MIDTERMS

FOHA 111 LECTURER: MIRACLE GOTIANGCO, PTRP

 General Senses - scattered throughout the body. hairs and the wax provide a sticky barrier that prevents the
 Somatic Senses - tactile (touch sensation), thermal (cold/hot entrance of foreign bodies.
sensation), pain, and proprioception (position sense).  The sensory nerve supply of the lining skin is derived from the
 Visceral Sensation – feeling sensations inside the internal auriculotemporal nerve and the auricular branch of the vagus
organs. nerve.
 Special Senses - concentrated to one or two particular structure,
more an complex than the general senses and can only be found BOUNDARIES OF THE MIDDLE EAR
in the head. Formed by a thin plate of bone, the tegmen
Roof
tympani.
AUDITORY APPARATUS, ORGANS OF HEARING, AND Formed by a thin plate of bone, which may be
EQULIBRIUM partly replaced by fibrous tissue. It separates the
Floor
tympanic cavity from the superior bulb of the
Hearing = Audition internal jugular vein.
Anterior Thin plate of bone that separates the tympanic
Divisions of the Ear wall cavity from the internal carotid artery.
 External ear - Auricle and an external auditory meatus. In its upper part a large, irregular opening, the
aditus to the mastoid antrum. Below this is a
Posterior
Auricle or pinna – outside of the ears, flap of elastic cartilage, looks small, hollow, conical projection, the pyramid,
wall
like a trumpet. from whose apex emerges the tendon of the
External auditory meatus – tube inside the ear, collects the sound stapedius muscle.
waves. Lateral wall Formed by the tympanic membrane (ear drum).
Medial wall Formed by the lateral wall of the inner ear.
 Middle ear, or tympanic cavity - Air-containing cavity in the
petrous part of the temporal bone and is lined with mucous Auditory Ossicles
membrane (secretion of sticky fluids). It contains the auditory 1. Malleus - Largest ossicle
ossicles (malleus, incus, and stapes), whose function is to 2. Incus - attached to the body of the stapes footplate (fits into the
transmit the vibrations of the tympanic membrane (eardrum, oval window).
semitransparent partition) to the perilymph of the internal ear. 3. Stapes - the incudomalleolar joint is a saddle-shaped
diarthrosis or synovial joint; it is surrounded by an articular
Stapes – smallest bone in the body. capsule, and the joint cavity is incompletely divided into two
Stapedius – smallest muscle in the body. by a wedge-shaped articular disk or meniscus. The
incudostapedial joint is an enarthrosis, surrounded by an
 Internal ear, or labyrinth - Contains the organs of hearing and articular capsule; some observers have described an articular
balance. disk or meniscus in this joint; others regard the joint as a
syndesmosis.
Vertigo – imbalance.
Cochlea – snail like structure.  Handle of malleus - attached to the tympanic membrane.
 Head of malleus - attached to the body of the incus.

External Auditory Meatus MUSCLES OF THE MIDDLE EAR

- ~2.5 or 1 inch Nerve
Muscle Origin Insertion Action
- Lies in the temporal bone. Supply
Tensor Wall of Handle Mandibular Dampens
tympani auditory tube of division of down
 Curved tube that leads from the auricle to the tympanic and wall of malleus trigeminal vibration of
membrane. It conducts sound waves from the auricle to the its own canal nerve tympanic
tympanic membrane. membrane
 The framework of the outer third of the meatus is elastic Stapedius Pyramid Neck of Facial nerve Dampens
cartilage, and the inner two thirds is bone, formed by the (bony stapes down
tympanic plate. The meatus is lined by skin, and its outer third projection on vibration of
is provided with hairs and sebaceous (produces oil or sebum) posterior wall stapes
of middle
and ceruminous glands (produces ear wax). The latter are ear)
modified sweat glands that secrete a yellowish brown wax. The
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AUDITORY TUBE NASAL AND ORAL CAVITIES, PARANASAL SINUSES, AND

The Eustachian tube (or auditory tube or pharyngotympanic PHARYNX
tube)
- Is a tube that links the pharynx to the middle ear. In adults the Smelling = Olfaction
Eustachian tube is approximately 35 mm long.
- Equalizes the pressure inside the tube. PARTS OF THE NOSE
- Passageway or route for pathogen (bacteria or foreign Root or upper Continuous with the forehead; Also called
substance) angle bridge.
Apex or free Tip of the nose.
angle
External nares Two elliptical apertures at the inferior aspect.
or nostrils
Septum Separates the nares
Dorsum nasi Lateral surfaces of the nose form by their union
(nose line) in the median plane.
Alae nasi Lateral surfaces end below in the rounded.
Supports the upper part.
Bony
 Nasal bones
framework of
 Frontal process of maxilla
the nose
 Nasal part of the frontal bone
These are connected with one another and
with the bones by the continuity of the
perichondrium and the periosteum.
a. Septal cartilages - Quadrilateral in shape
and forms the whole of the septum
between the anterior parts of the nasal
cavity.
b. Lateral (upper) cartilages - Triangular in
shape; Upper part is continuous with the
The labyrinth is situated in the petrous part of the temporal bone, Cartilaginous
cartilage of the septum but the lower part
medial to the middle ear. It consists of the bony labyrinth, comprising framework of
is separated; Its superior margin is
a series of cavities within the bone, and the membranous labyrinth, the nose
attached to the nasal bone and frontal
comprising a series of membranous sacs and ducts contained within process of the maxilla; Its inferior margin
the bony labyrinth. is connected with the major alar
 The bony labyrinth consists of three parts: the vestibule (oval cartilages.
central portion of the bony labyrinth), the semicircular canals, c. Major or greater alar (lower) cartilages
and the cochlea. These are cavities situated in the substance of - Situated below the lateral nasal
dense bone. They are lined by periosteum and contain a clear cartilages and is bent acutely around the
fluid, the perilymph (chemically similar to CSF or Cerebrospinal anterior part of the nares
Fluid), in which is suspended the membranous labyrinth. d. Minor or lesser alar cartilages
 The membranous labyrinth is lodged within the bony labyrinth.
It is filled with endolymph and surrounded by perilymph. It
consists of the utricle and saccule, which are lodged in the bony
vestibule; the three semicircular ducts, which lie within the bony
semicircular canals; and the duct of the cochlea, which lies within
the bony cochlea. All these structures freely communicate with
one another.

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CELLS IN OLFACTORY EPITHELIUM

bipolar neurons from cribriform plate of
Olfactory receptors
ethmoid then attached to olfactory bulb.
columnar epithelial cells of mucus
Supporting cells
membrane lining your nose.
stem cells that are seen between the
bases of supporting cells; they undergoes
Basal cells
cell division to replace the olfactory
receptors.

Olfactory gland – produces mucus that dissolves the odorants.

Olfactory hair – responds to inhaled chemicals.

ORAL CAVITY
The mouth extends from the lips to the pharynx. The entrance into the
pharynx, the oropharyngeal isthmus, is formed on each side by the
palatoglossal fold. The mouth is divided into the vestibule and the
mouth cavity proper.

Divisions of the Oral Cavity

 Vestibule - Between the lips and the cheeks externally and the
gums and the teeth internally. This slit like space communicates
with the exterior through the oral fissure between the lips. The
vestibule is limited above and below by the reflection of the
mucous membrane from the lips and cheeks to the gums.
 Mouth cavity proper
a. Roof of Mouth - Hard palate (anterior aspect) in front and
the soft palate (posterior aspect) behind.
b. Floor or Mouth - Anterior two thirds of the tongue and by
the reflection of the mucous membrane from the sides of the
Boundaries of the Nasal Cavity tongue to the gum of the mandible.
The nasal cavity extends from the nostrils in front to the posterior
nasal apertures or choanae behind, where the nose opens into the Isthmus of the fauces or Oropharyngeal Isthmus - is a part of the
nasopharynx. oropharynx directly behind the mouth cavity, bounded superiorly by
the soft palate, laterally by the palatoglossal arches, and inferiorly by
Divisions of the Nasal Cavity the tongue.
 The nasal vestibule (proximal aspect of nostril) is the area of
the nasal cavity lying just inside the nostril. The nasal cavity is TONGUE
divided into right and left halves by the nasal septum. The
septum is made up of the septal cartilage, the vertical plate of The tongue is a mass of striated muscle covered with mucous
the ethmoid, and the vomer membrane. The muscles attach the tongue to the styloid process and
 Medial Wall of the Nasal Cavity the soft palate above and to the mandible and the hyoid bone below.
 The lateral wall has three projections of bone called the The tongue is divided into right and left halves by a median fibrous
superior, middle, and inferior nasal conchae. The space septum
below each concha is called a meatus.
Sensory Innervation of the Tongue
Humans can smell ≈ 10,000 odors (≈ 10-100 million nasal 1. Anterior two thirds: Lingual nerve branch of mandibular division
receptors or 5cm² olfactory epithelium). of trigeminal nerve or Cranial Nerve V or V3 (general sensation)
and chorda tympani branch of the facial nerve Cranial Nerve VII
Basal Septum (nasal cartilage, vomer, ethmoid nose) - divides the (taste).
nose to left a right 2. Posterior third: Glossopharyngeal nerve or Cranial Nerve IX
(general sensation and taste)

PAPILLAE (PAPILLA = SINGULAR)

- These are rough texture elevations to the upper surface
of the tongue.
Vallete Papilla ≈ 10 days for a life span
mushroom like that are scattered around
Fungiform Papilla
the tongue. (~5 taste buds each)
located at small trenches of lateral margin
Foliate Papilla
of the tongue.
threadlike structure that but no taste buds,
Filiform Papilla
only tactile sensation.

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 Deciduous Teeth (Milk or Baby Teeth) - There are 20

TASTE BUDS AND PAPILLAE deciduous teeth: four incisors, two canines, and four molars in
Adults has ≈10,000 taste buds (tongue) soft palate. each jaw. They begin to erupt about 6 months after birth and
have all erupted by the end of 2 years. The teeth of the lower
Taste buds – oval body jaw usually appear before those of the upper jaw.

