Anatomy 25 Notes

Chapter 25, 2nd half of lecture Monday 11/30

2009-11-30T12:30:00.000-08:00

Digestive 2nd half – chapter 25
Review:
Know for practical:
Frenulum
Palates
Uvula
Arches/fauces
Tongue
Teeth/gingival

*submandibular salivary gland makes the most saliva – you want to know that
*parotid salivary gland makes amylase and is the largest – know that too
*slide #33, you want to know these slides and be able to tell the gland types, serous, mucous, mixed, etc. This will be on the practical, most likely.
*1.5 liters of saliva per day
*know sympathetic response vs parasympathetic response as far as salivation goes
*know the difference between incisors and canines, as these are things he mentioned in review as maybe being test questions – slide 39
*dental surfaces, might want to know which surface is what, see slide #40
*phases of swallowing, good to know – slide #42 – whatever the phase is is determined by where the food is.
*slide 48 – fair game for practical, know parts/regions of stomach
*remember you want to know the specific mesenteries noted in previous lecture, greater omentum, etc.
*know rugae of stomach – slide 50 – which are the striations inside stomach
*slide 53, can only be in stomach, might be on test, 3 layers of muscle
*know that mucous, pepsin, gastrin and HCL are all made in “gastric pits” by gastric glands.

NEW:
Small intestine
Finishes chemical digestion process, responsible for absorbing most nutrients
Ingested materials spend 12 hours (at least) in the small intestine
About 20 feet long. Ileum longest, jejunum, next longest, duodenum is shortest. So backwards, since DJI, they come in the opposite order.
Duodenum
**know “duodenal papilla” be able to find it on a model (medial part of duodenum) – this is where bile and pancreatic secretions enter duodenum.
this is where some accessory organs come into play – liver and gall bladder – which add bile to emulsify fats, and the pancreas adds buffers and enzymes.
Jejunum
Middle portion of small intestine
Absorption mostly starts here
7.5 feet about, ish, long
Ileum
Last segment of small intestine
10.8 feet ish in length
right lower quadrant
distal end terminates at “ileocecal valve”, a sphincter that controls the entry of materials into cecum of the large intestine

Histology: only 2 layers of muscle, see slide 68
You want to know plicae circularis or “plica”
Walls and plica are covered with villi, which increase absorption
Slide 69 would be good to know:
villi
Crypts
Goblet cells
Microvilli
Lamina propria – important layer – capillary network is here, this is where nutrients can be absorbed, also lacteals of the lymphatic system are here, which transport large fatty protein complexes that can’t enter the capillary beds. – slide 70

Difference in submucosa in DJI
D – submucosal glands
J – basic structure of plica and folds
I – peyers patches – lymphoid nodules

LARGE INTESTINE
Look for ileocecal valve, know this*
Large intestine begins at ileum and ends at anus
Almost completely frames the small intestine
About 5’ long
It would be great to know slide #73, parts of large intestine
*cancer most likely in colon below the splenic flexure, down in the descending colon, sigmoid colon and rectum
Absorbs fluids and ions, then compacts indigestible wastes– turns them into feces and stores that until defecation.

Cecum: first portion of large bowel (note the ileocecal valve** and the appendix)
Colon: this is the largest portion of the large bowel
Ascending – originates at ileocecal valve
Makes a 90 degree turn towards left at the hepatic flexure
Transverse – starts at hepatic flexure, straight across to splenic flexure (left colic flexure)
Descending - originates at left colic flexure (splenic)
On left side of abdomen
Contacts iliac fossa and terminates at sigmoid colon
Sigmoid – shaped like S sort of, and terminates at rectum. Turns inferomedially and is suspended by sigmoid mesentery.
Rectum: the final 15 centimeters of the large bowel which expands to store fecal material prior to defecation
3 thick transverse folds call rectal valves to insure fecal material is retained
terminates at anal canal
Anal canal –
terminal centimeters of large intestine
Anal columns line internal surface
Anal sinuses secrete mucin for lubrication
Internal and external anal sphincters open and close anal canal during defecation. Internal is involuntary, external is voluntary

BRBPR – hemmoroids are #1 cause of this.

Blood supplied by superior and inferior mesenteric arteries

HISTOLOGY of large intestine
Simple columnar
Thinner walls, no villi
Goblet cells make mucin, more lymphoid nodules
SLIDE 90 – one of these 3 will be on test
Longitudinal muscle layer is reduced to bands called taenie coli*
Haustrum – sacs*
Omental appendices (epiploic appendages)*

Accessory glandular organs
Liver –
upper right quadrant
Four incompletely separated lobes
Right (larger)
Left (smaller)
Caudate (inferior)
Quadrate (next to gall bladder)
Slide 94 – shows ligaments and r/l lobes
Slide 95/96 – might want to know the veins here, as this was gone over in class
*porta hepatis - where afferent artery and veins enter liver
*hepatic portal artery/vein – blood supply to liver (richer in nutrients as it’s had less filtration)
*hepatic vein – drainage of liver to inferior vena cava

LIVER HISTOLOGY:
Hepatocyte – liver cells with microvilli
Hexagonal in shape
Lobule – stacked plates, as in spokes of wheel
Filtration of HPV around the lobule into the sinusoids, which drain peripherally into a central vein
Sinusoidal capillaries – run in the spokes of the wheel, and are lined with large numbers of Kupffer cells (type of macrophage which gets rid of pathogens, damaged cells and heavy metals)
“PORTAL AREA” corners of each hexagon –
has a “triad”
*HPV branch
*hepatic artery branch
*bile duct branch
*know this as it is often on the test, what comprises a triad, etc.
Hepatocytes have bile canaliculi between each cell, which move away from central vein to bile ducts
L/R bile ducts become common bile duct
Bile secretion – know slide 101/102
Common hepatic duct leaves the liver and can move bile to either:
Common bile duct
Cystic duct
Bile emulsifies fat and can come from either gallbladder storage or directly from the liver where it is produced.

Gall Bladder
Pearshaped hollow organ which stores bile
Attached to inferior surface of liver
Concentrates and stores bile
*know cystic duct, which leads away from gall bladder, joins common hepatic duct and makes common bile duct superior to duodenum
*know fundus, body and neck of gall bladder
gallstones are “cholelisthiasis” which are hardened concentration of bile salts
*duodenal papilla, you need to know this
“Sphincter of Oddi” which controls flow from common bile duct and pancreatic ducts and limits bile flow into duodenum

Pancreas:
Exocrine functions
Pancreatic juices flow into duodenum via pancreatic duct (exocrine duct) and major duodenal papilla – pancreatic juices are made by acinar cells (enzymes and buffers)
Slide 109 histology – you might want to know the pancreatic islets.

double check online histology slides if you have time and feel like finding some:
pancreas
gall bladder
large intestine
ileum
jejunum
duodenum
stomach
esophagus
trachea
3 types of salivary gland

11/25 Wednesday lecture notes - Digestive System, Ch. 25

2009-11-25T21:20:00.000-08:00

Simplified: Digestive system is a tube. Sure, it’s a tube that gets twisty and kinky, but mostly just a tube from mouth to anus.
Additions to the tube (associated organs): Pancreas, liver, gall bladder
Modifications to the tube: teeth, gums, salivary glands (three paired sets) give off amylase/mucin to break down carbohydrates, stuff that helps you take in food and expel waste.

Digestion
Carbs in the mouth
Protein in stomach
Fats in small intestine

Small intestine mnemonic: “Don’t Jump In”
DJI: duodenum, jejunum, ileum

In a nutshell:
Ingestion
Mechanical processing
Digestion (chemical processing)
Secretion and absorption of nutrients
Compaction and expulsion of waste

Histology of the digestive tract (slide #4 – 8)
Epithelium: (glandular) varies from simple stratified to columnar with microvilli
Mucosa: membranous layer
Submucosa: dense irregular CT, large vessels and lymph, glands to buffer PH/produce enzymes, *Meissner’s Plexus which is a network of nerve fibers in the submucosal layer
Muscularis mucosa: smooth muscle, two thin layers of smooth muscle ( one is circular and one is longitudinal – for peristalsis), some elastic fibers, and helps shape the lumen
Muscularis externa: two thick layers of smooth muscle – for peristalsis, also both circular and longitudinal, includes sphincters, and movements are coordinated by
*Aurerbach’s myenteric plexus
Serosa: serous membrane, outermost layer visceral peritoneum. Is present in all areas for attachment EXCEPT in: oral cavity, pharynx, esophagus, rectum

Layers of the Ileum – slide 10, be able to label and know
Plica with folds and microvilli (mucosal fold)
Mucosa – goblet cells
Muscularis mucosa
Submucosa – remember NAV
Muscularis externa
Serosa

Peristalsis and Segmentation
How a bolus of food moves down the tube, in short.
Peristalsis is how the longitudinal AND circular muscles move it down the tube
Segmentation is breaking up the bolus into smaller bits, mixing and churning, and that’s what the circular muscles do.

**The smooth muscle of the GI tract go through spontaneous depolarization, somewhat like the heart – triggered by chemicals, hormones and physical stimulation

Peritoneum – see slide #13
Lining of the cavity in abdomen
Two continuous layers – all one sheet both visceral and parietal layers
7 liters of peritoneal fluid made per day to lube up the gutty bits
Organs are all either “intra” or “retro” that is to say in or behind the peritoneum.

Mesenteries (not in our text, see slides 14 – 17) know starred
Fused double sheets of the serous membrane which stabilize positions of attached organs, and prevent tangling during peristalsis. Keeps them from twisting or torquing.
Each mesentery has a different name, should know them off this slide
Omentum
lesser omentum
between stomach and liver
*Mesocolon
Large intestine, transverse and sigmoid colon
*Greater omentum
(this is where the beer belly comes from!)
hangs from the stomach
Parietal peritoneum
*Mesentery proper
Holds the small intestine in place
Visceral peritoneum

Blood supply:
Abdominal GI tract supplied by 3 unpaired arteries
Celiac trunk
Superior mesenteric
Inferior mesenteric

Innervation
Autonomic and sensory
Three autonomic plexuses
Celiac plexus
Superior mesenteric plexus
Inferior mesenteric plexus

**Should know the path food takes from mouth to anus
Should know slide #21 – organs, be able to identify, spend some time on this

Oral cavity
Slide #23, fair game for exam would be stuff like tonsils, salivary glands, uvula, landmarks in general
*labial frenulum
*uvula
*maybe arches or falces

Fauces are opening from oral cavity to oralpharynx
Laterally paired muscular folds are:
Glossopalatine arch
Pharyngopalatine arch
Palatine tonsils are between these two arches

Salivary glands
Parotid – largest of the thre paired glands and secrete 25-30% of saliva
Submandibular (don’t worry about knowing all the ducts, just know the glands) – produce about 70% of saliva
Sublingual

Two types of secretory cells which secrete a combination of mucous and serous material
Know slide #33, might be either on written or practical
Produce about 1 – 1.5 liters of saliva per day
Parasympathetics increase saliva production
Sympathetics decrease production (dry mouth, fight or flight)
Regulated by CN’s VII, IX, X (taste buds) and CN IV (object in mouth)

Teeth, slide 35 and 36
Enamel
Dentine
Crown
Neck
Roots which fit into the alveoli of the maxilla or mandible
Cementum covers the roots
Know the root canal
Periodontal ligaments
Pulp
6-30 months – 20 milk teeth, or deciduous teeth
adult teeth or permanent teeth are 32
incisors – 2 pairs
canines – 1 pair
bicuspids – 2 pairs
molars – 3 pairs
eight pairs up and eight pairs down, 32 teeth!
Might review dental surfaces but he didn’t spend much time on them in lecture

Pharynx
Shared by the respiratory and digestive systems
Muscles include pharyngeal constrictors
Elevators
movers of the soft palate
swallowing – movement of food bolus from oral cavity to esophagus
3 phases of swallowing
buccal
pharyngeal
esophageal
*first peristalsis movement takes place in esophagus

Esophagus (present in both thoracic and abdominal cavities, mostly in thoracic)
In upper right quadrant
In thorax (mediastinum)
10 inches long, enterior to vertebral bodies
**esophageal hiatus or “inferior esophageal sphincter – where it connects to stomach (about 1.5 cm in to the abdominal cavity), prevents reflux
It is quite possible to get a hiatal hernia, unfun
**Superior esphegeal sphincter, at unction of pharynx and esophagus

Stomach
Upper left quadrant
Mechanical and chemical digestion of food bolus, which is processed into “chyme”
3 layers of muscle aid in mechanical processing
longitudinal layer (outer)
circular layer (middle)
oblique layer (inner)
**TEST QUESTION**
REGIONS OF THE STOMACH
fundus – upper dome
cardia – adjacent to esophagus
body – largest region
pylorus – final funnel where chyme empties to duodenum

**SLIDE 52, what are folds? Answer “RUGAE”
Stomach wall:
Lined by simple columnar epithelium
Indented by numerous depressions called “gastric pits”

Slide #54, know the layers
Histology: along and at base of gastric pits slide 56
Cells:
Surface mucous cells
Mucous neck cells
*Parietal cells – HCL
*Chief cells – Pepsin
*Enteroendocrine cells - Gastrin

We made it to about slide #45 and will complete the lecture on Monday, 11/30

Ch 22 Vessels and Circulation

2009-11-21T14:33:00.000-08:00

When studying: arteries, by convention, are red. Veins will be shown in blue.

