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Lecture Notes

Ch. 1: Orientation to the Human Body

Overview

  • Anatomy - study of structure (shape of the body and its parts)

  • Physiology - study of function (how the body and its parts work or function)

  • A & P are always related

    • Structure determines function

      • Pathology - study of structural changes that lead to disease

  • Levels of Study

    • Gross (macroscopic) Anatomy

      • Study of large structures that are easily visible to the naked eye

      • Subdivisions include regional, systemic, and surface anatomy

    • Microscopic Anatomy

      • Study of very small structures that can only be viewed with a microscope

      • Subdivisions include cytology (study of cells) and histology (study of tissues)

    • Developmental Anatomy

      • Study of structural changes that occur in the body throughout the lifespan

      • Subdivisions include embryology

    • Physiology has many subdivisions as well

      • Renal physiology, neurophysiology, cardiovascular physiology, etc.

  • Levels of Structural Organization (Hierarchy)

    • Chemicals → Organelles → Cells → Tissues → Organs → Organ Systems → Organism

      • Chemical Level: Atoms and molecules

      • Cellular Level: Cells are formed from organelles

      • Tissue Level: Tissues from similar cells

      • Organ Level: Organs formed from different tissues

      • Organ System Level: 11 organ systems work together

      • Organism: Complete human body

  • Maintaining Life

    • Necessary Life Functions

      • Maintaining boundaries

      • Movement

        • Locomotion

        • Transport of substances throughout the body

      • Responsiveness

        • Ability to sense changes (stimuli) and respond to them

      • Digestion

        • Breakdown and absorption of nutrients

      • Metabolism - all chemical reactions within the body

        • Catabolism breaks things down

        • Anabolism builds things up (makes body structures)

        • Production of energy (ATP)

      • Excretion

        • Elimination of wastes from metabolic reactions

      • Reproduction

        • Production of offspring

      • Growth

        • Increase in cell size and number

    • Survival Needs

      • Nutrients

        • Chemicals for energy and cell building

        • Includes carbohydrates, proteins, lipids, vitamins, and minerals

      • Oxygen

        • Required for chemical reactions

      • Water

        • 60-80% of body weight

        • Involved in metabolic reactions

      • Normal body temperature

      • Appropriate atmospheric pressure

  • Homeostasis - maintaining a stable internal environment within narrow limits, regardless of environmental changes

    • Must be maintained for normal body functioning and to sustain life

    • Maintaining Homeostasis

      • The body communicates through neuronal & hormonal control systems

        • Receptor

          • Respond to changes in the environment (stimuli)

          • Sends information to the control center

        • Control Center

          • Determines the set point - the normal value the body is designed to maintain for a variable

            • Ex: Body temp. 37°C or 98.6°F

            • The body usually operates within a normal range (slight increases and decreases around the set point)

          • Analyzes information

          • Determines the appropriate response or course of action

        • Effector (only in muscles or glands)

          • Executes response

    • Feedback Mechanisms

      • Negative Feedback

        • Includes most homeostatic control mechanisms

          • Ex: heart rate, blood pressure, body temp., rate of respiration, blood glucose, oxygen, and carbon dioxide levels, etc.

        • Shuts off the original stimulus or reduces its intensity

          • Ex. moves the variable back toward the set point

        • Works like a household thermostat

      • Positive Feedback

        • Has an amplifying effect that increases the original stimulus to push the variable further away from the set point

        • Only normal occurrences are in blood clotting, the birth of a baby, and sexual response

          • Others are the result of pathology and are harmful

            • Ex: heart attack due to restricted blood flow to the heart eventually results in less cardiac output, which again decreases blood flow

    • Homeostatic Imbalance

      • A disturbance in homeostasis resulting in disease

      • It may be caused by infection, injury, or genetic abnormality

The Language of Anatomy

  • Special terminology is used to prevent misunderstanding

    • Exact terms are used for:

      • Position

      • Direction

      • Regions

      • Structures

    • Orientation and Directional Terms

      • Proper Anatomical Position

        • A point of reference

      • Directional Terms

        • Superior (above)/Inferior (below)

        • Anterior (front)/Posterior (back)

        • Medial (toward the midline)/Lateral (away from the midline)

        • Proximal (closer to the point of attachment)/Distal (further from the point of attachment)

        • Superficial (near body surface)/Deep (further from body surface)

      • Regional Terms

        • Axial

          • Head

          • Neck

          • Trunk

        • Thorax, Abdomen, Pelvis

        • Appendicular

        • Specific body areas

    • Body Planes and Sections

      • Frontal (divides anterior/posterior)

      • Transverse (superior/inferior)

      • Sagittal (left/right)

      • Midsagittal (perfect left/right)

      • Oblique

    • Body Cavities and Membranes

      • Dorsal Cavity

        • Composed of the cranial and vertebral (spinal) cavities

      • Ventral Cavity

        • Contains visceral organs

        • Composed of the thoracic, mediastinum (pericardial), and abdominopelvic cavities

        • Membranes

          • Lines the cavities and covers the outside of the organs

          • Named by location + the cavity word

            • The thoracic cavity is lined by parietal+pleura - parietal pleura

            • Thoracic organs are covered by the visceral pleura

            • The abdominopelvic cavity is lined by parietal peritoneum

            • Abdominopelvic organs are covered by visceral peritoneum

            • The pericardial cavity is lined by the parietal pericardium

            • The pericardial organ (heart) is covered by the visceral pericardium

        • Other body cavities

          • Oral and digestive, nasal, orbital, middle ear, synovial, etc.

    • Abdominal Regions and Quadrants

      • 9 regions (specific anatomical areas)

        • Right hypochondriac region

        • Epigastric region

        • Left hypochondriac region

        • Right lumbar region

        • Umbilical region

        • Left lumbar region

        • Right iliac region

        • Hypogastric region

        • Left iliac region

      • 4 quadrants (common clinical use)

        • Right upper quadrant (RUQ)

        • Left upper quadrant (LUQ)

        • Right lower quadrant (RLQ)

        • Left lower quadrant (LLQ)

Ch. 2: Chemistry (Organic & Inorganic)

Matter

  • Anything that occupies space and has mass (weight)

    • Ex. The physical (living and non-living) "stuff" of the universe

    • Can exist as a solid, liquid, or gas

    • Weight (mass)

      • We quantify the amount of a substance by its mass. Under the influence of gravity on the Earth's surface, mass is equal to the more familiar term "weight".

  • Composition of matter

    • Elements

      • Fundamental units of matter

        • They cannot be broken down into other substances

      • 96% of life is made up of 4 elements

        • C, H, O, N

    • Atoms

      • Building blocks of elements

      • Atomic Structure

        • Nucleus

          • Protons (p+)

          • Neutrons (n0)

        • Outside of the nucleus

          • Electrons (e-)

Identifying Elements

  • Elements differ in the number of subatomic particles in their atoms

    • Chemical Symbol

    • Atomic Number

      • Number of p+ that the atom contains

    • Mass Number/Atomic Mass

      • protons + neutrons

    • Isotopes

      • Same number of p+ and e-

      • Vary in the number of neutrons

        • Ex. 12C, 13C, 14C

      • Radioisotope

        • Heavy isotope

        • Tends to be unstable

        • Decomposes to a more stable isotope

      • Radioactivity

        • Process of spontaneous atomic decay

        • As some isotopes adjust to a more stable form, they will emit a measurable energy. This energy release is called "radiation".

