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Anatomy Final Exam Notes.docx

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York University
Kinesiology & Health Science
KINE 2031
Neil Smith

9Nervous system Function: sensory input (sensory receptors throughout the body which detect external and internal change), Integration (processes sensory input and decides if response required), Motor output (if response required, the nervous system sends motor messages to respond to stimulus) Organization: Central Nervous System (Brain + Spinal cord), neurons in CNS: Sensory, Motor, Interneuron (Connectors) integration component, decision making center * Peripheral Nervous System (cranial nerves + spinal nerves+ Ganglia), divided into two types of neurons: Sensory (Afferent) and Motor (Efferent) relaying signals * Sensory: receives information from receptors and transmits the information to Central nervous system, divided into: Somatic Sensory (of the body, e.g. touch, pain, pressure) and Visceral sensory (internal organs, e.g. blood vessels, digestive organs, respiratory organs) Side note: visceral sensory system does not reach conscious until the visceral sensory signals are strong enough (eating heavily stretches stomach and causes pain and reached conscious) Motor: transmits motor impulses from Central nervous system to muscles or glands (Effectors), divided into: Somatic Motor (of the body, Voluntary e.g. conscious contraction of striated or skeletal muscles) and Visceral or Autonomic Motor (organs, Involuntary, unconscious contraction of smooth muscle, cardiac muscle or glands) Visceral or Autonomic divided into: Sympathetic (fight or flight) and Parasympathetic (controls mostly at rest) * remember these are still involuntary, all internal things that determine how you act when you see a tiger Functional Unit: Neuron Structure of Neuron: Cell body (contain things you see in a cell), Dendrites (extension of cytoplasm that is responsible for directing information TOWARDS the cell body), Axon (extension of cytoplasm responsible for directing information AWAY from cell body) *myelin insulate axon and allow signal to travel faster because signal can skip, some axons don’t have myelin because signals do not need to be very fast* Non-Nervous Cells: Neuroglia Cells in the CNS Astrocytes: act as blood-to-brain barrier (positioned between capillary and neuron), act to regulate what substances come in contact with the neuron, act like glue in CNS, giving structural support Oligodendrocytes: cells responsible for production of Myelin around axon in CNS , Myelin is fat coating around axon that helps insulate axon (white in colour), myelinated axon are said to be “white matter” of the CNS Microglial cells: destroy viruses and bacteria which have entered the CNS (Act much like the Lymphatic system and what it does for the body) Ependymal Cells: cells that line ventricles of the brain, these cells along with capillary networks (Choroid Plexi) are responsible for the formation of Cerebrospinal Fluid Non-Nervous Cells: Peripheral nervous system Schwann (Neurolemmocytes) Cells: responsible for formation of myelin around axons in peripheral nervous system Satellite Cells: responsible for surrounding and separating cell bodies in ganglia, important in the regulation of exchange of nutrients and wastes between the neuron and their surrounding environment The Brain Forebrain Components: Cerebrum, Thalamus, Hypothalamus, Basal Ganglia Cerebrum: Frontal, Parietal, Temporal, Occipital Lobes Cortex (Gray matter (non myelinated), convoluted or folded) of cerebrum divided into Gyri (hills) and Sulci (valleys), sulci divide the cortex into lobes Longitudinal sulcus (fissures): deep sulcus, divided brain into right and left hemispheres Central sulcus: divides frontal from parietal, Anterior to the sulcus we have pre-central gyrus(motor control part) and posterior to the sulcus we have post-central gyrus (sensory component of brain) Lateral sulcus: divides temporal lobe from everything else Parietal-Occipital sulcus: divides occipital lobes from everything anterior to it Open the brain: you see Thalamus (pass sensory signals to the Cerebrum- relay center) and Hypothalamus (controls Autonomic nervous system, the motor visceral system (of glands which produce hormones and organs) Basal Ganglia: exist laterally to the thalamus (only 1 thalamus), they relay motor signal away from the cerebrum *What we have in gray matter is cell bodies (since they are not mylineated), and white matter is myleinated axons Commissural Tracts: myelinated axon that joins the right to left hemisphere, information can be connected on either side (Stay inside brain) Projection tracts: bring information up to the cerebrum and away from cerebrum (leave brain and come back to brain) Association Tracts: connecting gyri within same hemisphere, divided into Arcuate fibres: connect gyri within the same lobe, longitudinal fibres: connect gyri to different lobes in same hemisphere The Brainstem: Midbrain + Hindbrain, Thalamus (forebrain) Midbrain Responsible for things like eye movement, cranial nerves innervate muscles of eyes, and