Lecture Mosby''s paramedic textbook (4th ed) - Chapter 10: Review of human systems
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (2.42 MB, 182 trang )
9/10/2012
1
Chapter 10
Review of Human Systems
2
Lesson 10.1
Human Anatomy and
Terminology
3
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
1
9/10/2012
Learning Objectives
• Discuss the importance of human anatomy as
it relates to the paramedic profession.
• Describe anatomical position.
• Properly interpret anatomical directional
terms and body planes.
4
Learning Objectives
• List the structures that compose axial and
appendicular regions of the body.
• Define the divisions of the abdominal region.
• List the three major body cavities.
• Describe the contents of the three major
body cavities.
5
Human Anatomy
• Study of how the human body is organized
• Reason for anatomy knowledge
– To assess patient by body region
– To help communicate well with other health
team members
6
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
2
9/10/2012
Anatomical Position
• Directional terms for human body, used by
medical field
• Person standing erect with feet, palms
facing examiner
• Supine position
– Lying on back, face up
7
Anatomical Position
• Prone position
– Lying on stomach, face down
• Lateral recumbent position
– Lying on left, right side
• Regardless, patient’s position always
conveyed, reference anatomical position
8
Directional Terms
• Up, down, front, back, right, left
• Always refer to patient, not examiner
9
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
3
9/10/2012
10
Anatomical Planes
• Internal body structure relationships classified into
anatomical planes
• Viewed as imaginary straight‐line divisions of the
body
• Sagittal plane: runs vertically through middle, creates
right, left sections
• Parasagittal plane: to one side of midline
11
Anatomical Planes
• Transverse plane
– Horizontal division, divides body into top,
bottom sections
– Superior, inferior sections
• Coronal, frontal plane
– Divides body into front, back
– Anterior, posterior sections
12
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
4
9/10/2012
13
Body Regions
• Appendicular region
– Limbs
– Extremities
• Axial region
– Head
– Neck
– Thorax
– Abdomen
14
Body Regions
• Abdomen has four quadrants
– Upper right
– Lower right
– Upper left
– Lower left
– Run horizontally through umbilicus
– Run vertically from xiphoid process through
symphysis pubis
15
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
5
9/10/2012
16
Body Cavities: Thoracic
• Thoracic cavity
– Divided into two portions by midline
structure/mediastinum
– Includes trachea, esophagus, thymus, heart,
great vessels
– Lungs located on either side of mediastinum
– Surrounded by rib cage
– Separated from abdominal cavity by diaphragm
17
Body Cavities: Abdominal, Pelvic
• Contains two pleural cavities (contain lungs)
and pericardial cavity (contains heart)
– Cavities lined with serous membrane
– If serous membrane contacts organ, is visceral
– If serous membrane contacts cavity wall,
is parietal
– Thin lubricating fluid film produced by
membranes, reduces friction
18
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
6
9/10/2012
Body Cavities: Abdominal, Pelvic
• Lined with thin sheet, membranous tissue,
secretes serous fluid
• Visceral peritoneum
– Serous membrane that covers abdominal organs
• Parietal peritoneum
– Serous membrane that covers body cavity wall
19
Body Cavities: Abdominal, Pelvic
• Mesentery
– Peritoneal organs held in place by
connective tissue
– Holds some abdominal organs to body wall, offers
pathway for nerves, vessels to reach organs
20
Body Cavities: Abdominal, Pelvic
• Retroperitoneal
– Abdominopelvic organs with no mesentery,
peritoneum, are retroperitoneal
– Behind peritoneum
– Include kidneys, adrenal glands, pancreas, colon
portions, urinary bladder
• Pelvic cavity enclosed by pelvis bones
• Referred to collectively as peritoneal or
abdominopelvic cavity
21
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
7
9/10/2012
22
Lesson 10.2
Cell Structure
23
Learning Objectives
• Discuss the functions of the following cellular
structures: the cytoplasmic membrane, the
cytoplasm (and organelles), and the nucleus.
