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Nursing Seminar 1 (Phinma Upang College Urdaneta)

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Human Anatomy and Physiology with Pathophysiology

CHAPTER 12: BLOOD VESSELS AND CIRCULATION
OUTLINE • Venules -small vein that leads to a capillary
I. Functions of the Circulatory System • Capillaries -small network of vessels where air exchange
II. General Features of Blood Vessel Structure happens
A. Arteries
B. Capillaries
C. Veins Tunics:
III. Blood Vessels of the Pulmonary Circulation
IV. Blood Vessels of the Systemic Circulation: Arteries • tunica intima -innermost layer, consists of an
V. Blood Vessels of the Systemic Circulation: Veins endothelium composed of simple squamous epithelial
cells
• tunica media -middle layer, consists of smooth muscle
I. FUNCTIONS OF THE CIRCULATORY SYSTEM cells arranged circularly around the blood vessel
1. Carries blood. • tunica adventitia -composed of dense connective tissue
2. Exchanges nutrients, waste products, and gases with adjacent to the tunica media; becomes loose connective
tissues. tissue toward the outer portion
3. Transports substances.
4. Helps regulate blood pressure.
A. Arteries
5. Directs blood flow to the tissues.
• Elastic arteries
o the largest-diameter arteries and have the thickest
Blood vessels outside the heart are divided into:
walls
o greater proportion of their walls is composed of
• pulmonary vessels -transport blood from the right
elastic tissue, and a smaller proportion is smooth
ventricle of the heart through the lungs and back to the
muscle
left atrium
o examples: aorta and pulmonary trunk
• systemic vessels -transport blood from the left ventricle
• Muscular arteries
of the heart through all parts of the body and back to the
o include medium-sized and small arteries
right atrium
o walls are relatively thick compared to their diameter
o most of the wall’s thickness results from smooth
II. GENERAL FEATURES OF BLOOD VESSEL STRUCTURE muscle cells of the tunica media
o frequently called distributing arteries
• Arterioles
o transport blood from small arteries to capillaries
o smallest arteries in which the three tunics can be
identified

• Arteries -blood vessels that conduct blood away from the

heart; usually carry oxygenated blood
• Arterioles -small artery that leads to a capillary
• Veins -blood vessels that brings blood back to the heart;
usually carry deoxygenated blood

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B. Capillaries • pulmonary arteries -extend to the right and left lungs;

carry deoxygenated blood to the pulmonary capillaries in
• branch of to form networks the lungs
• regulated by smooth muscle cells called precapillary • pulmonary veins (four; two from each lung) -exit the lungs
sphincters and carry oxygenated blood to the left atrium
• capillary walls consist of endothelium, which is a layer of
simple squamous epithelium
CLINICAL IMPACT

Varicose veins -result when the veins of the lower limbs

become so dilated that the cusps of the valves no longer
overlap to prevent the backflow of blood

Thromboses -occurs when blood clots block veins

Phlebitis -inflammation of veins

Gangrene -death of body tissue due to a lack of blood flow or

C. Veins
a serious bacterial infection
• Venules
o have a diameter slightly larger than that of capillaries
• Small veins IV. BLOOD VESSELS OF THE SYSTEMIC CIRCULATION:
o slightly larger in diameter than venules ARTERIES
o all three tunics are present
• Medium-sized veins A. Aorta
o collect blood from small veins and deliver it to large
veins
o have three thin but distinctive tunics
• Large veins
o also have three thin but distinctive tunics

valves -ensure that blood flows toward the heart but not in the
opposite direction

Aorta -largest artery; originates from the left ventricle

Divisions of aorta:

• Ascending aorta -from the left ventricles, it goes upward;

where coronary arteries branch off
• Aortic arch -bend of the aorta
• Descending aorta -longest part of the aorta; extends
through the thorax and abdomen to the upper margin of
the pelvis
III. BLOOD VESSELS OF THE PULMONARY CIRCULATION o Thoracic aorta -portion of the aorta in the thorax
o Abdominal aorta -part of the descending aorta within
• pulmonary trunk -branches into right and left pulmonary the abdomen
arteries

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B. Arteries of the Head and Neck • Axillary artery -continuation of the subclavian artery
inferior to the clavicle
• Brachial artery -continuation of the axillary artery in the
upper arm
• Ulnar artery -medial branch of the brachial artery
• Radial artery -lateral branch of the brachial artery

D. Thoracic Aorta and Its Branches

• Brachiocephalic artery -1st branch from aortic arch

o Right common carotid artery -medial branch of the
brachiocephalic artery; transports blood to the right
side of the head and neck
o Right subclavian artery -lateral branch of the
brachiocephalic artery; transports blood to the right
upper limb
• Left common carotid artery -2nd branch of aortic arch;
• Thoracic aorta
transports blood to the left side of the head and neck
o Visceral arteries supply the thoracic organs
• Left subclavian artery -3rd branch of aortic arch;
o Parietal arteries supply the thoracic wall
transports blood to the left upper limb
• Intercostal artery -provide blood to the intercostal
• Internal and External Carotid Artery -branches of muscles
common carotid artery
• Phrenic artery -provide blood to the diaphragm
o Internal carotid artery -enter the brain to become
circle of Willis
• Circle of Willis -circular system of arteries around the E. Abdominal Aorta and Its Branches
brain’s base which keeps the brain oxygenated

C. Arteries of the Upper Limbs

• Visceral arteries
Unpaired:
o Celiac artery -to the stomach, pancreas, liver
o Superior mesenteric artery -small and proximal large
intestine

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o Inferior mesenteric artery -distal large intestine V. BLOOD VESSELS OF THE SYSTEMIC CIRCULATION: VEINS
Paired:
• Superior vena cava -returns blood from the head, neck,
o Renal artery -to the kidneys
thorax, and upper limbs to the right atrium of the heart
o Suprarenal artery -to the adrenals
• Inferior vena cava -returns blood from the abdomen,
o Gonadal artery -testicular and ovarian
pelvis, and lower limbs to the right atrium
• Parietal arteries
o inferior phrenic arteries -supply the diaphragm
o lumbar arteries -supply the lumbar vertebrae and A. Veins of the Head and Neck
back muscles
o median sacral artery -supplies the inferior vertebrae

F. Arteries od the Pelvis

• Common iliac -goes to the lower extremity

o Internal iliac -medial branch of common iliac;
provides blood to the pelvic organs
o External iliac -lateral branch of common iliac; goes
down to the lower limb

G. Arteries of the Lower limbs

• Brachiocephalic vein -drains into the SVC

• Subclavian vein -lateral branch which drains into the
brachiocephalic
• Internal jugular vein -medial branch which drains into the
brachiocephalic
• External jugular vein -external vein of the neck and is the
lateral branch which drains into subclavian

B. Veins of the Upper Limbs

• Femoral artery -from external iliac and supplies the thigh

• Popliteal artery -from femoral and supplies the posterior
knee
• Anterior and posterior tibial artery -from femoral and
supplies shin area
• Dorsalis pedis artery -from the anterior tibial
• Fibular artery -aka peroneal artery; from posterior tibial • Axillary vein -medial branch which drains into the
artery; supplies the lateral ed and foot subclavian
• Brachial vein -superficial vein which drains into the
axillary

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• Cephalic vein -lateral branch which drains into the • Common iliac vein -2 branches that join together to
subclavian become the IVC; receives blood from lower extremities
• Basilic vein -becomes the axillary vein; major superficial and brings it back to IVC
veins • Internal iliac vein -2 branches that join together to
• Median cubital vein -usually connects the cephalic vein or become the IVC; drains blood from the pelvic area and
its tributaries with the basilic vein brings it back to IVC

*Subclavian vein receives blood from three areas: external Pelvic area → internal iliac → common iliac
jugular vein, axillary vein, and cephalic vein • Portal system -a system of blood vessels that begins and
ends with capillary beds and has no pumping mechanism
o Inferior mesenteric vein -empties into the splenic
C. Veins of the Thorax
vein
o Splenic vein -carries blood from the spleen and
pancreas
o Hepatic portal vein -formed by splenic and superior
mesenteric vein; enters the liver
o Hepatic vein -drains blood from liver into IVC
• Renal vein -kidney to IVC
• Suprarenal veins -drain the adrenal glands
• Gonadal vein -gonads to IVC

E. Veins of the Lower Limbs

• Azygos vein -only found on the left side of the body;

unpaired branch which drains into the SVC

*SVC receives blood from two areas: brachiocephalic vein and

azygos vein

• Hemiazygos vein -2 sets of multiple veins that empty into

the azygos
• Intercostal vein -drains into azygos (left) and hemiazygos
(right)

D. Veins of the Abdomen and Pelvis

• External iliac vein -receives all the blood from lower

extremities; drains blood into the common iliac
• Femoral vein -major lateral branch into the external iliac
• Great saphenous vein -major medial branch into the
external iliac
• Popliteal vein -drains the posterior knee and drains into
the femoral
• Small saphenous -lateral branch draining to the popliteal
• Anterior/Posterior Tibial -draining to the popliteal

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Human Anatomy and Physiology with Pathophysiology

CHAPTER 13: LYMPHATIC SYSTEM AND IMMUNITY
OUTLINE A. Lymphatic Capillaries and Vessels
I. Functions of the Lymphatic System
II. Anatomy of the Lymphatic System Lymphatic capillaries
A. Lymphatic Capillaries and Vessels - tiny, closed-ended vessels consisting of simple squamous
B. Lymphatic Organs
epithelium
C. Overview of the Lymphatic System
- more permeable than blood capillaries because they lack
III. Immunity
IV. Innate Immunity a basement membrane, and fluid moves easily into them
A. Physical Barriers - joins to form larger lymphatic vessels
B. Chemical Mediators
Lymphatic vessels
C. White Blood Cells
D. Inflammatory Response - resemble small veins
V. Adaptive Immunity - have a beaded appearance because they have one-way
A. Origin and Development of Lymphocytes valves that are similar to the valves of veins
B. Activation and Multiplication of Lymphocytes
C. Antibody-Mediated Immunity Three factors cause compression of the lymphatic vessels:
D. Cell-Mediated Immunity
VI. Acquired Immunity 1. contraction of surrounding skeletal muscle during activity
VII. Overview of Immune Interactions 2. contraction of smooth muscle in the lymphatic vessel wall
VIII. Immunotherapy 3. pressure changes in the thorax during breathing
IX. Effects of Aging on the Lymphatic System and Immunity
X. Diseases

I. FUNCTIONS OF THR LYMPHATIC SYSTEM

1. Fluid balance
2. Lipid absorption
3. Defense

pathogen -any substance or microorganism that causes

disease or damage to the tissues of the body

II. ANATOMY OF THE LYMHATIC SYSTEM

• thoracic duct (uncolored area) -where lymphatic vessels

from the rest of the body enters; empties into the left
subclavian vein
• right lymphatic duct (darkened area) --lymphatic vessels
from the right upper limb and the right half of the head,
neck, and chest; empties into the right subclavian vein

B. Lymphatic Organs

• include the tonsils, the lymph nodes, the spleen, and the
thymus
• Lymphatic tissue -characterized by housing many
lymphocytes and other defense cells, such as
macrophages

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Tonsils • Germinal centers -lymphatic nodules containing the

rapidly dividing lymphocytes; sites of lymphocyte
- form a protective ring of lymphatic tissue around the production
openings between the nasal and oral cavities and the
pharynx Three superficial aggregations of lymph nodes:

Three groups of tonsils: • inguinal nodes in the groin

• axillary nodes in the axilla
• palatine tonsils -located on each side of the posterior • the cervical nodes in the neck
opening of the oral cavity; these are the ones usually
referred to as “the tonsils. Functions:
• pharyngeal tonsil -located near the internal opening of
the nasal cavity • activate the immune system
o adenoid/s -when the pharyngeal tonsil is enlarged • remove pathogens from the lymph through the action of
• lingual tonsil -located on the posterior surface of the macrophages
tongue

tonsillectomy -removal of the pharyngeal tonsils Spleen

adenoidectomy -removal of the palatine tonsil - roughly the size of a clenched fist and is located in the left,
superior corner of the abdominal cavity
- filters blood instead of lymph
- blood reservoir
- has an outer capsule of dense connective tissue and a
small amount of smooth muscle

Lymph Nodes
• Trabeculae -divide the spleen into small, interconnected
- rounded structures, varying from the size of a small seed compartments containing two specialized types of
to that of a shelled almond lymphatic tissue:
o white pulp -lymphatic tissue surrounding the arteries
within the spleen
o red pulp -associated with the veins

