CIS Human Anatomy Exam Two Study Guide

8/6/2019 CIS Human Anatomy Exam Two Study Guide

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Semester One Final Test Outcomes:

Skeletal SystemThree Functions of the Skeletal System:

• Support: The internal framework that anchors the soft organs. The legs are like pillarswhen we stand and the ribcage supports the thoracic wall.

• Protection: Bones protect the soft organs. The cranium protects the brain, the vertebraeprotect the spinal cord, and the rib cage protects the thoracic organs.

• Movement: Skeletal muscles are connected to the bones. The bones are levers for thebody to move by the use of the muscles.

• Storage: Fat is stored inside the cavities of bones. Calcium and Phosphorus are stored inbone itself. Hormones control the movement of calcium to and from the blood and bones.It depends on calcium levels in the blood.

• Blood Cell Formation: Blood cell formation, also known as hematopoiesis, occurs in themarrow of some bones.

Four Classifications of Bones:•

Bone ClassificationsCompact Bone: Dense, smooth looking, and homogeneous.Spongy Bone: Small needlelike pieces of bone with lots of open space. Full of redmarrow.Long Bones: Longer than wide. A shaft with heads at both ends. Mostly compactbone. Ex: Limbs, excluding wrist and ankle bones.Short Bones: “Cube-shaped.” Mostly spongy bone. Wrist and ankle bones. Sesamoid Bones , that form within tendons, are a special type of short bone. Ex: Patella.Flat Bones: Thin, flattened, usually curved. Two thin layers of compact bone withspongy bone inside. Ex: Skull, ribs, and sternum.Irregular Bones: Do not fit into any of the previous categories. Ex: Vertebrae and hipbones.

Major Areas of a Long Bone and Functions:• Diaphysis: The shaft of a long bone. Composed of compact bone. Covered andprotected by the fibrous connective tissue membrane named the periosteum. Inside thediaphysis, there is the medullary cavity where yellow marrow is stored.• Epiphyses: Ends of the long bone. Thin layer of compact bone enclosing spongybone. Articular cartilage covers the surface of the epiphyses. The cartilage provides for asmooth, slippery surface that decreases friction at joint surfaces. Some epiphyses havered marrow in their spongy bone.• Epiphyseal Plate: A flat plate of hyaline cartilage. Causes the lengthwise growthof long bones.• Epiphyseal Line: The remnants of the epiphyseal plate after puberty and growthare done.

How Bone Grows:• Long bones grow in length by bonereplacing cartilage in the epiphyseal plates asthe cartilage is continuously being formed. Onone side of the cartilage, more cartilage is beingformed, and on the other bone is replacing theolder cartilage of the epiphyseal plate. Thegrowth is regulated by growth hormone. The



process ends during adolescence, when the epiphyseal plate is turned into completelybone.• Bone remodeling is necessary to maintain bones that are strong and large enoughto support your body weight. The right proportions must be maintained. Bones becomethicker and form large projections for areas where bulky muscle is attached. To increase insize and strength, osteoblasts will lay down new matrix in the necessary areas and thenbecome trapped in it. Once trapped they turn into mature bone cells, osteocytes. Whensomeone is bedridden, bone is broken down and their bones atrophy because there isn’tany stress being put on the bones. Parathyroid Hormone determines when and if boneneeds to be broken down or added in different places. It depends on the amount of calcium ions in the blood. When there is too much calcium in the blood, new bone will beformed. If there’s not enough, bone is broken down. The stress and gravity on bonesdetermines where new bone is to go to make sure the skeleton remains strong.

Fractures:

Explain how homeostasis is maintained over blood calcium levels by the action of osteoblasts and osteoclasts.

• When there aren’t enough calcium ions in the blood, parathyroid hormone is released. ThePTH activates the osteoclasts to break down bone matrix and release calcium into theblood. When there are too many calcium ions in the blood, hypercalcemia , the excesscalcium is deposited into bone matrix. The osteoblasts are the bone-forming cells that do

this by laying down matrix where needed. Microscopic Bone:



Joints:• Synarthrotic: immovable joints. Ex: the sutures of the skull.• Diarthrotic: freely movable joints. Ex: the uniaxial elbow joint between thehumerus, radius, and ulna.• Amphiarthrotic: slightly movable joints. Ex: pubic symphisis and intervertebral

joints.