• Describe the process by which human
cells reproduce.
24
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
8
9/10/2012
Cell Structure
• Cells are basic life unit
– Highly organized, composed of protoplasm,
living matter
– Main parts are cytoplasmic membrane (plasma
membrane), cytoplasm, nucleus
• Cytoplasmic membrane
– Encloses cytoplasm, forms outer cell boundary
– Two layers of phosphate‐containing fat
molecules, phospholipids
25
Cell Structure
• Form fluid framework for membrane
– Substances outside membrane, extracellular
(outside cell), intercellular (between cells)
– Substances inside membrane, intracellular
– Enclose, support cell contents, regulate what
moves into, out of cell
26
27
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
9
9/10/2012
Cell Structure
• Central layer, lipid bilayer
– Composed of double layer lipid molecules
– Liquid quality
– Protein molecules “float” on inner, outer surfaces
28
Cytoplasm
• Lies between cytoplasmic membrane
and nucleus
– Nucleus is round structure in cell center
• Organelles
– Specialized structures in cell
– Perform functions important for cell survival
29
30
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
10
9/10/2012
Cytoplasm
• Endoplasmic reticulum
– Chain of connecting sacs or canals, winds
through cytoplasm
– Serves as tiny circulatory system
– Tubular passages, canals carry proteins, other
substances from one area to another
– Smooth endoplasmic reticulum
– Rough endoplasmic reticulum
31
Cytoplasm
• Ribosomes
– “Factories” in which protein is synthesized
– Macromolecules of protein, and ribonucleic acid
(RNA), composed of thousands of atoms
– Bound to endoplasmic reticulum, also found free
in cytoplasm
– Form complexes with RNA strands, which, through
genetic code, provide blueprint for new protein
– Individual amino acids attach in long chains with
peptide bonds to form new proteins
32
Cytoplasm
• Golgi apparatus
– Concentrates, packages materials for secretion
from cell
– Tiny sacs composed of smooth endoplasmic
reticulum
– Sacs stacked one on the other near nucleus
33
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
11
9/10/2012
Cytoplasm
• Golgi apparatus sometimes chemically
modifies proteins
– Synthesizes, attaches carbohydrate molecules to
proteins, forms glycoproteins or attaches lipids to
proteins, forms lipoproteins
– Concentrated globules move slowly outward to
and through cell membrane, then break open,
spill contents
– Example product of mucus
34
Cytoplasm
• Lysosomes
– Membranous‐walled organelles
– Contain enzymes to function as intracellular
digestive systems
35
Cytoplasm
• Lysosomes include those that digest nucleic
acids, proteins, polysaccharides, lipids
– Certain WBCs (leukocytes) have large numbers of
lysosomes that contain enzymes to digest
engulfed bacteria
– If tissues damaged, enzymes may escape from
ruptured lysosome sacs into cytoplasm, digesting
damaged and healthy cells
– Digest organelles of cell that are no longer
functional (autophagia)
36
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
12
9/10/2012
Cytoplasm
• Mitochondria
– Power plants of cell
– Found throughout the cell
– Site of aerobic oxidation
– Energy derived from efficient metabolism of
nutrients and oxygen used to synthesize high‐
energy triphosphate bonds
– Triphosphate bonds are energy source for
muscles, nerves, overall body function
37
Your patient has bad lung disease
and poor oxygenation. What effect
will this have on cellular
energy production?