 Permanent Teeth - There are 32 permanent teeth: four

incisors, two canines, four premolars, and six molars in each
jaw. They begin to erupt at 6 years of age. The last tooth to erupt
is the third molar, which may happen between the ages of 17
and 30. The teeth of the lower jaw appear before those of the
upper jaw.

Pharynx (a.k.a. Throat)

Musculocutaneous tube which extends from the basal surface of the
skull to the level of the 6th cervical vertebra opposite the lower border
of the cricoid cartilage.

Function: The pharynx is part of the digestive system and respiratory

system of many organisms. Because both food and air pass through
TYPES OF CELLS IN TASTE BUDS the pharynx. In humans the pharynx is important in vocalization.
Gustatory ≈ 10 days for a life span
receptor cells Divisions of the Pharynx
pinkish. Surrounds ≈ 50 gustatory  Nasopharynx – Behind the nasal cavity and above the soft
Supporting cells
receptor cell. palate.
for cell division and production of gustatory  Oropharynx – Soft palate to the upper border of the epiglottis;
Basal/ stem cells
receptor cells. Posteriorly C2 and upper C3.
 Laryngopharynx – Epiglottis to the cricoid cartilage; Posteriorly
Gustatory hair – appears at taste pores. C3 to upper C6.

PARTS OF THE TEETH

The hardest, white outer part of the tooth.
Enamel Enamel is mostly made of calcium
phosphate, a rock- hard mineral.
A layer underlying the enamel. Dentin is
Dentin made of living cells, which secrete a hard
mineral substance.
The softer, living inner structure of teeth.
Pulp Blood vessels and nerves run through the
pulp of the teeth. EYELIDS, LACRIMAL APPARATUS, AND ORBIT
A layer of connective tissue that binds the
Cementum roots of the teeth firmly to the gums and
jawbone. Functions of the Eyelids
Tissue that helps hold the teeth tightly 1. The eyelids protect the eye from injury and excessive light by
against the jaw. A fibrous joint or their closure.
Periodontal 2. Periodic blinking maintains a thin film of tears over the cornea
syndesmosis gomphosis.
ligament which prevents desiccation.
Aveolar socket – attach the teeth to
periodontal ligament. 3. Movement of the eyelid during blinking helps ensure the even
distribution of the tear.
Blue = veins, Red = artery, Yellow = nerve

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 Palpebral Fissure - elliptical space when the eye is open. The conjunctiva is a thin, transparent mucous membrane that
Space between the upper and lower eyelid. extends from the eyelid margins anteriorly, providing a lining to the
 Canthus - angle of the eye; corner of the eye where the upper lids, before turning sharply upon itself to form the fornices when it is
and lower eyelids meet. reflected onto the globe to cover the sclera up to its junction with the
a. Lateral canthus cornea.
b. Medial Canthus
 Cilia - eyelashes which are attached in the free edges of the Conjunctivitis or sore eyes – (+) inflammation, pink eye due to
eyelids. Ciliary glands open near the attachments of the bacteria or virus.
eyelashes.
PARTS OF CONJUNCTIVA
Palpebral conjunctiva Lines the eyelids.
Ocular conjunctiva Covers the eyeball, over the sclera.
Forms the junction between the bulbar
Conjunctival fornix
and palpebral conjunctivas.
Potential space that opens anteriorly
Conjunctival sac
through the palpebral fissure.
Groove in the eyelid which traps foreign
Subtarsal sulcus
body.

LAYERS OF THE EYELID

Extremely thin and is continuous at the
Skin
palpebral margins with the conjunctiva.
Subcutaneous Very delicate, seldom contains any
areolar tissue adipose tissue, and lacks elastic fibres.
Action = closing of eyelids. Eyeball - ~2.5cm or 1 inch diameter adult, 1/6 of the eyeball are only
exposed.
a. Ciliary
b. Pretarsal LAYERS OF THE EYEBALL
c. Preseptal parts - the palpebral fibre - superficial layer of the eyeball and consists of
bundles are thin and pale and lie anterior cornea and posterior sclera.
parallel with the palpebral margins. Fibrous
Deep to them is the submuscular tunic
Sclera – rigid because it protects the eye. Attachment
Fibers of the connective tissue, a loose fibrous of extraocular muscles.
orbicularis oculi layer that is continuous in the upper - middle layer of the eyeball.
lid with the subaponeurotic layer
of the scalp: effusions of blood or Choroid – posterior portion of the vascular tunic;
pus at this level can therefore pass contains melanocytes that produce the pigment
down from the scalp into the upper melanin. Highly vascularized, provides nutrients to the
eyelid. The main nerves lie in the posterior surface of retina.
submuscular layer, which means
that local anaesthetics should be Ciliary body
injected deep to orbicularis oculi.  Ciliary muscle – allows the dilation and
The orbital septum is a weak Vascular
constriction of pupil.
membranous sheath which is attached to tunic
 Ciliary process – appear to be dark brown
Tarsus and orbital the edge of the orbit where it is because they also contains your melanocytes.
septum continuous with the periosteum. The
orbital septum is thickened at the margins Iris – colored portion of the eye, suspended between
of the lids to form the tarsal plates. the cornea and lens. Amount of melanin will determine
Tarsal glands and Tarsal (Meibomian) glands are modified the eye color.
conjunctiva sebaceous glands embedded in the tarsi.
Fibers of the Only seen on the upper lid. Pupil – appears black. (+) bright light = red (blood
levator palpebrae vessels of the retina).
superioris

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- inner layer of the eyeball. Has 6 million cones and

120 million rods in one retina.

Pigmented layer – sheet of melanin containing

epithelial cells.

Neural (sensory) layer – processes visual data

extensively before sending nerve impulses.
Retina
Optic disc – where the optic nerve (II) exits the
eyeball.
cn 2👀
Photoreceptors of the eye – specialized cells where
in light ray converts to an impulse.
 Rods – allows you to see in dim light/ moon light
(black and white or shades of gray).
 Cones – for color vision (blue, red, and green).
6 million cones - light
12 million rodes - dark

Lacrimal Apparatus - the lacrimal system consists of structures

responsible for the production of tears (principally the main lacrimal
gland with a contribution from accessory lacrimal glands) and the
lacrimal drainage pathway which collects the tear fluid and conveys it
into the nasal cavity (paired lacrimal canaliculi, lacrimal sac and
nasolacrimal duct).
Vitreous body – jelly like substance that holds the retina against the PARTS OF LACRIMAL APPARATUS
choroid to provide clear image.
The lacrimal gland consists of orbital and
palpebral parts which are continuous
Myopia – near sighted; Hyperopia – far sighted posterolaterally around the concave lateral edge
of the aponeurosis of levator palpebrae
Inferior of the eyeball superioris. The main ducts of the lacrimal gland
 Anterior cavity – two chambers, the anterior chamber lies discharge into the conjunctival sac at the
between the cornea and the iris. Posterior chamber lies behind Lacrimal
superior lateral fornix. Those from the orbital
the iris and in front of the zonular fibers and lens. Filled with gland
part penetrate the aponeurosis of levator
aqueous humor – a transparent fluid which nourishes the cornea
palpebrae superioris to join those from the
and lens.
palpebral part.
 Posterior Cavity – has vitreous chamber which lies between the
Secretes ~ 6-12 lacrimal ducts, empty the tears
lens and the retina. onto the surface of conjunctiva.
Lacrimal About 10 mm long which starts at the puncta
canaliculi lacrimalia; Superior and inferior canaliculi.
Lacrimal sac Upper blind end of the nasolacrimal duct.
Membranous canal about 18mm or 1.8cm long
Nasolacrimal
which extends from the lacrimal sac to the
duct
inferior meatus of the nose.

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Neuroglia of the PNS

 Schwann - these cells encircle PNS axons. Like
oligodendrocytes, they form the myelin sheath around axons.
However, a single oligodendrocyte myelinates several axons, but
each Schwann cell myelinates a single axon.

 Satellite cells - these flat cells surround the cell bodies of

neurons of PNS ganglia. Besides providing structural support,
satellite cells regulate the exchanges of materials between
neuronal cell bodies and interstitial fluid.

THE PRIMARY DIVISIONS OF THE DEVELOPING BRAIN

Primary Division Subdivision Adult Structures
Cerebral hemisphere,
Flow of Lacrimal Secretion
Basal ganglia,
Tears from the Lacrimal Nasolacrimal Prosencephalon Hippocampus
Telencephalon
lacrimal gland punctum duct (Forebrain) Thalamus,
Hypothalamus Pineal
body, Infundibulum
Mesencephalon Mesencephalon Tectum, Tegmentum
Conjunctival Lacrimal Inferior meatus
sac canaliculi of the nose (Midbrain) (Midbrain) Crus cerebri
Rhombencephalon Metencephalon Pons, cerebellum
(Hindbrain) Myelencephalon Medulla oblongata
Lower lid
margin to the Lacrimal sac
lacus lacrimalis

