THE CARDIOVASCULAR SYSTEM

The cardiovascular system is a ​closed system of the ​heart and blood vessels​. Wherein ​the
heart pumps blood ​and ​the blood vessels allow blood to circulate to all parts of the body.
The function of the cardiovascular system is ​to deliver oxygen and nutrients and to ​remove
carbon dioxide and other waste products.

THE HEART

The heart is approximately the size of a person’s ​fist, the ​hollow​, ​cone-shaped heart ​weighs
less than a pound​.
· The heart is in the ​thoracic cavity ​between the lungs​, ​deep and slightly to the
left of the sternum.
· The ​base of the heart​, located ​deep to the sternum​, ​extends superiorly to the
second intercostal space​, and the ​apex of the heart is located ​deep to the fifth
intercostal space​, approximately ​7–9 cm to the left of the sternum where the
midclavicular line intersects with the fifth intercostal space​.

Functions of the Heart

1. Generating blood pressure
2. Routing blood: ​separates pulmonary and systemic circulations
3. Ensuring one-way blood flow​: valves
4. Regulating blood supply ​- Changes in contraction rate and force match blood delivery
to changing metabolic needs
Pericardium

Pericardium – is a ​double-walled sa​c which ​encloses the heart​.

· The pericardium consists of ​two layers​:

o ​Fibrous pericardium ​– the ​tough​, fibrous connective tissue ​outer lay​er which
helps protect the he​art and ​anchors it to surrounding structures​, such as the
diaphragm and sternum.

o ​Serous pericardium - the ​inner layer of flat epithelial cells​, with a ​thin layer of
connective tissue which is consists of two layers.

§ ​Parietal pericardium – is the portion of the serous pericardium ​lining the

fibrous pericardium.

§ ​Viscera​l pericardium or epicardium - is the portion ​covering the heart

surface.

· A ​slippery lubricating fluid (​serous fluid​) is ​produced by the serous pericardial

membranes.

o ​This fluid ​allows the heart to beat easily in a relatively f​rictionless

environment as the serous pericardial layers slide smoothly across each
other.

The heart walls are composed of three layers:

· Epicardium or Visceral pericardium ​- is the portion ​covering the heart surface

· Myocardium - consists of ​thick bundles of cardiac muscle ​twisted and whorled

into ​ring-like arrangements​. It is the layer that actually ​contracts​.

· Endocardium - is ​a thin, glistening sheet of endothelium that ​lines the heart

chambers​. ​It is continuous with the linings of the blood vessels leaving and entering
the heart.

The heart has ​four​ hollow ​chambers, or cavities​:

 · Right and left atria (singular atrium) - located at the ​base of the he​art and are
primarily ​receiving chambers​. The left and right atria ​receive blood from veins
and function mainly as ​reservoirs​. ​Contraction of the atria completes ventricular
filling.

· ​Right and left ventricles ​- ​extend from the base of the heart toward the apex and are
discharging chamb​ers. The ​right ventricle pumps blood into the pulmonary trunk​, and the
left ventricle, which has a thicker wall, pumps blood into the aorta.

The septum that divides the heart longitudinally is referred to as either the i​ nterventricular
septum or the interatrial septum,​ depending on which chamber it separates.

External Anatomy
· The ​atria are separated externally ​from the ventricles ​by the coronary sulcus​. The
right and left ventricles are separated externally​ by the ​interventricular sulci.
· The ​inferior and superior vena cava ​enter the right atrium​. ​The four pulmonary
veins​ enter the left atrium.
· The ​pulmonary trunk exits ​the right ventricle​, and the ​aorta exits the left
ventricle.
Heart Valves

The heart is equipped with ​four valves​, which allow blood to ​flow in only one direction through
the heart chambers​—​from the atria through the ventricles and out the great arteries leaving the
heart.
· Atrioventricular valves ​- ​are located between the atrial and ventricular chambers
on each side. These valves ​prevent backflow into the atria when the ventricles
contract.

o ​Bicuspid or mitral valve - consists of ​two flaps​, or cusps, of endocardium and

separates the left atrium and the left ventricle.

o ​Tricuspid valve - has ​three flaps and separates the right atrium and the right
ventricle.

Tiny white cords​, the ​chordae tendineae​ ​anchor the flaps to the walls of the ventricles​.
· Semilunar valves - ​guards the bases of the two large arteries leaving the ventricular
chambers.
o​ ​Pulmonary valves
o​ ​Aortic valves
Coronary Circulation

Although the heart chambers are bathed with blood almost continuously, ​the blood contained
in the heart does not nourish the myocardium.

§T
​ he functional blood supply that oxygenates and nourishes the heart is provided

by the ​right and left coronary arteries.

§ ​The coronary arteries branch from the base of the aorta and encircle the heart in the
coronary sulcus (atrioventricular groove) at the junction of the atria and ventricles.

​ he myocardium is drained by several cardiac veins​, ​which empty into an enlarged

§T
vessel on the posterior of the heart called the ​coronary sinus.​

§​ T
​ he coronary sinus, in turn, empties into the right atrium.

o ​The ​left coronary artery ​has ​three major branches​: the ​anterior

interventricular​, the ​circumflex​, and the ​left marginal arteries​.

o ​The r​ ight coronary arter​y has ​two major branches​: the ​posterior
interventricular and the right marginal arteries.
PHYSIOLOGY OF THE HEART

The Heart: ​Conduction System

Cardiac muscle cells can contract spontaneously and independently even without nerve
impulses​. ​Two systems act to regulate heart activity.​
· One of these involves the ​nerves of the autonomic nervous system​, which
decreases or increases the heart rate​ depending on which division is activated.
· The second system is the ​intrinsic conduction system​, or ​nodal system​, that is
built into the heart tissue and sets its basic rhythm​. The intrinsic conduction
system is composed of a ​special tissue:​
o​ ​Sinoatrial Node (SA) - is often called the ​pacemaker.
o​ ​Atrioventricular Node (AV)
o​ ​Atrioventricular bundle
o​ ​Bundle branches
o​ ​Purkinjie fibers
An ectopic beat results from an action potential that originates in an area of the heart other than
the SA node.​

Cardiac Cycle
The term cardiac cycle refers to the ​events of one complete heartbeat​, during which ​both
atria and ventricles contract and then relax​. ​Systole and diastole mean heart ​contraction
and relaxation​, respectively.
· Mid-to-late diastole​. The atria contract and force the blood remaining in their
chambers into the ventricles.
· Ventricular systole​. Blood pressure builds before ventricle contracts, pushing out
blood. The atria are relaxed, and their chambers are again filling with blood.
· Early diastole​. The atria finish re-filling and ventricular pressure is low.

Heart Sounds

When using a stethoscope, you can hear ​two distinct sounds during each cardiac cycle.
These heart sounds are often described by the two syllables ​“lub” and “dup​”.
· The ​first heart sound (lub​) is caused by the closing of the AV valves.
· The ​second heart sound (dup​) occurs when the semilunar valves close at the end
of systole. ​The first heart sound is longer and louder than the second heart sound,
which tends to be short and sharp.

Abnormal heart sounds, called ​murmurs​, can result from ​incompetent (leaky) valves or
stenosed (narrowed) valves.

Cardiac Output

Cardiac output (CO) is ​the amount of blood pumped out by each side of the heart (actually
each ventricle) in 1 minute.​ ​It is the product of the heart rate (HR) and the stroke volume (SV).
o​ ​CO = HR x SV
 · Stroke volume is ​the volume of blood pumped out by a ventricle with each
heartbeat.

Cardiac output varies with the demands of the body​. ​It rises when the stroke volume is
increased or the heart beats faster or both; it drops when either or both of these factors
decrease.

Regulation of Stroke Volume

Stroke volume usually remains relatively constant.

 · Starling’s law of the heart – the ​critical factor controlling stroke volume is ​how
much the cardiac muscle cells are stretched just before they contract.
The ​important factor stretching the heart muscle is ​venous return​, ​the amount of blood entering
the heart and distending its ventricles​.
Anything that increases the volume or speed of venous return also increases stroke volume and
force of contraction.

