ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM

MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

CHAPTER 4 - TISSUES CHARACTERISTICS OF TYPES OF EPITHELIAL

TISSUES

4. I TISSUES AND HISTOLOGY

1.​ Mostly composed of cells. Epithelial tissue
consists almost entirely of cells, with very
TISSUE little extracellular matrix between them
2.​ Covers body surfaces. Epithelial tissue
➔​ Tissues (TISH-yous) are groups of covers body surfaces and forms glands that
specialized cells and the extracellular are derived developmentally from body
substances surrounding them. Histology surfaces. The body surfaces include the
(his-TOL-oh-jee; histo, tissue; ology, study) is exterior surface, the lining of the digestive
the microscopic study of tissue structure. urinary, reproductive, and respiratory tracts,
➔​ Microscopic examination of tissues can the heart and blood vessels, and the linings
identify abnormalities, including cancer, of many body cavities.
resulting from changes in a tissue. The 3.​ Has an exposed surface. Because
structure and the function of a tissue are so epithelial tissues form 3, coverings and
closely related that we can often predict the linings, one surface of their cells is in direct
function of a tissue when given its structure, contact with either the outside environment
and vice versa. or the contents of our hollow organs.
4.​ Attaches at the basal surface. The surface
The four primary tissue types, from which all organs of the cells that is anchored in place is called
of the body are formed, are the basal surface. The basal surface is held
in place through attachment to a nonliving
(1) epithelial tissue material that is somewhat like mortar for
brick. Has specialized cell connections
(2) connective tissue and matrix attachments. Adjacent epithelial
cells are attached to each other by
(3) muscle tissue specialized cell connections and they are
specially anchored to the extracellular matrix
(4) nervous tissue of the basement membrane.
5.​ Is avascular. Because of the close
connections among the epithelial cells, there
are no blood vessels found among the
4.2 EPITHELIAL TISSUE epithelial cells.
6.​ Is capable of regeneration. Epithelial tissue
➔​ Epithelium (ep-ih-THEE-lee-um; epi-, upon: has the ability to replace damaged cells with
thele, covering) is found virtually new epithelial cells.
everywhere, both inside and outside the
body. It is primarily a cellular tissue, meaning MAJOR FUNCTION OF EPITHELIA
there is very little extracellular material
between the cells. It forms the layers that 1)​ Protecting underlying structures.
cover the surfaces and line the hollow Examples include the outer layer of the skin
organs of our body. and the epithelium of the oral cavity, which
➔​ Epithelium is especially important in hollow protect the underlying structures from
organs with openings to the outside abrasion.
environment, because it protects against 2)​ Acting as a barrier. Epithelium prevents
foreign materials entering the body. many substances from moving through it.
➔​ Many Epithelial tissues are capable of For example, the epithelium of the skin acts
secretion. as a barrier to water and thus reduces water
loss from the body. The epithelium of the
skin also prevents many toxic molecules and
microorganisms from entering the body.

1
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

3)​ Permitting the passage of substances. In most cases, an epithelium is given two names,
Epithelium also allows many substances to such as simple squamous, stratified squamous,
move through it. For example, oxygen and simple columnar, or pseudostratified columnar.
carbon dioxide are exchanged between the The first name indicates the number of layers, and the
air and blood by diffusion through the second indicates the shape of the cells at the free
epithelium in the lungs. surface (table 4.1). Table 4.2-4.3 provides an
4)​ Secreting substances. Sweat glands, overview of the major types of epithelial tissues and
mucous glands, and the enzyme-secreting their distribution.
portion of the pancreas are all composed of
epithelial cells. ➢​ Simple squamous epithelium is a single
5)​ Absorbing substances. The cell layer of thin, flat cells. Some substances
membranes of certain epithelial tissues easily pass through this thin layer of cells,
contain carrier proteins (see Chapter 3) that but other substances do not.
regulate the absorption of materials. For
example, The epithelial cells of the intestines
absorb digested food molecules, vitamins,
and ions.

CLASSIFICATION OF EPITHELIA

Epithelial tissues are classified primarily according to

the number of cell layers and the shape of the
superficial cells. There are three major types of
epithelium based on the number of cell layers in
each:

1.​ Simple epithelium consists of a single layer

of cells, with each cell extending from the
basement membrane to the free surface. ➢​ Simple cuboidal epithelium is a single
2.​ Stratified epithelium consists of more than layer of cubelike cells that carry out active
one layer of cells, but only the deepest layer transport, facilitated diffusion, or secretion.
of cells attaches to the basement membrane. ➢​ Simple columnar epithelium is a single
3.​ Pseudostratified columnar epithelium is a layer of tall, thin cells. The large size of these
special type of simple epithelium. The prefix cells enables them to perform complex
pseudo- means false, so this type of functions.
epithelium appears to be stratified but is not. ➢​ Pseudostratified columnar epithelium is
It consists of one layer of cells, with all the actually a single layer of cells, but the cells
cells attached to the basement membrane. appear to be layered due to the differing
There appear to be two or more layers of heights of adjacent cells and positions of
cells because some of the cells are tall and their nuclei. This epithelium provides
extend to the free surface, whereas others protection for the body.
are shorter and do not extend to the free ➢​ Stratified squamous epithelium forms a
surface. thick epithelium because it consists of
several layers of cells. The deepest cells are
There are three types of epithelium based on cuboidal or columnar and are capable of
idealized shapes of the epithelial cells: dividing and producing new cells. As these
newly formed cells are pushed to the
1)​ Squamous (SKWAY-mus) cells are flat or surface, they become flat and thin.
scalelike. ➢​ Transitional epithelium is a special type of
2)​ Cuboidal (cubelike) cells are stratified epithelium that can stretch. In the
cube-shaped-about as wide as they are tall. unstretched state transitional epithelium
3)​ Columnar (tall and thin, similar to a column) consists of five or more layers of cuboidal or
cells tend to be taller than they are wide. columnar cells. As transitional epithelium is

2
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

stretched, the cells flatten, and the number Lining of blood vessels and the heart, lymphatic
of cell layers decreases. Transitional vessels, alveoli of the lungs, portions of the kidney
epithelium lines cavities that expand, such tubules, lining of serous membranes of body cavities
as the urinary bladder. (pleural, pericardial, peritoneal)

THE RELATIONSHIP BETWEEN STRUCTURE AND (b)​ Simple Cuboidal Epithelium

FUNCTION OF EPITHELIAL TISSUES

Number of Cell Layers and Cell Shapes

●​ As the number of cell layers increases and

the shape of the cells becomes more robust,
we see a proportional increase in the degree
that epithelial tissue provides and increased
complexity of the function it performs.
Structure:

Single layer of cube-shaped cells; some cells have

1.​ One layer of flat cells. Simple squamous
microvilli (kidney tubules) or cilia (terminal bronchioles
epithelium is best adapted for areas of the
of the lungs)
body where filtration and diffusion are
common. For example, simple squamous
Function:
epithelium in the air sacs in the lungs allows
diffusion of gasses between the air and
Secretion and absorption by cells of the kidney
blood.
tubules; secretion by cells of glands and choroid
plexuses; movement of particles embedded in mucus
TABLE 4.2 SIMPLE EPITHELIUM
out of the terminal bronchioles by ciliated cells

(a)​ Simple Squamous Epithelium

Location:

Kidney tubules, glands and their ducts, choroid

plexuses of the brain, lining of terminal bronchioles of
the lungs, and surfaces of the ovaries

(c) Simple Columnar Epithelium

Structure:

Single layer of flat, often hexagonal cells, the nuclei

appear as bumps when viewed in cross section
because the cells are so flat

Function: Structure:

Diffusion, filtration, some secretion, and some Single layer of tall, narrow cells; some cells have cilia
protection against friction (bronchioles of lungs, auditory tubes, uterine tubes,
and uterus) or microvilli (intestines)
Location:
Function:

3
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

Movement of particles out of the bronchioles of the

lungs by ciliated cells; partially responsible for the
movement of oocytes through the uterine tubes by
ciliated cells; secretion by cells of the glands, the
stomach, and the intestines; absorption by cells of the
intestines

Location:

Glands and some ducts, bronchioles of lungs,

auditory tubes, uterus, uterine tubes, stomach,
intestines, gallbladder, bile ducts, and ventricles of the Structure:
brain
Several layers of cells that are cuboidal in the basal
(d) Pseudostratified Columnar Epithelium layer and progressively flattened toward the surface;
the epithelium can be nonkeratinized (moist) or
keratinized; in nonkeratinized stratified squamous, the
epithelium., the surface and every a news and
cytoplasm; in keratinized surface cells retain a
nucleus and cytoplasm; in keratinized stratified
epithelium, the cytoplasm of cells of the surface is
stratified epithelium, the cytoplasm of cells at the
surface is replaced by a protein called keratin, and the
cells are dead
Structure:
Function:
Single layer of cells; some cells are tall and thin and
reach the free surface, and others do not; the nuclei Protect against abrasion, forms a barrier against
of these cells are at different levels and appear infection, and reduces loss of water from the body
stratified; the cells are almost always ciliated and are
associated with goblet cells that secrete mucus into Location:
the free surface
Keratinized-outer layer of the skin:
Function: nonkeratinized–mouth, throat, larynx, esophagus,
anus, vagina, inferior urethra, and corneas
Synthesize and secrete mucus into the free surface
and move mucus (or fluid) that contains foreign (b)​ Transitional Epithelium
particles over the surface of the free surface and from
passages

Location:

Lining of nasal cavity, nasal sinuses, auditory tubes,

pharynx, trachea, and bronchi of lungs

TABLE 4.3 STRATIFIED EPITHELIUM

(a)​ Stratified Squamous Epithelium

Structure:

4
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

Stratified cells that appear cuboidal when the organ or epithelial cells of the uterus and
tube is not stretched and squamous when the organ uterine tubes, where cilia help move
or tube is stretched by fluid mucus and oocytes (eggs).
-​ The mucus is moved toward to the
Function: throat, where it is swallowed, and
the foreign particles are degraded
Accommodates fluctuations in the volume of fluid in by acid in the stomach.
an organ or a tube; protects against the caustic
effects of urine CELL CONNECTIONS

Location: ●​ Cells have structures that hold them to each

other or to the basement membrane. These
Lining of urinary bladder, ureters, and superior urethra structures do three things:

1.​ One layer of flat cells (1) mechanically bind the cells together
2.​ One layer of cubelike cells. Simple
cuboidal epithelium, due to the larger volume (2) help form a barrier to the movement of molecules
of these cells, has a greater secretory or ions, and
capacity than simple squamous epithelium.
3.​ One layer of tall, rectangular cells. Simple (3) provide a mechanism for intercellular
columnar epithelial cells are much taller than communication
those of cuboidal epithelium. Draw a sketch
of squamous, cuboidal, and columnar ●​ Cells connection structures that
epithelial cells side-by-side. mechanically bind epithelial cells together
4.​ Multiple layers of flat cells. Stratified are called desmosomes (DEZ-moh-sohms);
squamous epithelium forms a thick barrier, desmos, a band; soma, body),
which can be as many as 30-40 cells thick. ●​ While those that bind cells to the basement
membrane are called hemidesmosomes
FREE SURFACE MODIFICATION (HEM-ee-dez-moh-sohms; hemi, half),
●​ Many desmosomes are found in epithelial
●​ The free surfaces of epithelial tissues are not tissues subjected to mechanical stress, such
in contact with other cells and can be as the stratified squamous epithelium of the
smooth or folded. They may also have skin.
microvilli and cilia. ●​ Hemidesmosomes are the anchors of
-​ Smooth free surfaces reduce epithelial tissues to the underlying basement
friction; an example of such a membrane, preventing the movement of the
surface is the tissue lining blood tissue.
vessels. ●​ Tight junctions are cell connection
-​ This kind of tissue is a specialized structures that (1) form barriers and (2)
type of simple squamous epithelium anchor cells to each other. Tight junctions
called endothelium. form a barrier to movement of molecules or
-​ Folded free surfaces have ions between epithelial cells.
increased surface area. Microvilli ●​ Structures called adhesion belts are found
are stationary and are found in cells just below the tight junctions, and help the
that absorb or secrete, such as the tight junctions anchor the epithelial cells to
lining of the small intestine. each other.
-​ In contrast, cilia are not ●​ Cell connection structures that allow for
stationary—instead they can move, intercellular communication include gap
which allows them to remove from junctions. Gap junctions consist of groups
the respiratory airways mucus that of channels that allow small molecules and
contains foreign particles. ions to pass from one epithelial cell to an
-​ Cilia are also found on the free adjacent one.
surfaces of the simple columnar

5
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

GLANDS STRUCTURE OF EXOCRINE GLANDS

●​ Glands are composed of epithelium ●​ First, it's important to distinguish between the
supported by a network of connective tissue. duct and the secretory portion of the gland.
The duct refers to the tube in contact with
There are two major types of glands in the body: the epithelial tissue free surface, which
transports the secreted material.
(1) endocrine glands and ●​ Second, the secretory portion of the gland is
found deeper in the epithelium and is
(2) exocrine glands. composed of the cells responsible for
producing the secreted material.
Endocrine glands produce chemicals called
hormones and are often termed ductless glands
based on their structure and mode of secretion.
These glands are associated with an extensive The three major categories of exocrine glands are
network of blood vessels, and their hormones are
transported throughout the body by way of the blood. (1) unicellular,

(2) simple, and

(3) compound.

UNICELLULAR

-​ Some exocrine glands are composed of only

a single cell, such as goblet cells that
secrete mucus

SIMPLE

-​ Simple glands are multicellular glands that

have a single, nonbranched duct. The
secretory portions of the gland can be
shaped in one of

FIGURE 4.3 CELL CONNECTIONS two ways:

Exocrine glands produce a wide variety of products, (1) tubular, which is a straight, narrow tube the same
such as saliva, sweat, and digestive tract secretions. width as the duct, or
These secretions enter ducts, which are continuous
with the epithelial tissue surface. At the appropriate (2) acinar, a saclike structure whose width is greater
location, the secretions exit onto the free surface of than the width of the duct. We see several different
the target organ's tissue. types of simple glands.

The three specific distinctions we use in this textbook ●​ Simple tubular—glands forming a straight
are: tube with no branching of the secretory
portion
(1) structure of the duct, ●​ Simple branched tubular—gland with
several tubular secretory portions branching
(2) structure of the secretory portion of the gland, and from the single duct
●​ Simple acinar—glands with a single saclike
(3) mode of secretion within the secretory portion secretory portion

6
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

●​ Simple branched acinar—glands with Holocrine (HOL-oh-krin; holos, whole) secretion is

several acinar secretory portions branching the release of secretory products through shedding of
from the single duct entire cells. Once the secretory products have
accumulated in the epithelial cell, the cell
COMPOUND disintegrates and becomes part of the secretion.
Deeper cells in the gland replace lost cells.
-​ Compound glands are multicellular glands Sebaceous (oil) glands in the skin release sebum (oil)
that have several branched ducts. Again, the through holocrine secretion, which can help explain
secretory portions can be either tubular or the appearance of blackheads.
acinar, or a mixture of both.
●​ Compound tubular—glands with multiple
ducts, each with a narrow tubular secretory
portion
●​ Compound acinar—glands with multiple
ducts, each with several saclike secretory
portions
●​ Compound tubuloacinar—glands with
multiple ducts, each with several tubular and
acinar secretory portions
(a)​ Unicellular glands

MODES OF SECRETION BY EXOCRINE GLANDS

●​ Within each of the structural categories, the

cells of the secretory portion may use one of
three modes of secretion or even a
combination of secretion modes. (b)​ Simple glands (single, nonbranched
ducts)
The three modes are

(1) merocrine.

(2) apocrine, and

(3) holocrine.
(c)​ Compound glands (multiple, branched
Merocrine (MARE-oh-krin; mero, partial; crine, to
ducts)
separate) secretion is the release of secretory
products through exocytosis and is the most common.
For example, merocrine secretion is used by goblet
cells, temperature-sensitive sweat glands, and the
exocrine portion of the pancreas.

Apocrine (AP-oh-krin; apo, away from) secretion is

the release of secretory products when a portion of
the free surface of the epithelial cell pinches off,
releasing cytoplasmic contents. The remainder of the
cell is repaired. Release of the fatty portion of milk by (d)​ Mode of secretion
mammary glands occurs through apocrine secretion,
as does secretion of earwax. FIGURE 4.4 STRUCTURE OF EXOCRINE GLANDS

7
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

(a)​ Unicellular glands Exocrine glands can be 2.​ Connecting tissues to one another. Tendons
unicellular, but are most often multicellular. are strong cables, or bands, of connective
(b)​ Simple glonds. These have single, tissue that attach muscles to bone, and
nonbranched ducts. ligaments are connective tissue bands that
(c)​ Compound glands. These have multiple, hold bones together.
branched ducts, 3.​ Supporting and moving parts of the body.
(d)​ Modes of secretion, merocrine glands, Bones of the skeletal system provide rigid
holocrine glands, and holocrine glands. support for the body, and semirigid cartilage
supports structures, such as the nose, the
ears, and the surfaces of joints. Joints
between bones allow one part of the body to
move relative to other parts.
4.​ Storing compounds. Adipose tissue (fat)
stores high-energy 4 molecules, and bones
serve minerals, such as calcium and
phosphate.
5.​ Cushioning and insulating. Adipose tissue
cushions and 5 protects the tissues it
surrounds and provides an insulating layer
beneath the skin that helps conserve heat.
6.​ Transporting. Blood transports gasses,
nutrients, enzymes, hormones, and cells of
the immune system throughout the body.
7.​ Protecting. Cells of the immune system and
blood provide protection against toxins and
tissue injury, as structures from injury.

