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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. 2 REVIEW OF GENETICS The nucleus of the typical (diploid) cells of the body have 46 chromosomes . Each gamete (ovum or sperm) has 23 chromosomes. 3 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. 4 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. 5 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. 6 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) 7 Piebaldism: a rare autosomal dominant disorder of melanocyte development, causing a congenital white patch of hair. 8 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 9 TYPES OF FRACTURES 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. 10 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. 11 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. 13 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. 14 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. 16 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. 17 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. 18 BONE CELLS Osteoblast (makes bone) Osteocyte (mature bone cell) Osteoclast (reabsorbs bone) 19 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. 20 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. 21 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. 22 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. 23 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. 24 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. 25 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. 26 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 27 IX: GLOSSOPHARYNGEAL Along with CN X, the Glossopharyngeal nerve carries information from the baroreceptors in the head and neck to the brainstem. 28 X. VAGUS NERVE The only cranial nerve that “Wanders” into thorax and abdomen 29 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 30 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. 31 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. 32 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. 33 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 34 someone else’s speech. Carpel Tunnel Syndrome or Ape hand PERIPHERAL NERVE DAMAGE 35 PERIPHERAL NERVE DAMAGE SCIATICA Inflamed sciatic nerve NEUROMA Inflamed nerve in the ball of the foot Often caused from wearing high heels 36 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. 37 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). 38 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. 39 BLOOD DISEASES 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. 40 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 41 HEART BEATS 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. 42 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. 43 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. 44 HEART DISORDERS 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. 45 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. 46 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. 47 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. 48 RESPIRATORY DISORDERS LARYNGITIS: inflamed vocal cords (↓ sound production). Scar Tissue Nodules: Singers can this; may require surgery. 49 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. 50 INSPIRATION The diaphragm and the external intercostals are the muscle group that produces inspiration. 51 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. 52 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. 53 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. 54 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. 55 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. 56