ANATOMY &

PHYSIOLOGY BOOK
Basic information for entres exam

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ANATOMY &
PHYSIOLOGY BOOK
1. Skeleton system
2. Digestive system
3. Respiratory system
4. Vascular system
5. Cardiac system
6. Urinary system
7. Muscular system
8. Immune system
9. Genital system
10. Endocrine system
11. Exocrine system
12. Cellular system
13. Sensory system

Made by: - SADIK AZIZ

- IBRAHIM DAUD
- HAMZA DAUD

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APPENDICULAR SKELETON
- The bones of the appendicular skeleton make up the rest of the
skeleton, and are so called because they are appendages of the axial
skeleton. The appendicular skeleton includes the bones of the
shoulder girdle, the upper limbs, the pelvic girdle, and the lower
limbs. The appendicular skeleton is divided into six major regions:
Pectoral girdles (4 bones) - Left and right clavicle (2) and scapula (2).
Arms and forearms (6 bones) - Left and right humerus (2) (arm),
ulna (2) and radius (2) (forearm). Pelvis (2 bones) - Left and right hip
bone. Thigh 2 bone right and left femur , calf (4) right and left (tibia
and fibula)
- The carpal/ tarsal bones and the phalanges are smaller regions and
we will get to them later in this chapter.

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Pectoral gridle/ shoulder gridle
- The two bones of the shoulder, the clavicle and the scapula,
comprise the pectoral girdle.
- The clavicle, or collarbone, lies horizontally and is situated in the
superior part of the thorax anteriorly. It’s a long, thin bone that
curves outward at the middle of your body and curves inward on
the end where it goes to the shoulder. It’s easy to see and palpate in
most people.The clavicle articulates with the manubrium and with
the scapula, so it’s described as having two ends: the sternal end,
which attaches to the manubrium, and the acromial end, which
joins the scapula. The conoid tubercle is found on the bottom of the
acromial end of the clavicle.

- Situation: - between the thorax and neck -between

sternalmanubrium and acromion
- ORIENTATION The bigger end is medial Thes urface with a groove is
inferior The anterior border is concave laterally
- Clavicle presents – 2 faces - 2 borders - 2 ends

The scapula
- The scapula is easy to locate it is situated on the posterior superior
part of the thorax (the upper back); it’s the large bone that runs on
the surface of the 2nd and 7th ribs. It has a flat, triangle-shaped
body. The anterior surface of the body faces the ribs
- The posterior surface has a horizontal projection near the top called
the spine of the scapula that ends at the top of the shoulder at the

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 acromion. The spine divides the posterior surface of the scapula into
a supraspinous fossa and an infraspinous fossa.
- The glenoid cavity (socket for the humerus) is located at the upper
and lateral part of the scapula. The coracoid process is located just
above the glenoid cavity, and it projects forward and upward.

ANTERIOR SURFACE =costal surface -It is concave

- it present the subscapular fossa, this surface is in contact with the ribs

DORSAL SURFACE – presents the spine of scapulathis projection divides

the surface into
-supraspinous fossa; – the infraspinous fossa

BORDERS – the scapula has 3 borders

- the superior- with notch and coracoid process
- lateral border that is the side where you find the glenoid cavity
superiorly
- the medial border or vertebral border is the border near the
vertebral column like the name suggests

ANGELS – The scapula has 3 angels

- Superior angel is formed by the medial and the superior border
- Inferior angel this angel is formed by the lateral and medial borders
- Lateral angel this angel is formed by the glenoid cavity

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THE ARM
The humerus
The arm contains one bone, the humerus. The head is at the proximal end
of the humerus, which joins the shoulder girdle. Just below the head you
find the anatomic neck, which is a slightly narrower portion of the bone.
Greater and lesser tubercles are right below the anatomical neck and are
separated by the intertubercular sulcus (bicipital groove). The shaft, or
the longer middle portion of the humerus, joins the proximal part at the
surgical neck. The shaft has two important landmarks, the deltoid
tuberosity and the spiral groove.

ORIENTATION
- The head must be superior and the articular surface of the head is
medially intertubercular groove is situated anteriorly
THE BODY - it is rounded superiorly and trihedral in the lower part; the
body has 3 surfaces and 3 borders
Posterior surface - groove forradial nerve
Antero-lateral surface –deltoid tuberosity !!!
Antero-medial surface –nutrient foramina - intertuberculargroove
THE UPPER END = PROXIMAL EPIPHYS PRESENTS - head of the humerus
facing medially - anatomical neck dividing the head and the tuberosity of
the humerus –
the greater tuberosity situated more laterally - the lesser tuberosities
situated anteriorly
- intertubercular groove (bicipital groove) groove between the
tuberosities - surgical neck

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THE LOWER END = DISTAL EPIPHYS PRESENTS
- 2 Condyles one medial - and one lateral
- two epicondyles 2 epicondyles – one lateral and one medial
- capitulum of the humerus (for articulation with the head of the
radius)
- trochlea of the humerus (for articulation with ulna) - above the
trochlea there is coronoid fossa
- above the capitulum there is radial fossa
- olecranon fossa is situated on the posterior surface of the lower end
- 2 epicondyles– one lateral and one medial

THE FOREARM
The forearm contains two long bones, the radius and the ulna, forming
the radioulnar joint. The interosseous membrane connects these bones.
These bones are covered by muscles so that the hand and the wrist is
mobile. Ultimately, the forearm is covered by skin the

RADIUS
- It is situated in the lateral side of the forearm ( tumb side) Its upper
end is small and forms the part of the elbow joint. Its lower end is
large and forms the chief part of the wrist It is a long bone, prismatic
and a little curved.

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 ORIENTATION
- The bigger end is situated
inferiorly
- the styloid process laterally
- the rough surface of this
extremity posterior
ANTERIOR SURFACE
- is concave It has a nutrient
foramina
POSTERIOR SURFACE
- is rounded,convex
LATERAL SURFACE
- It is rounded and convex in the middle

THE BORDERS
Anterior border
- extends from the radial tuberosity to the base of the styloid process
Posterior border
- it is seen only in the middle part of the bone
Medial border
- it inserts the interosseus membrane
THE UPPER END
It presents – a head - a neck - a tuberosity
head of the radius styloid process
THE LOWER END
- is rough and irregular anteriorly
- Posterior – is convex and it carries 3 grooves for muscles
- Lateral – it has the styloidian process
- Medial – it has agroove for articulation with the head of the ulna
- The base – has 2 articular surfaces for articulation with the scaphoid
bone and lunate bone

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 ULNA
It is a long bone an it is situated in the inner side of the forearm medially
from radius
ORIENTATION
- The biggesr end is situated superiorly the opening of this end facing
anteriorly
- The thinnest border faces laterally
Ulna presents:
– a body - 2 ends – the lower end is smaller than the larger upper end
THE BODY
- It is a little concave It has - 3 surfaces 3 borders
Anterior surface – it has a nutrient foramina
Posterior surface - it is flat
Medial surface - it is flat, concave above and
convex below
The borders
anterior– it leads from the coronoid process
to the styloid process
posterior – it leads from the olecranon
process to the styloid process
lateral – it inserts interosseus membrane

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The upper end = proximal epiphysis presents
olecranon process for the articulation with the olecranon fossa of humerus
- coronoid process -it carries a radial notch for articulation with the
radius
- between olecranon and coronoid process there is trochlear notch
that articulates with humerus
The lower end = distal epiphysis
- The head of the ulna it articulates with the radius laterally
- Styloid process styloid process of ulna situated medially
- the base of the ulna

HAND
The skeleton of the hand is divided into 3 segments:
- Carpal bones these bones form the wrist also known as wrist bones
- Metacarpal bones are the bones one can find in the palm 5
metacarpals in total and they are more easily palpatable from the
posterior surface
- Phalanges or digities 14 bones in one
hand these are the bones that form
your fingers

CARPAL BONES
The bones are situated in 2 rows poroximal
and distal rows these bones articulate with
the forearm bones proximally and with the
metacarpals distally.

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 - Proximal row or the upper row – scaphoid bone - lunate bone -
triquetral bone - pisiform bone
- Distal row or the lower row – trapezium bone - trapezoid bone -
capitate or magnum bone - hamate bone
The land marks of these bones will not be needed for the entrance
exam, you will need to know the names and the order and the row
they are situated in.

METACARPAL BONES
They are shaped like a long bone but it is small ,it presents:
- a body with 3 surfaces: dorsal, lateral and medial
- The base articulates with the carpal bones
- The head articulates with the proximal phalanx

Left hand anterior surface

PHALANGES
They form the five digities which are named:
- 1st The thumb – 2nd The Index – 3rd The middle -4th The ring – 5th
The little finger
These bones have a similar structure with the metacarpal bones but are
more smaller

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 - the present a head, a body and a base
- the 2nd 3rd and the 4th and 5th finger present 3 phalange in each
finger. They are named the proximal, the middle and the distal
phalanges
- the thumb 1st digit presents only 2 phalanges the proximal and the
distal phalange

THE LOWER EXTREMITY

The lower extremity refers to the part of the body from the hip to the
toes. The lower extremity includes the hip, the knee, and the ankle joints,
and the bones of the thigh, leg, and foot.
People often refer to the lower extremity as the leg. In fact, the leg is the
part of the body between the knee and ankle joints. The correct way to
describe the lower limb is the lower extremity. This may seem like a
minor detail. However in anatomic terms, the body is described as
follows:
The lower Extremity
Thigh: the segment between the hip joint and the knee joint
Leg: the segment between the knee joint and the ankle joint
foot: the ankle joint to the distal phalanges

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FEMUR (THE THIGH BONE )
It is a long bone and it is a paired bone it is situated in the thigh between
the hip and the knee. it is the most voluminous bone in the human body .
The femur present
- a body and two extremities
ORIENTATION
Superior – extremity with an angle
Medial – hemispherical surface of
this extremity
Posterior – the rough border of the
body

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THE UPPER EXTREMITY= PROXIMAL EPIPHYSIS
It presents
The head
- it is spherical and directed upward, inward and a little forward It
has a depression called fovea capitis situated a little behind the
center for insertion of the teres ligamentum
The neck
- It connects the head with the body
- Anterior surface presents intertrochanteric line
- Posterior surface presents - intertrochanteric crest
The greater trochanter
- It is a large irregular eminence situated in the lateral part of the neck
and little backward (it inserts muscles)
The lesser trochanter
- It is situated medially and little backward (it also inserts muscles)
The intertrochanteric line
- is a line that is anteriorly and is formed between the 2 trochanters.

THE BODY = The diaphysis

- is cylindrical, convex in front and concave behind
- It presents 3 surfaces and 3 borders

THE LOWER EXTREMITY = DISTAL EPIPHYSIS

It is divided into 2 eminences called condyles; the medial condyle is
smaller and lower situated
- Anterior – this extremity presents a smooth depression for patella
-Posterior – it presents intercondilar fossa

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THE PATELLA = THE KNEE CAP

It is a circular (sesamoid bone ) – triangular bone

- It is articulated with the femur
and it protects the knee joint
- It is situated inside of the
tendon of quadriceps femoral
muscle
- It has a base - An anterior
surface- A posterior surface- An
apex and 2 borders
Anterior view Posterior view
TIBIA
The tibia is a long paired bone presents a body and 2 epiphyses this
bone is also the is the second largest bone in the human body (the
largest being the femur)
is articulated with the femur – superiorly , Fibula – laterally and with
the Talus (tarsal bone) – inferiorly

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 ORIENTATION
The small epiphysis is situated inferiorly
Medially the extension of this epiphysis also known as the (malleoulus)
Anteriorlly – the sharpest border is seen

THE BODY
It has 2 curves
-The superior curve is convexed medially
- The inferior curve is concave medially
The tibia has the shape of the letter “S”
The body presents
- 3 surfaces= Medial, Lateral and Posterior surfaces
- 3 borders = Anterior, Medial and Lateral borders

THE UPPER EXTREMITY

It is large and extended into 2 lateral eminences = condyles
Between the condyles there is intercondylar eminence (it is formed by
the 2 condyles)
The superior surface of the eminences is called articular surface (for
femur)
The central part of these condyles articulates with the condyles of the
femur
In front and behind there are 2 rough depressions which insert the
crucial ligaments ( anterior and posterior ) and the semilunar fiber
cartilages

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THE LOWER EXTREMITY - it presents 5 surfaces:
Anterior – smooth and covered by the extensor muscles
Posterior – it presents an oblique groove for the tendon of the flexor
longus hallucis
Lateral – presents a depression for articulation with fibula
Medial – is prolonged downward with the malleolus
Inferior – is articulated with tallus

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FIBULA
It is situated at the outer side of the leg the fibula is smaller than the
tibia. It is articulated with tibia above and below. fibula supports the
ankle laterally the (malleoulus part)

THE BODY
It is triangular bone it presents
3 surfaces and 3 borders

Surfaces
- Posterior surface – it has a nutrient
foramina
- Lateral surface – it inserts muscles
- Medial surface – it has a crest
Borders
- Anterior
- lateral – in the lower part it becomes posterior
- medial – interosseus

THE UPPER EXTREMITY

- The proximal end is small It presents the head of fibula and the apex
-The Neck is below the head, it is surrounded by the fibular nerve
THE LOWER EXTREMITY
It is formed by the external (lateral) malleolus which presents :
- A base
- An apex
- A lateral surface
- A medial surface – which has an articular facet for tibia and talus

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THE FOOT
The bones of the foot are divided in 3 parts:
- Tarsal bones – 7 bones
- Metatarsal bones – 5 bones
- Phalanges – 14 bones

Skeletal system
The Action and purpose of the skeletal system
Some functions of the skeletal system are more observable than other
body functions. When you move you can feel how your bones support
you, facilitate your movement, and protect the soft organs of your body.
The bones and cartilages of your skeletal system supports the rest of
your body. Without the skeletal system, you would be a limp mass of
organs, muscle, and skin. Bones facilitate movement by serving as points
of attachment for your muscles. Bones also protect internal organs from
injury by covering or surrounding them. For example, your ribs protect
your lungs and heart, the bones of your vertebral column (spine) protect
your spinal cord, and the bones of your cranium (skull) protect your
brain

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On a metabolic level, bone tissue performs several critical functions. For
example, the bone tissue acts as a storage for a number of minerals
important to the functioning of the body, especially calcium, and
phosphorus. These minerals, incorporated into bone tissue, can be
released back into the bloodstream to maintain levels needed to support
physiological processes and to maintain the homeostasis of the body.
Calcium ions, for example, are essential for muscle contractions and are
involved in the transmission of nerve impulses.

Yellow bone marrow

Bones also serve as a site for fat storage and blood cell production. The
unique connective tissue that fills the interior of most bones is referred to
as bone marrow. There are two types of bone marrow: yellow bone
marrow and red bone marrow. Yellow bone marrow contains adipose
tissue (fats), and it can be released to serve as a source of energy for
other tissues of the body.

