1

PREFACE
I am great full to almighty Allah to complete and published
the book. It gives me great pleasure to place ‘A hand book
on anatomy’ as a fully exam-oriented book on Anatomy.
I have tried my best to agreement all the requirements to
simplify information with relative figures which will be
justified by the readers.

There may be some error in this book any suggestion

towards the improvement of this book is most welcome.

It will give me pleasure if the book may become helpful to

the student

Dedicated
My dear father
Md. Mukbul Hossain
And
Mother
Nasima Begum

2
Published by
Dr. Md. Jakir Hossain

1st edition January 2020

@ All Rights Reserved. No part of this publication may be

reproduced, stored in a retrieval system, or transmitted, in any
form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without the prior written permission of
editor, is strictly prohibited

Price: 350 Taka.

Reference

Gray’s anatomy.
B. D churasia.
Cunninghams text book of anatomy.

3
Chapter 1

The Human Body: An Orientation

 Terms
 Anatomy: the study of body structure and relationships among structures
 Physiology: the study of body function

 Levels of Organization
Chemical level
Atoms and molecules

 Cells
The basic unit of all living things

 Tissues
Cells join together to perform a particular function

 Organs
Tissues join together to perform a particular function

 Organ system
Organs join together to perform a particular function

 Organismal
The whole body

 Organ Systems

 Anatomical Position

 Regional Names
 Axial region
1. head
2. neck
3. trunk
a. thorax
b. abdomen
c. pelvis
d. perineum

 Appendicular region
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 1. limbs

 Directional Terms
 Superior (above) vs. Inferior (below)

 Anterior (toward the front) vs. Posterior (toward the back)(Dorsal vs. Ventral)

 Medial (toward the midline) vs. Lateral (away from the midline)

 Intermediate (between a more medial and a more lateral structure)

 Proximal (closer to the point of origin) vs. Distal (farther from the point of
origin)

 Superficial (toward the surface) vs. Deep (away from the surface)

5
 Planes and Sections divide the body or organ
Frontal or coronal
1. Divides into anterior/posterior

6
Sagittal
1. divides into right and left halves
2. includes midsagittal and parasagittal

Transverse or cross-sectional
1. Divides into superior/inferior

 Body Cavities
 Dorsal
1. cranial cavity
2. vertebral cavity

Ventral
1. lined with serous membrane
2. viscera (organs) covered by serous membrane
3. thoracic cavity
a. two pleural cavities contain the lungs
b. pericardial cavity contains heart
c. the cavities are defined by serous membrane
d. mediastinum is the area between the pleurae, includes everything
in thoracic cavity except lungs
4. abdominopelvic cavity
a. abdominal cavity is lined by peritoneum (serous membrane), which also
covers organs
b. pelvic cavity has reproductive organs, bladder, portions of large intestine
c. regions and quadrants

7
Chapter 2

CELLS
 Cell basics
about 100 trillion cells in a human

size and shape related to function

 in general very small, but a range of sizes

1. 8 - -
1/25,000 inch)

 the Generalized Cell and its major parts

1. plasma membrane separates inside from outside
a. intracellular fluid (ICF)
b. extracellular fluid (ECF)

2. nucleus is the control center

3. cytoplasm is everything between the nucleus and the plasma membrane

a. cytosol - semiliquid portion (ICF), which suspends the other parts and is
a site of chemical reaction

b. organelles - specialized structures with specific functions

c. inclusions - temporary storage structures

8
 The Plasma Membrane
 Structure
1. phospholipid bilayer is the basic structure
a. important for fluidity
b. is a barrier
2. cholesterol
a. fluidity and stability
3. proteins
a. integral proteins span the membrane, may be channels, transporters,
receptors
b. peripheral proteins are on one side only, may be enzymes or anchors for
cytoskeleton
4. carbohydrates
a. on outer surface only, includes glycoproteins and glycolipids
(collectively called glycocalyx), important for recognition of
self, attachments to other cells

 Basic functions
1. communication within body and with non-self-cells
2. defines boundaries and protects
3. maintains chemical and electrical gradients
4. selective permeability - controls what gets in and out

 Membrane Transport
1. Passive (cell does not use up its own energy)

9
 a. diffusion - molecules move down their concentration gradient
from greater → lesser concentration, charged molecules move
down electrochemical gradients
1) simple diffusion - moves through bilayer or protein channel
2) osmosis - water moves across bilayer
3) facilitated diffusion - uses a protein carrier
b. filtration - water and solutes forced through membrane by hydrostatic
pressure

2. Active (requires the cell to use its ATP)

a. carrier proteins transport substance against its concentration gradient
b. endocytosis - substance brought into cell
1) piece of membrane surrounds substance and pinches off inside cell
(vesicle)
2) pinocytosis (cell drinking) and phagocytosis (cell eating)
c. exocytosis - opposite of endocytosis

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 Nucleus
 Usually round, at cell center
1. double membrane
2. has large nuclear pores
3. contains nucleoli - parts to make ribosomes
4. contains DNA
a. in the form of chromatin when cell not dividing (long thin strands)
b. in the form of chromosomes when cell dividing (coiled up)

 Organelles (see table in text for summary)

 Endoplasmic reticulum (ER)
1. membranous network of channels
2. rough ER
a. has ribosomes (rRNA plus proteins)
b. protein and lipid synthesis
3. smooth ER
a. continues processing of rough ER products
b. specialized in some cells for lipid synthesis or detoxifying chemicals

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 Golgi complex
1. stacked membranous sacs
2. processing, sorting, packaging of ER products
3. makes vesicles for transport to destinations inside cell, or for secretion

 Lysosomes
1. sacs contain digestive enzymes
a. recycles material from cell
b. breaks down substances brought in by endocytosis

 Peroxisomes
1. sacs contain oxidative enzymes - O2 used to detoxify harmful substances

 Mitochondria
1. double-membraned, makes ATP via cellular respiration
a. inner membrane has folds called cristae
b. gel inside called matrix

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 Vaults
1. probably involved in transport between nucleus and cytoplasm

 Centrosome
1. found near nucleus
2. consists of centrioles (protein tubules) surrounded by a centrosome matrix (a
cloud of protein)
3. organizing center for parts of the cytoskeleton

 Cytoskeleton
 protein filaments running through cytosol
1. important in movement of cell and within cell
2. supports cell and organelles

 cell projections for movement made of microtubules

1. flagella (on sperm) - one long projection, moves the whole cell
2. cilia are many small projections that move substances across the surface of
the cell

 Inclusions
 No membrane, temporary storage of products like fat or glycogen

13
 CELL DIVISION
Cells must divide for growth, replacement of dead cells, reproduction of the
organism (making sperm/eggs)

in somatic cells (typical body cells), division involves making two "daughter
cells" that are identical to the "parent cell"

 Cell cycle
1. the sequence of events from the time a cell begins to divide until the time
the daughter cells divide
2. cells divide at different rates
a. some don't divide at all, like mature neurons and RBCs
b. rapid dividers include skin cells and the cells lining the digestive tract
c. once a cell is going to divide the whole cycle may take 18 - 24 hours
3. Interphase
a. most of the cell's time spent in this phase
b. lots of metabolic activity, performing the cell's usual functions
c. consists of:
1) G1 - growth, can last several hours to days or years, toward the
end the centrioles begin replication
2) S - DNA synthesis (cell must double the amount of DNA so both
daughter cells have the correct genetic material)
3) G2 - another growth phase

14
4. Mitosis (nuclear division, lasts about 2 hours)
a. prophase - chromatin coils up into chromosomes, nucleoli and nuclear
membrane break apart, mitotic spindle forms from centrioles
b. metaphase - chromosomes line up in center of mitotic spindle
c. anaphase - chromosomes pull apart
d. telophase - chromosomes uncoil, nucleoli and nuclear membrane
form, mitotic spindle breaks down
5. Cytokinesis
a. division of the cytoplasm
b. in late anaphase or early telophase the plasma membrane indents
(cleavage furrow) and pinches into two separate cells

15
Chapter 4

TISSUES
 Four major tissue types
 Epithelial (epithelium)
1. covers and lines body parts (sheets of cells)

2. glandular epithelium
a. two major types
1) endocrine glands secrete hormones to blood (no ducts)
2) exocrine secrete products into ducts that open to skin or lumen of
organ
b. structural classification of exocrine glands
1) multicellular - form a distinctive structure or organ (e.g., sweat,
salivary)
2) unicellular - have no ducts but still considered exocrine (e.g., goblet
cells)
c. functional classification of exocrine glands
1) holocrine - cell accumulates product, cell dies, bursts open and
substance secreted (e.g., sebaceous)
2) merocrine - secrete by exocytosis (most glands)

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 3. epithelial sheets - special characteristics
a. continuous sheets of closely packed, tightly joined cells
b. have apical (free) and basal surface
c. attached to 2-layered basement membrane
1) basal lamina - proteins and polysaccharides secreted by epithelial cells
2) reticular lamina - protein fibers and glycoproteins secreted by
underlying connective tissue
d. avascular - exchanges occur by diffusion from blood supply of
underlying connective tissue
e. have nerve supply
f. high capacity for regeneration (lots of mitosis)
g. basic functions - protection, secretion, absorption

 Connective tissue
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 1. special characteristics
a. made up of living cells plus non-living extracellular matrix
1) -blasts are immature cells that secrete matrix (e.g., fibroblasts,
chondroblasts, osteoblasts)
2) -cytes are mature cells that help maintain matrix (e.g., chondrocytes,
osteocytes)
3) other cell types include macrophages, plasma cells (secrete
antibodies), mast cells (store chemicals that help fight invaders)

4) matrix consists of protein fibers embedded in ground substance

(polysaccharides and proteins); supports cells structurally and
functionally
5) fibers include collagen (strong, flexible), elastin (strong, very
stretchy), reticular fibers (collagen with coating of glycoprotein,
forms branching networks that support tissues and organs)
b. has nerve supply, except cartilage
c. most highly vascular, except cartilage which is avascular, and
tendons/ligaments which have a low supply
d. functions - support, protection, binding

 Muscle tissue
1. generates force, movement, generates heat
2. three types - skeletal, cardiac, smooth

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 Nervous tissue
1. initiates and transmits electrical signals
2. neurons and neuroglia (support cells)

19
 Cell Junctions
 Tight junctions
1. adjacent plasma membranes are fused
2. forms barrier that prevents leakage
3. common in epithelial sheets

 Gap junctions
1. cells linked by protein tunnels called connexons
2. allow small molecules to pass between cells
3. important in conducting electrical signals (e.g., cardiac muscle)

 Desmosomes
1. scattered over membrane surface
2. found all over body, but more common in tissues that experience
stretching (e.g., skin, digestive tract)

 Membranes
 Most are epithelial membranes
1. epithelium with underlying CT

 Cutaneous membrane covers body surface (skin)

 Mucous membranes (mucosa)

1. line body cavities open to the exterior
a. in respiratory, digestive, reproductive and urinary systems
2. form a barrier to invaders, important in body defense
3. tight junctions prevent leakage
4. secretes mucus, which moistens, lubricates, traps dust and invaders
5. underlying CT layer called lamina propria
6. formed from different kinds of epithelium

 Serous membranes (serosa)

1. lines body cavities not open to exterior, covers organs
2. simple squamous epithelium with areolar CT
3. two layers
a. parietal - attached to cavity wall
b. visceral - covers organs
c. between layers is serous fluid secreted by the epithelial cells
4. includes pleurae, pericardium, peritoneum

 Synovial membranes
1. line cavities of synovial joints
2. no epithelium
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3. areolar CT with elastic fibers and fat

21
Chapter 5

INTEGUMENTARY SYSTEM
 Epidermis
 Keratinized stratified squamous epithelium
1. keratinocytes (90% of cells)
a. produce fibrous protein keratin (as intermediate filaments of
cytoskeleton)
b. help provide protective properties of skin
2. melanocytes (8%)
a. produce pigment melanin that protects from UV light
b. have projections that extend between keratinocytes, keratinocytes
phagocytize projections to take in melanin
3. dendritic cells
a. produced in red bone marrow
b. important in immune response
c. projections form a network in some layers
4. tactile epithelial cells
a. associated with nerve endings (tactile discs)
b. important in sense of touch

 Thickness ranges from .1 mm – 2 mm

 Layers of epidermis (strata, from deep → superficial)

1. stratum basale
a. one row of mainly cuboidal or columnar keratinocytes
b. melanocytes and tactile cells scattered among keratinocytes
c. divide often, older cells push upward and become parts of other layers
(accumulate more keratin)
d. also known as stratum germinativum
2. stratum spinosum
a. 8 - 10 cells thick, more superficial keratinocytes are flatter
b. some keratinocytes can still divide
c. dendritic cells and projections of melanocytes
3. stratum granulosum
a. 3 - 5 cells thick, flattened keratinocytes
b. nuclei and organelles degenerate, lots of keratin (many cells dead)
c. cells contain keratohyaline granules (no membrane, bundles together
keratin filaments)
d. also lamellar granules (membrane, lots of lipids, forms waterproof
barrier between this and superficial layers)

