Au xl

MUSCULAR SYSTEM

Match the words with the definitions:

gastrocnemius; Achilles tendon; bursal talocrural joint; malleolus; plantarflexion;calcaneusl hyaline cartilage; greater trochanter; piriformis; greater sciatic notch;z1-gomatic bone; internal auditory meatusl pectoialis major; ribs; deltoid muscle;teres major; Iatissimus dorsi; suprascapular notch; foramen; humerusl clavicle;sternum; deltoid tuberosity; ilium; gruteus maximusl tibia; fibura; liopsoas; coccyx;cruciform ligaments (cruciate ligaments)

l)opening2)is a long bone in the arm or forelimb that runs from the shoulder to the elbow3)provides a cushion between bones and tendons and/or muscles around a joint4)muscle that is in the back part of the lower leg and also called the calf5)rynovial hinge joint that connects the distal ends of the tibia and fibula in the lower

limb *ith the proximal end of the talus bone in the foot6)makes up a large portion of the shape and appearance of the buttocksIF thicl-r fan-shaped muscle. situated at the chestt)*ankbone; shinbone9!he muscle forming the rounded contour of the shoulderl0)heel boneI llLe r-enual ends of ribs: in the larynx, trachea, and bronchi; and on the articular

sJrfaoe of bones1?icalf Lnne13) is tre flnovement rltich increases the approximate 90 degree angle between the frontpat of&e ibor ad the shinl4}arm"sc1e in tre glur€al regon of the lower limblll@ r=gule- quadrilderal eminence and a part of the skeletal system

-!ftrac+ps 6e plauurir gasEocnemius (calf) and soleus muscles to the calcaneustleefrtte

lftbe Weqn rrr aad tegEst bone of the pelvisitid hfuPEfiurs bone ofthe temporal bone of the skull that carries nerves fromiirsitufuqaimtos"rds the middle and inner earI9trhrranefurfrebonl'prominence on each side of the ankleshwred im a foramen by the sacrospinous ligamentlIk&etboae. malarf6ag]3hd iEGE lfieral part of the upper border of the scapula, just next to the base of&m*tprocssS$Fftlmgorrved bones which form the ribcageS{Fdeofthe upper limb and one of six scapulohumeral musclesSSFElrEEr- fla, dorso-lateral muscle on the trunk, posterior to the armSlnolhbme \lSffreas$one2t|freregion on the shaft of the humerus to which the deltoid muscle attaches3g)dffid hip muscles or inner hip muscles

30)tailbone31)pairs of ligaments arranged like a letter X

iI. Complete the sentences in a suitable way:

l. ... is a space or shallow depression located at the back of the knee-joint.2. , . . are the string-like tendons felt on either side of the back of the knee.3. . . . forms the lower and back part of the hip bone (os coxae).4. ... are layers of flat broad tendons. They have a shiny, whitish-silvery color, and

are histologically similar to tendons5. . . . an adjective that means of or pertaining to the abdominal segment of the torso,

between ihe diaphragm and the sacrum or lower spine6. ... the largest and the most superficial (outermost) of the three flat muscles of the

lateral anterior abdomen.7 , . . . is the superior border of the wing of ilium and the superolateral margin of the

greater pelvis.8. ... is a paired muscle running vertically on each side of the anterior wall of the

human abdomen9. . . . is formed by the aponeuroses of the Obliqui and Transversus. It contains the

Rectus abdominis and Pyramidalis muscles.10. ... is the midline carlilaginous joint (secondary cartilaginous) uniting the superior

rami of the left and right pubic bones. It is located anterior to the urinary bladderand superior to the external genitalia

1 L . . . is a layer of dense irregular connective tissue which surrounds the cartilage ofdeveloping bone. It consists of two separate layers: an outer fibrcus layer anCinner chondrogenic layer.

12. .. . is a hyaline cartilage plate in the metaphysis at each end of a long bone.13. ... is the wider portion of a long bone adjacent to the epiphyseal plate.It is this

part cf the bone that grows during childhood; as it grows, it ossifies near thediaphysis and the epiphyses.

14. ... a state in which muscles are floppy, lacking their normal elasticity.15. ... is the wasting away of a normaliy developed organ or tissue due to

degeneration of cells. In the case of muscle tissue, the individual muscle fibersdecrease in size due to a progressive loss of myofibrils

16. .. . is prolonged painful involuntary. contraction of skeletal muscle.17 . ... is inflammation of fibrous connective tissues in muscles. It often affects the

muscles of the trunk and back.18. ... is inflammation of muscle fibers19. ... represents a sustained involunrarl'rnuscriar contraction (which may occur

either as part ofa generaiized disorder sucl a: s:as:ic paralysis, or as a localresponse to an othenvise unconnected pai:^ui co:iiiion. i

20. ... represents muscular h1-pertonicitl'{i.e. a: :i;:e-e i:-:ie srate of readiness ofmuscle fibers to contract: an increase in pa::t:- c::-:1:-:: ','. ;:h an increasedresistance to stretch. \loderate cases shou'ir-ci'=:-;:-: ::;---:-:: ::eat effort and alack of normal coo:cinaiion. rrhi:e sii::: c.-.:. s:-:'.,. a]-:::=:::=: ::-,:r ements thatare coordinated.

---t:=:.-. :;-l-: :- --'' 3:Si:etChing'- la -: ''" -:,--:= -: =:.-s:.e. resulting in pain and swelling of the

i- '::::.: :.::osis. or ischemic bone necrosis is a

: -=:-..:,::1, .: Dermanent loss of blood supply to the

: :-: : -:. -.:.: '3r'ne tissue dies and the bone collapses'

"' ,..:: : l:-r e\pands due to abnormal development of-- -:, -:,:. :: :iore. of the following:uneven growlh of

= _=-- --.,-.\

- : --:r:-: -- '.i:-;: one (or more) of the parathyroid glands

--: : --:-:',1--.1l-Jlrilone. $'hich can result in the loss of bone

: - - ::,: : --:::\\'omen.- :: ::.: -.-::::r for an infection in abone. Infections can reach abone'r''

::; : :: :-:- -:: ;our bioodstream or spreading from nearby tissue' Infectiois

;: * . :.. . - =. bone itself if trauma exposes your boneto germs' Bone

: :-:- :. :-=-:--'li1' affect the long bones ofyour body, such as your leg'0"::sjr : -:::: a-- :-rne. as well as youf spine and pelvis'

: ::. ' i-.-i,= :,: bones in children potentially leading to fractures and det-o::::-:-

t: i :-- ---: :3 most frequent childhood diseases in many developing coun::lc.

-- . ::-:::--:lant cause is a vitamin D deficiency

Osteogenesis imperttc:a: Bursitis: Avascular necrosis; Fibrous dysplasia: Osie:=:----,Osteoporosis: Ricke',s: Primarl'h1'perparathyroidism; Paget's disease; Rheuma:.--:

Arthritis ; O steoml'e1 iti s

CARDIOVASCULAR SYSTEM

I Match the terms of the left with the right definition on the right:

1. Angioiogy2. Aortopathy3. Endoarterectomy4. Venogram5. Phlebolith

6. Cardialgia7. Cardiograph8. CardiomyophathY9. Myocardium10. Cardiomotility

11. Valvotomy

12. Vasculitisi3. CardiovalvulotomY14. Angiograml5.Angiosclerosis

16. Dextrocardia17. PhonocardiograPhY18. Endocarditis19. Pericardium20. Valvoplasty

HeartAortaVeinBlood clootBlood

a)disease ofan aorta

b)stone within a veinc)X-ray picture of a veind)removing fatty deposits on an artery

e)study of blood vessels and lymphatics

f)movements of the heartg)the heart muscleh)disease ofthe hearti)pain in the heartj)instrument for recording heart beat

k)surgical correction by cutting part of aheart valvel)incision into a valvem)hardening of blood vessels

n)inflammation of blood vessels

o)X-ray picture of blood vessels

p)surgical repair of heart valver) inflammation inside heart (lining)s)recording heart sounds

t)condition of right heartu)membrane sac around the heart

II Match the technical term on the left with the definition on the right:

phlebo-thrombo-aorto-cardio-haem(at)-

III Give the medical term of the following conditions:

1. paralysis of the heart

2. abnormal softening of the bones

3.4.

5.

6.

congenital condition in which some teeth are missingabnormal condition where the heart is located towards the right side of the chest

surgical removal of the uterussurgical creation of an opening through the abdominal wall into the stomach

near the pyloruspainful sensations in the tongueblood poisoning caused by bacterial toxic substances in the blood

the presence of stones (calculi) in the kidneyinflammation involving both the brain and the spinal cord

persistent watery mucus discharge from the nose

beneath the skinsurgical repair of the jawsurgical puncture to remove fluid from the chest cavitypertaining to the neck and the arms

drooping of an upper eyelid

IV. Give the adjective of the following:Neurosis; epilepsy; pleurae; larynx; ovary;brachim; meninges; lymph; nerve;

anastomosis ; dyspnea; pectus ; auris ; haemorrhagia; schizophren i a

V. Fill the gaps with the right word:

a). ...is the property of a system, either open or closed, that regulates its internal

environment and tends to maintain a stable, constant condition.

b). ...play a fundamental role in hemostasis and are a natural source of growth factors.

c). ... is a milky bodily fluid consisting of lymph and emulsified fats, or free fatty

acids, formed in the small intestine.

d)....is on the right side of the heart, between the right atrium and the right ventricle.

e). . . . is the large vein that carries de-oxygenated blood from the lower half of the body

into the right atrium of the heart.

0.... is a phase of the cardiac cycle where the myocardium is contracting in a

coordinated manner in response to an endogenous electrical stimulus, and pressure is

being generated within the chambers of the heart driving blood flow.g)....is the impulse-generating (pacemaker) tissue located in the right atrium of the

heart, and thus the generator of sinus rhythm. It is a group of cells positioned on the

wall of the right atrium, near the entrahce of the superior vena cava.

h). . .. is a network of streams that both branch out and reconnect, such as blood vessels

or leaf veins.i). . . . is the system of blood vessels that link the hypothalamus and the anterior

pituitary in the brain.j) . . . . i, the proportion of blood volume that is occupied by red blood cells.

k).... is a young cell of the granulocytic series, occurring normally in bone marrow,

but not in circulating blood.l). ...is the thickening and stiffening of heart muscle'

1

8.

9.

10.

11.

12.13.

14.15.

16.

m). There are three types of heart infections:. . . which affects the tissue surroundingthe heart; '.. which affects the muscular middle layer of the walls of the heart;...which affects the inner membrane that separates the chambers and valves oiyor.heart.

n).... is a slower than normal heart rate (fewer than 60 times a minute).o). . ' 'disease is also called mucocutaneous lymph node syndrome because it alsoaffects lymph nodes, skin, and the mucous membranes inside the mouth, nose andthroat.p). ... is a type of abnormal heart rhythm -also known as an arhythmia.r)..... can be found on the legs and face. They can cover either a small or large area ofSKlN.

s)....are enlarged veins that can be flesh-colored, dark purple, or blue. They often lookIike cords, and appear twisted and bulging. They are swolien and raised above thesurface of the skin.

RESPIRATORY SYSTEM

I. Fill the gaps with the right word:

a).... is a passage of airway in the respiratory tract that conducts air into the lungs.b). '.. are the first airway branches that no longer contain cartilage. They are braiches ofthe bronchi.c). . . . is an anatomical structure that has the form of a hollow cavity, found in the lung.d)' .. are air-filled spaces, communicating with the nasal cavity, within the bones of theskull and face.e).... is the uppermost part of the pharynx. It extends from the base of the skull to theupper surface ofthe soft palate; it differs from the oral and laryngeal parts ofthe pharynxin that its cavity always remains patent (open).f).... opens anteriorly, through the isthmus faucium, into the mouth, while in its lateralwall, between the two palatine arches, is the palatine tonsil.g). The anterior border of the right lung is almost vertical, and projects into thecostomediastinal sinus; that of the left lung presents, below, an angular notch, the..., inwhich the pericardium is exposed.h). ... is a serous membrane which folds back upon itself to form a two-layered,membrane structure. It has an outer layer (parietal) and an inner one (visceral).i). . ' . is a flap of elastic cartilage tissue covered with a mucus membrane, attached to theroot of the tongue. It projects obliquely upwards behind the tongue and the hyoid bone,pointing dorsally.j).... is the conic projection from the posterior edge ofthe middle of the soft palate,composed of connective tissue.k).. .. are variations of a type of clefting congenital deformity caused by abnormal facialdevelopment during gestation.l)...' is a sheet of internal muscle that extends across the bottom of the rib cage, separatesthe thoracic cavity (heart, lungs & ribs) from the abdominal cavity and perfoins animportant function in respiration.

m).... is a hole in the diaphragm through which the esophagus passes. It is located in the

right crus of the diaphragm.n)-.... is the protrusion (or herniation) of the upper part of the stomach into the thorax

through a tear or weakness in the diaphragm.

o) , . . .1s the specialty that deals with diseases of the lungs and the respiratory tract. It iscalled chest medicine and respiratory medicine in some countries and areas.

p). . .. is a muscle of the human body which runs from the chin to the tongue; is the major

muscle responsible for protruding (or sticking out) the tongue'

r). The action of the anterior and middle ...is to elevate the first rib and rotate the neck to

tire same side; the action of the posterior . . . is to elevate the second rib and tilt the neck to

the opposite side.

s). These nerves provide the only motor supply to the diaphragm as well as sensation to

the central tendon. In the thorax, each .,.supplies the mediastinal pleura and pericardium.

t), . ,.is a horseshoe-shaped bone situated in the anterior midline of the neck between the

chin and the thyroid cartilage. At rest, it lies at the level of the base of the mandible in the

front and the third cervical vertebra behind.