Cells Of Connective Tissue

4.3 CONNECTIVE TISSUE
-​ The specialized cells of the various
➔​ Connective tissue is a diverse primary connective tissues produce the extracellular
tissue type that makes up part of every matrix. The name of the cell identifies the
organ in the body. Connective tissue differs cell functions by means of one of the
from the other three tissue types in that it following suffixes: - blast. cyte, or -clast.
consists of cells separated from each other Blasts create the matrix, cytes maintain it,
by an abundant extracellular matrix. and clasts break it down for remodeling. For
Connective tissue is diverse in both structure bone, osteoblasts (osteo-, bone) form it,
and function osteocytes maintain it, and osteoclasts
break it down. For fibrous connective tissue,
Functions Of Connective Tissue fibroblasts form it, and fibrocytes maintain
it. For cartilage, chondroblasts form it
-​ Connective tissue performs the following (chondro-, cartilage), and chondrocytes
major functions: maintain it.
1.​ Enclosing and separating other tissues. -​ Also found in connective tissue are cells
Sheets of connective tissue form capsules associated with the immune system.
around organs, such as the liver and the Macrophages (MAK-roh-fay-jes; makros,
kidneys. Connective tissue also forms layers large + phago, to eat) are large white blood
that separate tissues and organs. For cells that are capable of moving about and
example, connective tissues separate ingesting foreign substances, including
muscles, arteries, veins, and nerves from microorganisms in the connective tissue.
one another Mast cells are nonmotile cells that release
chemicals, such as histamine, that promote
inflammation.

8
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

EXTRACELLULAR MATRIX The amount of fluid in the matrix is

correlated with the type and quantity of
-​ The extracellular matrix of connective tissue ground substance molecules. For example,
has three major components: proteoglycans trap large quantities of water
between the polysaccharides, which allows
(1) protein fibers, them to return to their original shape when
compressed or deformed.
(2) ground substance, and

(3) fluid.

-​ Ground substance consists of non fibrous Classification Of Connective Tissue

protein and other molecules. The structure of
the matrix is responsible for and functional ●​ Connective tissue types blend into one
characteristics of connective tissues-for another, and the transition points cannot be
example, they enable bones and cartilage to identified precisely. As a result, connective
bear weight, tendons and ligaments to tissue is somewhat arbitrarily classified by
withstand tension, and the skin's dermis to the type and proportions of cells and
withstand punctures, abrasions, and other extracellular matrix.
abuse.
The two main types of connective tissue are
PROTEIN FIBERS OF THE MATRIX embryonic and adult connective tissue. By eight
weeks of development, most of the embryonic
Three types of protein fibers connective tissue has become specialized to form the
types of connective tissue seen in adults.
(1) collagen,
Table 4.5 presents the classification of adult
(2) reticular, and connective tissue used in this text.

(3) elastic—help form most connective tissues. Adult connective tissue consists of three types:

-​ Collagen (KOL-ah-jen: glue-producing) (1) connective tissue proper (loose and dense),
fibers, which resemble microscopic ropes,
are very flexible but resist stretching. (2) supporting connective tissue (cartilage, bone)
-​ Reticular (reh-TIK-you-lar) fibers are very
fine, short collagen fibers that branch to form (3) fluid connective tissue (blood).
a supporting network.
-​ Elastic fibers have the ability to return to CONNECTIVE TISSUE PROPER
their original shape after being stretched or
compressed, giving tissue an elastic quality.
Loose Connective Tissue
This tissue stretches like a rubber hand in
response to force and recoils when relaxed.
●​ Loose connective tissue consists of relatively
few protein fibers that form a lacy network,
GROUND SUBSTANCE OF THE MATRIX
with numerous spaces filled with ground
substance and fluid.
-​ The ground substance consists of
nonfibrous molecules. It is the "shapeless"
Three subdivisions of loose connective tissue
background against which the collagen fibers
are:
are seen through the microscope.
Proteoglycans (PROH-tee-oh- GLYE-kans,
(1) areolar,
proteo, protein + glycan, polysaccharides)
are large molecules that consist of a protein
(2) adipose, and
core attached to many long polysaccharides.

9
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

(3) reticular same direction, and so the tissue is called dense

regular, but in the dermis and in organ capsules, the
fibers are oriented in many different directions, and so
the tissue is called dense irregular.

Dense elastic connective tissue has abundant

elastic fibers among its collagen fibers. The elastic
fibers allow the tissue to stretch and recoil.

TABLE 4.6 CONNECTIVE TISSUE PROPER:

LOOSE CONNECTIVE TISSUE

➢​ The extracellular matrix of areolar

(an-REE-oh-lar) connective tissue primarily (a)​ Areolar Connective Tissue
consists of collagen fibers and a few elastic
fibers. Structure:
➢​ Adipose (ADD-i-pose; fat) tissue consists of
adipocytes, or fat cells, which contain large A fine network of fibers (mostly collagen fibers with a
amounts of lipids for energy storage. few elastic fibers) with spaces between the fibers;
➢​ Reticular tissue forms the framework of fibroblasts, macrophages, and lymphocytes are
lymphatic tissue, such as in the spleen and located in the spaces
lymph nodes, as well as in bone marrow and
the liver. Function:

Loose packing, support, and nourishment for the

Dense Connective Tissue
structures with which it is associated

●​ Dense connective tissue has a relatively

Location:
large number of protein fibers that form thick
bundles and fill nearly all of the extracellular
Widely distributed throughout the body; substance on
space. These protein fibers are produced by
which epithelial basement membranes rest; packing
fibroblasts.
between glands, muscles, and nerves; attaches the
skin to underlying tissues
There are two major subcategories of dense
connective tissue:

(1) collagenous and

(2) elastic

Dense collagenous connective tissue has an

extracellular matrix consisting mostly of collagen
fibers. Structures made up of dense collagenous (b)​ Adipose Tissue
connective tissue include tendons, which attach
muscle to bone; many ligaments, which attach bones Structure:
to other bones; and much of the dermis, which is the
connective tissue of the skin. In tendons and
ligaments, the collagen fibers are oriented in the

10
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

Little extracellular matrix surrounding cells, the (la-KOO- nee; small spaces) within an
adipocytes, or fat cells, are so full of lipids that the extensive matrix. Collagen in the matrix
cytoplasm is pushed to the periphery of the cell gives cartilage flexibility and strength.
Cartilage is resilient because proteoglycans
Function: in the matrix trap water. This makes cartilage
relatively rigid but still able to spring back
Packing material, thermal insulator, energy storage, after being compressed.
and protection of organs against injury from being
bumped or jarred TABLE 4.7 CONNECTIVE TISSUE PROPER:
DENSE CONNECTIVE TISSUE
Location:

Predominantly in subcutaneous areas, mesenteries,

renal pelves, around kidneys, attached to the surface
of the colon, mammary glands, and in loose
connective tissue that penetrates into spaces and
crevices

(a)​ Dense Regular Collagenous Connective

Tissue

Structure:

Matrix composed of collagen fibers running

somewhat the same direction in tendons and
ligaments; collagen fibers run in several directions in
the claims of the skin and in organ capsules
(c)​ Reticular Tissue
Function:
Structure:
Withstand great pulling forces exerted in the direction
Fine network of reticular fibers irregularly arranged of fiber orientation due to great tensile strength and
stretch resistance
Function:
Location:
Provides a superstructure for lymphatic and
hematopoietic tissues Tendons (attach muscle to bone) and ligaments
attach bones to each other), also found in the dermis
Location: of the skin, organ capsules, and the outer layer of
many blood vessels
Within the lymph nodes, spleen, bone marrow

SUPPORTING CONNECTIVE TISSUE

Cartilage

●​ Cartilage (KAR-tih-lij) is composed of

chondrocytes (KON-droh-sites), or cartilage
cells, located in spaces called lacunae (b)​ Dense Regular Elastic Connective Tissue

11
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

2)​ Compact bone is more solid, with almost no

space between many thin layers of
mineralized matrix.

Structure:

Matrix composed of collagen fibers and elastin fibers FLUID CONNECTIVE TISSUE
running in somewhat the same direction in elastic
ligaments; elastic fibers run in connective tissue of Blood
blood vessel walls
●​ Blood is unique because the matrix is liquid,
Function: enabling blood cells and platelets,
collectively called formed elements, to move
Capable of stretching and recoiling like a rubber band through blood vessels.
with strength in the direction of liber orientation
TABLE 4.8 SUPPORTING CONNECTIVE TISSUE:
Location: CARTILAGE

Elastic ligaments between the vertebrae and along

the dorsal aspect of the neck (nucha) and in the vocal
cords; also found in elastic connective tissue of blood
vessel walls

There Are Three Types Of Cartilage:

1.​ Hyaline (HIGH-ah-lin; clear or glassy)

cartilage is the most abundant type of
cartilage and has many functions. It covers (a)​ Hyaline Cartilage
the ends of bones where they come together
to form joints. Structure:
2.​ Fibrocartilage has more collagen than does
hyaline cartilage, and bundles of collagen Collagen fibers are small and evenly dispersed in the
fibers can be seen in the matrix. matrix, making the matrix appear transparent. The
3.​ Elastic cartilage contains elastic fibers in chondrocytes are found in spaces, or lacunae, within
addition to collagen and proteoglycans. the firm but flexible matrix

Bone Function:

●​ Bone is a hard connective tissue that Allows growth of long bones; provides rigidity some
consists of living cells and a mineralized flexibility in the trachea, bronchi, ribs, and nose, forms
matrix. Osteocytes (osteo, bone), or bone strong, smooth, yet somewhat flexible articulating
cells, are located within lacunae. The surfaces; forms the embryonic skeleton
strength and rigidity of the mineralized matrix
enables bones to support and protect other Location:
tissues and organs.
Growing long bones, cartilage rings of the respiratory
Two types of bone tissue exist: system, costal cartilages, articulating surface of
bones, and the embryonic skeleton
1)​ Spongy bone has spaces between
trabeculae (trah-BEK-you-lee), or plates, of
bone and therefore resembles a sponge.

12
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

External ears, epiglottis, and auditory tubes

TABLE 4.9 SUPPORTING CONNECTIVE TISSUE:

BONE

(b)​ Fibrocartilage

Structure:

Collagen fibers similar to those in hyaline cartilage;

the fibers are more numerous than in other cartilages
and are arranged in thick bundles Structure:

Hard, bony matrix predominates; many osteocytes

(not seen in this bone preparation) are located within
Function: lacunae, the matrix is organized into layers called
lamellae
Somewhat flexible and capable of withstanding
considerable pressure; connects structures subjected Function:
to great pressure
Provides great strength and support and protects
Location: internal organs, such as the brain, bone also provides
attachment sites for muscles and ligaments; the joints
Intervertebral disks, public symphysis, and articular of bones allow movements
disks (e.g., knees and temporomandibular [jaw] joints)
Location:

All bones of the body

TABLE 4.10 FLUID CONNECTIVE TISSUE: BLOOD

(c)​ Elastic Cartilage

Structure:

Similar to hyaline cartilage, but matrix also contains

elastic fibers

Function: Structure:

Provides rigidity with even more flexibility than hyaline Formed elements and a fluid matrix
cartilage because elastic fibers return to their original
shape after being stretched Function:

Location:

13
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

Transport oxygen, carbon dioxide, hormones, ●​ Smooth muscle cells are tapered at
nutrients, waste products, and other substances; each end, have a single nucleus,
protects the body from infection and is involved in and are not striated.
temperature regulation
4.5 NERVOUS TISSUE
Location:
➔​ Nervous tissue forms the brain, spinal cord,
Within the blood vessels, white blood cells, frequently and nerves. It is responsible for coordinating
leave the blood vessels and enter the extracellular and controlling many body activities.
spaces
Nervous tissue consists of neurons and support cells,
4.4 MUSCLE TISSUE called glial cells. The neuron (NYUR-on), or nerve
cell, is responsible for conducting electrical signals.
➔​ The main function of muscle tissue is to
contract, or shorten, making movement It is composed of three parts:
possible. Muscle contraction results from
contractile proteins located within the muscle (1) a cell body.
cells, called muscle fibers.
(2) dendrites, and
The three types of muscle tissue are
(3) an axon
(1) skeletal.
The cell body contains the nucleus and is the site of
(2) cardiac, and general cell functions. Dendrites (DEN-drights;
relating to a tree) usually receive stimuli that lead to
(3) smooth electrical changes.

➔​ Skeletal muscle is what we normally think TABLE 4.11 MUSCLE TISSUE

of as "muscle"). It is the meat of animals and
constitutes about 40% of a person's body
weight.
●​ Skeletal muscle cells are striated
(STRI-ate-ed), or banded, because
of the arrangement of contractile
proteins within the cells.
➔​ Cardiac muscle is the muscle of the heart; it
is responsible for pumping blood. Cardiac
muscle is under involuntary (unconscious)
control although a person can learn to
influence the heart rate by using techniques
such as meditation and biofeedback. (a)​ Skeletal Muscle
●​ They are often branched and
connected to one another by Structure:
intercalated (in-TER-kah-lay-ted)
disks. The intercalated disks, which Skeletal muscle cells or fibers appear striated
contain specialized gap junctions, (banded); cells are large, long, and cylindrical, with
are important in coordinating the many nuclei
contractions of the cardiac muscle
cells. Function:
➔​ Smooth muscle forms the walls of hollow
organs (except the heart); it is also found in Movement of the body, under voluntary control
the skin and the eyes.
Location:

14
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

Attached to bone or other connective tissue Regulates the size of organs, forces fluid through
tubes, controls the amount of light entering the eye,
and produces "goose bumps" in the skin, under
involuntary (unconscious) control

Location:

In hollow organs, such as the stomach and intestine;

skin and eyes

TABLE 4.12 NERVOUS TISSUE

(b)​ Cardiac Muscle

Structure:

Cardiac muscle cells are cylindrical and striated and

have a single nucleus; they are branched and
connected to one another by intercalated disks, which
contain gap junctions

Function:

Pumps the blood, under involuntary (unconscious)

control Structure:

Location: A neuron consists of dendrites, a cell body, and a long

axon; glia, or support cells, surround the neurons
In the heart
Function:

Neurons transmit information in the form of action

potentials, store information, and integrate and
evaluate data; glia support, protect, and form
specialized sheaths around axons

Location:

In the brain, spinal cord, and ganglia

Axons (AK-sons) conduct electrical signals, which

(c)​ Smooth Muscle usually originate at the base of an axon where it joins
the cell body and travel to the end of the axon. Glial
Structure: cells (GLEE-al: glia, glue) are the support cells of the
nervous system. They nourish, protect, and insulate
Smooth muscle cells are tapered at each end, are not the neurons.
striated, and have a single nucleus
4.6 TISSUE MEMBRANES

➔​ A tissue membrane is a thin sheet or layer

Function: of tissue that covers a structure or lines a
cavity. Most membranes consist of

15
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

epithelium and the connective tissue on ●​ Synovial (sih-NOH-vee-al) membranes line

which the epithelium rests. There are four the cavities of freely movable joints. They
tissue membranes in the body, one external are made up of only connective tissue and
and three internal. The external tissue consist of modified connective tissue cells.
membrane is the skin, or cutaneous -​ Synovial membranes produce
(kyu-TAY-nee-us, skin) membrane. It is synovial fluid, which makes the
composed of stratified squamous epithelium joint very slippery, thereby reducing
and dense connective tissue. friction and allowing smooth
movement within the joint.
The three major categories of internal tissue
membranes are 4.7 TISSUE DAMAGE AND INFLAMMATION

(1) mucous ➔​ Inflammation (flamma, flame) occurs when

tissues are damaged.
(2) serous, and
Inflammation produces five major symptoms:
(3) synovial membranes
(1) redness.
MUCOUS MEMBRANES
(2) heat,
●​ Mucous (MYU-kus) membranes line
cavities that open to the outside of the body, (3) swelling,
such as the digestive, respiratory, and
reproductive tracts. (4) pain, and

SEROUS MEMBRANES (5) disturbance of function.

●​ Serous (SEER-us; producing watery ➔​ Although unpleasant, the processes of

secretion) membranes line cavities that do inflammation are usually beneficial.
not open to the exterior of the body, such as
the pericardial, pleural, and peritoneal
cavities.

Serous membranes consist of three components:

(1) a layer of simple squamous epithelium.

(2) its basement membrane, and

(3) a delicate layer of loose connective tissue.

