UNIVERSITY OF LA SALETTE, INC.

Santiago City, Isabela, Philippines

College of Nursing, Public Health & Midwifery

PCNPHM 001 – ANATOMY & PHYSIOLOGY LEC & LAB

LEARNING MODULE
Prepared by: MELISSA D. SARMIENTO, RN, RM, MSN

COURSE DESCRIPTION: This course deals with the physiologic concepts, principles and basic anatomical
structure.

This Anatomy and Physiology module introduces the structure and function of the human body. The
student will read about the cells, tissues and membranes that make up our bodies and how our major systems
function to help us develop and stay healthy.

MODULE I: THE HUMAN BODY: AN ORIENTATION

INTENDED LEARNING OUTCOMES:

Students are expected to:
• use proper anatomical terminology to describe body directions, surfaces and body planes.
• locate the major body cavities, and list the chief organs in each cavity.
• define homeostasis, negative feedback, explain its importance

LEARNING MATERIALS:
An Overview of Anatomy and Physiology
• Anatomy is the study of structure. Observation is used to see the sizes, shapes, and relationships of body
parts.
• Physiology is the study of how a structure (which may be a cell, an organ, or an organ system) functions
or works.

Levels of Structural Organization

There are six levels of structural organization.
• Atoms (at the chemical level) combine, forming the unit of life, the cell.
• Cells are grouped into tissues, which in turn are arranged in specific ways to form organs.
• An organ system is a group of organs that performs a specific function for the body (which no other
organ system can do). Together, all of the organ systems form the organism, or living body.
❖ Eleven organ systems make up the human body: the integumentary, skeletal, muscular, nervous,
endocrine, cardiovascular, lymphatic, respiratory, digestive, urinary, and reproductive systems.

Maintaining Life
• To sustain life, an organism must be able to maintain its boundaries, move, respond to stimuli, digest
nutrients and excrete wastes, carry on metabolism, reproduce itself, and grow.
• Survival needs include food, oxygen, water, appropriate temperature, and normal atmospheric
pressure.

Homeostasis
• is necessary for survival and good health; its loss results in illness.
• All homeostatic control mechanisms have three components:
(1) a receptor that responds to environmental changes (stimuli) and
(2) a control center that assesses those changes and produces a response by activating
(3) the effector.

• Most homeostatic control systems are negative feedback systems, which act to reduce or stop the initial
stimulus.

THE LANGUAGE OF ANATOMY

Anatomical position, or standard anatomical position
• refers to the positioning of the body when it is standing upright and facing forward with each arm
hanging on either side of the body, and the palms facing forward. The legs are parallel, with feet flat on
the floor and facing forward
Directional terms
o Superior (cranial, cephalic): above something else, toward the head.
o Inferior (caudal): below something else, toward the tail.
o Anterior (ventral): toward the front of the body or structure.
o Posterior (dorsal): toward the rear or back of the body or structure.
o Medial: toward the midline of the body.
o Lateral: away from the midline of the body.
o Proximal: closer to the point of attachment.
o Distal: farther from the point of attachment.
o Superficial (external): at or close to the body surface.
o Deep (internal): below or away from the body surface.

Regional terms. Visible landmarks on the body surface may be used to specifically refer to a body part or area.
These terms are sometimes used in describing the position of the body during specific physical
examinations or surgical procedures.
• The nine anatomical regions of the abdomen include the midline regions (epigastric, umbilical, and
hypogastric) and bilateral regions (left and right hypochondriac, lumbar, and iliac)
Body planes and sections
• Median sagittal/midsagittal plane is a vertical plane passing through the middle of the body, dividing it
into equal right and left halves. Planes parallel to this plane are called a sagittal or paramedian plane.
Thus the paramedian plane is a vertical plane that divides the body into right and left parts.
• Frontal or Coronal plane is the vertical plane at the right angle to the sagittal plane, and it divides the
body into anterior & posterior parts.
• Horizontal or the transverse planes are at right angles to both the sagittal & the coronal planes. It can
divide the body into upper and lower parts.

Terms of position

Body cavities
 ▪ Ventral: less protected than dorsal cavity; has two subdivisions.
▪ Thoracic: The superior cavity that extends inferiorly to the diaphragm; contains heart and lungs,
which are protected by the rib cage.
▪ Abdominopelvic: The cavity inferior to the diaphragm that contains the digestive, urinary, and
reproductive organs. The abdominal portion is vulnerable because it is protected only by the trunk
muscles. The pelvic portion is somewhat protected by the bony pelvis. The abdominopelvic cavity is
often divided into four quadrants or nine regions.
The lower part of the ventral (abdominopelvic) cavity can be further divided into two
portions: abdominal portion and pelvic portion. The abdominal cavity contains most of
the gastrointestinal tract as well as the kidneys and adrenal glands. The pelvic cavity
contains most of the urogenital system as well as the rectum.
▪ Dorsal cavity
The smaller of the two main cavities.
it contains organs lying more posterior in the body.
well protected by bone; has two subdivisions
a. Cranial: contains the brain.
b. Spinal: contains the spinal cord.
Smaller body cavities include the oral, nasal, orbital, and middle ear cavities. All are open to the outside of the
body except the middle ear cavity.

Review: Introduction to the Human Body

Here is what we have learned from Introduction to the Human Body:
• The human body is a single structure but it is made up of billions of smaller structures of four major
kinds: cells, tissues, organs, and systems.
• An organ is an organization of several different kinds of tissues so arranged that together they can
perform a special function.
• A system is an organization of varying numbers and kinds of organs so arranged that together they can
perform complex functions for the body.
• Ten major systems include the skeletal, muscular, nervous, endocrine, cardiovascular, lymphatic,
respiratory, digestive, urinary, and the reproductive system.
• Body functions are the physiological or psychological functions of body systems. Survival of the body
depends on the body's maintaining or restoring homeostasis, a state of relative constancy, of its internal
environment.
• Human life process includes organization, metabolism, responsiveness, movements, reproduction,
growth, differentiation, respiration, digestion, and excretion. All these processes work together, in fine-
tuned balance, for the well-being of the individual and to maintain life.
• Life depends on certain physical factors from the environment, which include water, oxygen, nutrients,
heat, and pressure.
• Useful terms for describing body parts and activities include:
o Directional terms
o Terms describing planes of the body
o Terms describing body cavities
MODULE II : THE BODY TISSUES

INTENDED LEARNING OUTCOMES:

Students are expected to:
• name the four major tissue types and their chief subcategories.
• explain how the four major tissue types differ structurally and functionally
• give the location of the various tissue types

LEARNING MATERIALS:
TISSUE - is a grouping of like cells working together.
• make up organs. An organ is a structure performing a particular function. An organ is composed of several
different tissues
• is a group of cells that have similar structure and that function together as a unit. A nonliving material,
called the intercellular matrix, fills the spaces between the cells. This may be abundant in some tissues
and minimal in others. The intercellular matrix may contain special substances such as salts and fibers that
are unique to a specific tissue and gives that tissue distinctive characteristics.
• There are four main tissue types in the body: epithelial, connective, muscle, and nervous. Each is designed
for specific functions

Four Main Types of Tissue in the Body

1. Epithelial tissues
• widespread throughout the body
• form the covering of all body surfaces, line body cavities and hollow organs, and are the major tissue in
glands
• perform a variety of functions that include protection, secretion, absorption, excretion,
filtration, diffusion, and sensory reception.
• The cells in epithelial tissue are tightly packed together with very little intercellular matrix. Opposite the
free surface, the cells are attached to underlying connective tissue by a non-cellular basement membrane.
This membrane is a mixture of carbohydrates and proteins secreted by the epithelial and connective
tissue cells.
• Epithelial cells may be squamous, cuboidal, or columnar in shape and may be arranged in single or multiple
layers.

A. Simple cuboidal epithelium - is found in glandular tissue and in the kidney tubules.
B. Simple columnar epithelium - lines the stomach and intestines.
C. Pseudostratified columnar epithelium - lines portions of the respiratory tract and some of the tubes of the
male reproductive tract.
D. Transitional epithelium - can be distended or stretched.
E. Glandular epithelium - is specialized to produce and secrete substances.

2. Connective Tissue
• bind structures together, form a framework and support for organs and the body as a whole, store fat,
transport substances, protect against disease, and help repair tissue damage
• occur throughout the body and are characterized by an abundance of intercellular matrix with relatively
few cells
• able to reproduce but not as rapidly as epithelial cells.
• Most connective tissues have a good blood supply but some do not

Numerous cell types are found in connective tissue. Three of the most common are the fibroblast, macrophage,
and mast cell. The types of connective tissue include loose connective tissue, adipose tissue,
dense fibrous connective tissue, elastic connective tissue, cartilage, osseous tissue (bone), and blood.

3. Muscle Tissue
• is composed of cells that have the special ability to shorten or contract in order to produce movement of
the body parts
• is highly cellular and is well supplied with blood vessels
• The cells are long and slender so they are sometimes called muscle fibers, and these are usually arranged
in bundles or layers that are surrounded by connective tissue.
• Actin and myosin are contractile proteins in muscle tissue.

Muscle tissue can be categorized into skeletal muscle tissue, smooth muscle tissue, and cardiac muscle tissue.

A. Skeletal muscle fibers are cylindrical, multinucleated, striated, and under voluntary control.
B. Smooth muscle cells are spindle shaped, have a single, centrally located nucleus, and lack striations. They are
called involuntary muscles.
C. Cardiac muscle has branching fibers, one nucleus per cell, striations, and intercalated disks. Its contraction is
not under voluntary control.

4. Nervous Tissue
• is found in the brain, spinal cord, and nerves
• responsible for coordinating and controlling many body activities
• It stimulates muscle contraction, creates an awareness of the environment, and plays a major role in
emotions, memory, and reasoning. To do all these things, cells in nervous tissue need to be able to
communicate with each other by way of electrical nerve impulses.
• The cells in nervous tissue that generate and conduct impulses are called neurons or nerve cells. These
cells have three principal parts: the dendrites, the cell body, and one axon.
• The main part of the cell, the part that carries on the general functions, is the cell body. Dendrites are
extensions, or processes, of the cytoplasm that carry impulses to the cell body.
An extension or process called an axon carries impulses away from the cell body.
• Nervous tissue also includes cells that do not transmit impulses, but instead support the activities of the
neurons. These are the glial cells (neuroglial cells), together termed the neuroglia. Supporting, or glia,
cells bind neurons together and insulate the neurons. Some are phagocytic and protect against bacterial
invasion, while others provide nutrients by binding blood vessels to the neurons.

Membranes
• are thin sheets of tissue that cover the body, line body cavities, and cover organs within the cavities in
hollow organs.
• They can be categorized into epithelial and connective tissue membrane.
A. Epithelial Membranes
• consist of epithelial tissue and the connective tissue to which it is attached.
• The two main types of epithelial membranes are the mucous membranes and serous membranes.
A.1 Mucous Membranes
o are epithelial membranes that consist of epithelial tissue that is attached to an underlying loose
connective tissue.
o These membranes, sometimes called mucosae, line the body cavities that open to the outside. The
entire digestive tract is lined with mucous membranes. Other examples include the respiratory, excretory,
and reproductive tracts.
A.2 Serous Membranes
o line body cavities that do not open directly to the outside, and they cover the organs located in those
cavities
o are covered by a thin layer of serous fluid that is secreted by the epithelium.
o Serous fluid lubricates the membrane and reduces friction and abrasion when organs in the thoracic
or abdominopelvic cavity move against each other or the cavity wall
o have special names given according to their location. For example, the serous membrane that lines
the thoracic cavity and covers the lungs is called pleura.
B. Connective Tissue Membranes
• contain only connective tissue. Synovial membranes and meninges belong to this category.
B.1 Synovial Membranes
o are connective tissue membranes that line the cavities of the freely movable joints such as the shoulder,
elbow, and knee
o Like serous membranes, they line cavities that do not open to the outside. Unlike serous membranes,
they do not have a layer of epithelium.
o secrete synovial fluid into the joint cavity, and this lubricates the cartilage on the ends of the bones so
that they can move freely and without friction.
B.2 Meninges
o The connective tissue covering on the brain and spinal cord, within the dorsal cavity, are called
meninges. They provide protection for these vital structures.

Review: Cells, Tissues, and Membranes

Here is what we have learned from Cells, Tissues, and Membranes:
• Basically, a cell consists of three parts: the cell membrane, the nucleus, and between the two, the
cytoplasm.
• The cell nucleus contains genetic material and regulates activities of the cell. It determines how the cell
will function, as well as the basic structure of that cell.
• All of the functions for cell expansion, growth and replication are carried out in the cytoplasm of a cell.
• Tissue is a group of cells that have similar structure and that function together as a unit. Primary types of
body tissues include epithelial, connective, muscular, and nervous tissues.
• Epithelial tissues form the covering of all body surfaces, line body cavities and hollow organs, and are the
major tissue in glands.
• Connective tissues bind structures together, form a framework and support for organs and the body as a
whole, store fat, transport substances, protect against disease, and help repair tissue damage.
• Muscle tissue is composed of cells that have the special ability to shorten or contract in order to produce
movement of body parts.
• Nervous tissue is responsible for coordinating and controlling many body activities.
• Body membranes are thin sheets of tissue that cover the body, line body cavities, and cover organs within
the cavities in hollow organs.
• Two main categories of body membranes are epithelial and connective tissue membranes. Sub-categories
include mucous membranes, serous membranes, synovial membranes, and meninges.

MODULE III: THE SKELETAL SYSTEM

INTENDED LEARNING OUTCOMES:

Students are expected to:
• Discuss the major division of the skeletal system
• Categorize the different bones according to major divisions where they belong and the shape of the
bone
• Identify the different bone markings seen on the surfaces of bones and state their functions.
• Show the different type of movements of joints

LEARNING MATERIALS:
• Humans are vertebrates, animals having a vertebral column or backbone. They rely on a
sturdy internal frame that is centered on a prominent spine.
• The human skeletal system consists of bones, cartilage, ligaments and tendons and accounts for about 20
percent of the body weight.
• The living bones in our bodies use oxygen and give off waste products in metabolism. They contain active
tissues that consume nutrients, require a blood supply and change shape or remodel in response to
variations in mechanical stress.
 • Bones provide a rigid framework, known as the skeleton that support and protect the soft organs of the
body. The skeleton supports the body against the pull of gravity. The large bones of the lower limbs
support the trunk when standing. The skeleton also protects the soft body parts. The fused bones of
the cranium surround the brain to make it less vulnerable to injury. Vertebrae surround and protect
the spinal cord and bones of the rib cage help protect the heart and lungs of the thorax.
• Bones work together with muscles as simple mechanical lever systems to produce body movement.
• Bones contain more calcium than any other organ. The intercellular matrix of bone contains large
amounts of calcium salts, the most important being calcium phosphate.
• When blood calcium levels decrease below normal, calcium is released from the bones so that there will
be an adequate supply for metabolic needs. When blood calcium levels are increased, the excess calcium
is stored in the bone matrix. The dynamic process of releasing and storing calcium goes on almost
continuously.
• Hematopoiesis, the formation of blood cells, mostly takes place in the red marrow of the bones.
• In infants, red marrow is found in the bone cavities. With age, it is largely replaced by yellow marrow for
fat storage. In adults, red marrow is limited to the spongy bone in the skull, ribs, sternum, clavicles,
vertebrae and pelvis. Red marrow functions in the formation of red blood cells, white blood cells and
blood platelets.

Structure of Bone Tissue

• There are two types of bone tissue: compact and spongy. The names imply that the two types differ in
density, or how tightly the tissue is packed together.
• There are three types of cells that contribute to bone homeostasis.
A. Osteoblasts are bone-forming cell,
B. Osteoclasts resorb or break down bone, and
C. Osteocytes are mature bone cells.
• An equilibrium between osteoblasts and osteoclasts maintains bone tissue.

1. Compact Bone
• consists of closely packed osteons or haversian systems. The osteon consists of a central canal called the
osteonic (haversian) canal, which is surrounded by concentric rings (lamellae) of matrix.
• Between the rings of matrix, the bone cells (osteocytes) are located in spaces called lacunae. Small
channels (canaliculi) radiate from the lacunae to the osteonic (haversian) canal to provide passageways
through the hard matrix.
• In compact bone, the haversian systems are packed tightly together to form what appears to be a
solid mass. The osteonic canals contain blood vessels that are parallel to the long axis of the bone. These
blood vessels interconnect, by way of perforating canals, with vessels on the surface of the bone.

2. Spongy (Cancellous) Bone

• is lighter and less dense than compact bone
 • consists of plates (trabeculae) and bars of bone adjacent to small, irregular cavities that contain red bone
marrow.
• The canaliculi connect to the adjacent cavities, instead of a central haversian canal, to receive their blood
supply. It may appear that the trabeculae are arranged in a haphazard manner, but they are organized to
provide maximum strength similar to braces that are used to support a building. The trabeculae of spongy
bone follow the lines of stress and can realign if the direction of stress changes.

Bone Development & Growth

• The terms osteogenesis and ossification are often used synonymously to indicate
the process of bone formation. Parts of the skeleton form during the first few weeks after conception. By
the end of the eighth week after conception, the skeletal pattern is formed in cartilage and connective
tissue membranes and ossification begins.
• Bone development continues throughout adulthood. Even after adult stature is attained, bone
development continues for repair of fractures and for remodeling to meet changing lifestyles.
• Osteoblasts, osteocytes and osteoclasts are the three cell types involved in the development, growth and
remodeling of bones. Osteoblasts are bone-forming cells, osteocytes are mature bone cells and
osteoclasts break down and reabsorb bone.

There are two types of ossification: intramembranous and endochondral.

