Lezione 1 GENERALITÀ

Ingegneria delle tecnologie per la salute

Fondamenti di anatomia e istologia

aa. 2019-20 Lezione 1

GENERALITÀ

LEZIONE 1

Presentazione del corso Generalità Organizzazione strutturale del corpo umano Terminologia

Dott. Luca Ansaloni Dott.ssa Paola Fugazzola

[email protected] [email protected] [email protected]

DOCENTI

mailto:[email protected]



Lezione frontali, laboratorio su manichino digitale

METODI DIDATTICI

Tot 48 ore (II semestre)

Il corso ha come principali finalità la conoscenza dell’organizzazione micro e macroscopica del corpo umano al fine di rendere possibile la comprensione della fisiologia e della patogenesi delle malattie. In particolare gli argomenti trattati dal corso saranno i seguenti: anatomia generale; cenni di citologia; istologia; cenni di embriologia generale; anatomia macroscopica e microscopica degli organi dell’apparato locomotore, dell’apparato circolatorio, dell’apparato respiratorio, dell’apparato digerente, dell’apparato urinario, dell’apparato genitale femminile, dell’apparato genitale maschile, dell’apparato endocrino, dell’apparato tegumentario; organizzazione anatomica del sistema nervoso centrale e del sistema nervoso periferico; apparati della sensibilità specifica; cenni di anatomia topografica, radiologica e clinica.

PROGRAMMA

ANATOMIA GEN. Organizzazione del corpo umano: cellule, tessuti, organi, apparati. Terminologia anatomica, piani di riferimento, terminologia relativa ai movimenti. Spazi corporei. CITOLOGIA Cell. eucariote. Membrana cell. Citosol, organelli citoplasmatici e nucleo. ISTOLOGIA Classificazione dei tessuti. Epiteli: di rivestimento; secernenti (esocrini, endocrini); sensoriali. Endoteli. T. connettivo: propriamente detto; t. adiposo; t. cartilagineo; t. osseo. Sangue: plasma ed elementi corpuscolati. T. muscolare (liscio; striato scheletrico e cardiaco). T. nervoso: neuroni, dendriti, assoni, fibre mieliniche. Cellule gliali. Mielina. Sinapsi. APPARATO LOCOMOTORE A. macro-microscop. di ossa, muscoli, tendini. Architettura gen. (segmenti scheletrici, articolazioni, gruppi muscolari) di testa, colonna vertebrale, cingolo scapolare, arto sup., torace, parete add., cingolo pelvico e arto inf. APPARATO CIRCOLATORIO Struttura dei vasi (arterie, vene, capillari, vasi linfatici). Cuore e pericardio. Tessuto di conduzione cardiaco. Arterie della circolazione gen.: origine, decorso e territorio di vascolarizzazione. Vene della circolazione gen.: origine, decorso e territorio di drenaggio. Sistema linfatico: dotti linfatici, drenaggio linfatico e stazioni linfonodali dei distretti corporei. A. macro-microscop. di timo, milza, linfonodi, tonsille, tessuto linfoide associato alle mucose. Midollo osseo.

