Introduction to Anatomy:

Anatomy is made from greek word Anatomia where ana means separate,
apart from , to cut up, cut open

It is the branch of natural Science dealing with the structural organization of

living things.

Gross Anatomy, Topographical Anatomy, Regional Anatomy, Anthropotomy

Microscopic Anatomy

Superficial Anatomy

Human Anatomy:

Human Anatomy is Primarily the scientific study of the Morphology of Human

body
Human anatomy can be taught regionally or systemically;that is,
respectively, studying anatomy by bodily regions such as the head and chest,
or studying by specific systems, such as the nervous or respiratory systems.

Definition of Human Body:

The human body is the entire structure of a human organism, and consists
of a head, neck, torso, two arms and two legs. By the time the human
reaches adulthood, the body consists of close to 100 trillion cells, the basic
unit of life. These cells are organised biologically to eventually form the whole
body.
Size, type & Proprtion
The average height of an adult male human (in developed countries) is about
1.71.8 m (5'7" to 5'11") tall and the adult female about 1.61.7 m (5'2" to
5'7") tall.[3] This size is firstly determined by genes and secondly by diet. Body
type and body composition are influenced by postnatal factors such as diet
and exercise[citation needed].

Constituents of Human Body

Constituent Weight Percent of atoms

Oxygen 38.8 Kg 25.5%
Carbon 10.9 Kg 9.5%
Hydrogen 6.0 Kg 63%
Nitrogen 1.9 kg 1.4%
Calcium 1.2 Kg 0.3%
 Phosphorus 0.6 Kg 0.2%
Potassium 0.2 Kg 0.06%

Few Definitions:
Cell: The cell in our bodies are small microscopic mass of protoplasm
bound externally by membrane.
Tissue; A collection of Similar cells that group together to perform a
Specific Function are called Tissues

Types of tissues:
Epithelial Tissue: they are pack highly together and serve as
membranes lining organ and helping to keep the bodys organ
separated, in place & Protected eg outer layer of skin, inside of
mouth & Stomach
Connective tissue: connective tissue adds support and structure to
the body.Most types of connective tissue contain fibrous strands of
the protein collagen that add strength to connective tissue. Some
examples of connective tissue include the inner layers of skin,
tendons, ligaments, cartilage, bone and fat tissue. Blood is also
considered as a form of connective tissue
Muscle Tissue - Muscle tissue is a specialized tissue that can
contract. Muscle tissue contains the specialized proteins actin and
myosin that slide past one another and allow movement. Examples
of muscle tissue are contained in the muscles throughout your body.
Nerve Tissue - Nerve tissue contains two types of cells: neurons and
glial cells. Nerve tissue has the ability to generate and conduct
electrical signals in the body. These electrical messages are
managed by nerve tissue in the brain and transmitted down the
spinal cord to the body.

Mucous Membrane
The Mucous Membrane are lining of mostly endodermal origin,
covered in epithelium, which are involved in absorption & Secretion.
They are at several places contagious with skin, at nostrils, Eyelids,
ears, genital areas etc.
Sticky thick fluid secreted by the mucus membranes & the glands is
termed Mucus.
Examples of Mucosa
Buccal Mucosa
Esophageal mucosa
Gastric Mucosa
Intestinal Mucosa
Nasal Mucosa
Oral Mucosa
Bronchial Mucosa
 Uterine Mucosa
Endometrium
Penile Mucosa

Glands
A gland is an organ in an animal's body that synthesizes a substance
for release of substances such as hormones or breast milk, often
into the bloodstream or into cavities inside the body or its outer
surface .

Types of Glands
Endocrine Gland; are glands that secret their Products through the
basal lamina and lack a duct system
Exocrine Glands; secrete their Products through a duct further
divided into 3 types
Apocrine Glands;Apical Part, Sebaceous
Holocrine glands; entire cell disntegratessebaceous
Merocrine Glands; secret by exocytosis

Functional Types of exocrine glands

Serous Glands: Secrete a watery , often protein rich product
Mucous Glands: secretes a viscous product, rich in carbohydrates
Sebaceous Glands: Secret a lipid product, also Known as oil Glands

Body Cavity:
Body cavity is a space within the body that contains internal organs.
Our body consist of five cavities such as spinal, pelvic, Abdominal,
thoracic & cranial
Description of cavity:

Spinal Cavity: Consist of Nerves of the spinal cord.

Pelvic Cavity: consist of urinary bladder, urethra, ureters, uterus &
Vagina in female
Abdominal cavity: stomach, small & large intestines, spleen, liver,
gall bladder & Pancreas. Abdominal Cavity is surrounded by double
folded Membrane called peritoneum. Two kidneys are situated at
back of it, in retroperitoneal area

What is an Organ?
An organ is a structure that contains at least two different types of tissue
functioning together for a common purpose.
What are Organ Systems?

Organ systems are composed of two or more different organs that

work together to provide a common function. There are 10 major
organ systems in the human body, they are the:

1) Skeletal System

Role; The main role of the skeletal system is to provide support for
the body, to protect delicate internal organs and to provide
attachment sites for the organs.
Organs; Bones, cartilage, tendons and ligaments.

2) Muscular System
Role; The main role of the muscular system is to provide movement.
Muscles work in pairs to move limbs and provide the organism with
mobility. Muscles also control the movement of materials through
some organs, such as the stomach and intestine, and the heart and
circulatory system.
Organs: Skeletal muscles and smooth muscles throughout the body.

3) Circulatory System
Role; The main role of the circulatory system is to transport
nutrients, gases (such as oxygen and CO2), hormones and wastes
through the body.
Organs: Heart, blood vessels and blood.

4) Nervous System
Role; The main role of the nervous system is to relay electrical
signals through the body. The nervous system directs behaviour and
movement and, along with the endocrine system, controls
physiological processes such as digestion, circulation, etc.
Organs: Brain, Spinal Cord & Peripheral nerves
 5) Respiratory System
Role: The main role of the respiratory system is to provide gas
exchange between the blood and the environment. Primarily,
oxygen is absorbed from the atmosphere into the body and carbon
dioxide is expelled from the body.
Organs: Nose, trachea and Lungs

6) Digestive system
Role: The main role of the digestive system is to breakdown and
absorb nutrients that are necessary for growth and maintenance.
Organs: Mouth, esophagus, stomach, small and large intestines.

7) Excretory System
Role: The main role of the excretory system is to filter out cellular
wastes, toxins and excess water or nutrients from the circulatory
system.
Organs: Ureters, Kidneys , Bladder & Urethra

8) Endocrine System
Role; The main role of the endocrine system is to relay chemical
messages through the body. In conjunction with the nervous
system, these chemical messages help control physiological
processes such as nutrient absorption, growth, etc.
Organs: Many glands exist in the body that secrete endocrine
hormones. Among these are the hypothalamus, pituitary, thyroid,
pancreas and adrenal glands.

9) Reproductive System
Role; The main role of the reproductive system is to manufacture
cells that allow reproduction. In the male, sperm are created to
inseminate egg cells produced in the female.
Organs:
Female : ovaries, oviducts, uterus, vagina and mammary glands.
Male : testes, seminal vesicles and penis.

10) Lymphatic System

Role; The main role of the immune system is to destroy and remove
invading microbes and viruses from the body. The lymphatic system
also removes fat and excess fluids from the blood.
Organs: Lymph, lymph nodes and vessels, white blood cells, T- and B-
cells.

Cardiovascular System:

It consist of two systems

Circulatory System
 Lymphatic System

Types of Cardiovascular system

Closed type-Verterbrates
Open type- Invertebrates

Definition of Circulatory System

The circulatory system is an organ system that passes nutrients
(such as amino acids, electrolytes and lymph), gases, hormones,
blood cells, etc. to and from cells in the body to help fight diseases
and help stabilize body temperature and pH to maintain
homeostasis.

Components & Division of Circulatory

Heart & Blood Vessels

Division into two

Systemic Circulation
Pulmonary Circulation

An Avg body consist of 4.7 to 5.7 liters of blood.

Heart:
Lies underneath the sternum, in a thoracic compartment called
Mediastinum.
Size of Mans Fist & is shaped like an inverted cone.
Wt is 300 gms in male, 200 in female, normal range 250-350 Gms,
2/3 rd of heart is on left side.
Narrow end Called Apex is above the Diaphragm at the level of 5-6 th
rib
Base is the broader side at the level of Second rib.

Location of Heart:
Posterior to Sternum
Medial To lungs
Anterior to vertebral column
Base Lines Beneath 2nd rib
Apex at 5th intercostal space
Lies upon diaphragm
Surface Points of heart
The other three points are:
(a) the seventh right sternocostal articulation;
(b) a point on the upper border of the third right costal cartilage 1
cm. from the right lateral sternal line;
(c) a point on the lower border of the second left costal cartilage 2.5
cm. from the left lateral sternal line.d) is 4 cm. distant from the
midsternal line opposite the fourth costal cartilage.
Coverings of Heart:
Pericardium: loose fitting, double layered sac
Parietal Pericardium; Serous Membrane that is on the surface of the
heart muscle
Visceral Pericardium; inner layer of sac , secrets pericardial Fluid
Pericardial Fluid: it is serous fluid that is between the parietal &
Visceral pericardium which prevents friction as the heart beats

Layers of Heart Tissue;

Epicardium
Myocardium
Endocardium

Endocardium
Inner lining
Smooth surface that permits blood to move easily through the heart
without agglutination.
Continuous with lining of blood vessels

Myocardium
Middle layer made of cardiac muscle
 Forms the bulk of the heart wall
Contains the septum- a thick muscular wall that completely
separates the blood in
the right side of the heart from the blood in the left side.
Endocardium
Protective, outer layer of the heart wall same as the visceral
pericardium
The coronary blood vessels that nourish the heart wall are located
here
Heart Anatomy

Anterior View of Heart Posterior view of Heart

1 Rt Coronary Artery
2 Lt Anterior Descending
3 Lt Circumplex
4 Superior Vena Cava
5 Inferior venaCava
6 Aorta
7 Pulmonary artery
8 Pulmonary Vein
9 Rt Atrium
10 Rt Ventricle
11 Lt Atrium
12Lt Ventricle
13 Papillary Muscles
14 Chordae Tendineae
15 Tricuspid Valve
16 Mitral Valve
17 Pulmonary Valve

Coronary Arteries
The coronary arteries are the network of blood vessels that carry
oxygen- and nutrient-rich blood to the cardiac muscle tissue.
Two coronary arteries, referred to as the "left" and "right" coronary
arteries, emerge from the beginning of the aorta, near the top of the
heart.
 Left Main Coronary is the Initial segment of coronary artery , abt a
width of soda straw & less than a inch long, divides into Lt anterior
descending Coronary artery & lt circumflex artery.

Vena Cava
Superior vena Cava: The superior vena cava is one of the two main
veins bringing de-oxygenated blood from the body to the heart.
Veins from the head and upper body feed into the superior vena
cava, which empties into the right atrium of the heart.
Inferior vena cava: The inferior vena cava is one of the two main
veins bringing de-oxygenated blood from the body to the heart.
Veins from the legs and lower torso feed into the inferior vena cava,
which empties into the right atrium of the heart.

Aorta, Pulmonary artery, Pulmonary vein

The aorta is the largest single blood vessel in the body. It is
approximately the diameter of your thumb. This vessel carries
oxygen-rich blood from the left ventricle to the various parts of the
body.
Pulmonary artery: The pulmonary artery is the vessel transporting
de-oxygenated blood from the right ventricle to the lungs.
Pulmonary Vein; The pulmonary vein is the vessel transporting
oxygen-rich blood from the lungs to the left atrium.

Rt Atrium
The right atrium receives de-oxygenated blood from the body
through the superior vena cava (head and upper body) and inferior
vena cava (legs and lower torso).
Thinner walls than ventricles
SA Node for pulses generation
The tricuspid valve, which separates the right atrium from the right
ventricle, opens to allow the de-oxygenated blood collected in the
right atrium to flow into the right ventricle.

Rt Ventricle
The right ventricle receives de-oxygenated blood as the right atrium
contracts. The pulmonary valve leading into the pulmonary artery is
closed, allowing the ventricle to fill with blood. Once the ventricles
are full, they contract. As the right ventricle contracts, the tricuspid
valve closes and the pulmonary valve opens
Thicker than atria

Lt Atrium
The left atrium receives oxygenated blood from the lungs through
the pulmonary vein. As the contraction triggered by the sinoatrial
node progresses through the atria, the blood passes through the
mitral valve into the left ventricle.

Lt Ventricle
 The left ventricle receives oxygenated blood as the left atrium
contracts. The blood passes through the mitral valve into the left
ventricle. The aortic valve leading into the aorta is closed, allowing
the ventricle to fill with blood.
Thickest myocardial Wall
Forms apex of heart

Papillary Muscle
The papillary muscles attach to the lower portion of the interior wall
of the ventricles The contraction of the papillary muscles opens
these valves. When the papillary muscles relax, the valves close.

Chordae Tendineae
As the papillary muscles contract and relax, the chordae tendineae
transmit the resulting increase and decrease in tension to the
respective valves, causing them to open and close. The chordae
tendineae are string-like in appearance and are sometimes referred
to as "heart strings."

Septa
Interatrial Septum
Muscular Division B/W Atria
Foramen OvaleOpening in Foetus
Fossa Ovalis--- Shallow Depression,,remnants of foramen Ovale

Interventricular Septum
Thick Muscular Wall
Seperates Ventricles

Heart Valves
Functions;
Prevent blood from flowing backwards
Responds to change in pressure

Two types
Atrioventricular Valves
Semi-lunar Valves

Semi-lunar Valves
Located at exit of ventricles, originate from endothelial lining of
veins
Two types
Pulmonary
Aortic

Atrioventricular Valves
Valve Cups are connected to papillary Muscles
Chordae Tendineaeis the string between two
Left AV Valve Mitral , Bicuspid
 Contains 2 cups
Right AV Valve Tricuspid
Contains 3 cups

Coronary Arteries & Veins

Coronary veins transport deoxygenated blood to coronary sinus
Coronary Sinus Drains into Rt Atrium

Posterior View of Heart Cardiac Muscle tissue.

Cardiac Myocyte Physiology

Self Contracting, Automatically regulated, contract in rhythmic
function
Cells are Y Shaped and are shorter and wider than Skeletal Muscle
cell.
Predominately Mononucleated
Depolarization differs,,repolarization takes longer time

Contractile Cells of heart

Actin & Myosin is same as skeletal muscle
Presence of calcium leads to contraction
Action potential is 30X longer than Skeletal Muscle

Conduction System
Cardiac Cells are automatic
They can depolarize spontaneously
Auto rhythmic Cells
Non Contractile cells
Self Excitable
Generate Spontaneous action Potential
 Trigger Heart contractions

Conduction System
Located in
SA node
AV node
AV bundle
Bundle branches
Purkinkie system

Heart Conduction System

Intrinsic Rates
Three potential areas capable of beginning
cardiac conduction
SA Node- Located in right atria; 60-100 bpm
AV Node- Located at AV junction; 40-60 bpm
Ventricular System- Ventricles; < 40
Rate depends upon where in ventricles conduction originates

Innervation of heart
Heart rate can be influenced by autonomic
nervous system
Sympathetic Speeds up heart rate and increases force
ofcontraction
Parasympathetic Slows down heart rate
Nerve supply to Heart
Sympathetic Fibres forms stellate ganglion then to cardiac
plexus supply to SA Node & cardiac Muscle
Vagus Provides the Parasympathetic control to heart. It
decreases the excitability of the junctional

Nerve Supply of Heart

Blood Vessels
Structure and Functions of Blood vessels:

Blood Structure Functions

Vessel
Arteries The walls (outer Transport blood away
structure) of from the heart;
arteries contain Transport oxygenated
smooth muscle blood only (except in the
fibre that contract case of the pulmonary
and relax under artery).
the instructions of
the sympathetic
nervous system.
Arterioles Arterioles are tiny Transport blood from
branches of arteries to capillaries;
arteries that lead Arterioles are the main
to capillaries. regulators of blood flow
These are also and pressure.
under the control
of the
sympathetic
nervous system,
and constrict and
dialate, to
regulate blood
flow.
Blood Structure Functions
Vessel
Capillarie Capillaries are Function is to supply
s tiny (extremely tissues with components
narrow) blood of, and carried by, the
vessels, of blood, and also to remove
approximately 5- waste from the
 20 micro-metres surrounding cells ... as
(one micro-metre opposed to simply moving
= 0.000001metre) the blood around the body
diameter. (in the case of other blood
There are vessels);
networks of Exchange of oxygen,
capillaries in most carbon dioxide, water,
of the organs and salts, etc., between the
tissues of the blood and the surrounding
body. These body tissues.
capillaries are
supplied with
blood by
arterioles and
drained by
venules. Capillary
walls are only one
cell thick (see
diagram), which
permits
exchanges of
material between
the contents of
the capillary and
the surrounding
tissue.
Blood Structure Functions
Vessel
Venules Venules are Drains blood from
 minute vessels capillaries into veins, for
that drain blood return to the heart
from capillaries
and into veins.
Many venules
unite to form a
vein.
Veins The walls (outer Transport blood towards
structure) of veins the heart
consist of three Transport deoxygenated
layers of tissues blood only (except in the
that are thinner case of the pulmonary
and less elastic vein).
than the
corresponding
layers of
aerteries.
Veins include
valves that aid
the return of
blood to the heart
by preventing
blood from
flowing in the
reverse direction.

Comparision Between Arteries & Veins

Arteris Veins
 Transport blood away from the Transport blood towards the
heart; heart;
Carry Oxygenated Blood
(except in the case of the
Pulmonary Artery);
Have relatively narrow lumens
(see diagram above);
Have relatively more
muscle/elastic tissue;
Transports blood under higher
pressure (than veins);
Do not have valves (except for
the semi-lunar valves of the
pulmonary artery and the
aorta).
Aorta
Carry De-oxygenated Blood
(except in the case of the
Pulmonary Vein);
Have relatively wide lumens
(see diagram above);
Have relatively less
muscle/elastic tissue;
Transports blood under lower
pressure (than arteries);
Have valves throughout the
main veins of the body. These
are to prevent blood flowing in
the wrong direction, as this
could (in theory) return waste
materials to the tissues.

Main trunk of series of Vessels Which carries oxygenated blood to

the tissues of the body for nutrition.
It commences at the Upper part of the ventricle where it is 3cm in
Diameter,,after ascen,ding for a short distance,arches backwards to
the left side over the root of lt Lung, it then descends within the
thorax & to the left side of the vertebral Column,Passes into the
abdominal cavity through Aortic Hiatus in Diapragm & Ends
Considerably Dimnished in size abt 1.75cm in diameter,Opp the
lower border of the 4th lumber vertebra by dividing into Lt & RT Illiac
arteries
Branches of Aorta

Ascending Aorta
It is abt 5cm in length,commences on the upper part of the base of
the Lt Ventricle,on a level with the lower border of 3rd costal
cartilage behind the lt half of the sternum.
It passes obliquely upward, forward to the right, in the direction of
heart axis as high as the upper border of the 2nd rt costal
cartilage,describing a slight curve in its course, & being situated abt
6 cm from the posterior surface of the sternum.
 At the union of Ascending aorta with the aortic arch the caliber of
vessel Is increased,owing to bulhing of its wall. The Dilatation is
termed as bulb of the aorta

Relations Of Ascending Aorta

CommencementCovered by Pulmonary artery & rt auricula
Anterior: Higher side Spereated by Sternum by pericardium,rt
Pleura,anterior Margin of rt Lung,loose aerolar tissue,remains of the
thymus
Posterior: Lt Aterium & RT pulmonary Artery
RT Side; Superior Vena cava & RT Atrium
Lt Side;Pulmonary artery
Branches: Two Coronary Arteries

Arch of Aorta
It begins at the level of the upper border of the second sternocostal
articulation of the right side, and runs at first upward, backward,
and to the left in front of the trachea; it is then directed backward
on the left side of the trachea and finally passes downward on the
 left side of the body of the fourth thoracic vertebra,then it becomes
Descending Aorta
Two Curvatures
Its upper border is usually about 2.5 cm. below the superior border
to the manubrium sterni.

Relations of Arch of Aorta

Anterior: Pleura, Anterior Margins of Lungs,remains of thymus
Left Backward: Lt Lung & pleura,,Lt Phrenic & lt Vagus Nerve
Right: Cardiac Plexus,Oesophagus,thoracic duct,trachea
Above; lt Common Carotid & Subclavian Arteries
Below Bifercation of pulmonary artery,lt Bronchus, Ligamentum
arteriosum

Branches
Innominate Artery(Brachio chephalic); largestBranch of arch of
aorta, 4 to 5 cm in Length, arises from second costal cartilage upper
border,,Plane anterior to the origin of lt Carotid
it ascends obliquely upward, backward, and to the right to the level
of the upper border of the right sternoclavicular articulation, where
it divides into the right common carotid and right subclavian
arteries.
Supplies blood to Head,Neck & Rt Arm

Common Carotid Artery

In human anatomy, the common carotid artery is an artery that
supplies the head and neck with oxygenated blood; it divides in the
neck to form the external and internal carotid arteries.[1]
The common carotid artery is a paired structure, meaning that there
are two in the body, one for each half. The left and right common
carotid arteries follow the same course with the exception of their
origin. The right common carotid originates in the neck from the
brachiocephalic trunk. The left arises from the aortic arch in the
thoracic region.
The left common carotid artery can be thought of as having two
parts: a thoracic (chest) part and a cervical (neck) part. The right
common carotid originates in or close to the neck, so it lacks a
thoracic portion.

Lt Sub Clavian Artery

In human anatomy, the subclavian arteries are two major arteries of
the upper thorax (chest), below the clavicle (collar bone). They
receive blood from the top (arch) of the aorta. The left subclavian
artery supplies blood to the left arm and the right subclavian artery
supplies blood to the right arm, with some branches supplying the
head and thorax.
 Branches vertebral Artery,Internal Thoracic Artery, thyrocervical
trunk, Costocervical trunk, Dorsal Scapular Artery

Descending Aorta
The descending aorta is part of the aorta, the largest artery in the
body. The descending aorta is the part of the aorta beginning at the
aortic arch that runs down through the chest and abdomen. The
descending aorta is divided into two portions, the thoracic and
abdominal, in correspondence with the two great cavities of the
trunk in which it is situated. Within the abdomen, the descending
aorta branches into the two common iliac arteries which serve the
pelvis and eventually legs.

Thoracic Aorta
The thoracic aorta is contained in the posterior mediastinal cavity.
It begins at the lower border of the fourth thoracic vertebra where it
is continuous with the aortic arch, and ends in front of the lower
border of the twelfth thoracic vertebra, at the aortic hiatus in the
diaphragm where it becomes the abdominal aorta.
At its commencement, it is situated on the left of the vertebral
column; it approaches the median line as it descends; and, at its
termination, lies directly in front of the column.

Branches of thoracic Aorta

Bronchial arteries,
Mediastinal arteries,
esophageal arteries,
Pericardial arteries, and the
Superior phrenic artery

Abdominal Aorta

The abdominal aorta is the largest artery in the abdominal cavity. As

part of the aorta, it is a direct continuation of the descending aorta
(of the thorax).
It begins at the level of the diaphragm, crossing it via the aortic
hiatus, technically behind the diaphragm, at the vertebral level of
T12. It travels down the posterior wall of the abdomen, anterior to
the vertebral column.
It runs parallel to the inferior vena cava, which is located just to the
right of the abdominal aorta, and becomes smaller in diameter as it
gives off branches. This is thought to be due to the large size of its
principal branches. At the 11th rib, the diameter is about 25 mm;
above the origin of the renal arteries, 22 mm; below the renals, 20
mm; and at the bifurcation, 19 mm.

Branches of Abdominal Aorta

Inferior Phrenic
Celiac
 Superior Mesentric
Middle Suprarenal
Renal
Gonadal
Lumber
Inferior Mesentric
Median Sacral
Common Iliac

Blood

Functions Of blood
Transports
1. Dissolved gases
2. Waste products of metabolism
3. Hormones
4. Enzymes
5. Nutrients
6. Plasma Proteins
Blood cells
Maintains Body temperature
Controls Ph
Removes toxins from body
Regulation of body fluid electrolytes

Composition of Blood
Blood Consist of Mainly two components
55% Plasma
45% Blood cells
(of these 99% are erythrocytes & 1% are leucocytes & Platelets)

Plasma

Structure
Plas Straw Coloured fluid
ma in which blood cells
are suspended, which
consist of 90-92%
water
Dissolved substances
Functions
Medium in which blood
cells are transported
around the body & are
able to Operate
effectively
Helps to maintain
 including electrolytes optimum body temp
such as throughout the organism
sodium,chlorine Helps to control Ph of the
Blood Plasma blood & the body tissue
Proteins like albumin, Helps to Maintain an ideal
globulin balance of electrolytes in
Hormones blood & body tissues

Erythrocytes
Immature erythrocytes have nucleus but mature erythrocyte has no
nucleus.
Haem; Erythrocytes have prosthetic group. The active component of
this prosthetic group is Haem. It relies on the presence of Fe. It
Combines with oxygen to form oxyhaemoglbin. Hb+O2=Hb02
It are eventually broken down by spleen into blood pigments called
billirubin, billivirdin & Iron. These Components are transported to
the liver where the Iron is recycled for use by new erythrocytes &
the blood Pigments froms bile salts.

Erythrocytes

Have a longevity of Approx 120 days

There are almost 4.5 to 5.8 million erythrocytes per micro liter of
human blood
Imp Function is to carry O2

Leucocytes.

Structure Function
Leucocytes Basically of two It is the Major Part
types of the Immune
Granular- System
Neutrophils,
Eosinophils,
Basophil
Agranular-
Monocytes &
Lymphocytes
Have a longevity
of few hrs to few
days
There are almost
5000-10000
leucocytes per
micro liter of
human blood

Thrombocytes

Structure Functions
Thrombocytes Blood Platelets Blood Clotting---
are cell to prevent blood
 Fragments loss
Disk Shaped
Diameter 2-4 um
Have many
granules but no
nucleus
Have a longevity
of 5-9 days
There are almost
1.5-4 lakh
Platelets per
micro liter of
human Blood
Lymphocytes
Approx 24% of leucocytes are Lymphocytes. These Produce foll
Anitbodies
T_cellsactivated by thymus Gland
B_cells activated by other lymphoid tissue( Bone Marrow Cells)
They Destroy antigen & produce antibody

Monocytes.
Approx 4% of leucocytes are monocytes. These are also Known as
Phagocytosis.
 Monocytes take longer to reach the site of infection than neutrophils
- but they eventually arrive in much larger numbers. Monocytes that
migrate into infected tissues develop into cells called wandering
macrophages that can phagocytize many more microbes than
neutrophils are able to.
Monocytes also clear up cellular debris after an infection.

Neutrophils

2-4% of Leucocytes are Neutrophils. Diameter 10-12mm.

Combat the effect of histamine in allergic reactions.
Phagocytize the anigen-antibody complexes
Destroy some parasitic worms.
Neutrophils are the first leucocytes to respond to bacterial invasion
of the body. They act by carrying out the process of phagocytosis
(see opposite), and also be releasing enzymes - such as lysozyme,
that destroy certain bacteria.
Basophils
60-70% of leucocytes are basophils.
Diameter 10-12mm
An increased (higher than usual) percentage of basophils in the
blood may indicate an inflammatory condition somewhere in the
body.
Also Helps in Phagocytosis

Eosinophils
0.5-1% of leucocytes are eosinophils.
Diameter 8-10mm
Liberate heparin, histamine, and seratonin in allergic reactions,
intensifying inflammatory response.
An increased (higher than usual) percentage of eosinophils in the
blood may indicate parasitic infection somewhere in the body.
Phagocytosis.