II. Match the terms of the left with the right definition on the right:

a). Oesophagoscopeb). OesophagectomYc). Oesophagotomyd). Oesophagitise). Oesophagalgia

f). Phrenohepaticg). Pleuritis (pleurisy)h). Pleurodynia

i). Pharyngoscopej). Thoracotomy

k). Bronchusl). Bronchogenicm). Bronchoplegian). BronchoesophagostomYo). Broncomycosis

p).Rhinoplastyr). Tracheotomys). TracheostomYt). Pneumonosisu).Rhinorrhoea

1).incision into the oesoPhagus

2).instrument to view the oesophagus

3).removal of the oesophagus4).pain in the oesophagusS).inflammation in the oesoPhagus

6). pain in the pleura7). incision in the chest8). instrument for viewing the

pharynx9). relating to the diaPhragm10). inflammation of the ribs and side

1l).fungi in bronchi12).windpipe13).originating in bronchi14).paralysis of bronchi

{S).opening between oesophagus and

bronchi

L6). incision on the trachea17).surgical repair of the nose

18).discharge from nose

L9).operation to maintain airways20).disease of lungs

m. Match the technical term on the left with the definition on the right:Condition of pain -agogueinside/within ortho-Inducing/stimulating -dyniaStraight -peri-Around endo-

IV. Give the disease that best fits the description:L is a contagious, viral infectious disease of the upper respiratory system, caused

primarily by rhinoviruses and coronaviruses.2. is a type of pneumonia associated with bacterial infection.3. is a blockage of the main artery of the lung or one of its branches by a substance

that has travelled from elsewhere in the body through the bloodstream.4. is a chronic inflammation of the bronchi (medium-size airways) in the lungs; s

defined clinically as a persistent cough that produces sputum (phlegm) and mucus.5. is a long-term, progressive disease of the lung that primarily causes shortness of

breath.6. is a predisposition to chronic inflammation of the lungs in which the airways

(bronchi) are reversibly narrowed.7. shortness of breath), also called shortness of breath (SOB) or air hunger, is a

debilitating symptom that is the experience of unpleasant or uncomfortablerespiratory sensations,

8. also known as diffuse parenchymal lung disease (DPLD), refers to a group of lungdiseases affecting the interstitium (the tissue and space around the air sacs of thelungs)

9. is a medical condition and potential emergency wherein air or gas is present in thepleural cavity (chest).

10. is fluid accumulation in the lungs.I f . is inflannnnation of the epiglottis - the flap that sits at the base of the tongue, which

keeps food from going into the trachea (windpipe).12. is the most common congenital deformity of the anterior wall of the chest , in

which several ribs and the sternum grow abnormally.13. is a term for suspension of external breathing.14. is characterized by rapid breathing.15. refers to an abnormally slow breathing rate.

16. is normal, good, unlaboured ventilation, sometimes known as quiet breathing orresting respiration.

17. is shortness of breath (dyspnea) which occurs when lying flat, causing the person

to have to sleep propped up in bed or sitting in a chair.18. the expectoration (coughing up) of blood or of blood-stained sputum from the

\ bronchi, larynx, trachea, or lungs.19. is a condition characterized by flaccidity of the tracheal support cartilage which

leads to tracheal collapse especially when increased airflow is demanded.

20. inflammation of the two layers of the pleura.

NERVOUS SYSTEM

I. Fill the gaps with the right word:1. Are almond-shaped groups of nuclei located deep within the medial temporal lobes

of the brain in complex vertebrates, including humans.2. One of the most important functions of the it is to link the nervous system to the

endocrine system via the pituitary gland (hypophysis).3. Is an endocrine gland about the size of a pea and weighing 0.5 g.

4. Is a structure located on the brain stem. It is superior to (up from) the medullaoblongata, inferior to (down from) the midbrain, and rostral to (in front of; thecerebellum.

5. Is one of the two components of the central nervous system and consists mostly ofmyelinated axons.

6. Is a major component of the central nervous system, consisting of neuronal cellbodies, neuropil (dendrites and both unmyelinated axons and myelinated axons),glial cells (astroglia and oligodendrocytes) and capillaries.

7. Contains the cardiac, respiratory, vomiting and vasomotor centers and deals withautonomic functions, such as breathing, heart rate and blood pressure.

8. Consist of three layers: the dura mater, the arachnoid mater, and the pia mater.

9. Comprises the tectum (or corpora quadrigemini), tegmentum, the ventricularmesocoelia (or "iter"), and the cerebral peduncles, as well as several nuclei and

fasciculi.10. Are a group of nuclei in the brains of vertebrates, situated at the base of the

forebrain and strongly connected with the cerebral cortex, thalamus and otherareas.

11. Is a clear bodily fluid that occupies the subarachnoid space and the ventricuiarsystem around and inside the brain. In essence, the brain "floats" in it.

12. Extends through the jugular foramen, then passing into the carotid sheath behveenthe internal carotid artery and the internal jugular vein down below the head, to the

neck, chest and abdomen, where it contributes to the innervation of the viscera.

13. Is a structure that permits a neuron to pass an electrical or chemical signal toanother cell.

14. is the interval between the arachnoid membrane and pia mater.

15. Is the outermost part of the spinal canal.

il. Match the common name with the medical one:

aden bileanglo ribsarterio bladder,sac

arthro sugar

cardio skincephal intestinecerebro drug

chem among the people

chole gland

colo red

III. FiII in the blankwith the appropriate suffix'

1. pain2. inflammation3. tumor4. stoppage5. urine6. poisonous7. fear8. condition of9. hardening10. destruction1i. sensation

12. breathing13. pertaining to14. enlarged15. surgical rePair

16. softening17. a disease

18. bloodi9. enzYme

20. vomit

IV.Give the name of the disorder that best fits the description:

1.A form ofNeuritis that involves paralysis of the facial nerve causing weakness of the

*ur.t.rofonesideofthefaceandaninabilitytoclosethe-eye'2. A nonprogressive disorder of movement reiulting from damage to the brain

before,during, or immediately after birth'

3. A progre.rir" A.g.r;il disease of the motor system occurring in middle age and

.uurirg muscle weakness and wasting'

10

4' A chronic disease of the nervous system that can affect young and middle-aged adults.The course of this illness usually involves recurrent relapses followed by remissions, butsome patients experience a chronic progressive course.

5' A condition characterized by extreme disabling fatigue that has lasted for at least sixmonths, is made worse by physical or mental exeition,-does not resolve with bed rest, andcannot be attributed to other disorders.

6. A severe burning or stabbing pain often following the course of a nerve.

7. Inflammation of the nerves, which may be painful.

8. Tremor, rigidity and poverty of spontaneous movements.

9' Pain felt down the back and outer side of the thigh, leg, and foot. The back is stiff andpainful. There may be numbness and weakness in ttre tei.

l0' Is a genetic nervous system disorder that causes tumors to grow around nerves.

ENDOCRII\E SYSTEM

I. Insert the right words into the gaps:1' " ' is the set of metabolic pathways thationstruct molecules from smaller units.2' ' ' . is a roughly 24-hour cycle in the biochemical, physiological or behavioural

processes of living entities.3' '..are recurrent periods or cycles repeated throughout aZ4-hour circadian day

(used in sleep studies).. ' . is the amount of energy expended while at rest in a neutrally temperateenvironment, in the post-absorptive state (meaning that the di[estivl system isinactive, which requires about twerve horrs of faJng in humins).' ' ' is a branch of medicine dealing with disorder of the endocrine system and itsspecific secretions called hormones." 'are glands that secrete their products (excluding hormones and other chemicalmessengers) into ducts (duct glands) which lead directly into the externalenvironment... 'are paired almond-shaped glands, one for each eye, that secrete the aqueouslayer of the tear film.. ' . are glands of the endocrine system that secrete their products, hormones,directly into the blood rather than through a duct.This gland is found in the neck, inferioito 1b.low) the thyroid cartilage (alsoknown as the Adam's apple) and at approximately the same level as the cricoidcartilage....are cells that release a hormone into the circulating blood in response to aneural stimulus.

4.

5.

6.

7.

8.

9.

10.

I1

I 1 . Situated along the perimeter of the adrenal gland, the . . . mediates the stressresponse through the production of mineralocorticoids and glucocorticoids,including aldosterone and cortisol respectively.

12. Is a small endocrine gland in the vertebrate brain. It produces melatonin, ahormone that affects the modulation of wake/sleep patterns and photoperiodic(seasonal) functions.

Exocrine glands; ultradian rhythms; thyroid; anabolism; adrenal cortexl circadianrhythm; endocrinology; pineal gland (also called the pineal body, epiphysis cerebri,epiphysis or the "@9re");endocrine glands; basal metabolic rate; lacrimalglands; neuroendocrine cells

II.Give the disorder that best fits the description:L.Also called a bronchocele, is a swelling in the thyroid gland, which can lead to aswelling of the neck or larynx (voice box).2. Is the absence of a menstrual period in a woman of reproductive age.3. Is the formal diagnosis used by psychologists and physicians to describe personswho experience significant gender dysphoria (discontent with the biological sex theywere born with).4. Is a medical term for decreased functional activity of the gonads5. Term used to describe ambiguous genitalia and gonadal mosaicism in individualsof gonochoristic species, especially human beings.6. Is decreased function ofthe parathyroid glands, leading to decreased levels ofparathyroid hormone.7. Is a syndrome that results when the pituitary gland produces excess groMhhormone after epiphyseal plate closure at puberty.8. Is a condition characterized by excessive thirst and excretion of large amounts ofseverely diluted urine, with reduction of fluid intake having no effect on the latter.

m. Match the medical terms with the explanations:A.1. hypervolaemia a). bacteria in blood2. hypoxaemia b). blood vessel inflammation3. vasculitis c). blood poisoning4. bacteraemia d).increase in blood volume5. toxaemia e). blood oxygen deficiencyB1. cholangitis a). muscle inflammation2. osteomyelitis b). bile duct inflammation3. encephalitis c). bone inflammation4. myositis d). brain inflammation5. rhinopharyngitis e). inflammation of the space behind the noseC1. laparoscopy a). visual examination of the stomach2. proctoscope b). visual examination of cavities3. gastroscopy c). instrument to view rectum4. panendoscopy d). taking photos with endoscope

12

IV. Match technical medical with their nontechnical meanings or explanations.

5. photoendoscopyD1. enteritis2. enterolith3. enteropathy4. enterotomy5. enterostomy

l.Column A(a) angi/o(b) cyst/o(c) cheil/o(d) chol/o(e) choledoch/o2. Column A:(a) gastroenterology(b) gastroenteropathystomach(c) gastroenteritis(d) gastroenteroscopy(e) gastrectomy

e). visual examination of abdominal cavity

a). opening into the intestineb). disease of intestinesc). intestinal stoned). inflammation of intestinese). incision into intestines

Column B1. bile2. common bile duct3. bladder4. lip5. vesselColumn B Column

t. Removal of the stomachz. Technique of viewing the intestines and

3. Study of intestines and stomach+. Inflammation of intestines and stomachs. Disease of intestines and stomach

13

The Muscular Systerm

(Musculoskele€aE Systern)

Muscle Cell Types

There are three types of muscle tissue:

I . s:pgJetal (or voluntary/striated) muscle, the most abundant tissue in the human

b<-,dy, producing movement. Each skeletal-muscle fiber is roughly cylindrical,contains many nuclei, and is crossed by alternating light and dark bands called

striations. Fibers bind together, via connective tissue, into bundles; and these

bundles, in turn, bind together to form muscles. Thus, skeletal nruscles are

composite structures composed of many muscle fibers, nerves, blood vessels,

and connective tissue. Skelet. ,nuscles are controlled by the somatic l'lervous

system (SNS).2. smooth (or visceral) muscle, forming the muscle layers in the rvalls of the

digestive tract, bladder, various ducts, arteries and veins, and other internal

organs. Srnooth- muscle cells are elongated and thin, not striated. have only one

nucleus, and interlace to form sheets rather than bundles of muscles. Srnooth

r cle is controlled by the autonomic nervous system (ANS).3. ardiac (or heart) muscle, a cross between the smooth and striated muscles,

comprising the heart tissue. Like smooth muscle, it is innervated by the

autonomic nervous system (ANS).

F.ach of more than 600 muscles is served by nerves which link the muscle to the brain

and spinal cord. 'rti :

Musculoskeletal SystemThe musculoskeletal system consists.lf the skeletal system -- bones arrd.ioints (union citwo or more bones) -- and lhe skeletal muscle system (voluntary or striated muscles).

These trvo systems work together to provide basio functions that are essential to life.

including:

. Protection: protects the brain and internal organs

" Support: maintains upright posture. Blood cell formation: hematopoiesis. Mineral homeostasis

" Storage: stores fat and minerals.n Leverage: A lever is a simple machine that rnagnifies speed of movement or

force. The levers are mainlythe lorrg bones of the body and the axes arethe.iointswhere the bones meet.

TissuesThere are 5 basic tissues comprising the musculoskeletal system:

1. [rones.2. ligarnents (attachirrg boue to bone)3. eartilage (protective gel-1ike subtance lining the joints and intenzertebral discs).