PROGRAMMA

APPARATO RESPIRATORIO Organizzazione gen. dell’apparato respiratorio. A. macro-microscop. di naso, cavità nasali e paranasali, laringe, trachea, albero bronchiale, polmone e pleure. Vascolarizzazione funzionale e nutrizia del polmone. Mediastino. APPARATO DIGERENTE A. macro-microscop. di cavità buccale, ghiandole salivari, faringe, esofago, stomaco, intestino tenue (duodeno, digiuno, ileo), intestino crasso (ceco, appendice vermiforme, colon, retto), fegato, vie biliari extraepatiche e pancreas. Cavità peritoneale. Organizzazione gen. della circolazione splancnica; vena porta. APPARATO URINARIO A. macro-microscop. di reni, ureteri, vescica, uretra. APPARATO GENITALE FEMMINILE E MASCHILE A. macro-microscop. di ovaio, utero, tube uterine, vagina, genitali esterni f., testicolo, dotto deferente, vescicole seminali, prostata e genitali esterni m. Pelvi e perineo. APPARATO ENDOCRINO A. macro-microscop. di ipofisi, epifisi, tiroide, paratiroidi, surrene, pancreas endocrino e sistema endocrino diffuso. APPARATO TEGUMENTARIO A. macro-microscop. di cute, annessi cutanei e mammella. SISTEMA NERVOSO CENTRALE E PERIFERICO A. macro-microscop. di midollo spinale, tronco encefalico, cervelletto, lamina quadrigemina, diencefalo, telencefalo. Ventricoli cerebrali e circolazione liquorale. Meningi. Vascolarizzazione del SNC. Vie della sensibilità generale. Retina e vie ottiche, recettori e vie statoacustiche, via gustativa, via olfattiva. Vie discendenti di moto. Sistemi di controllo del movimento: gangli della base, cervelletto. Sistemi di regolazione delle funzioni viscerali e attività emozionali : recettori e vie della sensibilità viscerale; ipotalamo; sistema limbico. Sistemi di regolazione delle funzioni cognitive e comportamentali. Formazione reticolare del tronco encefalico. Struttura dei nervi periferici e gangli. Sistema nervoso vegetativo: ortosimpatico, parasimpatico. Nervi spinali, plessi dei nervi spinali, nervi encefalici. APPARATI DELLA SENSIBILITÀ SPECIFICA A. macroscopica e microscopica del bulbo oculare e dell’orecchio (est, medio, int).

PROGRAMMA

- OpenStax Anatomy and physiology

(https://openstax.org/details/anatomy-and-physiology)

- Eroschenko V. "diFiore’s atlas of histology with functional

correlations" 12th ed. 2013 Lippincott Williams & Wilkins,

Philadelphia, USA

- Feneis H. and Dauber W. "Pocket Atlas of Human Anatomy"

4th ed. Thieme New York, New York, USA

- Snell R.S. "Clinical anatomy by regions" 9th ed. 2012

Lippincott Williams & Wilkins, Philadelphia, USA

- Kamina P. "Atlante di Anatomia" 2014 Piccin, Padova, Italy

- "The Biodigital Human" https://www.biodigital.com/

TESTI DI RIFERIMENTO

- OpenStax Anatomy and physiology (https://openstax.org/details/anatomy-and-physiology) - Eroschenko V. "diFiore’s atlas of histology with functional correlations" 12th ed. 2013 Lippincott Williams & Wilkins, Philadelphia, USA - Feneis H. and Dauber W. "Pocket Atlas of Human Anatomy" 4th ed. Thieme New York, New York, USA - Snell R.S. "Clinical anatomy by regions" 9th ed. 2012 Lippincott Williams & Wilkins, Philadelphia, USA - Kamina P. "Atlante di Anatomia" 2014 Piccin, Padova, Italy - "The Biodigital Human" https://www.biodigital.com/












2 sessioni = 1 semestre

24.2.2020 – 7.4.2020 = sessione 1 8.4 e 16-18.4.2020 = prova in itinere 1 20.4.2020 – 6.6.2020 = sessione 2 8.6.2020 – 12.6.2020 = prova in itinere 2

2 sessioni = 1 semestre

sessione 1 Lezioni (Martedì) 25.2 13,30-17,30 [4 ore] 3.3 13,30-17,30 [4 ore] 10.3 13,30-17,30 [4 ore] 17.3 13,30-17,30 [4 ore] 24.3 13,30-17,30 [4 ore] 7.4 13,30-17,30 [4 ore] Totale 24 ore

ESAMI

Introduzione del corso. Introduzione all’anatomia: terminologia. Organizzazione generale: cellule, tessuti,

organi, apparati, sistemi.

Overview of Anatomy and Physiology

By the end of this section, you will be able to: • Compare and contrast anatomy and physiology, including their specializations

and methods of study • Discuss the fundamental relationship between anatomy and physiology

Human anatomy is the scientific study of the body’s structures.

The word “anatomy” comes from a Greek root that means “to cut apart.”

Lezione di anatomia del dottor Tulp, Rembrandt (1632)

areas of specialization: Gross anatomy = the study of the larger structures of the body, those visible without the aid of magnification, also referred to as macroscopic anatomy. Microscopic anatomy = the study of structures that can be observed only with the use of a microscope or other magnification devices, includes cytology, the study of cells and histology, the study of tissues.