Three classes of blood vessels
Arteries – carry blood away from the heart, become progressively smaller, branch and become capillaries
Veins – return blood to the heart and become progressively larger.

Artery and vein walls have “tunics” – 3 of them
1. Tunica adventitia – connective tissue that anchors the vessel to the organ
Contains blood supply of their own **vasa vasorum – supplies the larger blood vessels themselves.
2. Tunic media – circularly arranged smooth muscle and elastic fibers
Sympathetic – vasoconstriction
Parasympathetic – vasodilation
3. Tunica intima – endothelial cells, simple squamous, lining artery and veins, plus some elastic tissue. (cracks and fissures in this layer gives cholesterol a place to cling to, so causes some problems later in life, given age and diet)
SEE SLIDE #5
Know types.
ARTERIES and VEINS
Larve Veins and Elastic Arteries – the largest vessels
Medium vein and Muscular artery – next size down
Venule (no muscle layer) and Arteriole (smooth muscle around them)
Fenestrated Capillary (vein) and Continuous capillary (artery)**
**Oxygenation only happens in capillary beds, not anywhere else. VERY important.
Slide #8, idealized slide, you want to know this and what to look for in Wednesday’s lab. *note, nerves, arteries and veins often run together – think NAV

Arteries vs.veins
More adventitia media – thicker walls,
Veins are thinner, more collapsible. “Collapsability” is a term associated with veins

Arteries – large to small
1. Elastic
Largest are approx 1”. Ex: aorta, pulmonary, brachiocephalic, common carotids and subclavians. Most of these are near the heart – they have to be elastic so that they can handle the pressure of flow, stretch under increased pressure. Elastic arteries then branch into the next size down, which is muscular. Elastic is present in all 3 tunics of these vessels.
2. Muscular
Medium diameter, elastic fibers are only in 2 of the tunics.
Internal elastic lamina – between intima and media
External elastic lamina – between media and extrema

3. Arterioles – 30 micrometers
Six cell layers of smooth muscle in media, control flow of blood between capillaries and venules, sympathetic innervation – vasoconstriction (increased blood pressure) and parasympathetic innervation – vasodilation (decreased pressure.)

Capillaries – smallest and most delicate of vessels
Diameter is only slightly larger than an erythrocyte
Walls are solely comprised of tunica intima
**only vessel where metabolic exchange can occur between blood and cells outside of the bloodstream.

Types of capillaries **KNOW slides 17 - 19
typical capillaries consist of an endothelial tube and a basal lamina
in the fenestrated capillary there are pores and tiny openings.
1. Continuous **
a. Tight junctions, complete endothelium, most areas of the body
2. Fenestrated **
a. Pores, no junctions, incomplete endothelium
3. Sinusoidal
a. In the liver, larger pores

Capillary BEDS
**You want to know slide #20, it will be on the test.
Know the flow, and be able to identify structures.
Basically, arterial flow (oxygenated blood) comes in, venous flow (deoxygenated blood) goes out, carrying Co2 back to lungs.
In some cases, arteries can send blood directly to the vein, bypassing capillary bed. “arteriovenous anastomosis”
Know:
arteriole
metarteriole
Precapillary spincters
True capillaries
Thoroughfare channel
Postcapillary venule

Anastamosis – direct connection between vessles
Guarantee reliable blood supply to match need of tissue
Smooth muscle directs flow

VEINS:
Veins collect blood from all tissues and organs and return it to the heart.
Walls are thinner and less elastic – there’s no pressure so they don’t need to be, pressure in veins is lower but diameter is larger than corresponding artery
At rest, veins hold about 60% of the body’s blood. Veins function as blood reservoirs.
Venules:
• Smallest veins which collect blood from capillaries
• Go with arterioles in the hierarchy
• Smallest ones are postcapillary venules, at distal end of capillary bed
• Smaller and medium sized veins travel with muscular arteries
• Blood pressure is too low to overcome gravitational pull, so skeletal muscles help pump blood towards the heart as they contract. This process is the skeletal muscle pump.

Large veins
Include great veins
Superior and inferior vena cava
Med large veins have thicker adventita
Outer layers are elastic/connective tissue

Valves in veins – slide 28
Valves oppose the force of gravity, to prevent backflow

**There’s a great set of flow charts on page 584, 592, 593 of the text, with the branchings and different arteries and veins in the upper and lower extremities.
Arterial flow – out of and away from the heart - THORAX
Oxygenated blood pumps out of left ventricle into ascending aorta which gives off into two branches. Right and Left coronary arteries. These supply the heart itself.
The aortic arch gives off three branches
a. braciocephalic trunk
first one off the arch, and “bifurcates” into right common carotid and right subclavian
b. left common carotid
not totally symmetrical, this is the branch in the middle of the arch
c. left subclavian
this is the last branch off the aortic arch
Descending Aorta – follows aortic arch and branches to the thoracic wall – renamed the descending abdominal aorta when it passes inferior and posterior to the diaphragm
At L4 – descending abdominal aorta bifurcates –first branch point
Left common iliac artery
Right common iliac artery
Then almost immediately again divides into
Internal iliac artery
External iliac artery

Arterial Flow through HEAD AND NECK –
brachiocephalic trunk – slide #34**
bifurcates into subclavian and right common carotid
At the superior border of the thyroid cartilage, the right common carotid bifurcates into internal and external carotid arteries. (see slide 36)
External carotid gives rise to arteries on the face, outside of cranium.
Internal carotid – supplies blood to the base of the brain.

At first rib, braciosephalic branches into Subclavian artery branches DOWN into
Inernal thoracic artery
And UP into
Vertebral artery – through transverse foramen of cervical vertebra

Venous blood return from cranium – HEAD AND NECK
From internal and external jugular veins (flipflopped)
Drain into subclavian vein
Becomes brachiocephalic vein
Becomes superior vena cava

Internal Carotid – supply to brain:
Enter cranium through carotid canal
Divide into anterior and middle cerebral arteries
*circle of WILLIS – gets blood supply from both carotid arteries (internal) and vertebral arteries **THIS WILL BE ON THE TEST** “cerebroarterial circle”

Vertebral arteries enter cranium through foramen magnum and merge to form the basilar artery which goes up to make the back side of the circle of willis with the carotids forming the anterior portion.

Venous drainage of cranium – most venous blood drains through dural venous sinuses
Superior sagittal sinus
Inferior sagittal sinus
Straight
Left and right transverse sinus
Sigmoid sinus

Internal Thoracic Artery
Arises from subclavian artery, then flow downward
Give rise to anterior intercostals
Then superior epigastrics

SLIDE #44 – try to be able to label this for exam, you should be good to go
Try to find landmarks for branchings if you can, this might help.

Venous return from thorax
All venous drainage from the thorax drain on the (left side) hamiazygos and (right side) accessory hemiazygos which drain into superior vena cava.

Blood flow to support lung tissue:
Bronchial arteries – paired arteries that branch off the descending thoracic aorta.
High, towards lungs
Esopheogeal arteries are also paired and in thorax, lower, down near stomach

Diaphragm is supplied from 3 sources
Superior phrenic arteries
Inferior phrenic
Musculophrenic

At the diaphragm and down:
3 unpaired arteries emerge from anterior wall of descending abdominal aorta
Celiac trunk
Superior mesenteric artery
Inferior mesenteric artery

The celiac trunk will give off 3 branches. Know them. *slide 52, 53
Left gastric artery – supplies lesser curvature of stomach and lower esophagus
Splenic artery – supplies spleen and part of the stomach
Common hepatic artery – liver, gall bladder and a portion of the stomach

Just inferior to celiac trunk
Inferior pancreaticoduodenal
Intestinal arteries
Jejunum and ileum
Ileocolic
Ileum, cecum and appy
Right colic
Middle colic

**Just above bifurcation of descending abd aorta, inferior mesenteric **know
Left colic
Distal transverse colon/proximal descending colon
Sigmoid
Distal descending colon/sigmoid colon
Superior rectal artery
Rectum and upper half of anal canal

Slide 58 is good for frame of reference organs/arteries

Friday lecture 11/13 end of CH 21 the heart

2009-11-13T11:44:00.000-08:00

Test has been moved up to the Monday before Thanksgiving.
Practical will no longer be a ‘moving around’ thing, but rather, we’ll have it entirely on slides on the power point, so make sure you know those.

KNOW:
4 chambers of the heart
directionality of flow (top to bottom up, top to bottom out)
Coronary sinus
Superior vena cava
Inferior vena cava
Widowmaker (coronary artery)
* left marginal branch of LCA – know this from multiple angles/images
Aorta
Ascending arch
Arch of aorta
Descending aorta
Pulmonary veins
Interventricular sulcus
Coronary sulcus
Orient and identify posterior and anterior heart
Chordae tendinae
Papillary muscles

NEW:
Conus arteriosus – high smooth area at the top of the R ventricle just before the pulmonary semilunar valve
*coronary arteries are the first to get oxygenated blood from the heart. These are what need to be bypassed whent hey get clogged.
L ventricle
Thicker
Extra thickness to force blood around systemic circuit
Know trabeculae carnae
Papillary muscles
Chordae tendinae
Ventricles/differences
R:
thinner
AV valve has three cusps
L:
thicker
AV valve has two cusps

Coronary arteries, slide 45
Circulation to the muscle of the heart (myocardium)
2 branches off the ascending aorta
KNOW
L coronary and R coronary artieries
Circumflex artery
Anterior interventricular artery
Right coronary artery

Slides 48-50
Left coronary artery
KNOW: Two main branches
Anterior interventricular
Circumflex artery

Right coronary artery
KNOW: two main branches
Posterior interventricular artery
Right marginal

Venous drainage of myocardium
Slide 52
Great cardiac
Middle cardiac
Small cardiac

Valve cycles know slide 53 for practical
(What is contracting?)
know “systole”
atria are contracting on this slide
semilunar valves are shut while AV are open

Know slide 54
Difference between ventricular and atrial systole
V systole/A systole

http://www.youtube.com/watch?v=D3ZDJgFDdk0

Autorhythmic
Cardiac muscles are conncted by gap junctions known as intercalated discs - contract as single unit
KNOW the cycle of conduction – slide 60 and 61
SA Node
down to
AV node
Know bundle branches and Purkinje fibers

P wave – when SA node goes off, before it hits the AV node
QRS complex – depolarization – ventricular – after AV node goes off
T wave is when the whole heart repolarizes

Slide 64 – purkinje fibers
Also “bundle of his”

Slide 67 and 68 – know coordinated sequence of heart chamber contractions/cardiac cycle
SA generates an impulse
Atria contract (systole) while Ventricles relax (diastole)
Impulse to AV node then to ventricles
Ventricles contract (systole) while atria relax (diastole)

Normal rhythm vs too fast or slow
Too fast = tachycardia
Too slow = brachycardia

Additional innervation to the heart outside of autorhythmic cells
Also innervated by divisions of the ANS – sympathetic ( makes it contract more quickly, fight or flight, etc, starts with neurons in T1-T5) and parasympathetic (make it contract slower, less forcefully - off medulla oblongata via left and right vagus nerves)

Anatomical components of both divisions make up the coronary plexus

**Sympathetics increase rate and force of contractions
**Parasympathetics, decreases rate but has no effect on contractions

Aging:
Nothing gets better – some issues and what is affected
Murmurs, sounds caused by changes in valves - VALVES
Hypertrophy, enlargement of the heart - MYOCARDIUM
Decreased conduction/electrical abnormalities – NERVES
Lifestyle caused issues, diet/exercises - VESSELS

the heart, slides 1-40, ch 21, Monday 11/9 lecture

2009-11-09T13:12:00.000-08:00

Test review – 5 extra points given to everyone, questions 10, 38 44, 57, and 62 were thrown out due to general confusion about them.

CH 21 notes – the heart
“The fastest way to a man’s heart is through the ribs. Though it’s a little bit easier if you go under and then up.”

