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Anatomy and Physiology: 2

by: Jocelyn Casker

Anatomy and Physiology: 2 BIO 162-31

Marketplace > La Salle University > Biology > BIO 162-31 > Anatomy and Physiology 2
Jocelyn Casker
La Salle
GPA 3.83

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These notes cover all topics covered during Anatomy and Physiology: Part 2. Each section has their own set of very detailed notes per chapter and covers very specific details from structures to fun...
Anatomy and Physiology II
Dr. Hazell
#anatomy #physiology #muscles #reproductive #urinary #respiratory #senses #digestivesystem #endocrine #hormones #cardio #cardiovascularsystem
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Date Created: 02/25/16
BLOOD NOTES  Blood is a common diagnostic tool  Most common blood test: CBC- complete blood count  The CBC tests: o RBC’s o WBC’s o Platelets o Hqb o Hct  If any of these are abnormal, you do more/ different tests  Adult RBC count = 4-6 million o Varies between men and women because of menstrual cycle  ***Women normal RBC = 3.5-6 million  *** Below 3.5 = anemia  A Red blood cell lives in your body for 120 days o Short life is because they have no nucleus so the cannot reproduce  RBC’s are semielliptical discs that are concave  RBC’s come from RED bone marrow, along with ALL blood cells  RBC, WBC, and platelets RED BLOOD CELLS  Hypothalamus sends signal to kidney  Kidney releases hormone EPO (erythropoietin)  This triggers RBM to begin “Erythropoiesis” (which is the production of new/fresh blood cells). It is a negative feedback system  ***Exception: trauma and heavy bleeding  Normal coagulation time for human adults is around 2 minutes OR LESS  Hemophilia: a coagulation problem where the person will bleed for an extremely long period of time and may have to go to the hospital for a blood transfusion to replace the volume of blood lost  They do have the proper clotting mechanisms. It is X-linked  ***ADULT BLOOD VOLUME IS 5-6 LITERS***  Large wounds (gunshot, stabbing, amputations) need medical attention  Blood will gush out but then ooze out which WILL cause death. You can’t just hope for a large clot to set in  The prefix ERYTHRO- means red  ***After 120 days, deposit in you spleen. They are broken apart and re-deposited*** WBC’s  “Leukocytes”  ***Normal adult has 5,000-10,000 WBC’s that live approx. 10-12 days  Are your protection cells  Your immune surveillance cells, They look for germs and attack them  Some people do have a low white blood cell count = immune deficiency (HIV, Cancer, etc.. ) Body can’t fight off foreign invaders  Common cold that one person has can cause pneumonia in an immunocompromised person  The virus over whelms their immune system  ***It’s called “Leukopenia” if your WBC count is too low ***  *** If your WBC count increases above 10.5, it means that you have an infection. The higher the number, the more dangerous***  WBC count above 12 usually means to “sepsis” - that the infection is in your blood and is moving to all parts of your body. *** THE MOST DANGEROUS TYPE OF INFECTION TO SEE. It leads to DEATH if untreated in 24 hours or less. Only way to treat sepsis is with IV antibiotics SUBDIVISIONS OF WBC’s  Two categories o Granular  B.E.N : Basophils, Eosinophil’s, and Neutrophils  All contain granules in the cytoplasm o Agranular  L & M: Lymphocytes and Monocytes  WBC have a nuclei so they can replicate when there is an infection  They rapidly multiply when there is a problem  ALL BLOOD CELLS COME FROM RED BONE MARROW  *** Leukopoiesis is an increased production of WBC’s coming from red bone marrow when you need to fight off an infection***  Neutrophil’s: 60-70%  Lymphocytes: 20-40%  Monocytes: 4-8%  Eosinophil’s: 1-3%  Basophil’s: 0-1%  Monocytes increase in size and number when you have mononucleosis PLATELETS  Normal count is 150,000-400,000  Only around for 9-12 days  Platelets are fragments of cells. They cannot reproduce or replicate  They function in patching tiny holes in our vessels (known as blood clotting)  Increased count: causes you to have thicker blood which = CLOTS. Give them a blood thinner (Heperin or Coumadin). You can bleed out with any minor cut, the blood is so thin so they will just continue to bleed  When on a blood thinner: you must get your blood tested because your blood can get TOO THIN (can cause internal problems)  Decreased count: Hemophilia, Leukemia, Diabetes (thin blood, bleed a lot)  Can give blood once every 56 days  Plasma= 55%  RBC= 45%  Buffy coat= >1%  Most important part of Plasma is the blood proteins  Hemoglobin: the oxygen carrying protein in the blood  Range level: 12-17 gm/dl  Hgb vs. Hct  RBC’s go to the spleen & liver for breakdown. Spleen recycles the RBC by splitting them into “heme” and “globin”. Protein gets recycled in erythropoiesis  Hemoglobin exists in DNA  Hemoglobin decreases when you are hemorrhaging and losing blood.  Hct (Hematocrit): measures the percentage of RBC’s in a given volume of blood  Drops with dehydration and polycythemia  Range: 33-49 % Women have lower levels during menstruation  When hemoglobin drops, as will Hematocrit  Treatment for low hemoglobin: Blood transfusion  ***Physical characteristic = what do I see  Characteristics: o 1. Blue hue = deoxygenation (decreased oxygen) also called CYANOTIC/ CYANOSIS  Causes: increased cold temp. , poisoning, poor circulation, asthma (not getting enough oxygen, bronchospasm=difficulty of air exchange). Increased blue hue means there is a decrease of oxygen binding to the RBC’s. C.O.P.D = Chronic Obstructive Pulmonary Disease.  Treatment: Forced oxygen via nasal cannula (best way to get oxygen to get tissues and bloodstream). o 2. Cherry Red (Fire Engine) = ):  Found in the oral mucosa  Causes: Only cause is CARBON MONOXIDE POISONING. Works by competing for oxygen spots on RBC membrane. Every time you breathe, the CO2 kicks out the O2 on the RBC and there is nowhere for it to go. CO2 poisoning is caused by  Car exhaust in closed environment (most common cause)  Faulty heating duct systems  Signs and systems of CO2 poisoning: headaches, dizziness, vomiting, general confusion. But everyone is affected in a different way. 1. Open window so gas goes out and good air goes in. 2. Call 911 3. Get everyone out of the room. You will literally will suffocate to death because of lack of oxygen.  Treatment: Immediately forced protrusion of oxygen (F.P.O2 ) o 3. Erythrema = reddened, flushed appearance  ***An erythemasis appearance can be an indication of an injury such as a contusion (area of injury is red but it is not bleeding. Blood vessels have been broken). If person is bleeding, it is an abrasion.  