves the blood through the vessels. Like all fluids, blood flows from a high pressure area to a
region with lower pressure. Blood flows in the same direction as the decreasing pressure gradient:
arteries to capillaries to veins.

The rate, or velocity, of blood flow varies inversely with the total cross-sectional area of the blood
vessels. As the total cross-sectional area of the vessels increases, the velocity of flow decreases.
Blood flow is slowest in the capillaries, which allows time for exchange of gases and nutrients.

Resistance is a force that opposes the flow of a fluid. In blood vessels, most of the resistance is due
to vessel diameter. As vessel diameter decreases, the resistance increases and blood flow
decreases.

Very little pressure remains by the time blood leaves the capillaries and enters the venules. Blood
flow through the veins is not the direct result of ventricular contraction. Instead, venous return
depends on skeletal muscle action, respiratory movements, and constriction of smooth muscle in
venous walls.

Pulse and Blood Pressure

Pulse refers to the rhythmic expansion of an artery that is caused by ejection of blood from the
ventricle. It can be felt where an artery is close to the surface and rests on something firm.

In common usage, the term blood pressure refers to arterial blood pressure, the pressure in the
aorta and its branches. Systolic pressure is due to ventricular contraction. Diastolic pressure occurs
during cardiac relaxation. Pulse pressure is the difference between systolic pressure and diastolic
pressure. Blood pressure is measured with a sphygmomanometer and is recorded as the systolic
pressure over the diastolic pressure. Four major factors interact to affect blood pressure: cardiac
output, blood volume, peripheral resistance, and viscosity. When these factors increase, blood
pressure also increases.

Arterial blood pressure is maintained within normal ranges by changes in cardiac output and
peripheral resistance. Pressure receptors (barareceptors), located in the walls of the large arteries
in the thorax and neck, are important for short-term blood pressure regulation.

 Task: Watch this video of Heart Blood Circulation.

https://www.youtube.com/watch?v=CWFyxn0qDEU

Circulatory Pathways
The blood vessels of the body are functionally divided into two distinctive circuits: pulmonary circuit
and systemic circuit. The pump for the pulmonary circuit, which circulates blood through the lungs,
is the right ventricle. The left ventricle is the pump for the systemic circuit, which provides the blood
supply for the tissue cells of the body.

Pulmonary Circuit
Pulmonary circulation transports oxygen-poor blood from the right ventricle to the lungs, where
blood picks up a new blood supply. Then it returns the oxygen-rich blood to the left atrium.

Systemic Circuit
The systemic circulation provides the functional blood supply to all body tissue. It carries oxygen
and nutrients to the cells and picks up carbon dioxide and waste products. Systemic circulation
carries oxygenated blood from the left ventricle, through the arteries, to the capillaries in the tissues
of the body. From the tissue capillaries, the deoxygenated blood returns through a system of veins
to the right atrium of the heart.

The coronary arteries are the only vessels that branch from the ascending aorta. The
brachiocephalic, left common carotid, and left subclavian arteries branch from the aortic arch. Blood
supply for the brain is provided by the internal carotid and vertebral arteries. The subclavian arteries
provide the blood supply for the upper extremity. The celiac, superior mesenteric, suprarenal, renal,
gonadal, and inferior mesenteric arteries branch from the abdominal aorta to supply the abdominal
viscera. Lumbar arteries provide blood for the muscles and spinal cord. Branches of the external
iliac artery provide the blood supply for the lower extremity. The internal iliac artery supplies the
pelvic viscera.

Major Systemic Arteries

All systemic arteries are branches, either directly or indirectly, from the aorta. The aorta ascends
from the left ventricle, curves posteriorly and to the left, then descends through the thorax and
abdomen. This geography divides the aorta into three portions: ascending aorta, arotic arch, and
descending aorta. The descending aorta is further subdivided into the thoracic arota and abdominal
aorta.

Major Systemic Veins

After blood delivers oxygen to the tissues and picks up carbon dioxide, it returns to the heart
through a system of veins. The capillaries, where the gaseous exchange occurs, merge into
venules and these converge to form larger and larger veins until the blood reaches either the
superior vena cava or inferior vena cava, which drain into the right atrium.

Fetal Circulation
Most circulatory pathways in a fetus are like those in the adult but there are some notable
differences because the lungs, the gastrointestinal tract, and the kidneys are not functioning before
birth. The fetus obtains its oxygen and nutrients from the mother and also depends on maternal
circulation to carry away the carbon dioxide and waste products.

The umbilical cord contains two umbilical arteries to carry fetal blood to the placenta and one
umbilical vein to carry oxygen-and-nutrient-rich blood from the placenta to the fetus. The ductus
venosus allows blood to bypass the immature liver in fetal circulation. The foramen ovale and
ductus arteriosus are modifications that permit blood to bypass the lungs in fetal circulation.

Learning Activities

I.
The heart is called a double pump because it serves two circulations. Trace the flow of blood
through the pulmonary and systemic circulations by writing the missing terms in the answer blanks.

From the right atrium through the tricuspid valve to the___________________, through
the___________________valve to the pulmonary trunk to the right and left___________________,
to the capillary beds of the____________________, to the_______________________, to
the_________________of the heart through the_______________________valve, to the
______________________through the____________________semilunar valve, to the
______________________, to the systemic arteries, to the_______________________of the body
tissues, to the systemic veins, to the_____________________and______________________,
which enter the right atrium of the heart.

II.
Circle the term that does not belong in each of the following groupings.
1. Low pressure Artery Capillary Vein

2. Carotid artery Cardiac vein Coronary sinus Coronary artery

3. Sphincters Vascular shunt Valves Microcirculation

4. High blood pressure Hemorrhage Weak pulse Low cardiac output

5. Resistance Friction Vasodilation Vasoconstriction

III.
Indicate what effect the following factors have on blood pressure. Indicate an increase in pressure
by I and a decrease in pressure by D. Place the correct letter response in the answer blanks.

______ 1. Increased diameter of the arterioles ______ 8. Physical exercise

______ 2. Increased blood viscosity ______ 9. Physical training
______ 3. Increased cardiac output ______ 10. Alcohol
______ 4. Increased pulse rate ______ 11. Hemorrhage
______ 5. Anxiety, fear ______ 12. Nicotine
______ 6. Increased urine output ______ 13. Arteriosclerosis
______ 7. Sudden change in position from
reclining to standing

Mastery Test

___1. The innermost layer of the pericardial sac is the:

A. epicardium
B. fibrous pericardium
C. parietal layer of the serous pericardium
D. visceral layer of the serous pericardium
___2. The thickest layer of the heart wall is:
A. endocardium C. epicardium
B. myocardium D. fibrous
pericardium

___3. Atrioventricular valves are held closed by:

A. papillary muscles
B. trabeculae carneae
C. pectinate muscles
D. chordae tendineae
___4. The fibrous skeleton of the heart:
 A. supports valves
B. anchors vessels
C. provides electrical insulation to separate the atrial mass from the ventricular
mass
D. anchors cardiac muscle fibers
___5. Freshly oxygenated blood is first received by the:
A. right ventricle C. right atrium
B. left ventricle D. left atrium
___6. Atrial repolarization coincides in time with the:
A. P wave C. QRS wave
B. T wave D. PQ interval