1. Intramembranous
• involves the replacement of sheet-like connective tissue membranes with bony tissue. Bones formed in
this manner are called intramembranous bones. They include certain flat bones of the skull and some of
the irregular bones. The future bones are first formed as connective tissue membranes. Osteoblasts
migrate to the membranes and deposit bony matrix around themselves. When the osteoblasts are
surrounded by matrix they are called osteocytes.
2. Endochondral Ossification
• involves the replacement of hyaline cartilage with bony tissue. Most of the bones of the skeleton are
formed in this manner. These bones are called endochondral bones. In this process, the future bones are
first formed as hyaline cartilage.

Bone Growth
• Bones grow in length at the epiphyseal plate by a process that is similar to endochondral ossification. The
cartilage in the region of the epiphyseal plate next to the epiphysis continues to grow by mitosis. The
chondrocytes, in the region next to the diaphysis, age and degenerate.
• Osteoblasts move in and ossify the matrix to form bone. This process continues throughout childhood and
the adolescent years until the cartilage growth slows and finally stops.
• When cartilage growth ceases, usually in the early twenties, the epiphyseal plate completely ossifies so
that only a thin epiphyseal line remains and the bones can no longer grow in length.
• Bone growth is under the influence of growth hormone from the anterior pituitary gland and sex
hormones from the ovaries and testes.
• Even though bones stop growing in length in early adulthood, they can continue to increase in thickness
or diameter throughout life in response to stress from increased muscle activity or to weight. The
increase in diameter is called appositional growth. Osteoblasts in the periosteum form compact bone
around the external bone surface. At the same time, osteoclasts in the endosteum break down bone on
the internal bone surface, around the medullary cavity. These two processes together increase the
diameter of the bone and, at the same time, keep the bone from becoming excessively heavy and bulky.
Classification of Bones
1. Long Bones

• Bones that are longer than they are wide are called long bones. They consist of a long shaft with two bulky
ends or extremities. They are primarily compact bone but may have a large amount of spongy bone at the
ends or extremities. Long bones include bones of the thigh, leg, arm, and forearm.
2. Short Bones
• are roughly cube shaped with vertical and horizontal dimensions approximately equal. They consist
primarily of spongy bone, which is covered by a thin layer of compact bone. Short bones include the bones
of the wrist and ankle.
3. Flat Bones
• are thin, flattened, and usually curved. Most of the bones of the cranium are flat bones.
4. Irregular Bones
• Bones that are not in any of the above three categories are classified as irregular bones. They are primarily
spongy bone that is covered with a thin layer of compact bone. The vertebrae and some of the bones in
the skull are irregular bones.

❖ All bones have surface markings and characteristics that make a specific bone unique. There are holes,
depressions, smooth facets, lines, projections and other markings. These usually represent passageways
for vessels and nerves, points of articulation with other bones or points of attachment for tendons and
ligaments.

Divisions of the Skeleton

❖ The adult human skeleton usually consists of 206 named bones. These bones can be grouped in two
divisions: axial skeleton and appendicular skeleton.
❖ The 80 bones of the axial skeleton form the vertical axis of the body. They include the bones of
the head, vertebral column, ribs and breastbone or sternum.
❖ The appendicular skeleton consists of 126 bones and includes the free appendages and their
attachments to the axial skeleton. The free appendages are the upper and lower extremities, or limbs,
and their attachments which are called girdles. The named bones of the body are listed below by
category.
Skull (28)

• Parietal (2)
• Temporal (2)
• Frontal (1)
• Occipital (1)
• Ethmoid (1)
• Sphenoid (1)

• Maxilla (2)
• Zygomatic (2)
• Mandible (1)
• Nasal (2)
• Platine (2)
• Inferior nasal concha (2)
• Lacrimal (2)
• Vomer (1)

Auditory Ossicles
• Malleus (2)
• Incus (2)
• Stapes (2)
• Hyoid (1)
 • Cervical vertebrae (7)
• Thoracic vertebrae (12)
• Lumbar vertebrae (5)
• Sacrum (1)
• Coccyx (1)

• Sternum (1)
• Ribs (24)

Appendicular Skeleton (126 bones)

Pectoral girdles
• Clavicle (2)
• Scapula (2)

• Humerus (2)
• Radius (2)
• Ulna (2)
• Carpals (16)
• Metacarpals (10)
• Phalanges (28)

• Coxal, innominate, or hip bones (2)

Lower Extremity
• Femur (2)
• Tibia (2)
• Fibula (2)
• Patella (2)
• Tarsals (14)
• Metatarsals (10)
• Phalanges (28)

Articulations
❖ An articulation, or joint, is where two bones come together. In terms of the amount of movement they
allow, there are three types of joints: immovable, slightly movable and freely movable.
1. Synarthroses
❖ are immovable joints. The singular form is synarthrosis. In these joints, the bones come in very close
contact and are separated only by a thin layer of fibrous connective tissue. The sutures in the skull are
examples of immovable joints.
2. Amphiarthroses
❖ Slightly movable joints
❖ The singular form is amphiarthrosis.
❖ the bones are connected by hyaline cartilage or fibrocartilage.
❖ The ribs connected to the sternum by costal cartilages are slightly movable joints connected by hyaline
cartilage.
❖ The symphysis pubis is a slightly movable joint in which there is a fibrocartilage pad between the two
bones. The joints between the vertebrae and the intervertebral disks are also of this type.

3. Diarthroses
❖ Most joints in the adult body are diarthroses, or freely movable joints.
❖ The singular form is diarthrosis.
❖ the ends of the opposing bones are covered with hyaline cartilage, the articular cartilage, and they are
separated by a space called the joint cavity. The components of the joints are enclosed in a dense fibrous
joint capsule. The outer layer of the capsule consists of the ligaments that hold the bones together. The
inner layer is the synovial membrane that secretes synovial fluid into the joint cavity for lubrication.
Because all of these joints have a synovial membrane, they are sometimes called synovial joints.

Review: The Skeletal System

Here is what we have learned from the Skeletal System:
 • The human skeleton is well-adapted for the functions it must perform. Functions of bones include support,
protection, movement, mineral storage, and formation of blood cells.
• There are two types of bone tissue: compact and spongy. Compact bone consists of closely packed
osteons, or haversian system. Spongy bone consists of plates of bone, called trabeculae, around irregular
spaces that contain red bone marrow.
• Osteogenesis is the process of bone formation. Three types of cells, osteoblasts, osteocytes, and
osteoclasts, are involved in bone formation and remodeling.
• In intramembranous ossification, connective tissue membranes are replaced by bone. This process occurs
in the flat bones of the skull. In endochondral ossification, bone tissue replaces hyaline cartilage models.
Most bones are formed in this manner.
• Bones grow in length at the epiphyseal plate between the diaphysis and the epiphysis. When the
epiphyseal plate completely ossifies, bones no longer increase in length.
• Bones may be classified as long, short, flat, or irregular. The diaphysis of a long bone is the central shaft.
There is an epiphysis at each end of the diaphysis.
• The adult human skeleton usually consists of 206 named bones and these bones can be grouped in two
divisions: axial skeleton and appendicular skeleton.
• The bones of the skeleton are grouped in two divisions: axial skeleton and appendicular skeleton.
• There are three types of joints in terms of the amount of movement they allow: synarthroses (immovable),
amphiarthroses (slightly movable), and diarthroses (freely movable).

MODULE IV: THE MUSCULAR SYSTEM

INTENDED LEARNING OUTCOMES:

The students are expected to:
• Identify the different muscles in the human body
• Describe the origin, insertion and action of major muscles
• State the action of each muscle

LEARNING MATERIALS:
• The muscular system is composed of specialized cells called muscle fibers. Their predominant function is
contractibility. Muscles, attached to bones or internal organs and blood vessels, are responsible for
movement. Nearly all movement in the body is the result of muscle contraction. Exceptions to this are the
action of cilia, the flagellum on sperm cells, and amoeboid movement of some white blood cells.
• The integrated action of joints, bones, and skeletal muscles produces obvious movements such as walking
and running. Skeletal muscles also produce more subtle movements that result in
various facial expressions, eye movements, and respiration.
• In addition to movement, muscle contraction also fulfills some other important functions in the body,
such as posture, joint stability, and heat production. Posture, such as sitting and standing, is maintained
as a result of muscle contraction.
The skeletal muscles are continually making fine adjustments that hold the body in stationary positions.
• The tendons of many muscles extend over joints and in this way contribute to joint stability. This is
particularly evident in the knee and shoulder joints, where muscle tendons are a major factor in stabilizing
the joint. Heat production, to maintain body temperature, is an important by-product of
muscle metabolism.
• Nearly 85 percent of the heat produced in the body is the result of muscle contraction.

Structure of Skeletal Muscle

❖ A whole skeletal muscle is considered an organ of the muscular system. Each organ or muscle consists of
skeletal muscle tissue, connective tissue, nerve tissue, and blood or vascular tissue.
❖ Skeletal muscles vary considerably in size, shape, and arrangement of fibers.
Muscle Types
1. Skeletal Muscle
• attached to bones, is responsible for skeletal movements.
• The peripheral portion of the central nervous system (CNS) controls the skeletal muscles. Thus, these
muscles are under conscious, or voluntary, control.
• The basic unit is the muscle fiber with many nuclei. These muscle fibers are striated
(having transverse streaks) and each acts independently of neighboring muscle fibers.
2. Smooth Muscle
• found in the walls of the hollow internal organs such as blood vessels, the gastrointestinal tract, bladder,
and uterus, is under control of the autonomic nervous system
• cannot be controlled consciously and thus acts involuntarily.
• The non-striated (smooth) muscle cell is spindle-shaped and has one central nucleus. Smooth muscle
contracts slowly and rhythmically.
3. Cardiac Muscle
• found in the walls of the heart, is also under control of the autonomic nervous system
• has one central nucleus, like smooth muscle, but it also is striated, like skeletal muscle.
• The cardiac muscle cell is rectangular in shape. The contraction of cardiac muscle is involuntary, strong,
and rhythmical.

Muscle Groups
• There are more than 600 muscles in the body, which together account for about 40 percent of a person's
weight.
• Most skeletal muscles have names that describe some feature of the muscle. Often several criteria are
combined into one name. Associating the muscle's characteristics with its name will help you learn and
remember them. The following are some terms relating to muscle features that are used in naming
muscles.
Size: vastus (huge); maximus (large); longus (long); minimus (small); brevis (short).
Shape: deltoid (triangular); rhomboid (like a rhombus with equal and parallel sides); latissimus (wide);
teres (round); trapezius (like a trapezoid, a four-sided figure with two sides parallel).
Direction of fibers: rectus (straight); transverse (across); oblique (diagonally); orbicularis (circular).
Location: pectoralis (chest); gluteus (buttock or rump); brachii (arm); supra- (above); infra- (below); sub-
(under or beneath); lateralis (lateral).
Number of origins: biceps (two heads); triceps (three heads); quadriceps (four heads).
Origin and insertion: sternocleidomastoideus (origin on the sternum and clavicle, insertion on the
mastoid process); brachioradialis (origin on the brachium or arm, insertion on the radius).
Action: abductor (to abduct a structure); adductor (to adduct a structure); flexor (to flex a structure);
extensor (to extend a structure); levator (to lift or elevate a structure); masseter (a chewer).
 Muscles of the Head and Neck
Humans have well-developed muscles in the face that permit a large variety of facial expressions. Because
the muscles are used to show surprise, disgust, anger, fear, and other emotions, they are an important
means of nonverbal communication.
Muscles of facial expression include frontalis, orbicularis oris, laris oculi, buccinator, and
zygomaticus.These muscles of facial expressions are identified in the illustration below.

o There are four pairs of muscles that are responsible for chewing movements or mastication. All of these
muscles connect to the mandible and they are some of the strongest muscles in the body. Two of the
muscles, temporalis and masseter, are identified in the illustration above.
o There are numerous muscles associated with the throat, the hyoid bone and the vertebral column; only
two of the more obvious and superficial neck muscles are identified in the illustration:
sternocleidomastoid and trapezius.

Muscles of the Trunk

The muscles of the trunk include those that move the vertebral column, the muscles that form the thoracic
and abdominal walls, and those that cover the pelvic outlet.

The erector spinae group of muscles on each side of the vertebral column is a large muscle mass that
extends from the sacrum to the skull. These muscles are primarily responsible for extending the vertebral
column to maintain erect posture. The deep back muscles occupy the space between the spinous
and transverse processes of adjacent vertebrae.
The muscles of the thoracic wall are involved primarily in the process of breathing. The intercostal
muscles are located in spaces between the ribs. They contract during forced expiration.
 External intercostal muscles contract to elevate the ribs during the inspiration phase of breathing. The
diaphragm is a dome-shaped muscle that forms a partition between the thorax and the abdomen. It has
three openings in it for structures that have to pass from the thorax to the abdomen.
The abdomen, unlike the thorax and pelvis, has no bony reinforcements or protection. The wall consists
entirely of four muscle pairs, arranged in layers, and the fascia that envelops them. The pelvic outlet is
formed by two muscular sheets and their associated fascia.

Muscles of the Upper Extremity

The muscles of the upper extremity include those that attach the scapula to the thorax and generally
move the scapula, those that attach the humerus to the scapula and generally move the arm, and those
that are located in the arm or forearm that move the forearm, wrist, and hand.

Muscles that move the shoulder and arm include the trapezius and serratus anterior. The pectoralis
major, latissimus dorsi, deltoid, and rotator cuff muscles connect to the humerus and move the arm.
The muscles that move the forearm are located along the humerus, which include the triceps brachii,
biceps brachii, brachialis, and brachioradialis. The 20 or more muscles that cause most wrist, hand, and
finger movements are located along the forearm.

Muscles of the Lower Extremity

The muscles that move the thigh have their origins on some part of the pelvic girdle and their insertions
on the femur.
The largest muscle mass belongs to the posterior group, the gluteal muscles, which, as a group, adduct
the thigh. The iliopsoas, an anterior muscle, flexes the thigh. The muscles in the medial compartment
adduct the thigh. The illustration below shows some of the muscles of the lower extremity.
 Muscles that move the leg are located in the thigh region. The quadriceps femoris muscle group
straightens the leg at the knee. The hamstrings are antagonists to the quadriceps femoris muscle group,
which are used to flex the leg at the knee.
The muscles located in the leg that move the ankle and foot are divided into anterior, posterior,
and lateral compartments. The tibialis anterior, which dorsiflexes the foot, is antagonistic to the
gastrocnemius and soleus muscles, which plantar flex the foot.

Review: The Muscular System

Here is what we have learned from the Muscular System:
• One of the most predominant characteristics of skeletal muscle tissue is its contractility and nearly all
movement in the body is the result of muscle contraction.
• Four functions of muscle contraction are movement, posture, joint stability, and heat production.
• Three types of muscle are skeletal, smooth, and cardiac.
• Each muscle fiber is surrounded by endomysium. The fibers are collected into bundles covered by
perimysium. Many bundles, or fasciculi, are wrapped together by the epimysium to form a whole muscle.
• Muscles are attached to bones by tendons.
• Muscle features such as size, shape, direction of fibers, location, number of origin, origin and insertion,
and action are often used in naming muscles.
• Four major muscle groups of the body include:
o Muscles of the head and neck;
o Muscles of the trunk;
o Muscles of the upper extremity; and
o Muscles of the lower extremity.

MODULE V: THE NERVOUS SYSTEM

INTENDED LEARNING OUTCOMES:

Students are expected to:
▪ list the general functions of the nervous system
▪ explain the structural and functional classifications of the nervous system
▪ define central nervous system and peripheral nervous system, and list the major parts of each
▪ describe the structures and functions of neurons and neuroglia
▪ describe the general structure of a neuron, and name its important anatomical regions.
▪ describe the composition of gray matter and white matter
▪ classify neurons according to structure and function
▪ identify and indicate the functions of the major regions of the cerebral hemispheres, diencephalon, brain
stem, and cerebellum
▪ name the three meningeal layers, and state their functions
▪ discuss the formation and function of cerebrospinal fluid, and the blood-brain barrier
▪ describe the general structure of a nerve
▪ identify the cranial nerves by number and by name, and list the major functions of each
▪ explain the function of the sympathetic and parasympathetic divisions of the autonomic nervous system
▪ contrast the effect of the parasympathetic and sympathetic divisions on the following organs: heart, lungs,
digestive

LEARNING MATERIALS:
• The nervous system is the major controlling, regulatory, and communicating system in the body. It is the
center of all mental activity including thought, learning, and memory.
• Together with the endocrine system, the nervous system is responsible for regulating and
maintaining homeostasis. Through its receptors, the nervous system keeps us in touch with our
 environment, both external and internal.
• Like other systems in the body, the nervous system is composed of organs, principally the brain, spinal
cord, nerves, and ganglia. These, in turn, consist of various tissues, including nerve, blood, and connective
tissue. Together these carry out the complex activities of the nervous system.

The various activities of the nervous system can be grouped together as three general, overlapping functions:
• Sensory
• Integrative
• Motor
Millions of sensory receptors detect changes, called stimuli, which occur inside and outside the body.
They monitor such things as temperature, light, and sound from the external environment. Inside the
body, the internal environment, receptors detect variations in pressure, pH, carbon
dioxide concentration, and the levels of various electrolytes. All of this gathered information is called
sensory input.
Sensory input is converted into electrical signals called nerve impulses that are transmitted to the brain.
There the signals are brought together to create sensations, to produce thoughts, or to add to memory;
Decisions are made each moment based on the sensory input. This is integration.
Based on the sensory input and integration, the nervous system responds by sending signals to muscles,
causing them to contract, or to glands, causing them to produce secretions. Muscles and glands are called
effectors because they cause an effect in response to directions from the nervous system. This is
the motor output or motor function.