Splenectomy -removal of the spleen

Thymus

- a bilobed gland roughly triangular in shape

• Capsule -a dense connective tissue that surrounds each - located in the superior mediastinum
lymph node - site for the maturation of a class of lymphocytes called T
• Trabeculae -extensions of the capsule; subdivide a lymph cells
node into compartments containing lymphatic tissue and - surrounded by a thin connective tissue capsule
lymphatic sinuses • trabeculae -divide each lobe into lobules
• Lymphatic nodules -lymphocytes and other cells that can • cortex -where lymphocytes are numerous and form dark-
form dense aggregations of tissue staining areas
• Lymphatic sinuses -spaces between the lymphatic tissue • medulla -lighter-staining, central portion of the lobules;
that contain macrophages on a network of fibers fewer lymphocytes

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C. Overview of the Lymphatic System IV. INNATE IMMUNITY

1. Lymphatic capillaries remove fluid from tissues. The fluid A. Physical Barriers
becomes lymph.
- prevent pathogens and chemicals from entering the body
2. Lymph flows through lymphatic vessels, which have
in two ways:
valves that prevent the backflow of lymph.
1. the skin and mucous membranes form barriers that
3. Lymph nodes filter lymph and are sites where
prevent their entry
lymphocytes respond to infections.
2. tears, saliva, and urine wash these substances from
4. Lymph enters the thoracic duct or the right lymphatic
body surfaces
duct.
5. Lymph enters the blood.
6. Lacteals in the small intestine absorb lipids, which enter
the thoracic duct. B. Chemical Mediators
7. Chyle, which is lymph containing lipids, enters the blood. - molecules responsible for many aspects of innate
8. The spleen filters blood and is a site where lymphocytes immunity.
respond to infections. - some chemicals on the surface of cells destroy pathogens
9. Lymphocytes (pre-B and pre-T cells) originate from stem or prevent their entry into the cells
cells in the red bone marrow. The pre-B cells become
mature B cells in the red bone marrow and are released
• Complement -a group of more than 20 proteins found in
into the blood. The pre-T cells enter the blood and migrate
plasma; can be activated by combining with foreign
to the thymus.
substances or antibodies; once activated, it can promote
10. The thymus is where pre-T cells derived from red bone
inflammation, phagocytosis, and lyse (rupture) bacterial
marrow increase in number and become mature T cells
cells
that are released into the blood.
• Interferons -are proteins that protect the body against
11. B cells and T cells from the blood enter and populate all
viral infections
lymphatic tissues. These lymphocytes can remain in
tissues or pass through them and return to the blood. B
cells and T cells can also respond to infections by dividing
and increasing in number. Some of the newly formed cells C. White Blood Cells
enter the blood and circulate to other tissues. - most important cellular components of immunity
- produced in red bone marrow and lymphatic tissue and
released into the blood
III. IMMUNITY
chemotaxis -movement of WBC toward chemicals such as
Immunity complement, leukotrienes, kinins, and histamine

- the ability to resist damage from pathogens, such as

microorganisms; harmful chemicals, such as toxins
Phagocytic Cells
released by microorganisms; and internal threats, such as
cancer cells Phagocytosis -ingestion and destruction of particles by cells
called phagocytes
Characterized into two systems:
• Neutrophils -small phagocytic WBC; usually the first WBC
• innate immunity (nonspecific resistance) - body to enter infected tissues from the blood in large numbers
recognizes and destroys certain pathogens, but the o Pus -an accumulation of fluid, dead neutrophils, and
response to them is the same each time the body is other cells at a site of infection
exposed • Macrophages -are monocytes that leave the blood, enter
• adaptive immunity (specific immunity) -body recognizes tissues, and enlarge about fivefold
and destroys pathogens, but the response to them o mononuclear phagocytic system -formed by
improves each time the pathogen is encountered monocytes and macrophages because they are
o specificity -the ability of adaptive immunity to phagocytes with a single, unlobed nucleus
recognize a particular substance o dust cells -lungs
o memory -the ability of adaptive immunity to o Kupffer cells -liver
“remember” previous encounters with a particular o microglia -CNS
substance

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Cells of Inflammation • Cell-mediated immunity -involves the actions of a second

type of lymphocyte, called T cells
• Basophils -derived from red bone marrow; motile WBCs o cytotoxic T cells -produce the effects of cell-mediated
that can leave the blood and enter infected tissues immunity
• Mast cells -derived from red bone marrow, are nonmotile o helper T cells can promote or inhibit the activities of
cells in connective tissue, especially near capillaries both antibody-mediated immunity and cell-mediated
• Eosinophils -participate in inflammation associated with immunity
allergies and asthma

A. Origin and Development of Lymphocytes

Natural Killer Cells
• Both B cells and T cells originate from stem cells in red
- a type of lymphocyte produced in red bone marrow, and bone marrow.
they account for up to 15% of lymphocytes
• B cells are processed from pre-B cells in the red marrow.
recognize classes of cells, such as tumor cells or virus
•
-
T cells are processed from pre-T cells in the thymus.
infected cells, in general, rather than specific tumor cells
• Both B cells and T cells circulate to other lymphatic tissues,
or cells infected by a specific virus
such as lymph nodes.
do not exhibit memory response
•
-
clones -small groups of identical B cells or T cells; form
during embryonic development

D. Inflammatory Response
B. Activation and Multiplication of Lymphocytes
Bacteria cause tissue damage that stimulates the release or
activation of chemical mediators, such as histamine, Antigen Recognition
prostaglandins, leukotrienes, complement, and kinins.
Antigen receptors -cell membrane proteins on the surfaces of
• Local inflammation -an inflammatory response confined lymphocytes
to a specific area of the body
• B-cell receptors -antigen receptors on B cells
• Systemic inflammation -an inflammatory response that is
• T-cell receptors -antigen receptors on T cells
generally distributed throughout the body
o Pyrogens -chemicals released by microorganisms, Major histocompatibility complex (MHC) molecules -are
neutrophils, and other cells, stimulate fever glycoproteins that have binding sites for antigens
production
• MHC class I molecules -found on the membranes of most
nucleated cells
V. ADAPTIVE IMMUNITY • MHC class II molecules -found on the membranes of
antigen-presenting cells, B lymphocytes, and other
Antigens defense cells

-substances that stimulate adaptive immune responses; can be derived from the B cells
divided into two groups:

• Foreign antigens -introduced from outside the body

(bacteria and viruses)
• Self-antigens -molecules the body produces to stimulate
an immune system response
o Autoimmune disease -results when self-antigens
stimulate unwanted destruction of normal tissue

Adaptive immunity can be divided into:

• Antibody-mediated immunity -involves a group of

lymphocytes called B cells and proteins called antibodies,
which are found in the plasma
o Antibodies -produced by plasma cells, which are
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Lymphocyte Proliferation

-important process that generates the needed defense

cells toprotect the body

Proliferation of Helper T Cells

1. Antigen-presenting cells, such as macrophages,

phagocytize, process, and display antigens on the
cell’s surface.
2. The antigens are bound to MHC class II molecules,
which present the processed antigen to the T-cell
receptor of thehelper T cell.
3. Costimulation results from interleukin-1, secreted
by themacrophage, and the CD4 glycoprotein of the
helper T cell.
4. Interleukin-1 stimulates the helper T cell to secrete
interleukin-2 and to produce interleukin-2 receptors.

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5. The helper T cell stimulates itself to divide when • variable region -end of each “arm” of the antibody; part
interleukin-2 binds to interleukin-2 receptors. that combines with the antigen
6. The “daughter” helper T cells resulting from this division • constant region -rest of the antibody
can be stimulated to divide again if they are exposed to • gamma globulins -found mostly in the gamma globulin
the same antigen that stimulated the “parent” helper T part of plasma
cell. This greatly increases the number of helper T cells. • immunoglobulins (Ig) -globulin proteins involved in
7. The increased number of helper T cells can facilitate the immunity.
activation of B cells or effector T cells.

Proliferation of B Cells The five general classes of antibodies are IgG, IgM, IgA, IgE,
and IgD
1. Before a B cell can be activated by a helper T cell, the B cell
must phagocytize and process the same antigen that Antibody Total Description
Serum
activated the helper T cell. The antigen binds to a B-cell
Antibody
receptor, and both the receptor and the antigen are taken
IgG 80-85 Activates complement and
into the cell by endocytosis.
increases phagocytosis; can
2. The B cell uses an MHC class II molecule to present the cross the placenta and provide
processed antigen to the helper T cell. immune protection to the fetus
3. The T-cell receptor binds to the MHC class II/antigen and newborn; responsible for Rh
complex. reactions, such as hemolytic
4. There is costimulation of the B cell by CD4 and other disease of the newborn
surface molecules. IgM 5-10 Activates complement and acts
5. There is costimulation by interleukins (cytokines) released as an antigen-binding receptor
from the helper T cell. on the surface of B cells;
6. The B cell divides, the resulting daughter cells divide, and responsible for transfusion
so on, eventually producing many cells that recognize the reactions in the ABO blood
system; often the first antibody
same antigen.
produced in response to an
7. Many of the daughter cells differentiate to become
antigen
plasma cells, which produce antibodies. Antibodies are
IgA 15 Secreted into saliva, into tears,
part of the immune response that eliminates the antigen.
and onto mucous membranes to
protect body surfaces; found in
colostrum and milk to provide
C. Antibody-Mediated Immunity immune protection to the
newborn
- effective against extracellular antigens, such as bacteria, IgE 0.002 Binds to mast cells and basophils
viruses (when they are outside cells), and toxins and stimulates the
inflammatory response
Structure of Antibodies

Antibodies -proteins produced in response to an antigen. They

are Y-shaped molecules consisting of four polypeptide chains: IgD 0,2 Functions as an antigen-binding
two identical heavy chains and two identical light chains receptor on B cells

Effects of Antibodies

• Antibodies directly affect antigens by inactivating the

antigens or by binding the antigens together.
• Antibodies indirectly affect antigens by activating other
mechanisms through the constant region of the antibody.

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1. Inactivate the antigen • active natural immunity -antigens are introduced through
2. Bind antigens together natural exposure such as disease-causing microorganism
3. Activate the complement cascade. An antigen binds to an • active artificial immunity -antigens are deliberately
antibody. As a result, the antibody can activate introduced in a vaccine
complement proteins, which can produce inflammation,
chemotaxis, and lysis. B. Passive immunity
4. Initiate the release of inflammatory chemicals. An
antibody binds to a mast cell or a basophil. When an -immunity is transferred from another person or an animal
antigen binds to the antibody, it triggers the release of
• passive natural immunity -antibodies from the mother
chemicals that cause inflammation.
5. Facilitate phagocytosis. An antibody binds to an antigen are transferred to her child across the placenta or in milk
and then to a macrophage, which phagocytizes the • passive artificial immunity -antibodies produced by
antibody and antigen. another person or an animal are injected

antiserum -antibodies that provide passive artificial immunity

Antibody Production

• primary response -results from the first exposure of a B VII. OVERVIEW OF IMMUNE INTERACTIONS
cell to an antigen; B cell proliferates to form plasma cells
and memory cells; plasma cells produce antibodies. Innate immunity -general response that does not improve
• memory B cells are responsible for the secondary with subsequent exposure
response
Adaptive immunity -specific response that improves with
• secondary response/memory response -occurs when the subsequent exposure; begins with a macrophage presenting
immune system is exposed to an antigen against which it an antigen to a helper T cell
has already produced a primary response
• Antibody-mediated immunity -antibodies act against
antigens in solution or on the surfaces of extracellular
D. Cell-Mediated Immunity microorganisms
• Cell-mediated immunity -cytotoxic T cells act against
- a function of cytotoxic T cells and is most effective against antigens bound to MHC molecules on the surface of cells;
microorganisms that live inside body cells; involved with they are effective against intracellular microorganisms,
allergic reactions, control of tumors, and graft rejection tumors, and transplanted cells.

