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Textbook of Anatomy and Physiology for Nurses
PR Ashalatha
PART ONE: ANATOMY: SECTION A GENERAL ANATOMY
1:
Introduction to Anatomy
INTRODUCTION
MEDICAL AND ANATOMICAL TERMINOLOGY
The Anatomical Position (Fig. 1.1)
The Anatomical Planes
The Median Plane (Fig. 1.2)
The Sagittal Planes
The Coronal Planes
The Horizontal Planes
TERMS
Terms of Relationship (Table 1.1)
Terms of Movement (Fig.1.5, Table 1.2)
The Meaning of Terms
Examples
APPROACHES IN STUDYING ANATOMY
Regional Anatomy or Topographical Anatomy
Systemic Anatomy (Table 1.4)
Clinical Anatomy
Gross Anatomy and Histology
Gross Anatomy
Histology
Anatomical Variations
2:
Primary Tissues
INTRODUCTION
DEFINITION
CLASSIFICATION
EPITHELIUM
Definition
Meaning
Development
Endothelium
Functions of Epithelium
Classification of Epithelium
Unilaminar or Simple
Simple Squamous Epithelium (Pavement epithelium)
Cuboidal and Columnar Epithelia
Pseudostratified Epithelium
Sensory Epithelia
Myoepitheliocytes or Basket Cells
Compound or Multilaminar Epithelia
Classification
Stratified Squamous Epithelium (Fig. 2.3)
Stratified Cuboidal
Stratified Columnar
Transitional Epithelium or Urothelium (Fig. 2.4)
Glands
Classification of Glands (Flow Chart 2.1)
Endocrine Glands
THE CONNECTIVE TISSUE
Classification (Flow Chart 2.2)
Components of Connective Tissue
Intercellular Substances
Composition
Types of Glycosaminoglycans
Fibres of Connective Tissue (Fig. 2.5)
(i) Collagen Fibres (“One which yields jelly or glue”)
Reticular Fibres
Elastic Fibres
CELLS OF CONNECTIVE TISSUE (FIG. 2.6)
Types of Connective Tissue
Adipose Tissue
Reticular Tissue
3:
Special Connective Tissues
INTRODUCTION
CARTILAGE
Properties
Components
Cells
Ground Substance
Fibres
Hyaline Cartilage (hyalos = glass) (Fig. 3.1)
Fibrocartilage (White Fibrocartilage)—Fig. 3.2
Elastic Cartilage (yellow elastic cartilage)—Fig. 3.3
BONE
Elements of Bone Tissue
Cells
Ground Substance
Gross Structure (Fig. 3.4)
Structure (Fig. 3.5)
Microscopic Structure of Compact Bone (Fig. 3.6)
Parts of a Long Bone and its Blood Supply (Fig. 3.7)
Functions of Bone
Applied Anatomy
4:
Nervous Tissue
INTRODUCTION
NEURONS
The Cell Body
Processes of Neuron
Dendrites
Axon
Classification of Neurons
Synapses
Neurotransmitters
Grey and White Matter
Arrangement of Grey and White Matter
NEUROGLIA
Classification
Macroglia
Microglia
Functions of Neuroglia
Applied Anatomy
5:
Muscle Tissue
INTRODUCTION
Classification
SKELETAL MUSCLE
Specialised Functions of Skeletal Muscles
Structure of Skeletal Muscle (Figs 5.1 and 5.2)
Muscle Fibres
Sarcomere
Innervation of Skeletal Muscle
Attachment of Skeletal Muscle
Common Terms Associated with Muscles
Origin and Insertion
Muscle Tone
Atrophy and Hypertrophy
Agonists and Antagonists
CARDIAC MUSCLE (FIG. 5.6)
SMOOTH MUSCLE
Distribution of Smooth Muscle
6:
Lymphoid Tissue
INTRODUCTION
LYMPH NODES
Structure (Fig. 6.1)
The Cortex
The Medulla
Cells of Lymph Node
Other Cells
Circulation of Lymph Through Lymph Node
Functions of Lymph Nodes
Applied Anatomy
The Cervical Lymph Nodes (Fig. 6.2)
The Axillary Lymph Nodes
Inguinal Lymph Nodes (Fig. 6.3)
The Superficial Inguinal Lymph Nodes
The Lower or Vertical Group
Deep Inguinal Nodes
Applied Anatomy
THE SPLEEN (GK: SPLEN, L: LIEN)—FIG. 6.4
External Features
Blood Supply
Arterial Supply
Venous Drainage
Structure: (Histology) (Fig. 6.5)
Functions of Spleen
Applied Anatomy
THE TONSIL (PALATINE TONSIL)
The Palatine Tonsils or ‘the Tonsils”
Blood Supply
Venous Drainage
Nerve Supply
Lymphatic Drainage
Histology (Fig. 6.6)
Applied Anatomy
THE THYMUS
Histology (Fig. 6.7)
Lymphocytes of Thymus (Thymocytes)
Functions of Thymus
Applied Anatomy
THE THORACIC DUCT (FIG. 6.8)
Applied Anatomy
7:
Skin and its Appendages
INTRODUCTION
THE EPIDERMIS
Stratum Basale
Stratum Spinosum
Stratum Granulosum
Stratum Lucidum (Lucid = Clear)
The Stratum Corneum
THE DERMIS
FUNCTIONS OF SKIN
APPENDAGES OF SKIN
Hairs
Parts of a Hair (Fig. 7.1)
Arrector Pili Muscle
Sebaceous Glands
Functions of Sebum
Modified Sebaceous Glands
Sweat Glands
Typical Sweat Glands
Atypical Sweat Glands
Modified Sweat Glands
Nails
Parts of a Nail
BLOOD SUPPLY OF SKIN
Cutaneous Receptors or Exteroceptive Receptors (Fig. 7.2)
APPLIED ANATOMY
SECTION B: MUSCULOSKELETAL SYSTEM
8:
Osteology
INTRODUCTION
BONES
Functions of Bones
Number of Bones
Classification
According to Position
According to Size and Shape
According to Structure
UPPER LIMB
Shoulder Region
Clavicle: (meaning “Little key”) (Fig. 8.2)
The Scapula (Fig. 8.3)
Upper Arm (Arm or Brachium)
The Humerus (Fig. 8.4)
Forearm Bones (Fig. 8.5)
Radius
Ulna
The Skeleton of Hand
Carpal Bones
Metacarpal Bones
Phalangeal Bones or Phalanges (Singular-phalanx)
THE SKELETON OF LOWER LIMB
The Hip Bone (Fig. 8.7)
Ilium
Iliac Crest
Ischium
Pubis
Femur (Fig. 8.8)
Skeleton of the Leg
Tibia (Fig. 8.9)
Fibula (Latin: Fibula = Pin)
Patella
Skeleton of the Foot (Fig. 8.12)
Tarsal Bones
Metatarsal Bones
Phalanges
Arches of Foot (Fig. 8.14)
SKULL
Introduction
Functions of Skull
Bones of Skull
Joints of Skull
Methods of Study of Skull
Exterior of Skull
Norma Verticalis (Fig. 8.15)
Norma Occipitalis
Norma Frontalis
Norma Lateralis (Fig. 8.17)
Norma Basalis
Interior of the Skull
Internal Surface of Vault
Internal Surface of Base of the Skull
Individual Skull Bones
The Frontal Bone
The Parietal Bones (Fig. 8.20)
Occipital Bone (Fig. 8.21)
Parts of Occipital Bone
Temporal Bone (Fig. 8.22)
The Sphenoid (Fig. 8.23)
Mandible (Fig. 8.24)
Maxilla (Fig. 8.25)
Ethmoid
Foetal Skull (Fig. 8.26)
THE SKELETON OF THE THORAX (THORACIC CAGE)
Formation
Shape
The Inlet of Thorax
The Outlet (Inferior Aperture)
Bones of Thorax
The Ribs (Costae)
Classification
Typical Ribs (Fig. 8.27)
First Rib
Second Rib
Tenth Rib
11th and 12th Ribs
Applied Anatomy—Ribs
The Sternum (Fig. 8.29)
Parts
Length
Manubrium
Sternal Angle or Angle of Louis— Clinical Importance
Body of the Sternum
Applied Anatomy
VERTEBRAL COLUMN (FIG. 8.30)
Curvatures of Vertebral Column
Primary Curvatures
Secondary Curvatures
Parts of a Typical Vertebra
The Body
The Vertebral Arch or Neural Arch
Pedicles
Laminae
The Cervical Vertebrae (Fig. 8.31)
Classification
Typical Cervical Vertebra
Atypical Vertebrae
Atlas
Axis
The Thoracic Vertebrae— 12 in Number (Fig. 8.32)
The Lumbar Vertebrae—5 in Number
Characteristic features(Fig. 8.33)
The Fifth Lumbar Vertebra
The Sacrum (L. the Sacred Bone) (Fig. 8.34)
Base
The Lateral Surface
Apex
Sacral Canal
Contents
Applied Anatomy
The Coccyx
Intervertebral Discs
