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ANATOMY LECTURE 1 Comprehensive Review CELL MEMBRANE The plasma (cell) membrane is made up of two layers of molecules = PHOSPHOLIPIDS. Phospholipids are amphipathic molecules. That means they have a polar region and a non-polar region. The polar region consists of PHOSPHATE HEADS and this region is considered to be HYDROPHILIC (likes water). The non-polar region of the cell membrane consists of FATTY ACID TAILS and this region is considered to be HYPDROPHOBIC (repels water). 2 CELL MEMBRANE The cell membrane is semi-permeable to allow only certain things into and out of the cell. Functions of the Plasma Membrane: Movement of materials into and out of cell Acts as a barrier to the external environment Acts as a site for receiving signals from the rest of the body Acts as a site for holding the cell in place 3 GOLGI COMPLEX The Golgi complex is like a Fed-Ex center that packages and ships the proteins from the ribosomes. The proteins from the ribosomes enter the Golgi channels from the RER. While in the Golgi complex, the proteins are modified and prepared for transport out of the cell. 4 MITOCHONDRIA Mitochondria are considered the smallest living units in the body because they can make their own energy (ATP). Cells have hundreds of mitochondria. Function of mitochondria is to make most of the cell’s ATP, which is cellular energy (ATP is an energy source). Some ATP is made in the cytosol, but most is made in the mitochondria. NOTE: Mitochondria must have OXYGEN to convert nutrients to ATP for energy. 5 AMINO ACIDS AMINO ACIDS are MONOMERS (building blocks) of protein. They are tiny carbon molecules, made of just a carbon atom and a few other atoms. There are only about 12 types of amino acids. They are like beads on a necklace. How they are arranged on the string determines the type of necklace. Each bead is an amino acid, and the whole necklace is the protein. A bunch of the same types of necklaces (proteins) woven together makes up our tissues. 6 NUCLEUS When GENE TRANSCRIPTION occurs, it is characterized by mRNA SYNTHESIS (messenger RNA is synthesized). This occurs in the nucleus. The mRNA then exits the nucleus and goes to the cytoplasm. When TRANSLATION occurs, it is characterized by PROTEIN SYNTHESIS. This occurs in the cytoplasm. 7 REVIEW OF GENETICS The nucleus of the typical (diploid) cells of the body have 46 chromosomes . Each gamete (ovum or sperm) has 23 chromosomes. A chromosome is a double-stranded string of DNA. DNA is made of a string of molecules called nucleic acids. There are only 4 different nucleic acids: Adenine (A), Thymine (T), Guanine (G), and Cytosine (C). Each A, T, G, or C on one strand of DNA is paired to its counterpart on the other strand of DNA. Adenine (A) only pairs with Thymine (T), and Guanine (G) only pairs with Cytosine (C). When they pair up, they are called base pairs. The double strand of DNA looks like a ladder. It is then twisted into a shape called a helix. 8 Therefore, DNA is a double-stranded helix. 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. 9 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. 10 Hair that goes grey has lost its melanin pigment. LAYERS OF THE EPIDERMIS Stratum corneum (most superficial layer of epidermis) Stratum lucidum (only in thick skin) Stratum granulosum (cells start to die here) Stratum spinosum Stratum basale (the deepest layer of epidermis; cells are reproducing only here) 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. 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 Highly metastatic. Asymmetrical, sharp but irregular borders and edges Not uniform in color. 12 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) KELOID: Thick, red, painful scars HEMANGIOMA: enlargement of the lining of blood vessels, and is treated with lasers 13 Piebaldism: a rare autosomal dominant disorder of melanocyte development, causing a congenital white patch of hair. 14 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 Osteomalacia: Rickets caused by lack of Vitamin D Achondroplasia: type of dwarfism Chondromalacia: cartilage rubbing off, usually under the patella of active people. 15 CLASSIFICATION OF FRACTURES COMPOUND (OPEN) Bone has broken through the skin Increased chance of infections, which can be lifethreatening. Requires surgery, hospitalization and IV antibiotics 16 SIMPLE (CLOSED) Skin is not broken May just require a cast CLASSIFICATION OF FRACTURES INCOMPLETE Only one side of the bone is broken 17 COMPLETE Both sides of bone is broken DISPLACED: The bone fragments don’t line up Produces new and abnormal bone arrangements Non-DISPLACED: The bone fragments stay lined up TYPES OF FRACTURES 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. 