EXSS 175 Exam 4 Study Guide
EXSS 175 Exam 4 Study Guide EXSS 175
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This 31 page Study Guide was uploaded by Lynde Wangler on Thursday April 14, 2016. The Study Guide belongs to EXSS 175 at University of North Carolina - Chapel Hill taught by Dr. Johna Register-Mihalik in Spring 2016. Since its upload, it has received 108 views. For similar materials see HUMAN ANATOMY in Physical Education at University of North Carolina - Chapel Hill.
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Date Created: 04/14/16
EXSS 175 Exam 4 Study Guide 9A Respiratory System Purpose of the Respiratory System: What is the primary purpose of the respiratory system? o Gas exchange – intake oxygen and deliver to body cells and elimination of CO2 produced by body cells; regulate blood pH level; contains receptors for the sense of smell, filters air, produces vocal sounds, excretes small amounts of water and heat Organs in the Respiratory System What are the organs of the respiratory system and what are their functions? STRUCTURE FUNCTION Nose/naval cavity Warms, moistens, and filters air as it is inhaled Pharynx (throat) Passageway for air, leads to trachea Larynx The voice box, where vocal chords are located Trachea (windpipe) Keeps the windpipe “open” – trachea is lined with fine hairs called cilia which filter air before it reaches the lungs Bronchi Two branches at the end of the trachea, each lead to a lung Bronchioles A network of smaller branches leading from the bronchi into the lung tissue and ultimately to air sacs Alveoli The functional respiratory units in the lung where gasses are exchanged Gas exchange between atmosphere and body cells (gas = oxygen, carbon dioxide) o 3 Processes of Respiration: Pulmonary Ventilation – movement of air – in lungs out of lungs Alveolar Respiration – movement of gases – lungs blood Tissue Respiration – movement of gases – blood cells (diffusion) General Pathway of Airflow: nose pharynx trachea bronchi lungs Nasal Cavity: Define the features of the nasal cavity. o Nose – covered with skin, supported internally by bone and cartilage o Nasal Cavity – hollow space behind nose, divided into R and L portions by nasal septum, anterior is cartilage, posterior is bone (vomer, ethmoid, maxillae, palatine) o 3 Areas Vestibule – anterior portion just inside nostrils, lined with skin and coarse hairs (filter large dust particles) Olfactory – roof of nasal cavity above superior nasal conchae, house olfactory cells (cranial nerve I = smell) Respiratory – major portion; superior, middle, inferior nasal conchae; curl out from lateral walls (provide superior, middle, and inferior meatuses “groove-like passageways”); inhaled air is warmed as it moves through passageways and mucus is released to trap dust particles Pharynx: “throat” Define the features of the pharynx. o Location – behind oral cavity, between nasal cavity and larynx o Funnel-shaped tube about five inches long o Functions – passageway for air and food; provides a resonating chamber for speech sounds o 3 Subdivisions of Pharynx (NOL): Nasopharynx (superior) – location: posterior to nasal cavity, extends to place of soft palate; functions: equalizes pressure between pharynx and inner ear via Eustachian tubes (auditory tubes) Oropharynx (middle) – location: posterior to oral cavity, extends from soft palate to hyoid; function: respiratory and digestive pathway, houses two pairs of tonsils found here (palatine and larynx) Laryngopharynx (inferior) – location: extends inferiorly from hyoid bone and becomes continuous with the esophagus posteriorly and larynx anteriorly; function: respiratory and digestive passageway Larynx: “voicebox” Define the features of the larynx. o Short passageway connecting the pharynx (laryngopharynx) to trachea; location: midline of neck anterior to C4-C6 o Cartilages of Larynx – Thyroid Cartilage – aka “adam’s apple” (forms anterior wall of larynx) Epiglottis – large piece of elastic cartilage (leaf-shaped trapdoor hinged to thyroid cartilage); involved in swallowing Swallowing pharynx and larynx rise epiglottis slides down seals off glottis prevents food and fluid from entering larynx, forces into esophagus Glottis – pair of folds of mucous membranes (vocal folds – true vocal cords); rima glottides: space between the two folds Cricoid Cartilage – ring of haline cartilage that forms the inferior wall of larynx (clinical landmark for tracheotomy – emergency air; only complete ring or cartilage in glottis/trachea) Larynx Conditions: o Laryngitis – inflammation of the larynx; most often caused by a respiratory infection or irritants (i.e. smoking); inflammation of the vocal folds causes hoarseness or loss of voice by interfering with the contraction of the folds or by causing them to swell to the point at which they can’t vibrate freely o Cancer of the Larynx – almost exclusively in individuals who smoke Trachea: Define the features of the trachea. o “windpipe” – cartilage; tubular air passageway; location: anterior to esophagus, extends from larynx to T5; divides into R and L primary bronchi at T5 level (Carina – cartilaginous ring surrounding trachea at division point Tracheotomy: “creating a whole in the trachea;” any type of obstruction (injury, swelling, foreign object, etc…) causing the airway not to function properly; a skin incision is made into trachea inferior to “cricoid cartilage” (patient breathes through a plastic or metal tracheal tube) Bronchial Tree: o Branched airways leading from trachea to (large) air sacs in lungs (microscopic) R and L Primary Bronchi Lobe Bronchi (secondary bronchi) Segmentary Bronchi (tertiary bronchi) Bronchioles Terminary Bronchioles Respiratory Bronchioles Alveolar ducts Alveoli o Primary Bronchi: extrapulmonary; arise from trachea at level of T5; right is more vertical and wider (common site for objects to become lodged) o Secondary (lobar) Bronchi: one branch to each lobe of the lungs; right lung (3 lobes = 3 secondary bronchi superior, middle, inferior); left lung (2 lobes = 2 secondary bronchi superior and inferior) o Tertiary (segmentary) Bronchi: smaller branches of bronchi; 10 total in each lung o Bronchioles: even smaller bronchi within the lungs o Terminal Bronchioles: end branches of bronchi; 50-80 per lobe o Respiratory Bronchioles: microscopic branches that penetrate deep into lungs (.55mm diameter = very short; few alveoli present on walls; named so because some air sacs bind to their sides (first structures in sequence that can take part in gas exchange) o Alveolar Ducts: 2-11 for each respiratory bronchiole; branch from each respiratory bronchiole o Alveoli: latin for “flask;” thin-walled microscopic air sacs that allow for air diffusion; each alveoli surrounded by capillary network pulmonary membrane is very thin (alveolar capillary membrane) & allows for diffusion of gases across alveolar and capillary wall; Are prevented from collapsing by “surfactant” (keeps the surface tension down – like soap creates water bubble) Lungs: What are the 2 layers of the pleural membrane and what are their purpose? o Pleural Membrane – serous membrane surrounding each lung; 2 layers Visceral (deep) – lines outer surface of each lung, cavity is not opened to the outside Parietal (superficial) – lines the walls of the interior thoracic cavity Both layers are continuous with each other (balloon-like) o Pleural Space/Cavity – space between the visceral and parietal pleural membranes (small); both pleural membranes secrete a lubricating fluid (allows for frictionless breathing, easy sliding; causes pleural membranes to adhere to the other) List the branches of the airway beginning at the trachea and ending at the alveoli. Gas exchange. Pathway of air. 9B Respiratory System continued… Lungs: soft, spongy, cone-shaped organs located in the thoracic cavity o Landmarks – Describe the important anatomical landmarks of the lungs. Base: broad inferior portion, concave Apex: superior portion, narrow Costal Surface: surface lying against ribs Mediastinal Surface (medial): contains hilus (entrance and exit site of bronchi, pulmonary blood vessels, lymph vessels, and nerves) Cardiac Notch: left lung only o Lobes and Fissures – Right Lung: 3 lobes (superior, middle, inferior); 2 fissures (horizontal – superior, middle; olique – inferior – superior and middle) Left Lung: 2 lobes (superior and inferior); 1 fissure (oblique – superior – inferior) Mechanics of Pulmonary Ventilation (“inspiration”): o Resting Pressure – inside lung pressure = atmosphere pressure (no air movement, normal resting pressure 760 mmHG sea level); changes in atmospheric pressure make it more difficult to breathe (i.e. mountain climbing and scuba diving) o 3 Basic Steps Define the 3 different types of respiration. Pulmonary Ventilation – inspiration and expiration of air between atmosphere and lungs Alveolar (Pulmonary) Respiration – exchange of gases between air spaces of lungs and blood in pulmonary capillaries (blood gains O2 and loses CO2) Tissue Respiration – exchange of gases between blood in systematic capillaries and tissue cells (blood loses O2 and gains CO2) o Flow & exchange of air occurs due to pressure gradients (high to low); air moves into lungs (pressure in lungs < pressure of atmosphere) air moves out of lungs (pressure in lungs > pressure of atmosphere) o Inspiration: internal lungs pressure goes down with increasing lung size; expand lungs intra-alveolar pressure decreases below atmospheric pressure (air pushed into lungs by atmospheric pressure) What are the mechanics of pulmonary ventilation (inspiration)? o Lung Expansion: diaphragm muscle fibers contract (innervation: phrenic nerve); diaphragm moves inferiorly (“flattens out”) allows thoracic cavity to enlarge intra-alveolar pressure falls to about 2 mmHg below atmospheric pressure air is then forced into lungs (accounts for about 75% of air entering lungs; obesity, pregnancy, etc. – can restrict diaphragm from flattening out causing breathing difficulties Also, external intercostal muscles contract; other muscles contract during labored breathing (sternocleidomastoid, scalenes, pectoralis major); ribs and sternum undergo elevation Rising anterior-posterior dimension of thoracic cavity; further decreasing intra-alveolar pressure allows more air to enter Mechanics of Pulmonary Ventilation (“expiration”): What are the mechanics of pulmonary ventilation (expiration)? o Reversal of pressure gradient (intra-alveolar pressure > atmospheric pressure); normal expiration depends on 2 factors: 1) normal recoil of elastic fibers that were stretched during inspiration & 2) inward pull of surface tension due to the film of alveolar fluid o Begins when inspiratory muscles relax; as the external intercostals relax, the internal intercostals contract (ribs depress and diaphragm relaxes and elevates; dome of diaphragm moves superiorly); decreased lung space increased intra-alveolar pressure; increased intra-alveolar pressure forces air out; additional muscles may assist in increasing pressure for forced expiration (abdominal muscles – external and internal obliques, rectus and transverse abdominis) Describe common conditions that affect the