Treatment: Ice and elevation o 4. Yellow-Orange (MJ Glow) – Jaundice : know differences between infants and adults  2 causes:  1. Infant – premature babies, decreased developed liver and closed ducts that don’t drain it. Liver is hepatic. They are Jaundice because of increased Bilirubin (bile pigments). If you can’t drain it out into the gallbladder, it precipitates. o Treatment: Bilirubin Light therapy which is phospho-fluorescent. This opens the ducts which allows the bile to drain out into the gallbladder.  2. Adults – Hepatitis: Inflammation of liver which could be caused by alcohol or drug abuse, bad food, tattoos. Other causes of jaundice could be liver failure (cirrhosis), liver cancer. First appears in the whites of your eyes. o Treatment: depends on the cause. A great treatment for all of the causes is prednisone. It is the most powerful anti- inflammatory you can give out (it is a steroid). o ***Blood has a pH range between 7.35-7.45 (***average pH is 7.4) o ***Its temperature is always slightly higher than body temperature (at 100 degrees F. o ***Blood volume in average human = 5-6 liters  Functions of blood o Distribution – transporting gases, nutrients, and waste  Regulatory functions (maintain) o Helps maintain appropriate body temperature. ***vasodilation- means to open the lumen, vasoconstriction = to close the lumen. o Increased H ions means Acidosis o Decreased H ions means Alkalotic  *** You have a backup reservoir system to help neutralize your blood so you aren’t Acidosis or Alkalotic. The reservoir is of bicarbonate (helps neutralize)  Protective functions of blood o Preventing blood loss. Platelets = Thrombocytes. Functions to plug up small holes in the body. o Prevents infections in blood stream. WBC’s.  ***Antigens vs. Antibodies o Antigens are bad. They are the invaders. o Antibodies are trying to protect you and they bind to antigens. o Called an Antigen-Antibody reaction  Plasma Proteins o Liver makes all plasma proteins  1. Albumins- highest percentage. Function+ transporting your steroid hormones (estrogen, testosterone etc..)  2. ***Globulins- immunoglobins. Are what are binding to the antigen and antibody reaction  1. IgG  2. IgA  3. IgM  4. IgE  5. IgD o Functions: o IgA is the most important immunoglobin. Found in the membranes of the respiratory and gastrointenstinal tract. o IgG – only one that crosses the placenta to protect newborns against infection o IgM: The first antibody the baby makes all by itself o IgE: Antibody triggered by allergic reactions of any type. Sneezing because of flowers, peanut butter, and perfume. Functions during problems with parasites. Your IgE levels are high when you have a parasitic infection. o IgD: present in blood serum in tiny amounts.  3. Fibrinogen: essential for blood clotting looks like #. Works with Vitamin K. Erythropoiesis vs. Leukopoieses vs. Thrombopoieses  All are made in red bone marrow  All start as stem cells.  Erythopoiesis: o Stem cell  proeryhthroblast  erythroblast  Reticulocyte  Erythrocyte. o Blast = immature cell that forms new cells o Cyte = mature cell o Proeythroblast and Erythroblast both contain nuclei o Reticulocyte and Erythrocyte do not contain nuclei. Have a limited life span o ***Catalyst = Hypoxia, decreased oxygen in your blood o Diapedesis = The movement from the red bone marrow into the general circulation o Occurs every couple of days Recycling of Red Blood cells  Primary is the spleen, secondary is the liver  After you use the RBC, it goes to the spleen and then splits o Hemoglobin is broken down into Heme and Globin o Globin is a protein and is recycled as Amino Acid o Heme breaks down into iron  Iron is transported into your blood stream o Break down protein of iron is Ferritin o Iron is stored so it takes a while for someone to become Iron deficient o In addition to iron, you have Biliverdin and Bilirubin (Bile pigment)  B.R is yellow red, causes jaundice  Biliverdin is a yellow green  Some goes through the G.I tract  Gets converted to a pigment called urobilinogen o Causes feces and urine to have color  Heme essentially breaks down, kicks off the iron, and the B.R and B.V causes the color of waste products  Anemia: know seven different types o 1. Iron deficiency Anemia (#1 anemia in the world)  In general, anemia is any condition where the oxygen carrying capacity is decreased.  Symptoms: Extreme or excess lethargy  Cause: Heavy menstrual cycle (#1 cause between ages 12-40), too little iron in diet, Don’t have the receptors to process the iron, Pregnancy demands, Decreased RBC production  Treatment: Iron supplements (side effect stool becomes hard), Blood transfusion if the CBC is showing very low levels, add iron to diet o 2. Pernicious Anemia  Cause: Insufficient hemopoiesis resulting from an inability of the stomach to produce intrinsic factor. This is needed for Vitamin B12 absorption in the small intestine. Typically from stomach surgery  Treatment: Only can have injections of B12 (oral will just pass through the G.I. tract and won’t absorb). o 3. Aplastic Anemia  Most common in those in chemotherapy and radiation therapy  #1 concern is how do you fight off infections  Cause: Abmornal destruction if Red bone marrow. Usually results from the exposure to toxins, radiation and certain medication. o 4. Hemolytic Anemia  Cause: premature rupture of RBC. Hemoglobin is released into your blood plasma and beats up your kidney causing kidney damage. *** Could be inherited, and can be developed very quickly because of a parasite. Or, can be caused by toxins (like cleaning products) ***  Treatment: because of damage, dialysis could be needed. o 5. Sickle Cell Anemia  Genetically inherited disease, BOTH parents have to be carriers.  RBC’s develop in an abnormal shape.  Before RBC becomes a mature, the cell becomes sickle  Decreased oxygenation in the blood because they cannot carry oxygen  Sickle cell crisis: cells block the vessels causing clots which cause strokes or attacks even as young as 8. Crisis because of edema in the smaller joints (fingers and toes).  Most commonly affects African Americans.  Treatment: Blood transfusion to help them come out of crisis. But there is no ultimate cure o 6. Hemorrhagic Anemia  Cause: From serious trauma, excess blood loss (amputation, heavy menstruation. Any type of excessive blood loss is hemorrhagic blood loss. Stomach ulcer could cause this IF it is untreated (know by bright red blood in stool if it is bleeding, dark red if not) o 7. Thalassemia  ***Hereditary hemolytic anemia  Most common in those of Mediterranean descent.  