VN 106 Anatomy and Physiology Final Exam Study Guide
1. General Organization and Terminology
* Anatomy: The study of the structure of the human body [1, 2].
* Physiology: The study of the functioning of the human body [2].
* Pathophysiology: The study of the diseases of the human body [2].
* Directional Terms:
* Terms pertaining to the head include the palate, while the tail is the caudal region [2].
* Proximal: Nearest to the origin of the part [3].
* Distal: Farthest from the origin of the part [3].
* Ventral: The front surface of the body [3].
* Body Planes:
* Frontal/Coronal Plane: Divides the body into front (anterior) and back (posterior) parts [4].
* Sagittal Plane: Divides the body into right and left parts [4].
* Midsagittal Plane: Equally divides the body into right and left halves [4].
* Transverse/Horizontal Plane: Crosses the body through the umbilicus, dividing it into upper and lower parts [4].
* Body Cavities: Know the ventral cavities (thoracic and pelvic) and dorsal cavities (cranial and spinal) [3].
* Visceral Organs: Internal organs, as opposed to external structures [3].
* Homeostasis: The dynamic process of maintaining balance in the body [5].
2. Cell Biology and Tissues
* Cell Structures:
* Nucleus: The control center of the cell [2].
* Cell Membrane: The boundary of the cell [2].
* Cytoplasm: The factory that makes up the body of the cells [2].
* Ribosomes: Responsible for protein synthesis [2].
* Endoplasmic Reticulum: Maintains the cell or its circulatory system [2].
* Golgi Apparatus: Makes carbohydrate compounds [2].
* Mitochondria: The workforce of the cell; does all the work [2].
* ATP: Produces and provides energy [2].
* **Cell Division:** Mitosis is for cell reproduction/division, while meiosis is for human reproduction [3].
* Connective Tissue: Anchors and supports other body structures [4].
3. Integumentary System (Skin)
* Functions: Thermoregulation (regulating body temperature via evaporation, conduction, radiation, and convection) and regulating body water content [5]. Conduction is the transfer of heat from direct contact between two bodies [4].
* Appendages: Hair, nails (which protect sensitive tips of fingers/toes), and sebaceous (oil) glands [3, 6].
* Epidermis Layers:
* Stratum Corneum: The horny top layer consisting of keratin [5, 6].
* Stratum Lucidum: The translucent layer found in the palms of the hands and soles of the feet [7].
* Stratum Granulosum: The granular layer where cells die [7].
* Stratum Spinosum: A possible cell layer [7].
* Stratum Basale (Basal Layer): A very important layer where mitosis takes place and new skin is created [7].
* Glands:
* Sudoriferous (Sweat) Glands: Associated with profuse sweating [5].
* Modified Sweat Glands: Ceruminal gland (in the ear), mammary glands, and ciliary glands (in the eyelids) [5].
* Eccrine Glands: Most numerous in the back, palms, and forehead [5].
* Skin Changes & Aging:
* Melanin provides pigmentation [7]. A loss of melanin production causes gray or white hair in aging [7, 8].
* Wrinkles in the elderly are caused by the loss of subcutaneous fat and collagen [7].
* Fluids & Vitamins:
* Sensible fluid loss via perspiration consists of water and electrolytes like sodium and potassium [3].
* Sunshine provides Vitamin D3, which helps absorb calcium and phosphorus [7].
4. Musculoskeletal System
* Bones:
* Types include flat, long, short, and irregular [9].
* Short bones: Found mostly in hands and feet [9].
* Long bones: Found in the leg, thigh, forearm, and upper arm [9].
* Irregular bones: Found in the vertebrae [8, 10].
* Skeletal Functions: Provide a framework, protect vital organs, produce red blood cells (RBCs), and act as attachment sites for muscles and tendons [9].
* Ligaments vs. Tendons: Ligaments attach bone to bone; tendons attach muscle to bone [9].
* Bone Growth & Remodeling: Growth occurs at the epiphyseal growth plate (proximal area of the epiphysis) [8]. Bone reabsorption and remodeling are handled by osteoclasts [9].
* Skeleton Divisions:
* Axial Skeleton: Skull, sinuses, vertebral column, thoracic rib cage, ribs, and sternum [8].
