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Semester One Final Test Outcomes:

Skeletal System
Three Functions of the Skeletal System:
• Support: The internal framework that anchors the soft organs. The legs are like pillars
when we stand and the ribcage supports the thoracic wall.
• Protection: Bones protect the soft organs. The cranium protects the brain, the vertebrae
protect the spinal cord, and the rib cage protects the thoracic organs.
• Movement: Skeletal muscles are connected to the bones. The bones are levers for the
body to move by the use of the muscles.
• Storage: Fat is stored inside the cavities of bones. Calcium and Phosphorus are stored in
bone itself. Hormones control the movement of calcium to and from the blood and bones.
It depends on calcium levels in the blood.
• Blood Cell Formation: Blood cell formation, also known as hematopoiesis, occurs in the
marrow of some bones.

Four Classifications of Bones:

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

Major Areas of a Long Bone and Functions:

• Diaphysis: The shaft of a long bone. Composed of compact bone. Covered and
protected by the fibrous connective tissue membrane named the periosteum. Inside the
diaphysis, there is the medullary cavity where yellow marrow is stored.
• Epiphyses: Ends of the long bone. Thin layer of compact bone enclosing spongy
bone. Articular cartilage covers the surface of the epiphyses. The cartilage provides for a
smooth, slippery surface that decreases friction at joint surfaces. Some epiphyses have
red marrow in their spongy bone.
• Epiphyseal Plate: A flat plate of hyaline cartilage. Causes the lengthwise growth
of long bones.
• Epiphyseal Line: The remnants of the epiphyseal plate after puberty and growth
are done.

How Bone Grows:

• Long bones grow in length by bone
replacing cartilage in the epiphyseal plates as
the cartilage is continuously being formed. On
one side of the cartilage, more cartilage is being
formed, and on the other bone is replacing the
older cartilage of the epiphyseal plate. The
growth is regulated by growth hormone. The
process ends during adolescence, when the epiphyseal plate is turned into completely
• Bone remodeling is necessary to maintain bones that are strong and large enough
to support your body weight. The right proportions must be maintained. Bones become
thicker and form large projections for areas where bulky muscle is attached. To increase in
size and strength, osteoblasts will lay down new matrix in the necessary areas and then
become trapped in it. Once trapped they turn into mature bone cells, osteocytes. When
someone is bedridden, bone is broken down and their bones atrophy because there isn’t
any stress being put on the bones. Parathyroid Hormone determines when and if bone
needs to be broken down or added in different places. It depends on the amount of
calcium ions in the blood. When there is too much calcium in the blood, new bone will be
formed. If there’s not enough, bone is broken down. The stress and gravity on bones
determines where new bone is to go to make sure the skeleton remains strong.


Explain how homeostasis is maintained over blood calcium levels by the action of
osteoblasts and osteoclasts.
• When there aren’t enough calcium ions in the blood, parathyroid hormone is released. The
PTH activates the osteoclasts to break down bone matrix and release calcium into the
blood. When there are too many calcium ions in the blood, hypercalcemia, the excess
calcium is deposited into bone matrix. The osteoblasts are the bone-forming cells that do
this by laying down matrix where needed.

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

Appendicular & Axial Skeleton Bones:

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

Blood Cells
Formed Elements and Plasma:
• Formed Elements: Living blood cells including the red and white blood cells.
• Plasma: Nonliving fluid matrix that is 90% water. Nutrients, salts, gases, hormones,
plasma proteins, wastes, and products are all in plasma.
Stages of Homeostasis:
• Hemostasis is the stoppage of blood when a blood vessel wall breaks, as in a cut. Blood
clots in 3 to 6 minutes.
• Stages of Hemostasis
1. Platelet plug forms. Platelets become “sticky” and get attached to the collagen
that’s exposed when a vessel breaks. The platelets stuck there release chemicals that
attract more platelets to the site so a small mass of platelets forms. This mass is
called a platelet plug, or white thrombus.
2. Vascular spasms occur. The plates that are anchored release serotonin which
makes the vessel have spasms. The blood vessel narrows so blood loss decreases until
it clots.
3. Coagulation events occur.
1. The injured tissues are releasing tissue factor (tf).
2. PF3 covers the platelet surfaces and interacts with the TF, vitamin K, other
proteins, and calciums. The interaction forms an activator that triggers the
clotting cascade.
3. The prothrombin activator converts prothrombin, present in the plasma, to
4. Thrombin joins fibrinogen proteins into the fibrin meshwork that traps red
blood cells and forms the basis of the clot. The plasma, called serum, is
squeezed from the mass and the ruptured edges of the blood vessel pull

