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Anatomy and Physiology

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Title: Anatomy and Physiology


1
Anatomy and Physiology
  • Heart, Lungs, Pancreas, Liver, Kidneys and Skin

B. Paul White, MD HOD ID 2078
2
(No Transcript)
3
HEART
4
HEART
  • Hollow, muscular organ
  • 300 grams (size of a fist)
  • 4 chambers
  • found in chest between lungs
  • surrounded by membrane called Pericardium
  • Pericardial space is fluid-filled to nourish and
    protect the heart.

5
HEART ANATOMY
  • The heart is a complex muscular pump that
    maintains blood pressure and flow through the
    lungs and the rest of the body.
  • The heart pumps about 100,000 times and moves
    7200 liters (1900 gallons) of blood every day.

6
HEART ANATOMY
  • The heart has four chambers.
  • Two atria act as collecting reservoirs.
  • Two ventricles act as pumps.
  • The heart has four valves for
  • Pumping action of the heart.
  • Maintaining unidirectional blood flow.

7
Functions of the Heart
  • Generates blood pressure
  • Routes blood
  • Heart separates pulmonary and systemic
    circulation
  • Ensures one-way blood flow
  • Heart valves ensure one-way flow

8
Functions of the Heart
  • Regulates blood supply
  • Changes in contraction rate and force match blood
    delivery to changing metabolic needs
  • Most healthy people can increase cardiac output
    by 300500
  • Heart failure is the inability of the heart to
    provide enough blood flow to maintain normal
    metabolism

9
Cardiac Cycle
  • The heart is two pumps that work together, right
    (pulmonary) and left (systemic) half
  • Repetitive, sequential contraction (systole) and
    relaxation (diastole) of heart chambers
  • Blood moves through circulatory system from areas
    of higher to lower pressure.
  • Contraction of heart produces the pressure

10
Cardiac Cycle
11
HEART
  • Deoxygenated blood returns to the heart via the
    superior and inferior vena cava, enters the right
    atrium, passes into the right ventricle, and from
    here it is ejected to the pulmonary artery.
  • Oxygenated blood returning from the lungs enters
    the left atrium via the pulmonary veins, passes
    into the left ventricle, and is then ejected to
    the aorta.

12
Blood Vessels
  • Blood vessels are divided into a pulmonary
    circuit and systemic circuit.
  • Artery - vessel that carries blood away from the
    heart. Usually oxygenated
  • Vein - vessel that carries blood towards the
    heart. Usually deoxygenated.
  • Capillary - a small blood vessel that allow
    diffusion of gases, nutrients and wastes between
    plasma and interstitial fluid.

13
Blood Vessels
  • Systemic vessels
  • Transport blood through the body part from left
    ventricle and back to right atrium
  • Pulmonary vessels
  • Transport blood from right ventricle through
    lungs and back to left atrium
  • Blood vessels and heart are regulated to ensure
    blood pressure is high enough for blood flow to
    meet metabolic needs of tissues

14
Blood Flow
15
LUNGS
  • Lungs comprised of
  • Airways
  • Alveoli

http//www.aduk.org.uk/gfx/lungs.jpg
16
What do the lungs do?
  • Primary function is gas exchange
  • Let oxygen move in
  • Let carbon dioxide move out

17
How do the lungs do this?
  • First, air has to move to the region where gas
    exchange occurs.
  • For this, you need a normal ribcage and
    respiratory muscles that work properly (among
    other things).

18
Conducting Airways
  • Air travels via laminar flow through the
    conducting airways comprised of the following
    trachea, lobar bronchi, segmental bronchi,
    subsegmental bronchi, small bronchi, bronchioles,
    and terminal bronchioles.

19
How do the lungs do this?
  • The airways then branch further to become
    transitional/respiratory bronchioles.
  • The transitional/respiratory zones are made up of
    respiratory bronchioles, alveolar ducts, and
    alveoli.

