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EXSS 175

by: Lynde Wangler
Lynde Wangler
GPA 3.836

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Anatomy lectures 8A and B (started C - continue next week)
Dr. Johna Register-Mihalik
Class Notes
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This 7 page Class Notes was uploaded by Lynde Wangler on Friday March 11, 2016. The Class Notes 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 32 views. For similar materials see HUMAN ANATOMY in Physical Education at University of North Carolina - Chapel Hill.


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Date Created: 03/11/16
EXSS 175 Week 9 Notes 7B The Digestive System  Stomach (anatomy, function); Small intestine; Large intestine; Accessory Digestive Organs (liver, pancreas, and gallbladder)  Stomach: J-shaped pouch which empties into the small intestine (most distensible part of the GI tract) o Functions: stores food prior to entry into small intestine (moves to SII as “chyme”); mechanically churns food and gastric secretions; partial digestion of proteins; limited absorption (alcohol, water, drugs, and electrolytes) o Stomach Regions:  Cardia – upper, narrow region just below lower esophageal sphincter  Fundus – dome shaped portion in contact with diaphragm, superior to and left of cardia  Body – main, central portion  Pyloris (funnel-shaped terminal portion)  Pyloric antrum – wide  Pyloric canal – narrow  Pyloric sphincter – junction of stomach and small intestine  Greater curvature  Lesser curvature o Application: Vomiting – forcible expulsion of the contents of the upper GI tract (stomach and sometimes duodenum) though the mouth; prolonged vomiting results in the loss of gastric juice and fluid disturbances in fluid and acid-base balance (especially serious in infants and elderly people)  Small Intestine: primary site of digestive and absorption events; absorption of nutrients enhanced due to large surface area o Segments:  Duodenum – originates at pyloric sphincter (C-shpaed); receives bile from the common bile duct that arises from the liver and the gallbladder; receives pancreatic juice from the pancreas via the pancreatic duct  Jejunum – connects duodenum to ileum; primary region of absorption  Ileum – distal portion; ileocecal valve between small and large intestines  Large Intestine: preparation of chyme for elimination; absorption of water and electrolytes; cecum – initial segment, inverted pouch, vermiform appendix: lymphatic tissue  Appendix: inflammation of the appendix due to blockage of the lumen by chyme, foreign body, carcinoma, stenosis, or kinking o Symptoms – high fever, elevated WBC count, neutrophil count above 75%, referred pain, anorexia, nausea and vomiting, pain localizes in right lower quadrant  infection may progress to gangrene and perforation within 24-36 hours  Large Intestine: o Colon – ascending colon (from the cecum up right abdominal wall to transverse colon); hepatic flexure (transverse colon); Splenic flexure to DC; descending colon (runs down left abdominal wall); sigmoid colon (S shaped attachment with rectum) o Rectum o Anal Canal – anal columns, sphincters (internal – involuntary & external – voluntary); anus (external opening for defecation)  Defecation Problems: o Diarrhea – chyme passes too quickly; H2O not reabsorbed; underdeveloped countries most common cause of death for children o Constipation – decreased intestinal motility; too much water is reabsorbed; remedy = fiber, exercise, and water o Colonoscopy – visual examination of the lining of the colon using an elongated, flexible, fiber optic endoscope  Accessory Digestive Organs: nd o Not part of GI tract, but aid in digestion; Liver –largest organ in body (3-4 lbs); heaviest gland; metabolic and regulatory functions; inferior to diaphragm on right side of abdominopelvic cavity (protected by rib cage) lobes: right lobe, left lobes, caudate, quadrate  Liver – Functions o Carbohydrate metabolism – glycogen to glucose, glucose to glycogen, gluconeogenesis o Lipid metabolism – bile secretion and production, released into gall bladder via hepatic duct, essential for fat digestion o Protein metabolism o Filtering of drugs and hormones o Storage – vitamins (A, B12, D, E, K) and minerals (Fe, Cu) o Phagocytosis – red/white blood cells and bacteria  Gall Bladder – sack-like organ on inferior/posterior surface of liver; stores/concentrates bile into the duodenum via the common bile duct  Pancreas – soft, lobulated, glandular organ; exocrine and endocrine function; Islets of Langerhans (control of blood glucose levels); divided into a head, body, and tail; connected to the duodenum via the pancreatic duct (Duct of Wirsung) and accessory duct (Duct of Sanitorini) o Pancreatic islets (Islets of Langerhans) secrete hormones  Insulin – high blood glucose levels  Glucagon – low blood glucose levels o Acini secrete a mixture of fluid and digestive enzymes called pancreatic juice (pancreatic juice into duodenum assists in digestion of triglycerides 8A Cardiovascular System  Cardiovascular System: strong emphasis placed on this system – imperative knowledge base for ALL exercise based coursework within the department o Focus on  heart, vessels, blood, and circulation:  Peripheral circulation (blood supply for the extremities); cerebral circulation (blood supply for the brain); coronary circulation (blood supply to the heart muscles); hepatic portal circulation (role of liver and other abdominal organs); fetal circulation; clinical assessment