Download CCC 24 Comprehensive Review

ANATOMY LECTURE
1
Comprehensive Review
There are 50 questions from unit 4 on the final exam.
There are 20 questions from this PPT.
All 70 questions are worth 1 point each.
All are multiple choice except 10 are fill in the blanks.
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REVIEW OF GENETICS

The nucleus of the typical (diploid) cells of the body have 46
chromosomes . Each gamete (ovum or sperm) has 23
chromosomes.
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TISSUES AND ORGANS
TISSUE: A group of cells, usually similar, which
share a particular function.
 Each ORGAN is made up of one or more tissues.
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INTEGUMENT SYSTEM
ARRECTOR PILLI: tiny muscles that make the
hairs stand up during “goosebumps”.
 HAIR PAPILLAE: what is destroyed by electrolysis,
so hair won’t grow back.
 The HAIR MATRIX is the leading edge of the
papillae. It is actually skin cells (keratocytes) which
are rapidly dividing. When they die, the new ones
push them out, forming the hair. Hair is just dead
skin cells. The HAIR ROOT is just the base of the
hair.
 The hair matrix is the part of the follicle that is
the site of hair growth and the location of the
melanocytes that determine hair color.
 Hair that goes grey has lost its melanin pigment.

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SKIN CANCER
This is the most common cancer in the USA, and its major
risk factor is exposure to ultraviolet light.
1) BASAL CELL CARCINOMA: Cancer of the blood vessels.
75% of all cancers
Almost never metastasizes or crosses the basement
membrane
Looks like shiny nodules
2) SQUAMOUS CELL CARCINOMA
25% of all cancers
Will metastasize if not treated.
3) MELANOMA: cancer of the melanocytes of the epidermis
<1% of all cancers
Highly metastatic.
Asymmetrical, sharp but irregular borders and edges
Not uniform in color.
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BURNS
FIRST DEGREE: Minor burn to the epidermis;
sunburn
 SECOND DEGREE: Dermis separates from
epidermis; blister
 THIRD DEGREE: Hypodermis is burned. (most
severe type of burn)

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
Piebaldism: a rare autosomal dominant disorder
of melanocyte development, causing a congenital
white patch of hair.
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GROSS ANATOMY OF BONES
TWO TYPES OF BONE TISSUE
 Compact bone – dense outer layer of bone


Found in the diaphysis (shaft) of long bones
Spongy (cancellous) bone – internal network of
bone

Found in the epiphysis (ends) of bones
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TYPES OF FRACTURES

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COMPOUND (open) FRACTURES: Bone breaks and
goes through skin. Increased chance of infections, which
can be life-threatening.
SIMPLE (closed)FRACTURES: Skin is not broken.
COMMINUTED: The most serious of the closed fractures;
bone shatters into many small pieces. Bone graft might be
needed.
SPIRAL: Bone was twisted.
GREENSTICK: most common in children
COMPRESSION: bone is crushed, like the vertebrae in
osteoporosis.
STRESS: least serious, get tiny, almost invisible breaks.
PATHOLOGICAL FRACTURE: When the bone
(especially the hip bone of someone with osteoporosis)
breaks first, then the patient falls.
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LIGAMENTS
•
•
The joint capsule alone is not strong enough, so
there are reinforcing LIGAMENTS, which provide
most of the strength of holding the bones to
bones. They are dense regular connective tissue.
In the knee joint, the collateral ligaments are
the main ligaments that keep the knee from
moving medially to laterally.
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LIGAMENTS
Ligaments take a long time to heal if torn because they
do not have blood vessels of their own, like bones do.
They already have enough fibroblasts and collagen,
though, so they eventually can heal. It is better to
break a bone than tear a ligament because bones have
a better blood supply and heal faster.
 SPRAINS: are tears in a ligament, and are fairly
serious. When a ligament is sprained, it can take 6
months to heal, and may even need surgery. Even with
a partial tear, you have to be careful.
 STRAIN: is a tear in a muscle, and is not as bad
because it has good circulation and heals faster. If you
can walk on it and it heals in a couple of days, it’s a 12
strain.

SKELETAL MUSCLE
For skeletal muscle to contract, a neuron must first
release a chemical called acetylcholine onto the
region known as the endplate.
 Calcium is also needed for muscle contraction.
 The nerve signal is called an ACTION POTENTIAL.
 It causes a release of calcium from the muscle fiber,
which causes contraction.

