Lecture 2 — CVS

The Thorax and Ribcage

● The chest
○ Heart
① sit on the diaphragm
② medially between the two lungs/is medial to the lungs/lungs are lateral to the heart
③ in the middle of the ribcage, along the midline of the body ④tilt to the left
⑤ pointing towards the sternum ⑥ Base (1.2cm from the middle)/Apex (7.5cm away)
● The boundaries
○ Ribcage (sternum, ribs [12 pairs], Thoracic vertebral column [T1-T12])
○ Diaphragm
● Thoracic cavity (heart, lungs) = mediastinum + pleural chambers
○ L & R pulmonary chambers are enclosed by pleural cavities, which are defined by pleural
membrane capex oftheheart)
to
RA RV LA LV Inerventricular Pulmonary vessels Aorta & vena cava
sulcus

Anterior ✓ part ✓✓ little ✓portion anterior X Ascending aorta +

aortic arch + SVC
LEFT ✓auricles ✓anterior ✓auricles ✓anterior pulmonary trunk continues as
Lateral left pulmonary arteries, right is
behind the ascending aorta

Posterior X X ✓✓ X X 4 pulmonary vessels Descending aorta,

(left/right pulmonary aortic arch
artery/vein)
Posterior X ✓ ✓ posterior Descending aorta
upright + IVC

RIGHT ✓ ✓ X X X (as the heart X SVC & IVC

Lateral is tilt to the left)
● the pulmonary trunk bifurcates into 2 pulmonary arteries
● aorta = ascending + aortic arch + descending (longest)
● Inter = b/w & sulcus = blood vessel of the heart
● The two atria/ventricles are partitioned by the interatrial/
interventricular septum
● Tricuspid valve = right atrioventricular valve
● Bicuspid/mitral valve = left atrioventricular valve
● Aortic valve & pulmonary valve = semilunar valves
● LA: inlet (base of pulmonary vein); outlet (bicuspid valve)

Structure of a heart wall

● Endocardium (innermost) [simple squamous endothelium]
● Myocardium (muscle) [thickest]
○ Cardiac muscles & intercalated discs
● Epicardium (outermost) mediastinum
● Pericardium (surround the heart) defines the middle mediastinum

-
(X the heart defines) thymus
○ Visceral layer = epicardium is

○ Serous fluid (reduce friction) ->

somewhere
here
○ Parietal layer = relatively inelastic connective tissue layer
**heart wall and the pericardium (membrane) is not separated

Route Oxygenated Deoxygenated

Systemic LV→Aorta→Systems→VC Arteries Veins

circuit → RA -
H

Pulmonary RV→Pulmonary arteries Veins Arteries

circuit →lungs→pulmonary veins
→LA
● Oxygenated doesn’t mean 100% O2; deoxygenated doesn’t mean 0% O2

Structure of blood vessels turiiaf

facilitate vasodilation and vasoconstriction
A. Arteries (carry blood away from heart)
● Elastic arteries eg. aorta, brachiocephalic, common carotids, subclavian, common iliac
○ Aorta & largest blood vessels at major pulse point
○ Withstanding the high pumping pressure
○ Maintaining constant pressure
● Muscular arteries = distributing arteries
○ Medium-sized
○ Thinner tunica media
● Arterioles
○ Small-sized
○ Entering the organ tissues → capillaries
Tunica externa Tunica media Tunica intima

Elastic artery ✓ Smooth muscle < Elastic fibre ✓

(connective (endothelium layer
Muscular artery tissue) Smooth muscle > Elastic fibre with basement
membrane)
Arteriole Smooth muscle
**Muscular artery contains more smoooth muscle cells in the tunica media than elastic artery
 B. Capillaries (X tunica media)
● Provide oxygen and nutrients to tissue cells
● Remove metabolic wastes from tissue cells
● Leave the capillary bed into small venule
○ Continuous (complete endothelial lining)
○ Fenestrated (pores in endothelial lining allow rapid
exchange)
○ Sinusoid
□ flattened, irregular, resemble fenestration
□ Thinner or absence of basement membrane →
permit free exchange b/w blood and intersitial fluid

C. Veins
● Medium-sized vein (in the limbs, relying on muscle contraction)
● Large vein (SVC, IVC, branches within thoracic and
abdominopelvic cavities)

● Lecture 2 - CVS p.27-30

Ascending aorta L. ventricle to sternal angle

(aortic sinuses → L/R coronary arteries)
Aortic arch
Brachiocephalic trunk Head, neck and R. upper limb
R. subclavian artery Neck and R. upper limb
R. axillary artery R. upper limb
L. subclavian artery Neck and L. upper limb
L. axillary artery L. upper limb
Thoracic aorta (T5-T12, diaphragm)
↑
Visceral branches terminal
- Pericardial - Pericadium branch
- Bronchial - Lungs and bronchi of

- Esophageal - Esophagus brachiocephalic

- mediastinal - Posterior mediastinum
Parietal branches
- Posterior intercostals - Intercoastal muscles, spinal cord,
vertebrae, pleurae, skin
- Superior phrenics - Posterior and superior diaphragm
Lecture 3 - Regional Anatomy of the thorax
A. The ribcage
1. Sternum rib(X have transverse process)
aperture

&
Superior
1 thoracic
↑

F
git
Af

costal -
groover

● Suprasternal/jugular
M
O
notch
Inferior
thoracic
● Clavicular notch x2 aperture lipid
● Manubrium ARFE &
● Sternal angle (junction b/w manubrium and body)
○ Costal cartilages of 2nd rib
○ Vertebral level of T4/T5 a as tort-
A
●
○ Boundary of superior and inferior mediastinum
Body
/
○ sternocostal articulations for the attachment of costal cartilages 1-7 osesphagn .

↓ aorta
● Xiphoid process aorta
↑
thoracic durt
● Thoracic cavity X include rib cage Vagas
n.

● Pleural cavity X include pleural membrane (visceral → pleural fluid → parietal)

● Superior mediastinum (oesophagus, trachea, blood vessels and nerves and - thymus)
● Inferior mediastinum
○ Anterior (blood vessels); Middle (heart + pericardium); Posterior (oesophagus)
+
thymus
2. Ribs Rib cage: strong >pt heart liver lungs
● True (ribs 1-7): attach directly to the sternum
● False (ribs 8-10): attach through costal cartilage
● Floating (ribs 11-12): have no attachment to the sternum
Absorb stress from body movement and gravity * Scoliosis
-
3. Thoracic vertebrae (curvature, T1-T12)
● Thoracic vertebra (rib is attached b/w two vertebrae) [T1, T6 & T12 are landmarks of curvature]
○ Vertebral body interear vertebral canal ,
facet
○ Superior costal facet for the head of superior rib

↓
↑
○ Inferior costal facet for the head of inferior rib
○ Vertebral foramen (protect the spinal cord)
○ Pedicle E

○ Lamina
○ Transverse process x2 pedicle/
○ Transverse costal facet for tubercle of superior rib
○ Spinous process super a

4. Thoracic inlet (入口) (X clavicle) head

superior
● Sternum (manubrium), 1st ribs, 1st thoracic vertebra ~

clarine & 17 & Interpr

X scapula, transverse ,
head
5. Thoracic outlet(出口) (X flat plane)
● Xiphoid process, curving coastal margin, 12th ribs, 12th thoracic vertebra (bounded by the
diaphragm)

6. Margins of the lungs

Landmark Margin of lung Margin of pleura

Midclavicular 6th rib (left 4th rib) 8th rib (Left 6th rib)

