Unit 5: The Skeletal System Classification of Bones: According to Shape: 1. Long Bones a. Are longer than wide b.

. Has a shaft with epiphysis at both end c. Composed mostly of compact bone; less spongy bone d. E.g. Bones of Extremities 2. Short Bone a. Cube-shaped b. Usually more spongy; thin layer of compact bone c. E.g. Wrist and ankle bones 3. *Sesamoid bone a. Short bones embedded in tendons b. E.g. Patella 4. Flat bones a. Thin, flattened, and usually curve b. Mostly spongy bone c. E.g. Skull, Ribs, sternum 5. Irregular Bones a. Complicated Shape b. Mainly spongy c. E.g. Vertebrae, hip bone

*Long Bones have diaphysis(causes length of bone) and epiphysis; more compact bone - shaft is covered by PERIOSTEUM - inner surface is covered by Endosteum and contains osteogenic cells - epiphysis is covered by a thin layer of articular cartilage or Hyaline cartilage. *Periosteum- dense connective tissue - cellular (osteogenic cells) for bone formation *Sharpeys Fibers- collagen fibers *Bone Marrow cavity- between diaphysis -YBM (adults only) -RBM are found in flat bones *Epiphyseal Line- junction between shaft and epiphysis - in adult =>artificial - remnant of the epiphyseal cartilage or epiphyseal plate-> makes bones longer *bone markings (see book) Microscopic Anatomy Compact Bone

Dense, smooth and homogeneous o Made up of 3 systems: Haversian system Interstitial System Circumferential System 1. Haversian System o Considered as the structure and function of a compact bone o Parts: a. Haversian Canal Center and contains small blood vessels and nerve fibers b. Haversian Lamellae Outside; composed of bone matrix arranged concentrically around H. Canal c. Osteocytes Lodged in spaces called lacunae d. Canalicular System/ Canaliculi Where osteocytes communicate with each other Minute canals that carry nutrients and Oxygen to osteocytes e. Volkmanns Canal Transverse or oblique running canals that connect blood vessels between osteons or osteons with BM cavity or connect osteons with outer surface of bone f. Cement Line Homogeneous refracting line separating osteon from interstitial lamellae-> regular fragments of bone matrix found between osteons. 2. Circumferential System Outer C. Lamellae found outermost Inner C. Lamellae- next to BM Cavity o Spongy Bone Composed of bone trabeculae or spicules Spaces are marrow cavities Osteocytes lodged in lacunae in bone trabeculae Chemical Composition: a. Organic collagen fibers

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Responsible for flexibility and tensile strength (resist twisting and stretching) of bone b. Inorganic- mineral Salts (Calcium Phosphate) Hardness of bone Allows resistance to compression

BONE DEVELOPMENT 1. Osteogenic Cells Undifferentiated cells that give rise to osteoblasts and osteocytes Found on surfaces of bone trabeculae, periosteum, and endosteum 2. Osteoblasts Columnar cells found on surface of bone trabeculae in developing bones Responsible for secretion of bone matrix Initiates Calcium deposition in the newly formed bone 3. Osteocytes Flattened cells and lodged in lacunae Comprise the principal cells of fully formed bones Responsible for maintenance of integrity of bone matrix 4. Osteoclasts Multinucleated, giant cells Responsible for resorption of bone matrix during bone remodeling Release of Calcium from bone matrix during remodeling *Ossification bone is formed by two processes: 1. intramembranous - formation of bone directly from mesenchymal tissue - bones from this process are membrane bone (flat bones of skull) 2. endochondral - formation of bone tissue from preexisting cartilage model - most bones of the body are formed from this process IMPORTANT EVENTS in ENDOCHONDRAL a. There has to be regeneration of cartilage

b. Invasion of the cartilage by vascular tissue which would carry the osteogenic cells c. Osteogenic cells are transformed into osteoblasts d. Osteoblasts secrete bone matrix e. Osteoblasts will be trapped in the matrix and become osteocytes f. Calcium will be deposited in the newly formed bone matrix *Growth in width of bone is through intramembranous Remodeling - to retain normal proportion of bones - to increase strength of bones as body increases in size and weight FRACTURES 1. Simple (Closed) No break in skin 2. Compound (Open) There is break in skin Infection can set in Types of Fractures 1. Greenstick not totally break into 2 2. Impacted- one end is greater than the other ( head and shaft) 3. Spiral- twisting movement; open reduction (treatment) 4. Compression- much pressure 5. Depressed- injury is not too much 6. Comminuted- fragments Events in Healing (about 2 months) 1. Hematoma Formation 2. Fibrocartilage callus Formation 3. Bony Callus Formation 4. Remodeling The Skeleton A. Axial Skeleton 1. Skull 2 sets of bone (cranium and facial bone) of entire bone *Cranial Bones: a. Frontal Bone Frontal wall of skull (forehead) Boundary: coronal suture Articulates with parietal Glabella (middle)- smooth surface between eyebrows Behind glabella is the frontal sinus b. Parietal Bone Lateral and superior wall of skull

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c. d.

e.

f.

Joined with other bones by: i. Coronal suture (frontal) ii. Sagittal S. (other parietal) iii. Lambdoid S. (occipital) iv. Squamousal S. (temporal) Temporal Bone Lateral wall and inferior to parietal Occipital Bone Most posterior bone of cranium FORAMEN MAGNUM- allows spinal cord to connect with brain OCCIPITAL CONDYLE- rockerlike; fits into atlas Sphenoid Bone Butterfly shaped i. Sella Turcica/ Turks Saddle -small depression that holds pituitary gland in place ii. Foramen Ovale -passes Trigeminal nerve Ethmoid Bone Very irregular shaped i. Crista Galli conical projection

e. Inferior Nasal Conchae- thin and

scroll like - Projects from the lateral walls of the nasal cavity - * Superior and Medial conchae is part of the Ethmoid Bone f. Vomer- plow shaped bone forming nasal septum g. Mandible- articulates with temporal bone - Freely movable joint in the skull Parts: o Mandibular body- forms the chin and possesses cavities where lower teeth lies o Mandibular Ramus- upward extension that connects to temporal bone o Mandibular Notch- superior border of Ramus o Mental Foramen- for passage of blood vessels and nerves supplying the bone 2. Hyoid Bone Closely related to Mandible U-shaped bone suspended in the neck region 2cm from the larynx Doesnt articulate with any other bone Anchored by ligaments to styloid process Provide movable support for tongue and attachment for muscles Parts: Body Horns (Greater and Lesser) FETAL SKULL o Relatively large size in comparison with other bones o of the entire skeleton o Predominant size of skull over facial region o Ossification is still incomplete; some bones are still cartilaginous o Suture lines are still unfused o Presence of membranous spaces called fontanels [ 2 lateral and 2 superior fontanels] Lateral close soon after birth >sphenoid >mastoid