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Don’t confuse these terms!
MUSCLE FASCICLE: a group of muscle fibers,
surrounded by perimysium.
MUSCLE FIBER: a single muscle cell
MYOFIBRIL: a long organelle inside a muscle fiber,
contains actin and myosin myofilaments.
MYOFILAMENTS: these are proteins, and there are two
types: actin (with troponin and tropomyosin) and myosin.
The myofilament is the lowest level of organization that is
composed of actin, myosin, troponin, and tropomyosin
proteins.
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Therefore, a myofilament is part of a myofibril, which is
inside a muscle fiber, which is inside a muscle fascicle.
MECHANISM OF CONTRACTION
The Sliding Filament Theory
 Contraction results as the myosin heads of the thick
filaments attach like hooks to the thin actin filaments at
both ends of the sarcomere and pull the thin filaments
toward the center of the sarcomere.
 The myosin head is like a hook with a hinge. After a
myosin head pivots at its hinge, it draws the actin closer,
then lets go, springs up again to grab the actin filament
again, pulls it closer, and it keeps repeating this until
the entire actin filament has been drawn in as far as it
can go.
 The sites where the myosin heads hook onto the actin 15
are called cross-bridges.
MUSCLE CONTRACTION
TROPONIN is a complex of three proteins.
 TROPOMYOSIN is a single protein.


Both troponin and tropomyosin cover the
ACTIN filament when the muscle is relaxed.
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ATP AND CREATINE PHOSPHATE
What do we do when we run out of ATP?
 Muscle fibers cannot stockpile ATP in preparation for
future periods of activity.
 However, they can store another high energy molecule
called creatine phosphate, which is the storage
form of ATP.
 Creatine phosphate is made from the excess ATP that
we accumulate when we are resting.
 During short periods of intense exercise, the small
reserves of ATP existing in a cell are used first.
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 Then creatine phosphate is broken down to produce
ATP.

MUSCLE DISEASE

MUSCULAR DYSTROPHY
Genetic lack of the protein DISTROPHIN.
 The muscle cell won’t contract.

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BONE CELLS
Osteoblast (makes bone)
 Osteocyte (mature bone cell)
 Osteoclast (reabsorbs bone)

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OSTEON
 Osteon:
The functional unit of compact bone.
 osteocytes The mature bone cells which are
trapped in the matrix and help to maintain it
 lacunae The pockets or cavities in which the
osteocytes live and are trapped
 canaliculi The “tiny channels” for the legs of
each star-shaped osteocyte. Canuliculi allow
for diffusion of nutrients and wastes to the
other osteocytes.
 lamellae The circular and concentric layers
formed by the osteocyte matrix because they
sit next to each other in circles.
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ARTHRITIS
OSTEOARTHRITIS: common in older people.
The articular cartilage begins to break down, and
bone spurs start to grow.
 RHEUMATOID ARTHRITIS: It’s an
autoimmune disease where body attacks and
destroys the cartilage in synovial joints. It is
NOT known for having spurs, like osteoarthritis.
 GOUTY ARTHRITIS (gout). Caused by eating
too much red meat or protein. The breakdown
product is urea, and acid, which causes uric acid
crystals in the cooler areas of the body, especially
big toes.

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TYPES OF GLIAL CELLS
1. OLIGODENDROCYTES (“few branches”).
They are found in the CNS, are very large and
complex cells. Oligodendrocytes form MYELIN
SHEATHS. This sheath is a covering around an
axon to speed up the nerve conduction.
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TYPES OF GLIAL CELLS
2. SCHWANN CELL is another cell that forms
myelin sheaths, but in the PNS. Each cell only
forms one myelin sheath.
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The action potential jumps from one Node of
Ranvier (the bare area) to the next Node,
skipping the myelin that is between the bare
areas. This speeds up the overall nerve
conduction.
 Therefore, a myelinated axon conducts
impulses faster than an unmyelinated axon.
 Why aren’t all neurons myelinated? Isn’t it good for
everything to be faster?
 No, myelin is a living cell, so it uses nutrients!
 We’d better save the myelin for where we need it.