Red bone marrow

is where the production of blood cells (named hematopoiesis, hemato =
“blood”, -poiesis = “to make”) takes place. Red blood cells, white blood
cells, and platelets are all produced in the red bone marrow. As we age,
the distribution of red and yellow bone marrow changes as seen in the
figure
*SHORTLY ▫ Provides shape and support to the body, Protects vital organs
, Acts as a set of levers, and together with ,muscles helps a person move
,Produces blood cells and Stores calcium + adipose tissue
Chemical composition of bones
Contains organic & inorganic components
Organic: Cells (osteoblasts, osteocytes,
osteoclasts)
Made of glycoproteins and collagen fibers
Inorganic: Mineral Salts (calcium phosphates)
Contribute to hardness of bone (allowing for
compression resistance)

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TYPES OF BONES
•Long bones = Are long as the name suggests these bones are not wide
they present a shaft and 2 ends
 All limb bones Except…. Kneecap( patella), Wrist bones ( carpals +
the rest of the hand ) and Ankle bones (tarsal bones + the rest of
the foot)

•Short bones = These bones are Cube Shaped they allow a wider range
of movement
 ex. Wrist bones (carpal) and the Ankle bones (tarsal)
•Flat bones = Thin, flat and curved in there apperance they protect soft
tissue
 ex. Shoulder blades (scapula ), Ribs (costal ) and Skull bones
(cranial)
•Irregular bones = Are complicated in there structure they are
unusually shaped
 The Muscles, tendons, ligaments usually attach to these
 Vertebrae
 Hip bones

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 SECTIONS OF THE SKELETAL SYSTEM
- The skeletal system is divided in to two sections due to their
localization

•Axial skeleton
the bones in the midline of the bodyare called the axial skeleton. Their
main purpose is to protect due to the fact that the bones are localized in
vital regions of the body ( ex. the cranium (the skull)

•Appendicular skeleton
the bones situated in the limbs , they are called appendicular skeleton.
they are mainly long bones. These skeletal section is strong and big for it
is responsible of the movement and support ex. the thigh bone (Femur)

The Axial skeleton

THE VERTEBRAE
- they are 33-34 in number the vertabraes are shaped like a ring
placed one above another which forms a single column called
vertebral or spinal column. the vertebral colomn provides
protection of the spinal cord and spinal nerves
it also maintains the body (the trunk and the head) allowing us an upright
position.
- vertebral column has the following parts:
- cervical part – noted C1 – C7
- thoracic part – noted T1 – T12
- lumbar part – noted L1 – L5

- sacral part – 5 vertabrae fused together forming a single bone

- coccygian part – 4-5 vertabrae fused together forming a single bone

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GENERAL CHARACTERISTICS OF VERTEBRAE
The vertebra presents
- a body
- an arch
- processes

the body – is situated anterior

- it has - an upper surface
- a lower surface
- in the posterior part, the body presents many nutrient foramina which
serve for the passage of vessels and nerves into the bone substance
- the bodies of the vertebrae are joined by means of intervertebral discs (
cartilages) – so that it results a very flexible column

The arch
– it forms the posterior and lateral boundaries of the vertebral foramen;
between the vertebral body and arch there is the pedicle of vertebral
arch ( one on the left side and one on the right side)
Processes – are 7 in number
- spinous process - posterior
- articular processes – which are 2 superior and 2 inferior
- transverse processes – extend from the lateral surfaces of the vertebral
arch

!! Between the body and the arch there is the vertebral foramen. The
foramina are placed one above another and form the vertebral canal.

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!!! Between two neighbors vertebrae there is the intervertebral foramen
for the spinal nerves and vessels.

ARTICULAR CHARACTERISTICS OF CERVICAL

VERTEBRAE

- small low bodies – exception the first two vertebrae

- the spinous process is bifid (!! Exception C1, C7)
- the transverse processes are short and project laterally
- the upper surface of each process carries a deep groove for the spinal
nerve – it separates an anterior tubercle from the posterior tubercle
- the transverse process has foramen transversarium for vessels ( artery
and veins)
-the articular processes are short, extended obliquely

C1 = ATLAS and C2=AXIS

- These two first cervical

vertabrae are diffrent from
the other cervical vertabrae
due to that the atlas doesnt
presnt a process it presents
two arches. And the Axis
present a projection called
the dense !!!!

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THORACIC VERTEBRAE

-they are 12 in number

- their bodies are much higher and thicker than the cervical vertebrae;
their bodies gradually increase in size downward toward the lumbar
vertebrae

Posterior part of lateral surface of the body carries two facets:

- The upper costal facet And The lower costal facet (for ribs)

-The spinous processes of thoracic vertebrae are long, three-sided,

pointed and slope downward. Those of the middle thoracic vertebrae fit
one over the other like tiles
- The transverse process carries a small costal facet for articulation with
the tubercle of the rib.

LUMBAR VERTEBRAE - They are 5 in number

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- The body is bean-shaped , very large.
- The spinous process is short and wide, thickened and rounded at the
end
- The transverse process is in front of the articular process; it is
compressed
- The articular processes arise from the arch, project to the back of the
transverse process almost vertically, in sagital plane

Sacrum
The sacral vertebrae, 5 in number they are fused to form a single
bone = SACRUM
It is located below to the last lumbar vertebra and contributes to the
formation of the posterior wall of the pelvis
Orientition The concave surface is anterior and the base is superior!!
It present :
– an anterior surface
-a posterior surface
-2 lateral borders
-a base
-an apex

-sacral canal which runs from the base to the apex.

Anterior surface:
it is smooth and concave, called pelvic surface
- it has 4 parallel transverse ridges which are the traces of fusion of the
bodies of the five sacral vertebrae
- laterally to these ridges on each side are 4 anterior sacral foramina for
the anterior branches of the sacral spinal nerves

Dorsal surface: it is convex longitudinally and rough

- it presents:
- median crest
- intermediary crests;
- still laterally, on both sides there is lateral crest
- 4 dorsal sacral foramina

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THE BASE OF THE SACRUM
It carries a transverse –oval depression for articulation with the inferior
surface of the body of the fifth lumbar vertebra
Between the base of the sacrum and the last lumbar vertebra there is the
promontory ( it is an angle)

THE APEX OF THE SACRUM

-It is narrow
-It has a small oval surface for articulation with coccyx
-Behind the apex there are the sacral cornua

Between the apex and sacral cornua there is the sacral hiatus; it looks like
“V” but turned with the apex upward

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THE COCCYX
The coccigeal vertebrae, 4-5 in number fuse to form the the coccyx
It has a curved pyramid shape
The base is articulated with the sacrum; it has coccigeal cornua (2 in
number) extending upward

The apex has a small tubercle

The anterior and posterior surfaces have 3-4 transverse ridges ( the fusion
of the bodies 4 or 5 )

STERNUM
a flat bone forming the middle of the anterior wall of the thorax and
articulating with the clavicles and the cartilages of the first seven ribs. It
consists of three parts, the manubrium, the body, and the xiphoid
process.

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It presents:
- manubrium
-Sternum body
-Xiphoidian
process (apex)
Orientation

CONFIGURATION
It has:
– an anterior surface
-a posterior surface
-2 lateral borders
-a base
-an apex

ANTERIOR SURFACE LATERAL BORDERS

-t is convex forward On each side there are 7 costal
incisura for articulation with the head of costal cartilages
2 intercostal space “Louis angle”
-3-4 transversal ridges

BASE
is called the manubrium of sternum it presents
– jugularis incisura
-clavicular incisura

THE RIBS (COSTAL)

They are bony arches which extend from the vertebral column to
the sternum .They are 12 pairs total of 24 ribs and there are divided into 3
groups of ribs:
- True ribs = 1st-5th rib they are true ribs based on their articulation
through costal cartilages to the sternum. each rib has its on articulation.

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- False ribs = 6th-10th tib are called the false ribs because their
articulations to the sternum are joined with multiple ribs
-Floatting ribs = 10th -12th ribs are the floattings ribs for they have no
articulations with the sternum they protect the rib cage laterally and
inferiory

ORIENTATION
The convex surface is lateral
Head of the rib is posterior attached to the vertebrae
The border with a groove is inferior the groove is formed by vessels
The rib presents:
- a bony part
- a costal cartilage

THE BONY PART OF THE RIB

- presents
-head , neck ,tubercle and the body of the rib
-The costal cartilage forms the articulation from the rib to the sternum

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Skull (Cranium)
The cranium (skull) is the skeletal structure of the head that supports the
face and protects the brain. It is divided into the facial bones and the
cranial vault. The facial bones underlie the facial structures, form the
nasal cavity, enclose the eyeballs, and support the teeth of the upper and
lower jaws. The rounded brain case surrounds and protects the brain and
houses the middle and inner ear structures.

The skull presents 22 bones 21 of them are immobile they are united
togeter with sutures (joint structure).
The caranial vault consists of these following bones
- frontal bone, parietal bone, temporal bone, occipital bone, sphinoid
bone and the ethmoid bone
- Facial skull is formed by the mandible bone, maxilla bone, nasal
bone and the zygomatic bone

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THE FRONTAL BONE
It is situated on the anterior part of the skull, median
It has – a vertical part = squamous part
- an horizontal part formed by – 2 orbital plates
- 1 nasal part

ORIENTATION
- Anterior surface is convex forward
- Orbital plates are inferior
THE FRONTAL SQUAMOUS
It is convex forward, and it has - an external surface
- an internal surface

External surface:

- It is smooth and convexed forward ,It has 2 frontal eminences below

the eminances there are 2 ridges called supraciliary arches. Between
these ridges there is a smooth surface called the glabella. Inferior to
the ridges there is an border known as supraorbital border

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The internal surface presents:

- the small foramen caecum, the crest of the frontal bone and the
superior sagital groove all of these land marks exists in the midline
of frontal bone on the internal surface

THE PARIETAL BONE

It is a paired bone which forms the upper part and lateral part of the
cranal vault
It is situated between - the frontal bone
- occipital bone
- temporal bone
it presents :
- 2 surfaces = internal and external
- 4 borders =sup.inf.post and anterior bordes
- 4 angles = (ant-sup) (ant-inf) (post-sup) and post-inf angel

EXTERNAL SURFACE
-It is convex
-It presents: - an eminence
-2 lines – upper temporal line –
inserts temporal fascia
- lower temporal line – inserts
temporal muscles
- a foramen – near the superior
border, in posterior part

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 INTERNAL SURFACE

It is concave; It has – many grooves for arteries

THE OCCIPITAL BONE

It is unpaired bone that forms the posterior and inferior part of the
cranial vault. It has an oval foramen in its lower part, which
connects the cranial cavity with the spinal canal (foramen magnum)

ORIENTATION
Anterior surface is concave forward and the oval foramen is inferior

It presents:
- 2 surfaces – external and internal
- 4 angles
- 4 borders
Basilar part
-It is situated in front of the foramen magnum
On the external surface it presents
– the basilar process
- in the median line – the pharyngeal tubercle
On the internal surface it presents the clivus, which supports the
medulla oblongata.

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Squamous part
-It is convex and it is situated above and behind foramen magnum
on the external surface squamous part presents a prominent tubercle
called external occipital protuberance and the external occipital crest.
- on the internal surface the squamous part present the internal occipital
protuberance and grooves for vessels inside the cranial volt.

Lateral parts
Each of them presents - a condyle for articulation with the atlas

THE ETHMOID BONE

It is a single bone situated median in the cranial vault , it is a groove It is a
complex bone in its stucture and participates at the formation of nasal
cavities, orbital cavities and the base of the skull

35
THE TEMPORAL BONE
The temporal bone is a paired bone. It is situated between the parietal
bone, occipital bone and the sphenoid bone this bone forms the lateral
inferior part of the cranium
-it is a irregular bone
-It has presents a squamous part, tympanic part ,petrous part and a
Mastoidian part

SQUAMOUS PART IS THE UPPER PART OF THES BONE THE FLAT PART!!
THE SPHENOID BONE

-It is unpaired bone It forms the central part of the skull’s base this bone
is shaped like a butterfly it presents ”wings”
-the sphinoid bone articulates with almost all the cranial bones
-It presents – a body , 2 pairs of wings-laterally and the pterigoid
processes – inferiorly

36
Superior view Anterior view

FACIAL BONES
Mandible
The mandible is the single midline bone of the lower jaw. It consists of a
curved, horizontal portion, the body, and two perpendicular portions, the
rami, which unite with the ends of the body nearly at right angles (angle
of the jaw). It articulates with both temporal bones at the mandibular
fossa at the temporomandibular joints

The ramus is quadrilateral in shape, and has two surfaces, four borders,
and two processes and one canal:
external surface
- it is flat and it gives attachment to the masseter muscle
internal surface
- mandibular foramen: opening of the mandibular canal, which
transmit the inferior alveolar vessels and nerve
- lingula of the mandible: prominent, sharp ridge in front of the
mandibular foramen.

Coronoid process
- thin, triangular eminence from the upper border of the ramus of the
mandible it is separated from the condylar process posteriorly by

37
 the mandibular notch temporalis muscle inserts into its medial and
lateral surfaces
Condylar process
- this process is thicker than the coronoid process it also consists of
two portions: condyle and neck the head presents articular surface
for articulation with the articular disk of the temporomandibular
joint (TMJ)

Maxilla

The maxilla (or maxillary bones) is a pair of symmetrical bones joined at

the midline, which forms the middle third of the face. It forms the floor of
the nasal cavity and parts of its lateral wall and roof, the roof of the oral
cavity, contains the maxillary sinus, and Its alveolar process houses the
teeth.

Orientation - Inferior surface the alveolar processes for the articulation

with the teeth
- Medial surface presents a big orifice (sinus) which communicates with
all the sinuses of the skull
- Posterior surface has the most voluminous border

Maxilla presents 4 process and a body

38
 - Frontal process, palatine process, zygomatic process and the
alveolar process
- The body has a pyramidal shape it has an apex and a base the apex
is oriented medially and the base presents the zygomatic process of
maxilla

Zygomatic Bone
- zygomatic bone) is an important facial bone which forms the
prominence of the cheek. It is roughly quadrangular in shape. it is
palpatable like most of the facial and cranial bones. It is a paired
bone that is situated on the lateral part of the face.

Presents 2 surfaces
-Lateral surface -is convex and presents the zygomatico-facial foramen
-Medial surface is concave and forms the temporal fossa.

39
The zygomatic bone presents 3 processes

Frontal - for articulation with the zygomatic process of the frontal bone.
Temporal -It is articulated with the zygomatic process of the temporal
bone.
Orbital -It is articulated with the greater wing of the sphenoid and with
the maxillary bone.

Nasal bone
It is little and paired, quadrilateral it participates to the formation of the
nasal cavity.

Relations and borders

- Superior border is articulated with the frontal bone.
- Inferior border is articulated with the nasal cartilage.
- Lateral border is articulated with the frontal process of the maxillary
bone.
- Medial border is articulated with the opposite side.

Little facial bones

- THE VOMER BONE
- SUPERIOR NASAL CONCHA
- MIDDLE NASAL CONCHA
- INFERIOR NASAL CONCHA
- LACRIMAL BONE
- THE HYOID BONE

40
 - THE HYOID BONE (This bone is not a facial bone it is situated in the
cervical region above the thyroid cartilage.
The face presents little bones that are not needed for this course to be
studying their anatomy and their relations it would be irrelevant for the
entrance exam, but they will come up later in the first semester of your
medical studies.