Appendicular & Axial Skeleton Bones:Frontal, parietal, temporal, external auditory meatus, styloid process, zygomatic process,mastoid process, occipital, foramen magnum, sphenoid, ethmoid, anteriolateral fontanel,posteriolateral fontanel, anterior fontanel, posterior fontanel, coronal suture, lamboidalsuture, squamosal suture, sagittal suture, frontal sinus, ethmoid sinus, sphenoid sinus,maxillary sinus, mandible, maxillae, palatine, zygomatic, lacrimal, nasal, vomer, nasalconchae, hyoid, atlas, axis, vertebrae prominens, cervical vertebrae, thoracic vertebrae,lumbar vertebrae, sacrum, coccyx, sternum, manubrium, body, xiphoid process, true ribs,false ribs, floating ribs, scapula, spine, acromion, glenoid cavity, coracoid cavity, lateralborder, medial border, clavicle, sternoclavicular joint, acromioclavicular joint, humerus,greater tubercle, lesser tubercle, intertubercular sulcus, capitulum, trochlea, radius,styloid process, ulna, olecranon process, styloid process, radial notch, carpals,metacarpals, proximal phalanges, medial phalanges, distal phalanges, ilium, ischium,pubis, pubis symphysis, acetabulum, obturator foramen, sacroiliac joint, iliac crest, femur,head, greater trochanter, lesser trochanter, lateral condyle, medial condyle, patella, tibia,tibial tuberosity, medial malleolus, fibula, lateral malleolus, talus, calcaneus, tarsals,metatarsals.

Blood:Blood Cells



Formed Elements and Plasma:• Formed Elements: Living blood cells including the red and white blood cells.• Plasma: Nonliving fluid matrix that is 90% water. Nutrients, salts, gases, hormones,

plasma proteins, wastes, and products are all in plasma.



Stages of Homeostasis:• Hemostasis is the stoppage of blood when a blood vessel wall breaks, as in a cut. Blood

clots in 3 to 6 minutes.• Stages of Hemostasis

1. Platelet plug forms. Platelets become “sticky” and get attached to the collagenthat’s exposed when a vessel breaks. The platelets stuck there release chemicals thatattract more platelets to the site so a small mass of platelets forms. This mass is

called a platelet plug , or white thrombus .2. Vascular spasms occur. The plates that are anchored release serotonin whichmakes the vessel have spasms. The blood vessel narrows so blood loss decreases untilit clots.

3. Coagulation events occur.1. The injured tissues are releasing tissue factor (tf).2. PF3 covers the platelet surfaces and interacts with the TF, vitamin K, other

proteins, and calciums. The interaction forms an activator that triggers theclotting cascade.

3. The prothrombin activator converts prothrombin , present in the plasma, tothrombin.

4. Thrombin joins fibrinogen proteins into the fibrin meshwork that traps red

blood cells and forms the basis of the clot. The plasma, called serum, issqueezed from the mass and the ruptured edges of the blood vessel pulltogether.

“Blood Clotting Cascade:”• The blood clotting cascade starts with the prothrombin being converted to thrombin .

Then the thrombin joins with fibrinogen to create the fibrin meshwork. Red bloodcells get trapped in it and squeeze serum out so the vessel walls pull together. Whenblood clots, the chemicals are rapidly inactivated to prevent all of the blood in the bodyfrom clotting. The endothelium regenerates and the blood clot is broken down. Placing agauze and pressure on a wound helps because the platelets can stick to the gauze and thepressure fractures cells, increasing the release of tissue factor.

Agglutinogens and Agglutinins:• Agglutinogens : red blood cell antigens that promote clumping that the body recognizes

as foreign and stimulates the immune system to release antibodies or use other means tomount a defense against it.