Size of a fist
100,000 beats per day
small organ made of muscle, and circulates blood on demand
1.5mil gallons of blood per year

Four chambers and four valves – remember “four by four”
*just an overview, more detail further down
Atria (2) UP
Ventricles (2) DOWN
A over V
Four valves, unidirectional flow
R – blue (pulmonic)
L – red (systemic)

Circuits
Pulmonary – to and from lungs/gas exchange
Systemic 02 to tissues/CO2 to lungs
Oxygenated blood is red
Deoxygenated blood is blue (exception is the lungs)

Heartbeat
blood pressure, which indicates how effectively the heart is pumping blood, how hard it has to work to get the blood through the body, what you are measuring is the force of the blood pushing against inside walls of blood vessels
Atria beat first followed by ventricles
Minimum pressure is necessary for circulation

Arteries – transport away
Veins – transport towards
Capillaries – small thinwalled vessels, interconnect with smallest veins and arteries

Through the heart – slide #7, know
Blood FROM body (deoxygenated), TO the right side of the heart
IN to the R atria from superior and inferior vena cava
TO the R ventricle below, pumps OUT
TO the lungs (R and L both sides equally via the pulmonary arteries)
BACK TO the lungs via the pulmonic veins, now oxygenated
TO L atrium, then
TO L ventricle, then out of the heart via the aorta to the systemic arteries
**you want to know the order of this pathway by Friday
also know the various valves, and where they are**

Geographic location and position of the heart (slide 9/10)
a. Runs from ribs 3-5
b. It is DEEP to the sternum, slightly LEFT of midline in the mediastinum (compartment of the thorax)
c. RIGHT border of the heart rests on the diaphragm, inside its happy little pericardial cavity **KNOW this border, you don’t need to know the others so much**
d. heart is rotated a little bit anteriorally and to the right, so that the left side of the heart ends up sitting a little bit posterior

TERMS – regarding positioning
Posterosuperior surface
Superior border
Apex
Inferior border

Pericardium
Fibrous sac that holds the heart in place, also lines the pericardial cavity
Lined by serous membranes
*pericarditis would be an inflammation of the heart, kind of painful
OUTER – fibrous
INNER – serous membrane
Parietal layer – lines the inner surface of the fibrous layer
Visceral layer – covers outer surface of the heart
*see slide 16
ORDER: superficial to deep
Fibrous pericardium
Parietal pericardium
Pericardial cavity (full of fluid, allows heart to float freely)
the following make up the wall of the heart
Visceral serous pericardium (epicardium)
Myocardium – muscle of the heart
Endocardium – lines the atria and ventricles

Heart wall: **slide 18, you want to know this slide
Epicardium
Myocardium
Endocardium
*know intercalated discs
*know that the heart is “autorhythmic”, the cells of the heart beat on their own

EXTERNAL heart anatomy – slide #19
**be able to identify the difference between anterior structures and posterior**
Anterior
a. auricle (be able to find it on the right side at least, smaller on the left)
b. Coronary sulcus – fatty valley between atrium and ventricle
c. Anterior Intraventricular sulcus – fatty valley between ventricles
*(know the difference between these two)
Posterior
a. Superior vena cava
b. Coronary sulcus
c. Coronary sinus – *refers to a special vessel feeding the heart’s own blood supply not a cavity as we are used to thinking of the term ‘sinus’
d. posterior interventricular sulcus
e. atria and ventricles
*the heart has its own circulation

4x4 – four chambers and four valves
Chambers:
Atria (2)
Ventricles(2)
Valves
“AV valves” (valves between atria and ventricles)
(2) atrioventricular valves
R is tricuspid, Left is mitral aka bicuspid
(2) Semilunar valves (pulmonary and aortic)

How blood moves around the heart:
Right atrium – deoxygenated venous blood flows IN to the R atrium>> via 3 veins
a. coronary sinus (blood from heart muscle itself)
b. superior vena cava (blood from head and neck)
c. inferior vena cava (blood from the lower body)
THROUGH:
Tricuspid valve – blood rushes through the right AV valve (tricuspid). Contraction of the right AV valve snaps the valve shut, preventing backflow.
*know chordae tendinae,
know what leaflets of the valve are
know location of tricuspid valve*
TO:
Right Ventricle –
*know Papillary muscles
know cusps
conus arteriosus*
THROUGH:
Pulmonary semilunar valve (which is also tricuspid)

Blood is oxygenated in lungs, then THROUGH
L atrium via pulmonary veins
This atrium has a smaller auricle
(left AV bicuspid valve) and into L ventricle
thicker wall, larger ventricle
then THROUGH
aortic semilunar valve
and into aorta
and then to system. This is where the blood is also fed to coronary arteries.

2009-11-09T11:22:00.000-08:00

Wed 11/4 lecture - Cardiovascular

2009-11-08T15:29:00.000-08:00

*noted during lecture, study pictures in chapter as this material might be pictorial in nature for the practical. Familiarize yourself with most of the diagrams*

Blood - function
1. transport of oxygen, nutrients, chemicals and waste gasses
a. 02 - lungs to body cells
b. C02 - body cells to lungs, exchange for oxygen, C02 exhaled
c. Nutrients - GI tract to body tissues
d. Hormones - endocrine glands to body cells and tissues
e. waste products (non gas) - via plasma to kidneys, excreted in urine
2. regulation of body temperature, ph balance, fluid volume
a. normal fluid level is "normovolemic"
b. dehydrated/low fluid level is "hypovolemic"
3. protection

Blood characteristics
1 degree warmer than the body
alkaline pH (7.35 to 7.45)

Immune response
monitors pathogens
immobilizes using antibodies
destroys pathogens using white cells

Whole blood
made up of plasma and formed elements
the male body has approximately 5-6 liters of blood
the female body has approximately 4-5 liters of blood
blood is slightly viscous and kind of sticky
If you look at a vial of blood that has been centrifuged, a typical sample, it will look stratified. The layers are comprised as follows:
50-55% plasma
44% erythrocites
<1% "Buffy Coat" - leukocytes and platelets

Plasma components
1. 92% water
2. 7% proteins
a. Albumins (smallest, approx 60%, most abundant) - think transport protein and delivery system (ions, lipids, hormones) - CARRY
b. globulins (35%, alpha/beta), antibodies - FIGHT
c. fibrogen - (4%, plasma protein) healing and clotting - CLOT
<1% regulatory proteins
3. 1% other solutes

Alpha and Gamma Globulins - Transport proteins
synthesized in liver
attach to lipids and carry things all over the body

Gas exchange
Plasma and interstitial fluid are basically the same thing, but the percentage of dissolved gasses and protein is higher in plasma than in extracellular fluids, that's how they travel around the body.

Formed elements
red and white cells and platelets
hematocrit - % of volume of formed elements in whole blood
varies along gender lines
M - 40-50%
F - 47-57%
99.9% of formed elements are red blood cells
.1% are platelets and white blood cells

*lecture note, you will want to be able to identify elements on a blood smear slide*

Erythrocytes (red blood cells)
biconcave
no nuclei or organelles
only job is to carry oxygen around
line up in a "rouleau" formation, a tidy straight line, to get through small places.
short life span, 3-4 months, 1% of your total erythrocytes are renewed daily
can't synthesize their own repair materials
old RBCs are removed via the liver and the spleen
PACKED CELL VOLUME = the percent of RBC in a sample
there are about 280 hemoglobin molecules per erythrocyte
2 alpha, 2 beta - make chains, 4 heme molecules - see page 536
Every 4 hemoglobin molecules contain FE2+ (iron)
and each hemoglobin molecule can bine 4 O2 or 4 CO2 molecules

Blood type
surface antigens - markers on surface of erythrocytes create blood "types", which are assigned into ABO groups.
Rhesus factor - another surface antigen, further typifies ABO blood types into "positive" or "negative", but has been designated as surface antigen "D" for some reason.

O- is the universal donor. Very popular at blood bank holiday parties.
AB+ is the universal recipient. Very lucky when in trauma centers. For some degree of luck and it could be argued that the bad luck of being in the trauma center at all trumps blood type, but you get my point.

**lecture note - you will want to know what agglutination is, why it happens and how. Basically? wrong blood type or RH factor, you get clumping, the cells can hemolyze and DEATH occurs, so you wind up dead like a big dead thing. Very bad. Do not recommend it. Read labels carefully and double check all bag labels against charted blood type that the hospital blood bank sends up, if you are going into the nursing field.**

WHITE BLOOD CELLS
leukocytes
nucleus and organelles are present
respond to pathogens and initiate immune response
some WBC can leave blood vessels (diapedesis) and go to peripheral tissues during immune response
"chemotaxis" - the attraction of WBC to site of injury
not enough WBC - leukopenia
too many - leukocytosis

Types:
Granulocytes - end in "phil", make up about 60-70% of WBC
neutrophil, eosinophil, basophil - cannot leave vessels
Agranulocytes - end in "cyte"
monocytes and lymphocytes - totally can leave vessels and go walkabout
Lymphocytes - 3 types:
T cells
B cells
Natural Killer cells

Platelets
made by megakaryocytes
continuously produced in red marrow
1/4 the size of RBC
work to make clots and patch damaged vessels until they heal, with actin and myosin fibers.

Youtube study guides

2009-11-01T16:12:00.000-08:00

The Cranial Nerves:

Chapter 18 - VISION

2009-10-31T19:52:00.001-07:00

General senses
We covered eyesight and hearing
Know what receptors are and what they do, also what a receptive field is (p. 471 18.1), and we'll cover more about those on Monday.

Vision (p. 491)
Receptors in the eye detect: light, color and movement
the visual cortex is the largest cortical area of the brain (occipital lobe) and is associated with cranial nerve II.

Accessory structures of the eye - lashes, brows, lids, etc. see page 492, fig 18.19 You want to know:
tarsal glands - sebacious glands
tarsal plate - connective tissue in eyelid
palpebral fissure - where eyelids come together
medial/lateral commisures - the corner of the eye
lacrimal apparatus - produces, collects and drains tears (lateral to medial, superior to inferior)
*know how this works and the structures of the apparatus - caruncle, puncta, canaliculus, duct, etc.
lacrimal caruncle - that reddish structure in hte corner of your eye
conjunctiva - a simple squamous epithelium that lines the anterior eye (not the cornea)

The eye - structure (p. 496)
3 layers:
a. fibrous tunic
b. vascular tunic
c. retina
Fibrous tunic
protects, gives shape to the eye
this is the white of your eye, the "sclera" though in front it becomes a clear sheet of tissue called the "cornea". Know that the corneal limbus is where the cornea and sclera come together.
Vascular tunic
There are 3 layers to the vascular tunic
1. Iris - pigmented cells, two layers of smooth muscle
anterior eye
the "pupil" in the inner margin of the iris allows light to pass through to the retina, and its diameter is determined by two sets of muscles
a. sphincter pupillae - constriction (light OUT)
b. dilator pupillae - dilation (light IN)
2. Ciliary body - muscles to focus, contract and expand the iris (p. 496, fig 18.22)
ciliary muscles pull the suspensory ligaments and help focus the eye by changing the shape of the lens
ciliary process
3. choroid - a capilary network
largest area of the vascular tunic, supplies oxygen and nutrients to the retina

The Neural Tunic (p. 497)
1. pigmented layer absorbs light
2. retina or "neural layer" is comprised of
a. photoreceptors
b. neurons
c. blood vessels

Retinal organization: *know how this works.
light comes in and passes through the eye, via the pupil. It goes all the way back to the rear of the eye where certain
rods and cones are activated, which send nerve impulses to
bipolar neurons and then to the
ganglion, and these impulses (translated from light) are sent to the occipital lobe via the cranial nerve II.

Optic disc (p. 497 fig c)
this is where the optic nerve enters the eye
the spot on the retina with about a million ganglion cells exit the retina to make CNII, there are veins and arteries present and it is a blind spot
Fovea (part of the retina)
area of sharpest vision
highest proportion of cones, but almost no rods
Lens
transparent, deformable structure attached to suspensory (ciliary) ligaments and suspended behind the pupil
tension from ciliary muscles cause lens to change shape, changing focus of eye.

Cavities (2) and chambers of the eye
Anterior Cavity (p. 498)
division between lens and cornea
full of aqueous humor (watery)
drains through the canal of Schlemm **know this
Posterior Cavity
behind the lens and in front of the retina
filled with vitreous humor (jelly)
maintains the shape and helps support the lens and retina

Know the visual pathways - when light enters eye, be able to put steps in order
Know where the optic nerves converge and where the medial visual fields cross over (optic chiasm)

Hearing and Equilibrium, didn't get typed up sorry!

Stimuli: receptors
Complex or simple
Receptive field – the area a nerve can “sense” where it is sensitive to

Clasification:
General sense and special sense
Stimulus origin
Exteroreceptors – skin or mucous membranes
Interoreceptors – walls of viscera, detects stretching, oxygen dep
Proprioreceptors – muscles, tendons, joints (where your body is in space)
Distribution
Somatic – body – receptors for external stimuli
Visceral – in walls of viscera
Special sences – vision, equilibrium and hearing
Modality
Chemoreceptors – chemical (taste)
Thermoreceptors – temperature
Photoreceptors – eye, change in light
Mechanoreceptors – physical deformation due to touch
Baroreceptors – pressure changes inside body structures
Nociceptors – tissue damage and pain
Phantom pain
Associated with missing limb – extreme to itching
Sensory cell bodies from limb remains alive as part of the dorsal spinal root, which provides sensation to the CNS, despite the limb removal which took out the axons of those sensory cell bodies
Referred pain
“goes somewhere else”, via dermosomes
impulses from certain viscera such as heart or appendix perceived as originating from somewhere else.

Tactile receptors **know from pictures
Mecnanoreceptors – most common
Location: dermis and subq layers of skin –
Unencapsulated
Free nerve endings – end of nerves
Root hair complex
Tactile discs
encapsulated
Krause bulbs
Lamellated corpuscles
Ruffini corpuscles
Tactile corpuscle

OLFACTION - smell
Special sense

Olfactory organs
Epithelium
Receptor cells – like the rods and cones or organ of corti, does the work
Basal cells -
Supporting cells –
Olfactory cilia – apical end of olfactory receptors, contain receptors for airborne molecules

Taste
Information about food and liquids consumed
Gustatory cells – taste receptors housed in specialized organs called taste buds
On dorsal surface of the tongue in papillae, elevated epithelial and connective tissues
Filiform
Fungiform
circumvallate
*know that these 3 terms refer to taste buds
Pathway:
CNVII anterior 2/3 - facial
CNVIII posterior 1/3 – hypoglossal
Taste discrimination
Sweet, salty, sour, bitter
Water receptors and umami

Chapter 15 notes

2009-10-31T19:48:00.000-07:00

I was sick and out all this chapter, so this is what people sent me as highlights. I have not corrected them or checked them.

