ANP 1106 - Midterm 1 Review: Key Concepts in Anatomy university of ottawa, Exams of Advanced Education

Anatomical terms Define the anatomical position, the regional and the directional terms, as well as planes and sections Standard anatomical position : - - - - - - To describe the body/positions precisely Initial reference point = standard anatomical position Indication of direction (right and left refer to patient not observer) Important because needs to be universal way to describe body Standard anatomical position : Body erect Feet slightly apart Palms face forward with thumbs pointing away from body (in lateral position) Any deviation is NOT the anatomical position Anatomical orientation and directional terms :

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ANP 1106 - Midterm 1 Review: Key Concepts in
Anatomy university of ottawa
ANP 1106 - midterm 1 review
Anatomical terms
Define the anatomical position, the regional and the directional terms, as well as planes and
sections
Standard anatomical position :
- To describe the body/positions precisely
- Initial reference point = standard anatomical position
- Indication of direction (right and left refer to patient not
observer)
- Important because needs to be universal way to describe
body
- Standard anatomical position :
Body erect
Feet slightly apart
Palms face forward with thumbs pointing away
from body (in lateral position)
- Any deviation is NOT the anatomical position
Anatomical orientation and directional terms :
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ANP 1106 - Midterm 1 Review: Key Concepts in

Anatomy university of ottawa

ANP 1106 - midterm 1 review Anatomical terms Define the anatomical position, the regional and the directional terms, as well as planes and sections Standard anatomical position :

  • To describe the body/positions precisely
  • Initial reference point = standard anatomical position
  • Indication of direction (right and left refer to patient not observer)
  • Important because needs to be universal way to describe body
  • Standard anatomical position : ➢ Body erect ➢ Feet slightly apart ➢ Palms face forward with thumbs pointing away from body (in lateral position)
  • Any deviation is NOT the anatomical position Anatomical orientation and directional terms :

Body planes & sections : 3 common body planes - 2 vertical & 1 horizontal Sagittal plane Frontal plane Transverse plane

  • Vertical - Vertical - Horizontal
  • Divides body in right and - Divides body in anterior - Divides in superior and left and posterior inferior
  • Not in halves bc not - Also called coronal plane - Transverse section = cross identical section
  • Parasagittal plane = off center, around middle Oblique section : any section not taken at a 90 degree angle Describe the body cavities Dorsal body cavity :
  • Cranial cavity : enclosed by bones & cranium and houses the brain
  • Vertebral (spinal) cavity : enclosed by the vertebrae and houses the spinal cord
  • Both cavities are continuous and well protected

Ventral body cavity :

  • Larger; houses the viscera
  • 2 major divisions, separated by diaphragm
  • Lined by membrane
  1. Thoracic cavity (superior): divided into 2 lateral pleural cavities,medial mediastinum (containing central pericardial cavity
  2. Abdominopelvic cavity (inferior) : superior abdominal cavity (stomach, intestines, spleen, liver) and inferior pelvic cavity (bladder, some repro. organs, rectum) Membranes in ventral body cavity : Serosa :
  • Also called serous membrane
  • Thin, double-layered
  • Covers surface in ventral body cavity ➢ Parietal serosa : lines internal body cavity walls ➢ Visceral serosa : covers internal organs (viscera)
  • Double layers separated by slit-like cavity filled with serous fluid ➢ Secreted by both layers of membrane
  • Named for specific cavity and organs they are associated with ➢ Pericardium – » heart ➢ Pleurae – » lungs ➢ Peritoneum – » abdominopelvic cavity

