DPC HANDOUT 2024 -2025 (1) (1)-1-36 (1).pdf

ANATOMY HANOUT DUBAI PHARMACY COLLEGE FOR GIRLS. DR SHIFAN KHANDAY DR HIBA ISMAEL Page 1 of 139 Introduction - It’s important for the healthcare providers to have a good knowledge and understanding of the basic anatomic terms. The accurate use of these t...

ANATOMY HANOUT DUBAI PHARMACY COLLEGE FOR GIRLS. DR SHIFAN KHANDAY DR HIBA ISMAEL Page 1 of 139 Introduction - It’s important for the healthcare providers to have a good knowledge and understanding of the basic anatomic terms. The accurate use of these terms helps the healthcare providers to communicate with one another nationally and internationally. It enables them to accurately describe the exact location of the body parts whether normal or diseased and record any abnormalities. - Anatomical terms:- The terms are grouped in 4 categories as follows: Anatomical position Anatomical planes Terms of Position (body parts and organs) Page 2 of 139  Terms of movement Body regions - Anatomical position: standing upright, eyes looking forward, arms by the sides and palms facing forwards with the thumbs pointing laterally and feet together. - Anatomical planes: these are imaginary planes that divide the body into two parts: 1) Sagittal plane: it’s the planes that runs vertically and divides the body into EQUAL right and left halves. It’s also called the Median plane. 2) Transverse plane: it’s the planes that runs horizontally and divides the body into upper and lower halves. 3) Coronal plane: it’s the plane that runs vertically and divides the body into front (anterior) and back (posterior) halves. Page 3 of 139 - Terms of Position (body parts and organs): these terms are related to the planes. They are 8 terms divided into pairs. * The 1st pair is related to the midline (sagittal plane): ~ Nearer to the midline à medial ~ Away from the midline à lateral * The 2nd pair is related to the head and feet (transverse plane): ~ Towards the head à superior Page 4 of 139  ~ Towards the feet à inferior * The 3rd pair is related to the trunk, and they usually describe structures of/and running in the limbs: ~ Nearer to the trunk à proximal ~ Away from the trunk à distal * The 4th pair is related to front and back (coronal plane): ~ Front à anterior ~ Back à posterior - Terms of Movement: Movement occur at the joints. A joint is a meeting of 2 bones with a little space between them. The general definitions of the terms of movement is as follows: 1) Flexion: bending easily. 2) Extension: straightening. 3) ABduction: moving away from the body. 4) ADduction: adding again to the body. Page 5 of 139  5) Circumduction: all of the above mentioned 4 movements = drawing a circle with the limb. 6) Medial rotation 7) Lateral rotation 8) Supination: resting on the spine (on the back). 9) Pronation: laying on the face. 10) Eversion: taking the soles of the feet away from the midline. 11) Inversion: turning the soles of the feet inside towards the midline. 12) Dorsiflexion: standing of the heel 13) Planter flexion: standing of the toes. Movements of the upper limb: ~ Shoulder joint: Flexion, Extension, Abduction, Adduction, Circumduction, Medial and Lateral Rotation. ~ Elbow joint: Flexion, Extension. ~ Radioulnar joint: Pronation, Supination. ~ Wrist joint: Flexion, Extension, Abduction, Adduction. ~ Joints of the fingers: Flexion, Extension, Abduction, Adduction. Movements of the lower limb: ~ Hip joint: (like the shoulder joint). ~ Knee joint: Flexion and Extension only. ~ Ankle joint: Dorsiflexion, Planter flexion, Eversion, Inversion. ~ Joints of the toes: (like the joints of the fingers). - Body regions: * Head * Neck * Chest * Abdomen * Back Page 6 of 139 * Pelvis and perineum (perineum is that area of the body that you see when you clean a baby when you change their diaper). * Upper limb, and is divided into: ~ Shoulder ~ Arm ~ Elbow ~ Forearm ~ Wrist ~ Hand (the fingers are thumb, index, middle, ring and little) * Lower limb, and is divided into: ~ Hip ~ Thigh ~ Knee ~ Leg ~ Ankle ~ Foot (the toes are hallux –big-, second, third, fourth and little) Hand Page 7 of 139 Upper Limb Lower Limb Hip Joint Thigh Knee Joint Leg Ankle JFooinott Page 8 of 139 For Reference video: https://youtu.be/KqgTERrYbQ4 Foot Hallux Little Toe Page 9 of 139  Basic Tissues There are four basic tissues in the body (1) Epithelia, (2) Connective Tissue, (3) Muscle Tissue and (4) Nervous Tissue. Epithelia All epithelia have a free surface. The free surface may contain specialized modifications, such as microvilli or cilia. Such Microvilli in the intestine greatly increase the absorptive surface, while cilia in the respiratory tract beat mucous secretions and entrapped particles away from the lungs toward the pharynx. Types of epithelium: Epithelia are classified according to the number of layers of cells they contain and the shape of the cells. Page 10 of 139  If the cells are arranged in a single layer, the epithelium is called simple; if the cells are arranged in two or more layers, the epithelium is called stratified. If the cells have a flattened shape, the epithelium is called squamous; if the cells have about the same height, width and depth, it is called cuboidal; if the height of the cells exceeds their width, it is called columnar. Simple squamous epithelium A simple squamous epithelium consists of a single layer of flattened cells. Simple columnar epithelium Simple columnar epithelium consists of a single layer of cells that are taller than they are wide. The cells can range from low columnar (with a height barely greater than their width) to tall columnar. Page 11 of 139 Stratified squamous epithelium Stratified squamous epithelium consists of several layers of cells, with the outermost layer consisting of flattened cells (usually there is more than one layer of flattened cells Stratified cuboidal epithelium Stratified cuboidal epithelium consists of at least two layers of cells. Stratified columnar epithelium A stratified columnar epithelium consists of at least two layers of cells, with the cells in the outer layer being taller than they are wide. The largest ducts of some exocrine glands have areas of stratified columnar epithelium. Pseudostratified epithelium Pseudostratified epithelium has the appearance of being stratified, because it has some low cells which do not reach the free surface, and some tall cells, which do. However, all the cells rest on the basement membrane, so it is in fact a simple epithelium. Transitional epithelium Transitional epithelium is the name given to the lining of the pelvis of the kidney, the ureter, the urinary bladder and parts of the urethra. When the ureter or bladder is empty, the epithelium can be six or more layers deep, when it is distended, the epithelium is only two or three layers deep. Connective Tissue The most diverse and abundant of tissue, connective tissue holds cells together and supports the body. Connective tissue is made up of cells suspended in a noncellular matrix. The matrix (also known as ground substance) is secreted by the connective tissue cells and determines the characteristics of the connective tissue. It is the consistency of Page 12 of 139  the matrix that determines the function of the connective tissue. The matrix can be liquid, gel-like or solid, all depending on the type of connective tissue. Fibroblast cells are responsible for synthesizing protein fibers for the matrix. Collagen fibers are strong, elastic fibers are flexible and reticular fibers form a supportive framework for organs and basement membranes. Types of connective tissue include: 1. Loose connective tissue: Thin and soft, this tissue contains many collagen and elastic fibers in a jell-like matrix. The cells in loose connective tissue are not close together. This tissue functions in binding the skin to underlying structures. 2. Dense connective tissue: This tissue consists of two categories, dense irregular connective tissue and dense regular connective tissue which differ on the arrangement of the fibrous elements of the extracellular matrix. Dense irregular connective tissue contains collage and elastic fibers which are found running in all different directions and planes. The dermis of the skin is composed of dense irregular connective tissue. Dense regular connective tissue has extracellular fibers that all run in the same direction and plane. Muscle tendons are a type of dense regular connective tissue. Page 13 of 139 3. Elastic connective tissue: Made up of freely branching elastic fibers with fibroblasts in the spaces between the fibers, this tissue allows the kind of stretch that is found in the walls of arteries. 