A phagocyte is a cell able to engulf and digest bacteria, protozoa,

cells, cell debris, and other small particles. Phagocytes include many
leucocytes (white blood cells) and macrophages - which play a major
role in the body's defence system.
Phagocytosis is the engulfment and digestion of bacteria and other
anigens by phagocytes.
Respiratory System.

Respiratory System

The Respiratory System is the anatomical system of an organism

that introduces respiratory gases into the interior and perform gas
exchange.
Molecules of Oxygen and carbon dioxide are passively exchanged by
diffusion, between the gaseous external environment and the blood.
This exchange occurs in the alveolar region of the Lungs

What is respiration?
Respiration is the act of breathing (Pulmonary Ventilation)
Inhalation also called as inspirationdraws gases into the lungs--
taking in O2
Exhalation also called as expirationforces gases out of the lungs---
giving off CO2

Functions of respiratory System

Supplies the Body with O2 and disposes of CO2
Filters inspired air
Produces sound
Contains receptors for smell
Rids the body of some excess water and heat
Helps regulate blood Ph

Components of respiratory System.

Nose
Pharynx
Larynx
Trachea
Bronchi
Lungs

Upper Respiratory system.

nose
nasal cavity
ethmoidal air cells
frontal sinuses
maxillary sinus
larynx
trachea

Lower respiratory tract.

Lungs
Bronchi
Alveoli
Nose
First portion of respiratory track. it is made up of Nose & an inner
chamber called the Nasal Cavity.
It serves as vent for air exchange
Two openings called Anterior Nares or Nostrils allows air to enter the
nose & pass into the nasal cavity.
Inside the Nasal cavity, inhaled air is warmed, moistened, and
cleaned so it can travel safely into other parts of the respiratory
tract.
It also contains chemical odorants and resonate the voice.
After circulating over the nasal cavity structures, air passes into
pharynx through two posterior nares.

Nose Bones & cartilage.

It is supported by bone, hyaline cartilage and dense fibrous
connective tissue.
The upper half is formed by the nasal bones and the medial plates of
the maxilla bones.
The more flexible lower half is framed by the lateral, greater alar,
and lesser alar cartilages.
Partitioning the nasal cavity into Rt & Lt Nasal Fossae(Sing Fossa) is
the septal cartilage.
Dense Fibrous connective tissue supports the rounded lateral wall of
the Nostrils, which are called as Ala Nasi.

Nasal Cavity.
Posterior to the nose is the Nasal cavity. This large passageway is
framed & supported by Several bones and cartilages.
RoofNasal bone, frontal bone, sphenoid bone& cribiform plate of
ethmoid bone.
 Lateral wallsby two maxilla bones
FloorPalatine processes of the maxilla bones& the horizontal
plates of the palatine bones

Vestibule
The vestibule is the portion of the Nasal cavity that lies directly
posterior to the external nares.
It is frequently exposed to destructive agents. To Compensate it is
lined by stratified squamous epithelium
Embedded in epithelial lining are large nose hairs called vibrissae.
The mucus that lines vibrissae entraps large airborne particles and
prevents them passing further.
Turbinates & Conchae
The turbinates are thin, curved, bony plates that project from the
walls of the nasal cavity into the respiratory passageway.
There are 3 turbinate on each side of the nasal cavity and all
covered by a thick layer of mucous membrane.
Smaller superior and middle turbinates are downward extensions of
the ethmoid bone. The large inferior turbinates are individual bones
that attach to Maxilla bone.
Each extends horizontally along the lateral wall of the nasal cavity
and add surface area to the passageway

Nasal Mucosa
Inside the nasal cavity, the surface of the turbinate's and meatuses
are lined by respiratory mucosa
Expanded view----- along the nasal surface is pseudostratified
ciliated columnar epithelium.
Interspersed among the columnar cells in the epithelium are many
flask shaped goblet cells.
All of the densely packed cells in the epithelium are embedded in
basement membrane, which adheres to a thick layer of lamina
propria. Dispersed throughout the loose connective tissue in the
lamina propria is a rich supply of blood vessels and many
seromucosal glands.
Respiratory Nasal Mucosaphysiology.
As air passes over the nasal mucosa, it is prepared or conditioned to
safely pass deeper into the respiratory system.
The heat radiated from the blood vessels in the lamina propria
warms the air to near body temp.
Simultaneously the watery mucus secreted from the globet cells and
seromucosal glands humidifies the air and traps foreign particles
Wave like beating of the cilia along the free surface of the columnar
epithelial cells moves the debris filled mucus to the throat

Olfactory Mucosa.
It lines the roof of the nasal cavity and superior turbinates and is
structurally modified to detect odor producing chemicalsodorants.
Expanded View in the epithelium layer are millions of the
specialized nerve cells called olfactory receptors. The odorant
sensitive tips of the receptor protrude into the nasal cavity from the
free surface of the eipthelium
Several non motile cilia extended from each bulbous tip. Along the
cilia are many binding sites for Odorants
Surrounding the receptors are many elongated supporting cells or
sustentacular cells
A thin layer of watery mucus made by the supporting cells and
olfactory gland covers the receptor cilia and microvilli
Odorants are drawn into this fluid layer where they dissolve and
then bind to cilia receptors.
Binding the odorants causes the olfactory receptors to generate
electro-chemical impulses. Receptor axons carry the impulses
through the holes in the cribiform plate to the olfactory bulbs at the
base of the brain
Paranasal Sinuses.
Several open, air filled chambers called paranasal sinuses are
present in the bones surrounding the nasal cavity. In the cheeks are
two large maxillary sinuses, just above the orbits are two frontal
sinuses, between the eyes are several small ethmoid air cells, and at
the base of the skull are two sphenoid sinuses.
A thin layer of nasal mucosa lines the paranasal sinuses. Mucus
produced in the sinuses normally drains out of small apperatures
and adds to the mucus in the nasal cavity
 The open sinuses also help lighten the skull and resonate the voice
sounds.
Sinusitis most often occurs when infections, allergies , or tissue
irritants cause the sinus mucosa to become inflamed. The
edematous membranes block the ostia drainageways that lead to
the nasal cavity and mucus accumulates in the open sinus chamber.
Air trapped in the sinus is absorbed into the blood stream, creating
a negative pressure or vaccum,,which indeed will create a pain

Pharynx.
It is 4 to 5 inch fibromuscular tube that conducts air from the nasal
cavity to the larynx. The cavity of Pharynx is abt 12.5 cm long. It is
conical in form, with the base upward, and the apex downward,
extended from the undersurface of the skull to the level of cricoid
cartilage in front,and that of 6th cervical vertebra behind
It is commonly known as Throat,serves dual function
Divided into 3 anatomical regions
Nasopharynxlocated behind nasal cavity, from interior nares to
soft palate, Pendulous Uvula
Oropharynx located behind root of tongue,, from soft palate to
epiglottis and hyoid bone
Laryngopharynx located behind larynx,from epiglottis to cricoid
cartilage

Epithelial Lining of Pharynx.

The surface of nasopharynx is covered by the same nasal mucosa.
 The other two regions of pharynx , the oropharynx and
laryngopharynx are lined by non keratinizing stratified squamous
epithelium.
These areas also forms the part of the digestive tract. When food is
swallowed, the multiple cell layer in the stratified epithelium help
protect the underlying tissues from damage caused by food moving
through the passageway.

Eustachian tubes.
Along the lateral walls of the nasopharynx are the openings to the
auditory tubes(Eustachian tubes or pharyngotympanic tubes)
Each Narrow tubes connect the nasopharynx with middle ear,
structure found inside the air filled tympanic cavity of the temporal
bone.
Auditory tubes are opened by yawning, which allows air to flow
between the middle ear and the nasopharynx.
This process equalizes the pressure on both sides of the eardrum,
making it easier for the eardrum to vibrate in response to sound
waves.

Tonsils & Adenoids.

The opening to the pharynx from the nose and mouth are protected
by a ring of tonsils and other type of lymphoid tissue
Palatine tonsils --- Along the anterolateral walls of oropharynx,,often
referred as the tonsils. Pathogens such as viruses and bacteria
drain into these masses, where they are destroyed. When this
structure become sore & inflammed are called as tonsillitis.
 Pharyngeal tonsil: Embedded in the posterior wall of the
nasopharynx, near the midline is the Pharyngeal tonsil (Adenoids)
Inflammation of the Adenoids causes breathing difficulties and an
alteration of voice.
Lingual Tonsil: Guarding the base of the tongue is the lingual tonsil
Larynx
It is almost 1.5 inch tube that is located in the throat, below the
base of the hyoid bone and tongue and anterior to oesophagus.
Making up its wall are several supportive cartilages, interconnecting
ligaments, intrinsic and extrinsic muscles and a mucosal lining.
Carefully guided passageway between the pharynx and trachea
It also houses the vocal folds and ligaments that produce voice
sounds
 The walls of the larynx are composed of cartilage,ligaments,
membranes, muscles & respiratory mucosa
There are 9 laryngeal cartilages, 3 paired & 3 single. Together they
form a skeletal framework.
Loosely holding the cartilages together are several ligaments &
membranes
Two set of muscles control larynx movements. Intrinsic muscles
regulates the tension & orientation of the ligaments that produce
voice.
Extrinsic muscles adjust the position of the larynx during the
swallowing process
Cricoid cartilage.
The U shaped hyoid bone serves as an attachment point for the
tongue muscles.
Inferior to the thyroid cartilage is the ring shaped cricoid cartilage.
It is also composed of hyaline cartilage
The anterior portion of the cricoid cartilage is narrow & referred to
as the arch. The posterior portion, called the lamina is much broader
and forms much of the larynx back wall.
Superior to the lamina are arytenoid cartilages, which attach to the
vocal cords
Inferior to the cricoid cartilage is trachea

Epiglottis
The epiglottis is a leaf shaped flap of tissues that projects obliquely
from the top of the larynx. Its shape and position are supported by a
band of elastic cartilage, which attaches to the back of the thyroid
cartilages by a small ligament
During the swallowing process, the extrinsic muscles move the
larynx upward. The flexible epiglottis flattens as it strikes the base
of the tongue & Covers the opening to the larynx.
Instead of entering the closed larynx, swallowed food particles
travel into the oesophagus. This allows extrinsic muscles to relax
and the larynx to reopen

Arytenoid, corniculate & cuneiform cartilages.

A pair of pyramid shaped arytenoid cartilages are located along the
upper edge of the cricoid lamina. On top of each arytenoid cartilage
is a small corniculate cartilage.
Each arytenoid cartilage attaches to the posterior end of vocal
ligament
Movements of the arytenoid cartilages control the length & Position
of vocal ligaments
Small cuneiform cartilages are embeded in the qudrangular
membranes and aryepiglottic folds that loosely connects arytenoid
cartilage to the eipglottis

Vocal Folds & Vestibular folds.

Projecting into the lumen of the larynx are two pairs of soft tissue
folds
Each folds run from the back of the thyroid cartilage to the front of
the arytenoid cartilage.
The inferior folds are called as vocal folds or vocal cords
A narrow vocal ligament is embedded in each vocal fold. These
elongated bands of elastic tissue vibrate to produce voice sounds.
Unlike the rest of the larynx, the surfaces of the vocal folds are
covered by a protective layer of stratified squamous epithelium
Above the vocal folds are the vestibular folds.
Each Vestibular fold is formed by a thick layer of respiratory mucosa
and a supportive vestibular ligament.
 The vestibular folds are not directly involved in the process of voice
production. Instead, they lubricate the vocal folds with mucous
sections and help prevent food from entering the LRT

Glottis
The vocal folds and the space between the folds are referred to as
Glottis (Glottic opening)
Laryngeal Muscles can adjust the size of the glottic opening, depending
on the need.
The glottis expands into a triangular shape opening while breathing.
This allows air to move freely enter & leave the trachea & Lungs.
To make voice sounds, the laryngeal muscle reduce the size to open to
a narrow slit.

Phonation
Voice sound protection occurs when the glottis nearly closes and air
forced up from the lungs causes the vocal folds to vibrate.
Voice pitch is determined in part by movements of the arytenoid
cartilages, which attach to the posterior ends of the vocal folds and
embedded ligaments.
The arytenoid cartilages sit on the upper edge of the lamina of
cricoid cartilage and can move in many directions

Intrinsic Muscles of the larynx.

 The intrinsic muscles move the arytenoid cartilages and adjust the
tension applied to the vocal folds & Ligaments. They are called as
intrinsic because they originate and insert on the larynx

Muscle Name Action

Transverse Adduction
Arytenoid
Lateral Adduction
cricoarytenoids
Posterior Abduction
Cricoarytenoids
Vocalis & Loosen
thryoarytenoids
Cricoarytenoids Tighten
Lower Respiratory Tract:
Trachea:
Trachea or windpipe Is a cartilaginous & Membranous tube,
extending from the lower part of the larynx with the 6 th Cervical
vertebra, to the upper border of the 5th thoracic vertebra, where it
divides into two bronchi.
4-5 inch (10-12Cm) vertical nearly cylindrical tube that runs through
the neck and chest, just anterior to esophagus
Trachea has a wide lumen (1 inch or 2.5 cm) & functions to conduct
air between the larynx & Primary Bronchi
Trachea Cartilagenous rings:
Embedded in the wall of trachea are 16 to 20 tracheal rings made up
of hyaline cartilage
The cartilage rings stiffen the tracheal wall so the lumen stays open
during breathing
In back the rings are incomplete, giving them a characteristic of C-
Shape
Cartilages are placed horizontal above each other, separated by a
narrow interval.
They measure abt 4 mm in depth and 1mm in thickness
Tracheal wall Anatomy:
The wall of trachea is made up of 4 layers
Along the luminal Surface the trachea is lined by respiratory
mucosa. Goblet cells in the pseudostratified ciliated columnar
epithelium produce mucus, which warms, moistens and remove
foreign particles from the air as it flows through trachea.
Deep to Mucus is submucosa. Like the Lamina Propria, it is
composed of areolar connective tissue, blood vessels, neurons and
glands are also present
The seromucous gland secret a combination of water and mucus to
the luminal surface of the trachea through narrow ducts. The mucus
adds to that secreted by the goblet cells.
External to submucosa is a cartilaginous layer containing C Shaped
cartilage rings.
The open end of the rings are attached by the trachealis muscle.
While coughing, these smooth muscle fibers contract. This narrow
the tracheal lumen and increases the velocity of airflow, which helps
dislodge mucus and foreign particles
 The outer layer of the trachea, the adventitia, is a band of loose
connective tissue that loosely binds the trachea to the esophagus
and other near by organs.

Blood & Nerve Supply

 The trachea is supplied with the blood by inferior thyroid arteries.
The
Nerves are derived from the vagus and the recurrent nerves, and
from the sympathetic, they are distributed to the Trachealis muscles
and between the epithelial cells.

Bronchi :
At the approximate level of the sternal angel, trachea bifurcates into
Rt & Lt primary Bronchi.
Each bronchus runs freely for a few centers, then enters into
respective lungs. Air is conducted through the primary bronchi into
& out of each lung.
After entering a lung, the primary bronchi each divide into
Secondary bronchi. The secondary bronchi are also known as lobar
bronchi because each one directly conducts air to and fro from one
of the five lobes
Within a lobe, tertiary bronchi branch from the secondary bronchi
Each tertiary bronchus conducts air to and from a bronchopulmonary
segment, which is an anatomical & Functional division of a lobe.
There are 10 bronchopulmonary segments in the Rt Lung & 8 in lt
Lung due to fusion of S1-2 & S7-8
Because they Conduct air in & out of the bronchopulmonary
segments, tertiary bronchi are also known as segmental bronchi.

Rt Bronchus:
Rt Bronchus (bronchus Dexter) is wider, shorter & more vertical in
direction than lt.
It is about 2.5 cm long, and enters Rt lung opposite the 5 th thoracic
vertebra.
Rt Pulmonary artery lies first below & then infront of it.
 About 2 cm from its commencement, it gives off a branch to the
upper lobe of the Rt Lung which is termed as eparterial branch
(since it rises above the Rt Pulmonary artery)
The bronchus then passes below the Rt Pulmonary artery and is
known as the hyparterial branch,which divides into two branches for
Middle & lower lobes

Lt bronchus:
Lt bronchus (bronchus sinister) is smaller in caliber but longer than
right, being nearly 5 cm long.
It enters the root of the Lt Lung opposite 6th thoracic vertebra.
It passes beneath the aortic arch, crosses infront of the oesophagus,
the thoracic duct, and the descending aorta & has Lt Pulmonary
artery lying first at above and then infront of it.

Bronchial wall Anatomy:

In cross section bronchial wall appears similar to trachea.
Respiratory mucosa lines the luminal surface. Mucus secreting
goblet cells are present in the epithelium. However they are less in
numerous than in the trachea.
Deep to mucosa is a layer containing smooth muscle fibres, hyaline
cartilage, & Scattered Seromucous & mucous glands
The cartilages appears as rings in the larger bronchi but changes
into irregular sized plates in the smaller bronchi.
The smooth muscle fibres are located between the mucosa &
Cartilage plates and form a nearly complete ring. They are
 involuntarily controlled & their movements alters the size of the
bronchial lumen.
The changes in lumen size may increase the air flow during normal
breathing, protects lungs tissue from foreign particles & irritants or
may improve the effectiveness of cough.
A narrow band of adventitia covers the outer bronchial wall, which
connects the bronchus to the surrounding lung tissues.

Lungs (Pulmones):
It is the essential organ of respiratory system, 2 in number, placed
one on either side within the thorax, & Separated from each other by
the heart & other contents of mediastinum.
The substance of the lung is of a light, porous, & Spongy texture; it
floats in water, and crepitates when handled, owing to presence of
air in the alveoli.
It is highly ealstic.
The surface is smooth shining and marked out into numerous
polyhedral areas, indicating the lobules of the organ, each of these
areas are crossed by numerous lighter lines.
 At birth lungs are pinkish white in color, in adult life color is a dark
slaty gray, mottled in patches, and as age advances this mottling
assumes as a black color. The coloring matter consists of granules of
a carbonaceous substances deposited in the aerolar tissue near the
surface of the organ. It increases in quantity as age advances, and is
more abundant in males than in females. As a rule the posterior
border of the lung is darker than anterior.
RT Lung Wt625gm,,Lt Lung 567gm
The lungs are heavier in male than females, their proportion to the
body is 1 to 37,,while in female it is 1 to43.
Each Lung is conical in shape,,& has apex,base,3 borders & 2
surfaces
The apex is rounded & extends into the root of the neck, reaching
from 2.5 to 4 cm above the level of the sternal end of first rib.
The base is broad, concave and rests upon the convex surface of the
diaphragm. Since the diaphragm extends higher on the rt than on
the lt side, the concavity on the base of the rt lung is deeper that on
the lt

Surfaces:
Costal Surface: Anterior, lateral, posterior surface which lies
adjacent to the ribs are called as Costal Surface
Mediastinal Surface:It is in contact with the Mediastinal Pleura. It
Presents a deep concavity, the cardiac impression, which
accomadates the pericardium.
Above & behind this concavity is a triangular depression named the
hilum, where the structures which form the root of the lung enter &
leave the viscus. This is the region where blood vessels, bronchi &
nerves enter & leave the lung.

Three Borders:
Inferior Border: it is thin & sharp where it separates the base from
the costal surface ,medially it divides the base from the mediastinal
surface is it blunt & rounded.
 Posterior Border: It is broad & rounded, and is received into deep
concavity on either side of the vertebral column
Anterior Border: it is thin & sharp & overlaps the front of the
pericardium. The anterior border of rt lung is almost vertical.

Lobes:
Lungs are anatomically & functionally divided into larger subunits
called Lobes.
Each lobe receives air from its own secondary bronchi & is separated
from its neighbours by one or more fissures.
Rt lung is divided into 3 lobes,Superior,middle and inferior.
Between the superior & middle lobes is the horizontal fissure.
Separating the middle and inferior lobe is the oblique fissure
The middle lobe, the smallest lobe of the Rt lung, is wedge shaped
and includes lower part of the anterior border & the anterior part of
the base of the lung.
The right lung, although shorter by 2.5 cm. than the left, in
consequence of the diaphragm rising higher on the right side to
accommodate the liver, is broader, owing to the inclination of the
heart to the left side; its total capacity is greater and it weighs more
than the left lung.
Lt Lung Lobes
Lt lobe is divided into two lobes, an upper and lower by an
interlobular fissure, which extends from the costal & mediastinal
surface of the lung both above and below the hilus.
Superior lobe lies above and infront of the fissure & includes apex,
anterior border and a considerable part of the costal surface and
greater part of the mediastinal surface of the lung.
Inferior lobe, larger of the two is situated below and behind the
fissure, and comprises almost the whole of the base, a large portion
of the costal surface and the greater part of the posterior border.

Bronchopulmonary Segments:
Lung lobes are divided by connective tissue walls into compartments
called bronchopulmonary segments.
Typically there are 10 segments in Rt Lung and 8 segments in Lt lung
Each Segment functions independently and is supplied by its own
tertiary bronchus, artery, lymph vessels and autonomic nerves.
Thus if one segment is infected or damaged, others in the same lobe
may not be affected.
Secondary Pulmonary lobules:
The bronchopulmonary segments are partitioned by walls of
connective tissues into many polygonal shaped secondary
pulmonary lobules
 The secondary pulmonary lobules measure appr 1-3 cm in diameter
and are most anatomically well-defined along the surface of the
lung.
A secondary pulmonary lobule typically contains 3-5 terminal
bronchioles, respiratory bronchioles, alveolar ducts and alveoli
(where gases are exchanged with surrounding blood vessels)

Bronchopulmonary segments:
It is partitioned by walls of connective tissue or septa into many
polygonal shaped secondary pulmonary lobules.
Secondary pulmopnary lobules measures approximately 1-3 cm in
diameter and are most anatomically well defined along the surface
of the lung.
A secondary pulmonary lobule typically contains 3-5 terminal
bronchioles and many respiratroy bronchioles, alveolar ducts and
alveoli.

Bronchioles;
From the tertiary bronchi, air is conducted to and fro from the
alveoli by a series of small branching tubules called bronchioles.
Bronchioles branch many times on their way to the alveoli, and each
division produces tubules that are progressively smaller in diameter
A lobular bronchiole (preterminal bronchiole) conducts air in & out
from the secondary pulmonary lobule
After entering a pulmonary lobule, a lobular bronchiole divides into
3 or more terminal bronchioles.
Terminal bronchiole measures 0.5-1 mm in diameter & have many
walls made of simple ciliated cuboidal cells, a few smooth muscle
cells and connective tissue.
They are two thick for air exchange, so these tubes are considered
to be the last of the conducting zone structures.
Two or three respiratory bronchioles typically branch from each
terminal bronchiole. These thin walled tubules are the first
respiratory zone structures, and they in turn give rise to alveoli,
alveolar ducts, and alveolar sacs
Anatomy of the bronchiole wall:
A cross sectional view of a bronchiole reveals more about the tissue
layer that make up the wall.
In the large bronchioles, the epithelial lining consist of ciliated
simple columnar cells. The epithelium changes to simple cuboid cells
in the small bronchioles.
Goblet cells and seromucus glands become less numeorus with each
bronchiole Division
A ring of smooth muscle fibres surrounds the epithelium. During
exhalation these muscles contract to help force air out of the
bronchioles. The resulting compression causes the eithelium to fold.
The thin walled bronchioles are attached to the surrounding elastic
alveoli. This connection keeps the bronchioles from collapsing during
the breathing movements. Because they are needed for support,
cartilage plates are characteristically absent.
Lungs Alveoli.
Each of the respiratory bronchiole inside a pulmonary tubule give
rise to alveolar ducts.
Protruding from the thin walls of the alveolar ducts and respiratory
bronchioles are numerous cup shaped alveoli, each measuring about
0.2 to 0.5 mm in diameter.
Along the distal end of an alveolar duct, the alveoli are arranged
into grape like clusters. When 2 or more alveoli share a common
opening to an alveolar duct, they are referred to as alveolar sac.
 A magnified view of an alveolar sac reveals that the alveoli are made
up of two types of cells. About 95% of the alveolar surface consist of
simple squamous epithelial type I cells, and the remaining 5% is
occupied by type II cells.
These large, rounded cells are located between the type I cells and
secret pulmonary surfactant.
The complex of phospholipids and proteins in the surfactant reduce
surface tension inside the alveoli, which keeps the alveolar walls
from sticking together as they deflate during exhalation
 Small openings called alveolar pores perforate the interalveolar wall
and allow air to pass between alveoli.
A network of capillaries and many supportive collagen and elastic
fibres are found in the interstitial spaces that separate the alveoli.
Numerous macrophages protect the lung from damage. They move
about the air spaces and between the alveoli, where they remove
inhaled particles, foreign invaders, and other types of harmful
substances.

Respiratory Membrane :
To be exchanged, O2in the alveoli and CO2 in the blood capillaries
must rapidly penetrate a thin structural barrier called the
respiratory membrane.
The Membrane, which is only 0.5um thick, consist of the alveolar
squamous cell, the capillary endothelial cell, and the fused
basement membrane between the two

Pleurae & pleural cavity:

Each Lung is enveloped in its own double walled sac called Pleurae.
The inner wall, the visceral pleura, adheres to the outer surface of
the lung. The outer wall, the parietal pleura, is an extension of the
visceral pleura that doubles back itself at the hilum and runs along
the surface of the rib cage, diaphragm, and Mediastinum.
Both pleurae are serous membrane which secret a thin layer of
watery pleural fluid into the pleural cavity that separates them.
An open space does not normally exist in the pleural cavity, because
the pleural fluid loosely attaches the two membranes. During
breathing movements, this slippery seal allows the two membranes
to freely slide past one another.
Respiration Mechanism:
Breathing or Ventilation
External Respiration exchange of gases between inhaled air and the
blood
Internal Respiration exchange of gases between the blood and the
tissue fluids
Cellular respiration

Breathing:
Ventilation is the exchange of air between the external environment
and the alveoli.
Air moves by flow from an area of high pressure to low pressure
All pressure in the respiratory system are related to the atmospheric
pressure (760mm hg at Sea level)
Air will move in and out depending on the pressure in the alveoli.
The body changes the pressure in the alveoli by changing the
volume of the lungs
The rhythm of ventilation is also controlled by the Respiratory
center which is located largely in the medulla oblongata of the
brain stem.
This is part of the autonomic system and as such is not controlled
voluntarily.
While resting, respiratory system sends out action potentials that
travel along the phrenic nerves into the diaphragm and the external
intercostal muscles of the rib cage, causing inhalation.
Relaxed exhalation occurs between the impulses when the muscles
relax.
Normal adult have a breathing rate of 12-20 respirations per
minute.

Pathway of Air
Inhaled air at sea level is composed of O2 21%, Nitrogen 78% and
CO2 0.04% and other are significantly Less.
Nose------Nasal Cavity---- Pharynx--- larynx----- Trachea------ Primary
Bronchi ---- Secondary Bronchi---- Tertiary bronchi----Bronchioles.

Inspiration or Inhalation:
Inspiration is initiated by contraction of the diaphragm & intercostal
muscles when they receive nervous impulses. The phrenic nerves
stimulate the diaphragm to contract and move downward into the
abdomen. Downward movement of the diaphragm enlarges the
thorax. Intercostal muscles also increases the thorax by contracting
and drawing the ribs upward and outward.
Due to contraction of the Diaphragm muscle and the intercostal
muscles, volume of the thoracic cavity increases.
The lungs are held to the thoracic wall by negative pressure in the
pleural cavity, a very thin space filled with few militers of pleural
 fluid. Negative pressure in the pleural cavity is enough to hold the
lungs open in spite of the inherent elasticity of the lung tissue.
Hence as the thoracic cavity increases in volume, lungs are pulled
from all sides to expand, causing a drop in the pressure within the
lung itself.
Assuming the air way is open, air from external environment follows
its pressure gradient down and expands the alveoli of the lungs,
where gas exchange with the blood takes place.
As long as pressure within the alveoli is lower than the atmospheric
pressure air will continue to move inwardly, but as soon as the
pressure is stabilized air movement stops.

