91400 Human Anatomy and Physiology Spring 2024 Practical Manual PDF

91400 HUMAN ANATOMY AND PHYSIOLOGY SPRING 2024 Name student email SID This is Carl Ferdinand and Gerty Cori. If you want to know more 1  91400 CLASS TIMES Lectures The PowerPoint slides that are use...

91400 HUMAN ANATOMY AND PHYSIOLOGY SPRING 2024 Name student email SID This is Carl Ferdinand and Gerty Cori. If you want to know more 1  91400 CLASS TIMES Lectures The PowerPoint slides that are used in any lecture will be posted on Canvas before the lecture is delivered. Some but not all the lectures are delivered as live Zoom sessions. Here are the Zoom links, Lecture 1: Wednesdays 8 AM – 9 AM (https://utsmeet.zoom.us/j/81734994678) Lecture 2: Wednesdays 12 PM - 1 PM (https://utsmeet.zoom.us/j/82284966607). *You can also access the same looks via the “Zoom” page on the HAP Canvas site* Because these are run on Zoom: the lectures are recorded and will be posted on the Canvas site after they have been processed. If you miss a live session: you have the recordings to look through in your own time. Similarly, if you are student who did not allocate to the live session: then you have the recordings after the live session is run. Practicals These are only run on campus and run in Weeks 2-9 and Week 12. The full details are provided in the Schedule further on in the manual. Your attendance is recorded in the class because in Weeks 3-8 and 9 and 12 there is an in-class quiz. As most classes are at capacity, a make-up session later in the same week will not be feasible. Instead, if you miss a class, you will need to complete the week's practical exercises in your own time. 2  91400 LECTURE AND PRACTICAL SCHEDULE WEEKS 1 TO 8 Week number: Lecture 1 Lecture 2 Practical (Tuesday’s date) Wed 8 am to 9 am Wed 12 noon to 1 pm (Tue/Wed/Thu/Fri) n Online Self-study: Intro to Medical Terminology (Medical Terminology videos with a practice quiz) 1: Aug 6th No live sessions No Practical 2: Aug 13th Hormones and the Endocrine Hormones and the Endocrine Welcome to your Body System 1 (LB) System 2 (LB) Pre-recorded lectures Bone Physiology (KMcG) -Introduction to the Nervous System (DVR) - 3: Aug 20th Action Potentials and Neurotransmitters (DVR) Skin and Histology No live session batyr student mental health session 4: Aug 27th Central Nervous System (LB) Peripheral Nervous System (LB) Bones and the Skeleton Pre-recording only: Muscles & Muscle Physiology (KMcG) 5: Sep 3rd Q&A Session on My Lectures: Intron to the Cardiovascular Brain and Spinal Cord and Reflexes KMcG System/ Electrical Activity of the Heart (GH) 6: Sep 10th Pump Activity of the Heart (GH) Blood Pressure and Flow (GH) The Major Muscles of the Human Body/Joints and Movement 7: Sep 17th Mechanics of Breathing (GH) Gas Exchange and Transport (GH) Cardiovascular Anatomy and Physiology 8: Sept 24th Pre-recording only: Haemostasis (DVR) Respiratory anatomy and measurement of lung function Blood and its components (DVR) UTS Careers Session Lecturers: DVR: David; GH: Dr George Herok; KMcG: A/Prof Kristine McGrath; LB: Dr Laura Bradfield 3  91400 LECTURE AND PRACTICAL SCHEDULE WEEKS 9 TO 12 1st Oct to 5th Oct: Mid-Session Stu Vac: no lectures and no tutorials 9: Oct 8th Pre-recording only: Gastrointestinal System 1 & 2 (HC) Blood and Circulatory System 10: Oct 15th Urinary System 1 (DVR) Urinary System 2 (DVR) GIS Anatomy and Histology [Online Self-Study Resource] 11: Oct 22nd Urinary System 3 (DVR) Body Fluid Homeostasis (DVR) 12: Oct 29th Reproductive System 1 (DVR) Reproductive System 2 (DVR) Urinary System Anatomy and Urinalysis Lecturers: DVR: David; HC: Prof Hui Chen 4  91400 ONLINE QUIZ SCHEDULE Each quiz runs from 10 AM Wednesday until 10 PM Thursday. As the quizzes are run online, please use the links provided on the Canvas site when you are ready to take the quiz. Quiz Dates Lectures Examined in the Quiz Hormones and the Endocrine System 1 &2 Bone Physiology 1 28th to 29th August Introduction to the Nervous System Action Potentials and Neurotransmitters Central Nervous System Peripheral Nervous System Muscles and Muscle Physiology 2 18th to 19th September Introduction to the Cardiovascular System Electrical Activity of the Heart Pump Activity of the Hear Blood Pressure and Flow Mechanics of Breathing Gas Exchange and Transport 3 16th to 17th October Haemostasis Blood and its components Gastrointestinal System 1&2 Urinary System 1,2 and 3 4 13th to 14th November Body Fluid Homeostasis Reproductive System 1 & 2 5  91400 IN-CLASS PRACTICAL QUIZZES Each quiz will run in the second hour of your practical class. Quiz # Week of the Quiz Practical Examined 1 3 Welcome to your body 2 4 Skin and Histology 3 5 Bones and the Skeleton 4 6 Brain and Spinal Cord and Reflexes 5 7 The Major Muscles of the Body/Joints & Movement 6 8 Cardiovascular Anatomy and Physiology 7 9 Respiratory Mechanics and Measurement of Lung Function 8 12 Blood and the Circulatory System 6  MISSING A SCHEDULED ON-CAMPUS PRACTICAL Do not attend class if you are feeling unwell. Situation 1: When there is no in-class quiz scheduled for the class, you have missed. You do not need to email the subject coordinator, David, about missing a class. You are not required to provide a medical certificate or any other documentation. The same arrangements applies for any other legitimate reasons you miss a class. For example, an unavoidable work or private commitment, that you miss a class. Situation 2: When there is an in-class quiz scheduled for the class, you have missed. If you miss a practical where there is time allocated for an in-class practical quiz: after the session has run you will need to email the subject coordinator, ([email protected]). Please attach as e-copies any supporting documentation you have to explain your absence. This could be: A medical certificate or hospital discharge letter A letter of support from a close family member A letter from someone in a position of responsibility such as a work supervisor, faith leader A statutory document 91400 ASSIGNMENT DEADLINE Disease Presentation 11.59pm Monday 11 November 2024  CONTENTS 91400 Class times................................................................................................................. 2 Lectures............................................................................................................................. 2 Practicals........................................................................................................................... 2 91400 Lecture and Practical Schedule Weeks 1 to 8............................................................ 3 91400 Lecture and Practical Schedule Weeks 9 to 12.......................................................... 4 91400 ONLINE Quiz Schedule............................................................................................ 5 91400 In-Class Practical Quizzes......................................................................................... 6 Missing A Scheduled On-Campus Practical......................................................................... 7 Situation 1: When there is no in-class quiz scheduled for the class, you have missed. 7 Situation 2: When there is an in-class quiz scheduled for the class, you have missed. 7 91400 Assignment Deadline................................................................................................. 7 Disease Presentation......................................................................................................... 7 Week 2 Welcome to your body.......................................................................................... 12 *Note to teachers and professional staff..................................................................... 12 1. So, you think you know your body............................................................................. 13 2. Anatomical directional terms...................................................................................... 16 The major anatomical directional terms..................................................................... 17 3. Surface anatomy markers............................................................................................ 20 4. Body cavities............................................................................................................... 22 The Thoracic Cavity................................................................................................... 23 The Abdominopelvic Cavity and the Abdominopelvic Sub-regions.......................... 24 Week 3 The Histology of Epithelial and Connective Tissues and the Skin....................... 25 1. Tissues......................................................................................................................... 26 Four tissue types......................................................................................................... 26 2. Epithelial tissue........................................................................................................... 26 Types of epithelia........................................................................................................ 28 3. Connective tissues....................................................................................................... 30 4 Skin structure............................................................................................................... 34 The Epidermis............................................................................................................. 34 The Dermis.................................................................................................................. 35 Week 4 Bones and the Skeleton.......................................................................................... 37 1. The chemical composition of bone............................................................................. 38 Applying some pressure to the baked bone................................................................ 38 Applying some pressure or twisting strain to the acid-soaked bones......................... 38 2. Structure of the long bone........................................................................................... 39 8  3. Bones of the human skeleton...................................................................................... 41 The Axial Skeleton..................................................................................................... 42 The Appendicular Skeleton......................................................................................... 