THE HIPBONE (COXAL BONE)

Located in the lower torso, the pelvis is a ring of bones that protects the
delicate organs of the abdominopelvic cavity while anchoring the
powerful muscles of the hip, thigh, and abdomen. Several bones unite to
form the pelvis, including the sacrum, coccyx (tail bone), and the left and
right coxal (hip) bones.
Throughout childhood, the pelvis is made of many smaller bones that
eventually fuse during adulthood to form the pelvis. Each of the coxal
bones begins as three separate bones: the ilium, ischium, and pubis

ORIENTATION
- The ilium is the largest, widest, and most superior of the hip bones.
When you place your hands on your hips, you can feel the curved
ridge of the ilium known as the iliac crest.
- The narrow ischium is inferior to the ilium and is the bone, along
with the coccyx, that you rest your body weight on while sitting.
- Anterior to the ischium is the pubis, the smallest of the hip bones.
The ilium, ischium, and pubis meet in the center of the hip bone to
form the deep, cup-like socket of the hip joint called the acetabulum

41
THE ILIUM - It is divided into 2 parts:
The body – which limits the acetabulum superiorly and the ala = also
called the wing of the hip bone
Between the body and the ala there is arcuate line this land mark
divides the body and the ala
- the arcuate line is visible only on the internal surface of the hip
bone

THE ISCHIUM
The body – it limits the acetabulum posteriorly and inferiorly
The ramy of ischium – it is joined with the inferior ramy of pubis to
enclose the obturator foramen

THE PUBIS
- The body limits acetabulum anteriorly
- Superior ramy
- Inferior ramy
-The limit between superior and inferior ramy is called the pubis
angle

42
CONFIGURATION
The hip bone presents
- 2 surfaces – lateral or external and medial or internal
- 4 borders – superior, inferior, anterior and posterior
- 4 angles
LATERAL SURFACE
ACETABULUM = Is the biggest land mark on this surface ,it is a deep,
hemispherical depression, limitated by:
Acetabulum is limited by a prominent brow which gives it its lunate
(moon like) surface
It presents a deep notch below = the acetabular notch, which is
continuous with a circular depression = acetabular fossa

THE OBTURATOR FORAMEN

- It is a large aperture situated between the ischium and pubis
- It is bounded by a thin margin
- A strong membrane is attached on this margin
- On the superior part, this margin is substituted by the obturator
groove

43
THE ALA OR WING - It is called gluteal surface
It is crossed by 3 lines
- Anterior gluteal line, Posterior gluteal line and the Inferior gluteal line
- These lines are the attachment points for the gluteal muscles

MEDIAL SURFACE - It is crossed by an arcuate line

Iliac fossa – above the arcuate line
Under the arcuate line there are:
Sacro-pelvic surface – formed by the tuberosity of illium and auricular
surface

SUPERIOR BORDER = Is called the iliac crest

It presents
– anterior superior iliac spine
- posterior superior iliac spine

INFERIOR BORDER
It begins at the ischiatic tuberosity and ends at the pubic angle
It is formed by the inferior ramus of pubis and the inferior ramus of
ischium and it is called ischio-pubian branch

44
ANTERIOR BORDER
It has 2 parts – one vertical = ilium part
- one horizontal = pubis part

It presents:
- antero-superior spine - Antero-inferior iliac spine (ilum part)
From here, the anterior border changes its direction
- Below – there is iliopectineal eminence - Pectineal surface (pubis part)

POSTERIOR BORDER
It presents-
- postero-superior iliac
spine - postero-inferior
iliac spine - the greater
sciatic notch - ischiatic
spine - lesser sciatic
notch - ischial
tuberosity

45
THE ANGLES
Antero-superior – represented by the antero-superior spine
Antero-inferior – represented by the pubis angle
Postero-superior – represented by the postero-superior iliac spine
Postero-inferior – represented by the ischiatic tuberosit

DIGESTIVE SYSTEM
- Digestive system starts when the salivary glands starts to produce
saliva, which is result of smell, vision or some times even thinking of
food.
- Digestion is important because your body needs nutrients from food
and drink to work properly and stay
healthy. proteins, fats, carbohydrates, vitamins, minerals, and water
are nutrients. Your digestive system breaks nutrients into parts
small enough for your body to absorb
and use for energy, growth, and cell
repair.
- Digestive system is formed by the
organs which have function in digestion
and absorbtion of food.

These organs are:

• oral cavity (mouth)
• pharynx
• esophagus
• stomach
• small intestine – duodenum, jejunum
and ileum
• large intestine – cecum, colon, rectum
• salivary glands, liver, pancreas

46
ORAL CAVITY (THE MOUTH)
It is the first part of the digestive tube.

Functions:
mastication, insalivation, deglutition
and speaking.

It is formed by: 

- a skeleton part: – represented by
mandible and maxillas; 

- soft parts:
 - superficial parts –
lips, the menton (chin), the cheek,
maseterin region; 
 - profound
parts – palatine region, the tongue,
salivary glands.

THE VESTIBLE 

- it is like a horseshoe with posterior opening;
- it receives the secretion of the parotid salivary glands (the orifice of
this gland is near the second upper molar – on each side). 


THE ORAL CAVITY PROPER

-The oral cavity is bounded at the sides and in front by the alveolar
provess.
-Its roof is formed by hard palate at the front, and a soft palate at the
back. The uvulaprojects downwards from the middle of the soft
palate at its back. The floor is formed by the mylohyoid muscles and
is occupied mainly by the tongue.

47
THE TONGUE
- it is a musculo-cutaneus organ covered
by a mucous membrane, and fixed at
the floor of the mouth; 

- it is situated between palatine arch and
alveolar arches; 

- it is – the principal organ of the sense
of the taste ; 
 - an important organ of
speech; 
 - assist in mastication and
deglutition of the food; 

it has: a root, an apex,2 surfaces and 2
borders.


 SURFACES: 

a) Superior or dorsal surface b) Inferior surface or ventral surface
which divides - in the median line it has the
it into symmetrical halves; the end lingual frenulum;
of this groove is a depression called - laterally there are the orifices of
foramen caecum; 
 sublingual glands (salivary glands)
- in front of this surface there are the
4 papillae of the tongue (taste buds):
filiformes. fungiformes, foliate and vallate.


STRUCTURE
the tongue presents muscles divided in: extrinsic muscles
-Genioglossus – from mandible to the root of the tongue; it draws the
apex of the to forward
- Styloglossus – from the styloid process of the temporal bone to the
tongue; it draws the 
 tongue backward;

 - Hyoglossus - from hyoid bone to the tongue; it draws the tongue
downward. 

- Palatoglossus – from palatine arch to the tongue; it draws the root of the
tongue upward
- Amygdaloglossus – it draws the tongue upward;
 - pharyngoglossus – it

48
draws the tongue backward;

THE TEETH
- the teeth are thick organs implanted in alveolar cavities at mandible and
maxillas.
- functions – in deglutition and articulated speaking; 

- they are placed in 2 rows called dental arches; 


The general aspect of the teeth:
 the tooth presents:

-a crown, a neck and a root.

SALIVARY GLANDS 

- numerous salivary glands empty their secretion into the oral cavity.
They are divided into 2 groups: 
 - the large salivary glands
–parotid glands;
 - sublingual glands; 
 - submandibular glands.
- the small salivary glands; 


49
PAROTIDE GLAND
- it is a paired gland; 

- it is situated immediately below of the 
 external ear;
- the canal of the gland goes above the maseter muscle, passes through the
buccinator 
 muscle and is opened in vestibule, near the second upper
molar. 


SUBMANDIBULAR GLAND
it is a paired gland;
 it is situated in the submandibular region.
– digastric muscle; the gland presents a part which goes to the sublingual,
the canal of this gland is called Wharton canal; it is opened in oral cavity,
beside the frenulum lingual.

50
 SUBLINGUAL GLAND
- it is situated in sublingual region.
- it is a small gland and it has: 8-12
excretory ducts, which are opened
beside the lingual frenulum.

THE SMALL SALIVARY

GLANDS 

These glands secrets saliva, serous
and mucous and are divided into
topographic groups:
-Labiojugular group

-Palatine group
-Lingual group

PHARYNX
= it is a musculo-
membranous organ,
situated at the
crossing of the
digestive way (from
the mouth to the
esophagus) with the
way of breathing
(from the nose to the
larynx).
- it is situated in
front of

51
 vertebral column, from the skull base to the C6;
- it communicates: -in first third with the nasal cavity;
-in the second third with oral cavity;
-in last third with larynx. 

Functions: The consecutive contractions of the circular muscles of the
pharynx help the ingested foods to pass through the oral cavity into the
esophagus The longitudinal muscles contribute to widening the pharynx,
elevating the larynx during the process of swallowing.
!!! Behind of the pharynx, between the pharynx and prevertebral fascia
there is a space called retropharyngian space which contains elastic
conjunctive tissue and 2 lymphatic nodes; this space determines the
mobility of pharynx and
protects it from the
vertebral bodies.!!!
!!! Laterally, there is
lateropharyngian space
which is divided by a
septum into 2 parts: in
front is prestylian space
and behind is retrostylian
space; the septum is
formed by conjunctive
tissue and stylian muscles
with their fascia.!!!

INTERNAL
CONFIGURATION
- the pharynx is divided in 3 levels: -first is nasopharynx;
-second is the oropharynx;
-the third is laryngopharynx;

NASOPHARYNX
- it lies from the base of the skull to the palatine arch; 

- it communicates in front with nasal cavity and below with oropharynx;


- the walls are formed by:

52
the upper wall: it is formed by sphenoid bone and basilar part of occipital
bone.
inferior wall - it appears only in deglutition time;

posterior wall - is formed by prevertebral plane (in front of atlas and
axis). 

lateral wall: presents the pharyngian orifice of auditiv tuba which permits
the communication of the pharynx with medial ear.

Waldeyer ring: is formed by 4 tonsils:

-lingual tonsil.
-pharyngyan tonsil.
-tubar tonsil.
-palatine tonsil.
OROPHARYNX
-it is situated between palatine
arch and an horizontal plane
which passes through the hyoid
bone;
-it communicates in front with
the mouth through the
oropharyingian istmus
determined by glossopalatine
arch

LARYNGOPHARYNX
-it is situated between the plane which passes through the hyoid bone and
the lower limit of the pharynx which is cricoid cartilage of larynx;
- in front there are: - epiglottis;
- the root of the tongue;

- lingual tonsil;
- glossoepiglotical folds;

- the enter of larynx
STRUCTURE

53
-mucous = nasopharynx has a respiratory type, but the others parts have
digestive type; 
 this plane has glands – mixted in the upper part of
pharynx and mucous glands in rest; 

-the muscle = are divided into two groups: 
 -constrictors muscles;

ESOPHAGUS
- it is a musculo-membranous organ situated between the pharynx and
the stomach; 

- it has 3 parts: - cervical part; 
 - thoracic part;
 - abdominal part; 


CERVICAL ESOPHAGUS
- it is situated inside of the neck, from the lower end of pharynx
(horizontal line which 
 passes through the crycoid cartilage of larynx) to
the limit between the neck and thorax = 
 a conventional line which cross
through the sternal manubrium; 

- it has a vertical direction but a little inclined to the left; 


THORACIC ESOPHAGUS
- it is limited in the upper part by the limit between neck and thorax and in
the lower part by the diaphragm muscle which represents the limit between
thorax and abdomen. 

- in thorax esophagus passes behind of aortic arch and descends in
mediastinum along the trachea; 


ABDOMINAL ESOPHAGUS 

- it is limited by diaphragm in the upper part and
 cardia in the lower part;
- on the right side it is followed by lesser 
 curvature of the stomach;
- at the left it forms with the greater curvature of 
 the stomach an angle;



THE TOPOGRAPHY OF THE ANTERIOR ABDOMINAL WALL

The abdomen is situated between the thorax and the pelvis.
- the anterior abdominal wall is limited in the upper part by the

54
 costal arches and the 
 xiphoidian process and in the lower part the
line which connects the inferior limit of the iliac crests. 


- it is divided into 9 regions by 2 pairs of lines:


- vertical lines –medioclavicular lines – connect the middle of clavicle
with the 
 inguinal fold (on each side);

- horizontal lines – the upper line is called bicostal line because it
connects the 
 anterior ends of the tenth ribs;
 - the lower line is
called bicristal line and it connects 
 anterior ends of the iliac crests;



- in the first row -the right hypocondrus;

-epigastric region; 

-the left hypocondrus; 

- in the second row –the right colic region;
-the ombilical region; 

-the left colic region; 

- in the third row –the right iliac fossa;
-hypogastrus;
-the left iliac fossa; 


STOMACH
-It is the most dilated organ of digestive tube; it is mobile; 


55
 -It continues the esophagus and it is followed by the duodenum;
-Stomach is the first organ were happens the absorbtion of digestive
system.
- Stomach is one of the two organs that storage food, other organ that
storages food is the rectum.
- One of the most important functions of the stomach is braking down the
food by stomach acid and the enzymes.
- it is situated in subphrenical space in gastric region.

It presents
 – 2 surfaces – anterior and posterior surface;

- 2 borders = curvatures
- the greater curvature which is orientated to the left;
- the lesser curvature which is orientated
to the right;
- 2 orifices:
 – the upper orifice = cardia
=the enter to the stomach;

- the lower orifice – pylorus = the limit
between the stomach and duodenum.
TRAUBE lunate space
-is important to know about this space
because the stomach is in direct contact
with the abdominal wall here; 

-in ABDOMEN the stomach has relations
with abdominal wall; the projecton of the
stomach here on the abdominal wall is in a
triangular area called Labbe triangle; 


The lesser curvature – the limit between it

and the first part of duodenum is
pyloroduodenal incisura.
The greater curvature – vertical part is
united with the diaphragm muscle by gastrophrenic ligament and
horizontal part is united with the transversal colon by gastrocolic ligament.



56
 STRUCTURE 

- the stomach presents 4 coats, from profund to superfisial.
1. the mucous coat - it is formed by epithelium which has mucous glands
and fundic glands
2. the submucous coat - it presents numerous vessels for blood and lymph
3. the muscular coat - the muscular fibers forms 3 layers:
- superficial layer - presents longitudinal fibers;
- the middle layer - presents circular fibers;
- the profound layer - presents oblique fibers;
4. the serous coat - !!! it is absent at the fornix (here the stomach is in
direct contact with abdominal wall);


SMALL INTESTINE
The small intestine is about 20 feet, It is the
part of the digestive tract where approx 90%
of the digestion and absorption of food
occurs. The other 10% takes place in the
stomach and large intestine.

-Like stomach it is formed by,

1. Mucouse layer
2. Submucous layer
3. Three muscular layer
4. Serous layer

DUODENUM
- it is the first part of the small intestine; it is the fixed part of the small
intestine, the mobile parts of the small intestine are represented by the
duodenum, jejunum and ileum.

EXTERNAL CONFIGURATION
- its shape is like a horseshoe with the opening upward
- it has 4 parts:
 - first part = Duodenal bulb
- the second part = Descending part
- the third part = Transversal part
- the fourth part = Asending part

57
 INTERNAL CONFIGURATION
- the greater duodenal papilla which contains the coledoc duct and
pancreatic duct are opened.
- above of this papilla there is another papilla = the lesser duodenal papilla
in which accesor pancreatic duct is opened; 


JEJUNUM AND ILEUM

-the mobile part of small intestine is represented by jejunum and ileum; 

- between jejunum and ileum there are some differences :
- jejunum - has more circular folds inside;
- its diameter is bigger;

- it has more blood vessels;
- its muscular fibers are stronger than the ileums’ fibers;

!!! Mesenterum = a serous membrane which connects the small intestine

with posterior abdominal wall;
THE LARGE INTESTINE
- it continues the small intestine;
- it is situated between ileocecal
valve to
 the rectum region;
- The major function of the large
intestine is to absorb water from
the remaining indigestible food
matter and transmit the useless
waste material from the body to
the sigmoid colon.

- it presents following regions:

1. first part = cecum;

2. second part = ascending colon;
3. third part = transversal colon;
4. fourth part = descending part;

5. fifth part = sigmoid colon; 


CECUM 


58
-it is situated at the end of ileum from ileocecal valve in the right iliac
fossa; 

-it is dilated and it is followed by ascending colon; 

-it presents vermiform appendix; there it can be more morphological types
of vermiform appendix, but frequently appendix is orientated downward;
-cecum hasn’t haustrae (it is a single cavity); inside it has ileocecal valve
and below of this valve there is vermiform appendix; 


Ascending colon
- it extends from the cecum to the lower surface of the liver and here it
changes its direction; this place is called the right colic flexure or hepatic
angle of the colon;

Transverse colon 

- it extends from the right flexure to the left flexure, which is near the
spleen and it can be called spleen angle of the colon; 



Descending colon
- it extends from the left flexure to the left iliac crest; 

- it is longer than the ascending
colon; 



 Sigmoid colon
- it extends from iliac crest until to
the rectum, at the third sacral
vertebra; - it is called ileo-pelvin
colon; 


RECTUM
- it is the last part of the digestive
tube; 

- its upper limit is at the end of the sigmoid colon 

it has 2 parts: - one perineal part = anal canal; 

- one pelvic part = rectal ampoule – situated inside of the sacrums’
concavity;

59
 Pelvic part 

– is like a cylindrical tube without the colon characteristics; 


Perineal part 

– rectum is surrounded by the levator anal muscles and sphincters; 


!!! even rect means something which is straight, at the human body rectum
presents 2 sagital curvatures;

- when the rectum is empty, the

walls of the rectum are in contact,
but when it is full it compresses
the others organs from proximity.