• Agglutinins : the antibodies that bind them together. They are the “recognizers.” Theyare present in the plasma to attach to red blood cells bearing surface antigens differentfrom those on the patient’s red blood cells.

• 4 Major blood groupsAB: A & B agglutinogens, No agglutinensB: B agglutinogens, Anti-A AgglutininsA: A agglutinogens, Anti-B AgglutininsO: No agglutinogens, Anti-A & B Agglutinins



Blood Type and Rh Compatibility:• Blood Typing: is finding out the blood group of the donor and recipient . You can

do so by testing the blood in anti-A and B immune serum.If it agglutinates with the anti-A, it’s type-A blood. If it agglutinates with anti-B, it’stype-B blood. If it agglutinates with anti-A and B, it’s type-AB blood. If it doesn’tagglutinate with either, it is type-O blood.Type-A blood can receive A or O blood.Type-B blood can receive type B or O blood.Type-AB blood can receive any blood.Type-O blood can receive O blood. O-blood can be given to any person and ABblood receives any blood.

* If the body doesn’t recognize the agglutinogen on the foreign blood, it has the agglutinins thatwill react with the agglutinogen. This causes agglutination , which is clumping of the blood.

• Rh Compatibility: involves the agglutinogen D, called the Rh agglutinogen. You are Rhpositive if you have the Rh agglutinogen . People with Rh negative blood don’tautomatically have anti-Rh agglutinens but they form once Rh positive blood is mixed withit. Hemolysis , the rupture of red blood cells, doesn’t occur during the first transfusion of blood, but the second time it does. When Rh negative women carry an Rh positive babythe mothers anti-Rh agglutinens can attack the agglutinogens of the baby unless shetakes RhoGAM.

Disorders:• iron deficiency anemia• pernicious anemia• sickle cell anemia• aplastic anemia• Leukemia : bone marrow becomes cancerous and huge amounts of white blood cells are

produced. The new white blood cells are immature and incapable of carrying out theirnormal protective functions so they crowd out the healthy white blood cells from doingtheir job so the body becomes susceptible for disease-causing bacteria and viruses.

• Leukopenia : abnormally low white blood cell count. Commonly caused by use of certain drugs such as corticosteroids and anticancer agents.



• Leukocytosis : A total white blood cell count above 11,000 cells/mm. Generallyindicates a bacterial or viral infection in the body.

• Polycythemia : An excessive/abnormal increase in the number of erythrocytes presentin blood. May result from bone marrow cancer. May also result from living in a highaltitude. The problem is the blood is more viscous so it flows sluggishly and impairscirculation.

• Fetal Hemolytic Disease : Rh negative woman with an Rh positive baby. Theagglutinins will cross through the placenta and destroy the baby’s red blood cells. The

baby becomes anemic and becomes hypoxic and cyanotic. Brain damage and evendeath may result unless transfusions are done for the baby.• Hemophilia : hereditary bleeding disorders resulting from a lack of any of the clotting

factors. Prolonged bleeding that can be life-threatening. Bleeding into joints can bepainful and cause the joints to become disabled. They’re given transfusions of theclotting factor they’re missing so the blood can clot.

• Thrombus : clot that develops and persists in an unbroken blood vessel. May preventblood flow. A coronary thrombosis can result in a heart attack.

• Embolus : a thrombus that breaks away from the vessel wall and floats freely in thebloodstream. Becomes a problem when it gets lodged in a narrow blood vessel.

The Heart



Pathway of Blood through the Heart:

1. Superior & Inferior Vena Cava2. Right Atrium3. Tricuspid Valve (Lub)4. Right Ventricle5. Pulmonary Valve (Dup)6. Pulmonary Arteries7. Lungs8. Pulmonary Veins9. Left Atrium10. Bicuspid Valve (Lub)11. Left Ventricle12. Aortic Valve (Dup)13. Aorta

Valve Activity Responsible for Heart Sounds:



* The atriums are filled with blood and valves open to allow blood flow into the ventricles. Whenthe valves are open and blood is flowing through this is called diastole (Dup sound). Once theventricles are filled the pulmonary and aortic valves open to allow blood to go to the lungs andthe rest of the body which is known as systole (Lub sound). Systole = Squeeze