Midaxillary 8th rib 10th rib

Midscapular 10th rib 12th rib

B. Circulation between the heart and lungs

● Aorta → descending/thoracic aorta → bronchial arteries and
veins (supply and drains blood from the lungs)
● Bronchial circulation
○ Bronchial arteries supply blood to the bronchial tree, the
connective tissue of the lung, and the visceral pleura
○ ① [⅞] they may anastomose with the branches of the
pulmonary arteries → pulmonary veins
○ ② [⅛] they may also carry the remaining blood (mainly
deoxygenated) to bronchial veins → drain into the azygos
and hemiazygos system
○ **Much of the oxygenated blood supplied by the
bronchial arteries is returned via the pulmonary veins
rather than the bronchial veins → the venous blood
dilutes the oxygenated alveolar blood with the pulmonary
vein → O2 lv of blood returned to the heart is never 100%
 upper:
nose +lanux

C. Trachea (begining of lower respiratory tract)

● Tough, flexible tube (2.5cm diameter & 11cm length)
● Ends in the mediastinum at T5 level (Carina separates right and left bronchus)
● Contains 15-20 C-shaped tracheal cartilages
● Trachealis muscle (smooth muscle) connects the ends of each tracheal cartilage
● Asthma → narrowed trachea

D. The bronchial tree (primary bronchi and branches)

extra intra
● [5 lobes & 19 segments]
● Conducting Division
○ Primary bronchi (extrapulmonary)
I
primary + secondary + tertiary
○ Secondary (lobar) bronchi (intrapulmonary) -bronchioles -> terminal bronchiole
○ Tertiary bronchi (segmental bronchi) respiratory bronchiole alreali
->
-

▫ Each segmental bronchus supplies air to a single bronchopulmonary segment

F
▫ The walls of primary, secondary, & tertiary bronchi contain progressively less cartilage
& more smooth muscle
○ Bronchioles smallest passageways
in the lungs having
○ Terminal bronchiole
ciliated epithelia
● Respiratory Division (no cartilage, dominated by smooth muscle)
○ Respiratory bronchiole → alveoli
▫ Changes in diameter controls resistance to airflow and distribution of air in the lungs
▫ Autonomic nervous system controls the diameter
 collect deoxygenated blood
E. Coronary circulation from the heart and empty
into RAS

·
a) Right Coronary Artery (RCA) → Right Marginal Artery (RMA) →
Posterior Interventricular Artery (PIA)
b) Left Coronary Artery (LCA) → Anterior Interventricular Artery (AIA) → Circumflex Artery →
Left Marginal Artery (LMA)
Right Right Coronary Artery (RCA) Small cardiac vein
phrenic
Right Marginal Artery (RMA) Anterior cardiac vein yes

Intere
Posterior Interventricular Artery (PIA) Middle cardiac vein

Left Anterior Interventricular Artery (AIA) Great cardiac vein

Left Marginal Artery (LMA) Posterior cardiac vein

F.
●
●
Diaphragm
Dome shape
Muscle fibres (L & R crus)
remacy -
● Central tendon (green)
● Innevated by the phrenic nerve (L & R)
● Functionally involved in normal respiration
● Hiatus: IVC, esophagus and thoracic aorta (T10)

**a single organ can be supplied by more than 1 artery

(eg. lungs are supplied by both pulmonary & systemic circuit)

Abdominal acrta
.

Sternal angle T4/55

Tramea ends at + 5
Hiafus T10
 Lecture 5 — Nervous system
A. Cellular components
are interneurons)
● Neurons 190%
E
○ dendrites, soma [cell body], neurofibrils [microtubules], nissl bodies [ER], axon, Schwann
cell [myelin sheath]
● Neuroglia (supporting cells in the nervous system)
nerve fibres in CNSX regenerate
○ Neuroglia : Neuron (10:1)
I as they lack neuvilemma &
CNS endomeurium PNS
a) Ependymal cells: line ventricles (brain) & central
canal (spinal cord) *
a) Satellite cells: surround
neuron cell bodies in ganglia
● Assist in producing circulating and monitoring ● Regulate O2, CO2, nutrient, and
cerebrospinal fluid neurotransmitter levels around

A
b) Astrocytes
● Maintain blood-brain barrier (BBB)
● Provide structural support
①
neurons in ganglia
b) Schwann cells: surround all
axons in PNS form neur, lemma
->

● Regulate ion, nutrient, and dissolved gas conc ● Responsible for myelination of
-
-

● Absorb and recycle neurotransmitters peripheral axons

● Form scar tissue after injury main component ● Participate in repair process
t is phospholipid
c) Oligodendrocytes (most abundant)
-
● Myelinate CNS axons
after injury

● Provide structural framework

d) Microglia
● Remove cell debris wastes and pathogens by phagocytosis
● Brain: Grey [outer], White [inner]; Spinal cord: Grey [inner], White [outer]

B. Nervous tissue (may include brain/spinal cord)

● Excitable (action potential); allow propagation of nerve impulse and communication
nucleus/ganglion ● CNS: nucleus; PNS: ganglion
(collection of cell ● Perform particular functions, eg dorsal root ganglion neurons transmit
body of neurons) signal from receptors to spinal cord

nerves/tract: ● CNS: tract; PNS: nerve

collation of bundles ● Bound by connective tissue (endoneurium, perineurium → form
of axons fascicles [bundles of axons], epineurium)

gray/white matter ● Gray matter: collection of neuronal cell bodies

● White matter: collection of myelinated axons

Meninges 腦膜 of
brain & spinal cord Spinal Cranial
Dura matter (tough) Separated from vertebra Attached to cranium
Epidural space Fat, vessels Only found in sinus

hillock axon
cell body -> axon -

Human Anatomy (Nervous system & Neuroanatomy) ৷ 1

 epidural

Cranium
↓

Dura-periosteal layer
mater-meningeay layer
C. Organs/structures of the nervous system I
a) Spinal cord (part of the CNS) arachnoid
● Connecting the brain with the peripheral receptors/effectors → allow communication mater
● **Mediates reflex rehabiors
pa mater

Gray matter White matter

● Integrates information & initiates commands ● Carries information from place to place
● Contains little myelin ● Myelinated axons
● Somas, dendrites, proximal axons ● Bundles of axons (tracts)
● Synaptic integration
Proximal banches (close to midline) Distal branches
● Dorsal root (dorsal root ganglion) ● Dorsal ramus
● Ventral root ● Ventral ramus
● Meningeal branch

not all
somatic reflexes
are monosynaptic Xtransverse

foramen for
thoracic vertebra

Human Anatomy (Nervous system & Neuroanatomy) ৷ 2

● Ascending and descending tracts (fasciculi): to the brain
○ Tract = a bundle of axons in the CNS
○ Ascending: carry sensory information toward the brain
○ Descending: carry motor commands to the spinal cord
○ Both ascending and descending tract are located on both R & L side

● Dermatome
○ The specific bilateral region of the skin surface monitored by a single pair of
spinal nerves (except C1)

b) Brain
● Perception and processing sensory stimulation
● Execution of voluntary motor responses
● Regulate homeostasis

cerebrum & cerebellum:

separate
tentorium cerebelli
x
speech
AVANS

Gray matter White matter

● Superficial ● Deep
● Neuron cell bodies ● Tracts (bundles of axons)
● Dendrites ● Myelinated
● Synapses
● Cortex and nuclei (collection of cell bodies)
● Central sulcus runs from the median longitudinal fissure towards the lateral sulcus

Human Anatomy (Nervous system & Neuroanatomy) ৷ 3

 separate them: falx celebri

● Cerebrum J
○ Cerebral hemispheres, longitudinal fissure, gyri, sulci
○ Lobes of the cerebrum
Frontal ● Cognition (think) Temporal ● Hearing
● Higher mental processes ● Smell
● Speech (Broca's area) ●
E
Learning
●
A Motor control ●
●
Memory
Some aspects of vision
Occipital ● Visual perception
and emotion
Parietal ● Receives & interprets Insula ● Taste
Asignals of general senses ● Hearing
and taste ● Visceral sensation