of cardiac function (scattered throughout)  General: central component of CV system; functions to propel blood through vessels; hollow, cone-shaped organ the size of a person’s fist; heart pumps over 1 million gallons per year (through over 60,000 miles of blood vessels)  Location of the Heart: located in the mediastinum (anatomical region extending from the sternum to the vertebral column, the first rib and between the lungs)  Pericardium: o Membrane surrounding and protecting the heart – confines while still allowing free movement; two main parts  Fibrous pericardium – tough, inelastic, dense irregular connective tissue; prevents overstretching, protection, and anchorage  Serous pericardium – thinner, more delicate membrane; double layer (parietal layer fused to fibrous pericardium, visceral layer also called epicardium)  Pericardial fluid reduces friction – secreted into pericardial cavity  Layers of the Heart Wall: o Epicardium (external layer) – visceral layer of serous pericardium; smooth, slippery texture to outermost surface o Myocardium – 95% of heart is cardiac muscle o Endocardium (inner layer) – smooth lining for chambers of heart, valves and continuous with lining of large blood vessels  Four Chambers of Heart (Receives blood from) o Two superior chambers: (receiving chambers)  Right atrium – superior and inferior vena cava, coronary sinus  Left atrium – four pulmonary veins  Separated by ineratrial septum o Two inferior chambers: (pumping chambers)  Right ventricle – right atrium  Left ventricle – left atrium  Separated by interventricular septum  Valves of Heart: prevent backflow of blood; Atrioventricular and semilunar valves open/close alternately (i.e., AV opens/ SL closes) o Atrioventricular valves – prevent backflow within heart; Tricuspid (right side) – located between right atrium and right ventricle; Bicuspid/Mitral (left side) – located between left atrium and left ventricle o Semilunar Valves: prevent backflow into the heart; Pulmonary semilunar – located between pulmonary trunk and right ventricle; Aortic semilunar – located between aorta and left ventricle o Papillary Muscles – conical muscles attached to the wall of the ventricle that insert on the chordae tendinae; contract just prior to ventricular contraction o Chordae Tendinae (CT) – tendon-like chords connecting papillary muscles to ventricular surfaces of valves; cusps close due to pressure associated with ventricular contraction (prevent backflow into atrium); CT prevent valve cusps from opening into atria during ventricular contraction  Heart Sounds: o Auscultation – sound of heartbeat comes primarily from blood turbulence caused by closing of heart valves; 4 heart sounds in each cardiac cycle – only loud enough to be heard; Lubb – AV valves closes, Dupp – SL valves close  Systematic and Pulmonary Circulation (2 circuits in series) o Systematic circuit (left side of heart): receives blood from lings; rejects blood into aorta; systematic arteries, arterioles; gas and nutrient exchange in systematic capillaries; systematic venules and veins lead back to right atrium o Pulmonary circuit (right side of heart): receives blood from systematic circulation; ejects blood into pulmonary trunk then pulmonary arteries; gas exchange in pulmonary capillaries; pulmonary veins take blood to left atrium  Intrinsic Cardiac Conduction System: o Cardiac muscle fibers form 2 networks; networks are described as “syncytium” areas that conduction signal spreads through easily o All cardiac muscle fibers in a network are physically connected by intercalated discs o Gap Junctions aid in conduction between networked cardiac muscle fibers o Two Functional Systems: atrial and ventricular syncytium – atrial and ventricular syncytia exclusive except for small area in floor of right atrium o Stimulation of one syncytium causes contraction of all cells in that network – atria contract as a unit, ventricles contract as a unit  Intrinsic Cardiac Conduction System: o Sinoatrial node (SA node) – located near right atrial wall; “pacemaker” sets heart rate; initiates each heartbeat; stimulation from SA node spread over both atria and to AV node; Electrical signal – atrial musculature within atrial syncytium o Atrioventricular node (AV node) – located I interatrial septum (floor of right atrium); small area on right atrium floor where atrial and ventricular syncytia are not exclusive; only normal electrical pathway between atrial and ventricular syncytia o Atrioventricular Bundle – aka “AV bundle” or “bundle of his;” large group of fibers sitting in interventricular septum; receives electrical signal from AV node; spreads electrical signal over ventricles (does not cause ventricular contraction); AV bundle enters upper part of interventricular septum and divides into right and left bundle branches  Right and Left bundle branches: receive electrical signals from AV bundle of His; branches extend through interventricular septum; sends electrical signal to Purkinje fibers  Purkinje Fibers – arise from bundle branches midway down septum; large sized fibers (allows for rapid signal transmission to distant regions of ventricular myocardium); Then the ventricles contract, pushing the blood upward toward the semilunar valves  Electrocardiogram (ECG/ECG): recording of electrical activity of cardiac muscle; uses – study of cardiac function, identify disorders of myocardium and conduction system; detects electrical currents between (-) charged depolarized cells and (+) charged repolarized cells o ECG: P