18 CLASSIFICATION OF JOINTS: TWO WAYS 1. What type of movement does the joint allow? 2. What tissue joins the bones? Fibrous Joints Fibrous connective tissue (dense regular CT) suture, tooth, ligament Cartilaginous Joints Fibrocartilage (vertebral discs, pubic symphysis) Hyaline cartilage, no capsule (epiphyseal plate, costal cart) Synovial: Hyaline cartilage with a capsule 19 No movement, limited movement, free movement TYPES OF MOVEMENT Synarthrotic Amphiarthrotic immoveable, allows no movement allows only limited movement Diarthrotic freely moveable 20 Cartilaginous Joints A cartilaginous joint is two bones joined by cartilage. The cartilage is either fibrocartilage or hyaline cartilage. Fibrocartilage joints (symphyses) are amphiarthrotic (slightly moveable). Examples are intervertebral discs and the pubic symphysis Hyaline cartilage joints (synchondroses) are synarthrotic (immovable). Examples are epiphyseal plates and costal cartilages Therefore, one type of cartilaginous joint is slightly moveable (fibrocartilage) and one type of cartilaginous joint is immovable (hyaline) 21 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. 22 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 23 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. 24 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. 25 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 26 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. PHRENIC NERVE: controls contraction rate of the diaphragm. 27 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. 28 Then creatinine phosphate is broken down to produce ATP. MUSCLE DISEASE MUSCULAR DYSTROPHY Genetic lack of the protein DISTROPHIN. The muscle cell won’t contract. 29 BONE CELLS Osteoblast (makes bone) Osteocyte (mature bone cell) Osteoclast (reabsorbs bone) Bone Infection = osteomyelitis 30 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. 31 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. 32 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. 33 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 RBC division). Leukemia is cancer of the stem cells, results in too few NORMAL WBCs, although overall WBC count is high. 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. Thrombocytopenia: too few platelets, and blood doesn’t clot properly. A thrombus is a blood clot in a vessel. An embolis is a thrombus that travels in the blood stream. Immunotherapy: form of cancer treatment that takes blood cells from a patient and fuses the blood with an antibody that is specifically designed to seek out and destroy the cancer cell. 34 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 35 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. 36 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. 37 HEART DISORDERS PERICARDITIS: inflamed outer layer of heart. ENDOCARDITIS: Bacteria enter bloodstream HEART MURMUR: The valve leaks PROLAPSED VALVE is more serious. Mitral valve is most likely to prolapse because it pumps the hardest. Might need artificial valve. 38 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 = Complete blockage 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. 39 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. 40 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. 41 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 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. 42 RESPIRATORY DISORDERS LARYNGITIS: inflamed vocal cords (↓ sound production). Scar Tissue Nodules: Singers can this; may require surgery. 43 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 #2 most deadly form of cancer. 85% of lung cancer is caused from smoking. RESPIRATORY DISTRESS SYNDROME: premature babies that don’t have enough surfactant. 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. 44 INSPIRATION The diaphragm and the external intercostals are the muscle group that produces inspiration. The diaphragm and the internal intercostals are the muscle group that produces expiration. 45 RESPIRATORY DISORDERS ASTHMA: In allergic conditions, bronchioles will constrict, blocking air flow to the lungs. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) It is one 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. 46 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. 47 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. 48 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 in the sclera of the eye because it is white there. 49 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. 50 Finished! Congratulations! 51