Anatomy & Physiology

Anatomy & Physiology
Anatomy
&
Physiology
For the students of

Pharmacy Technicians
(Category-B)
Compiled By
Syed Bilal Hussain
Lecturer
Lahore College of Pharmaceutical Sciences
Under Supervision of
Dr. Asim Zubair

Lecturer
Dr. Saima Rehmat

Lecturer
Dr. Sidra Ishaq

Lecturer
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Dedication
To
Prof. Dr. Naim Anwar Muzaffar “The Father of Pharmacy”
Whose Dedications Toward Pharmacy Education Are Priceless.
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Acknowledgement
I am very grateful to Ch. Muhammad Shamoon, Secretary, Punjab Pharmacy Council, Lahore, who give
me honor to compile Anatomy & Physiology Book for the students of Pharmacy Technician.
I am very thankful to my teachers Dr. Asim Zubair, Dr. Saima Rehmat & Dr. Sidra Ishaq who
generously contributed their time and efforts to help me make this book as accurate and as useful as
possible.
Special thanks to Hafiz Muhammad Zubair, Haroon Shahzad & Dr. Sara for providing help in
composing and proof reading of the text.
Syed Bilal Hussain

Lecturer
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Contents
ANATOMY 10
HUMAN ANATOMY 10
BRANCHES OF ANATOMY 10
MACROSCOPIC OR GROSS ANATOMY 10
MICROSCOPIC ANATOMY OR HISTOLOGY 10
HISTOLOGY 10
CYTOLOGY 10
EMBRYOLOGY 10
SURFACE ANATOMY 10
APPLIED ANATOMY 11
RADIOLOGICAL ANATOMY 11
TERMINOLOGY OF POSITION 11
TERMINOLOGY OF MOVEMENT 13
FLEXION AND EXTENSION 13
ABDUCTION AND ADDUCTION 13
ELEVATION AND DEPRESSION 13
DORSIFLEXION AND PLANTARFLEXION 13
EVERSION AND INVERSION 14
SURFACE ANATOMY 14
HUMAN SKELETON 14
OVER VIEW OF HUMAN SKULL 14
OVER VIEW O THE UPPER LIMB 16
OVER VIEW OF LOWER LIMB 16
VERTEBRAL COLUMN 16
ANATOMY OF PELVIC GIRDLE 17
ANATOMY OF DIGESTIVE SYSTEM 18
ANATOMY OF RESPIRATION SYSTEM 18
ANATOMY OF URINARY SYSTEM 19
ANATOMY OF CARDIOVASCULAR SYSTEM 19
ANATOMY OF REPRODUCTIVE SYSTEM 20
MALE REPRODUCTIVE SYSTEM 20
FEMALE REPRODUCTIVE SYSTEM 20
INTRODUCTION TO PHYSIOLOGY 21
HUMAN PHYSIOLOGY 21
CELL 21
STRUCTURE OF CELL 21
COMPONENT OF A CELL 22
PLASMA MEMBRANE OR CELL MEMBRANE 22
FUNCTIONS OF PLASMA MEMBRANE 23
CYTOPLASM 23
ZONES OF CYTOPLASM 23
NUCLEUS 23
FUNCTIONS OF NUCLEUS 23
MITOCHONDRIA 23
RIBOSOMES 23
ENDOPLASMIC RETICULUM (ER) 23
GOLGI APPARATUS 23
LYSOSOMES 23
MICROFILAMENTS AND MICROTUBULES 23
TISSUE 24
EPITHELIAL TISSUE 24
TYPES OF EPITHELIAL TISSUES 24
SIMPLE EPITHELIUM 24
STRATIFIED EPITHELIA 24
CONNECTIVE TISSUE 24
MAJOR FUNCTIONS OF CONNECTIVE TISSUE 24
STRUCTURE OF THE CONNECTIVE TISSUE 24
CELLS OF CONNECTIVE TISSUE 24
CONNECTIVE TISSUE FIBERS 25
GROUND SUBSTANCE OF THE CONNECTIVE TISSUE 25
MUSCULAR TISSUE 25
SKELETAL MUSCLE TISSUE 25
SMOOTH (VISCERAL) MUSCLE TISSUE 25
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CARDIAC MUSCLE TISSUE 26
NERVOUS TISSUE 26
BONE OR OSSEOUS TISSUES 27
BONE CELLS 27
BONE MATRIX 27
TYPES OF BONES 27
LONG BONES 27
SHORT, IRREGULAR, FLAT AND SESAMOID BONES 27
FUNCTIONS OF BONES 27
JOINTS 27
TYPES OF JOINTS 27
FIBROUS OR FIXED JOINTS 28
CARTILAGINOUS OR SLIGHTLY MOVABLE JOINTS 28
SYNOVIAL OR FREELY MOVABLE JOINTS 28
BLOOD 29
PROPERTIES OF BLOOD 29
COMPOSITION OF BLOOD 29
CELLULAR CONTENT OF BLOOD 29
ERYTHROCYTES OR RED BLOOD CELLS (RBC) 29
COMPOSITION OF RED BLOOD CELLS 29
PROPERTIES OF RBC 30
FUNCTIONS OF RBC 30
FATE OR PRODUCTION RBCS 30
FACTORS NEEDED FOR ERYTHROPOIESIS 30
RBC COUNT 31
VARIATION IN RBC COUNT 31
HEMOGLOBIN (HB) 31
NORMAL VALUE OF HEMOGLOBIN 31
FACTORS NECESSARY FOR HB SYNTHESIS 31
FUNCTIONS OF HEMOGLOBIN 31
LEUKOCYTES OR WHITE BLOOD CELLS (WBC) 31
PROPERTIES OF WHITE BLOOD CELLS 31
COUNT OF WHITE BLOOD CELLS 31
CLASSIFICATION OF WHITE BLOOD CELLS 31
GRANULOCYTES 31
AGRANULOCYTES 32
FUNCTION OF WHITE BLOOD CELLS 32
THROMBOCYTES OR PLATELETS 32
SHAPES OF PLATELETS 32
SIZE OF PLATELETS 33
COUNT OF PLATELETS 33
LIFE SPAN OF PLATELETS 33
TYPES OF PLATELETS 33
FUNCTIONS OF PLATELETS 33
BLOOD GROUPS 34
IMPORTANT TERMINOLOGY RELATED TO BLOOD GROUP 34
BLOOD GROUP SYSTEMS 34
O-A-B BLOOD TYPES 34
RH FACTORS (RHESUS FACTORS) 35
ERYTHROCYTE SEDIMENTATION RATE (ESR) 35
DETERMINATION OF ESR 35
NORMAL VALUE OF ESR 35
FACTORS EFFECTS ESR 35
ANEMIA 37
CLASSIFICATION OF ANEMIA 37
MORPHOLOGICAL CLASSIFICATION 37
NORMOCYTIC NORMOCHROMIC ANEMIA 37
MACROCYTIC NORMOCHROMIC ANEMIA 37
MACROCYTIC HYPOCHROMIC ANEMIA 37
MICROCYTIC HYPOCHROMIC ANEMIA 37
ETIOLOGICAL CLASSIFICATION 37
HEMORRHAGIC ANEMIA 37
ACUTE HEMORRHAGE 37
CHRONIC HEMORRHAGE 37
HEMOLYTIC ANEMIA 38
INTRINSIC HEMOLYTIC ANEMIA 38
SICKLE CELL ANEMIA 38
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EXTRINSIC HEMOLYTIC ANEMIA 38
NUTRITION DEFICIENCY ANEMIA 38
IRON DEFICIENCY ANEMIA 38
PROTEIN DEFICIENCY ANEMIA 38
PERNICIOUS ANEMIA (VITAMIN B12 DEFICIENCY ANEMIA) 38
MEGALOBLASTIC ANEMIA (FOLIC ACID DEFICIENCY ANEMIA) 39
APLASTIC ANEMIA 39
ANEMIA OF CHRONIC DISEASE 39
CIRCULATION 40
PULMONARY CIRCULATION 40
SYSTEMIC OR GENERAL CIRCULATION 40
FUNCTIONAL PARTS OF CIRCULATION 40
PROPERTIES OF CARDIAC MUSCLE 41
CARDIAC CYCLE 42
STAGES OF THE CARDIAC CYCLE 42
SUBDIVISIONS AND DURATION OF CARDIAC CYCLE 42
HEART SOUNDS 42
ELECTROCARDIOGRAPHY (ECG) 43
ELECTROCARDIOGRAPH 43
ELECTROCARDIOGRAPHIC PAPER AND GRID 43
ECG LEADS 43
WAVES OF NORMAL ECG 43
MAJOR COMPLEXES IN ECG 44
USES OF ECG 44
BLOOD PRESSURE 45
SYSTOLIC BLOOD PRESSURE 45
DIASTOLIC BLOOD PRESSURE 45
MEASUREMENT OF BLOOD PRESSURE 45
PALPATORY METHOD 45
AUSCULTATORY METHOD 45
PHYSIOLOGICAL VARIATIONS OF BLOOD PRESSURE 45
PULSE 46
HEMORRHAGES 46
TYPES AND CAUSES OF HEMORRHAGE 46
ACUTE HEMORRHAGE 47
CHRONIC HEMORRHAGE 47
LYMPH 47
LYMPHATIC SYSTEM 47
COMPOSITION OF LYMPH 47
FUNCTIONS OF LYMPH 47
RESPIRATORY SYSTEM 48
RESPIRATION 48
PHASES OF RESPIRATION 48
TYPES OF RESPIRATION 48
FUNCTIONAL ANATOMY OF RESPIRATORY TRACT 48
MECHANICS OF RESPIRATION 48
MECHANISM OF INSPIRATION 48
MECHANISM OF EXPIRATION 48
PULMONARY VENTILATION 49
LUNG VOLUMES 49
LUNG CAPACITIES 49
PHYSIOLOGICAL VARIATIONS OF VITAL CAPACITY 50
CARRIAGE OF O2 AND CO2 BY THE BLOOD 50
TRANSPORT OF OXYGEN 50
TRANSPORT OF CARBON DIOXIDE 51
REGULATION OF BREATHING/ RESPIRATION 51
NERVOUS OR NEURAL MECHANISM 51
CHEMICAL MECHANISM 52
TYPES OF CHEMORECEPTORS 52
CENTRAL CHEMORECEPTORS 52
MECHANISM OF ACTION OF CENTRAL CHEMORECEPTORS 52
PERIPHERAL CHEMORECEPTORS 52
MECHANISM OF ACTION OF PERIPHERAL CHEMORECEPTORS 52
SKIN 53
STRUCTURE OF SKIN 53
EPIDERMIS 53
DERMIS 53
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FUNCTIONS OF SKIN 54
TEMPERATURE REGULATION BY SKIN 54
MECHANISM OF TEMPERATURE REGULATION 55
WHEN BODY TEMPERATURE INCREASES 55
WHEN BODY TEMPERATURE DECREASES 55
DIGESTIVE SYSTEM 56
ACTIVITIES OF DIGESTIVE SYSTEM 56
FUNCTIONS OF DIGESTIVE SYSTEM 56
ORGANS OF THE DIGESTIVE SYSTEM 56
ALIMENTARY TRACT 56
ACCESSORY DIGESTIVE ORGANS 56
DIGESTIVE JUICES 56
SALIVA 57
SALIVARY GLANDS 57
COMPOSITION OF SALIVA 57
FUNCTIONS OF SALIVA 57
GASTRIC JUICE 58
COMPOSITION OF GASTRIC JUICE 58
FUNCTIONS OF GASTRIC JUICE 58
PANCREATIC JUICE 59
COMPOSITION OF PANCREATIC JUICE 59
FUNCTIONS OF PANCREATIC JUICE 59
BILE JUICE 60
COMPOSITION OF BILE 60
FUNCTIONS OF BILE 60
INTESTINAL JUICES 60
SMALL INTESTINE JUICE 60
COMPOSITION OF SUCCUS ENTERICUS 60
FUNCTIONS OF SUCCUS ENTERICUS 61
LARGE INTESTINE JUICE 61
COMPOSITION OF LARGE INTESTINAL JUICE 61
FUNCTIONS OF LARGE INTESTINAL JUICE 62
MOVEMENTS OF THE STOMACH AND INTESTINES 62
MOVEMENTS OF STOMACH 62
HUNGER CONTRACTIONS 62
RECEPTIVE RELAXATION 63
PERISTALSIS WAVES 63
MOVEMENTS OF THE INTESTINES 63
MOVEMENTS OF SMALL INTESTINE 63
TYPES OF MOVEMENTS OF SMALL INTESTINE 63
MIXING MOVEMENTS 63
PROPULSIVE MOVEMENTS 63
MIGRATING MOTOR COMPLEX (PERISTALSIS IN FASTING) 63
MOVEMENTS OF VILLI 63
MOVEMENTS OF LARGE INTESTINE 63
TYPES OF MOVEMENTS OF LARGE INTESTINE 63
MIXING MOVEMENTS – SEGMENTATION CONTRACTIONS 63
PROPULSIVE MOVEMENTS – MASS PERISTALSIS 64
FUNCTIONS OF LIVER AND GALL BLADDER 64
LIVER 64
FUNCTIONS OF LIVER 64
GALL BLADDER 64
FUNCTIONS OF THE GALLBLADDER 64
URINARY SYSTEM 65
KIDNEYS 65
URETERS 65
URINARY BLADDER 65
URETHRA 65
URINE FORMATION 65
PROCESSES OF URINE FORMATION 65
COMPOSITION OF URINE 66
GENERAL INTRODUCTION TO NERVOUS SYSTEM 67
NEURON 67
CLASSIFICATION OF NEURONS 67
NEUROGLIA 67
RECEPTOR 68
NEUROTRANSMITTER 68
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NERVOUS SYSTEM 68
CENTRAL NERVOUS SYSTEM 68
PERIPHERAL NERVOUS SYSTEM 69
SOMATIC NERVOUS SYSTEM 69
AUTONOMIC NERVOUS SYSTEM 69
SENSATION OF VISION 70
STRUCTURE OF EYE 70
FUNCTION OF EYE 71
SENSATION OF HEARING 71
STRUCTURE OF EAR 71
THE PARTS OF THE EAR 72
FUNCTIONS OF EAR 72
SENSATION OF TASTE 72
STRUCTURE OF TASTE BUD 72
SENSATION OF SMELL 73
SENSATION OF TOUCH 73
SKIN AND TOUCH 73
SKIN ABILITY TO SENSE TOUCH 74
HORMONES 75
ENDOCRINE SYSTEM 75
CHEMICAL MESSENGERS 75
ENDOCRINE GLANDS 75
THE MAIN ENDOCRINE GLANDS INCLUDE 75
HORMONES INTRODUCTION 75
CLASSIFICATION OF HORMONES 76
CLASSIFICATION OF HORMONES BASED ON THE SITE OF PRODUCTION/ ACCUMULATION 76
HORMONES OF PITUITARY GLANDS 76
HORMONES OF ANTERIOR PITUITARY FLANDS 76
HORMONES OF POSTERIOR PITUITARY FLANDS 76
HORMONES OF THYROID GLANDS 76
HORMONES OF PARATHYROID GLANDS 76
HORMONES OF ADRENAL GLAND 76
HORMONES OF OVARY GLAND 76
HORMONES OF TESTIS 76
HORMONE OF PANCREAS 76
CLASSIFICATION OF HORMONES BASED ON THE CHEMICAL NATURE 76
STEROID HORMONES 76
PROTEIN HORMONES 76
DERIVATIVE OF THE AMINO ACID CALLED TYROSINE 76
HORMONAL ACTIONS 77
GROWTH HORMONE (GH) 77
NORMAL FUNCTIONS OF GH 77
EFFECT ON PROTEIN METABOLISM 77
EFFECTS ON CARBOHYDRATE METABOLISM 77
EFFECTS ON FAT METABOLISM 77
EFFECTS ON INORGANIC METABOLISM 77
EFFECTS ON BONE, CARTILAGE, AND SOFT TISSUES 77
VASOPRESSIN/ ANTIDIURETIC HORMONE (ADH) 78
OXYTOCIN (OT) 78
ACTION IN FEMALES 78
ACTION IN MALES 78
INSULIN 78
EFFECTS OF INSULIN 78
EFFECTS OF INSULIN ON CARBOHYDRATE METABOLISM 78
EFFECTS OF INSULIN ON FAT METABOLISM 78
EFFECTS OF INSULIN ON PROTEIN METABOLISM 78
EFFECTS OF INSULIN ON GROWTH 79
TESTOSTERONE 79
EFFECTS OF TESTOSTERONE 79
EFFECT ON THE MALE REPRODUCTIVE SYSTEM 79
EFFECTS ON SECONDARY SEX CHARACTERISTICS 79
EFFECT ON PROTEIN MMETABOLISM 79
EFFECT ON BONE 79
EFFECT ON RBCS 79
EFFECT ON ELECTROLYTE AND WATER BALANCE 79
ESTROGEN 79
ACTIONS OF ESTROGENS 79
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ANATOMY
Anatomy is the study of structure and organization of the body. The word "anatomy" is the combination of
two Greek words, ana="apart", tomy="to cut". So, it means to study by cutting apart, that is, by dissection.
HUMAN ANATOMY
Human anatomy is the science concerned with the structure of the human body or structural organization
of the human body.
The science of physiology is concerned with the function of the body. Anatomy and physiology are both
subdivisions of the science of biology, the study of living organisms.
BRANCHES OF ANATOMY
Anatomy can be divided into various branches. Major branches are as follows
 Macroscopic Or Gross Anatomy