●​ Serous membranes do not contain glands,

but they secrete a small amount of fluid
called serous fluid, which lubricates the
surface of the membranes. Serous
membranes protect the internal organs from
friction, help hold them in place, and act as a
selectively permeable barrier to prevent
PROCESS Figure 4.7 Inflammation
large amounts of fluid from accumulating
within the serous cavities.
4.8 TISSUE REPAIR

SYNOVIAL MEMBRANES
➔​ Tissue repair is the substitution of variable
cells for dead cells. Tissue repair can occur

16
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

by regeneration or by replacement. In
regeneration, the new cells are the same
type as those that were destroyed, and
normal function is usually restored. In
replacement, a new type of tissue develops,
which eventually produces a scar and
causes loss of some tissue function. Most
wounds heal through regeneration and
replacement; which process dominates
depends on the tissues involved and the
nature and extent of the wound.
➔​ Much more granulation tissue forms, and
wound contracture, a result of the
contraction of fibroblasts in the granulation
tissue, pulls the edges of the wound closer
together

PROCESS Figure 4.8 Tissue Repair

17
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

CHAPTER 5 - INTEGUMENTARY SYSTEM ●​ The subcutaneous tissue is not part

of the skin, but it does connect the
5.1 FUNCTIONS OF THE INTEGUMENTARY skin to underlying muscle or bone.
SYSTEM
EPIDERMIS
➔​ The integumentary
(in-teg-you-MEN-tah-ree) system consists of ➢​ The epidermis is stratified squamous
the skin and accessory structures, such as epithelium; in its deepest layers, new cells
hair, glands, and nails. are produced by mitosis. As new cells form,
➔​ Integumentary means covering, and the they pish older cells to the surface, where
integumentary system is one of the more they slough, or flake off. The many cells of
familiar systems of the body to everyone the epidermis prevent water loss and resist
because it covers the outside of the body abrasion.
and is easily observed.
➔​ The integumentary system and the other
systems often interact in complex ways in
both healthy and diseased states.

Major functions of the integumentary system

include:

1.​ Protection.
2.​ Sensation.
3.​ Vitamin D production.
4.​ Temperature regulation..
5.​ Excretion.

5.2 SKIN ➢​ The outermost cells protect the cells

underneath, and the deeper, replicating cells
➔​ The skin is made up of two major tissue replace cells lost from the surface.
layers: ➢​ The epidermis prevents water loss and
resists abrasion.
(1) the epidermis, and ➢​ The epidermis, known as the cutaneous
membrane, is a keratinized stratified
(2) the dermis squamous epithelium.
➢​ The epidermis is composed of distinct layers
➔​ The epidermis (ep-ih-DER-miss; upon the called strata.
dermis) is the most superficial layer of skin. ➢​ During their movement, the cells change
●​ It is a layer of epithelial tissue that shape and chemical composition, a process
rests on the dermis (DER-miss), called keratinization
which is a layer of dense (KER-ah-tin-i-ZAY-shun). The term
connective tissue. keratinization reflects the fact that the cells
➔​ The thickness of the epidermis and dermis become filled with the protein keratin
varies, depending on location, but on (KER-ah-tin).
average the dermis is 10 to 20 times thicker ➢​ Keratinocytes - that produce keratin protein.
than the epidermis. ➢​ These characteristics are used to divide the
➔​ The epidermis provides protection. epidermis into layers called strata
➔​ The dermis is responsible for most of the (STRAH-tah; layers).
skin’s structural strength.
➔​ The skin rests on the subcutaneous From the deepest to the most superficial, the five
(sub-kwe-TAY-nee-us; under the skin) strata are the
tissue, which is also a layer of connective
tissue. (1)​ Stratum basale,

18
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

(2)​ Stratum spinosum

(3)​ Stratum granulosum
(4)​ Stratum lucidum
(5)​ Stratum corneum
➔​ The stratum basale or germinativum
(ba-SAL-eh; a base) consists of cuboidal or
columnar cells that undergo mitotic divisions
about every 19 days.
●​ One daughter cell becomes a new
stratum basale cell and can divide
again.
●​ The other daughter cell is pushed
toward the surface, a journey that
takes about 40-56 days.
➔​ Cells of the stratum spinosum
(spi-NO-sum) take on a flattened
appearance and accumulate lipid-filled
vesicles called lamellar bodies.
➔​ Cells of the stratum granulosum
(gran-you-LO-sum) are flat and
diamond-shaped. The cells accumulate more
keratin and release the contents of the
lamellar bodies to the extracellular space.
●​ The cells’ nuclei and organelles
degenerate, and the cell dies,
giving this layer its characteristic
grainy appearance.
Figure 5.2 Epidermis and Dermis
➔​ The stratum lucidum (LOO-see-dum) is a
thin, clear zone between the stratum
●​ Keratin gives the stratum corneum
granulosum and stratum corneum. The cells
its structural strength. The stratum
of this stratum no longer have nuclei or
corneum cells are the lamellar
organelles, and as a result, the cell stains
bodies of the skin cells.
more lightly.
●​ These lipids act as waterproofing
●​ Skin is classified as thick or thin
material, thereby preventing fluid
based on the structure of the
loss through the skin.
epidermis.
➔​ The stratum corneum is composed of 25 or
●​ Thick skin has all five strata and is
more layers of dead squamous cells joined
found in areas subject to pressure
by desmosomes. Eventually, the
or friction, such as the palms of the
desmosomes break apart, and the cells are
hands, the soles of the feet, and the
sloughed from the skin.
fingertips.
●​ Excessive sloughing of stratum
●​ Thin skin lacks the stratum lucidum
corneum cells from the surface of
and covers the rest of the body.
the scalp is called dandruff. In skin
●​ The term thick skin and thin skin
subjected to friction, the number of
only refer to the number of
layers in the stratum corneum
epidermal strata and not to the
greatly increases, producing, a
overall thickness of the skin, which
thickened area called callus
is determined by the dermis.
(KAL-us; hard skin). Over a bony
➔​ The stratum corneum (COR-nee-um) is the
prominence, the stratum corneum
most superficial stratum of the epidermis. It
can thicken to form a cone-shaped
consists of dead squamous cells filled with
structure called a corn.
keratin.

DERMIS

19
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

➢​ The dermis is composed of dense ●​ These lines, called stretch marks,

collagenous connective tissue containing can develop when a person
fibroblasts, adipocytes, and macrophages. increases in size quite rapidly.
●​ Nerves, hair follicles, smooth ➔​ The upper part of the dermis has projections
muscles, glands, and lymphatic called dermal papillae (pah-PILL-ee;
vessels extend into the dermis. nipple), which extend toward the epidermis.
➢​ Collagen and elastic fibers are responsible ➔​ Dermal papillae are projections toward the
for the strength of the dermis. The collagen epidermis found in the upper part of the
fibers of the dermis are oriented in many dermis.
different directions and can resist stretch. ●​ The dermal papillae in the palms of
➢​ However, more collagen fibers are oriented the hands, and the soles of the feet,
in some directions than in others. This and the tips of the digits are
produces cleavage lines, or tension lines, in arranged in parallel, curving ridges
the skin, and the skin is most resistant to that shape the overlying epidermis
stretch along these lines. into patterns called friction ridges.
➔​ An injection delivers substances, such as
medicines, to the body by puncturing the
skin. Substances are administered at
different depths in the skin, depending on
how quickly the material needs to enter the
blood.
●​ An intradermal injection delivers
material to the blood slowly and is
administered by drawing the skin
taut and inserting a small needle at
a shallow angle into the dermis; an
example is the tuberculin skin test.
●​ A subcutaneous injection is
achieved by pinching the skin to
form a “tent” and inserting a short
needle into the adipose tissue of
the subcutaneous tissue; an
Figure 5.3 Cleavage Lines example is an insulin injection.
●​ An intramuscular injection
delivers material to the blood faster
than intradermal or subcutaneous
injections. An intramuscular
injection is accomplished by
inserting a long needle at a
90-degree angle to the skin into a
muscle deep to the subcutaneous
tissue. Intramuscular injections are
used for most vaccines and certain
antibiotics.

SKIN COLOR
PROCESS Figure 5.4 Melanin Transfer to
Epithelial Cells
Several factors determine skin color:
➔​ If the skin is overstretched for any reason,
the dermis can be damaged, leaving lines (1)​ Pigments in the skin
that are visible through the epidermis. (2)​ Blood circulating through the skin, and
(3)​ The thickness of the stratum corneum

20
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

- Melanin (MEL-ah-nin; black) is the group of ●​ Jaundice is a condition characterized by the

pigments primarily responsible for skin, hair, and eye yellowing of the skin and eyes due to an
color. Most melanin molecules are brown to black excess of bilirubin in the body.
pigments, but some are yellowish or reddish -​ Carotene is lipid-soluble, and when
consumed it accumulates in the
●​ Melanin provides protection against lipids of the stratum corneum and in
ultraviolet light from the sun. the adipocytes of the dermis and
●​ Melanin is produced by melanocytes subcutaneous tissue.
(MEL-an-oh-cytes: melano, black + kytos, -​ If large amounts of carotene are
cell). consumed, the skin can become
-​ Melanocytes are irregularly shaped quite yellowish.
cells located between the stratum
basale and the stratum spinosum. 5.3 SUBCUTANEOUS TISSUE
-​ Melanosomes (Mel-ah-no-sohms)
within the Golgi apparatuses ➔​ Just as a house rests on a foundation, the
package melanin into vesicles. skin rests on the subcutaneous tissue, or
●​ Large amounts of melanin form freckles and hypodermis (high-poh-DER-miss; under the
moles in some regions of the skin, as well as dermis).
darkened areas in the genitalia, the nipples, ➔​ The subcutaneous tissue is not part of the
and the circular areas around the nipples. skin but instead attaches the skin to
-​ Other areas, such as the lips, palms underlying bone and muscle and supplies it
of the hands, and soles of the feet, with blood vessels and nerves.
contain less melanin ➔​ The subcutaneous tissue is loose connective
●​ Melanin production is determined by genetic tissue, including adipose tissue that contains
factors, exposure to light, and hormones. about half the body’s stored lipids.
-​ Genetic factors are responsible for -​ The amount and location of adipose
the amounts of melanin produced tissue vary with age, sex, and diet.
resulting in variation in skin color in -​ Adipose tissue in the subcutaneous
the human population. tissue functions as padding and
-​ Since all humans have about the insulation, and it is responsible for
same number of melanocytes, skin some of the differences in
color variations are determined by appearance between males and
the amount, kind, and distribution of females as well as between
melanin. individuals of the same sex.
-​ Example, albinism (AL-bi-niz-em) ➔​ The subcutaneous tissue can be used to
is a recessive genetic trait that estimate total body fat.
causes a deficiency or an absence ➔​ The skin and subcutaneous tissue are
of melanin, resulting in fair skin, pinched at selected locations, and the
white hair, and unpigmented irises thickness of the fold is measured.
in the eyes. -​ The thicker the fold, the greater the
●​ A decrease in blood flow, as occurs in shock, amount of total body fat.
can make the skin appear pale. A decrease ➔​ The percentage of body fat varies in the
in the blood O2 content produces a bluish population, but on average females have
color to the skin, called cyanosis higher total body fat than do males.
(sigh-ah-NOH-sis; dark blue). -​ The acceptable percentage of body
-​ Birthmarks are congenital (present fat varies from 21% to 30% for
at birth) disorders of the blood females and from 13% to 25% for
vessels in the dermis. males. A body fat percentage
●​ Carotene (KAIR-oh-teen) is a yellow above the acceptable range is an
pigment found in plants such as squash and indicator of obesity.
carrots. Humans normally ingest carotene
and use it as a source of vitamin A. 5.4 ACCESSORY SKIN STRUCTURES

21
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

-​ Accessory structure of the skin are attached ❖​ The hair papilla is an extension of the
to or embedded into the skin. The accessory dermis that protrudes into the hair bulb.
skin structures are hair, glands, and nails. ➔​ Blood vessels within the papilla supply the
hair bulb with the nourishment needed to
HAIR produce the hair.
➔​ Hair is produced in cycle of growth and
➢​ In humans, hair is found everywhere on the rest.
skin, except on the palms, the soles, the lips, -​ During the growth stage, a hair is
the nipples, part of the genitalia, and the formed by epithelial cells within the
distal segments of the fingers and toes. hair bulb.
-​ During the resting stage, growth
stops and the hair is held in the hair
follicle. When the next growth stage
begins, a new hair is formed and
the old hair falls out.
-​ The duration of each stage
depends on the individual hair.
-​ Eyelashes grow for about 30 days
and rest for 105 days, whereas
scalp hairs grow for 3 years and
rest for 1-2 years.
-​ The loss of hair normally means
that the hair is being replaced
because the old hair falls out of the
hair follicle when the new hair
begins to grow.
-​ Hair color is determined by varying
Figure 5.6 Hair Follicle
amounts and types of melanin.
-​ With age, the amount of melanin in
❖​ Each hair arises from a hair follicle, an
hair can decrease, causing the hair
invagination of the epidermis that extends
color to become faded, or the hair
deep into the dermis.
can contain no melanin and be
-​ A helpful analogy for the structure
white.
of the hair follicle and hair is a
-​ Each hair follicle is attached to
single flower in a vase.
smooth muscle cells called the
-​ The vase is like the hair follicle and
arrector pili muscle, which can
the flower stem is like the hair.
contract and cause the hair to
➔​ The shaft of the hair protrudes above the
become perpendicular to the skin’s
surface of the skin, whereas the root is
surface.
below the surface.
●​ Associated with each hair follicle are smooth
➔​ The hair bulb is the expanded base of the
muscle cells called the arrector (ah-REK-tor;
root.
that which raises) pili (PIE-lee; hair)
➔​ A hair has a hard cortex, which surrounds a
●​ Contraction of the arrector pili causes the
softer center, the medulla (meh-DULL-ah).
hair to become more perpendicular to the
The cortex is covered by the cuticle
skin’s surface, or to “stand on end,” and it
(KEW-tih-cul; skin), a single layer of
produces a raised area of skin called a
overlapping cells that holds the hair in the
“goose bump.”
hair follicle.
➔​ Because the hair follicle is composed of
GLANDS
epithelial tissue, hair follicles can play an
important role in repair of the skin.
➔​ Hair is produced in the hair bulb, which rests ➢​ The major glands of the skin are the
on the hair papilla. sebaceous (se-BAY-shus) glands and the
sweat glands.

22
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

●​ Sebaceous glands are simple, sweat glands produce sweat, which

branched acinar glands. Most evaporates\and cools the body
produce sebum, an oily, white -​ Emotional sweating can also occur
substance rich in lipids. in the palms, soles, armpits, and
●​ The sebum is released by holocrine other places.
secretion and lubricates the hair ●​ Apocrine (AP-oh-krin) sweat glands are
and the surface of the skin, which simple, coiled, tubular glands that produce a
prevents drying and protects thick secretion rich in organic substances.
against some bacteria. -​ These substances are released
primarily by merocrine secretion,
though some glands demonstrate
holocrine secretion.
-​ They open into hair follicles, but
only in the armpits and genitalia.
-​ Apocrine sweat glands become
active at puberty because of the
influence of reproductive hormones.
-​ The organic secretion, which is
essentially odorless when released,
is quickly broken down by bacteria
into substances responsible for
what is commonly known as body
odor.

Figure 5.7 Glands of the Skin NAILS

●​ Sweat glands are the appendages of the ➢​ The nail is a thin plate, consisting of layers
integument. Also known as Sudoriferous of dead stratum corneum cells that contain a
sweat glands that secrete sweat. very hard type of keratin.
●​ The visible part of the nail is the
There are two kinds of sweat glands: nail body, and the part of the nail
covered by skin is the nail root.
(1) Eccrine and ●​ The cuticle, or eponychium
(ep-oh-NIK-ee-um), is stratum
(2) apocrine corneum that extends onto the nail
body. The nail root extends distally
●​ Eccrine (EK-rin) sweat glands are simple, from the nail matrix.
coiled, tubular glands and release sweat by ●​ The nail also attaches to the
merocrine secretion. underlying nail bed, which is
-​ Eccrine glands are located in located distal to the nail matrix.
almost every part of the skin but ●​ The nail matrix and bed are
most numerous in the palms and epithelial tissue with a stratum
soles. basale that gives rise to the cells
-​ They produce a secretion that is that form the nail. The nail matrix is
mostly water with a few salts. thicker than the nail bed and
-​ Eccrine sweat glands have ducts produces most of the nail.
that open onto the surface of the ●​ A small part of the nail matrix, the
skin through sweat pores. lunula (LOO-noo-lah; moon), can
-​ When the body temperature starts be seen through the nail\body as a
to rise above normal levels, the whitish, crescent-shaped area at
the base of the nail.