Frontal-motor
·tre
A
cognitive
-

speech A
Insula
occipital -

sightAt
I 11
Temporas -

hearing # C occipital 7

factory W
4 -
temporal
frontal
Insula taste
S

I
-

hearing insula
parietal -

Sensory

●
Primary sensory/motor cortex: the distorted appearance of the homunculus / distorted look
○ The amount of cerebral tissue devoted to a given body region is proportional to [sensory]
how richly innervated & sensitive that region is / [motor] the no of muscles and motor units
in that region, not to its size
● Postcentral gyrus (primary somatosensory):
↑ General sensation [LEFT side → right brain]
○ ①Interprets pain & temp sensation; ②perceives pressure & touch sensation; x 2
+

posit
③discriminates shape, size and texture of objects
↑
○ Ascending tract (somatosensory) eg. spinothalamic pathway
▫ ①Lateral spinothalamic tracts ②Anterior spinothalamic tracts
▫ 1st order (sensory); 2nd order (interneuron passes through spinal cord, medulla
thalamus oblongata, midbrain to the thalamus); 3rd order neuron → primary sensory cortex)

↑
=
-
-

diencephalon
/

in

pinamic
pract

-07
⑪ Human Anatomy (Nervous system & Neuroanatomy) ৷ 4
● Precentral gyrus (primary motor): motor execution contralaterally
I
○ Descending tract (motor) eg. corticospinal pathway
▫ Primary motor cortex → midbrain → medulla oblongata → pyramid
▫ ①way: decussation of pyramid → lateral corticospinal tract
▫ ②way: anterior corticospinal tract
▫ Finally they will reach the motor neuron

● Cerebellum (Motor coordination + non-motor functions, like emotions)

○ Cerebellar hemispheres
○ Vermis = wormlike bridge
○ Cerebellar peduncles (feet)
○ Folia (gyri)
○ Arbor (white) vitae (white matter)
○ Deep nuclei (gray matter)
○ Purkinje cells (neuron)

D. Autonomic nervous system large, heavily branched neuron with a pear-shaped soma and numerous
large dendrites running out into the gray matter of the cerebellum.

ANS SNS -
Cardiac n smooth Skeletal muscle
muscle

Involuntary, voluntary
homeostasis
● Control glands, cardiac muscle and smooth muscle
● Visceral (internal) motor system
● Responsible for visceral reflexes (slower
response)
○ Unconscious, automatic, stereotyped responses to stimulation, which involves visceral
receptors and effectors
○ Receptors: stretch, tissue damage, blood chemicals, body temp and other internal stimuli
○ Afferent neurons leading to CNS, interneurons in the CNS, efferent neurons and effectors
(PNS)
● Sympathetic division: ‘fight or flight’
○ Respond to arousal, competition, stress, danger, anger and fear
○ Can be excitatory or inhibitory
● Parasympathetic division: ‘rest and digest’
○ Calming effect
● Autonomic tone (balance b/w sympathetic and parasympathetic division)
● Neural pathways of ANS
Preganglionic neuron Postganglionic neuron

Soma In brainsteam/spinal cord Ganglion

Axon Terminates in ganglion

AExtends to target
Human Anatomy (Nervous system & Neuroanatomy) ৷ 5
the autonomic ganglion releases Ach in both

sympathetic and parasympathetic site

 luse norephinephrine as UTS

1. Sympathetic division -postganglionic fibers are adrenergic

● I
Thoracolumbar division (nuclei arise at thoracic and lumbar regions)
● Relatively SHORT preganglionic fibers
● Relatively LONG postganglionic fibers
● Sympathetic chain ganglia (paravertebral ganglia)
● Communicating Rami
○ Preganglionic fibers (myelinated, travel to chain ganglia by a white communicating ramus)
○ Postganglionic fibers (unmyelinated, leave ganglion by various routes)
▫ 1) spinal nerve route
▫ 2) sympathetic nerve route
▫ 3) Splanchnic nerve route (pass sympathetic ganglion/collateral [prevertebral] ganglia)
to internal organs

S
I
X be found in
hypothalamus

2. Parasympathetic division eg. Salivation, lacrimation, urination, digestion, defecation

● ↑
Craniosacral division
● LONG preganglionic fibers (end in terminal ganglia in/near the target organ)
● Very SHORT postganglionic fibers
● More selective in its stimulation of target Many organs are innervated by
● Innervation to head (III, VII, IX) both sympathetic and parasympathetic
● Innervation to viscera (X)

Human Anatomy (Nervous system & Neuroanatomy) ৷ 6

Lecture 6 — Neuroanatomy
A. White matter of the brain
● Commissures (corpus callosum): Connect the corresponding cortices of the 2 hemispheres
● Projection tracts (eg. internal capsule): Connect the cortex to
more caudal parts of the CNS
● Association tracts: connect the cortex of the different parts of the same hemisphere
Coronal/frontal section

Medial Horizontal

(in blu the

thalamus (

graymatter
● Basal nuclei (caudate nucleus + Putamun + Globus Pallidus…)
○ General: Adjust activity in the descending tract (motor functions)
○ Specific: for sequencing movements; for regulating muscle tone & muscle force
● ~
Diencephalon
○ Thalamus (composed of several nuclei)
▫ Gateway to the cerebral cortex; *passage for sensory input*;
motor control; memory and emotion
○ Hypothalamus (major control center of ANS & endocrine system)
▫ Hormone secretion; autonomic effects; thermoregulation; food &
water intake; sleep & circadian rhythms; emotional responses; short-term memory
○ Epithalamus – pineal gland (found in posterior epithalamus)
▫ Secrete hormone melatonin, which triggers one to sleep

Human Anatomy (Nervous system & Neuroanatomy) ৷ 7

 midbrain
[
Pons
[
B. Brainstem
● Midbrain (cerebral aqueduct passes through)
reducethe
-

○ Superior colliculi (provides visual reflex)

344 ○ Inferior colliculi (provides auditory reflex)
○ Red nucleus (coordination of muscle groups)
○ Substantia nigra (controls fine movement; inhibitory motor center;
degeneration - Parkinson’s disease) G inhibit unwanted muscle
○ Cranial nerves III and IV
activity

Dopamine exerts inhibitory effect at the basal nuclei. Due to deficiency in

dopamine synthesis at the substantia nigra, the subject experiences
tremors/dyskinesia at the upper & lower extremities → Parkinson’s disease
● Pons (Continuation of midbrain)

5
-
8 ○ Peduncles (attach to cerebellum)
○ Conveys motor information from the cerebral cortex to the cerebellum
○ Ascending & descending tract
○ Ctainial nerves V - VIII
● Medulla oblongata
○ Nuclei (cardiac, vasomotor center, respiratory centre)
○ Pyramids; olive; ascending and descending tract; fourth ventricle

C. Sub systems in the nervous system

1. Functional brain system - Reticular activating system
● Reticular formation (loosely organized web of gray matter that runs vertically through
all levels of brainstem cell bodies

● Somatic motor control; Cardiovascular control; Pain modulation; Sleep and

consciousness

2. Functional brain system - Limbic system (emotion & learning)

● Consists of cingulate gyrus, hippocampus; amygdalaI fea
● ①Emotion behaviour (involves ANS & endocrine system)
● ②Memory
○ Converts recent memory (hippocampus) to long term memory
(prefrontal lobe)