 Microscopic Anatomy Or Histology
 Histology
 Cytology
 Embryology
 Surface Anatomy
 Applied Anatomy
 Radiological Anatomy
MACROSCOPIC OR GROSS ANATOMY

It is branch of anatomy which deals with the study of structure of human body parts by naked eye without
the aid of microscopes.
Gross anatomy can be studied using the following two approaches
1. Regional Approach
2. Systemic Approach
Regional Approach
In this approach, we focus on a particular region and study various structures and their arrangement in
that particular region. For example, in regional anatomy of the head, we will study the bones, muscles,
blood vessels, nerves, etc of the head region only.
Systemic Approach
In this approach, we study a particular system of the body as a whole. For example, in systemic study of
the cardiovascular system, we will study the heart and the blood vessels found in all parts of the body.
MICROSCOPIC ANATOMY OR HISTOLOGY

In this branch, we study the structures with the help of microscopes.
HISTOLOGY
It deals with the study of microscopic details of tissues that make human body.
CYTOLOGY
It is the branch of anatomy that deals with the study of structure of cell and its components.
EMBRYOLOGY
It is the branch of anatomy which deals with the study of embryo (a human being or animal in an early
stage of development, either in its mother’s uterus or in an egg or a plant that is developing in a seed is
called embryo).
SURFACE ANATOMY
In this branch, surface of the human body is studied in relation to the deeper parts. Hence, it enables us to
locate the internal structures from the surface of the body. Surface anatomy is of paramount importance in
physical examination and surgery.
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APPLIED ANATOMY
It is the direct application of facts of human anatomy to medicine and surgery. Applied anatomy is usually
concerned with human structural abnormalities, which are useful in medicine especially in surgical
techniques but also in clinical diagnosis.
RADIOLOGICAL ANATOMY
This is the study of the structure of human body that includes the use of several imaging techniques,
TERMINOLOGY OF POSITION
Anterior and Posterior (Ventral and Dorsal)
Anterior and posterior describe structures at the front (anterior) and back (posterior) of the body. For
example, the toes are anterior to the heel.
Superior And Inferior

Superior and Inferior Describe a position above (superior) or below (inferior) another part of the body. For
example, the pelvis is inferior to the abdomen.
Proximal And Distal

Proximal and distal describe a position that is closer (proximal) or greater distance (distal) from the trunk
of the body. For example, the shoulder is proximal to the arm, and the foot is distal to the knee.
[Trunk is an anatomical term for the central part of the many animal bodies (including that of the human)
from which extend the neck and limbs. The trunk includes the thorax and abdomen]
Superficial And Deep

Superficial and deep describe structures that are closer to (superficial) or further/ greater distance from
(deep) the surface of the body. For example, the skin is superficial to the bones, and the brain is deep to
the skull.
Medial And Lateral

Medial and lateral describe a position that is closer to (medial) or further/ greater distance from (lateral)
the midline of the body. For example, the nose is medial to the eyes, and the thumb is lateral to the other
fingers.
Medial line
The line which divides the body into two equal mean right and left parts is called medial line.
Inferomedial
It is the part of body that present near to the medial line and towards the lower side.
Ipsilateral
Two parts of body that present at the same side of body e.g. Liver and gall bladder.
Contra Lateral
Two body organs which are present opposite to each other is called contra lateral.
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TERMINOLOGY OF MOVEMENT
FLEXION AND EXTENSION
Flexion and extension refer to a movement that decreases (flexion) or increases (extension) the angle
between body parts.
ABDUCTION AND ADDUCTION

Abduction and adduction refers to a movement of limb away (abduction) or towards (adduction) the
medial line of the body.
ELEVATION AND DEPRESSION

Elevation and depression refers to movement of bones toward upper side (elevation) or toward lower side
(depression).
DORSIFLEXION AND PLANTARFLEXION

Dorsiflexion and Plantarflexion refers to decrease in distance (Dorsiflexion) or increase in distance
(Plantarflexion) between foot and leg.
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EVERSION AND INVERSION

Eversion and inversion refer to movements that tilt (move into a sloping position) the sole of the foot away
(eversion) or towards (inversion) the medial line of the body.
SURFACE ANATOMY
Surface anatomy is to observe the surface of body. Its aim is visualization in the mind’s “eye” of structure
that lies beneath the skin and or hidden by it. Surface anatomy is the basis for the physical examination of
the body to reach a physical diagnosis.
HUMAN SKELETON
The overall parts of human skeleton are following.
OVER VIEW OF HUMAN SKULL

It is a type of flat bone. It is very hard. It covers the brain. Skull is divided into following major parts.
1. Frontal Bone 6. Zigomatic Bone

2. Temporal Bone 7. Maxilla Bone
3. Lacrimal Bone 8. Mandible Bone
4. Viral Bone 9. Parietal Bone
5. Vomer Bone 10. Occipital Bone
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OVER VIEW O THE UPPER LIMB

It consists of three main parts.
1. Forearm
2. Arm
3. Hand
Fore Arm
 It starts from scapula and ended to elbow
joint
 It consists of single long bone which is
called humerus
 Humerus is long bone in upper limb
Arm
Arm consists of two bones.
 Radius
 Ulna
It is larger bone in this region. It is opposite to the
radius is called ulna.
Hand
In start of hand there are some little bones which
are called carpals. Then metacarpals are present,
after those phalanges are presents.
OVER VIEW OF LOWER LIMB

The lower limb consists of thigh bone, leg, knee and foot.
Thigh
It is upper portion in upper limb in which there is a single leg bone
which is called femur. Femur is start from pelvic girdle to knee. It is a
large bone of lower limb.
Leg
Technically it starts from knee to ankle. It consists of two bones which
are called tibia. Tibia is attached to the toe nearest to medial line.
Fibula is away from medial line tibia is large bone and bear whole of
the weight fibula is small it is attach to muscles.
Patella
It is also called knee cap. It connects femur and tibia its bone is
somewhat like triangular shape or sessamoid bone.
Foot
It consist of following bone
 Tarsal
 Metatarsal
 Phalanges
VERTEBRAL COLUMN
It is also called back bone. It is consist of 33 irregular bones. These bones are classified in to 5 different
regions.
1. C1 _ C7 (Cervical Region)
2. T1 _ T12 (Thoracic Region)
3. L1 _ L5 (Lumbar Region)
4. S1 _ S5 (Sacrum Region)
5. Coccyx 3 Bone (Coccyx Region)
 First seven vertebrae are called cervical vertebrae it helps for flexibility in work.
 Next twelve vertebras are considered as thoracic vertebra.
 It consist of 5 vertebras considered as lumbar vertebra, in these humerus is the large bone in
whole vertebral column.
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 It also supports the body consists of 5 vertebras considered as sacral region. Back muscles are
mostly attached here.
ANATOMY OF PELVIC GIRDLE

It is also called as hipbone. It is consist of two
coxal (hip) bones.
This coxal bone is also called ossabone. In child

hood this coxal bone is devided in to three parts.
 First part is Ileum

 Second part is Ischium
 Third part is Pubic bone
In adult these three bones are finely fused to

form a single bone. In the back side these two
bones are connected to the sacrum. In front it is
connected with the help of muscle to pubic fossa.
In man, ileum crest is very compact and distance
between them is narrow. In woman, ileum crest,
it is dedicated and distance between them is
wider.
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ANATOMY OF DIGESTIVE SYSTEM

The digestive system in human being is composed of a
long muscular tube called gastrointestinal tract (GIT) or
alimentary canal and accessory organs it extends from
the mouth to the anus and consists of the following
organs…
 Oral Cavity
 Pharynx
 Esophagus
 Stomach
 Small Intestine
 Large Intestine
 Rectum
 Liver
 Gall Bladder
 Pancreas
(Liver, Gall bladder and pancreas are supporting

organs)
ANATOMY OF RESPIRATION SYSTEM

From a clinical point of view, the respiratory
system is divided into the upper and lower
respiratory tract. The respiratory system consists
of the following…
1. Upper Respiratory Tract

The upper respiratory tract is consisting
of the nose, pharynx (throat) and
associated structures.
2. Lower Respiratory Tract

The lower respiratory tract is consisting
of the larynx, trachea, bronchi and
lungs.
Respiratory system consists of the following

organs.
 Nose
 Pharynx
 Larynx
 Trachea
 Bronchi
 Lungs
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ANATOMY OF URINARY SYSTEM

It is a set of organs producing urine in human beings,
comprised chiefly of the kidneys, ureters bladder, and
urethra. The main organs of the urinary system are the
kidneys, which form urine. The other parts of the system
are ureters, urinary bladder, and the urethra neither form
urine nor change its composition. They only transport
urine from the kidneys to the outside of the body.
Urinary system consists of the following organs
 Kidney
 Ureters
 Bladder
 Urethra
(Nephron is basic structural & functional unit of kidney)
ANATOMY OF CARDIOVASCULAR SYSTEM

Following are the major organs for the circulation of blood in the human body.
 Heart
 Aorta
 Arteries
 Arterioles
 Capillaries
 Venules
 Veins
 Vena-Cava
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ANATOMY OF REPRODUCTIVE SYSTEM

The anatomy of human reproductive system can be discussed as following.
MALE REPRODUCTIVE SYSTEM

The male reproductive system consists of the following organ.
 Testes  Prostate Gland

 Urethra  Seminal Vesicles
 Penis  Scrotum
FEMALE REPRODUCTIVE SYSTEM

The female reproductive system consists of the following organ.
 Ovaries  Vulva
 Uterus  Hyman
 Uterine Tube  Breasts
 Fallopian Tubes  Labia Minor
 Vagina  Labia Major
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INTRODUCTION TO PHYSIOLOGY
The goal of physiology is to explain the physical and chemical factors that are responsible for the origin,
development, and progression of life. Each type of life, from the simple virus to the largest tree or the
complicated human being, has its own functional characteristics.
Therefore, the vast field of physiology can be divided into

 Viral Physiology
 Bacterial Physiology
 Cellular Physiology
 Plant Physiology
 Human Physiology and many more subdivisions
HUMAN PHYSIOLOGY
You are about to begin the study of one of nature’s most wondrous structures the human body.
Physiology deals with body function that is how the body parts work to support life.
In human physiology, we attempt to explain the specific characteristics and mechanisms of the human
body that make it a living being. Physiology term is a combination of two Greek words (physis “nature”
and logos “science or study”). Simply stated it is the study of physiology that helps us to understand how
the body works. Physiologists attempt to discover and understand through active experimentation the
intricate control systems and regulatory mechanisms that permit the body to operate and survive in an
often hostile environment.
CELL
Cells are the smallest functional units of the body. They are grouped together to form tissues. Different
tissues are grouped together to form organs, e.g. heart, stomach, brain. Organs are grouped together to
form systems, each of which performs a particular function, for example, the digestive system is
responsible for taking in, digesting and absorbing food and involves a number of organs, including the
stomach and intestines.
Types Of Cell
 Nerve Cell
 Muscle Cell
 Connective Cell
 Immune Cell
 Blood Cell
Composition Of Cell
 Water 65-80%
 Proteins
 Electrolytes
 Lipids
 Carbohydrates
STRUCTURE OF CELL
A typical cell, as seen by the light microscope consist of two major parts are the nucleus and the
cytoplasm.
A cell consists of a plasma membrane inside which there are a number of organelles floating in a watery
fluid called cytosol.
(Watery fluid of cytoplasm is called cytosol)
(Organelles are small structures with highly specialized functions, many of which are contained within a
membrane. They include: the nucleus, mitochondria, ribosomes, endoplasmic reticulum, Golgi apparatus,
lysosomes, microfilaments and microtubules)
(The different substances that make up the cell are collectively called protoplasm. Protoplasm is
composed mainly of five basic substances: water, electrolytes, proteins, lipids, and carbohydrates.)
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COMPONENT OF A CELL
 Plasma Membrane Or Cell Membrane
 Cytoplasm
 Nucleus
 Mitochondria
 Ribosomes
 Endoplasmic Reticulum (ER)
 Golgi Apparatus
 Lysosomes
 Microfilaments And Microtubules
PLASMA MEMBRANE OR CELL MEMBRANE

It is outer covering of cell. It is a thin, elastic structure only 7.5 to 10 nanometers thick. The plasma
membrane consists of two layers of phospholipids with some protein molecules embedded in them. It is
composed almost entirely of proteins and lipids.
- 22 -
FUNCTIONS OF PLASMA MEMBRANE

 It protects the cell organelles
 It provides the passage of the water soluble substances
 These act as transported by attaching to the cell membrane proteins
 It permits the passage of ions and molecules outside the cell
 Some carbohydrates in plasma membrane are helpful for binding of hormones
CYTOPLASM
It is jelly-like substance that surrounds the nucleus of a cell.
ZONES OF CYTOPLASM
1. Ectoplasm --- near to the cell membrane

2. Endoplasm --- near to the nucleus
NUCLEUS
Every cell in the body has a nucleus, with the exception of mature erythrocytes (red blood cells). Skeletal
muscle and some other cells contain several nuclei. The nucleus is the largest organelle and is contained
within a membrane similar to the plasma membrane but it has tiny pores, through which some substances
can pass between it and the cytoplasm.
The nucleus contains the body's genetic material, which directs the activities of the cell.
FUNCTIONS OF NUCLEUS
 It is a control center of cell
 It controls the protein synthesis by messenger RNA
 It helps in hereditary material transformation
 It controls the cell division
 It controls the activity of cytoplasm
MITOCHONDRIA
The mitochondria are called the “powerhouses” of the cell. Without them, cells would be unable to extract
enough energy to perform its functions. Mitochondria are present in all areas of each cell’s cytoplasm
RIBOSOMES
These are tiny granules composed of RNA and protein. They synthesize proteins from amino acids, using
RNA as the template. Ribosomes are also found on the outer surface of rough endoplasmic reticulum.
ENDOPLASMIC RETICULUM (ER)

Endoplasmic reticulum is a series of interconnecting membranous canals in the cytoplasm.
There are two types of endoplasmic reticulum

1. Smooth surface ER: Smooth surface ER synthesizes lipids and steroid hormones, and is also
associated with the detoxification of some drugs.
2. Rough surface ER: Ribosomes are attached to outer surface of rough surface ER. Proteins are
synthesized by ribosome and then transferred to the endoplasmic lumen.
GOLGI APPARATUS
The Golgi apparatus is closely related to the endoplasmic reticulum. It is membranous organelle, which is
responsible for packaging and lysosomes formation.
LYSOSOMES
The lysosomes provide an intracellular digestive system. They contain a variety of enzymes involved in
breaking down fragments of organelles, large molecules (e.g. RNA, DNA, carbohydrates, proteins) and
unwanted matter such as bacteria inside the cell into smaller particles that are either recycled or extruded
(pushing out) from the cell as waste material.
MICROFILAMENTS AND MICROTUBULES

 Microfilaments: These are tiny strands of protein that provide structural support and maintain the
characteristic shape of the cell.
 Microtubules: These are contractile protein structures in the cytoplasm involved in the movement
of the cell
- 23 -
TISSUE
The tissues of the body consist of large numbers of cells and they are classified according to the size,
shape and functions of these cells. There are four main types of tissue, each of which has subdivisions.
1. Epithelial Tissue Or Epithelium

2. Connective Tissue
3. Muscular Tissue
4. Nervous Tissue
EPITHELIAL TISSUE
This group of tissues is found covering the body and lining cavities and tubes. It is also found in glands.
The structure of epithelium is closely related to its functions which include…
 Protection of underlying structures from, for example, dehydration, chemical and mechanical
damage
 Secretion
 Absorption
The cells are very closely packed and the intercellular substance, called the matrix, is minimal.
TYPES OF EPITHELIAL TISSUES

There are two types of epithelial tissues
1. Simple Epithelial Tissues

2. Stratified Epithelial Tissues
SIMPLE EPITHELIUM
Simple epithelium consists of a single layer of identical cells
and is divided into four types. It is usually found on
absorptive or secretory surfaces.
STRATIFIED EPITHELIA
Stratified epithelia consist of several layers of cells of
various shapes. The main function of stratified epithelium is to protect underlying structures.
CONNECTIVE TISSUE
Connective tissue is the most abundant
tissue in the body. Connective tissue is
characterized by the presence of
relatively few cells but a large amount of
inter cellular substance.
MAJOR FUNCTIONS OF CONNECTIVE

TISSUE
 Binding and structural support

 Protection
 Transport
 Insulation
STRUCTURE OF THE CONNECTIVE TISSUE

Basically all types of connective tissue
following three components.
1. Cells
2. Fibers
3. Ground Substance
The fibers and ground substance are collectively known as matrix.
CELLS OF CONNECTIVE TISSUE

Connective tissue, excluding blood is found in all organs supporting the specialized tissue. The different
types of cell involved include…
- 24 -
 Fibroblasts
 Fat Cells
 Macrophages
 Leukocytes
 Mast Cells
CONNECTIVE TISSUE FIBERS

Connective tissue fibers are of three types
1. Collagenous Fibers
2. Reticular Fibers
3. Elastic Fibers
GROUND SUBSTANCE OF THE CONNECTIVE TISSUE

The ground substance is composed mainly macromolecular protein polysaccharide complexes called
proteoglycans. In addition it contains glycoprotein, water and salts.
MUSCULAR TISSUE
There are more than 600 muscles in our
body. Muscles perform many useful
functions and help us in doing everything in
day-to-day life. There functions could be
voluntary and involuntary functions.
The two principal functions of muscle are to

produce movement and to maintain posture.
These functions are achieved by adjusting
the length and tension of muscle. In other
words, muscle works by contracting.
Therefore, when we look at the structure
and function of muscle, we see that muscle
is designed to contract.
Depending upon situation, there are three

types of muscle tissue, which consists of
specialized contractile cells…
1. Skeletal Muscle Tissue