Monday:
Must be able to identify cerebrum, cerebellum, and pons.
When we talked about divisions of the brain, he said if he picked one thing to know from the Diencephalon, it would be the Hypothalamus.
Know ventricles are always associated with the CSF.
Know Superior Sagital Sinus.
We will see again: Cerebrum overlap.
Know the different lobes of the brain and insulua (I think that's spelled wrong).
Know about Central Sulcus.
He mentioned the longitudinal fissure 4 or 5 times.
And he seems very keen on talking about the frontal lobe!

Wed:
Know these things:
BBB (brain blood barrier)
Choroid plexus
infundible
pineal gland
master controller of autonomic nerve system is the Hypothalamus
**vermis
arbor vitae
limbic system is connected with 1. general emotion 2. memory 3. drive
cranial nerves 1,2, and 5 will most likely be on practical using the picture on pg 417

we skipped the slide which is right before the one labeled 'Higher Order Process' (it is jammed packed with info)
and also the one with pic of cross section of the medulla oblongata.

Tutorial videos

2009-10-25T12:46:00.000-07:00

Ch 14, spinal cord

2009-10-25T11:35:00.001-07:00

Material for this chapter is difficult, lectures go very fast, and it can be tough to follow and write quickly - he is going over this material VERY fast and it is very conceptual, my notes are not entirely complete thus far. Seriously recommend getting a copy of the power points to study with if you don't already have one.

Exam note:
The test will be on Wednesday the 4th at 10:30 am. It will probably not include much in the way of models, he has said several times to focus on learning to label the illustrations in the book and study off pictures, as they will comprise a lot of the practical material. As he holds reviews, I am compiling a study guide for the class, this will be available next MOnday.

WEDNESDAY and FRIDAY's lectures, combined

Spinal Cord
1. It is the link between the brain and the PNS.
2. pathway for sensory and motor impulses
3. roughly cylindrical

Regions of the spinal cord
1. Cervical
2. Thoracic
3. Lumbar
4. Sacral

Anatomical landmarks of the spinal cord that you absolutely need to know
1. 2 longitudinal depressions
a. Posterior Median Sulcus - PMS
b. Anterior Median Fissure - AMF
2. 2 enlargements of the spinal cord
a. Cervical enlargement (biggest) - supplies and innervates pectoral girdle - lies at about C6, the plexus is between C4 and C8 (spinal nerve)
b. Lubrosacral enlargement - supplies and innervates lower limbs
3. Conus Medullaris - L1 - tapering end of the spinal cord proper.
4. Cauda Equina - L1 to sacrum - "Horse Tail" this is made up of bundles of nerves/axons. Looks like a horse's tail.
5. Filum Terminale - one terminal fiber which anchors the spinal cord to the end of the sacrom, comes off the cauda equina.

Spinal Nerves
there are 31 pairs - please note that the cervical spinal nerves have an extra set, C8. All the others correspond to the number of vertebra in that particular spine.
Know: diagram on page #363 (be able to fill it in)
a. Dorsal Root - posterior - paired structures of sensory nerves
b. Dorsal Root Ganglion (contains sensory nerve cell bodies)
c. Ventral Root - anterior - paired axons of motor neurons
"AMPS" anterior/motor and posterior/sensory
1. Spinal nerves start where the dorsal root ganglia and ventral root come together and join to become a mixed nerve/exit the spine at the intervertebral foramen.

DAP - 3 layers of meninges - page #364
1. Dura mater - outer meningeal layer, has two actual layers of it's own
a. periosteal (this is the outermost layer, next to the bone, thus 'osteal')
b. meningeal (inner layer)
2. Arachnoid mater
a. thin, spiderwebby
3. Pia mater
a. innermost meningeal layer, has blood supply, extensions that anchor the cord come off the pia matter and are known as "denticulate ligaments".

The order basically goes like this, from outside in:
Dura Mater outermost
a. periosteal
b. meningeal
SUBdural space - space between dura mater and arachnoid mater
Arachnoid mater middle layer
Subarachnoid space - this is the largest of the spaces between maters and this one is full of CerebroSpinalFluid (CSF) which bathes the spinal cord.
Pia Mater - inner most layer
Spinal cord.

The Spinal Cord proper:
see slide #20 and also page #368 for a good diagram of this. Memorize it.
So there's white matter which is around the outside and grey matter inside, which looks a lot like a butterfly or a Honda logo. The grey matter is made up of unmyelinated dendrites, axons and neurons. The front, side and back parts of the "butterfly" are called the "horns". You want to know them and what they do.
1. Anterior Horn:
cell bodies of somatic motor neurons (anterior motor)
2. Posterior Horn:
cell bodies of somatic sensory neurons and visceral sensory neurons (posterior sensory)
3. Lateral Horns
cell bodies of autonomic nervous neurons
4. know also the "grey commisure"
this is where nerve impulses cross over - remember that the right side of the brain deals with the left side of the body, etc. impulses cross over contralaterally at some point in the spine.

Page #368 has an important diagram that you need to memorize about somatic motor and somatic sensory impulses and where they are located on the "butterfly".

NOTE: You MUST get the power points or use the diagrams in the book to learn this. The diagrams are crucial to understanding this visually. slide 47-48
PLEXUS - this stuff is really important
A plexus is:
a. a group of spinal nerves that do a specific job
b. divided into groups
cervical, brachial, lumbar and sacral
Note: the Thoracic nerves are NOT A PLEXUS. They're different.

Cervical plexus - C1-C4 - deep to SCM muscle, innervates the muscles and skin of the face
a. Know the "Phrenic nerve" at C4 - innervates the diaphragm via the thoracic cavity, with a little assistance from C3 and C5.
Brachial Plexus C5-T1 (anterior rami) - innervates the upper limbs and pectoral girdle.
1. "Trunks" know these and in what order, what they do, etc. SLIDE #58-60- It's kind of like a tree, right? The spinal cord is the root of the tree, then the spinal nerves exit and branch out to:
a. superior trunk
b. middle trunk
c. inferior trunk
to
a. posterior cord
b. lateral cord
c. medial cord
to 5 major terminal branches (know these terms and functions)
a. axillary (armpit, shoulder)
b. median (down the middle of the arm)
c. musculocutaneous - high and shoulder, biceps brachii, some skin
d. radial - along the radial bone, thumb, fingers 2-3, underlying muscles
e. ulnar - along ulna, little finger, skin to little finger
Lumbar Plexus - ant rami L1-L4 SLIDE #64
give rise to
1. Femoral Nerve - posterior (refers to how it is relative to other nerves exiting spine, NOT where it lies in the leg)
a. lies beneath the inguinal ligament
b. primary nerve to the anterior thigh/leg
c. fibular, foot and gluteal innervation
2. Obdurator nerve - anterior
Sacral Plexus - L4-S4 anterior rami
1. Sciatic nerve
largest nerve in the body
longest nerve in the body
Distally, it has 2 divisions in a common sheath
a. common fibular divison
b. tibial division
Branches
a. Tibial
b. common fibular nerve
c. deep fibular nerve
d. superficial fibular nerve
Thoracic nerves - remember, these are not a plexus, see slide #45
T1-T11 and T12 subcostally
T1 is actually part of the brachial plexus, so T2 is where the thoracic nerves officially 'start'.
Intercostal nerves - along each rib, the lower border of the rib margin
innervated along ganglia

Dermosomes
a. each pair of spinal nerves controls a region of body surface sensation - the exception to this is C1, which does not.
b. from dorsal and ventral rami fibers
c. damage to the spinal nerve results in loss of sensation to a region of skin
d. this is a helpful diagnostic tool, sometimes pain is referred from one nerve to a corresponding region of skin.

Reflexes
a reflex is a specific, rapid and involuntary response to a specific stimulus (which is required, to elicit the reflex)
3 types:
a. rapid
b. automatic
c. involuntary
can be:
a. ipsilateral - receptor and effector are on the same side
b. contralateral - crosses over, receptor and effector cross over at commisure

Reflex arcs are either monosynaptic or polysynaptic
Steps of a Reflex Arc - slide 75-78, know these steps
1. peripheral stimulation
2. sensory neuron
3. dorsal root
4. posterior horn
5. activates motor neuron
6. response by effector muscle
EXAMPLES:
Withdrawal reflex - #79
polysynaptic reflex arc
Stretch reflex - #80
monosynaptic reflex arc

Slide #82, ignore, he said it will not be on the test.

Lecture: Ch. 13 Nervous Tissue: Monday 10/18

2009-10-19T21:33:00.001-07:00

**We now resume our regularly scheduled notes. Sorry about the gap last week, folks, blame the flu.**

Some notes before the actual notes:
1. The suggestion was made that this material is harder than anything we've encountered to date, by virtue of being very conceptual. Adjusting study habits to include reading before class to prepare was strongly suggested. It was also put forth that you want to read this material more than once. So, pre read, read after lecture, then maybe read once or twice more just for kicks.

2. A lot of the lab practical will have to be on pictures/charts and diagrams that are in the text or powerpoints. Using them while you study, very smart. Not referring to them, potentially problematic during the next exam. Your choice.

Neural Tissue/Ch. 13 - starts on p. 341 in the text, powerpoints are available on the computer in the anatomy lab.

Two main divisions of the nervous system: **KNOW THIS**
1. CNS - Central Nervous System
the brain and spinal cord
2. PNS - Peripheral Nervous System
everything else, all the peripheral nerves

Functional Categories
1. Receptors - collect information from internal/external environment and send it back to the CNS via 'receptor pathways' where the brain processes the input.
2. Effectors - signal is sent back down the neural pathways from the CNS, via the PNS, and cells in muscles or glands receive impulses which cause the body to react in a certain way.

Functional Organization
1. The Sensory Nervous System or SNS is "AFFERENT"
stimulus -> CNS ->
a. Somatic Sensory - touch, pain, pressure, vibration
b. Visceral Sensory - involuntary impulses from viscera - a stomach ache, sense of bladder being full, cramps.
2. The Motor Nervous System or MNS is "EFFERENT"
CNS -> PNS -> glands and muscles
a. Somatic Motor - causes contraction of skeletal muscles, running, walking, picking stuff up, scratching your nose in response to an itch (somatic sensory).
b. Autonomic Motor - smooth muscle such as the digestive tract, cardiac tissue, respiration, totally regulated unconsciously by impulses from the CNS.

quick summation/concept check:
Autonomic Nervous System - fight or flight, breathing, digestion
a. sympathetic
b. parasympathetic
Somatic Nervous System - body, causing movement
**REFER TO CHART ON PAGE 343 for flow and detail**

Cellular Organization
1. Neuron - a nerve cell
a. excitable, can be stimulated
b. can initiate, transmit and recieve nerve impulses
c. the basic structural unit of the nervous system
d. high metabolic rate and high O2 needs
e. longevity - some neurons last your entire lifespan
f. non-mitotic - they don't replace themselves.
So when your mom told you you'd totally destroy brain cells so don't do anything stupid, she was right and you should have listened.
Neuron structure is as such:
a. cell body
b. dendrite - directional/afferent - smaller, go into cell body, sensory
c. axon - directional/efferent - leave cell body, larger, motor

2. Glial Cells
do not conduct impulses and are not excitable. They are the staid, boring cells of the nervous system.
Neuroglia or neural cells are:
a. found in both the CNS and PNS
b. smaller than neurons
c. mitotic
d. protect and nourish neurons - worker bee cells
e. more numerous than neurons by a factor of 10
f. tumors are more likely to be made up of neuroglia
Types of neuroglia - see page 345 for helpful diagram -
In the CNS:
a. astrocytes
- most abundant glial cells
- help form the blood/brain barrier (**know what this is**)
- regulate fluids
- structural network
- makes repairs
- development of fetal neurons
- have perivascular feet, take 02 and nutrients from blood and transfers this to the neuron. **KNOW this - there's a great diagram/pic in powerpoint and a decent one in the text on page 346**
b. ependymal cells
- line the ventricles of the brain and central canal of spinal cord
- makes CSF - cerebrospinal fluid - in conjuction with other glial cells
- forms choroid plexus
c. microglial
- motile, they move around and do stuff, wander through CNS
- phagocytic activity, remove dead or dying material, etc.
d. oligodendrocyte
(same as neurolemmocytes, but slightly different function, know the difference and which goes to what system.)
- myelinate CNS axons ONLY **KNOW THIS KNOW THIS KNOW THIS**
- wrap around axons like electrical tape (the cell membrane) to make the myelin sheaths
- produce myelin which is a membranous coating around the axon made up of a phospholipid bilayer or the neurolemma of the oligodendrocyte
- myelin sheath improves speed of neural impulses
- Myelinated nodes - the "bumps" of myelin coated axon
- Nodes of Ranvier **KNOW THIS KNOW THIS KNOW THIS** - the unmyelinated part of an axon between myelinated nodes.
- white matter - made of myelinated axons
- grey matter - no myelin here! axons or cell bodies.
- one oligodendrocyte will coat 1mm of several different axons
Glial cells in the PNS:
a. Schwann cells or neurolemmocytes
(are the same as oligodendrocytes, except they do some slightly different things. Know which goes to which system.)
- myelinate PNS axons only
- same function and structure as oligodendrocytes
- nucleus gets sort of squished to the side as it wraps around the axon.
- one neurolemmocyte will coat one mm of one axon only
b. Satellite cells -
(know they exist and which system. Know that they're flattened around neural cells and ganglia. Don't need to know much more.)