4. sl<cleta! museles. and

5. tendons (attaching musele to bone)"

Muscl"s by FunctionEach"r,uscle has its own special name. Muscles, however. are also described by tneir

function. Muscles that bend a liml, areJlexors; those which straighter-r a limb are

extensors (e.g. elbow flexors and elbow extensors.) Muscles which move a limb to

the side, away from the body, are abductors;those which move a limb sideways

tor,vard the body are adductors (e.g. hip abductors and hip adductors') Other

functional groLlps are eleyators, depressors, rotators, doriflexors, plonar flexors, and

palntar ;flexors.

Major Skeletal MusclesThe muscular body is divide into ten different areas where muscles can be found: facial.

neck, shoulder, arm, forearm, thorax, abdomen, hip, pelvis/thigh, Ieg'

Facialln the faci..i are one finds all the muscles which move"the face. OrbicLrlaris oculi are'.ne

two muscles that move the eye are. Frontalis and Temporalis are the trvo muscles which

movethe forehead and sides of your head. Zygomaticus and Masseter are tl'ie tr'vo

muscles that work in conjunction to n,ove your jaw and upper lip area. Orbicularis oris is

the muscle which moves Your liPs.

NeckThe leck area is almost entirely moved by the sternohyoid and Sternocleidomastoid.

These muscles allow the neck to move your head left and right. Thel' worl< with the

platysma muscie to control how far you can move youl' head left and right. What allows

your head to move up and down is the trapezius. The trapezius is so Iarge that it extend

down tothe shoulder and thorax area. Thetrapezius is a good example of how some

muscles are named by their shape. The trapezius looks just like a trapezoid'

ShoulderA group of muscles all work together to move the u4role shoulder area. '['his group takes

into account the trapezius. deltoid, infraspinatus. teres major, and the rhornboid major.

The Lhornboid major is called so because its shaped like the geometric shape of a

rhombus. Along with the help of the b,ill and socket joint-hyperlink in your shouder.

ArmMost known amongst teenage weight iifters is the arm area. The famous bicep brachii is

the muscle that allows you to bring your forearm close to your body alrd forur a huge ball

of muscle which catches a lot of attention amongst weight lifters. The tricep brachii and

brachialis arethetwo othermuscles located inthe arm region. Tl-rese muscles allow a

./ person to do push-upsl

F orearnaA rnajori r of the musele in the forearm help control a part of the arm. Atllongst thesr- is

the Blrachiodialis major, palmaris longus, and Fiexor carpi radialis.'Ihe name of the

flexor carpi radialis is a good example of how muscles are named by their function and

location. This prusele is named earpibecause of the bones tliat it helps rnove. the carples.

Also. the name of radialis is n-rade by the bone that its attaehed to, the radiurs.

Thorax

The thorz.,, is the set of muscles which carrying your head, arms, stonach, and any other

upper body areas. These muscles are the trapezius and iatissirnus dorsi. Usually, the

majority of the muscles of the thorax can be damaged easily is one does not stretch before

exercise, or lifts a heave load.

AbdomenThe abdorninal area consists of the muscles that allows you to bend down and move your

waist frorn side to side. The internal oblique and external oblique are the nnuscles that

move your body from left to right. The Transversus abdominus and Rectus abdominus,

along with the trapezius an latissimus dorsi allow you to bend down and grab objects.

HipOnly two muscles make up the hip area. These are the gluteus medius and giuteus

maximus. Drobably the laziest muscles in the whole system the gluter-rs set of muscles are

used onl1 "o sit down on.

Pelvis/ThighAn overlapping of muscles is what makes this area so firm. The pelvis area is usually

referred to as the upper part of the leg. Muscles like the pectineus and illiopsoas, which

help support the upper leg area are known as pelvic muscles. Thigh muscles are very rich

in capillaries and support the whole body. The upper thigh muscles are abductor longus,

Gracilis, Sartorius, and Tensor fasciae latea. The lower thigh rnuscles are rectus femoris,

vastus lateralis and rnedialis. Located in the back of your leg are the hamstrings.

LegHelping the thigh region support the body is the leg region. These muscles like the

Gaslrocnemius, soleus, porenius longus, and Tibialis anterior absorb the irnpacl wlren otle

walks ar.d "uns. They also give better coordination for moving. The thigh region trusi the

body fon ,ard while the leg region co.idinates where it should be thrr.rsted and where it

should stand.

-\;-:'Disorders of Bones and Joints

Disorders of the skeleton often invoive surrounding tissues-ligaments, tendons, and muscles, and maybe studied together as diseases of the musculoskeletal slstem. Tho medical specialty that concentrates ondiseases of the skeletal and muscular systems is orthopeiics. Physical therapists and occupational therapistsmust also understand these systems" Most abnormalities of the bones and loints appear tn simple x-rays.Radioactive bone scans, CT, and MRI scans are used as well. Also indicative or disorders are changls in bloodlevels of calcium and alkaline phosphatase, an enzyme needed for calcification of bone.

Infection

- Osteomyelitis is an inflammation of bone (root oste/o) caused by pus-forming bacteria that enterthrough a wound or are carried by the blood. Often the blood-rich ends of the iong bones are invaded, and theinfection then spreads to other regions, such as the bone miurow and even the joints" The use of antibioties hasgreatly reduced the threat of osteomyelitis.

Tuberculosis may spread to bone, especially the long bones of the arms and legs and the bones of thewrist and ankle. Tuberculosis of the spine is Pott's disease. infeoted vertebrae are weakened and may collapse,causing pain, deformity, and pressure on the spinal cord. Antibiotics ean be usecl to control tuberculosir, u, iorrgas the strains are not resistant to these drugs and the host is not weakened by other diseases.

FracturesA fracture is a break in a bone. The effects of a fracture depend on the location and severity of the

break, the amount of associated injury, possible complicationr, ,r.L as infections, and success of tealing,which may take months. In a closed or simple fracture, the skin is not broken. If the fracture is accompaniedby a wound in the skin it is described as an open fracture. Reduction of a fracture refers to realignment of thebroken bone. If no surgery is required, the reduction is described as closed; an open reduction is one thatrequires surgery to place the bone in proper position.

Metabolic Bone DiseasesOsteoporosis is a loss of bone mass that results in weakening of the bones" A decline in estrogen after

menopause makes women over 50 most susceptible to this disorder. Efforts to prevent osteoporosis includeadequate intake of calcium, engaging in weight-bearing exercise, and estrogen replacement therapy (ERT).Osteoporosis may also be caused by nutritional deficiencies, disuse, as in paralysis or immobilization in u .*rt,and excess steroids from lhe adrenal cortex.

In osteomalacia there is a softening of bone tissue due to lack of fonnation of calcium salts. possiblecauses include deficiency of vitamin D, needed to absorb calcium an<i phosporus from the intestine, renaldisorders, liver disease, and certain intestinal disorders. When osteomalacia occurs in children, the disease iscalled rickets" It is usually due to deficiency of vitamin D.

Paget's disease (osteitis deformans) is a disorder of aging in which bones become larger but weaker. Itusually involves the bones of the axial skeleton, causing pain, fractures, and hearing loss. With time there maybe neurologic signs, heart failure, and predisposition to cancer ofthe bones.

NeoplasmsOsteogenic sarcoma (osteosarcoma) most commonly occurs in the growing region of a bone, especially

around the knee. This is a highly malignant tumor that often requires amputation. It most commonlymetastasizes to the lungs.

Chondrosarcoma usually appears in midlife. As the name implies, this tumor arises in cartilage. It mostfrequently metastasizes to the lungs and may require amputation.

In cases of malignant bone tumors, early surgical removal is important to prevent metastasis. Signs ofbone tumors are pain, easy fracture, and increases in serum calcium and alkaline phosphatase. Aside fiomprimary tumors, neopiasms at other sites often metastasize to bone, most commonly to the spine.

ArthritisIn general, arthritis means inflammation of a joint. The most common fonn is osteoarthritis or

degenerative joint disease (DJD). This is a gradual degeneration of articular (oint) cartilage due to wear-and*

tear. It usually appears at midlife and beyond zurd involves the weight-bearing joints and joints of the fingers"

X-rays show a narrowing of the joint cavity and thickening of the bone" The eartilage may erack and trreak

..,,i, causing inflammation in the joint and exposing the underlying bone. Osteoarthritis is treated with;nalgesics to relieve pain, anti-inflammatory agents, such as c<lrticosteroids, and nonsteroidai anti-inflammatorydrugs (NSAIDs)"

Rheumatoid arthritis is a systemic inflammatory discase ,:f the.;oints that commonly appears in youriqadult women. Its exact causes are unknown, but it may involvc immunologic reactions. A group of antibodiescalled rheumatoid factor often appears in the blood, but is not aiways specific for rheumatoid arthritis, as it mayoccur in other systemic diseases as well. There is an overgrowth of the synovial membrane that lines the jointcavity. As this covers and destroys the joint cartilage, synovial fluid accumulates, eausing swelling of the joint.There is degeneration of the underlying bone, eventually causing fusion of the bones, or ankvlosis" T'reatmentinciudes rest, physical therapy, analgesics, and anti-inflammatory drugs.

Gout is caused by an increased level of uric acid in the blood, salts of which are deposited in the joints.It mostiy occurs in middle-aged men and almost always involves pain at the base of the great toe. The cause

may be a primary metabolic disturbance or a secondary effect of another disease, as of the kidneys" Gout istreated with drugs to suppress for:mation of uric acid or to increase elimination of uric acid (uricosuric agent).

Disorders of the SpineAnkylosing spondylitis is a disease of the spine that appears mainly in males. Joint cartiiage is

destroyed and eventually the disks between the vertebrae calcify and the bones fuse (ankylosis)" Changes beginlow in the spine and progress upward, limiting mobility'

In cases of a herniated disk, the central mass (nucleus pulposus) of the disk between two vertebrae

ruptures into the spinal canal. This commonly occurs in the lumbosacral or cervical regions of the spine as a

result of injury or healy lifting. The herniated or "slipped" disk puts pressure on the spinal cord or spinal

nerves, often causing pain along the sciatic nerve (sciatica). There may be spasms of the back muscles leading

to disability. Treatment is by bed rest and drugs to reduce pain, muscle spasms, and inflammation, followed by

an exercise program to strengthen muscles. In severe cases, it may be necessary to perform a diskectomy

(surgical removal of the disk) and fuse the vertebrae.

Medical terminology

L. Match the following terms to their proper definitions: a) orthopedics, b) gout, c) Pott's disease, d)

osteogenic sarcoma, e) fracture l) alkaline phosphatase, g) osteoarthritis, h) osteoporosis, i) ankylosis, j)nucle.irs pulposus, k) osteomalacia, l) arthritis, m) ankylosing spondylitis, n) herniated disk, o) Paget's

disease, p) anti-inflammatory agent, q) osteomyelitis, r) diskectomy, s) chondrosarcomae t) nonsteroidal

anti-inflammatory drug.

1. An enzyrne needed in the formation of bone.

Z. A chronie, progressive inflammatory disease involving the joints of the spine and surrounding sofl

tissue. Most oommon in young males. Also ealled rheumatoid spondylitis"

3" Immobility and fixation of a joint'4. Drug that reduces inflamrnation.5. Inflammation of a joint.6. A malignant tumor of cartilage'

7 . progressive deterioration ofjoint cartilage with growth of new bone and soft tissue in and around th<

joint. tire most common form of arthritis. Results from wear-and tear, injury, or disease. Also eallec

degenerative joint disease'

B. Surgical removal of a herniated inter"'ertebral disk'

9. A break in a bone.10. A form of acute arthritis, usually beginning in the knee or foot; caused by deposit of urie aciel salts il

the joints.I 1. protrusion of the centre (nucleus pulposus) of an intervertebral disk into the splnal canal. Pressure ot

nerve roots causes pain" Usually n.",rir in the cervical or lumbar region" Ruptured or "slipped" disk'

12. Drug that reduces inflammation, but is not a steroid. Examples include aspirin and other inhibitors o

proslaglandins, which are naturally produced substances that promote inflammation"

i 3. The central portion of an intervertebral disk

niii. The study and treatment of disorders of the skcleton, rnuscles, and associated structures' Literallv

"straight" (ortho) plus "child" (ped)'

15. A malignant bone tumor; osteosarcoma'

16. A sortelning and *.ut "niog

of the bones due to vitamin D deficiency or other disease

17. Inflammation of bone and bone marrow caused by infection, usually bacterial

ig. A condition characterized by reduction in bone density" Most common in white women past menopause"

Causative factors include diet, activitY, and estrogen levels'

19. Skeletal disease of the elderly, "t

aru"i"rired by-thiekening and softening of bones and bowing of long

bones; osteitis deformans'

20. Inflammation of the vertebrae, usually caused by tuberculosis

2. Match the terms in each of theses sets with their definitions and write the appropriate letter (a-

e) to the left of each number.1 " acetabulum

- Z. axis

-- 3. phalanges

__ 4. carPals

_ 5. tarsals

__ 6. metacarPals

-- 7" patella

- 8. pubis

--_ 9. zygomatic

_ 10. occipital

1 1. osteoclast

-tZ. periosteum

13. exostosis14. osteoPenia

_ i5. olecranon

16. malleolustl. mYeloPoiesis

- 1 S.sPondYlolisthesis

-_ 19. ankYlosis

-20. rachiocentesis

2i. meniscectomY22.lordosis23. scoliosis24.laminectomY

- ZS.subluxation

Muscle function may be affected by disorders .eisewhere, particularly in the nervous system an(

connective tissue. rrr" ."raiiior,, a"r"ritld ulio* affect tir""*"r."rar system diiectly' Any disorder of muscle

is described as myopathy" Techniqu*r_io, diagnosingro.rr.i. Jirorders include eleitrical studies of muscie ir

action, erectromyography @Mq), una^r.rrr*"u.ruy -of .*y*". released in increased amounts from damage'

