ANPH 111 Finals Notes PDF

ANATOMY AND PHYSIOLOGY FINALS NOTES | GABRIELLE LYMPHATIC SYSTEM & IMMUNITY FUNCTIONS OF THE LYMPHATIC SYSTEM 01. Returns fluids that leaked from vascular system back to the blood 02. Protects the body by removing foreign material from...

ANATOMY AND PHYSIOLOGY FINALS NOTES | GABRIELLE LYMPHATIC SYSTEM & IMMUNITY FUNCTIONS OF THE LYMPHATIC SYSTEM 01. Returns fluids that leaked from vascular system back to the blood 02. Protects the body by removing foreign material from the lymph 03. immune surveillance SEMI-INDEPENDENT PARTS 01. Lymphatic vessels 02. Lymphatic organs A THORACIC DUCT → originates from cisterna chyli → which empties into the left subclavian vein at its junction with the left internal jugular vein B RIGHT LYMPHATIC DUCT → which empties into the right subclavian vein at its junction with the right internal jugular vein DISTRIBUTION OF LYMPHATIC VESSELS Lymphatic capillaries ↓ Lymphatic vessels ↓ Lymphatic trunks: Lumbar Intestinal Broncho mediastinal Subclavian Jugular LYMPH TRANSPORT 01. Skeletal muscle contraction LYMPH TRUNKS 02. Negative pressure in the thorax LUMBAR → Drains lower extremities and pelvis 03. Valves INTESTINAL → Drains abdominal region BRONCHOMEDIASTINAL → Drain thorax SUBCLAVIAN → Drains upper extremities JUGULAR → Drains head and neck 1 ANPH 111 FINALS GABRIELLE LYMPHATIC ORGANS → Basic structural components: → Primary Lymphatic organs: Thymus and Bone Marrow → Lymphocytes aggregates – loose, dense, nodular (Form a sphere or a ball), follicles 01. Loose connective tissue; reticular 02. Epithelial cells LYMPH NODE → Located along lymphatic vessels → Macrophages that phagocytize bacteria → Lymphocytes mounting immune response → Filters the lymph SPLEEN → largest lymphatic organ → located at the left hypochondriac region → graveyard for senescent or aged RBC → filters the blood → produces lymphocytes and plasma cells THYMUS → is a flat, pinkish-gray, two lobed organ lying high in the chest anterior to the aorta and posterior to the → sternum. → increases its size during childhood → characteristic feature is hassal’s or thymic corpuscles → In the thymus the lymphoid tissue is not arranged in nodules → Hassal’s are found in the medulla STRUCTURE → Capsule → Contains lymphocytes, macrophages, RBC → Red pulp contains abundant RBC and macrophages → White pulp contains lymphocytes TONSILS → several groups of tonsils forming a ring of lymphoid tissue, guard the entrance of the alimentary and respiratory tracts from invasion by microorganisms. This is called Waldeyer’s ring. 2  ANPH 111 FINALS GABRIELLE → the components of this ring are: 01. Palatine tonsils 02. Nasopharyngeal tonsil 03. Lingual tonsils PEYER’S PATCHES Gut associated lymphatic tissue (GALT) → Clusters of nodules in the ileum → Macrophages are in ideal position to capture and destroy bacteria, preventing them from reaching the intestinal wall. 2 B CELL → Involved in humoral immunity 01. Primary immune response 02. Secondary immune response DEVELOPMENTAL ASPECT OF THE LYMPATHICS → Lymphatics develop as out pocketing of developing vein, from mesoderm → Thymus gland develops from endoderm → The rest of the lymphoid organs develop from mesoderm IMMUNE RESPONSE IMMUNITY → defense of the body against disease causing agents like transplant, blood transfusion, autoimmune, allergies, AIDS → specific or non-specific NON-SPECIFIC → block the entry or spread of the disease RESPONSE SPECIFIC → very specific → tailored to individual treat → antibody mediated (B cells) and cells mediated (T cells) INNATE IMMUNITY (NON-SPECIFIC IMMUNE RESPONSE) → Present at birth → Non-specific → Does not become efficient upon the second exposure to same organism → skin, mucous membrane, phagocytes, natural killer cell, inflammatory response, interferon, complement, fever AQUIRED (ADAPTIVE/SPECIFIC) IMMUNE RESPONSE → Following certain infection → Antigen and antibody reaction → B lymphocytes humoral /antibody mediated immunity → T lymphocyte cell mediated immunity TYPES OF MATURE LYMPHOCYTES 1 T CELL → helper T cell- (+) other T cells → cytotoxic T cell- attack the infected cells, virus, cancer cells, foreign body → Suppressor T cell- terminate normal immune response 3 ANPH 111 FINALS GABRIELLE → composed of organs whose primary functions are ingestion, digestion, absorption of food and excretion of undigested food. → it includes the mouth, pharynx, esophagus, stomach, small and large intestines, and the accessory digestive organs (Salivary glands, Liver, pancreas, and gall bladder) HISTOLOGIC CHARACTERISTICS → Walls of