        • We can make use of radioactive isotopes in medicine (low-level radiation)

          • Normally, cells (epithelial tissue) in the thyroid gland (organ) take up the element iodine I) from your diet to make a thyroid hormone. If we want to check the activity of your thyroid gland, we can feed you radioactive iodine. As your thyroid cells take up the radioactive iodine, energy emitted from your thyroid gland is captured by a machine (scanned) and used to make an image (picture) of your gland. We may see cancer tumors, an underactive, overactive, or normal gland. This procedure is often called a "thyroid scan".

  • Electrons & Chemical Bonding

    • Electrons occupy energy levels called electron shells

    • Electrons closest to the nucleus are most strongly attracted

    • Each shell has distinct properties

      • The number of e- held has an upper limit

        • Rule of 8s (octet rule)

          • Shell 1 holds 2 e-

          • Shell 2 holds 8 e-

          • Shell 3 holds 8 e- (for bonding purposes)

      • Shells closest to the nucleus fill first

    • Bonding involves interactions between e- in the outer shell (valence shell)

    • Full valence shells do not form bonds

      • Inert Elements

        • Have complete valence shells and are stable

          • Ex. He, Ne

    • Reactive Elements

      • Valence shells are not full and are unstable

      • Tend to gain, lose, or share electrons

      • Allows for bond formation, which produces a stable valence shell

        • Ex. C, H, O, N

Chemical Bonds

  • Ionic Bonds

    • The attractive force between oppositely charged ions

    • Ions

      • Charged particles (elements)

    • Ex. NaCl

    • Will dissociate in water and form + and - ions

      • NaCl → Na+ + Cl-

    • Chemicals that are made up of atoms with ionic bonds are called salts or electrolytes

      • Ions with a positive charge are called cations: examples H+, K+

      • Ions with a negative charge are called anions: examples HCO, ОН-

  • Covalent Bonds

    • Atoms become stable through shared e-

    • Single covalent bonds share one e-

    • Double covalent bonds share two e-

    • Ex. CH4, O2

    • Polarity

      • Covalent-bonded molecules

        • Some are nonpolar

          • Electrically neutral as a molecule, as electrons are evenly shared

          • Ex. CO2

        • Some are polar

          • Electrons are unevenly shared

          • Results in a positive and a negative side

          • Ex. H2O

  • Hydrogen bonds

    • Weak chemical bonds

    • Hydrogen is attracted to the negative portion of a polar molecule

    • Provides attraction between molecules

Molecules, Compounds, and Solutions

  • Molecules: two or more atoms (same or different) joined together by chemical bonds

    • Ex. O2, N2, H2O

  • Compounds: substances composed of two or more different elements

    • Ex. H2O, CH4, NaCl, C6H12O6 (glucose), etc.

  • Exceptions: Note that because electrolytes are electrically attracted and not chemically combined, we do not use the term "molecule" to describe NaCl, etc.

  • Solutions: two or more components physically intermixed (not chemically bound)

    • Ex. saline solutions [table salt (NaCl) and water], blood plasma, interstitial fluid, urine, etc.

      • Solvent: dissolving medium

        • Present in the greatest amount

        • Ex. water

      • Solute: the dissolved substance

        • Present in smaller amounts

        • Ex. NaCl, glucose, O2, CO2, Ca2+, etc.

    • Concentrations

      • The amount (concentration) of a solute in the total solution is usually measured as one of the following:

        • Percent of the solute in the total solution (parts per 100)

        • Milligrams per deciliter (mg/dL)

          • Note: A deciliter is 100 mL

        • Molarity (moles per liter), indicated by M

Chemical Reactions

  • Terminology

    • Reactants: reacting substances

    • Products: end product (result)

    • Ex. 4 H + C → CH4

  • Three major types of reactions:

    • Atoms, molecules, ions, and compounds are built into more complicated forms (anabolism)

      • Always involves bond formation: A + B → AB

      • Ex. building of human muscle cells or amino acids into proteins

    • Decomposition reactions

      • Breaking down large molecules into smaller units (catabolism)

        • Bonds are broken: AB → A + B

        • Ex. dietary intake of animal protein or glycogen into glucose

    • Reversible reactions

      • Some chemical reactions don't just proceed in one direction but seek "equilibrium" and may proceed in both directions

      • Arrows indicate the direction of the reaction.

        • An important example of how the body maintains CO2 and acid-base balance is the carbonic acid buffering system:

          • CO2 + H2O ⇌ H2CO3 ⇌ H+ + HCO3-

Inorganic Compounds

  • Lacks carbon

    • Exception: CO2, HCO3-

  • Tend to be simpler than organic compounds

    • Ex. H2O, NaCl (inorganic) vs. C6H12O6 (organic)

  • Important Inorganic Compounds in Living Matter

    • Water (H2O)

      • Most abundant inorganic compound (60-80% of our body weight)

      • Vital properties

        • High heat capacity

        • High heat of vaporization

        • Polar solvent properties

          • Often called the "universal solvent"

            • Biological molecules do not react unless they are in solution, so this is crucial to sustain life

          • Will also form hydration layers to shield charges

          • Serves as a transport medium

        • Chemical reactivity

          • Hydrolysis reactions

          • Dehydration synthesis

        • Cushioning

        • Stabilizes the structure of all macromolecules

          • Hydrophobic interactions

    • Oxygen (O2)

      • Approximately 20% of the air you breathe is oxygen

      • O2 is essential for cells to extract energy from other compounds

      • Without O2, many cells die quickly as they run out of internal energy compounds (ATP)

    • Carbon dioxide (CO2)

      • As energy is extracted from molecules with long chains of carbon atoms, bonds are broken, and carbon atoms must be removed from the body. CO2 is formed.

    • Salts

      • Ionic compounds that contain cations other than H+ and anions other than OH-

        • Ex. NaCl, CaCO3, KCl, etc.

      • Easily dissociate into ions in the presence of water

        • Form electrolytes, which conduct electrical currents

      • Salts (and electrolytes) are vital to many body functions

        • Ex. Nerve cell communication, muscle contraction, etc.

        • If ionic balance in our body is not maintained (a function of the kidneys), the physiological activities listed above and thousands of others will become disrupted and stop. Virtually nothing in the body will then work, and death will quickly ensue.

      • The antidepressant Lithium Chloride:

        • LiCl → Li+ + Cl-

    • Acids and Bases

      • Note: Like salts, acids, and bases are electrolytes. They ionize and dissociate in water and can then conduct an electrical current.