Structure
Applied Anatomy of Vertebral Column
Movements of Vertebral Column
THE BONY PELVIS (FIG. 8.35)
Boundaries
Boundaries of Pelvic Inlet
Boundaries of Pelvic Outlet
Types
9:
Muscular System
CLASSIFICATION OF MUSCLES
MUSCLES OF THE HEAD
The Craniofacial Muscles
The Occipitofrontalis or the Epicranius
The Muscles of Facial Expression (Fig. 9.1)
Applied Anatomy
Masticatory Muscles (Fig. 9.2)
The Masseter
The Temporalis Muscle
Lateral Pterygoid
The Medial Pterygoid
ANTEROLATERAL MUSCLES OF THE NECK (FIG. 9.3)
Superficial and Lateral Cervical Muscles
Suprahyoid Muscles
Infrahyoid Muscles
Anterior Vertebral Muscles
The Lateral Vertebral Muscles
Platysma (Gk – flat plate)
Nerve Supply
The Sternocleidomastoid Muscle (Fig. 9.3)
Origin
Insertion
Relations
Nerve Supply
Action
Clinical Relevance
MUSCLES OF THE TRUNK
Deep Muscles of the Back
Muscles of the Thorax
Intercostal Muscles (Fig. 9.4)
The Diaphragm (Fig. 9.5)
Muscles of the Abdomen—Fig. 9.6
Muscles of the Anterior Abdominal Wall
External oblique muscle of abdomen
Muscles of the Posterior Abdominal Wall
Muscles of the Pelvis (Fig. 9.8)
The Levator Ani Muscles
The Piriformis
Relations
MUSCLES OF THE SHOULDER GIRDLE AND UPPER LIMB
The Rhomboideus Muscles or Rhomboid Muscles (Fig. 9.10)
Rhomboid Major
Rhomboid Minor
Trapezius (Fig. 9.11)
Serratus Anterior (Fig. 9.12)
Supraspinatus and Infraspinatus (Fig. 9.13)
Actions
Deltoid (Fig. 9.13)
Origin
Insertion
Nerve Supply
Action
Structures Under Cover of the Deltoid
Applied Anatomy
The Pectoralis Major (Fig. 9.14)
Origin
Insertion
Nerve Supply
Actions
The Pectoralis Minor (Fig. 9.15)
Origin
Insertion
Nerve supply
Action
Latissimus Dorsi (Fig. 9.16)
Origin
Insertion
Nerve Supply
Actions
Triangles
Muscles of the Arm
The Anterior Compartment
Muscles of the Posterior Compartment (Extensor Compartment)
Muscles of the Forearm
Posterior (Extensor) Compartment of Forearm
Intrinsic Muscles of the Hand
Thenar Muscles
Adductor Pollicis
Hypothenar Muscles
The Palmaris Brevis
Lumbrical Muscles (Fig. 9.23)
Interosseous Muscles
Flexor Retinaculum of the Hand (Fig. 9.24), (also see Fig. 8.6)
Attachments
Relations
Applied Anatomy
MUSCLES OF THE LOWER LIMB
Muscles of the Gluteal Region (Fig. 9.25)
Extent of Gluteal Region
The Tensor Fasciae Latae
The Gluteus Medius
Gluteus Minimus
Muscles of the Thigh (Fig. 9.26)
Subdivisions of the Thigh
The Extensor Muscles
The Adductor Muscles (Fig. 9.28)
Muscles of the Posterior Compartment (Flexors or Hamstrings)
Muscles of the Leg (Fig. 9.29)
Muscles of the Anterior Compartment of Leg (Fig. 9.30)
Extensor Digitorum Longus
Extensor Hallucis Longus
Retinacula (Fig. 9.31)
Muscles of the Lateral (Peroneal) Compartment (Fig. 9.32)
Muscles of the Posterior (Flexor) Compartment
Superficial Muscles (Fig. 9.33)
Origins
Deep Flexor Muscles (Fig. 9.34)
Muscles of the Foot
Plantar Muscles
Intrinsic Muscle of the Dorsum of the Foot— The Extensor Digitorum Brevis
Other Functions of the Intrinsic Muscles of the Foot
10:
Joints
INTRODUCTION
CLASSIFICATION OF JOINTS (TABLE 10.1)
Fibrous Joints (Fig. 10.1)
Sutures or Sutural Joints (Fig. 10.1A)
Syndesmosis (Syndesmos = Ligament) (Fig. 10.1B)
Gomphosis
CARTILAGINOUS JOINTS
Primary Cartilaginous Joints (Fig. 10.2A) (Hyaline Cartilaginous Joints or Synchondroses)
Secondary Cartilaginous Joints (Fibro- cartilaginous Joints or Symphyses) (Fig. 10.2B)
SYNOVIAL JOINTS
Joint Cavity
Articular Cartilage
Ligaments
Different Types of Synovial Joints (Fig. 10.4)
Ball and Socket Joint (Fig. 10.4A)
Hinge Joint (Fig. 10.4B)
Pivot Joint (Fig. 10.4C)
Condyloid Joint or Ellipsoid Joint (Fig. 10.4D)
Saddle Joint or Sellar Joint (Fig. 10.4E)
Plane Joint (Fig. 10.4F)
JOINTS OF THE UPPER LIMB
Joints of the Shoulder Girdle (Fig. 10.5)
The Sternoclavicular Joint
The Acromioclavicular Joint
The Shoulder Joint or the Glenohumeral Joint (Fig. 10.6)
Bones Forming the Joint
Ligaments
Relations of Shoulder Joint
Bursae Around the Joint
Applied Anatomy
The Elbow Joint (Figs 10.7A and B)
Humeroulnar Part (Fig. 10.7A)
Humeroradial Part (Fig. 10.7B)
Relations of Elbow Joint
Applied Anatomy
The Radioulnar Joints
The Superior Radioulnar Joint (Fig. 10.8A)
Middle Radioulnar Joint (Fig. 10.8B)
Inferior Radioulnar Joint
Wrist Joint (Fig. 10.9)
Bones Forming the Joint
Ligaments
Relations
Movements and Muscles Producing them
Applied Anatomy
Carpometacarpal Joint of the Thumb (Fig. 10.10)
Bones Forming the Joint
Ligaments
Relations
Movements (Fig. 10.11) and Muscles Producing Them
JOINTS OF THE LOWER LIMB
Hip Joint (Fig. 10.12)
Type
Articular Ends
Ligaments
The Capsule
Transverse Ligament
Iliofemoral Ligament (Ligament of Bigelow) (Fig. 10.13)
Pubofemoral Ligament
Ischiofemoral Ligament
Ligament of the Head of the Femur
Relations of Hip Joint
Unique Features of the Hip Joint
Applied Anatomy
The Knee Joint (Fig. 10.14)
Articular Surfaces
Ligaments of Knee Joint
Bursae Around the Knee Joint
Applied Anatomy
The Ankle Joint (Fig. 10.15)
Bones Forming the Joint
Ligaments
Movements (Fig. 10.16)
Muscles Producing Movements
Applied Anatomy
The Subtalar Joint
Inversion
Eversion
SECTION C: THE ORGAN SYSTEMS
11:
Cardiovascular System
INTRODUCTION
THE HEART
Chambers of Heart (Fig. 11.1)
Base, Apex and Surfaces
The Base of the Heart
The Apex of the Heart
Borders
COURSE OF BLOOD THROUGH THE HEART (Fig. 11.3)
Systemic Circulation (Flow Chart 11.1)
The Pulmonary Circulation (Fig. 11.3)
EXTERNAL AND INTERNAL FEATURES OF CHAMBERS OF THE HEART
The Right Atrium
The Right Ventricle
The Left Atrium
The Left Ventricle
Applied Anatomy
BLOOD SUPPLY OF HEART (FIG. 11.4)
Arterial Supply
The Right Coronary Artery (RCA)
The Left Coronary Artery (LCA)
Applied Anatomy
Venous Drainage of the Heart (Fig. 11.6)
Tributaries
Coverings of the Heart
Nerve Supply of Heart
Conducting System of the Heart
Parts
Applied Anatomy
BLOOD VESSELS
General Structure (Histology) of Blood Vessels (Fig. 11.7)
The Tunica Intima
The Tunica Media
The Tunica Adventitia
Veins
Structure of a Large Artery (e.g. Aorta) or Elastic Artery (Fig. 11.8)
Function of Large (Elastic) Arteries
Structure of Medium Sized (Muscular) Arteries or Distributing Arteries (Fig. 11.9)
Functions
Structure of a Large Vein (e.g. Venae Cavae) (Fig. 11.10)
THE AORTA
Parts
THE ASCENDING AORTA
Branches
THE ARCH OF THE AORTA (FIG. 11.11)
Course
Important Relations
Applied Anatomy
Branches of the Arch of Aorta
The Brachiocephalic Artery (or Trunk)
The Common Carotid Arteries (CCA) (Fig. 11.12)
The External Carotid Artery (Fig. 11.12)
Branches (8 branches)
