ANAPHY LEC ENDTERM compiled by Sean Gegato UPPER RESPIRATORY

Nose- Nasal Cavity

Week 12: RESPIRATORY SYSTEM
➢ During breathing, air enters the cavity by passing
The major function of the respiratory system is to
through the nostrils or nares.
supply the body with oxygen and dispose of carbon
➢ The nasal cavity is divided by a midline nasal
dioxide.
septum, formed anteriorly by the septa) cartilage
➢ To accomplish this function, at least four
and posteriorly by the vomer bone and
processes, collectively called respiration, must
perpendicular plate of the ethmoid bone
happen:
➢ The actual use of oxygen and production of
carbon dioxide by tissue cells, known as cellular
respiration, is the cornerstone of all energy-
producing chemical reactions in the body
➢ The actual use of oxygen and production of
carbon dioxide by tissue cells, known as cellular
respiration, is the cornerstone of all energy-
producing chemical reactions in the body

NOSE
• The roof of the nasal cavity is formed by the
ethmoid and sphenoid bones of the skull.
• The floor is formed by the palate, which
separates the nasal cavity from the oral cavity
below:
• Anteriorly, where the palate is supported by the
palatine bones and processes of the maxillary
bones, it is called the hard palate.
• The unsupported posterior portion is the
muscular soft palate.

Functional Anatomy:
➢ Upper respiratory - Nose, Nasal sinuses, Larynx
➢ Lower respiratory - Larynx Trachea, Airways,
Alveoli
Arterial Supply
PHARYNX
Kiesselbach plexus – most common site of epistaxis
• The funnel-shaped pharynx connects the nasal
cavity and mouth superiorly to the larynx and
esophagus inferiorly.
• Commonly called the throat.

Paranasal Sinuses
• The nasal cavity is surrounded by a ring of
paranasal sinuses
• They are located in the frontal, sphenoid,
ethmoid, and maxillary bones.
• Function: lighten the skull, and they may help
warm and moisten the air. The mucus they
produce ultimately flows into the nasal cavity,
and the suctioning effect created by nose blowing
helps drain the sinuses.
 LARYNX
The larynx is located in the anterior compartment of
the neck, suspended from the hyoid bone, and
spanning between C3 and C6.
It is a component of the respiratory tract and has
important functions:
• Provide a patent (open) airway
• Act as a switching mechanism to route air and
• The NASOPHARYNX food into the proper channels
• The nasopharynx is posterior to the nasal cavity, • Voice production [because it houses the vocal
inferior to the sphenoid bone, and superior to the folds (vocal cords)]
level of the soft palate.
• During swallowing, the soft palate and its
pendulous uvula move superiorly, an action that
closes off the nasopharynx and prevents food
from entering the nasal cavity.

ANATOMY: Supraglottis, Epiglottis, Subglottis

The OROPHARYNX
• The oropharynx lies posterior to the oral cavity
• Because the oropharynx extends inferiorly from
the level of the soft palate to the epiglottis, both
swallowed food and inhaled air pass through it.
• As the nasopharynx blends into the oropharynx,
the epithelium changes from pseudostratified
columnar to a more protective stratified
squamous epithelium.

The LARYNGOPHARYNX
• serves as a passageway for food and air and is
lined with a stratified squamous epithelium
• The laryngopharynx is continuous with the
esophagus posteriorly.
 continually propel debris-laden mucus toward
the pharynx.

Compartments of the laryngeal lumen

BRONCHI
➢ The trachea divides to form the right and left
main (primary) bronchi.
➢ Once inside the lungs, each main bronchus
subdivides into lobar (secondary) bronchi- three
on the right and two on the left-each supplying
one lung lobe
➢ The lobar bronchi branch into third-order
segmental (tertiary) bronchi, which divide
repeatedly into smaller bronchi (fourth-order, fifth
order, etc.). Passages smaller than 1 mm in
diameter are called bronchioles ("little bronchi"),
and the tiniest of these, the terminal bronchioles,
are less than 0.5 mm in diameter.