Cause: No blasts or cytes  Immature Blood cells. Coagulation and Hemostasis  Intrinsic and Extrinsic o Intrinsic-take several minutes or longer o Extrinsic- ***much more rapid response***. Wound causes an increase in Serotonin in your blood stream. Initially you have a vasodilation as you bleed. The vasoconstriction occurs causing throbbing. Serotonin deals with levels of content and happiness.  Both come together for a common point of denomination called PROTHROMBIN ACTIVATOR  Prothrombin  Thrombin  Fibrinogen (plasma protein from the liver. Liver defect will cause a clotting problem)  Fibrin clot  Goals: to stop bleeding  To make a blood clot you need: o Vitamin K o Calcium (8-10 mg) o Heparin (from basophils) o Platelets must be in a normal range  CC: Erythroblastosis Fetalis- (Hemolytics DS of Newborn) o Blood RH incompatibility between mother and fetus o There are no signs or symptoms o Occurs when mother is RH- and the baby is RH+ (25% chance with each pregnancy that the baby will be RH+) o The problem happens when the father is RH+ st o 1 pregnancy can normally go to term if no complications (with blood, when there’s no mixing of the blood) o Sometimes, the first pregnancy ends abruptly  spontaneous miscarriage (but there’s always a reason) o #1 reason why women lose babies is a genetic mutation that is incompatible with life o Treatment: Immediately give mother a shot of “Rhogam” which allows the shutdown of her immune response to future pregnancies. Shot given right after birth. Know the anatomy  4 chambered heart o Right and left atrium o Right and left ventricle (bottom)  Heart is the mediastinum cavity  Blue = veins, deoxygenated blood  Red= artery or oxygenated blood  3 structures feed into right atrium o Superior and inferior vena cava o Coronary sinus o All drain the deoxygenated blood in the body o ***C.S can only be seen posteriorly of the heart o ***Sinus= a dilated vein, takes a higher volume than a regular vein*** o C.S is draining the heart itself self  3 layers o Pericardium: the visceral parietal. Pericardial fluid (serous fluid) fills this cavity and allows the heart to slide against it. *** Pericardial effusion – excess fluid in the sac and the heart can’t contract like it normally would. You have signs and symptoms of S.O.B (shortness of breath). TX: Oral Diuretics which pulls off the excess fluid. If that doesn’t work, you are in C.H.F. and you get an IV of Lasix (#1 Diuretic) to treat C.H.F. Cardiac Tamponade- excess blood in the pericardial sac due to trauma to the chest wall. You have to remove the blood from the pericardial sac by using a needle to drain the blood. o ***Myocardium- the heart muscle itself, doing the actual pumping of the blood. Is what is draining the Coronary vein into the Coronary sinus. Has to have its own blood supply. Is the thickest portion o Endocardium- inner lining, simple squamous epithelium like the blood vessels. *** Attaches to the trabeculae carnae  Apex- Located around the 5 intercostal space. Is inferior. Is the point of the heart. Has a lateral extension.  Base- is posteriorly and is formed by the left atrium. Around the T5-T9. Points toward right shoulder posteriorly Pulmonary Circuit (right atrium to lungs)  One the right side, you have the tricuspid valves o Attached are parachute strings, chordae tendinae o Attached to those are papillary muscles  When they contract, they pull the cords and the valves open  Muscles relax, chords go back and valves close  Regurgitation: the blood goes down and the chords don’t close all the way and blood goes back into the right atrium. Often occurs with a heart mummer or valvular defect/ vegetative valve (not functioning properly because of a disease, a virus has eaten away the valve).  You leave the Right ventricle and come out of the pulmonary trunk (splits into right and left pulmonary arteries, 2 each). The blood goes to each lungs (deoxygenated blood goes there for reprofusion)  Coming back from the lungs are 4 pulmonary veins which empty into the left atrium  Bicuspid valve or atrioventricular valves  In between the chambers, is called the interventricular septum, interartial septum  One ligament attaches the pulmonary trunk to the inferior aspect to the aorta, the ligamentum arteriosum  ***The pulmonary trunks splits at the ligament  Coming out of the left ventricle, is the ascending aorta then arch of aorta, and descending thoracic aorta (in left thoracic region)  Coming off the ascending aorta, is the coronary arteries which gives blood to the heart to keep it pumping.  ***Lack of blood supply to heart causes “infarction”. Means that it has been deprived of blood and oxygen and it dies. Myocardial infarction= heart attack. Only way to tell is getting and EKG.  3 major branches of the aortic arch o 1. Brachiocephalic trunk: right common carotid and right subclavian o 2. Left common carotid artery o 3. Left Subclavian artery  The carotid go right up into the brain  The subclavian feeds into the axillary artery  The pulmonary trunk and aorta contain semilunar valves  prevents back flow. No chords on semilunar valves  Auricle- cauliflower ear piece that sits over the atrium. Catches the extra blood and puts it back into the atriums.  Pacemaker: goes into the SCV and into the Right atrium and the ventricle. o The SA node and AV node must both fail for an external pacemaker to be put in place.  LARGEST VEIN IN THE BODY IS THE INFERIOR VENA CAVA Cardiovascular System (systemic circuit)  Diagram everything out  Blood comes from your lungs to the rest of the body o 4 pulmonary veins are feeding into the left atria and through the bicuspid valve, then left ventricle and out the aorta  Descending thoracic aorta comes down the LEFT side of the body  Hiatus: a hole in the diaphragm  Axillary artery  Brachial  elbow  ulnar artery to pinky, radial artery to thumb o Arteries merge to form a superficial and deep palmar arch which feeds the 5 digits  Carotid: goes up and feeds the top portion of the body o Common carotid goes up and splits into internal and external  Internal: right against trachea  External: lateral o If you compress the vessels, you stop blood flow to the brain o Transverse foramen: cervical vertebrae  Vertebral artery supplies the brain through the transverse foramen  Circle of Willis: ***feeds and nurshes the brain*** o Feeds the Hypothalamus (vital for body functions) o Vertebral artery feeds into the Basilar artery (thicker than vertebral)  This goes into the Circle of Willis: gives oxygenated blood into 80% of the brain  Wherever there is an arterial supply to, there MUST be a venous drainage from  From the head, these structures drain into the heart from the SUPERIOR VENA CAVA o Jugular vein  subclavian  Superior Vena Cava (drains head, neck and rest of chest)  All the veins in the head drain into sinus which drains into jugular, into subclavian and the SVC  ***Veins drain backwards***  Tibia: Popliteal  femoral  Common Iliac  Inferior Vena cava  Internal iliac artery supplies privates  External artery goes under Inguinal ligament o Once under the ligament, it becomes the Femoral Artery  Deep femoral artery wraps around the thigh and supplies the posterior thigh muscles  Popliteal Artery at knee joint  Becomes the Anterior tibial Artery which ends in the dorsalis Pedis artery  Intermittent Claudication: Caused by poor blood flow to tissues in the legs. The vessels are narrow and the muscles aren’t receiving proper blood supply to muscles causing pain. They must stop, which then allows circulation to catch up but once they walk again, they have a problem again. Tx: Palpate the pulse of Posterior Tibial and Dorsalis Pedis, if poor pulse they have this.  