the Digestive tract composed of the following: 1 TUNICA MOCOSA - Functions: absorptive, secretory, and protective - Consists of the following: IMMUNOGLOBULIN CLASSES A EPITHELIUM IgG → 75% of Ig, All IgG are monomers - All are lined by simple columnar except mouth, pharynx, → Crosses the placenta esophagus, and lower anus which are lined by stratified → Weakly activates the complement system, most sq. non keratinized. abundant B LAMINA PROPRIA IgA → 15% of Ig - Loose areolar tissue → Serum IgA found in secretions is a dimer, the major class C MUSCULARIS MUCOSA of Ig in secretions – tears, saliva colostrum, mucus - made up of smooth muscles → Rich in antibodies 2 SUBMUCOSA → First milk produced by the mother - Connective tissue consisting of the ff: blood vessels, IgM → 7-10% lymphatics, and nerves. → largest size - Major function is nutritive and protective. → exists as a pentamer 3 TUNICA MUSCULARIS → most potent activator of complement system: IgM is the - Usually 2 layers of smooth muscles, inner circular and first Ig to be made by the fetus outer longitudinal muscle layer IgE → less than 1% of Ig - Stomach has 3 layers of tunica muscularis, inner → exists as a monomer, mediates allergic and parasitic oblique, middle circular, and outer longitudinal muscle reaction layer. → does not fix Ig to be made by the fetus 4 TUNICA SEROSA → Antibody in the surface of lymphocytes on newborn - Visceral peritoneum IgD → < 1% exists only as a monomer, main Ab on the surface of - It is a single layer of simple squamous epithelium which lymphocytes of newborn secretes a small amount of serous lubricating fluid which reduces friction among the GI tract organs and DIGESTIVE SYSTEM the body wall MAIN DIVISIONS I. DIGESTIVE TRACT A. Oral Cavity B. Pharynx  Oropharynx  Laryngopharynx C. Esophagus D. Stomach E. Small Intestines  Duodenum  Jejunum  Ileum 4  ANPH 111 FINALS GABRIELLE F. Large intestine  Cecum with vermiform appendix  Ascending colon  Transverse colon  Descending colon  Sigmoid colon (pelvic colon)  Rectum  Anal canal II. ACCESSORY ORGANS / GLANDS A. Lips B. Teeth C. Tongue D. Salivary glands 01. Big:  Parotid  Submandibular → papillae:  Sublingual a. vallate – largest 02. Small b. foliate  Lingual c. fungiform  Labial d. filiform  Buccal → taste buds – sensory organs of taste especially numerous around E. Liver vallate papillae. F. Gall bladder G. Pancreas NERVES OF TONGUE 1 GENERAL SENSORY MOUTH → lingual (CN V) (anterior 2/3 of tongue) → Glossopharyngeal (CN IX post. 1/3 of tongue) → Vagus (CN X) epiglottic area 2 SPECIAL SENSORY → anterior 2/3 - chorda tympani from VII → posterior 1/3 - glossopharyngeal (CN IX) 3 MOTOR → to intrinsic and extrinsic muscles of tongue - hypoglossal 01 ORAL VESTIBULE → space bounded anteriorly by lips and cheeks and posteriorly by teeth and gums. 02 ORAL CAVITY PROPER → space bounded by gums and teeth. → The floor is the tongue. → The roof is hard and soft palate. 03 TEETH → Two sets of teeth make their appearance during the lifetime of an individual - the deciduous teeth, or temporary (milk), teeth and the permanent teeth. → The deciduous set consists of 20 teeth, 5 in each quadrant: 2 incisors, 1 canine, and 2 molars. → The deciduous teeth erupt on average between 6 and 24 months after birth and are usually shed between the ages of 6 and 12. → There are 32 permanent teeth in a full set, 8 in each quadrant: 2 incisors, 1 canine, 2 premolars, and 3 molars. → Eruption of the third molars, or wisdom teeth, is delayed until after the age of 18. 05 SALIVARY GLANDS 04 TONGUE → secretions (salivary amylase) poured in the oral cavity start digestion → Chief organ of taste, important in speech, mastication, and deglutition. of carbohydrates. → parts: root, apex, body 1 PAROTID → Largest, lies on the posterior border of ramus of mandible → Secretion is purely serous 5 ANPH 111 FINALS GABRIELLE → Duct: Stensen's - opens into the vestibule of mouth opposite → It is posterior to the trachea and anterior to the vertebral column; it second molar tooth passes through the diaphragm in front of the aorta to enter the → Viral inflammation: mumps or parotitis stomach. → Important structure embedded : facial nerve → Lower esophageal sphincter is a physiologic sphincter. 