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 4. stratum lucidum
a. only in thicker skin (palms and soles)
b. 3 - 5 cells thick, very flat, dead keratinocytes
c. lots of keratin and keratohyaline
5. stratum corneum
a. 25 - 30 cells thick, very flat, dead keratinocytes
b. lots of keratin, keratohyaline and lipids from lamellar granules
c. waterproof barrier that protects from light, heat, chemicals and invaders
d. constantly shed

 Dermis
 Connective tissue with other embedded structures
1. cells include fibroblasts, macrophages
2. contains blood vessels and nerves
3. glands and hair follicles are embedded

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 Regions of dermis
1. papillary region
a. areolar CT with elastic fibers
b. projects into epidermis as dermal papillae
c. loops of capillaries
d. touch receptors
e. cause ridges in epidermis (fingerprints)
2. reticular region
a. dense irregular CT with lots of collagen and some elastin
b. contains bits of adipose, hair follicles, nerves, oil and sweat glands
c. differs in thickness in different body areas (up to 2 mm)

 Hypodermis
 Attaches dermis to underlying structures
1. areolar and adipose

 Also known as subcutaneous layer or superficial fascia

 Contains blood vessels and nerves

 Functions of Integumentary System

 Temperature regulation
1. evaporation of sweat decreases body T
2. changes in blood flow (more blood → lose heat, less blood → conserve heat)

 Protection
1. physical barrier to invasion, dehydration and UV radiation
2. contains cells of immune system

 Sensation
1. nerve cells with receptors for pain, touch, pressure, temperature
 Excretion
1. water and dissolved substances in sweat
 Acts as a blood reservoir
1. flow can be shifted to hard-working muscles if needed

 Vitamin D synthesis
1. epidermis makes inactive form of vitamin D upon exposure to UV
2. important in absorption of calcium

 Derivatives of the Epidermis (skin appendages)

 Hair
1. dead, keratinized cells
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2. shaft projects from surface of skin
3. root is beneath skin surface
a. surrounded by hair follicle (from epidermis)
b. root plexus consists of nerve endings that contribute to sense of touch
4. arrector pili
a. smooth muscle
b. can make hair "stand up" with cold or emotional stress
5. functions
a. protect from light
b. decrease heat loss
c. protect eyes and nose from particles
d. sense of touch
e. hold chemical signals (pheromones)

25
 Sebaceous (oil) glands
1. holocrine glands
2. ducts usually open to hair follicle
3. secrete sebum
a. mix of fats, cholesterol, proteins, salts, pheromones
b. coats hairs
c. holds moisture in the skin
d. inhibits most bacterial growth

 Sudoriferous (sweat) glands

1. eccrine sweat glands (functionally merocrine)
a. on most skin
b. ducts open to skin surface
c. secrete sweat
1) water, salt, some wastes (urea, ammonia)
2) mainly for cooling body, some excretion, acidity protects from
bacteria

2. apocrine sweat glands (functionally merocrine)

a. axillary, genital and anal regions
b. ducts open to hair follicles
c. secrete sweat, fats and proteins
d. may function in sexual signaling (pheromones)

 Nails
1. hard, keratinized cells
2. nail body is visible
3. root is under skin
4. functions - grasp and manipulate objects, scratching

26
 Chapter 6

BONES AND SKELETAL TISSUES

 Functions of bone
 Support soft tissues

 Protection of internal organs

 Movement
1. points of muscle attachment
2. form joints

 Mineral storage
1. mainly calcium and phosphorous

 Production of blood cells

1. red marrow in some bones

 Energy storage
1. yellow marrow is mostly fat

 Long bones
1. longer than they are wide (e.g., most bones of limbs)

Short bones
1. roughly cube shaped (e.g., bones of wrist and ankle)
2. sesamoid bones- in tendons, provide support (e.g., patella)

 Flat bones
1. flat and curved (e.g., cranial bones, ribs, sternum, scapula)

 Irregular bones
1. complex shapes (e.g., vertebrae and hip bones)

27
 Basic structure of a long bone
 Diaphysis
1. long part of bone (shaft)
 Epiphyses
1. ends of the bone

 Articular cartilage
1. hyaline cartilage covering ends of bone
2. decreases friction and absorbs shock

 Periosteum
1. white fibrous membrane covering surfaces not covered by articular
cartilage
 outer fibrous layer

28
 1) dense irregular CT
2) blood and lymphatic vessels, nerves
 inner osteogenic layer
1) elastic fibers, blood vessels, bone cells

functions
 bone growth in thickness
 repair of fractures
 protects and nourishes
 point of attachment for ligaments and tendons

29
 Medullary cavity
1. cavity in diaphysis containing yellow marrow

 Endosteum
1. lining of marrow cavities
2. delicate CT with bone cells

1. osteoblasts
a. secrete collagen and other parts of bone tissue
b. on inner and outer bone surfaces
c. become osteocytes
2. osteocytes
a. main cells of bone tissue
b. in cavities within bone called lacunae
c. exchange nutrients and wastes with blood
3. osteoclasts
a. may come from circulating WBCs
b. on inner and outer bone surfaces
c. break down bone (resorption)

30
 Matrix
1. 25% water
2. 25% protein fibers
a. collagen gives bones flexibility and strength
3. 50% mineral salts
a. mainly calcium phosphate and calcium carbonate (hydroxyapatite =
mineral salts)
b. gives bone hardness

 Compact bone
1. makes up outer portion of all bones and diaphyses of long bones
2. made up of osteons with interstitial lamellae in between
a. blood and lymphatic vessels and nerves run through canals
b. matrix arranged in lamella
c. osteocytes in lacunae
d. lacunae connected to one another by canaliculi (filled with ECF)

 Spongy bone
1. makes up most of bone tissue in short, flat and irregular bones, and
epiphyses of long bones
a. site of red marrow in adults (axial skeleton, girdles, proximal
epiphyses of humerus and femur)
2. no true osteons
3. lamellae arranged in trabeculae

 Ossification (formation of bone)

 Intramembranous
1. bone forms within a CT membrane
a. most bones of skull, clavicles
2. basic steps
a. mesenchyme (embryonic CT) develops into osteoblasts at center of
ossification, matrix is secreted
b. osteoblasts are now osteocytes in lacunae
c. matrix hardens as minerals deposited
d. trabeculae develop (woven bone)
e. outer layers replaced by compact bone

31
 Endochondral
1. bone replaces cartilage (most bone formed this way)
2. basic steps
a. hyaline cartilage model surrounded by perichondrium
b. periosteum develops, bone collar forms
c. cartilage in center of diaphysis calcifies
d. primary ossification center forms
e. secondary ossification centers form in epiphyses

 Bone Growth
 Growth in length of long bones
1. cartilage at epiphyseal plate grows toward epiphyseal end
2. other side of epiphyseal plate ossifies
3. continues until growth completed in early adulthood
a. eventually the whole plate ossifies and becomes epiphyseal line

 Appositional growth (growth in diameter)

1. osteoclasts in endosteum destroy inner portion of bone
2. osteoblasts in periosteum produce new bone on outer surface

 Bone Remodeling
 Bone is constantly being broken down and reformed
1. particularly in areas where bone is stressed

 Repair of Fractures
 Hematoma formation
1. due to broken blood vessels, hematoma forms (mass of clotted blood)
2. bone cells deprived of nutrition die
3. fracture site become swollen and painful
4. capillaries grow into hematoma, osteoclasts and macrophages remove dead
tissue and debris

 Fibrocartilage callus
1. fibroblasts and osteoblasts migrate from periosteal and endosteal membranes
2. fibroblasts make collagen that connects the broken bone ends
3. chondroblasts secrete cartilage matrix
4. osteoblasts form spongy bone
5. this callus "splints" the bone

 Bony callus
1. osteoclasts and osteoblasts break down fibrocartilage callus and form bony
callus

32
 Remodeling occurs until bone completely healed

33
Chapter 9

JOINTS
 Structural Classification
 Based on whether there is a joint cavity and the type of CT
1. fibrous joint
a. no cavity
b. fibrous CT holds bones together
2. cartilaginous joint
a. no cavity
b. cartilage holds bones together
3. synovial joint
a. has synovial cavity
b. articular capsule and ligaments hold bones together

 Functional Classification
 Based on movement allowed
1. synarthroses are immovable
2. amphiarthroses are partially movable
3. diarthroses are freely movable

 Fibrous Joints
 Sutures
1. in skull
a. dense fibrous CT
b. functionally synarthrotic
2. other sutures (synostoses)
a. complete fusion of bone
b. functionally synarthrotic

 Syndesmoses
1. more CT than a suture (longer fibers)
2. dense regular CT forms ligament or interosseous membrane
3. functionally amphiarthrotic (depends on length of fibers)

 Gomphoses
1. peg fits into a socket
2. functionally synarthrotic

 Cartilaginous
Joints
34
 1. hyaline cartilage
2. epiphyseal plate is functionally synarthrosis, later becomes synostosis
3. sternum and rib 1 is synarthrosis

 Symphyses
1. fibrocartilage
2. functionally amphiarthrotic

 Synovial Joints
 Basic structure
1. ends of bones covered with articular cartilage (hyaline), which reduces
friction and absorbs shock
2. joint surrounded by articular capsule
a. fibrous capsule is outer layer
1) mostly dense irregular CT
2) helps stabilize joint

35
 b. synovial membrane is inner layer
1) areolar CT, elastic fibers, adipose
2) secretes synovial fluid into synovial cavity, which lubricates
(hyaluronic acid), supplies nutrients to articular cartilage and
removes wastes (fluid is derived from plasma, coming from the
blood vessels in the synovial membrane)

3. accessory ligaments
a. some are intracapsular (part of articular capsule)
b. some are extracapsular
c. help stabilize joint

4. articular discs (menisci)

a. fibrocartilage
b. allow better fit of bone surfaces
c. found in temporomandibular, knee, sternoclavicular, distal radioulnar

5. rich nerve supply

a. same nerves that supply skeletal muscles that cause movement at that
joint
b. sensory nerves for pain and body position

6. rich blood supply

7. bursae
a. sacs of CT lined with synovial membrane
b. provide extra cushioning between bones, tendons, ligaments, muscles and
skin

8. tendon sheaths
a. like bursae, but wrap around tendons where there's lots of friction
b. around tendon of biceps at shoulder, at wrist and ankle

 Movements at synovial joints

1. gliding
a. flat bone surfaces move back & forth, side to side
b. example: intercarpal
ii.
3. angular
a. change in angle between bones
b. flexion (decrease in angle), example: bending elbow
c. extension (increase in angle), example: straightening elbow;
hyperextension is continuing beyond anatomical position
36
 d. abduction (moving bone away from midline), example: moving arm
laterally
e. adduction (moving bone toward midline), example: moving arm medially
f. circumduction (moving in a circle, involving b-e), example: move arm in
circle at shoulder

4. rotation
a. movement of bone around its own longitudinal axis
b. example: turning head

5. special movements
a. occur only at specific joints
b. elevation (upward motion), examples: closing mouth, shrugging
shoulders
c. depression (downward motion), examples: opening mouth
d. protraction (anterior movement), examples: moving jaw forward, move
clavicles forward
e. retraction (moving back from protracted position)
f. inversion (move soles of feet medially)
g. eversion (move soles of feet laterally)

37
 h. dorsiflexion (move dorsum of foot toward tibia)
i. plantar flexion (move sole of foot to "point the toe")
j. supination (turning palm anteriorly or superiorly)
k. pronation (turning palm posteriorly or inferiorly)
l. opposition (move thumb toward fingertips)

 Types of synovial joints

1. gliding or plane
a. articulating surfaces usually flat
b. allows gliding movement
c. nonaxial (does not involve movement around an axis)

2. hinge
a. convex surface fits into concave surface
b. allows flexion and extension
c. monaxial (allows movement in a single axis)
3. pivot
a. rounded or pointed surface articulates with a ring of bone and ligament
b. allows rotation
c. monaxial
4. condyloid
a. oval shaped projection fits into oval shaped depression
b. allows abduction, adduction, flexion, extension, circumduction
c. biaxial

38
5. saddle
a. modified condyloid with more freedom of motion
b. allows abduction, adduction, flexion, extension, circumduction
c. biaxial
6. ball & socket
a. ball shaped surface fits into a cup
b. allows abduction, adduction, flexion, extension, circumduction, and
rotation
c. triaxial

39
Chapter 10

MUSCLE TISSUE
 Muscle Basics
 Three types (cells are long and thin, called fibers)
1. skeletal
a. striated
b. voluntary control
c. many nuclei per cell
d. longest fibers (extend the length of the whole muscle
2. cardiac
a. striated
b. involuntary control
c. one nucleus per cell
3. smooth
a. not striated
b. involuntary control
c. one nucleus per cell

 Functions
1. movement
a. of whole body or body parts (skeletal)
b. of substances within body (cardiac - pumps blood, smooth -
substances move through hollow organs)
2. heat production (mostly skeletal)
3. maintain posture and stabilize joints (skeletal)