Expiration or Exhalation
Expiration is a passive process and does not require muscles to
work.
When the lungs are stretched and expanded, stretch receptors
within the alveoli send inhibitory nerve impulse to the medulla
oblongata, causing it to stop sending signals to the diaphragm and
the intercostal muscles to contract.
The muscles of the respiration and the lungs itself are elastic, so
when the diaphragm and intercostal muscles relax there is an elastic
recoil, which creates a positive pressure, and air moves out of the
lung by flowing down its pressure gradient.
Voluntarily control of respiratory system is control by higher brain
function of the cerebral cortex. Deeper breathing, Sneezing &
coughing we exhale forcibly.
Another function of the respiratory system is to sing and to speak.
By exerting conscious control over our breathing and regulating flow
of air across the vocal cords we are able to create and modify
sounds.

Respiratory System Function:

Gas Exchange: O2 Enters and CO2 leaves
Regulation of Blood Ph: Altered by changing blood Co2 level.
Voice production: Movement of air past vocal folds makes sound and
speech
Olfaction: smell occurs when airborne molecules drawn into nasal
cavity
Protection: Against microorganisms by preventing entry and
removing them

Lung Compliance:
It is the magnitude of change in lung volume produced by a change
in pulmonary pressure. Compliance can be considered opp to
stiffness
A low lung compliance would mean that the lungs would need
greater than average change in intrapleural pressure to change the
volume of the lung.
 Two major things determine lung compliance. Any thicknening of
lung tissues due to disease will decrease the lung compliance, the
second is the surface tension at air water interfaces in the alveoli.
The surface of the alveoli cells is moist. The attractive force,
between the water cells on the alveoli, is called surface tension.

Control of respiration:
Co2 is converted into HCo3; most co2 produced at the tissue cells is
carried to lungs in the form of Hco3.
Co2 and H20 form carbonic acid Hco3
Changes to Hco3 & H+ ions
Result is H+ ions are buffered by plasma proteins

Homeostasis and Gas exchange:

Homeostasis is maintained by the respiratory system into 2 ways,
gas exchange and regulation of blood Ph.
Gas Exchange is performed by the lungs by eliminating Co2, a waste
product given off by cellular respiration. As co2 exits the body, O2
needed for cellular respiration enters body through the lungs, which
provides the energy for the body to perform many functions,
including nerve conduction and muscle contraction. Lack of O2
affects brain function, sense of judgment and a host of other
problems. It is in the lungs between the alveolar air and the blood in
the pulmonary capillaries. This exchange is a result of increased
concentration of O2, and a decrease of Co2. This Process of
exchange is done through diffusion.

External Respiration:
It is the exchange of gas between the air in the alveoli and the blood
within the blood capillaries. A normal rate of respiration is 12-25
breaths per minute. In external respiration gases diffuse in either
direction across the walls of the alveoli. O2 diffuses from air into the
blood and Co2 diffuses out of the blood into the air. Most of the Co2
is carried to the lungs in plasma as bicarbonate ions. When blood
enters the pulmonary capillaries, HCO3+H=H2co3,,which again splits
into CO2+H2O. This chemical reaction also uses up the Hydrogen
Ions, which gives blood a neutral PH, allowing HB to Bind up with the
O2
Cellular respiration
Oxygen must diffuse from the alveolus into the capillaries. It is due
to permeability of the capillaries.
After it is in the capillary, about 5% will dissolved in the blood
plasma. The other O2 will bind to RBC. RBC contains Hb that Carries
O2.
Blood with Hb is able to transport 26 times more O2 than plasma
without Hb. It Combines with HB to form Oxyhemoglbin by osmosis.
Now the blood carrying oxygen is pumped through the heart to the
rest of the body. Oxygen will travel in the blood into arteries,
arterioles, and eventually capillaries where it will be very close to
body cells. Now with different conditions in temperature and pH
(warmer and more acidic than in the lungs), and with pressure being
exerted on the cells, the hemoglobin will give up the oxygen where
it will diffuse to the cells to be used for cellular respiration, also
called aerobic respiration. Cellular respiration is the process of
moving energy from one chemical form (glucose) into another (ATP),
since all cells use ATP for all metabolic reactions.
It is in the molecules of the cell where O2 Is actually consumed and
Co2 produced.
As cells take apart the carbon molecules from glucose, these get
released as carbon dioxide. Each body cell releases carbon dioxide
into nearby capillaries by diffusion, because the level of carbon
dioxide is higher in the body cells than in the blood. In the
capillaries, some of the carbon dioxide is dissolved in plasma and
some is taken by the hemoglobin, but most enters the red blood
cells where it binds with water to form carbonic acid. It travels to
the capillaries surrounding the lung where a water molecule leaves,
causing it to turn back into carbon dioxide. It then enters the lungs
where it is exhaled into the atmosphere.

Respiratory physiology:

Respiration:
 Ventilation: Movement of air into and out of lungs
External respiration: Gas exchange between air in lungs and blood
Transport of oxygen and carbon dioxide in the blood
Internal respiration: Gas exchange between the blood and tissues

Respiratory System Functions:

Gas exchange: Oxygen enters blood and carbon dioxide leaves
Regulation of blood pH: Altered by changing blood carbon dioxide
levels
Voice production: Movement of air past vocal folds makes sound and
speech
Olfaction: Smell occurs when airborne molecules drawn into nasal
cavity
Protection: Against microorganisms by preventing entry and
removing them

Respiratory System Divisions:

Upper tract
Nose, pharynx and associated structures
Lower tract
Larynx, trachea, bronchi, lungs
Nose and Pharynx:

Nose
External nose
Nasal cavity
Functions
Passageway for air
Cleans the air
Humidifies, warms air
Smell
Along with paranasal sinuses are resonating
chambers for speech
Pharynx
Common opening for digestive and respiratory systems
Three regions
Nasopharynx
Oropharynx
Laryngopharynx
Tracheobronchial Tree:

Conducting zone
Trachea to terminal bronchioles which is ciliated for removal of
debris
Passageway for air movement
Cartilage holds tube system open and smooth muscle controls
tube diameter
Respiratory zone
Respiratory bronchioles to alveoli
Site for gas exchange
Bronchioles and Alveoli:

Alveolus and Respiratory Membrane:

Thoracic Walls
Muscles of Respiration:
Thoracic Volume:
Ventilation:
Movement of air into and out of lungs
Air moves from area of higher pressure to area of lower pressure
Pressure is inversely related to volume

Alveolar Pressure Changes:

Changing Alveolar Volume:

 Lung recoil
Causes alveoli to collapse resulting from
Elastic recoil and surface tension
Surfactant: Reduces tendency of lungs to collapse
Pleural pressure
Negative pressure can cause alveoli to expand
Pneumothorax is an opening between pleural cavity and air
that causes a loss of pleural pressure

Compliance:

Measure of the ease with which lungs and thorax expand

The greater the compliance, the easier it is for a change in
pressure to cause expansion
A lower-than-normal compliance means the lungs and thorax
are harder to expand
Conditions that decrease compliance
Pulmonary fibrosis
Pulmonary edema
Respiratory distress syndrome

Pulmonary Volumes:
Tidal volume
Volume of air inspired or expired during a normal inspiration or
expiration, Average is 500Ml
Inspiratory reserve volume
Amount of air inspired forcefully after inspiration of normal
tidal volume. Average is 2500ml
Expiratory reserve volume
Amount of air forcefully expired after expiration of normal tidal
volume. Average is 1000ml
Residual volume
Volume of air remaining in respiratory passages and lungs
after the most forceful expiration. Average is 1100ml
Inspiratory capacity
Tidal volume plus inspiratory reserve volume,,3000ML
Functional residual capacity
Expiratory reserve volume plus the residual volume,2100ml
Vital capacity
Sum of inspiratory reserve volume, tidal volume, and
expiratory reserve volume,4000 Ml
Total lung capacity
Sum of inspiratory and expiratory reserve volumes plus the
tidal volume and residual volume,5300Ml
Spirometer and Lung Volumes/Capacities:

Minute and Alveolar Ventilation:

Minute ventilation: Total amount of air moved into and out of
respiratory system per minute
Respiratory rate or frequency: Number of breaths taken per minute
Anatomic dead space: Part of respiratory system where gas
exchange does not take place
Alveolar ventilation: How much air per minute enters the parts of
the respiratory system in which gas exchange takes place

Physical Principles of Gas Exchange

Diffusion of gases through the respiratory membrane
Depends on membranes thickness, the diffusion coefficient of
gas, surface areas of membrane, partial pressure of gases in
alveoli and blood
Relationship between ventilation and pulmonary capillary flow
Increased ventilation or increased pulmonary capillary blood
flow increases gas exchange
Physiologic shunt is deoxygenated blood returning from lungs
Changes in Partial Pressures:
Hemoglobin and Oxygen Transport:
Oxygen is transported by hemoglobin (98.5%) and is dissolved in
plasma (1.5%)
Oxygen-hemoglobin dissociation curve shows that hemoglobin is
almost completely saturated when P02 is 80 mm Hg or above. At
lower partial pressures, the hemoglobin releases oxygen.
A shift of the curve to the left because of an increase in pH, a
decrease in carbon dioxide, or a decrease in temperature results in
an increase in the ability of hemoglobin to hold oxygen
A shift of the curve to the right because of a decrease in pH, an
increase in carbon dioxide, or an increase in temperature results in a
decrease in the ability of hemoglobin to hold oxygen
The substance 2.3-bisphosphoglycerate increases the ability of
hemoglobin to release oxygen
Fetal hemoglobin has a higher affinity for oxygen than does
maternal

Transport of Carbon Dioxide:

Carbon dioxide is transported as bicarbonate ions (70%) in
combination with blood proteins (23%) and in solution with plasma
(7%)
Hemoglobin that has released oxygen binds more readily to carbon
dioxide than hemoglobin that has oxygen bound to it (Haldane
effect)
In tissue capillaries, carbon dioxide combines with water inside RBCs
to form carbonic acid which dissociates to form bicarbonate ions and
hydrogen ions
In lung capillaries, bicarbonate ions and hydrogen ions move into
RBCs and chloride ions move out. Bicarbonate ions combine with
hydrogen ions to form carbonic acid. The carbonic acid is converted
to carbon dioxide and water. The carbon dioxide diffuses out of the
RBCs.
Increased plasma carbon dioxide lowers blood pH. The respiratory
system regulates blood pH by regulating plasma carbon dioxide
levels

CO2 Transport and Cl- Movement:

Ventilation-perfusion coupling::

Regulation of Blood pH and Gases:

Digestive System:

What is digestion?

Digestion is the process by which food is broken down into smaller

pieces so that body can use them to build and nourish cells and to
provide energy. Digestion involves mixing of food , its movement
through the Digestive tract, and the chemical breakdown into
smaller nutrients that body can absorb.
Digestive tract in adult is about 30 feet long. It starts from Mouth,
teeth, Salivary glands, Tounge. Oropharynx, Oesophagus, Stomach,
Small intestine, Large intestine, Liver, Gall baldder, Pancreas,
Rectum And Anus.

The Digestive tract

Travel path of the Food
Mouth
Oesophagus
Stomach
 Small intestine
Liver
Large intestine
Gall bladder
Pancreas
Rectum
Anus

Functions of Digestive system:

Food undergoes 3 types of processes in the body
Digestion
Absorption
Elimination
Digestion and absorption occur in the digestive tract. After the
nutrients are absorbed, they are available to the cells in the body
and are utilized by body cells in metabolism.

Activities of digestive system:

The Digestive system prepares nutrients for utilization by body cells
through 6 activities
Ingestion: The First activity of the digestive system is to take in food
through the mouth. This has to take place before anything else can
happen.
Mechanical Digestion: the large pieces of food that are ingested
have to be broken into smaller particles that can be acted upon by
various enzymes. This is mechanical digestion, which begins in the
mouth with chewing or mastication and continues with churning and
mixing actions in the stomach.
Chemical Digestion: The Complex molecules of carbohydrates,
proteins and fats are transformed by chemical digestion into smaller
molecules that can be absorbed and utilized by the cells. Chemical
digestion, through a process called hydrolysis, uses water and
digestive enzymes to break down the complex molecules.
Movements: after ingestion and mastication, food particles moves
from Mouth into the pharynx, then into the esophagus. This
movement is deglutition, or swallowing. Mixing movements occurs in
the stomach as result of smooth muscle contraction. These
repetitive contractions usually occurs in the small segments of the
digestive tract and mix the food particles with enzymes and other
fluids. The movement that propel the food particles through the
digestive tract are called peristalsis. These are rhythmic waves of
contractions that move the food particles through the various
regions.
Absorption: the simple molecules that result from chemical digestion
pass through the cell membranes of the lining in the small intestines
into the blood or lymph capillaries. This process is called absorption
Elimination: the food molecules that cannot be digested or absorbed
need to be eliminated from the body. The removal of indigestible
 wastes through the anus, in the form of feces, is called defecation or
elimination.

General Structure of the digestive system:

The long continuous tube that is the digestive tract is abt 9 meter
long. It opens at both the ends. Although there are variations in
each region, the basic structure of the wall is the same throughout
the entire length of the tube.
The wall of the digestive tract has four layers or tunics
Mucosa
Submucosa
Muscular layer
Serous layer or Serosa
The mucosa or mucus membrane layer is the innermost tunic of the
wall. It lines the lumen of the digestive tract. The mucosa consist of
the epithelium, an underlying loose connective tissue layer called
Lamina Propria, and a thin layer of smooth muscle called the
muscularis mucosa. In certain regions Mucosa develops folds that
increase the surface area. Certain Cells in the mucosa secrete
mucus, digestive enzymes, and hormones. In the mouth and anus,
where thickness for protection against abrasions is needed, the
epithelium is stratified squamous tissue. The stomach and intestine
have a thin simple columnar epithelial layer for secretion and
absorption
Submucosa is a thick layer of connective tissue that surrounds the
mucosa. This layer contains blood vessels, lymphatic vessels and
nerves. Glands may be embedded in this layer.
The smooth muscle responsible for movements of the digestive tract
is arranged in two layers, an inner circular layer and outer
longitudinal layer. The myenteric plexus is between two muscular
layer.
Above the Diaphragm, the outermost layer of the digestive tract is a
connective tissue called adventitia. Below the diaphragm, it is called
as serosa.
Mouth or Oral Cavity
The mouth or oral cavity is the first part of the digestive tract. It is
adapted to receive food by ingestion, break it into small particles by
mastication, and mix it with saliva. The lips, cheeks, and palate form the
boundaries. The oral cavity contains the teeth and tongue and receives
the secretions from the salivary glands.
 Lips and cheeks: the lips and cheeks help hold food in the mouth and
keep it in place for chewing. They are also used in the formation of
words for speech. The lips contain numerous sensory receptors that
are useful for judging the temperature and texture of the foods.
Palate: Palate is the roof of the oral cavity. The anterior portion is
the hard palate, is supported by bone. The Posterior portion, Soft
palate is skeletal muscle and connective tissue. Posteriorly soft
palate ends in a projection called the Uvula. During swallowing soft
palate and uvula moves upward to direct the food away from the
nasal cavity and into the oropharynx.

Tongue (L: Lingua, Gk: glossa)

It is a muscular hydrostat on the floor of the mouth which
manipulates food for the mastication.
It is the primary organ of taste, as much of the upper surface of the
tongue is covered in papillae and taste buds.
It is sensitive and kept moist by saliva, and is richly supplied with
nerves and blood vessels.
Its secondary function is phonetic articulation.
The average length of the tongue from oropharynx to the tip is
10cm.
It also assists with mastication (chewing), deglutition (Swallowing),
Articulation(speech), and oral cleaning.

Gross anatomy
It is attached by muscles to the hyoid bone, mandible, styloid
processes, and pharynx.
From anterior to posterior, tongue has 3 surfaces tip, body and base.
The tip is highly mobile, pointed anterior portion of the tongue.
Posterior to the tip is lies the body of the tongue, which has dorsal
and ventral surface
The tip or apex usually rests against the incisors and continues each
side into the margin.
The dorsum extends from the oral cavity into the oropharynx. A v-
shaped groove, the sulcus terminalis, runs laterally and
anteriorward from a small pit, the foramen cecum. The sulcus
terminal is the boundary between the oral part or anterior 2/3 rd and
the pharyngeal part, or posterior 1/3rd of the tongue. The foramen
cecum, which present indicates the site of the origin of the
embryonic thyroglossal duct.
The oral part of the dorsum may show a shallow median groove. The
mucosa has numerous minute lingual papillae
The filiform papillae: the narrowest and most numerous
Fungiform papillae: with rounded heads and containing taste buds.
Vallate papillae: about a dozen large projections arranged in a V-
shaped row in front of the sulcus terminalis and containing
numerous taste buds.
Folia: inconstant grooves and ridges at the margin posteriorly.
 The pharyangeal part of the dorsum faces posteriorly. The base of
the tongue forms the anterior wall of the oropharynx and can be
inspected by downward pressure on the tongue with a spatula or by
mirror.
Lymphatic follicles in the sub mucosa are collectively known as the
lingual tonsil. The mucosa is reflected onto the anterior aspect of
the epiglottis (median glossoepiglottic fold)and onto the lateral wall
of the pharynx (lateral glosso-epiglottic fold)
The depression on each side of the median glosso-epiglottic fold is
termed as the Vallecula.
The inferior surface of the tongue is connected to the floor of the
mouth by the frenulum, lateral to which deep lingual vein can be
seen through the mucosa. Lateral to the vein is a fringed fold, the
plica fimbriata. The tongue contains a number of lingual glands.
The root of the tongue rests on the floor of the mouth and is
attached to the mandible and hyoid bone. The nerves, extrinsic
muscles, and vessels enter or leave the tongue through its root.

Teeth
Teeth are grinding machine of the body and important for
mastication
The Crown
This is the part of the tooth that we see in the mouth
It is made up of enamel, dentine and pulp.
The appearance of the teeth varies in shape and size.
The front incisor teeth have a straight edge as a cutting tool.
The canine or eye teeth are the pointed long teeth between the
incisor and premolar teeth.
The pre-molar and molar teeth are larger and have cusps.
A cusp is the raised pointed part of the chewing surface of a tooth.
The presence of large cusps on pre molar and molar teeth marks the
main difference between them and the front teeth.
Pre molar teeth have two cusps
Molar teeth each have four or more cusps

Enamel
The enamel is the white hard covering over the crown of the tooth
It is shaped into cusps, fissure and pits in premolar and molar teeth
It is the hardest material in the body and does not have a nerve
supply. Chipping or damage to enamel only will not be painful
It also does not have a blood supply.
This results in a chipped tooth remaining exactly as it is.
Enamel cannot heal or repair as bone or dentine can

Dentine
Dentine is a cream coloured hard material that makes up the bulk of
the tooth.
 It is covered by enamel on the crown, and by cementum on the
roots.
The dentine surrounds and protect the nerves and blood vessels in
the crown and the roots
Dentine is alive or vital in as much as more dentine can be formed,
and it can register pain
A protective layer of secondary dentine can be layed down over the
pulp
This happens in response to caries, attrition, abrasion, erosion or
fracture of a tooth, when the dentine becomes exposed.
The tooth becomes sensitive to temperature changes and feels
painful, when the dentine is exposed in the above mentioned ways.

Pulp
The nerves and blood vessels of the tooth are called the pulp
The pulp occupies the root canals, and the pulp chamber in the
crown of the tooth.
When it is exposed to infection by decay or injury it will die and
cause severe pain. An abscess will develop on the root.
The tooth will have to be extracted if a root canal treatment is not
performed to save it.

The roots
The roots are embedded in the tooth socket in the jaw bone.
The front incisor and eye teeth have a single root.
Pre-molar teeth (bicuspids) have one or two roots
The molar teeth can have two or three roots
Each root has a root canal for the nerves and blood vessels to pass
through
Roots are covered by cementum and held in place by the periodontal
ligament.

Periodontal membrane or ligament

The periodontal ligament attaches the roots to the alveolar bone of
the jaw
It has both a nerve and blood supply
The ligament provides an elastic cushion between the tooth and the
bone. Slight movement of a tooth is made possible by the ligament.
Teeth are not rigidly joined to bone. There is flexibility.
Salivary Glands
Salivary glands are defined as compound, tubuloacinar, merocrine,
exocrine glands, whose ducts open into the oral cavity. Compound
refers to the fact that salivary gland has more than one tubule
entering the main duct. Tubuloacinar describes the morphology of
the secreting cells. Merocrine indicates that only the secretion of the
cell is released and not the cytoplasm
Salivary glands are complex networks of hollow tubes and secretory
units that are found in specific location of the mouth
 In addition to three major paired salivary glands, 600-1000 minor
salivary gland line the oral cavity and oropharynx, contributing a
small portion of the salivary production

Parotid Glands
The parotid gland represents the largest salivary gland, averaging
5.8 cm in width, and 3.4 cm in length. The average weight of parotid
gland is 14.8 gm. It is irregular, wedge shaped, and unilobular,
yellowish mass, lying largely below the external acoustic meatus,
between the mandible and sternocleidomastoid. A detached part of
gland lies above the upper zygomatic arch.
The tail of the parotid overlies the upper 1/4th of the
sternocleidomastoid muscle and extends towards the mastoid
process.

Parotid Gland relations

It has 5 processes (3 superficial and 2 deep)
Above: lies external auditory meatus and temporomandibular joint.
anteriorly: it overflows the mandible with overlying masseter.
Medially: lies the styloid process and its muscle separating the
parotid from internal juglar vein, internal carotid artery, last four
cranial nerves and lateral wall of the pharynx
Branches of facial nerve emerges at the anterior, upper and lower
borders of gland.

Parotid Duct (Stenson Duct)

About 5 cm long, this duct begins at the confluence of the two main
tributaries within the anterior part of the gland, and then crosses
the masseter a finger breadth below the zygomatic arch. It runs
short obliquely forward and open upon a small papilla opposite the
second upper molar crown.
The wall of parotid duct is thick, with an external fibrous layer
containing smooth muscle and mucosa lined by low columnar
epithelium. Its caliber is about 2mm, although smaller at its oral
opening.

Vessels and nerves

The parotid artery is supplied transverse facial artery from the
superficial temporal artery providing blood to parotid gland,
stensens duct. The veins drain into the external jugular through the
local tributaries of retromandibular vein, which lies deep to the
facial nerve.
The lymph vessels end in the superficial and deep cervical lymph
nodes.
The nerve innervation is autonomic, consisting of sympathetic fibers
from the external carotid plexus and parasympathetic fibers which
reaches it via the tympanic branch of the glossopharyngeal nerve.

Sub mandibular glands

 It is situated in the anterior part of the digastrics triangle, formed by
the anterior and posterior bellies of the digastric muscle and the
inferior margin of the mandible.
The paired submandibular glands are irregular(roughly J) in shape
and about the size of walnuts (10gm). Each consist of a large
superficial duct, and a smaller deep part. Although predominately
serous, they are seromucous glands.
Submandibualr Duct (whartons Duct): this duct is abt 5 cm long,
and has a thinner wall than parotid duct. It begins from numerous
tributaries in the superficial part of the gland, and opens into the
floor of the mouth on the summit of the sub lingual papilla at the
side of the frenulum of the tongue.

Vessels and Nerves for submandibular

It is supplied by facial artery. The veins drain into the common facial
or lingual vein. Lymph passes to submandibular lymph nodes. Nerve
supply is from the branches of submandibular ganglion.

Sub lingual gland

This is the smallest of the major salivary glands. The almond shaped
gland lies just deep to the floor of the mouth mucosa between the
mandible and genioglossus muscle. It is bounded inferiorly by the
mylohyoid muscle. Whartons duct and the lingual nerve pass
between the sub lingual gland and the genioglossus muscle.
Unlike the parotid and submandibular glands, the sub lingual gland
lacks a single dominant duct. Instead it is drained by approximately
10 small ducts (Ducts of Rivinus), which exit the superior aspect of
the gland and open along the sublingual fold on the floor of the
mouth.

Vessels and nerves for the sub lingual gland

The gland receives its blood supply from the lingual and submental
arteries.
The nerve supply is similar to that of submandibular gland.
Lymphatic drainage goes to the sub mandibular nodes.

Minor Salivary glands

These are located beneath the epithelium in almost all parts of the
oral cavity. These glands usually consist of several small groups of
secretory units opening via short ducts directly into the mouth. They
lack a distinct capsule, instead mixing with the connective tissue of
submucosa or muscle fibres or tongue or cheek. It consist of labial
and buccal glands, glossopalatine glands, weber galnds(superior
pole of tonsil), von-ebner gland(base of tongue) and lingual gland.

Histology
The secretory unit consists of the acinus, myoepithelial cells, the
intercalated duct, the striated duct, and the excretory duct. All
 salivary acinar cells contain secretory granules, in serous glands,
these granules contain amylase, and in mucous glands, these
granules contain mucin Acini
Depending upon the primary secretion, glands are divided into 3
types
Serous (protein-Secreting): speherical cells rich in zymogen granules
Mucous(Mucin-Secreting): more tubular shaped cells, mucinogen
granules are washed out on histo preparations giving an empty cell
preperation
Mixed: serous demilunes or predominantly mucous acinar cells
capped by a few serous acinar cells.
Mucous cells: they contain large translucent mucinogen granules
consisting of precursor of mucin and appear pale or translucent. It
forms a viscous secretion containing mucin, a useful lubricant for
food and oral mucosa
Serous Cells; they contain opaque small zymogen granules
consisting of a precursor of ptyalin. It forms a thin watery secretion
containing ptyalin which initiates digestion of starch to maltose.
The parotid gland is a purely serous salivary gland. Ofnote, the
parotid gland is unique in that it contains many fat cells, in fact, the
adipocyte to acinar cell ratio in the parotid is 1:1
The sub mandibular cell is mixed, but predominately serous,
Approximately 10% of its acini are mucinous
The sub lingual gland is mixed, but predominately mucous

Saliva
Saliva is a clean, tasteless, odorless, slightly acidic viscous fluid,
consisting of secretions from the parotid, sublingual, submandibular
salivary glands and mucosal glands of oral cavity.
Composition: Mixed saliva contains 99.5% water and 0.5% solids.
Solids are organic substances and inorganic substances. Apart from
these gases are also found in saliva.
Organic Substances: salivary proteins: Mucin and albumin, Salivary
Enzymes: Amylase, maltase, lysozyme, phosphates and carbonic
anhydrase Blood group components: antigens, free amino acids, non
protein nitrogenous substances like urea, uric acid, creatinine and
hypoxanthine.
Inorganic Substances: Sodium, Calcium, Potassium, bicarbonate,
bromide, chloride, fluoride and Phosphate.
Gases: Oxygen, Carbon dioxide and nitrogen.