*Facial Bones a. Maxillae one of the largest and most important bone - Where all other bones attach except the mandible - Processes: i. Frontal Process frontal, nasal and lacrimal bone ii. Zygomatic Process- zygomatic bone iii. Palatine Processforms anteriot part of hard palate and articulates with Palatine bone iv. Alveolar processcontains socket where upper teeth resides. b. Palatine- posterior part of hard palate c. Zygomatic- cheek bone; part of lateral bone of orbit d. Lacrimal hardest of the facial; lacrimal groove which serves as passageway for tears

Superior >Anterior larger and diamond shaped; closes at age 2

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>Posterior- smaller and triangular in shape; closes at age 1

Presence of superior and inferior articulating processes b) Thoracic Heart shaped body No transverse foramen Spine is larger and slanted downward Presence of costal facets for ribs c) Lumbar Block-like body No costal facets Spine is thicker and hatchet shaped d) Sacrum Presence of crest ->median sacral crest Fused spinous process Lots of foramen. Foramina at sides Expended portion - cilae e) Coccyx Homologous to tail bone

3. Vertebral Column -> 26 to 33

(C-7; T-12; L-5; S- 5 fused 1; C- 4 fused 1) -Intervertebral discs act as shock absorbers -Curvatures (4) in spinal column give it its S-shaped form Advantage of Curvature- to increase flexibility and resilience of spine Divisions of curvature: 1. Primary- present during birth - thoracic and sacral curvature -convex posteriorly 2. Secondary- appear during infancy -concave posteriorly -cervical and lumbar curvature> develops when baby starts walking Abnormal Curvatures: 1. Scoliosis- abnormal lateral curve (usually Thoracic) -supporting braces; surgical(fusion of the vertebrae) - occurs mostly in late childhood and on girls 2. Lordosis- swayback; exaggeration of Lumbar 3. Kyphosis- hunchback; exaggerated curvature of thoracic - Vit. D. deficiency (rickets/ osteomalacia) General Structure of Vertebrae: 1. Body/Centrum weight bearing part; anterior 2. Vertebral Foramenposterior 3. Vertebral Arch- lateral and posterior o Pedicle o Laminae 4. Spinous Process 5. Transverse Process

4. Bony Thorax(thoracic, sternum, ribs)

1.) Sternum (3 fused 1) Parts: i. Manubrium ii. Body iii. Xiphoid Process 3 bony landmarks of sternum jugular notch Sternal angle (2nd ribs) Xiphisternal joint 2.) Ribs Head is attached to thoracic vertebrae(costal facet) End is attached to vertebral body Tubercle to transverse process Groove (where the intercostals vessels are) B. Appendicular Skeleton 1. Pectoral Girdle (anteriorclavicle; posterior-scapula) 1.) Clavicle Double curve bone Sternal end (convex anteriorly) Acromial end (convex posteriorly) Leverage 2.) Scapula Bony landmarks Body of scapula Spinous Process

Regional Differences a) Cervical One spinous process (split) Transverse foramen is present in transverse process ATLAS No body Superior facet is wide and has a shallow depression (for occipital condyle) AXIS Upright contusion (odontoid process)

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Tubercle ->Acromion; where acromial end of clavicle attaches Coracoid Process Glenoid Fossa- receives head of humerus

2. Upper Limb 1.) Humerus *bony landmarks - head -> rounded part; fits into glenoid fossa -greater tubercle->lateral -lesser tubercle -> medial -radial groove -deltoid tuberosity -lateral and medial condyle ^Lateral capitulum -> articulating surface of radius ^Medial- trochlea(looks like a spool) -> articulating surface of ulna -coronoid fossa -olecranon fossa -radial fossa 2.) Forearm a. Radius *Bony landmarks -head(proximal) -radial tuberosity tendon of biceps muscle is attached -styloid process b. Ulna *Bony landmarks -olecranon processsuperior -coronoid process -Semilunar notch- fits into trochlea -Styloid Process (medial) 3.) Hand a. Carpal forms Carpus(wrist) - 8 bones -arranged in two rows(4 proximal; 4 distal) -Never Lower Tellys Panty, Mama Might Come Home -[Navicular(scaphoid), Lunate, Triquetral, Pisiform, Trapezium(greater Mortangular), Trapezoid (lesser Mortangular), Capitate, Hamate] b. Metacarpals distal head (knuckles) c. Phalanges - 14 3. Pelvic Girdle

Bear weight of upper body Protection of pelvic organs [ reproductive organs, bladder, rectum] Attachment for bone of lower extremities *BONY PELVIS- 2 hip bones + sacrum + coccyx *PELVIC GIRDLE 2 hip bones - Hip Bone 1.)Ilium- connected to sacrum a. Ala wing expanded portion b. Iliac Crest- superior border -note for bone marrow puncture or spinal puncture c. Iliac Spine- anterior spine 2.)Ischium- sit down bone a. Ischial Tuberosity roughened area - gets hit when you sit down b. Ischial Spine- useful for females - narrow pelvic outlet c. Greater Sciatic Notch- where sciatic nerve passes 3.) Pubis a. Obturator Foramen b. Symphysis Pubis/ pubic symphisis c. Acetebulum- where head of femur articulates CLINICAL RELATION OF PELVIS True Pelvis inferior, narrower region (below ala) - dimensions are impt. In women during delivery -pelvic inlet and outlet False Pelvis- wide region bounded by ala of ilium -no clinical value Pelvic Inlet- bounded by pelvic brim and the promotory of your sacrum Male Vs Female Pelvis 1. Female inlet is larger and more circular 2. Female pelvis as a whole is shallower; bones are lighter and thinner 3. Female ilia flare more laterally 4. Female Sacrum is shorter and less curve 5. Female ischial spines are shorter and farther apart; thus outlet is larger