Factors Modifying Basic Heart Rate

1. Neural (​Autonomic Nervous system​) control​.

o ​During times of ​physical or emotional stress​, the ​nerves of the sympathetic
division of the autonomic nervous system more strongly ​stimulate the SA and
AV nodes and the cardiac muscle itself. As a result, ​the heart beats more
rapidly.
o ​Parasympathetic nerves, primarily the ​vagus nerves​, ​slow and steady the heart,
giving it more time to rest during non-crisis times.
2. Hormones and ions.
o ​Various hormones can have a dramatic effect on heart activity. (E.g. ​Epinephrine
and Thyroxine​)
o ​Electrolyte imbalances pose a real threat to the heart. (E.g. abnormal levels of
ionic calcium)
o ​Either ​excess or lack ​of needed ions such as ​sodium and potassium also
modifies heart activity.
3. Physical factors​.
o ​A number of physical factors, including ​age, gender, exercise, and body

temperature,​ influence heart rate.

o​ ​Heat​ ​increases heart rate by boosting the metabolic rate of heart cells.
o​ ​Cold​ has the opposite effect; it directly ​decreases heart rate.

BLOOD VESSELS

Blood circulates inside the blood vessels, which form a closed transport system, the so-called
vascular system​. There are ​five types ​of blood vessels: ​arteries, arterioles, capillaries,
venules, and veins.

General Features of Blood Vessel Structure

· The heart pumps blood through ​elastic arteries, muscular arteries, and arterioles
to the capillaries.
· Blood returns to the heart from the capillaries through venules, small veins,
medium-sized veins, and large veins.

· Except for capillaries and venules​, blood vessels have three layers​:
o ​Tunica externa - the ​most superficial layer​, is ​formed of dense irregular
connective tissue that includes both collagen and elastic fibers.​ Its function is
basically to ​support and protect the vessels​.

o ​Tunica media - the ​middle layer​, usually is the ​thickest layer​. It consists of
smooth muscle cells that encircle the blood vessel. ​It supports and produces
changes in the diameter of the blood vessel by contraction or relaxation.

o ​Tunica Intima - the ​deepest layer, ​forms the internal lining of blood vessels. It
consists of a ​simple squamous epithelium,​ called the ​endothelium​, ​supported
by thin layers of areolar connective tissue containing elastic and collagen
fibers​.
Arteries
· Large, elastic arteries have many elastic fibers but little smooth muscle in their walls.
They ​carry blood from the heart to smaller arteries with little decrease in
pressure.
· The walls of muscular arteries have much smooth muscle and some elastic fibers.
They undergo ​vasodilatio​n and ​vasoconstriction to control blood flow to
different regions of the body.
· Arterioles​, the ​smallest arteries,​ have smooth muscle cells and a few elastic fibers.
They undergo vasodilation and vasoconstriction to control blood flow to ​local areas.

Veins
 · Venule​s are composed of endothelium surrounded by a basement membrane.
· Small veins are venules covered with a layer of smooth muscle and a layer of
connective tissue.
· Medium-sized ​and ​large veins contain less smooth muscle and fewer elastic fibers
than arteries of the same size.
· Valves prevent the backflow of blood in the veins
· Veins use the milking action of muscles to help move blood

Capillaries
· Capillaries ​consist of only endothelium ​and are
surrounded by a basement membrane and loose
connective tissue.

· Nutrient and waste exchange thru diffusion

and filtration is the principal function of
capillaries.

· Blood is supplied to capillaries by arterioles.

Precapillary sphincters ​regulate blood flow
through capillary networks.

· The tiny capillaries tend to form interweaving

networks called ​capillary beds​. A capillary bed
consists of two types of vessels:

o ​Vascular shu​nt - a vessel that directly

connects the arteriole and venule at
opposite ends of the bed

o capillaries ​– the actual exchange

​True

vessels
PULMONARY CIRCULATION

Blood travels to the lungs to pick up oxygen and release carbon dioxide. As the blood moves
from the heart, to the lungs, and back again, it proceeds as follows:
1. Unoxygenated blood travels from the right ventricle through the pulmonic
valve into the pulmonary arteries.
2. Blood passes through progressively smaller arteries and arterioles into the
capillaries of the lungs.
3. Blood reaches the alveoli and exchanges carbon dioxide for oxygen.
 4. Oxygenated blood then returns via venules and veins to the pulmonary veins,
which carry it back to the heart’s left atrium.

SYSTEMIC CIRCULATION

Blood pumped from the left ventricle carries oxygen and other nutrients to body cells and
transports waste products for excretion.
The major artery, ​the aorta​, branches into vessels that supply specific organs and areas of the
body.

The aorta springs upward from the left ventricle of the heart as the ascending aorta, arches to
the left as the aortic arch, and then plunges downward through the thorax, following the spine
(thoracic aorta) finally to pass through the diaphragm into the abdominopelvic cavity, where it
becomes the abdominal aorta.

Most deep veins follow the course of the major arteries, and with a few exceptions, the naming
of these veins is identical to that of their companion arteries.
The veins converge on the venae cavae, which enter the right atrium of the heart.
Veins draining the head and arms empty into the superior vena cava, and those draining the
lower body empty into the inferior vena cava.

​Arterial Supply of the Brain and the Circle of Willis

The brain is supplied by ​two pairs of arteries​, the ​internal carotid arteries and the ​vertebral
arteries​.
The vertebral arteries join to form the ​basilar artery​.
Branches of the internal carotid arteries and the basilar artery supply blood to the brain and
complete a circle of arteries around the
pituitary gland and the base of the brain called the ​cerebral
arterial circle (circle of Willis).

Hepatic Portal Circulation

· The liver is a key body organ involved in maintaining the proper glucose, fat, and
protein concentrations in the blood.
· The veins of the hepatic portal circulation drain the digestive organs, spleen, and
pancreas and deliver this blood to the liver through the hepatic portal vein.
 · As blood flows slowly through the liver, some of the nutrients are removed to be
stored or processed in various ways for later release to the blood. The liver is
drained by the hepatic veins that enter the inferior vena cava.

​Fetal Circulation

Because the lungs and digestive system are not yet functioning in a fetus, all nutrient, excretory,
and gas exchanges occur through the placenta.
Nutrients and oxygen move from the mother’s blood into the fetal blood, and fetal wastes move
in the opposite direction.
The umbilical cord contains three blood vessels: ​one large umbilical vein and two smaller
umbilical arteries.
· The ​umbilical vein​ ​carries blood rich in nutrients and oxygen​ to the fetus.
· The ​umbilical arteries ​carry carbon dioxide and debris-laden blood from the fetus to
the placenta.

The immature liver is mostly bypassed through the ductus venosus which enters the inferior
vena cava.

Fetal lungs are almost entirely bypassed.

Some of the blood entering the right atrium is shunted directly into the left atrium through the
foramen ovale, a flaplike opening in the interatrial septum.
Blood that does manage to enter the right ventricle is pumped out the pulmonary trunk, where it
meets a second shunt, the ductus arteriosus, a short vessel that connects the aorta and the
pulmonary trunk
The aorta carries blood to the tissues of the fetal body and ultimately back to the placenta
through the umbilical arteries.

PHYSIOLOGY OF CIRCULATION
Adequate blood flow is required to provide nutrients and O2 to the tissues and to remove the
waste products of metabolism from the tissues. A fairly good
indication of the efficiency of a person’s circulatory system can be
obtained by taking arterial pulse and blood pressure
measurements.

Pulse - The alternating expansion and recoil of an artery that

occurs with each beat of the left ventricle creates a pressure wave
that travels through the entire arterial system.
· You can feel a pulse in any artery lying close to the
body surface by compressing the artery against firm
tissue; this provides an easy way of counting heart rate.
Blood Pressure ​- is the pressure the blood exerts against the inner walls of the blood vessels,
and it is the force that keeps blood circulating continuously even between heartbeats. Two
arterial blood pressure measurements are usually made:
· Systolic pressure​. When the ventricles contract, blood is forced into the arteries,
and the pressure reaches a maximum value.
· Diastolic pressure​. When the ventricles relax, blood pressure in the arteries falls to
a minimum value.
The standard unit for measuring blood pressure is ​millimeters of mercury (mm Hg).
· Pulse pressure ​- The difference between the systolic and diastolic blood pressures.
Effects of Various Factors on Blood Pressure

Arterial blood pressure (BP) is directly related to cardiac output (CO) and peripheral resistance
(PR).
BP = CO x PR
· Peripheral Resistance is the amount of friction the blood encounters as it flows
through the blood vessels.
o​ ​Neural factors: the ​autonomic nervous system​.
§ ​The major action of the sympathetic nerves on the vascular system is to
cause vasoconstriction, or narrowing of the blood vessels, which
increases the blood pressure.
o​ ​Renal Factors: the ​kidneys.
§ ​The kidneys play a major role in regulating arterial blood pressure by
altering blood volume.
§ ​When ​arterial blood pressure is low​, certain kidney cells release the
enzyme renin into the blood. ​Renin triggers a series of chemical
reactions that result in the formation of ​angiotensin II​, ​a potent
vasoconstrictor chemical.
o​ ​Temperature.
§​ ​Cold has a vasoconstricting effect.
§​ ​Heat has a vasodilating effect.
o​ ​Chemicals.
§ ​Various substances can cause increases or decreases (e.g.

