Chapter(1)

Anatomy of cardiovascular
system

 CVS is formed of

• the heart is the pump
• blood vessels which formed of arteries, veins, and capillaries.

Heart

Location
• A person closed hand
• Lies in the middle of the chest cavity
• Psteriorly it lies against 5-8th thoracic vertebrae

The cardiac wall is formed of 3 layers
• Epicardium : is the outer layer
• Myocardium : is a thick, muscular, contract automatically and it doesnot fatigue.
• Enndocardium: is lining of the myocardial wall.

  Chambers of the heart
• There are 4chambers
• 2 above called atria
• 2 below called ventricles.

  Atria
• Are left and right.
• Separated by a septum
• Receiving blood from the big veins
• Atrial wall not thick

Ventricles
• Pumping chambers right and left
• Their wall is thicker than the atrial wall
• left ventricale pumps blood to every part of the body, so its wall is the thicker one.

Cardiac valves
• permit blood flow only in one direction.

A.atrioventricular (AV) : two valves
• Tricusped valve:is right AV valve, has 3 flaps
• Mitral valves: is left AV valve, has 2 flaps.

Semilunar valve (SL): Two valve
• aortic valve: presents between left ventricale and aorta.
• pulmonary valve:presents between right ventricle and pulmonary artery.

Blood flow through the heart:
• Blood will be collected by superior and inferior vena cavae to right atrium
•  then its flows through tricuspid valve into right ventricle,
• then through pulmonary valve to pulmonary artery to the lung ,
• here the blood will be oxygenated,
• then it flow back through 4pulmonary veins to the left atrium,
• and pass through mitral valve into left ventricale to pass through aortic valve to the aorta.

Blood supply of heart tissue
• Right and left coronary artries supply myocardiac cells with blood.

Nerve supply of the heart:
• Sympathetic fibers:3 branches, increase cardiac activity
• Parasympathetic: part of vagus nerve, depress cardiac activity

Blood vessels
Types of blood vessels
Artery:
• carries blood from heart to periphery
• conducts oxygenated blood, except the pulmonary artery.
Vein:
• carries blood from periphery to the heart.
• conduct nonoxygenated blood, except 4 pulmonary veines.
Capillary:
• Carries blood from arteriole to venule

Function of blood vessels
The main function is blood transport.
• Arteries
o distribution o blood
o keep blood pressure proper to his unction.
• Veins
o collect the blood , their wall-------distend
- Capillary
o it decrease the blood pressure.
o it makes the blood flow is slow.

 Chapter(2)

Physiologyof the cardiovascular
System(CVS)

Physiology of cardiovascular system
The role of CVS depending on 2 factors
• Pumping of heart
• Peripheral resistance

Conducting system of the heart is formed of
• SA node
• AV bundle
• Purkinjie fibres
• AV node
It beginning in SA node (pacemaker) to make rhythmic activity without any stimulation from CNS, each impulse travels to both atria, reaching AV nod,this allows full contraction of both atria, the velocity of impulse will increase through AV bundle and purkinjie fibers to ventricular muscle to contract at the same time.

Ellectrocardiogram (ECG waves)
• Record the electral activity
• Its not record heart contraction. 

P wave:depolarization of both atria.
QRS:-ventricles depolarization
         -atria repolarization
T wave:ventricles repolarization

Natural blood pressure
1.In systemic  circulation (120/80)
• Systole(120):ventricles contractions.
• Diastol(80): ventricles relaxations.
   2. In pulmonary circulation (25/8)
• Systole(25):ventricles contractions.
• Diastol(8): ventricles relaxations.

Heart Sounds
• The heart makes sounds during cardiac cycle(dob,lop)
First sound:
• Caused by contraction of ventricles and closure AV valve (systole)
Second sound:
• Cause by closure of semilunar valve (SL)

Factors affecting blood pressure
• Cardiac output
• Perphral resistance.
Pulse
• Expantion and recoil of artery
Depends in 2 factors:
1. Cardiac pumping.
2. Elasticity of arteriolar wall.