ANUS
- it is the external orifice of the
rectum; 

- it is the last point of the
digestive system, and the
anus is controlled by two
sphincters voluntary and invoruntary sphincter.
THE LIVER
-it is a voluminous gland situated - in the right subphrenical space and
supramezocolic space, in hepatic region,
-The liver has two large sections, called the right and the left lobes. The
gallbladder sits under the liver, along with parts of the pancreas and
intestines. The liver and these organs work together to digest, absorb and
process food.
-The livers main job is to filter the blood coming from the digestive tract,
before passing it to the rest of the body. The livers one speciality is that he
also detoxifies chemicals and metabolizes drugs. As it does so, the liver
secretes bile that ends up back in the intestines. The liver also makes
proteins important for blood clotting and other functions.
- it presents 2 surfaces upper surface and the lower surface.
-Liver has: 3 ligamens: -coronary ligament

60
-falciform ligament
-(right + left) triangular ligament

-Right lobe presents: impressions of the costal arch

-Left lobe presents: cardiac impression:

-It has: 3 grooves – left sagital groove, right sagital groove and
transvers groove.

-sectors are divided in segments; each of these segment is irrigated by a

branch of portal
vein; there are 8 segments numbered in the sense of the clocks indicators.

PORTAL VEIN
- it is the collector trunk of the blood from digestive subdiaphragmatical
regions; 


- it has 3 principal roots: 


- the upper mesenteric vein – which collects the blood from
the small intestine, pancreas 
 and the right colon; 

- the lower mesenteric vein – which collects the blood from
the left colon and it spills 
 into the spleen vein; 

- the spleen vein – which units with the upper mesenteric vein
(at the second lombar 
 vertebra). 


The gallbladder, a small

pouch that sits just
under the liver, stores
bile produced by the
liver.
-The pancres gives
biles also to the liver try
the common bile duct.

ACCESOR BYLIAR DUCT

61
Gallbladder
- it looks like a pear; 

- it is situated on cystic fosa, on the lower surface of
 the liver; 

- it presents: - a fundus – anterior it outruns the
border of the liver;

-a body – it is under
the liver near
 the
duodenal bulb and the
hepatic angle of the
colon;

- a neck;

- a canal - cystic
canal; 

PANCREAS
- it is a mixed gland (exocrine and endocrine gland); 

- it is retroperitoneal organ; 

- it looks like a transversal hammer with its handle to the left; 


CONFORMATION 

- it has: 
 - a head
- a neck
- a body

- a tail 


STRUCTURE
- it has the same structure like
parotid gland; it has some
spherical formations from which
start small ducts; these ducts unit
and form bigger ducts which unit

62
again and form pancreatic duct = Wirsung duct and pancreatic accesor
duct = Santorini duct; 

- Wirsung duct opens in the lower (greater) duodenal papilla; 

- Santorini duct opens in the upper (lesser) duodenal papilla;

Respiratory system
NASAL REGION
Limits:- above – the horizontal line which passes through the nasion
point;
- below -
the horizontal
line which
passes through
subnasal point;

- laterally –
naso-genian
groove and
naso-
palpebral
groove; 

Shape: - variable, frequent pyramidal shape; 


63
 - base – nasal orifices; 

- borders - 3; 

- surfaces – 3; 


Structure: 

-skin – it is thin, mobile in the upper part;
- thicker and adhered in the lower part;

- it has many blood vessels;

- it has many glands (sweat); 


- muscular layer – “skin muscles” – are called in this way because they
have insertion on the skin; 
 - procerus muscle; - nasal muscle; 
 -
the common levator of nose and the upper lip; 
 - depressor of the
nasal septum; 

- skeleton – the frontal processes of maxillas; - nasal bones; 
 - the
anterior nasal spine;
 - palatine processes of the maxillas; 

- cartilages
 – the lateral cartilages of the nose; 
 - alar cartilages - 2 in
number –
 situated below of the nasal cartilages; 
 - accesor
cartilages - between alar cartilages; – small, sesamoide cartilages; 


64
 NASAL FOSSES
- they are 2 cavities situated in the centre of the face; 

- they communicate with paranasal 
 sinuses:

- frontal; 

- maxillary;
- sphenoid;
- ethmoid; 

- in front – they communicate with the 
 exterior of the body; 

- behind – they communicate with 
 nasopharinx; 

- each nasal fossa has 4 walls; 


- the upper wall = the arch of nasal fossa;

- it is formed by:
- the root of nasal bones;

- the nasal spine of the frontal bone;

- the cribriform lamina of the ethmoid; 

- the body of sphenoid bone; 


- the lower wall - the floor of the nasal fossa; it is formed by:
- palatine process of maxilla;

- horizontal plate of the palatine bone;

- lateral wall – it is irregular; it is formed by:

- the medial surface of the maxilla;

- the medial pterigoidian process;

- ethmoid labyrinth – medial wall;

- medial wall – it has - a skeleton part represented by:

- the perpendicular lamina of the ethmoid bone;
- vomer;

- cartilage of nasal septum;

65
 LARYNX
Situation:
- in front of pharynx;
- behind of: - sterno-tiroidian muscles;
- tiro-hyoidian muscles;
- sterno-hyoidian muscles;
- above of the first tracheal ring;
- below of the hyoid bone;

- it extends along of C5-C6 and is followed by the trachea;

- there are some factors which change the position of larynx: - age;
- sex (men, women);
- the movements of vertebral column:
- larynx goes upward in – extension of the head;
- deglutition;
- time of higher sounds
emission; - larynx goes
downward in – flexion of the head

STRUCTURE
- cartilages;

- joints;

- ligaments;

- membranes;
- muscles;
- vessels;
- nerves.

66
I. CARTILAGES

– there are - 3 unpaired cartilages;
- 4 paired cartilages;
1. Tyroid cartilage
2. Cricoid cartilage
3. Epiglottis

4. Arytenoid cartilage
5. Corniculat cartilage

6. Cuneiform cartilage

7. Triticee cartilages

II. LIGAMENTS

1. Hyo-tyroidian membrane
2. Hyo-epiglottical membrane
3. Glosso-epiglottical ligaments
4. Tyro-epiglottical ligament

5. Crico-tracheeal ligament

6. Vestibular ligaments

7. Vocal ligaments
8. Fibroelastical membrane

III. THE JOINTS OF THE LARYNX 


1. Crico-aritenoidian joint
- it is the joint between the base of the arytenoidian cartilage with the
upper border of the cricoid cartilage; 
 - movements: - slide in transversal
plane; - rotation in vertical
plane; 



2. Crico- tyroidian joint 

- it is realized between the
inferior horns of the tyroid

67
cartilage and cricoid cartilage;



MUSCLES
Of
LARYNX
1. Crico-tyroidian muscle
2. The posterior crico-
aritenoidian muscle
3. The lateral crico-arytenoidian muscle
4. Tyro-arytenoidian muscle
5. Arytenoidian muscle
6. Tiro-epiglotic muscle
7. Ary-epiglottic muscle

TRACHEA
- it continues the larynx and is followed by the
bronchi;
- it starts at C6-C7; 

- it has: - a cervical part;
- a thoracic part; 


CERVICAL TRACHEA 

- it has 5-7 cm; 

- it starts below of the cricoid cartilage until to the upper border 
 of
sternal manubrium; 


68
- it is inclined a little to the right; 


STRUCTURE 

- trachea looks like a cylindrical tube; 

- it has – a mucous (respiratory type); 

- a musculo-conjunctive tissue formed by 16-20 
 cartilaginous rings
which are incomplete; they are connected by elastic ligaments and their
ends are united by a muscular membrane formed by transversal fibers; 

- at the exterior there is a fibro-elastic membrane which covers the rings
= called adventice. 


THORACIC TRACHEA
- it starts at sternal manubrium and the end is represented by the
division at T4-T6 into 2 bronchii; 


THE PRINCIPAL BRONCHII

- they are 2 in number – one left and one right and result from trachea
which is divided in 2 at T4-T6;their direction is oblique, downward
and laterally to the hilus of the lung from where each of them is
followed by lobar bronchium; 

- between them there is an angle = 70 degrees; 

- the right bronchium is shorter then the left bronchium 
 and
voluminous and almost vertically; 

- the left bronchium is almost horizontal, longer and thin 
 like
letter “S” because of aortic arch and the heart; 

- the principal bronchi have - a part – extrapulmonary; 

- a part – intrapulmonary
(inside of the lungs). 

THE PEDICLE OF THE LUNG 

- it is formed by all the anatomical elements which go inside or outside
of the lung at hilus; 

-it contains: - principal bronchium;

- branches of pulmonary artery;
- branches of pulmonary vein;


69
 - bronhic vessels;

- lymphatics;

- nerves.

PLEURA
- it represents the serous membrane which covers the lungs; 

- it has 2 parts: 
 - parietal part – which covered the thoracic walls inside;


- visceral part – which covers the surfaces of the lungs; 

- these parts are united in hilus and determine between them a cavity –
pleural cavity which contain a small quantity of 
 fluid. 


THE LUNGS
- they represent the organs of

70
breathing in which the venous blood become arterial blood; 

- they are 2 in number separated by the mediastinum; 

- the right lung is bigger than the left lung; 

- they present: - a costal surface;
- a medial surface = mediastinal surface
- a base – diaphragmatic;

- an apex;

- borders: - anterior – sternal;
- posterior – vertebral;

- inferior – diaphragmatic.

EXTERNAL CONFIGURATION
- the lungs are divided in lobes separated by deep grooves which go from
surface to the hilus; these grooves are called fissure; 

- the right lung has 2 fissures and the left lung has one fissure; 

- the left lung – it presents an oblique fissure which determines 2 lobes –
the upper and the
 lower lobe; 

- the right lung – it presents 2 fissures – one is oblique fissure and one
horizontal fissure 
 which determine 3 lobes - the upper lobe;
- the middle lobe; 

- the lower lobe; 


HILUS OF THE LUNG

- it represents the place on the lung where the
pedicle of the lung goes inside of the lung; 

- it is situated on the mediastinal
surface of the lung; 

- it contains: - bronchium;


71
 - a branch of pulmonary artery;

- 2 pulmonary veins;

- bronhic vessels (artery and vein);
- limphatics;

- nerves;
BRANCHES OF THE BRONCHIUM
- they are different in the right lung and in the left lung;

THE RIGHT PRINCIPAL BRONCHIUM

- the right lung has 3 lobes upper, middle and lower; 

-The upper lobar bronchium: is divided 1. Apical segmentery bronchium
2. Anterior segmentery bronchium
3. Posterior segmentery bronchium
-The middle lobar bronchium: is divided 1. Medial segmentery bronchium
2. Lateral segmentery bronchium
-The lower lobar bronchium: is divided 1. Apical basal segmentery bronchium
2. Anterior basal segmentery bronchium
3. Posterior basal segmentery bronchium
4. Medial basal segmentery bronchium
5. Lateral basal segmentery bronchium
THE LEFT PRINCIPAL BRONCHIUM
- the left lung is divided in 2 lobes – the upper lobe and the lower
lobe;
-The upper lobar bronchium: is divided 1. Apical segmentery bronchium
2. Anterior segmentery bronchium
3. Posterior segmentery bronchium
4. Medial lingual segmentery bronchium
5. Lateral lingual segmentery bronchium
-The lower lobar bronchium: is divided 1. Apical basal segmentery bronchium
2. Anterior basal segmentery bronchium
3. Posterior basal segmentery bronchium
4. Lateral basal segmentery bronchium
5. Medial basal segmentery bronchium

The segment of lung represent an anatomic-surgical unit which has a hilus

with: - a segmentary bronchium; 

- an artery; 


72
 - a vein; 

- lymphatics; 

- nerves. 


Functional vascularization 

- Pulmonary artery starts from the right ventricle of the heart and it is
divided in 2 arteries; 

- each of these artery goes to the corresponding lung and enters inside of
the hilus; 


- the right pulmonary artery is divided in this way: (1-1-2) 


- one branch for the upper lobe which is divided again in 5 smaller
braches;

- one branch for the middle lobe which is divided in 2 smaller branches;

- two branches for the lower lobe, one for the apical segment and the other
is divided 
 in 4 branches for the others segments;

- the left pulmonary artery is divided in 3: (1-1+1) 

- one branch for the upper lobe, which is divided in 5 segmentary arteries;
- one branch for apical segment of the lower lobe;

- one branch for the rest of the lower lobe which divides in 4 branches; 

Nutritional vascularization
- bronhic arteries are 2 in number- one left and one right; their origin is
from aorta and they go to the hilus of lung, enter inside of the lung and
then are divided in branches for pulmonary vessels and for ramifications of
bronchi; 

- bronhic veins are anterior and posterior and they go to the azygos vein
(for the right side) and hemiazygos vein (for the left side)

Vessels of the body

General aspect

73
Blood vessel, a vessel in the human or animal body in
which blood circulates. The vessels that carry blood away from
the heart are called arteries, and their very small branches are arterioles.
Very small branches that collect the blood from the various organs and
parts are called venules, and they unite to form veins, which return the
blood to the heart. Capillaries are minute thin-walled vessels that connect
the arterioles and venules; it is through
the capillaries that nutrients and wastes
are exchanged between the blood and
body tissues.

The cardiovascular system consists of the

heart, blood vessels, and the
approximately 5 liters of blood that the
blood vessels transport. Responsible for
transporting oxygen, nutrients, hormones, and cellular waste products
throughout the body, the cardiovascular system is powered by the body’s
hardest-working organ — the heart, which is only about the size of a
closed fist.
Neurons are information messengers. They use
electrical impulses and chemical signals to
transmit information between different areas
of the brain, and between the brain and the
rest of the nervous system. Everything we
think and feel and do would be impossible
without the work of neurons and their
support cells.
Neurons have three basic parts: a cell body and two extensions called
an axon and a dendrite. Within the cell body is a nucleus, which controls
the cell's activities and contains the cell's genetic material.
The axon looks like a long tail and transmits messages from the cell.
Dendrites look like the branches of a tree and receive messages for
the cell.

74
Arteries:
The arteries start from the Aorta, which comes straight from heart. The
aorta is divided to 3 parts: Acending aorta, Arch of aorta and Decending
aorta.
Acending aorta: it is the part which comes straight from the heart, it
gives a branch: coronary artery that gives blood to the heart it self.
Arch of aorta: it gives blood to the upper extremity and to the head.
Common carotid artery goes to the head and the subclavian artery to the
upper extremity.
Left side it gives 2 branches: left subclavian artery
left common carotid artery
Right side it gives 1 branch: brachiocephalic trunk which gives the
right subclavian artery
right common carotid
artery
Descending aorta: it gives blood to the lower
part of the body, it becomes the abdominal aorta
after it passes through diaphragm muscle.
Abdominal aorta becomes left and right common
iliac aorta, when it reaches to the pelvic region.
Abdominal aorta gives several branches:
-Hepatic artery, splenic artery, right & left reinal
artery and superior & inferior mesenteric artery
before becoming common iliac aorta.

Veins:
Vein are almoust two time more in number than arteries.
Veins start from capillaries, they end to the superior and inferior vena
cava.
-Superior vena cava: it gives blood to the head and upper extremitys.

75
Superior vena cava gives 2 branches: right and left brachiochephalic
venous trunk, each brachiochephalic venous trunk gives 3 branches:
external jugular vein, internal jugular vein to the head and subclavian
vein.
Inferior vena cava: passes through diaphragm, then gives hepatic
branches and reinal branches.
Inferior vena cava, becomes common iliac vein, in the pelvic
region.

Nerves:
-The nervous system is divided in (CNS) = central nervous system
and (PNS) = peripheral nervous system.
-(CNS) comes from brain to the body through spinal cord, it is the
command system to the body. (PNS) goes from body to the brain it is the
sensory system, the main function of the (PNS) is to
Connect the (CNS) to the limbs and organs.