 Characteristics
1. excitability - respond to stimuli like neurotransmitters (from
neurons) or hormones with electrical signals
2. contractility - ability to develop tension (muscle fiber may shorten)
3. extensibility - can stretch
4. elasticity – assumes original length after stretching

 Skeletal Muscle
 Associated Connective Tissue
1. superficial fascia (subcutaneous layer or hypodermis)
a. areolar & adipose
1) stores water and fat
2) decreases heat loss
3) protects underlying tissues

40
2. deep fascia
a. dense irregular
1) holds together functional groups of muscle
2) allows free movement of muscles
3) packs spaces between muscles, nerves and blood vessels pass through
3. less coarse CT layers
a. protect and support muscle cells, reinforce whole muscle, provide
elasticity
1) epimysium - dense irregular CT, wraps whole muscle
2) perimysium - dense irregular CT, wraps bundles of fibers called
fascicles
3) endomysium - similar to areolar CT, lots of reticular fibers, wraps
each fiber
4. all the CT layers are continuous with one another and with the tendons that
attach the muscle to the periosteum of bone

a. tendons are dense regular CT

b. a flattened tendon is called an aponeurosis (may attach to bone, skin or
another muscle)

41
 Skeletal muscle cells
1. very large
a. 10 - long
2. plasma membrane called sarcolemma
3. cytoplasm called sarcoplasm
a. lots of glycogen (stored form of glucose) and myoglobin (a protein that
binds O2)
b. contains the usual organelles plus some modified ones
4. myofibrils
a. specialized organelles that run the length of the cell (100s-1000s/cell)
b. made up of contractile units called sarcomeres
1) sarcomeres are made up of myofilaments
2) the arrangement of myofilaments causes the striations
c. myofilaments
1) thick filaments- made of the protein myosin, often called cross-
bridges because they can bind with the thin filaments
2) thin filaments- made of the proteins actin (where myosin binds),
tropomyosin and troponin
5. sarcoplasmic reticulum
a. specialized smooth ER that stores calcium and releases it when
signaled by a nerve impulse (an electrical signal from a neuron)

6. T tubules
a. the sarcolemma penetrates into deeper parts of the cell,
forming hollow tubes surrounding all the myofibrils
b. conducts electrical signals throughout the cell so all myofibrils contract at
once
7. Sliding Filament Mechanism
a. when a nerve impulse signals the muscle cell, calcium is released from
the SR

42
 b. this allows myosin to bind to actin and pull the thin filaments
toward the center of the sarcomeres
c. ATP required

 Blood supply
1. lots of blood needed to supply oxygen and carry away wastes from these
very active cells
2. vessels penetrate CT layers, lot of capillaries in endomysium

 Nerve supply (see Chapter 14)

1. each muscle served by at least one motor nerve containing 100s of motor
neurons
a. a motor unit is one motor neuron plus all the muscle fibers it innervates
b. a motor unit may have only a few muscle fibers or 1000+
c. fewer muscle fibers per motor unit where fine, delicate control needed
(eyes, fingers)
d. more muscle fibers per motor unit where more power needed (limbs)
e. activating more motor units at one time means a more powerful

43
 contraction

2. neuromuscular junction
a. area where a neuron meets a muscle fiber
b. separated by a gap called synaptic cleft
c. when an electrical signal (action potential) travels to the end of a
neuron, the neuron releases a chemical message called a
neurotransmitter (specifically, acetylcholine at the neuromuscular
junction, also known as ACh)
d. the ACh binds to the muscle cell, and initiates an electrical signal (action
potential) there
e. this ultimately results in the muscle fiber contracting

 Muscle tone
1. small groups of motor units are periodically activated involuntarily
2. this keeps the muscle ready to contract

44
 Fiber types
1. red slow twitch (a.k.a. slow oxidative)
a. small
b. contract slowly (use ATP at a slow rate), have lots of mitochondria,
myoglobin, good capillary supply (for using O 2 to make ATP)
c. resist fatigue, good for low intensity endurance activity
d. postural muscles in back and lower limbs have lots
2. white fast twitch (a.k.a. fast glycolytic)
a. large
b. contract quickly, with lots of power (use ATP at a fast rate)
c. fewer oxygen use components (generate most ATP anaerobically -
without O2)
d. fatigue quickly, good for high intensity activity
e. lots in arms for lifting
3. intermediate fast twitch (a.k.a. fast oxidative)
a. medium sized
b. contract quickly, with lots of power (like white fast twitch)
c. have component for making ATP with oxygen (like red slow twitch)
d. fatigue resistant, good for intermediate activities
e. muscles used for walking have lots
4. each muscle has a mix of the three types, but has a greater proportion
of the type used most often
5. exercise can change fiber types
a. endurance activities(e.g., running long distances): white fast twitch →
intermediate fast twitch
b. intense activities (e.g., weight lifting): intermediate fast twitch → white
fast twitch
c. changes occur in size of fiber, blood supply, number of mitochondria, etc.
d. generally cannot convert between slow and fast fibers (depends on nerve
supply)

 Cardiac Muscle
 diameter
 Basically the same set-up of myofilaments, etc.
 Cells connected by intercalated discs
1. desmosomes and gap junctions
2. cells contract as a unit
 Main electrical stimulation from specialized cells that spontaneously activate
(autorhythmicity)
 Use oxygen to make ATP

45
 Smooth Muscle
 30 - - middle
 Arranged in sheets
 Has thick and thin filaments, but not in the same pattern as other muscle types
 Two basic types
1. multiunit
a. groups of cells function independently
b. innervated by autonomic (involuntary) nervous system
c. found in large blood vessels, large airways, eye (for adjusting lens and
iris), arrector pili
2. single unit (visceral)
a. cells electrically linked by gap junctions and contract as a unit
b. clusters of cells are self-excitable
1) pass electrical signal to other cells
2) also influenced by ANS
c. most smooth muscle in the body is this type (hollow organs)
d. uses oxygen to make ATP
e. can be influenced by local metabolic changes or hormones

46
 Chapter 11

MUSCLES

 Lever Systems
 A lever is a rigid bar that moves on a fixed point (the fulcrum) when a
force is applied to it; the force (effort) applied is used to move a resistance (load)
1. bones = levers
2. joints = fulcrum
3. muscles provide the effort

 Levers operate in one of two ways

1. mechanical advantage
a. load is closer to fulcrum, effort farther from fulcrum
b. little effort moves a large load over a small distance
2. mechanical disadvantage
a. load is farther from fulcrum, effort is closer to fulcrum
b. lots of effort moves a load rapidly over a large distance

 Types of levers
1. first-class
a. fulcrum between load and effort
b. seesaws, scissors, lifting head off chest
c. can be mechanical advantage or disadvantage
2. second-class levers
a. load between fulcrum and effort
b. wheelbarrow, standing on toes
c. mechanical advantage
3. third-class levers (most muscles in the body are set up this way)
a. effort between load and fulcrum
b. tweezers, lifting using biceps
c. mechanical disadvantage

 Arrangement of Fascicles
 Influences range of motion and power
1. longer fibers can shorten more and have greater range of motion
2. a greater number of shorter fibers means more power

 Types of arrangements
1. parallel (tend to be less powerful)
2. fusiform (nearly parallel)
3. circular
47
 4. convergent
5. pennate (tend to be the most powerful)

 Group Actions
 Functional types of muscles
1. prime mover/agonist: the muscle that has the main responsibility for a
particular movement
2. antagonist: opposes the action of the agonist
3. synergist: helps the agonist
a. add extra force
b. stabilize joint and prevent undesired movement
4. fixator: stabilizes prime mover

 One muscle may act as any of the functional types

48
 Origin and Insertion
 Origin: the attachment point on the more stationary (less movable) bone, usually
proximal
 Insertion: the attachment point on the more movable bone, usually distal
 The insertion moves toward the origin when the muscle shortens

 Naming Muscles
 Names may be based on...
1. location
2. shape
3. relative size
4. direction of fascicles and fibers
5. location of attachments
6. number of origins
7. action

 Selected Skeletal Muscles (see handouts)

49
Chapter 12

NERVOUS TISSUE
 Organization of the Nervous System
 Central nervous system (CNS)
1. brain and spinal cord
a. integrating and command center
 Peripheral nervous system (PNS)
1. cranial nerves
a. carry electrical signals to and from brain
2. spinal nerves
a. carry electrical signals to and from the spinal cord

3. two main functional divisions

a. sensory (afferent) division
1) carries signals toward CNS, from skin, muscles and joints (somatic),
and from visceral organs (visceral)
b. motor (efferent) division

50
 1) carries signals away from CNS to effector organs
2) somatic division (to skeletal muscle, voluntary control)
3) autonomic division (to smooth and cardiac muscle, glands;
involuntary control; further divided into sympathetic division ("fight
or flight") and parasympathetic division ("resting and digesting")

 Histology
 Nervous tissue made up of...
1. neurons
a. cells that receive and transmit electrical signals

2. neuroglia (glial cells)

a. supporting cells of CNS and PNS

51
 Neuroglia
1. in CNS
a. astrocytes
1) hold neurons together
2) repair of injury and scar formation
3) induce changes in blood vessels to form the blood-brain barrier hold
neurons together
4) take up and break down some neurotransmitters (chemical signal
molecules)
5) maintain ion concentrations
b. microglia
1) defense cells
c. ependymal
cells
1) line cavities in brain and spinal cord
2) help form and circulate cerebrospinal fluid
d. oligodendrocytes send out extensions that wrap neurons, forming myelin
sheaths
2. in PNS
a. Schwann cells make myelin sheaths
b. satellite cells support clusters of neuron cell bodies (in ganglia)

 Neurons (nerve cells)

1. highly specialized to conduct electrical signals
2. can vary in structure but all have some common features
3. common features
52
a. cell body (soma)
1) nucleus and other organelles
2) well developed rough ER
3) plasma membrane has receptors for neurotransmitters (receives
chemical signals)
4) clusters in CNS called nuclei, in PNS called ganglia

53
 b. dendrites
1) relatively short, highly branched projections from cell body
2) plasma membrane has receptors for neurotransmitters (receives
chemical signals)
3) conducts electrical signals toward cell body

c. axon (nerve fiber)

1) one long projection from cell body, begins at axon hillock
2) may be up to a few feet long
3) may have branches called collaterals
4) ends in many branches called axon terminals
5) carries electrical signals away from the cell body (signal called
depolarization or action potential or nerve impulse)
6) when AP reaches terminals, neurotransmitters are released

d. myelin sheath
1) many neurons have their axons covered in myelin sheaths (helps
conduct electrical signals faster)

4. connect to other neurons at synapses

 Bundles of Axons
 Called a nerve in PNS
1. wrapped in CT coverings (as in skeletal muscle)
a. endoneurium wraps each fiber
b. perineurium wraps groups of axons called fascicles
c. epineurium wraps entire nerve

 Called a tract in CNS

 Structural classification of neurons

 Multipolar neurons
1. many dendrites, one axon
2. most neurons of the brain and spinal cord

 Bipolar neurons
1. one dendrite, one axon
2. in retina of eye, inner ear, olfactory (smell) neurons

 Unipolar neurons
1. one short process from cell body branches into two processes
54
 a. sensory neurons
b. peripheral process has sensory receptor
2. central process enters CNS

 Functional Classification of Neurons

 Sensory (afferent) neurons
1. conduct signals toward CNS from skin, sensory organs, muscles, joints,
viscera
2. unipolar
3. cell bodies in ganglia

 Motor (efferent) neurons

1. conduct signals away from CNS to muscles and glands
2. multipolar
3. cell bodies usually in CNS

55
 Association neurons (interneurons)
1. between sensory and motor neurons, and throughout brain
2. multipolar
3. contained entirely within CNS
4. about 99% of neurons in the body
5. thousands of types

 Gray matter and white matter of CNS

 Gray matter
1. nerve cell bodies and dendrites
2. axon terminals
3. unmyelinated axons
4. neuroglia

 White matter

1. bundles of myelinated axons

56
Chapter 13/14

THE BRAIN AND CRANIAL NERVES

 Major Parts of the Brain

 Cerebrum
1. two cerebral hemispheres

 Diencephalon
1. thalamus
2. hypothalamus
3. epithalamus

 Brain stem
1. midbrain
2. pons
3. medulla oblongata

 Cerebellum
1. two cerebellar hemispheres

57
 Protection and Coverings
 Cranial meninges
1. continuous with the spinal meninges, same basic parts
a. dura mater
1) tough outer layer
2) dense irregular CT
b. arachnoid
mater
1) middle layer
2) collagen and elastin fibers
3) subdural space is between dura mater and arachnoid mater, contains a
little fluid
c. pia mater
1) inner layer
2) delicate CT covering brain
3) subarachnoid space is between arachnoid mater and pia
mater, contains cerebrospinal fluid

2. dura mater has 2 layers in cranial meninges

a. periosteal layer (outer)
1) periosteum of cranial bones
b. meningeal layer (inner)