“Blood Clotting Cascade:”

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

Agglutinogens and Agglutinins:

• Agglutinogens: red blood cell antigens that promote clumping that the body recognizes
as foreign and stimulates the immune system to release antibodies or use other means to
mount a defense against it.
• Agglutinins: the antibodies that bind them together. They are the “recognizers.” They
are present in the plasma to attach to red blood cells bearing surface antigens different
from those on the patient’s red blood cells.
• 4 Major blood groups
AB: A & B agglutinogens, No agglutinens
B: B agglutinogens, Anti-A Agglutinins
A: A agglutinogens, Anti-B Agglutinins
O: No agglutinogens, Anti-A & B Agglutinins
Blood Type and Rh Compatibility:
• Blood Typing: is finding out the blood group of the donor and recipient. You can
do so by testing the blood in anti-A and B immune serum.
If it agglutinates with the anti-A, it’s type-A blood. If it agglutinates with anti-B, it’s
type-B blood. If it agglutinates with anti-A and B, it’s type-AB blood. If it doesn’t
agglutinate with either, it is type-O blood.
Type-A blood can receive A or O blood.
Type-B blood can receive type B or O blood.
Type-AB blood can receive any blood.
Type-O blood can receive O blood. O-blood can be given to any person and AB
blood receives any blood.
* If the body doesn’t recognize the agglutinogen on the foreign blood, it has the agglutinins that
will react with the agglutinogen. This causes agglutination, which is clumping of the blood.
• Rh Compatibility: involves the agglutinogen D, called the Rh agglutinogen. You are Rh
positive if you have the Rh agglutinogen. People with Rh negative blood don’t
automatically have anti-Rh agglutinens but they form once Rh positive blood is mixed with
it. Hemolysis, the rupture of red blood cells, doesn’t occur during the first transfusion of
blood, but the second time it does. When Rh negative women carry an Rh positive baby
the mothers anti-Rh agglutinens can attack the agglutinogens of the baby unless she
takes RhoGAM.

• iron deficiency anemia
• pernicious anemia
• sickle cell anemia
• aplastic anemia
• Leukemia: bone marrow becomes cancerous and huge amounts of white blood cells are
produced. The new white blood cells are immature and incapable of carrying out their
normal protective functions so they crowd out the healthy white blood cells from doing
their job so the body becomes susceptible for disease-causing bacteria and viruses.
• Leukopenia: abnormally low white blood cell count. Commonly caused by use of
certain drugs such as corticosteroids and anticancer agents.
• Leukocytosis: A total white blood cell count above 11,000 cells/mm. Generally
indicates a bacterial or viral infection in the body.
• Polycythemia: An excessive/abnormal increase in the number of erythrocytes present
in blood. May result from bone marrow cancer. May also result from living in a high
altitude. The problem is the blood is more viscous so it flows sluggishly and impairs
• Fetal Hemolytic Disease: Rh negative woman with an Rh positive baby. The
agglutinins will cross through the placenta and destroy the baby’s red blood cells. The
baby becomes anemic and becomes hypoxic and cyanotic. Brain damage and even
death may result unless transfusions are done for the baby.
• Hemophilia: hereditary bleeding disorders resulting from a lack of any of the clotting
factors. Prolonged bleeding that can be life-threatening. Bleeding into joints can be
painful and cause the joints to become disabled. They’re given transfusions of the
clotting factor they’re missing so the blood can clot.
• Thrombus: clot that develops and persists in an unbroken blood vessel. May prevent
blood flow. A coronary thrombosis can result in a heart attack.
• Embolus: a thrombus that breaks away from the vessel wall and floats freely in the
bloodstream. Becomes a problem when it gets lodged in a narrow blood vessel.