      • Acids

        • Proton donors

          • H+ (hydrogen ion) = proton

        • Electrolytes are called acids if they yield H+ in water

          • Example of partial dissociation: (weak acid) H2CO3

          • Note: The body uses the decomposition part of this reversible reaction to form CO, for removal from the body

            • H2CO3 → H+ + HCO3-

          • Example of complete dissociation: (strong acid) HCl

          • Note: The stomach uses this dissociation to create a very acidic stomach environment

            • HCl → H+ + Cl-

      • Bases

        • Proton acceptors

        • They attract and combine with H+ in water

          • Examples:

            • NH3 + H+ → NH4+

            • H+ + HCO3- → H2CO3

          • The kidney uses the synthesis reaction above to get rid of excess acid (H+)

      • pH: Acid-Base Concentration

        • Measures H+ (proton) concentration

          • Scale runs from 0-14

            • pH = 7 neutral

            • pH < 7 = acid

            • pH > 7 = base

        • Concept of physiological pH

          • The normal pH range for human blood is 7.35-7.45

          • Therefore, <7.35 = acidosis and > 7.45 = alkalosis in humans

        • Buffers

          • Chemicals that can regulate pH change

          • Ex. carbonic acid-bicarbonate system

            • CO2 + H2O ⇌ H2CO3 ⇌ H+ + HCO3-

Properties of Organic Compounds

  • The Molecules of Life

    • Carbohydrates, lipids, proteins, & nucleic acids

  • Binding Properties of Carbon

    • Can covalently bind up to 4 different atoms

    • Can bind itself

      • Creates an infinite variety of carbon skeletons with energy-rich covalent bonds

    • Can form single, double, and triple bonds

    • Result: Infinite diversity and complexity of organic molecules

  • Hydrocarbons

    • Composed entirely of C and H atoms

    • Very strong

    • Form stable portions of most biological molecules

  • Functional Groups

    • Bind the carbon backbone and convey specific chemical properties to the compound

      • Ex. Estrogen vs. Testosterone

  • How do Cells Build Organic Compounds?

    • Overview: monomers → polymers

    • Cells join monomers into chains called polymers via dehydration reactions

      • Results in the covalent linkage of the monomer to the chain through the loss of an H2O molecule

    • Cells break polymers down into monomers via hydrolysis reactions

Biological Molecules

  • Carbohydrates (Polysaccharides /Sugar)

    • Functions:

      • Energy-yielding fuel stores

      • Extracellular structural elements & signals

      • Bulk in feces

    • Composition

      • Building blocks of monosaccharides

        • Ex. glucose, fructose, ribose, deoxyribose

      • Disaccharides

        • 2 monosaccharides covalently linked

        • Examples:

          • Sucrose (table sugar)

          • Lactose (milk sugar)

          • Maltose (grain sugar)

      • Polysaccharides (aka complex carbohydrates)

        • Many sugar units (same or different) are covalently linked

        • Examples:

          • Starch

            • Energy storage in plants

            • Polymer of glucose subunits

            • Amylase is an enzyme that breaks starch into monosaccharides usable by humans

          • Glycogen

            • Energy storage in animal cells

            • Polymer of glucose subunits

          • Cellulose

            • Polymer of glucose

            • Humans do not have cellulase, so linkages cannot be hydrolyzed

              • Therefore, the “fiber” or bulk in feces

  • Lipids

    • Intro:

      • Characterized by their inability to dissolve in H2O

        • All hydrophobic

      • Functions: Protection, insulation, regulation, vitamins, structure (like membranes, steroids, etc.), energy

    • Types:

      • Fats (aka triglyceride)

        • Building blocks

          • An alcohol (glycerol) + 3 fatty acids

            • Unsaturated fatty acids

              • Liquid at room temp.

              • Contains double bonds

            • Saturated fatty acids

              • Solid at room temp.

              • No double bonds

        • Stored in adipose cells

      • Phospholipids

        • Phosphate replaces one of the fatty acids

        • Forms a lipid bilayer with hydrophobic and hydrophilic molecular ends

      • Steroids

        • Very different from fats in structure and function, but still a lipid (hydrophobic)

          • The carbon skeleton forms 4 fused rings

          • Different steroids arise from different functional groups

          • Cholesterol

            • Serves as a “base steroid” or building block

        • Ex. Cholesterol, bile salts, estrogen, progesterone, testosterone

        • Anabolic steroids

  • Proteins

    • Intro

      • Protein = Polymer of amino acid monomers

      • Each protein has a unique 3D structure that corresponds to a specific function

      • Functions: Regulation, transport, protection, contraction, structure, energy

    • The Monomers: Amino Acids (AA)

      • All proteins are constructed from the same 20 amino acids

      • Each AA differs only in the “R group”

        • Gives each AA its special chemical behavior

        • AAs are grouped together according to their side-chain properties

          • Hydrophobic, hydrophilic, acidic, basic

    • Proteins as Polymers

      • Amino acids are linked together by dehydration reactions, forming a peptide bond

    • Protein Shape

      • A functional protein is 1 or more polypeptides precisely folded into a unique 3D shape

        • Its final 3D conformation facilitates its specific function

      • Proteins have at least 3 levels of structure. If the protein has more than 1 polypeptide, it has a 4th level: 4° structure

        • 1° structure (Primary)

          • The sequence of amino acids held together by peptide bonds

          • Sequence is determined by inherited genetic info

          • Even a slight change in the 1° structure may affect the structure and function of the protein

            • Ex. Sickle-cell anemia

        • 2° Structure (Secondary)

          • Hydrogen bonds between the backbone of the 1° structure

          • The result is a helical coil (α-helix) or sheet-like array (β-pleated sheet)

        • 3° Structure (Tertiary)

          • Final 3D conformation of a protein that results from weak interactions (hydrogen bonds, ionic bonds, hydrophobic interactions, etc.) between the R groups

            • Hydrophobic regions congregate in the interior, away from H2O

            • Hydrophilic regions congregate toward the exterior, in contact with H2O

            • Chemical bonding (hydrogen bonds, ionic bonds, etc.) between different parts of the polypeptide reinforces the shape

        • 4° structure (Quadernary)

          • Complexing of 2 or more polypeptide chains through weak interactions

            • Ex. Hemoglobin

    • Protein Classifications

      • Fibrous (structural) proteins

        • Extended and strand-like

        • Insoluble in water and very stable

        • Ideal for mechanical support and tensile strength

        • Ex. Collagen, keratin, etc.

      • Globular (functional) proteins

        • Compact and spherical

        • Water soluble and chemically active

        • Play crucial roles in virtually all biological processes

        • Ex. Antibodies, peptide hormones, enzymes, chaperones, etc.

    • Protein Denaturation

      • Fibrous proteins are stable (some exhibit only 2º structure), but globular proteins are not (most exhibit 3° or even 4°structure) and are therefore highly dependent on weak bonds to maintain their final, 3D conformation and ultimate function.

      • Since weak bonds are fragile, they are easily broken by chemical and physical factors (high temperatures, chemicals, extreme pH, etc.)