___7. Soon after the onset of ventricular systole the:

A. AV valves close
B. semilunar valves open
C. first heart sound is heard
D. aortic pressure increases
___8. Where in the heart is the Bundle of His found?
A. Chordae tendinae
B. Interventricular septum
C. Atria
D. Ventricles
___9. Which of the regulatory chemicals listed involve or target the kidneys?
A. Angiotensin C. ADH
B. Aldosterone D. ANP
___10. Cardiovascular conditioning results in:
A. ventricular hypertrophy
B. bradycardia
C. increase in SV
D. increase in CO
___11. Which of the following is (are) part of the tunica intima?
A. Simple squamous epithelium
B. Basement membrane
C. Loose connective tissue
D. Smooth muscle
___12. In comparing a parallel artery and vein, you would find that:
A. the artery wall is thicker
B. the artery diameter is greater
C. the artery lumen is smaller
D. the artery endothelium is thicker
___13. Fenestrated capillaries occur in the:
 A. liver
B. kidney
C. cerebrum
D. intestinal mucosa

___14. Which of the following is (are) part of a capillary bed?

A. Precapillary sphincter
B. Vascular shunt
C. True capillaries
D. Terminal arteriole

___15. Which of the following can function as a blood reservoir?

A. Brachiocephalic artery
B. Cerebral capillaries
C. Dural sinuses
D. Inferior vena cava
___16. An increase in which of the following results in increased filtration from capillaries to
the interstitial space?
A. Capillary hydrostatic pressure
B. Interstitial fluid hydrostatic pressure
C. Capillary osmotic pressure
D. Duration of precapillary sphincter contraction
___17. Vessels involved in the circulatory pathway to and from the brain are the:
A. brachiocephalic artery
B. subclavian artery
C. internal jugular vein
D. internal carotid artery
___18. When does the isovolumetric contraction phase occur?
A. Atrial systole
B. Ventricular diastole
C. Ventricular systole
D. Atrial diastole
___19. Which layer of the artery wall thickens most in atherosclerosis?
A. Tunica media
B. Tunica intima
C. Tunica adventitia
D. Tunica externa
___20. Heart rate can be increased by which of the following?
A. Parasympathetic activity
B. Calcium ions
C. Low potassium levels
D. Epinephrine
___21. Peripheral resistance is mainly increased by:
A. low blood viscosity
B. elevated heart rate
C. reduced blood volume
D. vasoconstriction
___22. A stroke that occludes a posterior cerebral artery will most likely affect:
A. hearing
B. vision
C. smell
D. higher thought processes
___23. Tracing the drainage of the superficial venous blood from the leg, we find that
blood enters the great saphenous vein, femoral vein, inferior vena cava, and right atrium.
Which veins are missing from that sequence?
A. Coronary sinus and superior vena cava
B. Posterior tibial and popliteal
C. Fibular (peroneal) and popliteal
D. External and common iliacs
___24. Tracing the drainage of venous blood from the small intestine, we find that blood
enters the superior mesenteric vein, hepatic vein, inferior vena cava, and right atrium.
Which vessels are missing from that sequence?
A. Coronary sinus and left atrium
B. Celiac and common hepatic veins
C. Internal and common iliac veins
D. Hepatic portal vein and liver sinusoids
 UNIT 7
The Respiratory System

Learning Outcomes

At the end of this lesson, you will be able to:

 name the organs forming the respiratory passageway;

 describe the functions of the respiratory organs;
 describe the process of gas exchange in the lungs and tissues;
 describe how oxygen and carbon dioxide are transported in the blood; and
 discuss measures on the care of respiratory organs.

Pretest

Circle the term that does not belong in each of the following groupings.
1. Sphenoidal Maxillary Mandibular Ethmoidal Frontal

2. Nasal cavity Trachea Alveolus Larynx Bronchus

3. Apex Base Hilum Larynx Pleura

4. Sinusitis Peritonitis Pleurisy Tonsillitis Laryngitis

5. Laryngopharynx Oropharynx Transports air and food Nasopharynx

6. Alveoli Respiratory zone Alveolar sac Main bronchus

Content

When the respiratory system is mentioned, people generally think of breathing, but breathing is
only one of the activities of the respiratory system. The body cells need a continuous supply of
oxygen for the metabolic processes that are necessary to maintain life. The respiratory system
works with the circulatory system to provide this oxygen and to remove the waste products of
metabolism. It also helps to regulate pH of the blood.

Respiration is the sequence of events that results in the exchange of oxygen and carbon dioxide
between the atmosphere and the body cells. Every 3 to 5 seconds, nerve impulses stimulate the
breathing process, or ventilation, which moves air through a series of passages into and out of the
lungs. After this, there is an exchange of gases between the lungs and the blood. This is called
external respiration. The blood transports the gases to and from the tissue cells. The exchange of
gases between the blood and tissue cells is internal respiration. Finally, the cells utilize the oxygen
for their specific activities: this is called cellular metabolism, or cellular respiration. Together, these
activities constitute respiration.

Mechanics of Ventilation
Ventilation, or breathing, is the movement of air through the conducting passages between the
atmosphere and the lungs. The air moves through the passages because of pressure gradients that
are produced by contraction of the diaphragm and thoracic muscles.

Pulmonary ventilation
Pulmonary ventilation is commonly referred to as breathing. It is the process of air flowing into the
lungs during inspiration (inhalation) and out of the lungs during expiration (exhalation). Air flows
because of pressure differences between the atmosphere and the gases inside the lungs.

Air, like other gases, flows from a region with higher pressure to a region with lower pressure.
Muscular breathing movements and recoil of elastic tissues create the changes in pressure that
result in ventilation. Pulmonary ventilation involves three different pressures:

Atmospheric pressure
Intraalveolar (intrapulmonary) pressure
Intrapleural pressure

Atmospheric pressure is the pressure of the air outside the body. Intraalveolar pressure is the
pressure inside the alveoli of the lungs. Intrapleural pressure is the pressure within the pleural
cavity. These three pressures are responsible for pulmonary ventilation.

Inspiration
Inspiration (inhalation) is the process of taking air into the lungs. It is the active phase of ventilation
because it is the result of muscle contraction. During inspiration, the diaphragm contracts and the
thoracic cavity increases in volume. This decreases the intraalveolar pressure so that air flows into
the lungs. Inspiration draws air into the lungs.

Expiration
Expiration (exhalation) is the process of letting air out of the lungs during the breathing cycle.
During expiration, the relaxation of the diaphragm and elastic recoil of tissue decreases the thoracic
volume and increases the intraalveolar pressure. Expiration pushes air out of the lungs.

Respiratory Volumes and Capacities

Under normal conditions, the average adult takes 12 to 15 breaths a minute. A breath is one
complete respiratory cycle that consists of one inspiration and one expiration.

An instrument called a spirometer is used to measure the volume of air that moves into and out of
the lungs, and the process of taking the measurements is called spirometry. Respiratory
(pulmonary) volumes are an important aspect of pulmonary function testing because they can
provide information about the physical condition of the lungs.

Respiratory capacity (pulmonary capacity) is the sum of two or more volumes.

Factors such as age, sex, body build, and physical conditioning have an influence on lung volumes
and capacities. Lungs usually reach their maximumin capacity in early adulthood and decline with
age after that.

Conducting Passages
Illustration of the conducting passages of the upper and lower respiratory tracts
The respiratory conducting passages are divided into the upper respiratory tract and the lower
respiratory tract. The upper respiratory tract includes the nose, pharynx, and larynx. The lower
respiratory tract consists of the trachea, bronchial tree, and lungs. These tracts open to the outside
and are lined with mucous membranes. In some regions, the membrane has hairs that help filter the
air. Other regions may have cilia to propel mucus.

Nose, Nasal Cavities, & Paranasal Sinuses

Nose & Nasal Cavities
The framework of the nose consists of bone and cartilage. Two small nasal bones and extensions
of the maxillae form the bridge of the nose, which is the bony portion. The remainder of the
framework is cartilage and is the flexible portion. Connective tissue and skin cover the framework.