Neuron - cell body or "soma" **note, this is where my brain began to glaze over due to saturation of information, so you will want to go over the powerpoint from this point, and fill in any gaps**
a. recieve/send/process impulses
b. have multiple components
c. have organelles
d. **KNOW "Nissl bodies"

Axons:
a. **KNOW** the "axon hillock" which is a slightly thickened area where the axon meets the body of the neural cell.
b. transmits away from cell body
c. at the far end -
d. axon collaterals - side branches
e. telodendria - tree like structures
f. synaptic knobs - at end of telodendria
g. terminal boutons

Classification - see page 350 in text
1. unipolar
2. bipolar
3. multipolar
4. pseudounipolar
5. anaxonic (no axon)
Functional Classification
1. sensory - "afferent" to the CNS
2. motor - "efferent" from the CNS
3. Interneuron - facilitate communication between sensory and motor neurons, fine tune responses, both working at once. 99% of these are in the CNS, mostly brain, a little in spinal cord.

Conduction:
**KNOW** the bigger the axon, the faster the conduction**
1. Nodes of Ranvier - neurofibril node - space in myelin sheath
2. Saltatory Conduction - nerve impulses from node to node, the fastest impulse
3. Continuous Conduction - slow, needs more ATP, pain/cold reception

Regeneration of the PNS
a neuron may regenerate if some neurolemma remains after being damaged
it depends on the amount of damage
certain factors stimulate regrowth and must be present
it also depends on the distance between the area of damage and the effector organ, if there is too much distance, regeneration is nearly impossible.

Wallerian Regeneration **KNOW THIS ONE**
1. trauma happens
2. proximal end of the axon seals itself by fusion and it swells
3. regeneration of the tube/new tube forms
4. axon growth and remyelinization occurs, 5mm per day
5. innervation is restored with the original effector.
Regeneration of the CNS
Not so much with that. Very limited.
why? Oligodendrocytes - no growth factor
Axons - too tightly packed
**check powerpoint, there were other points on this slide that I missed and he went too fast for me to get them down**

Nerve structure:
Endoneurium - a fibrous sheath that wraps around several fascicles of nerves
Perineurium - fibrous sheath wrapping around individual fascicle
Epineurium - fibrous sheath wrapping around one bundle of axons, a cablelike bundle of parallel axons, several within a fascicle.

Vesicular Synapses - the most common type of synapse
axons terminate at a synapse, branch at the telodendria, end in a synaptic knob which makes contact with the synaptic cleft of the tissue it is connected to.
Electrical Synapse
Chemical Synapse - (same as vesicular)

Neuronal Circuits - see p. 355
divergent - walking
convergent - appetite
serial -
parallel - math calculations, anatomy tests
reverberating - breathing at night (a feedback loop, positive reinforcement)

Ch 11 - Appendicular Skeletal Musculature Lecture dates: Friday 10/9 and Monday 10/12

2009-10-11T11:53:00.000-07:00

Lab was long, lecture was short. There will be WAY more in this space after Monday's lecture.

Stabilizers of the scapula
Anterior group:
The function of this group of muscles is to depress the scapula, stabilize it, and protraction.
1. Pectoralis minor
O: anterior ribs 3-5
I: coracoid process of the scapula
2. Serratus anterior (sawtooth)
O: anterior border of ribs 3-8
I: anterior scapula
3. Subclavius
O: anterior surface of the ribs
I: inferior clavicle

Posterior group:
1. Leveter Scapulae - elevates, rotates scapula inferiorly
O: transverse processes of C1-C4
I: superior medial border of the scapula
2. Rhomboid major AND minor - elevates, and adducts scapula (towards midline/spine)
O: C7-T5
I: medial border of the scapula
**the way to visualize the rhomboids is pretty easy. Think of a Christmas tree. The spine is the trunk of the tree. Rhomboid minor is the topmost branches while rhomboid major makes up the entire middle and bottom section of the tree**
3. Trapezius - elevates and superior rotation, retracts (mid) and depresses (inf)- the superficial muscle in this grouping.
O: occipital bone, spinal processes C7-T12
I: acromion of scapula, superior spine of the scapula

Muscles of the Glenohumeral Joint
There are 2 muscles of the Glenohumeral joint that originate on the axial skelly and insert on the appendicular skeleton
1. Latissimus Dorsi (the swimmers muscle, or "lats") - this is the prime mover of arm extension and lies posteriorally.

O: lower T spines, ribs, iliac crest, T-L fascia
I: intertercular sulcus, humerus.
2. Pectoralis Major - PRIME MOVER of arm flexion.
O: clavicle, ribs, sternum
I: lateral intertubercular groove of humerus.

There are 7 muscles of the Glenohumeral joint that originate on the scapula and insert on the humerus. The "rotator cuff" is 4 of them, with 3 others not being part of that group.
1. Deltoid - abduction, lies superficially
O: clavicle and scapula
I: lateral humerus (deltoid tuberosity)
2. Coracobrachialis - adduction and flexion
O: coracoid process of the scapula
I: mid-shaft of humerus
3. Teres major - adducts and flexion
O: inferior lateral border/inferior angle of the scapula
I: lesser tubercle of humerus
The 4 muscles of the "rotator cuff" are referred to as the SITS muscles
O: all of these muscles originate on the scapula
I: all of these insert on the humerus, either anteriorally or posteriorally.
Supraspinatus - abduction
Infraspinatus - adduction and lateral rotation
Teres minor - adduction and lateral rotation
subscapularis - medial rotation

Summary of action:
ABDUCTION:
Deltoid - mid
ADDUCTION
Latiss dorsi
Pectoralis major
EXTENSION
Latissimus dorsi
Deltoid - posterior
FLEXION
Pectoralis major
Delt – anterior
LATERAL ROTATION
Infraspinatus
Teres minor
MEDIAL ROTATION
Subscapularis

Chapter 10 - Axial Musculature

2009-10-08T21:48:00.000-07:00

Notes on muscle names - they'll generally give you clues as to location or what they do. Try to break the words down into their component bits if you can't remember something off the top of your head during the test.

Major groups of Axial skeletal muscles
1. Head and Neck
2. Vertebral Column
3. Abdomen
4. Pelvic Floor
The axial muscles have both their origins and insertions on the axial skeleton. They support the head and spine, are responsible for facial expression and chewing, keep your abdominal and pelvic organs in place as opposed to, you know, not.

Overview of the Muscles of the Head and Neck:

Muscles of Facial Expression:
These muscles are free floating - ie, they have both origin and insertion in the superficial fascia of the face. They are innervated by Cranial Nerve VII.
1. Frontalis - this is the anterior portion or belly of the occipitalfrontalis muscle. It retracts the scalp and raises your eyebrows. The posterior portion or belly of this muscle is the Occipitalis, and there is a band of connective tissue that runs along the superior skull between the two muscle bellies. The name tells you where it goes in this case. "Frontalis" lies over the frontal bone of the skull. "Occipitalis" lays over the occipital bone.
2. Orbicularis occuli - this is the muscle around the eye, responsible for winking and blinking or scrunching your eyes up. Break it down like so. "orbicularus", well we know that "orbit" means "round" right? And "occuli" has to mean the eye.
3. Orbicularis oris - kiss or pucker, the muscle around your mouth. "Orbicularis" again with round, so we know it's a circular structure or muscle and "oris" can't mean eye but it does sound a lot like "oral", so it has to be the mouth, the only other round thing on the face.
4. Buccinator (pron Bux-in-ator) - this compresses food in the mouth/holds it in, used in suckling, compresses air in oral cavity. This muscle lies deep to the masseter. "buccinator" is pretty easy to remember because it is in the "buccal" region.
5. Platysma - this makes a weird facial expression that is not attractive. It sort of pulls your chin down and lip down and I don't recommend it because your face would freeze that way.
6. Risorus - this moves the lips laterally but NOT up or down, so not smiling or frowning - a side to side grimace. You don't need to know the following on the test, but just for the record:
6a. levetor anguli oris makes us smile - levetor is a lever. Pulls UP.
6b. depressor anguli oris makes us frown - depressor pulls DOWN.
7. Masseter - the cheek muscle, helps for chewing by closing your mouth. Think "masticate" your food. You use the "masseter" to "masticate."
8. Temporalis - another chewing muscle, overlays the temporal bone. Name denotes location, in this case.

Muscles of the Eye:
There are 6 muscles of the eye. 4 "rectus" muscles and 2 "oblique" muscles. All 6 have their origin in the tendinous ring posterior to the eye, and insert in the anterior sclera (or white of the eye).
4 Rectus Muscles
a. Superior rectus - moves eye up
b. Inferior rectus - moves eye down
c. lateral rectus - moves eye to the side (to the side of your face)
d. medial rectus - moves eye to the side (crosseyed)
If you are looking to your right, then you are using your right lateral rectus and left medial rectus muscles, etc. They work together.
2 Oblique muscles
a. Inferior oblique - up and out (elevates and turns laterally)
b. Superior oblique - down and out (depresses and turns laterally)

The Muscles of Mastication (Chewing)
a. Temporalis - closes mouth, elevates and retracts mandible
b. Masseter - also closes mouth
c. Medial and Lateral Pterygoids - move the mandible side to side, protract and move. There is no easy mnemonic or cue with these, you just have to memorize them somehow.

Tongue muscles
"glossus" means tongue, so if it is something appended to "glossus" then you know it is a tongue muscle.
1. intrinsic - curl, freeze, and fold (but do not spindle)
2. extrinsic - protraction (stick your tongue out), elevation, retraction, depression.
2a. Genioglossus - sticks the tongue out
2b. Styloglossus
2c. Hypoglossus
2d. Palatoglossus
Muscles of the Throat/in the Pharynx
these constrictors initiate swallowing.
1. Superior pharyngeal constrictor
2. Middle pharyngeal constrictor
3. Inferior pharyngeal constrictor
Anterior Neck
1. Suprahyoid are superior to the hyoid. They originate on the hyoid and insert above. Mnemonic: "Dancing Green Silly Monkeys are superior...
a. digastric
b. geniohyoid
c. stylohyoid
d. mylohyoid
2. Infrahyoid are inferior to the hyoid. Originate on the hyoid and insert inferior. Mnemonic: ...Oily Stinky Tigers Singing which are inferior."
a. Omohyoid
b. Sternohyoid
c. Thyrohyoid
d. Sternothyroid

Mnemonic for all 8 muscles of the hyoid bone: "Dancing Green Silly Monkeys are superior to Oily Stinky Tigers Singing, which are inferior."

Anterolateral muscles (front/side of the neck):
1. Sternocleidomastoid or SCM - the major muscle of this compartment. When bilaterally contracting, it flexes the neck (look straight down at the ground). When unilaterally contracting, there is lateral flexion or rotation. The name breaks down and tells you the origins/insertions. Sterno - sternum - in this case, the origin (origins are usually on stable structures, insertions not so much). Cleido - clavicle. Mastoid - the mastoid process of the temporal bone - insertion.
Posterior Neck:
bilateral contraction - extend the head and neck (back)
unilateral contraction - turn head and neck to same side
1. Splenius capitis (V shaped)
2. Semispinalis capitis - vertical, deeper

Muscles of the Vertebral Column
Spinal Extensors:
1. Erector Spinae - these are the main stabilizers of the spine. You know when someone runs their thumbs straight up either side of your spine when your back hurts, and it feels SOOO good? Well, that's the erector spinae. This group extends the back, laterally when contracting unilaterally and when contracting bilaterally, to the back. It helps maintain posture and moves the spine. It runs all the way up the spine.
laterally
a. iliocostalis
cervical, thoracic, lumbar
b. longissimus
capitis, cervical, thoracic
medial
c. spinalis

2. Splenius - superficial
3. Transversospinalis - the deepest muscles of the spine
a. intertransversarius
b. rotoresthoracis
c. interspinalis
4. Quadratus Lumborum - this muscle inserts at the floating rib (#12) and on the transverse processes of the lumbar vertebra. It has its origin at the os coxae. Deep to erector spinae.

Abdominal Wall
mostly anterior/lateral
Anterolateral muscles (4) - work to flex the spine, compress abdomen, "crunch" body forward
1. external obliques - most superficial - creates inguinal line
2. internal obliques - middle (at 90 degree angle to external oblique)
3. transversus abdominus - deep (horizontal to ground)
4. rectus abdominus - "6 pack" which is really an 8 pack.
4a. line of connective tissue between rectus abdominus is "linea alba"

Muscles of Respiration
inhalation - muscles open thoracic cage
exhalation - muscles compress thoracic cage
1. serratus posterior superior - inhale
2. serratus posterior inferior - exhale
3. external intercostal - inhalation
a. origin - on the inferior border of the superior rib
b. insertion - on the rib lying inferior
4. internal intercostal - exhalation
a. origin - superior border of inferior rib
b. insertion - inferior border of rib lying superior
5. Transverse thoracis (3) - exhalation
6. Diaphragm
a. largest breathing muscle - dome shaped
b. physically separates abdomen from thoracic cavity
c. caval opening for inferior vena cava
d. esophageal opening for esophagus
e. up - air out
f. down - air in
g. origin - tendon to fascia(?)
h. insertion - along the ribs
7. Scalenes - inhalation
a. lie deep in the neck
b. lift the first and second ribs - "bucket motion"

Pelvis/Pelvic Diaphragm
1. supports the pelvic organs - muscles deep strengthen pelvic floor
2. controls defecation and urination
3. in males, muscles of erection and ejaculation
a. bulbospongiosis
b. ischiocavernosus
4. spincter muscles permit voluntary control urination and defecation (
5. Perineum - diamond shaped and separated into two triangles
a. anterior - urogenital triangle
b. posterior - anal triangle
6. The borders of the pelvic floor
anterior - pubic symphysis
posterior - coccyx
laterally - ischial tuberosities

Wednesday Sept. 31

2009-10-01T12:49:00.001-07:00

TEST REVIEW :
I didn't bother to take super in depth notes today, because the lecture was primarily review of stuff covered in previous lecture notes. We did a practice practical exam, which was helpful, but is kind of hard to translate to the blog.