2 general approaches to the study of the body’s structures: regional anatomy = the study of the interrelationships

of all of the structures in a specific body region.

systemic anatomy = the study of the structures that make up a discrete body system—that is, a group of structures that work together to perform a unique body function.


Whereas ANATOMY is about structure, PHYSIOLOGY is about function.

Human physiology is the scientific study of the chemistry and physics of the structures of the body and the ways in which they work together to support the functions of life. Much of the study of physiology centers on the body’s tendency toward homeostasis.


HOMEOSTASIS = state of steady internal conditions maintained by living things.

Form is closely related to function in all living things. Your study of anatomy and physiology will make more sense if you

continually relate the form of the structures you are studying to their function. In fact, it can be somewhat frustrating to attempt to study anatomy without an understanding of the physiology that a body structure supports.

Structural Organization of the Human Body

Basic architecture of the human body: its smallest parts are assembled into larger structures the structures of the body to be considered in terms of fundamental levels of organization that increase in complexity

By the end of this section, you will be able to: • Describe the structure of the human body in terms of six levels of organization

• List the eleven organ systems of the human body and identify at least one organ

and one major function of each


subatomic particles, atoms,

molecules, organelles,

cells,

tissues,

organs,

organ systems,

organisms and biosphere



Assigning organs to

organ systems can

be imprecise since

organs that

“belong” to one

system can also

have functions

integral to another

system.

11 DISTINCT ORGAN SYSTEMS IN THE HUMAN BODY

• different organ systems have different functions and therefore unique roles to perform in physiology

• functions can be summarized in terms of a few that we might consider definitive of human life:

Functions of Human Life

By the end of this section, you will be able to: • Explain the importance of organization to the function of the human organism

• Distinguish between metabolism, anabolism, and catabolism

• Provide at least two examples of human responsiveness and human movement

• Compare and contrast growth, differentiation, and reproduction

organization, metabolism, responsiveness, movement, development, and reproduction


Organization A human body consists of trillions of cells organized in a way that maintains distinct internal compartments.

These compartments keep body cells separated from external environmental threats and keep the cells moist

and nourished. They also separate internal body fluids from the countless microorganisms that grow on body

surfaces, including the lining of certain tracts, or passageways.

Metabolism The first law of thermodynamics holds that energy can

neither be created nor destroyed—it can only change form.

Your basic function as an organism is to consume (ingest)

energy and molecules in the foods you eat, convert some

of it into fuel for movement, sustain your body functions,

and build and maintain your body structures. There are

two types of reactions that accomplish this: Anabolism is the process whereby smaller, simpler

molecules are combined into larger, more complex

substances. Catabolism is the process by which larger more

complex substances are broken down into smaller simpler

molecules. Metabolism is the sum of all anabolic and catabolic

reactions that take place in the body and occur simultaneously and continuously.

adenosine triphosphate (ATP)


Responsiveness the ability of an organism to adjust to changes in its internal and external environments.

Movement Human movement includes not only actions at the joints of the body, but also the

motion of individual organs and even individual cells.

Development, growth and reproduction Development = all of the changes the body goes through in life, including the

processes of differentiation, growth, and renewal.

Growth = the increase in body size, by increasing the number of existing cells,

increasing the amount of non-cellular material around cells (such as mineral deposits

in bone), and, within very narrow limits, increasing the size of existing cells.

Reproduction = the formation of a new organism from parent organisms.

H. Sapiens has been adapted to life on Earth for at least the past 200,000 years with 4

requirements of life.

1. Oxygen Atmospheric air is only about 20% oxygen, but that oxygen is a key component of the chemical

reactions that keep the body alive, including the reactions that produce ATP, important

especially for brain.

2. Nutrients = substance in foods and beverages that is essential to human survival. 3 basic classes of

nutrients are water, the energy-yielding and body-building nutrients, and the micronutrients

(vitamins and minerals). Water and the energy-yielding nutrients also referred to as

macronutrients because the body needs them in large amounts. Some others micronutrients,

such as vitamin C and most of the B vitamins, are water-soluble and cannot be stored, so you

need to consume them every day or two.