Air enters the nasal cavity from the outside through two openings: the nostrils or external nares.
The openings from the nasal cavity into the pharynx are the internal nares. Nose hairs at the
entrance to the nose trap large inhaled particles.

Paranasal Sinuses
Paranasal sinuses are air-filled cavities in the frontal, maxilae, ethmoid, and sphenoid bones. These
sinuses, which have the same names as the bones in which they are located, surround the nasal
cavity and open into it. They function to reduce the weight of the skull, to produce mucus, and to
influence voice quality by acting as resonating chambers.

Pharynx
The pharynx, commonly called the throat, is a passageway that extends from the base of the skull
to the level of the sixth cervical vertebra. It serves both the respiratory and digestive systems by
receiving air from the nasal cavity and air, food, and water from the oral cavity. Inferiorly, it opens
into the larynx and esophagus. The pharynx is divided into three regions according to location: the
nasopharynx, the oropharynx, and the laryngopharynx (hypopharynx).

The nasopharynx is the portion of the pharynx that is posterior to the nasal cavity and extends
inferiorly to the uvula. The oropharynx is the portion of the pharynx that is posterior to the oral
cavity. The most inferior portion of the pharynx is the laryngopharynx that extends from the hyoid
bone down to the lower margin of the larynx.

The upper part of the pharynx (throat) lets only air pass through. Lower parts permit air, foods, and
fluids to pass.

The pharyngeal, palatine, and lingual tonsils are located in the pharynx. They are also called
Waldereyer's Ring.

The retromolar trigone is the small area behind the wisdom teeth.

Larynx & Trachea

Larynx
The larynx, commonly called the voice box or glottis, is the passageway for air between the pharynx
above and the trachea below. It extends from the fourth to the sixth vertebral levels. The larynx is
often divided into three sections: sublarynx, larynx, and supralarynx. It is formed by nine cartilages
that are connected to each other by muscles and ligaments.
The larynx plays an essential role in human speech. During sound production, the vocal cords close
together and vibrate as air expelled from the lungs passes between them. The false vocal cords
have no role in sound production, but help close off the larynx when food is swallowed.

The thyroid cartilage is the Adam's apple. The epiglottis acts like a trap door to keep food and other
particles from entering the larynx.

Trachea
The trachea, commonly called the windpipe, is the main airway to the lungs. It divides into the right
and left bronchi at the level of the fifth thoracic vertebra, channeling air to the right or left lung.

The hyaline cartilage in the tracheal wall provides support and keeps the trachea from collapsing.
The posterior soft tissue allows for expansion of the esophagus, which is immediately posterior to
the trachea.

The mucous membrane that lines the trachea is ciliated pseudostratified columnar epithelium
similar to that in the nasal cavity and nasopharynx. Goblet cells produce mucus that traps airborne
particles and microorganisms, and the cilia propel the mucus upward, where it is either swallowed
or expelled.

Bronchi, Bronchial Tree, & Lungs

Bronchi and Bronchial Tree

In the mediastinum, at the level of the fifth thoracic vertebra, the trachea divides into the right and
left primary bronchi. The bronchi branch into smaller and smaller passageways until they terminate
in tiny air sacs called alveoli.

The cartilage and mucous membrane of the primary bronchi are similar to that in the trachea. As
the branching continues through the bronchial tree, the amount of hyaline cartilage in the walls
decreases until it is absent in the smallest bronchioles. As the cartilage decreases, the amount of
smooth muscle increases. The mucous membrane also undergoes a transition from ciliated
pseudostratified columnar epithelium to simple cuboidal epithelium to simple squamous epithelium.

The alveolar ducts and alveoli consist primarily of simple squamous epithelium, which permits rapid
diffusion of oxygen and carbon dioxide. Exchange of gases between the air in the lungs and the
blood in the capillaries occurs across the walls of the alveolar ducts and alveoli.
Lungs
The two lungs, which contain all the components of the bronchial tree beyond the primary bronchi,
occupy most of the space in the thoracic cavity. The lungs are soft and spongy because they are
mostly air spaces surrounded by the alveolar cells and elastic connective tissue. They are
separated from each other by the mediastinum, which contains the heart. The only point of
attachment for each lung is at the hilum, or root, on the medial side. This is where the bronchi,
blood vessels, lymphatics, and nerves enter the lungs.

The right lung is shorter, broader, and has a greater volume than the left lung. It is divided into three
lobes and each lobe is supplied by one of the secondary bronchi. The left lung is longer and
narrower than the right lung. It has an indentation, called the cardiac notch, on its medial surface for
the apex of the heart. The left lung has two lobes.

Each lung is enclosed by a double-layered serous membrane, called the pleura. The visceral pleura
is firmly attached to the surface of the lung. At the hilum, the visceral pleura is continuous with the
parietal pleura that lines the wall of the thorax. The small space between the visceral and parietal
pleurae is the pleural cavity. It contains a thin film of serous fluid that is produced by the pleura. The
fluid acts as a lubricant to reduce friction as the two layers slide against each other, and it helps to
hold the two layers together as the lungs inflate and deflate.

Learning Activities

I.
Using the key choices, select the terms identified in the following descriptions by inserting the
appropriate term or letter in the answer blanks.
Key Choices:

A. Alveoli D. Epiglottis G. Palate J. Main bronchi M. Vocal cords

B. Bronchioles E. Esophagus H. Parietal pleura K. Trachea
C. Conchae F. Glottis I. Phrenic L. Visceral pleura

_________________________ 1. Smallest conducting respiratory passageways

_________________________ 2. Separates the oral and nasal cavities
_________________________ 3. Major nerve, stimulating the diaphragm
_________________________ 4. Food passageway posterior to the trachea
_________________________ 5. Closes off the larynx during swallowing
_________________________ 6. Windpipe
_________________________ 7. Actual site of gas exchanges
_________________________ 8. Pleural layer covering the thorax walls
_________________________ 9. Pleural layer covering the lungs
_________________________ 10. Opening between vocal folds
_________________________ 11. Fleshy lobes in the nasal cavity which increase its surface area
_________________________ 12. Vibrate with expired air

II.
Using the key choices, select the terms identified in the following descriptions by inserting the
appropriate term or letter in the answer blanks.

Key Choices:
A. Atmospheric pressure B. Intrapulmonary pressure C. Intrapleural pressure
_________________________ 1. In healthy lungs, it is always lower than atmospheric pressure
(that is, it is negative pressure)
_________________________ 2. Pressure of air outside the body
_________________________ 3. As it decreases, air flows into the passageways of the lungs
_________________________ 4. As it increases over atmospheric pressure, air flows out
of the lungs
_________________________ 5. If this pressure becomes equal to the atmospheric pressure,
the lungs collapse
_________________________ 6. Rises well over atmospheric pressure during a forceful cough
_________________________ 7. Also known as intra-alveolar pressure

III.
Use the key choices to respond to the following descriptions. Insert the correct term or letter in the
answer blanks.