One note for the practical exam. When he has the flagged pin stuck in the blob of sticky stuff - the TIP OF THE PIN will be pointing at what he wants you to identify. The blob of sticky stuff is not necessarily sitting on what he wants you to identify. So, look for the tip of the pin. Seeing as how I was going by where the blob of sticky stuff was attached on the last exam, this seems helpful to note.

Something to ask yourself about the articulations segment, that will come up on the exam: "What is weak about this joint? How could it be injured?"

TMJ:
know that it has an articular disc and a capsule
know/be able to identify the sphenomandibular, stylomandibular and temporomandibular ligaments.
INJURY: TMJ is a common disorder of this joint. Can come from chewing gum, grinding your teeth, clenching your jaw, etc. Also, jaw is easy to dislocate.

Intervertebral articulations:
know that superior to inferior facets are hyaline cartilage
know that intervertebral discs are fibrous cartilage
INJURY: know that ligaments in the spine can sprain from overuse or strain; discs can rupture or herniate/bulge; as well as more common spinal cord injuries from fractures in the vertebra.

Sternoclavicular joint:
know that there is an articular disc between where the clavicle and sternum articulate and that it is a classic planar joint.
know/be able to identify the costoclavicular, sternoclavicular and interclavicular ligaments

Glenohumeral joint (shoulder)
know the glenoid labrum (the lip that helps make the joint deeper/more stable)
know the 4 bursa - subacromial, subcoracoid, subdeltoid and subscapular
know the glenohumeral ligament
INJURY: this joint is easily dislocated because the glenoid fossa is not deep and the articulation is not well supported by ligaments/supporting structures in the posterior and inferior aspects.

Radioulnar joint (a hinge)
know the medial and lateral ligaments
know the annular ligament
know how the bones lay in pronation vs. supination

Radiocarpal joint
know that the radius articulates with the scaphoid, lunate and triquetrum bones to form the wrist joint
Intercarpal joints
plane joints
Metacarpophalangeal
condylar joint
Interphalangeal joints
synovial

Coxal, or Hip joint
ball and socket diarthrosis
articular capsule of the hip joint is reinforced by four ligaments
iliofemoral, pubofemoral, ischiofemoral and transverse acetabular ligaments, as well as the femur being attached (fovea to acetabulum) by the ligament of the femoral head. Of these, you want to definitely know the iliofemoral, pubofemoral and ligament of the femoral head.
INJURY: this joint is more prone to fracture at the neck of the femur than to actual dislocation, due to the superior stabilization. Lotta ligaments and musculature here to keep the joint in place, as well as the acetabulum being fairly deep.

Knee joint
know the patellar ligament and quadriceps tendon (also known as patellar tendon) - tendon connects bone to muscle, ligament connects bone to bone. Quad tendon is superior, wrapping around the patella, patellar ligament is inferior, attaching the apex of the patella to the proximal head of the tibia.
know that the joint is comprised of the femur, tibia and patella, with the distal end of the femur articulating with the proximal end of the tibia, patella riding on top.
know the medial (tibular) and lateral (fibular) collateral ligaments and that you can tear them
know the anterior and posterior cruciate ligaments. These originate in hte intercondylar fossa of the femur, criss cross and then one attaches to the anterior tibial surface with the other attaching to the tibia posteriorally. This is why they're anterior/posterior. ;-)

Talocrural joint (your ankle)
talus, fibula, tibia
know that there are 3 lateral ligaments and a medial deltoid ligament, as well as anterior and posterior tibiofibular ligaments.

Ok, that's it from the notes I took on yesterday's review. Most of it was the practical/lab portion. Good luck on tomorrow's test!

Monday 9/28 notes - end ch. 7/start ch. 8

2009-09-29T10:00:00.000-07:00

EXAM IS ON FRIDAY, 10:30 AM SHARP!!!! Same format as last time, practical then written.

Those of us who showed up early to class on Monday were given the two bonus questions that will be on the exam. Here ya go:
1. What are the bones of the hand?
2. What are the bones of the orbit?

You should know these anyway, it's totally a gimme. ;-)

1. EXAM Review I do not guarantee this is what is all gonna be on the exam, this is what he mentioned in class as being relevant and he went fast so I may have missed stuff.
The Scapula
know the angles
know the borders
spinous process
glenoid cavity
acromion
coracoid process
The Humerus
know the head
tubercles
deltoid tuberosity
olecranon fossa
intertubercular sulcis
epicondyles/condyles
The Ulna
know the olecranon
annular ligament (this helps the radius and ulna do their rotational dance with each other for pronation/supination. Know it. He mentioned it a lot. It will likely be on the test.)
styloid process of the unla
The Radius
know the styloid process of the radius
radial notch
neck and head
tuberosity
coranoid process
Also, know the interosseous membrane, what it does and why it is there. (pssst - it keeps stuff together and helps the ulna and radius do that pivot thing they do so well)
Wrist bones
Proximal: Scaphoid, Lunate, Triquetrum, Pisiform (Suzy Likes To Push)
Distal: Trapezium, Trapezoid, Capitate, Hamate (The Toy Car Hard)

In addition to the wrist bone, per hand, there are
5 metacarpals (1-V, starting with thumb)
14 phalanges (proximal, middle, distal, except thumb which is only proximal/distal)

Know the radialcarpal joint!

Pelvic Girdle - 2 bones (the os coxae)
Pelvis - the os coxae fused with the sacrum
Know the following:
the 3 bones of the os coxae and where they fuse together (at the acetabulum)
The Ilium, know:
ASIS
PSIS
Iliac crest
Arcuate line
greater sciatic notch
auricular surface site of articulation with sacrum)
acetabulum (where the head of the femur sits)
The Ischium, know:
lesser sciatic notch
ischial spine
ischial tuberosity (sits bones)
obdurator foramen
The Pubis, know:
symphysis
The Pelvis, stuff you should know in general
True Pelvis - where the urinary bladder and reproductive organs actually sit
False Pelvis - actually supports abdominal cavity/organs
outlet
inlet
brim
Gender differences in the pelvis
male -
pubic angle is about 90 degrees
taller
more narrow outlet
female - pubic angle is 100 - 120 degrees
wider, more bowl shaped
the outlet is enlarged for childbirth
Bones of the lower limb
Femur, know:
Fovea - the tiny depression in the head of the femur. The "ligament of the femoral head" attaches here and attaches the femur to the acetabulum.
greater trochanter
linea aspira
intertrochanteric line
adductor tubercle
intercondylar fossa (where the cruciate ligament attaches)
knee joint
Femur and Tibia articulate, patella sits on top of them
The patella is the site of attachment for the quadriceps tendon (superior, quad muscle to patella) and the patellar ligament (inferior, patella to tibia) KNOW THESE LIGAMENTS!
The Tibia, know
medial leg bone
tibial tuberosity
anterior margin or crest (your shins)
medial malleolus
The Femur, know
lateral leg bone
stabilizes
non weight bearing
lateral malleolus

NEW LECTURE **END REVIEW** NEW LECTURE
The Ankle Joint, know
Distal tib/fib
comprised of medial malleolus, distal tibial articular surface and lateral maleolus
articulates with the talus bone of the foot.

Bones of the foot
Calcaneus - the largest, site of attachment to achilles tendon, the heel bone
Talus - articulates with tib/fib to form ankle joint
Navicular - most medial
Cuboid - most lateral
3 Cuneiform bones - distal
PER FOOT you have:
5 Metatarsal bones (1-V like in the hand)
14 Phalanges (3 each, 2-5, proximal, middle, distal, and #1, the hallux, has two, proximal/distal)

Aging - the os coxae bone is the most reliable bone in the human body for determining age and gender.

Chapter 8 begin - Articulations
Ok. This is a LOT of information. Just saying.

3 types of joint.
ROM (range of motion) varies per joint, based on how stable it needs to be)
1. fibrous
2. cartilagious
3. fluid (synovial)

Classification
there's a table in our text, 8.1, pg 206
1. Synarthrosis - no movement
fibrous connections plus extensive interlocking
conversion of articular form to solid mass of bone
1. Gomphosis - teeth between mandible/maxilla
2. Sutures - bones of the skull
2. Amphiarthrosis - some movement
permits movement in one, two, or all three planes
ex: elbow, ribs, knees, ankles, etc.
ligamentous connection
pad of fibrous cartilage connecting
1. Syndesmosis - interosseous membrane like in the antebrachium or leg
2. Symphysis (pubic symphesis)
ex: between tibia/fibula
between right/left hip bones and adj. vertebral bodies
3. Diarthrosis - freely moving
complex joint, bounded by joint capsule/contains synovial fluid
1. articular capsule - a double "bag" surrounding joint, made of two layers, first is fibrous and protective/stabilizing, second secretes synovial fluid
2. joint cavity - the actual physical space that is full of synovial fluid
3. synovial fluid - an oily viscous fluid that protects, acts as shock absorber, lubricates, nourishes
4. articular cartilage - lining appositional surfaces of articulating bones, slightly different from hyaline cartilage.
5. Ligaments, vascular supply, and innervation

Freely moving joints
1. all articulating joints covered with a thin layer of cartilage - when it is gone, by the way, it's gone, so take care of it.
2. this cartilage keeps your bones from grinding together, ow
3. accessory structures:
a. menisci - discs, shock absorbers, cartilage pads between joints
b. fat pads or bursae - flattened sacks, have synovial fluid inside, protect tendons and reduce friction where ligaments, tendons, muscles and bone (or some combo of those) rub together.
c. ligaments and tendons
connect bones to bones (ligaments) or bones to muscles (tendons)
strengthen and support synovial membranes
innervated to keep from overstretching, send pain signals to the brain to "stop!"
some blood for nourishment and healing which btw is really crap after about age 30, so, don't mess up your ligaments in middle age or they'll take forever to heal.

Tendon sheaths - elongated bursa that wrap around and protect tendons

Joint movement
1. Gliding -
2 opposing surfaces sliding back and forth, planar joints, ex. carpals
2. Angular
a. Flexion/extension/hyper-extension - think, neck, wrist, knees. There is also lateral flexion of the spine, but mostly it is anterior/posterior or superior/inferior dep. on joint
b. adduction - towards midline/abduction - away from midline
3. Circumduction - making a cone shape, think of making circles with your arm with the proximal end of the humerus as the pointy end of the cone.
4. Rotational motion - the pivoting motion of a bone on a longitudinal axis, ex. alantoaxial joint (shaking your head "no) where C1 is pivoting around the dens of C2.

Types of joints:
1. Plane joint - clavicle at manubrium
2. Hinge - elbow
3. Pivot - atlas/axis
4. Condylar - bones of the hand
5. Saddle - base of the thumb or ankle
6. Ball and socket - hip or shoulder

Know:
1. Supination vs. Pronation: supination = turning arm so the palmar surface of the hand is facing up, pronation = turning arm so palmar surface of hand is pointing down.
2. Depression vs. Elevation: depression = mouth open, mandible 'depressed' elevation = mouth shut, mandible 'elevated'
3. Dorsiflection vs. Plantiflexion - motion of the ankle - dorsiflexion = 'toes to the noes' and plantiflexion = 'step on the gas'
4. Inversion vs. Eversion: Inversion = standing on the lateral side of your foot, ankle IN Eversion = kind of impossible to do, but ankle OUT.
5. Protraction vs Retraction: protraction = chin jutting out retraction = chin pulled in
6. Opposition: thumb to small finger. Opposable thumbs. That lucky genetic joint crapshoot which separates us from the apes and which has caused global warming. :-)

Ok, a note here. This marks the part where I really began to glaze over during the lecture, so my notes are NOT as great here. You will want to go over your powerpoints/books.

The spine:
Intervertebral discs, between the vertebra are fibrous cartilage and a form of joint.
the intervertebral articulations you need to know are:
1. superior articular facets (of the vertebra below) - up and in
articulate with the
2. inferior articular facets (of the vertebra above) - down and out

There are ligaments which you need to know that stabilize the spinal column/vertebral structure:
1. anterior longitudinal ligament - runs along the anterior, external end of the spinal column, towards the middle of the body.
2. posterior longitudinal ligament - runs inside the vertebral canal, on the anterior wall (along the base).
3. ligamentum flaveum - runs inside the vertebral canal, on the posterior side (closer to the spiny end)
4. intraspinous ligament - between the spinous processes, very short.
5. supraspinous ligament - along the outside of the spinous processes, that 'ridge', a long ligament that runs continuously along the spine.

There's a slide, #46, that shows what a herniated disc looks like. Probably should take a look at it and know basically what happens.

**OK, a note about the ligaments of joints for the test. Naming them tends to describe what they are connecting so if you panic and forget a name, just look at the structures that are being connected and see if you can figure it out.