58
 1) corresponds to spinal dura mater
c. between layers are dural sinuses
d. extensions of dura mater separate parts of the brain
1) falx cerebri- between cerebral hemispheres
2) falx cerebelli- between cerebellar hemispheres
3) tentorium cerebelli- between cerebrum and cerebellum

 Cerebrospinal fluid (CSF)

1. similar to plasma
2. circulates through subarachnoid space
3. functions
a. cushions CNS
d. maintained at optimal chemical levels (ions, nutrients, etc.)
4. the ventricles are cavities within the brain that contain CSF
a. all ventricles are interconnected to one another, the subarachnoid
space, and the central canal of the spinal cord
b. lined with ependymal cells

59
 c. four ventricles
1) two lateral- each within a cerebral hemisphere, separated by a thin
membrane called septum pellucidum
2) third ventricle- between the lateral ventricles, connected to
lateral ventricles by interventricular foramina
3) fourth ventricle- between brain stem and cerebellum, connected to
third ventricle by cerebral aqueduct
5. CSF formed at choroid plexuses
a. capillaries covered by ependymal cells, in all ventricles
6. CSF reabsorbed into venous circulation
a. through arachnoid villi (extensions of arachnoid mater projecting into
dural sinuses)
7. circulation of CSF

 Blood-brain barrier
1. brain capillary cells are joined by tight junctions
2. only things that can get through the lipid bilayer of capillary cells can
pass easily (e.g., O2, CO2), and some things are specially transported
(glucose, amino acids)
3. protects brain from harmful substances

 Cerebrum
 Gyri are the ridges

 Sulci are the grooves (deepest grooves called fissures)

 Paired lobes (frontal, parietal, temporal, occipital)

 Made up of...
1. gray matter (cortex)
a. allows us to perceive, understand, communicate, remember, do voluntary
movements
b. divided into many "functional areas" (but there is lots of overlap, and
no one area acts alone)
c. three major kinds of functional areas
1) motor areas- control voluntary motor function
2) sensory areas- conscious awareness of sensation
3) association areas- integrate diverse information
d. each hemisphere specializes in functions on the opposite side of the body
(contralateral)
e. hemispheres not equal in function
1) left side generally more involved in logical, analytical tasks like
language and math
60
 2) right side generally more involved in spatial perception, art, music
2. white matter
a. provides for communication between all areas of CNS and PNS
b. three main types of fibers
1) association fibers- transmit signals between gyri in the same
hemisphere
2) commissural fibers- transmit signals from gyri in one hemisphere to
the corresponding gyri in the other hemisphere (corpus callosum,
anterior and posterior commissures)
3) projection fibers- form ascending and descending tracts,
transmit signals from cerebrum and other parts of brain to and
from spinal cord
3. basal nuclei (basal ganglia)
a. groups of gray matter embedded in white matter
b. corpus striatum (caudate nucleus and lentiform nucleus, which
consists of putamen and globus pallidus)
c. amygdala (functionally part of limbic system)
d. mostly important in motor pathways (communicate with cortex)

61
  Diencephalon
 Epithalamus
1. pineal gland
a. part of endocrine system
b. produced melatonin, which helps regulate the biological clock

 Thalamus
1. masses of gray matter and tracts of white matter
a. two sides connected by intermediate mass
2. made up of several nuclei, each with a functional specialty
3. major functions
a. preliminary processing of sensory input - screens out unimportant
stimuli and passes on significant input to the appropriate area of cortex
b. crude awareness of sensation
c. some degree of consciousness

 Hypothalamus
1. many functionally grouped nuclei
2. integrating center for homeostasis, links the ANS and endocrine system
a. regulates body temperature (monitors temperature of blood)
b. regulates water balance through urine output and has "thirst
center" (contains osmoreceptors that sense concentration of
body fluids)
c. regulates food intake (monitors blood levels of nutrients and hormones)
d. controls endocrine functioning (produces hormones, regulates pituitary)
e. plays a role in emotional and behavioral patterns (part of limbic system)
f. controls ANS centers in brain stem (cardiovascular, respiratory)
g. contains biological clock
3. pituitary connected by infundibulum
a. pituitary has two lobes
1) anterior lobe is glandular tissue, produces and secretes hormones
in response to hormones released from the hypothalamus
2) posterior lobe is nervous tissue, stores hormones produced by the
hypothalamus and releases them in response to electrical signals
from hypothalamus

 Brain
Stem
 Mid brain
1. cerebral peduncles- motor and sensory fiber tracts
2. superior cerebellar peduncles- carry info from cerebellum toward cortex
3. reflex centers

62
 a. superior colliculi- visual reflexes, like eyes tracking an object
b. inferior colliculi- auditory reflexes, like turning toward a loud noise
4. other nuclei
a. substantial nigra and red nucleus- involved in motor pathways, interact
with basal nuclei
b. nuclei for cranial nerves III and IV
5. periaqueductal gray matter- sympathetic responses like increased
heart rate and blood pressure and pain suppression

 Pons
1. motor and sensory fiber tracts
2. middle cerebellar peduncles- carry info from cortex to cerebellum
3. nuclei for cranial nerves V, VI and VII
4. respiratory centers- smooth out inspirations and expirations

63
  Medulla oblongata
1. connects to spinal cord at foramen magnum
2. motor and sensory fiber tracts
3. pyramids - formed by pyramidal tracts, most fibers cross over here,
"decussation of the pyramids"
4. inferior cerebellar peduncles- carry info on equilibrium from
vestibular nuclei and info on proprioception from spinal cord to
cerebellum (olives are nuclei acting as relay stations)
5. nuclei for cranial nerves VIII-XII
6. ANS nuclei
a. cardiovascular centers- regulate rate and force of heartbeat, blood
pressure
b. respiratory center- regulates basic rhythm of respiration
c. centers for vomiting, sneezing, coughing, hiccuping, swallowing

 Functional Brain
Areas
 Reticular formation
1. an area of gray and white matter running through the core of the brain stem
2. motor and sensory functions
3. important in maintaining consciousness and overall alertness of cortex
(reticular activating system, RAS)

 Limbic System
1. parts of cortex, basal nuclei, thalamus, hypothalamus
2. deals with all aspects of emotion and physical expression of emotion (e.g.,
anger, fear, crying, laughing, gestures)

 Cerebellum
 Consists of vermis and cerebellar hemispheres with lobes (anterior, posterior,
flocculonodular)

 Has gray and white matter (white matter forms "arbor vitae")

 Cerebellar peduncles connect it to brain stem

 Receives sensory information, especially from proprioceptors

 Sends information to motor areas of brain

1. coordinates movements
2. adjusts posture to maintain equilibrium

 Cranial Nerves
64
 Mnemonic device- Oh, Oh, Oh, To Touch And Feel Very Good Velvet, AH

1 I OLFACTORY
2 II OPTIC
3 III OCULOMOTOR
4 IV TROCHLEAR
5 V TRIGEMINAL
6 VI ABDUCENS
7 VII FACIAL
8 VIII VESTIBULOCOCH
LEAR
9 IX GLOSSOPHARYN
GEAL
10 X VAGUS
11 XI ACCESSORY
12 XII HYPOGLOSSAL

65
Chapters 13/14

THE SPINAL CORD AND SPINAL

NERVES
 Protection and coverings
 Vertebral column
1. the spinal cord is in a canal formed by the vertebral foramina
2. vertebral ligaments also protect
 Fat in the epidural space between wall of vertebral canal and meninges
 Meninges (spinal meninges), cover cord and spinal nerves until they exit
vertebral column
1. Dura mater forms sac from foramen magnum to second sacral vertebra
2. extended thickened portions of pia mater called denticulate ligaments
fuse with arachnoid mater and dura mater to hold cord in place laterally

 External Anatomy
 Extends from brain to second lumbar vertebra
 Two thickened areas
1. cervical enlargement
a. nerves to and from upper limbs arise from this area
2. lumbar enlargement
a. nerves to and from lower limbs arise from this area

66
 Two grooves
1. anterior median fissure
2. posterior median sulcus
 Conus medullaris
1. end of cord tapers to a cone shape
 Filum terminale
1. extension of pia mater attaches cord to coccyx
 Cauda equina
1. some nerves exit the spinal cord and continue down the vertebral column to
exit farther down
 Dorsal and ventral roots fuse to form spinal nerves

 Internal Anatomy
 Gray matter
1. has two sides, connected by gray commissure
a. central canal is in center, extends the length of the spinal cord (contains
CSF)
b. anterior (ventral) horns - contain cell bodies of motor neurons supplying
skeletal muscle
c. posterior (dorsal) horns- contain cell bodies of interneurons, axon
terminals of sensory neurons
d. lateral horns- contain cell bodies for autonomic motor neurons
which supply smooth/cardiac muscle and glands, only in
67
 thoracic, lumbar and sacral segments
2. function: receives and integrates incoming and outgoing signals

 White matter
1. anterior (ventral) white columns, posterior (dorsal) white columns, lateral
white columns
a. ascending (sensory) tracts- carry signals to brain
b. descending (motor) tracts- carry signals away from brain
2. function: transmitting electrical signals
3. ascending tracts
a. spinothalamic (anterior and lateral)
1) carry info on pain, temperature, deep pressure, crude touch (poorly
localized)
b. posterior column tracts (fasciculus gracilis, fasciculus cuneatus)
1) carry info on proprioception (sense of body position, comes from
muscles, tendons, joints), fine touch, pressure
c. spinocerebellar tracts (anterior and posterior)
1) subconscious aspects of proprioception
4. descending tracts
a. corticospinal tracts (anterior and lateral, a.k.a. pyramidal tracts)

68
 1) precise voluntary movements
b. all other tracts (tectospinal, vestibulospinal, rubrospinal, reticulospinal)
1) subconscious movement like posture

 Reflexes (see ch 12)

 Rapid, predictable motor response to a stimulus
 Many are unlearned and involuntary
1. all spinal reflexes are unlearned and involuntary
a. integrating center is the spinal cord
b. no brain involvement necessary, but brain is informed of what happened
2. learned (acquired) reflexes
a. integrating center is brain
b. e.g., typing, playing a sport, driving
3. most reflexes can be modified with conscious effort
 Reflex arcs
1. receptor - receives stimulus
2. sensory neuron - electrical signal travels to...
3. integrating center - the part of the CNS that decides on response, brain
stem or spinal cord for unlearned reflexes
4. motor neuron - signal sent to...
5. effector - the part of the body that responds (skeletal muscle or gland)

 Spinal Nerves
 31 pairs
1. named and numbered by where they exit the vertebral column
a. 8 cervical (C1-C8, C1 exits between atlas and occipital bone)
b. 12 thoracic (T1-T12)
c. 5 lumbar (L1-L5)
d. 5 sacral (S1-S5)
e. 1 coccygeal (Co)
2. all are "mixed" nerves, meaning they carry both sensory and motor info
3. after exiting the vertebral column, they branch into...
a. dorsal rami, which serve the posterior body trunk
b. ventral rami, which serve the rest of the trunk and limbs
c. meningeal branch, which serves the meninges, vertebrae and blood
vessels
d. rami communicantes, which branch from thoracic ventral rami and
contain ANS fibers
4. intercostal (thoracic) nerves serve the thorax and abdominal wall

 Plexuses
1. the ventral rami of all the spinal nerves (except thoracic) branch into
69
 networks
a. cervical plexus (from C1-C4)
1) mostly serves skin and muscles of head, neck, shoulders, upper chest
2) phrenic nerve serves diaphragm (for breathing)
b. brachial plexus (from C5-T1)
1) serves upper limbs
c. lumbar plexus (from L1-L4)
1) serves abdomen, lower limbs
d. sacral plexus (from L4-S4)
1) serves lower limbs

 Dermatomes
 A segment of skin served by cutaneous branches of a particular spinal nerve (all
except C1)
 Some areas overlap (trunk tends to have lots of overlap, less on limbs)

70
Chapter 14

General Senses

 Basics
 Sensation: conscious or subconscious awareness of internal or external stimuli

 Perception: conscious awareness and interpretation of sensation

 Components of sensation
1. stimulus
a. a change in the environment capable of activating sensory neurons
2. transduction
a. sensory receptor or sense organ transduces stimulus into a nerve impulse
3. conduction
a. nerve impulse conducted to CNS by afferent fibers
4. translation
a. CNS receives and interprets information

 Sensory Receptors
 Display selectivity
1. respond to a particular kind of stimulus

 Classification by location
1. exteroceptors
a. near surface of body
b. sense the external environment
c. touch, pressure, vibration, temperature, pain, taste, smell, hearing, vision
2. interoceptors
a. in blood vessels and viscera
b. sense internal environment
c. stretch, chemical change, pain
3. proprioceptors
a. in muscles, tendons, joints, inner ear
b. sense body position and movement

 Classification by stimulus type

1. mechanoreceptors
a. sense mechanical pressure or stretching
b. touch, pressure, vibration, proprioception, hearing, blood pressure
2. thermoreceptors
a. sense temperature
71
 3. chemoreceptors
a. sense chemicals
b. taste, smell, changes in body fluids
4. photorecept
ors
a. sense light
5. nociceptors
a. sense pain

72
 Structural classification
1. free dendritic endings
a. mostly sense pain and temperature, itch
b. tactile discs are a modified type in the epidermis, sense light touch (adapt
slowly)
c. root hair plexuses sense movement of hairs (adapt quickly)

2. encapsulated dendritic endings are enclosed in a CT capsule

a. tactile corpuscles - in dermal papillae of hairless skin; sense light
pressure, discriminative touch, vibration
b. lamellar corpuscles - mainly subcutaneous, some more internal; sense
deep pressure, stretch, vibration (adapt quickly)
c. bulbous corpuscles - deep skin layers, joint capsules; deep pressure
and stretch (adapt slowly)
d. proprioceptors - muscle spindles and tendon organs sense stretch;
joint kinesthetic receptors in joint capsules sense stretch and pain
(includes lamellar and bulbous corpuscles, tendon organs, free
dendritic endings)

 Sensory (Ascending) Pathways

 Signals are carried to reticular formation, cortex, and cerebellum
1. first-order neurons
a. have sensory receptor
b. carry signals to brain stem (along cranial nerves) or to spinal cord (along
spinal nerves)
c. synapse with...