respiratory system. Asthma – chronic inflammation of airway; airway obstruction may be due to smooth muscle spasms in walls of smaller bronchi and bronchioles (excessive mucus production) Emphysema – destruction of alveoli walls; causes abnormally large air spaces that remain filled during expiration (less surface area for gas exchange); loss of elastic fibers in lungs (loss of elastic recoil – expiration difficult); causes: long-term smoking, air pollution Pneumonia – acute infection or inflammation of alveoli; cause alveoli damage and excessive mucous secretion (alveoli fill with debris and exudate); interferes with ventilation and gas exchange Pneumothorax/ Hemothorax – pleural cavity filled with air (pneumo-) and/or blood (hemo-); increases pressure on lungs (difficulty breathing, may cause lungs to collapse due to high pressure; lung is no longer able to function properly) Nose: o This is where the oxygen first enters your body and carbon dioxide leaves; air comes into your nose and is filtered by tiny hairs and moistened by mucus in your nose Pharynx and Trachea: o Air passes from the nose to the lungs; pharynx gathers air after it passes through your nose and then the air is passed down to your trachea; trachea is held open by incomplete rings of cartilage Bronchial Tree: o trachea splits up into primary bronchi; the primary bronchi split up to form the bronchioles; the bronchioles keep getting smaller and getting smaller and finally end with small air sacs (alveoli) Alveoli: o Tiny air sacs with air/oxygen when you breath in; surrounded by capillaries; the walls of your alveoli are so thin that the oxygen and carbon dioxide can pass through them, traveling right into, or out of your blood stream Key Words: o Respiratory System – the group of organs in your body that are responsible for taking in oxygen and breathing out the CO2, which is the waste product of cellular respiration o Oxygen – the gas that your body needs to work and function o Carbon Dioxide – the waste product (gas) that is produced through respiration of people and animals o Nose/Nasal Cavity – where oxygen first enters your body; tiny hairs help filter the air and air is moistened and heated by your nose; your nose leads into your nasal cavity o Mouth/Oral Cavity – oxygen/air can also enter through your mouth but it is not filtered; your mouth opens up into your oral cavity o Sinus – a cavity in the bones of your skull that helps moisten and heat the air that you breathe o Pharynx/ Throat – gathers air from your nasal and oral cavities and passes it to your trachea o Trachea/ Windpipe – a tube-like pathway that connects your throat to your Bronchi tubes and lungs; air passes through it when it travels from the pharynx to the bronchi tubes o Bronchi Tubes – each tube (one per lung) splits up into many smaller tubes called bronchiole, like branches on a tree o Bronchiole – keep splitting up until they reach your alveoli o Respiratory Bronchiole – the air-tubes that are actually connected to the alveoli o Alveolar Duct – the final tube, which is part of the alveoli, that leads to the air sacs o Alveolar Sac – where the chemical change takes place and where blood cells pick up oxygen and drop off carbon dioxide o Alveoli – tiny air-sacs at the end of your alveolar duct; they fill up with oxygen and are surrounded by capillaries o Capillaries – tiny blood streams (around one cell wide) that surround your alveoli; they take oxygen out of lungs and replace it with CO2, which you later breathe out o Diaphragm – the muscle membrane that helps you breathe in and out by changing the pressure in your chest cavity How the Respiratory System Works with Other Body Systems: o Integumentary System – gas exchange in lungs provides oxygen to skin and rids body of carbon dioxide from skin; skin helps to protect respiratory organs and helps regulate body temperature o Skeletal System – gas exchange in lungs provides oxygen and rids body of CO2; rib cage protects lungs and assists breathing: bones provide attachment sites for muscles involved in breathing o Cardiovascular System – gas exchange in lungs rids body of CO2, helping to regulate the pH of blood; breathing aids venous return; blood vessels transport gasses to and from lungs; blood services respiratory organs o Lymphatic System/Immunity – tonsils and adenoids occur along respiratory tract; breathing aids lymph flow; lungs carry out gas exchange; lymphatic vessels pick up excess tissue fluid; immune system protects against respiratory tract lung infections o Muscular System – lungs provide oxygen for contracting muscles and rid the body of CO2 from contracting muscles; muscle contraction assists breathing; physical exercise increases respiratory capacity o Nervous System – lungs provide oxygen for neurons and rid the body of CO2 produced by neurons; respiratory centers in brain regulate breathing rate o Endocrine System – gas exchange in lungs provides oxygen and rid body of carbon dioxide; epinephrine promotes ventilation by dilating bronchioles; growth factors control production of red blood cells that carry oxygen o Digestive System – gas exchange in lungs provides oxygen to the digestive system tract and excretes CO2 from the digestive tract; breathing is possible through the mouth because digestive tract and respiratory tract share the pharynx o Urinary System – lungs excrete CO2, provide oxygen, and convert angiotensin I to angiotensin II, leading to kidney regulation; kidneys compensate for water lost through respiratory tract; work with lungs to maintain blood pH o Reproductive System – gas exchange