20
The Airways
  • Conducting zone no gas exchange occurs
  • Anatomic dead space
  • Transitional zone alveoli appear, but are not
    great in number
  • Respiratory zone contain the alveolar sacs
  • Over 8 million branches

Weibel ER Morphometry of the Human Lung. Berlin
and New York Springer-Verlag, 1963
21
How does gas exchange occur?
  • Numerous capillaries are wrapped around alveoli.
  • Gas diffuses across this alveolar-capillary
    barrier.
  • This barrier is as thin as 0.3 µm in some places
    and has a surface area of 50-100 square meters!

22
Gas Exchange
  • Diffusion Barrier crossed by O2 moving from air
    to blood and CO2 from blood to air is made up
    of
  • 1. an aqueous surface film
  • 2. epithelial cells of alveolus
  • 3. interstitial layer
  • 4. endothelial cells of capillaries
  • 5. blood plasma
  • 6. membrane of RBCs

23
Alveoli
  • Approximately 300 million alveoli
  • 1/3 mm diameter
  • Total surface area about 85 sq. meters (size of a
    tennis court)

24
Gas Exchange
From Netter Atlas of Human Anatomy, 1989
25
Control of Ventilation
  • Arterial PO2
  • When PO2 is VERY low, ventilation increases
  • Arterial PCO2
  • The most important regulator of ventilation,
    small increases in PCO2, greatly increases
    ventilation
  • Arterial pH
  • As hydrogen ions increase, alveolar ventilation
    increases, but hydrogen ions cannot diffuse into
    CSF as well as CO2

26
PANCREAS
27
Anatomy of the Pancreas
  • 5" long by 1" thick
  • Head close to curve in C-shaped duodenum
  • Main duct joins common bile duct from liver
  • Sphincter of Oddi on major duodenal papilla
  • Opens 4" below pyloric sphincter

28
Anatomy of the Pancreas
Grays Anatomy of the Human Body
29
Anatomy of the Pancreas
Exocrine glands have ducts that carry their
secretions to specific locations.
Digestive gland that secretes digestive enzymes
into the duodenum through the pancreatic duct.
Grays Anatomy of the Human Body Robbins Basic
Pathology http//faculty.clintoncc.suny.edu/facult
y/Michael.Gregory/default.htm
30
Histology of the Pancreas
31
Histology of the Pancreas
  • Acini- dark clusters
  • 99 of gland
  • produce pancreatic juice
  • Islets of Langerhans
  • 1 of gland
  • pale staining cells
  • produce hormones

32
Bicarbonate Ion Production
33
Functions of the Pancreas
  • Anatomy
  • Endocrine
  • Pancreatic islets produce insulin and glucagon
  • Exocrine
  • Acini produce digestive enzymes
  • Regions Head, body, tail
  • Secretions
  • Pancreatic juice (exocrine)
  • Trypsin
  • Chymotrypsin
  • Carboxypeptidase
  • Pancreatic amylase
  • Pancreatic lipases
  • Enzymes that reduce DNA and ribonucleic acid

34
Bicarbonate Ion Production
35
LIVER
36
LIVER
  • Largest gland in the body (1.4 kg 3 lbs.)
  • Produces bile
  • Stored in GB
  • Emulsifies fats
  • Involved in metabolism
  • Diaphramatic and visceral surface
  • Right and left lobes
  • Porta hepatis major vessels and nerves
  • Right and left hepatic ducts, common bile, common

37
Histology of the Liver
  • Hepatocytes arranged in lobules
  • Sinusoids in between hepatocytes are blood-filled
    spaces
  • Kupffer cells phagocytize microbes foreign
    matter