The Internal Carotid Artery (Figs 11.12 and 11.13)
Cervical Part
The Petrous Part
The Cavernous Part
The Cerebral Part
Applied Anatomy
The Subclavian Artery (Fig. 11.14)
Branches
The Vertebral Artery (Fig. 11.15)
Parts
Branches
The Axillary Artery (Fig. 11.16)
Branches (Table 11.1)
The Brachial Artery (Fig. 11.16)
Branches
The Radial Artery (Fig. 11.16)
Branches
The Ulnar Artery (Fig. 11.16)
Palmar Arches (Fig. 11.16)
The Superficial Palmar Arch
The Deep Palmar Arch
THE DESCENDING AORTA (FIG. 11.17)
The Thoracic Part
Relations
Branches
The Abdominal Aorta (Fig. 11.18)
Relations
Branches
The Coeliac Trunk (Fig. 11.19)
Structures Supplied by Coeliac Trunk
Branches
The Superior Mesenteric Artery (Fig. 11.20)
Branches
The Inferior Mesenteric Artery (Fig. 11.21)
Branches
The Common Iliac Arteries (Fig. 11.18)
The External Iliac Artery
The Internal Iliac Artery
Branches from the Anterior Division
Branches from the Posterior Division
ARTERIES OF LOWER LIMB (FIG. 11.22, FLOW CHART 11.2)
Femoral Artery
Relations
Applied Anatomy
The Popliteal Artery
Branches
Applied Anatomy
Arteries of the Leg
Anterior Tibial Artery
Posterior Tibital Artery
Dorsalis Pedis Artery (Dorsal artery of the foot) pes = foot
Applied Anatomy
THE EFFECTS OF ARTERIAL OCCLUSION
Ischaemia
Atherosclerotic Obstruction
Gangrene
Clinical Features of Gangrene
“Claudication” (claudicare = to limp. Claudius, a Roman Emperor, walked with a limp)
VEINS
Factors Affecting Venous Return
THE VEINS OF HEAD AND NECK
Veins of the Face (Fig. 11.23)
Supratrochlear Vein
Supraorbital Vein
Facial Vein
The Superficial Temporal Vein
Applied Anatomy
Dural Venous Sinuses (Figs 11.25 A and B)
Classification
Paired Dural Sinuses
Unpaired Dural Venous Sinuses
The Cavernous Sinuses (Fig. 11.26)
Relations
Connections of Cavernous Sinus
Applied Anatomy
The Superior Sagittal Sinus
Inferior Sagittal Sinus
The Straight Sinus
The Transverse Sinuses
Confluence of Sinuses
Sigmoid Sinuses
Veins of the Neck
The Anterior Jugular Vein
The External Jugular Vein (Fig. 11.23)
The Internal Jugular Vein
The Subclavian Vein
VEINS OF THE UPPER LIMB
The Superficial Veins (Fig. 11.27)
The Cephalic Vein
Basilic Vein
The Median Cubital Vein
The Deep Veins
VEINS OF THE THORAX (FIGS 11.28 AND 11.29)
The Brachiocephalic Veins
Tributaries
The Superior Vena Cava (Fig. 11.28)
The Azygos System of Veins (Fig. 11.29) (Azygos = Unpaired)
The Azygos Vein
The Hemiazygos Vein
The Accessory Hemiazygos Vein
Intercostal Veins
VEINS OF THE ABDOMEN
The Portal Vein (Fig. 11.31)
Formation
Tributaries
Communications Between the Portal and Systemic Veins—the Portosystemic Anastomoses
Applied Anatomy
VEINS OF LOWER LIMB (FIGS 11.32A AND B)
The Superficial Veins
The Deep Veins
The Perforating Veins
Factors Assisting Venous Return from Lower Limb
The Great Saphenous Vein or the Long (Fig. 11.32A) Saphenous Vein: (Saphenous = Easily Seen)
The Small Saphenous Vein (The Short Saphenous Vein) (Fig. 11.32B)
Applied Anatomy of Superficial Veins
Deep Veins of Lower Limb
The Popliteal Vein
The Femoral Vein
VENOUS THROMBOSIS
Predisposing Factors—“Virchow's Triad”
Superficial Vein Thrombosis (Thrombophlebitis)
Deep Vein Thrombosis (Phlebothrombosis)
Prevention of Deep Vein Thrombosis
12:
Respiratory System
INTRODUCTION
EXCHANGE OF GASES
External Respiration
Internal Respiration
The Air Passages (Flow chart 12.1)
THE NOSE AND NASAL CAVITY
External Features
Nasal Cavity
Subdivision of Nasal Cavity
Boundaries of Nasal Cavity
The Medial Wall or the Nasal Septum (Fig. 12.1)
Components
Blood Supply of Septum (Fig. 12.2)
Applied Anatomy
The Lateral Wall of Nose (Fig. 12.4)
Superior Meatus
Middle Meatus
Paranasal Air Sinuses
Functions of Paranasal Sinuses
The Frontal Sinus
The Ethmoidal Sinuses
The Maxillary Sinus (Antrum of Highmore)
Sphenoidal Sinus
Applied Anatomy
PHARYNX
THE LARYNX
Size
The Skeleton (Cartilages) of Larynx (Fig. 12.5)
Unpaired Cartilages
The Paired Cartilages
The Thyroid Cartilage
The Cricoid Cartilage
The Epiglottis
Arytenoid Cartilages
Ligaments of Larynx
The Cavity of the Larynx (Fig. 12.6)
Extent
The Vestibule
Sinus or the Ventricle of the Larynx
Muscles of Larynx
Classification
Innervation of the Muscles of Larynx
Sensory Supply
Recurrent Laryngeal Nerves
Applied Anatomy
THE MEDIASTINUM (L. MIDDLE SEPTUM) (FIG. 12.8)
Subdivisions of Mediastinum
The Superior Mediastinum
Contents
Anterior Mediastinum
Contents
Middle Mediastinum
Boundaries
Contents
Posterior Mediastinum
Mediastinum—Surgical Importance
Common Causes
THE TRACHEA (FIG. 12.9)
Extent
The Cervical Part (Fig. 12.10)
Relations
Relations of Thoracic Part
Histology (Fig. 12.11)
Carina
Applied Anatomy
Tracheostomy
Other Indications for Tracheostomy
THE BRONCHI
The Right Principal Bronchus
Relations
The Left Principal Bronchus
Bronchoscopy
Further Division of Bronchi
THE LUNGS (FIG. 12.13)
Apex
Base
Border
Anterior Border
Posterior Border
Surfaces
Costal Surface
Medial Surface
Mediastinal Surface
Lobes and Fissures (Fig. 12.13)
The Bronchopulmonary Segments (Fig. 12.16 and Table 12.4)
Bronchopulmonary Segments of Right Lung
Bronchopulmonary Segments of Left Lung
Applied Anatomy
Blood Supply of Lungs
The Pulmonary Artery
The Pulmonary Veins
The Bronchial Artery
Histology (Fig. 12.17)
Alveoli
Intrapulmonary Passages
Connective Tissue
Nerve Supply of Lungs
Lymphatic Drainage of Lungs
THE PLEURA (FIG. 12.19)
Visceral Layer
Parietal Pleura
The Costal Pleura
The Mediastinal Pleura
Cervical Pleura
Pulmonary Ligament
Pleural Recesses (Figs 12.19 and 12.20)
Costomediastinal Recess
Costodiaphragmatic Recess
The Nerve Supply of Pleura
Applied Anatomy
Applied Anatomy (Lungs)
Bronchogram
13:
Digestive System
INTRODUCTION
PROCESS OF DIGESTION (FLOW CHART 13.1)
Ingestion
Digestion
Absorption
PARTS OF DIGESTIVE SYSTEM (FIG. 13.1)
MOUTH
Lips
Cheeks
Oral Cavity Proper
Boundaries
Gums
Teeth
Parts and Type of Teeth (Fig. 13.2)
Structure of a Tooth (Fig. 13.2)
Vessels of Teeth
Nerves of Teeth
Palate (Fig. 13.3)
Parts
The Hard Palate (Fig. 13.3)
The Soft Palate
Nerves of the Palate
Functions of Soft Palate
Tongue
Parts
Functions
The Dorsal Surface
The Ventral Surface
Muscles of Tongue (Fig. 13.6)
Motor Nerve Supply (Fig. 13.7)
Sensory Nerve Supply (Fig. 13.7)
Blood Supply
Lymphatic Drainage
Histology (Fig. 13.8)
Taste Buds
Applied Anatomy
PHARYNX (FIG. 13.1)
Parts of Pharynx
Nasopharynx
Oropharynx
Waldeyer's Ring (Fig. 13.10)
Laryngopharynx
Muscles of Pharynx
Nerve Supply of Pharynx
Applied Anatomy
Salivary Glands
Major Salivary Glands
Minor Salivary Glands