38
Cytoplasm
• Centrioles
– Paired, rod‐shaped organelles that lie at right
angles to each other in specialized cytoplasm
zone (centrosome)
– Composed of microtubules that play important
role in cell division process
– All human cells, at some point, contain nucleus in
which cell’s genetic material is located
39
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
13
9/10/2012
Nucleus
• Nucleus
– All human cells contain nucleus
– Contain genetic material
– Controls all organelle in cytoplasm
– Spherical, elongated, lobed, depending on
cell type
40
Nucleus
• Some cells lose the nucleus as they develop
– Red blood cells
– Erythrocytes
• Some cells have more than one nucleus
• Most categorizing feature of cell is
presence/absence of nucleus
41
Nucleus
• Relatively large structure, not always near
cell’s center
• Surrounded by nuclear membrane
– Encloses nucleoplasm, special type of protoplasm
• Nucleoplasm contains nucleolus,
chromatin granules
42
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
14
9/10/2012
Nucleus
• Nucleolus consists of deoxyribonucleic
acid (DNA)
– “Programs” RNA formation and protein, makes
ribosomes
– Ribosomes migrate through nuclear membrane
into cell’s cytoplasm, produce proteins
43
Nucleus
• Chromatin granules
– Threadlike structures made up of proteins, DNA
– During cell division, condense, form 23 pairs of
chromosomes in human cells
– Nuclear DNA information determines most
chemical events occurring within cell
44
Nucleus
• Basic functions are cell division, genetic
information control
• Not all cells capable of continuous division
• Some cells (nerve cells) cannot reproduce
45
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
15
9/10/2012
Major Cell Classes
• Free‐living cells of multicellular, “social”
organisms divided into two major classes
• Divided by how genetic material is organized
inside them
46
Major Cell Classes
• Eukaryotes
– “True nucleus”
– Larger than prokaryotes
– Have more extensive intracellular anatomy
– Have separate membrane‐bound nucleus that
holds genetic material (chromosomes, DNA)
47
Major Cell Classes
• Eukaryotes
– Fluid filling is divided into nucleoplasm, cytoplasm
– Nucleoplasm is inside nuclear membrane
– Cytoplasm is outside nuclear membrane
– Nearly all human body cells, living organism cells
are eukaryotes
48
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
16
9/10/2012
Major Cell Classes
• Prokaryote
– “Before nucleus”
– Genetic material, enzymes required for energy
production, cell growth, cell division, are
contained in cytoplasm
– Cytoplasm surrounded by plasma membrane
– Simple internal organization
– Do not have nucleus bound by plasma membrane
– DNA attached to plasma membrane
49
Chief Cellular Functions
• Through differentiation (maturation), cells
become specialized
– Act in concert with other cells to perform more
complex task
– RBCs transport respiratory gases around body
– Pancreatic cells synthesize, secrete large
quantities of digestive enzymes, which are
required to break down foods
50
Chief Cellular Functions
• Movement (muscle cells)
• Conductivity (nerve cells)
• Metabolic absorption (kidney, intestinal cells)
51
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
17
9/10/2012
Chief Cellular Functions
•
•
•
•
Secretion (mucous gland cells)
Excretion (all cells)
Respiration (all cells)
Reproduction (most cells)
52
What type of cells regenerate?
53
Cell Reproduction
• All human cells reproduce by mitosis process
– Exception is reproductive (sex) cells
– Cells divide to multiply: one cell divides, forms two
cells
– Many cell types (epithelial, liver, bone marrow)
undergo cell division throughout individual’s life
– Other cell types (nerve, skeletal muscle) divide
until near birth
54
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
18
9/10/2012
Lesson 10.3
Tissues
55
Learning Objective
• Differentiate and describe the following tissue
types: epithelial tissue, connective tissue,
muscle tissue, and nervous tissue.