Key Choices:
A. External respiration C. Inspiration E. Ventilation (breathing)
B. Expiration D. Internal respiration

_________________________ 1. Period of breathing when air enters the lungs

_________________________ 2. Exchange of gases between the systemic capillary blood
and body cells
_________________________ 3. Alternate flushing of air into and out of the lungs
_________________________ 4. Exchange of gases between alveolar air and pulmonary
capillary blood
_________________________ 5. Period of breathing when air leaves the lungs

Mastery Test

___1. Structures that are part of the respiratory zone include:

A. terminal bronchioles
B. respiratory bronchioles
C. tertiary bronchi
D. alveolar ducts
___2. Which structures are associated with the production of speech?
A. Cricoid cartilage
C. Arytenoid cartilage
B. Glottis
D. Pharynx
___3. The skeleton of the external nose consists of:
A. cartilage and bone
B. bone only
C. hyaline cartilage only
D. elastic cartilage only
___4. The respiratory zone function is:
A. conduction
B. moistening of air
C. gaseous exchange
D. warming of air
___5. Where does the pharyngotympanic tube drain into?
A. Oropharynx C. Nasopharynx
B. Larynx D. Laryngopharynx
___6. The function of the cuboid cells of the alveolar walls is:
A. to produce surfactant
B. to propel mucous sheets
C. phagocytosis of dust particles
D. to allow rapid diffusion of respiratory gases
___7. An examination of a lobe of the lung reveals many branches off the main passageway.
These branches are:
A. main bronchi C. tertiary bronchi
B. lobar bronchi D. segmental bronchi
___8. What feature can be used to allow alternate routes for air if bronchioles become
blocked?
A. Alveolar ducts
B. Alveolar sacs
C. Alveolar pores
D. Terminal bronchioles
___9. The respiratory membrane (air-blood barrier) consists of:
A. squamous cells, basal membranes, endothelial cells
B. air, connective tissue, lung
C. squamous and cuboidal epithelial cells and macrophages
D. pseudostratified epithelium, lamina pro- pria, capillaries
___10. Carbon dioxide is largely transported in the blood as:
A. bicarbonate ions
B. carbon monoxide
C. carbonic acid
D. free gas
___11. The basic rate of breathing is set by the:
A. ventral respiratory group
B. cerebellum
C. dorsal respiratory group
D. diaphragm
___12. Emphysema is characterized by:
A. excess mucus
B. destruction of alveolar walls
C. increased elasticity
D. chronic cough
___13. When the inspiratory muscles contract,
A. the size of the thoracic cavity increases in diameter
B. the size of the thoracic cavity increases in length
C. the volume of the thoracic cavity decreases
D. the size of the thoracic cavity increases in both length and diameter
___14. Lung collapse is prevented by:
A. high surface tension of alveolar fluid
B. high surface tension of pleural fluid
C. high pressure in the pleural cavities
D. high elasticity of lung tissue
___15. Resistance is increased by:
A. epinephrine
B. parasympathetic stimulation
C. inflammatory chemicals
D. contraction of the trachealis muscle
___16. Which of the following changes accompanies the loss of elasticity associated with aging?
A. Increase in tidal volume
B. Increase in inspiratory reserve volume
C. Increase in residual volume
D. Increase in vital capacity
 UNIT 8
The Digestive System

Learning Outcomes

At the end of this lesson, you will be able to:

 describe the structure and function of the organs of the digestive system;
 define the different process in the digestive system; and
 explain the roles of enzymes and gastric secretions in digestion.

Pretest
Complete the following statements by inserting your answers in the answer blanks.

The digestive system is responsible for many body processes. Its functions begin when food is
taken into the mouth, or __________________. The process called________________occurs as
food is broken down both chemically and mechanically. For the brokendown foods to be made
available to the body cells, they must be absorbed through the digestive system walls into
the_______________________. Undigestible food remains are removed, or ______________,
from the body in______________________. The organs forming a continuous tube from the mouth
to the anus are collectively called the___________________________. Organs located outside the
digestive tract proper, which secrete their products into the digestive tract, are referred to
as______________________ digestive system organs.

Content

The digestive system includes the digestive tract and its accessory organs, which process food into
molecules that can be absorbed and utilized by the cells of the body. Food is broken down, bit by
bit, until the molecules are small enough to be absorbed and the waste products are eliminated.
The digestive tract, also called the alimentary canal or gastrointestinal (GI) tract, consists of a long
continuous tube that extends from the mouth to the anus. It includes the mouth, pharynx,
esophagus, stomach, small intestine, and large intestine. The tongue and teeth are accessory
structures located in the mouth. The salivary glands, liver, gallbladder, and pancreas are major
accessory organs that have a role in digestion. These organs secrete fluids into the digestive tract.

Food undergoes three types of processes in the body:

Digestion
Absorption
Elimination

Digestion and absorption occur in the digestive tract. After the nutrients are absorbed, they are
available to all cells in the body and are utilized by the body cells in metabolism.
The digestive system prepares nutrients for utilization by body cells through six activities, or
functions.

Ingestion
The first activity of the digestive system is to take in food through the mouth. This process, called
ingestion, has to take place before anything else can happen.

Mechanical Digestion
The large pieces of food that are ingested have to be broken into smaller particles that can be acted
upon by various enzymes. This is mechanical digestion, which begins in the mouth with chewing or
mastication and continues with churning and mixing actions in the stomach.

Chemical Digestion
The complex molecules of carbohydrates, proteins, and fats are transformed by chemical digestion
into smaller molecules that can be absorbed and utilized by the cells. Chemical digestion, through a
process called hydrolysis, uses water and digestive enzymes to break down the complex
molecules. Digestive enzymes speed up the hydrolysis process, which is otherwise very slow.

Movements
After ingestion and mastication, the food particles move from the mouth into the pharynx, then into
the esophagus. This movement is deglutition, or swallowing. Mixing movements occur in the
stomach as a result of smooth muscle contraction. These repetitive contractions usually occur in
small segments of the digestive tract and mix the food particles with enzymes and other fluids. The
movements that propel the food particles through the digestive tract are called peristalsis. These
are rhythmic waves of contractions that move the food particles through the various regions in
which mechanical and chemical digestion takes place.

Absorption
The simple molecules that result from chemical digestion pass through cell membranes of the lining
in the small intestine into the blood or lymph capillaries. This process is called absorption.

Elimination
The food molecules that cannot be digested or absorbed need to be eliminated from the body. The
removal of indigestible wastes through the anus, in the form of feces, is defecation or elimination.

General Structure of the Digestive System

The long continuous tube that is the digestive tract is about 9 meters in length. It opens to the
outside at both ends, through the mouth at one end and through the anus at the other. Although
there are variations in each region, the basic structure of the wall is the same throughout the entire
length of the tube.

The wall of the digestive tract has four layers or tunics:

Mucosa
Submucosa
Muscular layer
Serous layer or serosa

The mucosa, or mucous membrane layer, is the innermost tunic of the wall. It lines the lumen of the
digestive tract. The mucosa consists of epithelium, an underlying loose connective tissue layer
called lamina propria, and a thin layer of smooth muscle called the muscularis mucosa. In certain
regions, the mucosa develops folds that increase the surface area. Certain cells in the mucosa
secrete mucus, digestive enzymes, and hormones. Ducts from other glands pass through the
mucosa to the lumen. In the mouth and anus, where thickness for protection against abrasion is
needed, the epithelium is stratified squamous tissue. The stomach and intestines have a thin simple
columnar epithelial layer for secretion and absorption.

The submucosa is a thick layer of loose connective tissue that surrounds the mucosa. This layer
also contains blood vessels, lymphatic vessels, and nerves. Glands may be embedded in this layer.

The smooth muscle responsible for movements of the digestive tract is arranged in two layers, an
inner circular layer and an outer longitudinal layer. The myenteric plexus is between the two muscle
layers.

Above the diaphragm, the outermost layer of the digestive tract is a connective tissue called
adventitia. Below the diaphragm, it is called serosa.

Regions of the Digestive System

At its simplest, the digestive system is a tube running from mouth to anus. Its chief goal is to break
down huge macromolecules (proteins, fats and starch), which cannot be absorbed intact, into
smaller molecules (amino acids, fatty acids and glucose) that can be absorbed across the wall of
the tube, and into the circulatory system for dissemination throughout the body.

Regions of the digestive system can be divided into two main parts: the alimentary tract and
accessory organs. The alimentary tract of the digestive system is composed of the mouth, pharynx,
esophagus, stomach, small and large intestines, rectum and anus. Associated with the alimentary
tract are the following accessory organs: salivary glands, liver, gallbladder, and pancreas.