Posterior Leg o Coming down the posterior tibial artery goes around the medial malleolus o POSTERIORLY ONLY: the Popliteal splits into the Posterior Tibial artery (medial) and the Fibular artery. o The Posterior Tibial becomes the medial and lateral plantar artery which feeds into the plantar arch  Atherosclerosis: hardening of the arteries in hypertensive people (high cholesterol)  Major Branches off of the Descending Abdominal Aorta o Once you move through the aorta hiatus, this is what to know  Ciliac trunk is the largest branch off of vena cava  Has 3 branches o Gastric (stomach) o Splenic (spleen) o Hepatic (liver)  Superior Mesenteric  Renal Arteries  Gonadal Arteries  Lumbar arteries  Inferior Mesenteric Artery  Aneurysms: abnormal swelling of a vessel. Breaks like a balloon o Tx: If not caught early, you will die. 95% of people do not survive. If caught, you cut out the bad part and re- patch the vessel. o Usually, someone who is hypertensive is more likely to get them Arterial and Venous Anatomy  Arteries carry oxygenated blood (away from the heart)  Veins carry de-oxygenated blood (toward the heart)  Largest artery in the body: Aorta  Largest Vein in the body: Vena Cava  Arteries are thicker walled than veins  Both have three layers: o Tunica Adventitia o Tunica Media o Tunica Intima  Both have smooth muscle in the walls of the vessels: they contract and either increase or decrease the size of the lumen  *** Veins have valves, arteries do not. Allows the blood to go up to the heart without going back down. ***  Atherosclerosis: plaque built up in arteries, decreases the size of the lumen, restricting blood flow.  Thrombus: blood clot dangling from the interior of the wall of the vessel.  Embolus: a moving blood clot that gets stuck in a small vessel causing a stroke. o A small blood clot gets the snowman effect. It will continue to get bigger o TX: Blood thinner (heparin or Coumadin) which thins out the clot.  Hypercholesterolemia: genetically inherited the tendency for HIGH cholesterol despite being the picture of perfect health.  Varicose Veins: A veins whose valve is failing (incompetent valve) o Overweight, Pregnancy, Trauma, crossing their legs (putting pressure on the vein causing them to fail overtime), sitting to close to the chair (back of legs are right up against the chair, should be able to put hand behind knees) o Cause: High blood pressure causes you to be more prone, compressing the veins. BOTH sexes get this. o Symptoms: swollen veins through the skin. Untreated, they get worse over time especially if the behavior continues. o TX: 1) Compression stockings 2) Sclerotherapy (injecting a chemical into the vein) 3) Ablation (putting electrode into the vein) 4) Vein Stripping 5) Laser treatment  Angina: Chest pain caused by a partial blocked like a thrombus leading to the heart. Blood isn’t flowing correctly o TX: Nitroglycerine causes a vasodilation. Put underneath tongue which takes the pain away IF the pain is angina. If it doesn’t work, you might be having an M.I. (heart attack).  Myocardial infarction means the blood isn’t reaching a part of the myocardium. o Signs: left arm pain (men), vomiting, Shortness of breath. o TX: EKG  gives diagnosis and where the problem is, blood work  Heart Murmurs: an unusual sound that is heard when you listen to someone’s heartbeat. Normally hear 2 heart st nd rd sounds, 1 is lupp, 2 is dupp. 3 sound would be the murmur o Cause: Valve isn’t closing properly, so blood is going back into the right atrium. o TX: Valve replacement if severe enough. ****KNOW HOW TO READ AN EKG**** ****KNOW STATS***** ***Majority of the Final is Digestive   Parameters of GI tract = 1 hollow tube o Mouth to anus   *** Sphincters are intermittently placed (a passage way that allows for constriction, is a  muscle around an orifice) o Begin in the esophagus and go to anus  o UES, LES, PS, Internal and external anal  o UES relaxes and the bolus goes through and down to LES o PS is important because it is the one that opens up when the food exists the  stomach   Accessory Digestive organs EXCEPT o ONLY ONE COMES INTO DIRECT CONTACT WITH FOOD: tongue and  teeth. o Everything else ADD SECRETIONS into the GI tract o Mastication: to chew, to grind, to tear apart food. o  Both the teeth and tongue are involved in chewing   6 Functions of the GI Tract o 1. Ingestion: to either eat OR drink  o 2. Secretion: Contribute to chemical breakdown of food (specifically HCL &  Pepsin) o 3. Mixing and Propulsion: peristalsis = moving food from the esophagus to anus.  Alternating contraction and relaxation o 4. Digestion: Mechanical Digestion= Mastication to form a bolus (a moistened  compact ball of food to be swallowed). Chemical Digestion= Lysis (to break  apart), the bolus is broken down by hydrolysis. 3 things giving you enzymes to  breakdown food (Salivary glands, stomach, and Pancreas) o 5. Absorption: Maximum of absorption in the body occurs in the DUODENUM  (first part of intestine)  o 6. Defecation  Histology of the wall of the GI Tract   4 Layers flow all the way down the tract  o 1. Mucosa (inner most): where chief and parietal cells are found. Parietal cells  secrete HCL and chief cells secrete Pepsin  MALT= (mucosa­associated lymphatic tissue) the highest % of lymphatic  tissue because the GI tract has a lot of bacteria going in it   Non­keratinized Stratified Squamous Epithelium lining peels off once a  week   There is also Simple columnar epithelium because you need Goblet cells  to produce mucus to protect your stomach  Smooth muscle is there to help stomach distend with RUGAE which are  inner folds found in the lining. They allow for expansion of the stomach  When you reach capacity, the sphincter loosens and you vomit  o 2. Submucosa  Home to a plexus (like a fish net) of nerves which wraps around the entire  layer. When they are stimulated, this triggers a reaction.   