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NEURON DISEASE
MULTIPLE SCLEROSIS is an autoimmune
disease where the oligodendrocytes (the
myelin sheaths) are destroyed (demyelination),
interfering with the neuron functions in the CNS.
Oligodendrocytes cannot regenerate.
MS is the most common neurological disease of young
adults. Starts to manifest in late teens and early
20’s.
It progresses to paralysis and sometimes death.
One in 1000 people get it. There are treatments, but
no cure.
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V. TRIGEMINAL NERVE
This is the main sensory nerve of the face. It
has a large branch that passes through the
foramen ovale of the skull. It has three parts.
 When a dentist numbs the lower teeth, he injects
the mandibular branch. For the upper teeth, he
injects the maxillary branch.
 The superior branch is the opthalmic branch.
 Problems with CN-V are called TRIGEMINAL
NEURALGIA, which is excruciating pain in the
face from nerve inflammation.

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VII FACIAL NERVE
This is the main motor nerve of the face. It
innervates the muscles of facial expression.
 A person who cannot blink or smile may have
damage to this nerve.
 Someone with a damaged facial nerve can
not easily taste sweet, sour, or salty
substances.
 It also supplies parasympathetic innervation to
most salivary glands.
 BELL’S PALSY is damage of the facial nerve
causing paralysis on one side. The nerves swell
from infection by herpes simplex virus, but only
the motor nerves are involved, not the sensory, so
it’s painless. Needs to be distinguished from a
stroke. . VIDEO

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IX: GLOSSOPHARYNGEAL

Along with CN X, the Glossopharyngeal nerve
carries information from the baroreceptors in the
head and neck to the brainstem.
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X. VAGUS NERVE
The only cranial nerve
that “Wanders” into
thorax and abdomen
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Table 14.2
PRE-CENTRAL GYRUS
There is a precise map of the different body parts in the
pre-central gyrus.
 This map is called a motor homunculus (Latin: little
man)
 Not all body parts are equally represented by cell density
in the motor area in proportion to their size in the body.
 Lips, parts of the face and hands enjoy especially large
areas of cells in the motor area.
 The face region of the homunculus is large so we can
have many facial expressions. The hands and tongue are
large, indicating that we have many fine motor skills in
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those areas as well.

SENSORY TRACTS
 Know
the difference between a nerve and
a tract.
 A tract is a collection of axons inside
the central nervous system.
 A nerve is a collection of axons
outside the central nervous system.
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VISCERAL (“ORGAN”) SENSES
A
visceral nerve innervates involuntary
effectors (smooth muscles in organs).
 A somatic nerve innervates voluntary
effectors (skeletal muscle).
 Remember,
the autonomic nervous system
does not innervate skeletal muscle, since
skeletal muscle is voluntary. The ANS is
only made of motor neurons that go to
organs.
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BRAIN DISEASES
 HYDROCEPHALY

This is usually congenital, caused by a
blockage of the cerebral aqueduct. So the CSF
is made but can’t leave, and the brain gets
expanded.
 MENINGITIS

This is when the meninges become infected.
Can be caused from virus (fatal in one week) or
bacteria (can be fatal in one day). The main
symptom is a headache.
 ENCEPHALITIS

This is infection of the brain. It can be caused
by mosquito-borne illnesses, or bacteria.
Treatment is to remove a piece of the skull
bone to allow the swelling.
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AUDITORY ASSOCIATION AREA
The auditory association area contains two
special regions
 BROCA'S AREA is a region of the brain that
allows for speech.
 Injury (stroke) in this location causes impairment of
speaking certain words. They know what they want
to say, they just cannot get the words out. Not being
able to speak at all is called aphasia.
 WERNICKE’S AREA is the region of the brain
that allows understanding of words.
 It does not affect a person’s speech.
 They can say what they want to, but
they cannot comprehend
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someone else’s speech.

Carpel Tunnel
Syndrome
or Ape hand
PERIPHERAL
NERVE
DAMAGE
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PERIPHERAL NERVE DAMAGE

SCIATICA


Inflamed sciatic nerve
NEUROMA
Inflamed nerve in the ball of the foot
 Often caused from wearing high heels

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EYE DISORDERS
PRESBYOPIA (“old eyes”; far-sighted). Can see far away but not up
close. Occurs around age 45-50. Caused from the lens not being
able to accommodate.
HYPEROPIA (far-sighted) Can see far away but not up close.
Caused from the eyes being too short
MYOPIA (nearsighted) Can see up close but not far away.
CATARACTS. Clouding of the lens.
RETINAL DETACHMENT
ASTIGMATISM is when the cornea has an irregular shape.
MACULAR DEGENERATION: the most common cause of
blindness in the US. It’s due to bleeding in the eye, causing
scar tissue.
DIABETIC RETINOPATHY: the high sugar levels destroy the
photoreceptors in the retina.
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GLAUCOMA: increased pressure within the anterior chamber
of the eye. It leads to blindness.
AMBLYOPIA = Lazy Eye.
EAR DISORDERS

VERTIGO
Inflammation of the semi-circular canals.
 Gives you a sense of motion when you’re not moving
= (dizziness).