NERVOUS SYSTEM
 Central Nervous System (CNS) = Brain & Spinal cord
 Peripheral Nervous System (PNS) = Spinal Nerves (31 pairs),
Cranial Nerves (12 pairs)
 Autonomic Nervous System (ANS) = Sympathetic Nervous
System, Parasympathetic Nervous system, Physiological
changes
 Somatic Nervous System = Muscles (Movements) MAJOR DIVISIONS OF THE NERVOUS SYSTEM
Cerebral  Brain
MICROSCOPIC STRUCTURES OF NERVOUS SYSTEM Nervous System  Spinal Cord
 Neurons  Cranial Nerves - a set of 12 paired
 Nerve Fibers (Axons and Dendrites) nerves in the back of your brain. It sends
 Nerve Tissue electrical signals between your brain,
face, neck and torso.
Neuroglia – Tissue supporting the neurons that make up about half Peripheral  Spinal Nerves - sends electrical signals
the volume of the CNS. Their name derives from the idea early Nervous System between your brain, spinal cord and the
histologists that they were the “glue” that held nervous tissue together. rest of your body. These electrical nerve
Generally, neuroglia are smaller than neurons, and they are 5 to 25 signals help you feel sensations
times more numerous. (sensory nerve) and move your body
(motor nerves).
Neuroglia of the CNS  Sympathetic - a network of nerves that
 Astrocytes - these star shaped cells have many processes and helps your body activate its “fight-or-
are the largest and most numerous of the neuroglia. The Autonomic flight” response.
processes of astrocytes make contact with blood capillaries, Nervous System  Parasympathetic - a network of nerves
neurons, and the pia mater. that relaxes your body after periods of
a. Protoplasmic astrocytes - have many short branching stress or danger.
processes and are found in gray matter.
b. Fibrous astrocytes - have many long unbranched Neurons
processes and are located mainly in white matter.  Nerve cell
 Functional cell of the nervous system
 Oligodendrocytes - these resemble astrocytes but are smaller
and contain fewer processes. Oligodendrocyte processes are Parts of Neuron:
responsible for forming and maintaining the myelin sheath  Dendrites - are the receiving or input portions of a neuron that
(covering of the axon) around CNS axons. are usually short, tapering, and highly branched. In many
neurons the dendrites form a tree shaped array of processes
 Microglia - these neuroglia are small cells with slender extending from the cell body. Their cytoplasm contains Nissl
processes that give off numerous spine like projections. bodies, mitochondria, and other organelles.
 Soma or nerve cell body - contains a nucleus surrounded by
 Ependymal cells - are cuboidal to columnar cells arranged in a cytoplasm that includes typical cellular organelles such as
single layer that possess microvilli and cilia. lysosomes, mitochondria, and a Golgi complex.

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 Axon - propagates nerve impulses toward another neuron, a Lobes of the Brain
muscle fiber, or a gland cell. The frontal lobe is situated in front of the central sulcus and above
 Axon hillock - a cone-shaped elevation that often join the cell the lateral sulcus. The parietal lobe is situated behind the central
bodies. sulcus and above the lateral sulcus. The occipital lobe lies below the
 Initial segment - part of the axon closest to the axon hillock. parietooccipital sulcus. Below the lateral sulcus is situated the
 Axoplasm – cytoplasm of an axon. temporal lobe.
 Axolemma – plasma membrane of an axon.
 Axon collaterals - side branches of an axon, typically at a right
angle to the axon. The axon and its collaterals end by dividing
into many fine processes called axon terminals (telodendria).
 Node of Ranvier - a space along a myelinated axon between the
individual Schwann cells that form the myelin sheath and the
neurolemma. Also called a neurofibral node.
 Synapse - site of communication between two neurons or
between a neuron and an effector cell.
 Cytoskeleton – a network of protein filaments (microfilaments,
intermediate filaments, and microtubules) that extends
throughout the cytosol.
 Lipofuscin - a pigment that occurs as clumps of yellowish brown
granules in the cytoplasm. Lipofuscin is a product of neuronal  Central sulcus – separates the frontal lobe from the parietal
lysosomes that accumulates as the neuron ages, but does not lobe.
seem to harm the neuron as it age.  Precentral gyrus – located immediately anterior to the central
sulcus, contains the primary motor area of the cerebral cortex.
STRUCTURAL CLASSIFICATION OF NEURONS  Post central gyrus - which is located immediately posterior to
Multipolar Usually have several dendrites and one axon. the central sulcus, contains the primary somatosensory area of
neurons the cerebral cortex.
Bipolar Have one main dendrite and one axon.  Lateral cerebral sulcus - separates the frontal lobe from the
neurons temporal lobe.
Have dendrites and one axon that are fused  Parieto-occipital sulcus - separates the parietal lobe from the
together to form a continuous process that emerges occipital lobe.
Unipolar from the cell body. These neurons are more
neurons appropriately called pseudounipolar neurons White Matter of the Cerebrum
because they begin in the embryo as bipolar The white matter is composed of myelinated nerve fibers of different
neurons. diameters supported by neuroglia. The nerve fibers may be classified
into three groups according to their connections:
BRAIN
- Brain develops on the ectodermal neural tube during fetus stage.  Commissural fibers/tracts
- It connects the right and left hemisphere
Several of the large sulci conveniently subdivide the surface of each - Contain axons that conduct nerve impulses from gyri in one
hemisphere into lobes. The lobes are named for the bones of the cerebral hemisphere to corresponding gyri in the other
cranium under which they lie. cerebral hemisphere.
- Three important groups of commissural tracts are the
Cerebrum corpus callosum (the largest fiber bundle in the brain,
- is the “seat of intelligence.” It provides us with the ability to containing about 300 million fibers), anterior commissure,
read, write, and speak; to make calculations and compose music; and posterior commissure.
and to remember the past, plan for the future, and imagine things
that have never existed before.  Association fibers/tracts
- Connects the cortical areas within the cortex
CEREBRUM - Contain axons that conduct nerve impulses between gyri in
is a region of gray matter that forms the outer the same hemisphere.
Cerebral
rim of the cerebrum, only 2–4 mm (0.08–0.16
cortex
in.) thick.  Projection fibers/tracts
cortical region rolls and folds on itself. - Connects the cerebral cortex to the brainstem or spinal cord
- Contain axons that conduct nerve impulses from the
 Fissures - deepest grooves between cerebrum to lower parts of the CNS (thalamus, brain stem,
folds. or spinal cord) or from lower parts of the CNS to the
Gyri or cerebrum.
convolutions The most prominent fissure, the longitudinal - An example is the internal capsule, a thick band of white
fissure, separates the cerebrum into right and matter that contains both ascending and descending axons
left halves called cerebral hemispheres.
Basal Nuclei / Ganglia
 Sulci - shallower grooves between folds. - Patients with Parkinson’s disease has a problem with their basal
a broad band of white matter containing axons nuclei
Corpus
that connects the cerebral hemispheres
callosum
internally. Components of basal nuclei:
 Globus pallidus – Closer to the thalamus
 Putamen – Closer to the cerebral cortex

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 Lentiform nucleus – Formed by the globus pallidus and Two nuclei of the thalamus
Anterior & Medial
putamen Participate in limbic circuits.
nucleus
 Caudate nucleus – Has a large head connected to a smaller tail
by a long comma-shaped body Flattened bodies of the olfactory pathway
Olfactory bulbs
 Corpus striatum – Formed by the lentiform and caudate nuclei that rest on the cribriform plate

 Claustrum
- Thin sheet of gray matter situated lateral to the putamen
- It is considered by some to be a subdivision of the basal
nuclei

LIMBIC SYSTEM
Anatomically speaking: Hypothalamus, Limbic lobe,
Hippocampus, and Amygdala

 It is responsible for emotion and judgement

 The powerful input to the limbic system is from the neocortical
association areas. CEREBELLUM
 It appears important to: Intellectual; judgmental; predictive - “the little brain”
faculties and the planning (regulation behavior), Memory, - Second only to the cerebrum in size, occupies the inferior and
emotional aspects of behavior and stereognosis (size; form and posterior aspects of the cranial cavity.
texture) an appreciation of the body image and perceptuospatial - Has a highly folded surface that greatly increases the surface area
function and drive. of its outer gray matter cortex, allowing for a greater number of
 The storage of previous sensory experiences. Recall objects neurons.
seen or music heard in the past. - The cerebellum accounts for about a tenth of the brain mass yet
 The limbic system, via the hypothalamus and its connections with contains nearly half of the neurons in the brain.
the outflow of the autonomic nervous system and its control of - The cerebellum is posterior to the medulla and pons and inferior
the endocrine system (pituitary gland) is able to influence to the posterior portion of the cerebrum.
emotional behavior. Like reactions to fear, anger, and sexual - Smooths and coordinates contractions of skeletal muscles.
behavior. - Regulates posture and balance.
- May have a role in cognition and language processing.
Functions:
 “Emotional brain” - emotional and motivational aspects of Functions of the Cerebellum
behavior. Provides emotional component to learning process  The cerebellum receives afferent information concerning
(especially the amygdala). voluntary movements from the cerebral cortex and from the
 Associated with memory (especially the hippocampus). muscles, tendons and joints. It also receives information
 Associated with pain/pleasure, rage. concerning balance from the vestibular nerve and possibly
concerning sight through the tectocerebellar tract.
Components: Amygdaloid body, Hippocampus (“seahorse”),  It is also a coordinator of precise movements by continually
Cingulate gyus, Parahippocampal gyrus, Hypothalamus, Mamillary comparing the output of the motor area of the cerebral cortex with
bodies, and Anterior nucleus of thalamus the proprioceptive information received from the site of muscle
action.
LIMBIC SYSTEM  It is also believed that the cerebellum can send back information
Coordinates sensory input with emotions. to the motor cerebral cortex to inhibit the agonist muscles and
Cingulate gyrus stimulate the antagonist muscles, thus limiting the extent of
Lies above the corpus callosum
Memory formation; The hippocampus is voluntary movements.
concerned with converting recent memory to  The essential function of the cerebellum is to coordinate by
long-term memory (permits a link to previous synergistic action, all reflex and voluntary muscular activity. Thus
Hippocampus experience). it graduates and harmonizes muscle tone and maintains normal
It is a portion of the parahippocampal gyrus body posture. It permits voluntary movements such as walking to
that extends into the floor of the lateral take place smoothly with precision and economy of effort. It
ventricle cannot initiate muscle movement.
Parahippocampal It can be found on the temporal lobe below
gyrus CEREBELLAR PEDUNCLES
It lies between the hippocampus and Connect the cerebellum to the midbrain; Afferent
Dentate gyrus Superior fibers traveling in this peduncle take proprioceptive
parahippocampal gyrus
Amygdala Plays a role in both arousal and aversion. cerebellar information to the cerebellum from the lower body.
Hippocampal Takes sensory information to the peduncles *Afferent – Sensory
gyrus hippocampus. *Efferent - Motor
Mammillary Receives olfactory inputs. Connect the cerebellum to the pons; Via this
Middle
bodies connection, the cerebellum receives a copy of the
cerebellar
Connects the mammillary body to the information for muscle movement that the pyramidal
Fornix peduncles
hippocampus. tract is carrying down to lower motor neurons.
Located within the septal area formed by Connect the cerebellum to the medulla oblongata;
Inferior
the regions under the corpus callosum and Proprioceptive information from the upper body,
Septal nuclei cerebellar
the paraterminal gyrus (a cerebral gyrus). traveling along the dorsospinocerebellar tract enters
peduncles
the cerebellum on the inferior cerebellar peduncle.