Integumentary system

  • Skin + accessory structures (sweat & oil glands, hair, nails)
  • 1.5 to 4mm thick consisting of two distinct regions (range of thickness because different regions)
  • Epidermis : superficial epithelial region, layered, thick, keratinized stratified squamous epithelium
  • Dermis : dense connective tissue, vascularized
  • Hypodermis : not part of skin, mostly adipose tissue Describe the layers of the epidermis and the cells that compose them 4 types of epidermal cells :
  1. Keratinocytes
  • 95% of epidermal cells, arranged in layers
  • Function : produce keratin
  • 30 day lifespan
  • Epidermal growth factor : hormone involved in replacement, stimulates proliferation
  1. Melanocytes
  • Produce melanin which is packed into melanosomes
  • Deepest layer of epidermis
  • Melanin important because it protects from UV damage
  • Comes in different colours, skin tone depends on type & amount of melanin one produces
  • Often determined by where you live, if warm, darker skin
  1. Dendritic cells
  • Migrate to epidermis from bone marrow
  • Macrophages activate immune system, alerts the rest of the immune system
  1. Tactile cells
  • Epidermis/dermis boundary
  • Touch receptors
  • Skin is sensitive to touch, these cells pick up that info and nerve pathway takes it to brain to interpret Layers of the epidermis : Four major epidermal layers in thin skin (from deep to superficial)
  1. Stratum basale : deepest layer, one row of actively mitotic stem cells
  2. Stratum spinosum : several keratinocyte layers, starting to mature, pre-keratin
  3. Stratum granulosum : 1 - 5 layers of flattened cells
  4. Stratum corneum : most superficial layer, 20 - 30 layers of dead cells filled with keratin

Thick skin contains five layers and is found in high abrasion areas (hands & feet, constantly in contact and at risk)

  1. Stratum basale
  2. Stratum spinosum
  3. Stratum granulosum
  4. Stratum lucidum (only in thick skin)
  5. Stratum corneum Describe the layers of the dermis
  • Not as many layers as epidermis
  • Strong, flexible connective tissue
  • Cells : fibroblasts, macrophages, mast cells and WBCS
  • Semi-fluid, embedded with collagen, elastin and reticular fibers
  • Contains nerves, blood vessels, lymphatic vessels, hair follicles, oil glands, sweat glands Layers of the dermis :
  1. Papillary (thin, superficial)
  • CT fibers interspersed with blood vessels
  • Dermal papillae : superficial region of dermis, indents epidermis ➢ contains capillary loops (source for blood supply), free nerve endings (sensory), corpuscles
  • Friction ridges : ➢ On palms of hand and soles of feet ➢ Enhance gripping, contribute to sense of touch, sweat pores leaves unique fingerprints ➢ Develop pre-birth ➢ Persistent during life except permanent scarring (burns) ➢ Details are unique, even identical twins is slightly different ➢ Overall patterns may vary within limits, allows classifications ➢ Fingers print are picked up because sweat pores open when we touch something
  1. Reticular (thick, deep) :
  • Deeper, thick irregular CT
  • Thick collagen bundles in different directions
  • Source of cleavage (tension) lines ➢ Important to surgeons because if you make incision on cleavage lines, heals faster
  • Collagen gives strength & resilience
  • Maintains skin hydration (binds to water)
  • Elastic fibers provide stretch-recoil, if you pinch skin and let go, it goes back

Describe the accessory structures of the skin Hair follicles, nails, sweat glands, sebaceous glands Hair (pili):