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6. Female pubic arch is more rounded because of the angle of the pubic arch is greater 4. Lower Limb 1. ) Femur/ Thigh Bone heaviest and strongest bone *bony landmarks a. rounded end b. Trochanter >greater trochanterlateral >lesser trochantermedial c. Intertrochanteric Lineanterior d. Intertrochanteric Crestposterior e. Gluteal Tuberosityattachment of gluteal muscle f. Condyle (medial condyle; lateral condyle) g. Intercondylar notch- between 2 condyles -cross sheet ligaments h. Patellar surface 2.) Leg a. Tibia (shinbone) medial >articulates with: femur proximally talus distally fibula laterally Bony Landmarks: Condyle Intercondylar eminence Tibial Tuberosity used when kneeling Tibial Crest/ Anterior crest Malleolus (medial) b. Fibula- thinner; lateral; doesnt take part in formation of knee joint - proximally attached to tibia and distally attached to talus -lateral malleolus 3.)Foot a. Tarsal Bones- 7 (2 are largecalcaneus[largest] and Talus) b. Metatarsals c. Phalanges 14 Joints - holds bone together -provide mobility to skeleton Functional Classification 1. Synarthroses- immovable joints -sutures of skull 2. Amphiarthroses- slightly movable

3. Diarthroses- freely movable Structural Classification 1. Fibrous Joint joined by fibrous tissue -sutures, syndesmosis 2. Cartilagenous- joined by cartilage -pubis symphisis; interbertebral joints 3. Synovial Joints- separated by joint cavity -Four Distinguishing Features: a. Articular Cartilage- ends are covered with articular cartilage b. Fibrous Articular Capsule c. Joint Cavity- Contains synovial fluid - cannot be stable without ligament that strengthen this joint to prevent dislocation. d. Reinforcing ligaments Types Of Synovial Joints 1. Plane joint- flat - non-axial movement(gliding) -intercarpal joints 2. Hinge Joint- are bone with cylindrical end that fits into another gutter- like or troughshape surface of another bone - uni-axial -elbow, ankle, phalanges 3. Pivot Joint- rounded end of one bone that fits into a ring-like or sleeve of another bone -radio-ulnar joint -atlas and dens -uni-axial 4. Condyloid- rounded fits into oval cavity -bi-axial movement -back and forth and side to side 5. Saddle Joint- structurally similar to condyloid -but allows more free bi-axial movement 6. Ball and Socket- multi-axial -shoulder joint Unit 6: The Muscular System General Characteristics of a Muscle Tissue 1. It is composed of elongated cells called muscle fibers 2. Contractility is highly developed

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3. It exist in combination with Connective Tissue o Function of the CT in Muscles To conduct blood vessels and nerves Serve as harness so that pull of muscle is effective Characteristics of a Muscle Fiber 1. Muscle Fibers are elongated in direction of action 2. Nuclei are elongated and oriented parallel to long axis of muscle fiber 3. Muscle fibers appear reddish brown due to pigment known as myoglobin Terms to Remember: 1. Sarcolemma- plasma membrane of muscle fiber 2. Sarcoplasm- cytoplasm 3. Myofibrils- smallest element of muscle fiber; composed of microfilament 4. Sarcoplasmic Reticulum- refers to Smooth ER; may be simple or highly developed(striated) Classification of Muscle tissue: According to Function 1. Voluntary- controlled by Somatic NS 2. Involuntary- controlled by ANS According to Structure 1. Smooth 2. Striated- presence of cross-striations Mircroscopic anatomy of the muscle

-attached to bones( except facial , tongue, and esophagus) -shift and forceful contractions (generally the red muscles) -generally not resistant to fatigue -structural and functional unit is the sarcomere -appearance in long section: *largest of the 3; long cylindrical multinucleated cells with obvious striations; nuclei located beneath sarcolemma A-band -> dark staining band -anisotropic -represent the entire length of myosin filament I-band -> light staining band -isotropic -made up of actin filaments that dont overlap with myosin filaments Z-line -> thin dark line seen at the center of the I-band -part where actin filaments are anchored H-band -> pale zone at the center of A-band -part where actin filaments dont extend -middle of myosin filament Sarcomere -> portion of the myofibril between two successive Z-line -composed of 1 A-band and of 2 successive I-bands Sarcoplasmic Reticulum-> smooth ER that forms a network that surrounds the myofibril -storage and release of Calcium during contraction T-tubule-> slender tubular invagination of the sarcolemma that penetrate deep into the muscle fibers carrying the impulse into the substance of the fiber ORGANIZATION OF SKELETAL MUSCLES & ORGAN Skeletal Muscle as an Organ-> covered by a Connective Tissue

1. Smooth Muscle- simplest structure

-unit of structure and function is the muscle fiber -contraction is slow, sustained, and resistant to fatigue -may occur in small bundles, in sheaths, or in thick interlacing bundles -Eg. Arrector Pili Muscle -appearance in long section: *elongated, spindle shaped cells; possess single elongated nucleus found in the thickest part; fibers are arranged offset to one another; myofibrils arent cross-striated because filaments arent laterally aligned -contract to regulate size of lumen -may contract in wavelike manner to move food along intestine

2. Skeletal Muscle- forms the bulk of the

musculature

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Epimysium- tough, dense, CT that covers the muscle as an organ Physiology Perimysium- CT that surrounds muscle fascicle (composed of bundle of muscle fiber) Endomysium- thin, delicate CT that surrounds individual muscle fibers -thickening of these CT forms the tendon Aponeurosis- not connected to bone

3. Synaptic Cleft- narrow space separating the 2 membrane

3. Cardiac Muscle- forms the thickest

layer of heart -myocardium -similar to skeletal but less obvious striations -have inherent automaticity and rhythm (independent of nervous control) -appearance in long section: *muscle fibers form branching and anastomosing bands; muscle fibers may contain 1 or 2 oval nuclei; muscle fibers are joined end to end by intercalated discs>contains gap junction 2 important Functional Properties of Muscles: 1. Irritability- ability to receive and respond to stimulus 2. Contractility- ability to shorten when there is adequate stimulus supply Nerve Stimulus Motor Unit= 1 neuron + all skeletal Muscle fibers that it would stimulate or innervate. -response is all or none(fibers contract fully or none at all) Neuromuscular Junction- junction formed by axon terminal + sarcolemma of muscle fiber Parts: 1. Axon Terminal- contains numerous mitochondria and synaptic vesicles which contain Ach 2. Motor End Plate part of sarcolemma beneath the axon terminal [Sarcolemma possesses numerous invagination that contain receptors for Ach]