23
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

●​ Cell production within the nail deeper tissues of the body to the surface of
matrix causes the nail to grow. the epidermis.
Unlike hair, nails grow continuously 2.​ The skin acts as a barrier that prevents
and do not have a resting stage. microorganisms and other foreign
substances from entering the body.
5 Parts of the Nails Secretions from the skin glands also produce
an environment unsuitable for some
1.​ Free edge microorganisms.
2.​ Nail body 3.​ The stratified squamous epithelium of the
3.​ Lunula skin protects underlying structures against
4.​ Cuticle abrasion.
5.​ Nail root 4.​ Melanin absorbs ultraviolet light and protects
underlying structures from its damaging
effects.
5.​ Hair provides protection in several ways: The
hair on the head acts as a heat insulator,
eyebrows keep sweat out of the eyes,
eyelashes protect the eyes from foreign
objects, and hair in the nose and ears
prevents the entry of dust and other
materials.
6.​ The nails protect the ends of the fingers and
Figure 5.8 Nail
toes from damage.
ADDITIONAL INFORMATION
SENSATION
Eumelanin - black
➢​ Many sensory receptors are associated
with the skin. Receptors in the epidermis and
Itis - inflammation
dermis can detect pain, heat, cold, and
pressure.
Tonsil/o - tonsils
➢​ Although hair does not have a nerve supply,
sensory receptors around the hair follicle can
Hepat/o - liver
detect the movement of a hair.
Hyp/o - below
VITAMIN D PRODUCTION
Sub - below/under Cutaneous - skin
➢​ When the skin is exposed to ultraviolet light,
Pubic hair - has the toughest hair a precursor molecule of vitamin D is formed.
➔​ The precursor is carried from the blood to
Alopecia areata - hair loss the liver, where it is modified, and then to the
kidneys, where the precursor is modified
5.5 PHYSIOLOGY OF THE INTEGUMENTARY further to form active vitamin D.
SYSTEM ➔​ If exposed to enough ultraviolet light,
humans can produce all the vitamin D they
need.
PROTECTION
➔​ However, many people need to ingest
vitamin D as well because clothing and
The integumentary system performs many
indoor living reduce their exposure to
protective functions.
ultraviolet light.

1.​ The intact skin plays an important role in

1.​ UV light causes the skin to produce a
reducing water loss because its lipids act as precursor molecule of vitamin D.
a barrier to the diffusion of water from the

24
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

2.​ The precursor molecule is carried by the ➔​ In addition to water and salts, sweat contains
blood to the liver where it is enzymatically small amounts of waste products, such as
converted. urea, uric acid, and ammonia.
➔​ Even though the body can lose large
3.​ The enzymatically converted molecule is
amounts of sweat, the sweat glands do not
carried by the blood to the kidneys where it
play a significant role in the excretion of
is converted again to the active form of
waste products.
vitamin D.
4.​ Vitamin D stimulates the small intestine to
absorb calcium and phosphate for many
body functions.
5.6 INTEGUMENTARY SYSTEM AS A DIAGNOSTIC
AID
TEMPERATURE REGULATION
➢​ The integumentary system is useful in
Body temperature normally is maintained at about diagnosis because it is observed easily and
37°C (98°F). Recall from Chapter 1 that homeostasis often reflects events occurring in other parts
control mechanisms maintain a relatively constant of the body. Can you think of three
internal environment, including body temperature. "illnesses" that are indicated by changes in
the skin? Here are a few examples.
➔​ Regulation of the body is important because Cyanosis, a bluish color to the skin caused
the rate of chemical reactions within the by decreased blood O, content, is an
body can be increased or decreased by indication of impaired circulatory or
changes in body temperature. respiratory function.
➔​ Even slight changes in temperature can ➔​ A yellowish skin color, called jaundice
make enzymes operate less efficiently and (JAWN-dis), can occur when the liver is
disrupt the normal rates of chemical changes damaged by a disease, such as viral
in the body. hepatitis. Normally, the liver secretes bile
➔​ Exercise, fever, and an increase in pigments, breakdown products of worn-out
environmental temperature tend to raise red blood cells, into the small intestine. Bile
body temperature. pigments are yellow, and their buildup in the
➔​ In order to maintain homeostasis, the body blood and tissues can indicate impaired liver
must rid itself of excess heat. function.
➔​ Blood vessels in the dermis dilate and ➔​ Rashes and lesions in the skin can be
enable more blood to flow within the skin, symptoms of problems elsewhere in the
thus causing heat to dissipate from the body. body. For example, scarlet fever results
➔​ Sweat also assists in loss of heat through when bacteria infecting the throat release a
evaporative cooling. toxin into the blood that causes a reddish
➔​ If body temperature begins to drop below rash on the skin. The development of a rash
normal, heat can be conserved by the can also indicate an allergic reaction to foods
constriction of dermal blood vessels, which or to drugs, such as penicillin.
reduces blood flow to the skin. ➔​ The condition of the skin, hair, and nails is
➔​ Less heat is transferred from deeper affected by nutritional status. In vitamin A
structures to the skin, and heat loss is deficiency, the skin produces excess keratin
reduced. and assumes a characteristic sandpaper
➔​ With smaller amounts of warm blood flowing texture, whereas in iron-deficiency anemia
through the skin, the skin temperature the nails lose their normal contour and
decreases. become flat or concave (spoon-shaped).
➔​ Hair concentrates many substances that can
EXCRETION be detected by laboratory analysis, and a
patient's hair can be compared with a
The integumentary system plays a minor role in "normal" hair for certain diagnoses. For
excretion, the removal of waste products from the example, lead poisoning results in high
body. levels of lead in the hair. However, the use of

25
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

hair analysis to determine the general health

or nutritional status of an individual is
unreliable.

5.7 BURNS

➢​ A burn is an injury to a tissue caused by

heat, cold, friction, chemicals, electricity, or
radiation. Burns are classified according to
their depth. In partial-thickness burns, part
of the stratum basale remains viable, and
regeneration of the epidermis occurs from
within the burn area, as well as from the
edges of the burn. Partial-thickness burns
are divided into first- and second-degree
burns.
●​ First-degree burns involve only the
epidermis and are red and painful. Slight
edema (ee-DEE-mah), or swelling, may be
present. They can be caused by sunburn or
brief exposure to very hot or very cold
objects, and they heal without scarring in
about a week. ●​ Third-degree burns often are surrounded
●​ Second-degree burns damage both the by areas of first- and second-degree burns.
epidermis and the dermis. If dermal damage Although the first- and second-degree burn
is minimal, symptoms include redness, pain, areas are painful, the region of third-degree
edema, and blisters. Healing takes about 2 burn is usually painless because sensory
weeks and no scarring results. receptors in the epidermis and dermis have
-​ However, if the burn goes deep into been destroyed. Third-degree burns appear
the dermis, the wound appears red, white, tan, brown, black, or deep cherry red.
tan, or white; can take several ●​ Fourth-degree burns are extremely severe
months to heal; and might scar. burns that affect tissues deeper than the
-​ In all second-degree burns, the subcutaneous tissue. These burns often
epidermis, including the stratum damage muscle, bone, and other tissues
basale where the stem cells are associated with them.
found, is damaged. As a result, the -​ Like third-degree burns,
epidermis regenerates from fourth-degree burns are painless
epithelial tissue in hair follicles and due to the destruction of the pain
sweat glands, as well as from the receptors. Because these burns are
edges of the wound. so severe, amputation or complete
➔​ In full-thickness burns, or third-degree burns, removal of the damaged tissue is
the epidermis and the dermis are completely required. Resultant increased
destroyed, and recovery occurs from the susceptibility to infection can cause
edges of the burn wound. death.
➔​ Deep partial-thickness and full-thickness
burns take a long time to heal, and they form
scar tissue with disfiguring and debilitating
wound contracture. To prevent these
complications and to speed healing, skin
grafts are often performed.
●​ Burn Healing. In all second-degree burns,
the epidermis, including the stratum basale
where the stem cells are found, is damaged.

26
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

-​ The epidermis regenerates from ●​ arises from melanocytes in a mole

epithelial tissue in hair follicles and
●​ rare type
sweat glands, as well as from the
edges of the wound.
●​ can cause death
-​ Deep partial-thickness and
full-thickness burns take a long time CANCER OF THE SKIN
to heal, and they form scar tissue
with disfiguring and debilitating
wound contractures.
●​ Treatment of Burns. To prevent
complications of deep partial-thickness and
full-thickness burns and to speed healing,
skin grafts are often performed.
-​ In a procedure called a split skin
graft, the epidermis and part of the
dermis are removed from another (a)​ Basal cell carcinoma
part of the body and placed over (b)​ Squamous cell carcinoma
the burn. (c)​ Malignant melanoma
-​ When it is not possible or practical
to move skin from one part of the AGING AND THE INTEGUMENTARY
body to a burn site, physicians
sometimes use artificial skin or
grafts from human cadavers. ➔​ Blood flow decreases and skin becomes
thinner due to decreased amounts of
collagen
➔​ Decreased activity of sebaceous and sweat
SKIN CANCER glands make temperature regulation more
difficult
➔​ Loss of elastic fibers cause skin to sag and
➔​ Most common cancer wrinkle
➔​ Mainly caused by UV light exposure
➔​ Fair-skinned people more prone
➔​ Prevented by limiting sun exposure and
using sunscreens
➔​ UVA rays cause tan and is associated with
malignant melanomas
➔​ UVB rays cause sunburns
➔​ Sunscreens should block UVA and UVB rays

TYPES OF SKIN CANCER

Basal cell carcinoma:

●​ cells in stratum basale affected

●​ cancer removed by surgery

Squamous cell carcinoma:

●​ cells above stratum basale affected

●​ can cause death

Malignant melanoma:

27
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

6.1 FUNCTIONS OF THE SKELETAL SYSTEM

➢​ Sitting, standing, walking, picking up a

pencil, and taking a breath all involve the
skeletal system. Without the skeletal system,
there would be no rigid framework to support
the soft tissue of the body and no system of
joints and levers to allow the body to move.
➢​ The skeletal system consists of bones as
well as their associated connective
tissues,including cartilage, tendons, and
ligaments. These are all dynamic, living
tissues that are able to grow, detect pain
stimuli, adapt to stress, and undergo repair
after injury.
➢​ The skeleton is usually thought of as the
framework of the body.

Functions of the Skeletal System:

1.​ Body support. Rigid strong bone is well

suited for bearing weight and is the major
supporting tissue of the body. Cartilage
provides firm yet flexible support within
certain structures, such as the nose, external
nose, external ear. Thoracic cage, and
trachea. Ligaments, strong bands of fibrous
connective tissue, hold bones together.
2.​ Organ protection. Bone is hard and
protects the organs it surround. For example,
the skull encloses and protects the brain,
and the vertebrae surround the spinal cord.
The rib cage protects the heart, lungs, and
other organs of the thorax.
3.​ Body movement. Skeletal muscles attach to
bones by tendons, which are strong bands of
connective tissue. Contraction of the skeletal
muscles moves the bones, producing body
movement. joints, which are formed where
two or more bones come together, allow
movement. Ligaments allow some
movement between bones but prevent
excessive movements.
4.​ Mineral storage. Some minerals in the
blood are stored in bone. If blood levels of
these minerals decrease, the minerals are
released from bone into the blood. The
CHAPTER 6 - SKELETAL SYSTEM: BONES AND principal minerals stored are calcium and
JOINTS phosporous, two minerals essential for many

28
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

physiological processes. Adipose tissue is ➔​ Brittle bone disease, or osteogenesis

also stored within bone cavities. If needed, imperfecta, which means imperfect bone
the lipids are released into the blood and formation, is a rare disorder caused by any
used by other tissues as a source of energy. one of a number of faulty genes that results
5.​ Blood cell production. Many bones contain in either too little collagen formation, or poor
cavities filled with red bone marrow, which quality collagen. A a result, the bone matrix
produces blood cells and platelets. has decreased flexibility and is more easily
broken than normal bone.

6.2 BONE HISTOLOGY

BONE CELLS
➢​ In these structures of the skeletal system,
the cells produce the matrix and become There are three types of bone cells
entrapped within kit. The cells also break (1)​ Osteoblasts
down old matrix so that new matrix can (2)​ Osteocytes
replace it. The composition of each tissue’s (3)​ Osteoclasts
matrix is responsible for its characteristics.
➢​ For example, the fibrous protein collagen Hem/o or Hemat/o (Hematopoiesis) - the blood cell
provides flexibility but resists pulling or production.
compression. This makes collagen
well-adapted for the attachment functions of OSTEOBLASTS
tendons and ligaments as well as the shock ➔​ Osteoblasts (OS-tee-oh-blasts) are
absorption of cartilage. In addition, recall bone-building cells. These cells have an
from chapter 4 that the matrix ground extensive endoplasmic reticulum and
substance consists of molecules called numerous ribosomes.
proteoglycans, water-tapping proteins, ➔​ Osteoblasts produce collagen and
which helps cartilage be smooth and proteoglycans, which are packaged into
resilient. vesicles by the Golgi apparatus and secreted
by exocytosis.
BONE MATRIX ➔​ Osteoblasts also secrete high concentrations
➔​ By weight, mature bone matrix is normally of Ca2+ and phosphate ions, forming
about 35% organic and 65% inorganic crystals called hydroxyapatite. The
material. The Organic material consists hydroxyapatite crystals act as templates that
primarily of collagen and proteoglycans. The stimulate further hydroxyapatite formation
inorganic material consists primarily of a and mineralization of the matrix.
calcium phosphate crystal called ➔​ The formation of new bone by osteoblasts is
hydroxyapatite (hye-DROK-see-ap-ah-tyte), called ossification (OS-ih-fih-KAY-shun), or
which has the molecular formula osteogenesis (OS-tee-ohJEN-eh-sis).
Ca10(PO4)6(OH2). The collagen and Ossification can occur multiple times during
mineral components are responsible for the life: as a fetus, when growing larger, and any
major functional characteristics of bone. Like time in life when a fracture is repaired.
reinforcing steel bars, the collagen fibers -​ Ossification occurs by appositional
lend flexible strength to the matrix; like growth on the surface of previously
concrete, the mineral components give the existing materials, either bone or
matrix weight bearing strength. cartilage. Foe example, osteoblasts
➔​ If mineral in a long bone is reduced, collagen beneath the periosteum cover the
becomes the primary constituent and the surface of preexisting bone. Bone
bone is overly flexible. On the other hand, if matrix produced by the osteoblasts
the amount of collagen is reduced in the covers the older bone surface and
bone, mineral component becomes the surrounds the osteoblast cell bodies
primary constituent and the bone is very and extensions. The result is a new
brittle. layer of bone.

29
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

OSTEOCYTES Enzymes are secreted into the sealed

compartment, where they digest the organic
➔​ Osteoblasts become osteocytes protein component of the bone matrix. After
(OS-tee-oh-sites) once the osteoblasts have breakdown of the matrix, the degradation
secreted sufficient bone matrix. Osteocytes products are secreted into the blood and
account for 90-95% of bone cells and are used elsewhere in the body.
very long lived, with a life span of up to 25
years. Osteocytes can produce the
components needed to maintain the bone SPONGY AND COMPACT BONE
matrix.
➔​ Osteocyte cell bodies are housed within the ➔​ As bone forms, the newly formed bone goes
bone matrix in spaces called lacunae through several stages. Recall that
(la-KOO-nee). Osteocyte cell extensions are ossification can occur throughout your
housed in narrow, long spaces called lifetime. Mature bone is called lamellar
canaliculi (kanah-LIK-yoo-lie; little canals). bone. It is organized into thin. concentric
In a sense, the cells and their extensions sheets or layers. called lamellae
form a "mold" around which the matrix is (lah-MEL-ee). In general, the collagen fibers
formed. Nutrients and gases can pass of one lamella lie parallel to one another, but
through the small amount of fluid at an angle to the collagen fibers in the
surrounding the cells in the canaliculi and adjacent lamellae. Osteocytes, within their
lacunae or pass from cell to cell. lacunae, are arranged in layers sandwiched
between lamellae.
➔​ Spongy bone - cancellous bone
OSTEOCLASTS ❖​ Spongy bone. which appears porous, has
less bone matrix and more space than
➔​ Osteoclasts (OS-tee-oh-klasts) are bone compact bone. In contrast, compact bone
destroying cells. These cells break down has more bone matrix and less space than
bone. Breakdown of bone is called bone spongy bone. Spongy bone consists of
reabsorption. This breakdown is important interconnecting rods or plates of bone called
for mobilizing crucial Ca2+ and phosphate trabeculae (trah-BEK-yoo-lee; beam).
ions for use in many metabolic processes. Between the trabeculae are spaces, which in
Note that we use the term reabsorption here life are filled with bone marrow and blood
because our point of reference is the vessels. Most trabeculae are thin and consist
bloodstream. As bone is broken down, the of several lamellae, with osteocytes located
Ca24 goes "back" into the blood. Osteoclasts in lacunae between the lamellae. Each
are massive, multinucleated cells and osteocyte is associated with other
develop from the red bone marrow cells that osteocytes through canaliculi. Usually, no
also differentiate into specialized white blood blood vessels penetrate the trabeculae, so
cells. osteocytes must obtain nutrients through
➔​ Mature osteoclasts carry out bone their canaliculi. The surfaces of trabeculae
reabsorption through a multistep process. are covered with a single layer of cells
First, the osteoclasts must access the bone consisting mostly of osteoblasts with a few
matrix. Once the osteoclasts have come in osteoclasts.
contact with the bone surface, the ❖​ Compact bone, or cortical bone, is the solid,
osteoclasts form attachment structures, outer layer surrounding each bone. It has
which create a sealed compartment under more matrix and is denser with fewer pores
the osteoclast. Next, the osteoclasts develop than spongy bone. Blood vessels enter the
a ruffled border. substance of the bone itself, and the
➔​ The ruffled border is a specialized lamellae of compact bone are primarily
reabsorption-specific area of the membrane. oriented around those blood vessels.
Osteoclasts create an acidic environment
within the sealed compartment, which
causes breakdown of the bone matrix.