The Heart
Pathway of Blood through the Heart:

1. Superior & Inferior Vena Cava

2. Right Atrium
3. Tricuspid Valve (Lub)
4. Right Ventricle
5. Pulmonary Valve (Dup)
6. Pulmonary Arteries
7. Lungs
8. Pulmonary Veins
9. Left Atrium
10. Bicuspid Valve (Lub)
11. Left Ventricle
12. Aortic Valve (Dup)
13. Aorta

Valve Activity Responsible for Heart Sounds:

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

Mid-to-late Diastole: Ventricular Systole:

• Ventricles contracting to eject blood
• Ventricles relaxing and filling with blood
• AV valves open • AV valves closed
• semi-lunar valves closed • Semi-lunar valves open

Electrocardiography: A graph of
electrical activity in the heart

- P wave-atrial depolarization.
Contraction of the atria
- QRS complex-ventricular SA Node: Also known as the heart’s
depolarization natural pacemaker, heart begins with a
• Q: Single leaving the bundle branches to the signal from SA node. When the atrium
Purkinje fibers is filled with blood the signal goes to
• R: Contraction of left ventricle the…
• S: Contraction of right ventricle
- T wave-ventricular repolarization . Heart ventricles Node: Signal that slows the nodes
relaxing after contractions. for an instant that allows ventricles to
fill with blood. Signal goes to bundle
Disorders from Abnormal ECG waves: branches and spreads all the way to
• the RPurkinje
Enlarged wave - fibers to restart
Enlarged the cycle
ventricles 
Pulmonary again
• SA Node
Enlarged P wave -AV Node atria
Enlarged AV Bundle
 
• Bundle Branches  Purkinje
Flat T wave - Inadequate oxygen  Fibers

Intrinsic Conduction System:

• Is built out of heart tissue and sets its basic rhythm. The intrinsic conduction system is
composed of a special tissue found nowhere else in the body that is a cross between
muscle and nervous tissue. This system causes heart muscle depolarization in only one
direction—from the atria to the ventricles.
• Enforces a contraction rate of approximately 75 beats per minute on the heart so the
heart beats as a coordinated unit.

Disease Causes Treatments

Heart Murmurs: Abnormal or
unusual heart sounds when
blood strikes obstructions.
Flutter: 240-360 beats per
minute in heart
Fibrillation: Completely
uncoordinated heartbeat

Cardiovascular System
Arteries: Blood is propelled here and then leaves the heart.
• Carry oxygen away from the
• Carry oxygenated blood
• Branch into arterioles
• Muscular and elastic
• Expand and contract with the
• Walls are usually thicker than
• Pumped by the heart

Veins: Empty into great veins (venae

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

Capillaries: Directly serve the needs of the body cells. Beds in tissues.
• Once cell thick – Just tunica intima
• Exchanges are easily made between the blood and the tissue cells
• Capillary beds are interweaving networks of capillaries (Arterioles, Capillaries, and
Vascular Shunt: Vessel that directly connects the arteriole and the venule at
opposite ends of the bed
True Capillaries: The exchange vessels of gas and nutrients
 Terminal Arteriole empties into the postcapillary veins
 Precapillary Sphincter: Cuff of smooth muscle fibers. Acts as a valve to
regulate the flow of blood into the capillary.
Arteries Veins