Epinephrine, nicotine, alcohol, histamin​e)

o​ ​Diet.
§ ​Diet modification such as lowering salt intake, saturated fats and
cholesterol helps to prevent hypertension (high blood pressure).

Variations in Blood Pressure

Blood pressure varies considerably from one person to another and cycles over a 24-hour
period. It also varies with age, weight, race, mood, physical activity, and posture.
§ ​Norma​l - ​Systolic blood pressure varies between 110 and 140 mm Hg, and diastolic
pressure between 70 and 80 mm Hg.

§ ​Hypotension or low blood pressure - is generally considered to be a systolic blood

pressure below 100 mm Hg.
 o ​Chronic hypotension may hint at poor nutrition and inadequate levels of
blood proteins.
o ​Acute hypotension is one of the most important warnings of circulatory

shock, a condition in which the blood vessels are inadequately filled and
​ lood loss.
blood cannot circulate normally. The most common cause is b

§ ​Hypertension or high blood pressure ​- is pathological and is defined as a condition

of sustained elevated arterial pressure of 140/90 or higher.
o ​Chronic hypertension is a common and dangerous disease that warns of
increased peripheral resistance.

Capillary Exchange of Gases and Nutrients

The substances to be exchanged diffuse through an intervening space between cells filled with
interstitial fluid (tissue fluid). Substances entering or leaving the blood may take one of ​four
routes ​across the plasma membranes of the single layer of endothelial cells forming the
capillary wall.
1. Direct diffusion through membrane ​- substances can diffuse directly through
(cross) their plasma membranes if the substances are lipid-soluble. (e.g. oxygen and
carbon dioxide)
2. Diffusion through intercellular clefts ​- Limited passage of fluid and small solutes is
allowed by intercellular clefts
3. Diffusion through pores ​- Very free passage of small solutes and fluids is allowed
by fenestrated capillaries. These unique capillaries are found where absorption is a
priority (intestinal capillaries or capillaries serving endocrine glands) or where
filtration occurs (the kidney).
4. Transport via vesic​les - Certain lipid-insoluble substances may enter or leave the
blood and/ or pass through the plasma membranes of endothelial cells within
vesicles, that is, by endocytosis or exocytosis.
Fluid moves out of or into capillaries according to the net difference between blood pressure
and osmotic pressure. Solutes diffuse out of or into capillaries according to each solute’s
concentration gradient.

BLOOD

Blood is unique: It is the only fluid tissue in the body. Although blood appears to be a thick,
homogeneous liquid, the microscope reveals that it has both solid and liquid components.

Functions of Blood
 · Blood transports gases, nutrients, waste products, processed molecules, and
regulatory molecules.
· Blood regulates pH as well as fluid and ion balance.
· Blood is involved with temperature regulation and protects against foreign
substances, such as microorganisms and toxins.
· Blood clotting prevents fluid and cell loss and is part of tissue repair.

Composition and Characteristics of Blood

Blood is a complex connective tissue in which living blood cells, the formed elements, are
suspended in a nonliving fluid matrix called ​plasma​.
· It is composed of plasma (55%) and formed elements (45%). Red blood cells
constitute nearly all of the formed elements.
· It is heavier and about five times more viscous than water, and it is slightly alkaline
(pH between 7.35 – 7.45).
· About 8% of the body weight consists of blood and blood volume ranges between 4
and 6 liters.
·
Depending on the amount of oxygen it is carrying, the color of blood varies from scarlet
(oxygen-rich) to a dull red (oxygen-poor).

PLASMA

Plasma, the liquid portion of the blood, consists of over 90% water along with a variety of
solutes, including nutrients, nitrogenous wastes, proteins, electrolytes, and respiratory gases.
Plasma proteins are the most abundant solutes in plasma. There are three major types of
plasma proteins:
· Albumins are most numerous. Their major
functions include the transport of hydrophobic
substances and helping to maintain the
osmotic pressure and pH of the blood.
· Alpha and beta globulins transport lipids and
lipid-soluble vitamins. Gamma globulins are
antibodies that are involved in immunity.
· Fibrinogen is a soluble protein that is
converted into insoluble fibrin during
coagulation.
FORMED ELEMENTS

Erythrocytes
Erythrocytes or red blood cells (RBCs) are biconcave discs that lack nuclei and other organelles
and contain a large amount of hemoglobin.
Their primary function is the transport of respiratory gases.
Hemoglobin, an iron-bearing protein, transports the bulk of the oxygen that is carried in the
blood and it also binds with a small amount of carbon dioxide
· RBCs are unable to synthesize proteins, grow, or divide. They live about ​120 days
before they are destroyed by macrophages in the spleen and liver. Hemoglobin is
broken down, iron and amino acids are reused, and heme becomes bilirubin that is
secreted in bile.
· The rate of production is controlled by the oxygen concentration of the blood via a
negative-feedback mechanism. A decreased oxygen concentration stimulates kidney
and liver cells to release erythropoietin, which stimulates increased production of
RBCs by ​red bone marrow.

Leukocytes
Leukocytes, or white blood cells (WBCs) are the only complete cells in blood; that is, they
contain nuclei and the usual organelles. White blood cells protect the body against
microorganisms and remove dead cells and debris. They are able to move into and out of blood
vessels (diapedesis) and most of their activities occur within body tissues. WBCs are classified
into two major groups:
o​ ​Granulocytes have visible cytoplasmic granules.
§ ​Neutrophils - are the most numerous of the WBCs. These phagocytic cells
engulf, ingest, and digest foreign materials. Neutrophils are the first cells
to arrive at the site of injury.
§​ ​Eosinophils​ - help to reduce inflammation and destroy parasitic worms.
§ ​Basophils - have histamine-containing granules which initiates
inflammation.
o​ ​Agranulocytes lack visible cytoplasmic granules.
§ ​Lymphocytes - are involved in antibody production and other immune
system responses.
§ ​Monocytes - become macrophages that ingest microorganisms and
cellular debris.
· The formation of leukocytes is stimulated by hormones.
· Colony stimulating factors (CSFs) and interleukins which are released in response to
specific chemical signals in the environment, such as inflammatory chemicals and
certain bacteria or their toxins to prompt red bone marrow to turn out leukocytes.
Platelets
Platelets are small, colorless, disk-shaped cytoplasmic fragments split from cells in bone
marrow called megakaryocytes. These fragments, which have a life span of approximately ​10
days​, perform ​three vital functions​:
o​ ​initiating contraction of damaged blood vessels to minimize blood loss
o​ ​forming hemostatic plugs in injured blood vessels
o​ ​with plasma, providing materials that accelerate blood coagulatio​n

· Thrombopoietin accelerates the production of platelets from megakaryocytes.

Blood Cell Formation (Hematopoiesis)

Blood cell formation, or hematopoiesis, occurs in red bone marrow, or myeloid tissue. All the
formed elements arise from a common type of stem cell, the hemocytoblast, which resides in
the red bone marrow. The population of stem cells renews itself by mitosis. Some daughter cells
become lymphoid stem cells, which develop into two classes of lymphocytes that function in the
immune response. All other blood cells differentiate from myeloid stem cells.
Hemostasis
Hemostasis is a series of processes involved in the stoppage of bleeding. It consists of three
processes: vascular spasm, platelet plug formation, and coagulation.
 · Vascular Spas​m - Blood vessels constrict in response to injury, resulting in
decreased blood flow.
· Platelet Plug Formation ​- Platelet plugs form when platelets adhere to collagen,
release chemicals (ADP and thromboxanes) that activate other platelets, and
connect to one another with fibrinogen which repair minor damage to blood vessels.
· Coagulatio​n - Platelets and the damaged blood vessel wall initiate clot formation by
releasing platelet factors and thromboplastin, which cause the formation of
prothrombin activator. Prothrombin activator converts prothrombin into thrombin,
which, in turn, converts fibrinogen into fibrin. ​Fibrin strands form the clot.

Undesirable Clotting
Undesirable clotting may be caused by anything that roughens the endothelium of a blood
vessel and encourages clinging of platelets, such as severe burns, physical blows, or an
accumulation of fatty material.
· Thrombu​s – is a clot that develops and persists in an unbroken blood vessel. If the
thrombus is large enough, it may prevent blood from flowing to the cells beyond the
blockage.
· Embolus – is a thrombus that breaks away from the vessel wall and floats freely in
the bloodstream. These emboli can later clog vessels in critical areas such as the
brain.