3. Lateralization of cerebral functions

● If the corpus callosum is being cut, one cannot
name a object even we can recognize it, as this action
requires the communication of L & R brain

Human Anatomy (Nervous system & Neuroanatomy) ৷ 8

4. Ventricular system of the brain
● Lateral ventricle → interventricular foramen → third
ventricle → cerebral aqueduct → fourth ventricle →
central canal
● 4 ventricles = 2 x lateral + 3rd + 4th
● Functions of cerebrospinal fluid (CSF)
○ Provides mechanical support of the brain
○ Controls brain excitability by regulating the ionic composition
○ Carries away metabolites
○ Provides some protection from pressure changes in
cells & fenestrate
● CSF circulation
↑hmguny, dependymal capillary
○ ① CSF is secreted by choroid plexus in each lateral ventricle
○ ② CSF flows through interventricular foramina into 3rd ventricle
-

○ ③ Choroid plexus in 3rd ventricle adds more CSF

○ ④ CSF flows down cerebral aqueduct to 4th ventricle lateral interventricular foraming
-

○ ⑤ Choroid plexus in 4th ventricle adds more CSF -iM7 cerebral admeduct + 4th
○ ⑥ CSF flows out 2 lateral apertures and 1 median aperture -> lateral/median aperture ->
○ ⑦ CSF fills subarachnoid space and bathes external surfaces of brain and spinal cord subarachnoid
○ ⑧ Arachnoid villi/granulations, CSF is reabsorbed into veins of dural venous sinuses. space
-
▫ Arachnoid villi penetrate the meningeal layer of the dura mater and extend into the
superior sagittal sinus.
superior
sagittal
▫ In adults, these extensions form large arachnoid granulations. CSF is absorbed into the sinus
venous circulation at the arachnoid granulations.

D. Special sense part I: Vision

● Eyelids (palpebrae)
● medial/lateral commissures (canthi)
● Tarsal plate & tarsal gland
● Eyelashes (blink reflex)

Human Anatomy (Nervous system & Neuroanatomy) ৷ 9

 Lacrimal apparatus Extrinsic eye muscles

Queens
④
②

③
⑰

● Optical components
○ Aqueous humor (secreted by ciliary processes; anterior and posterior chamber; scleral
venous sinus)
○ Lens (suspensory ligament)
○ Vitreous body/humor (vitreous chamber; hyaloid canal)
● Neural components
○ Retina (connections: ora serrata & optic disc); Optic nerve; Optic disc (blind spot)
○ Macula lutea/yellow spot → fovea centralis (most finely detailed image)
▫ The former is yellow spot that allows light to focus when looking at an object.
▫ The latter is an anatomical structure in the center of the macula lutea that contains a
high density of cone cells and allows the light to focus within the eye.
● Nerve supply
Motor Sensory
Cabduction)
● Lateral rectus - CN VI (abducens nerve) ● CN II: sight
● Superior oblique - CN IV (trochlear nerve) ● CN V1 (1st portion of CN V)
● All others - CN III (oculomotor nerve) ○ Lacrimal: conjunctiva
○ Frontal: forehead/eyelid
○ Nasociliary: orbit, nasal cavities

Human Anatomy (Nervous system & Neuroanatomy) ৷ 10

● Visual projection pathway
[1st order neuron] Optic chiasm → optic tracts →
hemidecussation → nucleus
[2nd order neuron] lateral geniculate (thalamus) →
A
[3rd order neuron] optic radiation (white matter)
Optic chiasm: not all axons go to the contralateral side
L
● Visual field
○ Visual field (L & R): a single eye receives information from both visual fields
○ Left/right side of each visual field: processed by right/left hemisphere

⑭
⑧ O ⑰
right anopin

Mem I

bitemporal hemianopia
⑬ e
- m
⑰ left homonymous hemianopia
I ↓
⑧ ⑧ An At
left homonymous superior
a
-

⑪
hemianopin

m -

left fiend
visum fiel

Human Anatomy (Nervous system & Neuroanatomy) ৷ 11

Lecture 7 — Special sense
A. Hearing and balance
● Outer ear: Auricle, auditory canal, external acoustic meatus, cerumen (ear wax)
● Middle ear: tympanic membrane (ear drum), auditory/eustachian tube, auditory ossicles
(malleus, incus, stapes), oval window, muscles (stapedius, tensor tympani)
○ Muscles: hv reflex → contract when there are loud noises to prevent ear bones from
getting too excited
● Inner ear: Bony labyrinth, membrane labyrinth, perilymph, endolymph, vestibule, semicircular
canals, cochlear

● Cochlear (hearing)
○ About 2½ coils
○ Modiolus (spongy bone axis), scala
vestibuli, scala tympani, round
window (secondary tympanic
membrane)
● Cochlear duct
○ Vestibular membrane
○ Basilar membrane
○ Endolymph
○ Spiral organ/acoustic organ/organ
stimulated
of Corti Hair cells in cochlear are
*

▫ Tectorial membrane as a result of the up-and-down

vibrations of the
▫ Outer hair cells (stereocilia)
basilar membrane
● 3 rows & frequencies
▫ Inner hair cells (stereocilia)
● 1 row & all hearing functions
▫ Cochlear nerve

5%
Human Anatomy (Nervous system & Neuroanatomy) ৷ 12

95%
● Vestibular apparatus
● Static Equilibrium: perception of the orientation of the head when the body is stationary
○ Three semicircular canals
○ Utricle: macula utriculi (horizontal) ->
horizontal axis & head filt A
○ Saccule: macula sacculi (vertical) vertical linear acceleration
-> J

○ Otolithic membrane & Otoliths (CaCO3)

● Dynamic Equilibrium: perception of the linear acceleration (saccule and utricle) and angular
- hair cells are
acceleration (semicircular ducts) clustered in
○ Semicircular ducts: Filled with endolymph; Ampulla, crista ampullaris, capula
○ Vestibular nerve salule
utricle -

numbe
e

El
-

maruia
&

-
-

B. Olfaction (smell)
● Olfactory mucosa: detect scent, contains about 10-20m olfactory neurons
● Determined by the medial side of the temporal lobe (X pass through thalamus)
● Evoke strong memories, emotions and visceral reactions
○ Hippocampus (memory); Amygdala; Insula

C. Gustation (Taste)
● Taste buds (4,000): tongue, soft palate, pharynx, epiglottis, cheeks
● Lingual papillae (surface projections on tongue)
○ Filiform (food texture)
○ Foliate (weakly developed in human)
○ Fungiform (mainly on apex)
○ Vallate (large, arranged in V at the rear of the tongue, MOST taste buds)
Human Anatomy (Nervous system & Neuroanatomy) ৷ 13
● Tase buds
○ Taste/Gustatory cells (banana shaped, taste hairs
[receptors of taste molecules], synapse with
sensory nerve)
○ Transitional & Basal cells (Stem cells)
● Taste pore (hole on epithelial surface of tongue)
● Taste modules
○ Sweet (tip); Salty & Sour (lateral margins); Bitter (rear) Glossopharyngeal
7
(ix)
movement
i
● Nerve innervation
○ Facial nerve (VII): Anterior ⅔ of tongue hyboglossal
○ Glossopharyngeal (IX): Posterior ⅓ of tongue (XIIS ↑
○ Vagus (X): palate, pharynx, epiglottis fairal (VII)
○ Hypoglossal nerve (XII): tongue movement of speech, food manipulation
and swallowing

D. Cranial nerves (CN) – 12 pairs

1 CN I Sensory ● There are many synapses in the olfactory bulb

(Olfactory nerve) ● CN I is in nasal cavity

2 CN II (Optic nerve) Ref p.11

3 CN III Motor ● For eyeball movement

(Oculomotor ● LR6(SO4)3 [Lateral rectus: VI] [Superior oblique: IV] [other: III]
nerve) ● CN III: control ciliary body