Requirements for Human Life

By the end of this section, you will be able to: • Discuss the role of oxygen and nutrients in maintaining human survival

• Explain why extreme heat and extreme cold threaten human survival

• Explain how the pressure exerted by gases and fluids influences human survival


3. Narrow Range of Temperature

T may cause deaths because chemical reactions upon which the body depends can only

take place within a narrow range of body T, from just below to just above 37°C (98.6°F).

When body temperature rises well above or drops well below normal, enzymes that

facilitate chemical reactions lose their normal structure and their ability to function and

the chemical reactions of metabolism cannot proceed.

Body can respond effectively to short-term exposure to heat (sweating) or cold (shivering

and increased breakdown of stored energy to generate heat. (When that energy reserve

is depleted, however, and the core temperature begins to drop significantly, red blood

cells will lose their ability to give up oxygen, denying the brain of this critical component of ATP production).


4. Narrow Range of Atmospheric Pressure Pressure is a force exerted by a substance that is in contact with another substance.

Atmospheric pressure is pressure exerted by the mixture of gases (primarily nitrogen

and oxygen) in the Earth’s atmosphere. Although you may not perceive it, atmospheric

pressure is constantly pressing down on your body. This pressure keeps gases within

your body, such as the gaseous nitrogen in body fluids, dissolved. Atmospheric pressure

does more than just keep blood gases dissolved. Your ability to breathe—that is, to take

in oxygen and release carbon dioxide—also depends upon a precise atmospheric

pressure.

Set point = the physiological value

around which the normal range

fluctuates.

Normal range = the restricted set of

values that is optimally healthful and

stable.

Control centers in the brain and other

parts of the body monitor and react to

deviations from homeostasis using

negative feedback.

Negative feedback = a mechanism that

reverses a deviation from the set point,

maintaining body parameters within

their normal range, it has 3 basic

components: sensor, (receptor), control

center, effector.

Homeostasis By the end of this section, you will be able to: • Discuss the role of homeostasis in healthy functioning

• Contrast negative and positive feedback, giving one physiologic example of

each mechanism

Homeostasis

Homeostasis

Positive Feedback

Positive feedback intensifies a change

in the body’s physiological condition

rather than reversing it. A deviation

from the normal range results in more

change, and the system moves

farther away from the normal range.

Positive feedback in the body is

normal only when there is a definite

end point. Childbirth and the body’s

response to blood loss are two

examples of positive feedback loops

that are normal but are activated only

when needed.

the purpose of this language is not to confuse, but rather to increase precision and reduce medical errors: by using precise anatomical terminology, we eliminate ambiguity.

Anatomical Terminology

By the end of this section, you will be able to: • Demonstrate the anatomical position

• Describe the human body using directional and regional terms

• Identify three planes most commonly used in the study of anatomy

• Distinguish between the posterior (dorsal) and the anterior (ventral) body cavities,

identifying their subdivisions and representative organs found in each • Describe serous membrane and explain its function


Anatomical Position To further increase precision, anatomists

standardize the way in which they view the

body: the standard body “map,” or

anatomical position, is that of the body

standing upright. It does not matter how

the body being described is oriented, the

terms are used as if it is in anatomical

position.

A body lying down is described as either prone (= face-down orientation) or supine(= face up orientation).


Anatomical Position


Anatomical Position

A body lying down is described as either prone (= face-down orientation) or supine(= face up orientation).


Regional Terms The human body’s

numerous regions have

specific terms to help increase precision


Regional Terms


Directional Terms directional anatomical terms

appear throughout anatomy

textbook and are essential for

describing the relative

locations of different body structures.


Directional Terms


Directional Terms


Directional Terms


Directional Terms


Body Planes

Section = 2-dimensional surface of a 3-dimensional

structure that has been cut [scan (“virtual sections”) of living

bodies for modern medical imaging] Body sections and scans can be correctly interpreted, however, only if the

viewer understands the plane along which the section was made.

Plane = imaginary 2-dimensional surface that passes

through the body.


Body Planes


Body Planes 3 planes commonly referred to in

anatomy:

• sagittal = divides vertically into

right and left sides: if runs directly

down the middle of the body, it is

called the midsagittal or median plane (if divides into unequal right and

left sides, it is called parasagittal or

longitudinal plane).