2 SUBMANDIBULAR → Second largest mixed serous and mucous gland, more of serous → Duct: Wharton's - which opens at sublingual papillae 3 SUBLINGUAL → salivary glands → mixed serous and mucous but more of mucous ducts: Rivinu's - small opens at summit of sublingual fold Bartholin's → large; opens into sublingual papillae STOMACH → located within peritoneal cavity. → with greater and lesser curvatures. PHARYNX → Parts: → 3 Parts: 01. Fundus – found on the left border Nasopharynx or → located behind the nasal cavity 02. Body Epipharynx 03. Pyloric antrum Oropharynx or → located behind oral cavity proper 04. Pylorus – tubular portion Mesopharynx → palatine tonsil bounded by palatoglossal 05. Cardiac region – area surrounding the point of entry of food and palatopharyngeal fold Laryngopharynx → located behind larynx → continuous with the esophagus → The stomach, the most dilated portion of the digestive tract, lies under the diaphragm just below the costal margin in the upper abdomen. → It serves mainly as a storage and mixing chamber for food prior to passage into the duodenum (the first part of the small intestine), but some digestion takes place, and the mixed, partially digested food is reduced to a semifluid mass. ESOPHAGUS → a muscular tube extending from the pharynx to the stomach → with 3 anatomical constrictions: 01. at the pharyngo-esophageal junction 02. when left main bronchus crosses esophagus 03. when it enters the diaphragm → The esophagus extends from the pharynx to the stomach for a distance of about 10 inches. CELLS IN THE STOMACH Parietal cell → secretes HCl and intrinsic factor. 6  ANPH 111 FINALS GABRIELLE Chief cell → secretes pepsin Mucus neck cell → secretes mucus G cell → secretes gastrin SWALLOWING PROCESS 01. Tongue moves upward and backward 02. Soft palate closes the nasopharynx 03. Epiglottis closes the laryngeal inlet 04. Pharynx contracts 05. Bolus enters the esophagus LARGE INTESTINES → Five feet long. → Parts: 1 Cecum → longest, found at the right lower quadrant SMALL INTESTINES → provided with Peyer's patches or → Longest, 20ft aggregated lymph nodules → Parts: 2 Vermiform appendix → located posteromedial to cecum DUODENUM → C-shaped 3 Ascending colon → with 4 parts (superior, descending, 4 Transverse colon transverse and ascending) 5 Descending colon → the CBD and main and accessory 6 Sigmoid colon → S-shaped pancreatic ducts enter 7 Rectum → continuation of sigmoid at S3 → Gross Structural Characteristics: vertebra major duodenal papilla 8 Anal canal with sphincter of Oddi around common duct and main pancreatic duct of Wirsung minor duodenal of accessory pancreatic duct of Santorini JEJUNUM → located at the left upper quadrant → upper 2/5 (8ft) → more vascular wider and thicker than ileum ILEUM → longest, found at the right lower quadrant → provided with Peyer's patches or aggregated lymph nodules 7  ANPH 111 FINALS GABRIELLE CHARACTERISTIC FEATURES OF LARGE INTESTINES ACCESSORY DIGESTIVE ORGANS 01. Plicae semilunaris 02. Haustra/sacculations 01 SALIVARY GLANDS 03. Taenia coli 1 PAROTID GLAND 04. Epiploicae appendices → purely serous, with stensen’s duct that open into oral vestibule opposite the upper 2nd molar tooth 2 SUBMANDIBULAR GLAND → mixed → its duct, Wharton’s opens into sublingual papilla 3 SUBLINGUAL GLAND → it has 2 ducts: a. Bartholin’s duct – opens into sublingual papilla b. Duct of rivinus – opens into sublingual fold 02 LIVER → largest gland of the body → with right and left lobe LOBES a. Quadrate Lobe b. Caudate Lobe DIFFERENCES BETWEEN SMALL AND LARGE INTESTINE SMALL INTESTINES LARGE INTESTINES Mobile except duodenum Fixed ascending and descending colon Narrower lumen Wider lumen With Peyer’s patches in the ileum With taenia coli, appendices eppiploicae, haustra / sacculation Plicae circulares Plicae semilunaris BLOOD SUPPLY OF GIT → Blood supply to the abdominal organs is provided by three major unpaired vessels arising from the abdominal aorta, namely the (a) coeliac trunk and the (b) superior and inferior mesenteric arteries. → The branches of these vessels form anastomotic systems that provide a rich blood supply to the adjoining organs. 8  ANPH 111 FINALS GABRIELLE LIGAMENTS 04 PANCREAS a. Falciform ligaments – anatomical division of the liver → retroperitoneal at the back of the stomach b. Coronary ligaments → both endocrine and exocrine organs c. Triangular ligaments → with head, neck, body and tail and uncinate process → Two ducts: a. Major duct of Wirsung b. Accessory duct of Santorini INFERIOR / VISCERAL SURFACE 01. Fissure for ligamentum teres hepatis, ligamentum venosum 02. Fossa of Gallbladder and IVC 03. Porta hepatis a. Common bile duct b. Hepatic artery c. Portal vein 04. Lymphatics and nerves EXTRAHEPATIC BILIARY TRACT → Common hepatic duct → formed by the union of right and left hepatic duct → Cystic duct → duct of gall bladder → Common bile duct → formed by the union