Properties of Saliva
It is also called as liquid enamel as it is a rich source of various
minerals.
Total amount: 1200-1500ml in 24 hrs. A large proportion of this
volume is secreted at meal time when the secretory rate is highest.
Consistency; Slightly cloudy because of the presence of cells and
mucin
Reaction: Usually slightly acidic PH(6.02 7.05)
 Specific Gravity: 1.002 to 1.02

Functions of saliva
8 Major functions
Moistens oral mucosa. In fact, the mucin layer on the oral mucosa is
thought to be the most imp nonimmune defense mechanism in the
oral cavity.
Moistens dry food and cools hot food
Provides a medium for dissolved foods to stimulate the taste buds.
Buffers Oral Cavity contents, Saliva has a high concentration of
bicarbonate ions.
Digestion: Alpha-amylase contained in saliva, breaks 1-4 glycoisde
bonds, while lingual lipase helps break down of fats. Ptyaline
converts cooked starch into maltose
Controls bacterial flora of the oral cavity.
Mineralization of new teeth and repair of precarious enamel lesions.
Saliva is high in calcium and Phosphate.
Protects the teeth by forming a protective Pellicle. This signifies a
saliva protein coat on the teeth which contains antibacterial
compounds. Thus, Problem with the salivary glands generally result
in rampant dental caries.
Parotid Gland relations

Salivary Glands
 Esophagus

The esophagus or gullet is a muscular canal. It is about 23 to 25cm

long extending from the pharynx to the stomach. It begins in the
neck at the lower border of the cricoid cartilage, opposite the sixth
cervical vertebra, descends along the front of the vertebral column,
through the posterior and superior mediastina, passes through the
diaphragm and enters the abdomen, & ends at the cardiac Orifice of
the stomach, opposite the 11th cervical vertebra.
The general direction of esophagus is vertical, but it presents two
slight curves in its course. At its commencement it is placed in the
middle line, but it inclines to the left side as far as the root of the
neck, gradually passes to the middle line again at the level of the 5 th
thoracic vertebra & finally deviates to the left as it passes forward to
the esophageal hiatus in the diaphragm. It is the narrowest part of
the digestive tube, and is most contracted at its commencement,
and at the point where it passes through the diaphragm

Relations of Esophagus
Cervical Portion:
Anteriorly: Trachea, thyroid gland(lower part of the neck)
Posteriorly: Vertebral Column
Either side: common carotid artery (especially to the left, as it
inclines to the lt side), lobes of the thyroid gland and recurrent
nerves

Thoracic Portion:
 It is first situated in the superior mediastinum
Anterior: Trachea

Posterior: Vertebral Column, a little to the lt side of median line

It then passes behind and to the right of the aortic arch
Then descends into the posterior mediastinum along the rt side of
the descending aorta, then runs infront and a little to the left of the
aorta
It enters the abdomen at the level of the 10th thoracic vertebra.
While perforating the diaphragm, there is distinct dilatation,
Anterior: Trachea, lt bronchus, pericardium and the diaphragm
Behind: Vertebral column, Rt aortic intercostal arteries, thoracic
duct
Lt side: ascending Aorta, lt subclavian artery, thoracic duct and Lt
pleura, Lt recurrent nerve
Rt side: Rt Pleura,

Abdominal Portion;
It lies in the esophagus groove on the posterior surface of the left
lobe of the liver. It measures about 1.25 cm in length and only its
front and left aspects are covered by peritoneum, it is somewhat
conical with its base applied to the upper orifice of the stomach, and
is known as antrum cardiacum

Structure of esophagus

4 coats
External or fibrous, Muscular, submucous or areolar and an internal
or mucous coat
Muscular coat (tunica Mucosa) is composed of two planes of
considerable thickness, an external of longitudinal and an internal of
circular fibers.
Areolar or sub mucosa(tela Submucosa) coat connects loosely the
mucous and muscular coats. It contains blood vessels, nerves and
mucous glands
Mucous Coat(tunica mucosa) is thick of reddish color above, and
pale below. It is covered throughout with a thick layer of stratified
squamous epithelium.
Muscularis Mucosa; between it and the areolar coat, is a layer of
longitudinally arranged non-striped muscular fibres.
Esophageal glands are small compound racemose glands of the
mucous type, they are lodged in the submucous tissue, and each
opens upon the surface by a long excretory duct.

Vessels and nerves

Artery: inferior thyroid branch of the thyrocervical trunk for cervical
region, from the descending thoracic aorta from the lt gastric branch
 of the celiac artery for thoracic region, and from the lt inferior
phrenic of the abdominal aorts for abdomen region
The nerves are derived from the vagi and from the sympathetic
trunks, they form a plexus

Stomach
It is the most dilated part of the digestive tube, and is situated
between the end of the esophagus and the begeinning of the small
intestine. It lies in epigastric, umbilical, and left hypochondriac
regions of the abdomen.
It is bounded by the upper abdominal viscera, and completed in
front and on the left side by the anterior abdominal wall and the
diaphragm.
The shape and position of the stomach are so greatly modified by
changes within itself and in the surrounding viscera, hence not
typical
Chief modifications are determined by
1) the amount of the stomach contents
2) the stage which the digestive process has reached
3) degree of development of the gastric musculature
4) the condition of the adjacent intestines

However it broadly can be described as having

2 Openings
2 Boundaries or Curvatures
2 Surfaces
 Openings
Cardiac Orifice; the opening by which the esophagus communicates
with the stomach is known as the cardiac orifice, which is situated
on the left of the middle line at the level of 11th thoracic vertebra.
The right margin of the abdominal esophagus is continuous with
lesser curvature of the stomach, while the left margin joins the
greater curvature at an acute angle, termed incisura cardiaca.
Pyloric Orifice: it communicated with the duodenum, and its position
is usually indicated on the surface of the stomach by a circular
groove, the duodenopyloric constriction. This orifice lies to the right
of the middle line at the level of the upper border of the first lumber
vertebra.

Curvatures
Lesser Curvature: extending between the cardiac orifice and the
pyloric orifice, forms the right or posterior border of the stomach. It
descends as a continuation of the right margin of the esophagus in
front of the diaphragm, turning to the right it crosses the 1 st lumber
vertebra and ends at the Pylorus. Lesser curvature gives attachment
to the two layers of the hepatogastric ligament, and between these
two layers are the lt gastric artery and the Rt Gastric artery branch
of the hepatic artery.
Nearer its pyloric end is a well marked notch, Incisura angularis,
which varies in position with the State, distension of the viscus, it
serves to separate the Rt and left portion

Greater Curvature
It is directed mainly forward, and is four or five times as long as the
lesser curvature.
Starting from the cardiac orifice at the incisura cardiaca, it forms an
arch backward, upward, and to the left, the highest point of the
convexity is on level with the sixth left costal cartilage. From this
level it may be followed downward and forward, with a slight
convexity to the left as low as the cartilage of 9th rib, it then turns to
the rt to the end of the pylorus.
Directly Opposite Incisura angularis of the lesser curvature the
greater curvature presents a dilatation, which is the Left extremity
of the pyloric part, this dilatation is limited on the rt side by the
groove, Sulcus intermedius, which is abt 2.5 cm from duodenoplyoric
constriction
The portion between the sulcus intermedius and the duodenopyloric
constriction is termed as Pyloric antrum.
At Commencement it is covered by the Peritoneum from the front
side of the organ
Lt part of the curvature gives attachment to the gastrolineal
ligament
Anteriorly two layers of greater Omentum and gastroepiploic
vessels
Stomach Surfaces
When the stomach is in the contracted condition, its surfaces are
directed upward and downward respectively, but when the viscus is
distended they are forward, and backward. They may therefore be
described as antero-superior and postero-inferior surfaces.

When the stomach is in the contracted condition, its surfaces are

directed upward and downward respectively, but when the viscus is
distended they are forward, and backward. They may therefore be
described as antero-superior and postero-inferior surfaces.

Antero-superior surface

The left half of this surface is in contract with the diaphragm, which
separates it from the base of the lt lung, pericardium, and the 7 th,
8th, and 9th, and intercostal spaces of the left side.
The Rt half is in relation with the lt lobe of the liver.
When the stomach is empty, transverse colon may lie on the front
part of this surface. Whole surface is covered by peritoneum.

Postero-inferior surface
It is in relation with the diaphragm, the spleen, Lt suprarenal gland,
Upper part of the front of Lt kidney, anterior surface of the
pancreas, Lt colic flexure and the upper layer of the transverse
mesocolon. these structure forms a shallow bed, Stomach Bed.
Transverse mesocolon separates the stomach from the
dudenojejunal flexure and small intestine. Postero inferior surface is
covered by peritoneum, except over the small area close to the
cardiac orifice, which is limited by the lines of attachment of
gastrophrenic ligament, and lies in opposition with the diaphragm
and closer to the upper portion of the lt suprarenal gland.

Parts of the stomach

A plane passing through the incisura angularis on the lesser
curvature and the left limit of the opposite dilatation on the greater
curvature divides the stomach into a lt portion or body and a rt or
pyloric portion
The lt portion of the body is known as the Fundus, and is marked off
from the remaining body by a plane passing horizontally through the
cardiac Orifice
The Pyloric portion is divided by a plane through the sulcus
intermedius at Rt angles to the Long axis of this portion, Portion to
the Rt of this plane is the Pyloric antrum.

Stomach Parts.
Position of the stomach
Position of stomach varies with the posture, amount of the stomach
contents, and with the condition of the intestine on which it rests.
In erect Posture the empty stomach is somewhat J shaped, part
above the cardiac orifice is usually distended with gas, Pylorus
distended to the level of first lumber vertebra and the most
dependent part of the stomach is at the level of the umbilicus.
Variation in the amount of its contents affects mainly the cardiac
portion, pyloric portion remaining is more or less in contracted
condition in the process of digestion.

Anatomy of Stomach Wall.

The wall of stomach consist of four coats
Serous Coat(tunica Serosa) derived from the peritoneum, and covers
entire surface of the organ, except at greater and lesser curvature
at the point of attachment of greater and lesser omenta, where the
2 layers of peritnoeum leave a small triangular space , along which
the nutrient vessels and nerves pass.
Muscular coat(tunica muscularis) is situated immediately beneath
the serous covering, with which it is closely connected. It consist of
three set of smooth muscle fibers: Longitudinal, circular and oblique
Longitudinal fibers are the most superficial, and are arranged in two
sets.
Circular fibers form a uniform layer over the whole extent of the
stomach beneath the longitudinal fibers. At Pylorus they are most
 abundant, and are arranged into a circular ring, which projects into
lumen, and along with the mucous membrane covering at its surface
forms the Pyloric valve.
Oblique fibers internal to the circular layer are limited chiefly to the
cardiac end of the stomach, where they are disposed as a thick
uniform layer, covering both surfaces.
Areolar or Submucous coat consist of a loose, areolar tissue,
connecting the mucous and muscular layer
Mucous Membrane is thick and its surface is smooth, soft and
velvety. In a fresh state it is of a pinkish tinge at the pyloric end, and
of a red or reddish brown color over the rest of its surface. It is thin
at cardiac extremity, but thicker towards the pylorus.
During the contracted stage of the organ, it is thrown into numerous
plaits or rugae. These folds are entirely obliterated when the organ
becomes distended.

Gastric Glands
These are of three kinds
Pyloric; these are found in the pyloric position of the stomach. They
consist of 2 or 3 short closed tubes opening into a common duct or
mouth.
Cardiac Glands: few in number, occur close to the cardiac orifice.
They are again sub divided into two types
Simple tubular glands resembling those of the pyloric end of the
stomach
Compound racemose glands resembling those duodenal glands
 Fundus Glands: these are found in the body and fundus of the
stomach.

Vessels and Nerves:

Artery: Lt Gatric, Rt Gastric, Rt Gastroepiploic branches of hepatic,
Lt Gastroepiploic branches of lineal.
Venous drainage: they end either in lineal or superior mesentric
veins or directly into the portal vein
Lymphatics; deep and superficial set along the curvatures
Nerves: terminal branches of rt and Lt vagi.
Duodenum
It is derived from the Greek word dudekadaktulos--- Meaning 12
fingers.
It is the shortest, widest and most fixed part of the small intestine.
It extends from the pylorus to the duodenojejunal flexure.
It is curved around the head of pancreas in the form of letter C
It lies above the level of umbilicus, opposite first, second and third
lumber vertebra.
Parts of duodenum

It is 25 cm long and is divided into following four parts

1 First or superior part 5 cm Long
2 Second or Descending part, 7.5 cm long
3 Third or Horizontal part, 10 Cm long
4 Fourth or ascending part, 2.5 cm Long

Relation to the peritoneum

It is mostly retroperitoneal and fixed, except at its two ends where it
is suspended by folds of peritoneum, and is therefore mobile.
Anteriorly it is partly covered with the peritoneum.

First part
It begins at the pylorus, and passes backwards, upwards and to the
right to meet the second part of the duodenal flexure.
 The proximal 2.5 cm of is movable, which is attached to the lesser
omentum above, and to the greater omentum below.
The Distal 2.5 cm is fixed, it is covered with the peritoneum only on
the anterior aspect.

Relations
Anteriorly: quadrate lobe of the liver, and gall bladder
Posteriorly: Gastroduodenal artery, bile duct and portal vein
Superiorly: Epiploic foramen
Inferiorly: Head and neck of the pancreas

Second part
This part is about 7.5 cm long, which begins at the superior
duodenal flexure, passes downward to reach the lower border of 3 rd
lumber vertebra, where it curves to left at the inferior duodenal
flexure to become continuous with the third part.
It is retroperitoneal and fixed. Its anterior surface is covered with
the peritoneum, except near the middle , where it is directly related
to the colon
Interior part of the second part of duodenum shows the following
special features
Major duodenal Papilla, is an elevation which present
posteromedially, 8 to 10 cm distal to the pylorus. Here the
hepatopancreatic ampulla opens at the summit(Ampulla of vater)
Minor duodenal papilla, is 6 to 8 cm distal to the pylorus, and
presents the opening of accessory pancreatic duct (of Santorini)

Anteriorly:
Rt Lobe of the liver
Transverse Colon
Root of the transverse mesocolon
Small intestine
Posteriorly
Anterior surface of the Rt Kidney
Rt renal Vessels
Rt edge of the inferior vena cava
Rt Psoas major
Medially
Head of the Pancreas
Bile Duct
Laterally; Rt Colic flexure
Third part

It is about 10cm long, it begins at the inferior duodenal flexure, on the rt

side of the third lumber vertebra. It passes horizontally and slightly
upwards in front of the inferior vena cava, and ends by joining the fourth
part infront of the abdominal descending aorta.

Relation to the peritoneum

It is retroperitoneal and fixed. Its anterior surface is covered with the
peritoneum, except in the median plane where it is crossed by the
superior mesentric vessels and by the root of the mesentry.

Anteriorly:
Superior mesentric vessels
Root of the mesentry
Posteriorly:
Rt Ureter
Rt Psoas Major
Rt testicular or ovarian vessels
Inferior vena cava
Abdominal aorta with origin of inferior mesentric artery
 Superiorly
Head of Pancreas and Ucinate process
Inferiorly: Coils of Jejunam

Fourth part

It is 2.5 cm long. It runs upwards on or immediately to the left of the

aorta, upto the border of 2nd lumber vertebra, where it turns forward
to become continuous with the jejunum at the duodenojejunal
flexure.
Relation to the peritoneum
It is mostly retro peritoneal and covered with peritoneum anteriorly.
The terminal part is suspended by the uppermost part of the
mesentry and is mobile.

Anteriorly:
Transverse Colon
Transverse Mesocolon
Stomach
Posteriorly:
Lt Renal artery
Lt Gonadal artery
Inferior mesentric vein
Right:
Upper part of the root of the mesentry
Left
Lt kidney
Lt ureter

Ligament of Tretiz
This is the fibromascular band which suspends and supports the
duodenojejunal flexure. It arises from the rt crus of the diaphragm,
close to the rt side of the oesophagus, and is attached to posterior
surface of the deuodenojejunal flexure and the third and fourth part
of the duodenum
It is made up of
A) striped muscle fibres in its upper part
B) Elastic fibres in middle part
C) Plain Muscle fibre in its lower part

Blood & Nerve supply

Arterial supply: Above the level of Ampulla of vater by superior
pancreaticoduodenal artery and below by the inferior
pancreaticoduodenal artery. Besides this first part also receives by
rt gastric artery, retroduodenal branches of hepatic artery and some
branches from the rt gastroepiploic artery.
Venous drainage; Veins of the duodenum drain into Splenic, superior
mesentric and portal veins.
Lymphatic drainage: Pancreaticoduodenal nodes--- hepatic
nodes/Coeliac nodes---superior mesentric nodes
Nerve Supply
Sympathetic nerves from thoracic ninth and tenth spinal segments
and parasympathetic nerves from the vagus, pass through the
Coeliac plexus to provide nerve supply to the duodenum.

Jejunum and Ileum

Jejunum and ileum are suspended from the posterior abdominal wall
by the mesentery, and therefore are mobile.
Jejunum constitutes the upper 2/5th of the mobile part of the small
intestine, while the ileum constitutes lower 1/5 th .
Jejunum begins at the duodenojejunal flexure and ileum terminates
at the ilocaecal junction.

Difference between Jejunum and ileum

Feature Jejunum Ileum

1. Location Occupies Upper Occupies lower
and lt part of the and rt part of the
intestine intestine
2. Walls Thicker and More Thinner and less
vascular vascular
3. Lumen Wider and often Narrower and
empty often loaded
4. Mesentery a. Windows a No windows
Present B Fat more
b. Fat less abundant
abundant
5. Circular Large and more Smaller and
mucosal folds closely set smarse
6. Villi Large, thick leaf- Shorter, thinner,
like and more finger-like and
abundant less abundant
 7. Peyers Absent Present
Patches
(Collection of
Lymphocytes)
8 Solitary Fewer More Numerous
Lymphocytes
follicles
Blood Supply, and Nerve supply

Blood Supply; Superior Mesenteric artery and vein

Lymphatic drainage: Lymph from lacteals drain into plexus which
open in the lymph vessels of the Mesentery which opens around the
aorta near the opening of superior mesenteric artery.
Nerve Supply; Sympathetic nerves are from T9-T11 segments and
parasympathetic nerves is from vagus.

Functions of small Intestine

Digestion of Food and absorption of digested materials.
By its peristaltic activity, it moves the food forward through the
ileocaecal valve into the large intestine

Large Intestine
It extends from the ileocaecal junction to the anus. It is about 1.5 cm
long, and is divided into caecum, ascending Colon, transverse colon,
descending colon, sigmoid colon, rectum and the anal canal.
In the angel between the caecum and the terminal part of the ileum
there is a narrow diverticulum called the vermiform appendix.

Functions of Large Intestine

Storage of Partially digested food which reaches from the small
intestine.
Absorption of fluids and solutes from digested food.
The epithelium of large intestine is absorptive (Columnar) but Villi
are absent.
Adequate lubrication for passage of digested food is provided by the
numerous Goblet cells scattered in the mucous membrane.
Presence of numerous Solitary lymphatic follicles provide protection
against bacteria present in the Lumen of the intestine.

Special characteristics of large intestine

The large intestine is wider in caliber than the small intestine.
Caliber is greatest at the commencement and gradually diminishes
towards the rectum.
 The Longitudinal muscle coat only forms thin layer in this part of the
gut. The great part of it forms three ribbon like bands called the
taeniae coli.(Taenia libera(anterior), taenia
Mesocolica(posteromedial), taenia omentalis (posterolateral))
Since the taeniae are shorter than circular muscle coat, Colon is
puckered and sacculated.
Small bags of Peritoneum filled with fat are called as appendices
epiploicae , which are scattered over the surface of the large
intestine, except over the caecum, appendix and the rectum.

Differences between small and large intestine.

Feature Small Intestine Large Intestine

1. Appendices Absent Present
Epiplociae
2. Taeniae Coli Absent Present
3. Sacculations Absent Present
4. Distensibility Less More
5. Fixity More part is More part is fixed
Mobile
6. Villi Present Absent
7. Transverse Permanent Obliterated when
Mucosal Folds longitudinal muscle
coat relaxes
8. Peyers Present in ileum Absent
Patches
9. Common Site a. Intestinal d. Entamoeba
for Worms histolytica
b. Typhoid e. Dysentery
c. Tuberculosi organisms
f. Carcinoma
 10 Effects of Diarrhoea Dysntery
Infection

Blood, nerve Supply

Blood Supply: Marginal artery
Lymphatic drainage: through 4 sets of lymph nodes
Epicolic Lymph nodes: along the walls of the gut
Paracolic nodes: on the medial side of the ascending and descending
colon and near the mesocolic border of the transverse and sigmoid
colon
Intermediate nodes: on the main branches of the vessels
Terminal nodes; on the superior and inferior mesenteric vessels.

Nerve supply

Nerve supply is both barring the lower half of anal canal

Sympathetic; Coeliac and Superior Mesenteric Ganglia (T11 to L1)
Parasympathetic supply: Vagus

Functions of Colon
A Lubrication of Faeces by Mucus
Absorption of water, salts and other solutes
Bacterial flora of Colon Synthesizes Vit B
Mucoid secretion of Colon is rich in antibodies of IgA group, which
protect it from invasion by microorganisms

Caecum
It is a large blind sac forming the commencement of the large
intestine.
It is situated in Rt iliac fossa, above the lateral half of inguinal
ligament.
It communicates superiorly with ascending colon, Medially at the
level of Caecocolic junction with ileum and Posteromedialy with
Appendix.

It is 6 cm Long and 7.5 Cm broad. One of those organ that have

greater width than the length. Other examples are Prostate, Pons
and Pituitary.

Relations
Anterior: Coils of Intestine and anterior abdominal wall.

Posterior: Rt Psoas and Iliacus Muscle, Femoral Nerve, Testicular or

Ovarian Vessels, Appendix in the retrocaecal recess.

Blood Supply: Caecal Branches of the ileocolic artery.

 Venous Drainage; Superior Mesenteric vein
Nerve Supply: Sympathetic T11-L1
Parasympathetic: Vagus

Ascending Colon
It is about 12.5 Cm long and extends from the caecum to the inferior
surface of rt lobe of the liver. Here it bends to the left to form the
Colic flexure. It is covered by peritoneum on 3 sides
Anteriorly; Colis of small Intestine, anterior abdominal wall
Posteriorly; iliacus, transverse abdominis, quadratus lumborum, Rt
Kidney, Iliohypogastric nerves.

Rt Colic Flexure lies at the junction of the Ascending Colon and

Transverse colon. Here the colon bends forwards, downwards, and to
the left. Flexure lies at the lower part of the Rt Kidney.
Anterosuperiorly it is related to the colic impression on the inferior
surface of the rt Lobe of the liver.
 Transverse Colon
It is about 50Cm long extending from the Rt Colic flexure to Lt colic
Flexure. It not exactly transverse but hangs low as a loop to the
variable extent. It is suspended by transverse mesocolon , which is
attached to the anterior border of pancreas, and has a wide range of
mobility.
Anteriorly: Greater Omentum, anterior Abdominal wall
Posteriorly; Second part of the duodenum, Head of pancreas, and
colis of small intestine.

Lt Colic Flexure
It lies at the junction of the transverse colon and the descending
colon. Here the colon bends down downwards and backwards.
Flexure lies on the lower part of the Lt kidney and Diaphragm,
behind the stomach and below the anterior end of the spleen.
Flexure is attached to the 11th rib in the midaxillary line by a
horizontal fold of peritnoeum , called the phrenicocolic ligament,
which supports spleen.

Descending Colon
It is about 25 Cm long and extends from the lt colic flexure to the
sigmoid colon. It runs vertically up to the iliac crest, and then
inclines medially on the iliacus ans psoas major to reach the pelvic
brim, where it is continuous with the sigmoid colon.
 Anteriorly; Coils of sigmoid colon
Posteriorly; Transverse abdominis, quadratus lumborum, iliacus,
Femoral, genitofemoral nerves, Gonadal and external iliac vessels.
Sigmoid Colon (Pelvic Colon)
It is about 37.5 cm long and extends from the pelvic brim to the 3 rd
piece of the Sacrum, where it becomes the rectum.
It forms a Sinuous loop, and hangs down in pelvis over the bladder
and uterus.
Sometimes it is short and takes a straight course.
It is suspended by Sigmoid mesocolon and is covered by coils of
small intestine.

Rectum
It is the distal part of the gut. It is placed between the sigmoid colon
above and the anal canal below. Distension of the rectum causes the
desire to defaecate.
It is not straight , but curved in an anteroposterior direction and also
from side to side. The 3 cardinal features of large intestine
Sacculations, Appendices epiploicae and taeniae are absent in the
rectum.
It is situated in the posterior part of the lesser pelvis. In front of the
lower 3 pieces of the sacrum and the coccyx.
It begins as a continuation of the sigmoid colon at the level of the 3 rd
sacral vertebra. The rectosigmoid junction is indicated by the lower
end of the sigmoid mesocolon. Rectum ends by becoming continuous
with the anal canal at the anorectal junction. Junction lies 2 to 3 cm
in front of and below the tip of the coccyx. In males junction
corresponds to the apex of the prostate.
It is 12cm long , where as diameter in upper part is same as sigmoid
colon i.e 4 Cm
In its course rectum runs first downwards and backwards, then
backwards and forwards.
The beginning and the end of the rectum lies in the median plane,
but it shows two types of curvatures in its course.
Two anteroposterior Curves:
Sacral flexure of the rectum follows the concavity of the sacrum and
the Coccyx.
The perineal flexure of the rectum is the backward bend at the
anorectal junction.
Three lateral curves;
Upper lateral curve of the rectum is convex to the right
Middle lateral curve is convex to the left and is most prominent
Lower lateral curve is convex to the left

Relations
Peritoneal relations;
Upper 1/3rd of rectum is covered with peritoneum infront and on the
sides
Middle 1/3rd of rectum is covered only in the front
 Lower 1/3rd which is dilated to form ampulla is devoid of peritoneum.

Visceral relations;
Anteriorly in Male: upper 2/3rd of rectum are related to the
rectovesical pouch with coils of intestine and sigmoid colon. Lower
1/3rd of rectum is related to the base of the urinary bladder, terminal
part of the ureters, seminal vesicles, and the prostate

Anteriorly in females:
Upper 2/3rd of rectum are related to the rectouterine pouch with
coils of intestine and sigmoid colon.
Lower 1/3rd of rectum is related to the lower part of vagina

Posteriorly;
Lower 3 vertebrae of sacrum, coccyx and the anococcygeal ligament.
Median Sacral, superior rectal and lower lateral sacral vessels

Functional anatomy of rectum

Rectum has two developmental parts, Upper part is related to the
peritoneum and the lower part is devoid of peritoneum.
Functionally, sigmoid colon is the faecal reservoir and the whole of
rectum is empty in normal conditions, being sensitive to distension.
Passage of faeces into the rectum, therefore causes the desire to
defecate.
 Blood Supply
Blood Supply: Superior rectal artery, Middle rectal arteries and
Median Sacral artery
Venous drainage: Superior rectal vein, Middle rectal vein and Median
Sacral vein

Lymphatic drainage:
Upper half: Superior rectal vessel pararectal and sigmoid nodes
inferior mesenteric nodes
Lower half: Middle rectal vessel Internal iliac nodes.