1. Electrical Impulse travel to the axon through its terminal 2. There will be influx of Calcium into the nerve ending 3. Release of Ach from the nerve terminal in form of exocytosis 4. Ach diffuses through the synaptic cleft and attaches to receptors in the motor end plate 5. Opening of Na channels and influx of Na into the muscle fibers 6. Influx of Na would create an electrical current known as Action Potential 7. Action potential would travel over entire sarcolemma 8. T-tubules carry impulse inward into the SR 9. There will be release of Calcium from SR to initiate muscle contraction 10.After fraction of a second, Ca ions would be stored back into the SR (initial relaxation of muscle) 11.Diffusion of K out of the cell due to NaK pump (restores ion to original position) Mechanism of Muscle Contraction SLIDING FILAMENT THEORY- no contraction of myofilaments but sliding of actin into myosin 1. Release of Ca from SR 2. Ca ion binds to acin filaments to expose their myosin binding sites 3. Head of myosin filaments would attach to actin filaments 4. Myosin head would bent towards the center of the sarcomere pulling the actin filament (energized by ATP) 5. Myosin head would detach and would be ready to attach again to another binding site farther along the actin filament 6. Some of the myosin heads wont detach but would hold the actin filament to prevent them from sliding back Contraction of Skeletal Muscles as a Whole- skeletal muscles contract in graded response (varying degrees of strength) -by increasing frequency of stimulation -by increasing the number of muscle fibers stimulated (determines forcefulness of muscle contraction)

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Muscle Twitch- quick muscle jerking contraction in response to single stimulus Tetanus- more sustained contraction produced by a series of stimuli delivered by rapid contraction Fused/complete- there is smooth continuous contraction without evidence of relaxation due to very rapid rate of stimulation Unfused/Incomplete- contraction isnt smooth enough since frequency of stimulation isnt fast enough Types of Muscle Contraction 1. Isotonic Contraction- there is actual shortening of muscle and movement occurs 2. Isometric Contraction- muscle length remains the same although there is increasing tension within the muscle 3. Toni c Contraction- continuous partial contraction of muscles in the body necessary for maintaining posture -cant be controlled consciously Energy for Muscle Contraction ATPonly source of energy for muscle contraction -store is only good for a few seconds Regeneration Of ATP 1. Direct phosphorylation of ATP by Creatine Phosphate - supply of Creatine Phosphate is good only for 20 sec 2. Aerobic Respiration - 95% of ATP for muscle activity -occurs in Mitochondria through oxidative phosphorylation -Glucose to CO2 and H2O + ATP ( 36 ATP per glucose) 3. Anaerobic Glycolysis - doesnt require Oxygen; faster process -occurs in cytosol where glucose is broken down into Pyruvic Acid (2ATP per glucose) however if Oxygen is present, Pyruvic Acid can be broken down and enter oxidative pathways to produce more ATP -during vigorous exercise, pyruvic acid is converted to Lactic Acid (accumulation leads to muscle pain and cramps) Effect of Exercise on Muscle 2 types of Exercise 1. Endurance/Aerobic Exercise

-dont cause mass increase in size of muscles -it can result to stronger and more flexible muscles and muscles are more resistant to fatigue due to a. Increase in blood supply b. Increase in mitochondria in muscle cells (more Oxygen store) c. Makes overall body metabolism more efficient 2. Resistance/Isometric -muscles are contracted against almost immovable objects or by lifting heavy weights -increase muscle size and strength due to a. Increase in size of muscle cells b. Increase in amount of CT Golden Rules of Muscle Activity 1. Most muscles cross at least one joint (Facial muscles dont cross any joint) 2. Bulk of muscle lies proximal to the muscle 3. All muscles have at least two attachments (Origin and Insertion) *Origin- attachment to immovable or less movable bone *Insertion- attachment to more movable bone 4. During Contraction, muscle insertion moves toward origin 5. Muscles can only pull, they never push Types of Movements [see book] Body Movements- results from the activity of 2 or more muscles acting together or against each other Types of Muscles according to Function: 1. Prime Mover- muscle that has the major responsibility for causing a particular movement 2. Antagonist- opposite muscle that is relaxed or stretched when the PM is contracting -muscle that opposes or reverses movement 3. Synergist- muscle that contract together with the PM that may help the PM to cause movement or stabilize a part of its joint 4. Fixators- are synergists that hold the bone or stabilize origin of prime mover Naming Skeletal Muscles By direction of muscle fibers - rectus(straight) -oblique(slant)

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To grin By relative size of muscles - maximus -medius -minimus By location of muscle -temporalis -occipitalis By number of origin - bi(ceps) -tri(ceps) -quadri (ceps) By location of origin and insertion -sterno -cleido -mastoid By shape of muscle -deltoid (triangle) -trapezius (diamond) By Action of muscle - Flexor -Extensor -Adductor -Tensor GROSS ANATOMY [know the O, I, A, and NS] Facial Muscles (NS= Facial Nerve) 1. Frontalis- muscle that covers the forehead A:Raise eyebrows(surprise) Wrinkle forehead horizontally 2. Occipitalis- posterior of skull A: Pull skull posteriorly 3. Currogator Supercilli- small muscle located medial to eyebrow A:Cause vertical forus over glabella during frowning 4. Orbicularis Oculi- fibers run in circles over the eye A:Closure of eyes (forcefully) Squint (when too bright) Blinking and Winking 5. Zygomaticus (major and minor)extend from corner of mouth to cheek bone A: Raise angle of mouth(smiling) 6. Orbicularis Oris- muscle of lips A:Close Mouth Protrude lips (kissing) 7. Risorius- transversely oriented muscle at lateral angle of mouth A:To draw corner of lips laterally 8. Buccinator- transversely oriented muscle found deeper to Risorius (larger); deepest and main muscle of cheek A: Draw corner of mouth laterally Flattens Cheek against teeth (chewing and Whistling) Chewing Muscles (NS= Trigeminal Nerve) 1. Temporalis- fan-shaped muscle covering temporal bone and inserting into mandible A:to close jaw(together with Masseter) Retract jaw 2. Masseter- quadrilateral muscle running from zygomatic process to mandible A: to close jaw Protract/Protrude Jaw 3. Pterygoid- inner A: lateral movement of jaw(grinding) Neck Muscles 1. Platysma- single sheet muscle that covers anterolateral part of neck O:from CT sheath to chest muscle I: Lower margin of chin and area under mouth A: Wrinkle skin of neck Depress corner of mouth (expressing sadness, fright, suffering) NS: Facial Nerve 2. Sternocleidomastoid- lateral part of neck O: medial third of clavicle and sternum I: Mastoid process of temporal A: Bend neck internally towards shoulder Rotate head opposite side Bow (contraction of both muscle) NS: Accessory Nerve + Branches of Cervical Nerve Trunk Muscles I. Anterior 1. Pectoralis major- large fan-shaped muscle covering upper part of chest O:medial of clavicle, sternum, and 1st 6 ribs I: Greater tubercle of humerus A: Adduct, flex, and medially rotate arm NS: C6- T1 Spinal Nerve