TMJ joint - Temporomandibular joint
diarthrosis of the skull, mandible to the temporal bone
articular capsule
disc inside
a. sphenomandibular ligament
b. styloid mandibular ligament

Sternoclavicular joint - SCJ
sternum to the clavicle
diarthrosis
where the pectoral girdle attaches to the axial skeleton
a. anterior and posterior sternoclavicular ligaments - clavicle to stenum (manubrium)
b. interclavicular ligament - clavicle bone to clavicle bone
c. costoclavicular ligament - from costal tuberosity of clavicle to fist rib and first costal cartilage

Acromioclavicular joint ACJ
acromion of scapula to clavicle
Ligaments to know:
a. acromioclavicular ligament - acromion to clavicle
b. coracoacromial ligament - spans gap between acromion and coracoid process
c. coracoclavicular ligament - clavicle to coracoid process
Bursa to know:
a. subacromial bursa
b. subdeltoid bursa
c. subcoracoid bursa

Glenohumeral joint GHJ
a. glenoid labrium (lip that helps build up the glenoid fossa to stabilize the joint, make it deeper, it isn't very deep as is)
b. rotator cuff made up of 4 muscles, the SITS muscles which we don't need to know yet
c. bursae - 4 bursae - subcoracoid, subscapular, subacromial, subdeltoid
d. glenohumeral ligament (anterior) connects humerus to scapula **KNOW slide 54

elbow
ulna radius humerus
"hinge" joint
3 ligaments to know:
a. ulnar collateral (stablizes)
b. radial collateral (stabilizes)
c. annular ligament (rotation)

Radioulnar:
annular ligament
interosseous membrane
there is a radioulnar joint proximally AND distally

Radiocarpal:
distal radius with scaphoid, lunate and triquetum bones of wrist
intercarpal joints are planar
carpal bones articulate with metacarpals
phalanges articulate with each other, distally, via interphalangeal joints, and proximally the proximal phalanx of each finger articulates with the corresponding metacarpal bone.

Lower Appendicular Skeleton - pelvic girdle/bones of leg

2009-09-26T18:38:00.001-07:00

Pt. 2 of the Appendicular Skeleton - lower half

The Pelvis
a composite structure formed of BOTH the "pelvic girdle" or os coxae articulating with the sacrum

The Pelvic Girdle
ONLY the 2 "hip bones" or os coxae, which articulate together at the pubic symphysis, anterior, and with the sacrum, posterior.

**Know the difference between the pelvis (whole) and pelvic girdle. V. important. Will be on test.

Os Coxae
a. formed by the fusion of 3 different bones
i. the ilium
ii. the ischium
iii. the pubis
b. these 3 bones fuse right around the area of the acetabulum (where the head of the femur rests)

Ilium - structure and features to know
a. the superior portion of the os coxae
b. iliac crest (superior)
c. ASIS - anterior superior iliac spine (superior)
d. PSIS - posterior superior iliac spine (superior)
e. Ala - the other side of the iliac fossa (lateral)
f. Iliac fossa - wide depression (medial)
g. Arcuate line - (medial)
h. Sacral articulation
i. Anterior, posterior and superior gluteal lines (attachments for gluteal muscles) - all lateral
j. Greater Sciatic notch (lateral and inferior on the ilium)

Ischium
a. inferior/posterior portion of the os coxae
b. ischial tuberosity (the sits bone)
c. obdurator foramen
d. lesser sciatic notch
e. ischial ramus - extends from tuberosity to fuse with the pubis
f. ischial spine - divides the two sciatic notches

Pubis
a. Inferior/anterior portion of the os coxae
b. 2 os coxae fuse/articulate at the pubic symphysis
c. pubic ramus

Greater or False pelvis vs. Lesser or True pelvis
you want to know the difference between these two parts of the pelvis and to be able to identify the
a. brim
b. inlet
c. outlet

Pelvic differences between genders
a. the "pubic angle" is wider in the female (120 degrees) and lesser in the male (90 degrees). The female pelvis is low/laterally, flared/broad, has an enlarged outlet, less curvature and a wider inlet. This is obviously to aid in childbirth!

Bones of lower limb
30 bones per limb
26 of these are in the feet
the other 4 are:
a. femur (thigh bone - articulates with os coxae)
b. patella (kneecap)
c. tibia (weight bearing lower leg bone, articulates with femur)
d. fibula (stabilizing lower leg bone, articulates with foot bones and tibia)

Femur
longest, strongest bone in the human body
Proximal end:
a. head
b. forea (where a ligament attaches to keep it in the os coxae)
c. greater trochanter
d. lesser trochanter
e. intertrochanteric line
Distal end:
a. ridge on back "Linea aspira" (posterior)
b. medial condyle and epicondyle
c. lateral condyle and epicondyle
d. patellar surface (anterior)
e. intercondylar fossa (posterior)

Patella
sesamoid bone, your "kneecap"
a. apex is inferior
b. base is superior
c. triangle shaped
d. acts as a fulcrum, site of attachment for the quad tendon

The knee joint is made up of the tibia and the femur where they articulate, the patella is not technically part of this actual joint but rather sits above it.

Tibia
a. medial to the fibula, articulates with femur
proximal end:
a. tibial tuberosity (insertion of quads)
the anterior margin of the shaft is the "shin"
distal:
a. medial malleolus

Fibula
a. lateral to the tibia
b. stabilizes
c. kept separate by the interosseous membrane
d. easily fractured by side blow
e. lateral malleolus

**GO OVER THE SLIDES FROM THIS LECTURE*** I wasn't feeling so hot when I was taking notes and they are not as complete as I'd like. There may be stuff missing. Double check.

Notes from Kari, wed 9/23

2009-09-25T10:20:00.001-07:00

Appendidcular Skeleton

Pectoral girdle * know this for test.

~ Consist of two bones (on each side)
1- Clavicle (collarbone)
2- Scapula (shoulder blade)

Bones that attach to the upper limbs are:

~Wings (Scapula)
~Arm bones (Humerus)
~Collar bone (Clavicle)

Clavicle - know this for test:
Acromial end
Sternal end
Coracoid - anterior scapula, inferior to the acromion, where the clavicle rests.

Know this for test* Pg. 178 in txt book.
~Scapula from the: (Anterior view is smooth), (Posterior view is rough)

Know the anatomical land marks of the (Humerus) Pg. 180 in txt.
land marks to know*
~Greater and lesser tubercle
~Deltiod tuberosity
~Radial Groove
~ Shaft
~Later and Medial epicondyle
~Capitulum and Trochlea (part of condyle)
~Coronoid fossa
~Head

Know the anatomical land marks of Radius and Ulna: Pg 182,183
land marks to know:
~Olecranon
~Radius bone
~Ulnar bone
~Ulnar notch of radius
~Ulnar head
~Ulnar styloid process
~Trochlear notch
~Olecranon fossa
~Coronoid fossa

~Shaft is the long process of the arm
~Radius articulates distal of the thumb always.

Carpal Bones: Pg. 184,185 in txt book.
Know this for test* (Sam Likes To Push The Toy Car Hard)
~Scaphoid=Sam
~Lunate=likes
~triquetrum=to
~pisiform=push
~Trapezium=the
~trapezoid=toy
~capitate=car
~hamate=hard

Phalanges
~Proximal
~Middle
~Distal

Thumb=I
Index=II
Middle=III
Ring finger=IV
Small finger=V

Slides to review of chapter #7
#3,4,7,8,9,10,12,15,19,22,24,26

Lecture notes Monday 9/21

2009-09-21T23:02:00.000-07:00

Please see previous post for animations and brief videos on spine and vertebra.

Reviewed:
Bones of the occipital complex
Nasal complex
Hyoid
Fontanels
landmarks of the above bones.

Short quiz on orbital complex.

Lecture
Vertebral column (text pages 158 - 170, lab manual pg. 34)
26 bones
24 vertebra
Sacrum (5 fused bones, for the purposes of this class, are counted as 1 bone)
Coccyx (4 fused bones, for the purposes of this class, are counted as 1 bone)

Divisions of the spine (you want to know these numbers)
Cervical spine - 7 vertebra
Thoracic spine - 12 vertebra
Lumbar spine - 5 vertebra

On the normal curvature of the spine
There are 4 curves of the spine - think APAP
Anterior - cervical
Posterior - thoracic
Anterior - lumbar
Posterior - sacrum/coccyx

Kyphosis - abnormally accentuated thoracic bow - to the posterior (think, a humped back)
Lordosis - abnormally accentuated anterior curvature of the spine, lumbar
Scoliosis - abnormal curvature of the thoracic spine to the side, like in a "C" shape, laterally.

Vertebral landmarks and features to know
Spinous processes - posterior
Transverse processes - laterally
Body - rounded/cylindrical, weight bearing
Vertebral arch - the bone arch that surrounds the spinal cord
Articular processes and facets - off the pedicles
Vertebral foramen - the hole that runs between the body and vertebral arch, houses the spinal cord.
Intravertebral foramen - site of nerve passageways

C-spine or Cervical vertebra C1-C7
a. Tips of spinous process of cervical vertebra are bifid
b. vertebra are much smaller than rest of spine
c. Look for transverse foramen, only in C spine, for blood vessels entering/exiting the brain.
C1 - Atlas
a. articulates with the occipital condyles of the skull (for nodding "yes")
b. no body
c. largest vertebral foramen in the spine
C2 - Axis
a. Pivot movement (shake head "no") allowed by the "Dens" which is a peg that articulates with C1.
b. no intervertebral disc
c. site of high C spine injuries, most commonly (think, Chris Reeve)
Vertebra prominens - C7
a. longest spinous process
b. site of attachment for the ligamentum nuchae which maintains curvature of C-spine and resists sudden acceleration/deceleration (think whiplash)

Thoracic Vertebra T1-T12
a. body - heart shaped
b. vertebral foramen are smaller
c. transverse foramen disappear
d. each T-spine articulates with a rib
d -i. T1-T8 have superior/inferior costal facets which articulate with 2 ribs at once. (demi-facets)
d - ii. T9-T12 - articulate only on costal facet
d - iii. T1-T10 - have transverse costal facets for rib articulation
e. ribs hinge/move the most in the back w/ hyaline cartilage

Lumbar L1-L5
a. the largest, bear the most weight
b. body is oval and thick
c. transverse processes are stumpy, not prominent
d. most common site of disc injuries

Sacrum (S1-S5)
a. Triangular bone articulating with the os coccae of the pelvic girdle at its auricular surface.
b. comprised of 5 fixed vertebra
c. promentory superior ridge
d. sacral canal
e. 4 visible sacral foramina
f. base is superior/apex is inferior
know: promentory superior ridge
articular process (facets)
the auricular surfaces and what they articulate with
the sacral canal and foramina

Coccyx (CO1-CO4)
4 fused vertebra, articulates with apex of the sacrum

The Thoracic Cage
the "rib cage"
Protects all organs of the thoracic cavity
site of muscle attachments
Thoracic vertebra - posterior
ribs - lateral
sternum - anterior

Features
12 pairs of ribs which originate to the posterior and end anterior
a. vertebrosterno or "true ribs" (7 pairs) - these articulate with the sternum directly via costal cartilage (1-7)
b. vertebrocostal or "false ribs" (3 pairs) - do not articulate directly with the sternum (8-12)
c. floating ribs (2 pairs) - no anterior articulation
d. Articulation - head w/ costal facet, tubercle w/ transverse process

Structures of the rib
a. head - articulates w the superior and inferior articular facets of T-spine
b. neck - area between head and tubercle
c. tubercle - articulates w transverse processes of vertebra
d. angle - where the rib is most curved
e. shaft - longest, straight part of rib
f. costal groove - inferior border of the rib, site of nerves/arteries

Rib Functions
a. complex musculature, dual vertebral articulation and flexible connections at the sternum makes the ribs very mobile, which is necessary for respiration.
b. know "bucket handle" movement, which opens up the ribs for increased respiration (say if you are out of breath, raising arms over head, etc)

The Sternum
anterior midline of the thoracic wall
a. manubrium (superior, widest)
b. body (the longest portion of this bone)
c. xiphoid process, inferior tip
know
sternal angle
jugular notch
suprasternal notch

Some helpful animations/lectures

2009-09-21T22:18:00.000-07:00

The overall spine:

The Cervical Spine:

Cervical vertebra:

Thoracic vertebra:

Lumbar vertebra:

Quick Youtube Review

2009-09-20T16:49:00.000-07:00

Friday 9/18 Lecture Cont'd - Facial bones and landmarks

2009-09-20T15:34:00.000-07:00

These are not, by far, all the landmarks (protruberances, processes, foramina, etc) that you could know on these bones, just the ones specifically pointed out in class as what we need to know.

On page #155 of our text, there is a handy dandy chart which will help you learn the formamina and fissures of the skull.

On page #156, 157 and 158, there is a chart which will help you learn the surface features and landmarks of the skull.

At The companion website to our text there is a very handy interactive tool. Go here. Mid page, you will find a link titled "Bone Review." Click on that, then find "Bones of the Skull" on the next list of links. Clicking that will take you to another set of links, various views and angles, where you will be asked to enter the names of the bones, landmarks and sutures. There will be a few not included in our lecture. You can skip them or not, if you choose. This kind of interactive stuff is incredibly helpful in getting this stuff into your long term memory. I really recommend using it as you review the material.