2. second-order neurons
a. carry signals from spinal cord and brain stem to thalamus
b. fibers cross over (decussate) in cord or brain stem
c. synapse with...

3. third-order neurons
a. signals go to primary somatosensory cortex (postcentral gyrus)

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Chapter 15

THE AUTONOMIC NERVOUS SYSTEM

 Basics
 Input
1. general visceral sensory neurons
a. e.g., chemoreceptors sensing blood gases, mechanoreceptors sensing
organ stretch

 Output
1. general visceral motor neurons
a. excite or inhibit their effectors (cardiac and smooth muscle, glands)
2. two neuron pathway from CNS to effector organ
a. preganglionic fiber has cell body in CNS, synapses with postganglionic
fiber in a ganglion, postganglionic fiber innervates effector organ
b. sympathetic division
1) preganglionic fibers originate in thoracic and lumbar regions of spinal
cord
2) preganglionic fibers are short, synapse in a sympathetic chain
ganglion lying along the vertebral column, release ACh (some pass
through the chain and synapse later in a collateral ganglion closer to
the effector organ)
3) postganglionic fibers are long, terminate on effector organ and
release norepinephrine (NE)
c. parasympathetic division
1) preganglionic fibers originate in brain stem or sacral spinal cord
2) preganglionic fibers are long, synapse in terminal ganglia in or near
effector organs, release ACh
3) postganglionic fibers are short, end on the effector organ, release Ach

 Dual innervation
1. most visceral organs are innervated by both sympathetic and
parasympathetic fibers
2. generally have opposite effects
3. can be excitatory or inhibitory depending on the organ innervated
4. both systems are usually partially active
a. sympathetic or parasympathetic tone, or tonic activity
5. when one division increases its rate of sending signals and the other
decreases, it's called dominance
a. sympathetic dominance
1) increase in blood flow to skeletal muscles (vessels dilate)

74
 2) heart beats faster and more forcefully
3) blood pressure increases (most vessels constrict)
4) respiratory airways dilate
5) stored nutrients are broken down
6) digestive and urinary activities are inhibited
7) pupils dilate
8) sweating
b. parasympathetic dominance
1) inhibits sympathetic activities (e.g., heart rate and blood pressure
decrease)
2) normal resting functions like digestive and urinary activities increase

 Details of Autonomic Anatomy

 rami communicantes
1. white rami
a. branch from thoracic and first few lumbar nerves
b. contain sympathetic preganglionic fibers
2. gray rami
a. branch from sympathetic chain ganglia back to a nerve
b. contain sympathetic postganglionic fibers

75
 autonomic plexuses
1. groupings of ANS fibers in thorax, abdomen and pelvis
2. contain sympathetic and parasympathetic fibers
3. pass along large blood vessels, supplying the vessels with fibers, then on to
visceral organs
4. four major ANS plexuses
a. cardiac plexus
c. pulmonary plexus
d. celiac (solar) plexus
e. hypogastric plexus

 Autonomic Reflexes
 Electrical signals travel through autonomic pathways (autonomic reflex arc)
1. e.g., adjustments made in heart rate and force of contraction, blood pressure,
respiration, digestion, defecation, urination, pupil size changes

 Control of ANS
 mainly by hypothalamus
1. sends signals to ANS centers in brain stem

 cortex can influence hypothalamus as a part of limbic system (some degree of

voluntary control)

 Adrenal Medulla
 center portion of adrenal gland is a modified part of sympathetic division
1. preganglionic sympathetic fibers innervate adrenal medulla
a. electrical signals result in release of epinephrine and
norepinephrine to bloodstream (enhances sympathetic effects)

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Chapter 16

SPECIAL SENSES
 Olfactory Sensations: Smell
 Types of cells
1. receptors lie in nasal epithelium of superior portion of nasal cavity
a. bipolar neurons
1) distal end is a dendrite with olfactory cilia (hairs), which
generate impulses in response to odor molecules
2) axon synapses with another neuron in the olfactory bulb
2. supporting cells
a. columnar epithelial cells, secrete mucus
3. basal cells
a. between supporting cells
b. stem cells that replace old receptor cells about every month
4. olfactory glands
a. produce mucus that empties onto the olfactory epithelium by ducts
(odor molecules must dissolve in mucus to be sensed)

 Olfactory pathway
1. olfactory bulb neurons receive signals from receptors
a. sends signals along olfactory tract to olfactory area on medial surface
of temporal lobe, limbic system and part of frontal lobe

 Gustatory Sensations: Taste

 Taste buds
1. mostly on tongue, some on soft palate, cheeks and pharynx
2. in papillae (elevations on tongue)
a. vallate papillae are on back of tongue
b. fungiform papillae are scattered over tongue surface
c. filiform papillae cover the surface of the tongue but do not have taste
buds
3. three kinds of epithelial cells
a. gustatory cells are the receptor cells (have microvilli with receptors,
substance to be tasted must be dissolved in saliva in a taste pore); they
synapse with sensory nerve fibers
b. supporting cells
c. basal cells, which can differentiate into other cell types
4. five primary taste sensations
a. sweet, sour, salty, bitter, savory
b. tongue maps no longer believed accurate, an individual receptor may

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 respond to more than one kind of taste

 Gustatory pathways
1. fibers leading from taste buds are in...
a. facial nerves (from anterior 2/3 of tongue)
b. glossopharyngeal nerves (from posterior 1/3)
c. vagus (from throat and epiglottis)
d. The three cranial nerves end in the medulla, from there fibers project to
gustatory area in parietal lobe via the thalamus

 Visual Sensations and the Eye

 Accessory structures of the eye
1. eyebrows
a. shade eyes from sunlight, protect from perspiration
2. eyelashes
a. protective, when disturbed trigger reflex blinking
3. eyelids (palpebrae)
a. upper and lower lids separated by palpebral fissure, they meet at medial
and lateral canthi

78
 (medial canthus contains lacrimal caruncle with sebaceous and sweat
glands)
b. tarsal plates - fold of connective tissue that supports lids, contains
tarsal glands that produce an oily secretion to lubricate lids and
prevent sticking together
4. conjuctiva
a. stratified columnar mucous membrane lubricates eye with mucus,
has palpebral and ocular layer
5. lacrimal apparatus
a. lacrimal glands secrete lacrimal fluid (tears)
b. blinking spreads tears to lacrimal canals, which drain to lacrimal sac
and nasolacrimal duct, and empties into nasal cavity
c. tears clean, protect and lubricate (contain mucus, antibodies, lysozyme)
extrinsic eye muscles
d. allow movement
e. origins are in bones of orbit, insert into outer surface of eyeball

 Eyeball structure
1. fibrous tunic
a. outer part of eye wall
b. dense CT, mostly collagen fibers
1) sclera - opaque, white; protects and shapes the eye, muscles insert
2) cornea - transparent; allows light to enter the eye and bends light;
covered by epithelium (outer surface is a protective stratified
squamous, inner surface simple squamous)

2. vascular tunic
a. middle layer
b. choroid
1) nourishes the tunics (has blood vessels)
2) contains melanin that absorbs light and prevents scattering
c. ciliary body
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 1) connects with choroid and retina at ora serrata
2) mostly smooth muscle that controls shape of lens
3) ciliary processes secrete fluid called the aqueous humor
d. suspensory ligament (a.k.a. ciliary zonule)
1) extends from ciliary body to lens
e. iris
1) colored portion of eye, continuous with ciliary body posteriorly
2) pupil is the opening
3) made up of smooth muscle

3. sensory tunic (retina)

a. pigmented layer prevents reflection and scattering of light within the eye
(melanocytes)
b. neural layer contains photoreceptors
1) rods - used in dim light, allow us to perceive shades of gray, shapes,
movement
2) cones - used in bright light, different types allow us to perceive
color and have sharp vision (red, green, blue)
3) macula lutea contains mostly cones, and in the center of it is the
fovea centralis which has only cones (sharpest vision when light hits
here)
4) optic disc is where the optic nerve exits the eye, called the blind
spot because it has no photoreceptors

4. lens
a. transparent fibrous proteins covered by simple cuboidal epithelium
b. changes shape to allow focusing of light on retina

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 5. internal chambers and fluids
a. anterior segment
1) filled with aqueous humor secreted by ciliary processes (drains
into scleral venous sinus)
2) nourishes lens and cornea, maintains shape of eye
b. posterior segment
1) contains vitreous humor, a gel that maintains pressure in the eye and
holds the retina in place

 Visual pathway
1. light hits rods and cones, which send signals to bipolar cells, then ganglion
cells
2. signal travels along optic nerve to thalamus, synapses with neurons to
visual cortex in the occipital lobes; also goes to nuclei in midbrain
which mediate pupillary light reflexes and control extrinsic eye
muscles, biological clock

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 Auditory Sensations and the Ear
 External ear
1. auricle (a.k.a. pinna)
a. elastic cartilage covered with skin
b. directs sound into ear

2. external auditory canal

(meatus)
a. cartilage and temporal bone
b. lined with skin
1) hairs, sebaceous glands, ceruminous glands (produce cerumin,
a.k.a. wax, that is sticky and traps potentially dangerous material)
3. tympanic membrane
a. thin CT membrane with skin on outer surface and mucosa on internal
surface
b. vibrates when hit by sound waves, transferring vibrations to the bones of
the middle ear

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 Middle ear
1. lined with mucosa and filled with air
2. medial end has oval window and round window
3. pharyngotympanic tube connects to pharynx (allows air pressure to
equalize to tympanic membrane can vibrate freely
4. ossicles are the bones that transmit vibration to the inner ear
a. malleus, incus, stapes

 Inner ear
1. the bony labyrinth is a cavity in the bone, filled with fluid (perilymph) that
conducts vibrations
2. the membranous labyrinth is a series of interconnecting sacs and
ducts floating in the perilymph (contains endolymph that conducts
vibrations)
3. the cochlea contains the structures for hearing
a. when sound waves strike the tympanic membrane vibration is
transmitted through the ossicles to the fluid in the cochlea
b. the structures inside vibrate and hair cells are stimulated, resulting
in nerve impulses being sent along the cochlear branch of the
vestibulocochlear nerve, to the medulla where most fibers cross
over, to thalamus where they synapse with fibers heading to primary
auditory cortex on the temporal lobe
5. vestibular apparatus contains the structures for equilibrium
a. vestibule contains sacs called saccule and utricle

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 1) each contains a macula which senses static equilibrium (head
position) and linear acceleration
b. semicircular canals contain cristae which sense rotational acceleration
c. when hair cells are stimulated by changes in body position or
movement, they send signals along the vestibular branch of the
vestibulocochlear nerve, to the vestibular nuclei in the medulla, then on
to nuclei that control eye/head/neck movements and to cerebellum

84
Chapter 18

BLOOD

 Blood Basics
 about 5 liters, about 8% of body weight

- pH ranges 7.35 - 7.45

 Is a connective tissue
1. formed elements
a. erythrocytes (RBCs)
b. leukocytes (WBCs)
c. platelets
2. matrix is plasma

 Functions
1. transport of O2, CO2, nutrients, wastes, heat, hormones
2. protection, from WBCs and other defenses

 Plasma
 55% of whole blood

 90% water

 Contains proteins, ions, buffers, respiratory gases, nutrients, wastes, hormones

 Proteins are functionally important

1. establish osmotic pressure (holds water)
2. three main types
a. albumins- bind substances for transport
b. globulins- bind substances for transport, blood clotting, inactive
precursor molecules, antibodies
c. fibrinogen- blood clotting

 Formation of Blood Cells (Hematopoiesis)

 Occurs in red marrow

 Erythrocytes
 About 45% of whole blood

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 capillaries

 About 5 million/mm3

 Mature cells have no nucleus or other organelles

 Make ATP anaerobically

 Live about 120 days, most die in spleen capillaries

 Contain hemoglobin
1. carries most of the oxygen
2. carries some carbon dioxide
3. helps buffer blood