;;;;i;t, mainly -cir

(creatine phosphokinase)'

lduscular Dystrophy refers * ;';.* of hereditary diseases invcrving progressive, n.ninflammator

degeneratio' of *,rs.ler. fh*r* i, t'*u["*" una wasting "i '"191t tissue- with gradual replaceme,t b

conneetive tissue and fat. There *ry ;ir; be cardioffipathy (disease of cardiac muscle) and mentz

impairment.

a. bones ofthe ankle

b. bones of the wristc" socket for the heaci of the femur

d" second cervical vertebra

e. bones ofthe fingers and toes

a. anterior hone of the Pelvisb" faeial bone

c. kneecaP

d. bones ofthe hand

e. posterior skull bone

a. outgrowth of bone

b. deficiencY of bone tissue

c. cell that destroYs bone

d. bone Projection at the elbow

e. fibrous membrane around bone

a" spinal taP

b. disPlacement of a vertebra

c. bone Projection at the ankle

d" immobilitY of a jointe. formation of bone mamow

a. removal of Part of a vertebra

b. removal of knee cartilage

e. partial dislocationd" iidewaYs curvature of the sPine

e" curvature of the lumbar sPine

Disorders of the Muscular SYstem

"'r';'o ' The most conunon fomr is Duchenne muscular dystrophy, a sex-linked disease passed from mothilr.to

"on' This appears at age 3 to 4, and patients are incapaciiated 6y"ugr 10 to 15. Death is commonly caused 5yrespiratory failure or infection.Polymyositis is the inflammation of skeletar muscle leading to

dysphagia (difficulty in swallow'ing) or cardiac problems. The cause isinfection or to autoirnrnunity. often the disorder is associated withrheumatoid arthritis or lupus erythematosus.

weakness, frequently associated withunkLclwn, and may be related to viralsome other systemic disease such as

When the skin is involved, the condition is termed derrnatomyositis. In this ease, there is erythema(redness of the skin), dermatitis (inflammation of the skin), and a typical lilae-colored rash, predominantly onthe face. In addition to enzyme studies and EMG, muscle biopsy is usea in diagnosis.

I\{yasthenia gravis is an acquired autoimmune disease in which antibodies interfere with musclestimulation at the neuromuscular junction. There is a progressive loss of mussle power, especially in theexternal eye muscles and other musoles of the face"

1" Match the terms in each of theses sets with their deflnitions and write the appropriate letter (a-e) to theleft of each number.

_- L deltoid

_ 2. triceps branchii

-__ 3" pectoralis major*_ 4. latissimus dorsi

___ 5. gastrocnemius

_ 6. rectus abdominis

__ 7. gluteus maximus

__ 8" sartorius

_ 9. semitendinosus

"*- 10. intercostal

11. myokinesis12" myotenositis13. myogoblin14. dystonia15. rhabdomyoma

_ 16" aponeurosis

_17 " ataxia

_ 18. torticollis

_)9. tetany

__-'2A. avulsion

2" tr'itl in the blanks:

a" Iarge muscle across the back below the trapeziusb. posterior mrmcle of the upper arm that extends the fnrearmc. triangular muscie that covers the shoulderd. main muscle of the calfe. large muscle aeross the upper chest

a. muscle between the ribsb. muscle that runs vertically at the center of the trunke. main muscle of the buttocksd" posterior muscle of the thighe. long, straplike muscle that runs across the inner thigh

a. faulty muscle toneb. muscle tumorc. oxygen-storing pigment in museled. inflammation of muscle and tendone. musele movement

a. muscle spasm due to a metabolic imbalanceb. forcible tearing away of a partc. flat, sheetlike tendond. lack of muscle eoordinatione. wryneek

1" The neurotransmitter released at the neurornuscular junction is

2" Any muscle that produces flexion at aioint is called a(n) ..".."."".3" The quadriceps femoris muscle has ....""."........"......attaehrnent points (heads)"

4" T'he sheath of connective tissue that eovers a muscle is called5" A band of connective tissue that attaches a rnuscle to a bone is a(n)

Disorders of the Muscular System

Muscle function may be affected by disorders else'where, particularly in the nervous system andconnective tissue. The conditions described below affect the musctilar system directly. Any disorder of musclesis described as myopathy.

Techniques for diagncsing muscle disorderselectromyography (EMG), and serum assay of enz).rnesmainly CPK (creatine phosphokinase)

N{uscular Dystrophy

include eleotrical studies of muscle in action,released in increased amounts from darnaged museles,

progressive, noninflammatorywith gradual replacement bycardiac muscle) and mental

disease passed from mother toDeath is commonly caused by

Muscular dystrophy refers to a group of hereditary diseases involvingdegeneration of muscles. There is weakness and wasting of muscle tissueconnective tissue and fat. There may also be cardiomyopathy (disease ofimpairment.

The most common form is Duchenne muscular dystrophy, a sex-linkedson. This appears at age 3 to 4, and patients are incapacitated by age 10 to 15.

respiratory failure or infection.

PolymyositisPolymyositis is inflammation of skeletal muscle leading to weakness, frequently associated with

dysphagia (difficulty in swallowing) or cardiac problems. T'he cause is unknown, and may be related to viralinfection or to autoimmunity. Often the disorder is associated with some other systemic disease such as

rheumatoid arthritis or lupus erythematosus.When the skin is involved, the condition is termed dermatomyositis. In this case, there is erythema

(redness of the skin), dermatitis (inflammation of the skin), and a typical lilac-colored rash, predominantly on

the face. in addition to enzyme studies and EMG, muscle biopsy is used in diagnosis.

Myasthenia GravisMyasthenia gravis is an acquired autoimmune disease in which antibodies interfere with muscle

stimulation at the neuromuscular junction. There is a progressive loss of muscle power, especially in the

extemal eye muscles and other muscles of the face.

l. Match the terms in each of theses sets with their definitions and write the apprripriate letter (a-e) to theleft of each number.

__ 1. deltoid

__ 2. triceps branchii

_- 3. pectoralis major

_ 4. latissimus dorsi

_ 5, gastrocnemius

_ 6. rectus abdominis

_ 7. gluteus maximus

__ 8. sartorius

_ 9. semitendinosus

_ 10. intercostal

11. myokinesis12. myotenositis13. myogoblin14. dystonia15. rhabdomyoma

16. aponeurosis17. ataxia18. torticollis

a. large muscle across the back below the trapeziusb. posterior muscle of the upper arm that extends the forearmc. triangular muscle that eovers the shoulderd. main muscle of the calfe. large muscle across the upper chest

a. muscle between the ribsb. muscle that runs vertically at the center of the trunkc. main muscle ofthe buttocksd. posterior muscle of the thighe. long, straplike muscle that runs across the inner thigh

a. faulty muscle tone

b. muscle tumorc. oxygen-storing pigment in muscled. inflammation of muscle and tendon

e. muscle movement

a. muscle spasm due to a metabolic imbalance

b. forcible tearing away of a Partc. flat, sheetlike tendon

9. tetany20. avulsion

d. lack of muscle coordinatione. wryneck

)

1.

2.J.

4.5"

Fill in the blanks:

The neurotransmitter released at the neuromuscurar junction isAny muscle that produces flexion at a joint is called a(n) .."."."...The quadriceps femoris muscle has .......................attachment points (heacs).The sheath of connective tissue that eovers a muscle is calledA band of connective tissue that attaches a muscle to a bone is a(n)

Circulatory System: The Circle of Blood

On average, the body has about 5 liters of blood continually traveling through it by wayof the circulatory system. The heart, the lungs, and the blood vessels work together toform the circle part of the circulatory system. The body's circulatory system really hasthree distinct parts: pulmonary circulation, coronary circulation, and systemic circulation.Or, the lungs (pulmonary), the heart (coronary), and the rest of the system (systemic).Each part must be working independently in order for them to all work together.

Systemic Circulation

Systemic circulation supplies nourishment to all of the tissue located throughout yourbody, with the exception of the heart and lungs because they have their own systems.Systemic circulation is a major part of the overall circulatory system.The blood vessels(arteries, veins, and capillaries) are responsible for the delivery ofoxygen and nutrients tothe tissue. Oxygen-rich blood enters the blood vessels through the heart's main arterycalled the aorta. The forceful contraction of the heart's left ventricle forces the blood intothe aorta which then branches into many smaller arteries which run throughout the body.The inside layer of an artery is very smooth, allowing the blood to flow quickly. Theoutside layer of an artery is very strong, allowing the blood to flow forcefully. Theoxygen-rich blood enters the capillaries where the oxygen and nutrients are released. Thewaste products are collected and the waste-rich blood flows into the veins in order to

' circulate back to the heart where pulmonary circulation will allow the exchange of gasesin the lungs.During systemic circulation, blood passes through the kidneys. This phase ofsystemic circulation is known as renal circulation. During this phase, the kidneys filtermuch of the waste from the blood. Blood also passes through the small intestine duringsystemic circulation. This phase is known as portal circulation. During this phase, theblood from the small intestine collects in the portal vein which passes through the liver.The liver filters sugars from the blood, storing them for later.

Pulmonary Circulation

Pulmonary circulation is the movement of blood from the heart, to the lungs, and back tothe heart again. This is just one phase of the overall circulatory system.The veins bringwaste-rich blood back to the heart, entering the right atrium throughout two large veinscalled vena cavae. The right atrium fills with the waste-rich blood and then contracts,pushing the blood through a one-way valve into the right ventricle. The right ventriclefills and then contracts, pushing the blood into the pulmonary artery which leads to thelungs. In the lung capillaries, the exchange of carbon dioxide and oxygen takes place.The fresh, oxygen-rich blood enters the pulmonary veins and then returns to the heart, re-entering through the left atrium. The oxygen-rich blood then passes through a one-wayvalve into the left ventricle where it will exit the heart through the main artery, called theaorta. The left ventricle's contraction forces the blood into the aorta and the blood beginsits journey throughout the body.

The one-way valves are important for preventing any backward flow of blood. Thecirculatory system is a network of one-way streets. if blood started flowing the wrongway, the blood gases (oxygen and carbon dioxide) might mix, causing a biious threat toyour body.

Coronary Circulation

Coronary circulation refers to the movement of blood through the tissues of the heart.The circulation of blood through the heart is just one part of-the overall circulatorysystem

Heart

The human heart is about the size of a clenched fist. It contains four chambers: twoatria and two ventricles. Oxygen-poor blood enters the right atrium through a majorvein called the vena cava. The blood passes through the iicuspid valve irito theright ventricle. Next, the blood is pumped through the pulmonary artery to thelungs for gas exchange. Oxygen-rich blood returns to the left atrium via ihepulmonary vein. The oxygen-rich blood flows through the bicuspid (mitral) valveinto the left ventricle, from which it is pumped through a major uit.ry, the aorta.Two valves called semilunar valves are found in the pulmonary artery and aorta.

'The ventricles contract about 70 times per minute, which represents a person's pulserate. Blood pressure, in contrast, is the pressure exerted against the walls of thearteries. Blood pressure is measured by noting the heightio which a column ofmercury can be pushed by the blood pressing against the arterial walls. A norrnalblood pressure is a height of 120 miliimeterr oi-"r"ury during t

"u.t "ont.u.tion (

s2tstole), and a height of 80 millimeters of mercury during heart relaxation (diastole). Normal blood pressure is usually expressed ur 2120 over g0.,,

Coronary arteries supply the heart muscle with blood. The heart is controlled bynerves that originate on the right side in the upper region of the atrium at thesinoatrial node. This node is called the pacemaker.Il generates nerve impulses thatspread to the atrioventricular node where the impulses are amplified and spread toother regions ofthe heart by nerves called purkinje fibers.

Blood

Blood is the medium of transport in the body. The fluid portion of the blood, theplasma, is a straw-colored liquid composed primarily of water. All the importantnutrients, the hormones, and the clotting proteins as well as the waste products are

transported in the plasma. Red blood cells and white blood cells are also suspendedin the plasma. Plasma from which the clotting proteins have been removed is serrm.

Red blood cells

Red blood cells are erythrocytes. These are disk-shaped cells produced in the bonemarrow. Red blood cells have no nucleus, and their cytoplasm is filled withhemoglobin.

Hemoglobin is a red-pigmented protein that binds loosely to oxygen atoms andcarbon dioxide molecules. It is the mechanism of transport of these substances.(Much carbon dioxide is also transported as bicarbonate ions.) Hemoglobin alsobinds to carbon monoxide. Unfortunately, this binding is irreversible, so it oftenleads to carbon-monoxide poisoning.

A red blood cell circulates for about 120 days and is then destroyed in the spleen, anorgan located near the stomach and composed primarily of lymph node tissue. Whenthe red blood cell is destroyed, its iron component is preservedtor reuse in the liver.The remainder of the hemoglobin converts to bilirubin. This amber substance is thechief pigment in human bile, which is produced in the liver.

Red blood cells commonly have immune-stimulating polysaccharides called antigens'on the surface of their cells. Individuals having the A antigen have blood type A (aswell as anti-B antibodies); individuals having the B antigen have blood type B (aswell as anti-A antibodies); individuals having the A and B antigens have blood typeAB (but no anti-A or anti-B antibodies); and individuals having no antigens haveblood type O (as well as anti-A and anti-B antibodies).