* Appendicular Skeleton: Upper and lower extremities, and the pelvic girdle [8].
* Specific Bones & Joints:
The *mandible** is the only movable bone in the skull [8].
* The wrist has 8 carpal bones, and there are 14 phalanges at the ends of fingers and toes [11].
Auditory ossicles (smallest bones) are the malleus, incus, and *stapes** (the absolute smallest) [8].
* Synarthrosis: Fixed joints (e.g., skull sutures, pelvis) [12].
* Amphiarthrosis: Slightly movable (e.g., symphysis pubis, spinal column) [12].
* Diarthrosis (Synovial joints): Freely movable, lubricated by synovial fluid [12]. Examples include gliding (wrist/ankles), hinge (knee/fingers/toes), pivot (head turning), and ball & socket (most movable) [12].
* Bursa: A flat sac lined by synovial fluid that reduces friction on a joint [12].
* Spinal Curvatures:
* Kyphosis: Forward curvature of the spine [8, 11].
* Scoliosis: S-curvature or lateral curvature [8].
* Lordosis: Exaggeration of the lumbar/lower spine [8, 13].
* Muscles & Movement:
* Types of muscle: Skeletal, smooth, and cardiac [8].
* Muscles obtain energy from oxygen and glucose during activity [8].
* Orbicularis oris: A facial muscle close to the mouth [4, 12].
* Hamstring group: Biceps femoris, semitendinosus, and semimembranosus [8].
* Isotonic Contraction: The muscle shortens and thickens, causing movement (e.g., swimming, jogging, bicycling) [8].
* Isometric Contraction: Muscle length does not increase, but muscle tension increases (e.g., pushing an immovable object or pulling a string) [8]. This is very good for bedridden patients [8].
* To walk on your heel, you must dorsiflex your ankle [7].
* Intramuscular (IM) Injection Sites: Rectus femoris (anterior thigh), vastus lateralis (lateral thigh), deltoid (upper arm), gluteus (outer glutes), ventrogluteal (outermost glutes), and dorsogluteal (the heaviest of all) [8]. Intradermal (ID) injections are deposited in the dermis [6].
5. Digestive System
* Mouth to Stomach:
* Uvula: Prevents food/fluid from entering the nasopharynx during swallowing [11, 14].
* Epiglottis: Prevents the passage of food into the windpipe (trachea) during swallowing [11].
* Salivary Glands: Parotid, submandibular, and sublingual glands [11, 15].
* Rugae: Mucosal folds in the inner wall of the stomach that allow for distension and increase surface area when full [16].
* Stomach Secretions: Mucus, gastrin, hydrochloric acid, and trypsin (an enzyme for the breakdown of protein) [16].
* Pyloric Sphincter: Regulates the entry of food from the lower stomach into the small intestine [16].
* Accessory Organs & Intestines:
* Liver: Detoxifies food, stores glycogen, produces heparin, and produces bile [11, 16, 17].
* Gallbladder: Stores bile (which emulsifies fat); if removed, the liver can take over its function [16, 17].
* Pancreas: Secretes amylase to digest carbohydrates [16]. Acinar cells produce pancreatic enzymes like lipase to digest fats [17].
* Duodenum: The shortest segment of the small intestine; it follows the stomach and receives bile from the gallbladder duct [17].
* Defecation: The elimination of feces [11].
* Dietary Adjustments: For indigestion, bloating, excess gas, or delayed gastric emptying, limit spicy and gas-forming foods [8].
6. Respiratory System
* Structures:
* Trachea (Windpipe): Bifurcates/divides into the primary bronchial tubes [14].
* Larynx: Where the vocal cords are located [15]. Hoarseness of voice is due to inflammation or injury to the larynx [6].
* Glottis: The opening on either side of the vocal cords [14].
* Thyroid Cartilage: Also known as the Adam's apple [18].
* Lungs: The left lung is divided into an upper and lower lobe by the oblique fissure [18]. The spongy appearance of the lungs comes from the alveoli [18].
* Pulmonary Respiration: Gas exchange takes place at the walls of the alveoli and the pulmonary capillaries [15].
* Breathing Mechanics & Volumes:
* Ventilation: Movement of air from the external to internal environment resulting from negative intrathoracic pressure (a vacuum) [18].