56
Tissues
• Epithelial tissue
– Covers surfaces, forms structures derived from
body surfaces
– Consists almost entirely of cells with little/no
intercellular material between them
– Forms continuous sheets, contain no blood vessels
– Covers outside body
– Lines digestive tract, vessels, many body cavities
57
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
19
9/10/2012
Tissues
• Epithelial tissue is classified by cell shape
• Squamous
– Flat, scalelike
• Cuboidal
– Cube shaped
• Columnar
– More tall than wide
58
Tissues
• Epithelial tissue is classified by arrangement
• Simple
– Single layer cells
– Same shape
• Stratified
– Multiple layers
– Same shape
59
Connective Tissue
• Most abundant type
• Most widely distributed type
• Consists of cells separated from each other by
intercellular material (extracellular matrix)
• Nonliving matrix gives fundamental
characteristics, basis for separating connective
tissue into subgroups
60
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
20
9/10/2012
Connective Tissue
• Areolar connective tissue
– Loose tissue
– Delicate fiber webs, variety of cells embedded in
matrix of soft, sticky gel
– “Loose packing” material of most organs,
other tissues
– Attaches skin to underlying tissues
– Contains major protein fiber types: collagen,
reticulum, elastin
61
Connective Tissue
• Adipose tissue, fat tissue
– Specialized tissue, stores lipids
– Lipids take up less space per calorie than
carbohydrates, proteins
– Acts as insulator, protector, energy storage site
• Fibrous connective tissue
– Bundles strong, white collagenous fibers in
parallel rows
– Compose tendons
– Characterized by strength, inelasticity
62
Connective Tissue
• Cartilage
– Cartilage cells, chondrocytes
– Located in tiny spaces distributed throughout
somewhat rigid matrix
– Makeup varies by location, ultimate role
– Makes up part of skeleton, covers articulating
bone surfaces
63
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
21
9/10/2012
Connective Tissue
• Cartilage
– Forms major skeletal tissue of embryo before
being replaced by bony tissue
– Type depends on relative amounts of collagen,
elastin, ground substance
– Blood vessels do not penetrate, heals slowly
after injury
64
Connective Tissue
• Bone
– Highly specialized form of hard, connective tissue
– Consists of living cells, mineralized matrix
– Matrix strength, rigidity allow support, tissue,
organ protection
– Classified by shape
65
66
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
22
9/10/2012
Bone
• Long bones, longer than wide
– Humerus
– Ulna
– Femur
– Tibia
– Fibula
– Phalanges
67
Bone
• Short bones, broad as they are long
– Carpal wrist bones
– Tarsal ankle bones
• Flat bones, thin, flattened shape
– Skull bones
– Ribs
– Sternum
– Scapulae
68
Bone
• Irregular bones, do not fit in other categories
– Vertebrae
– Facial bones
• Growing long bones
– Diaphysis (shaft)
– Epiphysis, at bone end
– Epiphyseal plate, growth plate
69
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
23
9/10/2012
Bone
• Epiphyseal plate, growth plate
– Bone elongation site
– Bone growth stops, plate becomes ossified, called
epiphyseal line
– Injury can impair bone growth if not recognized,
treated properly
70
Intraosseous infusion is a critical intervention that
can save a life. Intraosseous infusion is used to
administer fluids and drugs. This infusion requires
the insertion of a needle into the bone of the leg.
Why could the failure to identify anatomical
landmarks or place the needle correctly in the
epiphysis in a child be harmful?
71
Bone
• Contain large, smaller cavities
– Larger cavity, medullary cavity in diaphysis
– Smaller cavity, long bone epiphyses, throughout
some bone interiors
– Spaces filled with yellow marrow (mainly adipose
tissue) or red marrow (blood formation site)
72
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
24
9/10/2012
Bone
• Blood supply to most bones, excellent
– Some bones, including tibia, sternum are suitable
choices for venous access via intraosseous infusion
• Classified as cancellous/spongy bone,
compact bone
– Cancellous bone has spaces between bone plates,
resembles sponge
– Compact bone is essentially solid
• Rich blood supply, repairs itself
73
Connective Tissue
• Blood
– Unique connective tissue as matrix between cells
is liquid
– Liquid matrix allows rapid flow through body
– Carries nutrients, oxygen, waste products,
other materials
74
Connective Tissue
• Hemopoietic tissue
– In marrow cavities of bone
– In spleen, tonsils, lymph nodes
– Responsible for formation of blood cells of
lymphatic system cells, which are important
defense against disease
75
Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
25