White blood cells

White blood cells are referred to as leukocytes. They are generally larger than redblood cells and have clearly defined nuglei. They are also produced in ih" bon"marrow and have various functions in the body. Certain white blood cells calledIymphocytes are essential components of the immune system. Other cells calledneutrophils and monocytes function primarily as phagocytes; that is, they attackand engulf invading microorganisms. About 30 percent of the white blood cells arelymphocytes, about 60 percent are neutrophils, and about 8 percent are monocytes.The remaining white blood'cells are eosinophils and basophils. Their functions areuncertain; however, basophils are believed to function in allergic responses.

Platelets

Platelets are small disk-shaped blood fragments produced in the bone marrow. Theylack nuclei and are much smaller than erythrocytes. Also known technically asthrombocytes, they serve as the starting material for blood clotting. The plateletsadhere to damaged blood vessel walls, and thromboplastin is liberated from the

injured tissue. Thromboplastin, in turn, activates other clotting factors in the blood.Along with calcium ions and other factors, thromboplastin converts the blood proteinprothrombin into thrombin. Thrombin then catalyzei the conversion of its bloodprotein fibrinogen into a protein calledfibrir, *hi.h forms a patchwork mesh at theinjury site. As blood cells are trapped in the mesh, a blood clot forms.

Lymphatic system

The lymphatic system is an extension of the circulatory system consisting of a fluidknown as lymph, capillaries called lymphatic vessels, ani structures called lymphnodes. Lymph is a watery fluid derived from plasma that has seeped out of ihe bloodsystem capillaries and mingled with the cells. Rather than returning to the heartthrough the blood veins, this lymph enters a series of one-way tymptratic vessels thatreturn the fluid to the circulatory system. Along the way, the ducts pass throughhundreds of tiny, capsulelike bodies called tymptr noaes. Located in the neckarmpits, and groin, the lymph nodes contain cells that filter the lymph andphagocytize foreign particles.

The spleen is composed primarily of lymph node tissue. Lying close to the stomach,the spleen is also the site where red blood cells are destroyld.lhe spleen serves as areserve blood supply for the body.

.The lymph nodes are also the primary sites of the white blood cells calledlymphocytes. The body has two kinds of lymphocytes: B-lymphocytes and r-lymphocytes. Both of these cells can be stimulated by microorganisms or otherforeign materials called antigens in the blood. Antigens are pi&ed up by phagocytesand lymph and delivered to the lymph nodes. Here, ih" ly-pt ocyes are-stimulatedthrough a process called the immune response.

Certain antigens, primarily those of fungi and protozoa, stimulate the T-lymphocytes.After stimulation, these lymphocytes leave the lymph nodes, enter the circulation,and proceed to the site where the antigens of microorganisms were detected. The T-lymphocytes interact with the microorganisms cell toiell and destroy them. Thisprocess is called cell-mediated immunity.

B-lymphocytes are stimulated primarily by bacteria, viruses, and dissolved materials.On stimulation, the B-lymphocytes revert to large antibody-producing cells calledplasma cells. The plasma cells synthesize proteins called antibodier, which arereleased into the circulation. The antibodies flow to the antigen site and destroy themicroorganisms by chemically reacting with them in a highly specific manner. Thereaction encourages phagocytosis, neutralizes many microbial toxins, eliminates theability of microorganisms to move, and causes them to bind together in large masses.This process is called antibody-mediated immunify. After the microorganisms havebeen removed, the antibodies remain in the bloodstream and provide lifelongprotection to the body. Thus, the body becomes immune to specific diseasemicroorganisms.

Disorders of the Circulatory System

Atherosclerosis

The accumulation of fatty deposits within the liningThese a.reas, called plaques, gradually thicken and hardendeposits, restricting the lumen (opening) of the vessel andcondition knorm as ischemia.

of an artery is termed atherosclerosis.with fibrous material, sells, and otherredueing blood flow to the tissues, a

Atherosclerosis of the eoronary vesseis is a primary cause of heart disease. One sign of suchcoronary artety disease (CaOl is the type of chest pain known as angina pectoris. This is a feeling ofconstriction around the heart or pain that may radiate to the left arm or shoulder, usually brought oriUyexertion. Often there is anxiety, diaphoresis (sweating), and dyspnea (difficulty in breathing;. anginapectoris is treated by control of exercise and administration of nitroglycerin to dilate .oronuiy vesJels"Other drugs may be used to regulate the heartbeat, strengthen the force of heart cpntraction, or preventformation of blood clots. Severe cases may be candidates frir angioplasty, which is surgical dilatation ofthe blocked vessel by means of a catheter. Still further, the blocked vessel may be surgieally bypassedwith a vascular graft.

Atherosclerosis also predisposes to thrombosis, the formation of a blood clot or thrombus in avessel" Sudden occlusion (blockage) of a coronary artery by a thrombus causes local necrosis (death) i:ftissue and formation of an infarct. This is the myocardial infarction or "heart attack" that is a leadingcause of sudden death. Symptoms include pain over the heart (precr:rdial pain) or upper parl of theabdomen (epigastric pain) that may extend to the jaw or arms, pallor (paleness), diaphoresls, nuoseu,and dyspnea. There may be a burning sensation similar to indigestion or heartbum. Often there is anabnormality of heart rhythm, or arrhythmia, usually fibrillation, an extremely rapid, ineffectivebeating of the hearl" Outcome is based on the degree of damage and early treatment to dissolve the clotand reestablish normal heart rhythm. Myocardial infarction (MI) can be diagnosed byelectrocardiography (EKG), study of the electrical impulses given off by the heart as it functions, bymeasurement of certain enzymes (CPK, LDH, AST) released into the blood from the damaged heartmuscle, and by a variety of other methods.

Atherosclerosis is a major cause of disease in industrialized countries, and the factors thatcontribute to it are familiar to most people: heredity, high blood presswe, cigarette smoking, a diet highin fat, lack of exercise, and stress. Other vessels commonly affected are the aorta, the earotid arteriesieadiiig to the head, the cerebral arteries, arid afteries in thre leg"

Embolism

Occlusion of a vessel by a thrombus or other mass carried in the bloodstream is embotism" andthe mass itself is called an embolus. Usually the mass is a blood slot that breaks loose from the wail ofa vessel, but it rnay also be air (as from injection or trauma), fat (as from marrow released after a bonebreak), bacteria, or other solid materials. Often a venous thrombus will travel through the heart andthen lodge in an artery of the lungs, resulting in a life-threatening pulmonary embolism. An embolusfrom a carotid artery often blocks a cerebral vessel, causing a stroke.

Aneurysm

An arterial wall weakened by atherosclerosis or other cause rnay "nalloon out, forming aaaneurysm" If the aileurysm ruptures, hemorrhage results, causing a strttke, or cerebrovaseular accident(CVA), if a cerebral artery is involved. In a dissecting aneurysm, blood hemorrhages into the thickmiddie layer of the artery wail, separating the muscle as it spreads and sometimes rupturing the rressel.The aorta is most commonly involveci. It may be possible to repair a disseeting aneurysm surgicaliywith a graft.

Heart Failure

When the heart fails to cntpty cllbctivcty for any reason, the general term heart failure isapplied. The resulting increased pressure in the venous system leads io edema, often in the lungs(pulmonary edema), and justifies the description congestive heaft failure (CHp)" Other symptoms arecyanosis, dyspnea, and syncope. Heart failure is treated with rest, drugs to strengthen heartcontractions, diuretics to eliminate fluid, and restriction of salt in the diet.

Hypertension

Hypertension, or high blood pressure: is a contributing factor in all the conditions describedatcve. In simple terms, hypertension is defined as a systolic f...r,rr* greater than 140 mm Hg or adiastolic pressure greater than 90 mm I{g. It causes the left ventiicle to eniarge (hypertrophy) as a resultof increased work. Some cases are secondary to other disorders, such

-as'kidney maifrrnction or

endocrine disturbance, but most cases of hypertension are due to unknown causes and are described asprimary or essential hypertension. The condition is controlled with diuretics, vasorjilators, and mostrecently with drugs"

Medical terminology1. Match the following terms to their proper definitions: a) atherosclerosis, b) cyanosis, e)

dyspnea, d) edema, e) embolism, f) embolus, h) fibrillation, i) heart failure, j) hyperiension, k)infarction, l) ischemia, m) murmur, n) phlebitis, o) stenosis, p) stroke, q) syncope, r) thrombosis,s) thrombus.

20.2t.22.

19. The development of fatty, fibrous patches (plaques) in the riningof the lumen and hardening of the vessel wall. The most common

of arteries, eausing narrowingfonn of arteriosclerosis" (R.oot

reduction of blood flow. Causes includeftom a ruptured aneurysm. Also called

ather/o means "porridge" or "gruel").A blood clot that forms within a blood vessel"Inflarnmation of a vein.Localized necrosis (death) of tissue resulting from a blockage or a narrowing of the artery thatsupplies the area. A myocardial infarction (MI) ocours in eardiac muscle and usually rlsuitsfrom formation of a thrombus in a coronary artery.

23. Swelling of body tissues due to the presence of excess fluid. Causes include cardiovasculardisturbances, kidney failure, inflammation, and malnutrition.

24.Loeal deficiency of blood supply due to obstruction of the circulation.25. Constriction or narrowing of an opening.26. Bluish discoloration of the skin due to lack of oxygen.27. Development of a blood clot within a vessel.28. A condition caused by the inability of the heart to maintain adequate circulation of blood"29. Difficult or labored breathing"30" A temporary loss of eonsciousness due to inadequate blood flow to the brain; fainting.31. Spontaneous, quivering and ineffectual coniraction of rnuscle fibers, as in the atria or the

ventricles"32" An abnormal heart sound"33. Sudden damage to the brain resulting from

atherosclerosis, thrombosis, or herncrrhagecerebrovascular aecident. (CVA)

34. Obstruction of a blood vessel by a blood clot or other matter carried in the eirculation.35. A mass carried in the circulation. tlsually a blood clot, but rnay alser by air, fat, bacteria, or

other solid matter fiorn within or from outside the body.36. A condition of higher than normal bl<lod pressure.

VOCABTILAIT Y PRAC'TIC]E

1. Fiii il tlie blanl<s rvitlr tlie :rpproliriatc.,r,ord.

a) Intake. expeiiing. pliat'i,',r,* traoirea. air Sai's, Iari,trx. pici.,s 1p. ai'n.toius;. i^iasie itrcduct. moutli,L'rcinch ial iubes.The s5,'stem oithe boci;"'tha1 is resporrsible lor the .., clos,gelr a6d tire ... ,-rf carLron c!ioxide is caliecjthe respiratory s).'stem.

-l'i-re inain pafts of ihe respiratot.).s.,rs1s11i ar.e: tlre nose. . ... ancjtlie lungs. As in the circLiiatorysysten'i. the passages or tubes in the resniratory system become smaller and srnalier as the5, go fr-st1the nrouth to the ... in the iLrngs. Oxygen ancj oarbon ciioricie pass ii'eeii fi'om ihe ... to surroundinsblood vessels and vice versa. Blood carries cxygen to the cells and ,". carbon ciioxide as a ... .

b) Respilatory system, tisst:es, lymph nodes, lifeline. tissues, vital sigrrs, by r,,,;r.,- ol-rvastes, whiteblood cells. properly, ti'ri'n-rr-rs, nutrieirts. blooc clotring. relrove" circulation.Gooci ... is vitai toihealth, Ceils, ..., organs and 'oody systems cannc)i lirnction .." if circLrlation isinadequate. The cireulatory svstem is the "." for the cniire body. When yr)Li rx€aslrre .... you aremeasuring the vitality of the body.The circuiatory systetr serves three primar)/ functions. Tirey are: carrying fbod ancl oxygen to cells ...the biood vesselsl renroving.". fiorn cells: fighting infection by carrying ... and other ciisease flghtingsubstances.The heai'i, blood celis, blood vessels. and ,.. are considered part of tlre cii'culaiory system. Someiimesthe spleen and... are also inciuded. Tl-,e n:ain function within this s1,51sm is the puinping of blooci b,vthe heart to all pafis of the body, inclr"rciing the tiny ceils. T'he purpose is to bring dissolved food (.."j,oxygen, hortnones, antibodies and ... factors to lhe cells, and to ... r,vaste proCucts from the cells, Thecircuiation of blood also helps to heep the 'oody at an even temperature and balance the fluid level.The circulatorv system g,orlcs closell,'rvith the ... .

2. Tlte tenq;le, tlte throat, tlte left lireasl, the inner elbow, the wrist, the tliigh, the foot are the sevenprirnary puise points in tlie humen body. For each of them you are to supply synonyms, as in theexample"e.g., the temple - temporal pulse

3. h'Ia"ke uit the lvord famiiy of the foliowing rycrds: pharynx, larynx, trachea.