      • Causes protein to unravel & lose its normal 3D conformation; therefore, normal functioning is lost (which is often irreversible)

    • Enzymes

      • Globular proteins that speed up chemical reactions (catalysts)

      • Lock and key or hand-in-glove-induced fit models

      • Usually ends in “-ase”

        • Ex. Lipase, proteases, etc.

      • Clinical: Lactose intolerance

  • Nucleic Acids

    • Nucleotides

      • Composed of:

        • 5-carbon sugar (pentose)

          • Ribose in RNA

          • Deoxyribose in DNA

        • A base

          • A

          • T

          • C

          • U

          • G

        • A phosphate group

    • Nucleic Acids

      • Provides instructions for building proteins (blueprints for life)

      • DNA

        • Double-stranded; forms a double helix

          • Sugar-phosphate backbone

          • Bases are hydrogen-bonded between strands

        • A, T, C, G

        • Genetic messages are encoded in the base sequence

        • In a gene, the sequence of nucleotide bases is translated into an amino acid sequence to make a specific protein

      • RNA

        • Single-stranded

        • A, U, C, G

        • The function is the assembly of proteins

  • Adenosine Triphosphate (ATP)

    • Chemical energy is used by all cells

    • ATP/ADP Cycle

      • Energy is released by breaking a high-energy phosphate bond

        • A-P-P-P → A-P-P + P + Energy for anabolism and cellular activities

      • Restoration of energy bonds for future use

        • A-P-P + P + Energy (from catabolism) → ATP

    • How ATP Drives Cellular Work

      • Transport work

      • Mechanical work

      • Chemical work

Ch. 3: Cells

Introduction to Cells

  • Smallest living units in biology

    • They carry out all chemical activities needed to sustain life

    • Basic structural and functional unit of living organisms

  • Microscopic but vary in shape, size, and function

  • Humans have several trillion cells organized into groups of tissues in organs

  • The human body is based on proper cell function. We can study normal life functions as well as disease states by examining what happens at the cellular level.

  • Likewise, we can study cellular activity of the body by measuring clinical "vital signs"

  • Cells can link elements like C (carbon), H (hydrogen), and O (oxygen) into molecules like carbohydrates (C6H12O6), proteins, and lipids.

  • Cells produce enzymes that perform many chemical reactions in the body, including not only the assembly but also the breakdown of molecules and chemicals.

    • O2 + C6H12O6 → CO2 + H2O + energy for life activities (ATP)

  • Many different cell types share common structures that we study as the generalized cell model.

Anatomy of the Cell

  • The generalized cell

    • 3 main parts:

      • Plasma membrane

      • Cytoplasm with organelles

      • Nucleus

  • Plasma membrane

    • The cell membrane divides the intracellular and extracellular environments

      • Produces a charge difference (called membrane potential) across the membrane by regulation of intracellular and extracellular ion concentrations

        • Inside is negatively charged with respect to the outside

    • Construction: double (bilayer) of phospholipids with embedded proteins

      • Fluid Mosaic Model

        • Membrane is neither rigid nor static in structure, but instead highly flexible and can change its shape and composition through time

      • 3 major components:

        • Phospholipids

          • Hydrophilic head groups face water in the interior and exterior of the cell

          • Hydrophobic tails face each other on the interior of the membrane

          • Can keep some substances from flowing directly through the membrane

            • Lipid-soluble substances can get through (some hormones, drugs, etc.), while other substances cannot

        • Proteins

          • Integral (transmembrane) vs. peripheral proteins

          • Function as transport channels, receptors for signal transduction, attachment to cytoskeleton and extracellular matrix (ECM), enzymatic activity, intercellular joining, cell-cell recognition, etc.

        • Cholesterol

          • Stabilizes membrane

          • Amount determines how fluid the membrane will be

    • Selective permeability

      • Some substances (small, hydrophobic, not charged) can cross more easily than others

      • Membrane transport - movement of substances into and out of the cell

        • Transport of small molecules

          • Simple diffusion

            • Movement of molecules down their concentration gradient (high conc. → low)

            • Solutes are lipid-soluble materials and small enough to pass through membrane pores (e.g., O2, CO2, H2O, etc.)

            • No energy required

          • Facilitated diffusion (helps by membrane transport)

            • Diffusion with transport/carrier proteins

            • Mechanism for glucose, amino acids, and ion transport

            • Characteristics:

              • Specificity for a single type of molecule

              • Competition among molecules of similar shape

              • Saturation - rate of transport limited to the number of available transport proteins

          • Active transport

            • Movement of solutes against their concentration gradient (low → high conc.)

            • Requires energy (ATP) and a carrier protein

            • Example: Na+/K+ exchange pump that creates electrical potentials across membranes

        • Vesicular Transport - transport of large particles and macromolecules across plasma membranes

          • Endocytosis - bulk or large molecule transport into the cell

            • Phagocytosis

              • Ex: White blood cells (WBC) engulf invaders or cell debris and take it into the cell

            • Pinocytosis ("cell drinking")

            • Receptor-Mediated Endocytosis - When protein receptors are activated on the surface, the membrane takes in substances from the outside

              • Clinical: hypercholesterolemia

          • Exocytosis - bulk or large molecule transport out of the cell

        • Osmosis

          • Diffusion of water across a selectively permeable membrane

          • Affected by the total concentration of all solute particles in a solution (called osmolarity)

            • Hypotonic: low solute concentration compared to the human body plasma compartment

            • Hypertonic: high solute concentration compared to the human body plasma compartment

            • Isotonic: same solute concentration compared to the human body plasma compartment

          • H2O always moves from hypotonic to hypertonic

          • Important because large volume changes caused by water movement disrupt normal cell function

  • The cytoplasm

    • Fluid matrix like jello (cytosol) with embedded organelle structures

    • Organelles are small, separate, membrane-bound structures within the cell with distinct functions

      • Mitochondria: ATP synthesis

        • Provides all energy for cellular work

        • The number will increase in a cell when energy requirements increase

        • A small amount of mitochondrial DNA is present

        • Two energy-releasing pathways:

          • Both start with glycolysis in the cytoplasm

          • Anaerobic respiration/glycolysis

            • Occurs in the cytoplasm

            • Does not require oxygen

            • Results in very little ATP production

          • Aerobic respiration

            • Occurs in mitochondria

            • Requires oxygen

            • Results in a large amount of ATP production

      • Ribosomes: protein synthesis

        • Free ribosomes suspended in the cytosol synthesize proteins that will stay inside the cell

        • Attached ribosomes (to the endoplasmic reticulum) will synthesize proteins destined for secretion outside of the cell

      • Endoplasmic Reticulum (ER)

        • Smooth ER: drug detoxification, lipid and cholesterol production, steroid hormone production, etc.

          • Phenobarbital resistance

        • Rough ER: preparation of proteins for transport and secretion, and "membrane factory" (produces integral membrane proteins and phospholipids)

      • Golgi apparatus: packages, modifies, and segregates proteins

        • Secretory pathway: RER → Golgi → vesicle → exocytosis

      • Lysosomes: site of intracellular digestion

        • Filled with hydrolyzing enzymes

      • Peroxisomes: detoxification

        • Detoxifies harmful substances like alcohol and formaldehyde and neutralizes dangerous free radicals

      • Inclusions: temporary storage of pigments, fat droplets, etc.