of cystic duct and common hepatic duct 1 ANATOMICAL OR CLASSICAL DIVISION 2 FUNCTIONAL OR PHYSIOLOGICAL DIVISION → blood supply of liver → from portal vein and hepatic artery Venous drainage of the liver: → hepatic veins which drain into inferior vena cava 03 GALL BLADDER → location: undersurface of the liver → stores and concentrates the bile → parts: fundus, body, neck, infundibulum → mucosa, muscular layer, and serosa - Spiral valve of heister 9  ANPH 111 FINALS GABRIELLE RESPIRATORY SYSTEM B INTERNAL NOSE (NASAL CAVITY) → The respiratory system functions to supply oxygen for the metabolic Roof → ethmoid bone, sphenoid bone, frontal bone needs of the cells and to remove one of the waste materials of cellular Floor → hard palate metabolism, carbon dioxide. Laterally → conchae or turbinates (Superior, middle, → Involves the process of: inferior) which protrude medially forming External Respiration → absorption of O2 and removal of CO2 from grooves inferior to each conchae called the lungs. meatus Internal Respiration → gaseous exchanges between the cells of Medially → the nasal septum which is formed anteriorly the body and their fluid medium by hyaline cartilage, and posteriorly by the vomer bone and perpendicular plate of PULMONARY VENTILATION ethmoid → Movement of air in and out of the respiratory system. RECESS AND MEATUSES PARTS OF THE REPIRATORY SYSTEM 1 CONDUCTING PASSAGES (DEAD SPACES) → For passage of air 01. Nose 04. Trachea 02. Pharynx 05. Bronchi and their 03. Larynx divisions 2 RESPIRATORY PASSAGES → where absorption of O2 and removal of CO2 from the blood takes place. 01. Lungs (respiratory bronchioles, alveolar ducts, alveoli) NASAL CONCHAE CONDUCTING PASSAGES 01 NOSE A EXTERNAL NOSE BOUNDARIES Superiorly → nasal and frontal bones. Laterally → maxillary bones Inferiorly → Plates of hyaline cartilage → The lateral septal and alar cartilages Posteriorly → The nasal cavity lies posterior to the 1 Superior Concha Parts of ethmoid external nose 2 Middle Concha Anteriorly → Anterior nares (nostrils) - communication 3 Inferior Concha between nasal cavity and outside are separated by septum mobile nasi or columella 10  ANPH 111 FINALS GABRIELLE NASAL SEPTUM → only elastic cartilage (the rest are hyaline) Arytenoid Cartilage → paired → pyramidal Corniculate and → both paired Cuneiform cartilages VOCAL CORDS 02 PHARYNX False Vocal Cords → non-movable (Vestibular Fold) → surrounds the opening called rima vestibuli True Vocal Cords (Vocal → movable Fold) → surrounds the opening called rima glottidis (the narrowest part of the adult larynx) 04 TRACHEA → The trachea or "windpipe" is a cylindrical tube about 10-12 cm in length, 2.5 cm in diameter → 16-20 C-shaped cartilage Nasopharynx → cartilages → lined by pseudostratified columnar ciliated epithelium → C6-T5 Oropharynx → soft palate to epiglottis → located behind the oral cavity Laryngopharynx → located behind the larynx 03 LARYNX → extends 5 cm from the level of the 4th – 6th cervical vertebra → with 9 cartilages (3 paired, 3 unpaired) 05 BRONCHI Thyroid Cartilage → largest. → shield shaped; unpaired → with laryngeal prominence (Adam's Apple): angulation formed from the union of 2 laminae Cricoid Cartilage → unpaired: signet ring shaped Epiglottis → unpaired: spoon or leaf-shaped Primary bronchi divides into 3: right and 2 left secondary lobar → found behind the tongue bronchi which supply the lobes of the lungs 11  ANPH 111 FINALS GABRIELLE (superior, middle and inferior in the right lung; RESPIRATORY MEMBRANE superior and inferior in the left) Secondary bronchi divides into tertiary, or segmental bronchi, each of which is distributed to a unit of the lung called a bronchopulmonary segment. Segmental bronchi continues to divide into successively smaller branches. Type I pneumocytes → walls of alveoli composed of simple squamous epithelium. Type II pneumocytes → secretes surfactant Alveolar Surfactant → dust cells, defense against inhaled dust, bacteria, and foreign particles RESPIRATORY PASSAGES 01 LUNGS → soft, spongy, elastic organs, 0.5 kg each → Essential organs of respiration → situated on either side of the heart and the mediastinal structures 1 Bronchioles → Fine branches → enter basic units of the lung called lobules. 2 Terminal Bronchioles → Each bronchiole divides upon entering a lobule into several terminal bronchioles → each of which further subdivides into two or more respiratory bronchioles. 