A.K.A: Meissner’s plexus, function is to control the secretion of the GI  tract (hyper, hypo, or eusecretions)  Hyper secretors: high energy and very cranked up. What they  EXTERNALLY manifest, they also INTERNALLY manifest. Too much  acid can lead to erosion  Hypo­secretors: very mellow, not enough acid can also lead to erosion  Smooth muscle o 3. Muscularis  Skeletal muscle  Myenteric Plexus: a parasympathetic response (activated when you are  relaxed). When Parasympathetic increases stimulation is diarrhea. It  controls the GI mobility. If not stimulated, you are constipated.  Once the nerve plexus is activated, you cannot stop it o 4. Serosa (outer most)  Visceral /Peritoneum which secrete serous fluid to allow your organs to  slide around   Lamina propia: CT lining containing many blood vessels and lymphatic vessels   Greater Omentum: sheet of fatty tissue that hangs and suspends over the abdominal  cavity, fatty apron. Suspended from the transverse colon   Lesser Omentum: suspends the stomach, the straps that suspend  Falciform Ligament: suspends the liver from the diaphragm to anchor it   Messentery: Suspending the small intestine from the Posterior Abdominal wall  Mesocolon: suspends the large intestines   CC Ascites: Abnormal accumulation of serous fluid in the peritoneal cavity. You percuss the abdomen and if it is a hollow sound, there is fluid and not fat.  o Cause: Hyper­secretion of serous fluid caused by liver failure secondary to  alcoholism  o Healthy Liver is dark, purple, shiny and smooth o A diseased liver is rough, bumpy, and pink  o TX: Drain the fluid via a needle in the abdomen. Because there is so much fluid,  you must drain it into a container. Take a record of how much is being out to tell  you how serious the problem is   CC Peritonitis­ acute inflammation of the peritoneum. You cannot get it by eating bad  food. Only get it from something like a ruptured appendix. Most commonly gotten by  being shot/stabbed or a bowel rupture. You must have a drain to get rid of the  contaminated serous fluid. TX: antibiotics after the drainage   Salivary Glands o 1. Parotids: anterior to external auditory canal. Swell when you get the mumps o 2. Submandibular: Under mandible o 3. Sublingual : Under tongue   Each gland has its own duct to drain, you have 3 sources for saliva which secrete into the  oral cavity  Saliva contains the enzyme amylase which causes carbohydrate digestion   Primary: Oral cavity  Secondary: Stomach  Tertiary: Duodenum   Teeth o Are embedded in a GOMPHOTIC JOINT in the maxilla and mandible  o 1 single ligament holds the teeth in their socket, the periodontal ligament o If periodontal ligament weakens a lot, you teeth can fall out o OR gingivae recedes   Parts of a tooth o 3 major parts o Crown: contains enamel  the hardest substance in the body at 95% calcium salt  Enamel is damaged by acid erosion o Inferior to enamel BUT still in the crown, is the Dentin which is 70­75% calcium  salts  o Pulp Cavity contains blood vessels and nerves  o Most common cause of root canal in young age is trauma  o You have 2 sets of teeth, 20 up to the age of 12  o Typically break out around 6 months  o They are then replaced by 32 teeth (added teeth are molars) o Primary, secondary and Tertiary molars  o Tertiary molars are genetic (wisdom teeth)  Upper lip is connected to the gingivae by the FRENULUM (superior and inferior)  LINGUAL FRENULUM holds the tongue to the floor of the oral cavity  Hard palate= palatine process of the maxillary bone  Soft Palate is the actual palatine process  Uvula at the end of the soft process  Entry into the stomach  o Upper Esophageal Sphincter o Lower Esophageal Sphincter regulates what goes into the stomach o PS o 1  part of stomach is the cardia which is right below the LES o In the body of the stomach, is Rugae which allows you to have the capacity to  stretch out to 30cc’s . Increases the area for absorption  o When you pass the body, you come to Pyloric canal o The Pyloric Sphincter controls the exit chime out of the stomach and to the  Duodenum   Duodenum o 2 structures enter into it  Gallbladder (Common Bile Duct, formed by the Hepatic duct and the  Cystic Duct)   Has a duct because it has to break down large fat globs in you GI  tract.   Stores Bile  Bile contains: Acids, salts, cholesterol, and pigments (Bilirubin  and Biliverdin)   Gallstones are caused by precipitant of Bile pigments and Cholesterol   Removing them: Shock wave therapy and Surgery to remove them   Pancreatic Duct o Chyme is very acidic so the Pancreas neutralizes the acid  o #1 place for ulcerations are the Duodenum ulcers  o The Bi­card helps neutralizes the stomach acid so no hole happens  o The pancreas is secreting 99% digestive juices, 1% Endocrine, 99% Exocrine   Function of Liver o Liver detox’s any and all chemicals that come into the body  o Is making the Bile which is stored in the Gallbladder   Issues with Liver when You beat it up o Hepatitis­ Inflammation of the liver; many types, just know difference between  A,B, and C o Everyone with Hepatitis gets Jaundice, Tea colored urine  A­ from shellfish, contaminated water  B­ Spread by Blood and Sex.   C­ The most dangerous, commonly comes from tattooing, police, and  firefighters (they become injured more often). Metamorphs into Liver  cancer   Small Intestine  o D  J  I     ALWAYS  o Duedenum: has Brunner’s Glands which aid in the secondary (technically tertiary) digestive process o Jejenum (middle portion)  o Ileum found at the ileocecal junction (the appendix)  o Crypts of Lieberkuhn (intestinal glands)   Lactose Intolerance  o The enzyme of lactase isn’t there so you can’t break down lactose o Can take a dietary supplement but don’t need to   Large Instestine o 4 parts o Once it ascends up, it hits the liver and transverse. This point is called the Hepatic Flexure o When it goes to descend, it is called the Splenic Flexure   Ascending  Transverse  Descending  Sigmoid o Last 15­20 cm is your rectum o That is followed by your anal canal  o Teniae Coli – Elastic band the holds the colon together o Haustra – Pouches that give your fecal matter it shape o Omental appendices – pieces of fat that hang off your colon (epiploic appendages) o 2 sphincters in the anal canal.   