      • Cytoskeleton: small internal rods that determine cell shape and structure, support organelles, and provide machinery needed for transport and cell division

        • Composed of microtubules, microfilaments, and intermediate filaments

      • Centrioles within the centrosome structure produce fibers (microtubule spindle) necessary for cells to divide and replicate

        • Barrel-like structure

    • Cellular Extensions

      • Cilia

        • Hair-like projections used to propel substances across the cell surface

        • Beat in only one direction

      • Flagella

        • Single tail-like projection used to propel the entire cell forward only

        • Example: sperm cell

      • Microvilli

        • Finger-like projections on the surface of some cells that increase surface area for absorption (such as in the intestine)

  • The nucleus (contains DNA and all life-sustaining things)

    • Control center for cell activities (life)

      • Recipes for life are stored in the chemical form of DNA

      • All cells have at least one nucleus at some point.

    • Structural organization

      • Nuclear envelope with nuclear pores

      • Chromatin (uncoiled DNA)

      • Chromosomes (tightly coiled DNA)

      • Nucleolus (RNA for ribosome assembly)

        • Inside the nucleus

  • The Cell Cycle

    • Overview

      • Comparison of Mitosis and Meiosis

    Mitosis

    Meiosis

    • Primary function: growth and repair/replacement

    • Occurs in all of the somatic cells of the body (normal body cells like skin, liver, kidney, etc.)

    • One (1) round of cell division

    • Produces 2 genetically identical daughter cells

    • Each daughter cell has 46 chromosomes

    • Primary function: gametogenesis

    • Occurs only in the glands (testes in males; ovaries in females)

    • Two (2) rounds of cell division

      • Meiosis I and Meiosis II

    • Produces 4 (haploid) daughter cells, each with half the number of chromosomes

    • Each daughter cell has 23 chromosomes

    • Interphase

      • The phase between cell divisions

      • Period of cell growth and normal ongoing metabolic (chemical) activities

  • G1 (Gap 1): Normal metabolic activities (e.g., producing proteins, energy, interacting with the environment) and vigorous growth

    • The cell is just being a cell and doing its job

    • Virtually no activities related to cell division occur here

    • Although this is where the cell spends most of its time, G1 usually lasts only minutes to hours

  • S (Synthesis): DNA replication (exact duplication of all genetic material)

  • G2 (Gap 2): Growth and final preparations for cell division

    • Usually brief, but ensures everything is ready for entry into M phase

  • G0 (Resting Phase): Cells stop dividing and exit the cell cycle

    • Mature cardiac muscle cells, nerve cells, and often multinucleated skeletal muscle cells enter G0 and never re-enter the cell cycle

Mitosis

  • Process necessary for cell division into two identical cells (used for growth and replacement)

    • Goal: Exact and equal division of replicated DNA

      • Stages (PMAT):

        • Prophase

          • Chromosomes condense

          • Nuclear envelope breaks up

          • Microtubule spindle forms

        • Metaphase

          • Spindle microtubules attach to sister chromatids

          • Sister chromatids align at the metaphase plate

          • Tension builds for separation

        • Anaphase

          • Attachments between sister chromatids break

          • Chromatids migrate to opposite poles

          • Independent daughter chromosomes are now present

        • Telophase

          • Chromosomes arrive at opposite poles

          • They decondense

          • Spindle breaks down

          • Nuclear envelope reforms

        • Cytokinesis

          • Cleavage furrow and contractile ring form (via microfilaments)

          • Cytoplasm divides

          • Two genetically identical daughter cells are formed

      • If there’s any disruption in these phases, the cell is arrested in that phase and cannot proceed until corrected

      • Some chemotherapy drugs target these mitotic stages to stop cancerous cells from completing division

      Developmental Aspects of Cells

      • Life After Mitosis

        • Differentiation - taking on a cellular fate

          • All cells originate from one fertilized egg

          • Cells respond to different chemical signals to form:

            • 3 germ layers: endoderm, mesoderm, ectoderm

            • 4 major tissue types: epithelial, connective, muscle, nervous

          • Once differentiated, cells divide and carry out specialized functions

      • The issue with aging: Why cells quit doing their jobs

        • Cellular clock: Cells die after a certain number of divisions

        • Apoptosis: Programmed cell death

        • Free radical detox slows with age, speeding up cell death

        • Telomeres break down during mitosis, limiting the number of divisions

      Understanding Cancer: Uncontrolled division and spread of cells in the body

      • Neoplasm: Abnormal mass of growing cells

        • Benign Tumor

          • Encapsulated, not spreading

          • Can function normally, but in the wrong place

          • Often removable via surgery

        • Malignant Tumor (Cancer)

          • During mitosis, tumor-suppressor genes should stop cells with errors

          • If these genes fail, cells with faulty DNA can survive and divide uncontrollably

      • Causes of Gene Damage (Mutations)

        • Carcinogens (cancer-causing agents):

          • Radiation

          • Mechanical trauma

          • Certain viral infections

          • Chemicals (e.g., tobacco tars, saccharine)

      • Unregulated Growth

        • Cells ignore normal regulatory signals

        • No longer respond to contact inhibition or growth factor depletion

        • Begin metastasis (spreading throughout the body)

        • Cancer kills by disrupting, displacing, and starving normal tissues

      • Diagnosis & Treatments

        • Biopsy: Tissue sample examined for malignancy

        • Surgical Removal: Physical removal of the tumor

        • X-ray Therapy: Targets local cancer cells

        • Chemotherapy: Circulates throughout the body to kill escaped cells

DNA Replication

  • Structure of DNA

    • Double helix

    • Sugar-phosphate backbone (covalently bound)

    • 2 strands held together by hydrogen bonds between bases (nucleotides)

      • 4 nucleotides:

        • Adenine (A)

        • Cytosine (C)

        • Thymine (T)

        • Guanine (G)

      • Base pairing:

        • A = T

        • C = G

  • DNA Replication

    • Exact duplication of a cell's genetic material (DNA)

    • Semiconservative DNA Replication:

      • DNA helicases separate the 2 strands of the double helix.

      • Stretches of nucleotide bases are exposed.

      • The companion strand is assembled via DNA polymerases:

        • Parent strand serves as a template.

        • Complementary bases come in and base pair with the single-stranded template.

      • Nucleotides then connect to form the sugar-phosphate backbone.

      • Results in 2 identical daughter DNA molecules, each with one parent strand and one daughter strand (semi-conservative).

  • DNA Repair

    • DNA polymerases proofread.

    • DNA ligases glue pieces together.

Protein Synthesis

  • Overview

    • DNA contains the information to produce proteins.

    • Transcription of a gene (DNA segment for a protein) results in mRNA (mirror image copy).

    • mRNA leaves the nucleus and goes to a ribosome.

    • Amino acids are carried to the ribosome by tRNAs.

    • Translation uses mRNA information to determine the number, kinds, and arrangement of amino acids in the protein.