2. Smooth (Visceral) Muscle Tissue
3. Cardiac Muscle Tissue
SKELETAL MUSCLE TISSUE

Skeletal muscle tissues are rough,
cylindrical in shape and may be as long as
35 cm. skeletal muscles is the most
abundant type of muscle; they form 40%-
50% of body mass. It attaches to bone and
so is important in producing movements in
our joints and maintaining our posture.
Under the microscope, skeletal muscle cells
look like long fibers and have a striped
(striated) appearance. Skeletal muscle cells
also have many mitochondria and more
than one nucleus. We generally think of
skeletal muscle as being under voluntary control.
SMOOTH (VISCERAL) MUSCLE TISSUE

They are also called plain, un-striped, non-striated or involuntary muscles. Smooth muscle is the muscle,
which lines our blood vessels and internal organs. Under the microscope, visceral muscle cells do not
have the obvious striations of skeletal or cardiac muscle. Hence, it is called smooth muscle. Smooth
muscle cells are often relatively short, and usually they each have only one nucleus. We generally think of
visceral muscle as being involuntary.
- 25 -
CARDIAC MUSCLE TISSUE

Cardiac muscle is the muscle of the heart. Under the microscope, cardiac muscle cells also appear
striated; however the striations are not as well organized as in skeletal muscle. Cardiac muscle cells are
often branched, so that one cell forms connections with several of its neighbors. The activity of cardiac
muscle is controlled to a large degree by the autonomic nervous system. We generally think of cardiac
muscle as being involuntary.
NERVOUS TISSUE
The nervous system consists of a vast number of cells called neurons, supported by a special type of
connective tissue neuroglia. Each neuron consists of a cell body and its processes, one axon and many
dendrites. Neurons are commonly referred to simply as nerve cells. Nerve cells vary considerably in size
and shape but they are all too small to be seen by the naked eye.
Two types of tissue are found in the nervous system
1. Excitable Cells: These are called neurons and they initiate, receive, conduct and transmit
information.
2. Non-Excitable Cells: These support the neurons.
Neuron Cell
Nervous Tissue
- 26 -
BONE OR OSSEOUS TISSUES

Bone is a strong and durable type of connective tissue. Like other types of connective tissue the bone
(osseous tissue) also consists of cells and intera cellular substance or matrix. The matrix of bones has the
special property of being rigid because it is impregnated (saturated) with mineral salts mainly calcium
phosphate. Hence the chief physical property of the bone tissue is its toughness and hardness.
BONE CELLS
Three different cells types are found in the osseous tissue
1. Osteoblasts
2. Osteoclasts
3. Osteocytes
BONE MATRIX
The bone matrix consists of inorganic and organic components. The inorganic (minerals) components of
bone matrix are responsible for hardness of bone tissue and constitute about 65% of the dry weight of the
bone. Calcium and phosphate are chief bone minerals but substantial quantities of sodium, magnesium,
carbonate and citrate are also found. Calcium and Phosphorus also present in small quantity.
TYPES OF BONES
Bones are classified as
 Long Bone
 Short Bone
 Irregular Bone
 Flat Bone
 Sesamoid Bone
LONG BONES
These consist of a shaft and two extremities. As the name suggests the length is much greater than the
width. Examples include the femur, tibia and fibula.
SHORT, IRREGULAR, FLAT AND SESAMOID BONES

These have no shafts or extremities and are diverse in shape and size.
Examples include
 Short Bones, carpals (wrist)
 Irregular Bones, vertebrae and some skull bones
 Flat Bones, sternum, ribs and most skull bones
 Sesamoid Bones, patella (knee cap).
FUNCTIONS OF BONES
Bones have a variety of functions. They…
 Provide the framework of the body

 Give attachment to muscles and tendons (ligaments)
 Permit movement of the body as a whole and of parts of the body
 protect the organs they contain
 Contain red bone marrow in which blood cells develop (haematopoiesis)
 Provide a reservoir of minerals, especially calcium phosphate
JOINTS
A joint is the site at which any two or more bones articulate or come together. Some joints have no
movement (fibrous), some only slight movement (cartilaginous) and some are freely movable (synovial).
TYPES OF JOINTS
There are three types of joints
1. Fibrous or fixed joints

2. Cartilaginous or slightly movable joints
3. Synovial or freely movable joints
- 27 -
FIBROUS OR FIXED JOINTS

These immovable joints have fibrous tissue between the bones, e.g. joints between the bones of the skull
(sutures) and those between the teeth and the maxilla and mandible.
CARTILAGINOUS OR SLIGHTLY MOVABLE JOINTS

There is a pad of fibrocartilage between the ends of the bones that form the joint which allows for very
slight movement where the pad of cartilage is compressed. Examples include the symphysis pubis and
the joints between the vertebral bodies.
SYNOVIAL OR FREELY MOVABLE JOINTS

Synovial joints have characteristic features that enable a wide range of movements. They are classified
according to the range of movement possible or to the shape of the bones involved.
 Ball And Socket: The head or ball of one bone articulates with a socket of another and the shape
of the bones allows for a wide range of movement. Examples are the shoulder and hip.
 Hinge Joints: These allow the movements of flexion and extension only. Examples are the
elbow, knee, and ankle.
 Gliding Joints: The articular surfaces glide over each other. Examples are joints between the
carpal bones and those between the tarsal bones.
 Pivot Joints: Movement is round one axis (rotation).Examples is proximal and distal radioulnar
joints and the joint between the atlas and the odontoid process of the axis.
 Condyloid and Saddle Joints: Movements take place round two axes, permitting flexion,
extension, abduction, adduction and circumduction. Example is the wrist.
- 28 -
BLOOD
Blood is a connective tissue in fluid form. It is considered as the fluid of life, because it carries oxygen
from lungs to all parts of the body and carbon-dioxide from all parts of the body to the lungs. It is also
known as fluid of growth, because it carries nutrition from digestive system and hormones from endocrine
glands to all the tissues. Blood is also called the fluid of health, because it protects the body against
diseases and gets rid of the waste products and unwanted substances by transporting them to the
excretory organs like kidney.
PROPERTIES OF BLOOD
Color
Blood is red in color. Blood contain O 2 is bright red in color, while CO 2 containing blood is of purple
reddish color.
Volume
The average volume of blood is approximately 5 liters. In new born baby, the volume is approximately 450
ml. In females, it is approximately 4.5 liters.
pH
Blood is slightly alkaline and its pH in normal condition is 7.4.
Viscosity
Blood is 5-times more viscous than water. It is due to red blood cells and plasma proteins.
COMPOSITION OF BLOOD
Blood is made up of two parts
1. Cellular part (formed elements) 45%
2. Non-cellular part (plasma) 55%
CELLULAR CONTENT OF BLOOD

There are three types of blood cells
1. Erythrocytes or Red Blood Cells (RBC)

2. Leukocytes or White Blood Cells (WBC)
3. Thrombocytes or Platelets
All blood cells originate from stem cells and go through several developmental stages before entering the
blood.
ERYTHROCYTES OR RED BLOOD CELLS (RBC)

RBCs are the non-nucleated, oxygen carrying, hemoglobin containing cells present in blood.
COMPOSITION OF RED BLOOD CELLS
(Heme is a non-protein, iron containing substance)
- 29 -
PROPERTIES OF RBC
 Blood is a connective tissue in fluid form
 Life span of RBCs is about 120 days
 Hemoglobin in RBCs transport the respiratory gases
 It transports nutrition from digestive system and
hormones from endocrine glands to all the tissues.
 It transports waste products and unwanted
substances to the excretory organs like kidney
 These are non-nucleated cells present in blood
 Camel is the only mammal which has nucleated RBCs
 Because of the absent of nucleus in human RBCs, the
DNA is also absent in it
 Other organelles such as mitochondria and golgi-
apparatus are also absent in RBCs
 RBCs do not have insulin receptor and so the glucose
uptake by this cell is not controlled by insulin.
 During circulation, the RBCs remain suspended uniformly in the blood, this property of RBCs is
called suspension stability
FUNCTIONS OF RBC
Transport of O2
Hb in RBCs combines with O2 to form oxyhemoglobin. About 97% of oxygen is transported in the blood in
the form of oxyhemoglobin.
Transport of CO2
Hb in RBCs combines with CO2 and form carbhemoglobin. About 30% of CO2 is transported in this form.
Buffering Action Or Acid Base Balance

Hb in RBCs regulates H+ ions concentration and play a role in maintenance of acid base balance.
Ionic Balance
RBCs maintain ionic balance
Viscosity Of Blood
RBCs help to maintain the viscosity of blood
Blood Group Determination

RBCs carry the blood group antigens like A-antigen, B-antigen and Rh-factor. This helps in determination
of blood group.
FATE OR PRODUCTION RBCS

RBCs are produced in different areas of the body during different stages which are described below.
 1st Trimester (first three months of pregnancy): RBCs produced in the yolk sac.
 2nd Trimester (three to six months of pregnancy): RBCs are produced mostly in liver in spleen
and lymph nodes.
 3rd Trimester (six to nine months of pregnancy): During the last trimester of pregnancy and up
to 5-years age, RBCs are produced from bone marrow.
 After The Age Of 20 Years: Long bones do not produce RBC
 After The Age Of 25 Years: RBCs mostly produced in membranous bones, e.g. ribs, vertebrae,
sternum, illium.
FACTORS NEEDED FOR ERYTHROPOIESIS

 Vitamin B12, Vitamin C and folic acid
 Proteins (amino acid)
 Fe (iron) and some hormones
- 30 -
RBC COUNT
 Male: 5.4 millions/ mm3
 Female: 4.7 millions/ mm3
 Infant: 6.0 millions/ mm3
VARIATION IN RBC COUNT

RBC Count Decrease during sleep, early morning, repeated x-ray and during pregnancy.
RBC Count Increase in evening, & when increases in external temperature, at high altitudes or
deficiency of oxygen, after exercise, during the emotional conditions and after taking meals.
HEMOGLOBIN (HB)
Hemoglobin is iron containing coloring matter of RBCs. It is red oxygen carrying pigment present in RBCs.
Hemoglobin contains 4% Heme (non-protein, iron containing substance) and 96% Globin (protein).
NORMAL VALUE OF HEMOGLOBIN

 Male: 14-16 gm/100ml
 Female: 12-14 gm/100ml
 Fetus or newborn: approximately 23 gm/100ml
 Any conditi8on that increase or decrease the RBCs count will affect the Hb concentration
FACTORS NECESSARY FOR HB SYNTHESIS

 Proteins: proteins are necessary for the synthesis of Globin part of hemoglobin
 Metals: Fe is essential for the synthesis of non-protein part (Heme) of hemoglobin
 Vitamins: vitamins “B12” and vitamins “C” are necessary for hemoglobin synthesis
FUNCTIONS OF HEMOGLOBIN
 The function of Hb is to carry the respiratory gases, O 2 and CO2
 It also acts as a buffer
 Acid-Base balance
 Different pigments of bile, stool, urine etc. are formed from Hb
LEUKOCYTES OR WHITE BLOOD CELLS (WBC)

WBCs are colorless and nucleated elements of blood. These are large in size and lesser in number as
compared to RBCs.
They play very important role in defense mechanism of body and protect body from organism.
PROPERTIES OF WHITE BLOOD CELLS

 Large in size
 Irregular in shape
 Nucleated
 Many types
 Life span is shorter
 Mobile unit of body’s protective system
COUNT OF WHITE BLOOD CELLS

 Average WBCs present in the body = 7000/mm3
 Range = 4000 to 11000/mm3
CLASSIFICATION OF WHITE BLOOD CELLS

WBCs are classified into two groups
1. Granulocytes: Neutrophils, Eosinophils, Basophils

2. Agranulocytes: Monocytes, Lymphocytes
GRANULOCYTES
Some of WBCs have granules in the cytoplasm. These are developing from red bone marrow. We can
see granules easily in the cytoplasm of WBCs.
1. Neutrophils: First line defense, they engulf and destroy foreign particles; they destroy
microorganisms by their enzymes. They secrete platelets activating factor for blood clotting (PAF).
- 31 -
2. Eosinophils: They act against parasites; they are responsible for detoxification, disintegration
and removal of foreign proteins.
3. Basophils: They play important role in healing process and allergy.
AGRANULOCYTES
There are no granules present in the cytoplasm of this type of WBCs. They develop from the lymphoid
tissues.
1. Monocytes: They secrete platelets activating factor (PAF).
2. Lymphocytes: These cells develop the cellular immunity and hormonal immunity.
FUNCTION OF WHITE BLOOD CELLS

Generally, WBCs plays an important role in defense mechanism. These cells protect the body from
organisms or any foreign bodies either by destroying or inactivating them. However in defense
mechanism, each type of WBCs acts in different way.
Phagocytosis
This is a process by which Neutrophils and Monocytes engulf and destroy the bacteria, viruses and
foreign particles.
Antibody Formation
Lymphocytes play important role in defense mechanism of the body. They develop the immunity.
Fibroblast Formation
Lymphocytes may be converted into fibroblast at the site of inflammation, helping in the process of
repairing.
Secretion of Heparin
Basophils secret heparin which prevents intravascular clotting of blood.
THROMBOCYTES OR PLATELETS
Platelets are the formed elements of the blood. Platelets are small, colorless, non-nucleated cells.
SHAPES OF PLATELETS
Platelets are of several shapes e.g. spherical shape, rod shape, oval shape, disc shape, cigar shape or
any other unusual shape.
- 32 -
SIZE OF PLATELETS
Size of platelets is 2-4microne
COUNT OF PLATELETS
150,000 to 300,000 / mm3
LIFE SPAN OF PLATELETS

Life span of platelets is 4 to 9 days.
TYPES OF PLATELETS
Platelets can be classified into two types
1. Small or young or active platelets
2. Large or old platelets
FUNCTIONS OF PLATELETS
 Platelets play an important role in blood clotting
 Platelets prevents blood loss
 Platelets play role in repairing of ruptured blood vessel
 Platelets play role in defense mechanism
- 33 -
BLOOD GROUPS
Blood group (also called blood type) is a classification of blood based on the presence or absence of
inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins,
carbohydrates, glycoprotein, or glycolipids, depending on the blood group system. Some of these
antigens are also present on the surface of other types of cells of various tissues.
IMPORTANT TERMINOLOGY RELATED TO BLOOD GROUP
 Antigen: An antigen is any substance that causes your immune system to produce antibodies
against it. An antigen may be a foreign substance from the environment such as chemicals,
bacteria, viruses, or pollen. An antigen may also be formed within the body.
 Antibody: A blood protein produced in response to the counteracting a specific antigen.

Antibodies combine with substances and neutralize them which the body recognizes as harmful,
such as bacteria, viruses, and foreign substances in the blood.
 Agglutinin: An agglutinin is a substance, such as an antibody, that is capable of causing

agglutination of a particular antigen, especially red blood cells or bacteria.
 Agglutinogen: An antigen (antigen-A, antigen-B) present in blood cells, which stimulates the
formation of an agglutinin in blood serum is called agglutinogen.
 Agglutination: The clumping of red blood cells in the presence of an antibody, or simply we can
say that in the presence of antibodies, the binding of multiple red blood cells and creating a large
complex is called agglutination.
BLOOD GROUP SYSTEMS

More than 20 genetically determined blood group systems are known today. But O-A-B system and Rh
system are the most important ones that are determined before blood transfusions.
1. O-A-B Blood Types

2. Rh Blood Types
O-A-B BLOOD TYPES

The OAB blood groups were the first to be discovered (in 1900) and are the most important in assuring
safe blood transfusions. In transfusing blood from one person to another, the bloods of donors and
recipients are normally classified into four major O-A-B blood types.
Depending on the presence or absence of the two agglutinogens (antigen) “A” and “B” blood groups are
defined by the OAB system.
1. Blood group-A has A antigens on the red blood cells with anti-B antibodies in the plasma
2. Blood group-B has B antigens with anti-A antibodies in the plasma
3. Blood group-O has no antigens but both anti-A and anti-B antibodies in the plasma
4. Blood group-AB has both A and B antigens but no antibodies
- 34 -
RH FACTORS (RHESUS FACTORS)

Along with the O-A-B blood type system, the Rh blood type system is also important when transfusing
blood. Rh-factor is an antigen present in RBC. There are many Rh-antigens but only the “D” is more
antigenic in human.
The persons having D-antigen are called Rh-Positive, and those without D-antigen are called Rh-
negative.
This means that you can be one of eight blood groups

1. A RhD positive (A+)
2. A RhD negative (A-)
3. B RhD positive (B+)
4. B RhD negative (B-)
5. RhD positive (O+)
6. RhD negative (O-)
7. AB RhD positive (AB+)
8. AB RhD negative (AB-)
If Rh-positive blood is transfused to a Rh-negative person for the first time, then anti-D is formed in that
person. On the other hand, there is no risk of complications if Rh-positive person receives Rh-negative
blood.
ERYTHROCYTE SEDIMENTATION RATE (ESR)

ESR is the rate at which the RBCs settle down. Normally RBCs remains suspended uniformly in
circulation (suspension stability of RBCs). If blood is mixed with an anticoagulant and allow to stand on a
vertical tube, the RBCs settle down due to gravity.
DETERMINATION OF ESR
There are two methods to determine ESR
1. Westergren’s Method
2. Wintrobe’s Method
NORMAL VALUE OF ESR
Westergren’s Method
 Male: 5-10 mm
 Female: 10-15 mm
Wintrobe’s Method
 Male: 0-10 mm
 Female: 0-15 mm
FACTORS EFFECTS ESR