Internal is involuntary  External is voluntary (what you control to pass gas and defecate)  o Hemorrhoid – a dilated vein because of pressure   Cause: sitting on a hard surface for a long time and pushing too long,  giving birth/pregnancy,   Tx: you cut them out once they dilate (if they are bad) or if they are  thrombus; Medication to shrink the hemorrhoid; hot sits bath (hot water to  shrink the swelling of the tissue); insert a medicated suppository into the  canal   Internal: in the anal canal (makes you feel pain when you move bowels,  makes you bleed a little)  External: protrudes through   Can get a thrombus (clot)  Pancreas o Head­ in abdomen o Tail­ retroperitoneal o 99+1 o Secretes bi­carb so that the acid coming out the stomach doesn’t cause an ulcer o Pepsin protein digestion  o If you have a gallstone, it can block both the pancreatic and common bile duct  causing pain  o Impossible to have a transplant, because it is in 2 cavities   You can take out the pancreatic cancer but the rest must stay   Only 5% of people with pancreatic cancer live past 5 years   Unknown etiology  o Insulin vs. Glucagon  o Pancreatitis : acute pain, cannot stand up straight   Inflammation   Most commonly, these people drink a lot of alcohol or those who have  chronic gallstones   Can obstruct the ducts   Pain is so bad because the pancreas is self­digesting itself, causing  bleeding   Tx: morphine drip to decrease pain 50­60 questions on digestion Endocrine System  Exocrine: Secrete into ducts  Endocrine: are ductless, right into tissue  Hormone: chemical secreted into a gland  Steroid: lipid soluble; go through the membrane easily o A non-steroid must be taken in another way: Receptor Mediated Endocytosis (RME), or Carrier Protein- piggy back through (CP)  HYPOTHALMUS IS THE MASTER GLAND; controls the pituitary gland o Produces two hormones that are stored in the posterior pituitary  Infundibulum connects HYPOTHALMUS with PITUITARY  Posterior Pituitary: o ***1. ADH: Targets kidneys; means it causes the kidneys to pull water out so you urinate less. Helps with HYPERTENSION (they retain water because of high sodium levels) and DIABETICS. The more you drink, the lower the ADH levels. Can overdose on a fluid by 1. Not urinating 2. How fast you drink it (rapid succession). You overdose cells with too much too fast. Depends on body size and personal limits. Hypothalamus will shut down causing your body to shut down. Function = controls the body’s water balance o ***2. Oxytocin: part of the body’s positive feedback mechanism; both sexes have oxytocin BUT FEMALES HAVE MORE RECEPTORS FOR IT. “The cuddle hormone” Cause you to want to be held. When you get married your levels peak, called the orgasm. Women’s receptors causes more orgasms compared to men’s single. Sometimes women can't orgasm because they don’t have the receptors for it. POSITIVE FEEDBACK. When you’re pregnant, levels increases around the 7-8 months. They rise until you give birth. Long delivery = 1. Oxytocin levels aren’t high enough to cause contractions or 2. Receptors sites or inadequate. PITOCIN: synthetic oxytocin. Can help with delivery. If this doesn’t work, C- section is needed. After you delivery the baby, oxytocin targets your breast tissue (mammary glands). When you first deliver, there is no milk. PROLACTIN produces the milk, which takes about 24-48 hours. But at first, it is just a watery protein fluid called COLOSTRUM. Is a baby’s first meal. Contains antibodies from mother to baby. The sucking reaction on the nipple cause the prolactin levels to rise. Antibodies are good for 3 months then the baby must make their own. If no breast feeding occurs, prolactin levels decrease and the ducts are no longer filled with milk. Breast can dry up.  EVERYTHING ELSE IS ANTERIOR PITUITARY.  Anterior Pituitary: works via releasing and Inhibiting hormones.  HGH: Targets bone and skeletal muscles. GHrh - Works at night, which is why children sleep so much. GHih – growth plates close up and you stop growing. You need less sleep as a result. NEGATIVE FEEDBACK. Too little = hyposecretion. Too much = Hyper secretion. Pituitary dwarf (PD): Hyposecretion of GH during growth years and the epiphyseal plates close before normal height is reached. Typically very petite (4-5 feet tall). A midget does not have a proportioned body. TREATMENT: PD- you inject synthetic GH so while the growth plates are open, so they can grow. Sometimes parents opt to get a bone extension (second option). Fixators can cause weak bones and INFECTIONS. HYPERSECRETION: Gigantism (7-8 feet tall). #1 cause of death is cardiovascular abnormalities. After the plates fuse, you get Acromegaly: thickening of the face, hands and feet. Cause of gigantism or acromegaly is a pituitary tumor. TREATMENT: remove tumor, which could be affecting multiple organs and hormonal problems. POSSIBLE ESSAY TOPICS  Growth hormone  Thyroid  MG+MD  Cramps etc.. STUFF TO SKIP  Adrenal gland (ACTH)  Thymus MAJORITY  GH  TSH THYROID  Thyroid controls body’s metabolisim  Located in the center of neck  2 LOBES: connected by isthmus  In response to TSH, two thryoid hormones are secreted o T3: triidothyronine o T4: Thyroxine  1) Hypothalmus sends signal (Thyroid Stimulating Hormone [TSH]) to thyroid gland.  TSH + Amino Acid (Tyrosine) allow you to produce T3 and T4  AA= PROTIENS  Hormones = PROTEINS  T3 and T4 control you BMR, whether you are hyper, hypo thyroidism  CC HYPOTHYROID= symptoms: always cold, lethargic, decreased BMR (increased weight gain), depressed. TYPICAL in teenagers (young girls).  70% of women have an UNDIAGNOSED thyroid abnormality  Teens thru old age get MXYEDMNA (hypothyroidism)  In infants and children, it is called CRETINISM  ***anything that has developed in the womb and you come out with it, you have it for life. ***  Baby has problems because mother may have thyroid problems or baby doesn’t have receptors.  TREATMENT FOR HYPO: TX synthetic Thyroid Hormone called “synthroid”. Give them what they can’t produce. You know if you have problems if you get blood work done.  HYPERTHYROIDISM= aka GRAVE’S DISEASE (autoimmune disease). You have lots of energy, hot all the time, increased BMR (lose weight despite eating normally) Can cause you to have Tachycardia (rapid heart rate)  Men typically get thyroid cancer at a later age but it is much more aggressive.  GOITER: enlarged thyroid gland, secondary to tumor growth (isn’t always cancer). Either hypo or hyper thyroidism can cause goiter but not everyone gets it.  Some people get Exopthalamos: eyes protrude from pressure behind the sclera  TREATMENT: give them “synthroid”, not everyone has the same signs or symptoms.  RAI (treatment of tumor): Radioactive Iodine, used to kill off the rest of cancer not removed in surgery. You can’t hug your children or anyone after because you will fry their gonads making them sterile. HIGH RADIOTIAN=STERILE. Radiation is flushed out of you system by urinating and when safe, you can go home.  