Facial Bones
There are 14 facial bones, but only 8 names to remember. All but two of them are paired, that is to say, there are two of each. The two that are unpaired are the vomer, which we did not really go over much in class (just know it exists and where) and the mandible, or lower jaw.
a. Maxilla (paired)
b. Palatine (paired)
c. Nasal (paired)
d. Inferior Nasal Concha (paired)
e. Zygomatic (paired)
f. Lacrimal (paired)
g. Vomer
h. Mandible

The Orbital Complex (pg. 151/152 in text)
**note** Ok this bit is really important. This was mentioned a few times, so know which bones make this up, where they are located. There is, in the Bone Review portion of the book site, an interactive orbital complex review. I recommend you use it.
The orbital complex is the bony cavity which you might otherwise call your eye socket. It is comprised of 7 bones, and protects/houses the eyes.
a. Frontal
b. Sphenoid
c. Zygomatic
d. Maxilla
e. Ethmoid
f. Lacrimal
g. Palatine
Roof or Superior surface
a. Frontal
b. Sphenoid (lesser wings)
Floor or Inferior surface
a. Maxilla
Posterior wall
a. Sphenoid
Medial wall
a. Lacrimal
b. Maxilla
c. Ethmoid
d. Palatine (just a teeeeeny bit, articulating with the ethmoid and maxillary bones)
Lateral wall
a. Maxilla
b. Zygomatic
c. Sphenoid

Nasal Complex (pg. 152/153 in text)
the bones and cartilage that enclose the nasal cavities and paranasal sinuses.
a. Frontal
b. Sphenoid
c. Ethmoid
d. Maxilla
e. Vomer
d. Nasal
Superior wall
a. Frontal
b. Sphenoid
c. Ethmoid
Bony portion of nasal septum
a. Perpendicular plate of ethmoid bone
b. Vomer
Lateral walls
a. Maxilla
b. Ethmoid
c. Inferior Nasal Concha
Bridge
a. supported by maxillae
b. nasal bones

The Hyoid Bone
lies inferior to the skull and superior to the larynx, does not articulate with any other bones. It serves as an attachment for several muscles of the tongue and larynx. Shaped like a "C."
You want to know the following landmarks:
a. Greater horns
b. Lesser horns
c. Body

Landmarks and Foramen of the Facial bones that you should know:
Maxilla (paired)
a. articulates with all the other facial bones except for the mandible
b. The maxillary sinus is the largest in the cranium, sits on either side, lateral to the nasal cavity
c. Makes up the hard/bony palate (the first 2/3, articulates with palatine bone in back)
d. has "alveola" which are the holes in which our teeth sit (these are in both the maxilla and mandible)
e. landmarks:
i. infraorbital foramen
ii. inferior orbital fissure
iii. palatine process
iv. incisive foramen (nasopalatine nerve)

Palatine (paired)
a. the back 1/3 of the palate

Nasal (paired)
a. articulates with the frontal bone at the frontonasal suture

Inferior nasal conchae (paired)
a. perform the same function as the superior and middle concha
b. delicate, scrolled bones

Lacrimal bones (paired)
a. smallest bones of the skull
b. know the lacrimal groove

Zygomatic (paired)
a. articulates with the maxilla, temporal bone and frontal bone
b. your cheek bone
c. know zygomaticalfacial foramen on the anterior surface

Vomer
a. lower half of the septum

Mandible
a. the entire lower jaw
b. know:
i. the body
ii. the rami
iii. alveolar margin (roots of teeth in lower jaw)
iv. mental foramen
v. mental protruberance (chin)
vi. angle
vii. condylar process (posterior) - articular part of TMJ
viii. coronoid process (anterior)
ix. mandibular notch
x. mandibular foramen

Bones of the infant skull
know the following fontanels:
a. anterior fontanel (sagittal, coronal and frontal sutures)
b. posterior (lambdoid and sagittal sutures)

Friday 9/18 notes pt. 1 of 2 - Cranial Bones

2009-09-18T16:13:00.000-07:00

9/18 lecture notes
Axial skeleton
Cranial bones

If it is on here? It is important. Know it.

206 bones in the human body
a. 80 – Axial skeleton (skull, vertebra, thoracic bones)
b. 126 – Appendicular (shoulder/hip/extremities)

Cranium
a. 8 cranial bones
b. 14 facial bones
c. 6 auditory ossicles
d. 1 hyoid (floating) bone

The bones of the skull from various views

Lateral view
a. Parietal bones
b. Temporal bones
c. Frontal bone
d. Occipital bone
Posterior view
a. Parietal bones
b. Occipital bone
Superior view
a. Parietal
b. Frontal bone
c. Occipital (mostly the protruberance, the rest of the bone is kind of inferior)
Anterior view (excluding facial bones)
a. Frontal
b. Parietal
c. Temporal

Sutures of the skull
a. Lambdoid:
fuses parietal bones with the occipital bone (look for an inverted Y shape on the back of the skull) and temporal bone with occiputal bone
b. Sagittal:
suture down the center of the superior skull – fuses parietal bone to parietal bone. Corresponds to the sagittal plane.
c. Coronal:
fuses frontal to parietal bone, corresponds to the coronal plane.
d. Squamous:
fuses temporal to parietal bones. Flat looking, unlike other suture.
e. Frontonasal:
fuses frontal bone of skull to nasal bone of face.

“Wormian bones”or “sutural bones” which are small bones that fill in around suture lines, generally between occiput and parietal bones but can be found anywhere.

Occipital Bone
(inferior and posterior portion of cranium)
Sutures of the occipital bone:
lambdoid suture (the inverted V of the skull)
Landmarks:
a. Foramen magnum – A BIG HOLE. Where spinal cord enters skull
b. Occipital condyles – site of articulation, where bone meets C1 (cervical vertebra)
c. External protuberance – bump on the back of the occipital
d. Inferior nucal line – site of muscle attachment
e. Superior nucal line – site of muscle attachment
f. Hypoglossal canal (think horizontal) – canal for cranial nerve VII

Parietal Bone
(superior and lateral surfaces of the cranium)
Sutures:
a. sagittal – fuses R and L parietal bones
b. Lambdoid – fuse parietal bones to occipital bonnes
c. Coronal – fuse frontal bones to parietal bones
d. squamous – fuses parietal bone to temporal bone on L or R
Lines of attachment:
a. superior temporal line
b. inferior temporal line
Landmarks:
a. Parietal Eminence – the prominent convexity of the parietal bone, the bulge in your noggin.

Frontal bone
(the anterior portion of the cranium – not facial bone)
Sutures:
a. coronal
Landmarks:
a. supraorbital margin – sharp bone forming top of orbit
b. supraorbital foramen – hole or notch in supraorbital margin
c. supercilliary arch – just above margin, where your eyebrows are
d. lacrimal fossa – slight depression in lacrimal bone
e. frontal crest – attachment site for the falx cerebri (connective tissue that keeps your brain meat from sloshing around in your noggin)
f. Frontal sinus – not really visible, but just between supercilliary arch, there’s a hollow spot.

Temporal bone:
(lateral right or left bones of cranium)
Sutures:
a. coronal
b. lambdoid
c. squamous
Regions:
a. Squamous
b. Petrous
c. Tympanic
Landmarks:
Of the squamous region:
a. Mandibular fossa
b. Zygomatic process of temporal bone
Of the petrous region:
a. mastoid process
b. mastoid foramen
c. styloid process
Of the tympanic region:
a. site of the external acoustic canal
b. internal acoustic meatus
c. external acoustic meatus

Sphenoid bone
**The only bone that meets all the bones of the skull, facial and cranial. Lose this bone, your face will fall apart. Very bad. Don’t recommend it.
Landmarks:
a. Optic canal
b. Optic groove
c. Selae turcica
d. Foramen rotundum
e. Foramen ovale
f. Foramen spinosum
g. Greater sphenoid wings
h. Lesser sphenoid wings

(a note about the Foramen – remember the initials - R. O. S. - unlike the Princess Bride ROUS**es which don’t actually exist, these foramen DO exist. Know them. They will probably be on the practical. The three foramen are kind of in a row, rotundum on top, ovale in the middle (largest, oval shape), spinosum last.

Ethmoid bone
Warms air. Helps with smell.
Forms roof of mouth, septum of nose, orbital wall
Landmarks:
a. superior nasal concha – part of “ethmoidal labyrinth”
b. middle nasal concha – part of “ethmoidal labyrinth”
c. crista gallae – separates the right and left sides of the cribiform plate. The falx cerebri also attaches to this bony ridge. Remember, the falx cerebri is the connective tissue keeping your brain in place.
d. perpendicular plate – forms nasal septum (which includes vomer and hyaline cartilage)
e. cribiform plate – perforated by cribiform foramina, allow olfactory nerves through, which lets you smell things.

Cranial Fossa
a. Anterior – frontal lobes of the brain
b. Middle – cerebral hemispheres of the brain and anterior brain stem
c. Occipital lobe of the brain and posterior brain stem.

The facial bones will be up within 24 hours, this was just a lot to type out.

To clearly illustrate the difference between the foramen of the sphenoid bone of the face and Rodents of Unusual Size, I offer the following:
**R.O.U.S.

**R.O.S.

Study Group - This Friday 9/18

2009-09-17T14:35:00.001-07:00

We are meeting at The Novel Cafe (across the street from campus) from 2:00 - 4:00 (ish). Bring your notes, and any other study aids you think might be useful. We will be reviewing this week's lectures with a focus on terminology/definitions, histology of bone, as well as any actual structures that we are supposed to be memorizing:

9/16: bone tissue and the skeletal system
9/18: the axial skeleton (lecture 1 of 2)

The only place open on campus after 2pm does not allow drinks and I don't know about y'all, but I am going to need some coffee. Or something.

9/16 rough notes from lecture - Ch 5 Osseous Tissue and Skeletal Structure

2009-09-17T00:47:00.000-07:00

Wed 9/16 Anatomy Lecture
Lab manual pg 32
(anything starred **KNOW* is probably going to be on the test. Use this to build yourself an outline for review or flashcards or something useful)

PCC Virtual Anatomy Lab - Bone tissue models

Histology World! - Bone tissue

Skeletal system:
a. Organ system comprised of dynamic living tissues
b. Constantly renewing itself.
c. Includes bone, cartilage, ligaments
d. Stores calcium and phosphate (a mineral “bank”)

Function:
a. Structural support of the body
b. Mineral storage
c. Hematopoesis – the site of red blood cell production in the flat bones/hips. **KNOW** (In infants, it is all red marrow. Adults have yellow marrow, except in flat bones and epiphysial ends of long bones..)
d. protection
e. acts as levers for muscles (pectoral girdle, etc)

Structure of bone
a. Osteocytes in lacunae
b. Bone matrix
c. Separated from other tissues/structures by periosteum (which is innervated and vascular) on the outer layer and the endosteum on the inner layer.

Histology of bone **KNOW THIS**
a. 2/3 Calcified (extracellular matrix) – hydroxyaptite (calcium phosphate and calcium hydroxide)
1/3 Collagen fibers (provides flexibility) at right angles to each other.

Bone is comprised of 4 cell types
b. Osteoprogenitor cells
c. Osteocytes (in lacunae) – the mature cells of bone, release and store calcium/minerals.
d. Osteoblasts
e. Osteoclasts

**KNOW THIS**
Osteocytes (in lacunae)
the building blocks of mature cells
administer the storage and release of calcium/minerals.

Osteoblasts
build up bone ++
help repair bone when it is damaged

Osteoclasts
help break bone down -

Osteoprogenitor cells
Divide and give off osteoblasts
Increase osteoblast activity for bone healing
Found on innermost periosteum/endosteum
Cuboidal cells – secrete organic components of
Matrix, responsible for “osteogenesis.”

Compact Bone – solid and dense on external surfaces of long and flat bones**KNOW THIS**
a. Osteon – each total set of concentric lamellae/extracellular matrix rings – also known as the “Haversian system” – the basic functional unit of mature compact bone, run as struts to give strength along one direction, parallel to the shaft of the bone.
b. Circumferential Lamellae – at internal and external circumference of bone shafts.
c. Central Canal – supply blood to osteon, run inside the center of the osteon.
d. Perforating canals – supply blood along and between osteons.
e. Interstitial lamellae – those oddly shaped bits of matrix that are sort of filling in between concentric lamellae.
f. Canaliculi – allow for communication between cells

Cancellus/Trabecular or Spongy bone – open lattice of narrow plates of bone (trabeculae) on internal surface of bone and bone ends (epiphysis of long bones)**KNOW THIS**
a. Near the ends of long bones – reduces weight

General structure and gross anatomy of bones **KNOW THIS**
a. Diaphysis – shaft of long bone (cortical/compact bone)
b. Epiphysis – ends of long bones (spongy bone) – bone grows from here.
c. Metaphysis – where the diaphysis begins to spread out and widen into the epiphysis.
d. Periosteum – protects bone, tissue layer overlays bone, provides attachment for vessels and other tissues.

Random Terms and notes to know **KNOW**
Ossification – the formation of bone
a. Intramembranous – flat bones (between or within membranes)
b. Endochondral – long bones (from epiphysis)
1. fetal cartilage
2. calcifies from diaphysis out starting with ‘bone collar’
3. diaphysis becomes primarily bone
4. secondary ossification in epiphysis
5. epiphysial plate (growth plate)
c. Appositional growth – circumferential lamellae increase diameter around shaft of bone.
Blood Vessels of bones – enter through “foramen”
a. Nutrient arteries and veins
b. Metaphyseal arteries and veins
c. Epiphyseal arteries and veins
d. Pereosteal arteries and veins

Classification of fractures/bone injuries (only the more common ones)
Avulsing
Complete
Compound
Compression
Depressed
Epiphyseal
Greenstick
Hairline

Types of bone
Long bones
Flat bones
Pneumatized bones – ethmoid
Short bones
Irregular
Sesamoid - patella