Upper extremity:
(Arteries)
Subclavian artery: has 4 branches
1. Vertebral artery
2. Internal thoracic artery
3. Tireocervical trunk
4. Costocervical trunk
(muisti sääntö) V.I.T.C.
Vein is thight cord
Axillary artery: has 6 branches Brachial artery: has 5 branches
1. Superior thoracic artery 1. Profund brachial artery
2. Thoracoacromial artery 2. Nutrient artery
3. Lateral thoracic artery 3. Colateral radial artery
4. Subscapular trunk 4. Colateral ulnar artery
5. Anterior humeral circumflex 5. Terminal branches of radial artery
6. Posterior humeral circumflex 6. Terminal branches of ulnar artery
(muisti sääntö) S.T.L.S.A.P. (muistisääntö) P.N.C.C.T.T.

76
Radial artery: has 6 branches
1. Muscular branches
2. Radial recurrent artery
3. Carpal palmar artery
4. Radio-palmar artery
5. Dorsal carpal artery
6. Fist dorsal metacarpal artery
(muisti sääntö) M.R.C.R.D.F.
Ulnar artery: has 5 branches
Ulnar recurrent artery
Common interosseos artery
Carpal palmar artery
Dorsal carpal artery
Palmar artery
(muisti sääntö) U.C.C.D.P.
Usually cops cant do pasta

(Veins)
-Veins has same branches with arteries.
-Veins are divided in superfisial and deep veins.
Superficial vein:
1. Dorsal digitals vein
2. Dorsal metacarpals
3. Dorsal venous arch,
4. (A) Cephalic vein (B) Basilic vein.
5. (A)Axillary vein (B) Brachial vein.

Deep vein:
-Deep veins has two ways, that goes to the superior vena cava.
1. (A) Palmar metacarpals 1. (B) Palmar digital
2. (A) Deep palmar venous arch, 2. (B) Superficial palmar venous arch
3. (A) Radial vein 3. (B) Ulnar vein
4. Brachial vein.

77
 5. Axillary vein.

Branches / Cords / Divisions / Trunks / Roots

(Nerves)

-Nerves to the upper

extremity comes from spinal
cord root C5-T1.
-C5-C6 makes superior trunk. C7 makes middle trunk. C8-C9 makes
inferior trunk.
-Superior trunk makes posterior division. Middle trunk makes lateral
division.
Inferior trunk makes posterior division.
-Lateral cord gives musculocutaneous and medial branche.
-Posterior cord gives axillary and radial branche.
-Medial cord gives median and ulnar branche.

Lower extremity:
(arteries)
-Common iliac artery becomes external iliac artery & internal iliac artery.

78
-Internal iliac artery gives blood to the genital organs, external femoral
artery gives blood to the lower extremity.
-External femoral artery becomes femoral artery right after it passes
through inguinal ligament.
-Femoral artery divides into the deep femoral artery & superficial
femoral artery.
-Superficial femoral artery rotate medially to the posterior side of the
femur, and it becomes popliteal artery right after it passes through
adductor hiatus.
-Popliteal artery become posterior tibial artery & anterior tibial artery.

Femoral artery: has 5 branches Popliteal artery: has 7

branches
1) Superficial epigastric artery 1) Superior medial genicular artery
2) Superficial circumflex iliac artery 2) Superior lateral genicular artery
3) Deep circumflex iliac artery 3) Middle genicular artery
4) External pudendal arteries 4) Inferior medial genicular artery
5) Abdominal subcutaneus artery 5) Inferior lateral genicular artery
6) Medial sural artery
7) Lateral sural artery
Anterior tibial artery: has 4 branches
1) Anterior tibial recurrent artery
2) Posterior tibial recurrent artery
3) Anterior medial malleolar artery
4) Anterior lateral malleolar artery

Posterior tibial artery: has 3 branches

1) Medial planter artery
2) Lateral plantar artery
3) Fibular artery

(Veins)
-Lower veins are divided to superficial and deep veins.
Superficial: (S)

79
1. Digital veins
2. Deep plantar arch
3. Plantar veins
4. (S) Small saphenous vein.
5. (D) Femoral vein
6. (D) External iliac vein
7. (D) Common iliac vein
8. (D) Inferior vena cava
1. Dorsal metatarsal vein
2. Dorsal venous arch
3. Dorsalis pedic vein
4. (S) Great saphenous vein
5. (D) Femoral vein
6. (D) External iliac vein
7. (D) Common iliac vein
8. (D) Inferior vena cava

Deep veins:
1. Dorsal metatarsal veins 1. Dorsal metatarsal vein 1. Digital veins
2. Dorsal venous arch 2. Dorsal venous arch 2. Deep plantar arch
3. Fibular vein 3. Dorsalis pedis vein 3. Plantar vein
4. Popliteal vein 4. Anterior tibial vein 4. Posterior tibial vein
5. Femoral vein 5. Popliteal vein 5. Popliteal vein
6. Femoral vein 6. Femoral vein

(Nerves)
-Lower extremity nerves comes from Lumbar plexus (T12-L5) and sacral
plexus (L4-S4)
-It gives the following nerves from following spines:

Lumbar plexus:
1. Subcostal (T12)
2. Iliohypogastric & Ilioinguinal
(T12-L1)
3. Genitofemoral & Lateral
femoral cutaneous (L1-L3)
4. Femoral & Obturator (L2-L4)
5. Lumbo sacral trunk (L4-L5)

Plexus sacralis:
1. Lumbosacral trunk (L5)
2. Superior gluteal (L4-S1)

80
 3. Inferior gluteal (L4-S2)
4. Isciatic (L4-S3)
5. Common fibula (L4-S2)
6. Tibia (L4-S3)
7. Posterior femoral cutaneous (S1-S3)
8. Pudendal (S2-S4)

PERICARDUM
= it is a bag which covers the heart and its vessels;

- it has – an external membrane = fibrous pericardium;
- an internal membrane = serous pericardium which covers the heart.

SEROUS PERICARDUM
- it has 2 parts:

- one parietal – which covers the 
 internal surface of the fibrous
pericardium;
- one visceral = epicardum – first layer of the heart – it covers the heart;


- between them there is pericardic cavity which contains a small quantity
of fluid. 


THE HEART
- it is a muscular-cavitary organ; it has 4 cavities; 

- shape – conical, with the base posterior and the apex anterior; it is
orientated obliquely, forward, downward and 
 to the left; 


-it presents:
 - 3 surfaces:

- anterior = sterno-costal surface;
- inferior = diaphragmatic surface;
- lateral = mediastinal surface;
- 3 borders; 

- a base;
- an apex. 


81
- the right part of the heart is “venous heart” and it is situated anterior,
and the left part of the heart is “arterial heart” is situated posterior. 

- the base is formed by the posterior surfaces of the atriums and by the
veins

INTERNAL CONFIGURATION
- the heart presents 2 atriums and 2 ventricles; 

- we can talk about a “right heart” and a “left heart” because of the
interatrial septum and 
 interventricular septum; 


- cava veins ( upper and lower) and 4 pulmonary veins.

- the heart presents 2 atriums and 2 ventricles; 

- we can talk about a “right heart” and a “left heart” because of the
interatrial septum and 
 interventricular septum; 

- between the right atrium and the right ventricle there is an orifice = the
right atrio-ventricular orifice; 

- between the left atrium and the left ventricle there is an orifice = the
left atrio- ventricular orifice; 

- these orifices have atrio-ventricular valves. 

- valvular system
 – atrioventricular orifice: 

- the left has a bicuspid valve with 2 folds- one dorsal and one ventral ; 
 -
the right has a tricuspid valve with 3
 folds – anterior, posterior, and one
medial.

- interatrial septum – is thin and membranous and it forms the medial

walls of the atriums; it presents on the right wall an impresure called oval
fossa limited upward and in front by a prominence called the Vieussens
ring; - interventricular septum – is triangular with the apex orientated
downward; its base continues the interatrial septum; its right surface is
convex and it is a part of the right ventricle; its left surface is concave and
it is a part of the left ventricle; 

- in the right side it has relations with tricuspid orifice and pulmonary
orifice; - in the left side it has relations with mitral orifice and aortic
orifice. 


82
 ATRIUMS
- they are separated by interatrial
septum;

- the right atrium – has anterior pectinate
muscles;

- it presents orifices:
– above - from the upper cava vein;
- below - from the lower cava vein;
- from coronary sinus;

-in front-the right atrio-ventricular orifice
- the left atrium – presents –
in front – the left atrio-ventricular orifice = mitral orifice; - behind -
4 orifices from pulmonary veins;
- the left atrium – presents
- in front – the left atrio-ventricular orifice = mitral orifice;
- behind - 4 orifices from pulmonary veins;

VENTRICLES
- their walls are thicker; 

- the right ventricle - it has 3 papilary muscles; 

- its base present the right atrio-ventricular orifice;

- in front and above it presents the tricuspid orifice
(for pulmonary
 artery) . 

- the left ventricle – it presents:

- the left atrio - ventricular orifice = mitral orifice;

- aortic orifice (for aorta).

STRUCTURE OF THE HEART

- external layer – epicardium; 

- middle layer – myocardium; 

- internal layer – endocardium. 


83
 Epicardium = serous visceral pericardium;

Myocardium – is a muscular coat; its fibers are inserted on a fibrous
system situated at the base of the heart and which forms the “skeleton”
of the heart; it is formed by 4 fibrous rings.
Endocardium – it covers the cavities of the heart inside and it is
continued by the endothelium of the arteries. 


CARDIO-NECTOR SISTEM 

- it is a neuro-muscular system which generates intermittent the impulse
for contraction and ensures the transmission of this impulse to the
atriums and ventricles. 

- it is formed by : 

1. sino-atrial nod – Keith and Flack- situated at 
 the place of the
opening of the upper cava vein 
 into the right atrium; 

2. atrio-ventricular nod – Aschoff-Tawara – 
 situated inside of
interatrial wall; 

3. Hiss fascicle – it passes through the fibrous 
 skeleton situated
between the atriums and the ventricles and it is divided in : 

- a right branch for the right ventricle;

- a left branch for the left ventricle which is divided then in more
branches. 


84
VASCULARIZATION
- arteries – there are 2 coronary arteries – one left and one right from
aorta; 

- the left coronary artery passes through the anterior interventricular
groove and then to the apex of the heart; then is continued on the
posterior interventricular groove; 

- the right coronary artery is anastomosated with the left coronary
artery; 

- veins - there is a collector system = coronary sinus which is formed by
the great coronary vein (has 2 valves) and many smaller coronary veins;
other veins are Thebesius vein
Urinary system
The urinary system is composed of these following main organs
- The Kidneys as the main factor and filtration unit.
- The ureter as a pathway for the waste excretion from the kidneys to
the urinary blader (urine)
- The urinary bladder as the storage place for the urine, partially
voluntary.
- The urethra as the pathway from the urinary bladder to out side of
the body.

85
THE KIDNEY
There are two kidneys, each about the size of a fist, located on either side
of the spine at the lowest level of the rib cage. Each kidney contains up to
a million functioning units called nephrons. A nephron consists of a
filtering unit of tiny blood vessels called a glomerulus attached to a
tubule. When blood enters the glomerulus, it is filtered and the remaining
fluid then passes along the tubule. In the tubule, chemicals and water are
either added to or removed from this filtered fluid according to the
body's needs, the final product being the urine we excrete.

External configuration
- it is a paired retroperitoneal organ; the right kidney is situated a little
downward than the left kidney because of the liver. The kidney presents
bean shaped structure

86
- it has: - 2 surfaces – one ventral; - one dorsal;
- 2 borders – one lateral; - one medial;
- 2 poles – one superior; - one inferior;
- The dimensions of the kidney is – 12 cm in length / 6 cm in breadth / 3
cm in thickness
- The kidney weighs in between 120 gr – 140 gr
- it has a red color and is firm in consistence.

SITUATION AND RELATIONS

- the kidneys are situated retroperitoneal, in lumbar region;
- this region is delimitated by:
- above – a horizontal line which passes through T11;
- below – a horizontal line which passes through L3;
- laterally – a vertical line which passes through the apex of the 12th rib.

RELATIONS WITH THE SKELETON

- posterior surface has relations in the upper half with the 11th and 12th
ribs;
- the hilus has relations with L2.

87
THE ANTERIOR SURFACE OF THE KIDNEY

Right kidney
– in the upper third ( 1/3) – with the liver;
- in the lateral half of the second third – with the liver;

88
 - in the medial half of the second third – descending part of duodenum;
- in the lower third – the right colic flexure and intestinal Folds

Left kidney
– in the upper third – pancreas, spleen, posterior surface of
the stomach
- in the lower third – the left colic flexure and intestinal folds

THE POSTERIOR SURFACE OF THE KIDNEY

In thoracic part
- diaphragmatic pillars , diaphragm and costo-diaphragmatic sinuses
In abdominal part
- psoas muscle and quadratus lumbar ;

89
LATERAL BORDER
- the right kidney
-the liver (inferior surface); - ascending colon.
- the left kidney
-spleen - descending colon.

MEDIAL BORDER
- the right kidney
- descending part of duodenum, the lower vena cava;
- the left kidney
- duodeno- jejunal flexure;- abdominal aorta.
THE UPPER EXTREMITY – suprarenalian gland;
THE LOWER EXTREMITY - quadratus lumbar muscle.
STRUCTURE OF THE KIDNEY

- it is formed by renal parenchyma and in the center of it there is renal

sinous;
RENAL SINOUS = it is a cavity which contains the renal pedicle;
RENAL PEDICLE = it is formed by - urinary ducts (calices, renal pelvis,
vessels – renal artery and vein, nerves and from a mass of fat.

90
Renal parenchyma
- it is covered by a proper capsule which is dense;
- it is divided in 2 parts
- Medular part – situated profound
- it is formed by 7-14 renal Malpighi pyramids; they are orientated with
the base to the lateral border of the kidney and their apex presents renal
papilla; on each papilla there is a small calyx;
- Cortical part
– it is situated at periphery, like a band between the base of pyramids and
renal capsule it passes between pyramids and forms columns;
- medular part passes inside of the cortical part and forms Ferrein
pyramids; each of these pyramids has 50 – 100 urinary tubes.
!!! Ferrein pyramids form renal lobules - Malpighi pyramids form renal
lobes;
- the kidney is formed by lobes and one lobe is formed by one renal
Malpighi pyramid and all Ferrein pyramids from proximity
- the lobes are formed by lobules. One lobule is formed by one Ferrein
pyramid and the urinary tubes from proximity. Morphological and
functional unit of the kidney is THE NEPHRON = it is formed by renal
corpuscle and one urinary tube. There are 2 - 2,5 millions of nephrons in
our kidneys. !!!

RENAL CORPUSCLE

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- it has a capillary-epithelial structure;
- it is visible (with our eyes withoutmicroscope);
- it is formed by renal glomerul =capillary ball situated between 2
arteriolas and contained into an epithelial capsule with double walls =
Bowman capsule;
- the walls of this capsule are 2 layers parietal and visceral; visceral
membrane covers capillaries; between these layersthere is urinary space.

Each corpuscle presents 2 poles:

- vascular – it is a part of renal glomerul = the place for the enter of
afferent arteriola (which forms 30-50 capillary folds not anastomozated
between them and which form finally an efferent arteriola; this goes out
from glomerul through this vascular pole, too)
- urinary – it is a part of Bowman capsule because in this place, the
capsule is continued by the proximal urinary tube.

- Renal glomerul = it is a capillary ball situated between two arteriolas;

- the afferent arteriola which goes inside of the capsule and the efferent
arteriola which comes outside from the capsule the diameter of the
efferent arteriola is smaller than the diameter of afferent arteriola; in this
way it helps the glomerular filter; through both of kidney pass 1500 l of
blood/1 day from this quantity are filtered 180 l water, glucose, and
other.