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HEMATOCRIT
A quick screening test for anemia is the hematocrit.
 A drop of blood is drawn up a small glass capillary
tube and the tube is centrifuged to pack the red blood
cells at the bottom with the plasma on top.
 The hematocrit is the ratio of packed red blood
cells to total blood volume.
 Normal is 46% for men and 38% for women.

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BLOOD DISEASES
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Anemia is when the blood’s capacity for carrying
oxygen is diminished. It can be caused by blood loss,
deficiency in iron, B12, or folic acid, RBC destruction, or a
genetic defect of hemoglobin in the RBCs.
ANEMIA: Causes of anemia include lack of iron,
hemorrhage, lack of vitamin B12 (needed for cell division).
Thalassemia is a form of anemia. The RBCs have abnormal
hemoglobin.
Sickle cell disease is present in African Americans more
than in other groups, and is always characterized by
sickled erythrocytes.
Leukemia is cancer of the WBC stem cells, results in too
few mature WBCs (although you will have an increase
in immature forms)
Thrombocytopenia: too few platelets, and blood doesn’t
clot properly.
A thrombus is a blood clot in a vessel.
An embolism is a piece of thrombus or fat that travels in
the blood stream.
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
The left ventricle is the largest chamber. It pushes the
blood out of the aorta to be distributed to the rest of
the body. Therefore, it is the chamber which has the
greatest pressure upon contraction.
SVC
RA
IVC
RV
Tricuspid valve
Pulmonary
artery
Pulmonary
vein
LA
LV
Pulmonary
semilunar valve
Bicuspid valve (Mitral)
Aorta
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HEART BEATS
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
The heart does not need a nerve to stimulate it to contract,
rather, specialized heart cells can spontaneously start an action
potential that spreads to depolarize the rest of the cardiac muscle
cells.
First the Sinoatrial (SA) node starts an action potential which
causes the atria to depolarize.
This depolarization will then reach the AV node at the bottom
portion of the right atrium and there is a delay here because these
cells are so small in diameter.
Another delay in the transmission of the depolarization at the
bundle of His (AV bundle) because these special heart cells
travel through the atrioventricular septum which is nonconductive fibrous connective tissue.
Next, the depolarizing event travels through the left and right
bundle branches, found in the interventricular septum, to
finally arrive at the Purkinje fibers in the ventricular
myocardium.
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HEART BEATS
The left and right ventricles contract at the same
time = SYSTOLE.
 When the ventricles are relaxed = DIASTOLE.
 At which stage do the atria contract? Diastole.

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HEART DISORDERS
PERICARDITIS: inflamed outer layer of heart.
 ENDOCARDITIS: Bacteria enter
bloodstream and enter the inside of the
heart
 HEART MURMUR: The valve leaks
 PROLAPSED VALVE is more serious; the
valve turns inside out.


Mitral valve is most likely to prolapse because it
pumps the hardest. Might need artificial valve.
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HEART DISORDERS


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
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ARRHYTHMIA = problem with the SA or AV node  improper
heart beat. Treatment is medicine or a pacemaker.
ANGINA = Not enough blood to the heart wall  severe pain 
(angina pectoris)
MYOCARDIAL INFARCTION (MI) = Complete blockage of the
coronary arteries  not enough O2 to that area = ISCHEMIA 
that part of heart muscle dies.
Angioplasty is a surgical procedure to clean out a clogged artery.
Aspirin reduces blood clot formation.
Nitroglycerine dilates the coronary arteries so more blood can get
in.
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HEART DISORDERS
ATHEROSCLEROSIS is caused from eating fatty food
= build-up of fat inside artery  narrowing of artery.
 VENTRICULAR FIBRILLATION: (the ventricles are
unable to pump blood efficiently due to rapid, random
contraction of cardiac muscle fibers). The muscle doesn’t
contract as a unit. Treatment is defibrillate with electric
shock
 Congestive heart failure is progressive weakening of the
heart as it fails to keep up with the demands of pumping
blood.
 CORONARY BYPASS: Take another blood vessel graft
(from thigh) and go around the blockage.
 A ‘blue baby” has low oxygen levels in the blood that may
be due to failure of the foramen ovale to close at birth.