Cytotoxic T cells have two main effects:

VIII. IMMUNOTHERAPY
• When activated, cytotoxic T cells form many additional
cytotoxic T cells, as well as memory T cells. • Immunotherapy -treats disease by altering immune
• The cytotoxic T cells release cytokines that promote the system function or by directly attacking harmful cells
destruction of the antigen or cause the lysis of target cells,
such as virally infected cells, tumor cells, or transplanted
cells. The memory T cells are responsible for the IX. EFFECTS OF AGING ON THE LYMPHATIC SYSTEM AND
secondary response. IMMUNITY

• Aging has little effect on the lymphatic system’s ability to

VI. ACQUIRED IMMUNITY remove fluid from tissues, absorb lipids from the digestive
tract, or remove defective red blood cells from the blood.
• Natural -contact with the antigen or transfer of antibodies • Decreased helper T-cell proliferation results in decreased
occurs as part of everyday living and is not deliberate antibody-mediated and cell-mediated immune responses.
• Artificial -deliberate introduction of an antigen or • The primary and secondary antibody responses decrease
antibody into the body has occurred with age.
• The ability to resist intracellular pathogens decreases with
age.
A. Active immunity

-immunity is provided by the individual’s own immune system

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X. DISEASES

Condition Description
Lymphatic System
Lymphedema Abnormal accumulation of lymph
in tissues, often the limbs; 70%–
90% cases in women; can be
caused by developmental defects,
disease, or damage to the
lymphatic system
Lymphoma Cancer of lymphocytes that often
begins in lymph nodes; immune
system becomes depressed, with
increased susceptibility to
infections
Immune System
Immediate Allergic Symptoms occur within a few
Reactions minutes of exposure to an antigen
because antibodies are already
present from prior exposure

• Asthma Antigen combines with antibodies

on mast cells or basophils in the
lungs, which then release
inflammatory chemicals that
cause constriction of the air
tubes, so that the patient has
trouble breathing
• Anaphylaxis
Systemic allergic reaction, often
resulting from insect stings or
drugs such as penicillin; chemicals
released from mast cells and
basophils cause systemic
vasodilation, increased vascular
permeability, drop in blood
pressure, an possibly death
Delayed Allergic Symptoms occur in hours to days
Reactions following exposure to the antigen
because these types of reactions
involve migration of T cells to the
antigen, followed by release of
cytokines
Immunodeficiencies
• Severe combined Congenital; both B cells and T cells
immunodeficiency fail to form; unless patient kept in
(SCID) a sterile environment or provided
with a compatible bone marrow
transplant, death from infection
results

• Acquired Life-threatening disease caused

immunodeficiency by the human immunodeficiency
syndrome (AIDS) virus (HIV)

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Human Anatomy and Physiology with Pathophysiology

CHAPTER 14: RESPIRATORY SYSTEM
OUTLINE A. Nose
I. Functions of the Respiratory System
II. Anatomy of the Respiratory System
A. Nose
B. Pharynx
C. Larynx
D. Trachea
E. Bronchi
F. Lungs
G. Pleural Cavities
H. Lymphatic Supply
III. Ventilation and Respiratory Volumes
IV. Gas Exchange
A. Factors That Affect Gas Exchange
B. Movement of Gases in the Lungs
C. Movement of Gases in the Tissues
V. Gas Transport in the Blood
VI. Rhythmic Breathing • Nose -consists of the external nose and the nasal cavity
VII. Effects of Aging on the Respiratory System • External nose -visible structure that forms a prominent
VIII. Diseases feature of the face; composed of hyaline cartilage,
although the bridge of consists of bone
I. FUNCTIONS OF THE RESPIRATORY SYSTEM • Nares/nostrils -aka external nares; external openings of
the nose
1. Regulation of blood pH
• Choanae -aka internal nares; openings into the pharynx
2. Voice production
• Nasal cavity -extends from the nares to the choanae
3. Olfaction
• Nasal septum -midline wall dividing the nasal cavity into
4. Innate immunity
the right and left portions
o Deviated nasal septum -occurs when the septum
Respiration includes the following processes: bulges to one side
• Hard palate -forms the floor of the nasal cavity separating
1. ventilation, or breathing, which is the movement of air the oral and nasal cavity
into and out of the lungs • Conchae- nasal concha; 3 prominent bony ridges from the
2. the exchange of O2 and CO2 between the air in the lungs lateral wall of each side of the nasal cavity which increase
and the blood surface area and cause air to churn for it to be cleansed,
3. the transport of O2 and CO2 in the blood humidified, and warmed
4. the exchange of O2 and CO2 between the blood and the
o 3 types: superior, middle, and inferior nasal concha
tissues
• Paranasal sinuses -air-filled, mucus-lined spaces within
the bone that open into the nasal cavity; include the
frontal, maxillary, ethmoidal, and sphenoidal sinuses
II. ANATOMY OF THE RESPIRATORY SYSTEM o sinusitis -inflammation of the mucous membrane of a
sinus
Divided into two:
• Nasolacrimal duct - carry tears from the eyes, also open
• Upper Respiratory Tract into the nasal cavity
o Nose Sneeze reflex -dislodges foreign substances from the nasal
o Pharynx (throat) cavity; sensory receptors detect the foreign substances, and
o Larynx (voice box) action potentials are conducted along the trigeminal nerves to
• Lower Respiratory Tract the medulla oblongata, where the reflex is triggered
o Trachea (windpipe)
o Bronchi • ACHOO -autosomal-dominant-compelling-helio-
o Lungs ophthalmic-outburst

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B. Pharynx Three main functions:

- aka throat • maintains an open airway

- common passageway for both the respiratory and the • protects the airway during swallowing
digestive systems • produces the voice

Consists of nine cartilage structures:

- laryngeal cartilage function as attachment of the vocal

cords
- attached to each other by muscle and ligaments
- composed of hyaline cartilage except for epiglottis

• 3 single
o Thyroid cartilage -aka Adam’s apple; first single and
largest cartilage; attached superiorly to the hyoid
bone
2 parts:
o Cricoid cartilage -second single and most inferior;
• Nasopharynx -superior part; lined with pseudostratified forms the base of the larynx on which the other
ciliated columnar epithelium; where the ff are found: cartilages rest
o Uvula -grape-like posterior extension of soft palate o Epiglottis -third single and projects superiorly as a
o Soft palate -floor of the nasopharynx; an incomplete free flap toward the tongue; differs from other
muscle and connective tissue partition separating the cartilages in that it consists of elastic cartilage rather
nasopharynx from the oropharynx than hyaline; closes the airway during swallowing
o Pharyngeal tonsil - posterior part of the nasopharynx; • 3 paired
helps defend the body against infection o Cuneiform cartilage -paired and most superior
• Oropharynx -middle position from uvula to epiglottis; o Corniculate cartilage -paired and middle
where the oral cavity opens into; lined with stratified o Arytenoid cartilage -paired and most inferior;
squamous epithelium, which protects against abrasion responsible for moving the vocal cords laterally and
o Palatine tonsils -located in the lateral walls near the medially
border of the oral cavity and the oropharynx
o Lingual tonsil -located on the surface of the posterior
part of the tongue
• Laryngopharynx -inferior part; from epiglottis to
esophagus where food and drinks pass through with air;
lined with stratified squamous epithelium and ciliated
columnar epithelium

C. Larynx

- aka voice box

- where the vocal cords are found
- located in the anterior throat and extends from the base
of tongue to the trachea

• During normal breathing: vocal cords are open

• During speaking: vocal cords come together and vibrate
(Arytenoid cartilage moves the vocal cords laterally and
medially)
• Changing the tension of the vocal folds:
o lower note – shorten
o higher note – lengthen

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• Vocal folds -true vocal cords • Terminal bronchioles

• Vestibular folds -false vocal cords • respiratory bronchioles -subdivides to form the alveolar
• Glottis -opening when vocal folds and vestibular folds are ducts
open
• Laryngitis -an inflammation of the mucous epithelium of F. Lungs
the vocal folds
- principal organs of respiration
- cone-shaped, with its base resting on the diaphragm and
D. Trachea its apex extending superiorly to a point about 2.5 cm
- aka windpipe above the clavicle
- transports air from larynx to the lungs
- composed of 15-20 C-shaped pieces of hyalin cartilage • Right lung -divided into three lobes by the horizontal and
- divides into 2 primary bronchi: left and right primary oblique fissures
bronchi o Superior lobe
o Middle lobe
cough reflex -smooth muscle of the trachea contracts, o Inferior lobe
decreasing the trachea’s diameter; sensory receptors detect • Left lung -divided into two lobes by the oblique fissure
the foreign substance, and action potentials travel along the o Superior lobe
vagus nerves to the medulla oblongata, where the reflex is o Inferior lobe
triggered

E. Bronchi

- tubes that enter the lungs

• Bronchopulmonary segments -functional division of the

lungs
o 9 in the left
o 10 in the right
• Tracheobronchial tree -consists of the main bronchi and
many branches
o main bronchi
o lobar bronchi
o segmental bronchi
o bronchioles
o terminal bronchioles
o respiratory bronchioles
o alveolar ducts -long, branching ducts with many
openings into alveoli
Divides into: o alveoli -small air-filled chambers where air and blood
• Left and right main bronchi or primary bronchi -supplies come into close contact with each other in capillaries
for the purpose of air exchange; lined with simple
each lung; lined with pseudostratified ciliated columnar
squamous epithelium
epithelium
o alveolar sacs -chambers connected to two or more
o Left is more horizontal because it is displaced by the
alveoli
heart while the right is more vertical, shorter, and
wider; thus, foreign bodies usually lodge in the right respiratory membrane -where gas exchange between the air
• Secondary or lobar bronchi -conduct air to each lung lobe and blood takes place; formed mainly by the walls of the
(two in left, three in right) alveoli and the surrounding capillaries
• Tertiary or segmental bronchi -serves a lobule; supply the
bronchopulmonary segments surfactant -a chemical that reduces the tendency of alveoli to
• Bronchioles -serves each alveoli recoil

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G. Pleural Cavities o Quiet expiration -the external intercostal muscles

contract, elevating the ribs and moving the sternum
- surrounds each lung o Labored expiration -additional muscles contract,
- lined with a serous membrane called the pleura causing additional expansion of the thorax

Pleura consists of:

B. Pressure Changes and Airflow
• parietal pleura -lines the walls of the thorax, diaphragm,
and mediastinum Two physical principles govern the flow of air into and out of
• visceral pleura -covers the surface of the lungs the lungs:

pleural fluid -acts as lubricant; helps hold the pleural 1. Changes in volume result in changes in pressure
membranes together 2. Air flows from an area of higher pressure to an area of
lower pressure

The volume and pressure changes responsible for one cycle

of inspiration and expiration can be described as follows:

• During inspiration, air flows into the alveoli because

atmospheric pressure > alveolar pressure.
• During expiration, air flows out of the alveoli because
alveolar pressure > atmospheric pressure.

End of expiration and inspiration: alveolar pressure =

atmospheric pressure

• alveolar pressure -air pressure within the alveoli

• atmospheric pressure -air pressure outside the body
H. Lymphatic Supply

• superficial lymphatic vessels -deep to the visceral pleura;

drain lymph from the superficial lung tissue and the C. Lung Recoil
visceral pleura • lung recoil -the tendency for an expanded lung to
• deep lymphatic vessels -follow the bronchi; drain lymph decrease in size; due to the elastic properties of its tissues
from the bronchi and associated connective tissues and because the alveolar fluid has surface tension
• surface tension -exists because the oppositely charged
ends of water molecules are attracted to each other
III. VENTILATION AND RESPIRATORY VOLUMES

Ventilation -or breathing; the process of moving air into and Two factors keep the lungs from collapsing:
out of the lungs.
1. Surfactant -a mixture of lipoprotein molecules produced
Two phases of ventilation: by secretory cells of the alveolar epithelium; reducing
surface tension
• inspiration -or inhalation; movement of air into the lungs
• Infant respiratory distress syndrome (IRDS) -caused
• expiration -or exhalation; movement of air out of the
by too little surfactant; aka hyaline membrane
lungs
disease; common in premature infants
2. Pleural pressure -lower than alveolar pressure because of a
A. Changing Thoracic Volume suction effect caused by fluid removal by the lymphatic
system and by lung recoil
• Muscles of inspiration -include the diaphragm and the
muscles that elevate the ribs and sternum, such as the
external intercostals
D. Changing Alveolar Volume
o diaphragm -large dome of skeletal muscle that
separate the thoracic cavity from abdominal cavity 1. Increasing thoracic volume results in decreased pleural
• Muscles of expiration -include the internal intercostals pressure, increased alveolar volume, decreased alveolar
and depress the ribs and sternum pressure, and air movement into the lungs.