46 Week 5 The Anatomy of the Brain and the Spinal Cord.................................................... 50 1. Gross anatomy of the brain......................................................................................... 51 The hemisected mammalian head............................................................................... 51 The meninges.............................................................................................................. 52 The ventricles and the cerebrospinal fluid.................................................................. 53 2. Dissection of a sheep’s brain...................................................................................... 54 3. The human cerebral cortex.......................................................................................... 55 4. The thalamus and the hypothalamus........................................................................... 56 The thalamus............................................................................................................... 56 4. The brain stem and the cerebellum......................................................................... 56 5. The gross anatomy of the spinal cord......................................................................... 58 6. Cutaneous Sensation Exercise.................................................................................... 59 Two-point discrimination test..................................................................................... 59 7. The cranial nerves....................................................................................................... 61 Cranial Nerve Tests..................................................................................................... 62 Follow up.................................................................................................................... 63 Week 6 The Major Muscles of the Human Body & Joints and Movement........................ 66 1. Joints........................................................................................................................... 67 Introduction................................................................................................................. 67 Synovial joints............................................................................................................ 68 3. Movements allowed by synovial joints....................................................................... 70 3.1 Movements that are not unique to specific parts of the body............................... 70 4. Superficial skeletal muscles........................................................................................ 72 Muscles Crossing the Hip and Knee Joint: Movement of the Thigh and Leg............ 72 Muscles of leg: Movement of the Ankle and Foot..................................................... 73 Muscles of the Abdominal Wall: Trunk Movement................................................... 73 Muscles of the Upper Arm: Movement of the Forearm............................................. 74 5. Muscles, joints and bones........................................................................................... 77 Week 7 Cardiovascular Anatomy and Physiology............................................................. 78 1. Dissection of an animal heart...................................................................................... 78 Part 1: External features.............................................................................................. 78 Part 2 The internal structures of the heart................................................................... 79 Part 3: Additional features that would be seen in an intact heart................................ 79 9  2. The electrocardiograph (ECG/EKG) measuring the electrical activity of the heart... 82 The ECG..................................................................................................................... 83 Taking an ECG........................................................................................................... 84 Calculating heart rate.................................................................................................. 85 3 Blood pressure determinations..................................................................................... 85 Measuring Blood Pressure.......................................................................................... 86 Week 8 Respiratory anatomy and measurement of lung function...................................... 88 1. Anatomy of the Respiratory System........................................................................... 89 The Upper Respiratory Tract...................................................................................... 89 Lower respiratory tract................................................................................................ 91 Lung Pluck.................................................................................................................. 93 2.Measuring lung function.............................................................................................. 94 Introduction to Spirometry.......................................................................................... 94 Demonstration using the Vitalograph Mechanical Spirometer................................... 94 Volume vs. time curves............................................................................................... 94 Class Spirometry......................................................................................................... 96 Space allocated for presentation of pooled spirometry results................................... 99 Introduction............................................................................................................... 100 PhysioEx Animated Exercise.................................................................................... 101 Week 9 Blood and Circulatory System............................................................................. 104 1. Review of Spirometry results from Week 8............................................................. 105 Pooled results from the student spirometry will be presented............................... 105 2. Erythrocytes and Leukocytes.................................................................................... 105 3. Blood Groups............................................................................................................ 107 Introduction............................................................................................................... 107 Blood Groups and Blood Typing.............................................................................. 108 4. Veins and Arteries..................................................................................................... 109 Week 10/11 Gross and Microanatomy the Gastrointestinal System................................ 111 1. The gross anatomy of the gastrointestinal system.................................................... 111 2. The histological features of the gastrointestinal tract............................................... 113 The oesophagus......................................................................................................... 115 The Stomach............................................................................................................. 115 The Small Intestine................................................................................................... 116 The Large Intestine................................................................................................... 116 3. The anatomy of the liver and gall bladder................................................................ 117 Bile............................................................................................................................ 117 10  Hepatic circulation.................................................................................................... 118 Hepatic lobules.......................................................................................................... 118 4. Histology of the pancreas.......................................................................................... 119 Week 12: Gross and Microanatomy of the Urinary and an Introduction to Urinanalyis.. 120 1. Gross anatomy of the urinary system........................................................................ 121 2. The morphology of the kidney.................................................................................. 122 3..................................................................................................................................... 123 4. An introduction to urinalysis.................................................................................... 124 Performing a urinalysis............................................................................................. 125 Results....................................................................................................................... 126 11  WEEK 2 WELCOME TO YOUR BODY Text Chapter Frederic H Martini & Edwin W Bartholomew Essentials of Anatomy & Physiology, Global Edition, 8th Edition Chapter 1, Sections 1.7 & 1.8 Objectives This class is to introduce you to: The different ways we can describe the location of an organ. The surface anatomy terms commonly used by health professionals The principal cavities of the human body What you need for today Your own body Requisite Personal Protective Equipment (PPE) What is provided Class Laboratory Guides Torso models* Selected charts illustrating some of the organ systems Paper sheets, 1 sheet per three students. roughly 1.5 m x1 m Crayons or permanent markers *Note to teachers and professional staff. Until section 1 is finished, please have the models and charts turned away from the students so they cannot use them to help with section 1 Session procedure Introductions: your class teachers, you, your other classmates Watch: Welcome Video Watch “Stay Safe at UTS” (https://youtu.be/RgSzxki1suk?si=W6LgYupKlDc-fop9). Reading time for Laboratory safety rules in the Class Laboratory Guides Utilising the models, charts and your textbook and each other, please work through the exercises and answer the questions that follow 12 1. So, you think you know your body Work in groups of 3or 4 for this exercise. Your class teachers will step you through how to prepare for this exercise WITHOUT using a textbook-or any online resources, or any charts or any torsos in the room-work as a group draw in where the group thinks the following structures would be. The thyroid gland The lungs The heart The liver The gall bladder (this will be behind one of the organs and so you will have to indicate that somehow in your drawing) The stomach The kidneys (they will be behind some of the organs and so, again, you will have to indicate that somehow in your drawing) The pancreas The spleen The large intestine The small intestine The bladder On the table on the next page fill in the first blank column. Then, as a class, we are going to see how well each group went. On the table, track which ones are correct and make notes in the fourth column about the correct location. In the last column describe the location using suitable anatomical terms after you have completed the other parts of the practical How many did you group get right? Get your teacher to record the score for your group and then you can see if your group did the best in the class. 