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BLOOD VESSELS
Saphanous vein is often used to bypass a
damaged coronary artery in coronary bypass
surgery. It is the most likely vein to become
varicose anyway.
 Facial vein: squeezing pimples, and nose
piercings in the “danger triangle” of the face
can spread infection through the facial vein into
the dural sinuses of the brain.

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DISORDERS OF LYMPH SYSTEM

Hodgkins disease: Cancer of the lymph nodes; many
enlarged lymph nodes that do not feel tender
Mononucleosis: Epstein Barr virus attacks B
lymphocytes and causes inflammation of lymph vessels.
Lymphangitis: lymph vessel inflammation; usually from
infection.



EDEMA is the accumulation of excess tissue fluid in loose
connective tissue.
BUBO is an infected lymph node that contains a large
number of pathogens that are trapped in the node but not
destroyed.
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RESPIRATORY DISORDERS
LARYNGITIS: inflamed vocal cords
(↓ sound production).
 Scar Tissue Nodules: Singers can this; may
require surgery.

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RESPIRATORY DISORDERS


INFLUENZA This is the “flu” caused by a virus. This is
what you are vaccinated against when you get the flu
vaccine.
LUNG CANCER: the #3 most deadly form of cancer.




85% of lung cancer is caused from smoking.
RESPIRATORY DISTRESS SYNDROME: premature
babies
PNEUMOTHORAX (COLLAPSED LUNG) from a hole
in the pleura (injury from broken rib, knife), it’s like
opening the stopper; air flows in through the hole, and the
lungs don’t inflate.
PLEURISY: Infection of the pleura; The rubbing
together of inflamed pleural membranes that produces a
stabbing pain in the chest with every breath; it feels like a
broken rib.
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INSPIRATION

The diaphragm and
the external
intercostals are the
muscle group that
produces inspiration.
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RESPIRATORY DISORDERS
ASTHMA: In allergic conditions, bronchioles
will constrict, blocking air flow to the lungs.
 CHRONIC OBSTRUCTIVE PULMONARY
DISEASE (COPD)
 It is a combination of two conditions:



CHRONIC BRONCHITIS: inflammation of the
bronchi, produces mucous, the openings become smaller
= obstructed.
EMPHYSEMA: loss of elastic tissue on the bronchioles
and alveoli, which collapse now during exhalation.
Alveoli lose their shape and their surface area. When
you see someone at the mall with an oxygen tank, they
probably have emphysema, and need pure oxygen.
Emphysema is characterized by a person with a
large, “barrel” chest.
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TOOTH DISORDERS




CAVITY: Bacteria eat away at the enamel.
ROOT CANAL: If the cavity extends into the pulp cavity.
GINGIVITIS: Bacteria cause inflammation of the gingiva.
PERIODONTITIS: gingiva pulls away from the tooth and
extends down to the periodontal ligament. This is the
major cause of tooth loss.
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GI DISORDERS
GASTRIC ULCER: Bacterial infection can erode
the stomach lining.
 DIVERTICULITIS: a small pouch in the large
intestine becomes inflamed.
 COLITIS: inflammation of the colon.
 COLON CANCER: The #1 most deadly
cancer (kills more people) because it
metastasizes and there are no symptoms.
 COLONOSCOPY: Used to looks for POLYPS,
which are pre-cancerous growths Polyps might
cause blood in the stool.

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GI DISORDERS
 HEMORRHOIDS
are varicose veins
along the rectum.
 HEPATITIS: Infection of the liver =
(can be deadly)
 CIRRHOSIS: liver cells die; often
from alcoholism.
 JAUNDICE: This is not a disease; it is a
symptom of liver disorder. It first shows
up as a yellow color in the sclera of the eye
because it is white there.
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STOMACH CELLS
PARIETAL CELLS in the stomach secrete
hydrochloric acid and digestive enzymes which
kill bacteria in the stomach.
 They also secrete intrinsic factor, which is
needed to absorb vitamin B12. Lack of B12
causes pernicious (megaloblastic) anemia.
 CHIEF CELLS secrete an enzyme called
pepsinogen. When pepsinogen is exposed to
hydrochloric acid (HCl), it is cleaved into pepsin,
its active form. Pepsin digests proteins.

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