visual and auditory reflex centers (e.g. When you hear a loud sound you turn left or right) Cerebral peduncle: connecting our midbrain up to the forebrain and cerebrum Superior cerebellar peduncle: brings motor signals from cerebellum to the midbrain so they can be sent out to wherever they have to go Hindbrain Pons: regulate breathing; give rise to cranial nerves 5-8, you have middle cerebellar peduncle: motor signal from cerebrum Medulla Oblongata: gets inferior cerebellar peduncle: motor signal from cerebrum, rise to cranial nerves 8-12, and regulates Heart Rate, blood pressure, and breathing Cerebellum: right at back below cerebrum, has a convoluted cortex layer, divided into left and right hemisphere (Vermis divides the two hemisphere), The white matter form a tree (Arbor Vitae). Coordinates all motor movement in body Meninges Three layers that protect outside of brain (Dura mater, Arachnoid, Pia Mater) Dura Mater (thickest layer, physical protection, in the brain 2 layers or dura mater and spinal cord only 1, the 2 layers will split and join on the interior of the brain forming a blue area called Venous sinus (cleaning deoxygenated blood out of brain) Dura mater also create Dural folds Dural Folds Falx cerebri: splits the two cerebral hemispheres (Right and left) Falx Cerebelli: splits the two hemispheres between cerebellum (below the Tentorium cerebelli) Tontorium cerebelli: on both sides, tent over cerebellum, inferior to cerebrum and superior to cerebellum Diaphragma sellae: a “roof” of dura over the Sella Turcica of the Sphenoid bone form (roof of pituitary gland) we need pituitary to connect to brain above it Infundibulum: runs through diaphragma sellae, connecting pituary gland to brain which is above it Venous Sinuses All the little veins drain into them, within Dural fold there are venous sinuses They are within the fold of Dura, you see them within the Dural folds Superior Sagittal Sinus: within falx cerebri collecting deoxygenated blood Inferior Sagittal sinus: within falx cerebri collecting deoxygenated blood Straight sinus: inferior sagittal sinus blood is collected by this sinus Occipital sinus: within falx cerebelli Confluence of sinus: where superior, inferior, straight, occipital meet From confluence of sinus: you can go right or left Transverse sinus, which turns into Sigmoid Sinus (sigmoid mean “S” shaped), we turn and start to turn inferiorly towards heart, becomes the Internal Jugular vein Blood that is more on the inside of the brain if we are in sella turcica for example, the blood drains into different sinuses: First is the Cavernous sinus which drains into the Superior and Inferior Petrosal sinuses and those connect to Sigmoid sinus, from Sigmoid to Internal Jugular vein Arachnoid Mater Closely associated with Dura mater, they are not attached (potential space), deep to that we have subarachnoid space (spider webby things called Trabeculae: they connect the arachnoid layer to pia mater layer (They hold the layers together), Arachnoid Granulations or villi: projection of arachnoid mater and subarachnoid space into venous sinuses (they let waste products and old CSF enter the venous system) Pia Mater Delicate inner meningeal layer which follows all the contours of the cerebral cortex Ventricles of the Brain Spaces or cavities in the brain (open compartment) Lateral ventricles: number 1 and 2 CSF made here 3 ventricle: surrounded by the thalamus, CSF made here rd Lateral connected to 3 ventricle via Interventricular Foramina From the 3 ventricle, it continues in the midbrain region through Cerebral Aqueduct to the 4 th ventricle The 4 ventricle is the end where CSF is made, so now we distribute the fluid th Once we leave 4 ventricle, we enter Central Canal of the spinal cord, the central canal continues down and the CSF goes into the subarachnoid space where it flows through the brain and when it gets old enters venous sinuses Cerebrospinal fluid Formation: it is made for protecting the brain, it’s a watery layer that’s important when the brain is moving when you fall back and hit your head , buoyancy (brain is heavy), CSF used as a marker of health of nervous system ( with sample of CSF you can tell if anything is wrong) How is it made? : the ventricles are filled with stuff called Choroid Plexus : which makes the CSF, in the Choroid plexus, you have blood capillary surrounded by Pia mater and outside has Ependymal cells ( CSF is a combo of Plasma + extra fluid released by Ependymal cells that contains nutrients ) Spinal cord Cervical, thoracic, lumbar, sacral regions Cervical Enlargement and Lumbo-sacral enlargement : because huge chunk of nerves come off to supply our upper and lower limbs, they are enlarged) Anterior and Posterior median fissures: two depressions th Central canal from the brain is the continuation of the spinal cord from the 4 ventricle of the brain (CSF is what flows through it) Conus Medullaris: the ending of spinal cord at L2 After that, we have bunch of spinal nerves that come off and is called Caudia Equana (horse tail) Extension of pia mater, anchoring spinal cord to the coccyx is called Filum Terminale Internal Structure of