3 Respiratory → open into alveolar ducts from which Bronchioles alveoli arise RESPIRATORY ZONES → Respiratory bronchioles - branch into alveolar ducts —> alveolar sacs —> alveoli 12  ANPH 111 FINALS GABRIELLE FEATURES OF THE RIGHT LUNG MECHANISM OF BREATHING PHASES OF BREATHING 1 INSPIRATION / INHALATION → air is flowing into the lungs, active phase. 2 EXPIRATION / EXHALATION → air is flowing out of the lung, passive phase. 1 Three lobes → superior, middle and inferior 2 Two fissures → horizontal and oblique 3 → shorter, wider and heavier as compared to left 4 → deeper diaphragmatic surface due to presence of liver FEATURES OF THE LEFT LUNG A PRESSURE RELATIONSHIP IN THE THORACIC CAVITY → Gases travel from area of high pressure to area of lower pressure. 1 Two lobes → superior and inferior 2 One fissure → oblique only 3 → anterior border with cardiac notch 4 → lingula is present (tongue-like portion of the upper lobe between cardiac notch and oblique fissure) 02 PLEURA → a serous membrane covering the lungs and made up of parietal and visceral layers. → between visceral and parietal layer is the pleural cavity which contains a small amount of serous fluid → the 2 layers are continuous at the root of the lungs 1 Intrapulmonary pressure → pressure inside the alveoli 2 Intrapleural/Intrathoracic → pressure in the pleural cavity pressure B PHYSICAL FACTORS INFLUENCING PULMONARY VENTILATION 01. Friction in the air passageways – resistance 02. Lung compliance – elasticity and flexibility 03. Surface tension of the alveolar fluid – surfactant decreases surface tension 13  ANPH 111 FINALS GABRIELLE RESPIRATORY VOLUMES AND CAPACITIES GAS TRANSPORT 1 Oxygen 01. Oxyhemoglobin- O2 and Hemoglobin- 97% 02. Dissolved in plasma- 3% 2 Carbon dioxide 01. Dissolved in plasma- 7-10% 02. Carbaminohemoglobin- 20-30% 03. Bicarbonate (HCO3)- 60-70% Carbonic anhydrase CO2 + H2O_______HCO3 + H H2CO3 -> carbonic anhydrase -> HCO3 +H CONTROL OF RESPIRATION A Medullary Respiratory Centers 1 Dorsal inspiratory group or inspiratory centers → responsible for rhythm of breathing. GAS EXCHANGE IN THE BODY → Impulses travel to phrenic and intercostal nerve to diaphragm A External respiration: Pulmonary gas exchange 2 Ventral respiratory group/expiratory center 01. Partial pressure gradient and gas solubility - CO2 and O2 → contains both inspiratory and expiratory neurons 02. Thickness of the respiratory membranes → during forceful breathing 03. Surface area- alveoli increase the surface area 140meters 04. Ventilation - perfusion coupling B PONS Respiratory centers 1 Pneumotaxic center → continuously sends inhibitory impulses to the inspiratory center of the medulla → sets duration of inspiration 2 Apneustic center → provides inspiratory drive → sends signals for inspiration for long & deep breaths → controls intensity of breathing → inhibited by stretch receptors or by pneumotaxic center → increases tidal volume 14  ANPH 111 FINALS GABRIELLE C Herring-Breuer Reflex 04. Pararenal (paranephric fat) → Stretch receptors in the visceral pleura that transmit inhibitory signals to medullary inspiratory center CHEMICAL CONTROL OF RESPIRATION 1 Central chemoreceptors → located in the medulla oblongata → sensitive to changes in blood CO2 and Ph → increase CO2 or hypercapnia – respiratory stimulant 2 Peripheral chemoreceptors → carotid bodies → sensitive to changes in blood 02 levels EFFECTS OF EXERCISE 01. Increase of ventilation 02. Changes of blood pH, CO2 and O2 LUNG CANCER → 1/3 of cancer related deaths → Associated with smoking PARTS → aggressive URINARY SYSTEM 1 Cortex KIDNEY → Outer → paired, reddish brown, retroperitoneal 2 Medulla → Inner COVERINGS Pelvis → Union of major calyces 01. Real capsule 02. Perirenal fat (perinephric fat) Major calyx 03. Real fascia (gerota’s fascia) → Union of minor calyces Continuous with transversalis fascia 15  ANPH 111 FINALS GABRIELLE NEPHRON → Structural and functional unit of the kidney → 1 million nephron each kidney → Consists of the following: 01. Glomerulus 04. Loop of Henle 02. Bowman’s capsule 05. Distal convoluted tubule 03. Proximal convoluted tubule MECHANISM OF URINE FORMATION A Bowman’s capsule 1 Inner visceral layer → Composed of podocytes, octopus like that terminates in branching pedicles. 2 Parietal layer → simple squamous epithelium. 