Alimentary Tract of the Digestive System

Mouth
The mouth, or oral cavity, is the first part of the digestive tract. It is adapted to receive food by
ingestion, break it into small particles by mastication, and mix it with saliva. The lips, cheeks, and
palate form the boundaries. The oral cavity contains the teeth and tongue and receives the
secretions from the salivary glands.
Lips and Cheeks
The lips and cheeks help hold food in the mouth and keep it in place for chewing. They are also
used in the formation of words for speech. The lips contain numerous sensory receptors that are
useful for judging the temperature and texture of foods.

Palate
The palate is the roof of the oral cavity. It separates the oral cavity from the nasal cavity. The
anterior portion, the hard palate, is supported by bone. The posterior portion, the soft palate, is
skeletal muscle and connective tissue. Posteriorly, the soft palate ends in a projection called the
uvula. During swallowing, the soft palate and uvula move upward to direct food away from the nasal
cavity and into the oropharynx.

Tongue
The tongue manipulates food in the mouth and is used in speech. The surface is covered with
papillae that provide friction and contain the taste buds.

Teeth
A complete set of deciduous (primary) teeth contains 20 teeth. There are 32 teeth in a complete
permanent (secondary) set. The shape of each tooth type corresponds to the way it handles food.

Pharynx
Food is forced into the pharynx by the tongue. When food reaches the opening, sensory receptors
around the fauces respond and initiate an involuntary swallowing reflex. This reflex action has
several parts. The uvula is elevated to prevent food from entering the nasopharynx. The epiglottis
drops downward to prevent food from entering the larynx and trachea in order to direct the food into
the esophagus. Peristaltic movements propel the food from the pharynx into the esophagus.

Esophagus
The esophagus is a collapsible muscular tube that serves as a passageway between the pharynx
and stomach. As it descends, it is posterior to the trachea and anterior to the vertebral column. It
passes through an opening in the diaphragm, called the esophageal hiatus, and then empties into
the stomach. The mucosa has glands that secrete mucus to keep the lining moist and well
lubricated to ease the passage of food. Upper and lower esophageal sphincters control the
movement of food into and out of the esophagus. The lower esophageal sphincter is sometimes
called the cardiac sphincter and resides at the esophagogastric junction.

Stomach
The stomach, which receives food from the esophagus, is located in the upper left quadrant of the
abdomen. The stomach is divided into the fundic, cardiac, body, and pyloric regions. The lesser and
greater curvatures are on the right and left sides, respectively, of the stomach.
Gastric Secretions
The mucosal lining of the stomach is simple columnar epithelium with numerous tubular gastric
glands. The gastric glands open to the surface of the mucosa through tiny holes called gastric pits.
Four different types of cells make up the gastric glands:

Mucous cells
Parietal cells
Chief cells
Endocrine cells
The secretions of the exocrine gastric glands - composed of the mucous, parietal, and chief cells -
make up the gastric juice. The products of the endocrine cells are secreted directly into the
bloodstream and are not a part of the gastric juice. The endocrine cells secrete the hormone
gastrin, which functions in the regulation of gastric activity.

Regulation of Gastric Secretions

The regulation of gastric secretion is accomplished through neural and hormonal mechanisms.
Gastric juice is produced all the time but the amount varies subject to the regulatory factors.
Regulation of gastric secretions may be divided into cephalic, gastric, and intestinal phases.
Thoughts and smells of food start the cephalic phase of gastric secretion; the presence of food in
the stomach initiates the gastric phase; and the presence of acid chyme in the small intestine
begins the intestinal phase.

Stomach Emptying
Relaxation of the pyloric sphincter allows chyme to pass from the stomach into the small intestine.
The rate of which this occurs depends on the nature of the chyme and the receptivity of the small
intestine.

Small & Large Intestine

The small intestine extends from the pyloric sphincter to the ileocecal valve, where it empties into
the large intestine. The small intestine finishes the process of digestion, absorbs the nutrients, and
passes the residue on to the large intestine. The liver, gallbladder, and pancreas are accessory
organs of the digestive system that are closely associated with the small intestine.

The small intestine is divided into the duodenum, jejunum, and ileum. The small intestine follows
the general structure of the digestive tract in that the wall has a mucosa with simple columnar
epithelium, submucosa, smooth muscle with inner circular and outer longitudinal layers, and serosa.
The absorptive surface area of the small intestine is increased by plicae circulares, villi, and
microvilli.
Exocrine cells in the mucosa of the small intestine secrete mucus, peptidase, sucrase, maltase,
lactase, lipase, and enterokinase. Endocrine cells secrete cholecystokinin and secretin.

The most important factor for regulating secretions in the small intestine is the presence of chyme.
This is largely a local reflex action in response to chemical and mechanical irritation from the chyme
and in response to distention of the intestinal wall. This is a direct reflex action, thus the greater the
amount of chyme, the greater the secretion.

The large intestine is larger in diameter than the small intestine. It begins at the ileocecal junction,
where the ileum enters the large intestine, and ends at the anus. The large intestine consists of the
colon, rectum, and anal canal.

The wall of the large intestine has the same types of tissue that are found in other parts of the
digestive tract but there are some distinguishing characteristics. The mucosa has a large number of
goblet cells but does not have any villi. The longitudinal muscle layer, although present, is
incomplete. The longitudinal muscle is limited to three distinct bands, called teniae coli, that run the
entire length of the colon. Contraction of the teniae coli exerts pressure on the wall and creates a
series of pouches, called haustra, along the colon. Epiploic appendages, pieces of fat-filled
connective tissue, are attached to the outer surface of the colon.

Unlike the small intestine, the large intestine produces no digestive enzymes. Chemical digestion is
completed in the small intestine before the chyme reaches the large intestine. Functions of the large
intestine include the absorption of water and electrolytes and the elimination of feces.

Rectum and Anus

The rectum continues from the sigmoid colon to the anal canal and has a thick muscular layer. It
follows the curvature of the sacrum and is firmly attached to it by connective tissue. The rectum
ends about 5 cm below the tip of the coccyx, at the beginning of the anal canal.

The last 2 to 3 cm of the digestive tract is the anal canal, which continues from the rectum and
opens to the outside at the anus. The mucosa of the rectum is folded to form longitudinal anal
columns. The smooth muscle layer is thick and forms the internal anal sphincter at the superior end
of the anal canal. This sphincter is under involuntary control. There is an external anal sphincter at
the inferior end of the anal canal. This sphincter is composed of skeletal muscle and is under
voluntary control.
Accessory Organs of the Digestive System

The salivary glands, liver, gallbladder, and pancreas are not part of the digestive tract, but they
have a role in digestive activities and are considered accessory organs.

Salivary Glands
Three pairs of major salivary glands (parotid, submandibular, and sublingual glands) and numerous
smaller ones secrete saliva into the oral cavity, where it is mixed with food during mastication.
Saliva contains water, mucus, and enzyme amylase. Functions of saliva include the following:

It has a cleansing action on the teeth.

It moistens and lubricates food during mastication and swallowing.
It dissolves certain molecules so that food can be tasted.
It begins the chemical digestion of starches through the action of amylase, which breaks down
polysaccharides into disaccharides.

Liver
The liver is located primarily in the right hypochondriac and epigastric regions of the abdomen, just
beneath the diaphragm. It is the largest gland in the body. On the surface, the liver is divided into
two major lobes and two smaller lobes. The functional units of the liver are lobules with sinusoids
that carry blood from the periphery to the central vein of the lobule.