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2. Decreasing thoracic volume results in increased pleural IV. GAS EXCHANGE

pressure, decreased alveolar volume, increased alveolar
A. Factors That Affect Gas Exchange
pressure, and air movement out of the lungs.
• Respiratory Membrane Thickness
o increases during certain respiratory diseases
E. Respiratory Volumes and Capacities o result in decreased gas exchange
• Surface Area
• Spirometry -the process of measuring volumes of air that o small decreases in surface area adversely affect gas
move into and out of the respiratory system exchange during strenuous exercise
• Spirometer -the device that measures these respiratory o when the surface area is decreased to one-third to
volumes one-fourth of normal, gas exchange is inadequate
• Respiratory volumes -measures of the amount of air under resting conditions
movement during different portions of ventilation • Partial Pressure -the pressure exerted by a specific gas in
• Respiratory capacities -sums of two or more respiratory a mixture of gases
volumes

Four measurements of respiratory volume: B. Movement of Gases in the Lungs

• Tidal volume -the volume of air inspired or expired with 1. Oxygen diffuses from a higher partial pressure in the
each breath. (about 500 milliliters mL) alveoli to a lower partial pressure in the pulmonary
• Inspiratory reserve volume -the amount of air that can be capillaries.
inspired forcefully beyond the resting tidal volume (about 2. Oxygen diffuses from a higher partial pressure in the tissue
3000 mL) capillaries to a lower partial pressure in the tissue spaces.
• Expiratory reserve volume -the amount of air that can be
expired forcefully beyond the resting tidal volume (about
1100 mL) C. Movement of Gases in the Tissues
• Residual volume -the volume of air still remaining in the
respiratory passages and lungs after maximum expiration 1. Carbon dioxide diffuses from a higher partial pressure in
(about 1200 mL) the tissues to a lower partial pressure in the tissue
capillaries.
2. Carbon dioxide diffuses from a higher partial pressure in
Sum of two or more pulmonary volumes: the pulmonary capillaries to a lower partial pressure in the
alveoli.
• Functional residual capacity -expiratory reserve volume +
residual volume; amount of air remaining in the lungs at
the end of a normal expiration (about 2300 mL at rest).
• Inspiratory capacity -tidal volume + inspiratory reserve V. GAS TRANSPORT IN THE BLOOD
volume; amount of air a person can inspire maximally Oxygen Transport
after a normal expiration (about 3500 mL at rest)
• Vital capacity -inspiratory reserve volume + tidal volume • Most (98.5%) O2 is transported bound to hemoglobin.
+ expiratory reserve volume; maximum volume of air that Some (1.5%) O2 is transported dissolved in plasma.
a person can expel from the respiratory tract after a • oxyhemoglobin -hemoglobin with O2 bound to its heme
maximum inspiration (about 4600 mL) groups
• Total lung capacity -sum of the inspiratory and expiratory
Carbon Dioxide Transport and Blood pH
reserves and the tidal and residual volumes (about 5800
mL); also equal to the vital capacity plus the residual • Carbon dioxide is transported in solution as plasma (7%),
volume in combination with blood proteins (23%), and as
bicarbonate ions (70%).
• carbonic anhydrase -an enzyme that is located inside RBC
forced expiratory vital capacity -the rate at which lung volume
and on the surface of capillary epithelial cells; increases
changes during direct measurement of the vital capacity
the rate at which CO2 reacts with water to form H+ and
HCO3− in the tissue capillaries

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VI. RHYTHMIC BREATHING VIII. DISEASES

• The normal rate of breathing in adults is between 12 and Condition Description

20 breaths per minute. Respiratory Disorders
• In children, the rates are higher and may vary from 20 to Bronchitis Inflammation of bronchi impairs
40 per minute. breathing; bronchitis can progress to
emphysema
Emphysema Destruction of alveolar walls; loss of
Respiratory Areas in the Brainstem alveoli decreases surface area for gas
exchange; there is no cure; alone or
• medullary respiratory center -consists of two dorsal with bronchitis, known as chronic
respiratory groups and two ventral respiratory groups obstructive pulmonary disease
o dorsal respiratory groups -forming a longitudinal (COPD)
column of cells located bilaterally in the dorsal part of Adult respiratory Caused by damage to the respiratory
the medulla oblongata; responsible for stimulating distress membrane; amount of surfactant is
contraction of the diaphragm syndrome (ARDS) reduced lessening gas exchange
o ventral respiratory groups -forming a longitudinal Cystic fibrosis Genetic disorder that affects mucus
column of cells located bilaterally in the ventral part secretions throughout the body due to
of the medulla oblongata; responsible for stimulating an abnormal transport protein
the external intercostal, internal intercostal, and Lung cancer Occurs in the epithelium of the
abdominal muscles respiratory tract; can easily spread to
other parts of the body because of the
‣ pre-Bötzinger complex -known to establish the
rich blood and lymphatic supply to the
basic rhythm of breathing
lungs
• pontine respiratory group -collection of neurons in the Circulatory
pons; play a role in switching between inspiration and System Blood clot in lung blood vessels;
expiration Thrombosis of the inadequate blood flow through the
pulmonary pulmonary capillaries, affecting
arteries respiratory function
Effect of Exercise on Breathing
Nervous System
1. At the onset of exercise, the rate of breathing immediately Sudden infant Most frequent cause of death of
increases. death syndrome infants between 2 weeks and 1 year of
2. After the immediate increase in breathing, breathing (SIDS) age; cause is still unknown, but at-risk
babies can be placed on monitors that
continues to increase gradually.
warn if breathing stops
anaerobic threshold -the highest level of exercise that can be Infectious Diseases of the Respiratory System
performed without causing a significant change in blood pH Upper
Respiratory Tract
Strep throat Caused by Streptococcus pyogenes;
characterized by inflammation of the
VII. EFFECTS OF AGING ON THE RESPIRATORY SYSTEM pharynx and fever
1. Vital capacity and maximum minute ventilation decrease
Common cold Results from a viral infection
because of weakening of the respiratory muscles and
Lower
stiffening of the thoracic cage.
Respiratory Tract
2. Residual volume and dead space increase because the Tuberculosis Caused by the bacterium Clostridium
diameter of respiratory passageways increases. tuberculosis, which forms small,
3. An increase in resting tidal volume compensates for lumplike lesions called tubercles
increased dead space, loss of alveolar walls (surface area),
and thickening of alveolar walls. Pneumonia Many bacterial or viral infections ofthe
4. The ability to remove mucus from the respiratory lungs that cause fever, difficulty in
passageways decreases. breathing, and chest pain

Flu Viral infection of the respiratory

system; does not affect the digestive
system, as is commonly
misunderstood

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Human Anatomy and Physiology with Pathophysiology

CHAPTER 15: DIGESTIVE SYSTEM
OUTLINE 4. Stomach
I. Functions of the Digestive System 5. Small intestine
II. Anatomy and Histology of the Digestive System 6. Large intestine
III. Oral Cavity, Pharynx, and Esophagus 7. Rectum
IV. Stomach 8. Anus
V. Small Intestine
VI. Liver and Pancreas
VII. Large Intestine Accessory organs:
VIII. Digestion, Absorption, and Transport
A. Carbohydrates • Salivary Glands -secrete amylase
B. Lipids • Liver -produces bile
C. Proteins • Gallbladder -secretes bile
D. Water and Minerals • Pancreas -produce lipase
IX. Effects of Aging on the Digestive System
X. Diseases

Four Major Tunics/Layers

I. FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Mucosa -secretes mucus; inner tunic consists of three
1. Ingestion layers:
2. Digestion • mucous epithelium
3. Absorption • loose connective tissue (lamina propria)
4. Elimination
• thin outer layer of smooth muscle (muscularis
mucosae)
2. Submucosa -thick layer of loose connective tissue
II. ANATOMY AND HISTOLOGY OF THE DIGESTIVE SYSTEM containing nerves, blood vessels, and small glands; plexus
3. Muscularis -consists of:
Digestive tract -aka gastrointestinal tract; series of hollow
organs through which food passes • inner layer of circular smooth muscle
• outer layer of longitudinal smooth muscle
• sometimes has oblique middle layer (stomach)
4. Serosa (adventitia) -most superficial layer;
• adventitia -no peritoneum; composed of connective
tissue
• serosa -consists of the peritoneum, which is a smooth
epithelial layer

Order of food passage:

1. Oral cavity (mouth)

2. Pharynx (throat)
3. Esophagus

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Peritoneum • Oral cavity -aka mouth; beginning of the one-way

digestive tract; stratified squamous epithelia
• Lips -muscular structures formed by the orbicularis oris
• Cheek -forms the lateral walls and is made of buccinator
(flatten the cheeks against the teeth)
• Tongue -large, muscular organ that occupies most of the
oral cavity
• Frenulum -thin fold of tissue anchoring the underside of
the tongue to the floor of the mouth

3 types of lingual papillae:

• Filiform papillae -conical shape contain fingerlike

projections; do not contain taste buds; lined by stratified
squamous cornified epithelium
• Fungiform papillae -mushroom shape; constricted base
and expanded surface; found mostly at the tip of the
• Peritoneum -serous membrane that forms the lining of tongue; contain taste buds; lined by stratified squamous
the abdominal cavity non cornified epithelium
o Parietal peritoneum -lines the wall of abdominal • Foliate papillae -leaflike papillae with ridges and
cavity rudimentary in man
o Visceral peritoneum -covers the organs • Circumvallate papillae -large dome shaped; largest of the
• Mesenteries -connective tissue, holding organs in lingual papillae; contain taste buds
abdominal cavity
o Lesser omentum -mesentery connecting the lesser
Teeth
curvature of the stomach to the liver and diaphragm
o Greater omentum -mesentery connecting the greater
curvature of the stomach to the transverse colon and
posterior body wall; abdominal policeman
‣ omental bursa -a cavity, or pocket formed by
greater omentum
• retroperitoneal -behind peritoneum; other abdominal
organs that have no mesenteries

III. ORAL CAVITY, PHARYNX, AND ESOPHAGUS

A. Anatomy of Oral Cavity

• Permanent teeth or secondary teeth: 32 teeth

• Deciduous/ Milk / Primary teeth: 20 teeth
• Central incisor -central cutting
• Lateral incisor -lateral cutting
• Canine -tearing food
• First and second premolars -tearing and cutting; each
with 2 cusps or points
• 1st – 3rd molars -for grinding; with 3 cusps

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Three regions: • Sublingual glands -smallest pair and produce primarily

mucous secretions
1. Crown -superior portion; with one or more cusps
Mumps -inflammation of parotid glands
2. Neck -narrow portion
3. Root -largest region of the tooth and anchors it in the
jawbone B. Saliva

• Pulp -central space between tooth - a versatile fluid; a mixture of serous (watery) and mucous
• Dentin -a living, cellular, calcified tissue that surrounds the fluids
pulp - keep the oral cavity moist and contains enzymes that
• Enamel -hard nonliving mineralized substance that covers begin the process of digestion
dentin
• Cementum -helps anchor the tooth in the jaw • Salivary amylase -salivary enzyme that breaks down
• Gingiva -epithelial covering of alveolar ridges carbohydrates/starch
• Periodontal ligaments -secure the teeth in the alveoli by • Lysozyme -salivary enzymes that are active against
embedding into the cementum bacteria
• Dental caries -or tooth decay; result of the breakdown of • Mucin -a proteoglycan that gives a lubricating quality to
enamel by acids produced by bacteria on the tooth surface the secretions of the salivary glands
• Periodontal disease -inflammation and degeneration of
the periodontal ligaments, gingiva, and alveolar bone
C. Pharynx

Palate and Tonsils - aka throat; connects mouth to esophagus

- 3 parts:
• Palate -roof of oral cavity • Nasopharynx
o Hard palate -anterior part contains bone • Oropharynx
o Soft palate -posterior portion consists of skeletal
• Laryngopharynx
muscle and connective tissue
posterior walls of oropharynx and laryngopharynx are
‣ uvula -posterior extension of the soft palate
-
formed by pharyngeal constrictor muscle
• Tonsils -located in the lateral posterior walls of the oral
cavity, in the nasopharynx, and in the posterior surface of
the tongue D. Esophagus

- long muscular tube connecting the pharynx to the

Salivary Glands stomach
- 25 cm long; transport food to stomach
- exocrine glands with ducts that empty into the mouth
- joins stomach at cardiac opening
- produce saliva contains enzymes to breakdown food
- stratified squamous non keratinized

• Upper esophageal sphincter and lower esophageal

sphincter -opens and closes to allow passage of food
• Submucosa -deep esophageal glands
• T. Muscularis:
o upper 1/3 skeletal muscle
o middle 1/3 smooth and skeletal muscle
o lower 1/3 smooth muscle

E. Swallowing

- or deglutition
• Parotid glands -largest pair, anterior to each ear; flows - divided into three phases: voluntary, pharyngeal, and
thru the parotid duct esophageal phase
• Submandibular glands -medial to the angle of the
mandible which produces mostly serous fluids empties
into the floor of the mouth
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3 phases: 5 Groups of Epithelial Cells

1. Voluntary Phase - bolus (mass of food) formed in mouth • Surface Mucous Cells -goblet cells which secrete alkaline
and pushed into oropharynx mucus to protect itself from acid
2. Pharyngeal Phase - swallowing reflex initiated when bolus • Mucous neck cells -goblet cells that secretes acidic fluid
stimulates receptors in oropharynx • Parietal cells -very pale cells which produce HCl and
3. Esophageal Phase - moves food from pharynx to stomach intrinsic factor (for digestion of vitamin B12)
Peristalsis -wave-like contractions moves food through • Chief cells -darker staining cells which produce
digestive tract pepsinogen, a precursor hormone for pepsin – w/c digests
proteins
• Endocrine cells -produce regulatory chemicals
• G cells -secrete gastrin which triggers HCl production in
IV. STOMACH
parietal cells
A. Anatomy of the Stomach

Stomach

• Enlarged portion of the digestive tract inferior to the

diaphragm at the end of the esophagus
• Located in abdomen
• Storage tank and mixing chamber for food
• Can hold up to 2 liters of food
• Produces mucus, hydrochloric acid, protein digesting
enzymes
• Contains a thick mucus layer that lubricates and protects
epithelial cells on stomach wall form acidic pH (3)
• Lined by simple columnar epithelium