13  organ Where you said it was (Write this as a Correct Where it actually is (Write this as a Anatomical location (Use the regional sentence like “In the middle of sentence like “In the middle of terms found later in the notes like “in (Y or N) abdomen just below the rib cage”) abdomen just below the rib cage”) the cervical region anterior to the oesophagus”) thyroid gland lungs heart liver gall bladder stomach kidneys pancreas spleen The table continues on the next page organ Where you said it was (Write this as a Correct Where it actually is (Write this as a Anatomical location (Use the regional sentence like “In the middle of sentence like “In the middle of terms found later in the notes like “in (Y or N) abdomen just below the rib cage”) abdomen just below the rib cage”) the cervical region anterior to the oesophagus”) large intestine small intestine bladder Total number right 15 2. Anatomical directional terms We use directional terms to accurately give the location of a body part. Today we will go through four pairs of directional terms. The members of each pair are in opposite directions. As you will see, you can use the pairs to locate the position of one body part relative to another. The basis for all these terms is the anatomical position, which provides us with a constant reference for describing the body. When someone is in the anatomical position that person is standing erect and facing the observer; the arms are at the sides of the body, with the palms of the hands facing forward. Draw below a person in the anatomical position The Anatomical position 16 The major anatomical directional terms Externally, this is whatever you can see when facing Anterior someone who is in the anatomical position. Internally it also refers to a structure that is towards the front of the body compared to some reference point Externally, this is what is hidden when facing someone Posterior who is in the anatomical position. Internally, it also refers to a structure which is towards the back of the body compared to some reference point Superior In the anatomical position, this is towards the head Inferior In the anatomical position, this is towards the feet. This is away from the midline of the body. This line Lateral divides the body into a left half and a right half Medial This is towards the midline of the body. Proximal This is closer to the main mass of the body Distal This is further from the main mass of the body 17  Anatomical Directional Terms With the following diagram, please (i) draw in the midline (ii) add these labels: anterior, posterior, superior, inferior, medial, lateral, proximal, distal Now quiz yourself on anatomical directional terms 18 1) Cross out the incorrect answer The heart is superior to the brain (True/False) The ears are lateral to the nose (True/False) The ankle is distal to the knee (True/False) The spine is anterior to the heart (True/False) 2) List three things that are distal to the shoulders 3) List three internal organs that are inferior to stomach 4) Cross out the incorrect answer The nose is medial/lateral to the eyes The left kidney is anterior/posterior to the stomach The heart is superior/inferior to the stomach The ankle is proximal/distal to the knee 19 3. Surface anatomy markers Deltoid Upper shoulder Axillary Armpit Brachial Upper arm Antebrachial Forearm Palmar Palm of the hand Cervical Neck Orbital Eye area Buccal /Oral Mouth area Occipital Back of the head Thoracic/pectoral Anterior torso, superior to the diaphragm Sternal The breastbone Costal Pertaining to the rib Scapular Around the area of the scapula on the back Abdominal Anterior torso inferior to the diaphragm Lumbar Lower back, between ribs and pelvis Umbilical Around the umbilicus or navel Flank Lateral margin of the trunk Gluteal Buttocks Inguinal Groin, root of thigh between lower extremity and abdomen Pubic External genital area Femoral Thigh, upper leg Curial Lower leg or sometimes more specifically anterior portion Sural Specifically, the posterior portion of lower leg 1 Plantar Sole of foot 1 In some texts there is no distinction made with the anterior and the posterior portions referred to as “crural” 20  Surface Anatomy Markers Using the diagram below, map out the surface terms, except sternal and costal. 21 4. Body cavities This diagram illustrates the major body cavities 2. 2 While the abdominopelvic cavity is a single one, we can divide it by imagining a plane at the level of the superior edges of the pelvic girdle. In the previous figure you can see this imaginary plane 22 Q: What is the name of the structure that makes the border between the thoracic cavity and the abdominopelvic cavity? The Thoracic Cavity Within the thoracic cavity, there are two pleural cavities each one containing a ___________ (fill in the blank) The space in the middle of the thoracic cavity, between each pleural cavity, forms the mediastinum, which contains the pericardial cavity containing the __________________ (fill in the blank) parts of the upper respiratory tract: the trachea and two primary bronchi; the oesophagus, several major blood vessels and the thymus gland. https://commons.wikimedia.org/wiki/File:Dorsal_Ventral_Body_Cavities.jpg 23 The Abdominopelvic Cavity and the Abdominopelvic Sub-regions Using surface landmarks, the abdominopelvic region can be subdivided into nine sub regions 3.The boundaries between the subregions are shown in the diagram below The superior horizontal line is drawn near the bottom of the rib cage. The inferior horizontal line is drawn along the tops of the hip bones. Each vertical line is drawn just medial to the nipples. Regarding the names of each sub-region: The most central is the umbilical, flanked on each side by a lumbar area (one left one right). The epigastric is directly superior to the umbilical, flanked by hypochondriac 4 subregions The hypogastric is directly inferior to the umbilical, with iliac/inguinal areas lateral to it. Label the nine regions. Figure 01.07a Martini and Bartholomew op cit Using the torso models complete the table Region name Organ located in that region epigastric umbilical hypogastric 3 Many health professionals simply divide the body into quadrants (upper vs. lower and left vs. right). In this scheme head-to-toe and side-to-side lines are drawn through the umbilicus at right angles 4 This is a region beneath (hypo) the cartilage (chondriac) of the rib cage 24  WEEK 3 THE HISTOLOGY OF EPITHELIAL AND CONNECTIVE TISSUES AND THE SKIN Text Chapter Tissues: Martini & Bartholomew op. cit., Chapter 4 Skin (“The Integumentary System”): Martini & Bartholomew op. cit., Chapters 5 Objectives Tissues Students should be able to: Demonstrate a knowledge of the key characteristics of epithelial and connective tissues Demonstrate a knowledge of the features that distinguish the different types of epithelial, connective and tissue presented Demonstrate an understanding of how the unique features of each type of tissue serves the function or functions of that tissue Skin Students will be able to identify and distinguish between the different layers of the skin. What you will need requisite PPE What is provided Class laboratory guides (22 per class) Video introduction to setting up the microscope for optimal viewing of slides Bioviewers Bioviewer Sets: M7 (Epithelial Tissue); M8 (Connective Tissue); 57 (Skin) Demonstration slides o lung (alveoli) o small intestine (columnar epithelium) o elastic cartilage o fibrocartilage o skin The joint models with ligaments Skin: photomicrographs, models and or charts 25 1. Tissues A tissue is an anatomically constrained collection of cells of one or a few types that work cooperatively to undertake a limited set of functions. There is a histological/anatomical hierarchy in the body. For example, A lymphocyte is a type of cell Lymphocytes are a component of a connective tissue: blood Blood fills the lumen of each blood vessel and the heart, each of these is an organ Together all the vessels of the body and the heart comprise the cardiovascular system which is one of the organ systems of the human body Four tissue types Epithelial Connective Muscle 5 Nervous5 2. Epithelial tissue This is the tissue that forms the surfaces or internal linings in different organs but is also the tissue that forms glands. Discuss with your classmates and teachers and or refer to the e-text to complete this table Type of epithelium Example of a location where this type of epithelium is found External surface Inner lining Glandular 5 Muscle and nervous tissue will be presented in the classes dedicated to their respective organ systems 26 Here are photographs of epithelium (left), connective tissue (middle) and nervous tissue (right). In each you can see nucleated cells What do these images indicate about the defining feature of epithelia tissues? You are going to watch a training video about setting up the microscopes and the instructions are recorded in the Class Laboratory Guide 27 Types of epithelia Bioviewer Set: Epithelia +Slide demonstrations Space is allocated for you make an informative sketch of each of the first four images in the “Epithelia” Bioviewer set For the Bioviewer set ups: as you look at each image refer to the notes in the information card. For the microscope demonstrations. In the case of the lung and small intestine use the demonstration slides provided and you can call on your teachers if you need help Bioviewer/Frog skin: squamous Bioviewer/Kidney tubule: simple cuboidal Bioviewer/Trachea: pseudostratified Bioviewer/Skin: stratified Microscope/Lung (alveoli): simple squamous Microscope/Small intestine: simple columnar 28 This table sets out the way that epithelia are classified after you work through Bioviewer card “Epithelia” and the demonstration slides. You can complete the table by including a short description of each type of epithelial tissue Squamous Shape Cuboidal Columnar Simple Layers Pseudostratified Stratified Simple epithelia are typically found at sites of exchange or transport between two regions Simple squamous epithelia provide sites where distances for diffusion are minimised What are examples in two different organs, or region of an organ, where the lining is likely to be simple squamous epithelium? Columnar epithelia support exchange but provides more resistance to mechanical forces in comparison with flatter epithelia such as squamous and cuboidal What are examples in two different organs, or region of an organ, where the lining is a simple columnar epithelium? In a few parts of the body, columnar epithelium is pseudostratified. What causes the nuclear arrangement of the cells in a pseudostratified columnar epithelium? Stratified epithelia are sites that experience substantial mechanical forces or exposure to relatively harsh environments What is one organ where you would expect to find a stratified epithelium? 