The liver receives blood from two sources. Freshly oxygenated blood is brought to the liver by the
common hepatic artery, a branch of the celiac trunk from the abdominal aorta. Blood that is rich in
nutrients from the digestive tract is carried to the liver by the hepatic portal vein.

The liver has a wide variety of functions and many of these are vital to life. Hepatocytes perform
most of the functions attributed to the liver, but the phagocytic Kupffer cells that line the sinusoids
are responsible for cleansing the blood.

Liver functions include the following:

secretion
synthesis of bile salts
synthesis of plasma protein
storage
detoxification
excretion
carbohyrate metabolism
lipid metabolism
protein metabolism
filtering

Gallbladder
The gallbladder is a pear-shaped sac that is attached to the visceral surface of the liver by the
cystic duct. The principal function of the gallbladder is to serve as a storage reservoir for bile. Bile is
a yellowish-green fluid produced by liver cells. The main components of bile are water, bile salts,
bile pigments, and cholesterol.

Bile salts act as emulsifying agents in the digestion and absorption of fats. Cholesterol and bile
pigments from the breakdown of hemoglobin are excreted from the body in the bile.
Pancreas
The pancreas has both endocrine and exocrine functions. The endocrine portion consists of the
scattered islets of Langerhans, which secrete the hormones insulin and glucagon into the blood.
The exocrine portion is the major part of the gland. It consists of pancreatic acinar cells that secrete
digestive enzymes into tiny ducts interwoven between the cells. Pancreatic enzymes include
anylase, trypsin, peptidase, and lipase. Pancreatic secretions are controlled by the hormones
secretin and cholecystokinin.

Learning Activities

I.
Various types of glands secrete substances into the alimentary tube. Match the glands listed in
Column B to the functions/locations described in Column A. Place the correct term or letter
response in the answer blanks.

Column A Column B

_________________________ 1. Produce an enzyme-poor “juice” A. Gastric glands

containing mucus; found in the
submucosa of the small intestine B. Intestinal glands
_________________________ 2. Secretion includes amylase, which
begins starch digestion in the mouth C. Liver
_________________________ 3. Ducts a variety of enzymes in an
alkaline fluid into the duodenum D. Pancreas
_________________________ 4. Produces bile, which is transported
to the duodenum via the bile duct E. Salivary glands
_________________________ 5. Produce hydrochloric acid and
pepsinogen

II.
Using the key choices, select the terms identified in the following descriptions by inserting the
appropriate term or letter in the answer blanks.

Key Choices:

A. Anal canal J. Mesentery R. Rugae

B. Appendix K. Microvilli S. Small intestine
C. Colon L. Oral cavity T. Soft palate
D. Esophagus M. Parietal peritoneum U. Stomach
E. Greater omentum N. Peyer’s patches V. Tongue
F. Hard palate O. Pharynx W. Vestibule
G. Haustra P. Plicae circulares X. Villi
H. Ileocecal valve Q. Pyloric sphincter (valve) Y. Visceral peritoneum
I. Lesser omentum

_________________________ 1. Structure that suspends the small intestine from the posterior
body wall
_________________________ 2. Finger-like extensions of the intestinal mucosa that increase
the surface area
_________________________ 3. Collections of lymphatic tissue found in the submucosa of the
small intestine
_________________________ 4. Folds of the small intestine wall

_________________________ 5. Two anatomical regions involved in the mechanical breakdown

of food
_________________________ 6. Organ that mixes food in the mouth
_________________________ 7. Common passage for food and air
_________________________, 8. Three extensions/modifications of the peritoneum
_________________________, and _________________________
_________________________ 9. Literally a food chute; has no digestive or absorptive role
_________________________ 10. Folds of the stomach mucosa
_________________________ 11. Saclike outpocketings of the large intestine wall
_________________________ 12. Projections of the plasma membrane of a cell that increase the
cell’s surface area
_________________________ 13. Prevents food from moving back into the small intestine once
it has entered the large intestine
_________________________ 14. Organ responsible for most food and water absorption
_________________________ 15. Organ primarily involved in water absorption and feces
formation
_________________________ 16. Area between the teeth and lips/cheeks
_________________________ 17. Blind sac hanging from the initial part of the colon
_________________________ 18. Organ in which protein digestion begins
_________________________ 19. Membrane attached to the lesser curvature of the stomach
_________________________ 20. Organ into which the stomach empties
_________________________ 21. Sphincter controlling the movement of food from the stomach
into the duodenum
_________________________ 22. Uvula hangs from its posterior edge
_________________________ 23. Organ that receives pancreatic juice and bile
_________________________ 24. Serosa of the abdominal cavity wall
_________________________ 25. Region, containing two sphincters, through which feces are
expelled from the body
_________________________ 26. Anterosuperior boundary of the oral cavity; supported by bone
_________________________ 27. Serous membrane forming part of the wall of the small intestine

Mastery Test

___1. Which of the following terms are synonyms?

A. Gastrointestinal tract
B. Digestive system
C. Digestive tract
D. Alimentary canal
___2. A digestive organ that is not part of the ali mentary canal is the:
A. stomach D. large intestine
B. liver E. pharynx
C. small intestine
___3. The GI tube layer responsible for the actions of segmentation and peristalsis is:
A. serosa C. muscularis externa
 B. mucosa D. submucosa
___4. Which alimentary canal tunic has the great est abundance of lymph nodules?
A. Mucosa C. Serosa
B. Muscularis D. Submucosa
___5. Proteins secreted in saliva include:
A. mucin C. lysozyme
B. amylase D. IgA
___6. The closure of which valve is assisted by the diaphragm?
A. Ileocecal
B. Pyloric
C. Gastroesophageal
D. Upper esophageal
___7. Smooth muscle is found in the:
A. tongue
B. pharynx
C. esophagus
D. external anal sphincter
___8. Which of these organs lies in the right hypochondriac region of the abdomen?
A. Stomach C. Cecum
B. Spleen D. Liver

___9. Which phases of gastric secretion depend (at least in part) on the vagus nerve?
A. Cephalic
B. Gastric
C. Intestinal (stimulatory)
D. Intestinal (inhibitory)
___10. Which of the following are tied to sodium transport?
A. Glucose
B. Fructose
C. Galactose
D. Amino acids
___11. Excess iron is stored primarily in the:
A. liver
B. bone marrow
C. duodenal epithelium
D. blood
___12. A 3yearold girl was rewarded with a hug because she was now completely toilet
trained. Which muscle had she learned to control?
A. Levator ani
 B. Internal anal sphincter
C. Internal and external obliques
D. External anal sphincter
___13. Which cell type fits this description? It occurs in the stomach mucosa, contains
abundant mitochondria and many microvilli, and pumps hydrogen ions.
A. Absorptive cell C. Goblet cell
B. Parietal cell D. Mucous neck cell
___14. Which of the following are “essential” nutrients?
A. Glucose C. Cholesterol
B. Linoleic acid D. Leucine
___15. Deficiency of which of these vitamins results in anemia?
A. Thiamin C. Biotin
B. Riboflavin D. Folic acid
___16. Vitamins that act as coenzymes in the Krebs cycle include:
A. riboflavin C. biotin
B. niacin D. pantothenic acid
___17. Substratelevel phosphorylation occurs during:
A. glycolysis C. Krebs cycle
B. betaoxidation D. electron transport