Mid-to-late Diastole:• Ventricles relaxing and filling with blood•

AV valves open• semi-lunar valves closed• DUP

Electrocardiography : A graph of electrical activity in the heart

- P wave-atrial depolarization.Contraction of the atria- QRS complex-ventriculardepolarization

• Q: Single leaving the bundle branches to thePurkinje fibers

• R: Contraction of left ventricle• S: Contraction of right ventricle

- T wave-ventricular repolarization . Heart ventricles arerelaxing after contractions.

Disorders from Abnormal ECG waves:• Enlarged R wave - Enlarged ventriclesPulmonaryHypertension• Enlarged P wave - Enlarged atria• Flat T wave - Inadequate oxygen

Intrinsic Conduction System:

Ventricular Systole:• Ventricles contracting to eject blood• AV valves closed• Semi-lunar valves open• LUB

SA Node: Also known as the heart’snatural pacemaker, heart begins with asignal from SA node. When the atriumis filled with blood the signal goes tothe…

AV Node: Signal that slows the nodesfor an instant that allows ventricles tofill with blood. Signal goes to bundlebranches and spreads all the way tothe Purkinje fibers to restart the cycleagain

SA Node AV Node AV BundleBundle Branches Purkinje Fibers



• Is built out of heart tissue and sets its basic rhythm. The intrinsic conduction system iscomposed of a special tissue found nowhere else in the body that is a cross betweenmuscle and nervous tissue. This system causes heart muscle depolarization in only onedirection—from the atria to the ventricles.

• Enforces a contraction rate of approximately 75 beats per minute on the heart so theheart beats as a coordinated unit.

Disease Causes Treatments

Heart Murmurs: Abnormal orunusual heart sounds whenblood strikes obstructions.Arrhythmia:Flutter: 240-360 beats perminute in heartFibrillation: Completelyuncoordinated heartbeat

Cardiovascular System Arteries : Blood is propelled here and then leaves the heart.

• Carry oxygen away from theheart

• Carry oxygenated blood• Branch into arterioles• Muscular and elastic• Expand and contract with the

pulse• Walls are usually thicker than

veins• Pumped by the heart

Veins : Empty into great veins (venaecavae) entering the heart. Drain tissuesand return the blood to the heart.

• Carry blood to the heart• Carry deoxygenated blood• Branch into venules• Thin walled (tunica media)• Have valves to prevent back flow• Thinner walls than arteries.• Skeletal muscles “milk” the blood, valves keep blood moving in one direction

Capillaries : Directly serve the needs of the body cells. Beds in tissues.• Once cell thick – Just tunica intima• Exchanges are easily made between the blood and the tissue cells• Capillary beds are interweaving networks of capillaries (Arterioles, Capillaries, and

Venules)Vascular Shunt: Vessel that directly connects the arteriole and the venule atopposite ends of the bed



True Capillaries: The exchange vessels of gas and nutrientsTerminal Arteriole empties into the postcapillary veinsPrecapillary Sphincter: Cuff of smooth muscle fibers. Acts as a valve toregulate the flow of blood into the capillary.

Arterial Supply of the Brain & the Circle

of Willis: • The brain is supplied with two pairs of arteries, the internal carotid arteries andthe vertebral arteries. The internal carotidarteries are branches of the common carotidarteries that run through the neck and enter

the skull through the temporal bone. Onceinside the cranium, each divides into theanterior and middle cerebral arteries, which supply most of the cerebellum.• The vertebral arteries pass upward from the subclavian arteries at the base of theneck. Within the skull, the vertebral arteries join to form the single basilar artery , whichserves the brain stem and cerebellum as it travels upward. At the base of the cerebellumthe basilar artery divides to form the posterior cerebral arteries , which supply theposterior part of the cerebellum.• Circle of Willis: The united anterior and posterior blood supplies of the brain thatare united. Surrounds the base of the brain and protects it by providing more than oneroute for blood to reach the brain tissue incase of a clot or impaired blood flow .