Human Blood Groups

Blood types are determined by the presence or absence of specific antigens on the plasma
membranes of red blood cells.
· The four ABO blood types, A, B, AB, and O, are based on the presence or absence
of A antigen and B antigen.
· Anti-A and anti-B antibodies are spontaneously formed against the antigen(s) that is
(are) not present on a person's RBCs.
· Blood with RBCs containing the Rh antigen is typed as Rh +. Blood without the Rh
antigen is typed as Rh - .
· If incompatible blood is transferred, agglutination of the transfused RBCs occurs. The
clumped RBCs plug small blood vessels, depriving tissues of nutrients and oxygen.
The result may be fatal.
· The Endocrine System
o​ ​Second messenger system of the body
o​ ​Uses chemical messages (hormones) that are released into the blood
o​ ​Hormones control several major processes
§​ ​Reproduction
§​ ​Growth and development
§​ ​Mobilization of body defenses
§​ ​Maintenance of much of homeostasis
§​ ​Regulation of metabolism
· Hormone Overview
o​ ​Hormones are produced by specialized cells
o​ ​Cells secrete hormones into extracellular fluids
o​ ​Blood transfers hormones to target sites
o​ ​These hormones regulate the activity of other cells
· The Chemistry of Hormones
o​ ​Amino acid-based hormones
§​ ​Proteins
§​ ​Peptides
§​ ​Amines
o​ ​Steroids – made from cholesterol
o​ ​Prostaglandins – made from highly active lipids
· Mechanisms of Hormone Action
o​ ​Hormones affect only certain tissues or organs (target cells or organs)
o​ ​Target cells must have specific protein receptors
o​ ​Hormone binding influences the working of the cells
· Effects Caused by Hormones
o​ ​Changes in plasma membrane permeability or electrical state
o​ ​Synthesis of proteins, such as enzymes
o​ ​Activation or inactivation of enzymes
o​ ​Stimulation of mitosis
· Steroid Hormone Action
o​ ​Diffuse through the plasma membrane of target cells
o​ ​Enter the nucleus
o​ ​Bind to a specific protein within the nucleus
o​ ​Bind to specific sites on the cell’s DNA
o ​Activate genes that result in synthesis of new

proteins
· Nonsteroid Hormone Action
o​ ​Hormone binds to a membrane receptor
o​ ​Hormone does not enter the cell
o ​Sets off a series of reactions that activates
an enzyme
o ​Catalyzes a reaction that produces a second
messenger molecule
o ​Oversees additional intracellular changes to
promote a specific response

· Control of Hormone Release

o​ ​Hormone levels in the blood are maintained by negative feedback
o ​A stimulus or low hormone levels in the blood triggers the release of more
hormone
o​ ​Hormone release stops once an appropriate level in the blood is reached
· Hormonal Stimuli of Endocrine Glands
o​ ​Endocrine glands are activated by other hormones (HORMONAL)
§​ ​The Hypothalamus secretes hormones that stimulates the
§​ ​Anterior Pituitary Gland to secrete hormones that
§ ​Stimulate other endocrine glands to secrete hormones (Gonad, Adrenal
Cortex, Thyroid Gland)
o ​Changing blood levels of certain ions stimulate hormone release

(HUMORAL)
§ ​Capillary blood contains low concentration of ​Ca​2+, ​which
stimulates…secretion of parathyroid hormone (PTH) by parathyroid
gland
o​ ​Neural Stimuli of Endocrine Glands (NEURAL)
§​ ​Nerve impulses stimulate hormone release
§​ ​Most are under control of the sympathetic nervous[u1] system
- Preganglionic SNS fiber stimulates adrenal medulla cells to
secrete catecholamines
· Major Endrocrine Organs
o​ ​Pineal Gland
o​ ​Hypothalamus
o​ ​Pituitary Gland
o​ ​Thyroid Gland
o​ ​Adrenal Glands
o​ ​Ovary (female)
o​ ​Testis (male)

· Pituitary Gland
o​ ​Size of a grape
o​ ​Hangs by a stalk from the hypothalamus
o​ ​Protected by the sphenoid bone
o​ ​Has two functional lobes
§​ ​Anterior pituitary – glandular tissue
§​ ​Posterior pituitary – nervous tissue
o​ ​Hormones of the Anterior Pituitary
§​ ​Six anterior pituitary hormones
· Two affect non-endocrine targets
· Four stimulate other endocrine glands (tropic hormones)
§​ ​Characteristics of all anterior pituitary hormones
· Proteins (or peptides)
· Act through second-messenger systems
· Regulated by hormonal stimuli, mostly negative feedback
§​ ​Growth Hormone (GH)
· General metabolic hormone
· Major effects are directed to growth of skeletal muscles and
long bones
· Causes amino acids to be built into proteins
· Causes fats to be broken down for a source of energy
§​ ​Functions of Other Anterior Pituitary Hormones
· Prolactin (PRL)
o ​Stimulates and maintains milk production following

childbirth
o​ ​Function in males is unknown
· Adrenocorticotropic hormone (ACTH)
o​ ​Regulates endocrine activity of the adrenal cortex
· Thyroid-stimulating hormone (TSH)
o​ ​Influences growth and activity of the thyroid
· Gonadotropic hormones
o​ ​Regulate hormonal activity of the gonads
 §​ F​ ollicle-stimulating hormone (FSH)

·​ ​Stimulates follicle development in ovaries

·​ ​Stimulates sperm development in testes
§​ ​Luteinizing hormone (LH)
·​ ​Triggers ovulation
·​ ​Causes ruptured follicle to become the corpus luteum
· ​Stimulates testosterone production in males - Referred to
as interstitial cell-stimulating hormone (ICSH)
§​ ​Pituitary - Hypothalamus Relationship
· Release of hormones is controlled by releasing and inhibiting
hormones produced by the hypothalamus
· Hypothalamus produces two hormones that are transported to
neurosecretory cells of the posterior pituitary
· The posterior pituitary is not strictly an endocrine gland, but
does release hormones
o​ ​Hormones of the Posterior Pituitary
§​ ​Oxytocin
- Stimulates contractions of the uterus during labor
- Causes milk ejection
§​ ​Antidiuretic hormone (ADH)
- Can inhibit urine production
- In large amounts, causes vasoconstriction leading to
increased blood pressure (vasopressin)
· Thyroid Gland
o​ ​Found at the base of the throat
o​ ​Consists of two lobes and a connecting isthmus
o​ ​Produces two hormones
§​ ​Thyroid hormone
§​ ​Calcitonin
o​ ​Thyroid Hormone
§​ ​Major metabolic hormone
§​ ​Composed of two active iodine-containing hormones
- Thyroxine (T​4​) – secreted by thyroid follicles
- Triiodothyronine (T​3​) – conversion of T​4​ at target tissues
o​ ​Calcitonin
§​ ​Decreases blood calcium levels by causing its deposition on bone
§​ ​Antagonistic to parathyroid hormone
§​ ​Produced by C (parafollicular) cells
· Parathyroid Glands
o​ ​Tiny masses on the posterior of the thyroid
o​ ​Secrete parathyroid hormone
§​ ​Stimulate osterclasts to remove calcium from bone
§​ ​Stimulate the kidneys and intestine to absorb more calcium
 §​ ​Raise calcium levels in the blood
· Adrenal Glands
o​ ​Two glands
§​ ​Cortex​ – outer glandular region in three layers
§​ ​Medulla​ – inner neural tissue region
o​ ​Sits on top of the kidneys
o​ ​Hormones of the Adrenal Cortex
§​ ​Mineralocorticoids (mainly aldosterone)
· Produced in outer adrenal cortex
· Regulate mineral content in blood, water, and electrolyte
balance
· Target organ is the kidney
· Production stimulated by renin and aldosterone
· Production inhibited by atrial natriuretic peptide
§​ ​Glucocorticoids (including cortisone and cortisol)
· Produced in the middle layer of the adrenal cortex
· Promote normal cell metabolism
· Help resist long-term stressors
· Released in response to increased blood levels of ACTH
§​ ​Sex hormones
· Produced in the inner layer of the adrenal cortex
· Androgens (male) and some estrogen (female)
o​ ​Hormones of the Adrenal Medulla
§​ ​Produces two similar hormones (catecholamines)
· Epinephrine
· Norepinephrine
§​ ​These hormones prepare the body to deal with short-term stress

o​ R
​ oles of the Hypothalamus and Adrenal Glands in the Stress Response
Pancreatic Islets
o​ ​The pancreas is a mixed gland
o​ ​The islets of the pancreas produce hormones
§ ​Insulin – allows glucose to cross plasma membranes into cells from
beta cells
§​ ​Glucagon – allows glucose to enter the blood from alpha cells
§ ​These hormones are antagonists that maintain blood sugar
homeostasis
o​ ​Pancreatic Hormones and Blood Sugar