 Chapter(3)
             
The blood

Blood:
• One of the body fluid compartment
• Forms 6-8% of total body weight

Function of blood
• Transport medium (oxygen, hormones& enzymes)
• Heat regulation system
• Water balance

Blood volume
• Young male about 5-6 liters
• Young female about 4-5 liters

Two elements of blood
1. Plasma
• flouid part of blood represents 55%.
• 90% water& 10% solutes.
2. Formed elements
• Red blood cells(RBC)
 One third of the cell formed hemoglobin(HB)
 In man RBC number 5.5 million/mm3
 In woman 4.8 million/mm3
 The functhion of RBC transport of O2& CO2
 Average life RBC 105-120 days.
Note:-
 each 100ml of blood in male contains 14-16 grams of HB
 while in woman each 100ml contains 12-14 grams of HB
                       Anemia:-
 means each 100ml of the blood contains less than 10gr HB
  
                        

• White blood cell(WBC)
 5000-11000/mm3
 5 types of RBC according to the presence of the cytoplasmic granules
I- Granulocytes:-  a.Neutrophil
                                b. Basophil
                                c. Essinophil.
II- Agranulocytes:- a.Lymphocyte
                                  b.Monocytes
 The main function of WBC is immunity.

Notes:-
 Leukopenia:- The total count of WBC is less than
                              5000/mm3
 Leukocytosis:-The total count of WBC is more than             11000/mm3

• Platelets
 Count 150.000- 350.000mm3
 The main function of platelets is blood clotting.
 Average life 7 days.

Blood group
Blood group means the type of antigens present in RBC membrane, in other hand there are antibodys in plasma that react in specific group antigen.

ABO system
Blood types are named according to the antigens present on RBC membranes.
 Group types
 Type A:-
- RBC contains antigen A
- Plasma contains anti B antibodies
 Type B:-
- RBC contains antigen B
- plasma contains anti A antibodies
 Type AB:-
- RBC contains antigen AB
- Plasma contains no antibodies
 Type O:-
- RBC contains no antigen

RH system
 RH positive :- RBC contains antigen  on its membranes
  RH negative:- RBC has no antigen on its membranes

Notes:-
 O –ve :- universal donar
 AB +ve:-uneversal recepiant

 
Chapter(4)

Lymphatic system

 Lymphatic system

Lymphatic system is formed of 3 elements
• Lymph vessels
• Lymph
• Lymph nodes

Functions of the lymphatic system
• Immunity
• Fluid balance

Lymph and interstitial fluid
• Lymph is clear watery fluid found in the lymphatic vessels

Chapter(5)
Anatomy of respiratory
System(RS)

Anatomy of respiratory system (RS)

Structure:- two tracts
 Upper respiratory tract(present outside chest cavity)
a. Nose
b. Pharynx
c. Larynx

 Lower respiratory tract( present in chest cavity)
a. Trachea
b. Bronchial
c. Lungs

Functions of the respiratory system
a. Air dirbution.
b. Gas exchanges
c. Filtration, warming& humidification
d. Sense of smell
e. Influencing sound production

 Upper respiratory tract:-
A. Nose
Two portions:-
- external nose
- internal nose(nasal cavity)

            functions of the nose
a. air passage
b. filtration
c. warming
d. smelling
e. chemical examination

 Para nasal sinuses:-
                                   contains air spaces, that open or drain into nasal cavity.

   Types of sinuses
a. frontal sinus
b. maxillary sinuses
c. ethmoid sinuses
d. sphenoid sinuses
     
                      
Sinusitis:-
                 Infection of the Para nasal sinuses.