  • Flexible strands of dead, keratinized cells
  • Produced by hair follicles
  • None on palms, soles, lips, nipples & portions of external genitalia
  • Functions : sensory receptors, guard head from trauma, heat loss, sun/shield eyes/ filter particles from air (nose hair)
  • Composition : hard keratin (more durable) A) Hair shaft :
  • Medulla : large cells separated by air spaces, absent in vellus hair
  • Cortex : several layers of flattened keratinocytes, contains pigment
  • Cuticle : single layer of overlapping cells
  • Split ends are when the cuticle is damaged, raised area gets caught
  • When hair turns grey or white, less melanin is being produced, replaced by air bubbles, causes colour loss
  • Hair shaft shape determines if hair is straight or curly B) Hair structure :
  • Shaft : part that projects from skin
  • Root : part embedded in skin
  • Bulb : expanded deep end of follicle
  • Follicle : outer CT root sheath & inner epithelial root sheath (hair matrix)
  • Arrector pili muscle : contract to pull hair up and dimple skin (goosebumps)
  • Sebaceous glands : secretes sebum (oily, lubrication, waterproofing, bactericidal) C) Structure of hair follicle :
  • Hair papillae : dermal tissue containing a knot of capillaries, supplies nutrients
  • Hair matrix : dividing area of bulb, produces hair cells, pushes old ones up
  • Arrector pili : small band of smooth muscle attached to follicle (goosebumps) D) Types and growth of hair :
  • Vellus hair : covers body, fine hair, pale, on children, missing medulla
  • Terminal hair : hair, eyebrows, pubic area, faces (males), growth phase longer than vellus hair
  • Nutrition + hormones affect hair growth, 2 - 2.25 mm growth per week/lose 90 scalp hair daily
  • Follicles cycle between active (growth) and regressive (resting) phases (each hair has a certain amount of cycles before done) E) Hirsutism :
  • Excessive body hair
  • Production on body parts that are not common
  • Women grow hair like men F) Alopecia :
  • Level of hair thinning with age (both male and female, after 40)
  • Baldness, often patchy, autoimmune in origin, attack on hair follicles G) Male pattern baldness :
  • Genetically determined, gender-influenced
  • Altered response of hair follicle to androgen, which shortens growth cycle Nails :
  • Hard keratin, scale-like modification of epidermis (protective tool)
  • Free edge, body, nail folds (2 lateral, 1 proximal)
  • Consists of hard dead product, nail palate, four epithelia : proximal nail fold, nail matrix, nail bed, hyponychium
  • Nail bed : epidermis under keratinized nail
  • Nail folds : ➢ Eponychium : cuticle ➢ Hyponychium : under free edge, accumulates dirt
  • Nail matrix : thickened portion of bed, responsible for nail growth (lunule : thickened matrix, appears white)
  • Nails can help in diagnosis of diseases ➢ Yellow nails = respiratory or thyroid gland disorder ➢ Koilonychia (spoon nail) : outward concavity of nail = iron deficiency ➢ Beau’s lines : horizontal lines across nails = uncontrolled diabetes, heart attack, cancer chemotherapy

Explain the major functions of the skin Protection : 3 types of barriers

  1. Chemical :
    • Acidic skin secretions retards bacterial replication
    • Sweat contains dermacidin and other ante-bacterial agents
    • Melanin protects against UV rays
  2. Physical :
    • Barrier to trauma & bacterial invasion (what we are familiar with)
    • Waterproofing
    • Not impermeable to gasses, fat-soluble vitamins/steroids, salts of heavy metal
  3. Biological :
    • Langerhans cells of epidermis and macrophages in dermis Thermoregulation : sweating (0.5- 12 L daily), insensible vs. sensible Cutaneous sensation : tactile information picked up (ex : pain) Metabolic : Vitamin D needed for absorption of Ca2+, conversion of cortisone to hydrocortisone Excretion : some N-containing wastes (NaCl, & H 2 O loss via sweat) Blood reservoir : dermis can hold 5% of total blood volume Burns
  • Tissue damage caused by heat, electricity, radiation, chemicals
  • Classified by severity : ➢ First degree : only epidermis damaged (4-5 layers of dead cells, redness) ➢ Second degree : epidermis & upper dermis (blisters) ➢ Third degree : entire thickness of skin, epidermis + dermis (bones or muscles can be exposed)
  • First concern : fluid loss ➢ Hypovolemic shock, affect blood volume, heart has nothing to pump = death
  • Second concern : infection ➢ IV replenishes fluids in patient to prevent
  • Potential for repair : skin grafting (one area to burnt, artificial skin, skin bank) Rule of nines :
  • To evaluate burns
  • Used to estimate volume of fluid loss
  • Body is broken down into 11 sections
  • Each sections represents 9% of body surface (except genitals = 1%)

Anatomy of the Skeletal System Compare the structure of bony tissues and cartilages Cartilage :