the spinal cord Most of the outer compartment is made up of white matter and gray matter is in the middle. We have sensory in the posterior part and motor in the front In the Gray matter: Posterior Horn (at back): axons of sensory neurons (somatic and visceral sensory), cell bodies that go with them are on the ganglion, Anterior Horn (at front): cell bodies of motor neurons (somatic motor cell bodies) Lateral Horn: seen only from T1 to L2 (only levels of spinal cord where we get sympathetic neuron signals cell bodies) and S2 to S4 (parasympathetic cell bodies of neurons) going to be visceral motor cell bodies of autonomic nervous system Gray Commissural: connects left and right Interneurons: join the posterior horn to anterior horn Spinal Nerves 31 pairs of spinal nerves in total Structures: Spinal nerve: where everything is combined Our sensory signal comes in and come to Dorsal Root Ganglion (group of sensory cell bodies) , then we move up into Dorsal root which divide to give us Dorsal Rootlets ( not in notes*) and into the Posterior Horn (where sensory axon are located), we have sensory axon connection with interneurons and Gray commissure and from there Lateral Horn (visceral motor cell bodies) or Anterior horn (we have somatic motor cell bodies) (efferent signal) and the axons go out to Ventral rootlets and they combine to form Ventral Root then continues to the Spinal nerve then splits into Posterior and Anterior Ramus ( both of these are like spinal nerves and contain sensory and motor, posterior goes to posterior of body and anterior goes to anterior of body) Spinal Nerve Plexi 4 nervi plexi (Cervical, Brachial, Lumbar, Sacral) Cervical Plexus: using anterior rami of C1-C4, supplies muscles of neck, tongue, larynx, etc... The Phrenic nerve coming of spinal cord and its anterior rami roots is C3-C5 and supplied the Diaphragm Brachial Plexus: supplies entire upper limb plus some thoracic region, anterior rami of C5-T1, clearly see the criss-crossing layers (Roots TrunksDivisionsCordsBranches Randy Travis drinks cold beer) , in branches there is a “M” shape which are three nerves: 1) Musculocutaneous Nerve (not in notes, runs anteriorly, supplies anterior arm muscles and then skin of the forearm) 2) Median nerve (middle of M, runs down anteriorly of our arm and supplies wrist flexors and finger flexors 3) Ulnar nerve (medial part of M, behind elbow between medial epicondyle and olecranon process , intrinsic muscles of the hand) 4) Radial Nerve(goes posterior arm, supply wrist and finger extensor muscles, deep to axillary nerve ) Lumbar Plexus: from L1 to L4, contributes to lower extremities Femoral nerve: runs down anterior or leg and supplying quadriceps muscles Obturator nerve: runs fairly medial and supplied adductors Sacral Plexus: supply back of our leg, L4 –S4 (L4 contributes to both plexi) Sciatic nerve: huge nerve, supplies entire back of leg, if we follow the nerve down and it is going to divide into Tibial nerve and Common Peroneal or Common Fibular nerve ( the split happens above the knee) Visceral (Autonomic) motor Nervous System Divided into sympathetic and parasympathetic Typical somatic signal: we have anterior horn cell body, sends it axon on out to effector organ In autonomic system Autonomic ganglion: set of ganglia just for autonomic system (have sympathetic or parasympathetic signals only), we have 2 neuron: Preganglionic neuron and post ganglionic neuron Somatic Nervous system: you have signal from sensory receptor in skin that travels up the spinal nerve into the dorsal ganglion, goes to dorsal horn, synapses with interneurons and goes through anterior horn and out to spinal nerve (two way traffic) and into the effector muscle Autonomic Nervous system: everything same, it goes to Lateral horn and spinal nerve, instead of following spinal nerve to posterior and anterior rami, we go off the White Ramus which leads to the autonomic ganglion Parasympathetic and Sympathatheic division of the ANS: the parasympathic come of S2 to S4 and coupe of cranial nerve (they come off the brain) cranial nerve 3,7,9, 10 , the Vagus nerve (nerve 10) is the most wide spread of the four From sympathetic: we get from T1 to L2 (don’t get sympathetic signal outside those areas) , if you want to send the signal to higher and lower areas we have ways to do so Sympathetic trunk or chain: outside of the vertebral bones and runs next to them on either side, they are gangli all in a row attached by nervous tissues, so signals can travel up and down the chain, at the very bottom they attach forming the Ganglia Impar Parasympathatic and sympathetic given to most internal organs (E.g. Heart) things like superficial blood vessels and sweat glands get sympathetic only Types of sympathetic pathways: Spinal nerves Basic way a sympathic signal runs: comes out of spinal cord along spinal nerve and goes off white ramus going to synapse with the post ganglionic neuron in our ganglia and gray ramus takes back to spinal nerve and will go to posterior or anterior ramus Let say we need a sympathic signal where we don’t have signal coming out of spinal cord, so the signal comes out the same