B. pharynx
 functions of pharynx
a. pathway for respiratory & digestive tracts
b. change of the phonation

C. Larynx( voice box)
        Its triangular shape formed of cartilages.
       Cartilages of the larynx
a. Thyroid cartilage (Adams apple), it’s the largest larynx cartilage
b. Epiglottis, behind the tongue
c. Cricoid, posterior wall of larynx

        Functions of larynx
a. Vital airway of the lungs
b. Voice production
c. Humidification & warming of the air

 Lower respiratory tract:-
A. Trachea:-
- tube like 11cm long                                                    
- diameter, 2.5cm
- extends from larynx  to the primary bronchi

                                 Function of trachea is air passage
                                                            

                                                            Bronchi:-
                The trachea divides into tow primary bronchus

RT bronchus:- larger
                        -divides into three secondary bronchi

LT bronchus:- smaller
                        - divides into tow secondary bronchi

Notes:- bronchi divides to many bronchioles to be lastly small tube ended as
                alveoli 

 Alveoli:-
               These are the primar gaz exchanges.

 Functions of alveoli
 Gas exchanges                                                                   
 Distribution of the air
 Cleaning of the ear                                                    
 Warming of the air

                                                                    
 
Lungs:-
              Each lung has three surfaces
 Costal surface:- direct contact with the chest wall
 Medial surface:- the room of mediastinal structure
 Inferior surface:- diaphragmatic

Rt lung:- is divided into three lobes, upper, middle & lower lobes.
Lt lung:- is divided into upper& lower lobes.

Functions of lunges:-
                                    Gas exchange, getting O2 and giving CO2

Thorax cavity:-
                           Chest cavity is lined by serious membrane called pleura.

The pleura:-
 Parietal pleura
 Visceral pleura
 

Physiology of respiratory
system

 Physiology of the respiratory system
Process of respiratory system
 Breathing (pulmonary ventilation)
 Gas exchanges
 Gas transport by blood.
 
 Breathing:-
Two phase
a. inspiration
b. expiration

a. Inspiration:-
During inspiration the air will rush from atmosphere to the lung according to the pressure gradient.

b. Expiration:-
During the expiration the air will rush out the chest cavity according to passive process

 Gas exchange
a. exchange of gases in the lung:-
occur between the alveolar air and the blood capillaries for oxygenation of the blood.

                  b.   transportation of  gases by blood 
           O2 is carried in two forms:-
• dissolved O2 in plasma, its only 0.3ml per 100ml of blood.
• Oxyhemoglobin, each each gram of heamoglobin can unite with 1.34ml of O2 

          CO2 is carried by:-
• Dissolved CO2 in the plasma = 10%
• Carbainine compound 20-25 with NH3 (amine).
• Bicarbonate, more than 66% of CO2 is carried by form HCO3 and some of CO2 by form H2CO3.

   Regulation of brathing
 Regulation centers:-
• Rhythmic center(in medulla oblongata)
a. Inspiration :-by inspiratory centre.
b. Expiration :- by expiratory centre.
• Apneustic centre( in the pons)
This centre stimulates the inspiratory centre in the medulla to increase the length and depth of inspiration.

• Pneumotaxic centre(in the pons)
This centre inhibits both apenustic and inspiratory centres, to prevent over inflation of the lung.

common problems &diseases in RS
Pneumonia
Inflammation in the lung

Sleep Apnea
Sleep Apnea is the intermittent absence of breathing during sleep

COPD
Chronic (continual, permanent, incurable)
Obstructive (blocks)
Pulmonary (pertaining to the lungs)
Disease (condition with signs and symptoms)
COPD or chronic obstructive pulmonary disease has no single definition.

Chronic bronchitis
Inflammation in the bronchus
occurs when the airways in your lungs have become narrow and partly clogged with mucus.

Emphysema
Emphysema is an enlargement and destruction of the alveoli (air sacs) in the lungs. This causes the surrounding airways to collapse.
Asthma
Asthma is a chronic lung condition characterized by: one or a combination of the following breathing problems: cough, wheeze, shortness of breath, or chest tightness.