Parotid Gland (Para = near; otis – ear)
Relations (Fig. 13.11) within the Gland
Applied Anatomy
Submandibular Gland (Fig. 13.12)
Applied Anatomy
Sublingual Salivary Gland (Fig. 13.13)
THE OESOPHAGUS
Length
Diameter
Parts
External Appearance
Constrictions of Oesophagus
Important Relations (Figs 12.9 and 12.10)
Cervical Part
Thoracic Part
Histology (Fig. 13.14)
Applied Anatomy
Regions of Abdomen (Fig. 13.15)
The Transpyloric Plane (TPP)
Transtubercular Plane (TTP)
Quadrants of the Abdomen
STOMACH
Position
Shape (Fig. 13.16)
Capacity
Functions of Stomach
Parts of Stomach (Fig. 13.16)
Cardiac Part
Fundus
Body of the Stomach
Pyloric Part of the Stomach
Pylorus
Relations
The Left Border or Greater Curvature
Relations of Anterior Surface
Relations of Posterior Surface
Blood Supply of Stomach (Fig. 13.19)
Arterial Supply
Venous Drainage
Lymphatic Drainage (Fig. 13.21)
Nerve Supply
Interior of Stomach
Histology (Fig. 13.24)
Mucosa
Submucosa
Muscular Coat
Serosa
Applied Anatomy
THE SMALL INTESTINE
Extent
Parts
Important Features
THE DUODENUM (FIG. 13.25)
Jejunum and Ileum
The Mesentery of Jejunum and Ileum
Arterial Supply of Jejunum and Ileum
Applied Anatomy
Histology of Small Intestine (Fig. 13.29)
THE LARGE INTESTINE
Parts
The Caecum (Fig. 13.30)
The Vermiform Appendix (L: vermis = worm; forma = form)
Arterial Supply of Caecum and Appendix
Histology of Large Intestine (Fig. 13.33)
Applied Anatomy—Vermiform Appendix
The Ascending Colon (GK kolos = large intestine)
The Transverse Colon
The Descending Colon
The Sigmoid Colon
Blood Supply of Large Intestine
Rectum
The Shape and Flexures of Rectum
Relations
Applied Anatomy
The Anal Canal
Interior of Anal Canal (Fig. 13.35)
Anal Sphincters (Fig. 13.36)
Portocaval (Portosystemic) Anastomosis
The Ischiorectal (Ischioanal) Fossae (Fig. 13.38)
THE PERINEAL BODY (FIG. 13.39)
THE PERITONEUM (FIG. 13.40)
The Lesser Sac of Peritoneum or Omental Bursa
Boundaries of Epiploic (omental) Foramen
Mesentery
Omentum (Fig. 13.41)
Peritoneal Ligament
Peritoneal Recesses
Hepatorenal Pouch (Morison's Pouch)
Pouch of Douglas or Rectouterine Pouch (Fig. 13.42)
Applied Anatomy of Peritoneum
THE ACCESSORY ORGANS OF DIGESTION
The Liver
Position (Fig. 13.43)
Shape
Lobes (Fig. 13.44)
Functional or Physiological Lobe (Fig. 13.46)
Peritoneal Folds of Liver
Relations of Liver
Inferior Surface of Liver (Fig. 13.47) (Visceral Surface)
Histology (Fig. 13.48)
Functions of Liver
Applied Anatomy
Extrahepatic Biliary Apparatus (Fig. 13.49)
The Right and Left Hepatic Ducts
The Common Hepatic Duct
The Gallbladder
Parts of Gallbladder
Calot's Triangle or Triangle of Cystic Artery (Fig. 13.49)
Applied Anatomy
Pancreas
Dimensions
Parts (Fig. 13.51)
Body of Pancreas
Tail of the Pancreas
Ducts of Pancreas (Fig. 13.52)
Arterial Supply
Nerve Supply
Histology (Fig. 13.53)
Applied Anatomy
14:
Urinary System
INTRODUCTION
COMPONENTS OF URINARY SYSTEM (FIG. 14.1)
THE KIDNEYS (RENES; NEPHROS)
Shape and Size
Measurements
Coverings
Surface Anatomy
Relations
Posterior Relations (Fig. 14.3)
Anterior Relations (Fig. 14.4)
Structure (Fig. 14.5)
Macroscopic
Microscopic Structure (Histology) (Fig. 14.6)
Parts of a Nephron (Fig. 14.7)
Correlation of Structure and Function of a Nephron (Table 14.1)
Juxtaglomerular Apparatus (Fig. 14.8)
Blood Supply of Kidney
Nerve Supply
Applied Anatomy
THE URETERS
Length
Extent
Parts
Constrictions
Important Relations (Figs 14.10A and B)
Blood Supply
Nerve Supply
Histology (Fig. 14.11)
Applied Anatomy
URINARY BLADDER (FIG. 14.12)
Shape
Position
Capacity
Relations (Fig. 14.13)
Interior of Bladder (Fig. 14.15)
Histology (Fig. 14.16)
Blood Supply
Nerve Supply
Applied Anatomy
URETHRA
Female Urethra
Male Urethra (Fig. 14.17)
Prostatic Part (Fig. 14.17B)
Membranous Part
Spongy or Penile Part
Sphincters
Applied Anatomy
RADIOLOGICAL ANATOMY OF URINARY SYSTEM
15:
Reproductive System
FEMALE ORGANS OF REPRODUCTION
Mons Pubis (Mons = Mountain)
Labia Majora (Labia Majora = Large Lips) (Singular Labium Majus)
Labia Minora (= Small Lips) (Singular Labium Minus)
Vestibule of the Vagina (Vestibulum = Ante Chamber)
The Greater Vestibular Glands (Bartholin's Glands)
Clitoris
Bulbs of the Vestibule
Arterial Supply
Venous Drainage
Nerve Supply
Lymphatic Drainage
Applied Anatomy
UTERUS (L.WOMB), “HYSTERA” (FIG. 15.2)
Dimensions
Parts of the Uterus
Fundus
Cervix
Wall of the Uterus
Position (Fig. 15.3)
Relations (Fig. 15.4)
Anterior Surface or Vesical Surface
The Posterior Surface
Lateral Borders
Other Structures in the Broad Ligament
Supports of Uterus (Figs 15.5A and B)
Muscular Support
Pelvic Diaphragm
The Perineal Body (Fig. 13.39)
The Urogenital Diaphragm
Fibromuscular Ligaments (Fig. 15.5A)
The Pubocervical Ligaments
The Transverse Cervical Ligaments (or Mackenrodt's Ligaments or Cardinal Ligaments)
The Uterosacral Ligaments
The Round Ligaments of Uterus
Peritoneal Ligaments
Broad Ligaments
Blood Supply of Uterus
Arterial Supply
Venous Drainage
Lymphatic Drainage
Nerve Supply
Histology of Uterus (Figs 15.6A and B)
Applied Anatomy
UTERINE TUBES OR FALLOPIAN TUBES (FIG. 15.7)
Functions
Parts
The Ampulla
The Isthmus
The Uterine or Intramural Portion
Arterial Supply
Lymphatic Drainage
Nerve Supply
Sympathetic
Parasympathetic
Histology
Applied Anatomy
OVARIES (FIG. 15.9)
Boundaries of Ovarian Fossa
Size
Surface and Colour
Relations
Poles
Surfaces
Border
Blood Supply
Nerve Supply
Lymphatics
Histology
Medulla
Cortex
Oogenesis
Applied Anatomy
VAGINA (GK – KOLPOS)
Relations
The Wall of the Vagina has 3 Coats
Vaginal Examination
The Hymen
Imperforate Hymen
MAMMARY GLAND OR BREAST
Base
Nipple
Areola
Axillary Tail of Spence
Structure (Figs 15.12A and B)
Glandular Tissue
Blood Supply
Arterial Supply
Nerve Supply
Lymphatic Drainage (Fig. 15.13)
BREAST CANCER
Reason for Fixation of the Tumour
Retraction of Nipple
Peau D'Orange (“The Skin of an Orange”)
Mammography
Treatment
PENIS (L-TAIL) (FIG. 15.14)
The Body of Penis (Fig. 15.15)
Arteries of Penis
Deep Artery
Dorsal Artery
Artery of the Bulb
The Veins
Nerve Supply
Lymphatic Drainage
The Anatomical Basis of Erection
Applied Anatomy
Congenital Anomalies
Phimosis
Circumcision
SCROTUM
Layers of Scrotum
Nerve Supply
Lymphatic Drainage
Contents
Function
TESTES (SINGULAR TESTIS)
Size
External Features (Fig. 15.16)
Coverings of the Testis
Tunica Vaginalis
Tunica Albuginea
Tunica Vasculosa
Structure of Testis (Fig. 15.17)
The Spermiogenesis
Structure of a spermatozoon (sperm) (see Fig. 27.1)
Arterial Supply of Testis
Venous Drainage
Lymphatic Drainage
Nerve Supply
Descent of the Testes