Hepatic Portal Circulation: Veins that drain thedigestive organs, spleen, and pancreas and deliver thisblood to the liver through the hepatic portal vein. Makessure the liver processes the substances involved indigestion before they enter the systemic circulation. Isable to take some of the nutrients to be stored andprocessed for later use. In hepatic portal circulationveins feed the liver circulation.

• Process : Inferior Mesenteric Vein Splenic VeinSuperior Mesenteric Vein Left Gastric Vein

Stomach Hepatic Portal Vein

VArteries



Fetal Circulation:• All nutrients, excretory, and gas exchanges occur through the placenta. Nutrients and

oxygen move from the mother’s blood into the fetalblood, and fetal wastes move in the oppositedirection.

• Umbilical cord contains three blood vessels:Umbilical vein and two smaller umbilical

arteries. Umbilical vein carries blood rich innutrients and oxygen to the fetus. The umbilicalarteries carry carbon dioxide and debris-ladenblood from the fetus to the placenta.

• As blood flows to heart most of it bypasses theimmature liver through the ductus venosus andenters the inferior vena cava, which carries theblood to the right atrium of the heart. Some bloodentering the right atrium is shunted into the leftatrium through the foramen ovale (closes afterbirth).

• Blood that does not manage to enter the right

ventricle is pumped out of the pulmonary trunkwhere it meets the ductus arteriosus, a shortvessel that connects the aorta and the pulmonary trunk together. Blood tends to entersystemic circulation here.

Blood Pressure: The pressure the blood exerts against theinner walls of the blood vessels , and it is the force that keepsthe blood circulating continuously even between heartbeats. Isunderstood to mean the pressure within the large systematicarteries near the heart.

• Pulse : Occurs with the alternating expansion and recoil of anartery that occurs with each beat of the left ventricle creates

a pressure wave. The pulse travels through the entire arterialsystem. (Also known as pressure surges per minute)

Average pulse rate is 70-75beats per minute in a normalresting person

Flowsinto thesmallerarteries

arterioles capillaries venulesveins large venae cavae to theright atrium

Flows along pressure gradient from high to low pressure

Factors that influence blood pressure are:• Age, weight, time of day, exercise, body position, emotions, caffeine, nicotine, alcohol,

blood volume, & atherosclerosis• Neural Factors (The Autonomic Nervous System): Sympathetic nerves on the

vascular system causes vasoconstriction, narrowing of the blood vessels, which increasesblood pressure. Never caused vasoconstriction on the vessels in the heart or brain.



• Renal Factors (The Kidneys): The kidneys regulate arterial blood pressure by alteringblood volume. When we have more water in blood it releases it through urine whereas itstores water when we are deficient of water. Also releases the enzyme rennin when low of fluids

• Temperature : The cold has a vasoconstriction effect whereas heat has a vasodilatationeffect

• Chemicals : Chemicals can cause increases or decreases on blood pressure.• Diet : A diet low in salt and saturated fats generally prevents hypertension

Human normal range is variable• Normal

140–110 mm Hg systolic80–75 mm Hg diastolic

• Hypotension: Low blood pressure due to poor nutrition and inadequate levels of bloodproteins. Blood viscosity becomes low. Can be a warning sign for circulatory shock

Low systolic (below 110 mm HG)Often associated with illness

• Hypertension: Elevation in blood pressure from fever, physical exertion, and emotionalupset. Chronic hypertension strains the heart and damages arteries. Can bring onatherosclerosis

High systolic (above 140 mm HG)Can be dangerous if it is chronicAtherosclerosis : Arteries are narrowed and brings on the damming-up processfrom the inside out. Plaque builds up within the arteries and decreases blood flow

Capillary Exchanges of Gases and Nutrients:• Substances first diffuse through an intervening space filled with interstitial fluid.1. Lipid-soluble fluids can diffuse directly across the plasma membrane2. Lipid-insoluble substances enter or leave the blood and/or endothelium cells within the

vesicles via endocytosis or exocytosis3. Limited passage of fluid and small solutes is allowed by intercellular clefts (gaps or areas

of plasma membrane not joined by tight junctions). Most capillaries have intercellularclefts

4. Very few passage of small solutes and fluids is allowed by fenestrated capillaries. Theseare found where absorption is a priority or where filtration occurs

• Only substances unable to pass one of these routes are prevented from leaving orentering the capillaries. These include protein molecules in the plasma and blood cells

• Blood pressure is higher at the arterial end of the capillary bed and osmotic pressure ishigher at the venous end.