• frontal = divides into an anterior

(front) portion and a posterior (rear)

portion (often referred to as a

coronal plane).

• transverse = divides the body or

organ horizontally into upper and

lower portions (cross sections).


Body Planes • sagittal

• frontal = coronal

• transverse


Body Planes • sagittal


Body Cavities and Serous Membranes The body maintains its internal organization by means of membranes, sheaths, and

other structures that separate compartments. The dorsal (posterior) cavity and the

ventral (anterior) cavity are the largest body compartments.


Body Cavities and Serous Membranes


Abdominal Regions and Quadrants To promote clear communication, for instance about the location of a patient’s

abdominal pain or a suspicious mass, health care providers typically divide up the cavity into either 9 regions or 4 quadrants


Membranes of the Anterior (Ventral) Body Cavity A serous membrane (also referred to a serosa) is one of the thin membranes that

cover the walls and organs in the thoracic and abdominopelvic cavities. The parietal

layers of the membranes line the walls of the body cavity. The visceral layer of the

membrane covers the organs (the viscera). Between the parietal and visceral

layers is a very thin, fluid-filled serous space, or cavity.

3 serous cavities

and their associated

membranes:

1. pleura

2. pericardium

3. peritoneum

fourteenth and fifteenth centuries: Leonardo da Vinci and Andreas Vesalius

late nineteenth century: non-surgical methods to look inside the living body

Medical Imaging

By the end of this section, you will be able to: • Discuss the uses and drawbacks of X-ray imaging

• Identify four modern medical imaging techniques and how they are used

Perfezione del corpo umano?

La natura possiede delle perfezioni per mostrare che essa è l’immagine di Dio; e dei difetti, per mostrare che ne è solo l’immagine. (Blaise Pascal)

GENESI cap 1 26 Poi Dio disse: «Facciamo l'uomo a nostra immagine, conforme alla nostra somiglianza, e abbiano dominio sui pesci del mare, sugli uccelli del cielo, sul bestiame, su tutta la terra e su tutti i rettili che strisciano sulla terra». 27 Dio creò l'uomo a sua immagine; lo creò a immagine di Dio; li creò maschio e femmina. …31 Dio vide tutto quello che aveva fatto, ed ecco, era molto buono. Fu sera, poi fu mattina: sesto giorno.

…errori di design…

Brown P. «Letter to God» BMJ 2006;332:1341 doi: http://dx.doi.org/10.1136/bmj.332.7553.1341



«è chiaro che non era Sua intenzione farci camminare su due gambe, ma abbiamo perversamente insistito per farlo e il risultato sono i problemi che oggi affliggono la nostra spina dorsale e le nostre ginocchia. Sarebbe auspicabile se, per cancellare questo errore, Lei potesse raddrizzare il bacino al giusto angolo retto o rafforzare le giunture delle ginocchia che reggono tutto il peso corporeo»

…lucy…

…varicose vein…

…varicose vein…

…varicose vein…

VALVE

…defecation…

haemorroids

L’essere umano è tuttora costretto a flettere le anche a 90°

…inguinal hernia…

Inguinal hernia

…anche, ginocchia, colonna vertebrale…

Anche, ginocchia, colonna vertebrale



…eliminare le tonsille, che notoriamente non servono a niente, e riempire le cavità nasali, che vuote come sono diventano un comoda

coltura per le infezioni; rimpicciolire le falangette, ossia la punta delle dita delle mani, per

facilitare la scrittura sulla tastiera del computer, del Blackberry e del telefonino (ma polpastrelli più piccoli significa anche impronte digitali più piccole, complicando le indagini della polizia);

aggiungere un fegato e un cuore di riserva, per poter bere alcolici e mangiare una cucina grassa quanto si vuole, senza preoccupazioni dietetiche e per la salute;

eliminare l'appendice, di cui ci accorgiamo solo quando si infetta e bisogna dunque toglierla;

ricollocare i genitali maschili in una zona del corpo meno vicina agli organi dell'escrezione e possibilmente più riparata, al sicuro da colpi e oggetti volanti, per esempio mettendoli sotto le ascelle e rendendoli estraibili.

[email protected]

[email protected]

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Lezione 1 GENERALITÀ