30
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

➔​ A long bone is the traditional model for

overall bone structure (figure 6.4). The
diaphysis (die-AF-ih-sis) is the center
portion of the bone. It is composed primarily
of compact bone tissue, surrounding a
hollow center called the medullary cavity.
Some spongy bone tissue can be found
lining the medullary cavity. The ends of a
long bone are called epiphyses
(e-PIF-ih-seez; sing. - sis). The epiphyses
are mostly spongy bone, with an outer

-​ The functional unit of compact bone

is an osteon (OS-tee-on), or
haversian (hah-VER-shan)
system. An osteon is composed of
concentric rings of matrix, which
surround a central tunnel and
contain osteocytes. In
cross-section, an osteon resembles
a circular target; the bull's-eye of
the target is the central canal.
Surrounding the central canal are
rings of bone matrix. Central canals
are lined with endosteum and
contain blood vessels, nerves, and
loose connective tissue. Blood
vessels are contained within the
central canals. Osteocytes are
located in lacunae between the
lamellar rings, and canaliculi radiate
between lacunae across the
lamellae, looking like minute cracks layer of compact bone. Within joints, the end
across the rings of the target. of a long bone is covered with hyaline
cartilage called articular cartilage. The
6.3 BONE ANATOMY epiphyseal (ep-i-FEEZ-ee-al) plate, or
growth plate, is located between the
epiphysis and the diaphysis. Growth in bone
Structure of a Long Bone
length occurs at the epiphyseal plate.
Consequently, growth in length of the long
bones of the arm, forearm, thigh, and leg

31
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

occurs at both ends of the diaphysis, Endochondral ossification starts with a

whereas growth in length of the hand and cartilage model.
foot bones occurs at one end of the
diaphysis. When bone stops growing in INTRAMEMBRANOUS OSSIFICATION
length, the epiphyseal plate becomes
ossified and is called the epiphyseal line. ➔​ Many skull bones, part of the mandible
(lower jaw), and the diaphyses of the
➔​ The cavities of spongy bone and the clavicles (collarbones) develop by
medullary cavity are filled with marrow. Red intramembranous ossification. At
marrow is the site of blood cell formation, approximately the fifth week of development
and yellow marrow is mostly adipose in an embryo, a membrane of connective
tissue. In the fetus, the spaces within the tissue with delicate, randomly oriented
bones are filled with red marrow. The collagen fibers surrounds the brain. This
conversion of red marrow to yellow marrow membrane will eventually become cranial
begins just before birth and continues well bones of the skull. Intramembranous
into adulthood. Yellow marrow completely ossification of this membrane begins at
replaces the red marrow in the long bones of approximately the eighth week of embryonic
the limbs, except for some red marrow in the development and is completed by
proximal part of the arm bones and approximately 2 years of age. The locations
thighbones. The hipbone is used as a source in the membrane where intramembranous
of donated red bone marrow because it is a ossification begins are called centers of
large bone with more red bone marrow than ossification. The centers of ossification
smaller bones and it can be accessed expand to form a bone by gradually ossifying
relatively easily. the membrane. Thus, the centers have the
➔​ The periosteum (PER-ee-OSS-tee-um) is a oldest bone, and the expanding edges the
connective tissue membrane covering the youngest bone. Fontanels, or soft spots are
outer surface of a bone (figure 6.4c). The the larger, membrane-covered spaces
outer layer contains blood vessels and between the developing skull bones that
nerves, whereas the inner layer is a single have not yet been Ossified. The bones
layer of bone cells, including osteoblasts and eventually grow together, and all the
osteoclasts. Where tendons and ligaments fontanels have usually closed by 2 years of
attach to bone, the collagen fibers of the age shows the steps in intramembranous
tendon or ligament become continuous with ossification.
those of the periosteum.
➔​ The endosteum (en-DOSS-tee-um) is a 3 Steps of Intramembrannous Ossification
single-cell layer of connective tissue that
lines the internal surfaces of all cavities 1.​ Osteoblasts activity
within bones, such as the medullary cavity of 2.​ Spongy bone formation
the diaphysis and the smaller cavities in 3.​ Compact bone formation
spongy and compact bone. The endosteum
includes osteoblasts and osteoclasts.

6.4 BONE DEVELOPMENT

Bone formation in the fetus follows two

processes:

(1)​ intramembranous ossification and

(2)​ endochondral ossification.
➢​ Intramembranous ossification starts within
embryonic connective tissue membranes.

32
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

Figure 6.3 Structure of Bone Tissue

Figure 6.4 Structure of a Long Bone
ENDOCHONDRAL OSSIFICATION

➔​ The formation of cartilage begins at

approximately the end of the fourth week of
embryonic development. Endochondral
ossification of some of this cartilage starts at
approximately the eighth tion of some of this
cartilage starts at approximately the eighth
week of embryonic development, but this
process might not begin week of embryonic
development, but this process might not
begin ing and in other cartilage until as late
as 18-20 years of age. Bones of the base of
the skull, part of the mandible, the epiphyses
of the clavicles, and most of the remaining
skeletal system develops through
endochondral ossification.

5 Steps of Endochondral Ossification

1.​ Cartilage model formation

2.​ Bone collar formation
3.​ Primary ossification center formation
4.​ Secondary ossification center formation
5.​ Adult bone

33
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

6.5 BONE GROWTH

➢​ Unlike cartilage, bones do not grow by

interstitial growth only. Bones increase in
size in part by appositional growth, the
formation of new bone on the surface of
older bone or cartilage. For example,
6.6 BONE REMODELING
trabeculae grow in size when osteoblasts
deposit new bone matrix onto the surface of
➢​ Just as our homes must be remodeled when
the trabeculae
they fall into disrepair, bone that becomes
old is replaced with new bone in a process
GROWTH IN BONE LENGTH
called bone remodeling. In this process,
osteoclasts remove old bone and
➔​ Long bones increase in length because of osteoblasts deposit new bone. Bone
growth at the epiphyseal plate. In a long remodeling converts woven bone into
bone, the epiphyseal plate separates the lamellar bone and is involved in several
epiphysis from the diaphysis. important functions, including bone growth,
➔​ Long bones grow by creating new cartilage changes in bone shape, adjustment of the
in the epiphyseal plate. Cartilage calcification bone to stress, bone repair, and calcium ion
and ossification in the epiphyseal plate occur (Ca2+) regulation in the body.
by the same basic process as calcification
and ossification of the cartilage model during The structure of a long bone-a hollow cylinder with a
endochondral bONE formation. New medullary cavity in the center- has two mechanical
cartilage forms through interstitial cartilage advantages:
growth followed by appositional bone growth
on the surface of the existing cartilage. The (1)​ A hollow cylinder is lighter in weight than a
epiphyseal plate is organized into five zones. solid rod, and
➔​ Oppositional growth - the increase in the (2)​ a hollow cylinder with the same height,
diameter of bones by the addition of bone weight, and composition as a solid rod, but
tissue at the surface of bones. with a greater diameter, can support much
more weight without bending.
➢​ As a long bone increases in length and
diameter, the size of the medullary cavity
also increases, keeping the bone from
becoming very heavy. In addition, as the
bone grows in diameter, the relative
thickness of compact bone is maintained as

34
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

osteoclasts remove bone on the inside and

osteoblasts add bone to the outside.
➢​ Bone remodeling involves a group of
osteoclasts and osteoblasts that travel
through or across the surface of bone. These
cells remove old bone matrix and replace it
with a new bone matrix. In compact bone,
the osteoclasts break down the bone matrix.
Osteoblasts move in and lay down a layer of
bone. Additional lamellae are produced until
an osteon is formed. In spongy bone, the
bone matrix is removed from the surface of a
trabecula, forming a cavity, which is filled in
with new bone matrix.

6.7 BONE REPAIR

➢​ Bone is a living tissue that can undergo

repair if it is damaged. Figure 6.8 shows the
four major steps in bone repair.

(1)​ Hematoma formation. A hematoma

(hee-mah-TOH-mah) is a localized mass of
blood released from blood vessels but
confined within an organ or space. When a
bone is fractured, the blood vessels in the
bone and surrounding periosteum are
damaged, and a hematoma forms. Usually,
the blood in a hematoma forms a clot, which
consists of fibrous proteins that stop the
bleeding. Disruption of blood vessels in the
central canals results in inadequate blood
delivery to osteocytes, and bone tissue
adjacent to the fracture site dies. Tissues
around the bone often become inflamed and
swollen following the injury.
(2)​ Callus formation. A callus (KAL-us) is a
mass of bone tissue that forms at a fracture
site. Several days after the fracture, blood
vessels grow into the clot. As the clot
dissolves, (a) macrophages clean up cell
debris, (b)osteoclasts break down dead bone
tissue, and (c) fibroblasts produce collagen
and other extracellular materials to form
granulation tissue, the precursor to healed
tissue (see chapter 4). A collar is formed
around the opposing ends of the bone
fragments. Osteoblasts and chondroblasts
from the periosteum produce bone and

35
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

cartilage. The callus is a bone-cartilage also contribute to bone growth, remodeling,

collar that stabilizes the ends of the broken and repair.
bone. In modern medical practice, applying a ➔​ When osteoblast and osteoclast activities
cast or surgically implanting metal supports are balanced, the movements of Ca2+ into
can help stabilize the bone. and out of bone are equal. However, if blood
(3)​ Callus ossification. Like the cartilage models Ca2+ levels are abnormally depleted for too
formed during fetal development, the long, excess Ca2+ is released from bone,
cartilage in the callus is replaced by spongy causing it to become overly demineralized
bone through endochondral ossification. The and weak. When blood Ca2+ levels are low,
result is a stronger external callus. osteoclast activity increases and bone
(4)​ Bone remodeling. Repair is complete only reabsorption occurs.
when the new bone of the callus and the ➔​ Osteoclasts release more Ca2+ from bone
dead bone adjacent to the fracture site have into the blood than osteoblasts remove from
been replaced by compact bone. In this the blood to make new bone. Consequently,
compact bone, osteons from both sides of a net movement of Ca2+ levels increases.
the break extend across the fracture line to Conversely, if blood Ca2+ levels are high,
“peg” the bone fragments together. This osteoclast activity decreases. Osteoclasts
remodeling process takes time—as much as release less Ca2+ from bone into the blood
a year or more. Eventually, repair may be so than osteoblasts remove from the blood for
complete that no evidence of the break bone deposition. As a result, net movement
remains; however, the repaired zone usually of Ca2+ occurs from the blood to bone, and
remains slightly thicker than the adjacent blood Ca2+ levels decrease.
bone. If the fracture has occurred in the ➔​ Calcium homeostasis is regulated by three
diaphysis of a long bone, remodeling also hormones
restores the medullary cavity.
(chemical messengers delivered via the blood):

(1)​ parathyroid hormone (PTH);

6.8 CALCIUM HOMEOSTASIS (2)​ calcitriol, a biologically active form of vitamin
D3; and
➢​ Calcium is a critical physiological regulator (3)​ calcitonin.
of many processes required to achieve and
maintain homeostasis. STIMULUS
➢​ Hypercalcemia - calcium level in the blood
becomes too high. ●​ Parathyroid cells detect low blood Ca2+
➢​ Hypocalcemia - abnormally low calcium levels and secrete PTH
levels in the blood. ●​ PTH activates calcitriol in the kidney

The processes include: RESPONSE

(1)​ stimulation of skeletal muscle contraction, ●​ PTH and calcitriols stimulate formation of
(2)​ stimulation and regulation of cardiac muscle osteoclasts
contraction, and ●​ PTH stimulates Ca2+ reabsorption in the
(3)​ exocytosis of cellular molecules, including kidney tubules
those important for neural signaling. ●​ Calcitriol stimulates Ca2+ uptake in the
➔​ Because bone is the major storage site for small intestine
Ca2+ in the body, the cells governing bone
reabsorption and bone deposition are targets
for Ca2+-regulation hormones.
➔​ In addition to regulating blood Ca2+ levels,
interactions between osteoclasts,
osteoblasts, and Ca2+-regulating hormones

36
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

➢​ Further, PTH increases blood Ca2+ levels by

preventing inhibition of osteoclast formation.
It is interesting to note that PTH has been
found to also promote bone deposition.
Although contradictory to PTH's known one
reabsorption function, giving patients PTH
intermittently rather than continuously helps
prevent osteoporosis (bone
demineralization) from progressing.
However, the exact mechanism for PTH
stimulation of bone formation is as yet
unclear.

Kidney Tubules

➔​ PTH stimulates the reabsorption of Ca2+

from urine in the kidney tubules, which
reduces the amount of Ca2+ excreted in the
urine.

PARATHYROID HORMONE Indirect Effects of PTH in the Small Intestine

➢​ Parathyroid hormone (PTH) is secreted by ➔​ PTH regulates blood Ca2+ levels by

cells in the parathyroid gland and is essential indirectly increasing Ca2+ uptake from the
for the maintenance of blood Ca2+ levels small intestine. Increased PTH promotes the
within the homeostatic limits. PTH production activation of calcitriol in the kidneys.
and secretion are controlled by Calcitriol increases absorption of Ca2+ in the
Ca2+-sensing receptors in the parathyroid small intestine.
gland. The key signal for PTH secretion is a
reduction in blood Ca2+ levels.

PTH works through two general mechanisms: CALCITRIOL

(1)​ direct effects on bone cells and in the kidney ➔​ Calcitriol increases blood Ca2+ levels. It is
and a steroid hormone derived from vitamin D3.
(2)​ indirect effects on the small intestine. Recall from chapter 5 that vitamin D3
production is initiated in the skin and
continued in the liver and then in the kidney,
where calcitriol activation occurs. PTH
Direct Effects of PHT stimulates calcitriol activation in the kidney,
which contributes to PTH-induced increases
BONE CELLS in blood Ca2+ levels. Calcitriol and PTH
work together to increase osteoclast activity
for bone reabsorption. In addition, calcitriol
➢​ PTH increases blood Ca2+ levels by exerting
assists PTH in the kidney tubules by
direct regulatory control of osteoblasts and
preventing Ca2+ removal through urine.
osteocytes to increase formation and
These actions of calcitriol increase blood
activation of osteoclasts, the principal
Ca2+ levels.
bone-reabsorbing cells. Binding of PTH to its
➔​ Activated Vitamin D - calcitriol
receptor in osteoblast and osteocyte cell
membranes stimulates an increased number
of active osteoclasts.

37
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

CALCITONIN

➔​ Calcitonin (KAL-si-TOH-nin) is secreted

from C cells in the thyroid gland when blood
Ca2+ levels are too high. Calcitonin rapidly
lowers blood Ca2+ levels by inhibiting
osteoclast activity. However, the exact role of
calcitonin, especially in adult bone
remodeling, is still under investigation.

6.9 SKELETAL ANATOMY OVERVIEW

➢​ The average adult has 206 bones. However,

the actual number of bones varies among
people and decreases with age as bones
become fused. Bones are segregated into
the axial skeleton and the appendicular
skeleton. The axial skeleton consists of the
bones of the skull, the auditory ossicles, the
hyoid bone, the vertebral column, and the Axial Skeleton - a total of 80 bones
thoracic cage (rib cage). The appendicular
skeleton consists of the bones of the upper Appendicular Skeleton - a total of 126 bones
limbs, the lower limbs, and the grindles.
The term girdle, which means "belt" or
"zone," refers to the two zones where the
limbs are attached to the body. These two TOTAL BONES = 206
zones are the pectoral girdle and the pelvic
girdle.

BONE SHAPES

There are four categories of bone, based on their

shape:

(1)​ long,
(2)​ short,
(3)​ flat, and
(4)​ irregular.

➔​ Long bones are longer than they are wide.

This shape enhances their function in
movement of appendages. Most of the
bones of the upper and lower limbs are long
bones.

38
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

●​ If the hole is elongated into a tunnel-like

passage through the bone, it is called a
➔​ Short bones are approximately as wide as canal or a meatus (mee-AY-tus; a passage).
they are long; examples are the bones of the ●​ A depression in a bone is called a fossa
wrist and ankle. Short bones help transfer (FOSS-ah).
force between long bones. ●​ A rounded projection on a bone is called a
➔​ Flat bones are well-suited to provisioning a tubercle (TOO-ber-kul; a knob) or a
strong barrier around soft organs such as the tuberosity (TOO-ber-OS-i-tee), and a sharp
brain and heart. Examples of flat bones are projection from a bone is called a process.
certain skull bones, the ribs, the scapulae ●​ Most tubercles and processes are sites of
(shoulder blades), and the sternum. muscle attachment on the bone. Increased
➔​ Irregular bones include the vertebrae and muscle pull, as occurs when a person lifts
facial bones, which have shapes that do not weights to build up muscle mass, can
fit readily into the other three categories. increase the size of some tubercles. The
These bones tend to have specialized smooth, rounded end of a bone, where it
functions, such as providing protection while forms a joint with another bone, is called a
allowing bending and flexing of certain body condyle (KON-dile; knuckle).
regions such as the spine.