B. Secretions of the Stomach

Chyme -paste-like substance that forms when food begins to

be broken down; semifluid mixture; food + stomach secretions

• HCl -produces a pH of about 2.0; kills microorganism

• Pepsin -active form of pepsinogen; breaks down protein
• 3 muscular layers: outer longitudinal, middle circular, and
• Mucus -forms a thick layer; lubricates the the epithelial
inner oblique to produce churning action
cells
• Cardiac opening -aka lower esophageal sphincter; cardiac
• Intrinsic factor -binds to Vitamin B12
region-opening from the esophagus into the stomach
region Heartburn -or gastritis; painful or burning sensation in the
• Body -greater curvature and lesser curvature chest; occurs when gastric juices regurgitate into esophagus;
• Pyloric opening -opening between stomach and small caused by caffeine, smoking, or eating or drinking in excess
intestine
• Pyloric sphincter -thick, ring of smooth muscle around
pyloric opening Fluid Source Function
• Rugae -large folds of the mucosa that allow stomach to Mouth
stretch Saliva (water, Salivary Moistens and lubricates
• Fundus -upper part of stomach bicarbonate ions, glands food, neutralizes
• Gastric pits -opening of gastric glands; tubelike found in mucus) bacterial acids, flushes
mucosal surface bacteria from oral cavity
Salivary amylase Salivary Digests starch
glands

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Lysozyme Salivary Has weak antibacterial Secretin -released from the duodenum in response to low pH
glands action
Stomach Cholecystokinin -stimulated when fatty acids and peptides are
Hydrochloric acid Gastric Kills bacteria, converts released; inhibits gastric secretion
glands pepsinogen to pepsin
Pepsin* Gastric Digests protein
glands Major Digestive System Hormones
Mucus Mucous Protects stomach lining
cells Hormone Source Function
Intrinsic factor Gastric Binds to vitamin B12, aids Gastrin Gastric -Increases gastric secretions
glands in its absorption glands
Small Intestine and Associated Glands Secretin Duodenum -Decreases gastric
Bile salts Liver Emulsify fats secretions
Bicarbonate ions Pancreas Neutralize stomach acid -Increases pancreatic and
Trypsin*, Pancreas Digest protein bile secretions high in
chymotrypsin*, bicarbonate ions
carboxy- -Decreases gastric motility
peptidase* Cholecysto- Duodenum -Decreases gastric
Pancreatic Pancreas Digests starch kinin secretions
amylase -Strongly decreases gastric
Lipase Pancreas Digests lipid motility
(triglycerides) -Increases gallbladder
Nucleases Pancreas Digest nucleic acid (DNA contraction
or RNA) -Increases pancreatic
Mucus Duodenal Protects duodenum from enzyme secretion
glands and stomach acid and
goblet cells digestive enzymes
D. Movement in Stomach
Peptidases** Small Digest polypeptide
intestine • Mixing waves -weak contraction; thoroughly mix food to
Sucrase** Small Digests sucrose form chyme
intestine • Peristaltic waves -stronger contraction; force chyme
Lactase** Small Digests lactose toward and through pyloric sphincter
intestine
• Hormonal and neural mechanisms stimulate stomach
Maltase** Small Digests maltose
secretions
intestine
• Stomach empties every 4 hours after regular meal, and 6-
*These enzymes are secreted as inactive forms, then activated.
8 hours after high fatty meal
**These enzymes remain in the microvilli. • Distention of the stomach wall -major stimulus to gastric
motility & emptying
• Cholecystokinin -major inhibitor of motility and emptying
C. Regulation of Stomach Secretions • Hunger pangs -stomach is stimulated to contract by low
blood glucose levels usually 12-24 hours after a meal
1. Cephalic phase -1st phase; stomach secretions are
initiated by sight, smell, taste, or food thought
• Parasympathetic stimulation
V. SMALL INTESTINE
• gastrin, histamine increase stomach secretions

• Gastrin - hormone that enters the blood and is A. Anatomy of the Small Intestine
carried back to the stomach; stimulates additional
secretory activity • Long narrow tubes that folds to fill a large portion of the
• Histamine -stimulate gastric gland secretion; abdominal cavity
stimulates HCl acid production • Measures 6 meters in length
2. Gastric phase -2nd phase; partially digested proteins and • Major absorptive organ
distention of stomach promote secretion • Chyme takes 3-5 hours to pass through
3. Intestinal phase -3rd phase; acidic chyme stimulates • Contains enzymes to further breakdown food
neuronal reflexes and secretions of hormones that inhibit • Contains secretions for protection against chyme’s acidity
gastric secretions by negative feedback loops • Simple Columnar epithelium
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• Granular cells -protect the intestinal epithelium from

bacteria
• Endocrine cells -produce regulatory hormone

intestinal glands -or crypts of Lieberkühn; tubular glands of

the mucosa

duodenal glands -open into the base of the intestinal glands

Ileocecal junction -site where the ileum connects to the large

intestine; consist of:

• ileocecal sphincter -a ring of smooth muscle

• ileocecal valve -allow the intestinal contents to move
from the ileum to the large intestine

Peyer patches -clusters of lymphatic nodules in the ileum;

protection from microorganisms

Parts of Small Intestine

• Duodenum B. Secretions of the Small Intestine

- C-shaped beginning of SI; shortest and receives partial
• Peptidases -digest proteins; they break the peptide bonds
digestive food; for chemical digestion of food
in proteins to form amino acids
- 25 cm long
• Disaccharidases -digest small sugars, specifically
- contains absorptive cells, goblet cells, granular cells,
disaccharides
endocrine cells
- contains microvilli and many folds
- contains bile and pancreatic ducts C. Movement in the Small Intestine
• Jejunum
- middle and longest section; absorption of important • Peristaltic contractions -cause the chyme to move along
nutrients such as sugars, fatty acids, and amino acids the small intestine
- 2.5 meters long • Segmental contraction -propagated only for short
• Ileum distance; mix intestinal content
- main function is to absorb vitamin B12, bile salts, and
other analytes not absorbed by the jejunum; the wall D. Absorption in the Small Intestine
is made up of folds with many tiny finger-like
projections known as villi on its surface • Most absorption: duodenum and jejunum
- meters long

Three Modifications That Increase Surface Area VI. LIVER AND PANCREAS

• circular folds -run perpendicular to the long axis of the A. Anatomy of the Liver
digestive tract
• Processes nutrients and detoxifies harmful substances
• villi -tiny, fingerlike projections of the mucosa
from the blood
• microvilli - numerous cytoplasmic extensions
• Large gland in the RUQ that produces bile that is stored in
lacteal -a lymphatic capillary; important in transporting the gallbladder and secreted into the duodenum
absorbed nutrients • Weighs about 3 lbs.
• Consist of two lobes: right and left lobe
• falciform ligament -connective tissue septum that
4 Major Cell Types in the Mucosa separates the right and left lobes
• porta -gate where blood vessels, ducts, nerves enter and
• Absorptive cells -contain microvilli; produce digestive exit
enzymes, and absorb digested food • lobules -divisions of liver with portal triads at corners
• Goblet cells -produces a protective mucus
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• Portal triad -contain hepatic artery, hepatic portal vein, • Synthesizes new molecules
hepatic duct • Secretes 700ml of bile each day
• Hepatic artery -delivers oxygenated blood to the liver, o Bile -important for digestion because it neutralizes
which supplies liver cells with oxygen acid and dramatically increases fat digestion and
• Hepatic portal vein -carries nutrient-rich blood from the absorption
digestive tract to the liver o Bile salts -emulsify fats, breaking the fat globules into
smaller droplets
• Hepatic veins -where blood exits the liver; empty into the
o Bilirubin -a bile pigment that results from the
inferior vena cava
breakdown of hemoglobin
• Hepatic cords -between center margins of each lobule;
o Gallstones -may form if the amount of cholesterol
separated by hepatic sinusoids; formed by hepatocytes
secreted by the liver becomes excessive
(liver cells)
• Hepatic sinusoids - blood channels that separates hepatic
cords; contain phagocytic cells that remove foreign C. Anatomy of the Pancreas
particles from blood
• Central vein -center of each lobule; where mixed blood • Endo and exocrine gland cradled in the duodenum
flows towards; forms hepatic veins • Produces pancreatic juices which flow through the
• Bile canaliculus -a cleft like lumen between the cells of pancreatic duct
each hepatic cord • Located retroperitoneal
• Head near midline of body
Gallbladder • Tail extends to left and touches spleen
• Endocrine tissues have pancreatic islet or islets of
- small sac on inferior surface of liver Langerhans that produce insulin and glucagon
stores and concentrates bile (30-50ml)
•
-
Exocrine tissues produce digestive enzymes
• Acini -produce digestive enzymes
Liver Ducts • Pancreatic duct -joins the common bile duct and empties
into the duodenum
• Hepatopancreatic ampulla -bulb-like structure which
opens into the duodenum to aid in digestion

D. Functions of the Pancreas

• Hepatic duct -collects bile from the liver and fuse to
become the common hepatic duct Exocrine Secretions of Pancreas:
• Common hepatic duct -joins the cystic duct from the
• Bicarbonate ion (HCO3-) -neutralizes chyme
gallbladder to become the common bile duct
• Trypsin & Chymotrypsin -split whole and partially
• Cystic duct -joins common hepatic duct; from gallbladder
digested proteins into peptides
• Common bile duct -carries bile from the gallbladder or
• Carboxypeptidase -splits peptides into individual amino
liver and brings it to the duodenum
acids
• Pancreatic amylase -continues the polysaccharide
B. Functions of the Liver digestion
• Lipase -lipid digesting enzyme
• Digestive and excretory functions • Nucleases -enzymes that degrade DNA, RNA to
• Stores and processes nutrients nucleotides
• Detoxifies harmful chemicals

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VII. LARGE INTESTINE Defecation reflex

A. Anatomy of the Large Intestine • Stimulus: fecal distention of rectal wall

• Mediated by parasympathetic reflexes
• Effect: peristaltic contractions in the lower colon and
rectum

VIII. DIGESTION, ABSORPTION, AND TRANSPORT

1. Digestion -breakdown of food to molecules

• Mechanical Digestion - breaks large food particles
into smaller ones
• Chemical Digestion -breaking of covalent bonds into
organic molecules by digestive enzymes
2. Propulsion -moves food through digestive tract includes
swallowing and peristalsis
3. Absorption -primarily in duodenum and jejunum of small
• Cecum -joins small intestine at ileocecal junction; absorbs intestine
water and salt residues; on its posterior wall attach is your 4. Defecation -elimination of waste in the form of feces
appendix (wormlike blind sac; 9 cm structure that is often
removed) A. Carbohydrates
• Colon -1.5 meters long; reabsorbs fluid and process waste
products with 4 parts: ascending, transverse, descending, Carbohydrates consist primarily of starches, cellulose, sucrose
and sigmoid (table sugar), and small amounts of fructose (fruit sugar) and
1. Ascending colon -extends superiorly from the cecum lactose (milk sugar).
to the right colic flexure, near the liver, where it turns
• Polysaccharides split into disaccharides by salivary and
to the left
pancreatic amylases
2. Transverse colon -extends from the right colic flexure
to the left colic flexure near the spleen, where the • Disaccharides broken down into monosaccharides by
disaccharidases on surface of intestinal epithelium
colon turns inferiorly
3. Descending colon -extends from the left colic flexure • Glucose is absorbed by cotransport with Na+ into
to the pelvis, where it becomes the sigmoid colon intestinal epithelium
4. Sigmoid colon -forms an S-shaped tube that extends • Glucose is carried by hepatic portal vein to liver and enters
medially and then inferiorly into the pelvic cavity and most cells by facilitated diffusion
ends at the rectum
o crypts -straight, tubular glands in the muscular lining B. Lipids
of the colon
o teniae coli -three bands in the intestinal wall • Lipid molecules are insoluble or only slightly soluble in
• Rectum -straight tube that begins at sigmoid and ends at water
anal canal • Triglycerides -or fats, are the most common type of lipid
• Anal canal -canal that exits to the outside; last 2-3 cm of o Saturated fats -fatty acids have only single bonds
dig. tract between carbons
o Internal anal sphincter -smooth muscle o Unsaturated fats -fatty acids have double bonds
o Externa anal sphincter -skeletal muscle between carbons
o Hemorrhoids -enlarged or inflamed rectal, or • Emulsification -bile salts transform large lipid droplets
hemorrhoidal, veins that supply the anal canal into much smaller lipid droplets
• Bile salts emulsify lipids
• Lipase breaks down lipids which form micelles
B. Functions of the Large Intestine
• Micelles are in contact with intestinal epi. and diffuse with
• Food takes 18-24 hours to pass through the large intestine cells where they are packaged and released into lacteals
and 3-5 hours for chyme to move through small intestine • Lipids are stored in adipose tissue and liver
• Feces is product of water, indigestible food, and microbes
• Microbes synthesize vitamin K