~parasympathetic Human Anatomy (Nervous system & Neuroanatomy) ৷ 14

4 CN IV
(Trochlear nerve)

6 CN VI
(Abducens nerve)
abduction of
eyebal

5 CN V Mixed
(Trigeminal nerve)
11
X parasympathetic

7 CN VII

!I
(Facial nerve)

Functions: Hear [
Control the
movement of face
muscles
salivag
~parasympathetic

8 CN VIII Sensory ● 5 neurons: 1) CN VIII → cochlear nucleus; 2) superior olivary

Human Anatomy (Nervous system & Neuroanatomy) ৷ 15

 (Vestibulocochlear nucleus; 3) Inferior colliculus; 4) Thalamus; 5) Primary
nerve) auditory cortex

Functions:
brings sound &
info about one's
position &
movement in
space into the
brain

9 CN IX Mixed
(Glossopharyngeal
nerve)
~parasympathetic
Functions:
- Sensory: taste
(posterior ⅓)

partin
- Motor: salivary
gland secretion
(ANS) &
swallowing

10 CN X Longest CN which has the

(Vagus nerve) most extensive distribution
~parasympathetic
Functions:
- control cardiac,
pulmonary,
digestive & urinary
system

11 CN XI Motor Head and neck movement

(accessory nerve)

Human Anatomy (Nervous system & Neuroanatomy) ৷ 16

 12 CN XII Tongue movement
(Hypoglossal
nerve)

● Parasympathetic pathways:
oculomotor
○ CN III → ciliary ganglion → ciliary body movement
○ CNVII → pterygopalatine ganglion → lacrimal gland
→ submandibular ganglion → salivary gland
○ CN IX → Otic ganglion → salivary gland
○ CN X → heart/lungs
⑦ ⑪ musclesternocleidomastoid,
● Sensory: [1,2,8] smerl vision trapezius
hearing -
○ CN I, II, VIII (olfactory, optic, vestibulocochlear nerve) head n
● Motor: [3,4,6,11,12] SR, MR, IR, 10 SO tongue

● Mixed: [5,7,9,10] ⑪ Inet

○ CN III, IV, VI, XI, XII (oculomotor, trochlear, abducens, accessory, hypoglossal nerve)
# ⑧
○ CN V, VII, IX, X (trigeminal, facial, glossopharyngeal, vagus nerve)
↓ I
taster (parotids
staste
3 C
musication
face grand
salivary
sensation ~ anterior
secretion

openalimic)( facial expression, 0#

maxillary mandibularsalivary/lacrimal
&
swallowing
I secretion
motor submanibular OIt Tigemina
⑭ facial
A

* sensory & sublingual

mixed- 0
-

olfactory:smen -
I
⑧ Stssopharyne
-
A vision
e

sensory - optic:
Ex
O Vestibulocochlear:hearing
rectus inferior oblique
superior, median, interior
+

oculomotor
:

motor- superior oblique

↑ acessors:
-

as :

lateral ene
movement
Human Anatomy (Nervous system & Neuroanatomy) ৷ 17
neck
head &
movement
hypoglossal:tongue
 Lecture 8 — Regional anatomy of abdomen & pelvis
A. Introduction
Clinical subdivisions of the anterolateral abdominal wall Surface anatomy of the abdomen

● The reference lines/planes

○ Sagittal (vertical): left and right midclavicular
○ Transverse (horizontal): subcostal, transpyloric plane
(L1), transtubercular plane (L5)
● The umbilicus is located at the vertebral level of L3/L4
● Surface landmarks: Umbilicus/xiphoid sternum/pubic symphysis/anterior superior iliac spine

B. The abdominal and pelvic cavity

● abdominal cavity is directly continuous with the pelvic cavity
● Diaphragm (abdominal inlet)

Caval hiatus T8 (central tendon) IVC; right phrenic nerve

A
Oesophageal hiatus T10 Oesophagus, vagus nerves, oesophageal branches of
the gastric vessels and lymphatics

Aortic hiatus T12 (b/w crura) Abdominal aorta, azygos vein, thoracic duct

Human Anatomy (Abdomen & Pelvis) ৷ 1

 C. The anterolateral abdominal wall
-
tebou
● Each of the muscles (1-3) has a fibrous part (aponeurosis), adhering to one other when
approaching the mid-line of the abdominal wall

tendinous
intersections
-

(umborum
①phadratus
⑫ erector spinae
③ multifidus
D. The posterior abdominal wall (lumbar spine, skeletal muscles)
● It is not the back of the body Intrinsic (deep) muscles of the back

>

of
deepest muscle
the abdominal ·connectvertebraeteamatthe
wall

Lumber vertebrae
1. Vertebral body 7. Intervertebral disc
2. Pedicle 8. Anterior longitudinal ligament
3. Lamina 9. Posterior longitudinal ligament
4. Superior & inferior articular process 10. Ligamentum flavum
ne

5. Transverse process
-
11. Interspinous ligament
6. Spinous process 12. Supraspinous ligament
-

Human Anatomy (Abdomen & Pelvis) ৷ 2

 +8

E. The great vessels at the posterior abdominal wall

● Aorta = ascending aorta, aortic arch, descending aorta, abdominal aorta (T12 to L4)
○ Branches (supplies the GI tract and associated organs): Celiac trunk, superior mesenteric
IVL

-a
I
T12

artery (SMA), inferior mesenteric artery (IMA)

○ Terminal branches: L & R common iliac artery -5
24
ja

②
-

Yest
①
gonadal vein

● Inferior vena cava (IVC) extends from L5 to T8

● Venous drainage

O
Hilm

clower limbs

-
(pelvic)

● Kidneys: renal artery

● Adrenal glands: ①Inferior phrenic arteries → superior adrenal arteries ②aorta → middle
adrenal ③renal arteries → inferior adrenal arteries A
● Right gonadal vein → IVC; Left gonadal vein → left renal vein → IVC

F. The peritoneum and peritoneal cavity

The peritoneum is the serous membrane in
the abdominal cavity that covers
abdominal organs and forms double sheets
of mesenteries that suspend many of the
digestive organs

Human Anatomy (Abdomen & Pelvis) ৷ 3

 ● Visceral (external surface of an organ); Parietal (lines the abdominal wall)
● Peritoneal cavity: potential space between the parietal and visceral peritoneum
● Serous fluid secreted by the cells if the thin squamous mesothelium lubricates the membrane
and reduces abrasion and friction between organs
● Intraperitoneal organ = peritonealized organs having a mesentery

A,
liver
stomach
(all) + spleen
E payers
Duodenumcit

imvenewisi
·prix
reser
e

● Peritoneal folds envelope various abdominal organs, holding them to the dorsal surface of the
body wall. There are:
○ Visceral adipose tissue (fat)
○ blood vessels (artery, vein), lymphatic vessels, and nerves can also innervate the
organs with which they are in contact, supplying their adjacent organs

Mesocolon = mesentery of the colon

(attaches transverse colon and sigmoid colon to the posterior
abdominal wall)
● Omentum = fold of peritoneum (stomach → adjacent abdominal organ)
● Greater omentum = suspended from the greater survature of the stomach and attached to the
anterior surface of the transverse colon, loosely/superficially covers the small intestine as an
apron (a ventral mesentery) [4 layers of fused visceral peritoneum]
○ A site of fat deposition in people who are overweight