  • Transcription (DNA → mRNA)

    • Structure of mRNA:

      • Single-stranded.

      • 4 nucleotides:

        • Adenine (A)

        • Cytosine (C)

        • Uracil (U)

        • Guanine (G)

        • Base pairing:

          • A = U

          • C = G

      • Sugar-phosphate backbone with ribose sugar (instead of deoxyribose).

    • 3 types of RNA: mRNA, tRNA, rRNA.

    • Mechanism of Transcription:

      • Initiation:

        • RNA polymerase binds to the DNA promoter and unwinds the DNA.

        • A transcription bubble is formed.

      • Elongation:

        • RNA polymerase catalyzes base-pairing of RNA nucleotides to DNA bases (A-U and C-G).

      • Termination:

        • A termination signal is reached.

        • mRNA is released and travels out of the nucleus to the cytoplasm.

        • DNA returns to its original structure.

  • Translation (mRNA → protein)

    • Deciphering mRNA transcripts:

      • mRNA message is translated from nucleotides to amino acids (protein "language").

      • Every 3 nucleotides = a CODON.

      • One codon specifies a single amino acid.

        • The Genetic Code represents all possible codon combinations and their corresponding amino acids.

    • Steps in Translation:

      • Initiation:

        • The ribosome binds to mRNA and moves to the AUG start codon (binding site #1).

          • "Start" codon signals the beginning of a protein.

      • Elongation:

        • tRNA brings the appropriate amino acid to the binding site #1 based on the mRNA codon (codon-anticodon matching).

          • Binding site #2 on the ribosome is open.

        • The next tRNA with the corresponding amino acid binds to the open binding site #2.

        • The ribosome catalyzes the formation of a peptide bond between the two amino acids.

        • tRNA in binding site #1 is released, and the ribosome shifts down the mRNA by one codon.

        • Binding site #2 becomes the new binding site #1, and binding site #2 is now open for the next tRNA.

        • This process repeats until a stop codon is reached in the mRNA.

      • Termination:

        • A "Stop" codon is reached on the mRNA.

        • There is no tRNA anticodon for a stop codon.

        • mRNA and the polypeptide are released from the ribosome.

      • What happens next?

        • mRNA is recycled.

        • The new protein enters the cytoplasm or the rough ER (for processing in the Golgi apparatus and potential secretion).

  • Mutations

    • Mutations are changes in the genetic material of a cell.

    • Mutations can be beneficial, neutral, or harmful.

      • Harmful mutations can lead to genetic disorders or hereditary diseases.

        • Example: Sickle-cell anemia is caused by a single base pair mutation in the hemoglobin gene, leading to an abnormal protein and associated symptoms.

      • The Science Behind Genetically Inherited Diseases:

        • DNA change → mRNA change → codon change(s) → amino acid sequence change → altered protein folding → change in 3D conformation → altered protein structure → altered protein function.

    • What causes mutations?

      • Spontaneous: Errors during DNA replication, repair, or recombination that are not corrected.

      • Mutagens:

        • Physical agents: X-rays and other high-energy radiation (like UV light).

        • Chemical agents: Accutane, etc.

    • Types of mutations:

      • Silent mutations:

        • Result from the redundancy of the genetic code (different codons can code for the same amino acid).

      • Substitution mutations:

        • One or more bases are replaced by others.

        • Example: Sickle cell anemia.

      • Frame-shift mutations:

        • Insertions (addition of one or more bases).

        • Deletions (loss of one or more bases).

Ch. 4: Tissues & Membranes

Overview

  • Tissues - A “fabric” or group of cells with similar structure and function

  • Four primary types

    • Epithelium (covering)

    • Connective (support)

    • Muscle (movement)

    • Nervous (control)

  • The importance of the microscopic study of tissue

    • Histology

    • Biopsy

    • Autopsy

Epithelial Tissues and Glands

  • Definition: A Sheet of cells that covers all free body surfaces (inside and out), forming an interface or boundary between two environments.

  • Functions

    • Protection

    • Absorption - Intake of molecules and substances

    • Filtration - Closely fitted cells can form a “strainer” with small holes

    • Secretion - Release of molecules and substances

    • Sensory reception

  • Special Characteristics

    • Cellularity

    • Specialized contacts

    • Polarity (1 free surface; 1 bound surface)

      • Apical surface (free surface)

      • Basal surface (bound surface)

    • Supported by connective tissue

    • Avascular but innervated

    • Regeneration

  • Special Structural Features

    • Apical surface

      • Microvilli

        • Fingerlike extensions of epithelial cells lining some parts of the digestive tract or the kidney. The surface area is increased, increasing absorption and secretion. It may also create adhesion points for secreted mucus.

      • Cilia

        • Microtubules project from cell membranes as hairs that move uniformly in one direction (wave-like). They can move substances along the surface of a sheet of epithelial cells.

        • Clinical note: Nicotine decreases ciliary action

    • Lateral cell junctions

      • Desmosomes

        • Anchoring junctions linking proteins) between cells that prevent cells subjected to mechanical stress (such as skin cells) from being pulled apart

        • Confers strength

      • Tight junctions

        • Rivets that securely fuse adjacent plasma membranes together into leakproof sheets; seal the extracellular space

      • Gap junctions

        • Allow substances to leak between cells

    • Basal surface

      • Basal Lamina

        • A noncellular, adhesive sheet of glycoproteins secreted by epithelial cells toward the neighboring connective tissue layer.

        • Functions:

          • Selective filter

          • Scaffold to which epithelial cells can migrate or grow upon

        • Combines with fibers from the CT layer to form a basement membrane

      • Basement Membrane

        • Located just deep into the basal lamina

        • Reinforces the epithelial sheet and defines the epithelial boundary

  • Classification of Epithelium

    • Two names followed by “epithelium”

      • 1st name: # of cell layers

        • Simple - One layer

        • Stratified - More than one layer

        • Pseudostratified - Looks like more than one layer, but isn't

      • 2nd name: Shape of cells

        • Squamous - Flat, plate or scale-like

          • Nucleus: Flat & disc-like

        • Cuboidal - Cube-shaped or box-like

          • Nucleus: Large & round; spherical

        • Columnar - tall and column-shaped

          • Nucleus: Oval and elongated, located in the basal ⅓

  • Glandular Epithelium

    • Glands - One or more epithelial cells organized to make and secrete (export) a particular product (often an aqueous fluid that contains proteins)

    • Secretory pathway:

      • RER → Golgi → vesicles → exocytosis

    • Two major gland types

      • Endocrine glands

        • Ductless (secretion into the bloodstream)

        • Secretions are chemical messenger molecules called hormones

          • Each messenger (hormone) is a regulatory chemical manufactured to react with a specific “target” organ(s) in some specific way

            • Ex. The pancreas has an endocrine function where some of its glandular cells produce the hormone insulin, which affects the energy pathways used by many organs of the body

      • Exocrine glands

        • Secret products onto a body surface or into body cavities

        • Unicellular

          • Ex. Single goblet cell secretes a protein called mucin

            • Mucin + H2O = Slimy, viscous mucus

        • Multicellular

          • Secretory unit + duct

          • Ex. Sweat and oil glands, salivary glands, liver, pancreas (both endocrine and exocrine), etc.