___18. Chemicals that can be used for gluconeo genesis include:

A. amino acids
B. glycerol
C. fatty acids
D. alphaketoglutaric acid
___19. The chemiosmotic process involves:
A. buildup of hydrogen ion concentration
B. electron transport
C. oxidation and reduction
D. ATP synthase
___20. Only the liver functions to:
A. store iron
B. form urea
C. produce plasma proteins
D. form ketone bodies
___21. Which events occur during the absorptive state?
A. Use of amino acids as a major source of energy
B. Lipogenesis
C. Betaoxidation
D. Increased uptake of glucose by skeletal muscles
___22. Hormones that act to decrease blood glucose level include:
A. insulin C. epinephrine
B. glucagon D. growth hormone
___23. During the postabsorptive state:
A. glycogenesis occurs in the liver
B. fatty acids are used for fuel
C. amino acids are converted to glucose
D. lipolysis occurs in adipose tissue
___24. Which transport particles carry cholesterol destined for excretion from the body?
A. HDL C. LDL
B. Chylomicron D. VLDL (very low
density lipoprotein)
___25. Glucose (or its metabolites) can be converted to:
A. glycogen
B. triglycerides
C. nonessential amino acids
D. starch

___26. Basal metabolic rate:

A. is the lowest metabolic rate of the body
B. is the metabolic rate during sleep
C. is measured as kcal per square meter of skin per hour
D. increases with age
___27. Which of the following types of heat trans fer involves heat loss in the form of
infrared waves?
A. Conduction C. Evaporation
B. Convection D. Radiation
___28. PKU is the result of inability to metabolize:
A. tyrosine C. ketone bodies
B. melanin D. phenylalanine
 UNIT 9
The Urinary System

Learning Outcomes

At the end of this lesson, you will be able to:

 describe the parts of the urinary system and give the functions of each;
 name the processes involved in urine formation; and
 explain the significance of maintaining fluid and electrolyte balances.

Pretest

The kidney is referred to as an excretory organ because it excretes_______________wastes. It is

also a major homeostatic organ because it maintains the electrolyte,_______________,
and_________________ balance of the blood. Urine is continuously formed by
the__________________and is routed down the___________________by the mechanism
of_________________to a storage organ called the____________________. Eventually the urine
is conducted to the body exterior by the___________________. In males, this tubelike structure is
about__________________inches long; in females, it is approximately_______inches long.

Content

The principal function of the urinary system is to maintain the volume and composition of body fluids
within normal limits. One aspect of this function is to rid the body of waste products that accumulate
as a result of cellular metabolism, and, because of this, it is sometimes referred to as the excretory
system.

Although the urinary system has a major role in excretion, other organs contribute to the excretory
function. The lungs in the respiratory system excrete some waste products, such as carbon dioxide
and water. The skin is another excretory organ that rids the body of wastes through the sweat
glands. The liver and intestines excrete bile pigments that result from the destruction of hemoglobin.
The major task of excretion still belongs to the urinary system. If it fails the other organs cannot take
over and compensate adequately.

The urinary system maintains an appropriate fluid volume by regulating the amount of water that is
excreted in the urine. Other aspects of its function include regulating the concentrations of various
electrolytes in the body fluids and maintaining normal pH of the blood.

In addition to maintaining fluid homeostasis in the body, the urinary system controls red blood cell
production by secreting the hormone erythropoietin. The urinary system also plays a role in
maintaining normal blood pressure by secreting the enzyme renin.

Components of the Urinary System

The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The kidneys form
the urine and account for the other functions attributed to the urinary system. The ureters carry the
urine away from kidneys to the urinary bladder, which is a temporary reservoir for the urine. The
urethra is a tubular structure that carries the urine from the urinary bladder to the outside.

Kidneys
Ureters
Urinary Bladder
Urethra

Kidneys
The kidneys are the primary organs of the urinary system. The kidneys are the organs that filter the
blood, remove the wastes, and excrete the wastes in the urine. They are the organs that perform
the functions of the urinary system. The other components are accessory structures to eliminate the
urine from the body.

The paired kidneys are located between the twelfth thoracic and third lumbar vertebrae, one on
each side of the vertebral column. The right kidney usually is slightly lower than the left because the
liver displaces it downward. The kidneys, protected by the lower ribs, lie in shallow depressions
against the posterior abdominal wall and behind the parietal peritoneum. This means they are
retroperitoneal. Each kidney is held in place by connective tissue, called renal fascia, and is
surrounded by a thick layer of adipose tissue, called perirenal fat, which helps to protect it. A tough,
fibrous, connective tissue renal capsule closely envelopes each kidney and provides support for the
soft tissue that is inside.

In the adult, each kidney is approximately 3 cm thick, 6 cm wide, and 12 cm long. It is roughly bean-
shaped with an indentation, called the hilum, on the medial side. The hilum leads to a large cavity,
called the renal sinus, within the kidney. The ureter and renal vein leave the kidney, and the renal
artery enters the kidney at the hilum.

The outer, reddish region, next to the capsule, is the renal cortex. This surrounds a darker reddish-
brown region called the renal medulla. The renal medulla consists of a series of renal pyramids,
which appear striated because they contain straight tubular structures and blood vessels. The wide
bases of the pyramids are adjacent to the cortex and the pointed ends, called renal papillae, are
directed toward the center of the kidney. Portions of the renal cortex extend into the spaces
between adjacent pyramids to form renal columns. The cortex and medulla make up the
parenchyma, or functional tissue, of the kidney.

The central region of the kidney contains the renal pelvis, which is located in the renal sinus, and is
continuous with the ureter. The renal pelvis is a large cavity that collects the urine as it is produced.
The periphery of the renal pelvis is interrupted by cuplike projections called calyces. A minor calyx
surrounds the renal papillae of each pyramid and collects urine from that pyramid. Several minor
calyces converge to form a major calyx. From the major calyces, the urine flows into the renal
pelvis; and from there, it flows into the ureter.

Each kidney contains over a million functional units, called nephrons, in the parenchyma (cortex
and medulla). A nephron has two parts: a renal corpuscle and a renal tubule.The renal corpuscle
consists of a cluster of capillaries, called the glomerulus, surrounded by a double-layered epithelial
cup, called the glomerular capsule. An afferent arteriole leads into the renal corpuscle and an
efferent arteriole leaves the renal corpuscle. Urine passes from the nephrons into collecting ducts
then into the minor calyces.

The juxtaglomerular apparatus, which monitors blood pressure and secretes renin, is formed from
modified cells in the afferent arteriole and the ascending limb of the nephron loop.

Ureters
Each ureter is a small tube, about 25 cm long, that carries urine from the renal pelvis to the urinary
bladder. It descends from the renal pelvis, along the posterior abdominal wall, which is behind the
parietal peritoneum, and enters the urinary bladder on the posterior inferior surface.

The wall of the ureter consists of three layers. The outer layer, the fibrous coat, is a supporting layer
of fibrous connective tissue. The middle layer, the muscular coat, consists of the inner circular and
outer longitudinal smooth muscle. The main function of this layer is peristalsis: to propel the urine.
The inner layer, the mucosa, is transitional epithelium that is continuous with the lining of the renal
pelvis and the urinary bladder. This layer secretes mucus, which coats and protects the surface of
the cells.

Urinary Bladder
The urinary bladder is a temporary storage reservoir for urine. It is located in the pelvic cavity,
posterior to the symphysis pubis, and below the parietal peritoneum. The size and shape of the
urinary bladder varies with the amount of urine it contains and with the pressure it receives from
surrounding organs.

The inner lining of the urinary bladder is a mucous membrane of transitional epithelium that is
continuous with that in the ureters. When the bladder is empty, the mucosa has numerous folds
called rugae. The rugae and transitional epithelium allow the bladder to expand as it fills.

The second layer in the walls is the submucosa, which supports the mucous membrane. It is
composed of connective tissue with elastic fibers.