Human Anatomy (Abdomen & Pelvis) ৷ 4

 0xI,
lesser
liver omentum

xsmeas
Duodenum E
(IST)
greater
(tal+
omentum
spleen

↑ Renewisi
-> transverse
mesocolon

L I
/
mesenten

appendix of e Signing
mesocolon
retur
cupper 3d)
● Lesser omentum = joining the lesser curvature of the stomach & first part of the duodenum to
the liver (a dorsal mesentery)
○ Suspends the stomach from the inferior border of the liver
○ Provides a pathway for structures connecting to the liver
● Mesentery = suspends the small intestine, portions of large intestine
○ Vertical band of tissue anterior to the lumbar vertebrae and anchoring all the small
intestine except the initial portion (duodenum)

● Falciform ligament VS round ligament of the liver

○ Falciform ligament is a thickening of 2 folds of visceral peritoneum that anchors the liver to
the anterior abdominal wall
○ Round ligament of the liver (ligamentum teres) is a fibrous remnant of the umbilical vein
that carries blood from the umbilical cord to the fetal liver

G. Anatomy of the Gastrointestinal tract

Surface anatomy Gross anatomy of the stomach

Human Anatomy (Abdomen & Pelvis) ৷ 5

 teeth, tongue, salivary gland,
Accessory organ -

liver, gallbladder, pannery

of digestive system
stomach
X
sym & para
↑ I
Anatomy of the small intestine Anatomy of large intestine
● Jejunum & ileum (mesentry) (artery: abdominal aorta; Veins: portal venous system→liver)
inhibit
mobility disest

H. Anatomy of the liver, gall bladder & pancreas

1. Liver
● Left: lateral & medial segment 8
⑦ Pa ⑫
● Right: anterior & posterior segment
③
● Caudate lobe is seen on the posterior aspect of the liver
⑥ 4b
quadrate

Hobes
Human Anatomy (Abdomen & Pelvis) ৷ 6
 Liver Segment Numerical abbreviations
Caudate lobe I
Left lobe Lateral segment II, III
Medial segment /Quadrate lobe IVa, IVb
Right lobe Anterior segment V, VIII
Posterior segment VI. VII
● Hepato-portal venous system
○ Everything absorbed from the GI tract will reach the liver for the 1st pass
metabolism
● Bile secretion pathway

● Hepatobiliary flow

2. Pancreas

Human Anatomy (Abdomen & Pelvis) ৷ 7

I. Anatomy of the spleen & kidneys
1. Kidney (retroperitoneal organs, 9-13cm in length, at vertebral lv T12-L3)
● Right kidney is slightly LOWER than the left, because of the large liver which sits superior to it
● The ureters descend on the posterior abdominal wall to reach the urinary bladder
○ 3 narrowing process
(ureteropelvic junction → when crossing external iliac vessels at the pelvic brim → when
traversing bladder wall)

2. Spleen (intraperitoneal, left hypochondriac region)

● 5 inches = 12-13 cm (long axis)
● 7 fluid ounces = 210 cm3
● Located relative to 9 and 11th ribs; long axis along the 10th rib
● Clinical method by percussion: mid-clavicular line, mid-axillary line
● Clinical note: splenomegaly as a condition of spleen enlargement

J. Bony pelvis & pelvic cavity

Human Anatomy (Abdomen & Pelvis) ৷ 8

● Pelvic diaphragm (levator ani & coccygeus [muscle])
● Perineal body: fibromuscular node that represents the insertion
of the levator ani muscle at the floor of the pelvis
○ Attaches superficially onto the skin surface

● Urinary bladder & urethra (female vs male)

○ partially retroperitoneal with its peritoneal-covered

dome
○ Highly distensible organ comprised of irregular
cirsscrossing bands of smooth muscle collectively
(detrusor muscle)

Human Anatomy (Abdomen & Pelvis) ৷ 9

 prostate is posterior to blasder
gland
K. Anatomy of the male pelvis & Perineum

sp
cremaster muscles
contract in cold weather
● The vas deferens unites with the seminal vesicle at the posterior aspect of the urinary bladder
● Clinical note: benign prostatic hypertrophy & prostatic cancer

● Penis is composed of three column-like chambers/erectile tissue

○ Larger lateral chambers (corpus cavernosa)
○ Smaller chamber surrounding the urethra (corpus spongiosum)

● The structures of the male reproductive system include the testes, the epididymis, the penis,
and the ducts and glands that produce and carry semen.
● The testes are located in a skin-covered, highly pigmented, muscular sack called the scrotum
that extends from the body behind the penis.
● From the lumen of the seminiferous tubules, the immotile sperm are surrounded by testicular
fluid and moved to the epididymis, a highly coiled tube (around 6m if straightened) attached
to the testis where newly formed sperm continue to mature.
● Sperm exit the scrotum through the ductus deferens, which is bundled in the spermatic cord.
● The seminal vesicles and prostate gland add fluids to the sperm to create semen

Human Anatomy (Abdomen & Pelvis) ৷ 10

L. Anatomy of the female pelvis & Perineum

buluh

infunti

perineum
&diamond s
shaped)

● The external female reproductive structures are referred to collectively as the vulva. The
mons pubis is a pad of fat that is located at the anterior, over the pubic bone.
● The labia majora are folds of hair-covered skin that begin just posterior to the mons pubis.
The thinner and more pigmented labia minora extend medially to the labia majora.
● The clitoris/glans clitoris lies in the superior, anterior portions of the labia minora, an organ
that originates from the same cells as the glans penis and has abundant nerves.
● The vagina is a muscular canal (approximately 10 cm long) that serves as the entrance to the
reproductive tract.

Clitoris
is chiocavernosus:erection penis a
of
·

·
bulbospongioss:hup expessemen compressing by the return

Human Anatomy (Abdomen & Pelvis) ৷ 11

Lecture 9 — Digestive system
A. Anatomy of the oral cavity, pharynx & oesophagus
stratified squamous epithelium

glossopharyngem

W
↑ trigemina
soft plate
that separate
or
the nasal and

pharynx L
● Parasympathetic stimulation favors facial
serous (watery) secretion
● Sympathetic stimulation favors viscous (mucoid) secretion
● The oral cavity has a root, floor & two lateral walls
● Tonsils are made up of lymphoid tissues (lymphocytes), providing
defenses against foreign invading particles (bacterial infection)
● The skeletal muscles of the tongue are innervated by the
hypoglossal nerve (CN XII)

● The oseophagus begins at the neck at C5

Human Anatomy (Digestive System) ৷ 1

B. Anatomy & Function of the Stomach

● Mucous (columnar) cells secrete mucus

● Chief cells secrete pepsinogen, which is converted into pepsin that aids to
digest proteins into amino acid
● Parietal cells secrete HCl and intrinsic factor for Vit. B12 absorption
● Enteroendocrine cells (not labelled) secrete hormones into the blood that
regulate digestion
● Regenerative cells (not labelled) in repair processes

C. Microanatomy of the small intestine

● Duodenum stands alone as one organ (duodenum ulceration)

● Small intestine = jejunum & ileum (internal obstruction)
● Villi is the largest in the duodenum and become progressively
smaller in the remaining of the small intestine
○ Increase SA by the presence of microvilli at the apex of
columnar epithelial cells

Human Anatomy (Digestive System) ৷ 2

D. Functions of the liver, gall bladder & pancreas

Functions
● Carry out carbohydrate, lipid, and protein metabolism
● Storage of glucose in the form of glycogen (Glycogenesis).
Glycogenolysis and the release of glucose into the blood
● 1st pass metabolism of alcohol (ethanol), drugs, and detoxification.
● Bile salt synthesis and bile synthesis.
● Bilirubin (metabolic byproduct of haemoglobin) excretion into bile.
● Vitamin D activation from pre-Vitamin D3
● Defense against foreign particles via Kupffer cells.
Summary pathway of bile flow from the liver
● Bile (fat emulsification) is produced by the liver cells (hepatocytes)
● The gall bladder stores bile until it is needed after a fatty meal

Human Anatomy (Digestive System) ৷ 3

E. Functions of the large intestine

● It has a wider luminal diameter & a thinner wall when compared to the small intestine.
● It is characteristic of haustra formation, is a sac-like structure, teniae coli that is formed by the
thickening of the smooth muscle fibers at the outer wall of the large intestine
● Omental appendices are folds of the peritoneum and their functions are not clearly known

● Goblet cells secrete mucus into the lumen of the gut.