  Chapter(7)

Anatomy of the digestive system

Anatomy of the digestive system

Structure:-
• GIT, Gastrointestinal tract
• Digestive glands

Digetive system is the system of:-
• Alteration of the physical and chemical composition of the food.
• Digestion
• Elimination through defecation

1) Mouth:-
Structure of oral cavity
• Lips
• Cheeks
• Tongue
• Palate

Teeth
Teeth are organ of chewing

Types of teeth
• Decidous teeth:-
                                -20 teeth
                               -Appears at age 6 months & completed at age 2 years
• Permanent teeth:-
- 32 teeth
- Appear at age 6 years

2) pharynx
• pathway for respiratory & digestive tracts
• change of the phonation

   
3) esophagus
• 25 cm long
• Extends from the pharynx to the stomach
• Presents posterior to the trachea and the heart

4) Stomach
• Collapsible ponch
• Tube like
• Hold avolume 1-5 litter.
     Position:- it lies in the epigastrium and left hypochondrium.
      It has 3 parts:-
• Fundus
• Body
• Pylorus

Sphincters
• Lower esophageal
• Pyloric

Functions of stomach:-
• Reservoir for food till it can be partially digested
• Secreation of gastric juice enzymes & acid
• Secretes gastrin hormone, that regulating digestive function.
• Anti microbial function

5) Small intestine
          Its a tube 2.5cm wide and 6 meter long
Formed of 3 parts:-
• Duodenum
• Jejunum
• Ileum

Small intestine wall
• Mucosa
• Sub mucosa
• Muscular
• Serosa

Formed of three parts
• Cecum, in the Rt iliac fossa
• Colon, 4 parts
 Asceanding colon
 Transverse colon
 Descending colon
 Sigmoid colon
• Rectum, the last part of the GIT

Anal canal
It’s the last 2.5 cm of the rectum

Anus
The opening of the anal canal.

Hemorrhoid (pils)
Are the varicose of anal veins( of the anal canal)

Apendix
• Atube like 8-10 cm long
• Presents at the Rt iliac fossa
• Just behind the cecum
Fuction
• Defense mechanism
• Medium for intestinal bacterial growth

Digestive glands
1) Salivary glands
• Paroted:- between the skin and underlying  masseter muscle below externalear.
• Submandibular:- located below the mandibular angle
• Sublingeal
                                

 

           Functions of liver
• Detoxification of various substances e.g Alcohol
• Secretion of bile salts and bile pigments
• Secretion of plasma proteins
• Blood cell formation
• Storage of several substances e.g iron, vitamin A, B12 and D

                                                  
                                                                                                 
 Gall bladder
• Lies under the surface of liver
• 7-10 cm long
• Can hold 30- 50 ml of bile

Functions
• Storage of bile till the time of evacuation
• Concentration of bile

Pancreas
Parts of pancreas
• The head:- lies between the duodenum
• The body:- lies behind stomach
• The tail:-touch the spleen in the left side

Size:- 12-15cm long

Structures of pancreas
Pancreas formed of two glandular tissue
• Exocrine gland:- represents the majority of pancreas,
                                 - the tissue is acinar
• Endocrine gland:-between the exocrine gland.
- pancreas islets ( alpha& beta cells)

functions of pancreas
• the acinar units:- secrete the digestive enzymes in the pancreatic juice
• beta cells:- secrete insulin (hypoglycemic hormone)
• alpha cells:- secrete glucagons( hyperglycemic hormone)

 Chapter(8)
Physiology of digestive
system

 Physiology of digestive system
The primary function of digestive system is to make the essential nutrients available for every cell in the body .