Metabolism and Nutrition:

Enzyme:Metabolism : All chemical reactions that are necessary to sustain life. Includes:

• Anabolism : Larger molecules are built from smaller ones• Catabolism : Substances are broken down into simpler substances. Energy is released

here

Metabolic Roles of the Liver:• Detoxifies drugs and alcohol• Degrades hormones• Produce cholesterol, blood proteins (albumin and clotting proteins)• Maintains blood glucose levels by sorting or releasing glycogen



Sources of Energy:• Carbohydrates : Pasta, bread, fruit, etc. Cells get energy here first and then go to other

sources The body’s preferred source to produce cellular energy (ATP)Glucose (blood sugar) is the major breakdown product and fuel to make ATPHyperglycemia : High blood sugar levels; excess is stored in the liver as glycogenHypoglycemia : Low blood sugar levels; liver will break down glycogen to glucoseto raise levels.

• Fats :

Meat and dairyHandled mostly by liverUse some fats to make ATP

Synthesize lipoproteins, thromboplastin, and cholesterolBody cells remove fat and cholesterol to build membranes and steroid hormonesFats are used for myelin sheaths on neurons, storage around organs, etc.

• Proteins : Meats, eggs, poultryProteins are conserved by body cells because they are used for most cellularstructures; they are only used when there is inadequate carbs or fatIngested proteins are broken down to amino acids which are used to makeenzymes, ect.

There are 20 needed amino acids (8 essential, 12 nonessential)

Factors that Influence Metabolic Rate:• Energy intake = total energy output (heat + work + energy storage) Is liberated during

food oxidationEnergy outputHeat is usually 60%Storage energy is in the form of fat or glycogen

• Regulation of Food Intake:Body weight is usually relatively stable

Energy intake and output usually remain about equalMechanisms that regulate food intake are: levels of nutrients in the blood,hormones, body temperature, and psychological factors

• Metabolic Rate and Heat Production:Basal Metabolic Rate (BMR): Amount of heat produced by the body per unit of time at restFactors that influence BMR:

Surface Area: Small body usually has higher BMRGender : Males tend to have a higher BMRAge : Children have a higher BMR

The amount of thyroxine produced is the most important control factor.More thyroxine means a higher metabolic rate

Total Metabolic Rate (TMR): Total amount of kilocalories the body must consumeto fuel ongoing activities

Increases with an increase in body activity



TMR must equal calories consumed to maintain homeostasis and maintain aconstant weight

Temperature Regulation: Most energy is released as foods are oxidized and most energyescapes as heat.

• Has a narrow range of homeostatic temperature:Must remain between 35.6 to 37.8 C

The body’s thermostat is located in the hypothalamus

Initiates heat-loss or heat-promoting mechanisms• Heat Promoting Mechanisms:Vasoconstriction : Blood is rerouted to deeper, more vital body organs

Shivering : Contraction of muscles produces heat

• Heat Loss Mechanisms: Heat loss from the skin via radiation and evaporationSkin blood vessels and capillaries are flushed with warm blood

Evaporation of perspiration cools the skin

General Metabolic Functions:• Glycogenesis: “Glycogen formation” after carbohydrates are converted into glycogen

molecules to be stored in the liver.• Glycogenolysis: Liver cells break down the stored glycogen as body cells continue to

remove glucose from the blood to meet their needs. “Glycogen splitting.”• Gluconeogenesis: When the liver makes glucose from noncarbohydrates such as fats

and proteins, also known as “formation of new sugars .”

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CIS Human Anatomy Exam Two Study Guide