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Artery divisions
Inside of the renal sinus, segmentary arteries are divided in interlobare
arteries; these arteries
run to the base of the renal pyramids (Malpighi pyramids) and form
arcuate arteries; these are
divided into interlobulare arteries, from which result afferent arteriolas;
afferent arteriola runs
inside of the renal corpuscle and form the renal glomerul; from the
glomerul runs outside the
efferent arteriola; efferent arteriolas are branched around of the renal
tubes;

Venous draining
- arch veins accompany the arteries and they are situated at the base of
the renal pyramids; they collect the venous blood from ascending and
descending veins;
- arch veins form suprapyramidal venous arch;
- finally they unit one to another and form renal vein which runs to the
lower cava vein
!!! in the left renal vein arrives to the left spermatic vein or the left
ovarian vein and the left suprarenalian vein

THE EXCRETORY DUCTS OF THE KIDNEY

- minor and major calices;
- renal pelvis
- ureter;
- urinary bladder;
- urethra;

MINOR CALICES
- they are musculo-membranous formations, 6-12 in number;
- they are situated inside of the renal sinus, around of the renal papillas;
- they unit and form the major calices;

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MAJOR CALICES
- they are 2-3 in number, and result from the unit of the minor calices;
- they form renal pelvis;

RENAL PELVIS
- it is a musculo-membranous organ;
- at its base are opened the major calices;
- the apex is continued by the ureter;
- it has - an intrarenal part;
- an extrarenal part;

URETER

- it is a musculo-membranous duct
- it units the renal pelvis with urinary bladder;
- it has 30-35 cm;
- it presents – abdominal part and a pelvic part;
- it is orientated – oblique, downward and medial.
- it presents 3 curves:
– near - the kidney;
- terminal line = the limit between abdominal cavity and the pelvis;

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Ureter has a small part inside of the wall of the urinary bladder; this part
is oblique and the
orifice of ureter has a fold of the mucous of bladder.
!!! ureter orifices and the orifice of urethra form Lietaud triangle.

STRUCTURE
- adventice = conjunctive tissue fibrous and elastic;
- muscular coat;
– in the upper third and in the lower third muscular fibers form 3 layers
– longitudinal at the exterior, circular at the middle and longitudinal at
the interior;
- in the middle third it presents only 2 layers.
- mucous membrane.

URINARY BLADDER

- it is a musculo-membranous bag in which ureters are opened. These

ureters bring the urine which is produced by the kidneys and it is
eliminated outside of the body through urethra between micturitions
(micturition = elimination of urine outside) urine is stored by the
urinary bladder

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- it is ovoid when is full;
- it is prismatic when is empty;
- it has 250-350 ml capacity;
- it presents – a base;
- an apex;
- a body – from which it starts laterally ombilical ligaments.

RELATIONS

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- in front - pubian bones;
- behind - recto-vesical septum – in males.
-behind - vesico-vaginal septum – in females.

- above – peritoneum – male and female

- below uro – genital diaphragm – male and female
- below - prostate – at male;
-below - vagina at female;

- laterally – muscles – internal obturator muscles and the levator anus

muscles.

Urinary bladder is fixed and sustained by:

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- above – peritoneum
- below – perineum;
- in front – pubo-vesical ligaments;
- behind – muscular fibers which connect the urinary bladder by the
rectum (male) and uterus (female).

When the urinary bladder is empty, it presents

– 3 surfaces anterior, posterior and superior. it also has 2 lateral borders
and an apex.

STRUCTURE
- serous layer = peritoneum;
- fibrous layer = conjunctive tissue;
- muscular layer – it has fibers – longitudinal at the exterior and circular
fibers in the middle
-interior layer presents longitudinal and transversal fibers. these muscular
fibers form vesical muscle;
- submucous layer – conjunctive tissue
- mucous – epithelium.

Male Urethra

The male urethra is divided into 4 parts and they are named due to their
positions. The male urethra is approximately 15-20cm long. In addition to

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urine, the male urethra provides an exit for semen (a fluid containing
spermatozoa and sex gland secretions)

Pre-prostatic part is only 3 cm long and it extends from the urinary

bladder to the orifice of the prostate.
prostatic part is the part that is seen going in side the prosatic and its
ending point is before it exits the prostate gland
membranous part is the area where the the urethra is going inside the
spongeous body of the penis
the spongy part of the urethra is the longest part it is 15 cm long and it
extend from the
base of the spongeous body of the penis to its external orifice

Female Urethra

In women, the urethra is relatively short (approximately 4cm). This

predisposes women to urinary tract infections.

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The urethra begins at the neck of the bladder, and passes inferiorly
through the perineal membrane and muscular pelvic floor. It opens
directly onto the perineum, in an area between the labia minora, known
as the vestibule. Within the vestibule, the urethral orifice is located
anteriorly to the vaginal opening and 2-3cm posteriorly to the clitoris.

The distal end of the urethra is marked by the presence of two mucous
glands that lie either side of the urethra. These glands are homologous to
the male prostate.

Muscular system
The muscular system consists of various types of muscle that each play a
crucial role in the function of the body. There is more than 600 muscles
present in the human body working together to allow as the daily body
functions we need. Muscles allow a person to move, speak, and chew.
They control heartbeat, breathing, and digestion. Other seemingly
unrelated functions, including temperature regulation and vision, also
rely on the muscular system. We also have muscles that provide a smooth
nd sophisticated movment for ex. the movement of the eyelids
All movment of the muscles are controled by the nervous system

The muscular system is divided in 3 types

Skeletal muscle
- is a type of striated muscle, is multinucleated, and are usually
attached to tendons that connect them to bone. Skeletal muscles
generally contract voluntarily (via somatic nerve stimulation),
although they can contract involuntarily through reflexes or through
autonomic nerve stimulation. The whole muscle is wrapped in a
special type of connective tissue called epimysium.

Smooth muscle

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 - Smooth muscle lines the inside of blood vessels and organs, such as
the stomach, and is also known as visceral muscle.
- It is the weakest type of muscle but has an essential role in moving
food along the digestive tract and maintaining blood circulation
through the blood vessels.
- Smooth muscle acts involuntarily and cannot be consciously
controlled.
Cardiac muscle
- Located only in the heart, cardiac muscle pumps blood around the
body. Cardiac muscle stimulates its own contractions that form our
heartbeat. Signals from the nervous system control the rate of
contraction. This type of muscle is strong and acts involuntarily.

Muscles of the shoulder gridle

The muscles of the shoulder are associated with movements of the upper
limb. They produce the characteristic shape of the shoulder, and can be
divided into two groups:

Extrinsic – originate from the torso, and attach to the bones of the
shoulder (clavicle, scapula or humerus).

Intrinsic – originate from the scapula and/or clavicle, and attach to the
humerus.

The intrinsic muscles

There are six muscles in this group – the deltoid, teres major, and the four
rotator cuff muscles (supraspinatus, infraspinatus, subscapularis and
teres minor).

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THE MUSCLES OF THE ARM

The muscles of the arm are divided into two groups:

The anterior group presents:
- biceps brachial muscles
- Coracobrahial muscle
- Brachial muscle

The posterior group presents : - triceps muscle

*These muscles of the arm posterior and anterior groups are separated
by intermuscular septum which originates from the brachial fascia.

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THE MUSCLES OF THE FOREARM
The muscles of the forearm are divided into regions anterior and
posterior. The anterior compartment is resposible mainly flexing the wrist
and the hand while the posterior division is resposible of extension of the
wrist and the hand
togheter the anterior and posterior group present 20 muscles total that
are situated in different layers some deep some superficial.
Anterior group = 8 muscles in 4 planes

– 1st plane - pronator teres

- flexor carpi radialis
- longus palmaris
- flexor carpi ulnaris
2nd plane - flexor digitorum superficialis

3rd plane -flexor digitorum profundus

- Longus flexor policis
4th plane – pronator quadratus

POSTERIOR SURFACE OF THE FOREARM

This surface present only two planes
Superficial Profundus ( deep)
- Extensor digitorum - Extensor policis brevis
- Extensor minimi digiti (little finger) - Extensor policis longus
- Extensor carpi ulnaris - Extensor of indicis
- Anconeus - Abductor of policis

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THE MUSCLES OF THE HAND
There are 19 muscles total in this region, grouped in 3 groups :
Lateral group , medial group and the 3rd group is the middle group

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 MUSCLES OF THE TRUNK - POSTERIOR WALL
This muscles are divided in 2 groups :
 Superficial group
 Profundus group
SUPERFICIAL GROUP
 it is formed by muscles which
 connect the vertebral column with the humerus (latissimus dorsi)
 connect the vertebral column with the scapula (trapezius).
PROFUNDUS GROUP is formed by muscles of vertebral column. In fact,
there are 5 planes.

I.THE FIRST PLANE

It is the most superficial plane.
It is formed by latissimus dorsi and trapezius.

1. TRAPEZIUS MUSCLE
 It is a flat and triangular muscle, with the base on the vertebral
column and the apex to the shoulder.
 It covers the upper half of the back.
 If the fixed point is on the scapula :
 it inclines the head on the same side, and rotates the head to the
opposite side
 inclines the vertebral column.
 it rises the trunk during climbing.
 If the fixed point is on the vertebral column, the muscle rises the
shoulder. The muscle keeps the shoulders at a normal level.

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2. LATISSIMUS DORSI
 It is a flat and triangular muscle which covers the lumbar region and
the lower half of the back.
Actions :
 If the fixed point is on the vertebral column, the muscle adducts the
shoulder and rotates the shoulder inward.
 If the fixed point is on the shoulder, the muscle rises the trunk
during climbing.

THE SECOND PLANE

LEVATOR OF SCAPULA
RHOMBOIDEUS
SERRATUS POSTERO-SUPERIOR
SERRATUS POSTERO-INFERIOR
SPLENIUS
1. LEVATOR OF SCAPULA
 It is a triangular muscle situated on the postero-lateral side of the
neck.
 The same action with the TRAPEZIUS :
 Rises the scapula and inclines the head in the same side

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 2. RHOMBOID Action :
 Rises the scapula
 Inclines the head

3. POSTERO-SUPERIOR SERRATUS
 It is covered by rhomboideus muscle and it covers the inter-costal
muscles.
4. POSTERO-INFERIOR SERRATUS
 The muscle takes the ribs downward : it is expirator muscle.

!!!! When the muscle is contracted bilateral in the same time, the
muscles become inspirator muscles.

5. SPLENIUS MUSCLE
 It is situated on the posterior side of the neck.
 In case of bilateral contraction, it extends the head.
 In case of single contraction, it inclines the head on the same side.

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THE THIRD PLANE
 It is represented by ERECTOR SPINAE MUSCLE.
 It is called the extensor of vertebral column.
The fibers are grouped in 3 columns :
 Iliocostal muscle
 Longissimus
 Spinal muscle

THE FOURTH PLANE

 It is formed by TRANSVERSOSPINAL MUSCLE.
 This muscle connects the spinous process of one vertebra with
transverse processes of the suprerior vertebra.
 This muscle is formed by
 semispinal muscle,
 multifidi muscles and
 rotators muscles.

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THE FIFTH PLANE
 it is formed by - inter-spinous muscles,
 inter-transverse muscles,
 rotators of the head and
 sacrococcigian muscles.

MUSCLES OF THE TRUNK II

ANTERO – LATERAL WALLS OF THE TRUNK
The muscles are grouped in 2 groups :
1 Thoraco-humeral group formed by muscles which unit the
thorax with the humerus
Ex. Pectoralis major
2 Thoracal own muscles Ex. Intercostalis muscles

THE FIRST GROUP

It is formed by :
 Pectoralis major
 Pectoralis minor
 Sub-clavicularis
 Serratus anterior

1. PECTORALIS MAJOR:
ORIGIN
 It is situated in the upper part of the anterior wall of the trunk
 If the fix point is on the thorax, the muscle adducts the arm and
rotates it inward (= pronation).

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  If the fix point is on the humerus, the muscle rises the thorax. It is an
auxiliary breathing muscle : inspiration.

2. PECTORALIS MINOR
 It is a thin and triangular muscle.
 It is covered by the pectoralis major.

- If the fix point is on the thorax, the muscle draws the scapula and
the shoulder downward
- If the fix point is on the scapula, the muscle rises the ribs.

3. SUB-CLAVIUS MUSCLE
 It is a thin muscle, situated between the clavicle and the first rib.
 It draws the clavicle and the shoulder
 It protects the brachial plexus and the vessels

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4. SERRATUS ANTERIOR
- It is situated between the first 10 ribs and the medial border of the
scapula
- If the fix point is on the thorax, the muscle draws the scapula
forward.
- If the fix point is on the scapula, the superior and middle groups
make inspiration, and the inferior group expiration.

THE SECOND GROUP

 It is formed by :
 Inter-costal muscles
 Levator of the ribs
 Sub-costal muscle
 Transversus thoracic muscle

INTER-COSTAL MUSCLE
 These muscles connect the ribs.
 They are smaller than the space, so they are continued by an
intercostal membrane.

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 1. External intercostals muscle
 It is situated the vertebral end of the space and the cartilage of the
rib.
 The fibers of external muscles are orientated obliquely and
downward

2. Internal intercostals muscle
 It is situated between the costal angle and the sternum.
 The fibers of internal muscles are orientated obliquely and upward.

- External : rises the ribs - inspirator muscle

- Internal : draws the ribs downward - expirator muscle

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 LEVATORS OF THE RIBS
 They are 12 on each side.
 Each muscle is situated behind the external inter-costales muscle.
they rise the ribs → inspirator muscles

SUB-COSTALS MUSCLES
 They are thin muscles, situated inside of the thorax between the
pleura pulmonaris and the internal inter-costal muscle.

TRANSVERSUS THORACIS
 It is situated behind the sterno-costal wall.

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ABDOMINAL MUSCLES
Abdominal muscles are grouped into 2 groups :
 Anterior group formed by :
 Rectus abdominalis
 Pyramidalis muscle
 Lateral group formed by:
 External abdominalis oblique
 Internal abdominalis oblique
 Transversus abdominalis

RECTUS ABDOMINALIS
 It is a long and flat muscle which extends along the abdomen.
 It is separated by the rectus from the opposite side by “LINEA
ALBA”.
If the fix point is on the thorax, the muscle flexes the pelvis on the
thorax.
 If the fix point is on the pelvis, the muscle flexes the thorax on the
pelvis.

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PYRAMIDALIS MUSCLE
 It is very small and triangular.
 It is situated at the lower part of the abdomen in front of the rectus
abdominalis muscle.

EXTERNAL ABDOMINALIS OBLIQUE MUSCLE

 It is the most superficial muscle in the lateral wall of the abdomen.

 It is a flat and thin muscle.
 The muscle flexes the thorax to the pelvis, but laterally
 it rotates the trunk to the opposite side.

4. INTERNAL ABDOMINALIS OBLIQUE MUSCLE

 It is thinner and smaller,
 It is situated at the lateral wall of the abdomen under the external
abdominalis oblique.
 This muscle is antagonist of external abdominalis oblique muscle.
 In unilateral contraction, it rotates the trunk but on the same side.
 In bilateral contraction, it flexes the thorax on the pelvis or the
pelvis on the thorax.

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 TRANSVERSUS ABDOMINALIS
 It is a flat muscle situated under the internal abdominalis oblique.
 It presents fibers which are orientated horizontally.

Conclusion
All abdominal muscles present an action about the vertebral column,
because the muscles keep the vertebral column in rectitude and make the
flexion and rotation of vertebral column.
All abdominal muscles action like abdominal pressure.
These muscles fix the internal organs and participate to the physiological
acts.