way get off at white ramus, now instead of synapsing with the level we exited we will go up or down to the level we want and then we will synapse then gray ramus, spinal nerve, and out White ramus is only from T1 to L2, if no sympathetic signal coming off the level of spinal cord, we don’t need them Thoracic organs: in thoracic region, we only have spinal nerves that wrap around the ribs, they do not igo into the organs, so in this region, the signal exits the same way as usual, goes off white ramus, synapse with postganglion neuron and just exits (Does not go back to spinal nerve) straight to the effector (it has no neurons, kind of acts like postsynaptic signal) ( NO GRAY RAMUS , NO SPINAL NERVE) Abdominal organs: sympathetic signal comes of spinal nerve, gets off white ramus, no synapse in Sympathetic chain **, 2 types of ganglia: paravertebral (right next to vertebral column and make up the sympathetic chain) and Prevertebral (further away from vertebral column and closer to organs and sometimes in the organs) , our signal exits and goes to Prevertebral ganglia and synapses with post ganglionic neuron (which is a lot short) and goes to the effector Circulatory System Function: transport (of oxygen, carbon dioxide, nutrient, hormones, drugs), waste removal (takes them out to tissues, drop them to tissues, pick up waste products and bring them back), temperature maintenance ( when cold, blood vessel near skin constrict and when hot they open to let heat out) fluid balance ( homeostatic amount of fluid in interstitial fluid, plasma) Location of the heart: Found in Mediastinum (space between two lungs), around top of sternum to diaphragm (diaphragm domes up, when it contracts it flattens down , which gives more space in mediastinum ) , the heart is surrounded by a double layer membrane called Pericardium Sac The Pericardium is a double membrane, the First layer (the most outer layer) is termed the Parietal Pericardium, and the one that is closer to the heart is termed Visceral Pericardium (closest to the organ itself) The Parietal Pericardium is further broken into Fibrous Parietal pericardium (thicker solid, physically protective) and Serous parietal pericardium (secretes fluid) Visceral Pericardium (Epicardium) also is serous, between two serous layers (the serous parietal pericardium and visceral serous pericardium, we have a space called the Pericardial Cavity (allows the heart to have space, and for contraction) When we move in deeper: we get Myocardium (cardiac muscle in the walls of the chamber, when contracts send blood out) in the last layer we have Endocardium (Thin epithelial cell layers that surround all cavities of the heart and all veins and arteries coming into and out of heart) Heart Structure (Flow of blood) 1) Inferior and superior vena cava bring in the deoxygenated blood into the right atrium 2) Through the tricuspid valve or (right atrioventricular valve) going into the right ventricle 3) Blood still deoxygenated, so through left and right pulmonary arteries to the lung 4) Come back to pulmonary viens and drain to the left atrium and goes into left ventricle 5) From left ventricle going into the Aorta to rest of the body Detailed 1) Deoxygenated blood from tissues and all to right atrium through superior and inferior vena cava In right atrium (you have Interatrial septum : the wall between atrium, fossa ovalis or ovale:(fetus): whole in the atria that is there from the fetus because you use to go to moms lungs 2) Right Antrioventricular or tricuspid valve (how we get blood into right ventricle) 3) Chordae tendinae: collagen fibres, the attach the cusps of the wall to the Papillary muscles, these muscles attach to cardiac muscle in the wall *Papillary muscles do not open or close the walls, three cusp in tricuspid valve, the pressure of the blood in right atrium pushes the valve open (Atrium is empty), as we fill blood in ventricle, the blood in the ventricle pushes on valve and pushes it until it close , we cannot let the pressure be too strong because the valve will push back up ( SO The papillary muscles and chordae tendinae help make it stay close ) 4) From right ventricle the blood goes through pulmonary artery ( pulmonary semilunar valve (2 of them): three cusp, they are shaped like bowl, the blood pushes the door open for the valve, the bowls get filled and stops the blood from flowing back (don’t require papillary muscles or chordae tendinae) 5) Go to lungs get oxygen bring heart * Arteries always bring blood away from heart* 6) Pulmonary veins bring oxygenated blood back from the lungs and are dumped into the left atrium 7) From the left atrium, we go to the left ventricle via Left AV valve (bicuspid) : only valve that has 2 cusp 8) Left ventricle (Big strong muscular chamber of heart) has to push the blood to the entire body through the Aorta ( last valve: Aortic semilunar valve (same as pulmonary semilunar valve) Heart itself needs blood, so it has its own arteries and veins to supply themselves with blood (Left and Right coronary arteries: small , the little volume of blood in the cusp will go in them) So all the blood that goes out the aorta