29 3. Connective tissues These provide structural support and protection against mechanical trauma and against heat & water loss. Examples include: adipose tissue areolar or loose connective tissue bone cartilage dense connective tissue Connective tissues can be a means of transport. Namely, blood lymph Connective tissues can serve as sites of storage. For example: adipose tissue bone This image of areolar or loose connective tissue provides one of the best illustrations of what characterises connective tissue Cells of one or a few types embedded in an extracellular matrix the composition of which includes salts, protein fibres and water Blood and bone will be described and investigated in later classes. On the next pages there are tables of other types of connective tissue 30  description sketch example/example of a location Bioviewer/areolar connective tissue Bioviewer/tendon (dense 6 connective tissue) Bioviewer/fatty or adipose tissue 6 There are subtypes of this type of tissue: regular or irregular. This distinction is based on the arrangement of the collagen fibres. 31  description sketch example/example of a location Bioviewer/cartilage from the windpipe (hyaline cartilage) Microscope/elastic cartilage Microscope/fibrocartilage 32  Loose connective tissue has been described as the “universal packing material of the body”: it surrounds many internal organs and also holds them in their relative position. Dense connective tissue is the tissue of tendons (joining muscle to bone) and ligaments (joining bone to bone). What differences in the structure of loose in comparison to dense connective tissue are indicative of their different functions? Compare the “stiffness” of dense connective tissue (as in the ligaments in the joint models in the class) with that or hyaline cartilage (as is found in your nose) What might this tell you about differences in protein fibre arrangements between the dense fibrous connective tissue and hyaline cartilage? Compare the “stiffness” of elastic cartilage (your ears) with that of hyaline cartilage What might this tell you about differences in protein fibre composition between elastic and hyaline cartilage? 33 Get one of the demonstrators to show you on the skeletons where there is (or would be) fibrocartilage. Much more than is the case with hyaline and elastic cartilage, in fibrocartilage most of the matrix is collagen fibres. What do you see as the relationship between the composition of the matrix of fibrocartilage and hyaline and elastic cartilage and the roles they play? 4 Skin structure Two 7 layers of skin can be distinguished. The epidermis which is the outer-most layer and is in contact with external environment. The dermis which underlies and supports the epidermis. The Epidermis This epithelial tissue made up of multiple layers of cells. In the upper layers the cells are flattened. Given the description above, how would you classify the epidermis regarding its histological features? Blood vessels are absent from the epidermis. The epidermis consists of 4-5 histologically distinct strata depending on the site. The basal layer is the layer in contact with the dermis and contains constantly dividing stem cells. As the daughter cells (termed keratinocytes) are moved up through the consecutive layers, they lose their proliferative capacity. As well as this there is a loss of organelles, and the plasma membrane becomes progressively thicker and less permeable. The cytosolic components are progressively replaced by the protein keratin As a result of the upper most layers, collectively termed the stratum corneum, consists of dead and fully keratinised cells. The turnaround for skin is around a month. 7 Below the skin is a layer of subcutaneous adipose tissue. While not considered to be a layer of the skin, it is included in assessments of the depth of a burn, and you will see it sometimes referred to as the hypodermis. 34 Sloughing off the upper most layers is promoted by any abrasive actions which can include, rubbing up against hard surfaces, taking off clothes and rolling around in bed. Also located in the basal layer are the pigment-producing melanocytes. The Dermis The dermis is a layer of connective tissue with two distinguishable layers. The papillary layer consists of heavily vascularised loose connective tissue that interdigitates with the epidermis. The reticular layer consists of dense connective tissue and gives the skin its strength and elasticity. Other features of the skin Pores Sweat and sebaceous glands On the palms of the hand and the soles of the feet the skin ridges are clearly visible. This is thought to support better contact with surfaces during gripping and pacing. Using the demonstration slides, photomicrographs or Bioviewer Identify the two principal layers of the skin Confirm the histological arrangement of the epidermis Identify skin appendages such as hair follicles, exocrine glands We will watch a brief video on how to prepare low power plan diagrams o Dr Umar Memon Low power plan diagram. AS level Biology Make a low power plan diagram (sometimes referred to as an outline diagram) of skin. Remember that with an outline drawing: You don’t need to draw in the individual cells or bands of collagen. Make sure you indicate in your drawing: the comparative depths of the epidermis versus the dermis The interdigitation between the layers The presence of any skin appendages. 35 Low Power Plan Diagram of Skin 36  WEEK 4 BONES AND THE SKELETON Text Chapter Martini & Bartholomew op. cit., Chapter 6 Objectives You should be able to identify the chemical constituents of bone and their function the major structural features of long bones Students should be able to identify or demonstrate knowledge of the principal bones of the skeleton as presented in this practical manual For example, quiz or exam question might be: “Which of the bones of the lower limb is medial?” What you will need PPE What is provided Class Laboratory Guides Bones soaked in vinegar or nitric acid Bones baked in an oven Sectioned cow/sheep/pig femur (2per class) One metal probe per femur Skull, vertebrae, sternum and other models of bones Charts of bones showing compact and spongy bone if available Whole skeletons* *Note for professional support: if available please bring extra skeletons in from other classrooms 37 1. The chemical composition of bone Chemically, bone is approximately 65% mineral salt and 35% organic matter. The organic matter consists largely of the protein collagen. Examine the two bone preparations: (i) Bones which have been baked: this would destroy any of the organic matter of the bone (ii) Bones which have been soaked in acid this will lead to a leaching of the mineral salts from the bones Applying some pressure to the baked bone. What happens to the baked bones? What property of bone tissue is provided by the organic part of the bone? Applying some pressure or twisting strain to the acid-soaked bones. What happens to the acid-soaked bones? What key mineral of bone has been removed by the acid soaking? What property of bone tissue is provided by the mineral salts? 38 2. Structure of the long bone The shaft of a long bone consists of layers of tightly packed bone tissue: compact bone. The ends of the bone contain predominantly a meshwork of bony rods and plates: spongy bone or cancellous bone. In diagrams, long bones are commonly oriented so that the bone the proximal end is towards the top of the page. Your teachers will step you through the longitudinal sections of the femur of a cow. The femur is an example of a long bone. You will notice that the bone is strong, and the calcification is obvious. Have your manual open to the next page and sketch what you see including labelling: The diaphysis The central canal or the medullary canal The epiphyses articular cartilage. epiphyseal cartilage red marrow yellow marrow. 39  Part location Function and or description diaphysis articular cartilage red marrow yellow marrow 40 3. Bones of the human skeleton The skeleton is articulated at joints i.e. bones are brought into close apposition at a joint. Muscles are attached to the bones. Contraction of these skeletal muscles moves the bones they are attached to around the pivot point of the joint. This results in a movement of a part of the body. Tendons join muscle to bone. Ligaments surround the joint structure and stabilise it. The number of bones in each human being is usually 206. About one person in twenty has a thirteenth pair of ribs and this is not dependent on their sex. The human skeleton in conventionally divided between The axial 8 skeleton The appendicular skeleton 9 Axial Appendicular https://www.coursehero.com/study-guides/ap1x94x1/the-axial-skeleton/ https://www.coursehero.com/study-guides/ap1x94x1/the-appendicular-skeleton/ 8 From the word axis: https://www.merriam-webster.com/dictionary/axis 9 From the word appendage: https://www.merriam-webster.com/dictionary/appendage 41 The Axial Skeleton Using the diagram on the previous page list the bones of the axial skeleton It also includes the hyoid bone. The hyoid bone is located between the chin and the trachea (the “windpipe”), below the mandible (the “jawbone”) Examine the model skeleton to see the location of the hyoid bone The Skull The skull is made up all of the bones of the head. The cranium is a subset of these bones encases the __________________ (fill in the blank) while the other bones of the skull are associated with the face. Examine one of the human skulls and notice that the bones vary in the shape How would compare the degree of movement between the different bones in the cranium