1 Glomerular filtration 2 Tubular reabsorption 3 Tubular secretion B Renal (Malpighian) corpuscle → Glomerulus plus bowman’s capsule → Juxtaglomerular apparatus – consist of the ff: 01. JG cells 03. Mesangial cell 02. Macula densa 16  ANPH 111 FINALS GABRIELLE GLOMERULAR FILTRATION TUBULAR SECRETION → Acts as a filter → Adding substance to the filtrate from blood or tubular cells. → 1/5 of blood flowing through the kidneys is filtered from the glomeruli → Can be active or passive → Through filtration membrane → Important in eliminating urea, excess ions, drugs, and maintaining acid base balance PRESSURES ACTING ON THE GLOMERULUS REGULATION OF URINE CONCENTRATION AND VOLUME → Urine osmolarity ranges from 50-1200mosm → Hyperosmolarity of the medullary fluid ensures that the urine reaching the DCT is hypo-osmolar → In the absence of ADH, urine becomes diluted When Blood ADH increases the permeability of DCT and collecting duct to water increases 1 Glomerular hydrostatic pressure → a force that push the water and solutes across the filtration membrane. 2 Glomerular osmotic pressure → opposes filtration, hold the fluid inside the glomerulus exerted by plasma protein. 3 Capsular hydrostatic pressure → opposes filtration, force exerted by the fluid inside the bowman’s capsule. NET FILTRATION PRESSURE → Force responsible for filtrate formation NFP = glomerular hydrostatic pressure – (glomerular oncotic pressure + capsular hydrostatic pressure) GLOMERULAR FILTRATION RATE → Refers to the amount of filtrate formed per minute time → Equal to 125ml/min → Directly proportional to the net filtration pressure TUBULAR REABSORPTION → The process of returning needed substances from the filtrate to the capillary blood → Active or passive depending on a particular substance → PCT is the most active 80% of filtrate, nutrients water and Na, the bulk actively transported ions are reabsorbed here → Reabsorption in DCT tubule and collecting duct is controlled by Aldosterone and antidiuretic hormone RENAL CLEARANCE → The rate at which the kidneys clear the plasma for a particular solute 17  ANPH 111 FINALS GABRIELLE URETER B Female → 10 inches long muscular tube. → 4 cm → opens into vestibule 3 ANATOMICAL CONSTRICTIONS MALE REPRODUCTIVE SYSTEM 01. at the uretero-pelvic junction 02. where iliac vessels cross the ureter 03. where it joins the urinary bladder URINARY BLADDER → Hollow muscular organ → Wall consist of detrussor muscle → Inner- trigone occupied by ureteral orifices and urethral orifice FUNCTIONS 01. Production and transport of male sperm cells 02. Production of male hormones like testosterone GONADS Male → Testis Female → Ovary EXTERNAL GEITALIA URETHRA 1 Scrotum → wrinkled sac containing testis, epididymis, and vas deferens A Male → dartos muscle → regulates testicular temperature → spermatogenesis requires 2-3 °C lower than body temperature Cold temperature → testis gets closer to the body Warm temperature → testis hangs loosely 2 Penis 1 Body → made up of 3 erectile tissues Corpora cavernosa → 2, dorsolateral, vascular spaces Corpus spongiosum → contains spongy urethra 2 Root → proximal Bulb → expanded proximal portion of corpus 1 Prostatic spongiosum. → widest, most dilatable → Covered by bulbospongiosum 2 Membranous Crura → proximal tapered parts of corpora → traverses urogenital diaphragm, shortest and least dilatable cavernosa. 3 Penile → Covered by ischiocavernosum → longest, traverses corpus spongiosum 18 ANPH 111 FINALS GABRIELLE INTERNAL GEITALIA 1 Testis → intra-abdominal during fetal life → descends and covered by tunica vaginalis from peritoneum → deep covering tunica albuginea → divides the testis into lobules - each lobules contains seminiferous tubule 3 Glans Penis → expanded distal end of corpus spongiosum → distal terminal urethra is expanded called fossa navicularis → prepuce and frenulum CELLS IN THE TESTIS 1 Spermatogenic cells → grow and mature to form mature sperm cells 2 Sertoli cells/sustentacular cells → support and protect sperm cells 3 Interstitial cells of Leydig → secrete testosterone → located in between seminiferous tubules 2 Male Reproductive duct A EPIDIDYMIS → Comma shaped, 4cm long, located posterior to the testis, with ff parts, head, body, and tail → tail is continuous with vas deferens FUNCTIONS 01. Site of sperm maturation- mobility and capability to fertilize an ovum (10-14 days) 02. Storage of sperm cells 03. Propel sperm cells to vas deferens B VAS/DUCTUS DEFERENS → Continuation of epididymis → 45cm long → Passes through the inguinal canal and enter the pelvic cavity → Joins the duct of seminal vesicle to form ejaculatory duct 19  ANPH 111 FINALS GABRIELLE FUNCTIONS 3 Cowper’s (Bulbourethral) Gland 01. Storage of sperm cells → Located within the urogenital diaphragm on either side of 02. Conveys sperm cell from epididymis to ejaculatory duct and urethra membranous urethra 03. Reabsorbed not ejaculated sperm cells → opens into penile urethra 3 Ejaculatory duct SECRETIONS A URETHRA 