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2. Pectoralis minor- located beneath the major O:2nd to 5th ribs I: coracoid process of scapula A: Pull scapula forward and tilt it downward NS: Cervical Spinal Nerve 3. Intercostal Muscles a. External Intercostal O: lower margin of ribs I: upper margin of next rib(direction of fibers medially) A: contract and elevate ribs to enlarge thorax as in Inspiration NS: Intercostal Nerves b. Internal Intercostal O: lower margin of ribs I: upper margin of next rib(direction of fibers medially) A: Depress rib cage and help in forced expiration NS; Intercostal Nerves i. 4. Muscles of Abdominal Girdle (NS= Intercostal Nerve) a. Rectus Abdominis O: Xiphoid process and 5th to 7th costal cartilages I: Pubis A: Flex Vertebral Column or depress thorax during forced expiration b. External Oblique O: from lower 8 ribs(fibers run downward and medially) I: Iliac Crest A: Flex Vertebral Column and rotate trunk and bend laterally

II. Posterior 1. Trapezius- most superior muscle of the posterior neck and upper trunk -muscle of both sides, <> shape O: aponeurosis extending from the occipital bone down to the vertebral column up to the 12th Thoracic Vertebra I: Lateral third of clavicle, acromion, spine of scapula A: to extend the head, elevate the crest and adduct the scapula NS: Spinal Accessory nerve and Cervical nerve 2. Latissimus Dorsi- flat muscle covering lower back; below trapezius O: Aponeurosis attached to the spines of the lower thoracic and upper lumbar vertebra I: lesser tubercle of humerus A: Draw wrist arm down and backward; rotate it medially and adducts it NS: Thoracodorsal Nerve 3. Erector Spinae Sacrospinalis- a composite muscle made up of 3 muscle columns( longissimus, iliocostalis, spinalis) A: To extend the spinal column and bend it to the sides; provide resistance and control during bending of waist NS: Spinal Nerves Upper Limb Muscles 1. Deltoid- triangular muscle that forms the rounded shape of shoulder. O:Lateral curve of clavicle, acromion, and spine of scapula I: Deltoid tuberosity of humerus A: (Prime mover of arm abduction) NS: Axillary Nerve Clinical Importance: Site for intramuscular injection
2.

c.

Internal Oblique- beneath external; fibers run at angles perpendicular at external Oblique O: from iliac crest, inguinal ligament(fibers run upward and lateral) I: last 3 ribs A: same as external

d.

Transversus Abdominisdeepest muscle of Abdomen; chief girdle of abdomen O: Cartilages of lower ribs, iliac crest and inguinal ligament; fibers run horizontally across abdomen I:pubis; most fibers insert to aponeurosis In anterior abdomen A: Compress abdominal Viscera

Muscle of Arm a. Triceps Brachii- main muscle in posterior Arm O: three heads 1.Long Head- scapula 2.Medial and Lateral Head- Post. Surface of Humerus I:Olecranon of ulna A: prime mover for extension of elbow NS: radial nerve

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b. Flexor Group(NS:musculocutaneous Nerve) i. Biceps Brachiistongest supinator of arm O:short head from coracoids process; long head from scapula I: radial tuberosity A: Flexor of elbow; supinate ii. Brachialis O: lower shaft of humerus I: Coronoid process of ulna A: flexion of elbow
3.

1. Hip Muscles a. Iliopsoas Muscle- fused muscle composed of iliacus and psoas major O:Iliac bone and lumbar vertebra I: lesser trochanter of femur A: most powerful flexor of thigh; flex pelvis on thigh NS: Femoral Nerve b. Gluteus Maximus- forms flesh of buttocks O:Sacrum and posterior part of iliac crest I: Gluteal tuberosity of femur and iliotibial band A: Most powerful extensor of thigh esp. when climbing stairs/jumping; most powerful lateral rotator NS: Gluteal Nerve c. Gluteus Medius- partly covered by gluteus maximus O: Iliac crest I: Greater trochanter A: Abduction of thigh; medial rotator; site of IM injection 2. Thigh Muscles Anterior a. Sartorius- tailors muscle; long straplike muscle O: Anterior superior Iliac spine I: Medial surface of tibia A: Flex thigh of hip; abduct it and rotate it laterally; flex leg and rotate it medially; cross legs b. Quadriceps femoris i. Rectus Femoris O: Anterior Inferior Iliac spine and upper rim of acetabulum A: flexes thigh at hip; site for IM injection ii. Vastus lateralis (site for IM injection) O: Proximal part of femur iii. Vastus Medialis O: Intertrochanteric Line iv. Vastus Intermedius O: Intertrochanteric Line I: common tendon that inserts tibial tuberosity via patellar ligament A:powerful extensor of leg Medial a. Adductor Group O: pubis

Muscle of Forearm and Hand a. Extensor Group- extend the hand and fingers; supinators of forearm except for brachioradialis NS: Radial Nerve i. Brachioradialis O: lateral epicondyle of humerus I: styloid process of radius A: flexor of forearm; also a supinator and a pronator ii. Extensor carpi radialisextend the wrist and abduct the hand radialward Extensor digitorum cumonis- extend wrist and fingers Extensor carpi ulnarisextensor of wrist; abducts hand ulnarward

iii.

iv.

b.

Flexor Group- flexors of hand and fingers and pronators of forearm NS: Median Nerve i. Pronator Teris- most powerful pronator of forearm ii. Flexor carpi radialis- flexes the wrist; abducts hand radialward iii. Palmaris longus- flexes the wrist iv. Flexor carpi ulnaris- supplied by ulnar nerve; flexes wrist; abducts hand ulnarward v. Flexor digitorum- flexes phalanx -superficialis- doesnt reach terminal phalanx -profondus- reaches terminal phalanx

Lower Limb Muscles

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I: medial surface of femur A: adduct and flex thigh; lateral rotators(most) *adductor magnus- strongest adductor Posterior a. Hamstring Muscle i. Semitendinosus O: Ischial Tuberosity common tendon with long head of biceps femoris I: medial side of tibia A: Extend and adduct thigh and rotate it medialward ii. Biceps Femoris O:long head at ischial tuberosity; short head at shaft of femur I: Head of fibula and partly lateral condyle of tibia A: extend and adduct thigh; rotate laterally due to long head; flexes leg due to short head iii. Semimembranosus O: Ischial Tuberosity I: back of medial condyle of tibia A: Extend and adduct the thigh; flex leg and rotate medially 3. Leg Muscles a. Anterior Group A: flexes dorsally; dorsiflexion of foot; invert foot and extend toes i. Tibialis Anterior O: lateral surface of proximal tibia I: 1st metatarsal ii. Extensor digitorum longus O: anterior surface of fibula I: terminal phalanx of lateral toes iii. Extensor Hallucis longus O: middle part of fibula I:distal phalanx of big toe b. Lateral Group i. Fibularis A: extend the ankle(plantar) and everts the foot c. Posterior Group A: plantar flexion and inversion i. Gastrocnemius O: 2 heads from medial and lateral condyle of femur I: Achilles tendon to calcaneus A: plantar flexion; flex knee