 Specific gravity of RBCs
 Size of RBC
 Viscosity of blood
 RBCs count
 O2 concentration
 Cholesterol level
 Temperature
 Infection
Blood Coagulation
Coagulation or clotting of blood is the process of conversion of soluble plasma fibrinogen into insoluble
fibrin substance to form a clot.
Stages Of Blood Clotting

Blood clotting occurs in three stages
1. Formation of Prothrombin active
2. Conversion of Prothrombin into Thrombin (enzyme, factor-II)
3. Conversion of Fibrinogen (factor-I) into Fibrin (fibrin is fibrous, non-globular protein)
- 35 -
Factors Preventing Coagulation

 Decrease in temperature
 Avoiding contact with water and wet surface
 Precipitation of fibrinogen
 Addition of heparin, peptone, sodium citrate
Factors Increasing Coagulation

 Increase in temperature
 Contact with water and wet surface
 Addition of thrombin
 Addition of calcium chloride
- 36 -
ANEMIA
Anemia means deficiency of hemoglobin in the blood, which can be caused by either too few red blood
cells or too little hemoglobin in the cells. Some types of anemia and their physiologic causes are the
following.
CLASSIFICATION OF ANEMIA
Anemia is classified by two methods
1. Morphological Classification
2. Etiological Classification
MORPHOLOGICAL CLASSIFICATION
Morphological classification depends upon the size and color of RBCs. By this method, the anemia is
classified into four types…
1. Normocytic Normochromic Anemia

2. Macrocytic Normochromic Anemia
3. Macrocytic Hypochromic Anemia
4. Microcytic Hypochromic Anemia
NORMOCYTIC NORMOCHROMIC ANEMIA

In this type of anemia, the size and color of RBCs is normal but the number of RBC is less.
MACROCYTIC NORMOCHROMIC ANEMIA

In this type of anemia, the RBCs are larger in size with normal color. The RBC count is less
MACROCYTIC HYPOCHROMIC ANEMIA

In this type of anemia, the RBCs are larger in size and less colored.
MICROCYTIC HYPOCHROMIC ANEMIA

In this type of anemia, the RBCs are smaller with less colored.
ETIOLOGICAL CLASSIFICATION
On the basis of etiology (study of cause or origin), the anemia is divided into five types…
1. Hemorrhagic Anemia (Acute Hemorrhage, Chronic Hemorrhage)

2. Hemolytic Anemia (Intrinsic Hemolytic Anemia, Extrinsic Hemolytic Anemia)
3. Nutrition Deficiency Anemia (Iron Deficiency Anemia, Protein Deficiency Anemia, Pernicious
Anemia, Megaloblastic Anemia)
4. Aplastic Anemia
5. Anemia Of Chronic Disease
HEMORRHAGIC ANEMIA
Hemorrhage refers to excessive loss of blood. Anemia due to hemorrhage is known as hemorrhagic
anemia. It occurs both in acute and chronic hemorrhagic conditions.
ACUTE HEMORRHAGE
It refers to sudden loss of a large quantity of blood as in the case of accident. Decreased RBCs count
causes hypoxia (lack of oxygen) stimulates the bone marrow to produce more number of RBCs. This
condition is corrected within 4-6 weeks.
CHRONIC HEMORRHAGE
It refers to loss of blood by internal or external bleeding over a long period of time. It occurs in conditions
like peptic ulcer, purpura, hemophilia and menorrhagia.
 Purpura, A rash of purple spots on the skin caused by internal bleeding from small blood vessels.
 Hemophilia is a medical condition in which the ability of the blood to clot is severely reduced,
causing the sufferer to bleed severely from even a slight injury.
 Menorrhagia, abnormally heavy bleeding at menstruation in women.
- 37 -
HEMOLYTIC ANEMIA
Hemolysis means destruction of RBCs. Anemia due to excessive hemolysis which is not compensated by
increased RBCs production is called hemolytic anemia or
Hemolytic anemia occurs when the bone marrow is unable to replace the red blood cells that are being
destroyed.
There are two types of hemolytic anemia
1. Intrinsic Hemolytic Anemia

2. Extrinsic Hemolytic Anemia
INTRINSIC HEMOLYTIC ANEMIA

The destruction of the red blood cells is due to a defect within the red blood cells themselves. Intrinsic
hemolytic anemia is often inherited, such as sickle cell anemia. These conditions produce red blood cells
that do not live as long as normal red blood cells.
SICKLE CELL ANEMIA

Sickle cell anemia is a disease in which your body produces abnormally shaped red blood cells. The cells
are shaped like a crescent or sickle. They don't last as long as normal, round red blood cells. This leads to
anemia. The sickle cells also get stuck in blood vessels, blocking blood flow. This can cause pain and
organ damage.
EXTRINSIC HEMOLYTIC ANEMIA

Red blood cells are produced healthy but are later destroyed by external factors such as antibodies,
chemicals and drugs.
NUTRITION DEFICIENCY ANEMIA

Anemia that occurs due to deficiency of a nutritive substance necessary for erythropoiesis is called
nutrition deficiency anemia.
The substances which are necessary for erythropoiesis are iron, protein, vitamin C, B12 and folic acid.
Nutrition deficiency anemias are as follow…
 Iron Deficiency Anemia

 Protein Deficiency Anemia
 Pernicious Anemia (Vitamin B12 Deficiency Anemia)
 Megaloblastic Anemia (Folic Acid or Vitamin B9 Deficiency Anemia)
IRON DEFICIENCY ANEMIA

Iron deficiency anemia is a common anemia caused by insufficient dietary intake and absorption of iron.
Causes of iron deficiency anemia are…
 Loss of blood
 Decreased intake of iron
 Poor absorption of iron from intestine
 Increased demand for iron in conditions like growth and pregnancy
PROTEIN DEFICIENCY ANEMIA

Due to deficiency of proteins, the synthesis of hemoglobin is reduced. The RBCs are Macrocytic
Hypochromic Anemia (RBCs are larger in size and less colored).
PERNICIOUS ANEMIA (VITAMIN B12 DEFICIENCY ANEMIA)

Pernicious anemia is a decrease in red blood cells that occurs when your intestines cannot properly
absorb vitamin B12 because of a lack of intrinsic factor (IF) in gastric secretions.
Intrinsic factor is a special protein, helps your intestines absorb vitamin B12. This protein is released by
cells in the stomach. When the stomach does not make enough intrinsic factor, the intestine cannot
properly absorb vitamin B12.
Pernicious anemia is common in old age and it is more common in females than in male.
Common causes of pernicious anemia include

 Weakened stomach lining (atrophic gastritis)
- 38 -
 An autoimmune condition in which the body's immune system attacks intrinsic factor protein or the
cells that make it.
MEGALOBLASTIC ANEMIA (FOLIC ACID DEFICIENCY ANEMIA)

Megaloblastic anemia is a condition in which the bone marrow produces unusually large, structurally
abnormal, immature red blood cells. Megaloblastic anemia is due to the deficiency of another maturation
factor called folic acid. Here the RBCs are not matured. The DNA synthesis is also defective so the
nucleus remains immature.
APLASTIC ANEMIA
Aplastic anemia is due to the disorder of red bone marrow. The red bone marrow is reduced and replaced
by fatty tissues. Bone marrow disorder occurs in the following conditions…
 Repeated exposure to x-ray or gamma ray radiation

 Presence of bacterial toxins, quinine, gold salts, benzene etc
 Tuberculosis
 Viral infections like hepatitis and HIV infections
ANEMIA OF CHRONIC DISEASE

Anemia of chronic disease is anemia
that is found in people with certain long-
term (chronic) medical conditions.
Certain chronic infections, inflammatory

diseases, and other illnesses can affect
the body's ability to produce red blood
cells.
Conditions that can lead to anemia of

chronic disease include…
 Noninfectious inflammatory
diseases
 Autoimmune disorders
 Cancer
 Chronic kidney disease
 Liver cirrhosis
 Long-term infections, such as
HIV/AIDS, hepatitis B or
hepatitis C
Anemia of chronic disease is often mild. You may not notice symptoms of anemia. If they occur, smptoms
may include…
 Feeling weak or tired

 Headache
 Paleness
 Shortness of breath
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CIRCULATION
This is the transport system which circulates blood and lymph
throughout the body. There are two types of circulation.
PULMONARY CIRCULATION
This consists of the circulation of blood from the right ventricle of
the heart to the lungs and back to the left atrium. In the lungs,
carbon dioxide is excreted and oxygen is absorbed.
Right Ventricle of Heart  Pulmonary Arteries  Pulmonary

Arterioles  Pulmonary Capillaries  Pulmonary Venules
 Veins  Left Atrium of Heart
SYSTEMIC OR GENERAL CIRCULATION

In systemic or general circulation, the blood pumped out from the
left ventricle is carried by the branches of the aorta around the
body and is returned to the right atrium of the heart by the
superior and inferior vena cava.
It is also known as the general circulation or peripheral

circulation. This circulation supplies all the tissues of the body
except the lungs. The sequence of events of systemic circulation
is as follows.
Left Ventricle of Heart  Aorta  Arteries  Arterioles 

Capillaries  Venules  Veins  Vena Cave  Right
Atrium of Heart
The function of the circulation is to service the needs of the body tissues to transport nutrients to the body
tissues, to transport waste products away, to conduct hormones from one part of the body to another,
and, in general, to maintain an appropriate environment in all the tissue fluids of the body for optimal
survival and function of the cells.
FUNCTIONAL PARTS OF CIRCULATION

Heart
The heart is a roughly cone-shaped hollow muscular organ. It is about 10 cm long and is about the size of
the owner's fist (a person's hand when the fingers are bent in towards the palm and held there tightly). It
weighs about 225g in women and is heavier in men.
Arteries
These are a series of blood vessels which carry oxygenated blood away from the heart (except pulmonary
and umbilical arteries). The function of the arteries is to transport blood under high pressure to the tissues.
For this reason, the arteries have strong vascular walls, and blood flows at a high velocity in the arteries.
Arterioles
These are the smaller branches of arteries which deliver blood to capillaries. Arterioles play a key role in
regulating blood flow from arteries into capillaries.
Capillaries
These are diffuse net works of blood vessels which connect the arterioles and venules. Capillaries are
found in almost every cell in the body. The distribution of capillaries in the body varies with the activity of
the tissues. For example in those tissues whose activities are higher such as muscles, liver, kidneys, lings
and the nervous system, there are rich capillary supplies.
Venules
These are blood vessels that connect capillaries with veins. The venules collect blood from the capillaries,
and they gradually combine into larger veins.
Veins
These are a series of blood vessels which carry blood towards the heart (except pulmonary and umbilical
veins).
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PROPERTIES OF CARDIAC MUSCLE

Properties of cardiac muscle can be divided into 2 groups
Quiescent Heart
Beating Heart
(in a state or period of inactivity)
• Automaticity • All Or None Law
• Rhythmicity • The Staircase Phenomenon
• Contractibility • Length-Tension Relationship
• Excitability • Summation Of Subminimal Stimuli
• Conductivity
• Distensibility
• Functional Syncitium
• Long Refractory Period
• Extrasystole & Compensatory Pause
Nature
Cardiac muscle is involuntary in function and striated in appearance.
Automaticity
Capability of contract even in the absence of neural control
Rhythmicity
Heart beats are extremely regular
Contractibility
Cardiac muscle contracts in response to a stimulus in the presence of ATP (Adenosine triphosphate) and
calcium ion.
Excitability
Ability of the cardiac muscle to respond to different stimuli
Conductivity
This is the transfer of cardiac impulses from the sinoatrial node (S.A. node) to all the cardiac muscle.
Impulses produced in the SA node is conducted by the specialized conducting pathway
Distensibility
Occurs due to compliance of the cardiac muscle
Functional Syncytium
When a number of cells function as a single unit the whole functional unit is called a functional syncytium.
The heart is composed of two different syncytia, the atrial syncytium and ventricular syncytium.
Extrasystole & Compensatory Pause

When the ventricle is stimulated in the relaxation period (relative refractory period), the cardiac muscle
may contract. It may occurs because a papillary muscle may fire an impulse before normal impulse
reaches the ventricles
All Or None Law

The cardiac muscle fibers do not contract if the stimulus is sub-threshold. They will contract with constant
strength if the stimulus is at or above the threshold.
Staircase Phenomenon
If a quiescent ventricle is stimulated repeatedly such that the interval between consecutive stimuli is less
than 10 s, the first 3-4 contractions are progressively more forceful
Length-Tension Relationship (Frank-Starling Law)

Within the physiological limits, the force of contraction of cardiac muscle is directly proportional to the
initial length of the muscle fibers
Summation Of Subminimal Stimuli
- 41 -
When subminimal stimuli are applied repeatedly, the stimuli summate & produce a response
CARDIAC CYCLE
The function of the heart is to maintain a constant circulation of
blood throughout the body. The heart acts as a pump and its
action consists of a series of events known as the cardiac cycle.
During each heartbeat, or cardiac cycle, the heart contracts and

then relaxes. The period of contraction is called systole and that
of relaxation, diastole.
STAGES OF THE CARDIAC CYCLE

The normal number of cardiac cycles per minute ranges from 60
to 80. When the heart beats at the normal rate of 72/minute, the
duration of each cardiac cycle is about 0.8 seconds. The
duration of systole is 0.27 second and that diastole is 0.53
second.
SUBDIVISIONS AND DURATION OF CARDIAC CYCLE

The events of cardiac cycle are classified into two divisions, systole and diastole…
Systole
1. Isometric Contraction 0.05 Sec
2. Ejection Period 0.22 Sec
Total Time 0.27 Sec
Diastole
1. Protodiastole 0.04 Sec
2. Isometric Relaxation 0.08 Sec
3. Rapid Inflow 0.11 Sec
4. Slow Inflow 0.19 Sec
5. Atrial Systole 0.11 Sec
Total Time 0.53 Sec
Total duration of cardiac cycle is 0.27 + 0.53 = 0.8 seconds
HEART SOUNDS
Heart sounds are heard with the help of a stethoscope. Two sounds, separated by a short pause, can be
clearly distinguished. They are described in words as 'LUB DUP'. In some cases one may hear a 3 rd or 4th
heart sound. These sounds are made by the closure of the heat valves and the acceleration and
deceleration or vibration of valves due to blood flow in the cardiac chambers.
1st Heart Sound

The first sound, 'LUB', is fairly loud and is due to the closure of the atrioventricular valves. This
corresponds with ventricular systole.
2nd Heart Sound

The second sound, 'DUP', is softer and is due to the closure of the aortic and pulmonary valves. This
corresponds with atrial systole.
Murmurs
These are abnormal heart sounds produced when there is an excessive degree of turbulence of blood
flow in the heart chambers.
- 42 -
ELECTROCARDIOGRAPHY (ECG)
Electrocardiography is the technique by which the electrical activities of the heart are studied. The spread
of excitation through myocardium produces local electrical potential. This causes flow of small currents
through the body which acts as volume conductor. These small currents can be picked up from the
surface of the body by using suitable electrodes and recorded in the form of electrocardiogram.
ELECTROCARDIOGRAPH
Electrocardiograph is the instrument (ECG machine) by which the electrical activities of the heart are
recorded.
ELECTROCARDIOGRAPHIC PAPER AND GRID

The paper that is used for recording ECG is called ECG paper. Electrocardiographic grid refers to the
markings (lines) on ECG paper. ECG paper has horizontal and vertical lines at regular intervals of 1 mm.
Every 5th line (5 mm) is thickened.
Duration
Time duration of different ECG waves is plotted horizontally on X-axis.
On X-axis
1 mm = 0.04 second
5 mm = 0.20 second
On Y-axis
1 mm = 0.1 mV
5 mm = 0.5 mV
Amplitude of ECG waves is plotted vertically on Y-axis.
ECG LEADS
ECG is recorded by placing series of electrodes on the surface of the body. These electrodes are called
ECG leads and are connected to the ECG machine. Electrodes are fixed on the limbs. Usually, right arm,
left arm and left leg are chosen. Heart is said to be in the center of an imaginary equilateral triangle drawn
by connecting the roots of these three limbs. This triangle is called Einthoven triangle.
WAVES OF NORMAL ECG

Normal ECG consists of waves, complexes, intervals and segments. Waves of ECG recorded by limb
lead II are considered as the typical waves. Normal electrocardiogram has the following waves, namely P,
Q, R, S and T.
- 43 -
MAJOR COMPLEXES IN ECG

1. ‘P’ wave, the atrial complex
2. ‘QRS’ complex, the initial ventricular complex
3. ‘T’ wave, the final ventricular complex
4. ‘QRST’, the ventricular complex
‘P’ Wave
‘P’ wave is a positive wave and the first wave in ECG. It is also called atrial complex when atria contacts.
‘QRS’ Complex
‘QRS’ complex is also called the initial ventricular complex. ‘Q’ wave is a small negative wave. It is
continued as the tall ‘R’ wave, which is a positive wave. ‘R’ wave is followed by a small negative wave, the
‘S’ wave when ventricles contact.
‘T’ Wave
‘T’ wave is the final ventricular complex and is a positive wave when ventricles start repolarization.
‘U’ Wave
‘U’ wave is not always seen. It is also an insignificant wave in ECG. It is supposed to be due to
repolarization of papillary muscle.
USES OF ECG
Electrocardiogram is useful in determining and diagnosing the following…
 Heart rate
 Heart rhythm
 Abnormal electrical conduction
 Poor blood flow to heart muscle (ischemia)
 Heart attack
 Coronary artery disease
 Hypertrophy of heart chambers.
- 44 -
BLOOD PRESSURE
Blood pressure is the force or pressure which the blood exerts on the walls of the blood vessels.
 Blood Pressure = Cardiac Output X Peripheral Resistance