  • Features between dense CT (ligaments & tendons) and bone =» tough but flexible
  • Avascular, no nerve fibers
  • Chondronectin = adhesive protein, allows to connect to cells
  • Collagen fibers (and some elastin)
  • Up to 80% H 2 O
  • All types made of cells in small cavities (lacunae) in a jelly-like extracellular matrix
  • Perichondrium : layer of dense CT surrounding cartilage (quite firm, does not allow expansion) ➢ In damaged area, can form scar tissue bc poorly vascularized = repairs badly
  • Chondroblasts : immature cartilage cells, actively form cartilage
  • Chondrocytes : mature cartilage cells, maintain cartilage
  • Lacunae : localized clusters of chondrocytes in cartilage ➢ Why? : When perichondrium cells divide, they can’t expand so they are trapped and cluster together Types of cartilage :
  • Hyaline cartilage : ➢ Most abundant ➢ Firm support + pliability ➢ Lots of collagen, appears glassy white ➢ Chondrocytes - only 1-10% of volume ➢ Ends of long bones, nose, trachea, larynx
  • Elastic cartilage : ➢ Like hyaline but more elastic fibers ➢ External ear, epiglottis because need to be able to bend, flap open and closed
  • Fibrocartilage : ➢ Rows of chondrocytes alternating with rows of thick collagen ➢ Great tensile strength ➢ Discs of knee joints, intervertebral discs Bone tissue :
  • Bone = living dynamic tissue, responds to environment
  • Bone reacts to amount of force applied by increasing density and amount of roughening or decreasing density when force is reduced/eliminated (ex : paralysis) ➢ Stress bone, becomes thicker, more you pull the rougher the point of attachment ➢ Deposition : process where new bone is formed ➢ Resorption : dissolving of bone to release calcium
  • Bone stores calcium - resorbed & transferred to bloodstream when needed ➢ Calcium salts give hardness and strength for support/protection of softer tissue ➢ Cavities for fat storage and synthesis of blood cells ➢ Bones are bendy if lack of calcium (imagine femur is bendable)

Long bones :

  • Much longer than wide
  • Shaft = 2+ ends
  • Mostly compact bone with marrow cavity
  • Spongy bone near joint ends
  • Mostly in limbs
  • Ex : femur, fibula, tibia Short bones :
  • Roughly cube-shaped
  • Mostly spongy bone + thin outer layer of compact bone
  • Ex : bones in wrists or ankles Flat bones :
  • Thin, flattened & sometimes curved
  • Ex : skull, bones, ribs, sternum, scapula Irregular bones :
  • Leftovers
  • Complicated shapes
  • Mostly spongy bone + thin covering layer of spongy bone
  • Ex : vertebrae, hip bones Structure of typical long bone :
  • Diaphysis (shaft): ➢ Tubular shaft of long bone = long axis ➢ Collar of compact bone surrounding marrow cavity (medullary cavity) ➢ In adults, medullary cavity contains fat (yellow marrow) and is called the yellow bone marrow cavity
  • Epiphyses (bone ends) : ➢ Extremities of long bone, expanded for articulation with other bones ➢ Compact bone externally, interior filled with spongy bone ➢ Thin layer of hyaline cartilage on outer surface, responsible for longitudinal growth of the bone
  • Epiphyseal lines (membranes) : ➢ Between diaphysis & each epiphysis ➢ Remnant of epiphyseal (growth) plate Structure of short, irregular and flat bones :
  • All 3 have similar structure : compact bone outside, spongy bone inside
  • Periosteum : covers outside of compact bone
  • Endosteum : covers inside portion of compact bone + spongy bone
  • Not cylindrical = no shaft, marrow cavity or epiphyses
  • Contain bone marrow between trabeculae
  • Hyaline cartilage covers articular surfaces

Describe the microscopic structures of bones Microscopic structure of compact bone (lamellar bone) :