Applied Anatomy
EPIDIDYMIS
SPERMATIC CORD
Constituents of Spermatic Cord
Coverings of Spermatic Cord
Varicocele (Varicose Veins of Spermatic Cord)
THE VAS DEFERENS OR DUCTUS DEFERENS (FIGS 14.14 AND 14. 17)
Structure (Fig. 15.18)
Vasectomy (Cutting the Vas Deferens)
SEMINAL VESICLES AND EJACULATORY DUCTS
The Ejaculatory Ducts
PROSTATE (FIG. 15.19)
Lobes (Fig. 15.20)
Relations of Prostate (see Figs 14.13 and 14.14–Urinary System, Fig. 15.19)
The Prostatic Urethra
Applied Anatomy
THE MALE URETHRA
16:
Nervous System
INTRODUCTION
DIVISIONS OF NERVOUS SYSTEM
The Brain
Brainstem
Tissues Constituting the Nervous System
Meninges (Fig. 16.1)
The Dura Mater (Meaning—“Tough Mother”)
Pia Mater
Applied Anatomy
VENTRICLES OF THE BRAIN (FIG. 16.2)
The Lateral Ventricles
Third Ventricle
Fourth Ventricle
Choroid Plexuses
Components
Cerebrospinal Fluid (CSF)
Flow of CSF
Constituents
Functions of CSF
Applied Anatomy
Blood-brain Barrier
Constituents (Fig. 16.4)
Verticulography
Other Methods
THE BRAIN (FIG. 16.5)
The Cerebrum
External Features
Important Sulci (Singular-Sulcus) (Fig. 16.8)
The Central Sulcus or the Fissure of Rolando
The Lateral Sulcus or the Fissure of Sylvius
The Parieto-occipital Sulcus
Calcarine Sulcus
Important Gyri (Fig. 16.8)
Lobes
Important Functional Areas (Fig. 16.9)
Motor area or Area 4
Premotor Area (Area 6)
Motor Speech Area of Broca (Area 44 and 45)
Sensory Area (Areas 3, 1 and 2)
Visual Area
Visuosensory Area or Area 17
Visuopsychic or Psychovisual Area (Areas 18 and 19)
Auditory Area or Acoustic Area (Area 41-42)
Parietal Lobe or Parietal Area
BLOOD SUPPLY OF CEREBRUM
Introduction
Vertebral Arteries
Carotid System
The Circulus Arteriosus or the Circle of Willis (Fig. 16.10)
Venous Drainage
Applied Anatomy
Functions of Cerebrum
DIENCEPHALON
Subdivisions
Thalamus (Fig. 16.12)
Anterior Group of Nuclei
Medial Group of Nuclei
Ventral Group of Nuclei
Connections and Functions
Applied Anatomy
Hypothalamus
Important Nuclei
Functions
Other Functions
Applied Anatomy
Basal Nuclei (Ganglia) (Fig. 16.13)
Caudate Nucleus
Lentiform Nucleus
Amygdaloid Body
Applied Anatomy
WHITE MATTER OF CEREBRUM
Association Fibres
Projection Fibres
Commissural Fibres
Corpus Callosum (Figs 16.16 and 16.17)
Parts
Fibres of Corpus Callosum
Functions
The Internal Capsule (Fig. 16.19)
Parts of Internal Capsule (Fig. 16.20)
Applied Anatomy
Brainstem (Fig. 16.21)
Midbrain
The Pons (Fig. 16.21)
The Medulla Oblongata (Medulla, “bulb”) (Fig. 16.21)
The Cerebellum (Cerebellum = Little Brain)
Functions
THE SPINAL CORD
External Features (Fig. 16.24)
Coverings of Spinal Cord
Dura Mater
Extradural or Epidural Space
Arachnoid Mater
Pia Mater
Internal Features (Fig. 16.25)
Blood Supply
Applied Anatomy
CRANIAL NERVES (CN)
Meaning/Explanation
Olfactory Nerve—CN I (Chapter 18, Fig. 18.1)
Applied Anatomy
Optic Nerve—CN II
Applied Anatomy
Oculomotor Nerve—CN lll (Fig. 16.28B)
Applied Anatomy
Trochlear Nerve—CN IV (Fig. 16.28A)
Trigeminal Nerve—CN V (Fig. 16.28B)
Ophthalmic Nerve
Mandibular Nerve
Applied Anatomy
Abducent Nerve—CN VI or Abducens
Applied Anatomy
Facial Nerve—CN VII (Fig. 16.28B)
Distribution of Nervus Intermedius
Course
Branches
Posterior Auricular
Temporal Branch
Zygomatic Branch
Buccal Branch
Marginal Mandibular
Cervical Branch
Applied Anatomy
Vestibulocochlear—CN VIII
Applied Anatomy
Glossopharyngeal Nerve—CN IX
Function
Applied Anatomy
Vagus Nerve—CN X
Functions
Lesions of Vagus Nerve
Bulbar Palsy
Accessory Nerve—CN XI
Summary
Applied Anatomy
Hypoglossal Nerve—CN XII
Applied Anatomy
NERVI TERMINALIS—CN XIII
SUMMARY OF CRANIAL NERVES
NERVE PLEXUSES
Cervical Plexus
Brachial Plexus (Fig. 16.29)
Typical Plan of Brachial Plexus
Important Branches of Brachial Plexus
BRACHIAL PLEXUS INJURIES
Erb's Paralysis
Klumpke's Paralysis
Deformity in Klumpke's Paralysis
Musculocutaneous Nerve (C5,6,7)
Median Nerve or “Labourer's nerve” (Figs 16.29 and 16.30)
Area of Distribution of Median Nerve
Applied Anatomy
Ulnar Nerve
Branches of Ulnar Nerve (Motor)
Applied Anatomy
Radial Nerve
Applied Anatomy
Axillary Nerve (Fig. 16.31)
Applied Anatomy
Lumbar Plexus (Fig. 16.32)
Branches
Femoral Nerve
Obturator Nerve
Sacral Plexus (Fig. 16.33)
Sciatic Nerve (Fig. 16.34)
Branches
Applied Anatomy
Pudendal Nerve
Branches
Applied Anatomy
AUTONOMIC NERVOUS SYSTEM (ANS)
Definition
Subdivisions of ANS
Sympathetic System (Thoraco-lumbar outflow)
Parasympathetic Nervous System (Craniosacral Outflow)
Applied Anatomy
Visceral Referred Pain
Lumbar Sympathectomy
Syringing
Horner's Syndrome
17:
Endocrine System
INTRODUCTION
LOCAL HORMONES AND GENERAL HORMONES
Major Endocrine Glands
Other Endocrine Glands
THE HYPOPHYSIS CEREBRI OR PITUITARY (FIG. 17.1)
Important Relations (Fig. 17.2)
Blood Supply
Histology (Fig. 17.3)
Anterior Lobe (Pars Anterior)
Intermediate Lobe (Pars Intermedia)
Posterior Lobe (Pars Posterior)
Pars Posterior—Neurohypophysis
Hormones
Control of Secretion of Hormones of the Adenohypophysis
“Negative Feedback” in the Control of Hormone Secretion
Applied Anatomy
THE THYROID GLAND (thyroid = Shield-like)
Position
Parts
Capsules
Relations (Fig. 17.5)
Surfaces
Posterior Surface
Medial Surface
Isthmus
Blood Supply (Fig. 17.6)
Arterial Supply
Venous Drainage
Nerve Supply
Lymphatic Drainage
Histology (Fig. 17.7)
Applied Anatomy
THE PARATHYROIDS (FIG. 17.8)
Position
Blood Supply
Development
Histology (Fig. 17.8)
Applied Anatomy
THE SUPRARENAL OR ADRENAL GLANDS
Position
Shape
Sub-divisions (Fig. 17.10)
Important Relations
Right Suprarenal
The Left Suprarenal
Blood Supply
Histology (Fig. 17.11)
Cortex
The Medulla
Functions of Cortex
Control of Adrenal Cortex
Applied Anatomy
PINEAL GLAND (“EPIPHYSIS CEREBRI”)
Function
PANCREAS
INTERSTITIAL CELLS OF TESTES
OVARIAN HORMONES (FIGS 15.9 AND 15.10 CHAPTER 15 REPRODUCTIVE SYSTEM)
Placenta
18:
Sense Organs
INTRODUCTION
CLASSIFICATION OF SENSATIONS
SENSE OF SMELL OR OLFACTION
Mechanism
THE SENSE OF TASTE
Sensory Nerves of Tongue
SENSE OF HEARING
Functions
External Auditory Meatus
Nerve Supply
Applied Anatomy
Tympanic Membrane (Fig. 18.3)
Nerve Supply
Applied Anatomy
The Middle Ear
Parts
Communications
Boundaries
Contents of Middle Ear
Ear ossicles (Fig. 18.4)
Muscles of Middle Ear
Function
The Auditory Tube
Lining
Applied Anatomy: Middle Ear
Other Complication of Otitis Media
The Internal Ear (Fig. 18.5)
The Bony Labyrinth
The Cochlea (L = Snail Shell)
The Vestibule
The Semicircular Canals
Membranous Labyrinth
Parts
Mechanism of Hearing (Summary)
Applied Anatomy
THE SENSE OF VISION (SIGHT)
The Living Eye