ii. Soleus O: Tibia and Fibula I: Via Achilles tendon to Calcaneus A: Strong plantar flexor Unit 7: The Nervous System Divisions of the NS According to Structure: 1. Central NS- composed of brain and Spinal Cord 2. Peripheral NS- composed of all nervous tissue outside brain and spinal Cord (nerves, ganglia) According to Function: 1. Sensory (afferent) -nerve fibers that convey impulses to receptors in different regions of the body to CNS 1.1 Somatic tendons, ligaments, 1.2 Visceral or Autonomic organs, smooth muscle, glands 2. Motor (efferent) -carry impulses from CNS to effector organs Characteristics of Nerve Tissue 1. Made up of specialized cells called neurons->the structural and functional unit of nerve tissue 2. Supporting tissue is mainly made up of cells a. CNS supporting cells = neuroglial cells; devoid of CT b. PNS- supporting cells = capsule cells and Schwann Cells; have small amount of CT General Characteristics of Neurons 1. Presence of protoplasmic processes that can extend for quite some distance 2. Neurons possess vital protoplasmic properties necessary for IRRITABILITY(ability to respond to stimulus and generate impulse) and CONDUCTIVITY (ability to transmit impulse from one locality to another) Classifications of Neurons According to Structure: 1. Based on the number of processes a. Unipolar Neuron- has only a single process (usually the axon) -common in embryo; rare in adults

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b. Bipolar Neuron- two processes (axon and dendrite) -common in embryo and usually found in retinas, olfactory, epithelium, vestibular, and cochlear ganglia of ears in adults c. Pseudo-unipolar- has a single short process called dendraxon and divide into two processes i. Central process- serves as axon ii. Peripheral processserves as dendrite -found in dorsal root ganglia or spinal ganglia or sensory ganglia of Cranial Nerves d. Multipolar- several processes (one axon + lots of dendrites) -common in adult nervous tissue According to Function: 1. Based on the direction of impulse in relation to CNS a. Sensory neurons/ Afferent Neurons- carry impulse from the sensory receptors to CNS -cell bodies are located in ganglia (outside CNS) -Eg. Receptors i. Cutaneous Receptors- in skin (touch, pressure, pain, and temperature) ii. Proprioceptors detect amount of tension in Muscles, tendons, joints necessary to maintain balance in normal posture b. Motor/ efferent Neurons- carry impulse from CNS to effector organs c. Association / Interneuronsconnect sensory to motor neurons or vice versa -cell bodies are located in CNS Structure of a Neuron 1. Large cells and have extremely variable shape 2. Shape of neuron is determined by the number and arrangement of processes 3. Nerve cells are composed of cell body and processes Cell body- shape is variable (oval, elongated, or polygonal) - in CNS, they are only found in the gray matter

- group of cell bodies in CNS that belong to the same type and perform the same function = nucleus - group of cell bodies in PNS that belong to the same type and perform the same function = ganglion Cell Membrane of Neuron surrounds nerve cell body and processes *in axon, cell membrane= axolemma *cytoplasm= neuroplasm *cytoplasm of axon= axoplasm *R.ER = Nissl Bodies *Neurofibrils/neurofilaments=intermediate filaments at nerve cells Nucleus of Nerve Cells- single, large, and spherical and centrally located -pale in staining meaning less heterochromation and more euchromatin -prominent dark staining nucleolus (fish eye nucleolus) PROCESSES: AXON vs DENDRITE BASES 1. Numb er 2. Length 3. Nissl Bodies 4. Sheat hs AXON 1(one) Generally larger Absent Present(my elin/sheath of Schwann/ T-sheath) Present Away from Cell Body DENDRITE Generally several Generally longer Present Absent

5. Bundle s 6. Directi on of Impuls e and Action

Absent Towards Cell Body

Supporting Cells CNS 1. Neuroglia- more numerous than nerve cells -responsible for formation of Myelin Sheath -maintenance of Ionic Equilibrium -repair of injuries in Brain and Spinal Cord (through Glial cells not scar tissue) -serves as insulators Classification of neuroglial cells

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1. Ependymal Cells- columnar cells that line the central canal of cord and ventricles of brain 2. Neuroglial Propercharacterized by protoplasmic processes; capable of dividing Types: a. Astrocytes/ Astroglia- largest and most numerous -more processes -processes are attached to BV by their expanded pedicles called perivascular feet

2. In PNS, bundle from same origin, following same course, termination and function is known as NERVE *A nerve is considered an organ Nerves- enclosed by connective tissue sheaths called epineurium Nerve Fascicle- enclosed by perineurium Nerve Fiber- enclosed by endoneurium Physiology All or None Saltatory Conduction= faster way of conducting impulse -nerve impulse jumps from node to node along length of nerve fiber because current cant flow across axonal membrane covered by myelin -occur in myelinated nerve fiber Anatomical Parts of Synapse 1. Presynaptic Terminal- axon terminal that expand into terminal buttons that contain numerous mitochondria and synaptic vesicles 2. Postsynaptic Terminal- membrane of cell receiving impulse; possess receptors for neurotransmitters 3. Synaptic Cleft- between two terminals Reflexes- rapid predictable and involuntary responses to stimuli -occurs over neural pathways called reflex arches Basic Components: 1. Receptor 2. Sensory Neuron 3. Integrating Center (if simple reflex, SC is the IC) 4. Motor Neuron 5. Effector Organ 2 Neuron Reflex Vs 3 Neuron Reflex 1. 2 neuron reflex doesnt involve interneuron or association neuron; only sensory and motor 2. 3 neuron involves interneuron Types of Reflexes 1. Somatic- reflexes involving skeletal muscles 2. Autonomic- regulate activity of smooth muscles, heart, and gland -more complicated -Eg. Smell favorite food= saliva and secrete gastric Juice(olfactovisceral reflex); glaring light= pupils constrict (pupillary reflex) CENTRAL NERVOUS SYSTEM

b. Oligodendrocytessmaller than astrocytes -processes are fewer and more slender and shorter -formation of Myelin Sheath c. Microglia- small cells with wavy and branching short processes spiderlike -phagocytic cells and serve as macrophages of CNS PNS 1. Capsule Cells- satellite cells; flattened cells that form a continuous capsule around nerve cell bodies in ganglia 2. Schwann Cells- neurilemmal cells; elongated cells arranged end to end along the course of nerve fibers in CNS -form thin tube that surrounds nerve fibers (Sheath of Schwann or Neurilemma) Myelin Sheath- formed by Schwann cells in PNS Nodes of Ranvier- interruptions seen in neurilemma and myelin at regular intervals -mark point of discontinuity between successive Schwann Cells Nerve Fibers 1. In CNS, bundle from same origin, following same course, termination and function is known as FIBER TRACT(located in the white matter[white due to myelin sheaths of these tracts in fresh section])