4. Blood: Considered a fluid connective tissues because the matrix of blood is not a solid. The fluid matrix is called plasma, and formed elements of this tissue include white blood cells, red blood cells and platelets. 5. Cartilage: This connective tissue is relatively solid and is a non-vascularized tissue (does not have a blood supply). There are three types of cartilage: hyaline cartilage, elastic cartilage and fibrocartilage. Hyaline cartilage is the most common type of cartilage, contains many collagen fibers and is found in many places including the nose, between the ribs and the sternum and in the rings of the trachea. Elastic cartilage has many elastic fibers in the matrix and support the shape of ears and forms part of the larynx. Fibrocartilage is tough and contains many collagen fibers and is responsible for cushioning the knee joint and for forming the discs between the vertebrae. Page 14 of 139 6. Bone: A hard, mineralized tissue found in the skeleton. The bone matrix contains many collagen fibers as well as inorganic mineral salts, calcium carbonate and calcium phosphate, all features that make it a very rigid structure. Bone cells, called osteocytes, secrete the osteoid substance that eventualy hardens around the cells to form an ossified matrix. The osteon forms the basic unit of compact bone. 7. Adipose tissue: Commonly known as fat, this tissue is related loose connective tissue. Adipose tissue contains fat cells which are specialized for lipid storage. In addition to storing energy, this tissue also cushions and protects the organs. Muscular Tissue Muscle tissue is characterized by the ability to contract when stimulated. When muscle cells contract, they get shorter, generating force and often movement. Muscle cells contain filaments of two proteins: actin and myosin. When these two filaments slide past each other, the muscle contracts. There are three different types of muscle tissue: 1. Skeletal muscle: This tissue is composed of long, multinucleate cells with visible striations. Skeletal muscle allows movement by being attached to bones in the body. Because skeletal muscle contraction is consciously controlled, it is known as a voluntary muscle. 2. Smooth muscle: Composed of short, cylindrical cells that taper at the ends, smooth muscles are commonly involved in involuntary motions. Involuntary muscle contractions Page 15 of 139 are not consciously controlled and occurs in places like the digestive tract an in the walls of blood vessels. 3. Cardiac (heart) muscle: Cardiac muscle tissue contains short, branched, striated cells, with one nucleus at the center of each cell. Cardiac muscle cells within a fiber are joined to their neighbors by intercalated discs. These specialized communication junctions facilitate the heart beat by transmitting the signal to contract. Cardiac muscles are also involuntary muscles. Page 16 of 139  Nervous Tissue Nervous tissue responds to changes in the environment and conducts impulses to various organs in the body to respond to these changes. Nervous tissue is found in the brain, spinal cord and peripheral nerves that branch throughout the body. Nervous tissue contains two types of cells: 1. Neuroglia: These cells do not send or receive electrical impulses, but instead function to support neurons. They have important functions such as providing physical support, providing nutrients, removing debris and providing electrical insulation. Page 17 of 139  2. Neurons: These are the cells that carry electrical impulses. There are three main types of neurons, which are classified by their function. Sensory neurons conduct impulses from the sensory organs (eyes, nose, ears, etc) to the central nervous system (brain and spinal cord). Motor neurons are responsible for conducting impulses from the central nervous system to the effector organs (muscles and glands). Finally, interneurons are those neurons that connect sensory neurons to motor neurons. Important Structures of a Motor Neuron 1. Cell body: Enclosed by a plasma membrane and central nucleus, the cell body is responsible for producing all of the proteins for the dendrites, axons and synaptic terminals. The nucleus of the neuron is located in the cell body. 2. Dendrites: These structures branch out from the cell body in a tree-like fashion. Dendrites function in receiving signals from other nerve cells. 