38
Histology of the Liver
39
Histology of the Liver
40
Functions of the Liver
  • Bile production
  • Salts emulsify fats, contain pigments as
    bilirubin
  • Storage
  • Glycogen, fat, vitamins, copper and iron
  • Nutrient interconversion
  • Detoxification
  • Hepatocytes remove ammonia and convert to urea
  • Phagocytosis
  • Kupffer cells phagocytize worn-out and dying red
    and white blood cells, some bacteria
  • Synthesis
  • Albumins, fibrinogen, globulins, heparin,
    clotting factors

41
Bile
  • About 600 ml of bile is produced daily
  • Bile acid
  • Phospholipids
  • Cholesterol
  • Bilirubin
  • Waste products
  • Electrolytes
  • Mucin

42
KIDNEYS
43
KIDNEYS
  • Play a major role in maintaining homeostasis
  • Maintain water balance
  • Regulate the quantity and concentration of ECF
    ions
  • Regulate the plasma volume
  • Regulate pH by controlling elimination of acid
    and base in urine
  • Maintain osmolarity
  • Regulate the concentration of plasma constituents
    (e.g. electrolytes and water)

44
KIDNEYS
  • Kidneys have excellent blood supply 0.5 total
    body weight but 20 of Cardiac Output.
  • Kidneys process plasma portion of blood by
    removing substances from it, and in a few cases,
    by adding substances to it.
  • Works with cardiovascular system (and others!) in
    integrated manner

45
Functions of the kidneys
  • Regulation of H2O and inorganic ion balance
    most important function!
  • Removal of metabolic waste products from blood
    and excretion in urine.
  • Removal of foreign chemicals in the blood (e.g.
    drugs) and excretion in urine.
  • Gluconeogenesis
  • Endocrine functions (e.g. renin, erythropoetin,
    1,25-dihydroxyvitamin D)
  • In kidney disease, build-up of waste serious, but
    not a bad as ECF volume and composition
    disturbances.

46
Functions of the kidneys
  • Water balance
  • Electrolyte balance
  • Plasma volume
  • Acid-base balance
  • Osmolarity balance
  • Excretion
  • Hormone secretion

47
Acid-Base Balance
  • Kidneys VERY important for acid-base balance,
    along with respiratory system.
  • Important because all biochemical processes must
    occur within an optimal pH window.
  • Prevent ACIDOSIS or ALKALOSIS.
  • Although the lungs excrete a large amount of CO2,
    a potential acid formed by metabolism, the
    kidneys are crucial for excreting non-volatile
    acids.
  • To maintain acid-base balance, kidney must not
    only reabsorb virtually all filtered HCO3-, but
    must also secrete into the urine the daily
    production of non-volatile acids.

48
KIDNEY
49
Internal Anatomy of Kidneys
  • Cortex Outer area
  • Renal columns
  • Medulla Inner area
  • Renal pyramids
  • Calyces
  • Major Converge to form pelvis
  • Minor Papillae extend
  • Nephron Functional unit of kidney
  • Juxtamedullary
  • Cortical

50
Kidney Failure
  • at age 49 years, the expected duration of life of
    a patient with end-stage renal disease on
    hemodialysis is 7 additional years compared with
    approximately 30 additional years for a person of
    the same age from the general population.

51
Dialysis and Transplant
Hemo-dialysis
Peritoneal dialysis
52
SKIN
53
SKIN
  • Largest organ of the body.
  • Surface area 1.5 - 2 m2.
  • Average adult weight 9 kg.
  • Functions - protection, defence, sensation,
    thermoregulation, vit D synthesis, excretion,
    storage.