Calcitonin: Hypocalcemic hormone secreted by thyroid. Works to lower Blood calcium levels (below 10 grams). Body automatically leeches calcium from bones for normal function. If this last too long, Osteoporosis can occur because bones are so weak.  SLIDE 57  Iodine must be present for this to work (salts)  Salt targets the thyroid  T3 and T4 control you body’s normal growth (ESSENTIAL) PARATHYROID  4 glands embedded in the tissue of thyroid, attached to the thyroid  How do you maintains calcium levels if parathyroid and thyroid aren’t responding due to surgery to remove? SUPPLEMENTAL CALCIUM  ***PTH is a HYPERGLYCEMIC hormone. Raises Blood calcium levels (antagonist to thyroid)  NO CLINICALS ON PTH Pancreas SLIDE 84  ***Only focus on endocrine (1% endocrine, 99% exocrine)  In 2 body cavities: Abdominal (head) Retroperitoneal (tail)  Eyelets of Langerhans that produces ALPHA and BETA cells  Alpha: Glucagon; HYPERGLYCEMIC HORMONE  Beta: Insulin; HYPOGLYCEMIC HORMONE  If glucagon is secreted, the person hasn’t eaten so blood glucose level is raised  If insulin is secreted, they just ate. Blood sugar levels are higher so insulin lowers them. Does this by taking removing glucose from the blood (opening gates)  Non-functioning pancreas can lead to o TYPE 1 Non-insulin dependent: typical in infants. Baby can’t produce insulin because virus attacked Beta cells OR receptors aren’t working properly. 99% of people will remain this way o TYPE 2 Insulin dependent: adult onset, problem occurs when cells burn out or receptors stop working. 1) change their diet 2) give them medication to lower blood sugar levels 3) insulin shots Respiratory System  Topics: o Main components: nose, pharynx, larynx, trachea, lungs, diaphragm o Functions: gas exchange, *** intrapleural pressure keeps the lungs inflated. If altered, lung will collapse. o Pneumothorax: collapsed lung caused by trauma, toxins, Asthma, smoke inhalation, gunshots/stabbings. Outside of trauma: spontaneous P.T. Has to do with decreased serous fluid in between the membrane (pleuritis) TX: re-inflate the lung via chest tube  C3,4,5 is the supply for the phrenic which supplies the diaphragm  ***Respiratory center is your Medulla ***  External and Internal o 1. Breathing (ventilating): exchanging between your blood and your tissues (organs) o 2. External respiration: exchanging gases between gases and blood. Breathing in and going to the blood  Psuedostratified columnar epithelium lines respiratory tract  Route of Air Passage o Nose/Mouth  Pharynx  Larynx (your voice box, covered by the epiglottis, closes when you swallow anything other than air)  Trachea  Bronchi  Bronchioles  Lungs  Alveoli (gas exchange) o When drinking, epiglottis does not function properly, and you choke on your vomit and you die. Also occurs with the elderly. o Aspiration: occurs when your epiglottis doesn’t function properly and it doesn’t close and causes you to choke on vomit or saliva.  Voice Box: Larynx. You have true and false vocal cords o Tension on the vocal folds determine the pitch of the voice o Constant straining of vocal cords leads to polyps (irritation of the tissue). Are solid masses. To avoid them, you must rest your voice. o More tension = higher pitch o Has 9 pieces of cartilages  TEC = single pairs (thyroid, epiglottis, cricoid)  Thyroid cartilage: is the Adams apple. Men have a more anterior protrusion of thyroid cartilage because of hormonal activity.  Cricoid Cartilage: A landmark for tracheostomy. Occurs when you have any upper airway obstruction and you cannot breathe out of your nose or mouth. o Intubation: inserting a tube into the oral cavity, into the trachea. Has a collar to stabilize it from moving and slipping out of place. Must suction out mucus for adequate air exchange. If a person DOES NOT have a blockage, you do an oral or a nasal intubation for those who are unconscious and cannot respond to you  ACC = Double pairs (arytenoid, cuneiform, corniculate)  Trachea o The tube that is held open by hyaline C-shaped cartilage rings. o C helps the tube stay open so you can breathe while you eat (because the esophagus is posterior) and so it never collapses  RMSB: Right main stem Bronchus is shorter and wider than the left. Is where things become stuck.  Point of Bifurcation: pint where the trachea separates is called the CARNEA  Bronchioles do not have cartilaginous rings because they are smooth muscles which allows them to have the ability to narrow down and close o Bronchospasms = Broncho-constrictions o Asthmatics use inhalers that is a steroid which Broncho dilates the bronchioles o Asthma Chronic Bronchitis COPD Emphysema (irreversible respiratory disease, the damage is done to the sacs. The capacity of breathing is very decreased).  At the end of the bronchioles are where you find alveoli o Are the actual place of gas exchange o Have a blood supply o Each air sac has the surface area of a tennis court o You have millions because they do not regenerate. You can be exposed to some toxins and burn out some without impairing your breathing. o When you burn out too many, they blend into bigger sacs causing you to have fewer alveoli and you cannot breathe as well.  Only 2 Qu’s on the lung based on the anatomy of the thoracic cavity o Right lung has 3 lobes (upper, middle and lower) o Left has 2 lobes (upper and lower) o Lungs are surrounded by the visceral and parietal pleura o When you get an irritation of those membranes you get pleurisy or pleuritis o Hilaus: the medial indentation where blood vessels, nerves and other structures enter the tissue o Cardiac Notch: where the heart lays against the left lung  *** How do the alveoli stay inflated and work properly? *** o Type 2 alveoli cells produce surfactant. It is a secretion produced by the cells which reduces tension and keep the alveoli inflated o 7 months in utero, the baby produces surfactant which helps them breathe upon birth. o If a baby isn’t making surfactant, they can suddenly die because of lung collapse. o You have macrophages in the alveoli to decrease the risk of infection  Lung cancer has 2 causes o 80% is from smoking o 20% is not their control and from exposure to RADON which is an odorless, colorless gas therefor you don’t know you are breathing it in.  Common Obstructive problems o 1. Asthma: most commonly involves bronchospasms  Wheezing and difficulty breathing, and persistent inflammation o 2. COPD: tends to occur most often in people with chronic bronchitis, or chronic respiratory problems.  Over a period of years they get this.  