● Functions
○ Haustral churning, peristalsis and mass peristalsis drive contents of colon into rectum
○ Bacteria convert proteins to amino acids, breakdown amino acids and produce some vit. K
○ Absorption of some ions, water and vitamins
▫ Too little water absorption results in diarrhea; too much results in constipation
○ Formation of faeces
○ Defecation under voluntary and involuntary control

F. Blood supply to the GI tract & accessory organs

Human Anatomy (Digestive System) ৷ 4

● Differentiate the muscle fibers that constitute the levator ani (a muscle of the pelvic floor),
external anal sphincter and the internal anal sphincter.
● The external sphincter is under voluntary (somato-motor) control
● The internal sphincter is under involuntary (autonomic nervous) control.
○ Both anal sphincters are relaxed during the act of defecation.

Human Anatomy (Digestive System) ৷ 5

Lecture 11 — Musculoskeletal system
● 206 bones; ~350 joints; ~900 ligaments; ~650 muscles; ~4000 tendons

A. Bone
Bone histology
● Matrix
○ ⅔: hydroxyapatite crystals (mainly Ca3(PO4)2, strong but inflexible)
○ ⅓ collagen fibers (tough & flexible)
osteocytes
Osteoprogenitor -> Osteoblasts
->

● Cells
○ Osteocytes: mature bone cells LellS
○ Osteoblasts: immature bone cells that release organic
components of matrix and are able to form osteocytes
I
○ Osteoprogenitor cells: osteoblast-forming cells
○ Osteoclasts: dissolve bone matrix and release minerals
● Osteon = functional unit of a bone
● Lacunae = small channels that interconnect the lacunae;
providing a route for nutrients diffusion and waste products

Blood supply to the bone

● Periosteal artery + nutrient artery

Bone structure
● Periosteum (a fibrous tissue surrounding the outer surface of bones, except the
articular sites)
○ Inner layer: osteogenic, capable of differentiating into osteoblasts
○ Richly furnished with capillaries and nerves
● Compact bone (dense, solid mass, forms the outer surface layer of all bones)
● Spongy bone (cancellous, larger cavities, trabeculae (supporting fibres; where
blood cells are formed here) → make the whole bone lighter e
Bone markings

Human Anatomy (Musculoskeletal) ৷ 1

Long bone (X abt the size, but shape)
● Tubular in shape → movement
● Found in limbs and serves as levers for muscles
● Has a shaft (body) and 2 expanded ends
● Shaft covered by periosteum
● Diaphysis (central)
○ Shaft (compact + spongy bone + medullary cavity containing bone
marrow
● Metaphysis (recently developed end and adjacent to epiphyseal cartilage);
● Epiphysis (bone ends)
○ Formed by spongy bone covered with a thin layer of compact bone
○ Concave or convex fingers t fingers ties
tres
● Examples: femur, humerus, tibia, fibular, ulna, radius, phalanges, metacarpals and metatarsals
tarsals
u-leg warm lego reg warm e an
W
Short bone
● Cubical in shape (width & length are nearly equal)
● Spongy bone surrounded by a thin layer of compact bone * carpals
● Provide support and stability with little or no movement
● Examples: carpals (wrist bones), tarsals (ankle bones), ear bones

Flat bone
● 2 layers of compact bone, separated by a layer of spongy bone ⑰

(sandwiches-like)
● Flat surface, facilitating muscular attachment or providing protection to
underlying soft tissue
● Examples: ribs, sternum, scapula, skull (frontal, parietal, occipital, nasal,
lacrimal, vomer)

Sesamoid bones
● Small, round and flat bones that are embedded within tendons or muscles
● alter the direction of the pull of a tendon
● Protect the underlying tendons from excessive wear
● Examples: patella (knee cap - the largest one)

Irregular bones
● irregular/mixed shape
● Spongy bone, bone marrow, a thin layer of compact bone
● Examples: skull bones (sphenoid, ethmoid, temporal), facial bones (zygomatic, maxilla,
mandible, palatine, inferior nasal concha), vertebrae, hip bones

Sutural bone
● Small, flat, irregularly shaped bones between the flat bones of the skull
● Numbers, shapes, and positions of the sutural bones varied between
individuals

Human Anatomy (Musculoskeletal) ৷ 2

Pneumatic bones
● Spongy tissues being absorbed and air sinus are present
● Certain skull bones

Bone formation
● bone is capable of spontaneous scarless repair throughout adult life by producing new bone
● Although bones stop grow in length, it grows in diameter.thickness in response to exercises

B. Joints
● Fibrous - joints separated by dense fibrous CT
-
○ Suture (articulation by process & indentation)
▫ The bones of the joint are bound by fibrous CT eg. skull sagittal
suture
↓
▫ The coronal suture binds the frontal and parietal bones
○ Gomphosis (peg and socket joint)
▫ Conical process fits into a socket eg. roots of teeth into alveoli
of maxillae and mandible
ulna & radius
I
○ Syndesmosis (united by an interosseous ligament) eg. tiba & fibula
-

● Catilaginous - bones separated by cartilage tissue (hyaline/fibrocartilage) & allow no/very

little movements
○ Synchondrosis/primary cartilaginous joint
▫ Hyaline cartilage completely joins two bones together; immovable
▫ Cartilage ossifies in adult life (25 years)
▫ Eg. joints of the 1strib, epiphyseal plate of long bone
○ Symphyses/secondary cartilaginous joint
▫ Two bones are joined by fibrocartilage; allow little movement
▫ Eg. inter-body joints of the spine, pubic symphysis
S
● Bony - bones fused and the boundary in between disappear (synotosis)
N
● Synovial - freely movable joint surrounded by a two layered joint capsule (separated by synovial
fluid) (most joints, allow a wide range of movement [diarthrosis])
Synovial joint - Structure
● Articular capsule (outer fibrous capsule - continuous with periosteum)
○ Inner synovial membrane (secrete synovial fluid for lubrication, shock
(fibrocartilages

absorption & joint nourishment)x

○ Cuff around joint close to the articular surface
○ Articular/hyaline cartilages = coatings on the bone surface to provide a ⑲
wear-resistant, low-frition lubricated surface
○ Fibrocartilage (meniscus) located b/w the articular bones serve to smooth
the movement and reduce friction A
● intracapsular/join/intrinsic ligament (E.g. Anterior & posterior cruciate ligament)
○ Localized thickenings of fibrous CT commonly injured
○ Help thicken and reinforce the joint capsule
● accessory/extrinsic ligament (E.g. medial & lateral collateral ligament) E
○ Separate from joint capsule
○ Help to reinforce the joint by attaching the bones togethr

medianbea
Human Anatomy (Musculoskeletal) ৷ 3
 sempte

guiding)

enohumeral chal-and-sockets
>
&
joint
-

I humeroscapular
-

chingel

Spirot)
4 pronation and supination)

sadder
- LCondylar)
intercarpon
Igliding

eq. invertebral disc

Crondylar)

I hinge

maining (fibulal
⑭

Hinge:knee, ankle
maxial
·

pirot: all

metatarsophalange
say condylay:
·
saddle:
vertebro costa
Clariclosternas, samiliar,
·gliding:

② * hip joint
Y

polyaxial

when asked hinge

joint, and elbow
include numerouhar join is present
-

->
joint
-

-> ans elbow

O -
-

&
②

(112)
elbow joint
⑪
of
-> part
able for pronation &
->

supination

(geno-humeral)
③
 x typical)
● Bursa/bursae (sacs filled with synovial fluid that provide cushioning around a joint b/w the
bones and the muscle and tendons crossing the joint)
○ Usually form where tendons and ligaments being rubs against other tissues (eg. bone)
Nerve supply
● Nerves supplying a joint also supply the muscles moving the joint and the skin covering the
insertion of these muscles
● Provide proprioceptive feedback (reflex) for controlling posture and movements i.e. irritation of
joints causes reflex spasm of muscle→body re-position the joint to restore comfort
Blood supply
● Receive vascular supply by a rich anastomosis of arteries extending from either side of the joint
● Articular cartilage is nourished by synovial fluid
Uniaxial joint Biaxial joint Polyaxial joint

Hinge Pivot Condylar/ Saddle B

Plane/gluding Ball and socket
ellipsoid

Angular 1 direction Rotary 2 directions articular surface Gliding ALL directions

Movement (flexion & movement in (+abduction/ad of each articular movement (+rotation)
extension) one axis duction, bone is concave (usu small
circumduction) in 1 direction joints)
Oval shaped and convex in
talus (articulations head, elliptical another
cavity
↑
Example Elbow, ankle,
interphalangeal I
C1/2, proximal
radioulnar joint
Wrist joint, Carpo-metacarp Inter-carpal
metacarpophal al joint of
Hip,
joint, facet joint gleno-humeral
joint N angeal joint * thumb of spine, joint (shoulders
+ base
part of trapezium superior
elbow joint of the 135 tibioficular,
metacarpal bone acromioclavicul
-> pronation & ar joint blu tarsals
supiuation

Human Anatomy (Musculoskeletal) ৷ 4

 Stability of joints
● Articular surfaces - shape, size, arrangement
● Ligament and capsule
● Muscle tone around the joint

C. Cartilage
● Strong but flexible CT
● Chondrocytes release large quantities of extracellular matrix containing collagen, proteoglycans,
non-collagenous proteins and elastin fibers
○ Absorb shock; reduce friction; support structures

D. Skeletal muscles
● Produce skeletal movement; Maintain posture and body position; Support soft tissue; Control of
body openings and passages; Maintain body temperature; Store nutrients

disuse atrophy: muscles size

due to a lack of ex

Human Anatomy (Musculoskeletal) ৷ 5

● Functional unit of skeletal muscle: motor unit = neuron + muscle fibers
● Structural unit of skeletal muscle: muscle fibers = muscle cells
Muscle tone
● Described as a low level of contraction contributed by small groups of motor units (being active
and inactive in a constantly shifting pattern i.e. or continuously partial contraction) even at rest
● Not strong enough to produce a movement but able to keep skeletal muscle firm
● Established by motor neurons in the brain and spinal cord→if damage→muscle becomes flaccid
& atrophic
● The size of motor unit is an indication of how fine the control of movement can be
Muscle contraction

E. Tendon
● Tough, dense fibrous CT with high tensile strength broad sheet-like tendon
● Tenocytes synthesize extracellular matrix containing collagen and proteoglycans : aponecrosis

● At both proximal and distal ends of muscle; connect muscle to bones

1,
○ Myotendinous junction—point at which tendon attaches to muscles
○ Osteotendinous junction—point at which tendon attaches to bones
▫ origin (usu proximal) = attachment site that X move during contraction
▫ insertion (usu distal) = attachment site that move when the muscle contracts
▫ Origin of short head: Apex of coracoid process
▫ Origin of long head: Supraglenoid tubercle of scapula
▫ Insertion of biceps Brachill Radial tuberosity of the radius
Sternocleidomastoid (muscle)
Origin: sternal head - manubrium of the sternum; clavicular head - medial third of the clavicle
Insertion: mastoid process of the temporal bone

⑱
● Function to transmit forces generated from the muscle to the bone to elicit movement
● Have different shapes and sizes; muscle generating large power and force → shorter & wider
tendons; fine delicate movements → long & thin

Human Anatomy (Musculoskeletal) ৷ 6

A sinusoid regular blood filled space
-

hair cells clustered

A Crista ampullaris
of

in thalamus
optic
A nerve
optic chiasm
-

- optic tract - lateral geniculate nucleus

-> optic radiation primary somatosensory
->
region (posterior to the central gyms

A very brittle bone likely X collagen

-

[It is process in
Endochondral ossificationshyaline contilage (model for bones
a
*
which a develops
bone
vsex steroid hormone] promote
* bone growth from hyaline cartilage)
x parathyroid
A skeletal system is NOT for control
red bone marrow
A Tibia x
ritk is Not
A
normal factor in a the promotion ofbone deposition
centers of ossification [Time of birth]
secondary
A

sheath in CNS:multiple Sclerosis

Deterioration of myelin
*

brain tumors arise from neuroglial cells

most
undergo mitosisults
A
neurons x
glutamate (X lipofuscin)
A
acetylcholine, Serotonin,
Aneurotransmitter eg.

primary sex organ indiace(x

A penis, atems, ragings
by ligaments) ovary board - t

Aseminal resides:produce of
more the semen hol

II
area bound the ischial tuberosities
A triangle:
urogenital by and
public symphysis
Aanay triangle:area bound by conyx and iscial tuberosities
exocrine gland & perineum
male
A gonady:testes & endocrine &

fornices, hymen rugae

raging:
X &

x
rulva

A largestsalivary gland:parotid gland

* infundibulum in aterine tube
has frimbrial
duodenum -
* largest villi
in ileum: peyer'spatches
Clusters of lymphatic modules
*
parietal
* -> paired bone

A vertebral column (chain of 33 bones)

extension -
*
need restore body to matomical position after curling up
cord widens ofcervical and lumbar enlargement
spinal
A
-

jenclosed meninges
in
(3 CT membranes]
decessation (pathway crossing over from
A
one side
of the cord to others
in the thalamus before going the somesthetic
contex
all sensory fibers synapse
to

A -

thoracic
A
vertebrae (X plexuss
neurons in the body routinely undergo mitosis
* olfactory receptors:ONLY
blood air

provides for
and
1 Or & Lo exmange blur
Arespiratory system:
a serve speech
a provides a sense of smell

contributes
a to maintenance ofpH balance
& childbath
helps expelabdominal content during defecation
x

a
permits laughing
to fissues
X
E
helps gases transport
X
A serves to remove
area
from blood

opening
X blo vocal glottis
cords:
 starts
vi -
oesophagus
i

T475
-

sternal angle
-costal cartilage ofthe 2nd rib articulates wit the Sternum

- Thoracic aorta begins

[5 -trachen ends

T6

77
78
-

Ive ends & centrastedon (Laval hiatus)

79
maths
T10
-

Desophagus ends LAOAIC hiatus)

III
oesophagus
abdominal
-

morta
Cribs 9R-11R),

I
T1
-

spleen starts
Spinal ↓I Transpyloric plane (pyloris kidney
card
ends
[ 12

23
ends
jumbilicus
-abdominal aorta
24
IVC starts Transtubercular plane
15
-

4 -

5 (child haves
Respiratory system ,

Trachea ,

&
Tertiary
smaller
bronchides
epithelial c
.
-

-Squares
eli

1
. Protect x infection

frictint
Respiratory centre
Stretch receptor of control rol of lengs
DRG =

URG 2)

PRG2)