The next layer is the muscularis, which is composed of smooth muscle. The smooth muscle fibers
are interwoven in all directions and, collectively, these are called the detrusor muscle. Contraction
of this muscle expels urine from the bladder. On the superior surface, the outer layer of the bladder
wall is parietal peritoneum. In all other regions, the outer layer is fibrous connective tissue.
There is a triangular area, called the trigone, formed by three openings in the floor of the urinary
bladder. Two of the openings are from the ureters and form the base of the trigone. Small flaps of
mucosa cover these openings and act as valves that allow urine to enter the bladder but prevent it
from backing up from the bladder into the ureters. The third opening, at the apex of the trigone, is
the opening into the urethra. A band of the detrusor muscle encircles this opening to form the
internal urethral sphincter.

Urethra
The final passageway for the flow of urine is the urethra, a thin-walled tube that conveys urine from
the floor of the urinary bladder to the outside. The opening to the outside is the external urethral
orifice. The mucosal lining of the urethra is transitional epithelium. The wall also contains smooth
muscle fibers and is supported by connective tissue.

The internal urethral sphincter surrounds the beginning of the urethra, where it leaves the urinary
bladder. This sphincter is smooth (involuntary) muscle. Another sphincter, the external urethral
sphincter, is skeletal (voluntary) muscle and encircles the urethra where it goes through the pelvic
floor. These two sphincters control the flow of urine through the urethra.

In females, the urethra is short, only 3 to 4 cm (about 1.5 inches) long. The external urethral orifice
opens to the outside just anterior to the opening for the vagina.

In males, the urethra is much longer, about 20 cm (7 to 8 inches) in length, and transports both
urine and semen. The first part, next to the urinary bladder, passes through the prostate gland and
is called the prostatic urethra. The second part, a short region that penetrates the pelvic floor and
enters the penis, is called the membranous urethra. The third part, the spongy urethra, is the
longest region. This portion of the urethra extends the entire length of the penis, and the external
urethral orifice opens to the outside at the tip of the penis.
 Learning Activities

I.
Circle the term that does not belong in each of the following groupings.

1. Intraperitoneal Kidney Retroperitoneal Superior lumbar region

2. Drains kidney Ureter Urethra Renal pelvis

3. Peritubular capillaries Reabsorption Glomerulus Low-pressure vessels

4. Juxtaglomerular apparatus Distal tubule Glomerulus Afferent arteriole

5. Glomerulus Peritubular capillaries Blood vessels Collecting duct

6. Cortical nephrons Juxtamedullary nephrons Cortex/medulla junction

Long nephron loops

7. Nephron Proximal convoluted tubule Distal convoluted tubule

Collecting duct

8. Medullary pyramids Glomeruli Renal pyramids Collecting ducts

9. Glomerular capsule Podocytes Nephron loop Glomerulus

II.
Circle the term that does not belong in each of the following groupings.

1. Bladder Kidney Transitional epithelium Detrusor muscle

2. Trigone Ureter openings Urethral opening Bladder Forms urine

3. Surrounded by prostate gland Contains internal and external sphincters

Continuous with renal pelvis Urethra

4. Prostatic Male Female Membranous Spongy

III.
Using the key choices, identify the structures that best fit the following descriptions. Insert the
correct term(s) or corresponding letter(s) in the answer blanks.

Key Choices:

A. Bladder B. Urethra C. Ureter

_________________________ 1. Drains the bladder

_________________________ 2. Storage area for urine
_________________________ 3. Contains the trigone
_________________________ 4. In males has prostatic, membranous, and spongy parts
_________________________ 5. Conducts urine by peristalsis
_________________________ 6. Substantially longer in males than in females
_________________________ 7. A common site of “trapped” renal calculi
_________________________ 8. Contains transitional epithelium
_________________________ 9. Also transports sperm in males

Mastery Test

___1. A radiologist is examining an X-ray of the lumbar region of a patient. Which of the
following is (are) indicative of normal posi- tioning of the right kidney?
A. Slightly lower than the left kidney
B. More medial than the left kidney
C. Closer to the inferior vena cava than the left kidney
D. Anterior to the 12th rib
___2. Which of the following encloses both kidney and adrenal gland?
A. Renal fascia
B. Perirenal fat capsule
C. Fibrous capsule
D. Visceral peritoneum
___3. Microscopic examination of a section of the kidney shows a thick-walled vessel with
renal corpuscles scattered in the tissue on one side of the vessel but not on the other
side. What vessel is this?
A. Interlobar artery
B. Cortical radiate artery
C. Cortical radiate vein
D. Arcuate artery
___4. Structures that are at least partly composed of simple squamous epithelium include:
A. collecting ducts
B. glomerulus
C. glomerular capsule
D. nephron loop
___5. Where are glucose and amino acids reab- sorbed?
A. Descending limb of nephron loop
B. Glomerulus
C. Proximal convoluted tubule
D. Distal convoluted tubule
___6. Which process is used to excrete sodium ions?
A. Osmosis
B. Facilitated diffusion
C. Active transport
D. Passive diffusion
___7. What is the function of the juxtaglomerular apparatus?
A. Detects fall in blood pressure
B. Releases angiotensin
C. Releases renin
D. Releases aldosterone
___8. Urine passes through the ureters by which mechanism?
A. Ciliary action
B. Peristalsis
C. Gravity alone
D. Suction
___9. Sodium deficiency hampers reabsorption of:
A. glucose
B. albumin
C. creatinine
D. water
___10. The main function of transitional epithelium in the ureter is:
A. protection against kidney stones
B. secretion of mucus
C. reabsorption
D. stretching
___11. Jim was standing at a urinal in a crowded public restroom and a long line was
forming behind him. He became anxious (sym- pathetic response) and found he
could not micturate no matter how hard he tried. Use logic to deduce Jim’s problem.
A. His internal urethral sphincter was con- stricted and would not relax.
B. His external urethral sphincter was con- stricted and would not relax.
C. His detrusor muscle was contracting too hard.
D. He almost certainly had a burst bladder.
___12. What is the typical urine output per day?
A. 150 mL
B. 500 mL
C. 1500 mL
D. 3000 mL
___13. What is the normal range for urine specific gravity?
A. 500–1000 mL
B. pH 6.0–7.2
C. 60–80
D. 1.001–1.035

___14. The urinary bladder:

A. is lined with transitional epithelium
B. has a thick, muscular wall
 C. receives the ureteral orifices at its superior aspect
D. is innervated by the renal plexus
___15. Which of the following are controlled voluntarily?
A. Detrusor muscle
B. Internal urethral sphincter
C. External urethral sphincter
D. Levator ani muscle
___16. In movement between IF and ICF:
A. water flow is bidirectional
B. nutrient flow is unidirectional
C. ion flow is selectively permitted
D. ion fluxes are not permitted
___17. Loss of water from the body via the lungs is termed as:
A. respiratory water loss
B. insensible water loss
C. micturition
D. respiratory diuresis
___18. The smallest fluid compartment is the:
A. ICF C. plasma
B. ECF D. IF
___19. Which of the following are electrolytes?
A. Glucose
B. Lactic acid
C. Urea
D. Bicarbonate
___20. Chloride ion reabsorption:
A. exactly parallels sodium ion reabsorption
B. fluctuates according to blood pH
C. increases during acidosis
D. is controlled directly by aldosterone
___21. Respiratory acidosis occurs in:
A. asthma
B. emphysema
C. barbiturate overdose
D. cystic fibrosis

___22. Hyperkalemia:
A. triggers secretion of aldosterone
B. may result from severe alcoholism
C. disturbs acid-base balance
D. results from widespread tissue injury
___23. Renal tubular secretion of potassium is:
A. obligatory
B. increased by aldosterone
C. balanced by tubular reabsorption
D. increased in alkalosis
___24. Which buffer system(s) is (are) not important urine buffers?
A. Phosphate C. Protein
B. Ammonium D. Bicarbonate