with other pairs of bones, e.g. the upper arm and lower arm bones Bones of the cranium The anterior frontal bone The posterior occipital bone The inferior temporal bones The superior parietal bones The temporal bones each have a prominent inferior protrusion which are the mastoid processes. The mastoid processes are points of attachment for some muscles involved in head movement. Then there are the bones of the face Bones of the face The nasal bones form the upper most part (the “bridge”) of the nose The zygomatic bones contribute to the lateral walls of the orbits (the “eye sockets”) The maxilla bones contribute to medial wall of the orbits, the nasal cavity, the upper jaw and the hard part of the palate (the “roof” of the mouth) The mandible forms the jaw 42  Lateral View of the Human Skull Using the names of the cranial bones described on the previous page, please add labels to the diagram below https://opentextbc.ca/anatomyandphysiology/chapter/7-1-the-skull/ 43 The Vertebrae Vertebrae in each region of the body have characteristics that distinguish them from those in other regions Martini and Bartholomew op cit Figure 6.17 44 Examine the models of the individual vertebra and also the articulated vertebral column. Notice how the vertebrae articulate with each other and vary in appearance depending on where they are located. You may have a model where there are intervertebral discs. These serve as “shock absorbers” Where do you think the spinal cord would be located? From superior to inferior the vertebral body increases in volume. Why is this important? The Thoracic Cage Look at the human skeleton and answer the following questions. What structures form the thoracic cage? Do all ribs articulate directly with the sternum (anteriorly)? (Y/N) What are the structures that join some ribs to the sternum? Do all ribs articulate directly with the vertebral column (posteriorly)? (Y/N) The Sternum Examine the sternum as a separate bone and on the mounted skeleton. There are three parts: The manubrium is the superior part The body or gladiolus is a large blade of bone The xiphoid process is the most inferior softer, (originally)cartilaginous part. The sternum has ridges which serve as anatomical landmarks for important structures beneath the skin 10. 10 https://youtu.be/eltLjT8j1r0 45 The Appendicular Skeleton Q: Using the diagram on an earlier page list the four major parts of the appendicular skeleton The Pectoral Girdle This consists of the scapulae (the single is scapula) and the clavicles. With which bones does the clavicle articulate? The Upper Limb The bone of upper arm is the humerus The forearm bones are the radius and the ulna With the help of the models and/or your demonstrator, complete this table bone orientation (cross out the incorrect one) radius medial/lateral ulna lateral/medial With the help of the models and/or your demonstrator, complete this table bones What part of the upper limb carpals metacarpals phalanges Which bone of the arm does the glenoid cavity of the scapula articulate with? 46 The Pelvic Girdle The two bones of the pelvic gridle of a newborn consist of three components: a superior ilium. an inferior and anterior pubis. an inferior and posterior ischium. Eventually, the three separate bones fuse on each side of the body fuse The area of fusion called the acetabulum Anteriorly there is a wedge of fibrocartilage: the pubic symphysis Lateral and anterior view of human pelvic girdle Martini and Bartholomew op cit Figure 6.26 On the diagrams label the three bones that make up the girdle and the acetabulum. For the right-hand side image, you can also add a label for the pubis symphysis. Also. add for the image on the left arrows indicating superior and anterior 47 With which part of the skeleton do the two ilia of the pelvic girdle articulate with posteriorly? With which pair of bones articulates with the acetabula? The Lower Limb The bone of upper part of the leg is the femur The bones of the lower part of the are the tibia and the fibula Q: With the help of the models and/or your demonstrator, complete this table bone orientation (cross out the incorrect one) tibia medial/lateral fibula lateral/medial Q: Which of bones of the lower leg is larger? Q: When you palpate your shin, which of the two bones are you palpating? The bone of the knee is the patella Q: With the help of the models and/or your demonstrator, complete this table bones What part of the lower limb tarsals metatarsals phalanges 48  The Principal Bones of the Human Axial and Appendicular Skeletons http://www.thunderboltkids.co.za/Grade5/01-life-and-living/chapter2.html Here is an anterior view of the human skeleton in the anatomical position. Add to it labels for all the bones of the appendicular skeleton listed. The exception are the pelvic bones just indicate the entire pelvic girdle. 49  WEEK 5 THE ANATOMY OF THE BRAIN AND THE SPINAL CORD Text Chapter Martini & Bartholomew op. cit., Chapter 8 Objectives Students should be able to identify and name the meninges the major structures of the brain the major features of the cerebrum/cerebral hemispheres the major features of the spinal cord the principal components of a reflex arc Students should be able to demonstrate The principal features of the circulation of cerebrospinal fluid through the CNS A knowledge of the principal function of major parts of the brain Demonstrate a knowledge of the targets and functions of the cranial nerves What you will need PPE What is provided Class Laboratory Guides A hemisected sheep or pig head (2 per class) Sheep brains (1 per group of 2-4) Knives 11, forceps and blunt probes Plastic models of the brain, the ventricles and the spinal cord Charts on the Nervous System Items for cutaneous sensation o Dividers (up to 20 per class) o Rulers or tape measures with millimetre gradations (up to 20 per class) Tuning Forks Session procedure There is a lot in this class it is important to concentrate on section 1 as these involve material available exclusively in the lab. 11 We don’t supply scalpels for two reasons. Firstly, the blades just add to our sharps waste. Secondly putting on and taking off the blades takes care and practice in order to avoid serious cuts. 50 1. Gross anatomy of the brain The hemisected mammalian head. To get you started we will watch a video presentation on the hemisected animal head. This can be accessed in the Canvas module for this week Get a group of 5 or so people together and go over again the structures highlighted in the video. Here is a guide of what to go through With the features of the head as your guide orient yourself as to what are the anterior, posterior, superior and inferior parts of the brain Identify the principal regions of the brain (going from the anterior and superior aspect): The cerebrum or cerebral hemispheres The diencephalon The brain stem and cerebellum Where the brain is linked to the pituitary gland Where the brain stem blends with the spinal cord Two types of tissue are identifiable in the brain and the spinal cord. The white matter consists of nerve fibres coated in fatty myelin. The grey matter consists of nerve cell bodies and uncoated nerve fibres. The cranium encases the brain, the point of exit being the foramen magnum through which the spinal cord passes through. 51 The meninges Between the inner wall of the cranial cavity and the brain are three layers: the meninges. Pressed against the inner wall of the cranial cavity is the dura mater Beneath the dura mater is the thin and transparent arachnoid mater Closest to the brain is the pia mater which follows all the ridges and furrows of the brain. If they have not already done so, see if your demonstrator can show you the meninges in the sheep head Label the three layers of the meninges in the diagram above 52 The ventricles and the cerebrospinal fluid The brain is not a solid organ. It consists of bands of tissue surrounding interconnected chambers known as ventricles 12. Here is a diagram which illustrates the location of the ventricles. There is a cast of the ventricles on display in at least one of the labs during this class. Figure 8.17a Martini & Bartholomew op. cit. Cerebrospinal fluid (CSF) is a clear liquid produced from plasma through a process of filtration. The brain and spinal cord are immersed in CSF. CSF fills the ventricles and canals of the brain. It also travels across the meninges. It drains into a space between the two layers of the dura mater where it mixes with venous blood that pools here. The CSF provides buoyancy for the brain; acts as a shock absorber; and it also has homeostatic roles like that of blood. 12 Little rooms 53 2. Dissection of a sheep’s brain Before performing the dissection, please watch this video where Dr Francis Geronimo goes through the major features to look for. There is a small glitch in the video, Dr Geronimo does not mention the arachnoid mater. Below is an image the entire sheep’s brain. These directional terms used for quadrupedal animals. These are the terms that are used in the class laboratory guide. You will be able to identify the regions marked with the round-headed and sun-shape headed pins. You can label those any other structures you can identify Sourced through Creative Commons https://www.biologycorner.com/anatomy/sheepbrain/sheep_dissection.html Using the class laboratory guides and with help from your teachers you can now proceed to undertake the dissection 54 3. The human cerebral cortex The cerebral hemispheres that make up the cerebrum are the most prominent feature of the human brain. For this part work in groups with the models of the brain The cortex forms an outer layer of grey matter over cerebral hemispheres of the brain. There are several major sulci and gyri that are discernible on the lateral surfaces of hemisphere which serve as landmarks. These are shown below Figure 8-16 Martini and Bartholomew op. cit. These landmarks are the boundaries for separate regions of the cerebrum referred to as lobes. Specifically the frontal, parietal and the relatively inferior temporal lobes. In the posterior region of the cortex there is another prominent sulcus, but it is only seen well on the medial surfaces of the hemispheres. The parieto-occipital sulci are the boundary between the more anterior parietal lobes and the more posterior occipital lobes. Have a go at adding labels for all four lobes of the figure above. Throughout the brain individual functions are performed by particular parts of the brain. Refer to your lecture notes for the details 55 4. The thalamus and the hypothalamus The thalamus This consists of a number of distinct nuclei 13 that are found in a region of the brain