3. Axon: The axon is the main conducting unit of the neuron and is capable of conveying electrical signals over long and short distances. The axon transmits impulses from the cell body to other cells. Individual neurons may have many dendrites, but each neuron has only one axon. Page 18 of 139 Page 19 of 139  Skin - Definition: It’s the outer external layer covering the body. It’s divided into: Langer’s Lines 1) Epidermis 2) Dermis - It’s formed of epithelium - It’s dense connective tissue that (keratinized stratified squamous contains nerves, vessels, glands and epithelium). receptors, the thickness of which varies in different parts of the body. - It’s thicker in the palms of the hands and soles of the feet; to - It’s usually thinner on the anterior withstand the continuous daily surfaces use of these parts. - Its thinner in females than in males. - It contains collagen fibers that are arranged in parallel (same direction) rows. These rows are called Langer’s lines. Clinical notes regarding the Skin Page 20 of 139 1) Scars à to prevent them from occurring, surgical incisions should follow Langer’s Lines. If the incision is made across the lines, the wound would heal by an ugly broad scar (Keloid). 2) Wrinkles à are due to the loss of the elastic element of the skin. 3) Stretch marks à these are produced by the sudden change of the body size (pregnancy, body building, puberty) , or due to some diseases and medications, that leads to the sudden stretching the skin. 4) Skin creases à folds of skin that are usually located around the joints. They permit movement. Page 21 of 139 - Functions of the skin: 1. Protection from UV rays, chemicals, thermal factors and micro-orgamisms. 2. Sensation à as the skin contains receptors for pain, touch, temperature. 3. Regulation of body temperature: a) in COLD weather à prevents heat loss by vasoconstriction of its blood vessels. b) in HOT weather à increases heat loss by sweating and vasodilatation of its blood vessels 4. Metabolism à vitamin (D) synthesis. 5. Excretion à sweat by sweat glands. - Skin appendages: These are structures that are attached to the skin. They are: * Hair follicle * Nails * Sweat glands * Sebaceous glands * Arrector pili muscle Page 22 of 139 Page 23 of 139  Fascia - Definition: The connective tissue that lies directly under the skin. It connects the skin above to the underlying muscles or bones below. It’s divided into: Superficial Deep It’s a fibrous tissue filled with fat. It’s a dense fibrous tissue, deep to the It connects the dermis of the skin with superficial fascia. the deep fascia. It separates the superficial fascia from Characteristics: the underlying muscular tissue. o It’s thick and rich in fat in the Characteristics: breast, buttock and anterior o It’s thicked at the following abdominal wall. sites: o It’s thin and devoid in fat in the § Distal joints forming the eyelids, ear auricles, scrotum “Retinacula“. and penis. § In the palms of the hands o It contains dense collagen fibers and soles of the feet, in the scalp, back of the neck forming the and palms of the hands and “aponeurosis“, to protect soles of the feet. the underlying tissue. Functions: o It divides the skeletal muscle o Prevents heat loss. into groups by barriers called o It’s thicker in the females, so it “intermuscular septa“. gives them smooth rounded contours, while being thinner in males, their musculature are well-defined. Page 24 of 139  Blood Vessels - Definition: An elastic tubular channel through which the blood circulates. - Types: There 4 types of blood vessels, as in the following table: Artery Vein State of the blood Oxygenated blood Deoxygenated blood From Heart Body To Body Heart Elasticity Highly elastic Not elastic Muscularity Highly elastic Less muscular Recoils Collapses Lumen Narrower Wider Receives tributaries Gives off branches The veins of the lower Special character Each is accompanied limbs contain valves to by one vein ensure unidirectional flow of blood Page 25 of 139  Capillary Sinusoid Site of exchange between blood and Definition tissue. Continuous wall Discontinuous Wall (no pores) (has pores) Lumen Rounded Irregular A capillary Page 26 of 139  Bone - Definition: It is the tissue that forms the skeleton of the body. It is composed chiefly of calcium phosphate and calcium carbonate. - Functions: 1) Shape: it provides the central axis and gives form and shape to the body. Some bones (femurs of the thighs) support the body weight. 