Lower Respiratory
I. Trachea
II. Bronchi
III. Bronchioles

TRACHEA
➢ The trachea, or windpipe, descends from the
larynx through the neck and into the
mediastinum.
➢ Begins at neck, lower border of cricoid cartilage
(at level of 6th cervical vertebra)
➢ In thorax, trachea ends at the CARINA by dividing
into principle (main) bronchi (level of sternal
angle of louis)
➢ The mucosa has the same goblet cell-containing
pseudostratified epithelium that occurs
throughout most of the respiratory tract. Its cilia
 • Pleural tap – surgical puncture of the thoracic
wall into the pleural cavity for aspiration of fluid
- It is performed at or posterior to the
midaxillary line one or two intercostal spaces
below the fluid level but not below the 9th
intercostal space.
- IDEAL SITE is 7th, 8th or 9th intercostal space
- Needle should be inserted immediately
ABOVE the superior margin of a rib

The RESPIRATORY UNIT

➢ Defined by the presence of thin-walled air sacs
called alveoli, the respiratory zone begins as the
terminal bronchioles feed into respiratory
bronchioles within the lung.
➢ Protruding from these smallest bronchioles are
scattered alveoli.
➢ The respiratory bronchioles lead into winding
alveolar ducts, whose walls consist of diffusely
arranged rings of smooth muscle cells,
connective tissue fibers, and out-pocketing
alveoli.

Thoracentesis (ADVANCED TOPIC)

➢ Costal line of Pleural reflection (parietal
pleura) passes obliquely across the:
➢ 8th rib in MCL
10th rib in MAL
12th rib sides of vertebral column
➢ Lower margin of Lungs (visceral pleura) crosses
the:
➢ 6th rib in MCL
➢ 8th rib in MAL
➢ 10th rib sides of vertebral column

Oxygen Transport
➢ Gas exchange from the alveoli into the blood
uses PASSIVE/ SIMPLE DIFFUSION
➢ When the partial pressure of a gas is greater in
one area than in another area, there will be net
 diffusion from the high- pressure area toward the Major Processes during the digestive system activity
low-pressure area. [Link]
• is taking food into the digestive tract (eating).
2. Propulsion
• which moves food through the alimentary canal,
includes:
• swallowing, which is initiated voluntarily, and
peristalsis, an involuntary process.
• Peristalsis the major means of propulsion,
involves alternating waves of contraction and
relaxation of muscles in the organ walls
3. Mechanical breakdown
• increases the surface area of ingested food,
Week 13: The Digestive System
physically preparing it for digestion by enzymes.
• Mechanical processes include chewing, mixing
food with saliva by the tongue, churning food in
the stomach, and segmentation
• Segmentation mixes food with digestive juices
and makes absorption more efficient by
repeatedly moving different parts of the food
mass over the intestinal wall.
4. Digestion
• involves a series of steps in which enzymes
secreted into the lumen (cavity) of the alimentary
canal break down complex food molecules to
their chemical building blocks.
• That is, digestion is a catabolic process.
5. Absorption
• is the passage of digested end products (plus
vitamins, minerals, and water) from the lumen of
the GI tract through the mucosal cells
6. Defecation
• eliminates indigestible substances from the body
via the anus in the form of feces.
The Peritoneum • This localizes the infection, providing time for
➢ Most digestive system organs reside in the macrophages to prevent the inflammation from
abdominopelvic cavity. spreading.
KEYWORDS:
1. Peritoneum - the serous membrane that lines the Histology of the Alimentary tract
abdominal cavity and covers most abdominal organs. 1. MUCOSA
2. Mesentery – a double layer of peritoneum, fused • innermost layer
back-to-back • Has 3 sublayers: lining epithelium, lamina
• They provide routes for blood vessels, propria, muscularis mucosa
lymphatics, and nerves to reach the digestive • Lining epithelium:
viscera. • Mouth, esophagus, anus= stratified squamous
• They hold organs in place. • The rest of the digestive mucosa is lined with
• They store fat. simple columnar epithelium
3. Retroperitoneal – retro = behind; therefore, • Lamina propria:
retroperitoneal organs, are organs not inside the • underlies the epithelium, is a loose areolar
peritoneum but are behind it. connective tissues capillaries nourish the
Examples: epithelium and absorb digested nutrients.
• Most of the pancreas • Its isolated lymphoid follicles, part of MALT
• Duodenum (first part of the small intestines) (the mucosa- associated lymphoid tissue)
• Parts of the large intestines help defend us against bacteria and other
4. Intraperitoneal – inside the peritoneum. pathogens
Intraperitoneal organs are located inside the • Muscularis mucosae:
peritoneum • Scant layer of smooth muscle
• Ex: stomach • Produces local movement of the mucosae
• Enhances absorption and secretion
• Functions:
• Secrete mucus, digestive enzymes, and
hormones
• Absorb the end products of digestion into the
blood
• Protect against infectious disease

2. SUBMUCOSA
• external to the mucosa
• areolar connective tissue
• Contains a rich supply of blood and lymphatic
vessels, lymphoid follicles, and nerve fibers that
supply the surrounding tissues of the GI tract wall
• enable the stomach, for example, to regain its
normal shape after temporarily storing a large
meal.