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DIENCEPHALON
- Forms a central core of brain tissue just superior to the midbrain.
- It is almost completely surrounded by the cerebral hemispheres
and contains numerous nuclei involved in a wide variety of
sensory and motor processing between higher and lower brain
centers.
- It extends from the brain stem to the cerebrum and surrounds the
third ventricle; it includes the thalamus, hypothalamus, and
epithalamus.
- Hypophysis or Pituitary gland: Projection from the
hypothalamus

THALAMUS
Three main lobes:
Measures about 3 cm (1.2 in.) in length and makes up 80% of the
 Anterior lobe – Govern subconscious aspects of skeletal muscle
diencephalon, consists of paired oval masses of gray matter
movements
organized into nuclei with interspersed tracts of white matter.
 Middle lobe/Posterior lobe – largest part of the cerebellum;
Govern subconscious aspects of skeletal muscle movements
 Intermediate mass – A bridge of gray matter that joins the right
 Flocculonodular lobe – Contributes to equilibrium and balance
and left halves of the thalamus in about 70% of human brains.
 Internal medullary lamina - A vertical Y-shaped sheet of white
matter that divides the gray matter of the right and left sides of
the thalamus.
 Axons that connect the thalamus and cerebral cortex pass
through the internal capsule, a thick band of white matter
lateral to the thalamus.

SEVEN MAJOR GROUPS OF NUCLEI ON EACH SIDE OF

THE THALAMUS
Anterior nucleus
Receives input from the hypothalamus and sends output to the
limbic system.
Parts: Medial nuclei
 Cortex – outer gray covering Receive input from the limbic system and basal nuclei and send
 White matter – Inner part which is embedded by three masses output to the cerebral cortex.
of gray matter called the intracerebellar nuclei. Nuclei in the lateral group
Receive input from the limbic system, superior colliculi, and
BRAINSTEM cerebral cortex and send output to the cerebral cortex.
The brainstem occupies the posterior cranial fossa. It is stalk like in  Lateral dorsal nucleus functions in the expression of
shape and connects the narrow spinal cord with the forebrain. emotions.
 Medulla oblongata – Continuous with the superior part of the  Lateral posterior nucleus and pulvinar nucleus help
spinal cord integrate sensory information.
- It forms the inferior part of the brain stem Ventral nuclei group
- It begins at the foramen magnum and extends to the inferior  Ventral anterior nucleus - receives input from the basal
border of the pons nuclei and sends output to motor areas of the cerebral cortex;
- A distance of about 3 cm (1.2 in). it plays a role in movement control.
 Pons – Lies directly superior to the medulla and anterior to the  Ventral posterior nucleus - relays impulses for somatic
cerebellum sensations and proprioception from the face and body to the
- It is about 2.5 cm (1 in) long. cerebral cortex.
- Consists of both nuclei and tracts.  Ventral lateral nucleus - receives input from the cerebellum
- It is a bridge that connects parts of the brain with one and basal nuclei and sends output to motor areas of the
another. cerebral cortex; it also plays a role in movement control.
 Midbrain – Extends from the pons to the diencephalon.  Lateral geniculate nucleus - relays visual impulses for sight
- It is about 2.5 cm (1 in) long from the retina to the primary visual area of the cerebral
- Contains both nuclei and tracts cortex.
 Medial geniculate nucleus - relays auditory impulses for
hearing from the ear to the primary auditory area of the
tite
cerebral cortex.
Intralaminar nuclei
Lies within the internal medullary lamina and make connections
with the reticular formation, cerebellum, basal nuclei, and wide
areas of the cerebral cortex.
Midline nucleus
Forms a thin band adjacent to the third ventricle and has a
presumed function in memory and olfaction.
Reticular nucleus
Surrounds the lateral aspect of the thalamus, next to the internal
capsule.

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EPITHALAMUS
- A small region superior and posterior to the thalamus, consists of
the pineal gland and habenular nuclei.

 Pineal gland: Pinecone-like, about the size of a small pea, and

protrudes from the posterior midline of the third ventricle.
 Habenular nuclei - Are involved in olfaction, especially
emotional responses to odors such as a loved one’s cologne or
Mom’s chocolate chip cookies baking in the oven.

CRANIAL NERVE NAMES

# NAME COMPONENTS
I Olfactory Sensory
II Optic Sensory
III Oculomotor Motor
IV Trochlear Motor
V Trigeminal Sensory-Motor
VI Abducens Motor
VII Facial Sensory-Motor
VIII Vestibulocochlear Sensory
IX Glossopharyngeal Sensory-Motor
X Vagus Sensory-Motor
XI Spinal Accessory Motor
XII Hypoglossal Motor

HYPOTHALAMUS
Is a small part of the diencephalon located inferior to the thalamus. It
is composed of a dozen or so nuclei in four major regions:
1. Mammillary region - Adjacent to the midbrain, is the most
posterior part of the hypothalamus. It includes the mammillary
bodies and posterior hypothalamic nuclei. The mammillary
bodies are two small, rounded projections that serve as relay
stations for reflexes related to the sense of smell.
2. Tuberal region - The widest part of the hypothalamus, includes
the dorsomedial nucleus, ventromedial nucleus, and arcuate
nucleus.
- Infundibulum: Stalk-like, which connects the pituitary gland to
the hypothalamus. The median eminence is a slightly raised
region that encircles the infundibulum.
3. Supraoptic region – Lies superior to the optic chiasm (point of
crossing of optic nerves) and contains the paraventricular
MENINGES
nucleus, supraoptic nucleus, anterior hypothalamic nucleus, and
Protective coverings of the brain or protective membranes; three
suprachiasmatic nucleus.
concentric membranous coverings:
4. Preoptic region - Anterior to the supraoptic region is usually
considered part of the hypothalamus because it participates with
1. Dura Mater
the hypothalamus in regulating certain autonomic activities. The
- The outermost covering, by virtue of its toughness, serves
preoptic region contains the medial and lateral preoptic nuclei.
to protect the underlying nervous tissue.
- The dura protects the cranial nerves by forming a sheath
that covers each cranial nerve for a short distance as it
passes through foramina in the skull. The dura also provides
each spinal nerve root with a protective sheath.
2. Arachnoid Mater - Is a much thinner impermeable membrane
that loosely covers the brain.
3. Pia Mater - Vascular membrane that closely invests and supports
the brain and spinal cord.

Mamillary region, Tuberal region, Supraoptic region, Preopti

region

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The subdural space is a potential space that can be opened by the

separation of the arachnoid mater from the dura mater as the result of
trauma, pathologic process, or the absence of cerebrospinal fluid as
seen in a cadaver.

VENTRICULAR SYSTEM
The two lateral ventricles communicate through the interventricular
foramina (of Monro) with the 3rd ventricle. The 3rd ventricle is
connected to the 4th ventricle by the narrow cerebral aqueduct
(Aqueduct of Sylvius). The 4th ventricle is connected with the narrow
central canal of the spinal cord and through the 3 foramina in its roof,
with the subarachnoid space.

The ventricles are four fluid-filled cavities located within the brain:
 2 lateral ventricles – located at the cerebral hemisphere.
 3rd ventricle – located between the right and life thalamus.
 4th ventricle – located at pons and medulla.
SPINAL CORD
The spinal cord is continuous to the brain at the foramen magnum.
The end of the cord is the conus medullaris and this is found at the
region of the first or second lumbar vertebra. The shortness of the
spinal cord occurs because it matures early and the vertebral column
continues to grow. The neural fibers continue in the vertebral canal as
the cauda equine, a structure that resembles a horse’s tail. The cord
is attached to the coccyx by an extension of the pia mater called filum
terminal.

When seen on the cross section, the spinal cord is composed of an

internal arrangement of gray matter (inner) and an external white
matter (outer).
 Anterior gray horns – contains somatic motor nuclei, which are
clusters of cell bodies of somatic motor neurons that provide
nerve impulses for contraction of skeletal muscles.
 Posterior gray horns – contain cell bodies and axons of
FLOW OF THE CSF (CEREBROSPINAL FLUID) interneurons as well as axons of incoming sensory neurons.
1. Choroid plexus in the ventricles.  Lateral gray horns – which are present only in thoracic and
2. The fluid passes from the lateral ventricles into the 3rd ventricle upper lumbar segments of the spinal cord. The lateral gray horns
through the inter ventricular foramina. contain autonomic motor nuclei, which are clusters of cell bodies
3. It then passes through the 4th ventricle through the cerebral of autonomic motor neurons that regulate the activity of cardiac
aqueduct. muscle, smooth muscle, and glands.
4. From the 4th ventricle, the fluid passes slowly through the median  Central canal – CSF filled space at the center of your spinal cord,
aperture and the lateral foramina of the lateral recesses of the it extends the entire length of the spinal cord.
4th ventricle and enters the subarachnoid space.  Posterior median sulcus – is a narrow furrow on the posterior
5. The fluid then moves through the cerebellomedullary cistern and (dorsal) side.
pontine cisterns and flows superiorly through the tentorial notch  Anterior median fissure - is a wide groove on the anterior
of the tentorium cerebelli to reach the inferior surface of the (ventral) side.
cerebrum.  Dorsal, Ventral, and Lateral Column (White Matter)
6. It then moves superiorly over the lateral aspect of each cerebral  Sensory (Ascending) Tracts – consist of axons that conduct
hemisphere. Some of the CSF moves inferiorly only in the nerve impulses toward the brain.
subarachnoid space around the spinal cord and cauda equina.  Motor (Descending) Tract - tracts consisting of axons that carry
nerve impulses from the brain.
 Dorsal Root Ganglion – contains the cell bodies of sensory
neurons.
 Ventral Root Ganglion – contain axons of motor neurons, which
conduct nerve impulses from the CNS to effectors (muscles and
glands).