* Normal Respiratory Rate: 12 to 20 breaths per minute [18].
* Tidal Volume: The volume of air inhaled and exhaled with each normal breath [15].
* Vital Capacity: The maximum volume of air exhaled from the point of maximum inspiration [15].
* Cellular Respiration: Cells receive oxygen and dispose of carbon dioxide to tissues and capillaries [18].
* Brain Control: The medulla oblongata (in the brain stem) is the respiratory center [14, 15, 19]. During a stroke with left-sided weakness, you must support respiration because the medulla can be affected [15]. Damage to the cervical plexus (C1) will cause respiratory arrest and death [20].
* Conditions:
* Surfactant: Prevents collapse of the alveolar walls; develops between 24 and 26 weeks of gestation [18].
* Pneumothorax: A collection of air in the thoracic cavity [18].
7. Cardiovascular System & Blood
* Heart Anatomy & Conduction:
* Pericardium: Surrounds and protects the heart from over-distension [21]. Pericarditis is inflammation of the pericardium that causes a "rub" during auscultation [21].
* Apex of the Heart: Located in the fifth intercostal space on the left midclavicular line [21].
* Coronary Artery: Supplies nourishment to the heart [22].
* SA Node: The natural pacemaker of the heart [14].
* AV Node: Located in the right atrium at the lower portion [22].
* ECG: A diagnostic exam of the heart's electrical activity [14].
* Blood Flow:
* The left side of the heart has a higher oxygen content than the right side because it distributes freshly oxygenated blood from the lungs to the body [14, 23].
Three vessels drain deoxygenated blood into the right atrium: *Inferior Vena Cava** (drains abdomen/lower extremities), Superior Vena Cava, and the Coronary Sinus [6, 21, 22].
* Atrioventricular (AV) Valves: The Tricuspid valve is on the right, and the Mitral valve is on the left [21-23].
* Brachiocephalic Artery: A branch of the aortic arch that supplies the right arm and surrounding areas [23].
* Vessels & Pulses:
* Baroreceptors: Receptors in the blood vessel wall that detect changes in blood pressure [22].
* Dorsalis Pedis: The pulse located at the posterior (top) surface of the foot [22].
* Blood Components & Conditions:
* Erythrocytes (Red Blood Cells): Carry oxygen [22, 24].
* Leukocytes (White Blood Cells): The "warriors" that fight infection [22, 24].
* Thrombocytes (Platelets): Responsible for blood clotting [22, 24].
* Hypoxia: A decrease in oxygen in the lungs/tissues [21].
* Hypoxemia: A decrease in oxygen specifically in the blood [21].
* Pernicious Anemia: Caused by the loss of the intrinsic factor; treatment is giving Vitamin B12 (cobalamin or cyanocobalamin) [14].
8. Nervous System
* Divisions:
* Sympathetic vs. Parasympathetic: Both control involuntary or automatic body functions [24]. The sympathetic nervous system is involved in stress (releases epinephrine/norepinephrine) [25].
* Brain Structures:
* Frontal Lobe: Functions for judgment, planning, communication, and higher-level intelligence [24].
* Occipital Lobe: Functions only for vision (visual center of the cerebral cortex) [24, 26].
* Hypothalamus: The master gland; regulates appetite and body temperature (thermoregulation) [6, 20, 24].
* Corpus Callosum: Connects the right and left cerebral hemispheres [19, 26].
* Cerebrospinal Fluid (CSF): Produced in the choroid plexus and drained by the subarachnoid villi [24]. Trauma check: Fluid leaking from the nose and ears after head trauma can be tested for glucose; if positive, it is CSF leaking from the brain [20].
* Wernicke's Area: Damage here (common in chronic alcoholism/late-stage liver cirrhosis) causes a patient to lose the ability to comprehend written and spoken language, though they can still speak [27].
* Neurons & Nerves:
* Neuron parts: Dendrites, cell body, nucleus, and axon. The axon carries impulses away from the cell body [19].
* Cranial Nerves with Parasympathetic Activity: Oculomotor, Facial, Vagus, and Glossopharyngeal [19].
* Vagus Nerve: Innervates the heart, lungs, esophagus, and stomach [19].