 Cardiac Output = Stroke Volume X Heart Rate
SYSTOLIC BLOOD PRESSURE

This is the maximum pressure excreted by blood on the walls of blood vessels which develops at the peak
of ventricular systole. Systolic Blood Pressure = 120mm Hg
DIASTOLIC BLOOD PRESSURE

This is the minimum pressure exerted by blood on the wall of blood vessels during ventricular diastole.
Diastolic Blood Pressure = 80mm Hg
MEASUREMENT OF BLOOD PRESSURE

Blood pressure is measured clinically with a sphygmomanometer which is either of mercury or aneroid
type. Advise the patient for rest at least 15 to 20 minutes. The patient should be in a sitting or lying
position. There are two methods for taking blood pressure.
PALPATORY METHOD
Most common method for measuring blood pressure is palpatory but only systolic pressure can be
measured with this method. The palpatory method is useful when a stethoscope cannot be used due to
noise interference or other situations.
AUSCULTATORY METHOD
The auscultatory method uses a stethoscope and a sphygmomanometer. Sounds are heard with the help
of stethoscope. Both systolic & diastolic blood pressure can be measured with this method. The
auscultatory method is the predominant method of clinical measurement.
PHYSIOLOGICAL VARIATIONS OF BLOOD PRESSURE
Diurnal variation
Blood pressure is lowest early in the morning and
highest in the afternoon.
Age
Blood pressure rises with age. The systolic blood
pressure at different ages:
 Infancy 80-90mm Hg
 Childhood 90-110mm Hg
 Adult 110-120mm Hg
 Elderly 140-150mm Hg
(mm Hg  "millimeters of mercury". Hg is symbol of

Mercury_
Sex
Before the occurrence of menopause in females
both the systolic and diastolic blood pressures are
slightly lower than males. After menopause blood
pressure may be slightly higher than males of the
same age.
Body Build
Overweight persons tend to have higher blood pressure.
Sleep
In resting conditions as in sleep blood pressure is decreased.
Exercise
Light exercise such as walking increases the systolic blood pressure, but decreases the diastolic blood
pressure. In severe exercise the systolic blood pressure may rise up to 180mm Hg
- 45 -
Posture
Standing position causes an increase in both systolic and diastolic blood pressure.
Excitement Or Emotion
This may cause an increase in systolic blood pressure.
After Digestion Of Food

There is a slight rise in systolic blood pressure but the diastolic blood pressure falls due to vasodilatation
in certain vessels of the body.
PULSE
The pulse is a wave of distension and elongation felt in an artery wall due to the contraction of the left
ventricle forcing about 60 to 80 milliliters of blood through the already full aorta and into the arterial
system.
(Distension: The act of expanding by pressure)

(Elongation: The action or process of lengthening something)
The pulse is most often measured by feeling the arteries of the wrist. There is also a pulse, although far
weaker in veins.
Pulse Rate
The number of times a heart beats per minute in a person’s body.
Heart Rate
The number of contractions of the cardiac ventricles per unit of time is called heart rate.
Radial Pulse
Arteries carry oxygenated blood away from the heart to the tissues of the body; veins carry blood depleted
of oxygen from the same tissues back to the heart. The arteries are the vessels with the “pulse” a
rhythmic pushing of the blood in the heart followed by a refilling of the heart chamber. To determine heart
rate one feels the beats at a pulse point like the inside of the wrist for 10 seconds and multiplies this
numbers by 6. This is the per-minute total.
Wrist Pulse
To measure the pulse at the wrist places the index
and middle finger over the underside of the
opposite wrist below the base of the thumb. Press
firmly with flat fingers until you feel the pulse in the
radial artery.
Arterial Pulse
Arterial pulse is the transient expansion of arteries
due to internal pressure changes with in the
arteries. This pulse move much faster than the
blood itself.
Venous Pulse
This is the transient expansion of veins due to
pressure changes. The venous pulse can be
recorded directly by introducing of cannula into a
vein and recoding the pressure changes via a
mercury manometer.
HEMORRHAGES
Hemorrhage is defined as the excess loss of blood due to rupture of blood vessels.
TYPES AND CAUSES OF HEMORRHAGE
1. Accidental Hemorrhage
2. Capillary Hemorrhage
3. Internal Hemorrhage
4. Postpartum Hemorrhage
5. Hemorrhage Due To Premature Detachment Of Placenta
- 46 -
Accidental Hemorrhage
Accidental hemorrhage occurs in road accidents and industrial accidents, which are very common in the
developed and developing countries.
Accidental hemorrhage is of two types…
1. Primary hemorrhage, which occurs immediately after the accident

2. Secondary hemorrhage, which takes place sometime (about few hours) after the accident.
Capillary Hemorrhage
Capillary hemorrhage is the bleeding due to the rupture of blood vessels, particularly capillaries. It is very
common in brain (cerebral hemorrhage) and heart during cardiovascular diseases. The rupture of the
capillary is followed by spilling (leak) of blood into the surrounding areas.
Internal Hemorrhage
Internal hemorrhage is the bleeding in viscera. It is caused by rupture of blood vessels in the viscera. The
blood accumulates in viscera.
(Viscera = The internal organs in the main cavities of the body, especially those in the abdomen, e.g. the
intestines)
Postpartum Hemorrhage
Excess bleeding that occurs immediately after labor (delivery of the baby) is called postpartum
hemorrhage. In some cases, it is very severe and leads to major complications.
Hemorrhage Due To Premature Detachment Of Placenta

In some cases, the placenta is detached from the uterus of mother before the due date of delivery causing
severe hemorrhage.
ACUTE HEMORRHAGE
It refers to sudden loss of a large quantity of blood as in the case of accident. This condition is corrected
within 4-6 weeks.
CHRONIC HEMORRHAGE
It refers to loss of blood by internal or external bleeding over a long period of time. It occurs in conditions
like peptic ulcer, purpura, hemophilia and menorrhagia.
 Purpura, A rash of purple spots on the skin caused by internal bleeding from small blood vessels.
 Hemophilia is a medical condition in which the ability of the blood to clot is severely reduced,
causing the sufferer to bleed severely from even a slight injury.
 Menorrhagia, abnormally heavy bleeding at menstruation in women.
LYMPH
Lymph defined as a colorless fluid containing white blood cells, which bathes the tissues and drains
through the lymphatic system into the bloodstream.
LYMPHATIC SYSTEM
Lymphatic system is a closed system of lymph channels or lymph vessels, through which lymph flows. It is
a one-way system and allows the lymph flow from tissue spaces toward the blood.
COMPOSITION OF LYMPH
Usually, lymph is a clear and colorless fluid. It is formed by 96% water and 4% solids. Some blood cells
are also present in lymph.
FUNCTIONS OF LYMPH
1. Important function of lymph is to return the proteins from tissue spaces into blood.
2. It is responsible for redistribution of fluid in the body.
3. Bacteria, toxins and other foreign bodies are removed from tissues via lymph.
4. Lymph flow is responsible for the maintenance of structural and functional integrity of tissue.
5. Lymph flow serves as an important route for intestinal fat absorption.
6. It plays an important role in immunity by transport of lymphocytes.
- 47 -
RESPIRATORY SYSTEM
RESPIRATION
Respiration is the process by which oxygen is taken in and carbon dioxide is given out. The first breath
takes place only after birth. Fetal lungs are non-functional. So, during intrauterine life the exchange of
gases between fetal blood and mother’s blood occurs through placenta. After the first breath, the
respiratory process continues throughout the life. Permanent stoppage of respiration occurs only at death.
PHASES OF RESPIRATION
Respiration occurs in two phases
1. Inspiration during which air enters the lungs from atmosphere

2. Expiration during which air leaves the lungs.
TYPES OF RESPIRATION
Respiration is classified into two types…
1. External respiration: Involves exchange of respiratory gases, i.e. oxygen and carbon dioxide
between lungs and blood.
2. Internal respiration: Involves exchange of gases between blood and tissues.
FUNCTIONAL ANATOMY OF RESPIRATORY TRACT

Respiratory tract is the anatomical structure through which air moves in and out. It includes nose,
pharynx, larynx, trachea, bronchi and lungs. From a clinical point of view, the respiratory system is divided
into the upper and lower respiratory tract.
1. Upper Respiratory Tract

The upper respiratory tract is consisting of the nose, pharynx (throat) and associated structures.
2. Lower Respiratory Tract

The lower respiratory tract is consisting of the larynx, trachea, bronchi and lungs.
MECHANICS OF RESPIRATION
Respiration occurs in two phases namely inspiration and expiration. During inspiration, lungs expand so
that air enters the lungs easily. During expiration, lungs decrease in size and attain the pre-inspiratory
position so that air leaves the lungs easily.
MECHANISM OF INSPIRATION
Contraction Of Diaphragm

Vertical Diameter Of Chest Cavity Increase

Expansion Of Lungs

Pressure Inside Lungs Decrease

Air Move From Atmosphere To Lungs

Inspiration
MECHANISM OF EXPIRATION
Relaxation Of Inspiratory Muscle


Decreased Vertical Diameter Of The Chest Cavity

Size Of Lungs Decreases

Increased Pressure Inside The Lungs

Air Moves From Lung Alveoli Towards Atmosphere

Expiration
- 48 -
PULMONARY VENTILATION
(Pulmo = lungs, ventilation = breathing)
This is the inspiration (inflow) and expiration (outflow) of air between the atmosphere and lungs. In other
words, pulmonary ventilation may be defined as the inflow and outflow of air between the atmosphere and
the alveoli of the lungs.
In the process of pulmonary ventilation an important factor called the pressure gradient exist & air moves
into the lings when the pressure inside the lungs is less than that of the atmospheric pressure. Air moves
from the lungs to the atmosphere when the pressure in the lungs is greater than the atmospheric
pressure.
LUNG VOLUMES
Static lung volumes are the volumes of air breathed by an individual. Each of these volumes represents
the volume of air present in the lung under a specified static condition (specific position of thorax). Static
lung volumes are of four types…
1. Tidal Volume (TV)

2. Inspiratory Reserve Volume (IRV)
3. Expiratory Reserve Volume (ERV)
4. Residual Volume (RV)
Tidal Volume (TV)

Volume of air inspired or expired in each normal breath is called tidal volume.
Normal Value = 500 ml
Inspiratory Reserve Volume (IRV)

Inspiratory reserve volume is an additional volume of air that can be inspired forcefully after the end of
normal inspiration.
Expiratory Reserve Volume (EVR)

Expiratory reserve volume is the additional volume of air that can be expired out forcefully, after normal
expiration.
Residual Volume (RV)

Residual volume (RV) is the volume of air remaining in lungs even after forced expiration.
LUNG CAPACITIES
Static lung capacities are the combination of two or more lung volumes. Static lung capacities are of four
types…
1. Inspiratory Capacity (IC)

2. Vital Capacity (VC)
3. Functional Residual Capacity (FRC)
4. Total Lung Capacity (TLC)
Inspiratory Capacity (IC)

Inspiratory capacity (IC) is the maximum volume of air that is inspired after normal expiration (end
expiratory position). It includes tidal volume and inspiratory reserve volume.
IC = TV + IRV
= 500 + 3300 = 3800 ml
Vital Capacity (VC)

Vital capacity is the maximum volume of air that can be expelled out forcefully after a deep (maximal)
inspiration. Vital capacity includes inspiratory reserve volume, tidal volume and expiratory reserve volume.
VC = IRV + TV + ERV
= 3300 + 500 + 1000 = 4800 ml
- 49 -
Functional Residual Capacity (FRC)

Functional residual capacity (FRC) is the volume of air remaining in lungs after normal expiration (after
normal tidal expiration). Functional residual capacity includes expiratory reserve volume and residual
volume.
FRC = ERV + RV
= 1000 + 1200 = 2200 ml
Total Lung Capacity (TLC)

Total lung capacity (TLC) is the volume of air present in lungs after a deep (maximal) inspiration. It
includes all the volumes.
TLC = IRV + TV + ERV + RV

= 3300 + 500 + 1000 + 1200 = 6000 ml
Lung Volumes & Capacities: TV = Tidal volume, IRV = Inspiratory reserve volume, ERV = Expiratory
reserve volume, RV = Residual volume, IC = Inspiratory capacity, FRC = Functional residual capacity, VC
= Vital capacity, TLC = Total lung capacity.
PHYSIOLOGICAL VARIATIONS OF VITAL CAPACITY

 Age: In childhood and old age vital capacity is less than normal adults.
 Sex: In female it is 20% less than male.
 Height: Greater the height more will be vital capacity.
 Exercise: (athletes and swimmers) vital capacity is increased in persons.
 Position: vital capacity is greater at standing and less in lying or sleeping position.
 Pregnancy: It is decreased in pregnancy.
CARRIAGE OF O2 AND CO2 BY THE BLOOD

Blood serves to transport the respiratory gases. Oxygen, which is essential for the cells, is transported
from alveoli of lungs to the cells. Carbon dioxide, which is the waste product in cells, is transported from
cells to lungs.
TRANSPORT OF OXYGEN
Oxygen is transported from alveoli to the tissue by blood in two forms.
1. As Simple Physical Solution (3%)

2. In Combination With Hemoglobin (97%)
As Simple Physical Solution

Oxygen dissolves in water of plasma and is transported in this physical form. Amount of oxygen
transported in this way is very negligible. It is only 0.3 ml/100 ml of plasma. It forms only about 3% of total
oxygen in blood. It is because of poor solubility of oxygen in water content of plasma.
In Combination With Hemoglobin

Oxygen combines with hemoglobin in blood and is transported as oxyhemoglobin. Transport of oxygen
in this form is important because, maximum amount (97%) of oxygen is transported by this method.
- 50 -
TRANSPORT OF CARBON DIOXIDE

Carbon dioxide is transported by the blood from cells to the alveoli. Carbon dioxide is transported in the
blood in four ways…
1. As Dissolved Form (7%)

2. As Carbonic Acid (Negligible)
3. As Bicarbonate (63%)
4. As Carbamino Compounds (30%).
As Dissolved Form
Carbon dioxide diffuses into blood and dissolves in the fluid of plasma forming a simple solution. It is
about 7% of total carbon dioxide in the blood.
As Carbonic Acid
Part of dissolved carbon dioxide in plasma combines with the water to form carbonic acid. Transport of
carbon dioxide in this form is negligible.
As Bicarbonate
About 63% of carbon dioxide is transported as bicarbonate. From plasma, carbon dioxide enters the
RBCs. In the RBCs, carbon dioxide combines with water to form carbonic acid. The reaction inside RBCs
is very rapid because of the presence of carbonic anhydrase. This enzyme accelerates the reaction.
Carbonic anhydrase is present only inside the RBCs and not in plasma. That is why carbonic acid
formation is at least 200 to 300 times more in RBCs than in plasma.
As Carbamino Compounds
About 30% of carbon dioxide is transported as carbamino compounds. Carbon dioxide is transported in
blood in combination with hemoglobin and plasma proteins. Carbon dioxide combines with hemoglobin to
form carbamino hemoglobin or carbhemoglobin. And it combines with plasma proteins to form carbamino
proteins. Carbamino hemoglobin and carbamino proteins are together called carbamino compounds.
Carbon dioxide combines with proteins or hemoglobin with a loose bond so that, carbon dioxide is easily
released into alveoli, where the partial pressure of carbon dioxide is low. Thus, the combination of carbon
dioxide with proteins and hemoglobin is a reversible one.
REGULATION OF BREATHING/ RESPIRATION

Respiration is regulated by two different mechanisms, these are the
1. Nervous Or Neural Mechanism

2. Chemical Mechanism
NERVOUS OR NEURAL MECHANISM

The nervous system normally adjusts the rate of alveolar ventilation almost exactly to the demands of the
body.
Respiratory Centers
The respiratory center is composed of several groups of neurons located bilaterally in the medulla
oblongata and pons of the brain stem. It is divided into three major collections of neurons…
1. A dorsal respiratory group, located in the dorsal portion of the medulla, which mainly causes
inspiration
2. A ventral respiratory group, located in the ventrolateral part of the medulla, which mainly causes
expiration
3. The pneumotaxic center, located dorsally in the superior portion of the pons, which mainly
controls rate and depth of breathing
The dorsal respiratory group of neurons plays the most fundamental role in the control of respiration.
(The pons is a portion of the hindbrain that connects the cerebral cortex with the medulla oblongata. It
also serves as a communications and coordination center between the two hemispheres of the brain.)
Dorsal Respiratory Group of Neurons

The dorsal respiratory group of neurons is involved in the generation of respiratory rhythm, and is
primarily responsible for the generation of inspiration.
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Ventral Respiratory Group of Neurons