86
 Erythropoiesis (production of RBCs)
1. controlled by hormone erythropoietin, which is released from the kidneys in
response to low oxygen levels

 Blood types
1. based on certain proteins (antigens) found on RBC surface
a. 100+ kinds of antigens
b. ABO and Rh most important

 Platelets
 Cell fragments (no nucleus, but do have organelles)
 Live about 10 days
- 250,000 - 400,000/mm3
 Can be stored in spleen
 Important in stopping blood flow through damaged vessels (hemostasis)

 Leukocytes
 Less than 1% of whole blood
 May live a few hours or last a lifetime
 Usually larger than RBCs, range from 6 – diameter
- 5000 - 10,000/mm3
 Present in blood and tissues
 Able to move from blood → tissues
1. sense chemicals released from damaged tissues and move by chemotaxis

87
 Granulocytes
1. contain visible granules in cytoplasm (colors due to staining)
2. three kinds
a. neutrophils
1) function: active phagocytes of bacteria
2) granules contain lysosomal enzymes and "antibiotics"
3) most common of WBCs, about 60 - 70% of total
b. eosinophils
1) function: kill parasites, active in ending allergic responses
2) granules contain digestive enzymes
3) 1 - 4% of all WBCs
c. basophils
1) function: inflammatory response
2) granules contain histamine, which acts as a vasodilator and attracts
other WBCs
3) .5% of all WBCs

 Agranulocytes
1. no visible granules
2. two major kinds
a. lymphocytes
1) function: immune responses
2) second most common of all WBCs, about 25% of total
3) often similar in size to RBCs
b. monocytes
1) function: become active macrophages in tissues
2) 4 - 8% of all WBCs
3) very large, may look like big blobs

88
Chapter 19

THE HEART
 Basics
 Found in mediastinum

 Enclosed in
pericardium
1. fibrous pericardium
a. attached to diaphragm, fused to vessels going to/from heart
b. dense irregular CT
c. protects heart, attaches it to surrounding structures, prevents over-filling
2. serous pericardium
a. parietal layer lines inside of fibrous pericardium
b. visceral layer (epicardium)
c. both layers are simple squamous epithelium and areolar CT
d. pericardial cavity lies between layers and contains serous fluid (a.k.a.
pericardial fluid) which decreases friction for the beating heart

3.

-Cardiac muscle cells

1. lots of mitochondria, uses oxygen to make ATP
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 2. contraction triggered by electrical signals
a. signal spreads to all cells and heart contracts as a unit
b. some cells are autorhythmic (they generate their own electrical
activity), but can also be influenced by ANS

 Layers of the heart

1. epicardium
2. myocardium
a. mostly cardiac muscle
b. fibrous skeleton
1) dense CT fibers that reinforce myocardium and support valves
2) limits spread of electrical activity
3. endocardium
a. endothelium (simple squamous epith/areolar CT)
b. lines chambers, covers valves
c. continuous with lining of blood vessels

4.

 Anatomy of Heart
 Know all structures from figs. 19.5bde

 Pathway of blood through the heart

 Pulmonary circuit
1. heart to lungs and back
2. gas exchange occurs in lungs (picks up O2, drops off CO2)
3. right side of heart is pump

90
 4. short distance, low pressure circulation

5.

 Systemic circulate
1. heart to body tissues and back
2. gas exchange at tissues (drops off O 2, picks up CO2)
3. left side of heart is pump
4. long distance, high resistance pathway

 Heart Valves
 Keep blood flowing in one direction only

91
 Atrioventricular valves
1. CT covered with endothelium
2. attached to chordae tendinae (collagen cords) which attach to...
3. papillary muscles
a. anchor valves, prevent opening backwards

 Semilunar valves
1. CT covered with endothelium
2. shaped like cups so won't open backwards

 Coronary Circulation
 Heart receives its blood supply from right and left coronary arteries
1. branches from ascending aorta
2. capillaries bring blood to tissues
3. veins carry blood back to the circulation via coronary sinus, which empties
into right atrium

92
 Most blood delivered to heart when ventricles are relaxed

 Intrinsic Conduction System

 Sets basic rhythm of heart beats

 Autorhythmic cells
1. noncontractile
2. specialized to initiate and distribute electrical signals

 Located in...
1. sinoatrial (SA) node (the pacemaker)
2. atrioventricular (AV) node
3. atrioventricular bundle (AV bundle)
4. right and left bundle branches
5. Purkinje fibers (subendocardial conducting network)

 Extrinsic Innervation
 Modifies basic rhythm as needed

 ANS
1. sympathetic division increases rate and force
2. parasympathetic slows rate

 Cardiac cycle
 All the events associated with blood flow during one complete heartbeat

 Systole is contraction phase

 Diastole is relaxation phase

 Heart sounds
 Described as lub-dup

 Caused by blood turbulence when valves close

1. "lub" - closing of AV valves
2. "dup" - closing of semilunar valves

93
Chapter 20

BLOOD VESSELS
 General Pattern
 heart → arteries → arterioles → capillaries → venules → veins → heart

 Basic Structure
 Three tunics surrounding a lumen
1. tunica intima
a. endothelium- slick surface reduces friction
b. basement membrane
c. elastic lamina
2. tunica media
a. smooth muscle and elastin sheets
b. regulates circulation by vasoconstriction or vasodilation
3. tunica externa
a. collagen and elastin fibers protect vessel and anchor it to other structures
b. larger vessels have their own blood vessels to supply outer tissues (called
vasa vasorum)

4.

 Arteries
 Carry blood away from heart

 Withstand high pressure

94
 Three groups
1. elastic arteries (conducting)
a. aorta and major branches
b. large (1 - 2.5 cm in diameter)
c. lots of elastin allows expansion and recoil (recoil keeps blood moving
between heartbeats)
2. muscular arteries
a. deliver blood to specific body organs
b. .3 mm – 1 cm in diameter
c. more smooth muscle, less elastin
d. active in vasoconstriction
3. arterioles
a. - .3 mm in diameter
b. larger ones have all three tunics
c. smaller ones are just smooth muscle surrounding endothelium

 Anastomoses
1. most tissues receive blood from more than one artery
2. anastomoses are branches between arteries
3. also occur between veins
4. called collateral circulation (allows alternate pathways for blood flow)

 Capillaries
 Smallest vessels, 3 – diameter

 Thin tunica intima only

 Allow exchanges between blood and tissues

 Near almost all cells (epithelial sheets, cartilage, some parts of eye have none)

 Varying distribution based on need

1. e.g., muscles, liver, kidneys, lungs, and nervous system have lots

95
 Types
1. continuous
a. tight junctions
b. small gaps called intercellular clefts allow fluids and small solutes to pass
c. most common type
2. fenestrated
a. some cells have "windows" covered with a thin membrane
b. greater permeability to fluids and solutes
c. found where absorption or filtration needed (small intestine, endocrine
glands, kidney)
3. sinusoidal
a. very "leaky" with fenestrations and large intercellular clefts
b. allows relatively large molecules to pass
c. found in liver, bone marrow, lymphoid tissues, some endocrine glands

 Capillary beds
1. network of capillaries that feeds tissues
2. parts
a. terminal arteriole feeds bed
b. metarteriole
c. true capillaries (have precapillary sphincters that regulate blood flow)
d. thoroughfare channel
e. postcapillary venule

 Veins
 Venules
1. smallest are mostly endothelium (8 – diameter)
2. larger ones have 3 tunics

 Veins
1. have 3 tunics
2. lumens larger and walls thinner than corresponding arteries
3. not much smooth muscle or elastin
4. valves
a. folds of tunica intima
b. prevent backflow due to gravity (mostly in limbs)
5. venous sinuses
a. specialized, flattened veins with endothelium surrounded by dense CT
b. receive blood draining from certain areas of body (e.g., brain, heart)

 Circulatory Routes
 The "vascular tree" is constructed so all organs get a fresh supply of blood

96
 Systemic circulation
1. all systemic arteries branch from the aorta
a. elastic arteries are the aorta, brachiocephalic, common carotid,
subclavian, vertebral, common iliac
b. all other named arteries are muscular
2. all systemic veins drain into one of the following:
a. superior vena cava (head, neck, chest, upper limbs)
b. inferior vena cava (lower parts of body)
c. coronary sinus (coronary vessels)

 Pulmonary circulation

97
 Special Circulations
 Hepatic portal circulation
1. picks up nutrients absorbed from digestive tract and brings them to liver
a. liver processes and stores nutrients
b. breaks down toxins

 Fetal circulation
1. fetal respiratory organ is the placenta
a. gets nutrients and oxygen from mother's blood
b. does not need to send much blood through pulmonary circuit

2. must send blood to and from placenta

a. two umbilical arteries
1) branch from internal iliac arteries
2) carry blood to placenta
b. one umbilical vein
1) brings blood from placenta to fetus
2) some blood goes to hepatic portal vein so liver can process
3) most diverted to a shunt called ductus venosus
4) eventually goes to inferior vena cava then heart

3. two shunts divert blood away from the pulmonary circuit

a. foramen ovale

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 1) hole in interatrial septum with a valve (blood goes from right atrium
→ left atrium)
2) a bit less than half the blood entering the heart is diverted this way
b. ductus arteriosus
1) a branch from the pulmonary trunk to the aorta
2) blood flows to the rest of the body

99
4. postnatal changes (begin immediately)
a. umbilical arteries → medial umbilical ligaments

10
0
b. umbilical vein → ligamentum teres (round ligament)
c. ductus venosus → ligamentum venosum
d. foramen ovale → fossa ovalis
e. ductus arteriosus → ligamentum arteriosum
1) with first breaths, ductus arteriosus constricts, more blood in left
atrium raises pressure and keeps foramen ovale closed until
completely fused at about one year

10
1
Chapter 21

LYMPHATIC SYSTEM
 Lymphatic Vessels and Lymph
 Collect excess fluid in tissues and return it to bloodstream

 Lymph is basically the same as interstitial fluid (once in lymphatic vessels, it's
called lymph)

 Lymphatic vessels (lymphatics)

1. begin at lymphatic capillaries (initial lymphatics)
a. closed-ended vessels
b. found most anywhere capillary beds are (not in avascular tissues, not
in CNS, red bone marrow, parts of spleen)
c. very permeable
1) constructed with overlapping cells that act as one-way valves
2) cells of lymphatic capillaries are attached to tissues by anchoring
filaments; when excess interstitial fluid accumulates (edema) these
pull on the cells and make the openings even bigger
3) allow any leaked plasma proteins to return to blood

2.
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2
 3. lymphatic collecting vessels
a. lymph in lymphatic capillaries flows into larger vessels
b. have 3 tunics, but very thin walls
c. have valves similar to the ones in veins
d. flow maintained mainly by squeezing from surrounding skeletal
muscles (also smooth muscle of vessels, also breathing - the lymph
flows toward low pressure of thoracic region)

4. lymph nodes
a. filters lymph, catches invaders

5. lymphatic trunks drain large areas of body

6. lymphatic ducts
a. thoracic duct
1) main collecting duct for lymph
2) receives lymph from left side of upper body, entire body inferior to
ribs
3) begins at cisterna chyli
4) empties into subclavian vein
b. right lymphatic duct
1) receives lymph from upper right side of body
2) empties into right subclavian vein

 Lymphoid Organs and Tissues

 Lymph nodes
1. found throughout body
a. lots in neck, axillary region and groin
2. structure
a. capsule made of dense fibrous CT extends into node as
trabeculae, which form compartments
b. inner portions supported by reticular tissue
c. cortex
1) lymph sinuses (filter lymph)
2) lymphoid tissue - has lots of lymphocytes and other defense cells, has
germinal center where B lymphocytes reproduce during an immune
response
d. medulla has lymphocytes and other defense cells

10
3
 3. lymph flows in through afferent lymphatic vessels, through sinuses,
exits through efferent lymphatic vessels
4. catch particles in lymph (trapped in reticular fibers)
a. macrophages destroy particles
b. immune responses are activated, lymphocytes can leave node and move
around the body

 Red bone marrow

1. produces blood cells
2. reticular tissue and cells

 Thymus gland
1. T lymphocytes migrate here and go through a maturing process signaled by
thymic hormones
2. posterior to sternum
3. reticular tissue and cells

 Spleen
1. has capsule with trabeculae, reticular tissue, lots of fibroblasts
2. other cells include RBCs, macrophages, lymphocytes and other WBCs
3. functions
a. houses defense cells and immune responses are activated
b. breaks down old blood cells (RBCs, WBCs, platelets)
c. stores platelets

 Lymphoid nodules
1. concentrations of lymphatic tissue, no capsule
2. in lamina propria of mucous membranes (mucosa-associated lymphoid tissue
or MALT)
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4
 a. gastrointestinal tract (gut-associated lymphoid tissue or GALT)
b. respiratory tract
c. urinary tract
d. reproductive tract
e. tonsils
3. houses defense cells and destroys invaders

 Appendix
1. piece of the first part of the large intestine
2. similar to lymphoid nodules

10
5
Chapter 22

RESPIRATORY SYSTEM

 Basics
 Two zones
1. conducting zone (air passages)
2. respiratory zone (site of gas exchange)

 Function
1. gas exchange (O2 in, CO2 out)
2. other functions such as acid/base balance, route for water and heat loss

 Four major processes

1. pulmonary ventilation (breathing)
2. external respiration
a. gas exchange between lung air sacs and blood
3. gas transport
a. cardiovascular system carries O 2 to tissues and CO2 back to lungs
4. internal respiration
a. gas exchange between blood and tissues

5.