Nerve Tissue
• Although the nervous system is very complex, there are only two main types of cells in nerve tissue. The
actual nerve cell is the neuron. It is the "conducting" cell that transmits impulses and the structural unit
of the nervous system.
• The other type of cell is neuroglia, or glial, cell. The word "neuroglia" means "nerve glue." These cells are
nonconductive and provide a support system for the neurons. They are a special type of "connective
tissue" for the nervous system.

Neurons
• or nerve cells, carry out the functions of the nervous system by conducting nerve impulses. They are highly
specialized and amitotic. This means that if a neuron is destroyed, it cannot be replaced because neurons
do not go through mitosis. The image below illustrates the structure of a typical neuron.

Each neuron has three basic parts: cell body (soma), one or more dendrites, and a single axon.
Organization of the Nervous System
The nervous system as a whole is divided into two subdivisions:
1. The Central Nervous System (CNS)
• The brain and spinal cord are the organs of the central nervous system. Because they are so vitally
important, the brain and spinal cord, located in the dorsal body cavity, are encased in bone for protection.
The brain is in the cranial vault, and the spinal cord is in the vertebral canal of the vertebral column.
Although considered to be two separate organs, the brain and spinal cord are continuous at the foramen
magnum.
2. The Peripheral Nervous System (PNS)
• The organs of the peripheral nervous system are the nerves and ganglia. Nerves are bundles
of nerve fibers, much like muscles are bundles of muscle fibers. Cranial nerves and spinal nerves extend
from the CNS to peripheral organs such as muscles and glands. Ganglia are collections, or small knots, of
nerve cell bodies outside the CNS.
• The peripheral nervous system is further subdivided into an afferent (sensory) division and an efferent
(motor) division. The afferent or sensory division transmits impulses from peripheral organs to the CNS.
The efferent or motor division transmits impulses from the CNS out to the peripheral organs to cause an
effect or action.
• Finally, the efferent or motor division is again subdivided into the somatic nervous system and
the autonomic nervous system. The somatic nervous system, also called the somatomotor
or somatic efferent nervous system, supplies motor impulses to the skeletal muscles. Because these
nerves permit conscious control of the skeletal muscles, it is sometimes called the voluntary nervous
system. The autonomic nervous system, also called the visceral efferent nervous system, supplies motor
impulses to cardiac muscle, to smooth muscle, and to glandular epithelium. It is further subdivided into
sympathetic and parasympathetic divisions. Because the autonomic nervous system regulates involuntary
or automatic functions, it is called the involuntary nervous system.

The Central Nervous System

• The CNS consists of the brain and spinal cord, which are located in the dorsal body cavity.
• The brain is surrounded by the cranium, and the spinal cord is protected by the vertebrae. The brain is
continuous with the spinal cord at the foramen magnum. In addition to bone, the CNS is surrounded
by connective tissue membranes, called meninges, and by cerebrospinal fluid.

• There are three layers of meninges around the brain and spinal cord. The outer layer, the dura mater, is
tough white fibrous connective tissue. The middle layer of meninges is arachnoid, which resembles a
cobweb in appearance, is a thin layer with numerous threadlike strands that attach it to the innermost
layer. The space under the arachnoid, the subarachnoid space, is filled with cerebrospinal fluid and
 contains blood vessels. The pia mater is the innermost layer of meninges. This thin, delicate membrane is
tightly bound to the surface of the brain and spinal cord and cannot be dissected away without damaging
Brain
• The brain is divided into the cerebrum, diencephalons, brain stem, and cerebellum.
1. Cerebrum
o The largest and most obvious portion of the brain is the cerebrum, which is divided by a deep longitudinal
fissure into two cerebral hemispheres. The two hemispheres are two separate entities but are connected
by an arching band of white fibers, called the corpus callosum that provides a
communication pathway between the two halves.
o Each cerebral hemisphere is divided into five lobes, four of which have the same name as the bone over
them: the fontal lobe, the parietal lobe, the occipital lobe, and the temporal lobe. A fifth lobe,
the insula or Island of Reil, lies deep within the lateral sulcus.
2. Diencephalon
o The diencephalons is centrally located and is nearly surrounded by the cerebral hemispheres. It includes
the thalamus, hypothalamus, and epithalamus.
o The thalamus, about 80 percent of the diencephalons, consists of two oval masses of gray matter that
serve as relay stations for sensory impulses, except for the sense of smell, going to the cerebral cortex.
o The hypothalamus is a small region below the thalamus, which plays a key role in
maintaining homeostasis because it regulates many visceral activities.
o The epithalamus is the most dorsal portion of the diencephalons. This small gland is involved with the
onset of puberty and rhythmic cycles in the body. It is like a biological clock.
3. Brain Stem
o The brain stem is the region between the diencephalons and the spinal cord. It consists of three
parts: midbrain, pons, and medulla oblongata.
o The midbrain is the most superior portion of the brain stem.
o The pons is the bulging middle portion of the brain stem. This region primarily consists of nerve fibers that
form conduction tracts between the higher brain centers and spinal cord.
o The medulla oblongata, or simply medulla, extends inferiorly from the pons. It is continuous with the
spinal cord at the foramen magnum. All the ascending (sensory) and descending (motor) nerve fibers
connecting the brain and spinal cord pass through the medulla.
4. Cerebellum
o The cerebellum, the second largest portion of the brain, is located below the occipital lobes of the
cerebrum. Three paired bundles of myelinated nerve fibers, called cerebellar peduncles, form
communication pathways between the cerebellum and other parts of the central nervous system.

Ventricles and Cerebrospinal Fluid

• A series of interconnected, fluid-filled cavities are found within the brain. These cavities are the
ventricles of the brain, and the fluid is cerebrospinal fluid (CSF).

Spinal Cord
• The spinal cord extends from the foramen magnum at the base of the skull to the level of the first lumbar
vertebra. The cord is continuous with the medulla oblongata at the foramen magnum. Like the brain, the
spinal cord is surrounded by bone, meninges, and cerebrospinal fluid.
• The spinal cord is divided into 31 segments with each segment giving rise to a pair of spinal nerves. At
the distal end of the cord, many spinal nerves extend beyond the conus medullaris to form a collection
that resembles a horse's tail. This is the cauda equina. In cross section, the spinal cord appears oval in
shape.
The spinal cord has two main functions:
• Serving as a conduction pathway for impulses going to and from the brain. Sensory impulses travel to the
brain on ascending tracts in the cord. Motor impulses travel on descending tracts.
 • Serving as a reflex center. The reflex arc is the functional unit of the nervous system. Reflexes are
responses to stimuli that do not require conscious thought and consequently, they occur more quickly
than reactions that require thought processes. For example, with the withdrawal reflex, the reflex action
withdraws the affected part before you are aware of the pain. Many reflexes are mediated in the spinal
cord without going to the higher brain centers.

The Peripheral Nervous System

• consists of the nerves that branch out from the brain and spinal cord. These nerves form the
communication network between the CNS and the body parts
• The peripheral nervous system is further subdivided into the somatic nervous system and the autonomic
nervous system.
• The somatic nervous system consists of nerves that go to the skin and muscles and is involved in
conscious activities.
• The autonomic nervous system consists of nerves that connect the CNS to the visceral organs such as
the heart, stomach, and intestines. It mediates unconscious activities.

Structure of a Nerve
• A nerve contains bundles of nerve fibers, either axons or dendrites, surrounded by connective tissue.
Sensory nerves contain only afferent fibers, long dendrites of sensory neurons. Motor nerves have only
efferent fibers, long axons of motor neurons. Mixed nerves contain both types of fibers.

Cranial Nerves
• Twelve pairs of cranial nerves emerge from the inferior surface of the brain. All of these nerves, except
the vagus nerve, pass through foramina of the skull to innervate structures in the head, neck,
and facial region.
• The cranial nerves are designated both by name and by Roman numerals, according to the order in which
they appear on the inferior surface of the brain. Most of the nerves have both sensory and motor
components. Three of the nerves are associated with the special senses of smell, vision, hearing, and
equilibrium and have only sensory fibers. Five other nerves are primarily motor in function but do have
some sensory fibers for proprioception. The remaining four nerves consist of significant amounts of both
sensory and motor fibers.

Spinal Nerves
• Thirty-one pairs of spinal nerves emerge laterally from the spinal cord. Each pair of nerves corresponds
to a segment of the cord and they are named accordingly. This means there are 8 cervical nerves, 12
thoracic nerves, 5 lumbar nerves, 5 sacral nerves, and 1 coccygeal nerve.
• Each spinal nerve is connected to the spinal cord by a dorsal root and a ventral root.

Autonomic Nervous System

• The autonomic nervous system is a visceral efferent system, which means it sends motor impulses to the
visceral organs. It functions automatically and continuously, without conscious effort, to
innervate smooth muscle, cardiac muscle, and glands. It is concerned with heart rate, breathing
rate, blood pressure, body temperature, and other visceral activities that work together to
maintain homeostasis.
• The autonomic nervous system has two parts, the sympathetic division and the parasympathetic
division. Many visceral organs are supplied with fibers from both divisions. In this case, one stimulates
and the other inhibits. This antagonistic functional relationship serves as a balance to help maintain
homeostasis.

Review: The Nervous System

Here is what we have learned from the Nervous System:
• The nervous system is the major controlling, regulatory, and communicating system in the body. It is the
center of all mental activity including thought, learning, and memory.
• The various activities of the nervous system can be grouped together as three general, overlapping
functions: sensory, integrative, and motor.
• Neurons are the nerve cells that transmit impulses. Supporting cells are neuroglia.
• The three components of a neuron are a cell body or soma, one or more afferent processes called
dendrites, and a single efferent process called an axon.
• The central nervous system consists of the brain and spinal cord. Cranial nerves, spinal nerves, and ganglia
make up the peripheral nervous system.
• The afferent division of the peripheral nervous system carries impulses to the CNS; the efferent division
carries impulses away from the CNS.
• There are three layers of meninges around the brain and spinal cord. The outer layer is dura mater, the
middle layer is arachnoid, and the innermost layer is pia mater.
• The spinal cord functions as a conduction pathway and as a reflex center. Sensory impulses travel to the
brain on ascending tracts in the cord. Motor impulses travel on descending tracts.

MODULE VI: THE SENSES

INTENDED LEARNING OUTCOMES:

Students are expected to:
• identify the accessory eye structures and their functions
• identify the internal structures of the eyeball and their functions
• identify the structures of the external, middle and internal ear, and list the functions of each
• distinguish between static and dynamic equilibrium
• explain the function of the spiral organ of Corti in hearing
• describe the location, structure, and function of the olfactory and taste receptors
• name the five basic taste sensations

LEARNING MATERIALS:
Sensory System
• is a part of the nervous system responsible for processing sensory information
• consists of sensory receptors, neural pathways, and parts of the brain involved in sensory perception.
Commonly recognized sensory systems are those for vision, hearing, somatic sensation (touch), taste and
olfaction (smell)
• senses are transducers from the physical world to the realm of the mind

A. OLFACTORY (SMELL)
A.1 Nose
• The nose has two primary functions.
olfaction – the sense of smell
filtration, heating and humidification of the inhaled air: the nasal cavity contains a convoluted
set of passageways called the turbinates on the lateral wall of each nasal cavity

The nose performs other various functions such as:

▪ Respiration.
▪ Air conditioning of the inspired air.
▪ Filtration of the inspired air.
▪ Olfaction or sense of smell.
 ▪ Resonating the spoken voice.
▪ Draining the paranasal sinuses and the nasolacrimal duct.

The nose consists of the following:

▪ External nose – triangular-shaped projection in the center of the face.
▪ Nostrils – The two openings into the nasal passages.
▪ Nasal passages – passages that are lined with mucous membranes and tiny hairs (cilia) that help to filter
the air and move nasal and sinus mucous to the back of the throat. Nasal passages are separated by the
nasal septum.
▪ Septum – made up of cartilage and bone and covered by mucous membranes. The cartilage also gives
support to the lower part of the nose and divides the nasal passages into right and left sides.
▪ Sinuses – four-paired, air-filled cavities.

B. TASTE BUDS AND SENSE OF TASTE

The tongue is a versatile organ with specialized functions like taste and speech.
Beneath a cover of taste buds, the tongue is almost entirely made up of muscle. The muscles of the tongue
are essential for its bodily movement and intrinsic manipulations, required for actions like speech,
articulation, deglutition or swallowing, whistling, licking, kissing and even cleaning teeth.

Taste is the brain’s interpretation of chemicals that trigger receptors on the tongue, which are housed in
the taste buds. The basic chemical components, are found in foods, toxins, and other ingested matter.
Unappealing tastes are usually associated with toxins, as this is a defense mechanism preventing
consumption. The chemicals bind their particular receptors and initiate signaling that travels through the
nerves to the brain, where they are interpreted.

Taste Buds: are specific receptors for the sense of taste which are widely distributed in the oral cavity. Of the
10,000 taste buds that humans have, most are located in the tongue. Few are found on the soft palate and inner
surface of the cheeks.

Papillae – small peg-like projections that covers the dorsal surface of the tongue. These peg-like projections are
of three types namely:
▪ Sharp filiform papillae
▪ Rounded fungiform papillae
▪ Circumvallate papillae

To carry the taste impulses three cranial nerves transports it to the gustatory cortex namely:
▪ Cranial nerve VII
▪ Cranial nerve IX
▪ Cranial nerve X
C. AUDITORY (HEARING)
▪ Hearing is one of the major senses and like vision is important for distant warning and communication.
▪ It can be used to alert, to communicate pleasure and fear. It is a conscious appreciation of vibration
perceived as sound. In order to do this, the appropriate signal must reach the higher parts of the brain.

Functions of the ear

▪ The ears are paired sensory organs comprising the auditory system, involved in the detection of sound,
and the vestibular system, involved with maintaining body balance or the equilibrium.
▪ The ear divides anatomically and functionally into three regions: the external ear, the middle ear, and the
inner ear. All three regions are involved in hearing. Only the inner ear functions in the vestibular system.
1. SOUND DETECTION. The function of the ear is to convert physical vibration into an encoded nervous
impulse. It can be thought of as a biological microphone. Like a microphone the ear is stimulated by
vibration: in the microphone the vibration is transduced into an electrical signal, in the ear into a nervous
impulse which in turn is then processed by the central auditory pathways of the brain.
2. MAINTAINING BODY BALANCE or EQUILIBRIUM. The prime function of the vestibular system is to detect
and compensate for movement. This includes the ability to maintain optic fixation despite movement and
to initiate muscle reflexes to maintain balance.

The ear is divided into three major areas: the outer or external ear, the middle ear and the inner or internal ear.
The outer and middle ear are involved with hearing only whilst the inner ear functions both equilibrium and
hearing.
OUTER (EXTERNAL) EAR
▪ collects sound waves in the air and channels them to the inner parts of the ear.
▪ The outer ear along with its canal has been shown to enhance sounds within a certain frequency
range. That range just happens to be the same range that most of the characteristics of human speech
sounds fall into. This allows the sounds to be boosted to twice their original intensity. Parts of the
outer ear are the following:
1. Pinna – Also called the auricle. It is the part which protrudes from the side of the skull made of cartilage
covered by skin. The pinna collects sound and channels it into the ear canal. The pinna’s shape enables it
to funnel sound waves into the external auditory meatus. The various folds in the pinna’s structure amplify
some high frequency components of the sound. They also help in the localization of sound in the vertical
plane. As sounds hit the pinna from above and below, their paths to the external auditory meatus vary in
length. This means that they take different times to reach the meatus.
2. External acoustic meatus or external auditory canal – this is a short chamber about 1 inch long by ¼ inch
wide. It is carved into the temporal bone of the skull. The canal has bends in both the vertical and
horizontal planes. This means that it is difficult for anything poked into the meatus to hit the drum. Any
trauma is likely to be to the walls of the canal. In its skin-lined walls are the ceruminous glands, which
secrete a waxy yellow substance, called earwax or cerumen.
 ▪ Sound waves entering the external auditory canal eventually hit the tympanic membrane or eardrum
and cause it to vibrate. The canal ends at the eardrum, which separates the outer ear from the middle
ear.
MIDDLE EAR
▪ The middle ear or tympanic cavity is an air filled space within the temporal bone.
▪ It transforms the acoustical vibration of the sound wave into mechanical vibration and passes it onto
the inner ear. The three tiny bones of the middle ear act as a lever to bridge the eardrum with the
oval window. Incoming forces are magnified by about 30 %. This increased force allows the fluid in
the cochlea of the inner ear to be activated.
▪ The tympanic cavity is spanned by the three smallest bones in the body, the ossicles which transmit
the vibratory motion of the eardrum to the fluids of the inner ear. These bones, named for their shape,
are the following:
Hammer or malleus
Anvil or incus
Stirrup or stapes
▪ When the eardrum moves the hammer moves with it and transfers the vibration to the anvil. In response
to this, the anvil passes it on to the stirrup which in turn presses on the oval window of the inner ear. The
movement of the oval window sets the fluids of the inner ear into motion, eventually exciting the hearing
receptors.
▪ The Eustachian tube is a canal that links the middle ear with the throat area. This tube helps to equalize
the pressure between the outer ear and the middle ear. Having the same pressure allows for the proper
transfer of sound waves. The eustachian tube is lined with mucous, just like the inside of the nose and
throat.

INNER EAR
▪ consists of a maze of fluid-filled tubules running through the temporal bone of the skull.
▪ The bony tubes, the bony labyrinth, are filled with a fluid called perilymph. Within this bony labyrinth is
a second series of delicate cellular tubes, called the membranous labyrinth, filled with the fluid called
endolymph. This membranous labyrinth contains the actual hearing cells, the hair cells of the organ of
Corti.