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 MUSCLES OF THE PELVIS

Psoas major
Psoas minor
Iliacus
Quadratus lumbar
Gluteal muscles
Piriform muscle
Obturator muscles
Gemellus muscles
Quadratus femoris
The tensor of Lata fascia

PSOAS MAJOR + ILIACUS = ILIO-PSOAS MUSCLE

PSOAS MAJOR
 It is a long fusiform muscle
 It is placed on the side of the lumbar region of the vertebral column
 it connects the vertebral column with the pelvis
ILIAC MUSCLE
 It is a triangular muscle
PSOAS MINOR
 It is rudimentary muscle and inconstant (it is often absent).
 It protects femoral nerve

Quadratus lumbar
 It has a quadrilateral shape
 It is situated on the lateral surface of the lumbar vertebral column,
between the last rib and iliac crest
GLUTEAL MUSCLES
 They are 3 in number - the major gluteus
 The minor gluteus
 The middle gluteus
 They have their origin on the gluteal surface of the coxal bone,
between the gluteal lines and their insertion is on the greater
trochanter

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5. PIRIFORM MUSCLE
 The piriform is flat, pyramidal, with the base inside of the pelvis on
the anterior surface of the sacrum and the apex at the greater
trochanter
6. OBTURATOR MUSCLES
 They are 2 in number – internal and external
 The obturator internal - is situated between the internal surface of
the obturator
 the Obturator external – is situated between external surface of the
obturator membrane and the greater trochanter

7. GEMELLUS MUSCLES
 They are 2 in number – superior and inferior
 The gemellus superior is smaller than the inferior
 They rotate the femur
8. QUADRATUS FEMORIS MUSCLE
 It is short, flat, quadrilateral
 It is situated between the the ischiatic tuberosity and
intertrochanteric crest
 It rotates the femur
9. THE TENSOR OF THE LATA FASCIA
 It is quadrilateral
 It is situated at the junction of the lateral surface of the pelvis with
the anterior surface of the thigh
 Action – it flexes the thigh

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 MUSCLES OF THE THIGH

These muscles are grouped in 3 groups :

Anterior group :
SARTORIUS MUSCLE
QUADRICEPS FEMORIS MUSCLE
TENSOR OF FASCIA LATA

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Medial group :
ADDUCTOR MUSCLES

Posterior group :
BICEPS FEMORIS
SEMI-TENDINOUS MUSCLE
SEMI-MEMBRANOUS MUSCLE

MUSCLES OF THE CALF

The muscles of the calf are divided

in 3 groups:
Anterior group presents 4 muscles
TIBIALIS ANTERIOR
LONGUS EXTENSOR OF HALLUCIS
LONGUS EXTENSOR OF DIGITORUM
PERONEUS III

Lateral group presents 2 muscles

LONGUS PERONEUS
BREVIS PERONEUS

Posterior group presents 5 muscles in 2 different layers

Superficial :
TRICEPS SURAL
PLANTARIS

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Profound:
LONGUS FLEXOR OF HALLUCIS
LONGUS FLEXOR OF DIGITORUM
TIBIAL POSTERIOR
POPLITEUS

PLANTAR MUSCLES

-Muscles situated in the plantar aspect of the foot that allow the
movement of the toes and the foot

1st or medial group : 2nd or lateral group :

FLEXOR BREVIS OF HALLUCIS FLEXOR BREVIS OF LITTLE TOE
ABDUCTOR OF HALLUCIS ABDUCTOR OF LITTLE TOE
ADDUCTOR OF HALLUCIS

3rd or middle group :

FLEXOR BREVIS OF DIGITORUM
LOMBRICALES
INTER-OSSEI MUSCLES

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DORSAL MUSCLES
-Muscles situated in the dorsal aspect of the foot that allow the
movement of the toes and the foot

BREVIS EXTENSOR OF DIGITIES

- BREVIS EXTENSOR OF HALUCIS

!!They have origin on the calcaneus and insertion on the digities

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Immune system
General information:
-The immune system is the body's system for protecting itself from
viruses and bacteria or any foreign substances.
-Immune system is divided into 2 categorized: External immune system &
Internal immune system.
-Internal immune system is like your army that protects you from
anything straing substance and harmful.
-As long as our body's system of defense is running smoothly, we do not
notice the immune system.
-The immune system, which is made up of special cells, proteins, tissues,
and organs, defends people against germs and microorganisms every day.
In most cases, the immune system does a great job of keeping people
healthy and preventing infections. But sometimes problems with the
immune system can lead to illness and infection.

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-The immune system is made up of a network of cells,
tissues, and organs that work together to protect the body.
One of the important cells involved are white blood cells,
also called leukocytes, which come in two basic types that
combine to seek out and destroy disease-causing
organisms or substances.
-Immune system try to kill the enemy everytime but if it
can´t be killed, then they through the enemy to the prison
= lymph node.
Sturucture
The immune system is composed of several things

LEUCOCYTES ( white blood cells )

Which are divided in, Classification, Leucopoiesis, Neutrophils,
Eosinophils, Basophils, Monocytes, Lymphocytes, T cells and B cells

The formation of leucocytes take place in the bone marrow from a stem
cell, similar to that for erythrocytes, and is called leucopoiesis.

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Neutrophi
- Metamyelocyte
- Non–segmented neutrophil
- Segmented neutrophil

Eosinophils
-Eosinophils are involved in allergies and increase in number during
parasitic (worm infections).


Basophils
-Basophils produce heparin that prevents the blood clotting and are
involved in the inflammation and allergies (bronchial asthma) due to the
substances (histamin) that contract smooth muscles of the airways.

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Monocytes
-Monocytes interact with lymphocytes to recognize and destroy foreign
bodies, when stimulated monocytes are transformed in macrophages
-Monocytes produce several substances with important
roles in the immune response of the body (interleukins, interferons,
growth factors, toxic radicals), prepare and present the antigens to the
lymphocytes simultaneously with the major histocompatibility complex
(MHC).

Lymphocytes
-Lymphocytes play a crucial role in the immune response.
There are 2 types of lymphocytes.
-T lymphocytes or T cells - B lymphocytes or B cells
-T cells are so called because they mature in the thymus and are
instructed to recognize different antigens presented by the antigen
presenting cells.

-There are 3 lines of defense against pathogens (bacteria, fungi, viruses)

-The first line of defense is represented by the surface coverage. The
skin acts as a physical barrier and defeat most pathogens, since they are
not able to penetrate and enter easily .
-The second line of defense is represented by a non-specific, immediate
response involving phagocytes and some proteins.
-The third line of defense is represented by the specific response of the
immune system represented by lymphocytes.
The jobs of the immune system:
1. Communication 8. Produce antibodies
2. Cause inflammation 9. Mark/disable enemies
3. Strategic decisions 10. Fight worms
4. Kill enemy 11. Kill infected cells
5. Activate other cells
6. Remember enemies
7. Standby mode

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Genital system
INTERNAL MALE GENITAL ORGANS

- they are represented by

- testis;
- epididymis;
- deferens duct;
- ejaculatory duct;
- prostate;
- seminal vesicles;
- urethra.

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TESTIS

- it is a paired organ;
- it produces spermatozoa and androgen hormones
- it develops in lumbar region and it descends into the scrotum through
the inguinal canal during the 7th month of pregnancy;
- dimensions – 4-5 cm / 2,5 cm;
- white color;
- their consistence is like the consistence of the ocular globe (firm but in
the same time elastic)
- it has ovoid shape and it is orientated oblique, downward and
backward.

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EPIDIDYMIS

- it is a tubular organ situated on the posterior part of the testis;

- it presents
- a head;
- a body;
- a tail.
- the head is voluminous, it is united with the testis by conjunctive
tissue

VAS DEFERENS DUCT

- it is a cylindrical tube but at its end it becomes irregular with some

folded parts
- it starts at the tail of the epididymis and it is finished at the point of the
uniting of the seminal vesicles with the ejaculatory duct;
- it is 60 cm and 3-4 mm diameter;

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 - it has 3 parts - epididymo-testis part – from the tail of the epididymis it
goes upward on the posterior surface of the testis, along of the medial
surface of the epididymis
- the second part start at the upper part of the epididymis and it goes to
the external orifice of the inguinal canal like a part of the spermatic cord
- ilio-pelvin part – inside ot the inguinal canal, from the superficial
orifice of the inguinal canal to the profound orifice of the inguinal canal.
- spermatic cord
– it is a pedicle which sustains the testis and the epididymis;
- it contains – deferent duct, arteries ,internal spermatic artery,
deferential artery, cremasteric artery, venous plexus one anterior and
one posterior they form spermatic vein ,nervous fibers, lymphatics,
Cloquet ligament and conjunctive tissue.

EJACULATORY DUCT
- ejaculatory duct is a paired organ which results from the unit of
deferens duct with the duct of seminal vesicle;
- it passes inside of prostatic parenchyma and is opened inside of
urethra
- structure is the same with deferens duct, but adventice is missed in the
prostatic part;
- its diameter is smaller than the diameter of deferens duct and this
permit the expulsation of the spermatic fluid with power and high
speed.

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PROSTATE
- it is situated under the urinary bladder, being an unpaired glandular
organ;
- dimensions – 2-3 cm / 4 cm;
- it presents
– a base it is in relation with urinary bladder
- an apex – inferior;
- surfaces:
– anterior in relation with pubic simphys;
- posterior in relation with rectum.
- it has 2 lobes
- laterally from prostatic urethra, on each side are opened ejaculatory
ducts and 30 – 50 orifices from prostatic glands (proper glands) they
have a secretion which ensure the mobility of the spermatozoa.
- prostate is covered by a proper capsule from this capsule gives the
prostate a septum which delimitate lobules.

SEMINAL VESICLES

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- they are 2 in number
- they produce a secretion which participates to the formation of
seminal fluid and in the same time they are bags in which is accumulated
the secretion of the spermatic ducts
- they have a conical shape, oblique orientated;
- they are situated above of the prostate, between the rectum and
urinary bladder.

EXTERNAL MALE GENITAL ORGANS

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SCROTUM
- it is a prominent unpaired bag, median situated between the legs of
male
- shape is variable, determined by the age
- it is divided in 2 cavities; between them there is a median suture =
scrotal rapheus.

THE PENIS

- it is a pendulous organ suspended in front and beside of the pubic

bones. It contains the biggest part from urethra;
- it is a copulator organ but in the same time it is the organ for
micturition;
- it has 2 parts
– perineal part and one free part;
- it is 10-11 cm and diameter 8-9 cm, but in the erection time these
dimensions increase;
THE ROOT
- it is formed by the roots of cavernosum bodies and penian bulb.

THE BODY
- is cylindrical;
- it has - a superior surface and an inferior surface;
- the anterior extremity is called gland = a conic prominence;
- the gland has:

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 - a base – oblique, with a glandular crown, limited posterior by a
groove retroglandular sulcus
- an apex – it presents the urinary meatus
- posterior surface is concave.
- prepuce = a part from skin which covers the gland
- it is determined by the erectile organs and the formations which cover
them
- cavernous bodies – 2 in number;
- spongious body – 1.
Cavernous bodies
- they are situated on the posterior surface of the penis
- 15-16 cm and in erection time 20 – 21 cm;
- cylindrical shape and united on the median line inside of the penis,
but they are separated behind these posterior parts are called branches
of cavernosum bodies

INTERNAL FEMALE GENITAL ORGANS

- they are grouped in three groups
– vaginal region, uterine region and the tubo-ovary region.

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VAGINAL REGION
- it contains vagina = a cylindrical musculo-membranous conduct, which
is very extensible and elastic
- its functions are – copulation (sexual act) it keeps the spermatozoa
near the uterine col (col = the entry into the uterus)
- through vagina, the baby and fetal annexes passes in birth
- dimensions – 8-9 cm;
- cylindrical shape in the first third and flat in rest;
- it has oblique direction, downward and forward.

UTERIN REGION

- this region is limited in front by urinary bladder;

- behind by rectum
- laterally by uterine tube and ovaries
- below by vagina.
- uterus looks like a pear with voluminous part orientated upward and
the apex orientated downward.
- it presents – a body
- anterior surface is flat
- posterior surface is convex its upper part form the uterine fundus
with 2 horns

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 - colus – it is the lower extremity of the uterus;
- it is invaginated (it slides inside of the vagina) at the upper end of the
vagina it has - a supravaginal part and an invaginated part
- istmus – it appears only in pregnancy and it is a groove on the
anterior
surface of the uterus
- ostium – is is the external orifice of colus it looks like a transversal
depression with 2 lips united laterally;
- dimensions – 7cm / 5 cm and 3 cm diameter;

THE SUSPENSION APARATUS OF THE UTERUS

- peritoneum;
- the large ligaments;
- teres ligaments;
- utero-sacrat ligaments;

COCLUSION – vagina and perineum fixes the uterus;

- teres ligaments stop the upset of the uterus;
- utero-sacrat ligaments stop the inclining of the uterus forward
- large ligaments and sacro-recto-genito- pubian ligaments stop the
inclining of the uterus laterally.

UTERIN TUBES
( FALLOPIAN TUBES )
- they are musculo-membranous organs situated in the upper part of
the large ligaments;
they start at the uterine horns and each of them is orientated to the
lateral side, until to the middle part of ovary, where it forms an arch
and with concavity orientated medially (covering the ovary)
- dimensions – 10-12 cm.
- mucous membrane – with numerous secretor cells the mucous
determines the migration of the fertilized ovum to the uterine cavity
the secretor cells produce some mucus which covers the ovum and it is
nutrition for the spermatozoa and ovum.

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OVARY
- it is a paired female genital organ with double secretor function
internal (it is endocrine gland because it produces hormones) and
external (it is exocrine gland because it produces ovules);
- it is homologous with the testes in the male;
- it has ovoid shape, 3 cm/2cm/1 cm;
- it weighs 6-8 gr
- its aspect is variable, and consistence – elastic, but after menstruation
it becomes fibrous
- its surface is smooth in childhood, but it becomes irregular in time
- it develops in lumbar region and it descents in pelvis at the last part of
the intrauterine life
- it is not covered by peritoneum, so it doesnt have a visceral layer

EXTERNAL FEMALE GENITAL ORGANS

- they are represented by labiums the major and the minor

- interlabial space;
- clitoris;
- erectile apparatus

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 MAJOR LABIUMS
- they are ovoid cutaneos folds, 2 in number. They contain fat,
conjunctive tissue, smooth muscles, vessels and nerves, and the
terminations of the teres ligaments;
- they present an external surface and a cutaneus surface, brownish
color
MINOR LABIUMS
- they are cutaneous folds with aspect of mucous membrane
- 3-4 cm;
- they present – an external surface – in relation with the major labium
from the same side and an internal surface in relation with the minor
labium from the other side;
- an anterior extremity – near the clitoris
- a posterior extremity – it is united with the opposite and forms
navicular

ERECTIL APPARATUS - it is represented by the clitoris and vestibular

bulbs.

CLITORIS – it is homologous of the penis

- it is cylindrical;
- it presents: 2 thinner roots and a body with 2 cavernous bodies
- an extremity = the gland which is 5-6 mm long
- it has presents a profound part (hiden) and a free part covered by the
prepuce

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 Endocrine System

Endocrinology concerns the "internal secretions of the body“. The original

concept was that a chemical substance called a hormone, is liberated by
one kind of a cell, is carried by the bloodstream to act on a distant target
cell. It suggested a basic mechanism for maintaining the stability of the
internal milieu in the face of irregular nutrient, mineral, and water fluxes,
as well as physical alterations in the environment. Secretion of the
hormone was evoked by a specific change in that milie as a result of the
hormone's action on its target cells, the change was counteracted and
chemical or physical homeostasis was restored.
This basic homeostatic notion has grown increasingly complex,
and the overall mission of the endocrine system is now understood also
to include regulation of growth, maturation, body mass, reproduction,
senescence, and behaviour. The multiple activities of the cells, tissues,
and organs of the body are coordinated by the interplay of several types
of communication systems, including:

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Neural, in which chemicals (neurotransmitters) are released at synaptic
junctions and act locally to control cell function

Endocrine, in which glands or specialized cells release into the circulating

blood chemicals (hormones) that influence the function of cells at
another location in the body

Neurocrine, in which neurons secrete substances (neurohormones) that

reach the circulating blood and influence the function of cells at another
location in the body

Paracrine, in which cells secrete substances that diffuse into the

extracellular fluid and affect neighboring cells

Autocrine in which a cell secretes substances that affect the function of

the same cell by binding to the cell surface receptors.