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Division of Brain I. Cerebral Hemisphere- largest part of the brain -covers most of diencephalon and brain stem -divided by a longitudinal fissure -at the middle, it is connected by a line known as the corpus callosum -characterized by presence of convoluted folds known as gyri -shallow groove= sulci -deeper and wider groove=fissure -fissures divide brain into larger regions -sulci divide brain into smaller gyri -gray matter= outer surface -white matter= inner Main Sulci/Fissures: 1. Lateral Sulcus/Sylvian Fissureseparates temporal from frontal and parietal lobe 2. Central Sulcus- divide frontal from parietal lobe 3. Parieto-occipital Fissure- separates occipital from parietal and temporal Gyri Frontal Lobe 1. Pre-central Gyrus- bounded by central and pre-central sulcus 2. Superior Frontal Gyrus- located superior to the superior-frontal sulcus 3. Middle Frontal Gyrus- located between superior and inferior frontal Sulcus 4. Inferior Frontal Gyrus- below inferior frontal Sulcus Parietal Lobe 1. Post-central Gyrus- Central and Postcentral Sulcus 2. Superior-parietal Lobule- above intraparietal Sulcus 3. Inferior Parietal Lobule- below intraparietal Sulcus Temporal Lobe 1. Superior Temporal Gyrus- located beyween Sylvian fissure and Superior Temporal Sulcus 2. Middle Temporal Gyrus- located between Superior and middle Temporal Sulcus 3. Inferior Temporal Gyrus- Middle and Inferior Temporal Sulcus Occipital Lobe (forget about Gyrus) Functional Areas 1. Primary Motor area- located in precentral Gyrus

-control Skeletal Muscles for voluntary movement -axons of these neurons would descend to the brain stem through the SC and their axon are composed of Corticospinal or Pyramidal Tract-> cross in the medulla and terminate motor neurons spinal cord of opposite side *Motor neurons (spinal cord part is the synapse; longest axon) *Motor neurons in SC would give out fibers that innervate Skeletal Muscles 2. Pre-Motor Area- anterior to Primary Motor Area -concerned with control of mass movement and postural movement -movement of smaller muscles= skilled movement -movement of larger muscles= postural movement 3. Frontal Association Area- most of anterior lobe -concerned with individuals personality and ones personal judgment -FRONTAL LOBE SYNDROMEchange personality{no sense of moral value); destruction of both Frontal Lobes 4. Brocas Speech Area- inferior frontal Gyrus -concerned with ones ability to express his thoughts in words -damage results to expressive/motor Aphasia or Brocas Aphasia->individual will not be able to communicate verbally; no paralysis or sensory loss *Aphasia- conditions related to communication or language 5. Primary Somatic/ Sensory Area- postcentral Gyrus of Parietal Lobe -concerned with interpretation of Somatic Sensation Touch, Pain, Temperature -damage results to loss or demunition of sensation on opposite side of body 6. Gustatory Area- locate din the most inferior part of the post-central gyrus 7. Wernickes Area- occupies inferior parietal gyrus and posterior part of superior temporal Gyrus

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-gives meaning to sounds heard and objects seen -damage results to Wernickes Aphasia which is a sensory aphasia-> inability to interpret sound or spoken language and read/interpret written symbols given no sensory impairment 8. Auditory Area- transverse gyrus found in inferior wall of Sylvian Fissure -responsible for reception of sounds -damage results to partial deafness of both ears 9. Visual Area- located in occipital lobe -reception of visual stimuli -damage results to blindness *Basal Ganglia- masses of gray matter embedded in White Matter -regulates mass/postural movement -damage results to Parkingsons and Huntingtons DSE II. Diencephalon- located between brain stem and cerebral hemisphere A. Epithalamus- posterior part that forms the roof of the 3rd ventricle -components include the pineal gland B. Thalamus- upper part of Diencephalon that is divided into 2 halves by the 3rd ventricle -serves as relay station for sensory impulses going to cerebral cortex -recognizes sensation as pleasant or unpleasant C. Hypothalamus- below thalamus -makes up floor of 3rd ventricle -chief regulating center for ANS -regulate H2O balance, body temperature and controls pituitary gland -concerned with expression and emotions, thus part of LIMBIC SYSTEM D. Subthalamus- small component located laterally -related to basal ganglia functionally III. Brain Stem- connects diencephalon with SC

-contains nuclei that give rise to Cranial Nerve 3 Regions: 1. Midbrain- smallest part extending from the Mamillary bodies to the pons -encloses Cerebral Aqueduct-> narrow canal connecting 3rd and 4th Ventricle -Cerebral Pedunclesbulging tracts located anteriorly and would contain the fiber tracts that ascend and descend from the Cerebral Cortex -Corposa Quadrigeminafour oval protrusions located dorsally; serve as reflex centers involved in vision and hearing 2. Pons- oval structures located between brain stem and medulla -dorsal portion serves as upper half of floor of the 4th ventricle - connected to the cerebellum by cerebral peduncles -respiratory 3. Medulla- most inferior; serves as lower half of floor of the 4th ventricle -contain numerous nuclei that regulate visceral activities BRAINSTEM RETICULAR FORMATION -RAS -composed of diffused masses of gray matter extending entire length of brain stem -concerned with maintenance of attention, arousal, and wakefulness -involves in motor control of different organs IV. Cerebellum- lie posteriorly to pons and medulla - Attached to pons by peduncles - Form rood of 4th ventricle - Project dorsally to be located beneath occipital lobe - Surface is characterized by numerous parallel folds - Concerned with coordination of voluntary skilled movement - Maintenance of posture and equilibrium or unconscious proprioception 2 Hemispheres: 1. Outer Gray Matter 2. Inner White Matter