increases during sexual activity; sexual activity increasing breathing; pregnancy causes breathing rate and vital capacity to increase 10A Renal (Urinary) System Renal System: What organs/structures make up the renal system? o Consists: 2 kidneys, 2 ureters, 1 urinary bladder, 1 urethra o General Function: What is the general function of the renal system? filter blood and keep necessary fluid components; excrete wastes Kidneys: What are the key characteristics of the anatomy of the kidney? o “size of a fist” (4-5 inches long, 2-3 inches wide, 1 inch thick) o Location: lateral to T12-L3; right slightly lower o Retroperitoneal cavity Kidney External Anatomy: What are the key features of the external anatomy of the kidney? Where are they on the kidney and what are their functions? o Renal Hilus (hilum) – notch located near the center concavity; passageway to renal sinus (cavity) Ureter, renal artery, renal vein, lymphatic vessels, nervous innervation Kidney Tissue Layer: o Renal Fascia (superficial) – anchor kidney to surrounding structures and posterior abdominal wall o Adipose Capsule (intermediate) – protection; holds kidney in place o Renal Capsule (deep) – protection from trauma and infection; maintenance of shape; continuous with ureter Blood Supply of Kidneys: What are key structures and features of the blood supply of kidneys? o Renal Artery – delivers blood into kidney o Afferent Arteriole – delivers blood into glomerulus o Efferent Arteriole – delivers blood away from glomerulus o Peritubular Capillaries – surrounds renal tubule, to collect the filtered blood o Renal Vein –delivers blood away from kidney Kidney Functions: What are the key functions of the kidneys – describe them. 1. Regulation of blood ionic composition 2. Regulation of blood pH 3. Regulation of blood pressure 4. Regulation of blood volume 5. Maintenance of blood osmolarity 6. Regulation of blood glucose level 7. Production of hormones 8. Excretion of wastes and substances Regulation of Blood Ionic Composition: o Regulate blood levels of Sodium ions Na+ (normal = 135-145 milliequivalents per liter) Potassium ions (K+) Calcium ions (Ca2+) Chloride ions (Cl-) Phosphate ions (HPO42-) Hyponatremia: abnormally low sodium in blood (<130mmol/L); ingestion of too much fluid before, during, or after activity; completely avoidable condition; S/S headache, nausea, vomiting, swelling of hands and feet, lethargy, apathy, agitation, low blood sodium Regulation of Blood pH: o Excretion – hydrogen ions (H+) into urine o Conservation – Bicarbonate ions (HCO3-) Alcohol and Kidney Function: o Inhibits production of antidiuretic (ADH; aka vasopressin) o Increase in urination – as well as sweating and altered function of smooth muscle of blood vessels Regulation of Blood Volume and Pressure: conserve vs. eliminate water o Lower volume = lower pressure o Constriction of blood vessel = higher blood pressure o Maintenance of blood osmolarity = loss of water and solutes Regulation of Blood Glucose: gluconeogenesis release glucose into blood Production of Hormones: o Calcitrol – active form of vitamin D; helps with calcium homeostasis o Erythropoietin – stimulate production of RBC o Adrenal Glands glucocorticoids (cortisol); mineralocorticoids (aldosterone); sex steroids (testosterone); catecholamines (epinephrine & norepinephrine) Excretion of Waste and Foreign Substance: metabolic reaction wastes (ammonia, urea, bilirubin, creatine, uric acid; drugs and toxins 10B Renal System continued… Kidney Internal Anatomy: o Two Regions: Renal Cortex – outer reddish covering; extends from renal capsule to bases of the renal pyramids and into the spaces in between them; renal columns (spaces between pyramids) Renal Medulla – inner reddish brown area; renal pyramids (8-18 cone shaped structures; bases of pyramids face cortex); apex = renal papillae (points toward center of kidney renal hilium) What is the parenchyma? o Parenchyma = renal cortex + renal pyramids; functional portion of kidney; contains about 1 million nephrons Nephron = functional unit of the kidney; urine is produced here and drained to papillary ducts What is the functional unit of the kidney? How many are there> What is their function? Nephrons: o Functional units of the kidneys (consists of renal corpuscle and renal tubule) o Functions – filtration (wastes filtered from blood into nephron) o Resorption – useful materials returned to blood o Secretion – wastes released from nephron into filtrate Nephron Anatomy: What are the key components of nephron anatomy? Where are they and what are their functions? These are key things to know about the renal system. o Renal Corpuscle – site of blood filtration (plasma is filtered); glomerulus (capillary network); Bowman’s Capsule (encapsulates glomerulus) Filtrate – blood that passed through the glomerular capillary to the space of Bowman’s capsule o Renal Tubule: passage of filtrate – proximal convoluted tubule (descending portion, attached to glomerulus/bowman’s capsule, located in renal cortex) Loop of Henle (located in renal cortex and medulla) distal convoluted tubule (ascending portion, located in renal cortex) Pathway of Urine: renal tubule collecting ducts papillary duct (renal papilla – apex of renal medulla) minor calyx (calyces; small depressions at apex of pyramid/papillae & 8-18 per kidney) major calyx (2-3 per kidney) renal pelvis (expanded upper end of the ureter; collection center for urine) o Physiology of Urinary System – filtration of blood; re-absorption; secretion What is glomerular filtration? Glomerular Filtration: filtration of blood at the renal