· Pineal Gland
o​ ​Found on the third ventricle of the brain
o​ ​Secretes melatonin
§​ ​Helps establish the body’s wake and sleep cycles
§​ ​May have other as-yet-unsubstantiated functions
· Thymus
o​ ​Located posterior to the sternum
o​ ​Largest in infants and children
o​ ​Produces thymosin
§​ ​Matures some types of white blood cells
§​ ​Important in developing the immune system
· Hormones of the Ovaries
o​ ​Estrogens
§​ ​Produced by Graafian follicles or the placenta
§​ ​Stimulates the development of secondary female characteristics
§​ ​Matures female reproductive organs
§​ ​Helps prepare the uterus to receive a fertilized egg
§​ ​Helps maintain pregnancy
§​ ​Prepares the breasts to produce milk
o​ ​Progesterone
§​ ​Produced by the corpus luteum
§​ ​Acts with estrogen to bring about the menstrual cycle
§​ ​Helps in the implantation of an embryo in the uterus
· Hormones of the Testes
o​ ​Interstitial cells of testes are hormone-producing
o​ ​Produce several androgens
o​ ​Testosterone is the most important androgen
§​ ​Responsible for adult male secondary sex characteristics
§​ ​Promotes growth and maturation of male reproductive system
§​ ​Required for sperm cell production
· Other Hormone-Producing Tissues and Organs
o​ ​Parts of the small intestine
o​ ​Parts of the stomach
o​ ​Kidneys
o​ ​Heart
o​ ​Many other areas have scattered endocrine cells
· Endocrine Function of the Placenta
o​ ​Produces hormones that maintain the pregnancy
o​ ​Some hormones play a part in the delivery of the baby
o​ ​Produces HCG in addition to estrogen, progesterone, and other hormones
· Developmental Aspects of the Endocrine System
o​ ​Most endocrine organs operate smoothly until old age
§​ ​Menopause is brought about by lack of efficiency of the ovaries
§​ ​Problems associated with reduced estrogen are common
§​ ​Growth hormone production declines with age
§​ ​Many endocrine glands decrease output with age
THE NERVOUS SYTEM

Functions of the Nervous System

•Receiving sensory input
•Integrating information
•Controlling muscles and glands
•Maintaining homeostasis
•Serving as the center of mental activity.

Structural Classification

Two subdivisions
•The central nervous system (CNS) - consists of the brain and spinal cord, which occupy
the dorsal body cavity and act as the integrating and command centers of the nervous
system.
•The peripheral nervous system (PNS) - is the part of the nervous system outside the
CNS. It consists mainly of the nerves that extend from the brain and spinal cord.

NERVOUS TISSUE: STRUCTURE and FUNCTION

two principal types of cells:

1.Supporting cells or neuroglia (glia or glial cells) - includes many types of cells that
generally support, insulate, and protect the delicate neurons. The CNS glia include the
following:
oAstrocytes - abundant star-shaped cells that account for nearly half of the
neural tissue. Form a living barrier between capillaries and neurons, help determine capillary
permeability, and play a role in making exchanges between the two.
oMicroglia - spiderlike phagocytes that monitor the health of nearby neurons,
and dispose of debris, including dead brain cells and bacteria.
oEpendymal cells - glial cells that line the central cavities of the brain and
the spinal cord. The beating of their cilia helps to circulate the cerebrospinal fluid that fills
those cavities and forms a protective cushion around the CNS.
Oligodendrocytes - glia that wrap their flat extensions (processes) tightly
around the nerve fibers, producing fatty insulating coverings called myelin sheaths.

oThey are not able to transmit nerve impulses

oThey never lose their ability to divide
oSupporting cells in the PNS come in two major varieties
oSchwann cells form the myelin sheaths around nerve fibers that are found in the
PNS.
 oSatellite cells act as protective, cushioning cells.

Neurons - also called nerve cells, are highly specialized to transmit messages (nerve
impulses) from one part of the body to another. All neurons have a cell body, which
contains the nucleus and is the metabolic center of the cell, and one or more slender
processes extending from the cell body

Major regions of neurons:

oCell Body - is the metabolic center of the neuron. Its transparent nucleus
contains a conspicuous nucleolus.
oThe cytoplasm surrounding the nucleus contains the usual organelles
except it lacks centrioles.
oThe rough ER, called Nissl bodies, and neurofibrils (intermediate filaments
that are important in maintaining cell shape) are particularly abundant in the cell body.
oProcesses - The arm-like processes, or fibers, vary in length. The longest
ones in humans reach from the lumbar region of the spine to the great toe.
oDendrites are neuron processes that convey incoming messages (electrical
signals) toward the cell body. Axons are neuron processes that generate nerve impulses and
typically conduct them away from the cell body.
oEach neuron has only one axon, which arises from a cone-like region of the
cell body called the axon hillock.
oAxons end in axonal terminals. Axonal terminals contain vesicles with
neurotransmitters.
oAxonal terminals are separated from the next neuron by a gap called
synaptic cleft.
oA junction between nerves is called a synapse.
oMyelin Sheaths – are whitish, fatty material that covers most long nerve
fibers.
oMyelin protects and insulates the fibers and increases the transmission rate
of nerve impulses.
oAxons outside the CNS are myelinated by Schwann cells.
oNeurilemma is the outermost part of the Schwann cells which is external to
the myelin sheath.
oGaps in myelin sheath along the axon is called Nodes of Ranvier.

Terminology

Central Nervous System

Nuclei are cell bodies found in the CNS in clusters.
Tracts are bundles of nerve fibers (neuron processes) running through theCNS.
 White matter consists of dense collections of myelinated fibers (tracts).
Gray matter contains mostly unmyelinated fibers and cell bodies.

Peripheral Nervous System

Ganglia are collection of cell bodies found in a few sites of the PNS
Nerves are bundles of nerve fibers running through the PNS

Functional Classifications of Neurons

Functional classification groups neurons according to the direction the nerve impulse is traveling
relative to the CNS.

Sensory (afferent) neurons - Neurons carrying impulses from sensory receptors (in the
internal organs or the skin) to the CNS.
-The cell bodies of sensory neurons are always found in a ganglion outside the CNS.
-Their dendrites are associated with sensory receptors or are specialized to detect
changes directly.
-Most sensory neurons are unipolar neurons, although bipolar neurons are found in
special sense organs.
Cutaneous sense organs - sensory receptors in the skin
Proprioceptors - sensory receptors in the muscles and tendons which detect stretch
or tension
Motor (efferent) neurons - Neurons carrying impulses from the CNS to the viscera and/or
muscles and glands.
- Their cell bodies and dendrites are located within the CNS, while their axons are
located in cranial and spinal nerves.
- Motor neurons are multipolar neurons.

Interneurons (association neurons) - They connect the motor and sensory neurons in
neural pathways.Their cell bodies are typically located in the CNS. They are responsible
for the processing and interpretation of nerve impulses by the CNS.

Structural Classifications of Neurons

•Multipolar neurons - have several dendrites and a single axon extending from the cell body.
•Bipolar neurons - have only two processes: a dendrite and an axon extending from
opposite ends of the cell body.
•Unipolar neurons - have a single process extending from the cell body.
Physiology: Nerve Impulse

two major functional properties:

•Irritability - the ability to respond to a stimulus and convert it into a nerve impulse.
•Conductivity - the ability to transmit the impulse to other neurons, muscles, or glands.

Nerve Impulse
Resting membrane is polarized.
In the resting state, the external face of the membrane is slightly positive;
its internal face is slightly negative.
The chief extracellular ion is sodium (Na+), whereas the chief intracellular
ion is potassium (K+).
The membrane is relatively impermeable to both ions.
Stimulus initiates local depolarization.
A stimulus changes the permeability of a local "patch" of the membrane,
and sodium ions diffuse rapidly into the cell.
This changes the polarity of the membrane (the inside becomes more
positive; the outside becomes more negative) at that site.
Depolarization and generation of an action potential.
If the stimulus is strong enough, depolarization causes membrane polarity
to be completely reversed and an action potential is initiated.
Propagation of the action potential.
Depolarization of the first membrane patch causes permeability changes
in the adjacent membrane, and the events described in local
depolarization (2) are repeated. Thus, the action potential propagates
rapidly along the entire length of the membrane.
Repolarization.
Potassium ions diffuse out of the cell as the membrane permeability
changes again, restoring the negative charge on the inside of the
membrane and the positive charge on the outside surface.
Repolarization occurs in the same direction as depolarization.
Initial ionic conditions restored.
The ionic conditions of the resting state are restored later by the activity of
the sodium-potassium pump.
Three sodium ions are ejected for every two potassium ions carried back
into the cell.