Connective Tissue

  • 4 main classes (several subclasses)

    • Connective tissue proper

    • Cartilage

    • Osseous tissue (bone)

    • Blood

  • Functions

    • Binding (connection) and support

    • Protection

    • Insulation

    • Transportation

  • Structural Elements

    • Cell type

      • Fibrocyte

      • Chondrocyte

      • Osteocyte

      • Red Blood Cells (RBCs)/White Blood Cells (WBCs)

    • Extracellular Matrix (ECM) is composed of:

      • Ground substance

        • Holds water and ranges from liquid to jelly to firm

        • Composition:

          • Water

          • Adhesion proteins

          • Polysaccharide molecules

      • Fibers

        • Produced by the cells

        • 3 types

          • Collagen fibers

            • Extremely tough; high tensile strength

          • Elastic fibers

            • Stretch and recoil

          • Reticular fibers

            • Fine collagen, but more give

Muscle Tissue

  • Highly cellular, well-vascularized tissue that functions to produce movement

  • Cells are also called muscle fibers

  • Contains internal myofilaments (actin and myosin) for contraction

  • 3 types:

    • Skeletal muscle

    • Cardiac muscle

    • Smooth muscle

Nervous Tissue

  • Main component of the Nervous System (brain, spinal cord, nerves, etc.)

  • 2 major cell types:

    • Neuroglia (nerve support cells that protect, insulate, etc.)

    • Neurons (nerve cells)

      • Functions:

        • Irritability

        • Conductivity (send impulses to other areas of the body)

      • Common structural components

        • Dendrites

        • Cell body

        • Axon

        • Axonal (presynaptic) terminals

Tissue Repair

  • Overview

    • The body has many techniques for protecting itself against pathogens and/or injury:

      • External Defenses

        • Mechanical

          • Intact skin

          • Mucous membranes

        • Chemical

          • Fatty acids - Lower pH on skin

          • Enzymes (lysozyme & pepsin)

          • Stomach acid

          • Vaginal secretions

          • Urine

        • Microbiological

      • Internal Defenses

        • Inflammatory Response

          • Nonspecific

          • Develops quickly

      • Specific Immune Response

        • Targets specific pathogens

        • Takes longer

    • When tissue injury occurs, external barriers are penetrated, and internal defenses are therefore activated.

    • Repair occurs in two major ways: Regeneration and fibrosis

      • Regeneration: replacement of destroyed tissue with the same kind of tissue (i.e., epithelium with epithelium)

      • Fibrosis: replacement of destroyed tissue with fibrous connective tissue (called scar tissue)

  • Steps

    • Inflammation sets the stage

      • Severed blood vessels bleed, and inflammatory chemicals are released.

      • Local blood vessels become more permeable, allowing white blood cells, fluid, clotting proteins, and other plasma proteins to seep into the injured area.

      • Clotting occurs; the surface dries and forms a scab.

    • The organization restores the blood supply

      • The clot is replaced by granulation tissue, which restores the vascular supply.

      • Fibroblasts produce collagen fibers that bridge the gap.

      • Macrophages phagocytize cell debris.

      • Surface epithelial cells multiply and migrate over the granulation tissue.

    • Regeneration and fibrosis affect permanent repair

      • The fibrotic area matures and contracts; the epithelium thickens.

      • A fully regenerated epithelium with an underlying area of scar tissue results.

    • Note: The repair process described above follows the healing of a wound (cut, scrape, puncture, etc.) that breaches an epithelial barrier. In simple infections (i.e., pimples, sore throats, etc.), healing is solely by regeneration. There is usually no clot formation or scarring. Only severe (destructive) infections lead to scarring.

  • Regenerative Capacity of Different Tissues

    • Epithelial tissues, bone, areolar, and blood-forming tissue regenerate extremely well

    • Smooth muscles and dense, regular connective tissue have a moderate capacity for regeneration

    • Skeletal muscle and cartilage have a weak regenerative capacity

    • Cardiac muscle and nervous tissue in the brain and spinal cord have virtually no functional regenerative capacity and are routinely replaced by scar tissue

  • Simplest Organs: Membranes

    • Continuous multicellular sheets composed of epithelial + connective tissue

    • 3 types:

      • Cutaneous membranes (skin)

      • Mucous membranes

        • Cover all portals to the inside

        • Produces mucus

      • Serous membranes

        • Lines close internal cavities & cover the outside of organs

        • Produces slippery serous fluid

        • Named by lining location + the cavity word

          • The thoracic cavity is lined by parietal + pleura = parietal pleura

          • Thoracic organs are covered by the visceral pleura

          • The abdominopelvic cavity is lined by parietal peritoneum

          • Abdominopelvic organs are covered by visceral peritoneum

          • The pericardial cavity is lined by the parietal pericardium

          • The heart (inside the pericardial cavity) is covered by the visceral pericardium

    • Connective Tissue only

      • Synovial membranes

        • Line the inside of freely movable joints

        • Produces synovial fluid

Ch. 5: The Integumentary System

  • Overview

    • Composition

      • Skin (integument)

      • Skin derivatives (appendages)

        • Sweat (sudoriferous) glands

        • Sebaceous (oil) glands

        • Hairs and hair follicles

        • Nails

      • Skin functions

        • Protection

          • The skin consists of at least three types of barriers: chemical, physical, and biological

          • Protects deeper tissue from:

            • Mechanical damage

            • Chemical damage

            • Bacterial damage

            • Thermal damage

            • UV radiation

            • Desiccation

        • Body temperature regulation

        • Cutaneous sensation

        • Metabolic functions (synthesizes vitamin D precursor, etc.)

        • Blood reservoir

          • It can hold about 5% of the body's total blood volume, which can then be shunted into general circulation for use by vigorously working muscles and/or other body organs

        • Excretion

          • Eliminating nitrogen-containing wastes (ammonia, urea, uric acid), NaCl, H2O, etc.

  • Skin Structure

    • Epidermis (5 strata)

      • Stratified squamous epithelium with keratin

      • Cells are tightly connected by desmosomes

      • Keratinocytes form several layers

      • Layers of the epidermis

        • Stratum basale

          • Single row of cells that serve as the origin of keratinocytes for all superficial strata

          • High mitotic activity

          • Contains melanocytes

            • Accounts for about 10-25% of stratum basale cells

        • Stratum spinosum

        • Stratum granulosum

        • Stratum lucidum

        • Stratum corneum

          • 20-30 cell layers thick, and accounts for three-quarters of epidermal thickness

          • Located on the exposed surface of the skin

          • Protective barrier of dead, durable, and expendable cells

            • Cells are filled with keratin (keratin-filled plasma membranes)

              • Helps give the epidermis its protective properties, etc.

            • The thickness will vary depending on use

              • Calluses can develop on the palms of hands and soles of feet

          • Glycolipids secreted between cells provide waterproofing and preserve some permeability characteristics of the skin

            • Allows for transdermal medications (nicotine patches, birth control patches, etc.)