corpuscle; glomerular filtration rate = volume of fluid filtered per unit time (males 125ml/min, females 105ml/min) Re-Absorption: What is the pathway of urine? (be able to label and write out) Briefly describe the physiology of urinary system (filtration, resorption, and secretion) o Proximal convoluted tube – 65% of the filtered water; glucose, amino acids, lactic acids, vitamins, etc. o Descending loop of Henle – 15% of the filtered water o Ascending loop of Henle – re-absorption of Na+, K+, Cl2- o Distal convoluted tube – re-absorption of Na+. K+, Cl2- o Collecting duct – re-absorption of Na+, K+, Cl2- What are the major functions of the ureters, the urinary bladder, and the urethra (and where are they each located)? Ureters: 2 ureters, each about 10 inches in length; communicating link between the renal pelvis and the urinary bladder; transport urine from kidney to urinary bladder (muscle contraction (walls), gravity, & pressure) Urinary Bladder: o Hollow muscular organ – size increases as it fills with urine; rises into abdominal cavity when full; capacity about 700-800 mL (smaller in females due to uterus sitting superiorly) o Located posterior to the pubic symphysis; storage area for urine o Trigone – triangular area on floor of bladder; posterior: ureteral openings; anterior: urethral opening Urinary Bladder: What are functional anatomical issues that may have clinical implications in the urinary system? o Valve Mechanism – no actual valve between ureter and urinary bladder; as the urinary bladder swells, pressure is placed on ureter openings ureters are shut off, preventing backflow of urine (potential role in kidney infection) Urethra: transports urine from the bladder to outside the body; external urethral orifice shorter in females than in males (results in higher rate of urinary tract infections in females) Micturition: What is micturition? Describe it and key components of the physiology of it. o Caused by voluntary and involuntary actions; micturition reflex urine level <200-400mL; stretch receptors in urinary bladder wall activated; conscious desire to urinate; relaxation of the internal urethral sphincter & contraction of detrusor muscle Renal Calculi: What are renal calculi? Describe how they happen. o Kidney stones – crystallization of salts within filtrate; excess calcium; decreased water intake; abnormal pH of filtrate; over activity of the parathyroid glands (parathyroid hormone = increases calcium content of blood) 11A Integumentary System Body Membranes: 2 Major Groups o Epithelial Membranes Contain epithelial layer & underlying connective tissue 3 Types: cutaneous (skin), Mucous, and Serous o Connective Tissue Membranes Synovial Epithelial Membranes: Cutaneous Membrane; “skin,” discussed in detail later Epithelial Membranes: Mucous Membrane o Lines body cavities that open directly to exterior (ex. respiratory, digestive, urinary, reproductive) o Composition: epithelium resting on a loose connective tissue membrane (lamina propria) Lamina propria: connection and flexibility to underlying tissue o Function: defense mechanism, prevents cavities from drying out, lubricates GI tract Epithelial Membranes: Serous Membranes o Lines body cavities closed to exterior and covers organs within cavities o Two Layers: (balloon-like formation) Parietal – attached to cavity wall; folds on itself to form the visceral layer Visceral – covers and attaches organs within a cavity Balloon-like = push fist into balloon; balloon to fist = visceral; outer wall of balloon = parietal Both layers secrete serous fluid watery, lubricating fluid (organs easily slide across membrane and other organs) Locations: Peritoneum – abdominal cavity and organs Pleura – lungs Pericardium – heart cavity and heart Connective Tissue Membrane: Synovial Membrane o Composition – connective tissue (fibrous), do not contain epithelial cells o Location – line cavities of freely moveable joints (articular); surround tendons or form sacs (bursa) o Function – secrete synovial fluid that lubricates bones and provides nutrients; Bursa cushioning and lubrication between tendons and bones Integumentary System: o Components – skin = cutaneous membrane; accessory structures (sweat glands, oild glands, hairs, nails, and sensory structures Basic Skin Functions: o Skin = “integument” = covering (protection – 6 protective functions) o Regulates body temperature (sweat) o Excretion (urea and uric acid) o Synthesizes Vitamin D (interaction with UV rays) o Blood reservoir Protective Functions of the Skin: o 1) Mechanical damage (pressure receptors) o 2) Chemical damage (pain receptors) o 3) Bacterial (preventing invasion of foreign substances; prevents infections) o 4) Ultraviolet Radiation (melanocytes protect from harmful UV rays) o 5) Thermal damage (heat/cold damage) o 6) Desiccation (drying out/ waterproof Structure of Skin: o Epidermis (superficial, thinner, avascular) Composition – stratified squamous epithelium (capable of “keratinizing” becomes hard and tough); 4 major cell types, 4- 5 layers o Dermis (deeper, thicker, vascular) Composition – dense fibrous connective tissue; 2 layers o Subcutaneous (deepest, not part of skin) Composition – areolar tissue containing fat cells (anchors skin to underlying organs; “shock absorber and insulator” Epidermis: o 4 Major Cell Types Keratinocytes produce keratin; toughens and waterproofs skin Melanocytes produce melanin; provides pigment of skin and absorbs UV light Langerhans cells come from bone marrow and interact with WBC’s (helper t-cells) during immune response; easily damaged by UV light Merkel cells sensation of