9. Sensory System (Eyes & Ears)
* Eye:
* Anterior Chamber: Located between the cornea and the iris [26].
* Vitreous Humor: Maintains the shape of the eyeball [26].
* Fovea Centralis (Macula): Provides the sharpest vision [28].
* Visual Receptors (Retina):
* Rods: For dim light, known as scotopic vision [26, 27, 29].
* Cones: For daylight/color, known as photopic vision [26, 27, 29].
* Optic Nerve: Carries impulses from the retina to the brain [27].
* Optic Chiasm: Where the inner fibers of the optic nerve cross to the opposite side [26].
* Oculomotor Nerve: Controls eye movement [28].
* Presbyopia: The gradual loss of eye accommodation (focusing ability) in the elderly [26].
* Ear:
* Endolymph: Fluid inside the cochlea that transmits sound waves [28].
* Cranial Nerve VIII (Vestibulocochlear): Supplies the semicircular canal in the inner ear and regulates balance (equilibrium) during movement [28].
10. Endocrine System
* Endocrine vs. Exocrine: Endocrine glands produce hormones released into the bloodstream, whereas exocrine glands produce substances like sweat and tears [25]. Hormones are secretions produced by the endocrine glands [25].
* Pituitary Gland (Located in the sella turcica/Turk's saddle) [30]:
* Anterior Pituitary Hormones: Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH - regulates the graafian follicle), Growth Hormone (Somatotropic hormone - regulates bone and muscle growth), Adrenocorticotropic Hormone (ACTH), Lipotropic Hormone, and Prolactin (PRL - milk production) [6, 25, 31].
* Posterior Pituitary Hormones: Produced in the hypothalamus and stored here. There are only two: Antidiuretic Hormone (ADH) (reabsorption of water in the kidney) and Oxytocin (stimulates uterus contraction for delivery and mammary gland milk ejection) [6, 30].
* Thyroid Gland: Requires sufficient iodine (found in seafood/seashells) to function properly [6, 27]. Produces 3 hormones: T3, T4 (**thyroxine**, which determines the rate of metabolism), and calcitonin (which regulates calcium deposits by lowering blood calcium) [6, 25, 27, 30].
* Pancreas (Islets of Langerhans): Alpha cells produce glucagon (raises blood glucose), Beta cells produce insulin (lowers blood glucose), and Delta cells produce somatostatin [17, 25].
* Adrenal Medulla: Releases epinephrine and norepinephrine, which prepare the body for stress (like a fire) [25].
* Testes: Produce testosterone [6]. The Interstitial Cell Stimulating Hormone (ICSH) stimulates testosterone production [6].
11. Immune System
* Acquired Natural Passive Immunity: Immunity an infant receives directly from the mother [28].
* **Immunoglobulins (IGs):** IgG is the only one that crosses the placenta. IgA is found in breast milk [28].
* Lymphocytes: T-lymphocytes are produced and mature in the thymus [28]. A decrease in B and T lymphocytes means the client needs to be monitored for signs of infection [29].
* Non-specific Immunity: Includes tears (wash away irritants), cilia in respiratory mucous membranes, vomiting, defecating, and urinating [29].
12. Urinary & Reproductive Systems
* Urinary System:
* Nephron: The functional unit of the urinary system, composed of the glomerulus and tubules [6].
* Kidney Structure: The renal cortex is the outer layer, and the renal medulla is the inner layer [6].
* Ureters: Narrow tubes that travel from the kidney to the urinary bladder, moving urine drop by drop [6].
* Nitrogenous Wastes: Products of protein metabolism include uric acid, creatinine, and urea [6].
* Reproductive System:
* Estrogen: The hormone responsible for female secondary sex characteristics. A decrease in estrogen requires a diet change to low fat and low sodium [6].
* Menopause: During early signs of menopause, do not stop birth control pills immediately because pregnancy can still occur; couples must wait over a year [6].
* Endometrium: The mucous layer of the uterus that forms the maternal portion of the placenta during pregnancy [6].
13. Pediatrics (Newborns)
* Fontanels: The soft spots on a newborn's head. The anterior fontanel (front) is larger than the posterior fontanel (back) [6, 20].