▪ The bony cochlea is so called because it is shaped like a snail shell. It has two and a half turns and houses
the organ of hearing known as the membranous labyrinth surrounded by fluid called the perilymph. The
cochlea has a volume of about 0.2 of a millilitre. In this space lie up to 30,000 hair cells which transduce
vibration into nervous impulses and about 19,000 nerve fibers which transmit the signals to and from the
brain.
 ▪ Nerve impulses generated in the inner ear travel along the vestibulocochlear area (cranial nerve VIII),
which leads to the brain. This is actually two nerves, somewhat joined together, the cochlear nerve for
hearing and the vestibular nerve for equilibrium.

How Do We Hear?
▪ Hearing starts with the outer ear. When a sound is made outside the outer ear, the sound waves, or
vibrations, travel down the external auditory canal and strike the eardrum (tympanic membrane).
▪ The eardrum vibrates. The vibrations are then passed to three tiny bones in the middle ear called the
ossicles.
▪ The ossicles amplify the sound and send the sound waves to the inner ear and into the fluid-filled hearing
organ (cochlea).
▪ Once the sound waves reach the inner ear, they are converted into electrical impulses which the auditory
nerve sends to the brain. The brain then translates these electrical impulses as sound.

The Mechanism of hearing:

1. Sound
2. Pinna collects the sound heard
3. External auditory canal
4. Vibration in the ear drum is produced
5. Amplified by the ossicular chain. The sound is then transmitted to the inner ear.
6. The cochlea converts the sound vibration to electrical impulses. Within the cochlear duct, the endolymph-
containing membranous labyrinth of the snail-like cochlea is the organ of Corti, which contains the hearing
receptors or hair cells. The chambers above and below the cochlear duct contain perilymph. Sound waves
that reach the cochlea through vibrations of the eardrum, ossiscles and oval window set cochlear fluids
into motion.
7. The hair cells transmit impulses along the cochlear nerve or auditory nerve (a division of cranial nerve VIII
– the vestibulocochlear nerve) to the auditory cortex in the temporal lobe.
8. Auditory cortex interprets the sound, or hearing occurs.

D. Vision (sight)
▪ Vision is arguably the most used of the 5 senses and is one of the primary means that we use to gather
information from our surroundings.
▪ The human eye is the organ which gives us the sense of sight, allowing us to observe and learn more about
the surrounding world than we do with any of the other four senses.
▪ This special organ takes in tons of information about the world around you — shapes, colors, movements,
and more. Then they send the information to your brain for processing so the brain knows what’s going
on outside of your body.
External and Accessory Structures
▪ The adult eye is a sphere-shaped organ that measures about 1 inch or 2.5 cm in diameter. However, only
one sixth (1/6) of the eye’s surface can normally be seen and the rest is enclosed and protected by a
cushion of fat and the walls of the bony orbit.

The accessory structures of the eye are the following:

▪ Extrinsic eye muscles. The extrinsic muscles of the eye come from the bones of the orbit and are movable
due to broad tendons in the eye’s tough outer surface. There are six extrinsic eye muscles that function
to MOVE the eye in various directions:
1. Superior rectus muscle – rotates the eye upward and toward the midline
2. Inferior rectus muscle – rotates the eye downward and toward the midline
3. Medial rectus – rotates the eye toward the midline
4. Lateral rectus – rotates the eye away from the midline
5. Superior oblique – rotates the eye downward and away from the midline
6. Inferior oblique – rotates the eye upward and away from the midline

▪ Eyelids: protect the eyes anteriorly which meet at the medial and the lateral corners of the eye. From the
border of each eyelid are the EYELASHES. The eyelashes help filter out foreign matter, including dust and
debris, and prevent it from getting into the eye. Eyelid edges associate with modified sebaceous glands
make up the TARSAL GLANDs. These glands produce an oily secretion that lubricates the eye. Between
the eyelashes, modified sweat glands called ciliary glands are found.
▪ Conjunctiva: is a mucous membrane that begins at the edge of the cornea and lines the inside surface of
the eyelids and sclera, which serves to lubricate the eye. It is the thin, transparent tissue that covers the
outer surface of the eye. This structure is nourished by tiny blood vessels that are nearly invisible to the
naked eye. The conjunctiva is composed of 3 sections:
▪ Palpebral Conjuctiva: covers the posterior surface of the eyelids
▪ Bulbar Conjuctiva: coats the anterior portion of the eyeball
▪ Fornix: the transition portion, forming the junction between the posterior eyelid and the eyeball
Within the bulbar conjunctiva are “goblet cells,” which secrete “mucin.” This is an important component
of the pre-corneal tear layer that protects and nourishes the cornea.
▪ Lacrimal Apparatus: consists of the lacrimal gland and a number of ducts that drain the lacrimal secretions
into the nasal cavity. Located above the lateral end of each eye are the lacrimal glands that continually
release a dilute salt solution, known as tears, onto the anterior surface of the eyeball through several
small ducts. The flow of tears flush across the following structures orderly:
1. Eyeball
2. Lacrimal canals medially
3. Lacrimal sac
4. Nasolacrimal duct that empties into the nasal cavity.
 Lacrimal secretion contains antibodies and an enzyme that destroys bacteria known as lysozyme. Hence,
tears cleanse and protect the eye surface as it moistens and lubricates it. in cases when lacrimal secretion
substantially increases, tears spill over the eyelids and fill the nasal cavities. This causes congestion and
the “sniffles.” When eyes are irritated by foreign objects or chemicals and when a person is emotionally
upset lacrimal secretion is stimulated and increased.

Internal Eye structures

The Eyeball
The eye, commonly called the eyeball, is a hollow sphere and is composed of:
▪ 3 tunics or coats
▪ Humors – the interior filled with fluids that help maintain the shape of the eye
▪ Lens – the main focusing apparatus of the eye. This structure is supported within the eye cavity dividing
it into two chambers.
TUNICS of the EYEBALL
▪ Fibrous Tunic – this is the outermost tunic and is also known as the sclera, the thick and white connective
tissue. The fibrous tunic (sclera) is seen anteriorly as the “white part of the eye.” The central portion of
this tunic is modified so that it is crystal clear. The cornea is the transparent “window” through which light
enters the eye and is well supplied with nerve endings. This is the main reason why blinking and increased
tearing occur when the cornea is touched because most nerve endings found here are pain fibers.
▪ Vascular tunic – this is the middle coat of the eyeball and has three distinguishable regions namely:
1. Choroid – this is located posteriorly and lies between the sclera and the retina. It contains the blood
vessels that provide nourishment to the outer layers of the retina. It is composed of layers of blood vessels
that nourish the back of the eye.
2. Ciliary Body – the ciliary body is made up of ciliary muscles and ciliary processes. It lies just behind the iris.
This is the structure to which lens are attached by a suspensory ligament called the ciliary zonule and then
the iris.
3. Sensory Tunic – this is the innermost tunic of the eye and is called the retina. This structure extends
anteriorly only to the ciliary body. It converts images into electrical impulses that are sent along the optic
nerve to the brain where the images are interpreted. The retina can be compared to the film of a camera.
It contains millions of receptor cells, the rods and cones. Rods and cones are called photoreceptors
because they respond to light.

LENS
The crystalline lens is located just behind the iris. Light entering the eye is focused on the retina by the
lens. The nucleus, the innermost part of the lens, is surrounded by softer material called the cortex.
The lens is encased in a capsular-like bag. It is held upright in the eye by a suspensory ligament, the ciliary
zonule, attached to the ciliary body. Together, the lens and the ciliary body help control fine focusing of
light as it passes through the eye. The lens is divided into two segments namely:
1. Anterior (aqueous) segment – located anterior to the lens and contains a clear watery fluid called
aqueous humor. The aqueous humor helps to nourish the cornea and the lens. It is continually produced
by the ciliary body.
2. Posterior (vitreous) segment – located posterior to the lens and is filled with a gel-like substance called
the vitreous humor or the vitreous body. The vitreous is a thick, transparent substance that fills the center
of the eye. It is composed mainly of water and comprises about 2/3 of the eye’s volume, giving it form
and shape. The viscous properties of the vitreous allow the eye to return to its normal shape if
compressed. The vitreous humor helps maintain the shape of the eye.

MODULE VII: THE ENDOCRINE SYSTEM

INTENDED LEARNING OUTCOMES:
Students are expected to:
• Identifying the major endocrine glands
• List down the hormones released by each major endocrine gland
• Explain the effect of each of these hormones on target organs
• Explain the effects of hyposecretion and hypersecretion of hormones

LEARNING MATERIALS:
• The endocrine system, along with the nervous system, functions in the regulation of body activities. The
nervous system acts through electrical impulses and neurotransmitters to cause muscle contraction and
glandular secretion. The effect is of short duration, measured in seconds, and localized.
• The endocrine system acts through chemical messengers called hormones that influence growth,
development, and metabolic activities. The action of the endocrine system is measured in minutes, hours,
or weeks and is more generalized than the action of the nervous system.
THE ENDOCRINE SYSTEM
• is made up of glands and the hormones they secrete.
• Although the endocrine glands are the primary hormone producers, the brain, heart, lungs, liver, skin,
thymus, gastrointestinal mucosa, and placenta also produce and release hormones.

PRIMARY ENDOCRINE GLANDS

• pituitary (the master gland)
• pineal
• thyroid
• parathyroid
• islets of Langerhans
• adrenals
• ovaries in the female
• testes in the male

FUNCTION OF THE ENDOCRINE SYSTEM

• production and regulation of chemical substances called hormones.

HORMONE
• is a chemical transmitter.
• released in small amounts from glands, and is transported in the bloodstream to target organs or other
cells.
• are chemical messengers, transferring information and instructions from one set of cells to another.
• regulate growth, development, mood, tissue function, metabolism, and sexual function.
A. SECRETIONS FROM THE ANTERIOR PITUITARY GLAND

1. Growth Hormone (GH): essential for the growth and development of bones, muscles, and other organs.
It also enhances protein synthesis, decreases the use of glucose, and promotes fat destruction.
2. Adrenocorticotropin (ACTH): essential for the growth of the adrenal cortex.

3. Thyroid-Stimulating Hormone (TSH): essential for the growth and development of the thyroid gland.

4. Follicle-Stimulating Hormone (FSH): is a gonadotropic hormone.

• It stimulates the growth ovarian follicles in the female and the production of sperm in the male.
5. Luteinizing Hormone (LH): is a gonadotropic hormone

6. Prolactin (PRL): stimulates the development and growth of the mammary glands and milk production during
pregnancy.
• The sucking motion of the baby stimulates prolactin secretion.

7. Melanocyte-stimulating hormone (MSH): regulates skin pigmentation and promotes the deposit of melanin in
the skin after exposure to sunlight.

II. SECRETIONS FROM THE POSTERIOR LOBE OF THE PITUITARY GLAND

1. Antidiuretic Hormone (ADH): stimulates the reabsorption of water by the renal tubules. Hyposecretion of this
hormone can result in diabetes insipidus.
2. Oxytocin: stimulates the uterus to contract during labor, delivery, and parturition. A synthetic version of this
hormone, used to induce labor, is called Pitocin. It also stimulates the mammary glands to release milk.

III. SECRETIONS FROM THE PINEAL GLAND

1. Melatonin: communicates information about environmental lighting to various parts of the body. Has some
effect on sleep/awake cycles and other biological events connected to them, such as a lower production
of gastric secretions at night.

2. Serotonin: a neurotransmitter that regulates intestinal movements and affects appetite, mood, sleep, anger,
and metabolism.

III. SECRETIONS OF THE THYROID GLAND

1. Calcitonin: influences bone and calcium metabolism; maintains a homeostasis of calcium in the blood plasma

IV. SECRETIONS FROM THE ISLETS OF LANGERHANS

1. Insulin : secreted by Beta cells

• essential for the maintenance of normal blood sugar levels. Inadequate levels result in diabetes mellitus.
• Alpha cells facilitate the breakdown of glycogen to glucose. This elevates the blood sugar.
• Delta cells suppress the release of glucagon and insulin.
V. SECRETIONS FROM THE ADRENAL CORTEX

1. Cortisol: regulates carbohydrate, protein, and fat metabolism; has an anti-inflammatory effect; helps the body
cope during times of stress
• Hyposecretion results in Addison’s disease; hypersecretion results in Cushing’s disease

2. Corticosterone: like cortisol, it is a steroid; influences potassium and sodium metabolism

3. Aldosterone: essential in regulating electrolyte and water balance by promoting sodium and chloride retention
and potassium excretion.
4. Androgens: several hormones including testosterone; they promote the development of secondary sex
characteristics in the male.

VI. SECRETIONS FROM THE ADRENAL MEDULLA

1. Dopamine is used to treat shock. It dilates the arteries, elevates systolic blood pressure, increases cardiac
output, and increases urinary output.
2. Epinephrine is also called adrenalin. It elevates systolic blood pressure, increases heart rate and cardiac output,
speeds up the release of glucose from the liver… giving a spurt of energy, dilates the bronchial tubes and
relaxes airways, and dilates the pupils to see more clearly. It is often used to counteract an allergic
reaction.
3. Norepinephrine, like epinephrine, is released when the body is under stress. It creates the underlying
influence in the fight or flight response. As a drug, however, it actually triggers a drop in heart rate.

VII. SECRETIONS OF THE OVARIES

1. Estrogen and Progesterone : These hormones prepare the uterus for pregnancy, promote the development of
mammary glands, play a role in sex drive, and develop secondary sex characteristics in the female.
• Estrogen : is essential for the growth, development, and maintenance of female sex organs.

VIII. SECRETIONS OF THE TESTES

1. Testosterone : the male sex hormone. It is essential for normal growth and development of the male sex
organs. Testosterone is responsible for the erection of the penis.
IX. SECRETIONS OF THE PLACENTA
• During pregnancy, the placenta serves as an endocrine gland.
• It produces chorionic gonadotropin hormone, estrogen, and progesterone.

Review: The Endocrine System

Here is what we have learned from the Endocrine System:
• Chemical messengers from the endocrine system help regulate body activities. Their effect is of longer
duration and is more generalized than that of the nervous system.
• Neurons are the nerve cells that transmit impulses. Supporting cells are neuroglia.
• Endocrine glands secrete hormones directly into the blood, which transports the hormones through the
body.
• Cells in a target tissue have receptor sites for specific hormones.
• Many hormones are regulated by a negative feedback mechanism; some are controlled by other
hormones; and others are affected by direct nerve stimulation.
• Even though the endocrine glands are scattered throughout the body, they are still considered to be one
system because they have similar functions, similar mechanisms of influence, and many important
interrelationships.
• Major glands include: pituitary gland, thyroid gland, parathyroid gland, adrenal (suprarenal) gland,
pancreas, gonads (testes and ovaries), pineal gland, and other endocrine glands.

MODULE VIII: THE CARDIOVASCULAR SYSTEM

INTENDED LEARNING OUTCOME:

Students are expected to:
• describe the location of the heart in the body, and identify its major anatomical areas on an appropriate
model or diagram
• trace the pathway of blood through the heart
• compare the pulmonary and systemic circuits
• name the elements of the intrinsic conduction system of the heart, and describe the pathway of
impulses through this system
• compare and contrast the structure and function of arteries, veins and capillaries
• describe the unique features of the arterial circulation of the brain, and hepatic portal circulation

LEARNING MATERIALS:
CARDIOVASCULAR SYSTEM
• is sometimes called the blood-vascular, or simply the circulatory system
• consists of the heart, which is a muscular pumping device, and a closed system of vessels
called arteries, veins, and capillaries.
• Incredible as it seems, the primitive heart begins to beat regularly early in the fourth week
following fertilization.
• The vital role of the cardiovascular system in maintaining homeostasis depends on the continuous and
controlled movement of blood through the thousands of miles of capillaries that permeate
every tissue and reach every cell in the body.
 • It is in the microscopic capillaries that blood performs its ultimate transport function. Nutrients and other
essential materials pass from capillary blood into fluids surrounding the cells as waste products are
removed.

Heart
• is a muscular pump that provides the force necessary to circulate the blood to all the tissues in the body.
• Its function is vital because, to survive, the tissues need a continuous supply of oxygen and nutrients,
and metabolic waste products have to be removed.
• Deprived of these necessities, cells soon undergo irreversible changes that lead to death.
• While blood is the transport medium, the heart is the organ that keeps the blood moving through the
vessels. The normal adult heart pumps about 5 liters of blood every minute throughout life. If it loses its
pumping effectiveness for even a few minutes, the individual's life is jeopardized.

Structure of the Heart

• is a four-chambered muscular organ, shaped and sized roughly like a man's closed fist with two-thirds of
the mass to the left of midline
• is enclosed in a pericardial sac that is lined with the parietal layers of a serous membrane.
• The visceral layer of the serous membrane forms the epicardium.

Layers of the Heart Wall - Three layers of tissue form the heart wall.
• epicardium - outer layer of the heart wall
• myocardium - the middle layer is the , and
• endocardium - the inner layer

Chambers of the Heart

The internal cavity of the heart is divided into four chambers:
• Right atrium
• Right ventricle
• Left atrium
• Left ventricle
The two atria are thin-walled chambers that receive blood from the veins.
The two ventricles are thick-walled chambers that forcefully pump blood out of the heart.
The right atrium receives deoxygenated blood from systemic veins; the left atrium receives oxygenated
blood from the pulmonary veins.
Valves of the Heart
• The heart has two types of valves that keep the blood flowing in the correct direction.
• The valves between the atria and ventricles are called atrioventricular valves (also called cuspid valves),
while those at the bases of the large vessels leaving the ventricles are called semilunar valves.
• The right atrioventricular valve is the tricuspid valve.
• The left atrioventricular valve is the bicuspid, or mitral, valve.
• The valve between the right ventricle and pulmonary trunk is the pulmonary semilunar valve.
• The valve between the left ventricle and the aorta is the aortic semilunar valve.
When the ventricles contract, atrioventricular valves close to prevent blood from flowing back into the
atria.
When the ventricles relax, semilunar valves close to prevent blood from flowing back into the ventricles.
Pathway of Blood through the Heart
• While it is convenient to describe the flow of blood through the right side of the heart and then through
the left side, it is important to realize that both atria and ventricles contract at the same time.
• The heart works as two pumps, one on the right and one on the left, working simultaneously.
• Blood flows from the right atrium to the right ventricle, and then is pumped to the lungs to
receive oxygen. From the lungs, the blood flows to the left atrium, then to the left ventricle. From there
it is pumped to the systemic circulation.