Transmission of the Signal at Synapses: a neurotransmitter chemical crosses the

synapse to transmit the signal from one neuron to the next cell.

Action potential reaches an axon terminal.

 The electrical change opens calcium channels which causes the tiny vesicles
containing the neurotransmitter chemical to fuse with the axonal membrane.
Pore-like openings form, releasing the transmitter.
The neurotransmitter molecules diffuse across the synapse and bind to receptors
on the membrane of the next neuron.
Ion channels will open. Leading to generation of a graded potential, and
eventually a nerve impulse in the neuron beyond the synapse.
Ion channel closes. The electrical changes prompted by neurotransmitter binding
are very brief because the neurotransmitter is quickly removed from the
synapse, either by diffusion away, by reuptake into the axon terminal, or by
enzymatic breakdown.

• The transmission of an impulse is an electrochemical event.

• Transmission down the length of the neuron’s membrane is basically electrical,
• But the next neuron is stimulated by a neurotransmitter, which is a chemical.

Physiology: Reflexes

Reflexes are rapid, predictable, and involuntary responses to stimuli. Reflexes occur over neural
pathways called reflex arcs and involve both CNS and PNS structures.

Types of Reflexes and Regulation

Autonomic reflexes - regulate the activity of smooth muscles, the heart, and glands.
Autonomic reflexes regulate such body functions as digestion, elimination,
blood pressure, and sweating.
Somatic reflexes - include all reflexes that stimulate the skeletal muscles.

All reflex arcs have a minimum of five elements:

a. A sensory receptor - which reacts to a stimulus
b.Sensory neuron
c.Synapse or interneurons - acts as the CNS integration center
d.Motor neuron
e.
An effector organ - the muscle or gland eventually stimulated

Reflex arcs can be a two-neuron reflex arc (involves the synapses) or a three-neuron reflex
arc (involves an interneuron).
THE CENTRAL NERVOUS SYSTEM

The CNS includes the brain and the spinal cord. Encased by the bones of the skull and
vertebral column, the CNS is protected by the CSF and the meninges.

CNS develops from the embryonic neural tube.

• The anterior end of the neural tube forms the brain.
• The rest of the neural tube posterior to the forming brain becomes the spinal
cord.
• The central canal of the neural tube becomes enlarged in four regions of the
brain to form chambers called ventricles.

BRAIN
The brain is the largest and most complex mass of nervous tissue in the body. Four major
regions of the brain include:

Cerebral Hemispheres (cerebrum) - The cerebrum is the largest part of the brain. It houses
the nerve center that controls sensory and motor activities and intelligence.

• The entire surface of the cerebral hemispheres exhibits elevated ridges of tissue
called gyri.
• It is separated by shallow grooves called sulci.
• The deeper grooves which separate large regions of the brain are called fissures.
• The cerebral hemispheres are separated by a single deep fissure called the
longitudinal fissure.
• Each cerebral hemisphere is divided into four lobes, based on anatomic landmarks
and functional differences.
• These lobes— the frontal, temporal, parietal, and occipital—are named for the
cranial bones that lie over them.
• The cerebrum interprets sensations; initiates voluntary motor responses; and is
involved in will, personality traits, and intellectual processes.
• The left cerebral hemisphere is dominant in most people.
•
• Each cerebral hemisphere has three basic regions:
Cerebral Cortex (Gray matter) - Speech, memory, logical and emotional
response, as well as consciousness, interpretation of sensation, and
voluntary movement, are all functions of neurons of the cerebral cortex.
• Sensory areas occur in the parietal, temporal, and occipital lobes.
• Motor areas occur in the frontal lobe.
• Association areas occur in all lobes of the cerebrum.
 Cerebral White Matter - is composed of fiber tracts carrying impulses to, from,
or within the cortex.
• The corpus callosum arches above the structures of the brain stem
and allows the cerebral hemispheres to communicate with one
another.
• Association fiber tracts connect areas within a hemisphere.
• Projection fiber tracts connect the cerebrum with lower CNS
centers.
Basal Nuclei – are several patches of gray matter buried deep within the
white matter of the cerebral hemispheres.Help regulate voluntary motor
activities by modifying instructions sent to the skeletal muscles by the
primary motor cortex.

Diencephalon - sits atop the brain stem and is enclosed by the cerebral hemispheres. The
major structures of the diencephalon are:
The thalamus - is a relay station for sensory impulses passing upward to the sensory cortex.
Encloses the shallow third ventricle of the brain.
As impulses surge through the thalamus, we have a crude recognition of
whether the sensation we are about to have is pleasant or unpleasant.

The hypothalamus - is an important autonomic nervous system center

because it plays a role in the regulation of body temperature, water
balance, and metabolism.
Makes up the floor of the diencephalon.
The center for many drives and emotions, and as such it is an important part
of the so-called limbic system, or “emotional-visceral brain.”
It regulates the pituitary gland which hangs from the anterior floor of the
hypothalamus by a slender stalk.
The mammillary bodies, reflex centers involved in olfaction (the sense of
smell), bulge from the floor of the hypothalamus posterior to the pituitary
gland.
The epithalamus - forms the roof of the third ventricle.
Important parts of the epithalamus are the pineal gland (part of the endocrine
system) and the choroid plexus of the third ventricle.
The choroid plexuses form the cerebrospinal fluid.

Brain Stem - The brain stem lies immediately below the cerebrum, just in front of the
cerebellum. It continues from the cerebrum above and connects with the spinal cord
below. The brain stem consists of:

The midbrain - It extends from the mammillary bodies to the pons inferiorly.
 The cerebral peduncles – Has two bulging fiber tracts that convey ascending
and descending impulses and is located anterior of the midbrain.

The corpora quadrigemina - Has four rounded protrusions and are reflex
centers involved with vision and hearing and is located dorsal of the
midbrain.

The pons - is the rounded structure that protrudes just below the midbrain.
Involved in the control of breathing.

The medulla oblongata - is the most inferior part of the brain stem. It merges into the
spinal cord below without any obvious change in structure.

The area where the important pyramidal tracts cross over to the opposite
side.
Contains many nuclei that regulate vital visceral activities.
The medulla oblongata contains three integration centers that are vital for
homeostasis:
• The respiratory rhythmicity center controls the basic rhythm of
breathing by triggering each cycle of inhale and exhale. It is also
involved in associated reflexes such as coughing and sneezing.
• The cardiac control center regulates the rate and force of heart
contractions.
• The vasomotor center regulates blood pressure and blood flow by
controlling the diameter of blood vessels.
The fourth ventricle lies posterior to the pons and medulla and anterior to the
cerebellum.

Reticular Formation - is a diffuse mass of gray matter extending the entire length of
the brain stem
Involved in motor control of the visceral organs.
Reticular activating system plays a role in awake/sleep cycles and
consciousness

Cerebellum - is the brain’s second largest region. It lies behind and below the cerebrum.
Like the cerebrum, the cerebellum has two hemispheres, a convoluted surface, outer
cortex made up of gray matter and an inner region of white matter.
Provides the precise timing for skeletal muscle activity and controls our balance and
equilibrium.
PROTECTION OF THE CENTRAL NERVOUS SYSTEM

Nervous tissue is very soft and delicate, and the irreplaceable neurons are injured by even the
slightest pressure. To protect the brain and spinal cord, they are enclosed within bones (the
skull and vertebral column), membranes (the meninges), and a watery cushion (cerebrospinal
fluid).
Meninges - the three connective tissue membranes covering and protecting the CNS
structures.
Dura mater - is a double-layered membrane where it surrounds the brain and is the
outermost layer.
Periosteum (periosteal layer) - attached to the inner surface of the skull.
Meningeal layer - forms the outermost covering of the brain and continues as the dura mater
of the spinal cord.
The dural layers are fused together except in three areas where they separate to enclose
dural venous sinuses that collect venous blood.
The inner dural membrane extends inward to form a fold that attaches the brain to the
cranial cavity.