bordered by the lateral and third ventricles It is described as “the gateway to the cortex” 14 as neurons of the thalamus receive signals from other regions of the brain, as well as outside the central nervous system; and convey them to specific regions of the cortex. In the video on the hemisected sheep’s head Dr Harrison pointed out fibre tracts (bundles of axons) that run through the thalamus In doing so it regulates the flow of information with regard to functions such as sensation/perceptions and voluntary movements The hypothalamus The hypothalamus is embedded in the lower part of the walls and the floor of the third ventricle. It is attached to the pituitary gland by a stalk called the infundibulum. Its functions include: Regulating the hormone secreting activity of the pituitary gland Control of water balance via the hormone anti-diuretic hormone Stimulation of milk ejection and contractions of the uterus via the hormone oxytocin. Regulating body temperature Regulating food and water intake 4. The brain stem and the cerebellum Three major structures located in this the most inferior part of the human brain are described in this section. The pons The pons is the anterior bulbous part of the brain stem It is principally composed of white matter that connect regions 15 of the brain superior and posterior to it as well connections between the cerebellum and structures superior to it. However, it also contains important clusters of nerves cells that control the rate and depth of breathing. The medulla oblongata This is the most inferior region of the brain and is continuous with the spinal cord. It is rich in white matter. It also contains vital groups of nerve cells which control functions which include: 13 Clusters of the cell body of neurons in the Central Nervous System whereby the neurons serve the same function. 14 For example: McAlonan K, Cavanaugh J, Wurtz RH. (2008) Guarding the gateway to cortex with attention in visual thalamus. Nature, 456(7220), 391-394. 15 Hence its name, pons, which is Latin for bridge. 56 The cerebellum This is a very prominent feature which is inferior to the occipital lobes and posterior to the pons and medulla. The arrangement of grey and white matter resembles the cerebral hemispheres. It controls and coordinates the action of the different muscles as well as having a role in maintenance of posture and balance. Damage to this region is detectable by clumsy and weak movements in the affected person. Internal Structures of the Human Brain Spend some time with the brain models and aim to identify the structures listed in sections 3 and 4. Label the model below with: the cerebrum, corpus callosum, third ventricle, pituitary gland, cerebellum, pons, medulla oblongata. Martini and Bartholomew op. cit. 8.16 57 5. The gross anatomy of the spinal cord The spinal cord consists bundles of myelinated axons, tracts, that surround a column of grey matter. In turn, the grey matter surrounds the central canal By convention the posterior (older books will use dorsal) side of the spinal cord is always placed uppermost when being viewed. In contemporary texts, the other region of the spinal cord is termed the anterior replacing the older term: ventral. The grey matter has both in the posterior and anterior directions which are called horns. The human spinal cord has 31 segments, and the organisation of these segments is aligned with the different vertebrae of the vertebral column. For each segment they are a pair of ganglia that contain the cell bodies of sensory neurons. The axons of these neurons are bundled together as the posterior root of the segment. The posterior horns of a segment contain interneurons, that synapse with the sensory neurons of the ganglia. The anterior horns contain the cell bodies motor neurons which carry signals to the muscles and glands. Their axons are bundled together to give rise to the anterior root. Distal to the spinal cord the roots of each segment converge to form a single spinal nerve. The Spinal Cord Now you can label all the structure mentioned in the diagram below. Also indicate with labels the regions of white and grey matter. Figure 8.14b Martini and Bartholomew op. cit. 58 6. Cutaneous Sensation Exercise Receptor-type neurons, in the skin, the connective tissue under the skin, mucous membranes and around the mouth and anus are responsive to tactile sensations (touch, stretch, pressure and vibration), thermal sensations (hot and cold) and pain The distribution of these receptors is not even throughout the body as the following exercise will illustrate. Two-point discrimination test The capacity to distinguish between two fine points differs between parts of the body. In some parts points very close together are still recognised as two points while in other parts of the body the sensation from two points the same distance apart feels like a single point. Have a look at how the test is performed and in the second column of the table below rank the sits (1=least sensitive, 6=most sensitive, where the lower the two-point discrimination threshold the higher the sensitivity) Region Sensitivity Two-point Subject results discrimination ranking threshold (mm) Tip of thumb Palm of hand Back of hand Anterior part of forearm Back of neck Back of calf There is a spreadsheet on David Van Reyk’s Google Drive where you can enter your subject’s results. The link is accessible in the module for this week. At the beginning of the class in Week 6 you will get the results from all the students which you can enter into the final column of the table On the next page there is space allocated for the follow up work in Week 6 59 Did your subject’s results align with what you predicted. If so, how well aligned were they? Did the class results align with your subjects? If so, how well aligned were they? What could be an explanation for any differences between different regions that are shown in the class results? 60 7. The cranial nerves There are 12 pairs of cranial nerves that serve parts of the head and neck but also organs in the abdomen. The cranial nerves are known either by their names or by the appropriate Roman numeral 16 I-XII. The arrangement of the cranial nerves is shown below. Damage to or lack of function of a particular cranial nerve can be assessed The Cranial Nerves https://www.coursehero.com/study-guides/ap1/the-peripheral-nervous-system/ 16 https://youtu.be/oyQxhBLkWnY 61 Cranial Nerve Tests We will watch a video of a cranial nerve examination Geeky Medics “Cranial Nerve Examination | OSCE Guide | NEW | UKMLA | CPSA” You can see that the tests assess different motor or sensory functions depending on which nerve is being examined. Most of the tests are pretty self-evident from the video, However, the tests for Cranial Nerve VIII are experienced only by the subject so we will perform the test class Test for Cranial Nerve VIII/Auditory function There are two types of deafness. Conductive deafness is where the sound is not being converted into an electrical signal due to damage or blockage of external or middle ear. Sensorineural deafness occurs when the signal is not detected by the brain due to damage to the cochlea or the auditory nerve. The Rinne Test is one of two tests that can distinguish these two types of deafness. Take a tuning fork and GENTLY strike it so that a sound is produced. Place the tuning fork on the mastoid process on one side of your partners head, they should be able to hear the sound. When they can’t hear the sound via the bone move the tuning fork to the opening of the ear canal and ask them if they can still hear the sound A positive Rinne is where sound is clearly heard when you put the tuning fork near the ear canal. To see the procedure performed, along with the Weber test, and how to interpret results you can look at video via the link on Canvas 17 17 https://youtu.be/FgF91K7dU8Y 62 Follow up. On the Canvas site in the Module for Week 5, there is set reading from the e-text that you can refer to complete this table. Nerve Function I Olfactory II Optic III Oculomotor IV Trochlear V Trigeminal VI Abducens 63 VII Facial VIII Auditory (Also, Vestibulo- Cochlear) IX Glosso- pharyngeal X Vagus XI Spinal /Accessory XII Hypoglossal Eleven of the twelve nerves innervate regions of the face and neck. One is an exception to this, Which one is the exception? Some cranial nerves are exclusively sensory and convey sensations to the brain. What is an example? There are more questions on the next page 64 Some cranial nerves are exclusively motor and control of muscles. What is an example? Other cranial nerves are mixed nerves with sensory and motor What is an example? 65  WEEK 6 THE MAJOR MUSCLES OF THE HUMAN BODY & JOINTS AND MOVEMENT Text Chapter Martini & Bartholomew op. cit., Chapters 6&7 Objectives You should be able to demonstrate a knowledge of the major structural features of a synovial joint. the major types of synovial joints and movements capable at synovial joints. You should be able to identify or demonstrate knowledge of the major superficial muscles of human body and what movements they are responsible for when that is listed in this practical manual. What you will need PPE What is provided. Class Laboratory Guides Whole skeletons, two or more per class if possible Whole bodies with musculature, if available Muscle models Muscle charts Synovial Joint Models at least two per class Session procedure We will review the results of the cutaneous sensation task The rest of the time will be periods of self-study, class demonstrations and working in small groups. 66 1. Joints Introduction A joint or articulation is a point where two bones meet. Joints both hold the parts of the body together and are sites of movement. They can be classified by their structure fibrous cartilaginous synovial joints. They can also be classified by the degree of movement immovable slightly movable freely movable Here is a copy of the table from your text 67 Synovial joints In groups or as the whole class, your demonstrators will take you through the parts of a synovial joint. Specifically: two articulating bones ligaments over/around the joint the joint capsule (made up of the inner synovial membrane and the outer fibrous layer) filled with synovial fluid articular (hyaline) cartilage on the articulating surface of each bone Depending on what model you have access to you may also be able to examine the arrangement of the muscles and tendons. Please complete the labelling of the diagram. Figure 6.1 p 220 Martini and Bartholomew op. cit. 68 The properties of synovial fluid The composition of synovial fluid renders it a non-Newtonian fluid 18. This YouTube video steps you through this. It is loaded up on Canvas. The key take homes being Viscosity is how easily it is to deform a liquid when a force is applied. This property is manifested when you pour different liquids. Comparing pouring water with pouring honey illustrates how the two fluids vary dramatically in viscosity. For a Newtonian fluid the viscosity does not change if the force applied changes For non-Newtonian fluids (like synovial fluid) the viscosity is dependent upon the force applied Oobleck is described as a colloid which means the particles are dispersed evenly in the liquid (water). 