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9. Dural Sinuses 10. Veins (Venous System) MENINGES-composed of CT membrane that serve as covering and protection of CNS 3 Layers: 1. Dura Mater- thick outermost covering made up of 2 layers a. Periosteal Layer- outer layer attached to cranium and serve as periosteum b. Meningeal inner layer covering brain; extends to SC *2 Layers are fused together except in areas where they separate to surround dural sinuses-> blood channels that collect venous blood from the brain *Dura mater may extend inward to form folds that attach brain to cranium; these folds separate different parts of CNS a. Falx Cerebri- fold of dura that extends to the longitudinal fissure that divide the 2 hemisphere b. Tentorium Cerebelli- fold that separates Cerebellum from Cerebrum 2. Arachnoid Membrane- thinner membrane that possess threadlike extensions that are attached to underlying Pia Mater 3. Pia Mater- innermost, thin, and delicate membrane -adheres closely to surface of brain and would follow every fold of the surface 4. Subarachnoid Space- between arachnoid and Pia Mater -contain CSF-> similar to blood plasma from which it is derived -contains less proteins, more vitamin C, and have different Ion Composition -secreted by the choroid plexus-> clusters of capillaries attached to ventricles of brain -serve as protective caution for brain Circulation of CSF 1. Choroid Plexus at lateral Ventricles (through) 2. Foramen of Monroe or Interventricular Foramen (to) 3. 3rd Ventricle (to) 4. Cerebral Aqueduct (to) 5. 4th Ventricle (to) 6. A. Central Canal of Spinal Cord (or) B. 3 openings (to) 7. Subarachnoid Space 8. Arachnoid Villi (exit) Hydrocephalus- obstruction of drainage of CSF -occurs in infants -results in an enlarged head and brain damage(if uncorrected) Lumbar Tap- done to withdraw samples of CSF for laboratory testing - L3 and L4 interspace Blood Brain Barrier- barrier that separates nervous tissue from blood and serves to protect nervous tissue from substances coming from blood -composed of perivascular feet and astrocytes *Capillaries of brain are less permeable to substances Brain Dysfunctions Trauma: (1) Cerebral Concussion- occurs when there is slight injury to brain that can lead to temporary loss of concussion (2) Contusion- occurs when there is damage or destruction of brain tissue; leads to coma (3) Cerebral Edema- swelling of brain due to inflammatory response to injury; leads to increase ICP (4) CVA or stroke- blockage of blood flow to the brain that cause death of brain tissue *Aphasia- defect involving comprehension of language *TIA(Transient Ischemic Attack)- temporary blockage of circulation that may cause transient or non-permanent deficits lasting several minutes Spinal Cord External Features -elongated, cylindrical part of CNS occupying upper 2/3 of vertebra; canal -extend from Foramen Magnum to L1 or L2 Vertebrae -possess meningeal covering -subarachnoid space extends up to S2 -Structurally unsegmented but functionally segmented, the cord is divided into 31 cord segments -Functional Cord Segment-> part of the cord that gives rise to a pair of Spinal Nerve -Cauda Equina-> collection of spinal nerve roots at the caudal end of cord; tail of horse

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Internal Features -has 2 major Divisions: 1. Gray Matter-found inner to WM -shaped like a butterfly or H -surrounds Central Canal -mainly composed of neurons which are grouped together to form nuclei -unmyelinated nerve fibers 2 Parts of Gray Matter: a. Dorsal Horn- upper wing of butterfly -contain association neurons that receive fibers from dorsal root -fibers are central processes of Sensory Neurons(pseudounipolar) in Spinal Ganglia -damage to dorsal horn, dorsal root, or dorsal ganglia results to sensory loss b. Ventral Horn- contains motor neurons that send axons out of the cord to form ventral root -damage to ventral horn results to flaccid paralysis-> affects lower motor neuron including cord, nerves; there is atrophy of muscles 2. White Matter- found external to GM -composed of myelinated nerve fibers that ascend and descend the cord 3 Parts of White Matter a. Posterior Column- contain only sensory tracts that ascend to the brain b. Lateral Column- contain ascending and descending fibers c. Anterior Column- same as lateral Clinical 1. Spastic Paralysis- damage to cord including motor tracts 2. Impairment/loss of sensation- damage to sensory tracts 3. Quadriplegia- paralysis of muscles of 4 limbs(C4-up) 4. Paraplegia- lower extremities 5. Hemiplegia- of body *Paralysis= more complete; paresis= weakness only PERIPHERAL NERVOUS SYSTEM 1. Cranial Nerve- 12 a. Purely Sensory- 1,2,8 b. Purely Motor- 11,12 c. Mixed- others

*vestibulocochlear=stato-acoustic 2. Spinal nerve and Plexus(combination of SN) Autonomic Nervous System -controls body activities automatically -sensory and motor (not just motor) -Central and peripheral (not just peripheral) Somatic Vs Autonomic Somati Autonomic c Effector Skelet Smooth/cardiac/gla Organs al nds Muscle Neurotransmit Ach Ach+ epinephrine+ ters norepinephrine Patterns of Motor Pre-ganglionic Efferent neuron neurons in CNS Pathways s in makes synapse CNS which postgoes ganglionic neurons to in PNS Skelet al Muscle s (no synaps e) Anatomy of ANS 1. Parasympathetic Division -cranio-sacral division -pre-ganglionic neurons are located in brain stem; the nuclei of cranial nerves (3,7,9,10) -S2 to S4 also -pre-ganglionic neurons will make synapse with post-ganglionic neurons found in terminal ganglia->located between organs; ganglia of ANS -post-ganglionic fibers would innervate effector organs -in sacral region, pre-ganglionic fibers would form pelvic nerve -terminate in terminal ganglia of pelvic organ 2. Sympathetic Division -thoraco-lumbar division -confined only to SC -pre-ganglioinic neurons are located in the lateral horn of spinal segments of T1-T2 -pre-ganglionic fibers passes through white ramus communicans to enter sympathetic chain *those that pass through ganglia without making synapse will form part of splancnic nerves that will travel to the viscera and this would supply abdominal and pelvic organs *those that synapse with sympathetic chain, their post-ganglionic fibers would reenter the spinal nerve

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through gray ramus communicans and this will supply most BV and structures found in the skin Functions of ANS *When both divisions will supply an organ, they will supply opposite effects due to postganglionic fibers releasing different transmitters Parasympathetic-release Ach Sympathetic release epinephrine/norepinephrine *Both pre-ganglionic fibers would secrete Ach Parasympathetic [pre to post-> Ach; post to effector organ->Ach] Sympathetic [pre to post-> Ach; post to effector organ->epinephrine/norepinephrine] *Most organs in body receive fibers from both division except most of BV structures on skin and adrenal medulla and other glands in the body Sympathetic->responsible for body for an emergency [flight, fight, or fright] Parasympathetic-> activities directed toward conserving and restoring energy [digestion, defecation, urination]

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