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 Ansa cervicalis
Gray matter – center of spinal cord, looks like H or butterfly.  Phrenic nerve – arises from cervical plexus (C2 to C5), supplies
White matter – outside of spinal cord, contains myelin fibers. the diaphragm.

Brachial plexus – C5 to T1, related to upper extremities. It passes

above the first rib posterior to the clavicle and then enters the axilla.

SPAM – Sensory Posterior Anterior Motor

SPINAL NERVES
The spinal nerves are mixed nerves that pass through the
intervertebral foramina of the vertebral column. It splits into a dorsal
and ventral root. The dorsal root ganglion is a swelling of the dorsal  Posterior Cord Branches:
root within its intervertebral foramen. The dorsal root ganglion a. STAR - Subscapular (upper and lower), Thoracodorsal,
contains the nerve cell bodies of the sensory neurons coming from the Axillary, and Radial
body. The ventral root carries motor information from the anterior gray b. ULTRA - Upper subscapular, Lower subscapular,
horn and innervates muscles. Thoracodorsal, Radial, Axillary

Plexus  Lateral Cord Branches:

There are 31 spinal nerves grouped by region of the vertebral column. a. LLM "Lucy Loves Me" - Lateral pectoral, Lateral root of the
 Cervical = 8 (C1-C8) median nerve, Musculocutaneous
 Thoracic = 12
 Lumbar = 5  Medial Cord Branches:
 Sacral = 5 MMMUM "Most Medical Men Use Morphine" - Medial pectoral,
 Coccygeal = 1 Medial cutaneous nerve of arm, Medial cutaneous nerve of forearm,
Ulnar, Medial root of the median nerve
Plexuses is a web-like arrangement of nerves that is near the spinal
cord and gives rise to terminal nerves.

PLEXUS
Cervical plexus – First 5 cervical nerves (C1 to C5), supplies the skin
and muscles of the head, neck, and superior part of the shoulders and
chest.
 Hypoglossal nerve (CN XII)

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Lumbar plexus – L1 to L4
 Femoral nerve – Quadriceps
 Obturator nerve – Adductor muscles of medial thigh
 Genitofemoral nerve – Sensory nerve that receives impulses
from the scrotal sac and labia majora DERMATOMES
 Iliohypogastric nerve – Innervates the muscles of the abdomen Dermatomes are regions of the skin innervated by nerves. The nerves
and skin of the belly receive sensory inputs from the skin and take that information back to
 Ilioinguinal nerve - innervates the same muscles as does the the spinal cord. The clinical importance of dermatomes is the role they
iliohypogastric nerve and it receives sensory information from the play in assessing spinal cord damage. If there is a significant spinal
base of the penis and the scrotum in males, and from the labia cord injury, then the regions below the level of the injury may not
majora in females. transmit sensory signals to the brain. Lack of sensation in specific
areas of the skin provides a base of understanding of where the
Lateral femoral cutaneous nerve of the thigh – Receives sensory trauma may be located.
information from the skin of the lateral thigh.

Sacral plexus – L4 to S4
 Pudendal nerve - nerve innervates the penis and scrotum in
males, the clitoris, labia, and distal vagina in females, and the
muscles of the pelvic floor in both sexes.
 Superior and inferior gluteal nerves
 Sciatic nerve – Tibial and common peroneal nerve, it is also the
largest nerve.
 Tibial nerve - innervates the hamstring muscles, the muscles of
the calf, and the muscles originating on the foot.
 Common fibular nerve - innervates the short head of the biceps
femoris muscle, the muscles on the lateral side of the leg and the
anterior surface of the leg.

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Reflex divisions. At the terminal end of the parasympathetic division, the

A fast, involuntary, unplanned sequence of actions that occurs in neurotransmitter is acetylcholine. At the terminal end of the
response to a particular stimulus. Some reflex are inborn while other sympathetic division, the neurotransmitter is mostly norepinephrine.
reflex are acquired or learned through time, they can also last only
during a certain duration. The neurons leaving the NS are called preganglionic neurons. In the
 Spinal reflex - when integration takes place in the spinal cord case of the parasympathetic division, the preganglionic neurons
gray matter. secrete acetylcholine as neurotransmitters. The ganglia of the
 Cranial reflex - if integration occurs in the brain stem rather parasympathetic division are next to, or in, the organ they innervate.
than the spinal cord. The postganglionic neurons secrete acetylcholine as well. In the
 Somatic reflex - involve contraction of skeletal muscles. sympathetic division, the preganglionic neurons secrete acetylcholine
 Autonomic reflex - involve responses of smooth muscle, in the sympathetic chain ganglia. The postganglionic neurons mostly
cardiac muscle, and glands. secrete norepinephrine to stimulate or inhibit the organs they
 Monosynaptic reflex - reflex pathway having only one synapse innervate.
in the CNS.
 Polysynaptic reflex – involves more than two types of neurons
and more than one CNS synapse.

General Components of Reflex Arc

AUTONOMIC NERVOUS SYSTEM ENDORCINE SYSTEM

The autonomic nervous system (ANS) regulates automatic Endocrinology - the science of the structure and function of the
functions of the human body. There are two divisions of the autonomic endocrine glands and the diagnosis and treatment of disorders of the
nervous system. endocrine system.

 The resting state of the body is controlled by the  Ductless glands produce hormones
parasympathetic division. Digestion, kidney filtration, erection  Secreted directly into the bloodstream
of the clitoris, erection of the penis, and pupil constriction are  Gland may be entire organ: Pituitary, thyroid, parathyroid, pineal,
some of the functions of the parasympathetic division. This adrenal
division is also known as the craniosacral division because the  Or bits of tissue interspersed within an organ: Gonads, kidneys,
nerves exit the central nervous system (CNS) in these locations. many others
The cranial segments go to the eye, salivary glands, heart, lung,
digestive system, and kidneys. The sacral segments go to the The endocrine system controls body activities by releasing mediators,
lower digestive tract, bladder, and reproductive organs. called hormones that works as a mediator molecule that is released
in one part of the body but regulates the activity of cells in other parts
 The sympathetic division controls the "fight or flight" response of the body. Most hormones enter interstitial fluid and then the
of the body, shutting down the digestive functions, inhibiting bloodstream.
erections, shunting blood away from the kidneys, and dilating the
pupils. The sympathetic division increases heart rate, dilates Two kinds of glands:
capillaries in the lungs, brain and muscle tissue, and stimulates  Exocrine glands - secrete their products into ducts that carry the
the adrenal glands. This division is also known as the secretions into body cavities, into the lumen of an organ, or to the
thoracolumbar division because the nerves exit the CNS in the outer surface of the body.
thoracic and lumbar regions of the spinal cord. There are ganglia  Endocrine glands - secrete their products (hormones) into the
associated with the sympathetic division and these are located interstitial fluid surrounding the secretory cells rather than into
on either side of the ventral portion of the vertebral column. They ducts. From the interstitial fluid, hormones diffuse into blood
are called the sympathetic chain ganglia and the neurons from capillaries and blood carries them to target cells throughout the
the thoracolumbar division synapse with nerve cells in these body.
ganglia.
PITUITARY GLAND & HYPOTHALAMUS
The parasympathetic and sympathetic divisions are antagonistic to Also called hypophysis cerebri measures 1–1.5 cm (0.5 in.) in
one another and organs under the influence of the ANS have dual diameter; Ovoid in shape and connected by the infundibulum to the
innervation. Typically, one division either inhibits the organ from tuber cinerium of the brain.
functioning or causes an increase in activity in the organ. This occurs
due to the difference in neurotransmitters secreted by the separate The tuber cinereum is a hollow eminence of gray matter situated

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between the mammillary bodies and the optic chiasma. The tuber ADENOHYPOPHYSIS
cinereum is part of the hypothalamus. Adrenocorticotropic hormone
Thyroid-stimulating hormone
Infundibulum - It was called the “master” endocrine gland because Growth hormone
it secretes several hormones that control other endocrine glands. We Leutenizing hormone
now know that the pituitary gland itself has a master - the Follicle stimulating hormone
hypothalamus. Interstitial cell-stimulating hormone (ICSH)
Melanocyte–stimulating hormones
Location: Hypophyseal fossa which is the deepest part of the sella NEUROHYPOPHYSIS
turcica of the sphenoid bone. Prolactin
Oxytocin and Antidiuretic hormone
Relations:
 Superiorly = Diaphragm sella Hypothalamus - It synthesizes and secretes certain neurohormones,
 Inferiorly = Sphenoid often called hypothalamic-releasing hormones, and these in turn
 Laterally = Cavernous sinus stimulate or inhibit the secretion of pituitary hormones. The
 Posteriorly = Dorsum sella, vertebral arteries, and pons hypothalamus controls body temperature, hunger, thirst, fatigue,
sleep, and circadian cycles. Regulatory hormone production (RH and
Average dimensions of the pituitary: IH) controls pituitary gland directly and all other endocrine glands
 10 mm A-P indirectly.
 15 mm side to side
 5 mm superior to inferior PINEAL GLAND
Also called the pineal body, epiphysis cerebri, epiphysis or the
Average weight of the pituitary: "third eye" is a small endocrine gland in the vertebrate brain. It
 0.5 gm produces the serotonin derivative melatonin, a hormone that affects
 Female pituitary gland is approximately larger than the male by the modulation of wake/sleep patterns and seasonal functions. Its
approximately 20%. During pregnancy, female pituitary gland shape resembles a tiny pine cone and it is located near the center of
increases in size approximately 10% because of the hypertrophy the brain, between the two hemispheres, tucked in a groove where the
of prolactin secreting cells. two rounded thalamic bodies join.