Arachnoid mater - is a thin, web-like membrane and is the middle meningeal layer.
Between the pia mater and the arachnoid mater is the subarachnoid space,
which contains cerebrospinal fluid.
Specialized projections of the arachnoid membrane, arachnoid villi, protrude
through the dura mater.
Pia mater – is the very thin, deepest membrane.
It tightly envelops both the brain and the spinal cord and penetrates into each
groove and depression.
It contains many blood vessels that nourish the underlying brain and spinal
cord.
•Cerebrospinal Fluid - is a clear, colorless body fluid found in the brain and spinal cord. 
o
oSimilar makeup to blood plasma but contains less protein and more vitamin C, and
its ion composition is different.
oFormed by the choroid plexus
oForms a watery cushion to protect the brain
oCirculated in arachnoid space, ventricles, and central canal of the spinal cord

oThe Blood-Brain Barrier - neurons are kept separated from bloodborne substances by the
blood-brain barrier that is composed of the least permeable capillaries in the whole body.
oMetabolic wastes, such as urea, toxins, proteins, and most drugs, are prevented
from entering the brain tissue.
 oWater, glucose, and essential amino acids pass easily through the walls of these
capillaries.
oThe blood-brain barrier is useless against fats, respiratory gases, and other fat-
soluble molecules that diffuse easily through all plasma membranes.
This explains why bloodborne alcohol, nicotine, and anesthetics can affect
the brain.

Traumatic Brain Injuries

•Concussion - occurs when brain injury is slight and no permanent brain damage.
•Brain contusion - is the result of marked tissue destruction.
•Cerebral edema - swelling of the brain due to inflammatory response to injury which may
compress and kill brain tissue.
•Intracranial hemorrhage - bleeding from ruptured vessels inside the brain.
•Cerebrovascular accident (CVA) - Commonly called as stroke, occur when blood circulation
to a brain area is blocked, as by a blood clot or a ruptured blood vessel, and vital brain
tissue dies. Loss of some functions or death may result.

SPINAL CORD

The spinal cord is a cylindrical structure in the vertebral canal that extends from the foramen
magnum at the base of the skull to the upper lumbar region of the vertebral column.

•The spinal cord is cushioned and protected by meninges.

•31 pairs of spinal nerves arise from the cord and exit from the vertebral column to serve the
body area close by.
•The spinal cord is divided into four segments— cervical, thoracic, lumbar, and sacral —
based upon where the spinal nerves exit the vertebral column.
•This collection of spinal nerves at the inferior end of the vertebral canal is called the cauda
equine.

Spinal Cord Anatomy

•Gray matter - The gray matter of the spinal cord looks like a butterfly or the letter H in cross
section. Neurons with specific functions can be located in the gray matter.
Anterior (ventral) horns of gray matter contain cell bodies of somatic motor neurons.
Lateral horns contain cell bodies of autonomic motor neurons and are found only in
the thoracic and lumbar segments of the spinal cord.

oWhite matter – surrounds the gray matter and contains ascending and descending tracts of
myelinated and unmyelinated axons.
oThe central canal extends the length of the spinal cord and contains CSF.
Spinal Nerves

The 31 pairs of human spinal nerves are formed by the combination of the ventral and dorsal
roots of the spinal cord.
•Spinal nerves are named for the region from which they arise.
•Each spinal nerve divides into dorsal and ventral rami.
•The rami contain both motor and sensory fibers.
Autonomic Nervous System

The autonomic nervous system (ANS) consists of portions of the central and peripheral nervous
systems and functions without conscious control.
•Consists of two motor neurons
opreganglionic neuron
opostganglionic neuron
 oDivided into two divisions:
oSympathetic division - mobilizes the body during extreme situations. Often referred
to as the “fight-or-flight” system.
Nerves of the sympathetic division arise from the thoracic (T1) and lumbar
(L2) segments of the spinal cord
Short pre-ganglionic neuron and long postganglionic neuron transmit
impulse from CNS to the effector
Norepinephrine and epinephrine are neurotransmitters to the effector
organs
Remember as the “E” division = exercise, excitement, emergency, and
embarrassment

oParasympathetic division - allows us to “unwind” and conserve energy.

sacral segment (S1 through S4) of the spinal cord
Terminal ganglia are at the effector organs
Always uses acetylcholine as a neurotransmitter
Maintains daily necessary body functions
Remember as the “D” division - digestion, defecation, and diuresis
Nerves of the parasympathetic division arise from the brain and the

Developmental Aspects of the Nervous System

The nervous system is formed during the first month of embryonic development
Any maternal infection can have extremely harmful effects
The hypothalamus is one of the last areas of the brain to develop
No more neurons are formed after birth, but growth and maturation continues for several
years
 THE SENSES
• General senses of touch (tactile)
o Temperature- thermoreceptors (heat)
o Pressure- mechanoreceptors (movement)
o Pain- mechanoreceptors
• Special senses
o Smell- chemoreceptors (chemicals)
o Taste- chemoreceptors
o Sight- photoreceptors (light)
o Hearing- mechanoreceptors
o Equilibrium- (balance) mechanoreceptors

The Eye and Vision

• 70 percent of all sensory receptors are in the eyes
• Each eye has over a million nerve fibers
• Protection for the eye
o Most of the eye is enclosed in a bony orbit made up of the lacrimal (medial),
ethmoid (posterior), sphenoid (lateral), frontal (superior), and zygomatic and
maxilla (inferior)
• A cushion of fat surrounds most of the eye
• Accessory Structures of the Eye
o Eyelids- brush particles out of eye or cover eye
o Eyelashes- trap particles and keep them out of the eye
o Ciliary glands – modified sweat glands between the eyelashes- secrete acidic sweat
to kill bacteria, lubricate eyelashes
o Membrane that lines the eyelids
o Connects to the surface of the eye- forms a seal
o Secretes mucus to lubricate the eye
CONJUNCTIVITIS
- Inflammation of the conjunctiva
- Caused by bacterial or viral infection
- Highly contagious

• Accessory Structures of the Eye

o Lacrimal apparatus
§ Lacrimal gland – produces lacrimal fluid
§ Lacrimal canals – drains lacrimal fluid from eyes
§ Lacrimal sac – provides passage of lacrimal fluid towards nasal cavity
§ Nasolacrimal duct – empties lacrimal fluid into the nasal cavity
• Function of the Lacrimal Apparatus
o Properties of lacrimal fluid
§ Dilute salt solution (tears)
§ Contains antibodies (fight antigens- foreign substance) and lysozyme (enzyme that
destroys bacteria)
o Protects, moistens, and lubricates the eye
o Empties into the nasal cavity

• Extrinsic Eye Muscles

o Muscles attach to the outer surface of the eye
o Produce eye movements
o When Extrinsic Eye Muscles Contract
§ Superior oblique- eyes look out and down
§ Superior rectus- eyes looks up
§ Lateral rectus- eyes look outward
§ Medial rectus- eyes look inward
§ Inferior rectus- eyes looks down
Structure of the Eye

• The wall is composed of three tunics

o Fibrous tunic – outside layer
o Choroid–middle layer
o Sensory tunic – inside layer

• The Fibrous Tunic

o Sclera
§ White connective tissue layer
§ Seen anteriorly as the “white of the eye”
§ Semi-transparent
• Cornea
o Transparent, central anterior portion
o Allows for light to pass through (refracts, or bends, light slightly)
o Repairs itself easily
o The only human tissue that can be transplanted without fear of rejection

• Choroid Layer
o Blood-rich nutritive tunic
o Pigment prevents light from scattering (opaque- blocks light from getting in, has melanin)
o Modified interiorly into two structures
§ Cilliary body – smooth muscle (contracts to adjust the shape of the lens)
§ Iris- pigmented layer that gives eye color (contracts to adjust the size of the pupil-
regulates entry of light into the eye)
§ Pupil – rounded opening in the iris
• Sensory Tunic (Retina)
o Contains receptor cells (photoreceptors)
§ Rods
§ Cones
o Signals leave the retina toward the brain through the optic nerve

• Sensory Tunic (Retina)

o Signals pass from photoreceptors via a two-neuron chain
o Bipolar neurons and Ganglion cells

• VISUAL PIGMENTS
o Rhodopsin- visual purple, in high concentration in RODS
o Composed of opsin and retinal (a derivative of vitamin A) proteins
o When light hits the protein it “bleaches”- turns yellow and then colorless. It straightens
out and breaks down into opsin and retinal.
o There are three different other opsins beside rhodopsin, with absorption for yellowish-
green (photopsin I), green (photopsin II), and bluish-violet (photopsin III) light.

• Neurons of the Retina and Vision

o Rods
§ Most are found towards the edges of the retina
 § Allow dim light vision and peripheral vision (more sensitive to light, do not
respond in bright light)
§ Perception is all in gray tones

• Neurons of the Retina and Vision

o Cones
§ Allow for detailed color vision
§ Densest in the center of the retina
§ Fovea centralis – area of the retina with only cones
§ Respond best in bright light
o No photoreceptor cells are at the optic disk, or blind spot
Cone Sensitivity
• There are three types of cones
• Different cones are sensitive to different wavelengths
o red- long
o green- medium
o blue- short
• Color blindness is the result of lack of one or more cone type

How do we see colors?