Nerve Supply

Nerve Supply;
Sympathetic Nerves; L1, L2
Parasympathetic Nerves; S2, S3, S4
Sympathetic nerves are vasoconstrictor, inhibtory to the rectal
musculature and motor to the Internal Sphincter
Parasympathetic nerves are motor to the muculature of the rectum
and inhibitory to the internal sphincter

Supports of rectum
Pelvic floor formed by levator ani muscle
 Fascia of Waldeyer: it attaches the lower part of the ampulla to the
sacrum. Formed by the condensation of the Pelvic fascia behind the
rectum. It encloses the superior rectal vessel and the Lymphatics
Lateral ligaments of the rectum; formed by condensation of the
pelvic fascia on each side of the rectum. It encloses the middle rectal
vessels and branches of pelvic plexus.
Rectovesical Fascia: it extends from the rectum behind to the
seminal vesicles and prostate in front
Perineal Body with its muscles
Pelvic Peritoneum also supports

Anal Canal
It is the terminal part of the large intestine. It lies in anal triangle of
perineum and Rt and Lt Ischioanal fossae, which allows its expansion
during passage of Faeces. Sacculation and taeniae are absent here
also.
It is 3.8 Cm long. It extends from the anorectal junction to the anus.
It is directed downwards and backwards.
It is surrounded by inner involuntary and outer involuntary
sphincters which keep the lumen closed in form of an ateroposterior
slit.
Anorectal junction lies 2-3cm in front of and slightly below the tip of
Coccyx.
 Anus is the surface opening of the anal canal, situated above 4cm
below and infront of the tip of the coccyx in the cleft between two
buttocks. Surrounding Skin is Pigmented and thrown into radiating
folds and contains a ring of large apocrine glands.
Relations:
Anteriorly:
In both sexes: Perineal Body
In males; Membranous urethra and bulb of penis
In females; Lower end of the vagina.
Posteriorly;
Anococcygeal ligament
Tip of the coccyx
Laterally: Ischioanal Fossae
All round: Sphicter Muscles, tone of which keeps the canal closed

Interior to the anal canal

It can be divided into 3 parts
Upper part about 15 Mm long
Middle part about 15Mm long
Lower part about 8 Mm Long
 Upper Mucous part
Upper Mucous part; it is about 15 Mm long and is lined by Mucous
Membrane, and is of endodermal in origin.
Mucous membrane shows 6 to 10 Vertical folds, which are called as
Anal Columns of Morgagni
Lower ends of the anal columns are united to each other by a short
transverse folds of mucous membrane, these folds are called the
anal valves.
Above each valve there is a depression in the mucosa which is called
the anal sinus.
Anal valves together form a transverse line that runs all around the
anal canal. This is the pectinate line. It is situated opposite the
middle of internal anal sphincter.\

Middle part or transition Zone or Pecten

Next 15mm of the anal canal is also lined by mucous membrane, but
anal columns are not present here.
The Mucosa has a bluish appearance because of dense venous
plexus that lies between it and the muscle coat.
The mucosa is less mobile than in the upper part.
Lower limit of the Pecten often has a whitish appearance because of
which it is referred to as white line of Hilton. It is situated at the
level of internal between the subcutaneous part of the external anal
sphincter and the lower border of internal anal sphincter.
It marks the lower limit of pecten which is thin, pale, glossy and is
devoid of sweat glands.

Lower Cutaneous part

It is about 8Mm long and is lined by skin containing sweat and
sebaceous glands.

Anal Sphincters
Internal anal Sphincter is involuntary in nature. It is formed by
thickened circular Muscle coat of this part of the gut. It surrounds
the upper 3/4th of the anal canal extending from the upper end of the
canal to the white line of Hilton.
External anal sphincter is under voluntary control. It is made up of
striated muscle and is supplied by the inferior rectal nerve and the
perineal branch of the 4th sacral nerve. It surrounds whole of the
anal canal and has 3 parts subcutaneous(Lower), superficial(Middle)
and deep(upper)
Uppermost fibres blend with fibres of Puborectalis Muscle
Middle fibres surround lower part of the internal anal sphincter.
Related to the perineal body anteriorly and coccyx through
anococcygeal ligament posteriorly.
 Blood Supply
Arterial Supply:
Superior rectal artery
Inferior rectal artery

Venous drainage
Internal venous plexus
External Venous plexus
Anal veins

Lymphatic Drainage:
Above the pectinate line: Internal iliac nodes
Below the pectinate line: superficial inguinal nodes.

Nerve supply
Above the pectinate Line:
Sympathetic Nerve: L1,L2, inferior hypogastric plexus)
Parasympathetic Nerve: Pelvic splanchnic, S2, S3, S4)
Below the pectinate line;
Somatic nerves: Inferior rectal, S2, S3, and S4

Digestive system Accessory Glands

Pancreas
Pan- all, Kreas Flesh
It is gland that is partly exocrine and partly endocrine. The exocrine
part secretes the digestive pancreatic juice and the endocrine part
secretes hormones i.e Insulin.
 It is soft, lobulated and elongated organ.
It lies more or less transversely across the posterior abdominal wall
at the level of L1 and L2 vertebra.
It is J-shaped or retort shaped, set obliquely.
It is about 15-20cm long, 2.5-3.8cm broad and 1.2-1.8cm thick and
weighs about 90Gm
It is divided into Head, Neck, Body and tail.
The head is enlarged and lies within the concavity of the duodenum.
Tail reaches the hilum of the spleen.
Entire organ lies posterior to the stomach.

Head of Pancreas
It is the enlarged flattened rt end of pancreas, situated within the
curves of duodenum.
It has 3 borders, superior, Inferior and rt lateral
2 surfaces anterior and posterior
One process called the Ucinate process

Relations:
Superior Border-Overlapped by first part of duodenum
Inferior Border- related to the 3rd part of duodenum
Rt lateral border- related to the second part of duodenum, terminal
part of the bile duct.

Anterior Surface:
First part of duodenum
Transverse colon
Jejunum which is separated by peritoneum
Posterior surface
Inferior vena cava
Terminal part of the renal veins
Rt Crus of the diaphragm.
Bile duct which runs downwards to the rt side.
Ucinate process: anteriorly to the superior mesentric vessels and
posteriorly to the aorta.

Neck of Pancreas
It is slightly constricted part between the Head and Body. It is
directed forwards and upwards to the left. It has anterior and
posterior surface.
Relations
Anterior surface; Peritoneum and the pylorus.
Posterior surface; termination of the superior mesenteric vein and
the beginning of the portal vein.

Body of the pancreas

 Body of the pancreas is elongated, which extends from neck to tail.
It passes towards the left with a slight upward and backward
inclination.
It is triangular on cross section and has 3 borders and 3 surfaces.

Relations
Anterior border: it provides attachment to the root of the transverse
mesocolon.
Superior border: related to the coeliac trunk, Hepatic artery to the rt
side and splenic artery to the Lt side.

Inferior border is related to the mesenteric vessels at its right end.

Three surfaces
Anterior surface is concave and is directed forward and upwards. It
is covered by peritoneum and is related to the stomach.
Posterior surface is devoid peritoneum and is related to the
Aorta with origin of superior mesenteric artery
Lt crus of the diaphragm.

Lt suprarenal Gland
Lt Kidney
Lt renal vein
Splenic vein.
Inferior surface is covered by peritoneum and is related to the
duodenojejunal flexure, coils of jejunum and the lt colic flexure.

Tail of Pancreas
This is the left end of the pancreas. It lies in the lienorenal ligament
together with the splenic vessels. It is related to the lower part of
the gastric surface of the spleen.
Ducts of Pancreas
The main pancreatic duct lies near the posterior surface of the
pancreas and is white in color. It begins at the tail runs towards the
rt through the body and bends at the neck to run downwards
backwards and to the right in the head.
Its lumen is about 3mm in diameter.
It has many small tributaries which join in its way.
Within the head of the pancreas pancreatic duct is related to the bile
duct which lies on its rt side, which opens in second part of
duodenum.
Accessory pancreatic duct begins in the lower part of the head,
crosses major duct and opens in duodenum at Minor duodenual
papilla.

Blood Supply
Arterial supply: Pancreatic branches of splenic artery.
Superior pancreaticoduodenal artery
Inferior pancreaticoduodenal artery.
Venous Drainage:
Splenic vein, inferior mesenteric and portal veins
Lymphatic drainage: Pancreaticospleniccoeliac-- superior
mesenteric lymph nodes

Nerve supply.
Parasympathetic : Vagus
Sympathetic Nerves: Splanchnic Nerves
Sympathetic nerves are vasomotor. Parasympathetic nerves control
pancreatic secretion. Secretion is also influenced by the hormone
cholecystokinin produced by cells in the duodenal epithelium.

Functions
Digestive: It contains digestive enzymes. Trypsin breaks down
proteins to lower peptides. Amylase hydrolyses starch and glycogen
to diasaccharides. Lipase breaks down fat into fatty acid and
glycerols.
Endocrine: Carbohydrates are the immediate source of energy.
Insulin helps in utilization of sugar in the cells.
Pancreatic juice: it provides appropriate alkaline medium for the
activity of the pancreatic enzymes.
Liver
It is the largest gland in the body. This solid gland is situated in the
Rt upper quadrant of the abdominal cavity. It is reddish brown in
color, soft in consistency and very friable.
weighs about 1600gms in males and 1300gms in female.
It occupies the whole of Rt hypochondrium, greater part of the
epigastrium and extends into the lt hypochondrium reaching upto
the left lateral line of the body.
It is also called as Hepar from which we have the objective Hepatic
applied to structures associated with the organ
It is wedge shaped. It resembles a four sided pyramid laid on one
side.
It has 5 surfaces, Anterior, posterior, Superior, inferior and rt .
Out of these, inferior surface is well defined because it is
demarcated anteriorly by a sharp inferior border. Other surfaces are
more or less continuous with each other and are imperfectly
separated from one another by ill defined, rounded borders.
Inferior border is a sharp prominent border which separates anterior
surface with the Inferior surface. It is rounded on the lateral side
where it separates Rt surface from the inferior surface. It extends
from 8th costal rib of Lt side to the rt 9th costal cartilage.
It has an interlobular notch for ligamentum teres and a cystic notch
for the fundus of gall bladder.
Lobes of liver
Liver is divided into Rt and Lt lobe by the following attachments
Anteriorly superiorly- Falciform ligament
Anteriorly inferiorly- Liagmentum teres
Posteriorly Ligamentum venosum
Rt lobe is much larger than the Lt lobe and forms 5/6 th of the liver. It
contributes to all 5 surfaces of the liver, and presents the Caudate
and quadrate lobes.
Caudate Lobe is situated on the posterior surface. It is bounded on
the Rt by inferior vena cava groove and to the lt by the ligamentum
venosum fissure and inferiorly by porta hepatis fissure. Above it is
continuous with the superior surface, below and to the rt it is
connected to the rt lobe of the liver by the caudate process.
Quadrate lobe is situated on the inferior surface and is rectangular
in shape. It is bounded anteriorly by inferior border, posteriorly by
porta hepatis, on the rt side by fossa for Gall bladder and on the left
by the fissure for the ligamentum teres.
Porta hepatis is a deep, transverse fissure about 5 cm long, situated
on the inferior surface of the rt lobe of the liver. It lies between the
Caudate lobe above and the quadrate lobe below and in front. The
Portal vein, Hepatic artery and the Hepatic plexus of nerve enter the
liver through the porta hepatis, while the rt and lt Hepatic ducts and
few lymphatics leave it. It porvides attachment to the lesser
Omentum.
 Lt lobe of the liver is much smaller and forms only 1/6 th of the liver. It
is flattened from above downwards. Near the ligamentum venosum
fissure, its inferior surface presents a rounded elevation, called the
omental tuberosity or tuber omentale.

Relations of Liver
Liver is covered by peritoneum, over the triangular bare area limited
by coronary ligament and triangular ligament, groove of the inferior
vena cava, fossa for the gall bladder, coronary ligament and lesser
omentum.
Visceral relations
Anteriorly It is related to xiphoid process and anterior abdominal
wall in the median plane and to diaphragm on each side

Posterior surface
Posterior surface is triangular. Its middle part shows a deep
concavity for the vertebral column.
Bare area is related to the diaphragm and the rt suprarenal gland.
Inferior vena cava and hepatic veins
 Caudate lobe is related to the coeliac trunk, diaphragm and rt
inferior phrenic artery near the aorta
Fissure for the liagmentum venosum is deep and extends to the
caudate lobe. It contains two layers of lesser omentum, and it is
remnants of ductus venosus(opening between the lt branch of portal
vein and lt hepatic vein to inferior vena cava) of foetal life

Superior Surface
It is quadrilateral and shows a concavity in the middle. This is the
cardiac impression. On each side of the impression surface is convex
to fit the dome of the diaphragm.
Inferior surface
It is also quadrilateral and is directed downwards, backwards and to
the left.
On the inferior surface of the lt lobe, there is a large concave gastric
impression and also a raised area that comes in contact with the
lesser omentum called as omental tuberosity.
Fissure for ligamentum teres passes from the inferior border to the
lt end of the porta hepatis.
Quadrate lobe is related to the pylorus, first part of duodenum,
lesser omentum and to transverse colon to some extent.
Fossa for gall bladder lies on the rt of quadrate lobe
Rt side of fossa, there is heaptic flexure of the colon, renal
impression for the rt kidney and duodenal impression for second
part of duodenum

Rt Surface.
It is quadrilateral and is convex. It is related to the diaphragm opp
to 7th to 11th rib in midaxillary line. Upper 1/3rd if realted to the
pleura and the lung , middle 1/3rd to the diaphragm and the
costodiaphgramatic recess of the pleura.

Blood supply
20% through hepatic artery and 80% through portal vein. Both after
entering divide into rt and lt branches, then redivide to form
segmental vesselsinterlobular vessels which runs into portal
canals.
Venous drainage; Hepatic sinusoids interlobular veins sublobular
veins hepatic veins inferior vena cavas
Lymphatic drainage: it runs superficial beneath the peritnoeum and
terminate in Caval, hepatic, paracardial and coeliac lymph nodes.
Nerve supply Hepatic plexus consisting of sympatheic and
parasympathetic or vagal fibres.

Internal Structure of liver

The liver lobes are made up of microscopic units called lobules which
are roughly hexagonal in shape.
These lobules comprise of rows of liver cells (hepatocytes) which
radiate out from a central point. The hepatic cells are in close
 contact with blood-filled sinusoids and also lie adjacent to canaliculi
into which bile is secreted.
Situated around the perimeter of the lobule are branches of the
hepatic artery, hepatic portal vein and bile duct. These cluster
together at the "corners" of the lobule forming what is called the
portal triad. At the mid-point of the lobule is the central vein. Blood
flows out of the sinusoids into the central vein and is transported
out of the liver

Lobule Activity
The hepatic portal vein and hepatic artery deliver oxygen and
nutrients into to the blood sinusoids. This close relationship
between the hepatocytes and surrounding blood enables many
metabolic processes to take place.
Blood flows out of the sinusoids into the central vein, removing
detoxified substances and metabolic end products. The central vein
ultimately reunites with the hepatic vein transporting these
substances out of the liver.
Bile that is produced by the hepatocytes drains into tiny canals
called bile canaliculi (singular canaliculus). These drain into bile
ducts located around the lobule perimeter.

Hepatocytes
Hepatocytes are the predominant cell type in the liver. An estimated
80% of the liver mass is made of these cells. The hepatocytes are
round in shape containing a nucleus and an abundance of cellular
organelles associated with metabolic and secretory functions.

Functions of Liver.
Secretes Bile which helps in digestion of fats
Stores Glucose in the form of Glycogen
Helps in protein metabolism
Stores fat, Glycogen, Iron, vit A and Vit D
It is the main Heat producing organ
Drugs and poisons are detoxicated here
Plasma Proteins are Synthesized here
Vit A is synthesized and stored with Vitamin D
Prothrombin and fibrinogen are synthesized here.
Heparin is manufactured
Stores anti anemic factor
Antibodies and Antitoxins are manufactured here.
Excretion f drugs, toxins, poisons, cholesterol, bile pigments and
Heavy metals
Protection by conjugation, Destruction, Phagocytosis, antibody
formation and excretion.
Metabolism of Carbohydrates, Fats and Proteins

Biliary apparatus.
 Biliary apparatus collects bile from the liver, stores in the gall
bladder, and transmits it to the second part of duodenum. The
apparatus consists of
Rt and Lt Hepatic ducts
Common Hepatic Duct,
Gall Bladder
Cystic Duct
Bile Duct

Hepatic Ducts
Rt and Lt hepatic ducts emerge at the porta hepatis from the right
and left lobe of the liver.

Common Hepatic Duct:

It is formed by the union of Rt and Lt Hepatic ducts near the rt end
of the porta hepatis. It runs downwards and is joined on rt side by
the Cystic duct to form the bile duct.

Gall Bladder.
It is a pear shaped reservoir of bile situated in a fossa on the inferior
surface of the rt lobe of liver. The fossa of gall bladder extends from
the rt end of the porta hepatis to the inferior border of the liver.
 It is 7 -10 cm long, 3cm broad at its widest part and about 30-50 ml
in capacity.
Gall bladder is divided into Fundus, body and Neck.
Fundus projects beyond the inferior border of the liver. It is entirely
surrounded by peritoneum and is related anteriorly to anterior
abdominal wall and posteriorly to the beginning of the transverse
colon.
Body lies in the fossa for the gall bladder on the liver. Narrow end of
the body is related to the porta hepatis, superior surface is devoid of
peritoneum and is adherent to the liver and the inferior surface is
related to the Rt Colic flexure, first and Second part of duodenum.
Neck is narrow upper end of the gall bladder. It first curves
anterosuperiorly and then posteroinferiorly to become continous
with the cystic duct and is marked by a constriction. Neck is
attached to the liver by aerolar tissue. Inferiorly it is related to the
first part of duodenum. Mucous membrane of neck is folded spirally
to prevent any obstruction to inflow or outflow of bile.

Cystic Duct
It is 3-4 cm long, which begins at neck of the gall bladder, runs
downwards, backwards and to the left and ends by joining the
common hepatic duct to form bile duct.
Bile Duct.
It is formed by the union of the cystic and common hepatic ducts
near the porta hepatis. It is 8cm long and has diameter of 6mm.
Course:
Supraduodenal part: downwards and backwards in the free margin
of the lesser omentum. A part which is above the 1st part of
duodenum.
Retroduodenal part: behind the 1st part of duodenum
Infraduodenal part; embedded in head of pancreas
Intraduodenal; to the left side of the medial border of the 2 nd part of
dudoenum, it comes in contact with pancreatic duct to form
hepatopancreatic duct which opens through ampulla of vater.

Sphincters related to the Bile duct

Terminal part of bile duct is surrounded by sphincter choledochus,
which normally keeps the bile duct closed. As a result bile produced
in the liver keeps accumulating in the gall bladder and goes
considerable concenteration. When food enters the duodenum the
sphincter opens and bile stored in the gall bladder is poured into the
duodenum.
Sphincter pancreaticus: usually present but may not be there also.
Third sphincter present at hepatopancreatic duct is sphincter
ampullae or sphincter of oddi.

Arterial supply for Bile apparatus.

Cystic artery, Several pancreaticoduodenal artery, rt hepatic artery.
Venous drainage: Tributaries of the portal vein, cystic vein
Lymphatic drainage;
Upper part of the appartus(till some extent to upper part of bile
duct: Cystic nodes Epiploic Nodes Upper hepatic nodes
Lower part of the bile duct: Lower hepatic nodes and upper
pancreaticosplenic nodes

Nerve supply.
Sympathetic : Cystic plexus of the nerves, Hepatic plexus which
receives nerve fibre from the coeliac plexus. T7 to T9
Parasympathetic; rt and Lt vagi and rt phrenic nerves.
Parasympathetic are inhibitors to the sphincters and vasomotor to
the gall bladder, where as Sympathetic are motor to the sphincters
and constrictor to the gall bladder.

Functions of Gall Bladder.

Storage of bile, and its release in duodenum when required
Absorption of water by the way of bile concenteration.
It regulates pressure in the biliary system by appropriate dilatation
and contraction. This normal mechanism is called as
Cholecoduodenal mechanism
Digestive system Physiology

Digestion:
It is defined as the process by which food is broken down into simple
chemical substances that can be absorbed and used as nutrients by
the body. Digestive process is accomplished by mechanical and
enzymatic breakdown of foods into simpler chemical compounds.
All food particles are subjected to the digestive process before being
absorbed into blood and distributed to the tissues of the body.
Digestive system plays the major role in the digestion and
absorption of the food substances.,

Functions of digestive system

Ingestion or consumption of food substances.
Breaking them into small particles
Transport of the small particles to different areas of the digestive
tract.
Secretion of necessary enzymes and other substances for digestion.
Digestion of food particles.
Absorption of the digestive products.
Removal of unwanted substances from the body.

Digestive process
1. Ingestion- taking food into mouth. Teeth here helps to start
tearing and crushing the food down into small enough pieces so that
it can pass down to throat.
2. Secretion- cells with in the walls of the GI tract secretes about 9
liters of water, acids, buffers and enzymes into the GI tract. 6
digestive juices are formed during the entire process of digestion.
3. Mixing and Propulsion: Alternating contraction and relaxation of
smooth muscles in the walls of the GI tract mix food with secretion
 and propel them towards the anus. Peristalsis movement is the
movement caused.
4. Digestion- Both mechanical and chemical process mix secreted
fluid s with ingested food and breakdown food molecules into
smaller fragments. Mechanical Digestion is through churning,
peristalsis movements etc. Chemical digestion is a series of
catabolic reaction. Enzymes aid in the chemical digestion.
5. Absorption- end products if digestion enters the wall of the GI
tract either through the active transport or by passive diffusion.
Absorption means the passage of digested substances through the
mucus membrane of the GI tract into the blood or lymph.
In mouth no absorption, only few drugs
Stomach- water, glucose, alcohol and some drugs
Small intestine- Most of the digested food are absorbed
Carbohydrates broken down into glucose
Proteins broken down into amino acids are abrobed with the
glucose. They go via the portal vein to the liver.
Fats splited into fatty acids and glycerin enter the villi and then join
up in fat droplets. Through lymphatic vessels into blood stream
In large intestine glucose, salt and water are absorbed.
Defecation the elimination of variable amount of indigestable
substances and bacteria from the GI tract through the anus.

Functions of Mouth
1. Ingestion of food particles
 2. Chewing and mixing the food with saliva
3. Appreciation of the taste
4. Transfer of food to the esophagus by swallowing
5. Role in speech
6. Social functions such as smiling and other expressions.

Saliva

Saliva is produced by Major salivary glands like parotid gland, Sub

maxillary gland and sublingual gland and also in few quantity from
Minor salivary glands like lingual Mucus glands, lingual serous
glands and buccal glands
Normally 1000-1500 ml of saliva is secreted per day and it is
approximately about 1ml/minute.
Contribution to saliva production by each major salivary gland is
A. Parotid gland- 25%
B. Submaxillary glands-70%
C. sub lingual glands- 5%
Reaction: Mixed saliva from all the glands is slightly acidic with ph of
6.35 to 6.85
Specific gravity ranges between 1.002 to 1.012
Saliva is hypotonic to plasma
Composition of Saliva
Mixed saliva contains 99.5% water and 0.5% solids.
Solids are further classified into
Organic substances
A. Enzymes Amylase, Maltase, Lingual lipase, Lysozyme, proline rich
proteins, etc
B. Other organic substances Proteins like mucin and albumin, Blood
group antigens, free amino acids and non protein nitrogenous
substances like urea, uric acid, creatinine.
Inorganic Substances: Sodium, calcium, potassium, bicarbonate,
bromide, chloride, fluoride and phosphate
Gases Like oxygen, carbon dioxide and nitrogen.

Functions of Saliva
1. Preparation of food for swallowing
2. Appreciation of tasteby solvent nature
3. Digestive function through digestive enzymes
 4. Cleansing and protective functions: Mouth is kept free of food
debris, shed epithelial cells and foreign particles.
Enzyme lysozyme of saliva kills some bacteria such as
staphlococcus, streptococcus and brucella.
Proline rich proteins in saliva posses antimicrobial property and
play an imp role in neutralizing toxic substance such as tannin.
5. Role in speech
6. Excretory functions- It excrete substances like mercury,
potassium, lead, and also to some extent viruses causing rabies and
Mumps.
7. Regulation of water balance.

Functions of stomach.
1. Storage function: food is stored in stomach for 3-4hrs and
emptied in intestine slowly. Maximum capacity of stomach is upto
1.5 liters.
Formation of chyme: peristaltic movements of stomach mix the bolus
and gastric juice and convert it into the semisolid material known as
chyme.
Digestive functions through digestive function of gastric juice
Protective function- Mucus present in the gastric juice is responsible
for protection from mechanical injury, and also from the digestive
action of pepsin on gastric mucosa and also from HCL .
Hemopoietic function- again through the gastric mucosa intrinsic
factor for erythropoiesis is responsible.
Excretory functions- many substances like toxins, alkaloids and
metals are excreted through gastric juice.

Secretory units of Gastric glands

Functions of gastric juice
1. Digestive Function it acts mainly on proteins. Role of digestive
enzymes in gastric juice are

2. Hemopoietic function The intrinsic factor of castle present

in gastric juice plays an important role in erythropoiesis. It is
necessary for absorption of vit B12 from GI tract into Blood.
3. Protective function Mucus present in the gastric juice is
responsible for protection of gastric wall.
4. Functions of HCL
 A. it activates pepsinogen into pepsin
B. Bacteriolytic action- kills bacteria entering along with food.
C Provides acid medium which is necessary for the actions of
the hormones.

Pancreatic juice
Pancreatic juice is secreted by the exocrine part of the pancreas.
Like the salivary glands the exocrine part of the pancreas is made up
of alveoli and acini. The acinar cells contain the zymogen granules,
which posses digestive enzymes. Main duct of pancreas is called
wirsungs duct which unite to common bile duct to open in ampulla
of vater.

Properties and composition of pancreatic juice

Volume- 500 to 800 ml/day
Reaction- highly alkaline with ph of 8-8.3
Specific gravity 1.010 to 1.018
The Bicarbonate content is very high in pancreatic juice. It is about
110-150meq/l. the high concentration of bile is responsible for the
alkalinity of pancreatic juice.
Composition of Pancreatic Juice it contains 99.5% water and 0.5%
solids. Solids are further classified into
Enzymes A Proteolytic Enzymes- trypsin, chymotrypsin,
carboxypeptidase, nuclease, elastase and collagenase
B. Lipolytic enzymes- Pancreatic lipase, Cholesterol ester hydrase,
phopholipase A, Phospholipase B, colipase and bile salt activated
lipase
Amylotic Enzyme- Pancreatic Amylase
Other organic Substances Albumin and globulin
Inorganic Substances Sodium, calcium, potassium, magnesium,
bicarbonate, chloride, phosphate and Sulfate.

Functions of Pancreatic Juice

1. Digestive functions of Pancreatic Juice Pancreatic juice plays an
important role in digestion of proteins and lipids.
Digestion of Proteins
Digestion of Lipids
Digestion of Carbohydrates
2. Neutralizing action of Pancreatic Juice Neutralizing action is an
important function of pancreatic juice because it protects the
intestine from the destructive action of acidic chyme.

Digestive Enzymes of Pancreatic juice

Functions of Liver
 1. Metabolic function: it plays an important role in energy
metabolism. Metabolism of carbohydrates, proteins, fats, vitamins
and many hormones is carried out in liver.
2. Storage function: Many substances like glycogen, amino acids,
iron, folic acid and Vit A, B12 and D are stored in liver.
3. Synthetic function; Liver produce glucose by gluconegenesis. It
synthesizes all the plasma proteins and other proteins(except
immunoglobulins) such as clotting factors, complement factors and
hormone binding factors. It also synthesizes steroids, somatomedin
and heparin.
4. Secretion of Bile; Liver secretes bile, which contains bile salts,
bile pigments, cholesterol, fatty acids and lecithin. The bile salts are
required for digestion and absorption of fats in the intestine. Bile
helps to carry away waste products and breakdown fats, which are
excreted through feces or urine.
5. Excretory function; Liver excretes cholesterol, bile pigments,
heavy metals like lead, arsenic, toxins, bacteria and virus like that of
yellow fever through bile.
6. Heat production; Enormous amount of heat is produced in the
liver because of metabolic reactions. Liver is the organ where
maximum heat is produced.
7. Hemopoietic function; In fetus liver produces the blood cells. It
stores vit B12 necessary for erythropoiesis and iron necessary for
synthesis of haemoglobin. Liver produces thrombopoietin that
promotes production of thrombocytes.
8. Hemolytic function; The senile RBC after life span of 120 days are
destroyed by reticuloendothelial cells of liver.
9. In activation of Hormones and drugs; Liver catabolizes the
hormones such as growth hormone, parathormone, cortisol, insulin,
glucagon and estrogen. It also inactivates the drugs particularly the
fat soluble drugs. Fat soluble drugs are converted into water soluble
substances which are excreted through bile or urine.
Defensive and detoxification function; the reticuloendothelial cells of
liver plays an important role in the defense of the body. Liver is also
involved in the detoxification of foreign bodies. Foreign bodies are
swallowed and digested by RE cells of liver by phagocytosis.
Removal of toxic property of harmful agent is known as
detoxification. The detoxification in liver occurs in 2 ways
A. Total destruction of the substance by means of metabolic
degradation.
B Conversion of toxic substances into non toxic substances by means
of conjugation with glucuronic acid or sulfates.