 Nose
 Functions
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6
 1. airway
2. moistens, warms and filters air

 External nose
1. bone and hyaline cartilage

 Nasal cavity
1. air enters by external nares (nostrils)
2. divided by nasal septum (cartilage and bone)
3. contains olfactory mucosa and respiratory mucosa
a. respiratory mucosa is pseudostratified ciliated columnar epithelium
b. debris is trapped in mucus and can be swallowed or spit out
4. nasal conchae
a. projections in cavity (soft tissue and bone)
b. allow air to bounce around, so most debris is caught by mucosa
5. internal nares (posterior nasal aperture) open to throat

 Pharynx (throat)
 Air passageway

 Three parts
1. nasopharynx
a. pseudostratified ciliated columnar epithelium
b. pharyngeal tonsils (adenoids) in posterior walls
c. uvula closes it off during swallowing
2. oropharynx
a. also a food passageway
b. stratified squamous epithelium
c. palatine and lingual tonsils
3. laryngopharynx
a. also a food passageway
b. stratified squamous epithelium

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7
 Larynx (voice box)
 Air passageway
 Made up of cartilages, ligaments, muscles
 Epiglottis
1. elastic cartilage flap that prevents food from entering trachea
 Glottis
1. contains the vocal folds
a. elastic fibers running between cartilages under the mucosa
b. vibrate as air passes by
c. space between called rima glottidis
 Mucosa above vocal folds is stratified squamous, below is pseudostratified
ciliated columnar

 Trachea
 Air passageway

 Three layers
1. mucosa
a. pseudostratified ciliated columnar, lots of goblet cells
2. submucosa
a. areolar CT, seromucous glands
3. adventitia
a. CT with rings of hyaline cartilage
b. cartilage keeps trachea open

 Bronchi and bronchial tree

 Right and left primary bronchi

 Secondary bronchi are branches that supply each lobe of lung (3 right, 2 left)

 Tertiary (segmental) bronchi are further branches

 Branches finally lead to bronchioles which are <1 mm in diameter

 Terminal bronchioles (<.5 mm diameter) lead to air sacs of lungs

 Walls of bronchi
1. past primary bronchi cartilage rings become irregular plates of
cartilage (no cartilage in smallest bronchioles)
2. whole tree surrounded with elastic fibers
3. smooth muscle becomes more important as the tree branches
4. epithelium changes to columnar and cuboidal in terminal bronchioles
a. no cilia in smallest bronchioles, macrophages take on role of debris
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 removal

 Lungs
 Three right lobes, two left

 Covered by plurae
1. visceral and parietal layers, pleural fluid between decreases friction

 Terminal bronchioles lead to alveoli (air sacs)

 Respiratory membrane is a thin layer for gas exchange, includes capillary walls

 Cells in alveoli
1. simple squamous epithelium (type I cells) with thin basal lamina
2. scattered type II cells secrete surfactant, which helps alveoli stay open
3. macrophages

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 Chapter 23

DIGESTIVE SYSTEM

STOMACH
It is widest parts of digestive tract which connects with first parts of duodenum. when empty it is J
shape
Anatomical Position:
1. The cardiac orifice is situated on the left of the median plane 2.5cm. from the lateral border of
sternum.

2. The pyloric orifice lies 1.25cm into the right of the median plane and its position is indicated
by the pyloric constriction;

3. The greater curvature is directed anteroinferiorly, starting from the cardiac notch, it forms an
arch backwards, upwards and to the left.

4. The lesser curvature extends between the cardiac and pyloric orifice and pyloric orifice is
directed poster superiorly.

5. When the stomach is empty, the antero superior surface faces superiorly and the posterior
inferior

parts of the stomach

1. Fundus 2; Body. 3. Pyloric parts
two ends
i) Cardiac end
ii) Pyloric end..
surfaces and borders of stomach
1) Surfaces-
1. Antero-superior
2. Postero-inferior
2) Borders-
1. Grater curvature
2. Lesser curvature

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 The ligaments of the stomach
a) At me lesser curvature: Two layers of lesser
omentum.
b) At the greater curvature:
1) Gastrosplenic ligament left
side of the fundus and the
adjoining part of the body.
2) Two layers of greater
omentum
c) At posteroirgferior surface: Gastrophrenic
ligament near the cardiac end.

stomach bed
1) The diaphragm.
2) Left suprarenal gland.
3) Upper part of left kidney.
4) splenic artery.
5) Transverse mesocolon.
6) Anterior surface of-
pancreas.
7) Left colic flexure.

The arterial supply of stomach.

1) Left gastric artery - Branch of coeliac trunk.

2) Right gastric artery - Branch of common hepatic artery.

3) Short gastric artery - Branch of splenic artery.

4) Right gastro epiploic artery -Branch of gestrodudenal artery

5) Left gastro epiploic artery

The nerve supply of the stomach

Sympathetic- Mainly from the coeliac plexus (T6-10) through the plexuses around the gastric and
gastro epiploic vessels Branches from the left phrenic nerve pass to cardiac end of the stomach. In
addition branches come to the stomach from left thoracic splanchnic nerves and branch of
sympathetic trunk.
Parasympathetic: from vagus nerve.

The cells of gastric gland

1. Parietal cells or oxyntic cells secrets HCL, intrinsic factors.
2. Zymogenic cells or chief cells - secrets pepsin.
3. Mucous neck cells - secrets mucous
4. Argentamn cells secrets serotonin v/ p, glucon, somatostatin, SHT,
5. Undifferentiated columnar cell

*layers of stomach

1. Serous

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 2. Muscular
 Outer : longitudinal layer
 Middle : circular layer
 Inner : oblique layer.
3. Subarelolar
4. Mucosal layer

DOUDENUM
It is the shortest and the widest fixed pan of the small intestine extending from pylorus to
duodenojejunal flexure. Food staffs are mixed with pancreatic juice and bile in this part of digestive
canal.

Anatomical Position:

1. lst part or superior part starts from 1.25 cm to the right of the median plane and passes
upwards, back-wards and to the right for about 5 cm.
2. 2nd part or descending part de scends downwards for about 7.5 cm and 3.5 cm lateral to the
mid line to the right side.
3. 3rd part or horizontal part is horizontal and runs transversely from right to the left for about
5 to 10 cm just above the level of the umbilicus.
4. 4th part or ascending part ascends upwards for about 2.5 cm upto the upper border of L2
vertebra.
5. These parts form an incomplete circle

Parts of duodenum

1. Superior part – 5 cm
2. Descending parts 10 cm
3. Horizontal parts 10 cm
4. Ascending parts 2.5 cm.

*(note Total length

parts 25 cm)

Blood supply of duodenum.

1) Superior pancreatico duodenal artery.

2) Inferior pancreatico duodenal artery.
3) Right gastric artery.
4) Supra duodenal artery.
5) Right gastroepiploic artery
 Posteriorly-
1) Right ureter.
2) Right psoas major muscle.
*the relation of horizontal part of duodenum. 3) Right testicular vessels.
4) Inferior vena cava.
 Anteriorly 5) Descending aorta.
1) Uncinate process of pancreas.
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 2) Superior mesenteric vessels
3) Root of the mesentery.

SMALL INTESTINE
Small intestine the longest portion of the digestive tract. It extends from the pylorus of the stomach to
the ileocecal junction. It is about 6 meter long. Small intestine is also known as small gut.
Anatomical Position.
1. It is the specimen of small intestine with the mesentery.
2. The root of the mesentery lies posteriorly and runs obliquely downwards from left to right.
3. Iliac end lies in the right iliac fossa, and duodeno - jejunal ilexure lies to the left of the upper
border of 2nd lumbar vertebrae.

It has three parts

1. Duodenum
2. Jejunum
3. Ileum

Difference between jejunum & ileum

Point Jejunum Ileum
Length A) paroximal 2/5th A. paroximal
B) Length 230 cm 2/5th
C) Diameter 4cm B. Length 230 c
C. Diameter
4cm
Wall thicker Thinner
Location Upper & left part of the Lower & right parts
intestine of the intestine
Lumen Wider Narrower
Villi Large thick Shorter thicker

Length 6-7 M. average 5m

LARGE INTESTINE
The large intestine is the part of alimentary system that extends iiom ileocaecal junction to anus. The
greater part of large intestine is fixed. Large intestine is also known as large gut. The term colon is
used for large intestine.
Features of large intestine
 Total length - 1.5 meter
 Two ends: Ileocaecal & Anal
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  Parts with approximate length
i. Caecum with appendix- 6 cm
ii. Colon
o Ascending colon- 12.5 cm
o Transverse colon- 50 cm
o Descending colon - 25 cm
o Sigmoid colon - 10 cm
iii. Rectum - 12 cm “
iv. Anal canal & anus - 3.8 cm.

Difference between small intestine and large intestine

Point Small Large

intestine intestine
Length 6-7 meter 1.5 meter
Villi Present Absent
Caliber Smaller Larger
Taenia coli Absent Present
Sacculation Absent present

RECTUM
The distal part of the large intestine lies between the sigmoid colon and anal canal. lt acts as a
temporary reservoir of faecal materials. Distension of rectum causes the desire of defecation. The
prefixproct means related to rectum.
Location
It occupies within hypogastric region. Specifically at posterior part of lesser pelvis in front of lower
three pieces of sacrum and coccyx.
Features
 Length - about 12 cm.
 Two ends: Colonic and Anal
 Curvatures: Two anterior posterior curvatures & Three lateral curvatures.

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 PANCARES
It is a mixed gland.

Functions-

2) Exocrine part secrets pancreaticjuice. -

3) Endocrine part secrets glucagon, insulin. and somatostatin (by delta Cell)

Anatomical Points:

1) The pancreas passes obliquely to the left and slightly upwards.

2) The anterior surface of the body is concave and is directed forwards and upwards. In the
posterior surface there is a groove for splenic vein.
3) The superior border is blunt to the fight but narrow and sharp to the left and is in contact with
splenic artery.

*Parts of pancreas

i. Head
ii. Neck
iii. Tail

(Length 12-15 cm weight 85

gm)

The posterior relation of the pancreas.

1) Bile duct and portal vein. The blood supply of the pancreas .
2) Inferior vena cava.
3) Abdominal aorta with origin of 1. Pancreatic branch of the splenic artery
superior mesenteric artery. 2. Superior pancreatico – duodenal artery
4) Left crus of diaphragm. 3. Inferior pancreatico – duodenal
5) Left psoas major muscle. p
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 6) Left suprarenal gland.
7) Left kidney.

LIVER
Define liver.

Liver is the largest gland in the body situated in the right upper quadrant of abdominal cavity.

Anatomical points.

lt is a specimen of liver with gall bladder, ligamentum teris. ligarnenturn venosum, falciform ligament
and inferior vena cava (If these are present).

1) (For anterior and posterior): Groove for the inferior vena cava lies posteriorly and is
directed vertically downwards.
2) (For right and left): Right lobe is larger than the left.
3) (For superior and inferior): Fossa for gall bladder lies in the inferior surface and this
surface is directed downwards, backwards and to the left.
4) The right lobe of liver lies in a higher level than the left lobe.

* Region of abdomen it lies

It lies in whole of the right hypochondrium, the greater part of epigastric and also extends into lei?
hypochondriurn as far as the left lateral line. Upper part of Rt. Lumber region.

For: remaember

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*BORDERS
1. Inferior border.

2. Superior, anterior and right lateral surface are united by rounder border so they are not
defined.

*SURFACES
1) Anterior surface.

2) Superior surface.
3) Posterior surface.
4) Inferior surface.
5) Right lateral surface.

The bare area of the liver

1) The bare area.
2) Groove for inferior vena cava.
3) Fossa for gall bladder.
4) Along the attachment of
falciform coronary, right and left
triangular ligaments.
5) Fissure for ligarnentum teres
6) Portal hepatis .

Fig: the bare area of liver

*The ligaments of the liver

 False ligaments
I. Falcifrom ligaments
II. Coronary ligaments
III. Left triangular ligaments
IV. Right triangular ligaments
V. Lesser omentum.
 True ligaments
I. Ligamentum teres hepatis
II. Ligamentum venosum.

Fig : The ligaments of liver

Structures Enter.
1. Right and left division of portal vein.

2. Right and left hepatic artery.

3. Hepatic plexus of nerves.
****(For Remember VAN.)
Structures Emerge:

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 1. Right and left hepatic duct.

2. Lymph Vessels.

*Relation of inferior surface of liver

 Left lobe
1. Stomach
2. Oesophaguas
(*** for remember SO)
 Right lobe
1. Duodenum
2. Gall bladder
3. Right kidney
4. Right suprarenal gland
5. Transverse colon
6. Right colic flexure.