4. il{rtclr the u,orC rvith the correct description oi" dcfinition:

Carb<thvdraies, plasma, vt,ltite corpu,scles, aorta, capiilctries, bile, stomctcit, incoittinence. excretiL)n.,insuliit

A sac-lil<e bulge in the alimentary canal belo'w the esophagus and above the srna.li intestine whichc!igests arid holds foodA hon one secreted by the itancreas essential for prr'spsl.metabolisrn of srigar.Sugars, starches, and ceilulose. Foocis containrng carbon hydl'ogen, and oxygen.A secretion of the liver stored in the gall bladder and releaseC into the srnail intesiine to aid indigesting fats.The iargest artery carrying blood frcm the left sicje of the heait.Tiny L,lood vessels with thin r,vails that ailorv ox,vgen and nutrients to be passed thi-oLrgli tirem tonearby cells.The liquid porlion of tiie blood.White blcod cells. They, fight infbction.'I-lre process of excreting and eliminating rvastes fiorn the bocii,.The inability to control one's bolel or bladder' f,unctiorrs.

2. Match the terms in each of theses sets with thr:ir definitions and write the appropriateletter (a-e) to the left of each number._ l. endocardium a. heart's pacemaker

_2. mitral b. thin membrane that lines the heart

- 3' pericardium c. pertaining to the left atrioventricular valve

_ 4" SA node d. vessel that empties into the right atrium_ 5. vena cava e. fibrous sac around the heart

_ 6. thrombosis

_,7. dysrhghmia_ 8. cardioversion

__ 9. aneurysm10. ischemia

a. local blood deficiencyb. formation of a blood clot in a vesselc. abnormal heartbeatd. defibrillatione. localized dilatation of a blood vessel

_ 11. fibrillation a. twisted and swollen vessel

*-12. heart block b.part of the heart's conduction system

_ 13. atheriosclerosis e. accumulation of fatty material in the vessels

_ 14" varix d. ineffective quivering of muscle

_ 15. Purkinje fibers e. interruption in the heart conduction system

_ 16. embolism a. central opening, as of avessel'

_17. ductus arteriosus b. area over the heart

_ 18. lumen c. blockage of a vessel with a clot or plug_ 19. infarct d. vessel that bypasses the lungs in fetal circulation__20" precordium. e. area of dead tissue caused by lack of blood supply

__21. Hodgkin's disease a. removal of a dilatation in a vessel

_Z2.lymphedema b. swelling of tissue due to lymph blockage

_23. tkombolysis c" malignant disease of lymphoid tissue

__24.lymphadenopathy d. any disease of a ll,rnph node

_25" aneurysmectomy e. dissolving of a blood clot

3. Fill in the blanks:I " Each upper receiving chamber of the heart is a(n) . . ..

2. The heart chamber that pumps into the aorta is the . .. "

3. A vessel that carries blood back to the heart is a(n) . " ".

4. The microscopic vessels through which materials are exchanged between the blood and the tissues

are the . ...5. The relaxation phase of the heart cycle is called . " . .

6. The large lymphoid organ in the upper left abdomen is the .. ".7. The large artery that supplies the head is the .....8. The large vein that drains the head is the .. ...9. Endarteritis is inflammation of the lining of a(n) ."...10. Pirlebostasis is stoppage of blood flow in a(n) ....1 1 . Thrombophlebitis is inflammation of a vein associated with formation cf a(n) . " ".i2. Blood returning to the heart from the lungs enters the chamber of the heart named the .,..13 " A small artery is called a(n) . . ..

14. The adjeetive ischemic means lacking in....15. The lymphoid gland in the chest is the . ...16" An embolectomy is the removal of a(n)."..17" The largest artery is the ....18" At its lower end, the aorta divides into a pair of arteries called the " . . .

19. T'he longest vein in the body, which runs the length of the leg, is the . " ,.

20. A phlebotomist is one who drains blood from a .. ..

21. A varicotomy is the incision of a(n) " . ..22. A sin"us rhythm is a normal heart rhythm that originar.cs at the .. ".23. Another term for the leaflet of a valve is the . . ".24. The word that means inflammation of a vein is . " . .

4. Select the correct answer:1. The wordpercutaneous means:a. on the skinb. through the skinc. into a vesseld. into the bloode" into the skin2. The word transluminal pertains to the lumen of a vessel, whieh is thea. wallb. branchc. outer layerd. central openinge" valve3. The term that means baclc/low, as of blood, isa" infarctionb. regurgitationc. amplituded. prolapsee. tourniquet4.The popliteal vein is in thea. armb. thishc. kneed. hearte" ankle5. The interventricular septum is thea. cavity of the ventricleb. wall between the atrium and ventriclec. valve between the atrium and ventricle

e. vessel that carries blood out ofthe ventricle

5. Write the adjective form of each of the following words:1. septum2. apex3. aorta4. artery5. vein6. ventricle7. diastole8. sclerosis9. spleen10. varix

Urinary systemThe principal function of the urinary system is to maintain the volume and composition of bodyfluids within normal limits. One aspect of this function is to rid the body of wasie products thataccumulate as a result of cellular metabolism, and because of this, it is sometimes referred to asthe excretory system. The urinary system maintains an appropriate fluid volume by reguiating theamount of water that is excreted in the urine. Other aspects of its function include regutating ineconcentrations of various electrolytes in the body fluids and maintaining normal pU of tne blood.In addition to maintaining fluid homeostasis in the body, the urinary system controls red bloodcell production by secreting the hormone erythropoietin. The urinary system also plays a role inmaintaining normal blood pressure by secreting the en4rme renin.

The urinary system consists ofthe kidneys, ureters, urinary bladder, and urethra

The kidneys are the primary organs of the urinary system. The kidneys are the organs that filterthe blood, remove the wastes, and excrete the wastes in the urine. They are the orfans thatperform the functiors of the urinary system. The other components are accessory structures toeliminate the urine from the body. The paired kidneys are Iocated between the twelfth thoracicand third lumbar vertebrae, one on each side of the vertebral column. The right kidney usually isslightly lower than the left because the liver displaces it downward. The kidneys protected by thelower ribs, lie in shallow depressions against the posterior abdominal wall and behind the parietalperitoneum. This means they are retroperitoneal. Each kidney is held in place by connectivetissue, called renal fasci4 and is surrounded by athick layer ofadipose tissue, called perirenal falwhich helps to protect it. A tough, fibrous, connective tissue renal capsule closely envelopes eachkidney and provides support for the soft tissue that is inside. In the adult, each kidney isapproximately 3 cm thick, 6 cm wide, and12 cm long. It is roughly bean-shaped with anindentation, called the hilum, on the medial side. The hilum leads to a large cavify, called therenal sinus, within the kidney. The ureter and renal vein leave the kidney, and the renal arteryenters the kidney at the hilum. The outer, reddish region is the renal cortex.This surrounds adarker region called renal medulla. The latter consists of a series od renal pyramids which appearstriated because they contain straight tubular structures and blood vessels. The wide bases of thepyramids are adjacent to the cortex and the pointed ends, called renal papillae, are directedtoward the center ofthe kidney. Portions ofthe renal cortex extend into the spaces betweenadjacent pyramids to form renal columns. The cortex and medulla make up the parenchyrna, orfunctional tissue, of the kidney. The central region of the kidney contains the renal pelvis, whichis located in the renal sinus and is continuouS with the ureter. The renal pelvis is a large cavitythat collects the urine as it is produced. The periphery of the renal pelyis is intemrpted by cuplikeprojections called calyces. A minor calyx surrounds the renal papillae of each pyramid andcollects urine from that pyramid. Several minor calyces converge to form a major calyx. From themajor calyces the urine flows into the renal pelvis and from there into the ureter.

Each kidney contains over a million functional units, called nephrons, in the parenchyma (cortexand medulla). A nephron has two parts: a renal corpuscle and a renal tubule.The renal corpuscleconsists of a cluster of capillaries, called the glomerulus, surrounded by a double-layeredepithelial cup, called the glomerular capsule. An afferent arteriole leads into the renal corpuscleand an efferent arteriole leaves the renal corpuscle. Urine passes from the nephrons intocollecting ducts then into the minor calyces.The juxtaglomerular apparatus, which monitors bloodpressue and secretes renin, is formed from modified cells in the afferent arteriole and theascending limb of the nephron loop.

Each ureter is a small tube, about 25 cm long, that carries urine from the renal pelvis to theurinary bladder. It descends from the renal pelvis, along the fori"rio. abdominair*tl b.hind th.parietal peritoneum, and enters the urinary 6luad"r on ti. portoio. inferior surface.

The urinary bladder is a temporary storage reservoir for urine. It is located in the pelvic cavity,posteriorlo the symphysis pubis, and belowlhe parietal peritoneum. The size and sirape of theurinary bladder varies with the amount of urine it contains and with pressure it receives fromsurrounding organs. The inner lining of the urinary bladder is a mucous membrane of transitionalepithelium that is continuous with that in the ureters. When the bladder is empty, the mucosa hasnumerous folds called rugae, The rugae and transitional epithelium allow the biadder to expand asit fiils. The second layer in the walls is the submucosa thai ,rppo.t, the mucous membrane. It iscomposed of connective tissue with elastic fibers. The next laylr is the muscularis, which iscomposed of smooth muscle. The smooth muscle fibers are interwoven in all directions andcollectively these are called the detrusor muscle. Contraction of this muscle expels u.ine aom ttrebladder. on the superior surface, the outer layer of the bladder wall is parietal peritoneum. ln allother regions, the outer layer is fibrous connective tissue. There is a triangular area, called thetrigone, formed by three openings in the floor of the urinary bladder. TwJ of the openings arefrom the ureters and form the base of the trigone. Small flaps of mucosa cover these openings andact as valves that allow urine to enter the bladder but prevent it from backing up fromihe bladderinto the ureters' The third opening, at the apex of the trigone, is the openinglnto the urethra. Aband of the detrusor muscle encircles this opening to foim the internal uretLal sphincter.

The final passageway for the flow of urine is the urethra, a thin-walled tube that conveys urinefrom the floor of the urinary bladder to the outside. The opening to the outside is the externalurethral orifice. The mucosal lining of the urethra is transitionaiepithelium. The wall alsocontains smooth muscle fibers and is supported by connective tissue. The internal urethralsphincter surrounds the beginning of the urethra, where it leaves the urinary bladder. Thissphincter is smooth (involuntary) muscle. Another sphincter, the extemal urethral sphincter, isskeletal (voluntary) muscle and encircles the urethra where it go., through tt

" p.fri. n"or. These

two sphincters control the flow of urine through the urethra.In-females, tf," ,r."ih.u is short, only 3to 4 cm (about 1.5 inches) long. The external urethral orifice opens to ine outsiae jrrt *i"rio. tothe opening for the vagina. In males, the urethra is much longei, about 20 cm (7 to g inches) inl:ngrt, and transports both urine and semen. The first part, nExt to the urinarytladder, passesthrough the prostate gland and is called the prostatic urethra. The second pui, ushort iegion thatpenetrates the pelvic floor and enters the penis, is called the membranous urethra. The third part,the spongy urethr4 is the longest region. This portion of the urettra extends the entire length ofthe penis, and the external urethral orifice opens to the outside at the tip ofthe penis.

ENDOCRINE SYSTEM

The endocrine system is instrumental in regulating mood, growth and development,tissue function, metabolism, and sexual function and reproductive processes.In general,the endocrine system is in charge of body processes that happen slowly, such as cellgrowth. Faster processes like breathing and body rnovement are controlled by the nervoussystem' But even though the nervous system and endocrine system are separate systems,they often work together to help the body function properly.

What Is the Endocrine System?

The foundations of the endocrine system are the hormones and glands. As the body,schemical messengers, hormones transfer information and instructions from one set ofcells to another. Many different hormones rnove through the bloodstream, but each typeof hormone is designed to affect only certain cells.A gland is a group of cells thatproduces and secretes, or gives off, chemicals. A gland selects and removes materialsfrom the blood, processes them, and secretes the finished chemical product for usesomewhere in the body. Some types of glands release their secretions in specific areas.For instance, exocrine glands, such as the sweat and salivary glands, release secretionsin the skin or inside the mouth. Endocrine glands, on the other hand, release more than20 major hormones directly into the bloodstream where they can be transported to cells inother parls of the body.The major glands that rnake up the human endocrine systeminclude the:

. hypothalamus

. pituitary gland

. thyroidr parathyroids

. adrenal glands

. pineal body

. reproductive glands (rvhich include the ovaries and testes)

The hypothalamus, a collection of specialized cells that is located in the lower centralpart of the brain, is the main link between the endocrine and nervous systems. Nerve cellsin the hypothalamus control the pituitary gland by producing chernicals that eitherstimulate or suppress hormone secretions fiorn the pituitary.

Although it is no bigger than a pea, the pituitary gland, located at the base of the brainjust beneath the hypothalamus, is considered the most irrportant paft of the endocrine

system. It's often called the "master gland" because it makes hormones that control

several other endocrine glands. The production and secretion of pituitary hormones can

be influenced by factors such as emotions and changes in the seasons. To accomplish

this, the hypothalamus provides information sensed by the brain (such as environmental

temperature, light exposure patterns, and feelings) to the pituitary.The tiny pituitary is

divided into two parts: the anterior lobe and the posterior lobe. The anterior lobe

regulates the activity of the thyroid, adrenals, and reproductive glands. The anterior lobe

produces hormones such as:

o growth hormone, which stimulates the growth of bone and other body tissues

and plays a role in the body's handling of nutrients and minerals

. prolactin which activates milk production in women who are breastfeeding

. thyrotropin, which stimulates the thyroid gland to produce thyroid hormones

. corticotropin which stimulates the adrenal gland to produce certain hormones

The pituitary also secretes endorphins, chemicals that act on the nervous system and

reduce feeiings of pain. In addition, the pituitary secretes hormones that signal the

reproductive organs to make sex hormones. The pituitary gland also controls ovulation

and the menstrual cycle in women.The posterior lobe of the pituitary releases

antidiuretic hormone, which helps control the balance of water in the body. The

posterior lobe also produces oxytocin, which triggers the contractions of the uterus in a

woman having a baby.