The ventral respiratory group of neurons contains both inspiratory and expiratory neurons. The VRG is
secondarily responsible for initiation of inspiratory activity, after the dorsal respiratory group. The nucleus
para-ambiguus is active during inspiration, while the nucleus retrofacialis and the nucleus retroambiguus
are active during exhalation. The ventral respiratory group of neurons is responsible for motor control of
inspiratory and expiratory muscles during exercise.
Pneumotaxic Center
The pneumotaxic center regulates the amount of air a person can take into the body in each breath. The
dorsal respiratory group has rhythmic bursts of activity that are constant in duration and interval. When we
need to breathe faster, the pneumotaxic center tells the dorsal respiratory group to speed up. When we
need longer breaths the bursts of activity are elongated. All the information that our body uses to help us
breath happens in the pneumotaxic center.
CHEMICAL MECHANISM
Chemical mechanism of regulation of respiration is operated through the chemoreceptors.
Chemoreceptors are the sensory nerve endings, which give response to changes in chemical constituents
of blood.
Changes in Chemical Constituents of Blood which Stimulate Chemoreceptors are as follow…

 Hypoxia (decreased pO2)
 Hypercapnea (increased pCO2)
 Increased hydrogen ion concentration
(pO2 = Partial Pressure of Oxygen)

(pCO2 = Partial Pressure of Carbon Dioxide)
TYPES OF CHEMORECEPTORS
Chemoreceptors are classified into two groups
1. Central Chemoreceptors
2. Peripheral Chemoreceptors.
CENTRAL CHEMORECEPTORS
Central chemoreceptors are the chemoreceptors present in the brain.
MECHANISM OF ACTION OF CENTRAL CHEMORECEPTORS

Central chemoreceptors are connected with respiratory centers. These chemoreceptors act slowly but
effectively. Central chemoreceptors are responsible for 70% to 80% of increased ventilation through
chemical regulatory mechanism. Main stimulant for central chemoreceptors is the increased hydrogen ion
concentration. However, if hydrogen ion concentration increases in the blood, it cannot stimulate the
central chemoreceptors because, the hydrogen ions from blood cannot cross the blood brain barrier.
On the other hand, if carbon dioxide increases in the blood, it can easily cross the blood-brain barrier.
Carbon dioxide combines with water to form carbonic acid. It immediately dissociates into hydrogen ion
and bicarbonate ion. Hydrogen ions stimulate the central chemoreceptors. From chemoreceptors, the
excitatory impulses are sent to dorsal respiratory group of neurons, resulting in increased ventilation
(increased rate and force of breathing).
PERIPHERAL CHEMORECEPTORS
Peripheral chemoreceptors are the chemoreceptors present in carotid and aortic region.
MECHANISM OF ACTION OF PERIPHERAL CHEMORECEPTORS

Hypoxia is the most potent stimulant for peripheral chemoreceptors. It is because of the presence of
oxygen sensitive potassium channels in the glomus cells of peripheral chemoreceptors.
Hypoxia causes closure of oxygen sensitive potassium channels and prevents potassium efflux. This
leads to depolarization of glomus cells (receptor potential) and generation of action potentials in nerve
ending.
These impulses pass through aortic and hering nerves and excite the dorsal group of neurons. Dorsal
group of neurons in turn, send excitatory impulses to respiratory muscles, resulting in increased
ventilation. This provides enough oxygen and rectifies the lack of oxygen.
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SKIN
Skin is the largest organ of the body. It is not uniformly thick. At some places it is thick and at some places
it is thin. The average thickness of the skin is about 1 to 2 mm. In the sole of the foot, palm of the hand
and in the interscapular region, it is considerably thick, measuring about 5 mm. In other areas of the body,
the skin is thin. It is thinnest over eyelids and penis, measuring about 0.5 mm only.
STRUCTURE OF SKIN
Skin is made up of two layers
1. Epidermis Or Outer Epidermis

2. Dermis Or Inner Dermis
EPIDERMIS
Epidermis is the outer layer of skin. It is formed by stratified epithelium. Important feature of epidermis is
that, it does not have blood vessels Nutrition is provided to the epidermis by the capillaries of dermis.
Layers of Epidermis
Epidermis is formed by five layers
1. Stratum Corneum
2. Stratum Lucidum
3. Stratum Granulosum
4. Stratum Spinosum
5. Stratum Germinativum.
DERMIS
Dermis is the inner layer of the skin. It is a connective tissue layer, made up of dense and stout collagen
fibers, fibroblasts and histiocytes. Collagen fibers exhibit elastic property and are capable of storing or
holding water. Collagen fibers contain the enzyme collagenase, which is responsible for wound healing.
Layers of Dermis
Dermis is made up of two layers
- 53 -
1. Superficial Papillary Layer

2. Deeper Reticular Layer
FUNCTIONS OF SKIN
Primary function of skin is protection of organs. However, it has many other important functions also.
 Protective Function
 Regulation Of Body Temperature
 Regulation Of Water And Electrolyte Balance
 Absorptive Function
 Excretory Function
 Secretory Function
 Sensory Function
 Storage Function
 Synthetic Function
 Social Affect Of Skin
Protective Function
Skin forms the covering of all the organs of the body and protects these organs from bacteria and toxic
substances, mechanical blow, ultraviolet rays etc.
Regulation of Body Temperature

Skin plays an important role in the regulation of body temperature. Excess heat is lost from the body
through skin by evaporation. Sweat glands of the skin play an active part in heat loss, by secreting sweat.
While the lipid content of sebum prevents loss of heat from the body in cold environment.
Regulation of Water and Electrolyte Balance

Skin regulates water balance and electrolyte balance by excreting water and salts through sweat.
Absorptive Function
Skin absorbs fat-soluble substances and some ointments.
Excretory Function
Skin excretes small quantities of waste materials like urea, salts and fatty substance.
Secretory Function
Skin secretes sweat through sweat glands and sebum through sebaceous glands. By secreting sweat,
skin regulates body temperature and water balance. Sebum keeps the skin smooth and moist.
Sensory Function
Skin is considered as the largest sense organ in the body. It has many nerve endings. Nerve ending in the
skin allows us to feel heat, cold, touch, pleasure, pressure, and pain.
Storage Function
Skin stores fat, water, chloride and sugar. It can also store blood by the dilatation of the cutaneous blood
vessels.
Synthetic Function
Vitamin D3 is synthesized in skin by the action of ultraviolet rays from sunlight on cholesterol.
Social Affect of Skin

By its colors, texture and odor, it transmit social and sexual signals to others.
TEMPERATURE REGULATION BY SKIN

The body keeps its temperature constant at about 37°C by physiological adjustments controlled by the
hypothalamus (Thermostat Center) where there are neurons sensitive to changes in skin and blood
temperatures.
Hypothalamus has two centers which regulate the body temperature…
1. Heat Loss Center

2. Heat Gain Center
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Heat Loss Center

Heat loss center is situated in preoptic nucleus of anterior hypothalamus. Neurons in preoptic nucleus are
heatsensitive nerve cells, which are called thermoreceptors Stimulation of preoptic nucleus results in
cutaneous vasodilatation and sweating.
Heat Gain Center

Heat gain is otherwise known as heat production center. It is situated in posterior hypothalamic nucleus.
Stimulation of posterior hypothalamic nucleus causes shivering.
MECHANISM OF TEMPERATURE REGULATION
WHEN BODY TEMPERATURE INCREASES

When body temperature increases, blood temperature also increases. When blood with increased
temperature passes through hypothalamus, it stimulates the thermoreceptors that brings the temperature
back to normal by two mechanisms
1. Promotion of Heat Loss: By increasing the secretion of sweat.
2. Prevention of Heat Production: By inhibiting mechanisms involved in heat production, such as

shivering and metabolic reactions.
WHEN BODY TEMPERATURE DECREASES

When the body temperature decreases, it is brought back to normal by two mechanisms…
1. Prevention Of Heat Loss: By decrease in blood flow to skin and so the heat loss is prevented.
2. Promotion Of Heat Production: By increased metabolic reactions and shivering
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DIGESTIVE SYSTEM
The digestive system is the collective name used to describe the alimentary canal, some accessory
organs and a variety of digestive processes which take place at different levels in the canal to prepare
food eaten in the diet for absorption.
ACTIVITIES OF DIGESTIVE SYSTEM

Activities in the digestive system can be grouped under five main headings…
1. Ingestion: This is the process of taking food into the alimentary tract.
2. Propulsion: This moves the contents along the alimentary tract.
3. Digestion: This consists of mechanical breakdown of food by (chewing), chemical digestion of
food by enzymes of the digestive system.
4. Absorption: This is the process by which digested food substances pass through the walls of
some organs of the alimentary canal into the blood and lymph capillaries for circulation round the
body.
5. Elimination: Food substances which have been eaten but cannot be digested and absorbed are
excreted by the bowel as feces.
FUNCTIONS OF DIGESTIVE SYSTEM
 Ingestion or consumption of food substances

 Breaking them into small particles
 Transport of small particles to different areas of the digestive tract
 Secretion of necessary enzymes and other substances for digestion
 Digestion of the food particles
 Absorption of the digestive products (nutrients)
 Removal of unwanted substances from the body
ORGANS OF THE DIGESTIVE SYSTEM
ALIMENTARY TRACT
This is a long tube through which food passes. It starts from mouth and terminates at the anus, and the
various parts are given separate names, although structurally they are remarkably similar. The parts are…
 Mouth  Small Intestine

 Pharynx  Large Intestine
 Esophagus  Rectum
 Stomach  Anal Canal
ACCESSORY DIGESTIVE ORGANS

Accessory digestive organs are those which help primary digestive organs in the process of digestion.
They consist of…
 Teeth
 Tongue
 Salivary Glands
 Pancreas
 Liver
 Gallbladder
DIGESTIVE JUICES
The digestive juices are the secretions of the digestive tract that break down food. They include saliva,
gastric juice, pancreatic juice, bile, and intestinal juice. The digestive juices are secreted by different
organs, vary widely in chemical composition, and play different roles in the digestive process. Each is
constantly produced by the body in small amounts, but the presence of food as it passes through the
digestive tract causes increased production and secretion.
 Saliva
 Gastric Juice
 Pancreatic Juice
 Bile Juice
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 Intestinal Juices
SALIVA
Saliva is a clear watery substance secreted by the salivary glands into the mouth.
SALIVARY GLANDS
There are three pairs of salivary glands
1. Parotid Glands
2. Submandibular Glands
3. Sublingual Glands
Parotid Glands
Parotid glands are the largest of all salivary glands, situated at the side of the face just below and in front
of the ear.
Submandibular Glands
These are present on each side of the face under the angle of the jaw.
Sublingual Glands
Sublingual glands are the smallest salivary glands situated in the mucosa at the floor of the mouth.
COMPOSITION OF SALIVA
Saliva is the combined secretions from the salivary glands and the small mucus-secreting glands of the
lining of the oral cavity. About 1.5 liters of saliva is produced daily and it consists of 99.5% water and 0.5%
solids.
Composition of Saliva
FUNCTIONS OF SALIVA
Preparation Of Food For Swallowing

When food is taken into the mouth, it is moistened and dissolved by saliva. The mucus membrane of
mouth is also moistened by saliva. It facilitates chewing.
Digestive Function
Saliva has three digestive enzymes that help in the process of digestion.
Appreciation Of Taste
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Taste is a chemical sensation. By its solvent action, saliva dissolves the solid food substances, so that the
dissolved substances can stimulate the taste buds. The stimulated taste buds recognize the taste.
Cleansing And Protective Functions

An adequate flow of saliva is necessary to cleanse the mouth and keep its tissues soft, moist and pliable.
Role In Speech
By moistening and lubricating soft parts of mouth and lips, saliva helps in speech. If the mouth becomes
dry, articulation and pronunciation becomes difficult.
Excretory Function
Many substances, both organic and inorganic, are excreted in saliva.
Regulation Of Water Balance

When the body water content decreases, salivary secretion also decreases. This causes dryness of the
mouth and induces thirst. When water is taken, it quenches the thirst and restores the body water content.
GASTRIC JUICE
Gastric juice is a mixture of secretions from different gastric glands. About 2 litters of gastric juice are
secreted daily.
COMPOSITION OF GASTRIC JUICE

Gastric juice contains 99.5% of water and 0.5% organic and inorganic substances.
Composition Of Gastric Juice
 Water, further liquefies the food swallowed.

 Mucus: it prevents mechanical injury to the stomach wall by lubricating the contents. It prevents
chemical injury by acting as a barrier between the stomach wall and the corrosive (acidic) gastric
juice.
 Hydrochloric acid: acidifies the food and stops the action of salivary amylase, kills ingested
microbes, provides the acid environment needed for effective digestion by pepsins.
 Intrinsic factor: It is a protein which is necessary for the absorption of vitamin B12.
 Pepsinogens, They begin the digestion of proteins, breaking them into smaller molecules.
FUNCTIONS OF GASTRIC JUICE
Digestive Function
Gastric juice acts mainly on proteins. Proteolytic enzymes of the gastric juice are pepsin and rennin
Hemopoietic Function
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Intrinsic factor of Castle, secreted by parietal cells of gastric glands plays an important role in
erythropoiesis. It is necessary for the absorption of vitamin B12.
Protective Function
Mucus is a mucoprotein, secreted in stomach; it prevents mechanical injury to the stomach wall by
lubricating the contents. It prevents chemical injury by acting as a barrier between the stomach wall and
the corrosive (acidic) gastric juice.
Functions Of Hydrochloric Acid

Hydrochloric acid is present in the gastric juice. It activates pepsinogen into pepsin, kills some of the
bacteria entering the stomach along with food substances and provides acid medium, which is necessary
for the action of hormones.
PANCREATIC JUICE
Pancreas is a dual organ having two functions, namely endocrine function and exocrine function.
Endocrine function is concerned with the production of hormones. The exocrine function is concerned with
the secretion of digestive juice called pancreatic juice.
COMPOSITION OF PANCREATIC JUICE

Pancreatic juice contains 99.5% of water and 0.5% of solids. The solids are the organic and inorganic
substances.
Composition Of Pancreatic Juice
FUNCTIONS OF PANCREATIC JUICE

Pancreatic juice has digestive functions and neutralizing action.
Digestive Functions Of Pancreatic Juice

Pancreatic juice plays an important role in the digestion of proteins and lipids. It also has mild digestive
action on carbohydrates.
Neutralizing Action Of Pancreatic Juice

When acid chyme enters intestine from stomach, pancreatic juice with large quantity of bicarbonate is
released into intestine. Presence of large quantity of bicarbonate ions makes the pancreatic juice highly
alkaline. This alkaline pancreatic juice neutralizes acidity of chyme in the intestine. Neutralizing action is
an important function of pancreatic juice because it protects the intestine from the destructive action of
acid in the chyme.
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BILE JUICE
Bile is a thick alkaline fluid that is secreted by the liver and stored in the gall bladder, from which it is
ejected intermittently into the duodenum via the common bile duct.
COMPOSITION OF BILE
Bile contains 97.6% of water and 2.4% of solids. Solids include organic and inorganic substances.
Composition Of Bile
FUNCTIONS OF BILE
Digestive and Absorptive Function

Bile salts are required for digestion and absorption of fats in the intestine.
Excretory Functions
Bile pigments are the major excretory products of the bile. Other substances excreted in bile are...
 Heavy Metals Like Copper And Iron  Cholesterol

 Some Bacteria Like Typhoid Bacteria  Lecithin
 Some Toxins  Alkaline Phosphatase
Laxative Action
Bile salts act as laxatives by stimulating peristaltic movements of the intestine.
Antiseptic Action
Bile inhibits the growth of certain bacteria in the lumen of intestine by its natural detergent action.
Maintenance of pH in Gastrointestinal Tract

As bile is highly alkaline, it neutralizes the acid chyme which enters the intestine from stomach. Thus, an
optimum pH is maintained for the action of digestive enzymes.
Prevention of Gallstone Formation

Bile plays important role in prevention of gall stone formation.
Lubrication Function
The mucin in bile acts as a lubricant for the chyme in intestine.
INTESTINAL JUICES
SMALL INTESTINE JUICE

Secretion from small intestine is called succus entericus.
COMPOSITION OF SUCCUS ENTERICUS

Succus entericus contains water (99.5%) and solids (0.5%). Solids include organic and inorganic
substances.
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Composition Of Succus Entericus
FUNCTIONS OF SUCCUS ENTERICUS
Digestive Function
Enzymes of succus entericus act on the partially digested food and convert them into final digestive
products.
Protective Function
Mucus present in the succus entericus protects the intestinal wall from the acid chyme, which enters the
intestine from stomach; thereby it prevents the intestinal ulcer.
Activator Function
Enterokinase present in intestinal juice activates trypsinogen into trypsin. Trypsin, in turn activates other
enzymes
Hemopoietic Function
Intrinsic factor of Castle present in the intestine plays an important role in erythropoiesis. It is necessary
for the absorption of vitamin B12.
Hydrolytic Process
Intestinal juice helps in all the enzymatic reactions of digestion.
LARGE INTESTINE JUICE

Large intestinal juice is a watery fluid with pH of 8.0.
COMPOSITION OF LARGE INTESTINAL JUICE

Large intestinal juice contains 99.5% of water and 0.5% of solids. Digestive enzymes are absent and
concentration of bicarbonate is high in large intestinal juice.
- 61 -
Composition Of Large Intestinal Juice
FUNCTIONS OF LARGE INTESTINAL JUICE
Neutralization of Acids
Strong acids formed by bacterial action in large intestine are neutralized by the alkaline nature of large
intestinal juice. The alkalinity of this juice is mainly due to the presence of large quantity of bicarbonate.
Lubrication Activity
Mucin present in the secretion of large intestine lubricates the mucosa of large intestine and the bowel
contents, so that, the movement of bowel is facilitated. Mucin also protects the mucus membrane of large
intestine by preventing the damage caused by mechanical injury or chemical substances.
MOVEMENTS OF THE STOMACH AND INTESTINES