Functions of the liver:

1. Metabolic function: Carbohydrate, protein & fat metabolism

2. Secretary function: Secretion of bile.

3. Synthetic function: Prothrombine synthesis.
4. Excretory function: Excretes the drugs, toxins, poisons , cholesterol, bile pigments and
heavy metals.
5. Protective function: By conjugation. Destruction, phagocytosis and antibody formation.
6. Storage function: Stores glycogen, iron, fat, vitamin-A,vitamin-D and blood.
7. Haemopoietic function: ln intrauterine life, RBC product' ln adults: main site of RBC
destruction.

GALL BLADDER
This is a pear shaped reservoir of bile
situated in a fossa on the inferior surface of
the right lobe of the liver.
 Measurement:

1. Length = 7-l0 cm.

2. Breadth = 3 cm (widest part).
3. Capacity `= 30-50 ml.

 Parts

1. Fundus Function of gall bladder :

2. Body a. Storage of bile.
3. Neck b. Concentration of bile about 10 times.
 Blood supply: c. Absorb inorganic salts and reduces the
1. Arterial supply :Cystic artery alkalinity of liver.
branch of right hep n d. lt secrets cholesterol and mucous
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 2. Venous drainage: into - e. It helps in equalization of pressure in billiary
a. Gallbladder (except its superior duct System
surface): Drained by cystic
(one/two) veins, which drain
into the portal vein.
b. Superior surface is drained by
some veins, which enter directly
into the liver through the fossa
of gall bladder and join
tributaries of hepatic vein.

KIDNEY
Kidneys are a pair of excretory organ situated in the abdominal cavity

Chapter 24

URINARY SYSTEM
KIDNEY
Kidneys are a pair of excretory organ situated in the abdominal cavity

Position
Each kidney is situated retroperitoneally in the posterior abdominal wall. Right kidney is slightly
lower than left due to presence of liver. Kidney is subdiaphragmatic organ, so it moves 1.5-2.5 cm
with respiration Vertically they extend from T12 to L 3 vertebrae. They occupied in hypochondriac,
epigastric, lumber and umbilical region.

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Relation of kidney
 Anterior relation of Right kidney সহজ এ মনে রাখার জেয
1. Suprarenal gland
2. Hepatic
3. Right colic flexure সখখ হহনে দুনে হ াথায় যাও
4. Duodenum S H D C J
5. Jejunum

 Anterior relation of Left kidney সহজ এ মনে রাখার জেয

1. Suprarenal gland
2. Splenic
3. Gastric
4. Pancreas
5. Jejunum সখখ সখখ গানয় পানয় জে হ ে
6. Left colic flexure S S G P J C
7. Colon

 Posterior Relation: (Same in both kidneys).

1) Diaphragm.
2) Medial and lateral lumbocostal arches.
3) Psoas major muscle.
4) Quadratus lumborum muscle.
5) Aponeurosis to transversus abdominis muscle. ’
6) Subcostal vessels.
7) Last thoracic, iliohypogastric and ilio-inguinal nerve.

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 Structur enter and emerge through the hilus of the kidney
 Enter
1. Renal artery
2. Nerve plexus
3. Capsul
 Emerge
1. Renal vein
2. Pelvis of the liver
3. Lymph vessles
 Weight of both kidney
1. In male 150 gm
2. In female 135 gm
 the functions of the kidney.
1) Conservation of valuable substance and excretion of unnecessary waste product of
metabolism
2) Regulation of water balance.
3) Regulation of electrolyte balance.
4) Helps in amino acid metabolism
5) 5)It helps in the regulation of blood pressure by secreting renin.
6) It helps in the formation of R.B.C by secreting renal erythropoietin factor.
 Mode of blood supply of the kidney:

Renal artery → Divides into anterior & posterior division →Each divides into 5 segmental arteries
→Iobar artery (usually for each pyramid) →2-3 lobar artery -> Arcuate artery →lnterlobular
artery→Afferent arteriole →Glomerular capillaries →Efferent arteriole →Peritubular capillary and
vasa recta →lnterlobular vein →Arcuate vein →lnterlobar vein → Renal vein .ln case of juxtra-
medulla glomerulus, efferent arteriole
vasa recta →lnterlobar vein →arcuate veinrenal vein
 Histological structure of kidney:

A coronal section of kidney shows:

a) Outer cortex &
b) lnner medulla.

The cortex: lt is divisible into two parts:

1) Cortical arches which form caps over the base of pyramid
2) Renal columns which deep in between the pyramid.
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The medulla: lt is made up of about IO cortical masses.called the renal pyramids. Apices of renal
pyramid are called renal papillae. which indent the minor calyces. I6-20 ducts
of Bellini open at the apex of renal papillae.
A) The secretory part: Called nephron, which elaborates urine. lt is the
structural and functional unit of kidney. Lt is made up ofglomerulus
& Bowman`s capsule.
B) The collecting part: lt is made up of proximal and distal convoluted
tubules. collecting ducts. I2-I5 collecting ducts unite to form duct Of
Bellini. which opens into minor calyx.

NEPHRON

Nephron is the structural and iiinctional unit of kidney. Each kidney contains more than 1 million
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nephron . length of nephron varies between 50-55 mm It consist of two parts .
 Renal corpuscle or malpighian body: It is consist of Glomerular plexus of capillary and a
BowmanS Capsule
 °Renal tubule `
1. Proximal convoluted tubule.
2. Descending limb of loop of Henle
3. Loop of Henle
4. Ascending limb of Loop of Henle,
5. Distal convoluted tubule
6. Collecting tubule
UTETER
Ureters is muscular tube connect kidney with urinary bladder
Location
It situated in umbilical and hypogastric region. It located at posterior of abdomen
Features
1. Length - 25 cm
2. Breath average 3 mm.
3. Three Parts : (1)Abdominal: (2)Pelvic (3)Bladder
4. Constriction-Three constriction
o Pelvic-ureteric junction
o Brim of lesser pelvis
o Entrance point of urinary bladder.

URINARY BLADDER
Urinary bladder is a muscular bag like structure situated in pelvis which act as a temporary reservoir
of urine
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o Location

In empty state it lies within pelvis But as it fills it expands and extends upward up to unbilical region.
In empty state it lies in hypogastric region.
features (empty state)
A) Shape –tetrahedral
B) Capacity -120-320ml
C) Parts
o Apex: directed forward to upper parts symphysis pubis.
o Base or fundus: Directed backward and downwards and triangular in outline.
o Neck : lowet point of the bladder from here urethra begins
D) Three surface: Superior, Right inferolateral left inferolateral.

Chapter 25

REPRODUCTIVE SYSTEM
TESTIS
Testis are the primary male sex organ.
Anatomical Position
It is the specimen of testis with epididymis and spermatic cord.
1) Superior pole is directed antero-laterally.
2) Sinus of epldidymis is dlreted postero-laterally.
3) Summit of the testis is covered by the head of the epididyrnis.
4) Anterior border is convex and is directed forwards and downwards.

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What is size and shape of testis.
 Shape: oval .
 Length : 5 cm.
 Breath :2.5 cm.
 Thickness (antero-posteriorly) :3 cm.
 Weight- 10.5 to 14 gm.

Tell the coverings of the testis.

From inward to outside
1) Tunica vasculosa.
2) Tunica albugenla
3) Visceral layer of tunica vaginalis
4) Capillary interval or space between visceral layer of tunica vaginalis and parietal layer of
tunica vaginalis.
5) Parletal layer of tunica vaginalis.
6) Internal spermatlc fascia.
7) Cremasterlc muscle and fascia
8) Extemal spermatlc fascia.
9) Dartos muscle and superficial facia
10) Skin

Contents of spermatic cord

1) Ductus deferens
2) Artery to ductus deferens
3) Testicular artery
4) Pampiniform plexus of vein
5) Artery to cremaster
6) Genital branches of genitor femoral nerve
7) Testicular plexus of femoral nerve
8) Testicular lymph vessels
9) Some adipose tissue.

Pathway of sperm
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 Convulated seminiferous tubule→ Straight seminiferous tubule→ Rete testis→ Ductuli efference->
Head of the epididymis→ Body of the epididymis→ Tail of the epididyrnis→ Ductus deferens
Ejaculatory duct Prostatic part of the urethra Membranous part of urethra→ Spongy part of urethra
→(intercourse) Vagina→ Vaginal part of the cervix→ Uterine part of the cervix→ Body of the
utems→ Uterine part of the uterine tube → isthmus→ ampullary part of the uterine tube, where
fertilization occurs.

PENIS
Penis is a male sex organ . located in the perineal region.

Parts of penis:
 Root of the penis
 Body of the penis

Erection of penis
In presence of sexual stimulation the artery of penis become dilated and arterial blood enters to
erectile tissues. Thus the erectile tissue become elongated and broad and causes temporary occlusion
to its venous drainage. Thus the penis becomes elongated, braod and strong. This state is erection of
penis.
Friction of glans penis causes stimulation `for ejaculation.Alter ejaculation or cessation of stimulation
the arterial blood flow becomes reducer and venous obstruction reduced, thus the blood retums
through vein. Thus the penis becomes flaccid
Structures get in a transverse section
From dorsal to ventral
1) Skin and superficial fascia and superficial dorsal vein on this fascia.
2) Dorsal vessels and nerves

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 3) Tunica albugenia
4) Corpora cavernosa of the penis
5) Deep artery of the penis
6) Corpus spongiosum
7) Urethra and urethral artery in it

SCROTUM
It is a cutaneous bag containing testis epididymis and lower parts of spermatic cord

Layer of scrotum
1) Skin
2) Dartos muscle in superficial fascia
3) External spermatic fascia
4) Cremasteric muscle
5) Internal spermatic fascia
6) Parietal layer of tunica vaginalis

Function
1) It suspends the testis
2) It protects the testis from external temperature
3) It protects the testis from of the inferior epigestric artery.

Hydroceles
It is a condition in which the fluid accumulates in the cavity of tunica vaginalis of testis

PROSTATE

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Prostate is a conial fibro-musculo-glandular male accessory reproductive organ which the proximal
parts of male urethra.
Position
It lies just below the neck of urinary bladder surrounding the male urethra.
Feature
 Shape : inverted cone
 Size : base 4 cm , vertical – 3 cm, anteroposterioer 2 cm, wight 8gm
 Two arts : an apex a base
 Three surface : anterior,posterior,inferoleteral
 Five lobes : anterior,posterior,median,right lateral, left letaral

UTERUS

It is a child bearing organ of females situated in the lesser pelvis between the rectum and urinary
bladder.
Anatomical Position
i. Uterus lies within the lesser pelvis posterior to the bladder and anterior to rectum.
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 ii. Anterior surface is less covex and is covered by peritoneum upto the isthmus.
iii. The fundus lies above and cervix below
iv. Long axis of the uterus usually lies approximately in the axis of the pelvic inlet.
v. In the normal position it is ante-

Parts
It has 3 parts
1. Fundus
2. Body
3. Cervix : 1.supra vaginal part 2. Vaginal part.

Weight: 30-40 gm
Size 7.5 cm and 2.5 cm in thickness
The ligaments of uterus
1) Anterior ligament - Utero vesical fold of peritoneum.
2) Posterior ligament – Rectovaginal fold of peritoneum
3) Two broad ligaments
4) Two uterosacral ligaments.
5) Round ligaments.
6) Transverse cervical ligament.

The contents of broad ligament

i. Uterine & its free margin
ii. Roung ligament of uterus
iii. Ligament of ovary
iv. Uterine artery
v. Ovarian vessels
vi. Lymph vessels & nerve fibres
vii. Some smooth muscles
viii. Extra-peritoneal fatty tissue
ix. Epophoron
x. Parophoron

Layer of uterus
 Perimetrium
 Myometrium
 Endometrium

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 OVARY

Ovaries are a pair (left & right) of female reproductive gland that situated in lesser pelvis. It is the
primary sex organ of female.Prefix oophor denotes ovary.
Location
lt lies in lesser pelvis near uterus. It occupies at hypogastric region.
Features
 Shape: almond shape.
 Color: Dull grey in color.
 Measurement: Vertical: 3 cm, Anterio-posterior: 1.5 Transverse: 1 cm.
 Two poles or ends: (a) Upper tubal pole: this end related to fimbria of fallopian tube. (b)Lower
uterine pole.
 Two borders: (a)Anterior: attached to broad ligament. (b)Posterior: related to uterine tube
and peritoneum.
 Two surfaces: (a)Lateral: It rests on a peritoneal depression named ovarian fossa. (b)Medial:
related to terminal part of uterine tube

UTERINE TUBE
It is a tortuous duct which conveys ova from the ovary to the uterus and the sperm from the uterus to
the lateral part of the tube where the fertilization commonly takes place.

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Parts of fallopian tube
 Uterin parts 1 cm
 Isthmus 3 cm
 Ampulla 5 cm
 Infundibulum 1 cm

Function
 Act as channel for ovum introduction
 Acts channel for spermatozoa to in order to fertilization
 It is the site normal fertilization

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