Bile:
Bile is golden yellow or greenish fluid. It enters the digestive tract
along with the pancreatic juice through the common opening called
ampulla of vater.
Bile is secreted by hepatocytes. The initial bile secreted by
hepatocytes contain large quantity of bile acids, bile pigments,
cholesterol, lecithin and fatty acids. From common hepatic duct, bile
 is diverted either directly into the intestine or into gall bladder
where it is stored. Sodium, bicarbonate and water are added to bile
when it passes through the ducts.
Volume- 800-1200ml/daily
Reaction- Alkaline
Ph 8 to 8.6
Specific gravity 1.010 to 1.011

Composition of Bile
Bile contains 97.6% water and 2.4% of solids. Solids are further classified
into
Organic substances- Bile salts, bile pigments, cholesterol, fatty acids,
lecithin and Mucin
Inorganic Substances- Sodium, calcium, potassium, chloride, and
bicarbonate.

Storage of bile
Most of the bile from liver enters the gall bladder where it is stored.
It is released from gall bladder into the intestine whenever it is
required. When bile is stored into gall bladder it undergoes many
changes in quality and quantity such as
A large amount of water and electrolytes are absorbed resulting in
high concentration of bile salts, bile pigments, cholesterol, fatty
acids and lecithin
Ph and specific gravity of the bile are altered in gall bladder
Some amount of mucin is added to bile.

Functions of bile.
1. Digestive function emulsification is the process by which the fat
globules are broken down into minute droplets and made in the form
of milky fluid called emulsion. Fats are made into an emulsion in the
small intestine by the action of bile salts. Emulsification increases
the surface area of the lipids making them much easier to digest.
The lipolytic enzymes of GI tract cannot digest the fats directly
because the fats are insoluble in water due to the surface tension.
The emulsification of fats by bile salts needs the presence of lecithin
from bile.
2. Absorptive functions- Bile salts help in the absorption of digested
fats from intestine into blood.
3. Excretory functions- bile pigments are the major excretory
products of the bile. Other substances excreted in the bile are
Heavy Metals like copper and iron
Some bacteria like typhoid bacteria
Some toxins
Cholesterol
Lecithin
Alkaline Phosphatase
4. Laxative action Laxative is an agent which induces defecation.
Bile salts act as laxatives by stimulating peristaltic movements of
the intestine.
 5. Antiseptic action Bile inhibits the growth of certain bacteria in
the lumen of intestine by its natural detergent action
6. Choleretic action- Bile salts stimulate the secretion of bile from
liver. This action is called choleretic action
7. Maintenance of ph in the gastrointestinal tract as the bile is
highly alkaline, it neutralizes acid chyme which enters the intestine
from stomach. An Optimum Ph is maintained for the action of
digestive enzymes.
8. Prevention of gall stone formation it prevent the formation of
gall stone by keeping the cholesterol and lecithin in solution. In the
absence of bile salts, cholesterol precipitates along with the lecithin
and forms gall stone.
9. Lubrication function The mucin in act as a lubricant for the chyme
in intestine
10 Cholagogue Action- Cholagogue is an agent, which increases the
release of bile from gall bladder into the intestine by contraction of
gall bladder. Bile salts act as indirectly cholagogue by stimulating
the secretion of hormone cholecystokinin, which causes contraction
of gall bladder resulting in release of bile.

Functions of Gall Bladder.

1. Storage of bile; Bile is continously secreted from the liver. But it is
relased into intestine only intermittently and most of the bile is
stored in gall bladder till it is required.
2. Concentration of bile: Bile is concenterated while it is stored in
gall bladder. The mucosa of gall bladder reapidly reabsorbs water
and electrolytes except calcium and potassium. But the bile salts,
bile pigments, cholesterol and lecithin are not reabsorbed, so its
concentration increases 5 to 10 times
3. Alteration of Ph of Bile: the Ph of bile decreases from 8-8.6 to 7-
7.6 and it becomes less alkaline when it is stored in gall bladder.
4. Secretion of Mucin; gall bladder secretes Mucin, which act as a
lubricant for movement of chyme in the intestine.
Maintenance of pressure in Biliary system; Due to concentrating
capacity, gall bladder maintains a pressure of about 7cm H20 in
biliary system. This pressure in the biliary system is essential for
release of bile into the intestine.

Functions of Small intestine.

1. Mechanical Function; the mixing movements of small intestine
help in thorough mixing of chyme with the digestive juices like
succus entericus, pancreatic juice and bile.
2. Secretory function; Small intestine secretes succus entericus,
enterokinase and GI hormones.
3. Hormonal Functions; Small intestine secretes many GI hormones
such as secretin, cholecystokinin etc. these hormones regulate the
movement of GI tract and secretory activities of intestine and
pancreas.
 4. Digestive Function the enzymes of succus entericus act on the
partially digested food and convert them into final digestive
products.
5. Activator function- through Succus entericus
6. Hemopoetic function- intrinsic factor of castle plays an imp role in
eryhtropoiesis.
7. hydrolytic function intestinal juice helps in all the enzymatic
reactions or digestion
8. Absorptive Function- the presence of villi and microvilli in small
intestinal mucosa increases the surface area of the mucosa. This
facilitates the absorptive function of intestine.
Absorption of carbohydrates, proteins, fats and other nutritive
substances such as vitamins, minerals and water are absorbed
mostly in the small intestine.

Succus entericus
Succus Entericus is secreted from Small intestine. The cyrpts of
Liberkuhn or Intestinal glands are simple tubular glands of small
intestine. They have further 3 types of cells
Argentaffin cells also known as enterochromaffin cells, it secretes
intrinsic factor that is essential for the absorption of Vit B12.
Goblet cells which secrete Mucus
Paneth cells which secrete the cytokines called defensins.
Brunners Glands in addition to the intestinal glands, the first part
of duodenum contains some mucus glands called as brunners gland.
It secretes mucus and traces of enzymes.

Properties and composition of succus entericus.

Volume- 1800ml/day
Reaction- Alkaline
Ph -8.3
Composition; 99.5% water and Solids 0.5%. The bicarbonate
concenteration is slightly high in succus entericus.
Organic Substances Enzymes
A Proteolytic Enzymes- Peptidases, Amino Peptidase, dipeptidase,
tripeptidase
B Lipolytic Enzymes- Lipase
C Amylolytic functions- Sucrase, Maltase, lactase, Dextrinase and
trehalase
D Enterokinase
Other organic substances Mucus, intrinsic factor and defensins
Inorganic substances Sodium, calcium, Potassium, Bicarbonate,
chloride, phosphate and Sulfate

Functions
1. Digestive Functionthe enzymes of succus entericus act on the
partially digested food and convert them into final digestive
products
 2. Protective Functions- the mucus present in the succus entericus
protects the intestinal wall from the acid chyme, which enters the
intestine from stomach thereby it prevents the intestinal ulcer.
Paneth cells of the intestinal glands secrete defensins which are the
antimicrobial peptides.
3. Activator fucntion- the enterokinase present in intestinal juice
activates trypsinogen into trypsin. Trypsin activates other enzymes.
4. Hemopoietic function- the intrinsic factor of castle, which is
present in the intestine plays an imp role in absorption of Vit b12.
5 Hydrolytic Process it helps in all the enzymatic reactions of
digestion.

Functions of large intestine

1. Absorptive functions; it plays an important role in the absorption
of various substances such as water, electrolytes, glucose, alcohol
and drugs like anesthetic agents, sedatives and steroids.
2. Formation of feces; after absorption, the unwanted substances in
the large intestine form feces, which is excreted out.
3. Excretory function; it excretes heavy metals like mercury, lead,
bismuth and arsenic through feces
4. Secretory function; it secretes mucin and inorganic substances
like chlorides and bicarbonates.
5. Synthetic functions; it synthesizes folic acid, vit b12 and vit K. by
this function large intestine contributes in erythropoietic activity
and blood clotting mechanism

Secretion of large intestine

The crypts of liberkuhn are present in the mucus layer of the large
intestine. Only mucus secreting glands are present in the mucosa of
large intestine.
Secretion of Large intestine is a watery fluid with ph of 8.0
It contains 99.5% water and 0.5% solids. Digestive enzymes are
absent and concentration of bicarbonate ion is high.
 Organic Substances Albumin, globulin, Mucin, Urea, Debris of
epithelial cells
Inorganic Substances- Sodium, calcium, Potassium, bicarbonate,
chloride, phosphate and sulfate.

Functions of Large intestine Juice

Neutralization of acids strong acids formed by bacterial action in
large intestine are neutralized by the alkaline nature of large
intestine juice.
Lubrication Activity- The mucin present in secretion of large
intestine lubricates the mucosa of large intestine and the bowel
contents, so that movement of bowel is facilitated.
It also protects the mucous membrane of large intestine by
preventing the damage caused by mechanical injury or chemical
substances.
Cell Physiology

What is cell?
* The cell is the basic unit of life. All organisms are made up of cells
(or in some cases, a single cell). Most cells are very small; most are
invisible without using a microscope. Cells are covered by a cell
membrane and come in many different shapes. The contents of a cell
are called the protoplasm.
Animal cell Parts
* cell membrane - the thin layer of protein and fat that surrounds the
cell. The cell membrane is semipermeable, allowing some substances
to pass into the cell and blocking others.it is thin and elastic.
* centrosome - (also called the "microtubule organizing center") a
small body located near the nucleus - it has a dense center and
radiating tubules. The centrosomes is where microtubules are made.
During cell division (mitosis), the centrosome divides and the two
parts move to opposite sides of the dividing cell. The centriole is the
dense center of the centrosome.
* cytoplasm - the jellylike material outside the cell nucleus in which
the organelles are located.it contains molecules of ribonucleic
acid(RNA) which is messenger carrying information out from the
nucleus to the cytoplasm.
* Golgi body - (also called the Golgi apparatus or golgi complex) a
flattened, layered, sac-like organelle that looks like a stack of
pancakes and is located near the nucleus. It produces the
membranes that surround the lysosomes. The Golgi body packages
proteins and carbohydrates into membrane-bound vesicles for
"export" from the cell.
* lysosome - (also called cell vesicles) round organelles surrounded by
a membrane and containing digestive enzymes. This is where the
 digestion of cell nutrients takes place. It removes the particles which
are not useful for the cell.
* nucleus - spherical body containing many organelles, including the
nucleolus. The nucleus controls many of the functions of the cell (by
controlling protein synthesis) and contains deoxyribonucleic acid
(DNA in chromosomes). The nucleus is surrounded by the nuclear
membrane. DNA Contains genetically inherited information required
for the maintenance of the cell. The nucleoplasm, which is
protoplasm within the nuclear membrane, stores the information for
the cell to grow and to divide into daughter cells. The information is
stored in Genes which are stung together to form chromosomes.
Genes are composed of DNA.
* ribosome - small organelles composed of RNA-rich cytoplasmic
granules that are sites of protein synthesis.
* rough endoplasmic reticulum - (rough ER) a vast system of
interconnected, membranous, infolded and convoluted sacks that
are located in the cell's cytoplasm (the ER is continuous with the
outer nuclear membrane). Rough ER is covered with ribosomes that
give it a rough appearance. Rough ER transports materials through
the cell and produces proteins in sacks called cisternae (which are
sent to the Golgi body, or inserted into the cell membrane).
smooth endoplasmic reticulum - (smooth ER) a vast system of
interconnected, membranous, infolded and convoluted tubes that
are located in the cell's cytoplasm (the ER is continuous with the
outer nuclear membrane). The space within the ER is called the ER
lumen. Smooth ER transports materials through the cell. It contains
enzymes and produces and digests lipids (fats) and membrane
proteins; smooth ER buds off from rough ER, moving the newly-made
proteins and lipids to the Golgi body, lysosomes, and membranes.
vacuole - fluid-filled, membrane-surrounded cavities inside a cell.
The vacuole fills with food being digested and waste material that is
on its way out of the cell.
* Mitochondrion: Spherical to rod shaped organellles with a double
membrane. The inner membrane is infolded many times, forming a
series of projections called cristae. The mitochondrion converts the
energy stored in glucose into ATP (adenosine triphosphate) for the
cell. Mitochondria are tiny sac-like structures found near the
nucleus. Little shelves called cristae are formed from folds in the
inner membrane. Cells that are metabolically active such as muscle,
liver and kidney cells have high energy requirements and therefore
have more mitochondria.

Functions of cell
* Cellular metabolism: Cells are capable of breaking down sugars and
other molecules to provide the necessary energy to keep a body
alive. This process of metabolism allows all the other normal
functions that a cell must complete. By breaking down the specific
molecules, cells create ATP, or Adenosine Triphosphate.
* Reproduction: This is the process by which cells promote the
synthesis of life. There are two methods of reproduction: mitosis and
 meiosis. For generation of new cells within a body, mitosis is
performed by somatic cells. Meiosis only occurs in reproductive
cells. These cells have a slightly different genetic code than the cells
that created them and they are used to propagate the advancement
of a species through sexual reproduction.
* Transportation: The last cell and function concern is the transport of
molecules throughout the body. This is the important process by
which blood is circulated and oxygen reaches the various organs in
the body. There are two types of molecular transport: active and
passive transport. In the first, active transport, the cells are able to
move macromolecules, such as proteins, to their destination. The
second, passive transport, occurs when the cells are able to absorb
molecules by allowing them to cross the cellular membrane

Functions of cell
* Ingestion and assimilation: all cells take in various oxygen and
nutrients and utilize them for the production of energy and other
processes.
* Growth and repair: Cells continually divide and enlarge to replace
and repair the damaged cells, this process is also important in
enlargement of various body parts and individuals as a whole.
* Metabolism: it involves the breakdown process(Catabolism) and the
synthesizing process (anabolism), the larger molecules obtained
from food are breakdown into smaller and easily usable forms and
the smaller molecules are used to synthesize larger ones, used in
building various components like proteins.
* Respiration: Cells utilise glucose and oxygen to produce energy in
the form of high energy bonds of adenotriphosphate (ATP).
* Excretion of the waste products; waste products of cell metabolism
are removed with the help of vacoules
* Irritability and contractility: it is important in functioning of
muscular and nervous tissues, contraction of muscles, production
and transmission of impulse, and contraction of heart.

Function of Cell parts;

Part Function
Plasma Protein studded phospholipid bilayer that surrounds
Membrane the cell, it protects cellular content and makes
contact with other cells, provide receptor for
hormones, enzymes, and antibodies and mediates the
entrance and exit of the material
Cytosol Viscous, transparent, gel-like intracellular fluid
containing water, ions, enzymes, medium in which
 many of the cell chemical reaction occur. The
cytoplasm includes cytosol and all organelles
Nucleus It contains genes and cellular activities
Ribosomes Site for protein synthesis, may be either free in the
cytosol or attached to ER
Part Function

Lysosomes Enzymes found here break down unwanted microbes

and toxins
Peroxisomes Contains enzymes that use molecular oxygen to
oxidize various organic substances
Mitochondria Main sites of ATP production during cellular respiration

Cytoskeleton Includes 3 types of filaments (microfilaments,

microtubules, and intermediate filament) that give
the cell shape and allow coordinated movements of
organelles. In some cells the cytoskeleton is
responsible for movement of the cell itself.
Centrosome Centrosome helps organize microtubules in a non
and dividing cell and forms the mitotic spindle during cell
Centrioles division, centrioles play a role in the formation and
regeneration of flagella and cilia
Transport Process of the cell
* Active Processes: With active transport a molecule or iron combines
with carrier molecule. This combination alters the shape of the
carrier molecule. Using ATP energy, the carrier transports the
molecule from an area of lower concentration to an area of higher
concentration.
* 1) Primary active transport: is the movement of the solutes against
the gradient and requires the expenditure of energy, usually in the
form of ATP
* 2) Protein Pumps; transports protein in the plasma membrane
transfer solutes such as small ions (Na+, K+, Cl-, H+) aminoacids
and monosaccharides
* Protein involved with active transport are also known as ion pumps.
* Protein binds to a molecule of the substance to be transported on
one side of the membrane , then it uses the released energy to
change its shape, and releases it on the other side.
* Protein pumps are specific, there is a different pump for each
molecule to be transported.
* Protein pump are catalysts in the splitting of ATP_____ADP+
Phosphate, so they are called ATPase enzymes.
* Sodium-potassium pump (also called the NA+/K+--ATPase enzyme)
actively moves out of the cell and potassium into the cell. These
pumps are found in the membrane of virtually every cell, and are
essential in transmission of nerve impulses and in muscular
contractions.
Vesicular transport
* Vesicles or other bodies in the cytoplasm move macromolecules or
large particles across the plasma membrane. Types of Vesicular
transport are
* 1. Exocytosis; which describes the process of vesicles fusing with the
plasma membrane and releasing their contents to the outside of the
cell(extra cellular fluid). This process is common when a cell
produces substances for export.
* 2. Endocytosis: which describes the capture of a substance outside
the cell when the plasma membrane merges to engulf it. The
substance subsequently enters the cytoplasm enclosed in a vesicle.
There are 3 Kinds of endocytosis
* Phagocytosis: or cellular eating, occurs when the dissolved materials
enter the cell. The plasma membrane engulfs the solid material,
forming a phagocytic vesicle.
* Pinocytosis or cellular drinking occurs when the plasma membrane
folds inward to form a channel allowing dissolved substance to enter
the cell. When the channel is closed, liquid is encircled within a
pinocytic vesicle.
* Receptor-mediated endocytosis; occurs when specific molecules in
the fluid surrounding the cell bind to specialized receptors in the
plasma membrane. As in PinocytosisAs in pinocytosis, the plasma
membrane folds inward and the formation of a vesicle follows.
* Note: Certain hormones are able to target specific cells by receptor-
mediated endocytosis

Passive transport across the cell membrane

* Passive transport describes the movement of substances down a
concentration gradient and does not require energy use.
* Bulk flow is the collective movement of substances in the same
direction in response to a force, such as pressure. Blood moving
through a vessel is an example of bulk flow.
* Simple diffusion, or diffusion, is the net movement of substances
from an area of higher concentration to an area of lower
concentration. This movement occurs as a result of the random and
constant motion characteristic of all molecules, (atoms or ions) and
is independent from the motion of other molecules. Since, at any
one time, some molecules may be moving against the gradient and
some molecules may be moving down the gradient, although the
motion is random, the word "net" is used to indicate the overall,
eventual end result of the movement.
* Facilitated diffusion is the diffusion of solutes through channel
proteins in the plasma membrane. Water can pass freely through the
plasma membrane without the aid of specialized proteins (though
facilitated by aquaporins).
* Osmosis is the diffusion of water molecules across a selectively
permeable membrane. When water moves into a body by osmosis,
hydrostatic pressure or osmotic pressure may build up inside the
body.
* Dialysis is the diffusion of solutes across a selectively permeable
membrane.

Cell reproduction
* There are two kinds of cell division: mitosis and meiosis. Mitosis is
essentially a duplication process: It produces two genetically
identical "daughter" cells from a single "parent" cell. You grew from
a single embryonic cell to the person you are now through mitosis.
Even after you are grown, mitosis replaces cells lost through
everyday wear and tear. The constant replenishment of your skin
cells, for example, occurs through mitosis. Mitosis takes place in
cells in all parts of your body, keeping your tissues and organs in
good working order.
* Meiosis, on the other hand, is quite different. It shuffles the genetic
deck, generating daughter cells that are distinct from one another
and from the original parent cell. Although virtually all of your cells
can undergo mitosis, only a few special cells are capable of meiosis:
those that will become eggs in females and sperm in males. So,
basically, mitosis is for growth and maintenance, while meiosis is for
sexual reproduction.

Normal Cell Division

* Cell Division is the process of Cellular reproduction. It consist of
Nuclear division (mitosis and Meiosis) and Cytoplasmic
Division( Cytokinesis)
* Cell Division that results in an increase in number of body cells is
called somatic cell division and involves a nuclear division called
Mitosis+ Cytokinesis
* Cell Division that results in the production of sperm and ova is called
reproductive cell division and consist of a nuclear division called
Meiosis + Cytokinesis.

Somatic cell Division

* This cycle begins when the cell is produced by mitosis and runs until
the cell undergoes its own mitosis and splits in two. The cycle is
divided into distinct phases: G1 (gap 1) S (synthesis), G2 (gap 2), and
M (mitosis). As you can see, mitosis only occupies a fraction of the
cycle. The rest of the time-phases G1 through G2is known as
interphase.
* Scientists used to think of interphase as a resting phase during
which not much happened, but they now know that this is far from
the truth. It is during interphase that chromosomesthe genetic
materialare copied, and cells typically double in size. While this is
happening, cells continue to do their jobs: Your heart muscle cells
contract and pump blood, your intestinal cells absorb the food you
eat, your thyroid gland cells churn out hormones, and so on. In
contrast, most of these activities cease during mitosis while the cell
focuses on dividing. But as you have probably figured out, not all
cells in an organ undergo mitosis at the same time. While one cell
divides, its neighbors work to keep your body functioning
Meiosis
* Theoretically, this cell would then grow into a person with 46 pairs of
chromosomes per cell (rather than the usual 23 pairs). Subsequent
generations would have even more chromosomes per cell. there
must be a way to cut in half the number of chromosomes in egg and
sperm cells.
* To accomplish that task, nature devised a special kind of cell division
called meiosis. In preparation for meiosis, the chromosomes are
copied once, just as for mitosis, but instead of one cell division,
there are two. The result is four daughter cells, each containing 23
individual chromosomes rather than 23 pairs.
 Difference between Mitosis and Meiosis

Sr Mitosis Meiosis
no
1 The Cell Divides only once after one There are two
round of DNA replication successive division
first and the second
meiotic division
2 Mitosis take place in Somatic cell Meiosis take place
division in Germ Cells
3 DNA replicates only once for one DNA replicates once
cell division for two cell
divisions
4 Cell Divides only once and also There are two cell
chromosomes divides only once Divisions but
chromosome divides
only once
5 There is no Synopsis (Pairing) Synopsis of
Homologous
chromosomes take
place during
Prophase I

Sr Mitosis Meiosis
No
6 The two Chromatids of The Chromatids of two
a chromosome do not homologus chromosomes
exchange segments exchange Homologous
during prophase segments during prophase at
the pachytene
7 The Chromosomes Chromosomes number is
number remain reduced from diploid to
constant at the end of haploid
Mitosis

8 Genetic constitution of Genetic constitution of the

the daughter cell is daughter cells differ from the
identical to that of the parent cell due to crossing
parent cell over. Each Chromosomes
contain a mixture of maternal
and paternal genes.
Tissue Anatomy and Physiology

Tissue
Tissue is a group of cells that have similar structure and that
function together as a unit. A nonliving material, called the
intercellular matrix, fills the spaces between the cells. This may be
abundant in some tissues and minimal in others. The intercellular
matrix may contain special substances such as salts and fibers that
are unique to a specific tissue and gives that tissue distinctive
characteristics. There are four main tissue types in the body:
epithelial, connective, muscle, and nervous. Each is designed for
specific functions.

Epithelial Tissue
Epithelial tissues are widespread throughout the body. They form
the covering of all body surfaces, line body cavities and hollow
organs, and are the major tissue in glands. They perform a variety of
functions that include protection, secretion, absorption, excretion,
filtration, diffusion, and sensory reception.
The cells in epithelial tissue are tightly packed together with very
little intercellular matrix. Because the tissues form coverings and
linings, the cells have one free surface that is not in contact with
other cells. Opposite the free surface, the cells are attached to
underlying connective tissue by a non-cellular basement membrane.
This membrane is a mixture of carbohydrates and proteins secreted
by the epithelial and connective tissue cells.

Types of epithelium
 Simple Epithelium: It consist of a single layer of cells. The cell type
may be squamous, cuboidal or columnar giving rise to 3 types of
simple epithelium.
A Simple Squamous epithelium; This is a single layer of flat cells.
Cells are so thin that bulging are produced by nuclei.
B Simple Cuboidal Epithelium: the length and breadth of the cell are
equal with centrally placed rounded nuclei.
C Simple Columnar epithelium: Height of the cells are much greater
than the width. Nuclei are oval and are near the base of the cell.

Stratified Epithelium
It consist of several layers of cells. The commonest type of stratified
epithelium is stratified squamous epithelium in the skin. Cell in the
deepest layer are columnar, middle layer are polyhedral and in the
superficial layer shows flattening. Nuclei are correspondingly oval in
the basal layer, rounded in the middle layer and transversely
elongated in the superficial layer. In the keratinised variety most
superficial layer loose their nuclei, become a non living, hard
cornified layer called Keratin.

Transitional Epithelium
They are like stratified epithelium, but the surface cells instead of being
flattened, are rounded or large umbrella shaped. Middle layer are
polyhedral or pear shaped. Cells in the deeper layer are columnar or
cuboidal. It has expansible property and are found in the urinary bladder
and urethra.

Simple Cuboidal epithelium is found in the glandular tissue and in

the Kidney tubules.
Simple Columnar epithelium lies the stomach and intestines.
Pseudo stratified columnar epithelium lines portion of the
respiratory tract and some of the tubes of the male reproductive
tract.
Transitional Epithelium can be distended or stretched.
Glandular epithelium is specialized to produce and secrete
substances.

Connective tissues
Connective tissues bind structures together, form a framework and
support for organs and the body as a whole, store fat, transport
substances, protect against disease, and help repair tissue damage.
They occur throughout the body. Connective tissues are
characterized by an abundance of intercellular matrix with relatively
few cells. Connective tissue cells are able to reproduce but not as
rapidly as epithelial cells. Most connective tissues have a good blood
supply but some do not.
Numerous cell types are found in connective tissue. Three of the
most common are the fibroblast, macrophage, and mast cell. The
types of connective tissue include loose connective tissue, adipose
tissue, dense fibrous connective tissue, elastic connective tissue,
cartilage, osseous tissue (bone), and blood.
Adipose tissue
Adipose Tissue is a loose fibrous connective tissue packed with many
cells (called "adipocytes") that are specialized for storage of
triglycerides more commonly referred to as "fats".
Each adipocyte cell is filled with a single large droplet of triglyceride
(fat). As this occupies most of the volume of the cell, its cytoplasm,
nucleus, and other components are pushed towards the edges of the
cell - which is bounded by the plasma membrane
Adipose tissue acts as an insulating layer, helping to reduce heat
loss through the skin.
It also has a protective function, providing mechanical protection
("padding") and support around some of the major organs, e.g.
kidneys.
Adipose tissue is also a means of energy storage.
Food that is excess to requirements is converted into fat and stored
within adipose tissue in the body
Specific examples of the locations of adipose tissue include:
Subcutaneous layer deep to skin;
Around the heart;
Around the kidneys;
Yellow marrow of the long bones
Padding around the joints
Inside the eye-socket, posterior to the eyeball.
Dense Connective tissue

Collagen (from the Greek kolla, meaning "glue," and genos, meaning
"descent") is a dense connective tissue, also known as fibrous
connective tissue. It has a matrix of densely packed collagen fibers.
There are two types of collagen: regular and irregular. The collagen
fibers of regular dense connective tissue are lined up in parallel.
Tendons, which bind muscle to bone, and ligaments, which join
bones together, are examples of dense regular connective tissue.
The strong covering of various organs, such as kidneys and muscle,
is dense irregular connective tissue.
Dense Irregular connective tissue is found in areas where greater
protection is required or in areas of Mechanical stress.