Wave – small upward deflection on the ECG; represents atrial depolarization (spreads from SA node through contractile fibers in both atria) o ECG: QRS Complex – 3 parts to it 1) starts with downward deflection, 2) followed by large, upright, triangular wave, 3) ends with a downward wave; represents rapid ventricular depolarization action potential spreads through ventricular contractile fibers o ECG: T Wave – dome-shaped upward deflection; indicates ventricular repolarization; occurs as ventricles are starting to relax; smaller and wider than QRS complex (repolarization occurs more slowly than depolarization) 8B Cardiovascular System  Function of Blood: o 3 Primary Functions –  Transportation – oxygen from the lungs to tissues; carries nutrients from GI tract and hormones from endocrine glands to body’s tissues; transports heat and waste products for organs to eliminate from the body  Regulation – helps to regulate body’s pH levels; blood osmotic pressure affects water content of cells  Protection – blood clots in injury repair; WBCs protect against disease  Physical Characteristics of Blood: thinker and denser than water; feels slightly sticky; 38C (100.4F)  1C warmer than oral or rectal temperatures; amounts to about 8% of total body mass; volume in average males and females  males: between 5-6 liters; females: between 4-5 liters  Components of Blood: Two components of blood o Blood plasma – watery liquid containing dissolved substances o Formed elements – cells and cell fragments  Composition of Blood: Plasma o Makes up 55% of blood; contains 2 substances (water – 91.5%, solutes – 8.5%); plasma proteins – 7% (blood osmotic pressure); hepatocytes (liver cells) synthesize plasma proteins  Albumins (54%) – transport steroid hormones  Globulins (38%) – antibodies help attack viruses and bacteria  Fibrinogen (7%) – plays essential role in blood clotting  Other solutes (1.5%) – electrolytes, nutrients, gases, regulatory substances, waste products  Components of Blood: Formed Elements o Makes up 45% of blood; include 3 principal components -  Erythrocytes (red blood cells RBCs) – contain oxygen-carrying protein (hemoglobin); accounts for 99% of formed elements; mature cells enter circulation at a rate of 2 million/sec/ RBC destruction occurs at this same rate  Leukocytes (white blood cells WBCs) – protect and fight against diseases  Platelets (thrombocytes) – release substances essential for initiation of blood clotting; plug leaks in vessels  Shock: failure of CV system to deliver enough oxygen and nutrients to meet cellular metabolic needs’ if shock persists, cells and organs become damaged; cells may die unless proper treatment begins quickly; 4 types of shock o Hypovolemic (decreased blood volume) o Cardiogenic (poor heart function) o Vascular (inappropriate vasodilation) o Obstructive (obstruction of blood flow)  Types of Shock: Hypovolemic – common cause is acute hemorrhage; external  trauma; internal aortic aneurysm; excessive sweating, vomiting, diarrhea; steps to the condition: volume of body fluids decreases, venous return to heart drops, filling of heart lessens, stroke volume decreases, cardiac output decreases  Types of Shock: Cardiogenic – heart fails to pump adequately (often MI); other causes include poor perfusion of heart (ischemia), heart valve problems, excessive preload or afterload, impaired contractility of heart muscle fibers, arrhythmias  Types of Shock: Vascular – if BP drops due to decrease in systematic vascular resistance; some conditions cause excessive dilation: o Anaphylaxis – severe allergic reaction releases histamines that cause vasodilation o Neurogenic shock – vasodilation following head trauma causes CV center malfunction in medulla o Septic shock – bacterial toxins cause vasodilation (100,000 deaths per year in US, most common cause of death in critical care unit patients)  Types of Shock: Obstructive – occurs when blood flow through a portion of the circulation is blocked; pulmonary embolism  most common cause of obstructive shock; a blood clot lodged in a blood vessel of the lungs 8C Cardiovascular System continued …  Structure & Function of Blood Vessels: o 5 main types of blood vessels – Arteries (carry blood away from the heart to other organs), Arterioles (very small arteries), Capillaries (tiny vessels that allow exchange of substances between blood and body tissues), Venules (very small veins), Veins (carry blood from the tissues back to the heart)  Blood Vessels: Arteries – carry blood away from the heart to tissues; consists of three coats (tunics)  Tunica interna – innermost coat: elastic tissue & endothelial lining  Tunica media – thickest layer: elastic fibers and smooth m. fibers; high compliance of arteries due to this coat  Tunica externa – outmost coat: elastic and collagen fibers o Elastic Arteries: aka conducting arteries; typical of large-diameter (>1cm) arteries; walls stretch to accommodate surge of blood; function as a pressure reservoir; fibers recoil causing blood flow (even without ventricular contraction); ex. aorta, brachiocephalic, common carotid, subclavian, vertebral, pulmonary, and common iliac arteries o Muscular Arteries: aka distributing arteries because they distribute blood to different parts of the body; typical of medium-sized arteries (.1-10mm); capable of greater vasoconstriction (narrowing of blood vessel) and vasodilation (widening of vessel); very thick walls; ex. brachial artery in arm and radial a. in forearm


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