2) Movement: produced the attached skeletal muscles. 3) Protection: it protects the underlying or contained structures, e.g. the skull protects the brain, and the sternum and ribs overlie the heart and lungs. 4) Calcium: it’s the stored form of calcium. The bones play a major role in calcium balance in the blood. 5) Blood cells: it’s the factory for the production of different blood cells. - Classification: The bone can be classified according to the region they belong to or by their shape. * Regional classification: series of bones form the skeleton which is divided into the following regions: Page 27 of 139 Page 28 of 139 * Morphology classification: there are 5 types: a. Long: are longer than they are wide. They are tubular in shape and have two ends. Typical long bones are bones of the limbs. * The long bone has tubular shaft, that is called the diaphysis, and the ends of the bone are called epiphyses. The diaphysis and epiphysis are separated by cartilaginous plate, that is responsible for growing in length and ossifies at puberty, that is called the epiphyseal plate. The expanded part of the diaphysis that is adjacent to the plate is called metaphysis. Page 29 of 139 b. Short: they are cubical in shape. They can be found in the wrist and ankle. c. Flat: example of these are some bones of the skull and scapulae. d. Irregular: these can’t fit in any of the previous categories. The vertebrae and some bones of the skull are examples of this type. e. Sesamoid: small nodules of bone that are found in certain tendons where they rub over bony surfaces. This type of bone helps reducing the friction on the tendon. The largest sesamoid bone is the patella which is located in the tendon of quadraceps muscle. f.Pneumatic bones.example Maxilla. Page 30 of 139 Page 31 of 139 Page 32 of 139  Muscle - Definition: The contractile tissue of the body that produces movement of the body parts and viscera. The muscle cells are usually referred to as muscle fibers. - Types: There are 3 types of muscular tissue: 1) Skeletal: the muscles that are attached to the skeleton. 2) Smooth: these are the ones found in the viscera and blood vessels. 3) Cardiac: the muscle of the heart. Skeletal Smooth Cardiac Site Skeleton Viscera and blood heart vessels Control Voluntary Involuntary Involuntary Histological Striated Non-striated Striated appearance Non-branching Spindle-shaped Branching Skeletal Muscle This type of muscles produce movements of the skeleton when they contract. The site of the attachment from which the muscle starts is called the Origin, while the site of attachment at which the muscle ends is called Insertion. So, when the muscle contracts, the insertion is PULLED towards the origin. The fleshy part of the muscle is called the Belly, while the ends that are attached to the bone are called Tendons. Generally the skeletal muscle is attached to the bone by one of 3 structures. These structures are made up of fibrous tissue. These structures are: 1) Tendons à cylindrical, cord-like 2) Aponeuroses à flat sheet 3) Raphe à crossing of the tendons of the flat muscles Page 33 of 139 1) Tendon: Cylindrical, Cord-like 2) Aponeurosis: Flat sheet 3) Raphe: Crossing of the tendons of the flat muscles Page 34 of 139  Joint - Definition: A site where two bones or more come together, regardless of any movement occurring at that site. - Type: Joints are classified according to the tissues that lie between the bones into three types: 1) Fibrous joints: the articulating surfaces of the bones are joined by fibrous tissue, allowing no/very little movement. Examples are the sutures of the skull. 2) Cartilaginous joints: The articulating surfaces of the bones are joined by a plate of cartilage, allowing no/very little movement. Examples are : * Union between the epiphysis and the diaphysis à NO movement * Joints between the vertebrae à Little movement. Page 35 of 139 3) Synovial joints: the articulating surfaces of the bones are lined by hyaline cartilage and are separated by a joint cavity. These joints are highly mobile. Examples are joints of the upper limb (shoulder, elbow and wrist) and the lower limbs (hip, knee and ankle). Page 36 of 139