Blood supply and venous drainage: Superior and inferior  The pineal is an endocrine gland of major regulatory importance.
hypophyseal arteries from the ICA; Intercavernous sinu It modifies the activity of the adenohypophysis, neurohypophysis,
endocrine pancreas, parathyroids, adrenal cortex, adrenal
 Anterior pituitary - also called the adenohypophysis. Secretes medulla and gonads. Its effects are largely inhibitory.
hormones that regulate a wide range of bodily activities, from  Primary timing center for circadian rhythms.
growth to reproduction. Accounts for about 75% of the total - Reset by daily light/dark changes.
weight of the gland and is composed of epithelial tissue.  Melatonin is involved in aligning physiology with sleep/wake cycle
a. Pars distalis - is the larger portion. & seasons
b. Pars tuberalis - forms a sheath around the infundibulum. - Secreted at night & is inhibited by light.
- The abundant melatonin levels in children are believed to
inhibit sexual development, and pineal tumors have been
linked with precocious puberty.
- When puberty arrives, melatonin production is reduced.
- Calcification of the pineal gland is typical in adults.

Location: Lies between the superior colliculi. It is attached by a stalk

to the region of the posterior wall of the third ventricle. It is located in
basal forebrain near thalamus.

Blood supply and drainage: Posterior choroidal artery with venous

drainage into great cerebral veins.
Those anterior pituitary hormones that act on other endocrine glands THYROID GLAND
are called tropic hormones or tropins. Location: Located in the middle of the lower neck, below the larynx
and just above the clavicle and anterior to the trachea.
 Posterior pituitary - also called the neurohypophysis, is
composed of neural tissue. Gross features: Consist of right and left lobes connected by the
a. Pars nervosa - the larger bulbar portion, and the isthmus. Vascular organ surrounded by pretracheal layer of the deep
infundibulum. cervical fascia. Lobe is pea-shaped. The isthmus extends from 2 nd –
b. Pars intermedia - third region of the pituitary gland, 4 th tracheal rings. A pyramidal lobe is often present and it projects
atrophies during human fetal development and ceases to upward from the isthmus with glandulae thyroidea, a band connecting
exist as a separate lobe in adults. However, some of its cells the pyramidal lobe to the hyoid bone
migrate into adjacent parts of the anterior pituitary, where
they persist. Normal Weight: 15 to 20 grams

Hormones secreted: These hormones regulate the rate of

metabolism and affect the growth and brain development and rate of
function of many other systems in the body.

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 Thyroxine HORMONES STRUCTURES THAT SECRETES

 Triiodothyronine Insulin Beta cells; beta cells more centrally
 Calcitonin – Decreases blood calcium concentration Alpha cells; concentrated at the periphery of
Glucagon
islets
 Superior thyroid artery – Descend to the upper poles of each Pancreatic PP cells; Head and uncinated
lobe accompanied by the external laryngeal nerve; Originates Polypeptide
from the ECA Delta cells; peripherally placed within the islets;
Somatostatin
 Inferior thyroid artery – Ascends behind the gland to the level Periphery of the gland
of the cricoid cartilage. Accompanied by the recurrent laryngeal
nerve; Originates from the thyrocervical trunk (subclavian artery) ADRENAL GLANDS
 Thyroidea ima artery – Ascends in front of the trachea to the Describe the location and relations: Anatomically, the adrenal
isthmus; brachiocephalic trunk, arch of aorta, left common carotid glands are located in the retroperitoneum situated atop the kidneys,
artery one on each side. They are surrounded by the perinephric fascia but
separated from the kidneys by the perinephric fat. In humans, the
Venous and lymphatic drainage: adrenal glands are found at the level of the 12th thoracic vertebra.
Superior thyroid vein – IJV
Middle thyroid vein – IJV In an adult, each adrenal gland is 3–5cm in height, 2–3cm in width,
Inferior thyroid vein – L brachiocephalic vein and a little less than 1 cm thick, with a mass of 3.5–5g, only half its
Deep cervical and paratracheal group of nodes size at birth.

 Right adrenal gland is pyramidal in shape. It lies behind the right

lobe of the liver and extends medially behind the IVC. It rest
posteriorly on the diaphragm.
 Left adrenal gland is crescentric in shape and extends along the
medial border of the left kidney. It lies behind the pancreas, lesser
sac, stomach and rest posteriorly on the diaphragm.

Blood supply:
 The superior suprarenal artery is provided by the inferior phrenic
artery.
 The middle suprarenal artery is provided by the abdominal aorta.
 The inferior suprarenal artery is provided by the renal artery.

Venous and Lymphatic Drainage:

 The right suprarenal vein drains into the inferior vena cava.
 The left suprarenal vein drains into the left renal vein or the left
inferior phrenic vein.

Lymphatic drainage: Lateral aortic nodes

HORMONES ORIGIN
Aldosterone Cortex
Cortisol Cortex
PARATHYROID GLANDS Androgens Cortex
Four in number and intimately related to the posterior border of the Epinephrine Medulla
thyroid gland, lying within its fascial capsule. The superior parathyroid Norepinephrine Medulla
glands are more constant in location and lie in the level of the middle
of the posterior border of the thyroid gland. Inferior parathyroid glands TESTIS AND OVARY
lie close to the inferior pole of the thyroid gland. They may lie within Location: Testis is a mobile organ within the scrotum. Ovary is an
the fascial sheath, embeded in the thyroid substance or outside the almond shape organ which lies against the lateral wall of the pelvis on
fascial sheath. At times they are found caudal to the thyroid gland a depression called ovarian fossa.
even in the superior mediastinum. Each has a mass of about 40mg
(0.04g). TESTES OVARY
Stimulating
FSH and LH FSH and LH
Gross Features: Yellowish brown and ovoid shape measuring 6 mm Hormones
in its greatest diameter. LH stimulates the FSH stimulates the
Leydig cells to maturation of the graafian
Target
Hormones Secreted: PTH – Increases blood levels of calcium. produce follicle and its production of
Cells of the
testosterone; FSH estradiol. LH causes
Stimulating
Blood supply: Superior and inferior thyroid arteries binds to Sertoli cells folicular rupture, ovulation
Hormones
Venous drainage: Superior, middle and inferior thyroid veins to enhance and maintenance of the
Lymphatic drainage: Deep cervical and paratracheal group of nodes spermatogenesis. corpus luteum.

PANCREAS Blood supply (Testes)

Has both endocrine and exocrine functions. Best known endocrine 1. Testicular artery from the aorta.
function of the pancreas involves glucose homeostasis. Endocrine 2. Collateral blood supply from the cremasteric artery (a branch of
function of the pancreas is served by the islets of langerhans. the inferior epigastric artery, which is a branch of the external iliac

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artery), and the artery to the ductus deferens (a branch of the

inferior vesical artery, which is a branch of the internal iliac artery.

Blood supply (ovary): Ovarian artery from aorta.

Lymphatic drainage: Paraaortic nodes

Venous drainage (Testes): Right spermatic vein > IVC Left spermatic
vein > Left renal vein

Venous drainage (Ovary): Ovarian vein > right on the IVC left renal
vein

OTHER SECRETING ORGANS

Stomach
The fibrous pericardium is roughly conical and clothes the heart.
Hormone: Gastrin
Superiorly, it is continuous exteriorly with the adventitia of the great
Fx: Plays an important role in control of gastric acid secretion.
vessels; inferiorly it is attached to the central tendon of the diaphragm
Small Intestine
and a small muscular area of its left half. Above, the fibrous
Hormone: Cholecystokinin and Secretin pericardium not only blends externally with the great vessels, but is
Fx:
continuous with the pretracheal fascia. Anteriorly, it is also attached to
Cholecystokinin: A small intestinal hormone that stimulates
the posterior surface of the sternum by superior and inferior
secretion of pancreatic enzymes and bile. sternopericardial ligaments, although the extent of these ligaments is
Secretin: stimulates secretion of a bicarbonate- rich fluids from the
extremely variable, and the superior one is often undetectable.
pancreas and live
Liver The serosal pericardium is a closed sac within the fibrous
Hormone: Insulin-like Growth Factor-1, Angiotensinogen, pericardium, and has a visceral and a parietal layer. The visceral
Thrombopoietin , Hepcidin layer, or epicardium, covers the heart and great vessels and is
Fx: Insulin-like Growth Factor-1 - immediate stimulus for growth reflected into the parietal layer, which lines the internal surface of the
of the body; Angiotensinogen serves as the precursor for fibrous pericardium and is reflected around the roots of the great
angiotensin; the role it plays in maintaining blood pressure; vessels. The slitlke space between the visceral and parietal layers is
Thrombopoietin stimulates precursor cells in the bone marrow to called the pericardial cavity.
differentiate into megakaryocytes; Hepcidin It blocks the release
of iron from intracellular stores in the body; also serves as a
defense against invasion by pathogenic bacteria
Kidney
Hormone: Erythropoietin and Calcitriol
Fx: Erythropoietin increases the production of red blood cells;
Calcitriol stimulates the cells of the intestine to promote the
absorption of calcium from food and bone to mobilize calcium from
the bone to the blood.
Placenta
Hormone: Human chorionic gonadotropin, Placental, Lactogen,
and Progesterone
Fx: HCG maintains the corpus luteum of pregnancy Placental
lactogen prepares the mammary glands for lactation

CARDIOVASCULAR SYSTEM
 Transport of nutrients, oxygen, and hormones to cells throughout
the body and removal of metabolic wastes (carbon dioxide, Innervation of the Pericardium
nitrogenous wastes). The pericardium is innervated by the vagus, together with phrenic
 Protection of the body by white blood cells, antibodies, and nerves and the sympathetic trunks. Pericardial pain is typically a
complement proteins that circulate in the blood and defend the sharp severe substernal pain. It may be exacerbated by lying back or
body against foreign microbes and toxins. Clotting mechanisms on the left side and relieved by leaning forward. It occasionally radiates
are also present that protect the body from blood loss after to the upper border of trapezius.
injuries.
 Regulation of body temperature. Pericardial Sac
1. Shape – Cone shaped bag.
HEART AND RELATED STRUCTURES IN THE MIDDLE 2. Relations – Behind the body of the sternum and the cartilages of
MEDIASTINUM the ribs from the 2nd to the 6th and in front of the thoracic vertebra
5th to 8th.
Boundaries of the Middle Mediastinum 3. Contents – Heart and the roots of the great vessels namely the
Anteriorly: fibrous and parietal layers of the pericardium. aorta, pulmonary trunk, SVC and IVC, and pulmonary veins.
Posteriorly: fibrous and parietal layers of the pericardium 4. Importance – Restricts excessive movements of the heart and
Superiorly: horizontal plane through the sternal angle of louis and the serve as a lubricated container.
intervertebral disc t4/t5
Inferiorly: diaphragm

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Functions of the Heart

 Generates blood pressure
 Routing of blood
 Ensure one way blood flow
 Regulating the blood supply

Weight of the Heart

Male: 280 – 340 grams; Average 300 grams
Female: 230 – 280 grams; Average 250 grams
Cardiac weight is 0.45% of body weight in males and 0.40% in
females. Adult weight is achieved between the ages of 17 and 20 year.