Digestion
Includes tow process
1) Mechanical digestion
2) Chemical digestion

1) Mechanical digestion
Includes the mastication, mixing with digestive juice, till the elimination

A- Mastication
• Oral stage:- voluntary
           -tongue will press the bolus, pushing it backward to 
     the oropharynx   
• pharyngeal & esoohageal stages:- involuntary
                                                              - will push the bolus to the  ---                      -                                                              - stomach
         
            During this stage three opening wll be closed: -
• the mouth:- by the tongue
• the oropharynx:- by the soft palate
• larynx:- by the epiglottis

B- Motility:-
• Peristalsis:- wave like
                         - step by step
                         - contraction & relaxation
• Segmentation:-forward& backward
- movements occur within a single region(segments)

            Regulation of motility
a. Gastric motility
b. Hormonal
c. Nervous
d. Intestinal motility
                                                                                                    

 2) Chemical digestion
   Means changes in food composition through the GIT

• Protein digestion:- by proteases (enzymes) that hydrolyze proteins
                                     - proteases are, pepsin(gastri)& typsin(pancreatic)
• Fat digestion:- Emulisification, change fat to very small droplets
          - Pancreatic lipease--- fat digesting enzyme.
Secretion:-
     The digestive secretion includes the release of saliva, gastric, pancreatic,     
      And intestinal juices.

Absorption
The passage of ingested food, water, salts and vitamins through the intestinal mucosa to the blood.

Vomiting
Expulsion of food through mouth.

Defecation:-
Is the process of expulsion the waste product of food

Constipation
Occurs when the lower colon content move slower than normal so the water will be absorbed

Diarrhea
Occurs when the movements through the small intestine too quickly

Epigastric pain
Pain in the stomach

Peptic ulcer
Ulceration in the stomach

Deodenum ulcer
Ulceration in the duodenum

Hepatitis
Inflammation in the liver

Cholicystitis
Inflammation in Gall bladder

Appendicitis
Inflammation of appendix

 Chapter(9)

Anatomy of urinary
system

  The urinary system

Structure:-
1) Kidney:- the principle organ of the urinary system
2) Ureters
3) Urinary bladder
4) Urethra

Kidney
Size:- 11 cm by 7 cm by 3 cm
Site:-  along the sides of the vertebral column, extend from the level of T12      to the level of L3.

The right kidney:- is slightly lower because of the liver.

 
Kidney tissue:-
Each kidney is formed of:-
a. Cortex:- the outer region
b. Medulla:- the inner region

Renal blood vessels:-
a. Renal artery
b. Renal vain
c. Interlobar arteries
d. Interlobar vein

Ureter:-
• It’s a tube about 25cm long
• Its formed 3 layers: -Mucosa
                                        -smooth muscle layer
                                        -Fibrous layer

Urinary bladder:-
• It’s a collapsible bage
• Present just behined the symphysis pubis
• Have 3 opening

Function
• Reservior for urine, average volume is about 250cc
• Expels urine from the body.

Micturation(voiding):- starts by
• Voluntary relaxation of the external sphincter of the bladder
• Bladder muscle contraction, internal sphincter relaxation.

Incontinence:- means involuntary urination

Nephron:-
Is the structurel unit of the kidney, there are 1.25 million per kidney 

Physiology of urinary system

 Physiology of the urinary system

Functions of the kidney:-
• plasma homeostasis
• keeping fluid electrolyte and acid base
• influence the rate of secretion of antidiretic hormone(ADH) and aldestrone.
• The synthesis of active form of vit D

Kidneys perform their function through 3 processes
• Filtration
• Reabsorption
• Tubular secretion

1) Filtration:-
• Is a physical process occurs in renal corpuscles.
• Water and small solutes filter out of blood into bowmans capsules.
• the only blood cells and most plasma proteins that don’t move out.

2) Reabsorption:-
• Reabsorption of Na through active transport
• Glucose and aminoacid passively absorped in accompanying with Na.
• Water, passage of Na and Cl from tubules to the blood will create osmatic pressure, drives water out the tubules to the blood
• Urea, will be reabsorped passively

3) Secretion:-
is the movement of substances out of blood into tubular fluid

Urine composition:-
• Electrolytes e.g Na, K, CL
• Toxins, during disease, bacteria
• Pigments
• Hormones
• Urea, uric acid, creatinin, ammonia
• Abnormal conditions, blood, stones, glucose, albumin.