MOVEMENTS OF STOMACH
Activities of smooth muscles of stomach increase during gastric digestion (when stomach is filled with
food) and when the stomach is empty.
Types of movements in stomach

1. Hunger Contractions
2. Receptive Relaxation
3. Peristalsis Waves
HUNGER CONTRACTIONS
Hunger contractions are the movements of empty stomach. These contractions are related to the
sensations of hunger. Hunger contractions are the peristaltic waves superimposed over the contractions
of gastric smooth muscle as a whole.
Hunger contractions are of three types…
1. Type I Hunger Contractions: Type I hunger contractions are the first contractions to appear in
the empty stomach, when the tone of the gastric muscles is low.
2. Type II Hunger Contractions: Type II hunger contractions appear when the tone of stomach is
stronger. Tone increases in stomach if food intake is postponed, even after the appearance of the
type I contractions.
3. Type III Hunger Contractions: Type III hunger contractions are like incomplete tetanus. These
contractions appear when the hunger becomes severe and the tone increases to a great extent.
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RECEPTIVE RELAXATION
Receptive relaxation is the relaxation of the upper portion of the stomach when bolus enters the stomach
from esophagus. Receptive relaxation is the relaxation of the upper portion of the stomach when bolus
enters the stomach from esophagus. This process is called accommodation of stomach.
PERISTALSIS WAVES
When food enters the stomach, the peristaltic contraction or peristaltic wave appears with a frequency of 3
per minute. It starts from the lower part of the body of stomach, passes through the pylorus till the pyloric
sphincter.
Some of the waves disappear before reaching the sphincter. Each peristaltic wave takes about one
minute to travel from the point of origin to the point of ending. This type of peristaltic contraction is called
digestive peristalsis because it is responsible for the grinding of food particles and mixing them with
gastric juice for digestive activities.
MOVEMENTS OF THE INTESTINES
MOVEMENTS OF SMALL INTESTINE

Movements of small intestine are essential for mixing the chyme with digestive juices, propulsion of food
and absorption.
TYPES OF MOVEMENTS OF SMALL INTESTINE

Movements of small intestine are of four types…
1. Mixing Movements
2. Propulsive Movements
3. Migrating Motor Complex (Peristalsis In Fasting)
4. Movements Of Villi
MIXING MOVEMENTS
Mixing movements of small intestine are responsible for proper mixing of chyme with digestive juices such
as pancreatic juice, bile and intestinal juice.
PROPULSIVE MOVEMENTS
Propulsive movements are the movements of small intestine which push the chyme in the aboral direction
through intestine.
MIGRATING MOTOR COMPLEX (PERISTALSIS IN FASTING)

Migrating motor complex is a type of peristaltic contraction, which occurs in stomach and small intestine
during the periods of fasting for several hours. It is different from the regular peristalsis because, a large
portion of stomach or intestine is involved in the contraction. The contraction extends to about 20 to 30 cm
of stomach or intestine.
MOVEMENTS OF VILLI
Intestinal villi also show movements simultaneously along with intestinal movements. Movements of villi
are shortening, which occur alternatively and help in emptying lymph from the central lacteal into the
lymphatic system.
MOVEMENTS OF LARGE INTESTINE

Usually, the large intestine shows sluggish movements. Still, these movements are important for mixing,
propulsive and absorptive functions.
TYPES OF MOVEMENTS OF LARGE INTESTINE

Movements of large intestine are of two types…
1. Mixing Movements: Segmentation Contractions

2. Propulsive Movements: Mass Peristalsis
MIXING MOVEMENTS – SEGMENTATION CONTRACTIONS

Large circular constrictions, which appear in the colon, are called mixing segmentation contractions.
These contractions occur at regular distance in colon. Length of the portion of colon involved in each
contraction is nearly about 2.5 cm.
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PROPULSIVE MOVEMENTS – MASS PERISTALSIS

Mass peristalsis or mass movement propels the feces from colon towards anus. Usually, this movement
occurs only a few times every day. Duration of mass movement is about 10 minutes in the morning before
or after breakfast. This is because of the neurogenic factors like gastrocolic reflex and parasympathetic
stimulation.
FUNCTIONS OF LIVER AND GALL BLADDER

LIVER
Liver is the largest gland in the body it weighs about 1.5kg (3-4 lb) lies immediately under the diaphragm
and occupies most of the right hypochondrium and part of the epigastrium.
FUNCTIONS OF LIVER
 Liver cells detoxify the various substances.

 Liver cells secrete about a pint of bile in a day.
 Liver cells produce plasma proteins and serves as a site of hematopoiesis (process of blood cell
production and maturation) during fetal development.
 Liver cells store several substances e.g. iron and vitamins A, B12 and D.
 Liver cells carry on numerous important steps in the metabolism of all three kind of food i.e.
proteins carbohydrates and lipids.
GALL BLADDER
Gallbladder is pear shaped sac from 7-10 cm (3-4 inches) long and 3cm is broad at its widest pont.
It can hold 30-50ml of bile it lies on the undersurface of the liver and is attached there by areolar
connective tissue.
FUNCTIONS OF THE GALLBLADDER

The main function of the gallbladder is to store bile, or gall. The gallbladder is part of the biliary system
and serves as a reservoir for bile, which is produced by the liver. The liver produces the bile and then it
flows through the bile ducts into the gallbladder, when digestion occurs in the stomach and intestines, the
gallbladder contracts, ejecting the concentrated bile into the duodenum. Bile is highly alkaline; it
neutralizes the acid chyme which enters the intestine from stomach. Thus, an optimum pH is maintained
for the action of digestive enzymes.
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URINARY SYSTEM
The urinary system is one of the excretory systems of the body. It is a set of organs producing urine in
human beings. It consists of the following structures…
 2-Kidneys
 2-Ureters
 1-Urinary Bladder
 1-Urethra
The urinary system plays a vital part in maintaining homeostasis of water and electrolyte concentrations
within the body.
KIDNEYS
Kidneys are bean-shaped organs. These are a pair of excretory organs situated on the posterior
abdominal wall on each side of the vertebral column behind the peritoneum. Nephron is the basic
structural and functional unit of the kidney which is capable of forming urine. The kidneys produce urine
that contains metabolic waste products, including the nitrogenous compounds urea and uric acid, excess
ions and some drugs.
The main functions of the kidneys are…

 Formation and secretion of urine
 Production and secretion of erythropoietin, the hormone responsible for controlling the rate of
formation of red blood cells
 Production and secretion of renin, an important enzyme in the control of blood pressure
URETERS
The ureters are the tubes that convey urine from the kidneys to the urinary bladder.
URINARY BLADDER
The urinary bladder is a reservoir for urine. Its size and position vary, depending on the amount of urine it
contains.
URETHRA
The urethra is a canal extending from the neck of the bladder to the exterior, at the external urethral
orifice. Its length differs in the male and in the female.
URINE FORMATION
Urine formation is a blood cleansing function. Normally, about 1,300 mL of blood (26% of cardiac output)
enters the kidneys. Kidneys excrete the unwanted substances along with water from the blood as urine.
Normal urinary output is 1 L/day to 1.5 L/day.
PROCESSES OF URINE FORMATION

Urine formation takes place in three processes
1. Glomerular Filtration
2. Tubular Reabsorption
3. Tubular Secretion
Glomerular Filtration
Glomerular filtration is the process by which the blood is filtered while passing through the glomerular
capillaries by filtration membrane. It is the first process of urine formation. Plasma is filtered in glomeruli
and the substances reach the renal tubules along with water as filtrate.
Tubular Reabsorption
Tubular reabsorption is the process by which water and other substances are transported from renal
tubules back to the blood. When the glomerular filtrate flows through the tubular portion of nephron, both
quantitative and qualitative changes occur. Large quantity of water (more than 99%), electrolytes and
other substances are reabsorbed by the tubular epithelial cells. The 99% of filtrate is reabsorbed in
different segments of renal tubules.
Tubular Secretion
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Tubular secretion is the process by which the substances are transported from blood into renal tubules. It
is also called tubular excretion. Some substances are transported from blood into the renal tubule. With all
these changes, the filtrate becomes urine.
Structure And Function Of Nephron
COMPOSITION OF URINE
Urine is composed mostly of water containing organic wastes as well as some salts. The composition of
urine can vary according to diet, time of day, and diseases. Normal constituents of urine or Composition of
urine are as follow
Organic Substances
 Urea  Oxalic Acid
 Uric Acid  Amino Acid
 Creatine  Vitamins
 Creatinine  Enzymes
 Ammonia  Hormones
Inorganic Substances
 Sodium  Potassium
 Chloride  Calcium
 Phosphate  Magnesium
 Sulphate  Iodine
Abnormal Constituents of Urine

 Proteins  Pigments
 Sugar  Casts
 RBCs, WBCs  Pus
 Ketone Bodies  Renal Calculi
 Indicant  Microbes
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GENERAL INTRODUCTION TO NERVOUS SYSTEM

NEURON
Neuron or nerve cell is defined as the structural and functional unit of nervous system. Neuron is similar to
any other cell in the body, having nucleus and all the organelles in cytoplasm. However, it is different from
other cells by two ways
1. Neuron has branches or processes called axon and dendrites

2. Neuron does not have centrosome. So, it cannot undergo division
Types Of Neuron
CLASSIFICATION OF NEURONS
On the basis of function, nerve cells are classified into two types
1. Motor Or Efferent Neurons: Efferent neurons carry nerve impulse from CNS to the effector
organs
2. Sensory Or Afferent Neurons: Afferent neurons of ANS bring nerve impulse back to CNS from
periphery
NEUROGLIA
Neuroglia or glia (glia = glue) is the supporting cell of the nervous system. Neuroglia cells are non-
excitable and do not transmit nerve impulse (action potential). So, these cells are also called non-neural
cells or glial cells.
Neuroglia Cells In CNS
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RECEPTOR
Pharmacology defines a receptor as any biological molecule to which a drug binds and produces a
measurable response. Thus, enzymes and structural protein can be considered to be pharmacological
receptors.
NEUROTRANSMITTER
Neurotransmitter is a chemical substance that acts as a mediator for the transmission of nerve impulse
from one neuron to another neuron through a synapse.
NERVOUS SYSTEM
Nervous system controls all the activities of the body. It is quicker than other control system in the body.
Primarily, nervous system is divided into two parts…
1. Central Nervous System

2. Peripheral Nervous System
Organization Of Nervous System
CENTRAL NERVOUS SYSTEM

Central nervous system (CNS) includes brain and spinal cord. It is formed by neurons and supporting
cells called neuroglia.
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Parts Of Central Nervous System
PERIPHERAL NERVOUS SYSTEM

Peripheral nervous system (PNS) is formed by neurons and their processes present in all regions of the
body. It consists of cranial nerves, arising from brain and spinal nerves, arising from the spinal cord.
Peripheral Nervous System Divided Into Two Subdivisions
 Somatic Nervous System

 Autonomic Nervous System
SOMATIC NERVOUS SYSTEM

Somatic nervous system is concerned with somatic functions. It includes the nerves supplying the skeletal
muscles. Somatic nervous system is responsible for muscular activities and movements of the body.
AUTONOMIC NERVOUS SYSTEM

Autonomic nervous system is concerned with regulation of visceral or vegetative functions. So, it is
otherwise called vegetative or involuntary nervous system.
- 69 -
Introductory knowledge of structure and functions of the special senses
Special Senses
This is a special type of faculty by which the conditions or properties of things are perceived. There are
five special types of senses, these are
1. Sensation of Vision
2. Sensation of Hearing
3. Sensation of Taste
4. Sensation of Smell
5. Sensation of Touch
SENSATION OF VISION
Eye
Eye is the organ of vision among all the sensory organs of our body. The eyes are act as optical
instrument, sensory receptor organ, and also our windows on the world.
STRUCTURE OF EYE
Human eyeball is approximately globe shaped, with a diameter of about 24 mm. Major parts of eye are as
follow…
Eyeball
Eyeball is made up of two segments, an anterior part and a posterior part. Anterior part is small and forms
one sixth of the eyeball. Posterior part is larger and forms five sixth of the eyeball.
Orbital Cavity
Eyeball is situated in a bony cavity known as orbital cavity or eye socket.
Eyelids
Eyelids protect the eyeball from foreign particles coming in contact with its surface and cutoff the light
during sleep. Eyelids are opened and closed voluntarily, as well as by reflex action.
Conjunctiva
Conjunctiva is a thin mucus membrane, which covers the exposed part of eye.
- 70 -
Lacrimal Gland And Tear

The lacrimal glands are exocrine glands. The glands secrete tears composed of water, mineral salts, and
antibodies etc.
Lens
Lens of the eyeball is crystalline in nature. It is situated behind the pupil. It is a biconvex, transparent and
elastic structure. It is avascular and receives its nutrition mainly from the aqueous humor. Lens refracts
light rays and helps to focus the image of the objects on retina.
Sclera
Sclera is the tough white fibrous outer layer of eyeball.
Cornea
Cornea is the transparent convex anterior portion of the outer layer of eyeball, which covers the iris and
pupil.
Iris
Iris is a thin colored curtain-like structure of eyeball, located in front of the lens.
Pupil
Pupil is the circular opening in the centre of the iris, through which light passes into the lens of the eye.
FUNCTION OF EYE
The major function of the eye is to work with the brain to provide us with vision.
SENSATION OF HEARING
The ear is the organ of hearing and balance. Sound waves travel through the outer ear, are modulated by
the middle ear, and are transmitted to a nerve in the inner ear. This nerve transmits information to the
brain, where it is registered as sound. Ears provide balance, when moving or stationary, is also a central
function of the ear.
STRUCTURE OF EAR
The ear is divided into three distinct parts
1. Outer Ear
2. Middle Ear
3. Inner Ear
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THE PARTS OF THE EAR
Outer Ear
The outer ear consists of the auricle (pinna) and the external acoustic meatus.
Middle Ear
This is an irregular-shaped air-filled cavity within the petrous portion of the temporal bone. The cavity, its
contents and the air sacs which open out of it are lined with either simple squamous or cuboidal
epithelium.
Inner Ear
The inner (internal) ear contains the organs of hearing and balance.
FUNCTIONS OF EAR
Hearing
Major function of ears is hearing. Sound waves travel through the outer ear, are modulated by the middle
ear, and are transmitted to a nerve in the inner ear. This nerve transmits information to the brain, where it
is recognized as sound.
Balance
Ears provide balance, when moving or stationary, is also a central function of the ear. The ear facilitates
two types of balance: static balance, which allows a person to feel the effects of gravity, and dynamic
balance, which allows a person to sense acceleration.
SENSATION OF TASTE
Taste is a chemical sense; its sensory modality is mediated by chemoreceptors of tongue mouth and
pharynx. Sense organs for taste or gustatory sensation are the taste buds. Taste buds are ovoid bodies
with a diameter of 50 μ to 70 μ.
STRUCTURE OF TASTE BUD

Taste bud is a bundle of taste receptor cells, with supporting cells embedded in the epithelial covering of
the papillae. Each taste bud contains about 40 cells, which are the modified epithelial cells.
Cells of taste bud are divided into four groups…
1. Type I Cells Or Sustentacular Cells

2. Type II Cells
3. Type III Cells
4. Type IV Cells or Basal Cells.
Type I cells and type IV cells are supporting cells. Type III cells are the taste receptor cells. Function of
type II cell is unknown.
Taste Receptor
Generally, taste receptor is a G-protein coupled receptor. However, several other receptors are also
involved in taste sensation.
- 72 -
Cells Of Taste Bud
Primary Taste Sensations

Primary or fundamental taste sensations are divided into five types…
1. Sweet
2. Salt
3. Sour
4. Bitter
5. Umami (any taste which is delicious and tasty)
SENSATION OF SMELL
Nasal cavity is the organ of sensation of smell. The nasal cavity has a dual function, a passageway for
respiration and sense of smell.
Olfactory nerves
These are the sensory nerves of smell.
Receptors of Smell
The olfactory receptor cells are located high in the roof of the nasal cavity in the specialized area’s of the
nasal mucosa called olfactory epithelium. Each nostril contains a small patch of pseudostratified columnar
olfactory epithelium.
Mechanism Of Odor
There are two important theories which explain the excitation of olfactory cells.
Physical Theory
According to this theory the physical shapes of odorant molecules determine and stimulate the olfactory
cells.
Chemical Theory
According to this theory the odorant molecules bind chemically to specific protein receptors in the
membrane of olfactory cilia.
SENSATION OF TOUCH
Touch is considered one of the five traditional senses, the impression of touch is formed from several
modalities including pressure, skin stretch, vibration and temperature.
SKIN AND TOUCH

Our skin acts as the protective barrier between our internal body systems and the outside world. Its ability
to perceive touch sensations gives our brains a wealth of information about the environment around us,
such as temperature, pain, and pressure. Without our sense of touch, it would be very hard to get around
in this world! We wouldn't feel our feet hitting the floor when we walked
- 73 -
SKIN ABILITY TO SENSE TOUCH