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C. Proteins Hepatitis C often a chronic disease leading to

cirrhosis and possibly cancer of the
• Proteins are split into polypeptides by enzymes secreted liver
by stomach and pancreas Intestine
• Peptides and amino acids are absorbed into intestinal epi. Inflammatory localized inflammatory degeneration
cells bowel disease (IBD) that may occur anywhere along the
• Amino acids are actively transported into cells (help from digestive tract but most commonly
GH and insulin) involves the distal ileum and
• Amino acids used to build new proteins proximal colon
Irritable bowel disorder of unknown cause marked
syndrome (IBS) by alternating bouts of constipation
D. Water and Minerals and diarrhea
Gluten enteropathy malabsorption in the small intestine
• Water can move across intestinal wall in either direction (celiac disease) due to the effects of gluten, a protein
• Depends on osmotic conditions in certain grains, especially wheat
• 99% of water entering intestine is absorbed Constipation slow movement of feces through the
• Minerals are actively transported across wall of small large intestine, causing the feces to
intestine become dry and hard because of
increased fluid absorption while
being retained
Infections of the Digestive Tract
IX. EFFECTS OF AGING ON THE DIGESTIVE SYSTEM
Food poisoning caused by ingesting bacteria or
• With advancing age, the layers of the digestive tract thin, toxins, such as Staphylococcus
and the blood supply decreases. aureus, Salmonella, or Escherichia
coli
• Mucus secretion and motility also decrease in thedigestive
Giardiasis caused by a protozoan, Giardia
tract.
lamblia, that invades the intestine
• The defenses of the digestive tract decline, leaving it more Intestinal parasites common under conditions of poor
sensitive to infection and the effects of toxic agents. sanitation; parasites include
• Tooth enamel becomes thinner, and the gingiva recede, tapeworms, pinworms, hookworms,
exposing dentin, which may become painful and affect and roundworms
eating habits. Dysentery severe form of diarrhea with blood
or mucus in the feces; can be caused
by bacteria, protozoa, or amoebae
X. DISEASES

Condition Description
Stomach
Peptic ulcer lesions in the lining of the stomach or
duodenum, usually due to infection
by the bacterium Helicobacter pylori
Liver
Cirrhosis characterized by damage to and
death of hepatic cells and
replacement by connective tissue
Hepatitis inflammation of the liver that causes
liver cell death and replacement by
scar tissue
Hepatitis A infectious hepatitis; usually
transmitted by poor sanitation
practices or from mollusks living in
contaminated waters
Hepatitis B serum hepatitis; usually transmitted
through blood or other body fluids
through either sexual contact or
contaminated hypodermic needles

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Human Anatomy and Physiology with Pathophysiology

CHAPTER 16: URINARY SYSTEM AND FLUID BALANCE
OUTLINE II. ANATOMY OF THE KIDNEYS
I. Functions of the Urinary System
II. Anatomy of the Kidneys A. Location and External Anatomy of the Kidneys
A. Location and External Anatomy of the Kidneys Kidney
B. Internal Anatomy and Histology of the Kidneys
C. Arteries and Veins - bean-shaped organs
III. Urine Production
- behind the peritoneum (retroperitoneal), with one kidney
A. Filtration
on each side of the vertebral column
B. Tubular Reabsorption
C. Tubular Secretion - main function is to eliminate waste product through
IV. Regulation of Urine Concentration and Volume urination
V. Urine Movement - weighs 5 oz. (bar of soap or size of fist)
A. Anatomy and Histology of the Ureters, Urinary - between 12th thoracic and 3rd lumbar vertebra
Bladder, and Urethra - right kidney lower than the left
B. Micturition Reflex
VI. Body Fluid Compartments
VII. Regulation of Extracellular Fluid Composition
VIII. Regulation of Acid-Base Balance
IX. Diseases

I. FUNCTIONS OF THE URINARY SYSTEM

1. Excretion
2. Regulation of blood volume and pressure
3. Regulation of the concentration of solutes in the blood.
4. Regulation of extracellular fluid pH
5. Regulation of red blood cell synthesis
6. Regulation of vitamin D synthesis

Components: • Renal Fat Pad -adipose tissue that surrounds and protects
each kidney
• 2 Kidneys • Renal Capsule -layer of connective tissue that surrounds
• 2 Ureters each kidney; protects and acts as a barrier
• 1 Urinary bladder • Hilum -indentation on medial side of kidney where blood
• 1 Urethra vessels and nerves exit
• Renal Sinus -fat-filled cavity containing the blood vessels,
adipose tissue, and collecting tubes

B. Internal Anatomy and Histology of the Kidneys

• Renal cortex -outer region

• Renal medulla -inner region
• Renal pyramids -cone-shaped section of the medulla;
junction between cortex and medulla
• Renal papilla -tip of the pyramids where urine is collected
before it is brought to the renal calyx
• Renal calyx -funnel-shaped structure which when joined
together forms the renal pelvis

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• Renal pelvis - where calyces join; wide section of the • Collecting duct -empties into calyces; carry fluid from
urinary channel where the smaller tubules exit before cortex through medulla
going to the ureter • Papillary duct -where collecting duct drains and empty
• Ureter -exits the kidney and connects to the urinary their contents into calyx
bladder

Nephron • Filtration membrane -in renal corpuscle

o endothelium of glomerular capillaries
- functional unit of the kidney; composed of a renal o podocytes
corpuscle and a renal tubule o basement membrane
• Filtrate -fluid that passes across filtration membrane
• Afferent arteriole -supplies blood to the glomerulus for
filtration
• Efferent arteriole -transports the filtered blood away from
the glomerulus
• Juxtaglomerular apparatus -located next to the
glomerulus; consists of a unique set of afferent arteriole
cells and specialized cells in the distal convoluted cells that
are in close contact with each other
o Juxtaglomerular cells -specialized smooth muscle
cells found at the point where the afferent arteriole
enters the renal corpuscle
o Macula densa -group of specialized cells in distal
convoluted tubule

Flow of Filtrate Through Nephron

1. Renal corpuscle
2. Proximal tubule
Two types of nephrons: 3. Descending loop of Henle
4. Ascending loop of Henle
• juxtamedullary nephrons -15% of the nephron; have 5. Distal tubule
loops of Henle that extend deep into the medulla of the 6. Collecting duct
kidney 7. Calyx
• cortical nephrons -remining 85%; have loops of Henle that do 8. Renal pelvis
not extend deep into the medulla 9. Ureter

Components of Nephron C. Arteries and Veins

• Renal Corpuscle -roughly spherical structure at the Blood Flow through Kidneys
beginning of the nephron
1. Renal artery - branch off the abdominal aorta and enter
o Glomerulus -ball of glomerular capillaries the kidneys
o Bowman’s Capsule - enlarged end of nephron; double
2. Interlobar artery -pass between the renal pyramids
walled capsule surrounding the Glomerulus with
3. Arcuate artery -between the cortex and the medulla
specialized cells called Podocytes
4. Interlobular artery -project into the cortex
• Proximal Convoluted Tubule -narrow coiled channel from
5. Afferent arteriole
the Bowman’s capsule 6. Glomerulus
• Loop of Henle -has 2 parts: Descending loop (medulla) and 7. Efferent arteriole
returns as the Ascending loop (cortex); water and solutes 8. Peritubular capillaries -surround the proximal convoluted
pass through thin walls by diffusion tubules, the distal convoluted tubules, and the loops of
• Distal Convoluted Tubule -receives the filtrate from the Henle
loop; between Loop of Henle and collecting duct
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9. Vasa recta -specialized portions of the peritubular IV. REGULATION OF URINE CONCENTRATION AND VOLUME
capillaries that extend deep into the medulla and
Hormonal Mechanisms
surround loops of Henle and collecting ducts
10. Interlobular vein A. Renin-Angiotensin-Aldosterone Mechanism
11. Arcuate vein
12. Interlobar vein - initiated under low blood pressure conditions
13. Renal vein

III. URINE PRODUCTION

1. Glomerular Filtration
2. Tubular Reabsorption
3. Tubular Secretion

A. Filtration

-a nonspecific process whereby materials are separated based

on size or charge

• Movement of water, ions, small molecules through

filtration membrane into Bowman’s capsule to form
filtrate 1. Renin is produced by the kidneys and converts
• 19% of plasma becomes filtrate angiotensinogen, which is produced in the liver, to the
• 180 Liters of filtrate are produced by the nephrons each hormone angiotensin I
day 2. Angiotensin-converting enzyme converts angiotensin I to
• 1% of filtrate (1.8 L) become urine rest is reabsorbed angiotensin II
• Only small molecules are able to pass through filtration 3. Angiotensin II causes vasoconstriction
membrane 4. Angiotensin II acts on adrenal cortex to release
• Formation of filtrate depends on filtration pressure aldosterone
• Filtration pressure -forces fluid across filtration 5. Aldosterone increases rate of active transport of Na+ in
membrane; is influenced by blood pressure distal tubules and collecting duct
• glomerular capillary pressure -blood pressure in the 6. Volume of water in urine decreases
glomerular capillary
• capsular pressure -due to the pressure of filtrate already B. Antidiuretic Hormone Mechanism
inside the Bowman capsule
• colloid osmotic pressure -pressure inside the glomerular - stimulated by a high blood solute concentration
capillary - ADH increases the permeability of the distal convoluted
tubules and collecting ducts to water

B. Tubular Reabsorption

• 99% of filtrate is reabsorbed and reenters circulation

• proximal tubule is primary site for reabsorption of solutes
and water
• descending Loop of Henle concentrates filtrate
• reabsorption of water and solutes from distal tubule and
collecting duct is controlled by hormones

C. Tubular Secretion

• water, small ions, by products of metabolism, drugs, urea 1. ADH is secreted by posterior pituitary gland
are found in urine 2. ADH acts of kidneys and they absorb more water
• solutes are secreted across the wall of the nephron into (decrease urine volume)
the filtrate 3. Result is maintain blood volume and blood pressure
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C. Atrial Natriuretic Hormone V. BODY FLUID COMPARTMENTS

- triggers by increased blood pressure 1. Intracellular fluid -includes the fluid inside all the cells of
the body; two-thirds of all the water in the body is in the
2. intracellular fluid compartment
3. Extracellular fluid -includes all the fluid outside the cells;
includes the interstitial fluid, plasma within blood vessels,
and fluid in the lymphatic vessels

VII. REGULATION OF EXTRACELLULAR FLUID COMPOSITION

A. Thirst Regulation

• Water intake is controlled by neurons in the

hypothalamus, collectively called the thirst center
• Concentration of blood increase thirst center responds by
1. ANH is secreted from cardiac muscle to right atrium of initiating sensation of thirst
heart when blood pressure increases • When water is consumed, conc. of blood decreases and
2. ANH acts on kidneys to decrease Na+ reabsorption sensation of thirst decreases
3. Sodium ions remain in nephron to become urine
4. Increased loss of sodium and water reduced blood volume
and blood pressure Ion Concentration Regulation

• Sodium ions are the dominant extracellular ions.