The thyroid, located in the front part of the lower neck, is shaped like a bow tie or

butterfly and produces the thyroid hormones thyroxine and triiodothyronine. These

hormones control the rate at which cells burn fuels from food to produce energy. The

production and release of thyroid hormones is controlled by thyrotropin which is

secreted by the pituitary gland. The more thyroid hormone there is in a person's

bloodstream, the faster chemical reactions occur in the body.

Attached to the thyroid are four tiny glands that function together called the

parathyroids. They release parathyroid hormone, which regulates the level of calcium

in the blood with the help of calcitonin, which is produced in the thyroid.

The body also has two triangular adrenal glands, one on top of each kidney. The adrenal

glands have two parts, each of which produces a set of hormones and has a different

function. The outer part, the adrenal cortex, produces hormones called corticosteroidsthat influence or regulate salt and water balance in the body, the body's response to stress,metabolism, the immune system, and sexual development and function. The inner part,the adrenal medulla, produces catecholamines, such as epinephrine. Also calledadrenaline, epinephrine increases blood pressure and heart rate when the bodyexperiences stress.

The pineal body, also called the pineal gland, is located in the middle of the brain. ltsecretes melatonin, a hormone that may help regulate when you sleep at night and whenyou wake in the morning.

The gonads are the main source of sex hormones. Most people don't realize it, but bothguys and girls have gonads. In guys the male gonads, or testes are located in tl-re scrotum.They secrete hormones called androgens the most important of which is testosterone . Agirl's gonads, the ovaries are located in her pelvis. They produce eggs and secrete thefemale hormones estrogen and progesterone. Estrogen and progesterone are alsoinvolved in the regulation of a girl's menstrual cycle. These hormones also play a role inpregnancy.

Although the endocrine glands are the body's main hormone producers, some otherorgans not in the endocrine system - such as the brain, heart, lungs, kidneys, liver, andskin - also produce and release hormones. The pancreas is also part of the body,shormone-secreting system, even though it is also associated with the digestive systembecause it produces and secretes digestive enzymes. The pancreas produces (in additionto others) two important hormones, insulin and glucagon. They work together tomaintain a steady level of glucose, or sugar, in the blood and to keep the body suppliedwith fuelto produce and maintain stores of energy.

What Does the Endocrine System Do?

Once a hormone is secreted, it travels from the endocrine gland that produced it throughthe bloodstream to the cells designed to receive its message. These cells are called targetcells. Along the way to the target cells, specialproteins bind to some of the hormones.These proteins act as carriers that control the amount of hormone that is available for thecells to use. The target cells have receptors that latch onto only specific hormones, andeach hormone has its own receptor, so that each hormone will communicate only withspecific target cells that have receptors for that hormone. When the hormone reaches itstarget cell, it locks onto the cell's specific receptors and these hormone-receptorcornbinations transmit chemical instructions to the inner workings of the cell.

When hormone levels reach a certain normal amount, the endocrine system helps the

body to keep that level of hormone in the blood. For example, if the thyroid gland has

secreted the right amount of thyroid hormones into the blood, the pituitary gland senses

the normal levels of thyroid hormone in the bloodstream. Then the pituitary gland adjusts

its release of thyrotropin, the hormone that stimulates the thyroid gland to produce

thyroid hormones.

Another example of this process is parathyroid hormone. Parathyroid hormone increases

the level of calcium in the blood. When the blood calcium level rises, the parathyroid

glands sense the change and reduce their secretion of parathyroid hormone' This turnoff

process is called a negative feedback system'

Things That Can Go Wrong With the Endocrine System

Too much or too little of any hormone can be harmful to your body. For example, if the

pituitary gland produces too much growth hormone, a teen may grow excessively tall' If

it produ"es too little, a teen may be unusually short. Doctors can often treat problems

with the endocrine system by controlling the production of hormones or replacing certain

hormones with medication. Some endocrine probleffrs that affect teens include:

Adrenal insufficiency. This condition occurs when the adrenal glands don't produce

enough corticosteroids. The symptoms of adrenal insufficiency may include weakness'

fatigue, abdorninal pain, nausea, dehydration, and skin changes' Doctors treat adrenal

insufficiency with medications to replace corticosteroid hormones'

Type 1 diabetes. When the pancreas fails to produce enough insulin, type 1 diabetes

occurs. In kids and teens, type I diabetes is usually an autoimmune disorder, which

means that some parts of the body's immune system attack and destroy the cells of the

pancreas that produce insulin. To control their blood sugar levels and reduce the risk of

developing diabetes problems, kids and teens with this condition need regular injections

of insulin.

Type 2 diabetes. unlike type 1 diabetes, in which the body can't produce normal

amounts of insulin, in type 2 diabetes the body can't respond to insulin normally' Kids

and teens rvith the condition tend to be overr'veight. Some kids and teens can control their

blood sugar level with dietary changes, exercise, and oral medications, but many will

needtotakeinsulininjectionslikepeoplewithtypeidiabetes.

grorving uill maiie teir 3r-'s E: irk 5n{. qrs _JC,t 3\v-ESsir-eir. This rare condition(sometimes called gigantisn r is usr.miil caused b1- a piruitan-tumor and can be treated byremoving the tumor. The opposite can happen rvhen a kid or teen has a pituitary glad thatdoesn't produce enough grourh hormone. Doctors may treat these growth problems withmedication.Hyperthyroidism. Hrperthl,roidism is a condition in w'hich the levels ofthyroid hormones in the blood are very high. In kids and teens, the condition is usuallycaused by Graves' disease, an immune system problem that causes the thyroid gland tobecome very active. Doctors ma,v treat hyperthyroidism with medications, surgery, orradiation treatments.

Hypothyroidism. Hypothyroidism is a condition in which the levels of thyroid hormonesin the blood are very low. Thyroid hormone deficiency slows body processes and maylead to fatigue, a slow heart rate, dry skin, weight gain, constipation. Kids and teens withthis condition may also grow more slowly and reach puberty at a later age. Hashimoto'sthyroiditis is an immune system problem that often causes problems with the thyroid and

blocks the production of thyroid hormone. Doctors often treat this problem withmedication.

Precocious puberty. If the pituitary glands release hormones that stimulate the gonads toproduce sex hormones too early, some kids may begin to go through puberty at a veryyoung age. This condition is called precocious puberty. Kids and teens rvho are affected

by precocious puberty can be treated with medication that will help them develop at a

normal rate.

The Digestive Process

The main purpose of the Digestive system is to break down food and absorb nutrients.There are two basic divisions to the digestive system, these are the gastrointestinal (GI)tract' also known as the alimentary canai, and the accesory digestive organs. your mouth,pharynx, esophagus, stomach, small intestine and large iniestilre compo"se the GI tract,and your teeth, tongue, salivary glands, liver, gall blidaer and pancrels are accessoryorgans.The.digestive system carries out six basic processes; ingestion, secretion,propulsion, digestion, absorption and defecation" lngestion is iaking food into the mouth.Secretion is the act of expelling a liquid. The cells lining the GI tract secrete about 9liters (9.5 quarts) of water, acid, buffers, ancl enzymes eich day to lubricate the canal andaid in the prooess of digestion. Propulsion consiits of alternating contraction andrelaxation of smooth muscle in the walls of the GI tract to squeeze food downwards.Digestion has two parts, mechanical and chemic al. Mechanical digestion is chewing upthe food and your stomach and smobth intestine chuming the food, while chemicaldigestion is the work the enzymes do when breaking large carbohydrate, lipid, proteinand nucleic acid molecules down into their subcomponents -these and others are thenutrients-. Absorption occurs in the digestive system when the nutrients move from thegastrointestinal tract to the blood or lymph. Defecation is the process of expelling whatthe body couldn't use"The start of the process - the mouth: The digestive process begins in the mouth. Foodis partly broken down by the process of chewing and 6y the chernical action of salivaryenzymes (these enzymes are produced by the salivary glands and break dorvn starchesinto smaller molecules).The esophagus - After being &ewed and swallowed, the foodenters the esophagus. The esophagus is a long tube that runs from the mouth io thestomach. It uses rhythmic, wave-like muscle movements (called peristalsis) to force foodfrom the throat into the stomach. This musele movement gives ui th" abiliiy to eat ordrink even when we're upside-dorvn" In the stomach - The stomach is a laige, sack-likeorgan that churns the food and bathes it in a very strong acid (gastric acid). Food in thestomach that is partly digested and mixed with stomach acids is called chyme. In thesmall intestine - After being in the stomach, food enters the duodenum, t-he first part ofthe srnall intestine" It then enters the jejunum and then the ileum (the final part of thesmall intestine). In the small intestine, bile (produced in the liver and stored in the gallbladder), pancreatic enzymes, and other digestive enzymes produced by the inner wall ofthe small intestine help in the breakdown of food. tn ihe large intestine - After passingthrough the small intestine, food passes into the large intestine. In the large intestile,some of the water and electrolytes (chemicals like sodium) are removed from the food"Many microbes (bacteria like Bacteroides, Lactobacillus acidophilus, Escherichia coli,and Klebsiella) in the large intestine help in the digestion process. The first part of thelarge intestine is called the cecum (the appendix is connected to the cecum). Food thentravels upward in the ascending colon. The food travels across the abdomen in thetransverse colon, goes back down the other side of the body in the descending colon, andthen through the sigmoid colon" The end of the proeess - Solld waste is then"stored inthe rectum until it is excreted via the anus.

Digestive System Glossary:anus - the opening at the end of the digestive system from which feces (waste) exits the body.

appendix - a small sac located on the cecum.ascending colon - the part of the large intestine that run upwarcls; it is located after the eecum.bile - a digestive chemical that is produced in rhe liver, stored in the gall bladder, and seeretedinto the small intestine.cecum - the first part of the large intestine; the appendix is connected to the ceeum.chyme - food in the stom-ac\ttrat is partly digested and mixed with stomach acids" Chy,me goeson to the small intestine for further <iigestion.descending colon - the part of the large intestine that run downwards after the transverse colonand before the sigmoid colon.duodenum - the first part of the small intestine; it is C-shaped and runs from the stomach to theJeJunum.epiglottis is the flap of cartilage lying behind the tongue and in front of the entrance to the larynx(voice box). At rest, the epiglottis is upright and allows air to pass through the larynx and into therest of the respiratory system. During swaliowing, it folds baci to cover the entrance to thelarynx, preventing food and drink from entering ihe windpipe(trachea)

esophagus - the long tube between the mouth and the stomach. It uses rhythmie musclemovements (called peristalsis) to force food from the throat into the stomach.gall bladder - a small, sac-like organ located by the duodenum. It stores and releases bile (adigestive chemical which is produced in the liver) into the small intestine.ileum - the last part of the small intestine before the large intestine begins.jejunum - the long, coiied mid-section of the small intestine; it is between the duodenum and theileum.Iiver - a large organ located above and in front of the stomach. It filters toxins from the blood,and makes bile (which breaks down fats) and some blood proteins"omentum is an apronlike double fold of fatty membrane that hangs down in front of theintestines. It contains blood vessels, nelves, lymph vessels and lymph nodes" It acls as a storagefor fat and also may limit the spread of infectionin the abdominal cavity.pancreas - an enzyme-producing gland located below the stomactr and above the intestines.Enzymes from the pancreas help in the digestion of carbohydrates, fats and proteins in the smallintestine.peristalsis - rhythmic muscle movements that force food in the esophagus from the throat into thestomach. Peristalsis is invoiuntary * you cannot control it. It is also what allows you to eat anddrink while upside-down.rectum - the lower part ofthe large intestine, where feces are stored before they are excreted.salivary glands - glands located in the mouth that produce saliva. Saliva contains enzymes thatbreak down carbohydrates (starch) into smaller molecules"sigrnoid colon - the part of the large intestine between the descending colon and the rectum.stomach - a sack-like, muscular organ that is attached to the esophagus. Both chernical andmechanical digestion takes place in the stomach. When food enters fre stomach, it is churned in abath of acids and enzymes.transverse colon - the part of the large intestine that runs horizontally across the abdomen.

Disorders of the Ear and Hearing

Hearing Loss. Hearing impairment may result from disease, injury, or developmental problemsthat affect the ear itself or any nervous pathways concerned with the ,.nr. of hearing. Sensorineuralhearing loss results from damage to the eighth cranial nerve or to central auditory put-h*uyr. Heredity,toxins, exposure to ioud noises, and the aging process are possible causes for this type gf hearing toss. iimay range lrom inability to hear certain frequencies of sound to a complete loss tf hearing (deafness).Conductive hearing loss results from blockage in sound transmission 6 the inner ear. Causes includeobstruction, severe infection, or fixation of the middle ear ossicles. Often the conclitions that causeconductive hearing loss can be treated successfuliy"

Otitis is any inflammation of the ear" Otitis media refers to an infection that leads to theaccumulation of fluid in the middle ear cavity. One cause is malfunction or obstruction of the eustaclfantube, such as by ailergy, enlarged adenoids, injury, or congenital abnormalities. Another cause is infectionthat spreads to the middle ear, most commonly from the upper respiratory tract. Continued infection maylead to accumulation of pus and perforation of the eardrum. Otitis media usually affects children under 5years of age and may result in hearing loss. If untreated, the infection may spread to other regions of theear and head treatment is with antibiotics. A tube may also be placed in the tympanic membrane toventilate the middle ear cavity, a procedure called a myringotomy.