Essential Organs
Accessory Organs
The Eyebrows
The Eyelids or Palpebrae
Functions of Eyelids
Applied Anatomy
The Lacrimal Apparatus (Fig. 18.6)
The Lacrimal Gland
The Conjunctival Sac
Lacrimal Puncta and Canaliculi
The Lacrimal Sac
Extraocular Muscles (Fig. 18.7)
Rectus Muscles (Fig. 18.7A)
The Oblique Muscles (Fig. 18.7B)
Levator Palpebrae Superioris; (Muscle which Elevates the Upper Eyelid)
Insertion
Action
Nerve Supply of the Muscles of the Orbit
The Actions of the Extraocular Muscles
Applied Anatomy
The Eyeball (Fig. 18.8)
Structure (Table 18.1, Fig. 18.8)
Fibrous Coat
The Sclera (SKLEROS = HARD)
The Cornea
The Vascular Coat
The Choroid
The Ciliary Body
The Iris
Nervous Coat
The Retina
Histology (Fig. 18.10)
The Light Transmitting Media or Refractive Media
The Aqueous Humor
The Lens
The Vitreous Body
Summary of the Sense of Light (Visual Pathway Fig. 18.11)
Applied Anatomy
19:
Appendix
THE ADDUCTOR CANAL (FIG. 19.1)
Extent
Boundaries
Contents
THE AXILLA (FIG. 19.2)
Boundaries
Apex
Base
Walls
Contents
THE CAROTID SHEATH (SEE FIG. 17.5)
Contents
Relations
THE CUBITAL FOSSA (FIG. 19.3)
Boundaries
Contents
THE FEMORAL TRIANGLE (FIG. 19.4)
Boundaries
Contents
THE FEMORAL SHEATH (FIG. 19.5)
Formation
The Fascia Transversalis
The Fascia Iliaca
Function
Subdivisions
The Lateral Compartment
The Intermediate Compartment
The Medial Compartment or the Femoral Canal
Contents
Femoral Hernia
THE INGUINAL LIGAMENT (POUPART'S LIGAMENT) (FIG. 19.6)
Extent
Attachments
Relations
Extensions
Lacunar Ligament
The Reflected Part
The Pectineal Ligament (Pectinate Ligament)
Middle Point of Inguinal Ligament
Mid Inguinal Point
INGUINAL CANAL
Extent
The Deep Inguinal Ring
The Superficial Inguinal Ring
Boundaries of Inguinal Canal
Structures Passing Through Inguinal Canal
INGUINAL HERNIA
Types of Hernia
Indirect Inguinal Hernia
Direct Inguinal Hernia
THE POPLITEAL FOSSA (FIG. 19.9)
Boundaries
Contents
Popliteal Artery
THE SCALP (FIG. 19.10)
Extent
Structure
Skin
Dense Connective Tissue
Aponeurosis of Occipitofrontalis
Loose Areolar Connective Tissue
Pericranium
Blood Supply of Scalp
Nerve Supply
Applied Anatomy
TRIANGLES OF NECK (FIG. 19.11)
Boundaries
Posterior Triangle
Boundaries and Contents
Apex
Contents
Nerves
Vessels
The Anterior Triangle
Boundaries
Subdivisions of Anterior Triangle (Fig. 19.11B)
Submental Triangle
Digastric Triangle or Submandibular Triangle
Carotid Triangle
Muscular Triangle
Model Question Paper-I 1 Year BSc (Nursing) Degree Examination Part I: Biological Science Paper I: Anatomy Including Histology
PART TWO: PHYSIOLOGY
20:
Introduction to Physiology
INTRODUCTION
THE CELL
Structure of a Cell (Fig. 20.1)
Cell Membrane or Plasma Membrane or Unit Membrane
Functions of Cell Membrane
Synthesis of Cell Membrane
Specialisation of Plasma Membrane
Nucleus and its Chromosomes
Cytoplasm and its Organelles
Endoplasmic Reticulum
Ribosomes
Mitochondria
Lysosomes
Peroxisomes or ‘Microbodies’
Golgi Complex or Golgi Apparatus or Dictyosomes
Cytoskeleton
Centrioles
21:
Blood and Body Fluids
INTRODUCTION
COMPOSITION OF BLOOD
Plasma
Formed Elements
FUNCTIONS OF BLOOD
Transport of Respiratory Gases
Excretory Function
Nutritional Function
Acid-base Balance
Transport of Hormones
Protection or Defense
Temperature Regulation
Water Balance
Osmotic Pressure
PROPERTIES OF BLOOD
Colour
Clotting
Specific Gravity
Viscosity
Osmotic Pressure
Rouleaux Formation
Suspension Stability or Sedimentation
Estimation of ESR
Factors Influencing ESR
Packed Cell Volume (PCV)
PLASMA PROTEINS
Synthesis
Functions
Oncotic Pressure
Immunity
Coagulation
Acid-base Balance
Viscosity
Storage Proteins
Transport of Substances
Rouleaux Formation
Applied Physiology
RED BLOOD CORPUSCLES (RBC)
Advantage of the Bioconcave Shape of RBC
Composition of RBC
Normal RBC Count
Variations in Size and Shape of RBC
Haemoglobin (Hb)
Structure
Fetal Haemoglobin
Fate of Haemoglobin
Applied Physiology
Development of Red Blood Cells
Site of Erythropoiesis
Origin of Blood Cells
Steps
Erythropoiesis
Factors Influencing Erythropoiesis
Fate of RBC
Anaemia
Cut off Values
Classification
Iron Deficiency Anaemia
Blood Picture
Megaloblastic Anaemia
THE WHITE BLOOD CELLS (LEUCOCYTES)
Types of Leucocytes
Development of WBCs (Leucopoiesis)
Steps of Leucopoiesis
Normal WBC Count
Differential Count (DC)
Functions of WBCs
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes
Immunity
Reticuloendothelial System (RES)
Functions of RES
PLATELETS OR THROMBOCYTES
Development of Platelets
Functions of Platelets
HAEMOSTASIS
Haemostatic Events
Immediate Vasoconstriction
Formation of a Platelet Plug
Secondary Haemostasis
Procoagulants
Procoagulant Factors
Mechanism of Coagulation
Role of Vitamin K in Coagulation
Role of Liver
Role of vWF (von Willebrand's Factor)
Anticoagulants
Classification
Anticoagulants Used In Vivo
Anticoagulants Used In Vitro
BLEEDING DISORDERS (FLOW CHART 21.3)
Haemophilia
BLOOD GROUPS
ABO System
Landsteiner's Law
Inheritance of Blood Groups
The Rh (Rhesus) System
Rh Incompatibility
Erythroblastosis Foetalis
Prevention
Uses of Blood Grouping
BLOOD TRANSFUSION
Indications
Cross Matching
Hazards of Blood Transfusion
Due to Mismatched Blood Transfusion
Due to Causes Other Than Mismatching
BODY FLUID COMPARTMENTS
Blood Volume
LYMPH
Formation of Lymph
Functions of Lymph
OEDEMA (EDEMA)
22:
Nerve and Muscle
INTRODUCTION
THE NERVOUS TISSUE
Properties of a Neuron
Resting Membrane Potential (RMP)
Action Potential
Synapse (Fig. 22.1)
Synaptic Transmission
THE MUSCLE TISSUE
Physiologic Anatomy of Skeletal Muscles
Parts
Sarcomere
Mechanism of Muscle Contraction
The Neuromuscular Junction
Structure (Fig. 22.3)
Transmission of Impulse
Applied Physiology
Myasthenia Gravis
23:
Digestive System
INTRODUCTION
GASTROINTESTINAL TRACT (GIT)
Parts of GIT
General Histology
Layers
Innervation of Gut
Enteric Nervous System (ENS) or Intrinsic Nervous System
Extrinsic or Autonomic Nervous System (ANS)
DIGESTION IN THE MOUTH
Salivary Glands
Types of Salivary Glands and Their Structure
Saliva
Composition of Saliva
Functions of Saliva
DIGESTION IN THE STOMACH
Gastric Glands
Glands in the Fundus and Body of Stomach
Cardiac Glands
Pyloric or Antral Glands
Gastric Juice
Hydrochloric Acid (HCl)
Regulation of Acid Secretion
Phases of Gastric Secretion
Pepsinogen
Secretion of Mucous
Abnormal Gastric Secretion
EXOCRINE PART OF PANCREAS
Pancreatic Juice
Organic Constituents
Proteases
Trypsin
Amylolytic Enzyme—α-Amylase
Lipolytic Enzymes
Nucleases
Regulation of Pancreatic Secretion
Neural Regulation