      • Melanin

        • Pigment produced by melanocytes

        • Gets packaged in melanosomes and then deposited into the keratinocytes in more superficial layers

        • Melanin granules then position themselves on the superficial (or sunny) side of the keratinocyte nucleus to protect against UV radiation

        • The amount produced depends on genetics and exposure to sunlight

          • Cell production of tyrosinase (acts on the amino acid tyrosine) is critical for melanin production

          • Albinism - failure to produce tyrosinase is the most common form

    • Dermis

      • Strong, flexible connective tissue

      • Two layers

        • Papillary layer

          • Thin, superficial layer of areolar connective tissue

          • Accounts for about 20% of dermis thickness

          • Supports and nourishes the overlying epidermis through blood vessels (dermal capillaries)

          • Has nipple-like projections called dermal papillae

            • Has ridges that increase surface area for things like fingerprints

          • Pain receptors

          • Capillary loops

        • Reticular layer

          • Accounts for about 80% of dermis thickness

          • Dense irregular connective tissue with a meshwork of collagen and elastic fibers

          • Blood vessels

          • Glands

          • Nerve receptors

    • Hypodermis (subcutaneous)

      • Technically, it's not part of the skin

      • Anchors skin to the underlying organs

      • Composed mostly of adipose tissue (accounts for half of the body's stored fat)

  • Appendages of the Skin

    • Sebaceous glands

      • Produces oil (sebum)

        • Softens and lubricates the hair and skin

      • Most have ducts that empty into hair follicles

      • Distributed body-wide except for palms of hands and soles of feet

      • Glands are activated at puberty (under hormonal control)

        • Clinical: Acne

          • Accutane is teratogenic (birth defect)

    • Sweat (sudoriferous) glands

      • Widely distributed in the skin (up to 3 million body wide)

      • Comes in two types:

        • Eccrine

          • Coiled, tubular portion in the dermis with an opening via a duct to the pore on the skin’s surface

          • Distributed body-wide (most numerous)

          • Helps dissipate excess heat through evaporative cooling

        • Apocrine

          • Ducts empty into hair follicles

          • Localized to axillary and pubic (anogenital) areas

            • Only about 2000 in number

          • Activated by stress, pain, and sexual excitement, not temperature

          • Fatty acid and protein secretion

            • Bacteria breakdown produces body odor

        • Modified sweat glands

          • Ceruminous glands

            • Found in the lining of the external ear canal

            • Secretion mixes with sebum to produce cerumen (earwax)

          • Mammary glands

    • Hair

      • Distributed body-wide except for palms, soles, lips, nipples, and part of the external genitalia

      • Strand of dead, hard keratinized epithelial cells projecting from an invaginated tunnel in the epidermal and dermal layers called the hair follicle

      • Hair follicle

        • Tubular invaginations of the epidermis

        • Formed by mitotically active stratum basale cells

        • Melanocytes provide pigment for hair color

        • Dermal capillaries provide the blood supply

      • 3 major parts:

        • Bulb - growth zone at the inferior end of the hair follicle

        • Root - part of the hair enclosed in the hair follicle

        • Shaft - visible part of hair; projects from the surface of the skin

      • Arrector pili (smooth muscle)

      • Clinical: Minoxidil (Rogaine)

    • Nails

      • Nail structures

        • Nail fold (lateral and proximal skin coverings)

        • Eponychium (cuticle)

        • Nail body

          • A sheet of hard keratin attached to the nail bed

          • Lanula - crescent-shaped vascular area at the proximal end of the nail bed and visible through the nail. Used for visual checks of oxygen status in patients.

      • Clinical: Eponychiitis, ingrown toenail

  • Clinical Applications

    • Injection Sites

      • Intradermal (ID)

      • Subcutaneous (“subcue” or SQ)

      • Intramuscular (IM)

      • Intravenous (IV)

    • Blisters

      • Fluid-filled pocket between epidermis and dermis

    • Lines of Cleavage

      • Formed by uniform alignment of collagen and elastic fibers

    • Stretch marks

    • Decubitus ulcers or "bed sores"

      • Blood supply restricted → ischemia (O2 reduced) → necrosis (tissue death)

      • Bacterial infections result, difficult-to-heal, secondary intention

      • Areas of highest risk are least padded (elbow, heels, backbone)

      • Patients of high risk: elderly (less body fat for padding) in care homes

      • The importance of rotating patient positions, artificial padding, and clean bedding

    • Burns

      • Tissue damage inflicted by heat, electricity, UV radiation, or chemicals that denature proteins and cause cell death in affected areas

      • Associated dangers

        • Catastrophic loss of body fluids can lead to:

          • Dehydration

          • Electrolyte imbalance

          • Renal failure

          • Circulatory shock

        • Infection

          • Sepsis (widespread bacterial infection) is the leading cause of death in burn victims

      • Rule of Nines

        • A way to approximate the extent of burns

        • Special tables are used when greater accuracy is desired

      • Severity of burns

        • 1st degree

          • Only the epidermis is damaged

          • Redness, pain, and swelling (inflammation)

          • Usually heals in 2-3 days

        • 2nd degree

          • Damage to the epidermis and dermis

          • Same symptoms as 1st degree, but also blistering

          • Usually requires 3-4 weeks to heal

        • 3rd degree

          • Total tissue destruction (epidermis, dermis, and even hypodermis)

          • Tissue becomes discolored, but no edema, pain, etc.

          • Usually requires a skin graft

    • Skin Cancer

      • The most common type of cancer

      • 3 types of skin cancer:

        • Basal cell carcinoma

          • Least malignant but most common type

            • Accounts for about 80% of all skin cancers

          • Arises from stratum basale cells that then go on and invade the underlying dermis and hypodermis

          • Results in a shiny, dome-shaped nodule most commonly found in sun-exposed regions of the face

          • Slow growth and, therefore, metastasis seldom

          • Full cure by surgical excision in 99% of cases

        • Squamous cell carcinoma

          • Arises from the stratum spinosum

          • Results in a scaly, reddened papule, most commonly on the head (scalp, ears, and lower lip) and hands

          • Tends to grow rapidly and will metastasize if not removed

          • The chance of a complete cure is good if the condition is caught early and removed by surgery or radiation

        • Malignant melanoma

          • Most deadly of skin cancers

            • Accounts for only about 5% of all skin cancers, but 90% of skin cancer deaths are due to metastasis and resistance to chemotherapy

          • Cancer of melanocytes

          • Metastasizes rapidly to the lymph and blood vessels

          • Can occur body-wide

          • Most appear spontaneously, but about 1/3 appear from pre-existing moles (wherever there is pigment)

          • The key to survival is early detection, so it is strongly encouraged to evaluate moles regularly using the ABCDE rule:

            • A = Asymmetry

            • B = Irregular border

            • C = Color

            • D = Larger than 6mm in diameter (about the size of a pencil eraser)

            • E = Elevation above the skin surface and evolution (changes over time)