Arterial Supply of the Brain & the Circle

of Willis:
•The brain is supplied with two pairs of
arteries, the internal carotid arteries and
the vertebral arteries. The internal carotid
arteries are branches of the common carotid
arteries that run through the neck and enter
the skull through the temporal bone. Once
inside the cranium, each divides into the
anterior and middle cerebral arteries, which supply most of the cerebellum.
• The vertebral arteries pass upward from the subclavian arteries at the base of the
neck. Within the skull, the vertebral arteries join to form the single basilar artery, which
serves the brain stem and cerebellum as it travels upward. At the base of the cerebellum
the basilar artery divides to form the posterior cerebral arteries, which supply the
posterior part of the cerebellum.
• Circle of Willis: The united anterior and posterior blood supplies of the brain that
are united. Surrounds the base of the brain and protects it by providing more than one
route for blood to reach the brain tissue in
case of a clot or impaired blood flow.
Hepatic Portal Circulation: Veins that drain the
digestive organs, spleen, and pancreas and deliver this
blood to the liver through the hepatic portal vein. Makes
sure the liver processes the substances involved in
digestion before they enter the systemic circulation. Is
able to take some of the nutrients to be stored and
processed for later use. In hepatic portal circulation
veins feed the liver circulation.
• Process: Inferior Mesenteric Vein  Splenic Vein
 Superior Mesenteric Vein  Left Gastric Vein 
Stomach  Hepatic Portal Vein
Fetal Circulation:
• All nutrients, 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
• Umbilical cord contains three blood vessels:
Umbilical vein and two smaller umbilical
arteries. 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.
• As blood flows to heart most of it bypasses the
immature liver through the ductus venosus and
enters the inferior vena cava, which carries the
blood to the right atrium of the heart. Some blood
entering the right atrium is shunted into the left
atrium through the foramen ovale (closes after
• Blood that does not manage to enter the right
ventricle is pumped out of the pulmonary trunk
where it meets the ductus arteriosus, a short
vessel that connects the aorta and the pulmonary trunk together. Blood tends to enter
systemic circulation here.

Blood Pressure: The pressure the blood exerts against the

inner walls of the blood vessels, and it is the force that keeps
the blood circulating continuously even between heartbeats. Is
understood to mean the pressure within the large systematic
arteries near the heart.
• Pulse: Occurs with the alternating expansion and recoil of an
artery that occurs with each beat of the left ventricle creates
a pressure wave. The pulse travels through the entire arterial
system. (Also known as pressure surges per minute)
Average pulse rate is 70-75
beats per minute in a normal
resting person
into the

arterioles  capillaries  venules 
veins  large venae cavae to the
right atrium
Flows along pressure gradient from high to low pressure

Factors that influence blood pressure are:

• Age, weight, time of day, exercise, body position, emotions, caffeine, nicotine, alcohol,
blood volume, & atherosclerosis
• Neural Factors (The Autonomic Nervous System): Sympathetic nerves on the
vascular system causes vasoconstriction, narrowing of the blood vessels, which increases
blood pressure. Never caused vasoconstriction on the vessels in the heart or brain.
• Renal Factors (The Kidneys): The kidneys regulate arterial blood pressure by altering
blood volume. When we have more water in blood it releases it through urine whereas it
stores water when we are deficient of water. Also releases the enzyme rennin when low of
• Temperature: The cold has a vasoconstriction effect whereas heat has a vasodilatation
• Chemicals: Chemicals can cause increases or decreases on blood pressure.
• Diet: A diet low in salt and saturated fats generally prevents hypertension

Human normal range is variable

• Normal
140–110 mm Hg systolic
80–75 mm Hg diastolic
• Hypotension: Low blood pressure due to poor nutrition and inadequate levels of blood
proteins. Blood viscosity becomes low. Can be a warning sign for circulatory shock
Low systolic (below 110 mm HG)
Often associated with illness
• Hypertension: Elevation in blood pressure from fever, physical exertion, and emotional
upset. Chronic hypertension strains the heart and damages arteries. Can bring on
High systolic (above 140 mm HG)
Can be dangerous if it is chronic
Atherosclerosis: Arteries are narrowed and brings on the damming-up process
from the inside out. Plaque builds up within the arteries and decreases blood flow

Capillary Exchanges of Gases and Nutrients:

• Substances first diffuse through an intervening space filled with interstitial fluid.
1. Lipid-soluble fluids can diffuse directly across the plasma membrane
2. Lipid-insoluble substances enter or leave the blood and/or endothelium cells within the
vesicles via endocytosis or exocytosis
3. Limited passage of fluid and small solutes is allowed by intercellular clefts (gaps or areas
of plasma membrane not joined by tight junctions). Most capillaries have intercellular
4. Very few passage of small solutes and fluids is allowed by fenestrated capillaries. These
are found where absorption is a priority or where filtration occurs
• Only substances unable to pass one of these routes are prevented from leaving or
entering the capillaries. These include protein molecules in the plasma and blood cells
• Blood pressure is higher at the arterial end of the capillary bed and osmotic pressure is
higher at the venous end.