Their lungs tend to hyper inflate which doesn’t work  Smoking/ pollution are the most common causes o 3. Emphysema: irreversible damage to the alveoli sacs which decreases your respiratory ability o 4. Chronic bronchitis: in your lower respiratory tract.  mucus hyper secretion o 5. Pneumonia: inflammation of the lung tissue itself.  Fluid accumulates in the alveoli which reduces the gas exchange resulting in shortness of breath.  Inspiration: when you take a deep breathe. The pressure in your lungs decreases, your ribs are elevated, and your diaphragm moves DOWN (ID)  Expiration: the pressure increases. You are blowing out the air. Diaphragm moves back up when you exhale o ALWAYS NOTICE THE POSITION OF THE DIAPHRAGM  Tidal volume: the volume of air inhaled or exhaled during a normal breath ( around 3000, total lung capacity is about 6000)  In a normal breath, you have approx... 500 ml  Vital Capacity: maximum amount of air that can be inhaled or exhaled in a single breath  Residual Volume: how much is left over after a normal breath Muscles  Over 700 muscles in the body  Look at pictures when studying the muscles  Study by compartment FACE MUSCLES (don’t need to know origin insertion)  Frontalis: forehead; when your forehead wrinkles  Orbicularis Oculi: around eyes; helps you blink  Temporalis: temporal lobe; scrunching around the ear  Masseter: Cheek; when you puff out your cheeks  Buccinator: Mouth; blowing a kiss  Orbicularis Oris: around mouth; open/closing mouth  *** Platysme: bottom of the chin to bottom of neck; drapes over top of neck muscles NECK  ***Sternocleidomastoid: lateral, connects sternum, clavicle, and mastoid process (on the manubrium part of sternum). This muscle can pull on mastoid process causing a headache. If you just relax and be still, it will be gone. CHEST  Are very similar to cat except for one  Pectoralis major: INNERVATION – pectoral nerve  Pectoralis minor: INNERVATION- pectoral nerve  ***Cannot see pec. minor in non-dissected chest in humans  Deltoid: aka shoulder; INNERVATION- Axillary nerve  ***Serratus Anterior: INNERVATION- Long thoracic nerve; overtop ribs, they literally go with ribs (feather appearance)  ***Rectus abdominus: Rectus = straight, muscle goes straight down chest (the xiphoid to privates)  ***Linea alba cover rectus abdominus***  CLINICAL: Men automatically have a weaker fascae because their testicles drop from the abdomen and weakens the sheet. The fasca pulls apart.  CLINICAL: Inguinal Hernia- Organ protrusion through an opening abnormally. Example: intestines pop out through the separation. Intestines must be put back in and the opening is closed.  External Oblique:  Internal oblique:  Transverse abdominus: MEDIAL THIGH  Pectineus- medial most thigh muscle  Adductor longus  Adductor magnes (add Femoris in cat)  Adductor brevis  Gracilis (poker straight muscle running all the way down to the tibia)  ***Action of entire compartment: Adduction or closing legs  NERVE INNERVATION = Obturator nerve (except pectineus which also has femoral nerve)  Literally the Gracilis goes straight down from pubis all the way down to tibia. Inserts on tibia QUADRICEPS KNOW SLIDE 15  Anterior Thigh Quadriceps 4+1  Vastus lateralis  Vastus medialis  Vastus intermedialis (Location is deep to R.F.)  Rectus femoris  +1 Sartorius (strap like muscle that separates the quads from the adductors)  INNERVATION FOR ALL- Femoral nerve  *** Insertion via the Q tendon (patellar tendon) on tibial tuberosity  ***Patella is a sesmoid bone which picks up the tendon and inserts on the tuberosity  ***They all function to extend the thigh  ***They all run into the quadriceps tendon (superior) and then to the patellar ligament(inferior) and insert into tibial tuberosity  ***EXCEPTION: Sartorius muscle, it is a flexor/flexor (Thigh/knee)  Muscles include: Vastus triplets, R.F., Sartorius ANTEROIR LEG/Extensors  Tom- Tibialis anterior  Dick- Extensor digitorium (EDL) (tendons of EDL go to 4 digits)  Harry-Extensor Hallucis longus (EHL) (tendon of EHL goes to big toe)  Important because they go to toes and help extend them up in the air  *** Tom is immediately lateral to tibia***  ACTION OF ALL MUSCLES = Dorsiflexion or extension (pulling toes toward nose)  INNERVATION OF ALL MUSCLES = Deep peroneal/fibular nerve  ***What happens at a red light with foot? Dorsiflexion***  ANTERIOR=DORSIFLEXION POSTERIOR LEG  POSTERIOR=FLEXION  Two layers to the posterior: Deep-Tom, Dick, Harry. Superficial: Gastrocnemius (medial and Lateral head) and Soleus which fans out wider than the tendon  ***Gastroc-Soleus complex forms the Calcaneal/Achilles tendon  ***Calcaneal tendon inserts into the calcaneus  CC: Ripped calcaneal tendon causes the person to be unable to flex the foot. If it isn’t fix, it will go back up the leg, causing more problems. If it is torn completely, surgery is required but full function is not restored. If not completely torn, scarring can occur and the patient must strengthen the surrounding muscles.  ***Plantar flexion: means you are pushing your foot towards the ground (pressing on the gas pedal)  ***The plantaris (deepest on the superficial) is a small muscle under the gastrocnemius with a very long tendon insertion (don’t mistake for nerve)  Actually originates above the joint  ***All hamstrings and compartments are innervated by the posterior tibial branch of the sciatic nerve***  MTB is mnemonic  ***Origin = Ischial tuberosity, Insertion = M+T is Tibia, Biceps in Fibula  Semimembranousus- most medial (cat has this muscle on the anterior side of medial comp.)  Semitendinousus  Biceps Femoris- most lateral  ACTION is all the same = flexion of thigh  NERVE = Posterior tibial branch of sciatic nerve LATERAL LEG  Peroneus/fibularis longus (hurts when you roll your ankle)  Peroneus/fibularis brevis  Peroneus/fibularis tertius (considered anterior)  ACTION: EVERSION OF FOOT  Deep is in front, superficial on the side  INNERVATION: SUPERFICIAL PERONEAL NERVE ARM MUSCLES  Only need to know 3 muscles o Deltiod NERVE: Axillary. INSERTION: Deltiod tuberosity on humerus o Biceps Brachii: NERVE: musculocutaneous, ACTION: Flexor o Triceps Brachii: NERVE: Radial, ACTION: Extensor BACK MUSCLES  ***ROTATOR CUFF MUSCLES: common injury in non-athletic women because of slinging bags onto shoulders. This causes them to be unable to move their arm. These muscles are: SUPRASPINATUS (above spine of scapula), INFRASPINATUS(below spine of scapula), SUBSCAPULARIS(only one that is anterior, right up against the bone of the scapula; extremely deep), AND TERES MINOR(abuts the infraspinatus)  All inserted into the upper shoulder  Latissimus Dorsi: Spans across the width of the back; AKA the swimmers muscles; *** NERVE- THORACODORSAL NERVE  Trapeziu


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