19. Let’s watch an in-house presentation about oobleck to illustrate its properties which it shares with synovial fluid. It posted in this week’s module on Canvas What are two functions that synovial fluid serves? 18 https://www.orthopaedicsone.com/display/Main/Synovial+fluid 19 This is in contrast to for example saline which is considered a solution of hydrated sodium and chloride ions https://chem.libretexts.org/Bookshelves/Physical_and_Theoretical_Chemistry_Textbook_Maps/Supplemental_ Modules_(Physical_and_Theoretical_Chemistry)/Physical_Properties_of_Matter/Solutions_and_Mixtures/Collo id 69 3. Movements allowed by synovial joints 3.1 Movements that are not unique to specific parts of the body Flexion and Extension and Hyperextension Flexion is bending a joint to make the angle between the bones more acute (less than 90o) Extension involves straightening a joint to make the angle between the bones more obtuse (more than 90o). An extension greater than 180o is known as a hyperextension. Abduction and Adduction Abduction is moving parts of the body away from each other Adduction is moving parts of the body closer together. Rotation Rotation is twisting a bone about its longitudinal axis With the whole skeletons, or each other. Complete this table. That is for each row list the number of joints you can find where the number is given. So, for example see if you can find two joints which are capable of hyperextension but three joints where flexion and extension can occur Examples of joints Flexion and extension (3) Hyperextension (2) Abduction and adduction (3) Rotation (1) 20 20 Swinging you arm in a circle at the should is NOT simply rotation: it is a combination of movements. There is an extra video on this if you are interested “Nice to know, not need to know: Circumduction” 70 3.2 Movements restricted to particular joints. Pronation and Supination This is movement of the radius around the ulna. Stand in the anatomical position (palms forward). Now turn your left hand around so that the palm faces posteriorly. This involves pronation between the radius and the ulna. Now return your hands to the anatomical position: this involves supination. Now go over to one of the skeletons and perform pronation and supination of the skeleton’s arm. What happens to the positions of the two bones of the lower arm during pronation? Inversion and Eversion of the Foot Turning the sole of the foot medially is inversion. Turning the foot laterally is eversion. Dorsiflexion and Plantar Flexion of the Foot and the Ankle They are flexions relative to the superior (dorsal) or inferior (plantar) surfaces of the foot. This is shown directly below. https://biology.stackexchange.com/questions/30468/why-is-the-opposite-of-plantar-flexion-called-dorsiflexion Flexion at the ankle involves your foot so the superior surface approaches the shin: dorsiflexion. Extension at the ankle involves depressing your foot so the toes are pointing away: plantar flexion. 71 Please cross out the wrong answer You have just touched your chin to your chest this is flexion/extension of the neck. Moving your head to signify “NO” is rotation/flexion/extension Standing on your toes as in ballet requires dorsiflexion/plantar flexion of the foot. The action that moves the distal end of the radius across the ulna is: rotation/pronation/supination. To keep your seat when riding a horse, you need to adduct/extend/abduct your thighs. 4. Superficial skeletal muscles Work independently or in small groups. Generally, muscles are usually involved in the movement of a joint that is distal to them. Muscles Crossing the Hip and Knee Joint: Movement of the Thigh and Leg Muscles of the thigh: anterior They are usually grouped together as the quadriceps, and they are responsible for thigh flexion and knee extension. Going in a lateral to medial direction, the individual muscles are: vastus lateralis rectus femoris vastus intermedius is beneath the rectus femoris. vastus medialis Muscles of the thigh: posterior They are usually grouped together as the hamstrings, and they are responsible for knee flexion. Going in a lateral to medial direction, the individual muscles are: Biceps femoris Semitendinosus Semimembranosus Muscles of the buttocks The gluteus maximus is a large muscle involved in thigh extension and lateral rotation. 72 Muscles of leg: Movement of the Ankle and Foot On the anterior side you may be able locate the tibialis anterior it runs laterally along the tibia. It is the principal muscle involved in dorsiflexion of the foot. On the posterior side the most prominent muscle is gastrocnemius. When the knee is extended it is involved in plantar flexion. At the distal end, the gastrocnemius joins onto the calcaneus (“heel”) bone via the calcaneal or Achilles 21 tendon. You should be able to feel this tendon at the back of your own foot. Muscles of the Abdominal Wall: Trunk Movement The medial superficial muscle is the rectus abdominis Lateral to it are the external oblique muscles. Apart from their involvement in movement of the lumbar region of the torso, these muscles protect the abdominal organs and help in such diverse actions as. urination, defecation, childbirth, vomiting, screaming, sneezing, coughing, burping, blowing your nose. Try one of these activities (but not any of the first 4) and feel your abdominal muscles contract. Muscles of the Thorax and Shoulder and Neck: Movements of Head, Shoulder and Arms The pectoralis major covers the upper part of the chest it is the primary muscle involved in arm flexion (as you do when you point to something straight in front of you). The latissimus dorsi is a broad triangular muscle covering the lower back it is the primary muscle involved in arm extension. The deltoid forms the front part of the shoulder 22. The trapezius occupies most of the upper back. It is involved in movements such as shrugging your shoulders as well as extension and hyperextension at the neck. The sternocleidomastoid muscle gets its name from the bones it is attached to the sternum, the clavicle and the mastoid process of the skull. It is the primary muscle in head flexion (e.g. raising your head when you are lying on your back). It is also involved in tilting your head laterally towards your shoulders. 21 https://www.thecollector.com/how-did-achilles-die-lets-look-closer-at-his-story/ 22 The movement this muscle is involved in will be something you uncover later in the class 73 Muscles of the Upper Arm: Movement of the Forearm On the anterior surface, the biceps brachii22. On the posterior surface the triceps brachii22. Here is a list of parts of some of the muscle names. Have a go at working out what they mean. One has been put in for you as it is not as obvious. bi-, tri, quadriceps deltoid dorsi latissimus widest (as is the word “latitude”) major maximus oblique rectus trapezius 74  Major Superficial Muscles of the Anterior Surface of the Body In this diagram (Martini & Bartholomew op. cit. Fig 7-12), the vastus intermedius is not visible as it lies beneath the rectus femoris. Aside from this you should be able to add labels for the: vastus lateralis, rectus femoris, vastus medialis, tibialis anterior, rectus abdominis, the external obliques, the sternocleidomastoids, the deltoids and the biceps brachii. 75  Major Superficial Muscles of the Posterior Surface of the Body In this diagram (Martini & Bartholomew op. cit. Fig 7-13), please add labels for the: deltoids, triceps brachii, trapezius, latissimus dorsi, gluteus maximus, biceps femoris, semitendinosus, semimembranosus, gastrocnemius and the calcaneal tendon. 76 5. Muscles, joints and bones Work in a small group For each of the following muscles deltoid biceps brachii triceps brachii Use models (both muscles and skeletons) or yourselves but not a reference source, like a website or a textbook: have a go at filling out this table If you are unsure about points of attachment, come up with some and check with your demonstrator. Muscle Which bones does it attach to? What type of movement deltoid biceps brachii triceps brachii When the table is complete have a demonstrator check it Q: What feature of the elbow joint puts constraints on the degree movement at this joint? Hint: Compare bones, and degree of movement, between the elbow, the shoulder and the wrist. 77  WEEK 7 CARDIOVASCULAR ANATOMY AND PHYSIOLOGY Text Chapter Martini & Bartholomew op. cit., Chapters 12 & 13 Objectives You will be able to identify structures of the mammalian heart, You will collect an ECG trace and use it in the measurement of heart rate, You will see how blood pressure is measured, What you will need PPE What is provided Class Laboratory Guides Plastic heart models at least 4 per class Sheep hearts (1 per group of 3-4) Dissecting instruments: forceps, scissors, knife and blunt probe ECG equipment and disposables (up to 4 per class) Yoga mats, or single use spills sheets, since students may be barefoot, on per each ECG set up Scissors, sticky tape (or glue sticks) for the students to store their ECG after use Alcohol wipes Automated blood pressure monitors 1. Dissection of an animal heart The instructions for the dissection are in the Class Laboratory Guide Part 1: External features In the first video today, Dr Geronimo will get you oriented and then go through the external features. This video is loaded up on Canvas in this week’s module. Now use the Class Laboratory Guide to examine the external features of the heart 78 Part 2 The internal structures of the heart In the next video Dr Geronimo will step you through a useful way to perform the dissection. This video is loaded up on Canvas in this week’s module. Now use the Class Laboratory Guide to dissect the heart Part 3: Additional features that would be seen in an intact heart Blood is delivered to and ejected from the heart via several major vessels. The walls of the heart are too thick to rely solely upon diffusion of nutrients and wastes between the blood in the chambers and the cells of the heart wall. Instead, the heart has its own supply of vessels. Use the plastic models for this next part Blood leaves the left ventricle via the aorta At the base of the aorta are two branches that give rise to left and right coronary 23 arteries. They and their smaller branching arteries run through the sulci and margins of the heart. Veins run alongside the arteries. They drain blood from the myocardium and ultimately empty into the coronary sinus that empties into the right atrium. The coronary sulcus encircles the heart and marks out the boundary between the atria and the ventricles. Blood is returned to the right atrium by two large veins: the superior and inferior vena cavae (singular cava) and this blood is depleted in oxygen. Blood leaves the right ventricle via the pulmonary trunk which branches to form the left and right pulmonary arteries carrying the blood to the lungs. Blood is returned from the lungs to the left atrium via the left and right pulmonary veins. This blood is enriched in oxygen. 