Metabolism and Nutrition:

Metabolism: All chemical reactions that are necessary to sustain life. Includes:
• Anabolism: Larger molecules are built from smaller ones
• Catabolism: Substances are broken down into simpler substances. Energy is released

Metabolic Roles of the Liver:

• Detoxifies drugs and alcohol
• Degrades hormones
• Produce cholesterol, blood proteins (albumin and clotting proteins)
• Maintains blood glucose levels by sorting or releasing glycogen
Sources of Energy:
• Carbohydrates: Pasta, bread, fruit, etc. Cells get energy here first and then go to other
The body’s preferred source to produce cellular energy (ATP)
Glucose (blood sugar) is the major breakdown product and fuel to make ATP
Hyperglycemia: High blood sugar levels; excess is stored in the liver as glycogen
Hypoglycemia: Low blood sugar levels; liver will break down glycogen to glucose
to raise levels.

• Fat

Meat and dairy

Handled mostly by liver
Use some fats to make ATP
Synthesize lipoproteins, thromboplastin, and cholesterol
Body cells remove fat and cholesterol to build membranes and steroid hormones
Fats are used for myelin sheaths on neurons, storage around organs, etc.
• Proteins: Meats, eggs, poultry
Proteins are conserved by body cells because they are used for most cellular
structures; they are only used when there is inadequate carbs or fat
Ingested proteins are broken down to amino acids which are used to make
enzymes, ect.
There are 20 needed amino acids (8 essential, 12 nonessential)

Factors that Influence Metabolic Rate:

• Energy intake = total energy output (heat + work + energy storage) Is liberated during
food oxidation
Energy output
 Heat is usually 60%
 Storage energy is in the form of fat or glycogen
• Regulation of Food Intake:
Body weight is usually relatively stable
 Energy intake and output usually remain about equal
 Mechanisms that regulate food intake are: levels of nutrients in the blood,
hormones, body temperature, and psychological factors
• Metabolic Rate and Heat Production:
Basal Metabolic Rate (BMR): Amount of heat produced by the body per unit of
time at rest
Factors that influence BMR:
 Surface Area: Small body usually has higher BMR
 Gender: Males tend to have a higher BMR
 Age: Children have a higher BMR
 The amount of thyroxine produced is the most important control factor.
More thyroxine means a higher metabolic rate
Total Metabolic Rate (TMR): Total amount of kilocalories the body must consume
to fuel ongoing activities
 Increases with an increase in body activity
 TMR must equal calories consumed to maintain homeostasis and maintain a
constant weight

Temperature Regulation: Most energy is released as foods are oxidized and most energy
escapes as heat.
• Has a narrow range of homeostatic temperature:
Must remain between 35.6 to 37.8 C
The body’s thermostat is located in the hypothalamus
 Initiates heat-loss or heat-promoting mechanisms
• Heat Promoting Mechanisms:
Vasoconstriction: Blood is rerouted to deeper, more vital body organs
Shivering: Contraction of muscles produces heat

• Heat Loss Mechanisms: Heat loss from the skin via radiation and evaporation
Skin blood vessels and capillaries are flushed with warm blood
Evaporation of perspiration cools the skin

General Metabolic Functions:

• Glycogenesis: “Glycogen formation” after carbohydrates are converted into glycogen
molecules to be stored in the liver.
• Glycogenolysis: Liver cells break down the stored glycogen as body cells continue to
remove glucose from the blood to meet their needs. “Glycogen splitting.”
• Gluconeogenesis: When the liver makes glucose from noncarbohydrates such as fats
and proteins, also known as “formation of new sugars.”