1 Alkaline fluid A Prostatic 2 Mucus → lubricates penis and lining of urethra → (2-3 cm) → widest, most dilatable SEMEN B Membranous → volume: 2.5- 5ml with 50-150 million sperm cells/ml approximately → (1 cm) 300-500 millions sperm → traverses urogenital diaphragm, shortest and least dilatable → Slightly alkaline 7.2-7.7 C Penile → Contains seminal plasmin destroys certain bacteria → (15-20 cm) → Once ejaculated sperm coagulates in 5 min due to clotting protein → longest, traverses corpus spongiosum from seminal vesicle → About 10-20min liquefies due to prostate specific antigen(PSA) and ACCESSORY REPRODUCTIVE ORGANS other proteolytic enzymes from prostate 1 Prostate Gland → located beneath urinary bladder with 5 lobes → surround prostatic urethra COMPONENTS → secretes milky, slightly acidic pH 6.5 seminal fluid 1 Seminal fluid → secretion from glands → prostate gives milky white, seminal vesicle and bulbourethral gland sticky appearance 2 Sperm → 70um, viable in 72hrs SECRETIONS OF PROSTATE GLAND 1 Citric acid → for ATP energy of sperm cells 2 Acid phosphatase 3 Proteolytic enzyme → breaks down clotting protein LOBES OF PROSTATE SPERM CELLS A Head → Acrosomes with lysosomal enzymes for penetration of zona pellucida of 2° oocyte → Nucleus- with 23 chromosomes haploid number B Mid piece → with mitochondria 2 Seminal Vesicle C Tail → Located postero-inferior to urinary bladder → flagella for motility → 5cm long → Convoluted pouch ERECTION → 60% of semen volume - Secretes fructose → Enlargement and stiffening of the penis → Due to tactile, visual, auditory, olfactory and imagination reaches SECRETIONS erection center in hypothalamus -> sends parasympathetic nerve 1 Alkaline viscous fluid → neutralizes acidic environment of impulses into the penis -> vasodilatation of helicine arteries into the vagina and male urethra penis -> erection → contains fructose for energy source of sperm cells EJACULATION 2 Prostaglandin → mobility and sperm viability → Powerful expulsion of semen from the urethra to the exterior -> due to → stimulate smooth muscle contraction sympathetic reflex -> closure of smooth muscle sphincter at the base of female 3 Clotting protein → coagulate sperm after ejaculation of urinary bladder → peristaltic contraction of the male reproductive tract 20  ANPH 111 FINALS GABRIELLE EMISSION → Many sebaceous gland → Discharge of small volume of semen before ejaculation VESTIBULE → May occur during sleep, nocturnal emission → space between labia minora → Due to peristaltic contraction of male reproductive tracts 1 Clitoris → frenulum and prepuce CRYPTORCHIDISM → homologue of the penis → Undescended testis 2 → Urethral orifice → 80% will spontaneously descend during 1 year of life 3 Paraurethral glands → secretes mucus → May result to sterility and testicular cancer (skene’s gland) → homologue to prostate → vaginal orifice – guarded with hymen FEMALE REPRODUCTIVE SYSTEM 4 Bartholin’s (greater vestibular) gland INTERNAL GENITALIA FUNCTIONS 01. Production and transport of ovum 02. Production of hormones: 1 Vagina a. Estrogen c. relaxin → fibromuscular canal b. progesterone d. inhibin → lined by mucous membrane 03. Nurture the developing zygote → rugae → hymen PERINEUM → acidic → Diamond shape → fornices → Contains genitalia and anus FUNCTIONS 01. copulation - receives the penis during sexual intercourse 02. Birth canal 03. Outlet of menstrual flow 2 Uterus PARTS Fundus → Pubic symphysis Body → from attachment of fundus to isthmus uteri Cervix → distal portion with canal → surrounded by proximal part of vaginal canal LAYERS 1 Perimetrium → outer covering → derived from peritoneum → forms the uterovesical and BOUNDARIES rectouterine pouch Anterior → Pubic symphysis 2 Myometrium → Middle layer Lateral → Ischial tuberosities → Smooth muscles Posterior → Coccyx → Thickest at the fundus and thinnest at EXTERNAL GENITALIA the cervix 1 Mons Pubis → Response to oxytocin stimulation → mound of fats beneath and symphysis pubis during labor and delivery → puberty -> growth of pubic hair 3 Endometrium → Innermost 2 Labia Majora → Contains endometrial glands → skin fold with hair → Response to estrogen and progesterone that prepares the → pudendal cleft uterus for possible implantation → space in between labia majora → Layers: → sweat, sebaceous glands, apocrine A Stratum functionalis → slough off during menstruation → homologue of male scrotum B Stratum basalis → does not slough off during 3 Labia Minora menstruation → Skin fold, hairless → gives rise to new stratum functionalis → Few sweat gland 21  ANPH 111 FINALS