Hormonal
Phases of Secretion
Cephalic Phase
Gastric Phase
Intestinal Phase
Autoprotection of Pancreas
Applied Physiology
Acute Pancreatitis
Chronic Pancreatitis
LIVER AND GALLBLADDER
Bile
Composition of Bile
Bile Salts
Functions of Bile
Bile Pigments
Regulation of Bile Secretion
Applied Physiology
Gallstones
THE SMALL INTESTINE
Small Intestinal Secretions
Succus Entericus or the Intestinal Juice
Regulation of Intestinal Secretion
Applied Physiology
Tropical Sprue
Lactose Intolerance
THE LARGE INTESTINE OR COLON
Functions of Large Intestine
Secretory Function
Absorptive Function
Storage Function
Dietary Fibres
GASTROINTESTINAL HORMONES
Characteristics
Gastrin
Actions
Cholecystokinin-Pancreozymin (CCK-PZ)
Actions
Secretin
Actions
GIP (Gastrointestinal Peptide)
Actions
MOVEMENTS OF GIT
Mastication
Mechanism
Deglutition
Oral or Buccal Stage
Pharyngeal Stage
Oesophageal Stage
Applied Physiology
Achalasia or Cardiospasm
Reflux Oesophagitis
Movements of Stomach
Receptive Relaxation
Mixing-Churning-Breaking (Gastric peristalsis)
Gastric Emptying
Applied Physiology
Mechanism
Movements of Small Intestine
Mixing Contractions
Peristaltic (Propulsive) Movements
Minor Movements
Ileal Emptying
Movements of Villi
Applied Physiology
Movements of Large Intestine
Segmentation or Haustration
Mass Peristalsis
Gastrocolic Reflex
Applied Physiology
24:
Respiratory System
INTRODUCTION
FUNCTIONAL ANATOMY OF RESPIRATORY SYSTEM
Respiratory Membrane (Fig. 24.1)
Respiratory Function
PULMONARY VENTILATION
Mechanism
During Inspiration
Expiration
Muscles of Inspiration
Muscles of Expiration
Lung Volumes and Capacities/Spirometry
Pulmonary Volumes
Pulmonary Capacities
Ventilation
Pulmonary Ventilation
Alveolar Ventilation
Surfactant
Hyaline Membrane Disease or Infant Respiratory Distress Syndrome
PULMONARY DIFFUSION
Factors Affecting the Rate of Diffusion
Diffusion Capacity
Ventilation–Perfusion Ratio
TRANSPORT OF GASES BETWEEN LUNGS AND TISSUES
Transport of Oxygen (O2)
Role of Hb in Oxygen Transport
O2-Hb Dissociation Curve
Factors Affecting O2 Dissociation Curve
Transport of Carbon Dioxide (CO2)
As Physically Dissolved Form
As Bicarbonate
As Carbamino Haemoglobin
CO2 Dissociation Curve
REGULATION OF RESPIRATION
Neural Mechanisms
Automatic Control
Voluntary Control
Chemical Control of Respiration
The Central Chemoreceptors
The Peripheral Chemoreceptors
RESPIRATORY ADJUSTMENTS IN HEALTH AND DISEASE
Hypoxia
Hypoxic Hypoxia
Anaemic Hypoxia
Stagnant Hypoxia
Histotoxic Hypoxia
Mountain Sickness
Cyanosis
Respiratory Pattern Abnormalities
Apnoea
Tachypnoea
Dyspnoea
Cheyne-Stokes Breathing (Fig. 24.10)
Decompression Sickness or Caisson's Disease
Symptoms
Prevention and Treatment
Artificial Respiration
25:
Cardiovascular System
INTRODUCTION
CARDIAC MUSCLE
Action Potential in Cardiac Muscle
Depolarisation Phase or Phase 0
Initial Rapid Repolarisation or Phase 1
Plateau Phase or Phase 2
Late Rapid Repolarization or Phase 3
Phase 4
Properties of Myocardium
Frank-starling Law
Innervation of Heart
ORIGIN AND SPREAD OF CARDIAC IMPULSE
Pacemaker Tissues
The Conducting Tissues of Heart (Fig. 25.2)
SA Node
AV Node
Internodal Tracts
AV Bundle (Atrioventricular Bundle)
Purkinje Fibres
Spread of Cardiac Impulse
CARDIAC CYCLE
Definition
Major Events
Isovolumetric Contraction Phase
Phase of Rapid Ejection
Reduced Ejection Phase
Protodiastolic Phase of Ventricles
Isovolumetric Relaxation Phase
Rapid Filling Phase
Reduced Filling Phase or Diastasis
Atrial Systole
HEART SOUNDS
First Heart Sound
Second Heart Sound
Third Heart Sound
Fourth Heart Sound
Apex Beat or Cardiac Impulse
Applied Physiology
Murmurs
ATRIAL PRESSURE CURVE (FIG. 25.3)
Clinical Importance of JVP
Arterial Pulse
ELECTROCARDIOGRAPHY
Bipolar (Standard) Limb Leads
Einthovan's Triangle and Einthovan's Law
Unipolar Limb Leads (Fig. 25.6)
Unipolar Chest Leads
Normal ECG (Fig. 25.7)
Waves
Intervals
Segments
Uses of ECG
CARDIAC OUTPUT
Stroke Volume
Variations in Cardiac Output
Physiological
Pathological
Factors Affecting Cardiac Output
Venous Return
Force of Contraction of the Heart
Heart Rate
Peripheral Resistance
Measurement of Cardiac Output
Direct Method
Indirect Methods
Cardiovascular Changes During Exercise
ARTERIAL BLOOD PRESSURE
Systolic Blood Pressure (Systolic BP)
Diastolic BP
Pulse Pressure
Mean Arterial Pressure
Methods of Measurement of BP
Direct Method
Indirect Method (Sphygmomanometry)
Sphygmomanometry
Principle
Procedure
Variations in BP
Physiological
Pathological
Factors Maintaining Blood Pressure
Cardiac Output
Peripheral Resistance
Elasticity of the Vessel Wall
Blood Volume
Regulation of Arterial BP
Short-term Regulation Mechanisms
Baroreceptor Mechanism
Chemoreceptor Mechanism
CNS Ischaemic Response
Intermediate-term Regulation Mechanisms
Renin-Angiotensin Mechanism
Stress Relaxation Mechanism
Capillary Fluid Shift
Long-term Regulation of BP
Mechanisms for Regulation of Blood Volume by Kidneys
Hormonal Mechanisms:
CORONARY CIRCULATION
Regulation of Coronary Blood Flow
Pressure Changes in Aorta
Chemical Factors
Neural Factors
Applied Physiology
Coronary Artery Disease
26:
Endocrine System
INTRODUCTION
FUNCTIONS OF ENDOCRINE GLANDS
PITUITARY GLAND
Adenohypophysis
Types of Cells
Regulation of the Functions of Adenohypophysis
Hypothalamic Control
Feedback Control
Growth Hormone (GH)
Actions of GH
Actions on Growth
Actions on Metabolism
Regulation of GH Secretion
Applied Physiology
Prolactin
Functions
Regulation
Applied Physiology
Neurohypophysis
Antidiuretic Hormone (ADH)
Actions
Regulation of ADH Secretion
Applied Physiology
Oxytocin
Actions
Applied Physiology
THYROID GLAND
Hormones of Thyroid Gland
Biosynthesis and Secretion of Thyroid Hormone
Iodide Trapping
Synthesis and Secretion of Thyroglobulin
Oxidation of Iodide into Iodine
Iodination of Tyrosine
Coupling
Storage
Secretion
Actions of Thyroid Hormones
Growth
Calorigenic Action
Brain and Nervous System
Cardiovascular System
Metabolism of Proteins, Carbohydrates and Lipids
Vitamin Metabolism
Skeletal Muscle
Reproduction and Fertility
Other Effects
Regulation of Secretion
Role of TSH
Role of Hypothalamus
Applied Physiology
Hyperthyroidism (Thyrotoxicosis or Grave's Disease)
Hypothyroidism
Cretinism
Myxoedema
Goitre
HORMONES REGULATING CALCIUM METABOLISM
Functions of Calcium
Parathormone (PTH)
Actions
Abnormalities of Parathormone Synthesis
Hyperparathyroidism
Mechanism
Hypoparathyroidism
Mechanism
1,25-Dihydroxycholecalciferol or Calcitriol
Sources of Vitamin D
Synthesis of Calcitriol
Actions
Abnormalities of Calcitriol Levels