V. URINE MOVEMENT • Aldosterone increases Na+ reabsorption from the filtrate
• ADH increases water reabsorption from the nephron
A. Anatomy and Histology of the Ureters, Urinary bladder, • ANH increases Na+ loss in the urine.
and Urethra • PTH -increases extracellular Ca2+ levels by
• Calcitonin -lowers blood Ca2+ levels when they are too
• Ureters - small tubes that carry urine from renal pelvis of
high
kidney to bladder
• Urinary Bladder - hollow, muscular container that lies in
the pelvic cavity just posterior to the pubic symphysis;
stores urine; can hold a few ml to a max. of 1000 ml VIII. REGULATION OF ACID-BASE BALANCE
• Urethra - tube that exits bladder; carries urine from
A. Buffers
urinary bladder to outside of body
o trigone -triangle-shaped portion of the urinary - chemicals resist change in pH of a solution
bladder located between the opening of the ureters - buffers in body contain salts of weak acids or bases that
and the opening of the urethra combine with H+
o internal urethral sphincter -prevents urine leakage
from the urinary bladder 3 classes of buffers:
o external urethral sphincter -allows a person to • proteins
voluntarily start or stop the flow of urine through the • phosphate buffer
urethra
• bicarbonate buffer

B. Micturition reflex
B. Respiratory System
-activated by stretch of urinary bladder wall
• responds rapidly to change in pH
• Action potentials are conducted from bladder to spinal • increased respiratory rate raise pH due to rate of carbon
cord through pelvic nerves dioxide elimination being increased
• Parasympathetic action potentials cause bladder to • reduced respiratory rate reduced pH due to rate of carbon
contract dioxide elimination being reduced
• Stretching of bladder stimulates sensory neurons to
inform brain person needs to urinate
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C. Kidneys

• Nephrons secrete H+ into urine and directly regulate pH of

body fluids
• More H+ if pH is decreasing and less H+ if pH is increasing

D. Acidosis and Alkalosis

• Acidosis -occurs when pH of blood falls below 7.35

o respiratory acidosis -results when the respiratory
system is unable to eliminate adequate amounts of
CO2
o metabolic acidosis -results from excess production of
acidic substances
• Alkalosis -occurs when pH of blood increases above 7.45
o respiratory alkalosis -results from hyperventilation,
as can occur in response to stress
o metabolic alkalosis -usually results from the rapid
elimination of H+ from the body

IX. DISEASES

Condition Description
Inflammation of the Kidneys
Glomerulonephritis inflammation of the
filtration membrane within
the renal corpuscle, causing
increased membrane
permeability
Acute glomerulonephritis often occurs 1–3 weeks
after a severe bacterial
infection, such as strep
throat; normally subsides
after several days
Chronic glomerulonephritis long-term and progressive
process whereby the
filtration membrane
thickens and is eventually
replaced by connective
tissue and the kidneys
become nonfunctional
Renal Failure - can result from any condition that interferes
with kidney function
Acute renal failure occurs when damage to the
kidney is rapid and
extensive; leads to
accumulation of wastes in
the blood
Chronic renal failure results from permanent
damage to so many
nephrons that theremaining
nephrons are inadequate for
normal
kidney function

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Human Anatomy and Physiology with Pathophysiology

CHAPTER 17: REPRODUCTIVE SYSTEM
OUTLINE Meiosis II
I. Functions of the Reproductive System
II. Formation of Gametes 6. Prophase II -each chromosome consists of two chromatids
III. Male Reproductive System 7. Metaphase II -chromosomes align along the center of the
A. Scrotum cell
B. Testes 8. Anaphase II -chromatids separate, and each is now called
C. Spermatogenesis a chromosome
D. Ducts 9. Telophase II -new nuclei form around the chromosomes.
E. Penis The cells divide to form four daughter cells with half as
F. Glands many chromosomes as the parent cell
G. Secretions
IV. Physiology of Male Reproduction • synapsis -a process where chromosomes align as pairs
V. Female Reproductive System
• crossing over -allows the exchange of genetic material
A. Ovaries
B. Oogenesis and Fertilization between chromosomes
C. Uterine Tubes • fertilization -union of sperm and oocyte
D. Uterus • zygote -what develops after fertilization; develops into an
E. Vagina embryo 3-14 days after fertilization
F. External Genitalia • embryo -14-56 days after fertilization
G. Mammary Glands • fetus -56 days after fertilization
VI. Physiology of Female Reproduction
VII. Effects of Aging on the Reproductive System
VIII. Diseases
III. MALE REPRODUCTIVE SYSTEM

Consists of:
I. FUNCTIONS OF THE REPRODUCTIVE SYSTEM

1. Production of gametes • Testes

2. Fertilization • Series of ducts
3. Development and nourishment of a new individual o Epididymis
4. Production of reproductive hormones o Ductus deferens/ vas deferens
o Urethra
• Accessory glands
II. FORMATION OF GAMETES o Seminal vesicles
o Prostate gland
• Gametes -sperm in males and oocytes (eggs) in females o Bulbourethral glands
• Meiosis -special type of cell division that leads to • Supporting structures
formation of sex cells; produce four daughter cells o Scrotum
• Each sperm cell and each oocyte contain 23 chromosomes o Penis

Two divisions

Meiosis I (reduction division)

1. Early prophase I -the duplicated chromosomes become

visible chromatids
2. Middle prophase I -pairs of chromosomes synapse.
Crossing over may occur at this stage.
3. Metaphase I -pairs of chromosomes align along the center
of the cell. Random assortment of chromosomes occurs.
4. Anaphase I -chromosomes move apart to opposite sides
of the cell
5. Telophase I -new nuclei form, and the cell divides. Each
cell now has two sets of half the chromosomes

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Functions • seminiferous tubules produce germ cells and

Sustentacular cells
• Produce sperm cells (sex cells)
• Produce male sex hormones
Production of Sperm Cells
• Transfer sperm cells to female
1. Germ cells -partially embedded in the sustentacular cells
2. Spermatogonia - cells from which sperm cells arise; divide
A. Scrotum
through mitosis; one daughter cell remains a
- a saclike structure containing the testes spermatogonium
- contains dartos muscle (layer of loose connective tissue 3. Primary spermatocytes
and a layer of smooth muscle) that moves scrotum and 4. Secondary spermatocytes
testes close to and away from body depending on temp 5. Spermatids -form mature sperm cells
- sperm must develop at temperature less than body 6. Sperm cells or spermatozoon
temperature
- cremaster muscles -extensions of abdominal muscles that
enter the scrotum

B. Testes

- or male gonads
- primary sex organ
- produces sperm
- oval organs, each about 4–5 cm long, within the scrotum

Sperm Cells Structure

• Head -contain a nucleus and DNA

• Midpiece -contain mitochondria
• Tail -flagellum for movement

acrosome -a vesicle which contains enzymes that are released

during the process of fertilization; necessary for the sperm cell
to penetrate the oocyte

• Capsule - thick, white connective tissue that divides the

testes into lobes
• Seminiferous Tubules -long coiled tubes; site of sperm cell
development
• interstitial cells or Leydig cells -secrete testosterone
• germ cells -begin of sperm cell
• sustentacular cells or Sertoli cells -nourish germ cells and
produce hormones

C. Spermatogenesis Path of Sperm

- formation of sperm cells 1. Seminiferous tubules
- begins at puberty 2. Rete Testis
• interstitial cells increase in number and size 3. Efferent ductules
• seminiferous tubules enlarge 4. Epididymis

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5. Ductus (vas) deferens Spermatic cord:

6. Ampulla
7. Ejaculatory duct • ductus deferens
8. Urethra where semen exit body • testicular artery and veins
• lymphatic vessels,
Some Real Energetic Earthworms Divide And Even Unite • testicular nerve

D. Ducts Seminal Vesicle and Ejaculatory Duct

• seminal vesicle -a sac-shaped gland near the ampulla of

each ductus deferens
• ejaculatory duct -union of vas deferens and seminal
vesicles; carries semen to the urethra

Urethra

- extends from urinary bladder to end of penis

- passageway for urine and male reproductive fluids (not at
same time)

Three parts:

• prostatic urethra -passes through the prostate gland

• membranous urethra -passes through the floor of the
pelvis and is surrounded by the external urinary sphincter
• spongy urethra -extends the length of the penis and opens
at its end

E. Penis

- male organ of copulation and functions in the transfer of

sperm cells to female; excrete urine
Epididymis
Three columns of erectile tissue:
- a tightly coiled series of threadlike tubules that form a
comma-shaped structure on the posterior side of the • corpora cavernosa -two columns of erectile tissue that
testis form the dorsal portion and the sides of the penis
- where seminiferous tubules empty new sperm • corpus spongiosum -third, smaller erectile column
- where sperm continue to mature develop ability to swim occupies the ventral portion of the penis
and bind to oocytes • spongy urethra - passes through the corpus spongiosum
and opens to the exterior as the external urethral orifice
• rete Testis -network of tubes that empties into the
erection - engorgement of the erectile tissue with blood which
efferent ductules
causes the penis to enlarge and become firm
• efferent ductules -carry sperm cells from the testis to
epididymis glans penis -head of the penis; covered with prepuce or
• capacitation -final changes in sperm cells; occur after foreskin
ejaculation of semen into the vagina and prior to
fertilization
F. Glands
Ductus Deferens Two seminal vesicles:
- or vas deferens • Prostate gland -surrounds the urethra and the two
- extends from epididymis and joins seminal vesicle ejaculatory ducts; consists of both glandular and muscular
- cut during a vasectomy tissue; size and shape of a walnut
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• Bulbourethral gland -or Cowper glands; pair of small, • spermatogenesis

mucus-secreting glands located near the base of the penis • some aspects of sexual behavior

G. Secretions Mature neural mechanisms are primarily involved in:

Semen • controlling the sexual act

• expression of sexual behavior
- mixture of sperm cells and secretions from male
reproductive glands
- provides a transport medium and nutrients that protect
A. Regulation of Reproductive Hormone Secretion
and activate sperm
• 60% of fluid is from seminal vesicles Hormone Source Target Tissue Response
• 30% of fluid is from prostate gland Gonadotropin- Hypothalamus Anterior Stimulates secretion
releasing pituitary of LH and FSH
• 5% of fluid is from bulbourethral gland hormone
• 5% of fluid is from testes (GnRH)
Luteinizing Anterior Interstitial Stimulates synthesis
hormone (LH) pituitary cells of the and secretion of
testes testosterone
Mucous secretions from the bulbourethral glands functions: Follicle- Anterior Seminiferous Supports
stimulating pituitary tubules spermatogenesis
• lubrication of the urethra hormone (sustentacular and inhibin
• neutralization of the contents of the normally acidic (FSH) cells) secretion
Testosterone Interstitial Testes; body Development of
urethra
cells of testes tissues reproductive
• providing a small amount of lubrication during intercourse organs and
• reduction of acidity in the vagina secondary sexual
characteristics;
supports
spermatogenesis
Mucus-like secretion of the seminal vesicles contains
substances: Anterior Inhibits GnRH, LH,
pituitary and and FSH secretion
• Fructose -nourish the sperm cells as they move through hypothalamus through
negative feedback
the female reproductive tract Inhibin Sustentacular Anterior Inhibits FSH
• Coagulation proteins -help thicken the semen, which cells pituitary secretion through
keeps the sperm cells in the vagina for a longer period of negative feedback

time
• Enzymes -help destroy abnormal sperm cells B. Puberty in Males
• Prostaglandins -stimulate smooth muscle contractions of
the female reproductive tract to propel sperm cells • Sequence of events in which a boy begins to produce male
through the tract hormones and sperm cells
• Begins at 12-14 and ends around 18
• Testosterone is major male hormone secreted by the
Function of secretions of the prostate testes
1. Regulate pH • Secondary sexual characteristics develop: skin texture, fat
2. Liquefy the coagulated semen distribution, hair growth, skeletal muscle growth, and
larynx changes
Testicular secretions -include sperm and small amount of fluid.

• 2-5 ml of semen is ejaculated each time C. Effects of Testosterone

• 1 ml of semen contains 100 million sperm
Target Tissue Response
• sperm can live for 72 hours once inside female
Penis and Enlargement and differentiation
scrotum
Hair follicles Hair growth and coarser hair in the pubic area,
IV. PHYSIOLOGY OF MALE REPRODUCTION
legs, chest, axillary region, face, and
occasionally back; male pattern baldness on the
Hormones control:
head if the person has the appropriate genetic
makeup
• the development of reproductive structures
• the development of secondary sexual characteristics

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Skin Coarser texture of skin; increased rate of

secretion of sebaceous glands, frequently
resulting in acne at the time of puberty;
increased secretion of sweat glands in axillary
regions
Larynx Enlargement of larynx and deeper masculine
voice
Most tissues Increased rate of metabolism
Red blood cells Increased rate of red blood cell production; a
red blood cell count increase by about 20% as a
result of increased erythropoietin secretion
Kidneys Retention of sodium and water to a small
degree, resulting in increased extracellular fluid
volume
Skeletal muscle A skeletal muscle mass increase at puberty;
average increase is greater in males than in
females
Bone Rapid bone growth, resulting in increased rate
of growth and early cessation of bone growth;
males who mature sexually at a later age do not
exhibit a rapid period of growth, but they grow
for a longer time and can become taller than
men who mature earlier

D. Male Sexual Behavior and the Male Sex Act

• Emission -movement of sperm cells, mucus, prostatic

secretions, and seminal vesicle secretions into the Functions
prostatic, membranous, and spongy urethra
• Ejaculation -forceful expulsion of the secretions that have • Produce female oocytes (sex cells)
accumulated in the urethra to the exterior • Produce female sex hormones
• Orgasm -or climax; occur during the male sex act and • Receive sperm from males
result in an intense sensation • Develop and nourish embryos
• Resolution -occurs after ejaculation; penis becomes
flaccid, an overall feeling of satisfaction exists, and the
male is unable to achieve erection and a second
A. Ovaries
ejaculation
• Erection -first major component of the male sex act; - primary female reproductive organ
neural stimuli cause the penis to enlarge and become firm - produces oocytes and sex hormones
• Erectile dysfunction -failure to achieve erections - one on either side of uterus
• Infertility -reduced or diminished fertility; most common
cause in males is a low sperm cell count
• Artificial insemination -collecting several ejaculations,
concentrating the sperm cells, and inserting them into the
female’s reproductive tract

V. FEMALE REPRODUCTIVE SYSTEM

Consists of:

• Ovaries
• Uterine tubes/ fallopian tubes
• Uterus
• Vagina
• External genitalia
• Mammary glands

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• suspensory ligaments -anchor ovaries to pelvic cavity; 11. The remaining granulosa cells in the follicle develop into
extends from each ovary to the lateral body wall the corpus luteum.
12. If fertilization occurs, the corpus luteum persists. If there
• ovarian ligament -attaches the ovary to the superior
is no fertilization, it degenerates.
margin of the uterus
• mesovarium - ovarian mesentery where the broad
ligament is attached Ovulation -when a mature follicle ruptures, forcing oocyte into
• ovarian follicle -contains oocytes (female sex cell) peritoneal (pelvic) cavity; due to LH (anterior pit. gland)

Corpus luteum -mature follicle after ovulation; degenerates if

egg is not fertilized
B. Oogenesis and Fertilization
Oogonia → Primary oocyte → Secondary oocyte (outside
• Oogonia -cells from which oocytes develop
ovary after ovulation) → + sperm cell → zygote → fetus
• Fertilization -begins when a sperm cell penetrates the
cytoplasm of a secondary oocyte
• Zygote -has 23 pairs of chromosomes (a total of 46
chromosomes)

Oocyte Follicle
Fetus oogonium primordial follicle
primary oocyte primordial follicle
Puberty primary oocyte primary follicle
primary oocyte secondary follicle
Menopause primary oocyte mature follicle
secondary oocyte mature follicle

Maturation of the Oocyte and Follicle

1. By the fourth month of development, the ovaries contain

5 million oogonia.
2. By birth, many oogonia have degenerated, and for the
remaining oogonia meiosis has stopped in prophase I,
causing them to become primary oocytes.
3. By puberty, 300,000 to 400,000 primary oocytes remain,
of which about 400 will be released from the ovaries.
4. Ovulation is the release of an oocyte from an ovary. The
first meiotic division is completed, and a secondary oocyte
is released.
C. Uterine Tubes
5. A sperm cell penetrates the secondary oocyte, the second
meiotic division is completed, and the nuclei of the oocyte - aka fallopian tubes or oviduct
and sperm cell are united to complete fertilization. - part of uterus which extends toward ovaries and receive
6. A primordial follicle is a primary oocyte surrounded by a oocytes
single layer of flat granulosa cells.
7. In primary follicles, the oocyte enlarges, and granulosa fimbriae -fringe-like structures around opening of uterine
cells become cuboidal and form more than one layer. A tubes that help sweep oocyte into uterine tubes; surround the
zona pellucida is present. surface of the ovary
8. In a secondary follicle, fluid-filled vesicles appear, and a ampulla - part of the uterine tube near the ovary; where
theca forms around the follicle. fertilization usually occurs
9. In a mature follicle or graafian follicle, vesicles fuse to
form an antrum, and the primary oocyte is surrounded by implantation -a process where the fertilized oocyte travels to
cumulus cells. uterus, where it embeds in the uterine wall
10. During ovulation, the mature follicle ruptures, releasing
the secondary oocyte, surrounded by cumulus cells, into
the peritoneal cavity.

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D. Uterus • Vulva -or pudendum; external female sex organs; consists

of mons pubis, labia majora and minora, clitoris, and
- pear sized structure located in pelvic cavity vestibule
- functions: receive, retain, and provide nourishment for • Vestibule -space in which vagina and urethra open
fertilized oocyte, where embryo resides and develops • Labia minora -thin, inner folds of skin
- supported by broad ligament and round ligament • Labia majora - two prominent, rounded folds of skin;
equivalent to male scrotum
• fundus -part of the uterus superior to the entrance of the • Clitoris -small erectile structure located in vestibule;
uterine tubes equivalent to male penis
• body -main part of the uterus • Prepuce -a fold of skin where 2 labia minora unite over
• cervix -narrow region that leads to vagina clitoris
• cervical canal -opens into the vagina • Greater vestibular glands - produce a lubricating fluid that
helps maintain the moistness of the vestibule
Uterine wall is composed of three layers: • Mons pubis -fatty layer of skin covering pubic symphysis
• Pudendal cleft -space between the labia majora
• Perimetrium -serous layer; outer layer • Clinical perineum -region between the vagina and the
• Myometrium -muscular layer; middle layer; accounts for anus
the bulk of the uterine wall o Episiotomy -incision in the clinical perineum
• Endometrium -inner layer/lining of uterus; consists of
simple columnar epithelial cells; sloughed off during
G. Mammary Glands
menstruation
- organs of milk production located in the breasts
prolapsed uterus - ligaments that support the uterus or
- modified sweat glands
muscles of the pelvic floor are weakened
- female breasts begin to enlarge during puberty
- consists of lobes covered by adipose
- lobes, ducts, lobules are altered during lactation to expel
E. Vagina milk
- internal genitalia
- extends from uterus to outside of body
- female copulation organ that receives penis during
intercourse
- allows menstrual flow and childbirth
- contains very muscular walls and a mucous membrane
- very acidic to keep bacteria out

Hymen -thin membrane covering the vagina

F. External Genitalia

External structures

• Areola - a circular, pigmented area that surrounds the

nipple
• Nipple - very sensitive to tactile stimulation

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Internal structures • progesterone levels are increasing

• cervical mucus thins
• Lobes
• Lactiferous duct - opens independently to the surface of Days 15-28 Secretory phase (between ovulation and next
the nipple menses)
• Lobules
• endometrium is preparing for implantation
• Alveoli -secretory sacs
• estrogen levels decrease (low)
• Myoepithelial cells -surround the alveoli and contract to
• progesterone levels high
expel milk from the alveoli
• cervical mucus thickens
gynecomastia -condition where the breasts of a male can
Endometriosis -a condition in which endometrial tissue
become permanently enlarged
migrates from the lining of the uterus into the peritoneal
cavity, where it attaches to the surface of organs

VI. PHYSIOLOGY OF FEMALE REPRODUCTION Blastocyst -a collection of cells when the zygote undergoes
several cell divisions (if fertilization occurs)
A. Puberty in Females
Ectopic pregnancy -if fertilized oocyte (zygote) implants
• begins between 11-13 and is usually completed by 16 somewhere beside uterus (usually in uterine tube)
• Menarche -first episode of menstrual bleeding
• vagina, uterus, uterine tubes, and external genitalia to
enlarge and adipose tissue is deposited in breast and hips
• elevated levels of estrogen and progesterone are secreted
by ovaries

B. Menstrual Cycle

• Series of changes that occur in sexually mature,

nonpregnant females and that result in menses
• Menses -a period of mild hemorrhage, during which part
of the endometrium is sloughed and expelled from the
uterus
• Average is 28 days and results from cyclical changes that
occur in endometrium

Stages of Menstrual Cycle

Days 1-5: Menses (shedding of endometrium)

• menstrual bleeding (menses)

• estrogen and progesterone levels are low
• follicle begins to mature

Days 6-13: Proliferative phase (between end of menses and

C. Menopause
ovulation)
- time when ovaries secrete less hormones and number of
• endometrium rebuilds follicles in ovaries is low
• estrogen levels begin to increase - cessation of menstrual cycles
• progesterone levels remain low - menstrual cycle and ovulation are less regular
• follicle matures - hot flashes, fatigue, irritability may occur
- estrogen replacement therapy may be used to decreases
Day 14: Ovulation
side effects
• oocyte is released due to LH climacteric -whole time period from the onset of irregular
• estrogen levels high cycles to their complete cessation

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Hormone Secretion D. Female Sexual Behavior and Female Sex Act

Hormone Source Target Tissue Response • Female sex drive is partially influenced by testosterone-
Gonadotropin- Hypothalamus Anterior Stimulates secretion like hormones produced by the adrenal cortex and
releasing pituitary of LH and FSH
hormone estrogen produced by the ovary.
(GnRH) • Autonomic nerves cause erectile tissue to become
Luteinizing Anterior Ovaries Causes follicles to engorged with blood, the vestibular glands to secrete
hormone (LH) pituitary complete
maturation and mucus, and the vagina to produce a lubricating fluid.
undergo ovulation;
causes ovulation
Follicle- Anterior Ovaries Causes follicles to E. Control of Pregnancy
stimulating pituitary begin development
hormone
(FSH)
Behavioral methods
Estrogen Follicles of Uterus Proliferation of
ovaries and endometrial cells • Abstinence -refraining from sexual intercourse; 100%
corpus luteum effective in preventing pregnancy when it is practiced
Breasts Development of consistently
mammary glands
(duct systems) • Coitus interruptus -or withdrawal; removal of the penis
from the vagina just before ejaculation
Anterior Positive feedback
pituitary and before ovulation;
• Natural family planning -requires abstaining from sexual
hypothalamus negative feedback intercourse near the time of ovulation
with progesterone • Lactation - lactation amenorrhea, or LAM; continuous
on the
hypothalamus and breastfeeding; often stops the menstrual cycle for up to
anterior pituitary the first 6 months after childbirth; 99% effective
after ovulation

Other tissues Development and

Barrier methods
maintenance of
secondary sexual
characteristics -prevent contact between sperm and oocyte
Progesterone Corpus Uterus Enlargement of
luteum of endometrial cells • Condom -a sheath made of animal membrane, rubber, or
ovaries and secretion of plastic, such as latex; a barrier device that collects the
fluid from uterine
glands;
semen
maintenance of • Vaginal condom -or female condom
pregnant state • Diaphragm and cervical cap -flexible latex domes that are
Breast Development of placed over the cervix within the vagina
mammary glands o diaphragm cap -larger, shallow latex cup
(alveoli) o cervical cap -smaller, thimble-shaped latex cup
Anterior Negative feedback, • Spermicidal agents -foams or creams that kill sperm cells
pituitary with estrogen, on • Intrauterine devices (IUDs) -inserted into the uterus
the hypothalamus
through the cervix
and anterior
pituitary after
ovulation
Chemical methods
Other tissues Secondary sexual
characteristics -prevent oocyte ovulation
Oxytocin Posterior Uterus and Contraction of
pituitary mammary uterine smooth • Oral contraceptives -synthetic estrogen and
glands muscle and
contraction of cells progesterone; among the most effective contraceptives
in the breast, • Mini-pill -an oral contraceptive that contains only
resulting in milk
synthetic progesterone
letdown in lactating
women • Patch (Ortho Evra) -an adhesive skin patch containing
Human Placenta Corpus Maintains corpus synthetic estrogen and progesterone
chorionic luteum of luteum and
gonadotropin ovaries increases its rate of
• Vaginal contraceptive ring (Nuva Ring) -inserted into the
progesterone vagina, where it releases synthetic estrogen and
secretion during the progesterone
first trimester of
pregnancy

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• RU486 -or mifepristone; blocks the action of urethra of men; results in a

progesterone, causing the endometrium of the uterus to greenish-yellow discharge with a
slough off foul odor
• Morning-after pills -similar in composition to birth control Gonorrhea caused by the bacterium Neisseria
pills gonorrhoeae that attaches to the
epithelial cells of vagina or male
urethra and causes pus to form
Surgical methods Genital herpes caused by herpes simplex 2 virus;
characterized by lesions on the
-are typically permanent genitals that progress into blister
like areas
• Vasectomy -a common method used to render males
Genital warts caused by a viral infection; very
permanently infertile without affecting the performance contagious; warts vary from
of the sex act separate, small growths to large,
• Tubal ligation -common method of permanent birth cauliflower-like clusters
control in females; uterine tubes are tied and cut or Syphilis caused by the bacterium
clamped by means of an incision through the wall of the Treponema pallidum; multiple
abdomen disease stages occur; children born
• Laparoscopy -an instrument is inserted into the abdomen to infected mothers may be
through a small incision developmentally delayed
Acquired caused by the human
immunodeficiency immunodeficiency virus (HIV);
F. Infertility in Females syndrome (AIDS) ultimately destroys the immune
system
• Causes of infertility in females include malfunctions of the
uterine tubes, reduced hormone secretion from the
pituitary or ovary, and interruption of implantation

VII. EFFECTS OF AGING ON THE REPRODUCTIVE SYSTEM

1. Benign prostatic enlargement affects men as they age, and

it blocks urine flow through the prostatic urethra.
2. Prostate cancer is more common in elderly men.
3. Menopause is the most common age-related change in
females.
4. Cancers of the breast, the cervix, and the ovaries increase
in elderly women.

DISEASE AND DISORDERS

Condition Description
Infectious Diseases
Pelvic inflammatory bacterial infection of the female
disease (PID) pelvic organs; commonly caused bya
vaginal or uterine infection with
the bacteria gonorrhea or
chlamydia
Sexually Transmitted Infections
Nongonococcal inflammation of the urethra that is
urethritis not caused by gonorrhea; usually
due to infection with the bacterium
Chlamydia trachomatis
Trichomoniasis caused by Trichomonas, a
protozoan commonly found in the
vagina of women and in the

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