Mucoid Tissue

It is an embryonic tissue and consists of a homogenous matrix with a

fine meshwork of collagen fibres with fibroblasts. This tissue is
found in the vitreous body and the umbilical cord
Pigmented connective tissue

It contains abundant melanocytes and is found in the choroid, sclera

and Skin. Melanocytes produce a pigment melanin, which provides
colour to the skin.

Cartilage tissue in general

Cartilage is a connective tissue consisting of a dense matrix of
collagen fibres and elastic fibres embedded in a rubbery ground
substance. The matrix is produced by cells called chondroblasts,
which become embedded in the matrix as chondrocytes.
That is, mature cartilage cells are called chondrocytes.
They occur, either singly or in groups, within spaces called lacunae
(sing. lacuna) in the matrix.
The surface of most of the cartilage in the body is surrounded by a
membrane of dense irregular connective tissue called
perichondrium. This is important to remember especially because
(unlike other connective tissues), cartilage contains no blood vessels
or nerves - except in the perichondrium.
Hyaline cartilage

Hyaline cartilage is the most abundant of the three types of

cartilage.
It is found in many locations in the body, including:
Bronchi; Bronchial Tubes; Costal Cartilages; Larynx (voice-box);
Nose; Trachea
Covering the surface of bones at joints - especially in areas where
damage due to wear may lead to osteoarthritis incl. e.g. the ends of
the long bones, and also the anterior ends of the ribs.
Embryonic skeleton (i.e. in the fetus).
Hyaline cartilage consists of a bluish-white, shiny ground elastic
material with a matrix of chondroitin sulphate into which many fine
collagen fibrils are embedded. It contains numerous chondrocytes.
Hyaline cartilage tissue provides smooth surfaces, enabling tissues
to move/slide easily over each other, e.g. facilitating smooth
movements at joints. It is also provides flexibility and support.
Fibrocartilage
Examples include:
Calli (sing. callus), which is the tissue formed between the ends of
the bone at the site of a healing fracture (bloodclot -> granulation
tissue -> cartilage -> bone);
Intevertebral discs (i.e. the discs between the vertebrae of the
spine);
Menisci (cartilage pads) of the knee joint.
Pubic symphysis, which is the position at which the hip bones join at
the front of the body.
Also in the portions of the tendons that insert into the cartilage
tissue, especially at joints.
Fibrocartilage is a tough form of cartilage that consists of
chondrocytes scattered among clearly visible dense bundles of
collagen fibres within the matrix. Fibrocartilage lacks a
perichondrium.
Fibrocartilage tissue provides support and rigidity to
attached/surrounding structures and is the strongest of the three
types of cartilage.

Elastic Cartilage.
Auditory (Eustachian) Tubes; External Ear (Auricle); Epiglottis (the
lid on the top of the larynx)
 In elastic cartilage, which is yellowish in colour, the cartilage cells
(chondrocytes) are located in a threadlike network of elastic fibres
within the matrix of the cartilage. A perichondrium is present.
Elastic cartilages provides support to surrounding structures and
helps the define and maintain the shape of the area in which it is
present, e.g. the external ear.

Bone tissue
The bones themselves are formed from several different connective
tissues, including:
Bone (called "Osseous") tissue,
Periosteum,
Red Bone Marrow,
Yellow Bone Marrow, and
Endosteum.
Bone tissue is classified as either "compact bone", or "spongy bone"
depending on how the bone matrix and cells are organized.
Compact Bone
The basic unit of Compact Bone is an "osteon", which is also known
as a "Haversian System".
Each Haversian System (unit) has a cylindrical structure that
consists of four parts:
A central tube called a Haversian Canal, which contains blood
vessels and nerves.
The Haversian Canal is surrounded by alternate layers of:
Lamellae (the word lamellae literally means "little plates") are
concentric rings of a strong matrix formed from mineral salts
including calcium and phosphates and collagen fibres. The mineral
salts result in the hardness of the bone structure, while the collagen
fibres contribute its strength.
Lacunae are the small spaces between the lamellae in which contain
the bone cells (called "osteocytes") are located.
The lacunae are linked together by minute channels called canaliculi.
The canaliculi provide routes by which nutrients can reach the
osteocytes and waste products can leave them.

Spongy Bone
Spongy Bone does not include osteons (the basic unit/s of Compact
Bone - see above).
Instead, spongy bone consists of an irregular lattice of thin columns
of bone called trabeculae (literally "little beams"), which contain
lamellae, osteocytes, lacunae and canaliculi. The spaces between
the trabeculae of some spongy bones are filled with red bone
marrow.
 Blood vessels from the periosteum, penetrate into the trabeculae
lattice allowing the osteocytes in the trabeculae to receive
nourishment from the blood passing through the marrow cavities.

Functions of bone tissue

Support
Protection
Assisting in Movements
Storage of minerals
Production of Blood cells
Storage of chemical energy. With increasing age bone marrow
changes from red bone marrow to yellow bone marrow. Yellow bone
marrow consist of adipose cells and a few blood cells, which is an
imp chemical energy reserve.

Muscular tissue
Muscle tissue is composed of cells that have the special ability to
shorten or contract in order to produce movement of the body parts.
The tissue is highly cellular and is well supplied with blood vessels.
The cells are long and slender so they are sometimes called muscle
fibers, and these are usually arranged in bundles or layers that are
surrounded by connective tissue. Actin and myosin are contractile
proteins in muscle tissue.
Muscle tissue can be categorized into skeletal muscle tissue, smooth
muscle tissue, and cardiac muscle tissue.

Skeletal Muscle tissue

Skeletal muscle is called "striated" because of its appearance
consisting of light and dark bands visible using a light microscope. A
single skeletal muscle cell is long and approximately cylindrical in
shape, with many nuclei located at the edges (periphery) of the cell.
Movement of the skeleton under concious control, including
movement of limbs, fingers, toes, neck, etc.
Movement of tissues of facial expression under concious control, e.g.
ability to smile and to frown.
Cardiac Muscle tissue
Cardiac muscle fibers are striated, branched (sometimes described
as Y-shaped), and have a single central nucleus. These fibers are
attached at their ends to adjoining fibers by thick plasma
membranes called intercalated discs.
Pumping of blood through the heart: Alternate contraction and
relaxation of cardiac muscle pumps
De-oxygenated blood through the Right Atrium and Right
Ventricle to the lungs, and
Oxygenated blood through the Left Atrium and Left Ventricle
to the aorta, then the rest of the body.
Smooth Muscle tissue:
Unlike Skeletal and Cardiac muscle tissue, Smooth muscle is not
striated. Smooth muscle fibers are small and tapered - with the ends
reducing in size, in contrast to the cylindrical shape of skeletal
muscle. Each smooth muscle fiber has a single centrally located
nucleus.
Contractions of smooth muscle constrict (i.e. narrow = reduce the
diameter of) the vessels they surround. This is particularly important
in the digestive system in which the action of smooth muscle helps
to move food along the gastrointestinal tract as well as breaking the
food down further. Smooth muscle also contributes to moving fluids
through the body and to the elimination of indigestible matter from
the gastrointestinal system.

Types of Muscle tissue

Types of Locatio Voluntar Striatio Cell

Muscle n in the y or ns Nuclei
tissue body involunt
ary
Skeletal Attached Voluntary Striated Many
Muscle to Bones Muscle nuclei(loca
tissue mostly ted at
periphery
of long
cylindrical
 Muscle
fibers)
Cardiac Wall of Involunta Striated One
Muscle the Heart ry Muscle Centrally
tissue Only located
nuclei
Smooth Blood Involunta Non- One
Muscle Vessels ry striated Centrally
tissue Stomach located
Intestine Nuclei
s
Gall
Bladder
Urinary
Bladder
Airways
to the
lungs

Nervous Tissue

Nervous tissue is found in the brain, spinal cord, and nerves. It is

responsible for coordinating and controlling many body activities. It
stimulates muscle contraction, creates an awareness of the
environment, and plays a major role in emotions, memory, and
reasoning. To do all these things, cells in nervous tissue need to be
able to communicate with each other by way of electrical nerve
impulses.
The cells in nervous tissue that generate and conduct impulses are
called neurons or nerve cells. These cells have three principal parts:
the dendrites, the cell body, and one axon. The main part of the cell,
the part that carries on the general functions, is the cell body.
Dendrites are extensions, or processes, of the cytoplasm that carry
impulses to the cell body. An extension or process called an axon
carries impulses away from the cell body.
 Nervous tissue also includes cells that do not transmit impulses, but
instead support the activities of the neurons. These are the glial
cells (neuroglial cells), together termed the neuroglia. Supporting,
or glia, cells bind neurons together and insulate the neurons. Some
are phagocytic and protect against bacterial invasion, while others
provide nutrients by binding blood vessels to the neurons.

Neuron Structure
The cell body (soma or perikaryon) contains the nucleus and other
cell organelles.
There are clusters of rough endoplasmic reticulum that are called
Nissl bodies or are sometimes referred to as chromatophilic
substances.
The dendrite is typically a short, abundantly branched, slender
process (extension) of the cell body that receives stimuli.
The axon is typically a long, slender process of the cell body that
sends nerve impulses. It emerges from the cell body at the cone-
shaped axon hillock. Nerve impulses arise in the trigger zone,
generally located in the initial segment, an area just outside the
axon hillock. The cytoplasm of the axon, the axoplasm, is
surrounded by its plasma membrane, the axolemma. A few axons
 branch along their lengths to form axon collaterals, and these
branches may return to merge with the main axon. At its end, each
axon or axon collateral usually forms numerous branches (
telodendria), with most branches terminating in bulb-shaped
structures called synaptic knobs (synaptic end bulbs, also called
terminal boutons). The synaptic knobs contain neurotransmitters,
chemicals that transmit nerve impulses to a muscle or another
neuron.

Types of Neurons
Functionally they fall into 3 groups;
Sensory Neuronswhich transmit sensory impulses from the sensory
organs to the CNS. Ex-brain and Spinal Cord
Motor Neurons--- transmit nerve impulse from the CNS towards the
effectors, target cells that produce some kind of response.
Association Neurons are located in the CNS and transmit impulse
from sensory neurons to motor neurons. 90% of neurons are
association Neurons.

Structure classification of Neurons

Multipolar neurons have one axon and several to numerous
dendrites. Most neurons are of this type.
Bipolar Neurons have one axon and one dendrite. They are found as
specialized sensory organs in the eye, ear, or olfactory organs
Unipolar Neurons both axon and dendrites function together as
single axon. Dendrites emerge from one of the terminal ends of the
axon. Trigger zone in unipolar neuron is located at the junction of
the axon and dendrites. Unipolar neurons are mostly sensory
neurons.

Skeletal System
Osteology
The general framework of the body is built up mainly of a series of
bones, supplemented however in certain regions by cartilages, the
bony part of the framework constitutes the Skeleton.

In the skeleton of the adult there are 206 distinct bones, as follows

Skeleton Details No
Axial skeleton Vertebral 26
column
Skull 22
Hyoid Bone 1
Ribs and 25
sternum
Total 74
Appendicular Upper 64
skeleton Extremities
Lower 62
Extremities
Total 126
Auditory 6
ossicles
Total 206
Types of Bones:
Bones are divisible into 4 classes
Long Bones: the long bones are found in the limbs, and each consist
of body or shaft and two extremities. This are usually curved.
Example clavicle, humerus, radius, ulna, femur.
Short Bones: where a part of the skeleton is intended for strength
and compactness with limited movement, it is constructed of a
 number of short bones, as in the carpus and tarsus. Patellae also
falls in same class.
Flat bones: where the principle requirement is either protection or
the provision of broad surface for muscular attachment. Bones are
expanded into broad, flat plates as in the skull and scapula.
Examples are occipital, parietal, frontal, nasal, lacrimal, vomer,
scapula, sternum and ribs.
Irregular bones: irregular bones are such as, from their peculiar
form, cannot be grouped under the preceding heads. Examples are
vertebrae, sacrum, coccyx, temporal, sphenoid, ethmoid, maxilla,
mandible, hyoid etc.

Basic understanding of surfaces

Articular Eminence well marked articular surface
Articular depressions- articulating depressed area
Tuberosity, protuberance or process broad, rough, uneven elevation
non articulating
Spine- Non articulating, sharp slender pointed prominence
Tubercle- small rough prominence
Ridge, crest or line- a narrow, rough elevation running some way
along the surface.
Non Articular depressions are described as fossae, pits, depressions,
grooves, furrows, fissure, notches etc.
A short perforation is called foramen and a longer passage is called
as canal.

Bone Tissue
The bones themselves are formed from several different connective
tissues, including:
Bone (called "Osseous") tissue,
Periosteum,
Red Bone Marrow,
Yellow Bone Marrow, and
Endosteum.
Bone tissue is classified as either "compact bone", or "spongy bone"
depending on how the bone matrix and cells are organized.
Compact bone
The basic unit of Compact Bone is an "osteon", which is also known
as a "Haversian System".
Each Haversian System (unit) has a cylindrical structure that
consists of four parts:
A central tube called a Haversian Canal, which contains blood
vessels and nerves.
The Haversian Canal is surrounded by alternate layers of:
Lamellae (the word lamellae literally means "little plates") are
concentric rings of a strong matrix formed from mineral salts
including calcium and phosphates and collagen fibres. The mineral
salts result in the hardness of the bone structure, while the collagen
fibres contribute its strength.
Lacunae are the small spaces between the lamellae in which contain
the bone cells (called "osteocytes") are located.
The lacunae are linked together by minute channels called canaliculi.
The canaliculi provide routes by which nutrients can reach the
osteocytes and waste products can leave them.

Spongy Bone
Spongy Bone does not include osteons (the basic unit/s of Compact
Bone - see above).
 Instead, spongy bone consists of an irregular lattice of thin columns
of bone called trabeculae (literally "little beams"), which contain
lamellae, osteocytes, lacunae and canaliculi. The spaces between
the trabeculae of some spongy bones are filled with red bone
marrow.
Blood vessels from the periosteum, penetrate into the trabeculae
lattice allowing the osteocytes in the trabeculae to receive
nourishment from the blood passing through the marrow cavities.

The Vertebral column (columna vertebralis)

The vertebral column is a flexible column, formed of series of bones
called vertebrae.
The vertebrae are 33 in no and are grouped under the names
cervical, thoracic, lumber, sacral and coccygeal according to the
regions they occupy. There are 7 in cervical, 12 in thoracic, 5 in
lumber, 5 in sacral and 4 in the coccygeal.
The vertebrae in the upper three regions of the column remain
distinct throughout the life and are known as true or movable
vertebrae. Those of the sacral and coccygeal on the other hand are
termed as false or fixed vertebrae, because they are united with one
another in the adult to form two bones sacrum and coccyx.

General characteristics of a thoracic vertebra

A typical vertebra consist of two essential parts an anterior
segment, the body and s posterior part , the vertebral arch or neural
arch, these enclose a foramen, the vertebral foramen. The vertebral
arch consist of a pair of pedicles and a pair of laminae, and supports
seven processes 4 articular, 2 transverse and one spinous.
When the vertebrae are articulated with each other the bodies form
a strong pillar for the support of head and trunk, and the vertebral
foramina constitute a canal for the protection of the spinal cord,
while between every pair of vertebrae are two apertures, the
intevertebral foramina, one on either side for the transmission of
spinal nerves and vessels.
The Cervical Vertebra
The cervical vertebrae are the smallest of the true vertebrae, and
can be readily distinguished from those of the thoracic or lumber
regions by the the presence of foramen in each transverse process.
The first, second and seventh present exceptional features

The First cervical vertebra

 The first cervical vertebra is named the atlas because it supports the
globe of the head. Its chief peculiarity is that it has no body, and this
is due to the fact that body of the atlas has fused with that of the
next vertebra. Its other pecularities that it has no spinous process,
and is ring-like, and consist of an anterior and posterior arch and
two lateral masses.
The anterior arch forms about one fifth of the ring, its anterior
surface is convex, and presents at its center the anterior tubercle
for attachment of muscle, posteriorly it is concave and marked by a
smooth , oval or circular facet for articulation with the odontoid
process of the axis.
The posterior arch forms about 2/5th of the circumference of the ring
and ends behind in the posterior tubercle, which is rudiment of the
spinous process.
Superior facets are of large size, oval, concave, forming a cup for the
corresponding condyle of the occipital bone, and are adapted to the
nodding movements of the head.
Inferior articular facets are circular in form, flattened or slightly
convex and directed downward and medialward articulating with the
axis and permitting the rotatory movements of the head.
The transverse process are large, they project lateralward and
downward from the lateral masses and serves for the attachment of
muscles which assist in rotating the head.

Second Cervical vertebrae

The second cervical vertebrae is named the axis because it forms the
pivot upon which the first vertebrae, carrying the head rotates. The
most distinctive characteristic of this bone is the strong odontoid
process which rises perpendicularly from the upper surface of the
body. The body is deeper in front than the behind, and prolonged
downward anteriorly so as to overlap the upper part of the third
vertebrae.
Dens or odontoid process exhibits a slight constriction or neck,
where it joins the body. On its anterior surface is an oval or nearly
circular facet for articulation with that an anterior arch of the atlas.
 Apex is pointed, and gives attachment to the apical odontoid
ligament, below the apex the process has rough impression for alar
ligament , which connect the process to the occipital bone.
The spinous process is large, very strong, deeply channelled on its
under surface, and presents a bifid tuberculated extremity.
Thoracic vertebrae
The thoracic vertebrae are intermediate in size between those of the
cervical and lumber regions, they increase in size from above
downward, the upper vertebrae being much smaller than those in
the lower part of the region. They are distinguished by the presence
of the facets on the sides of the bodies for articulation with the head
of the ribs, and facets on the transverse process of all, except 11 th
and 12th for articulation with the tubercle of the ribs.
Body; the bodies in the middle of the thoracic region are heart
shaped and as broad in the anteroposterior as in the transverse
direction.
Pedicles are directed backwards and slightly upwards and the
inferior vertebral notches are of large size and deeper than any
other region in the vertebral column.
Laminae are borad thick
Vertebral foramen is small and of circular form.
Spinous process is long, triangular on coronal section, directed
obliquely downwards and ends in tuberculated extremity.
Superior articular facets are at junction of pedicles and laminae
Transverse process arise from the arch behind the superior articular
process and are thick, strong, and of considerable length, directed
obliquely backwards and lateral ward , on the front of which is
there small articulation for the tubercle of rib.
Peculiar thoracic vertebra
The First Thoracic Vertebra has, on either side of the body, an entire
articular facet for the head of the first rib, and a demi-facet for the
upper half of the head of the second rib.
The Ninth Thoracic Vertebra may have no demi-facets below.
The Tenth Thoracic Vertebra has (except in the cases just
mentioned) an entire articular facet on either side, which is placed
partly on the lateral surface of the pedicle.
In the Eleventh Thoracic Vertebra the body approaches in its form
and size to that of thelumbar vertebr. The articular facets for the
heads of the ribs are of large size, and placed chiefly on the
pedicles, which are thicker and stronger in this and the next
vertebra than in any other part of the thoracic region. The spinous
process is short, and nearly horizontal in direction. The transverse
processes are very short, tuberculated at their extremities, and have
no articular facets.
 The Twelfth Thoracic Vertebra has the same general characteristics
as the eleventh

Lumber vertebrae
Lumber vertebrae are the largest segments of the movable part of
the vertebral column, and can be distinguished by the absence of
foramen in the transverse process, and by the absence of a foramen
in the transverse process, and by the absence of facets on the sides
of the body.
Body is large, wider and a little thicker infront than behind
Pedicles are very strong, directed backward from the upper part of
the body and inferior vertebral notch are of considerable size
Laminae are borad, short and strong
Vertebral foramen is trinagular , larger in the thoracic but shorter
than cervical
Spinous process is thick, broad and somewhat quadrilateral
Superior and inferior articular processes are very well defined
Transverse process are long, slender and horizontal in the upper
three lumber vertebrae, they incline a little upward in the lower two.
Of the 3 tubercles noticed in connection with the transverse process
of the lower thoracic vertebrae, the superior one is connected in the
lumber region with the back part of the superior articular process,
and is named the mammillary process. The inferior is situated at the
back part of the base of the transverse process and is called the
accessory process.
Sacral and coccygeal vertebrae
The sacral and coccygeal vertebr consist at an early period of life
of nine separate segments which are united in the adult, so as to
form two bones, five entering into the formation of the sacrum, four
into that of the coccyx. Sometimes the coccyx consists of five bones;
occasionally the number is reduced to three.

Sacrum
Sacrum is large, triangular bone, situated in the lower part of the
vertebral column and at the upper and back part of the pelvic cavity
where it is inserted like a wedge between the two hip bones, its
upper part or base articulates with the last lumber vertebra, its apex
with the coccyx. It is curved upon itself and placed very obliquely, its
base projecting forward and forming the prominent sacrovertebral
angle when articulated with the last lumbar vertebra; its central part
is projected backward, so as to give increased capacity to the pelvic
cavity.
It has
3 surfaces- Pelvic, Dorsal and lateral
Apex and Base

Pelvic surface
The pelvic surface is concave from above downward, and slightly so
from side to side. Its middle part is crossed by four transverse
ridges, the positions of which correspond with the original planes of
separation between the five segments of the bone.
 At the ends of the ridges are seen the anterior sacral foramina, four
in number on either side, somewhat rounded in form, diminishing in
size from above downward, and directed lateralward and forward;
they give exit to the anterior divisions of the sacral nerves and
entrance to the lateral sacral arteries.
Lateral to these foramina are the lateral parts of the sacrum, each
consisting of five separate segments at an early period of life; in the
adult, these are blended with the bodies and with each other

Lateral Surface
The lateral surface is broad above, but narrowed into a thin edge
belowThe upper half presents in front an ear-shaped surface, the
auricular surface, covered with cartilage in the fresh state, for
articulation with the ilium. Behind it is a rough surface, the sacral
tuberosity, on which are three deep and uneven impressions, for the
attachment of the posterior sacroiliac ligament. The lower half is
thin, and ends in a projection called the inferior lateral angle; medial
to this angle is a notch, which is converted into a foramen by the
transverse process of the first piece of the coccyx
 Base of the sacrum is broad and expanded, is directed upward and
forward.
Apex is directed downward and present an oval articulation with the
coccyx.
Vertebral canal runs through out the greater part of the bone, above
it is triangular in form, below its posterior walls is incomplete. It
lodges the sacral nerves and its walls are perforated by the anterior
and posterior sacral foramina though which the sacral nerve pass
out.
Articulations: The sacrum articulates with four bones; the last
lumbar vertebra above, the coccyx below, and the hip bone on either
side
In female the sacrum is shorter and wider than in the male.

Coccyx
The coccyx is usually formed of four rudimentary vertebrae. In each
of the first three segments may be traced a rudimentary body and
articular and transverse processes; the last piece (sometimes the
third) is a mere nodule of bone. The first is the largest; it resembles
the lowest sacral vertebra, and often exists as a separate piece; the
last three diminish in size from above downward, and are usually
fused with one another.
 It has two surfaces anterior and posterior, base, apex and the two
lateral borders
Anterior surface is slightly concave and marked with three
transverse grooves which indicate the junctions of different
segments . It gives attachment to the anterior sacrococcygeal
ligament and supports part of the rectum.
Posterior surface is convex, marked by transverse groove Similar to
the anterior surface and presents on either side a linear row of
tubercles, rudimentary articular process of the coccygeal vertebrae.
Of these, the superior pair are large and are called the coccygeal
cornua which articulate with the cornua of the sacrum.
The lateral borders are thin and narrow and gives attachment on the
either side to the sacrotuberous and sacrospinous ligaments.
Base of the coccyx presents an oval surface for the articulation with
the coccyx
Apex is rounded and has attached to it the tendon for the sphincter
ani externus. It may be bifid and is sometimes deflected to one or
either side.

The Vertebral Column as a whole

 The vertebral column is situated in the median line, as the posterior
part of the trunk; its average length in the male is about 71 cm. Of
this length the cervical part measures 12.5 cm., the thoracic about
28 cm., the lumbar 18 cm., and the sacrum and coccyx 12.5 cm. The
female column is about 61 cm. in length. Viewed laterally the
vertebral column presents several curves, which correspond to the
different regions of the column, and are called cervical, thoracic,
lumbar, and pelvic.

Name of Direction Starts Ends

Curve
Cervical Convex Apex of the Middle of
Curve Forward odontoid the Second
Process thoracic
vertebra

Thoracic Concave Middle of Ends at the

Curve Forward the Second middle of
thoracic the twelfth
vertebra thoracic
vertebra

Lumber More Middle of Sacrovertebr

Curve marked in last thoracic al angel
female than vertebrae
male
Pelvic Curve Concavity Sacrovertebr Point of the
downward al coccyx
and forward articulation
 The thoracic and pelvic curves are termed primary curves, because
they alone are present during fetal life. The cervical and lumbar
curves are compensatory or secondary, and are developed after
birth, the former when the child is able to hold up its head (at three
or four months), and to sit upright (at nine months), the latter at
twelve or eighteen months, when the child begins to walk.
The vertebral column has also a slight lateral curvature, the
convexity of which is directed toward the right side.
Surfaces; Anterior Surfaces-- When viewed from in front, the width
of the bodies of the vertebr is seen to increase.
Posterior Surface-- The posterior surface of the vertebral column
presents in the median line the spinous processes. In the cervical
region (with the exception of the second and seventh vertebr)
these are short and horizontal, with bifid extremities. In the upper
part of the thoracic region they are directed obliquely downward; in
the middle they are almost vertical, and in the lower part they are
nearly horizontal. In the lumbar region they are nearly horizontal.
The spinous processes are separated by considerable intervals in the
lumbar region, by narrower intervals in the neck, and are closely
approximated in the middle of the thoracic region.
Lateral Surfaces--The lateral surfaces are separated from the
posterior surface by the articular processes in the cervical and
lumbar regions, and by the transverse processes in the thoracic
region.

The Thorax
 The skeleton of the thorax or chest is an osseo-cartilaginous cage,
containing and protecting the principal organs of respiration and
circulation. It is conical in shape, being narrow above and broad
below, flattened from before backward, and longer behind than in
front. It is somewhat reniform on transverse section on account of
the projection of the vertebral bodies into the cavity
The Upper opening of the thorax is reniform in shape, being broader
from side to side than from before backward. It is formed by the first
thoracic vertebra behind, the upper margin of the sternum in front
and the first rib on either side.
The Lower opening of the thorax is formed by the 12th thoracic
vertebra behind, by the 11th and 12th ribs at the sides, and in front
by the cartilages of the tenth,ninth, eighth and Seventh ribs, which
ascend on either side and form an angel.

Boundaries of the thorax

Posterior Surface: the posterior surface is formed by the twelve
thoracic vertebrae and the posterior parts of the ribs.
Anterior Surface; It is formed by the sternum and costal cartilages
and is flattened or slightly convex.
Lateral Surface; are convex, they are formed by the ribs, separated
from each other by the intercostal spaces 11 in no.
The thorax of the female differs from that of the male as follows: 1.
Its capacity is less. 2. The sternum is shorter. 3. The upper margin of
the sternum is on a level with the lower part of the body of the third
thoracic vertebra, whereas in the male it is on a level with the lower
part of the body of the second. 4. The upper ribs are more movable,
and so allow a greater enlargement of the upper part of the thorax.