6.10 AXIAL SKELETON

The axial skeleton forms the central axis of the body.

It protects the brain, the spinal cord, and the vital
organs housed within the thorax.

Skull

➢​ The skull consists of 8 cranial bones and 14

facial bones, a total of 22 bones. The cranial
bones, or cranium (KRAY-nee-um), house
and protect the brain. Both the exterior and
the interior of the skull have visible ridges
and lines.
➢​ 7 associated bones, in a total of 29 bones
both for skull and associated bones.
➢​ Most of these are locations where head and
neck muscles attach to the cranium. The
cranial bones are connected by immovable
joints called sutures.
SKELETAL TERMINOLOGY
There are four principal sutures:
Anatomists use several common terms to describe
the features of bones. (1)​ coronal,
(2)​ sagittal,
●​ For example, a hole in a bone is called a (3)​ lambdoid, and
foramen (foh-RAY-men; pl. foramina, (4)​ squamous.
foh-RAH-min-ah; foro, to pierce). A foramen ➢​ The specific sutures will be discussed along
usually exists in a bone because some with the bones they connect. All other skull
structure, such as a nerve or blood vessel, bones are held together by sutures as well
passes through the bone at that point. and are named according to the bones they
connect. The top of the skull, called the
calvaria (kal-VAY-ree-ah), is often removed

39
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

to view the interior of the skull. The facial bone by the lambdoid suture. Along with
bones form the basis of the face; contain the temporal bones, the parietal bones make
cavities for the eyes, nose, and mouth; and up the majority of the lateral portion of the
are the attachment sites for our facial skull.
expression muscles.

CRANIAL BONES
TEMPORAL BONES
The 8 bones of the cranium include:
The temporal bones are connected to the
(1) the frontal bone, skull by the squamous sutures. The term
temporal means "related to time"; the
(2 and 3) the 2 parietal bones, temporal bone's name is derived from the
observation that the hair on the temples
(4 and 5) the 2 temporal bones, turns gray as a person ages.

(6) the occipital bone, The temporal bone is subdivided into three main
regions:
(7) the sphenoid bone, and
(1)​ the squamous part,
(8) the ethmoid bone. (2)​ the tympanic part, and
(3)​ the petrous part.
FRONTAL BONE

➔​ The frontal bone is connected to the two

parietal bones by the coronal suture. The
frontal bone is most well-known as the
"forehead." It forms the roof of both the orbit
of the eye and the nasal cavity.
●​ The superior border of each of the
orbits contains a supraorbital
foramen, or notch, which allows
passage of a blood vessel and
nerve for the eyelid and eye.
●​ Between the two orbits is the
glabella (smooth), a smooth region
of bone.
●​ The frontal bone also contains the
Figure 6.12 Superior View of the Skull
frontal sinus, one of the paranasal
sinuses. Internally, the frontal bone
forms the anterior cranial fossa,
which supports lobes of the brain.

PARIETAL BONES

➔​ The paired parietal bones form nearly half of

the superior portion of the skull. The two
parietal bones are joined by the sagittal
suture and are connected to the occipital

40
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

Figure 6.13 Right Lateral View of the Skull

Four Types of Paranasal Sinuses

1.​ Frontal sinus

2.​ Sphenoidal sinus
3.​ Ethmoidal labyrinth (sinus)
4.​ Maxillary sinus
Figure 6.14 Anterior View of the Skull and
Face Sinusitis - inflammation in sinuses

1.​ The squamous part of each temporal bone Figure 6.15 Paranasal Sinuses
meets the parietal bone. The zygomatic
(zie-goh-MAT-ik) process extends from the
squamous part anteriorly toward the
zygomatic bone of the face.
➔​ It joins with the zygomatic bone to
form the zygomatic arch, a bridge
across the side of the skull. Note
that bone processes are named for
the bones to which they extend.
➔​ The zygomatic process has an
oval-shaped fossa on the inferior
side, called the mandibular fossa.
The mandibular fossa is the
attachment site of the mandible Figure 6.16 Floor of the Cranial Cavity
(lower jaw).
2.​ The tympanic part of the temporal bone has
the prominent external auditory canal
(external acoustic meatus), which transmits
sound waves toward the eardrum, or
tympanic membrane. The external ear
surrounds the external acoustic meatus.
3.​ The petrous part of the temporal bone
extends inward toward the center of the
skull. The petrous part is a thick, bony ridge
(petrous; rocky), is hollow and houses the
middle and inner ears.

Figure 6.17 Inferior View of the Skull

41
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

➔​ The internal auditory canal is (large hole), the opening where the
located on the posterior surface of brainstem connects to the spinal cord.
the petrous part and is the opening ➔​ This region also forms the posterior cranial
for a nerve-controlling hearing and fossae that support the cerebellum of the
balance. Externally, the mastoid brain. Externally, two rounded projections on
(MASS-toyd) process is a large, either side of the foramen magnum are the
bony inferior projection that can be occipital condyles. The occipital condyles
seen and felt just posterior to the are the points of articulation between the
external ear. skull and the first cervical vertebra. This
➔​ This process is not solid bone but is articulation partly allows for nodding "yes."
filled with cavities called mastoid ➔​ The nuchal (NOO-kal; nape of neck) lines
air cells, which are connected to are points of attachment for several neck
the middle ear and can sometimes muscles that move the head.
become infected causing
mastoiditis. Neck muscles that
rotate the head attach to the
mastoid process. SPHENOID BONE
●​ The styloid (STY-loyd; stylus, or
pen-shaped) process projects from the ➔​ Although appearing to be two bones, one on
lower portion of the petrous part of the each side of the skull anterior to the temporal
temporal bone. The styloid process serves bone, the sphenoid (SFEE-noyd) bone is
as an attachment site for three muscles actually a single bone that extends
necessary for movement of the tongue, completely across the skull. When viewed as
hyoid bone, and pharynx. a whole, the sphenoid bone somewhat
●​ The stylomastoid foramen is located resembles a butterfly.
between the styloid process and mastoid ➔​ The center of the sphenoid bone forms a
process and allows for passage of a nerve central prominence within the floor of the
controlling facial muscles. cranial cavity. The shape of this prominence
resembles a saddle, called the sella turcica
There are three additional important foramina on (SEL-ah TUR-sih-kah; Turkish saddle).
the inferior side of the pennus part. ➔​ The sella turcica surrounds and protects the
pituitary gland. Within the body of the
➔​ The jugular (JUG-you-lar) foramina allow sphenoid bone are the sphenoidal sinuses.
the jugular veins to carry the majority of the ➔​ An optic canal is located on each side of the
blood away from the brain. sphenoid bone just anterior to the sella
➔​ The carotid (kah-ROT-id) canals are the turcica. The optic canal is the passageway
major entry point for blood delivery to the for the optic nerve to enter the brain from the
brain. eyes.
➔​ The foramen lacerum (lah-SER-um; torn) is
an easily noticeable opening in a dried skull Three additional paired foramina are located on
at the border of the petrous part and the either side of the sella turcica:
sphenoid bone.
-​ However, this foramen is only an (1)​ the foramen rotundum,
artifact of the dried skull; in life, this (2)​ the foramen ovale (oh-VAL-ee), and
opening is closed off by cartilage. (3)​ the foramen spinosum

OCCIPITAL BONE ➔​ These foramina are passageways for blood

vessels and nerves that service the brain as
➔​ The occipital bone makes up the majority of well as the meninges, protective membranes
the skull's posterior wall and base. Its most that surround the brain.
prominent feature is the foramen magnum

42
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

The lateral portions of the sphenoid bone -​ The perpendicular plate

forms the superior portion
(1)​ form the floor of the middle cranial fossa, of the nasal septum,
(2)​ are a part of the lateral skull wall, and which divides the nasal
(3)​ form the posterior wall of the orbits. cavity into right and left
➔​ The sphenoid bone also forms a ridge on halves.
each side of the optic canal. This ridge ●​ Protruding medially from the
separates the anterior cranial fossa from the ethmoid bone are two scroll-shaped
middle cranial fossa. Additionally, this ridge bones called the conchae (KON-
is the superior border of the superior orbital kee). The inferior nasal concha
fissure, where cranial nerves controlling eye (KON-kah) is a separate bone,
movement enter the orbit. The pterygoid which will be discussed later.
processes, which extend inferiorly, are Together, the three nasal conchae
attachment sites for muscles of mastication increase the surface area in the
nasal cavity, thereby facilitating
moistening of and removal of
particles from air in the nasal cavity,
ETHMOID BONE and warming of the air inhaled
through the nose
➔​ The ethmoid (ETH-moid; ethmos, sieve)
bone is appropriately named because it is a
very porous, fragile bone. It is centrally
located in the skull, forming the nasal
septum (wall), a large portion of the nasal
cavity, as well as the medial wall of the SPECIALIZED REGIONS IN THE SKULL
orbits.
➔​ The sinuses within the ethmoid bone form PARANASAL SINUSES
the ethmoidal sinuses.
●​ The crista galli (KRIS-tah GAL-ee; ➔​ Considered together, the sinuses found in
rooster's comb) is a prominent ridge the frontal bone, the ethmoid bone, the
of the ethmoid bone. The crista galli sphenoid bone, and the maxilla are called
is an attachment site for the the paranasal sinuseS. The paranasal
meninges of the brain. sinuses are openings within particular bones
-​ Located on each side of that open into the nasal cavity.
the crista galli are the
cribriform (KRIB-ri-form; The sinuses have two major functions:
sievelike) plates, each of
which houses one of the (1)​ they decrease the weight of the skull and
two olfactory bulbs that (2)​ they act as a resonating chamber when
transmit signals for the speaking. Compare the sound of your voice
sense of smell from the during a head cold to its sound normally.
nasal cavity to the brain.
-​ The cribriform plates
contain numerous
foramina, called olfactory ORBITS
foramina, which allow
olfactory nerves to enter ➔​ Orbits The orbits are cone-shaped fossae.
the nasal cavity. They are called the orbits because they
●​ Extending inferiorly from the allow the eyes to rotate within the fossae.
ethmoid bone is a central, thin bony Portions of multiple bones converge to form
plate called the perpendicular the orbits. The orbits protect the eyes and
plate. are the locations where the muscles
controlling eye movements attach. The orbits

43
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

have several openings through which (9 and 10) the pair of nasal bones,
structures communicate between the orbit
and other cavities. (11) the mandible,
➔​ The nasolacrimal duct passes from the orbit
into the nasal cavity through the (12) the vomer bone, and
nasolacrimal canal, carrying tears from the
eyes to the nasal cavity. The optic nerve for (13 and 14) the pair of inferior nasal conchae.
vision passes from the eye through the optic
canal and enters the cranial cavity. Superior ➢​ These bones, in addition to two cranial
and inferior orbital fissures in the posterior of bones (the frontal and ethmoid bones), form
the orbits provide openings through which the structure of the face in the anterior of the
nerves and blood vessels communicate with skull. The facial bones protect the major
structures in the orbit or pass to the face. sensory organs located in the face: the eyes,
nose, and tongue. These bones also provide
attachment points for muscles controlling
mastication, facial expressions associated
NASAL CAVITY with our emotions, and eye movements. It is
the bones of the face and their soft tissues
➔​ The nasal cavity has a rounded opening that determine the uniqueness of each
anteriorly and is separated into right and left individual's facial appearance.
halves by the nasal septum. The posterior
part of the nasal septum consists primarily of
the perpendicular plate of the ethmoid bone,
as discussed earlier, and the vomer bone, to ZYGOMATIC BONES
be discussed with the facial bones. Hyaline
cartilage forms the anterior part of the nasal ➔​ The zygomatic (zie-goh-MAT-ik) bones,
septum. The entrances to the nasal cavity in commonly known as the cheekbones, are
a dried skull are much larger than the anterior to the sphenoid bone. There they
openings in a living person. This is because form part of the border of the orbits. As
the external nose is formed mostly of hyaline previously discussed, the temporal process
cartilage and will be absent from a dried of the zygomatic bone articulates with the
skull. zygomatic process of the temporal bone to
form the zygomatic arch.
The only visible portions of the external nose in a
dried skull are MAXILLAE

(1)​ the two nasal bones and ➔​ Each maxilla (mak-SIL-ah; pl. maxillae,
(2)​ the maxilla upper jaw) is anterior and inferior to the
zygomatic bones, and the two maxillae are
fused in the center.

FACIAL BONES The maxillae are two of the three jaw bones and form

The 14 facial bones of the skull include (1)​

the upper jaw,
(2)​
the majority of the roof of the mouth, and
(1 and 2) the pair of zygomatic bones, (3)​
the center portion of the face.
➔​ Each of the two maxillary bones has a
(3 and 4) the pair of maxilla bones, palatine process.
➔​ These join medially to form the anterior
(5 and 6) the pair of palatine bones, two-thirds of the hard palate or the roof of
the mouth. The incisive foramen is located
(7 and 8) the pair of lacrimal bones, just posterior to the front teeth and allows
passage of blood vessels and nerves. The

44
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

posterior one-third is formed by two other VOMER

facial bones, the palatine bones to be
discussed later. The palate separates the ➔​ The vomer forms most of the posterior
nasal cavity from the mouth, enabling portion of the nasal septum.
humans to chew and breathe at the same
time.
➔​ Below the orbits, within each maxilla is an
infraorbital foramen for passage of a facial
nerve and artery. At the junction of the
maxilla with the greater wing of the sphenoid
bone is the inferior orbital fissure. This
fissure allows the passage of several nerves
and blood vessels to the face.

PALATINE BONES

➔​ The palatine bones have horizontal plates

that fuse centrally to form the posterior
portion of the hard palate as described
earlier with the maxillae.

LACRIMAL BONES

➔​ The lacrimal (LAK-rim-al; tears) bones are

the smallest of the skull bones and house FIGURE 6.18 HYOID BONE
the depression through which the
nasolacrimal duct enters the nasolacrimal INFERIOR NASAL CONCHAE
canal, joining the orbits and nasal cavity.
➔​ The inferior nasal concha, as discussed
NASAL BONES with the ethmoid bone, is one of the three
conchae in the nasal cavity that provide
➔​ The nasal bones, along with the frontal increased surface area.
processes of the maxillae, form the bridge of
the nose.

MANDIBLE HYOID BONE

➔​ The mandible (lower jaw) is the only skull ➢​ The hyoid bone is important for speech and
bone that is freely movable relative to the swallowing. Some tongue muscles as well as
other skull bones. It is inferior to the maxillae neck muscles that elevate the larynx attach
and attaches posteriorly to the temporal to the hyoid. The hyoid bone is unpaired and
bone via the mandibular fossae. is often listed as part of the facial bones.
➔​ The mandible joins the temporal bone by However, it is not part of the adult skull.
way of the attachment of the mandibular ➢​ The hyoid bone has the unique distinction of
condyle with the mandibular fossa. The being the only bone in the body not directly
coronoid (KOR-ohnoyd) process is anterior attached to another bone. It has no direct
to the mandibular condyle. The powerful bony attachment to the skull. Instead,
muscle of mastication, the temporalis muscles and ligaments attach it to the skull,
muscle, attaches to the coronoid process. so the hyoid is embedded in soft tissue in the
On each anterior surface of the mandible is neck just below the mandible.
the mental foramen for passage of nerves
and blood vessels to the chin.

45
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

VERTEBRAL COLUMN aligning our body weight with our pelvis and
lower limbs.
The vertebral column performs five major functions:

(1)​ It supports the weight of the head and trunk,

(2)​ it protects the spinal cord,
(3)​ it allows spinal nerves to exit the spinal cord,
(4)​ it provides a site for muscle attachment, and
(5)​ it permits movement of the head and trunk.