Blood Supply to the Myocardium,

• The myocardium of the heart wall is a working muscle that needs a continuous supply of oxygen and
nutrients to function efficiently. For this reason, cardiac muscle has an extensive network of blood vessels
to bring oxygen to the contracting cells and to remove waste products.
• The right and left coronary arteries, branches of the ascending aorta, supply blood to the walls of the
myocardium. After blood passes through the capillaries in the myocardium, it enters
a system of cardiac (coronary) veins. Most of the cardiac veins drain into the coronary sinus, which opens
into the right atrium.

Physiology of the Heart

• The conduction system includes several components.
• The first part of the conduction system is the sinoatrial node .
• Without any neural stimulation, the sinoatrial node rhythmically initiates impulses 70 to 80 times per
minute. Because it establishes the basic rhythm of the heartbeat, it is called the pacemaker of the heart.
• Other parts of the conduction system include the atrioventricular node, atrioventricular bundle, bundle
branches, and conduction myofibers. All of these components coordinate the contraction and relaxation
of the heart chambers.

Cardiac Cycle
• refers to the alternating contraction and relaxation of the myocardium in the walls of the heart chambers,
coordinated by the conduction system, during one heartbeat.
• Systole is the contraction phase of the cardiac cycle, and diastole is the relaxation phase.
• At a normal heart rate, one cardiac cycle lasts for 0.8 second.

Heart Sounds
• The sounds associated with the heartbeat are due to vibrations in the tissues and blood caused
by closure of the valves.
• Abnormal heart sounds are called murmurs.

Heart Rate
 • The sinoatrial node, acting alone, produces a constant rhythmic heart rate. Regulating factors are reliant
on the atrioventricular node to increase or decrease the heart rate to adjust cardiac output to meet the
changing needs of the body.
• Most changes in the heart rate are mediated through the cardiac center in the medulla oblongata of
the brain.
• The center has both sympathetic and parasympathetic components that adjust the heart rate to meet the
changing needs of the body.
• Peripheral factors such as emotions, ion concentrations, and body temperature may affect heart rate.
These are usually mediated through the cardiac center.
Blood
• central to keep every human alive
• medium of how we transport glucose and gases
• carries oxygen and nutrients to the cells in the body
• carries waste materials to lungs, kidneys, and digestive system to be removed from the body
• helps fight infection and carry hormones

Functions of Blood
1. Transport of gases, nutrients and waste products
2. Transport of processed molecules
3. Transport of regulatory molecules
4. Regulation of pH and osmosis
5. Maintenance of body temperature
6. Protection against foreign substances
7. Clot formation

Composition/Components of Blood
A. Plasma: 55% of total blood; largest component
• pale, yellow liquid portion that surrounds cells
• 91% water, 7% proteins, and 2% other
B. Formed Elements: 45% of total blood
• cells and cell fragments
• erythrocytes, leukocytes, thrombocytes
1. Red Blood Cells ( Erythrocytes) – produced inside the bone cavities called bone marrow
- contain iron containing CHON called “Hemoglobin” that carries oxygen
* blood gets its red color when it picks up oxygen from the lungs
- do the transporting of gases
- has 120 days life span, everyday the body produces RBC to replace those that died

Hemoglobin
• Main component of erythrocytes
• Transports O2
• Each globin protein is attached to a heme molecule
• Each heme contains one iron atom
• O2 binds to iron

Oxyhemoglobin:
• hemoglobin with an O2 attached

2. White Blood Cells ( Leukocytes) – protects the body from foreign body and against infectious
diseases; remove dead cells and debris by phagocytosis
- divided into multi-protein cells in the bone marrow called the hematopoietic stem cells
✓ lymphocytes – 20 – 25%
✓ neutrophil – 60 – 70%
✓ basophil – 0.5 – 1.0%
✓ eosinophil – 2 – 4%
✓ monocytes/macrophages – 3 – 8%

Types of Leukocytes
I. Granulocytes: contain specific granules and include neutrophils, eosinophils, and basophils
a. Neutrophils: most common
• remain in blood for 10 to 12 hours then move to tissues
• phagocytes
 b. Eosinophils: reduce inflammation
• destroy parasites
c. Basophils: least common
• release histamine and heparin
II. Agranulocytes: no specific granules
a. Monocytes: largest sized white blood cells
• produce macrophages
b. Lymphocytes: immune response
• several different types (T cells and B cells)
• lead to production of antibodies
3. Platelets (Thrombocytes)
• if one of the blood vessels is damaged, it sends signals to the tiny platelets, then it rush to site and form
a blood clot (coagulation)
• They are produced in the red bone marrow from large cells called megakaryocytes.

Plasma Proteins
Albumin: 58% of plasma proteins
• helps maintain water balance
Globulins: 38% of plasma proteins
• helps immune system
Fibrinogen: 4% of plasma proteins
• aids in clot formation

Hematopoiesis: is the process that produces formed elements.

• In the fetus, hematopoiesis occurs in several tissues, including the liver, thymus, spleen, lymph nodes,
and red bone marrow.
• After birth, hematopoiesis is confined primarily to red bone marrow, but some white blood cells are
produced in lymphatic tissues.

Blood Grouping
• Injury or surgery can lead to a blood transfusion

Transfusion reactions/Aggulination: clumping of blood cells (bad)

Antigens:
• molecules on surface of erythrocytes
Antibodies:
• proteins in plasma
Blood groups:
• named according to antigen (ABO)

ABO Blood Groups

• In the ABO blood group system, there are two types of antigens that may appear on the surface of the red
blood cells, type A antigen and type B antigen.
• Type A blood has type A antigens, type B blood has type B antigens, and type AB blood has both types of
antigens.
• Type O blood has neither A nor B antigens.
• The types of antigens found on the surface of the red blood cells are genetically determined.
• Antibodies against the antigens are usually present in the plasma of blood.
 • Plasma from type A blood contains anti-B antibodies, which act against type B antigens; plasma from type
B blood contains anti-A antibodies, which act against type A antigens.
• Type AB blood plasma has neither type of antibody, and type O blood plasma has both anti-A and anti-B
antibodies.

Blood Donor and Recipient According to ABO Blood Types

• are universal donors because they have no antigens
• Type A can receive A and O blood
• Type B can receive B and O blood
• Type AB can receive A, B, AB blood
• Type O can only receive O blood

Rh Blood Group
• Rh positive means you have Rh antigens
• 95 to 85% of the population is Rh+
• Antibodies only develop if an Rh- person is exposed to Rh+ blood by transfusion or from mother to fetus

Diagnostic Blood Tests

Complete blood count: provides information such as RBC count, hemoglobin, hematocrit, and WBC count
Hematocrit: % of total blood volume composed of RBC
Hemoglobin: determines amount of hemoglobin
• indicate anemia
Prothrombin time: time it takes for blood to begin clotting (9 to 12 sec.)
White blood cell count: total number of white blood cells
White blood cell differential count: Determines the % of each 5 kinds of leukocytes
neutrophils: 60 to 70%
lymphocytes: 20 to 25%
monocytes: 3 to 8%
eosinophils: 2 to 4%
basophils: 0.5 to 1%

Leukopenia: low white blood cell count

• caused by radiation, chemotherapy drugs, tumors, viral infections
Leukocytosis: high white blood cell count
• caused by infections and leukemia

Review: The Cardiovascular System

Here is what we have learned from The Cardiovascular System:
• The cardiovascular system consists of the heart, which is a muscular pumping device, and a closed
system of vessels called arteries, veins, and capillaries.
• The vital role of the cardiovascular system in maintaining homeostasis depends on the continuous and
controlled movement of blood through the thousands of miles of capillaries that permeate every tissue
and reach every cell in the body.
• The heart is a muscular pump that provides the force necessary to circulate the blood to all the tissues in
the body.
• Three layers of the heart are: the epicardium, the myocardium, and the endocardium.
• The four chambers of the heart are: the right atrium, the right ventricle, the left atrium, and the left
ventricle.
• Two types of valves of the heart are the atrioventricular valves and semilunar valves.
 • Blood flows from the right atrium to the right ventricle and then is pumped to the lungs to receive
oxygen. From the lungs, the blood flows to the left atrium, then to the left ventricle. From there it is
pumped to the systemic circulation.
• Specialized cardiac muscle cells that make up the conduction system of the heart coordinate contraction
of the chambers.
• The pulmonary vessels transport blood from the right ventricle to the lungs and back to the left atrium.
• The systemic vessels carry blood from the left ventricle to the tissues in all parts of the body and then
returns the blood to the right atrium.
• Substances pass through the capillary wall by diffusion, filtration, and osmosis.

MODULE IX: THE LYMPHATIC SYSTEM & IMMUNITY

INTENDED LEARNING OUTCOME:

Students are expected to:
• explain how the lymphatic system is functionally related to the cardiovascular system and the immune
defences
• name the two major types of structures composing the lymphatic system
• describe the source of lymph, and explain its formation and transport
• describe the functions of lymph nodes, tonsils, the thymus, Peyer's patches, and the spleen
• describe the protective functions of skin and mucous membranes
• name the two arms of the adaptive defense system
• compare and contrast the development of B and T cells
• state the roles of B cells and T cells
• define humoral immunity
• distinguish the roles of helper, regulatory, and cytotoxic T cells

LEARNING MATERIALS:
Functions of the Lymphatic System
1. Fluid balance
2. Fat Absorption
3. Defense

Lymphatic System and Lymph Drainage

Components of the Lymphatic System
Lymph:
• fluid that enters lymphatic capillaries composed of water and some solutes
Lymphocytes
Lymphatic vessels
Lymph nodes
Tonsils
Spleen
Thymus gland

Lymphatic Capillaries: Carries fluid in one direction from tissues to circulatory system
Fluid moves from blood capillaries into tissue spaces
• tiny, closed-ended vessels
• fluid moves easily into
• in most tissues
• join to form lymphatic vessels

Lymphatic vessels: resemble small veins

• where lymphatic capillaries join
• one way valves

Right lymphatic duct: where lymphatic vessels from right upper limb and right head, neck, chest empty
• empties into right subclavian vein

Thoracic duct: rest of body empties from lymphatic vessels

• empties into left subclavian vein

Lymphatic Organs
Tonsils: palatine tonsils on each side of oral cavity
 • pharyngeal tonsils near internal opening of nasal cavity (adenoid)
• lingual tonsils posterior surface of tongue
• form a protective ring of lymphatic tissue around nasal and oral cavities

The Tonsils

Lymph Nodes: rounded structures that vary in size

• located near lymphatic vessels
• groin, armpit, neck
• lymph passes through lymph nodes before entering blood
• lymph moves through and immune system
• is activated (lymphocytes produced) if foreign substances are detected
• removal of microbes by macrophages

The Spleen: size of clenched fist

• located in abdomen
• filters blood
• detect and respond to foreign substances
• destroy old red blood cells
• blood reservoir
white pulp: lymphatic tissue surrounding arteries
red pulp: contains macrophages and red blood cells that connect to veins

The Thymus Gland: bilobed gland

• located in mediastinum behind the sternum
• stops growing at age 1
• at age 60 decreases in size
• produces and matures lymphocytes
Immunity - is the ability to resist damage from foreign substances; can protect against microbes, toxins, and
cancer cells.

Types of immunity:
• innate
• adaptive

Physical Barriers: First line of defense

• Skin and mucous membranes to act as barriers
• Tears, saliva, urine wash away pathogens

Chemical Mediators: are chemicals that can kill microbes and prevent their entry into cells
Lysozyme: found in tears and saliva to kill bacteria
Mucous membranes: prevent entry of microbes
Histamine: promote inflammation by causing vasodilation
Interferons: proteins that protect against viral infections by stimulating surrounding cells to produce
antiviral proteins

Cells of the Immune System

White blood cells: produce in red bone marrow and lymphatic tissue that fight foreign substances
Phagocytic cells: ingest and destroy foreign substances
• Example—neutrophils and macrophages
Neutrophils: first to respond to infection but die quickly
Eosinophils: produced in red bone marrow
• release chemicals to reduce inflammation
Basophils: made in red bone marrow
• leave blood and enter infected tissues
• can release histamine
Macrophages: initially were monocytes
• leave blood and enter tissues
• can ingest more than neutrophils
• protect lymph in lymph nodes and blood in spleen and liver
• given specific names for certain areas of body (Kupffer cells in liver)
Mast cells: made in red bone marrow
 • found in skin, lungs, gastrointestinal tract, urogenital tract
• can release leukotrienes
Natural Killer Cells: type of lymphocyte
• produce in red bone marrow
• recognize classes of cells such as tumor cells or virus infected cells
• release chemicals to lysis cells

Adaptive Immunity is defense that involves specific recognition to a specific antigen.

This immunity: is acquired after birth
• reacts when innate defenses don’t work
• slower than innate immunity
• has memory
• uses lymphocytes (B and T cells)
• 2 types antibody-mediated and cell-mediated

Terms Related to Adaptive Immunity

Antigen: substance that stimulates an immune response
• Example—bacteria, virus, pollen, food, drugs
Self-antigen: molecule produced by the person’s body that stimulates an immune system response
Antibody: proteins the body produces in response to an antigen

Origin and Development of Lymphocytes

Stem cells: red bone marrow
• give rise to all blood cells
• give rise to some pre T cells and pre B cells

Lymphocytes: type of white blood cell

• involved in adaptive immunity
• develop from stem cells
• differentiate into specific lymphocytes such as B or T cells
B cells:
▪ type of lymphocytes
▪ involved in antibody-mediated immunity
▪ originate from stem cells
▪ mature in red bone marrow
▪ move to lymphatic tissue after mature
▪ lead to production of antibodies
T cells:
▪ type of lymphocyte
▪ involved in cell-mediated immunity primarily and antibody-mediated immunity
▪ mature in thymus gland
▪ move to lymphatic tissue after mature
Cytokines: proteins secreted by a cell that regulates neighboring cells
• Example—interleukin 1 released by macrophages stimulates helper T cells
Antibodies
IgG: 80 to 85% in serum
• activates compliment and increases phagocytosis
• can cross the placenta and provide protection to the fetus
• responsible for Rh reactions, such as hemolytic disease of the newborn
IgM: 5 to 10% in serum
 • activates compliment
• acts as an antigen binding receptor on the surface of B cells
• responsible for transfusion reactions in the ABO blood system
• often the first antibody produced in response to an antigen
IgA: 15% in serum
• secreted into saliva, into tears, and onto mucous membranes
• protects body surfaces
• found in colostrum and milk to provide immune protection to the newborn
• 0.002% in serum
• binds to mast cells and basophils and stimulates the inflammatory response
IgD: 2% in serum
• functions as an antigen-binding receptor on B cells

Effects of Antibodies
• Inactivate antigen
• Bind antigens together
• Active complement cascades
• Initiate release of inflammatory chemicals
• Facilitate phagocytosis

Types of T Cells for Cell-Mediated Immunity

Helper T cells (TH): activate macrophages
• help form B cells
• promote production of Tc
Cytotoxic T cells (Tc): precursor to cytotoxic T lymphocytes (CTL)
Cytotoxic T lymphocytes (CTL): destroys antigen on contact
Regulatory T cells (Tr): turn off immune system response when antigen is gone

Types of Adaptive Immunity

1. Naturally Acquired Immunity
Active: natural exposure to antigens causes production of antibodies
• can be lifelong immunity
• Example—mononucleosis
Passive: transfer of antibodies from mother to child
• Example—breast milk or placenta
2. Artificially Acquired Immunity
Active: injection of antigens using vaccines which cause the production of antibodies
• immunization is a process of introducing killed, live, or inactivated pathogen
Passive: injection of antibodies from another person or animal

Review: The Lymphatic System

Here is what we have learned from the Lymphatic System:
• The lymphatic system returns excess interstitial fluid to the blood, absorbs fats and fat-soluble vitamins,
and provides defense against disease.
• Lymph is the fluid in the lymphatic vessels. It is picked up from the interstitial fluid and returned to the
blood plasma.
• Lymphatic vessels carry fluid away from the tissues.
• The right lymphatic duct drains lymph from the upper right quadrant of the body and the thoracic duct
drains all the rest.
 • Pressure gradients that move fluid through the lymphatic vessels come from the skeletal muscle action,
respiratory movements, and contraction of smooth muscle in vessel walls.
• Lymph enters a lymph node through afferent vessels, filters through the sinuses, and leaves through
efferent vessels.
• Tonsils are clusters of lymphatic tissue associated with openings into the pharynx and provide protection
against pathogens that may enter through the nose and mouth.
• The spleen is a lymph organ that filters blood and also acts as a reservoir for blood.
• The thymus is large in the infant and atrophies after puberty.

MODULE X: THE RESPIRATORY SYSTEM

INTENDED LEARNING OUTCOME:

Students are expected to:
• name the organs forming the respiratory passageway from the nasal cavity to the alveoli of the lungs, and
describe the function of each
• describe the structure and function of the lungs and pleural coverings
• describe the structure of the respiratory membrane
• define cellular respiration, external respiration, internal respiration, pulmonary ventilation, expiration and
inspiration
• name the brain areas involved in control of respiration

LEARNING MATERIALS:
• Respiration is the sequence of events that results in the exchange of oxygen and carbon dioxide between
the atmosphere and the body cells.
• Every 3 to 5 seconds, nerve impulses stimulate the breathing process, or ventilation, which moves air
through a series of passages into and out of the lungs. After this, there is an exchange of gases between
the lungs and the blood. This is called external respiration. The blood transports the gases to and from
the tissue cells. The exchange of gases between the blood and tissue cells is internal respiration. Finally,
the cells utilize the oxygen for their specific activities: this is called cellular metabolism, or cellular
respiration. Together, these activities constitute respiration.