Our sense of touch is controlled by a huge network of nerve endings and touch receptors in the skin
known as the somatosensory system. This system is responsible for all the sensations we feel e.g. cold,
hot, smooth, rough, pressure, tickle, itch, pain, vibrations, and more. Within the somatosensory system,
there are four main types of receptors: mechanoreceptors, thermoreceptors, pain receptors, and
proprioceptors.
Mechanoreceptors
These receptors perceive sensations such as pressure, vibrations, and texture.
Thermoreceptors
As their name suggests, these receptors perceive sensations related to the temperature of objects the
skin feels.
Pain Receptors
These receptors detect pain or stimuli that can or does cause damage to the skin and other tissues of the
body.
Proprioceptors
These receptors sense the position of the different parts of the body in relation to each other and the
surrounding environment.
- 74 -
HORMONES
All the physiological activities are regulated by two major systems in the body
1. Nervous System
2. Endocrine System
These two systems interact with one another and regulate the body functions.
ENDOCRINE SYSTEM
The endocrine system is the system of glands, each of which secretes different types of hormone directly
into the bloodstream to regulate the body. The endocrine system does not include exocrine glands such
as salivary glands, sweat glands and glands within the gastrointestinal tract.
CHEMICAL MESSENGERS
The chemical messengers are the substances involved in cell signaling, these messengers are mainly
secreted form endocrine glands.
Some chemical messengers are secreted by nerve endings and the cells of several other tissues.
Generally the chemical messengers are classified into two types
 Classical Hormones
 Local Hormones
(Classical hormones secreted by endocrine glands)

(Local hormones secreted from other tissues)
ENDOCRINE GLANDS
Endocrine glands are glands, which synthesize and release the classical hormones into the blood. The
endocrine glands are also called ductless glands because the hormones secreted by them are released
directly into the blood without any duct.
These hormones are transported by blood to the target organs or tissues in different parts of the body
where the actions are executed.
THE MAIN ENDOCRINE GLANDS INCLUDE

 Pineal Gland  Adrenal Gland
 Pituitary Gland  Pancreas
 Thyroid Gland  Ovaries (in female only)
 Parathyroid Gland  Testes (in male only)
HORMONES INTRODUCTION
These are chemical substances released by a cell or a gland into the bloodstream and have a
physiological control effect on other cells of the body.
Some important hormones are growth hormone (GH), Testosterone, Estrogen, Progesterone, Oxytocin,
Calcitonin, Aldosterone, Cortisol, and Insulin. Or
Hormones are the chemical messengers of the body. They are defined as organic substances secreted
into blood stream to control the metabolic and biological activities. These hormones are involved in
transmission of information from one tissue to another and from cell to cell.
These substances are produced in small amounts by various endocrine (ductless) glands in the body.
They are delivered directly to the blood in minute quantities and are carried by the blood to various target
organs where these exert physiological effect and control metabolic activities. Thus frequently their site of
action is away from their origin.
- 75 -
CLASSIFICATION OF HORMONES
1. Based on the site of production/ accumulation
2. Based on the chemical nature
CLASSIFICATION OF HORMONES BASED ON THE SITE OF PRODUCTION/ ACCUMULATION

HORMONES OF PITUITARY GLANDS
HORMONES OF ANTERIOR PITUITARY FLANDS

 Growth hormone
 Thyroid stimulating hormone
HORMONES OF POSTERIOR PITUITARY FLANDS

 Oxytocin hormone
 Antidiuretic hormone (ADH)
HORMONES OF THYROID GLANDS

 Tri-iodothyronine (T3)
 Tetraiodothyronine (T4)
 Calcitonin
HORMONES OF PARATHYROID GLANDS

 Parathormone (PTH)
HORMONES OF ADRENAL GLAND

 Aldosterone hormone
 Cortisol hormone
HORMONES OF OVARY GLAND

 Estrogen hormone
 Progesterone hormone
HORMONES OF TESTIS
 Testosterone hormone
 Dihydrotestosterone hormone
HORMONE OF PANCREAS
 Insulin
CLASSIFICATION OF HORMONES BASED ON THE CHEMICAL NATURE

Chemically, most hormones belong to one of three major groups…
1. Steroid Hormones
2. Protein Hormones
3. Derivative of the Amino Acid Called Tyrosine
STEROID HORMONES
These are hormones formed from cholesterol or its derivatives, e.g. testosterone, aldosteron, estrogen,
progesterone.
Steroid hormones help control metabolism, inflammation, immune functions, salt and water balance,
development of sexual characteristics.
PROTEIN HORMONES
These are large or small peptide, e.g. growth hormone, oxytocin, insulin. Several important peptide
hormones are secreted from the pituitary gland.
DERIVATIVE OF THE AMINO ACID CALLED TYROSINE

These are derivatives of amino acid, e.g. dopamine, adrenaline.
- 76 -
HORMONAL ACTIONS
Hormone does not act directly on the cellular structures. First the hormone combines with transmembrane
(transmembrane existing or occurring across a cell membrane) receptors present on the target cells and
form a hormone-receptor complex. This hormone-receptor complex induces various changes or reactions
in the target cells.
The hormones receptors are situated either in cell membrane, cytoplasm or nucleus of the cells.
Cell Membrane
Receptors of protein hormones are situated in the cell membrane.
Cytoplasm
Receptors of steroid hormones are situated in cytoplasm of target cells.
Nucleus
Receptors of the thyroid hormones are in the nucleus of the cell.
Generally when a hormone is secreted in excess, the number of receptors of that hormone decreases this
process is called down-regulation. During the deficiency of hormones, the number of receptors increases
which is called up-regulation.
Proteins and peptides cannot enter the cell and so act via cell membrane receptors, producing their
effects by 'second messengers', which are activated in the cell as soon as the hormone binds to the
receptor. Thus peptide hormones can produce quite rapid responses. Steroid and thyroid hormones, by
contrast, can enter the cell and bind to intracellular receptors, producing their effects by stimulating the
production of new proteins. There is therefore a relatively long lag period before the response to these
hormones is seen.
GROWTH HORMONE (GH)

Growth hormone (GH) is a peptide hormone that stimulates growth, cell reproduction and regeneration in
humans and other animals. Growth hormone is a 191-amino acid, single-chain polypeptide that is
synthesized, stored, and secreted by anterior pituitary gland. Its half life is about 20 minutes.
NORMAL FUNCTIONS OF GH
Effects of growth hormone on the tissues of the body can generally be described as anabolic (building
up). Like most other protein hormones, GH acts by interacting with a specific receptor on the surface of
cells. Increased height during childhood is the most widely known effect of GH.
EFFECT ON PROTEIN METABOLISM

Growth hormone has predominately anabolic effects on skeletal and cardiac muscles. It stimulates the
synthesis of protein, RNA, DNA.
It promotes amino acid entry into cells.
It decreases the catabolism of protein because growth hormone mobilizes free fatty acids to supply
energy.
EFFECTS ON CARBOHYDRATE METABOLISM

Growth hormone is one of an important chemical substance that maintains blood glucose within a normal
range. Growth hormone is often said to have anti-insulin activity
EFFECTS ON FAT METABOLISM

Growth hormone enhances the utilization of fat by stimulating triglyceride breakdown and oxidation in
adipose tissues.
EFFECTS ON INORGANIC METABOLISM

Growth hormone increases the retention of the phosphorus and calcium. It also causes the retention of
sodium, potassium, and magnesium.
EFFECTS ON BONE, CARTILAGE, AND SOFT TISSUES
 It acts on cartilage and bone to stimulate the growth.

 It increases the deposition of connective tissue.
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 It increases the thickness of skin.

 It increases the growth of important organs of the body like liver and kidney etc.
 It increases milk secretion in lactating animals.
VASOPRESSIN/ ANTIDIURETIC HORMONE (ADH)

The Antidiuretic hormone is the hormone of the posterior pituitary gland. It prevents excessive urine
production. ADH is a polypeptide, containing 9 amino acids. Its half life is 18-20 minutes.
Vasopressin is responsible for regulating the body's retention of water by acting to increase water
absorption in the collecting ducts of the kidney nephron.
It increases the permeability of the collecting tubules and ducts to water, increasing water absorption from
the lumen of the collecting tubules and ducts.
ADH can also raise blood pressure by bringing about constriction of arterioles. It causes the contraction of
all smooth muscles in the body such as the GIT, Bile Duct, and Uterus.
OXYTOCIN (OT)
Oxytocin (OT) is traditionally thought of as a ‘female’ hormone due to its role in milk ejection. However,
OT is recognized as having roles in male reproduction. It is secreted in both males and females. Oxytocin
is best known for its roles in sexual reproduction, in particular during and after childbirth.
This is a hormone of the posterior pituitary gland. It is polypeptide containing 8 amino acids. Its half-life is
about 6 minutes.
ACTION IN FEMALES
In females, oxytocin acts on mammary glands and uterus. It causes ejection of milk from the mammary
glands.
Oxytocin causes contraction of uterus and helps in the expulsion of fetus. It is released in large quantity
just prior to delivery.
ACTION IN MALES
In male, the release of oxytocin increases during ejaculation. It facilitates release of sperm into urethra by
causing contraction of smooth muscles fibers in reproductive tract.
INSULIN
Insulin is a peptide hormone, produced by beta cells of the pancreas, which acts to lower the blood
glucose level, regulating carbohydrate and fat metabolism in the body.
Chemical Nature
Insulin is small soluble protein containing 51 amino acids.
EFFECTS OF INSULIN
EFFECTS OF INSULIN ON CARBOHYDRATE METABOLISM

 It increases the entry of glucose into cells by stimulating the process of facilitated diffusion,
especially in muscles, adipose tissue, the heart, smooth muscles, of the uterus by activating
glucokinase. But on the other hand insulin does not facilitate glucose entry into the brain and
RBCs.
 It increases utilization of glucose for energy.
 It increases glycogen storage in cells
 It increases the conversion of glucose into fat to be stored in adipose tissues.
EFFECTS OF INSULIN ON FAT METABOLISM

 Insulin forms fatty acids from excess liver glucose.
 Fatty acids are utilized from triglycerides which are stored in adipose tissues.
 It inhibits hydrolysis of triglycerides in fat cells by inhibiting hormone sensitive lipase.
EFFECTS OF INSULIN ON PROTEIN METABOLISM

 It causes active transport of amino acids into cells.
 It promotes translation of mRNA in ribosomes to form new proteins.
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 It promotes transcription of DNA in nucleus to form mRNA.

 It inhibits protein catabolism.
EFFECTS OF INSULIN ON GROWTH

Insulin is essential for growth as it increases protein formation.
TESTOSTERONE
This is the principle hormone of the testes which consists of 19 carbon atoms. It is responsible for the
proper development of male sexual characteristics. Testosterone is also important for maintaining muscle
bulk, adequate levels of red blood cells, bone growth, a sense of well-being, and sexual function.
Nature
Steroid in nature
EFFECTS OF TESTOSTERONE
EFFECT ON THE MALE REPRODUCTIVE SYSTEM

During intrauterine life, testosterone is secreted by the genital ridge. Later on it is secreted by the
placenta. At this stage it causes the development of male sex organs including the penis, scrotum
prostate, seminal vesicle, and male genital duct.
This hormone also causes descent of the testes (during last 2 months of gestation) and suppresses the
formation of female genital organs.This hormone causes the enlargement of the male sexual organs. It
acts on different male sex organs, increasing spermatogenesis and maintaining the motility and fertilizing
power of sperm.
EFFECTS ON SECONDARY SEX CHARACTERISTICS

The effects of testosterone on secondary sex characteristics are as follow. Growth of hairs on the face,
chest, and pubis are increases, while decreased on top of the head, voice becomes deeper.
Testosterone causes thickness of the skin, roughness of the subcutaneous tissue. Testosterone is also
responsible for aggressive moods, active attitudes and interest in the opposite sex.
EFFECT ON PROTEIN MMETABOLISM

 It increases protein synthesis and build up the musculature.
 Causes positive N- balance.
 Decreases blood urea levels.
EFFECT ON BONE
 Increases thickness of bones
 Increases total quantity of bone matrices.
 Increases the deposition of calcium salts in bones.
 Narrows the length of the male pelvis outlet.
 Increases the length of the male pelvis and makes it funnel shaped.
 Increases the strength of the pelvis and makes it strong.
EFFECT ON RBCS
Testosterone increases the number of RBCs (15-20%). However this difference may be due to the
increased metabolic rate following testosterone administration rather than to a direct effect of testosterone
on RBC production.
EFFECT ON ELECTROLYTE AND WATER BALANCE

Testosterone can increase the reabsorption of NA+ and water in the distal tubules of the kidneys. This
effect of testosterone is of a minor degree.
ESTROGEN
Estrogen is a group of hormones that play an important role in the normal sexual and reproductive
development in women. They are also called sex hormones. The woman's ovaries produce most estrogen
hormones, although the adrenal glands also produce small amounts of the hormones.
Nature
An 18 carbon steroid
- 79 -
ACTIONS OF ESTROGENS
 Increases the size of the vagina

 Increases the size of the uterus
 Causes growth of the uterine glands
 Causes enlargement of the musculature of the walls of the vagina
 Increases the size of the llitoris and labia minora
 Promotes the development of the tubular duct system
 Increases vascularity of the skin. Causes softness and smoothness of the skin (This is why
estrogen is used in creams, soaps and oils for cosmetic purposes)
 The larynx of a female retains its prepubertal, so size the voice remains high pitched
 Causes broadness of the pelvis
 Increases the synthesis and deposition of proteins
 Increases the synthesis of fat
 Increases the deposition of fat in subcutaneous tissue especially the breasts medial side of the
thigh and buttocks
 It increases the retention of Na+ and water increasing the E.C.F.
 This hormone is responsible for the proliferative phase of the menstrual cycle
 Decreases blood cholesterol levels
COURSE OUTLINE
ANATOMY AND PHYSIOLOGY (WRITTEN)
Paper 1 Part-1 100 (20+80) Marks
Anatomy
1. Introduction to Anatomy.
2. Anatomical Terminologies.
3. Surface Anatomy.
Physiology
1. Introduction to physiology.
2. Structure of Cell and Tissues of the body.
i) Bone Structure, types of bones and joints.
ii) Muscles (structure of skeletal, smooth and Cardiac muscle).
3. Blood-Composition of blood (RBC, WBC and Platelets). Fate of Red Blood cells, blood groups,
RH factors, E.S.R Blood coagulation, Anaemias.
4. Circulatory system-Properties of the cardiac muscle. Heart beat cardiac cycle ECG, Blood
pressure, Pulse, Hemorrhages, and Lymph.
5. Respiratory system—Mechanics of respiration. Pulmonary ventilation. Lungs volume and
capacities. Carriage of O2 and CO2 by the blood. Regulation of breathing (Nervous and chemical control).
6. Skin—Structure, Function of skin, Temperature regulation by skin.
7. Digestive system—Introduction of digestive juices saliva Gastric juice, pancreatic juice, Bile and
intestinal juices their composition. Movements of the stomach and intestines. Functions of liver and gall
bladder.
8. Urinary System—Urine formation and composition of urine.
9. Physiology of nerve and muscle—General introduction to Nervous and muscular system.
10. Nervous system—General introduction to nervous and muscular system.
11. Special sense—Introductory knowledge of structure and functions of the special senses.
12. Endocrinology—Definition of hormone, nature, function and action of hormone.
- 80 -

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Anatomy & Physiology

For the students of

Dr. Asim Zubair

Dr. Saima Rehmat

Dr. Sidra Ishaq

Prof. Dr. Naim Anwar Muzaffar “The Father of Pharmacy”

Whose Dedications Toward Pharmacy Education Are Priceless.

Syed Bilal Hussain

 Macroscopic Or Gross Anatomy

MACROSCOPIC OR GROSS ANATOMY

Gross anatomy can be studied using the following two approaches

MICROSCOPIC ANATOMY OR HISTOLOGY

Superior And Inferior

Proximal And Distal

Superficial And Deep

Medial And Lateral

ABDUCTION AND ADDUCTION

ELEVATION AND DEPRESSION

DORSIFLEXION AND PLANTARFLEXION

EVERSION AND INVERSION

OVER VIEW OF HUMAN SKULL

1. Frontal Bone 6. Zigomatic Bone

OVER VIEW O THE UPPER LIMB

OVER VIEW OF LOWER LIMB

ANATOMY OF PELVIC GIRDLE

This coxal bone is also called ossabone. In child

 First part is Ileum

In adult these three bones are finely fused to

ANATOMY OF DIGESTIVE SYSTEM

(Liver, Gall bladder and pancreas are supporting

ANATOMY OF RESPIRATION SYSTEM

1. Upper Respiratory Tract

2. Lower Respiratory Tract

Respiratory system consists of the following

ANATOMY OF URINARY SYSTEM

Urinary system consists of the following organs

(Nephron is basic structural & functional unit of kidney)

ANATOMY OF CARDIOVASCULAR SYSTEM

ANATOMY OF REPRODUCTIVE SYSTEM

MALE REPRODUCTIVE SYSTEM

 Testes  Prostate Gland

FEMALE REPRODUCTIVE SYSTEM

Therefore, the vast field of physiology can be divided into

(Watery fluid of cytoplasm is called cytosol)

PLASMA MEMBRANE OR CELL MEMBRANE

FUNCTIONS OF PLASMA MEMBRANE

1. Ectoplasm --- near to the cell membrane

ENDOPLASMIC RETICULUM (ER)

There are two types of endoplasmic reticulum

MICROFILAMENTS AND MICROTUBULES

1. Epithelial Tissue Or Epithelium

TYPES OF EPITHELIAL TISSUES

1. Simple Epithelial Tissues

MAJOR FUNCTIONS OF CONNECTIVE

 Binding and structural support

STRUCTURE OF THE CONNECTIVE TISSUE

The fibers and ground substance are collectively known as matrix.

CELLS OF CONNECTIVE TISSUE

CONNECTIVE TISSUE FIBERS

GROUND SUBSTANCE OF THE CONNECTIVE TISSUE

The two principal functions of muscle are to

Depending upon situation, there are three

1. Skeletal Muscle Tissue