touch Epidermis (4-5 Layers – superficial to deep) o Stratum Corneum Stratum Lucidum Stratum Granulosum Stratum Spinosum Stratum Basale o Stratum Basale: Deepest cell layer, contacts dermis; single cell layer (contains all 4 cell types found in epidermis); continuous cell division as cells move from deep to superficial layers o Stratum Spinosum: 8-10 cell layers; mainly keratinocytes; some melanocytes; tightly packed; spine-like projections (anchoring of cells) o Stratum Granulosum: 3-5 cell layers (flattened keratinocytes precursor for keratin; various stages of degeneration) Granules develop in keratinocytes (produce lipid-rich secretion; water-proof sealant, prevents water loss, prevents entrance of foreign materials) Transition from metabolically active (deep) to dead (superficial) areas o Stratum Lucidum: 3-5 cell layers (clear, flat, and dead); not always present (palms and soles of feet mostly) o Stratum Corneum: 20-30 cell layers (flat and dead; rub and flake away; replaced by cells from deeper strata) Greatest amount of keratin (full keratinization) Outermost layer of epidermis Skin Coloration: o Melanin: pigment ranging from yellow-brown-black concentrated areas of melanin produce dark patches on skin (freckles or moles) o Produced by melanocytes same number in all races, differences in color are due to amount of melanin produced; exposure to UV rays increases melanin production (tanning) o Protects against damaging UV rays from sun; excessive UV ray exposure damages skin “leathery skin;” depress immune system (herpes simplex); alter skin cells DNA and possibly causes skin cancer o Depends on 3 Things: Amount and type of melanin (yellow and black coloration) Amount of carotene in stratum corneum and subcutaneous tissue (yellow-orange coloration) Amount of oxygen bound to hemoglobin (red to blue coloration) Conditions of the Skin: o Albinism (albino) – individual has melanocytes, but cells are unable to synthesize and produce melanin (inherited) o Vitiligo – partial or complete loss of melanocytes from patches of skin (irregular white spots) o Mongolian Spots – dense collections of melanocytes; most common in babies of Native American, African American, and Hispanic descent (also in about 10% of fair-skinned infants); common on lower back and buttocks; not cancer causing; usually fade by about age two Dermis: “The Body’s Hide” o Composition – connective tissue containing collagen and elastic fibers (strong and stretchy envelope helping hold body together) o Two Layers – 1. Papillary layer (superficial) and 2. Reticular layer (deep) Collagen Fiber Responsibility: o Is found throughout the dermis; responsible for the toughness of the dermis; attracts and binds to water skin hydration Elastic Fiber Responsibility: o Provides elasticity to skin; aging collagen and elastic fibers skin less elastic skin beings to sag and wrinkle Papillary Layer: o Contacts stratum basale; contains dermal papillae Fingerlike projections indenting into epidermis; increases surface area of papillary layer increases area for vascular supply; ridges cause fingerprints (secretions leave fingerprints on objects) Contains Meissner’s Corpuscles (light touch) Reticular Layer: o Deepest skin layer; composed of elastin and collagen (provides strength, extensibility, and elasticity); bound to underlying organs, bone, or muscle via the superficial fascia; Contains blood vessels, glands (sweat and oil), Pacinian Corpuscles (deep pressure) Integumentary System 11B continued… Skin Appendages: includes cutaneous glands, hair, hair follicles, and nails; each of these appendages arises from the epidermis and plays a unique role in maintaining body homeostasis Glands: o Exocrine glands – located in skin (dermis layer) Sebaceous (oil) Sudoriferous (sweat) Ceruminous (ear-wax) o Release secretions via ducts Sudoriferous Glands (Sweat Glands): o Eccrine Glands – more numerous; mixture of water, salt, and metabolic wastes; sweat reaches the surface through funnel shaped “pores;” regulates heat (98.6) o Apocrine Glands – largely confined to axillary and genital areas; contains fatty acids and proteins, as well as secretions from eccrine glands; begin functioning at puberty; increased activity during emotional stress; minimal role in thermoregulation Sebaceous Glands: o Secrete sebum – mixture of oily substances and fragmented cells; keeps skin and hair soft and hydrated o Acne – infection of the sebaceous glands accompanied by pimples Whitehead – sebaceous glands duct becomes blocked by sebum Blackhead – whitehead dries and darkens Hair: o Dead, keratinized epidermal cells; minor protective functions Eyebrows and eyelashes – collect foreign particles Head – absorbs force, sunlight and decreases heat loss Nasal Passage – filters foreign particles from respiratory system o Hair Anatomy: 3 Columns of Cells Connected Together Shaft – superficial, projects from skin Root – deep to surface layer, penetrates into dermis; surrounded by follicles External root sheath (composed of dermal tissue; supplies blood vessels to epidermal portion and reinforces) Internal root sheath (composed of epithelial tissue; forms a tubular sheath and forms the hair) Bulb – enlarged base at end of root (onion shaped at inferior end of follicle) Hair Anatomy: 3 Concentric Layers (root and shaft) o Medulla (inner) – contains pigment granules o Cortex (middle) – major part of shaft, pigment granules in dark hair o Cuticle (outer) – single layer of heavily keratinized cells, arranged like shingles going towards tip o Arrector Pili: small bands of smooth muscle cells; connect each side of