  • Consists of osteon, canals and canaliculi, interstitial and circumferential lamellae
  • Osteon (Haversian system) : ➢ Structural unit of compact bone ➢ Elongated cylinder that runs parallel to long axis of bone ➢ Acts as tiny weight-bearing pillars ➢ Several rings of bone matrix called lamellae
  • Haversian (central) canal : series of microscopic tubes in the outermost region of bone
  • Volkmann’s (perforating) canal : perpendicular to long axis and central canals, help transport nutrients to bone tissue and supply blood from the periosteum
  • Osteocytes : mature bone cells, sit in lacunae within bony matrix in areas where adjacent lamellae meet
  • Canaliculi : small canals, connect lacunae with each other, also connected to central canal of haversian system
  • Interstitial lamellae : fill the gaps between forming osteons or leftovers of previous osteons destroyed by bone remodeling
  • Circumferential lamellae : sheets of bone located just deep to periosteum, extend around circumference of shaft Microscopic structure of spongy bone :
  • Contains trabeculae, lamellarly arranged osteocytes & canaliculi
  • Trabeculae arranged along lines of stress, helps bones resist stress
  • Trabeculae only a few cell layers thick, contain irregularly arranged lamellae & osteocytes connected by canaliculi
  • No osteons
  • Nutrients diffuse through canaliculi from marrow spaces between trabeculae to reach osteocytes Histology of bone tissue :
  • In short bones, only primary ossification center is formed
  • Most irregular bones are formed using several ossification centers
  • When secondary ossification is complete, hyaline cartilage remains : ➢ On epiphyseal surfaces (articular cartilage) ➢ Junctions of diaphysis and epiphyses : forms epiphyseal plates Bone growth :
  • Infancy & youth, long bones lengthen only by interstitial growth of epiphyseal plates
  • Grow in thickness by appositional growth
  • Most bones stop growing during adolescence/early adulthood ➢ Some facial bones continue to grow throughout life (ex : nose, lower jaw) Bone modeling/remodeling :
  • When bone lengthens, shape of ends must be altered (remodeling)
  • Epiphyseal plates located in wider parts of long bones but diaphysis will get longer
  • Bone has to be reshaped to be incorporated into diaphysis ➢ Diaphysis also has to get thicker and stronger as bone lengthens
  • Summary :
  1. Bone is destroyed by osteoclasts
  2. Laid down by osteoblasts on inner and outer surfaces of a growing long bone
  • Epiphyseal plates same size throughout childhood and adolescence ➢ Why? : cartilage cells produced are replaced by bone
  • Becomes thinner (cartilage cells multiply more slowly)
  • Longitudinal growth ends when bone of epiphysis and diaphysis fuse (epiphyseal plate closure, about 18 in females and 21 in males) Growth in width :
  • Appositional growth
  • Layers of bone laid down on top of one another
  • Osteoblasts on periosteal side secreting bone matrix
  • Osteoclasts on endosteal side secreting bone matrix Fracture repair : Four major stages :
  1. Hematoma formation :
  • Local bone cells deprived of oxygen and die
  • Inflammation causes pain
  1. Fibrocartilage callus formation :
  • Invaded by blood vessels that also bring macrophages to clean up area
  • Osteoclasts resorb damaged bone
  • Fibroblasts,chondroblasts and osteoblasts lay down collagen fibers and tissue components to span the break
  1. Bony callus formation :
  • Cartilage converted to trabecular bone
  • Complete in 2 months
  1. Bone remodeling :
  • Extra bony material is removed
  • Outer bone of shaft walls converted to compact bone and bone regains original shape
  • Can take a few years Osteoporosis :
  • Bone resorption » bone formation » bone becomes porous
  • Some areas of skeleton more vulnerable : spine, neck of femur
  • Risk factors : ➢ Age/estrogen and testosterone promote bone health by restraining osteoclast activity and promoting deposition of new bone
  • Other factors : insufficient exercise / poor calcium and protein diet / abnormal vitamin D receptors / smoking (reduces estrogen) Bone markings : Name of bone marking Description Muscle and ligament attachment Tuberosity Large, rounded projection (roughened) Crest Narrow ridge of bone, prominent Trochanter Large, blunt, irregularly shaped process (femur)