Steroid hormones

Steroid hormones are usually synthesized from cholesterol and are not
stored. The chemical structure of steroid hormones is similar to
cholesterol, and in most instances they are synthesized from cholesterol
itself. They are lipid soluble and consist of three cyclohexyl rings and one
cyclopentyl ring combined into a single structure.
Usually there is very little hormone storage in steroid-producing
endocrine cells, but large stores of cholesterol esters in cytoplasm
vacuoles can be rapidly mobilized for steroid synthesis after a stimulus.
Much of the cholesterol in steroid-producing cells comes from the
plasma, but there is also de novo synthesis of cholesterol in these cells.
Because the steroids are highly lipid soluble, once they are synthesized,
they simply diffuse across the cell membrane and enter the interstitial
fluid and then the blood.

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Transport of hormones in the blood
Water-soluble hormones (peptides and catecholamines) are dissolved in
the plasma and transported from their sites of synthesis to target tissues,
where they diffuse out of the capillaries, into the interstitial fluid, and
ultimately to target cells.
Steroid and thyroid hormones, in contrast, circulate in the blood mainly
bound to plasma proteins. Usually less than 10% of steroid or thyroid
hormones in the plasma exist free in solution. For example, more than
99% of the thyroxine in the blood is bound to plasma proteins. Protein-
bound hormones cannot easily diffuse across the capillaries and gain
access to their target cells and are therefore biologically inactive until
they dissociate from plasma proteins.

Mechanisms and the action of hormones

The first step of a hormone's action is to bind to specific receptors at the
target cell. Cells that lack receptors for the hormones do not respond.
Receptors for some hormones are located on the target cell membrane,
whereas other hormone receptors are located in the cytoplasm or the
nucleus. When the hormone combines with its receptor, this usually
initiates a cascade of reactions in the cell, with each stage becoming more
powerfully activated so that even small concentrations of the hormone
can have a large effect.
Hormonal receptors are large proteins, and each cell that is to be
stimulated usually has some 2000 to 100,000 receptors. Also, each
receptor is usually highly specific for a single hormone; this determines
the type of hormone that will act on a particular tissue. The target tissues
that are affected by a hormone are those that contain its specific
receptors. The number of receptors in a target cell usually does not
remain constant from day to day, or even from minute to minute. The
receptor proteins themselves are often inactivated or destroyed during
the course of their function, and at other times either they are
reactivated or new ones are manufactured by the protein-manufacturing
mechanism of the cell. For instance, binding of a hormone with its target
cell receptors often causes the number of active receptors to decrease,
either because of inactivation of some of the receptor molecules or

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because of decreased production of the receptors. In either event, this
down-regulation of the receptors decreases the responsiveness of the
target tissue to the hormone. Some hormones can cause up-regulation of
receptors; that is, the stimulating hormone induces the formation of
more receptor molecules than normal.- When this occurs, the target
tissue becomes progressively more sensitive to the stimulating effects of
the hormone.

Exocrine System

Exocrine glands are modified type of epithelial tissue specialized in

production of secretions via ducts . The following glands are exocrine
glands ; Salivary glands, Mammary glands, Sweat glands, Lacrimal glands
, Sebeceous glands

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Salivary glands
They are composed of parotid gland, submandibular and sublingual gland.
Saliva production, the main function of the salivary glands, is crucial in
the processes of digestion, lubrication, and protection in the body. Saliva
is actively produced in high volumes relative to the mass of the salivary
glands, and it is almost completely controlled extrinsically by both the
parasympathetic and sympathetic divisions of the autonomic nervous
system.
Saliva plays a crucial role in the digestion of carbohydrates and fats
through two main enzymes. Ptyalin enzyme functions at an optimal pH of
7, Saliva also serves to dissolve and transport food particles away from
taste buds to increase taste sensitivity. The mucus constituent of saliva
facilitates the lubrication of food particles during the act of chewing,
which serves to mix the food with saliva. Lubrication eases the processes
of swallowing and of the bolus traveling down the esophagus.

Mammary gland
Various stressful stimuli that inhibit milk ejection are associated with
increased activity of the sympathetic nervous system. Oxytocin action can
be blocked by the hormones catecholamines, which are made by the
adrenal glands localized above the kidneys. The main catecholamines are
dopamine, norepinephrine and epinephrine (which used to be called
adrenalin). These hormones are released in response to stressful
situations and increase the tone of the smooth muscles of the mammary
ducts and blood vessels. This results in the reduction of oxytocin reaching
the myoepithelial cells and partial occlusion of the mammary ducts

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Lacrimal gland
The lacrimal gland is situated in the superior lateral corner of the orbit
Four different types of lacrimation can be identified in humans:
(a) continuous tearing, produced constantly for protection and
maintenance of a healthy corneal epithelium and a perfectly smooth and
transparent corneal refractive surface;
(b) reflex tearing, stimulated by exposure of the free nerve endings in the
eye, nose, and face to light, cold, wind, foreign bodies, or irritating gases
and liquids
(c) induced tearing, which often develops as an allergically or chemically
mediated response to local irritants
(d) psychogenic tearing or tears of emotion. Young infants cry without
shedding tears during the first days of life, and infants born prematurely
may not shed tears for weeks. This delayed capacity for psychogenic
weeping suggests that the connections within the CNS that indirectly
innervate the lacrimal system are not fully developed in most newborns

Sebaceous gland
Sebaceous glands are found in the skin of all mammals except whales and
porpoises. One of their apparent functions is to excrete sebum, a mixture
of relatively neutral lipids most of which are synthesized.
sebaceous glands are responsible for the three-dimensional organization
of the skin surface lipids, which supports the integrity of the skin barrier
Sebum, the product of active sebaceous glands, transports fat-soluble
antioxidants from and to the skin surface and exhibits a natural
photoprotective activity.

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Eucariotic cell
Eukaryotic cells are cells that contain a nucleus and organelles, and are
enclosed by a plasma membrane. Organisms that have eukaryotic cells
include protozoa, fungi, plants and animals. These organisms are grouped
into the biological domain Eukaryota. Eukaryotic cells are larger and more
complex than prokaryotic cells, which are found in Archaea and Bacteria,
the other two domains of life.

The Nucleus
Typically, the nucleus is the most prominent organelle in a cell. Eukaryotic
cells have a true nucleus, which means the cell’s DNA is surrounded by a
membrane. Therefore, the nucleus houses the cell’s DNA and directs the
synthesis of proteins and ribosomes, the cellular organelles responsible
for protein synthesis. The nuclear envelope is a double-membrane
structure that constitutes the outermost portion of the nucleus. Both the
inner and outer membranes of the nuclear envelope are phospholipid
bilayers. The nuclear envelope is punctuated with pores that control the
passage of ions, molecules, and RNA between the nucleoplasm and
cytoplasm. The nucleoplasm is the semi-solid fluid inside the nucleus
where we find the chromatin and the nucleolus.

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Cytoplasm
The cell’s plasma membrane also helps contain the cell’s cytoplasm,
which provides a gel-like environment for the cell’s organelles. The
cytoplasm is the location for most cellular processes, including
metabolism, protein folding, and internal transportation.

The Plasma Membrane

Despite differences in structure and function, all living cells in
multicellular organisms have a surrounding plasma membrane (also
known as the cell membrane). As the outer layer of your skin separates
your body from its environment, the plasma membrane separates the
inner contents of a cell from its exterior environment. The plasma
membrane can be described as a phospholipid bilayer with embedded
proteins that controls the passage of organic molecules, ions, water, and
oxygen into and out of the cell. Wastes (such as carbon dioxide and
ammonia) also leave the cell by passing through the membrane.

Mitochondria
Mitochondria are organelles that are responsible for making
adenosine triphosphate (ATP), the cell’s main energy-carrying molecule.
One of the major features distinguishing prokaryotes from eukaryotes is
the presence of mitochondria. Mitochondria are double-membraned
organelles that contain their own ribosomes and DNA. Each membrane is
a phospholipid bilayer embedded with proteins. Eukaryotic cells may
contain anywhere from one to several thousand mitochondria, depending
on the cell’s level of energy consumption. Each mitochondrion measures
1 to 10 micrometers (or greater) in length and exists in the cell as an
organelle that can be ovoid to worm-shaped to intricately branched.

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Lysosomes
Animal cells have another set of organelles not found in plant cells:
lysosomes. The lysosomes are the cell’s “garbage disposal.” In plant cells,
the digestive processes take place in vacuoles. Enzymes within the
lysosomes aid the breakdown of proteins, polysaccharides, lipids, nucleic
acids, and even worn-out organelles. These enzymes are active at a much
lower pH than that of the cytoplasm. Therefore, the pH within lysosomes
is more acidic than the pH of the cytoplasm. Many reactions that take
place in the cytoplasm could not occur at a low pH, so the advantage of
compartmentalizing the eukaryotic cell into organelles is apparent.

The Cell Wall

The cell wall is a rigid covering that protects the cell, provides structural
support, and gives shape to the cell. Fungal and protistan cells also have
cell walls. While the chief component of prokaryotic cell walls is
peptidoglycan, the major organic molecule in the plant cell wall is
cellulose, a polysaccharide comprised of glucose units. When you bite
into a raw vegetable, like celery, it crunches. That’s because you are
tearing the rigid cell walls of the celery cells with your teeth.

The Endoplasmic Reticulum

Endoplasmic reticulum has two types, rough endoplasmic reticulum (RER)
and smooth endoplasmic reticulum (SER).
The endoplasmic reticulum (ER) is a series of interconnected
membranous sacs and tubules that collectively modifies proteins and
synthesizes lipids. However, these two functions are performed in
separate areas of the ER: the rough ER and the smooth ER. The hollow
portion of the ER tubules is called the lumen or cisternal space. The
membrane of the ER, which is a phospholipid bilayer embedded with
proteins, is continuous with the nuclear envelope.

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Ribosome
Ribosomes are the sites at which information carried in the genetic
code is converted into protein molecules. Ribosomal molecules
of messenger RNA(mRNA) determine the order of transfer RNA (tRNA)
molecules that are bound to nucleotide triplets (codons). The order of
tRNA molecules ultimately determines the amino acid sequence of a
protein. Molecules of rRNA catalyze the peptidyl transferase reaction,
which forms peptide bonds between the amino acids, linking them
together to form proteins. The newly formed proteins detach themselves
from the ribosome site and migrate to other parts of the cell for use.

Centrioles
Centrioles are barrel-shaped structures present in eukaryotic cells except
for fungal and plant cells. A pair of centrioles is contained within a
structure called centrosome, present near the nucleus. These structures
play and important role in the attachment and orientation of
microtubules. Microtubules are thin, hollow cylinders that play a major
role in cell division, intracellular transport, motility, and are also
important to maintain the structural integrity of a cell.

Golgi apparatus
The Golgi apparatus is an organelle in eukaryotic organisms that moves
molecules from the endoplasmic reticulum to their destination, and also
modifies products of the endoplasmic reticulum to their final form. The
Golgi apparatus is comprised of a series of flattened sacs that extend
from the endoplasmic reticulum outward, into the cytoplasm. This gives
the Golgi apparatus the ability to deliver vesicles, or packets of various
cell products, to different locations throughout the cell.

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Eukaryotes vs Prokaryotes
The distinction between prokaryotes and eukaryotes is considered to be
the most important distinction among groups of organisms. Eukaryotic
cells contain membrane-bound organelles, such as the nucleus, while
prokaryotic cells do not. Differences in cellular structure of prokaryotes
and eukaryotes include the presence of mitochondria and chloroplasts,
the cell wall, and the structure of chromosomal DNA.

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Leukocyte
A type of blood cell that is made in the bone marrow and found in the
blood and lymph tissue. Leukocytes are part of the body’s immune
system. They help the body fight infection and other diseases. Types of
leukocytes are granulocytes (neutrophils, eosinophils, and basophils),
monocytes, and lymphocytes (T cells and B cells). Checking the number of
leukocytes in the blood is usually part of a complete blood cell (CBC) test.
It may be used to look for conditions such as infection, inflammation,
allergies, and leukemia. Also called WBC and white blood cell.

Erythrocytes
Erythrocyte: A cell that contains hemoglobin and can carry oxygen to the
body. Also called a red blood cell (RBC). The reddish color is due to the
hemoglobin. Erythrocytes are biconcave in shape, which increases the
cell's surface area and facilitates the diffusion of oxygen and carbon
dioxide. This shape is maintained by a cytoskeleton composed of several
proteins. Erythrocytes are very flexible and change shape when flowing
through capillaries.

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Vision
The human eye, the organ
responsible for the sense
of sight, is a very complez
structure. We use our
vision in every activity, so
the eye is a most
important organ.

Physiology of the eye

1. Light enters the eye through the cornea, the clear front surface of
the eye, which acts like a camera lens.
2. The iris works much like the diaphragm of a camera--controlling
how much light reaches the back of the eye. It does this by
automatically adjusting the size of the pupil which, in this scenario,
functions like a camera's aperture.
3. The eye’s crystalline lens sits just behind the pupil and acts like
autofocus camera lens, focusing on close and approaching objects.
4. Focused by the cornea and the crystalline lens, the light makes its
way to the retina. This is the light-sensitive lining in the back of the
eye. Think of the retina as the electronic image sensor of a digital
camera. Its job is to convert images into electronic signals and send
them to the optic nerve.
5. The optic nerve then transmits these signals to the visual cortex of
the brain which creates our sense of sight.

Hearing
The auditory system is comprised of three components; the outer,
middle, and inner ear, all of which work together to transfer sounds from
the environment to the brain.

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THE OUTER EAR
The outer ear includes the portion of
the ear that we see—the
pinna/auricle and the ear canal.
Pinna The pinna or auricle is a
concave cartilaginous structure,
which collects and directs sound
waves traveling in air into the ear
canal or external auditory meatus.
Ear Canal, The inner two-thirds of the
ear canal is imbedded in the
temporal bone. The outer one-third
of the canal is cartilage

MIDDLE EAR
The middle ear is composed of the tympanic membrane and the cavity,
which houses the ossicular chain.

Tympanic Membrane
The tympanic membrane or eardrum serves as a divider between the
outer ear and the middle ear structures. It is gray-pink in color when
healthy and consists of three very thin layers of living tissue.

Middle Ear Cavity

The middle ear cavity is located in the mastoid process of the temporal
bone. The middle ear cavity extends from the tympanic membrane to the
inner ear

THE INNER EAR

The inner ear is composed of the sensory organ for hearing—the cochlea,
as well as for balance—the vestibular system

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Vestibular or Balance System
The balance part of the ear is referred to as the vestibular apparatus. It is
composed, in part, of three semicircular canals located within the inner
ear. The vestibular system helps to maintain balance, regardless of head
position or gravity, in conjunction with eye movement and
somatosensory input. The semicircular canals are innervated by the
VIIIth cranial nerve.

THE PHYSIOLOGY OF HEARING

The process of hearing begins with the occurrence of a sound. Sound is
initiated when an event moves and causes a motion or vibration in air.
When this air movement stimulates the ear, a sound is heard

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Taste
Taste is the special sense associated
with the tongue. The surface of the
tongue, along with the rest of the oral
cavity, is lined by a stratified squamous
epithelium. Raised bumps called
papillae(singular = papilla) contain the
structures for taste transduction. There
are four types of papillae, based on
their appearance: vallate, foliate,
filiform, and fungiform.

Smell
Like taste, the sense of smell, or olfaction, is also responsive to chemical
stimuli. The olfactory receptor neurons are located in a small region
within the superior nasal cavity. This region is referred to as the olfactory
epithelium and contains bipolar sensory neurons. Each olfactory sensory
neuron has dendrites that extend from the apical surface of the
epithelium into the mucus lining the cavity.

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