The Sternum (breast bone)

It is an elongated, flattened bone, forming the middle portion of the
anterior wall of the thorax. Its upper end support the clavicles, and
its margin articulate with the cartilages of the first seven pairs of
ribs. It consist of 3 parts, named from above downward the
manubrium, the body or gladiolus, and the Xiphoid Process. It is
slightly convex in front and concave behind. Its average length in
the adult is about 17Cm, and is rather greater in male than in
female.
Manubrium: is of somewhat quadrangular form, broad and thick
above, narrow below at its junction with the body.it has anterior and
Posterior surface and superior, Lateral and inferior borders. In
center of Superior border there is presternal or jugular notch.
Anterior Surface of Manubrium is convex from side to side and
posterior surface is concave and smooth.
Body (corpus Sterni, gladiolus) the body considerably longer,
narrower, and thinner than manubrium, attains its greatest breadth
close to the lower end. It also has anterior and posterior surface,
and superior inferior and lateral border.
 Its anterior surface is nearly flat, directed forward and upward and
marked by three transverse ridges which crosses the bone opposite
the 3rd, 4th and 5th articulation.
The posterior surface is slightly concave, is also marked by three
transverse lines, less distinct than those in front.
The Superior Border is oval and articulates with the manubrium, the
junction of two forming the sternal angel.
The inferior border is narrow, and articulates with the Xiphoid
Process.
Each lateral border at its superior angel has a small facet, which
with a similar facet on the manubrium forms a cavity for the
cartilage of the second rib, below which are the four angular
depressions which receive the cartilages for the 3,4,5, and 6 th rib
While the inferior angel has a small facet, which with a
corresponding facet on the xiphoid process form a notch for the
cartilage of 7th rib.

Xiphoid Process
The xiphoid process is the smallest of the three pieces, it is thin and
elongated, cartilaginous in structure in youth , but more or less
ossified at its upper part in the adult. The Xiphoid process varies
much in form, it may be broad and thin, pointed, bifid, perforated
curved or deflected considerably to one or other side.
 Its anterior surface affords attachment on either side to the anterior
costoxiphoid ligament and a small part of the rectus abdominis. Its
posterior surface to the posterior costoxiphoid ligament and to
some of the fibers of the diaphragm. Its laterl border along with the
Body presents a facet for the cartilage of the 7th rib.
Articulations.The sternum articulates on either side with the
clavicle and upper seven costal cartilages.

Ribs
Ribs are elastic arches of the bone, which form a large part of the
thoracic Skeleton. They are 12 in number on either side.
The first seven are connected behind with the vertebral column, and
in front, through the intervention of the costal cartilages, with the
sternum they are called true or vertebro-sternal ribs.
The remaining five are false ribs; of these, the first three have their
cartilages attached to the cartilage of the rib above (vertebro-
chondral)
the last two are free at their anterior extremities and are termed
floating or vertebral ribs.
The ribs vary in their direction, the upper ones being less oblique
than the lower; the obliquity reaches its maximum at the ninth rib,
and gradually decreases from that rib to the twelfth. The ribs are
situated one below the other in such a manner that spaces called
intercostal spaces are left between them. The length of each space
corresponds to that of the adjacent ribs and their cartilages; the
breadth is greater in front than behind, and between the upper than
the lower ribs. The ribs increase in length from the first to the
seventh, below which they diminish to the twelfth. In breadth they
decrease from above downward; in the upper ten the greatest
breadth is at the sternal extremity.
Each Rib has two extremities a posterior or vertebral, and an
anterior or sternal and an intervening portion the body or shaft.

Posterior Extremity
The posterior or vertebral extremity presents for examination a
head, neck and tubercle.
Head is marked by a Kidney shaped articular surface, divided by a
horizontal crest into facets for articulation with the depressions
formed on the bodies of two adjacent thoracic vertebrae.
Neck is flattened portion which extends lateral ward from the head,
it is about 2.5 cm long and is placed infront of the transverse
process of two vertebrae's with which the head articulates. Anterior
surface of neck is smooth and flat and posterior surface is rough for
the attachment of the ligament.

Body
Body or shaft is thin and flat, with two surfaces an external and
internal and two borders superior and inferior.
 The External Surface is convex, smooth and marked a little infront of
the tubercle by a prominent line and is called the angel. At this point
the rib is bent in two directions and at the same time tilted upwards.
The internal surface is concave, smooth, directed a little upward
behind the angel,
Between internal surface and inferior border is a groove, the costal
groove for the intercostal vessels and nerves.
The superior border is thick and rounded and is marked by an
external and internal lip which serves attachment of intercostales
externus and internus.
The inferior border is thin and has attached to it an intercostalis
externus.

Anterior Extremity
The anterior or sternal extremity is flattened and presents a porous,
oval, concave depression into which the costal cartilage is received.
Peculiar Ribs: The first, second, tenth, eleventh, and twelfth ribs
present certain variations from the common characteristics
described above, and require special consideration.
First Rib
The first rib is the most curved and usually the shortest of all the
ribs. It is broad and flat, its surfaces looking upwards and
downwards and its borders inward and outward.
Head is small, rounded and possesses only a single articular facet
for articulation with the body of the first thoracic vertebra.
There is no angel, but the tubercle of the rib is slightly bent.

Second Rib; the second rib is much longer than the first, but has a
very similar curvature
The body of second rib is not twisted, so that both ends touch any
plane surface upon which it may be laid.
Tenth Rib; the tenth rib has only a single articular facet on its head.
Eleventh and twelfth ribs; The eleventh and twelfth ribs have each a
single articular facets on the head, which is of large size, they have
no necks or tubercles and are pointed at the anterior ends. The 11 th
has a slight angel and a shallow costal groove, the 12 th has neither ,
it is much shorter than the 11th and its head is inclined downwards.
Sometimes it is also shorter than 1st rib.

Costal Cartilages (Cartilagines costales)

The costal cartilages are bars of hyaline cartilage which serves to
prolong the ribs forward and contribute very materially to the
elasticity of the walls of the thorax.
The first seven pairs are connected with the sternum; the next three
are each articulated with the lower border of the cartilage of the
preceding rib; the last two have pointed extremities, which end in
the wall of the abdomen.
 Like the ribs, the costal cartilages vary in their length, breadth, and
direction. They increase in length from the first to the seventh, then
gradually decrease to the twelfth. Their breadth, as well as that of
the intervals between them, diminishes from the first to the last.
They are broad at their attachments to the ribs, and taper toward
their sternal extremities, excepting the first two, which are of the
same breadth throughout, and the sixth, seventh, and eighth, which
are enlarged where their margins are in contact.
They also vary in direction: the first descends a little, the second is
horizontal, the third ascends slightly, while the others are angular,
following the course of the ribs for a short distance, and then
ascending to the sternum or preceding cartilage. Each costal
cartilage presents two surfaces(Anterior and Posterior), two
borders(Superior and inferior), and two extremities(Medial end and
lateral end).

The Skull
The Skull is supported on the summit of the vertebral column, and is
of an oval shape, wider behind than in front. It is composed of a
series of flattened or irregular bones which, with one exception the
(mandible) are immovably jointed together. It is Divisible into 2 parts
the cranium which lodges and protects the brain consist of 8 bones
and the skeleton of the face consist of 14 bones as follows
In the Basle nomenclature, certain bones developed in association
with the nasal capsule, viz., the inferior nasal conch, the lacrimals,
the nasals, and the vomer, are grouped as cranial and not as facial
bones.
The hyoid bone, situated at the root of the tongue and attached to
the base of the skull by ligaments, is described in this section.
The Occipital bone
The Occipital bone is situated at the back and lower part of the
cranium. It is trapezoid in shape and curved on itself.
It is pierced by a large oval aperture, the foramen magnum through
which the cranial cavity communicates with vertebral canal.
The curved, expanded plate behind the foramen magnum is named
the squama, the thick, somewhat quadrilateral piece infront of the
foramen is called the basilar part, whilst on either side of the
foramen is the lateral portion.
Articulations: The occipital articulates with six bones: the two
parietals, the two temporals, the sphenoid, and the atlas.
The Parietal Bone
The parietal bones form, by their union, the sides and roof of the
cranium. Each bone is irregularly quadrilateral in form, and has two
surfaces (External and internal Surface), four borders( Sagittal,
Squamous, frontal border and lambdoidal border), and four
angles(frontal, sphenoidal, occipital and Mastoid angel).
Articulations.The parietal articulates with five bones: the opposite
parietal, the occipital, frontal, temporal, and sphenoid.
The frontal Bone
The frontal bone resembles a cockle-shell in form, and consists of
two portionsa vertical portion, the squama, corresponding with the
region of the forehead; and an orbital or horizontal portion, which
enters into the formation of the roofs of the orbital and nasal
cavities.
Articulations.The frontal articulates with twelve bones: the
sphenoid, the ethmoid, the two parietals, the two nasals, the two
maxill, the two lacrimals, and the two zygomatics.

The Temporal bone

The temporal bones are situated at the sides and base of the skull.
Each consists of five parts, viz., the squama, the petrous, mastoid,
and tympanic parts, and the styloid process.
Articulations.The temporal articulates with five bones: occipital,
parietal, sphenoid, mandible and zygomatic.

The Sphenoid Bone

The sphenoid bone is situated at the base of the skull in front of the
temporals and basilar part of the occipital. It somewhat resembles a
bat with its wings extended, and is divided into a median portion or
body, two great and two small wings extending outward from the
sides of the body, and two pterygoid processes which project from it
below.
 Articulations.The sphenoid articulates with twelve bones: four
single, the vomer, ethmoid, frontal, and occipital; and four paired,
the parietal, temporal, zygomatic, and palatine.

Ethmoid Bone
The ethmoid bone is exceedingly light and spongy, and cubical in
shape; it is situated at the anterior part of the base of the cranium,
between the two orbits, at the roof of the nose, and contributes to
each of these cavities. It consists of four parts: a horizontal or
cribriform plate, forming part of the base of the cranium; a
perpendicular plate, constituting part of the nasal septum; and two
lateral masses or labyrinths.
Articulations.The ethmoid articulates with fifteen bones: four of
the craniumthe frontal, the sphenoid, and the two sphenoidal
conch; and eleven of the facethe two nasals, two maxill, two
lacrimals, two palatines, two inferior nasal conch, and the vomer.
The Facial Bones, The Nasal Bones
The nasal bones are two small oblong bones, varying in size and
form in different individuals; they are placed side by side at the
middle and upper part of the face, and form, by their junction, the
bridge of the nose. Each has two(outer and inner surface) surfaces
and four borders(medial, lateral, superior and inferior).
Articulations.The nasal articulates with four bones: two of the
cranium, the frontal and ethmoid, and two of the face, the opposite
nasal and the maxilla.
The Maxillae (upper Jaw)
The maxill are the largest bones of the face, excepting the
mandible, and form, by their union, the whole of the upper jaw. Each
assists in forming the boundaries of three cavities, viz., the roof of
the mouth, the floor and lateral wall of the nose and the floor of the
orbit; it also enters into the formation of two foss, the
infratemporal and pterygopalatine, and two fissures, the inferior
orbital and pterygomaxillary.
Each bone consists of a body and four processeszygomatic,
frontal, alveolar, and palatine.
The Palatine Bone
 The palatine bone is situated at the back part of the nasal cavity
between the maxilla and the pterygoid process of the sphenoid. It
contributes to the walls of three cavities: the floor and lateral wall of
the nasal cavity, the roof of the mouth, and the floor of the orbit; it
enters into the formation of two foss, the pterygopalatine and
pterygoid foss; and one fissure, the inferior orbital fissure. The
palatine bone somewhat resembles the letter L, and consists of a
horizontal and a vertical part and three outstanding processesviz.,
the pyramidal process, and the orbital and sphenoidal processes,
and are separated by a deep notch, the sphenopalatine notch.
Articulations.The palatine articulates with six bones: the sphenoid,
ethmoid, maxilla, inferior nasal concha, vomer, and opposite
palatine.

The inferior Nasal Concha

The inferior nasal concha extends horizontally along the lateral wall
of the nasal cavity and consists of a lamina of spongy bone, curled
upon itself like a scroll. It has two surfaces, two borders, and two
extremities.
Articulations.The inferior nasal concha articulates with four bones:
the ethmoid, maxilla, lacrimal, and palatine.
The Vomer
The vomer is situated in the median plane, but its anterior portion is
frequently bent to one or other side. It is thin, somewhat
quadrilateral in shape, and forms the hinder and lower part of the
nasal septum
Articulations.The vomer articulates with six bones: two of the
cranium, the sphenoid and ethmoid; and four of the face, the two
maxill and the two palatine bones; it also articulates with the
septal cartilage of the nose.
The Mandible(Lower Jaw)
The mandible, the largest and strongest bone of the face, serves for
the reception of the lower teeth. It consists of a curved, horizontal
portion, the body, and two perpendicular portions, the rami, which
unite with the ends of the body nearly at right angles.
The body is curved somewhat like a horseshoe and has two
surfaces(external and Internal) and two borders(Superior or alveolar
and inferior border).
The ramus is quadrilateral in shape, and has two surfaces(medial
and Lateral), four borders(anterior, posterior, Lateral and Medial),
and two processes(Coronoid and Condyloid).
The mandibular notch, separating the two processes, is a deep
semilunar depression, and is crossed by the masseteric vessels and
nerve.
Articulations.The mandible articulates with the two temporal
bones.
The Hyoid Bone
The hyoid bone is shaped like a horseshoe, and is suspended from
the tips of the styloid processes of the temporal bones by the
stylohyoid ligaments. It consists of five segments, viz., a body, two
greater cornua, and two lesser cornua.
The body or central part is of a qudrilateral form. It has anterior and
posterior surface and superior, inferior and lateral borders.
The greater Cornua project backward from the lateral borders of the
body and are flattened from above downward and diminish in size
from before backward.
The lesser cornua are two small conical eminences, attached by their
bases to the angels of junction between the body and the greater
cornua.
The Extremities
The bones by which the upper and lower limbs are attached to the
trunk constitute respectively the shoulder and pelvic girdles. The
shoulder girdle or girdle of the superior extremity is formed by the
scapul and clavicles, and is imperfect in front and behind. In front,
however, it is completed by the upper end of the sternum, with
which the medial ends of the clavicles articulate. Behind, it is widely
imperfect, the scapul being connected to the trunk by muscles
only. The pelvic girdle or girdle of the inferior extremity is formed by
the hip bones, which articulate with each other in front, at the
symphysis pubis. It is imperfect behind, but the gap is filled in by
the upper part of the sacrum. The pelvic girdle, with the sacrum, is a
complete ring, massive and comparatively rigid, in marked contrast
to the lightness and mobility of the shoulder girdle.

Bones of Upper Extremity the clavicle:

The Clavicle forms the anterior portion of the shoulder girdle. It is a
long bone, curved somewhat like italic letter f. it is placed nearly
 horizontally at the upper and anterior part of the thorax,
immediately above the first rib. It articulates medially with the
manubrium sterni, and laterally with the acromion of the scapula. It
presents a double curvature, the convexity being directed forward at
the sternal end, and the concavity at the scapular end. Its lateral
third is flattened from above downward, while its medial two-thirds
is of a rounded or prismatic form.
The sternal extremity is triangular in form and it presents an
articular facet for articulation with the maubrium sterni
The acromion extremity has an small oval surface for articulation
with the acromion of the scapula

The Scapula or shoulder blade

The scapula forms the posterior part of the shoulder girdle. It is a
flat, triangular bone, with two surfaces, three borders, and three
angles.
The Costal or ventral surface presents a broad concavity, the
subscapular fossa.
The Dorsal surface is arched from above downward and is divided
into two unequal parts by the spine, the portion above the spine is
called the supraspinatous fossa, and the below it is the
infraspinatous fossa.
The supraspinatous is smaller of the two and is concave and smooth
where as infraspinatous is much larger.
The spine: The spine is a prominent plate of bone, which crosses
obliquely the medial four-fifths of the dorsal surface of the scapula
at its upper part, and separates the supra- from the infraspinatous
fossa. It is triangular in shape with its apex being directed towards
the vertebral column.
 The Acromion: the acromion forms the summit of the shoulder, and is
large, somewhat triangular or oblong processflattened from behind
forward, projecting at first lateralward, and then curving forward
and upward, so as to overhang the glenoid cavity.
Its apex, which corresponds to the point of meeting of these two
borders in front, is thin, and has attached to it the coracoacromial
ligament.
It has three borders superior, Axillary and vertebral border. And
three angel medial angel, inferior angel and lateral angel.
The lateral angel is the thickest part of the bone and is sometimes
called as head of the scapula. On it is a shallow pyriform articular
surface the glenoid cavity which artiuclates with the head of the
humerus to form the Shoulder joint.
The coracoid process is a thick curved process attached by a broad
base to the upper part of the neck of the scapula;
The Humerus
The humerus is the longest and the largest bone of the upper
extremity. It is divisible into a body and two extremities.
The upper extremity consist of a large rounded head joined to the
body by a constricted portion called the neck, and two eminences
the greater and lesser tubercles.
The head nearly hemispherical in form is directed upward,
medialward and little backwards and articulates with the glenoid
cavity of the scapula.
The greater tubercle: The greater tubercle situated lateral to the
head and lesser tubercle. Its upper surface is rounded and marked
by three flat impressions
 The lesser tubercle; the lesser tubercle although smaller is more
prominent than the greater, it is situated infront and is directed
medialward and forward.
The tubercles are separated from each other by a deep groove the
intertubercular groove which lodges the long tendon of Biceps
Brachii Muscle.
The body is almost cylindrical in the upper half of its extent,
prismatic and flattened below and has 3 borders(anterior Border,
medial border and lateral border) and 3 surfaces (antero-lateral
surface, antero-medial surface and Posterior surface)
Above the middle of the antero-lateral surface is a rough, triangular
elevation, the deltoid tuberosity for insertion of deltoideus muscle,
below which is radius sulcus transmitting the radial nerves
The Lower Extremity is flattened from before backward and curved
slightly forward, it ends below in a broad articular surface, which is
divided into two parts by a slight ridge. Projecting on either sides
are lateral and medial epicondyles.
The lateral portion of the articular surface consist of a smooth
rounded eminence named the capitulum of humerus, which
articulated with the cup shaped depression on the head of the
radius.
Above the front part of the capitulum is a slight depression, the
radial fossa, which receives the anterior border of the head of the
radius, when the forearm is flexed. The medial portion of the
articular surface is named the trochlea.
Above the front part of the trochlea is a small depression, the
coronoid fossa, which receives the coronoid process of the ulna
during flexion of the forearm. Above the back part of the trochlea is
a deep triangular depression, the olecranon fossa, in which the
summit of the olecranon is received in extension of the forearm.
These foss are separated from one another by a thin, transparent
lamina of bone, which is sometimes perforated by a supratrochlear
foramen;
The lateral epicondyle is a small, tuberculated eminence, The medial
epicondyle, larger and more prominent than the lateral
The Ulna Elbow Bone
The ulna is a long bone, prismatic in form, placed at the medial side
of the forearm, parallel with the radius. It is divisible into a body and
two extremities. Its upper extremity of great thickness and strength
forms a large part of the elbow joint, the bone diminishes in size
from above downward, its lower extremity being very small and
excluded from the wrist joint by the interposition of an articular
disk.
 The upper extremity presents two curved processes, the olecranon
and the coronoid process; and two concave, articular cavities, the
semilunar and radial notches.
The olecranon is a large, thick, curved eminence, situated at the
upper and back part of the ulna. It is bent forward at the summit so
as to present a prominent lip which is received into the olecranon
fossa of the humerus in extension of the forearm.
The coronoid process is a triangular eminence projecting forward
from the upper and front part of the ulna.
The semilunar notch is a large depression, formed by the olecranon
and the coronoid process, and serving for articulation with the
trochlea of the humerus.
radial notch is a narrow, oblong, articular depression on the lateral
side of the coronoid process; it receives the circumferential articular
surface of the head of the radius.
The body is Prismatic form, straight in central, tapers gradually from
above downward and has 3 border(Volar, Dorsal and interosseous
crest) and 3 surfaces (Volar, dorsal and medial)
The lower extremity of the ulna is small, and presents two
eminences; the lateral and larger is a rounded, articular eminence,
termed the head of the ulna; the medial, narrower and more
projecting, is a non-articular eminence, the styloid process.
The head presents an articular surface for articulating with the
triangular articuclar disk which separates it from the wrist joint.
The styloid process projects from the medial and back part of the
bone; it descends a little lower than the head, and its rounded end
affords attachment to the ulnar collateral ligament of the wrist-joint.
The Radius
The Radius is situated on the lateral side of the ulna, which exceeds
it in length and size. Its upper end is small, and forms only a small
part of the elbow-joint; but its lower end is large, and forms the
chief part of the wrist-joint. It is a long bone, prismatic in form and
slightly curved longitudinally. It has a body and two extremities.
The Upper extremity presents a head, neck and tuberosity.
The head is of a cylindrical form, and on its upper surface is a
shallow cup or fovea for articulation with the capitulum of the
humerus. The head is supported on a round, smooth, and constricted
portion called the neck. Beneath the neck, on the medial side, is an
eminence, the radial tuberosity; its surface is divided into a
posterior, rough portion, for the insertion of the tendon of the Biceps
brachii.
The body is prismoid in form, narrower above than below, and
slightly curved, so as to be convex lateralward. It presents three
borders(Volar, Dorsal and interosseous crest) and three
surfaces(Volar, dorsal and lateral).
The lower extremity is large, of quadrilateral form, and provided
with two articular surfacesone below, for the carpus, and another
at the medial side, for the ulna. The carpal articular surface is
triangular, concave, smooth, and divided by a slight antero-posterior
ridge into two parts. Of these, the lateral, triangular, articulates with
 the navicular bone; the medial, quadrilateral, with the lunate bone.
The articular surface for the ulna is called the ulnar notch (sigmoid
cavity) of the radius; it is narrow, concave, smooth, and articulates
with the head of the ulna.
These two articular surfaces are separated by a prominent ridge, to
which the base of the triangular articular disk is attached; this disk
separates the wrist-joint from the distal radioulnar articulation.

The Hand
The skeleton of hand is divided into 3 segments
The carpus or wrist bones
The metacarpus or bones of the palm
The phalanges or bones of the digits
The carpal bones, eight in number, are arranged in two rows. Those
of the proximal row, from the radial to the ulnar side, are named the
navicular, lunate, triangular, and pisiform; those of the distal row, in
the same order, are named the greater multangular, lesser
multangular, capitate, and hamate. Each bone presents 6 surfaces.
The navicular bone is the largest bone of the proximal row, and has
received its name from its fancied resemblance to a boat. The lunate
bone may be distinguished by its deep concavity and crescentic
outline. The triangular bone may be distinguished by its pyramidal
shape, and by an oval isolated facet for articulation with the
pisiform bone. pisiform bone may be known by its small size, and by
its presenting a single articular facet.
The greater multangular bone may be distinguished by a deep
groove on its volar surface. The lesser multangular is the smallest
bone in the distal row. It may be known by its wedge-shaped form,
The capitate bone is the largest of the carpal bones, and occupies
the center of the wrist. The hamate bone may be readily
distinguished by its wedge-shaped form, and the hook-like process
which projects from its volar surface.
The Metacarpus
The metacarpus consists of five cylindrical bones which are
numbered from the lateral side each consists of a body and two
extremities.
The first Metacarpal bone is shorter and stouter than others
The second metacarpal bone is the longest and its base the largest
of the four remaining bones
The third metacarpal is little shorter than second
Base of the fourth metacarpal is quadrilateral in shape
The fifth metacarpal presents one facet on its superior surface
The phalanges are fourteen in number, three for each finger, and two
for the thumb. Each consists of a body and two extremities.
Femur
Femur or thigh bone is the longest and strongest bone of the body.
It has two ends upper and lower and a body shaft.
Side determination
Upper end bears a rounded head whereas the lower end is expanded
to form Condyle.
Head is always directed medially and slightly upwards
Shaft is directed obliquely downwards and medially so that the
lower surface of two condyles of femur lie in same horizontal plane.
Upper end of the femur includes head, neck, greater trochanter,
lesser trochanter, intertrochantric line and intertrochantric crest.
Head forms more than half a sphere, and it articulates with the
acetabulum to form the hip joint.
It connects the head with shaft, it makes an angel of about
125degree with the shaft and is less in females due to wider pelvis.
Greater trochanter: this is large quadrangular prominence located at
the upper part of the junction of the neck and the shaft. The upper
border of the trochanter lies at the level of center of the head.
Lesser trochanter: It is conical eminence directed medially and
backwards from the junction of the posteroinferior part of the neck
with the shaft.
Shaft: it is more or less cylindrical. It is narrowest in the middle, and
is expanded more inferiorly than superiorly. It is convex forward and
is directed obliquely downwards and medially.
Lower end: the lower end of the femur is widely expanded to form
two large condyles, one medial and one lateral. Anteriorly two
condyles are united and are in line with the fro nt of the shaft.
Posteriorly they are separated by a deep gap, termed intercondylar
notch or intercondylar fossa, which projects much beyond the plane
of popliteal surface.
Patella
The patella is the largest sesamoid bone in the body developed in
the tendon of the quadriceps femoris. It is situated infront of the
lower end of the femur about 1 cm above the Knee joint.
Patella is triangular in shape with its apex downwards. Anterior
surface is rough and non articular. Posterior surface are smooth and
articular.
The bone laid on a table rests on the broad lateral area and
determines the side of bone.
During different phases of movements of the knee, different portions
of the patella articulate with the femur.
Tibia
The tibia is the medial and larger bone of the leg. It is homologous
with the radius of the upper limb.
The upper end is much larger than the lower end.
The medial side of the lower end projects downwards beyond the
rest of the bone. This projection is called medial malleolus.
The tibia has an upper end, a shaft and a lower end.
Upper end; the upper end of the tibia is markedly expanded from
side to side to form two large condyles medial and lateral condyle
and an intercondylar area and tuberosity.
Medial condyle: it is larger than lateral condyle and it articulates
with medial condyle of the femur.
Lateral condyle; it overhangs the shaft more than the medial condyle
and it articulates with the lateral condyle of the femur.
Intercondylar area is the roughened area in between the two
condyles. The area is narrowest in the middle part.
The shaft of the tibia is prismoid in shape as its anterior border is
sharp and s- shaped.
 Lower end: the lower end of tibia is slightly expanded. The medial
malleolus is a short but strong process which projects downwards
from the medial surface of the lower end of the tibia. It forms
subcutenous prominence on the medial side of the ankle.

Fibula
The fibula is the lateral and smaller bone of the leg. It is very thin
and is homologous to the ulna of the upper limb.
Head is slightly expanded in all directions. Lower end or lateral
malleolus is expanded anteroposteriorly and is flattened from side to
side.
The medial side of the lower end bears a triangular articular facet
anteriorly and a deep or malleolar fossa posteriorly.
Head: the superior surface bears a circular articular facet which
articulates with the lateral condyle of the tibia.
Shaft shows considrable variation in its form because it is moulded
by the muscles attached to it.
Lower end or lateral malleolus; the tip of the lateral malleolus is
0.5cm lower than that of the medial maellolus. The lateral surface of
the lateral malleolus is subcutaneous and the medial surface has a
triangular facet for articulation with talus.

Bones of the foot- tarsus

The tarsus is made up of 7 tarsal bone, arranged in two rows. In the
proximal row there is talus above and the calcaneus below. In the
distal row there are four tarsal bones lying side by side. From medial
to lateral side these are medial cuneiform, intermediate cuneiform,
 lateral cuneiform and the cuboid. Anterior bone the navicular bone is
interposed between the talus and the 3 cuneiform bones.

The tarsal bones are much larger and stronger than the carpal bones
because they have to support and distribute the body weight. Each
tarsal bone is roughly cuboidal in shape.

Metatarsus
The metatarsus is made up of 5 metatarsal bones, which are numbered from
medial to lateral side.
Each metatarsal is a miniature long bone and has shaft, base and head.

Phalanges
There are 14 Phalanges in each foot, 2 for the great toe and 3 for each of the
other toes. As compared to the phalanges of hand, these are much smaller in
size and the shaft particularly of the first row are compressed from side to
side. Otherwise there arrangements and features are similar to upper limbs.