hair follicle to dermal tissue; contraction causes hair to “stand”/ “goosebumps” Alopecia: o Affects about 1.7% of the population; occurs equally in males and females of all ages and races o Autoimmune skin disease resulting in hair loss on the scalp and elsewhere on the body; affected hair follicles are mistakenly attacked by a person’s own immune system (white blood cells), resulting in the arrest of the hair growth stage o Usually starts with a small, round, smooth bald patch, and progresses to complete scalp or body hair loss although not life threatening, it is life-altering Nail: o Scale-like modification of the epidermis (tightly packed, hard, keratinized cells) o Nail Components: Nail body – visible portion; free edge (extends past the end of digit) Nail root – embedded in the skin Lunula – whitish, semilunar area at proximal end Cuticle – epidermal attachment surrounding nail wall Nail bed – stratum spinosum layer that nail rests on Nail Matrix: o Underlies the nail bed; where cell division and growth occurs; pinkish color of nails comes from rich blood supply to underlying dermis Homeostatic Imbalances of Skin: o Skin can develop more than 1000 different ailments; most commonly result from allergies or bacterial, viral, fungal infections; less common, but far more damaging are burns and skin cancer Dermis Blood Supply: o Abundantly supplied with blood vessels regulate body temperature o Restriction blood supply to skin cell death and severe skin ulcers “Decubitus Ulcers” – occurs in bedridden patients due to a lack of movement (constant compression) Contusions: o Sites where blood has escaped from circulatory system and clotted in tissue spaces (black and blue marks aka hematoma or bruise o Unusual tendency to bruise may signify a Vitamin C deficient diet or blood clotting disorder Cyanosis: o Hemoglobin is poorly oxygenated; “blue skin – lack oxygen;” both blood and skin appear blue may only be noticeable in nail beds and mucous membranes in individuals with dark skin coloration Erythema: increased blood flow to skin; may indicate embarrassment (blushing), fever, hypertension, inflammation, or allergy; “red skin” Burns: o Tissue damage and cell death caused by intense hear, electricity, UV radiation, or chemicals o Can cause – accelerated or impaired metabolism; cardiovascular system failure; most serious threat to skin; circulatory shock may occur because of decreased blood flow due to decreased BP Classification of Burn Degrees: o First Degree Burns – damage: only epidermis; severity: limited, “partial thickness;” symptoms: temporary discomfort, swollen and red for approximately 2-3 days, will easily heal o Second Degree Burns – damage: injury to epidermis, possibly upper region of dermis; severity: moderate, “partial thickness;” symptoms: skin is red and painful, blistering (usually no permanent scars if care taken to prevent infection) o Third Degree Burns – damage: destroys entire thickness of the skin; severity: extreme, “full thickness;” symptoms: appears blackened, not terribly painful at first (nerve endings destroyed) regeneration is not possible; skin grafting must occur Burns Considered Critical: o If following conditions exist 2nddegree burns over 25% of body rd 3 degree burns over 10% of body 3 degree burns to hands, face, or feet Facial burns are considered dangerous because respiratory passageways can cause suffocation Skin Cancer: o Most skin tumors are benign (don’t spread) to other areas; most common type of cancer in humans; 3 Types basal cell carcinoma, squamous cell carcinoma, and malignant melanoma Basal Cell Carcinoma: o Most common type (78%), most common on face; typically do not metastasize o Cause: sun exposure o Affects the cells of stratum basale (germinativum) unable to form Keratin; no longer a good boundary between epidermis and dermis Squamousndell Carcinoma: o 2 most common (20%); affects cells of stratum basale (not those in direct contact with basement membrane) o Cause: chronic sun exposure, poorly treated burns, long standing sores, radiation exposure o Lesions appear as a scaly, reddened papule (gradually forms a shallow ulcer within a firm raised border) o Metastasize slowly and steadily and can invade neighboring tissue Malignant Melanoma: o Least common (2%), most dangerous; most life-threatening cancer in young females o Malignant tumor originating in melanocytes; metastasize rapidly to surround blood and lymph vessels o Initially appear brown to black patches – overtime, no longer produce melanin; color turns pink, red, or purple ABCD Rule for Recognizing Melanomas: o A = Asymmetry two sides of pigmented spot/mole do not match o B = Border Irregularity un-smooth lesion borders (indentations) o C = Color pigmented spot contains different colored areas o D = Diameter spot larger than 6mm in diameter or grows daily Seborrhea: “Cradle Cap” o Occurs in infants, due to over activity of sebaceous glands; begins: pink tone to scalp raised lesions (pimples) yellow to brown flakes oily dandruff; careful washing to remove the excess oil helps Infections and Allergies: o “Athletes Foot” (tinea pedis); itchy, red peeling condition of the skin between the toes; fungus infection o “Boils and Carbuncles” – Inflammation of hair follicles and sebaceous glands; common on dorsal neck; carbuncles are composite boils typically caused by bacterial infection o “Cold Sores/ Fever Blisters” – Small fluid-filled blosters that itch and sting; caused by a herpes simplex infection; virus localizes in a cutaneous nerve and remains dormant until activated by emotional stress, fever, or radiation o “Impetigo” – pink, water-filled raised lesions that develop a yellow crust and eventually rupture; caused by a highly contagious staphylococcus infection o “Contact Dermatitis” – itching, redness, and swelling of the skin, progressing to blister formation; caused by exposure of skin to elements that provoke an allergic response o “Psoriasis” – chronic skin condition characterized by reddened epidermal lesions covered with dry silvery scales; unknown cause, yet often triggered by trauma, infections, hormonal changes, and stress Muscles #6 67-78 Iliac Region: o Psoas major o Iliacus Psoas Major Origin Transverse processes of lumbar vertebrae (bodies, intervertebral disks) Insertion Lesser trochanter of femur Action Flexes thigh and flexes trunk Innervation L2 and L3 branches of lumbar plexus Iliacus Origin Upper 2/3 of iliac fossa Insertion Lesser trochanter with tendon of psoas major Action Flexes thigh Innervation Femoral nerve; iliopsoas Gluteal Region: o Gluteus maximus o Gluteus medium o Gluteus minimus o Tensor fascia latae o Pirformis o Obturator internus o Gemellus superior o Gemellus inferior o Quadratus femoris o Obturator externus Gluteus Maximus Origin Outer surface of ilium, adjacent posterior surface of sacrum and coccyx Insertion Iliotibial band; gluteal tuberosity Action Abducts, extends, and laterally rotates thigh Innervation Inferior gluteal nerve Gluteus Medius Origin Outer surface of ilium inferior to iliac crest Insertion Lateral surface of greater trochanter Action Abducts and medially rotates thigh Innervation Superior gluteal nerve Gluteus Minimus Origin Outer surface of ilium between anterior and inferior gluteal line Insertion Anterior surface of greater trochanter Action Abducts and medially rotates thigh Innervation Superior gluteal nerve Tensor Fascia Latae Origin Outer of iliac crest between ASIS and iliac tubercle Insertion Upper part of iliotibial tract Action Abducts and flexes thigh Innervation Superior gluteal nerve Hip External Rotators Piriformis Origin Internal surface of sacrum Insertion Upper border of greater trochanter Action Laterally rotates and abducts thigh st nd Innervation Anterior rami of 1 and 2 sacral nerve ***tightness = irritation of sciatic nerve Obturator Internus Origin Pelvic surface of obturator membrane and surrounding bones Insertion Common tendon with superior and inferior gemelli to medial surface of greater trochanter Action Laterally rotates thigh Innervation L5, S1-S3, Sacral plexus Gemellus Superior Origin Spine of ischium Insertion With tendon of obturator internus into upper border greater trochanter Action Laterally rotates thigh Innervation Branch of nerve to obturator internus from sacral plexus Gemellus Inferior Origin Upper margin of ischial tuberosity Insertion Common tendon of obturator internus into upper border of greater trochanter Action Laterally rotates thigh Innervation Branch of nerve to quadratus femoris from sacral plexus Quadratus Femoris Origin Lateral border of ischial tuberosity Insertion Below intertrochanteric crest Action Laterally rotates thigh Innervation Branch of sacral plexus Obturator Externus Origin Outer surface of inferior and superior rami of pubis, ramus of ischium Insertion Trochanteric fossa of femur Action Laterally rotates thigh Innervation Obturator nerve (L3, L4) Muscles #7 79-91 Thigh – Anterior o Sartorius o Rectus femoris o Vastus lateralis o Vastus medialis o Vastus intermedius Sartorius Origin ASIS Insertion Upper part of medial surface of shaft of tibia Action Flexes, abducts, external rotation; can slightly internally rotate the leg at the knee joint after flexion Innervation Femoral nerve Rectoral Femoris Origin AIIS Insertion Tibial tuberosity via patellar tendon Action Flexes thigh, extends leg Innervation Femoral nerve Vastus Lateralis Origin Intertrochanteric line Insertion Tibial tuberosity via patellar tendon Action Extends leg Innervation Femoral nerve Vastus Medialis Origin Intertrochanteric line Insertion Tibial tuberosity via patellar tendon Action Extends leg Innervation Femoral nerve; VMO (vastus medialis oblique) Vastus Intermedius Origin Anterior and lateral 2/3 of femur Insertion Tibial tuberosity via patellar tendon Action Extends leg Innervation Femoral nerve Thigh – Medial o Gracilis o Pectineus o Adductor longus o Adductor brevis o Adductor magnus Gracilis Origin Pubic ramus Insertion Upper, medial shaft of tibia Action Adducts thigh Innervation Obturator nerve Pectineus Origin Superior ramus of pubis Insertion Lesser trochanter Action Flexes thigh, assists in adduction when hip flexed Innervation Femoral nerve Adductor Longus Origin Anterior pubis Insertion Linea aspera Action Adducts thigh, assisting medial rotation Innervation Obturator nerve Adductor Brevis Origin Inferior ramus of pubis Insertion Linea aspera Action Adducts thigh Innervation Obturator nerve Adductor Magnus Origin Inferior ramus of pubis Insertion Linea aspera, adductor tubercle of femur Action Adducts and extends thigh Innervation Obturator nerve Thigh – Posterior o Biceps femoris o Semitendinosus o Semimembranosus Biceps Femoris Origin LH – ischial tuberosity; SH – linea aspera Insertion Head of fibula Action Flexes knee; LH extends thigh Innervation LH – tibial nerve; SH – common peroneal nerve Semitendinosus Origin Ischial tuberosity Insertion Medial, superior, tibia Action Flexes knee, extends thigh Innervation Tibial nerve Semimembranosis Origin Ischial tuberosity Insertion Posterior, superior tibia Action Flexes knee, extends thigh Innervation Tibial nerve
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