Mechanics of Ventilation
• Ventilation, or breathing, is the movement of air through the conducting passages between the
atmosphere and the lungs. The air moves through the passages because of pressure gradients that are
produced by contraction of the diaphragm and thoracic muscles.
• Pulmonary ventilation is commonly referred to as breathing. It is the process of air flowing into the lungs
during inspiration (inhalation) and out of the lungs during expiration (exhalation). Air flows because of
pressure differences between the atmosphere and the gases inside the lungs.
• Air, like other gases, flows from a region with higher pressure to a region with lower pressure. Muscular
breathing movements and recoil of elastic tissues create the changes in pressure that result in ventilation.
Pulmonary ventilation involves three different pressures:
✓ Atmospheric pressure
✓ Intraalveolar (intrapulmonary) pressure
✓ Intrapleural pressure

Atmospheric pressure: is the pressure of the air outside the body.

Intraalveolar pressure: is the pressure inside the alveoli of the lungs.
Intrapleural pressure: is the pressure within the pleural cavity.

❖ These three pressures are responsible for pulmonary ventilation.

Inspiration (inhalation): is the process of taking air into the lungs.
• It is the active phase of ventilation because it is the result of muscle contraction. During inspiration, the
diaphragm contracts and the thoracic cavity increases in volume. This decreases the intraalveolar
pressure so that air flows into the lungs. Inspiration draws air into the lungs.
Expiration (exhalation): is the process of letting air out of the lungs during the breathing cycle. During
expiration, the relaxation of the diaphragm and elastic recoil of tissue decreases the thoracic volume
and increases the intraalveolar pressure. Expiration pushes air out of the lungs.

The respiratory conducting passages are divided into the upper respiratory tract and the lower
respiratory tract. The upper respiratory tract includes the nose, pharynx, and larynx. The lower respiratory tract
consists of the trachea, bronchial tree, and lungs. These tracts open to the outside and are lined with mucous
membranes. In some regions, the membrane has hairs that help filter the air. Other regions may have cilia to
propel mucus.

Nose & Nasal Cavities

• The framework of the nose consists of bone and cartilage. Two small nasal bones and extensions of
the maxillae form the bridge of the nose, which is the bony portion. The remainder of the framework is
cartilage and is the flexible portion. Connective tissue and skin cover the framework.

• Air enters the nasal cavity from the outside through two openings: the nostrils or external nares. The
openings from the nasal cavity into the pharynx are the internal nares. Nose hairs at the entrance to the
nose trap large inhaled particles.
Paranasal Sinuses
 • are air-filled cavities in the frontal, maxilae, ethmoid, and sphenoid bones. These sinuses, which have
the same names as the bones in which they are located, surround the nasal cavity and open into it. They
function to reduce the weight of the skull, to produce mucus, and to influence voice quality by acting as
resonating chambers.
Pharynx
• commonly called the throat, is a passageway that extends from the base of the skull to the level of the
sixth cervical vertebra. It serves both the respiratory and digestive systems by receiving air from the nasal
cavity and air, food, and water from the oral cavity. Inferiorly, it opens into the larynx and esophagus. The
pharynx is divided into three regions according to location: the nasopharynx, the oropharynx, and
the laryngopharynx (hypopharynx).

• The nasopharynx is the portion of the pharynx that is posterior to the nasal cavity and extends inferiorly
to the uvula. The oropharynx is the portion of the pharynx that is posterior to the oral cavity. The
most inferior portion of the pharynx is the laryngopharynx that extends from the hyoid bone down to the
lower margin of the larynx.
• The upper part of the pharynx (throat) lets only air pass through. Lower parts permit air, foods, and fluids
to pass.
• The pharyngeal, palatine, and lingual tonsils are located in the pharynx. They are also called
Waldereyer's Ring.
• The retromolar trigone is the small area behind the wisdom teeth.

Larynx & Trachea

Larynx: commonly called the voice box or glottis, is the passageway for air between the pharynx above and
the trachea below. It extends from the fourth to the sixth vertebral levels. The larynx is often divided
into three sections: sublarynx, larynx, and supralarynx. It is formed by nine cartilages that are
connected to each other by muscles and ligaments.
 • plays an essential role in human speech. During sound production, the vocal cords close together and
vibrate as air expelled from the lungs passes between them. The false vocal cords have no role in sound
production, but help close off the larynx when food is swallowed.
• The thyroid cartilage is the Adam's apple. The epiglottis acts like a trap door to keep food and other
particles from entering the larynx.

Trachea: commonly called the windpipe, is the main airway to the lungs. It divides into the right and
left bronchi at the level of the fifth thoracic vertebra, channeling air to the right or left lung.
• The hyaline cartilage in the tracheal wall provides support and keeps the trachea from collapsing.
The posterior soft tissue allows for expansion of the esophagus, which is immediately posterior to the
trachea.
• The mucous membrane that lines the trachea is ciliated pseudostratified columnar epithelium similar to
that in the nasal cavity and nasopharynx. Goblet cells produce mucus that traps airborne particles and
microorganisms, and the cilia propel the mucus upward, where it is either swallowed or expelled.

Bronchi, Bronchial Tree, & Lungs

Bronchi and Bronchial Tree
• In the mediastinum, at the level of the fifth thoracic vertebra, the trachea divides into the right and left
primary bronchi. The bronchi branch into smaller and smaller passageways until they terminate in tiny air
sacs called alveoli.
• The cartilage and mucous membrane of the primary bronchi are similar to that in the trachea. As the
branching continues through the bronchial tree, the amount of hyaline cartilage in the walls decreases
until it is absent in the smallest bronchioles. As the cartilage decreases, the amount of smooth
muscle increases. The mucous membrane also undergoes a transition from ciliated pseudostratified
columnar epithelium to simple cuboidal epithelium to simple squamous epithelium.
• The alveolar ducts and alveoli consist primarily of simple squamous epithelium, which permits
rapid diffusion of oxygen and carbon dioxide. Exchange of gases between the air in the lungs and
the blood in the capillaries occurs across the walls of the alveolar ducts and alveoli.

Lungs
• The two lungs, which contain all the components of the bronchial tree beyond the primary bronchi, occupy
most of the space in the thoracic cavity.
• The lungs are soft and spongy because they are mostly air spaces surrounded by the alveolar cells and
elastic connective tissue.
 • They are separated from each other by the mediastinum, which contains the heart. The only point of
attachment for each lung is at the hilum, or root, on the medial side. This is where the bronchi, blood
vessels, lymphatics, and nerves enter the lungs.
• The right lung is shorter, broader, and has a greater volume than the left lung. It is divided into three lobes
and each lobe is supplied by one of the secondary bronchi.
• The left lung is longer and narrower than the right lung. It has an indentation, called the cardiac notch, on
its medial surface for the apex of the heart. The left lung has two lobes.
• Each lung is enclosed by a double-layered serous membrane, called the pleura. The visceral pleura is
firmly attached to the surface of the lung. At the hilum, the visceral pleura is continuous with the parietal
pleura that lines the wall of the thorax.
• The small space between the visceral and parietal pleurae is the pleural cavity. It contains a thin film of
serous fluid that is produced by the pleura. The fluid acts as a lubricant to reduce friction as the two layers
slide against each other, and it helps to hold the two layers together as the lungs inflate and deflate.

Review: The Respiratory System

Here is what we have learned from the Respiratory System:
• The entire process of respiration includes ventilation, external respiration, transport of gases, internal
respiration, and cellular respiration.
• The three pressures responsible for pulmonary ventilation are atmospheric pressure, intraalveolar
pressure, and intrapleural pressure.
• A spirometer is used to measure respiratory volumes and capacities. These measurements provide useful
information about the condition of the lungs.
• The frontal, maxillary, ethmoidal, and sphenoidal sinuses are air-filled cavities that open into the nasal
cavity.
• The pharynx, commonly called the throat, is a passageway that extends from the base of the skull to the
level of the sixth cervical vertebra.
• The larynx, commonly called the voice box, is the passageway for air between the pharynx above and the
trachea below.
• The trachea, commonly called the windpipe, is the main airway to the lungs.
• The trachea divides into the right and left primary bronchi, which branch into smaller and smaller
passageways until they terminate in tiny air sacs called alveoli.
• The two lungs contain all the components of the bronchial tree beyond the primary bronchi.
• The right lung is shorter, broader, and is divided into three lobes.
• The left lung is longer, narrower, and is divided into two lobes.

MODULE XI: THE DIGESTIVE SYSTEM

INTENDED LEARNING OUTCOMES:

Students are expected to:
• name the organs of the alimentary canal and accessory digestive organs
• identify the overall function of the digestive system as digestion and absorption of foodstuffs
• list the accessory digestive organs, and describe the general function of each

• The digestive system includes the digestive tract and its accessory organs, which process food into
molecules that can be absorbed and utilized by the cells of the body. Food is broken down, bit by bit, until
the molecules are small enough to be absorbed and the waste products are eliminated.
• The digestive tract, also called the alimentary canal or gastrointestinal (GI) tract, consists of a long
continuous tube that extends from the mouth to the anus. It includes the
mouth, pharynx, esophagus, stomach, small intestine, and large intestine.
• The tongue and teeth are accessory structures located in the mouth.
 • The salivary glands, liver, gallbladder, and pancreas are major accessory organs that have a role
in digestion. These organs secrete fluids into the digestive tract.

Food undergoes three types of processes in the body:

• Digestion
• Absorption
• Elimination

• Digestion and absorption occur in the digestive tract. After the nutrients are absorbed, they are available
to all cells in the body and are utilized by the body cells in metabolism.
• The digestive system prepares nutrients for utilization by body cells through six activities, or functions.
Ingestion: The first activity of the digestive system is to take in food through the mouth. This process,
called ingestion, has to take place before anything else can happen.
Mechanical Digestion: The large pieces of food that are ingested have to be broken into smaller
particles that can be acted upon by various enzymes. This is mechanical digestion, which begins in the
mouth with chewing or mastication and continues with churning and mixing actions in the stomach.
Chemical Digestion: The complex molecules of carbohydrates, proteins, and fats are transformed by
chemical digestion into smaller molecules that can be absorbed and utilized by the cells. Chemical
digestion, through a process called hydrolysis, uses water and digestive enzymes to break down the
complex molecules. Digestive enzymes speed up the hydrolysis process, which is otherwise very slow.
Movements: After ingestion and mastication, the food particles move from the mouth into the
pharynx, then into the esophagus. This movement is deglutition, or swallowing. Mixing movements
occur in the stomach as a result of smooth muscle contraction. These repetitive contractions usually
occur in small segments of the digestive tract and mix the food particles with enzymes and other
fluids. The movements that propel the food particles through the digestive tract are called peristalsis.
These are rhythmic waves of contractions that move the food particles through the various regions in
which mechanical and chemical digestion takes place.
Absorption: The simple molecules that result from chemical digestion pass through cell membranes
of the lining in the small intestine into the blood or lymph capillaries. This process is called absorption.
Elimination: The food molecules that cannot be digested or absorbed need to be eliminated from the
body. The removal of indigestible wastes through the anus, in the form of feces, is defecation or
elimination.

Regions of the Digestive System

At its simplest, the digestive system is a tube running from mouth to anus.
Its chief goal is to break down huge macromolecules (proteins, fats and starch), which cannot be absorbed
intact, into smaller molecules (amino acids, fatty acids and glucose) that can be absorbed across the wall
of the tube, and into the circulatory system for dissemination throughout the body.
 Regions of the digestive system can be divided into two main parts: the
alimentary tract and accessory organs.
The alimentary tract of the digestive system is composed of the mouth, pharynx, esophagus, stomach,
small and large intestines, rectum and anus. Associated with the alimentary tract are the following
accessory organs: salivary glands, liver, gallbladder, and pancreas.

1. The mouth, or oral cavity: is the first part of the digestive tract.
It is adapted to receive food by ingestion, break it into small particles by mastication, and mix it
with saliva.
The lips, cheeks, and palate form the boundaries.
The oral cavity contains the teeth and tongue and receives the secretions from the salivary glands.
2. Lips and Cheeks: help hold food in the mouth and keep it in place for chewing.
They are also used in the formation of words for speech.
The lips contain numerous sensory receptors that are useful for judging the temperature and texture of
foods.
3. Palate: is the roof of the oral cavity. It separates the oral cavity from the nasal cavity.
The anterior portion, the hard palate, is supported by bone.
The posterior portion, the soft palate, is skeletal muscle and connective tissue.
Posteriorly, the soft palate ends in a projection called the uvula. During swallowing, the soft palate and
uvula move upward to direct food away from the nasal cavity and into the oropharynx.

4. Tongue: manipulates food in the mouth and is used in speech. The surface is covered with papillae that
provide friction and contain the taste buds.
5. Teeth
A complete set of deciduous (primary) teeth contains 20 teeth. There are 32 teeth in a complete
permanent (secondary) set. The shape of each tooth type corresponds to the way it handles food.

6. Pharynx & Esophagus

Pharynx
Food is forced into the pharynx by the tongue. When food reaches the opening, sensory receptors around
the fauces respond and initiate an involuntary swallowing reflex. This reflex action has several parts.
The uvula is elevated to prevent food from entering the nasopharynx. The epiglottis drops downward to
prevent food from entering the larynx and trachea in order to direct the food into the esophagus.
Peristaltic movements propel the food from the pharynx into the esophagus.
Esophagus
is a collapsible muscular tube that serves as a passageway between the pharynx and stomach. As it
descends, it is posterior to the trachea and anterior to the vertebral column. It passes through an opening
in the diaphragm, called the esophageal hiatus, and then empties into the stomach.
 The mucosa has glands that secrete mucus to keep the lining moist and well lubricated to ease the
passage of food. Upper and lower esophageal sphincters control the movement of food into and out of
the esophagus. The lower esophageal sphincter is sometimes called the cardiac sphincter and resides at
the esophagogastric junction.

7. Stomach
The stomach, which receives food from the esophagus, is located in the upper left quadrant of
the abdomen.
The stomach is divided into the fundic, cardiac, body, and pyloric regions.
The lesser and greater curvatures are on the right and left sides, respectively, of the stomach.

Gastric Secretions
The mucosal lining of the stomach is simple columnar epithelium with numerous tubular gastric glands. The
gastric glands open to the surface of the mucosa through tiny holes called gastric pits. Four different types of cells
make up the gastric glands:
• Mucous cells
• Parietal cells
• Chief cells
• Endocrine cells

The secretions of the exocrine gastric glands - composed of the mucous, parietal, and chief cells - make
up the gastric juice.
The products of the endocrine cells are secreted directly into the bloodstream and are not a part of the
gastric juice. The endocrine cells secrete the hormone gastrin, which functions in the regulation of gastric
activity.

Regulation of Gastric Secretions

The regulation of gastric secretion is accomplished through neural and hormonal mechanisms.
Gastric juice is produced all the time but the amount varies subject to the regulatory factors. Regulation
of gastric secretions may be divided into cephalic, gastric, and intestinal phases.
Thoughts and smells of food start the cephalic phase of gastric secretion; the presence of food in the
stomach initiates the gastric phase; and the presence of acid chyme in the small intestine begins the
intestinal phase.

Stomach Emptying
Relaxation of the pyloric sphincter allows chyme to pass from the stomach into the small intestine.
The rate of which this occurs depends on the nature of the chyme and the receptivity of the small
intestine.
8. Small & Large Intestine
Small Intestine:
• extends from the pyloric sphincter to the ileocecal valve, where it empties into the large intestine.
• finishes the process of digestion, absorbs the nutrients, and passes the residue on to the large intestine
• liver, gallbladder, and pancreas are accessory organs of the digestive system that are closely associated
with the small intestine
• divided into the duodenum, jejunum, and ileum.
• Exocrine cells in the mucosa of the small intestine secrete mucus, peptidase, sucrase, maltase, lactase,
lipase, and enterokinase. Endocrine cells secrete cholecystokinin and secretin.
• The most important factor for regulating secretions in the small intestine is the presence of chyme. This
is largely a local reflex action in response to chemical and mechanical irritation from the chyme and in
response to distention of the intestinal wall. This is a direct reflex action, thus the greater the amount of
chyme, the greater the secretion.

Large Intestine: larger in diameter than the small intestine. It begins at the ileocecal junction, where the ileum
enters the large intestine, and ends at the anus.
• The large intestine consists of the colon, rectum, and anal canal.
• The wall of the large intestine has the same types of tissue that are found in other parts of the digestive
tract but there are some distinguishing characteristics. The mucosa has a large number of goblet cells but
does not have any villi.
• Chemical digestion is completed in the small intestine before the chyme reaches the large intestine.
• Functions of the large intestine include the absorption of water and electrolytes and the elimination
of feces.

9. Rectum and Anus

• The rectum continues from the sigmoid colon to the anal canal and has a thick muscular layer.
• It follows the curvature of the sacrum and is firmly attached to it by connective tissue.
• The rectum ends about 5 cm below the tip of the coccyx, at the beginning of the anal canal.
• The last 2 to 3 cm of the digestive tract is the anal canal, which continues from the rectum and opens to
the outside at the anus.
• The mucosa of the rectum is folded to form longitudinal anal columns. The smooth muscle layer is thick
and forms the internal anal sphincter at the superior end of the anal canal. This sphincter is under
involuntary control. There is an external anal sphincter at the inferior end of the anal canal. This sphincter
is composed of skeletal muscle and is under voluntary control.