Rickets
Mechanism
Osteomalacia
Calcitonin
Actions
Abnormalities of Calcitonin Secretion
Other Hormones Regulating Calcium Level in Blood
ENDOCRINE PANCREAS
Insulin
Actions
Regulation of Insulin Secretion
NORMAL BLOOD SUGAR LEVEL
Applied Physiology
Diabetes Mellitus (DM)
Classical Features of Diabetes Mellitus
Metabolic Changes Occurring in Diabetes Mellitus
Complications
Hypoglycemia or Hyperinsulinism
Clinical Features
Glucagon
Actions
Regulation of Glucagons Secretion
Somatostatin
Actions
ADRENAL GLANDS
Adrenal Cortex
Biosynthesis of Corticosteroids
Actions of Glucocorticoids
Effects on the Metabolism of Carbohydrates
Effects on Protein Metabolism
Effects on Fat Metabolism
Effects on Electrolyte and Water Metabolism
Role in Stress and Inflammation
Antiallergic Action
Permissive Action
Effects on CNS
Effects on Blood Cells and Lymphoid Tissues
Immunosuppressive Effects
Actions on Bone
Effects on Gastric Secretions
Regulation of Glucocorticoid Secretion
Anterior Pituitary
Hypothalamus
Feedback Control
Applied Physiology
Cushing's Syndrome
Actions of Mineralocorticoids
Regulation of Aldosterone Secretion
Applied Physiology
Sex Hormones (Adrenal Androgens)
Applied Physiology
Adrenal Medulla
Actions of Adrenaline and Noradrenaline
Applied Physiology
27:
Reproductive System
INTRODUCTION
THE MALE REPRODUCTIVE SYSTEM
Spermatogenesis
Steps of Spermatogenesis
Factors Controlling Spermatogenesis
Effect of Temperature
Effect of Hormones
Role of Sertoli Cells
Spermatozoon/Sperm (Fig. 27.1)
Semen or Seminal Fluid
Applied Physiology
Vasectomy
ENDOCRINE FUNCTIONS OF TESTES
Actions of Testosterone
Androgenic Effects
Anabolic Effects
Control of Testicular Function
FSH
LH
THE FEMALE REPRODUCTIVE SYSTEM
Sexual Cycle in the Female
Oogenesis
The Ovarian Cycle
The Follicular Phase
The Luteal Phase
Hormones and the Ovarian Cycle
The Menstrual Cycle or Uterine Cycle (Fig. 27.3)
Proliferative Phase
Secretory Phase
Menstrual Phase
Anovulatory Cycles
Cyclical Changes in Cervix
Indicators of Ovulation
Basal Body Temperature (BBT)
Cervical Mucus
Endometrial Biopsy
Ultrasonography (USG) of Ovaries
Hormonal Control of Menstrual Cycle (Fig. 27.4)
Menopause
Applied Physiology
PREGNANCY
Fertilization and Implantation
Functions of Placenta
Endocrine Function
Respiratory Function
Nutritive Function
Excretory Function
Other Functions
Diagnostic Tests for Pregnancy
The Immunological Tests
Physiological Changes during Pregnancy
Changes in the Uterus and Ovary
Breast
Blood Volume
CVS
Weight Gain
Skin
Respiratory System
GIT
Kidney
Endocrine Glands
Parturition or Labour
LACTATION
Initiations of Lactation After Delivery
Ejection (“Let down”) of Milk
Colustrum
CONTRACEPTION
Temporary Methods
Barrier Methods
Natural Methods
Intrauterine Contraceptive Devices (IUCDs)
Oral Contraceptive Pills (OCP)
Adverse Effects of OCP
Permanent Methods
Female Sterilisation (Tubectomy)
Male Sterilisation (Vasectomy)
28:
Nervous System
INTRODUCTION
CENTRAL NERVOUS SYSTEM
THE SENSORY SYSTEM
Proprioception
Synthetic Senses
Receptors
Types of Receptors
Cutaneous Receptors
Properties of Receptors
Reflex
Reflex Arc
Classification of Reflexes
TRACTS OF SPINAL CORD
Ascending Tracts of Spinal Cord (Sensory Tracts)
Dorsal (Posterior) Column Tract or Fibres (Fig. 28.2)
Anterior (Ventral) Spinothalamic Tract (Fig. 28.2)
Lateral Spinothalamic Tract (Fig. 28.2)
Descending Tracts of Spinal Cord or the Motor Pathways
Pyramidal Tract or Corticospinal Tract (Fig. 28.3)
The Extrapyramidal Tracts or System
Applied Physiology
CEREBELLUM
Structure of Cerebellum and Its Connections
Refer chapter 16 Anatomy
Archicerebellum
Paleocerebellum
Neocerebellum
Functions of Cerebellum
Applied Physiology
Cerebellar Syndrome
BASAL GANGLIA (BASAL NUCLEI)
Structures and Connections of Basal Ganglia
Functions of Basal Ganglia
THALAMUS AND HYPOTHALAMUS
Thalamus
Functions
Hypothalamus
Functions
THE AUTONOMIC NERVOUS SYSTEM
The Sympathetic Nervous System (Thoracolumbar Outflow)
The Parasympathetic System (Craniosacral Outflow)
Neurotransmitters in ANS
Actions of Autonomic Neurons
Higher Control of ANS
29:
Special Senses
SIGHT
Structure of Eye
Visual Pathway (Fig. 29.1)
The Receptors
Lesions in Visual Pathway (Fig. 29.1)
Pupillary Reflexes
Light Reflex
Accommodation Reflex
Optical Defects in Eye (Errors of Refraction)
Myopia (Short Sightedness)
Hypermetropia (Far Sightedness) (Fig. 29.2)
Astigmatism
Presbyopia
Colour Blindness
HEARING
Structure of Ear
Cochlea
Mechanism of Hearing
Auditory Pathway (Fig. 29.4)
Applied Physiology
Deafness or Hearing Loss
Conduction Deafness
Sensory Neural Deafness
Tests for Hearing
Rinne's Test
Weber's Test
Absolute Bone Conduction (ABC) Test
THE CHEMICAL SENSES
Taste
Location of Taste Buds
Types of Taste
Taste Pathway
Applied Physiology
Smell
Olfactory Pathway (Fig. 29.6)
Applied Physiology
30:
Urinary System
INTRODUCTION
FUNCTIONS OF KIDNEY
Excretory Function
Non-excretory Functions
NEPHRON
Juxtaglomerular Apparatus (JGA) (Fig. 30.1)
Functions of JGA
Types of Nephron
Blood Vessels of Kidney
MECHANISM OF FORMATION OF URINE
Glomerular Filtration
Definition
Composition of Glomerular Filtrate
Factors Determining GFR
Factors Affecting GFR
Filtration—Fraction (FF)
Tubular Reabsorption
Tubular Secretion
PCT (Table 30.2)
Loop of Henle
Distal Tubule and Collecting Duct
GLUCOSE REABSORPTION
URINARY EXCRETION OF WATER
Medullary Interstitial Hyperosmolality
Counter-current Multiplier System
Counter-current Exchange System
ACIDIFICATION OF URINE
Micturition
Higher Control of Micturition Reflex
Urine
Normal Volume
Normal Colour
Normal Specific Gravity
Normal pH
Renal Function Tests
Urine Examination
Blood Analysis
Renal Clearance Tests
Intravenous Pyelography (IVP)
31:
Temperature Regulation
INTRODUCTION
NORMAL TEMPERATURE
SOURCES OF BODY HEAT
CHANNELS OF HEAT LOSS
CONTROL MECHANISMS OF THERMOREGULATION
Hypothalamic Thermostat
MECHANISMS ACTIVATED BY HEAT
Cutaneous Vasodilataton
Sweating
Anorexia
Behavioural Responses
Panting
MECHANISMS ACTIVATED BY COLD
Mechanisms for Heat Conservation
Cutaneous Vasoconstriction
Piloerection
Measures for Increasing Heat Production
Shivering
Increased Catecholamine Secretion
Increased Secretion of Thyroxine
Heat Production by the Brown Fat
Applied Physiology
Fever
Heat Exhaustion
Heat Stroke
Hypothermia
Annexe
NORMAL VALUES (IN A HEALTHY YOUNG ADULT)
Blood, Formed Elements
Respiratory System
Cardiovascular System
Urinary System
Model Question Paper-II (Physiology)
INDEX
TOC
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