GABRIELLE LIGAMENTAL SUPPORT OF THE UTERUS 1 Broad ligament → derived from peritoneum 2 Round ligament of the → remnant of embryonic uterus gubernaculum → attaches to labia minora 3 Uterosacral ligament 4 Cardinal ligament or → provides support to vagina and transverse cervical cervix Progesterone → prepares the uterine glands and maintains the and estrogen endometrium for implantation 3 Fallopian Tube → Prepares the mammary for milk production PARTS → inhibits FSH and LH if high Inhibin → secreted by granulosa cell and inhibits FSH secretion Relaxin → relaxes the uterus during implantation and pregnancy → help dilates the cervix → from ovary & placenta HORMONAL REGULATION → Controlled by GnRH from hypothalamus that causes the release of FSH and LH 1 Follicle → stimulate growth of follicle and secretion stimulating of estrogen Infundibulum → with fimbria hormone Ampulla → most dilated 2 Luteinizing → stimulate further development of follicle, → site of fertilization hormone ovulation, corpus luteum production of → longest, lateral 2/3 progesterone Isthmus → narrowest 3 Estrogen → maintenance of female repro, secondary Intramural / Interstitial → buried into uterus characteristics and breast development 4 Progesterone → secreted by corpus luteum FUNCTIONS → acts synergistically with estrogen 01. Provide route for sperm to reach the ovum → prepares the endometrium for 02. Transport oocyte from ovary to fallopian tube during ovulation implantation and mammary gland for milk 03. Site of oocyte digestion if no fertilization production 04. Transport fertilized ovum to be implanted in the endometrium of the uterus FEMALE REPRODUCTIVE CYCLE 4 Ovary A Ovarian Cycle → Almond shape → Involves maturation of oocyte → located lateral to the uterus → produces oocyte → mesovarium - portion of the broad ligament that suspends the ovary → ovarian (utero-ovarian) ligament → infundibulopelvic (suspensory) ligament HORMONE SECRETED BY THE OVARY 22  ANPH 111 FINALS GABRIELLE B Uterine Cycle DEFINITION OF TERMS → Changes in the endometrium Menarche → Start of menstruation Menopause → End of menstruation PHASES OF FEMALE REPRODUCTIVE CYCLE Amenorrhea → Absence of menstruation 1 Menstrual → Last for 3-5 days METHODS OF CONTRACEPTION Phase → 1st day of menstruation is 1st day of cycle Rhythm method → Count the days when you are fertile → 50-150 ml of menstrual flow → Usually during ovulation → decreased estrogen and progesterone → Unsafe days: 3 days before and after level in the blood causes ischemia of ovulation functionalis leading to menstruation → Sperm cell lifespan: 72 hours 2 Proliferative → Between menstruation and ovulation Condom → Prevents fertilization as this will trap the (Follicular) → More variable length sperm cell Phase → Dominant follicle is selected to mature Diaphragm or cap → Spermicidal cell that kills sperm cells → Estrogen and inhibin secreted by with spermicidal gel → Carrier methods of birth control that are dominant follicle and stop FSH secretion to used with spermicidal gel or cream to prevent another follicle to grow prevent pregnancy → Repair of endometrium Intrauterine device → Prevents the sperm cells from meeting up → Cells of basalis form new functionalis the oocytes 3 Secretory → Constant phase last for 14 days Oral contraceptive → Prevents fertilization (Luteal) Phase → After ovulation, LH stimulated remnants of pills → hormone-based medications that prevent mature graafian follicle to develop into pregnancy by stopping ovulation and corpus luteum stopping sperm from entering the cervix → Corpus luteum secretes progesterone and Injectable hormones → Also known as birth control shots some estrogen → Depo-Provera, progesterone → In the Ovary, if oocyte is fertilized, corpus Tubal ligation → also known as "getting your tubes tied" luteum can persist up to 2 weeks due to → a surgical procedure that permanently Human Chorionic Gonadotropin produced prevents pregnancy by blocking, clipping, by placenta or removing the fallopian tube → If not fertilized, corpus luteum degenerates CLINICAL CORRELATION in 10 to 12 days time, forming corpus Ectopic Pregnancy → Pregnancy outside the uterus albicans → when a fertilized egg implants itself → Endometrium thickens and edema outside of the womb, usually in one of the formation for preparation of implantation fallopian tube Placenta Previa → the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix → Can cause bleeding Polycystic Ovarian → Development of cist In the ovaries Syndrome (PCOS) → Common type of hormone imbalance in people assigned female at birth. 23