Accessory Organs
• The salivary glands, liver, gallbladder, and pancreas are not part of the digestive tract, but they have a
role in digestive activities and are considered accessory organs.

Salivary Glands
 Three pairs of major salivary glands (parotid, submandibular, and sublingual glands) and numerous
smaller ones secrete saliva into the oral cavity, where it is mixed with food during mastication. Saliva
contains water, mucus, and enzyme amylase. Functions of saliva include the following:
• It has a cleansing action on the teeth.
• It moistens and lubricates food during mastication and swallowing.
• It dissolves certain molecules so that food can be tasted.
• It begins the chemical digestion of starches through the action of amylase, which breaks down
polysaccharides into disaccharides.

Liver
The liver is located primarily in the right hypochondriac and epigastric regions of the abdomen, just
beneath the diaphragm. It is the largest gland in the body. On the surface, the liver is divided into two major lobes
and two smaller lobes.
The functional units of the liver are lobules with sinusoids that carry blood from the periphery to
the central vein of the lobule.
• The liver receives blood from two sources. Freshly oxygenated blood is brought to the liver by
the common hepatic artery, a branch of the celiac trunk from the abdominal aorta. Blood that is rich in
nutrients from the digestive tract is carried to the liver by the hepatic portal vein.
• The liver has a wide variety of functions and many of these are vital to life. Hepatocytes perform most of
the functions attributed to the liver, but the phagocytic Kupffer cells that line the sinusoids are
responsible for cleansing the blood.

Liver functions include the following:

• secretion
• synthesis of bile salts
• synthesis of plasma protein
• storage
• detoxification
• excretion
• carbohydrate metabolism
• lipid metabolism
• protein metabolism
• filtering

Gallbladder
• is a pear-shaped sac that is attached to the visceral surface of the liver by the cystic duct. The principal
function of the gallbladder is to serve as a storage reservoir for bile.
• Bile is a yellowish-green fluid produced by liver cells. The main components of bile are water, bile salts,
bile pigments, and cholesterol.
• Bile salts act as emulsifying agents in the digestion and absorption of fats. Cholesterol and bile pigments
from the breakdown of hemoglobin are excreted from the body in the bile.

Pancreas
• has both endocrine and exocrine functions
• The endocrine portion consists of the scattered islets of Langerhans, which secrete the
hormones insulin and glucagon into the blood.
• The exocrine portion is the major part of the gland. It consists of pancreatic acinar cells that secrete
digestive enzymes into tiny ducts interwoven between the cells.
• Pancreatic enzymes include amylase, trypsin, peptidase, and lipase. Pancreatic secretions are controlled
by the hormones secretin and cholecystokinin.
Review: The Digestive System
Here is what we have learned from the Digestive System:
• The digestive tract includes the digestive tract and its accessory organs, which process food into
molecules that can be absorbed and utilized by the cells of the body.
• Food undergoes three types of processes in the body: digestion, absorption, and elimination.
• The digestive system prepares nutrients for utilization by body cells through six activities, or functions:
ingestion, mechanical digestion, chemical digestion, movements, absorption, and elimination.
• The wall of the digestive tract has four layers or tunics: mucosa, submucosa, muscular layer, and serous
layer or serosa.
• Regions of the digestive system can be divided into two main parts: alimentary tract and accessory
organs.
• The alimentary tract of the digestive system is composed of the mouth, pharynx, esophagus, stomach,
small and large intestines, rectum and anus.
• Associated with the alimentary tract are the following accessory organs: salivary glands, liver,
gallbladder, and pancreas.

MODULE 12: THE URINARY SYSTEM

INTENDED LEARNING OUTCOME:

Students are expected to:
• describe the location of the kidneys in the body
• recognize that the nephron is the structural and functional unit of the kidney, and describe its anatomy
• describe the process of urine formation, identifying the areas of the nephron that are responsible for
filtration, reabsorption, and secretion
• describe the general structure and function of the ureters, urinary bladder, and urethra

LEARNING MATERIALS:
The principal function of the urinary system is to maintain the volume and composition of body fluids within
normal limits.
The function of the kidneys are as follows:
1. Filter. Every day, the kidneys filter gallons of fluid from the bloodstream.
2. Waste processing. The kidneys then process this filtrate, allowing wastes and excess ions to leave the
body in urine while returning needed substances to the blood in just the right proportions.
3. Elimination. Although the lungs and the skin also play roles in excretion, the kidneys bear the major
responsibility for eliminating nitrogenous wastes, toxins, and drugs from the body.
4. Regulation. The kidneys also regulate the blood’s volume and chemical makeup so that the proper
balance between water and salts and between acids and bases is maintained.
5. Other regulatory functions. By producing the enzyme renin, they help regulate blood pressure, and their
hormone erythropoietin stimulates red blood cell production in the bone marrow.
6. Conversion. Kidney cells also convert vitamin D to its active form.

• The urinary system consists of two kidneys, two ureters, a urinary bladder, and a urethra.
• The kidneys alone perform the functions just described and manufacture urine in the process, while the
other organs of the urinary system provide temporary storage reservoirs for urine or serve as
transportation channels to carry it from one body region to another.
The Kidneys which maintain the purity and constancy of our internal fluids, are perfect examples of homeostatic
organs.

• Location. These small, dark red organs with a kidney-bean shape lie against the dorsal body wall in a
retroperitoneal position (beneath the parietal peritoneum) in the superior lumbar region; they extend
from the T12 to the L3 vertebra, thus they receive protection from the lower part of the rib cage.
• Positioning. Because it is crowded by the liver, the right kidney is positioned slightly lower than the left.
Size. An adult kidney is about 12 cm (5 inches) long, 6 cm (2.5 inches) wide, and 3 cm (1 inch) thick,
about the size of a large bar of soap.
• Adrenal gland. Atop each kidney is an adrenal gland, which is part of the endocrine system is a distinctly
separate organ functionally.
• Fibrous capsule. A transparent fibrous capsule encloses each kidney and gives a fresh kidney a glistening
appearance.
• Perirenal fat capsule. A fatty mass, the perirenal fat capsule, surrounds each kidney and acts
to cushion it against blows.
• Renal fascia. The renal fascia, the outermost capsule, anchors the kidney and helps hold it in place
against the muscles of the trunk wall.
• Renal cortex. The outer region, which is light in color, is the renal cortex.
• Renal medulla. Deep to the cortex is a darker, reddish-brown area, the renal medulla.
• Renal pyramids. The medulla has many basically triangular regions with a striped appearance, the renal,
or medullary pyramids; the broader base of each pyramid faces toward the cortex while its tip, the apex,
points toward the inner region of the kidney.
• Renal columns. The pyramids are separated by extensions of cortex-like tissue, the renal columns.
• Renal pelvis. Medial to the hilum is a flat, basinlike cavity, the renal pelvis, which is continuous with the
ureter leaving the hilum.
• Calyces. Extensions of the pelvis, calyces, form cup-shaped areas that enclose the tips of the pyramid
and collect urine, which continuously drains from the tips of the pyramids into the renal pelvis.
• Renal artery. The arterial supply of each kidney is the renal artery, which divides into segmental
arteries as it approaches the hilum, and each segmental artery gives off several branches
called interlobar arteries.
• Arcuate arteries. At the cortex-medulla junction, interlobar arteries give off arcuate arteries, which
curve over the medullary pyramids.
• Cortical radiate arteries. Small cortical radiate arteries then branch off the arcuate arteries and run
outward to supply the cortical tissue.
Nephrons: are the structural and functional units of the kidneys.
• Each kidney contains over a million tiny structures called nephrons, and they are responsible for forming
urine.
• Glomerulus. One of the main structures of a nephron, a glomerulus is a knot of capillaries.
• Renal tubule. Another one of the main structures in a nephron is the renal tubule.
• Bowman’s capsule. The closed end of the renal tubule is enlarged and cup-shaped and completely
surrounds the glomerulus, and it is called the glomerular or Bowman’s capsule.
• Podocytes. The inner layer of the capsule is made up of highly modified octopus-like cells called
podocytes.
• Foot processes. Podocytes have long branching processes called foot processes that intertwine with one
another and cling to the glomerulus.
• Collecting duct. As the tubule extends from the glomerular capsule, it coils and twists before forming a
hairpin loop and then again becomes coiled and twisted before entering a collecting tubule called the
collecting duct, which receives urine from many nephrons.
• Proximal convoluted tubule. This is the part of the tubule that is near to the glomerular capsule.
• Loop of Henle. The loop of Henle is the hairpin loop following the proximal convoluted tubule.
• Distal convoluted tubule. After the loop of Henle, the tubule continues to coil and twist before the
collecting duct, and this part is called the distal convoluted tubule.
• Cortical nephrons. Most nephrons are called cortical nephrons because they are located almost entirely
within the cortex.
• Juxtamedullary nephrons. In a few cases, the nephrons are called juxtamedullary nephrons because they
are situated next to the cortex-medullary junction, and their loops of Henle dip deep into the medulla.
• Afferent arteriole. The afferent arteriole, which arises from a cortical radiate artery, is the “feeder
vessel”.
• Efferent arteriole. The efferent arteriole receives blood that has passed through the glomerulus.
• Peritubular capillaries. They arise from the efferent arteriole that drains the glomerulus.

URETERS: The ureters do play an active role in urine transport.

• Size. The ureters are two slender tubes each 25 to 30 cm (10 to 12 inches) long and 6 mm (1/4 inch) in
diameter.
• Location. Each ureter runs behind the peritoneum from the renal hilum to the posterior aspect of the
bladder, which it enters at a slight angle.
• Function. Essentially, the ureters are passageways that carry urine from the kidneys to the bladder
through contraction of the smooth muscle layers in their walls that propel urine into the bladder
 by peristalsis and is prevented from flowing back by small valve-like folds of bladder mucosa that flap over
the ureter openings.

URINARY BLADDER: The urinary bladder is a smooth, collapsible, muscular sac that stores urine temporarily.
• Location. It is located retroperitoneally in the pelvis just posterior to the symphysis pubis.
• Function. The detrusor muscles and the transitional epithelium both make the bladder uniquely suited
for its function of urine storage.
• Trigone. The smooth triangular region of the bladder base outlined by these three openings is called the
trigone, where infections tend to persist.
• Detrusor muscles. The bladder wall contains three layers of smooth muscle, collectively called the
detrusor muscle, and its mucosa is a special type of epithelium, transitional epithelium.

URETHRA: The urethra is a thin-walled tube that carries urine by peristalsis from the bladder to the outside of
the body.
• Internal urethral sphincter. At the bladder-urethral junction, a thickening of the smooth muscle forms
the internal urethral sphincter, an involuntary sphincter that keeps the urethra closed when the urine is
not being passed.
• External urethral sphincter. A second sphincter, the external urethral sphincter, is fashioned by skeletal
muscle as the urethra passes through the pelvic floor and is voluntarily controlled.
• Female urethra. The female urethra is about 3 to 4 cm (1 1/2 inches) long, and its external orifice, or
opening, lies anteriorly to the vaginal opening.
• Male urethra. the urethra is approximately 20 cm (8 inches) long and has three named regions:
the prostatic, membranous, and spongy (penile) urethrae; it opens at the tip of the penis after traveling
down its length.

Physiology of the Urinary System

• Every day, the kidneys filter gallons of fluid from the bloodstream. The normal physiology that takes
place in the urinary system is as follows:
• Urine Formation - Urine formation is a result of three processes:
Glomerular filtration. Water and solutes smaller than proteins are forced through the capillary walls and
pores of the glomerular capsule into the renal tubule.
Tubular reabsorption. Water, glucose, amino acids, and needed ions are transported out of the filtrate
into the tubule cells and then enter the capillary blood.
Tubular secretion. Hydrogen, potassium, creatinine, and drugs are removed from the peritubular blood
and secreted by the tubule cells into the filtrate.

Characteristics of Urine
• In 24 hours, the marvelously complex kidneys filter some 150 to 180 liters of blood plasma through their
glomeruli into the tubules.
• Daily volume. In 24 hours, only about 1.0 to 1.8 liters of urine are produced.
• Components. Urine contains nitrogenous wastes and unneeded substances.
• Color. Freshly voided urine is generally clear and pale to deep yellow.
• Odor. When formed, urine is sterile and slightly aromatic, but if allowed to stand, it takes on an ammonia
odor caused by the action of bacteria on the urine solutes.
• pH. Urine pH is usually slightly acidic (around 6), but changes in body metabolism and certain foods may
cause it to be much more acidic or basic.
• Specific gravity. Whereas the specific gravity of pure water is 1.0, the specific gravity of urine usually
ranges from 1.001 to 1.035.
• Solutes. Solutes normally found in urine include sodium and potassium ions, urea, uric acid, creatinine,
ammonia, bicarbonate ions, and various other ions.
Micturition or voiding - is the act of emptying the bladder.
• Accumulation. Ordinarily, the bladder continues to collect urine until about 200 ml have accumulated.
• Activation. At about this point, stretching of the bladder wall activates stretch receptors.
• Transmission. Impulses transmitted to the sacral region of the spinal cord and then back to the bladder
via the pelvic splanchnic nerves cause the bladder to go into reflex contractions.
• Passage. As the contractions become stronger, stored urine is forced past the internal urethral sphincter
into the upper part of the urethra.
• External sphincter. Because the lower external sphincter is skeletal muscle and voluntarily controlled, we
can choose to keep it closed or it can be relaxed so that urine is flushed from the body.

Review: The Urinary System

Here is what we have learned from the Urinary System:
• The urinary system rids the body of waste materials, regulates fluid volume, maintains electrolyte
concentrations in body fluids, controls blood pH, secretes erythropoietin, and renin.
• The components of the urinary system are the kidneys, ureters, urinary bladder, and urethra.
• The primary organs of the urinary system are the kidneys, which are located retroperitoneally between
the levels of the twelfth thoracic and third lumbar vertebrae.
• The cortex and medulla make up the parenchyma of the kidney.
• The central region of the kidney is the renal pelvis, which collects the urine as it is produced.
• The functional unit of the kidney is a nephron, which consists of a renal corpuscle and a renal tubule.
• The ureters transport urine from the kidney to the urinary bladder.
• The urinary bladder is a temporary storage reservoir for urine.
• The urethra is the final passageway for the flow of urine.
• The flow of urine through the urethra is controlled by an involuntary internal urethral sphincter and
voluntary external urethral sphincter.

MODULE XII: THE REPRODUCTIVE SYSTEM

INTENDED LEARNING OUTCOME:

Students are expected to:
• identify the organs of the male reproductive system, and discuss the general functions of each
• discuss the composition of semen, and name the glands that produce it
• identify the organs of the female reproductive system, and discuss the general functions of each
• indicate the location of the following regions of the female uterus: cervix, fundus and body

LEARNING MATERIALS:
• The major function of the reproductive system is to ensure survival of the species
• An individual may live a long, healthy, and happy life without producing offspring, but if the species is to
continue, at least some individuals must produce offspring.

Within the context of producing offspring, the reproductive system has four functions:
• To produce egg and sperm cells
• To transport and sustain these cells
• To nurture the developing offspring
• To produce hormones

These functions are divided between the primary and secondary, or accessory, reproductive organs.
The primary reproductive organs, or gonads, consist of the ovaries and testes. These organs are
responsible for producing the egg and sperm cells gametes), and hormones. These hormones function in
 the maturation of the reproductive system, the development of sexual characteristics, and regulation of
the normal physiology of the reproductive system.
All other organs, ducts, and glands in the reproductive system are considered secondary, or accessory,
reproductive organs. These structures transport and sustain the gametes and nurture the developing
offspring.

Male Reproductive System

• The male reproductive system, like that of the female, consists of those organs whose function is to
produce a new individual, i.e., to accomplish reproduction. This system consists of a pair of testes and a
network of excretory ducts (epididymis, ductus deferens (vas deferens), and ejaculatory ducts), seminal
vesicles, the prostate, the bulbourethral glands, and the penis.

Testes
• The male gonads, testes or testicles, begin their development high in the abdominal cavity, near the
kidneys.
• During the last two months before birth, or shortly after birth, they descend through the inguinal
canal into the scrotum, a pouch that extends below the abdomen, posterior to the penis.
• Although this location of the testes, outside the abdominal cavity, may seem to make them vulnerable to
injury, it provides a temperature about 3° C below normal body temperature. This lower temperature is
necessary for the production of viable sperm.

• The scrotum consists of skin and subcutaneous tissue.

• A vertical septum, or partition, of subcutaneous tissue in the center divides it into two parts, each
containing one testis.
• Smooth muscle fibers, called the dartos muscle, in the subcutaneous tissue contract to give the scrotum
its wrinkled appearance. When these fibers are relaxed, the scrotum is smooth. Another muscle,
the cremaster muscle, consists of skeletal muscle fibers and controls the position of the scrotum and
 testes. When it is cold or a man is sexually aroused, this muscle contracts to pull the testes closer to the
body for warmth.

Structure
• Each testis is an oval structure about 5 cm long and 3 cm in diameter. A tough, white fibrous connective
tissue capsule, the tunica albuginea, surrounds each testis and extends inward to form septa that partition
the organ into lobules.
• There are about 250 lobules in each testis. Each lobule contains 1 to 4 highly coiled seminiferous
tubules that converge to form a single straight tubule, which leads into the rete testis.
• Short efferent ducts exit the testes. Interstitial cells (cells of Leydig), which produce male sex hormones,
are located between the seminiferous tubules within a lobule.

Spermatogenesis
• Sperm are produced by spermatogenesis within the seminiferous tubules. A transverse section of a
seminiferous tubule shows that it is packed with cells in various stages of development.
• Interspersed with these cells, there are large cells that extend from the periphery of the tubule to
the lumen. These large cells are the supporting, or sustentacular cells (Sertoli's cells), which support and
nourish the other cells.