➢​ The vertebral column usually consists of 26

bones, called vertebrae, which can be
divided into

five regions:

-​ 7 cervical vertebrae (VER-teh-bray),

-​ 12 thoracic vertebrae,
-​ 5 lumbar vertebrae,
-​ 1 sacral bone, and
-​ 1 coccygeal (kok-SIJ-ee-al) bone

➢​ For convenience, each of the five regions is

identified by a letter, and the vertebrae within
each region are numbered: C1-C7, T1-T12,
L1-L5, S, and CO. You can remember the
number of vertebrae in the non-fused
regions of the vertebral column by
remembering mealtimes: 7, 12, and 5. The
developing embryo has about 33 or 34
vertebrae, but by adulthood, the 5 sacral
vertebrae have fused to form 1 bone, and
the 4 or 5 coccygeal bones usually have
fused to form 1 bone.
➢​ The adult vertebral column has four major
curvatures. The cervical region curves
anteriorly, the thoracic region curves
posteriorly, the lumbar region curves
anteriorly, and the sacral and coccygeal
regions together curve posteriorly. The Figure 6.19 Vertebral Column
curves form during embryonic development.
Because the embryo and fetus are C-shaped
within the uterus, the vertebral column is
naturally curved from the beginning. After GENERAL FEATURES OF THE VERTEBRAE
birth, when the infant raises its head, a
secondary curve, which curves anteriorly, Each vertebra consists of
develops in the These spinal curvatures help
accommodate our upright posture by (1)​ a body,
(2)​ a vertebral arch, and

46
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

(3)​ various processes. Figure 6.20 Vertebra

➔​ Two specific portions of the vertebrae help
support the body's weight and protect the ➢​ The intervertebral foramina are the
spinal cord. The vertebral body, the solid locations where two vertebrae meet. Each
bony disk of each vertebra, supports the intervertebral foramen is formed by
body's weight. intervertebral notches in the pedicles of
➢​ The vertebral arch, along with the body, adjacent vertebrae. These foramina are
protects the spinal cord. The vertebral arch where spinal nerves exit the spinal cord.
projects posteriorly from the body. ➢​ Movement and additional support of the
➢​ Together, the vertebral arch and the body vertebral column are made possible by the
form a complete bony circle enclosing the verteb ral process. Each vertebra has two
vertebral foramen, which is occupied by the superior and two inferior articular
spinal cord in a living person. processes, with the superior processes of
➢​ The vertebral foramina of adjacent vertebrae one vertebra articulating with the inferior
combine to form the vertebral canal, which processes of the next superior vertebra.
contains the entire spinal cord and cauda Overlap of these processes increases the
equina. rigidity of the vertebral column.
➢​ The region of overlap and articulation
The vertebral arch is divided into left and right between the superior and inferior articular
halves, and each half has two parts: processes creates a smooth articular facet
(FAS-et; little face) on each articular process.
(1) the pedicle (PED-ih-kul; foot), which is attached to In a living person, vertebrae are separated
the body, and by intervertebral disks.

(2) the lamina (LAM-i-na; thin plate), which forms the REGIONAL DIFFERENCES IN VERTEBRAE
posterior portion of the vertebral foramen.
➢​ Each of the five regions of the vertebral
➢​ A transverse process extends laterally from column has uniquely shaped vertebrae that
each side of the arch between the lamina contribute to the particular function of each
and the pedicle, and a single spinous region of the vertebral column. As one region
process lies at the junction between the two gives way to another region, the
laminae The spinous processes can be seen characteristics between regional vertebrae
and felt as a series of rounded projections become less distinct.
down the midline of the back. Much vertebral
movement is accomplished by the
contraction of the skeletal muscles attached
to the transverse and spinous processes.

47
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

first 10 possess articular facets for the ribs.

The bodies have articular facets for the
CERVICAL VERTEBRAE heads of the ribs.

➔​ Cervical vertebrae are located in the LUMBAR VERTEBRAE

vertebral column region with the greatest
range of motion. These vertebrae support ➔​ The lumbar vertebrae support the majority
and move the head. However, because the of the body's bodies and heavy, rectangular
cervical vertebrae support only the weight of transverse and spinous processes. The
the head, they have very small bodies, thickness of the bodies makes fractures of
making dislocations and fractures in this the lumbar vertebrae less common, but
area of the vertebral column more common ruptured intervertebral disks are more
than in other regions. Cervical vertebrae are common in this area than in other regions of
also unique in that the transverse processes the vertebral column. The fifth lumbar
have transverse foramina through which vertebra or first coccygeal vertebra may
the vertebral arteries extend toward the become fused into the sacrum. Conversely,
head. the first sacral vertebra may fail to fuse with
the rest of the sacrum, resulting in six lumbar
The first two cervical vertebrae include vertebrae.

(1)​ the atlas (C1) and SACRUM

(2)​ the axis (C2).
➔​ The atlas and axis are heftier than the other ➔​ The sacrum is located between the two hip
five cervical vertebrae because they directly bones. The sacrum is formed from five
support the weight of the head and control its separate sacral vertebrae that begin to fuse
movements. The atlas derives its name from during adolescence, resulting in a solid bony
the Greek mythology character, Atlas, who plate by the mid-20s. The sacrum is part of
held the world (the head) on his shoulders. the pelvic girdle, which provides stable
The atlas does not have a body or a spinous support for our lower limbs. The pelvic girdle
process. The connection between the will be described more fully with the
occipital condyles and the superior articular appendicular skeleton.
facets forms a joint that allows you to nod
your head "yes"
➔​ The axis is so named because the joint
between the atlas and the axis allows for a
significant amount of head rotation. Shaking
your head "no" occurs when the atlas rotates
on the axis. This rotation occurs around the
highly modified superior process of the axis,
called the dens.

THORACIC VERTEBRAE

➔​ In contrast to the large degree of motion of

the cervical region, the thoracic region is the ➔​ The former spinous processes, now partially
least moveable of the five regions due to the fused, form a ridge called the median sacral
articulation of the thoracic vertebrae with the crest. At the inferior surface of the comm,
ribs. The thoracic vertebrae support the there is an opening, called the sacral hiatus
thoracic cage, which houses and protects (high-AYE- to gap) which is the termination
the heart and lungs). These vertebrae have of the vertebral canal. The sacral is a
the longest spinous processes, which project common anesthesia injection site.
inferiorly. In addition, their transverse ➔​ The first sacral vertebra bulges anteriorly
processes are longer than others, and the into the pelvic cavity. This bulge is called the

48
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

sacral promontory. It is used as a clinical attach to the sternum. The costal cartilage is
landmark for separation of the abdominal flexible and permits the thoracic cage to
cavity the pelvic cavity. expand during respiration.

COCCYX STERNUM

➔​ The coccyx (KOK-siks) is commonly ➔​ The sternum, or breastbone, has been

referred to as the tailbone. It is the terminal described as sword-shaped and
portion of the vertebral column. It can be
formed from three to five semifused has three parts:
vertebrae. In males, the coccyx may project
anteriorly, but in females, it often projects (1)​ The manubrium (mah-NOO-bree-um;
more inferiorly. handle) is the "sword handle":
➔​ These vertebrae are much smaller than the (2)​ the body, or gladiolus (sword), is the "blade";
other vertebrae and have neither vertebral and
foramina nor well-developed processes. The (3)​ the xiphoid (ZI-foyd; sword) process is the
coccyx is easily broken when a person falls "sword tip."
by sitting down hard on a solid surface. ➔​ The superior margin of the manubrium has a
jugular (suprasternal) notch in the midline,
which can be easily felt at the anterior base
of the neck.
THORACIC CAGE ➔​ The first rib and the clavicle articulate with
the manubrium. The point at which the
➢​ The thoracic cage, commonly called the rib manubrium joins the body of the sternum
cage, protects the heart and lungs within the can be felt as a prominence on the anterior
thorax. It forms a semirigid chamber, which thorax called the sternal angle. The
can increase and decrease in volume during cartilage of the second rib attaches to the
respiration. sternum at the sternal angle, the third
through seventh ribs attach to the body of
It consists of the sternum, and no ribs attach to the
xiphoid process.
(1)​ the thoracic vertebrae,
(2)​ the ribs with their associated costal no)
cartilages, and
(3)​ the sternum

RIBS AND COSTAL CARTILAGES

➢​ There are 12 pairs of ribs. Ribs are

classified as either true ribs or false ribs.
Ribs 1-7 are called true ribs. True ribs
attach directly through costal cartilage to
the sternum.
➢​ Ribs 8-12 are called false ribs because they
do not attach directly to the sternum. The
false ribs consist of two groups.
➢​ Ribs 8-10 are joined by a common cartilage Figure 6.23 Thoracic Cage
to the costal cartilage of rib 7, which in turn is
attached to the sternum.
➢​ Two of the false ribs, ribs 11 and 12, are also
called floating ribs because they do not

49
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

6.11 APPENDICULAR SKELETON upper limb away from the body, it facilitates
the limb's mobility.
➢​ The appendicular skeleton allows movement
of and supports our weight in an upright ARMS: HUMERUS
position
➢​ The arm, the part of the upper limb from the
shoulder to the elbow, contains only one
PECTORAL GIRDLE AND UPPER LIMB bone, the humerus. The humeral head
articulates with the glenoid cavity of the
➔​ Picture a baseball pitcher winding up to scapula.
throw a fastball and you have a great
demonstration of the mobility of your upper
limb. This mobility is possible because
muscles atta the upper limb and its girdle
rather loosely to the rest of the be Thus, the
upper limb is capable of a wide range of
movements including throwing, lifting,
grasping, pulling, and touching.

PECTORAL GIRDLE: SCAPULA AND CLAVICLE

➔​ The pectoral (PEK-toh-ral) girdle consists

of two pairs of bones that attach each of the
upper limbs to the body. Each pair is
composed of a scapula (SKAP-you-lah),
commonly known as the shoulder blade
(figure 6.25), and a clavicle (KLAV-i-kul),
commonly known as the collarbone. The
scapula is a flat, triangular bone that can
easily be seen and felt in a living person.
➔​ At the tip of the shoulder, there is the large
acromion (ah- CROH-mee-on; shoulder tip)
process of the scapula. The scapular spine
extends from the acromion process across
the posterior surface of the scapula. The
smaller coracoid (crow's beak) process
provides attachments for some shoulder and
arm muscles. A glenoid (gLEE-noyd, ➔​ The anatomical neck, immediately distal to
gLEN-oyd) cavity, located in the superior the head, is almost nonexistent; thus, a
lateral portion of the bone, articulates with surgical neck has been designated. The
the head of the humerus. surgical neck is so named because it is a
➔​ The clavicle is a long bone with a slight common fracture site that often requires
sigmoid (S-shaped) curve. It is easily seen surgical repair. Removal of the humeral head
and felt in the living human. It articulates with due to disease or injury occurs down to the
the scapula and the sternum. level of the surgical neck.
➔​ On the lateral end, it articulates with the
acromion process. On the medial end, it The proximal end of the humerus has two
articulates with the manubrium of the prominent landmarks, both sites of muscle
sternum. attachment:
➔​ These are the only bony connections
between the pectoral girdle and the axial (1)​ Laterally, it is the greater tubercle.
skeleton. Because the clavicle holds the (2)​ Anteriorly, it is the lesser tubercle.

50
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

➢​ The ulna is medial, the same side as the little

finger, and the radius is lateral, the same
➔​ The diaphysis of the humerus has a side as the thumb. Recall from apter 1 that
noticeable lateral landmark. The deltoid the body is in anatomical position when the
tuberosity is the site of attachment of the palm of hand faces anteriorly. The ulna and
deltoid muscle. The distal end of the radius articulate with the nerus at the elbow
humerus has several unique features where joint. There are several unique features of
it articulates with the two forearm bones at these two bones at the site of attachment to
the elbow. the humerus.
➔​ Laterally, the humerus articulates with the
radius. This location is called the capitulum ULNA
(kah-PIT-you-lum; head-shaped). Medially,
the humerus articulates with the ulna. This ➢​ The portion of the ulna that articulates with
location is called the trochlea (TROK-lee-ah; the humerus is the C-shaped trochlear
spool). Forearm muscles attach to the notch. The trochlear notch rotates over the
humerus just superior to the capitulum and trochlea of the humerus when bending the
trochlea. The attachment sites are the elbow. The anterior surface of the proximal
medial epicondyle and the lateral end of the ulna has a process called the
epicondyle. coronoid process. The coronoid process
➔​ Posteriorly, on the distal end, is a large fossa inserts into a foss the humerus when the
called the olecranon (oh-LEK-rah-non; elbow is bent. The posterior surface of
elbow) fossa, which accommodates a proximal end of the ulna has a much larger
portion of the ulna that is easily felt as the process called the olecranon process. The
point of the elbow. olecranon process inserts into the olecranon
fossa of the humerus when the elbow is
straightened.
➔​ On the distal end of the ulna, on the medial
side, is the head of the ulna. The head of the
ulna articulates with both the radius and the
wrist bones. On the distal end of the ulna, on
the lateral side, there is a small process
called the styloid (STY-loyd: stylus)
process. Ligaments of the wrist attach to the
styloid process.

RADIUS

➢​ The portion of the radius that articulates with

the humerus is the head. The head of the
radius rotates over the capitulum of the
humerus when bending the elbow. Just
inferior to the radial head on the medial side
is the radial tuberosity, the site of
attachment for the biceps brachii muscle of
FOREARM: ULNA AND RADIUS
the arm.

The forearm has two bones:

(1)​ The ulna

➔​ The distal end of the radius also has a
(2)​ The radius
styloid process. The styloid process of the
radius is lateral and also serves as an
attachment location for wrist ligaments.

51
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

WRIST: CARPALS ➔​ The metacarpal bones form a curve so that,

in the resting position, the palm of the hand
➢​ The wrist is a relatively short region between is concave. The distal ends of the
the forearm and the hand; it is composed of metacarpal bones help form the knuckles of
eight carpal (KAR-pal) bones arranged into the hand. The spaces between the
two rows of four each. metacarpal bones are occupied by soft
tissue.
The proximal row of carpal bones, lateral to
medial, includes

(1)​ the scaphoid (SKAF-oid), which is

boat-shaped;
(2)​ the lunate (LOO-nayt), which is
moon-shaped;
(3)​ the three-cornered triquetrum (try-
KWEE-trum, try-KWET-rum); and
(4)​ the pea-shaped pisiform (PIS-i-form), which
is located on the palmar surface of the
triquetrum.

The distal row of carpal bones, from medial to

lateral, includes

(1)​ the hamate (HA-meyt), which has a hooked

process on its palmar side, called the hook
of the hamate;
(2)​ the head-shaped capitate (KAP-i-tate);
(3)​ the trapezoid (TRAP- e-zoid), which is
named for its resemblance to a four-sided
geometric form with two parallel sides; and
(4)​ the trapezium (tra-PEE-zee-um), which is
named after a four-sided geometric form with
no two sides parallel.
➔​ A number of mnemonics have been
developed to help students remember the Figure 6.27 Right Ulna and Radius
carpal bones. The following one represents
them in order from lateral to medial for the ➔​ The five digits of each hand include one
proximal row (top) and from medial to lateral thumb (pollex) and four fingers. Each digit
(by the thumb) for the distal row: Straight consists of small long bones called
Line To Pinky, Here Comes The Thumb-that phalanges (fah-LAN-jeez; sing. phalanx).
is, Scaphoid, Lunate, Triquetrum, Pisiform, The thumb has two phalanges, called
Hamate, Capitate, Trapezoid, and proximal and distal. Each finger has three
Trapezium. phalanges, designated proximal, middle, and
distal.

HAND: METACARPALS AND PHALANGES

PELVIC GIRDLE AND LOWER LIMB
➢​ Five metacarpal bones are attached to the
carpal bones and make up the central
➢​ The lower limbs support the body and are
portion of the hand. They are numbered one
essential for normal standing, walking, and
to five, starting with the most lateral
running. The general pattern of the lower
metacarpal bone at the base of the thumb.
limb is very similar to that of the upper limb,

52
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

except that the pelvic girdle is attached much

more firmly to the body than the pectoral
girdle is and the bones in general are thicker, ➔​ The three individual bones converge near
heavier, and longer than those of the upper the center of the hip socket, called the
limb. These structures reflect the function of acetabulum (as-eh-TAB-you-lum; vinegar
the lower limb in supporting and moving the cup). The lower limbs articulate with the
body. pelvic girdle in the acetabulum.
➔​ The articular surface of the acetabulum is
crescent-shaped and occupies only the
superior and lateral aspects of the fossa.
The pelvic girdle serves as the place of
attachment for the lower limbs, supports the
weight of the body, and protects internal
organs.
➔​ Because the pelvic girdle is a complete bony
ring, it provides more stable support but less
mobility than the incomplete ring of the
pectoral girdle. In addition, the pelvis in a
woman protects a developing fetus and
forms a passageway through which the fetus
passes during delivery.

PELVIC GIRDLE: HIP BONES AND SACRUM

HIP BONES

➢​ The pelvic girdle is formed by the two hip

bones (coxal bones) and the sacrum. The
hip bones join each other anteriorly and
connect with the sacrum posteriorly forming
a complete circle of bone. The pelvis
(PEL-vis; basin) includes the pelvic girdle
and the coccyx.

Each hip bone is a large bony plate formed from

the fusion of three separate bones:

(1)​ the ilium (IL-ee-um; groin), ILLIUM

(2)​ the ischium (IS-kee-um; hip), and
(3)​ the pubis (PYOO-bis; genital hair). ➢​ The largest of the three hip bones is the
ilium. The iliac crest forms the most

53
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

superior border of the ilium. The crest ends consistent with the need to allow the fetus to
anteriorly as the anterior superior iliac pass through these openings in the female
spine and posteriorly as the posterior pelvis during childbirth. A wide, circular
superior iliac spine. The crest and anterior pelvic inlet and e a pelvic outlet with widely
spine can be felt and even seen in thin spaced ischial spines can facilitate tio
individuals. The greater sciatic (sigh-AT-ik) delivery of the newborn.
notch is on the posterior side of the lli ilium,
just inferior to the posterior inferior iliac
spine. The sciatic nerve passes through the
greater sciatic notch. The auricular surface
of the ilium joins the sacrum to form the
sacroiliac joint. The medial side of the ilium
consists of a large is t depression called the
iliac fossa.