In otosclerosis the bony structure of the inner ear deteriorates and then refbrms into spongy bonetissue that may eventually harden. Most commonly, the stapes beeomes fixed against the innei ear and isunable to vibrate, resulting in conductive hearing loss. The cause is unknown, but some cases arehereditary" The damaged bone can usually be removed surgically. In a stapedectomy the stapes isremoved and a prosthetic bone is inser:ted"

Meniere's Disease is a disorder that affects the inner ear. It appears to involve the productioir andcirculation of the fluid that fills the inner ear, but the cause is unknown. The symptoms are vertigo(dizziness), hearing loss, pronounced tinnitus (ringing in the ears), and a feeling of pressure in the ear" Thecourse of the disease is uneven, and symptoms may become less severe with time. Meniere's disease istreated with drugs to control nausea and dizziness, such as those used to treat motion sickness. In severecases, the inner ear or part of the 8th cranial nerve may be destroyed surgically.

An acoustic neuroma is a tumor that arises from the neurilemma (sheath) of the Sth cranial nerve.As the tumor enlarges, it presses on surrounding nerves and interferes with blood supply. This leads totinnitus, dizziness, and progressive hearing loss. Other symptoms develop as the tumor presses on the brainstem and other cranial nerves. Usually it is necessary to remove the tumor surgically.

Disorders of the Eye and Vision

Errors of Refraction" If the eyeball is too long, images will form in front of the retina. In order tofocus clearly, an object must be brought eloser to the eye. This condition of nearsightedness is technicallycalled myopia. The opposite condition is hyperopia, or farsightedness, in which the eyeball is too shortand images form behind the retina. Objects must be moved away from the eye in order to focus clearly.The same effect is produced by presbyopia, which accompanies aging. The lens loses elasticity and can nolonger accommodate for near vision. The person becomes increasingly farsighted. An astigmatism is aninegularity in the curve of the cornea or lens that distorts light entering the eye and blurs vision. Most ofthese impairments can be compensated for with glasses.

Infection. Several microorganisms can cause conjunctivitis (inflammation of the conjunctiva).T'his is a highly infeetious disease commonly called "pinkeye". The bacterium Chlaniydia trachomatiscauses trachoma, inflammation of the oornea and conjunctiva that results in scarring. 'Ihis disease is easilycured with sulfa drugs and antibiotics.

Gonorrhea contracted in the birth process is the usual cause of an acute conjunctivitis in newbomsealled ophthalmia neonatorum. Silver nitrate is routinely instilled in the eyes of newbonis to preventsuch infections.

Disorders of the Retina. Retinal detachment, separation of the retina from the underiying layerof the eye (the choroid), may be caused by atumor, hemorrhage, or injury to the eye. This interferes withvision and is eommonly repaired with laser surgery.

Degeneration of the macula, the point of sharpest vision, is a common cause of visual problems inthe elderly. When associated with aging, this del,erioration is described as senile macular dLgeneration(SMD)" Other causes are <irug toxicity and hereditary diseases.

Circulatory problems associated with diabctes mellitus eventually cause changes in the retinareferred to as diabetic retinopathy. In addition to vascular damage, there is a yellowish, waxy exudatehigh in lipoproteins. With time, new blood vessels form and penetrate the vitreous humor, causinghemorrhage, detachment of the retina, and blindness.

A cataract is an opacity (cloudiness) of the lens. Causes of eataract include disease, injury,chemicals, and exposure to physical forces, especially the ultraviolet radiation in sunlight. The cataractsthat frequently appear with age may result from exposure to environmeniai factors in combination withdegeneration due to aging. In order to prevent blindness, the cloudy lens must be removed surgically byone of several methods" Following cataract removal, an artificial lens can be implanted or the person canwear a contact lens or special glasses.

Glaucoma is an abnormal increase in pressure r,,ithin the eyeball. It occurs when more aqueoushumor is produced than can be drained away from the eye. There is pressure on blood vessels in the eyeand on the optic nerve, leading to blindness" There are many causes of glaucoma, and screening forglaucoma should be a part of every routine eye examination" Fetal infeetion with German rneasles (rubella)early in pregnancy can cause glaucoma, as well as cataracts and hearing impairment. Glaueoma is usuallytreated with medication to reduce pressure in the eye, and is occasionaliy treated with surgery"

1" N{atch the terms in each of theses sets with their definitions and write the appropriateIetter (a-e) to the left of each number._ 1. proprioception

_* 2. olfaetion__ 3. gustation

_ 4. labyrinth

_ 5. ossicles

_ 6" pinna

_ 7. vestibular apparatus

_ 8. Eustachian tube

__ 9. lacrimal gland

_ 10" lens

_ 11. presbyacusis

_12. myopia

_- 13. achromatopsia

_ l .emmetropia

_- 15. ophtalmometer

_ 16. strabismus

_17. vertigo

_ 18. mastoid process

_ 19. cataract

_20" fovea

a. inner earb. sense of smellc" small bones of the middle eard. sense of tastee" awareness of body position

a. passage that cormects the middle ear and pharynxb. produces tearsc. projecting portion of the eard. part of the ear concemed with equilibriume. changes shape for near and far vision

a. normal refiaction of the eyeb. complete color blindnessc. loss of hearing due to aged. nearsightednesse" instrument for measuring the eyes

a. point of sharpest visionb. false sensation of movcmente. deviation of the eyed. projection of the temporal bonee. opacity of the lens

2" Fill in the blanks:i. The coiled portion of the inner ear that contains the receptor for hearing is the . ".2" The innermost layer of the eye that eontains the receptors for vision is the ...3. 'fhe scientifie name for the eardrum is .. .

4. The niiddle layer of the eye, consisting of the choroids, eiliary body, and iris is the ...5. The term oculornotar refers to rnovements of the . ".6. The ossicle that is in c,ontact with the inner ear is the ". "

7 . The muscular ring that adjusts the size of the pupil is the ...8. Ivlydriasis is abnormal dilation of the ...

System Clinical studyThe nerrrous system consists ofthe central nervoussystem (whioh is the brain and spinal cord) andperipheial nervous system. The Lrain is the organ "f :,",1i"-t-:',"'ce,

neurology

thought, emotion, and sensory processing, anJ (dlsease)' psychtatry

serves many aspects of communication and eontrol (behavioral),

of various othei systems and tunctions. The speciat :l^11f1]*:l"sv (vision),

senses consist of vision, hearing, taste, and smell. otolaryngo.logy (hearing,

The eyes, ears, tongue, and nose gather inforrnat'on taste, smell)

about the body's environment.

The musculoskeletal system consists of the humanskeleton (which includes bones, ligaments, tendons,and cartilage) and attached muscles. It gives thebody basiJsiructure and rhe abitity for

-movemen," ::]:ol"q (skeleton),

In addition to their structural role, the larger bones orthopedics (bone

in the body contain bone marrow, the site of cusorclers)

production of blood cells. Also, all bones are majorstorag€ sites for calcium and phosphate.

The circulatory system consists ofthe heart andblood vessels (arteries, veins, capillaries)" The heartpropels the circulation ofthe blood, which serves asa "transportation system" to transfer oxygen, fuel,nutrients, waste products, immune cells, and cardiology (heart),signalling molecules (i.e., hormones) from one part hematology (blood)of the body to another. The btood consists of fluid

. that carries cells in the circulation, including somethat move from tissue to blood vessels and back, aswell as the spleen and bone m€urow.

The respiratory system consists ofthe nose,nasopharynx, trachea, and lungs. It brings oxygenfrornthe air and excretes carbon dioxidJ and water pulmollology'

back into the air.

The gastrointestinal system consists ofthe mouth,esophagus, stomach, gut (small and large intestines),and rectum, as well as the liver, pancreas,gallbladder, and salivary glands. It converts food gastroenterologyinto small, nutritional, non-toxic molecules fordistribution by the circulation to all tissues ofthebody, and excretes the unused residue.

The integumentary system consists of the coveringof the body (the skin), including hair and nails aswell as other functionally important structures suchasthe sweat glands and sebaceous glands, The skin dermatologyprovides containment, structure, aird protection forother organs, but it also serves urs a major sensoryinterface with the outside world.The urinary system consists ofthe kidneys, ureters,bladder, and urethra. It removes water from the nephrology (function),blood to produce urine, which carries a variefy of urology (strueturalwaste molecules and excess ions 6nd water out of disease)the body.

The reproductive system consists ofthe gonads gynecology (wornen),and the intemal and externai sex organs. The andrology (men),

Physiology

neurophysiology

cell physiology,musculoskeletalphysiology

cardiovascularphysiology

respiratoryphysiology

gastrointestinalphysiology

cell physiology,skin physiology

renal pliysiology

reproductivephysiology

reproductive system produces gametes in each sex, sexology (behaviorala mechanism for their combination, and a nurturing usp""tsj embryologyenvironment for the hrst 9 months of development (divelopmentat asfects;of the offspring.

The irnmune system consists of the white bloodcells, the thymus, lymph nodes and lyrnph channels,which are also part of the Iymphatic system. Theimmune system provides a mechanism for the bodyto distinguish its own cells and tissues from alien immunologycells and substances and to neutralize or destroy theIatter by using specialized proteins such asantibodies, cytokines, and toll-like receptors, amongmany others.

The endocrine system consists ofthe principalendoorine glands: the pituitary, thyroid, adrenals,pancreas, parathyroids, and gonads, but nearly allorgans and tissues produce specific endocrinehormones as well. The endocrine hormones serve as

endocrinologl

signals from one body system to another regardingan enornous array ofconditions, and resulting invariety of changes of firnction.

immunology

endocrinology

1. Mary is a healthy 2l-year-old Olympic athlete who no longer has her menses due to her excessivetraining. Her condition is called .

a. menorrhagiab. dysmenorrheac. amenorrhea

d. menorrhea2. Stopping a patient's blood flow during surgery is vital for the patient's survival" This act ofstopping

blood flow is calleda. hemostasisb" phlebostasisc. arteriostasis

d. venostasis3. when doctors refer to pain in the internal organs of the body, they use the term _.a. visceroskeletal

b. viscerogenicc. visceroptosis

d. visceralgia4. Human blood contains two types of cells, red and white.

a. melanocyteb. leukocytec. cyanocyte

d. xanthocyte

The white blood eells are also called _"

5. When an examination of the interior ofthe eye is needed, the instrument that a doctor uses is called

a. ophthalmologistb. ophthalamopathyc. ophthalmoscope

d. ophthalmoplegia6. High blood sugar is a conCition knorvn as ._"

a. hypoglycemiab. hyperglycemiac. hypoglycogen

d. hyperglycogen

7.

8.

sometimes the testicles of a male child fail to descend from the abdominal cavity when he is born.This condition of hidden testicles is called

a" cryptotesticlesb" cryptorchidismc. orchidism

d. orchidoplastyWhen a woman's vagina needs to be examined for abnormalities, a specific instrument is used. Thisinstrument is called _.

a" colopopathyb. colposcopec. vaginascope

d. rynoscope9. There are three main layers oftissue in humans"

a- ectodermb" endodermc, mesoderm

d. retroderm10. There are three main layers of tissue in humans.

a. ectodermb. endodermc. mesoderm

d. paraderm

The outer germ layer is called the _.

The middle germ layer is called the _.

I l. There are many one-celled organisms in the world. Another word for one-cell isa. nullicyteb. monocytec" multicyte

d. muticellular12. A high fever can cause the body to lose water.

a. dehydrationb. dehydratedc. exhydration

d. exhydrated

This loss of water is called

13" when a tumor is found, it is often cut out and removed. This process is called _.a" aberesisb. exeresisc. decretion

d. excretion14. Opium belongs to a certain class of drugs that produces sleep. This type of drug is called a _.a. narcolepsy

b. narcoticc. narcosis

d. pseudocotic15' Whenever a solution is injected into thdblood, it must have the same osmotic prossure as red blood

cells. A solution which has the same osmotic pressure is called:.a. isotonicb. anotonicc. peritonic

d. circumotonic16. When people have an allergic reaction, they may develop hives, which are limited in the space that

they cover. Hives may be called _ wheals"a. isoscribedb. diascribe.dc. periscribed

d. circumscribed17. Soft contact lenses easily attract water. They are _"a" hyrirophobia

1

t't

b. hydrophobicc. hydrophilic

d. hydrosis18. When a country's population has people from different ethnic backgrounds, the population is _.a. homogeneous

b. heterogeneousc. homosexual

d. heterosexual19. When a patient has a problem over the stomach region of the body, the region is called _.a. epigasuic

b. infragasticc. subgasric

d. intragastric20. When an area is &ee from infection, the area is said to be

a. sepsisb. septicc. aseptic

d.d. antiseptic21. Atype of drug that works against infection is called

a. anticonvulsiveb. antipyreticc. anitnarcotic

d.d. antibiotic22. Wher- a person has his/her heart on the right side of the body, the condition is called cardiac

a. transposition

b. contralateralc. intransposition

d.d. anti-transposition23. Arteries and nerves can divide into two branches. This division is also called _.a. unifurcation

b. bifurcationc. trifiroation

d. hemifurcation24' A child may be bom with a deformity or condition. This type of deformity or condition is called

a. unicongenitalb. bicongenitalc. congenital

d. consanguinity25. Sometimes tissue is cui into parts for the purpose of study. This action is called _.

a. consectionb. dissectionc. transsection

d. unsection

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