and the backflow blood into the cusps it will go into the coronary arteries (so the heart gets the blood after the body) Auricle is the flap that comes of the atrium that helps protect the coronary arteries We need a venous system: big blue vein called Coronary sinus: drains deoxygenated blood from heart muscle and other cells of heart and goes into the right atrium Surface of the heart On anterior surface we have groove that (Anterior interventricular sulcus) separated ventricles Bottom point: called Apex of heart (point bit made up of mostly left ventricle) Base of heart: with all the vessels in it, superior and posterior Coronary sulcus: groove between atria and ventricle on the posterior surface of the heart, coronary sinus the vein runs through it Posterior interventricular sulcus: artery and vein running through it dividing the ventricles at back Excitability of the heart Sinoatrial (SA) node: pacemaker, modified cardiac muscle, found in right atrium near were the SVC comes in, going to an electrical signal to the heart, it will send a signal so that both atria contract which sends blood down to ventricles, it will happen 70ish times a minute, it is controlled by sympathic and parasympathetic signals from the Vagus nerve) , we have another node called the Atrioventricular node (AV) node, it only the floor of the atrium, it will take the signal and send it down the Interventricular Bundle (bundle of His) , it splits to give a right and left bundle branch then signal picked up by Purkinjie fibres and delivered to myocardium which will allow ventricles to contract ( the order of this is really important) Blood vessels Structure: Tunica intima: inner most layer, simple squamous epithelial cells + areolar connective tissue In a capillary: we have epithelial layer and basement membrane because stuff has to cross the wall Tunica Media: smooth muscle (thick layer in arteries and think layer on veins), controls the width of the vessel, a sympathetic signal will go to muscle of GI tract and it will contract (Vasoconstriction happens in arteries only, reduces blood flow to the area) , when smooth muscle relaxes we have Vasodilation (the removal of the sympathetic signal) Tunica Externa: made up on areolar connective tissue (thick on vein, think of arteries), protective layer, it anchors the vessel to other structures around it Arteries: as we move away from the heart we go from large Elastic artery (like aorta) , we branch and each vessel has less volume and pressure, so they are called Muscular artery, they branch and branch and then we get Arteriole then they branch into capillaries (where gas exchanges takes place) From there we do same thing but backwards, we go to make Venule which branch to make Medium- sized Vein which branch to make Large vein Blood in venous system: biggest challenge of venous system is to get blood back into heart (going again gravity), we have one way valves (similar to semi lunar valve, and function similarly), and second way is called Muscles massage (big way we push blood back to heart, during exercise) Arteries: Upper Torso and Limbs From the Aorta we have arteries coming out Right and Left coronary Arteries: In arch of the aorta: we have 3 branches, the first branch we have Brachiocephalic artery which branches into Right subclavian and Right common carotid, the second branch off the Aorta gives us the Left common Carotid and the last branch gives Left Subclavian The common carotid artery splits to give us Internal carotid artery ( headed to internal of skull) and External carotid artery (stays external to the skull) , we follow the external carotid artery now goes up near the ears and divides and give us Maxillary arteries (goes to maxilla) and the Superficial temporal artery ( heads superior towards the temporal region) Branches of the subclavian artery: Right and Left subclavian artery pass under the clavicle and over the st 1 rib and gives a lot of branches, the very first branch is the Vertebral artery (1 on each side), the vertebral arteries will travel through the Transverse foramen of the cervical vertebra will go inside the skull and contribute to blood supply in the brain Ones the subclavian artery passes the clavicle it will change name, and will be called Axillary artery (now we are in the axilla, underarm , armpit area) , and it gives a lot of branches and we need to know the lateral thoracic artery (heading to front of thorax), and Subscapular artery (going to back near scapula), if we follow the axillary artery down, we hit the Brachial artery ( brachial= arm, when passing teres major it then is called brachial artery, it immediately gives branches and the branch is called Deep brachial artery (posterior of arm) , continuing from the brachial artery it will split to give us the Radial and Ulnar artery , Radial artery is superficial ( so we can feel the pulse there), the Ulnar artery runs underneath the Flexor Carpi ulnaris (hard to feel pulse), once we get across the wrist, both arteries split to give Deep branch and Superficial branch, they all come together to make Deep palmar ar
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