EXTERNAL FEATURES OF THE HEART

Cardiac Orientation
The general shape and orientation of the heart are that of a pyramid
that has fallen over and is resting on one of its sides. Placed in the
thoracic cavity, the apex of this pyramid projects forward, downward,
and to the left, whereas the base is opposite the apex and faces in a GROOVES ON THE CARDIAC SURFACE
posterior direction. Interatrial groove – Separates atria which is an external landmark
of interatrial septum.
A. Base Atrioventricular (coronary) groove (or sulcus) - separates the
1. Mainly by the left atrium into which open the 4 pulmonary atria from the ventricles. This groove, containing the main trunks of
veins. the coronary arteries, is oblique. It descends to the right on the
2. Small posterior portion of the right atrium. sternocostal surface, separating the right atrium (and its auricle or
3. Proximal parts of the great veins (superior and inferior appendage) from the oblique right margin of the right ventricle. The
venae cavae and the pulmonary veins). The base of the coronary sulcus circles the heart, separating the atria from the
heart is fixed posteriorly to the pericardial wall, opposite the ventricles. As it circles the heart, it contains the right coronary
bodies of vertebrae T5 to T8 (TVI to TIX when standing). artery, the small cardiac vein, the coronary sinus, and the
The esophagus lies immediately posterior to the base. circumflex branch of the left coronary artery.
B. Apex Interventricular groove - This groove provides an external
Apex of the conical left ventricle, which is directed down, forwards and landmark between the territories of each ventricle. The anterior
to the left. It is overlapped by the left lung and pleura. The apex is interventricular sulcus is on the anterior surface of the heart and
located most commonly behind the fifth left intercostal space, near or contains the anterior interventricular artery and the great cardiac
a little medial to the midclavicular line. vein, and the posterior interventricular sulcus is on the
diaphragmatic surface of the heart and contains the posterior
interventricular artery and the middle cardiac vein.

Describe the Interatrial and Interventricular Septa

SURFACES OF THE HEART a. Interatrial Septum - It prevents the mixing of blood between the
Anterior/Sternocostal surface - faces anteriorly and consists two atrial chamber which faces forward and to the right because
mostly of the right ventricle with some of the right atrium on the right the left atrium lies posteriorly and to the left of the right atrium. A
and some of the left ventricle on the left. depression is clearly visible in the septum just above the orifice
Inferior/Diaphragmatic surface - consists of the left ventricle and of the inferior vena cava. This is the fossa ovalis, with its
a small portion of the right ventricle separated by the posterior prominent margin, the limbus fossa ovalis (border of oval fossa).
interventricular groove. This surface faces inferiorly, rests on the
diaphragm, is separated from the base of the heart by the coronary b. Interventricular Septum – is the wall of cardiac muscle and
sinus, and extends from the base to the apex of the heart. membranous tissue that left and right ventricles of the heart. The
septum is placed obliquely with one surface facing forward and
Posterior/Base
to the right and the other facing backward and to the left. The
Left surface - left ventricle, but a small part of the left atrium and
lower part of the septum is thick and formed of muscle.
its auricle contribute superiorly.
Right surface - The right surface is rounded and formed by the
right atrial wall.

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The septomarginal trabecula (moderator band), forms a bridge

between the lower portion of the interventricular septum and the base
of the anterior papillary muscle. It is a band of cardiac muscle found in
the right ventricle of the heart. The septomarginal trabeculum
carries a portion of the cardiac conduction system, right bundle of the
atrioventricular bundle, to the anterior wall of the right ventricle.

Blood Vessels that Terminate in the Heart

 Superior vena cava
 Inferior vena cava
 Coronary sinus
 Pulmonary veins

Blood Vessels that Arise in the Heart

 Ascending aorta
 Pulmonary trunk

Blood Supply of the Heart

Describe the Openings Between Atria and Ventricles. Two coronary arteries arise from the aortic sinuses in the initial
The right atrioventricular orifice is closed during ventricular portion of the ascending aorta and supply the muscle and other
contraction by the tricuspid valve (right atrioventricular valve), tissues of the heart. They circle the heart in the coronary sulcus, with
which is so-named because it usually consists of three cusps or marginal and interventricular branches, in the interventricular sulci,
leaflets. The base of each cusp is secured to the fibrous ring that converging toward the apex of the heart.
surrounds the atrioventricular orifice. This fibrous ring helps to  The right coronary artery supplies the right atrium and right
maintain the shape of the opening. The naming of the three cusps, the ventricle, the sinu-atrial and atrioventricular nodes, the interatrial
anterior, septal, and posterior cusps, is based on their relative septum, a portion of the left atrium, the posteroinferior one-third
position in the right ventricle. The free margins of the cusps are of the interventricular septum, and a portion of the posterior part
attached to the chordae tendineae, which arise from the tips of the of the left ventricle.
papillary muscles.  Left coronary artery enables it to supply most of the left atrium
and left ventricle, and most of the interventricular septum,
The (left atriventricular) mitral orifice is a well-defined transitional including the atrioventricular bundle and its branches.
zone between the atrial wall and the bases of the cusps. It is smaller
than the tricuspid orifice (mean circumference is 9.0cm in males,
7.2cm in females). The approximately circular orifice is almost vertical
in diastole and at 45° to the sagittal plane, but with a slight forward tilt.
Its ventricular aspect faces anterolaterally to the left and a little
inferiorly towards the left ventricular apex.

Venous Drainage of the Heart

 Coronary sinus – it is the largest vein of the heart that drains
over half of deoxygenated blood to the right atrium. Located at
posterior part of the AV groove and is the continuation of the
great cardiac vein.
 Anterior cardiac vein
 Small veins that open directly into the heart chambers

Tributaries of the Coronary Sinus

 Great cardiac vein
 Middle cardiac vein
 Small cardiac vein
 Posterior vein of the left ventricle
 Oblique vein of the left atrium

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Role played by the conducting system of the heart:

The human heart beats ceaselessly to maintain perfusion of
pulmonary and systemic tissues. The unique distribution pattern of the
cardiac conduction system establishes an important unidirectional
pathway of excitation/contraction. Thus, a unidirectional wave of
excitation and contraction is established, which moves from the
papillary muscles and apex of the ventricles to the arterial outflow
tracts.

BORDERS OF THE HEART ON THE THORAX

Nervous Control of the Heart Apex – left ventricle, corresponds to the apex beat and is found in
The heart is innervated by the sympathetic and parasympathetic fibers the 5th left ICS 3 ½ inches from the midline.
of the ANS via the cardiac plexus situated below the arch of the aorta. Superior border – roots of the great vessels, 2nd left costal
 Superficial cardiac plexus cartilage ½ inch from the edge of the sternum to the 3rd right costal
 Deep cardiac plexus cartilage ½ inch from the edge of the sternum.
Right border – right atrium, 3rd right costal cartilage ½ inch from
CARDIAC PLEXUSES the edge of the sternum to 6th right costal cartilage ½ inch from the
edge of sternum.
 Superficial (Ventral) Part of the Cardiac Plexus Left border – left ventricle, 2nd left costal cartilage ½ inch from the
This lies below the aortic arch and anterior to the right pulmonary edge of the sternum to the apex beat.
artery. It is formed by the cardiac branch of the left superior cervical Inferior border – right ventricle and apical part, 6th right costal
sympathetic ganglion and the lower of the two cervical cardiac cartilage ½ inch from the sternum to the apex beat.
branches of the left vagus. A small cardiac ganglion is usually present
in this plexus immediately below the aortic arch, to the right of the Location of the Clinical Valvular Areas on the Anterior Thorax
ligamentum arteriosum.  Tricuspid valve – Lies behind the right half of the sternum
opposite the 4th ICS.
 Deep (Dorsal) Part of the Cardiac Plexus  Mitral valve – Lies behind the left half of the sternum opposite
The deep (dorsal) part of the cardiac plexus is anterior to the tracheal the 4th costal cartilage.
bifurcation, above the point of division of the pulmonary trunk and  Pulmonary valve – Lies behind the medial end of the 3rd left
posterior to the aortic arch. It is formed by the cardiac branches of the costal cartilage and the adjoining part of the sternum.
cervical and upper thoracic sympathetic ganglia and of the vagus and  Aortic valve – Lies behind the left half of the sternum opposite
recurrent laryngeal nerves. The only cardiac nerves that do not join it the 3rd.
are those that join the superficial part of the plexus.
Auscultation of Heart Sounds
Sensory Innervation of the Heart  The tricuspid valve is heard right half of the lower end of the
The heart possesses a double sensory innervation made up of body of sternum.
afferent nerve fibers coursing into the vagal and sympathetic nerves
 The mitral valve is heard over the apex of the heart in the left
to the medulla and spinal cord respectively.
fifth intercostal space at the midclavicular line.
 The pulmonary valve is heard over the medial end of the left
Conducting System of the Heart
second intercostal space.
The nodes and networks of the so-called specialized myocardial
 The aortic valve is heard over the medial end of the right second
cells constitute the cardiac conduction system. The components of
intercostal space.
this system are the sinu-atrial and atrioventricular nodes, the
atrioventricular bundle with its left and right bundle branches and the
Significance of knowledge of the cardiac borders and the clinical
subendocardial plexus of ventricular conduction cells (Purkinje fibres).
valvular areas: Cardiomegaly and Murmurs
 SA node – Pacemaker; Wall of the right atrium near the SVC
 AV node – Interatrial septum
VASCULAR SYSTEM
 Bundle of His – Divides into right and left branches to supply the
ventricles
 Purkinje fibers – Endocardial surface
largest pacemaker