Duct System: Sperm cells pass through a series of ducts to reach the outside of the body. After they leave the
testes, the sperm passes through the epididymis, ductus deferens, ejaculatory duct, and urethra.
1. Epididymis
• Sperm leave the testes through a series of efferent ducts that enter the epididymis. Each epididymis is a
long (about 6 meters) tube that is tightly coiled to form a comma-shaped organ located along
the superior and posterior margins of the testes.
• When the sperm leave the testes, they are immature and incapable of fertilizing ova. They complete their
maturation process and become fertile as they move through the epididymis. Mature sperm are stored in
the lower portion, or tail, of the epididymis.
2. Ductus Deferens
• also called vas deferens, is a fibromuscular tube that is continuous ( or contiguous) with the epididymis.
It begins at the bottom (tail) of the epididymis then turns sharply upward along the posterior margin of
the testes.
• The ductus deferens enters the abdominopelvic cavity through the inguinal canal and passes along
the lateral pelvic wall. It crosses over the ureter and posterior portion of the urinary bladder, and then
descends along the posterior wall of the bladder toward the prostate gland.
• Just before it reaches the prostate gland, each ductus deferens enlarges to form an ampulla. Sperm are
stored in the proximal portion of the ductus deferens, near the epididymis, and peristaltic movements
propel the sperm through the tube.
3. Ejaculatory Duct
• Each ductus deferens, at the ampulla, joins the duct from the adjacent seminal vesicle (one of
the accessory glands) to form a short ejaculatory duct. Each ejaculatory duct passes through the prostate
gland and empties into the urethra.
4. Urethra
• The urethra extends from the urinary bladder to the external urethral orifice at the tip of the penis. It is a
passageway for sperm and fluids from the reproductive system and urine from the urinary system.
• While reproductive fluids are passing through the urethra, sphincters contract tightly to keep urine from
entering the urethra.
• The male urethra is divided into three regions. The prostatic urethra is the proximal portion that passes
through the prostate gland. It receives the ejaculatory duct, which contains sperm and secretions from
the seminal vesicles, and numerous ducts from the prostate glands. The next portion, the membranous
 urethra, is a short region that passes through the pelvic floor. The longest portion is the penile urethra
(also called spongy urethra or cavernous urethra), which extends the length of the penis and opens to the
outside at the external urethral orifice. The ducts from the bulbourethral glands open into the penile
urethra.

Accessory Glands
• The accessory glands of the male reproductive system are the seminal vesicles, prostate gland, and the
bulbourethral glands. These glands secrete fluids that enter the urethra.
Seminal Vesicles
• The paired seminal vesicles are saccular glands posterior to the urinary bladder. Each gland has a
short duct that joins with the ductus deferens at the ampulla to form an ejaculatory duct, which then
empties into the urethra.
• The fluid from the seminal vesicles is viscous and contains fructose, which provides an energy source for
the sperm; prostaglandins, which contribute to the mobility and viability of the sperm; and proteins that
cause slight coagulation reactions in the semen after ejaculation.
Prostate
• The prostate gland is a firm, dense structure that is located just inferior to the urinary bladder. It is about
the size of a walnut and encircles the urethra as it leaves the urinary bladder. Numerous short ducts from
the substance of the prostate gland empty into the prostatic urethra. The secretions of the prostate are
thin, milky colored, and alkaline. They function to enhance the motility of the sperm.
Bulbourethral Glands
• The paired bulbourethral (Cowper's) glands are small, about the size of a pea, and located near the base of
the penis. A short duct from each gland enters the proximal end of the penile urethra. In response to
sexual stimulation, the bulbourethral glands secrete an alkaline mucus-like fluid. This fluid neutralizes
the acidity of the urine residue in the urethra, helps to neutralize the acidity of the vagina, and provides
some lubrication for the tip of the penis during intercourse.
Seminal Fluid
• Seminal fluid, or semen, is a slightly alkaline mixture of sperm cells and secretions from the accessory
glands. Secretions from the seminal vesicles make up about 60 percent of the volume of the semen, with
most of the remainder coming from the prostate gland. The sperm and secretions from the bulbourethral
gland contribute only a small volume.
• The volume of semen in a single ejaculation may vary from 1.5 to 6.0 ml. There are usually between 50 to
150 million sperm per milliliter of semen. Sperm counts below 10 to 20 million per milliliter usually
present fertility problems. Although only one sperm actually penetrates and fertilizes the ovum, it takes
several million sperm in an ejaculation to ensure that fertilization will take place.

Penis
• The penis, the male copulatory organ, is a cylindrical pendant organ located anterior to the scrotum and
functions to transfer sperm to the vagina. The penis consists of three columns of erectile tissue that are
wrapped in connective tissue and covered with skin. The two dorsal columns are the corpora cavernosa.
The single, midline ventral column surrounds the urethra and is called the corpus spongiosum.
 • The penis has a root, body (shaft), and glans penis. The root of the penis attaches it to the pubic arch, and
the body is the visible, pendant portion. The corpus spongiosum expands at the distal end to form the
glans penis. The urethra, which extends throughout the length of the corpus spongiosum, opens through
the external urethral orifice at the tip of the glans penis. A loose fold of skin, called the prepuce,
or foreskin, covers the glans penis.

Male Sexual Response and Hormonal Control

• The male sexual response includes erection and orgasm accompanied by ejaculation of semen. Orgasm is
followed by a variable time period during which it is not possible to achieve another erection.
• Three hormones are the principle regulators of the male reproductive system: follicle-stimulating
hormone (FSH) stimulates spermatogenesis; luteinizing hormone (LH) stimulates the production
of testosterone; and testosterone stimulates the development of male secondary sex characteristics and
spermatogenesis.

Female Reproductive System

The organs of the female reproductive system produce and sustain the female sex cells (egg cells or ova),
transport these cells to a site where they may be fertilized by sperm, provide a favorable environment for the
developing fetus, move the fetus to the outside at the end of the development period, and produce the female
sex hormones. The female reproductive system includes the ovaries, Fallopian
tubes, uterus, vagina, accessory glands, and external genital organs.
• Ovaries
• Genital Tract
• External Genitalia
• Female Sexual Response and Hormonal Control
• Mammary Glands

Ovaries
 • The primary female reproductive organs, or gonads, are the two ovaries. Each ovary is a solid, ovoid
structure about the size and shape of an almond, about 3.5 cm in length, 2 cm wide, and 1 cm thick. The
ovaries are located in shallow depressions, called ovarian fossae, one on each side of the uterus, in
the lateral walls of the pelvic cavity. They are held loosely in place by peritoneal ligaments.
• The ovaries are covered on the outside by a layer of simple cuboidal epithelium called germinal (ovarian)
epithelium. This is actually the visceral peritoneum that envelops the ovaries. Underneath this layer is a
dense connective tissue capsule, the tunica albuginea.
• The substance of the ovaries is distinctly divided into an outer cortex and an inner medulla. The cortex
appears more dense and granular due to the presence of numerous ovarian follicles in various stages of
development. Each of the follicles contains an oocyte, a female germ cell. The medulla is a loose
connective tissue with abundant blood vessels, lymphatic vessels, and nerve fibers.
Oogenesis
• Female sex cells, or gametes, develop in the ovaries by a form of meiosis called oogenesis. The sequence
of events in oogenesis is similar to the sequence in spermatogenesis, but the timing and final result are
different. Early in fetal development, primitive germ cells in the ovaries differentiate into oogonia.
• These divide rapidly to form thousands of cells, still called oogonia, which have a full complement of 46
(23 pairs) chromosomes. Oogonia then enter a growth phase, enlarge, and become primary oocytes.
The diploid (46 chromosomes) primary oocytes replicate their DNA and begin the first meiotic division,
but the process stops in prophase and the cells remain in this suspended state until puberty.
• Many of the primary oocytes degenerate before birth, but even with this decline, the two ovaries together
contain approximately 700,000 oocytes at birth. This is the lifetime supply, and no more will develop. This
is quite different than the male in which spermatogonia and primary spermatocytes continue to be
produced throughout the reproductive lifetime. By puberty the number of primary oocytes has further
declined to about 400,000.
• Beginning at puberty, under the influence of follicle-stimulating hormone, several primary oocytes start
to grow again each month. One of the primary oocytes seems to outgrow the others and it resumes
meiosis I. The other cells degenerate. The large cell undergoes an unequal division so that nearly all
the cytoplasm, organelles, and half the chromosomes go to one cell, which becomes a secondary oocyte.
The remaining half of the chromosomes go to a smaller cell called the first polar body.
• The secondary oocyte begins the second meiotic division, but the process stops in metaphase. At this
point ovulation occurs. If fertilization occurs, meiosis II continues. Again this is an unequal division with
all of the cytoplasm going to the ovum, which has 23 single-stranded chromosome. The smaller cell from
this division is a second polar body. The first polar body also usually divides in meiosis I to produce two
even smaller polar bodies. If fertilization does not occur, the second meiotic division is
never completed and the secondary oocyte degenerates. Here again there are obvious differences
between the male and female. In spermatogenesis, four functional sperm develop from each primary
spermatocyte. In oogenesis, only one functional fertilizable cell develops from a primary oocyte. The other
three cells are polar bodies and they degenerate.
Ovarian Follicle Development
• An ovarian follicle consists of a developing oocyte surrounded by one or more layers of cells called
follicular cells. At the same time that the oocyte is progressing through meiosis, corresponding changes
are taking place in the follicular cells. Primordial follicles, which consist of a primary oocyte surrounded
by a single layer of flattened cells, develop in the fetus and are the stage that is present in the ovaries at
birth and throughout childhood.
 • Beginning at puberty, follicle-stimulating hormone stimulates changes in the primordial follicles. The
follicular cells become cuboidal, the primary oocyte enlarges, and it is now a primary follicle. The follicles
continue to grow under the influence of follicle-stimulating hormone, and the follicular cells proliferate
to form several layers of granulose cells around the primary oocyte.
• Most of these primary follicles degenerate along with the primary oocytes within them, but usually one
continues to develop each month. The granulosa cells start secreting estrogen and a cavity, or antrum,
forms within the follicle. When the antrum starts to develop, the follicle becomes a secondary follicle.
• The granulose cells also secrete a glycoprotein substance that forms a clear membrane, the zona
pellucida, around the oocyte.
• After about 10 days of growth the follicle is a mature vesicular (graafian) follicle, which forms a "blister"
on the surface of the ovary and contains a secondary oocyte ready for ovulation.
Ovulation
• Ovulation, prompted by luteinizing hormone from the anterior pituitary, occurs when the mature follicle
at the surface of the ovary ruptures and releases the secondary oocyte into the peritoneal cavity.
• The ovulated secondary oocyte, ready for fertilization is still surrounded by the zona pellucida and a few
layers of cells called the corona radiata. If it is not fertilized, the secondary oocyte degenerates in a couple
of days.
• If a sperm passes through the corona radiata and zona pellucida and enters the cytoplasm of the
secondary oocyte, the second meiotic division resumes to form a polar body and a mature ovum
• After ovulation and in response to luteinizing hormone, the portion of the follicle that remains in the ovary
enlarges and is transformed into a corpus luteum. The corpus luteum is a glandular structure that
secretes progesterone and some estrogen. Its fate depends on whether fertilization occurs.
• If fertilization does not take place, the corpus luteum remains functional for about 10 days; then it begins
to degenerate into a corpus albicans, which is primarily scar tissue, and its hormone output ceases.
• If fertilization occurs, the corpus luteum persists and continues its hormone functions until
the placenta develops sufficiently to secrete the necessary hormones. Again, the corpus luteum ultimately
degenerates into corpus albicans, but it remains functional for a longer period of time.

Genital Tract
Fallopian Tubes
• There are two uterine tubes, also called Fallopian tubes or oviducts. There is one tube associated with
each ovary. The end of the tube near the ovary expands to form a funnel-shaped infundibulum, which is
surrounded by fingerlike extensions called fimbriae.
 • Because there is no direct connection between the infundibulum and the ovary, the oocyte enters
the peritoneal cavity before it enters the Fallopian tube. At the time of ovulation, the fimbriae increase
their activity and create currents in the peritoneal fluid that help propel the oocyte into the Fallopian tube.
• Once inside the Fallopian tube, the oocyte is moved along by the rhythmic beating of cilia on the epithelial
lining and by peristaltic action of the smooth muscle in the wall of the tube. The journey through the
Fallopian tube takes about 7 days.
• Because the oocyte is fertile for only 24 to 48 hours, fertilization usually occurs in the Fallopian tube.
Uterus
• The uterus is a muscular organ that receives the fertilized oocyte and provides an appropriate
environment for the developing fetus.
• Before the first pregnancy, the uterus is about the size and shape of a pear, with the narrow portion
directed inferiorly. After childbirth, the uterus is usually larger, then regresses after menopause.

• The uterus is lined with the endometrium. The stratum functionale of the endometrium sloughs off
during menstruation. The deeper stratum basale provides the foundation for rebuilding the stratum
functionale.
Vagina
• The vagina is a fibromuscular tube, about 10 cm long, that extends from the cervix of the uterus to the
outside. It is located between the rectum and the urinary bladder.
• Because the vagina is tilted posteriorly as it ascends and the cervix is tilted anteriorly, the cervix projects
into the vagina at nearly a right angle.
• The vagina serves as a passageway for menstrual flow, receives the erect penis during intercourse, and is
the birth canal during childbirth

External Genitalia
• The external genitalia are the accessory structures of the female reproductive system that are external to
the vagina. They are also referred to as the vulva or pudendum. The external genitalia include the labia
majora, mons pubis, labia minora, clitoris, and glands within the vestibule.
• The clitoris is an erectile organ, similar to the male penis, that responds to sexual stimulation. Posterior to
the clitoris, the urethra, vagina, paraurethral glands and greater vestibular glands open into the vestibule.
Female Sexual Response & Hormone Control
• The female sexual response includes arousal and orgasm, but there is no ejaculation. A woman may
become pregnant without having an orgasm.
• Follicle-stimulating hormone, luteinizing hormone, estrogen, and progesterone have major roles in
regulating the functions of the female reproductive system.
• At puberty, when the ovaries and uterus are mature enough to respond to hormonal stimulation, certain
stimuli cause the hypothalamus to start secreting gonadotropin-releasing hormone. This hormone enters
the blood and goes to the anterior pituitary gland where it stimulates the secretion of follicle-stimulating
hormone and luteinizing hormone. These hormones, in turn, affect the ovaries and uterus and the
monthly cycles begin. A woman's reproductive cycles last from menarche to menopause.
• The monthly ovarian cycle begins with the follicle development during the follicular phase, continues
with ovulation during the ovulatory phase, and concludes with the development and regression of
the corpus luteum during the luteal phase.
• The uterine cycle takes place simultaneously with the ovarian cycle. The uterine cycle begins
with menstruation during the menstrual phase, continues with repair of the endometrium during the
proliferative phase, and ends with the growth of glands and blood vessels during the secretory phase.
• Menopause occurs when a woman's reproductive cycles stop. This period is marked by decreased levels
of ovarian hormones and increased levels of pituitary follicle-stimulating hormone and luteinizing
hormone. The changing hormone levels are responsible for the symptoms associated with menopause.

Mammary Glands
• Functionally, the mammary glands produce milk; structurally, they are modified sweat glands. Mammary
glands, which are located in the breast overlying the pectoralis major muscles, are present in both sexes,
but usually are functional only in the female.
• Externally, each breast has a raised nipple, which is surrounded by a circular pigmented area called
the areola. The nipples are sensitive to touch, due to the fact that they contain smooth muscle that
contracts and causes them to become erect in response to stimulation.
• Internally, the adult female breast contains 15 to 20 lobes of glandular tissue that radiate around the
nipple. The lobes are separated by connective tissue and adipose. The connective tissue helps support the
breast. Some bands of connective tissue, called suspensory (Cooper's) ligaments, extend through the
breast from the skin to the underlying muscles. The amount and distribution of the adipose tissue
determines the size and shape of the breast. Each lobe consists of lobules that contain the glandular units.
• A lactiferous duct collects the milk from the lobules within each lobe and carries it to the nipple. Just
before the nipple, the lactiferous duct enlarges to form a lactiferous sinus (ampulla), which serves as a
reservoir for milk. After the sinus, the duct again narrows and each duct opens independently on the
surface of the nipple.
 • Mammary gland function is regulated by hormones. At puberty, increasing levels of estrogen stimulate
the development of glandular tissue in the female breast. Estrogen also causes the breast to increase in
size through the accumulation of adipose tissue. Progesterone stimulates the development of the
duct system.
• During pregnancy, these hormones enhance further development of the mammary glands. Prolactin from
the anterior pituitary stimulates the production of milk within the glandular tissue, and oxytocin causes
the ejection of milk from the glands.

Review: The Reproductive System

Here is what we have learned from Introduction to the Reproductive System:
• The four functions of the reproductive system are:
o To produce egg and sperm cells
o To transport and sustain these cells
o To nurture the developing fetus
o To produce hormones
• The primary reproductive organs are the gonads, which produce the gametes and hormones. The
secondary, or accessory, structures transport and sustain the gametes and nurture the developing
offspring.
• The male reproductive system consists of the testes, duct system, accessory glands, and penis.
• The male gonads are the testes. Their location within the scrotum is necessary for the production of viable
sperm.
• The female reproductive system includes the ovaries, uterine tubes, uterus, vagina, accessory glands, and
external genital organs.
• The female gonads are the ovaries, which are located on each side of the uterus in the pelvic cavity.
• Estrogen and progesterone stimulate the development of glandular tissue and ducts in the breast.
Prolactin stimulates the production of milk, and oxytocin causes the ejection of milk.

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