3. MUSCULARIS EXTERNA
• responsible for segmentation and peristalsis.
• typically has an inner circular layer and an outer
longitudinal layer of smooth muscle cells
• In several places along the tract, the circular layer
thickens, forming sphincters that act as valves to
control food passage from one organ to the next
Peritonitis
and prevent backflow.
• Peritonitis is inflammation of the peritoneum.
• It can arise from a piercing abdominal wound, a
4. SEROSA
perforating ulcer that leaks stomach juices into
• outermost layer of the intraperitoneal organs
the peritoneal cavity, or poor sterile technique
• formed of areolar connective tissue covered with
during abdominal surgery.
mesothelium, a single layer of squamous
• However, most commonly it results from a burst
epithelial cells
appendix that sprays bacteria-containing feces
all over the peritoneum. In peritonitis, the
peritoneal coverings tend to stick together
around the infection site.
Histology

Functional Anatomy
The Mouth
• The mouth is also called the oral cavity, or buccal
cavity
• The walls of the mouth are lined with a thick The Teeth
stratified squamous epithelium • The teeth lie in sockets (alveoli) in the gum-
• The Palate - forming the roof of the mouth, has covered margin of the mandible and maxilla.
two distinct parts: the hard palate anteriorly and • Ordinarily by age 21, two sets of teeth, the
the soft palate posteriorly primary and permanent dentitions, have formed.
• The hard palate is underlain by the palatine • Dental caries, or cavities, result from bacterial
bones and the palatine processes of the action that gradually demineralizes enamel and
maxillae, underlying dentin.
• The soft palate is a mobile fold formed mostly • Decay begins when dental plaque (a film of sugar,
of skeletal muscle that rises reflexively to bacteria, and other mouth debris) adheres to the
close off the nasopharynx when we swallow. teeth.
• Projecting downward from the free edge of the
soft palate is the fingerlike uvula

The Tongue
• The mouth is also called the oral cavity, or buccal
cavity
• Regarding taste:

The Pharynx
• From the mouth, food passes posteriorly into the
oropharynx and then the laryngopharynx both
common passageways for food, fluids, and air.
(The nasopharynx has no digestive role.)
• The histology of the pharyngeal wall resembles
that of the oral cavity.
• The mucosa contains a friction-resistant • The wider and more superior area of the pyloric
stratified squamous epithelium well supplied part, the pyloric antrum narrows to form the
with mucus-producing glands. pyloric canal, which terminates at the pylorus.
The pylorus is continuous with the duodenum
The Esophagus through the pyloric sphincter or valve, which
• The esophagus is a muscular tube about 25 cm controls stomach emptying
(10 inches) long and is collapsed when not
involved in food propulsion
• It pierces the diaphragm at the esophageal hiatus
(at the level of T10) to enter the abdomen.
• It joins the stomach at the cardinal orifice within
the abdominal cavity. The cardinal orifice is
surrounded by the gastroesophageal or cardiac
sphincter , which is a physiological sphincter