Parts of the Artery and Vein

CLASSIFICATION OF ARTERIES
a. Large or Elastic arteries - The aorta and its branches
(brachiocephalic, subclavian, pulmonary, beginning of common
carotid and iliac); Smooth out the large fluctuations in blood
pressure created by the heartbeat
b. Medium (Muscular / Distributive) arteries

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c. Arterioles - Less than 0.5 mm in diameter The circle of Willis lies in the interpeduncular fossa at the base of the
brain. It is formed by the anastomosis between the two internal carotid
An end artery (terminal artery) is an artery that is the only supply of arteries and the two vertebral arteries. The anterior communicating,
oxygenated blood to a portion of tissue. Examples of an end artery anterior cerebral, internal carotid, posterior communicating,
include the splenic artery that supplies the spleen and the renal artery posterior cerebral, and basilar arteries all contribute to the circle.
that supplies the kidneys. The circle of Willis allows blood that enters by either internal carotid or
vertebral arteries to be distributed to any part of both cerebral
Tributary hemispheres. Cortical and central branches arise from the circle and
- Smaller veins. supply the brain substance. Variations in the sizes of the arteries
- A vein that empties into a larger vein. forming the circle are common, and the absence of one or both
posterior communicating arteries has been reported.
Collateral circulation - is the redundant circulation in an area of
tissue or an organ that blood can reach by more than one pathway.
This is often a result of anastomoses.

PULMONARY CIRCULATION SYSTEMIC CIRCULATION

Portion of the cardiovascular Part of the cardiovascular
system which carries system which carries
deoxygenated blood away from oxygenated blood away from
the heart, to the lungs, and the heart to the body, and
returns oxygenated (oxygen- returns deoxygenated blood
rich) blood back to the heart. back to the heart.
PORTAL CIRCULATON
Arteries to Specific Brain Areas
Arterial Supply of the Brain 1. The corpus striatum and the internal capsule are supplied
The brain is supplied by the two internal carotid arteries and two mainly by the medial and lateral striate central branches of the
vertebral arteries. The four arteries lie within the subarachnoid space, middle cerebral artery; the central branches of the anterior
and their branches anastomose on the inferior surface of the brain to cerebral artery supply the remainder of these structures.
form the circle of Willis. 2. The thalamus is supplied mainly by branches of the posterior
communicating, basilar, and posterior cerebral arteries.
The internal carotid artery begins at the bifurcation of the common 3. The midbrain is supplied by the posterior cerebral, superior
carotid artery, where it usually possesses a localized dilatation, called cerebellar, and basilar arteries.
the carotid sinus. It ascends the neck and perforates the base of the 4. The pons is supplied by the basilar and the anterior, inferior, and
skull by passing through the carotid canal of the temporal bone. The superior cerebellar arteries.
artery then runs horizontally forward through the cavernous sinus and 5. The medulla oblongata is supplied by the vertebral, anterior and
emerges on the medial side of the anterior clinoid process by posterior spinal, posterior inferior cerebellar, and basilar arteries.
perforating the dura mater. It now enters the subarachnoid space by 6. The cerebellum is supplied by the superior cerebellar, anterior
piercing the arachnoid mater and turns posteriorly to the region of the inferior cerebellar, and posterior inferior cerebellar arteries.
medial end of the lateral cerebral sulcus. Here, it divides into the
anterior and middle cerebral arteries. VEINS OF THE BRAIN
The veins of the brain have no muscular tissue in their very thin
walls, and they possess no valves. They emerge from the brain and
lie in the subarachnoid space. They pierce the arachnoid mater and
the meningeal layer of the dura and drain into the cranial venous
sinuses.

External Cerebral Veins

1. Superior cerebral veins pass upward over the lateral surface of
the cerebral hemisphere and empty into the superior sagittal
sinus.
2. Superficial middle cerebral veins drains the lateral surface of
the cerebral hemisphere. It runs inferiorly in the lateral sulcus and
empties into the cavernous sinus.
3. Deep middle cerebral veins drains the insula and is joined by
the anterior cerebral and striate veins to form the basal vein. The
basal vein ultimately joins the great cerebral vein, which in turn
drains into the straight sinus.

Internal Cerebral Veins

The vertebral artery, a branch of the first part of the subclavian artery, There are two internal cerebral veins and they are formed by the
ascends the neck by passing through the foramina in the transverse union of thalamostriate vein and choroid vein. They unite to form
processes of the upper six cervical vertebrae. It enters the skull the great cerebral vein which empties into the straight sinus.
through the foramen magnum and pierces the dura mater and
arachnoid to enter the subarachnoid space. It then passes upward, Dural venous sinuses
forward, and medially on the medulla oblongata. At the lower border The venous sinuses of the cranial cavity are situated between the
of the pons, it joins the vessel of the opposite side to form the basilar layers of the dura mater. Their main function is to receive blood
artery. from the brain through the cerebral veins and the CSF from the
subarachnoid space through the arachnoid villi. The blood in the dural

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venous sinuses ultimately drains into the IJV. The dural venous
sinuses are lined by endothelium and their walls are thick but it is CIRCULATORY SYSTEM
devoid of muscular tissue. They have no valves; They receive Blood
tributaries from the brain, the diploë of the skull, the orbit, and the A. Formed Elements
internal ear. 1. RBCs - With hemoglobin for oxygen transport.
1. Superior sagittal sinus - Lies in the upper fixed border of the 2. WBCs
falx cerebri. The superior sagittal sinus receives the superior  Granular – Basophils, Eosinophils and Neutrophils
cerebral veins.  Agranular – Lymphocytes and Monocytes
2. Inferior sagittal sinus - Lies in the free lower margin of the falx 3. Thrombocytes – Blood coagulation
cerebri; It receives cerebral veins from the medial surface of the
cerebral hemisphere. B. Blood Plasma
3. Straight sinus - Lies at the junction of the falx cerebri with the
tentorium cerebelli. Formed by the union of the inferior sagittal
sinus with the great cerebral vein, it ends by turning to form the
transverse sinus.
4. Right transverse sinus - Begins as a continuation of the
superior sagittal sinus; Left transverse sinus is usually a
continuation of the straight sinus. Each sinus lies in the lateral
attached margin of the tentorium cerebelli, and they end on each
side by becoming the sigmoid sinus.
5. Sigmoid sinuses are a direct continuation of the transverse
sinuses.
6. Occipital sinus - Lies in the attached margin of the falx cerebelli.
It communicates with the vertebral veins through the foramen
magnum and the transverse sinuses. 2 Major Blood Groups
7. Cavernous sinus - Lies on the lateral side of the body of the  ABO Group
sphenoid bone.  Rh Factor
8. Superior and inferior petrosal sinuses – Lies on the superior
and inferior borders of the petrous part of the temporal bone on Significance of Blood Typing:
each side of the skull; Superior petrosal sinuses drains the A. Identification
cavernous into the transverse while inferior drains the cavernous B. Screening for donors
into the IJV. C. Medicolegal

Significance of Crossmatching:
A. Blood transfusion
B. Organ transplant

BLOOD
A B AB O
TYPE
Antigens
Rbc Antigen A Antigen B No antigens
A and B
Anti-A and
Anti-B Anti-A No
Plasma Anti-B
antibody antibody antibodies
antibodies

BLOOD INCOMPATIBILITY
Recipient A B AB O
A and O B and O AB, A, B
Compatible
(packed (packed (packed O
Donor
cells) cells) cells)
AB, B AB, A
A, B and
Incompatible and O and O A, B and
O (whole
Donor (whole (whole AB
blood)
blood) blood)

BLOOD VESSELS
A. Arteries – Carry oxygenated blood
 Elastic/Conducting
 Muscular/Distributing

B. Veins – Carry deoxygenated blood; (+) Valves

C. Capillaries – Exchange of gases takes place

Electrocardiogram Basics
1. Each small square represents 0.04 second.
2. Each large square represents 0.20 second.
3. The P wave represents atrial depolarization.

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4. The PR interval represents the time it takes an impulse to travel

from atria to the Purkinje fibers.
5. The QRS complex represents ventricular depolarization.
6. The ST segment represents part of the of ventricular
repolarization.
7. The T wave represents ventricular repolarization and ventricular
diastole.
8. U wave may follow the T wave; Prominent U wave may indicate
electrolyte abnormality like hypokalemia.

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[Link]
cranial-nerves.
Cleveland Clinic. (2021). Spinal cord. Cleveland Clinic.
[Link]
spinal-cord.
Cleveland Clinic. (2022). Sympathetic nervous system (SNS):
what it is & function. Cleveland Clinic.
[Link]
sympathetic-nervous-system-sns-fight-or-flight.
Miracle Gotiangco, PTRP. (2023). Week 8-9 PPT Nervous
System.
Miracle Gotiangco, PTRP. (2023). Week 11 PPT Cardiovascular
System
Miracle Gotiangco, PTRP. (2023). Week 7 PPT Sensory Organs.
Snell, R. S., M.D. PhD. (2012). Clinical anatomy by regions. 9th
ed. Lippincott Williams & Wilkins. ISBN: 978-1-60913-
446-4.
Tortora, G. J., & Derrickson, B. (2020). Principles of anatomy and
physiology. 13th ed. John Wiley & Sons, Inc. ISBN 13 978-
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