• To see any color, the brain must compare the input from different kinds of cone cells—and then
make many other comparisons as well.
• The lightning-fast work of judging a color begins in the retina, which has three layers of cells. Signals
from the red and green cones in the first layer are compared by specialized red-green "opponent"
cells in the second layer. These opponent cells compute the balance between red and green light
coming from a particular part of the visual field. Other opponent cells then compare signals from
blue cones with the combined signals from red and green cones.

• COLORBLINDNESS
o An inherited trait that is transferred on the sex chromosomes (23rd pair)- sex-linked trait
 o Occurs more often in males
o Cannot be cured or corrected
o Comes from a lack of one or more types of color receptors.
o Most are green or red or both and that is due to a lack of red receptors.
o Another possibility is to have the color receptors missing entirely, which would result in black
and white vision.

Lens
• Biconvex crystal-like structure
• Held in place by a suspensory ligament attached to the ciliary body
• Refracts light greatly
Internal Eye Chamber Fluids
• Aqueous humor
o Watery fluid found in chamber between the lens and cornea
o Similar to blood plasma
o Helps maintain intraocular pressure
o Provides nutrients for the lens and cornea
o Reabsorbed into venous blood through the canal of Schlemm
o Refracts light slightly

o Internal Eye Chamber Fluids

o Vitreous humor
§ Gel-like substance behind the lens
§ Keeps the eye from collapsing
§ Lasts a lifetime and is not replaced
§ Refracts light slightly
§ Holds lens and retina in place
Lens Accommodation
• Light must be focused to a point on the retina for optimal vision
• The eye is set for distance vision
(over 20 ft away)
• 20/20 vision- at 20 feet, you see what a normal eye would see at 20 feet (20/100- at 20,
normal person would see at 100)
• The lens must change shape to focus for closer objects

MYOPIA
• Nearsightedness, or myopia is the difficulty of seeing objects at a distance.
• Myopia occurs when the eyeball is slightly longer than usual from front to back. This causes light
rays to focus at a point in front of the retina, rather than directly on its surface.
 • Concave lenses are used to correct the problem.

HYPEROPIA
• Hyperopia, or farsightedness, is when light entering the eye focuses behind the retina.
• Hyperoptic eyes are shorter than normal.
• Hyperopia is treated using a convex lens.
Images Formed on the Retina

• If the image is focused at the spot where the optic disk is located, nothing will be seen. This is
known as the blind spot. There are no photoreceptors there, as nerves and blood vessels pass
through this point.

Visual Pathway
• Photoreceptors of the retina
• Optic nerve
• Optic nerve crosses at the optic chiasma
• Optic tracts
• Thalamus (axons form optic radiation)
• Visual cortex of the occipital lobe
 Eye Reflexes
• Internal muscles are controlled by the autonomic nervous system
o Bright light causes pupils to constrict through action of radial (iris) and ciliary
muscles
o Viewing close objects causes accommodation
• External muscles control eye movement to follow objects- voluntary, controlled at the
frontal eye field
• Viewing close objects causes convergence (eyes moving medially)
Anatomy of the Ear
Anatomy of the Ear
• The ear is divided into three areas
• Outer (external) ear
• Middle ear
• Inner ear
 The External Ear
• Involved in hearing only
• Structures of the external ear
o Pinna (auricle)- collects sound
o External auditory canal- channels sound inward
• The External Auditory Canal
o Narrow chamber in the temporal bone- through the external auditory meatus
o Lined with skin
o Ceruminous (wax) glands are present
o Ends at the tympanic membrane (eardrum)
• The Middle Ear or Tympanic Cavity
o Air-filled cavity within the temporal bone
o Only involved in the sense of hearing

o Two tubes are associated with the inner ear

• The opening from the auditory canal is covered by the tympanic membrane
(eardrum)
• The auditory tube connecting the middle ear with the throat (also know as
the eustacian tube)
• Allows for equalizing pressure during yawning or swallowing
• Bones of the Tympanic Cavity
o Three bones span the cavity
o Malleus (hammer)
o Incus (anvil)
o Stapes (stirrip)
 o Vibrations from eardrum move the malleus
o These bones transfer sound to the inner ear

• Inner Ear or Bony Labyrinth

o Also known as osseous labyrinth- twisted bony tubes
o Includes sense organs for hearing and balance filled with perilymph
o Vibrations of the stapes push and pull on the membranous oval window, moving
the perilymph through the cochlea. The round window is a membrane at the
opposite end to relieve pressure.
o A maze of bony chambers within the temporal bone
o Cochlea
o Upper chamber is the scala vestibuli
o Lower chamber is the scala tympani
o Vestibule
o Semicircular canals
Organs of Hearing
• Organ of Corti
o Located within the cochlea
o Receptors = hair cells on the basilar membrane
o Gel-like membrane is capable of bending hair cells (endolymph in the membranous
labyrinth of the cochlear duct flows over it and pushes on the membrane)
o Cochlear nerve attached to hair cells transmits nerve impulses to auditory cortex on
temporal lobe

Mechanisms of Hearing
• Vibrations from sound waves move tectorial membrane (pass through the endolymph fluid filling
the membranous labyrinth in the cochlear duct)
• Hair cells are bent by the membrane
• An action potential starts in the cochlear nerve
• The signal is transmitted to the midbrain (for auditory reflexes and then directed to the auditory
cortex of the temporal lobe)
• Continued stimulation can lead to adaptation (over stimulation to the brain makes it stop
interpreting the sounds)
Organs of Equilibrium
• Receptor cells are in two structures
o Vestibule
o Semicircular canals
• Equilibrium has two functional parts
o Static equilibrium- in the vestibule
o Dynamic equilibrium- in the semicircular canals

Static Equilibrium
• Maculae – receptors in the vestibule
o Report on the position of the head
o Send information via the vestibular nerve
• Anatomy of the maculae
o Hair cells are embedded in the otolithic membrane
 o Otoliths (tiny stones) float in a gel around the hair cells
o Function: Movements cause otoliths to bend the hair cells (gravity moves the
“rocks” over and pulls the hairs)
• Dynamic Equilibrium
o Whole structure is the ampulla
o Crista ampullaris – receptors in the semicircular canals
• Tuft of hair cells
o Action of angular head movements
• The cupula stimulates the hair cells
• Movement of endolymph pushes the cupula over and pulls the hairs
• An impulse is sent via the vestibular nerve to the cerebellum

CHEMICAL SENSES – TASTE AND SMELL

• Both senses use chemoreceptors
o Stimulated by chemicals in solution
o Taste has four types of receptors
o Smell can differentiate a large range of chemicals
• Both senses complement each other and respond to many of the same stimuli

Olfaction – The Sense of Smell

• Olfactory receptors are in the roof of the nasal cavity
o Neurons with long cilia
o Chemicals must be dissolved in mucus for detection
o Impulses are transmitted via the olfactory nerve
o Interpretation of smells is made in the cortex (olfactory area of temporal lobe)
• Neuronal Pathways for Olfaction
o Axons of the olfactory neurons form the olfactory nerves, which enter the olfactory bulb.
Olfactory tracts carry action potentials from the olfactory bulbs to the olfactory cortex of
the brain.
The Sense of Taste
• Taste buds house the receptor organs
• Location of taste buds
o Most are on the tongue
o Soft palate
o Cheeks
• The tongue is covered with projections called papillae
o Filiform papillae – sharp with no taste buds
o Fungifiorm papillae – rounded with taste buds
o Circumvallate papillae – large papillae with taste buds
• Taste buds are found on the sides of papillae

Structure of Taste Buds

• Gustatory cells are the receptors
o Have gustatory hairs (long microvilli)
o Hairs are stimulated by chemicals dissolved in saliva
• Impulses are carried to the gustatory complex (pareital lobe) by several cranial nerves
because taste buds are found in different areas
o Facial nerve
o Glossopharyngeal nerve
o Vagus nerve
 Taste Sensations
• Sweet receptors
o Sugars
o Saccharine
o Some amino acids
• Sour receptors
o Acids
• Bitter receptors
o Alkaloids
• Salty receptors
o Metal ions
• Umami
o Glutamate, aspartate (MSG, meats)
Developmental Aspects of the Special Senses
• Formed early in embryonic development
• Eyes are outgrowths of the brain
• All special senses are functional at birth