54
SKIN
  • 2 Principal portions
  • Epidermis - epithelium
  • Dermis areolar dense irregular connective
    tissue
  • Hypodermis
  • beneath the dermis
  • the subcutaneous layer next to
  • adipose layer or
  • muscle or
  • bone

55
Functions of the Skin
  • Protection
  • Prevents invasion of environmental toxins and
    microorganisms
  • Immunologic
  • Sebum has antibacterial properties which helps
    shed topical bacteria
  • Thermoregulation
  • Insulates from heat loss and controls loss of
    heat through evaporation

56
Functions of the Skin
  • Fluid and Electrolyte Balance
  • Controls sodium excretion
  • Sebum retards fluid loss from skin
  • Metabolism
  • Produces Vitamin D
  • Prevents excessive fluid loss
  • Neurosensory
  • Nerve endings and receptors process environmental
    stimuli for pain, touch, heat and cold
  • Social and Interactive
  • Provides body image and personal identity

57
Epidermis
  • Provides barrier function.
  • Multilayered structure, continually regenerating.
  • Thickness dependent on exposure to friction.
  • Stratified squamous epithelium, organised in five
    layers.
  • Stratum basale Stratum spinosum, Stratum
    granulosum, Stratum lucidum, Stratum corneum.

58
Epidermis
  • First layer of defense
  • Composed of dead, keratinized cells and
    surrounded by a lipid monolayer
  • There are no blood vessels. It is fed by
    capillaries in the dermis.
  • If the epidermis is destroyed but the appendages
    of the dermis remain, a new epidermis is formed
    when the epithelial grow out of the hair
    follicles.

59
  • EPIDERMIS
  • 4 cell types
  • Keratinocytes - 90
  • filled with keratin (protein)
  • waterproof barrier
  • Melanocytes - 8
  • produce melanin (pigment)
  • pass melanin to keratinocytes
  • Langerhans cells
  • phagocytes (from immune system)
  • easily damaged by UV light
  • Merkel cells
  • in deepest layer of hairless skin
  • sensory transduction - touch

60
Epidermis
SC
SG
SS
B
61
Dermis
  • Varies in thickness across body.
  • 1 mm on face , 4 mm on back.
  • Responsible for most major functions of the skin.
  • Two distinct layers
  • Papillary dermis,
  • Reticular dermis.

62
Dermis
  • Few cells present - fibroblasts, macrophages,
    adipocytes
  • Intracellular matrix thick with many protein
    fibers collagen, elastin, reticular
  • The location for blood vessels, nerves and
    sensory receptors, glands, hair follicles

63
Dermis
  • Collagen and fibrous connective tissue
  • Contains capillaries and arterioles
  • Has special sensory nerve fibers and lymph system
  • Meissner Corpuscle light touch, just beneath
    epidermis
  • Vater Pacini Corpuscles pressure sensors, deep
    in subq
  • Ruffini Corpuscles heat sensors, deep in subq
    tissue
  • Krause Corpuscles cold sensors, deep in
    subcutaneous tissue

64
Dermis
  • Papillary region - outer layer - 20
  • areolar connective tissue, elastic fibers
  • dermal papillae mound-like projections to
    increase the surface area for nutrition from
    capillaries
  • some papillae contain Meissner's corpuscles (for
    light touch)

65
Dermis
  • Reticular region-80
  • dense, irregular connective tissue
  • collagen, elastic fibers in a network surrounding
    the various cells
  • fibers give strength, elasticity, extensibility
  • tears in reticular region - "stretch marks -
    long straight red or white streaks

66
Layers of the Dermis.
67
Subcutaneous Tissue
  • Connective tissue
  • Fat cells in most areas
  • Blood vessels
  • Nerves
  • Base of hair follicles
  • Function
  • Insulation
  • Storage of nutrients

68
Skin Blood Vessels
Superficial dermal plexus.
Cutaneous plexus
Subcutaneous plexus.
69
Types of Burns
  • Superficial
  • Superficial partial thickness
  • Deep partial thickness
  • Full thickness

70
Partial Thickness Burn
  • Can be superficial or deep
  • Involves epidermis and dermis
  • Has blister formation
  • Moist appearance
  • Tactile and pain sensors intact
  • Will usually heal on own but will scar

71
Full Thickness Burn
  • Involves all layer of skin
  • Has waxy and dry appearance
  • Elasticity destroyed
  • Painless
  • Does not heal without intervention
  • Autologous skin graft or banked skin
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