ISCHIUM

➢​ Of the two inferior hip bones, he ischium Is

more posterior than the pubis. The ischium
has a thick ischial (IS-kee-ul) tuberosity.
➢​ Posterior thigh muscles attach to the ischial
tuberosity and it's the portion of the pelvis on
which a person sits. The ischium also has a
posterior ischial spine, a site of ligament
attachment.

PUBIS

➢​ The pubis forms the anterior portion of the

pelvic girdle. The two pubic bones are joined
by the pubic symphysis (SIM-fi-sis; joined),
a thick pad of fibrocartilage.
➢​ At the point of fusion with the ischium, the
two bones surround the noticeable
obturator (OB-tour-ate-or; closed up)
foramen. However, in a living person, only a
few nerves and blood vessels pass through;
it is otherwise closed by a ligament.
➢​ The pelvis is subdivided into a true pelvis
and a false pelvis. The opening to the true
pelvis is the pelvic inlet, and the inferior
opening of the true pelvis is the pelvic
outlet. The false pelvis is formed by muscle
overlying bone of the true pelvis.

Comparison of the Male Pelvis and the Female

Pelvis

-​ The male pelvis is usually more massive

than the female pelvis as a result of the
greater weight and size of the male body.
The female pelvis is broader and has a
larger, more rounded pelvic inlet and outlet,

54
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

THIGH: FEMUR

➢​ The thigh, like the arm, contains a single Figure 6.33 Bones of the Thigh
bone, the femur. The femur has a
prominent, rounded head, where it ➢​ The patella, or kneecap, is a large sesamoid
articulates with the acetabulum. The femur bone located within the tendon of the
also has a well-defined neck. Both the head quadriceps femoris muscle group, which is
and neck of the femur are located at an the major muscle group of the anterior thigh
oblique angle to its shaft. The proximal shaft (figure 6.33c). The patella articulates with the
exhibits two projections: a greater patellar groove of the femur to create a
trochanter (TROH-kan-ter; runner) lateral to smooth articular surface over the anterior
the neck and a smaller, lesser trochanter distal end of the femur. The patella holds the
inferior and posterior to the neck. tendon away from the distal end of the
➢​ Both trochanters are attachment sites for femur.
muscles that fasten the hip to the thigh. The
greater trochanter and its attached muscles LEG: TIBIA AND FIBULA
form a bulge that can be seen as the widest
part of the hips. ➢​ The leg is the part of the lower limb between
➢​ The femur articulates with the tibia to form the knee and the ankle.
the knee. There are two smooth rounded
projections that rotate on the superior Like the forearm, it consists of two bones:
surface of the tibia when we bend our knee.
(1)​ the medial tibia (TIB-ee-ah), or shinbone,
and
(2)​ the lateral fibula (FIB- you-lah; figure 6.34).
The tibia is the larger of the two and is the
major weight-bearing bone of the leg.

➢​ The rounded condyles of the femur rest on

flat condyles on the proximal end of the tibia.
Just distal to the condyles of the tibia, on its
anterior surface, is the easily felt tibial
tuberosity.
➢​ The tibial tuberosity is the point of
attachment for the quadriceps femoris
muscle group. The fibula does not articulate

55
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

with the femur, but its head articulates with (4-6) the medial, intermediate, and lateral
the proximal end of the tibia. cuneiforms (KYOO-nee-ih-forms), and

(7) the cuboid (KYOO-boyd)

ANKLE ➔​ A mnemonic used for the tarsal bones is

Tiger Cub Needs MILC (Talus, Calcaneus,
➢​ The ankle consists of the distal ends of the Navicular, Medial cuneiform, Intermediate
tibia and fibula forming a partial socket that cuneiform, Lateral cuneiform, and Cuboid).
articulates with a bone of the foot (the talus). ➔​ The metatarsal bones and phalanges of
A prominence can be seen on each side of the foot are arranged in a manner very
the ankle. These are the medial malleolus similar to that of the metacarpal bones and
of the distal tibia and the lateral malleolus phalanges of the hand, with the great toe
of the distal fibula. (hallux) comparable to the thumb. Small
sesamoid bones often form in the tendons of
muscles attached to the great toe. The ball
of the foot is the junction between the
metatarsal bones and the phalanges.
➔​ There are three primary arches in the foot
formed by the positions of the tarsal bones
and metatarsal bones and held in place by
ligaments. Two longitudinal arches extend
from the heel to the ball of the foot, and a
transverse arch extends across the foot.
The transverse arch is located at the
connection between the five metatarsals, the
three cuneiforms, and the cuboid.

The arches serve as an adjustable lever to assist

in the two main functions of the foot:

(1)​ to support the body in its upright position

both while standing and in forward
movement during walking and
(2)​ to push the body forward during walking and
to absorb shock when the foot contacts the
ground.
➔​ The arches function similarly to the springs
of a car, allowing the foot to give and spring
back.

FOOT: TARSALS, METATARSALS, AND

PHALANGES
6.12 JOINTS
➢​ There are seven tarsal (TAR-sahl; foot)
➢​ Joints, or articulations, are commonly
bones.
named according to the bones or portions of
bones that join together; for example, the
The tarsal bones include:
temporomandibular joint is between the
temporal bone and the mandible. Some
(1)​ the talus (TAY-lus; ankle),
joints are given the Greek or Latin equivalent
(2)​ the calcaneus (kal-KAY-nee-us; heel),
of the common name, such as cubital
(3)​ the navicular (nah-VIK- you-lar),

56
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

(KYOO-bi-tal; cubit, elbow or forearm) joint ➢​ Fibrous joints are the articulating surfaces
for the elbow joint. of two bones united by fibrous connective
➢​ Joints are classified structurally as fibrous, tissue. They have no joint cavity and exhibit
cartilaginous, or synovial, according to the little or no movement.
major connective tissue type that binds the
bones together and whether a fluid-filled joint Joints in this group are further subdivided on the
capsule is present. Joints can also be basis of structure as
classified in functional categories according
to their degree of motion as synarthroses (1)​ sutures,
(nonmovable joints), amphiarthroses (slightly (2)​ syndesmoses, or
movable joints), or diarthroses (freely (3)​ gomphoses.
movable joints).
➢​ In general, fibrous and cartilaginous joints SUTURES
have little or no movement, while synovial
joints have considerable movement. ➔​ Sutures (SOO-churs) are fibrous joints
Because this functional classification is between the bones of the skull. In a
somewhat limited, our discussions are based newborn, some parts of the sutures are quite
on the more precise structural classification wide and are called fontanels
scheme. (FON-tah-nels), or soft spots. They allow
flexibility in the skull during the birth process,
as well as growth of the head after birth.

SYNDESMOSES

➔​ Syndesmoses (SIN-des-MOH-seez) are

fibrous joints in which the bones are
separated by some distance and held
together by ligaments. An example is the
fibrous membrane connecting most of the
distal parts of the radius and ulna.

GOMPHOSES

➔​ Gomphoses (gom-FOH-seez) consist of

pegs fitted into sockets and held in place by
ligaments. The joint between a tooth and its
socket is a gomphosis.

CARTILAGINOUS JOINTS

➢​ Cartilaginous joints hold two bones

together by a pad of cartilage. Like fibrous
joints. these joints exhibit little or no
movement.

Cartilaginous joints are subdivided on the basis of the

FIBROUS JOINTS type of cartilage as

57
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

(1)​ synchondroses, which contain hyaline ➔​ The articular surfaces of bones within
cartilage, and synovial joints are covered with a thin layer
(2)​ symphyses, which contain fibrocartilage of hyaline cartilage called articular
cartilage. The articular cartilage provides a
smooth surface where the bones meet.
➔​ In some synovial joints, a flat pad of
SYNOVIAL JOINTS fibrocartilage called a meniscus
(meh-NIS-kus; pl. menisci, crescent-shaped)
➢​ Synovial (sih-NOH-vee-al) joints contain is present. A meniscus is a type of articular
synovial fluid and allow considerable disk that only partially spans the synovial
movement between articulating bones. cavity such that there is an opening in the
➔​ These joints are anatomically more complex center. Joints with menisci include the knee
than fibrous and cartilaginous joints. Most and wrist. The meniscus helps adjust the
joints that unite the bones of the connection between articulating bones,
appendicular skeleton are synovial joints, which improves joint stability and reduces
reflecting the far greater mobility of the wear on the articular cartilage.
appendicular skeleton compared with the ➢​ The space around the articular surfaces of
axial skeleton. the bones in a synovial joint is called the
joint cavity. The joint cavity is filled with
synovial fluid and surrounded by a joint
capsule. The joint capsule helps hold the
bones together while still allowing for
movement. The joint capsule consists of two
layers: an outer fibrous capsule and an inner
synovial membrane.
➢​ The fibrous capsule is the outer layer of the
joint capsule. It consists of dense irregular
connective tissue and is continuous with the
fibrous layer of the periosteum that covers
the bones united at the joint. Portions of the
fibrous capsule may thicken, and the
collagen fibers may become regularly
arranged to form ligaments. In addition,
ligaments and tendons may be present
outside the fibrous capsule, thereby
contributing to the strength and stability of
the joint while limiting movement in some
directions.
➢​ The synovial membrane is the inner layer
of the joint capsule. It lines the joint cavity,
except over the articular cartilage and
articular disks, and is a thin, delicate
membrane The membrane produces
synovial fluid, a viscous lubricating film that
covers the surfaces of a joint. Synovial fluid
is a complex mixture of polysaccharides,
proteins, lipids, and cells derived from serum
(blood fluid) filtrate and secretions from the
synovial cells. The major polysaccharide,
hyaluronic acid, provides much of the
slippery consistency and lubricating qualities
of synovial fluid.

58
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

➢​ In certain synovial joints, such as the Examples are the articular processes
shoulder and knee, the synovial membrane between vertebrae.
extends as a pocket, or sac called a bursa
(BURR-sah; pocket; pl. bursae, BURR-see).
Bursae contain synovial fluid and provide a
cushion between structures that would
otherwise rub against each other, such as
tendons rubbing on bones or other tendons.
Other bursae extend along tendons for some
distance, forming tendon sheaths. Bursitis
(ber-SIGH- tis), inflammation of a bursa, may
cause considerable pain around the joint and
restrict movement.
➢​ Articular cartilage receives nourishment from
blood vessels that are at the peripheral
margin of the cartilage but do not actually
penetrate the cartilage or enter the joint
cavity. Because the cartilage does not
contain blood vessels, nutrients, and oxygen
must diffuse from the surrounding vessels
into the cartilage. Nerves do not enter the
cartilage or joint cavity.

➔​ A saddle joint consists of two

TYPES OF SYNOVIAL JOINTS saddle-shaped articulating surfaces oriented
at right angles to each other so that their
●​ Synovial joints are classified according to the complementary surfaces articulate Saddle
shape of the adjoining articular surfaces. joints are biaxial joints. The carpometacarpal
joint of the thumb is an example.
The six types of synovial joints are ➔​ A hinge joint is a uniaxial joint in which a
convex cylinder in one bone is applied to a
(1)​ plane, corresponding concavity in the other bone.
(2)​ saddle, Examples include the elbow and knee joints.
(3)​ hinge, ➔​ A pivot joint is a uniaxial joint that restricts
(4)​ pivot. movement to rotation around a single axis. A
(5)​ ball-and-socket, and pivot joint consists of a relatively cylindrical
(6)​ ellipsoid bony process that rotates within a ring
composed partly of bone and partly of
ligament. The articulation between the head
of the radius and the proximal end of the
●​ Movements at synovial joints are described ulna is an example. The articulation between
as uniaxial, occurring around one axis; the dens, a process on the axis, and the
biaxial, occurring around two axes situated atlas is another example.
at right angles to each other; or multiaxial, ➔​ A ball-and-socket joint consists of a ball
occurring around several axes. (head) at the end of one bone and a socket
➔​ A plane joint, or gliding joint, consists of two in an adjacent bone into which a portion of
flat bone surfaces of about equal size the ball fits. This type of joint is multiaxial,
between which a slight gliding motion can allowing a wide range of movement in almost
occur. These joints are considered uniaxial any direction. Examples are the shoulder
because some rotation is also possible but is and hip joints.
limited by ligaments and adjacent bone. ➔​ An ellipsoid joint (condyloid joint) is a
modified ball-and-socket joint. The articular

59
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

surfaces are ellipsoid in shape, rather than and bringing the legs back together is
spherical as in regular ball-and-socket joints. adduction.
Ellipsoid joints are biaxial because the shape ➔​ Pronation (proh-NAY-shun) and supination
of the joint limits its range of movement (soo-pih-NAY- shun) refer to the unique
almost to a hinge motion in two axes and rotation of the forearm. They are best
restricts rotation. The atlantooccipital joint of demonstrated with the elbow flexed at a
the neck is an example. 90-degree angle. When the elbow is flexed,
pronation is rotation of the forearm so that
the palm is down, and supination is rotation
of the forearm so that the palm faces up.
TYPES OF MOVEMENT ➔​ Eversion (ee-VER-shun) is turning the foot
so that the plantar surface (bottom of the
●​ The types of movement occurring at a given foot) faces laterally; inversion (in-VER-
joint are related to the structure of that joint. shun) is turning the foot so that the plantar
Some joints are limited to only one type of surface faces medially.
movement, whereas others permit ➔​ Rotation is the turning of a structure around
movement in several directions. All the its long axis, as in shaking the head "no."
movements are described relative to the Rotation of the arm can best be
anatomical position. Because most demonstrated with the elbow flexed so that
movements are accompanied by movements rotation is not confused with supination and
in the opposite direction, they are often pronation of the forearm. With the elbow
illustrated in pairs. flexed, medial rotation of the arm brings the
●​ Flexion and extension are common opposing forearm against the anterior surface of the
movements. Flexion is a bending movement abdomen, and lateral rotation moves it away
that decreases the angle of the joint to bring from the body.
the articulating bones closer together. ➔​ Circumduction (ser-kum-DUK-shun) occurs
Extension is a straightening movement that at freely movable joints, such as the
increases the angle of the joint to extend the shoulder. In circumduction, the arm moves
articulating bones. These bending and so that it traces a cone where the shoulder
extending movements can easily be seen at joint is at the cone's apex.
the elbow and knee joints. Hyperextension -​ In addition to the movements
is usually defined as extension of a joint pictured, several other movement
beyond 180 degrees. Hyperextension can be types have been identified:
a normal movement, such as looking up at ●​ Protraction (proh-TRAK-shun) is a
the stars, but it can also result in injury. For movement in which a structure,
example, when a person attempts to break a such as the mandible, glides
fall by putting out a hand, the force of the fall anteriorly.
can result in hyperextension of the wrist, ●​ In retraction (rec-TRAK-shun), the
resulting in a sprained joint or broken bone. structure glides posteriorly.
●​ There are special cases of flexion when ●​ Elevation is movement of a
describing the movement of the foot. structure in a superior direction.
Movement of the foot toward the plantar Closing the mouth involves
surface, as when standing on the toes, is elevation of the mandible.
commonly called plantar flexion; movement ●​ Depression is a movement of a
of the foot toward the shin, as when walking structure in an inferior.
on the heels, is called dorsiflexion. ●​ direction. Opening the mouth
➔​ Abduction (ab-DUK-shun; to take away) is involves depression of the
movement away from the median or mandible.
midsagittal plane; adduction (to bring ●​ Excursion is movement of a
together) is movement toward the median structure to one side, as in moving
plane. Moving the legs away from the the mandible from side to side.
midline of the body, as in the outward ●​ Opposition is a movement unique
movement of "jumping jacks," is abduction, to the thumb and little finger. It

60
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

occurs when the tips of the thumb results. A separation exists when the bones
and little finger are brought toward remain apart after injury to a joint. A
each other across the palm of the dislocation is when the end of one bone is
hand. The thumb can also oppose pulled out of the socket in a ball-and-socket,
the other digits. ellipsoid, or pivot joint. Most dislocations
●​ Reposition returns the digits to the result in stretching of the joint capsule. Once
anatomical position. the joint capsule has been stretched by a
dislocation, the joint may be predisposed to
TABLE 6.4 Synovial Joints future dislocations. Some individuals have
hereditary "loose" joints and are more likely
to experience a dislocation.

MEDICAL TERMINOLOGIES

itis - inflammation

Hemo - blood

Osteo - bone

Chondro - cartilage

Arthro - joint

Sinusitis - inflammation in sinuses

Hepato - liver
➔​ Most movements occur in the course of
normal activities When the bones of a joint
are forcefully pulled apart and the ligaments
around the joint are pulled or torn, a sprain

61
ANATOMY AND PHYSIOLOGY Transcribed by: KIMKIM
MIDTERM | 1ST SEMESTER, QUARTER 1 | S.Y. 2024-2025

62