23 Why “coronary” was explained in the Medical Terminology videos 79  External Anterior View of the Heart Martini and Bartholomew Fig 12.03 Label diagram with the following the: superior vena cava, the right atrium 24, coronary sulcus, right ventricle 25, pulmonary trunk, interventricular sulcus, left ventricle, aorta, left atrium 24 atrium = entrance way. A prominent feature shown in the diagram are the auricles of the atria. This are out- foldings which accommodate overfilling of the atria 25 ventricle = little room 80  Internal Anterior View of the Heart Please label the: superior vena cava, inferior vena cava, right atrium, right AV valve 26, right ventricle, right semilunar valve, pulmonary trunk, pulmonary arteries, pulmonary veins, left atrium, left AV valve 27, interventricular septum, left semilunar valve, aorta, chordae tendineae, papillary muscle 26 Dr Geronimo uses the clinical name the tricuspid valve since this valve has three leaflets 27 Dr Geronimo gives it the clinical name the mitral valve because it looks like the hat a Catholic bishop where http://fallibleblogma.com/index.php/why-do-catholic-bishops-wear-funny-hats/ 81 Why do you think the AV valves need to be tethered to the floor of each ventricle? 2. The electrocardiograph (ECG/EKG) measuring the electrical activity of the heart The next video we will watch is an animation linking the electrical activity of the heart with taking an ECG. As a guide to today’s activity, label the peaks in the diagram and in the table write down the corresponding electrical event P QRS T 82 The ECG In a clinical setting an array of electrodes is used across the body 6 chest electrodes (V1-V6) 4 electrodes one placed on each limb. The combination of the signals from these 10 electrodes is used to derive 12 leads. A lead is the signal from one of the electrodes referenced against a different electrode. Hence, you will see professionals discussing a 12 Lead ECG. In these classes we set up the ECG to record from Lead II utilising electrodes placed on a leg and an arm on opposite sides of the body. This will allow us to monitor the wave of depolarisation (and subsequent repolarisation) that travels from the base of the heart to the apex. Relationship between lead placement and the heart 28 28 Kablunde RE, Electrocardiogram Standard Limb Leads (Bipolar) Cardiovascular Physiology Concepts https://www.cvphysiology.com/Arrhythmias/A013a (accessed 11/07/2019) 83 Taking an ECG First let’s watch video demonstration of an ECG test which is on the Canvas site Now use the Class Laboratory Guides to perform an ECG The space below can be used to store your traces. If you only have one long trace that ran for around 15 s you can divide it up and still do the estimated on the next page If you want a permanent record, you need to make a photocopy or take a photograph. Thermal paper fades quickly 84 Calculating heart rate Knowing the speed of the chart the number of peaks is counted for a specified length of time. The paper speed is set at 25 mm /s. Thus 1 mm represents 0.04 s 5 mm (the distance between two of the darker lines on the graph) represents 0.2 s as shown above Five big squares (25 mm) is 1 s also shown above Then 375 mm is 15 s Count the number of R peaks in 37.5 cm of the trace and multiply by 4 to get the heart rate in beats per minute. If you don’t have a full-length trace count the number of peaks is a reasonably long section, work out how many seconds, divide the length in mm by 25, and convert that to beats per minute Resting heart rate (bpm) 3 Blood pressure determinations Pressure changes in the circulation can be linked to events occurring in the cardiac cycle. Systolic blood pressure (SBP) is the peak pressure in the large arteries during the ejection phase of ventricular systole. Diastolic blood pressure (DBP) is the minimum pressure in these arteries during ventricular diastole. During diastole blood pressure is maintained mainly by the elastic recoil of the large arteries. That is, they spring back into shape during diastole after the arteries were stretched during systole. Whereas SBP can be used as an indicator of the stroke volume component of cardiac output, DBP is used as an indicator of peripheral resistance. Pulse pressure (PP) is the difference between SBP and DBP and is a useful indicator of the extent and efficiency of blood flow. It is normally about 40 mmHg and can be calculated as follows: PP = SBP- DBP 85 Measuring Blood Pressure In today’s class we will be using oscillometric blood pressure monitors. The way these monitors work is very different to the methods which involve a stethoscope and a pressure meter known as auscultation. Unlike devices that use the auscultatory method, the oscillometric meters require less specialist training. However, there remain concerns about the accuracy of these devices. Let’s watch a video as to how to properly use the blood pressure monitor which is on the Canvas site The instructions for use are in the class laboratory guide Resting blood pressure 120-130/60-80 mm Hg for young men 105-115/60-70 mm Hg for young women are considered normal Repeat taking the determinations twice more, wait a few minutes between the estimates. One way to achieve this is to have a group that rotates through having their BP taken, as that will give sufficient breaks between repeated measurements for the same person. For each set of determinations, you can calculate the PP. Compare the individual SBP and DBP readings with the average as an indicator of the event-to-event variation. Trial SBP difference DBP difference PP from from average average 1 2 3 Average Anatomical sex: male/female/intersex/prefer not to say: Age (yrs.): 86 Effect of a cognitive challenge on cardiovascular function Physical and mental stresses can affect cardiovascular function. In this activity, you can see what the impact is likely to be. There is a choice of three different cognitive tasks. In the first instance, just pick one. Serial subtraction Digits backwards The Stroop colour word test The instructions for each test are in Class Laboratory Guide One person in a pair is the test subject. Using the automated blood pressure monitors take three consecutive measurements of SBP, DBP and heart rate. This is the baseline data Systolic BP Diastolic BP Heart Rate AVERAGE Keep the blood pressure monitor cuff on the subject and get them to decide which one of the cognitive tasks they want to do. Immediately after the end of the task, take another three consecutive SBP, DBP and heart rate. This is the post-cognitive task data Systolic BP Diastolic BP Heart Rate AVERAGE What was the outcome, if any, of conducting the cognitive challenge? Whatever result you got, have a go at explaining it 87  WEEK 8 RESPIRATORY ANATOMY AND MEASUREMENT OF LUNG FUNCTION Text Chapter Martini & Bartholomew op. cit., Chapter 15 Objectives Students can identify the principal organs of the respiratory system. Students will be able to demonstrate a knowledge of the differences in histology between different regions of the respiratory tract and lungs. Students will be able to demonstrate their understanding of FVC, FEV1 and their clinical relevance. Students can distinguish between the different lung volumes and capacities measured in a lung volume trace. What you will need PPE What is provided Class Laboratory Guides Respiratory System Folder Any additional torso models from the other laboratories and stand-alone respiratory system charts and models (including some skulls if the nasal conchae can be seen) Lung pluck (two per class) and plastic tubing to inflate the pluck Metal probes and kitchen knives. A Vitalograph (bellows-type) spirometer, sheets of recording paper, matched disposable mouthpieces. Vitalograph alpha touch spirometers and matched disposable mouthpieces Nose clips (+ some plastic clothes pegs) Wall-mounted 1 metre rulers set 1 metre off the ground to allow students to estimate their height. Laptops 88 1. Anatomy of the Respiratory System The respiratory tract is conveniently divided into two parts 29 The Upper Respiratory Tract What are the two portals of entry of the respiratory tract? The nostrils open into the nasal cavity. The lining of the cavity: the nasal mucosa, has two parts. A ciliated pseudostratified columnar epithelium including mucus secreting goblet cells Protruding into the nasal cavity are bony projections nasal conchae the presence of which greatly increases the mucosal surface area. 29 There is an error in this diagram in that the larynx is generally considered part of the upper respiratory tract. 89 Have a look at the models of skeletons and any skulls to see the nasal conchae The second part is an epithelium which consists of special sensory neurons, supporting cells and stem cells which can resupply both the neurons and supporting cells. Follow the airways from the nasal and oral cavities to the top of the trachea The pharynx opens into both the oesophagus and the trachea. Superior to the trachea is the larynx. The epiglottis is a flap of elastic cartilage covered with a mucous membrane attached to the superior edge of the larynx and the tongue What is the common name for the pharynx? What function does the epiglottis appear to serve? What is one thing that the larynx is involved in with humans? 90 Lower respiratory tract The combination of structures is termed the bronchial tree. Think of the trachea as the “trunk” giving rise to an elaborate network of “roots” and “rootlets”. The Bronchial Tree Martini and Bartholomew op. cit. Fig, 15.06a 91 Histological changes in the lower respiratory tract Going down the tract the type of epithelial lining changes: Columnar => Cuboidal =>Squamous Columnar epithelium provides a greater degree of resistance to mechanical stress than either cuboid