The Stomach- Gland cells

DIGESTIVE PROCESS OF SWALLOWING

The Stomach
• The stomach lies in the upper left quadrant of the
peritoneal cavity, nearly hidden by the liver and
diaphragm.
• The small cardial part, or cardia surrounds the
cardial orifice through which food enters the
stomach from the esophagus.
• The fundus is the stomach's dome-shaped part,
tucked beneath the diaphragm, that bulges
superolaterally to the cardia.
• The body, or the midportion of the stomach, is
continuous inferiorly with the funnel-shaped
pyloric part
The Liver, Gallbladder and Pancreas • Bile is the major vehicle for excreting
(Accessory Organs) cholesterol from the body, and bile salts keep
the cholesterol dissolved within bile.
The Liver
• The ruddy, blood-rich liver is the largest gland in
the body
• Located under the diaphragm
• The hepatic artery proper and the hepatic portal
vein, which enter the liver at the porta hepatis
and the common hepatic duct, which runs
inferiorly from the liver, all travel through the
lesser omentum to reach their destinations.
• The gallbladder rests in a recess on the inferior
surface of the right liver lobe
• The liver is composed of sesame seed-sized
structural and functional units called liver
lobules.
• At each of the six corners of a lobule is a portal The Pancreas
triad, containing three basic structures: • The pancreas is important to the digestive
• A branch of the hepatic artery (supplying process because it produces enzymes that break
oxygen-rich arterial blood to the liver) down all categories of foodstuffs.
• A branch of the hepatic portal vein (carrying • The pancreas contains exocrine and endocrine
venous blood laden with nutrients from the parts.
digestive viscera) • The pancreatic enzymes include:
• A bile duct • Proteases (for proteins)
• Amylase (for starch)
• Lipases(for fats)
• Nucleases (for nucleic acids)

The Small Intestines

The Gallbladder
• The gallbladder is a thin-walled muscular sac
that may appear green when filled with bile.
• take note that bile itself is produced continuously
by the liver
• The gallbladder stores bile that is not
immediately needed for digestion and
concentrates it by absorbing some of its water
and ions.
The Duodenum • The large intestine frames the small intestine on
• The Duodenum curves around the head of the three sides and extends from the ileocecal valve
pancreas to the anus
• Widest and fixed part • Its major digestive functions are to absorb most
• Divisions: of the remaining water from indigestible food
• 1st part - superior residues, store the residues temporarily, and then
• 2nd part - descending; where the bile duct and eliminate them from the body as semisolid feces.
main pancreatic duct unite to form the • The large intestine exhibits three features not
hepatopancreatic ampulla which drain the seen elsewhere - teniae coli, haustra, and
pancreatic contents into the small intestines. epiploic appendages
• 3rd part - horizontal
• 4th part - ascending; duodenal flexure is held
in position by the suspensory muscle of the
duodenum: Ligament of Trietz

The Jejunum vs Ileum

Nutrition, Metabolism and Energy Balance

• Nutrients - A nutrient is a substance in food the
body uses to promote normal growth,
maintenance, and repair.

The Large Intestines - Major site of water absorption

Carbohydrates
• Carbohydrates are major constituents of
physiologic systems.
• They are organic compounds composed of
carbon, hydrogen, and oxygen [C(HO)], which,
 along with lipids and proteins, provide energy and Metabolism
contribute to the structure of organisms. • Many of the reactions that take place within cells
• Complex carbohydrates are digested into simple are oxidation reactions. Oxidation was originally
sugars, principally glucose, which are used defined as the combination of oxygen with other
primarily as energy sources or are stored as elements
glycogen • Essentially all oxidation of food fuels involves the
• The pancreas functions as both an endocrine step-by-step removal of pairs of hydrogen atoms
and an exocrine organ in the control of (with their electrons) from the substrate
carbohydrate metabolism. molecules, eventually leaving only carbon dioxide
• As an exocrine gland, it produces and secretes (C0 2).
amylase responsible for the breakdown of • Molecular oxygen (02) is the final electron
ingested complex carbohydrates. acceptor. It combines with the removed hydrogen
atoms at the very end of the process, to form
Lipids water (H20 ).
• Lipids are soluble in nonpolar organic solvents, • Whenever one substance loses electrons (is
such as chloroform and ether, but relatively oxidized), another substance gains them (is
insoluble in polar solvents such as water. reduced).
• Thus, cholesterol and triglycerides travel in • For this reason, oxidation and reduction are
plasma not as free-floating molecules but as part coupled reactions and we speak of oxidation-
of water-soluble complexes called lipoproteins. reduction (redox) reactions.
• Four major lipoprotein classes have been
identified: Fin.
• chylomicrons (CM)
• very-low-density lipoprotein (VLDL)
• low-density lipoprotein (LDL)
• high-density lipoprotein (HDL).

Proteins
• Proteins in eggs, milk, fish, and most meats are
complete proteins that meet all the body's amino
acid requirements for tissue maintenance and
growth

• Animal products contain the highest-quality

proteins, in other words, those with the greatest
amount and best ratios of essential amino acids
• In healthy adults the rate of protein synthesis
equals the rate of protein breakdown and loss, a
homeostatic state called nitrogen balance.
• The body is in nitrogen balance when the amount
of nitrogen ingested in proteins equals the
amount excreted in urine and feces.